diff --git "a/data/train.conll" "b/data/train.conll" --- "a/data/train.conll" +++ "b/data/train.conll" @@ -1,32756 +1,28920 @@ -En B-PRESENT_ILLNESS -Mayo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1997, I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -intervenida, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -otro I-PRESENT_ILLNESS -centro, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS un I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -glándula I-PRESENT_ILLNESS -suprarrenal I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -clínicamente I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -funcionante I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -manifestó I-PRESENT_ILLNESS -clínicamente I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -molestias I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -flanco I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -poco I-PRESENT_ILLNESS -específicas, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +trasplantado B-PAST_MEDICAL_HISTORY +hepático, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +inmunosupresor I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +esteroides I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tacrolimus, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS el I-PRESENT_ILLNESS -postparto I-PRESENT_ILLNESS -inmediato; I-PRESENT_ILLNESS -la B-EXPLORATION -ecografía I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computerizada I-EXPLORATION -abdominales I-EXPLORATION -mostraron I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -suprarrenal I-EXPLORATION -izquierda I-EXPLORATION +trasplante I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +intervenido I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +neoplasia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +colon I-PRESENT_ILLNESS +obstructiva I-PRESENT_ILLNESS +realizándose B-TREATMENT +resección. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION +informó I-EXPLORATION de I-EXPLORATION -10 I-EXPLORATION -cmts., I-EXPLORATION -sólida I-EXPLORATION -y I-EXPLORATION +adenocarcinoma I-EXPLORATION +bien I-EXPLORATION +diferenciado I-EXPLORATION con I-EXPLORATION -áreas I-EXPLORATION +infiltración I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +perirrectal, I-EXPLORATION +sin I-EXPLORATION +afectación I-EXPLORATION de I-EXPLORATION -calcificación I-EXPLORATION -y I-EXPLORATION -necrosis I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior, I-EXPLORATION -siendo I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION +márgenes I-EXPLORATION +quirúrgicos I-EXPLORATION +o I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -gammagrafía I-EXPLORATION -ósea I-EXPLORATION -normales. I-EXPLORATION -En I-EXPLORATION los I-EXPLORATION -análisis, I-EXPLORATION -presentaba I-EXPLORATION -ligero I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cortisoluria I-EXPLORATION -(284.5 I-EXPLORATION -mcgr./24h.) I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -17-OH-esteroides I-EXPLORATION -en I-EXPLORATION -orina I-EXPLORATION -(12.7 I-EXPLORATION -mcg./24h.), I-EXPLORATION -sin I-EXPLORATION -síntomas I-EXPLORATION -de I-EXPLORATION -hipercortisolismo I-EXPLORATION -sistémico. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -resección I-TREATMENT -completa I-TREATMENT -de I-TREATMENT +ganglios I-EXPLORATION +linfáticos. I-EXPLORATION +Tras B-TREATMENT la I-TREATMENT -tumoración, I-TREATMENT -con I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -histológico I-TREATMENT -de I-TREATMENT -carcinoma I-TREATMENT -suprarrenal I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -x I-TREATMENT -7 I-TREATMENT -x I-TREATMENT -5 I-TREATMENT -cmts. I-TREATMENT -(215 I-TREATMENT -grs.) I-TREATMENT -bien I-TREATMENT -encapsulado, I-TREATMENT -aunque I-TREATMENT -con I-TREATMENT -invasión I-TREATMENT -vascular, I-TREATMENT -amplias I-TREATMENT -zonas I-TREATMENT -de I-TREATMENT -necrosis I-TREATMENT -y I-TREATMENT -un I-TREATMENT -índice I-TREATMENT -mitótico I-TREATMENT -de I-TREATMENT -5.8/50; I-TREATMENT -el I-TREATMENT -estudio I-TREATMENT -histoquímico I-TREATMENT -fue I-TREATMENT -(+) I-TREATMENT -para I-TREATMENT -Vimentina I-TREATMENT -y I-TREATMENT -(-) I-TREATMENT -para I-TREATMENT -Citoqueratina, I-TREATMENT -EMA, I-TREATMENT -Cromogranina I-TREATMENT -y I-TREATMENT -Sm- I-TREATMENT -100. I-TREATMENT -Se I-TREATMENT -etiquetó I-TREATMENT -como I-TREATMENT -Estadio I-TREATMENT -II I-TREATMENT -y I-TREATMENT -Grado I-TREATMENT -II. I-TREATMENT -Treinta B-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -estudios I-EVOLUTION -radiológicos I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -una I-EVOLUTION -masa I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -lecho I-EVOLUTION -de I-EVOLUTION -resección I-EVOLUTION -previo I-EVOLUTION -de I-EVOLUTION -7 I-EVOLUTION -cmts., I-EVOLUTION -en I-EVOLUTION -contacto I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -hilio I-EVOLUTION -renal I-EVOLUTION -izquierdo I-EVOLUTION -y I-EVOLUTION -técnicamente I-EVOLUTION -resecable; I-EVOLUTION -se B-TREATMENT -reintervino I-TREATMENT -y I-TREATMENT +cirugía I-TREATMENT se I-TREATMENT -llevó I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -una I-TREATMENT -resección I-TREATMENT -de I-TREATMENT +modificó I-TREATMENT la I-TREATMENT -recidiva I-TREATMENT -asociada I-TREATMENT -a I-TREATMENT -nefrectomía I-TREATMENT -izquierda, I-TREATMENT -esplenectomía I-TREATMENT -y I-TREATMENT -pancreatectomía I-TREATMENT -distal I-TREATMENT -(radical I-TREATMENT -completa I-TREATMENT -y I-TREATMENT -con I-TREATMENT -márgenes I-TREATMENT -libres). I-TREATMENT -Posteriormente, I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -quimioterápico I-TREATMENT -sistémico I-TREATMENT -adyuvante I-TREATMENT -con I-TREATMENT -6 I-TREATMENT -ciclos I-TREATMENT -completos I-TREATMENT -de I-TREATMENT -cisplatino I-TREATMENT -(CDDP) I-TREATMENT -y I-TREATMENT -etopósido I-TREATMENT -(VP-16) I-TREATMENT -en I-TREATMENT -régimen I-TREATMENT -adyuvante. I-TREATMENT +inmunosupresión I-TREATMENT +introduciendo I-TREATMENT +everolimus. I-TREATMENT I-TREATMENT -Cuatro B-EVOLUTION -años I-EVOLUTION -y I-EVOLUTION -once I-EVOLUTION +A B-EVOLUTION +los I-EVOLUTION +seis I-EVOLUTION meses I-EVOLUTION -tras I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -inicial, I-EVOLUTION se I-EVOLUTION -detecta I-EVOLUTION +detectaron I-EVOLUTION +metástasis I-EVOLUTION +hepáticas I-EVOLUTION en I-EVOLUTION -el I-EVOLUTION -seguimiento I-EVOLUTION -radiológico I-EVOLUTION -la I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -varios I-EVOLUTION -nódulos I-EVOLUTION -hepáticos I-EVOLUTION -sugerentes I-EVOLUTION -de I-EVOLUTION -metástasis. I-EVOLUTION +segmentos I-EVOLUTION +IV I-EVOLUTION +y I-EVOLUTION +VII. I-EVOLUTION Se B-TREATMENT -sometió I-TREATMENT +intervino I-TREATMENT de I-TREATMENT nuevo I-TREATMENT -a I-TREATMENT -cirugía I-TREATMENT -abdominal I-TREATMENT -realizándose, I-TREATMENT -previo I-TREATMENT -control I-TREATMENT -con I-TREATMENT -ecografía I-TREATMENT -hepática I-TREATMENT -intraoperatoria, I-TREATMENT +realizando I-TREATMENT una I-TREATMENT -bisegmentectomía I-TREATMENT -IV-B I-TREATMENT -y I-TREATMENT -V I-TREATMENT +hepatectomía I-TREATMENT +izquierda I-TREATMENT y I-TREATMENT una I-TREATMENT -resección I-TREATMENT -limitada I-TREATMENT -del I-TREATMENT -segmento I-TREATMENT -VIII; I-TREATMENT -el B-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -anatomía-patológica I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -7 I-EXPLORATION -nódulos I-EXPLORATION -(de I-EXPLORATION -tamaño I-EXPLORATION -variable I-EXPLORATION -entre I-EXPLORATION -0.5 I-EXPLORATION -y I-EXPLORATION -1.5 I-EXPLORATION -cmts.) I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -metástasis I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -suprarrenal. I-EXPLORATION - I-EXPLORATION -Diez B-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -se I-EVOLUTION -detecta I-EVOLUTION -una I-EVOLUTION -nueva I-EVOLUTION -recidiva I-EVOLUTION -tumoral I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -subdiafragmático I-EVOLUTION -izquierdo I-EVOLUTION -(de I-EVOLUTION -6 I-EVOLUTION -x I-EVOLUTION -4 I-EVOLUTION -cmts. I-EVOLUTION -según I-EVOLUTION -la I-EVOLUTION -TAC) I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -raiz I-EVOLUTION -del I-EVOLUTION -mesenterio, I-EVOLUTION -esta I-EVOLUTION -última I-EVOLUTION -de I-EVOLUTION -4 I-EVOLUTION -x I-EVOLUTION -3 I-EVOLUTION -cmts. I-EVOLUTION -y I-EVOLUTION -localizada I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -salida I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -arteria I-EVOLUTION -mesentérica I-EVOLUTION -superior I-EVOLUTION -(AMS). I-EVOLUTION -Dada B-TREATMENT -la I-TREATMENT -difícil I-TREATMENT -resecabilidad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -nueva I-TREATMENT -recidiva I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -tratamiento I-TREATMENT -quimioterápico I-TREATMENT -con I-TREATMENT -intención I-TREATMENT -neoadyuvante I-TREATMENT -( I-TREATMENT -5 I-TREATMENT -ciclos I-TREATMENT -completos I-TREATMENT -de I-TREATMENT -CDDP I-TREATMENT -y I-TREATMENT -VP-16), I-TREATMENT -decidiéndose I-TREATMENT +ablación I-TREATMENT por I-TREATMENT -regresión I-TREATMENT -parcial I-TREATMENT -de I-TREATMENT -las I-TREATMENT -lesiones I-TREATMENT -una I-TREATMENT -nueva I-TREATMENT -exploración I-TREATMENT -quirúrgica. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -resección I-TREATMENT +microondas I-TREATMENT de I-TREATMENT -las I-TREATMENT -dos I-TREATMENT -masas I-TREATMENT -tumorales, I-TREATMENT la I-TREATMENT -primera I-TREATMENT -incluyendo I-TREATMENT -el I-TREATMENT -pilar I-TREATMENT -izquierdo I-TREATMENT +metástasis I-TREATMENT del I-TREATMENT -diafragma I-TREATMENT -y I-TREATMENT -una I-TREATMENT -pastilla I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -cmts. I-TREATMENT -de I-TREATMENT -dicho I-TREATMENT -músculo, I-TREATMENT -y I-TREATMENT -la I-TREATMENT -segunda I-TREATMENT -disecando I-TREATMENT -en I-TREATMENT -su I-TREATMENT -origen I-TREATMENT -el I-TREATMENT -tronco I-TREATMENT -celíaco I-TREATMENT -y I-TREATMENT -la I-TREATMENT -AMS I-TREATMENT -y I-TREATMENT -resecando I-TREATMENT -todo I-TREATMENT -el I-TREATMENT -tejido I-TREATMENT -tumoral I-TREATMENT -entre I-TREATMENT -ambos I-TREATMENT -vasos. I-TREATMENT -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -recidiva, I-EXPLORATION -estando I-EXPLORATION -los I-EXPLORATION -bordes I-EXPLORATION -de I-EXPLORATION -resección I-EXPLORATION -no I-EXPLORATION -afectos. I-EXPLORATION -La B-EVOLUTION -evolución I-EVOLUTION -postoperatoria I-EVOLUTION -fue I-EVOLUTION -satisfactoria. I-EVOLUTION - I-EVOLUTION -La I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra, I-EVOLUTION -tras I-EVOLUTION -7 I-EVOLUTION -años I-EVOLUTION -y I-EVOLUTION -3 I-EVOLUTION +segmento I-TREATMENT +VII. I-TREATMENT +Tras B-EVOLUTION +tres I-EVOLUTION meses I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -del I-EVOLUTION -tumor I-EVOLUTION -primario, I-EVOLUTION -libre I-EVOLUTION de I-EVOLUTION +seguimiento, I-EVOLUTION +la I-EVOLUTION enfermedad I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -calidad I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -aceptable, I-EVOLUTION -mínimamente I-EVOLUTION -limitada I-EVOLUTION -por I-EVOLUTION -las I-EVOLUTION -deposiciones I-EVOLUTION -diarreicas I-EVOLUTION -secundarias I-EVOLUTION -a I-EVOLUTION +está I-EVOLUTION +en I-EVOLUTION la I-EVOLUTION -denervación I-EVOLUTION -simpática I-EVOLUTION -celíaca. I-EVOLUTION +actualidad I-EVOLUTION +controlada. I-EVOLUTION I-EVOLUTION -Varón B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -66 I-PRESENT_ILLNESS +28 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -controlado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Consultas I-PRESENT_ILLNESS -Externas I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hipertrofia I-PRESENT_ILLNESS -benigna I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -próstata. I-PRESENT_ILLNESS -Presenta I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -hematuria I-PRESENT_ILLNESS -monosintomática I-PRESENT_ILLNESS -autolimitada I-PRESENT_ILLNESS +duración I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -urinocultivos I-PRESENT_ILLNESS -negativos. I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +kg I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +epigástrico I-PRESENT_ILLNESS +postprandrial, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +diarrea. I-PRESENT_ILLNESS En B-EXPLORATION -estudio I-EXPLORATION -ecográfico I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -ureteropielocaliectasia I-EXPLORATION -grado I-EXPLORATION -II I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -U.I.V. I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -anulación I-EXPLORATION -funcional I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -derecho, I-EXPLORATION -motivo B-TREATMENT -por I-TREATMENT -el I-TREATMENT -cuál, I-TREATMENT -se I-TREATMENT -practica I-TREATMENT -nefrostomia I-TREATMENT -percutánea I-TREATMENT -derecha, I-TREATMENT -que I-TREATMENT -confirma I-TREATMENT -el I-TREATMENT -hallazgo I-TREATMENT -urográfico. I-TREATMENT -Ocho B-EXPLORATION -meses I-EXPLORATION -antes, I-EXPLORATION -est: I-EXPLORATION -udio I-EXPLORATION -ecográfico I-EXPLORATION -y I-EXPLORATION -U.I.V. I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION - I-EXPLORATION -Entre B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -cabe I-PAST_MEDICAL_HISTORY -destacar: I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -conocidas. I-PAST_MEDICAL_HISTORY -HTA. I-PAST_MEDICAL_HISTORY -Diabetes I-PAST_MEDICAL_HISTORY -Mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -II. I-PAST_MEDICAL_HISTORY -Miocardiopatía I-PAST_MEDICAL_HISTORY -hipertrófica. I-PAST_MEDICAL_HISTORY -Aneurisma I-PAST_MEDICAL_HISTORY -carotídeo I-PAST_MEDICAL_HISTORY -intracerebral I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -secuelas. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La B-EXPLORATION +la I-EXPLORATION exploración I-EXPLORATION física I-EXPLORATION -practicada I-EXPLORATION -es I-EXPLORATION -la I-EXPLORATION -siguiente: I-EXPLORATION -Abdomen I-EXPLORATION -blando I-EXPLORATION +estaba I-EXPLORATION +pálida I-EXPLORATION y I-EXPLORATION -depresible, I-EXPLORATION -no I-EXPLORATION -doloroso, I-EXPLORATION -no I-EXPLORATION -megalias, I-EXPLORATION -Fosas I-EXPLORATION -renales I-EXPLORATION -libres I-EXPLORATION -indoloras. I-EXPLORATION -Genitales I-EXPLORATION -externos I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -patológicos. I-EXPLORATION -Tacto I-EXPLORATION -rectal I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -HBP I-EXPLORATION -grado I-EXPLORATION -I-II. I-EXPLORATION -Se I-EXPLORATION -llevan I-EXPLORATION +presentaba I-EXPLORATION +dolor I-EXPLORATION +epigástrico I-EXPLORATION a I-EXPLORATION -cabo I-EXPLORATION -las I-EXPLORATION -siguientes I-EXPLORATION -EXPLORACIONES I-EXPLORATION -COMPLEMENTARIAS: I-EXPLORATION - I-EXPLORATION -ANALISIS: I-EXPLORATION -Glucemia I-EXPLORATION -145 I-EXPLORATION -mg/dl, I-EXPLORATION -Creatinina I-EXPLORATION -1.4 I-EXPLORATION -mg/dl. I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +abdominal. I-EXPLORATION +Analítica: I-EXPLORATION +Hb I-EXPLORATION +8, I-EXPLORATION +6 I-EXPLORATION +g/dl, I-EXPLORATION +Htco I-EXPLORATION +28%, I-EXPLORATION +VCM I-EXPLORATION +64, I-EXPLORATION +Fe I-EXPLORATION +6 I-EXPLORATION +mcg/dl, I-EXPLORATION +ferritina I-EXPLORATION +1 I-EXPLORATION +ng/ml, I-EXPLORATION +saturación I-EXPLORATION +transferrina I-EXPLORATION +1, I-EXPLORATION +5%, I-EXPLORATION +vitamina I-EXPLORATION +B12 I-EXPLORATION +y I-EXPLORATION +ácido I-EXPLORATION +fólico I-EXPLORATION +normales. I-EXPLORATION +Anticuerpos I-EXPLORATION +antigliadina I-EXPLORATION +24, I-EXPLORATION +5 I-EXPLORATION +(0-20 I-EXPLORATION +UI/ml) I-EXPLORATION +y I-EXPLORATION +antiendomisio I-EXPLORATION +> I-EXPLORATION +20. I-EXPLORATION Resto I-EXPLORATION de I-EXPLORATION parámetros I-EXPLORATION +biológicos I-EXPLORATION dentro I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION - I-EXPLORATION -CITOLOGIA I-EXPLORATION -URINARIA: I-EXPLORATION -Compatible I-EXPLORATION +límites I-EXPLORATION +normales. I-EXPLORATION +Ca19.9, I-EXPLORATION +CEA, I-EXPLORATION +alfafetoproteína I-EXPLORATION +normales. I-EXPLORATION +Hemólisis I-EXPLORATION +negativo. I-EXPLORATION +Rx I-EXPLORATION +gastroduodenal-tránsito I-EXPLORATION +intestinal: I-EXPLORATION +varias I-EXPLORATION +estenosis I-EXPLORATION +duodenales, I-EXPLORATION con I-EXPLORATION -carcinoma I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -transicionales I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -grado. I-EXPLORATION - I-EXPLORATION -PIELOGRAFIA I-EXPLORATION -DESCENDENTE I-EXPLORATION -a I-EXPLORATION -traves I-EXPLORATION -de I-EXPLORATION -Nefrostomia: I-EXPLORATION -Defecto I-EXPLORATION -de I-EXPLORATION -replección I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -uréter I-EXPLORATION -sacro-ilíaco I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -20 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -longitud, I-EXPLORATION +ulceración I-EXPLORATION +e I-EXPLORATION +imágenes I-EXPLORATION +diverticulares I-EXPLORATION +en I-EXPLORATION +duodeno I-EXPLORATION +distal-yeyuno. I-EXPLORATION +Esofagogastroscopia: I-EXPLORATION +mucosa I-EXPLORATION +duodenal I-EXPLORATION con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION +aspecto I-EXPLORATION +atrófico I-EXPLORATION +y I-EXPLORATION +ulceraciones I-EXPLORATION +lineales I-EXPLORATION +postbulbares. I-EXPLORATION +Anatomía I-EXPLORATION +patológica: I-EXPLORATION +atrofia I-EXPLORATION +vellositaria I-EXPLORATION +severa I-EXPLORATION +e I-EXPLORATION infiltración I-EXPLORATION +extensa I-EXPLORATION +inflamatoria. I-EXPLORATION +No I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -pared. I-EXPLORATION - I-EXPLORATION -ESTUDIO I-EXPLORATION -FUNCIONAL I-EXPLORATION -DE I-EXPLORATION -RIÑON I-EXPLORATION -DERECHO: I-EXPLORATION -Aclaramiento I-EXPLORATION +granulomas, I-EXPLORATION +tejido I-EXPLORATION +linfoide I-EXPLORATION +ni I-EXPLORATION +carcinoma. I-EXPLORATION +Biopsia I-EXPLORATION +con I-EXPLORATION +cápsula I-EXPLORATION de I-EXPLORATION -Creatinina I-EXPLORATION -inferior I-EXPLORATION +Crosby I-EXPLORATION +dirigida I-EXPLORATION a I-EXPLORATION -5 I-EXPLORATION -ml/minuto. I-EXPLORATION - I-EXPLORATION +zona I-EXPLORATION +estenótica: I-EXPLORATION +hallazgos I-EXPLORATION +histológicos I-EXPLORATION +similares. I-EXPLORATION TAC I-EXPLORATION -ABDOMINO-PELVICO: I-EXPLORATION -Aneurisma I-EXPLORATION -de I-EXPLORATION -Aorta I-EXPLORATION -infrarrenal. I-EXPLORATION -Atrofia I-EXPLORATION -hidronefrótica I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -derecho, I-EXPLORATION +abdominal: I-EXPLORATION sin I-EXPLORATION -visualizarse I-EXPLORATION -imágenes I-EXPLORATION -endoluminales I-EXPLORATION -intraureterales. I-EXPLORATION -Dudosas I-EXPLORATION -adenopatías I-EXPLORATION -paravesicales. I-EXPLORATION +hallazgos I-EXPLORATION +significativos. I-EXPLORATION I-EXPLORATION -Ante B-TREATMENT -estos I-TREATMENT -hallazgos I-TREATMENT -y I-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -tumor I-TREATMENT -de I-TREATMENT -vías I-TREATMENT -de I-TREATMENT -uréter I-TREATMENT -derecho, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -intervenido I-TREATMENT -quirúrgicamente I-TREATMENT -practicándose I-TREATMENT -nefroureterectomía I-TREATMENT -radical I-TREATMENT -derecha I-TREATMENT -con I-TREATMENT -evolución I-TREATMENT -postoperatoria I-TREATMENT -satisfactoria. I-TREATMENT -El B-EXPLORATION -dictamen I-EXPLORATION -histopatológico I-EXPLORATION -de I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +dieta I-TREATMENT +sin I-TREATMENT +gluten I-TREATMENT +con B-EVOLUTION +mejoría I-EVOLUTION +analítica I-EVOLUTION +y I-EVOLUTION +clínica I-EVOLUTION +progresiva I-EVOLUTION +y I-EVOLUTION +posterior I-EVOLUTION +normalización I-EVOLUTION +de I-EVOLUTION +todos I-EVOLUTION +los I-EVOLUTION +parámetros. I-EVOLUTION +Ocho I-EVOLUTION +años I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +diagnóstico I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +continúa I-EVOLUTION +asintomática I-EVOLUTION +con I-EVOLUTION +controles I-EVOLUTION +anuales. I-EVOLUTION +La B-EXPLORATION +endoscopia I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -pieza I-EXPLORATION -nos I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -pielonefritis I-EXPLORATION -crónica I-EXPLORATION +histología I-EXPLORATION +objetivaron I-EXPLORATION +una I-EXPLORATION +mucosa I-EXPLORATION +intestinal I-EXPLORATION +normal I-EXPLORATION y I-EXPLORATION -cambios I-EXPLORATION +la I-EXPLORATION +analítica, I-EXPLORATION +incluidos I-EXPLORATION +anticuerpos I-EXPLORATION +de I-EXPLORATION +celiaquia, I-EXPLORATION +no I-EXPLORATION +presenta I-EXPLORATION +hallazgos I-EXPLORATION +significativos. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +estenosis I-EXPLORATION +del I-EXPLORATION +duodeno I-EXPLORATION +es I-EXPLORATION +una I-EXPLORATION +forma I-EXPLORATION +inusual I-EXPLORATION +del I-EXPLORATION +presentación I-EXPLORATION de I-EXPLORATION -arteriosclerosis, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -lesión I-EXPLORATION -inflamatoria I-EXPLORATION -ureteral I-EXPLORATION -que I-EXPLORATION -oblitera I-EXPLORATION la I-EXPLORATION -luz I-EXPLORATION +enfermedad I-EXPLORATION +celiaca I-EXPLORATION +(3). I-EXPLORATION +La I-EXPLORATION +ulceración I-EXPLORATION +intestinal I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +estenosis I-EXPLORATION +se I-EXPLORATION +cree I-EXPLORATION +que I-EXPLORATION +aparecen I-EXPLORATION +en I-EXPLORATION +zonas I-EXPLORATION con I-EXPLORATION -infiltrado I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION +mucosa I-EXPLORATION +inflamatoria. I-EXPLORATION +Estas I-EXPLORATION +lesiones I-EXPLORATION +típicamente I-EXPLORATION +se I-EXPLORATION +localizan I-EXPLORATION en I-EXPLORATION -capas I-EXPLORATION -musculares, I-EXPLORATION -erosión I-EXPLORATION -de I-EXPLORATION -urotelio I-EXPLORATION +el I-EXPLORATION +intestino I-EXPLORATION +delgado I-EXPLORATION +proximal I-EXPLORATION y I-EXPLORATION -presencia I-EXPLORATION +generalmente I-EXPLORATION +se I-EXPLORATION +describen I-EXPLORATION +en I-EXPLORATION +fases I-EXPLORATION +avanzadas I-EXPLORATION de I-EXPLORATION -Actinomices. I-EXPLORATION -Tras B-EVOLUTION -9 I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -mantiene I-EVOLUTION -una I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -aceptable I-EVOLUTION -(Creatinina I-EVOLUTION -sérica I-EVOLUTION -2.1 I-EVOLUTION -mg/dl I-EVOLUTION -) I-EVOLUTION -y I-EVOLUTION -es I-EVOLUTION -controlado I-EVOLUTION -por I-EVOLUTION -HBP I-EVOLUTION -sintomática. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -51 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -monorrena I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -incluída I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -programa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hemodiálisis I-PRESENT_ILLNESS -9 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -previos I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -trasplante I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -IRC I-PRESENT_ILLNESS -secundaria I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -pielonefritis I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Antecedentes B-PAST_MEDICAL_HISTORY -personales: I-PAST_MEDICAL_HISTORY -nefrectomía I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -absceso I-PAST_MEDICAL_HISTORY -pararrenal I-PAST_MEDICAL_HISTORY -secundario I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -rotura I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -riñón I-PAST_MEDICAL_HISTORY -izquierdo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -contenía I-PAST_MEDICAL_HISTORY -cálculo I-PAST_MEDICAL_HISTORY -coraliforme I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ureteroscopia I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cálculo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -uréter I-PAST_MEDICAL_HISTORY -pelviano I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -febrero I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -1990. I-PAST_MEDICAL_HISTORY -Hígado I-PAST_MEDICAL_HISTORY -graso I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -Servicio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Digestivo, I-PAST_MEDICAL_HISTORY -HTA, I-PAST_MEDICAL_HISTORY -hipertrigliceridemia, I-PAST_MEDICAL_HISTORY -sobrepeso I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -gota. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Trasplante I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -riñón I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -fosa I-PAST_MEDICAL_HISTORY -ilíaca I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -incidencias I-PAST_MEDICAL_HISTORY -(también I-PAST_MEDICAL_HISTORY -arteria I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -doble I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -parche I-PAST_MEDICAL_HISTORY -único I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -anastomosis I-PAST_MEDICAL_HISTORY -vasculares I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -ilíacas I-PAST_MEDICAL_HISTORY -externas, I-PAST_MEDICAL_HISTORY -implante I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -uréter I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -vejiga I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -Paquin). I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -día I-PAST_MEDICAL_HISTORY -+5 I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -trasplante I-PAST_MEDICAL_HISTORY -rechazo I-PAST_MEDICAL_HISTORY -agudo I-PAST_MEDICAL_HISTORY -siendo I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -pulses I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -6-Metil-Prednisolona I-PAST_MEDICAL_HISTORY -(400mg/día, I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -días) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -dada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -niveles I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -creatinina I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2'3 I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -progresivamente I-PAST_MEDICAL_HISTORY -descenderán I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -mantendrán I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -actualidad I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -0'8-1'1. I-PAST_MEDICAL_HISTORY -Al I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -seguía I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -inmunosupresor I-PAST_MEDICAL_HISTORY -también I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -ciclosporina I-PAST_MEDICAL_HISTORY -8mg/Kg, I-PAST_MEDICAL_HISTORY -micofenolato I-PAST_MEDICAL_HISTORY -mofetilo I-PAST_MEDICAL_HISTORY -2gr/día I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -prednisona I-PAST_MEDICAL_HISTORY -1mg/Kg. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -abril I-PAST_MEDICAL_HISTORY -de1999, I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -trasplante, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -temblor I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ambas I-PAST_MEDICAL_HISTORY -manos I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -inicialmente I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -atribuído I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -toxicidad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ciclosporina I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -comenzó I-PAST_MEDICAL_HISTORY -descenso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -pauta I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -corticoides. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -embargo, I-PAST_MEDICAL_HISTORY -ante I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -empeoramiento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -cuadro, I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -asintomática, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -inició I-PAST_MEDICAL_HISTORY -estudio I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -Servicio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Neurología. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -ese I-PRESENT_ILLNESS -momento, I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -medio I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -trasplante I-PRESENT_ILLNESS -(marzo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2000) I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -inestabilidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -marcha, I-PRESENT_ILLNESS -temblores I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -parestesias I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -inferiores. I-PRESENT_ILLNESS -En B-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION +enfermedad I-EXPLORATION +celiaca I-EXPLORATION +(1,2). I-EXPLORATION +Más I-EXPLORATION +recientemente, I-EXPLORATION +Schweger I-EXPLORATION +y I-EXPLORATION +Murray I-EXPLORATION +(3) I-EXPLORATION +han I-EXPLORATION +descrito I-EXPLORATION +5 I-EXPLORATION +casos I-EXPLORATION +más I-EXPLORATION +indicando I-EXPLORATION +que I-EXPLORATION +estas I-EXPLORATION +complicaciones, I-EXPLORATION +si I-EXPLORATION +bien I-EXPLORATION +raras, I-EXPLORATION +pueden I-EXPLORATION +presentarse I-EXPLORATION +más I-EXPLORATION +frecuentemente I-EXPLORATION +que I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -objetivaron I-EXPLORATION -moderados I-EXPLORATION -signos I-EXPLORATION -piramidales I-EXPLORATION -en I-EXPLORATION -ambas I-EXPLORATION -EEII, I-EXPLORATION +pensaba I-EXPLORATION +y I-EXPLORATION +parece I-EXPLORATION +que I-EXPLORATION +podrían I-EXPLORATION +aparecer I-EXPLORATION más I-EXPLORATION -acusados I-EXPLORATION +temprano I-EXPLORATION en I-EXPLORATION -eI I-EXPLORATION -izquierdo, I-EXPLORATION -sin I-EXPLORATION -claro I-EXPLORATION -déficit I-EXPLORATION -motor; I-EXPLORATION +el I-EXPLORATION +curso I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -sensibilidad I-EXPLORATION -profunda I-EXPLORATION -estaba I-EXPLORATION -también I-EXPLORATION -levemente I-EXPLORATION -alterada. I-EXPLORATION +enfermedad. I-EXPLORATION Las I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -ayudaron I-EXPLORATION -a I-EXPLORATION -esclarecer I-EXPLORATION -el I-EXPLORATION -diagnóstico: I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION +erosiones I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -RMN I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -2 I-EXPLORATION -lesiones I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -mielitis I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -cervical I-EXPLORATION -C2-C4 I-EXPLORATION +segunda I-EXPLORATION +porción I-EXPLORATION +duodenal I-EXPLORATION +en I-EXPLORATION +pacientes I-EXPLORATION +celiacos I-EXPLORATION +han I-EXPLORATION +sido I-EXPLORATION +descritas I-EXPLORATION +recientemente I-EXPLORATION +endoscópicamente I-EXPLORATION +(4). I-EXPLORATION +Nuestra I-EXPLORATION +paciente I-EXPLORATION +no I-EXPLORATION +tenía I-EXPLORATION +clínica I-EXPLORATION +típica I-EXPLORATION +de I-EXPLORATION +enfermedad I-EXPLORATION +celiaca, I-EXPLORATION +presentando I-EXPLORATION +estreñimiento I-EXPLORATION y I-EXPLORATION -dorsal I-EXPLORATION -alto I-EXPLORATION -D1. I-EXPLORATION - I-EXPLORATION +dolor I-EXPLORATION +epigástrico. I-EXPLORATION +La I-EXPLORATION +radiología I-EXPLORATION +objetivó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +estenosis I-EXPLORATION +duodenal I-EXPLORATION +y I-EXPLORATION +ulceración, I-EXPLORATION +y I-EXPLORATION +tuvimos I-EXPLORATION +que I-EXPLORATION +realizar I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +diferencial I-EXPLORATION +entre I-EXPLORATION +enfermedad I-EXPLORATION +celiaca I-EXPLORATION +y I-EXPLORATION +enfermedad I-EXPLORATION +de I-EXPLORATION +Crohn, I-EXPLORATION +linfoma, I-EXPLORATION +carcinoma I-EXPLORATION +intestinal, I-EXPLORATION +y I-EXPLORATION +yeyunitis I-EXPLORATION +ulcerativa. I-EXPLORATION Los I-EXPLORATION -potenciales I-EXPLORATION -evocados I-EXPLORATION -demostraron I-EXPLORATION -retraso I-EXPLORATION -significativo I-EXPLORATION -en I-EXPLORATION +hallazgos I-EXPLORATION +analíticos, I-EXPLORATION +endoscópicos I-EXPLORATION +e I-EXPLORATION +histológicos, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION la I-EXPLORATION -latencia I-EXPLORATION -del I-EXPLORATION -nervio I-EXPLORATION -tibial. I-EXPLORATION - I-EXPLORATION -LCR: I-EXPLORATION -leve I-EXPLORATION -pleocitosis I-EXPLORATION -linfocítica, I-EXPLORATION -aumento I-EXPLORATION +evolución I-EXPLORATION +posterior I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -concentración I-EXPLORATION +paciente I-EXPLORATION +con I-EXPLORATION +dieta I-EXPLORATION +sin I-EXPLORATION +gluten, I-EXPLORATION +confirmaron I-EXPLORATION +la I-EXPLORATION +enfermedad. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +enfermedad I-EXPLORATION +celiaca I-EXPLORATION +debe I-EXPLORATION +ser I-EXPLORATION +tenido I-EXPLORATION +en I-EXPLORATION +cuenta I-EXPLORATION +el I-EXPLORATION +desarrollo I-EXPLORATION +temprano I-EXPLORATION de I-EXPLORATION -proteínas I-EXPLORATION +estenosis I-EXPLORATION +duodenal I-EXPLORATION y I-EXPLORATION -presencia I-EXPLORATION de I-EXPLORATION -bandas I-EXPLORATION -IgG I-EXPLORATION -oligoclonales. I-EXPLORATION - I-EXPLORATION -Pruebas I-EXPLORATION -serológicas, I-EXPLORATION -ELISA I-EXPLORATION +ulceraciones, I-EXPLORATION y I-EXPLORATION -Western I-EXPLORATION -Blot, I-EXPLORATION -resultaron I-EXPLORATION -positivas I-EXPLORATION -para I-EXPLORATION -HTLV-I I-EXPLORATION +más I-EXPLORATION en I-EXPLORATION -LCR I-EXPLORATION +aquellos I-EXPLORATION +pacientes I-EXPLORATION +con I-EXPLORATION +síntomas I-EXPLORATION +no I-EXPLORATION +típicos I-EXPLORATION +o I-EXPLORATION +con I-EXPLORATION +hallazgos I-EXPLORATION +radiológicos I-EXPLORATION +inespecíficos, I-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION +que I-EXPLORATION +los I-EXPLORATION +cambios I-EXPLORATION +radiológicos I-EXPLORATION +antes I-EXPLORATION +mencionados I-EXPLORATION +pueden I-EXPLORATION +preceder I-EXPLORATION +al I-EXPLORATION +diagnóstico I-EXPLORATION +clínico I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +enfermedad. I-EXPLORATION + I-EXPLORATION +A. I-EXPLORATION +Castiella, I-EXPLORATION +I. I-EXPLORATION +Aramberri1, I-EXPLORATION +J. I-EXPLORATION +Fernández, I-EXPLORATION +C. I-EXPLORATION +Carrera1, I-EXPLORATION +L. I-EXPLORATION +Legasa2, I-EXPLORATION +I. I-EXPLORATION +Ruiz3 I-EXPLORATION y I-EXPLORATION -sangre. I-EXPLORATION +E. I-EXPLORATION +Zapata I-EXPLORATION I-EXPLORATION -PCR I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -positiva I-EXPLORATION -también I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -virus I-EXPLORATION -detectándose I-EXPLORATION -también I-EXPLORATION -en I-EXPLORATION -este I-EXPLORATION -caso I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -elevada. I-EXPLORATION +Unidad I-EXPLORATION +de I-EXPLORATION +Gastroenterología, I-EXPLORATION +1Medicina I-EXPLORATION +de I-EXPLORATION +Familia, I-EXPLORATION +2Servicios I-EXPLORATION +de I-EXPLORATION +Radiología I-EXPLORATION +y I-EXPLORATION +3Anatomía I-EXPLORATION +Patológica. I-EXPLORATION +Hospital I-EXPLORATION +Mendaro. I-EXPLORATION +Gipuzkoa I-EXPLORATION I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT -con I-TREATMENT -pulses I-TREATMENT -de I-TREATMENT -6-Metil-Prednisolona I-TREATMENT -en I-TREATMENT -el I-TREATMENT -momento I-TREATMENT -de I-TREATMENT -agudización I-TREATMENT -del I-TREATMENT -proceso I-TREATMENT -y I-TREATMENT -pauta I-TREATMENT -descendente I-TREATMENT -progresivamente I-TREATMENT -de I-TREATMENT -corticoides. I-TREATMENT -Sin B-EVOLUTION -embargo, I-EVOLUTION -además I-EVOLUTION -de I-EVOLUTION -hábito I-EVOLUTION -cushingoide, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -pérdida I-EVOLUTION -de I-EVOLUTION -audición I-EVOLUTION -progresiva, I-EVOLUTION -incontinencia I-EVOLUTION -de I-EVOLUTION -orina I-EVOLUTION -de I-EVOLUTION -predominio I-EVOLUTION -nocturno I-EVOLUTION -que I-EVOLUTION -ha I-EVOLUTION -mejorado I-EVOLUTION -con I-EVOLUTION -Tolterodina I-EVOLUTION -(pendiente I-EVOLUTION -de I-EVOLUTION -estudio I-EVOLUTION -urodinámico I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -momento I-EVOLUTION -actual) I-EVOLUTION -y I-EVOLUTION -evoluciona I-EVOLUTION -hacia I-EVOLUTION -discreta I-EVOLUTION -invalidez. I-EVOLUTION - I-EVOLUTION -Nuestra B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -77 I-PRESENT_ILLNESS +89 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -medicamentosas I-PAST_MEDICAL_HISTORY -conocidas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY +con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -miocardiopatía I-PAST_MEDICAL_HISTORY -dilatada, I-PAST_MEDICAL_HISTORY -artrosis, I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -histerectomía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -doble I-PAST_MEDICAL_HISTORY -anexectomía I-PAST_MEDICAL_HISTORY -junto I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -quimio I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +diabetes I-PAST_MEDICAL_HISTORY +mellitus I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +2, I-PAST_MEDICAL_HISTORY +fibrilación I-PAST_MEDICAL_HISTORY +aurícular I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -radioterapia I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -tumoración I-PAST_MEDICAL_HISTORY -ginecológica I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS +EPOC, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -cólico I-PRESENT_ILLNESS +ictericia I-PRESENT_ILLNESS +cutaneomucosa I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -ocho I-PRESENT_ILLNESS +15 I-PRESENT_ILLNESS días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -localizado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -fosa I-PRESENT_ILLNESS -lumbar I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -flanco I-PRESENT_ILLNESS -derechos I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -cara I-PRESENT_ILLNESS -anterior I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -muslo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -aumentando I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -deambulación. I-PRESENT_ILLNESS -A I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -vez, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -acompaña I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +acompañada I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -nauseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -picos I-PRESENT_ILLNESS -febriles I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -profusa I-PRESENT_ILLNESS -aunque I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encuentra I-PRESENT_ILLNESS -afebril I-PRESENT_ILLNESS +prurito I-PRESENT_ILLNESS +intenso, I-PRESENT_ILLNESS +coluria I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -miccional. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-EXPLORATION +astenia. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +anorexia I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -presenta: I-EXPLORATION -soplo I-EXPLORATION -protomesosistólico I-EXPLORATION -en I-EXPLORATION -ápex, I-EXPLORATION -abdomen I-EXPLORATION -blando I-EXPLORATION -y I-EXPLORATION -depresible, I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -fosa I-EXPLORATION -iliaca I-EXPLORATION -y I-EXPLORATION -flanco I-EXPLORATION -derechos. I-EXPLORATION -También I-EXPLORATION -destaca I-EXPLORATION -dolor I-EXPLORATION -espontáneo I-EXPLORATION +física I-EXPLORATION +se I-EXPLORATION +palpaba I-EXPLORATION +zona I-EXPLORATION +indurada I-EXPLORATION +no I-EXPLORATION +dolorosa I-EXPLORATION en I-EXPLORATION -cara I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -muslo I-EXPLORATION -derecho I-EXPLORATION -que I-EXPLORATION -aumenta I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -presión I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -movilidad I-EXPLORATION +epigastrio I-EXPLORATION +siendo I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -extremidad. I-EXPLORATION +exploración I-EXPLORATION +irrelevante. I-EXPLORATION I-EXPLORATION En I-EXPLORATION la I-EXPLORATION analítica I-EXPLORATION de I-EXPLORATION -Urgencias I-EXPLORATION -destaca I-EXPLORATION -leucocitosis I-EXPLORATION -con I-EXPLORATION -desviación I-EXPLORATION -izquierda I-EXPLORATION -(17.200 I-EXPLORATION -leucocitos I-EXPLORATION +sangre I-EXPLORATION +destacaban I-EXPLORATION +los I-EXPLORATION +siguientes I-EXPLORATION +parámetros: I-EXPLORATION +bilirrubina I-EXPLORATION +total I-EXPLORATION +de I-EXPLORATION +12, I-EXPLORATION +88 I-EXPLORATION +mg/dl I-EXPLORATION +(rango, I-EXPLORATION +0, I-EXPLORATION +1-1), I-EXPLORATION +bilirrubina I-EXPLORATION +directa I-EXPLORATION +de I-EXPLORATION +9, I-EXPLORATION +92 I-EXPLORATION +mg/dl I-EXPLORATION +(rango, I-EXPLORATION +0, I-EXPLORATION +01-0, I-EXPLORATION +25), I-EXPLORATION +AST I-EXPLORATION +de I-EXPLORATION +244 I-EXPLORATION +U/L I-EXPLORATION +(rango, I-EXPLORATION +5-35), I-EXPLORATION +ALT I-EXPLORATION +de I-EXPLORATION +272 I-EXPLORATION +U/L I-EXPLORATION +(rango, I-EXPLORATION +5-44), I-EXPLORATION +GGT I-EXPLORATION +de I-EXPLORATION +420 I-EXPLORATION +U/L I-EXPLORATION +(rango, I-EXPLORATION +5-46) I-EXPLORATION +y I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina I-EXPLORATION +de I-EXPLORATION +1.926 I-EXPLORATION +U/L I-EXPLORATION +(rango, I-EXPLORATION +90-360) I-EXPLORATION con I-EXPLORATION -84% I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -neutrófilos), I-EXPLORATION -567.000 I-EXPLORATION -plaquetas, I-EXPLORATION -urea I-EXPLORATION -1.35, I-EXPLORATION -creatinina I-EXPLORATION -1.80. I-EXPLORATION +parámetros I-EXPLORATION +bioquímicos, I-EXPLORATION +incluidos I-EXPLORATION +amilasa I-EXPLORATION +y I-EXPLORATION +lipasa, I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +normalidad. I-EXPLORATION I-EXPLORATION -Como I-EXPLORATION -pruebas I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION de I-EXPLORATION -imagen I-EXPLORATION +urgencia, I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION se I-EXPLORATION -solicitan I-EXPLORATION -Rx. I-EXPLORATION +puso I-EXPLORATION de I-EXPLORATION -vías I-EXPLORATION -urinarias I-EXPLORATION -y I-EXPLORATION -ecografía I-EXPLORATION +manifiesto I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +voluminosa I-EXPLORATION +localizada I-EXPLORATION en I-EXPLORATION +la I-EXPLORATION +cabeza I-EXPLORATION +pancreática, I-EXPLORATION +de I-EXPLORATION +predominio I-EXPLORATION +quístico I-EXPLORATION +multitabicada I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +contornos I-EXPLORATION +lobulados, I-EXPLORATION +con I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +principal I-EXPLORATION +y I-EXPLORATION las I-EXPLORATION +vías I-EXPLORATION +biliares I-EXPLORATION +intrahepáticas. I-EXPLORATION +Se I-EXPLORATION +practicó I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +computarizada, I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION -imagen I-EXPLORATION -cálcica I-EXPLORATION +objetivó I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION en I-EXPLORATION -silueta I-EXPLORATION -renal I-EXPLORATION -derecha I-EXPLORATION +la I-EXPLORATION +cabeza I-EXPLORATION +del I-EXPLORATION +páncreas, I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +multiquístico I-EXPLORATION +con I-EXPLORATION +tabiques I-EXPLORATION y I-EXPLORATION -ectasia I-EXPLORATION -pielocalicial I-EXPLORATION -derecha I-EXPLORATION -respectivamente. I-EXPLORATION +calcificaciones I-EXPLORATION +«en I-EXPLORATION +puesta I-EXPLORATION +de I-EXPLORATION +sol», I-EXPLORATION +que I-EXPLORATION +provocaba I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +Wirsung; I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +cistoadenoma I-EXPLORATION +seroso I-EXPLORATION +pancreático. I-EXPLORATION +Además I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +vesícula I-EXPLORATION +biliar I-EXPLORATION +muy I-EXPLORATION +distendida I-EXPLORATION +y I-EXPLORATION +marcada I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +intrahepática I-EXPLORATION +y I-EXPLORATION +del I-EXPLORATION +colédoco. I-EXPLORATION I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnostico I-TREATMENT -de I-TREATMENT -cólico I-TREATMENT -nefrítico I-TREATMENT -derecho I-TREATMENT -complicado I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -ingreso I-TREATMENT -para I-TREATMENT -derivación I-TREATMENT -urinaria I-TREATMENT +Dada B-TREATMENT +la I-TREATMENT +edad I-TREATMENT y I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -intravenoso. I-TREATMENT -Se I-TREATMENT -coloca I-TREATMENT -en I-TREATMENT -quirófano I-TREATMENT -catéter I-TREATMENT -externo I-TREATMENT -en I-TREATMENT -uréter I-TREATMENT -derecho I-TREATMENT -con I-TREATMENT -salida I-TREATMENT +los I-TREATMENT +antecedentes I-TREATMENT +personales I-TREATMENT de I-TREATMENT -abundante I-TREATMENT -orina I-TREATMENT -limpia. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -lo I-EVOLUTION -largo I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -cólico I-EVOLUTION -va I-EVOLUTION -cediendo I-EVOLUTION -aunque I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -refiere I-EVOLUTION -dolor I-EVOLUTION -sordo I-EVOLUTION -en I-EVOLUTION -fosa I-EVOLUTION -lumbar I-EVOLUTION -y I-EVOLUTION -continúa I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -muslo I-EVOLUTION -derecho. I-EVOLUTION -Es B-TREATMENT -valorada I-TREATMENT -por I-TREATMENT -el I-TREATMENT -servicio I-TREATMENT -de I-TREATMENT -Traumatología I-TREATMENT -pautando I-TREATMENT -tratamiento I-TREATMENT -antiinflamatorio I-TREATMENT -ante I-TREATMENT la I-TREATMENT -sospecha I-TREATMENT +paciente I-TREATMENT +no I-TREATMENT +fue I-TREATMENT +considerada I-TREATMENT +subsidiaria I-TREATMENT de I-TREATMENT -rotura I-TREATMENT -fibrilar I-TREATMENT -del I-TREATMENT -cuadriceps. I-TREATMENT - I-TREATMENT -Debido B-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -persistencia I-EXPLORATION -del I-EXPLORATION -dolor I-EXPLORATION -lumbar I-EXPLORATION +intervención I-TREATMENT +quirúrgica I-TREATMENT +y B-EXPLORATION se I-EXPLORATION -decide I-EXPLORATION -revisión I-EXPLORATION -ecográfica I-EXPLORATION -objetivándose I-EXPLORATION +practicó I-EXPLORATION una I-EXPLORATION -masa I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -músculo I-EXPLORATION -psoas I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -x I-EXPLORATION -5.5 I-EXPLORATION -cm. I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -un I-EXPLORATION -TAC. I-EXPLORATION -En I-EXPLORATION +colangiopancreatografía I-EXPLORATION +retrógrada I-EXPLORATION +endoscópica I-EXPLORATION +(CPRE). I-EXPLORATION +Al I-EXPLORATION +realizar I-EXPLORATION la I-EXPLORATION -tomografía I-EXPLORATION +CPRE I-EXPLORATION se I-EXPLORATION -confirma I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -del I-EXPLORATION -absceso I-EXPLORATION -retroperitoneal I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -compartimento I-EXPLORATION +objetivó I-EXPLORATION +cierta I-EXPLORATION +dificultad I-EXPLORATION +de I-EXPLORATION +paso I-EXPLORATION del I-EXPLORATION -músculo I-EXPLORATION -psoas I-EXPLORATION -iliaco I-EXPLORATION -derecho I-EXPLORATION +endoscopio I-EXPLORATION a I-EXPLORATION -nivel I-EXPLORATION +través I-EXPLORATION de I-EXPLORATION -L2-L3 I-EXPLORATION -sin I-EXPLORATION -perder I-EXPLORATION +rodilla I-EXPLORATION +duodenal I-EXPLORATION +superior, I-EXPLORATION +en I-EXPLORATION +probable I-EXPLORATION +relación I-EXPLORATION +con I-EXPLORATION +compresión I-EXPLORATION +por I-EXPLORATION la I-EXPLORATION -continuidad I-EXPLORATION -hasta I-EXPLORATION -anillo I-EXPLORATION -inguinal I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -poder I-EXPLORATION -descartar I-EXPLORATION +lesión I-EXPLORATION +primaria I-EXPLORATION +pancreática. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -participación I-EXPLORATION -del I-EXPLORATION -uréter I-EXPLORATION -derecho I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -tercio I-EXPLORATION -medio. I-EXPLORATION - I-EXPLORATION -Una B-DERIVED_FROM/TO -vez I-DERIVED_FROM/TO -confirmado I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -nos I-DERIVED_FROM/TO -ponemos I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -contacto I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Radiología I-DERIVED_FROM/TO -Intervensionista I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -drenaje I-DERIVED_FROM/TO -percutáneo. I-DERIVED_FROM/TO -Mediante B-EXPLORATION -ecografía I-EXPLORATION -se I-EXPLORATION -coloca I-EXPLORATION -catéter I-EXPLORATION -10 I-EXPLORATION -fr. I-EXPLORATION -evacuando I-EXPLORATION -200 I-EXPLORATION -cc. I-EXPLORATION -material I-EXPLORATION -purulento, I-EXPLORATION -del I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -envía I-EXPLORATION -muestra I-EXPLORATION -microbiológica I-EXPLORATION -(en I-EXPLORATION -los I-EXPLORATION -días I-EXPLORATION -sucesivos I-EXPLORATION +colangiografía I-EXPLORATION se I-EXPLORATION -confirma I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +apreció I-EXPLORATION +una I-EXPLORATION +gran I-EXPLORATION +dilatación I-EXPLORATION de I-EXPLORATION -Bacteriodes I-EXPLORATION -fragilis I-EXPLORATION -y I-EXPLORATION -Streptococcus I-EXPLORATION -sanguis). I-EXPLORATION -El I-EXPLORATION -débito I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -drenaje I-EXPLORATION -es I-EXPLORATION -progresivamente I-EXPLORATION -menor I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -nuevo I-EXPLORATION -estudio I-EXPLORATION +colédoco I-EXPLORATION +proximal I-EXPLORATION con I-EXPLORATION -TAC, I-EXPLORATION -evidenciándose I-EXPLORATION -la I-EXPLORATION -disminución I-EXPLORATION -del I-EXPLORATION -volumen I-EXPLORATION -del I-EXPLORATION -absceso. I-EXPLORATION -Se B-EVOLUTION -decide I-EVOLUTION -retirar I-EVOLUTION +estenosis I-EXPLORATION +distal I-EXPLORATION +de I-EXPLORATION +aproximadamente I-EXPLORATION +3-4 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +longitud. I-EXPLORATION +Se B-TREATMENT +colocó I-TREATMENT +una I-TREATMENT +prótesis I-TREATMENT +biliar I-TREATMENT +metálica I-TREATMENT +autoexpandible I-TREATMENT +tipo I-TREATMENT +Wallstent I-TREATMENT +(Boston I-TREATMENT +Scientific, I-TREATMENT +Natick, I-TREATMENT +MA, I-TREATMENT +USA) I-TREATMENT +de I-TREATMENT +8 I-TREATMENT +cm I-TREATMENT +de I-TREATMENT +longitud I-TREATMENT +y I-TREATMENT +1 I-TREATMENT +cm I-TREATMENT +de I-TREATMENT +calibre I-TREATMENT +sin I-TREATMENT +incidencias, I-TREATMENT +comprobando I-TREATMENT +la I-TREATMENT +correcta I-TREATMENT +colocación I-TREATMENT +y I-TREATMENT +drenaje I-TREATMENT +posterior. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +progresiva I-EVOLUTION +despigmentación I-EVOLUTION +cutaneomucosa I-EVOLUTION +con I-EVOLUTION +descenso I-EVOLUTION +de I-EVOLUTION +niveles I-EVOLUTION +de I-EVOLUTION +bilirrubina. I-EVOLUTION +Finalmente I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +asintomática. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +52 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hipercolesterolemia, I-PAST_MEDICAL_HISTORY +obesidad, I-PAST_MEDICAL_HISTORY +rigidez I-PAST_MEDICAL_HISTORY +articular, I-PAST_MEDICAL_HISTORY +microadenoma I-PAST_MEDICAL_HISTORY +hipofisiario I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY +migrañoso, I-PAST_MEDICAL_HISTORY +quien I-PAST_MEDICAL_HISTORY +ejerce I-PAST_MEDICAL_HISTORY +funciones I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +pinche I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +Hospital I-PAST_MEDICAL_HISTORY +Universitario I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Ceuta I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +diez I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Inicia B-PRESENT_ILLNESS +enfermedad I-PRESENT_ILLNESS +presentando I-PRESENT_ILLNESS +contracturas I-PRESENT_ILLNESS +musculares I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +lumbalgias I-PRESENT_ILLNESS +severas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +mayoría I-PRESENT_ILLNESS +ocasionadas I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +rol I-PRESENT_ILLNESS +dentro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +cocina, I-PRESENT_ILLNESS +solicitando I-PRESENT_ILLNESS +constantes I-PRESENT_ILLNESS +bajas I-PRESENT_ILLNESS +laborales, I-PRESENT_ILLNESS +evoluciona I-PRESENT_ILLNESS +presentando I-PRESENT_ILLNESS +parestesias I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +miembros I-PRESENT_ILLNESS +inferiores I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +incontinencia I-PRESENT_ILLNESS +urinaria, I-PRESENT_ILLNESS +es B-DERIVED_FROM/TO +referida I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +especializado I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +decide I-DERIVED_FROM/TO +realizar I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +artrodesis I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +columna I-DERIVED_FROM/TO +lumbo-sacra I-DERIVED_FROM/TO +L4-L5-S1 I-DERIVED_FROM/TO +precisando I-DERIVED_FROM/TO +incapacidad I-DERIVED_FROM/TO +temporal I-DERIVED_FROM/TO +durante I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +año, I-DERIVED_FROM/TO +posteriormente B-EVOLUTION +presenta I-EVOLUTION +síntomas I-EVOLUTION +sugestivos I-EVOLUTION +de I-EVOLUTION +compresión I-EVOLUTION +radicular I-EVOLUTION +y I-EVOLUTION +estenosis I-EVOLUTION +de I-EVOLUTION +canal I-EVOLUTION +medular, I-EVOLUTION +por B-DERIVED_FROM/TO +lo I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +nuevamente I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +referida I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +tratamiento I-DERIVED_FROM/TO +quirúrgico, I-DERIVED_FROM/TO +realizándose I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +resección I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +hernias I-DERIVED_FROM/TO +discales I-DERIVED_FROM/TO +C5-C6 I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +C6-C7, I-DERIVED_FROM/TO +necesitando I-DERIVED_FROM/TO +nuevamente I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +incapacidad I-DERIVED_FROM/TO +temporal I-DERIVED_FROM/TO +otro I-DERIVED_FROM/TO +año I-DERIVED_FROM/TO +más. I-DERIVED_FROM/TO +Al B-EVOLUTION +reincorporarse I-EVOLUTION +a I-EVOLUTION +su I-EVOLUTION +puesto I-EVOLUTION +de I-EVOLUTION +trabajo, I-EVOLUTION +se I-EVOLUTION +realiza I-EVOLUTION +una I-EVOLUTION +valoración I-EVOLUTION +médica I-EVOLUTION +en I-EVOLUTION el I-EVOLUTION -tubo I-EVOLUTION +Servicio I-EVOLUTION de I-EVOLUTION -drenaje I-EVOLUTION +Prevención I-EVOLUTION +de I-EVOLUTION +Riesgos I-EVOLUTION +Laborales I-EVOLUTION +del I-EVOLUTION +Hospital, I-EVOLUTION +donde I-EVOLUTION +posterior I-EVOLUTION al I-EVOLUTION -quinto I-EVOLUTION -día I-EVOLUTION +estudio I-EVOLUTION de I-EVOLUTION -su I-EVOLUTION -colocación I-EVOLUTION -pero I-EVOLUTION -es I-EVOLUTION -necesario I-EVOLUTION -recolocación I-EVOLUTION +los I-EVOLUTION +protocolos I-EVOLUTION de I-EVOLUTION -catéter I-EVOLUTION -14 I-EVOLUTION -fr. I-EVOLUTION +manipulación I-EVOLUTION +manual I-EVOLUTION +de I-EVOLUTION +cargas I-EVOLUTION +y I-EVOLUTION +movimientos I-EVOLUTION +repetitivos, I-EVOLUTION +se I-EVOLUTION +valora I-EVOLUTION +como I-EVOLUTION +No I-EVOLUTION +Apta I-EVOLUTION +para I-EVOLUTION +realizar I-EVOLUTION +las I-EVOLUTION +funciones I-EVOLUTION +de I-EVOLUTION +pinche I-EVOLUTION +dentro I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +cocina. I-EVOLUTION +Se I-EVOLUTION +propone I-EVOLUTION +una I-EVOLUTION +adaptación I-EVOLUTION +del I-EVOLUTION +puesto I-EVOLUTION +de I-EVOLUTION +trabajo, I-EVOLUTION +de I-EVOLUTION +imposible I-EVOLUTION +cumplimiento I-EVOLUTION por I-EVOLUTION -empeoramiento I-EVOLUTION -clínico. I-EVOLUTION +su I-EVOLUTION +mando I-EVOLUTION +intermedio. I-EVOLUTION I-EVOLUTION -Se B-EXPLORATION -desconoce I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -foco I-EXPLORATION -primario I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -durante I-EXPLORATION -el I-EXPLORATION -ingreso, I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -colonoscopia I-EXPLORATION -para I-EXPLORATION -intentar I-EXPLORATION -buscar I-EXPLORATION -un I-EXPLORATION -origen I-EXPLORATION -digestivo I-EXPLORATION -del I-EXPLORATION -problema. I-EXPLORATION -No I-EXPLORATION -es I-EXPLORATION -posible I-EXPLORATION -sobrepasar I-EXPLORATION -el I-EXPLORATION -ángulo I-EXPLORATION -esplénico I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -halla I-EXPLORATION -un I-EXPLORATION -foco I-EXPLORATION -primario. I-EXPLORATION -Desde I-EXPLORATION -el I-EXPLORATION -punto I-EXPLORATION -de I-EXPLORATION -vista I-EXPLORATION -urológico I-EXPLORATION -tampoco I-EXPLORATION -se I-EXPLORATION -justifica I-EXPLORATION -la I-EXPLORATION -aparición I-EXPLORATION -del I-EXPLORATION -absceso. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -hace I-EXPLORATION -cavitograma I-EXPLORATION -para I-EXPLORATION -estudiar I-EXPLORATION -la I-EXPLORATION -morfología I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -tamaño I-EXPLORATION -del I-EXPLORATION -absceso I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -indica I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -lavados I-EXPLORATION -con I-EXPLORATION -fibrinolíticos I-EXPLORATION -intracavitarios I-EXPLORATION -(100.000 I-EXPLORATION -unidades I-EXPLORATION -de I-EXPLORATION -urokinasa I-EXPLORATION -en I-EXPLORATION -10 I-EXPLORATION -cc I-EXPLORATION -de I-EXPLORATION -suero I-EXPLORATION -fisiológico). I-EXPLORATION - I-EXPLORATION -Después B-EVOLUTION +El I-EVOLUTION +caso I-EVOLUTION +es I-EVOLUTION +estudiado I-EVOLUTION +por I-EVOLUTION +Gerencia I-EVOLUTION +para I-EVOLUTION +solicitar I-EVOLUTION +su I-EVOLUTION +reubicación I-EVOLUTION +en I-EVOLUTION +un I-EVOLUTION +puesto I-EVOLUTION +acorde I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +patologías I-EVOLUTION +que I-EVOLUTION +presenta, I-EVOLUTION +donde I-EVOLUTION +pudiera I-EVOLUTION +desempeñar I-EVOLUTION +funciones I-EVOLUTION +que I-EVOLUTION +no I-EVOLUTION +perjudicaran I-EVOLUTION +su I-EVOLUTION +salud; I-EVOLUTION +en I-EVOLUTION +vista I-EVOLUTION de I-EVOLUTION +no I-EVOLUTION +tener I-EVOLUTION un I-EVOLUTION -mes I-EVOLUTION +puesto I-EVOLUTION +con I-EVOLUTION +esas I-EVOLUTION +características I-EVOLUTION +dentro I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +empresa, I-EVOLUTION +la I-EVOLUTION +trabajadora I-EVOLUTION +denuncia I-EVOLUTION +ante I-EVOLUTION +la I-EVOLUTION +inspectoría I-EVOLUTION +del I-EVOLUTION +trabajo I-EVOLUTION +su I-EVOLUTION +situación I-EVOLUTION y I-EVOLUTION -diez I-EVOLUTION -días I-EVOLUTION +solicita I-EVOLUTION +una I-EVOLUTION +minusvalía I-EVOLUTION +al I-EVOLUTION +Instituto I-EVOLUTION de I-EVOLUTION -ingreso, I-EVOLUTION +Mayores I-EVOLUTION +y I-EVOLUTION +Servicios I-EVOLUTION +Sociales, I-EVOLUTION +donde I-EVOLUTION +el I-EVOLUTION +equipo I-EVOLUTION +de I-EVOLUTION +valoración I-EVOLUTION +y I-EVOLUTION +orientación I-EVOLUTION +otorga I-EVOLUTION +un I-EVOLUTION +grado I-EVOLUTION +de I-EVOLUTION +discapacidad I-EVOLUTION +del I-EVOLUTION +65% I-EVOLUTION +según I-EVOLUTION +los I-EVOLUTION +baremos I-EVOLUTION +vigentes I-EVOLUTION +a I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION -es I-EVOLUTION -dada I-EVOLUTION +fecha I-EVOLUTION +y I-EVOLUTION +además I-EVOLUTION +la I-EVOLUTION +resolución I-EVOLUTION de I-EVOLUTION -alta I-EVOLUTION -ante I-EVOLUTION la I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION +Inspección I-EVOLUTION +de I-EVOLUTION +Trabajo I-EVOLUTION +requiere I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +empresa I-EVOLUTION +realizar I-EVOLUTION +una I-EVOLUTION +adaptación I-EVOLUTION del I-EVOLUTION -cuadro I-EVOLUTION -confirmada I-EVOLUTION -mediante I-EVOLUTION -técnicas I-EVOLUTION +puesto I-EVOLUTION +de I-EVOLUTION +trabajo I-EVOLUTION +ya I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +debe I-EVOLUTION +garantizar I-EVOLUTION +la I-EVOLUTION +reinserción I-EVOLUTION de I-EVOLUTION -imagen. I-EVOLUTION -En I-EVOLUTION los I-EVOLUTION -controles I-EVOLUTION -posteriores I-EVOLUTION +trabajadores I-EVOLUTION +con I-EVOLUTION +minusvalías I-EVOLUTION +por I-EVOLUTION +condiciones I-EVOLUTION +médicas. I-EVOLUTION +Se I-EVOLUTION +replantea I-EVOLUTION +la I-EVOLUTION +adaptación I-EVOLUTION +del I-EVOLUTION +puesto I-EVOLUTION +de I-EVOLUTION +trabajo I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +nueva I-EVOLUTION +valoración I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +riesgos I-EVOLUTION +por I-EVOLUTION +parte I-EVOLUTION +del I-EVOLUTION +Técnico I-EVOLUTION +de I-EVOLUTION +Prevención I-EVOLUTION en I-EVOLUTION -nuestras I-EVOLUTION -consultas, I-EVOLUTION +conjunto I-EVOLUTION +con I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION +Gobernanta, I-EVOLUTION +haciéndolo I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +minuciosa I-EVOLUTION +y I-EVOLUTION +específica, I-EVOLUTION se I-EVOLUTION -encuentra I-EVOLUTION -asintomática I-EVOLUTION +logra I-EVOLUTION +un I-EVOLUTION +acuerdo I-EVOLUTION +para I-EVOLUTION +su I-EVOLUTION +reintegro I-EVOLUTION +a I-EVOLUTION +dicha I-EVOLUTION +área. I-EVOLUTION +Sin I-EVOLUTION +embargo I-EVOLUTION +a I-EVOLUTION +su I-EVOLUTION +reincorporación, I-EVOLUTION +la I-EVOLUTION +trabajadora I-EVOLUTION +sufre I-EVOLUTION +múltiples I-EVOLUTION +episodios I-EVOLUTION +conflictivospor I-EVOLUTION +parte I-EVOLUTION +de I-EVOLUTION +compañeros, I-EVOLUTION +quienes I-EVOLUTION +se I-EVOLUTION +niegan I-EVOLUTION +a I-EVOLUTION +asumir I-EVOLUTION +gran I-EVOLUTION +parte I-EVOLUTION +de I-EVOLUTION +sus I-EVOLUTION +actividades I-EVOLUTION +diarias I-EVOLUTION +por I-EVOLUTION +la I-EVOLUTION +adaptación I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +ha I-EVOLUTION +realizado. I-EVOLUTION +Pasado I-EVOLUTION +un I-EVOLUTION +tiempo, I-EVOLUTION +su I-EVOLUTION +jefe I-EVOLUTION +inmediato I-EVOLUTION +ha I-EVOLUTION +logrado I-EVOLUTION +establecer I-EVOLUTION +un I-EVOLUTION +plan I-EVOLUTION +de I-EVOLUTION +trabajo I-EVOLUTION +adecuado I-EVOLUTION +para I-EVOLUTION +distribuir I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +homogénea I-EVOLUTION +las I-EVOLUTION +actividades I-EVOLUTION +diarias I-EVOLUTION +de I-EVOLUTION +cocina I-EVOLUTION +y I-EVOLUTION +mejorar I-EVOLUTION +las I-EVOLUTION +relaciones I-EVOLUTION +interpersonales. I-EVOLUTION +Actualmente I-EVOLUTION +desempeña I-EVOLUTION +las I-EVOLUTION +funciones I-EVOLUTION +de I-EVOLUTION +pinche I-EVOLUTION +de I-EVOLUTION +cocina, I-EVOLUTION con I-EVOLUTION -resolución I-EVOLUTION -total I-EVOLUTION -del I-EVOLUTION -proceso. I-EVOLUTION +las I-EVOLUTION +restricciones I-EVOLUTION +impuestas I-EVOLUTION +por I-EVOLUTION +el I-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Prevención I-EVOLUTION +de I-EVOLUTION +Riesgos I-EVOLUTION +Laborales, I-EVOLUTION +además I-EVOLUTION +acude I-EVOLUTION +a I-EVOLUTION +reconocimientos I-EVOLUTION +médicos I-EVOLUTION +anuales I-EVOLUTION +valorando I-EVOLUTION +la I-EVOLUTION +evolución I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +patología. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +Hombre B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY +16 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +procedente B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -obesidad, I-PAST_MEDICAL_HISTORY -brucelosis, I-PAST_MEDICAL_HISTORY -lumboartrosis, I-PAST_MEDICAL_HISTORY -litiasis I-PAST_MEDICAL_HISTORY -biliar, I-PAST_MEDICAL_HISTORY -apendicectomía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cesárea. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY +rural I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +municipio I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +Peñón, I-PAST_MEDICAL_HISTORY +Santander. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cinco I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +consistente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +eritema I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +edema I-PRESENT_ILLNESS +palpebral I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +progresivo I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +secreción I-PRESENT_ILLNESS +ocular I-PRESENT_ILLNESS +purulenta. I-PRESENT_ILLNESS +En B-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +edema I-EXPLORATION +palpebral I-EXPLORATION +y I-EXPLORATION +conjuntiva I-EXPLORATION +izquierda I-EXPLORATION +hiperémica I-EXPLORATION +sin I-EXPLORATION +secreciones. I-EXPLORATION +Se B-TREATMENT +hizo I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +celulitis I-TREATMENT +periorbitaria I-TREATMENT +y I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +manejo I-TREATMENT +antibiótico I-TREATMENT +ambulatorio. I-TREATMENT +Un B-EVOLUTION +año I-EVOLUTION +después I-EVOLUTION +consultó I-EVOLUTION +por I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +tres I-EVOLUTION +días I-EVOLUTION +consistente I-EVOLUTION +en I-EVOLUTION +debilidad, I-EVOLUTION +fiebre I-EVOLUTION +subjetiva, I-EVOLUTION +disnea, I-EVOLUTION +cefalea, I-EVOLUTION +malestar I-EVOLUTION +general I-EVOLUTION +y I-EVOLUTION +dolor I-EVOLUTION +faríngeo. I-EVOLUTION En B-EXPLORATION -estudio I-EXPLORATION -ecográfico I-EXPLORATION -de I-EXPLORATION la I-EXPLORATION -vía I-EXPLORATION -biliar, I-EXPLORATION +ficha I-EXPLORATION +epide-miológica I-EXPLORATION se I-EXPLORATION -objetiva I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -casual, I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -cm. I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -en I-EXPLORATION -polo I-EXPLORATION -superior I-EXPLORATION +consignó I-EXPLORATION +signo I-EXPLORATION de I-EXPLORATION -riñón I-EXPLORATION -derecho. I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -confirma I-EXPLORATION -este I-EXPLORATION -hallazgo I-EXPLORATION -evidenciándose I-EXPLORATION -masa I-EXPLORATION -sólida I-EXPLORATION +Romaña I-EXPLORATION +positivo I-EXPLORATION +(probablemente I-EXPLORATION en I-EXPLORATION -polo I-EXPLORATION -superior I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -derecho; I-EXPLORATION -comprobándose I-EXPLORATION -realce I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -infusión I-EXPLORATION +retrospectiva). I-EXPLORATION +Se I-EXPLORATION +realizaron I-EXPLORATION +pruebas I-EXPLORATION +serológicas, I-EXPLORATION +reportadas I-EXPLORATION +como I-EXPLORATION +Elisa I-EXPLORATION +positivo I-EXPLORATION +e I-EXPLORATION +IFI I-EXPLORATION +reactivo I-EXPLORATION +con I-EXPLORATION +título I-EXPLORATION de I-EXPLORATION -contraste, I-EXPLORATION -no I-EXPLORATION -objetivándose I-EXPLORATION -adenopatías I-EXPLORATION -hiliares, I-EXPLORATION -ni I-EXPLORATION -afectación I-EXPLORATION +1: I-EXPLORATION +32, I-EXPLORATION +por I-EXPLORATION +parte I-EXPLORATION +del I-EXPLORATION +Laboratorio I-EXPLORATION +Departamental I-EXPLORATION de I-EXPLORATION -órganos I-EXPLORATION +Salud I-EXPLORATION +Pública I-EXPLORATION de I-EXPLORATION -vecindad. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -masa I-TREATMENT -sólida I-TREATMENT -compatible I-TREATMENT +Santander. I-EXPLORATION +Se B-TREATMENT +administró I-TREATMENT +tratamiento I-TREATMENT +etiológico I-TREATMENT con I-TREATMENT -adenocarcinoma I-TREATMENT -renal I-TREATMENT -es I-TREATMENT -intervenida, I-TREATMENT -realizándose I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -lumbar I-TREATMENT -oblícua I-TREATMENT -nefrectomía I-TREATMENT -radical, I-TREATMENT -siendo I-TREATMENT -el I-TREATMENT -curso I-TREATMENT -postoperatorio I-TREATMENT -sin I-TREATMENT -incidencias. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -microscópico I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -tumoración I-EXPLORATION -en I-EXPLORATION -polo I-EXPLORATION -superior I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -invade I-EXPLORATION -cápsula, I-EXPLORATION -su I-EXPLORATION -aspecto I-EXPLORATION -al I-EXPLORATION -corte I-EXPLORATION -es I-EXPLORATION -homogéneo, I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -blancogrisaceo. I-EXPLORATION -La I-EXPLORATION -pelvis I-EXPLORATION -y I-EXPLORATION -cálices I-EXPLORATION -no I-EXPLORATION -están I-EXPLORATION -afectados I-EXPLORATION +benzonidazol I-TREATMENT +a I-TREATMENT +una I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +250 I-TREATMENT +mg/día I-TREATMENT +durante I-TREATMENT +60 I-TREATMENT +días. I-TREATMENT +El B-EXPLORATION +diagnóstico I-EXPLORATION +fue I-EXPLORATION +confirmado I-EXPLORATION +mediante I-EXPLORATION +serología I-EXPLORATION por I-EXPLORATION -la I-EXPLORATION -tumoración I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -renal I-EXPLORATION -esta I-EXPLORATION -libre. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION +IFI I-EXPLORATION +reactiva I-EXPLORATION +1: I-EXPLORATION +64 I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION -microscópico I-EXPLORATION +INS. I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION -tumoración I-EXPLORATION -redondeada I-EXPLORATION +envió I-EXPLORATION +muestra I-EXPLORATION de I-EXPLORATION -márgenes I-EXPLORATION -bien I-EXPLORATION -definidos, I-EXPLORATION -que I-EXPLORATION -crece I-EXPLORATION -por I-EXPLORATION -expansión I-EXPLORATION -sin I-EXPLORATION -invadir, I-EXPLORATION +sangre I-EXPLORATION +para I-EXPLORATION +cultivo. I-EXPLORATION + I-EXPLORATION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +27 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +previamente I-PRESENT_ILLNESS +sana, I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +diarrea, I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +difuso I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +estaba I-PRESENT_ILLNESS +tomando I-PRESENT_ILLNESS +anovulatorios I-PRESENT_ILLNESS +orales I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +momento I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +ingreso. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +presenta I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -naturaleza I-EXPLORATION -mesenquimal, I-EXPLORATION -compuesta I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -dispuestas I-EXPLORATION +irritación I-EXPLORATION +peritoneal I-EXPLORATION en I-EXPLORATION -fascículos I-EXPLORATION -entrelazados, I-EXPLORATION -los I-EXPLORATION -núcleos I-EXPLORATION -presentan I-EXPLORATION -ligera I-EXPLORATION -variación I-EXPLORATION +fosa I-EXPLORATION +iliaca I-EXPLORATION +derecha. I-EXPLORATION +Presentaba I-EXPLORATION +leucocitosis I-EXPLORATION +con I-EXPLORATION +importante I-EXPLORATION +desviación I-EXPLORATION +izquierda. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -tamaño I-EXPLORATION +estudios I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION y I-EXPLORATION -forma, I-EXPLORATION -la I-EXPLORATION -actividad I-EXPLORATION -mitótica I-EXPLORATION -es I-EXPLORATION -inferior I-EXPLORATION -a I-EXPLORATION -5 I-EXPLORATION -mitosis I-EXPLORATION -por I-EXPLORATION -50 I-EXPLORATION -CGA, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -aprecian I-EXPLORATION -hemorragias I-EXPLORATION -ni I-EXPLORATION -necrosis. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -negatividad I-EXPLORATION -para I-EXPLORATION -queratinas I-EXPLORATION -(AE-1,AE-3), I-EXPLORATION -EMA I-EXPLORATION -(anfígeno I-EXPLORATION -epitelial I-EXPLORATION +radiológicos I-EXPLORATION +resultaron I-EXPLORATION +normales. I-EXPLORATION +Ante B-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +apendicitis I-TREATMENT +aguda I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +laparotomía I-TREATMENT +de I-TREATMENT +urgencia I-TREATMENT +encontrándose I-TREATMENT +una I-TREATMENT +apendicitis I-TREATMENT +aguda I-TREATMENT +gangrenosa I-TREATMENT +(anat. I-TREATMENT +patológica: I-TREATMENT +apendicitis I-TREATMENT +aguda), I-TREATMENT +realizándose I-TREATMENT +apendicectomía. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +le I-TREATMENT +administró I-TREATMENT +empíricamente I-TREATMENT +1 I-TREATMENT +g/8 I-TREATMENT +h I-TREATMENT +endovenoso I-TREATMENT +de I-TREATMENT +amoxicilina-clavulánico, I-TREATMENT +en I-TREATMENT +el I-TREATMENT +en I-TREATMENT +el I-TREATMENT +5º I-TREATMENT +día I-TREATMENT +postoperatorio I-TREATMENT +empezó I-TREATMENT +con I-TREATMENT +fiebre I-TREATMENT +"en I-TREATMENT +picos" I-TREATMENT +de I-TREATMENT +hasta I-TREATMENT +40 I-TREATMENT +ºC. I-TREATMENT +Se B-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +TC I-EXPLORATION +abdominal I-EXPLORATION +siendo I-EXPLORATION +informado I-EXPLORATION +como I-EXPLORATION +trombosis I-EXPLORATION de I-EXPLORATION -membrana) I-EXPLORATION -con I-EXPLORATION -lo I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +mesentérica I-EXPLORATION +superior I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -excluye I-EXPLORATION -la I-EXPLORATION -naturaleza I-EXPLORATION -epitelial I-EXPLORATION +extiende I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +ramas I-EXPLORATION +ileocólicas, I-EXPLORATION +resto I-EXPLORATION del I-EXPLORATION -tumor. I-EXPLORATION -Negatividad I-EXPLORATION +estudio I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +la I-TREATMENT +instauró I-TREATMENT +sueroterapia, I-TREATMENT +reposo I-TREATMENT +intestinal I-TREATMENT +y I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +enoxiparina I-TREATMENT +subcutánea I-TREATMENT +60 I-TREATMENT +mg/12 I-TREATMENT +h I-TREATMENT +y I-TREATMENT +meropenem I-TREATMENT +endovenoso I-TREATMENT +1 I-TREATMENT +g/8 I-TREATMENT +h. I-TREATMENT +Se B-EVOLUTION +completan I-EVOLUTION +14 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +antibiótico I-EVOLUTION +y I-EVOLUTION +ante I-EVOLUTION +ausencia I-EVOLUTION +de I-EVOLUTION +fiebre I-EVOLUTION +y I-EVOLUTION +problemas I-EVOLUTION +digestivos I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +causa I-EVOLUTION +alta I-EVOLUTION +el I-EVOLUTION +24º I-EVOLUTION +día I-EVOLUTION +del I-EVOLUTION +postoperatorio I-EVOLUTION +con I-EVOLUTION +acenocumarol I-EVOLUTION +oral. I-EVOLUTION + I-EVOLUTION +En B-EXPLORATION +los I-EXPLORATION +cultivos I-EXPLORATION +intraoperatorios I-EXPLORATION +crecieron I-EXPLORATION +Proteus I-EXPLORATION +mirabilis I-EXPLORATION +y I-EXPLORATION +Escherichia I-EXPLORATION +coli I-EXPLORATION +sensibles I-EXPLORATION +a I-EXPLORATION +todos I-EXPLORATION +los I-EXPLORATION +antibióticos I-EXPLORATION +testados. I-EXPLORATION +El I-EXPLORATION +cultivo I-EXPLORATION +intraoperatorio I-EXPLORATION para I-EXPLORATION -vimentina, I-EXPLORATION -HMB45, I-EXPLORATION -S-100. I-EXPLORATION -Positividad I-EXPLORATION +gérmenes I-EXPLORATION +anaerobios I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION +Dos I-EXPLORATION +hemocultivos I-EXPLORATION +resultaron I-EXPLORATION +positivos I-EXPLORATION para I-EXPLORATION -marcadores I-EXPLORATION -vasculares I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -trama I-EXPLORATION -vascular I-EXPLORATION +Bacteroides I-EXPLORATION +fragilis I-EXPLORATION +resistente I-EXPLORATION +a I-EXPLORATION +clindamicina I-EXPLORATION y I-EXPLORATION -positividad I-EXPLORATION +penicilina, I-EXPLORATION +siendo I-EXPLORATION +sensible I-EXPLORATION +al I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +antibióticos I-EXPLORATION +testados. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION para I-EXPLORATION -actino. I-EXPLORATION +anticuerpos I-EXPLORATION +antifosfolípido I-EXPLORATION +resultó I-EXPLORATION +negativo. I-EXPLORATION I-EXPLORATION +Al B-EVOLUTION +mes I-EVOLUTION +del I-EVOLUTION +alta I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +asintomática. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -51 I-PRESENT_ILLNESS +19 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -diagnosticado B-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY +que I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +sido I-PRESENT_ILLNESS +seguido I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +Departamento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Pediatría I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +anemia I-PRESENT_ILLNESS +ferropénica. I-PRESENT_ILLNESS +Se B-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +realizado I-PAST_MEDICAL_HISTORY +gastroscopia, I-PAST_MEDICAL_HISTORY +colonoscopia, I-PAST_MEDICAL_HISTORY +tránsito I-PAST_MEDICAL_HISTORY +gastrointestinal, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +gammagrafía I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +descartar I-PAST_MEDICAL_HISTORY +divertículo I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Neurolues, I-PAST_MEDICAL_HISTORY +Meckel, I-PAST_MEDICAL_HISTORY +siendo I-PAST_MEDICAL_HISTORY +todas I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +pruebas I-PAST_MEDICAL_HISTORY +negativas. I-PAST_MEDICAL_HISTORY +Había I-PAST_MEDICAL_HISTORY +estado I-PAST_MEDICAL_HISTORY +todos I-PAST_MEDICAL_HISTORY +estos I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +asintomático I-PAST_MEDICAL_HISTORY +recibiendo I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -secuelas I-PAST_MEDICAL_HISTORY -establecidas I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -trastornos I-PAST_MEDICAL_HISTORY -mnésicos I-PAST_MEDICAL_HISTORY -visuales I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -verbales, I-PAST_MEDICAL_HISTORY -así I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -radiculoneuropatía I-PAST_MEDICAL_HISTORY -múltiple. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -radiología I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -presentaba I-EXPLORATION -elongación I-EXPLORATION -aórtica I-EXPLORATION +hierro I-PAST_MEDICAL_HISTORY +oral. I-PAST_MEDICAL_HISTORY +El B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +seguimiento I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +estudio. I-DERIVED_FROM/TO +Se B-EXPLORATION +le I-EXPLORATION +repitieron I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +diagnósticas I-EXPLORATION +iniciales I-EXPLORATION +(gastroscopia, I-EXPLORATION +colonoscopia I-EXPLORATION +y I-EXPLORATION +tránsito I-EXPLORATION +gastrointestinal), I-EXPLORATION +pero I-EXPLORATION sin I-EXPLORATION -repercusión I-EXPLORATION -clínica. I-EXPLORATION +conseguir I-EXPLORATION +llegar I-EXPLORATION +al I-EXPLORATION +diagnóstico. I-EXPLORATION Se I-EXPLORATION realizó I-EXPLORATION -electroencefalograma I-EXPLORATION -con I-EXPLORATION -trazado I-EXPLORATION -normal, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION TC I-EXPLORATION -craneal I-EXPLORATION +abdominal I-EXPLORATION +que I-EXPLORATION +objetivo I-EXPLORATION +un I-EXPLORATION +engrosamiento I-EXPLORATION +mural I-EXPLORATION +concéntrico I-EXPLORATION +ileal I-EXPLORATION con I-EXPLORATION -y I-EXPLORATION +realce I-EXPLORATION +homogéneo I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +pared I-EXPLORATION +de I-EXPLORATION +unos I-EXPLORATION +8 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +longitud. I-EXPLORATION +Los I-EXPLORATION +hallazgos I-EXPLORATION +sugerían I-EXPLORATION +como I-EXPLORATION +primera I-EXPLORATION +posibilidad I-EXPLORATION +una I-EXPLORATION +enfermedad I-EXPLORATION +inflamatoria I-EXPLORATION +intestinal I-EXPLORATION +crónica I-EXPLORATION +tipo I-EXPLORATION +enfermedad I-EXPLORATION +de I-EXPLORATION +Crohn, I-EXPLORATION +pero I-EXPLORATION sin I-EXPLORATION -contraste I-EXPLORATION +poder I-EXPLORATION +descartarse I-EXPLORATION +linfoma I-EXPLORATION +intestinal. I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT +rechazó I-TREATMENT +el I-TREATMENT +estudio I-TREATMENT +con I-TREATMENT +cápsula I-TREATMENT +endoscópica, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +empírico I-TREATMENT +con I-TREATMENT +5-ASA I-TREATMENT +y I-TREATMENT +hierro I-TREATMENT +intravenoso. I-TREATMENT + I-TREATMENT +Fue B-EVOLUTION +ingresado I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +hospital I-EVOLUTION +dos I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +por I-EVOLUTION +anemia I-EVOLUTION +severa I-EVOLUTION +(hemoglobina: I-EVOLUTION +4, I-EVOLUTION +8 I-EVOLUTION +g/dl), I-EVOLUTION +secundaria I-EVOLUTION +a I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION +melenas, I-EVOLUTION +aceptando B-TREATMENT +esta I-TREATMENT +vez I-TREATMENT +realizarse I-TREATMENT +cápsula I-TREATMENT +endoscópica. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION mostró I-EXPLORATION una I-EXPLORATION -morfología I-EXPLORATION -cerebral I-EXPLORATION -dentro I-EXPLORATION +gran I-EXPLORATION +lesión I-EXPLORATION +polipoidea I-EXPLORATION +submucosa I-EXPLORATION de I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -Lues I-EXPLORATION +color I-EXPLORATION +violáceo I-EXPLORATION en I-EXPLORATION -los I-EXPLORATION -test I-EXPLORATION -RPR I-EXPLORATION -y I-EXPLORATION -TPHA I-EXPLORATION -fueron I-EXPLORATION -positivos. I-EXPLORATION -El I-EXPLORATION -ácido I-EXPLORATION -fólico I-EXPLORATION -y I-EXPLORATION +una I-EXPLORATION +zona I-EXPLORATION +que I-EXPLORATION +parecía I-EXPLORATION +corresponder I-EXPLORATION +a I-EXPLORATION +íleon I-EXPLORATION +proximal, I-EXPLORATION +que I-EXPLORATION +ocluía I-EXPLORATION la I-EXPLORATION -vitamina I-EXPLORATION -B12 I-EXPLORATION -estaban I-EXPLORATION -dentro I-EXPLORATION -del I-EXPLORATION -rango I-EXPLORATION +mitad I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -normalidad. I-EXPLORATION - I-EXPLORATION -El B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -derivado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestras I-DERIVED_FROM/TO -consultas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Urodinámica I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -trastornos I-DERIVED_FROM/TO -miccionales I-DERIVED_FROM/TO -refiriendo I-DERIVED_FROM/TO -incontinencia I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -urgencia, I-DERIVED_FROM/TO -no I-DERIVED_FROM/TO -precisando I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -prensa I-DERIVED_FROM/TO -abdominal I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -vaciado I-DERIVED_FROM/TO -vesical. I-DERIVED_FROM/TO -Se B-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -urodinámico I-EXPLORATION -objetivándose I-EXPLORATION -un I-EXPLORATION -detrusor I-EXPLORATION -hiperrefléxico I-EXPLORATION -con I-EXPLORATION -presiones I-EXPLORATION -altas I-EXPLORATION +circunferencia I-EXPLORATION +ileal I-EXPLORATION y I-EXPLORATION -contracciones I-EXPLORATION -involuntarias I-EXPLORATION -no I-EXPLORATION -inhibidas I-EXPLORATION -que I-EXPLORATION -ocasionaban I-EXPLORATION -escapes; I-EXPLORATION -la I-EXPLORATION -curva I-EXPLORATION +pareciendo I-EXPLORATION +rezumar I-EXPLORATION +sangre I-EXPLORATION de I-EXPLORATION -Presión/ I-EXPLORATION -Flujo I-EXPLORATION -no I-EXPLORATION -mostraba I-EXPLORATION -alteraciones. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT +dicha I-EXPLORATION +zona. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +laparotomía I-TREATMENT +encontrando I-TREATMENT +una I-TREATMENT +tumoración I-TREATMENT de I-TREATMENT -detrusor I-TREATMENT -hiperactivo I-TREATMENT +10 I-TREATMENT +cm I-TREATMENT de I-TREATMENT -causa I-TREATMENT -neurogénica I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -anticolinérgicos, I-TREATMENT -estando B-EVOLUTION -en I-EVOLUTION +longitud I-TREATMENT +de I-TREATMENT +color I-TREATMENT +púrpura, I-TREATMENT +vascularizada, I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +resecada, I-TREATMENT +siendo I-TREATMENT +diagnosticado I-TREATMENT +histológicamente I-TREATMENT +como I-TREATMENT +hemangioma I-TREATMENT +cavernoso I-TREATMENT +gigante I-TREATMENT +de I-TREATMENT +intestino I-TREATMENT +delgado. I-TREATMENT + I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +cinco I-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION la I-EVOLUTION -actualidad I-EVOLUTION -estable I-EVOLUTION -clínicamente I-EVOLUTION +cirugía, I-EVOLUTION +permanecido I-EVOLUTION +posteriormente I-EVOLUTION +asintomático, I-EVOLUTION con I-EVOLUTION -urgencia I-EVOLUTION -ocasional I-EVOLUTION -sin I-EVOLUTION -incontinencia. I-EVOLUTION +análisis I-EVOLUTION +de I-EVOLUTION +sangre I-EVOLUTION +normales I-EVOLUTION +desde I-EVOLUTION +entonces. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS -femenina, I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -27 I-PRESENT_ILLNESS +43 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -blanca, I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -cólico I-PRESENT_ILLNESS -nefrítico I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS -Se B-EXPLORATION -le I-EXPLORATION -realiza I-EXPLORATION -ultrasonido I-EXPLORATION -donde I-EXPLORATION +pérdida I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +agudeza I-PRESENT_ILLNESS +visual I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +izquierdo. I-PRESENT_ILLNESS +Como B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +destacaba I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +estrías I-PAST_MEDICAL_HISTORY +angioides I-PAST_MEDICAL_HISTORY +cinco I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +oftalmológica I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION -un I-EXPLORATION -doble I-EXPLORATION -sistema I-EXPLORATION -pieloureteral I-EXPLORATION +objetivó I-EXPLORATION +una I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +lejana I-EXPLORATION +de I-EXPLORATION +unidad I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +ojo I-EXPLORATION derecho I-EXPLORATION -con I-EXPLORATION -litiasis I-EXPLORATION +y I-EXPLORATION de I-EXPLORATION -6 I-EXPLORATION -mm I-EXPLORATION +«contar I-EXPLORATION +dedos» I-EXPLORATION +a I-EXPLORATION +dos I-EXPLORATION +metros I-EXPLORATION en I-EXPLORATION -cáliz I-EXPLORATION -medio, I-EXPLORATION -doble I-EXPLORATION -sistema I-EXPLORATION -pieloureteral I-EXPLORATION +el I-EXPLORATION +ojo I-EXPLORATION izquierdo. I-EXPLORATION -En I-EXPLORATION +La I-EXPLORATION +tensión I-EXPLORATION +ocular I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -urografía I-EXPLORATION -excretora I-EXPLORATION -se I-EXPLORATION -confirma I-EXPLORATION +biomicroscopía I-EXPLORATION +estaban I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +parámetros I-EXPLORATION +normales. I-EXPLORATION +La I-EXPLORATION +oftalmoscopia I-EXPLORATION +bajo I-EXPLORATION +dilatación I-EXPLORATION +mostró, I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +ojos, I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION +lesiones I-EXPLORATION +lineales I-EXPLORATION +serpenteantes I-EXPLORATION +radiales I-EXPLORATION +al I-EXPLORATION +disco I-EXPLORATION +óptico I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +extendían I-EXPLORATION +hacia I-EXPLORATION la I-EXPLORATION -litiasis I-EXPLORATION -renal I-EXPLORATION -derecha, I-EXPLORATION -con I-EXPLORATION -doble I-EXPLORATION -sistema I-EXPLORATION -pieloureteral I-EXPLORATION -derecho I-EXPLORATION -e I-EXPLORATION -hidronefrosis I-EXPLORATION -derecha, I-EXPLORATION +periferia. I-EXPLORATION +Además, I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION +ojo I-EXPLORATION +izquierdo, I-EXPLORATION se I-EXPLORATION -observan I-EXPLORATION -tres I-EXPLORATION -sistemas I-EXPLORATION -ureteropielocaliciales. I-EXPLORATION -Con I-EXPLORATION -el I-EXPLORATION -objetivo I-EXPLORATION +apreciaba I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +cicatricial I-EXPLORATION de I-EXPLORATION -poder I-EXPLORATION -visualizar I-EXPLORATION -la I-EXPLORATION -desembocadura I-EXPLORATION +gran I-EXPLORATION +tamaño I-EXPLORATION +con I-EXPLORATION +áreas I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -uréteres I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -vejiga I-EXPLORATION -realizamos I-EXPLORATION -urografía I-EXPLORATION -excretora I-EXPLORATION -por I-EXPLORATION -venoclisis I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -confirma I-EXPLORATION -en I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -los I-EXPLORATION -tres I-EXPLORATION -sistemas I-EXPLORATION -ureteropielocaliciales I-EXPLORATION +movilización I-EXPLORATION +de I-EXPLORATION +pigmento I-EXPLORATION y I-EXPLORATION +fibrosis I-EXPLORATION +que I-EXPLORATION +englobaba I-EXPLORATION +toda I-EXPLORATION +el I-EXPLORATION +área I-EXPLORATION +macular. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +angiografía I-EXPLORATION +fluoresceínica I-EXPLORATION +(AGF) I-EXPLORATION +con I-EXPLORATION los I-EXPLORATION -tres I-EXPLORATION -uréteres I-EXPLORATION -desembocando I-EXPLORATION -independientes I-EXPLORATION +siguientes I-EXPLORATION +resultados: I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -vejiga. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -TAC I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION el I-EXPLORATION -triple I-EXPLORATION -sistema I-EXPLORATION -ureteropielocalicial I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION +ojo I-EXPLORATION +derecho I-EXPLORATION +se I-EXPLORATION +apreciaron I-EXPLORATION +unas I-EXPLORATION +líneas I-EXPLORATION +hipo I-EXPLORATION +e I-EXPLORATION +hiperfluorescentes I-EXPLORATION con I-EXPLORATION -entrada I-EXPLORATION -independiente I-EXPLORATION +movilización I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -uréteres I-EXPLORATION -en I-EXPLORATION -vejiga. I-EXPLORATION +pigmento I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +macular I-EXPLORATION +sin I-EXPLORATION +difusión I-EXPLORATION +de I-EXPLORATION +contraste. I-EXPLORATION En I-EXPLORATION -la I-EXPLORATION -cistoscopia I-EXPLORATION +el I-EXPLORATION +ojo I-EXPLORATION +izquierdo I-EXPLORATION se I-EXPLORATION observaron I-EXPLORATION -tres I-EXPLORATION -meatos I-EXPLORATION -ureterales I-EXPLORATION -del I-EXPLORATION -lado I-EXPLORATION -izquierdo, I-EXPLORATION -uno I-EXPLORATION +la I-EXPLORATION +mismas I-EXPLORATION +lesiones I-EXPLORATION +lineales I-EXPLORATION +acompañadas I-EXPLORATION de I-EXPLORATION -ellos I-EXPLORATION -por I-EXPLORATION -delante I-EXPLORATION -del I-EXPLORATION -trígono, I-EXPLORATION -cerca I-EXPLORATION -del I-EXPLORATION -cuello, I-EXPLORATION -otro I-EXPLORATION +un I-EXPLORATION +área I-EXPLORATION +hipo I-EXPLORATION +e I-EXPLORATION +hiperfluorescente I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +macular I-EXPLORATION +sin I-EXPLORATION +difusión I-EXPLORATION +de I-EXPLORATION +contraste I-EXPLORATION en I-EXPLORATION +tiempos I-EXPLORATION +tardíos I-EXPLORATION +siendo I-EXPLORATION el I-EXPLORATION -trígono I-EXPLORATION +diagnóstico I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +estrías I-EXPLORATION +angioides I-EXPLORATION +bilaterales I-EXPLORATION y I-EXPLORATION +además, I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -último I-EXPLORATION -por I-EXPLORATION -encima I-EXPLORATION -del I-EXPLORATION -mismo, I-EXPLORATION -del I-EXPLORATION -lado I-EXPLORATION -derecho I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -dos I-EXPLORATION -meatos I-EXPLORATION -ureterales. I-EXPLORATION -Todos I-EXPLORATION -eyaculando I-EXPLORATION -orinas I-EXPLORATION -claras I-EXPLORATION -y I-EXPLORATION +ojo I-EXPLORATION +izquierdo, I-EXPLORATION +complicadas I-EXPLORATION con I-EXPLORATION -el I-EXPLORATION -aspecto I-EXPLORATION -de I-EXPLORATION -'hoyo I-EXPLORATION -de I-EXPLORATION -golf'. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -intervenido B-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -hipospadias I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -correcta I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -micción I-PAST_MEDICAL_HISTORY -confortable. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -urólogo I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -sordo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ingle I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tamaño I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -testículo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -varias I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración, I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -un I-EXPLORATION -testículo I-EXPLORATION -izquierdo I-EXPLORATION -muy I-EXPLORATION -aumentado I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -totalidad, I-EXPLORATION -irregular I-EXPLORATION -e I-EXPLORATION -indurado I-EXPLORATION -sugestivo I-EXPLORATION -de I-EXPLORATION -tumor I-EXPLORATION -testicular I-EXPLORATION -con I-EXPLORATION -resto I-EXPLORATION +una I-EXPLORATION +membrana I-EXPLORATION +neovascular I-EXPLORATION +subretiniana I-EXPLORATION +no I-EXPLORATION +susceptible I-EXPLORATION de I-EXPLORATION +tratamiento. I-EXPLORATION +Se B-EVOLUTION +aconsejó I-EVOLUTION +el I-EVOLUTION +seguimiento I-EVOLUTION +clínico I-EVOLUTION +periódico. I-EVOLUTION + I-EVOLUTION +Dos I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +acudió I-EVOLUTION +refiriendo I-EVOLUTION +empeoramiento I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +agudeza I-EVOLUTION +visual, I-EVOLUTION +esta I-EVOLUTION +vez, I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +ojo I-EVOLUTION +derecho. I-EVOLUTION +La B-EXPLORATION exploración I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION +oftalmológica I-EXPLORATION +reveló I-EXPLORATION una I-EXPLORATION -ecografía I-EXPLORATION -testicular I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -describe I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -quístico I-EXPLORATION -con I-EXPLORATION -tabiques I-EXPLORATION -finos I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -granuloma I-EXPLORATION -con I-EXPLORATION -calcificaciones I-EXPLORATION -intratesticular I-EXPLORATION -y I-EXPLORATION -fuera I-EXPLORATION -del I-EXPLORATION -testículo I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION de I-EXPLORATION -polo I-EXPLORATION -inferior I-EXPLORATION -otro I-EXPLORATION -quiste I-EXPLORATION +unidad I-EXPLORATION con I-EXPLORATION -múltiples I-EXPLORATION -ecos I-EXPLORATION +dificultad I-EXPLORATION en I-EXPLORATION -su I-EXPLORATION -interior I-EXPLORATION -a I-EXPLORATION -descartar I-EXPLORATION -quiste I-EXPLORATION -epidermoide I-EXPLORATION -o I-EXPLORATION -hidatídico. I-EXPLORATION -Los I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -alfa I-EXPLORATION -fetoproteína I-EXPLORATION +el I-EXPLORATION +ojo I-EXPLORATION +derecho I-EXPLORATION y I-EXPLORATION -BHCG I-EXPLORATION -se I-EXPLORATION -encontraban I-EXPLORATION -dentro I-EXPLORATION de I-EXPLORATION -parámetros I-EXPLORATION -normales. I-EXPLORATION -En I-EXPLORATION +«contar I-EXPLORATION +dedos» I-EXPLORATION +a I-EXPLORATION +dos I-EXPLORATION +metros I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -TAC I-EXPLORATION -solicitado I-EXPLORATION -durante I-EXPLORATION +ojo I-EXPLORATION +izquierdo. I-EXPLORATION +Funduscópicamente, I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -ingreso I-EXPLORATION -del I-EXPLORATION -paciente I-EXPLORATION +ojo I-EXPLORATION +derecho, I-EXPLORATION se I-EXPLORATION -evidenciaba I-EXPLORATION +apreció I-EXPLORATION una I-EXPLORATION -tumoración I-EXPLORATION -sólida I-EXPLORATION -retroperitoneal I-EXPLORATION -izquierda I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -hilio I-EXPLORATION -renal I-EXPLORATION -lateroaórtica I-EXPLORATION +pequeña I-EXPLORATION +hemorragia I-EXPLORATION y I-EXPLORATION -prerrenal I-EXPLORATION +movilización I-EXPLORATION de I-EXPLORATION -54x51x90 I-EXPLORATION -mm I-EXPLORATION +pigmento I-EXPLORATION +en I-EXPLORATION +polo I-EXPLORATION +posterior I-EXPLORATION +con I-EXPLORATION +estrías I-EXPLORATION +anaranjadas, I-EXPLORATION +ya I-EXPLORATION +presentes I-EXPLORATION +en I-EXPLORATION +exploraciones I-EXPLORATION +previas. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +AGF I-EXPLORATION +del I-EXPLORATION +ojo I-EXPLORATION +derecho I-EXPLORATION +que I-EXPLORATION +puso I-EXPLORATION +de I-EXPLORATION +manifiesto I-EXPLORATION +una I-EXPLORATION +hiperfluorescencia I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +macular I-EXPLORATION +desde I-EXPLORATION +tiempos I-EXPLORATION +iniciales I-EXPLORATION +rodeada I-EXPLORATION de I-EXPLORATION -diámetro. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -llevó I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -una I-TREATMENT -orquiectomía I-TREATMENT -inguinal I-TREATMENT -izquierda I-TREATMENT -con I-TREATMENT -resultado I-TREATMENT -anatomo-patológico I-TREATMENT -de I-TREATMENT -teratoma I-TREATMENT -maduro I-TREATMENT -puro I-TREATMENT -poco I-TREATMENT -diferenciado I-TREATMENT -limitado I-TREATMENT -a I-TREATMENT -testículo I-TREATMENT -sin I-TREATMENT -invasión I-TREATMENT -vascular I-TREATMENT -que I-TREATMENT -afectaba I-TREATMENT -a I-TREATMENT -túnica I-TREATMENT -albugínea I-TREATMENT -pero I-TREATMENT -no I-TREATMENT -a I-TREATMENT -vaginal, I-TREATMENT -sin I-TREATMENT -afectación I-TREATMENT -de I-TREATMENT -rete I-TREATMENT -testis I-TREATMENT -de I-TREATMENT -5x3x3 I-TREATMENT -mm. I-TREATMENT -de I-TREATMENT -tamaño. I-TREATMENT -El B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -valoración I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -adyuvante. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Nos B-EXPLORATION -encontramos I-EXPLORATION -ante I-EXPLORATION un I-EXPLORATION -tumor I-EXPLORATION -testicular I-EXPLORATION -no I-EXPLORATION -seminomatoso I-EXPLORATION -estadio I-EXPLORATION -pT2 I-EXPLORATION -N3, I-EXPLORATION -M0 I-EXPLORATION -según I-EXPLORATION +halo I-EXPLORATION +hipofluorescente I-EXPLORATION +con I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -clasificación I-EXPLORATION -TNM I-EXPLORATION +fluorescencia I-EXPLORATION +hacia I-EXPLORATION +tiempos I-EXPLORATION +tardíos I-EXPLORATION y I-EXPLORATION +mínima I-EXPLORATION +difusión, I-EXPLORATION +no I-EXPLORATION +existente I-EXPLORATION en I-EXPLORATION -estadio I-EXPLORATION -II I-EXPLORATION -c I-EXPLORATION -sin I-EXPLORATION -factores I-EXPLORATION -de I-EXPLORATION -mal I-EXPLORATION -pronóstico. I-EXPLORATION -En B-TREATMENT -esta I-TREATMENT -situación I-TREATMENT -se I-TREATMENT -plantean I-TREATMENT -dos I-TREATMENT -opciones, I-TREATMENT -comenzar I-TREATMENT +AGF I-EXPLORATION +previas, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +membrana I-EXPLORATION +neovascular I-EXPLORATION +subfoveal. I-EXPLORATION +Se I-EXPLORATION +estableció, I-EXPLORATION +por I-EXPLORATION +tanto, I-EXPLORATION +un I-EXPLORATION +nuevo I-EXPLORATION +diagnóstico, I-EXPLORATION +estrías I-EXPLORATION +angioides I-EXPLORATION +complicadas I-EXPLORATION +con I-EXPLORATION +membrana I-EXPLORATION +neovascular I-EXPLORATION +subfoveal I-EXPLORATION +en I-EXPLORATION +ojo I-EXPLORATION +derecho. I-EXPLORATION +Se B-TREATMENT +le I-TREATMENT +planteó I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -quimioterapia I-TREATMENT +TFD I-TREATMENT y I-TREATMENT -plantear I-TREATMENT -resección I-TREATMENT -si I-TREATMENT -persistía I-TREATMENT -masa I-TREATMENT -residual I-TREATMENT -o I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -linfadenectomia I-TREATMENT -retroperitoneal. I-TREATMENT - I-TREATMENT -Dada I-TREATMENT +tras I-TREATMENT la I-TREATMENT -negatividad I-TREATMENT -de I-TREATMENT -los I-TREATMENT -marcadores I-TREATMENT -tumorales I-TREATMENT -y I-TREATMENT +primera I-TREATMENT +sesión I-TREATMENT +se I-TREATMENT +produjo I-TREATMENT la I-TREATMENT -anatomía I-TREATMENT -patológica I-TREATMENT +reabsorción I-TREATMENT +parcial I-TREATMENT de I-TREATMENT la I-TREATMENT -pieza I-TREATMENT -testicular I-TREATMENT -y I-TREATMENT +hemorragia I-TREATMENT +con I-TREATMENT +mantenimiento I-TREATMENT +de I-TREATMENT la I-TREATMENT -conocida I-TREATMENT -quimioresistencia I-TREATMENT -del I-TREATMENT -teratoma I-TREATMENT -maduro I-TREATMENT -puro I-TREATMENT +pigmentación I-TREATMENT +central. I-TREATMENT +Dichos I-TREATMENT +hallazgos I-TREATMENT se I-TREATMENT -decidió I-TREATMENT +confirmaron I-TREATMENT +con I-TREATMENT la I-TREATMENT -realización I-TREATMENT +AGF I-TREATMENT +que I-TREATMENT +reveló I-TREATMENT +una I-TREATMENT +ligera I-TREATMENT +difusión I-TREATMENT de I-TREATMENT -linfadenectomía I-TREATMENT -retroperitoneal I-TREATMENT -por I-TREATMENT -las I-TREATMENT -posibilidades I-TREATMENT +contraste I-TREATMENT +en I-TREATMENT +tiempos I-TREATMENT +tardíos. I-TREATMENT +Por I-TREATMENT +ello, I-TREATMENT +a I-TREATMENT +pesar I-TREATMENT de I-TREATMENT -ser I-TREATMENT -curativa I-TREATMENT -si I-TREATMENT -la I-TREATMENT -histología I-TREATMENT -era I-TREATMENT -coincidente I-TREATMENT -con I-TREATMENT -el I-TREATMENT -primario I-TREATMENT -sin I-TREATMENT -existir I-TREATMENT -otros I-TREATMENT -componentes I-TREATMENT -tumorales I-TREATMENT -no I-TREATMENT -seminomatosos. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -linfadenectomía I-TREATMENT -retroperitoneal I-TREATMENT -hasta I-TREATMENT -vasos I-TREATMENT -iliacos I-TREATMENT -obteniendo I-TREATMENT la I-TREATMENT -pieza I-TREATMENT -observada I-TREATMENT -en I-TREATMENT -Figura I-TREATMENT -2. I-TREATMENT -El B-EXPLORATION -resultado I-EXPLORATION -anatomo-patológico I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -teratoma I-EXPLORATION -maduro I-EXPLORATION -puro I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -componentes I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -tres I-EXPLORATION -capas I-EXPLORATION -embrionarias I-EXPLORATION -sin I-EXPLORATION -invasión I-EXPLORATION -linfovascular. I-EXPLORATION -EL B-EVOLUTION -paciente I-EVOLUTION -sigue I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -vigilancia I-EVOLUTION -en I-EVOLUTION -consulta I-EVOLUTION -mediante I-EVOLUTION -marcadores, I-EVOLUTION -TAC I-EVOLUTION -abdominal I-EVOLUTION -y I-EVOLUTION -radiografía I-EVOLUTION -de I-EVOLUTION -tórax I-EVOLUTION -periódicas. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -70 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -blanco, B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -llevando I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -enalapril I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -mg/día, I-PAST_MEDICAL_HISTORY -así I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -prostatismo I-PAST_MEDICAL_HISTORY -caracterizado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -polaquiuria I-PAST_MEDICAL_HISTORY -nocturna I-PAST_MEDICAL_HISTORY -(3-4 I-PAST_MEDICAL_HISTORY -veces I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -noche), I-PAST_MEDICAL_HISTORY -disuria, I-PAST_MEDICAL_HISTORY -chorro I-PAST_MEDICAL_HISTORY -débil, I-PAST_MEDICAL_HISTORY -micción I-PAST_MEDICAL_HISTORY -demorada, I-PAST_MEDICAL_HISTORY -micciones I-PAST_MEDICAL_HISTORY -imperiosas, I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -aproximadamente I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -año, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -mejorando I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -impuesto I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -médico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cabecera I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -llegando I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -RAO. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urología I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -sonda I-PRESENT_ILLNESS -vesical I-PRESENT_ILLNESS -permanente I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -debido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -RAO, I-PRESENT_ILLNESS -fracasando I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -intentos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -retirar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -misma, I-PRESENT_ILLNESS -al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION +recuperación I-TREATMENT +visual, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +aplicar I-TREATMENT +dos I-TREATMENT +sesiones I-TREATMENT +más I-TREATMENT +de I-TREATMENT +TFD. I-TREATMENT +En B-EXPLORATION +la I-EXPLORATION +última I-EXPLORATION +revisión I-EXPLORATION +la I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION se I-EXPLORATION -constata I-EXPLORATION -mucosas: I-EXPLORATION -húmedas I-EXPLORATION -y I-EXPLORATION -normocoloreadas, I-EXPLORATION -tejido I-EXPLORATION -celular I-EXPLORATION -subcutáneo I-EXPLORATION -no I-EXPLORATION -infiltrado, I-EXPLORATION -auscultación I-EXPLORATION -cardiorespiratoria I-EXPLORATION -normal, I-EXPLORATION -abdomen I-EXPLORATION -negativo, I-EXPLORATION -fosas I-EXPLORATION -lumbares I-EXPLORATION -libres, I-EXPLORATION -puntos I-EXPLORATION -pielorreno-ureterales I-EXPLORATION -no I-EXPLORATION -dolorosos, I-EXPLORATION -genitales I-EXPLORATION -externos I-EXPLORATION +mantenía I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +unidad I-EXPLORATION y I-EXPLORATION -regiones I-EXPLORATION -inguinales I-EXPLORATION -normales, I-EXPLORATION -al I-EXPLORATION -tacto I-EXPLORATION -rectal I-EXPLORATION +angiográficamente I-EXPLORATION se I-EXPLORATION -palpa I-EXPLORATION +observaba I-EXPLORATION una I-EXPLORATION -próstata I-EXPLORATION -aumentada I-EXPLORATION -de I-EXPLORATION -volumen, I-EXPLORATION -superficie I-EXPLORATION -regular, I-EXPLORATION -bien I-EXPLORATION -delimitada, I-EXPLORATION -consistencia I-EXPLORATION -fibroadenomatosa, I-EXPLORATION -grado I-EXPLORATION -III, I-EXPLORATION +lesión I-EXPLORATION +hipo I-EXPLORATION +e I-EXPLORATION +hiperfluorescente I-EXPLORATION compatible I-EXPLORATION con I-EXPLORATION una I-EXPLORATION -hiperplasia I-EXPLORATION -benigna I-EXPLORATION -de I-EXPLORATION -próstata I-EXPLORATION -(HBP). I-EXPLORATION -Analítica I-EXPLORATION -sanguínea I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -hemoglobina, I-EXPLORATION -hematocrito, I-EXPLORATION -leucocitos I-EXPLORATION -totales, I-EXPLORATION -urea I-EXPLORATION -creatinina, I-EXPLORATION -PSA I-EXPLORATION -y I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina, I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Ecográfícamente I-EXPLORATION -llamó I-EXPLORATION -la I-EXPLORATION -atención I-EXPLORATION +lesión I-EXPLORATION +cicatricial I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION +área I-EXPLORATION +macular. I-EXPLORATION +En I-EXPLORATION +tiempos I-EXPLORATION +angiográficos I-EXPLORATION +medios I-EXPLORATION +aparecía I-EXPLORATION +un I-EXPLORATION aumento I-EXPLORATION de I-EXPLORATION -volumen I-EXPLORATION -prostático I-EXPLORATION -con I-EXPLORATION -ecogenicidad I-EXPLORATION -heterogénea. I-EXPLORATION - I-EXPLORATION -Dado B-TREATMENT -el I-TREATMENT -cuadro I-TREATMENT -clínico I-TREATMENT -y I-TREATMENT -los I-TREATMENT -antecedentes, I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -tratamiento I-TREATMENT -quirúrgico, I-TREATMENT -realizándosele I-TREATMENT -una I-TREATMENT -prostatectomía I-TREATMENT -retropúbica. I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -se I-EXPLORATION -describe I-EXPLORATION -un I-EXPLORATION -fragmento I-EXPLORATION -de I-EXPLORATION -próstata I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -linfocitario I-EXPLORATION -monomorfo, I-EXPLORATION +hiperfluorescencia I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -corresponde I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -linfoma I-EXPLORATION -linfocítico I-EXPLORATION -bien I-EXPLORATION -diferenciado. I-EXPLORATION -Posteriormente B-TREATMENT -es I-TREATMENT -remitido I-TREATMENT -al I-TREATMENT -servicio I-TREATMENT -de I-TREATMENT -Oncología I-TREATMENT -donde I-TREATMENT -la I-TREATMENT -aplican I-TREATMENT -tratamiento I-TREATMENT -radioterapia. I-TREATMENT -Actualmente B-EVOLUTION -continúa I-EVOLUTION -seguimiento I-EVOLUTION -en I-EVOLUTION -consulta I-EVOLUTION -de I-EVOLUTION -Urología. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -solicitar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -realización I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -vasectomía. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -los I-EXPLORATION -testes I-EXPLORATION -eran I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -y I-EXPLORATION -tamaño I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -pene I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -torsión I-EXPLORATION +mantenía I-EXPLORATION +en I-EXPLORATION +tiempos I-EXPLORATION +tardíos, I-EXPLORATION +pero I-EXPLORATION +sin I-EXPLORATION +difusión I-EXPLORATION de I-EXPLORATION -unos I-EXPLORATION -60 I-EXPLORATION -grados. I-EXPLORATION -Hasta I-EXPLORATION -la I-EXPLORATION -fecha, I-EXPLORATION -dicha I-EXPLORATION -alteración I-EXPLORATION -no I-EXPLORATION -le I-EXPLORATION -había I-EXPLORATION -producido I-EXPLORATION -sintomatología I-EXPLORATION -alguna. I-EXPLORATION +contraste. I-EXPLORATION I-EXPLORATION Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +hombre I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -61 I-PRESENT_ILLNESS -años B-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY +23 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -acudió B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -escrotal I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -aparecida I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -ido I-PRESENT_ILLNESS -creciendo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tamaño I-PRESENT_ILLNESS -muy I-PRESENT_ILLNESS -lentamente I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS +mórbidos I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS +ictal I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -presencia I-PRESENT_ILLNESS +compromiso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -hernia I-PRESENT_ILLNESS -inguinal I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -el I-EXPLORATION -testículo I-EXPLORATION -derecho I-EXPLORATION -parecía I-EXPLORATION -situarse I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -raíz I-EXPLORATION -escrotal, I-EXPLORATION +conciencia I-PRESENT_ILLNESS +cuantitativo I-PRESENT_ILLNESS +progresivo. I-PRESENT_ILLNESS +Consultó B-EXPLORATION +inicialmente I-EXPLORATION +en I-EXPLORATION +otro I-EXPLORATION +hospital I-EXPLORATION +donde I-EXPLORATION se I-EXPLORATION -apreciaba I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -móvil I-EXPLORATION +diagnosticó I-EXPLORATION +mediante I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION de I-EXPLORATION -consistencia I-EXPLORATION -elástica I-EXPLORATION +encéfalo I-EXPLORATION +un I-EXPLORATION +hematoma I-EXPLORATION +intraparenquimatoso I-EXPLORATION +parietal I-EXPLORATION +derecho I-EXPLORATION +de I-EXPLORATION +42 I-EXPLORATION +ml, I-EXPLORATION +asociado I-EXPLORATION +a I-EXPLORATION +hidrocefalia I-EXPLORATION +aguda. I-EXPLORATION +En I-EXPLORATION +pabellón I-EXPLORATION y I-EXPLORATION -suave I-EXPLORATION de I-EXPLORATION -unos I-EXPLORATION -15 I-EXPLORATION +forma I-EXPLORATION +urgente, I-EXPLORATION +se I-EXPLORATION +instaló I-EXPLORATION +un I-EXPLORATION +drenaje I-EXPLORATION +ventricular I-EXPLORATION +externo I-EXPLORATION +(DVE). I-EXPLORATION +Se I-EXPLORATION +registróuna I-EXPLORATION +presión I-EXPLORATION +intracraneana I-EXPLORATION +(PIC) I-EXPLORATION +inicial I-EXPLORATION +de I-EXPLORATION +45 I-EXPLORATION cm I-EXPLORATION -que I-EXPLORATION -ocupaba I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -hemiescroto. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -clínico I-EXPLORATION -fue I-EXPLORATION de I-EXPLORATION -lipoma I-EXPLORATION -escrotal. I-EXPLORATION +H2O. I-EXPLORATION +Se I-EXPLORATION +conectó I-EXPLORATION +a I-EXPLORATION +ventilación I-EXPLORATION +mecánica I-EXPLORATION +(VM) I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +indicó I-EXPLORATION +sedación I-EXPLORATION +profunda. I-EXPLORATION +Inicialmente, B-EVOLUTION +la I-EVOLUTION +hipertensión I-EVOLUTION +intracraneana I-EVOLUTION +se I-EVOLUTION +trató I-EVOLUTION +con I-EVOLUTION +drenaje I-EVOLUTION +de I-EVOLUTION +líquido I-EVOLUTION +cefalorraquídeo I-EVOLUTION +y I-EVOLUTION +sodio I-EVOLUTION +hipertónico I-EVOLUTION +intravenoso I-EVOLUTION +en I-EVOLUTION +bolos, I-EVOLUTION +según I-EVOLUTION +necesidad. I-EVOLUTION +Se I-EVOLUTION +trasladó I-EVOLUTION +a I-EVOLUTION +nuestro I-EVOLUTION +servicio I-EVOLUTION +tres I-EVOLUTION +días I-EVOLUTION +más I-EVOLUTION +tarde. I-EVOLUTION + I-EVOLUTION +Ingresó I-EVOLUTION +intubado I-EVOLUTION +y I-EVOLUTION +conectado I-EVOLUTION +a I-EVOLUTION +VM, I-EVOLUTION +sedado I-EVOLUTION +con I-EVOLUTION +propofol I-EVOLUTION +0, I-EVOLUTION +71 I-EVOLUTION +mg/kg/h, I-EVOLUTION +y I-EVOLUTION +hemodinamia I-EVOLUTION +apoyada I-EVOLUTION +con I-EVOLUTION +noradrenalina I-EVOLUTION +a I-EVOLUTION +0, I-EVOLUTION +06 I-EVOLUTION +μg/kg/min, I-EVOLUTION +PIC I-EVOLUTION +de I-EVOLUTION +6 I-EVOLUTION +cm I-EVOLUTION +de I-EVOLUTION +H2O I-EVOLUTION +y I-EVOLUTION +presión I-EVOLUTION +de I-EVOLUTION +perfusión I-EVOLUTION +cerebral I-EVOLUTION +(PPC) I-EVOLUTION +de I-EVOLUTION +80 I-EVOLUTION +mmHg. I-EVOLUTION +En B-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +neurológico I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +en I-EXPLORATION +coma, I-EXPLORATION +con I-EXPLORATION +midriasis I-EXPLORATION +fija I-EXPLORATION +a I-EXPLORATION +derecha, I-EXPLORATION +reflejos I-EXPLORATION +corneales I-EXPLORATION +abolidos, I-EXPLORATION +reflejos I-EXPLORATION +oculocefálicos I-EXPLORATION +esbozados, I-EXPLORATION +tono I-EXPLORATION +y I-EXPLORATION +reflejos I-EXPLORATION +osteotendíneos I-EXPLORATION +disminuidos, I-EXPLORATION +reflejos I-EXPLORATION +plantares I-EXPLORATION +indiferentes I-EXPLORATION +bilaterales. I-EXPLORATION I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION +Exámenes I-EXPLORATION +generales I-EXPLORATION de I-EXPLORATION -sangre I-EXPLORATION +ingreso: I-EXPLORATION +Na+ I-EXPLORATION +146 I-EXPLORATION +mEq/L, I-EXPLORATION +K+ I-EXPLORATION +3, I-EXPLORATION +5 I-EXPLORATION +mEq/L, I-EXPLORATION +hematocrito I-EXPLORATION +31%, I-EXPLORATION +lactato I-EXPLORATION +1, I-EXPLORATION +4 I-EXPLORATION +mmol/L, I-EXPLORATION +leucocitos I-EXPLORATION +9.600 I-EXPLORATION +por I-EXPLORATION +mm3 I-EXPLORATION y I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +11, I-EXPLORATION +4 I-EXPLORATION +mg/dl. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +angiografía I-EXPLORATION +cerebral I-EXPLORATION de I-EXPLORATION -orina, I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION +6 I-EXPLORATION +vasos I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +malformación I-EXPLORATION +arteriovenosa I-EXPLORATION +(MAV) I-EXPLORATION +parietal I-EXPLORATION +mesial I-EXPLORATION +derecha I-EXPLORATION +con I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -electrocardiograma I-EXPLORATION -fueron I-EXPLORATION -todos I-EXPLORATION -normales. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -escrotal I-EXPLORATION -y B-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -la I-TREATMENT -intervención. I-TREATMENT - I-TREATMENT -Durante I-TREATMENT -la I-TREATMENT -operación, I-TREATMENT -en I-TREATMENT -primer I-TREATMENT -lugar, I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -reparación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -hernia I-TREATMENT -inguinal I-TREATMENT -izquierda I-TREATMENT +rotura I-EXPLORATION +reciente, I-EXPLORATION +asociada I-EXPLORATION +a I-EXPLORATION +tres I-EXPLORATION +aneurismas I-EXPLORATION +paranidales. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +embolización I-TREATMENT con I-TREATMENT -malla I-TREATMENT +N-butil-cianocrilato I-TREATMENT +(Histoacryl®, I-TREATMENT +Braun, I-TREATMENT +Alemania), I-TREATMENT +logrando I-TREATMENT +reducir I-TREATMENT +el I-TREATMENT +nido I-TREATMENT de I-TREATMENT -prolene I-TREATMENT +la I-TREATMENT +MAV I-TREATMENT y I-TREATMENT -después I-TREATMENT -se I-TREATMENT +excluir I-TREATMENT +sus I-TREATMENT +aneurismas. I-TREATMENT +Después I-TREATMENT +del I-TREATMENT +procedimiento, I-TREATMENT +la I-TREATMENT +TC I-TREATMENT +de I-TREATMENT +encéfalo I-TREATMENT +mostró I-TREATMENT +el I-TREATMENT +Histoacryl® I-TREATMENT +correctamente I-TREATMENT +situado. I-TREATMENT +Sin B-EVOLUTION +embargo, I-EVOLUTION +se I-EVOLUTION +observó I-EVOLUTION +un I-EVOLUTION +incremento I-EVOLUTION +del I-EVOLUTION +hematoma I-EVOLUTION +con I-EVOLUTION +acentuado I-EVOLUTION +efecto I-EVOLUTION +de I-EVOLUTION +masa I-EVOLUTION +y I-EVOLUTION +presencia I-EVOLUTION +de I-EVOLUTION +edema I-EVOLUTION +cerebral I-EVOLUTION +difuso I-EVOLUTION +con I-EVOLUTION +obliteración I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +surcos I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +convexidad, I-EVOLUTION +además I-EVOLUTION +de I-EVOLUTION +herniaciones I-EVOLUTION +subfalcina I-EVOLUTION +y I-EVOLUTION +uncal I-EVOLUTION +con I-EVOLUTION +desviación I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +línea I-EVOLUTION +media I-EVOLUTION +de I-EVOLUTION +10 I-EVOLUTION +mm, I-EVOLUTION +a I-EVOLUTION +nivel I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +glándula I-EVOLUTION +pineal. I-EVOLUTION +Se B-TREATMENT realizó I-TREATMENT la I-TREATMENT -exploración I-TREATMENT +evacuación I-TREATMENT del I-TREATMENT -hemiescroto I-TREATMENT -derecho. I-TREATMENT - I-TREATMENT -A I-TREATMENT -través I-TREATMENT -de I-TREATMENT +hematoma I-TREATMENT +y I-TREATMENT una I-TREATMENT -primera I-TREATMENT -incisión I-TREATMENT -cutánea I-TREATMENT -escrotal I-TREATMENT +craniectomía I-TREATMENT +descompresiva I-TREATMENT +frontoparietoccipital I-TREATMENT derecha I-TREATMENT -intentamos I-TREATMENT -aislar I-TREATMENT +extensa I-TREATMENT +de I-TREATMENT +10, I-TREATMENT +2 I-TREATMENT +x I-TREATMENT +9, I-TREATMENT +3 I-TREATMENT +cm. I-TREATMENT +La I-TREATMENT +TC I-TREATMENT +de I-TREATMENT +encéfalo I-TREATMENT +de I-TREATMENT +control I-TREATMENT +al I-TREATMENT +día I-TREATMENT +siguiente I-TREATMENT +mostró I-TREATMENT una I-TREATMENT -voluminosa I-TREATMENT -masa I-TREATMENT -blanquecina. I-TREATMENT -Sin I-TREATMENT -embargo, I-TREATMENT -por I-TREATMENT -la I-TREATMENT -dificultad I-TREATMENT -que I-TREATMENT -teníamos I-TREATMENT -en I-TREATMENT -separar I-TREATMENT +reducción I-TREATMENT +del I-TREATMENT +hematoma I-TREATMENT +a I-TREATMENT +11 I-TREATMENT +ml, I-TREATMENT +pero I-TREATMENT +aún I-TREATMENT +se I-TREATMENT +mantenía I-TREATMENT +un I-TREATMENT +importante I-TREATMENT +efecto I-TREATMENT +de I-TREATMENT +masa, I-TREATMENT +con I-TREATMENT +desviación I-TREATMENT +de I-TREATMENT la I-TREATMENT -neoformación I-TREATMENT +línea I-TREATMENT +media I-TREATMENT de I-TREATMENT -los I-TREATMENT -tejidos I-TREATMENT -circundantes I-TREATMENT +5 I-TREATMENT +mm. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +pesar I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +craniectomía I-EVOLUTION +evolucionó I-EVOLUTION +con I-EVOLUTION +PIC I-EVOLUTION +mayores I-EVOLUTION +a I-EVOLUTION +20 I-EVOLUTION +cm I-EVOLUTION +H2O I-EVOLUTION +(23 I-EVOLUTION +± I-EVOLUTION +5 I-EVOLUTION +cm I-EVOLUTION +H2O; I-EVOLUTION +media I-EVOLUTION +± I-EVOLUTION +DS). I-EVOLUTION +Se B-TREATMENT +instauró I-TREATMENT +un I-TREATMENT +manejo I-TREATMENT +médico I-TREATMENT +escalonado I-TREATMENT +de I-TREATMENT +la I-TREATMENT +HEC, I-TREATMENT +con I-TREATMENT +sedación I-TREATMENT +profunda I-TREATMENT +(fentanilo I-TREATMENT +2, I-TREATMENT +86 I-TREATMENT +μg/kg/h, I-TREATMENT +midazolam I-TREATMENT +0, I-TREATMENT +11 I-TREATMENT +mg/kg/h I-TREATMENT y I-TREATMENT -encontrar I-TREATMENT -el I-TREATMENT -testículo I-TREATMENT -derecho, I-TREATMENT -que I-TREATMENT -estaba I-TREATMENT -envuelto I-TREATMENT -por I-TREATMENT +propofol I-TREATMENT +1, I-TREATMENT +43 I-TREATMENT +mg/kg/h), I-TREATMENT +bloqueo I-TREATMENT +neuromuscular I-TREATMENT +(vecuronio I-TREATMENT +0, I-TREATMENT +09 I-TREATMENT +mg/kg/h), I-TREATMENT +además I-TREATMENT +del I-TREATMENT +uso I-TREATMENT +frecuente I-TREATMENT +de I-TREATMENT +bolos I-TREATMENT +de I-TREATMENT +sodio I-TREATMENT +hipertónico I-TREATMENT +frente I-TREATMENT +a I-TREATMENT +cifras I-TREATMENT +de I-TREATMENT +PIC I-TREATMENT +> I-TREATMENT +30 I-TREATMENT +cm I-TREATMENT +H2O. I-TREATMENT +Se B-EVOLUTION +descartó I-EVOLUTION +actividad I-EVOLUTION +epiléptica I-EVOLUTION +no I-EVOLUTION +convulsiva I-EVOLUTION +mediante I-EVOLUTION +un I-EVOLUTION +electroencefalograma I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +TC I-EVOLUTION +de I-EVOLUTION +encéfalo I-EVOLUTION +48 I-EVOLUTION +h I-EVOLUTION +post I-EVOLUTION +craniectomía I-EVOLUTION +no I-EVOLUTION +mostró I-EVOLUTION +cambios I-EVOLUTION +significativos. I-EVOLUTION +Debido B-TREATMENT +a I-TREATMENT la I-TREATMENT -masa, I-TREATMENT -decidimos I-TREATMENT -eligir I-TREATMENT -otra I-TREATMENT -vía. I-TREATMENT +persistencia I-TREATMENT +de I-TREATMENT +cifras I-TREATMENT +de I-TREATMENT +PIC I-TREATMENT +> I-TREATMENT +a I-TREATMENT +20 I-TREATMENT +cm I-TREATMENT +H2O, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +iniciar I-TREATMENT +hipotermia I-TREATMENT +terapéutica. I-TREATMENT I-TREATMENT Se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -segunda I-TREATMENT -incisión I-TREATMENT -inguinoescrotál I-TREATMENT -a I-TREATMENT -través I-TREATMENT +empleó I-TREATMENT +hipotermia I-TREATMENT +moderada, I-TREATMENT +con I-TREATMENT +temperatura I-TREATMENT +objetivo I-TREATMENT de I-TREATMENT -la I-TREATMENT -cual, I-TREATMENT +33°C, I-TREATMENT mediante I-TREATMENT -disección I-TREATMENT -roma I-TREATMENT -fue I-TREATMENT -más I-TREATMENT -fácil I-TREATMENT -aislar I-TREATMENT -la I-TREATMENT -neoformación, I-TREATMENT -que I-TREATMENT -se I-TREATMENT -extendía I-TREATMENT -superiormente I-TREATMENT -hasta I-TREATMENT +técnica I-TREATMENT +intravascular I-TREATMENT +(Alsius, I-TREATMENT +Zoll, I-TREATMENT +Chelmsford, I-TREATMENT +Massachusetts, I-TREATMENT +EEUU). I-TREATMENT +Se I-TREATMENT +midió I-TREATMENT la I-TREATMENT -altura I-TREATMENT -del I-TREATMENT -anillo I-TREATMENT -inguinal I-TREATMENT -externo. I-TREATMENT +temperatura I-TREATMENT +central I-TREATMENT +con I-TREATMENT +catéter I-TREATMENT +intravesical. I-TREATMENT Una I-TREATMENT vez I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -aislado I-TREATMENT -el I-TREATMENT -cordón I-TREATMENT -espermático I-TREATMENT -conseguimos I-TREATMENT -traer I-TREATMENT -fuera I-TREATMENT -el I-TREATMENT -testículo, I-TREATMENT -que I-TREATMENT -tenía I-TREATMENT -aspecto I-TREATMENT -hipotrófico I-TREATMENT -pero I-TREATMENT -no I-TREATMENT -resultaba I-TREATMENT -afectado. I-TREATMENT -También I-TREATMENT +conseguida I-TREATMENT la I-TREATMENT -resección I-TREATMENT +hipotermia I-TREATMENT +(~12 I-TREATMENT +h I-TREATMENT +desde I-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT de I-TREATMENT -la I-TREATMENT -masa I-TREATMENT -resultaba I-TREATMENT -más I-TREATMENT -facil I-TREATMENT -y I-TREATMENT -segura. I-TREATMENT -Los I-TREATMENT -márgenes I-TREATMENT +HEC I-TREATMENT +refractaria), I-TREATMENT +se I-TREATMENT +logró I-TREATMENT +un I-TREATMENT +rápido I-TREATMENT +control I-TREATMENT de I-TREATMENT la I-TREATMENT -lesión I-TREATMENT -estaban I-TREATMENT -bien I-TREATMENT -delimitados I-TREATMENT -y I-TREATMENT -fáciles I-TREATMENT -de I-TREATMENT -separarse I-TREATMENT +PIC I-TREATMENT +con I-TREATMENT +cifras I-TREATMENT +entre I-TREATMENT +9 I-TREATMENT a I-TREATMENT -excepción I-TREATMENT +12 I-TREATMENT +cm I-TREATMENT +H2O I-TREATMENT +(~3 I-TREATMENT +desde I-TREATMENT +el I-TREATMENT +inicio I-TREATMENT +del I-TREATMENT +procedimiento). I-TREATMENT +El I-TREATMENT +bloqueo I-TREATMENT +neuromuscular I-TREATMENT +se I-TREATMENT +mantuvo I-TREATMENT +en I-TREATMENT +infusión I-TREATMENT +continua I-TREATMENT +los I-TREATMENT +primeros I-TREATMENT +dos I-TREATMENT +días I-TREATMENT +de I-TREATMENT +hipotermia, I-TREATMENT +para I-TREATMENT +evitar I-TREATMENT +los I-TREATMENT +calofríos. I-TREATMENT + I-TREATMENT +Luego I-TREATMENT +de I-TREATMENT +48 I-TREATMENT +h I-TREATMENT +en I-TREATMENT +hipotermia, I-TREATMENT +se I-TREATMENT +realizaron I-TREATMENT +intentos I-TREATMENT +programados I-TREATMENT de I-TREATMENT +recalentamiento I-TREATMENT +a I-TREATMENT una I-TREATMENT -zona I-TREATMENT -del I-TREATMENT -fondo I-TREATMENT +tasa I-TREATMENT +de I-TREATMENT +0, I-TREATMENT +5°C/h. I-TREATMENT +Sin I-TREATMENT +embargo, I-TREATMENT +todos I-TREATMENT +ellos I-TREATMENT +fueron I-TREATMENT +interrumpidos I-TREATMENT +por I-TREATMENT +rebote I-TREATMENT de I-TREATMENT la I-TREATMENT -bolsa I-TREATMENT -escrotal, I-TREATMENT -donde I-TREATMENT -la I-TREATMENT -neoformación I-TREATMENT -tenía I-TREATMENT -más I-TREATMENT -adherencia I-TREATMENT +PIC. I-TREATMENT +A B-EVOLUTION +partir I-EVOLUTION +del I-EVOLUTION +día I-EVOLUTION +20 I-EVOLUTION +de I-EVOLUTION +evolución I-EVOLUTION +del I-EVOLUTION +cuadro I-EVOLUTION +clínico I-EVOLUTION +y I-EVOLUTION +coincidiendo I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +disminución I-EVOLUTION +del I-EVOLUTION +edema I-EVOLUTION +cerebral I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +neuroimágenes, I-EVOLUTION +se I-EVOLUTION +logró I-EVOLUTION +el I-EVOLUTION +control I-EVOLUTION +definitivo I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +PIC. I-EVOLUTION +Completó I-EVOLUTION +~13 I-EVOLUTION +días I-EVOLUTION +en I-EVOLUTION +hipotermia I-EVOLUTION +moderada, I-EVOLUTION +sin I-EVOLUTION +evidenciarse I-EVOLUTION +arritmias, I-EVOLUTION +trastornos I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +coagulación I-EVOLUTION +o I-EVOLUTION +electrolíticos. I-EVOLUTION +Presentó B-TREATMENT +una I-TREATMENT +traqueobronquitis I-TREATMENT +asociada I-TREATMENT +a I-TREATMENT +ventilación I-TREATMENT +mecánica, I-TREATMENT +resuelta I-TREATMENT +satisfactoriamente I-TREATMENT con I-TREATMENT -el I-TREATMENT -dartos. I-TREATMENT +antibioticoterapia. I-TREATMENT I-TREATMENT -El B-EXPLORATION -aspecto I-EXPLORATION -macroscópico I-EXPLORATION -de I-EXPLORATION +Se I-TREATMENT +suspendió I-TREATMENT +progresivamente I-TREATMENT +la I-TREATMENT +sedación, I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +adquirió I-TREATMENT +vigilia I-TREATMENT +y B-EVOLUTION +se I-EVOLUTION +objetivó I-EVOLUTION +una I-EVOLUTION +hemiparesia I-EVOLUTION +leve I-EVOLUTION +con I-EVOLUTION +heminegligencia I-EVOLUTION +y I-EVOLUTION +hemianopsia I-EVOLUTION +homónima I-EVOLUTION +izquierda. I-EVOLUTION +Una I-EVOLUTION +vez I-EVOLUTION +extubado I-EVOLUTION +se I-EVOLUTION +constató I-EVOLUTION +lenguaje I-EVOLUTION +apropiado. I-EVOLUTION +Se B-TREATMENT +inició I-TREATMENT +neurorrehabilitación I-TREATMENT +y B-EVOLUTION +finalmente, I-EVOLUTION +luego I-EVOLUTION +de I-EVOLUTION +40 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +hospitalización, I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta. I-EVOLUTION +Dos I-EVOLUTION +años I-EVOLUTION +después I-EVOLUTION +se I-EVOLUTION +encuentraen I-EVOLUTION +Rankin I-EVOLUTION +2, I-EVOLUTION +con I-EVOLUTION +hemiparesia I-EVOLUTION +izquierda I-EVOLUTION +espástica I-EVOLUTION +leve I-EVOLUTION +y I-EVOLUTION +completando I-EVOLUTION +sus I-EVOLUTION +estudios I-EVOLUTION +universitarios. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +importancia, I-PAST_MEDICAL_HISTORY +de B-PRESENT_ILLNESS +21 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad. I-PRESENT_ILLNESS +Refiere I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +madre I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +inicia I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +padecimiento I-PRESENT_ILLNESS +actual I-PRESENT_ILLNESS +11 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +previos I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ingreso, I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +detectar I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +manera I-PRESENT_ILLNESS +súbita I-PRESENT_ILLNESS +alteración I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +marcha, I-PRESENT_ILLNESS +descrito I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +“arrastrando I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +pie I-PRESENT_ILLNESS +izquierdo”; I-PRESENT_ILLNESS +esto I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +causaba I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +equilibrio, I-PRESENT_ILLNESS +caída I-PRESENT_ILLNESS +o I-PRESENT_ILLNESS +inhabilidad I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +desplazarse. I-PRESENT_ILLNESS +Así I-PRESENT_ILLNESS +mismo, I-PRESENT_ILLNESS +nota I-PRESENT_ILLNESS +debilidad I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +brazo I-PRESENT_ILLNESS +ipsilateral I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +disminución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +movimientos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +discapacidad I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +manipular I-PRESENT_ILLNESS +objetos, I-PRESENT_ILLNESS +caracterizada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +pasarlos I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +otra I-PRESENT_ILLNESS +mano, I-PRESENT_ILLNESS +niega I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +poder I-PRESENT_ILLNESS +localizar I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +exactitud I-PRESENT_ILLNESS +si I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +predominio I-PRESENT_ILLNESS +proximal I-PRESENT_ILLNESS +o I-PRESENT_ILLNESS +distal; I-PRESENT_ILLNESS +esto I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +manera I-PRESENT_ILLNESS +constante, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +ceder, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +horario I-PRESENT_ILLNESS +o I-PRESENT_ILLNESS +calendario, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +atenuantes, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +exacerbantes I-PRESENT_ILLNESS +o I-PRESENT_ILLNESS +acompañantes. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +A B-EXPLORATION la I-EXPLORATION -neoformación I-EXPLORATION -extirpada I-EXPLORATION -era I-EXPLORATION -el I-EXPLORATION +exploración I-EXPLORATION +neurológica I-EXPLORATION +se I-EXPLORATION +encuentran I-EXPLORATION +funciones I-EXPLORATION +superiores I-EXPLORATION +preservadas, I-EXPLORATION +nervios I-EXPLORATION +craneales I-EXPLORATION +sin I-EXPLORATION +alteraciones, I-EXPLORATION +sistema I-EXPLORATION +sensorial I-EXPLORATION +—lo I-EXPLORATION +posible I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION +valorar I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +edad I-EXPLORATION +y I-EXPLORATION +cooperación I-EXPLORATION +del I-EXPLORATION +paciente— I-EXPLORATION +normal, I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +inspección I-EXPLORATION +muscular I-EXPLORATION +se I-EXPLORATION +encuentran I-EXPLORATION +las I-EXPLORATION +cuatro I-EXPLORATION +extremidades I-EXPLORATION +simétricas I-EXPLORATION +y I-EXPLORATION +eutróficas I-EXPLORATION +con I-EXPLORATION +tono I-EXPLORATION +muscular I-EXPLORATION +sin I-EXPLORATION +alteraciones, I-EXPLORATION +la I-EXPLORATION +fase I-EXPLORATION +activa I-EXPLORATION de I-EXPLORATION -forma I-EXPLORATION -alongada I-EXPLORATION +las I-EXPLORATION +extremidades I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +fuerza I-EXPLORATION +3/5 I-EXPLORATION +en I-EXPLORATION +porcion I-EXPLORATION +distal I-EXPLORATION +y I-EXPLORATION +4/5 I-EXPLORATION +en I-EXPLORATION +seccion I-EXPLORATION +proximal I-EXPLORATION de I-EXPLORATION -15 I-EXPLORATION -x I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -5cm I-EXPLORATION +hemicuerpo I-EXPLORATION +izquierdo I-EXPLORATION y I-EXPLORATION -peso I-EXPLORATION +5/5 I-EXPLORATION +en I-EXPLORATION +extremidades I-EXPLORATION de I-EXPLORATION -140 I-EXPLORATION -gr I-EXPLORATION -aparentemente I-EXPLORATION -encapsulada I-EXPLORATION +hemicuerpo I-EXPLORATION +derecho. I-EXPLORATION +No I-EXPLORATION +presenta I-EXPLORATION +dificultad I-EXPLORATION +para I-EXPLORATION +mantener I-EXPLORATION +la I-EXPLORATION +bipedestación I-EXPLORATION +sin I-EXPLORATION +apoyo. I-EXPLORATION +La I-EXPLORATION +marcha I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +sin I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +base I-EXPLORATION +de I-EXPLORATION +sustentación, I-EXPLORATION con I-EXPLORATION -superficie I-EXPLORATION +una I-EXPLORATION +fase I-EXPLORATION +de I-EXPLORATION +contacto I-EXPLORATION +simetrica I-EXPLORATION +bilateral, I-EXPLORATION +pero I-EXPLORATION +con I-EXPLORATION +discreta I-EXPLORATION +rotación I-EXPLORATION externa I-EXPLORATION -lisa I-EXPLORATION +de I-EXPLORATION +todo I-EXPLORATION +el I-EXPLORATION +miembro I-EXPLORATION +pelvico I-EXPLORATION +izquierdo I-EXPLORATION +con I-EXPLORATION +caída I-EXPLORATION +del I-EXPLORATION +pie I-EXPLORATION +golpeando I-EXPLORATION +el I-EXPLORATION +suelo I-EXPLORATION +con I-EXPLORATION +toda I-EXPLORATION +la I-EXPLORATION +planta I-EXPLORATION y I-EXPLORATION -regular. I-EXPLORATION -Al I-EXPLORATION -corte I-EXPLORATION +sin I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -superficie I-EXPLORATION -se I-EXPLORATION -presentaba I-EXPLORATION -uniforme, I-EXPLORATION +fase I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -denso I-EXPLORATION -y I-EXPLORATION -fibroso, I-EXPLORATION +oscilación, I-EXPLORATION +con I-EXPLORATION +movimientos I-EXPLORATION +asimétricos, I-EXPLORATION +acompañados I-EXPLORATION de I-EXPLORATION -color I-EXPLORATION -blanquecino I-EXPLORATION -y I-EXPLORATION +extensión I-EXPLORATION +incompleta I-EXPLORATION de I-EXPLORATION -consistencia I-EXPLORATION -elástica I-EXPLORATION +la I-EXPLORATION +rodilla I-EXPLORATION +izquierda. I-EXPLORATION +Puede I-EXPLORATION +realizar I-EXPLORATION +la I-EXPLORATION +marcha I-EXPLORATION sin I-EXPLORATION -evidencia I-EXPLORATION +apoyo. I-EXPLORATION +Reflejos I-EXPLORATION +primitivos I-EXPLORATION +ausentes, I-EXPLORATION +Babinski I-EXPLORATION +negativo, I-EXPLORATION +reflejo I-EXPLORATION +braquioradial I-EXPLORATION +2/4, I-EXPLORATION +bicipital I-EXPLORATION +2/4, I-EXPLORATION +tricipital I-EXPLORATION +2/4, I-EXPLORATION +rotulaino I-EXPLORATION +2/4, I-EXPLORATION +aquileo I-EXPLORATION +2/4 I-EXPLORATION +bilaterales. I-EXPLORATION +Rigidez I-EXPLORATION +nucal, I-EXPLORATION +signo I-EXPLORATION de I-EXPLORATION -degeneración I-EXPLORATION -mixoide I-EXPLORATION -o I-EXPLORATION -necrosis. I-EXPLORATION +Brudsinski I-EXPLORATION +y I-EXPLORATION +signo I-EXPLORATION +de I-EXPLORATION +Kernig I-EXPLORATION +negativos. I-EXPLORATION I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -microscópico I-EXPLORATION -demostró I-EXPLORATION +Se I-EXPLORATION +solicitan I-EXPLORATION +radiografías I-EXPLORATION +de I-EXPLORATION +columna I-EXPLORATION +y I-EXPLORATION +cadera, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +reportan I-EXPLORATION +como I-EXPLORATION +normales I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +solicita I-EXPLORATION una I-EXPLORATION -tumoración I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -grupos I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION +simple I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -fusiformes, I-EXPLORATION -onduladas I-EXPLORATION -e I-EXPLORATION -hipercrómicas, I-EXPLORATION -estrechamente I-EXPLORATION -interpuestas I-EXPLORATION -en I-EXPLORATION -haces I-EXPLORATION +cráneo, I-EXPLORATION +sin I-EXPLORATION +encontrar I-EXPLORATION +datos I-EXPLORATION +radiográficos I-EXPLORATION +sugestivos I-EXPLORATION +del I-EXPLORATION +origen I-EXPLORATION de I-EXPLORATION -fibras I-EXPLORATION +la I-EXPLORATION +causa I-EXPLORATION de I-EXPLORATION -colágeno. I-EXPLORATION -Con I-EXPLORATION la I-EXPLORATION -inmunohistoquímica I-EXPLORATION -se I-EXPLORATION -evidenciaba I-EXPLORATION -positividad I-EXPLORATION -citoplásmica I-EXPLORATION -para I-EXPLORATION +sintomatología, I-EXPLORATION +razón I-EXPLORATION +por I-EXPLORATION la I-EXPLORATION -proteína I-EXPLORATION -S-100. I-EXPLORATION -No I-EXPLORATION +cual I-EXPLORATION se I-EXPLORATION -documentaron I-EXPLORATION -signos I-EXPLORATION +le I-EXPLORATION +solicita I-EXPLORATION +una I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RM) I-EXPLORATION +simple I-EXPLORATION +y I-EXPLORATION +contrastada I-EXPLORATION de I-EXPLORATION -necrosis, I-EXPLORATION -mitosis I-EXPLORATION -ni I-EXPLORATION -atipias I-EXPLORATION -nucleares. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -histopatológico I-EXPLORATION -definitivo I-EXPLORATION -fue I-EXPLORATION +cráneo I-EXPLORATION +y I-EXPLORATION +médula I-EXPLORATION +espinal, I-EXPLORATION +encontrándose I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +intramedular I-EXPLORATION +heterogénea I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +extiende I-EXPLORATION +desde I-EXPLORATION +C3 I-EXPLORATION +hasta I-EXPLORATION +T3 I-EXPLORATION +con I-EXPLORATION +zonas I-EXPLORATION +hipointensas I-EXPLORATION +en I-EXPLORATION +T1 I-EXPLORATION +y I-EXPLORATION +zonas I-EXPLORATION +hiperintensas I-EXPLORATION +en I-EXPLORATION +T2 I-EXPLORATION +que I-EXPLORATION +involucran I-EXPLORATION el I-EXPLORATION -de I-EXPLORATION -neurofibroma. I-EXPLORATION - I-EXPLORATION -Un B-EVOLUTION -año I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -han I-EVOLUTION -revelado I-EVOLUTION -signos I-EVOLUTION -objetivos I-EVOLUTION -de I-EVOLUTION -recidiva. I-EVOLUTION - I-EVOLUTION +espesor I-EXPLORATION +del I-EXPLORATION +canal I-EXPLORATION +medular I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +mide I-EXPLORATION +7, I-EXPLORATION +6 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +longitud I-EXPLORATION +y I-EXPLORATION +oblitera I-EXPLORATION +el I-EXPLORATION +espacio I-EXPLORATION +subaracnoideo. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +preparó I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +biopsia, I-EXPLORATION +extrayéndose I-EXPLORATION +muestras I-EXPLORATION +para I-EXPLORATION +análisis I-EXPLORATION +por I-EXPLORATION +parte I-EXPLORATION +del I-EXPLORATION +Servicio I-EXPLORATION +de I-EXPLORATION +Patología, I-EXPLORATION +que I-EXPLORATION +observó I-EXPLORATION +neoplasia I-EXPLORATION +fibrilar I-EXPLORATION +compuesta I-EXPLORATION +de I-EXPLORATION +hipercelularidad I-EXPLORATION +de I-EXPLORATION +tipo I-EXPLORATION +astrocítica I-EXPLORATION +con I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +hemorragia; I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +necrosis I-EXPLORATION +ni I-EXPLORATION +hiperplasia I-EXPLORATION +vascular, I-EXPLORATION +se I-EXPLORATION +encontraron I-EXPLORATION +células I-EXPLORATION +irregulares, I-EXPLORATION +cromatina I-EXPLORATION +grumosa I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +ninguna I-EXPLORATION +mitosis, I-EXPLORATION +realizándose I-EXPLORATION +el I-EXPLORATION +diagnostico I-EXPLORATION +de I-EXPLORATION +astrocitoma I-EXPLORATION +fibrilar I-EXPLORATION +difuso I-EXPLORATION +grado I-EXPLORATION +II I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +OMS I-EXPLORATION +de I-EXPLORATION +localización I-EXPLORATION +intramedular. I-EXPLORATION + I-EXPLORATION +Posteriormente B-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +traslada I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +especializado I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +patología I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +EE. I-DERIVED_FROM/TO +UU., I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +realiza I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +extracción I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +mayor I-DERIVED_FROM/TO +cantidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +tumoración, I-DERIVED_FROM/TO +aproximadamente I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +80-90%, I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +envía I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +muestra I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +patología I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +encuentran I-DERIVED_FROM/TO +dos I-DERIVED_FROM/TO +mitosis I-DERIVED_FROM/TO +positivas, I-DERIVED_FROM/TO +reclasificando I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +tumoración I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +grado I-DERIVED_FROM/TO +III I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +OMS. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO -Varón B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +femenina I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -65 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -70 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS +13 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -RTU I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -próstata. I-PRESENT_ILLNESS -Desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -medio I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -prostático. I-PRESENT_ILLNESS -Estudiado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS +Cirugía I-PRESENT_ILLNESS +Oral I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Urología, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -diagnostica I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -hipertrofia I-PRESENT_ILLNESS -benigna I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS +odontológica I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -próstata. I-PRESENT_ILLNESS -El B-EXPLORATION -examen I-EXPLORATION -preoperatorio I-EXPLORATION +la I-PRESENT_ILLNESS +Corporación I-PRESENT_ILLNESS +Universitaria I-PRESENT_ILLNESS +Rafael I-PRESENT_ILLNESS +Núñez I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +agrandamiento I-PRESENT_ILLNESS +gingival I-PRESENT_ILLNESS +generalizado. I-PRESENT_ILLNESS +Como B-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +familiares, I-FAMILY_HISTORY +la I-FAMILY_HISTORY +madre I-FAMILY_HISTORY +y I-FAMILY_HISTORY +un I-FAMILY_HISTORY +hermano I-FAMILY_HISTORY +describieron I-FAMILY_HISTORY +presentar I-FAMILY_HISTORY +aumento I-FAMILY_HISTORY +en I-FAMILY_HISTORY +el I-FAMILY_HISTORY +volumen I-FAMILY_HISTORY +del I-FAMILY_HISTORY +tejido I-FAMILY_HISTORY +gingival I-FAMILY_HISTORY +de I-FAMILY_HISTORY +forma I-FAMILY_HISTORY +generalizada. I-FAMILY_HISTORY +En B-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +manifestó I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +edad, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +practicó I-PAST_MEDICAL_HISTORY +gingivectomía I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +aumento I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +tamaño I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +encía I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +resultados I-PAST_MEDICAL_HISTORY +satisfactorios, I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +8 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +episodios I-PAST_MEDICAL_HISTORY +epilépticos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +recibió I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +farmacológico I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +anticonvulsivante I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +fenitoína, I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +periodo I-PAST_MEDICAL_HISTORY +aproximado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +25 I-PAST_MEDICAL_HISTORY +días; I-PAST_MEDICAL_HISTORY +en B-EXPLORATION +la I-EXPLORATION +revisión I-EXPLORATION +de I-EXPLORATION +órganos I-EXPLORATION +y I-EXPLORATION +sistemas I-EXPLORATION no I-EXPLORATION -presentaba I-EXPLORATION -alteraciones I-EXPLORATION -(electrocardiograma, I-EXPLORATION -hemograma I-EXPLORATION +presentó I-EXPLORATION +alteraciones. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +clínico I-EXPLORATION +intraoral I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +agrandamiento I-EXPLORATION +gingival I-EXPLORATION +generalizado I-EXPLORATION +comprometiendo I-EXPLORATION +maxilar I-EXPLORATION y I-EXPLORATION -bioquímica I-EXPLORATION -normales). I-EXPLORATION -Se B-TREATMENT -programa I-TREATMENT -para I-TREATMENT -RTU. I-TREATMENT -No I-TREATMENT -se I-TREATMENT -realizo I-TREATMENT -premedicación. I-TREATMENT -La I-TREATMENT -anestesia I-TREATMENT -intrarraquídea I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -con I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -en I-TREATMENT -sedestación. I-TREATMENT -Antes B-EXPLORATION +mandíbula, I-EXPLORATION +cubriendo I-EXPLORATION +más I-EXPLORATION +del I-EXPLORATION +85% I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -inducción I-EXPLORATION -anestésica I-EXPLORATION +corona I-EXPLORATION +dentaria I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +dientes I-EXPLORATION +posteriores I-EXPLORATION +y I-EXPLORATION +90% I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +anteriores, I-EXPLORATION +de I-EXPLORATION +aproximadamente I-EXPLORATION +un I-EXPLORATION +año I-EXPLORATION +de I-EXPLORATION +evolución, I-EXPLORATION +consistencia I-EXPLORATION +firme, I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +sangrado, I-EXPLORATION +sin I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +placa I-EXPLORATION +bacteriana, I-EXPLORATION +asintomático, I-EXPLORATION +originando I-EXPLORATION +discapacidad I-EXPLORATION +funcional, I-EXPLORATION +estética I-EXPLORATION +y I-EXPLORATION +problemas I-EXPLORATION +psicosociales. I-EXPLORATION +Examen I-EXPLORATION +radiográfico: I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +ortopantomografía I-EXPLORATION se I-EXPLORATION -monitorizo I-EXPLORATION +observó I-EXPLORATION +dientes I-EXPLORATION +en I-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION +general I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +del I-EXPLORATION +diente I-EXPLORATION +número I-EXPLORATION +73. I-EXPLORATION + I-EXPLORATION +Por I-EXPLORATION +ser I-EXPLORATION un I-EXPLORATION -electrocardiograma I-EXPLORATION -continuo I-EXPLORATION -(ECG), I-EXPLORATION -una I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -(PA) I-EXPLORATION -no I-EXPLORATION -invasiva I-EXPLORATION +crecimiento I-EXPLORATION +gingival I-EXPLORATION +fibroso, I-EXPLORATION +espontáneo, I-EXPLORATION +de I-EXPLORATION +gran I-EXPLORATION +tamaño, I-EXPLORATION +sin I-EXPLORATION +asociación I-EXPLORATION +a I-EXPLORATION +síndromes I-EXPLORATION y I-EXPLORATION +por I-EXPLORATION la I-EXPLORATION -SpO2. I-EXPLORATION -La B-TREATMENT -intervención I-TREATMENT -tuvo I-TREATMENT -duración I-TREATMENT -de I-TREATMENT -60 I-TREATMENT -minutos I-TREATMENT +historia I-EXPLORATION +familiar I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +la I-EXPLORATION +madre I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +hermano I-EXPLORATION +presentaron I-EXPLORATION +la I-EXPLORATION +misma I-EXPLORATION +patología, I-EXPLORATION +se I-EXPLORATION +estableció I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +fibromatosis I-EXPLORATION +gingival I-EXPLORATION +hereditaria. I-EXPLORATION + I-EXPLORATION +Procedimiento B-TREATMENT + I-TREATMENT +El I-TREATMENT +tratamiento I-TREATMENT +consistió I-TREATMENT +en I-TREATMENT +una I-TREATMENT +gingivectomía I-TREATMENT y I-TREATMENT -transcurrio I-TREATMENT -sin I-TREATMENT -incidencias. I-TREATMENT -Durante I-TREATMENT +gingivoplastía I-TREATMENT +en I-TREATMENT +2 I-TREATMENT +fases I-TREATMENT +quirúrgicas I-TREATMENT +inicialmente I-TREATMENT +en I-TREATMENT la I-TREATMENT -misma I-TREATMENT -se I-TREATMENT -administraron I-TREATMENT -3, I-TREATMENT -5 I-TREATMENT -litros I-TREATMENT +mandíbula I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +en I-TREATMENT +el I-TREATMENT +maxilar I-TREATMENT +bajo I-TREATMENT +anestesia I-TREATMENT +local. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +incisión I-TREATMENT +primaria I-TREATMENT +a I-TREATMENT +bisel I-TREATMENT +interno I-TREATMENT +a I-TREATMENT +un I-TREATMENT +ángulo I-TREATMENT de I-TREATMENT -agua I-TREATMENT -estéril I-TREATMENT -(hipotónica) I-TREATMENT -como I-TREATMENT -liquido I-TREATMENT +45o I-TREATMENT +hacia I-TREATMENT +el I-TREATMENT +ápice I-TREATMENT de I-TREATMENT -irrigación, I-TREATMENT -contabilizandose I-TREATMENT -un I-TREATMENT -balance I-TREATMENT -negativo I-TREATMENT +los I-TREATMENT +dientes, I-TREATMENT +previa I-TREATMENT +localización I-TREATMENT de I-TREATMENT -1500ml. I-TREATMENT -En B-EVOLUTION -la I-EVOLUTION -sala I-EVOLUTION -de I-EVOLUTION -despertar I-EVOLUTION -presento I-EVOLUTION -vómitos I-EVOLUTION -e I-EVOLUTION -hipotensión I-EVOLUTION -(100/60mmHg). I-EVOLUTION -No B-TREATMENT -se I-TREATMENT -objetivaron I-TREATMENT -alteraciones I-TREATMENT -neurológicas, I-TREATMENT -ni I-TREATMENT -cardiovasculares, I-TREATMENT -ni I-TREATMENT -edema I-TREATMENT -pulmonar. I-TREATMENT -ECG I-TREATMENT -y I-TREATMENT -Rx I-TREATMENT -torax I-TREATMENT -sin I-TREATMENT -alteraciones. I-TREATMENT -En I-TREATMENT +los I-TREATMENT +mismos I-TREATMENT +con I-TREATMENT la I-TREATMENT -bioquímica I-TREATMENT -sanguínea I-TREATMENT -destacaba: I-TREATMENT -sodio I-TREATMENT -: I-TREATMENT -122 I-TREATMENT -mEq/L, I-TREATMENT -potasio I-TREATMENT -: I-TREATMENT -5, I-TREATMENT -9 I-TREATMENT -mmol/L, I-TREATMENT -osmolaridad I-TREATMENT -: I-TREATMENT -256 I-TREATMENT -mOsmol/kg, I-TREATMENT -urea I-TREATMENT -: I-TREATMENT -1, I-TREATMENT -5 I-TREATMENT -g/L, I-TREATMENT -creatinina I-TREATMENT -(cr.s) I-TREATMENT -: I-TREATMENT -38 I-TREATMENT -mg/L, I-TREATMENT -calcio I-TREATMENT -: I-TREATMENT -80 I-TREATMENT -mg/L, I-TREATMENT -proteínas I-TREATMENT -totales I-TREATMENT -: I-TREATMENT -51 I-TREATMENT -g/L, I-TREATMENT -albúmina I-TREATMENT -: I-TREATMENT -28 I-TREATMENT -g/L, I-TREATMENT -CPK I-TREATMENT -: I-TREATMENT -225 I-TREATMENT -U/L, I-TREATMENT -LDH I-TREATMENT -: I-TREATMENT -416 I-TREATMENT -U/L, I-TREATMENT -GOT I-TREATMENT -: I-TREATMENT -48 I-TREATMENT -U/L, I-TREATMENT -GPT I-TREATMENT -: I-TREATMENT -97 I-TREATMENT -U/L, I-TREATMENT -haptoglobina I-TREATMENT -: I-TREATMENT -43.8 I-TREATMENT -mg/dL I-TREATMENT -(rango I-TREATMENT -normal I-TREATMENT -50-220 I-TREATMENT -mg/dL), I-TREATMENT -las I-TREATMENT -pruebas I-TREATMENT +sonda I-TREATMENT +periodontal I-TREATMENT de I-TREATMENT -coagulación I-TREATMENT -salieron I-TREATMENT -normales, I-TREATMENT -Hb I-TREATMENT -: I-TREATMENT -10 I-TREATMENT -g/dl, I-TREATMENT -HCT I-TREATMENT -: I-TREATMENT -28.8 I-TREATMENT -%, I-TREATMENT -leucocitos I-TREATMENT -: I-TREATMENT -6400/mm3, I-TREATMENT -plaquetas I-TREATMENT -: I-TREATMENT -220.000/mm3. I-TREATMENT -Gasometría: I-TREATMENT -pH I-TREATMENT -: I-TREATMENT -7, I-TREATMENT -30; I-TREATMENT -PCO2 I-TREATMENT -: I-TREATMENT -36 I-TREATMENT -mmHg; I-TREATMENT -PO2 I-TREATMENT -: I-TREATMENT -72 I-TREATMENT -mmHg. I-TREATMENT -Se B-EVOLUTION -procede I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -ingreso I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -unidad I-EVOLUTION -de I-EVOLUTION -Reanimación. I-EVOLUTION - I-EVOLUTION -Tras B-TREATMENT -la I-TREATMENT -estabilización I-TREATMENT -clínica I-TREATMENT +Williams, I-TREATMENT +aproximadamente I-TREATMENT +a I-TREATMENT +5 I-TREATMENT +mm I-TREATMENT +del I-TREATMENT +surco I-TREATMENT +gingival, I-TREATMENT con I-TREATMENT -normalización I-TREATMENT +hoja I-TREATMENT de I-TREATMENT -la I-TREATMENT -tensión I-TREATMENT -arterial, I-TREATMENT +bisturí I-TREATMENT +del I-TREATMENT +número I-TREATMENT +11 I-TREATMENT +y I-TREATMENT +12 I-TREATMENT +y I-TREATMENT +mango I-TREATMENT +bard I-TREATMENT +parker I-TREATMENT +número I-TREATMENT +3; I-TREATMENT +luego I-TREATMENT se I-TREATMENT -pudo I-TREATMENT -prescindir I-TREATMENT +efectuó I-TREATMENT +incisión I-TREATMENT +intrasurcular I-TREATMENT +creando I-TREATMENT +un I-TREATMENT +collar I-TREATMENT de I-TREATMENT -las I-TREATMENT -drogas I-TREATMENT -vasopresoras, I-TREATMENT +tejido I-TREATMENT +gingival, I-TREATMENT +el I-TREATMENT +cual I-TREATMENT +fue I-TREATMENT +removido I-TREATMENT +posteriormente I-TREATMENT +por I-TREATMENT +curetas I-TREATMENT +gracey I-TREATMENT +específicas I-TREATMENT +de I-TREATMENT +cada I-TREATMENT +diente, I-TREATMENT +después I-TREATMENT se I-TREATMENT -administraron I-TREATMENT -Furosemida I-TREATMENT -IV I-TREATMENT +realizó I-TREATMENT +un I-TREATMENT +reafinado I-TREATMENT +del I-TREATMENT +bisel I-TREATMENT +con I-TREATMENT +el I-TREATMENT +bisturí I-TREATMENT +de I-TREATMENT +Kirklan I-TREATMENT y I-TREATMENT -suero I-TREATMENT -salino I-TREATMENT -hipertónico I-TREATMENT -al I-TREATMENT -3% I-TREATMENT +Orban I-TREATMENT para I-TREATMENT -minimizar I-TREATMENT -la I-TREATMENT -sobrecarga I-TREATMENT -de I-TREATMENT -volumen. I-TREATMENT -A I-TREATMENT -pesar I-TREATMENT -de I-TREATMENT las I-TREATMENT -medidas I-TREATMENT -aplicadas I-TREATMENT -persistia I-TREATMENT -con I-TREATMENT -insuficiencia I-TREATMENT -renal I-TREATMENT -aguda I-TREATMENT -oligúrica I-TREATMENT -durante I-TREATMENT -15 I-TREATMENT -días, I-TREATMENT -llegando I-TREATMENT +áreas I-TREATMENT +interproximales I-TREATMENT +y I-TREATMENT +exodoncia I-TREATMENT +del I-TREATMENT +diente I-TREATMENT +73; I-TREATMENT +finalmente I-TREATMENT +se I-TREATMENT +llevó I-TREATMENT a I-TREATMENT -cifras I-TREATMENT -máximas I-TREATMENT -de I-TREATMENT -urea I-TREATMENT -de I-TREATMENT -2, I-TREATMENT -70 I-TREATMENT -g/L I-TREATMENT +cabo I-TREATMENT +hemostasia I-TREATMENT y I-TREATMENT +colocación I-TREATMENT de I-TREATMENT -creatinina I-TREATMENT -de I-TREATMENT -72 I-TREATMENT -mg/L, I-TREATMENT -precisando I-TREATMENT +un I-TREATMENT +tutor I-TREATMENT +en I-TREATMENT +acetato I-TREATMENT +diseñado I-TREATMENT +prequirúrgicamente I-TREATMENT +en I-TREATMENT +modelos I-TREATMENT de I-TREATMENT -04 I-TREATMENT -sesiones I-TREATMENT +estudios I-TREATMENT +con I-TREATMENT +cemento I-TREATMENT +quirúrgico I-TREATMENT +periodontal, I-TREATMENT +para I-TREATMENT +proteger I-TREATMENT +en I-TREATMENT +forma I-TREATMENT +física I-TREATMENT +la I-TREATMENT +superficie I-TREATMENT de I-TREATMENT -hemodiálisis. I-TREATMENT -A I-TREATMENT -las I-TREATMENT -3 I-TREATMENT -semanas, I-TREATMENT -reinició I-TREATMENT la I-TREATMENT -diuresis I-TREATMENT -entrando I-TREATMENT -en I-TREATMENT -fase I-TREATMENT -poliúrica, I-TREATMENT -recuperandose I-TREATMENT -así I-TREATMENT -progresivamente I-TREATMENT +herida I-TREATMENT +del I-TREATMENT +trauma I-TREATMENT +mecánico I-TREATMENT +durante I-TREATMENT la I-TREATMENT -función I-TREATMENT -renal, I-TREATMENT -siendo I-TREATMENT +cicatrización, I-TREATMENT +evitar I-TREATMENT la I-TREATMENT -Cr.s. I-TREATMENT -al I-TREATMENT -alta I-TREATMENT +formación I-TREATMENT de I-TREATMENT -14 I-TREATMENT -mg/L. I-TREATMENT -A B-EVOLUTION +tejido I-TREATMENT +excesivo I-TREATMENT +de I-TREATMENT +granulación I-TREATMENT +y I-TREATMENT +empaquetamiento I-TREATMENT +de I-TREATMENT +alimentos, I-TREATMENT +se I-TREATMENT +ordenó I-TREATMENT +farmacoterapia I-TREATMENT +con I-TREATMENT +antibiótico, I-TREATMENT +analgésico I-TREATMENT +y I-TREATMENT +antiinflamatorio, I-TREATMENT +las I-TREATMENT +indicaciones I-TREATMENT +postoperatorias I-TREATMENT +incluyeron I-TREATMENT +adecuada I-TREATMENT +higiene I-TREATMENT +oral I-TREATMENT +con I-TREATMENT +uso I-TREATMENT +del I-TREATMENT +cepillo, I-TREATMENT +seda I-TREATMENT +dental I-TREATMENT +y I-TREATMENT +enjuagues I-TREATMENT +con I-TREATMENT +colutorios I-TREATMENT +sin I-TREATMENT +alcohol. I-TREATMENT +El I-TREATMENT +mismo I-TREATMENT +procedimiento I-TREATMENT +fue I-TREATMENT +realizado I-TREATMENT +en I-TREATMENT +el I-TREATMENT +maxilar I-TREATMENT +20 I-TREATMENT +días I-TREATMENT +después. I-TREATMENT + I-TREATMENT +El B-EXPLORATION +examen I-EXPLORATION +histopatológico I-EXPLORATION +describe I-EXPLORATION +microscópicamente I-EXPLORATION +fragmentos I-EXPLORATION +de I-EXPLORATION +mucosa I-EXPLORATION +oral I-EXPLORATION +revestidos I-EXPLORATION +por I-EXPLORATION +epitelio I-EXPLORATION +paraqueratósico, I-EXPLORATION +hiperplásico, I-EXPLORATION +sobre I-EXPLORATION +estroma I-EXPLORATION +con I-EXPLORATION +abundante I-EXPLORATION +haces I-EXPLORATION +gruesos I-EXPLORATION +de I-EXPLORATION +colágeno I-EXPLORATION +dispuestos I-EXPLORATION +al I-EXPLORATION +azar, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +fibromatosis I-EXPLORATION +gingival. I-EXPLORATION + I-EXPLORATION +En B-EVOLUTION +el I-EVOLUTION +control I-EVOLUTION +posquirúrgico I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +realizó I-EVOLUTION +a I-EVOLUTION los I-EVOLUTION -4 I-EVOLUTION -meses I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +20 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +cada I-EVOLUTION +procedimiento I-EVOLUTION +(maxilar I-EVOLUTION +y I-EVOLUTION +mandíbula), I-EVOLUTION +se I-EVOLUTION +evidenció I-EVOLUTION +disminución I-EVOLUTION +en I-EVOLUTION el I-EVOLUTION +volumen I-EVOLUTION +del I-EVOLUTION +tejido I-EVOLUTION +gingival, I-EVOLUTION +buen I-EVOLUTION +proceso I-EVOLUTION +de I-EVOLUTION +cicatrización, I-EVOLUTION +las I-EVOLUTION +coronas I-EVOLUTION +dentarias I-EVOLUTION +no I-EVOLUTION +se I-EVOLUTION +encontraron I-EVOLUTION +cubiertas I-EVOLUTION +por I-EVOLUTION +tejido, I-EVOLUTION +la I-EVOLUTION paciente I-EVOLUTION -permanece I-EVOLUTION -normotenso, I-EVOLUTION -con I-EVOLUTION -cifras I-EVOLUTION +manifestó I-EVOLUTION +mejoras I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +proceso I-EVOLUTION de I-EVOLUTION -Cr.s. I-EVOLUTION -10 I-EVOLUTION -mg/L I-EVOLUTION +masticación, I-EVOLUTION +que I-EVOLUTION +sonríe I-EVOLUTION +frecuentemente I-EVOLUTION y I-EVOLUTION -un I-EVOLUTION -Ccr. I-EVOLUTION -76 I-EVOLUTION -ml/minuto. I-EVOLUTION +tiene I-EVOLUTION +mayor I-EVOLUTION +relación I-EVOLUTION +social I-EVOLUTION +con I-EVOLUTION +los I-EVOLUTION +compañeros I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +escuela. I-EVOLUTION +También I-EVOLUTION +presentó I-EVOLUTION +alteraciones I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +oclusión I-EVOLUTION +dental, I-EVOLUTION +como I-EVOLUTION +diastemas, I-EVOLUTION +mordida I-EVOLUTION +profunda, I-EVOLUTION +mala I-EVOLUTION +posición I-EVOLUTION +dentaria, I-EVOLUTION +entre I-EVOLUTION +otros, I-EVOLUTION +razón I-EVOLUTION +por I-EVOLUTION +la I-EVOLUTION +cual I-EVOLUTION +se I-EVOLUTION +remitió I-EVOLUTION +al I-EVOLUTION +servicio I-EVOLUTION +de I-EVOLUTION +ortodoncia I-EVOLUTION +para I-EVOLUTION +su I-EVOLUTION +terapéutica. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +65 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -conocida I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -enero I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -2003, I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -acudir I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS nuestro I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -sólida I-PRESENT_ILLNESS -dependiente I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -mesorriñón I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tamaño, I-PRESENT_ILLNESS -acompañada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -adenomegalias I-PRESENT_ILLNESS -retrocavas I-PRESENT_ILLNESS +deterioro I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +estado I-PRESENT_ILLNESS +general, I-PRESENT_ILLNESS +ictericia I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -nódulo I-PRESENT_ILLNESS -hepático I-PRESENT_ILLNESS -sospechoso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -metástasis, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -varios I-PRESENT_ILLNESS -nódulos I-PRESENT_ILLNESS -pulmonares I-PRESENT_ILLNESS -bilaterales I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -campos I-PRESENT_ILLNESS -basales. I-PRESENT_ILLNESS -Para B-EXPLORATION -filiar I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -percutánea I-EXPLORATION -renal I-EXPLORATION -que I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -nefroblastoma. I-EXPLORATION -Se B-TREATMENT -estadió I-TREATMENT -como I-TREATMENT -IV I-TREATMENT -y I-TREATMENT -conforme I-TREATMENT -a I-TREATMENT -ello I-TREATMENT -se I-TREATMENT -administraron I-TREATMENT -según I-TREATMENT -protocolo I-TREATMENT -SIOP, I-TREATMENT -6 I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -poliquimioterapia I-TREATMENT -sistémica I-TREATMENT -con I-TREATMENT -actinomicina I-TREATMENT -D, I-TREATMENT -vincristina I-TREATMENT -y I-TREATMENT -doxorrubicina I-TREATMENT -separados I-TREATMENT -3 I-TREATMENT -semanas. I-TREATMENT -Al B-EVOLUTION -cabo I-EVOLUTION -de I-EVOLUTION -este I-EVOLUTION -período I-EVOLUTION -se I-EVOLUTION -constató I-EVOLUTION -la I-EVOLUTION -reducción I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -masa I-EVOLUTION -renal I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -evidente I-EVOLUTION -cambio I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -densidad I-EVOLUTION -del I-EVOLUTION -nódulo I-EVOLUTION -hepático, I-EVOLUTION -no I-EVOLUTION -habiendo I-EVOLUTION -variado I-EVOLUTION -ni I-EVOLUTION -el I-EVOLUTION -tamaño I-EVOLUTION -ni I-EVOLUTION -la I-EVOLUTION -densidad I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -ganglios I-EVOLUTION -regionales. I-EVOLUTION -Se B-TREATMENT -sometió I-TREATMENT -a I-TREATMENT -nefrectomía I-TREATMENT -radical I-TREATMENT -dcha, I-TREATMENT -linfadenectomía I-TREATMENT -regional I-TREATMENT -y I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -nódulo I-TREATMENT -hepático. I-TREATMENT -En I-TREATMENT -riñón I-TREATMENT -se I-TREATMENT -reconfirmó I-TREATMENT -la I-TREATMENT -existencia I-TREATMENT -de I-TREATMENT -nefroblastoma I-TREATMENT -con I-TREATMENT -componente I-TREATMENT -mixto, I-TREATMENT -un I-TREATMENT -tercio I-TREATMENT -de I-TREATMENT -blastema, I-TREATMENT -y I-TREATMENT -2 I-TREATMENT -tercios I-TREATMENT -epiteliales, I-TREATMENT -acompañados I-TREATMENT -de I-TREATMENT -un I-TREATMENT -60% I-TREATMENT -de I-TREATMENT -necrosis. I-TREATMENT -Tras I-TREATMENT -la I-TREATMENT -nefrectomía I-TREATMENT -continuó I-TREATMENT -con I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -actinomicina I-TREATMENT -D I-TREATMENT -y I-TREATMENT -vincristina, I-TREATMENT -hasta I-TREATMENT -que I-TREATMENT -en I-TREATMENT -estudio I-TREATMENT -control I-TREATMENT -aparece I-TREATMENT -un I-TREATMENT -nódulo I-TREATMENT -pulmonar I-TREATMENT -basal I-TREATMENT -izdo, I-TREATMENT -estudiado I-TREATMENT -mediante I-TREATMENT -PET, I-TREATMENT -ofreciendo I-TREATMENT -resultado I-TREATMENT -positivo, I-TREATMENT -y I-TREATMENT -procediéndose I-TREATMENT -a I-TREATMENT -resección I-TREATMENT -quirúrgica I-TREATMENT -poniendo I-TREATMENT -de I-TREATMENT -manifiesto I-TREATMENT -la I-TREATMENT -existencia I-TREATMENT -de I-TREATMENT -componente I-TREATMENT -nefroblastomatoso I-TREATMENT -sin I-TREATMENT -poder I-TREATMENT -reconocer I-TREATMENT -un I-TREATMENT -claro I-TREATMENT -patrón I-TREATMENT -de I-TREATMENT -crecimiento. I-TREATMENT -Posteriormente I-TREATMENT -y I-TREATMENT -siguiendo I-TREATMENT -las I-TREATMENT -indicaciones I-TREATMENT -de I-TREATMENT -la I-TREATMENT -SIOP I-TREATMENT -se I-TREATMENT -continuó I-TREATMENT -con I-TREATMENT -la I-TREATMENT -poliquimioterapia I-TREATMENT -sistémica I-TREATMENT -asociando I-TREATMENT -carboplatino I-TREATMENT -y I-TREATMENT -etopósido, I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -26 I-TREATMENT -semanas. I-TREATMENT -En B-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -46 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -inicial I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY +aumento I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +perímetro I-PRESENT_ILLNESS +abdominal. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +El B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +trabaja I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +auxiliar I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +despacho I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -H.T.A. I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +notario I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -isquémica I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +tiene I-PAST_MEDICAL_HISTORY +hábitos I-PAST_MEDICAL_HISTORY +tóxicos. I-PAST_MEDICAL_HISTORY +Durante I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +cuatro I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +previos I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +seguido I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +intermitente I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -tratamiento. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY +consultas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Digestivo I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +cuadro I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alteración I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +perfil I-PAST_MEDICAL_HISTORY +hepático I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +predominio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +colestasis I-PAST_MEDICAL_HISTORY +leve. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +resto I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consulta B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hematuria I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -coágulos I-PRESENT_ILLNESS -intermitente I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -otros I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -urológicos I-PRESENT_ILLNESS -destacables I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -es I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -ecográfico I-EXPLORATION -no I-EXPLORATION -detecta I-EXPLORATION -anomalías I-EXPLORATION -de I-EXPLORATION -interés, I-EXPLORATION -con I-EXPLORATION -riñones I-EXPLORATION -y I-EXPLORATION -vías I-EXPLORATION -excretoras I-EXPLORATION -normales, I-EXPLORATION -próstata I-EXPLORATION -discretamente I-EXPLORATION -aumentada I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -y I-EXPLORATION -vejiga I-EXPLORATION -sin I-EXPLORATION -hallazgos. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -cistoscopia I-EXPLORATION -practicada I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -papilar I-EXPLORATION -en I-EXPLORATION -cara I-EXPLORATION -lateral I-EXPLORATION -izquierda I-EXPLORATION -retromeatal I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -hasta I-EXPLORATION -vertiente I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -cuello I-EXPLORATION -vesical. I-EXPLORATION -Se B-TREATMENT -practica I-TREATMENT -resección I-TREATMENT -transuretral. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -diagnóstico I-EXPLORATION -anatomopatológico I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -adenoma I-EXPLORATION -de I-EXPLORATION -Brunner I-EXPLORATION -(papiloma I-EXPLORATION -invertido) I-EXPLORATION -sobre I-EXPLORATION -varios I-EXPLORATION -fragmentos I-EXPLORATION -resecados I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -conjunto I-EXPLORATION -miden I-EXPLORATION -10x15x5 I-EXPLORATION -mm.. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -permanece I-EVOLUTION -asintomático I-EVOLUTION -tras I-EVOLUTION -24 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -61 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +y B-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +carecían I-FAMILY_HISTORY +de I-FAMILY_HISTORY +interés. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Durante B-PAST_MEDICAL_HISTORY +esos I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -histerectomía I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -doble I-PAST_MEDICAL_HISTORY -anexectomía I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -miomas I-PAST_MEDICAL_HISTORY -uterinos I-PAST_MEDICAL_HISTORY +seguimiento I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +realizaron I-PAST_MEDICAL_HISTORY +múltiples I-PAST_MEDICAL_HISTORY +analíticas, I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -1997, I-PAST_MEDICAL_HISTORY -hernia I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +cuales I-PAST_MEDICAL_HISTORY +únicamente I-PAST_MEDICAL_HISTORY +destacaba I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +consabido I-PAST_MEDICAL_HISTORY +patrón I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -hiato, I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY +colestasis I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +trombocitopenia I-PAST_MEDICAL_HISTORY +leve I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -médico. I-PAST_MEDICAL_HISTORY -Presentaba I-PAST_MEDICAL_HISTORY -asimismo I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -nódulo I-PAST_MEDICAL_HISTORY -tiroideo I-PAST_MEDICAL_HISTORY +algunos I-PAST_MEDICAL_HISTORY +controles. I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +largo I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY +este I-PAST_MEDICAL_HISTORY +periodo I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -diámetro, I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY +tiempo I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +cifras I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -bocio I-PAST_MEDICAL_HISTORY -coloide I-PAST_MEDICAL_HISTORY -nodular I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -PAAF I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1995. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Fue I-PAST_MEDICAL_HISTORY -intervenida I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2001, I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -nefrectomía I-PAST_MEDICAL_HISTORY -radical I-PAST_MEDICAL_HISTORY -derecha, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -tumor I-PAST_MEDICAL_HISTORY -heterogéneo I-PAST_MEDICAL_HISTORY +GOT I-PAST_MEDICAL_HISTORY +oscilaron I-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY +31-56 I-PAST_MEDICAL_HISTORY +UI/l; I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY +GPT, I-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY +27-75 I-PAST_MEDICAL_HISTORY +UI/l; I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -diámetro I-PAST_MEDICAL_HISTORY -localizado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -tercio I-PAST_MEDICAL_HISTORY -medio I-PAST_MEDICAL_HISTORY +GGT, I-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY +150-185 I-PAST_MEDICAL_HISTORY +UI/l; I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -riñón I-PAST_MEDICAL_HISTORY -derecho, I-PAST_MEDICAL_HISTORY -correspondiendo I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY +FA, I-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY +213-456 I-PAST_MEDICAL_HISTORY +UI/l. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +bilirrubina I-PAST_MEDICAL_HISTORY +total I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +movió I-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY +1, I-PAST_MEDICAL_HISTORY +2-2, I-PAST_MEDICAL_HISTORY +56 I-PAST_MEDICAL_HISTORY +mg/dl. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +realizó I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY estudio I-PAST_MEDICAL_HISTORY -anatomopatológico I-PAST_MEDICAL_HISTORY -posterior, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -adenocarcinoma I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -alto I-PAST_MEDICAL_HISTORY -grado, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -infiltración I-PAST_MEDICAL_HISTORY +autoinmunidad, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +negativo. I-PAST_MEDICAL_HISTORY +Igual I-PAST_MEDICAL_HISTORY +resultado I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +obtuvo I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -vena I-PAST_MEDICAL_HISTORY -renal, I-PAST_MEDICAL_HISTORY -estadio I-PAST_MEDICAL_HISTORY -pT3bNoMo. I-PAST_MEDICAL_HISTORY -Fue I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -posteriormente I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +serologías I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -coadyuvante I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -interleukina- I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -subcutánea I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -meses. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -informe I-PAST_MEDICAL_HISTORY -anatomopatológico I-PAST_MEDICAL_HISTORY -macroscópico I-PAST_MEDICAL_HISTORY +virus I-PAST_MEDICAL_HISTORY +hepatotropos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +VIH, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -pieza I-PAST_MEDICAL_HISTORY -describía I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -nódulo I-PAST_MEDICAL_HISTORY -tumoral I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -infiltraba I-PAST_MEDICAL_HISTORY -pelvis I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +marcadores I-PAST_MEDICAL_HISTORY +tumorales I-PAST_MEDICAL_HISTORY +(CEA, I-PAST_MEDICAL_HISTORY +Ca I-PAST_MEDICAL_HISTORY +19.9 I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -vena I-PAST_MEDICAL_HISTORY -renal, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -diámetro I-PAST_MEDICAL_HISTORY +α-fetoproteína). I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +resto I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -x I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -x I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -cm, I-PAST_MEDICAL_HISTORY -combinando I-PAST_MEDICAL_HISTORY -áreas I-PAST_MEDICAL_HISTORY -grisáceas I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -otras I-PAST_MEDICAL_HISTORY -pardoamarillentas. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY +datos I-PAST_MEDICAL_HISTORY +analíticos, I-PAST_MEDICAL_HISTORY +incluyendo I-PAST_MEDICAL_HISTORY +hemograma, I-PAST_MEDICAL_HISTORY +bioquímica I-PAST_MEDICAL_HISTORY +completa, I-PAST_MEDICAL_HISTORY +coagulación, I-PAST_MEDICAL_HISTORY estudio I-PAST_MEDICAL_HISTORY -microscópico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ferrocinética, I-PAST_MEDICAL_HISTORY +proteinograma, I-PAST_MEDICAL_HISTORY +hormonas I-PAST_MEDICAL_HISTORY +tiroideas, I-PAST_MEDICAL_HISTORY +... I-PAST_MEDICAL_HISTORY +fueron I-PAST_MEDICAL_HISTORY +siempre I-PAST_MEDICAL_HISTORY +normales. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +También I-PAST_MEDICAL_HISTORY se I-PAST_MEDICAL_HISTORY -observó I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -tumoración I-PAST_MEDICAL_HISTORY -pseudocapsular I-PAST_MEDICAL_HISTORY -correspondiente I-PAST_MEDICAL_HISTORY +sometió I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY -adenocarcinoma I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alto I-PAST_MEDICAL_HISTORY -grado, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -alguna I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -anaplásica. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -tumor I-PAST_MEDICAL_HISTORY -invadía I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -sistema I-PAST_MEDICAL_HISTORY -pielocalicial I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -evidencia I-PAST_MEDICAL_HISTORY +diversas I-PAST_MEDICAL_HISTORY +pruebas I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -invasión I-PAST_MEDICAL_HISTORY -vascular I-PAST_MEDICAL_HISTORY +imagen. I-PAST_MEDICAL_HISTORY +Durante I-PAST_MEDICAL_HISTORY +esos I-PAST_MEDICAL_HISTORY +cuatro I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +llevaron I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +cabo I-PAST_MEDICAL_HISTORY +varias I-PAST_MEDICAL_HISTORY +ecografías I-PAST_MEDICAL_HISTORY +abdominales, I-PAST_MEDICAL_HISTORY +todas I-PAST_MEDICAL_HISTORY +ellas I-PAST_MEDICAL_HISTORY +normales I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +excepción I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -vena I-PAST_MEDICAL_HISTORY -renal. I-PAST_MEDICAL_HISTORY -Los I-PAST_MEDICAL_HISTORY -márgenes I-PAST_MEDICAL_HISTORY -quirúrgicos I-PAST_MEDICAL_HISTORY -estaban I-PAST_MEDICAL_HISTORY -libres. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -2004 I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -estudio I-PAST_MEDICAL_HISTORY +realizada I-PAST_MEDICAL_HISTORY +cuatro I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -control, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -detectó I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -TAC, I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -marcado I-PAST_MEDICAL_HISTORY -crecimiento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -lóbulo I-PAST_MEDICAL_HISTORY -tiroideo I-PAST_MEDICAL_HISTORY -izquierdo, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +ingreso, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +informaba I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -nódulo I-PAST_MEDICAL_HISTORY +discreta I-PAST_MEDICAL_HISTORY +esplenomegalia. I-PAST_MEDICAL_HISTORY +Dos I-PAST_MEDICAL_HISTORY +estudios I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -heterogéneo, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -nódulo I-PAST_MEDICAL_HISTORY -coloide I-PAST_MEDICAL_HISTORY -previo I-PAST_MEDICAL_HISTORY -conocido. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -2005, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -nuevo I-PAST_MEDICAL_HISTORY TAC, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -observó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -mismo I-PAST_MEDICAL_HISTORY -lóbulo I-PAST_MEDICAL_HISTORY -tiroideo I-PAST_MEDICAL_HISTORY -izquierdo, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -crecimiento I-PAST_MEDICAL_HISTORY +uno I-PAST_MEDICAL_HISTORY +abdominal, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +otro I-PAST_MEDICAL_HISTORY +abdómino-pélvico I-PAST_MEDICAL_HISTORY +realizado I-PAST_MEDICAL_HISTORY +siete I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY del I-PAST_MEDICAL_HISTORY -nódulo I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -5, I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -desplazando I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -tráquea. I-PAST_MEDICAL_HISTORY -La B-EXPLORATION -gammagrafía I-EXPLORATION -tiroidea I-EXPLORATION -mostraba I-EXPLORATION -un I-EXPLORATION -'nódulo I-EXPLORATION -frío' I-EXPLORATION +ingreso I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +nuestro I-PAST_MEDICAL_HISTORY +centro, I-PAST_MEDICAL_HISTORY +habían I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +igualmente I-PAST_MEDICAL_HISTORY +informados I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +normales. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +A B-EXPLORATION +su I-EXPLORATION +recepción I-EXPLORATION en I-EXPLORATION -lóbulo I-EXPLORATION -izquierdo, I-EXPLORATION -mientras I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -sanguínea I-EXPLORATION +nuestra I-EXPLORATION +planta I-EXPLORATION +de I-EXPLORATION +hospitalización I-EXPLORATION +se I-EXPLORATION +pone I-EXPLORATION +de I-EXPLORATION +manifiesto I-EXPLORATION +una I-EXPLORATION +ictericia I-EXPLORATION +mucocutánea I-EXPLORATION +franca I-EXPLORATION +y I-EXPLORATION +ascitis I-EXPLORATION no I-EXPLORATION -demostró I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION +a I-EXPLORATION +tensión, I-EXPLORATION +además I-EXPLORATION de I-EXPLORATION -hormonas I-EXPLORATION -tiroideas. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -el I-TREATMENT -crecimiento I-TREATMENT -progresivo I-TREATMENT -del I-TREATMENT -nódulo I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -hemitiroidectomía I-TREATMENT -izquierda. I-TREATMENT -El B-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION -describía I-EXPLORATION -un I-EXPLORATION -hemitiroides I-EXPLORATION -izquierdo I-EXPLORATION -con I-EXPLORATION un I-EXPLORATION -nódulo I-EXPLORATION +leve I-EXPLORATION +deterioro I-EXPLORATION +del I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -8 I-EXPLORATION -x I-EXPLORATION +conciencia I-EXPLORATION +del I-EXPLORATION +paciente. I-EXPLORATION +Analíticamente I-EXPLORATION +destaca: I-EXPLORATION +Hb: I-EXPLORATION +9, I-EXPLORATION 6 I-EXPLORATION -x I-EXPLORATION -2 I-EXPLORATION -cm, I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -zonas I-EXPLORATION -amarillentas I-EXPLORATION -en I-EXPLORATION -superficie, I-EXPLORATION -alternando I-EXPLORATION -con I-EXPLORATION -otras I-EXPLORATION +g/dl; I-EXPLORATION +Hcto: I-EXPLORATION +26, I-EXPLORATION +9%; I-EXPLORATION +plaquetas: I-EXPLORATION +37000; I-EXPLORATION +leucocitos: I-EXPLORATION +3800; I-EXPLORATION +bilirrubina I-EXPLORATION +total: I-EXPLORATION +27, I-EXPLORATION +5 I-EXPLORATION +mg/dl; I-EXPLORATION +GOT: I-EXPLORATION +88; I-EXPLORATION +GPT: I-EXPLORATION +73; I-EXPLORATION +GGT: I-EXPLORATION +243; I-EXPLORATION +FA: I-EXPLORATION +305; I-EXPLORATION +actividad I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -más I-EXPLORATION -carnoso. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -microscópico I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -tumorales I-EXPLORATION -con I-EXPLORATION -citoplasma I-EXPLORATION -claro, I-EXPLORATION -las I-EXPLORATION -cuales I-EXPLORATION -presentaban I-EXPLORATION -una I-EXPLORATION -acusada I-EXPLORATION -atipia, I-EXPLORATION -con I-EXPLORATION -zonas I-EXPLORATION -incluso I-EXPLORATION -anaplásicas I-EXPLORATION +protrombina: I-EXPLORATION +33%; I-EXPLORATION +INR: I-EXPLORATION +2, I-EXPLORATION +1; I-EXPLORATION +creatinina: I-EXPLORATION +2, I-EXPLORATION +09 I-EXPLORATION +mg/dl; I-EXPLORATION +urea: I-EXPLORATION +172 I-EXPLORATION +mg/dl; I-EXPLORATION +α-fetoproteína: I-EXPLORATION +1 I-EXPLORATION +ng/ml; I-EXPLORATION +Las I-EXPLORATION +serologías I-EXPLORATION +de I-EXPLORATION +VHB, I-EXPLORATION +VHC, I-EXPLORATION +VIH, I-EXPLORATION +CMV I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION -figuras I-EXPLORATION +Epstein I-EXPLORATION +Barr I-EXPLORATION +son I-EXPLORATION +nuevamente I-EXPLORATION +negativas. I-EXPLORATION +Se I-EXPLORATION +lleva I-EXPLORATION +a I-EXPLORATION +cabo I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +abdominal, I-EXPLORATION +que I-EXPLORATION +informa I-EXPLORATION de I-EXPLORATION -mitosis. I-EXPLORATION -Presentaban I-EXPLORATION -un I-EXPLORATION -crecimiento I-EXPLORATION -difuso I-EXPLORATION -constituyendo I-EXPLORATION -nódulos I-EXPLORATION +hígado I-EXPLORATION con I-EXPLORATION -zonas I-EXPLORATION -de I-EXPLORATION -esclerosis I-EXPLORATION -y I-EXPLORATION -extensas I-EXPLORATION -áreas I-EXPLORATION +estigmas I-EXPLORATION de I-EXPLORATION -necrosis. I-EXPLORATION -La I-EXPLORATION -lesión I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -rodeada I-EXPLORATION -por I-EXPLORATION -tejido I-EXPLORATION -tiroideo I-EXPLORATION -respetado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -objetivaban I-EXPLORATION -folículos I-EXPLORATION -linfoides. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -técnicas I-EXPLORATION +hepatopatía I-EXPLORATION +crónica, I-EXPLORATION +con I-EXPLORATION +múltiples I-EXPLORATION +nódulos I-EXPLORATION de I-EXPLORATION -inmunohistoquímica I-EXPLORATION +regeneración I-EXPLORATION en I-EXPLORATION -las I-EXPLORATION -cuales I-EXPLORATION -dichas I-EXPLORATION -células I-EXPLORATION -tumorales I-EXPLORATION -presentaron I-EXPLORATION -negatividad I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -tiroglobulina I-EXPLORATION +su I-EXPLORATION +interior; I-EXPLORATION y I-EXPLORATION -positividad I-EXPLORATION -para I-EXPLORATION -CK8, I-EXPLORATION -CK18, I-EXPLORATION -EMA, I-EXPLORATION +una I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +nuclear, I-EXPLORATION +con I-EXPLORATION +imágenes I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +cirrosis I-EXPLORATION +hepática I-EXPLORATION +macronodular I-EXPLORATION y I-EXPLORATION -Vimentina. I-EXPLORATION - I-EXPLORATION -Dadas I-EXPLORATION -las I-EXPLORATION -características I-EXPLORATION -histológicas I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION +ascitis I-EXPLORATION +perihepática I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -perfil I-EXPLORATION -inmunohistoquímico, I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -historia I-EXPLORATION -clínica I-EXPLORATION -del I-EXPLORATION -paciente, I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -fue I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -metástasis I-EXPLORATION -de I-EXPLORATION -adenocarcinoma I-EXPLORATION -renal I-EXPLORATION +periesplénica I-EXPLORATION +en I-EXPLORATION +escasa I-EXPLORATION +cantidad. I-EXPLORATION +Con I-EXPLORATION +todo I-EXPLORATION +ello I-EXPLORATION +se I-EXPLORATION +decide I-EXPLORATION +realización I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -claras. I-EXPLORATION - I-EXPLORATION - -Niño B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Puertas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -escrotal I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hemiescroto I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y B-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -traumático I-PAST_MEDICAL_HISTORY -conocido. I-PAST_MEDICAL_HISTORY -No B-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -miccional. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Sin B-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -medicamentosas, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -tiene I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física, I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +hepática I-EXPLORATION +transyugular. I-EXPLORATION + I-EXPLORATION +No B-EVOLUTION +obstante, I-EVOLUTION +y I-EVOLUTION +mientras I-EVOLUTION +se I-EVOLUTION +espera I-EVOLUTION +el I-EVOLUTION +resultado I-EVOLUTION +histológico I-EVOLUTION +de I-EVOLUTION +dicha I-EVOLUTION +biopsia, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +sufre I-EVOLUTION +un I-EVOLUTION +empeoramiento I-EVOLUTION +brusco I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +situación I-EVOLUTION +clínica I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +función I-EVOLUTION +respiratoria, I-EVOLUTION +requiriendo B-TREATMENT +ventilación I-TREATMENT +mecánica, I-TREATMENT +intubación I-TREATMENT +orotraqueal I-TREATMENT +e I-TREATMENT +ingreso I-TREATMENT +en I-TREATMENT +UCI I-TREATMENT +por I-TREATMENT +cuadro I-TREATMENT +de I-TREATMENT +distrés I-TREATMENT +respiratorio. I-TREATMENT +Fallece B-EVOLUTION +36 I-EVOLUTION +horas I-EVOLUTION +después. I-EVOLUTION + I-EVOLUTION +La B-EXPLORATION +biopsia I-EXPLORATION +hepática, I-EXPLORATION +cuyo I-EXPLORATION +resultado I-EXPLORATION se I-EXPLORATION -detecta I-EXPLORATION -edema I-EXPLORATION -y I-EXPLORATION -enrojecimiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -escrotal, I-EXPLORATION -más I-EXPLORATION -acusado I-EXPLORATION -en I-EXPLORATION +recibió I-EXPLORATION +tras I-EXPLORATION el I-EXPLORATION -hemiescroto I-EXPLORATION -izquierdo I-EXPLORATION -ligeramente I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION -palpación. I-EXPLORATION -Cordón I-EXPLORATION -y I-EXPLORATION -testículos I-EXPLORATION +fallecimiento I-EXPLORATION +del I-EXPLORATION +enfermo, I-EXPLORATION +es I-EXPLORATION +informada I-EXPLORATION +como I-EXPLORATION +dilatación I-EXPLORATION +irregular I-EXPLORATION de I-EXPLORATION -tamaño I-EXPLORATION -y I-EXPLORATION -consistencia I-EXPLORATION -normales I-EXPLORATION -no I-EXPLORATION -dolorosos. I-EXPLORATION - I-EXPLORATION -No I-EXPLORATION -aparece I-EXPLORATION -hidrocele I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -transluminación I-EXPLORATION +los I-EXPLORATION +sinusoides I-EXPLORATION +(peliosis) I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -maniobra I-EXPLORATION +proliferación I-EXPLORATION de I-EXPLORATION -Prehn I-EXPLORATION -es I-EXPLORATION -negativa. I-EXPLORATION -Reflejos I-EXPLORATION -cremastéricos I-EXPLORATION -conservados. I-EXPLORATION +células I-EXPLORATION +endoteliales, I-EXPLORATION +sin I-EXPLORATION +que I-EXPLORATION +estas I-EXPLORATION +presenten I-EXPLORATION +mitosis. I-EXPLORATION I-EXPLORATION Se I-EXPLORATION -solicitó I-EXPLORATION -estudio I-EXPLORATION -ultrasonográfico I-EXPLORATION +realizó I-EXPLORATION +necropsia, I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION que I-EXPLORATION -informó I-EXPLORATION -de: I-EXPLORATION -testículo I-EXPLORATION -y I-EXPLORATION -epidídimos I-EXPLORATION -bilaterales I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -normales I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -inflamación I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -el I-EXPLORATION -flujo I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +macroscópicamente I-EXPLORATION +hígado I-EXPLORATION +con I-EXPLORATION +superficie I-EXPLORATION +externa I-EXPLORATION +macronodular, I-EXPLORATION +que I-EXPLORATION +muestra I-EXPLORATION al I-EXPLORATION -Eco-Doppler. I-EXPLORATION -Cubiertas I-EXPLORATION -testiculares I-EXPLORATION -y I-EXPLORATION -tejido I-EXPLORATION -celular I-EXPLORATION -subcutáneo I-EXPLORATION +corte I-EXPLORATION +áreas I-EXPLORATION +peliótico-esponjosas, I-EXPLORATION +entre I-EXPLORATION +las I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +sitúan I-EXPLORATION +zonas I-EXPLORATION +con I-EXPLORATION +parénquima I-EXPLORATION de I-EXPLORATION -hemiescroto I-EXPLORATION -izquierdo I-EXPLORATION -engrosados I-EXPLORATION +aspecto I-EXPLORATION +sano I-EXPLORATION +pero I-EXPLORATION con I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -flujo I-EXPLORATION -Doppler. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -le I-TREATMENT -diagnosticó I-TREATMENT -de I-TREATMENT -edema I-TREATMENT -de I-TREATMENT -escroto I-TREATMENT -agudo I-TREATMENT -idiopático, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -recetaron I-TREATMENT -AINES I-TREATMENT -y B-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -cito I-EVOLUTION -para I-EVOLUTION -revisión I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -días, I-EVOLUTION -donde I-EVOLUTION -se I-EVOLUTION -pudo I-EVOLUTION -observar I-EVOLUTION -que I-EVOLUTION -el I-EVOLUTION -edema, I-EVOLUTION -el I-EVOLUTION -eritema I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -habían I-EVOLUTION -desaparecido I-EVOLUTION -casi I-EVOLUTION -por I-EVOLUTION -completo. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -Colombiana B-PAST_MEDICAL_HISTORY -de B-PRESENT_ILLNESS -65 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -9 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -episódico I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -punzada I-PRESENT_ILLNESS -localizado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -flanco I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -hematuria, I-PRESENT_ILLNESS -nauseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -Con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -patológico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -obstructiva I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -quirúrgico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -histerectomía. I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -tenía I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -sus I-EXPLORATION signos I-EXPLORATION -vitales, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION +macroscópicos I-EXPLORATION de I-EXPLORATION -masa I-EXPLORATION -corporal I-EXPLORATION +colestasis. I-EXPLORATION +Al I-EXPLORATION +microscopio I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +proliferación I-EXPLORATION +neoplásica I-EXPLORATION +con I-EXPLORATION +patrón I-EXPLORATION de I-EXPLORATION -20kg/Mts2, I-EXPLORATION +crecimiento I-EXPLORATION +sinusoidal, I-EXPLORATION +configurando I-EXPLORATION +espacios I-EXPLORATION +cavernosos I-EXPLORATION +tapizados I-EXPLORATION +por I-EXPLORATION +células I-EXPLORATION +atípicas. I-EXPLORATION +La I-EXPLORATION +afectación I-EXPLORATION +hepática I-EXPLORATION +es I-EXPLORATION +difusa I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -único I-EXPLORATION -signo I-EXPLORATION -que I-EXPLORATION -presentaba I-EXPLORATION -era I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -de I-EXPLORATION -flanco I-EXPLORATION -izquierdo. I-EXPLORATION -Se B-TREATMENT -inicia I-TREATMENT -manejo I-TREATMENT -médico I-TREATMENT -considerando I-TREATMENT -pielonefritis, I-TREATMENT -sin B-EVOLUTION -resolución I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sintomatología, I-EVOLUTION -por B-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION +parcheada, I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +algunas I-EXPLORATION +zonas I-EXPLORATION se I-EXPLORATION -toma I-EXPLORATION -Tomografía I-EXPLORATION -Axial I-EXPLORATION -Computarizada, I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -informa I-EXPLORATION -masa I-EXPLORATION -dependiente I-EXPLORATION +observa I-EXPLORATION +crecimiento I-EXPLORATION +intravascular I-EXPLORATION +neoplásico, I-EXPLORATION +a I-EXPLORATION +veces I-EXPLORATION +con I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION +mitosis, I-EXPLORATION +algunas I-EXPLORATION de I-EXPLORATION -9 I-EXPLORATION -x I-EXPLORATION -10 I-EXPLORATION -cms, I-EXPLORATION -y I-EXPLORATION +ellas I-EXPLORATION +atípicas. I-EXPLORATION +Las I-EXPLORATION +células I-EXPLORATION se I-EXPLORATION -realiza I-EXPLORATION -nefrectomía. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -muestra I-EXPLORATION -quirúrgica I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -renal I-EXPLORATION -fue I-EXPLORATION -fijada I-EXPLORATION -luego I-EXPLORATION -de I-EXPLORATION -extraerse I-EXPLORATION -con I-EXPLORATION -formaldehído I-EXPLORATION -al I-EXPLORATION -10% I-EXPLORATION -y I-EXPLORATION -embebido I-EXPLORATION -en I-EXPLORATION -parafina I-EXPLORATION +muestran I-EXPLORATION +intensamente I-EXPLORATION +positivas I-EXPLORATION para I-EXPLORATION -su I-EXPLORATION -preparación I-EXPLORATION -y I-EXPLORATION -análisis I-EXPLORATION -microscópico, I-EXPLORATION -la I-EXPLORATION -coloración I-EXPLORATION -empleada I-EXPLORATION -fue I-EXPLORATION -Hematoxilina I-EXPLORATION +marcadores I-EXPLORATION +endoteliales I-EXPLORATION +CD-31 I-EXPLORATION y I-EXPLORATION -Eosina. I-EXPLORATION +CD-34. I-EXPLORATION +Todo I-EXPLORATION +ello I-EXPLORATION +es I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +angiosarcoma I-EXPLORATION +hepático I-EXPLORATION +primario. I-EXPLORATION I-EXPLORATION -Varón B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -62 I-PRESENT_ILLNESS +22 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS urgencias I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -referir I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS -testicular I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -acompañado I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Como B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +alergia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +penicilina I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +episodio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +dolor I-PAST_MEDICAL_HISTORY +abdominal I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +año, I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +características I-PAST_MEDICAL_HISTORY +similares I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +actual. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +El B-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +comenzó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +periumbilical I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +irradió I-PRESENT_ILLNESS +posteriormente I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +FID, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -termometrada I-PRESENT_ILLNESS +carácter I-PRESENT_ILLNESS +continuo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -40ºC, I-PRESENT_ILLNESS -junto I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +intensidad I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -escalofríos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -miccional I-PRESENT_ILLNESS -acompañante I-PRESENT_ILLNESS -(disuria, I-PRESENT_ILLNESS -polaquiuria, I-PRESENT_ILLNESS -tenesmo I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +deambulación. I-PRESENT_ILLNESS +Presentó I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -miccional), I-PRESENT_ILLNESS -ausencia I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +previos. I-PRESENT_ILLNESS +Ausencia I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -lumbar. I-PRESENT_ILLNESS +fiebre, I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +mareo. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +alteraciones I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +hábito I-PRESENT_ILLNESS +intestinal I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +miccional. I-PRESENT_ILLNESS I-PRESENT_ILLNESS -Durante B-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -anamnesis I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -revela I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -profesión, I-PAST_MEDICAL_HISTORY -veterinario, I-PAST_MEDICAL_HISTORY -profesión I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -riesgo I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -ciertas I-PAST_MEDICAL_HISTORY -patologías I-PAST_MEDICAL_HISTORY -infecciosas I-PAST_MEDICAL_HISTORY -(brucelosis, I-PAST_MEDICAL_HISTORY -triquinosis I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -algunas I-PAST_MEDICAL_HISTORY -parasitosis). I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -un I-EXPLORATION -teste I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -características I-EXPLORATION -normales, I-EXPLORATION -y, I-EXPLORATION -en I-EXPLORATION el I-EXPLORATION -teste I-EXPLORATION -izquierdo, I-EXPLORATION -se I-EXPLORATION -visualiza I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -eritema I-EXPLORATION +paciente I-EXPLORATION +estaba I-EXPLORATION +afebril, I-EXPLORATION +normotenso I-EXPLORATION y I-EXPLORATION -dolor I-EXPLORATION -al I-EXPLORATION -tacto I-EXPLORATION -sin I-EXPLORATION -fluctuación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -afecta I-EXPLORATION -aunque I-EXPLORATION con I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -movilización I-EXPLORATION -testicular. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -tacto I-EXPLORATION -rectal I-EXPLORATION -resulta I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -patológicos I-EXPLORATION +afectación I-EXPLORATION +del I-EXPLORATION +estado I-EXPLORATION +general. I-EXPLORATION +Presentaba I-EXPLORATION +abdomen I-EXPLORATION +blando I-EXPLORATION y I-EXPLORATION +depresible, I-EXPLORATION +sin I-EXPLORATION +masas I-EXPLORATION +ni I-EXPLORATION +megalias, I-EXPLORATION +doloroso I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -abdominal I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -percusión I-EXPLORATION -renal I-EXPLORATION -también I-EXPLORATION -descartó I-EXPLORATION -afecciones I-EXPLORATION -acompañantes I-EXPLORATION -al I-EXPLORATION -ser I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Analíticamente I-EXPLORATION -destaca I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -22.240 I-EXPLORATION +palpación I-EXPLORATION +en I-EXPLORATION +FID I-EXPLORATION +e I-EXPLORATION +hipogastrio, I-EXPLORATION con I-EXPLORATION -neutrofilia I-EXPLORATION -(neutrófilos I-EXPLORATION -90%). I-EXPLORATION +defensa I-EXPLORATION +y I-EXPLORATION +peritonismo. I-EXPLORATION I-EXPLORATION En I-EXPLORATION la I-EXPLORATION -Ecografía I-EXPLORATION -testicular I-EXPLORATION -realizada I-EXPLORATION -previa I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -muestra I-EXPLORATION -aumentos I-EXPLORATION -homogéneos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -ecogenicidad I-EXPLORATION -del I-EXPLORATION -testículo I-EXPLORATION -afecto, I-EXPLORATION -sin I-EXPLORATION -afectación I-EXPLORATION -del I-EXPLORATION -epidídimo. I-EXPLORATION -Engrosamiento I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -absceso I-EXPLORATION -testicular. I-EXPLORATION -Imágenes I-EXPLORATION -compatibles I-EXPLORATION +analítica I-EXPLORATION +destacaba I-EXPLORATION +leucocitosis I-EXPLORATION +(13.390 I-EXPLORATION +x I-EXPLORATION +103/mcl) I-EXPLORATION con I-EXPLORATION -orquitis I-EXPLORATION -sin I-EXPLORATION -afectación I-EXPLORATION -del I-EXPLORATION -epidídimo. I-EXPLORATION +neutrofilia I-EXPLORATION +(66,7%). I-EXPLORATION I-EXPLORATION -Se B-TREATMENT -realiza I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT +Con B-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT de I-TREATMENT -orquitis I-TREATMENT -infecciosa, I-TREATMENT -procediéndose I-TREATMENT -a I-TREATMENT +apendicitis I-TREATMENT +aguda I-TREATMENT +se I-TREATMENT +intervino I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +urgente I-TREATMENT +encontrando I-TREATMENT +divertículo I-TREATMENT +en I-TREATMENT +cara I-TREATMENT +anterior I-TREATMENT +de I-TREATMENT +ciego I-TREATMENT +inflamado I-TREATMENT +y I-TREATMENT +necrótico I-TREATMENT +por I-TREATMENT +fecalito I-TREATMENT +impactado I-TREATMENT +en I-TREATMENT su I-TREATMENT -ingreso I-TREATMENT -con I-TREATMENT -un I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -que I-TREATMENT -comprendió I-TREATMENT -Doxiciclina, I-TREATMENT -Imipenem I-TREATMENT +interior I-TREATMENT y I-TREATMENT -Teicoplanina, I-TREATMENT -asociando I-TREATMENT -Corticoides I-TREATMENT +apéndice I-TREATMENT +ileocecal I-TREATMENT +hiperémico. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +apendicectomía I-TREATMENT +reglada I-TREATMENT y I-TREATMENT -terapia I-TREATMENT -analgésica. I-TREATMENT - I-TREATMENT -Dos B-EXPLORATION -días I-EXPLORATION -tras I-EXPLORATION -el I-EXPLORATION -ingresse I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -ecografía, I-EXPLORATION -objetivándose I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -ecogenicidad I-EXPLORATION -homogénea I-EXPLORATION -similar I-EXPLORATION -al I-EXPLORATION -contralateral, I-EXPLORATION -afectación I-EXPLORATION -epididimaria. I-EXPLORATION -Engrosamiento I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -absceso I-EXPLORATION -testicular. I-EXPLORATION -Se I-EXPLORATION -termina I-EXPLORATION -de I-EXPLORATION -filiar I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -sindrómico: I-EXPLORATION -Orquiepididimitis I-EXPLORATION -infecciosa. I-EXPLORATION - I-EXPLORATION -Para I-EXPLORATION -averiguar I-EXPLORATION -la I-EXPLORATION -causa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -patología I-EXPLORATION -que I-EXPLORATION -presenta I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -hace I-EXPLORATION -necesaria I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -pruebas I-EXPLORATION -que I-EXPLORATION -permitan I-EXPLORATION -conocer I-EXPLORATION -el I-EXPLORATION -germen I-EXPLORATION -causante. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -urocultivo I-EXPLORATION -resulta I-EXPLORATION -ser I-EXPLORATION -negativo, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -aglutinación I-EXPLORATION -específica I-EXPLORATION -de I-EXPLORATION -Brucella. I-EXPLORATION -Sin I-EXPLORATION -embargo I-EXPLORATION -la I-EXPLORATION -seroaglutinación I-EXPLORATION -de I-EXPLORATION -Rosa I-EXPLORATION -de I-EXPLORATION -Bengala I-EXPLORATION -resulta I-EXPLORATION -positiva, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -los I-EXPLORATION -hemocultivos, I-EXPLORATION -que I-EXPLORATION -son I-EXPLORATION -positivos I-EXPLORATION -a I-EXPLORATION -Brucella I-EXPLORATION -spp. I-EXPLORATION -(los I-EXPLORATION -tres). I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -confirmación I-TREATMENT -del I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -orquiepididimitis I-TREATMENT -brucelar I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -mantener I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT +diverticulectomía I-TREATMENT con I-TREATMENT -Doxiciclina I-TREATMENT -y I-TREATMENT -ciprofloxacino. I-TREATMENT - I-TREATMENT +sutura I-TREATMENT +manual I-TREATMENT +transversal I-TREATMENT +con I-TREATMENT +Byosin® I-TREATMENT +2-0, I-TREATMENT +dejando I-TREATMENT +drenaje I-TREATMENT +de I-TREATMENT +Penrose. I-TREATMENT El B-EVOLUTION paciente I-EVOLUTION -evoluciona I-EVOLUTION +evolucionó I-EVOLUTION favorablemente I-EVOLUTION -con I-EVOLUTION -remisión I-EVOLUTION -completa I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION de I-EVOLUTION -los I-EVOLUTION -síntomas. I-EVOLUTION +alta I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +12º I-EVOLUTION +día I-EVOLUTION +postoperatorio I-EVOLUTION +completamente I-EVOLUTION +asintomático. I-EVOLUTION I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -litiasis I-PRESENT_ILLNESS -piélica I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -nicturia I-PRESENT_ILLNESS -3-4, I-PRESENT_ILLNESS -polaquiuria, I-PRESENT_ILLNESS -escozor I-PRESENT_ILLNESS -miccional I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -aislados I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hematuria. I-PRESENT_ILLNESS La B-EXPLORATION -exploración I-EXPLORATION -física, I-EXPLORATION -el I-EXPLORATION -sistemático I-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION de I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION la I-EXPLORATION -bioquímica I-EXPLORATION -están I-EXPLORATION -dentro I-EXPLORATION +pieza I-EXPLORATION +reveló I-EXPLORATION +apéndice I-EXPLORATION +ileocecal, I-EXPLORATION +periapendicitis, I-EXPLORATION +fecalito I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION +2, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +y I-EXPLORATION +segmento I-EXPLORATION de I-EXPLORATION -aparato I-EXPLORATION -urinario, I-EXPLORATION -se I-EXPLORATION -visualiza I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -radiopaca I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION +intestino I-EXPLORATION +grueso I-EXPLORATION de I-EXPLORATION -riñón I-EXPLORATION -izquierdo. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -anecóica I-EXPLORATION -que I-EXPLORATION -afecta I-EXPLORATION -a I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -riñón I-EXPLORATION -derecho, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -hidronefrosis I-EXPLORATION -e I-EXPLORATION -importante I-EXPLORATION -atrofia I-EXPLORATION -cortical. I-EXPLORATION -En I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -se I-EXPLORATION -visualiza I-EXPLORATION -hidronefrosis I-EXPLORATION -izquierda, I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION con I-EXPLORATION -imágenes I-EXPLORATION -ecogénicas I-EXPLORATION -en I-EXPLORATION -pelvis, I-EXPLORATION -cálices I-EXPLORATION -medios I-EXPLORATION -e I-EXPLORATION -inferiores I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -cálculos. I-EXPLORATION -Ante I-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -urografía I-EXPLORATION -intravenosa, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -distinguen I-EXPLORATION -un I-EXPLORATION -riñón I-EXPLORATION -derecho I-EXPLORATION -no I-EXPLORATION -funcionante I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -bifidez I-EXPLORATION -pieloureteral, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -litiasis I-EXPLORATION -coraliforme I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -pielón I-EXPLORATION -inferior I-EXPLORATION -izquierdo. I-EXPLORATION +severa I-EXPLORATION +inflamación I-EXPLORATION +aguda. I-EXPLORATION I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -TAC I-EXPLORATION -abdomino-pélvico, I-EXPLORATION -el I-EXPLORATION -riñón I-EXPLORATION -derecho I-EXPLORATION -aparece I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -cavidad I-EXPLORATION -quística, I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -cortical I-EXPLORATION -funcionante. I-EXPLORATION -El I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -presenta I-EXPLORATION -hipertrofia I-EXPLORATION -compensadora, I-EXPLORATION -con I-EXPLORATION -varias I-EXPLORATION -lesiones I-EXPLORATION -quísticas I-EXPLORATION -corticales I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -polo I-EXPLORATION -superior I-EXPLORATION -y I-EXPLORATION -cálculos I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -polo I-EXPLORATION -inferior. I-EXPLORATION -Se I-EXPLORATION -decide I-EXPLORATION -practicar I-EXPLORATION -punción I-EXPLORATION -percutánea I-EXPLORATION -bilateral, I-EXPLORATION -observando I-EXPLORATION -gran I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -derecho, I-EXPLORATION -sin I-EXPLORATION -paso I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -al I-EXPLORATION -uréter I-EXPLORATION -y I-EXPLORATION -bifidez I-EXPLORATION -pieloureteral I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION -izquierdo, I-EXPLORATION -con I-EXPLORATION -litiasis I-EXPLORATION -coraliforme I-EXPLORATION -en I-EXPLORATION -pielón I-EXPLORATION -inferior. I-EXPLORATION -Se B-TREATMENT -deja I-TREATMENT -colocada I-TREATMENT -una I-TREATMENT -sonda I-TREATMENT -de I-TREATMENT -nefrostomía I-TREATMENT -en I-TREATMENT -el I-TREATMENT -lado I-TREATMENT -izquierdo I-TREATMENT -y I-TREATMENT -se I-TREATMENT -instaura I-TREATMENT -tratamiento I-TREATMENT -antibiótico, I-TREATMENT -al I-TREATMENT -extraer I-TREATMENT -orina I-TREATMENT -purulenta I-TREATMENT -en I-TREATMENT -la I-TREATMENT -descarga I-TREATMENT -del I-TREATMENT -pielón I-TREATMENT -inferior. I-TREATMENT + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +61 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +histerectomía I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +doble I-PAST_MEDICAL_HISTORY +anexectomía I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +miomas I-PAST_MEDICAL_HISTORY +uterinos I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +1997, I-PAST_MEDICAL_HISTORY +hernia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hiato, I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +médico. I-PAST_MEDICAL_HISTORY +Presentaba I-PAST_MEDICAL_HISTORY +asimismo I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +nódulo I-PAST_MEDICAL_HISTORY +tiroideo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +cm I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +diámetro, I-PAST_MEDICAL_HISTORY +diagnosticado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +bocio I-PAST_MEDICAL_HISTORY +coloide I-PAST_MEDICAL_HISTORY +nodular I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +PAAF I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +1995. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Fue I-PAST_MEDICAL_HISTORY +intervenida I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2001, I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +nefrectomía I-PAST_MEDICAL_HISTORY +radical I-PAST_MEDICAL_HISTORY +derecha, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +tumor I-PAST_MEDICAL_HISTORY +heterogéneo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +8 I-PAST_MEDICAL_HISTORY +cm I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +diámetro I-PAST_MEDICAL_HISTORY +localizado I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +nivel I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +tercio I-PAST_MEDICAL_HISTORY +medio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +riñón I-PAST_MEDICAL_HISTORY +derecho, I-PAST_MEDICAL_HISTORY +correspondiendo I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +estudio I-PAST_MEDICAL_HISTORY +anatomopatológico I-PAST_MEDICAL_HISTORY +posterior, I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +adenocarcinoma I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alto I-PAST_MEDICAL_HISTORY +grado, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +infiltración I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vena I-PAST_MEDICAL_HISTORY +renal, I-PAST_MEDICAL_HISTORY +estadio I-PAST_MEDICAL_HISTORY +pT3bNoMo. I-PAST_MEDICAL_HISTORY +Fue I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +posteriormente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +coadyuvante I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +interleukina- I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +subcutánea I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +12 I-PAST_MEDICAL_HISTORY +meses. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +informe I-PAST_MEDICAL_HISTORY +anatomopatológico I-PAST_MEDICAL_HISTORY +macroscópico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +pieza I-PAST_MEDICAL_HISTORY +describía I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +nódulo I-PAST_MEDICAL_HISTORY +tumoral I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +infiltraba I-PAST_MEDICAL_HISTORY +pelvis I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +vena I-PAST_MEDICAL_HISTORY +renal, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +diámetro I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +8 I-PAST_MEDICAL_HISTORY +x I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +x I-PAST_MEDICAL_HISTORY +7 I-PAST_MEDICAL_HISTORY +cm, I-PAST_MEDICAL_HISTORY +combinando I-PAST_MEDICAL_HISTORY +áreas I-PAST_MEDICAL_HISTORY +grisáceas I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +otras I-PAST_MEDICAL_HISTORY +pardoamarillentas. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +estudio I-PAST_MEDICAL_HISTORY +microscópico I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +observó I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +tumoración I-PAST_MEDICAL_HISTORY +pseudocapsular I-PAST_MEDICAL_HISTORY +correspondiente I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +adenocarcinoma I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alto I-PAST_MEDICAL_HISTORY +grado, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +alguna I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY +anaplásica. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +tumor I-PAST_MEDICAL_HISTORY +invadía I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +sistema I-PAST_MEDICAL_HISTORY +pielocalicial I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +evidencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +invasión I-PAST_MEDICAL_HISTORY +vascular I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +vena I-PAST_MEDICAL_HISTORY +renal. I-PAST_MEDICAL_HISTORY +Los I-PAST_MEDICAL_HISTORY +márgenes I-PAST_MEDICAL_HISTORY +quirúrgicos I-PAST_MEDICAL_HISTORY +estaban I-PAST_MEDICAL_HISTORY +libres. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +2004 I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +estudio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +control, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +detectó I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +TAC, I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +marcado I-PAST_MEDICAL_HISTORY +crecimiento I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +lóbulo I-PAST_MEDICAL_HISTORY +tiroideo I-PAST_MEDICAL_HISTORY +izquierdo, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +presencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +nódulo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +cm I-PAST_MEDICAL_HISTORY +heterogéneo, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +relación I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +nódulo I-PAST_MEDICAL_HISTORY +coloide I-PAST_MEDICAL_HISTORY +previo I-PAST_MEDICAL_HISTORY +conocido. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +2005, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +nuevo I-PAST_MEDICAL_HISTORY +TAC, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +observó I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +mismo I-PAST_MEDICAL_HISTORY +lóbulo I-PAST_MEDICAL_HISTORY +tiroideo I-PAST_MEDICAL_HISTORY +izquierdo, I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +crecimiento I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +nódulo I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +5, I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +cm I-PAST_MEDICAL_HISTORY +desplazando I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +tráquea. I-PAST_MEDICAL_HISTORY La B-EXPLORATION gammagrafía I-EXPLORATION -renal I-EXPLORATION -confirma I-EXPLORATION -la I-EXPLORATION -escasa I-EXPLORATION -función I-EXPLORATION -riñón I-EXPLORATION -derecho I-EXPLORATION -(11%). I-EXPLORATION -En I-EXPLORATION +tiroidea I-EXPLORATION +mostraba I-EXPLORATION +un I-EXPLORATION +'nódulo I-EXPLORATION +frío' I-EXPLORATION +en I-EXPLORATION +lóbulo I-EXPLORATION +izquierdo, I-EXPLORATION +mientras I-EXPLORATION +que I-EXPLORATION la I-EXPLORATION -cistoscopia I-EXPLORATION +analítica I-EXPLORATION +sanguínea I-EXPLORATION no I-EXPLORATION -se I-EXPLORATION -objetivan I-EXPLORATION -neorformaciones I-EXPLORATION -vesicales. I-EXPLORATION +demostró I-EXPLORATION +alteración I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +hormonas I-EXPLORATION +tiroideas. I-EXPLORATION I-EXPLORATION -Tras B-TREATMENT -estudios I-TREATMENT -preoperatorios I-TREATMENT -dentro I-TREATMENT -de I-TREATMENT -la I-TREATMENT -normalidad I-TREATMENT +Ante B-TREATMENT el I-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -intervenido I-TREATMENT -quirúrgicamente I-TREATMENT -realizándose I-TREATMENT -nefrolitotomía I-TREATMENT -percutánea I-TREATMENT -izquierda, I-TREATMENT -con I-TREATMENT -fragmentación I-TREATMENT -de I-TREATMENT -litiasis I-TREATMENT -con I-TREATMENT -lithoclast I-TREATMENT -y I-TREATMENT -extracción I-TREATMENT -de I-TREATMENT -fragmentos. I-TREATMENT -A I-TREATMENT -los I-TREATMENT -quince I-TREATMENT -días I-TREATMENT +crecimiento I-TREATMENT +progresivo I-TREATMENT +del I-TREATMENT +nódulo I-TREATMENT se I-TREATMENT -lleva I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -una I-TREATMENT -nueva I-TREATMENT -nefrolitotomía I-TREATMENT -con I-TREATMENT -el I-TREATMENT -fin I-TREATMENT -de I-TREATMENT -eliminar I-TREATMENT -todos I-TREATMENT -los I-TREATMENT -restos I-TREATMENT -litiásicos. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -continúa I-EVOLUTION -eliminando I-EVOLUTION -orina I-EVOLUTION -purulenta I-EVOLUTION -por I-EVOLUTION -sonda I-EVOLUTION -de I-EVOLUTION -nefrostomía I-EVOLUTION -percutánea. I-EVOLUTION -La B-EXPLORATION -angiografía I-EXPLORATION -por I-EXPLORATION -sustracción I-EXPLORATION -digital' I-EXPLORATION -(DIVAS) I-EXPLORATION -demuestra I-EXPLORATION -una I-EXPLORATION -escasa I-EXPLORATION -vascularización I-EXPLORATION -del I-EXPLORATION -polo I-EXPLORATION -inferior I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -izquierdo. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -una I-TREATMENT -heminefrectomía I-TREATMENT -polar I-TREATMENT -inferior I-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +hemitiroidectomía I-TREATMENT izquierda. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -postoperatorio I-TREATMENT -inmediato I-TREATMENT -se I-TREATMENT -produce I-TREATMENT -un I-TREATMENT -empeoramiento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -función I-TREATMENT -renal, I-TREATMENT -con I-TREATMENT -fiebre I-TREATMENT -y I-TREATMENT -leucocitosis, I-TREATMENT -proceso I-TREATMENT -compatible I-TREATMENT -con I-TREATMENT -sepsis I-TREATMENT -de I-TREATMENT -origen I-TREATMENT -urinario I-TREATMENT -que I-TREATMENT -mejora I-TREATMENT -con I-TREATMENT -sueroterapia I-TREATMENT -y I-TREATMENT -antibioterapia I-TREATMENT -parenteral. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -pieza I-EXPLORATION -extirpada I-EXPLORATION -corresponde I-EXPLORATION -a I-EXPLORATION +El B-EXPLORATION +informe I-EXPLORATION +anatomopatológico I-EXPLORATION +describía I-EXPLORATION un I-EXPLORATION -riñón I-EXPLORATION +hemitiroides I-EXPLORATION izquierdo I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION de I-EXPLORATION -452 I-EXPLORATION -gramos I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -acompaña I-EXPLORATION +8 I-EXPLORATION +x I-EXPLORATION +6 I-EXPLORATION +x I-EXPLORATION +2 I-EXPLORATION +cm, I-EXPLORATION +con I-EXPLORATION +múltiples I-EXPLORATION +zonas I-EXPLORATION +amarillentas I-EXPLORATION +en I-EXPLORATION +superficie, I-EXPLORATION +alternando I-EXPLORATION +con I-EXPLORATION +otras I-EXPLORATION de I-EXPLORATION -abundante I-EXPLORATION -grasa I-EXPLORATION -intimamente I-EXPLORATION -pegada I-EXPLORATION -al I-EXPLORATION -parenquima I-EXPLORATION -renal. I-EXPLORATION -Al I-EXPLORATION -corte I-EXPLORATION +aspecto I-EXPLORATION +más I-EXPLORATION +carnoso. I-EXPLORATION +En I-EXPLORATION el I-EXPLORATION -parenquima I-EXPLORATION -está I-EXPLORATION -sustituido I-EXPLORATION -por I-EXPLORATION -grandes I-EXPLORATION -cavidades I-EXPLORATION -quísticas I-EXPLORATION -ocupadas I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -material I-EXPLORATION -blanquecino I-EXPLORATION -y I-EXPLORATION -blando. I-EXPLORATION -Histológicamente I-EXPLORATION +examen I-EXPLORATION +microscópico I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION +observó I-EXPLORATION una I-EXPLORATION -tumoración I-EXPLORATION +lesión I-EXPLORATION constituida I-EXPLORATION por I-EXPLORATION -grandes I-EXPLORATION -masas I-EXPLORATION -sólidas, I-EXPLORATION -nidos I-EXPLORATION -y I-EXPLORATION -regueros I-EXPLORATION -infiltrantes I-EXPLORATION -de I-EXPLORATION células I-EXPLORATION -de I-EXPLORATION -hábito I-EXPLORATION -escamoso I-EXPLORATION -que I-EXPLORATION -presentan I-EXPLORATION -grandes I-EXPLORATION -núcleos I-EXPLORATION -vesiculosos I-EXPLORATION -e I-EXPLORATION -irregulares I-EXPLORATION +tumorales I-EXPLORATION con I-EXPLORATION -nucleolo I-EXPLORATION -prominente, I-EXPLORATION citoplasma I-EXPLORATION -amplio, I-EXPLORATION -bien I-EXPLORATION -definido, I-EXPLORATION -eosinófilo I-EXPLORATION claro, I-EXPLORATION +las I-EXPLORATION +cuales I-EXPLORATION +presentaban I-EXPLORATION +una I-EXPLORATION +acusada I-EXPLORATION +atipia, I-EXPLORATION con I-EXPLORATION -abundantes I-EXPLORATION -imágenes I-EXPLORATION +zonas I-EXPLORATION +incluso I-EXPLORATION +anaplásicas I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +figuras I-EXPLORATION +de I-EXPLORATION +mitosis. I-EXPLORATION +Presentaban I-EXPLORATION +un I-EXPLORATION +crecimiento I-EXPLORATION +difuso I-EXPLORATION +constituyendo I-EXPLORATION +nódulos I-EXPLORATION +con I-EXPLORATION +zonas I-EXPLORATION de I-EXPLORATION -queratinización I-EXPLORATION -individual I-EXPLORATION +esclerosis I-EXPLORATION y I-EXPLORATION -formación I-EXPLORATION +extensas I-EXPLORATION +áreas I-EXPLORATION de I-EXPLORATION -perlas I-EXPLORATION -corneas. I-EXPLORATION +necrosis. I-EXPLORATION +La I-EXPLORATION +lesión I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +rodeada I-EXPLORATION +por I-EXPLORATION +tejido I-EXPLORATION +tiroideo I-EXPLORATION +respetado I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +objetivaban I-EXPLORATION +folículos I-EXPLORATION +linfoides. I-EXPLORATION I-EXPLORATION -En I-EXPLORATION -urografía I-EXPLORATION +Se I-EXPLORATION +realizaron I-EXPLORATION +técnicas I-EXPLORATION de I-EXPLORATION -control I-EXPLORATION -posterior I-EXPLORATION -a I-EXPLORATION +inmunohistoquímica I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +cuales I-EXPLORATION +dichas I-EXPLORATION +células I-EXPLORATION +tumorales I-EXPLORATION +presentaron I-EXPLORATION +negatividad I-EXPLORATION +para I-EXPLORATION la I-EXPLORATION -cirugía I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -una I-EXPLORATION -función I-EXPLORATION -normal I-EXPLORATION -del I-EXPLORATION -hemirriñón I-EXPLORATION -superior I-EXPLORATION -izquierdo, I-EXPLORATION -sin I-EXPLORATION -uropatía I-EXPLORATION -obstructiva. I-EXPLORATION +tiroglobulina I-EXPLORATION +y I-EXPLORATION +positividad I-EXPLORATION +para I-EXPLORATION +CK8, I-EXPLORATION +CK18, I-EXPLORATION +EMA, I-EXPLORATION +y I-EXPLORATION +Vimentina. I-EXPLORATION I-EXPLORATION -Un B-EVOLUTION -año I-EVOLUTION -y I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -ingresa I-EVOLUTION -desde I-EVOLUTION -urgencias I-EVOLUTION -por I-EVOLUTION -hematuria I-EVOLUTION -macroscópica. I-EVOLUTION -En B-EXPLORATION +Dadas I-EXPLORATION +las I-EXPLORATION +características I-EXPLORATION +histológicas I-EXPLORATION +del I-EXPLORATION +tumor I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +perfil I-EXPLORATION +inmunohistoquímico, I-EXPLORATION +junto I-EXPLORATION +con I-EXPLORATION la I-EXPLORATION -urografía I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -un I-EXPLORATION -defecto I-EXPLORATION +historia I-EXPLORATION +clínica I-EXPLORATION +del I-EXPLORATION +paciente, I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +fue I-EXPLORATION +informada I-EXPLORATION +como I-EXPLORATION +metástasis I-EXPLORATION de I-EXPLORATION -replección I-EXPLORATION -en I-EXPLORATION -cara I-EXPLORATION -lateral I-EXPLORATION -derecha, I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -corroborado I-EXPLORATION -mediante I-EXPLORATION -cistoscopia. I-EXPLORATION -Se B-TREATMENT -realiza I-TREATMENT -resección I-TREATMENT -transuretral I-TREATMENT -de I-TREATMENT -tumoración I-TREATMENT -sólida I-TREATMENT -en I-TREATMENT -cara I-TREATMENT -lateral I-TREATMENT -derecha I-TREATMENT -de I-TREATMENT -vejiga, I-TREATMENT -con I-TREATMENT -diagnóstico I-TREATMENT -anatomo-patológico I-TREATMENT -de I-TREATMENT -carcinoma I-TREATMENT -vesical I-TREATMENT -con I-TREATMENT -áreas I-TREATMENT -de I-TREATMENT -diferenciación I-TREATMENT -escamosa I-TREATMENT -que I-TREATMENT -infiltra I-TREATMENT -la I-TREATMENT -muscular, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -cistoprostatectomía I-TREATMENT -radical I-TREATMENT -con I-TREATMENT -derivación I-TREATMENT -urinaria I-TREATMENT -de I-TREATMENT -uréter I-TREATMENT -izquierdo I-TREATMENT -a I-TREATMENT -sigma I-TREATMENT -(Mainz I-TREATMENT -II). I-TREATMENT -En I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -acto I-TREATMENT -quirúrgico I-TREATMENT -se I-TREATMENT -practica I-TREATMENT -una I-TREATMENT -nefroureterectomía I-TREATMENT -derecha, I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -observa I-TREATMENT -un I-TREATMENT -riñón I-TREATMENT -hidronefrótico, I-TREATMENT -con I-TREATMENT -un I-TREATMENT -síndrome I-TREATMENT -de I-TREATMENT -la I-TREATMENT -unión I-TREATMENT -pieloureteral I-TREATMENT -por I-TREATMENT -un I-TREATMENT -vaso I-TREATMENT -polar. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -reveló I-EXPLORATION -un I-EXPLORATION -carcinoma I-EXPLORATION +adenocarcinoma I-EXPLORATION +renal I-EXPLORATION de I-EXPLORATION células I-EXPLORATION -escamosas, I-EXPLORATION -estadio I-EXPLORATION -pT3a, I-EXPLORATION -pNx, I-EXPLORATION -pMx. I-EXPLORATION +claras. I-EXPLORATION I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -fallece I-EVOLUTION -cuatro I-EVOLUTION -meses I-EVOLUTION -más I-EVOLUTION -tarde, I-EVOLUTION -con I-EVOLUTION -metástasis I-EVOLUTION -pulmonares I-EVOLUTION -y I-EVOLUTION -hepáticas. I-EVOLUTION - I-EVOLUTION Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS +50 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +no B-PAST_MEDICAL_HISTORY +fumador. I-PAST_MEDICAL_HISTORY +Como I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +destaca I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +ingresos I-PAST_MEDICAL_HISTORY +hospitalarios I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +intoxicación I-PAST_MEDICAL_HISTORY +aguda I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +organofosforados. I-PAST_MEDICAL_HISTORY +Aporta I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +informes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +reconocimientos I-PAST_MEDICAL_HISTORY +médicos I-PAST_MEDICAL_HISTORY +periódicos I-PAST_MEDICAL_HISTORY +realizados I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +23 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +ha I-PAST_MEDICAL_HISTORY +trabajado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +empresa I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +fabricaba I-PAST_MEDICAL_HISTORY +diversos I-PAST_MEDICAL_HISTORY +productos I-PAST_MEDICAL_HISTORY +fitosanitarios I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +obtención I-PAST_MEDICAL_HISTORY +empleaba I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +amplio I-PAST_MEDICAL_HISTORY +número I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +disolventes I-PAST_MEDICAL_HISTORY +orgánicos, I-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY +ellos I-PAST_MEDICAL_HISTORY +acetona, I-PAST_MEDICAL_HISTORY +acetofenona, I-PAST_MEDICAL_HISTORY +ciclohexanona, I-PAST_MEDICAL_HISTORY +nafta, I-PAST_MEDICAL_HISTORY +tolueno I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +xileno, I-PAST_MEDICAL_HISTORY +donde I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +único I-PAST_MEDICAL_HISTORY +control I-PAST_MEDICAL_HISTORY +específico I-PAST_MEDICAL_HISTORY +realizado I-PAST_MEDICAL_HISTORY +esporádicamente I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +exposición I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +organofosforados I-PAST_MEDICAL_HISTORY +(determinación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +acetilcolinesterasa I-PAST_MEDICAL_HISTORY +intraeritrocitaria), I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +presenta I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +familiares I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +nefropatías, I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +analíticas I-PAST_MEDICAL_HISTORY +generales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +sangre I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +orina I-PAST_MEDICAL_HISTORY +son I-PAST_MEDICAL_HISTORY +normales, I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +tensiones I-PAST_MEDICAL_HISTORY +arteriales I-PAST_MEDICAL_HISTORY +oscilan I-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY +100/60 I-PAST_MEDICAL_HISTORY +mm/Hg I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +120/80 I-PAST_MEDICAL_HISTORY +mm/Hg. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +uno I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +reconocimientos I-PAST_MEDICAL_HISTORY +realizados I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +detectó I-PAST_MEDICAL_HISTORY +proteinuria I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +microhematuria, I-PAST_MEDICAL_HISTORY +creatinina I-PAST_MEDICAL_HISTORY +sérica I-PAST_MEDICAL_HISTORY +1, I-PAST_MEDICAL_HISTORY +06 I-PAST_MEDICAL_HISTORY +mg/dl; I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +nuevo I-PAST_MEDICAL_HISTORY +reconocimiento I-PAST_MEDICAL_HISTORY +realizado I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +siguiente I-PAST_MEDICAL_HISTORY +presenta I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +creatinina I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +1, I-PAST_MEDICAL_HISTORY +43 I-PAST_MEDICAL_HISTORY +mg/dl, I-PAST_MEDICAL_HISTORY +hematuria I-PAST_MEDICAL_HISTORY +(10 I-PAST_MEDICAL_HISTORY +hematíes/campo), I-PAST_MEDICAL_HISTORY +proteinuria I-PAST_MEDICAL_HISTORY +1 I-PAST_MEDICAL_HISTORY +g/día. I-PAST_MEDICAL_HISTORY +Hace B-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS años I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +diagnosticado I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS una I-PRESENT_ILLNESS -litiasis I-PRESENT_ILLNESS -piélica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -riñón I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS +glomerulonefritis I-PRESENT_ILLNESS +proliferativa I-PRESENT_ILLNESS +mesangial I-PRESENT_ILLNESS +difusa I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -diámetro I-PRESENT_ILLNESS +depósitos I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -cm. I-PRESENT_ILLNESS -Se B-TREATMENT -le I-TREATMENT -propone I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -una I-TREATMENT -NLPC. I-TREATMENT -Bajo I-TREATMENT -anestesia I-TREATMENT -general I-TREATMENT -y I-TREATMENT -en I-TREATMENT -posición I-TREATMENT -de I-TREATMENT -decúbito I-TREATMENT -prono I-TREATMENT -se I-TREATMENT -accede I-TREATMENT -al I-TREATMENT -riñón I-TREATMENT -por I-TREATMENT -grupo I-TREATMENT -calicial I-TREATMENT -inferior, I-TREATMENT -bajo I-TREATMENT -control I-TREATMENT -de I-TREATMENT -escopia. I-TREATMENT -Se I-TREATMENT -dilata I-TREATMENT -el I-TREATMENT -trayecto I-TREATMENT -de I-TREATMENT -acceso I-TREATMENT -percutáneo I-TREATMENT -con I-TREATMENT -dilatadores I-TREATMENT -metálicos I-TREATMENT -coaxiales I-TREATMENT -de I-TREATMENT -Alken. I-TREATMENT -Se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -la I-TREATMENT -fragmentación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -litiasis I-TREATMENT -con I-TREATMENT -el I-TREATMENT -litotriptor I-TREATMENT -intracorpóreo I-TREATMENT -StoneBreakerTM I-TREATMENT -(LMA I-TREATMENT -Urology, I-TREATMENT -Gland, I-TREATMENT -Switzerland). I-TREATMENT -El I-TREATMENT -tiempo I-TREATMENT -de I-TREATMENT -fragmentación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -litiasis I-TREATMENT -fue I-TREATMENT -de I-TREATMENT -30 I-TREATMENT -minutos I-TREATMENT -utilizando I-TREATMENT -tres I-TREATMENT -cartuchos I-TREATMENT -de I-TREATMENT -dióxido I-TREATMENT -de I-TREATMENT -carbono I-TREATMENT -comprimido. I-TREATMENT -No B-EVOLUTION -existieron I-EVOLUTION -complicaciones I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION +IgA. I-PRESENT_ILLNESS +En B-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +renal I-EXPLORATION +destacaba I-EXPLORATION +un I-EXPLORATION +20% I-EXPLORATION +de I-EXPLORATION +glomérulos I-EXPLORATION +con I-EXPLORATION +esclerosis I-EXPLORATION +severa, I-EXPLORATION +un I-EXPLORATION +10% I-EXPLORATION +estaban I-EXPLORATION +obliterados, I-EXPLORATION +había I-EXPLORATION +una I-EXPLORATION +fibrosis I-EXPLORATION +intersticial, I-EXPLORATION +atrofia I-EXPLORATION +tubular, I-EXPLORATION +discreto I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION +crónico I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +inmunofluorescencia I-EXPLORATION +se I-EXPLORATION +detectaban I-EXPLORATION +depósitos I-EXPLORATION +mesangiales I-EXPLORATION +difusos I-EXPLORATION +de I-EXPLORATION +IgA I-EXPLORATION +y I-EXPLORATION +C3; I-EXPLORATION +a B-EVOLUTION +pesar I-EVOLUTION +de I-EVOLUTION +ello, I-EVOLUTION +siguió I-EVOLUTION +trabajando I-EVOLUTION +hasta I-EVOLUTION +hace I-EVOLUTION +un I-EVOLUTION +año, I-EVOLUTION +que I-EVOLUTION fue I-EVOLUTION -dado I-EVOLUTION +diagnosticado I-EVOLUTION +de I-EVOLUTION +una I-EVOLUTION +enfermedad I-EVOLUTION +renal I-EVOLUTION +crónica I-EVOLUTION +de I-EVOLUTION +grado I-EVOLUTION +3. I-EVOLUTION + I-EVOLUTION +La I-EVOLUTION +evolución I-EVOLUTION de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION las I-EVOLUTION -72 I-EVOLUTION -horas I-EVOLUTION -del I-EVOLUTION -procedimiento I-EVOLUTION -con B-TREATMENT -un I-TREATMENT -catéter I-TREATMENT -doble I-TREATMENT -J I-TREATMENT -por I-TREATMENT -la I-TREATMENT -existencia I-TREATMENT -de I-TREATMENT -restos I-TREATMENT -litiásicos I-TREATMENT -menores I-TREATMENT -de I-TREATMENT -3 I-TREATMENT -mm. I-TREATMENT - I-TREATMENT +analíticas I-EVOLUTION +renales, I-EVOLUTION +realizadas I-EVOLUTION +cada I-EVOLUTION +seis I-EVOLUTION +meses I-EVOLUTION +desde I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +realizó I-EVOLUTION +el I-EVOLUTION +diagnóstico I-EVOLUTION +hasta I-EVOLUTION +la I-EVOLUTION +actualidad, I-EVOLUTION +vienen I-EVOLUTION +expresadas I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +tabla I-EVOLUTION +2. I-EVOLUTION +Las I-EVOLUTION +determinaciones I-EVOLUTION +puntuales I-EVOLUTION +de I-EVOLUTION +beta I-EVOLUTION +2-microglobulina I-EVOLUTION +y I-EVOLUTION +NAG I-EVOLUTION +urinarios I-EVOLUTION +se I-EVOLUTION +encontraban I-EVOLUTION +dentro I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +valores I-EVOLUTION +de I-EVOLUTION +normalidad. I-EVOLUTION +Después I-EVOLUTION +de I-EVOLUTION +un I-EVOLUTION +año I-EVOLUTION +de I-EVOLUTION +haber I-EVOLUTION +cesado I-EVOLUTION +su I-EVOLUTION +actividad I-EVOLUTION +laboral I-EVOLUTION +la I-EVOLUTION +proteinuria I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +hematuria I-EVOLUTION +se I-EVOLUTION +normalizaron I-EVOLUTION +pero I-EVOLUTION +la I-EVOLUTION +creatinina I-EVOLUTION +sérica I-EVOLUTION +se I-EVOLUTION +mantuvo I-EVOLUTION +alta. I-EVOLUTION + I-EVOLUTION -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -63 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -al B-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ecografía I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -solicitada I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -estudio I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -prostático, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -diagnosticó I-PRESENT_ILLNESS +65 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +diagnosticada I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -RH I-PRESENT_ILLNESS +hepatitis I-PRESENT_ILLNESS +crónica I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +virus I-PRESENT_ILLNESS +C I-PRESENT_ILLNESS +genotipo I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS con I-PRESENT_ILLNESS una I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -sólida I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -asienta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -istmo I-PRESENT_ILLNESS -renal. I-PRESENT_ILLNESS -El B-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +carga I-PRESENT_ILLNESS +viral I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +4.300.000 I-PRESENT_ILLNESS +copias/ml I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +hipertensión I-PRESENT_ILLNESS +arterial I-PRESENT_ILLNESS +(HTA). I-PRESENT_ILLNESS +Se B-TREATMENT +instauró I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +IFN I-TREATMENT +pegilado I-TREATMENT +alpha-2b I-TREATMENT +(180µg/semana) I-TREATMENT +junto I-TREATMENT +a I-TREATMENT +ribavirina I-TREATMENT +(800mg/día). I-TREATMENT +Dados B-EXPLORATION +sus I-EXPLORATION +antecedentes I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION +HTA I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +exploración I-EXPLORATION +oftalmológica I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +15 I-EXPLORATION +días I-EXPLORATION +del I-EXPLORATION +inicio I-EXPLORATION +del I-EXPLORATION +tratamiento. I-EXPLORATION +Presentó I-EXPLORATION +una I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +(AV) I-EXPLORATION de I-EXPLORATION -8 I-EXPLORATION -cm. I-EXPLORATION +10/10 I-EXPLORATION +con I-EXPLORATION +corrección I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -istmo I-EXPLORATION -renal I-EXPLORATION -sin I-EXPLORATION -evidenciar I-EXPLORATION -adenopatías, I-EXPLORATION -metástasis I-EXPLORATION -locoregionales I-EXPLORATION -ni I-EXPLORATION -lesiones I-EXPLORATION -a I-EXPLORATION -distancia I-EXPLORATION +ambos I-EXPLORATION +ojos I-EXPLORATION +y I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -extensión. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -vascular I-EXPLORATION -preoperatorio I-EXPLORATION -mediante I-EXPLORATION -arteriografía, I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION +fondo I-EXPLORATION de I-EXPLORATION -dos I-EXPLORATION -arterias I-EXPLORATION -renales I-EXPLORATION +ojo I-EXPLORATION +(FO): I-EXPLORATION +papilas I-EXPLORATION +y I-EXPLORATION +máculas I-EXPLORATION +normales. I-EXPLORATION +Esclerosis I-EXPLORATION +arterial I-EXPLORATION +y I-EXPLORATION +tortuosidad I-EXPLORATION +venosa I-EXPLORATION con I-EXPLORATION -nacimiento I-EXPLORATION -ortotópico. I-EXPLORATION -Las I-EXPLORATION -imágenes I-EXPLORATION -selectivas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -renal I-EXPLORATION -derecha, I-EXPLORATION -evidenciaron I-EXPLORATION -vasos I-EXPLORATION -neoformados I-EXPLORATION -a I-EXPLORATION -expensas I-EXPLORATION -de I-EXPLORATION +cruces I-EXPLORATION +arterio-venosos I-EXPLORATION +patológicos. I-EXPLORATION + I-EXPLORATION +A B-EVOLUTION +los I-EVOLUTION +3 I-EVOLUTION +meses, I-EVOLUTION +y I-EVOLUTION +estando I-EVOLUTION +asintomática, I-EVOLUTION +fue I-EVOLUTION +de I-EVOLUTION +nuevo I-EVOLUTION +valorada. I-EVOLUTION +Presentó B-EXPLORATION la I-EXPLORATION -rama I-EXPLORATION -medial I-EXPLORATION +misma I-EXPLORATION +AV I-EXPLORATION +pero I-EXPLORATION en I-EXPLORATION -su I-EXPLORATION -bifurcación I-EXPLORATION +el I-EXPLORATION +FO I-EXPLORATION +aparecían I-EXPLORATION +múltiples I-EXPLORATION +exudados I-EXPLORATION +algodonosos I-EXPLORATION +en I-EXPLORATION +arcadas I-EXPLORATION +y I-EXPLORATION +polo I-EXPLORATION +posterior, I-EXPLORATION con I-EXPLORATION -normalidad I-EXPLORATION -del I-EXPLORATION -árbol I-EXPLORATION -venoso I-EXPLORATION -intra I-EXPLORATION +respeto I-EXPLORATION +de I-EXPLORATION +área I-EXPLORATION +macular, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +alguna I-EXPLORATION +microhemorragia I-EXPLORATION y I-EXPLORATION -extrarrenal. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -la I-TREATMENT -presunción I-TREATMENT -diagnóstica I-TREATMENT +microaneurisma. I-EXPLORATION +Se B-TREATMENT +etiquetó I-TREATMENT de I-TREATMENT -carcinoma I-TREATMENT -renal, I-TREATMENT -se I-TREATMENT -practicó I-TREATMENT -istmectomía I-TREATMENT +retinopatía I-TREATMENT +por I-TREATMENT +IFN I-TREATMENT y I-TREATMENT -nefrectomía I-TREATMENT -izquierda I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -una I-TREATMENT -laparotomía I-TREATMENT -media. I-TREATMENT -Durante I-TREATMENT -el I-TREATMENT -acto I-TREATMENT -operatorio I-TREATMENT se I-TREATMENT -apreció I-TREATMENT -que I-TREATMENT +decidió I-TREATMENT +continuar I-TREATMENT +con I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +dada I-TREATMENT la I-TREATMENT -pelvis I-TREATMENT -renal I-TREATMENT +nula I-TREATMENT +repercusión I-TREATMENT +en I-TREATMENT +la I-TREATMENT +AV, I-TREATMENT +la I-TREATMENT +carga I-TREATMENT +viral I-TREATMENT +alta I-TREATMENT y I-TREATMENT -el I-TREATMENT -uréter I-TREATMENT -izquierdos I-TREATMENT -se I-TREATMENT -hallaban I-TREATMENT -infiltrados I-TREATMENT +la I-TREATMENT +posibilidad I-TREATMENT +de I-TREATMENT +un I-TREATMENT +seguimiento I-TREATMENT +estrecho. I-TREATMENT + I-TREATMENT +La I-TREATMENT +respuesta I-TREATMENT +virológica I-TREATMENT +fue I-TREATMENT +tardía I-TREATMENT +en I-TREATMENT +la I-TREATMENT +semana I-TREATMENT +24, I-TREATMENT por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +prolongó I-TREATMENT el I-TREATMENT -tumor. I-TREATMENT -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -renal I-EXPLORATION -neoformada I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -cm. I-EXPLORATION -afectando I-EXPLORATION -cápsula, I-EXPLORATION -grasa I-EXPLORATION -perirrenal, I-EXPLORATION -así I-EXPLORATION -como, I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -urinaria I-EXPLORATION -izquierda. I-EXPLORATION -La I-EXPLORATION -histología I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -neuroendocrino I-EXPLORATION -de I-EXPLORATION -célula I-EXPLORATION -no I-EXPLORATION -pequeña. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmuno-histoquímico I-EXPLORATION -resultó I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -CD-56 I-EXPLORATION -y I-EXPLORATION -sinaptofisina. I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -4 I-EXPLORATION -meses I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -intervención, I-EXPLORATION -el I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -apreció I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -sólido I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm. I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -polo I-EXPLORATION -inferior I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION -derecho, I-EXPLORATION -así I-EXPLORATION -como, I-EXPLORATION -adenopatías I-EXPLORATION -para-aórticas I-EXPLORATION -izquierdas I-EXPLORATION -y I-EXPLORATION -múltiples I-EXPLORATION -nódulos I-EXPLORATION -retrocrurales I-EXPLORATION -subcentimétricos. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -PET-TC I-EXPLORATION -mostró I-EXPLORATION -que I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -descritas I-EXPLORATION -eran I-EXPLORATION -sugestivas I-EXPLORATION -de I-EXPLORATION -metástasis. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT tratamiento I-TREATMENT -con I-TREATMENT -radioterapia I-TREATMENT -externa I-TREATMENT -(RT) I-TREATMENT -y I-TREATMENT -quimioterapia I-TREATMENT -(QT) I-TREATMENT -(carboplatino I-TREATMENT -y I-TREATMENT -VP-16) I-TREATMENT +72 I-TREATMENT +semanas I-TREATMENT con I-TREATMENT buena I-TREATMENT -tolerancia I-TREATMENT +respuesta. I-TREATMENT +Durante I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +se I-TREATMENT +produjo I-TREATMENT +neutropenia I-TREATMENT +que I-TREATMENT +como I-TREATMENT +máximo I-TREATMENT +llegó I-TREATMENT +a I-TREATMENT +ser I-TREATMENT +de I-TREATMENT +600/mm3 I-TREATMENT y I-TREATMENT -respuesta I-TREATMENT -parcial. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -permaneció I-EVOLUTION -asintomático I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -efectos I-EVOLUTION -secundarios I-EVOLUTION -tardíos I-EVOLUTION -de I-EVOLUTION -RT I-EVOLUTION -ni I-EVOLUTION -QT. I-EVOLUTION -Dos I-EVOLUTION -años I-EVOLUTION -tras I-EVOLUTION +anemia I-TREATMENT +como I-TREATMENT +máximo I-TREATMENT +de I-TREATMENT +8, I-TREATMENT +5g/dl I-TREATMENT +de I-TREATMENT +hemoglobina, I-TREATMENT +pero I-TREATMENT +no I-TREATMENT +se I-TREATMENT +modificaron I-TREATMENT +las I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +IFN. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +los I-EVOLUTION +sucesivos I-EVOLUTION +controles I-EVOLUTION +siempre I-EVOLUTION +mantuvo I-EVOLUTION la I-EVOLUTION -cirugía I-EVOLUTION -el I-EVOLUTION -TAC I-EVOLUTION -abdominal I-EVOLUTION -muestra I-EVOLUTION +misma I-EVOLUTION +AV, I-EVOLUTION +los I-EVOLUTION +exudados I-EVOLUTION +se I-EVOLUTION +fueron I-EVOLUTION +reabsorbiendo I-EVOLUTION +y I-EVOLUTION +quedó I-EVOLUTION +sólo I-EVOLUTION +una I-EVOLUTION +microhemorragia I-EVOLUTION +en I-EVOLUTION la I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -pequeños I-EVOLUTION -ganglios I-EVOLUTION -retroperitoneales, I-EVOLUTION -sin I-EVOLUTION -otros I-EVOLUTION -hallazgos I-EVOLUTION -destacables. I-EVOLUTION +arcada I-EVOLUTION +vascular I-EVOLUTION +temporal I-EVOLUTION +superior I-EVOLUTION +del I-EVOLUTION +ojo I-EVOLUTION +derecho. I-EVOLUTION I-EVOLUTION -Varón B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -37 I-PRESENT_ILLNESS +53 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -realizado I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -hemorragia I-PRESENT_ILLNESS -bilateral. I-PRESENT_ILLNESS -Resto B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -bulto I-PRESENT_ILLNESS +reconocimiento I-PRESENT_ILLNESS +medico I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -pene, I-PRESENT_ILLNESS -doloroso I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -erección. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -cordón I-EXPLORATION -longitudinal I-EXPLORATION +abril I-PRESENT_ILLNESS +2015. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +- B-PAST_MEDICAL_HISTORY +Antecedentes I-PAST_MEDICAL_HISTORY +personales: I-PAST_MEDICAL_HISTORY +bocio I-PAST_MEDICAL_HISTORY +coloide I-PAST_MEDICAL_HISTORY +(tiroidectomía I-PAST_MEDICAL_HISTORY +total I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2010), I-PAST_MEDICAL_HISTORY +intervención I-PAST_MEDICAL_HISTORY +quirúrgica I-PAST_MEDICAL_HISTORY +debida I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +hernia I-PAST_MEDICAL_HISTORY +cervical I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +accidente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tráfico I-PAST_MEDICAL_HISTORY +(1995). I-PAST_MEDICAL_HISTORY +Menopausia I-PAST_MEDICAL_HISTORY +precoz, I-PAST_MEDICAL_HISTORY +anemia I-PAST_MEDICAL_HISTORY +hipocrómica, I-PAST_MEDICAL_HISTORY +accidente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tráfico I-PAST_MEDICAL_HISTORY +(2009), I-PAST_MEDICAL_HISTORY +rinitis I-PAST_MEDICAL_HISTORY +vasomotora I-PAST_MEDICAL_HISTORY +alergia I-PAST_MEDICAL_HISTORY +extrínseca I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +polen I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +asma, I-PAST_MEDICAL_HISTORY +gonalgia, I-PAST_MEDICAL_HISTORY +hipocalcemia, I-PAST_MEDICAL_HISTORY +adenoma I-PAST_MEDICAL_HISTORY +tubular I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +colon I-PAST_MEDICAL_HISTORY +(2014), I-PAST_MEDICAL_HISTORY +obesidad. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Hace I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +aparecen I-PAST_MEDICAL_HISTORY +lesiones I-PAST_MEDICAL_HISTORY +pigmentada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY +dorsal I-PAST_MEDICAL_HISTORY +siendo I-PAST_MEDICAL_HISTORY +diagnosticadas I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +notalgia I-PAST_MEDICAL_HISTORY +parestésica. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +relaciona I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +aparición I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +ninguna I-PAST_MEDICAL_HISTORY +situación I-PAST_MEDICAL_HISTORY +especial, I-PAST_MEDICAL_HISTORY +no B-FAMILY_HISTORY +refiere I-FAMILY_HISTORY +otros I-FAMILY_HISTORY +casos I-FAMILY_HISTORY +en I-FAMILY_HISTORY +familiares. I-FAMILY_HISTORY + I-FAMILY_HISTORY +- B-EXPLORATION +Exploración I-EXPLORATION +física: I-EXPLORATION +mácula I-EXPLORATION +hiperpigmentada I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -dorso I-EXPLORATION -del I-EXPLORATION -pene I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -tres I-EXPLORATION -centímetros, I-EXPLORATION -móvil I-EXPLORATION -y I-EXPLORATION -doloroso. I-EXPLORATION -Afebril. I-EXPLORATION -No I-EXPLORATION -adenopatías I-EXPLORATION -inguinales. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -eco-doppler I-EXPLORATION -peneano I-EXPLORATION +zona I-EXPLORATION +supraescapular; I-EXPLORATION +contracturas I-EXPLORATION +musculares I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -clara I-EXPLORATION -trombosis I-EXPLORATION +zona I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -dorsal I-EXPLORATION -superficial I-EXPLORATION -del I-EXPLORATION -pene I-EXPLORATION +ambos I-EXPLORATION +trapecios I-EXPLORATION y I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -colapsaba I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -presión I-EXPLORATION -del I-EXPLORATION -transductor. I-EXPLORATION -Estudio I-EXPLORATION -de I-EXPLORATION -coagulación I-EXPLORATION -normal. I-EXPLORATION +zona I-EXPLORATION +supraescapular I-EXPLORATION +izquierda. I-EXPLORATION I-EXPLORATION -Juicio I-EXPLORATION -Diagnóstico: I-EXPLORATION -Enfermedad I-EXPLORATION +- I-EXPLORATION +Síntomas: I-EXPLORATION +refiere I-EXPLORATION +mucho I-EXPLORATION +prurito I-EXPLORATION +y I-EXPLORATION +"pinchazos", I-EXPLORATION +mejora I-EXPLORATION +cuando I-EXPLORATION +está I-EXPLORATION +más I-EXPLORATION +relajada I-EXPLORATION +y I-EXPLORATION +tras I-EXPLORATION +tratamiento I-EXPLORATION +rehabilitador I-EXPLORATION +con I-EXPLORATION +fisioterapia I-EXPLORATION de I-EXPLORATION -Mondor. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT +las I-EXPLORATION +contracturas I-EXPLORATION +musculares. I-EXPLORATION +Los I-EXPLORATION +síntomas I-EXPLORATION +empeoran I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +rascado. I-EXPLORATION + I-EXPLORATION +- B-TREATMENT +Tratamiento: I-TREATMENT +no I-TREATMENT +ha I-TREATMENT +requerido I-TREATMENT tratamiento I-TREATMENT -con I-TREATMENT -heparina I-TREATMENT -de I-TREATMENT -bajo I-TREATMENT -peso I-TREATMENT -molecular I-TREATMENT +específico I-TREATMENT +salvo I-TREATMENT +hidratación I-TREATMENT y I-TREATMENT -antiinflamatorios. I-TREATMENT +evitar I-TREATMENT +irritación I-TREATMENT +la I-TREATMENT +zona. I-TREATMENT I-TREATMENT -Paciente B-PRESENT_ILLNESS +Varón, B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -67 I-PRESENT_ILLNESS +39 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY +(172 I-PRESENT_ILLNESS +cm, I-PRESENT_ILLNESS +78 I-PRESENT_ILLNESS +Kg), I-PRESENT_ILLNESS +ASA I-PRESENT_ILLNESS +I I-PRESENT_ILLNESS +U, I-PRESENT_ILLNESS +que B-PAST_MEDICAL_HISTORY +procedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -18/9/07 I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -sufre I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -caída I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -calle, I-PRESENT_ILLNESS -golpeándose I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -lumbar. I-PRESENT_ILLNESS -Acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -MAP I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -lumbar, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -aumenta I-PRESENT_ILLNESS +un I-PAST_MEDICAL_HISTORY +buque I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +Armada I-PAST_MEDICAL_HISTORY +española I-PAST_MEDICAL_HISTORY +es B-PRESENT_ILLNESS +evacuado I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -flexo-extensión I-PRESENT_ILLNESS +diagnóstico I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -piernas; I-PRESENT_ILLNESS -se B-TREATMENT -pauta I-TREATMENT -tratamiento I-TREATMENT -analgésico I-TREATMENT -y I-TREATMENT -observación I-TREATMENT -domiciliaria. I-TREATMENT -Dos B-EVOLUTION -horas I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -avisan I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -domicilio I-EVOLUTION -por I-EVOLUTION -hematuria I-EVOLUTION -franca I-EVOLUTION -e I-EVOLUTION -intenso I-EVOLUTION -dolor I-EVOLUTION -abdominal; I-EVOLUTION -presenta B-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION +fractura I-PRESENT_ILLNESS +bimaleolar I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +tobillo I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +subsidiaria I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +osteosíntesis. I-PRESENT_ILLNESS +Se B-EXPLORATION +le I-EXPLORATION +monitorizó I-EXPLORATION +la I-EXPLORATION +SaO2, I-EXPLORATION +la I-EXPLORATION +frecuencia I-EXPLORATION +cardíaca, I-EXPLORATION la I-EXPLORATION -palpación I-EXPLORATION -abdominal I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal, I-EXPLORATION tensión I-EXPLORATION arterial I-EXPLORATION -de I-EXPLORATION -110/70 I-EXPLORATION -y I-EXPLORATION -palidez I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION +no I-EXPLORATION +invasiva, I-EXPLORATION +la I-EXPLORATION +temperatura, I-EXPLORATION +la I-EXPLORATION +capnografía I-EXPLORATION y I-EXPLORATION -mucosas; I-EXPLORATION -se B-DERIVED_FROM/TO -decide I-DERIVED_FROM/TO -traslado I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -Universitario I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Salamanca I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -valoración. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -A B-EXPLORATION -su I-EXPLORATION -llegada I-EXPLORATION -al I-EXPLORATION -servicio I-EXPLORATION -de I-EXPLORATION -urgencias I-EXPLORATION -(en I-EXPLORATION -torno I-EXPLORATION -las I-EXPLORATION -23 I-EXPLORATION -horas) I-EXPLORATION el I-EXPLORATION -paciente I-EXPLORATION -presenta I-EXPLORATION -marcada I-EXPLORATION -defensa I-EXPLORATION -abdominal, I-EXPLORATION -con I-EXPLORATION -tensiones I-EXPLORATION -de I-EXPLORATION -135/85, I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION +grado I-EXPLORATION de I-EXPLORATION -94 I-EXPLORATION -latidos I-EXPLORATION -por I-EXPLORATION -minuto I-EXPLORATION +hipnosis I-EXPLORATION +mediante I-EXPLORATION +el I-EXPLORATION +monitor I-EXPLORATION +BIS®. I-EXPLORATION +Tras B-TREATMENT +administración I-TREATMENT +de I-TREATMENT +250 I-TREATMENT +ml I-TREATMENT +de I-TREATMENT +coloide I-TREATMENT +en I-TREATMENT +bolo I-TREATMENT +iv, I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +anestesia I-TREATMENT +intradural I-TREATMENT +empleando I-TREATMENT +bupivacaína I-TREATMENT +0, I-TREATMENT +5% I-TREATMENT +hiperbara I-TREATMENT +10 I-TREATMENT +mg I-TREATMENT +y I-TREATMENT +fentanilo I-TREATMENT +10 I-TREATMENT +µg. I-TREATMENT +Como I-TREATMENT +medicación I-TREATMENT +coadyuvante I-TREATMENT +se I-TREATMENT +empleó I-TREATMENT +midazolam I-TREATMENT +(3 I-TREATMENT +mg I-TREATMENT +en I-TREATMENT +bolo I-TREATMENT +iv) I-TREATMENT +y I-TREATMENT +propofol I-TREATMENT +(1, I-TREATMENT +5 I-TREATMENT +mg/Kg/h). I-TREATMENT +La I-TREATMENT +profilaxis I-TREATMENT +antibiótica I-TREATMENT +fue I-TREATMENT +cefazolina I-TREATMENT +2 I-TREATMENT +g I-TREATMENT +iv. I-TREATMENT +Asimismo I-TREATMENT +se I-TREATMENT +pautó I-TREATMENT +omeprazol I-TREATMENT +40 I-TREATMENT +mg I-TREATMENT +iv, I-TREATMENT +granisetron I-TREATMENT +3 I-TREATMENT +mg I-TREATMENT +iv I-TREATMENT +y I-TREATMENT +ácido I-TREATMENT +tranexámico I-TREATMENT +1 I-TREATMENT +g I-TREATMENT +iv. I-TREATMENT +Al I-TREATMENT +final I-TREATMENT +de I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +se I-TREATMENT +administró I-TREATMENT +desketoprofeno I-TREATMENT +(50 I-TREATMENT +mg I-TREATMENT +iv) I-TREATMENT +y I-TREATMENT +dexametasona I-TREATMENT +(4 I-TREATMENT +mg I-TREATMENT +iv). I-TREATMENT +Se I-TREATMENT +finalizó I-TREATMENT +la I-TREATMENT +perfusión I-TREATMENT +de I-TREATMENT +propofol I-TREATMENT +aproximadamente I-TREATMENT +5 I-TREATMENT +minutos I-TREATMENT +antes I-TREATMENT +de I-TREATMENT +la I-TREATMENT +finalización I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cirugía. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +ingresó I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +unidad I-EVOLUTION +de I-EVOLUTION +reanimación I-EVOLUTION +postquirúrgica I-EVOLUTION +y I-EVOLUTION +posteriormente I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +a I-EVOLUTION +sala I-EVOLUTION +de I-EVOLUTION +hospitalización I-EVOLUTION +sin I-EVOLUTION +incidencias. I-EVOLUTION + I-EVOLUTION +La B-EXPLORATION +monitorización I-EXPLORATION +mediante I-EXPLORATION +BIS® I-EXPLORATION +mostró I-EXPLORATION +unos I-EXPLORATION +valores I-EXPLORATION +comprendidos I-EXPLORATION +entre I-EXPLORATION +98 I-EXPLORATION y I-EXPLORATION -pulsos I-EXPLORATION -conservados; I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION +47, I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -sin I-EXPLORATION -datos I-EXPLORATION +curva I-EXPLORATION de I-EXPLORATION -interés. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -ECG I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -detecta I-EXPLORATION -fibrilación I-EXPLORATION -auricular I-EXPLORATION -no I-EXPLORATION -conocida I-EXPLORATION -previamente. I-EXPLORATION -Presenta I-EXPLORATION -una I-EXPLORATION -analítica I-EXPLORATION +la I-EXPLORATION +capnografía I-EXPLORATION +fue I-EXPLORATION +normal I-EXPLORATION +(onda I-EXPLORATION +cuadrada I-EXPLORATION con I-EXPLORATION -12.8 I-EXPLORATION -g/dl I-EXPLORATION -de I-EXPLORATION -hemoglobina I-EXPLORATION +valores I-EXPLORATION +comprendidos I-EXPLORATION +entre I-EXPLORATION +35 I-EXPLORATION y I-EXPLORATION -69 I-EXPLORATION -% I-EXPLORATION -de I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -como I-EXPLORATION -datos I-EXPLORATION -más I-EXPLORATION -destacables. I-EXPLORATION -Se I-EXPLORATION -decide I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -urgente I-EXPLORATION -con I-EXPLORATION -contraste, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -informa I-EXPLORATION -como I-EXPLORATION -riñón I-EXPLORATION -en I-EXPLORATION -herradura I-EXPLORATION -con I-EXPLORATION -rotura I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -central I-EXPLORATION +45 I-EXPLORATION +mmHg) I-EXPLORATION +durante I-EXPLORATION +el I-EXPLORATION +acto I-EXPLORATION +quirúrgico I-EXPLORATION y I-EXPLORATION -medial I-EXPLORATION -izquierdo, I-EXPLORATION -con I-EXPLORATION -gran I-EXPLORATION -hematoma I-EXPLORATION -retroperitoneal, I-EXPLORATION -con I-EXPLORATION -extravasación I-EXPLORATION -activa I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -próxima I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -fractura I-EXPLORATION -renal; I-EXPLORATION -no I-EXPLORATION -existe I-EXPLORATION -afectación I-EXPLORATION +valoración I-EXPLORATION de I-EXPLORATION -otras I-EXPLORATION -estructuras. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION -y I-EXPLORATION la I-EXPLORATION -situación I-EXPLORATION -clínica I-EXPLORATION -del I-EXPLORATION -enfermo I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -laparotomía I-EXPLORATION -media I-EXPLORATION -exploradora, I-EXPLORATION +sedación I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -gran I-EXPLORATION -hemorretroperitoneo I-EXPLORATION -que I-EXPLORATION -afecta I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -raíz I-EXPLORATION -de I-EXPLORATION -mesenterio, I-EXPLORATION -consecuencia I-EXPLORATION -de I-EXPLORATION -rotura I-EXPLORATION -múltiple I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -hemi-riñón I-EXPLORATION -izquierdo, I-EXPLORATION -llegando I-EXPLORATION -a I-EXPLORATION -comprometer I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -intrarrenal I-EXPLORATION -(grado I-EXPLORATION -IV I-EXPLORATION -según I-EXPLORATION -la I-EXPLORATION -escala I-EXPLORATION -de I-EXPLORATION -lesión I-EXPLORATION -orgánica I-EXPLORATION +unidad I-EXPLORATION de I-EXPLORATION +reanimación I-EXPLORATION +postquirúrgica I-EXPLORATION +fue I-EXPLORATION +máxima: I-EXPLORATION +10 I-EXPLORATION +puntos I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -American I-EXPLORATION -Association I-EXPLORATION -for I-EXPLORATION -the I-EXPLORATION -Surgery I-EXPLORATION -of I-EXPLORATION -Trauma) I-EXPLORATION -(5); I-EXPLORATION -se B-TREATMENT -realiza I-TREATMENT -evacuación I-TREATMENT -del I-TREATMENT -hematoma I-TREATMENT -retroperitoneal I-TREATMENT -junto I-TREATMENT -con I-TREATMENT -nefrectomía I-TREATMENT -del I-TREATMENT -hemi-riñón I-TREATMENT -izquierdo. I-TREATMENT -Durante I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -permanece I-TREATMENT -estable, I-TREATMENT -precisando I-TREATMENT -la I-TREATMENT -transfusión I-TREATMENT -de I-TREATMENT -2 I-TREATMENT -concentrados I-TREATMENT -de I-TREATMENT -hematíes. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -inmediato I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -permanece I-EVOLUTION -estable I-EVOLUTION -hemodinámicamente, I-EVOLUTION -con I-EVOLUTION -cifras I-EVOLUTION -de I-EVOLUTION -hemoglobina I-EVOLUTION -en I-EVOLUTION -torno I-EVOLUTION -a I-EVOLUTION -10 I-EVOLUTION -g/dl, I-EVOLUTION -ligera I-EVOLUTION -febrícula, I-EVOLUTION -continúa I-EVOLUTION -con I-EVOLUTION -cierta I-EVOLUTION -distensión I-EVOLUTION -abdominal I-EVOLUTION -y I-EVOLUTION -escaso I-EVOLUTION -peristaltismo. I-EVOLUTION -En B-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -realizado I-EXPLORATION -el I-EXPLORATION -día I-EXPLORATION -23/9/07 I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION +Escala I-EXPLORATION de I-EXPLORATION -aproximadamente I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION +Aldrete I-EXPLORATION +(actividad I-EXPLORATION +muscular: I-EXPLORATION +0-2, I-EXPLORATION +respiración: I-EXPLORATION +0-2, I-EXPLORATION +hemodinámica: I-EXPLORATION +0-2, I-EXPLORATION +conciencia: I-EXPLORATION +0-2 I-EXPLORATION +y I-EXPLORATION +coloración I-EXPLORATION de I-EXPLORATION -tamaño I-EXPLORATION -optando I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -vigilancia I-EXPLORATION -activa. I-EXPLORATION +piel: I-EXPLORATION +0-2). I-EXPLORATION I-EXPLORATION -Varón B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -51 I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino, I-PRESENT_ILLNESS +38 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -trasplantado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -1986 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -glomerulonefritis I-PRESENT_ILLNESS -mesangiocapilar I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -II, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -disfunción I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -injerto I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -recidiva I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -enfermedad I-PRESENT_ILLNESS -renal I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -mismo, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -obliga I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alcoholismo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +policonsumo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +drogas, I-PAST_MEDICAL_HISTORY +trastorno I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +ánimo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +hepatitis I-PAST_MEDICAL_HISTORY +B I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2005. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS a I-PRESENT_ILLNESS -reanudar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -hemodiálisis I-PRESENT_ILLNESS +Infectología I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -1996. I-PRESENT_ILLNESS -Se I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -realizado I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -descenso I-PRESENT_ILLNESS +febrero I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -inmunosupresión I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -CsA I-PRESENT_ILLNESS +2011 I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +tumores I-PRESENT_ILLNESS +eritemato-violáceos I-PRESENT_ILLNESS +dolorosos, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +crecimiento I-PRESENT_ILLNESS +progresivo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +asociados I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +compromiso I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +estado I-PRESENT_ILLNESS +general I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -adición I-PRESENT_ILLNESS +baja I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Azathioprina, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -resultados. I-PRESENT_ILLNESS -Presenta I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -iniciar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -hemodiálisis I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +kg I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -agudo I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -injerto I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -inestabilidad I-PRESENT_ILLNESS -hemodinámica I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +fiebre, I-PRESENT_ILLNESS +sudoración I-PRESENT_ILLNESS +nocturna, I-PRESENT_ILLNESS +disfagia I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -refractaria I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -médico. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -urgente I-EXPLORATION -se I-EXPLORATION -detecta I-EXPLORATION -hematoma I-EXPLORATION -subcapsular I-EXPLORATION -e I-EXPLORATION -intraparenquimatoso I-EXPLORATION -en I-EXPLORATION +diarrea. I-PRESENT_ILLNESS +Por B-EXPLORATION el I-EXPLORATION -injerto, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -confirma I-EXPLORATION -mediante I-EXPLORATION -TC, I-EXPLORATION -realizándose B-TREATMENT -trasplantectomía I-TREATMENT -pocas I-TREATMENT -horas I-TREATMENT -después. I-TREATMENT -Durante B-EXPLORATION -la I-EXPLORATION -intervención I-EXPLORATION +cuadro I-EXPLORATION +clínico I-EXPLORATION se I-EXPLORATION -aprecia I-EXPLORATION -lesión I-EXPLORATION -sólida I-EXPLORATION -en I-EXPLORATION -polo I-EXPLORATION -superior I-EXPLORATION -del I-EXPLORATION -injerto, I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -con I-EXPLORATION -evidentes I-EXPLORATION -signos I-EXPLORATION +sospechó I-EXPLORATION +inicialmente I-EXPLORATION +sarcoma I-EXPLORATION de I-EXPLORATION -ruptura I-EXPLORATION -espontánea I-EXPLORATION +Kaposi I-EXPLORATION +(SK) I-EXPLORATION y I-EXPLORATION -sangrado. I-EXPLORATION -También I-EXPLORATION se I-EXPLORATION -advierten I-EXPLORATION -otras I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -sólidas I-EXPLORATION -y I-EXPLORATION -quísticas I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -tamaño I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION -del I-EXPLORATION -injerto. I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -anatomopatológico I-EXPLORATION -reveló I-EXPLORATION -un I-EXPLORATION -CCR I-EXPLORATION -multicéntrico, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -seno I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -enfermedad I-EXPLORATION -quística I-EXPLORATION -renal I-EXPLORATION -adquirida I-EXPLORATION -del I-EXPLORATION -injerto. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -reanudó I-EVOLUTION -la I-EVOLUTION -hemodiálisis I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -y I-EVOLUTION -asintomático I-EVOLUTION -tras I-EVOLUTION -12 I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY -litiásica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -otro I-PAST_MEDICAL_HISTORY -centro I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ambos I-PAST_MEDICAL_HISTORY -riñones. I-PAST_MEDICAL_HISTORY -Según I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -informaba I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -realizado, I-PAST_MEDICAL_HISTORY -pielolitotomía I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -15 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Dos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -practica I-PAST_MEDICAL_HISTORY -pielolitotomía I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -atendida I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -nuestro I-PAST_MEDICAL_HISTORY -Servicio I-PAST_MEDICAL_HISTORY -(año I-PAST_MEDICAL_HISTORY -2005) I-PAST_MEDICAL_HISTORY -nueva I-PAST_MEDICAL_HISTORY -nefrolitotomía I-PAST_MEDICAL_HISTORY -sobre I-PAST_MEDICAL_HISTORY -riñón I-PAST_MEDICAL_HISTORY -izquierdo, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -litiasis I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -compleja. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -infección I-PRESENT_ILLNESS -urinaria I-PRESENT_ILLNESS -complicada I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -pionefrosis I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -septicemia, I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -coloca I-PRESENT_ILLNESS -cateter I-PRESENT_ILLNESS -doble I-PRESENT_ILLNESS -J I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -queda I-PRESENT_ILLNESS -mal I-PRESENT_ILLNESS -posicionado, I-PRESENT_ILLNESS -subpiélico, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -resuelve I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -séptico, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -preciso I-PRESENT_ILLNESS -realizar I-PRESENT_ILLNESS -nefrostomia I-PRESENT_ILLNESS -percutánea I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -drenaje I-PRESENT_ILLNESS -renal, I-PRESENT_ILLNESS -situación, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -remitida I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -urografía I-EXPLORATION -intravenosa I-EXPLORATION +solicitó I-EXPLORATION +ELISA I-EXPLORATION +para I-EXPLORATION +VIH I-EXPLORATION que I-EXPLORATION -aporta I-EXPLORATION -la I-EXPLORATION -enferma, I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -litiasis I-EXPLORATION -radiodensa I-EXPLORATION -infecciosa, I-EXPLORATION -pielolocalicial I-EXPLORATION -múltiple I-EXPLORATION -compleja, I-EXPLORATION -sobre I-EXPLORATION -riñón I-EXPLORATION -con I-EXPLORATION -hidronefrosis I-EXPLORATION -grado I-EXPLORATION -III-IV I-EXPLORATION +fue I-EXPLORATION +positivo I-EXPLORATION +y I-EXPLORATION +confirmado I-EXPLORATION por I-EXPLORATION -importante I-EXPLORATION -esclerosis I-EXPLORATION -piélica I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -cirugías I-EXPLORATION -previas I-EXPLORATION -sobre I-EXPLORATION -dicha I-EXPLORATION -unidad I-EXPLORATION -renal. I-EXPLORATION -Presenta I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION -relativamente I-EXPLORATION -conservada. I-EXPLORATION -Observamos I-EXPLORATION -asimismo, I-EXPLORATION -cambios I-EXPLORATION -postquirúrgicos I-EXPLORATION -con I-EXPLORATION -moderada I-EXPLORATION -atrofia I-EXPLORATION -parenquimatosa I-EXPLORATION -de I-EXPLORATION -unidad I-EXPLORATION -renal I-EXPLORATION -derecha. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION +el I-EXPLORATION +Instituto I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -reflejaba I-EXPLORATION -cifras I-EXPLORATION +Salud I-EXPLORATION +Pública I-EXPLORATION de I-EXPLORATION -urea I-EXPLORATION -y I-EXPLORATION -creatinina I-EXPLORATION -normales. I-EXPLORATION +Chile. I-EXPLORATION I-EXPLORATION -Ante B-TREATMENT -los I-TREATMENT -hallazgos I-TREATMENT -urográficos, I-TREATMENT -dada I-TREATMENT +Dada B-TREATMENT la I-TREATMENT -situación I-TREATMENT -del I-TREATMENT -riñón I-TREATMENT -contralateral I-TREATMENT +extensión I-TREATMENT +de I-TREATMENT +las I-TREATMENT +lesiones I-TREATMENT +cutáneas I-TREATMENT y I-TREATMENT la I-TREATMENT -edad I-TREATMENT +presencia I-TREATMENT de I-TREATMENT -la I-TREATMENT -paciente, I-TREATMENT +fiebre I-TREATMENT se I-TREATMENT -decide I-TREATMENT -lumbotomía I-TREATMENT -exploradora I-TREATMENT +hospitalizó I-TREATMENT para I-TREATMENT -intentar I-TREATMENT -cirugía I-TREATMENT -conservadora, I-TREATMENT -consistente I-TREATMENT -en I-TREATMENT -nefrectomía I-TREATMENT -polar I-TREATMENT -inferior I-TREATMENT -con I-TREATMENT -nefrolitotomía I-TREATMENT -y I-TREATMENT -reconstrucción I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vía I-TREATMENT -urinaria I-TREATMENT -superior I-TREATMENT -mediante I-TREATMENT -uréterocalicostomía. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -requiere I-EVOLUTION -la I-EVOLUTION -trasfusión I-EVOLUTION -de I-EVOLUTION -dos I-EVOLUTION -concentrados I-EVOLUTION -de I-EVOLUTION -hematíes I-EVOLUTION -por I-EVOLUTION -anemia I-EVOLUTION -persistente. I-EVOLUTION -La I-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -no I-EVOLUTION -presenta I-EVOLUTION -mayores I-EVOLUTION -complicaciones I-EVOLUTION -dándose I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -séptimo I-EVOLUTION -día. I-EVOLUTION -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION +mayor I-TREATMENT +estudio. I-TREATMENT +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -informó I-EXPLORATION +ingreso I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +estaba I-EXPLORATION +en I-EXPLORATION +regulares I-EXPLORATION +condiciones I-EXPLORATION +generales, I-EXPLORATION +hipotenso, I-EXPLORATION +febril, I-EXPLORATION +enflaquecido I-EXPLORATION +(índice I-EXPLORATION de I-EXPLORATION -cambios I-EXPLORATION -compatibles I-EXPLORATION +masa I-EXPLORATION +corporal I-EXPLORATION +de I-EXPLORATION +17), I-EXPLORATION con I-EXPLORATION -pielonefritis I-EXPLORATION -crónica I-EXPLORATION -postlitiásica I-EXPLORATION +adenopatías I-EXPLORATION +inguinales I-EXPLORATION +induradas, I-EXPLORATION +indoloras I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -del I-EXPLORATION -cálculo I-EXPLORATION -reveló I-EXPLORATION -su I-EXPLORATION -composición I-EXPLORATION -de I-EXPLORATION -fosfato I-EXPLORATION -amónico I-EXPLORATION -magnésico. I-EXPLORATION - I-EXPLORATION -Dos B-EVOLUTION -años I-EVOLUTION -y I-EVOLUTION -medio I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -refiere I-EVOLUTION -únicamente I-EVOLUTION -molestias I-EVOLUTION -leves I-EVOLUTION -en I-EVOLUTION -flanco I-EVOLUTION -izquierdo. I-EVOLUTION - I-EVOLUTION -La B-EXPLORATION -urografía I-EXPLORATION +poco I-EXPLORATION +móviles. I-EXPLORATION +Presentaba I-EXPLORATION +tumores I-EXPLORATION +eritemato-violáceos I-EXPLORATION de I-EXPLORATION -control I-EXPLORATION -refleja I-EXPLORATION -ausencia I-EXPLORATION +hasta I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -litiasis I-EXPLORATION -con I-EXPLORATION -cierto I-EXPLORATION -retraso I-EXPLORATION -nefrográfico I-EXPLORATION -izquierdo I-EXPLORATION +diámetro I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +supraciliar I-EXPLORATION +derecho, I-EXPLORATION +en I-EXPLORATION +mentón I-EXPLORATION y I-EXPLORATION -vía I-EXPLORATION -excretora I-EXPLORATION -derecha I-EXPLORATION +en I-EXPLORATION +pierna I-EXPLORATION +izquierda. I-EXPLORATION +En I-EXPLORATION +cara, I-EXPLORATION +paladar, I-EXPLORATION +tronco I-EXPLORATION +y I-EXPLORATION +extremidades I-EXPLORATION +presentaba I-EXPLORATION +múltiples I-EXPLORATION +pápulas I-EXPLORATION +erite-matosas I-EXPLORATION +brillantes I-EXPLORATION +y I-EXPLORATION +nódulos I-EXPLORATION +dolorosos I-EXPLORATION +subcutáneos I-EXPLORATION sin I-EXPLORATION cambios I-EXPLORATION -respecto I-EXPLORATION -a I-EXPLORATION -previos. I-EXPLORATION -El I-EXPLORATION -renograma I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION +de I-EXPLORATION +coloración. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +pesquisó I-EXPLORATION +visceromegalia. I-EXPLORATION +De I-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION +generales I-EXPLORATION +destacaba: I-EXPLORATION +hematocrito I-EXPLORATION +28, I-EXPLORATION +3%; I-EXPLORATION +leucocitos I-EXPLORATION +6.200 I-EXPLORATION +céls/mm3, I-EXPLORATION +sin I-EXPLORATION +desviación I-EXPLORATION +izquierda; I-EXPLORATION +VHS I-EXPLORATION +100 I-EXPLORATION +mm/h; I-EXPLORATION +PCR I-EXPLORATION +9, I-EXPLORATION +1 I-EXPLORATION +(VN I-EXPLORATION +< I-EXPLORATION +1); I-EXPLORATION función I-EXPLORATION renal I-EXPLORATION -izquierda I-EXPLORATION -del I-EXPLORATION -30%, I-EXPLORATION -con I-EXPLORATION -riñón I-EXPLORATION -derecho I-EXPLORATION -compensador, I-EXPLORATION -70%. I-EXPLORATION -Continúa B-EVOLUTION -con I-EVOLUTION -cifras I-EVOLUTION -de I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -dentro I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -normalidad, I-EVOLUTION -y I-EVOLUTION -solo I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -un I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -ITU I-EVOLUTION -que I-EVOLUTION -ha I-EVOLUTION -cedido I-EVOLUTION -con I-EVOLUTION -ciprofloxacino. I-EVOLUTION -Presencia B-EXPLORATION +normal; I-EXPLORATION +pruebas I-EXPLORATION +hepáticas I-EXPLORATION +normales, I-EXPLORATION +excepto I-EXPLORATION +por I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina I-EXPLORATION +elevada I-EXPLORATION +(211 I-EXPLORATION +U/L); I-EXPLORATION +albúmina I-EXPLORATION +3 I-EXPLORATION +g/dl; I-EXPLORATION +LDH I-EXPLORATION +159 I-EXPLORATION +U/L. I-EXPLORATION +Del I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -pequeños I-EXPLORATION -restos I-EXPLORATION -litiásicos I-EXPLORATION -bilaterales I-EXPLORATION -subclínicos I-EXPLORATION -según I-EXPLORATION -técnicas I-EXPLORATION +su I-EXPLORATION +patología I-EXPLORATION de I-EXPLORATION -imagen. I-EXPLORATION - I-EXPLORATION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -49 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -Hospital, I-PRESENT_ILLNESS -porque I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -introducción I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -objeto I-PRESENT_ILLNESS -metálico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -área I-PRESENT_ILLNESS -genital I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -contexto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -prácticas I-PRESENT_ILLNESS -erótico-sexuales. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Clínicamente B-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -asintomática, I-EXPLORATION +base I-EXPLORATION +tenía I-EXPLORATION +carga I-EXPLORATION +viral I-EXPLORATION +para I-EXPLORATION +VIH I-EXPLORATION +de I-EXPLORATION +875.000 I-EXPLORATION +copias I-EXPLORATION +ARN I-EXPLORATION +viral/ml I-EXPLORATION y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -genital I-EXPLORATION -no I-EXPLORATION +recuento I-EXPLORATION +de I-EXPLORATION +linfocitos I-EXPLORATION +CD4 I-EXPLORATION +de I-EXPLORATION +87, I-EXPLORATION +6 I-EXPLORATION +céls/ I-EXPLORATION +mm3. I-EXPLORATION +Los I-EXPLORATION +hemocultivos, I-EXPLORATION +urocultivos, I-EXPLORATION +RPR, I-EXPLORATION +PPD I-EXPLORATION +y I-EXPLORATION +serología I-EXPLORATION +IgG I-EXPLORATION +para I-EXPLORATION +toxoplasma I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION + I-EXPLORATION +Al I-EXPLORATION +reevaluar I-EXPLORATION +el I-EXPLORATION +cuadro I-EXPLORATION +clínico I-EXPLORATION se I-EXPLORATION -objetivó I-EXPLORATION -material I-EXPLORATION -alguno I-EXPLORATION -en I-EXPLORATION +planteó I-EXPLORATION el I-EXPLORATION -interior I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -vagina. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION +AB. I-EXPLORATION +Al B-PAST_MEDICAL_HISTORY +preguntar I-PAST_MEDICAL_HISTORY +dirigidamente I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +refirió I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +viajes I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +extranjero: I-PAST_MEDICAL_HISTORY +Bolivia I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +Perú I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +México I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Además I-PAST_MEDICAL_HISTORY +vivió I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +casa I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +gatos, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +rasguñaban I-PAST_MEDICAL_HISTORY +ocasionalmente. I-PAST_MEDICAL_HISTORY +Se B-EXPLORATION +solicitó I-EXPLORATION +serología I-EXPLORATION de I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -un I-EXPLORATION -objeto I-EXPLORATION -metálico I-EXPLORATION +Bartonella I-EXPLORATION +henselae I-EXPLORATION que I-EXPLORATION -sobresalía I-EXPLORATION -del I-EXPLORATION -contorno I-EXPLORATION +resultó I-EXPLORATION +negativa. I-EXPLORATION +La I-EXPLORATION +nasofibroscopia I-EXPLORATION +informó I-EXPLORATION +lesiones I-EXPLORATION +angiomatosas I-EXPLORATION +en I-EXPLORATION +fosas I-EXPLORATION +nasales, I-EXPLORATION +rinofaringe I-EXPLORATION +y I-EXPLORATION +laringe. I-EXPLORATION +La I-EXPLORATION +endoscopia I-EXPLORATION +digestiva I-EXPLORATION +alta I-EXPLORATION +no I-EXPLORATION +detectó I-EXPLORATION +lesiones. I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +mostró I-EXPLORATION +hígado I-EXPLORATION +normal, I-EXPLORATION +leve I-EXPLORATION +esplenomegalia, I-EXPLORATION +adenopatías I-EXPLORATION +inguinales I-EXPLORATION +izquierdas I-EXPLORATION de I-EXPLORATION +aspecto I-EXPLORATION +secundario I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -vejiga I-EXPLORATION -urinaria. I-EXPLORATION -Se I-EXPLORATION -practica I-EXPLORATION -finalmente I-EXPLORATION -ecografia, I-EXPLORATION -seguida I-EXPLORATION +musculatura I-EXPLORATION +paravertebral I-EXPLORATION +lumbar. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +Doppler I-EXPLORATION de I-EXPLORATION -TAC I-EXPLORATION -abdominal, I-EXPLORATION +extremidades I-EXPLORATION +superiores I-EXPLORATION +e I-EXPLORATION +inferiores I-EXPLORATION +mostró I-EXPLORATION +nódulos I-EXPLORATION +hipervascularizados I-EXPLORATION +inespecíficos I-EXPLORATION en I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -un I-EXPLORATION -objeto I-EXPLORATION -metálico I-EXPLORATION +dermis, I-EXPLORATION +tejido I-EXPLORATION +subcutáneo I-EXPLORATION +y I-EXPLORATION +plano I-EXPLORATION +muscular. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +biopsia I-EXPLORATION de I-EXPLORATION -8 I-EXPLORATION -cm I-EXPLORATION +lesiones I-EXPLORATION +cutáneas I-EXPLORATION +mostró I-EXPLORATION +orto-queratosis, I-EXPLORATION +hipogranulosis, I-EXPLORATION +atrofia I-EXPLORATION +epidérmica, I-EXPLORATION +exocitosis I-EXPLORATION de I-EXPLORATION -longitud I-EXPLORATION -alojado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -interior I-EXPLORATION -del I-EXPLORATION -uréter I-EXPLORATION -pelviano I-EXPLORATION -derecho. I-EXPLORATION +linfocitos I-EXPLORATION +e I-EXPLORATION +hiperpigmentación I-EXPLORATION +basal; I-EXPLORATION +dermis I-EXPLORATION +reticular I-EXPLORATION +con I-EXPLORATION +proliferación I-EXPLORATION +vascular, I-EXPLORATION +nodular, I-EXPLORATION +multifocal, I-EXPLORATION +compuesta I-EXPLORATION +por I-EXPLORATION +vasos I-EXPLORATION +capilares I-EXPLORATION +pequeños, I-EXPLORATION +endotelio I-EXPLORATION +prominente, I-EXPLORATION +con I-EXPLORATION +extravasación I-EXPLORATION +de I-EXPLORATION +eritrocitos I-EXPLORATION +e I-EXPLORATION +infiltrado I-EXPLORATION +leve I-EXPLORATION +disperso I-EXPLORATION +de I-EXPLORATION +linfocitos, I-EXPLORATION +neutrófilos I-EXPLORATION +y I-EXPLORATION +eritrocitos. I-EXPLORATION +Además, I-EXPLORATION +había I-EXPLORATION +acúmulos I-EXPLORATION +eosinófilos, I-EXPLORATION +extracelulares, I-EXPLORATION +granulares, I-EXPLORATION +multifocales. I-EXPLORATION +La I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +Warthin-Starry I-EXPLORATION +mostró I-EXPLORATION +numerosos I-EXPLORATION +bacilos, I-EXPLORATION +siendo I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +AB. I-EXPLORATION I-EXPLORATION -Se B-TREATMENT -procede I-TREATMENT -a I-TREATMENT -intervenir I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -cistoscopia I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general, I-TREATMENT -objetivándose I-TREATMENT -cilindro I-TREATMENT -metálico I-TREATMENT -que I-TREATMENT -sobresale I-TREATMENT -del I-TREATMENT -interior I-TREATMENT -del I-TREATMENT -orificio I-TREATMENT -ureteral I-TREATMENT -derecho. I-TREATMENT - I-TREATMENT -Ante I-TREATMENT -la I-TREATMENT -imposibilidad I-TREATMENT -de I-TREATMENT -extraer I-TREATMENT -dicho I-TREATMENT -objeto I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -endoscópica, I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -una I-TREATMENT -laparotomía I-TREATMENT -media I-TREATMENT -infraumbilical, I-TREATMENT -con I-TREATMENT -apertura I-TREATMENT -de I-TREATMENT -vejiga I-TREATMENT -y I-TREATMENT -extracción I-TREATMENT -de I-TREATMENT -cilindro I-TREATMENT -metálico I-TREATMENT -de I-TREATMENT -8 I-TREATMENT -cm. I-TREATMENT -de I-TREATMENT -longitud, I-TREATMENT -que I-TREATMENT -correspondía I-TREATMENT -a I-TREATMENT -perfilador I-TREATMENT -de I-TREATMENT -ojos. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -femenina I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -anexo I-PAST_MEDICAL_HISTORY -histerectomía I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -miomatosis I-PAST_MEDICAL_HISTORY -uterina, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -gastritis I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -severo I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -40 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Debuta B-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -importante I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -macrohematuria I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -efectúa I-PRESENT_ILLNESS -diagnostico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -exofítica I-PRESENT_ILLNESS -vesical. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -sometida I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -primera I-PRESENT_ILLNESS -resección I-PRESENT_ILLNESS -endoscópica I-PRESENT_ILLNESS -(RTUV). I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al I-PRESENT_ILLNESS -corto I-PRESENT_ILLNESS -plazo I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -recidiva I-PRESENT_ILLNESS -tumoral I-PRESENT_ILLNESS -requiriendo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -múltiples I-PRESENT_ILLNESS -RTUV. I-PRESENT_ILLNESS -Tras I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -última I-PRESENT_ILLNESS -resección I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -material I-PRESENT_ILLNESS -remitido I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -informa I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -trabecular I-PRESENT_ILLNESS -anaplásico. I-PRESENT_ILLNESS -Concurre B-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -segunda I-DERIVED_FROM/TO -opinión I-DERIVED_FROM/TO -tras I-DERIVED_FROM/TO -ser I-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -oncólogo I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -urólogo I-DERIVED_FROM/TO -tratante. I-DERIVED_FROM/TO -En B-EXPLORATION -ecografía I-EXPLORATION +Se I-EXPLORATION +envió I-EXPLORATION +una I-EXPLORATION +muestra I-EXPLORATION +de I-EXPLORATION +tejido I-EXPLORATION +al I-EXPLORATION +laboratorio I-EXPLORATION +de I-EXPLORATION +microbiología I-EXPLORATION de I-EXPLORATION -control I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION la I-EXPLORATION -pared I-EXPLORATION -lateral I-EXPLORATION -derecha I-EXPLORATION +Universidad I-EXPLORATION +Católica I-EXPLORATION +para I-EXPLORATION +realizar I-EXPLORATION +PCR I-EXPLORATION +universal I-EXPLORATION con I-EXPLORATION -imagen I-EXPLORATION -nodular I-EXPLORATION -sólida I-EXPLORATION +amplificación I-EXPLORATION +y I-EXPLORATION +secuenciación I-EXPLORATION +posterior I-EXPLORATION +del I-EXPLORATION +gen I-EXPLORATION +que I-EXPLORATION +codifica I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +subu-nidad I-EXPLORATION +ribosomal I-EXPLORATION +16S. I-EXPLORATION +La I-EXPLORATION +extracción I-EXPLORATION +del I-EXPLORATION +ADN I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +subcutáneo I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +utilizando I-EXPLORATION +un I-EXPLORATION +método I-EXPLORATION +comercial I-EXPLORATION +(QIAamp I-EXPLORATION +Tissue I-EXPLORATION +kit, I-EXPLORATION +Qiagen®), I-EXPLORATION +según I-EXPLORATION +las I-EXPLORATION +recomendaciones I-EXPLORATION +del I-EXPLORATION +fabricante. I-EXPLORATION +La I-EXPLORATION +amplificación I-EXPLORATION +del I-EXPLORATION +gen I-EXPLORATION +que I-EXPLORATION +codifica I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +16S I-EXPLORATION +ARNr I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION con I-EXPLORATION -vascularización I-EXPLORATION -central I-EXPLORATION +partidores I-EXPLORATION +universales. I-EXPLORATION +Posteriormente, I-EXPLORATION +se I-EXPLORATION +secuenció I-EXPLORATION +el I-EXPLORATION +producto I-EXPLORATION +amplificado I-EXPLORATION y I-EXPLORATION -periférica I-EXPLORATION +se I-EXPLORATION +evaluó I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +analizador I-EXPLORATION +genético I-EXPLORATION +ABI-310 I-EXPLORATION +(Applied-Biosystems, I-EXPLORATION +Foster I-EXPLORATION +City, I-EXPLORATION +CA). I-EXPLORATION +Para I-EXPLORATION +la I-EXPLORATION +comparación I-EXPLORATION de I-EXPLORATION -35 I-EXPLORATION -x I-EXPLORATION -28 I-EXPLORATION -x I-EXPLORATION -33 I-EXPLORATION -mm I-EXPLORATION +la I-EXPLORATION +secuencia I-EXPLORATION +nucleotídica I-EXPLORATION +obtenida I-EXPLORATION con I-EXPLORATION -otra I-EXPLORATION -imagen I-EXPLORATION -polipoidea I-EXPLORATION +las I-EXPLORATION +secuencias I-EXPLORATION +depositadas I-EXPLORATION en I-EXPLORATION -pared I-EXPLORATION -postero I-EXPLORATION -lateral I-EXPLORATION -derecha I-EXPLORATION +banco I-EXPLORATION de I-EXPLORATION -10 I-EXPLORATION -x I-EXPLORATION -9 I-EXPLORATION -x I-EXPLORATION -9 I-EXPLORATION -mm. I-EXPLORATION -En I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION +genes I-EXPLORATION +Genebank, I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION -severa I-EXPLORATION -atrofia I-EXPLORATION -renal I-EXPLORATION -derecha. I-EXPLORATION -Ausencia I-EXPLORATION +utilizó I-EXPLORATION +al I-EXPLORATION +programa I-EXPLORATION +BLAST. I-EXPLORATION +Se I-EXPLORATION +encontró I-EXPLORATION +una I-EXPLORATION +homología I-EXPLORATION de I-EXPLORATION -adenomegalias. I-EXPLORATION -Vejiga I-EXPLORATION -con I-EXPLORATION -pólipo I-EXPLORATION +100% I-EXPLORATION +sobre I-EXPLORATION +421 I-EXPLORATION +pares I-EXPLORATION de I-EXPLORATION -38 I-EXPLORATION -x I-EXPLORATION -35 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -cara I-EXPLORATION -lateral I-EXPLORATION -derecha I-EXPLORATION -sólido I-EXPLORATION -y I-EXPLORATION +bases I-EXPLORATION +depositadas I-EXPLORATION con I-EXPLORATION -superficie I-EXPLORATION -irregular. I-EXPLORATION -Otra I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -posterolateral I-EXPLORATION -derecha I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -mm. I-EXPLORATION -El I-EXPLORATION -centellograma I-EXPLORATION -óseo I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION +la I-EXPLORATION +especie I-EXPLORATION +B. I-EXPLORATION +quintana I-EXPLORATION +cepa I-EXPLORATION +Toulouse. I-EXPLORATION + I-EXPLORATION Se B-TREATMENT -indica I-TREATMENT -cistectomía I-TREATMENT -radical I-TREATMENT -con I-TREATMENT -linfadenectomía I-TREATMENT -pelviana I-TREATMENT -bilateral I-TREATMENT -laparoscópica I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +antiretroviral I-TREATMENT +para I-TREATMENT +el I-TREATMENT +VIH I-TREATMENT y I-TREATMENT -ureterostomía I-TREATMENT -cutánea I-TREATMENT -izquierda. I-TREATMENT -La I-TREATMENT -técnica I-TREATMENT -empleada I-TREATMENT -fue I-TREATMENT +profilaxis I-TREATMENT +para I-TREATMENT +Pneumocystis I-TREATMENT +jiroveci. I-TREATMENT +Se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT la I-TREATMENT -desarrollada I-TREATMENT -por I-TREATMENT -Castillo I-TREATMENT -et I-TREATMENT -al. I-TREATMENT -(4). I-TREATMENT - I-TREATMENT +AB I-TREATMENT +con I-TREATMENT +Azitromicina I-TREATMENT +500 I-TREATMENT +mg/ I-TREATMENT +día I-TREATMENT +vo I-TREATMENT +y I-TREATMENT +Ciprofloxacino I-TREATMENT +500 I-TREATMENT +mg I-TREATMENT +c/12 I-TREATMENT +h I-TREATMENT +vo. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente, I-EVOLUTION +con I-EVOLUTION +regresión I-EVOLUTION +progresiva I-EVOLUTION +de I-EVOLUTION +síntomas I-EVOLUTION +sistémicos I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +lesiones I-EVOLUTION +cutáneas I-EVOLUTION +en I-EVOLUTION +pocos I-EVOLUTION +días. I-EVOLUTION + I-EVOLUTION -Varón B-PRESENT_ILLNESS +Lactante B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +vida I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -inflamación I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -prepucial I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -tumefacción I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -dorso I-PRESENT_ILLNESS -peneano I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +primera I-PRESENT_ILLNESS +visita I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS +control I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +recién I-PRESENT_ILLNESS +nacido. I-PRESENT_ILLNESS +Varón, B-PAST_MEDICAL_HISTORY +fruto I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +segunda I-PAST_MEDICAL_HISTORY +gestación I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +término I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +complicaciones I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +parto I-PAST_MEDICAL_HISTORY +eutócico I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +incidencias. I-PAST_MEDICAL_HISTORY +La B-PRESENT_ILLNESS +madre I-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -niega I-PRESENT_ILLNESS -relaciones I-PRESENT_ILLNESS -sexuales I-PRESENT_ILLNESS +aproximadamente I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +cm I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -riesgo, I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -miccional, I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -Refiere I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS +diámetro I-PRESENT_ILLNESS en I-PRESENT_ILLNESS el I-PRESENT_ILLNESS -dorso I-PRESENT_ILLNESS +vértice I-PRESENT_ILLNESS del I-PRESENT_ILLNESS -pene I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cordón I-PRESENT_ILLNESS -indurado I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -palpable I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -dicha I-PRESENT_ILLNESS -región, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -acentúa I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -erección. I-PRESENT_ILLNESS +cuero I-PRESENT_ILLNESS +cabelludo I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +momento I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +nacimiento. I-PRESENT_ILLNESS I-PRESENT_ILLNESS -En B-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -sólo I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -cigarrillos/ I-PAST_MEDICAL_HISTORY -día, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -ninguna I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -base I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -habitual; I-PAST_MEDICAL_HISTORY -en B-FAMILY_HISTORY -su I-FAMILY_HISTORY -historia I-FAMILY_HISTORY -familiar I-FAMILY_HISTORY -tampoco I-FAMILY_HISTORY -se I-FAMILY_HISTORY -encontraron I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Durante B-EXPLORATION -la I-EXPLORATION +La B-EXPLORATION exploración I-EXPLORATION física I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -una I-EXPLORATION -inflamación I-EXPLORATION -prepucial I-EXPLORATION -intensa I-EXPLORATION -con I-EXPLORATION -erosiones I-EXPLORATION -blanquecinas I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -candidiasis. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -dorso I-EXPLORATION -peneano I-EXPLORATION -se I-EXPLORATION evidencia I-EXPLORATION -un I-EXPLORATION -cordón I-EXPLORATION -duro I-EXPLORATION -y I-EXPLORATION -doloroso I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -desde I-EXPLORATION la I-EXPLORATION -base I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -surco I-EXPLORATION -balanoprepucial, I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -inflamación I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -adyacente. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION +lesión I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION +1 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro, I-EXPLORATION +de I-EXPLORATION +bordes I-EXPLORATION +limpios, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +sobreinfección. I-EXPLORATION Ante I-EXPLORATION la I-EXPLORATION sospecha I-EXPLORATION de I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Mondor I-EXPLORATION +aplasia I-EXPLORATION +cutis I-EXPLORATION +congénita I-EXPLORATION +(ACC) I-EXPLORATION se I-EXPLORATION realizó I-EXPLORATION -ecografía I-EXPLORATION -doppler I-EXPLORATION -peneana I-EXPLORATION -que I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -instaurado I-TREATMENT -fue I-TREATMENT -Fluconazol I-TREATMENT -tópico I-TREATMENT -1 I-TREATMENT -aplicación I-TREATMENT -/12h, I-TREATMENT -Amoxicilina- I-TREATMENT -Clavulanico I-TREATMENT -875 I-TREATMENT -mg/8h I-TREATMENT -e I-TREATMENT -Ibuprofeno I-TREATMENT -600 I-TREATMENT -mg/8h I-TREATMENT -durante I-TREATMENT -10 I-TREATMENT -días, I-TREATMENT -asociado I-TREATMENT -a I-TREATMENT -reposo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -actividad I-TREATMENT -sexual I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -resolución I-TREATMENT -del I-TREATMENT -cuadro. I-TREATMENT - I-TREATMENT -Durante B-EVOLUTION -la I-EVOLUTION -primera I-EVOLUTION -semana, I-EVOLUTION -se I-EVOLUTION -objetiva I-EVOLUTION -una I-EVOLUTION -disminución I-EVOLUTION -progresiva I-EVOLUTION -del I-EVOLUTION -cordón I-EVOLUTION -dorsal I-EVOLUTION -en I-EVOLUTION -sentido I-EVOLUTION -distal I-EVOLUTION -y I-EVOLUTION -del I-EVOLUTION -dolor. I-EVOLUTION -Las I-EVOLUTION -lesiones I-EVOLUTION -relacionadas I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -candidiasis I-EVOLUTION -han I-EVOLUTION -desaparecido. I-EVOLUTION -En B-EXPLORATION -este I-EXPLORATION -momento I-EXPLORATION -se I-EXPLORATION -pone I-EXPLORATION +una I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -manifiesto I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION +cráneo I-EXPLORATION +y I-EXPLORATION una I-EXPLORATION -fimosis I-EXPLORATION -puntiforme I-EXPLORATION +ecografía I-EXPLORATION +cerebral I-EXPLORATION +transfontanelar, I-EXPLORATION que I-EXPLORATION -impide I-EXPLORATION -la I-EXPLORATION -retracción I-EXPLORATION -prepucial, I-EXPLORATION -y I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -precisará I-EXPLORATION -ser I-EXPLORATION -circuncidado. I-EXPLORATION -A I-EXPLORATION -las I-EXPLORATION -6 I-EXPLORATION -semanas I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -ecografía I-EXPLORATION -doppler I-EXPLORATION -peneana I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -la I-EXPLORATION -repermeabilización I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -dorsal I-EXPLORATION -superficial I-EXPLORATION -del I-EXPLORATION -pene I-EXPLORATION -en I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -trombo I-EXPLORATION -venoso, I-EXPLORATION -dando I-EXPLORATION -por I-EXPLORATION -resuelto I-EXPLORATION -el I-EXPLORATION -cuadro. I-EXPLORATION - I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +El I-EXPLORATION +genograma I-EXPLORATION +no I-EXPLORATION +evidenció I-EXPLORATION +enfermedades I-EXPLORATION +genéticas, I-EXPLORATION +pero B-FAMILY_HISTORY +el I-FAMILY_HISTORY +padre I-FAMILY_HISTORY +también I-FAMILY_HISTORY +presentaba I-FAMILY_HISTORY +una I-FAMILY_HISTORY +zona I-FAMILY_HISTORY +de I-FAMILY_HISTORY +alopecia I-FAMILY_HISTORY +cicatricial I-FAMILY_HISTORY +en I-FAMILY_HISTORY +el I-FAMILY_HISTORY +vértice I-FAMILY_HISTORY +del I-FAMILY_HISTORY +cuero I-FAMILY_HISTORY +cabelludo, I-FAMILY_HISTORY +que I-FAMILY_HISTORY +refiere I-FAMILY_HISTORY +desde I-FAMILY_HISTORY +la I-FAMILY_HISTORY +infancia. I-FAMILY_HISTORY + I-FAMILY_HISTORY -Se B-PRESENT_ILLNESS -revisaron I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -historias I-PRESENT_ILLNESS -clínicas I-PRESENT_ILLNESS +Recién B-PRESENT_ILLNESS +nacido I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -todos I-PRESENT_ILLNESS +17 I-PRESENT_ILLNESS +días, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +perinatales I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +destacar. I-PAST_MEDICAL_HISTORY +A B-PRESENT_ILLNESS los I-PRESENT_ILLNESS -pacientes I-PRESENT_ILLNESS -intervenidos I-PRESENT_ILLNESS +11 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +internación I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -les I-PRESENT_ILLNESS -realizó I-PRESENT_ILLNESS -RTU I-PRESENT_ILLNESS -vesical I-PRESENT_ILLNESS -entre I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -1990-2009 I-PRESENT_ILLNESS -descartando I-PRESENT_ILLNESS -aquellos I-PRESENT_ILLNESS -tumores I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -cumplían I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -criterios I-PRESENT_ILLNESS -histológicos, I-PRESENT_ILLNESS -excluyendo I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -adenocarcinomas I-PRESENT_ILLNESS -metastáticos I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +UCI I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -infiltración I-PRESENT_ILLNESS -local I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +bronquiolitis I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +VRS I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +fiebre, I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +flebitis I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +brazo I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +vía I-PRESENT_ILLNESS +venosa I-PRESENT_ILLNESS +periférica I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +tumefacción I-PRESENT_ILLNESS +dolorosa, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +rubor I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +calor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -vejiga. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Encontramos B-EXPLORATION -nueve I-EXPLORATION -casos I-EXPLORATION -con I-EXPLORATION -carcinoma I-EXPLORATION -vesical I-EXPLORATION +segunda I-PRESENT_ILLNESS +articulación I-PRESENT_ILLNESS +condrocostal I-PRESENT_ILLNESS +derecha. I-PRESENT_ILLNESS +Con B-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +osteoartritis I-TREATMENT +condrocostal I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +antibacteriano I-TREATMENT +empírico I-TREATMENT +con I-TREATMENT +meropenem I-TREATMENT +60 I-TREATMENT +mg/kg/día I-TREATMENT +y I-TREATMENT +vancomicina I-TREATMENT +40 I-TREATMENT +mg/kg/día I-TREATMENT +durante I-TREATMENT +72 I-TREATMENT +h. I-TREATMENT +Los B-EXPLORATION +hemocultivos I-EXPLORATION +fueron I-EXPLORATION +positivos I-EXPLORATION +a I-EXPLORATION +Klebsiella I-EXPLORATION +pneumoniae I-EXPLORATION +sensible I-EXPLORATION +a I-EXPLORATION +oxiiminocefaslosporinas, I-EXPLORATION +amikacina, I-EXPLORATION +gentamicina, I-EXPLORATION +meropenem I-EXPLORATION +e I-EXPLORATION +imipenem. I-EXPLORATION +Se B-TREATMENT +suspendió I-TREATMENT +vancomicina I-TREATMENT +y I-TREATMENT +continuó I-TREATMENT +con I-TREATMENT +meropenem I-TREATMENT +durante I-TREATMENT +14 I-TREATMENT +días I-TREATMENT +con B-EXPLORATION +negativización I-EXPLORATION +del I-EXPLORATION +hemocultivo I-EXPLORATION +al I-EXPLORATION +7° I-EXPLORATION +día I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -en I-EXPLORATION -anillo I-EXPLORATION +terapia. I-EXPLORATION +Mejoraron B-EVOLUTION +los I-EVOLUTION +signos I-EVOLUTION +locales I-EVOLUTION +pero I-EVOLUTION +continuó I-EVOLUTION +febril I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +agregó I-EVOLUTION +limitación I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +rotación I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +cadera I-EVOLUTION +derecha. I-EVOLUTION +Con B-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +probable I-TREATMENT +osteoartritis I-TREATMENT +coxofemoral I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +punción I-TREATMENT +articular I-TREATMENT +y I-TREATMENT +drenaje I-TREATMENT +quirúrgico I-TREATMENT +que I-TREATMENT +dio I-TREATMENT +salida I-TREATMENT +a I-TREATMENT +material I-TREATMENT +purulento. I-TREATMENT +En I-TREATMENT +ese I-TREATMENT +momento I-TREATMENT +se I-TREATMENT +agregó I-TREATMENT +amikacina I-TREATMENT +15 I-TREATMENT +mg/kg/día I-TREATMENT +por I-TREATMENT +el I-TREATMENT +antecedente I-TREATMENT +de I-TREATMENT +K. I-TREATMENT +pneumoniae I-TREATMENT +aislada I-TREATMENT +del I-TREATMENT +hemocultivo. I-TREATMENT +Del B-EXPLORATION +cultivo I-EXPLORATION +del I-EXPLORATION +líquido I-EXPLORATION +articular I-EXPLORATION +se I-EXPLORATION +obtuvo I-EXPLORATION +K. I-EXPLORATION +pneumoniae I-EXPLORATION +(cepa I-EXPLORATION +OA1) I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +mismo I-EXPLORATION +perfil I-EXPLORATION de I-EXPLORATION -sello I-EXPLORATION -diagnosticados I-EXPLORATION -y I-EXPLORATION -tratados I-EXPLORATION +susceptibilidad I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +cepa I-EXPLORATION +aislada I-EXPLORATION en I-EXPLORATION -nuestro I-EXPLORATION -servicio I-EXPLORATION -entre I-EXPLORATION -Enero I-EXPLORATION -de I-EXPLORATION -1992 I-EXPLORATION -y I-EXPLORATION -Enero I-EXPLORATION -de I-EXPLORATION -2009; I-EXPLORATION -ocho I-EXPLORATION -de I-EXPLORATION +sangre. I-EXPLORATION +Dado B-TREATMENT +que I-TREATMENT +persistió I-TREATMENT +febril, I-TREATMENT +se I-TREATMENT +realizaron I-TREATMENT +aseos I-TREATMENT +quirúrgicos I-TREATMENT +sucesivos I-TREATMENT +aislándose, B-EXPLORATION +a I-EXPLORATION los I-EXPLORATION -pacientes I-EXPLORATION -eran I-EXPLORATION -varones I-EXPLORATION +17 I-EXPLORATION +días I-EXPLORATION +del I-EXPLORATION +primer I-EXPLORATION +aislado I-EXPLORATION +(OA1), I-EXPLORATION +K. I-EXPLORATION +pneumoniae I-EXPLORATION +(cepa I-EXPLORATION +OA2) I-EXPLORATION +resistente I-EXPLORATION +a I-EXPLORATION +oxiiminocefalosporinas, I-EXPLORATION +amikacina I-EXPLORATION y I-EXPLORATION -sólo I-EXPLORATION -había I-EXPLORATION +gentamicina. I-EXPLORATION +Los I-EXPLORATION +hemocultivos I-EXPLORATION +realizados I-EXPLORATION +durante I-EXPLORATION +la I-EXPLORATION +evolución I-EXPLORATION +fueron I-EXPLORATION +negativos, I-EXPLORATION +manteniéndose I-EXPLORATION +el I-EXPLORATION +mismo I-EXPLORATION +esquema I-EXPLORATION +antibacteriano. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -mujer, I-EXPLORATION -con I-EXPLORATION -de I-EXPLORATION -edades I-EXPLORATION -comprendidas I-EXPLORATION -entre I-EXPLORATION -los I-EXPLORATION -39 I-EXPLORATION +evaluación I-EXPLORATION +inmunológica I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +normal. I-EXPLORATION +Luego B-TREATMENT +de I-TREATMENT +múltiples I-TREATMENT +aseos I-TREATMENT +quirúrgicos, I-TREATMENT +35 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +fiebre I-TREATMENT +y I-TREATMENT +45 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +antibacteriano I-TREATMENT +se B-EVOLUTION +dio I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +con I-EVOLUTION +buena I-EVOLUTION +evolución I-EVOLUTION +posterior. I-EVOLUTION + I-EVOLUTION +Tipificación B-EXPLORATION +molecular I-EXPLORATION y I-EXPLORATION -los I-EXPLORATION -82 I-EXPLORATION -años, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -media I-EXPLORATION +mecanismo I-EXPLORATION de I-EXPLORATION -69 I-EXPLORATION -años. I-EXPLORATION - I-EXPLORATION +resistencia: I-EXPLORATION El I-EXPLORATION -debut I-EXPLORATION -clínico I-EXPLORATION -fue I-EXPLORATION +análisis I-EXPLORATION +por I-EXPLORATION +EFCP I-EXPLORATION +mostró I-EXPLORATION +que I-EXPLORATION +las I-EXPLORATION +cepas I-EXPLORATION +OA1 I-EXPLORATION +y I-EXPLORATION +OA2 I-EXPLORATION +no I-EXPLORATION +estaban I-EXPLORATION +genéticamente I-EXPLORATION +relacionadas. I-EXPLORATION + I-EXPLORATION +A I-EXPLORATION +diferencia I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +cepa I-EXPLORATION +OA1, I-EXPLORATION +OA2 I-EXPLORATION +presentó I-EXPLORATION +el I-EXPLORATION +gen I-EXPLORATION +para I-EXPLORATION la I-EXPLORATION -hematuria I-EXPLORATION +BLEE I-EXPLORATION +CTX-M-9 I-EXPLORATION en I-EXPLORATION -seis I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -casos I-EXPLORATION -y I-EXPLORATION -clínica I-EXPLORATION -irritativa I-EXPLORATION -con I-EXPLORATION -polaquiuria I-EXPLORATION +un I-EXPLORATION +plásmido I-EXPLORATION +IncHI1-HI2 I-EXPLORATION +no I-EXPLORATION +conjugativo. I-EXPLORATION +Adicionalmente I-EXPLORATION +OA2 I-EXPLORATION +presentaba I-EXPLORATION +el I-EXPLORATION +gen I-EXPLORATION +aac I-EXPLORATION +(6') I-EXPLORATION +1b, I-EXPLORATION +que I-EXPLORATION +confiere I-EXPLORATION +resistencia I-EXPLORATION +a I-EXPLORATION +amikacina I-EXPLORATION y I-EXPLORATION -disuria I-EXPLORATION -importante I-EXPLORATION -en I-EXPLORATION -uno I-EXPLORATION -de I-EXPLORATION -ellos. I-EXPLORATION -Uno I-EXPLORATION +un I-EXPLORATION +integrón I-EXPLORATION de I-EXPLORATION -estos I-EXPLORATION -pacientes I-EXPLORATION -presentaba I-EXPLORATION -importante I-EXPLORATION -síndrome I-EXPLORATION -general I-EXPLORATION +clase I-EXPLORATION +1 I-EXPLORATION con I-EXPLORATION -caquexia I-EXPLORATION +los I-EXPLORATION +genes I-EXPLORATION +aadB-aadA2 I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION -del I-EXPLORATION -diagnóstico. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -citológico I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +variable, I-EXPLORATION +responsables I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -orina I-EXPLORATION -mostró I-EXPLORATION -células I-EXPLORATION -malignas I-EXPLORATION -en I-EXPLORATION -tres I-EXPLORATION -pacientes, I-EXPLORATION -atipias I-EXPLORATION -en I-EXPLORATION -dos I-EXPLORATION -y I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -dos I-EXPLORATION -restantes. I-EXPLORATION +resistencia I-EXPLORATION +a I-EXPLORATION +gentamicina. I-EXPLORATION I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -mostró I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION + +Nuestra B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +77 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +alergias I-PAST_MEDICAL_HISTORY +medicamentosas I-PAST_MEDICAL_HISTORY +conocidas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +miocardiopatía I-PAST_MEDICAL_HISTORY +dilatada, I-PAST_MEDICAL_HISTORY +artrosis, I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +histerectomía I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +doble I-PAST_MEDICAL_HISTORY +anexectomía I-PAST_MEDICAL_HISTORY +junto I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +quimio I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +radioterapia I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +tumoración I-PAST_MEDICAL_HISTORY +ginecológica I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +12 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Acude B-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +cólico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +ocho I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +localizado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +fosa I-PRESENT_ILLNESS +lumbar I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +flanco I-PRESENT_ILLNESS +derechos I-PRESENT_ILLNESS +así I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +cara I-PRESENT_ILLNESS +anterior I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +muslo I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +aumentando I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +deambulación. I-PRESENT_ILLNESS +A I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +vez, I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +acompaña I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nauseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +picos I-PRESENT_ILLNESS +febriles I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +sudoración I-PRESENT_ILLNESS +profusa I-PRESENT_ILLNESS +aunque I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +momento I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +encuentra I-PRESENT_ILLNESS +afebril I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +miccional. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +A B-EXPLORATION la I-EXPLORATION -pared I-EXPLORATION -vesical I-EXPLORATION +exploración I-EXPLORATION +presenta: I-EXPLORATION +soplo I-EXPLORATION +protomesosistólico I-EXPLORATION en I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -casos, I-EXPLORATION -con I-EXPLORATION -infiltración I-EXPLORATION -del I-EXPLORATION -pericistio I-EXPLORATION +ápex, I-EXPLORATION +abdomen I-EXPLORATION +blando I-EXPLORATION y I-EXPLORATION -adenopatías I-EXPLORATION -múltiples I-EXPLORATION -retroperitoneales I-EXPLORATION +depresible, I-EXPLORATION +doloroso I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION en I-EXPLORATION -cuatro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -pacientes I-EXPLORATION +fosa I-EXPLORATION +iliaca I-EXPLORATION y I-EXPLORATION -uropatía I-EXPLORATION -obstructiva I-EXPLORATION -uni I-EXPLORATION -o I-EXPLORATION -bilateral I-EXPLORATION +flanco I-EXPLORATION +derechos. I-EXPLORATION +También I-EXPLORATION +destaca I-EXPLORATION +dolor I-EXPLORATION +espontáneo I-EXPLORATION en I-EXPLORATION -cuatro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -casos. I-EXPLORATION - I-EXPLORATION -Dos I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -casos I-EXPLORATION -presentaron I-EXPLORATION -alteración I-EXPLORATION +cara I-EXPLORATION +anterior I-EXPLORATION del I-EXPLORATION -estudio I-EXPLORATION -radiológico I-EXPLORATION -gastroduodenal I-EXPLORATION -siendo I-EXPLORATION -completado I-EXPLORATION +muslo I-EXPLORATION +derecho I-EXPLORATION +que I-EXPLORATION +aumenta I-EXPLORATION con I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION +la I-EXPLORATION +presión I-EXPLORATION y I-EXPLORATION -baja I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -hallazgo I-EXPLORATION -de I-EXPLORATION -gastritis I-EXPLORATION -crónica I-EXPLORATION -antral I-EXPLORATION con I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -metaplasia I-EXPLORATION -intestinal I-EXPLORATION -en I-EXPLORATION -uno I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -sujetos I-EXPLORATION -y I-EXPLORATION -pólipo I-EXPLORATION -adenomatoso I-EXPLORATION +la I-EXPLORATION +movilidad I-EXPLORATION de I-EXPLORATION -sigma I-EXPLORATION -en I-EXPLORATION -otro. I-EXPLORATION +la I-EXPLORATION +extremidad. I-EXPLORATION I-EXPLORATION En I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -casos I-EXPLORATION -se I-EXPLORATION -realizaron I-EXPLORATION -estudios I-EXPLORATION -histológicos I-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -masas I-EXPLORATION -resecadas I-EXPLORATION +Urgencias I-EXPLORATION +destaca I-EXPLORATION +leucocitosis I-EXPLORATION con I-EXPLORATION -inclusión I-EXPLORATION -en I-EXPLORATION -parafina, I-EXPLORATION -colorante I-EXPLORATION -Hematoxilina/Eosina I-EXPLORATION -y I-EXPLORATION -tinción I-EXPLORATION -PAS. I-EXPLORATION -En I-EXPLORATION -algunos I-EXPLORATION -casos I-EXPLORATION -se I-EXPLORATION -realizaron I-EXPLORATION -estudios I-EXPLORATION -inmunohistoquimicos I-EXPLORATION -(PSA, I-EXPLORATION -E-caderina, I-EXPLORATION -citoqueratina I-EXPLORATION -20, I-EXPLORATION -S100) I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -origen I-EXPLORATION -extravesical I-EXPLORATION -(1). I-EXPLORATION - I-EXPLORATION -Tras I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -encontramos I-EXPLORATION -cuatro I-EXPLORATION -casos I-EXPLORATION -de I-EXPLORATION -adenocarcinoma I-EXPLORATION -vesical I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -en I-EXPLORATION -anillo I-EXPLORATION -de I-EXPLORATION -sello I-EXPLORATION -primario I-EXPLORATION -puros I-EXPLORATION -y I-EXPLORATION -cinco I-EXPLORATION -mixtos I-EXPLORATION +desviación I-EXPLORATION +izquierda I-EXPLORATION +(17.200 I-EXPLORATION +leucocitos I-EXPLORATION con I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -en I-EXPLORATION -anillo I-EXPLORATION -de I-EXPLORATION -sello I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -seno I-EXPLORATION -de I-EXPLORATION -carcinomas I-EXPLORATION +84% I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -transicionales. I-EXPLORATION +neutrófilos), I-EXPLORATION +567.000 I-EXPLORATION +plaquetas, I-EXPLORATION +urea I-EXPLORATION +1.35, I-EXPLORATION +creatinina I-EXPLORATION +1.80. I-EXPLORATION I-EXPLORATION -La I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION +Como I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -estos I-EXPLORATION -tumores I-EXPLORATION -mostró I-EXPLORATION -células I-EXPLORATION +imagen I-EXPLORATION +se I-EXPLORATION +solicitan I-EXPLORATION +Rx. I-EXPLORATION de I-EXPLORATION -citoplasma I-EXPLORATION -amplio I-EXPLORATION -eosinófilo I-EXPLORATION -con I-EXPLORATION -vacuola I-EXPLORATION -central I-EXPLORATION -PAS I-EXPLORATION -positiva I-EXPLORATION +vías I-EXPLORATION +urinarias I-EXPLORATION y I-EXPLORATION -desplazamiento I-EXPLORATION -del I-EXPLORATION -núcleo I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -periferia I-EXPLORATION -(morfología I-EXPLORATION -típica I-EXPLORATION +ecografía I-EXPLORATION en I-EXPLORATION -anillo I-EXPLORATION -de I-EXPLORATION -sello). I-EXPLORATION +las I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +imagen I-EXPLORATION +cálcica I-EXPLORATION +en I-EXPLORATION +silueta I-EXPLORATION +renal I-EXPLORATION +derecha I-EXPLORATION +y I-EXPLORATION +ectasia I-EXPLORATION +pielocalicial I-EXPLORATION +derecha I-EXPLORATION +respectivamente. I-EXPLORATION I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -definitivo I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -cistectomía I-TREATMENT -radical I-TREATMENT -con I-TREATMENT -derivación I-TREATMENT -tipo I-TREATMENT -Bricker I-TREATMENT -en I-TREATMENT -tres I-TREATMENT +Con B-TREATMENT +el I-TREATMENT +diagnostico I-TREATMENT de I-TREATMENT -los I-TREATMENT -pacientes, I-TREATMENT -cistectomía I-TREATMENT -con I-TREATMENT +cólico I-TREATMENT +nefrítico I-TREATMENT +derecho I-TREATMENT +complicado I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +ingreso I-TREATMENT +para I-TREATMENT derivación I-TREATMENT -Mainz I-TREATMENT -II I-TREATMENT -en I-TREATMENT -otro I-TREATMENT -de I-TREATMENT -ellos I-TREATMENT -y I-TREATMENT -paliativo I-TREATMENT -en I-TREATMENT -los I-TREATMENT -cuatro I-TREATMENT -restantes I-TREATMENT -con I-TREATMENT -RTU I-TREATMENT -en I-TREATMENT -tres I-TREATMENT -casos I-TREATMENT +urinaria I-TREATMENT y I-TREATMENT -NPC I-TREATMENT -paliativas I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +intravenoso. I-TREATMENT +Se I-TREATMENT +coloca I-TREATMENT en I-TREATMENT -otro. I-TREATMENT - I-TREATMENT -Recibieron I-TREATMENT -quimioterapia I-TREATMENT -adyuvante I-TREATMENT -tres I-TREATMENT -pacientes I-TREATMENT -consistentes I-TREATMENT +quirófano I-TREATMENT +catéter I-TREATMENT +externo I-TREATMENT en I-TREATMENT -MVAC. I-TREATMENT +uréter I-TREATMENT +derecho I-TREATMENT +con I-TREATMENT +salida I-TREATMENT +de I-TREATMENT +abundante I-TREATMENT +orina I-TREATMENT +limpia. I-TREATMENT I-TREATMENT -La B-EVOLUTION -supervivencia I-EVOLUTION -fue I-EVOLUTION +A B-EVOLUTION +lo I-EVOLUTION +largo I-EVOLUTION de I-EVOLUTION -570, I-EVOLUTION -480, I-EVOLUTION -250 I-EVOLUTION -y I-EVOLUTION -8 I-EVOLUTION -días I-EVOLUTION -para I-EVOLUTION los I-EVOLUTION -tumores I-EVOLUTION -puros I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -512, I-EVOLUTION -410, I-EVOLUTION -280, I-EVOLUTION -270 I-EVOLUTION días I-EVOLUTION -y I-EVOLUTION -mayor I-EVOLUTION -de I-EVOLUTION -4 I-EVOLUTION -años I-EVOLUTION -en I-EVOLUTION -un I-EVOLUTION -caso, I-EVOLUTION -para I-EVOLUTION -los I-EVOLUTION -tumores I-EVOLUTION -mixtos. I-EVOLUTION -Todos I-EVOLUTION -los I-EVOLUTION -pacientes, I-EVOLUTION -excepto I-EVOLUTION -dos I-EVOLUTION -habían I-EVOLUTION -fallecido I-EVOLUTION -en I-EVOLUTION el I-EVOLUTION -momento I-EVOLUTION -de I-EVOLUTION -realizarse I-EVOLUTION -este I-EVOLUTION -estudio. I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -literatura I-EVOLUTION -revisada I-EVOLUTION +dolor I-EVOLUTION +cólico I-EVOLUTION +va I-EVOLUTION +cediendo I-EVOLUTION +aunque I-EVOLUTION la I-EVOLUTION -supervivencia I-EVOLUTION -global I-EVOLUTION -no I-EVOLUTION -supera I-EVOLUTION +paciente I-EVOLUTION +refiere I-EVOLUTION +dolor I-EVOLUTION +sordo I-EVOLUTION +en I-EVOLUTION +fosa I-EVOLUTION +lumbar I-EVOLUTION +y I-EVOLUTION +continúa I-EVOLUTION +con I-EVOLUTION el I-EVOLUTION -11% I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -años I-EVOLUTION -(2,3). I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -21 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -quien I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -cervical. I-PRESENT_ILLNESS -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -bocio I-EXPLORATION -difuso I-EXPLORATION +dolor I-EVOLUTION +en I-EVOLUTION +muslo I-EVOLUTION +derecho. I-EVOLUTION +Es B-TREATMENT +valorada I-TREATMENT +por I-TREATMENT +el I-TREATMENT +servicio I-TREATMENT +de I-TREATMENT +Traumatología I-TREATMENT +pautando I-TREATMENT +tratamiento I-TREATMENT +antiinflamatorio I-TREATMENT +ante I-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +rotura I-TREATMENT +fibrilar I-TREATMENT +del I-TREATMENT +cuadriceps. I-TREATMENT + I-TREATMENT +Debido B-EXPLORATION a I-EXPLORATION la I-EXPLORATION -palpación I-EXPLORATION -y I-EXPLORATION -sus I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -revelaron I-EXPLORATION -hormonas I-EXPLORATION -tiroideas I-EXPLORATION -normales I-EXPLORATION -y I-EXPLORATION -anticuerpos I-EXPLORATION -anti-tiroglobulina I-EXPLORATION -(AAT) I-EXPLORATION -positivos. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -tiroidea I-EXPLORATION -reveló I-EXPLORATION -tres I-EXPLORATION -nódulos I-EXPLORATION -tiroideos, I-EXPLORATION +persistencia I-EXPLORATION +del I-EXPLORATION +dolor I-EXPLORATION +lumbar I-EXPLORATION +se I-EXPLORATION +decide I-EXPLORATION +revisión I-EXPLORATION +ecográfica I-EXPLORATION +objetivándose I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +localizada I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -mayor I-EXPLORATION +músculo I-EXPLORATION +psoas I-EXPLORATION +derecho I-EXPLORATION de I-EXPLORATION -7 I-EXPLORATION -mm I-EXPLORATION -con I-EXPLORATION -microcalcificaciones I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -punción-biopsia I-EXPLORATION -bajo I-EXPLORATION -ecografía, I-EXPLORATION -demostrándose I-EXPLORATION -cáncer I-EXPLORATION -papilar I-EXPLORATION -del I-EXPLORATION -tiroides. I-EXPLORATION -Se B-TREATMENT -sometió I-TREATMENT -a I-TREATMENT -tiroidectomía I-TREATMENT -total, I-TREATMENT -resultando I-TREATMENT -un I-TREATMENT -foco I-TREATMENT -de I-TREATMENT -cáncer I-TREATMENT -papilar I-TREATMENT -de I-TREATMENT -6x5x5 I-TREATMENT -mm I-TREATMENT -y I-TREATMENT -metástasis I-TREATMENT -paratraqueales I-TREATMENT -bilaterales. I-TREATMENT -Recibió I-TREATMENT -200 I-TREATMENT -mCi I-TREATMENT -de I-TREATMENT -radioyodo I-TREATMENT -con I-TREATMENT -rastreo I-TREATMENT -sistémico I-TREATMENT -post-dosis I-TREATMENT -terapéutica I-TREATMENT -negativo. I-TREATMENT -Se I-TREATMENT -mantuvo I-TREATMENT -con I-TREATMENT -dosis I-TREATMENT -supresiva I-TREATMENT -de I-TREATMENT -levotiroxina I-TREATMENT -(Eutirox®). I-TREATMENT - I-TREATMENT -Al B-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -un I-EVOLUTION -nuevo I-EVOLUTION -rastreo I-EVOLUTION -sistémico I-EVOLUTION -con I-EVOLUTION -dosis I-EVOLUTION -trazadora I-EVOLUTION -de I-EVOLUTION -10 I-EVOLUTION -mCi, I-EVOLUTION -resultando I-EVOLUTION -negativo, I-EVOLUTION -la I-EVOLUTION -tiroglobulina I-EVOLUTION -no I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -utilidad I-EVOLUTION -dado I-EVOLUTION -la I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -anticuerpos I-EVOLUTION -AAT: I-EVOLUTION -164 I-EVOLUTION -ng/mL. I-EVOLUTION -En I-EVOLUTION -el I-EVOLUTION -segundo I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -por I-EVOLUTION -ecografía I-EVOLUTION -cervical, I-EVOLUTION -se I-EVOLUTION -detectó I-EVOLUTION -la I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -nódulo I-EVOLUTION -de I-EVOLUTION -9, I-EVOLUTION -6 I-EVOLUTION -mm, I-EVOLUTION -el I-EVOLUTION -cual I-EVOLUTION -no I-EVOLUTION -fue I-EVOLUTION -técnicamente I-EVOLUTION -posible I-EVOLUTION -de I-EVOLUTION -puncionar, I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -asoció I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -aumento I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -títulos I-EVOLUTION -de I-EVOLUTION -AAT I-EVOLUTION -174 I-EVOLUTION -ng/mL. I-EVOLUTION -Se B-TREATMENT -decidió I-TREATMENT -dar I-TREATMENT -una I-TREATMENT -nueva I-TREATMENT -dosis I-TREATMENT -terapéutica I-TREATMENT -de I-TREATMENT -200 I-TREATMENT -mCi I-TREATMENT -con I-TREATMENT -rastreo I-TREATMENT -que I-TREATMENT -mostró I-TREATMENT -captación I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -cervical. I-TREATMENT - I-TREATMENT -En B-EXPLORATION +10 I-EXPLORATION +x I-EXPLORATION +5.5 I-EXPLORATION +cm. I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +un I-EXPLORATION +TAC. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -ecografía I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -al I-EXPLORATION -año I-EXPLORATION -post I-EXPLORATION -segunda I-EXPLORATION -dosis I-EXPLORATION -de I-EXPLORATION -radioyodo, I-EXPLORATION +tomografía I-EXPLORATION se I-EXPLORATION -detectó I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION +confirma I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +del I-EXPLORATION +absceso I-EXPLORATION +retroperitoneal I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +compartimento I-EXPLORATION +del I-EXPLORATION +músculo I-EXPLORATION +psoas I-EXPLORATION +iliaco I-EXPLORATION +derecho I-EXPLORATION a I-EXPLORATION nivel I-EXPLORATION -supraesternal I-EXPLORATION -central I-EXPLORATION -y I-EXPLORATION -3 I-EXPLORATION -ganglios I-EXPLORATION de I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -cada I-EXPLORATION -uno, I-EXPLORATION +L2-L3 I-EXPLORATION +sin I-EXPLORATION +perder I-EXPLORATION +la I-EXPLORATION +continuidad I-EXPLORATION +hasta I-EXPLORATION +anillo I-EXPLORATION +inguinal I-EXPLORATION +y I-EXPLORATION +sin I-EXPLORATION +poder I-EXPLORATION +descartar I-EXPLORATION +la I-EXPLORATION +participación I-EXPLORATION +del I-EXPLORATION +uréter I-EXPLORATION +derecho I-EXPLORATION en I-EXPLORATION -cadena I-EXPLORATION -cervical I-EXPLORATION -izquierda, I-EXPLORATION -sugerentes I-EXPLORATION +su I-EXPLORATION +tercio I-EXPLORATION +medio. I-EXPLORATION + I-EXPLORATION +Una B-DERIVED_FROM/TO +vez I-DERIVED_FROM/TO +confirmado I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +diagnóstico I-DERIVED_FROM/TO +nos I-DERIVED_FROM/TO +ponemos I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +contacto I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Radiología I-DERIVED_FROM/TO +Intervensionista I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +drenaje I-DERIVED_FROM/TO +percutáneo. I-DERIVED_FROM/TO +Mediante B-EXPLORATION +ecografía I-EXPLORATION +se I-EXPLORATION +coloca I-EXPLORATION +catéter I-EXPLORATION +10 I-EXPLORATION +fr. I-EXPLORATION +evacuando I-EXPLORATION +200 I-EXPLORATION +cc. I-EXPLORATION +material I-EXPLORATION +purulento, I-EXPLORATION +del I-EXPLORATION +cual I-EXPLORATION +se I-EXPLORATION +envía I-EXPLORATION +muestra I-EXPLORATION +microbiológica I-EXPLORATION +(en I-EXPLORATION +los I-EXPLORATION +días I-EXPLORATION +sucesivos I-EXPLORATION +se I-EXPLORATION +confirma I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -neoplasia, I-EXPLORATION -contralaterales I-EXPLORATION -a I-EXPLORATION +Bacteriodes I-EXPLORATION +fragilis I-EXPLORATION +y I-EXPLORATION +Streptococcus I-EXPLORATION +sanguis). I-EXPLORATION +El I-EXPLORATION +débito I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +drenaje I-EXPLORATION +es I-EXPLORATION +progresivamente I-EXPLORATION +menor I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +nuevo I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +TAC, I-EXPLORATION +evidenciándose I-EXPLORATION la I-EXPLORATION -lesión I-EXPLORATION -primaria, I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -ascenso I-EXPLORATION +disminución I-EXPLORATION +del I-EXPLORATION +volumen I-EXPLORATION +del I-EXPLORATION +absceso. I-EXPLORATION +Se B-EVOLUTION +decide I-EVOLUTION +retirar I-EVOLUTION +el I-EVOLUTION +tubo I-EVOLUTION +de I-EVOLUTION +drenaje I-EVOLUTION +al I-EVOLUTION +quinto I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +colocación I-EVOLUTION +pero I-EVOLUTION +es I-EVOLUTION +necesario I-EVOLUTION +recolocación I-EVOLUTION +de I-EVOLUTION +catéter I-EVOLUTION +14 I-EVOLUTION +fr. I-EVOLUTION +por I-EVOLUTION +empeoramiento I-EVOLUTION +clínico. I-EVOLUTION + I-EVOLUTION +Se B-EXPLORATION +desconoce I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -AAT I-EXPLORATION -a I-EXPLORATION -217 I-EXPLORATION -ng/mL. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -exploración I-TREATMENT -quirúrgica, I-TREATMENT -con I-TREATMENT -una I-TREATMENT -disección I-TREATMENT -selectiva I-TREATMENT -de I-TREATMENT -cuello I-TREATMENT -bilateral I-TREATMENT -de I-TREATMENT -los I-TREATMENT -niveles I-TREATMENT -II, I-TREATMENT -III, I-TREATMENT -IV I-TREATMENT -y I-TREATMENT -Vb I-TREATMENT -y I-TREATMENT -una I-TREATMENT -disección I-TREATMENT -del I-TREATMENT -nivel I-TREATMENT -VI I-TREATMENT -izquierdo I-TREATMENT -y I-TREATMENT -pretraqueal. I-TREATMENT -La B-EXPLORATION -biopsia I-EXPLORATION -confirmó I-EXPLORATION +foco I-EXPLORATION +primario I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +durante I-EXPLORATION el I-EXPLORATION -compromiso I-EXPLORATION -neoplásico I-EXPLORATION -ganglionar I-EXPLORATION +ingreso, I-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +colonoscopia I-EXPLORATION +para I-EXPLORATION +intentar I-EXPLORATION +buscar I-EXPLORATION +un I-EXPLORATION +origen I-EXPLORATION +digestivo I-EXPLORATION +del I-EXPLORATION +problema. I-EXPLORATION +No I-EXPLORATION +es I-EXPLORATION +posible I-EXPLORATION +sobrepasar I-EXPLORATION +el I-EXPLORATION +ángulo I-EXPLORATION +esplénico I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +halla I-EXPLORATION +un I-EXPLORATION +foco I-EXPLORATION +primario. I-EXPLORATION +Desde I-EXPLORATION +el I-EXPLORATION +punto I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -IV I-EXPLORATION -y I-EXPLORATION -Vb I-EXPLORATION -derechos I-EXPLORATION +vista I-EXPLORATION +urológico I-EXPLORATION +tampoco I-EXPLORATION +se I-EXPLORATION +justifica I-EXPLORATION +la I-EXPLORATION +aparición I-EXPLORATION +del I-EXPLORATION +absceso. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +hace I-EXPLORATION +cavitograma I-EXPLORATION +para I-EXPLORATION +estudiar I-EXPLORATION +la I-EXPLORATION +morfología I-EXPLORATION y I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -IIb, I-EXPLORATION -III, I-EXPLORATION -IV, I-EXPLORATION -Vb I-EXPLORATION +el I-EXPLORATION +tamaño I-EXPLORATION +del I-EXPLORATION +absceso I-EXPLORATION y I-EXPLORATION -VI I-EXPLORATION -izquierdo. I-EXPLORATION -Recibió B-TREATMENT -300 I-TREATMENT -mCi I-TREATMENT -de I-TREATMENT -radioyodo I-TREATMENT -con I-TREATMENT -rastreo I-TREATMENT -post-dosis I-TREATMENT -negativo I-TREATMENT -y I-TREATMENT -los I-TREATMENT -AAT I-TREATMENT -se I-TREATMENT -hicieron I-TREATMENT -negativos I-TREATMENT -con I-TREATMENT -una I-TREATMENT -tiroglobulina I-TREATMENT -(TG) I-TREATMENT -menor I-TREATMENT -de I-TREATMENT -0, I-TREATMENT -2 I-TREATMENT -ng/mL, I-TREATMENT -con I-TREATMENT -85% I-TREATMENT -de I-TREATMENT -recuperación. I-TREATMENT - I-TREATMENT -A B-FAMILY_HISTORY -solicitud I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -familia, I-FAMILY_HISTORY -se I-FAMILY_HISTORY -realizó I-FAMILY_HISTORY -estudio I-FAMILY_HISTORY -tiroideo I-FAMILY_HISTORY -a I-FAMILY_HISTORY -padres I-FAMILY_HISTORY -y I-FAMILY_HISTORY -dos I-FAMILY_HISTORY -hermanos I-FAMILY_HISTORY -quienes I-FAMILY_HISTORY -no I-FAMILY_HISTORY -presentaban I-FAMILY_HISTORY -evidencia I-FAMILY_HISTORY -de I-FAMILY_HISTORY -enfermedad. I-FAMILY_HISTORY -La I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -presentó I-FAMILY_HISTORY -en I-FAMILY_HISTORY -la I-FAMILY_HISTORY -ecografía I-FAMILY_HISTORY -tiroidea I-FAMILY_HISTORY -un I-FAMILY_HISTORY -nódulo I-FAMILY_HISTORY -de I-FAMILY_HISTORY -7 I-FAMILY_HISTORY -mm, I-FAMILY_HISTORY -el I-FAMILY_HISTORY -cual I-FAMILY_HISTORY -resultó I-FAMILY_HISTORY -ser I-FAMILY_HISTORY -cáncer I-FAMILY_HISTORY -papilar, I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -compromiso I-FAMILY_HISTORY -capsular I-FAMILY_HISTORY -ni I-FAMILY_HISTORY -ganglionar. I-FAMILY_HISTORY -El I-FAMILY_HISTORY -hermano I-FAMILY_HISTORY -presentó I-FAMILY_HISTORY -2 I-FAMILY_HISTORY -nódulos I-FAMILY_HISTORY -de I-FAMILY_HISTORY -8 I-FAMILY_HISTORY -y I-FAMILY_HISTORY -5 I-FAMILY_HISTORY -mm I-FAMILY_HISTORY -cuyo I-FAMILY_HISTORY -estudio I-FAMILY_HISTORY -con I-FAMILY_HISTORY -biopsia I-FAMILY_HISTORY -fue I-FAMILY_HISTORY -negativo I-FAMILY_HISTORY -para I-FAMILY_HISTORY -células I-FAMILY_HISTORY -neoplásicas I-FAMILY_HISTORY -y I-FAMILY_HISTORY -la I-FAMILY_HISTORY -hermana I-FAMILY_HISTORY -presentó I-FAMILY_HISTORY -signos I-FAMILY_HISTORY -ecográficos I-FAMILY_HISTORY -de I-FAMILY_HISTORY -tiroiditis I-FAMILY_HISTORY -crónica I-FAMILY_HISTORY -con I-FAMILY_HISTORY -AAT I-FAMILY_HISTORY -positivos. I-FAMILY_HISTORY - I-FAMILY_HISTORY - -Paciente B-PRESENT_ILLNESS -diestro, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos. I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -iniciar I-PRESENT_ILLNESS -disartria I-PRESENT_ILLNESS -severa, I-PRESENT_ILLNESS -desviación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -mirada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -hemiplejia I-PRESENT_ILLNESS -facio-braquio-crural, I-PRESENT_ILLNESS -hemianestesia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -hemianopsia I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -El B-EXPLORATION -resto I-EXPLORATION +se I-EXPLORATION +indica I-EXPLORATION +la I-EXPLORATION +realización I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -examen I-EXPLORATION -no I-EXPLORATION -evidenciaba I-EXPLORATION -otras I-EXPLORATION -alteraciones. I-EXPLORATION -La I-EXPLORATION -TC I-EXPLORATION -mostró I-EXPLORATION -signos I-EXPLORATION -precoces I-EXPLORATION +lavados I-EXPLORATION +con I-EXPLORATION +fibrinolíticos I-EXPLORATION +intracavitarios I-EXPLORATION +(100.000 I-EXPLORATION +unidades I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -IMACM I-EXPLORATION -derecho. I-EXPLORATION -Se B-TREATMENT -discutió I-TREATMENT -con I-TREATMENT -la I-TREATMENT -familia I-TREATMENT -la I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -una I-TREATMENT -progresión I-TREATMENT -a I-TREATMENT -un I-TREATMENT -IMACM I-TREATMENT -y I-TREATMENT -la I-TREATMENT -eventual I-TREATMENT -necesidad I-TREATMENT -de I-TREATMENT -una I-TREATMENT -HD. I-TREATMENT -La I-TREATMENT -familia I-TREATMENT -comprendió I-TREATMENT -y I-TREATMENT -aceptó I-TREATMENT -la I-TREATMENT -intervención. I-TREATMENT - I-TREATMENT -Su B-EXPLORATION -estudio I-EXPLORATION -etiológico I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION -A I-EXPLORATION -las I-EXPLORATION -24 I-EXPLORATION -h, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -estaba I-EXPLORATION +urokinasa I-EXPLORATION en I-EXPLORATION -sopor I-EXPLORATION -superficial I-EXPLORATION -sin I-EXPLORATION -midriasis I-EXPLORATION -ni I-EXPLORATION -aparición I-EXPLORATION +10 I-EXPLORATION +cc I-EXPLORATION de I-EXPLORATION -Babinski I-EXPLORATION -a I-EXPLORATION -derecha. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -TC. I-EXPLORATION -Debido B-TREATMENT -a I-TREATMENT -la I-TREATMENT -progresión I-TREATMENT -del I-TREATMENT -cuadro I-TREATMENT -clínico I-TREATMENT -y I-TREATMENT -de I-TREATMENT -la I-TREATMENT -TC, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -la I-TREATMENT -HD, I-TREATMENT -la I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -efectuó I-TREATMENT -sin I-TREATMENT -complicaciones. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -recuperó I-EVOLUTION -conciencia I-EVOLUTION -antes I-EVOLUTION +suero I-EXPLORATION +fisiológico). I-EXPLORATION + I-EXPLORATION +Después B-EVOLUTION de I-EVOLUTION -24 I-EVOLUTION -h I-EVOLUTION +un I-EVOLUTION +mes I-EVOLUTION y I-EVOLUTION -fue I-EVOLUTION -extubado I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -h. I-EVOLUTION -No I-EVOLUTION -presentó I-EVOLUTION -complicaciones. I-EVOLUTION -Recuperó I-EVOLUTION -la I-EVOLUTION -movilidad I-EVOLUTION +diez I-EVOLUTION +días I-EVOLUTION de I-EVOLUTION +ingreso, I-EVOLUTION la I-EVOLUTION -pierna I-EVOLUTION -izquierda, I-EVOLUTION -logró I-EVOLUTION -deglución I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -22 I-EVOLUTION -días. I-EVOLUTION -Desde B-TREATMENT -el I-TREATMENT -séptimo I-TREATMENT -día I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -aspirina I-TREATMENT -(325 I-TREATMENT -mg/día). I-TREATMENT -Se I-TREATMENT -mantuvo I-TREATMENT -en I-TREATMENT -neurorrehabilitación I-TREATMENT -en I-TREATMENT -su I-TREATMENT -domicilio, I-TREATMENT -logrando B-EVOLUTION -marcha I-EVOLUTION -en I-EVOLUTION -3 I-EVOLUTION -meses. I-EVOLUTION - I-EVOLUTION -Al B-TREATMENT -cuarto I-TREATMENT -mes I-TREATMENT -se I-TREATMENT -instaló I-TREATMENT -la I-TREATMENT -plaqueta I-TREATMENT -ósea, I-TREATMENT -siendo B-EVOLUTION -dado I-EVOLUTION +paciente I-EVOLUTION +es I-EVOLUTION +dada I-EVOLUTION de I-EVOLUTION alta I-EVOLUTION -al I-EVOLUTION -quinto I-EVOLUTION -día. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -8 I-EVOLUTION -meses I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -crisis I-EVOLUTION -convulsiva, I-EVOLUTION -se B-TREATMENT -inició I-TREATMENT -fenitoína I-TREATMENT -(300 I-TREATMENT -mg/día). I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -años I-EVOLUTION -realiza I-EVOLUTION -una I-EVOLUTION -vida I-EVOLUTION -independiente I-EVOLUTION -pero I-EVOLUTION -limitada I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -casa: I-EVOLUTION -camina I-EVOLUTION -ayudado I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -bastón, I-EVOLUTION -come I-EVOLUTION -solo, I-EVOLUTION -se I-EVOLUTION -viste I-EVOLUTION -y I-EVOLUTION -va I-EVOLUTION -al I-EVOLUTION -baño I-EVOLUTION -ayudado I-EVOLUTION -por I-EVOLUTION -su I-EVOLUTION -señora I-EVOLUTION -(escala I-EVOLUTION -modificada I-EVOLUTION -de I-EVOLUTION -Rankin= I-EVOLUTION -3). I-EVOLUTION - I-EVOLUTION -Al I-EVOLUTION -preguntarle I-EVOLUTION -a I-EVOLUTION -ambos I-EVOLUTION -pacientes I-EVOLUTION -y I-EVOLUTION -sus I-EVOLUTION -familias, I-EVOLUTION -individualmente, I-EVOLUTION -si I-EVOLUTION -volverían I-EVOLUTION -a I-EVOLUTION -realizar I-EVOLUTION +ante I-EVOLUTION la I-EVOLUTION -cirugía I-EVOLUTION -después I-EVOLUTION +mejoría I-EVOLUTION +clínica I-EVOLUTION +del I-EVOLUTION +cuadro I-EVOLUTION +confirmada I-EVOLUTION +mediante I-EVOLUTION +técnicas I-EVOLUTION de I-EVOLUTION -haber I-EVOLUTION -sufrido I-EVOLUTION +imagen. I-EVOLUTION +En I-EVOLUTION +los I-EVOLUTION +controles I-EVOLUTION +posteriores I-EVOLUTION +en I-EVOLUTION +nuestras I-EVOLUTION +consultas, I-EVOLUTION la I-EVOLUTION -experiencia, I-EVOLUTION -respondieron I-EVOLUTION -afirmativamente. I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +asintomática I-EVOLUTION +con I-EVOLUTION +resolución I-EVOLUTION +total I-EVOLUTION +del I-EVOLUTION +proceso. I-EVOLUTION I-EVOLUTION -Hombre, B-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +51 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -cardiovasculares. I-PAST_MEDICAL_HISTORY -Mientras B-PRESENT_ILLNESS -jugaba I-PRESENT_ILLNESS -fútbol, I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +disminución I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -palpitaciones I-PRESENT_ILLNESS -rápidas, I-PRESENT_ILLNESS -regulares, I-PRESENT_ILLNESS -asociadas I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -retroesternal I-PRESENT_ILLNESS -opresivo, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -cedieron I-PRESENT_ILLNESS -espontáneamente I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS +agudeza I-PRESENT_ILLNESS +visual I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -min. I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cinco I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS +Como B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +diabetes I-PAST_MEDICAL_HISTORY +mellitus I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +insulino I-PAST_MEDICAL_HISTORY +dependiente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +seis I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +evolución, I-PAST_MEDICAL_HISTORY +así I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +haber I-PAST_MEDICAL_HISTORY +padecido I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +traumatismo I-PAST_MEDICAL_HISTORY +contuso I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +mismo I-PAST_MEDICAL_HISTORY +ojo I-PAST_MEDICAL_HISTORY +15 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Refería B-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -ciudad I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -hospitalizado I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -monitorización. I-PRESENT_ILLNESS -Su B-EXPLORATION -ECG I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -mostró I-EXPLORATION -síndrome I-EXPLORATION +visión I-PRESENT_ILLNESS +asintomático I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cinco I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +izquierdo. I-PRESENT_ILLNESS +La B-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +(AV) I-EXPLORATION +tomada I-EXPLORATION +mediante I-EXPLORATION +el I-EXPLORATION +test I-EXPLORATION de I-EXPLORATION -preexcitación I-EXPLORATION -ventricular, I-EXPLORATION -con I-EXPLORATION -intervalo I-EXPLORATION -PR I-EXPLORATION -corto, I-EXPLORATION -onda I-EXPLORATION -delta I-EXPLORATION -positiva I-EXPLORATION -en I-EXPLORATION -todas I-EXPLORATION -las I-EXPLORATION -derivaciones I-EXPLORATION -precordiales I-EXPLORATION +Snellen I-EXPLORATION +era I-EXPLORATION +1 I-EXPLORATION +para I-EXPLORATION +su I-EXPLORATION +ojo I-EXPLORATION +derecho I-EXPLORATION y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -inferior, I-EXPLORATION +0, I-EXPLORATION +5 I-EXPLORATION +para I-EXPLORATION +su I-EXPLORATION +ojo I-EXPLORATION +izquierdo, I-EXPLORATION +mejorando I-EXPLORATION +este I-EXPLORATION +último I-EXPLORATION +a I-EXPLORATION +1 I-EXPLORATION con I-EXPLORATION -alteraciones I-EXPLORATION +una I-EXPLORATION +corrección I-EXPLORATION +esférica I-EXPLORATION de I-EXPLORATION ++1, I-EXPLORATION +5D. I-EXPLORATION + I-EXPLORATION +Tanto I-EXPLORATION la I-EXPLORATION -repolarización I-EXPLORATION -ventricular, I-EXPLORATION -caracterizadas I-EXPLORATION -por I-EXPLORATION -supradesnivel I-EXPLORATION -ST I-EXPLORATION -en I-EXPLORATION -V2 I-EXPLORATION +motilidad I-EXPLORATION +ocular I-EXPLORATION +intrínseca I-EXPLORATION +como I-EXPLORATION +extrínseca, I-EXPLORATION +biomicroscopía I-EXPLORATION +anterior I-EXPLORATION y I-EXPLORATION -V3. I-EXPLORATION -Se I-EXPLORATION -controlaron I-EXPLORATION -enzimas I-EXPLORATION -cardíacas I-EXPLORATION -seriadas. I-EXPLORATION -Debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -éstas, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -coronariografía I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION +tonometría I-EXPLORATION +del I-EXPLORATION +paciente I-EXPLORATION +eran I-EXPLORATION +normales. I-EXPLORATION I-EXPLORATION -Fue B-DERIVED_FROM/TO -derivado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -EEF I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -mostró I-DERIVED_FROM/TO -HPE I-DERIVED_FROM/TO -lateral I-DERIVED_FROM/TO -izquierdo, I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -cual I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -exitosamente I-DERIVED_FROM/TO -fulgurado. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO - -Mujer, B-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tetralogía I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Fallot, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY -correctora I-PAST_MEDICAL_HISTORY -definitiva I-PAST_MEDICAL_HISTORY -consistente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -cierre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -comunicación I-PAST_MEDICAL_HISTORY -interventricular I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ampliación I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -TSVD I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -anillo I-PAST_MEDICAL_HISTORY -valvular I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -parche I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pericardio, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia. I-PAST_MEDICAL_HISTORY -Desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -TVS I-PAST_MEDICAL_HISTORY -recurrentes, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -pesar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -farmacológico I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -amiodarona, I-PAST_MEDICAL_HISTORY -requiriendo I-PAST_MEDICAL_HISTORY -múltiples I-PAST_MEDICAL_HISTORY -hospitalizaciones I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antiarrítmicos I-PAST_MEDICAL_HISTORY -intravenosos I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -cardioversión I-PAST_MEDICAL_HISTORY -eléctrica. I-PAST_MEDICAL_HISTORY -Su I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -ecocardiográfico I-PAST_MEDICAL_HISTORY -mostró I-PAST_MEDICAL_HISTORY -compromiso I-PAST_MEDICAL_HISTORY -moderado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -función I-PAST_MEDICAL_HISTORY -sistólica I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ventrículo I-PAST_MEDICAL_HISTORY -derecho, I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -libre I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dilatación I-PAST_MEDICAL_HISTORY -progresiva I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -TSVD, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -llegó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -constituir I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -verdadero I-PAST_MEDICAL_HISTORY -aneurisma, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -cual I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -sometida I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nueva I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -implantó I-PAST_MEDICAL_HISTORY -homoinjerto I-PAST_MEDICAL_HISTORY -valvulado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -arteria I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -resecó I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -aneurisma I-PAST_MEDICAL_HISTORY -ventricular. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Desde I-PAST_MEDICAL_HISTORY -esta I-PAST_MEDICAL_HISTORY -última I-PAST_MEDICAL_HISTORY -intervención I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -mantuvo I-PAST_MEDICAL_HISTORY -asintomática, I-PAST_MEDICAL_HISTORY -libre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -arritmias, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -capacidad I-PAST_MEDICAL_HISTORY -funcional I-PAST_MEDICAL_HISTORY -I. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -mantuvo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -amiodarona I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -suspendió I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -23 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -embarazo. I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -palpitaciones I-PRESENT_ILLNESS -rápidas, I-PRESENT_ILLNESS -sostenidas. I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia, I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -documentó I-PRESENT_ILLNESS -taquicardia I-PRESENT_ILLNESS -ventricular I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -frecuencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -150 I-PRESENT_ILLNESS -latidos I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -minuto I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -imagen I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -bloqueo I-PRESENT_ILLNESS -completo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -rama I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -eje I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -hemodinámico. I-PRESENT_ILLNESS -Se B-TREATMENT -hospitalizó I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -amiodarona I-TREATMENT -intravenosa, I-TREATMENT -a I-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -permaneció I-TREATMENT -con I-TREATMENT -taquicardia, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -24 I-TREATMENT -h I-TREATMENT -después I-TREATMENT -de I-TREATMENT -su I-TREATMENT -ingreso I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -cardioversión I-TREATMENT -eléctrica. I-TREATMENT -Su B-EXPLORATION -electrocardiograma I-EXPLORATION +La I-EXPLORATION +funduscopia I-EXPLORATION +del I-EXPLORATION +ojo I-EXPLORATION +a I-EXPLORATION +estudio I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +yuxtapapilar I-EXPLORATION +de I-EXPLORATION +color I-EXPLORATION +rojo-anaranjado I-EXPLORATION +brillante, I-EXPLORATION +sobreelevada, I-EXPLORATION +bien I-EXPLORATION +delimitada. I-EXPLORATION +También I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +una I-EXPLORATION +alteración I-EXPLORATION +del I-EXPLORATION +epitelio I-EXPLORATION +pigmentario I-EXPLORATION en I-EXPLORATION -ritmo I-EXPLORATION -sinusal I-EXPLORATION -mostró I-EXPLORATION -conducción I-EXPLORATION -aurículo-ventricular I-EXPLORATION -con I-EXPLORATION -PR I-EXPLORATION +región I-EXPLORATION +macular I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +una I-EXPLORATION +alteración I-EXPLORATION de I-EXPLORATION -200 I-EXPLORATION -ms I-EXPLORATION -y I-EXPLORATION -complejos I-EXPLORATION -QRS I-EXPLORATION -ancho I-EXPLORATION -con I-EXPLORATION -imagen I-EXPLORATION +la I-EXPLORATION +capa I-EXPLORATION de I-EXPLORATION -bloqueo I-EXPLORATION -completo I-EXPLORATION +fibras I-EXPLORATION +nerviosas I-EXPLORATION +superiores I-EXPLORATION +e I-EXPLORATION +inferiores. I-EXPLORATION +La I-EXPLORATION +exploración I-EXPLORATION +oftalmoscópica I-EXPLORATION +del I-EXPLORATION +ojo I-EXPLORATION +adelfo I-EXPLORATION +presentaba I-EXPLORATION +asimismo I-EXPLORATION +una I-EXPLORATION +leve I-EXPLORATION +alteración I-EXPLORATION de I-EXPLORATION -rama I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -240 I-EXPLORATION -ms I-EXPLORATION +epitelio I-EXPLORATION +pigmentario. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +angiografía I-EXPLORATION +fluoresceínica I-EXPLORATION +que I-EXPLORATION +demostró I-EXPLORATION +el I-EXPLORATION +relleno I-EXPLORATION de I-EXPLORATION -duración. I-EXPLORATION -Estando B-TREATMENT -hospitalizada I-TREATMENT -presentó I-TREATMENT -recurrencia I-TREATMENT -de I-TREATMENT -TVS, I-TREATMENT -apareciendo I-TREATMENT -una I-TREATMENT -segunda I-TREATMENT -morfología, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -intentar I-TREATMENT -tratamiento I-TREATMENT -mediante I-TREATMENT -fulguración I-TREATMENT -con I-TREATMENT -radiofrecuencia. I-TREATMENT -Bajo B-EXPLORATION -sedación I-EXPLORATION +un I-EXPLORATION +árbol I-EXPLORATION +vascular I-EXPLORATION +intratumoral I-EXPLORATION +compuesto I-EXPLORATION +de I-EXPLORATION +finos I-EXPLORATION +capilares I-EXPLORATION con I-EXPLORATION -midazolam I-EXPLORATION -y I-EXPLORATION -fentanyl, I-EXPLORATION -se I-EXPLORATION +exudación I-EXPLORATION +en I-EXPLORATION +tiempos I-EXPLORATION +tardíos, I-EXPLORATION +confirmando I-EXPLORATION +la I-EXPLORATION +primera I-EXPLORATION +sospecha I-EXPLORATION +de I-EXPLORATION +hemangioma I-EXPLORATION +capilar I-EXPLORATION +yuxtapapilar. I-EXPLORATION +Se I-EXPLORATION +observaron I-EXPLORATION +puntos I-EXPLORATION +de I-EXPLORATION +fuga I-EXPLORATION +en I-EXPLORATION +polo I-EXPLORATION +posterior I-EXPLORATION +de I-EXPLORATION +ambos I-EXPLORATION +ojos, I-EXPLORATION +sugestivos I-EXPLORATION +de I-EXPLORATION +retinopatía I-EXPLORATION +central I-EXPLORATION +serosa. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION realizó I-EXPLORATION -estudio I-EXPLORATION -electrofisiológico. I-EXPLORATION -Por I-EXPLORATION -vía I-EXPLORATION -venosa I-EXPLORATION -femoral I-EXPLORATION -derecha I-EXPLORATION -se I-EXPLORATION -avanzaron I-EXPLORATION -tres I-EXPLORATION -catéteres I-EXPLORATION -cuadripolares I-EXPLORATION -(Daig®, I-EXPLORATION -St. I-EXPLORATION -Jude I-EXPLORATION -Medical I-EXPLORATION -Inc) I-EXPLORATION +un I-EXPLORATION +campo I-EXPLORATION +visual I-EXPLORATION +SITA- I-EXPLORATION +Standard I-EXPLORATION +24-2 I-EXPLORATION +(Zeiss-Humphrey I-EXPLORATION +Instruments, I-EXPLORATION +Dublin, I-EXPLORATION +CA) I-EXPLORATION +con I-EXPLORATION +visión I-EXPLORATION +corregida, I-EXPLORATION +estímulo I-EXPLORATION +III, I-EXPLORATION +hallándose I-EXPLORATION +un I-EXPLORATION +defecto I-EXPLORATION +infero-nasal I-EXPLORATION +del I-EXPLORATION +ojo I-EXPLORATION +izquierdo. I-EXPLORATION + I-EXPLORATION +Cuatro I-EXPLORATION +semanas I-EXPLORATION +más I-EXPLORATION +tarde, I-EXPLORATION +la I-EXPLORATION +visión I-EXPLORATION +del I-EXPLORATION +ojo I-EXPLORATION +izquierdo I-EXPLORATION +era I-EXPLORATION +de I-EXPLORATION +0, I-EXPLORATION +6 I-EXPLORATION +corregida I-EXPLORATION +(+0.5 I-EXPLORATION +esf I-EXPLORATION ++ I-EXPLORATION +1 I-EXPLORATION +x I-EXPLORATION +48 I-EXPLORATION +cil) I-EXPLORATION +1; I-EXPLORATION +mientras I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -ubicaron I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -región I-EXPLORATION -alta I-EXPLORATION +visión I-EXPLORATION +del I-EXPLORATION +ojo I-EXPLORATION +derecho I-EXPLORATION +fue I-EXPLORATION de I-EXPLORATION +0, I-EXPLORATION +4 I-EXPLORATION +corregida I-EXPLORATION +(+0.5 I-EXPLORATION +esf I-EXPLORATION ++0.25 I-EXPLORATION +x I-EXPLORATION +170 I-EXPLORATION +cil) I-EXPLORATION +0, I-EXPLORATION +6. I-EXPLORATION +Una I-EXPLORATION +nueva I-EXPLORATION +angiografía I-EXPLORATION +fluoresceínica I-EXPLORATION +demostró I-EXPLORATION +que I-EXPLORATION la I-EXPLORATION -aurícula I-EXPLORATION -derecha, I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION +disminución I-EXPLORATION +de I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION del I-EXPLORATION -His I-EXPLORATION +ojo I-EXPLORATION +derecho I-EXPLORATION +se I-EXPLORATION +debía I-EXPLORATION +a I-EXPLORATION +retinopatía I-EXPLORATION +central I-EXPLORATION +serosa. I-EXPLORATION + I-EXPLORATION +Ocho B-EVOLUTION +semanas I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +inicio I-EVOLUTION +del I-EVOLUTION +cuadro I-EVOLUTION +se I-EVOLUTION +encontró I-EVOLUTION +una I-EVOLUTION +regresión I-EVOLUTION +espontánea I-EVOLUTION +tanto I-EVOLUTION +del I-EVOLUTION +hemangioma I-EVOLUTION +capilar I-EVOLUTION +yuxtapapilar I-EVOLUTION +como I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +retinopatía I-EVOLUTION +central I-EVOLUTION +serosa I-EVOLUTION +bilateral, I-EVOLUTION +regresando I-EVOLUTION +la I-EVOLUTION +AV I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +1 I-EVOLUTION +difícil I-EVOLUTION +en I-EVOLUTION +ambos I-EVOLUTION +ojos. I-EVOLUTION + I-EVOLUTION + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +71 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +proveniente B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Palmira I-PAST_MEDICAL_HISTORY +(población I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +suroccidente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Colombia I-PAST_MEDICAL_HISTORY +cerca I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +Costa I-PAST_MEDICAL_HISTORY +Pacífica), I-PAST_MEDICAL_HISTORY +referida B-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +Clínica I-DERIVED_FROM/TO +Sebastián I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Belalcázar I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Cali, I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +historia I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +20 I-DERIVED_FROM/TO +días I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +evolución I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +fiebre I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +tos I-DERIVED_FROM/TO +productiva, I-DERIVED_FROM/TO +asociada I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +pérdida I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +peso I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +seis I-DERIVED_FROM/TO +meses I-DERIVED_FROM/TO +(4 I-DERIVED_FROM/TO +kg) I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +infección I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +vías I-DERIVED_FROM/TO +aéreas I-DERIVED_FROM/TO +superiores I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +tratamiento I-DERIVED_FROM/TO +antibiótico I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +evolución I-DERIVED_FROM/TO +tórpida. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +En B-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +hepatoesplenomegalia I-EXPLORATION y I-EXPLORATION +adenopatía I-EXPLORATION +de I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION en I-EXPLORATION +la I-EXPLORATION +axila I-EXPLORATION +derecha; I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +manifestaciones I-EXPLORATION +cutáneas. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION el I-EXPLORATION -ápex I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -derecho, I-EXPLORATION -para I-EXPLORATION -registrar I-EXPLORATION -potenciales I-EXPLORATION -endocavitarios I-EXPLORATION +cuadro I-EXPLORATION +hemático I-EXPLORATION +inicialmente I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +anemia I-EXPLORATION y I-EXPLORATION -realizar I-EXPLORATION -estimulación. I-EXPLORATION -Con I-EXPLORATION -estimulación I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -ápex I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -derecho I-EXPLORATION +leucopenia, I-EXPLORATION +seguidas I-EXPLORATION +por I-EXPLORATION +leucocitosis, I-EXPLORATION +linfocitosis I-EXPLORATION +(11.000/mm I-EXPLORATION +3 I-EXPLORATION +) I-EXPLORATION +y I-EXPLORATION +neutropenia I-EXPLORATION +absoluta. I-EXPLORATION +Se I-EXPLORATION +encontraron I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +deshigrogenasa I-EXPLORATION +láctica I-EXPLORATION +de I-EXPLORATION +300 I-EXPLORATION +mg/dl I-EXPLORATION +y I-EXPLORATION +calcio I-EXPLORATION +sérico I-EXPLORATION +de I-EXPLORATION +7, I-EXPLORATION +1 I-EXPLORATION +mg/dl. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +obtuvieron I-EXPLORATION +biopsias I-EXPLORATION +de I-EXPLORATION +ganglio I-EXPLORATION +linfático I-EXPLORATION +y I-EXPLORATION +médula I-EXPLORATION +ósea I-EXPLORATION con I-EXPLORATION -ciclo I-EXPLORATION -basal I-EXPLORATION +el I-EXPLORATION +fin I-EXPLORATION de I-EXPLORATION -550 I-EXPLORATION -ms I-EXPLORATION -e I-EXPLORATION -introduciendo I-EXPLORATION +descartar I-EXPLORATION +un I-EXPLORATION +linfoma. I-EXPLORATION +Estos I-EXPLORATION dos I-EXPLORATION -extraestímulos I-EXPLORATION +tejidos I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +sangre I-EXPLORATION +estaban I-EXPLORATION +infiltrados I-EXPLORATION +por I-EXPLORATION +una I-EXPLORATION +neoplasia I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +T I-EXPLORATION +con I-EXPLORATION +importante I-EXPLORATION +pleomorfismo I-EXPLORATION +nuclear. I-EXPLORATION +En I-EXPLORATION +los I-EXPLORATION +extendidos I-EXPLORATION +de I-EXPLORATION +sangre I-EXPLORATION se I-EXPLORATION -indujo I-EXPLORATION -fácilmente I-EXPLORATION +observaron I-EXPLORATION +"células I-EXPLORATION +flor" I-EXPLORATION +( I-EXPLORATION +flower I-EXPLORATION +cells I-EXPLORATION +) I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +identificó I-EXPLORATION +un I-EXPLORATION +fenotipo I-EXPLORATION +CD3+, I-EXPLORATION +CD2+, I-EXPLORATION +CD4+, I-EXPLORATION +CD5+, I-EXPLORATION +CD7-, I-EXPLORATION +CD8-, I-EXPLORATION +CD56- I-EXPLORATION +y I-EXPLORATION +TdTen I-EXPLORATION las I-EXPLORATION -dos I-EXPLORATION -morfologías I-EXPLORATION +células I-EXPLORATION +tumorales, I-EXPLORATION +tanto I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION de I-EXPLORATION -taquicardia. I-EXPLORATION -Mediante I-EXPLORATION -mapeo I-EXPLORATION -durante I-EXPLORATION -estimulación I-EXPLORATION +ganglio I-EXPLORATION +linfático I-EXPLORATION +como I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -TSVD, I-EXPLORATION -con I-EXPLORATION -catéter I-EXPLORATION +la I-EXPLORATION de I-EXPLORATION -fulguración I-EXPLORATION -EPT I-EXPLORATION -curva I-EXPLORATION -estándar I-EXPLORATION +médula I-EXPLORATION +ósea I-EXPLORATION y I-EXPLORATION -punta I-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -mm I-EXPLORATION -(Boston I-EXPLORATION -Scientific® I-EXPLORATION -Corporation) I-EXPLORATION -se I-EXPLORATION -reprodujo I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -morfología I-EXPLORATION +citometría I-EXPLORATION de I-EXPLORATION -ambas I-EXPLORATION -taquicardias, I-EXPLORATION -con I-EXPLORATION -concordancia I-EXPLORATION +flujo I-EXPLORATION +de I-EXPLORATION +sangre I-EXPLORATION +periférica. I-EXPLORATION + I-EXPLORATION +Teniendo I-EXPLORATION en I-EXPLORATION +cuenta I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +anteriores, I-EXPLORATION +se I-EXPLORATION +sospechó I-EXPLORATION +una I-EXPLORATION +leucemia/linfoma I-EXPLORATION +de I-EXPLORATION +célula I-EXPLORATION +T I-EXPLORATION +del I-EXPLORATION +adulto; I-EXPLORATION +por I-EXPLORATION +consiguiente, I-EXPLORATION +se I-EXPLORATION +solicitaron I-EXPLORATION las I-EXPLORATION -12 I-EXPLORATION -derivaciones I-EXPLORATION +pruebas I-EXPLORATION +ELISA I-EXPLORATION +y I-EXPLORATION +Western I-EXPLORATION +Blot I-EXPLORATION +para I-EXPLORATION +HTLV I-EXPLORATION +1-2, I-EXPLORATION +las I-EXPLORATION +cuales I-EXPLORATION +resultaron I-EXPLORATION +positivas, I-EXPLORATION +confirmando I-EXPLORATION +el I-EXPLORATION +diagnóstico. I-EXPLORATION +El I-EXPLORATION +resultado I-EXPLORATION del I-EXPLORATION -electrocardiograma. I-EXPLORATION -Además B-TREATMENT -se I-TREATMENT -aplicó I-TREATMENT -radiofrecuencia I-TREATMENT -en I-TREATMENT -la I-TREATMENT -región I-TREATMENT -del I-TREATMENT -infundíbulo, I-TREATMENT -identificando I-TREATMENT -zonas I-TREATMENT -de I-TREATMENT -electrogramas I-TREATMENT -fragmentados I-TREATMENT -y I-TREATMENT -potenciales I-TREATMENT -mediodiastólicos I-TREATMENT -durante I-TREATMENT -taquicardia. I-TREATMENT -Se I-TREATMENT -completó I-TREATMENT -un I-TREATMENT -total I-TREATMENT -de I-TREATMENT -46 I-TREATMENT -pulsos I-TREATMENT -de I-TREATMENT -radiofrecuencia. I-TREATMENT -Post-radiofrecuencia I-TREATMENT -se I-TREATMENT -repitió I-TREATMENT -la I-TREATMENT -estimulación I-TREATMENT -ventricular, I-TREATMENT -introduciendo I-TREATMENT -hasta I-TREATMENT -tres I-TREATMENT -extraestímulos, I-TREATMENT -sin I-TREATMENT -lograr I-TREATMENT -reinducir I-TREATMENT -TVS I-TREATMENT -aun I-TREATMENT -bajo I-TREATMENT -efecto I-TREATMENT -de I-TREATMENT -infusión I-TREATMENT -de I-TREATMENT -isoproterenol I-TREATMENT -endovenoso. I-TREATMENT - I-TREATMENT -La I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -dada I-TREATMENT -de I-TREATMENT -alta I-TREATMENT -a I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -h I-TREATMENT -con I-TREATMENT -amiodarona I-TREATMENT -100 I-TREATMENT -mg/día. I-TREATMENT -Después B-EVOLUTION -de I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -suspendió I-EVOLUTION -el I-EVOLUTION -antiarrítmico I-EVOLUTION -por I-EVOLUTION -nuevo I-EVOLUTION -embarazo. I-EVOLUTION -A I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -mantenido I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -su I-EVOLUTION -monitorización I-EVOLUTION -con I-EVOLUTION -electrocardiograma I-EVOLUTION -de I-EVOLUTION -24 I-EVOLUTION -h I-EVOLUTION -muestra I-EVOLUTION -sólo I-EVOLUTION -extrasistolia I-EVOLUTION -ventricular I-EVOLUTION -aislada I-EVOLUTION -ocasional I-EVOLUTION +Western I-EXPLORATION +blot I-EXPLORATION +fue I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +HTLV-1 I-EXPLORATION +con I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +bandas I-EXPLORATION +p19, I-EXPLORATION +GD21 I-EXPLORATION +y I-EXPLORATION +rgp46-I. I-EXPLORATION +La B-EVOLUTION +forma I-EVOLUTION de I-EVOLUTION -morfología I-EVOLUTION -diferente I-EVOLUTION +leucemia I-EVOLUTION +identificada I-EVOLUTION +correspondió I-EVOLUTION a I-EVOLUTION -la I-EVOLUTION +leucemia I-EVOLUTION +aguda. I-EVOLUTION +La I-EVOLUTION +paciente I-EVOLUTION +falleció I-EVOLUTION +antes I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -taquicardias I-EVOLUTION -ventriculares I-EVOLUTION -tratadas. I-EVOLUTION +iniciar I-EVOLUTION +el I-EVOLUTION +tratamiento. I-EVOLUTION I-EVOLUTION -Historia B-PRESENT_ILLNESS -actual: I-PRESENT_ILLNESS -mujer, I-PRESENT_ILLNESS -84 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -mantenía I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -buenas I-PRESENT_ILLNESS -condiciones I-PRESENT_ILLNESS -generales, I-PRESENT_ILLNESS -autovalente I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -sus I-PRESENT_ILLNESS -actividades I-PRESENT_ILLNESS -habituales. I-PRESENT_ILLNESS -Ingresó I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -31/12/04 I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -través I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Urgencia I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -decaimiento I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS -inespecífico. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -anterior I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -semilíquidas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -cólico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -intensidad I-PRESENT_ILLNESS -leve. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -observada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -hijo I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -domicilio I-PRESENT_ILLNESS -quien I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -encontró I-PRESENT_ILLNESS -comprometida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conciencia, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -falta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -reactividad I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -órdenes I-PRESENT_ILLNESS -verbales, I-PRESENT_ILLNESS -mirada I-PRESENT_ILLNESS -fija, I-PRESENT_ILLNESS -midriasis I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hipoventilación I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -evoluciona I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -apnea, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -sometida I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -reanimación I-PRESENT_ILLNESS -básica, I-PRESENT_ILLNESS -recuperando I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ventilación I-PRESENT_ILLNESS -espontánea. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Antecedentes B-PAST_MEDICAL_HISTORY -mórbidos: I-PAST_MEDICAL_HISTORY -angina I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pecho I-PAST_MEDICAL_HISTORY -estable I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -varios I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY +48 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -evolución, I-PAST_MEDICAL_HISTORY -accidente I-PAST_MEDICAL_HISTORY -cerebrovascular I-PAST_MEDICAL_HISTORY -cerebeloso I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -secuelas, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes. I-PAST_MEDICAL_HISTORY -Linfoma I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -recidiva I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY +obesidad, I-PAST_MEDICAL_HISTORY +diabetes I-PAST_MEDICAL_HISTORY +mellitus I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY 2 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -(HTA) I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -difícil I-PAST_MEDICAL_HISTORY -manejo I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -mitral I-PAST_MEDICAL_HISTORY -severa, I-PAST_MEDICAL_HISTORY +controlada I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -disnea I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -medianos I-PAST_MEDICAL_HISTORY -esfuerzos. I-PAST_MEDICAL_HISTORY -Terapia I-PAST_MEDICAL_HISTORY -habitual: I-PAST_MEDICAL_HISTORY -carvedilol I-PAST_MEDICAL_HISTORY -6, I-PAST_MEDICAL_HISTORY -25 I-PAST_MEDICAL_HISTORY -mg/día, I-PAST_MEDICAL_HISTORY -losartan I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -mg/día, I-PAST_MEDICAL_HISTORY -espironolactona I-PAST_MEDICAL_HISTORY -25 I-PAST_MEDICAL_HISTORY -mg/día, I-PAST_MEDICAL_HISTORY -hidroclorotiazida I-PAST_MEDICAL_HISTORY -12, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -mg/día, I-PAST_MEDICAL_HISTORY -amlodipino I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -mg/día. I-PAST_MEDICAL_HISTORY -Mantenía I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -laboratorio I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -periódica. I-PAST_MEDICAL_HISTORY -De I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -exámenes I-PAST_MEDICAL_HISTORY -previos, I-PAST_MEDICAL_HISTORY -destacaba I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -creatinina I-PAST_MEDICAL_HISTORY -basal I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -1, I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -mg/dl, I-PAST_MEDICAL_HISTORY -clearence I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -creatinina I-PAST_MEDICAL_HISTORY -35-40 I-PAST_MEDICAL_HISTORY -ml/min I-PAST_MEDICAL_HISTORY +dieta I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -electrocardiograma I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ritmo I-PAST_MEDICAL_HISTORY -sinusal. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Examen B-EXPLORATION -físico: I-EXPLORATION -soporosa, I-EXPLORATION -sin I-EXPLORATION -déficit I-EXPLORATION -neurológico I-EXPLORATION -focal, I-EXPLORATION -presión I-EXPLORATION -arterial: I-EXPLORATION -146/76 I-EXPLORATION -mmHg, I-EXPLORATION -pulso I-EXPLORATION -30 I-EXPLORATION -a I-EXPLORATION -40 I-EXPLORATION -por I-EXPLORATION -min, I-EXPLORATION -Sa02 I-EXPLORATION ->95%. I-EXPLORATION -Pulso I-EXPLORATION -venoso I-EXPLORATION -yugular I-EXPLORATION -normal. I-EXPLORATION -Examen I-EXPLORATION -cardíaco: I-EXPLORATION -ruidos I-EXPLORATION -regulares, I-EXPLORATION -soplo I-EXPLORATION -holosistólico I-EXPLORATION -intensidad I-EXPLORATION -III/VI I-EXPLORATION -en I-EXPLORATION -foco I-EXPLORATION -mitral. I-EXPLORATION -Sin I-EXPLORATION -signos I-EXPLORATION -congestivos I-EXPLORATION -pulmonares, I-EXPLORATION -sin I-EXPLORATION -edema I-EXPLORATION +tabaquismo, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +diagnosticado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +insuficiencia I-PRESENT_ILLNESS +renal I-PRESENT_ILLNESS +secundaria I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +glomerulonefritis I-PRESENT_ILLNESS +rápidamente I-PRESENT_ILLNESS +progresiva, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +anticuerpos I-PRESENT_ILLNESS +antimembrana I-PRESENT_ILLNESS +basal I-PRESENT_ILLNESS +glomerular. I-PRESENT_ILLNESS +Por B-TREATMENT +este I-TREATMENT +motivo, I-TREATMENT +recibió I-TREATMENT +tratamiento I-TREATMENT +inmunosupresor I-TREATMENT +con I-TREATMENT +esteroides, I-TREATMENT +ciclofosfamida I-TREATMENT +y I-TREATMENT +también I-TREATMENT +plasmaféresis, I-TREATMENT +todo I-TREATMENT +ello, I-TREATMENT +sin I-TREATMENT +resultado I-TREATMENT +satisfactorio I-TREATMENT +para I-TREATMENT +su I-TREATMENT +función I-TREATMENT +renal. I-TREATMENT + I-TREATMENT +Inicialmente I-TREATMENT +recibió I-TREATMENT +tratamiento I-TREATMENT +renal I-TREATMENT +sustitutivo I-TREATMENT +mediante I-TREATMENT +HD I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +pasó I-TREATMENT +a I-TREATMENT +DP. I-TREATMENT +Durante B-EVOLUTION +los I-EVOLUTION +5 I-EVOLUTION +años I-EVOLUTION +en I-EVOLUTION +esta I-EVOLUTION +técnica, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +desarrolló I-EVOLUTION +10 I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION +peritonitis, I-EVOLUTION +9 I-EVOLUTION +de I-EVOLUTION +ellos I-EVOLUTION +por I-EVOLUTION +Staphilococcus I-EVOLUTION +(8 I-EVOLUTION +epidermidis I-EVOLUTION +y I-EVOLUTION +1 I-EVOLUTION +capitis). I-EVOLUTION +El I-EVOLUTION +último I-EVOLUTION +de I-EVOLUTION +ellos I-EVOLUTION +por I-EVOLUTION +Candida I-EVOLUTION +albicans, I-EVOLUTION +que I-EVOLUTION +motivó I-EVOLUTION +la I-EVOLUTION +retirada I-EVOLUTION +del I-EVOLUTION +catéter I-EVOLUTION +de I-EVOLUTION +DP I-EVOLUTION +y I-EVOLUTION +su I-EVOLUTION +transferencia I-EVOLUTION +a I-EVOLUTION +HD. I-EVOLUTION +Durante I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +con I-EVOLUTION +DP I-EVOLUTION +se I-EVOLUTION +transformó I-EVOLUTION +en I-EVOLUTION +un I-EVOLUTION +"alto I-EVOLUTION +transportador". I-EVOLUTION + I-EVOLUTION +Seis I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +cambio I-EVOLUTION +de I-EVOLUTION +modalidad I-EVOLUTION +terapéutica, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +sufre I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +con I-EVOLUTION +vómitos, I-EVOLUTION +pérdida I-EVOLUTION +de I-EVOLUTION +peso, I-EVOLUTION +distensión I-EVOLUTION +abdominal I-EVOLUTION +y I-EVOLUTION +efecto I-EVOLUTION +masa I-EVOLUTION +en I-EVOLUTION +hipogastrio. I-EVOLUTION +Se B-EXPLORATION +realizó I-EXPLORATION +ecografía I-EXPLORATION +abdominal, I-EXPLORATION +apreciándose I-EXPLORATION +marcada I-EXPLORATION +dilatación I-EXPLORATION +del I-EXPLORATION +estómago I-EXPLORATION +y I-EXPLORATION +asa I-EXPLORATION +proximal I-EXPLORATION +del I-EXPLORATION +intestino I-EXPLORATION +delgado, I-EXPLORATION +que I-EXPLORATION +presenta I-EXPLORATION +pared I-EXPLORATION +moderadamente I-EXPLORATION +engrosada; I-EXPLORATION +colección I-EXPLORATION de I-EXPLORATION -extremidades. I-EXPLORATION -Abdomen I-EXPLORATION -depresible I-EXPLORATION -e I-EXPLORATION -indoloro. I-EXPLORATION +líquido I-EXPLORATION +con I-EXPLORATION +múltiples I-EXPLORATION +septos I-EXPLORATION +en I-EXPLORATION +hipogastrio. I-EXPLORATION I-EXPLORATION -Laboratorio I-EXPLORATION -al I-EXPLORATION -ingreso: I-EXPLORATION -electrocardiograma: I-EXPLORATION -ritmo I-EXPLORATION -idioventricular I-EXPLORATION -50/min, I-EXPLORATION -trastorno I-EXPLORATION -de I-EXPLORATION +También I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computorizada I-EXPLORATION +(TAC) I-EXPLORATION +abdominal, I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +constató I-EXPLORATION la I-EXPLORATION -conducción I-EXPLORATION -intraventricular I-EXPLORATION -mal I-EXPLORATION -definido I-EXPLORATION -con I-EXPLORATION -QRS I-EXPLORATION -0, I-EXPLORATION -12 I-EXPLORATION -s I-EXPLORATION -y I-EXPLORATION -ondas I-EXPLORATION -T I-EXPLORATION -aumentadas I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -voltaje. I-EXPLORATION -Electrólitos I-EXPLORATION -plasmáticos: I-EXPLORATION -K: I-EXPLORATION -8, I-EXPLORATION -4 I-EXPLORATION -mEq/l, I-EXPLORATION -Cl: I-EXPLORATION -109 I-EXPLORATION -mEq/l, I-EXPLORATION -Na: I-EXPLORATION -132 I-EXPLORATION -mEq/, I-EXPLORATION -pH I-EXPLORATION -7, I-EXPLORATION -24, I-EXPLORATION -PCO2: I-EXPLORATION -27, I-EXPLORATION -HCO3 I-EXPLORATION +una I-EXPLORATION +pequeña I-EXPLORATION +cantidad I-EXPLORATION de I-EXPLORATION -12 I-EXPLORATION -mEq/, I-EXPLORATION -anion I-EXPLORATION -gap I-EXPLORATION -10. I-EXPLORATION -BE: I-EXPLORATION --14, I-EXPLORATION -4. I-EXPLORATION -Nitrógeno I-EXPLORATION -ureico I-EXPLORATION -61 I-EXPLORATION -mg/dl, I-EXPLORATION -creatinina I-EXPLORATION -2, I-EXPLORATION -63 I-EXPLORATION -mg/dl, I-EXPLORATION -hematocrito I-EXPLORATION -33%, I-EXPLORATION -hemoglobina I-EXPLORATION -0, I-EXPLORATION -7 I-EXPLORATION -mg/dl, I-EXPLORATION -glóbulos I-EXPLORATION -blancos I-EXPLORATION -8.660, I-EXPLORATION -glicemia I-EXPLORATION -137 I-EXPLORATION -mg/dl, I-EXPLORATION -troponinas I-EXPLORATION -T I-EXPLORATION -<0, I-EXPLORATION -01, I-EXPLORATION -orina I-EXPLORATION -completa I-EXPLORATION -normal. I-EXPLORATION -Radiografía I-EXPLORATION +líquido I-EXPLORATION +perihepático I-EXPLORATION +además I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -sin I-EXPLORATION -congestión I-EXPLORATION -pulmonar. I-EXPLORATION -Ecocardiograma: I-EXPLORATION -mixomatosis I-EXPLORATION -mitral I-EXPLORATION -y I-EXPLORATION -tricuspídea, I-EXPLORATION +periesplénico, I-EXPLORATION con I-EXPLORATION -prolapso I-EXPLORATION -mitral I-EXPLORATION -e I-EXPLORATION -insuficiencia I-EXPLORATION -mitral I-EXPLORATION -y I-EXPLORATION -tricuspídea I-EXPLORATION -severas, I-EXPLORATION -hipertrofia I-EXPLORATION -ventricular I-EXPLORATION -izquierda I-EXPLORATION -concéntrica I-EXPLORATION -leve I-EXPLORATION +engrosamiento I-EXPLORATION +peritoneal, I-EXPLORATION +asociada I-EXPLORATION +a I-EXPLORATION +colección I-EXPLORATION +líquida I-EXPLORATION +pélvica I-EXPLORATION con I-EXPLORATION -función I-EXPLORATION -sistólica I-EXPLORATION -normal, I-EXPLORATION +septos I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +interior I-EXPLORATION +que I-EXPLORATION +engloba I-EXPLORATION +asas I-EXPLORATION +de I-EXPLORATION +intestino I-EXPLORATION +delgado, I-EXPLORATION +condicionando I-EXPLORATION +gran I-EXPLORATION dilatación I-EXPLORATION -biauricular I-EXPLORATION -moderada. I-EXPLORATION +gástrica, I-EXPLORATION +duodenal I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +yeyuno, I-EXPLORATION +con I-EXPLORATION +niveles I-EXPLORATION +hidroaéreos, I-EXPLORATION +lo I-EXPLORATION +cual I-EXPLORATION +condujo I-EXPLORATION +al I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +esclerosis I-EXPLORATION +peritoneal. I-EXPLORATION I-EXPLORATION -Evolución: B-EVOLUTION -no I-EVOLUTION -presentó I-EVOLUTION -diarrea I-EVOLUTION -durante I-EVOLUTION -la I-EVOLUTION -hospitalización. I-EVOLUTION -No B-TREATMENT -hubo I-TREATMENT -respuesta I-TREATMENT -a I-TREATMENT -las I-TREATMENT -medidas I-TREATMENT -médicas I-TREATMENT -habituales I-TREATMENT -para I-TREATMENT -controlar I-TREATMENT -la I-TREATMENT -hiperkalemia, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT +Por B-TREATMENT +otra I-TREATMENT +parte, I-TREATMENT +al I-TREATMENT +paciente I-TREATMENT se I-TREATMENT -efectuó I-TREATMENT -hemodiálisis I-TREATMENT -de I-TREATMENT -emergencia I-TREATMENT -después I-TREATMENT -de I-TREATMENT -su I-TREATMENT -ingreso. I-TREATMENT -Durante I-TREATMENT -el I-TREATMENT -procedimiento I-TREATMENT -recuperó I-TREATMENT -ritmo I-TREATMENT -sinusal I-TREATMENT -102 I-TREATMENT -por I-TREATMENT -min, I-TREATMENT -inicialmente I-TREATMENT -hipertensa I-TREATMENT -sistólica I-TREATMENT -hasta I-TREATMENT -208/63 I-TREATMENT -mmHg I-TREATMENT -y I-TREATMENT -luego I-TREATMENT -con I-TREATMENT -uso I-TREATMENT -de I-TREATMENT -propanolol I-TREATMENT -mantuvo I-TREATMENT -presiones I-TREATMENT -normales, I-TREATMENT -en B-EXPLORATION -estas I-EXPLORATION -circunstancias I-EXPLORATION -presentó I-EXPLORATION -angina I-EXPLORATION +le I-TREATMENT +propuso I-TREATMENT +tratamiento I-TREATMENT +quirúrgico, I-TREATMENT +que I-TREATMENT +desestimó. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +evolución I-EVOLUTION +fue I-EVOLUTION +tórpida, I-EVOLUTION +con I-EVOLUTION +varios I-EVOLUTION +ingresos I-EVOLUTION +por I-EVOLUTION +cuadros I-EVOLUTION +de I-EVOLUTION +oclusión I-EVOLUTION +intestinal, I-EVOLUTION +precisando I-EVOLUTION +alimentación I-EVOLUTION +parenteral, I-EVOLUTION +administración I-EVOLUTION +sin I-EVOLUTION +éxito I-EVOLUTION +de I-EVOLUTION +esteroides I-EVOLUTION +y I-EVOLUTION +progresivo I-EVOLUTION +deterioro I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +estado, I-EVOLUTION +con I-EVOLUTION +ascitis I-EVOLUTION +y I-EVOLUTION +desnutrición I-EVOLUTION +que I-EVOLUTION +motivaron I-EVOLUTION +su I-EVOLUTION +fallecimiento I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +del I-EVOLUTION +diagnóstico. I-EVOLUTION + I-EVOLUTION +Resultados B-EXPLORATION +y I-EXPLORATION +descripción I-EXPLORATION + I-EXPLORATION +Tenemos I-EXPLORATION +una I-EXPLORATION +serie I-EXPLORATION de I-EXPLORATION -pecho I-EXPLORATION -con I-EXPLORATION -infradesnivel I-EXPLORATION -del I-EXPLORATION -segmento I-EXPLORATION -ST I-EXPLORATION +marcadores I-EXPLORATION +predictivos I-EXPLORATION +de I-EXPLORATION +esta I-EXPLORATION +entidad, I-EXPLORATION +como I-EXPLORATION +son I-EXPLORATION +el I-EXPLORATION +tiempo I-EXPLORATION en I-EXPLORATION +DP, I-EXPLORATION el I-EXPLORATION -ECG I-EXPLORATION +que I-EXPLORATION +sea I-EXPLORATION +alto I-EXPLORATION +transportador, I-EXPLORATION y I-EXPLORATION -elevación I-EXPLORATION +factores I-EXPLORATION +predisponentes I-EXPLORATION +como I-EXPLORATION +son, I-EXPLORATION +el I-EXPLORATION +hiperparatiroidismo I-EXPLORATION +grave I-EXPLORATION +(primer I-EXPLORATION +caso) I-EXPLORATION +o I-EXPLORATION +los I-EXPLORATION +episodios I-EXPLORATION de I-EXPLORATION -marcadores I-EXPLORATION +peritonitis I-EXPLORATION de I-EXPLORATION -daño I-EXPLORATION -miocárdico: I-EXPLORATION -CPK I-EXPLORATION -fracción I-EXPLORATION -MB I-EXPLORATION -hasta I-EXPLORATION -8, I-EXPLORATION -3 I-EXPLORATION -mg/dl, I-EXPLORATION -TT I-EXPLORATION -hasta I-EXPLORATION -0, I-EXPLORATION -072 I-EXPLORATION -y I-EXPLORATION -mioglobina I-EXPLORATION -hasta I-EXPLORATION -384 I-EXPLORATION -mg/dl, I-EXPLORATION +repetición I-EXPLORATION +(en I-EXPLORATION el I-EXPLORATION -K I-EXPLORATION -había I-EXPLORATION -descendido I-EXPLORATION -a I-EXPLORATION -4, I-EXPLORATION -7 I-EXPLORATION -mEq/L. I-EXPLORATION -Fracción I-EXPLORATION -excretada I-EXPLORATION +segundo). I-EXPLORATION +Hay I-EXPLORATION +que I-EXPLORATION +tener I-EXPLORATION +en I-EXPLORATION +cuenta, I-EXPLORATION +que I-EXPLORATION +más I-EXPLORATION de I-EXPLORATION -Na I-EXPLORATION -13%, I-EXPLORATION -fracción I-EXPLORATION -excretada I-EXPLORATION +la I-EXPLORATION +mitad I-EXPLORATION de I-EXPLORATION -nitrógeno I-EXPLORATION -ureico: I-EXPLORATION -16%. I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -normalizó I-EVOLUTION -antes I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -h I-EVOLUTION -su I-EVOLUTION -potasio I-EVOLUTION -y B-EXPLORATION -diuresis, I-EXPLORATION -mantuvo I-EXPLORATION -cifras I-EXPLORATION -tensionales I-EXPLORATION -normales, I-EXPLORATION -con I-EXPLORATION -niveles I-EXPLORATION +los I-EXPLORATION +casos, I-EXPLORATION +se I-EXPLORATION +producen I-EXPLORATION +tras I-EXPLORATION +el I-EXPLORATION +abandono I-EXPLORATION de I-EXPLORATION -creatinina I-EXPLORATION +la I-EXPLORATION +técnica I-EXPLORATION de I-EXPLORATION -1, I-EXPLORATION -3 I-EXPLORATION -m/dl, I-EXPLORATION -nitrógeno I-EXPLORATION -ureico I-EXPLORATION -24 I-EXPLORATION -mg/dl I-EXPLORATION -y B-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -quinto I-EVOLUTION -día I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -ni B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -traumatismo I-PRESENT_ILLNESS -local, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -mejilla I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -malar I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -previo I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta, I-PRESENT_ILLNESS -tratada I-PRESENT_ILLNESS -inicialmente I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -absceso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -origen I-PRESENT_ILLNESS -dental. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION +DP. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION +efectúa I-EXPLORATION +mediante I-EXPLORATION +pruebas I-EXPLORATION +de I-EXPLORATION +imagen: I-EXPLORATION +Rx I-EXPLORATION +simple, I-EXPLORATION +ecografía I-EXPLORATION +o I-EXPLORATION +TAC I-EXPLORATION +abdominal, I-EXPLORATION +aunque I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +definitivo I-EXPLORATION +se I-EXPLORATION +puede I-EXPLORATION +obtener I-EXPLORATION +mediante I-EXPLORATION +biopsia I-EXPLORATION +peritoneal, I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +puede I-EXPLORATION +apreciar, I-EXPLORATION +un I-EXPLORATION aumento I-EXPLORATION +del I-EXPLORATION +tamaño I-EXPLORATION de I-EXPLORATION -volumen I-EXPLORATION +los I-EXPLORATION +fibroblastos, I-EXPLORATION +depósito I-EXPLORATION de I-EXPLORATION -consistencia I-EXPLORATION -firme, I-EXPLORATION -fijo I-EXPLORATION -y I-EXPLORATION -levemente I-EXPLORATION -doloroso I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -maxilar I-EXPLORATION -superior I-EXPLORATION -derecha, I-EXPLORATION -con I-EXPLORATION -ocupación I-EXPLORATION -del I-EXPLORATION -vestíbulo I-EXPLORATION -superior I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -extensión I-EXPLORATION -al I-EXPLORATION -paladar I-EXPLORATION -duro I-EXPLORATION -y I-EXPLORATION -blando I-EXPLORATION -derechos. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -sólido-quística I-EXPLORATION +fibrina, I-EXPLORATION +angiogénesis I-EXPLORATION +capilar, I-EXPLORATION +sangrado I-EXPLORATION +perivascular I-EXPLORATION +e I-EXPLORATION +infiltración I-EXPLORATION de I-EXPLORATION -contornos I-EXPLORATION -netos, I-EXPLORATION +mononucleares. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +tratamiento I-EXPLORATION de I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -5 I-EXPLORATION -cm, I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -a I-EXPLORATION -planos I-EXPLORATION -musculares I-EXPLORATION -faciales I-EXPLORATION -profundos I-EXPLORATION +este I-EXPLORATION +grave I-EXPLORATION +cuadro, I-EXPLORATION +dependerá I-EXPLORATION +del I-EXPLORATION +grado I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -malar I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -rellenaba I-EXPLORATION -seno I-EXPLORATION -maxilar. I-EXPLORATION +afectación I-EXPLORATION +peritoneal. I-EXPLORATION En I-EXPLORATION +los I-EXPLORATION +estadios I-EXPLORATION +iniciales I-EXPLORATION +podría I-EXPLORATION +ser I-EXPLORATION +suficiente I-EXPLORATION el I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -(TAC) I-EXPLORATION -de I-EXPLORATION -cavidades I-EXPLORATION -paranasales, I-EXPLORATION +reposo I-EXPLORATION +peritoneal; I-EXPLORATION +con I-EXPLORATION +lavados I-EXPLORATION +peritoneales I-EXPLORATION +y I-EXPLORATION +esteroides. I-EXPLORATION +En I-EXPLORATION +casos I-EXPLORATION +más I-EXPLORATION +avanzados I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -proceso I-EXPLORATION -expansivo, I-EXPLORATION -sólido I-EXPLORATION -quístico, I-EXPLORATION +necesitará I-EXPLORATION +tratamiento I-EXPLORATION +inmunosupresor I-EXPLORATION +(ciclofosfamida, I-EXPLORATION +azatioprina, I-EXPLORATION +ciclosporina) I-EXPLORATION +e I-EXPLORATION +incluso I-EXPLORATION +tamoxifeno. I-EXPLORATION +En I-EXPLORATION +casos I-EXPLORATION +extremos I-EXPLORATION +con I-EXPLORATION +compromiso I-EXPLORATION +visceral, I-EXPLORATION +puede I-EXPLORATION +ser I-EXPLORATION +necesario I-EXPLORATION +recurrir I-EXPLORATION a I-EXPLORATION -partir I-EXPLORATION -de I-EXPLORATION la I-EXPLORATION -quinta I-EXPLORATION -pieza I-EXPLORATION -dental I-EXPLORATION -superior I-EXPLORATION -derecha, I-EXPLORATION +cirugía, I-EXPLORATION +realizando I-EXPLORATION +enterolisis, I-EXPLORATION +técnica I-EXPLORATION que I-EXPLORATION -ocupaba I-EXPLORATION -la I-EXPLORATION -totalidad I-EXPLORATION +tiene I-EXPLORATION +una I-EXPLORATION +mortalidad I-EXPLORATION +entre I-EXPLORATION +40-80%. I-EXPLORATION + I-EXPLORATION +Entre I-EXPLORATION +las I-EXPLORATION +medidas I-EXPLORATION +de I-EXPLORATION +prevención I-EXPLORATION del I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -derecho, I-EXPLORATION -expandía I-EXPLORATION -y I-EXPLORATION -adelgazaba I-EXPLORATION -sus I-EXPLORATION -paredes, I-EXPLORATION -especialmente I-EXPLORATION -hacia I-EXPLORATION -fosa I-EXPLORATION -maxilar I-EXPLORATION -y I-EXPLORATION -pterigomaxilar, I-EXPLORATION -destruyendo I-EXPLORATION +desarrollo I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -mitad I-EXPLORATION -ventral I-EXPLORATION +peritonitis I-EXPLORATION +esclerosante, I-EXPLORATION +cabe I-EXPLORATION +destacar I-EXPLORATION +la I-EXPLORATION +importancia I-EXPLORATION +del I-EXPLORATION +papel I-EXPLORATION de I-EXPLORATION -cornetes I-EXPLORATION -nasales I-EXPLORATION -y I-EXPLORATION -ascendiendo I-EXPLORATION +enfermería I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -piso I-EXPLORATION -orbitario I-EXPLORATION -con I-EXPLORATION -abombamiento I-EXPLORATION +entrenamiento I-EXPLORATION del I-EXPLORATION -paladar I-EXPLORATION -óseo I-EXPLORATION -hacia I-EXPLORATION -cavidad I-EXPLORATION -oral. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -incisional, I-EXPLORATION -cuyo I-EXPLORATION -diagnóstico I-EXPLORATION -fue: I-EXPLORATION -quiste I-EXPLORATION -óseo I-EXPLORATION -aneurismático. I-EXPLORATION -A B-TREATMENT -los I-TREATMENT -2 I-TREATMENT -meses I-TREATMENT -fue I-TREATMENT -reintervenida I-TREATMENT -extirpándose I-TREATMENT -la I-TREATMENT -masa I-TREATMENT -tumoral I-TREATMENT -que I-TREATMENT -ocupaba I-TREATMENT -todo I-TREATMENT -el I-TREATMENT -seno I-TREATMENT -maxilar I-TREATMENT -derecho, I-TREATMENT -con I-TREATMENT -destrucción I-TREATMENT -de I-TREATMENT -su I-TREATMENT -pared I-TREATMENT -anterior I-TREATMENT -y I-TREATMENT -medial, I-TREATMENT -paladar I-TREATMENT -óseo I-TREATMENT -y I-TREATMENT -reborde I-TREATMENT -alveolar I-TREATMENT -superior. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -extracción I-TREATMENT -amplia I-TREATMENT -mediante I-TREATMENT -maxilectomía I-TREATMENT -de I-TREATMENT -infraestructura, I-TREATMENT -que I-TREATMENT -consiste I-TREATMENT -en I-TREATMENT -la I-TREATMENT -extirpación I-TREATMENT -de I-TREATMENT -las I-TREATMENT -estructuras I-TREATMENT -antes I-TREATMENT -mencionadas, I-TREATMENT -conservando I-TREATMENT -el I-TREATMENT -piso I-TREATMENT -de I-TREATMENT -la I-TREATMENT -órbita. I-TREATMENT -La B-EXPLORATION -pieza I-EXPLORATION -quirúrgica, I-EXPLORATION -macroscópicamente, I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -expansiva, I-EXPLORATION -bien I-EXPLORATION -delimitada, I-EXPLORATION -compuesta I-EXPLORATION -por I-EXPLORATION -múltiples I-EXPLORATION -cavidades, I-EXPLORATION -separadas I-EXPLORATION -por I-EXPLORATION -tabiques I-EXPLORATION -pardo I-EXPLORATION -rojizos, I-EXPLORATION -rellenos I-EXPLORATION -por I-EXPLORATION -material I-EXPLORATION -hemático. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -microscópico I-EXPLORATION -reveló I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -numerosos I-EXPLORATION -tabiques I-EXPLORATION -que I-EXPLORATION -separaban I-EXPLORATION -cavidades, I-EXPLORATION -sin I-EXPLORATION -revestimiento I-EXPLORATION -endotelial, I-EXPLORATION +paciente I-EXPLORATION +para I-EXPLORATION +reducir I-EXPLORATION +al I-EXPLORATION +máximo I-EXPLORATION +los I-EXPLORATION +episodios I-EXPLORATION de I-EXPLORATION -tamaño I-EXPLORATION -irregular I-EXPLORATION +peritonitis I-EXPLORATION y I-EXPLORATION -contenido I-EXPLORATION -hemático. I-EXPLORATION -Los I-EXPLORATION -tabiques I-EXPLORATION -tenían I-EXPLORATION -estroma I-EXPLORATION -fibroso, I-EXPLORATION -células I-EXPLORATION -gigantes I-EXPLORATION -multinucleadas, I-EXPLORATION -fibroblastos, I-EXPLORATION -signos I-EXPLORATION +tratarlos I-EXPLORATION +adecuadamente I-EXPLORATION de I-EXPLORATION -hemorragia I-EXPLORATION -antigua I-EXPLORATION -y I-EXPLORATION -áreas I-EXPLORATION -con I-EXPLORATION -tejido I-EXPLORATION -osteoide, I-EXPLORATION -sin I-EXPLORATION -evidencias I-EXPLORATION +forma I-EXPLORATION +precoz; I-EXPLORATION +además I-EXPLORATION +debemos I-EXPLORATION +utilizar I-EXPLORATION +soluciones I-EXPLORATION +lo I-EXPLORATION +más I-EXPLORATION +biocompatibles I-EXPLORATION +posible, I-EXPLORATION +evitando I-EXPLORATION de I-EXPLORATION -anaplasia. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -actividad I-EXPLORATION -mitótica. I-EXPLORATION -No I-EXPLORATION +ese I-EXPLORATION +modo I-EXPLORATION +altas I-EXPLORATION +concentraciones I-EXPLORATION +de I-EXPLORATION +glucosa. I-EXPLORATION +Así I-EXPLORATION +mismo, I-EXPLORATION +es I-EXPLORATION +muy I-EXPLORATION +importante I-EXPLORATION +el I-EXPLORATION +control I-EXPLORATION +del I-EXPLORATION +hiperparatiroidismo I-EXPLORATION +secundario I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +pacientes I-EXPLORATION +urémicos. I-EXPLORATION + I-EXPLORATION +Finalmente, I-EXPLORATION +debemos I-EXPLORATION +estar I-EXPLORATION +alerta I-EXPLORATION +en I-EXPLORATION +aquellos I-EXPLORATION +pacientes I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -encontró I-EXPLORATION -coexistencia I-EXPLORATION +convierten I-EXPLORATION +en I-EXPLORATION +altos I-EXPLORATION +transportadores I-EXPLORATION con I-EXPLORATION -otras I-EXPLORATION -lesiones. I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -mantiene I-EVOLUTION -en I-EVOLUTION -controles I-EVOLUTION -permanentes, I-EVOLUTION -evolucionando I-EVOLUTION -de I-EVOLUTION -manera I-EVOLUTION -favorable. I-EVOLUTION - I-EVOLUTION +el I-EXPLORATION +paso I-EXPLORATION +del I-EXPLORATION +tiempo I-EXPLORATION +en I-EXPLORATION +DP. I-EXPLORATION +Por I-EXPLORATION +tanto, I-EXPLORATION +es I-EXPLORATION +conveniente I-EXPLORATION +realizar I-EXPLORATION +un I-EXPLORATION +PET I-EXPLORATION +(test I-EXPLORATION +de I-EXPLORATION +equilibrio I-EXPLORATION +peritoneal), I-EXPLORATION +al I-EXPLORATION +menos I-EXPLORATION +una I-EXPLORATION +vez I-EXPLORATION +al I-EXPLORATION +año I-EXPLORATION +y I-EXPLORATION +tras I-EXPLORATION +episodios I-EXPLORATION +de I-EXPLORATION +peritonitis. I-EXPLORATION + I-EXPLORATION -Hombre B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -28 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -soldado. B-PAST_MEDICAL_HISTORY -Al B-PRESENT_ILLNESS -reiniciar I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -entrenamiento I-PRESENT_ILLNESS -físico I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -intención I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -participar I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -triatlón, I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -actividad I-PRESENT_ILLNESS -física I-PRESENT_ILLNESS -intensa, I-PRESENT_ILLNESS -recorrió I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS -kilómetros I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -bicicleta I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -luego I-PRESENT_ILLNESS -ascendió I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cima I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cerro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1.828 I-PRESENT_ILLNESS -metros, I-PRESENT_ILLNESS -bajo I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -calor I-PRESENT_ILLNESS -ambiental I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -ingiriendo I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -escaso I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS +23 I-PRESENT_ILLNESS +kg I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -líquidos. I-PRESENT_ILLNESS -Al I-PRESENT_ILLNESS -bajar I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +corporal, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +parálisis I-PAST_MEDICAL_HISTORY +cerebral I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +asfixia I-PAST_MEDICAL_HISTORY +neonatal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +epilepsia, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +prolongado I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +ácido I-PAST_MEDICAL_HISTORY +valproico I-PAST_MEDICAL_HISTORY +oral, I-PAST_MEDICAL_HISTORY +32 I-PAST_MEDICAL_HISTORY +mg/kg/día I-PAST_MEDICAL_HISTORY +administrados I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +sonda I-PAST_MEDICAL_HISTORY +nasogástrica I-PAST_MEDICAL_HISTORY +(SNG). I-PAST_MEDICAL_HISTORY +Ingresó B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -montaña I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -mareos, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -náuseas, I-PRESENT_ILLNESS -vómitos, I-PRESENT_ILLNESS -diarrea, I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -debilidad I-PRESENT_ILLNESS -muscular I-PRESENT_ILLNESS +UPC I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +neumonía I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +adenovirus, I-PRESENT_ILLNESS +asociada I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +insuficiencia I-PRESENT_ILLNESS +respiratoria I-PRESENT_ILLNESS +grave I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -calambres I-PRESENT_ILLNESS -musculares I-PRESENT_ILLNESS -intensos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -extremidades. I-PRESENT_ILLNESS -En B-TREATMENT -el I-TREATMENT -servicio I-TREATMENT +shock I-PRESENT_ILLNESS +séptico-hipovolémico I-PRESENT_ILLNESS +refractario I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +catecolaminas, I-PRESENT_ILLNESS +recibiendo B-TREATMENT +hidrocortisona I-TREATMENT +en I-TREATMENT +dosis I-TREATMENT de I-TREATMENT -urgencia I-TREATMENT -se I-TREATMENT -lo I-TREATMENT -hidrató, I-TREATMENT -enviándolo I-TREATMENT -posteriormente I-TREATMENT -a I-TREATMENT -su I-TREATMENT -domicilio. I-TREATMENT -Al B-EVOLUTION +estrés I-TREATMENT +y I-TREATMENT +asociándose I-TREATMENT +terapia I-TREATMENT +antimicrobiana I-TREATMENT +con I-TREATMENT +cefotaxima, I-TREATMENT +clindamicina I-TREATMENT +y I-TREATMENT +amikacina I-TREATMENT +iv. I-TREATMENT +El B-EVOLUTION +octavo I-EVOLUTION día I-EVOLUTION -subsiguiente I-EVOLUTION -acudió I-EVOLUTION -al I-EVOLUTION -hospital I-EVOLUTION -por I-EVOLUTION -debilidad I-EVOLUTION -muscular, I-EVOLUTION -mialgias I-EVOLUTION -difusas, I-EVOLUTION -calambres I-EVOLUTION -y I-EVOLUTION -malestar I-EVOLUTION -general. I-EVOLUTION -Había I-EVOLUTION -orinado I-EVOLUTION -escasamente I-EVOLUTION -desde I-EVOLUTION +de I-EVOLUTION +hospitalización I-EVOLUTION +se I-EVOLUTION +tomó I-EVOLUTION +un I-EVOLUTION +nivel I-EVOLUTION +plasmático I-EVOLUTION +de I-EVOLUTION +ácido I-EVOLUTION +valproico, I-EVOLUTION el I-EVOLUTION +que I-EVOLUTION +resultó I-EVOLUTION +en I-EVOLUTION +90, I-EVOLUTION +1 I-EVOLUTION +μg/ml. I-EVOLUTION +El I-EVOLUTION +décimo I-EVOLUTION día I-EVOLUTION -anterior. I-EVOLUTION -Existía B-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -fuerzas I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -y I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -muscular. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -mostraron I-EXPLORATION -azotemia I-EXPLORATION -y I-EXPLORATION -elevación I-EXPLORATION +de I-EVOLUTION +hospitalización I-EVOLUTION +presentó I-EVOLUTION +un I-EVOLUTION +deterioro I-EVOLUTION +hemodinámico I-EVOLUTION +y I-EVOLUTION +respiratorio, I-EVOLUTION +con I-EVOLUTION +cultivo I-EVOLUTION +de I-EVOLUTION +aspirado I-EVOLUTION +traqueal I-EVOLUTION +para I-EVOLUTION +Pseudomonas I-EVOLUTION +aeruginosa, I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +cambió I-TREATMENT +esquema I-TREATMENT +antimicrobiano I-TREATMENT +a I-TREATMENT +vancomicina I-TREATMENT +y I-TREATMENT +meropenem I-TREATMENT +(120 I-TREATMENT +mg/kg/día), I-TREATMENT +manteniendo I-TREATMENT +amikacina. I-TREATMENT +Tras B-EXPLORATION +cinco I-EXPLORATION +días I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -enzimas I-EXPLORATION -musculares. I-EXPLORATION -La I-EXPLORATION -orina I-EXPLORATION -era I-EXPLORATION -rosada I-EXPLORATION -y I-EXPLORATION +tratamiento I-EXPLORATION +con I-EXPLORATION +meropenem I-EXPLORATION +se I-EXPLORATION +monitorizó I-EXPLORATION el I-EXPLORATION -sedimento I-EXPLORATION -mostró I-EXPLORATION -1 I-EXPLORATION -a I-EXPLORATION -2 I-EXPLORATION -eritrocitos I-EXPLORATION -por I-EXPLORATION -campo. I-EXPLORATION -Se I-EXPLORATION -diagnosticó I-EXPLORATION -una I-EXPLORATION -insuficiencia I-EXPLORATION -renal I-EXPLORATION -aguda I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -RML I-EXPLORATION -de I-EXPLORATION -esfuerzo I-EXPLORATION -y B-EVOLUTION +ácido I-EXPLORATION +valproico, I-EXPLORATION +encontrándose I-EXPLORATION +un I-EXPLORATION +valor I-EXPLORATION +plasmático I-EXPLORATION +< I-EXPLORATION +3 I-EXPLORATION +μg/ I-EXPLORATION +ml. I-EXPLORATION +Por B-TREATMENT +estrategia I-TREATMENT +de I-TREATMENT +de-escalamiento I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT +el I-TREATMENT +carbapenémico. I-TREATMENT +El B-EVOLUTION +ácido I-EVOLUTION +valproico I-EVOLUTION se I-EVOLUTION -trasladó I-EVOLUTION +aumentó I-EVOLUTION a I-EVOLUTION -la I-EVOLUTION -unidad I-EVOLUTION -de I-EVOLUTION -cuidados I-EVOLUTION -intensivos. I-EVOLUTION -Allí B-TREATMENT -recibió I-TREATMENT -solución I-TREATMENT -salina I-TREATMENT -isotónica, I-TREATMENT -bicarbonato I-TREATMENT -y I-TREATMENT -furosemide, I-TREATMENT -recuperando B-EVOLUTION -rápidamente I-EVOLUTION -la I-EVOLUTION -diuresis. I-EVOLUTION -En I-EVOLUTION -los I-EVOLUTION -9 I-EVOLUTION +45 I-EVOLUTION +mg/kg/día, I-EVOLUTION +controlándose I-EVOLUTION +un I-EVOLUTION +nuevo I-EVOLUTION +nivel I-EVOLUTION +plasmático I-EVOLUTION +siete I-EVOLUTION días I-EVOLUTION -siguientes I-EVOLUTION -se I-EVOLUTION -obtuvo I-EVOLUTION -una I-EVOLUTION -recuperación I-EVOLUTION -paulatina I-EVOLUTION +después I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -función I-EVOLUTION -renal, I-EVOLUTION -sin I-EVOLUTION -emplearse I-EVOLUTION -diálisis, I-EVOLUTION -persistiendo I-EVOLUTION -las I-EVOLUTION -mialgias, I-EVOLUTION -los I-EVOLUTION -calambres I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -elevación I-EVOLUTION +suspensión I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -enzimas I-EVOLUTION -musculares. I-EVOLUTION -Fue I-EVOLUTION -dado I-EVOLUTION +meropenem, I-EVOLUTION +cuyo I-EVOLUTION +resultado I-EVOLUTION +fue I-EVOLUTION de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -décimoprimer I-EVOLUTION -día I-EVOLUTION +55 I-EVOLUTION +μg/ml. I-EVOLUTION +Catorce I-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION de I-EVOLUTION -hospitalización I-EVOLUTION -con I-EVOLUTION -azotemia I-EVOLUTION -leve I-EVOLUTION -(creatinina I-EVOLUTION -1, I-EVOLUTION -43 I-EVOLUTION -mg/dl, I-EVOLUTION -uremia I-EVOLUTION -51 I-EVOLUTION -mg/dl) I-EVOLUTION -y I-EVOLUTION -persistencia I-EVOLUTION +la I-EVOLUTION +suspensión I-EVOLUTION de I-EVOLUTION +mero-penem I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +nuevo I-EVOLUTION +deterioro I-EVOLUTION +hemodinámico I-EVOLUTION +debido I-EVOLUTION +a I-EVOLUTION una I-EVOLUTION -creatinquinasa I-EVOLUTION -(CK) I-EVOLUTION --total I-EVOLUTION -elevada. I-EVOLUTION -Un I-EVOLUTION -mes I-EVOLUTION -después, I-EVOLUTION -estando I-EVOLUTION -con I-EVOLUTION -actividad I-EVOLUTION -física I-EVOLUTION -liviana, I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION +sepsis I-EVOLUTION +por I-EVOLUTION +Enterobacter I-EVOLUTION +cloacae I-EVOLUTION +identificada I-EVOLUTION +en I-EVOLUTION +hemocultivos I-EVOLUTION y I-EVOLUTION -la I-EVOLUTION -concentración I-EVOLUTION +secreción I-EVOLUTION +traqueal, I-EVOLUTION +reiniciándose B-TREATMENT +nuevamente I-TREATMENT +el I-TREATMENT +carbapenémico I-TREATMENT +a I-TREATMENT +igual I-TREATMENT +dosis I-TREATMENT +que I-TREATMENT +la I-TREATMENT +vez I-TREATMENT +anterior, I-TREATMENT +provocando B-EVOLUTION +una I-EVOLUTION +nueva I-EVOLUTION +caída I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -enzimas I-EVOLUTION -musculares I-EVOLUTION -fue I-EVOLUTION -normal. I-EVOLUTION +los I-EVOLUTION +niveles I-EVOLUTION +plasmáticos I-EVOLUTION +de I-EVOLUTION +ácido I-EVOLUTION +valproico I-EVOLUTION +a I-EVOLUTION +< I-EVOLUTION +3 I-EVOLUTION +μg/ml, I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +dos I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +reiniciado. I-EVOLUTION +Se B-TREATMENT +mantuvo I-TREATMENT +con I-TREATMENT +igual I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +valproato. I-TREATMENT +Transcurridos B-EVOLUTION +20 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +terapia I-EVOLUTION +carbapenémica I-EVOLUTION +falleció I-EVOLUTION +por I-EVOLUTION +falla I-EVOLUTION +hipoxémica I-EVOLUTION +refractaria. I-EVOLUTION I-EVOLUTION -Hombre B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -44 I-PRESENT_ILLNESS +14 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -obeso, I-PRESENT_ILLNESS -marino I-PRESENT_ILLNESS -mercante, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -estilo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -sedentario. I-PRESENT_ILLNESS -Estando I-PRESENT_ILLNESS +previamente B-PAST_MEDICAL_HISTORY +sano, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +adenopatías I-PRESENT_ILLNESS +occipitales, I-PRESENT_ILLNESS +yugulares, I-PRESENT_ILLNESS +submandibulares I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +inguinales I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -vacaciones, I-PRESENT_ILLNESS -observó I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -niña I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -ahogaba I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -mar. I-PRESENT_ILLNESS -Intentó I-PRESENT_ILLNESS -rescatarla I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -mucho I-PRESENT_ILLNESS -esfuerzo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -desesperación, I-PRESENT_ILLNESS -aspirando I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tragando I-PRESENT_ILLNESS -mucha I-PRESENT_ILLNESS -agua, I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -casi I-PRESENT_ILLNESS -ahogarse. I-PRESENT_ILLNESS -Durante I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS dos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -siguientes I-PRESENT_ILLNESS -tuvo I-PRESENT_ILLNESS -vómitos, I-PRESENT_ILLNESS -incapacidad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -alimentarse, I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS -mialgias I-PRESENT_ILLNESS -intensas I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +sensibles, I-PRESENT_ILLNESS +asociadas I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +fiebre, I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso, I-PRESENT_ILLNESS +fatiga, I-PRESENT_ILLNESS +anorexia I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -débito I-PRESENT_ILLNESS -urinario. I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +máculo-petequiales I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +dorso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Urgencia. I-PRESENT_ILLNESS -Estaba B-EXPLORATION -hipertenso I-EXPLORATION -(170/110 I-EXPLORATION -mmHg) I-EXPLORATION -y I-EXPLORATION -tenía I-EXPLORATION -aliento I-EXPLORATION -urémico. I-EXPLORATION -Era I-EXPLORATION -llamativa I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +ambos I-PRESENT_ILLNESS +pies. I-PRESENT_ILLNESS +El B-EXPLORATION +hemograma I-EXPLORATION +mostraba I-EXPLORATION +3.400 I-EXPLORATION +leucocitos I-EXPLORATION +x I-EXPLORATION +mm3, I-EXPLORATION +46% I-EXPLORATION de I-EXPLORATION -petequias I-EXPLORATION -conjuntivales I-EXPLORATION -(signo I-EXPLORATION +linfo I-EXPLORATION +citos I-EXPLORATION +y I-EXPLORATION +50% I-EXPLORATION de I-EXPLORATION -asfixia) I-EXPLORATION +neutro I-EXPLORATION +filos. I-EXPLORATION +La I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +(PCR) I-EXPLORATION y I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -palpación I-EXPLORATION +velocidad I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -músculos I-EXPLORATION +sedimentación I-EXPLORATION +(VHS) I-EXPLORATION +fueron I-EXPLORATION de I-EXPLORATION +6, I-EXPLORATION +2 I-EXPLORATION +mg/L I-EXPLORATION +y I-EXPLORATION +28 I-EXPLORATION +mm/h, I-EXPLORATION +respectivamente. I-EXPLORATION +El I-EXPLORATION +perfil I-EXPLORATION +hepático, I-EXPLORATION las I-EXPLORATION -extremidades I-EXPLORATION +pruebas I-EXPLORATION +de I-EXPLORATION +coagulación I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +función I-EXPLORATION +renal I-EXPLORATION +no I-EXPLORATION +mostraron I-EXPLORATION +alteraciones. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +complementario I-EXPLORATION +fue I-EXPLORATION +negativo: I-EXPLORATION +hemocultivos, I-EXPLORATION +urocultivo, I-EXPLORATION +coprocultivo, I-EXPLORATION +inmunofluorescencia I-EXPLORATION +directa I-EXPLORATION +para I-EXPLORATION +virus I-EXPLORATION +respiratorios, I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +virus I-EXPLORATION +Epstein-Barr I-EXPLORATION +(VEB), I-EXPLORATION +Bartonella I-EXPLORATION +hensenlae, I-EXPLORATION +parvovirus I-EXPLORATION +B-19, I-EXPLORATION +citomegalovirus I-EXPLORATION +(CMV), I-EXPLORATION +Toxoplasma I-EXPLORATION +gondii I-EXPLORATION y I-EXPLORATION +ELISA I-EXPLORATION +para I-EXPLORATION +VIH. I-EXPLORATION +No I-EXPLORATION +hubo I-EXPLORATION +hallazgos I-EXPLORATION +significativos I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computada I-EXPLORATION +(TAC) I-EXPLORATION de I-EXPLORATION +tórax, I-EXPLORATION +abdomen I-EXPLORATION +y I-EXPLORATION +pelvis, I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -pared I-EXPLORATION -abdominal. I-EXPLORATION +eco I-EXPLORATION +cardiografía I-EXPLORATION +transtorácica. I-EXPLORATION La I-EXPLORATION -ecotomografía I-EXPLORATION +ecografía I-EXPLORATION +cervical I-EXPLORATION mostró I-EXPLORATION -riñones I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION +adenopatías I-EXPLORATION +bilaterales, I-EXPLORATION +tanto I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +triángulos I-EXPLORATION +cervicales I-EXPLORATION +anteriores I-EXPLORATION y I-EXPLORATION +posteriores, I-EXPLORATION +de I-EXPLORATION aspecto I-EXPLORATION -normal. I-EXPLORATION -En I-EXPLORATION +inespecífico. I-EXPLORATION + I-EXPLORATION +Durante B-EVOLUTION +la I-EVOLUTION +hospitalización I-EVOLUTION +apareció I-EVOLUTION +un I-EVOLUTION +exantema I-EVOLUTION +máculo-papular I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +región I-EVOLUTION +malar, I-EVOLUTION +tronco I-EVOLUTION +y I-EVOLUTION +extremidades I-EVOLUTION +asociado I-EVOLUTION +a I-EVOLUTION +artralgias. I-EVOLUTION +Los B-EXPLORATION +anticuerpos I-EXPLORATION +anti-nucleares I-EXPLORATION +(ANA) I-EXPLORATION +y I-EXPLORATION +anti-DNA I-EXPLORATION +fueron I-EXPLORATION +negativos I-EXPLORATION +y I-EXPLORATION los I-EXPLORATION -exámenes I-EXPLORATION +anticuerpos I-EXPLORATION +anti-antígenos I-EXPLORATION +nucleares I-EXPLORATION +extraíbles I-EXPLORATION +(ENA) I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +factor I-EXPLORATION +reumatoide I-EXPLORATION +(FR) I-EXPLORATION +no I-EXPLORATION +presentaron I-EXPLORATION +alteraciones. I-EXPLORATION +Los I-EXPLORATION +niveles I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -destacó I-EXPLORATION -azotemia I-EXPLORATION -marcada I-EXPLORATION +complemento I-EXPLORATION +C3 I-EXPLORATION y I-EXPLORATION -elevación I-EXPLORATION +C4 I-EXPLORATION +fueron I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -enzimas I-EXPLORATION -musculares. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION +131 I-EXPLORATION +mg/dL I-EXPLORATION +y I-EXPLORATION +45 I-EXPLORATION +mg/dL I-EXPLORATION +respectivamente. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +biopsia I-EXPLORATION de I-EXPLORATION -orina I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -sangre I-EXPLORATION +adenopatía I-EXPLORATION +cervical I-EXPLORATION +que I-EXPLORATION +reveló I-EXPLORATION +distorsión I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arquitectura, I-EXPLORATION +focos I-EXPLORATION +de I-EXPLORATION +necrosis I-EXPLORATION +fibrinoide I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -sedimento I-EXPLORATION -mostró I-EXPLORATION -sólo I-EXPLORATION -2 I-EXPLORATION -a I-EXPLORATION -3 I-EXPLORATION -eritrocitos I-EXPLORATION -por I-EXPLORATION -campo. I-EXPLORATION -Se B-TREATMENT -manejó I-TREATMENT -con I-TREATMENT -aporte I-TREATMENT -de I-TREATMENT -volumen I-TREATMENT -y I-TREATMENT -bicarbonato I-TREATMENT -parenteral. I-TREATMENT -Al I-TREATMENT -día I-TREATMENT -siguiente I-TREATMENT -los I-TREATMENT -síntomas I-TREATMENT -urémicos I-TREATMENT -se I-TREATMENT -intensificaron I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -hemodializó I-TREATMENT -por I-TREATMENT -dos I-TREATMENT -días I-TREATMENT -consecutivos. I-TREATMENT -Al B-EVOLUTION -cuarto I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -inició I-EVOLUTION -una I-EVOLUTION -poliuria I-EVOLUTION -con I-EVOLUTION -recuperación I-EVOLUTION -progresiva I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -función I-EVOLUTION -renal, I-EVOLUTION -hasta I-EVOLUTION -alcanzar I-EVOLUTION -una I-EVOLUTION -creatinina I-EVOLUTION -de I-EVOLUTION -1, I-EVOLUTION +restos I-EXPLORATION +apoptóticos I-EXPLORATION +rodeados I-EXPLORATION +de I-EXPLORATION +abundantes I-EXPLORATION +histiocitos, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +linfadenitis I-EXPLORATION +necrotizante I-EXPLORATION +histiocitaria. I-EXPLORATION +El B-EVOLUTION +cuadro I-EVOLUTION +se I-EVOLUTION +resolvió I-EVOLUTION +espontáneamente I-EVOLUTION +en I-EVOLUTION 1 I-EVOLUTION -mg/dl I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -20 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -episodio I-EVOLUTION -inicial I-EVOLUTION -referido. I-EVOLUTION +mes I-EVOLUTION +y I-EVOLUTION +tras I-EVOLUTION +un I-EVOLUTION +año I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +no I-EVOLUTION +ha I-EVOLUTION +presentado I-EVOLUTION +recurrencias. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS +Hombre B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -hipertenso, B-PAST_MEDICAL_HISTORY -tabáquico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dislipidémico. I-PAST_MEDICAL_HISTORY -Comenzó B-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -torácico I-PRESENT_ILLNESS -retroesternal I-PRESENT_ILLNESS -bajo, I-PRESENT_ILLNESS -opresivo, I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -hipocondrios I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -espalda, I-PRESENT_ILLNESS +72 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +importancia I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +ingresó I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -decidió I-PRESENT_ILLNESS -consultar I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS +insuficiencia I-PRESENT_ILLNESS +respiratoria I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +diagnóstico I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -síntomas. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -estaba I-EXPLORATION -vígil, I-EXPLORATION -orientado, I-EXPLORATION -con I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION +neumonía. I-PRESENT_ILLNESS +Los B-EXPLORATION +cultivos I-EXPLORATION +y I-EXPLORATION +las I-EXPLORATION +serologías I-EXPLORATION +para I-EXPLORATION +virus I-EXPLORATION +herpes I-EXPLORATION +y I-EXPLORATION +CMV I-EXPLORATION +fueron I-EXPLORATION +negativos, I-EXPLORATION +además I-EXPLORATION de I-EXPLORATION -140/90, I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION +todas I-EXPLORATION +las I-EXPLORATION +serologías I-EXPLORATION +al I-EXPLORATION +igual I-EXPLORATION +que I-EXPLORATION +los I-EXPLORATION +pacientes I-EXPLORATION +previos. I-EXPLORATION +Recibió B-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +empírico. I-TREATMENT +A B-EXPLORATION +las I-EXPLORATION +dos I-EXPLORATION +semanas I-EXPLORATION de I-EXPLORATION -80 I-EXPLORATION -lat/min, I-EXPLORATION -con I-EXPLORATION -pulsos I-EXPLORATION -distales I-EXPLORATION -simétricos I-EXPLORATION +su I-EXPLORATION +ingreso I-EXPLORATION +presentó I-EXPLORATION +fiebre I-EXPLORATION y I-EXPLORATION -normales, I-EXPLORATION -sin I-EXPLORATION -otros I-EXPLORATION -hallazgos I-EXPLORATION -relevantes. I-EXPLORATION - I-EXPLORATION -Un I-EXPLORATION -electrocardiograma I-EXPLORATION -practicado I-EXPLORATION -al I-EXPLORATION +empeoramiento I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +imágenes I-EXPLORATION +radiológicas I-EXPLORATION +basales I-EXPLORATION +derechas. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +BAL I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION +crecimiento I-EXPLORATION +bacteriano. I-EXPLORATION +El I-EXPLORATION paciente I-EXPLORATION -sólo I-EXPLORATION -demostró I-EXPLORATION -hipertrofia I-EXPLORATION -ventricular I-EXPLORATION -izquierda. I-EXPLORATION +desarrolló I-EXPLORATION +paulatinamente I-EXPLORATION +citopenias I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +tres I-EXPLORATION +series: I-EXPLORATION +Hb: I-EXPLORATION +7 I-EXPLORATION +g/l; I-EXPLORATION +recuento I-EXPLORATION +de I-EXPLORATION +leucocitos: I-EXPLORATION +1.600/ I-EXPLORATION +mm3; I-EXPLORATION +plaquetas: I-EXPLORATION +49.000 I-EXPLORATION +/mm3. I-EXPLORATION La I-EXPLORATION -radiografía I-EXPLORATION -no I-EXPLORATION -presentó I-EXPLORATION -hallazgos I-EXPLORATION -relevantes. I-EXPLORATION - I-EXPLORATION -Debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -persistencia I-EXPLORATION -del I-EXPLORATION -fuerte I-EXPLORATION -dolor I-EXPLORATION -torácico I-EXPLORATION -y I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -disección I-EXPLORATION -aórtica, I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -angiografía I-EXPLORATION -por I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION +ferritina I-EXPLORATION +fue I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -abdomen I-EXPLORATION -(Angio-Tac), I-EXPLORATION +4.000 I-EXPLORATION +µg/l, I-EXPLORATION +trigliceridos I-EXPLORATION +607 I-EXPLORATION +mg/dl, I-EXPLORATION +fibrinógeno I-EXPLORATION +111%. I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +PAMO I-EXPLORATION que I-EXPLORATION mostró I-EXPLORATION -flap I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -disección I-EXPLORATION +macrófagos I-EXPLORATION +en I-EXPLORATION +10% I-EXPLORATION +con I-EXPLORATION +hemofa-gocitosis. I-EXPLORATION +Al I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +solo I-EXPLORATION +presentó I-EXPLORATION +ligera I-EXPLORATION +hepato I-EXPLORATION +esplenomegalia. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +le I-TREATMENT +administró I-TREATMENT +metilprednisona I-TREATMENT +a I-TREATMENT +una I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +1 I-TREATMENT +g/día I-TREATMENT +por I-TREATMENT +tres I-TREATMENT +días I-TREATMENT +y I-TREATMENT +gammaglobulina I-TREATMENT +en I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +400 I-TREATMENT +mg/kg/día I-TREATMENT +por I-TREATMENT +5 I-TREATMENT +días. I-TREATMENT +Evolucionó B-EVOLUTION +con I-EVOLUTION +fiebre I-EVOLUTION +persistente I-EVOLUTION +y B-TREATMENT +requerimiento I-TREATMENT +de I-TREATMENT +asistencia I-TREATMENT +respiratoria I-TREATMENT +mecánica. I-TREATMENT +Las B-EVOLUTION +citopenias I-EVOLUTION +no I-EVOLUTION +mejoraron. I-EVOLUTION +Se B-EXPLORATION +repitieron I-EXPLORATION +cultivos I-EXPLORATION +que I-EXPLORATION +siempre I-EXPLORATION +fueron I-EXPLORATION +negativos, I-EXPLORATION +a I-EXPLORATION +excepción I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -agudo, I-EXPLORATION +un I-EXPLORATION +BAL I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -extendía I-EXPLORATION -desde I-EXPLORATION +evidenció I-EXPLORATION el I-EXPLORATION -tercio I-EXPLORATION -distal I-EXPLORATION +crecimiento I-EXPLORATION +significativo I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -aorta I-EXPLORATION -descendente I-EXPLORATION -hasta I-EXPLORATION +una I-EXPLORATION +Acinetobacter I-EXPLORATION +baumannii I-EXPLORATION +multirresistente I-EXPLORATION +que B-TREATMENT +recibió I-TREATMENT +tratamiento. I-TREATMENT +Falleció B-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +44 I-EVOLUTION +días I-EVOLUTION +del I-EVOLUTION +ingreso I-EVOLUTION +con I-EVOLUTION +falla I-EVOLUTION +multiorgánica. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +42 I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS +primer B-PAST_MEDICAL_HISTORY +hijo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +padres I-PAST_MEDICAL_HISTORY +sanos I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +consanguíneos, I-PAST_MEDICAL_HISTORY +diagnosticado B-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +ecografía I-PRESENT_ILLNESS +prenatal I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +ureterohidronefrosis I-PRESENT_ILLNESS +bilateral I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dilatación I-PRESENT_ILLNESS +gástrica. I-PRESENT_ILLNESS +En B-EXPLORATION el I-EXPLORATION -nivel I-EXPLORATION +período I-EXPLORATION +neonatal I-EXPLORATION +precoz I-EXPLORATION +únicamente I-EXPLORATION +llamó I-EXPLORATION +la I-EXPLORATION +atención, I-EXPLORATION +un I-EXPLORATION +abdomen I-EXPLORATION +globuloso I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +primera I-EXPLORATION +deposición I-EXPLORATION +meconial I-EXPLORATION +al I-EXPLORATION +4º I-EXPLORATION +día I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -hilios I-EXPLORATION -renales, I-EXPLORATION +vida, I-EXPLORATION con I-EXPLORATION -permeabilidad I-EXPLORATION -del I-EXPLORATION -falso I-EXPLORATION -lumen I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION +ausencia I-EXPLORATION +absoluta I-EXPLORATION +posterior I-EXPLORATION de I-EXPLORATION -hemotórax I-EXPLORATION -menor I-EXPLORATION +deposiciones. I-EXPLORATION +Un I-EXPLORATION +enema I-EXPLORATION +opaco I-EXPLORATION +evidenció I-EXPLORATION +microcolon I-EXPLORATION y I-EXPLORATION -hemopericardio. I-EXPLORATION -Se I-EXPLORATION -diagnosticó I-EXPLORATION -entonces I-EXPLORATION -disección I-EXPLORATION -aórtica I-EXPLORATION -aguda I-EXPLORATION -tipo I-EXPLORATION -B, I-EXPLORATION -complicada I-EXPLORATION -por I-EXPLORATION -rotura. I-EXPLORATION - I-EXPLORATION -Debido B-TREATMENT -a I-TREATMENT -la I-TREATMENT -complicación I-TREATMENT +malrotación I-EXPLORATION +intestinal, I-EXPLORATION +corrigiéndose I-EXPLORATION +éstaúltima I-EXPLORATION +quirúrgicamente. I-EXPLORATION +Una I-EXPLORATION +biopsia I-EXPLORATION +rectal I-EXPLORATION +fue I-EXPLORATION +positiva I-EXPLORATION +para I-EXPLORATION +enolasa I-EXPLORATION +neuronal I-EXPLORATION +y I-EXPLORATION +descartó I-EXPLORATION +aganglionismo. I-EXPLORATION +Se B-TREATMENT +mantuvo I-TREATMENT +en I-TREATMENT +todo I-TREATMENT +momento I-TREATMENT +con I-TREATMENT +nutrición I-TREATMENT +parenteral, I-TREATMENT +con I-TREATMENT +intentos I-TREATMENT de I-TREATMENT -la I-TREATMENT -disección, I-TREATMENT -anatomía I-TREATMENT -favorable I-TREATMENT +ingesta I-TREATMENT +oral I-TREATMENT +que I-TREATMENT +toleró I-TREATMENT +finalmente I-TREATMENT +a I-TREATMENT +los I-TREATMENT +2 I-TREATMENT +meses I-TREATMENT de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -y I-TREATMENT +vida I-TREATMENT +con I-TREATMENT +un I-TREATMENT +volumen I-TREATMENT +máximo I-TREATMENT de I-TREATMENT -los I-TREATMENT -accesos I-TREATMENT -vasculares, I-TREATMENT +7 I-TREATMENT +ml/h. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +siempre I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +diuresis I-EVOLUTION +adecuada, I-EVOLUTION +aunque I-EVOLUTION +mantenía I-EVOLUTION +las I-EVOLUTION +cifras I-EVOLUTION +de I-EVOLUTION +creatinina I-EVOLUTION +en I-EVOLUTION +límites I-EVOLUTION +altos I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +normalidad. I-EVOLUTION +Posteriormente B-TREATMENT se I-TREATMENT -decidió I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -prótesis I-TREATMENT -endovascular. I-TREATMENT - I-TREATMENT -Se I-TREATMENT +le I-TREATMENT realizó I-TREATMENT +pieloureterostomía I-TREATMENT +bilateral I-TREATMENT +mejorando I-TREATMENT +su I-TREATMENT +función I-TREATMENT +renal. I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +20 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +vida I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +sepsis I-EVOLUTION +nosocomial I-EVOLUTION +relacionada I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +catéter I-EVOLUTION +por I-EVOLUTION +Staphylococcus I-EVOLUTION +epidermidis, I-EVOLUTION +tratada B-TREATMENT +con I-TREATMENT +teicoplanina I-TREATMENT +y I-TREATMENT +cefotaxima I-TREATMENT +con B-EVOLUTION +buena I-EVOLUTION +respuesta9. I-EVOLUTION +Estos I-EVOLUTION +datos I-EVOLUTION +amplían I-EVOLUTION +lo I-EVOLUTION +ya I-EVOLUTION +publicado I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +año I-EVOLUTION +2004 I-EVOLUTION +por I-EVOLUTION +parte I-EVOLUTION +del I-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Neonatología I-EVOLUTION +y I-EVOLUTION +del I-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Cirugía I-EVOLUTION +Pediátrica I-EVOLUTION +del I-EVOLUTION +Hospital I-EVOLUTION +Universitario I-EVOLUTION +Central I-EVOLUTION +de I-EVOLUTION +Asturias10. I-EVOLUTION + I-EVOLUTION +Actualmente I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presenta I-EVOLUTION +buen I-EVOLUTION +estado I-EVOLUTION +general, I-EVOLUTION +ureterostomía I-EVOLUTION +cutánea I-EVOLUTION +bilateral, I-EVOLUTION +peristaltismo I-EVOLUTION +y I-EVOLUTION +hábito I-EVOLUTION +intestinal I-EVOLUTION +conservados, I-EVOLUTION +relativamente I-EVOLUTION +bien I-EVOLUTION +nutrido I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +aceptable I-EVOLUTION +y I-EVOLUTION +progresivo I-EVOLUTION +desarrollo I-EVOLUTION +ponderal: I-EVOLUTION +percentil I-EVOLUTION +10 I-EVOLUTION +de I-EVOLUTION +peso I-EVOLUTION +y I-EVOLUTION +talla, I-EVOLUTION +índice I-EVOLUTION +de I-EVOLUTION +Waterlow I-EVOLUTION +del I-EVOLUTION +96%. I-EVOLUTION +Recibe B-TREATMENT +nutrición I-TREATMENT +parenteral I-TREATMENT +(NP) I-TREATMENT +desde I-TREATMENT el I-TREATMENT -procedimiento I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general, I-TREATMENT +tercer I-TREATMENT +día I-TREATMENT +de I-TREATMENT +vida I-TREATMENT +y I-TREATMENT +actualmente I-TREATMENT +en I-TREATMENT +régimen I-TREATMENT +ambulatorio, I-TREATMENT +suplementada I-TREATMENT con I-TREATMENT -acceso I-TREATMENT +aportes I-TREATMENT +orales I-TREATMENT a I-TREATMENT -través I-TREATMENT +débito I-TREATMENT +continuo, I-TREATMENT +desde I-TREATMENT +que I-TREATMENT +inició I-TREATMENT +tolerancia I-TREATMENT +a I-TREATMENT +los I-TREATMENT +mismos. I-TREATMENT +La I-TREATMENT +composición I-TREATMENT de I-TREATMENT -arterias I-TREATMENT -femorales I-TREATMENT -e I-TREATMENT -hipotensión I-TREATMENT -controlada, I-TREATMENT -instalándose I-TREATMENT -prótesis I-TREATMENT -endovascular I-TREATMENT -(Talent®) I-TREATMENT +la I-TREATMENT +NP I-TREATMENT +por I-TREATMENT +kg I-TREATMENT de I-TREATMENT -34 I-TREATMENT -mm I-TREATMENT +peso I-TREATMENT +y I-TREATMENT +día I-TREATMENT +es I-TREATMENT de I-TREATMENT -diámetro I-TREATMENT +1, I-TREATMENT +8 I-TREATMENT +g I-TREATMENT +de I-TREATMENT +aminoácidos, I-TREATMENT +8, I-TREATMENT +6 I-TREATMENT +g I-TREATMENT +de I-TREATMENT +glucosa, I-TREATMENT +1, I-TREATMENT +4 I-TREATMENT +g I-TREATMENT +lípidos, I-TREATMENT +Na I-TREATMENT +3, I-TREATMENT +7 I-TREATMENT +mEq, I-TREATMENT +k I-TREATMENT +1, I-TREATMENT +4 I-TREATMENT +mEq, I-TREATMENT +Ca I-TREATMENT +0, I-TREATMENT +7 I-TREATMENT +mEq, I-TREATMENT +Cl I-TREATMENT +4, I-TREATMENT +4 I-TREATMENT +mEq, I-TREATMENT +P I-TREATMENT +0, I-TREATMENT +2 I-TREATMENT +mEq, I-TREATMENT +Mg I-TREATMENT +0, I-TREATMENT +3 I-TREATMENT +mEq, I-TREATMENT +contiene I-TREATMENT +55, I-TREATMENT +7 I-TREATMENT +kcal I-TREATMENT +totales I-TREATMENT y I-TREATMENT -130 I-TREATMENT -mm I-TREATMENT +un I-TREATMENT +volumen I-TREATMENT +total I-TREATMENT de I-TREATMENT -longitud I-TREATMENT +1.295 I-TREATMENT +ml. I-TREATMENT +La I-TREATMENT +NP I-TREATMENT +es I-TREATMENT +perfundida I-TREATMENT +durante I-TREATMENT +17 I-TREATMENT +horas, I-TREATMENT en I-TREATMENT -la I-TREATMENT -aorta I-TREATMENT -torácica I-TREATMENT +pases I-TREATMENT +de I-TREATMENT +40 I-TREATMENT +ml/hora, I-TREATMENT con I-TREATMENT -resultado I-TREATMENT -técnico I-TREATMENT -adecuado, I-TREATMENT -cobertura I-TREATMENT +ascenso I-TREATMENT +y I-TREATMENT +descenso I-TREATMENT +en I-TREATMENT +una I-TREATMENT +hora, I-TREATMENT +siendo I-TREATMENT +el I-TREATMENT +tiempo I-TREATMENT de I-TREATMENT -sitio I-TREATMENT +reposo I-TREATMENT +sin I-TREATMENT +NPD I-TREATMENT de I-TREATMENT -fractura I-TREATMENT -proximal I-TREATMENT +7 I-TREATMENT +horas. I-TREATMENT +Recibe I-TREATMENT +tratamiento I-TREATMENT +profiláctico I-TREATMENT +frente I-TREATMENT +al I-TREATMENT +sobrecrecimiento I-TREATMENT +bacteriano I-TREATMENT +intestinal I-TREATMENT +con I-TREATMENT +metronidazol, I-TREATMENT +además I-TREATMENT +de I-TREATMENT +trimetropim, I-TREATMENT +fenobarbital, I-TREATMENT +hierro, I-TREATMENT +ácido I-TREATMENT +ursodesoxicólico, I-TREATMENT +ranitidina, I-TREATMENT +eritromicina, I-TREATMENT +vitamina I-TREATMENT +E, I-TREATMENT +vitamina I-TREATMENT +D3 I-TREATMENT y I-TREATMENT -sin I-TREATMENT -complicaciones I-TREATMENT -inmediatas. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION +darbepoetina. I-TREATMENT +Mensualmente, B-EXPLORATION se I-EXPLORATION -comprobó I-EXPLORATION -adecuada I-EXPLORATION -posición I-EXPLORATION -de I-EXPLORATION -endoprótesis I-EXPLORATION -con I-EXPLORATION -exclusión I-EXPLORATION -del I-EXPLORATION -falso I-EXPLORATION -lumen I-EXPLORATION +realiza I-EXPLORATION +control I-EXPLORATION +clínico, I-EXPLORATION +analítico I-EXPLORATION +(bioquímica I-EXPLORATION +completa, I-EXPLORATION +función I-EXPLORATION +renal, I-EXPLORATION +hemograma I-EXPLORATION +y I-EXPLORATION +reactantes I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -aorta I-EXPLORATION -torácica, I-EXPLORATION -sólo I-EXPLORATION -con I-EXPLORATION -permeabilidad I-EXPLORATION +fase I-EXPLORATION +aguda) I-EXPLORATION +y I-EXPLORATION +control I-EXPLORATION +microbiológico I-EXPLORATION de I-EXPLORATION -éste I-EXPLORATION -distal I-EXPLORATION -a I-EXPLORATION -origen I-EXPLORATION +piel I-EXPLORATION de I-EXPLORATION -arteria I-EXPLORATION -mesentérica I-EXPLORATION -inferior, I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -había I-EXPLORATION -aumentado I-EXPLORATION -con I-EXPLORATION -respecto I-EXPLORATION -a I-EXPLORATION -examen I-EXPLORATION +ostomías I-EXPLORATION +y I-EXPLORATION de I-EXPLORATION -ingreso. I-EXPLORATION -Los I-EXPLORATION -accesos I-EXPLORATION -vasculares I-EXPLORATION -no I-EXPLORATION -presentaban I-EXPLORATION -complicaciones. I-EXPLORATION -Se B-EVOLUTION -decidió I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -cinco I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -procedimiento, I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones. I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -control I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -procedimiento, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encontraba I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -generales, I-EVOLUTION -con I-EVOLUTION -Angio-Tac I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -demostró I-EVOLUTION +catéter I-EXPLORATION +Hickman. I-EXPLORATION +Ha B-EVOLUTION +presentado I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION +obstrucción I-EVOLUTION +abdominal, I-EVOLUTION +uno B-TREATMENT +de I-TREATMENT +los I-TREATMENT +cuales, I-TREATMENT +secundario I-TREATMENT +a I-TREATMENT +bridas I-TREATMENT +intestinales, I-TREATMENT +requirió I-TREATMENT +intervención I-TREATMENT +quirúrgica. I-TREATMENT +Las B-EVOLUTION complicaciones I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -endoprótesis, I-EVOLUTION +relacionadas I-EVOLUTION con I-EVOLUTION -exclusión I-EVOLUTION -total I-EVOLUTION -del I-EVOLUTION -falso I-EVOLUTION -lumen I-EVOLUTION -torácico I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -variaciones I-EVOLUTION +la I-EVOLUTION +NP I-EVOLUTION +han I-EVOLUTION +sido I-EVOLUTION +dos: I-EVOLUTION +citolisis I-EVOLUTION +hepática I-EVOLUTION +transitoria, I-EVOLUTION +que B-TREATMENT +remitió I-TREATMENT +tras I-TREATMENT +normalizar I-TREATMENT +la I-TREATMENT +relación I-TREATMENT +de I-TREATMENT +calorías I-TREATMENT +procedentes I-TREATMENT +de I-TREATMENT +hidratos I-TREATMENT +de I-TREATMENT +carbono I-TREATMENT +frente I-TREATMENT +a I-TREATMENT +grasas I-TREATMENT +(60/40) I-TREATMENT +(durante I-TREATMENT +este I-TREATMENT +período I-TREATMENT +tenía I-TREATMENT +niveles I-TREATMENT +elevados I-TREATMENT +de I-TREATMENT +GOT, I-TREATMENT +GPT, I-TREATMENT +fosfatasa I-TREATMENT +alcalina I-TREATMENT +y I-TREATMENT +bilirrubina, I-TREATMENT +que I-TREATMENT +se I-TREATMENT +normalizaron) I-TREATMENT +y B-EVOLUTION +una I-EVOLUTION +sepsis I-EVOLUTION +nosocomial I-EVOLUTION +relacionada I-EVOLUTION con I-EVOLUTION -respecto I-EVOLUTION -a I-EVOLUTION -examen I-EVOLUTION -de I-EVOLUTION -alta. I-EVOLUTION - I-EVOLUTION +el I-EVOLUTION +catéter I-EVOLUTION +por I-EVOLUTION +Staphylococcus I-EVOLUTION +epidermidis, I-EVOLUTION +que B-TREATMENT +respondió I-TREATMENT +adecuadamente I-TREATMENT +a I-TREATMENT +tratamiento I-TREATMENT +antibiótico. I-TREATMENT + I-TREATMENT -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -segundo I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY +Ingresa B-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +Hematología I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +masculino I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -enseñanza I-PAST_MEDICAL_HISTORY -media I-PAST_MEDICAL_HISTORY -completa, I-PAST_MEDICAL_HISTORY -casada, I-PAST_MEDICAL_HISTORY +16 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY una I-PAST_MEDICAL_HISTORY -hija I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -hijo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Asistió B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -consultorio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -atención I-PRESENT_ILLNESS -primaria I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -angustiosos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -depresivos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ocho I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -iniciados I-PRESENT_ILLNESS -posteriormente I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -nacimiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -hija I-PRESENT_ILLNESS -mayor. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -exacerbado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -año, I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -nacimiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -segundo I-PRESENT_ILLNESS -hijo. I-PRESENT_ILLNESS -Junto I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -anterior, I-PRESENT_ILLNESS -golpeaba I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -hija, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -marido I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -sugirió I-PRESENT_ILLNESS -consultar. I-PRESENT_ILLNESS -Fue B-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Psiquiatría I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -pesquisa I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -hizo I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -médico I-DERIVED_FROM/TO -general I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -antecedente I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -abuso I-DERIVED_FROM/TO -sexual I-DERIVED_FROM/TO -infantil, I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -hasta I-DERIVED_FROM/TO -esa I-DERIVED_FROM/TO -fecha I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -había I-DERIVED_FROM/TO -silenciado. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Antecedentes. B-PAST_MEDICAL_HISTORY -Fue I-PAST_MEDICAL_HISTORY -golpeada I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -padre I-PAST_MEDICAL_HISTORY -alcohólico, I-PAST_MEDICAL_HISTORY -quién I-PAST_MEDICAL_HISTORY -abusó I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ella I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -caricias I-PAST_MEDICAL_HISTORY -sexuales I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -penetración, I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -15, I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -abandonó I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -colegio I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -trasladó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -otra I-PAST_MEDICAL_HISTORY -ciudad I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -trabajar I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -asesora I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -hogar. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -primera I-PAST_MEDICAL_HISTORY -casa I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -trabajó I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -violada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -hijo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -patrona. I-PAST_MEDICAL_HISTORY -Esta I-PAST_MEDICAL_HISTORY -experiencia I-PAST_MEDICAL_HISTORY -traumática I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -silenció I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -susto, I-PAST_MEDICAL_HISTORY -vergüenza I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -culpa. I-PAST_MEDICAL_HISTORY -Posteriormente I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -angustia, I-PAST_MEDICAL_HISTORY -pesadillas I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -imágenes I-PAST_MEDICAL_HISTORY -intrusivas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -violación I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -cedieron I-PAST_MEDICAL_HISTORY -espontáneamente I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -mes, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -abandono I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -lugar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -trabajo. I-PAST_MEDICAL_HISTORY -Estos I-PAST_MEDICAL_HISTORY -síntomas I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -reactivaron I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -después, I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -divisó I-PAST_MEDICAL_HISTORY -casualmente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -calle I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -victimario I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -nuevamente I-PAST_MEDICAL_HISTORY -cedieron I-PAST_MEDICAL_HISTORY -espontáneamente I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -regreso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -lugar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -origen. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -casó I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -inició I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -problemas I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -sexual. I-PAST_MEDICAL_HISTORY -Durante I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -primer I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -comenzó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -presentar I-PAST_MEDICAL_HISTORY -angustia I-PAST_MEDICAL_HISTORY -relacionada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -idea I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tener I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -hija, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -podría I-PAST_MEDICAL_HISTORY -suceder I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -mismo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -ella, I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -decir I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -violada. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -angustia I-PAST_MEDICAL_HISTORY -aumentó I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -nació I-PAST_MEDICAL_HISTORY -ésta, I-PAST_MEDICAL_HISTORY -agregándose I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -puerperio I-PAST_MEDICAL_HISTORY -anhedonia, I-PAST_MEDICAL_HISTORY -intolerancia, I-PAST_MEDICAL_HISTORY -irritabilidad I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -labilidad I-PAST_MEDICAL_HISTORY -emocional, I-PAST_MEDICAL_HISTORY -síntomas I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -cuales I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -consultó. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al I-PAST_MEDICAL_HISTORY -reiniciar I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -sexual, I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -parto, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -oportunidad I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -marido I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -bajo I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -efecto I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -alcohol, I-PAST_MEDICAL_HISTORY -reaparecieron I-PAST_MEDICAL_HISTORY -imágenes I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -percepciones I-PAST_MEDICAL_HISTORY -olfativas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -padre I-PAST_MEDICAL_HISTORY -abusaba I-PAST_MEDICAL_HISTORY -sexualmente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ella. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -volvió I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -«sentir I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -olor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -padre» I-PAST_MEDICAL_HISTORY -cerca I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ella. I-PAST_MEDICAL_HISTORY -Antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -este I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -recuerdos I-PAST_MEDICAL_HISTORY -borrosos I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -abuso I-PAST_MEDICAL_HISTORY -sufrido I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -niñez. I-PAST_MEDICAL_HISTORY -Después I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -este I-PAST_MEDICAL_HISTORY -incidente, I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -imágenes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -abuso I-PAST_MEDICAL_HISTORY -infantil I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -presentaron I-PAST_MEDICAL_HISTORY -egodistónicamente I-PAST_MEDICAL_HISTORY -cada I-PAST_MEDICAL_HISTORY -vez I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -relaciones I-PAST_MEDICAL_HISTORY -sexuales. I-PAST_MEDICAL_HISTORY -Además, I-PAST_MEDICAL_HISTORY -aparecieron I-PAST_MEDICAL_HISTORY -síntomas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipervigilancia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -conductas I-PAST_MEDICAL_HISTORY -evitativas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -sexual, I-PAST_MEDICAL_HISTORY -originándose I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -frigidez I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -serios I-PAST_MEDICAL_HISTORY -problemas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pareja. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -violación I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -disfunción I-PAST_MEDICAL_HISTORY -sexual I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -habían I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -develadas I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente. I-PAST_MEDICAL_HISTORY -Un I-PAST_MEDICAL_HISTORY -ejemplo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -anterior I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -constata I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -ficha I-PAST_MEDICAL_HISTORY -clínica, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -consulta I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -ginecología I-PAST_MEDICAL_HISTORY -previa I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -matrimonio I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -fibroadenoma I-PAST_MEDICAL_HISTORY -mamario, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -médico I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -atendió I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -esa I-PAST_MEDICAL_HISTORY -oportunidad I-PAST_MEDICAL_HISTORY -consignó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -antecedentes: I-PAST_MEDICAL_HISTORY -nulípara I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -relaciones I-PAST_MEDICAL_HISTORY -sexuales, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -referencia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -traumáticos I-PAST_MEDICAL_HISTORY -sexuales. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Evolución B-EVOLUTION +LLA I-PAST_MEDICAL_HISTORY +común, I-PAST_MEDICAL_HISTORY +(Philadelphia I-PAST_MEDICAL_HISTORY +negativo). I-PAST_MEDICAL_HISTORY +Inducción B-TREATMENT +con I-TREATMENT +esquema I-TREATMENT +LLA I-TREATMENT +15-30 I-TREATMENT +según I-TREATMENT +protocolo, I-TREATMENT +con I-TREATMENT +rápida I-TREATMENT +respuesta I-TREATMENT +y I-TREATMENT +remisión I-TREATMENT +completa. I-TREATMENT +En I-TREATMENT +la I-TREATMENT +etapa I-TREATMENT +de I-TREATMENT +consolidación I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +QI I-TREATMENT +triple I-TREATMENT +(Metrotrexato I-TREATMENT +15 I-TREATMENT +mg, I-TREATMENT +Citarabina I-TREATMENT +50 I-TREATMENT +mg, I-TREATMENT +Betametasona I-TREATMENT +4 I-TREATMENT +mg). I-TREATMENT +Durante B-EVOLUTION +esta I-EVOLUTION +etapa I-EVOLUTION +apareció I-EVOLUTION +neutropenia I-EVOLUTION y I-EVOLUTION -tratamiento. I-EVOLUTION -La I-EVOLUTION -paciente I-EVOLUTION -experimentó I-EVOLUTION -un I-EVOLUTION -gran I-EVOLUTION -alivio I-EVOLUTION -cuando I-EVOLUTION -el I-EVOLUTION -médico I-EVOLUTION -general I-EVOLUTION -le I-EVOLUTION -preguntó I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -antecedente I-EVOLUTION -de I-EVOLUTION -abuso I-EVOLUTION -sexual. I-EVOLUTION -Uno I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -aspectos I-EVOLUTION -que I-EVOLUTION -más I-EVOLUTION -la I-EVOLUTION -habían I-EVOLUTION -angustiado I-EVOLUTION -durante I-EVOLUTION -su I-EVOLUTION -vida I-EVOLUTION -era I-EVOLUTION el I-EVOLUTION -miedo I-EVOLUTION -de I-EVOLUTION -que I-EVOLUTION -otras I-EVOLUTION -personas, I-EVOLUTION -incluyendo I-EVOLUTION -su I-EVOLUTION -marido, I-EVOLUTION -supiesen I-EVOLUTION +mielograma I-EVOLUTION +mostró I-EVOLUTION +71% I-EVOLUTION de I-EVOLUTION -su I-EVOLUTION -historia I-EVOLUTION -traumática I-EVOLUTION -sexual, I-EVOLUTION -pues I-EVOLUTION -se I-EVOLUTION -imaginaba I-EVOLUTION -que I-EVOLUTION -sería I-EVOLUTION -rechazada I-EVOLUTION +linfoblastos I-EVOLUTION y I-EVOLUTION -enjuiciada, I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -para I-EVOLUTION -su I-EVOLUTION -alivio I-EVOLUTION -no I-EVOLUTION -ocurrió. I-EVOLUTION - I-EVOLUTION -Con I-EVOLUTION -el I-EVOLUTION -equipo I-EVOLUTION +presencia I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -especialidad I-EVOLUTION -habló I-EVOLUTION +blastos I-EVOLUTION +en I-EVOLUTION +LCR, I-EVOLUTION +sin I-EVOLUTION +síntomas I-EVOLUTION +neurológicos. I-EVOLUTION +Se I-EVOLUTION +definió I-EVOLUTION +como I-EVOLUTION +una I-EVOLUTION +recaída I-EVOLUTION +combinada I-EVOLUTION +precoz. I-EVOLUTION +En B-TREATMENT +la I-TREATMENT +terapia I-TREATMENT +de I-TREATMENT +rescate, I-TREATMENT +recibió I-TREATMENT +seis I-TREATMENT +pulsos I-TREATMENT +de I-TREATMENT +QI, I-TREATMENT +lográndose I-TREATMENT +remisión I-TREATMENT +completa I-TREATMENT +y I-TREATMENT +desaparición I-TREATMENT +de I-TREATMENT +los I-TREATMENT +blastos I-TREATMENT +del I-TREATMENT +LCR. I-TREATMENT +Al I-TREATMENT +octavo I-TREATMENT +mes I-TREATMENT +se I-TREATMENT +continuó I-TREATMENT +con I-TREATMENT +block I-TREATMENT +R2. I-TREATMENT +Después B-EVOLUTION +del I-EVOLUTION +primer I-EVOLUTION +procedimiento I-EVOLUTION +intratecal I-EVOLUTION +inició I-EVOLUTION +inestabilidad I-EVOLUTION de I-EVOLUTION -sus I-EVOLUTION -otros I-EVOLUTION -antecedentes I-EVOLUTION -traumáticos. I-EVOLUTION -Posteriormente I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -tercera I-EVOLUTION -intervención, I-EVOLUTION la I-EVOLUTION +marcha. I-EVOLUTION +El B-EXPLORATION +examen I-EXPLORATION +neurológico I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +paciente I-EXPLORATION +vigil, I-EXPLORATION +orientado, I-EXPLORATION +sin I-EXPLORATION +alteración I-EXPLORATION +de I-EXPLORATION +pares I-EXPLORATION +craneanos, I-EXPLORATION +ni I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +potencia I-EXPLORATION +muscular, I-EXPLORATION +ROT I-EXPLORATION +preservados, I-EXPLORATION +marcha I-EXPLORATION +insegura, I-EXPLORATION +Romberg I-EXPLORATION +positivo I-EXPLORATION +y I-EXPLORATION +alteración I-EXPLORATION +propioceptiva I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +EEII, I-EXPLORATION +prueba I-EXPLORATION +índice-nariz I-EXPLORATION +y I-EXPLORATION +talón-rodilla I-EXPLORATION +normales. I-EXPLORATION +Se B-TREATMENT +suspendió I-TREATMENT +quimioterapia, I-TREATMENT +iniciándose I-TREATMENT +Tiamina I-TREATMENT +90 I-TREATMENT +mg I-TREATMENT +c/12 I-TREATMENT +h, I-TREATMENT +Piridoxina I-TREATMENT +150 I-TREATMENT +mg I-TREATMENT +c/12 I-TREATMENT +h, I-TREATMENT +Leucovorina I-TREATMENT +50 I-TREATMENT +mg I-TREATMENT +c/12 I-TREATMENT +h, I-TREATMENT +Cianocobalamina I-TREATMENT +2 I-TREATMENT +ampollas I-TREATMENT +y I-TREATMENT +c/24 I-TREATMENT +h I-TREATMENT +Meteonina I-TREATMENT +S-adenosylmetionina. I-TREATMENT + I-TREATMENT +Dos B-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION paciente I-EVOLUTION -refirió I-EVOLUTION -sus I-EVOLUTION -traumas I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -marido, I-EVOLUTION -quien I-EVOLUTION -no I-EVOLUTION -sólo I-EVOLUTION +vigil I-EVOLUTION +con I-EVOLUTION +funciones I-EVOLUTION +superiores I-EVOLUTION +preservadas, I-EVOLUTION +había I-EVOLUTION +progresado I-EVOLUTION la I-EVOLUTION -comprendió I-EVOLUTION -sino I-EVOLUTION -que I-EVOLUTION -también I-EVOLUTION -le I-EVOLUTION -brindó I-EVOLUTION -apoyo. I-EVOLUTION -Después I-EVOLUTION +inestabilidad I-EVOLUTION de I-EVOLUTION -este I-EVOLUTION -acontecimiento I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION -mejoró I-EVOLUTION -sustancialmente, I-EVOLUTION -remitieron I-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -depresivos, I-EVOLUTION +marcha, I-EVOLUTION +agregándose I-EVOLUTION +hipostesia I-EVOLUTION +táctil, I-EVOLUTION +dificultad I-EVOLUTION +para I-EVOLUTION la I-EVOLUTION -disfunción I-EVOLUTION -sexual I-EVOLUTION +bipedestación I-EVOLUTION +por I-EVOLUTION +debilidad I-EVOLUTION +proximal I-EVOLUTION +de I-EVOLUTION +EEII, I-EVOLUTION +hiperreflexia, I-EVOLUTION +Babinski I-EVOLUTION +e I-EVOLUTION +incontinencia I-EVOLUTION +urinaria. I-EVOLUTION +RM B-EXPLORATION +de I-EXPLORATION +médula I-EXPLORATION +mostró I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +señal I-EXPLORATION +en I-EXPLORATION +cordones I-EXPLORATION +posteriores I-EXPLORATION +desde I-EXPLORATION +cervical I-EXPLORATION +a I-EXPLORATION +T11. I-EXPLORATION + I-EXPLORATION +Al B-EVOLUTION +sexto I-EVOLUTION +día I-EVOLUTION +aumentó I-EVOLUTION +la I-EVOLUTION +debilidad I-EVOLUTION +en I-EVOLUTION +EEII I-EVOLUTION y I-EVOLUTION +pared I-EVOLUTION +abdominal, I-EVOLUTION +ROT I-EVOLUTION +apagados, I-EVOLUTION +Babinski, I-EVOLUTION +las I-EVOLUTION +alteraciones I-EVOLUTION +propioceptivas I-EVOLUTION +persistían, I-EVOLUTION +tenía I-EVOLUTION +preservada I-EVOLUTION +la I-EVOLUTION +sensibilidad I-EVOLUTION +dolorosa, I-EVOLUTION +sin I-EVOLUTION +compromiso I-EVOLUTION +en I-EVOLUTION +EESS. I-EVOLUTION +En I-EVOLUTION el I-EVOLUTION -maltrato I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -hija. I-EVOLUTION - I-EVOLUTION -Asistió I-EVOLUTION +día I-EVOLUTION +decimosegundo I-EVOLUTION +tenía I-EVOLUTION +paraplejia I-EVOLUTION +fláccida, I-EVOLUTION +ROT I-EVOLUTION +abolidos, I-EVOLUTION +sin I-EVOLUTION +nivel I-EVOLUTION +sensitivo. I-EVOLUTION +Un I-EVOLUTION +hemograma I-EVOLUTION +con I-EVOLUTION +recaída I-EVOLUTION +leucémica I-EVOLUTION en I-EVOLUTION -total I-EVOLUTION +el I-EVOLUTION +día I-EVOLUTION +decimonono I-EVOLUTION +obligó I-EVOLUTION a I-EVOLUTION -cinco I-EVOLUTION -controles I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -Unidad I-EVOLUTION -de I-EVOLUTION -Psiquiatría I-EVOLUTION +continuar I-EVOLUTION +con I-EVOLUTION +cuidados I-EVOLUTION +paliativos I-EVOLUTION en I-EVOLUTION -los I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -constató I-EVOLUTION su I-EVOLUTION -mejoría. I-EVOLUTION -Durante B-TREATMENT -ese I-TREATMENT -tiempo I-TREATMENT -se I-TREATMENT -la I-TREATMENT -trató I-TREATMENT -con I-TREATMENT -fluoxetina I-TREATMENT -20 I-TREATMENT -mg/día I-TREATMENT -y I-TREATMENT -meleril I-TREATMENT -25 I-TREATMENT -mg/día. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -el I-EVOLUTION -equipo I-EVOLUTION +domicilio. I-EVOLUTION +El I-EVOLUTION +compromiso I-EVOLUTION +neurológico I-EVOLUTION +no I-EVOLUTION +progresó, I-EVOLUTION +falleciendo I-EVOLUTION de I-EVOLUTION -salud I-EVOLUTION -mental I-EVOLUTION -se I-EVOLUTION -enteró I-EVOLUTION -que I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION -estaba I-EVOLUTION -asintomática, I-EVOLUTION -trabajando I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -conflictos I-EVOLUTION -de I-EVOLUTION -pareja. I-EVOLUTION +LLA. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer, I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +Sra. I-PRESENT_ILLNESS +A, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +39 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -intenso, I-PAST_MEDICAL_HISTORY -bronquítico I-PAST_MEDICAL_HISTORY -crónico, I-PAST_MEDICAL_HISTORY -portador I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -(HTA) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -prostático I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución. I-PAST_MEDICAL_HISTORY -Enfermedad B-PRESENT_ILLNESS -actual: I-PRESENT_ILLNESS -comenzó I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -4/6/04 I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +quien I-PRESENT_ILLNESS +viene I-PRESENT_ILLNESS +citada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS +programada I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +juzgado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +instrucción, I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -precordial I-PRESENT_ILLNESS -opresivo. I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +fin I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dilucidar I-PRESENT_ILLNESS +si I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +víctima I-PRESENT_ILLNESS +o I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +negligencia I-PRESENT_ILLNESS +médica. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Como I-PRESENT_ILLNESS +prolegómeno I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +caso, I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +hospitalarias I-PRESENT_ILLNESS +refiriendo I-PRESENT_ILLNESS +haber I-PRESENT_ILLNESS +sufrido I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +posteriormente I-PRESENT_ILLNESS +fuera I-PRESENT_ILLNESS +catalogado I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +luxación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +rodilla I-PRESENT_ILLNESS +izquierda, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +resolvió I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +manera I-PRESENT_ILLNESS +espontánea. I-PRESENT_ILLNESS Se B-TREATMENT -diagnosticó I-TREATMENT -infarto I-TREATMENT -agudo I-TREATMENT +actúa I-TREATMENT de I-TREATMENT -miocardio I-TREATMENT -y I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -fibrinolítico I-TREATMENT -sistémico I-TREATMENT +forma I-TREATMENT +conservadora, I-TREATMENT +observándose I-TREATMENT +tras I-TREATMENT +dos I-TREATMENT +semanas I-TREATMENT +de I-TREATMENT +inmovilización I-TREATMENT +inguino-pédica I-TREATMENT +una I-TREATMENT +buena I-TREATMENT +evolución I-TREATMENT +clínica I-TREATMENT +que I-TREATMENT +no I-TREATMENT +se I-TREATMENT +corresponde I-TREATMENT con I-TREATMENT -estreptoquinasa. I-TREATMENT -Reapareció B-EXPLORATION -angor, I-EXPLORATION -realizándose I-EXPLORATION -cineangiocoronariografía I-EXPLORATION -(CACG) I-EXPLORATION -de I-EXPLORATION -urgencia I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -arterias I-EXPLORATION -coronarias I-EXPLORATION -sin I-EXPLORATION -lesiones I-EXPLORATION -significativas. I-EXPLORATION -En B-EVOLUTION -forma I-EVOLUTION -inmediata I-EVOLUTION -al I-EVOLUTION -inicio I-EVOLUTION +la I-TREATMENT +percepción I-TREATMENT +de I-TREATMENT +la I-TREATMENT +propia I-TREATMENT +lesionada. I-TREATMENT +Desde I-TREATMENT +entonces I-TREATMENT +se I-TREATMENT +manifiesta I-TREATMENT +como I-TREATMENT +un I-TREATMENT +cuadro I-TREATMENT +clínico I-TREATMENT +de I-TREATMENT +anquilosis I-TREATMENT +de I-TREATMENT +rodilla, I-TREATMENT +siendo I-TREATMENT +sometida I-TREATMENT +a I-TREATMENT +tratamiento I-TREATMENT +rehabilitador I-TREATMENT +sin I-TREATMENT +éxito I-TREATMENT +alguno. I-TREATMENT +La B-EVOLUTION +evolución I-EVOLUTION del I-EVOLUTION -procedimiento, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -frialdad I-EVOLUTION -intensa I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -ambos I-EVOLUTION -miembros I-EVOLUTION -inferiores I-EVOLUTION -de I-EVOLUTION -predominio I-EVOLUTION -distal, I-EVOLUTION -con I-EVOLUTION -cianosis I-EVOLUTION +proceso I-EVOLUTION +fue I-EVOLUTION +tórpida, I-EVOLUTION +proponiéndose I-EVOLUTION +finalmente I-EVOLUTION +intervención I-EVOLUTION +quirúrgica I-EVOLUTION de I-EVOLUTION -dedos I-EVOLUTION +rodilla I-EVOLUTION +bajo I-EVOLUTION +el I-EVOLUTION +diagnóstico I-EVOLUTION +clínico I-EVOLUTION de I-EVOLUTION -los I-EVOLUTION -pies. I-EVOLUTION -Concomitantemente I-EVOLUTION -apareció I-EVOLUTION -epigastralgia, I-EVOLUTION -náuseas I-EVOLUTION -y I-EVOLUTION -vómitos. I-EVOLUTION +"artrofibrosis", I-EVOLUTION +que I-EVOLUTION +es I-EVOLUTION +suspendida I-EVOLUTION +a I-EVOLUTION +criterio I-EVOLUTION +del I-EVOLUTION +cirujano, I-EVOLUTION +por I-EVOLUTION +no I-EVOLUTION +encontrar I-EVOLUTION +base I-EVOLUTION +clínica I-EVOLUTION +que I-EVOLUTION +justificara I-EVOLUTION +la I-EVOLUTION +sintomatología I-EVOLUTION +padecida. I-EVOLUTION I-EVOLUTION -Al B-EXPLORATION -examen I-EXPLORATION -destacaba I-EXPLORATION -cianosis I-EXPLORATION +Tras I-EVOLUTION +este I-EVOLUTION +último I-EVOLUTION +episodio, I-EVOLUTION +la I-EVOLUTION +interesada I-EVOLUTION +decide I-EVOLUTION +emitir I-EVOLUTION +denuncia I-EVOLUTION +por I-EVOLUTION +negligencia I-EVOLUTION +médica, I-EVOLUTION +haciéndola I-EVOLUTION +extensible I-EVOLUTION +a I-EVOLUTION +todos I-EVOLUTION +aquellos I-EVOLUTION +especialistas I-EVOLUTION +que I-EVOLUTION +estuvieron I-EVOLUTION +atendiéndola I-EVOLUTION +desde I-EVOLUTION +el I-EVOLUTION +principio. I-EVOLUTION + I-EVOLUTION +Acude B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +Médico I-PRESENT_ILLNESS +Forense I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +primera I-PRESENT_ILLNESS +asistencia I-PRESENT_ILLNESS +recibida I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +urgencias, I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +poco I-PRESENT_ILLNESS +tiempo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +ser I-PRESENT_ILLNESS +emitida I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +denuncia, I-PRESENT_ILLNESS +siendo I-PRESENT_ILLNESS +citada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS +programada I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +dependencias I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +Instituto I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Medicina I-PRESENT_ILLNESS +Legal I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Huelva, I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +compañía I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +cónyuge I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +muleta I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +descarga. I-PRESENT_ILLNESS +Se B-EXPLORATION +aprecia I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +hipotrofia I-EXPLORATION +moderada I-EXPLORATION +global I-EXPLORATION de I-EXPLORATION -dedos I-EXPLORATION +la I-EXPLORATION +musculatura I-EXPLORATION +del I-EXPLORATION +miembro I-EXPLORATION +inferior I-EXPLORATION +izquierdo I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +total I-EXPLORATION +falta I-EXPLORATION de I-EXPLORATION -pies, I-EXPLORATION -con I-EXPLORATION -necrosis I-EXPLORATION -seca I-EXPLORATION +movilidad I-EXPLORATION +de I-EXPLORATION +rodilla I-EXPLORATION +homolateral I-EXPLORATION en I-EXPLORATION -3º, I-EXPLORATION -4º I-EXPLORATION +flexoextensión. I-EXPLORATION +No I-EXPLORATION +existe I-EXPLORATION +componente I-EXPLORATION +inflamatorio I-EXPLORATION +asociado I-EXPLORATION y I-EXPLORATION -5º I-EXPLORATION -dedos I-EXPLORATION -derechos I-EXPLORATION +presenta I-EXPLORATION +genu I-EXPLORATION +valgo I-EXPLORATION +bilateral. I-EXPLORATION +Se I-EXPLORATION +detecta I-EXPLORATION +durante I-EXPLORATION +la I-EXPLORATION +entrevista I-EXPLORATION +un I-EXPLORATION +marcado I-EXPLORATION +componente I-EXPLORATION +conversivo. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +inicial I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +mediante I-EXPLORATION +entrevista I-EXPLORATION +semiestructurada I-EXPLORATION +bajo I-EXPLORATION +los I-EXPLORATION +criterios I-EXPLORATION +propuestos I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +clasificación I-EXPLORATION +DSM I-EXPLORATION +IV-TR. I-EXPLORATION + I-EXPLORATION +Tras I-EXPLORATION +acordarse I-EXPLORATION +entrevista I-EXPLORATION y I-EXPLORATION -3º I-EXPLORATION +exploración I-EXPLORATION +pormenorizada I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +Psicólogo I-EXPLORATION +Forense I-EXPLORATION +se I-EXPLORATION +decide I-EXPLORATION +pasar I-EXPLORATION +el I-EXPLORATION +test I-EXPLORATION +MMPI I-EXPLORATION +(Inventario I-EXPLORATION +Multifásico I-EXPLORATION +de I-EXPLORATION +Personalidad I-EXPLORATION +de I-EXPLORATION +Minessotta), I-EXPLORATION +destacando I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +mismo I-EXPLORATION +un I-EXPLORATION +marcado I-EXPLORATION +perfil I-EXPLORATION +represivo I-EXPLORATION y I-EXPLORATION -5º I-EXPLORATION -dedos I-EXPLORATION -izquierdos. I-EXPLORATION - I-EXPLORATION -Examen I-EXPLORATION -cardiovascular: I-EXPLORATION -ritmo I-EXPLORATION -irregular I-EXPLORATION -110 I-EXPLORATION -lpm, I-EXPLORATION -pulsos I-EXPLORATION -distales I-EXPLORATION -conservados, I-EXPLORATION -simétricos I-EXPLORATION +una I-EXPLORATION +elevada I-EXPLORATION +preocupación I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +salud I-EXPLORATION en I-EXPLORATION -4 I-EXPLORATION -miembros. I-EXPLORATION +forma I-EXPLORATION +de I-EXPLORATION +hipocondría, I-EXPLORATION +que I-EXPLORATION +daría I-EXPLORATION +finalmente I-EXPLORATION +lugar I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +manifestaciones I-EXPLORATION +histéricas I-EXPLORATION +a I-EXPLORATION +modo I-EXPLORATION +de I-EXPLORATION +quejas I-EXPLORATION +somáticas I-EXPLORATION +(somatizaciones). I-EXPLORATION I-EXPLORATION -Exámenes I-EXPLORATION +Se I-EXPLORATION +decide I-EXPLORATION +corroborar I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +mediante I-EXPLORATION +sesión I-EXPLORATION +programada I-EXPLORATION de I-EXPLORATION -laboratorio. I-EXPLORATION -Azoemia: I-EXPLORATION -140 I-EXPLORATION -mg/dL. I-EXPLORATION -Creatininemia: I-EXPLORATION -5, I-EXPLORATION -8 I-EXPLORATION -mg/dL I-EXPLORATION -(función I-EXPLORATION -renal I-EXPLORATION -3 I-EXPLORATION -meses I-EXPLORATION -previos I-EXPLORATION -normal). I-EXPLORATION -Depuración I-EXPLORATION +hipnosis, I-EXPLORATION +previo I-EXPLORATION +consentimiento I-EXPLORATION de I-EXPLORATION -creatinina: I-EXPLORATION -11 I-EXPLORATION -ml/min. I-EXPLORATION -Hemograma, I-EXPLORATION -ionograma I-EXPLORATION -sanguíneo I-EXPLORATION -y I-EXPLORATION -glicemia: I-EXPLORATION -normales. I-EXPLORATION -Examen I-EXPLORATION +la I-EXPLORATION +interesada, I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +objetivo I-EXPLORATION de I-EXPLORATION -orina: I-EXPLORATION -densidad I-EXPLORATION -1015; I-EXPLORATION -proteínas I-EXPLORATION -2, I-EXPLORATION -09 I-EXPLORATION -g/L; I-EXPLORATION -hematíes+++; I-EXPLORATION -leucocitos++. I-EXPLORATION -Antígeno I-EXPLORATION -prostático I-EXPLORATION -específico: I-EXPLORATION -2, I-EXPLORATION -4 I-EXPLORATION -ng/mL. I-EXPLORATION -Ecografía I-EXPLORATION -aparato I-EXPLORATION -urinario: I-EXPLORATION -tamaño I-EXPLORATION -renal I-EXPLORATION +conseguir I-EXPLORATION +la I-EXPLORATION +flexión I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +rodilla I-EXPLORATION +anquilosada. I-EXPLORATION + I-EXPLORATION +Método: I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +proceso I-EXPLORATION +hipnótico I-EXPLORATION +se I-EXPLORATION +desarrolla I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +propias I-EXPLORATION +dependencias I-EXPLORATION +del I-EXPLORATION +Instituto I-EXPLORATION +de I-EXPLORATION +Medicina I-EXPLORATION +Legal I-EXPLORATION +de I-EXPLORATION +Huelva, I-EXPLORATION +previa I-EXPLORATION +sesión I-EXPLORATION +preparatoria I-EXPLORATION +en I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +explican I-EXPLORATION +las I-EXPLORATION +bases I-EXPLORATION +del I-EXPLORATION +mismo I-EXPLORATION y I-EXPLORATION -espesor I-EXPLORATION -parenquimatoso I-EXPLORATION -conservados, I-EXPLORATION -leve I-EXPLORATION -dilatación I-EXPLORATION -pielocalicial I-EXPLORATION -izquierda, I-EXPLORATION -hipertrofia I-EXPLORATION -prostática I-EXPLORATION -grado I-EXPLORATION -III. I-EXPLORATION -ECG: I-EXPLORATION -fibrilación I-EXPLORATION -auricular I-EXPLORATION -con I-EXPLORATION -frecuencia I-EXPLORATION -promedio I-EXPLORATION +se I-EXPLORATION +trata I-EXPLORATION de I-EXPLORATION -90 I-EXPLORATION -lpm. I-EXPLORATION -Radiografía I-EXPLORATION +conseguir I-EXPLORATION +un I-EXPLORATION +adecuado I-EXPLORATION +vínculo I-EXPLORATION +explorador-explorada, I-EXPLORATION +estando I-EXPLORATION +presentes I-EXPLORATION +durante I-EXPLORATION +su I-EXPLORATION +desarrollo I-EXPLORATION +tanto I-EXPLORATION +el I-EXPLORATION +Médico I-EXPLORATION +Forense I-EXPLORATION +como I-EXPLORATION +el I-EXPLORATION +Psicólogo I-EXPLORATION +Forense I-EXPLORATION +encargado I-EXPLORATION de I-EXPLORATION -tórax: I-EXPLORATION -normal. I-EXPLORATION -Ecocardiograma: I-EXPLORATION -hipertrofia I-EXPLORATION -ventricular I-EXPLORATION -izquierda, I-EXPLORATION -dilatación I-EXPLORATION +llevarlo I-EXPLORATION +a I-EXPLORATION +cabo. I-EXPLORATION +Para I-EXPLORATION +ello I-EXPLORATION +se I-EXPLORATION +coloca I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +Sra. I-EXPLORATION +A I-EXPLORATION +en I-EXPLORATION +posición I-EXPLORATION de I-EXPLORATION -aurícula I-EXPLORATION -izquierda, I-EXPLORATION -fracción I-EXPLORATION +decúbito I-EXPLORATION +supino, I-EXPLORATION +sobre I-EXPLORATION +una I-EXPLORATION +camilla I-EXPLORATION +estándar I-EXPLORATION de I-EXPLORATION -eyección I-EXPLORATION -ventricular I-EXPLORATION -izquierda: I-EXPLORATION -57%. I-EXPLORATION -Doppler I-EXPLORATION -arterial I-EXPLORATION -miembros I-EXPLORATION -inferiores: I-EXPLORATION -lesiones I-EXPLORATION -hemodinámicamente I-EXPLORATION -significativas I-EXPLORATION +consulta, I-EXPLORATION +cuya I-EXPLORATION +base I-EXPLORATION +basculante I-EXPLORATION +fue I-EXPLORATION +recogida, I-EXPLORATION +de I-EXPLORATION +manera I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +rodilla I-EXPLORATION +sana I-EXPLORATION +cayera I-EXPLORATION en I-EXPLORATION -sector I-EXPLORATION -ilíaco I-EXPLORATION +flexión I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +efecto I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +gravedad, I-EXPLORATION +quedando I-EXPLORATION +la I-EXPLORATION +rodilla I-EXPLORATION +izquierda I-EXPLORATION +en I-EXPLORATION +extensión I-EXPLORATION +completa I-EXPLORATION y I-EXPLORATION -femoral I-EXPLORATION -común, I-EXPLORATION -bilaterales; I-EXPLORATION -arterias I-EXPLORATION -distales I-EXPLORATION -sin I-EXPLORATION -lesiones I-EXPLORATION -significativas. I-EXPLORATION -Colonoscopia: I-EXPLORATION -edema I-EXPLORATION +sobresaliendo I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +límites I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +camilla. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +proceso I-EXPLORATION +se I-EXPLORATION +desarrolló I-EXPLORATION +bajo I-EXPLORATION +una I-EXPLORATION +atmósfera I-EXPLORATION +empática I-EXPLORATION y I-EXPLORATION -lesiones I-EXPLORATION -ulceradas I-EXPLORATION -superficiales I-EXPLORATION -cubiertas I-EXPLORATION +relajada, I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +buena I-EXPLORATION +predisposición I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +colaboración I-EXPLORATION por I-EXPLORATION -fibrina, I-EXPLORATION -desde I-EXPLORATION -recto I-EXPLORATION -bajo I-EXPLORATION -hasta I-EXPLORATION -sigmoides I-EXPLORATION -proximal, I-EXPLORATION -donde I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -eran I-EXPLORATION -más I-EXPLORATION -extensas I-EXPLORATION -e I-EXPLORATION -impidieron I-EXPLORATION -proseguir I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -(aspecto I-EXPLORATION +parte I-EXPLORATION de I-EXPLORATION -colitis I-EXPLORATION -isquémica). I-EXPLORATION -Biopsia I-EXPLORATION +la I-EXPLORATION +paciente. I-EXPLORATION +La I-EXPLORATION +inducción I-EXPLORATION +hipnótica I-EXPLORATION +se I-EXPLORATION +inició I-EXPLORATION +a I-EXPLORATION +partir I-EXPLORATION de I-EXPLORATION -colon I-EXPLORATION -sigmoides: I-EXPLORATION -sin I-EXPLORATION -elementos I-EXPLORATION +instrucciones I-EXPLORATION +dirigidas I-EXPLORATION +a I-EXPLORATION +favorecer I-EXPLORATION +la I-EXPLORATION +relajación I-EXPLORATION de I-EXPLORATION -especificidad. I-EXPLORATION -Gastroscopia: I-EXPLORATION -lesiones I-EXPLORATION -ulceradas I-EXPLORATION +la I-EXPLORATION +paciente, I-EXPLORATION +empleando I-EXPLORATION +para I-EXPLORATION +ello I-EXPLORATION +una I-EXPLORATION +técnica I-EXPLORATION +de I-EXPLORATION +relajación I-EXPLORATION +muscular I-EXPLORATION +(visualización I-EXPLORATION +corporal I-EXPLORATION +o I-EXPLORATION +"imaging"), I-EXPLORATION +seguida I-EXPLORATION +de I-EXPLORATION +"instrucciones I-EXPLORATION +de I-EXPLORATION +imaginación" I-EXPLORATION +(visualización I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +escalera I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +desciende I-EXPLORATION +peldaño I-EXPLORATION +a I-EXPLORATION +peldaño, I-EXPLORATION +acompañando I-EXPLORATION +ésta I-EXPLORATION +del I-EXPLORATION +mensaje I-EXPLORATION +sugestivo I-EXPLORATION +de I-EXPLORATION +"profundización I-EXPLORATION en I-EXPLORATION -cara I-EXPLORATION -anterior I-EXPLORATION +el I-EXPLORATION +estado I-EXPLORATION +hipnótico") I-EXPLORATION y I-EXPLORATION -posterior I-EXPLORATION -de I-EXPLORATION -duodeno. I-EXPLORATION -Fondo I-EXPLORATION +finalizando I-EXPLORATION +este I-EXPLORATION +primer I-EXPLORATION +estadio I-EXPLORATION +con I-EXPLORATION +instrucciones I-EXPLORATION de I-EXPLORATION -ojo: I-EXPLORATION -embolias I-EXPLORATION -colesterínicas I-EXPLORATION +actuación, I-EXPLORATION en I-EXPLORATION -retina I-EXPLORATION -izquierda. I-EXPLORATION -Biopsia I-EXPLORATION +concreto I-EXPLORATION +la I-EXPLORATION de I-EXPLORATION -piel: I-EXPLORATION -cristales I-EXPLORATION +"elevación I-EXPLORATION +del I-EXPLORATION +brazo". I-EXPLORATION +Dichas I-EXPLORATION +técnicas I-EXPLORATION +están I-EXPLORATION +encaminadas I-EXPLORATION +tanto I-EXPLORATION +a I-EXPLORATION +una I-EXPLORATION +mayor I-EXPLORATION +predisposición I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +sugestión I-EXPLORATION +como I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +evaluación I-EXPLORATION de I-EXPLORATION -colesterol I-EXPLORATION -ocluyendo I-EXPLORATION la I-EXPLORATION -luz I-EXPLORATION +misma. I-EXPLORATION +Una I-EXPLORATION +vez I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +Inducción I-EXPLORATION +Hipnótica I-EXPLORATION +ha I-EXPLORATION +logrado I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +focalice I-EXPLORATION +su I-EXPLORATION +atención I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +instrucciones I-EXPLORATION +emitidas I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +psicólogo I-EXPLORATION +y I-EXPLORATION +que I-EXPLORATION +otras I-EXPLORATION +fuentes I-EXPLORATION de I-EXPLORATION -vasos I-EXPLORATION +información I-EXPLORATION +pasen I-EXPLORATION +a I-EXPLORATION +ser I-EXPLORATION +secundarias I-EXPLORATION +(ruidos I-EXPLORATION +ambientales, I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -mediano I-EXPLORATION -calibre; I-EXPLORATION -trombosis I-EXPLORATION -vascular I-EXPLORATION +otras I-EXPLORATION +personas, I-EXPLORATION +etcétera), I-EXPLORATION +se I-EXPLORATION +ha I-EXPLORATION +logrado I-EXPLORATION +una I-EXPLORATION +buena I-EXPLORATION +disposición I-EXPLORATION +a I-EXPLORATION +que I-EXPLORATION +las I-EXPLORATION +instrucciones I-EXPLORATION +hipnóticas I-EXPLORATION +cobren I-EXPLORATION +más I-EXPLORATION +relevancia I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +pueda I-EXPLORATION +iniciar I-EXPLORATION +el I-EXPLORATION +trabajo I-EXPLORATION +sugestivo I-EXPLORATION +propuesto. I-EXPLORATION +Logrado I-EXPLORATION +el I-EXPLORATION +estado I-EXPLORATION +de I-EXPLORATION +sugestionabilidad I-EXPLORATION +perseguido, I-EXPLORATION +se I-EXPLORATION +procedió I-EXPLORATION +a I-EXPLORATION +orientar I-EXPLORATION +las I-EXPLORATION +sugestiones I-EXPLORATION +hacia I-EXPLORATION +el I-EXPLORATION +síntoma I-EXPLORATION +motor, I-EXPLORATION +ligando I-EXPLORATION +elementos I-EXPLORATION +de I-EXPLORATION +relajación I-EXPLORATION +muscular I-EXPLORATION +con I-EXPLORATION +mensajes I-EXPLORATION +de I-EXPLORATION +carácter I-EXPLORATION +positivo I-EXPLORATION +centrados I-EXPLORATION en I-EXPLORATION -vasos I-EXPLORATION +la I-EXPLORATION +flexión I-EXPLORATION de I-EXPLORATION -pequeño I-EXPLORATION -calibre. I-EXPLORATION - I-EXPLORATION -Evolución B-EVOLUTION -y I-EVOLUTION -tratamiento. I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -evolución, I-EVOLUTION -destacó I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -hemorragia I-EVOLUTION -digestiva I-EVOLUTION -masiva I-EVOLUTION -(reiterado I-EVOLUTION -en I-EVOLUTION -dos I-EVOLUTION -oportunidades) I-EVOLUTION -que B-TREATMENT -requirió I-TREATMENT -uso I-TREATMENT -de I-TREATMENT -tranfusiones; I-TREATMENT -posteriormente, B-EVOLUTION -diarrea I-EVOLUTION -mantenida. I-EVOLUTION -Esto I-EVOLUTION -impidió I-EVOLUTION -su I-EVOLUTION -traslado I-EVOLUTION -para I-EVOLUTION -realización I-EVOLUTION +la I-EXPLORATION +rodilla I-EXPLORATION +[12, I-EXPLORATION +13]. I-EXPLORATION +Tras B-EVOLUTION +aproximadamente I-EVOLUTION +una I-EVOLUTION +hora I-EVOLUTION de I-EVOLUTION -angiorresonancia I-EVOLUTION -magnética I-EVOLUTION -para I-EVOLUTION -evaluación I-EVOLUTION +proceso, I-EVOLUTION +iniciado I-EVOLUTION +con I-EVOLUTION +la I-EVOLUTION +técnica I-EVOLUTION de I-EVOLUTION -aorta I-EVOLUTION -torácica I-EVOLUTION +relajación I-EVOLUTION y I-EVOLUTION -abdominal. I-EVOLUTION -A I-EVOLUTION -nivel I-EVOLUTION -ocular, I-EVOLUTION -presentó I-EVOLUTION -gran I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -agudeza I-EVOLUTION -visual. I-EVOLUTION -Hubo I-EVOLUTION -franco I-EVOLUTION -empeoramiento I-EVOLUTION +finalizado I-EVOLUTION +con I-EVOLUTION +la I-EVOLUTION +recuperación I-EVOLUTION del I-EVOLUTION -dolor I-EVOLUTION +estado I-EVOLUTION de I-EVOLUTION -ambos I-EVOLUTION -miembros I-EVOLUTION -inferiores, I-EVOLUTION -llegando B-TREATMENT -a I-TREATMENT -requerir I-TREATMENT -opiáceos, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -simpaticectomía I-TREATMENT -lumbar I-TREATMENT -unilateral, I-TREATMENT -con I-TREATMENT -criterio I-TREATMENT -analgésico, I-TREATMENT -con I-TREATMENT -resultado I-TREATMENT -favorable. I-TREATMENT - I-TREATMENT -Bajo B-EVOLUTION -tratamiento I-EVOLUTION -médico, I-EVOLUTION +vigilia, I-EVOLUTION se I-EVOLUTION -logró I-EVOLUTION -estabilización I-EVOLUTION -de I-EVOLUTION -cifras I-EVOLUTION +acabó I-EVOLUTION +consiguiendo I-EVOLUTION +una I-EVOLUTION +flexión I-EVOLUTION de I-EVOLUTION -creatinina, I-EVOLUTION -destacando I-EVOLUTION -el I-EVOLUTION -difícil I-EVOLUTION -manejo I-EVOLUTION +rodilla I-EVOLUTION +izquierda I-EVOLUTION de I-EVOLUTION +90º, I-EVOLUTION +recuperando I-EVOLUTION la I-EVOLUTION -HTA, I-EVOLUTION -que I-EVOLUTION -requirió I-EVOLUTION -de I-EVOLUTION -múltiples I-EVOLUTION -fármacos. I-EVOLUTION +posición I-EVOLUTION +anquilótica I-EVOLUTION +inicial I-EVOLUTION +una I-EVOLUTION +vez I-EVOLUTION +concluido. I-EVOLUTION I-EVOLUTION -Como B-TREATMENT -tratamiento I-TREATMENT -tentativo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -enfermedad I-TREATMENT -de I-TREATMENT -base, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -terapia I-TREATMENT -anticoagulante I-TREATMENT -(enoxaparina I-TREATMENT -1 I-TREATMENT -mg/kg I-TREATMENT -peso I-TREATMENT -corporal I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -h) I-TREATMENT -y I-TREATMENT -corticoides I-TREATMENT -(prednisona I-TREATMENT -0, I-TREATMENT -5 I-TREATMENT -mg/kg I-TREATMENT -peso I-TREATMENT -corporal), I-TREATMENT -debiendo I-TREATMENT -ser I-TREATMENT -suspendida I-TREATMENT -por I-TREATMENT -la I-TREATMENT -hemorragia I-TREATMENT -digestiva I-TREATMENT -relatada. I-TREATMENT - I-TREATMENT -Evolución B-EVOLUTION +Posteriormente I-EVOLUTION +se I-EVOLUTION +realizaron I-EVOLUTION +dos I-EVOLUTION +entrevistas I-EVOLUTION +adicionales I-EVOLUTION a I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses. I-EVOLUTION -En I-EVOLUTION +la I-EVOLUTION +Sra. I-EVOLUTION +A, I-EVOLUTION +así I-EVOLUTION +como I-EVOLUTION +otra I-EVOLUTION +a I-EVOLUTION +su I-EVOLUTION +cónyuge, I-EVOLUTION +con I-EVOLUTION el I-EVOLUTION -control: I-EVOLUTION -hubo I-EVOLUTION -caída I-EVOLUTION -espontánea I-EVOLUTION -de I-EVOLUTION -falanges I-EVOLUTION -distales I-EVOLUTION -del I-EVOLUTION -tercer I-EVOLUTION -dedo I-EVOLUTION -de I-EVOLUTION -ambos I-EVOLUTION -pies I-EVOLUTION -y I-EVOLUTION -quinto I-EVOLUTION -dedo I-EVOLUTION -de I-EVOLUTION -pie I-EVOLUTION -izquierdo, I-EVOLUTION -estabilización I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -cifras I-EVOLUTION +fin I-EVOLUTION de I-EVOLUTION -insuficiencia I-EVOLUTION -renal. I-EVOLUTION -Azoemia: I-EVOLUTION -80 I-EVOLUTION -mg/dL. I-EVOLUTION -Creatininemia: I-EVOLUTION -2, I-EVOLUTION -5 I-EVOLUTION -mg/dL. I-EVOLUTION -Continúa I-EVOLUTION -actualmente I-EVOLUTION -bajo I-EVOLUTION -tratamiento I-EVOLUTION -médico I-EVOLUTION +conocer I-EVOLUTION +mejor I-EVOLUTION +el I-EVOLUTION +entorno I-EVOLUTION +psicobiográfico I-EVOLUTION y I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -repetido I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -deterioro I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -agudeza I-EVOLUTION -visual I-EVOLUTION -ni I-EVOLUTION -de I-EVOLUTION -sangrado I-EVOLUTION -digestivo. I-EVOLUTION +contextualizar I-EVOLUTION +adecuadamente I-EVOLUTION +el I-EVOLUTION +proceso I-EVOLUTION +psicogénico. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -51 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -hipotiroidea. B-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -2000 I-PRESENT_ILLNESS -debutó I-PRESENT_ILLNESS +25 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +diagnosticado B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vejiga I-PAST_MEDICAL_HISTORY +hiperrefléxica I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +sección I-PAST_MEDICAL_HISTORY +medular I-PAST_MEDICAL_HISTORY +traumática I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +El B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS +disparos I-PRESENT_ILLNESS +miccionales I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -falla I-PRESENT_ILLNESS -renal, I-PRESENT_ILLNESS -ingresando I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -hemodiálisis I-PRESENT_ILLNESS -crónica. I-PRESENT_ILLNESS -En B-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -años I-EVOLUTION -siguientes I-EVOLUTION -tuvo I-EVOLUTION -múltiples I-EVOLUTION -oclusiones I-EVOLUTION -de I-EVOLUTION -sus I-EVOLUTION -accesos I-EVOLUTION -vasculares, I-EVOLUTION -practicándose B-TREATMENT -fístulas I-TREATMENT -arteriovenosas I-TREATMENT -radiocefálicas I-TREATMENT -y I-TREATMENT -braquiales I-TREATMENT -bilaterales, I-TREATMENT -instalación I-TREATMENT -de I-TREATMENT -prótesis I-TREATMENT -axilohumerales I-TREATMENT -bilaterales I-TREATMENT -de I-TREATMENT -politetrafluoretileno I-TREATMENT -(PTFE) I-TREATMENT -y I-TREATMENT -numerosos I-TREATMENT -catéteres I-TREATMENT -transitorios I-TREATMENT -y I-TREATMENT -tunelizados I-TREATMENT -en I-TREATMENT -posiciones I-TREATMENT -yugular, I-TREATMENT -subclavia I-TREATMENT -y I-TREATMENT -femoral. I-TREATMENT +incontinencia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cuadros I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pielonefritis I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +repetición. I-PRESENT_ILLNESS En B-EXPLORATION -2003 I-EXPLORATION +la I-EXPLORATION +cistografía I-EXPLORATION se I-EXPLORATION -determinó I-EXPLORATION +evidenció I-EXPLORATION +una I-EXPLORATION +vejiga I-EXPLORATION +de I-EXPLORATION +escasa I-EXPLORATION +capacidad, I-EXPLORATION +sin I-EXPLORATION +reflujo I-EXPLORATION +vesicoureteral. I-EXPLORATION +En I-EXPLORATION el I-EXPLORATION -tiempo I-EXPLORATION +estudio I-EXPLORATION +urodinámico I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +un I-EXPLORATION +disparo I-EXPLORATION +miccional I-EXPLORATION +desde I-EXPLORATION +los I-EXPLORATION +60cc I-EXPLORATION de I-EXPLORATION -protrombina, I-EXPLORATION -TTPK, I-EXPLORATION -anticoagulante I-EXPLORATION -lúpico, I-EXPLORATION -VDRL, I-EXPLORATION -antitrombina I-EXPLORATION -III I-EXPLORATION -y I-EXPLORATION -anticuerpos I-EXPLORATION -anticardiolipina I-EXPLORATION -IgG I-EXPLORATION -e I-EXPLORATION -IgM, I-EXPLORATION -los I-EXPLORATION +llenado I-EXPLORATION +con I-EXPLORATION +altas I-EXPLORATION +presiones I-EXPLORATION +vesicales I-EXPLORATION que I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -o I-EXPLORATION -negativos. I-EXPLORATION -En I-EXPLORATION -2004 I-EXPLORATION -se I-EXPLORATION -diagnosticó I-EXPLORATION -una I-EXPLORATION -diabetes I-EXPLORATION -mellitus I-EXPLORATION -2. I-EXPLORATION +había I-EXPLORATION +resultado I-EXPLORATION +refractario I-EXPLORATION +al I-EXPLORATION +tratamiento I-EXPLORATION +conservador. I-EXPLORATION I-EXPLORATION -En B-TREATMENT -marzo I-TREATMENT +Se B-TREATMENT +realizó I-TREATMENT +enterocistoplastia I-TREATMENT de I-TREATMENT -2005 I-TREATMENT -recibió I-TREATMENT +ampliación I-TREATMENT +laparoscópica I-TREATMENT +con I-TREATMENT un I-TREATMENT -riñón I-TREATMENT +segmento I-TREATMENT +ileal I-TREATMENT de I-TREATMENT -donante I-TREATMENT -cadáver, I-TREATMENT -con I-TREATMENT -el I-TREATMENT -que I-TREATMENT -compartía I-TREATMENT -2 I-TREATMENT -antígenos I-TREATMENT -DR I-TREATMENT -y I-TREATMENT -presentaba I-TREATMENT -incompatibilidades I-TREATMENT +25 I-TREATMENT +cm I-TREATMENT +plegado I-TREATMENT en I-TREATMENT -los I-TREATMENT -2 I-TREATMENT -antígenos I-TREATMENT -A I-TREATMENT -y I-TREATMENT -B. I-TREATMENT -Su B-EXPLORATION -reactividad I-EXPLORATION -histórica I-EXPLORATION -y I-EXPLORATION -previa I-EXPLORATION -al I-EXPLORATION -trasplante I-EXPLORATION -frente I-EXPLORATION -a I-EXPLORATION -linfocitos I-EXPLORATION -de I-EXPLORATION -panel I-EXPLORATION -era I-EXPLORATION -0%. I-EXPLORATION -Hubo B-TREATMENT -un I-TREATMENT -sangrado I-TREATMENT -intraoperatorio I-TREATMENT -abundante, I-TREATMENT -usaba I-TREATMENT -clopidogrel I-TREATMENT -para I-TREATMENT -evitar I-TREATMENT +U. I-TREATMENT +La I-TREATMENT +duración I-TREATMENT +de I-TREATMENT la I-TREATMENT -oclusión I-TREATMENT +cirugía I-TREATMENT +fue I-TREATMENT de I-TREATMENT -los I-TREATMENT -catéteres. I-TREATMENT -Recibió I-TREATMENT -glóbulos I-TREATMENT -rojos, I-TREATMENT -plaquetas, I-TREATMENT -plasma I-TREATMENT -fresco I-TREATMENT -congelado I-TREATMENT -e I-TREATMENT -inmunosupresión I-TREATMENT +4, I-TREATMENT +5 I-TREATMENT +horas I-TREATMENT con I-TREATMENT -ciclosporina I-TREATMENT -(CsA), I-TREATMENT -micofenolato I-TREATMENT -(MMF) I-TREATMENT -y I-TREATMENT -esteroides. I-TREATMENT -Evolucionó B-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -necrosis I-EVOLUTION -tubular I-EVOLUTION -aguda, I-EVOLUTION -hemodializándose I-EVOLUTION -en I-EVOLUTION -6 I-EVOLUTION -ocasiones I-EVOLUTION -durante I-EVOLUTION -los I-EVOLUTION -primeros I-EVOLUTION -14 I-EVOLUTION -días. I-EVOLUTION -Recibió B-TREATMENT -insulina, I-TREATMENT -y I-TREATMENT -por I-TREATMENT -no I-TREATMENT -tener I-TREATMENT -anticuerpos I-TREATMENT -de I-TREATMENT -tipo I-TREATMENT -IgG I-TREATMENT -anti I-TREATMENT -CMV I-TREATMENT -utilizó I-TREATMENT -ganciclovir I-TREATMENT -endovenoso I-TREATMENT -y I-TREATMENT -luego I-TREATMENT -valganciclovir I-TREATMENT -(VGC) I-TREATMENT -oral. I-TREATMENT -Como I-TREATMENT -complicaciones I-TREATMENT -tuvo I-TREATMENT -una I-TREATMENT -infección I-TREATMENT -urinaria I-TREATMENT -y I-TREATMENT un I-TREATMENT -urinoma, I-TREATMENT -que I-TREATMENT -requirió I-TREATMENT -de I-TREATMENT -drenaje I-TREATMENT -quirúrgico. I-TREATMENT -Egresó B-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -34 I-EVOLUTION -días, I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -creatinina I-EVOLUTION -de I-EVOLUTION -1, I-EVOLUTION -6 I-EVOLUTION -mg/dl. I-EVOLUTION -Una I-EVOLUTION -semana I-EVOLUTION -después, I-EVOLUTION -notó I-EVOLUTION -edema I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -extremidad I-EVOLUTION -superior I-EVOLUTION -derecha, I-EVOLUTION -tos I-EVOLUTION -y I-EVOLUTION -disnea I-EVOLUTION -de I-EVOLUTION -esfuerzos. I-EVOLUTION -Una B-EXPLORATION -ecotomografía I-EXPLORATION -doppler I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -trombosis I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -axilar I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -cintigrama I-EXPLORATION -pulmonar I-EXPLORATION -mostró I-EXPLORATION -imagen I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -embolia I-EXPLORATION -pulmonar. I-EXPLORATION -Inició B-TREATMENT -terapia I-TREATMENT -con I-TREATMENT -heparina I-TREATMENT -de I-TREATMENT -bajo I-TREATMENT -peso I-TREATMENT -molecular I-TREATMENT -y I-TREATMENT -luego I-TREATMENT -acenocumarol. I-TREATMENT -Egresó B-EVOLUTION -2 I-EVOLUTION -semanas I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -creatinina I-EVOLUTION -de I-EVOLUTION -1, I-EVOLUTION -6 I-EVOLUTION -mg/dl I-EVOLUTION -y I-EVOLUTION +sangrado I-TREATMENT +mínimo. I-TREATMENT +Durante B-EVOLUTION +el I-EVOLUTION +postoperatorio I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION un I-EVOLUTION -clearence I-EVOLUTION -de I-EVOLUTION -creatinina I-EVOLUTION -de I-EVOLUTION -35 I-EVOLUTION -ml/min. I-EVOLUTION - I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -cuatro I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -trasplante I-EVOLUTION -renal I-EVOLUTION -(TxR) I-EVOLUTION -y I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -reducir I-EVOLUTION -la I-EVOLUTION -dosis I-EVOLUTION -de I-EVOLUTION -MMF I-EVOLUTION -desde I-EVOLUTION -1.500 I-EVOLUTION -a I-EVOLUTION -500 I-EVOLUTION -mg/día I-EVOLUTION -por I-EVOLUTION -leucopenia, I-EVOLUTION -utilizando I-EVOLUTION -prednisona I-EVOLUTION -10 I-EVOLUTION -mg I-EVOLUTION -y I-EVOLUTION -CsA I-EVOLUTION -80 I-EVOLUTION -mg I-EVOLUTION -(obteniendo I-EVOLUTION -una I-EVOLUTION -concentración I-EVOLUTION -sanguínea I-EVOLUTION +cuadro I-EVOLUTION de I-EVOLUTION -504 I-EVOLUTION -ng/ml I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -2 I-EVOLUTION -h I-EVOLUTION +constipación, I-EVOLUTION +que I-EVOLUTION +ya I-EVOLUTION +presentaba I-EVOLUTION +ocasionalmente I-EVOLUTION +antes I-EVOLUTION de I-EVOLUTION -ingerida) I-EVOLUTION la I-EVOLUTION -creatinina I-EVOLUTION -se I-EVOLUTION -elevó I-EVOLUTION -a I-EVOLUTION -4, I-EVOLUTION -9 I-EVOLUTION -mg/dl, I-EVOLUTION -el I-EVOLUTION -clearence I-EVOLUTION -de I-EVOLUTION -creatinina I-EVOLUTION -cayó I-EVOLUTION -a I-EVOLUTION -8, I-EVOLUTION -7 I-EVOLUTION -ml/min I-EVOLUTION -y I-EVOLUTION -apareció I-EVOLUTION -proteinuria I-EVOLUTION -de I-EVOLUTION -14, I-EVOLUTION -9 I-EVOLUTION -g/día. I-EVOLUTION +cirugía. I-EVOLUTION Se I-EVOLUTION -diagnosticó I-EVOLUTION -un I-EVOLUTION -rechazo I-EVOLUTION -agudo. I-EVOLUTION -No B-EXPLORATION -se I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -renal I-EXPLORATION -por I-EXPLORATION -estar I-EXPLORATION -bajo I-EXPLORATION -terapia I-EXPLORATION -anticoagulante. I-EXPLORATION -Se B-TREATMENT -trató I-TREATMENT -con I-TREATMENT -metilprednisolona I-TREATMENT -por I-TREATMENT -3 I-TREATMENT -días, I-TREATMENT -descendiendo I-TREATMENT -la I-TREATMENT -creatinina I-TREATMENT -a I-TREATMENT -1, I-TREATMENT -7 I-TREATMENT -mg/dl I-TREATMENT -y I-TREATMENT -la I-TREATMENT -proteinuria I-TREATMENT -a I-TREATMENT -780 I-TREATMENT -mg/día, I-TREATMENT -elevándose I-TREATMENT -el I-TREATMENT -clearence I-TREATMENT -de I-TREATMENT -creatinina I-TREATMENT -a I-TREATMENT -40 I-TREATMENT -ml/min. I-TREATMENT -La B-EXPLORATION -antigenemia I-EXPLORATION -para I-EXPLORATION -CMV I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION -Egresó B-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -mismo I-EVOLUTION -esquema I-EVOLUTION -inmunosupresor. I-EVOLUTION +procedió I-EVOLUTION +al I-EVOLUTION +alta I-EVOLUTION +hospitalaria I-EVOLUTION +al I-EVOLUTION +duodécimo I-EVOLUTION +día I-EVOLUTION +postoperatorio. I-EVOLUTION I-EVOLUTION -Once I-EVOLUTION -semanas I-EVOLUTION -después, I-EVOLUTION -recibiendo I-EVOLUTION -MMF I-EVOLUTION -1.000 I-EVOLUTION -mg, I-EVOLUTION -CsA I-EVOLUTION -70 I-EVOLUTION -mg I-EVOLUTION -(obteniendo I-EVOLUTION -un I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -457 I-EVOLUTION -ng/ml I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -segunda I-EVOLUTION -hora I-EVOLUTION -de I-EVOLUTION -ingerida) I-EVOLUTION -y I-EVOLUTION -prednisona I-EVOLUTION -10 I-EVOLUTION -mg, I-EVOLUTION -hizo I-EVOLUTION -un I-EVOLUTION -nuevo I-EVOLUTION -rechazo I-EVOLUTION -agudo, I-EVOLUTION -tratándose I-EVOLUTION -con I-EVOLUTION -pulsos I-EVOLUTION +El I-EVOLUTION +seguimiento I-EVOLUTION +ha I-EVOLUTION +sido I-EVOLUTION de I-EVOLUTION -metilprednisolona, I-EVOLUTION -descendiendo I-EVOLUTION -la I-EVOLUTION -creatinina I-EVOLUTION -desde I-EVOLUTION -2, I-EVOLUTION -9 I-EVOLUTION -a I-EVOLUTION -1, I-EVOLUTION 6 I-EVOLUTION -mg/dl. I-EVOLUTION -Posterior B-TREATMENT -a I-TREATMENT -ello I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -la I-TREATMENT -CsA I-TREATMENT -por I-TREATMENT -tacrolimus I-TREATMENT -(TCR) I-TREATMENT -4 I-TREATMENT -mg I-TREATMENT -c/12 I-TREATMENT -h I-TREATMENT -(obteniendo I-TREATMENT -un I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -8 I-TREATMENT -ng/ml) I-TREATMENT -y I-TREATMENT -se I-TREATMENT -reinició I-TREATMENT -el I-TREATMENT -VGC I-TREATMENT -por I-TREATMENT -aparición I-TREATMENT -de I-TREATMENT -febrículas I-TREATMENT -asociadas I-TREATMENT -a I-TREATMENT -una I-TREATMENT -antigenemia I-TREATMENT -(+). I-TREATMENT -A I-TREATMENT -los I-TREATMENT -7 I-TREATMENT -meses I-TREATMENT -del I-TREATMENT -TxR I-TREATMENT -y I-TREATMENT -a I-TREATMENT -los I-TREATMENT -6 I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -iniciada I-TREATMENT -la I-TREATMENT -terapia I-TREATMENT -anticoagulante, I-TREATMENT -ésta I-TREATMENT -se I-TREATMENT -suspendió, I-TREATMENT -de I-TREATMENT -acuerdo I-TREATMENT -a I-TREATMENT -lo I-TREATMENT -programado I-TREATMENT -a I-TREATMENT -su I-TREATMENT -inicio. I-TREATMENT -Egresó B-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -creatinina I-EVOLUTION +meses. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +en I-EVOLUTION +programa I-EVOLUTION de I-EVOLUTION -1, I-EVOLUTION -6 I-EVOLUTION -mg/dl. I-EVOLUTION -Dos I-EVOLUTION -días I-EVOLUTION -más I-EVOLUTION -tarde, I-EVOLUTION -12 I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION +autocateterismos, I-EVOLUTION +continente I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +nuevos I-EVOLUTION +episodios I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -suspensión I-EVOLUTION -del I-EVOLUTION -anticoagulante, I-EVOLUTION -cayó I-EVOLUTION -bruscamente I-EVOLUTION -en I-EVOLUTION -anuria. I-EVOLUTION -Una B-EXPLORATION -ecotomografía I-EXPLORATION -doppler I-EXPLORATION -no I-EXPLORATION -evidenció I-EXPLORATION -flujo I-EXPLORATION -arterial I-EXPLORATION -y I-EXPLORATION +infección I-EVOLUTION +urinaria. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +oriundo B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Marchigüe, I-PAST_MEDICAL_HISTORY +VI I-PAST_MEDICAL_HISTORY +Región I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Chile, I-PAST_MEDICAL_HISTORY +quien I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +vida I-PAST_MEDICAL_HISTORY +laboral I-PAST_MEDICAL_HISTORY +trabajó I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +faenador I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +corderos. I-PAST_MEDICAL_HISTORY +Tenía I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +dislipidemia I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +quiste I-PAST_MEDICAL_HISTORY +hidatídico I-PAST_MEDICAL_HISTORY +pulmonar I-PAST_MEDICAL_HISTORY +operado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +1996. I-PAST_MEDICAL_HISTORY +Quince I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +después, I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +accidente I-PAST_MEDICAL_HISTORY +vascular I-PAST_MEDICAL_HISTORY +encefálico, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +referir I-PAST_MEDICAL_HISTORY +otro I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +sintomatología I-PAST_MEDICAL_HISTORY +cardiovascular. I-PAST_MEDICAL_HISTORY +Dentro B-EXPLORATION +del I-EXPLORATION +estudio I-EXPLORATION +etiológico I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION un I-EXPLORATION -cintigrama I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -perfusión I-EXPLORATION -renal. I-EXPLORATION -Se I-EXPLORATION -planteó I-EXPLORATION +ecocardiograma I-EXPLORATION +y I-EXPLORATION una I-EXPLORATION -trombosis I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -renal. I-EXPLORATION -Se B-TREATMENT -instalaron I-TREATMENT -nuevos I-TREATMENT -catéteres I-TREATMENT -tunelizados I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -femoral I-TREATMENT -derecha I-TREATMENT -e I-TREATMENT -inició I-TREATMENT -hemodiálisis. I-TREATMENT -Tres B-EXPLORATION -días I-EXPLORATION -después I-EXPLORATION +tórax I-EXPLORATION +(TAC) I-EXPLORATION +donde I-EXPLORATION se I-EXPLORATION -efectuó I-EXPLORATION +evidenció I-EXPLORATION una I-EXPLORATION -biopsia I-EXPLORATION -renal I-EXPLORATION +masa I-EXPLORATION +quística I-EXPLORATION +de I-EXPLORATION +4 I-EXPLORATION +x I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +ventrículo I-EXPLORATION +izquierdo, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +ruptura. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +además I-EXPLORATION +una I-EXPLORATION +ecotomografía I-EXPLORATION +abdominal I-EXPLORATION que I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -infarto I-EXPLORATION -renal I-EXPLORATION -y B-TREATMENT -posteriormente I-TREATMENT -se I-TREATMENT -efectuó I-TREATMENT -una I-TREATMENT -nefrectomía. I-TREATMENT -Se B-EXPLORATION -confirmó I-EXPLORATION +descartó I-EXPLORATION la I-EXPLORATION -trombosis I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -renal I-EXPLORATION +quistes I-EXPLORATION +hepáticos. I-EXPLORATION +Tampoco B-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +síntomas I-PAST_MEDICAL_HISTORY +previos I-PAST_MEDICAL_HISTORY +sugerentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +anafilaxia. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Posteriormente, B-EVOLUTION +evolucionó I-EVOLUTION +con I-EVOLUTION +dolor I-EVOLUTION +precordial I-EVOLUTION +opresivo I-EVOLUTION +sin I-EVOLUTION +irradiación, I-EVOLUTION +de I-EVOLUTION +intensidad I-EVOLUTION +EVA I-EVOLUTION +6/10. I-EVOLUTION +Evaluado B-TREATMENT +por I-TREATMENT +cardiología I-TREATMENT +en I-TREATMENT +su I-TREATMENT +hospital I-TREATMENT +base I-TREATMENT +se I-TREATMENT +indicó I-TREATMENT +anticoagulación I-TREATMENT +oral I-TREATMENT +siendo B-DERIVED_FROM/TO +derivado I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Instituto I-DERIVED_FROM/TO +Nacional I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +Tórax I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +sospecha I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +hidatidosis I-DERIVED_FROM/TO +cardiaca. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +El B-EXPLORATION +paciente I-EXPLORATION +ingresó I-EXPLORATION +en I-EXPLORATION +buenas I-EXPLORATION +condiciones I-EXPLORATION +generales, I-EXPLORATION +afebril I-EXPLORATION +y I-EXPLORATION +sin I-EXPLORATION +alteraciones I-EXPLORATION +hemodinámicas, I-EXPLORATION con I-EXPLORATION -infarto I-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION de I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -injerto, I-EXPLORATION +130/85 I-EXPLORATION +mmHg I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -intersticial I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -rechazo I-EXPLORATION -leve. I-EXPLORATION -Frente I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION +90 I-EXPLORATION +latidos I-EXPLORATION +por I-EXPLORATION +min. I-EXPLORATION +Al I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +no I-EXPLORATION +presentaba I-EXPLORATION +ingurgitación I-EXPLORATION +yugular, I-EXPLORATION +roces I-EXPLORATION +ni I-EXPLORATION +soplos I-EXPLORATION +cardiacos I-EXPLORATION +(que I-EXPLORATION +fueron I-EXPLORATION +exhaustivamente I-EXPLORATION +buscados) I-EXPLORATION +ni I-EXPLORATION +tampoco I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION +insuficiencia I-EXPLORATION +cardiaca. I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +pulmonar I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +hemograma I-EXPLORATION +reveló I-EXPLORATION una I-EXPLORATION -trombofilia I-EXPLORATION -como I-EXPLORATION -causa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -trombosis I-EXPLORATION -arterial, I-EXPLORATION -se I-EXPLORATION -tomaron I-EXPLORATION -muestras I-EXPLORATION -para I-EXPLORATION -confirmar I-EXPLORATION -dicha I-EXPLORATION -hipótesis. I-EXPLORATION -Los I-EXPLORATION -niveles I-EXPLORATION +eosinofilia I-EXPLORATION de I-EXPLORATION -antitrombina I-EXPLORATION -III, I-EXPLORATION -resistencia I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -activada, I-EXPLORATION -factor I-EXPLORATION -V I-EXPLORATION -Leiden, I-EXPLORATION -mutación I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -G20210A I-EXPLORATION +21%, I-EXPLORATION +sin I-EXPLORATION +leucocitosis. I-EXPLORATION +El I-EXPLORATION +perfil I-EXPLORATION +bioquímico I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +determinación I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -protrombina, I-EXPLORATION -proteína I-EXPLORATION -S, I-EXPLORATION -anticoagulante I-EXPLORATION -lúpico, I-EXPLORATION anticuerpos I-EXPLORATION -anticardiolipinas I-EXPLORATION IgG I-EXPLORATION -e I-EXPLORATION -IgM I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -o I-EXPLORATION -negativos. I-EXPLORATION +anti-Echinococcus I-EXPLORATION +granulosus I-EXPLORATION +no I-EXPLORATION +fue I-EXPLORATION +realizada. I-EXPLORATION + I-EXPLORATION La I-EXPLORATION -actividad I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION +tórax I-EXPLORATION +era I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +electrocardiograma I-EXPLORATION +presentaba I-EXPLORATION +ritmo I-EXPLORATION +sinusal, I-EXPLORATION +ondas I-EXPLORATION +T I-EXPLORATION +negativas I-EXPLORATION +en I-EXPLORATION +DII I-EXPLORATION +y I-EXPLORATION +alteraciones I-EXPLORATION +inespecíficas I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -PrC I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -sólo I-EXPLORATION -39, I-EXPLORATION -1% I-EXPLORATION -(VN: I-EXPLORATION -72-106%) I-EXPLORATION +repolarización. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +ecocardiografía I-EXPLORATION +realizada I-EXPLORATION +en I-EXPLORATION +nuestro I-EXPLORATION +servicio I-EXPLORATION +evidenció I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +poliquística, I-EXPLORATION +ovalada I-EXPLORATION y I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION +adherida I-EXPLORATION +al I-EXPLORATION +macizo I-EXPLORATION de I-EXPLORATION -homocisteína I-EXPLORATION -total I-EXPLORATION -estuvieron I-EXPLORATION -levemente I-EXPLORATION -elevados I-EXPLORATION -16, I-EXPLORATION -6 I-EXPLORATION -umol/L I-EXPLORATION -(VN: I-EXPLORATION +músculos I-EXPLORATION +papilares I-EXPLORATION +anterolaterales, I-EXPLORATION +de I-EXPLORATION +contornos I-EXPLORATION +bien I-EXPLORATION +delimitados I-EXPLORATION +en I-EXPLORATION +pared I-EXPLORATION +libre I-EXPLORATION +del I-EXPLORATION +ventrículo I-EXPLORATION +izquierdo I-EXPLORATION +que I-EXPLORATION +medía I-EXPLORATION 4, I-EXPLORATION -5-11). I-EXPLORATION +5 I-EXPLORATION +x I-EXPLORATION +3, I-EXPLORATION +2 I-EXPLORATION +x I-EXPLORATION +2, I-EXPLORATION +7 I-EXPLORATION +cm, I-EXPLORATION +sin I-EXPLORATION +derrame I-EXPLORATION +pericárdico. I-EXPLORATION +Estos I-EXPLORATION +hallazgos I-EXPLORATION +fueron I-EXPLORATION +confirmados I-EXPLORATION +por I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RNM). I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +preoperatorio I-EXPLORATION +fue I-EXPLORATION +completado I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +coronariografía, I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION I-EXPLORATION -Días B-EVOLUTION -después I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -trombosis I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -vena I-EVOLUTION -femoral I-EVOLUTION -común I-EVOLUTION -y I-EVOLUTION -profunda I-EVOLUTION -derechas. I-EVOLUTION -Se B-TREATMENT -trató I-TREATMENT +La B-TREATMENT +cirugía I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +bajo I-TREATMENT +esternotomía I-TREATMENT +media I-TREATMENT +y I-TREATMENT +circulación I-TREATMENT +extracorpórea, I-TREATMENT +poniendo I-TREATMENT +principal I-TREATMENT +atención I-TREATMENT +en I-TREATMENT +la I-TREATMENT +manipulación I-TREATMENT +cardiaca I-TREATMENT +para I-TREATMENT +no I-TREATMENT +lesionar I-TREATMENT +el I-TREATMENT +quiste. I-TREATMENT +Una I-TREATMENT +vez I-TREATMENT +puesto I-TREATMENT +el I-TREATMENT +clamp I-TREATMENT +aórtico, I-TREATMENT +se I-TREATMENT +disecó I-TREATMENT +la I-TREATMENT +superficie I-TREATMENT +del I-TREATMENT +quiste, I-TREATMENT +se I-TREATMENT +aisló I-TREATMENT +el I-TREATMENT +campo I-TREATMENT con I-TREATMENT -heparina I-TREATMENT +compresas I-TREATMENT +embebidas I-TREATMENT +en I-TREATMENT +cloruro I-TREATMENT de I-TREATMENT -bajo I-TREATMENT -peso I-TREATMENT -molecular I-TREATMENT +sodio I-TREATMENT +al I-TREATMENT +10% I-TREATMENT y I-TREATMENT -posteriormente I-TREATMENT se I-TREATMENT -inició I-TREATMENT -terapia I-TREATMENT +puncionó I-TREATMENT +el I-TREATMENT +quiste I-TREATMENT +vaciándolo I-TREATMENT +parcialmente I-TREATMENT +e I-TREATMENT +inyectando I-TREATMENT +solución I-TREATMENT +salina I-TREATMENT +hipertónica I-TREATMENT +al I-TREATMENT +30%. I-TREATMENT +Posteriormente, I-TREATMENT +se I-TREATMENT +abrió I-TREATMENT +el I-TREATMENT +quiste I-TREATMENT +hacia I-TREATMENT +la I-TREATMENT +cara I-TREATMENT +anterior I-TREATMENT +del I-TREATMENT +ventrículo I-TREATMENT +izquierdo I-TREATMENT +y I-TREATMENT +se I-TREATMENT +vació, I-TREATMENT +retirando I-TREATMENT +las I-TREATMENT +membranas I-TREATMENT +y I-TREATMENT +vesículas I-TREATMENT +hijas. I-TREATMENT +Se I-TREATMENT +completó I-TREATMENT +el I-TREATMENT +aseo I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cavidad I-TREATMENT con I-TREATMENT -acenocumarol I-TREATMENT -permanente. I-TREATMENT - I-TREATMENT +sodio I-TREATMENT +hipertónico I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +quistectomía I-TREATMENT +parcial I-TREATMENT +y I-TREATMENT +cierre I-TREATMENT +por I-TREATMENT +capitonaje I-TREATMENT +del I-TREATMENT +remanente. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +presentó I-EVOLUTION +complicaciones I-EVOLUTION +intraoperatorias I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +evolución I-EVOLUTION +posterior I-EVOLUTION +fue I-EVOLUTION +favorable. I-EVOLUTION +En I-EVOLUTION +control I-EVOLUTION +ambulatorio I-EVOLUTION +post-quirúrgico, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +ha I-EVOLUTION +mantenido I-EVOLUTION +asintomático, I-EVOLUTION +sin I-EVOLUTION +evidencias I-EVOLUTION +de I-EVOLUTION +complicaciones I-EVOLUTION +o I-EVOLUTION +recidivas I-EVOLUTION +y B-EXPLORATION +se I-EXPLORATION +controlará I-EXPLORATION +semestralmente I-EXPLORATION +con I-EXPLORATION +ecocardiografía I-EXPLORATION +y I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +E. I-EXPLORATION +granulosus. I-EXPLORATION + I-EXPLORATION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -37 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -procedente B-PAST_MEDICAL_HISTORY +57 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Puerto I-PAST_MEDICAL_HISTORY -Aisén, I-PAST_MEDICAL_HISTORY +colecistectomía I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +artrosis I-PAST_MEDICAL_HISTORY +poliarticular I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tiroidectomía I-PAST_MEDICAL_HISTORY -realizada I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -causa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -bocio I-PAST_MEDICAL_HISTORY -difuso I-PAST_MEDICAL_HISTORY -hipertiroideo. I-PAST_MEDICAL_HISTORY -Como I-PAST_MEDICAL_HISTORY -consecuencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cirugía, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -desarrolló I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -hipoparatiroidismo I-PAST_MEDICAL_HISTORY -definitivo. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -indicó I-PAST_MEDICAL_HISTORY -suplemento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -calcio I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -vitamina I-PAST_MEDICAL_HISTORY -D, I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -cumplió I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -muy I-PAST_MEDICAL_HISTORY -irregular I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -laboratorio. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Quince I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -tarde, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1999, I-PAST_MEDICAL_HISTORY -consultó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -nuestro I-PAST_MEDICAL_HISTORY -hospital I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -calambres, I-PAST_MEDICAL_HISTORY -parestesias I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -espasmos I-PAST_MEDICAL_HISTORY -faciales, I-PAST_MEDICAL_HISTORY -además I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -signos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Chvostek I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -Trousseau I-PAST_MEDICAL_HISTORY -manifiestos. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -reinició I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -calcio I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -vitamina I-PAST_MEDICAL_HISTORY -D I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -solicitó I-PAST_MEDICAL_HISTORY -exámenes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -calcemia, I-PAST_MEDICAL_HISTORY -T4 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -TSH. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -regresó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -control. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Reapareció I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -noviembre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2003, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -tratamiento. I-PAST_MEDICAL_HISTORY -Presentaba I-PAST_MEDICAL_HISTORY -marcado I-PAST_MEDICAL_HISTORY -compromiso I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY -general, I-PAST_MEDICAL_HISTORY -astenia, I-PAST_MEDICAL_HISTORY -debilidad I-PAST_MEDICAL_HISTORY -muscular, I-PAST_MEDICAL_HISTORY -calambres, I-PAST_MEDICAL_HISTORY -parestesias I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cefalea. I-PAST_MEDICAL_HISTORY -Sus I-PAST_MEDICAL_HISTORY -menstruaciones I-PAST_MEDICAL_HISTORY -eran I-PAST_MEDICAL_HISTORY -abundantes. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -examen I-PAST_MEDICAL_HISTORY -físico I-PAST_MEDICAL_HISTORY -destacaban I-PAST_MEDICAL_HISTORY -facies I-PAST_MEDICAL_HISTORY -hipotiroidea, I-PAST_MEDICAL_HISTORY -cicatriz I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -tiroidectomía, I-PAST_MEDICAL_HISTORY -pulso I-PAST_MEDICAL_HISTORY -regular I-PAST_MEDICAL_HISTORY -70x', I-PAST_MEDICAL_HISTORY -presión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -110/70 I-PAST_MEDICAL_HISTORY -mmHg, I-PAST_MEDICAL_HISTORY -palidez I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -signos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Chvostek I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -Trousseau; I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -examen I-PAST_MEDICAL_HISTORY -cardiopulmonar I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -abdominal I-PAST_MEDICAL_HISTORY -eran I-PAST_MEDICAL_HISTORY -normales. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Sus I-PAST_MEDICAL_HISTORY -exámenes I-PAST_MEDICAL_HISTORY -revelaron: I-PAST_MEDICAL_HISTORY -calcemia I-PAST_MEDICAL_HISTORY -7, I-PAST_MEDICAL_HISTORY -98 I-PAST_MEDICAL_HISTORY -mg/dL I-PAST_MEDICAL_HISTORY -(probable I-PAST_MEDICAL_HISTORY -error I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -laboratorio, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -discordancia I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -calcemias I-PAST_MEDICAL_HISTORY -posteriores), I-PAST_MEDICAL_HISTORY -fosfemia I-PAST_MEDICAL_HISTORY -6, I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -mg/dL, I-PAST_MEDICAL_HISTORY -BUN I-PAST_MEDICAL_HISTORY -14 I-PAST_MEDICAL_HISTORY -mg/dL, I-PAST_MEDICAL_HISTORY -proteína I-PAST_MEDICAL_HISTORY -total I-PAST_MEDICAL_HISTORY -6, I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -g/dL, I-PAST_MEDICAL_HISTORY -albuminemia I-PAST_MEDICAL_HISTORY -3, I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -g/dL, I-PAST_MEDICAL_HISTORY -hematocrito I-PAST_MEDICAL_HISTORY -27%, I-PAST_MEDICAL_HISTORY -hemoglobina I-PAST_MEDICAL_HISTORY -6, I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -g/dL, I-PAST_MEDICAL_HISTORY -microcitosis I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipocromía, I-PAST_MEDICAL_HISTORY -TSH I-PAST_MEDICAL_HISTORY -9, I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -µU/ml I-PAST_MEDICAL_HISTORY -(vn: I-PAST_MEDICAL_HISTORY -0, I-PAST_MEDICAL_HISTORY -4-4, I-PAST_MEDICAL_HISTORY -8). I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Con I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipoparatiroidismo I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -postiroidectomía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -anemia I-PAST_MEDICAL_HISTORY -ferropriva, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -indicó I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -Elcal I-PAST_MEDICAL_HISTORY -D I-PAST_MEDICAL_HISTORY -Forte® I-PAST_MEDICAL_HISTORY -(carbonato I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -calcio I-PAST_MEDICAL_HISTORY -1.125 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -+ I-PAST_MEDICAL_HISTORY -vitamina I-PAST_MEDICAL_HISTORY -D I-PAST_MEDICAL_HISTORY -175 I-PAST_MEDICAL_HISTORY -UI) I-PAST_MEDICAL_HISTORY -1, I-PAST_MEDICAL_HISTORY -Elcal® I-PAST_MEDICAL_HISTORY -(carbonato I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -calcio I-PAST_MEDICAL_HISTORY -800 I-PAST_MEDICAL_HISTORY -mg) I-PAST_MEDICAL_HISTORY -1, I-PAST_MEDICAL_HISTORY -levotiroxina I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -µg I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sulfato I-PAST_MEDICAL_HISTORY -ferroso I-PAST_MEDICAL_HISTORY -400 I-PAST_MEDICAL_HISTORY -mg/día. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Dos B-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -después, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS +ibuprofeno. I-PAST_MEDICAL_HISTORY +Acude B-PRESENT_ILLNESS a I-PRESENT_ILLNESS -mínimos I-PRESENT_ILLNESS -esfuerzos, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -epigástrico, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +diarrea I-PRESENT_ILLNESS +acuosa I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -rápida I-PRESENT_ILLNESS -progresión. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -afebril, I-EXPLORATION +4 I-PRESENT_ILLNESS +kg I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +este I-PRESENT_ILLNESS +tiempo. I-PRESENT_ILLNESS +Exploración B-EXPLORATION +física: I-EXPLORATION +anodina. I-EXPLORATION +Pruebas I-EXPLORATION +complementarias: I-EXPLORATION +hematimetría, I-EXPLORATION +coagulación, I-EXPLORATION +bioquímica I-EXPLORATION +completa I-EXPLORATION con I-EXPLORATION -frecuencia I-EXPLORATION -cardíaca I-EXPLORATION -70x' I-EXPLORATION -regular, I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -100/70 I-EXPLORATION -mmHg, I-EXPLORATION -ortopnea, I-EXPLORATION -edema I-EXPLORATION -generalizado, I-EXPLORATION -ingurgitación I-EXPLORATION -yugular, I-EXPLORATION -estertores I-EXPLORATION -pulmonares, I-EXPLORATION -ruidos I-EXPLORATION -cardíacos I-EXPLORATION -apagados, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -auscultaron I-EXPLORATION -soplos, I-EXPLORATION -hepatomegalia I-EXPLORATION -sensible I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION -bajo I-EXPLORATION -el I-EXPLORATION -reborde I-EXPLORATION -costal. I-EXPLORATION -No I-EXPLORATION -presentaba I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -trombosis I-EXPLORATION -venosa I-EXPLORATION -profunda. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -indicó I-EXPLORATION -hospitalización. I-EXPLORATION -En I-EXPLORATION -sus I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -destacaba: I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax: I-EXPLORATION -cardiomegalia I-EXPLORATION +ionograma, I-EXPLORATION +transaminasas I-EXPLORATION +hepáticas, I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina I-EXPLORATION y I-EXPLORATION -congestión I-EXPLORATION -pulmonar. I-EXPLORATION -ECG: I-EXPLORATION -ritmo I-EXPLORATION -sinusal, I-EXPLORATION -83x', I-EXPLORATION -bajo I-EXPLORATION -voltaje I-EXPLORATION -generalizado, I-EXPLORATION -intervalo I-EXPLORATION -QT I-EXPLORATION -prolongado I-EXPLORATION +bilirrubina I-EXPLORATION +total: I-EXPLORATION +sin I-EXPLORATION +alteraciones. I-EXPLORATION +TSH I-EXPLORATION y I-EXPLORATION -alteraciones I-EXPLORATION -inespecíficas I-EXPLORATION +hormonas I-EXPLORATION +tiroideas: I-EXPLORATION +valores I-EXPLORATION +dentro I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -repolarización I-EXPLORATION -ventricular. I-EXPLORATION -Ecocardiograma: I-EXPLORATION -marcada I-EXPLORATION -dilatación, I-EXPLORATION -disfunción I-EXPLORATION -sistólica I-EXPLORATION -y I-EXPLORATION -disfunción I-EXPLORATION -diastólica I-EXPLORATION +normalidad. I-EXPLORATION +Niveles I-EXPLORATION +plasmáticos I-EXPLORATION de I-EXPLORATION -tipo I-EXPLORATION -restrictivo I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo, I-EXPLORATION -severa I-EXPLORATION -insuficiencia I-EXPLORATION -mitral I-EXPLORATION -y I-EXPLORATION -tricuspídea, I-EXPLORATION -hipertensión I-EXPLORATION -pulmonar I-EXPLORATION -sistólica I-EXPLORATION -moderada, I-EXPLORATION -derrame I-EXPLORATION -pericárdico I-EXPLORATION -moderado I-EXPLORATION -y I-EXPLORATION -dilatación I-EXPLORATION +péptido I-EXPLORATION +intestinal I-EXPLORATION +vasoactivo I-EXPLORATION +(VIP): I-EXPLORATION +5 I-EXPLORATION +pg/ml I-EXPLORATION +(valores I-EXPLORATION +normales: I-EXPLORATION +0-70 I-EXPLORATION +pg/ml). I-EXPLORATION +Niveles I-EXPLORATION de I-EXPLORATION -aurícula I-EXPLORATION -izquierda. I-EXPLORATION -Ecotomografía I-EXPLORATION -abdominal: I-EXPLORATION -hepatomegalia I-EXPLORATION -congestiva. I-EXPLORATION -Endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta: I-EXPLORATION -gastritis I-EXPLORATION -hiperémica. I-EXPLORATION -Calcemia I-EXPLORATION -2, I-EXPLORATION -9 I-EXPLORATION -mg/dL, I-EXPLORATION -parathormona I-EXPLORATION -5, I-EXPLORATION -9 I-EXPLORATION -ng/l I-EXPLORATION -(vn: I-EXPLORATION -10-73), I-EXPLORATION -magnesio I-EXPLORATION -1, I-EXPLORATION -08 I-EXPLORATION -mEq/l I-EXPLORATION -(vn: I-EXPLORATION -1, I-EXPLORATION -4-2, I-EXPLORATION -1), I-EXPLORATION -albúmina I-EXPLORATION -3, I-EXPLORATION -3 I-EXPLORATION -g/dL, I-EXPLORATION -sodio I-EXPLORATION -140 I-EXPLORATION -mEq/l, I-EXPLORATION -potasio I-EXPLORATION -2, I-EXPLORATION -3 I-EXPLORATION -mEq/l, I-EXPLORATION -hematocrito I-EXPLORATION -26%, I-EXPLORATION -hemoglobina I-EXPLORATION -7, I-EXPLORATION -4 I-EXPLORATION -g/dL, I-EXPLORATION -proteinuria I-EXPLORATION +ácido I-EXPLORATION +5-hidroxindol-acético I-EXPLORATION +(5HIAA) I-EXPLORATION +en I-EXPLORATION +orina I-EXPLORATION de I-EXPLORATION 24 I-EXPLORATION -h: I-EXPLORATION -negativa, I-EXPLORATION -bilirrubinemia I-EXPLORATION -total I-EXPLORATION -1, I-EXPLORATION -3 I-EXPLORATION -mg/dL, I-EXPLORATION -transaminasas I-EXPLORATION -glutámico I-EXPLORATION -oxalacéticas I-EXPLORATION -63 I-EXPLORATION -U/l I-EXPLORATION -(vn: I-EXPLORATION -<35), I-EXPLORATION -creatinfosfokinasa I-EXPLORATION -total I-EXPLORATION -1.260 I-EXPLORATION -U/l I-EXPLORATION -(vn: I-EXPLORATION -<70) I-EXPLORATION -(fracción I-EXPLORATION -miocárdica I-EXPLORATION -3%), I-EXPLORATION -TSH I-EXPLORATION -18, I-EXPLORATION -1 I-EXPLORATION -µU/ml. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -planteó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -insuficiencia I-EXPLORATION -cardíaca I-EXPLORATION -congestiva I-EXPLORATION -secundaria I-EXPLORATION +horas: I-EXPLORATION +0, I-EXPLORATION +5 I-EXPLORATION +mg/24 I-EXPLORATION +horas I-EXPLORATION +(las I-EXPLORATION +cifras I-EXPLORATION +normales I-EXPLORATION +son I-EXPLORATION +inferiores I-EXPLORATION a I-EXPLORATION -hipocalcemia I-EXPLORATION -severa, I-EXPLORATION -descompensada I-EXPLORATION -por I-EXPLORATION -sustitución I-EXPLORATION -con I-EXPLORATION -hormona I-EXPLORATION -tiroidea I-EXPLORATION -y I-EXPLORATION -agravada I-EXPLORATION -por I-EXPLORATION -anemia I-EXPLORATION -ferropriva. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -trató I-TREATMENT -con I-TREATMENT -gluconato I-TREATMENT -de I-TREATMENT -calcio I-TREATMENT -1 I-TREATMENT -g I-TREATMENT -iv I-TREATMENT -c/12 I-TREATMENT -h, I-TREATMENT -carbonato I-TREATMENT -de I-TREATMENT -calcio I-TREATMENT -2 I-TREATMENT -g I-TREATMENT -vo, I-TREATMENT -vitamina I-TREATMENT -D I-TREATMENT -175 I-TREATMENT -µ/día, I-TREATMENT -vitamina I-TREATMENT -D I-TREATMENT -300.000 I-TREATMENT -UI I-TREATMENT -por I-TREATMENT -una I-TREATMENT -vez, I-TREATMENT -l-tiroxina I-TREATMENT -100 I-TREATMENT -µg, I-TREATMENT -sulfato I-TREATMENT -ferroso I-TREATMENT -400 I-TREATMENT -mg, I-TREATMENT -furosemida I-TREATMENT -40 I-TREATMENT -mg, I-TREATMENT -cloruro I-TREATMENT -de I-TREATMENT -potasio I-TREATMENT -1, I-TREATMENT -8 I-TREATMENT -g, I-TREATMENT -captopril I-TREATMENT -12, I-TREATMENT -5 I-TREATMENT -mg I-TREATMENT -y I-TREATMENT -digoxina I-TREATMENT -0, I-TREATMENT -125 I-TREATMENT -mg/día. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente, I-EVOLUTION -con I-EVOLUTION -diuresis I-EVOLUTION -intensa I-EVOLUTION -y I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -manifestaciones I-EVOLUTION -de I-EVOLUTION -insuficiencia I-EVOLUTION -cardíaca, I-EVOLUTION -desaparición I-EVOLUTION -del I-EVOLUTION -edema I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -hepatomegalia. I-EVOLUTION -Diez B-EXPLORATION -días I-EXPLORATION -después I-EXPLORATION -tenía I-EXPLORATION -calcemia I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -mg/dL, I-EXPLORATION -hematocrito I-EXPLORATION -de I-EXPLORATION -37% I-EXPLORATION -y I-EXPLORATION +10 I-EXPLORATION +mg/24 I-EXPLORATION +horas). I-EXPLORATION +PCR: I-EXPLORATION +1, I-EXPLORATION +2 I-EXPLORATION +mg/dl I-EXPLORATION +(cifras I-EXPLORATION +normales I-EXPLORATION en I-EXPLORATION -ecocardiograma I-EXPLORATION -de I-EXPLORATION -control, I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -reducción I-EXPLORATION -del I-EXPLORATION -grado I-EXPLORATION -del I-EXPLORATION -reflujo I-EXPLORATION -mitral I-EXPLORATION -y I-EXPLORATION -tricuspídeo, I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -presión I-EXPLORATION -sistólica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -pulmonar I-EXPLORATION -de I-EXPLORATION -50 I-EXPLORATION -a I-EXPLORATION -33 I-EXPLORATION -mmHg I-EXPLORATION -(vn: I-EXPLORATION -15-30) I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -derrame I-EXPLORATION -pericárdico. I-EXPLORATION -En B-EVOLUTION -controles I-EVOLUTION -posteriores, I-EVOLUTION -hasta I-EVOLUTION -los I-EVOLUTION -18 I-EVOLUTION -meses, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -cumplía I-EVOLUTION -rigurosamente I-EVOLUTION -el I-EVOLUTION -tratamiento, I-EVOLUTION -sólo I-EVOLUTION -presentaba I-EVOLUTION -disnea I-EVOLUTION -a I-EVOLUTION -esfuerzos I-EVOLUTION -medianos I-EVOLUTION -a I-EVOLUTION -mayores, I-EVOLUTION -su B-EXPLORATION -calcemia I-EXPLORATION -se I-EXPLORATION -mantenía I-EXPLORATION -entre I-EXPLORATION +nuestro I-EXPLORATION +laboratorio I-EXPLORATION +hasta I-EXPLORATION +0, I-EXPLORATION 8 I-EXPLORATION +mg/dl), I-EXPLORATION +VSG: I-EXPLORATION +46 I-EXPLORATION +mm I-EXPLORATION +en I-EXPLORATION +1ª I-EXPLORATION +hora. I-EXPLORATION +Anticuerpos I-EXPLORATION +antiendomisio I-EXPLORATION y I-EXPLORATION -8, I-EXPLORATION -5 I-EXPLORATION -mg/dL I-EXPLORATION -y I-EXPLORATION +antigliadina I-EXPLORATION +negativos I-EXPLORATION +Leucocitos I-EXPLORATION en I-EXPLORATION -seguimiento I-EXPLORATION -ecocardiográfico, I-EXPLORATION -se I-EXPLORATION -observó, I-EXPLORATION -además, I-EXPLORATION -una I-EXPLORATION -recuperación I-EXPLORATION +heces: I-EXPLORATION +negativos. I-EXPLORATION +Coprocultivos, I-EXPLORATION +e I-EXPLORATION +investigación I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -marcada I-EXPLORATION -disfunción I-EXPLORATION -diastólica I-EXPLORATION -inicial I-EXPLORATION --evaluada I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -índice I-EXPLORATION -E/A: I-EXPLORATION -relación I-EXPLORATION -entre I-EXPLORATION -fase I-EXPLORATION +Cl I-EXPLORATION +difficile, I-EXPLORATION de I-EXPLORATION -llene I-EXPLORATION -ventricular I-EXPLORATION -rápido I-EXPLORATION -(E) I-EXPLORATION +parásitos I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -fase I-EXPLORATION de I-EXPLORATION -llene I-EXPLORATION -relacionada I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -contracción I-EXPLORATION -auricular I-EXPLORATION -(A) I-EXPLORATION --, I-EXPLORATION -normalización I-EXPLORATION -del I-EXPLORATION -tamaño I-EXPLORATION +huevos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -aurícula I-EXPLORATION -izquierda I-EXPLORATION -y I-EXPLORATION -desaparición I-EXPLORATION -del I-EXPLORATION -derrame I-EXPLORATION -pericárdico, I-EXPLORATION -persistiendo I-EXPLORATION -la I-EXPLORATION -dilatación I-EXPLORATION -y I-EXPLORATION -disfunción I-EXPLORATION -sistólica I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo, I-EXPLORATION +estos I-EXPLORATION en I-EXPLORATION -grado I-EXPLORATION -similar I-EXPLORATION +heces: I-EXPLORATION +negativos. I-EXPLORATION +Tránsito I-EXPLORATION +esófago-gastro-duodenal I-EXPLORATION +(TEGD): I-EXPLORATION +normal. I-EXPLORATION +Ecografía I-EXPLORATION +abdominal: I-EXPLORATION +normal I-EXPLORATION +salvo I-EXPLORATION +aerobilia I-EXPLORATION +con I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +vesícula I-EXPLORATION +biliar. I-EXPLORATION +Colonoscopia I-EXPLORATION +e I-EXPLORATION +ileoscopia: I-EXPLORATION +sin I-EXPLORATION +alteraciones I-EXPLORATION +macroscópicas. I-EXPLORATION +Se I-EXPLORATION +toman I-EXPLORATION +6 I-EXPLORATION +biopsias I-EXPLORATION a I-EXPLORATION -la I-EXPLORATION -observada I-EXPLORATION +lo I-EXPLORATION +largo I-EXPLORATION +de I-EXPLORATION +todo I-EXPLORATION +el I-EXPLORATION +colon I-EXPLORATION +(incluido I-EXPLORATION +sigma I-EXPLORATION +y I-EXPLORATION +recto), I-EXPLORATION +observándose I-EXPLORATION en I-EXPLORATION -exámenes I-EXPLORATION -iniciales. I-EXPLORATION +todas I-EXPLORATION +ellas I-EXPLORATION +un I-EXPLORATION +importante I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION +con I-EXPLORATION +gran I-EXPLORATION +cantidad I-EXPLORATION +de I-EXPLORATION +linfocitos I-EXPLORATION +intraepiteliales. I-EXPLORATION I-EXPLORATION -Paciente B-PRESENT_ILLNESS +Niña B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tiroidectomía I-PAST_MEDICAL_HISTORY -total I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -CPT. I-PAST_MEDICAL_HISTORY -La B-EXPLORATION -biopsia I-EXPLORATION -quirúrgica I-EXPLORATION -informó I-EXPLORATION +15 I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS +de B-PAST_MEDICAL_HISTORY +origen I-PAST_MEDICAL_HISTORY +africano, I-PAST_MEDICAL_HISTORY +a B-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +detecta I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +genu I-PRESENT_ILLNESS +varo I-PRESENT_ILLNESS +simétrico I-PRESENT_ILLNESS +bilateral I-PRESENT_ILLNESS +llamativo I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +revisión I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +puericultura. I-PRESENT_ILLNESS +No B-PAST_MEDICAL_HISTORY +tiene I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +médicos I-PAST_MEDICAL_HISTORY +ni B-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +interés. I-FAMILY_HISTORY +Presenta B-EXPLORATION un I-EXPLORATION -CPT I-EXPLORATION -bifocal, I-EXPLORATION -variedad I-EXPLORATION -usual, I-EXPLORATION -con I-EXPLORATION -foco I-EXPLORATION -de I-EXPLORATION -20 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -15 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -izquierdo, I-EXPLORATION -sin I-EXPLORATION -permea-ción I-EXPLORATION -vascular, I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -cápsula I-EXPLORATION -ni I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -borde I-EXPLORATION -quirúrgico. I-EXPLORATION -Recibió B-TREATMENT -150 I-TREATMENT -mCi I-TREATMENT -I131 I-TREATMENT -y B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -sistémica I-EXPLORATION -posdosis I-EXPLORATION -mostró I-EXPLORATION -remanente I-EXPLORATION -tiroideo I-EXPLORATION +desarrollo I-EXPLORATION +psicomotor I-EXPLORATION +normal. I-EXPLORATION +Es B-DERIVED_FROM/TO +derivada I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Traumatología, I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +realiza I-DERIVED_FROM/TO +estudio I-DERIVED_FROM/TO +radiológico I-DERIVED_FROM/TO +confirmándose I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +alteración I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +ángulo I-DERIVED_FROM/TO +metafisodiafisario, I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +componente I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +torsión I-DERIVED_FROM/TO +tibial I-DERIVED_FROM/TO +interna I-DERIVED_FROM/TO +marcado I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +alteración I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +cartílago I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +crecimiento I-DERIVED_FROM/TO +proximal I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +tibia. I-DERIVED_FROM/TO +Se B-EXPLORATION +completa I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION con I-EXPLORATION -compromiso I-EXPLORATION -ganglionar I-EXPLORATION -derecho. I-EXPLORATION -Inició B-TREATMENT -terapia I-TREATMENT -supresiva I-TREATMENT +análisis I-EXPLORATION +del I-EXPLORATION +metabolismo I-EXPLORATION +óseo, I-EXPLORATION +siendo I-EXPLORATION +los I-EXPLORATION +resultados I-EXPLORATION +normales. I-EXPLORATION +Se B-TREATMENT +inicia I-TREATMENT +tratamiento I-TREATMENT +ortésico I-TREATMENT +inicial I-TREATMENT +sin I-TREATMENT +observarse I-TREATMENT +mejoría I-TREATMENT +tras I-TREATMENT +diez I-TREATMENT +meses I-TREATMENT +de I-TREATMENT +seguimiento, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +realizar I-TREATMENT +tratamiento I-TREATMENT +quirúrgico I-TREATMENT +corrector I-TREATMENT +(osteotomía I-TREATMENT +desrotatoria I-TREATMENT +tibial I-TREATMENT +distal I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +osteotomía I-TREATMENT +valguizante I-TREATMENT +proximal) I-TREATMENT con I-TREATMENT -levotiroxina I-TREATMENT -y B-EVOLUTION -en I-EVOLUTION +muy I-TREATMENT +buena I-TREATMENT +evolución. I-TREATMENT +Los B-EVOLUTION controles I-EVOLUTION posteriores I-EVOLUTION -presentó I-EVOLUTION -niveles I-EVOLUTION -de I-EVOLUTION -Tg I-EVOLUTION -indetectables I-EVOLUTION -(<0, I-EVOLUTION -2 I-EVOLUTION -ng/ml) I-EVOLUTION -en I-EVOLUTION -ausencia I-EVOLUTION +son I-EVOLUTION +favorables, I-EVOLUTION +manteniendo I-EVOLUTION +un I-EVOLUTION +alineamiento I-EVOLUTION +correcto I-EVOLUTION de I-EVOLUTION -AcTg I-EVOLUTION -y B-EXPLORATION -las I-EXPLORATION -ecografías I-EXPLORATION -cervicales I-EXPLORATION -no I-EXPLORATION -mostraron I-EXPLORATION -evidencias I-EXPLORATION -de I-EXPLORATION -recidiva I-EXPLORATION -tumoral. I-EXPLORATION -En I-EXPLORATION -control I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -18 I-EXPLORATION -meses I-EXPLORATION -poscirugía I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -cervical I-EXPLORATION -mostró I-EXPLORATION -imagen I-EXPLORATION -nodular I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -cervical I-EXPLORATION -derecha, I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -linfonodo. I-EXPLORATION -En I-EXPLORATION -forma I-EXPLORATION -simultánea, I-EXPLORATION -la I-EXPLORATION -Tg-s I-EXPLORATION -estimulada I-EXPLORATION -(TSH I-EXPLORATION -=105 I-EXPLORATION -uUI/mL) I-EXPLORATION -fue I-EXPLORATION -<0, I-EXPLORATION -2 I-EXPLORATION -ng/ml, I-EXPLORATION -en I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -AcTg. I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION -sistémica I-EXPLORATION -mostró I-EXPLORATION -captación I-EXPLORATION -aumentada I-EXPLORATION -en I-EXPLORATION -compartimento I-EXPLORATION -central I-EXPLORATION -a I-EXPLORATION -ambos I-EXPLORATION -lados I-EXPLORATION -de I-EXPLORATION -línea I-EXPLORATION -media, I-EXPLORATION -mayor I-EXPLORATION -a I-EXPLORATION -derecha. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -por I-EXPLORATION -punción I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -fue I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -CPT. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -disección I-TREATMENT -cervical, I-TREATMENT -cuya B-EXPLORATION -biopsia I-EXPLORATION -confirmó I-EXPLORATION -metástasis I-EXPLORATION -de I-EXPLORATION -CPT I-EXPLORATION -en I-EXPLORATION -ganglio I-EXPLORATION -del I-EXPLORATION -grupo I-EXPLORATION -VI, I-EXPLORATION -intrano-dal, I-EXPLORATION -sin I-EXPLORATION -extensión I-EXPLORATION -al I-EXPLORATION -tejido I-EXPLORATION -adiposo. I-EXPLORATION -La I-EXPLORATION -tinción I-EXPLORATION -para I-EXPLORATION -Tg I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -difusa I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -coloide I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -citoplasma I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -tumorales. I-EXPLORATION - I-EXPLORATION +ambas I-EVOLUTION +extremidades. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS +56 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Unidad I-PRESENT_ILLNESS -Dental I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Centro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Referencia I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hepatopatía I-PAST_MEDICAL_HISTORY +previa, I-PAST_MEDICAL_HISTORY +consumidora B-PRESENT_ILLNESS +habitual I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +productos I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Salud I-PRESENT_ILLNESS +Herbalife I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +zumo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Peñalolén, I-PRESENT_ILLNESS -Cordillera I-PRESENT_ILLNESS -Oriente, I-PRESENT_ILLNESS -Santiago, I-PRESENT_ILLNESS -Chile. I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS +Noni. I-PRESENT_ILLNESS +Acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -labio I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -lado I-PRESENT_ILLNESS -izquierdo. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -señaló I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -crecido I-PRESENT_ILLNESS -lentamente I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ella I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -detectó. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -inspección I-EXPLORATION -clínica I-EXPLORATION +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +inespecífico, I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +ictericia I-PRESENT_ILLNESS +mucocutánea. I-PRESENT_ILLNESS +No B-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -el I-EXPLORATION -labio I-EXPLORATION -con I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -nodular, I-EXPLORATION -irregular, I-EXPLORATION -globuloso I-EXPLORATION -(como I-EXPLORATION -racimo), I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -mayor, I-EXPLORATION -indoloro, I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -firme I-EXPLORATION +evidenció I-EXPLORATION a I-EXPLORATION la I-EXPLORATION -palpación, I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -más I-EXPLORATION -o I-EXPLORATION -menos I-EXPLORATION -difusos I-EXPLORATION -y I-EXPLORATION -recubierto I-EXPLORATION -por I-EXPLORATION -mucosa I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -normal. I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +deterioro I-EXPLORATION +neurológico. I-EXPLORATION En I-EXPLORATION la I-EXPLORATION -anamnesis I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -pesquisaron I-EXPLORATION -otros I-EXPLORATION -procesos I-EXPLORATION -ni I-EXPLORATION -antecedentes I-EXPLORATION -mórbidos I-EXPLORATION -relevantes. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -la I-TREATMENT -hipótesis I-TREATMENT -diagnóstica I-TREATMENT -de I-TREATMENT -adenoma I-TREATMENT -pleomorfo, I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -realizar I-TREATMENT -la I-TREATMENT -biopsia I-TREATMENT -excisional I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -local. I-TREATMENT -Se I-TREATMENT -logró I-TREATMENT -extraer I-TREATMENT -toda I-TREATMENT -la I-TREATMENT -tumoración I-TREATMENT -además I-TREATMENT -de I-TREATMENT -tejido I-TREATMENT -adyacente, I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -si I-TREATMENT -bien I-TREATMENT -se I-TREATMENT -observaba I-TREATMENT -algo I-TREATMENT -de I-TREATMENT -fibrosis I-TREATMENT -periférica, I-TREATMENT -ésta I-TREATMENT -se I-TREATMENT -entremezclaba I-TREATMENT -con I-TREATMENT -el I-TREATMENT -tejido I-TREATMENT -conjuntivo I-TREATMENT -y I-TREATMENT -capa I-TREATMENT -muscular I-TREATMENT -de I-TREATMENT -los I-TREATMENT -labios. I-TREATMENT -La B-EXPLORATION -muestra I-EXPLORATION -fue I-EXPLORATION -enviada I-EXPLORATION -a I-EXPLORATION -análisis I-EXPLORATION -histopatológico. I-EXPLORATION +analítica I-EXPLORATION +sanguínea I-EXPLORATION +destacaba: I-EXPLORATION +ALT I-EXPLORATION +940 I-EXPLORATION +U/l, I-EXPLORATION +AST I-EXPLORATION +1300 I-EXPLORATION +U/l, I-EXPLORATION +GGT I-EXPLORATION +173U/l, I-EXPLORATION +FA I-EXPLORATION +187 I-EXPLORATION +U/l, I-EXPLORATION +LDH I-EXPLORATION +431 I-EXPLORATION +U/l, I-EXPLORATION +bilirrubina I-EXPLORATION +total I-EXPLORATION +21, I-EXPLORATION +45 I-EXPLORATION +mg/dl, I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +actividad I-EXPLORATION +de I-EXPLORATION +protrombina I-EXPLORATION +del I-EXPLORATION +41% I-EXPLORATION +(INR I-EXPLORATION +2.03). I-EXPLORATION I-EXPLORATION El I-EXPLORATION -informe I-EXPLORATION -histopatológico I-EXPLORATION -reveló I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -proliferación I-EXPLORATION -bien I-EXPLORATION -delimitada, I-EXPLORATION -pero I-EXPLORATION -no I-EXPLORATION -capsulada, I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -tejido I-EXPLORATION -compuesto I-EXPLORATION -por I-EXPLORATION -vasos I-EXPLORATION -sanguíneos I-EXPLORATION +la I-EXPLORATION +etiología I-EXPLORATION +incluyó I-EXPLORATION +serologías I-EXPLORATION de I-EXPLORATION -paredes I-EXPLORATION -engrosadas, I-EXPLORATION -entremezclados I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -linfocitario I-EXPLORATION +virus I-EXPLORATION +hepatotropos: I-EXPLORATION +VHA, I-EXPLORATION +VHB, I-EXPLORATION +VHC, I-EXPLORATION +VHE, I-EXPLORATION +CMV, I-EXPLORATION +EB, I-EXPLORATION +VVZ, I-EXPLORATION +HHV I-EXPLORATION +6-8 I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -disponía I-EXPLORATION -a I-EXPLORATION -manera I-EXPLORATION +fueron I-EXPLORATION +IgG I-EXPLORATION +e I-EXPLORATION +IgM I-EXPLORATION +negativas. I-EXPLORATION +Serología I-EXPLORATION +VIH I-EXPLORATION +negativa. I-EXPLORATION +ARN-VHC I-EXPLORATION +y I-EXPLORATION +ADN-VHB I-EXPLORATION +negativos. I-EXPLORATION +La I-EXPLORATION +serología I-EXPLORATION de I-EXPLORATION - I-EXPLORATION -folículos I-EXPLORATION -con I-EXPLORATION -centros I-EXPLORATION -germinativos, I-EXPLORATION +Coxiella, I-EXPLORATION +T. I-EXPLORATION +Cruzi, I-EXPLORATION +Treponema I-EXPLORATION +y I-EXPLORATION +Brucella, I-EXPLORATION +fueron I-EXPLORATION +negativas I-EXPLORATION +para I-EXPLORATION +IgG I-EXPLORATION +e I-EXPLORATION +IgM. I-EXPLORATION +Se I-EXPLORATION +descartó I-EXPLORATION además I-EXPLORATION +enfermedad I-EXPLORATION de I-EXPLORATION -presencia I-EXPLORATION -destacada I-EXPLORATION -de I-EXPLORATION -eosinófilos. I-EXPLORATION -El I-EXPLORATION -tejido I-EXPLORATION -presentaba I-EXPLORATION -múltiples I-EXPLORATION -tabicaciones I-EXPLORATION -por I-EXPLORATION -haces I-EXPLORATION +Wilson, I-EXPLORATION +deficiencia I-EXPLORATION de I-EXPLORATION -fibras I-EXPLORATION -colágenas. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -histopatológico I-EXPLORATION -correspondió I-EXPLORATION -a I-EXPLORATION -hiperplasia I-EXPLORATION -angiolinfoidea I-EXPLORATION +alfa I-EXPLORATION +1 I-EXPLORATION +antitripsina I-EXPLORATION +y I-EXPLORATION +hepatitis I-EXPLORATION +autoinmune. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +y I-EXPLORATION +colangio-hepato I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +descartaron I-EXPLORATION +patología I-EXPLORATION +biliopancreática. I-EXPLORATION +La I-EXPLORATION +evolución I-EXPLORATION +analítica I-EXPLORATION +fue I-EXPLORATION +tórpida I-EXPLORATION +como I-EXPLORATION +se I-EXPLORATION +muestra I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +tabla I-EXPLORATION +I. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +hepática I-EXPLORATION +transyugular I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +hepatitis I-EXPLORATION +lobulillar I-EXPLORATION con I-EXPLORATION -eosinofilia. I-EXPLORATION -Los I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -distintos I-EXPLORATION -parámetros I-EXPLORATION -del I-EXPLORATION -hemograma I-EXPLORATION -estaban I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -rangos I-EXPLORATION -normales. I-EXPLORATION +necrosis I-EXPLORATION +confluente I-EXPLORATION +que I-EXPLORATION +iniciaba I-EXPLORATION +transformación I-EXPLORATION +nodular. I-EXPLORATION I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -controlada I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -días I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -procedió I-EVOLUTION -al I-EVOLUTION -retiro I-EVOLUTION +En B-EVOLUTION +la I-EVOLUTION +tercera I-EVOLUTION +semana I-EVOLUTION de I-EVOLUTION +evolución I-EVOLUTION la I-EVOLUTION -sutura. I-EVOLUTION -Luego I-EVOLUTION -se I-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -controlar I-EVOLUTION -al I-EVOLUTION -mes I-EVOLUTION +paciente I-EVOLUTION +desarrolló I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +encefalopatía I-EVOLUTION +hepática I-EVOLUTION +grado I-EVOLUTION +II I-EVOLUTION y I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION +un I-EVOLUTION +empeoramiento I-EVOLUTION +clínico I-EVOLUTION +con I-EVOLUTION +aparición I-EVOLUTION de I-EVOLUTION -realizada I-EVOLUTION -la I-EVOLUTION -cirugía, I-EVOLUTION -sin I-EVOLUTION -observarse I-EVOLUTION -recidiva. I-EVOLUTION - I-EVOLUTION +ascitis. I-EVOLUTION +El B-TREATMENT +cuadro I-TREATMENT +clínico I-TREATMENT +progresó I-TREATMENT +hacia I-TREATMENT +fallo I-TREATMENT +hepático I-TREATMENT +que I-TREATMENT +precisó I-TREATMENT +trasplante I-TREATMENT +hepático I-TREATMENT +urgente, I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +evolución I-TREATMENT +posterior. I-TREATMENT + I-TREATMENT Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY +previamente B-PAST_MEDICAL_HISTORY +sano, I-PAST_MEDICAL_HISTORY +originario I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -relevancia, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS +Concepción I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +radicado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +AAntofagasta I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +año. I-PAST_MEDICAL_HISTORY +Fue B-PRESENT_ILLNESS +internado I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -junio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2005, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -epigástrico, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -carácter I-PRESENT_ILLNESS -sordo, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -moderada I-PRESENT_ILLNESS -intensidad, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -cedió I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -antiespasmó-dicos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -bloqueadores I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -bomba I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -protones, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -dada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -alta I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -domicilio. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -reconsultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +privado I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -siguiente I-PRESENT_ILLNESS +salud I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -persistencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -epigastralgia, I-PRESENT_ILLNESS -realizándose B-EXPLORATION -una I-EXPLORATION -ecotomografía I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -quística I-EXPLORATION -retroperitoneal. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -(TAC), I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -quística I-EXPLORATION -multitabicada I-EXPLORATION -de I-EXPLORATION -44 I-EXPLORATION -x I-EXPLORATION -26 I-EXPLORATION -mm, I-EXPLORATION -bien I-EXPLORATION -delimitada, I-EXPLORATION -que I-EXPLORATION -contactaba I-EXPLORATION -caudalmente I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -cuerpo I-EXPLORATION -del I-EXPLORATION -páncreas. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -sometida I-TREATMENT -a I-TREATMENT -una I-TREATMENT -laparotomía I-TREATMENT -exploradora I-TREATMENT -subcostal I-TREATMENT -bilateral, I-TREATMENT -encontrándose I-TREATMENT -la I-TREATMENT -lesión, I-TREATMENT -descrita I-TREATMENT -en I-TREATMENT -la I-TREATMENT -TAC, I-TREATMENT -íntimamente I-TREATMENT -adherida I-TREATMENT -al I-TREATMENT -páncreas, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -debió I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -pancreatectomía I-TREATMENT -distal I-TREATMENT -junto I-TREATMENT -a I-TREATMENT -la I-TREATMENT -resección I-TREATMENT -del I-TREATMENT -quiste, I-TREATMENT -enviándose I-TREATMENT -la I-TREATMENT -pieza I-TREATMENT -a I-TREATMENT -anatomía I-TREATMENT -patológica. I-TREATMENT - I-TREATMENT -Hallazgos I-TREATMENT -patológicos I-TREATMENT - I-TREATMENT -El I-TREATMENT -páncreas I-TREATMENT -mostraba I-TREATMENT -acinos I-TREATMENT -e I-TREATMENT -islotes I-TREATMENT -pancreáticos I-TREATMENT -de I-TREATMENT -arquitectura I-TREATMENT -normal. I-TREATMENT -Se I-TREATMENT -identificaban I-TREATMENT -además I-TREATMENT -dos I-TREATMENT -ganglios I-TREATMENT -linfáticos I-TREATMENT -peripancreáticos I-TREATMENT -sin I-TREATMENT -alteraciones. I-TREATMENT - I-TREATMENT -El I-TREATMENT -diagnóstico I-TREATMENT -histológico I-TREATMENT -fue I-TREATMENT -compatible I-TREATMENT -con I-TREATMENT -un I-TREATMENT -quiste I-TREATMENT -broncogénico I-TREATMENT -retroperitoneal. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -posopera-torio, I-EVOLUTION -siendo I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -décimo I-EVOLUTION -día I-EVOLUTION -posoperatorio. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcoholismo I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Unidad I-PRESENT_ILLNESS +seis I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Emergencia I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Complejo I-PRESENT_ILLNESS -Asistencial I-PRESENT_ILLNESS -Barros I-PRESENT_ILLNESS -Luco I-PRESENT_ILLNESS -(CABL) I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -caracterizada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -muslo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cadera I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -intensidad. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -asoció I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cuadrante I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -ipsilateral I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +alta, I-PRESENT_ILLNESS +mialgias, I-PRESENT_ILLNESS +cefalea, I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +seca I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -lipotimia. I-PRESENT_ILLNESS -No B-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY +vómitos I-PRESENT_ILLNESS +alimentarios. I-PRESENT_ILLNESS +Tenía B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -trauma I-PAST_MEDICAL_HISTORY -abdominal I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -otras I-PAST_MEDICAL_HISTORY -enfermedades I-PAST_MEDICAL_HISTORY -asociadas. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -el I-EXPLORATION +haber I-PAST_MEDICAL_HISTORY +viajado I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +Región I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +Bío-Bío I-PAST_MEDICAL_HISTORY +(zona I-PAST_MEDICAL_HISTORY +urbana I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Concepción) I-PAST_MEDICAL_HISTORY +36 I-PAST_MEDICAL_HISTORY +días I-PAST_MEDICAL_HISTORY +antes, I-PAST_MEDICAL_HISTORY +donde I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +tenido I-PAST_MEDICAL_HISTORY +contacto I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +amigo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +estaba I-PAST_MEDICAL_HISTORY +cursando I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +cuadro I-PAST_MEDICAL_HISTORY +diarreico. I-PAST_MEDICAL_HISTORY +Al B-EXPLORATION examen I-EXPLORATION físico I-EXPLORATION -de I-EXPLORATION +del I-EXPLORATION ingreso I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -de I-EXPLORATION -80/54 I-EXPLORATION -mmHg, I-EXPLORATION -pulso I-EXPLORATION -78 I-EXPLORATION -x', I-EXPLORATION -coloración I-EXPLORATION -lívida I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -infraumbilical I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -inferiores. I-EXPLORATION -Se I-EXPLORATION -aportaron I-EXPLORATION -entonces I-EXPLORATION -1.000 I-EXPLORATION -ce I-EXPLORATION -de I-EXPLORATION -solución I-EXPLORATION -cristaloide I-EXPLORATION -intravenosa I-EXPLORATION -que I-EXPLORATION -permitieron I-EXPLORATION -normalizar I-EXPLORATION -la I-EXPLORATION -presión I-EXPLORATION -arterial. I-EXPLORATION -El I-EXPLORATION -abdomen I-EXPLORATION -aparecía I-EXPLORATION -distendido, I-EXPLORATION -con I-EXPLORATION -dolor I-EXPLORATION -intenso I-EXPLORATION +presentaba I-EXPLORATION +escasas I-EXPLORATION +crepitaciones I-EXPLORATION a I-EXPLORATION la I-EXPLORATION -palpación I-EXPLORATION -superficial I-EXPLORATION +auscultación I-EXPLORATION +pulmonar I-EXPLORATION y I-EXPLORATION -profunda I-EXPLORATION en I-EXPLORATION -hipocondrio, I-EXPLORATION -flanco I-EXPLORATION -y I-EXPLORATION -fosa I-EXPLORATION -ilíaca I-EXPLORATION -derecha. I-EXPLORATION -Presentaba, I-EXPLORATION -además, I-EXPLORATION -dolor I-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -rebote I-EXPLORATION -difuso, I-EXPLORATION -resistencia I-EXPLORATION -muscular I-EXPLORATION -difusa I-EXPLORATION -y I-EXPLORATION -puño I-EXPLORATION -percusión I-EXPLORATION -derecha I-EXPLORATION -positiva. I-EXPLORATION +tórax I-EXPLORATION +no I-EXPLORATION +había I-EXPLORATION +imágenes I-EXPLORATION +de I-EXPLORATION +consolidación. I-EXPLORATION En I-EXPLORATION los I-EXPLORATION exámenes I-EXPLORATION de I-EXPLORATION laboratorio I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -obtuvo: I-EXPLORATION -glicemla I-EXPLORATION -de I-EXPLORATION -250 I-EXPLORATION -mg/dl, I-EXPLORATION -nitrógeno I-EXPLORATION -ureico I-EXPLORATION -de I-EXPLORATION -17 I-EXPLORATION -mg/dl, I-EXPLORATION -creatininemia I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -17 I-EXPLORATION -mg/dl, I-EXPLORATION -amilasa I-EXPLORATION -86 I-EXPLORATION -U/1, I-EXPLORATION -lipasa I-EXPLORATION -40 I-EXPLORATION -U/1, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -2 I-EXPLORATION -mg/1, I-EXPLORATION -protrombine-mia I-EXPLORATION -83, I-EXPLORATION -5%; I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -tromboplastina I-EXPLORATION -parcial I-EXPLORATION -activado: I-EXPLORATION -28, I-EXPLORATION -1 I-EXPLORATION -s, I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -leucocitos I-EXPLORATION -de I-EXPLORATION -18.200/fxl, I-EXPLORATION -hemoglobinemia I-EXPLORATION -de I-EXPLORATION -12, I-EXPLORATION -7 I-EXPLORATION +destacaba I-EXPLORATION +un I-EXPLORATION +hemograma I-EXPLORATION +con I-EXPLORATION +28.400 I-EXPLORATION +leucocitos/mm3 I-EXPLORATION +y I-EXPLORATION +desviación I-EXPLORATION +a I-EXPLORATION +izquierda I-EXPLORATION +(63% I-EXPLORATION +segmentados I-EXPLORATION +y I-EXPLORATION +17% I-EXPLORATION +baciliformes), I-EXPLORATION +35.000 I-EXPLORATION +plaquetas/mm3, I-EXPLORATION +PCR I-EXPLORATION +7, I-EXPLORATION +5 I-EXPLORATION mg/dl I-EXPLORATION +(N I-EXPLORATION += I-EXPLORATION +0-1), I-EXPLORATION +LDH I-EXPLORATION y I-EXPLORATION -un I-EXPLORATION -hematocrito I-EXPLORATION -de I-EXPLORATION -39%. I-EXPLORATION -Se I-EXPLORATION +transaminasas I-EXPLORATION +elevadas. I-EXPLORATION +Al B-EVOLUTION +segundo I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +hospitalización I-EVOLUTION +presentó I-EVOLUTION +disnea, I-EVOLUTION +polipnea I-EVOLUTION +e I-EVOLUTION +hipoxemia. I-EVOLUTION +Se B-EXPLORATION realizó I-EXPLORATION una I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -(TC) I-EXPLORATION +TAC I-EXPLORATION de I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis, I-EXPLORATION -con I-EXPLORATION -contraste, I-EXPLORATION +tórax I-EXPLORATION que I-EXPLORATION mostró I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -espontáneamente I-EXPLORATION -hiperdensa I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -hipocondrio I-EXPLORATION -y I-EXPLORATION -flanco I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -16 I-EXPLORATION -por I-EXPLORATION -12 I-EXPLORATION -por I-EXPLORATION -9 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -desplazaba I-EXPLORATION -el I-EXPLORATION -colon I-EXPLORATION -derecho I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -periferia, I-EXPLORATION -manteniendo I-EXPLORATION -un I-EXPLORATION -plano I-EXPLORATION -de I-EXPLORATION -clivaje I-EXPLORATION -con I-EXPLORATION -él. I-EXPLORATION -Se I-EXPLORATION -sugería I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -extenso I-EXPLORATION -hematoma I-EXPLORATION -mesentérico, I-EXPLORATION -sin I-EXPLORATION -poder I-EXPLORATION -descartar I-EXPLORATION -también I-EXPLORATION -neoplasia I-EXPLORATION -subyacente. I-EXPLORATION -Al B-EVOLUTION -segundo I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -estaba I-EVOLUTION -hemodinámicamente I-EVOLUTION -estable, I-EVOLUTION -afebril I-EVOLUTION +opacidades I-EXPLORATION +pulmonares I-EXPLORATION +bilaterales. I-EXPLORATION +Se B-DERIVED_FROM/TO +trasladó I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +Unidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Cuidados I-DERIVED_FROM/TO +Intensivos I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +conectó I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +ventilación I-DERIVED_FROM/TO +mecánica. I-DERIVED_FROM/TO +Evolucionó B-EVOLUTION +rápidamente I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +SDRA I-EVOLUTION y I-EVOLUTION +al I-EVOLUTION +tercer I-EVOLUTION +día, I-EVOLUTION con I-EVOLUTION -menos I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -espontáneo, I-EVOLUTION -sin I-EVOLUTION -embargo, I-EVOLUTION -el I-EVOLUTION -hematocrito I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -descendió I-EVOLUTION -a I-EVOLUTION -21%, I-EVOLUTION -decidiéndose B-TREATMENT -entonces I-TREATMENT -transfundir I-TREATMENT -2 I-TREATMENT -U I-TREATMENT -de I-TREATMENT -glóbulos I-TREATMENT -rojos I-TREATMENT -e I-TREATMENT -intervenir I-TREATMENT -quirúrgicamente I-TREATMENT -al I-TREATMENT -paciente. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -efectuó I-TREATMENT -laparotomía I-TREATMENT -exploradora, I-TREATMENT -encontrándose I-TREATMENT -un I-TREATMENT -gran I-TREATMENT -hematoma I-TREATMENT -encapsulado I-TREATMENT -retrope-ritoneal I-TREATMENT -derecho, I-TREATMENT -que I-TREATMENT -se I-TREATMENT -extendía I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -mesocolon I-TREATMENT -transverso I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -pelvis, I-TREATMENT -sin I-TREATMENT -observar I-TREATMENT -lesión I-TREATMENT +una I-EVOLUTION +disfunción I-EVOLUTION +multiorgánica. I-EVOLUTION +Se B-TREATMENT +manejó I-TREATMENT con I-TREATMENT -sangrado I-TREATMENT -activo. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -vaciamiento, I-TREATMENT -aseo, I-TREATMENT -instalación I-TREATMENT +corticoesteroides I-TREATMENT +i.v., I-TREATMENT +aminas I-TREATMENT +vasoactivas, I-TREATMENT +antimicrobianos I-TREATMENT de I-TREATMENT -drenajes I-TREATMENT -en I-TREATMENT -el I-TREATMENT -retroperito-neo I-TREATMENT +amplio I-TREATMENT +espectro I-TREATMENT y I-TREATMENT -toma I-TREATMENT -de I-TREATMENT -muestras I-TREATMENT -para I-TREATMENT -biopsia, I-TREATMENT -la I-TREATMENT -que, I-TREATMENT -posteriormente, I-TREATMENT -se I-TREATMENT -informó I-TREATMENT -como I-TREATMENT -hematoma I-TREATMENT -de I-TREATMENT -mesenterio I-TREATMENT -sin I-TREATMENT -evidencias I-TREATMENT -de I-TREATMENT -neoplasia. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -satisfactoriamente I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION +oseltamivir I-TREATMENT +empíricos. I-TREATMENT +La B-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +VIH I-EXPLORATION +y I-EXPLORATION +RPC I-EXPLORATION +para I-EXPLORATION +virus I-EXPLORATION +influenza I-EXPLORATION +A I-EXPLORATION +H1N1, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +los I-EXPLORATION +hemocultivos I-EXPLORATION +resultaron I-EXPLORATION +negativos. I-EXPLORATION +Además I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +hantavirus I-EXPLORATION +al I-EXPLORATION +Instituto I-EXPLORATION +de I-EXPLORATION +Salud I-EXPLORATION +Pública. I-EXPLORATION +Al B-EVOLUTION sexto I-EVOLUTION día I-EVOLUTION -del I-EVOLUTION -posoperatorio, I-EVOLUTION -cuando I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -salida I-EVOLUTION de I-EVOLUTION -líquido I-EVOLUTION -fecal I-EVOLUTION +hospitalización I-EVOLUTION +falleció I-EVOLUTION por I-EVOLUTION -los I-EVOLUTION -drenajes, I-EVOLUTION -realizándose I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -fístula I-EVOLUTION -estercorácea. I-EVOLUTION -Se B-TREATMENT -decidió, I-TREATMENT -entonces, I-TREATMENT -conectar I-TREATMENT -los I-TREATMENT -tubulares I-TREATMENT -a I-TREATMENT -aspiración I-TREATMENT -e I-TREATMENT -iniciar I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -con I-TREATMENT -metronidazol I-TREATMENT -más I-TREATMENT -ciprofloxacina, I-TREATMENT -con I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -consiguió I-TREATMENT -buen I-TREATMENT -control I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fístula, I-TREATMENT -la I-TREATMENT -cual I-TREATMENT -evolucionó I-TREATMENT -al I-TREATMENT -cierre I-TREATMENT -definitivo I-TREATMENT -al I-TREATMENT -vigésimo I-TREATMENT -día I-TREATMENT -desde I-TREATMENT -la I-TREATMENT -operación, I-TREATMENT -dándose I-TREATMENT -de I-TREATMENT -alta I-TREATMENT -en I-TREATMENT -óptimas I-TREATMENT -condiciones I-TREATMENT -generales I-TREATMENT -y I-TREATMENT -de I-TREATMENT -la I-TREATMENT -herida. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -mantenido I-EVOLUTION -en I-EVOLUTION -control I-EVOLUTION -ambulatorio I-EVOLUTION -en I-EVOLUTION -policlínico I-EVOLUTION -de I-EVOLUTION -cirugía, I-EVOLUTION -permaneciendo I-EVOLUTION -asintomático I-EVOLUTION -a I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -egreso. I-EVOLUTION - I-EVOLUTION +hipotensión I-EVOLUTION +arterial I-EVOLUTION +refractaria, I-EVOLUTION +oligoanuria, I-EVOLUTION +hipoxemia I-EVOLUTION +y I-EVOLUTION +acidosis I-EVOLUTION +metabólica I-EVOLUTION +grave. I-EVOLUTION +Postmortem B-EXPLORATION +se I-EXPLORATION +informó I-EXPLORATION +una I-EXPLORATION +serología I-EXPLORATION +positiva I-EXPLORATION +para I-EXPLORATION +hantavirus I-EXPLORATION +(IgM I-EXPLORATION +e I-EXPLORATION +IgG) I-EXPLORATION +10. I-EXPLORATION + I-EXPLORATION -Familia B-PRESENT_ILLNESS -afectada I-PRESENT_ILLNESS +Niña B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -madre. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Estudio I-PRESENT_ILLNESS -molecular I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -hormonal. I-PRESENT_ILLNESS -El B-FAMILY_HISTORY -estudio I-FAMILY_HISTORY -hormonal I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -tía I-FAMILY_HISTORY -y I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -del I-FAMILY_HISTORY -probando I-FAMILY_HISTORY -(sujetos I-FAMILY_HISTORY -II. I-FAMILY_HISTORY -2 I-FAMILY_HISTORY -y I-FAMILY_HISTORY -II. I-FAMILY_HISTORY -3) I-FAMILY_HISTORY -incluyó I-FAMILY_HISTORY -una I-FAMILY_HISTORY -prueba I-FAMILY_HISTORY -de I-FAMILY_HISTORY -ACTH, I-FAMILY_HISTORY -cuyos I-FAMILY_HISTORY -valores I-FAMILY_HISTORY -de I-FAMILY_HISTORY -170H I-FAMILY_HISTORY -Progesterona I-FAMILY_HISTORY -basal I-FAMILY_HISTORY -y I-FAMILY_HISTORY -estimulado I-FAMILY_HISTORY -fueron I-FAMILY_HISTORY -normales, I-FAMILY_HISTORY -no I-FAMILY_HISTORY -permitiendo I-FAMILY_HISTORY -aclarar I-FAMILY_HISTORY -si I-FAMILY_HISTORY -estos I-FAMILY_HISTORY -sujetos I-FAMILY_HISTORY -eran I-FAMILY_HISTORY -heterocigotos I-FAMILY_HISTORY -de I-FAMILY_HISTORY -una I-FAMILY_HISTORY -mutación I-FAMILY_HISTORY -del I-FAMILY_HISTORY -CYP21A2. I-FAMILY_HISTORY - I-FAMILY_HISTORY -El B-EXPLORATION -estudio I-EXPLORATION -molecular I-EXPLORATION +8 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +remitida B-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +pediatra I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +hospital I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +estudio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +adenopatía I-DERIVED_FROM/TO +cervical I-DERIVED_FROM/TO +dolorosa I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +semana I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +evolución, I-DERIVED_FROM/TO +sin I-DERIVED_FROM/TO +respuesta I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +tratamiento I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +amoxicilina-clavulánico. I-DERIVED_FROM/TO +No B-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +fiebre, I-PRESENT_ILLNESS +astenia, I-PRESENT_ILLNESS +anorexia I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +otra I-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS +asociada. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -en I-EXPLORATION -ADN I-EXPLORATION -genómi-co I-EXPLORATION -extraído I-EXPLORATION +apreciaron I-EXPLORATION +adenopatías I-EXPLORATION +laterocervicales I-EXPLORATION +izquierdas I-EXPLORATION +menores I-EXPLORATION de I-EXPLORATION -leucocitos I-EXPLORATION +1 I-EXPLORATION +cm I-EXPLORATION y I-EXPLORATION +adenopatía I-EXPLORATION +laterocervical I-EXPLORATION +inferior I-EXPLORATION +de I-EXPLORATION +3, I-EXPLORATION +5 I-EXPLORATION +x I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +consistencia I-EXPLORATION +dura, I-EXPLORATION +no I-EXPLORATION +adherida, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +inflamatorios I-EXPLORATION +asociados. I-EXPLORATION +En I-EXPLORATION las I-EXPLORATION -siete I-EXPLORATION -mutaciones I-EXPLORATION -más I-EXPLORATION -frecuentes I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -CYP21A2 I-EXPLORATION +pruebas I-EXPLORATION +complementarias I-EXPLORATION +destacaba I-EXPLORATION +hemograma, I-EXPLORATION +bioquímica I-EXPLORATION +y I-EXPLORATION +coagulación I-EXPLORATION +normales, I-EXPLORATION +VSG I-EXPLORATION +30 I-EXPLORATION +mm, I-EXPLORATION +anticuerpos I-EXPLORATION +antinucleares I-EXPLORATION +y I-EXPLORATION +factor I-EXPLORATION +reumatoideo I-EXPLORATION +negativos. I-EXPLORATION +PPD I-EXPLORATION +5U I-EXPLORATION +negativo. I-EXPLORATION +Serología I-EXPLORATION +Herpesvirus I-EXPLORATION +6 I-EXPLORATION +IgM I-EXPLORATION +positiva. I-EXPLORATION +Serologías I-EXPLORATION +CMV, I-EXPLORATION +VEB, I-EXPLORATION +VHS I-EXPLORATION +I I-EXPLORATION +- I-EXPLORATION +II, I-EXPLORATION +Hepatitis I-EXPLORATION +B I-EXPLORATION +y I-EXPLORATION +C, I-EXPLORATION +VIH, I-EXPLORATION +Toxoplasma I-EXPLORATION +gondii, I-EXPLORATION +Bartonella I-EXPLORATION +henselae, I-EXPLORATION +Parvovirus I-EXPLORATION +B19 I-EXPLORATION +y I-EXPLORATION +Salmonella I-EXPLORATION +typhi I-EXPLORATION +negativas. I-EXPLORATION +La I-EXPLORATION +Rx I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION fueron I-EXPLORATION -estudiadas I-EXPLORATION -con I-EXPLORATION -PCR I-EXPLORATION -alelo I-EXPLORATION -específica I-EXPLORATION -(Fardella, I-EXPLORATION -1998). I-EXPLORATION -Este B-FAMILY_HISTORY -estudio I-FAMILY_HISTORY -demostró I-FAMILY_HISTORY -en I-FAMILY_HISTORY -la I-FAMILY_HISTORY -familia I-FAMILY_HISTORY -paterna I-FAMILY_HISTORY -(sujetos I-FAMILY_HISTORY -II.2, I-FAMILY_HISTORY -II.4, I-FAMILY_HISTORY -II.6) I-FAMILY_HISTORY -la I-FAMILY_HISTORY -mutación I-FAMILY_HISTORY -Q318X I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -exón I-FAMILY_HISTORY -8, I-FAMILY_HISTORY -que I-FAMILY_HISTORY -consiste I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -cambio I-FAMILY_HISTORY -de I-FAMILY_HISTORY -una I-FAMILY_HISTORY -glutamina I-FAMILY_HISTORY -por I-FAMILY_HISTORY -un I-FAMILY_HISTORY -codón I-FAMILY_HISTORY -de I-FAMILY_HISTORY -stop. I-FAMILY_HISTORY -Este I-FAMILY_HISTORY -resultado I-FAMILY_HISTORY -no I-FAMILY_HISTORY -permitió I-FAMILY_HISTORY -clasificar I-FAMILY_HISTORY -a I-FAMILY_HISTORY -la I-FAMILY_HISTORY -familia I-FAMILY_HISTORY -materna I-FAMILY_HISTORY -y I-FAMILY_HISTORY -por I-FAMILY_HISTORY -ende I-FAMILY_HISTORY -decidir I-FAMILY_HISTORY -sobre I-FAMILY_HISTORY -la I-FAMILY_HISTORY -necesidad I-FAMILY_HISTORY -del I-FAMILY_HISTORY -tratamiento I-FAMILY_HISTORY -prenatal I-FAMILY_HISTORY -en I-FAMILY_HISTORY -estas I-FAMILY_HISTORY -parejas. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Posteriormente, B-EXPLORATION -el I-EXPLORATION -gen I-EXPLORATION -CYP21A2fue I-EXPLORATION -secuenciado I-EXPLORATION +normales I-EXPLORATION +y I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -Universidad I-EXPLORATION -de I-EXPLORATION -Sao I-EXPLORATION -Paulo I-EXPLORATION -según I-EXPLORATION +ecografía I-EXPLORATION +cervical I-EXPLORATION +se I-EXPLORATION +confirmaron I-EXPLORATION las I-EXPLORATION -técnicas I-EXPLORATION -clásicas I-EXPLORATION -(Wedell, I-EXPLORATION -1993). I-EXPLORATION -Usando B-FAMILY_HISTORY -esta I-FAMILY_HISTORY -metodología, I-FAMILY_HISTORY -se I-FAMILY_HISTORY -encontró I-FAMILY_HISTORY -en I-FAMILY_HISTORY -uno I-FAMILY_HISTORY -de I-FAMILY_HISTORY -los I-FAMILY_HISTORY -alelos I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -familia I-FAMILY_HISTORY -paterna I-FAMILY_HISTORY -(sujetos I-FAMILY_HISTORY -II.2, I-FAMILY_HISTORY -II.4, I-FAMILY_HISTORY -II.6) I-FAMILY_HISTORY -la I-FAMILY_HISTORY -mutación I-FAMILY_HISTORY -Q318X I-FAMILY_HISTORY -junto I-FAMILY_HISTORY -a I-FAMILY_HISTORY -la I-FAMILY_HISTORY -mutación I-FAMILY_HISTORY -R483W, I-FAMILY_HISTORY -la I-FAMILY_HISTORY -que I-FAMILY_HISTORY -consiste I-FAMILY_HISTORY -en I-FAMILY_HISTORY -la I-FAMILY_HISTORY -sustitución I-FAMILY_HISTORY -de I-FAMILY_HISTORY -una I-FAMILY_HISTORY -arginina I-FAMILY_HISTORY -por I-FAMILY_HISTORY -triptofano I-FAMILY_HISTORY -(CGG>TGG). I-FAMILY_HISTORY -En I-FAMILY_HISTORY -la I-FAMILY_HISTORY -familia I-FAMILY_HISTORY -materna I-FAMILY_HISTORY -(sujetos I-FAMILY_HISTORY -II. I-FAMILY_HISTORY -1, I-FAMILY_HISTORY -II.3, I-FAMILY_HISTORY -II.5) I-FAMILY_HISTORY -se I-FAMILY_HISTORY -encontró I-FAMILY_HISTORY -un I-FAMILY_HISTORY -alelo I-FAMILY_HISTORY -con I-FAMILY_HISTORY -la I-FAMILY_HISTORY -mutación I-FAMILY_HISTORY -R483->frameshift, I-FAMILY_HISTORY -también I-FAMILY_HISTORY -conocida I-FAMILY_HISTORY -como I-FAMILY_HISTORY -R483delGGinsC, I-FAMILY_HISTORY -la I-FAMILY_HISTORY -cuál I-FAMILY_HISTORY -consiste I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -cambio I-FAMILY_HISTORY -de I-FAMILY_HISTORY -los I-FAMILY_HISTORY -nucleótidos I-FAMILY_HISTORY -GG I-FAMILY_HISTORY -por I-FAMILY_HISTORY -C, I-FAMILY_HISTORY -alterando I-FAMILY_HISTORY -la I-FAMILY_HISTORY -lectura I-FAMILY_HISTORY -del I-FAMILY_HISTORY -codón. I-FAMILY_HISTORY -De I-FAMILY_HISTORY -este I-FAMILY_HISTORY -modo I-FAMILY_HISTORY -se I-FAMILY_HISTORY -certificó I-FAMILY_HISTORY -que I-FAMILY_HISTORY -los I-FAMILY_HISTORY -seis I-FAMILY_HISTORY -cónyuges I-FAMILY_HISTORY -poseen I-FAMILY_HISTORY -mutaciones I-FAMILY_HISTORY -para I-FAMILY_HISTORY -HSC I-FAMILY_HISTORY -perdedora I-FAMILY_HISTORY -de I-FAMILY_HISTORY -sal, I-FAMILY_HISTORY -y I-FAMILY_HISTORY -por I-FAMILY_HISTORY -lo I-FAMILY_HISTORY -tanto, I-FAMILY_HISTORY -se I-FAMILY_HISTORY -encuentran I-FAMILY_HISTORY -en I-FAMILY_HISTORY -riesgo I-FAMILY_HISTORY -de I-FAMILY_HISTORY -tener I-FAMILY_HISTORY -hijas I-FAMILY_HISTORY -con I-FAMILY_HISTORY -ambigüedad I-FAMILY_HISTORY -genital. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Consejo B-TREATMENT -genético I-TREATMENT -y I-TREATMENT -manejo I-TREATMENT -de I-TREATMENT -los I-TREATMENT -embarazos. I-TREATMENT -Se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -dar I-TREATMENT -consejo I-TREATMENT -genético I-TREATMENT -a I-TREATMENT -los I-TREATMENT -tres I-TREATMENT -matrimonios I-TREATMENT -afectados. I-TREATMENT -La B-EVOLUTION -tía I-EVOLUTION -paterna I-EVOLUTION -(sujeto I-EVOLUTION -II.2), I-EVOLUTION -mujer I-EVOLUTION -sana I-EVOLUTION -de I-EVOLUTION -34 I-EVOLUTION -años, I-EVOLUTION -suspende I-EVOLUTION -el I-EVOLUTION -método I-EVOLUTION -anticonceptivo I-EVOLUTION -por I-EVOLUTION -deseos I-EVOLUTION -de I-EVOLUTION -fertilidad I-EVOLUTION -y I-EVOLUTION -logra I-EVOLUTION -concepción I-EVOLUTION -espontánea I-EVOLUTION -en I-EVOLUTION -marzo I-EVOLUTION -2005. I-EVOLUTION -Se B-TREATMENT -explican I-TREATMENT -los I-TREATMENT -beneficios I-TREATMENT -y I-TREATMENT -riesgos I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -prenatal I-TREATMENT -con I-TREATMENT -corti-coides, I-TREATMENT -los I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -entiende I-TREATMENT -y I-TREATMENT -acepta, I-TREATMENT -firmando I-TREATMENT -un I-TREATMENT -consentimiento I-TREATMENT -en I-TREATMENT -que I-TREATMENT -opta I-TREATMENT -por I-TREATMENT -realizar I-TREATMENT -esta I-TREATMENT -terapia. I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -comenzó I-TREATMENT -a I-TREATMENT -las I-TREATMENT -6 I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -edad I-TREATMENT -gestacional I-TREATMENT -(EG) I-TREATMENT -con I-TREATMENT -dexametasona I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -20 I-TREATMENT -µg/kg/día. I-TREATMENT - I-TREATMENT -A B-EXPLORATION +adenopatías. I-EXPLORATION + I-EXPLORATION +Ante I-EXPLORATION +la I-EXPLORATION +persistencia I-EXPLORATION +de I-EXPLORATION las I-EXPLORATION -13 I-EXPLORATION -semanas I-EXPLORATION +adenopatías I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -sexo I-EXPLORATION -fetal I-EXPLORATION -masculino I-EXPLORATION -por I-EXPLORATION -ultrasonografía I-EXPLORATION -de I-EXPLORATION -alta I-EXPLORATION -resolución I-EXPLORATION -(Voluson I-EXPLORATION -730, I-EXPLORATION -General I-EXPLORATION -Electric, I-EXPLORATION -Austria, I-EXPLORATION -transductor I-EXPLORATION -transabdominal I-EXPLORATION +practicó I-EXPLORATION +biopsia I-EXPLORATION +abierta I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +18 I-EXPLORATION +días I-EXPLORATION de I-EXPLORATION -3, I-EXPLORATION -5-5 I-EXPLORATION -MHz), I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -es I-EXPLORATION -capaz I-EXPLORATION +evolución. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +mostró I-EXPLORATION +focos I-EXPLORATION de I-EXPLORATION -predecir I-EXPLORATION -conectamente I-EXPLORATION -el I-EXPLORATION -sexo I-EXPLORATION -fetal I-EXPLORATION +necrosis I-EXPLORATION +paracortical, I-EXPLORATION +rodeados I-EXPLORATION +por I-EXPLORATION +linfocitos I-EXPLORATION +T I-EXPLORATION +CD4 I-EXPLORATION +y I-EXPLORATION +CD8 I-EXPLORATION ++ I-EXPLORATION +y I-EXPLORATION +abundantes I-EXPLORATION +histiocitos I-EXPLORATION +CD68+, I-EXPLORATION +entremezclados I-EXPLORATION con I-EXPLORATION -99% I-EXPLORATION +células I-EXPLORATION +plasmocitoides I-EXPLORATION +y I-EXPLORATION +ausencia I-EXPLORATION +significativa I-EXPLORATION de I-EXPLORATION -certeza I-EXPLORATION -después I-EXPLORATION +neutrófilos. I-EXPLORATION +La I-EXPLORATION +tinción I-EXPLORATION de I-EXPLORATION -12+6 I-EXPLORATION -semanas I-EXPLORATION -EG I-EXPLORATION -(Efrat, I-EXPLORATION -2006); I-EXPLORATION -la I-EXPLORATION -familia I-EXPLORATION -no I-EXPLORATION -aceptó I-EXPLORATION -técnicas I-EXPLORATION -invasivas I-EXPLORATION +Auramina, I-EXPLORATION +cultivo I-EXPLORATION +para I-EXPLORATION +micobacterias, I-EXPLORATION +PCR I-EXPLORATION de I-EXPLORATION -diagnóstico I-EXPLORATION -prenatal. I-EXPLORATION -Se B-TREATMENT -disminuyó I-TREATMENT -progresivamente I-TREATMENT -las I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -esteroides, I-TREATMENT -suspendiéndolo I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -completa I-TREATMENT -a I-TREATMENT -las I-TREATMENT -22 I-TREATMENT -semanas. I-TREATMENT -Durante B-EVOLUTION -el I-EVOLUTION -período I-EVOLUTION +Enterovirus, I-EXPLORATION +HSV, I-EXPLORATION +VVZ, I-EXPLORATION +CMV, I-EXPLORATION +VEB I-EXPLORATION +y I-EXPLORATION +Herpesvirus I-EXPLORATION +tipos I-EXPLORATION +6, I-EXPLORATION +7 I-EXPLORATION +y I-EXPLORATION +8 I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +ganglionar I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +El B-EVOLUTION +curso I-EVOLUTION de I-EVOLUTION -tratamiento I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -edema I-EVOLUTION -e I-EVOLUTION -hipertensión I-EVOLUTION -arterial I-EVOLUTION -que B-TREATMENT -requirió I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ametildo-pa. I-TREATMENT -Los B-EVOLUTION -síntomas I-EVOLUTION -revirtieron I-EVOLUTION -parcialmente I-EVOLUTION -con I-EVOLUTION la I-EVOLUTION -suspensión I-EVOLUTION -de I-EVOLUTION -terapia I-EVOLUTION -corticoidal, I-EVOLUTION -y I-EVOLUTION -totalmente I-EVOLUTION -posparto. I-EVOLUTION -A I-EVOLUTION -las I-EVOLUTION -39 I-EVOLUTION -semanas I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -cesárea I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -obtuvo I-EVOLUTION -recién I-EVOLUTION -nacido I-EVOLUTION -de I-EVOLUTION -sexo I-EVOLUTION -masculino, I-EVOLUTION -con I-EVOLUTION -peso I-EVOLUTION -adecuado I-EVOLUTION +enfermedad I-EVOLUTION +fue I-EVOLUTION +favorable I-EVOLUTION y I-EVOLUTION -examen I-EVOLUTION -físico I-EVOLUTION -normal. I-EVOLUTION -Los I-EVOLUTION -niveles I-EVOLUTION -de I-EVOLUTION -170HP I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -días I-EVOLUTION +autolimitado. I-EVOLUTION +Dos I-EVOLUTION +años I-EVOLUTION +después I-EVOLUTION se I-EVOLUTION -muestran I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -Figura I-EVOLUTION -IB. I-EVOLUTION +encuentra I-EVOLUTION +asintomática. I-EVOLUTION I-EVOLUTION -La I-EVOLUTION -tía I-EVOLUTION -materna I-EVOLUTION -(sujeto I-EVOLUTION -II.5) I-EVOLUTION -de I-EVOLUTION -37 I-EVOLUTION -años I-EVOLUTION -consultó I-EVOLUTION -por I-EVOLUTION -embarazo I-EVOLUTION -inicial I-EVOLUTION -de I-EVOLUTION -5 I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -EG. I-EVOLUTION -Se B-TREATMENT -ofrece I-TREATMENT -nuevamente I-TREATMENT -tratamiento I-TREATMENT -prenatal I-TREATMENT -de I-TREATMENT -HSC, I-TREATMENT -y I-TREATMENT -también I-TREATMENT -se I-TREATMENT -solicitó I-TREATMENT -firma I-TREATMENT -de I-TREATMENT -consentimiento I-TREATMENT -informado. I-TREATMENT -La I-TREATMENT -familia I-TREATMENT -optó I-TREATMENT -nuevamente I-TREATMENT -por I-TREATMENT -seguir I-TREATMENT -este I-TREATMENT -tratamiento. I-TREATMENT -A I-TREATMENT -las I-TREATMENT -6 I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -EG I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -dexametasona I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -20 I-TREATMENT -Lig/kg/día. I-TREATMENT -La B-EXPLORATION -madre I-EXPLORATION -no I-EXPLORATION -aceptó I-EXPLORATION -las I-EXPLORATION -técnicas I-EXPLORATION -invasivas I-EXPLORATION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +cutáneas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +cuyo I-PRESENT_ILLNESS +inicio I-PRESENT_ILLNESS +coincidió I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +faringoamigdalitis I-PRESENT_ILLNESS +tratada I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +amoxicilina. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +últimas I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +aparición I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +vesículo-ampollosas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +artralgias I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +ambos I-PRESENT_ILLNESS +tobillos, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +impiden I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +deambulación. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +destaca I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -diagnóstico I-EXPLORATION -prenatal I-EXPLORATION +lesiones I-EXPLORATION +purpúricas I-EXPLORATION +palpables, I-EXPLORATION +localizadas I-EXPLORATION +en I-EXPLORATION +piernas, I-EXPLORATION +glúteos, I-EXPLORATION +codos I-EXPLORATION y I-EXPLORATION +dorso I-EXPLORATION +de I-EXPLORATION +manos, I-EXPLORATION +acompañadas I-EXPLORATION +de I-EXPLORATION +ampollas I-EXPLORATION +de I-EXPLORATION +contenido I-EXPLORATION +serohemorrágico. I-EXPLORATION +Además I-EXPLORATION se I-EXPLORATION -decidió I-EXPLORATION -realizar I-EXPLORATION -diagnóstico I-EXPLORATION +observó I-EXPLORATION +edema I-EXPLORATION +doloroso I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +dorso I-EXPLORATION de I-EXPLORATION -sexo I-EXPLORATION -fetal I-EXPLORATION -mediante I-EXPLORATION -ecografía I-EXPLORATION -precoz. I-EXPLORATION -En B-TREATMENT -caso I-TREATMENT +la I-EXPLORATION +mano I-EXPLORATION +izquierda, I-EXPLORATION +pies I-EXPLORATION +y I-EXPLORATION +tobillos, I-EXPLORATION +e I-EXPLORATION +hiperemia I-EXPLORATION +amigdalar I-EXPLORATION +sin I-EXPLORATION +exudados. I-EXPLORATION + I-EXPLORATION +Las I-EXPLORATION +exploraciones I-EXPLORATION +complementarias I-EXPLORATION +(hemograma, I-EXPLORATION +bioquímica, I-EXPLORATION +coagulación I-EXPLORATION +y I-EXPLORATION +tira I-EXPLORATION +reactiva I-EXPLORATION +de I-EXPLORATION +orina) I-EXPLORATION +resultaron I-EXPLORATION +normales. I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT de I-TREATMENT -que I-TREATMENT -se I-TREATMENT -tratara I-TREATMENT +sospecha I-TREATMENT de I-TREATMENT -un I-TREATMENT -feto I-TREATMENT -femenino I-TREATMENT -continuarían I-TREATMENT +PSH I-TREATMENT +con I-TREATMENT +afectación I-TREATMENT +sistémica, I-TREATMENT el I-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +hospitalizado I-TREATMENT +para I-TREATMENT +iniciar I-TREATMENT tratamiento I-TREATMENT -hasta I-TREATMENT -el I-TREATMENT -término I-TREATMENT -del I-TREATMENT -embarazo. I-TREATMENT -A I-TREATMENT -las I-TREATMENT -12 I-TREATMENT -semanas I-TREATMENT -se I-TREATMENT -diagnosticó I-TREATMENT -sexo I-TREATMENT -fetal I-TREATMENT -masculino I-TREATMENT -y I-TREATMENT -se I-TREATMENT -programó I-TREATMENT -suspensión I-TREATMENT -de I-TREATMENT -esteroides. I-TREATMENT +esteroideo I-TREATMENT +(prednisona I-TREATMENT +2 I-TREATMENT +mg/kg/día). I-TREATMENT La B-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presentó I-EVOLUTION -efectos I-EVOLUTION -adversos I-EVOLUTION +evolución I-EVOLUTION +fue I-EVOLUTION +favorable, I-EVOLUTION +con I-EVOLUTION +mejoría I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +síntomas I-EVOLUTION +articulares, I-EVOLUTION +siendo I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION a I-EVOLUTION -la I-EVOLUTION -dexametasona. I-EVOLUTION -A I-EVOLUTION las I-EVOLUTION -40 I-EVOLUTION -semanas I-EVOLUTION -nació I-EVOLUTION -niño I-EVOLUTION -sano, I-EVOLUTION -no I-EVOLUTION -afectado. I-EVOLUTION +24 I-EVOLUTION +horas I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +hospitalización. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS +62 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS +en B-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +trastorno I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +personalidad I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +ánimo, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +intentos I-PAST_MEDICAL_HISTORY +suicidas. I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +febrero I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad. I-PRESENT_ILLNESS -Después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -presentado I-PRESENT_ILLNESS -varicela, I-PRESENT_ILLNESS -inició I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -deglutir I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -progresiva, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -evidencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS +2017 I-PRESENT_ILLNESS +ingirió I-PRESENT_ILLNESS +bupropión I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +dosis I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -hipo I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -hipertiroidismo. I-PRESENT_ILLNESS -Su I-PRESENT_ILLNESS -velocidad I-PRESENT_ILLNESS +9, I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +g, I-PRESENT_ILLNESS +clorpromazina I-PRESENT_ILLNESS +1, I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +g I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +copas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -pondoestatural I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -normal I-PRESENT_ILLNESS -(5 I-PRESENT_ILLNESS -cm/año) I-PRESENT_ILLNESS +vino. I-PRESENT_ILLNESS +Los I-PRESENT_ILLNESS +familiares I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +encontraron I-PRESENT_ILLNESS +alterada I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -ósea I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +llevaron I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +Hospital I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +Salvador, I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +ingresó I-PRESENT_ILLNESS +comprometida I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Antecedentes B-PAST_MEDICAL_HISTORY -previos. I-PAST_MEDICAL_HISTORY -Recién I-PAST_MEDICAL_HISTORY -nacido I-PAST_MEDICAL_HISTORY -pretérmino I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -33 I-PAST_MEDICAL_HISTORY -semanas; I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -periodo I-PAST_MEDICAL_HISTORY -neonatal I-PAST_MEDICAL_HISTORY -cursó I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -distress I-PAST_MEDICAL_HISTORY -respiratorio; I-PAST_MEDICAL_HISTORY -requirió I-PAST_MEDICAL_HISTORY -ventilación I-PAST_MEDICAL_HISTORY -mecánica I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -días. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -relevantes. I-PAST_MEDICAL_HISTORY -Actualmente I-PAST_MEDICAL_HISTORY -cursa I-PAST_MEDICAL_HISTORY -sexto I-PAST_MEDICAL_HISTORY -básico I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -buen I-PAST_MEDICAL_HISTORY -rendimiento I-PAST_MEDICAL_HISTORY -escolar. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Historia B-FAMILY_HISTORY -familiar I-FAMILY_HISTORY -Hijo I-FAMILY_HISTORY -de I-FAMILY_HISTORY -padres I-FAMILY_HISTORY -sanos, I-FAMILY_HISTORY -con I-FAMILY_HISTORY -antecedente I-FAMILY_HISTORY -de I-FAMILY_HISTORY -tiroiditis I-FAMILY_HISTORY -de I-FAMILY_HISTORY -Hashimoto I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -abuelo I-FAMILY_HISTORY -y I-FAMILY_HISTORY -tía I-FAMILY_HISTORY -materna. I-FAMILY_HISTORY -Su I-FAMILY_HISTORY -talla I-FAMILY_HISTORY -familiar I-FAMILY_HISTORY -es I-FAMILY_HISTORY -de I-FAMILY_HISTORY -l69±5 I-FAMILY_HISTORY -cm I-FAMILY_HISTORY -(percentil I-FAMILY_HISTORY -13, I-FAMILY_HISTORY -7). I-FAMILY_HISTORY - I-FAMILY_HISTORY -Examen B-EXPLORATION -físico. I-EXPLORATION -Talla: I-EXPLORATION -146, I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION -(percentil I-EXPLORATION -54), I-EXPLORATION -índice I-EXPLORATION +conciencia I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +Glasgow I-PRESENT_ILLNESS +10, I-PRESENT_ILLNESS +presión I-PRESENT_ILLNESS +arterial I-PRESENT_ILLNESS +90/60, I-PRESENT_ILLNESS +taquicárdica I-PRESENT_ILLNESS +115 I-PRESENT_ILLNESS +lpm, I-PRESENT_ILLNESS +electrocardiograma I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +segmento I-PRESENT_ILLNESS +Q-t I-PRESENT_ILLNESS +alargado I-PRESENT_ILLNESS +(550 I-PRESENT_ILLNESS +ms) I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +ácido I-PRESENT_ILLNESS +láctico I-PRESENT_ILLNESS +elevado I-PRESENT_ILLNESS +(32, I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +mg/dl). I-PRESENT_ILLNESS +Dentro B-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +primeras I-EVOLUTION +24 I-EVOLUTION +h I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +ingreso I-EVOLUTION +presentó I-EVOLUTION +dos I-EVOLUTION +breves I-EVOLUTION +episodios I-EVOLUTION +convulsivos, I-EVOLUTION +de I-EVOLUTION +30 I-EVOLUTION +seg I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +menos I-EVOLUTION +de I-EVOLUTION +un I-EVOLUTION +minuto. I-EVOLUTION +El B-EXPLORATION +electroencefalograma I-EXPLORATION +(EEG) I-EXPLORATION +mostró I-EXPLORATION +actividad I-EXPLORATION +delta-theta I-EXPLORATION de I-EXPLORATION -Masa I-EXPLORATION -Corporal: I-EXPLORATION -18, I-EXPLORATION -2 I-EXPLORATION -kg/m2 I-EXPLORATION -(percentil I-EXPLORATION -62, I-EXPLORATION -5); I-EXPLORATION +bajo I-EXPLORATION +voltaje, I-EXPLORATION sin I-EXPLORATION -desarrollo I-EXPLORATION -puberal I-EXPLORATION -(vello I-EXPLORATION -púbico I-EXPLORATION -Tanner I-EXPLORATION -I, I-EXPLORATION -testículos I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -ce, I-EXPLORATION -simétricos). I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -faringe, I-EXPLORATION -se I-EXPLORATION -visualiza I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -rojiza I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -aproximadamente I-EXPLORATION -2x2 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION +epilepsia. I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -lengua, I-EXPLORATION -con I-EXPLORATION -vasos I-EXPLORATION -venosos I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -superficie, I-EXPLORATION +cerebro I-EXPLORATION +(TAC) I-EXPLORATION sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -hemorragia I-EXPLORATION -o I-EXPLORATION -ulceración. I-EXPLORATION -Sin I-EXPLORATION -estridor I-EXPLORATION -u I-EXPLORATION -odinofagia. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -cuello I-EXPLORATION -no I-EXPLORATION +contraste I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +tenía I-EXPLORATION +escaza I-EXPLORATION +reactividad I-EXPLORATION +y I-EXPLORATION se I-EXPLORATION -palpó I-EXPLORATION -tiroides I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -posición I-EXPLORATION -pre I-EXPLORATION -traqueal. I-EXPLORATION - I-EXPLORATION -Laboratorio. I-EXPLORATION -Las I-EXPLORATION -pruebas I-EXPLORATION +mantuvo I-EXPLORATION +alterada I-EXPLORATION de I-EXPLORATION -función I-EXPLORATION -tiroidea I-EXPLORATION -revelaron I-EXPLORATION -TSH I-EXPLORATION -elevada I-EXPLORATION -10, I-EXPLORATION -79 I-EXPLORATION -UI/mL I-EXPLORATION -(rango I-EXPLORATION -normal I-EXPLORATION -=0, I-EXPLORATION -7-5, I-EXPLORATION -7 I-EXPLORATION -UI/mL), I-EXPLORATION +conciencia, I-EXPLORATION con I-EXPLORATION -tiroxina I-EXPLORATION -normal, I-EXPLORATION -pero I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -cuartil I-EXPLORATION -más I-EXPLORATION -bajo, I-EXPLORATION -6, I-EXPLORATION -0 I-EXPLORATION -Lig/dl I-EXPLORATION -(rango I-EXPLORATION -normal I-EXPLORATION -TT I-EXPLORATION -=5, I-EXPLORATION -5-11, I-EXPLORATION -7 I-EXPLORATION -Hg/dl) I-EXPLORATION -y I-EXPLORATION -triyodotironina I-EXPLORATION -baja I-EXPLORATION -57, I-EXPLORATION -8 I-EXPLORATION -ng/dL I-EXPLORATION -(rango I-EXPLORATION -normal I-EXPLORATION -=84, I-EXPLORATION -4-214, I-EXPLORATION -3 I-EXPLORATION -ng/dL) I-EXPLORATION +mioclonías I-EXPLORATION +generalizadas I-EXPLORATION y I-EXPLORATION -anticuerpos I-EXPLORATION -antiperoxidasa I-EXPLORATION +movimientos I-EXPLORATION +involuntarios I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +extremidades; I-EXPLORATION +tono I-EXPLORATION +muscular I-EXPLORATION +aumentado, I-EXPLORATION +reflejos I-EXPLORATION +osteotendíneos I-EXPLORATION +(ROT) I-EXPLORATION +policinéticos I-EXPLORATION y I-EXPLORATION -antiroglobulina I-EXPLORATION -ausentes. I-EXPLORATION - I-EXPLORATION -Estudio I-EXPLORATION +reflejos I-EXPLORATION +plantares I-EXPLORATION +flexores. I-EXPLORATION +En B-EVOLUTION +la I-EVOLUTION +mañana I-EVOLUTION +del I-EVOLUTION +tercer I-EVOLUTION +día I-EVOLUTION +sufrió I-EVOLUTION +paro I-EVOLUTION +cardiorrespiratorio I-EVOLUTION +por I-EVOLUTION +asistolia, I-EVOLUTION +recibió B-TREATMENT +reanimación I-TREATMENT +inmediata, I-TREATMENT +adrenalina, I-TREATMENT +intubación, I-TREATMENT +luego I-TREATMENT +de I-TREATMENT +5 I-TREATMENT +min I-TREATMENT +logró I-TREATMENT +actividad I-TREATMENT +cardiaca I-TREATMENT +espontánea. I-TREATMENT + I-TREATMENT +Al B-EVOLUTION +día I-EVOLUTION +siguiente I-EVOLUTION +habían I-EVOLUTION +desaparecido I-EVOLUTION +las I-EVOLUTION +mioclonías, I-EVOLUTION +estaba I-EVOLUTION +inconsciente I-EVOLUTION +y I-EVOLUTION +mantenía I-EVOLUTION +una I-EVOLUTION +persistente I-EVOLUTION +apertura I-EVOLUTION +palpebral I-EVOLUTION +con I-EVOLUTION +escaso I-EVOLUTION +pestañeo I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +sobre-elevación I-EVOLUTION +anormal I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +ojos, I-EVOLUTION +como I-EVOLUTION +mirando I-EVOLUTION +hacia I-EVOLUTION +atrás. I-EVOLUTION +Las I-EVOLUTION +pupilas I-EVOLUTION +estaban I-EVOLUTION +iguales I-EVOLUTION +y I-EVOLUTION +reactivas I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +luz, I-EVOLUTION +con I-EVOLUTION +reflejos I-EVOLUTION +oculocefálicos I-EVOLUTION +conservados. I-EVOLUTION +Sus I-EVOLUTION +extremidades I-EVOLUTION +se I-EVOLUTION +mostraban I-EVOLUTION +hipotónicas I-EVOLUTION +y I-EVOLUTION +tenía I-EVOLUTION +los I-EVOLUTION +ROT I-EVOLUTION +exaltados I-EVOLUTION +con I-EVOLUTION +Babinski I-EVOLUTION +bilateral. I-EVOLUTION +Los B-EXPLORATION +estímulos I-EXPLORATION +nociceptivos I-EXPLORATION +desencadenaban I-EXPLORATION +respuestas I-EXPLORATION +extensoras I-EXPLORATION de I-EXPLORATION -imágenes. I-EXPLORATION -La I-EXPLORATION -nasofibrolaringoscopia I-EXPLORATION -óptica I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -rojiza, I-EXPLORATION -tensa, I-EXPLORATION -redondeada, I-EXPLORATION +las I-EXPLORATION +cuatro I-EXPLORATION +extremidades I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +simultáneo I-EXPLORATION +cierre I-EXPLORATION +palpebral I-EXPLORATION con I-EXPLORATION -vasos I-EXPLORATION -sanguíneos I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -superficie. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -de I-EXPLORATION -cuello I-EXPLORATION -confirmó I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -bien I-EXPLORATION -circunscrita I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lengua, I-EXPLORATION +descenso I-EXPLORATION de I-EXPLORATION -2, I-EXPLORATION -0 I-EXPLORATION -x I-EXPLORATION -1, I-EXPLORATION -9 I-EXPLORATION -x I-EXPLORATION -1, I-EXPLORATION -8 I-EXPLORATION -cm, I-EXPLORATION -hiperdensa I-EXPLORATION -en I-EXPLORATION los I-EXPLORATION -cortes I-EXPLORATION -sin I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -endovenoso, I-EXPLORATION -sin I-EXPLORATION -nodulos I-EXPLORATION +globos I-EXPLORATION +oculares, I-EXPLORATION +que I-EXPLORATION en I-EXPLORATION -su I-EXPLORATION -interior. I-EXPLORATION +la I-EXPLORATION +reapertura I-EXPLORATION +palpebral I-EXPLORATION +volvían I-EXPLORATION +a I-EXPLORATION +elevarse I-EXPLORATION +simulando I-EXPLORATION +un I-EXPLORATION +rebote I-EXPLORATION +ocular. I-EXPLORATION El I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -cinügrafía I-EXPLORATION +fenómeno I-EXPLORATION +se I-EXPLORATION +repetía I-EXPLORATION con I-EXPLORATION -Tc-99 I-EXPLORATION +cualquier I-EXPLORATION +estímulo. I-EXPLORATION +La I-EXPLORATION +RM I-EXPLORATION +de I-EXPLORATION +cerebro I-EXPLORATION +realizada I-EXPLORATION +al I-EXPLORATION +octavo I-EXPLORATION +día, I-EXPLORATION mostró I-EXPLORATION -captación I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -base I-EXPLORATION +difusión I-EXPLORATION +imágenes I-EXPLORATION +hiperintensas I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -lengua, I-EXPLORATION -sin I-EXPLORATION -evidencias I-EXPLORATION -de I-EXPLORATION -tiroides I-EXPLORATION +sustancia I-EXPLORATION +blanca I-EXPLORATION +del I-EXPLORATION +centro I-EXPLORATION +oval I-EXPLORATION +y I-EXPLORATION +del I-EXPLORATION +cuerpo I-EXPLORATION +calloso I-EXPLORATION +y I-EXPLORATION en I-EXPLORATION -su I-EXPLORATION -localización I-EXPLORATION -normal, I-EXPLORATION -concordante I-EXPLORATION +secuencia I-EXPLORATION +FLAIR I-EXPLORATION +áreas I-EXPLORATION +menores I-EXPLORATION +hiperintensas I-EXPLORATION +en I-EXPLORATION +ganglios I-EXPLORATION +basales I-EXPLORATION +y I-EXPLORATION +corteza, I-EXPLORATION +compatibles I-EXPLORATION con I-EXPLORATION una I-EXPLORATION -ectopia I-EXPLORATION -lingual I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -glándula I-EXPLORATION -tiroides. I-EXPLORATION +encefalopatía I-EXPLORATION +hipóxico-isquémica. I-EXPLORATION I-EXPLORATION -Seguimiento. B-TREATMENT -Después I-TREATMENT -que I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -fue I-TREATMENT -realizado, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -inició I-TREATMENT -L-Tiroxina I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -75 I-TREATMENT -\ig/día. I-TREATMENT -Al B-EVOLUTION -mes I-EVOLUTION +La B-EVOLUTION +supraversión I-EVOLUTION de I-EVOLUTION -tratamiento I-EVOLUTION la I-EVOLUTION -TSH I-EVOLUTION -estaba I-EVOLUTION -suprimida I-EVOLUTION -(0, I-EVOLUTION -11 I-EVOLUTION -UI/mL) I-EVOLUTION +mirada I-EVOLUTION +se I-EVOLUTION +mantuvo I-EVOLUTION +al I-EVOLUTION +menos I-EVOLUTION +diez I-EVOLUTION +días, I-EVOLUTION +luego I-EVOLUTION +la I-EVOLUTION +mirada I-EVOLUTION +se I-EVOLUTION +hizo I-EVOLUTION +central, I-EVOLUTION +mientras I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +seguía I-EVOLUTION +en I-EVOLUTION +coma I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +variaciones I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +un I-EVOLUTION +mes. I-EVOLUTION +Las I-EVOLUTION +pupilas I-EVOLUTION +se I-EVOLUTION +mantenían I-EVOLUTION +iguales I-EVOLUTION con I-EVOLUTION -tiroxina I-EVOLUTION -libre I-EVOLUTION -normal I-EVOLUTION -alta I-EVOLUTION -1, I-EVOLUTION -93 I-EVOLUTION -ng/dL I-EVOLUTION -(0,8-2,0). I-EVOLUTION -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -reveló I-EXPLORATION +respuesta I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +luz I-EVOLUTION +y I-EVOLUTION +reflejos I-EVOLUTION +oculocefálicos I-EVOLUTION +conservados, I-EVOLUTION +los I-EVOLUTION +ROT I-EVOLUTION +estaban I-EVOLUTION +vivos I-EVOLUTION +con I-EVOLUTION +reflejos I-EVOLUTION +plantares I-EVOLUTION +extensores. I-EVOLUTION +Los I-EVOLUTION +estímulos I-EVOLUTION +nociseptivos I-EVOLUTION +seguían I-EVOLUTION +generando I-EVOLUTION +respuestas I-EVOLUTION +extensoras. I-EVOLUTION +El I-EVOLUTION +EEG I-EVOLUTION +estaba I-EVOLUTION +prácticamente I-EVOLUTION +plano. I-EVOLUTION +La B-EXPLORATION +RM I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +mostró I-EXPLORATION una I-EXPLORATION -disminución I-EXPLORATION -gradual I-EXPLORATION +definida I-EXPLORATION +atrofia I-EXPLORATION +cerebral, I-EXPLORATION +con I-EXPLORATION +hiperintensidades I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -tamaño I-EXPLORATION +los I-EXPLORATION +núcleos I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -tiroides I-EXPLORATION -lingual I-EXPLORATION +base I-EXPLORATION y I-EXPLORATION -desaparición I-EXPLORATION +en I-EXPLORATION +distintas I-EXPLORATION +áreas I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -disfagia. I-EXPLORATION - I-EXPLORATION +corteza I-EXPLORATION +cerebral I-EXPLORATION +y I-EXPLORATION +cerebelosa. I-EXPLORATION +Había B-EVOLUTION +desaparecido I-EVOLUTION +la I-EVOLUTION +hiperintensidad I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +substancia I-EVOLUTION +blanca. I-EVOLUTION +La I-EVOLUTION +paciente I-EVOLUTION +falleció I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +47 I-EVOLUTION +días. I-EVOLUTION + I-EVOLUTION -Varón B-PRESENT_ILLNESS +Un B-PRESENT_ILLNESS +hombre I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -47 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -DM I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -9 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -actual I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -esquema I-PAST_MEDICAL_HISTORY -insulínico I-PAST_MEDICAL_HISTORY -intensivo I-PAST_MEDICAL_HISTORY -(una I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -nocturna I-PAST_MEDICAL_HISTORY +74 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +residente B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -insulina I-PAST_MEDICAL_HISTORY -glargina I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -insulina I-PAST_MEDICAL_HISTORY -lispro I-PAST_MEDICAL_HISTORY -previo I-PAST_MEDICAL_HISTORY +Puerto I-PAST_MEDICAL_HISTORY +Vallarta, I-PAST_MEDICAL_HISTORY +fue B-PRESENT_ILLNESS +atacado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cocodrilo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +río I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +8: I-PRESENT_ILLNESS +20 I-PRESENT_ILLNESS +h I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +junio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2010 I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +orilla I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +estero I-PRESENT_ILLNESS +Boca I-PRESENT_ILLNESS +Negra, I-PRESENT_ILLNESS +mientras I-PRESENT_ILLNESS +realizaba I-PRESENT_ILLNESS +faenas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pesca I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +atarraya. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +víctima I-PRESENT_ILLNESS +relata I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +observó I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +cocodrilo I-PRESENT_ILLNESS +"saltar" I-PRESENT_ILLNESS +fuera I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +agua I-PRESENT_ILLNESS +y, I-PRESENT_ILLNESS +aunque I-PRESENT_ILLNESS +intentó I-PRESENT_ILLNESS +esquivarlo, I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +atrapado I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +brazo I-PRESENT_ILLNESS +izquierdo. I-PRESENT_ILLNESS +Posteriormente, I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +reptil I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +haló I-PRESENT_ILLNESS +hacia I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +agua I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +hundió. I-PRESENT_ILLNESS +Aunque I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +hombre I-PRESENT_ILLNESS +logró I-PRESENT_ILLNESS +liberarse, I-PRESENT_ILLNESS +sufrió I-PRESENT_ILLNESS +amputación I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +desgarre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +antebrazo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +músculo I-PRESENT_ILLNESS +braquiorradial I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +tríceps I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cabeza I-PRESENT_ILLNESS +lateral I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +tríceps I-PRESENT_ILLNESS +braquial, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +exposición I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +cóndilo I-PRESENT_ILLNESS +humeral I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +articulación I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +fragmento I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +cúbito I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +tuberosidad I-PRESENT_ILLNESS +radial. I-PRESENT_ILLNESS +La B-EVOLUTION +persona I-EVOLUTION +fue I-EVOLUTION +trasladada I-EVOLUTION +al I-EVOLUTION +hospital I-EVOLUTION +donde I-EVOLUTION +se I-EVOLUTION +recuperó I-EVOLUTION +de I-EVOLUTION +sus I-EVOLUTION +lesiones. I-EVOLUTION +Cabe B-PRESENT_ILLNESS +destacar I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +víctima I-PRESENT_ILLNESS +manifiesta I-PRESENT_ILLNESS +haber I-PRESENT_ILLNESS +golpeado I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +ojos I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +cocodrilo I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +lograr I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +liberación. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS + +Varón, B-PRESENT_ILLNESS +75 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +gastrectomía B-PAST_MEDICAL_HISTORY +parcial I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +Billroth I-PAST_MEDICAL_HISTORY +II I-PAST_MEDICAL_HISTORY +(gastroyeyunostomía) I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -comidas). I-PAST_MEDICAL_HISTORY -Entre I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -destacaban I-PAST_MEDICAL_HISTORY -gran I-PAST_MEDICAL_HISTORY -tabaquismo, I-PAST_MEDICAL_HISTORY -dislipidemia I-PAST_MEDICAL_HISTORY -mixta I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +21 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +ulcus I-PAST_MEDICAL_HISTORY +gástrico. I-PAST_MEDICAL_HISTORY +Lumbalgia I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY tratamiento I-PAST_MEDICAL_HISTORY -irregular I-PAST_MEDICAL_HISTORY +sintomático I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -ciprofibrato I-PAST_MEDICAL_HISTORY -100 I-PAST_MEDICAL_HISTORY -mg/día I-PAST_MEDICAL_HISTORY +paracetamol I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -microalbuminuria I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -mg/12 I-PAST_MEDICAL_HISTORY -h, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -enalapril I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -mg/día. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -salud I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -febril I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -cuantificada, I-PRESENT_ILLNESS -calofríos, I-PRESENT_ILLNESS -odinofagia, I-PRESENT_ILLNESS +metamizol. I-PAST_MEDICAL_HISTORY +Ingresó I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +pancreatitis I-PAST_MEDICAL_HISTORY +aguda I-PAST_MEDICAL_HISTORY +biliar. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +ecoendoscopia I-EXPLORATION +oral: I-EXPLORATION +mucosa I-EXPLORATION +metaplásica I-EXPLORATION +en I-EXPLORATION +anastomosis I-EXPLORATION +de I-EXPLORATION +gastrectomía. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +colecistectomía I-TREATMENT +programada. I-TREATMENT +Desde B-PRESENT_ILLNESS +hacía I-PRESENT_ILLNESS +varias I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +dorsolumbar I-PRESENT_ILLNESS +irradiado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +flanco I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +derechos, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS náuseas I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +hiporexia, I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -alimentarios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +últimos I-PRESENT_ILLNESS días I-PRESENT_ILLNESS +palidez I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +coloración I-PRESENT_ILLNESS +amarillenta I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Se B-EXPLORATION -constató I-EXPLORATION -deshidratación I-EXPLORATION -moderada, I-EXPLORATION -temperatura I-EXPLORATION -axilar I-EXPLORATION +piel, I-PRESENT_ILLNESS +orinas I-PRESENT_ILLNESS +oscuras I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +pico I-PRESENT_ILLNESS +febril I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +antes. I-PRESENT_ILLNESS +En B-EXPLORATION +exploración I-EXPLORATION +física, I-EXPLORATION +febrícula I-EXPLORATION +(37, I-EXPLORATION +2 I-EXPLORATION +oC), I-EXPLORATION +palidez I-EXPLORATION +cutánea I-EXPLORATION +e I-EXPLORATION +ictericia. I-EXPLORATION +Dolor I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +en I-EXPLORATION +epigastrio I-EXPLORATION +e I-EXPLORATION +hipocondrio I-EXPLORATION +derecho, I-EXPLORATION +con I-EXPLORATION +hepatomegalia I-EXPLORATION de I-EXPLORATION -37, I-EXPLORATION -8°C I-EXPLORATION -y I-EXPLORATION -glicemia I-EXPLORATION -capilar I-EXPLORATION -mayor I-EXPLORATION +7 I-EXPLORATION +cm I-EXPLORATION +al I-EXPLORATION +borde I-EXPLORATION +costal. I-EXPLORATION +En I-EXPLORATION +analítica, I-EXPLORATION +destacaba: I-EXPLORATION +hiperbilirrubinemia I-EXPLORATION +(bilirrubina I-EXPLORATION +total I-EXPLORATION +3 I-EXPLORATION +mg/dl) I-EXPLORATION de I-EXPLORATION -400 I-EXPLORATION -mg/dl. I-EXPLORATION -Fue B-TREATMENT -internado, I-TREATMENT -recibiendo I-TREATMENT -solución I-TREATMENT -fisiológica I-TREATMENT -e I-TREATMENT -insulina I-TREATMENT -cristalina I-TREATMENT -en I-TREATMENT -esquema I-TREATMENT -de I-TREATMENT -minidosis. I-TREATMENT -Entre B-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION +predominio I-EXPLORATION +indirecta I-EXPLORATION +(bilirrubina I-EXPLORATION +directa I-EXPLORATION +0, I-EXPLORATION +02 I-EXPLORATION +mg/dl), I-EXPLORATION +LDH I-EXPLORATION +muy I-EXPLORATION +elevada I-EXPLORATION +(2.960 I-EXPLORATION +mU/ml), I-EXPLORATION +hipertransaminasemia I-EXPLORATION +ligera I-EXPLORATION +(GOT I-EXPLORATION +303 I-EXPLORATION +mU/ml, I-EXPLORATION +GPT I-EXPLORATION +129 I-EXPLORATION +mU/ml, I-EXPLORATION +GGT I-EXPLORATION +383 I-EXPLORATION +mU/ml) I-EXPLORATION +y I-EXPLORATION +ligera I-EXPLORATION +elevación I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -obtenidos I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -destacaban I-EXPLORATION -glicemia I-EXPLORATION -549 I-EXPLORATION -mg/dl, I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina I-EXPLORATION +(371 I-EXPLORATION +mU/ml). I-EXPLORATION +Además, I-EXPLORATION +insuficiencia I-EXPLORATION +renal I-EXPLORATION +leve I-EXPLORATION +(urea I-EXPLORATION +58 I-EXPLORATION +mg/dl I-EXPLORATION creatinina I-EXPLORATION 1, I-EXPLORATION -67 I-EXPLORATION -mg/dl, I-EXPLORATION -pH I-EXPLORATION -6, I-EXPLORATION -91, I-EXPLORATION -BE I-EXPLORATION --27, I-EXPLORATION -HC03 I-EXPLORATION -4, I-EXPLORATION -6 I-EXPLORATION -(en I-EXPLORATION +3 I-EXPLORATION +mg/dl). I-EXPLORATION +En I-EXPLORATION +hemograma: I-EXPLORATION +anemia I-EXPLORATION +moderada I-EXPLORATION +(Hb I-EXPLORATION +8, I-EXPLORATION +1 I-EXPLORATION +g/dl; I-EXPLORATION +Hto I-EXPLORATION +24, I-EXPLORATION +3%) I-EXPLORATION +macrocítica I-EXPLORATION +(VCM I-EXPLORATION +102 I-EXPLORATION +fl) I-EXPLORATION +con I-EXPLORATION +series I-EXPLORATION +blanca I-EXPLORATION +y I-EXPLORATION +plaquetaria I-EXPLORATION +normales. I-EXPLORATION +Frotis I-EXPLORATION +en I-EXPLORATION sangre I-EXPLORATION -arterial), I-EXPLORATION -cetonemia I-EXPLORATION -+++, I-EXPLORATION -natremia I-EXPLORATION -141, I-EXPLORATION -7 I-EXPLORATION -mEq/L, I-EXPLORATION -kalemia I-EXPLORATION -5, I-EXPLORATION -92 I-EXPLORATION -mEq/L, I-EXPLORATION -cloremia I-EXPLORATION -98 I-EXPLORATION -mEq/L, I-EXPLORATION -amilasemia I-EXPLORATION -48 I-EXPLORATION -U/L, I-EXPLORATION -hematocrito I-EXPLORATION -40, I-EXPLORATION -5%, I-EXPLORATION -leucocitos I-EXPLORATION -9-100 I-EXPLORATION -mm3, I-EXPLORATION -VHS I-EXPLORATION -38 I-EXPLORATION -mm/h I-EXPLORATION +periférica I-EXPLORATION +con I-EXPLORATION +frecuentes I-EXPLORATION +esquistozitos I-EXPLORATION y I-EXPLORATION -urocultivo I-EXPLORATION -negativo. I-EXPLORATION -Fue B-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -cetoacidosis I-EVOLUTION -diabética, I-EVOLUTION -se B-TREATMENT -le I-TREATMENT -indicó I-TREATMENT -mantener I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT -insulínico I-TREATMENT -intensificado I-TREATMENT -y I-TREATMENT -asistir I-TREATMENT -a I-TREATMENT -control I-TREATMENT -ambulatorio. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -trasladó I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -ciudad I-EVOLUTION -de I-EVOLUTION -Temuco, I-EVOLUTION -consultando I-EVOLUTION -10 I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -por I-EVOLUTION -sensación I-EVOLUTION -febril I-EVOLUTION -no I-EVOLUTION -cuantificada, I-EVOLUTION -sudoración I-EVOLUTION -nocturna, I-EVOLUTION -odinofagia I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -al I-EVOLUTION -movilizar I-EVOLUTION -el I-EVOLUTION -cuello. I-EVOLUTION -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -gran I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION +algunos I-EXPLORATION +esferocitos. I-EXPLORATION +Test I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -cuello, I-EXPLORATION -sensible, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -inflamatorios I-EXPLORATION -ni I-EXPLORATION -crepitación, I-EXPLORATION -fetor I-EXPLORATION -pútrido I-EXPLORATION +Coombs I-EXPLORATION +directo I-EXPLORATION +negativo. I-EXPLORATION +Haptoglobina I-EXPLORATION +baja I-EXPLORATION +(3 I-EXPLORATION +mg/dl), I-EXPLORATION +reticulocitos I-EXPLORATION +elevados I-EXPLORATION +(7,3%). I-EXPLORATION +Vitamina I-EXPLORATION +B12 I-EXPLORATION +sérica I-EXPLORATION y I-EXPLORATION -faringe I-EXPLORATION -congestiva I-EXPLORATION -con I-EXPLORATION -escaso I-EXPLORATION -exudado I-EXPLORATION -purulento. I-EXPLORATION -Se B-EVOLUTION -indicó I-EVOLUTION -hospitalización I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -DM I-EVOLUTION -descompensada, I-EVOLUTION -faringo-amigdalitis I-EVOLUTION -pultácea I-EVOLUTION -y I-EVOLUTION -masa I-EVOLUTION -cervical I-EVOLUTION -en I-EVOLUTION -estudio. I-EVOLUTION -Entre B-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -destacaban I-EXPLORATION -glicemia I-EXPLORATION -270 I-EXPLORATION -mg/dl, I-EXPLORATION -creatinina I-EXPLORATION -0, I-EXPLORATION -8 I-EXPLORATION -mg/ I-EXPLORATION -di, I-EXPLORATION -hematocrito I-EXPLORATION -35, I-EXPLORATION -7%, I-EXPLORATION -leucocitos I-EXPLORATION -18.800 I-EXPLORATION -por I-EXPLORATION -mm3, I-EXPLORATION -VHS I-EXPLORATION -91 I-EXPLORATION -mm/hora, I-EXPLORATION -PCR I-EXPLORATION -309 I-EXPLORATION -mg/L. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -hidratación I-TREATMENT -con I-TREATMENT -solución I-TREATMENT -fisiológica I-TREATMENT -e I-TREATMENT -infusión I-TREATMENT -endovenosa I-TREATMENT -continua I-TREATMENT -de I-TREATMENT -insulina, I-TREATMENT -fue B-EXPLORATION -evaluado I-EXPLORATION -por I-EXPLORATION -otorrinolaringólogo I-EXPLORATION -con I-EXPLORATION -nasofaringoscopia, I-EXPLORATION -pesquisándose I-EXPLORATION -flegmón I-EXPLORATION -faríngeo. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -terapia I-TREATMENT -con I-TREATMENT -penicilina I-TREATMENT -sódica I-TREATMENT -EV I-TREATMENT -20 I-TREATMENT -millones I-TREATMENT -U/día, I-TREATMENT -cloxacilina I-TREATMENT -12 I-TREATMENT -g I-TREATMENT -EV/ I-TREATMENT -día I-TREATMENT -y I-TREATMENT -ceftriaxona I-TREATMENT -2 I-TREATMENT -g I-TREATMENT -EV/día. I-TREATMENT -El B-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -cervical I-EXPLORATION -fue I-EXPLORATION -estudiado I-EXPLORATION -con I-EXPLORATION -ecotomografía I-EXPLORATION -cervical, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -compartimiento I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -cuello I-EXPLORATION +ácido I-EXPLORATION +fólico I-EXPLORATION +sérico I-EXPLORATION +e I-EXPLORATION +intraeritrocitario I-EXPLORATION +normales. I-EXPLORATION +Coagulación: I-EXPLORATION +hipoprotrombinemia I-EXPLORATION +(73%), I-EXPLORATION +fibrinógeno I-EXPLORATION +normal. I-EXPLORATION +Orina: I-EXPLORATION +urobilinógeno I-EXPLORATION y I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -multicorte I-EXPLORATION +bilirrubinuria I-EXPLORATION +positivas. I-EXPLORATION +Serologías I-EXPLORATION +VHB, I-EXPLORATION +VHC I-EXPLORATION +VIH I-EXPLORATION +negativas. I-EXPLORATION +Marcadores I-EXPLORATION +tumorales: I-EXPLORATION +elevación I-EXPLORATION de I-EXPLORATION -cuello I-EXPLORATION +CEA I-EXPLORATION +(66 I-EXPLORATION +ng/ml, I-EXPLORATION +VN I-EXPLORATION +< I-EXPLORATION +5 I-EXPLORATION +ng/ml) I-EXPLORATION +y I-EXPLORATION +CA I-EXPLORATION +19-9 I-EXPLORATION +(82 I-EXPLORATION +U/ml, I-EXPLORATION +VN I-EXPLORATION +< I-EXPLORATION +37 I-EXPLORATION +U/ml). I-EXPLORATION +En I-EXPLORATION +gastroscopia: I-EXPLORATION en I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -aumento I-EXPLORATION +muñón I-EXPLORATION +gástrico, I-EXPLORATION +5-6 I-EXPLORATION +cm I-EXPLORATION +proximal I-EXPLORATION +a I-EXPLORATION +anastomosis, I-EXPLORATION +lesión I-EXPLORATION +sobreelevada I-EXPLORATION de I-EXPLORATION -volumen I-EXPLORATION -del I-EXPLORATION -espacio I-EXPLORATION -retrofa-ríngeo I-EXPLORATION +25-30 I-EXPLORATION +mm, I-EXPLORATION +con I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +ulceración I-EXPLORATION y I-EXPLORATION +necrosis, I-EXPLORATION +friable, I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -compartimientos I-EXPLORATION -posteriores I-EXPLORATION -del I-EXPLORATION -cuello I-EXPLORATION +consistencia I-EXPLORATION +pétrea I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +toma I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -flegmonoso. I-EXPLORATION - I-EXPLORATION -Evaluado B-TREATMENT -en I-TREATMENT -conjunto I-TREATMENT -con I-TREATMENT -otorrinolaringólogo I-TREATMENT -y I-TREATMENT -cirujano I-TREATMENT -de I-TREATMENT -cabeza I-TREATMENT -y I-TREATMENT -cuello, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -practicar I-TREATMENT -drenaje I-TREATMENT -quirúrgico I-TREATMENT -de I-TREATMENT -la I-TREATMENT -colección. I-TREATMENT -Al I-TREATMENT -segundo I-TREATMENT -día I-TREATMENT -de I-TREATMENT -hospitalización I-TREATMENT -se I-TREATMENT -realizaron I-TREATMENT -2 I-TREATMENT -incisiones I-TREATMENT -en I-TREATMENT -la I-TREATMENT -región I-TREATMENT -posterior I-TREATMENT -del I-TREATMENT -cuello, I-TREATMENT -drenando I-TREATMENT -líquido I-TREATMENT -purulento. I-TREATMENT -No B-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -evidencias I-EXPLORATION +biopsia, I-EXPLORATION +con I-EXPLORATION +histopatología I-EXPLORATION de I-EXPLORATION -necrosis I-EXPLORATION -o I-EXPLORATION -gas. I-EXPLORATION -Se I-EXPLORATION -obtuvo I-EXPLORATION -cultivo I-EXPLORATION +adenocarcinoma I-EXPLORATION +moderadamente I-EXPLORATION +bien I-EXPLORATION +diferenciado, I-EXPLORATION +tipo I-EXPLORATION +intestinal. I-EXPLORATION +En I-EXPLORATION +tomografía I-EXPLORATION +computerizada I-EXPLORATION +(TAC) I-EXPLORATION +toracoabdominal: I-EXPLORATION +hepatomegalia I-EXPLORATION +con I-EXPLORATION +múltiples I-EXPLORATION +lesiones I-EXPLORATION +hipodensas I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -secreción, I-EXPLORATION -aislándose I-EXPLORATION -Streptococcus I-EXPLORATION -grupo I-EXPLORATION -B, I-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Luego B-TREATMENT -de I-TREATMENT -una I-TREATMENT -semana I-TREATMENT -con I-TREATMENT -antibióticos I-TREATMENT -EV, I-TREATMENT -los I-TREATMENT -drenajes I-TREATMENT -Penrose I-TREATMENT -dejaron I-TREATMENT -de I-TREATMENT -entregar I-TREATMENT -secreción I-TREATMENT -y I-TREATMENT -fueron I-TREATMENT -retirados. I-TREATMENT -La B-EVOLUTION -exploración I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -incisiones I-EVOLUTION -fue I-EVOLUTION -satisfactoria. I-EVOLUTION +diferentes I-EXPLORATION +tamaños, I-EXPLORATION +diseminadas I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +lóbulos, I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +metástasis I-EXPLORATION +hepáticas. I-EXPLORATION Se B-TREATMENT -dio I-TREATMENT -de I-TREATMENT -alta I-TREATMENT +consultó I-TREATMENT con I-TREATMENT -antibiótico I-TREATMENT -oral I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -otra I-TREATMENT -semana I-TREATMENT -(Ampicilina/Sulbactam). I-TREATMENT - I-TREATMENT +Oncología, I-TREATMENT +que I-TREATMENT +desestimó I-TREATMENT +quimioterapia, I-TREATMENT +pautándose I-TREATMENT +tratamiento I-TREATMENT +sintomático I-TREATMENT +paliativo. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +falleció I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +20 I-EVOLUTION +días I-EVOLUTION +del I-EVOLUTION +diagnóstico. I-EVOLUTION + I-EVOLUTION -Hombre B-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +23 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -(20 I-PAST_MEDICAL_HISTORY -cig/día) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -urolitiasis I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -27 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS +que B-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +urgencias I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +hospital I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +alteraciones I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +conducta I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +vía I-DERIVED_FROM/TO +pública. I-DERIVED_FROM/TO +Sus B-PRESENT_ILLNESS +padres I-PRESENT_ILLNESS +referían I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hacía I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +ido I-PRESENT_ILLNESS +disminuyendo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -flanco I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -súbito, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -irradiación, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómito I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS +sueño, I-PRESENT_ILLNESS +así I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +verbalizado I-PRESENT_ILLNESS +ideas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +carácter I-PRESENT_ILLNESS +mesiánico. I-PRESENT_ILLNESS +Parecía I-PRESENT_ILLNESS +llevar I-PRESENT_ILLNESS una I-PRESENT_ILLNESS -ocasión I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -cede I-PRESENT_ILLNESS -espontáneamente. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -repitió I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -después, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS +vida I-PRESENT_ILLNESS +desorganizada I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +descuido I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -similares I-PRESENT_ILLNESS -características I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -anterior. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -No B-EXPLORATION -presentó I-EXPLORATION -fiebre I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -de I-EXPLORATION -140/82 I-EXPLORATION -mmHg I-EXPLORATION -y I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION +las I-PRESENT_ILLNESS +tareas I-PRESENT_ILLNESS +básicas, I-PRESENT_ILLNESS +dedicación I-PRESENT_ILLNESS +excesiva I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +videojuegos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +deficiente I-PRESENT_ILLNESS +alimentación. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -fosa I-EXPLORATION -ilíaca I-EXPLORATION -derecha I-EXPLORATION -(FID). I-EXPLORATION - I-EXPLORATION -Dentro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION +entrevista I-EXPLORATION se I-EXPLORATION -encontró I-EXPLORATION -orina I-EXPLORATION -completa I-EXPLORATION -sin I-EXPLORATION -hematuria, I-EXPLORATION -hemogra-ma I-EXPLORATION +mostró I-EXPLORATION +hostil, I-EXPLORATION +suspicaz, I-EXPLORATION +e I-EXPLORATION +interpretativo I-EXPLORATION con I-EXPLORATION -leucocitosis I-EXPLORATION -(17.200 I-EXPLORATION -x I-EXPLORATION -mm3), I-EXPLORATION -creatininemia I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -2 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -LDH I-EXPLORATION -de I-EXPLORATION -1.457 I-EXPLORATION -UI/1. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -pieloTC I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -ser I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -urolitiasis, I-EXPLORATION -prosiguiéndose I-EXPLORATION +el I-EXPLORATION +entorno, I-EXPLORATION +especialmente I-EXPLORATION con I-EXPLORATION -TC I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION +los I-EXPLORATION +colores, I-EXPLORATION +llegando I-EXPLORATION +a I-EXPLORATION +referir I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -extensa I-EXPLORATION -área I-EXPLORATION -hipodensa I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -cuneiforme I-EXPLORATION +"sentía" I-EXPLORATION +azul. I-EXPLORATION +Negó I-EXPLORATION +alteraciones I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -cara I-EXPLORATION -posterior I-EXPLORATION +esfera I-EXPLORATION +sensoperceptiva. I-EXPLORATION +Desde B-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +encontraba I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +seguimiento I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +psiquiatría I-PAST_MEDICAL_HISTORY +debido I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +varios I-PAST_MEDICAL_HISTORY +episodios I-PAST_MEDICAL_HISTORY +psicóticos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +afectivos, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +buena I-PAST_MEDICAL_HISTORY +respuesta I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +psicofarmacológico, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +abandonado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +últimos I-PAST_MEDICAL_HISTORY +meses. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Ya B-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +unidad, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +mostró I-EVOLUTION +tranquilo, I-EVOLUTION +pero I-EVOLUTION +muy I-EVOLUTION +desconfiado. I-EVOLUTION +Explicó I-EVOLUTION +lo I-EVOLUTION +sucedido I-EVOLUTION +como I-EVOLUTION +resultado I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +percepción I-EVOLUTION +de I-EVOLUTION +"pistas I-EVOLUTION +falsas" I-EVOLUTION +que I-EVOLUTION +le I-EVOLUTION +llevaron I-EVOLUTION +a I-EVOLUTION +alertar I-EVOLUTION +a I-EVOLUTION +determinadas I-EVOLUTION +personas I-EVOLUTION +de I-EVOLUTION +que I-EVOLUTION +estaban I-EVOLUTION +en I-EVOLUTION +peligro. I-EVOLUTION +Su B-FAMILY_HISTORY +madre I-FAMILY_HISTORY +refirió I-FAMILY_HISTORY +llevar I-FAMILY_HISTORY +varios I-FAMILY_HISTORY +años I-FAMILY_HISTORY +en I-FAMILY_HISTORY +tratamiento I-FAMILY_HISTORY +psiquiátrico I-FAMILY_HISTORY +por I-FAMILY_HISTORY +distimia, I-FAMILY_HISTORY +mientras I-FAMILY_HISTORY +que I-FAMILY_HISTORY +el I-FAMILY_HISTORY +padre I-FAMILY_HISTORY +había I-FAMILY_HISTORY +recibido I-FAMILY_HISTORY +un I-FAMILY_HISTORY +diagnóstico I-FAMILY_HISTORY +de I-FAMILY_HISTORY +trastorno I-FAMILY_HISTORY +obsesivo I-FAMILY_HISTORY +compulsivo I-FAMILY_HISTORY +en I-FAMILY_HISTORY +el I-FAMILY_HISTORY +pasado. I-FAMILY_HISTORY +Los B-EXPLORATION +familiares I-EXPLORATION +no I-EXPLORATION +refirieron I-EXPLORATION +ninguna I-EXPLORATION +alteración I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +desarrollo I-EXPLORATION del I-EXPLORATION -parénquima I-EXPLORATION -renal I-EXPLORATION -derecho, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -infarto I-EXPLORATION -parcial I-EXPLORATION -renal I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION -Se B-EVOLUTION -hospitalizó I-EVOLUTION -al I-EVOLUTION -paciente. I-EVOLUTION -Se B-EXPLORATION -tomaron I-EXPLORATION -exámenes I-EXPLORATION -para I-EXPLORATION -trombofilia, I-EXPLORATION -cuyos I-EXPLORATION -resultados I-EXPLORATION -fueron I-EXPLORATION -normales, I-EXPLORATION -previo I-EXPLORATION -al I-EXPLORATION -inicio I-EXPLORATION -de I-EXPLORATION -anticoagulación I-EXPLORATION -(Fragmin I-EXPLORATION -y I-EXPLORATION -Neosintrón I-EXPLORATION -). I-EXPLORATION -Además I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -ecocardiografía I-EXPLORATION -transesofágica I-EXPLORATION +paciente, I-EXPLORATION +si I-EXPLORATION +bien I-EXPLORATION +él I-EXPLORATION +mismo I-EXPLORATION +reconoció I-EXPLORATION que I-EXPLORATION -resultó I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION +siempre I-EXPLORATION +se I-EXPLORATION +había I-EXPLORATION +sentido I-EXPLORATION un I-EXPLORATION -angioTC I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION +"bicho I-EXPLORATION +raro". I-EXPLORATION +Recordaba I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -arteria I-EXPLORATION -renal I-EXPLORATION -derecha I-EXPLORATION -dominante I-EXPLORATION -(AD) I-EXPLORATION -y I-EXPLORATION -otra I-EXPLORATION -polar I-EXPLORATION -de I-EXPLORATION -menor I-EXPLORATION -calibre I-EXPLORATION -con I-EXPLORATION -trayecto I-EXPLORATION -normal, I-EXPLORATION -e I-EXPLORATION -imagen I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -alteración I-EXPLORATION +etapa I-EXPLORATION +escolar I-EXPLORATION +como I-EXPLORATION +un I-EXPLORATION +"infierno", I-EXPLORATION +presentando I-EXPLORATION +un I-EXPLORATION +mal I-EXPLORATION +manejo I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -arterial I-EXPLORATION -con I-EXPLORATION -infarto I-EXPLORATION -renal. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -prosiguió I-EXPLORATION -con I-EXPLORATION -estudio I-EXPLORATION -angiográfico, I-EXPLORATION +las I-EXPLORATION +relaciones I-EXPLORATION +interpersonales, I-EXPLORATION +hasta I-EXPLORATION el I-EXPLORATION -cual I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -aortografía I-EXPLORATION -normal, I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION +punto I-EXPLORATION +de I-EXPLORATION +reconocer I-EXPLORATION +que I-EXPLORATION +le I-EXPLORATION +daba I-EXPLORATION +"fobia" I-EXPLORATION la I-EXPLORATION -perfusión I-EXPLORATION -del I-EXPLORATION -polo I-EXPLORATION -superior, I-EXPLORATION cara I-EXPLORATION -anterior I-EXPLORATION -y I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -riñon I-EXPLORATION -derecho, I-EXPLORATION -sin I-EXPLORATION -compromiso I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -perfusión I-EXPLORATION -del I-EXPLORATION -polo I-EXPLORATION -inferior I-EXPLORATION -dado I-EXPLORATION +las I-EXPLORATION +personas. I-EXPLORATION +Es I-EXPLORATION +por I-EXPLORATION +esta I-EXPLORATION +razón I-EXPLORATION por I-EXPLORATION la I-EXPLORATION -arteria I-EXPLORATION -polar I-EXPLORATION -secundaria. I-EXPLORATION -La I-EXPLORATION -arteria I-EXPLORATION -renal I-EXPLORATION -dominante I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -irregular, I-EXPLORATION -dilatada I-EXPLORATION -a I-EXPLORATION -partir I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -tercio I-EXPLORATION -medio I-EXPLORATION -que I-EXPLORATION -además I-EXPLORATION -presentó I-EXPLORATION -un I-EXPLORATION -flap I-EXPLORATION -de I-EXPLORATION -disección I-EXPLORATION que I-EXPLORATION -comprometió I-EXPLORATION -el I-EXPLORATION -origen I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -ramas I-EXPLORATION -interlobares, I-EXPLORATION -limitando I-EXPLORATION -así I-EXPLORATION -el I-EXPLORATION -flujo I-EXPLORATION -distal. I-EXPLORATION -El I-EXPLORATION -flap I-EXPLORATION +desde I-EXPLORATION +la I-EXPLORATION +adolescencia I-EXPLORATION +mantenía I-EXPLORATION +contacto I-EXPLORATION +interpersonal I-EXPLORATION +casi I-EXPLORATION de I-EXPLORATION -disección I-EXPLORATION -fue I-EXPLORATION -descrito I-EXPLORATION -como I-EXPLORATION +manera I-EXPLORATION +exclusiva I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION de I-EXPLORATION -alta I-EXPLORATION -complejidad I-EXPLORATION -sin I-EXPLORATION -posibilidades I-EXPLORATION +juegos I-EXPLORATION de I-EXPLORATION -maniobras I-EXPLORATION -endovasculares. I-EXPLORATION +ordenador I-EXPLORATION +en I-EXPLORATION +línea. I-EXPLORATION I-EXPLORATION -Dos B-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -presentó I-EVOLUTION -nuevo I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -flanco I-EVOLUTION -derecho. I-EVOLUTION -Nuevo B-EXPLORATION -angioTC I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -clara I-EXPLORATION -progresión I-EXPLORATION -del I-EXPLORATION -infarto I-EXPLORATION -renal I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -2/3 I-EXPLORATION -superiores I-EXPLORATION -del I-EXPLORATION -riñon I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -presiones I-EVOLUTION -arteriales I-EVOLUTION -en I-EVOLUTION +A B-EVOLUTION +medida I-EVOLUTION +que I-EVOLUTION +avanzó I-EVOLUTION el I-EVOLUTION -rango I-EVOLUTION +ingreso I-EVOLUTION +se I-EVOLUTION +le I-EVOLUTION +observaba I-EVOLUTION +más I-EVOLUTION +distendido, I-EVOLUTION +si I-EVOLUTION +bien I-EVOLUTION +refería I-EVOLUTION +sentirse I-EVOLUTION +incómodo I-EVOLUTION +rodeado I-EVOLUTION de I-EVOLUTION -160/100 I-EVOLUTION -mmHg I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -deterioro I-EVOLUTION +gente. I-EVOLUTION +También I-EVOLUTION +comentó I-EVOLUTION +que I-EVOLUTION +le I-EVOLUTION +molestaba I-EVOLUTION +el I-EVOLUTION +sonido I-EVOLUTION +del I-EVOLUTION +tubo I-EVOLUTION +del I-EVOLUTION +televisor I-EVOLUTION +situado I-EVOLUTION +en I-EVOLUTION +una I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +salas I-EVOLUTION +comunes I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -(creatininemia I-EVOLUTION -1, I-EVOLUTION -2 I-EVOLUTION -mg/dl). I-EVOLUTION -Fue B-TREATMENT -dado I-TREATMENT -de I-TREATMENT -alta I-TREATMENT -con I-TREATMENT -terapia I-TREATMENT -antihipertensiva I-TREATMENT -(Blox I-TREATMENT -4 I-TREATMENT -mg/día) I-TREATMENT -en I-TREATMENT -buenas I-TREATMENT -condiciones I-TREATMENT -generales I-TREATMENT -para I-TREATMENT -su I-TREATMENT -manejo I-TREATMENT -ambulatorio. I-TREATMENT -En B-EVOLUTION -control I-EVOLUTION -ambulatorio I-EVOLUTION -a I-EVOLUTION +unidad, I-EVOLUTION +el I-EVOLUTION +cual I-EVOLUTION +percibía I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +nítida. I-EVOLUTION +Como I-EVOLUTION +estrategia I-EVOLUTION +de I-EVOLUTION +afrontamiento I-EVOLUTION +en I-EVOLUTION los I-EVOLUTION -dos I-EVOLUTION -y I-EVOLUTION -diecisiete I-EVOLUTION -días I-EVOLUTION -posterior I-EVOLUTION -al I-EVOLUTION -alta I-EVOLUTION -se I-EVOLUTION -encontró I-EVOLUTION -al I-EVOLUTION -paciente I-EVOLUTION -asintomático, I-EVOLUTION -normotenso I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION +momentos I-EVOLUTION +de I-EVOLUTION +estrés, I-EVOLUTION +deambulaba I-EVOLUTION +por I-EVOLUTION el I-EVOLUTION -resto I-EVOLUTION -del I-EVOLUTION -examen I-EVOLUTION -físico I-EVOLUTION -sin I-EVOLUTION -hallazgos I-EVOLUTION -patológicos. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -76 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -quien B-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -operado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -urgencia I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1974 I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -lesión I-PAST_MEDICAL_HISTORY -ulcerada I-PAST_MEDICAL_HISTORY -gástrica I-PAST_MEDICAL_HISTORY -sangrante. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -practicó I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -gastrectomía I-PAST_MEDICAL_HISTORY -subtotal I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -reconstrucción I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -Billroth I-PAST_MEDICAL_HISTORY -II. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -postoperatoria I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -normal. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -pieza I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -gastrectomía I-PAST_MEDICAL_HISTORY -subtotal I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontró I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -tumor I-PAST_MEDICAL_HISTORY -ulcerado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cara I-PAST_MEDICAL_HISTORY -anterior, I-PAST_MEDICAL_HISTORY -distante I-PAST_MEDICAL_HISTORY -15 I-PAST_MEDICAL_HISTORY -mm I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -sección I-PAST_MEDICAL_HISTORY -gástrica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -píloro. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -tumor I-PAST_MEDICAL_HISTORY -medía I-PAST_MEDICAL_HISTORY -3, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -eje I-PAST_MEDICAL_HISTORY -longitudinal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -transversal, I-PAST_MEDICAL_HISTORY -comprometiendo I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -curvatura I-PAST_MEDICAL_HISTORY -menor I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -extendiéndose I-PAST_MEDICAL_HISTORY -2, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cara I-PAST_MEDICAL_HISTORY -posterior. I-PAST_MEDICAL_HISTORY -Al I-PAST_MEDICAL_HISTORY -corte, I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -constituido I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -tejido I-PAST_MEDICAL_HISTORY -rosado I-PAST_MEDICAL_HISTORY -pálido I-PAST_MEDICAL_HISTORY -lobulado, I-PAST_MEDICAL_HISTORY -liso I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -brillante, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -reemplazaba I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -túnicas I-PAST_MEDICAL_HISTORY -submucosa, I-PAST_MEDICAL_HISTORY -muscular I-PAST_MEDICAL_HISTORY -propia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -subserosa, I-PAST_MEDICAL_HISTORY -abombando I-PAST_MEDICAL_HISTORY -levemente I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -serosa. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -examen I-PAST_MEDICAL_HISTORY -histopatológico I-PAST_MEDICAL_HISTORY -demostró I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -linfoma I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -Hodgkin I-PAST_MEDICAL_HISTORY -mixto I-PAST_MEDICAL_HISTORY -linfo-histiocítico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -clasificación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Rappaport I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -1966, I-PAST_MEDICAL_HISTORY -vigente I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -formularon I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -clasificaciones I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Kiel I-PAST_MEDICAL_HISTORY -(1974) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Lukes I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -Collins I-PAST_MEDICAL_HISTORY -(1974). I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontró I-PAST_MEDICAL_HISTORY -compromiso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -ganglios I-PAST_MEDICAL_HISTORY -linfáticos I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -linfoma. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -enfermo I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -radioterapia I-PAST_MEDICAL_HISTORY -adyuvante I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -seguido I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -endoscopias I-PAST_MEDICAL_HISTORY -anuales I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -23 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -observaron I-PAST_MEDICAL_HISTORY -nuevas I-PAST_MEDICAL_HISTORY -lesiones I-PAST_MEDICAL_HISTORY -gástricas I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -demostró I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Helicobacter I-PAST_MEDICAL_HISTORY -pylori. I-PAST_MEDICAL_HISTORY -Durante I-PAST_MEDICAL_HISTORY -este I-PAST_MEDICAL_HISTORY -período, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -desarrolló I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -tumores I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Warthin I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ambas I-PAST_MEDICAL_HISTORY -glándulas I-PAST_MEDICAL_HISTORY -parótidas, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -cuales I-PAST_MEDICAL_HISTORY -sólo I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -resecó I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cáncer I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -piel I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -epidermoide I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -extremidad I-PAST_MEDICAL_HISTORY -inferior I-PAST_MEDICAL_HISTORY -derecha. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -septiembre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2006, I-PRESENT_ILLNESS -32 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -operación I-PRESENT_ILLNESS -gástrica, I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -anemia. I-PRESENT_ILLNESS -En B-EXPLORATION +pasillo I-EVOLUTION +siguiendo I-EVOLUTION +una I-EVOLUTION +secuencia I-EVOLUTION +rutinaria I-EVOLUTION +que I-EVOLUTION +podía I-EVOLUTION +durar I-EVOLUTION +varias I-EVOLUTION +horas I-EVOLUTION +y I-EVOLUTION +que, I-EVOLUTION +según I-EVOLUTION +decía, I-EVOLUTION +le I-EVOLUTION +ayudaba I-EVOLUTION +a I-EVOLUTION +relajarse. I-EVOLUTION +Mencionó B-EXPLORATION +tener I-EXPLORATION +habitualmente I-EXPLORATION +"paranoias" I-EXPLORATION +que I-EXPLORATION +asociaba I-EXPLORATION +con I-EXPLORATION +su I-EXPLORATION +comportamiento I-EXPLORATION +anterior I-EXPLORATION +al I-EXPLORATION +ingreso. I-EXPLORATION +Relacionó I-EXPLORATION el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -palidez, I-EXPLORATION -sin I-EXPLORATION -masas I-EXPLORATION -abdominales. I-EXPLORATION -El I-EXPLORATION -hematocrito I-EXPLORATION -fue I-EXPLORATION +episodio I-EXPLORATION +conductual I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +sentimiento I-EXPLORATION +profundo I-EXPLORATION de I-EXPLORATION -34, I-EXPLORATION -5% I-EXPLORATION +soledad I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -proliferativa I-EXPLORATION +frustración I-EXPLORATION +por I-EXPLORATION +su I-EXPLORATION +incapacidad I-EXPLORATION +para I-EXPLORATION +mantener I-EXPLORATION +relaciones I-EXPLORATION +interpersonales I-EXPLORATION +estables. I-EXPLORATION +Al I-EXPLORATION +ser I-EXPLORATION +preguntado I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +relación I-EXPLORATION +entre I-EXPLORATION +percepción I-EXPLORATION y I-EXPLORATION -ulcerada I-EXPLORATION +color I-EXPLORATION +manifestada I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -muñón I-EXPLORATION -gástrico I-EXPLORATION -que I-EXPLORATION -obstruía I-EXPLORATION -parcialmente I-EXPLORATION -la I-EXPLORATION -anastomosis I-EXPLORATION -gastroyeyunal. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -mostró I-EXPLORATION +servicio I-EXPLORATION +de I-EXPLORATION +urgencias, I-EXPLORATION +respondió I-EXPLORATION que I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -gástrica I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -infiltrada I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION -tubular I-EXPLORATION -moderadamente I-EXPLORATION -diferenciado. I-EXPLORATION -No I-EXPLORATION se I-EXPLORATION -comprobó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +trataba I-EXPLORATION de I-EXPLORATION -Helicobacter I-EXPLORATION -pylori. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION +la I-EXPLORATION +letra I-EXPLORATION +traducida I-EXPLORATION de I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION +una I-EXPLORATION +canción I-EXPLORATION +(en I-EXPLORATION +inglés I-EXPLORATION +la I-EXPLORATION +palabra I-EXPLORATION +"blue" I-EXPLORATION +presenta I-EXPLORATION +dos I-EXPLORATION +significados: I-EXPLORATION +azul I-EXPLORATION y I-EXPLORATION -pelvis I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION +triste. I-EXPLORATION +Al I-EXPLORATION +decir I-EXPLORATION +sentirse I-EXPLORATION +azul I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +realmente I-EXPLORATION +expresaba I-EXPLORATION +un I-EXPLORATION +sentimiento I-EXPLORATION +de I-EXPLORATION +tristeza). I-EXPLORATION I-EXPLORATION El B-TREATMENT paciente I-TREATMENT -fue I-TREATMENT -operado I-TREATMENT -y I-TREATMENT -se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -gastrectomía I-TREATMENT -total I-TREATMENT -con I-TREATMENT -disección I-TREATMENT -ganglionar. I-TREATMENT -La B-EVOLUTION -recuperación I-EVOLUTION -postoperatoria I-EVOLUTION -fue I-EVOLUTION -normal. I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION +presentó I-TREATMENT +buena I-TREATMENT +respuesta I-TREATMENT +al I-TREATMENT +tratamiento I-TREATMENT +antipsicótico, I-TREATMENT +si B-EVOLUTION +bien I-EVOLUTION +tanto I-EVOLUTION +los I-EVOLUTION +síntomas I-EVOLUTION +afectivos I-EVOLUTION +como I-EVOLUTION +la I-EVOLUTION +rigidez I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +pensamiento I-EVOLUTION +nunca I-EVOLUTION +desaparecieron. I-EVOLUTION + I-EVOLUTION +La B-EXPLORATION +tabla I-EXPLORATION +1 I-EXPLORATION +muestra I-EXPLORATION la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -tumoral I-EXPLORATION -ulcerada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -muñón I-EXPLORATION -gástrico I-EXPLORATION -con I-EXPLORATION -infiltración I-EXPLORATION +comparación I-EXPLORATION de I-EXPLORATION +los I-EXPLORATION +resultados I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -anastomosis I-EXPLORATION -gastroyeyunal. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -microscópico I-EXPLORATION -demostró I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION -tubular I-EXPLORATION -moderadamente I-EXPLORATION -diferenciado I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION +Escala I-EXPLORATION de I-EXPLORATION +Inteligencia I-EXPLORATION +Wechsler I-EXPLORATION +para I-EXPLORATION +Adultos I-EXPLORATION +(WAIS) I-EXPLORATION +(30), I-EXPLORATION la I-EXPLORATION -subserosa I-EXPLORATION +Escala I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -gástrica, I-EXPLORATION -metástasis I-EXPLORATION +Síndromes I-EXPLORATION +Positivos I-EXPLORATION +y I-EXPLORATION +Negativos I-EXPLORATION +(PANSS) I-EXPLORATION +(32) I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +Cociente I-EXPLORATION +de I-EXPLORATION +Espectro I-EXPLORATION +Autista I-EXPLORATION +(AQ) I-EXPLORATION +(31) I-EXPLORATION en I-EXPLORATION -10 I-EXPLORATION -linfonodos I-EXPLORATION +los I-EXPLORATION +tres I-EXPLORATION +pacientes. I-EXPLORATION +La I-EXPLORATION +tabla I-EXPLORATION +2 I-EXPLORATION +muestra I-EXPLORATION +una I-EXPLORATION +comparación I-EXPLORATION +entre I-EXPLORATION +los I-EXPLORATION +criterios I-EXPLORATION de I-EXPLORATION -16 I-EXPLORATION -resecados I-EXPLORATION +esquizofrenia I-EXPLORATION y I-EXPLORATION -permeaciones I-EXPLORATION -vasculares I-EXPLORATION -linfáticas I-EXPLORATION -(T2bN2M0, I-EXPLORATION -Etapa I-EXPLORATION -IIIB). I-EXPLORATION +autismo I-EXPLORATION +compartidos I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +tres I-EXPLORATION +casos I-EXPLORATION +descritos. I-EXPLORATION I-EXPLORATION -En B-PRESENT_ILLNESS -septiembre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2006 I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -Dento-Máxilo-Facial I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -Clínico I-PRESENT_ILLNESS +Los B-PRESENT_ILLNESS +autores I-PRESENT_ILLNESS +presentan I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Universidad I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +hombre I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Chile, I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS +78 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -17 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -estudiante, B-PAST_MEDICAL_HISTORY -derivada B-DERIVED_FROM/TO +edad, I-PRESENT_ILLNESS +insuficiente B-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +crónico I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +programa I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hemodiálisis, I-PAST_MEDICAL_HISTORY +referenciado B-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +realización I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +cápsula I-DERIVED_FROM/TO +endoscópica I-DERIVED_FROM/TO por I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO +hemorragia I-DERIVED_FROM/TO +gastrointestinal I-DERIVED_FROM/TO de I-DERIVED_FROM/TO -Hematología I-DERIVED_FROM/TO +causa I-DERIVED_FROM/TO +oscura, I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +necesidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +transfusión I-DERIVED_FROM/TO +sanguínea, I-DERIVED_FROM/TO +no I-DERIVED_FROM/TO +esclarecida I-DERIVED_FROM/TO por I-DERIVED_FROM/TO -presentar I-DERIVED_FROM/TO -lesiones I-DERIVED_FROM/TO -blanquecinas I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -mucosa I-DERIVED_FROM/TO -bucal. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -La B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -anemia I-PAST_MEDICAL_HISTORY -aplásica I-PAST_MEDICAL_HISTORY -severa I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2005, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -atribuyó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -derivado I-PAST_MEDICAL_HISTORY -fenotiacínico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -cual I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -sometida I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -trasplante I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -médula I-PAST_MEDICAL_HISTORY -ósea I-PAST_MEDICAL_HISTORY -(TMO) I-PAST_MEDICAL_HISTORY -alogénico. I-PAST_MEDICAL_HISTORY -Presentó B-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -primeras I-PRESENT_ILLNESS -manifestaciones I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -EICH I-PRESENT_ILLNESS -agudo, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -predominante I-PRESENT_ILLNESS -cutáneo I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -+42, I-PRESENT_ILLNESS -manifestado B-EXPLORATION -como I-EXPLORATION -lesión I-EXPLORATION -máculo-pápulo I-EXPLORATION -eritematosa I-EXPLORATION +gastroscopia I-DERIVED_FROM/TO +o I-DERIVED_FROM/TO +colonoscopia. I-DERIVED_FROM/TO +Se B-EXPLORATION +usó I-EXPLORATION +una I-EXPLORATION +cápsula I-EXPLORATION +PillCam I-EXPLORATION +SB I-EXPLORATION +(Given I-EXPLORATION +Imaging, I-EXPLORATION +Israel). I-EXPLORATION +La I-EXPLORATION +ingesta I-EXPLORATION de I-EXPLORATION -tronco I-EXPLORATION -y I-EXPLORATION -extremidades I-EXPLORATION -con I-EXPLORATION -biopsia I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -EICH I-EXPLORATION -agudo, I-EXPLORATION -momento B-TREATMENT -en I-TREATMENT -que I-TREATMENT -se I-TREATMENT -administró I-TREATMENT -asociación I-TREATMENT -de I-TREATMENT -corticoides I-TREATMENT -(prednisona I-TREATMENT -20 I-TREATMENT -mg/dia) I-TREATMENT -con I-TREATMENT -ciclosporina, I-TREATMENT -reemplazándose I-TREATMENT -luego I-TREATMENT -la I-TREATMENT -ciclosporina I-TREATMENT -por I-TREATMENT -tacrolimus, I-TREATMENT -3 I-TREATMENT -mg/dia I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -toxicidad I-TREATMENT -neurológica I-TREATMENT -de I-TREATMENT -la I-TREATMENT -primera. I-TREATMENT -Las B-EVOLUTION -lesiones I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mucosa I-EVOLUTION -oral I-EVOLUTION -aparecieron I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -más I-EVOLUTION -tardía I-EVOLUTION -y I-EVOLUTION -su I-EVOLUTION -primera I-EVOLUTION -descripción I-EVOLUTION -aparece I-EVOLUTION +la I-EXPLORATION +cápsula I-EXPLORATION +fue I-EXPLORATION +presenciada I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +médico. I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +tuvo I-EVOLUTION +dificultad I-EVOLUTION en I-EVOLUTION +iniciar I-EVOLUTION la I-EVOLUTION -evolución I-EVOLUTION -del I-EVOLUTION -día I-EVOLUTION -+310. I-EVOLUTION - I-EVOLUTION -En B-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -clínico, I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -bucales I-EXPLORATION -comprometían I-EXPLORATION -casi I-EXPLORATION -la I-EXPLORATION -totalidad I-EXPLORATION +deglución, I-EVOLUTION +con I-EVOLUTION +varias I-EVOLUTION +tentativas I-EVOLUTION +sin I-EVOLUTION +éxito. I-EVOLUTION +Súbitamente I-EVOLUTION +desarrolló I-EVOLUTION +una I-EVOLUTION +crisis I-EVOLUTION +de I-EVOLUTION +tos I-EVOLUTION +vigorosa I-EVOLUTION +que I-EVOLUTION +revertió I-EVOLUTION +espontáneamente I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +algunos I-EVOLUTION +minutos, I-EVOLUTION +sin I-EVOLUTION +recurrencia I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +sintomatología I-EVOLUTION +respiratoria. I-EVOLUTION +El B-EXPLORATION +grabador I-EXPLORATION de I-EXPLORATION +datos I-EXPLORATION +fue I-EXPLORATION +recuperado I-EXPLORATION +agotada I-EXPLORATION la I-EXPLORATION -mucosa, I-EXPLORATION -pero I-EXPLORATION -se I-EXPLORATION -manifestaban I-EXPLORATION -mayormente I-EXPLORATION -en I-EXPLORATION -cara I-EXPLORATION -interna I-EXPLORATION -de I-EXPLORATION -labios, I-EXPLORATION -cara I-EXPLORATION -interna I-EXPLORATION +duración I-EXPLORATION de I-EXPLORATION -mejilla I-EXPLORATION +la I-EXPLORATION +batería I-EXPLORATION +(9 I-EXPLORATION +h) I-EXPLORATION y I-EXPLORATION -cara I-EXPLORATION -ventral I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +fue I-EXPLORATION +interpretado I-EXPLORATION +al I-EXPLORATION +día I-EXPLORATION +siguiente. I-EXPLORATION +Se I-EXPLORATION +constató I-EXPLORATION +que, I-EXPLORATION +después I-EXPLORATION de I-EXPLORATION -lengua. I-EXPLORATION -Las I-EXPLORATION -lesiones I-EXPLORATION -eran I-EXPLORATION +un I-EXPLORATION +periodo I-EXPLORATION de I-EXPLORATION -color I-EXPLORATION -blanquecino, I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -reticular I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -desprendían I-EXPLORATION -al I-EXPLORATION -raspado. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -refería I-EXPLORATION -síntomas I-EXPLORATION -asociados. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION +permanencia I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -hipótesis I-EXPLORATION -diagnóstica I-EXPLORATION +cavidad I-EXPLORATION +oral I-EXPLORATION de I-EXPLORATION -compromiso I-EXPLORATION +75 I-EXPLORATION +segundos, I-EXPLORATION +la I-EXPLORATION +cápsula I-EXPLORATION +transitó I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +aérea, I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +típica I-EXPLORATION +estructura I-EXPLORATION +anular I-EXPLORATION de I-EXPLORATION -mucosa I-EXPLORATION -oral I-EXPLORATION -por I-EXPLORATION -enfermedad I-EXPLORATION +la I-EXPLORATION +tráquea I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +bifurcación I-EXPLORATION de I-EXPLORATION -injerto I-EXPLORATION -contra I-EXPLORATION -huésped I-EXPLORATION -se I-EXPLORATION -procedió I-EXPLORATION -a I-EXPLORATION -realizar I-EXPLORATION -biopsia I-EXPLORATION -incisional I-EXPLORATION +los I-EXPLORATION +bronquios I-EXPLORATION +principales. I-EXPLORATION +Después I-EXPLORATION de I-EXPLORATION -mucosa I-EXPLORATION +cerca I-EXPLORATION de I-EXPLORATION -cara I-EXPLORATION -interna I-EXPLORATION +dos I-EXPLORATION +minutos I-EXPLORATION de I-EXPLORATION -labio I-EXPLORATION -inferior, I-EXPLORATION -lugar I-EXPLORATION +inactividad, I-EXPLORATION +la I-EXPLORATION +cápsula I-EXPLORATION +transmite I-EXPLORATION +imágenes I-EXPLORATION +del I-EXPLORATION +esófago. I-EXPLORATION +Una I-EXPLORATION +vez I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -cual I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -eran I-EXPLORATION -manifiestas. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -informe I-EXPLORATION -histopatológico I-EXPLORATION -fue I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -EIVH. I-EXPLORATION +tubo I-EXPLORATION +digestivo, I-EXPLORATION +la I-EXPLORATION +cápsula I-EXPLORATION +sigue I-EXPLORATION +el I-EXPLORATION +trayecto I-EXPLORATION +habitual, I-EXPLORATION +alcanzando I-EXPLORATION +el I-EXPLORATION +ciego I-EXPLORATION +transcurridas I-EXPLORATION +7 I-EXPLORATION +h I-EXPLORATION +28 I-EXPLORATION +m. I-EXPLORATION Se I-EXPLORATION -describió I-EXPLORATION -un I-EXPLORATION -epitelio I-EXPLORATION +identificaron I-EXPLORATION +abundantes I-EXPLORATION +angiodisplasias I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +intestino I-EXPLORATION +delgado, I-EXPLORATION +probable I-EXPLORATION +causa I-EXPLORATION de I-EXPLORATION -revestimiento I-EXPLORATION -plano I-EXPLORATION -pluriestratificado I-EXPLORATION -hiperparaqueratinizado I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -hiperplasia I-EXPLORATION -agujiforme. I-EXPLORATION -Un I-EXPLORATION -estrato I-EXPLORATION -basal I-EXPLORATION -con I-EXPLORATION -desorganización I-EXPLORATION -celular I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -corion I-EXPLORATION -inmediatamente I-EXPLORATION -subyacente I-EXPLORATION -infiltración I-EXPLORATION -linfocitaria I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -vasos I-EXPLORATION -de I-EXPLORATION -neoformación I-EXPLORATION -y I-EXPLORATION -proliferación I-EXPLORATION -fibroblástica. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -describió I-EXPLORATION -leve I-EXPLORATION -infiltrado I-EXPLORATION -linfocitario I-EXPLORATION -periductal I-EXPLORATION +la I-EXPLORATION +hemorragia I-EXPLORATION +gastrointestinal I-EXPLORATION en I-EXPLORATION -glándula I-EXPLORATION -salival I-EXPLORATION -menor I-EXPLORATION -vecina. I-EXPLORATION +este I-EXPLORATION +paciente. I-EXPLORATION I-EXPLORATION -Se B-TREATMENT -indicaron I-TREATMENT -medidas I-TREATMENT -locales I-TREATMENT -para I-TREATMENT -disminuir I-TREATMENT -el I-TREATMENT -riesgo I-TREATMENT + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +80 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +afecto B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +leucemia I-PAST_MEDICAL_HISTORY +linfática I-PAST_MEDICAL_HISTORY +crónica, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +carcinoma I-PRESENT_ILLNESS +epidermoide I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cuero I-PRESENT_ILLNESS +cabelludo. I-PRESENT_ILLNESS +El B-TREATMENT +tumor I-TREATMENT +infiltra I-TREATMENT +localmente I-TREATMENT +sin I-TREATMENT +llegar I-TREATMENT +a I-TREATMENT +afectar I-TREATMENT +a I-TREATMENT +la I-TREATMENT +duramadre. I-TREATMENT +Se I-TREATMENT +realiza I-TREATMENT +exéresis I-TREATMENT de I-TREATMENT -infecciones I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT y I-TREATMENT -mantener I-TREATMENT -adecuada I-TREATMENT -humectación I-TREATMENT -del I-TREATMENT -medio I-TREATMENT -bucal; I-TREATMENT -clorhexidina I-TREATMENT -al I-TREATMENT -0, I-TREATMENT -12% I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -sustituto I-TREATMENT -de I-TREATMENT -saliva I-TREATMENT -de I-TREATMENT -uso I-TREATMENT -diario, I-TREATMENT -además I-TREATMENT +colgajo I-TREATMENT de I-TREATMENT -instrucción I-TREATMENT +periostio I-TREATMENT +que I-TREATMENT +se I-TREATMENT +complica I-TREATMENT +con I-TREATMENT +necrosis. I-TREATMENT +Se I-TREATMENT +decide I-TREATMENT +entonces I-TREATMENT +colocar I-TREATMENT +sistema I-TREATMENT de I-TREATMENT -higiene I-TREATMENT -oral. I-TREATMENT - I-TREATMENT -Seis B-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -controlada I-EVOLUTION -manifestando I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -algunas I-EVOLUTION -zonas I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mucosa I-EVOLUTION -bucal, I-EVOLUTION -evidenciándose I-EVOLUTION -lesiones I-EVOLUTION -erosivas I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -examen I-EVOLUTION -clínico. I-EVOLUTION -Se B-TREATMENT -decidió I-TREATMENT -incorporar I-TREATMENT -en I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT +terapia I-TREATMENT +Renasys® I-TREATMENT +a I-TREATMENT +-50 I-TREATMENT +mm I-TREATMENT +Hg. I-TREATMENT +Tras I-TREATMENT +3 I-TREATMENT +semanas I-TREATMENT de I-TREATMENT tratamiento I-TREATMENT -local, I-TREATMENT -el I-TREATMENT -uso I-TREATMENT -de I-TREATMENT -betametasona I-TREATMENT -al I-TREATMENT -0, I-TREATMENT -1% I-TREATMENT -en I-TREATMENT -plastibase, I-TREATMENT -reforzando I-TREATMENT -las I-TREATMENT -medidas I-TREATMENT -de I-TREATMENT -higiene I-TREATMENT -bucal. I-TREATMENT -Sin B-EVOLUTION -embargo, I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -permanecieron I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -aumentó, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -cual I-TREATMENT se I-TREATMENT -cambió I-TREATMENT -por I-TREATMENT -tacrolimus I-TREATMENT -0, I-TREATMENT -1% I-TREATMENT -en I-TREATMENT -aplicación I-TREATMENT -tópica I-TREATMENT -3 I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -agregándose I-TREATMENT -además I-TREATMENT -miconazol I-TREATMENT -2% I-TREATMENT -(Daktarin I-TREATMENT -Gel) I-TREATMENT +observa I-TREATMENT +reducción I-TREATMENT +del I-TREATMENT +diámetro I-TREATMENT de I-TREATMENT -aplicación I-TREATMENT -tópica, I-TREATMENT -3 I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día. I-TREATMENT -Además I-TREATMENT -se I-TREATMENT -sustituyó I-TREATMENT la I-TREATMENT -clorhexidina I-TREATMENT -al I-TREATMENT -0, I-TREATMENT -12% I-TREATMENT -por I-TREATMENT -una I-TREATMENT -concentración I-TREATMENT -más I-TREATMENT -baja, I-TREATMENT -0, I-TREATMENT -05%, I-TREATMENT -dado I-TREATMENT -que I-TREATMENT +herida I-TREATMENT +y I-TREATMENT +granulación I-TREATMENT +sobre I-TREATMENT la I-TREATMENT -paciente I-TREATMENT -le I-TREATMENT -costaba I-TREATMENT -tolerar I-TREATMENT +duramadre. I-TREATMENT +Posteriormente, I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +cierre I-TREATMENT +de I-TREATMENT la I-TREATMENT -primera I-TREATMENT -por I-TREATMENT -provocarle I-TREATMENT -ardor I-TREATMENT -al I-TREATMENT -momento I-TREATMENT +lesión I-TREATMENT +con I-TREATMENT +triple I-TREATMENT +colgajo I-TREATMENT de I-TREATMENT -usarla. I-TREATMENT -Después B-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -semana I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -remitieron I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presentaba I-EVOLUTION -dolor I-EVOLUTION -ni I-EVOLUTION -dificultades I-EVOLUTION -para I-EVOLUTION -alimentarse. I-EVOLUTION - I-EVOLUTION +Guillis. I-TREATMENT + I-TREATMENT -Mujer B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -70 I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +59 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY +hipertenso, B-PAST_MEDICAL_HISTORY +tabáquico I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -tabaquista I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -paquetes/año, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -quien I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -LNH I-PAST_MEDICAL_HISTORY -sistémico I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -características I-PAST_MEDICAL_HISTORY -clínicas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -SAA, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -variante I-PAST_MEDICAL_HISTORY -disección I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -aorta I-PAST_MEDICAL_HISTORY -descendente. I-PAST_MEDICAL_HISTORY -Se B-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS +dislipidémico. I-PAST_MEDICAL_HISTORY +Comenzó B-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +torácico I-PRESENT_ILLNESS +retroesternal I-PRESENT_ILLNESS +bajo, I-PRESENT_ILLNESS +opresivo, I-PRESENT_ILLNESS +irradiado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +ambos I-PRESENT_ILLNESS +hipocondrios I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +espalda, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +decidió I-PRESENT_ILLNESS +consultar I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -emergencias I-PRESENT_ILLNESS -luego I-PRESENT_ILLNESS +urgencia I-PRESENT_ILLNESS +cinco I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS del I-PRESENT_ILLNESS inicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -dorsal I-PRESENT_ILLNESS -agudo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -disnea. I-PRESENT_ILLNESS -La B-EXPLORATION -TAC I-EXPLORATION -reveló I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +los I-PRESENT_ILLNESS +síntomas. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +estaba I-EXPLORATION +vígil, I-EXPLORATION +orientado, I-EXPLORATION +con I-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION +140/90, I-EXPLORATION +frecuencia I-EXPLORATION +cardiaca I-EXPLORATION de I-EXPLORATION -tejido I-EXPLORATION -blando, I-EXPLORATION -periaórtico, I-EXPLORATION -tóraco-abdominal I-EXPLORATION +80 I-EXPLORATION +lat/min, I-EXPLORATION +con I-EXPLORATION +pulsos I-EXPLORATION +distales I-EXPLORATION +simétricos I-EXPLORATION y I-EXPLORATION -un I-EXPLORATION -gran I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -derecho, I-EXPLORATION +normales, I-EXPLORATION sin I-EXPLORATION -adenopatías. I-EXPLORATION -Posteriormente I-EXPLORATION +otros I-EXPLORATION +hallazgos I-EXPLORATION +relevantes. I-EXPLORATION + I-EXPLORATION +Un I-EXPLORATION +electrocardiograma I-EXPLORATION +practicado I-EXPLORATION +al I-EXPLORATION +paciente I-EXPLORATION +sólo I-EXPLORATION +demostró I-EXPLORATION +hipertrofia I-EXPLORATION +ventricular I-EXPLORATION +izquierda. I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION +no I-EXPLORATION +presentó I-EXPLORATION +hallazgos I-EXPLORATION +relevantes. I-EXPLORATION + I-EXPLORATION +Debido I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +persistencia I-EXPLORATION +del I-EXPLORATION +fuerte I-EXPLORATION +dolor I-EXPLORATION +torácico I-EXPLORATION +y I-EXPLORATION +para I-EXPLORATION +descartar I-EXPLORATION +disección I-EXPLORATION +aórtica, I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION +solicitó I-EXPLORATION una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION -(RMN). I-EXPLORATION -Se I-EXPLORATION -internó I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -Unidad I-EXPLORATION +angiografía I-EXPLORATION +por I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computada I-EXPLORATION de I-EXPLORATION -Cuidados I-EXPLORATION -Intensivos, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -ecocardiograma I-EXPLORATION -transesofágico I-EXPLORATION +tórax I-EXPLORATION +y I-EXPLORATION +abdomen I-EXPLORATION +(Angio-Tac), I-EXPLORATION que I-EXPLORATION -descartó I-EXPLORATION -la I-EXPLORATION +mostró I-EXPLORATION +flap I-EXPLORATION +de I-EXPLORATION disección I-EXPLORATION -aórtica. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -toracocentesis, I-EXPLORATION -donde I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +agudo, I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -aspiraron I-EXPLORATION -cerca I-EXPLORATION +extendía I-EXPLORATION +desde I-EXPLORATION +el I-EXPLORATION +tercio I-EXPLORATION +distal I-EXPLORATION de I-EXPLORATION -2 I-EXPLORATION -litros I-EXPLORATION +la I-EXPLORATION +aorta I-EXPLORATION +descendente I-EXPLORATION +hasta I-EXPLORATION +el I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -líquido I-EXPLORATION -hemorrágico, I-EXPLORATION -cuya I-EXPLORATION -citología I-EXPLORATION -reveló I-EXPLORATION -células I-EXPLORATION -malignas I-EXPLORATION -compatibles I-EXPLORATION +los I-EXPLORATION +hilios I-EXPLORATION +renales, I-EXPLORATION con I-EXPLORATION -LNH. I-EXPLORATION +permeabilidad I-EXPLORATION +del I-EXPLORATION +falso I-EXPLORATION +lumen I-EXPLORATION +y I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +hemotórax I-EXPLORATION +menor I-EXPLORATION +y I-EXPLORATION +hemopericardio. I-EXPLORATION +Se I-EXPLORATION +diagnosticó I-EXPLORATION +entonces I-EXPLORATION +disección I-EXPLORATION +aórtica I-EXPLORATION +aguda I-EXPLORATION +tipo I-EXPLORATION +B, I-EXPLORATION +complicada I-EXPLORATION +por I-EXPLORATION +rotura. I-EXPLORATION I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION +Debido B-TREATMENT +a I-TREATMENT +la I-TREATMENT +complicación I-TREATMENT +de I-TREATMENT +la I-TREATMENT +disección, I-TREATMENT +anatomía I-TREATMENT +favorable I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +y I-TREATMENT +de I-TREATMENT +los I-TREATMENT +accesos I-TREATMENT +vasculares, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +prótesis I-TREATMENT +endovascular. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +el I-TREATMENT +procedimiento I-TREATMENT +bajo I-TREATMENT +anestesia I-TREATMENT +general, I-TREATMENT +con I-TREATMENT +acceso I-TREATMENT +a I-TREATMENT +través I-TREATMENT +de I-TREATMENT +arterias I-TREATMENT +femorales I-TREATMENT +e I-TREATMENT +hipotensión I-TREATMENT +controlada, I-TREATMENT +instalándose I-TREATMENT +prótesis I-TREATMENT +endovascular I-TREATMENT +(Talent®) I-TREATMENT +de I-TREATMENT +34 I-TREATMENT +mm I-TREATMENT +de I-TREATMENT +diámetro I-TREATMENT +y I-TREATMENT +130 I-TREATMENT +mm I-TREATMENT +de I-TREATMENT +longitud I-TREATMENT +en I-TREATMENT +la I-TREATMENT +aorta I-TREATMENT +torácica I-TREATMENT +con I-TREATMENT +resultado I-TREATMENT +técnico I-TREATMENT +adecuado, I-TREATMENT +cobertura I-TREATMENT +de I-TREATMENT +sitio I-TREATMENT +de I-TREATMENT +fractura I-TREATMENT +proximal I-TREATMENT +y I-TREATMENT +sin I-TREATMENT +complicaciones I-TREATMENT +inmediatas. I-TREATMENT + I-TREATMENT +En B-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -médula I-EXPLORATION -ósea I-EXPLORATION -mostró I-EXPLORATION -linfoma I-EXPLORATION +control I-EXPLORATION +se I-EXPLORATION +comprobó I-EXPLORATION +adecuada I-EXPLORATION +posición I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -pequeñas, I-EXPLORATION -fenotipo I-EXPLORATION -B. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -por I-EXPLORATION -laparotomía I-EXPLORATION +endoprótesis I-EXPLORATION +con I-EXPLORATION +exclusión I-EXPLORATION +del I-EXPLORATION +falso I-EXPLORATION +lumen I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -masa I-EXPLORATION -periaórtica I-EXPLORATION -mostró I-EXPLORATION -LNH I-EXPLORATION -folicular I-EXPLORATION +aorta I-EXPLORATION +torácica, I-EXPLORATION +sólo I-EXPLORATION +con I-EXPLORATION +permeabilidad I-EXPLORATION de I-EXPLORATION -bajo I-EXPLORATION -grado I-EXPLORATION +éste I-EXPLORATION +distal I-EXPLORATION +a I-EXPLORATION +origen I-EXPLORATION +de I-EXPLORATION +arteria I-EXPLORATION +mesentérica I-EXPLORATION +inferior, I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +había I-EXPLORATION +aumentado I-EXPLORATION con I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -arribó I-EXPLORATION -al I-EXPLORATION -diagnóstico I-EXPLORATION +respecto I-EXPLORATION +a I-EXPLORATION +examen I-EXPLORATION de I-EXPLORATION -LP. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -quimioterapia I-TREATMENT -con I-TREATMENT -CHOP-R I-TREATMENT -fue I-TREATMENT -efectiva, I-TREATMENT -con I-TREATMENT -resolución I-TREATMENT -inicial I-TREATMENT -completa I-TREATMENT -de I-TREATMENT -la I-TREATMENT -masa I-TREATMENT -objetivado I-TREATMENT -por I-TREATMENT -TAC, I-TREATMENT -pero B-EVOLUTION -desarrolló I-EVOLUTION -luego I-EVOLUTION -quilotórax, I-EVOLUTION -malnutrición I-EVOLUTION +ingreso. I-EXPLORATION +Los I-EXPLORATION +accesos I-EXPLORATION +vasculares I-EXPLORATION +no I-EXPLORATION +presentaban I-EXPLORATION +complicaciones. I-EXPLORATION +Se B-EVOLUTION +decidió I-EVOLUTION +el I-EVOLUTION +alta I-EVOLUTION +cinco I-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +procedimiento, I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +en I-EVOLUTION +buenas I-EVOLUTION +condiciones. I-EVOLUTION + I-EVOLUTION +En I-EVOLUTION +control I-EVOLUTION +un I-EVOLUTION +año I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +procedimiento, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encontraba I-EVOLUTION +en I-EVOLUTION +buenas I-EVOLUTION +condiciones I-EVOLUTION +generales, I-EVOLUTION +con I-EVOLUTION +Angio-Tac I-EVOLUTION +que I-EVOLUTION +no I-EVOLUTION +demostró I-EVOLUTION +complicaciones I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +endoprótesis, I-EVOLUTION +con I-EVOLUTION +exclusión I-EVOLUTION +total I-EVOLUTION +del I-EVOLUTION +falso I-EVOLUTION +lumen I-EVOLUTION +torácico I-EVOLUTION y I-EVOLUTION -falleció. I-EVOLUTION +sin I-EVOLUTION +variaciones I-EVOLUTION +con I-EVOLUTION +respecto I-EVOLUTION +a I-EVOLUTION +examen I-EVOLUTION +de I-EVOLUTION +alta. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Preescolar B-PRESENT_ILLNESS de I-PRESENT_ILLNESS sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -74 I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS +8 I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS sin B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -o B-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -importancia. I-FAMILY_HISTORY +mórbidos, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +vacunas I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +PNI I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +día I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +asistencia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +jardín I-PAST_MEDICAL_HISTORY +infantil. I-PAST_MEDICAL_HISTORY Consultó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -septiembre I-PRESENT_ILLNESS +menos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +h I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +40°C I-PRESENT_ILLNESS +axilar, I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -2007 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -afebril, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS vómitos I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tránsito I-PRESENT_ILLNESS -intestinal. I-PRESENT_ILLNESS -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -no I-EXPLORATION -fue I-EXPLORATION -concluyente I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION +alimentarios, I-PRESENT_ILLNESS +coriza I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS +frontal. I-PRESENT_ILLNESS +Presentó I-PRESENT_ILLNESS +alucinaciones I-PRESENT_ILLNESS +visuales I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +fiebre. I-PRESENT_ILLNESS +En B-EXPLORATION +el I-EXPLORATION +Servicio I-EXPLORATION +de I-EXPLORATION +Urgencia I-EXPLORATION +(SU) I-EXPLORATION se I-EXPLORATION -solicitaron I-EXPLORATION +constató I-EXPLORATION +febril, I-EXPLORATION +decaída, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +examen I-EXPLORATION +segmentario I-EXPLORATION +y I-EXPLORATION +neurológico I-EXPLORATION +normal. I-EXPLORATION +Dentro I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION exámenes I-EXPLORATION de I-EXPLORATION laboratorio I-EXPLORATION -e I-EXPLORATION -imágenes. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -análisis I-EXPLORATION -destacaba I-EXPLORATION +destacaban I-EXPLORATION una I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -de I-EXPLORATION -7, I-EXPLORATION -2 I-EXPLORATION -mg/dL, I-EXPLORATION -leucocitos I-EXPLORATION -8.080/mm3 I-EXPLORATION -con I-EXPLORATION -67, I-EXPLORATION -8% I-EXPLORATION +leucocitosis I-EXPLORATION de I-EXPLORATION -neutrófilos I-EXPLORATION +36.100 I-EXPLORATION +céls/mm3 I-EXPLORATION +(25% I-EXPLORATION +segmentados), I-EXPLORATION +PCR I-EXPLORATION +205 I-EXPLORATION +mg/L I-EXPLORATION +(valor I-EXPLORATION +normal I-EXPLORATION +< I-EXPLORATION +10), I-EXPLORATION +orina I-EXPLORATION +completa I-EXPLORATION +normal I-EXPLORATION y I-EXPLORATION -amilasemia I-EXPLORATION -normal. I-EXPLORATION -Una I-EXPLORATION -ecotomografía I-EXPLORATION -demostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -sólido-quística I-EXPLORATION -compleja I-EXPLORATION -de I-EXPLORATION -alrededor I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -izquierdo I-EXPLORATION -del I-EXPLORATION -hígado. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION +tórax I-EXPLORATION +con I-EXPLORATION +escaso I-EXPLORATION +infiltrado I-EXPLORATION +intersticial. I-EXPLORATION +Se I-EXPLORATION +hospitalizó I-EXPLORATION +con I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -abdomen I-EXPLORATION -reveló I-EXPLORATION +síndrome I-EXPLORATION +febril I-EXPLORATION +sin I-EXPLORATION +foco. I-EXPLORATION +Evolucionó I-EXPLORATION +con I-EXPLORATION +fiebre I-EXPLORATION +persistente, I-EXPLORATION +regular I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +sin I-EXPLORATION +foco I-EXPLORATION +evidente I-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +parámetros I-EXPLORATION +inflamatorios I-EXPLORATION +elevados. I-EXPLORATION +Se I-EXPLORATION +planteó I-EXPLORATION una I-EXPLORATION probable I-EXPLORATION -colecistitis I-EXPLORATION -aguda I-EXPLORATION -y I-EXPLORATION +neumonía I-EXPLORATION +neumocóccica; I-EXPLORATION +sin I-EXPLORATION +embargo, I-EXPLORATION +tenía I-EXPLORATION una I-EXPLORATION -lesión I-EXPLORATION -focal I-EXPLORATION -hepática I-EXPLORATION -sospechosa I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -absceso. I-EXPLORATION +tórax I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +evidenciaba I-EXPLORATION +consolidación I-EXPLORATION +pulmonar. I-EXPLORATION Se B-TREATMENT -efectuó I-TREATMENT -colecistectomía I-TREATMENT -y I-TREATMENT -biopsia I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +antimicrobiano I-TREATMENT +con I-TREATMENT +ampicilina I-TREATMENT +i.v. I-TREATMENT +100 I-TREATMENT +mg/kg/día I-TREATMENT +fraccionado I-TREATMENT +cada I-TREATMENT +6 I-TREATMENT +h, I-TREATMENT +previa I-TREATMENT +toma I-TREATMENT de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -hepática. I-TREATMENT -No I-TREATMENT -se I-TREATMENT -identifican I-TREATMENT -otras I-TREATMENT -lesiones I-TREATMENT -abdominales I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -exploración I-TREATMENT -quirúrgica. I-TREATMENT +hemocultivos. I-TREATMENT El B-EXPLORATION estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -demuestra I-EXPLORATION -una I-EXPLORATION -metástasis I-EXPLORATION -hepática I-EXPLORATION -de I-EXPLORATION -tumor I-EXPLORATION -neuroendocrino I-EXPLORATION +se I-EXPLORATION +complementó I-EXPLORATION con I-EXPLORATION -inmunohistoquímica I-EXPLORATION -concordante. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION un I-EXPLORATION -PET/CT I-EXPLORATION -con I-EXPLORATION -18FDG I-EXPLORATION +panel I-EXPLORATION +viral I-EXPLORATION +(por I-EXPLORATION +inmunofluorescencia) I-EXPLORATION de I-EXPLORATION -cuerpo I-EXPLORATION -entero I-EXPLORATION -el I-EXPLORATION +aspirado I-EXPLORATION +nasofaríngeo, I-EXPLORATION +urocultivo, I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +LCR I-EXPLORATION +y I-EXPLORATION +hemocultivos I-EXPLORATION que I-EXPLORATION -mostró I-EXPLORATION -sólo I-EXPLORATION -captación I-EXPLORATION -fisiológica I-EXPLORATION -en I-EXPLORATION -diversos I-EXPLORATION -órganos I-EXPLORATION -sin I-EXPLORATION -observarse I-EXPLORATION -un I-EXPLORATION -incremento I-EXPLORATION -significativo I-EXPLORATION -del I-EXPLORATION -metabolismo I-EXPLORATION -glucídico I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Por I-EXPLORATION +persistir I-EXPLORATION +febril, I-EXPLORATION +luego I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -metástasis I-EXPLORATION -del I-EXPLORATION -lóbulo I-EXPLORATION -izquierdo I-EXPLORATION -del I-EXPLORATION -hígado I-EXPLORATION -en I-EXPLORATION -comparación I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -parénquima I-EXPLORATION -hepático. I-EXPLORATION -Una I-EXPLORATION -colonoscopia I-EXPLORATION -en I-EXPLORATION -búsqueda I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION +48 I-EXPLORATION +h I-EXPLORATION de I-EXPLORATION -origen I-EXPLORATION -fue I-EXPLORATION -catalogada I-EXPLORATION -como I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Tres I-EXPLORATION -meses I-EXPLORATION -más I-EXPLORATION -tarde I-EXPLORATION +terapia I-EXPLORATION +antimicrobiana, I-EXPLORATION se I-EXPLORATION realizó I-EXPLORATION -un I-EXPLORATION -examen I-EXPLORATION -PET/CT I-EXPLORATION -utilizando I-EXPLORATION -el I-EXPLORATION -nuevo I-EXPLORATION -radiofármaco I-EXPLORATION -68Ga-DOTATATE I-EXPLORATION -(CGM I-EXPLORATION -Nuclear, I-EXPLORATION -Santiago-Chile) I-EXPLORATION -recientemente I-EXPLORATION -incorporado I-EXPLORATION -a I-EXPLORATION -nuestro I-EXPLORATION -centro. I-EXPLORATION -El I-EXPLORATION -control I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION de I-EXPLORATION -calidad I-EXPLORATION -del I-EXPLORATION -producto I-EXPLORATION -reveló I-EXPLORATION +abdomen I-EXPLORATION +que I-EXPLORATION +demostró I-EXPLORATION una I-EXPLORATION -pureza I-EXPLORATION -radioquímica I-EXPLORATION -superior I-EXPLORATION -al I-EXPLORATION -99%. I-EXPLORATION -Se I-EXPLORATION -inyectaron I-EXPLORATION -por I-EXPLORATION -vía I-EXPLORATION -e.v. I-EXPLORATION -111 I-EXPLORATION -MBq I-EXPLORATION -(3 I-EXPLORATION -mCi) I-EXPLORATION -del I-EXPLORATION -radiotrazador. I-EXPLORATION -Cincuenta I-EXPLORATION -minutos I-EXPLORATION +asimetría I-EXPLORATION +renal, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +riñón I-EXPLORATION +izquierdo I-EXPLORATION más I-EXPLORATION -tarde I-EXPLORATION -se I-EXPLORATION -registraron I-EXPLORATION -imágenes I-EXPLORATION -PET/ I-EXPLORATION -CT I-EXPLORATION -3D I-EXPLORATION +grande, I-EXPLORATION de I-EXPLORATION -cuerpo I-EXPLORATION -entero I-EXPLORATION +aspecto I-EXPLORATION +más I-EXPLORATION +globuloso I-EXPLORATION +y I-EXPLORATION +mayor I-EXPLORATION +ecogenicidad. I-EXPLORATION +Se B-TREATMENT +ajustó I-TREATMENT +terapia I-TREATMENT +antimicrobiana I-TREATMENT +a I-TREATMENT +ceftriaxona I-TREATMENT +50 I-TREATMENT +mg/kg/día I-TREATMENT +una I-TREATMENT +vez I-TREATMENT +al I-TREATMENT +día, I-TREATMENT +por I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +un I-TREATMENT +foco I-TREATMENT +urinario I-TREATMENT +y I-TREATMENT +se I-TREATMENT +solicitó I-TREATMENT +un I-TREATMENT +cintigrama I-TREATMENT +renal I-TREATMENT +con I-TREATMENT +DMSA I-TREATMENT +(dimercaptosuccinic I-TREATMENT +acid), I-TREATMENT +que I-TREATMENT +se I-TREATMENT +informó I-TREATMENT +como I-TREATMENT +sugerente I-TREATMENT +de I-TREATMENT +un I-TREATMENT +proceso I-TREATMENT +inflamatorio I-TREATMENT +agudo I-TREATMENT +renal I-TREATMENT +izquierdo. I-TREATMENT +La B-EVOLUTION +fiebre I-EVOLUTION +cedió I-EVOLUTION +al I-EVOLUTION +cuarto I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION +con I-EVOLUTION +ceftriaxona, I-EVOLUTION +junto I-EVOLUTION +con I-EVOLUTION +descenso I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +parámetros I-EVOLUTION +inflamatorios. I-EVOLUTION +Se I-EVOLUTION +dio I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +séptimo I-EVOLUTION +día, I-EVOLUTION +en I-EVOLUTION +buenas I-EVOLUTION +condiciones I-EVOLUTION +clínicas, I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +diagnóstico I-EVOLUTION +de I-EVOLUTION +una I-EVOLUTION +nefronia I-EVOLUTION +izquierda. I-EVOLUTION +Recibió B-TREATMENT +cefadroxilo I-TREATMENT +30 I-TREATMENT +mg/kg/día I-TREATMENT +por I-TREATMENT +siete I-TREATMENT +días, I-TREATMENT +completando I-TREATMENT +14 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +antimicrobiano I-TREATMENT +en I-TREATMENT +total. I-TREATMENT +Se I-TREATMENT +mantuvo B-EVOLUTION +en I-EVOLUTION +seguimiento I-EVOLUTION +en I-EVOLUTION +policlínico I-EVOLUTION +de I-EVOLUTION +infectología I-EVOLUTION +y I-EVOLUTION +nefrología, I-EVOLUTION +con I-EVOLUTION +evolución I-EVOLUTION +favorable. I-EVOLUTION + I-EVOLUTION + +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +49 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +urgencia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +Hospital, I-PRESENT_ILLNESS +porque I-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +introducción I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +objeto I-PRESENT_ILLNESS +metálico I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +área I-PRESENT_ILLNESS +genital I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +contexto I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +prácticas I-PRESENT_ILLNESS +erótico-sexuales. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Clínicamente B-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +asintomática, I-EXPLORATION +y I-EXPLORATION en I-EXPLORATION -un I-EXPLORATION -aparato I-EXPLORATION -Biograph I-EXPLORATION -6 I-EXPLORATION -HiRez I-EXPLORATION -P3D I-EXPLORATION -(Siemens I-EXPLORATION -Medical I-EXPLORATION -Systems, I-EXPLORATION -USA). I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -mostró, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION la I-EXPLORATION -intensa I-EXPLORATION -captación I-EXPLORATION -del I-EXPLORATION -radiofármaco I-EXPLORATION +exploración I-EXPLORATION +genital I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +material I-EXPLORATION +alguno I-EXPLORATION en I-EXPLORATION +el I-EXPLORATION +interior I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -metástasis I-EXPLORATION -del I-EXPLORATION -lóbulo I-EXPLORATION -hepático I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -segundo I-EXPLORATION -foco I-EXPLORATION +vagina. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION +simple I-EXPLORATION de I-EXPLORATION -sobreexpresión I-EXPLORATION +abdomen I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +un I-EXPLORATION +objeto I-EXPLORATION +metálico I-EXPLORATION +que I-EXPLORATION +sobresalía I-EXPLORATION +del I-EXPLORATION +contorno I-EXPLORATION de I-EXPLORATION -receptores I-EXPLORATION +la I-EXPLORATION +vejiga I-EXPLORATION +urinaria. I-EXPLORATION +Se I-EXPLORATION +practica I-EXPLORATION +finalmente I-EXPLORATION +ecografia, I-EXPLORATION +seguida I-EXPLORATION de I-EXPLORATION -SST I-EXPLORATION -situado I-EXPLORATION +TAC I-EXPLORATION +abdominal, I-EXPLORATION en I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION un I-EXPLORATION -asa I-EXPLORATION -de I-EXPLORATION -íleon I-EXPLORATION -distal I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION +objeto I-EXPLORATION +metálico I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -válvula I-EXPLORATION -ileocecal I-EXPLORATION -altamente I-EXPLORATION -sugerente I-EXPLORATION +8 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -corresponder I-EXPLORATION -al I-EXPLORATION -tumor I-EXPLORATION -primario. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -otros I-EXPLORATION -focos I-EXPLORATION -patológicos. I-EXPLORATION +longitud I-EXPLORATION +alojado I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +interior I-EXPLORATION +del I-EXPLORATION +uréter I-EXPLORATION +pelviano I-EXPLORATION +derecho. I-EXPLORATION I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT +Se B-TREATMENT +procede I-TREATMENT a I-TREATMENT -una I-TREATMENT -nueva I-TREATMENT -cirugía I-TREATMENT -mediante I-TREATMENT -laparotomía I-TREATMENT -subcostal I-TREATMENT -identificándose I-TREATMENT -un I-TREATMENT -nodulo I-TREATMENT -de I-TREATMENT -16 I-TREATMENT -mm I-TREATMENT -en I-TREATMENT -el I-TREATMENT -íleon I-TREATMENT -terminal, I-TREATMENT -vecino I-TREATMENT +intervenir I-TREATMENT a I-TREATMENT la I-TREATMENT -válvula I-TREATMENT -ileocecal, I-TREATMENT -sin I-TREATMENT -extensión I-TREATMENT -regional I-TREATMENT -macroscópica. I-TREATMENT -Se I-TREATMENT -efectúa I-TREATMENT -resección I-TREATMENT -del I-TREATMENT -íleon I-TREATMENT -terminal, I-TREATMENT -ciego I-TREATMENT +paciente I-TREATMENT y I-TREATMENT -apéndice I-TREATMENT -cecal I-TREATMENT -mediante I-TREATMENT -laparotomía I-TREATMENT -subcostal I-TREATMENT -ampliada. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -acto I-TREATMENT se I-TREATMENT -extirpa I-TREATMENT +realiza I-TREATMENT +cistoscopia I-TREATMENT +bajo I-TREATMENT +anestesia I-TREATMENT +general, I-TREATMENT +objetivándose I-TREATMENT +cilindro I-TREATMENT +metálico I-TREATMENT +que I-TREATMENT +sobresale I-TREATMENT +del I-TREATMENT +interior I-TREATMENT +del I-TREATMENT +orificio I-TREATMENT +ureteral I-TREATMENT +derecho. I-TREATMENT + I-TREATMENT +Ante I-TREATMENT la I-TREATMENT -metástasis I-TREATMENT -hepática I-TREATMENT -mediante I-TREATMENT -hepatectomía I-TREATMENT -izquierda. I-TREATMENT -Como I-TREATMENT -hallazgos I-TREATMENT -intraoperatorio I-TREATMENT +imposibilidad I-TREATMENT +de I-TREATMENT +extraer I-TREATMENT +dicho I-TREATMENT +objeto I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +endoscópica, I-TREATMENT se I-TREATMENT -identifica I-TREATMENT +procede I-TREATMENT +a I-TREATMENT +la I-TREATMENT +realización I-TREATMENT +de I-TREATMENT una I-TREATMENT -segunda I-TREATMENT -metástasis I-TREATMENT +laparotomía I-TREATMENT +media I-TREATMENT +infraumbilical, I-TREATMENT +con I-TREATMENT +apertura I-TREATMENT +de I-TREATMENT +vejiga I-TREATMENT +y I-TREATMENT +extracción I-TREATMENT +de I-TREATMENT +cilindro I-TREATMENT +metálico I-TREATMENT de I-TREATMENT 8 I-TREATMENT -mm I-TREATMENT -del I-TREATMENT -segmento I-TREATMENT -VII I-TREATMENT -del I-TREATMENT -hígado I-TREATMENT -la I-TREATMENT +cm. I-TREATMENT +de I-TREATMENT +longitud, I-TREATMENT que I-TREATMENT -se I-TREATMENT -reseca I-TREATMENT -en I-TREATMENT -cuña. I-TREATMENT +correspondía I-TREATMENT +a I-TREATMENT +perfilador I-TREATMENT +de I-TREATMENT +ojos. I-TREATMENT + I-TREATMENT + La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -confirmó I-EXPLORATION -un I-EXPLORATION -carcinoma I-EXPLORATION -neuroendocrino I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -grado I-EXPLORATION -del I-EXPLORATION -íleon I-EXPLORATION -terminal I-EXPLORATION -de I-EXPLORATION -16 I-EXPLORATION -mm I-EXPLORATION -que I-EXPLORATION -infiltraba I-EXPLORATION -el I-EXPLORATION -espesor I-EXPLORATION +isquemia I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +extremidades I-EXPLORATION +inferiores I-EXPLORATION +es I-EXPLORATION +una I-EXPLORATION +complicación I-EXPLORATION +a I-EXPLORATION +largo I-EXPLORATION +plazo I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -pared I-EXPLORATION -y I-EXPLORATION +diabetes. I-EXPLORATION +Los I-EXPLORATION +pacientes I-EXPLORATION +evolucionan I-EXPLORATION con I-EXPLORATION -penetración I-EXPLORATION -linfovascular, I-EXPLORATION -6 I-EXPLORATION -linfonodos I-EXPLORATION -regionales I-EXPLORATION -sin I-EXPLORATION -tumor I-EXPLORATION -y I-EXPLORATION -2 I-EXPLORATION -metástasis I-EXPLORATION -hepáticas I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -neuroendocrino I-EXPLORATION +claudicación I-EXPLORATION +intermitente I-EXPLORATION +y, I-EXPLORATION +posteriormente, I-EXPLORATION +con I-EXPLORATION +dolor I-EXPLORATION de I-EXPLORATION -también I-EXPLORATION +reposo I-EXPLORATION +asociado I-EXPLORATION +a I-EXPLORATION +alteraciones I-EXPLORATION de I-EXPLORATION -bajo I-EXPLORATION -grado, I-EXPLORATION la I-EXPLORATION -ya I-EXPLORATION -conocida I-EXPLORATION +sensibilidad10, I-EXPLORATION +11. I-EXPLORATION +Pueden I-EXPLORATION +presentar I-EXPLORATION +alteraciones I-EXPLORATION +tróficas I-EXPLORATION de I-EXPLORATION -4, I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION +las I-EXPLORATION +extremidades, I-EXPLORATION +engrosamiento I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +uñas, I-EXPLORATION +xerosis, I-EXPLORATION +edema, I-EXPLORATION +linfangitis, I-EXPLORATION +pulsos I-EXPLORATION +disminuidos, I-EXPLORATION +piel I-EXPLORATION +fría, I-EXPLORATION +eritema, I-EXPLORATION +palidez I-EXPLORATION +o I-EXPLORATION +cianosis. I-EXPLORATION +Finalmente, I-EXPLORATION +aparecen I-EXPLORATION +úlceras I-EXPLORATION y I-EXPLORATION -otra I-EXPLORATION +necrosis12, I-EXPLORATION +13. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +Doppler I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +angiografía I-EXPLORATION +permiten I-EXPLORATION +cuantificar I-EXPLORATION +la I-EXPLORATION +magnitud I-EXPLORATION +del I-EXPLORATION +deterioro I-EXPLORATION de I-EXPLORATION -0, I-EXPLORATION -8 I-EXPLORATION -cm. I-EXPLORATION - I-EXPLORATION +la I-EXPLORATION +circulación I-EXPLORATION +arterial. I-EXPLORATION +El B-TREATMENT +tratamiento I-TREATMENT +incluye I-TREATMENT +ejercicio I-TREATMENT +físico, I-TREATMENT +manejo I-TREATMENT +de I-TREATMENT +la I-TREATMENT +diabetes I-TREATMENT +y I-TREATMENT +de I-TREATMENT +los I-TREATMENT +otros I-TREATMENT +factores I-TREATMENT +de I-TREATMENT +riesgo14. I-TREATMENT +El I-TREATMENT +tratamiento I-TREATMENT +definitivo I-TREATMENT +es I-TREATMENT +la I-TREATMENT +revascularización15. I-TREATMENT + I-TREATMENT -Mujer B-PRESENT_ILLNESS +Niño B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS +11 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -sana, I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -previas I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -ictericia, I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -adinamia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -progresivo. I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso I-EXPLORATION -hubo I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -transaminasas, I-EXPLORATION -gamaglutamiltranspeptidasas, I-EXPLORATION -aumento I-EXPLORATION +edad I-PRESENT_ILLNESS +cuando I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +realizó I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +diagnóstico. I-PRESENT_ILLNESS +Presentó I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +traumatismo I-PRESENT_ILLNESS +previo I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +esguince I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tobillo I-PRESENT_ILLNESS +izquierdo. I-PRESENT_ILLNESS +Fue B-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +Unidad I-DERIVED_FROM/TO +4 I-DERIVED_FROM/TO +meses I-DERIVED_FROM/TO +después I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +diagnóstico. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Se B-TREATMENT +le I-TREATMENT +administra I-TREATMENT +tratamiento I-TREATMENT +farmacológico I-TREATMENT +más I-TREATMENT +aplicación I-TREATMENT +del I-TREATMENT +parche I-TREATMENT +de I-TREATMENT +capsaicina I-TREATMENT +al I-TREATMENT +8 I-TREATMENT +%. I-TREATMENT +Remisión B-EVOLUTION +completa I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +síntomas. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +69 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +gastrectomía I-PRESENT_ILLNESS +total I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +Y I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Roux I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +adenocarcinoma I-PRESENT_ILLNESS +gástrico I-PRESENT_ILLNESS +pobremente I-PRESENT_ILLNESS +diferenciado I-PRESENT_ILLNESS +hace I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS +meses. I-PRESENT_ILLNESS +Como B-TREATMENT +tratamiento I-TREATMENT +adyuvante I-TREATMENT +recibió I-TREATMENT +radioterapia I-TREATMENT +y I-TREATMENT +quimioterapia, I-TREATMENT +debido I-TREATMENT +a I-TREATMENT +que I-TREATMENT +presentaba I-TREATMENT +implantes I-TREATMENT +peritoneales I-TREATMENT +en I-TREATMENT +el I-TREATMENT +estudio I-TREATMENT +histológico I-TREATMENT +de I-TREATMENT +la I-TREATMENT +pieza I-TREATMENT +quirúrgica. I-TREATMENT +Se B-EXPLORATION +realiza I-EXPLORATION +endoscopia I-EXPLORATION +alta I-EXPLORATION +por I-EXPLORATION +disfagia I-EXPLORATION +progresiva I-EXPLORATION +y I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -INR I-EXPLORATION +peso, I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +evidencia I-EXPLORATION +anillo I-EXPLORATION +fibroso I-EXPLORATION +en I-EXPLORATION +anastomosis I-EXPLORATION +esofagoenteral, I-EXPLORATION y I-EXPLORATION -disfunción I-EXPLORATION -renal. I-EXPLORATION -No B-PAST_MEDICAL_HISTORY -hubo I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -fármacos I-PAST_MEDICAL_HISTORY -y B-EXPLORATION -los I-EXPLORATION -marcadores I-EXPLORATION -virales I-EXPLORATION -e I-EXPLORATION -inmunológicos I-EXPLORATION +una I-EXPLORATION +estenosis I-EXPLORATION +yeyunal I-EXPLORATION +próxima I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +anastomosis. I-EXPLORATION +Se I-EXPLORATION +tomaron I-EXPLORATION +biopsias I-EXPLORATION +que I-EXPLORATION fueron I-EXPLORATION -negativos I-EXPLORATION -exceptuando, I-EXPLORATION -un I-EXPLORATION -título I-EXPLORATION -de I-EXPLORATION -intensidad I-EXPLORATION -menor I-EXPLORATION +negativas I-EXPLORATION para I-EXPLORATION -virus I-EXPLORATION -hepatitis I-EXPLORATION -A. I-EXPLORATION -Evolucionó B-TREATMENT -rápidamente I-TREATMENT +malignidad. I-EXPLORATION +Ante B-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +recidiva I-TREATMENT +local I-TREATMENT +por I-TREATMENT +carcinomatosis I-TREATMENT +peritoneal, I-TREATMENT +se I-TREATMENT +coloca I-TREATMENT +prótesis I-TREATMENT +esofágica I-TREATMENT +expandible I-TREATMENT +no I-TREATMENT +recubierta I-TREATMENT +de I-TREATMENT +10 I-TREATMENT +cm I-TREATMENT +de I-TREATMENT +longitud. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +fallece I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +4 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +por I-EVOLUTION +invasión I-EVOLUTION +tumoral I-EVOLUTION +sistémica. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +69 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +exfumador, B-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +aneurisma I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +aorta I-PAST_MEDICAL_HISTORY +abdominal I-PAST_MEDICAL_HISTORY +infrarrenal I-PAST_MEDICAL_HISTORY +7, I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +cm I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +anticoagulación I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +tromboembolismo I-PAST_MEDICAL_HISTORY +pulmonar I-PAST_MEDICAL_HISTORY +previo, I-PAST_MEDICAL_HISTORY +recibió B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +diagnóstico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +carcinoma I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pulmón I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +microcítico I-PRESENT_ILLNESS +CPNM I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +epidermoide I-PRESENT_ILLNESS +T3aN2M0 I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +lóbulo I-PRESENT_ILLNESS +superior I-PRESENT_ILLNESS +izquierdo. I-PRESENT_ILLNESS +Considerado B-TREATMENT +irresecable, I-TREATMENT +fue I-TREATMENT +sometido I-TREATMENT a I-TREATMENT -sopor I-TREATMENT -profundo, I-TREATMENT -requirió I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -invasiva I-TREATMENT -y B-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -de I-EXPLORATION -encéfalo I-EXPLORATION -(TC) I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -edema I-EXPLORATION -encefálico I-EXPLORATION -con I-EXPLORATION -elementos I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -HIC. I-EXPLORATION -La I-EXPLORATION -monitorización I-EXPLORATION -electroencefalográfica I-EXPLORATION -mostró I-EXPLORATION -ritmos I-EXPLORATION -lentos I-EXPLORATION +4 I-TREATMENT +ciclos I-TREATMENT +de I-TREATMENT +cisplatino-vinorelbina I-TREATMENT +junto I-TREATMENT +con I-TREATMENT +radioterapia I-TREATMENT +torácica; I-TREATMENT +con I-TREATMENT +moderada I-TREATMENT +respuesta. I-TREATMENT +Seis B-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +diagnóstico, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +ingresó I-EVOLUTION +por I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +difuso I-EVOLUTION +de I-EVOLUTION +seis I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +evolución I-EVOLUTION +y I-EVOLUTION +vómitos I-EVOLUTION +esporádicos. I-EVOLUTION +Presentaba B-EXPLORATION +hipoalbuminemia I-EXPLORATION +leve I-EXPLORATION y I-EXPLORATION -simétricos I-EXPLORATION -bilaterales. I-EXPLORATION -El I-EXPLORATION -INR I-EXPLORATION -inicial I-EXPLORATION +anemia I-EXPLORATION de I-EXPLORATION -5, I-EXPLORATION -0 I-EXPLORATION -se I-EXPLORATION -corrigió I-EXPLORATION -a I-EXPLORATION -1, I-EXPLORATION -6 I-EXPLORATION -con I-EXPLORATION -40 I-EXPLORATION -ug/kg I-EXPLORATION +6, I-EXPLORATION +5 I-EXPLORATION +g/dl I-EXPLORATION +-precisando I-EXPLORATION +concentrados I-EXPLORATION de I-EXPLORATION -Factor I-EXPLORATION -VII I-EXPLORATION -activado I-EXPLORATION -recombinante I-EXPLORATION -(rFVIIa) I-EXPLORATION -previo I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -instalación I-EXPLORATION +hematíes-. I-EXPLORATION +La I-EXPLORATION +TC I-EXPLORATION +abdómino-pélvica I-EXPLORATION +informó I-EXPLORATION de I-EXPLORATION -catéter I-EXPLORATION -intraparenquimatoso I-EXPLORATION -Raudemic® I-EXPLORATION -para I-EXPLORATION -medición I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +procedente I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -presión I-EXPLORATION -intracraneana I-EXPLORATION -(PIC) I-EXPLORATION -y I-EXPLORATION -temperatura I-EXPLORATION -encefálica. I-EXPLORATION -Los I-EXPLORATION -valores I-EXPLORATION -iniciales I-EXPLORATION +mesenterio I-EXPLORATION +que I-EXPLORATION +englobaba I-EXPLORATION +varias I-EXPLORATION +asas I-EXPLORATION de I-EXPLORATION -PIC I-EXPLORATION -fluctuaron I-EXPLORATION +intestino. I-EXPLORATION +La I-EXPLORATION +ultrasonografía I-EXPLORATION +evidenció I-EXPLORATION +un I-EXPLORATION +trayecto I-EXPLORATION +fistuloso I-EXPLORATION entre I-EXPLORATION -20 I-EXPLORATION +asas I-EXPLORATION +de I-EXPLORATION +intestino I-EXPLORATION +delgado I-EXPLORATION y I-EXPLORATION -25 I-EXPLORATION -mmHg, I-EXPLORATION +un I-EXPLORATION +área I-EXPLORATION +flemonosa I-EXPLORATION con I-EXPLORATION -temperatura I-EXPLORATION -cerebral I-EXPLORATION +pequeñas I-EXPLORATION +burbujas I-EXPLORATION de I-EXPLORATION -37°C. I-EXPLORATION -El I-EXPLORATION -Doppler I-EXPLORATION -transcraneano I-EXPLORATION -determinó I-EXPLORATION -velocidad I-EXPLORATION -sistólica I-EXPLORATION -e I-EXPLORATION -índice I-EXPLORATION +gas I-EXPLORATION +extraluminal, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +instauró I-EXPLORATION +tratamiento I-EXPLORATION +antibiótico. I-EXPLORATION +Al B-EVOLUTION +5o I-EVOLUTION +día I-EVOLUTION +desarrolló I-EVOLUTION +un I-EVOLUTION +franco I-EVOLUTION +cuadro I-EVOLUTION +obstructivo; I-EVOLUTION +siendo B-TREATMENT +entonces I-TREATMENT +intervenido I-TREATMENT +con I-TREATMENT +carácter I-TREATMENT +urgente. I-TREATMENT +Se B-EXPLORATION +halló I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +abdominal I-EXPLORATION de I-EXPLORATION -pulsatibilidad I-EXPLORATION -normales; I-EXPLORATION -siendo I-EXPLORATION -enlistada I-EXPLORATION -para I-EXPLORATION -trasplante I-EXPLORATION -hepático I-EXPLORATION +15 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -acuerdo I-EXPLORATION +diámetro I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +mesenterio I-EXPLORATION a I-EXPLORATION -los I-EXPLORATION -criterios I-EXPLORATION +nivel I-EXPLORATION del I-EXPLORATION -King's I-EXPLORATION -College8. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -HIC I-TREATMENT -se I-TREATMENT -tornó I-TREATMENT -refractaria I-TREATMENT +promontorio I-EXPLORATION +y I-EXPLORATION +cercana I-EXPLORATION +al I-EXPLORATION +aneurisma. I-EXPLORATION +Esta I-EXPLORATION +englobaba I-EXPLORATION +al I-EXPLORATION +intestino I-EXPLORATION +delgado, I-EXPLORATION +dos I-EXPLORATION +asas I-EXPLORATION +de I-EXPLORATION +yeyuno, I-EXPLORATION +una I-EXPLORATION +de I-EXPLORATION +íleon I-EXPLORATION +-a I-EXPLORATION +30 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +válvula I-EXPLORATION +cecal- I-EXPLORATION +y I-EXPLORATION +al I-EXPLORATION +colon I-EXPLORATION +sigmoideo I-EXPLORATION +en I-EXPLORATION +una I-EXPLORATION +longitud I-EXPLORATION +de I-EXPLORATION +10 I-EXPLORATION +cm. I-EXPLORATION +Se B-TREATMENT +procedió I-TREATMENT a I-TREATMENT -medidas I-TREATMENT +la I-TREATMENT +resección I-TREATMENT +segmentaria I-TREATMENT de I-TREATMENT -primera I-TREATMENT -línea, I-TREATMENT -iniciándose I-TREATMENT -hipotermia I-TREATMENT -intravascular I-TREATMENT +sigma I-TREATMENT +y I-TREATMENT +asas I-TREATMENT +englobadas I-TREATMENT +en I-TREATMENT +el I-TREATMENT +tumor I-TREATMENT +mesentérico, I-TREATMENT +reconstruyendo I-TREATMENT mediante I-TREATMENT -catéter I-TREATMENT -tipo I-TREATMENT -ICY® I-TREATMENT -vía I-TREATMENT -femoral I-TREATMENT -con I-TREATMENT -máquina I-TREATMENT -Alsius I-TREATMENT -CoolGard®, I-TREATMENT -disminuyendo I-TREATMENT -la I-TREATMENT -temperatura I-TREATMENT -encefálica I-TREATMENT -a I-TREATMENT -33oC. I-TREATMENT -Recibió I-TREATMENT -sedación I-TREATMENT +tres I-TREATMENT +anastomosis I-TREATMENT +de I-TREATMENT +intestino I-TREATMENT +delgado I-TREATMENT con I-TREATMENT -opiáceos I-TREATMENT -(Fentanyl) I-TREATMENT -e I-TREATMENT -infusión I-TREATMENT -continua I-TREATMENT +autosutura I-TREATMENT +mecánica I-TREATMENT +latero-lateral, I-TREATMENT +y I-TREATMENT +una I-TREATMENT de I-TREATMENT -relajante I-TREATMENT -muscular I-TREATMENT -(vecuronium) I-TREATMENT -para I-TREATMENT -prevenir I-TREATMENT -escalofríos; I-TREATMENT -en B-EVOLUTION -3, I-EVOLUTION -5 I-EVOLUTION -h I-EVOLUTION -se I-EVOLUTION -logró I-EVOLUTION -la I-EVOLUTION -meta I-EVOLUTION -de I-EVOLUTION -33oC. I-EVOLUTION -A B-TREATMENT -las I-TREATMENT -72 I-TREATMENT -h, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -ofreció I-TREATMENT -un I-TREATMENT -injerto I-TREATMENT -hepático I-TREATMENT -de I-TREATMENT -donante I-TREATMENT -cadavérico I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT -trasplante I-TREATMENT -ortotópico I-TREATMENT -bajo I-TREATMENT -hipotermia I-TREATMENT -intravascular I-TREATMENT -activa. I-TREATMENT -Posteriormente B-EVOLUTION -en I-EVOLUTION +sigma I-TREATMENT +término-terminal. I-TREATMENT +La B-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +demostró I-EXPLORATION +la I-EXPLORATION +infiltración I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +grasa I-EXPLORATION +mesentérica I-EXPLORATION +y I-EXPLORATION +su I-EXPLORATION +extensión I-EXPLORATION +hacia I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +asas I-EXPLORATION +intestinales I-EXPLORATION +-alcanzando I-EXPLORATION +la I-EXPLORATION +mucosa-, I-EXPLORATION +englobándolas, I-EXPLORATION +con I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +abscesificación I-EXPLORATION +y I-EXPLORATION +fistulización. I-EXPLORATION +El B-EVOLUTION +postoperatorio I-EVOLUTION +transcurrió I-EVOLUTION +sin I-EVOLUTION +incidencias I-EVOLUTION +-recuperó I-EVOLUTION la I-EVOLUTION -unidad I-EVOLUTION -de I-EVOLUTION -cuidados I-EVOLUTION -intensivos, I-EVOLUTION +ingesta I-EVOLUTION +oral I-EVOLUTION y I-EVOLUTION -luego I-EVOLUTION -de I-EVOLUTION -comprobar I-EVOLUTION -la I-EVOLUTION -perfusión I-EVOLUTION -del I-EVOLUTION -injerto, I-EVOLUTION -se I-EVOLUTION -reinició I-EVOLUTION -recalentamiento I-EVOLUTION -lento I-EVOLUTION -controlado I-EVOLUTION -alcanzando I-EVOLUTION -la I-EVOLUTION -normotermia I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -76 I-EVOLUTION -h I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -continua I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -pruebas I-EVOLUTION -de I-EVOLUTION +el I-EVOLUTION +tránsito I-EVOLUTION +intestinal- I-EVOLUTION +hasta I-EVOLUTION +el I-EVOLUTION +8o I-EVOLUTION +día, I-EVOLUTION +cuando I-EVOLUTION +presentó I-EVOLUTION +un I-EVOLUTION +pico I-EVOLUTION +febril. I-EVOLUTION +La B-EXPLORATION +TC I-EXPLORATION +evidenció I-EXPLORATION +una I-EXPLORATION +colección I-EXPLORATION +de I-EXPLORATION +8 I-EXPLORATION +cm I-EXPLORATION +-por I-EXPLORATION +mínima I-EXPLORATION +dehiscencia I-EXPLORATION +de I-EXPLORATION +sigma- I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +drenó I-EXPLORATION +y I-EXPLORATION +resolvió I-EXPLORATION +radiológicamente. I-EXPLORATION +Con B-EVOLUTION función I-EVOLUTION -hepática, I-EVOLUTION -completando I-EVOLUTION -de I-EVOLUTION -esta I-EVOLUTION -manera I-EVOLUTION -122 I-EVOLUTION -h I-EVOLUTION +intestinal I-EVOLUTION +normal, I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION de I-EVOLUTION -hipotermia I-EVOLUTION -a I-EVOLUTION -33oC. I-EVOLUTION -Desarrolló I-EVOLUTION -mioneuropatía I-EVOLUTION +alta. I-EVOLUTION +En I-EVOLUTION +las I-EVOLUTION +semanas I-EVOLUTION +posteriores, I-EVOLUTION +experimentó I-EVOLUTION +rápido I-EVOLUTION +deterioro I-EVOLUTION del I-EVOLUTION -paciente I-EVOLUTION -crítico I-EVOLUTION +estado I-EVOLUTION +general I-EVOLUTION y I-EVOLUTION -permaneció I-EVOLUTION -en I-EVOLUTION -ventilación I-EVOLUTION -mecánica I-EVOLUTION -durante I-EVOLUTION -15 I-EVOLUTION -días, I-EVOLUTION -requiriendo B-TREATMENT -de I-TREATMENT -traqueostomía I-TREATMENT -percutánea I-TREATMENT -para I-TREATMENT -facilitar I-TREATMENT -el I-TREATMENT -destete I-TREATMENT -del I-TREATMENT -ventilador I-TREATMENT -mecánico. I-TREATMENT - I-TREATMENT -Luego I-TREATMENT -de I-TREATMENT -un I-TREATMENT -despertar I-TREATMENT -lento, I-TREATMENT -se I-TREATMENT -retiró I-TREATMENT -la I-TREATMENT -cánula I-TREATMENT -de I-TREATMENT -traqueostomía I-TREATMENT -al I-TREATMENT -día I-TREATMENT -37. I-TREATMENT -Recibió B-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -luego I-EVOLUTION +progresión I-EVOLUTION de I-EVOLUTION -69 I-EVOLUTION -días I-EVOLUTION +la I-EVOLUTION +enfermedad I-EVOLUTION +tumoral I-EVOLUTION +(linfangitis I-EVOLUTION +carcinomatosa I-EVOLUTION +pulmonar, I-EVOLUTION +crecimiento I-EVOLUTION de I-EVOLUTION -hospitalización I-EVOLUTION +metástasis I-EVOLUTION +subcutánea I-EVOLUTION +en I-EVOLUTION +pared I-EVOLUTION +torácica, I-EVOLUTION +hipercalcemia I-EVOLUTION +tumoral). I-EVOLUTION +No I-EVOLUTION +estando I-EVOLUTION en I-EVOLUTION -buenas I-EVOLUTION condiciones I-EVOLUTION -generales, I-EVOLUTION -nutritivas, I-EVOLUTION -neurológicas I-EVOLUTION +de I-EVOLUTION +iniciar I-EVOLUTION +una I-EVOLUTION +segunda I-EVOLUTION +línea I-EVOLUTION +de I-EVOLUTION +quimioterapia, I-EVOLUTION +falleció I-EVOLUTION +al I-EVOLUTION +mes I-EVOLUTION y I-EVOLUTION -ligada I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -programa I-EVOLUTION +medio I-EVOLUTION +tras I-EVOLUTION +la I-EVOLUTION +exéresis I-EVOLUTION +quirúrgica I-EVOLUTION de I-EVOLUTION -rehabilitación I-EVOLUTION -física. I-EVOLUTION -Actualmente I-EVOLUTION -asiste I-EVOLUTION +la I-EVOLUTION +metástasis I-EVOLUTION +abdominal. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +55 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +diagnosticado B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +osteoartrosis I-PAST_MEDICAL_HISTORY +primaria, I-PAST_MEDICAL_HISTORY +muy I-PAST_MEDICAL_HISTORY +invalidante, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +prótesis I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cadera I-PAST_MEDICAL_HISTORY +derecha I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +Durogesic® I-PAST_MEDICAL_HISTORY +25 I-PAST_MEDICAL_HISTORY +μg/h. I-PAST_MEDICAL_HISTORY +Durante I-PAST_MEDICAL_HISTORY +8 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +tratado I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +mismo I-PAST_MEDICAL_HISTORY +modo. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +actualidad I-PAST_MEDICAL_HISTORY +continúa I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +Durogesic® I-PAST_MEDICAL_HISTORY +50 I-PAST_MEDICAL_HISTORY +μg/h. I-PAST_MEDICAL_HISTORY +Hace I-PAST_MEDICAL_HISTORY +1 I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +brote I-PAST_MEDICAL_HISTORY +psicótico, I-PAST_MEDICAL_HISTORY +motivo I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +tuvo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +ingresado I-PAST_MEDICAL_HISTORY +psiquiátricamente. I-PAST_MEDICAL_HISTORY +Al B-TREATMENT +alta I-TREATMENT +del I-TREATMENT +hospital I-TREATMENT +se I-TREATMENT +le I-TREATMENT +prescribió I-TREATMENT +fentanilo I-TREATMENT +50 I-TREATMENT +μg/h I-TREATMENT +(genérico). I-TREATMENT +A B-EVOLUTION +raíz I-EVOLUTION +de I-EVOLUTION +dicho I-EVOLUTION +cambio I-EVOLUTION +se I-EVOLUTION +volvieran I-EVOLUTION a I-EVOLUTION +agravar I-EVOLUTION sus I-EVOLUTION -estudios I-EVOLUTION -secundarios I-EVOLUTION +algias I-EVOLUTION y I-EVOLUTION +un I-EVOLUTION +síndrome I-EVOLUTION +de I-EVOLUTION +abstinencia I-EVOLUTION +que I-EVOLUTION se I-EVOLUTION -mantiene I-EVOLUTION -en I-EVOLUTION -control I-EVOLUTION -ambulatorio. I-EVOLUTION - I-EVOLUTION +caracterizaba I-EVOLUTION +por I-EVOLUTION +inquietud, I-EVOLUTION +irritabilidad I-EVOLUTION +y B-TREATMENT +un I-TREATMENT +cuadro I-TREATMENT +confusional I-TREATMENT +que I-TREATMENT +desapareció I-TREATMENT +al I-TREATMENT +volver I-TREATMENT +a I-TREATMENT +prescribirse I-TREATMENT +nuevamente I-TREATMENT +Durogesic® I-TREATMENT +50 I-TREATMENT +μg/h. I-TREATMENT + I-TREATMENT -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -obesa B-PAST_MEDICAL_HISTORY -mórbida I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipertensa, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -agosto I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -2007 I-PRESENT_ILLNESS +43 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS +inflamación I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -intermitente I-PRESENT_ILLNESS +edema I-PRESENT_ILLNESS +prepucial I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +tumefacción I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +dorso I-PRESENT_ILLNESS +peneano I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +niega I-PRESENT_ILLNESS +relaciones I-PRESENT_ILLNESS +sexuales I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +riesgo, I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +miccional, I-PRESENT_ILLNESS +o I-PRESENT_ILLNESS +fiebre. I-PRESENT_ILLNESS +Refiere I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +dorso I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +pene I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +relación I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cordón I-PRESENT_ILLNESS +indurado I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +palpable I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +dicha I-PRESENT_ILLNESS +región, I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -posteriormente I-PRESENT_ILLNESS se I-PRESENT_ILLNESS -asoció I-PRESENT_ILLNESS +acentúa I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -cervical I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -rápido I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ortopnea. I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +erección. I-PRESENT_ILLNESS I-PRESENT_ILLNESS -La B-EXPLORATION -radiografía I-EXPLORATION +En B-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +clínica I-PAST_MEDICAL_HISTORY +sólo I-PAST_MEDICAL_HISTORY +destaca I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +fumador I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +cigarrillos/ I-PAST_MEDICAL_HISTORY +día, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +ninguna I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +base I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +habitual; I-PAST_MEDICAL_HISTORY +en B-FAMILY_HISTORY +su I-FAMILY_HISTORY +historia I-FAMILY_HISTORY +familiar I-FAMILY_HISTORY +tampoco I-FAMILY_HISTORY +se I-FAMILY_HISTORY +encontraron I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +de I-FAMILY_HISTORY +interés. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Durante B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +una I-EXPLORATION +inflamación I-EXPLORATION +prepucial I-EXPLORATION +intensa I-EXPLORATION +con I-EXPLORATION +erosiones I-EXPLORATION +blanquecinas I-EXPLORATION +sugerentes I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION +candidiasis. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +dorso I-EXPLORATION +peneano I-EXPLORATION +se I-EXPLORATION +evidencia I-EXPLORATION +un I-EXPLORATION +cordón I-EXPLORATION +duro I-EXPLORATION +y I-EXPLORATION +doloroso I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +extiende I-EXPLORATION +desde I-EXPLORATION +la I-EXPLORATION +base I-EXPLORATION +hasta I-EXPLORATION +el I-EXPLORATION +surco I-EXPLORATION +balanoprepucial, I-EXPLORATION +asociado I-EXPLORATION +a I-EXPLORATION +inflamación I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +adyacente. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION fue I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION normal. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -cervical I-EXPLORATION -mostró I-EXPLORATION -bocio I-EXPLORATION -con I-EXPLORATION -nodulo I-EXPLORATION -sólido I-EXPLORATION -izquierdo I-EXPLORATION + I-EXPLORATION +Ante I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION de I-EXPLORATION -gran I-EXPLORATION -tamaño I-EXPLORATION -(4, I-EXPLORATION -3 I-EXPLORATION -x I-EXPLORATION -5, I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -4, I-EXPLORATION -5 I-EXPLORATION -cm), I-EXPLORATION -hipoecogénico, I-EXPLORATION -escasamente I-EXPLORATION -vascularizado I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -adenopatías I-EXPLORATION -cervicales I-EXPLORATION -bilaterales I-EXPLORATION +enfermedad I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -reactivo. I-EXPLORATION -En I-EXPLORATION +Mondor I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +ecografía I-EXPLORATION +doppler I-EXPLORATION +peneana I-EXPLORATION +que I-EXPLORATION +confirmó I-EXPLORATION el I-EXPLORATION -laboratorio I-EXPLORATION -destacó I-EXPLORATION -TSH I-EXPLORATION -elevada I-EXPLORATION -y I-EXPLORATION -T4 I-EXPLORATION -disminuida. I-EXPLORATION -Se B-TREATMENT -sospechó I-TREATMENT -cáncer I-TREATMENT +diagnóstico. I-EXPLORATION + I-EXPLORATION +El B-TREATMENT +tratamiento I-TREATMENT +instaurado I-TREATMENT +fue I-TREATMENT +Fluconazol I-TREATMENT +tópico I-TREATMENT +1 I-TREATMENT +aplicación I-TREATMENT +/12h, I-TREATMENT +Amoxicilina- I-TREATMENT +Clavulanico I-TREATMENT +875 I-TREATMENT +mg/8h I-TREATMENT +e I-TREATMENT +Ibuprofeno I-TREATMENT +600 I-TREATMENT +mg/8h I-TREATMENT +durante I-TREATMENT +10 I-TREATMENT +días, I-TREATMENT +asociado I-TREATMENT +a I-TREATMENT +reposo I-TREATMENT de I-TREATMENT -tiroides, I-TREATMENT -inició I-TREATMENT -levotiroxina I-TREATMENT -y I-TREATMENT -se I-TREATMENT -programó I-TREATMENT -resección I-TREATMENT -quirúrgica. I-TREATMENT - I-TREATMENT -En I-TREATMENT -la I-TREATMENT -cirugía, I-TREATMENT -se I-TREATMENT -seccionaron I-TREATMENT -los I-TREATMENT -músculos I-TREATMENT -pretiroideos I-TREATMENT -izquierdos I-TREATMENT -para I-TREATMENT -facilitar I-TREATMENT la I-TREATMENT -exploración, I-TREATMENT -los I-TREATMENT -que I-TREATMENT -estaban I-TREATMENT -adheridos I-TREATMENT -a I-TREATMENT +actividad I-TREATMENT +sexual I-TREATMENT +hasta I-TREATMENT la I-TREATMENT -lesión. I-TREATMENT -El I-TREATMENT -gran I-TREATMENT -nodulo I-TREATMENT -blanquecino I-TREATMENT -se I-TREATMENT -proyectaba I-TREATMENT -hacia I-TREATMENT -esófago I-TREATMENT -cervical. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -tiroidectomía I-TREATMENT -total. I-TREATMENT -La B-EXPLORATION -biopsia I-EXPLORATION -rápida I-EXPLORATION +resolución I-TREATMENT +del I-TREATMENT +cuadro. I-TREATMENT + I-TREATMENT +Durante B-EVOLUTION +la I-EVOLUTION +primera I-EVOLUTION +semana, I-EVOLUTION +se I-EVOLUTION +objetiva I-EVOLUTION +una I-EVOLUTION +disminución I-EVOLUTION +progresiva I-EVOLUTION +del I-EVOLUTION +cordón I-EVOLUTION +dorsal I-EVOLUTION +en I-EVOLUTION +sentido I-EVOLUTION +distal I-EVOLUTION +y I-EVOLUTION +del I-EVOLUTION +dolor. I-EVOLUTION +Las I-EVOLUTION +lesiones I-EVOLUTION +relacionadas I-EVOLUTION +con I-EVOLUTION +la I-EVOLUTION +candidiasis I-EVOLUTION +han I-EVOLUTION +desaparecido. I-EVOLUTION +En B-EXPLORATION +este I-EXPLORATION +momento I-EXPLORATION +se I-EXPLORATION +pone I-EXPLORATION de I-EXPLORATION +manifiesto I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -informó I-EXPLORATION -proliferación I-EXPLORATION -linfoide I-EXPLORATION -atípica I-EXPLORATION -sugerente I-EXPLORATION +exploración I-EXPLORATION +una I-EXPLORATION +fimosis I-EXPLORATION +puntiforme I-EXPLORATION +que I-EXPLORATION +impide I-EXPLORATION +la I-EXPLORATION +retracción I-EXPLORATION +prepucial, I-EXPLORATION +y I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +precisará I-EXPLORATION +ser I-EXPLORATION +circuncidado. I-EXPLORATION +A I-EXPLORATION +las I-EXPLORATION +6 I-EXPLORATION +semanas I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +ecografía I-EXPLORATION +doppler I-EXPLORATION +peneana I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +la I-EXPLORATION +repermeabilización I-EXPLORATION de I-EXPLORATION -linfoma. I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +dorsal I-EXPLORATION +superficial I-EXPLORATION +del I-EXPLORATION +pene I-EXPLORATION +en I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +trombo I-EXPLORATION +venoso, I-EXPLORATION +dando I-EXPLORATION +por I-EXPLORATION +resuelto I-EXPLORATION +el I-EXPLORATION +cuadro. I-EXPLORATION I-EXPLORATION -Evolucionó B-EVOLUTION -con I-EVOLUTION -hipocalcemia I-EVOLUTION -sintomática I-EVOLUTION -de I-EVOLUTION -7, I-EVOLUTION -6 I-EVOLUTION -mg/dl I-EVOLUTION -que I-EVOLUTION -cedió I-EVOLUTION -con I-EVOLUTION -calcio I-EVOLUTION -oral. I-EVOLUTION -Fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -postoperatorio. I-EVOLUTION - I-EVOLUTION -La B-EXPLORATION -biopsia I-EXPLORATION -definitiva I-EXPLORATION -concluyó I-EXPLORATION -"infiltrado I-EXPLORATION -linfoide I-EXPLORATION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +34 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que B-DERIVED_FROM/TO +acude I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +consulta I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +optometrista I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +valorar I-DERIVED_FROM/TO +tumoración I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nivel I-DERIVED_FROM/TO +iridiano I-DERIVED_FROM/TO +sin I-DERIVED_FROM/TO +repercusión I-DERIVED_FROM/TO +funcional. I-DERIVED_FROM/TO +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION +una I-EXPLORATION +formación I-EXPLORATION +sobreelevada I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -grandes, I-EXPLORATION +aspecto I-EXPLORATION +quístico I-EXPLORATION +y I-EXPLORATION +contenido I-EXPLORATION +lechoso I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +iris, I-EXPLORATION +cerca I-EXPLORATION +del I-EXPLORATION +reborde I-EXPLORATION +pupilar. I-EXPLORATION +No B-PAST_MEDICAL_HISTORY +refiere I-PAST_MEDICAL_HISTORY +ningún I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +oftalmológico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés. I-PAST_MEDICAL_HISTORY +Se B-EXPLORATION +obtienen I-EXPLORATION +imágenes I-EXPLORATION con I-EXPLORATION -metaplasia I-EXPLORATION +BMU I-EXPLORATION +y I-EXPLORATION +OCT I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +establece I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION +quiste I-EXPLORATION +estromal I-EXPLORATION +primario I-EXPLORATION de I-EXPLORATION -Hürtle, I-EXPLORATION -que I-EXPLORATION -comprometió I-EXPLORATION -la I-EXPLORATION -cápsula I-EXPLORATION -tiroidea I-EXPLORATION -y I-EXPLORATION -focalmente I-EXPLORATION +iris. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +todos I-EXPLORATION +los I-EXPLORATION +casos I-EXPLORATION +anteriormente I-EXPLORATION +mencionados, I-EXPLORATION el I-EXPLORATION -tejido I-EXPLORATION -muscular I-EXPLORATION -peritiroideo. I-EXPLORATION -Inmunohistoquímica: I-EXPLORATION -CD20 I-EXPLORATION -(+) I-EXPLORATION -difuso, I-EXPLORATION -CD3 I-EXPLORATION -(+) I-EXPLORATION -focal I-EXPLORATION -en I-EXPLORATION -linfocitos I-EXPLORATION -pequeños, I-EXPLORATION -CD10 I-EXPLORATION -(+) I-EXPLORATION -difuso, I-EXPLORATION -BCL2 I-EXPLORATION -(-) I-EXPLORATION -". I-EXPLORATION -Compatible I-EXPLORATION -con I-EXPLORATION -LNH I-EXPLORATION -tiroideo I-EXPLORATION +tiempo I-EXPLORATION +medio I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -grandes I-EXPLORATION -estirpe I-EXPLORATION -B, I-EXPLORATION -tiroiditis I-EXPLORATION +exploración I-EXPLORATION +utilizando I-EXPLORATION +ambos I-EXPLORATION +instrumentes I-EXPLORATION +varío I-EXPLORATION +considerablemente, I-EXPLORATION de I-EXPLORATION -Hashimoto I-EXPLORATION -y I-EXPLORATION -metaplasia I-EXPLORATION -con I-EXPLORATION -células I-EXPLORATION +esta I-EXPLORATION +forma, I-EXPLORATION +mediante I-EXPLORATION +el I-EXPLORATION +OCT I-EXPLORATION +se I-EXPLORATION +lograron I-EXPLORATION +exploraciones I-EXPLORATION +completas I-EXPLORATION +del I-EXPLORATION +segmento I-EXPLORATION +anterior I-EXPLORATION +en I-EXPLORATION +tiempos I-EXPLORATION +inferiores I-EXPLORATION +a I-EXPLORATION +5 I-EXPLORATION +minutos. I-EXPLORATION +En I-EXPLORATION +cambio, I-EXPLORATION +la I-EXPLORATION +BMU, I-EXPLORATION +fundamentalmente I-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +preparación I-EXPLORATION +previa I-EXPLORATION +que I-EXPLORATION +conlleva, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +mayor I-EXPLORATION +dificultad I-EXPLORATION +para I-EXPLORATION +localizar I-EXPLORATION +la I-EXPLORATION +lesiones I-EXPLORATION +a I-EXPLORATION +estudiar I-EXPLORATION +implicó I-EXPLORATION +tiempos I-EXPLORATION de I-EXPLORATION -Hürtle. I-EXPLORATION +exploración I-EXPLORATION +superiores I-EXPLORATION +a I-EXPLORATION +10 I-EXPLORATION +minutos. I-EXPLORATION I-EXPLORATION -Se B-TREATMENT -indicó I-TREATMENT -quimioterapia I-TREATMENT -pero I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -la I-TREATMENT -rechazó I-TREATMENT -por I-TREATMENT -motivos I-TREATMENT -religiosos. I-TREATMENT - I-TREATMENT -Seis B-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -consultó I-EVOLUTION -en I-EVOLUTION -cirugía I-EVOLUTION -por I-EVOLUTION -recidiva I-EVOLUTION -local I-EVOLUTION -con I-EVOLUTION -sintomatología I-EVOLUTION -obstructiva I-EVOLUTION -de I-EVOLUTION -vía I-EVOLUTION -aérea. I-EVOLUTION -Fue B-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -hematología I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -pierde I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -control. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS +27 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -morbilidad I-PAST_MEDICAL_HISTORY -previa, I-PAST_MEDICAL_HISTORY -proveniente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Puerto I-PAST_MEDICAL_HISTORY -Varas. I-PAST_MEDICAL_HISTORY -Fue I-PAST_MEDICAL_HISTORY -sometida I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -colecistec-tomía I-PAST_MEDICAL_HISTORY -laparoscópica I-PAST_MEDICAL_HISTORY -electiva I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -julio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2003 I-PAST_MEDICAL_HISTORY -recibiendo I-PAST_MEDICAL_HISTORY -anestesia I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -halotano. I-PAST_MEDICAL_HISTORY -Evolucionó I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -complicaciones I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -dada I-PAST_MEDICAL_HISTORY +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +peruana, B-PAST_MEDICAL_HISTORY +procedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -alta. I-PAST_MEDICAL_HISTORY -Al B-PRESENT_ILLNESS -quinto I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -postoperatorio I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS +Lima, I-PAST_MEDICAL_HISTORY +consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +múltiples I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +piel I-PRESENT_ILLNESS del I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS -náuseas, I-PRESENT_ILLNESS -vómitos, I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -alteración I-PRESENT_ILLNESS +pie I-PRESENT_ILLNESS +derecho, I-PRESENT_ILLNESS +pruriginosas, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -compatible I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -encefalopatía I-PRESENT_ILLNESS -hepática, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Posteriormente I-PRESENT_ILLNESS se I-PRESENT_ILLNESS -hospitalizó I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS +asoció I-PRESENT_ILLNESS +edema I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -hepatitis I-PRESENT_ILLNESS -fulminante. I-PRESENT_ILLNESS -El B-EXPLORATION -estudio I-EXPLORATION -etiológico I-EXPLORATION -viral, I-EXPLORATION -metabólico, I-EXPLORATION -autoinmune I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -otras I-EXPLORATION -drogas I-EXPLORATION -resultó I-EXPLORATION -negativo. I-EXPLORATION -Fue B-DERIVED_FROM/TO -trasladada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Paciente I-DERIVED_FROM/TO -Crítico I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -Clínico I-DERIVED_FROM/TO -San I-DERIVED_FROM/TO -Borja I-DERIVED_FROM/TO -Arriarán I-DERIVED_FROM/TO -(HCSBA) I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -5 I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -agosto I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -2003 I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -hepatitis I-DERIVED_FROM/TO -aguda I-DERIVED_FROM/TO -fulminante I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -halotano I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -activó I-DERIVED_FROM/TO -como I-DERIVED_FROM/TO -urgencia I-DERIVED_FROM/TO -nacional I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -trasplante I-DERIVED_FROM/TO -hepático. I-DERIVED_FROM/TO -Dada B-TREATMENT -la I-TREATMENT -emergencia I-TREATMENT -vital I-TREATMENT -se I-TREATMENT -efectuó I-TREATMENT -un I-TREATMENT -trasplante I-TREATMENT -hepático I-TREATMENT -de I-TREATMENT -donante I-TREATMENT -cadáver I-TREATMENT -ABO I-TREATMENT -incompatible I-TREATMENT -(donante I-TREATMENT -grupo I-TREATMENT -A, I-TREATMENT -receptor I-TREATMENT -grupo I-TREATMENT -O) I-TREATMENT -el I-TREATMENT -8 I-TREATMENT -de I-TREATMENT -agosto I-TREATMENT -de I-TREATMENT -2003, I-TREATMENT -en I-TREATMENT -Clínica I-TREATMENT -Las I-TREATMENT -Condes. I-TREATMENT -El I-TREATMENT -protocolo I-TREATMENT -terapéutico I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -plasmaféresis I-TREATMENT -intra I-TREATMENT -y I-TREATMENT -postrasplante, I-TREATMENT -esplenectomía I-TREATMENT -e I-TREATMENT -inmunosupresión I-TREATMENT -cuádruple, I-TREATMENT -con I-TREATMENT -metilprednisolona, I-TREATMENT -ciclofosfamida, I-TREATMENT -timoglobulina I-TREATMENT -y I-TREATMENT -ciclosporina. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION +la I-PRESENT_ILLNESS +extremidad I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +malestar I-PRESENT_ILLNESS +general, I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +previos I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +evaluación. I-PRESENT_ILLNESS +Como B-PAST_MEDICAL_HISTORY +antecedente, I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +visitado I-PAST_MEDICAL_HISTORY +Tulum I-PAST_MEDICAL_HISTORY +(Riviera I-PAST_MEDICAL_HISTORY +Maya, I-PAST_MEDICAL_HISTORY +México) I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +días, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +caminó I-PAST_MEDICAL_HISTORY +descalza I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +arena I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +practicó I-PAST_MEDICAL_HISTORY +buceo, I-PAST_MEDICAL_HISTORY +además I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +haber I-PAST_MEDICAL_HISTORY +sufrido I-PAST_MEDICAL_HISTORY +múltiples I-PAST_MEDICAL_HISTORY +picaduras I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +mosquitos I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +extremidades I-PAST_MEDICAL_HISTORY +inferiores. I-PAST_MEDICAL_HISTORY +Había I-PAST_MEDICAL_HISTORY +retornado I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +Lima I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +consultar. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Al B-EXPLORATION +examen I-EXPLORATION +físico, I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +presentaba I-EXPLORATION +múltiples I-EXPLORATION +lesiones I-EXPLORATION +serpiginosas, I-EXPLORATION +solevantadas, I-EXPLORATION +eritematosas, I-EXPLORATION +confluentes, I-EXPLORATION +de I-EXPLORATION +uno I-EXPLORATION +a I-EXPLORATION +tres I-EXPLORATION +centímetros I-EXPLORATION +de I-EXPLORATION +longitud I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +uno I-EXPLORATION +a I-EXPLORATION +dos I-EXPLORATION +milímetros I-EXPLORATION +de I-EXPLORATION +espesor, I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +dorso I-EXPLORATION +y I-EXPLORATION +2°, I-EXPLORATION +3° I-EXPLORATION +y I-EXPLORATION +4° I-EXPLORATION +ortejos I-EXPLORATION del I-EXPLORATION -explante I-EXPLORATION -concluyó I-EXPLORATION -necrosis I-EXPLORATION -submasiva. I-EXPLORATION +pie I-EXPLORATION +derecho. I-EXPLORATION +Además, I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +dedos I-EXPLORATION +se I-EXPLORATION +observaban I-EXPLORATION +pequeñas I-EXPLORATION +vesículas I-EXPLORATION +pruriginosas. I-EXPLORATION I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -5 I-TREATMENT -sesiones I-TREATMENT -de I-TREATMENT -plasmaféresis, I-TREATMENT -que I-TREATMENT -disminuyó I-TREATMENT -significativamente I-TREATMENT +Se B-TREATMENT +realizó I-TREATMENT el I-TREATMENT -título I-TREATMENT +diagnóstico I-TREATMENT +clínico I-TREATMENT de I-TREATMENT -isohemoglutininas I-TREATMENT -anti I-TREATMENT -A. I-TREATMENT -Sin I-TREATMENT -embargo, I-TREATMENT -su I-TREATMENT -incremento I-TREATMENT -posterior I-TREATMENT -no I-TREATMENT -se I-TREATMENT -tradujo I-TREATMENT -en I-TREATMENT -una I-TREATMENT -injuria I-TREATMENT -significativa I-TREATMENT -al I-TREATMENT -injerto. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -temprano I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -hemoperitoneo I-EVOLUTION -que B-TREATMENT -requirió I-TREATMENT -cirugía, I-TREATMENT +larva I-TREATMENT +migrans I-TREATMENT +cutánea I-TREATMENT y I-TREATMENT -posteriormente I-TREATMENT -una I-TREATMENT -neumopatía I-TREATMENT -aguda. I-TREATMENT -Los B-EXPLORATION -estudios I-EXPLORATION -imagenológicos I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION -resultaron I-EXPLORATION -normales. I-EXPLORATION -El B-EVOLUTION -egreso I-EVOLUTION -médico I-EVOLUTION -fue I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -54 I-EVOLUTION -días I-EVOLUTION -del I-EVOLUTION -trasplante, I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -y B-TREATMENT +se I-TREATMENT +indicó I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -terapia I-TREATMENT -inmunosupre-sora I-TREATMENT +ivermectina I-TREATMENT +6 I-TREATMENT +mg/ml, I-TREATMENT +solución I-TREATMENT +oral I-TREATMENT en I-TREATMENT -base I-TREATMENT +gotas, I-TREATMENT a I-TREATMENT -ciclosporina, I-TREATMENT -ciclofosfamida I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +200 I-TREATMENT +μg/kg I-TREATMENT +de I-TREATMENT +peso, I-TREATMENT +durante I-TREATMENT +dos I-TREATMENT +días I-TREATMENT y I-TREATMENT -prednisona. I-TREATMENT -En B-EVOLUTION -su I-EVOLUTION -evolución I-EVOLUTION -intrahospitalaria I-EVOLUTION -presentó I-EVOLUTION -infección I-EVOLUTION -por I-EVOLUTION -citomegalovirus I-EVOLUTION -en I-EVOLUTION -dos I-EVOLUTION -oportunidades I-EVOLUTION -tratadas I-EVOLUTION -satisfactoriamente, I-EVOLUTION -un I-EVOLUTION -rechazo I-EVOLUTION -agudo I-EVOLUTION -moderado I-EVOLUTION -corticoide-sensible I-EVOLUTION -y I-EVOLUTION +reposo. I-TREATMENT +Presentó B-EVOLUTION un I-EVOLUTION -bilioma I-EVOLUTION -que B-TREATMENT -requirió I-TREATMENT -drenaje I-TREATMENT -bajo I-TREATMENT -tomografía I-TREATMENT -computarizada. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -asiste I-EVOLUTION -a I-EVOLUTION -controles I-EVOLUTION -médicos I-EVOLUTION -periódicos I-EVOLUTION -y I-EVOLUTION -cumplió I-EVOLUTION -cinco I-EVOLUTION -años I-EVOLUTION -postrasplante. I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -desarrollando I-EVOLUTION -una I-EVOLUTION -vida I-EVOLUTION -laboralmente I-EVOLUTION -activa, I-EVOLUTION -con I-EVOLUTION -pruebas I-EVOLUTION -hepáticas I-EVOLUTION -normales, I-EVOLUTION -uso I-EVOLUTION +episodio I-EVOLUTION de I-EVOLUTION -inmunosupresión I-EVOLUTION +fiebre, I-EVOLUTION +de I-EVOLUTION +38°C I-EVOLUTION +axilar. I-EVOLUTION +Las I-EVOLUTION +lesiones I-EVOLUTION +empezaron I-EVOLUTION a I-EVOLUTION -dosis I-EVOLUTION -bajas I-EVOLUTION -(ciclosporina I-EVOLUTION -200 I-EVOLUTION -mg/día, I-EVOLUTION -azatioprina I-EVOLUTION -100 I-EVOLUTION -mg/día) I-EVOLUTION -y I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -conservada. I-EVOLUTION +remitir I-EVOLUTION +a I-EVOLUTION +partir I-EVOLUTION +del I-EVOLUTION +tercer I-EVOLUTION +día I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +tratamiento. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -38 I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +23 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +soltera, B-PAST_MEDICAL_HISTORY +madre I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +niños I-PAST_MEDICAL_HISTORY +menores I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +cuales I-PAST_MEDICAL_HISTORY +convivía I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +les I-PAST_MEDICAL_HISTORY +provocó I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +muerte. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +mantenía I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +adecuada I-PAST_MEDICAL_HISTORY +relación I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +respectivos I-PAST_MEDICAL_HISTORY +padres. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +momento I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +hecho I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +encontraba I-PAST_MEDICAL_HISTORY +embarazada I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +resultó I-PAST_MEDICAL_HISTORY +evidente I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +actitud I-PAST_MEDICAL_HISTORY +irresponsable I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +relaciones I-PAST_MEDICAL_HISTORY +sexuales I-PAST_MEDICAL_HISTORY +íntimas, I-PAST_MEDICAL_HISTORY +ya I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +mantenía I-PAST_MEDICAL_HISTORY +protección, I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +asistido I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +captarse I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +embarazo, I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +cual I-PAST_MEDICAL_HISTORY +resultó I-PAST_MEDICAL_HISTORY +finalmente I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +aborto I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +solicitud I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +evaluada, I-PAST_MEDICAL_HISTORY +argumentando I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +era I-PAST_MEDICAL_HISTORY +otro I-PAST_MEDICAL_HISTORY +hijo I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +deseado, I-PAST_MEDICAL_HISTORY +pues I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +relación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +pareja I-PAST_MEDICAL_HISTORY +estaba I-PAST_MEDICAL_HISTORY +rota. I-PAST_MEDICAL_HISTORY +Sin I-PAST_MEDICAL_HISTORY +vínculo I-PAST_MEDICAL_HISTORY +laboral I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY historia I-PAST_MEDICAL_HISTORY +psicosocial I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +evaluada I-PAST_MEDICAL_HISTORY +destacan I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +siguientes I-PAST_MEDICAL_HISTORY +elementos: I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +pequeña I-PAST_MEDICAL_HISTORY +consideró I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +hija I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +deseada, I-PAST_MEDICAL_HISTORY +sintiendo I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +esto I-PAST_MEDICAL_HISTORY +resentimiento I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +celos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +hermanos. I-PAST_MEDICAL_HISTORY +Nunca I-PAST_MEDICAL_HISTORY +"sintió" I-PAST_MEDICAL_HISTORY +amor I-PAST_MEDICAL_HISTORY +maternal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +reconoció I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +figura I-PAST_MEDICAL_HISTORY +afectiva I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +padre, I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +pesar I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -NF1 I-PAST_MEDICAL_HISTORY que I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +padres I-PAST_MEDICAL_HISTORY se I-PAST_MEDICAL_HISTORY -manifestó I-PAST_MEDICAL_HISTORY +divorciaron I-PAST_MEDICAL_HISTORY +cuando I-PAST_MEDICAL_HISTORY +ella I-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +desarrolló I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +medio I-PAST_MEDICAL_HISTORY +familiar I-PAST_MEDICAL_HISTORY +disfuncional, I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -abundantes I-PAST_MEDICAL_HISTORY -efélides I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +padrastro I-PAST_MEDICAL_HISTORY +maltratador I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +todas I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -todo I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +casa. I-PAST_MEDICAL_HISTORY +Refirió I-PAST_MEDICAL_HISTORY +haber I-PAST_MEDICAL_HISTORY +sufrido I-PAST_MEDICAL_HISTORY +maltrato, I-PAST_MEDICAL_HISTORY +incluso I-PAST_MEDICAL_HISTORY +físico, I-PAST_MEDICAL_HISTORY +proveniente I-PAST_MEDICAL_HISTORY +tanto I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +madre I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +padrastro. I-PAST_MEDICAL_HISTORY +Su I-PAST_MEDICAL_HISTORY +desarrollo I-PAST_MEDICAL_HISTORY +escolar I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +enseñanza I-PAST_MEDICAL_HISTORY +primaria I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +adecuado; I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +gustaba I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +pequeña I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +líder I-PAST_MEDICAL_HISTORY +ante I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +amigos. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY el I-PAST_MEDICAL_HISTORY -cuerpo, I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -axilar I-PAST_MEDICAL_HISTORY +nivel I-PAST_MEDICAL_HISTORY +secundario I-PAST_MEDICAL_HISTORY +era I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +adolescente I-PAST_MEDICAL_HISTORY +rebelde I-PAST_MEDICAL_HISTORY e I-PAST_MEDICAL_HISTORY -inguinal I-PAST_MEDICAL_HISTORY +impulsiva. I-PAST_MEDICAL_HISTORY +Ha I-PAST_MEDICAL_HISTORY +tenido I-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY +cuatro I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -neurofibro-mas I-PAST_MEDICAL_HISTORY -discretos. I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Unidad I-PRESENT_ILLNESS +cinco I-PAST_MEDICAL_HISTORY +parejas, I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ellas I-PAST_MEDICAL_HISTORY +considera I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +formales, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +relaciones I-PAST_MEDICAL_HISTORY +también I-PAST_MEDICAL_HISTORY +han I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +caracterizadas I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +maltrato. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Entre I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +comprobó I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +estuvo I-PAST_MEDICAL_HISTORY +ingresada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +2012, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +Sala I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Psiquiatría I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +Hospital I-PAST_MEDICAL_HISTORY +General, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +haber I-PAST_MEDICAL_HISTORY +atentado I-PAST_MEDICAL_HISTORY +contra I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +vida I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +menores, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +diagnosticó I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +trastorno I-PAST_MEDICAL_HISTORY +situacional I-PAST_MEDICAL_HISTORY +ansioso. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +mental I-EXPLORATION +de I-EXPLORATION +urgencia I-EXPLORATION +realizado I-EXPLORATION +el I-EXPLORATION +día I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +hechos I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +describen I-EXPLORATION +alteraciones I-EXPLORATION +psiquiátricas. I-EXPLORATION +Explica I-EXPLORATION +que I-EXPLORATION +estaba I-EXPLORATION +"cansada I-EXPLORATION +de I-EXPLORATION +pasar I-EXPLORATION +trabajo, I-EXPLORATION +que I-EXPLORATION +intentó I-EXPLORATION +matarse I-EXPLORATION +pero I-EXPLORATION +no I-EXPLORATION +pudo". I-EXPLORATION +Redactó I-EXPLORATION +tres I-EXPLORATION +notas I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +dirigían I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +padres I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +víctimas I-EXPLORATION +y I-EXPLORATION +a I-EXPLORATION +su I-EXPLORATION +madre. I-EXPLORATION +Sobre I-EXPLORATION +el I-EXPLORATION +hecho I-EXPLORATION +refirió I-EXPLORATION +"mi I-EXPLORATION +cabeza I-EXPLORATION +tenía I-EXPLORATION +deseos I-EXPLORATION +de I-EXPLORATION +hacer I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +hice, I-EXPLORATION +pero I-EXPLORATION +que I-EXPLORATION +nos I-EXPLORATION +fuéramos I-EXPLORATION +los I-EXPLORATION +tres I-EXPLORATION +juntos, I-EXPLORATION +lo I-EXPLORATION +intenté I-EXPLORATION +pero I-EXPLORATION +no I-EXPLORATION +pude". I-EXPLORATION + I-EXPLORATION + +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Emergencia I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS +63 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +al B-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +ecografía I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +solicitada I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +estudio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -Serena I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +prostático, I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +diagnosticó I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS +RH I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -inicialmente I-PRESENT_ILLNESS -epigástrico I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -posteriormente I-PRESENT_ILLNESS -difuso. I-PRESENT_ILLNESS -Ingresó B-EXPLORATION +una I-PRESENT_ILLNESS +masa I-PRESENT_ILLNESS +sólida I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +asienta I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +istmo I-PRESENT_ILLNESS +renal. I-PRESENT_ILLNESS +El B-EXPLORATION +TAC I-EXPLORATION +abdominal I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +de I-EXPLORATION +8 I-EXPLORATION +cm. I-EXPLORATION en I-EXPLORATION -shock I-EXPLORATION -séptico I-EXPLORATION -y I-EXPLORATION -mala I-EXPLORATION -condición I-EXPLORATION -general. I-EXPLORATION -Después B-TREATMENT -de I-TREATMENT -estabilización I-TREATMENT -hemodi-námica I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -su I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -con I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -abdomen I-TREATMENT -agudo I-TREATMENT -de I-TREATMENT -origen I-TREATMENT -no I-TREATMENT -precisado I-TREATMENT -y I-TREATMENT -peritonitis I-TREATMENT -secundaria. I-TREATMENT -No B-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -ningún I-EXPLORATION -estudio I-EXPLORATION -radiológico I-EXPLORATION -debido I-EXPLORATION +el I-EXPLORATION +istmo I-EXPLORATION +renal I-EXPLORATION +sin I-EXPLORATION +evidenciar I-EXPLORATION +adenopatías, I-EXPLORATION +metástasis I-EXPLORATION +locoregionales I-EXPLORATION +ni I-EXPLORATION +lesiones I-EXPLORATION a I-EXPLORATION -que I-EXPLORATION -nuestro I-EXPLORATION -hospital I-EXPLORATION -no I-EXPLORATION -cuenta I-EXPLORATION +distancia I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +extensión. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +vascular I-EXPLORATION +preoperatorio I-EXPLORATION +mediante I-EXPLORATION +arteriografía, I-EXPLORATION +demostró I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +dos I-EXPLORATION +arterias I-EXPLORATION +renales I-EXPLORATION con I-EXPLORATION -radiólogo I-EXPLORATION +nacimiento I-EXPLORATION +ortotópico. I-EXPLORATION +Las I-EXPLORATION +imágenes I-EXPLORATION +selectivas I-EXPLORATION de I-EXPLORATION -turno I-EXPLORATION -y I-EXPLORATION -tampoco I-EXPLORATION -ecografía I-EXPLORATION -o I-EXPLORATION -tomografía I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +renal I-EXPLORATION +derecha, I-EXPLORATION +evidenciaron I-EXPLORATION +vasos I-EXPLORATION +neoformados I-EXPLORATION +a I-EXPLORATION +expensas I-EXPLORATION de I-EXPLORATION -urgencia. I-EXPLORATION -El B-TREATMENT -abordaje I-TREATMENT -del I-TREATMENT -abdomen I-TREATMENT +la I-EXPLORATION +rama I-EXPLORATION +medial I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +bifurcación I-EXPLORATION +con I-EXPLORATION +normalidad I-EXPLORATION +del I-EXPLORATION +árbol I-EXPLORATION +venoso I-EXPLORATION +intra I-EXPLORATION +y I-EXPLORATION +extrarrenal. I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT +la I-TREATMENT +presunción I-TREATMENT +diagnóstica I-TREATMENT +de I-TREATMENT +carcinoma I-TREATMENT +renal, I-TREATMENT se I-TREATMENT -realizó I-TREATMENT +practicó I-TREATMENT +istmectomía I-TREATMENT +y I-TREATMENT +nefrectomía I-TREATMENT +izquierda I-TREATMENT a I-TREATMENT través I-TREATMENT de I-TREATMENT una I-TREATMENT laparotomía I-TREATMENT -mediana. I-TREATMENT -Se I-TREATMENT -aspiraron I-TREATMENT -3 I-TREATMENT -litros I-TREATMENT -de I-TREATMENT -exudado I-TREATMENT -purulento I-TREATMENT -y I-TREATMENT -en I-TREATMENT -la I-TREATMENT -exploración I-TREATMENT +media. I-TREATMENT +Durante I-TREATMENT +el I-TREATMENT +acto I-TREATMENT +operatorio I-TREATMENT se I-TREATMENT -evidenció I-TREATMENT -un I-TREATMENT -tumor I-TREATMENT -quístico I-TREATMENT -de I-TREATMENT -15 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -diámetro I-TREATMENT +apreció I-TREATMENT que I-TREATMENT -se I-TREATMENT -originaba I-TREATMENT -en I-TREATMENT la I-TREATMENT -A- I-TREATMENT -porción I-TREATMENT -del I-TREATMENT -duodeno, I-TREATMENT -perforado, I-TREATMENT -adherido I-TREATMENT -al I-TREATMENT -colon I-TREATMENT -sigmoides I-TREATMENT +pelvis I-TREATMENT +renal I-TREATMENT y I-TREATMENT -cubierto I-TREATMENT -de I-TREATMENT -epiplón I-TREATMENT -mayor. I-TREATMENT -El I-TREATMENT -tumor I-TREATMENT -fue I-TREATMENT -resecado I-TREATMENT -en I-TREATMENT -bloque I-TREATMENT -con I-TREATMENT el I-TREATMENT -epiplón I-TREATMENT -y I-TREATMENT -la I-TREATMENT -A- I-TREATMENT -porción I-TREATMENT -del I-TREATMENT -duodeno. I-TREATMENT -El I-TREATMENT -tránsito I-TREATMENT -intestinal I-TREATMENT +uréter I-TREATMENT +izquierdos I-TREATMENT se I-TREATMENT -reconstituyó I-TREATMENT -mediante I-TREATMENT -anastomosis I-TREATMENT -término-terminal I-TREATMENT -entre I-TREATMENT -la I-TREATMENT -3a I-TREATMENT -porción I-TREATMENT -del I-TREATMENT -duodeno I-TREATMENT -y I-TREATMENT +hallaban I-TREATMENT +infiltrados I-TREATMENT +por I-TREATMENT el I-TREATMENT -yeyuno. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -postoperatoria I-EVOLUTION -fue I-EVOLUTION -tórpida, I-EVOLUTION -con I-EVOLUTION -complicaciones: I-EVOLUTION -infección I-EVOLUTION -del I-EVOLUTION -sitio I-EVOLUTION -quirúrgico I-EVOLUTION -superficial, I-EVOLUTION -íleo I-EVOLUTION -intestinal I-EVOLUTION -prolongado I-EVOLUTION -y I-EVOLUTION -neumonía I-EVOLUTION -nosocomial. I-EVOLUTION -Después I-EVOLUTION -de I-EVOLUTION -37 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones. I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -demostró I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -sólido-quísti-co, I-EXPLORATION -parcialmente I-EXPLORATION -necrótico I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -bajo I-EXPLORATION -índice I-EXPLORATION -mitótico I-EXPLORATION -(1 I-EXPLORATION -a I-EXPLORATION -2 I-EXPLORATION -mitosis I-EXPLORATION -por I-EXPLORATION -50 I-EXPLORATION -campos I-EXPLORATION +tumor. I-TREATMENT +La B-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +renal I-EXPLORATION +neoformada I-EXPLORATION de I-EXPLORATION -aumento I-EXPLORATION -mayor). I-EXPLORATION -Se I-EXPLORATION -observaron I-EXPLORATION -células I-EXPLORATION -epiteloides I-EXPLORATION -y I-EXPLORATION -fusiformes, I-EXPLORATION -positivas I-EXPLORATION -para I-EXPLORATION -CD117, I-EXPLORATION -CD34 I-EXPLORATION -y I-EXPLORATION -desmina. I-EXPLORATION +10 I-EXPLORATION +cm. I-EXPLORATION +afectando I-EXPLORATION +cápsula, I-EXPLORATION +grasa I-EXPLORATION +perirrenal, I-EXPLORATION +así I-EXPLORATION +como, I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +urinaria I-EXPLORATION +izquierda. I-EXPLORATION La I-EXPLORATION -reacción I-EXPLORATION -inmunohistoquímica I-EXPLORATION -fue I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -S100, I-EXPLORATION -vimentina I-EXPLORATION -y I-EXPLORATION -acüna-a I-EXPLORATION -de I-EXPLORATION -músculo I-EXPLORATION -liso. I-EXPLORATION -El I-EXPLORATION -tamaño I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -clínico I-EXPLORATION -de I-EXPLORATION -presentación I-EXPLORATION -(necrosis I-EXPLORATION -y I-EXPLORATION -perforación), I-EXPLORATION -constituyen I-EXPLORATION -indicaciones I-EXPLORATION -para I-EXPLORATION -terapia I-EXPLORATION -con I-EXPLORATION -imatinib I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -derivada I-EXPLORATION -al I-EXPLORATION -Comité I-EXPLORATION -Oncológico I-EXPLORATION -Regional I-EXPLORATION -para I-EXPLORATION -iniciar I-EXPLORATION -tratamiento I-EXPLORATION -pertinente. I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -seguimiento I-EVOLUTION -hace I-EVOLUTION -11 I-EVOLUTION -meses. I-EVOLUTION -Figura I-EVOLUTION -2 I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia, I-PAST_MEDICAL_HISTORY -hospitalizada B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -peritonitis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -origen I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -precisado. I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -distensión I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -La B-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION +histología I-EXPLORATION fue I-EXPLORATION -131/76, I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION de I-EXPLORATION -126 I-EXPLORATION -x' I-EXPLORATION -y I-EXPLORATION -38, I-EXPLORATION -9eC I-EXPLORATION +carcinoma I-EXPLORATION +neuroendocrino I-EXPLORATION de I-EXPLORATION -temperatura I-EXPLORATION -rectal. I-EXPLORATION +célula I-EXPLORATION +no I-EXPLORATION +pequeña. I-EXPLORATION El I-EXPLORATION -abdomen I-EXPLORATION -estaba I-EXPLORATION -distendido, I-EXPLORATION -mate I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION +estudio I-EXPLORATION +inmuno-histoquímico I-EXPLORATION +resultó I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +CD-56 I-EXPLORATION y I-EXPLORATION -ausencia I-EXPLORATION +sinaptofisina. I-EXPLORATION + I-EXPLORATION +A I-EXPLORATION +los I-EXPLORATION +4 I-EXPLORATION +meses I-EXPLORATION de I-EXPLORATION -ruidos I-EXPLORATION -intestinales I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -auscultación. I-EXPLORATION -La I-EXPLORATION -evaluación I-EXPLORATION -ginecológica I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION la I-EXPLORATION -ecografía I-EXPLORATION -reveló I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -intraperitoneal I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -estructura I-EXPLORATION -quística I-EXPLORATION -adyacente I-EXPLORATION -al I-EXPLORATION -intestino I-EXPLORATION -delgado. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -abdominal I-EXPLORATION -(TAC), I-EXPLORATION -demostró I-EXPLORATION -algunas I-EXPLORATION -asas I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -rodeando I-EXPLORATION -una I-EXPLORATION -estructura I-EXPLORATION -tubular I-EXPLORATION -quística I-EXPLORATION -y I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -peritoneal. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -revelaron I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -25.700 I-EXPLORATION -x I-EXPLORATION -mm3 I-EXPLORATION -y I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -de I-EXPLORATION -356, I-EXPLORATION -06 I-EXPLORATION -mg/dl. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -tumor I-TREATMENT -quístico I-TREATMENT -intestinal I-TREATMENT -complicado I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -operada. I-TREATMENT -La B-EXPLORATION -cavidad I-EXPLORATION +intervención, I-EXPLORATION +el I-EXPLORATION +TAC I-EXPLORATION abdominal I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -llena I-EXPLORATION +apreció I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +sólido I-EXPLORATION de I-EXPLORATION -líquido I-EXPLORATION -seroso I-EXPLORATION -del I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -tomaron I-EXPLORATION -muestras I-EXPLORATION -para I-EXPLORATION -citología I-EXPLORATION -y I-EXPLORATION -cultivo. I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION -reveló I-EXPLORATION -múltiples I-EXPLORATION -implantes I-EXPLORATION -tumorales I-EXPLORATION +2 I-EXPLORATION +cm. I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -peritoneo I-EXPLORATION -parietal I-EXPLORATION -y I-EXPLORATION -visceral, I-EXPLORATION -e I-EXPLORATION -infiltración I-EXPLORATION -extensa I-EXPLORATION -del I-EXPLORATION -epiplón I-EXPLORATION -mayor, I-EXPLORATION -se I-EXPLORATION -tomaron I-EXPLORATION -muestras I-EXPLORATION -de I-EXPLORATION -estos I-EXPLORATION -implantes I-EXPLORATION -para I-EXPLORATION -biopsia. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -mesenterio I-EXPLORATION +polo I-EXPLORATION +inferior I-EXPLORATION del I-EXPLORATION -íleon I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -quístico I-EXPLORATION -tubular I-EXPLORATION -blanquecino I-EXPLORATION -rodeado I-EXPLORATION -de I-EXPLORATION -asas I-EXPLORATION -intestinales, I-EXPLORATION +riñón I-EXPLORATION +derecho, I-EXPLORATION +así I-EXPLORATION +como, I-EXPLORATION +adenopatías I-EXPLORATION +para-aórticas I-EXPLORATION +izquierdas I-EXPLORATION +y I-EXPLORATION +múltiples I-EXPLORATION +nódulos I-EXPLORATION +retrocrurales I-EXPLORATION +subcentimétricos. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +PET-TC I-EXPLORATION +mostró I-EXPLORATION que I-EXPLORATION -medía I-EXPLORATION -12 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -por I-EXPLORATION -15 I-EXPLORATION -cm I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +descritas I-EXPLORATION +eran I-EXPLORATION +sugestivas I-EXPLORATION de I-EXPLORATION -longitud. I-EXPLORATION -Se B-TREATMENT -abrió I-TREATMENT -el I-TREATMENT -tumor I-TREATMENT -aspirándose I-TREATMENT -un I-TREATMENT -líquido I-TREATMENT -oscuro I-TREATMENT -y I-TREATMENT -espeso I-TREATMENT -que I-TREATMENT +metástasis. I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT fue I-TREATMENT -enviado I-TREATMENT +sometido I-TREATMENT a I-TREATMENT -citología. I-TREATMENT -Se I-TREATMENT -resecó I-TREATMENT -la I-TREATMENT -mayor I-TREATMENT -cantidad I-TREATMENT -posible I-TREATMENT -de I-TREATMENT -pared I-TREATMENT -tumoral I-TREATMENT -quedando I-TREATMENT -una I-TREATMENT -parte I-TREATMENT -adherida I-TREATMENT -al I-TREATMENT -mesenterio, I-TREATMENT -la I-TREATMENT -resección I-TREATMENT -completa I-TREATMENT -del I-TREATMENT -tumor I-TREATMENT -no I-TREATMENT -fue I-TREATMENT -posible I-TREATMENT -por I-TREATMENT -la I-TREATMENT -diseminación I-TREATMENT -peritoneal I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +radioterapia I-TREATMENT +externa I-TREATMENT +(RT) I-TREATMENT y I-TREATMENT -su I-TREATMENT -localización I-TREATMENT -en I-TREATMENT -el I-TREATMENT -mesenterio I-TREATMENT -del I-TREATMENT -íleon. I-TREATMENT -La B-EVOLUTION -recuperación I-EVOLUTION -postoperatoria I-EVOLUTION -fue I-EVOLUTION -satisfactoria I-EVOLUTION +quimioterapia I-TREATMENT +(QT) I-TREATMENT +(carboplatino I-TREATMENT +y I-TREATMENT +VP-16) I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +tolerancia I-TREATMENT +y I-TREATMENT +respuesta I-TREATMENT +parcial. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +permaneció I-EVOLUTION +asintomático I-EVOLUTION y I-EVOLUTION sin I-EVOLUTION -complicaciones. I-EVOLUTION -Sin I-EVOLUTION -embargo, I-EVOLUTION -treinta I-EVOLUTION -y I-EVOLUTION -cuatro I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION +efectos I-EVOLUTION +secundarios I-EVOLUTION +tardíos I-EVOLUTION +de I-EVOLUTION +RT I-EVOLUTION +ni I-EVOLUTION +QT. I-EVOLUTION +Dos I-EVOLUTION +años I-EVOLUTION +tras I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION -falleció. I-EVOLUTION -La B-EXPLORATION -muestras I-EXPLORATION -citológicas I-EXPLORATION -tomadas I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -contenido I-EXPLORATION -tumoral I-EXPLORATION -fueron I-EXPLORATION -positivas I-EXPLORATION -para I-EXPLORATION -células I-EXPLORATION -neoplásicas. I-EXPLORATION -La I-EXPLORATION -histopatología I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -arquitectura I-EXPLORATION -típica I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -intestinal, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -reconocían I-EXPLORATION -capas I-EXPLORATION -de I-EXPLORATION -músculo I-EXPLORATION -liso I-EXPLORATION -circular I-EXPLORATION -y I-EXPLORATION -longitudinal I-EXPLORATION -bien I-EXPLORATION -organizadas, I-EXPLORATION -identificándose I-EXPLORATION -plexos I-EXPLORATION -nerviosos I-EXPLORATION -mientéricos I-EXPLORATION -entre I-EXPLORATION -ambas I-EXPLORATION -capas I-EXPLORATION -musculares. I-EXPLORATION -La I-EXPLORATION -superficie I-EXPLORATION -interna I-EXPLORATION -estaba I-EXPLORATION -revestida I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -adeno I-EXPLORATION -carcinoma I-EXPLORATION -mucosecretor I-EXPLORATION -moderadamente I-EXPLORATION -diferenciado I-EXPLORATION -que I-EXPLORATION -infiltraba I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -espesor I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -en I-EXPLORATION -varias I-EXPLORATION -partes I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extendió I-EXPLORATION -superficialmente I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -serosa. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -intraoperatorios I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -informe I-EXPLORATION -histopatológico I-EXPLORATION -confirmaron I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -adenocarcinoma I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -duplicación I-EXPLORATION -intestinal I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -paciente I-EXPLORATION -adulta. I-EXPLORATION - I-EXPLORATION +cirugía I-EVOLUTION +el I-EVOLUTION +TAC I-EVOLUTION +abdominal I-EVOLUTION +muestra I-EVOLUTION +la I-EVOLUTION +persistencia I-EVOLUTION +de I-EVOLUTION +pequeños I-EVOLUTION +ganglios I-EVOLUTION +retroperitoneales, I-EVOLUTION +sin I-EVOLUTION +otros I-EVOLUTION +hallazgos I-EVOLUTION +destacables. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -31 I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +joven I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +17 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +lograr I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mejoría I-PRESENT_ILLNESS +estético I-PRESENT_ILLNESS +funcional I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +dedo I-PRESENT_ILLNESS +pulgar I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +mano I-PRESENT_ILLNESS +izquierda. I-PRESENT_ILLNESS +Había B-PAST_MEDICAL_HISTORY +nacido I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +dedo I-PAST_MEDICAL_HISTORY +pulgar I-PAST_MEDICAL_HISTORY +pequeño I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +función, I-PAST_MEDICAL_HISTORY +unido I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +resto I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -FQ I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +mano I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY +través I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +pequeño I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -regulares I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -mayo I-PAST_MEDICAL_HISTORY +delgado I-PAST_MEDICAL_HISTORY +tubo I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -2000, I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY +piel; I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +lactancia, I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +Hospital I-PAST_MEDICAL_HISTORY +Infantil I-PAST_MEDICAL_HISTORY +donde I-PAST_MEDICAL_HISTORY le I-PAST_MEDICAL_HISTORY -realizó I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -trasplante I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -bilateral, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -muy I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -2009. I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -actual I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -caracterizó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -descompensación I-PRESENT_ILLNESS -respiratoria I-PRESENT_ILLNESS -diagnosticada I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -bronquiolitis I-PRESENT_ILLNESS -obliterante I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -hospitalizado I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -tratamiento. I-PRESENT_ILLNESS -Al B-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -refirió I-EVOLUTION -un I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -tipo I-EVOLUTION -cólico I-EVOLUTION -de I-EVOLUTION -intensidad I-EVOLUTION -progresiva, I-EVOLUTION -localizado I-EVOLUTION -mayormente I-EVOLUTION -en I-EVOLUTION -hemiabdomen I-EVOLUTION -inferior I-EVOLUTION -derecho, I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -3 I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -vómitos I-EVOLUTION -alimentarios. I-EVOLUTION -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -el I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -palpaba I-EXPLORATION -distendido I-EXPLORATION -y I-EXPLORATION -sensible I-EXPLORATION -en I-EXPLORATION -hemiabdomen I-EXPLORATION -derecho I-EXPLORATION +habían I-PAST_MEDICAL_HISTORY +únicamente I-PAST_MEDICAL_HISTORY +extirpado I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +área I-PAST_MEDICAL_HISTORY +cutánea I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +pequeño I-PAST_MEDICAL_HISTORY +tubo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +unión I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +fin I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +lograr I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +implantación I-PAST_MEDICAL_HISTORY +directa I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +apéndice I-PAST_MEDICAL_HISTORY +pulgar I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +mano. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Cuando B-EXPLORATION +acude I-EXPLORATION +a I-EXPLORATION +nuestra I-EXPLORATION +consulta I-EXPLORATION +presenta I-EXPLORATION +un I-EXPLORATION +pulgar I-EXPLORATION con I-EXPLORATION -bazuqueo. I-EXPLORATION -Se I-EXPLORATION -decidió I-EXPLORATION -tomar I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -moderada I-EXPLORATION -dilatación I-EXPLORATION +implantación I-EXPLORATION +distal I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -asas I-EXPLORATION +la I-EXPLORATION +articulación I-EXPLORATION +metacarpofalangica I-EXPLORATION +del I-EXPLORATION +índice, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +primer I-EXPLORATION +espacio I-EXPLORATION +estrecho, I-EXPLORATION +sin I-EXPLORATION +capacidad I-EXPLORATION +motora I-EXPLORATION de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION +oposición I-EXPLORATION +ni I-EXPLORATION +flexo-extensión, I-EXPLORATION +pero I-EXPLORATION +con I-EXPLORATION +buena I-EXPLORATION +sensibilidad I-EXPLORATION en I-EXPLORATION -hemiabdomen I-EXPLORATION -superior I-EXPLORATION +ambos I-EXPLORATION +bordes I-EXPLORATION +del I-EXPLORATION +mismo. I-EXPLORATION +No I-EXPLORATION +presentaba I-EXPLORATION +eminencia I-EXPLORATION +tenar I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +palpaba I-EXPLORATION +el I-EXPLORATION +primer I-EXPLORATION +metacarpiano; I-EXPLORATION además I-EXPLORATION +tenía I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION +pulso I-EXPLORATION +radial I-EXPLORATION +pero I-EXPLORATION +sí I-EXPLORATION +se I-EXPLORATION +palpaba I-EXPLORATION +adecuadamente I-EXPLORATION +el I-EXPLORATION +pulso I-EXPLORATION +cubital. I-EXPLORATION +La I-EXPLORATION +parte I-EXPLORATION +funcional I-EXPLORATION +compensatoria I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -abundante I-EXPLORATION -aire I-EXPLORATION +realizaba I-EXPLORATION +con I-EXPLORATION +alguna I-EXPLORATION +dificultad I-EXPLORATION +mediante I-EXPLORATION +una I-EXPLORATION +pinza I-EXPLORATION +dígito-digital I-EXPLORATION +lateral I-EXPLORATION +entre I-EXPLORATION +el I-EXPLORATION +índice I-EXPLORATION y I-EXPLORATION -contenido I-EXPLORATION -estercoráceo I-EXPLORATION -en I-EXPLORATION -todo I-EXPLORATION el I-EXPLORATION -marco I-EXPLORATION -cólico. I-EXPLORATION +medio. I-EXPLORATION Se I-EXPLORATION -solicitó I-EXPLORATION -además I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION +solicitaron I-EXPLORATION +estudios I-EXPLORATION +radiológicos I-EXPLORATION que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -importante I-EXPLORATION -dilatación I-EXPLORATION +evidenciaron I-EXPLORATION +hipoplasia I-EXPLORATION +y I-EXPLORATION +fusión I-EXPLORATION de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -porción I-EXPLORATION -más I-EXPLORATION -alta I-EXPLORATION +las I-EXPLORATION +falanges, I-EXPLORATION +agenesia I-EXPLORATION del I-EXPLORATION -yeyuno I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -parte I-EXPLORATION -proximal I-EXPLORATION +primer I-EXPLORATION +metacarpiano, I-EXPLORATION +atrofia I-EXPLORATION del I-EXPLORATION -íleon I-EXPLORATION -que I-EXPLORATION -parecían I-EXPLORATION -ocupados I-EXPLORATION +trapecio I-EXPLORATION y I-EXPLORATION -distendidos I-EXPLORATION -por I-EXPLORATION -material I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -fecaloideo, I-EXPLORATION -concluyendo I-EXPLORATION -con I-EXPLORATION +huesos I-EXPLORATION +del I-EXPLORATION +carpo, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +también I-EXPLORATION +atrofia I-EXPLORATION +del I-EXPLORATION +radio; I-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +doppler I-EXPLORATION +color I-EXPLORATION +revelo I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -SOID. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -Gastrografin® I-TREATMENT -(100 I-TREATMENT -mi I-TREATMENT -diluidos I-TREATMENT -en I-TREATMENT -400 I-TREATMENT -mi. I-TREATMENT -de I-TREATMENT -suero I-TREATMENT -fisiológico) I-TREATMENT -presentando I-TREATMENT -al I-TREATMENT -cabo I-TREATMENT -de I-TREATMENT -2 I-TREATMENT -horas, I-TREATMENT -gran I-TREATMENT -cantidad I-TREATMENT -de I-TREATMENT -deposiciones I-TREATMENT -líquidas I-TREATMENT -e I-TREATMENT -importante I-TREATMENT -disminución I-TREATMENT -de I-TREATMENT -los I-TREATMENT -síntomas. I-TREATMENT -La B-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +radial I-EXPLORATION +con I-EXPLORATION +dilatación I-EXPLORATION +compensatoria I-EXPLORATION de I-EXPLORATION -abdomen I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +ulnar. I-EXPLORATION +Con I-EXPLORATION +este I-EXPLORATION +examen I-EXPLORATION +clínico I-EXPLORATION +se I-EXPLORATION +diagnosticó I-EXPLORATION +un I-EXPLORATION +típico I-EXPLORATION +pulgar I-EXPLORATION +flotante I-EXPLORATION +izquierdo I-EXPLORATION +parcialmente I-EXPLORATION +tratado. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +su I-EXPLORATION +mano I-EXPLORATION +derecha I-EXPLORATION +dominante I-EXPLORATION +presentaba I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +pulgar I-EXPLORATION +las I-EXPLORATION +siguientes I-EXPLORATION +anomalías: I-EXPLORATION +primer I-EXPLORATION +espacio I-EXPLORATION +estrecho, I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -control I-EXPLORATION -mostró I-EXPLORATION -distensión I-EXPLORATION +los I-EXPLORATION +pliegues I-EXPLORATION de I-EXPLORATION -algunas I-EXPLORATION -asas I-EXPLORATION +flexión, I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -en I-EXPLORATION -menor I-EXPLORATION -grado I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -anterior I-EXPLORATION -además I-EXPLORATION +la I-EXPLORATION +eminencia I-EXPLORATION +tenar, I-EXPLORATION +imposibilidad I-EXPLORATION +para I-EXPLORATION +flexionar I-EXPLORATION +la I-EXPLORATION +articulación I-EXPLORATION +metacarpofalángica I-EXPLORATION +pero I-EXPLORATION +con I-EXPLORATION +buena I-EXPLORATION +movilidad I-EXPLORATION +pasiva I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +misma, I-EXPLORATION +anquílosis I-EXPLORATION de I-EXPLORATION -medio I-EXPLORATION +la I-EXPLORATION +articulación I-EXPLORATION +interfalángica; I-EXPLORATION +a I-EXPLORATION +pesar I-EXPLORATION de I-EXPLORATION -contraste I-EXPLORATION +todo I-EXPLORATION +esto I-EXPLORATION +había I-EXPLORATION +buena I-EXPLORATION +función I-EXPLORATION +del I-EXPLORATION +mismo. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +radiológico I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +doppler I-EXPLORATION +color I-EXPLORATION +no I-EXPLORATION +evidenciaron I-EXPLORATION +anomalías I-EXPLORATION +óseas I-EXPLORATION +o I-EXPLORATION +vasculares. I-EXPLORATION +Con I-EXPLORATION +estos I-EXPLORATION +hallazgos I-EXPLORATION +podríamos I-EXPLORATION +clasificar I-EXPLORATION +el I-EXPLORATION +pulgar I-EXPLORATION +derecho I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -intestino I-EXPLORATION -distal I-EXPLORATION -y I-EXPLORATION -marco I-EXPLORATION -colónico. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -suplemento I-EVOLUTION -de I-EVOLUTION -enzimas I-EVOLUTION -pancreáticas, I-EVOLUTION -encontrándose I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -tras I-EVOLUTION -10 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -hospitalización I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -nuevos I-EVOLUTION -cuadros I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -abdominal, I-EVOLUTION -distensión I-EVOLUTION -o I-EVOLUTION -constipación. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -indio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -44 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -hipertenso B-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -ocasional, I-PAST_MEDICAL_HISTORY -quien B-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -levantó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mañana I-PRESENT_ILLNESS -previa I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -debilidad I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hemicuerpo I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sensibilidad I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -hemicara I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -progresó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -siguientes I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -imposibilidad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -marcha, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -hubo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ingresar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -vez I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -llevado I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -departamento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -emergencias, I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -constató I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -presión I-PRESENT_ILLNESS -arterial I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -165/105 I-PRESENT_ILLNESS -mmHg, I-PRESENT_ILLNESS -pulso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -92 I-PRESENT_ILLNESS -latidos I-PRESENT_ILLNESS -x' I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -16 I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -frecuencia I-PRESENT_ILLNESS -respiratoria I-PRESENT_ILLNESS -x'. I-PRESENT_ILLNESS -El B-EXPLORATION -examen I-EXPLORATION -neurológico I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -hipoestesia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -rama I-EXPLORATION -maxilar I-EXPLORATION -del I-EXPLORATION -trigémino I-EXPLORATION -derecho I-EXPLORATION -como I-EXPLORATION -único I-EXPLORATION -trastorno I-EXPLORATION -objetivo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -sensibilidad. I-EXPLORATION -La I-EXPLORATION -fuerza I-EXPLORATION -muscular I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -tono I-EXPLORATION -estaba I-EXPLORATION -conservados I-EXPLORATION -a I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -niveles, I-EXPLORATION -pero I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -hiperreflexia I-EXPLORATION -osteotendinosa I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hemicuerpo I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -Babinski I-EXPLORATION -ipsilateral. I-EXPLORATION -Elementos I-EXPLORATION +grupo I-EXPLORATION +I I-EXPLORATION de I-EXPLORATION -disfunción I-EXPLORATION -cerebelosa I-EXPLORATION +Blauth. I-EXPLORATION + I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -evidenciaron I-EXPLORATION -al I-EXPLORATION -existir I-EXPLORATION -disdiadococinesia, I-EXPLORATION -dismetría I-EXPLORATION -y I-EXPLORATION -discronometría I-EXPLORATION -al I-EXPLORATION -movilizar I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -derechas. I-EXPLORATION -La I-EXPLORATION -marcha I-EXPLORATION -era I-EXPLORATION -imposible I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -tendencia I-EXPLORATION -a I-EXPLORATION -caer I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -derecha I-EXPLORATION -al I-EXPLORATION -tratar I-EXPLORATION -de I-EXPLORATION -hacerla I-EXPLORATION -sin I-EXPLORATION -apoyo. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -sanguínea I-EXPLORATION -mostró I-EXPLORATION -hemoglobina, I-EXPLORATION -conteo I-EXPLORATION -diferencial I-EXPLORATION -de I-EXPLORATION -leucocitos I-EXPLORATION -y I-EXPLORATION -electrolitos I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -constató I-EXPLORATION -una I-EXPLORATION -hiperlipidemia I-EXPLORATION -dada I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -incremento I-EXPLORATION -del I-EXPLORATION -colesterol I-EXPLORATION -total I-EXPLORATION -(7, I-EXPLORATION -42 I-EXPLORATION -mm/1). I-EXPLORATION -El I-EXPLORATION -electrocardiograma I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -ecocardiograma I-EXPLORATION -transtorácico I-EXPLORATION -resultaron I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RMN) I-EXPLORATION -identificó I-EXPLORATION -un I-EXPLORATION -área I-EXPLORATION -de I-EXPLORATION -infarto I-EXPLORATION -isquémico I-EXPLORATION -subagudo I-EXPLORATION -que I-EXPLORATION -comprendía I-EXPLORATION -el I-EXPLORATION -núcleo I-EXPLORATION -lenticular I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -cápsula I-EXPLORATION -interna I-EXPLORATION -izquierdos. I-EXPLORATION +detectaron I-EXPLORATION +otras I-EXPLORATION +anomalías I-EXPLORATION +corporales I-EXPLORATION +congénitas. I-EXPLORATION I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -anti-agregantes I-TREATMENT -plaquetarios, I-TREATMENT -estatinas I-TREATMENT +Tratamiento B-TREATMENT y I-TREATMENT -fisioterapia. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -egresado I-EVOLUTION -una I-EVOLUTION -semana I-EVOLUTION -después I-EVOLUTION -con I-EVOLUTION -evidente I-EVOLUTION -mejoría. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -inercia I-PAST_MEDICAL_HISTORY -colónica. I-PAST_MEDICAL_HISTORY -En B-TREATMENT -mayo I-TREATMENT -de I-TREATMENT -2003, I-TREATMENT -a I-TREATMENT -los I-TREATMENT -46 I-TREATMENT -años, I-TREATMENT +resultados I-TREATMENT + I-TREATMENT +Al I-TREATMENT +reconstruir I-TREATMENT +un I-TREATMENT +pulgar I-TREATMENT se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT +deben I-TREATMENT +tener I-TREATMENT +bien I-TREATMENT +claros I-TREATMENT +algunos I-TREATMENT +objetivos I-TREATMENT +generales I-TREATMENT +que I-TREATMENT +ayudarán I-TREATMENT +a I-TREATMENT +la I-TREATMENT +funcionabilidad I-TREATMENT +del I-TREATMENT +mismo, I-TREATMENT +como I-TREATMENT +son I-TREATMENT +lograr I-TREATMENT +estabilidad, I-TREATMENT +oposición, I-TREATMENT +sensibilidad, I-TREATMENT +darle I-TREATMENT una I-TREATMENT -colectomía I-TREATMENT -total I-TREATMENT -laparoscópica I-TREATMENT -con I-TREATMENT -anastomosis I-TREATMENT -ileorrectal I-TREATMENT -sin I-TREATMENT -incidentes. I-TREATMENT -Durante B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -taquicardia, I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -e I-EVOLUTION -hipotensión. I-EVOLUTION -Se B-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -laparotomía I-EXPLORATION -exploradora I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -necrosis I-EXPLORATION -de I-EXPLORATION -yeyuno I-EXPLORATION -distal I-EXPLORATION -e I-EXPLORATION -ileon, I-EXPLORATION -realizándose I-EXPLORATION -resección I-EXPLORATION -del I-EXPLORATION -intestino I-EXPLORATION -desde I-EXPLORATION -los I-EXPLORATION -120 I-EXPLORATION -cm I-EXPLORATION -distales I-EXPLORATION -al I-EXPLORATION -Treitz, I-EXPLORATION -además B-TREATMENT +longitud I-TREATMENT +adecuada, I-TREATMENT +darle I-TREATMENT +movilidad I-TREATMENT +en I-TREATMENT +lo I-TREATMENT +posible I-TREATMENT +y I-TREATMENT +un I-TREATMENT +buen I-TREATMENT +aspecto I-TREATMENT +estético. I-TREATMENT + I-TREATMENT +En I-TREATMENT +la I-TREATMENT +reconstrucción I-TREATMENT de I-TREATMENT -una I-TREATMENT -yeyunostomía I-TREATMENT -terminal I-TREATMENT +un I-TREATMENT +pulgar I-TREATMENT +flotante I-TREATMENT +existen I-TREATMENT +dos I-TREATMENT +conductas I-TREATMENT +básicamente I-TREATMENT +opuestas, I-TREATMENT +que I-TREATMENT +deben I-TREATMENT +discutirse I-TREATMENT +ampliamente I-TREATMENT +con I-TREATMENT +los I-TREATMENT +padres I-TREATMENT y I-TREATMENT -cierre I-TREATMENT -del I-TREATMENT -muñón I-TREATMENT -rectal. I-TREATMENT -La B-EXPLORATION -biopsia I-EXPLORATION -informó I-EXPLORATION -segmento I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -con I-EXPLORATION -hallazgos I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -enteropatía I-EXPLORATION -isquémica I-EXPLORATION -aguda. I-EXPLORATION -Evolucionó B-EVOLUTION -con I-EVOLUTION -fujos I-EVOLUTION -de I-EVOLUTION -4.500 I-EVOLUTION -cc/día I-EVOLUTION -por I-EVOLUTION -yeyunostomía I-EVOLUTION -y I-EVOLUTION -desnutrición I-EVOLUTION -calórico-proteica. I-EVOLUTION -Manejada B-TREATMENT -inicialmente I-TREATMENT con I-TREATMENT -NPTC, I-TREATMENT -en I-TREATMENT el I-TREATMENT -día I-TREATMENT -12 I-TREATMENT -post I-TREATMENT -operatorio I-TREATMENT +paciente I-TREATMENT +si I-TREATMENT +éste I-TREATMENT se I-TREATMENT -inició I-TREATMENT -alimentación I-TREATMENT -por I-TREATMENT -sonda I-TREATMENT -nasoenteral I-TREATMENT -y I-TREATMENT +encuentra I-TREATMENT en I-TREATMENT +una I-TREATMENT +edad I-TREATMENT +de I-TREATMENT +comprender. I-TREATMENT + I-TREATMENT +Desde I-TREATMENT el I-TREATMENT -día I-TREATMENT -50 I-TREATMENT -se I-TREATMENT -logró I-TREATMENT -alimentación I-TREATMENT -oral I-TREATMENT -exclusiva. I-TREATMENT -Al B-EVOLUTION -alta I-EVOLUTION -toleró I-EVOLUTION -bien I-EVOLUTION -régimen I-EVOLUTION -oral I-EVOLUTION -con I-EVOLUTION -suplementos I-EVOLUTION -nutricionales. I-EVOLUTION -Hasta I-EVOLUTION -junio I-EVOLUTION -2008 I-EVOLUTION -presentó I-EVOLUTION -17 I-EVOLUTION -hospitalizaciones, I-EVOLUTION -4 I-EVOLUTION -por I-EVOLUTION -cuadros I-EVOLUTION -de I-EVOLUTION -íleo I-EVOLUTION -mecánico, I-EVOLUTION -todos B-TREATMENT -resueltos I-TREATMENT -sin I-TREATMENT -necesidad I-TREATMENT +punto I-TREATMENT de I-TREATMENT -cirugía, I-TREATMENT -y B-EVOLUTION -13 I-EVOLUTION -por I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -deshidratación I-EVOLUTION -moderada I-EVOLUTION -secundaria I-EVOLUTION -a I-EVOLUTION -altos I-EVOLUTION -débitos I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -ostomía, I-EVOLUTION -los I-EVOLUTION -que B-TREATMENT +vista I-TREATMENT +práctico I-TREATMENT se I-TREATMENT -manejaron I-TREATMENT -con I-TREATMENT -reposición I-TREATMENT -hidroelectrolítica I-TREATMENT -y I-TREATMENT -ajuste I-TREATMENT +trata I-TREATMENT de I-TREATMENT -fármacos I-TREATMENT -para I-TREATMENT -disminuir I-TREATMENT -fujo I-TREATMENT -por I-TREATMENT -yeyunostomía I-TREATMENT -logrando B-EVOLUTION -volumen I-EVOLUTION -de I-EVOLUTION -deposiciones I-EVOLUTION -de I-EVOLUTION -2.000-3.000 I-EVOLUTION -cc/día. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -26/06/08 I-EVOLUTION -ingresó I-EVOLUTION -nuevamente I-EVOLUTION -por I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -deshidratación I-EVOLUTION -grave. I-EVOLUTION -Se I-EVOLUTION -constató I-EVOLUTION -creatininemia I-EVOLUTION -de I-EVOLUTION -4, I-EVOLUTION -39 I-EVOLUTION -mg/dl, I-EVOLUTION -objetivándose I-EVOLUTION -clearence I-EVOLUTION -de I-EVOLUTION -creatinina I-EVOLUTION -de I-EVOLUTION -30 I-EVOLUTION -ml/min. I-EVOLUTION -Dado B-TREATMENT -el I-TREATMENT -deterioro I-TREATMENT +decidir I-TREATMENT +entre I-TREATMENT +una I-TREATMENT de I-TREATMENT -la I-TREATMENT -función I-TREATMENT -renal I-TREATMENT +las I-TREATMENT +siguientes I-TREATMENT +actitudes I-TREATMENT +terapéuticas: I-TREATMENT + I-TREATMENT +Amputación I-TREATMENT y I-TREATMENT -compromiso I-TREATMENT -nutricional I-TREATMENT -de I-TREATMENT -predominio I-TREATMENT -calórico I-TREATMENT +reconstrucción: I-TREATMENT + I-TREATMENT +La I-TREATMENT +amputación I-TREATMENT +del I-TREATMENT +pulgar I-TREATMENT +flotante I-TREATMENT +conducirá I-TREATMENT +a I-TREATMENT +una I-TREATMENT +aplasia I-TREATMENT +que I-TREATMENT +necesitará I-TREATMENT +una I-TREATMENT +reconstrucción I-TREATMENT con I-TREATMENT -IMC I-TREATMENT -de I-TREATMENT -14, I-TREATMENT -2 I-TREATMENT -kg/m2 I-TREATMENT -y I-TREATMENT -albúmina I-TREATMENT -de I-TREATMENT -ingreso I-TREATMENT -de I-TREATMENT -3, I-TREATMENT -1 I-TREATMENT -gr/dl, I-TREATMENT +técnicas I-TREATMENT +microquirúrgicas I-TREATMENT +tales I-TREATMENT +como I-TREATMENT +pulgarización I-TREATMENT +del I-TREATMENT +índice I-TREATMENT +que I-TREATMENT se I-TREATMENT -planteó I-TREATMENT +realiza I-TREATMENT +con I-TREATMENT +buenos I-TREATMENT +resultados I-TREATMENT +desde I-TREATMENT +1964 I-TREATMENT +( I-TREATMENT +3, I-TREATMENT +4), I-TREATMENT +o I-TREATMENT la I-TREATMENT -realización I-TREATMENT +transferencia I-TREATMENT de I-TREATMENT un I-TREATMENT -procedimiento I-TREATMENT -de I-TREATMENT -elongación I-TREATMENT -intestinal I-TREATMENT +ortejo, I-TREATMENT +técnica I-TREATMENT +que I-TREATMENT +conlleva I-TREATMENT +muchos I-TREATMENT +riesgos I-TREATMENT +sobre I-TREATMENT +todo I-TREATMENT +cuando I-TREATMENT +no I-TREATMENT +se I-TREATMENT +tiene I-TREATMENT +un I-TREATMENT +buen I-TREATMENT +entrenamiento I-TREATMENT +en I-TREATMENT +microcirugía I-TREATMENT +(5,6) I-TREATMENT +o I-TREATMENT +no I-TREATMENT +se I-TREATMENT +cuenta I-TREATMENT +con I-TREATMENT +la I-TREATMENT +infraestructura I-TREATMENT +idonea. I-TREATMENT +En I-TREATMENT +teoría, I-TREATMENT +son I-TREATMENT +las I-TREATMENT +técnicas I-TREATMENT +que I-TREATMENT +mejor I-TREATMENT +resultado I-TREATMENT +estético-funcional I-TREATMENT +producen. I-TREATMENT + I-TREATMENT +Conservación I-TREATMENT y I-TREATMENT -reconstitución I-TREATMENT +estabilización: I-TREATMENT + I-TREATMENT +Son I-TREATMENT +posibles I-TREATMENT +tres I-TREATMENT +tipos I-TREATMENT +de I-TREATMENT +conducta I-TREATMENT +dependiendo I-TREATMENT del I-TREATMENT -tránsito I-TREATMENT -para I-TREATMENT -mejorar I-TREATMENT +tipo I-TREATMENT +de I-TREATMENT +patología I-TREATMENT +según I-TREATMENT la I-TREATMENT -condición I-TREATMENT -clínica I-TREATMENT -y I-TREATMENT -calidad I-TREATMENT +clasificación I-TREATMENT de I-TREATMENT -vida I-TREATMENT +Blauth I-TREATMENT + I-TREATMENT +-Estabilización I-TREATMENT de I-TREATMENT la I-TREATMENT -paciente. I-TREATMENT +articulación I-TREATMENT +metacarpofalángica. I-TREATMENT +-Estabilización I-TREATMENT +de I-TREATMENT +la I-TREATMENT +metacarpofalángica I-TREATMENT +más I-TREATMENT +una I-TREATMENT +transferencia I-TREATMENT +de I-TREATMENT +oposición. I-TREATMENT +- I-TREATMENT +Reconstrucción I-TREATMENT +del I-TREATMENT +metacarpiano I-TREATMENT +con I-TREATMENT +una I-TREATMENT +transferencia I-TREATMENT +ósea I-TREATMENT +vascularizada I-TREATMENT +o I-TREATMENT +no. I-TREATMENT I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -preoperatorio I-EXPLORATION -incluyó I-EXPLORATION -una I-EXPLORATION -rectoscopia I-EXPLORATION -rígida I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -un I-EXPLORATION -muñón I-EXPLORATION -rectal I-EXPLORATION -de I-EXPLORATION -12 I-EXPLORATION -cm. I-EXPLORATION -El I-EXPLORATION -tránsito I-EXPLORATION -intestinal I-EXPLORATION -demostró I-EXPLORATION -140 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -sin I-EXPLORATION -estrecheces I-EXPLORATION -y I-EXPLORATION -leve I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -asas. I-EXPLORATION -Por I-EXPLORATION -sospecha I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -de I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -mesentérica I-EXPLORATION -superior I-EXPLORATION -(AMS), I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -ecografía I-EXPLORATION -Doppler I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -estenosis I-EXPLORATION -signifcativa I-EXPLORATION -(70%) I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -AMS, I-EXPLORATION -que B-TREATMENT +En I-TREATMENT +nuestra I-TREATMENT +paciente, I-TREATMENT +una I-TREATMENT +vez I-TREATMENT +hecho I-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +e I-TREATMENT +identificados I-TREATMENT +los I-TREATMENT +problemas, I-TREATMENT se I-TREATMENT -resolvió I-TREATMENT -mediante I-TREATMENT -angioplastía I-TREATMENT +plantearon I-TREATMENT +a I-TREATMENT +la I-TREATMENT +madre I-TREATMENT y I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -endoprótesis. I-TREATMENT -Con I-TREATMENT -aporte I-TREATMENT +a I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +las I-TREATMENT +conductas I-TREATMENT +quirúrgicas I-TREATMENT +presentadas I-TREATMENT +anteriormente, I-TREATMENT +pero I-TREATMENT +en I-TREATMENT +definitiva I-TREATMENT +fue I-TREATMENT +sumamente I-TREATMENT +difícil I-TREATMENT +convencerlas I-TREATMENT de I-TREATMENT -régimen I-TREATMENT -hipercalórico-hiperproteico I-TREATMENT +amputar I-TREATMENT +el I-TREATMENT +pulgar I-TREATMENT +vestigial I-TREATMENT y I-TREATMENT -NPTC I-TREATMENT +reconstruirlo I-TREATMENT +con I-TREATMENT +una I-TREATMENT +pulgarización I-TREATMENT +del I-TREATMENT +índice, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT se I-TREATMENT -logró I-TREATMENT -optimización I-TREATMENT +tomó I-TREATMENT +la I-TREATMENT +decisión I-TREATMENT de I-TREATMENT -parámetros I-TREATMENT -nutricionales I-TREATMENT -(albúmina: I-TREATMENT -3, I-TREATMENT -8 I-TREATMENT -mg/dl). I-TREATMENT +reconstrucción I-TREATMENT +y I-TREATMENT +estabilización I-TREATMENT +del I-TREATMENT +metacarpiano. I-TREATMENT I-TREATMENT -Cinco I-TREATMENT -semanas I-TREATMENT -luego I-TREATMENT +Debido I-TREATMENT +a I-TREATMENT +que I-TREATMENT +la I-TREATMENT +posibilidad I-TREATMENT de I-TREATMENT +efectuar, I-TREATMENT +por I-TREATMENT +ejemplo, I-TREATMENT +una I-TREATMENT +transferencia I-TREATMENT +con I-TREATMENT +colgajo I-TREATMENT +óseo I-TREATMENT +del I-TREATMENT +tercio I-TREATMENT +distal I-TREATMENT +del I-TREATMENT +radio I-TREATMENT +nutrido I-TREATMENT +por I-TREATMENT la I-TREATMENT -colocación I-TREATMENT +rama I-TREATMENT +perforante I-TREATMENT +superior I-TREATMENT de I-TREATMENT la I-TREATMENT -endoprótesis I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -operar I-TREATMENT +arteria I-TREATMENT +ínterósea I-TREATMENT +anterior I-TREATMENT a I-TREATMENT -la I-TREATMENT -paciente. I-TREATMENT -En I-TREATMENT +flujo I-TREATMENT +retrogrado I-TREATMENT +(7), I-TREATMENT +no I-TREATMENT +era I-TREATMENT +viable I-TREATMENT +por I-TREATMENT +las I-TREATMENT +anomalías I-TREATMENT +vasculares I-TREATMENT +observadas I-TREATMENT +con I-TREATMENT el I-TREATMENT -intraoperatorio I-TREATMENT +doppler, I-TREATMENT se I-TREATMENT -midió I-TREATMENT -intestino I-TREATMENT -remanente I-TREATMENT -con-frmando I-TREATMENT -una I-TREATMENT -longitud I-TREATMENT -de I-TREATMENT -140 I-TREATMENT -cm. I-TREATMENT -Se I-TREATMENT -desmanteló I-TREATMENT +optó I-TREATMENT +por I-TREATMENT la I-TREATMENT -yeyunostomía I-TREATMENT -y I-TREATMENT +toma I-TREATMENT +de I-TREATMENT +un I-TREATMENT +injerto I-TREATMENT +óseo I-TREATMENT +convencional I-TREATMENT +a I-TREATMENT +pesar I-TREATMENT +del I-TREATMENT +riesgo I-TREATMENT +de I-TREATMENT +reabsorción I-TREATMENT +que I-TREATMENT +puede I-TREATMENT +presentarse I-TREATMENT +a I-TREATMENT +largo I-TREATMENT +plazo. I-TREATMENT +Para I-TREATMENT +no I-TREATMENT +cambiar I-TREATMENT +de I-TREATMENT +campo I-TREATMENT +operatorio I-TREATMENT se I-TREATMENT -practicó I-TREATMENT -una I-TREATMENT -anastomosis I-TREATMENT -mecánica I-TREATMENT -término-terminal I-TREATMENT -yeyunorectal. I-TREATMENT -Luego I-TREATMENT +cosechó I-TREATMENT +el I-TREATMENT +injerto I-TREATMENT +óseo I-TREATMENT +del I-TREATMENT +olécranon I-TREATMENT +ipsilateral; I-TREATMENT +después I-TREATMENT se I-TREATMENT -hicieron I-TREATMENT -15 I-TREATMENT -secciones I-TREATMENT -transversas I-TREATMENT -parciales I-TREATMENT +estabilizó I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +del I-TREATMENT +trapecio I-TREATMENT +vestigial I-TREATMENT con I-TREATMENT -cargas I-TREATMENT -lineales I-TREATMENT +una I-TREATMENT +miniplaca I-TREATMENT +y I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT de I-TREATMENT -3, I-TREATMENT -5 I-TREATMENT -mm I-TREATMENT -para I-TREATMENT -seccionar I-TREATMENT +las I-TREATMENT +falanges I-TREATMENT +con I-TREATMENT +alambre, I-TREATMENT +logrando I-TREATMENT +darle I-TREATMENT +al I-TREATMENT +neo-pulgar I-TREATMENT +orientación I-TREATMENT +en I-TREATMENT +oposición. I-TREATMENT +Para I-TREATMENT +mantener I-TREATMENT +estable I-TREATMENT +esta I-TREATMENT +posición I-TREATMENT +y I-TREATMENT +evitar I-TREATMENT +futuros I-TREATMENT +desplazamientos I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +efectuar I-TREATMENT la I-TREATMENT -mitad I-TREATMENT -del I-TREATMENT -lumen I-TREATMENT +transferencia I-TREATMENT del I-TREATMENT -intestino I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -de I-TREATMENT -zig-zag I-TREATMENT -según I-TREATMENT -lo I-TREATMENT -descrito I-TREATMENT -por I-TREATMENT -Kim9. I-TREATMENT -La I-TREATMENT -longitud I-TREATMENT -fnal I-TREATMENT +músculo I-TREATMENT +abductor I-TREATMENT del I-TREATMENT -intestino I-TREATMENT -delgado I-TREATMENT -fue I-TREATMENT -de I-TREATMENT -180 I-TREATMENT -cm, I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -sumado I-TREATMENT +meñique I-TREATMENT +para I-TREATMENT +fijarlo I-TREATMENT al I-TREATMENT -muñón I-TREATMENT -rectal I-TREATMENT -da I-TREATMENT -una I-TREATMENT -longitud I-TREATMENT +neo-metacarpiano I-TREATMENT +y I-TREATMENT +reforzar I-TREATMENT +o I-TREATMENT +estabilizar I-TREATMENT +la I-TREATMENT +oposición I-TREATMENT +del I-TREATMENT +pulgar, I-TREATMENT +así I-TREATMENT +como I-TREATMENT +para I-TREATMENT +tratar I-TREATMENT de I-TREATMENT -190 I-TREATMENT -cm I-TREATMENT -hasta I-TREATMENT +aumentar I-TREATMENT el I-TREATMENT -ano. I-TREATMENT +volumen I-TREATMENT +y I-TREATMENT +por I-TREATMENT +ende I-TREATMENT +la I-TREATMENT +estética I-TREATMENT +del I-TREATMENT +área I-TREATMENT +tenar. I-TREATMENT +La I-TREATMENT +cirugía I-TREATMENT +se I-TREATMENT +efectuó I-TREATMENT +con I-TREATMENT +un I-TREATMENT +bloqueo I-TREATMENT +regional I-TREATMENT +bajo I-TREATMENT +torniquete I-TREATMENT +neumático. I-TREATMENT I-TREATMENT -Dentro B-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -eventos I-EVOLUTION -del I-EVOLUTION -postoperatorio I-EVOLUTION -destacó I-EVOLUTION -la I-EVOLUTION -formación I-EVOLUTION -de I-EVOLUTION -colecciones I-EVOLUTION -hemáticas I-EVOLUTION -intraabdominales, I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION -de I-EVOLUTION -fltración. I-EVOLUTION -Por B-EXPLORATION -persistencia I-EXPLORATION -de I-EXPLORATION -episodios I-EXPLORATION -febriles, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -eco-cardiograma I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -trombo I-EXPLORATION -séptico I-EXPLORATION -en I-EXPLORATION -aurícula I-EXPLORATION -derecha I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -para I-TREATMENT -endocarditis I-TREATMENT -bacteriana. I-TREATMENT - I-TREATMENT -La B-EVOLUTION +No B-EVOLUTION +se I-EVOLUTION +presentaron I-EVOLUTION +complicaciones I-EVOLUTION +postoperatorias I-EVOLUTION + I-EVOLUTION +La B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Fisioterapia I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +diseño I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +ortesis I-DERIVED_FROM/TO +funcional I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +posteriormente, I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +inicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +reeducación I-DERIVED_FROM/TO +funcional. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Psicológicamente B-EVOLUTION +la I-EVOLUTION paciente I-EVOLUTION -evolucionó I-EVOLUTION -afebril, I-EVOLUTION -con I-EVOLUTION -aumento I-EVOLUTION -progresivo I-EVOLUTION -del I-EVOLUTION -aporte I-EVOLUTION -por I-EVOLUTION -vía I-EVOLUTION -oral. I-EVOLUTION -El B-TREATMENT -día I-TREATMENT -34 I-TREATMENT -del I-TREATMENT -post I-TREATMENT -operatorio I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -la I-TREATMENT -NPTC, I-TREATMENT -logrando I-TREATMENT -balance I-TREATMENT -hidroelectrolitico I-TREATMENT -y I-TREATMENT -nutricional I-TREATMENT -adecuado I-TREATMENT -exclusivamente I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -tránsito I-EXPLORATION -intestinal I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -98 I-EXPLORATION -días I-EXPLORATION -post I-EXPLORATION -cirugía I-EXPLORATION -no I-EXPLORATION -demostró I-EXPLORATION -evidencias I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -enterotomías. I-EXPLORATION - I-EXPLORATION -Actualmente B-TREATMENT -en I-TREATMENT -control I-TREATMENT -ambulatorio, I-TREATMENT -en I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -loperamida I-TREATMENT -y I-TREATMENT -suplementos I-TREATMENT -nutricionales, I-TREATMENT -logrando I-TREATMENT -adecuado I-TREATMENT -balance I-TREATMENT -hidroelectrolítico, I-TREATMENT -aumento I-TREATMENT -de I-TREATMENT -peso I-TREATMENT -y I-TREATMENT -con I-TREATMENT -una I-TREATMENT -frecuencia I-TREATMENT -de I-TREATMENT -deposiciones I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -veces I-TREATMENT -por I-TREATMENT -día I-TREATMENT -con I-TREATMENT -escurrimiento I-TREATMENT -escaso. I-TREATMENT - I-TREATMENT +ha I-EVOLUTION +respondido I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +positiva I-EVOLUTION +ya I-EVOLUTION +que I-EVOLUTION +ha I-EVOLUTION +logrado I-EVOLUTION +darle I-EVOLUTION +utilidad I-EVOLUTION +a I-EVOLUTION +su I-EVOLUTION +nuevo I-EVOLUTION +pulgar I-EVOLUTION +y I-EVOLUTION +éste I-EVOLUTION +ha I-EVOLUTION +mejorado I-EVOLUTION +en I-EVOLUTION +su I-EVOLUTION +aspecto I-EVOLUTION +estético, I-EVOLUTION +aunque I-EVOLUTION +no I-EVOLUTION +es I-EVOLUTION +el I-EVOLUTION +aspecto I-EVOLUTION +que I-EVOLUTION +sus I-EVOLUTION +expectativas, I-EVOLUTION +normales I-EVOLUTION +o I-EVOLUTION +no, I-EVOLUTION +le I-EVOLUTION +hicieron I-EVOLUTION +desear. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS +40 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -IMC B-PAST_MEDICAL_HISTORY -21, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -legrado I-PAST_MEDICAL_HISTORY -uterino I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -aborto I-PAST_MEDICAL_HISTORY -provocado I-PAST_MEDICAL_HISTORY +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -primer I-PAST_MEDICAL_HISTORY -trimestre, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -17 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -marzo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2007 I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -siete I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dismenorrea I-PRESENT_ILLNESS -invalidante, I-PRESENT_ILLNESS +interés, I-PAST_MEDICAL_HISTORY +acude B-PRESENT_ILLNESS a I-PRESENT_ILLNESS -pesar I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -uso I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +último I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +8-10 I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -anticonceptivos I-PRESENT_ILLNESS -orales, I-PRESENT_ILLNESS -polimenorrea I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hipermenorrea I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -ciclos I-PRESENT_ILLNESS -menstruales, I-PRESENT_ILLNESS -refriendo I-PRESENT_ILLNESS -además I-PRESENT_ILLNESS -dispareunia. I-PRESENT_ILLNESS -Examen B-EXPLORATION -físico I-EXPLORATION -general I-EXPLORATION -y I-EXPLORATION -ginecológico I-EXPLORATION -normal I-EXPLORATION -en I-EXPLORATION -primera I-EXPLORATION -consulta. I-EXPLORATION +hematuria I-PRESENT_ILLNESS +macroscópica, I-PRESENT_ILLNESS +indolora I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +coágulos. I-PRESENT_ILLNESS +Asimismo I-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +frecuencia I-PRESENT_ILLNESS +miccional, I-PRESENT_ILLNESS +escozor I-PRESENT_ILLNESS +miccional I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +tenesmo I-PRESENT_ILLNESS +vesical, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ha I-PRESENT_ILLNESS +seguido I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +ciprofloxacino I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +Diclofenaco I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +evidenciar I-PRESENT_ILLNESS +mejoría. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +La B-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +no I-EXPLORATION +evidencia I-EXPLORATION +ningún I-EXPLORATION +signo I-EXPLORATION +de I-EXPLORATION +interés I-EXPLORATION +(trayectos I-EXPLORATION +uretero-renales I-EXPLORATION +no I-EXPLORATION +dolorosos, I-EXPLORATION +puño I-EXPLORATION +percusión I-EXPLORATION +bilateral I-EXPLORATION +negativa). I-EXPLORATION + I-EXPLORATION Se I-EXPLORATION -solicitó I-EXPLORATION -ecotomografía I-EXPLORATION -transvaginal I-EXPLORATION +realiza I-EXPLORATION +ecografía I-EXPLORATION que I-EXPLORATION -mostraba I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -cavidad I-EXPLORATION -endometrial I-EXPLORATION -ocupada I-EXPLORATION -por I-EXPLORATION -imagen I-EXPLORATION -hiperecogénica I-EXPLORATION -lineal I-EXPLORATION -con I-EXPLORATION -sombra I-EXPLORATION -acústica I-EXPLORATION -posterior, I-EXPLORATION -compatible I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +intravesical I-EXPLORATION +de I-EXPLORATION +35, I-EXPLORATION +7 I-EXPLORATION +mm I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +máximo, I-EXPLORATION con I-EXPLORATION -extensa I-EXPLORATION -metaplasia I-EXPLORATION -ósea. I-EXPLORATION +unos I-EXPLORATION +riñones I-EXPLORATION +ecográficamente I-EXPLORATION +normales. I-EXPLORATION I-EXPLORATION -La I-EXPLORATION -histeroscopía I-EXPLORATION -mostró I-EXPLORATION -cavidad I-EXPLORATION -uterina I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +cistoscopia I-EXPLORATION +flexible, I-EXPLORATION +que I-EXPLORATION +pone I-EXPLORATION de I-EXPLORATION -7, I-EXPLORATION -5 I-EXPLORATION -cm, I-EXPLORATION -poco I-EXPLORATION -distensible, I-EXPLORATION -revestida I-EXPLORATION +manifiesto I-EXPLORATION +una I-EXPLORATION +gran I-EXPLORATION +masa I-EXPLORATION +bilobulada I-EXPLORATION en I-EXPLORATION -su I-EXPLORATION -totalidad I-EXPLORATION -por I-EXPLORATION -múltiples I-EXPLORATION -fragmentos I-EXPLORATION -espiculados I-EXPLORATION +pared I-EXPLORATION +posterior I-EXPLORATION de I-EXPLORATION aspecto I-EXPLORATION -y I-EXPLORATION -consistencia I-EXPLORATION -ósea. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -extracción I-TREATMENT -de I-TREATMENT -éstos I-TREATMENT -con I-TREATMENT -asa I-TREATMENT -de I-TREATMENT -resectoscopio I-TREATMENT -asistido I-TREATMENT -con I-TREATMENT -cucharilla I-TREATMENT -N° I-TREATMENT -2 I-TREATMENT -y I-TREATMENT -pinza I-TREATMENT -Randall, I-TREATMENT -sin I-TREATMENT -incidentes. I-TREATMENT -Posteriormente B-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -cavidad I-EVOLUTION -endometrial I-EVOLUTION -sana I-EVOLUTION -y I-EVOLUTION -ostium I-EVOLUTION -tubarios I-EVOLUTION -permeables. I-EVOLUTION - I-EVOLUTION -Su B-EXPLORATION -laparoscopía I-EXPLORATION -exploradora I-EXPLORATION -mostró I-EXPLORATION -pelvis I-EXPLORATION -sana, I-EXPLORATION -útero I-EXPLORATION -y I-EXPLORATION -anexos I-EXPLORATION -normales, I-EXPLORATION -con I-EXPLORATION -buena I-EXPLORATION -relación I-EXPLORATION -tubo I-EXPLORATION -ovárica. I-EXPLORATION -Trompas I-EXPLORATION -permeables I-EXPLORATION +infiltrante I-EXPLORATION con I-EXPLORATION -índigo I-EXPLORATION -carmín. I-EXPLORATION +áreas I-EXPLORATION +parcialmente I-EXPLORATION +necróticas I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +superficie. I-EXPLORATION I-EXPLORATION -Biopsia I-EXPLORATION -operatoria I-EXPLORATION -estuvo I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -fragmentos I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -óseo I-EXPLORATION -maduro, I-EXPLORATION -reconociéndose I-EXPLORATION -además I-EXPLORATION -colonias I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -Actinomyces. I-EXPLORATION -No I-EXPLORATION +Posteriormente I-EXPLORATION se I-EXPLORATION -observaban I-EXPLORATION -evidencias I-EXPLORATION -de I-EXPLORATION -neoplasia. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -fueron I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -metaplasia I-EXPLORATION +realiza I-EXPLORATION +Tomografía I-EXPLORATION +computerizada I-EXPLORATION +(TC) I-EXPLORATION +tóraco-abdominal, I-EXPLORATION +gammagrafía I-EXPLORATION ósea I-EXPLORATION -del I-EXPLORATION -endometrio. I-EXPLORATION -Se B-TREATMENT -indicaron I-TREATMENT -anticonceptivos I-TREATMENT -orales I-TREATMENT -hasta I-TREATMENT -deseo I-TREATMENT -de I-TREATMENT -embarazo. I-TREATMENT - I-TREATMENT -Una B-EXPLORATION -histerosonografía I-EXPLORATION -tres I-EXPLORATION -meses I-EXPLORATION -post I-EXPLORATION -cirugía I-EXPLORATION -mostraba I-EXPLORATION -cavidad I-EXPLORATION -uterina I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -En B-TREATMENT -agosto I-TREATMENT -de I-TREATMENT -2008 I-TREATMENT -consultó I-TREATMENT -cursando I-TREATMENT -embarazo I-TREATMENT -espontáneo I-TREATMENT -único I-TREATMENT -de I-TREATMENT -6 I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -gestación I-TREATMENT -confirmado I-TREATMENT -ecográficamente. I-TREATMENT -A I-TREATMENT -las I-TREATMENT -39 I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -gestación, I-TREATMENT -se I-TREATMENT -obtuvo I-TREATMENT -un I-TREATMENT -recién I-TREATMENT -nacido I-TREATMENT -sano I-TREATMENT -de I-TREATMENT -3.380 I-TREATMENT -g I-TREATMENT -mediante I-TREATMENT -operación I-TREATMENT -cesárea I-TREATMENT -por I-TREATMENT -prueba I-TREATMENT -de I-TREATMENT -trabajo I-TREATMENT -de I-TREATMENT -parto I-TREATMENT -fracasada. I-TREATMENT -Durante I-TREATMENT -la I-TREATMENT -misma, I-TREATMENT -se I-TREATMENT -produjo I-TREATMENT -inercia I-TREATMENT -uterina I-TREATMENT -que I-TREATMENT -logró I-TREATMENT -ser I-TREATMENT -revertida I-TREATMENT -con I-TREATMENT -uso I-TREATMENT -de I-TREATMENT -retractores I-TREATMENT -en I-TREATMENT -altas I-TREATMENT -dosis. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -65 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -larga I-PAST_MEDICAL_HISTORY -data, I-PAST_MEDICAL_HISTORY -trasplante I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1999 I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -rechazó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -meses, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -hemodiálisis I-PAST_MEDICAL_HISTORY -trisemanal I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2000 I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -secundaria. I-PAST_MEDICAL_HISTORY -Tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -eritropoyetina, I-PAST_MEDICAL_HISTORY -ácido I-PAST_MEDICAL_HISTORY -fólico, I-PAST_MEDICAL_HISTORY -atenolol I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -losartan. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -caracterizada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -pruriginosas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -manos, I-PRESENT_ILLNESS -antebrazos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -espalda. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaban I-EXPLORATION -hiperpigmentación I-EXPLORATION -difusa, I-EXPLORATION -erosiones, I-EXPLORATION -úlceras I-EXPLORATION -y I-EXPLORATION -pápulas I-EXPLORATION -costrosas, I-EXPLORATION -ubicadas I-EXPLORATION -preferentemente I-EXPLORATION -en I-EXPLORATION -dorso I-EXPLORATION -de I-EXPLORATION -manos, I-EXPLORATION -antebrazos, I-EXPLORATION -tórax I-EXPLORATION -anterior I-EXPLORATION y I-EXPLORATION -región I-EXPLORATION -interescapular. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION +Resección I-EXPLORATION +trans-uretral I-EXPLORATION +(RTU) I-EXPLORATION biopsia I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -piel I-EXPLORATION -con I-EXPLORATION -úlcera I-EXPLORATION +para I-EXPLORATION +establecer I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION y I-EXPLORATION -costra I-EXPLORATION -fibrinoleucocitaria. I-EXPLORATION -El I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION +valorar I-EXPLORATION la I-EXPLORATION -úlcera I-EXPLORATION -con I-EXPLORATION -haces I-EXPLORATION -de I-EXPLORATION -colágeno I-EXPLORATION +extensión I-EXPLORATION de I-EXPLORATION -disposición I-EXPLORATION -vertical, I-EXPLORATION -epidermis I-EXPLORATION -adyacente I-EXPLORATION -con I-EXPLORATION -hiperortoqueratosis, I-EXPLORATION -acantosis I-EXPLORATION -y I-EXPLORATION -leve I-EXPLORATION -espongiosis. I-EXPLORATION +la I-EXPLORATION +enfermedad. I-EXPLORATION La I-EXPLORATION -dermis I-EXPLORATION -con I-EXPLORATION -leve I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -disperso I-EXPLORATION -y I-EXPLORATION -perivascular I-EXPLORATION -superfcial I-EXPLORATION -linfocitario, I-EXPLORATION -con I-EXPLORATION -algunos I-EXPLORATION -plasmocitos I-EXPLORATION -y I-EXPLORATION -neutróflos I-EXPLORATION -y I-EXPLORATION -foco I-EXPLORATION -hemorrágico. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -informados I-EXPLORATION -fueron I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -colagenosis I-EXPLORATION -perforante I-EXPLORATION +TC I-EXPLORATION +muestra I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +vesical I-EXPLORATION de I-EXPLORATION -tipo I-EXPLORATION -reactivo. I-EXPLORATION -Se B-TREATMENT -indicaron I-TREATMENT -antihistamínicos I-TREATMENT -orales I-TREATMENT -y I-TREATMENT -clobetasol I-TREATMENT -0, I-TREATMENT -05% I-TREATMENT -+ I-TREATMENT -cloranfenicol I-TREATMENT -2% I-TREATMENT -con B-EVOLUTION -respuesta I-EVOLUTION -parcial I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -seguimiento. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -residencia I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -IX I-PAST_MEDICAL_HISTORY -región, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -conocidos. I-PAST_MEDICAL_HISTORY -Ingresó B-EXPLORATION -al I-EXPLORATION -servicio I-EXPLORATION +8, I-EXPLORATION +5 I-EXPLORATION +cm. I-EXPLORATION de I-EXPLORATION -urgencia I-EXPLORATION -luego I-EXPLORATION +diámetro I-EXPLORATION +máximo, I-EXPLORATION +bien I-EXPLORATION +definida I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -sufrir I-EXPLORATION -accidente I-EXPLORATION +infiltración I-EXPLORATION de I-EXPLORATION -tránsito I-EXPLORATION +la I-EXPLORATION +grasa I-EXPLORATION +perivesical, I-EXPLORATION +ni I-EXPLORATION +evidencia I-EXPLORATION de I-EXPLORATION -baja I-EXPLORATION -energía I-EXPLORATION -sin I-EXPLORATION -presentar I-EXPLORATION -lesiones I-EXPLORATION +adenopatías I-EXPLORATION de I-EXPLORATION -consideración I-EXPLORATION -secundarias I-EXPLORATION -a I-EXPLORATION -el. I-EXPLORATION -Luego I-EXPLORATION +tamaño I-EXPLORATION +significativo. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION +extensión I-EXPLORATION +se I-EXPLORATION +completó I-EXPLORATION +con I-EXPLORATION una I-EXPLORATION -semana, I-EXPLORATION -consultó I-EXPLORATION -por I-EXPLORATION -presentar I-EXPLORATION -debilidad I-EXPLORATION -progresiva I-EXPLORATION +gammagrafía I-EXPLORATION +ósea I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION de I-EXPLORATION -extremidades I-EXPLORATION -inferiores, I-EXPLORATION -dorsalgia I-EXPLORATION +la I-EXPLORATION +RTU I-EXPLORATION +muestra I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -moderada I-EXPLORATION -intensidad I-EXPLORATION -y I-EXPLORATION -dificultad I-EXPLORATION -para I-EXPLORATION -orinar. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -se I-EXPLORATION -constata I-EXPLORATION -con I-EXPLORATION -hipoestesia I-EXPLORATION -bilateral I-EXPLORATION -desde I-EXPLORATION -nivel I-EXPLORATION -D5 I-EXPLORATION -hacia I-EXPLORATION -distal, I-EXPLORATION -paraparesia I-EXPLORATION -moderada, I-EXPLORATION -hiperrefexia I-EXPLORATION -osteotendínea I-EXPLORATION -patelar I-EXPLORATION -y I-EXPLORATION -aquiliana I-EXPLORATION -bilateral I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +mesenquimal, I-EXPLORATION +fusocelular, I-EXPLORATION con I-EXPLORATION -signo I-EXPLORATION +haces I-EXPLORATION +largos I-EXPLORATION de I-EXPLORATION -Babinski I-EXPLORATION -positivo I-EXPLORATION -bilateral; I-EXPLORATION -se I-EXPLORATION -hospitalizó I-EXPLORATION -planteándose I-EXPLORATION -un I-EXPLORATION -trauma I-EXPLORATION -raquimedular I-EXPLORATION -complicado. I-EXPLORATION +células I-EXPLORATION +fusiformes I-EXPLORATION +y I-EXPLORATION +frecuentes I-EXPLORATION +mitosis. I-EXPLORATION El I-EXPLORATION estudio I-EXPLORATION -de I-EXPLORATION -imágenes I-EXPLORATION +inmunohistoquímico I-EXPLORATION +muestra I-EXPLORATION +una I-EXPLORATION +intensa I-EXPLORATION +inmunorreactividad I-EXPLORATION con I-EXPLORATION -radiografía I-EXPLORATION -(Rx) I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -dorsal I-EXPLORATION -mostraba I-EXPLORATION -aplastamiento I-EXPLORATION -de I-EXPLORATION -cuerpo I-EXPLORATION -D3. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -(TC) I-EXPLORATION +vimentina I-EXPLORATION y I-EXPLORATION -resonancia I-EXPLORATION -nuclear I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -dorsal I-EXPLORATION -demostraron I-EXPLORATION -múltiples I-EXPLORATION -quistes I-EXPLORATION +actina I-EXPLORATION +muscular I-EXPLORATION +específica. I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +leiomiosarcoma I-TREATMENT +vesical I-TREATMENT +clínicamente I-TREATMENT +localizado I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +exenteración I-TREATMENT +pélvica I-TREATMENT +anterior I-TREATMENT +(cistectomía I-TREATMENT +radical, I-TREATMENT +histerectomía I-TREATMENT +más I-TREATMENT +doble I-TREATMENT +anexectomía I-TREATMENT +y I-TREATMENT +derivación I-TREATMENT +urinaria I-TREATMENT +ileal). I-TREATMENT + I-TREATMENT +El B-EXPLORATION +informe I-EXPLORATION +anatomopatológico I-EXPLORATION de I-EXPLORATION -tamaño I-EXPLORATION -variable I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +quirúrgica I-EXPLORATION +reveló I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -zona I-EXPLORATION -paravertebral I-EXPLORATION -derecha I-EXPLORATION -que I-EXPLORATION -compromete I-EXPLORATION -cuerpos I-EXPLORATION -vertebrales I-EXPLORATION -y I-EXPLORATION -elementos I-EXPLORATION -posteriores I-EXPLORATION +pared I-EXPLORATION +posterior I-EXPLORATION de I-EXPLORATION -D2, I-EXPLORATION -D3 I-EXPLORATION -y I-EXPLORATION -D4 I-EXPLORATION -e I-EXPLORATION -invasión I-EXPLORATION -del I-EXPLORATION -canal I-EXPLORATION -raquídeo I-EXPLORATION -junto I-EXPLORATION -a I-EXPLORATION -imagen I-EXPLORATION +la I-EXPLORATION +vejiga I-EXPLORATION de I-EXPLORATION -aplastamiento I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION +crecimiento I-EXPLORATION +exofítico I-EXPLORATION +y I-EXPLORATION +consistencia I-EXPLORATION +elástica I-EXPLORATION de I-EXPLORATION -D3 I-EXPLORATION -compatible I-EXPLORATION +8, I-EXPLORATION +5 I-EXPLORATION +x I-EXPLORATION +6 I-EXPLORATION +x I-EXPLORATION +4 I-EXPLORATION +cm, I-EXPLORATION con I-EXPLORATION -probable I-EXPLORATION -etiología I-EXPLORATION -hidatídica. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -anamnesis I-EXPLORATION -dirigida I-EXPLORATION -donde I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -señaló I-EXPLORATION -presentar I-EXPLORATION -dorsalgia I-EXPLORATION +un I-EXPLORATION +pedículo I-EXPLORATION de I-EXPLORATION -tres I-EXPLORATION -años I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -evolución I-EXPLORATION -con I-EXPLORATION +diámetro. I-EXPLORATION + I-EXPLORATION +Era I-EXPLORATION un I-EXPLORATION -episodio I-EXPLORATION +tumor I-EXPLORATION +mesenquimal I-EXPLORATION +maligno I-EXPLORATION de I-EXPLORATION -disminución I-EXPLORATION +células I-EXPLORATION +alargadas, I-EXPLORATION de I-EXPLORATION -fuerzas I-EXPLORATION +nucleolos I-EXPLORATION +longilíneos I-EXPLORATION +bordes I-EXPLORATION +romos I-EXPLORATION +y I-EXPLORATION +citoplasmas I-EXPLORATION +fibrilares. I-EXPLORATION +En I-EXPLORATION +algunas I-EXPLORATION +zonas I-EXPLORATION +se I-EXPLORATION +muestran I-EXPLORATION +figuras I-EXPLORATION +de I-EXPLORATION +mitosis I-EXPLORATION +(20 I-EXPLORATION +mitosis I-EXPLORATION +por I-EXPLORATION +10 I-EXPLORATION +campos I-EXPLORATION +de I-EXPLORATION +gran I-EXPLORATION +aumento). I-EXPLORATION +El I-EXPLORATION +tumor I-EXPLORATION +se I-EXPLORATION +alojaba I-EXPLORATION en I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -que I-EXPLORATION -revirtió I-EXPLORATION -espontáneamente. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -(hemograma, I-EXPLORATION -pruebas I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +vesical, I-EXPLORATION +sin I-EXPLORATION +infiltrar I-EXPLORATION +el I-EXPLORATION +urotelio I-EXPLORATION de I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION +superficie, I-EXPLORATION +ni I-EXPLORATION +la I-EXPLORATION +capa I-EXPLORATION +muscular I-EXPLORATION +propia I-EXPLORATION +vesical, I-EXPLORATION +presentando I-EXPLORATION +su I-EXPLORATION +origen I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +capa I-EXPLORATION +muscular I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +submucosa I-EXPLORATION +(Muscularis I-EXPLORATION +Mucosae). I-EXPLORATION + I-EXPLORATION +Tanto I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +ganglios I-EXPLORATION +iliacos I-EXPLORATION +e I-EXPLORATION +ilio-obturatrices, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +la I-EXPLORATION +grasa I-EXPLORATION +perivesical I-EXPLORATION y I-EXPLORATION -renal) I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +estructuras I-EXPLORATION +estudiadas, I-EXPLORATION no I-EXPLORATION mostraron I-EXPLORATION -alteraciones. I-EXPLORATION +ninguna I-EXPLORATION +alteración. I-EXPLORATION I-EXPLORATION -Si B-TREATMENT -inició I-TREATMENT +Tras B-EVOLUTION +un I-EVOLUTION +postoperatorio I-EVOLUTION +sin I-EVOLUTION +incidencias I-EVOLUTION +relevantes, I-EVOLUTION +se B-TREATMENT +decidió I-TREATMENT +completar I-TREATMENT +el I-TREATMENT tratamiento I-TREATMENT con I-TREATMENT -albendazol I-TREATMENT -y I-TREATMENT -realizó I-TREATMENT -hemilaminectomía I-TREATMENT -D3-D4 I-TREATMENT -con I-TREATMENT -exéresis I-TREATMENT +quimioterapia I-TREATMENT +adyuvante I-TREATMENT +que I-TREATMENT +la I-TREATMENT +paciente, I-TREATMENT +con I-TREATMENT +Adriamicina I-TREATMENT +e I-TREATMENT +Ifosfamida I-TREATMENT +realizó I-TREATMENT +en I-TREATMENT +su I-TREATMENT +Centro I-TREATMENT +de I-TREATMENT +referencia, I-TREATMENT +recibiendo I-TREATMENT +un I-TREATMENT +total I-TREATMENT de I-TREATMENT -quistes I-TREATMENT -confirmando I-TREATMENT +6 I-TREATMENT +ciclos I-TREATMENT +(1 I-TREATMENT +mensual) I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +tolerancia. I-TREATMENT +Se I-TREATMENT +retrasó I-TREATMENT el I-TREATMENT -estudio I-TREATMENT -histopatológico I-TREATMENT +inicio I-TREATMENT +del I-TREATMENT +ciclo I-TREATMENT +en I-TREATMENT +una I-TREATMENT +ocasión I-TREATMENT +por I-TREATMENT +fiebre. I-TREATMENT + I-TREATMENT +Al B-EVOLUTION +año I-EVOLUTION +de I-EVOLUTION +finalizar I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +complementario I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +recidiva I-EVOLUTION +locorregional I-EVOLUTION +en I-EVOLUTION +una I-EVOLUTION +T.C. I-EVOLUTION +realizada I-EVOLUTION +durante I-EVOLUTION +una I-EVOLUTION +revisión. I-EVOLUTION +Por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +la I-TREATMENT +extirpación I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión, I-TREATMENT +con I-TREATMENT +informe I-TREATMENT +anatomopatológico I-TREATMENT +de I-TREATMENT +leiomiosarcoma I-TREATMENT +de I-TREATMENT +6, I-TREATMENT +5 I-TREATMENT +cms. I-TREATMENT +de I-TREATMENT +diámetro I-TREATMENT +con I-TREATMENT +un I-TREATMENT +borde I-TREATMENT +afecto. I-TREATMENT +Se I-TREATMENT +decidió I-TREATMENT +completar I-TREATMENT el I-TREATMENT -diagnóstico I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +quicio-radioterapia I-TREATMENT +adyuvante, I-TREATMENT +con I-TREATMENT +régimen I-TREATMENT +quimioterápico I-TREATMENT +basado I-TREATMENT +en I-TREATMENT +Ifosfamida I-TREATMENT +a I-TREATMENT +altas I-TREATMENT +dosis I-TREATMENT +(3.520 I-TREATMENT +mg I-TREATMENT +cada I-TREATMENT +24 I-TREATMENT +horas I-TREATMENT +por I-TREATMENT +5 I-TREATMENT +días), I-TREATMENT de I-TREATMENT -hidatidosis I-TREATMENT -ósea. I-TREATMENT - I-TREATMENT -El B-EVOLUTION +los I-TREATMENT +cuales I-TREATMENT +se I-TREATMENT +ha I-TREATMENT +administrado I-TREATMENT +6 I-TREATMENT +ciclos, I-TREATMENT +uno I-TREATMENT +mensual. I-TREATMENT +Una I-TREATMENT +vez I-TREATMENT +completados I-TREATMENT +los I-TREATMENT +2 I-TREATMENT +primeros I-TREATMENT +ciclos I-TREATMENT +de I-TREATMENT +quimioterapia, I-TREATMENT +recibió I-TREATMENT +radioterapia I-TREATMENT +externa, I-TREATMENT +a I-TREATMENT +razón I-TREATMENT +de I-TREATMENT +1, I-TREATMENT +8 I-TREATMENT +Gy/día, I-TREATMENT +hasta I-TREATMENT +completar I-TREATMENT +una I-TREATMENT +dosis I-TREATMENT +total I-TREATMENT +de I-TREATMENT +45 I-TREATMENT +Gy I-TREATMENT +sobre I-TREATMENT +lecho I-TREATMENT +tumoral I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +una I-TREATMENT +sobreimpresión I-TREATMENT +pélvica I-TREATMENT +con I-TREATMENT +16 I-TREATMENT +Gy I-TREATMENT +hasta I-TREATMENT +completar I-TREATMENT +una I-TREATMENT +dosis I-TREATMENT +pélvica I-TREATMENT +de I-TREATMENT +61 I-TREATMENT +Gy. I-TREATMENT +Posteriormente B-EVOLUTION +pasó I-EVOLUTION +a I-EVOLUTION +revisiones I-EVOLUTION +periódicas. I-EVOLUTION + I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +ocho I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +haber I-EVOLUTION +finalizado I-EVOLUTION +el I-EVOLUTION +segundo I-EVOLUTION +tratamiento I-EVOLUTION +adyuvante, I-EVOLUTION +32 I-EVOLUTION +meses I-EVOLUTION +desde I-EVOLUTION +el I-EVOLUTION +diagnóstico, I-EVOLUTION +la I-EVOLUTION paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -recuperando I-EVOLUTION -movilidad I-EVOLUTION -completa I-EVOLUTION +vuelve I-EVOLUTION +a I-EVOLUTION +presentar I-EVOLUTION +una I-EVOLUTION +recidiva I-EVOLUTION +pélvica I-EVOLUTION de I-EVOLUTION -extremidades I-EVOLUTION -inferiores I-EVOLUTION -sin I-EVOLUTION -déficit I-EVOLUTION -esfinteriano. I-EVOLUTION -El B-EXPLORATION +5 I-EVOLUTION +x I-EVOLUTION +5, I-EVOLUTION +8 I-EVOLUTION +cm., I-EVOLUTION +con I-EVOLUTION +probable I-EVOLUTION +infiltración I-EVOLUTION +de I-EVOLUTION +recto-sigma I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +vejiga I-EVOLUTION +ileal. I-EVOLUTION +Se B-TREATMENT +realiza I-TREATMENT +rectosigmoidoscopia I-TREATMENT +con I-TREATMENT +punción I-TREATMENT +aspiración I-TREATMENT +con I-TREATMENT +aguja I-TREATMENT +fina, I-TREATMENT +con I-TREATMENT +resultado I-TREATMENT +anatomopatológico I-TREATMENT +de I-TREATMENT +citología I-TREATMENT +maligna, I-TREATMENT +sarcoma I-TREATMENT +fusocelular I-TREATMENT +compatible I-TREATMENT +con I-TREATMENT +leiomiosarcoma. I-TREATMENT +Se B-EXPLORATION +ha I-EXPLORATION +realizado I-EXPLORATION estudio I-EXPLORATION +inmunohistoquímico I-EXPLORATION con I-EXPLORATION -Rx I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION +anticuerpos I-EXPLORATION +frente I-EXPLORATION +a I-EXPLORATION +Caldesmón I-EXPLORATION y I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -no I-EXPLORATION -demostraron I-EXPLORATION -enfermedad I-EXPLORATION -hidatídica I-EXPLORATION -diseminada. I-EXPLORATION -Completa B-TREATMENT -cuatro I-TREATMENT -ciclos I-TREATMENT +Miosina I-EXPLORATION +de I-EXPLORATION +músculo I-EXPLORATION +liso, I-EXPLORATION +observándose I-EXPLORATION +inmunorreactividad I-EXPLORATION +intensa I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +tumorales I-EXPLORATION +frente I-EXPLORATION +a I-EXPLORATION +ambos I-EXPLORATION +anticuerpos. I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT de I-TREATMENT -albendazol. I-TREATMENT - I-TREATMENT -Luego B-EVOLUTION -de I-EVOLUTION +segunda I-TREATMENT +recidiva I-TREATMENT +se I-TREATMENT +recomendó I-TREATMENT +realizar I-TREATMENT +resección I-TREATMENT +quirúrgica I-TREATMENT +con I-TREATMENT +consolidación I-TREATMENT +con I-TREATMENT +braquiterapia. I-TREATMENT +La I-TREATMENT +paciente I-TREATMENT +desestimó I-TREATMENT +la I-TREATMENT +realización I-TREATMENT +de I-TREATMENT +cirugía I-TREATMENT +con I-TREATMENT +braquiterapia I-TREATMENT +por I-TREATMENT +miedo I-TREATMENT +a I-TREATMENT +las I-TREATMENT +complicaciones I-TREATMENT +de I-TREATMENT +la I-TREATMENT +braquiterapia, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +intervenida I-TREATMENT +en I-TREATMENT +otro I-TREATMENT +centro, I-TREATMENT +realizando I-TREATMENT +exenteración I-TREATMENT +pélvica I-TREATMENT +posterior. I-TREATMENT +En B-EVOLUTION +el I-EVOLUTION +primer I-EVOLUTION +control I-EVOLUTION +tras I-EVOLUTION +la I-EVOLUTION +cirugía, I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION tres I-EVOLUTION meses I-EVOLUTION -fue I-EVOLUTION -nuevamente I-EVOLUTION -intervenido I-EVOLUTION -quirúrgicamente I-EVOLUTION -por I-EVOLUTION -absceso I-EVOLUTION -dorsal I-EVOLUTION -hidatídico I-EVOLUTION -y I-EVOLUTION -5 I-EVOLUTION -años I-EVOLUTION -después I-EVOLUTION -por I-EVOLUTION -nuevo I-EVOLUTION -episodio I-EVOLUTION de I-EVOLUTION -paraparesia I-EVOLUTION -progresiva I-EVOLUTION -con I-EVOLUTION +la I-EVOLUTION +misma I-EVOLUTION +volvió I-EVOLUTION +a I-EVOLUTION +presentar I-EVOLUTION +una I-EVOLUTION +nueva I-EVOLUTION +recidiva, I-EVOLUTION +a I-EVOLUTION nivel I-EVOLUTION -sensitivo I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +incisión, I-EVOLUTION +realizándose B-TREATMENT +resección I-TREATMENT +del I-TREATMENT +mismo. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +la I-EVOLUTION +actualidad, I-EVOLUTION +y I-EVOLUTION +41 I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +diagnóstico I-EVOLUTION +inicial, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +asintomática, I-EVOLUTION en I-EVOLUTION -D5 I-EVOLUTION -realizándose I-EVOLUTION -laminectomía I-EVOLUTION -D3-D4 I-EVOLUTION -con I-EVOLUTION -exéresis I-EVOLUTION +controles I-EVOLUTION +periódicos I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +evidencia I-EVOLUTION de I-EVOLUTION -quistes. I-EVOLUTION +enfermedad. I-EVOLUTION I-EVOLUTION -Hombre B-PRESENT_ILLNESS +El B-PRESENT_ILLNESS +cadáver I-PRESENT_ILLNESS +carbonizado I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +campesina I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +68 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY +edad, I-PRESENT_ILLNESS +que B-PAST_MEDICAL_HISTORY +vivía I-PAST_MEDICAL_HISTORY +sola I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +apartado I-PAST_MEDICAL_HISTORY +lugar I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -B I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -VIH I-PAST_MEDICAL_HISTORY -positivo I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -decaimiento, I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS +la I-PAST_MEDICAL_HISTORY +provincia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Panamá, I-PAST_MEDICAL_HISTORY +fue B-PRESENT_ILLNESS +encontrado I-PRESENT_ILLNESS +entre I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +restos I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -torácico I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -conducta I-PRESENT_ILLNESS -frontalizada. I-PRESENT_ILLNESS -La B-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -resultó I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -VDRL, I-EXPLORATION -toxoplasma I-EXPLORATION -y I-EXPLORATION -VEB I-EXPLORATION -(por I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -PCR). I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -hematológicos I-EXPLORATION -mostraron I-EXPLORATION -una I-EXPLORATION -anemia I-EXPLORATION -leve I-EXPLORATION +una I-PRESENT_ILLNESS +vivienda I-PRESENT_ILLNESS +rural I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +madera, I-PRESENT_ILLNESS +completamente I-PRESENT_ILLNESS +quemada. I-PRESENT_ILLNESS +El B-DERIVED_FROM/TO +cuerpo I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +morgue I-DERIVED_FROM/TO +judicial I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +ciudad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Panamá I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +identificación I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +determinación I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +causa I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +muerte. I-DERIVED_FROM/TO +No B-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +registros I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +fallecida. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Examen B-EXPLORATION +necrópsico I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +recibió I-EXPLORATION +un I-EXPLORATION +cuerpo I-EXPLORATION +incompleto, I-EXPLORATION +quemado I-EXPLORATION +hasta I-EXPLORATION +la I-EXPLORATION +carbonización, I-EXPLORATION con I-EXPLORATION -Hb I-EXPLORATION +amputaciones I-EXPLORATION +térmicas I-EXPLORATION +y I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -10, I-EXPLORATION -3 I-EXPLORATION -g/dL I-EXPLORATION -(ref. I-EXPLORATION -13, I-EXPLORATION -5-17, I-EXPLORATION -5 I-EXPLORATION -g/dL), I-EXPLORATION -Hto I-EXPLORATION -30% I-EXPLORATION -(ref. I-EXPLORATION -41-53%), I-EXPLORATION -leucopenia I-EXPLORATION -con I-EXPLORATION -3.100 I-EXPLORATION -leucocitos/mm3 I-EXPLORATION -(ref. I-EXPLORATION -4.500-11.000/mm3) I-EXPLORATION +estructuras I-EXPLORATION +anatómicas I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +tronco I-EXPLORATION y I-EXPLORATION -linfopenia I-EXPLORATION -con I-EXPLORATION -800/mm3 I-EXPLORATION -(ref. I-EXPLORATION -1.000-4.800/mm3). I-EXPLORATION -LDH I-EXPLORATION +los I-EXPLORATION +miembros. I-EXPLORATION +Fue I-EXPLORATION +identificado I-EXPLORATION +por I-EXPLORATION +sus I-EXPLORATION +características I-EXPLORATION +antropológicas I-EXPLORATION y I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +información I-EXPLORATION +recibida I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +investigadores. I-EXPLORATION + I-EXPLORATION +Al I-EXPLORATION +revisar I-EXPLORATION +las I-EXPLORATION +cavidades, I-EXPLORATION +las I-EXPLORATION +vísceras I-EXPLORATION +estaban I-EXPLORATION +bien I-EXPLORATION +conservadas. I-EXPLORATION +Había I-EXPLORATION +coágulos I-EXPLORATION +cocidos I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +hemitórax I-EXPLORATION +izquierdo. I-EXPLORATION +En I-EXPLORATION +las I-EXPLORATION +vías I-EXPLORATION +aéreas I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -encontraban I-EXPLORATION -dentro I-EXPLORATION +encontraron I-EXPLORATION +partículas I-EXPLORATION de I-EXPLORATION -límites I-EXPLORATION -normales I-EXPLORATION -(133 I-EXPLORATION -U/L I-EXPLORATION -[ref. I-EXPLORATION -135-225 I-EXPLORATION -U/L] I-EXPLORATION +carbón, I-EXPLORATION y I-EXPLORATION -0, I-EXPLORATION -1 I-EXPLORATION -mg/dL I-EXPLORATION -[ref. I-EXPLORATION -0-1 I-EXPLORATION -mg/dL], I-EXPLORATION -respectivamente). I-EXPLORATION +tampoco I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +partículas I-EXPLORATION +de I-EXPLORATION +hollín I-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +microscópico. I-EXPLORATION El I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -además I-EXPLORATION -severo I-EXPLORATION -estado I-EXPLORATION +saco I-EXPLORATION +pericárdico I-EXPLORATION +estaba I-EXPLORATION +roto I-EXPLORATION +y I-EXPLORATION +contenía I-EXPLORATION +coágulos I-EXPLORATION +cocidos I-EXPLORATION +; I-EXPLORATION +al I-EXPLORATION +evacuarlos, I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +una I-EXPLORATION +herida I-EXPLORATION +punzo-cortante, I-EXPLORATION de I-EXPLORATION -inmunosupresión I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -recuento I-EXPLORATION +1, I-EXPLORATION +2 I-EXPLORATION +× I-EXPLORATION +0, I-EXPLORATION +8 I-EXPLORATION +cm, I-EXPLORATION +que I-EXPLORATION +interesaba I-EXPLORATION +todo I-EXPLORATION +el I-EXPLORATION +espesor I-EXPLORATION de I-EXPLORATION -linfocitos I-EXPLORATION -T I-EXPLORATION -CD4 I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +anterior I-EXPLORATION +del I-EXPLORATION +ventrículo I-EXPLORATION +izquierdo. I-EXPLORATION +Al I-EXPLORATION +examen I-EXPLORATION +microscópico I-EXPLORATION de I-EXPLORATION -6, I-EXPLORATION -9/mm3. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +fragmentación I-EXPLORATION de I-EXPLORATION -imágenes I-EXPLORATION -revelaron I-EXPLORATION -2 I-EXPLORATION -nódulos I-EXPLORATION -córtico-subcorticales I-EXPLORATION -en I-EXPLORATION -zonas I-EXPLORATION -frontal I-EXPLORATION -media I-EXPLORATION +fibras I-EXPLORATION +miocárdicas I-EXPLORATION y I-EXPLORATION -derecha I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -inflamatorio. I-EXPLORATION -No I-EXPLORATION -había I-EXPLORATION -compromiso I-EXPLORATION -pulmonar I-EXPLORATION -ni I-EXPLORATION -de I-EXPLORATION -otros I-EXPLORATION -sitios I-EXPLORATION -anatómicos. I-EXPLORATION +hemorragia I-EXPLORATION +reciente. I-EXPLORATION + I-EXPLORATION Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -estereotáxica I-EXPLORATION +estableció I-EXPLORATION que I-EXPLORATION -mostró I-EXPLORATION -tejido I-EXPLORATION -cerebral I-EXPLORATION -con I-EXPLORATION -gliosis I-EXPLORATION -reactiva I-EXPLORATION -y I-EXPLORATION -extenso I-EXPLORATION -infiltrado I-EXPLORATION -celular I-EXPLORATION -mixto, I-EXPLORATION -predominantemente I-EXPLORATION -perivascular I-EXPLORATION -y I-EXPLORATION -zonas I-EXPLORATION -con I-EXPLORATION -angiotropismo I-EXPLORATION -y I-EXPLORATION -angiodestruccción I-EXPLORATION -compuestas I-EXPLORATION -por I-EXPLORATION -linfocitos I-EXPLORATION -pequeños I-EXPLORATION -inmunorreactivos I-EXPLORATION -para I-EXPLORATION -CD3 I-EXPLORATION -(linfocitos I-EXPLORATION -T). I-EXPLORATION -Además I-EXPLORATION -se I-EXPLORATION -identificaron I-EXPLORATION -abundantes I-EXPLORATION -células I-EXPLORATION -linfoides I-EXPLORATION -atípicas I-EXPLORATION -medianas I-EXPLORATION -y I-EXPLORATION -grandes, I-EXPLORATION +la I-EXPLORATION +causa I-EXPLORATION de I-EXPLORATION -núcleos I-EXPLORATION -vesiculosos I-EXPLORATION +la I-EXPLORATION +muerte I-EXPLORATION +fue I-EXPLORATION +la I-EXPLORATION +herida I-EXPLORATION +punzo-cortante I-EXPLORATION +que I-EXPLORATION +interesó I-EXPLORATION +el I-EXPLORATION +corazón, I-EXPLORATION y I-EXPLORATION -pleomórficos I-EXPLORATION -inmunorreactivas I-EXPLORATION -para I-EXPLORATION -CD20 I-EXPLORATION -(linfocitos I-EXPLORATION -B). I-EXPLORATION -Los I-EXPLORATION -linfocitos I-EXPLORATION -mostraron I-EXPLORATION -reacción I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +deceso I-EXPLORATION +ocurrió I-EXPLORATION +antes I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -secuencia I-EXPLORATION -pequeña I-EXPLORATION +exposición I-EXPLORATION +térmica. I-EXPLORATION +Basándose B-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +resultados I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +necropsia, I-EVOLUTION +los I-EVOLUTION +investigadores I-EVOLUTION +interrogaron I-EVOLUTION +a I-EVOLUTION +un I-EVOLUTION +familiar I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +fallecida, I-EVOLUTION +quien I-EVOLUTION +confesó I-EVOLUTION +ser I-EVOLUTION +el I-EVOLUTION +autor I-EVOLUTION +del I-EVOLUTION +femicidio. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +37 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +realizado I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +hemorragia I-PRESENT_ILLNESS +bilateral. I-PRESENT_ILLNESS +Resto B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +interés. I-PAST_MEDICAL_HISTORY +Acude B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hace I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +bulto I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +pene, I-PRESENT_ILLNESS +doloroso I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +erección. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +presentaba I-EXPLORATION +un I-EXPLORATION +cordón I-EXPLORATION +longitudinal I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +dorso I-EXPLORATION +del I-EXPLORATION +pene I-EXPLORATION de I-EXPLORATION -ARN I-EXPLORATION -asociado I-EXPLORATION -al I-EXPLORATION -VEB I-EXPLORATION -EBER-1 I-EXPLORATION -mediante I-EXPLORATION -hibridización I-EXPLORATION -in I-EXPLORATION -situ. I-EXPLORATION -Estas I-EXPLORATION -células I-EXPLORATION -mostraron I-EXPLORATION -reacción I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -CD30, I-EXPLORATION -CD68 I-EXPLORATION +unos I-EXPLORATION +tres I-EXPLORATION +centímetros, I-EXPLORATION +móvil I-EXPLORATION y I-EXPLORATION -proteína I-EXPLORATION -S-100. I-EXPLORATION +doloroso. I-EXPLORATION +Afebril. I-EXPLORATION No I-EXPLORATION -se I-EXPLORATION -identificaron I-EXPLORATION -microorganismos I-EXPLORATION +adenopatías I-EXPLORATION +inguinales. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +eco-doppler I-EXPLORATION +peneano I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -con I-EXPLORATION -tinciones I-EXPLORATION -de I-EXPLORATION -Gram, I-EXPLORATION -PAS, I-EXPLORATION -Ziehl-Neelsen I-EXPLORATION -y I-EXPLORATION -Warthin-Starry. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -citometría I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +evidenció I-EXPLORATION +una I-EXPLORATION +clara I-EXPLORATION +trombosis I-EXPLORATION de I-EXPLORATION -flujo I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +dorsal I-EXPLORATION +superficial I-EXPLORATION del I-EXPLORATION -tejido I-EXPLORATION -cerebral I-EXPLORATION -reveló I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -atípicas I-EXPLORATION -medianas I-EXPLORATION -de I-EXPLORATION -estirpe I-EXPLORATION -B I-EXPLORATION -con I-EXPLORATION -restricción I-EXPLORATION -de I-EXPLORATION -cadena I-EXPLORATION -ligera I-EXPLORATION -Kappa, I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -síndrome I-EXPLORATION -linfoproliferativo. I-EXPLORATION -El I-EXPLORATION -mielograma I-EXPLORATION +pene I-EXPLORATION y I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +colapsaba I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -médula I-EXPLORATION -ósea I-EXPLORATION -resultaron I-EXPLORATION -negativos. I-EXPLORATION -En I-EXPLORATION -conjunto, I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -fueron I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -GL I-EXPLORATION -cerebral I-EXPLORATION -grado I-EXPLORATION -3 I-EXPLORATION -(linfoma I-EXPLORATION -B I-EXPLORATION -difuso I-EXPLORATION +presión I-EXPLORATION +del I-EXPLORATION +transductor. I-EXPLORATION +Estudio I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -grandes). I-EXPLORATION +coagulación I-EXPLORATION +normal. I-EXPLORATION I-EXPLORATION +Juicio I-EXPLORATION +Diagnóstico: I-EXPLORATION +Enfermedad I-EXPLORATION +de I-EXPLORATION +Mondor. I-EXPLORATION El B-TREATMENT -caso I-TREATMENT -comunicado I-TREATMENT -en I-TREATMENT -el I-TREATMENT -presente I-TREATMENT -artículo I-TREATMENT -fue I-TREATMENT -confirmado I-TREATMENT -como I-TREATMENT -síndrome I-TREATMENT +paciente I-TREATMENT +recibió I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +heparina I-TREATMENT de I-TREATMENT -inmunodeficiencia I-TREATMENT -por I-TREATMENT -virus I-TREATMENT -VIH I-TREATMENT -etapa I-TREATMENT -C3 I-TREATMENT +bajo I-TREATMENT +peso I-TREATMENT +molecular I-TREATMENT y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -terapia I-TREATMENT -antirretroviral. I-TREATMENT -El B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -solicitó I-DERIVED_FROM/TO -posteriormente I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -traslado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -otro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -continuar I-DERIVED_FROM/TO -manejo. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO +antiinflamatorios. I-TREATMENT + I-TREATMENT -Hombre B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +originario B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -importancia I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresó I-PRESENT_ILLNESS +Puebla I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +residente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Tijuana, I-PAST_MEDICAL_HISTORY +B.C., I-PAST_MEDICAL_HISTORY +agricultor, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +enalapril I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +amlodipino. I-PAST_MEDICAL_HISTORY +Acudió B-PRESENT_ILLNESS por I-PRESENT_ILLNESS -insuficiencia I-PRESENT_ILLNESS -respiratoria I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +ala I-PRESENT_ILLNESS +nasal I-PRESENT_ILLNESS +derecha I-PRESENT_ILLNESS +caracterizada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +volumen, I-PRESENT_ILLNESS +eritema, I-PRESENT_ILLNESS +exulceraciones I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS +exudado I-PRESENT_ILLNESS +seroso, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -neumonía. I-PRESENT_ILLNESS -Los B-EXPLORATION -cultivos I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -serologías I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -herpes I-EXPLORATION -y I-EXPLORATION -CMV I-EXPLORATION -fueron I-EXPLORATION -negativos, I-EXPLORATION -además I-EXPLORATION +dos I-PRESENT_ILLNESS +cm I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +diámetro I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cinco I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +El B-EXPLORATION +diagnóstico I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -todas I-EXPLORATION -las I-EXPLORATION -serologías I-EXPLORATION -al I-EXPLORATION -igual I-EXPLORATION -que I-EXPLORATION -los I-EXPLORATION -pacientes I-EXPLORATION -previos. I-EXPLORATION +esférulas I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +directo I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +cultivo I-EXPLORATION +positivo I-EXPLORATION +a I-EXPLORATION +Coccidioides I-EXPLORATION +spp. I-EXPLORATION Recibió B-TREATMENT tratamiento I-TREATMENT -antibiótico I-TREATMENT -empírico. I-TREATMENT -A B-EXPLORATION -las I-EXPLORATION -dos I-EXPLORATION -semanas I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -presentó I-EXPLORATION -fiebre I-EXPLORATION +con I-TREATMENT +itraconazol I-TREATMENT +400 I-TREATMENT +mg I-TREATMENT +al I-TREATMENT +día. I-TREATMENT + I-TREATMENT + +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +madre I-FAMILY_HISTORY +fallecida I-FAMILY_HISTORY +por I-FAMILY_HISTORY +hepatopatía I-FAMILY_HISTORY +crónica I-FAMILY_HISTORY +inespecífica I-FAMILY_HISTORY +evolucionada I-FAMILY_HISTORY +hacia I-FAMILY_HISTORY +cirrosis I-FAMILY_HISTORY +hepática I-FAMILY_HISTORY +y I-FAMILY_HISTORY +hermana I-FAMILY_HISTORY +con I-FAMILY_HISTORY +hepatopatía I-FAMILY_HISTORY +no I-FAMILY_HISTORY +filiada. I-FAMILY_HISTORY +En B-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +destaca I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +presencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hepatitis I-PAST_MEDICAL_HISTORY +C I-PAST_MEDICAL_HISTORY +(VHC) I-PAST_MEDICAL_HISTORY +genotipo I-PAST_MEDICAL_HISTORY +1b I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +nula I-PAST_MEDICAL_HISTORY +respuesta I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +peginterferón I-PAST_MEDICAL_HISTORY +α-2a I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +ribavirina I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +ocasiones. I-PAST_MEDICAL_HISTORY +Además, I-PAST_MEDICAL_HISTORY +cólicos I-PAST_MEDICAL_HISTORY +nefríticos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +repetición. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +febrero I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2011 I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +ictericia I-PRESENT_ILLNESS +intensa, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +prurito I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +epigastralgia I-PRESENT_ILLNESS +asociada. I-PRESENT_ILLNESS +Los B-EXPLORATION +valores I-EXPLORATION +analíticos I-EXPLORATION +más I-EXPLORATION +destacables I-EXPLORATION +fueron: I-EXPLORATION +AST I-EXPLORATION +145 I-EXPLORATION +U/L I-EXPLORATION +(0-37 I-EXPLORATION +U/L), I-EXPLORATION +ALT I-EXPLORATION +121 I-EXPLORATION +U/L I-EXPLORATION +(0-37 I-EXPLORATION +U/L), I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina I-EXPLORATION +116 I-EXPLORATION +U/L I-EXPLORATION +(50-190 I-EXPLORATION +U/L), I-EXPLORATION +GGT I-EXPLORATION +167 I-EXPLORATION +U/L I-EXPLORATION +(6-50 I-EXPLORATION +U/L), I-EXPLORATION +bilirrubina I-EXPLORATION +total I-EXPLORATION +14, I-EXPLORATION +6 I-EXPLORATION +mg/dl I-EXPLORATION +(0-1, I-EXPLORATION +8 I-EXPLORATION +mg/dl), I-EXPLORATION y I-EXPLORATION -empeoramiento I-EXPLORATION +alfa-feto I-EXPLORATION +proteína I-EXPLORATION +19, I-EXPLORATION +14 I-EXPLORATION +ng/ml I-EXPLORATION +(0-5 I-EXPLORATION +ng/ml), I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +carga I-EXPLORATION +viral I-EXPLORATION +VHC I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -imágenes I-EXPLORATION -radiológicas I-EXPLORATION -basales I-EXPLORATION -derechas. I-EXPLORATION +14.600.000 I-EXPLORATION +UI I-EXPLORATION +ml. I-EXPLORATION Se I-EXPLORATION -realizó I-EXPLORATION -BAL I-EXPLORATION +realizaron I-EXPLORATION +las I-EXPLORATION +siguientes I-EXPLORATION +pruebas I-EXPLORATION +diagnósticas: I-EXPLORATION +ecografía I-EXPLORATION +digestiva, I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION que I-EXPLORATION no I-EXPLORATION -mostró I-EXPLORATION -crecimiento I-EXPLORATION -bacteriano. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -desarrolló I-EXPLORATION -paulatinamente I-EXPLORATION -citopenias I-EXPLORATION +se I-EXPLORATION +apreciaban I-EXPLORATION +lesiones I-EXPLORATION +ocupantes I-EXPLORATION +del I-EXPLORATION +espacio I-EXPLORATION +ni I-EXPLORATION +dilatación I-EXPLORATION de I-EXPLORATION las I-EXPLORATION -tres I-EXPLORATION -series: I-EXPLORATION -Hb: I-EXPLORATION -7 I-EXPLORATION -g/l; I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -leucocitos: I-EXPLORATION -1.600/ I-EXPLORATION -mm3; I-EXPLORATION -plaquetas: I-EXPLORATION -49.000 I-EXPLORATION -/mm3. I-EXPLORATION -La I-EXPLORATION -ferritina I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -4.000 I-EXPLORATION -µg/l, I-EXPLORATION -trigliceridos I-EXPLORATION -607 I-EXPLORATION -mg/dl, I-EXPLORATION -fibrinógeno I-EXPLORATION -111%. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION +vías I-EXPLORATION +biliares I-EXPLORATION +y I-EXPLORATION +mostraba I-EXPLORATION una I-EXPLORATION -PAMO I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION +bilis I-EXPLORATION +espesa I-EXPLORATION +sin I-EXPLORATION +datos I-EXPLORATION +concluyentes I-EXPLORATION de I-EXPLORATION -macrófagos I-EXPLORATION +colelitiasis; I-EXPLORATION +colangio-RM I-EXPLORATION en I-EXPLORATION -10% I-EXPLORATION -con I-EXPLORATION -hemofa-gocitosis. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -solo I-EXPLORATION -presentó I-EXPLORATION -ligera I-EXPLORATION -hepato I-EXPLORATION -esplenomegalia. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -le I-TREATMENT -administró I-TREATMENT -metilprednisona I-TREATMENT -a I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -1 I-TREATMENT -g/día I-TREATMENT -por I-TREATMENT -tres I-TREATMENT -días I-TREATMENT -y I-TREATMENT -gammaglobulina I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -400 I-TREATMENT -mg/kg/día I-TREATMENT -por I-TREATMENT -5 I-TREATMENT -días. I-TREATMENT -Evolucionó B-EVOLUTION -con I-EVOLUTION -fiebre I-EVOLUTION -persistente I-EVOLUTION -y B-TREATMENT -requerimiento I-TREATMENT -de I-TREATMENT -asistencia I-TREATMENT -respiratoria I-TREATMENT -mecánica. I-TREATMENT -Las B-EVOLUTION -citopenias I-EVOLUTION -no I-EVOLUTION -mejoraron. I-EVOLUTION -Se B-EXPLORATION -repitieron I-EXPLORATION -cultivos I-EXPLORATION +la I-EXPLORATION que I-EXPLORATION -siempre I-EXPLORATION -fueron I-EXPLORATION -negativos, I-EXPLORATION -a I-EXPLORATION -excepción I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -BAL I-EXPLORATION +se I-EXPLORATION +descartó I-EXPLORATION +coledocolitiasis I-EXPLORATION +y I-EXPLORATION +litiasis I-EXPLORATION +intrahepática; I-EXPLORATION +endoscopia I-EXPLORATION +oral I-EXPLORATION +normal; I-EXPLORATION +angio-TAC I-EXPLORATION que I-EXPLORATION -evidenció I-EXPLORATION +mostró I-EXPLORATION +hepatomegalia I-EXPLORATION +homogénea I-EXPLORATION +y I-EXPLORATION +ecoendoscopia I-EXPLORATION +que I-EXPLORATION +descartó I-EXPLORATION +lesiones I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -crecimiento I-EXPLORATION -significativo I-EXPLORATION -de I-EXPLORATION +páncreas I-EXPLORATION +o I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar. I-EXPLORATION +La I-EXPLORATION +biopsia I-EXPLORATION +hepática I-EXPLORATION +reveló I-EXPLORATION una I-EXPLORATION -Acinetobacter I-EXPLORATION -baumannii I-EXPLORATION -multirresistente I-EXPLORATION -que B-TREATMENT -recibió I-TREATMENT -tratamiento. I-TREATMENT -Falleció B-EVOLUTION +fibrosis I-EXPLORATION +grado I-EXPLORATION +3 I-EXPLORATION +según I-EXPLORATION +METAVIR I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +hepatitis I-EXPLORATION +C, I-EXPLORATION +sin I-EXPLORATION +otras I-EXPLORATION +alteraciones I-EXPLORATION +valorables. I-EXPLORATION + I-EXPLORATION +Un B-EVOLUTION +año I-EVOLUTION +después I-EVOLUTION +(febrero I-EVOLUTION +2012) I-EVOLUTION +vuelve I-EVOLUTION a I-EVOLUTION -los I-EVOLUTION -44 I-EVOLUTION -días I-EVOLUTION +consulta I-EVOLUTION +presentando I-EVOLUTION +un I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +similares I-EVOLUTION +características I-EVOLUTION +(ictericia, I-EVOLUTION +prurito I-EVOLUTION +y I-EVOLUTION +epigastralgia); I-EVOLUTION +ante B-TREATMENT +la I-TREATMENT +recurrencia I-TREATMENT +del I-TREATMENT +cuadro I-TREATMENT +se I-TREATMENT +prescribió I-TREATMENT +AUDC, I-TREATMENT +con B-EVOLUTION +una I-EVOLUTION +mejoría I-EVOLUTION +rápida I-EVOLUTION del I-EVOLUTION -ingreso I-EVOLUTION -con I-EVOLUTION -falla I-EVOLUTION -multiorgánica. I-EVOLUTION +cuadro. I-EVOLUTION I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -candidato I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -trasplante I-PRESENT_ILLNESS -hepático. I-PRESENT_ILLNESS -Presentó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -hepatorenal I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -motivó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -importante I-PRESENT_ILLNESS -aporte I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -furosemida, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -obtener I-PRESENT_ILLNESS -respuesta I-PRESENT_ILLNESS -diurética. I-PRESENT_ILLNESS -A I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -esto I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encontró I-PRESENT_ILLNESS -donante. I-PRESENT_ILLNESS -En B-EXPLORATION -ese I-EXPLORATION -momento I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -estaba I-EXPLORATION -soporoso, I-EXPLORATION -con I-EXPLORATION -escasa I-EXPLORATION -respuesta I-EXPLORATION -a I-EXPLORATION -estímulos I-EXPLORATION -verbales, I-EXPLORATION -PA I-EXPLORATION -110/60, I-EXPLORATION -FC I-EXPLORATION -115 I-EXPLORATION -por I-EXPLORATION -minuto, I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION -35x'. I-EXPLORATION -Un I-EXPLORATION -ecocardiograma I-EXPLORATION -de I-EXPLORATION -superficie I-EXPLORATION -mostró I-EXPLORATION -buena I-EXPLORATION -función I-EXPLORATION -ventricular I-EXPLORATION -global, I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -cuatro I-EXPLORATION -cavidades I-EXPLORATION +Ante B-EXPLORATION +la I-EXPLORATION +clínica I-EXPLORATION +recidivante I-EXPLORATION y I-EXPLORATION -presión I-EXPLORATION -sistólica I-EXPLORATION -de I-EXPLORATION -arteria I-EXPLORATION -pulmonar I-EXPLORATION -(PSAP) I-EXPLORATION +la I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -50 I-EXPLORATION -mmHg. I-EXPLORATION -En I-EXPLORATION -pabellón, I-EXPLORATION +causa I-EXPLORATION +etiológica, I-EXPLORATION se I-EXPLORATION -intubó I-EXPLORATION -e I-EXPLORATION -instaló I-EXPLORATION -sonda I-EXPLORATION -para I-EXPLORATION -ETE I-EXPLORATION -y I-EXPLORATION -CAP I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION +sospechó I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +síndrome I-EXPLORATION +LPAC. I-EXPLORATION +Se I-EXPLORATION +envió I-EXPLORATION una I-EXPLORATION -PVC I-EXPLORATION +muestra I-EXPLORATION +al I-EXPLORATION +Hospital I-EXPLORATION +Universitario I-EXPLORATION +La I-EXPLORATION +Paz I-EXPLORATION +(Madrid) I-EXPLORATION +para I-EXPLORATION +estudio I-EXPLORATION +inmunohistoquímico I-EXPLORATION de I-EXPLORATION -25 I-EXPLORATION -mmHg, I-EXPLORATION -PCP I-EXPLORATION -26 I-EXPLORATION -mm I-EXPLORATION -Hg, I-EXPLORATION -RVSI I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +hepática, I-EXPLORATION +apreciándose I-EXPLORATION +una I-EXPLORATION +expresión I-EXPLORATION +canicular I-EXPLORATION +normal I-EXPLORATION de I-EXPLORATION -987 I-EXPLORATION -dinas*segundo/cm5/m2. I-EXPLORATION -El I-EXPLORATION -IC I-EXPLORATION -y I-EXPLORATION -PSAP I-EXPLORATION -medidas I-EXPLORATION -por I-EXPLORATION -CAP I-EXPLORATION -y I-EXPLORATION -ETE I-EXPLORATION -fueron I-EXPLORATION -respectivamente I-EXPLORATION -4, I-EXPLORATION -7 I-EXPLORATION -y I-EXPLORATION -5, I-EXPLORATION -3 I-EXPLORATION -1/ I-EXPLORATION -m2, I-EXPLORATION -y I-EXPLORATION -49/32 I-EXPLORATION -y I-EXPLORATION -48. I-EXPLORATION -El I-EXPLORATION -volumen I-EXPLORATION +MRD3. I-EXPLORATION +Posteriormente I-EXPLORATION +se I-EXPLORATION +estudió I-EXPLORATION +la I-EXPLORATION +secuencia I-EXPLORATION +codificante I-EXPLORATION +del I-EXPLORATION +gen I-EXPLORATION +ABCB4 I-EXPLORATION +(muestra I-EXPLORATION de I-EXPLORATION -fin I-EXPLORATION +ADN I-EXPLORATION de I-EXPLORATION -diástole I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo I-EXPLORATION -indexado I-EXPLORATION -(VFDVII) I-EXPLORATION -fue I-EXPLORATION -98 I-EXPLORATION -ml/m2 I-EXPLORATION -(valor I-EXPLORATION -normal: I-EXPLORATION -35-75 I-EXPLORATION -ml/m2). I-EXPLORATION -Se B-TREATMENT -aportaron I-TREATMENT -fluidos I-TREATMENT -de I-TREATMENT -manera I-TREATMENT -muy I-TREATMENT -restringida, I-TREATMENT -observándose I-TREATMENT -durante I-TREATMENT -todo I-TREATMENT -el I-TREATMENT -procedimiento I-TREATMENT -buena I-TREATMENT -concordancia I-TREATMENT -entre I-TREATMENT -los I-TREATMENT -valores I-TREATMENT -de I-TREATMENT -IC I-TREATMENT -y I-TREATMENT -PSAP I-TREATMENT -medidos I-TREATMENT -con I-TREATMENT -CAP I-TREATMENT -y I-TREATMENT -ETE. I-TREATMENT -Al B-EXPLORATION -término I-EXPLORATION +linfocitos I-EXPLORATION de I-EXPLORATION +sangre I-EXPLORATION +periférica) I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +Hospital I-EXPLORATION +Universitario I-EXPLORATION +Saint-Antoine I-EXPLORATION +(París) I-EXPLORATION +mediante I-EXPLORATION la I-EXPLORATION -cirugía I-EXPLORATION -la I-EXPLORATION -PVC I-EXPLORATION -era I-EXPLORATION -14 I-EXPLORATION -mmHg, I-EXPLORATION -PCP I-EXPLORATION -19 I-EXPLORATION -mmHg, I-EXPLORATION -PAP I-EXPLORATION -33/22 I-EXPLORATION -e I-EXPLORATION -IC I-EXPLORATION -5, I-EXPLORATION -1/ I-EXPLORATION -m2. I-EXPLORATION -El I-EXPLORATION -ETE I-EXPLORATION -mostraba I-EXPLORATION +tecnología I-EXPLORATION +Roche I-EXPLORATION +454 I-EXPLORATION +GS I-EXPLORATION +Junior I-EXPLORATION +sequencing, I-EXPLORATION +siendo I-EXPLORATION +esta I-EXPLORATION una I-EXPLORATION -PSAP I-EXPLORATION -de I-EXPLORATION -32, I-EXPLORATION -IC I-EXPLORATION +nueva I-EXPLORATION +generación I-EXPLORATION de I-EXPLORATION -5 I-EXPLORATION -1/ I-EXPLORATION -m2, I-EXPLORATION -y I-EXPLORATION -VFDVI67ml/m2. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -hipertenso B-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tabáquico, I-PAST_MEDICAL_HISTORY -programado B-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -tiroidectomía I-PRESENT_ILLNESS -total. I-PRESENT_ILLNESS -Inducción B-EXPLORATION -anestésica I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -hemodinámicas, I-EXPLORATION -pero I-EXPLORATION -con I-EXPLORATION -modificación I-EXPLORATION +secuenciación I-EXPLORATION +del I-EXPLORATION +ADN I-EXPLORATION +por I-EXPLORATION +medio I-EXPLORATION de I-EXPLORATION -onda I-EXPLORATION -T I-EXPLORATION -y I-EXPLORATION -segmento I-EXPLORATION -ST I-EXPLORATION -sugerente I-EXPLORATION +una I-EXPLORATION +secuenciación I-EXPLORATION +ultraprofunda I-EXPLORATION de I-EXPLORATION -isquemia. I-EXPLORATION -La I-EXPLORATION -ETE I-EXPLORATION +productos I-EXPLORATION +PCR, I-EXPLORATION no I-EXPLORATION -mostraba I-EXPLORATION -alteraciones I-EXPLORATION +encontrándose I-EXPLORATION +tampoco I-EXPLORATION +ninguna I-EXPLORATION +mutación. I-EXPLORATION +Ante I-EXPLORATION +la I-EXPLORATION +persistencia I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -motilidad I-EXPLORATION -ventricular. I-EXPLORATION -Se I-EXPLORATION -decide I-EXPLORATION -suspender I-EXPLORATION -y I-EXPLORATION -realizar I-EXPLORATION -coronariografía I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -antecedentes I-PRESENT_ILLNESS -mórbidos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -importancia, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -rápida I-PRESENT_ILLNESS -progresión, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -expectoración I-PRESENT_ILLNESS -hemoptoica I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -general. I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -AngioTAC I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -tumoral, I-EXPLORATION -intracavitaria I-EXPLORATION +sospecha I-EXPLORATION +clínica, I-EXPLORATION en I-EXPLORATION -aurícula I-EXPLORATION -izquierda I-EXPLORATION -infiltrativa I-EXPLORATION -a I-EXPLORATION -venas I-EXPLORATION -pulmonares. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -complementó I-EXPLORATION +el I-EXPLORATION +Hospital I-EXPLORATION +Universitario I-EXPLORATION +La I-EXPLORATION +Paz I-EXPLORATION +se I-EXPLORATION +analizó I-EXPLORATION +nuevamente I-EXPLORATION +el I-EXPLORATION +gen I-EXPLORATION +ABCB4 I-EXPLORATION +esta I-EXPLORATION +vez I-EXPLORATION con I-EXPLORATION -ecocardiograma I-EXPLORATION -confirmando I-EXPLORATION -masa I-EXPLORATION -hiperdensa I-EXPLORATION +la I-EXPLORATION +técnica I-EXPLORATION +MLPA® I-EXPLORATION +(Multiplex I-EXPLORATION +Ligation-dependent I-EXPLORATION +Probe I-EXPLORATION +Amplification) I-EXPLORATION +(9), I-EXPLORATION +tratándose I-EXPLORATION de I-EXPLORATION -43 I-EXPLORATION -x I-EXPLORATION -38 I-EXPLORATION -mm I-EXPLORATION -ocupando I-EXPLORATION +una I-EXPLORATION +técnica I-EXPLORATION +complementaria I-EXPLORATION +que I-EXPLORATION +detecta I-EXPLORATION +cambios I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -75% I-EXPLORATION +número I-EXPLORATION +de I-EXPLORATION +copias I-EXPLORATION +genómicas, I-EXPLORATION +inserciones I-EXPLORATION +o I-EXPLORATION +deleciones I-EXPLORATION +no I-EXPLORATION +detectados I-EXPLORATION +por I-EXPLORATION +los I-EXPLORATION +métodos I-EXPLORATION +convencionales I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -aurícula I-EXPLORATION -izquierda. I-EXPLORATION - I-EXPLORATION +secuenciación. I-EXPLORATION Se I-EXPLORATION -resecó I-EXPLORATION -quirúrgicamente I-EXPLORATION -cerca I-EXPLORATION -de I-EXPLORATION -95% I-EXPLORATION +comparó I-EXPLORATION +la I-EXPLORATION +muestra I-EXPLORATION del I-EXPLORATION -tumor I-EXPLORATION -por I-EXPLORATION -infiltración I-EXPLORATION -a I-EXPLORATION -venas I-EXPLORATION -pulmonares. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -histológico I-EXPLORATION -demostró I-EXPLORATION +paciente I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +muestra I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +hermana I-EXPLORATION +(control I-EXPLORATION +1) I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION de I-EXPLORATION un I-EXPLORATION -tumor I-EXPLORATION -fusado I-EXPLORATION -con I-EXPLORATION -algunas I-EXPLORATION -células I-EXPLORATION -ovaladas, I-EXPLORATION -pericitos, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -disponían I-EXPLORATION +individuo I-EXPLORATION +sano I-EXPLORATION +(control I-EXPLORATION +2). I-EXPLORATION +Se I-EXPLORATION +identificó I-EXPLORATION +una I-EXPLORATION +mutación I-EXPLORATION en I-EXPLORATION -un I-EXPLORATION -patrón I-EXPLORATION -sólido, I-EXPLORATION -interrumpido I-EXPLORATION -por I-EXPLORATION -espacios I-EXPLORATION -vasculares I-EXPLORATION -delgados, I-EXPLORATION -revestidos I-EXPLORATION +heterocigosis I-EXPLORATION por I-EXPLORATION -células I-EXPLORATION -endoteliales I-EXPLORATION -y I-EXPLORATION -aplanadas. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -inmuno-histoquímica I-EXPLORATION -demostró I-EXPLORATION -reactividad I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -vimentina I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -proliferantes, I-EXPLORATION -CD-34 I-EXPLORATION -positivo I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -endotelio I-EXPLORATION +la I-EXPLORATION +deleción I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -vasos I-EXPLORATION -y I-EXPLORATION -pericitos, I-EXPLORATION -factor I-EXPLORATION -VIII I-EXPLORATION -positivo I-EXPLORATION -sólo I-EXPLORATION -en I-EXPLORATION -endotelio, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -negatividad I-EXPLORATION -para I-EXPLORATION -S-100 I-EXPLORATION -y I-EXPLORATION -CD-68. I-EXPLORATION -Estos I-EXPLORATION -hallazgos, I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -claro I-EXPLORATION -patrón I-EXPLORATION +un I-EXPLORATION +fragmento I-EXPLORATION de I-EXPLORATION -reticulina I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -técnicas I-EXPLORATION -argénticas, I-EXPLORATION -indicaron I-EXPLORATION +gen I-EXPLORATION +que I-EXPLORATION +contiene I-EXPLORATION el I-EXPLORATION -carácter I-EXPLORATION -pericítico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -neoplasia I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -su I-EXPLORATION -carácter I-EXPLORATION -benigno I-EXPLORATION -histológico, I-EXPLORATION +exón I-EXPLORATION +4 I-EXPLORATION +completo, I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION -mitótico I-EXPLORATION -inferior I-EXPLORATION -a I-EXPLORATION -tres I-EXPLORATION -mitosis I-EXPLORATION -por I-EXPLORATION -10 I-EXPLORATION -campos I-EXPLORATION -de I-EXPLORATION -mayor I-EXPLORATION -aumento. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -satisfactoriamente I-EVOLUTION -post I-EVOLUTION -cirugía I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -decidió I-EVOLUTION -el I-EVOLUTION -alta. I-EVOLUTION - I-EVOLUTION -Al I-EVOLUTION -mes I-EVOLUTION -siguiente, I-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -consultar I-EVOLUTION -por I-EVOLUTION -presentar I-EVOLUTION -dolor I-EVOLUTION -cervical I-EVOLUTION -intenso I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -odinofagia. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION +una I-EXPLORATION +deficiencia I-EXPLORATION +parcial I-EXPLORATION de I-EXPLORATION -diseminación I-EXPLORATION -con I-EXPLORATION -PET-CP I-EXPLORATION -que I-EXPLORATION -mostraba I-EXPLORATION -zonas I-EXPLORATION -hipermetabólicas I-EXPLORATION -en I-EXPLORATION -pulmón, I-EXPLORATION -base I-EXPLORATION +MDR3 I-EXPLORATION +(10), I-EXPLORATION +confirmándose I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -cráneo, I-EXPLORATION -hígado, I-EXPLORATION -amígdala I-EXPLORATION -izquierda, I-EXPLORATION -aurícula I-EXPLORATION -izquierda, I-EXPLORATION -suprarrenal I-EXPLORATION -izquierda, I-EXPLORATION -cola I-EXPLORATION -de I-EXPLORATION -páncreas I-EXPLORATION -y I-EXPLORATION -colon I-EXPLORATION -descendente. I-EXPLORATION -Esto I-EXPLORATION -se I-EXPLORATION -explicó I-EXPLORATION -por I-EXPLORATION -embolización I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -circulación I-EXPLORATION -sistémica. I-EXPLORATION +LPAC. I-EXPLORATION I-EXPLORATION -Se B-TREATMENT -presentó I-TREATMENT -caso I-TREATMENT -a I-TREATMENT -comité I-TREATMENT -oncológico I-TREATMENT + +Se B-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +78 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +fáquico, I-PRESENT_ILLNESS +diagnosticado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +degeneración I-PRESENT_ILLNESS +macular I-PRESENT_ILLNESS +asociada I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +exudativa I-PRESENT_ILLNESS +(DMAE) I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +al B-TREATMENT que I-TREATMENT +se I-TREATMENT +le I-TREATMENT +realiza I-TREATMENT +terapia I-TREATMENT +fotodinámica I-TREATMENT +(TFD). I-TREATMENT +48 I-TREATMENT +horas I-TREATMENT +después I-TREATMENT +se I-TREATMENT +le I-TREATMENT +inyecta I-TREATMENT +en I-TREATMENT +cámara I-TREATMENT +vítrea I-TREATMENT +20 I-TREATMENT +mg I-TREATMENT +en I-TREATMENT +0, I-TREATMENT +1 I-TREATMENT +ml I-TREATMENT +de I-TREATMENT +acetato I-TREATMENT +de I-TREATMENT +triamcinolona I-TREATMENT +obtenida I-TREATMENT +mediante I-TREATMENT +la I-TREATMENT +técnica I-TREATMENT +de I-TREATMENT +sedimentación. I-TREATMENT + I-TREATMENT +La I-TREATMENT +operación I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +en I-TREATMENT +el I-TREATMENT +quirófano I-TREATMENT +bajo I-TREATMENT +medidas I-TREATMENT +asépticas. I-TREATMENT +La I-TREATMENT +inyección I-TREATMENT +se I-TREATMENT +hizo I-TREATMENT +con I-TREATMENT +aguja I-TREATMENT +de I-TREATMENT +27 I-TREATMENT +G I-TREATMENT +a I-TREATMENT +4 I-TREATMENT +mm I-TREATMENT +del I-TREATMENT +limbo I-TREATMENT +en I-TREATMENT +el I-TREATMENT +cuadrante I-TREATMENT +temporo-inferior I-TREATMENT +ayudado I-TREATMENT +de I-TREATMENT +un I-TREATMENT +blefarostato. I-TREATMENT +Durante I-TREATMENT +el I-TREATMENT +procedimiento, I-TREATMENT +y I-TREATMENT +coincidiendo I-TREATMENT +con I-TREATMENT +un I-TREATMENT +intento I-TREATMENT +de I-TREATMENT +cierre I-TREATMENT +forzado I-TREATMENT +de I-TREATMENT +los I-TREATMENT +párpados, I-TREATMENT +se I-TREATMENT +observó I-TREATMENT +con I-TREATMENT +el I-TREATMENT +microscopio I-TREATMENT +cómo I-TREATMENT +parte I-TREATMENT +de I-TREATMENT +la I-TREATMENT +sustancia I-TREATMENT +lechosa I-TREATMENT +pasaba I-TREATMENT +a I-TREATMENT +cámara I-TREATMENT +anterior. I-TREATMENT + I-TREATMENT +Se I-TREATMENT decidió I-TREATMENT -manejo I-TREATMENT -paliativo I-TREATMENT +actuar I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +expectante I-TREATMENT +instilando I-TREATMENT +colirio I-TREATMENT +de I-TREATMENT +ciprofloxacino I-TREATMENT y I-TREATMENT -del I-TREATMENT -dolor. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -meses, I-EVOLUTION +observando I-TREATMENT +el I-TREATMENT +pulso I-TREATMENT +arterial I-TREATMENT +espontáneo. I-TREATMENT +Al B-EVOLUTION +día I-EVOLUTION +siguiente I-EVOLUTION el I-EVOLUTION paciente I-EVOLUTION -falleció I-EVOLUTION +presentaba I-EVOLUTION +la I-EVOLUTION +triamcinolona I-EVOLUTION +precipitada I-EVOLUTION +en I-EVOLUTION +cámara I-EVOLUTION +anterior I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +cámara I-EVOLUTION +vítrea I-EVOLUTION +sin I-EVOLUTION +otros I-EVOLUTION +signos I-EVOLUTION +inflamatorios. I-EVOLUTION +La B-TREATMENT +PIO I-TREATMENT +era I-TREATMENT +de I-TREATMENT +25 I-TREATMENT +mm I-TREATMENT +Hg, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +prescribió I-TREATMENT +maleato I-TREATMENT +de I-TREATMENT +timolol I-TREATMENT +al I-TREATMENT +0, I-TREATMENT +5% I-TREATMENT +en I-TREATMENT +colirio I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas. I-TREATMENT + I-TREATMENT +Se B-EVOLUTION +le I-EVOLUTION +realizaron I-EVOLUTION +controles I-EVOLUTION +periódicos I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +detectó I-EVOLUTION +un I-EVOLUTION +descenso I-EVOLUTION de I-EVOLUTION -falla I-EVOLUTION -multiorgánica. I-EVOLUTION +la I-EVOLUTION +PIO I-EVOLUTION +hasta I-EVOLUTION +valores I-EVOLUTION +normales, I-EVOLUTION +una I-EVOLUTION +reabsorción I-EVOLUTION +progresiva I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +triamcinolona I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +córnea I-EVOLUTION +transparente I-EVOLUTION +sin I-EVOLUTION +reacción I-EVOLUTION +inflamatoria. I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +dos I-EVOLUTION +meses I-EVOLUTION +quedaban I-EVOLUTION +escasos I-EVOLUTION +restos I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +sustancia, I-EVOLUTION +la I-EVOLUTION +PIO I-EVOLUTION +era I-EVOLUTION +de I-EVOLUTION +17 I-EVOLUTION +mm I-EVOLUTION +Hg I-EVOLUTION +sin I-EVOLUTION +tratamiento I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +biomicroscopía I-EVOLUTION +endotelial I-EVOLUTION +resultó I-EVOLUTION +un I-EVOLUTION +recuento I-EVOLUTION +celular I-EVOLUTION +normal I-EVOLUTION +e I-EVOLUTION +igual I-EVOLUTION +que I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +ojo I-EVOLUTION +contralateral. I-EVOLUTION I-EVOLUTION -Hombre B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -73 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY +65 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +70 I-PRESENT_ILLNESS +kg I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -valsartán I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hidroclorotiazida I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -trombocitemia I-PAST_MEDICAL_HISTORY -esencial I-PAST_MEDICAL_HISTORY -bajo I-PAST_MEDICAL_HISTORY -terapia I-PAST_MEDICAL_HISTORY -inicialmente I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hidroxiurea I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -luego I-PAST_MEDICAL_HISTORY -anagrelide. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -mediados I-PRESENT_ILLNESS +interés I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +RTU I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -diciembre I-PRESENT_ILLNESS +próstata. I-PRESENT_ILLNESS +Desde I-PRESENT_ILLNESS +hace I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +medio I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +sintomatología I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -2007 I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -porque I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -fatigabilidad, I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -adinamia, I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -nocturna, I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +prostático. I-PRESENT_ILLNESS +Estudiado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -esfuerzo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -seca I-PRESENT_ILLNESS -frecuente I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -productiva. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -tenido I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS +Urología, I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +diagnostica I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +hipertrofia I-PRESENT_ILLNESS +benigna I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -prurito. I-PRESENT_ILLNESS +próstata. I-PRESENT_ILLNESS El B-EXPLORATION -electrocardiograma I-EXPLORATION -y I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -fueron I-EXPLORATION -normales, I-EXPLORATION -salvo I-EXPLORATION -elongación I-EXPLORATION -aórtica I-EXPLORATION -moderada I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -ecocardiograma I-EXPLORATION -mostró I-EXPLORATION -insuficiencia I-EXPLORATION -aórtica I-EXPLORATION -leve, I-EXPLORATION -aurícula I-EXPLORATION -y I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -y I-EXPLORATION -función I-EXPLORATION -conservada. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -hemograma I-EXPLORATION -destacaba I-EXPLORATION -hematocrito I-EXPLORATION -de I-EXPLORATION -29%, I-EXPLORATION -macrocitosis, I-EXPLORATION -rouleaux I-EXPLORATION -++, I-EXPLORATION -VHS I-EXPLORATION -49 I-EXPLORATION -mm/hora I-EXPLORATION -y I-EXPLORATION -plaquetas I-EXPLORATION -de I-EXPLORATION -717.000 I-EXPLORATION -mm3. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -generales I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Una B-EVOLUTION -semana I-EVOLUTION -después I-EVOLUTION -presentó I-EVOLUTION -esputo I-EVOLUTION -hemoptoico I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -hospitalizado I-EVOLUTION -por I-EVOLUTION -sospecha I-EVOLUTION -de I-EVOLUTION -embolia I-EVOLUTION -pulmonar. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -AngioTAC I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -que I-EXPLORATION -descartó I-EXPLORATION -trombos I-EXPLORATION -pero I-EXPLORATION -mostró I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -aorta I-EXPLORATION -ascendente, I-EXPLORATION -sobre I-EXPLORATION -el I-EXPLORATION -plano I-EXPLORATION -valvular I-EXPLORATION -aórtico, I-EXPLORATION -estaba I-EXPLORATION -cubierta I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -tejido I-EXPLORATION -hipodenso, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extendía I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -aorta I-EXPLORATION -abdominal I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -mesentérica I-EXPLORATION -inferior. I-EXPLORATION -También I-EXPLORATION -presentaban I-EXPLORATION -un I-EXPLORATION -halo I-EXPLORATION -similar I-EXPLORATION -las I-EXPLORATION -arterias I-EXPLORATION -subclavia I-EXPLORATION -izquierda, I-EXPLORATION -renales I-EXPLORATION -y I-EXPLORATION -mesentérica I-EXPLORATION -superior I-EXPLORATION -(AMS). I-EXPLORATION -Las I-EXPLORATION -arterias I-EXPLORATION -renales I-EXPLORATION -y I-EXPLORATION -mesentéricas I-EXPLORATION -estaban I-EXPLORATION -estenosadas, I-EXPLORATION -el I-EXPLORATION -tronco I-EXPLORATION -celíaco I-EXPLORATION +examen I-EXPLORATION +preoperatorio I-EXPLORATION +no I-EXPLORATION presentaba I-EXPLORATION -dilatación I-EXPLORATION -post-estenótica I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -flujo I-EXPLORATION -sanguíneo I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -AMS I-EXPLORATION -era I-EXPLORATION -filiforme. I-EXPLORATION -Existía I-EXPLORATION -un I-EXPLORATION -leve I-EXPLORATION -derrame I-EXPLORATION -pericárdico, I-EXPLORATION -esplenomegalia I-EXPLORATION -de I-EXPLORATION -15 I-EXPLORATION -cm I-EXPLORATION +alteraciones I-EXPLORATION +(electrocardiograma, I-EXPLORATION +hemograma I-EXPLORATION y I-EXPLORATION -edema I-EXPLORATION -perinéfrico I-EXPLORATION -bilateral. I-EXPLORATION -El I-EXPLORATION -cintigrama I-EXPLORATION -renal I-EXPLORATION -mostró I-EXPLORATION -disminución I-EXPLORATION +bioquímica I-EXPLORATION +normales). I-EXPLORATION +Se B-TREATMENT +programa I-TREATMENT +para I-TREATMENT +RTU. I-TREATMENT +No I-TREATMENT +se I-TREATMENT +realizo I-TREATMENT +premedicación. I-TREATMENT +La I-TREATMENT +anestesia I-TREATMENT +intrarraquídea I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +con I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +en I-TREATMENT +sedestación. I-TREATMENT +Antes B-EXPLORATION de I-EXPLORATION la I-EXPLORATION -perfusión I-EXPLORATION -y I-EXPLORATION -función I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -(RD I-EXPLORATION -62%, I-EXPLORATION -RI I-EXPLORATION -38%). I-EXPLORATION -Los I-EXPLORATION -vasos I-EXPLORATION -del I-EXPLORATION -cuello I-EXPLORATION -eran I-EXPLORATION -normales I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -ecografía. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -angioresonancia I-EXPLORATION -el I-EXPLORATION -tejido I-EXPLORATION -periaórtico I-EXPLORATION +inducción I-EXPLORATION +anestésica I-EXPLORATION se I-EXPLORATION -reforzó I-EXPLORATION -con I-EXPLORATION -gadolinio I-EXPLORATION -concluyéndose I-EXPLORATION -que I-EXPLORATION -era I-EXPLORATION +monitorizo I-EXPLORATION un I-EXPLORATION -tejido I-EXPLORATION -inflamatorio-fibroso. I-EXPLORATION -La I-EXPLORATION -estenosis I-EXPLORATION -de I-EXPLORATION -AMS I-EXPLORATION -era I-EXPLORATION -crítica; I-EXPLORATION -las I-EXPLORATION -dos I-EXPLORATION -arterias I-EXPLORATION -renales I-EXPLORATION -izquierdas I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -tronco I-EXPLORATION -celíaco I-EXPLORATION -presentaban I-EXPLORATION -estenosis I-EXPLORATION -de I-EXPLORATION -70% I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -renal I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -mesentérica I-EXPLORATION -inferior, I-EXPLORATION -estenosis I-EXPLORATION -de I-EXPLORATION -50%. I-EXPLORATION -Los I-EXPLORATION -senos I-EXPLORATION -renales I-EXPLORATION +electrocardiograma I-EXPLORATION +continuo I-EXPLORATION +(ECG), I-EXPLORATION +una I-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION +(PA) I-EXPLORATION +no I-EXPLORATION +invasiva I-EXPLORATION y I-EXPLORATION -áreas I-EXPLORATION -perinéfricas I-EXPLORATION -estaban I-EXPLORATION -ocupados I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -tejido I-EXPLORATION -que I-EXPLORATION -envolvía I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -aorta. I-EXPLORATION -Se B-TREATMENT -instaló I-TREATMENT -stents I-TREATMENT -en I-TREATMENT -AMS I-TREATMENT +SpO2. I-EXPLORATION +La B-TREATMENT +intervención I-TREATMENT +tuvo I-TREATMENT +duración I-TREATMENT +de I-TREATMENT +60 I-TREATMENT +minutos I-TREATMENT y I-TREATMENT -en I-TREATMENT -ambas I-TREATMENT -arterias I-TREATMENT -renales, I-TREATMENT -mejorando B-EVOLUTION +transcurrio I-TREATMENT +sin I-TREATMENT +incidencias. I-TREATMENT +Durante I-TREATMENT +la I-TREATMENT +misma I-TREATMENT +se I-TREATMENT +administraron I-TREATMENT +3, I-TREATMENT +5 I-TREATMENT +litros I-TREATMENT +de I-TREATMENT +agua I-TREATMENT +estéril I-TREATMENT +(hipotónica) I-TREATMENT +como I-TREATMENT +liquido I-TREATMENT +de I-TREATMENT +irrigación, I-TREATMENT +contabilizandose I-TREATMENT +un I-TREATMENT +balance I-TREATMENT +negativo I-TREATMENT +de I-TREATMENT +1500ml. I-TREATMENT +En B-EVOLUTION la I-EVOLUTION -perfusión. I-EVOLUTION -El B-EXPLORATION -radiólogo I-EXPLORATION -planteó I-EXPLORATION -ECD. I-EXPLORATION -El I-EXPLORATION -cintigrama I-EXPLORATION -óseo I-EXPLORATION -fue I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -dicho I-EXPLORATION -diagnóstico I-EXPLORATION -al I-EXPLORATION -mostrar I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -captación I-EXPLORATION -en I-EXPLORATION -fémures I-EXPLORATION -y I-EXPLORATION -tibias. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -60 I-TREATMENT -mg/día I-TREATMENT +sala I-EVOLUTION +de I-EVOLUTION +despertar I-EVOLUTION +presento I-EVOLUTION +vómitos I-EVOLUTION +e I-EVOLUTION +hipotensión I-EVOLUTION +(100/60mmHg). I-EVOLUTION +No B-TREATMENT +se I-TREATMENT +objetivaron I-TREATMENT +alteraciones I-TREATMENT +neurológicas, I-TREATMENT +ni I-TREATMENT +cardiovasculares, I-TREATMENT +ni I-TREATMENT +edema I-TREATMENT +pulmonar. I-TREATMENT +ECG I-TREATMENT y I-TREATMENT -metotrexato I-TREATMENT +Rx I-TREATMENT +torax I-TREATMENT +sin I-TREATMENT +alteraciones. I-TREATMENT +En I-TREATMENT +la I-TREATMENT +bioquímica I-TREATMENT +sanguínea I-TREATMENT +destacaba: I-TREATMENT +sodio I-TREATMENT +: I-TREATMENT +122 I-TREATMENT +mEq/L, I-TREATMENT +potasio I-TREATMENT +: I-TREATMENT +5, I-TREATMENT +9 I-TREATMENT +mmol/L, I-TREATMENT +osmolaridad I-TREATMENT +: I-TREATMENT +256 I-TREATMENT +mOsmol/kg, I-TREATMENT +urea I-TREATMENT +: I-TREATMENT +1, I-TREATMENT +5 I-TREATMENT +g/L, I-TREATMENT +creatinina I-TREATMENT +(cr.s) I-TREATMENT +: I-TREATMENT +38 I-TREATMENT +mg/L, I-TREATMENT +calcio I-TREATMENT +: I-TREATMENT +80 I-TREATMENT +mg/L, I-TREATMENT +proteínas I-TREATMENT +totales I-TREATMENT +: I-TREATMENT +51 I-TREATMENT +g/L, I-TREATMENT +albúmina I-TREATMENT +: I-TREATMENT +28 I-TREATMENT +g/L, I-TREATMENT +CPK I-TREATMENT +: I-TREATMENT +225 I-TREATMENT +U/L, I-TREATMENT +LDH I-TREATMENT +: I-TREATMENT +416 I-TREATMENT +U/L, I-TREATMENT +GOT I-TREATMENT +: I-TREATMENT +48 I-TREATMENT +U/L, I-TREATMENT +GPT I-TREATMENT +: I-TREATMENT +97 I-TREATMENT +U/L, I-TREATMENT +haptoglobina I-TREATMENT +: I-TREATMENT +43.8 I-TREATMENT +mg/dL I-TREATMENT +(rango I-TREATMENT +normal I-TREATMENT +50-220 I-TREATMENT +mg/dL), I-TREATMENT +las I-TREATMENT +pruebas I-TREATMENT +de I-TREATMENT +coagulación I-TREATMENT +salieron I-TREATMENT +normales, I-TREATMENT +Hb I-TREATMENT +: I-TREATMENT 10 I-TREATMENT -mg I-TREATMENT -semanales, I-TREATMENT -con B-EVOLUTION -mejoría I-EVOLUTION -sintomática I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT +g/dl, I-TREATMENT +HCT I-TREATMENT +: I-TREATMENT +28.8 I-TREATMENT +%, I-TREATMENT +leucocitos I-TREATMENT +: I-TREATMENT +6400/mm3, I-TREATMENT +plaquetas I-TREATMENT +: I-TREATMENT +220.000/mm3. I-TREATMENT +Gasometría: I-TREATMENT +pH I-TREATMENT +: I-TREATMENT +7, I-TREATMENT +30; I-TREATMENT +PCO2 I-TREATMENT +: I-TREATMENT +36 I-TREATMENT +mmHg; I-TREATMENT +PO2 I-TREATMENT +: I-TREATMENT +72 I-TREATMENT +mmHg. I-TREATMENT +Se B-EVOLUTION +procede I-EVOLUTION +a I-EVOLUTION +su I-EVOLUTION +ingreso I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +unidad I-EVOLUTION +de I-EVOLUTION +Reanimación. I-EVOLUTION + I-EVOLUTION +Tras B-TREATMENT +la I-TREATMENT +estabilización I-TREATMENT +clínica I-TREATMENT +con I-TREATMENT +normalización I-TREATMENT +de I-TREATMENT +la I-TREATMENT +tensión I-TREATMENT +arterial, I-TREATMENT se I-TREATMENT -redujo I-TREATMENT +pudo I-TREATMENT +prescindir I-TREATMENT +de I-TREATMENT +las I-TREATMENT +drogas I-TREATMENT +vasopresoras, I-TREATMENT +se I-TREATMENT +administraron I-TREATMENT +Furosemida I-TREATMENT +IV I-TREATMENT +y I-TREATMENT +suero I-TREATMENT +salino I-TREATMENT +hipertónico I-TREATMENT +al I-TREATMENT +3% I-TREATMENT +para I-TREATMENT +minimizar I-TREATMENT +la I-TREATMENT +sobrecarga I-TREATMENT +de I-TREATMENT +volumen. I-TREATMENT +A I-TREATMENT +pesar I-TREATMENT +de I-TREATMENT +las I-TREATMENT +medidas I-TREATMENT +aplicadas I-TREATMENT +persistia I-TREATMENT +con I-TREATMENT +insuficiencia I-TREATMENT +renal I-TREATMENT +aguda I-TREATMENT +oligúrica I-TREATMENT +durante I-TREATMENT +15 I-TREATMENT +días, I-TREATMENT +llegando I-TREATMENT +a I-TREATMENT +cifras I-TREATMENT +máximas I-TREATMENT +de I-TREATMENT +urea I-TREATMENT +de I-TREATMENT +2, I-TREATMENT +70 I-TREATMENT +g/L I-TREATMENT +y I-TREATMENT +de I-TREATMENT +creatinina I-TREATMENT +de I-TREATMENT +72 I-TREATMENT +mg/L, I-TREATMENT +precisando I-TREATMENT +de I-TREATMENT +04 I-TREATMENT +sesiones I-TREATMENT +de I-TREATMENT +hemodiálisis. I-TREATMENT +A I-TREATMENT +las I-TREATMENT +3 I-TREATMENT +semanas, I-TREATMENT +reinició I-TREATMENT +la I-TREATMENT +diuresis I-TREATMENT +entrando I-TREATMENT en I-TREATMENT -forma I-TREATMENT -gradual I-TREATMENT +fase I-TREATMENT +poliúrica, I-TREATMENT +recuperandose I-TREATMENT +así I-TREATMENT +progresivamente I-TREATMENT la I-TREATMENT -dosis I-TREATMENT +función I-TREATMENT +renal, I-TREATMENT +siendo I-TREATMENT +la I-TREATMENT +Cr.s. I-TREATMENT +al I-TREATMENT +alta I-TREATMENT de I-TREATMENT -corticoides I-TREATMENT -hasta I-TREATMENT -10 I-TREATMENT -mg. I-TREATMENT -Tres B-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -(marzo I-EVOLUTION -de I-EVOLUTION -2008) I-EVOLUTION -fue I-EVOLUTION -hospitalizado I-EVOLUTION -por I-EVOLUTION -neumonía I-EVOLUTION -y I-EVOLUTION -tuvo I-EVOLUTION -una I-EVOLUTION -buena I-EVOLUTION -respuesta I-EVOLUTION -al I-EVOLUTION -tratamiento I-EVOLUTION -antibiótico. I-EVOLUTION -A I-EVOLUTION +14 I-TREATMENT +mg/L. I-TREATMENT +A B-EVOLUTION los I-EVOLUTION -12 I-EVOLUTION +4 I-EVOLUTION meses I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -(diciembre I-EVOLUTION -de I-EVOLUTION -2008) I-EVOLUTION -y I-EVOLUTION -estando I-EVOLUTION el I-EVOLUTION paciente I-EVOLUTION -prácticamente I-EVOLUTION -asintomático, I-EVOLUTION -salvo I-EVOLUTION -edema I-EVOLUTION -de I-EVOLUTION -piernas I-EVOLUTION -atribuido I-EVOLUTION -al I-EVOLUTION -uso I-EVOLUTION +permanece I-EVOLUTION +normotenso, I-EVOLUTION +con I-EVOLUTION +cifras I-EVOLUTION de I-EVOLUTION -anagrelide, I-EVOLUTION -persistía I-EVOLUTION -anémico I-EVOLUTION +Cr.s. I-EVOLUTION +10 I-EVOLUTION +mg/L I-EVOLUTION y I-EVOLUTION -con I-EVOLUTION -leucocitosis. I-EVOLUTION -Un B-EXPLORATION -scanner I-EXPLORATION -mostró I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -grosor I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -periaórtico I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -aorta I-EXPLORATION -ascendente I-EXPLORATION -como I-EXPLORATION -descendente I-EXPLORATION +un I-EVOLUTION +Ccr. I-EVOLUTION +76 I-EVOLUTION +ml/minuto. I-EVOLUTION + I-EVOLUTION + +En B-PRESENT_ILLNESS +primer I-PRESENT_ILLNESS +lugar, I-PRESENT_ILLNESS +presentamos I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +17 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +retroesternal, I-PRESENT_ILLNESS +disfagia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +39 I-PRESENT_ILLNESS +oC. I-PRESENT_ILLNESS +La B-EXPLORATION +endoscopia I-EXPLORATION +oral I-EXPLORATION +mostraba I-EXPLORATION +erosiones I-EXPLORATION +longitudinales I-EXPLORATION +profundas, I-EXPLORATION +de I-EXPLORATION +bordes I-EXPLORATION +irregulares I-EXPLORATION y I-EXPLORATION -prolongación I-EXPLORATION +sobreelevados, I-EXPLORATION +desde I-EXPLORATION +esófago I-EXPLORATION +medio I-EXPLORATION hasta I-EXPLORATION +distal. I-EXPLORATION +Se B-TREATMENT +pautó I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +aciclovir I-TREATMENT +por I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +EH I-TREATMENT +que I-TREATMENT +se I-TREATMENT +confirmó I-TREATMENT +histológicamente. I-TREATMENT +Además, B-EXPLORATION el I-EXPLORATION -inicio I-EXPLORATION +recuento I-EXPLORATION de I-EXPLORATION -arterias I-EXPLORATION -ilíacas I-EXPLORATION -primitivas. I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -18 I-EXPLORATION -meses I-EXPLORATION -(julio I-EXPLORATION +eosinófilos I-EXPLORATION +en I-EXPLORATION +esófago I-EXPLORATION +proximal I-EXPLORATION +fue I-EXPLORATION de I-EXPLORATION -2009), I-EXPLORATION +> I-EXPLORATION +15 I-EXPLORATION por I-EXPLORATION -dolor I-EXPLORATION -en I-EXPLORATION -rodillas I-EXPLORATION -se I-EXPLORATION -tomó I-EXPLORATION -radiografías I-EXPLORATION -que I-EXPLORATION -mostraron I-EXPLORATION -osteoesclerosis I-EXPLORATION -en I-EXPLORATION -fémures I-EXPLORATION -y I-EXPLORATION -tibias I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -localización I-EXPLORATION -que I-EXPLORATION -las I-EXPLORATION -alteraciones I-EXPLORATION -del I-EXPLORATION -cintigrama I-EXPLORATION -óseo I-EXPLORATION -y I-EXPLORATION -calcificaciones I-EXPLORATION -del I-EXPLORATION -cartílago I-EXPLORATION -compatibles I-EXPLORATION +campo, I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -condrocalcinosis. I-EXPLORATION -Un I-EXPLORATION -nuevo I-EXPLORATION -scanner, I-EXPLORATION -mostró I-EXPLORATION -persistencia I-EXPLORATION +EEo. I-EXPLORATION +La I-EXPLORATION +endoscopia I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -previos I-EXPLORATION -y I-EXPLORATION -aumento I-EXPLORATION -(70%) I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -estenosis I-EXPLORATION +revisión I-EXPLORATION +al I-EXPLORATION +mes I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -mesentérica I-EXPLORATION -inferior. I-EXPLORATION -A B-EVOLUTION -28 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -(abril I-EVOLUTION -de I-EVOLUTION -2010), I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -comenzó I-EVOLUTION -a I-EVOLUTION -presentar I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -insuficiencia I-EVOLUTION -cardiaca I-EVOLUTION -congestiva. I-EVOLUTION -El B-EXPLORATION -scanner I-EXPLORATION -mostró I-EXPLORATION -acentuación I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -perirrenal, I-EXPLORATION -engrosamiento I-EXPLORATION +finalizar I-EXPLORATION +el I-EXPLORATION +tratamiento I-EXPLORATION +mantenía I-EXPLORATION +signos I-EXPLORATION +endoscópicos I-EXPLORATION +e I-EXPLORATION +histológicos I-EXPLORATION +sugestivos I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -pleuras I-EXPLORATION -bibasales I-EXPLORATION -y I-EXPLORATION -aumento I-EXPLORATION +EEo I-EXPLORATION +sin I-EXPLORATION +aislarse I-EXPLORATION +VHS-I. I-EXPLORATION + I-EXPLORATION +Asimismo, B-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +36 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +asma, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +broncodilatador, I-PAST_MEDICAL_HISTORY +corticoideo I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +antibiótico, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +disfagia I-PRESENT_ILLNESS +aguda I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +endoscopia I-EXPLORATION +oral I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +ulcerada I-EXPLORATION +longitudinal I-EXPLORATION +subcentimétrica I-EXPLORATION +en I-EXPLORATION +cardias, I-EXPLORATION +que I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -cantidad I-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +presentaba I-EXPLORATION +inclusiones I-EXPLORATION de I-EXPLORATION -líquido I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -pericardio. I-EXPLORATION -El I-EXPLORATION -ecocardiograma I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -gran I-EXPLORATION -derrame I-EXPLORATION -pericárdico I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -iniciales I-EXPLORATION +Cowdry I-EXPLORATION +tipo I-EXPLORATION +A I-EXPLORATION +sugestivas I-EXPLORATION de I-EXPLORATION -taponamiento I-EXPLORATION +EH. I-EXPLORATION +Histológicamente, I-EXPLORATION +coexistían I-EXPLORATION +una I-EXPLORATION +candidiasis I-EXPLORATION +esofágica I-EXPLORATION y I-EXPLORATION -superficie I-EXPLORATION -pericárdica I-EXPLORATION -irregular I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -infiltración I-EXPLORATION -tumoral. I-EXPLORATION -El I-EXPLORATION -electrocardiograma I-EXPLORATION -mostró I-EXPLORATION -bajo I-EXPLORATION -voltaje. I-EXPLORATION -Fue B-TREATMENT -hospitalizado I-TREATMENT -efectuándose I-TREATMENT -una I-TREATMENT -ventana I-TREATMENT -pleuro-pericárdica. I-TREATMENT -Durante I-TREATMENT -la I-TREATMENT -operación I-TREATMENT -se I-TREATMENT -encontró I-TREATMENT -el I-TREATMENT -pericardio I-TREATMENT -a I-TREATMENT -tensión I-TREATMENT -drenando I-TREATMENT -1.200 I-TREATMENT -ml I-TREATMENT +una I-EXPLORATION +EEo. I-EXPLORATION +A B-TREATMENT +las I-TREATMENT +ocho I-TREATMENT +semanas I-TREATMENT de I-TREATMENT -un I-TREATMENT -líquido I-TREATMENT -amarillo I-TREATMENT -pardusco. I-TREATMENT -El B-EXPLORATION -pericardio I-EXPLORATION -parietal I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -visceral I-EXPLORATION -estaba I-EXPLORATION -infiltrado I-EXPLORATION -difusamente I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -tejido I-EXPLORATION -duro. I-EXPLORATION -El I-EXPLORATION -líquido I-EXPLORATION -pericárdico I-EXPLORATION -tenía I-EXPLORATION -abundantes I-EXPLORATION -histiocitos I-EXPLORATION -al I-EXPLORATION -igual I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -tejido I-EXPLORATION -pericárdico I-EXPLORATION -parietal I-EXPLORATION -resecado, I-EXPLORATION -que I-EXPLORATION -tenía I-EXPLORATION -infiltración I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -citoplasma I-EXPLORATION -granular I-EXPLORATION -y I-EXPLORATION -espumoso I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -inmunohistoquímico I-EXPLORATION -confirmó I-EXPLORATION -que I-EXPLORATION -dichas I-EXPLORATION -células I-EXPLORATION -correspondían I-EXPLORATION -a I-EXPLORATION -histiocitos, I-EXPLORATION -CD68 I-EXPLORATION -(+), I-EXPLORATION -CD1a I-EXPLORATION -(-) I-EXPLORATION -y I-EXPLORATION -proteína I-EXPLORATION -S100 I-EXPLORATION -(-), I-EXPLORATION -confirmando I-EXPLORATION -la I-EXPLORATION -ECD. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -clara I-EVOLUTION -mejoría I-EVOLUTION +finalizar I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +fluconazol, I-TREATMENT +aciclovir I-TREATMENT +y I-TREATMENT +pantoprazol I-TREATMENT +habían B-EVOLUTION +desaparecido I-EVOLUTION +las I-EVOLUTION +alteraciones I-EVOLUTION +sugestivas I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -sintomatología I-EVOLUTION -posterior I-EVOLUTION -al I-EVOLUTION -procedimiento. I-EVOLUTION +esofagitis I-EVOLUTION +infecciosa, I-EVOLUTION +persistiendo I-EVOLUTION +las I-EVOLUTION +compatibles I-EVOLUTION +con I-EVOLUTION +EEo. I-EVOLUTION I-EVOLUTION +El B-EXPLORATION +estudio I-EXPLORATION +inmunológico I-EXPLORATION +fue I-EXPLORATION +normal I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +pacientes. I-EXPLORATION + I-EXPLORATION -Paciente B-PAST_MEDICAL_HISTORY -chileno, I-PAST_MEDICAL_HISTORY -masculino, B-PRESENT_ILLNESS +Preescolar B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +8 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -viaje I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino, I-PRESENT_ILLNESS +sano, B-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +mórbidos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +importancia, I-PAST_MEDICAL_HISTORY +con B-PRESENT_ILLNESS +controles I-PRESENT_ILLNESS +ocasionales I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS el I-PRESENT_ILLNESS -Cuzco, I-PRESENT_ILLNESS -Perú, I-PRESENT_ILLNESS -inicia I-PRESENT_ILLNESS -súbitamente I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS +pediatra I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -reposo I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -agrega I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -epigástrico I-PRESENT_ILLNESS -intenso, I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -distensión I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -general. I-PRESENT_ILLNESS -Se B-TREATMENT -diagnostica I-TREATMENT -mal I-TREATMENT -de I-TREATMENT -altura I-TREATMENT -agudo, I-TREATMENT -recibiendo I-TREATMENT -furosemida, I-TREATMENT -acetazolamida, I-TREATMENT -dexametasona, I-TREATMENT -ranitidina I-TREATMENT -y I-TREATMENT -ceftriaxona. I-TREATMENT - B-EVOLUTION -En I-EVOLUTION -Chile, I-EVOLUTION -6 I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -consultó I-EVOLUTION -por I-EVOLUTION -persistir I-EVOLUTION -con I-EVOLUTION -idéntica I-EVOLUTION -sintomatología I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -derivado I-EVOLUTION -al I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Urgencia I-EVOLUTION -del I-EVOLUTION -Hospital I-EVOLUTION -Clínico I-EVOLUTION -Universidad I-EVOLUTION -de I-EVOLUTION -Chile I-EVOLUTION -por I-EVOLUTION -sospecha I-EVOLUTION -de I-EVOLUTION -tromboembolismo I-EVOLUTION -pulmonar. I-EVOLUTION -Ingresó B-EXPLORATION -afebril, I-EXPLORATION -disneico, I-EXPLORATION -con I-EXPLORATION -tope I-EXPLORATION -inspiratorio I-EXPLORATION +el I-PRESENT_ILLNESS +último I-PRESENT_ILLNESS +año. I-PRESENT_ILLNESS +Estado B-EXPLORATION +nutricional I-EXPLORATION +eutrófico I-EXPLORATION +según I-EXPLORATION +P/E I-EXPLORATION y I-EXPLORATION -distensión I-EXPLORATION -abdominal. I-EXPLORATION -Tenía B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY +P/T. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +destacaba I-EXPLORATION +el I-EXPLORATION +desaseo I-EXPLORATION +personal. I-EXPLORATION + I-EXPLORATION +La B-PAST_MEDICAL_HISTORY +familia I-PAST_MEDICAL_HISTORY +procedía I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY +rural I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -apnea-hipopnea I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -sueño, I-PAST_MEDICAL_HISTORY -trastorno I-PAST_MEDICAL_HISTORY -bipolar I-PAST_MEDICAL_HISTORY -manejado I-PAST_MEDICAL_HISTORY +Casablanca, I-PAST_MEDICAL_HISTORY +Región I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Valparaíso, I-PAST_MEDICAL_HISTORY +donde I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +dedicaban I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +crianza I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vacunos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +aves. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +casa I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -ácido I-PAST_MEDICAL_HISTORY -valproico, I-PAST_MEDICAL_HISTORY -rinitis I-PAST_MEDICAL_HISTORY -alérgica, I-PAST_MEDICAL_HISTORY -várices I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -miembros I-PAST_MEDICAL_HISTORY -inferiores, I-PAST_MEDICAL_HISTORY -apendicectomizado, I-PAST_MEDICAL_HISTORY -tabáquico I-PAST_MEDICAL_HISTORY +piso I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -paquetes-año, I-PAST_MEDICAL_HISTORY -bebedor I-PAST_MEDICAL_HISTORY +madera, I-PAST_MEDICAL_HISTORY +disponía I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -copas I-PAST_MEDICAL_HISTORY +agua I-PAST_MEDICAL_HISTORY +potable I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +alcantarillado, I-PAST_MEDICAL_HISTORY +patio I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -vino I-PAST_MEDICAL_HISTORY -diarias I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -30 I-PAST_MEDICAL_HISTORY +tierra. I-PAST_MEDICAL_HISTORY +Tenían I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +perros, I-PAST_MEDICAL_HISTORY +uno I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ellos I-PAST_MEDICAL_HISTORY +adulto I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +gato I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY años. I-PAST_MEDICAL_HISTORY +Las I-PAST_MEDICAL_HISTORY +mascotas I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +contaban I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +control I-PAST_MEDICAL_HISTORY +veterinario. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +madre I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +niño I-PAST_MEDICAL_HISTORY +refería I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +presencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +abundantes I-PAST_MEDICAL_HISTORY +pulgas. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +niño I-PAST_MEDICAL_HISTORY +jugaba I-PAST_MEDICAL_HISTORY +frecuentemente I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +mascotas. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -Signos B-EXPLORATION -vitales: I-EXPLORATION -Pulso I-EXPLORATION -81, I-EXPLORATION -ventilación I-EXPLORATION -18 I-EXPLORATION -por I-EXPLORATION -minuto, I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -102-67 I-EXPLORATION -mmHg, I-EXPLORATION -temperatura I-EXPLORATION -axilar I-EXPLORATION -36°C. I-EXPLORATION -Al I-EXPLORATION -examen: I-EXPLORATION -en I-EXPLORATION -decúbito I-EXPLORATION -dorsal, I-EXPLORATION -consciente, I-EXPLORATION -hidratado, I-EXPLORATION -bien I-EXPLORATION -perfundido, I-EXPLORATION -piel I-EXPLORATION -blanca, I-EXPLORATION -pálida. I-EXPLORATION -Destacaba I-EXPLORATION -abdomen I-EXPLORATION -doloroso I-EXPLORATION -en I-EXPLORATION -hipocondrio I-EXPLORATION -izquierdo, I-EXPLORATION -con I-EXPLORATION -bazo I-EXPLORATION -aumentado I-EXPLORATION -de I-EXPLORATION -tamaño, I-EXPLORATION -várices I-EXPLORATION -en I-EXPLORATION -extremidades I-EXPLORATION -inferiores. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio: I-EXPLORATION -hemograma I-EXPLORATION -con I-EXPLORATION -hematocrito I-EXPLORATION -27, I-EXPLORATION -1%, I-EXPLORATION -hemoglobina I-EXPLORATION -8, I-EXPLORATION -7 I-EXPLORATION -g/dl, I-EXPLORATION -VCM I-EXPLORATION -y I-EXPLORATION -CHCM I-EXPLORATION -normales, I-EXPLORATION -leucocitos I-EXPLORATION -10.100/uL, I-EXPLORATION -VHS I-EXPLORATION -28 I-EXPLORATION -mm/hr, I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -y I-EXPLORATION -TTPK I-EXPLORATION -normales. I-EXPLORATION -Dímero I-EXPLORATION -D I-EXPLORATION -4.683 I-EXPLORATION -ng/ml I-EXPLORATION -(normal I-EXPLORATION -< I-EXPLORATION -500), I-EXPLORATION -LDH I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -1.247 I-EXPLORATION -(rango: I-EXPLORATION -313-618), I-EXPLORATION -proBNP, I-EXPLORATION -CK, I-EXPLORATION -CK-MB I-EXPLORATION -y I-EXPLORATION -troponinas I-EXPLORATION -normales. I-EXPLORATION -Angio-TAC I-EXPLORATION -pulmonar I-EXPLORATION -descartó I-EXPLORATION -tromboembolismo I-EXPLORATION -y I-EXPLORATION -demostró I-EXPLORATION +El B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +derivado I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +Cátedra I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Parasitología I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +control I-DERIVED_FROM/TO +post I-DERIVED_FROM/TO +tratamiento I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +Hymenolepis I-DERIVED_FROM/TO +diminuta, I-DERIVED_FROM/TO +diagnosticada I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +otro I-DERIVED_FROM/TO +centro, I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +había I-DERIVED_FROM/TO +consultado I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +dolor I-DERIVED_FROM/TO +abdominal. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Al B-PAST_MEDICAL_HISTORY +interrogar I-PAST_MEDICAL_HISTORY +dirigidamente I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +madre I-PAST_MEDICAL_HISTORY +destacaba I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +eliminación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +elementos I-PAST_MEDICAL_HISTORY +blanquecinos I-PAST_MEDICAL_HISTORY +móviles I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +deposiciones. I-PAST_MEDICAL_HISTORY +Se B-EXPLORATION +realizó I-EXPLORATION un I-EXPLORATION -hematoma I-EXPLORATION -periesplénico, I-EXPLORATION -subcapsular I-EXPLORATION +estudio I-EXPLORATION +copro-parasitológico I-EXPLORATION +y I-EXPLORATION +test I-EXPLORATION de I-EXPLORATION -17 I-EXPLORATION -cm, I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -ingresado I-EVOLUTION -a I-EVOLUTION -cuidados I-EVOLUTION -intermedios I-EVOLUTION -con I-EVOLUTION -diagnóstico I-EVOLUTION -probable I-EVOLUTION -de I-EVOLUTION -infarto I-EVOLUTION -esplénico I-EVOLUTION -con I-EVOLUTION -transformación I-EVOLUTION -hemorrágica. I-EVOLUTION - I-EVOLUTION -Hemogramas B-EXPLORATION -seriados I-EXPLORATION -no I-EXPLORATION -mostraron I-EXPLORATION -cambios, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -ecocardiografía I-EXPLORATION +Graham, I-EXPLORATION que I-EXPLORATION -resultó I-EXPLORATION -normal I-EXPLORATION +fueron I-EXPLORATION +negativos I-EXPLORATION y I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION una I-EXPLORATION -tomografía I-EXPLORATION +muestra I-EXPLORATION de I-EXPLORATION -control I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION -crecimiento I-EXPLORATION +los I-EXPLORATION +elementos I-EXPLORATION +eliminados I-EXPLORATION +por I-EXPLORATION +las I-EXPLORATION +deposiciones I-EXPLORATION del I-EXPLORATION -hematoma I-EXPLORATION -esplénico I-EXPLORATION -a I-EXPLORATION -19 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro. I-EXPLORATION -Ante B-EVOLUTION -estabilidad I-EVOLUTION -clínica I-EVOLUTION -fue I-EVOLUTION -trasladado I-EVOLUTION -a I-EVOLUTION -sala I-EVOLUTION -en I-EVOLUTION -cirugía. I-EVOLUTION - I-EVOLUTION -La B-EXPLORATION -clínica I-EXPLORATION +niño. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +observación I-EXPLORATION +macro I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -laboratorio I-EXPLORATION -no I-EXPLORATION -sugerían I-EXPLORATION -etiologías I-EXPLORATION -infecciosas I-EXPLORATION +microscópica I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -hematoma I-EXPLORATION -esplénico, I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -había I-EXPLORATION +estos I-EXPLORATION elementos I-EXPLORATION -sospechosos I-EXPLORATION -de I-EXPLORATION -síndromes I-EXPLORATION -mieloproliferativos, I-EXPLORATION -linfoproliferativos I-EXPLORATION -u I-EXPLORATION -otra I-EXPLORATION -neoplasia I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION +permitió I-EXPLORATION +la I-EXPLORATION +visualización I-EXPLORATION de I-EXPLORATION -tomografía I-EXPLORATION +un I-EXPLORATION +doble I-EXPLORATION +poro I-EXPLORATION +genital I-EXPLORATION +característico I-EXPLORATION y I-EXPLORATION -bioquímicos. I-EXPLORATION -Hemogramas I-EXPLORATION -previos I-EXPLORATION -a I-EXPLORATION -este I-EXPLORATION -evento I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION -Ante I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -síndrome I-EXPLORATION -esplénico, I-EXPLORATION -pese I-EXPLORATION -a I-EXPLORATION -ser I-EXPLORATION +huevos I-EXPLORATION +agrupados I-EXPLORATION +en I-EXPLORATION una I-EXPLORATION -causa I-EXPLORATION -rara, I-EXPLORATION -fue I-EXPLORATION -estudiado I-EXPLORATION -para I-EXPLORATION -un I-EXPLORATION -posible I-EXPLORATION -rasgo I-EXPLORATION -falciforme I-EXPLORATION +membrana I-EXPLORATION +o I-EXPLORATION +cápsula I-EXPLORATION +ovígera, I-EXPLORATION con I-EXPLORATION -una I-EXPLORATION -prueba I-EXPLORATION -de I-EXPLORATION -inducción I-EXPLORATION +liberación I-EXPLORATION de I-EXPLORATION -drepanocitos I-EXPLORATION -con I-EXPLORATION -metabisulfito I-EXPLORATION +huevos. I-EXPLORATION +De I-EXPLORATION +acuerdo I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +macro I-EXPLORATION +y I-EXPLORATION +microscópico I-EXPLORATION +se I-EXPLORATION +hizo I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -sodio I-EXPLORATION -al I-EXPLORATION -2%, I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -positiva. I-EXPLORATION -Dada B-TREATMENT -la I-TREATMENT -evolución I-TREATMENT -intrahospitalaria I-TREATMENT -favorable, I-TREATMENT -acompañado I-TREATMENT -de I-TREATMENT -laboratorio I-TREATMENT -general I-TREATMENT +dipilidiosis. I-EXPLORATION + I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT +recibió I-TREATMENT +medidas I-TREATMENT +preventivas I-TREATMENT +para I-TREATMENT +dipilidiosis I-TREATMENT y I-TREATMENT -estudios I-TREATMENT -radiológicos I-TREATMENT -sin I-TREATMENT -progresión, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -no I-TREATMENT -intervenir I-TREATMENT -quirúrgicamente I-TREATMENT -y B-EVOLUTION +tratamiento I-TREATMENT +con I-TREATMENT +praziquantel I-TREATMENT +por I-TREATMENT +una I-TREATMENT +vez. I-TREATMENT +Acudió B-EVOLUTION +a I-EVOLUTION +control I-EVOLUTION +con I-EVOLUTION +estudio I-EVOLUTION +copro-parasitológico I-EVOLUTION +de I-EVOLUTION +deposiciones I-EVOLUTION +post I-EVOLUTION +tratamiento, I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +3 I-EVOLUTION +y I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +después, I-EVOLUTION +que I-EVOLUTION +fueron I-EVOLUTION +todos I-EVOLUTION +negativos. I-EVOLUTION +No I-EVOLUTION +volvió I-EVOLUTION +a I-EVOLUTION +eliminar I-EVOLUTION +proglótidas I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +actualmente I-EVOLUTION +asinto-mático. I-EVOLUTION +En I-EVOLUTION el I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION +último I-EVOLUTION +control I-EVOLUTION +se I-EVOLUTION +informó I-EVOLUTION de I-EVOLUTION -alta. I-EVOLUTION +la I-EVOLUTION +muerte I-EVOLUTION +del I-EVOLUTION +perro I-EVOLUTION +adulto. I-EVOLUTION I-EVOLUTION -En B-EXPLORATION -control I-EXPLORATION -ambulatorio I-EXPLORATION -por I-EXPLORATION -hematología I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -electroforesis I-EXPLORATION -de I-EXPLORATION -hemoglobina I-EXPLORATION -en I-EXPLORATION -medio I-EXPLORATION -alcalino I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION -hemoglobina I-EXPLORATION -normal I-EXPLORATION -A I-EXPLORATION -54, I-EXPLORATION -8% I-EXPLORATION -y I-EXPLORATION -41, I-EXPLORATION -8% I-EXPLORATION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +66 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +controlado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +Consultas I-PRESENT_ILLNESS +Externas I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +hipertrofia I-PRESENT_ILLNESS +benigna I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +próstata. I-PRESENT_ILLNESS +Presenta I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hematuria I-PRESENT_ILLNESS +monosintomática I-PRESENT_ILLNESS +autolimitada I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +urinocultivos I-PRESENT_ILLNESS +negativos. I-PRESENT_ILLNESS +En B-EXPLORATION +estudio I-EXPLORATION +ecográfico I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +ureteropielocaliectasia I-EXPLORATION +grado I-EXPLORATION +II I-EXPLORATION de I-EXPLORATION -fracción I-EXPLORATION -3, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -hemoglobina I-EXPLORATION -S I-EXPLORATION +riñón I-EXPLORATION +derecho I-EXPLORATION y I-EXPLORATION +en I-EXPLORATION +U.I.V. I-EXPLORATION se I-EXPLORATION -diagnosticó I-EXPLORATION -rasgo I-EXPLORATION -falciforme. I-EXPLORATION +objetiva I-EXPLORATION +anulación I-EXPLORATION +funcional I-EXPLORATION +de I-EXPLORATION +riñón I-EXPLORATION +derecho, I-EXPLORATION +motivo B-TREATMENT +por I-TREATMENT +el I-TREATMENT +cuál, I-TREATMENT +se I-TREATMENT +practica I-TREATMENT +nefrostomia I-TREATMENT +percutánea I-TREATMENT +derecha, I-TREATMENT +que I-TREATMENT +confirma I-TREATMENT +el I-TREATMENT +hallazgo I-TREATMENT +urográfico. I-TREATMENT +Ocho B-EXPLORATION +meses I-EXPLORATION +antes, I-EXPLORATION +est: I-EXPLORATION +udio I-EXPLORATION +ecográfico I-EXPLORATION +y I-EXPLORATION +U.I.V. I-EXPLORATION +sin I-EXPLORATION +hallazgos I-EXPLORATION +patológicos. I-EXPLORATION I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -14 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY +Entre B-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -mórbidos, I-PAST_MEDICAL_HISTORY -quien I-PAST_MEDICAL_HISTORY -consultó I-PAST_MEDICAL_HISTORY -luego I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sufrir I-PAST_MEDICAL_HISTORY -trauma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -baja I-PAST_MEDICAL_HISTORY -intensidad I-PAST_MEDICAL_HISTORY -(pelotazo) I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -genital. I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +cabe I-PAST_MEDICAL_HISTORY +destacar: I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +alergias I-PAST_MEDICAL_HISTORY +conocidas. I-PAST_MEDICAL_HISTORY +HTA. I-PAST_MEDICAL_HISTORY +Diabetes I-PAST_MEDICAL_HISTORY +Mellitus I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +II. I-PAST_MEDICAL_HISTORY +Miocardiopatía I-PAST_MEDICAL_HISTORY +hipertrófica. I-PAST_MEDICAL_HISTORY +Aneurisma I-PAST_MEDICAL_HISTORY +carotídeo I-PAST_MEDICAL_HISTORY +intracerebral I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +secuelas. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -presentaba I-EXPLORATION -dolor I-EXPLORATION -que I-EXPLORATION -dificultaba I-EXPLORATION +La B-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +practicada I-EXPLORATION +es I-EXPLORATION la I-EXPLORATION -palpación, I-EXPLORATION -evidenciándose I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -asimétrico I-EXPLORATION -testicular I-EXPLORATION -izquierdo, I-EXPLORATION +siguiente: I-EXPLORATION +Abdomen I-EXPLORATION +blando I-EXPLORATION +y I-EXPLORATION +depresible, I-EXPLORATION +no I-EXPLORATION +doloroso, I-EXPLORATION +no I-EXPLORATION +megalias, I-EXPLORATION +Fosas I-EXPLORATION +renales I-EXPLORATION +libres I-EXPLORATION +indoloras. I-EXPLORATION +Genitales I-EXPLORATION +externos I-EXPLORATION sin I-EXPLORATION -otras I-EXPLORATION -lesiones I-EXPLORATION -asociadas. I-EXPLORATION +signos I-EXPLORATION +patológicos. I-EXPLORATION +Tacto I-EXPLORATION +rectal I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +HBP I-EXPLORATION +grado I-EXPLORATION +I-II. I-EXPLORATION Se I-EXPLORATION -solicitó I-EXPLORATION -ecotomografía I-EXPLORATION -testicular I-EXPLORATION -presentándose I-EXPLORATION +llevan I-EXPLORATION a I-EXPLORATION -control I-EXPLORATION -luego I-EXPLORATION +cabo I-EXPLORATION +las I-EXPLORATION +siguientes I-EXPLORATION +EXPLORACIONES I-EXPLORATION +COMPLEMENTARIAS: I-EXPLORATION + I-EXPLORATION +ANALISIS: I-EXPLORATION +Glucemia I-EXPLORATION +145 I-EXPLORATION +mg/dl, I-EXPLORATION +Creatinina I-EXPLORATION +1.4 I-EXPLORATION +mg/dl. I-EXPLORATION +Resto I-EXPLORATION de I-EXPLORATION -transcurridos I-EXPLORATION -5 I-EXPLORATION -meses, I-EXPLORATION -constatándose I-EXPLORATION -clínicamente I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -indurada I-EXPLORATION -en I-EXPLORATION -testículo I-EXPLORATION -izquierdo I-EXPLORATION +parámetros I-EXPLORATION +dentro I-EXPLORATION de I-EXPLORATION -aproximadamente I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION +la I-EXPLORATION +normalidad. I-EXPLORATION + I-EXPLORATION +CITOLOGIA I-EXPLORATION +URINARIA: I-EXPLORATION +Compatible I-EXPLORATION +con I-EXPLORATION +carcinoma I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION -mayor, I-EXPLORATION -no I-EXPLORATION -dolorosa I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -compromiso I-EXPLORATION -escrotal; I-EXPLORATION -testículo I-EXPLORATION +células I-EXPLORATION +transicionales I-EXPLORATION +de I-EXPLORATION +bajo I-EXPLORATION +grado. I-EXPLORATION + I-EXPLORATION +PIELOGRAFIA I-EXPLORATION +DESCENDENTE I-EXPLORATION +a I-EXPLORATION +traves I-EXPLORATION +de I-EXPLORATION +Nefrostomia: I-EXPLORATION +Defecto I-EXPLORATION +de I-EXPLORATION +replección I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +uréter I-EXPLORATION +sacro-ilíaco I-EXPLORATION derecho I-EXPLORATION -y I-EXPLORATION -pene I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION -La I-EXPLORATION -ultrasonografía I-EXPLORATION -demostró I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -espesor I-EXPLORATION -del I-EXPLORATION -testículo I-EXPLORATION -izquierdo I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION de I-EXPLORATION -18 I-EXPLORATION -x I-EXPLORATION -19 I-EXPLORATION -x I-EXPLORATION -15 I-EXPLORATION -mm, I-EXPLORATION -bien I-EXPLORATION -delimitado, I-EXPLORATION +aproximadamente I-EXPLORATION +20 I-EXPLORATION +mm I-EXPLORATION de I-EXPLORATION -paredes I-EXPLORATION -hiperecogénicas I-EXPLORATION +longitud, I-EXPLORATION con I-EXPLORATION -sombra I-EXPLORATION -acústica I-EXPLORATION -posterior. I-EXPLORATION -El I-EXPLORATION -testículo I-EXPLORATION -derecho, I-EXPLORATION -epidídimos I-EXPLORATION -y I-EXPLORATION -cordones I-EXPLORATION -espermáticos I-EXPLORATION -no I-EXPLORATION -presentan I-EXPLORATION -alteraciones I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -ecoestructura. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -serológico I-EXPLORATION -para I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -(α-feto I-EXPLORATION -proteína I-EXPLORATION -y I-EXPLORATION -hormona I-EXPLORATION -gonadotropina I-EXPLORATION -coriónica I-EXPLORATION -sub-unidad I-EXPLORATION -β) I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -complementó I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -(TC) I-EXPLORATION +infiltración I-EXPLORATION de I-EXPLORATION -pelvis, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -tórax I-EXPLORATION -las I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -demostraron I-EXPLORATION -lesiones I-EXPLORATION -secundarias. I-EXPLORATION +la I-EXPLORATION +pared. I-EXPLORATION I-EXPLORATION -Se B-TREATMENT -efectuó I-TREATMENT -enucleación I-TREATMENT -del I-TREATMENT -tumor I-TREATMENT -y I-TREATMENT -biopsia I-TREATMENT -intra-operatoria. I-TREATMENT -Se B-EXPLORATION -examinó I-EXPLORATION -un I-EXPLORATION -fragmento I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -testicular I-EXPLORATION +ESTUDIO I-EXPLORATION +FUNCIONAL I-EXPLORATION +DE I-EXPLORATION +RIÑON I-EXPLORATION +DERECHO: I-EXPLORATION +Aclaramiento I-EXPLORATION de I-EXPLORATION +Creatinina I-EXPLORATION +inferior I-EXPLORATION +a I-EXPLORATION 5 I-EXPLORATION -g I-EXPLORATION +ml/minuto. I-EXPLORATION + I-EXPLORATION +TAC I-EXPLORATION +ABDOMINO-PELVICO: I-EXPLORATION +Aneurisma I-EXPLORATION de I-EXPLORATION -35 I-EXPLORATION -x I-EXPLORATION -17 I-EXPLORATION -x I-EXPLORATION -15 I-EXPLORATION -mm I-EXPLORATION -presentando I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION +Aorta I-EXPLORATION +infrarrenal. I-EXPLORATION +Atrofia I-EXPLORATION +hidronefrótica I-EXPLORATION de I-EXPLORATION -corte I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -subcapsular I-EXPLORATION -redondeada, I-EXPLORATION -bien I-EXPLORATION -delimitada, I-EXPLORATION -amarillenta, I-EXPLORATION +riñón I-EXPLORATION +derecho, I-EXPLORATION +sin I-EXPLORATION +visualizarse I-EXPLORATION +imágenes I-EXPLORATION +endoluminales I-EXPLORATION +intraureterales. I-EXPLORATION +Dudosas I-EXPLORATION +adenopatías I-EXPLORATION +paravesicales. I-EXPLORATION + I-EXPLORATION +Ante B-TREATMENT +estos I-TREATMENT +hallazgos I-TREATMENT +y I-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +tumor I-TREATMENT +de I-TREATMENT +vías I-TREATMENT +de I-TREATMENT +uréter I-TREATMENT +derecho, I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +es I-TREATMENT +intervenido I-TREATMENT +quirúrgicamente I-TREATMENT +practicándose I-TREATMENT +nefroureterectomía I-TREATMENT +radical I-TREATMENT +derecha I-TREATMENT +con I-TREATMENT +evolución I-TREATMENT +postoperatoria I-TREATMENT +satisfactoria. I-TREATMENT +El B-EXPLORATION +dictamen I-EXPLORATION +histopatológico I-EXPLORATION de I-EXPLORATION -consistencia I-EXPLORATION -firme I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +nos I-EXPLORATION +informa I-EXPLORATION de I-EXPLORATION -22 I-EXPLORATION -mm I-EXPLORATION +pielonefritis I-EXPLORATION +crónica I-EXPLORATION +y I-EXPLORATION +cambios I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION -mayor, I-EXPLORATION +arteriosclerosis, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +lesión I-EXPLORATION +inflamatoria I-EXPLORATION +ureteral I-EXPLORATION +que I-EXPLORATION +oblitera I-EXPLORATION +la I-EXPLORATION +luz I-EXPLORATION con I-EXPLORATION -áreas I-EXPLORATION -grumosas I-EXPLORATION +infiltrado I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -arenoso. I-EXPLORATION -El I-EXPLORATION -corte I-EXPLORATION -histológico I-EXPLORATION -por I-EXPLORATION -congelación I-EXPLORATION +linfocitos I-EXPLORATION +en I-EXPLORATION +capas I-EXPLORATION +musculares, I-EXPLORATION +erosión I-EXPLORATION +de I-EXPLORATION +urotelio I-EXPLORATION y I-EXPLORATION -diferido I-EXPLORATION -demostró I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +Actinomices. I-EXPLORATION +Tras B-EVOLUTION +9 I-EVOLUTION +años I-EVOLUTION +de I-EVOLUTION +seguimiento, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +mantiene I-EVOLUTION +una I-EVOLUTION +función I-EVOLUTION +renal I-EVOLUTION +aceptable I-EVOLUTION +(Creatinina I-EVOLUTION +sérica I-EVOLUTION +2.1 I-EVOLUTION +mg/dl I-EVOLUTION +) I-EVOLUTION +y I-EVOLUTION +es I-EVOLUTION +controlado I-EVOLUTION +por I-EVOLUTION +HBP I-EVOLUTION +sintomática. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +género I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +55 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +mórbidos I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +excepción I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +proctitis I-PAST_MEDICAL_HISTORY +ulcerosa I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +1994. I-PAST_MEDICAL_HISTORY +Inicialmente B-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +líquidas I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +mucosidades. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +colonoscopia I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +compromiso I-EXPLORATION +inflamatorio I-EXPLORATION +continuo I-EXPLORATION +del I-EXPLORATION +recto I-EXPLORATION +con I-EXPLORATION una I-EXPLORATION -lesión I-EXPLORATION -que I-EXPLORATION -presentaba I-EXPLORATION -nidos I-EXPLORATION +mucosa I-EXPLORATION +friable I-EXPLORATION y I-EXPLORATION -cordones I-EXPLORATION -conformados I-EXPLORATION +pequeñas I-EXPLORATION +erosiones I-EXPLORATION +cubiertas I-EXPLORATION por I-EXPLORATION -células I-EXPLORATION -ovales I-EXPLORATION -a I-EXPLORATION -poligonales I-EXPLORATION +fibrina I-EXPLORATION +(Subíndice I-EXPLORATION +Endoscópico I-EXPLORATION +Mayo I-EXPLORATION +2). I-EXPLORATION +En I-EXPLORATION +las I-EXPLORATION +biopsias I-EXPLORATION +se I-EXPLORATION +apreciaron I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -núcleos I-EXPLORATION -grandes, I-EXPLORATION -excéntricos I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -nucléolo I-EXPLORATION -prominente, I-EXPLORATION -el I-EXPLORATION -citoplasma I-EXPLORATION -es I-EXPLORATION -eosinófilo I-EXPLORATION +inflamación I-EXPLORATION +aguda I-EXPLORATION +(criptitis I-EXPLORATION y I-EXPLORATION -abundante, I-EXPLORATION -apreciándose I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -polimorfonuclear I-EXPLORATION -neutrófilo I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -central I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION +abscesos I-EXPLORATION +crípticos) I-EXPLORATION y I-EXPLORATION -linfocitos I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -periferia I-EXPLORATION -en I-EXPLORATION -partes I-EXPLORATION -formando I-EXPLORATION -agregados I-EXPLORATION -linfoides. I-EXPLORATION -El I-EXPLORATION -estroma I-EXPLORATION -es I-EXPLORATION -en I-EXPLORATION -partes I-EXPLORATION -hialino I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION +crónica I-EXPLORATION +reflejada I-EXPLORATION +como I-EXPLORATION +alteraciones I-EXPLORATION +estructurales I-EXPLORATION de I-EXPLORATION -degeneración I-EXPLORATION -mixoide I-EXPLORATION +las I-EXPLORATION +criptas I-EXPLORATION +(acortamiento I-EXPLORATION y I-EXPLORATION -abundantes I-EXPLORATION -calcificaciones I-EXPLORATION -dispuestas I-EXPLORATION +ramificación I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +glándulas I-EXPLORATION +asociadas I-EXPLORATION a I-EXPLORATION -nivel I-EXPLORATION -intersticial I-EXPLORATION +disminución I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +caliciformes). I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +mesalazina I-TREATMENT +oral I-TREATMENT +(3 I-TREATMENT +g/día) I-TREATMENT +y I-TREATMENT +rectal I-TREATMENT +(supositorios I-TREATMENT +de I-TREATMENT +500 I-TREATMENT +mg/noche), I-TREATMENT +con I-TREATMENT +remisión I-TREATMENT +clínica I-TREATMENT +y I-TREATMENT +endoscópica I-TREATMENT +(curación I-TREATMENT +de I-TREATMENT +la I-TREATMENT +mucosa) I-TREATMENT +(colonoscopia I-TREATMENT +2007, I-TREATMENT +Subíndice I-TREATMENT +Endoscópico I-TREATMENT +Mayo I-TREATMENT +0). I-TREATMENT +Posteriormente, B-EVOLUTION +abandona I-EVOLUTION +tratamiento I-EVOLUTION +y I-EVOLUTION +control, I-EVOLUTION +manteniéndose I-EVOLUTION +asintomática I-EVOLUTION +hasta I-EVOLUTION +agosto I-EVOLUTION +de I-EVOLUTION +2015 I-EVOLUTION +donde I-EVOLUTION +consulta I-EVOLUTION +por I-EVOLUTION +presentar I-EVOLUTION +desde I-EVOLUTION +hace I-EVOLUTION +un I-EVOLUTION +mes I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +malestar I-EVOLUTION +abdominal I-EVOLUTION +asociado I-EVOLUTION +a I-EVOLUTION +deposiciones I-EVOLUTION +líquidas I-EVOLUTION +una I-EVOLUTION +a I-EVOLUTION +dos I-EVOLUTION +veces I-EVOLUTION +al I-EVOLUTION +día I-EVOLUTION +sin I-EVOLUTION +sangre I-EVOLUTION +ni I-EVOLUTION +mucosidades. I-EVOLUTION +No I-EVOLUTION +refería I-EVOLUTION +compromiso I-EVOLUTION +del I-EVOLUTION +estado I-EVOLUTION +general, I-EVOLUTION +fiebre, I-EVOLUTION +baja I-EVOLUTION +de I-EVOLUTION +peso, I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +y/o I-EVOLUTION +articular. I-EVOLUTION +Sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tabaquismo, I-PAST_MEDICAL_HISTORY +transgresión I-PAST_MEDICAL_HISTORY +alimentaria I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +uso I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +fármacos I-PAST_MEDICAL_HISTORY +(específicamente I-PAST_MEDICAL_HISTORY +antiinflamatorios I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +esteroidales, I-PAST_MEDICAL_HISTORY +antibióticos, I-PAST_MEDICAL_HISTORY +inhibidores I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +bomba I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +protones, I-PAST_MEDICAL_HISTORY +hormonas I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +antidepresivos). I-PAST_MEDICAL_HISTORY +Se B-EXPLORATION +solicitaron I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +que I-EXPLORATION +incluyó I-EXPLORATION +hemograma, I-EXPLORATION +VHS, I-EXPLORATION +PCR I-EXPLORATION y I-EXPLORATION +perfil I-EXPLORATION +hepático, I-EXPLORATION +todos I-EXPLORATION +normales. I-EXPLORATION +Además, I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +enfermedad I-EXPLORATION +celíaca I-EXPLORATION +con I-EXPLORATION +anticuerpos I-EXPLORATION +anti-transglutaminasa I-EXPLORATION +negativos I-EXPLORATION +e I-EXPLORATION +inmunoglobulina I-EXPLORATION +A I-EXPLORATION +en I-EXPLORATION +valores I-EXPLORATION +normales. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +colonoscopia I-EXPLORATION +completa I-EXPLORATION +donde I-EXPLORATION +sólo I-EXPLORATION +se I-EXPLORATION +apreciaron I-EXPLORATION +erosiones I-EXPLORATION +mínimas I-EXPLORATION +e I-EXPLORATION +inespecíficas I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -lumen I-EXPLORATION +recto. I-EXPLORATION +Se I-EXPLORATION +tomaron I-EXPLORATION +biopsias I-EXPLORATION +escalonadas I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -nidos I-EXPLORATION -tumorales, I-EXPLORATION -concluyéndose I-EXPLORATION +íleon, I-EXPLORATION +colon I-EXPLORATION +y I-EXPLORATION +recto I-EXPLORATION en I-EXPLORATION +frascos I-EXPLORATION +separados I-EXPLORATION +las I-EXPLORATION +cuales I-EXPLORATION +fueron I-EXPLORATION +consistentes I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +CL I-EXPLORATION +dado I-EXPLORATION la I-EXPLORATION -biopsia I-EXPLORATION -contemporánea I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION +> I-EXPLORATION +40 I-EXPLORATION +linfocitos/100 I-EXPLORATION células I-EXPLORATION -de I-EXPLORATION -Sertoli I-EXPLORATION -calcificado. I-EXPLORATION -No I-EXPLORATION +epiteliales I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +muestras I-EXPLORATION +obtenidas I-EXPLORATION +desde I-EXPLORATION +colon I-EXPLORATION +transverso I-EXPLORATION +a I-EXPLORATION +recto. I-EXPLORATION +Además, I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -extensión I-EXPLORATION -tumoral I-EXPLORATION -intratubular, I-EXPLORATION -figuras I-EXPLORATION -mitóticas, I-EXPLORATION -necrosis, I-EXPLORATION -acentuada I-EXPLORATION -atipía I-EXPLORATION -citológica I-EXPLORATION -ni I-EXPLORATION -extensión I-EXPLORATION -tumoral I-EXPLORATION -extra-testicular. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -demostró I-EXPLORATION -intensa I-EXPLORATION -positividad I-EXPLORATION -para I-EXPLORATION -α-inhibina, I-EXPLORATION -S-100 I-EXPLORATION -y I-EXPLORATION -vimentina; I-EXPLORATION +describieron I-EXPLORATION +alteraciones I-EXPLORATION +compatibles I-EXPLORATION con I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION +CU I-EXPLORATION +(leve I-EXPLORATION +distorsión I-EXPLORATION de I-EXPLORATION -proliferación I-EXPLORATION -(Ki-67) I-EXPLORATION -bajo I-EXPLORATION -(< I-EXPLORATION -1%). I-EXPLORATION - I-EXPLORATION +arquitectura I-EXPLORATION +glandular, I-EXPLORATION +criptitis I-EXPLORATION +y I-EXPLORATION +microabscesos) I-EXPLORATION +exclusivamente I-EXPLORATION +en I-EXPLORATION +sigmoides I-EXPLORATION +y I-EXPLORATION +recto. I-EXPLORATION Se B-TREATMENT -completó I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +budesonida I-TREATMENT +9 I-TREATMENT +mg/día, I-TREATMENT +presentando I-TREATMENT +una I-TREATMENT +respuesta I-TREATMENT +favorable I-TREATMENT +a I-TREATMENT la I-TREATMENT -cirugía I-TREATMENT -realizándose I-TREATMENT -orquiectomía I-TREATMENT -radical. I-TREATMENT -No B-EVOLUTION -se I-EVOLUTION -registraron I-EVOLUTION -complicaciones I-EVOLUTION -post-operatorias. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -8 I-EVOLUTION +semana I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +un I-TREATMENT +descenso I-TREATMENT +progresivo I-TREATMENT +del I-TREATMENT +fármaco I-TREATMENT +hasta I-TREATMENT +suspenderlo I-TREATMENT +al I-TREATMENT +tercer I-TREATMENT +mes. I-TREATMENT +Luego B-EVOLUTION +de I-EVOLUTION +6 I-EVOLUTION meses I-EVOLUTION -post-cirugía, I-EVOLUTION -el I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +la I-EVOLUTION paciente I-EVOLUTION se I-EVOLUTION -encuentra I-EVOLUTION -sano, I-EVOLUTION -sin I-EVOLUTION -evidencia I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -en I-EVOLUTION -TC I-EVOLUTION -de I-EVOLUTION -tórax-abdomen I-EVOLUTION +ha I-EVOLUTION +mantenido I-EVOLUTION +asintomática I-EVOLUTION +(remisión I-EVOLUTION +clínica) I-EVOLUTION y I-EVOLUTION -pelvis; I-EVOLUTION -descartándose I-EVOLUTION en I-EVOLUTION -este I-EVOLUTION -paciente I-EVOLUTION -la I-EVOLUTION -asociación I-EVOLUTION +control I-EVOLUTION con I-EVOLUTION -complejo I-EVOLUTION -de I-EVOLUTION -Carney I-EVOLUTION -y I-EVOLUTION -síndrome I-EVOLUTION +calprotectina I-EVOLUTION +fecal I-EVOLUTION +dentro I-EVOLUTION de I-EVOLUTION -Peutz-Jeghers. I-EVOLUTION +rango I-EVOLUTION +normal. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -53 I-PRESENT_ILLNESS +61 I-PRESENT_ILLNESS +años B-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY +acudió B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +tumoración I-PRESENT_ILLNESS +escrotal I-PRESENT_ILLNESS +derecha I-PRESENT_ILLNESS +aparecida I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hace I-PRESENT_ILLNESS +unos I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -domiciliada B-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Calama, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -terminal I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -causa I-PAST_MEDICAL_HISTORY -desconocida, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -programa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hemodiálisis I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -año. I-PAST_MEDICAL_HISTORY -Durante I-PAST_MEDICAL_HISTORY -este I-PAST_MEDICAL_HISTORY -período I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -agregó I-PAST_MEDICAL_HISTORY -baja I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -30 I-PAST_MEDICAL_HISTORY -kg, I-PAST_MEDICAL_HISTORY -cefalea, I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -polineuropático I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -guante I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -calcetín I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -poliartralgias. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -aparecido I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ha I-PRESENT_ILLNESS +ido I-PRESENT_ILLNESS +creciendo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -blando, I-PRESENT_ILLNESS -indoloro, I-PRESENT_ILLNESS -progresivo, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -hombros, I-PRESENT_ILLNESS -antebrazo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS +tamaño I-PRESENT_ILLNESS +muy I-PRESENT_ILLNESS +lentamente I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -muslos, I-PRESENT_ILLNESS -inmovilidad I-PRESENT_ILLNESS -articular I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +presencia I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -ambas I-PRESENT_ILLNESS -manos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -rodillas, I-PRESENT_ILLNESS -postración I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -últimas I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -semanas. I-PRESENT_ILLNESS -Fue B-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -estudio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -posible I-DERIVED_FROM/TO -enfermedad I-DERIVED_FROM/TO -reumatológica. I-DERIVED_FROM/TO -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -paciente I-EXPLORATION -caquéctica, I-EXPLORATION -pálida, I-EXPLORATION -postrada. I-EXPLORATION -Destacó I-EXPLORATION -macroglosia I-EXPLORATION -con I-EXPLORATION -lengua I-EXPLORATION -geográfica, I-EXPLORATION -masas I-EXPLORATION -gomosas I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -hombros I-EXPLORATION -(periarticulares) I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -cm: I-EXPLORATION -signo I-EXPLORATION -de I-EXPLORATION -shoulder I-EXPLORATION -pad, I-EXPLORATION +hernia I-PRESENT_ILLNESS +inguinal I-PRESENT_ILLNESS +izquierda. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +el I-EXPLORATION +testículo I-EXPLORATION +derecho I-EXPLORATION +parecía I-EXPLORATION +situarse I-EXPLORATION +hacia I-EXPLORATION +la I-EXPLORATION +raíz I-EXPLORATION +escrotal, I-EXPLORATION +se I-EXPLORATION +apreciaba I-EXPLORATION +una I-EXPLORATION masa I-EXPLORATION +móvil I-EXPLORATION de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -antebrazo I-EXPLORATION -derecho I-EXPLORATION +consistencia I-EXPLORATION +elástica I-EXPLORATION y I-EXPLORATION -12 I-EXPLORATION +suave I-EXPLORATION +de I-EXPLORATION +unos I-EXPLORATION +15 I-EXPLORATION cm I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -muslos, I-EXPLORATION -manos I-EXPLORATION -contracturadas I-EXPLORATION -en I-EXPLORATION -flexión I-EXPLORATION -y I-EXPLORATION -rigidez I-EXPLORATION +que I-EXPLORATION +ocupaba I-EXPLORATION +todo I-EXPLORATION +el I-EXPLORATION +hemiescroto. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +clínico I-EXPLORATION +fue I-EXPLORATION de I-EXPLORATION -ambas I-EXPLORATION -rodillas. I-EXPLORATION +lipoma I-EXPLORATION +escrotal. I-EXPLORATION + I-EXPLORATION Los I-EXPLORATION exámenes I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -mostraron I-EXPLORATION -hemoglobina I-EXPLORATION -8, I-EXPLORATION -7 I-EXPLORATION -g/dL, I-EXPLORATION -creatinina I-EXPLORATION -6, I-EXPLORATION -5 I-EXPLORATION -mg/dL, I-EXPLORATION -calcemia I-EXPLORATION -12 I-EXPLORATION -mg/dL, I-EXPLORATION -albúmina I-EXPLORATION -1, I-EXPLORATION -9 I-EXPLORATION -g/L, I-EXPLORATION -proteína I-EXPLORATION -total I-EXPLORATION -5, I-EXPLORATION -4 I-EXPLORATION -g/dL I-EXPLORATION +sangre I-EXPLORATION y I-EXPLORATION -triglicéridos I-EXPLORATION -450 I-EXPLORATION -mg/dL. I-EXPLORATION -Debido I-EXPLORATION -a I-EXPLORATION +de I-EXPLORATION +orina, I-EXPLORATION la I-EXPLORATION -fuerte I-EXPLORATION -sospecha I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -mieloma I-EXPLORATION -múltiple I-EXPLORATION +tórax I-EXPLORATION y I-EXPLORATION -amiloidosis I-EXPLORATION -asociada, I-EXPLORATION +el I-EXPLORATION +electrocardiograma I-EXPLORATION +fueron I-EXPLORATION +todos I-EXPLORATION +normales. I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION realizó I-EXPLORATION -mielograma I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -infiltrado I-EXPLORATION -de I-EXPLORATION -25% I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +escrotal I-EXPLORATION +y B-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +la I-TREATMENT +intervención. I-TREATMENT + I-TREATMENT +Durante I-TREATMENT +la I-TREATMENT +operación, I-TREATMENT +en I-TREATMENT +primer I-TREATMENT +lugar, I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +la I-TREATMENT +reparación I-TREATMENT +de I-TREATMENT +la I-TREATMENT +hernia I-TREATMENT +inguinal I-TREATMENT +izquierda I-TREATMENT +con I-TREATMENT +malla I-TREATMENT +de I-TREATMENT +prolene I-TREATMENT +y I-TREATMENT +después I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +la I-TREATMENT +exploración I-TREATMENT +del I-TREATMENT +hemiescroto I-TREATMENT +derecho. I-TREATMENT + I-TREATMENT +A I-TREATMENT +través I-TREATMENT +de I-TREATMENT +una I-TREATMENT +primera I-TREATMENT +incisión I-TREATMENT +cutánea I-TREATMENT +escrotal I-TREATMENT +derecha I-TREATMENT +intentamos I-TREATMENT +aislar I-TREATMENT +una I-TREATMENT +voluminosa I-TREATMENT +masa I-TREATMENT +blanquecina. I-TREATMENT +Sin I-TREATMENT +embargo, I-TREATMENT +por I-TREATMENT +la I-TREATMENT +dificultad I-TREATMENT +que I-TREATMENT +teníamos I-TREATMENT +en I-TREATMENT +separar I-TREATMENT +la I-TREATMENT +neoformación I-TREATMENT +de I-TREATMENT +los I-TREATMENT +tejidos I-TREATMENT +circundantes I-TREATMENT +y I-TREATMENT +encontrar I-TREATMENT +el I-TREATMENT +testículo I-TREATMENT +derecho, I-TREATMENT +que I-TREATMENT +estaba I-TREATMENT +envuelto I-TREATMENT +por I-TREATMENT +la I-TREATMENT +masa, I-TREATMENT +decidimos I-TREATMENT +eligir I-TREATMENT +otra I-TREATMENT +vía. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +segunda I-TREATMENT +incisión I-TREATMENT +inguinoescrotál I-TREATMENT +a I-TREATMENT +través I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cual, I-TREATMENT +mediante I-TREATMENT +disección I-TREATMENT +roma I-TREATMENT +fue I-TREATMENT +más I-TREATMENT +fácil I-TREATMENT +aislar I-TREATMENT +la I-TREATMENT +neoformación, I-TREATMENT +que I-TREATMENT +se I-TREATMENT +extendía I-TREATMENT +superiormente I-TREATMENT +hasta I-TREATMENT +la I-TREATMENT +altura I-TREATMENT +del I-TREATMENT +anillo I-TREATMENT +inguinal I-TREATMENT +externo. I-TREATMENT +Una I-TREATMENT +vez I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +aislado I-TREATMENT +el I-TREATMENT +cordón I-TREATMENT +espermático I-TREATMENT +conseguimos I-TREATMENT +traer I-TREATMENT +fuera I-TREATMENT +el I-TREATMENT +testículo, I-TREATMENT +que I-TREATMENT +tenía I-TREATMENT +aspecto I-TREATMENT +hipotrófico I-TREATMENT +pero I-TREATMENT +no I-TREATMENT +resultaba I-TREATMENT +afectado. I-TREATMENT +También I-TREATMENT +la I-TREATMENT +resección I-TREATMENT +de I-TREATMENT +la I-TREATMENT +masa I-TREATMENT +resultaba I-TREATMENT +más I-TREATMENT +facil I-TREATMENT +y I-TREATMENT +segura. I-TREATMENT +Los I-TREATMENT +márgenes I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +estaban I-TREATMENT +bien I-TREATMENT +delimitados I-TREATMENT +y I-TREATMENT +fáciles I-TREATMENT +de I-TREATMENT +separarse I-TREATMENT +a I-TREATMENT +excepción I-TREATMENT +de I-TREATMENT +una I-TREATMENT +zona I-TREATMENT +del I-TREATMENT +fondo I-TREATMENT +de I-TREATMENT +la I-TREATMENT +bolsa I-TREATMENT +escrotal, I-TREATMENT +donde I-TREATMENT +la I-TREATMENT +neoformación I-TREATMENT +tenía I-TREATMENT +más I-TREATMENT +adherencia I-TREATMENT +con I-TREATMENT +el I-TREATMENT +dartos. I-TREATMENT + I-TREATMENT +El B-EXPLORATION +aspecto I-EXPLORATION +macroscópico I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -plasmáticas. I-EXPLORATION -El I-EXPLORATION -inmunofenotipo I-EXPLORATION +la I-EXPLORATION +neoformación I-EXPLORATION +extirpada I-EXPLORATION +era I-EXPLORATION +el I-EXPLORATION de I-EXPLORATION -médula I-EXPLORATION -ósea I-EXPLORATION -mostró I-EXPLORATION -presencia I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -plasmáticas I-EXPLORATION -con I-EXPLORATION -restricción I-EXPLORATION +forma I-EXPLORATION +alongada I-EXPLORATION de I-EXPLORATION -cadena I-EXPLORATION -liviana I-EXPLORATION -lambda I-EXPLORATION +15 I-EXPLORATION +x I-EXPLORATION +7 I-EXPLORATION +x I-EXPLORATION +5cm I-EXPLORATION y I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -mieloma. I-EXPLORATION -La I-EXPLORATION -electroforesis I-EXPLORATION +peso I-EXPLORATION de I-EXPLORATION -proteínas I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -pequeño I-EXPLORATION -componente I-EXPLORATION -M I-EXPLORATION -en I-EXPLORATION -G1 I-EXPLORATION +140 I-EXPLORATION +gr I-EXPLORATION +aparentemente I-EXPLORATION +encapsulada I-EXPLORATION +con I-EXPLORATION +superficie I-EXPLORATION +externa I-EXPLORATION +lisa I-EXPLORATION y I-EXPLORATION -cuantificación I-EXPLORATION -de I-EXPLORATION -inmunoglobulinas I-EXPLORATION -muy I-EXPLORATION -disminuidas, I-EXPLORATION -IgA I-EXPLORATION -27, I-EXPLORATION -7 I-EXPLORATION -mg/dL, I-EXPLORATION -IgG I-EXPLORATION -e I-EXPLORATION -IgM I-EXPLORATION -de I-EXPLORATION -8, I-EXPLORATION -8 I-EXPLORATION -mg/dL. I-EXPLORATION -No I-EXPLORATION -fue I-EXPLORATION -posible I-EXPLORATION -estudiar I-EXPLORATION -proteinuria I-EXPLORATION -ya I-EXPLORATION -que I-EXPLORATION +regular. I-EXPLORATION +Al I-EXPLORATION +corte I-EXPLORATION la I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION +superficie I-EXPLORATION +se I-EXPLORATION presentaba I-EXPLORATION -diuresis. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION +uniforme, I-EXPLORATION de I-EXPLORATION -muslo I-EXPLORATION -izquierdo, I-EXPLORATION -informó I-EXPLORATION -tejido I-EXPLORATION -fibroadiposo, I-EXPLORATION -escaso I-EXPLORATION -tejido I-EXPLORATION -muscular I-EXPLORATION -estriado I-EXPLORATION +aspecto I-EXPLORATION +denso I-EXPLORATION y I-EXPLORATION -depósitos I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -Rojo I-EXPLORATION -Congo, I-EXPLORATION -confirmando I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +fibroso, I-EXPLORATION de I-EXPLORATION -amiloidosis. I-EXPLORATION -Las I-EXPLORATION -radiografías I-EXPLORATION -óseas I-EXPLORATION -mostraron I-EXPLORATION -lesiones I-EXPLORATION -líticas I-EXPLORATION -en I-EXPLORATION -cadera I-EXPLORATION -y I-EXPLORATION -fémur I-EXPLORATION -derecho I-EXPLORATION +color I-EXPLORATION +blanquecino I-EXPLORATION y I-EXPLORATION -aumento I-EXPLORATION de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -en I-EXPLORATION -correspondencia I-EXPLORATION -a I-EXPLORATION -masas I-EXPLORATION -descritas I-EXPLORATION -anteriormente, I-EXPLORATION +consistencia I-EXPLORATION +elástica I-EXPLORATION sin I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -estructuras I-EXPLORATION -óseas. I-EXPLORATION -Una I-EXPLORATION -electromiografía I-EXPLORATION -mostró I-EXPLORATION +evidencia I-EXPLORATION +de I-EXPLORATION +degeneración I-EXPLORATION +mixoide I-EXPLORATION +o I-EXPLORATION +necrosis. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +microscópico I-EXPLORATION +demostró I-EXPLORATION una I-EXPLORATION -neuropatía I-EXPLORATION +tumoración I-EXPLORATION +constituida I-EXPLORATION por I-EXPLORATION -atrapamiento I-EXPLORATION -de I-EXPLORATION -nervio I-EXPLORATION -peroneo I-EXPLORATION -y I-EXPLORATION -nervio I-EXPLORATION -mediano I-EXPLORATION -derecho. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -depósitos I-EXPLORATION +grupos I-EXPLORATION de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION +células I-EXPLORATION +fusiformes, I-EXPLORATION +onduladas I-EXPLORATION +e I-EXPLORATION +hipercrómicas, I-EXPLORATION +estrechamente I-EXPLORATION +interpuestas I-EXPLORATION en I-EXPLORATION -hombros I-EXPLORATION -(periarticulares), I-EXPLORATION -pericardio, I-EXPLORATION -pared I-EXPLORATION -intestinal, I-EXPLORATION -hepatomegalia I-EXPLORATION -y I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION +haces I-EXPLORATION de I-EXPLORATION -cabeza I-EXPLORATION +fibras I-EXPLORATION de I-EXPLORATION -páncreas. I-EXPLORATION -No I-EXPLORATION +colágeno. I-EXPLORATION +Con I-EXPLORATION +la I-EXPLORATION +inmunohistoquímica I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -ecocardiograma. I-EXPLORATION -Se I-EXPLORATION -concluyó I-EXPLORATION -que I-EXPLORATION +evidenciaba I-EXPLORATION +positividad I-EXPLORATION +citoplásmica I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +proteína I-EXPLORATION +S-100. I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -trataba I-EXPLORATION +documentaron I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -mieloma I-EXPLORATION -múltiple, I-EXPLORATION -amiloidosis I-EXPLORATION -asociada I-EXPLORATION -e I-EXPLORATION -insuficiencia I-EXPLORATION -renal I-EXPLORATION -terminal. I-EXPLORATION -Recibió B-TREATMENT -bisfosfonatos, I-TREATMENT -con I-TREATMENT -reducción I-TREATMENT -de I-TREATMENT -la I-TREATMENT -hipercalcemia I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -melfalan I-TREATMENT -10 I-TREATMENT -mg/día I-TREATMENT -y I-TREATMENT -prednisona I-TREATMENT -40 I-TREATMENT -mg/día I-TREATMENT -por I-TREATMENT -4 I-TREATMENT -días. I-TREATMENT -Luego I-TREATMENT -se I-TREATMENT -agregó I-TREATMENT -talidomida I-TREATMENT -50 I-TREATMENT -mg/día. I-TREATMENT -Lamentablemente, B-EVOLUTION +necrosis, I-EXPLORATION +mitosis I-EXPLORATION +ni I-EXPLORATION +atipias I-EXPLORATION +nucleares. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +histopatológico I-EXPLORATION +definitivo I-EXPLORATION +fue I-EXPLORATION +el I-EXPLORATION +de I-EXPLORATION +neurofibroma. I-EXPLORATION + I-EXPLORATION +Un B-EVOLUTION +año I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION -falleció I-EVOLUTION -al I-EVOLUTION -mes I-EVOLUTION +intervención I-EVOLUTION +no I-EVOLUTION +se I-EVOLUTION +han I-EVOLUTION +revelado I-EVOLUTION +signos I-EVOLUTION +objetivos I-EVOLUTION de I-EVOLUTION -tratamiento. I-EVOLUTION +recidiva. I-EVOLUTION I-EVOLUTION -Un B-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -ingeniero, B-PAST_MEDICAL_HISTORY -previamente I-PAST_MEDICAL_HISTORY -sano, I-PAST_MEDICAL_HISTORY -presentó B-PRESENT_ILLNESS +33 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +médicos I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +quirúrgicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -curso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas, I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -retención I-PRESENT_ILLNESS -urinaria, I-PRESENT_ILLNESS -debilidad I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +sala I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -extremidades I-PRESENT_ILLNESS -inferiores I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -déficits I-PRESENT_ILLNESS -sensoriales I-PRESENT_ILLNESS -irregulares I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS +traumatología I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS el I-PRESENT_ILLNESS -tórax I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -abdomen. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -único I-PAST_MEDICAL_HISTORY -antecedente, I-PAST_MEDICAL_HISTORY -comunicó I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -tos I-PAST_MEDICAL_HISTORY -leve I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -4-5 I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -admisión I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -clínica. I-PAST_MEDICAL_HISTORY -Una I-PAST_MEDICAL_HISTORY -evaluación I-PAST_MEDICAL_HISTORY -urológica I-PAST_MEDICAL_HISTORY -descartó I-PAST_MEDICAL_HISTORY -uropatía I-PAST_MEDICAL_HISTORY -obstructiva. I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -neurológico I-EXPLORATION -estaba I-EXPLORATION -alerta, I-EXPLORATION -febril I-EXPLORATION -(38°C), I-EXPLORATION -sin I-EXPLORATION -déficits I-EXPLORATION -en I-EXPLORATION -nervios I-EXPLORATION -craneales. I-EXPLORATION -La I-EXPLORATION -fuerza I-EXPLORATION +diagnostico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +lumbalgia I-PRESENT_ILLNESS +rebelde I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +domiciliario. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Se B-EXPLORATION +realizó I-EXPLORATION +TAC I-EXPLORATION +abdominopélvico I-EXPLORATION en I-EXPLORATION -los I-EXPLORATION -miembros I-EXPLORATION -superiores I-EXPLORATION -era I-EXPLORATION -normal, I-EXPLORATION -pero I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -debilidad I-EXPLORATION -moderada I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION +aprecia I-EXPLORATION +gran I-EXPLORATION +masa I-EXPLORATION +retroperitoneal I-EXPLORATION +(paraaórtica) I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +continua I-EXPLORATION con I-EXPLORATION -incapacidad I-EXPLORATION -para I-EXPLORATION -levantarse I-EXPLORATION -desde I-EXPLORATION -una I-EXPLORATION -posición I-EXPLORATION -sentada. I-EXPLORATION -Los I-EXPLORATION -reflejos I-EXPLORATION -plantares I-EXPLORATION -eran I-EXPLORATION -extensores, I-EXPLORATION -había I-EXPLORATION -déficit I-EXPLORATION -sensorial I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -parte I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -cuello I-EXPLORATION +cadena I-EXPLORATION +iliaca I-EXPLORATION +primitiva I-EXPLORATION y I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -dermatoma I-EXPLORATION -D6. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -rutina: I-EXPLORATION -hemograma, I-EXPLORATION -velocidad I-EXPLORATION +las I-EXPLORATION +cadenas I-EXPLORATION +iliacas, I-EXPLORATION +sobre I-EXPLORATION +todo I-EXPLORATION +la I-EXPLORATION +externa I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lado I-EXPLORATION +izquierdo I-EXPLORATION de I-EXPLORATION -sedimentación, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva, I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -urocultivos I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -del I-EXPLORATION -LCR I-EXPLORATION -mostró I-EXPLORATION -35 I-EXPLORATION -glóbulos I-EXPLORATION -blancos I-EXPLORATION -por I-EXPLORATION -mm3, I-EXPLORATION +la I-EXPLORATION +cavidad I-EXPLORATION +abdominopelviana I-EXPLORATION +(9¥28 I-EXPLORATION +cm). I-EXPLORATION +La I-EXPLORATION +tumoración I-EXPLORATION +es I-EXPLORATION +sólida I-EXPLORATION con I-EXPLORATION -predominio I-EXPLORATION +pequeñas I-EXPLORATION +áreas I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -mononucleares. I-EXPLORATION -La I-EXPLORATION -proteínorraquia I-EXPLORATION +necrosis. I-EXPLORATION +El I-EXPLORATION +TAC I-EXPLORATION +cervicotorácico I-EXPLORATION fue I-EXPLORATION -75 I-EXPLORATION -mg/dl. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -detectaron I-EXPLORATION -bandas I-EXPLORATION -oligoclonales. I-EXPLORATION -La I-EXPLORATION -detección I-EXPLORATION -de I-EXPLORATION -ARN I-EXPLORATION -viral I-EXPLORATION -por I-EXPLORATION -técnica I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +practicó I-EXPLORATION +punción I-EXPLORATION +biopsia I-EXPLORATION de I-EXPLORATION -PCR-Microarray I-EXPLORATION -(Entherpex®, I-EXPLORATION -Genomica, I-EXPLORATION -España), I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -en I-EXPLORATION +la I-EXPLORATION +masa I-EXPLORATION +siendo I-EXPLORATION el I-EXPLORATION -LCR I-EXPLORATION -sólo I-EXPLORATION -para I-EXPLORATION -VHH-7. I-EXPLORATION -Los I-EXPLORATION -herpes I-EXPLORATION -virus I-EXPLORATION -VHS-1, I-EXPLORATION -VHS-2, I-EXPLORATION -VHH-6, I-EXPLORATION -Epstein-Barr, I-EXPLORATION -VVZ, I-EXPLORATION -citomegalovirus I-EXPLORATION -y I-EXPLORATION -también I-EXPLORATION -anterovirus I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -El I-EXPLORATION -test I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION -y I-EXPLORATION -HTLV-1 I-EXPLORATION -fue I-EXPLORATION -negativo, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -pruebas I-EXPLORATION -inmunológicas I-EXPLORATION -para I-EXPLORATION -vasculitis I-EXPLORATION -y I-EXPLORATION -test I-EXPLORATION -serológico I-EXPLORATION -para I-EXPLORATION -Mycoplasma I-EXPLORATION -pneumoniae. I-EXPLORATION +resultado I-EXPLORATION +anatomopatológico I-EXPLORATION +de I-EXPLORATION +tumor I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +germinales I-EXPLORATION +tipo I-EXPLORATION +seminoma. I-EXPLORATION + I-EXPLORATION La I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RNM) I-EXPLORATION -cerebral I-EXPLORATION +exploración I-EXPLORATION +testicular I-EXPLORATION +bilateral I-EXPLORATION fue I-EXPLORATION normal I-EXPLORATION y I-EXPLORATION la I-EXPLORATION -RNM I-EXPLORATION +ecografía I-EXPLORATION +testicular I-EXPLORATION +informó I-EXPLORATION de I-EXPLORATION -médula I-EXPLORATION -evidenció I-EXPLORATION -lesiones I-EXPLORATION -inflamatorias, I-EXPLORATION -difusas, I-EXPLORATION +múltiples I-EXPLORATION +imágenes I-EXPLORATION +ecogénicas I-EXPLORATION +puntiformes I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +testículos I-EXPLORATION +(mas I-EXPLORATION +llamativas I-EXPLORATION +y I-EXPLORATION extensas I-EXPLORATION en I-EXPLORATION -los I-EXPLORATION -segmentos I-EXPLORATION -cervical, I-EXPLORATION +el I-EXPLORATION +teste I-EXPLORATION +izquierdo), I-EXPLORATION +pero I-EXPLORATION +sin I-EXPLORATION +masa I-EXPLORATION +clara. I-EXPLORATION +Ante I-EXPLORATION +estos I-EXPLORATION +hallazgos I-EXPLORATION +ecográficos, I-EXPLORATION +se I-EXPLORATION +practicó I-EXPLORATION +biopsia I-EXPLORATION +testicular I-EXPLORATION +bilateral. I-EXPLORATION +En I-EXPLORATION +ambos I-EXPLORATION +testes I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +informó I-EXPLORATION +de I-EXPLORATION +atrofia I-EXPLORATION +testicular I-EXPLORATION +con I-EXPLORATION +patrón I-EXPLORATION +de I-EXPLORATION +síndrome I-EXPLORATION +de I-EXPLORATION +"solo I-EXPLORATION +células I-EXPLORATION +de I-EXPLORATION +Sertoli", I-EXPLORATION +hialinización I-EXPLORATION +tubular I-EXPLORATION y I-EXPLORATION -dorsal I-EXPLORATION +microlitiasis. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION de I-EXPLORATION +sangre I-EXPLORATION +practicada I-EXPLORATION +al I-EXPLORATION +paciente I-EXPLORATION +llamaba I-EXPLORATION la I-EXPLORATION -médula I-EXPLORATION -(ver I-EXPLORATION -Figuras I-EXPLORATION -1 I-EXPLORATION +atención I-EXPLORATION +una I-EXPLORATION +LDH I-EXPLORATION +de I-EXPLORATION +1903 I-EXPLORATION y I-EXPLORATION -2). I-EXPLORATION +b-HCG I-EXPLORATION +de I-EXPLORATION +23, I-EXPLORATION +8, I-EXPLORATION +con I-EXPLORATION +α-fetoproteína I-EXPLORATION +normal. I-EXPLORATION I-EXPLORATION -Se B-TREATMENT +El B-TREATMENT +paciente I-TREATMENT inició I-TREATMENT -metilprednisolona I-TREATMENT -1 I-TREATMENT -g I-TREATMENT -al I-TREATMENT -día I-TREATMENT -durante I-TREATMENT -3 I-TREATMENT -días I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +quimioterapia I-TREATMENT +CTEP I-TREATMENT +(Cisplatino I-TREATMENT y I-TREATMENT -ganciclovir I-TREATMENT -iv I-TREATMENT -300 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día. I-TREATMENT -A I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -h I-TREATMENT +Etopósido). I-TREATMENT +Después B-EXPLORATION +de I-EXPLORATION +4 I-EXPLORATION +ciclos I-EXPLORATION +se I-EXPLORATION +practicó I-EXPLORATION +TAC I-EXPLORATION +de I-EXPLORATION +control, I-EXPLORATION +observándose I-EXPLORATION +la I-EXPLORATION +total I-EXPLORATION +desaparición I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +masa I-EXPLORATION +retroperitoneal, I-EXPLORATION +quedando I-EXPLORATION +tan I-EXPLORATION +solo I-EXPLORATION +dos I-EXPLORATION +adenopatías I-EXPLORATION +paraaórticas I-EXPLORATION +izquierdas I-EXPLORATION +y I-EXPLORATION +otra I-EXPLORATION +en I-EXPLORATION +cadena I-EXPLORATION +iliaca I-EXPLORATION +izquierda I-EXPLORATION +de I-EXPLORATION +aproximadamente I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION +cada I-EXPLORATION +una, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT el I-TREATMENT paciente I-TREATMENT -recuperó I-TREATMENT -la I-TREATMENT -fuerza I-TREATMENT -en I-TREATMENT -extremidades I-TREATMENT -por I-TREATMENT -completo; I-TREATMENT -la B-EVOLUTION -retención I-EVOLUTION -urinaria I-EVOLUTION -persistió I-EVOLUTION -por I-EVOLUTION -1 I-EVOLUTION -mes I-EVOLUTION -para I-EVOLUTION -resolverse I-EVOLUTION -por I-EVOLUTION -completo I-EVOLUTION +recibió I-TREATMENT +dos I-TREATMENT +ciclos I-TREATMENT +mas I-TREATMENT +de I-TREATMENT +CTEP, I-TREATMENT +sin B-EVOLUTION +conseguirse I-EVOLUTION +reducción I-EVOLUTION en I-EVOLUTION el I-EVOLUTION -segundo I-EVOLUTION -mes I-EVOLUTION +tamaño I-EVOLUTION de I-EVOLUTION -seguimiento. I-EVOLUTION +dichas I-EVOLUTION +adenopatías. I-EVOLUTION I-EVOLUTION +Con B-TREATMENT +la I-TREATMENT +intención I-TREATMENT +de I-TREATMENT +extirpar I-TREATMENT +la I-TREATMENT +masa I-TREATMENT +tumoral I-TREATMENT +restante I-TREATMENT +tras I-TREATMENT +la I-TREATMENT +quimioterapia, I-TREATMENT +se I-TREATMENT +practicó I-TREATMENT +laparotomía I-TREATMENT +media I-TREATMENT +con I-TREATMENT +resección I-TREATMENT +de I-TREATMENT +las I-TREATMENT +adenopatías I-TREATMENT +y I-TREATMENT +orquiectomía I-TREATMENT +bilateral. I-TREATMENT El B-EXPLORATION -control I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -LCR I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -10 I-EXPLORATION -días I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -PCR I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION +las I-EXPLORATION +adenopatías I-EXPLORATION +informó I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -familia I-EXPLORATION -Herpesviridae. I-EXPLORATION -Se I-EXPLORATION -observaron I-EXPLORATION -15 I-EXPLORATION -células I-EXPLORATION +tejido I-EXPLORATION +fibroso I-EXPLORATION con I-EXPLORATION -proteinas I-EXPLORATION -en I-EXPLORATION -rango I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -repetición I-EXPLORATION +infiltrado I-EXPLORATION +linfoide I-EXPLORATION +disperso I-EXPLORATION +y I-EXPLORATION +necrosis I-EXPLORATION +sin I-EXPLORATION +observarse I-EXPLORATION +tumor. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -PCR I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -muestra I-EXPLORATION -inicial I-EXPLORATION +los I-EXPLORATION +testículos I-EXPLORATION +informo I-EXPLORATION de I-EXPLORATION -LCR, I-EXPLORATION -tomada I-EXPLORATION -al I-EXPLORATION -ingreso, I-EXPLORATION -también I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION +síndrome I-EXPLORATION de I-EXPLORATION -alta I-EXPLORATION -fue I-EXPLORATION -mielitis I-EXPLORATION -viral I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -HHV-7. I-EXPLORATION +solo I-EXPLORATION +células I-EXPLORATION +de I-EXPLORATION +Sertoli, I-EXPLORATION +con I-EXPLORATION +importante I-EXPLORATION +atrofia I-EXPLORATION +tubular, I-EXPLORATION +hialinosis, I-EXPLORATION +calcificaciones I-EXPLORATION +y I-EXPLORATION +microlitiasis I-EXPLORATION +sin I-EXPLORATION +observarse I-EXPLORATION +tumor. I-EXPLORATION I-EXPLORATION -Los B-EVOLUTION -controles I-EVOLUTION -posteriores I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION +Tras B-EVOLUTION +doce I-EVOLUTION meses I-EVOLUTION de I-EVOLUTION -evolución I-EVOLUTION -evidenciaron I-EVOLUTION -un I-EVOLUTION +seguimiento, I-EVOLUTION +el I-EVOLUTION paciente I-EVOLUTION -sano, I-EVOLUTION +está I-EVOLUTION +clínicamente I-EVOLUTION +asintomático I-EVOLUTION +con B-TREATMENT +tratamiento I-TREATMENT +hormonal I-TREATMENT +sustitutivo I-TREATMENT +y B-EVOLUTION sin I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -haber I-EVOLUTION -desarrollado I-EVOLUTION -inmunodeficiencia. I-EVOLUTION +recidiva I-EVOLUTION +radiológica I-EVOLUTION +ni I-EVOLUTION +analítica. I-EVOLUTION I-EVOLUTION -Sexo B-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -25 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -VIH B-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -2000, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -enfermedades I-PAST_MEDICAL_HISTORY -marcadoras I-PAST_MEDICAL_HISTORY -etapa I-PAST_MEDICAL_HISTORY -SIDA, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -terapia I-PAST_MEDICAL_HISTORY -antirretroviral I-PAST_MEDICAL_HISTORY -(TARV) I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -con: I-PAST_MEDICAL_HISTORY -zidovudina, I-PAST_MEDICAL_HISTORY -lamivudina, I-PAST_MEDICAL_HISTORY -indinavir/ritonavir, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -migraña. I-PAST_MEDICAL_HISTORY -Cuarenta B-PRESENT_ILLNESS +Niña B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -ocho I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -previas I-PRESENT_ILLNESS +medio, I-PRESENT_ILLNESS +de B-PAST_MEDICAL_HISTORY +origen I-PAST_MEDICAL_HISTORY +asiático, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS a I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -consulta, I-PRESENT_ILLNESS -comenzó I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -características I-PRESENT_ILLNESS -tensionales, I-PRESENT_ILLNESS -automedicándose I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -ibuprofeno/ergotamina I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -agregando I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas: I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -intenso, I-PRESENT_ILLNESS -parestesias I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS +Atención I-PRESENT_ILLNESS +Primaria I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +siguiente I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tercio I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS +llegar I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +orfanato I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -inferiores. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -presentaba: I-EXPLORATION -palidez I-EXPLORATION -cutánea I-EXPLORATION -alternante I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -cianosis I-EXPLORATION -y I-EXPLORATION -frialdad I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -tobillos I-EXPLORATION -junto I-EXPLORATION -a I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -pulso I-EXPLORATION -tibial I-EXPLORATION -posterior I-EXPLORATION -y I-EXPLORATION -pedio.. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS +China I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +estado I-PRESENT_ILLNESS +viviendo, I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +haber I-PRESENT_ILLNESS +sido I-PRESENT_ILLNESS +adoptada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +familia I-PRESENT_ILLNESS +española I-PRESENT_ILLNESS +compuesta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +padre, I-PRESENT_ILLNESS +madre I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +hijos I-PRESENT_ILLNESS +biológicos I-PRESENT_ILLNESS +adolescentes. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +acompaña I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +madre I-PRESENT_ILLNESS +adoptiva, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +solicita I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +valoración I-PRESENT_ILLNESS +general I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +estado I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -originario B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Tamaulipas, I-PAST_MEDICAL_HISTORY -México, I-PAST_MEDICAL_HISTORY -evaluado B-PRESENT_ILLNESS +salud, I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +espera I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +ser I-PRESENT_ILLNESS +atendida I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -xerosis I-PRESENT_ILLNESS -generalizada, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -origen I-PRESENT_ILLNESS -incierto. I-PRESENT_ILLNESS -Producto B-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -segundo I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -pareja I-PAST_MEDICAL_HISTORY -sin B-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -aparentes I-FAMILY_HISTORY -de I-FAMILY_HISTORY -consanguineidad, I-FAMILY_HISTORY -se B-PAST_MEDICAL_HISTORY -caracteriza I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -presentar I-PAST_MEDICAL_HISTORY -intolerancia I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -calor I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ausencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -sudoración I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -nacimiento. I-PAST_MEDICAL_HISTORY -No B-FAMILY_HISTORY -refierían I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -heredofamiliares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -importancia. I-FAMILY_HISTORY +referencia I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +Comunidad I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Madrid I-PRESENT_ILLNESS +establece I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +Protocolo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Adopción I-PRESENT_ILLNESS +Internacional. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS En B-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destacaba I-EXPLORATION +inspección I-EXPLORATION +destaca I-EXPLORATION +su I-EXPLORATION +fenotipo I-EXPLORATION +mongoloide I-EXPLORATION +racial, I-EXPLORATION +un I-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION +nutricional I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +comportamiento I-EXPLORATION +tranquilo. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -frenteprominente, I-EXPLORATION -hipoplasia I-EXPLORATION -del I-EXPLORATION -puente I-EXPLORATION -nasal, I-EXPLORATION -dos I-EXPLORATION -incisivos I-EXPLORATION -únicos I-EXPLORATION +exploración I-EXPLORATION +se I-EXPLORATION +descubre I-EXPLORATION +que I-EXPLORATION en I-EXPLORATION -forma I-EXPLORATION -de I-EXPLORATION -cono, I-EXPLORATION -pigmentación I-EXPLORATION -periorbitaria, I-EXPLORATION -pelo I-EXPLORATION -escaso, I-EXPLORATION -fino, I-EXPLORATION -disperso I-EXPLORATION -y I-EXPLORATION -frágil I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -cejas I-EXPLORATION -y I-EXPLORATION -pestañas. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION +el I-EXPLORATION +periné I-EXPLORATION +hay I-EXPLORATION una I-EXPLORATION -dermatosis I-EXPLORATION -diseminada I-EXPLORATION -a I-EXPLORATION -cabeza, I-EXPLORATION -tronco I-EXPLORATION +lesión I-EXPLORATION +lineal I-EXPLORATION +entre I-EXPLORATION +la I-EXPLORATION +horquilla I-EXPLORATION +vulvar I-EXPLORATION y I-EXPLORATION -principalmente I-EXPLORATION -en I-EXPLORATION -extremidades I-EXPLORATION -superiores I-EXPLORATION -e I-EXPLORATION -inferiores, I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -pápulas I-EXPLORATION -puntiformes I-EXPLORATION -eritematosas, I-EXPLORATION +el I-EXPLORATION +ano, I-EXPLORATION con I-EXPLORATION -eritema I-EXPLORATION -difuso I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -piel I-EXPLORATION -xerótica. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION +aspecto I-EXPLORATION de I-EXPLORATION -piel I-EXPLORATION +herida I-EXPLORATION +incisa, I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -palma I-EXPLORATION +fondo I-EXPLORATION +eritematoso, I-EXPLORATION +recubierta I-EXPLORATION +de I-EXPLORATION +mucosa I-EXPLORATION +y I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION +sangrado. I-EXPLORATION +La I-EXPLORATION +uretra, I-EXPLORATION la I-EXPLORATION -mano I-EXPLORATION -izquierda I-EXPLORATION -demostró I-EXPLORATION +vagina, I-EXPLORATION la I-EXPLORATION -ausencia I-EXPLORATION -parcial I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -glándulas I-EXPLORATION -sudoríparas I-EXPLORATION +vulva I-EXPLORATION y I-EXPLORATION -sebáceas. I-EXPLORATION -Después I-EXPLORATION -de I-EXPLORATION -obtener I-EXPLORATION -el I-EXPLORATION -consentimiento I-EXPLORATION -informado, I-EXPLORATION -obtuvimos I-EXPLORATION -sangre I-EXPLORATION -periférica I-EXPLORATION -para I-EXPLORATION -realizar I-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION +ano I-EXPLORATION +tienen I-EXPLORATION +un I-EXPLORATION +aspecto I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +primera I-EXPLORATION +sospecha I-EXPLORATION +diagnóstica I-EXPLORATION +fue I-EXPLORATION +la I-EXPLORATION de I-EXPLORATION -cariotipo I-EXPLORATION -reportándose I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION +una I-EXPLORATION +agresión I-EXPLORATION +sexual, I-EXPLORATION +pero I-EXPLORATION +se I-EXPLORATION +optó I-EXPLORATION +por I-EXPLORATION +una I-EXPLORATION +actitud I-EXPLORATION +expectante, I-EXPLORATION +debido I-EXPLORATION a I-EXPLORATION la I-EXPLORATION -vez, I-EXPLORATION -obtuvimos I-EXPLORATION -sangre I-EXPLORATION -no I-EXPLORATION -coagulada I-EXPLORATION -en I-EXPLORATION -tubos I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -EDTA I-EXPLORATION -(ácido I-EXPLORATION -etilendiaminotetraacético) I-EXPLORATION +sangrado I-EXPLORATION +activo I-EXPLORATION +y I-EXPLORATION de I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -miembros I-EXPLORATION +dolor, I-EXPLORATION +al I-EXPLORATION +aspecto I-EXPLORATION +normal I-EXPLORATION +del I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -familia I-EXPLORATION -siguiendo I-EXPLORATION los I-EXPLORATION -Principios I-EXPLORATION +genitales I-EXPLORATION +externos I-EXPLORATION +y I-EXPLORATION +al I-EXPLORATION +comportamiento I-EXPLORATION +tranquilo I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -Declaración I-EXPLORATION -de I-EXPLORATION -Helsinki. I-EXPLORATION +niña I-EXPLORATION +durante I-EXPLORATION +la I-EXPLORATION +exploración. I-EXPLORATION Se I-EXPLORATION -extrajo I-EXPLORATION -ADN I-EXPLORATION +solicitó I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +renal I-EXPLORATION +y I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -muestras I-EXPLORATION -sanguíneas I-EXPLORATION -utilizando I-EXPLORATION -el I-EXPLORATION -equipo I-EXPLORATION -PUREGENER I-EXPLORATION -(Systema I-EXPLORATION -Gentra). I-EXPLORATION -Para I-EXPLORATION -el I-EXPLORATION +vías I-EXPLORATION +urinarias, I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Tras B-EVOLUTION +los I-EVOLUTION +primeros I-EVOLUTION +controles I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +hospital I-EVOLUTION +de I-EVOLUTION +referencia I-EVOLUTION +antes I-EVOLUTION +mencionado, I-EVOLUTION +la I-EVOLUTION +madre I-EVOLUTION +acude I-EVOLUTION +angustiada I-EVOLUTION +al I-EVOLUTION +centro I-EVOLUTION +de I-EVOLUTION +salud, I-EVOLUTION +porque I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +hospital I-EVOLUTION +sospechan I-EVOLUTION +que I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +familia I-EVOLUTION +se I-EVOLUTION +está I-EVOLUTION +abusando I-EVOLUTION +sexualmente I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +niña, I-EVOLUTION +e I-EVOLUTION +incluso I-EVOLUTION +se I-EVOLUTION +les I-EVOLUTION +ha I-EVOLUTION +amenazado I-EVOLUTION +con I-EVOLUTION +denunciarlo I-EVOLUTION +así I-EVOLUTION +ante I-EVOLUTION +las I-EVOLUTION +autoridades. I-EVOLUTION +En I-EVOLUTION +este I-EVOLUTION +intervalo, I-EVOLUTION +la I-EVOLUTION +oportuna I-EVOLUTION +lectura I-EVOLUTION +de I-EVOLUTION +un I-EVOLUTION +artículo I-EVOLUTION +relacionado I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +surco I-EVOLUTION +perineal3 I-EVOLUTION +proporciona I-EVOLUTION +la I-EVOLUTION +clave I-EVOLUTION +para I-EVOLUTION +el I-EVOLUTION +diagnóstico I-EVOLUTION +definitivo I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +malformación, I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +consiguiente I-EVOLUTION +alivio I-EVOLUTION +de I-EVOLUTION +todos I-EVOLUTION +los I-EVOLUTION +implicados. I-EVOLUTION +El B-EXPLORATION estudio I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -mutaciones I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -exones I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -las I-EXPLORATION -secuencias I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -uniones I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -intrones-exones I-EXPLORATION -fueron I-EXPLORATION -amplificados I-EXPLORATION +microbiológico I-EXPLORATION +solicitado I-EXPLORATION por I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -PCR I-EXPLORATION -(reacción I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -polimerasa) I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -EDA-A1 I-EXPLORATION -en I-EXPLORATION -condiciones I-EXPLORATION -reportadas I-EXPLORATION -previamente. I-EXPLORATION -Las I-EXPLORATION -condiciones I-EXPLORATION +el I-EXPLORATION +hospital I-EXPLORATION para I-EXPLORATION -la I-EXPLORATION -amplificación I-EXPLORATION -de I-EXPLORATION -cada I-EXPLORATION -PCR I-EXPLORATION -fueron I-EXPLORATION +descartar I-EXPLORATION +enfermedades I-EXPLORATION de I-EXPLORATION -94 I-EXPLORATION -°C I-EXPLORATION -por I-EXPLORATION -2 I-EXPLORATION -minutos, I-EXPLORATION -seguido I-EXPLORATION -por I-EXPLORATION -35 I-EXPLORATION -ciclos I-EXPLORATION +transmisión I-EXPLORATION +sexual I-EXPLORATION +fue I-EXPLORATION +negativo I-EXPLORATION +(lúes, I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION -94°C I-EXPLORATION -durante I-EXPLORATION -30 I-EXPLORATION -segundos, I-EXPLORATION -55°C I-EXPLORATION -por I-EXPLORATION -30 I-EXPLORATION -segundos I-EXPLORATION +la I-EXPLORATION +inmunodeficiencia I-EXPLORATION +humana I-EXPLORATION y I-EXPLORATION -72°C I-EXPLORATION -por I-EXPLORATION -30 I-EXPLORATION -segundos I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -extensión I-EXPLORATION -final I-EXPLORATION -a I-EXPLORATION -72°C I-EXPLORATION -durante I-EXPLORATION -7 I-EXPLORATION -minutos. I-EXPLORATION -Los I-EXPLORATION -productos I-EXPLORATION -de I-EXPLORATION -PCR I-EXPLORATION -fueron I-EXPLORATION -colocados I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -gel I-EXPLORATION de I-EXPLORATION -agarosa I-EXPLORATION -al I-EXPLORATION -1% I-EXPLORATION +las I-EXPLORATION +hepatitis I-EXPLORATION +B, I-EXPLORATION +C I-EXPLORATION y I-EXPLORATION -posteriormente I-EXPLORATION -fueron I-EXPLORATION -analizados I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -Secuenciadora I-EXPLORATION -Automática I-EXPLORATION -Directa I-EXPLORATION -ABI I-EXPLORATION -Prism I-EXPLORATION -310, I-EXPLORATION -utilizando I-EXPLORATION -el I-EXPLORATION -equipo I-EXPLORATION -de I-EXPLORATION -Reacción I-EXPLORATION -"ABI I-EXPLORATION -PRISM® I-EXPLORATION -BigDye™ I-EXPLORATION -Terminator I-EXPLORATION -Cycle I-EXPLORATION -Sequencing' I-EXPLORATION -(PE I-EXPLORATION -Biosystem) I-EXPLORATION -8. I-EXPLORATION - I-EXPLORATION -Debido I-EXPLORATION -a I-EXPLORATION -que I-EXPLORATION -comúnmente I-EXPLORATION -la I-EXPLORATION -displasia I-EXPLORATION -ectodérmica I-EXPLORATION -hipohidrótica I-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -ligada I-EXPLORATION -a I-EXPLORATION -X, I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -obtener I-EXPLORATION -ADN I-EXPLORATION -genómico, I-EXPLORATION -logrando I-EXPLORATION -identificar I-EXPLORATION -la I-EXPLORATION -mutación I-EXPLORATION -sinsentido I-EXPLORATION -Ala349Thr I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -gen I-EXPLORATION -EDA, I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -la I-EXPLORATION -correlación I-EXPLORATION -clínico-patológica, I-EXPLORATION -concluyendo I-EXPLORATION -así I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -displasia I-EXPLORATION -ectodérmica I-EXPLORATION -hipohidrótica.. I-EXPLORATION - I-EXPLORATION +A, I-EXPLORATION +herpes I-EXPLORATION +y I-EXPLORATION +gonococo). I-EXPLORATION +La B-EVOLUTION +niña I-EVOLUTION +refiere, I-EVOLUTION +de I-EVOLUTION +modo I-EVOLUTION +ocasional, I-EVOLUTION +dolor I-EVOLUTION +leve I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +vulva I-EVOLUTION +y I-EVOLUTION +tiene I-EVOLUTION +cierta I-EVOLUTION +tendencia I-EVOLUTION +al I-EVOLUTION +estreñimiento, I-EVOLUTION +aunque I-EVOLUTION +estas I-EVOLUTION +molestias I-EVOLUTION +no I-EVOLUTION +interfieren I-EVOLUTION +con I-EVOLUTION +su I-EVOLUTION +actividad I-EVOLUTION +habitual I-EVOLUTION +y I-EVOLUTION +no I-EVOLUTION +hay I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +irritación I-EVOLUTION +local. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS +55 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY +con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -ictal I-PRESENT_ILLNESS +de I-PAST_MEDICAL_HISTORY +hidatidosis I-PAST_MEDICAL_HISTORY +hepática I-PAST_MEDICAL_HISTORY +intervenida I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2009 I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +portal I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +cavernomatosis I-PAST_MEDICAL_HISTORY +portal I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +complicación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +cirugía, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +cirrosis I-PAST_MEDICAL_HISTORY +hepática I-PAST_MEDICAL_HISTORY +asociada. I-PAST_MEDICAL_HISTORY +Presentó I-PAST_MEDICAL_HISTORY +varices I-PAST_MEDICAL_HISTORY +esofágicas I-PAST_MEDICAL_HISTORY +grado I-PAST_MEDICAL_HISTORY +III-IV I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +ingresos I-PAST_MEDICAL_HISTORY +previos I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +sangrado I-PAST_MEDICAL_HISTORY +digestivo. I-PAST_MEDICAL_HISTORY +Acudió B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +agudo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hematemesis I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +melénicas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -cuantitativo I-PRESENT_ILLNESS -progresivo. I-PRESENT_ILLNESS -Consultó B-EXPLORATION -inicialmente I-EXPLORATION +15 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Se B-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +gastroscopia I-EXPLORATION +urgente I-EXPLORATION en I-EXPLORATION -otro I-EXPLORATION -hospital I-EXPLORATION -donde I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -diagnosticó I-EXPLORATION -mediante I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -de I-EXPLORATION -encéfalo I-EXPLORATION -un I-EXPLORATION -hematoma I-EXPLORATION -intraparenquimatoso I-EXPLORATION -parietal I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -42 I-EXPLORATION -ml, I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -hidrocefalia I-EXPLORATION -aguda. I-EXPLORATION -En I-EXPLORATION -pabellón I-EXPLORATION -y I-EXPLORATION +observaron I-EXPLORATION +4 I-EXPLORATION +cordones I-EXPLORATION +varicosos I-EXPLORATION de I-EXPLORATION -forma I-EXPLORATION -urgente, I-EXPLORATION +gran I-EXPLORATION +tamaño I-EXPLORATION +desde I-EXPLORATION +tercio I-EXPLORATION +medio I-EXPLORATION +esofágico I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -instaló I-EXPLORATION -un I-EXPLORATION -drenaje I-EXPLORATION -ventricular I-EXPLORATION -externo I-EXPLORATION -(DVE). I-EXPLORATION -Se I-EXPLORATION -registróuna I-EXPLORATION -presión I-EXPLORATION -intracraneana I-EXPLORATION -(PIC) I-EXPLORATION -inicial I-EXPLORATION -de I-EXPLORATION -45 I-EXPLORATION -cm I-EXPLORATION +prolongan I-EXPLORATION +hacia I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +subcardial, I-EXPLORATION +con I-EXPLORATION +signos I-EXPLORATION +rojos I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +pared I-EXPLORATION +aunque I-EXPLORATION +sin I-EXPLORATION +evidencia I-EXPLORATION de I-EXPLORATION -H2O. I-EXPLORATION -Se I-EXPLORATION -conectó I-EXPLORATION -a I-EXPLORATION -ventilación I-EXPLORATION -mecánica I-EXPLORATION -(VM) I-EXPLORATION -y I-EXPLORATION +sangrado I-EXPLORATION +activo. I-EXPLORATION +Se B-TREATMENT +colocaron I-TREATMENT +9 I-TREATMENT +bandas I-TREATMENT +de I-TREATMENT +ligadura I-TREATMENT +sin I-TREATMENT +complicaciones I-TREATMENT +inmediatas. I-TREATMENT +En B-EXPLORATION +estómago I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -indicó I-EXPLORATION -sedación I-EXPLORATION -profunda. I-EXPLORATION -Inicialmente, B-EVOLUTION -la I-EVOLUTION -hipertensión I-EVOLUTION -intracraneana I-EVOLUTION -se I-EVOLUTION -trató I-EVOLUTION -con I-EVOLUTION -drenaje I-EVOLUTION +evidenciaron I-EXPLORATION +lesiones I-EXPLORATION +potencialmente I-EXPLORATION +sangrantes I-EXPLORATION +ni I-EXPLORATION +restos I-EXPLORATION +hemáticos, I-EXPLORATION +ni I-EXPLORATION +tampoco I-EXPLORATION +en I-EXPLORATION +duodeno. I-EXPLORATION +Posteriormente B-EVOLUTION +presentó I-EVOLUTION +múltiples I-EVOLUTION +episodios I-EVOLUTION de I-EVOLUTION -líquido I-EVOLUTION -cefalorraquídeo I-EVOLUTION -y I-EVOLUTION -sodio I-EVOLUTION -hipertónico I-EVOLUTION -intravenoso I-EVOLUTION -en I-EVOLUTION -bolos, I-EVOLUTION -según I-EVOLUTION -necesidad. I-EVOLUTION -Se I-EVOLUTION -trasladó I-EVOLUTION -a I-EVOLUTION -nuestro I-EVOLUTION -servicio I-EVOLUTION -tres I-EVOLUTION -días I-EVOLUTION -más I-EVOLUTION -tarde. I-EVOLUTION - I-EVOLUTION -Ingresó I-EVOLUTION -intubado I-EVOLUTION -y I-EVOLUTION -conectado I-EVOLUTION -a I-EVOLUTION -VM, I-EVOLUTION -sedado I-EVOLUTION +melenas, I-EVOLUTION con I-EVOLUTION -propofol I-EVOLUTION -0, I-EVOLUTION -71 I-EVOLUTION -mg/kg/h, I-EVOLUTION +anemización I-EVOLUTION +secundaria I-EVOLUTION y I-EVOLUTION -hemodinamia I-EVOLUTION -apoyada I-EVOLUTION -con I-EVOLUTION -noradrenalina I-EVOLUTION -a I-EVOLUTION -0, I-EVOLUTION -06 I-EVOLUTION -μg/kg/min, I-EVOLUTION -PIC I-EVOLUTION -de I-EVOLUTION -6 I-EVOLUTION -cm I-EVOLUTION +necesidad I-EVOLUTION de I-EVOLUTION -H2O I-EVOLUTION -y I-EVOLUTION -presión I-EVOLUTION +transfusión I-EVOLUTION de I-EVOLUTION -perfusión I-EVOLUTION -cerebral I-EVOLUTION -(PPC) I-EVOLUTION +un I-EVOLUTION +total I-EVOLUTION de I-EVOLUTION -80 I-EVOLUTION -mmHg. I-EVOLUTION +22 I-EVOLUTION +UCH. I-EVOLUTION +Se B-TREATMENT +realizaron I-TREATMENT +dos I-TREATMENT +intentos I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +endoscópica I-TREATMENT +de I-TREATMENT +controlar I-TREATMENT +el I-TREATMENT +sangrado I-TREATMENT +sin I-TREATMENT +objetivar I-TREATMENT +sangrado I-TREATMENT +de I-TREATMENT +las I-TREATMENT +escaras I-TREATMENT +de I-TREATMENT +las I-TREATMENT +bandas I-TREATMENT +previas I-TREATMENT +ni I-TREATMENT +a I-TREATMENT +otro I-TREATMENT +nivel I-TREATMENT +gastrointestinal. I-TREATMENT En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -neurológico I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +computerizada I-EXPLORATION +(TC) I-EXPLORATION +realizada, I-EXPLORATION se I-EXPLORATION -encontraba I-EXPLORATION -en I-EXPLORATION -coma, I-EXPLORATION -con I-EXPLORATION -midriasis I-EXPLORATION -fija I-EXPLORATION +observaron I-EXPLORATION +varices I-EXPLORATION +esofágicas I-EXPLORATION +secundarias I-EXPLORATION a I-EXPLORATION -derecha, I-EXPLORATION -reflejos I-EXPLORATION -corneales I-EXPLORATION -abolidos, I-EXPLORATION -reflejos I-EXPLORATION -oculocefálicos I-EXPLORATION -esbozados, I-EXPLORATION -tono I-EXPLORATION -y I-EXPLORATION -reflejos I-EXPLORATION -osteotendíneos I-EXPLORATION -disminuidos, I-EXPLORATION -reflejos I-EXPLORATION -plantares I-EXPLORATION -indiferentes I-EXPLORATION -bilaterales. I-EXPLORATION - I-EXPLORATION -Exámenes I-EXPLORATION -generales I-EXPLORATION -de I-EXPLORATION -ingreso: I-EXPLORATION -Na+ I-EXPLORATION -146 I-EXPLORATION -mEq/L, I-EXPLORATION -K+ I-EXPLORATION -3, I-EXPLORATION -5 I-EXPLORATION -mEq/L, I-EXPLORATION -hematocrito I-EXPLORATION -31%, I-EXPLORATION -lactato I-EXPLORATION -1, I-EXPLORATION -4 I-EXPLORATION -mmol/L, I-EXPLORATION -leucocitos I-EXPLORATION -9.600 I-EXPLORATION -por I-EXPLORATION -mm3 I-EXPLORATION +trombosis I-EXPLORATION +crónica I-EXPLORATION +del I-EXPLORATION +eje I-EXPLORATION +espleno-portal, I-EXPLORATION +esplenomegalia I-EXPLORATION y I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -11, I-EXPLORATION -4 I-EXPLORATION -mg/dl. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -angiografía I-EXPLORATION -cerebral I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -vasos I-EXPLORATION +ascitis I-EXPLORATION +sin I-EXPLORATION +identificar I-EXPLORATION +sangrado I-EXPLORATION +activo. I-EXPLORATION +Una I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RM) I-EXPLORATION mostró I-EXPLORATION -una I-EXPLORATION -malformación I-EXPLORATION -arteriovenosa I-EXPLORATION -(MAV) I-EXPLORATION -parietal I-EXPLORATION -mesial I-EXPLORATION -derecha I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -rotura I-EXPLORATION -reciente, I-EXPLORATION +hidatidosis I-EXPLORATION +hepática I-EXPLORATION +ya I-EXPLORATION +descrita I-EXPLORATION +en I-EXPLORATION +estudios I-EXPLORATION +anteriores, I-EXPLORATION +cavernomatosis I-EXPLORATION asociada I-EXPLORATION a I-EXPLORATION -tres I-EXPLORATION -aneurismas I-EXPLORATION -paranidales. I-EXPLORATION +trombosis I-EXPLORATION +portal I-EXPLORATION +y I-EXPLORATION +esplenomegalia. I-EXPLORATION +Ante I-EXPLORATION +estos I-EXPLORATION +hallazgos I-EXPLORATION +decidimos I-EXPLORATION +realizar I-EXPLORATION +una I-EXPLORATION +arteriografía I-EXPLORATION +abdominal I-EXPLORATION +selectiva I-EXPLORATION +del I-EXPLORATION +tronco I-EXPLORATION +celiaco I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +mesentérica I-EXPLORATION +superior I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +identificó I-EXPLORATION +puntos I-EXPLORATION +sangrantes I-EXPLORATION +activos I-EXPLORATION +ni I-EXPLORATION +malformaciones I-EXPLORATION +vasculares. I-EXPLORATION +Ante I-EXPLORATION +la I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +hallazgos, I-EXPLORATION +se I-EXPLORATION +decide I-EXPLORATION +realizar I-EXPLORATION +enteroscopia I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +primera I-EXPLORATION +rodilla I-EXPLORATION +duodenal I-EXPLORATION +un I-EXPLORATION +conglomerado I-EXPLORATION +de I-EXPLORATION +varices I-EXPLORATION +submucosas I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +comprueban I-EXPLORATION +con I-EXPLORATION +ecoendoscopio I-EXPLORATION +radial. I-EXPLORATION Se B-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -embolización I-TREATMENT -con I-TREATMENT -N-butil-cianocrilato I-TREATMENT -(Histoacryl®, I-TREATMENT -Braun, I-TREATMENT -Alemania), I-TREATMENT -logrando I-TREATMENT -reducir I-TREATMENT -el I-TREATMENT -nido I-TREATMENT -de I-TREATMENT -la I-TREATMENT -MAV I-TREATMENT -y I-TREATMENT -excluir I-TREATMENT -sus I-TREATMENT -aneurismas. I-TREATMENT -Después I-TREATMENT -del I-TREATMENT -procedimiento, I-TREATMENT -la I-TREATMENT -TC I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +inyectar I-TREATMENT +3 I-TREATMENT +cc I-TREATMENT de I-TREATMENT -encéfalo I-TREATMENT -mostró I-TREATMENT -el I-TREATMENT -Histoacryl® I-TREATMENT -correctamente I-TREATMENT -situado. I-TREATMENT -Sin B-EVOLUTION -embargo, I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -un I-EVOLUTION -incremento I-EVOLUTION +pegamento I-TREATMENT +(cianoacrilato) I-TREATMENT +en I-TREATMENT +varices I-TREATMENT +duodenales I-TREATMENT +sin I-TREATMENT +complicaciones I-TREATMENT +inmediatas. I-TREATMENT +Tras B-EVOLUTION +48 I-EVOLUTION +horas I-EVOLUTION +sin I-EVOLUTION +recidiva I-EVOLUTION del I-EVOLUTION -hematoma I-EVOLUTION -con I-EVOLUTION -acentuado I-EVOLUTION -efecto I-EVOLUTION -de I-EVOLUTION -masa I-EVOLUTION -y I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -edema I-EVOLUTION -cerebral I-EVOLUTION -difuso I-EVOLUTION -con I-EVOLUTION -obliteración I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -surcos I-EVOLUTION -de I-EVOLUTION +sangrado I-EVOLUTION la I-EVOLUTION -convexidad, I-EVOLUTION -además I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +hematemesis I-EVOLUTION de I-EVOLUTION -herniaciones I-EVOLUTION -subfalcina I-EVOLUTION +alto I-EVOLUTION +volumen I-EVOLUTION +que I-EVOLUTION +le I-EVOLUTION +ocasionó I-EVOLUTION +una I-EVOLUTION +broncoaspiración I-EVOLUTION y I-EVOLUTION -uncal I-EVOLUTION -con I-EVOLUTION -desviación I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -línea I-EVOLUTION -media I-EVOLUTION -de I-EVOLUTION -10 I-EVOLUTION -mm, I-EVOLUTION +secundariamente I-EVOLUTION +parada I-EVOLUTION +cardiorrespiratoria I-EVOLUTION a I-EVOLUTION -nivel I-EVOLUTION +pesar I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -glándula I-EVOLUTION -pineal. I-EVOLUTION -Se B-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -evacuación I-TREATMENT -del I-TREATMENT -hematoma I-TREATMENT +las I-EVOLUTION +maniobras I-EVOLUTION +de I-EVOLUTION +resucitación I-EVOLUTION +realizadas. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +múltiples I-PAST_MEDICAL_HISTORY +lesiones I-PAST_MEDICAL_HISTORY +cutáneas I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +cinco I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +que, I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +últimos I-PAST_MEDICAL_HISTORY +dos, I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +piodermitis, I-PAST_MEDICAL_HISTORY +sarna I-PAST_MEDICAL_HISTORY +corporis, I-PAST_MEDICAL_HISTORY +candidiasis I-PAST_MEDICAL_HISTORY +esofágica I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +cinco I-PAST_MEDICAL_HISTORY +cuadros I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +abscesos I-PAST_MEDICAL_HISTORY +cutáneos I-PAST_MEDICAL_HISTORY +ubicados I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +codo I-PAST_MEDICAL_HISTORY +derecho I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +ocasiones, I-PAST_MEDICAL_HISTORY +uno I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +dorso I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +mano I-PAST_MEDICAL_HISTORY +izquierda, I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +cual I-PAST_MEDICAL_HISTORY +deja I-PAST_MEDICAL_HISTORY +secuelas I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +movilidad I-PAST_MEDICAL_HISTORY +extensora I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +compromiso I-PAST_MEDICAL_HISTORY +tendinoso, I-PAST_MEDICAL_HISTORY +uno I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +dorso I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +mano I-PAST_MEDICAL_HISTORY +derecha I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +uno I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY +escapular I-PAST_MEDICAL_HISTORY +izquierda, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +cuales I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +cultivo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +lesiones I-PAST_MEDICAL_HISTORY +resultó I-PAST_MEDICAL_HISTORY +positivo I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +Staphylococcus I-PAST_MEDICAL_HISTORY +aureus I-PAST_MEDICAL_HISTORY +multisensible. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +volumen I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +glúteo I-PRESENT_ILLNESS +izquierdo, I-PRESENT_ILLNESS +se B-TREATMENT +diagnosticó I-TREATMENT +celulitis I-TREATMENT y I-TREATMENT -una I-TREATMENT -craniectomía I-TREATMENT -descompresiva I-TREATMENT -frontoparietoccipital I-TREATMENT -derecha I-TREATMENT -extensa I-TREATMENT -de I-TREATMENT -10, I-TREATMENT -2 I-TREATMENT -x I-TREATMENT -9, I-TREATMENT -3 I-TREATMENT -cm. I-TREATMENT -La I-TREATMENT -TC I-TREATMENT -de I-TREATMENT -encéfalo I-TREATMENT -de I-TREATMENT -control I-TREATMENT -al I-TREATMENT -día I-TREATMENT -siguiente I-TREATMENT -mostró I-TREATMENT -una I-TREATMENT -reducción I-TREATMENT -del I-TREATMENT -hematoma I-TREATMENT -a I-TREATMENT -11 I-TREATMENT -ml, I-TREATMENT -pero I-TREATMENT -aún I-TREATMENT se I-TREATMENT -mantenía I-TREATMENT -un I-TREATMENT -importante I-TREATMENT -efecto I-TREATMENT -de I-TREATMENT -masa, I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -desviación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -línea I-TREATMENT -media I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -mm. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -pesar I-EVOLUTION +clindamicina I-TREATMENT +y I-TREATMENT +cefazolina. I-TREATMENT +Al B-EVOLUTION +séptimo I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +hospitalización I-EVOLUTION +presentó I-EVOLUTION +necrosis I-EVOLUTION +distal I-EVOLUTION +del I-EVOLUTION +pulpejo I-EVOLUTION +del I-EVOLUTION +cuarto I-EVOLUTION +dedo I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -craniectomía I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -PIC I-EVOLUTION -mayores I-EVOLUTION +mano I-EVOLUTION +derecha, I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +dejó I-EVOLUTION a I-EVOLUTION -20 I-EVOLUTION -cm I-EVOLUTION -H2O I-EVOLUTION -(23 I-EVOLUTION -± I-EVOLUTION -5 I-EVOLUTION -cm I-EVOLUTION -H2O; I-EVOLUTION -media I-EVOLUTION -± I-EVOLUTION -DS). I-EVOLUTION -Se B-TREATMENT -instauró I-TREATMENT -un I-TREATMENT -manejo I-TREATMENT -médico I-TREATMENT -escalonado I-TREATMENT -de I-TREATMENT -la I-TREATMENT -HEC, I-TREATMENT -con I-TREATMENT -sedación I-TREATMENT -profunda I-TREATMENT -(fentanilo I-TREATMENT -2, I-TREATMENT -86 I-TREATMENT -μg/kg/h, I-TREATMENT -midazolam I-TREATMENT -0, I-TREATMENT -11 I-TREATMENT -mg/kg/h I-TREATMENT -y I-TREATMENT -propofol I-TREATMENT -1, I-TREATMENT -43 I-TREATMENT -mg/kg/h), I-TREATMENT -bloqueo I-TREATMENT -neuromuscular I-TREATMENT -(vecuronio I-TREATMENT -0, I-TREATMENT -09 I-TREATMENT -mg/kg/h), I-TREATMENT -además I-TREATMENT -del I-TREATMENT -uso I-TREATMENT -frecuente I-TREATMENT -de I-TREATMENT -bolos I-TREATMENT -de I-TREATMENT -sodio I-TREATMENT -hipertónico I-TREATMENT -frente I-TREATMENT -a I-TREATMENT -cifras I-TREATMENT -de I-TREATMENT -PIC I-TREATMENT -> I-TREATMENT -30 I-TREATMENT -cm I-TREATMENT -H2O. I-TREATMENT -Se B-EVOLUTION -descartó I-EVOLUTION -actividad I-EVOLUTION -epiléptica I-EVOLUTION -no I-EVOLUTION -convulsiva I-EVOLUTION -mediante I-EVOLUTION -un I-EVOLUTION -electroencefalograma I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -TC I-EVOLUTION +evolución I-EVOLUTION +natural I-EVOLUTION +debido I-EVOLUTION +a I-EVOLUTION +encontrarse I-EVOLUTION +fuera I-EVOLUTION de I-EVOLUTION -encéfalo I-EVOLUTION -48 I-EVOLUTION -h I-EVOLUTION -post I-EVOLUTION -craniectomía I-EVOLUTION -no I-EVOLUTION -mostró I-EVOLUTION -cambios I-EVOLUTION -significativos. I-EVOLUTION -Debido B-TREATMENT -a I-TREATMENT -la I-TREATMENT -persistencia I-TREATMENT -de I-TREATMENT -cifras I-TREATMENT -de I-TREATMENT -PIC I-TREATMENT -> I-TREATMENT -a I-TREATMENT -20 I-TREATMENT -cm I-TREATMENT -H2O, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -iniciar I-TREATMENT -hipotermia I-TREATMENT -terapéutica. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -empleó I-TREATMENT -hipotermia I-TREATMENT -moderada, I-TREATMENT -con I-TREATMENT -temperatura I-TREATMENT -objetivo I-TREATMENT -de I-TREATMENT -33°C, I-TREATMENT -mediante I-TREATMENT -técnica I-TREATMENT -intravascular I-TREATMENT -(Alsius, I-TREATMENT -Zoll, I-TREATMENT -Chelmsford, I-TREATMENT -Massachusetts, I-TREATMENT -EEUU). I-TREATMENT -Se I-TREATMENT -midió I-TREATMENT -la I-TREATMENT -temperatura I-TREATMENT -central I-TREATMENT -con I-TREATMENT -catéter I-TREATMENT -intravesical. I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -conseguida I-TREATMENT -la I-TREATMENT -hipotermia I-TREATMENT -(~12 I-TREATMENT -h I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -HEC I-TREATMENT -refractaria), I-TREATMENT -se I-TREATMENT -logró I-TREATMENT -un I-TREATMENT -rápido I-TREATMENT -control I-TREATMENT +alcance I-EVOLUTION +quirúrgico. I-EVOLUTION +Luego B-TREATMENT de I-TREATMENT -la I-TREATMENT -PIC I-TREATMENT -con I-TREATMENT -cifras I-TREATMENT -entre I-TREATMENT -9 I-TREATMENT -a I-TREATMENT 12 I-TREATMENT -cm I-TREATMENT -H2O I-TREATMENT -(~3 I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -inicio I-TREATMENT -del I-TREATMENT -procedimiento). I-TREATMENT -El I-TREATMENT -bloqueo I-TREATMENT -neuromuscular I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -en I-TREATMENT -infusión I-TREATMENT -continua I-TREATMENT -los I-TREATMENT -primeros I-TREATMENT -dos I-TREATMENT días I-TREATMENT de I-TREATMENT -hipotermia, I-TREATMENT -para I-TREATMENT -evitar I-TREATMENT -los I-TREATMENT -calofríos. I-TREATMENT - I-TREATMENT -Luego I-TREATMENT -de I-TREATMENT -48 I-TREATMENT -h I-TREATMENT -en I-TREATMENT -hipotermia, I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT se I-TREATMENT -realizaron I-TREATMENT -intentos I-TREATMENT -programados I-TREATMENT -de I-TREATMENT -recalentamiento I-TREATMENT -a I-TREATMENT -una I-TREATMENT -tasa I-TREATMENT -de I-TREATMENT -0, I-TREATMENT -5°C/h. I-TREATMENT -Sin I-TREATMENT -embargo, I-TREATMENT -todos I-TREATMENT -ellos I-TREATMENT -fueron I-TREATMENT -interrumpidos I-TREATMENT -por I-TREATMENT -rebote I-TREATMENT -de I-TREATMENT -la I-TREATMENT -PIC. I-TREATMENT -A B-EVOLUTION -partir I-EVOLUTION -del I-EVOLUTION -día I-EVOLUTION -20 I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -clínico I-EVOLUTION -y I-EVOLUTION -coincidiendo I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -disminución I-EVOLUTION -del I-EVOLUTION -edema I-EVOLUTION -cerebral I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -neuroimágenes, I-EVOLUTION -se I-EVOLUTION -logró I-EVOLUTION -el I-EVOLUTION -control I-EVOLUTION -definitivo I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -PIC. I-EVOLUTION -Completó I-EVOLUTION -~13 I-EVOLUTION -días I-EVOLUTION -en I-EVOLUTION -hipotermia I-EVOLUTION -moderada, I-EVOLUTION -sin I-EVOLUTION -evidenciarse I-EVOLUTION -arritmias, I-EVOLUTION -trastornos I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -coagulación I-EVOLUTION -o I-EVOLUTION -electrolíticos. I-EVOLUTION -Presentó B-TREATMENT -una I-TREATMENT -traqueobronquitis I-TREATMENT -asociada I-TREATMENT +cambió I-TREATMENT +esquema I-TREATMENT +debido I-TREATMENT a I-TREATMENT -ventilación I-TREATMENT -mecánica, I-TREATMENT -resuelta I-TREATMENT -satisfactoriamente I-TREATMENT -con I-TREATMENT -antibioticoterapia. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -suspendió I-TREATMENT -progresivamente I-TREATMENT -la I-TREATMENT -sedación, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -adquirió I-TREATMENT -vigilia I-TREATMENT -y B-EVOLUTION -se I-EVOLUTION -objetivó I-EVOLUTION -una I-EVOLUTION -hemiparesia I-EVOLUTION -leve I-EVOLUTION -con I-EVOLUTION -heminegligencia I-EVOLUTION -y I-EVOLUTION -hemianopsia I-EVOLUTION -homónima I-EVOLUTION -izquierda. I-EVOLUTION -Una I-EVOLUTION -vez I-EVOLUTION -extubado I-EVOLUTION -se I-EVOLUTION -constató I-EVOLUTION -lenguaje I-EVOLUTION -apropiado. I-EVOLUTION -Se B-TREATMENT -inició I-TREATMENT -neurorrehabilitación I-TREATMENT -y B-EVOLUTION -finalmente, I-EVOLUTION -luego I-EVOLUTION -de I-EVOLUTION -40 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -hospitalización, I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta. I-EVOLUTION -Dos I-EVOLUTION -años I-EVOLUTION -después I-EVOLUTION -se I-EVOLUTION -encuentraen I-EVOLUTION -Rankin I-EVOLUTION -2, I-EVOLUTION -con I-EVOLUTION -hemiparesia I-EVOLUTION -izquierda I-EVOLUTION -espástica I-EVOLUTION -leve I-EVOLUTION -y I-EVOLUTION -completando I-EVOLUTION -sus I-EVOLUTION -estudios I-EVOLUTION -universitarios. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -conocidos. I-PAST_MEDICAL_HISTORY -Presentó B-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -odinofagia, I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -seca, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -precordial I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dorsal I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -reposo. I-PRESENT_ILLNESS -Consultó B-EXPLORATION +mala I-TREATMENT +respuesta I-TREATMENT +clínica, I-TREATMENT +iniciándose I-TREATMENT +metronidazol, I-TREATMENT +ceftriaxona I-TREATMENT +y I-TREATMENT +vancomicina. I-TREATMENT +Se B-EXPLORATION +realizaron I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio, I-EXPLORATION +inmunológicos I-EXPLORATION +e I-EXPLORATION +infecciosos, I-EXPLORATION en I-EXPLORATION -centro I-EXPLORATION +busca I-EXPLORATION de I-EXPLORATION -atención I-EXPLORATION -primaria I-EXPLORATION -donde I-EXPLORATION +una I-EXPLORATION +patología I-EXPLORATION +subyacente, I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -le I-EXPLORATION -solicita I-EXPLORATION -radiografía I-EXPLORATION +muestran I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +Tabla I-EXPLORATION +1 I-EXPLORATION +(A), I-EXPLORATION de I-EXPLORATION -tórax, I-EXPLORATION -destacando I-EXPLORATION -gran I-EXPLORATION -cardiomegalia I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION +los I-EXPLORATION +cuales I-EXPLORATION +los I-EXPLORATION +resultados I-EXPLORATION +del I-EXPLORATION +factor I-EXPLORATION +reumatoide, I-EXPLORATION +ANCA-p, I-EXPLORATION +ANCA-c, I-EXPLORATION +anti I-EXPLORATION +ANA, I-EXPLORATION +anti I-EXPLORATION +ENA, I-EXPLORATION +anti-DNA, I-EXPLORATION +anticardiolipina, I-EXPLORATION +test I-EXPLORATION de I-EXPLORATION -congestión I-EXPLORATION -pulmonar. I-EXPLORATION -Se B-PAST_MEDICAL_HISTORY -contaba I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -examen I-PAST_MEDICAL_HISTORY -físico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -radiografía I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tórax I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -atrás I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -ninguna I-PAST_MEDICAL_HISTORY -alteración. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Fue B-DERIVED_FROM/TO -derivado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -atención I-DERIVED_FROM/TO -terciaria I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -cuarto I-DERIVED_FROM/TO -día I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -cuadro. I-DERIVED_FROM/TO -Hemodinamia B-EVOLUTION -siempre I-EVOLUTION -estable. I-EVOLUTION -Se B-EXPLORATION -objetivó I-EXPLORATION -en I-EXPLORATION -electrocardiograma I-EXPLORATION -(ECG) I-EXPLORATION -taquicardia I-EXPLORATION -auricular I-EXPLORATION -intermitente, I-EXPLORATION -tratada I-EXPLORATION -inicialmente I-EXPLORATION -con I-EXPLORATION -amiodarona. I-EXPLORATION - I-EXPLORATION -Ingresó I-EXPLORATION -a I-EXPLORATION -nuestro I-EXPLORATION -servicio I-EXPLORATION -hipotenso I-EXPLORATION -(84/56 I-EXPLORATION -mmHg), I-EXPLORATION -taquicárdico I-EXPLORATION -(116 I-EXPLORATION -latidos I-EXPLORATION -por I-EXPLORATION -minuto, I-EXPLORATION -irregular), I-EXPLORATION -afebril, I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION +Coombs I-EXPLORATION +indirecto, I-EXPLORATION +antígenos I-EXPLORATION de I-EXPLORATION -18 I-EXPLORATION -por I-EXPLORATION -minuto I-EXPLORATION -y I-EXPLORATION -saturando I-EXPLORATION -92% I-EXPLORATION -con I-EXPLORATION -oxígeno I-EXPLORATION -ambiental, I-EXPLORATION -bien I-EXPLORATION -perfundido. I-EXPLORATION -La I-EXPLORATION -faringe I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -algo I-EXPLORATION -enrojecida, I-EXPLORATION -yugulares I-EXPLORATION -ingurgitadas. I-EXPLORATION -Sin I-EXPLORATION -congestión I-EXPLORATION -pulmonar I-EXPLORATION -y I-EXPLORATION -examen I-EXPLORATION -cardíaco I-EXPLORATION -demostró I-EXPLORATION -tercer I-EXPLORATION -ruido I-EXPLORATION +VHB I-EXPLORATION y I-EXPLORATION -ritmo I-EXPLORATION -de I-EXPLORATION -galope. I-EXPLORATION -Extremidades I-EXPLORATION -sin I-EXPLORATION -edema. I-EXPLORATION - I-EXPLORATION -De I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION +VHC I-EXPLORATION +fueron I-EXPLORATION +negativos; I-EXPLORATION +destacaron I-EXPLORATION +valores I-EXPLORATION +elevados I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -destacaba I-EXPLORATION -discreta I-EXPLORATION -leucocitosis, I-EXPLORATION -PCR I-EXPLORATION -baja, I-EXPLORATION -enzimas I-EXPLORATION -cardíacas I-EXPLORATION +IgE I-EXPLORATION +sérica I-EXPLORATION +(3.740 I-EXPLORATION +UI/ml) I-EXPLORATION y I-EXPLORATION -troponinas I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -ecocardiograma I-EXPLORATION -realizado I-EXPLORATION +precipitación I-EXPLORATION en I-EXPLORATION -nuestra I-EXPLORATION -unidad I-EXPLORATION -mostró I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo I-EXPLORATION -(VI) I-EXPLORATION -severamente I-EXPLORATION -dilatado I-EXPLORATION -(82/74 I-EXPLORATION -mm) I-EXPLORATION -con I-EXPLORATION -disfunción I-EXPLORATION -sistólica I-EXPLORATION -global I-EXPLORATION -severa I-EXPLORATION -[fracción I-EXPLORATION -de I-EXPLORATION -eyección I-EXPLORATION -(FE): I-EXPLORATION -20%], I-EXPLORATION -hipokinesia I-EXPLORATION -difusa, I-EXPLORATION -disfunción I-EXPLORATION -diastólica I-EXPLORATION -tipo I-EXPLORATION -III I-EXPLORATION -de I-EXPLORATION -IV. I-EXPLORATION -AI I-EXPLORATION -de I-EXPLORATION -49 I-EXPLORATION -mm, I-EXPLORATION -con I-EXPLORATION -disfunción I-EXPLORATION -sistólica I-EXPLORATION -ventricular I-EXPLORATION -derecha, I-EXPLORATION -leve I-EXPLORATION -dilatación I-EXPLORATION +frío I-EXPLORATION de I-EXPLORATION -cavidades I-EXPLORATION -derechas I-EXPLORATION -e I-EXPLORATION -hipertensión I-EXPLORATION -pulmonar I-EXPLORATION -(HTP) I-EXPLORATION -moderada. I-EXPLORATION - I-EXPLORATION +crioglobulinas I-EXPLORATION +positiva. I-EXPLORATION Se I-EXPLORATION realizó I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -cardiaca I-EXPLORATION +además I-EXPLORATION +ecografía I-EXPLORATION +glútea I-EXPLORATION +izquierda, I-EXPLORATION que I-EXPLORATION -concluyó I-EXPLORATION -miocardiopatía I-EXPLORATION -dilatada, I-EXPLORATION -sin I-EXPLORATION -elementos I-EXPLORATION -de I-EXPLORATION -fibrosis I-EXPLORATION -ni I-EXPLORATION -necrosis, I-EXPLORATION +mostró I-EXPLORATION +tejido I-EXPLORATION +celular I-EXPLORATION +subcutáneo I-EXPLORATION con I-EXPLORATION -disfunción I-EXPLORATION -sistólica I-EXPLORATION -severa. I-EXPLORATION - I-EXPLORATION -Paciente B-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -taquicárdico, I-EVOLUTION -presión I-EVOLUTION -arterial I-EVOLUTION -en I-EVOLUTION -límite I-EVOLUTION -bajo, I-EVOLUTION -en I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -inhibi I-EVOLUTION -dores I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enzima I-EVOLUTION -convertidora I-EVOLUTION -de I-EVOLUTION -angiotensina I-EVOLUTION -(IECA) I-EVOLUTION -y I-EVOLUTION -betabloqueo I-EVOLUTION -en I-EVOLUTION -dosis I-EVOLUTION -bajas. I-EVOLUTION - I-EVOLUTION -Dentro B-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -solicitado: I-EXPLORATION -función I-EXPLORATION -tiroidea I-EXPLORATION -normal; I-EXPLORATION -VHB I-EXPLORATION -(-), I-EXPLORATION -VHC I-EXPLORATION -(-), I-EXPLORATION -VIH I-EXPLORATION -(-), I-EXPLORATION -citomegalovirus I-EXPLORATION -(-), I-EXPLORATION -Chagas I-EXPLORATION -(-), I-EXPLORATION -IgM I-EXPLORATION -Mycoplasma I-EXPLORATION -pneumoniae I-EXPLORATION -(+) I-EXPLORATION -Se I-EXPLORATION -trato I-EXPLORATION +aspecto I-EXPLORATION +inflamatorio, I-EXPLORATION +sin I-EXPLORATION +colecciones. I-EXPLORATION +Tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TAC) I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION con I-EXPLORATION -azitromicina I-EXPLORATION -por I-EXPLORATION -5 I-EXPLORATION -días. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -endomiocárdica I-EXPLORATION -que I-EXPLORATION -concluyó I-EXPLORATION -cambios I-EXPLORATION -inespecíficos, I-EXPLORATION -compatibles I-EXPLORATION +contraste I-EXPLORATION +sugirió I-EXPLORATION +fibrosis I-EXPLORATION +basal I-EXPLORATION con I-EXPLORATION -miocardiopatía I-EXPLORATION -dilatada, I-EXPLORATION +engrosamiento I-EXPLORATION +pleural I-EXPLORATION +e I-EXPLORATION +imagen I-EXPLORATION +nodular I-EXPLORATION +periférica I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +hemitórax. I-EXPLORATION +Radiografía I-EXPLORATION +de I-EXPLORATION +manos, I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +cintura I-EXPLORATION +escapular, I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +columna I-EXPLORATION +dorsolumbar, I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +codos, I-EXPLORATION +ecografía I-EXPLORATION +abdominal, I-EXPLORATION +TAC I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +y I-EXPLORATION +ecocardiograma I-EXPLORATION sin I-EXPLORATION -evidencias I-EXPLORATION +hallazgos I-EXPLORATION +patológicos. I-EXPLORATION +Biopsia I-EXPLORATION de I-EXPLORATION -enfermedad I-EXPLORATION -inflamatoria I-EXPLORATION -activa. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -Holter I-EXPLORATION +piel I-EXPLORATION de I-EXPLORATION -ECG I-EXPLORATION -evidenció I-EXPLORATION -taquicardia I-EXPLORATION -auricular I-EXPLORATION -incesante I-EXPLORATION -sobre I-EXPLORATION -90% I-EXPLORATION +zona I-EXPLORATION +medial I-EXPLORATION del I-EXPLORATION -tiempo. I-EXPLORATION -Se I-EXPLORATION -planteo I-EXPLORATION -el I-EXPLORATION -diagnostico I-EXPLORATION +brazo I-EXPLORATION +derecho I-EXPLORATION +informada I-EXPLORATION +como I-EXPLORATION +dermatitis I-EXPLORATION +crónica I-EXPLORATION +en I-EXPLORATION +granulación I-EXPLORATION +con I-EXPLORATION +calcificación I-EXPLORATION de I-EXPLORATION -taquicardiomiopatía. I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -amiodarona, I-TREATMENT -bisoprolol I-TREATMENT -y I-TREATMENT -digitálicos I-TREATMENT -no I-TREATMENT -fueron I-TREATMENT -efectivas I-TREATMENT -en I-TREATMENT -el I-TREATMENT -manejo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -taquiarritmia. I-TREATMENT -Se I-TREATMENT -decidió I-TREATMENT -mapeo I-TREATMENT -y I-TREATMENT -ablación I-TREATMENT -de I-TREATMENT -taquicardia I-TREATMENT -auricular I-TREATMENT -incesante I-TREATMENT -usando I-TREATMENT -el I-TREATMENT -sistema I-TREATMENT -EnSite I-TREATMENT -Navx™. I-TREATMENT -Se I-TREATMENT -identificó I-TREATMENT -y I-TREATMENT -realizó I-TREATMENT -ablación I-TREATMENT -a I-TREATMENT -foco I-TREATMENT -asociado I-TREATMENT -a I-TREATMENT -vena I-TREATMENT -cava I-TREATMENT -superior I-TREATMENT -y I-TREATMENT -vena I-TREATMENT -pulmonar I-TREATMENT -superior I-TREATMENT -derecha, I-TREATMENT -convirtiendo I-TREATMENT -a I-TREATMENT -ritmo I-TREATMENT -sinusal I-TREATMENT -con I-TREATMENT -85 I-TREATMENT -latidos I-TREATMENT -por I-TREATMENT -minuto. I-TREATMENT - I-TREATMENT -Dado B-EVOLUTION +tipo I-EXPLORATION +distrófica, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +vasculitis. I-EXPLORATION +Una B-EVOLUTION +vez I-EVOLUTION +completado I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +antibiótico I-EVOLUTION +se I-EVOLUTION +dio I-EVOLUTION de I-EVOLUTION alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -21 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -admisión. I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -los I-EVOLUTION -controles I-EVOLUTION -posteriores I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -mantenido I-EVOLUTION -en I-EVOLUTION -capacidad I-EVOLUTION -funcional I-EVOLUTION -I, I-EVOLUTION -ritmo I-EVOLUTION -sinusal, I-EVOLUTION con I-EVOLUTION -frecuencia I-EVOLUTION -cardíaca I-EVOLUTION -alrededor I-EVOLUTION +sospecha I-EVOLUTION +diagnóstica I-EVOLUTION de I-EVOLUTION -70 I-EVOLUTION -latidos I-EVOLUTION -por I-EVOLUTION -minuto, I-EVOLUTION -regular I-EVOLUTION +síndrome I-EVOLUTION +de I-EVOLUTION +hiper I-EVOLUTION +IgE I-EVOLUTION y I-EVOLUTION -normotenso. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -3 I-EVOLUTION -meses I-EVOLUTION +crioglobulinemia. I-EVOLUTION + I-EVOLUTION +Un I-EVOLUTION +mes I-EVOLUTION posterior I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -ablación, I-EVOLUTION -el I-EVOLUTION -ecocardiograma I-EVOLUTION -evidenció I-EVOLUTION -marcada I-EVOLUTION -reducción I-EVOLUTION +del I-EVOLUTION +alta I-EVOLUTION +consultó I-EVOLUTION +por I-EVOLUTION +nuevo I-EVOLUTION +cuadro I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -cámaras I-EVOLUTION -cardiacas I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION +5 I-EVOLUTION +días I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -sistólica I-EVOLUTION -del I-EVOLUTION -VI I-EVOLUTION -y I-EVOLUTION -mínimo I-EVOLUTION -reflujo I-EVOLUTION -mitral. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION +dolor I-EVOLUTION en I-EVOLUTION -capacidad I-EVOLUTION -funcional I-EVOLUTION -I I-EVOLUTION +glúteo I-EVOLUTION +izquierdo, I-EVOLUTION +calor I-EVOLUTION +local I-EVOLUTION y I-EVOLUTION -el I-EVOLUTION -ecocardiograma I-EVOLUTION -en I-EVOLUTION -límite I-EVOLUTION -normal I-EVOLUTION -con I-EVOLUTION -radiografía I-EVOLUTION -de I-EVOLUTION -tórax I-EVOLUTION -normal. I-EVOLUTION - I-EVOLUTION - -Escolar B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -residencia I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -IX I-PAST_MEDICAL_HISTORY -región. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -manifestaciones I-PRESENT_ILLNESS -clínicas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -hipertensión I-PRESENT_ILLNESS -intracraneana I-PRESENT_ILLNESS -(cefalea I-PRESENT_ILLNESS -holocránea I-PRESENT_ILLNESS -recurrente I-PRESENT_ILLNESS -[2-3 I-PRESENT_ILLNESS -veces I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -semana], I-PRESENT_ILLNESS -mareos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -ocasionales) I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -irritativa I-PRESENT_ILLNESS -(dos I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -crisis I-PRESENT_ILLNESS -convulsivas I-PRESENT_ILLNESS -tónico-clónicas I-PRESENT_ILLNESS -generalizadas). I-PRESENT_ILLNESS -El B-EXPLORATION -electroencefalograma I-EXPLORATION -(EEG) I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -(TC) I-EXPLORATION -cerebral I-EXPLORATION +supuración. I-EVOLUTION +Se B-TREATMENT +realizó I-TREATMENT +drenaje I-TREATMENT +manual I-TREATMENT +y I-TREATMENT +pasivo I-TREATMENT +con I-TREATMENT +penrose. I-TREATMENT +Fue I-TREATMENT +hospitalizado I-TREATMENT +por I-TREATMENT +absceso I-TREATMENT +en I-TREATMENT +glúteo I-TREATMENT +izquierdo I-TREATMENT +y I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +con I-TREATMENT +ceftriaxona I-TREATMENT +y I-TREATMENT +clindamicina. I-TREATMENT +Se B-EXPLORATION +realizaron I-EXPLORATION +exámenes I-EXPLORATION que I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -quiste I-EXPLORATION -intraxial I-EXPLORATION -temporal I-EXPLORATION -izquierdo I-EXPLORATION -de I-EXPLORATION -65 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -bien I-EXPLORATION -delimitado I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -severo I-EXPLORATION -efecto I-EXPLORATION -de I-EXPLORATION -masa, I-EXPLORATION -desviación I-EXPLORATION -de I-EXPLORATION -línea I-EXPLORATION -media I-EXPLORATION -de I-EXPLORATION -8 I-EXPLORATION -mm, I-EXPLORATION -herniación I-EXPLORATION -uncal I-EXPLORATION -e I-EXPLORATION -hidrocefalia. I-EXPLORATION -La I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -mostró I-EXPLORATION -además I-EXPLORATION -un I-EXPLORATION -doble I-EXPLORATION -contorno I-EXPLORATION +se I-EXPLORATION +muestran I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -periferia, I-EXPLORATION -por I-EXPLORATION -desprendimiento I-EXPLORATION +Tabla I-EXPLORATION +1 I-EXPLORATION +(B) I-EXPLORATION +donde I-EXPLORATION +nuevamente I-EXPLORATION +destacó I-EXPLORATION +niveles I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -membrana I-EXPLORATION -germinal, I-EXPLORATION -con I-EXPLORATION +IgE I-EXPLORATION +elevados, I-EXPLORATION una I-EXPLORATION -ligera I-EXPLORATION -impregnación I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -administración I-EXPLORATION +primera I-EXPLORATION +muestra I-EXPLORATION +con I-EXPLORATION +valores I-EXPLORATION de I-EXPLORATION -gadolinio. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION +4.170 I-EXPLORATION +UI/ml I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +segunda I-EXPLORATION +muestra I-EXPLORATION +el I-EXPLORATION +día I-EXPLORATION +siguiente I-EXPLORATION de I-EXPLORATION -fondo I-EXPLORATION +4.210 I-EXPLORATION +UI/ml. I-EXPLORATION +Se I-EXPLORATION +aplicó I-EXPLORATION +la I-EXPLORATION +escala I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION -demostró I-EXPLORATION -edema I-EXPLORATION +Grimbacher9 I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +consignó I-EXPLORATION +el I-EXPLORATION +valor I-EXPLORATION de I-EXPLORATION -papila I-EXPLORATION -bilateral, I-EXPLORATION -sin I-EXPLORATION -evidenciarse I-EXPLORATION -déficit I-EXPLORATION -motor I-EXPLORATION -ni I-EXPLORATION -sensitivo I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico. I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION -y I-EXPLORATION -pruebas I-EXPLORATION -hepáticas I-EXPLORATION -resultaron I-EXPLORATION -normales, I-EXPLORATION -sin I-EXPLORATION -demostrarse I-EXPLORATION -la I-EXPLORATION +IgE, I-EXPLORATION +candidiasis I-EXPLORATION +sistémica, I-EXPLORATION +infecciones I-EXPLORATION +graves, I-EXPLORATION +infecciones I-EXPLORATION +cutáneas I-EXPLORATION +recurrentes, I-EXPLORATION presencia I-EXPLORATION de I-EXPLORATION -lesiones I-EXPLORATION -quísticas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -(Rx) I-EXPLORATION +paladar I-EXPLORATION +alto, I-EXPLORATION +dientes I-EXPLORATION +primarios I-EXPLORATION +retenidos, I-EXPLORATION +hiperextensibilidad I-EXPLORATION +articular, I-EXPLORATION +nariz I-EXPLORATION +amplia I-EXPLORATION +con I-EXPLORATION +distancia I-EXPLORATION +interalar I-EXPLORATION +mayor I-EXPLORATION +a I-EXPLORATION +2 I-EXPLORATION +DS I-EXPLORATION +y I-EXPLORATION +facies I-EXPLORATION +característica, I-EXPLORATION +lo I-EXPLORATION +cual I-EXPLORATION +dio I-EXPLORATION +un I-EXPLORATION +resultado I-EXPLORATION +total I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -ni I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -ecotomografía I-EXPLORATION -abdominal. I-EXPLORATION -Se B-TREATMENT -planteó I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT +50 I-EXPLORATION +puntos, I-EXPLORATION +confirmándose I-EXPLORATION +clínicamente I-EXPLORATION +el I-EXPLORATION +diagnóstico. I-EXPLORATION +Tras B-TREATMENT +21 I-TREATMENT +días I-TREATMENT de I-TREATMENT -hidatidosis I-TREATMENT -cerebral I-TREATMENT -y I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT se I-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -completa I-TREATMENT -e I-TREATMENT -intacta I-TREATMENT -del I-TREATMENT -quiste, I-TREATMENT -confirmando I-TREATMENT -el I-TREATMENT -estudio I-TREATMENT -histopatológico I-TREATMENT -la I-TREATMENT -etiología I-TREATMENT -hidatídica I-TREATMENT +dio I-TREATMENT de I-TREATMENT -la I-TREATMENT -lesión. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente, I-EVOLUTION -asintomático, I-EVOLUTION +alta, I-TREATMENT +utilizando I-TREATMENT +profilaxis I-TREATMENT +antibiótica I-TREATMENT +con I-TREATMENT +trimetoprim/sulfametoxazol. I-TREATMENT +En B-EVOLUTION +1 I-EVOLUTION +año I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +evolución I-EVOLUTION +favorable I-EVOLUTION sin I-EVOLUTION -déficit I-EVOLUTION -neurológico I-EVOLUTION -ni I-EVOLUTION -complicaciones I-EVOLUTION -post I-EVOLUTION -operatorias. I-EVOLUTION +nuevos I-EVOLUTION +cuadros I-EVOLUTION +de I-EVOLUTION +infecciones I-EVOLUTION +cutáneas, I-EVOLUTION +sistémicas I-EVOLUTION +o I-EVOLUTION +eventos I-EVOLUTION +trombóticos. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -19 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +41 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +de B-PAST_MEDICAL_HISTORY +nacionalidad I-PAST_MEDICAL_HISTORY +argentina, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -residencia I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -IX I-PAST_MEDICAL_HISTORY -región, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -secundaria I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hipertensión I-PRESENT_ILLNESS -intracraneana I-PRESENT_ILLNESS -(cefalea I-PRESENT_ILLNESS -recurrente I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -asociada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -vómitos, I-PRESENT_ILLNESS -refractaria I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -papilar I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS -acentuado I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -fondo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ojo). I-PRESENT_ILLNESS -La B-EXPLORATION -TC I-EXPLORATION -cerebral I-EXPLORATION -y I-EXPLORATION -RM I-EXPLORATION -mostraron I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -formación I-EXPLORATION -quística I-EXPLORATION -intraxial I-EXPLORATION -temporal I-EXPLORATION -izquierda, I-EXPLORATION -de I-EXPLORATION -60 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -de I-EXPLORATION -características I-EXPLORATION -similares I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -casos I-EXPLORATION -anteriores I-EXPLORATION -y I-EXPLORATION +estreñimiento. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración, I-EXPLORATION +presenta I-EXPLORATION +discomfort I-EXPLORATION +abdominal I-EXPLORATION +en I-EXPLORATION +hemiabdomen I-EXPLORATION +inferior I-EXPLORATION con I-EXPLORATION -moderado I-EXPLORATION -efecto I-EXPLORATION +sensación I-EXPLORATION de I-EXPLORATION masa I-EXPLORATION -sobre I-EXPLORATION -el I-EXPLORATION -parénquima I-EXPLORATION -adyacente I-EXPLORATION +en I-EXPLORATION +hipogastrio. I-EXPLORATION +Tacto I-EXPLORATION +rectal I-EXPLORATION +normal. I-EXPLORATION +Se I-EXPLORATION +descarta I-EXPLORATION +patología I-EXPLORATION +ginecológica I-EXPLORATION y I-EXPLORATION -sistema I-EXPLORATION -ventricular, I-EXPLORATION -con I-EXPLORATION -desviación I-EXPLORATION -de I-EXPLORATION -línea I-EXPLORATION -media I-EXPLORATION -de I-EXPLORATION -5, I-EXPLORATION -5 I-EXPLORATION -mm. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION Rx I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION +abdomen I-EXPLORATION +que I-EXPLORATION +muestra I-EXPLORATION +abundante I-EXPLORATION +material I-EXPLORATION +fecal. I-EXPLORATION +La I-EXPLORATION +analítica I-EXPLORATION +con I-EXPLORATION +marcadores I-EXPLORATION +tumorales I-EXPLORATION +es I-EXPLORATION +normal I-EXPLORATION y I-EXPLORATION -ecotomografía I-EXPLORATION +el I-EXPLORATION +TAC I-EXPLORATION abdominal I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -lesiones I-EXPLORATION -quísticas. I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -eosinofilia I-EXPLORATION +objetiva I-EXPLORATION +un I-EXPLORATION +fecaloma I-EXPLORATION +recto-sigmoidal I-EXPLORATION y I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -hepáticas I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -planteó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +dilatación I-EXPLORATION +del I-EXPLORATION +colon. I-EXPLORATION +Los I-EXPLORATION +enemas I-EXPLORATION de I-EXPLORATION -quiste I-EXPLORATION -hidatídico I-EXPLORATION -temporal I-EXPLORATION -izquierdo. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -intacta I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión, I-TREATMENT -confirmando I-TREATMENT -el I-TREATMENT -estudio I-TREATMENT -histopatológico I-TREATMENT -la I-TREATMENT -etiología I-TREATMENT -hidatídica. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente, I-EVOLUTION -sin I-EVOLUTION -déficit I-EVOLUTION -neurológico I-EVOLUTION -ni I-EVOLUTION -complicaciones I-EVOLUTION -post I-EVOLUTION -operatorias. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -60 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -cirrosis I-PAST_MEDICAL_HISTORY -hepática I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -alcohol I-PAST_MEDICAL_HISTORY -Child-Pugh I-PAST_MEDICAL_HISTORY -B I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2004 I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -várices I-PAST_MEDICAL_HISTORY -esofágicas I-PAST_MEDICAL_HISTORY -ligadas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -erradicadas. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -2009 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -desorientación, I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -demostrándose I-PRESENT_ILLNESS -anemia I-PRESENT_ILLNESS -severa I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -hemoglobina I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4, I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -g/dL. I-PRESENT_ILLNESS -Una B-EXPLORATION -primera I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -(EDA) I-EXPLORATION -mostró I-EXPLORATION -EVA I-EXPLORATION -tipo I-EXPLORATION -watermelon I-EXPLORATION -stomach I-EXPLORATION -manejándose B-TREATMENT -con I-TREATMENT -APC I-TREATMENT -y I-TREATMENT -transfusiones I-TREATMENT -de I-TREATMENT -plaquetas, I-TREATMENT -plasma I-TREATMENT -y I-TREATMENT -glóbulos I-TREATMENT -rojos, I-TREATMENT -en I-TREATMENT -unidad I-TREATMENT -de I-TREATMENT -cuidados I-TREATMENT -intermedios. I-TREATMENT - I-TREATMENT -Dos B-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -reinició I-EVOLUTION -la I-EVOLUTION -disnea, I-EVOLUTION -por B-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION +limpieza I-EXPLORATION +son I-EXPLORATION +efectivos I-EXPLORATION +y I-EXPLORATION se I-EXPLORATION -hizo I-EXPLORATION -nueva I-EXPLORATION -EDA I-EXPLORATION +practica I-EXPLORATION +fibrocolonoscopia I-EXPLORATION que I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -EVA, I-EXPLORATION -realizándose B-TREATMENT -una I-TREATMENT -nueva I-TREATMENT -sesión I-TREATMENT -de I-TREATMENT -APC. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -3, I-EVOLUTION -5 I-EVOLUTION +es I-EXPLORATION +normal. I-EXPLORATION +Durante B-FAMILY_HISTORY +el I-FAMILY_HISTORY +ingreso I-FAMILY_HISTORY +se I-FAMILY_HISTORY +reinterroga I-FAMILY_HISTORY +a I-FAMILY_HISTORY +la I-FAMILY_HISTORY +paciente I-FAMILY_HISTORY +destacando I-FAMILY_HISTORY +como I-FAMILY_HISTORY +antecedente I-FAMILY_HISTORY +familiar I-FAMILY_HISTORY +la I-FAMILY_HISTORY +muerte I-FAMILY_HISTORY +de I-FAMILY_HISTORY +su I-FAMILY_HISTORY +madre I-FAMILY_HISTORY +por I-FAMILY_HISTORY +afectación I-FAMILY_HISTORY +cardíaca I-FAMILY_HISTORY +por I-FAMILY_HISTORY +ECH I-FAMILY_HISTORY +a I-FAMILY_HISTORY +los I-FAMILY_HISTORY +45 I-FAMILY_HISTORY +años. I-FAMILY_HISTORY +Se B-EXPLORATION +realiza I-EXPLORATION +serología I-EXPLORATION +de I-EXPLORATION +ECH I-EXPLORATION +siendo I-EXPLORATION +esta I-EXPLORATION +positiva. I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +es I-EVOLUTION +sometida I-EVOLUTION +a I-EVOLUTION +tratamiento I-EVOLUTION +conservador, I-EVOLUTION +con I-EVOLUTION +buena I-EVOLUTION +evolución I-EVOLUTION y I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -presentó I-EVOLUTION -otros I-EVOLUTION -tres I-EVOLUTION -episodios I-EVOLUTION +siendo I-EVOLUTION +dada I-EVOLUTION de I-EVOLUTION -hematemesis, I-EVOLUTION -requiriendo B-TREATMENT -en I-TREATMENT -todos I-TREATMENT -hospitalización, I-TREATMENT -transfusiones I-TREATMENT -y B-EXPLORATION -EDA, I-EXPLORATION -encontrando I-EXPLORATION -siempre I-EXPLORATION -la I-EXPLORATION -EVA I-EXPLORATION -sangrando I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -hicieron I-TREATMENT -3 I-TREATMENT -sesiones I-TREATMENT -más I-TREATMENT -de I-TREATMENT -APC. I-TREATMENT - I-TREATMENT -De B-EXPLORATION -la I-EXPLORATION -última I-EXPLORATION -hospitalización I-EXPLORATION -se I-EXPLORATION -dio I-EXPLORATION -el I-EXPLORATION -alta I-EXPLORATION -programando I-EXPLORATION -un I-EXPLORATION -control I-EXPLORATION -endoscópico I-EXPLORATION -ambulatorio I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -un I-EXPLORATION -estómago I-EXPLORATION -con I-EXPLORATION -sangre I-EXPLORATION -fresca I-EXPLORATION -y I-EXPLORATION -EVA, I-EXPLORATION -realizando B-TREATMENT -ligadura I-TREATMENT -endoscópica I-TREATMENT -con I-TREATMENT -8 I-TREATMENT -bandas. I-TREATMENT - I-TREATMENT -Un B-EXPLORATION -mes I-EXPLORATION -despuês I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -EDA I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -franca I-EXPLORATION -reducción I-EXPLORATION -del I-EXPLORATION -aspecto I-EXPLORATION -de I-EXPLORATION -watermelon I-EXPLORATION -stomach, I-EXPLORATION -realizando B-TREATMENT -nuevas I-TREATMENT -ligaduras I-TREATMENT -al I-TREATMENT -antro. I-TREATMENT - I-TREATMENT +alta I-EVOLUTION +sin I-EVOLUTION +necesidad I-EVOLUTION +de I-EVOLUTION +intervención I-EVOLUTION +quirúrgica. I-EVOLUTION + I-EVOLUTION -Los B-PRESENT_ILLNESS -casos I-PRESENT_ILLNESS -fueron I-PRESENT_ILLNESS -recolectados I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -retrospectiva I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presentan I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS +Acude B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -Tabla1; I-PRESENT_ILLNESS -sólo I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -detalla I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último. I-PRESENT_ILLNESS -Eran I-PRESENT_ILLNESS -hombres I-PRESENT_ILLNESS +revisión I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +Programa I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -media, I-PRESENT_ILLNESS -4/5 I-PRESENT_ILLNESS -heterosexuales, I-PRESENT_ILLNESS -todos I-PRESENT_ILLNESS -VIH I-PRESENT_ILLNESS -negativos. I-PRESENT_ILLNESS -Presentaron I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -frontal I-PRESENT_ILLNESS -subagudo; I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -casos I-PRESENT_ILLNESS -destacó I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -apatía, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -otros I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ánimo I-PRESENT_ILLNESS -subido. I-PRESENT_ILLNESS -Todos I-PRESENT_ILLNESS -tenían I-PRESENT_ILLNESS -amnesias I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS +Salud I-PRESENT_ILLNESS +Infantil I-PRESENT_ILLNESS un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Korsakoff. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -existían I-PRESENT_ILLNESS -signos I-PRESENT_ILLNESS -piramidales I-PRESENT_ILLNESS -discretos; I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -retención I-PRESENT_ILLNESS +lactante I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -orina, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -uno I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -ellos I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -ataxia. I-PRESENT_ILLNESS -Cuando I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -aplicaron I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -pruebas I-PRESENT_ILLNESS -Minimental I-PRESENT_ILLNESS -test I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Folstein I-PRESENT_ILLNESS -(MM), I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -mide I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -eficiencia I-PRESENT_ILLNESS -cognitiva I-PRESENT_ILLNESS -global, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -Frontal I-PRESENT_ILLNESS -Assessment I-PRESENT_ILLNESS -Battery I-PRESENT_ILLNESS -(FAB), I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -evalúa I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -funciones I-PRESENT_ILLNESS -frontales, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -mayor I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -esta I-PRESENT_ILLNESS -confirmó I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -disejecutivo. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -existía I-PRESENT_ILLNESS -laconismo I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -afasia. I-PRESENT_ILLNESS -Dos I-PRESENT_ILLNESS -casos I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -isquemia I-PRESENT_ILLNESS -cerebral I-PRESENT_ILLNESS -tenían I-PRESENT_ILLNESS -factores I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -riesgo I-PRESENT_ILLNESS -vascular. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El B-EXPLORATION -líquido I-EXPLORATION -cefaloraquídeo I-EXPLORATION -(LCR) I-EXPLORATION -fue I-EXPLORATION -siempre I-EXPLORATION -inflamatorio I-EXPLORATION +vida. I-PRESENT_ILLNESS +Antecedentes B-PAST_MEDICAL_HISTORY +personales: I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +ecografía I-PAST_MEDICAL_HISTORY +fetal I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +tercer I-PAST_MEDICAL_HISTORY +trimestre I-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +dilatación I-PAST_MEDICAL_HISTORY +pielocalicial I-PAST_MEDICAL_HISTORY +bilateral I-PAST_MEDICAL_HISTORY +(derecha: I-PAST_MEDICAL_HISTORY +4, I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +mm; I-PAST_MEDICAL_HISTORY +izquierda: I-PAST_MEDICAL_HISTORY +4, I-PAST_MEDICAL_HISTORY +1 I-PAST_MEDICAL_HISTORY +mm). I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +parto I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +cesárea I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +semana I-PAST_MEDICAL_HISTORY +41+4 I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +gestación I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +fallo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +inducción. I-PAST_MEDICAL_HISTORY +Su I-PAST_MEDICAL_HISTORY +Apgar I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +5/9 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +precisó I-PAST_MEDICAL_HISTORY +reanimación I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +III; I-PAST_MEDICAL_HISTORY +permaneció I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +transición I-PAST_MEDICAL_HISTORY +menos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +24 I-PAST_MEDICAL_HISTORY +horas. I-PAST_MEDICAL_HISTORY +Antecedentes B-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +interés: I-FAMILY_HISTORY +prima I-FAMILY_HISTORY +hermana I-FAMILY_HISTORY +paterna I-FAMILY_HISTORY +con I-FAMILY_HISTORY +escoliosis I-FAMILY_HISTORY +congénita. I-FAMILY_HISTORY +Exploración: B-EXPLORATION +Peso: I-EXPLORATION +3, I-EXPLORATION +960 I-EXPLORATION +kg I-EXPLORATION +(percentil I-EXPLORATION +25); I-EXPLORATION +talla: I-EXPLORATION +53 I-EXPLORATION +cm I-EXPLORATION +(percentil I-EXPLORATION +50); I-EXPLORATION y I-EXPLORATION +perímetro I-EXPLORATION +cefálico: I-EXPLORATION +37 I-EXPLORATION +cm I-EXPLORATION +(percentil I-EXPLORATION +25). I-EXPLORATION +Se I-EXPLORATION +aprecian I-EXPLORATION +un I-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +cráneo I-EXPLORATION con I-EXPLORATION -VDRL I-EXPLORATION -reactivo; I-EXPLORATION -en I-EXPLORATION -uno I-EXPLORATION +fontanela I-EXPLORATION +anterior I-EXPLORATION +de I-EXPLORATION +1 I-EXPLORATION +x I-EXPLORATION +1 I-EXPLORATION +cm, I-EXPLORATION +plagiocefalia I-EXPLORATION +leve, I-EXPLORATION +cuello I-EXPLORATION +corto I-EXPLORATION +con I-EXPLORATION +desviación I-EXPLORATION +lateral I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -serología I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION -El I-EXPLORATION -electroencefalograma I-EXPLORATION -(EEG) I-EXPLORATION -estuvo I-EXPLORATION -alterado I-EXPLORATION +cabeza I-EXPLORATION +al I-EXPLORATION +lado I-EXPLORATION +izquierdo I-EXPLORATION +y I-EXPLORATION +ligera I-EXPLORATION +limitación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +movilidad, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +escoliosis I-EXPLORATION +congénita I-EXPLORATION +cervical. I-EXPLORATION +Se I-EXPLORATION +observa I-EXPLORATION +una I-EXPLORATION +asimetría I-EXPLORATION en I-EXPLORATION -3/3 I-EXPLORATION -casos; I-EXPLORATION +la I-EXPLORATION +parte I-EXPLORATION +superior I-EXPLORATION +del I-EXPLORATION +tórax I-EXPLORATION +posterior, I-EXPLORATION +con I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +escápula I-EXPLORATION +izquierda: I-EXPLORATION en I-EXPLORATION -cambio I-EXPLORATION -las I-EXPLORATION -imágenes I-EXPLORATION -estructurales I-EXPLORATION -no I-EXPLORATION -siempre I-EXPLORATION -fueron I-EXPLORATION -anormales. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -caso I-EXPLORATION -T I-EXPLORATION -una I-EXPLORATION -angiografía I-EXPLORATION -(indicada I-EXPLORATION -por I-EXPLORATION +la I-EXPLORATION +inspección I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION un I-EXPLORATION -infarto I-EXPLORATION -cerebral I-EXPLORATION +hoyuelo I-EXPLORATION +cutáneo I-EXPLORATION en I-EXPLORATION +esa I-EXPLORATION +escápula, I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +presenta I-EXPLORATION un I-EXPLORATION -hombre I-EXPLORATION -joven I-EXPLORATION -con I-EXPLORATION -VDRL I-EXPLORATION -no I-EXPLORATION -reactivo I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION +tamaño I-EXPLORATION +inferior I-EXPLORATION y I-EXPLORATION -antes I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION +parece I-EXPLORATION +más I-EXPLORATION +horizontalizada I-EXPLORATION +con I-EXPLORATION +respecto I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +contralateral. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -LCR) I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +y I-EXPLORATION +neurológica I-EXPLORATION fue I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -vasculitis. I-EXPLORATION -Todos B-TREATMENT -recibieron I-TREATMENT -altas I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -penicilina I-TREATMENT -sódica I-TREATMENT -ev, I-TREATMENT -pero B-EVOLUTION -la I-EVOLUTION -mejoría I-EVOLUTION -fue I-EVOLUTION -parcial I-EVOLUTION -y I-EVOLUTION -quedaron I-EVOLUTION -con I-EVOLUTION -secuelas I-EVOLUTION -cognitivas. I-EVOLUTION - I-EVOLUTION -W B-PRESENT_ILLNESS -tenía I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -era B-PAST_MEDICAL_HISTORY -supervisor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ventas, I-PAST_MEDICAL_HISTORY -soltero; I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia I-PAST_MEDICAL_HISTORY -salvo I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -promiscuo; I-PAST_MEDICAL_HISTORY -fumaba I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -bebía I-PAST_MEDICAL_HISTORY -poco, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -consumía I-PAST_MEDICAL_HISTORY -drogas. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -2° I-PRESENT_ILLNESS -semestre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2008 I-PRESENT_ILLNESS -aparecieron I-PRESENT_ILLNESS -tendencia I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -aislarse, I-PRESENT_ILLNESS -olvidos, I-PRESENT_ILLNESS -insomnio, I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -libido, I-PRESENT_ILLNESS -disartria, I-PRESENT_ILLNESS -cefaleas. I-PRESENT_ILLNESS -Existía I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mezcla I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -labilidad I-PRESENT_ILLNESS -emocional I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -apatía. I-PRESENT_ILLNESS -Perdió I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -trabajo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -abril I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2009. I-PRESENT_ILLNESS -En B-DERIVED_FROM/TO -mayo I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -psiquiatra I-DERIVED_FROM/TO -lo I-DERIVED_FROM/TO -derivó I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -neurólogo, I-DERIVED_FROM/TO -quien I-DERIVED_FROM/TO -pidió I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -batería I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -exámenes, I-DERIVED_FROM/TO -entre I-DERIVED_FROM/TO -ellos I-DERIVED_FROM/TO -VDRL I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -sangre I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -reactivo. I-DERIVED_FROM/TO -El B-EXPLORATION -examen I-EXPLORATION -general I-EXPLORATION -era I-EXPLORATION normal. I-EXPLORATION -Se I-EXPLORATION -mostraba I-EXPLORATION -alerta I-EXPLORATION -y I-EXPLORATION -colaboraba I-EXPLORATION -al I-EXPLORATION -examen; I-EXPLORATION -destacaban I-EXPLORATION -un I-EXPLORATION -síndrome I-EXPLORATION -frontal I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -afasia I-EXPLORATION -no I-EXPLORATION -fluente I-EXPLORATION -mixta. I-EXPLORATION -Existían I-EXPLORATION -nistagmo I-EXPLORATION -en I-EXPLORATION -miradas I-EXPLORATION -extremas, I-EXPLORATION -paramimesis, I-EXPLORATION -enganche I-EXPLORATION -digital, I-EXPLORATION -tics I-EXPLORATION + I-EXPLORATION +Ante B-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +hallazgos I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +escápula I-DERIVED_FROM/TO +elevada, I-DERIVED_FROM/TO +escoliosis, I-DERIVED_FROM/TO +tortícolis I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +plagiocefalia I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +decide I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +derivación I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +traumatología I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +hospital I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +referencia. I-DERIVED_FROM/TO +Debido B-EXPLORATION +a I-EXPLORATION +sus I-EXPLORATION +antecedentes I-EXPLORATION de I-EXPLORATION -elevación I-EXPLORATION +dilatación I-EXPLORATION +pielocalicial I-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +abdominorrenal I-EXPLORATION de I-EXPLORATION -hombros. I-EXPLORATION -Una I-EXPLORATION -discreta I-EXPLORATION -ataxia I-EXPLORATION +control. I-EXPLORATION + I-EXPLORATION +En B-EVOLUTION +la I-EVOLUTION +revisión I-EVOLUTION +del I-EVOLUTION +cuarto I-EVOLUTION +mes I-EVOLUTION +la I-EVOLUTION +asimetría I-EVOLUTION +escapular I-EVOLUTION +es I-EVOLUTION +más I-EVOLUTION +manifiesta, I-EVOLUTION +se I-EVOLUTION +observa I-EVOLUTION +una I-EVOLUTION +mayor I-EVOLUTION +discrepancia I-EVOLUTION +entre I-EVOLUTION +el I-EVOLUTION +tamaño I-EVOLUTION +de I-EVOLUTION +ambas I-EVOLUTION +escápulas I-EVOLUTION +(la I-EVOLUTION +derecha I-EVOLUTION +mide I-EVOLUTION +7 I-EVOLUTION +cm, I-EVOLUTION +frente I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +4, I-EVOLUTION +5 I-EVOLUTION +cm I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +izquierda), I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +altura I-EVOLUTION +del I-EVOLUTION +ángulo I-EVOLUTION +inferior I-EVOLUTION +de I-EVOLUTION +ambas I-EVOLUTION +dista I-EVOLUTION +2, I-EVOLUTION +5 I-EVOLUTION +cm. I-EVOLUTION +La B-EXPLORATION +movilidad I-EXPLORATION +del I-EXPLORATION +brazo I-EXPLORATION +está I-EXPLORATION +conservada, I-EXPLORATION +aunque I-EXPLORATION +existe I-EXPLORATION +una I-EXPLORATION +limitación I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -marcha, I-EXPLORATION -arreflexia I-EXPLORATION -tendinosa I-EXPLORATION +abducción I-EXPLORATION +del I-EXPLORATION +hombro I-EXPLORATION +izquierdo I-EXPLORATION +(activa: I-EXPLORATION +85o; I-EXPLORATION +pasiva: I-EXPLORATION +115o). I-EXPLORATION +La I-EXPLORATION +plagiocefalia I-EXPLORATION +ahora I-EXPLORATION +es I-EXPLORATION +moderada, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +decide I-EXPLORATION +derivar I-EXPLORATION +al I-EXPLORATION +servicio I-EXPLORATION de I-EXPLORATION -miembros I-EXPLORATION -inferiores I-EXPLORATION +neurocirugía I-EXPLORATION +para I-EXPLORATION +valorar I-EXPLORATION +ortesis I-EXPLORATION +craneal. I-EXPLORATION + I-EXPLORATION +Con I-EXPLORATION +el I-EXPLORATION +fin I-EXPLORATION +de I-EXPLORATION +confirmar I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -retención I-EXPLORATION +descartar I-EXPLORATION +otras I-EXPLORATION +alteraciones I-EXPLORATION +asociadas I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +realizan I-EXPLORATION +las I-EXPLORATION +siguientes I-EXPLORATION +pruebas I-EXPLORATION +complementarias: I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Ecografía I-EXPLORATION +renal I-EXPLORATION +(mayo I-EXPLORATION de I-EXPLORATION -orina I-EXPLORATION -configuraban I-EXPLORATION +2009): I-EXPLORATION +se I-EXPLORATION +aprecian I-EXPLORATION una I-EXPLORATION -tabes I-EXPLORATION -dorsal. I-EXPLORATION +dilatación I-EXPLORATION +pielocalicial I-EXPLORATION +bilateral I-EXPLORATION +de I-EXPLORATION +grado I-EXPLORATION +II/IV, I-EXPLORATION +pelvis I-EXPLORATION +renal I-EXPLORATION +derecha I-EXPLORATION +de I-EXPLORATION +9 I-EXPLORATION +mm I-EXPLORATION +e I-EXPLORATION +izquierda I-EXPLORATION +de I-EXPLORATION +1 I-EXPLORATION +cm. I-EXPLORATION I-EXPLORATION -El I-EXPLORATION -síndrome I-EXPLORATION -frontal I-EXPLORATION -se I-EXPLORATION -expresaba I-EXPLORATION -en I-EXPLORATION -apatía, I-EXPLORATION -abulia I-EXPLORATION -y I-EXPLORATION -conducta I-EXPLORATION +- I-EXPLORATION +Ecografía I-EXPLORATION de I-EXPLORATION -imitación. I-EXPLORATION -Fue I-EXPLORATION -incapaz I-EXPLORATION +caderas I-EXPLORATION +(mayo I-EXPLORATION de I-EXPLORATION -comprender I-EXPLORATION -escenas I-EXPLORATION -complejas I-EXPLORATION -y I-EXPLORATION +2009) I-EXPLORATION +por I-EXPLORATION +sospecha I-EXPLORATION de I-EXPLORATION -interpretar I-EXPLORATION -proverbios; I-EXPLORATION -perseveraba I-EXPLORATION -con I-EXPLORATION -frecuencia. I-EXPLORATION -Tenía I-EXPLORATION -defectos I-EXPLORATION -atencionales I-EXPLORATION -(cálculo, I-EXPLORATION -retención I-EXPLORATION +displasia I-EXPLORATION de I-EXPLORATION -cifras, I-EXPLORATION -inversión I-EXPLORATION +caderas: I-EXPLORATION +sin I-EXPLORATION +hallazgos I-EXPLORATION +significativos. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Radiografía I-EXPLORATION de I-EXPLORATION -series I-EXPLORATION -automáticas) I-EXPLORATION +columna I-EXPLORATION +completa I-EXPLORATION y I-EXPLORATION -existía I-EXPLORATION -una I-EXPLORATION -afasia I-EXPLORATION -no I-EXPLORATION -fluente I-EXPLORATION -mixta. I-EXPLORATION -En I-EXPLORATION -MM I-EXPLORATION -obtuvo I-EXPLORATION -9/30 I-EXPLORATION -puntos, I-EXPLORATION -en I-EXPLORATION -FAB I-EXPLORATION -3/18 I-EXPLORATION -puntos; I-EXPLORATION -fue I-EXPLORATION -incapaz I-EXPLORATION +escápula I-EXPLORATION +(mayo I-EXPLORATION de I-EXPLORATION -abstraer. I-EXPLORATION -Rindió I-EXPLORATION -mejor I-EXPLORATION -en I-EXPLORATION -Matrices I-EXPLORATION -Progresivas I-EXPLORATION -Coloreadas I-EXPLORATION -(MPC, I-EXPLORATION -25/36 I-EXPLORATION -puntos) I-EXPLORATION -y I-EXPLORATION +2009): I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +alteraciones I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -prueba I-EXPLORATION +fusión I-EXPLORATION de I-EXPLORATION -asociación I-EXPLORATION -semántica I-EXPLORATION -del I-EXPLORATION -4° I-EXPLORATION -excluido I-EXPLORATION -(acertó I-EXPLORATION -en I-EXPLORATION -7/8 I-EXPLORATION -ensayos). I-EXPLORATION -No I-EXPLORATION -existían I-EXPLORATION -agnosias I-EXPLORATION -visuales I-EXPLORATION -ni I-EXPLORATION -espaciales, I-EXPLORATION -apraxia I-EXPLORATION -constructiva, I-EXPLORATION -ideatoria, I-EXPLORATION -ideomotora I-EXPLORATION -ni I-EXPLORATION +los I-EXPLORATION +cuerpos I-EXPLORATION +vertebrales I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +columna I-EXPLORATION +dorsal I-EXPLORATION +alta I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +cervical I-EXPLORATION +baja. I-EXPLORATION +Primera I-EXPLORATION +costilla I-EXPLORATION +izquierda I-EXPLORATION +hipoplásica. I-EXPLORATION +Costillas I-EXPLORATION +2.a I-EXPLORATION +a I-EXPLORATION +5.a I-EXPLORATION +izquierdas I-EXPLORATION +con I-EXPLORATION +disminución I-EXPLORATION del I-EXPLORATION -vestir. I-EXPLORATION -Tampoco I-EXPLORATION -tenía I-EXPLORATION -agnosia I-EXPLORATION -digital I-EXPLORATION -ni I-EXPLORATION -desorientación I-EXPLORATION -derecha-izquierda. I-EXPLORATION +espacio I-EXPLORATION +intercostal. I-EXPLORATION +Elevación I-EXPLORATION +de I-EXPLORATION +escápula I-EXPLORATION +izquierda I-EXPLORATION +("escápula I-EXPLORATION +alada"). I-EXPLORATION I-EXPLORATION -El I-EXPLORATION -LCR I-EXPLORATION -mostró I-EXPLORATION -pleocitosis I-EXPLORATION -(130 I-EXPLORATION -mononuclea-res, I-EXPLORATION -88% I-EXPLORATION +- I-EXPLORATION +Radiografía I-EXPLORATION de I-EXPLORATION -linfocitos, I-EXPLORATION -10% I-EXPLORATION +columna I-EXPLORATION +lateral I-EXPLORATION +(junio I-EXPLORATION de I-EXPLORATION -polinucleares I-EXPLORATION -y I-EXPLORATION -2% I-EXPLORATION +2009): I-EXPLORATION +se I-EXPLORATION +objetivan I-EXPLORATION +alteraciones I-EXPLORATION de I-EXPLORATION -monocitos), I-EXPLORATION -glucosa I-EXPLORATION -21 I-EXPLORATION -mg/dL I-EXPLORATION -y I-EXPLORATION -proteínas I-EXPLORATION -180 I-EXPLORATION -mg/dL. I-EXPLORATION -El I-EXPLORATION -VRDL I-EXPLORATION -fue I-EXPLORATION -reactivo I-EXPLORATION -1/128. I-EXPLORATION -La I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -cerebral I-EXPLORATION -mostró I-EXPLORATION -atrofia I-EXPLORATION +segmentación I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +cuerpos I-EXPLORATION +vertebrales I-EXPLORATION de I-EXPLORATION -predominio I-EXPLORATION -frontotemporal I-EXPLORATION -izquierdo, I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -EEG I-EXPLORATION -actividad I-EXPLORATION -irritativa I-EXPLORATION -y I-EXPLORATION -lenta I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -misma I-EXPLORATION -zona. I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION -fue I-EXPLORATION -negativa, I-EXPLORATION -y I-EXPLORATION -otros I-EXPLORATION -exámenes I-EXPLORATION -humorales I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -(función I-EXPLORATION -hepática, I-EXPLORATION -coagulación, I-EXPLORATION -hemograma I-EXPLORATION +columna I-EXPLORATION +vertebral I-EXPLORATION +dorsal I-EXPLORATION +alta I-EXPLORATION y I-EXPLORATION -VHS, I-EXPLORATION -nivel I-EXPLORATION +cervical I-EXPLORATION +baja, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +elevación I-EXPLORATION de I-EXPLORATION -vitamina I-EXPLORATION -B12, I-EXPLORATION -Na, I-EXPLORATION -K I-EXPLORATION +la I-EXPLORATION +escápula I-EXPLORATION +izquierda. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Ecocardiograma I-EXPLORATION y I-EXPLORATION -Cl, I-EXPLORATION -perfil I-EXPLORATION -bioquímico, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva, I-EXPLORATION -PCR I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -herpes I-EXPLORATION -simple I-EXPLORATION -en I-EXPLORATION -LCR). I-EXPLORATION +electrocardiograma: I-EXPLORATION +normales. I-EXPLORATION I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +72 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +diagnosticada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +estenosis I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +canal I-PRESENT_ILLNESS +medular I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +hernia I-PRESENT_ILLNESS +discal, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +Durogesic® I-PRESENT_ILLNESS +50 I-PRESENT_ILLNESS +μg/h I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +buena I-PRESENT_ILLNESS +eficacia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +seguridad. I-PRESENT_ILLNESS Se B-TREATMENT -trató I-TREATMENT -con I-TREATMENT -penicilina I-TREATMENT -sódica I-TREATMENT -4.000.000 I-TREATMENT -ui I-TREATMENT -ev I-TREATMENT -c/4 I-TREATMENT -horas I-TREATMENT -durante I-TREATMENT -15 I-TREATMENT -días, I-TREATMENT -betametasona I-TREATMENT -4 I-TREATMENT -mg I-TREATMENT -ev I-TREATMENT -c/8 I-TREATMENT -horas I-TREATMENT +cambia I-TREATMENT por I-TREATMENT -3 I-TREATMENT -días I-TREATMENT +fentanilo I-TREATMENT +genérico, I-TREATMENT +notándose I-TREATMENT +un I-TREATMENT +empeoramiento I-TREATMENT +del I-TREATMENT +cuadro I-TREATMENT +doloroso. I-TREATMENT +Se I-TREATMENT +vuelve I-TREATMENT +a I-TREATMENT +cambiar I-TREATMENT +a I-TREATMENT +Durogesic®, I-TREATMENT y I-TREATMENT -fenitoina I-TREATMENT -100 I-TREATMENT -mg I-TREATMENT -c/8 I-TREATMENT -horas. I-TREATMENT -El B-EVOLUTION -tratamiento I-EVOLUTION -fue I-EVOLUTION -bien I-EVOLUTION -tolerado I-EVOLUTION -y I-EVOLUTION -parcialmente I-EVOLUTION -eficaz. I-EVOLUTION -A B-EXPLORATION -comienzos I-EXPLORATION +de I-TREATMENT +nuevo I-TREATMENT +se I-TREATMENT +estabiliza I-TREATMENT +la I-TREATMENT +analgesia. I-TREATMENT + I-TREATMENT + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +56 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +fumador, B-PAST_MEDICAL_HISTORY +diagnosticado I-PAST_MEDICAL_HISTORY +quince I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +acalasia, I-PAST_MEDICAL_HISTORY +realizándose I-PAST_MEDICAL_HISTORY +dilatación I-PAST_MEDICAL_HISTORY +endoscópica I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +ese I-PAST_MEDICAL_HISTORY +momento, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +seguimiento I-PAST_MEDICAL_HISTORY +posterior I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +decisión I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +paciente. I-PAST_MEDICAL_HISTORY +Ingresa B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +disfagia I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +sólidos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +líquidos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso. I-PRESENT_ILLNESS +Se B-EXPLORATION +realiza I-EXPLORATION +endoscopia I-EXPLORATION +oral I-EXPLORATION +objetivando I-EXPLORATION +esófago I-EXPLORATION +con I-EXPLORATION +abundantes I-EXPLORATION +restos I-EXPLORATION +líquidos, I-EXPLORATION +con I-EXPLORATION +paredes I-EXPLORATION +dilatadas, I-EXPLORATION +morfología I-EXPLORATION +sigmoide I-EXPLORATION +y I-EXPLORATION +mucosa I-EXPLORATION +distal I-EXPLORATION de I-EXPLORATION -2010 I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -neurológico I-EXPLORATION -básico I-EXPLORATION -era I-EXPLORATION -normal, I-EXPLORATION -en I-EXPLORATION -MM I-EXPLORATION -obtuvo I-EXPLORATION -28/30 I-EXPLORATION -puntos, I-EXPLORATION -en I-EXPLORATION -MPC I-EXPLORATION -31/36, I-EXPLORATION +aspecto I-EXPLORATION +agrietado, I-EXPLORATION +friable I-EXPLORATION +y I-EXPLORATION +cardias I-EXPLORATION +puntiforme, I-EXPLORATION +con I-EXPLORATION +resistencia I-EXPLORATION +al I-EXPLORATION +paso I-EXPLORATION +del I-EXPLORATION +endoscopio, I-EXPLORATION en I-EXPLORATION -FAB I-EXPLORATION -13/18. I-EXPLORATION -Persistía I-EXPLORATION -un I-EXPLORATION -síndrome I-EXPLORATION -frontal, I-EXPLORATION +relación I-EXPLORATION con I-EXPLORATION -actitud I-EXPLORATION -pueril, I-EXPLORATION -fallas I-EXPLORATION +acalasia I-EXPLORATION +evolucionada, I-EXPLORATION +sin I-EXPLORATION +lesiones I-EXPLORATION +subcardiales I-EXPLORATION +que I-EXPLORATION +justifiquen I-EXPLORATION +pseudoacalasia. I-EXPLORATION +A I-EXPLORATION +22 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +arcada I-EXPLORATION +dentaria I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +lesión I-EXPLORATION +mucosa I-EXPLORATION +excavada, I-EXPLORATION +profunda, I-EXPLORATION +cubierta I-EXPLORATION de I-EXPLORATION -juicio I-EXPLORATION +fibrina I-EXPLORATION y I-EXPLORATION +punteado I-EXPLORATION +hemático, I-EXPLORATION de I-EXPLORATION -coherencia I-EXPLORATION -del I-EXPLORATION -discurso. I-EXPLORATION -El I-EXPLORATION -LCR I-EXPLORATION -era I-EXPLORATION -normal, I-EXPLORATION -con I-EXPLORATION -serología I-EXPLORATION -reactiva I-EXPLORATION -a I-EXPLORATION -1/32, I-EXPLORATION -lo I-EXPLORATION +gran I-EXPLORATION +tamaño, I-EXPLORATION que I-EXPLORATION -unido I-EXPLORATION -a I-EXPLORATION +abarca I-EXPLORATION la I-EXPLORATION -aparición I-EXPLORATION +mitad I-EXPLORATION de I-EXPLORATION -crisis I-EXPLORATION -convulsivas I-EXPLORATION -llevó B-TREATMENT -a I-TREATMENT -un I-TREATMENT -segundo I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -penicilina, I-TREATMENT +la I-EXPLORATION +circunferencia, I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +maligno I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +biopsia, I-EXPLORATION +con I-EXPLORATION +histología I-EXPLORATION +de I-EXPLORATION +carcinoma I-EXPLORATION +epidermoide I-EXPLORATION +moderadamente I-EXPLORATION +diferenciado. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +TC I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +esófago I-EXPLORATION +marcadamente I-EXPLORATION +dilatado I-EXPLORATION +y I-EXPLORATION +engrosamiento I-EXPLORATION +parietal I-EXPLORATION +del I-EXPLORATION +tercio I-EXPLORATION +proximal I-EXPLORATION +esofágico I-EXPLORATION +con I-EXPLORATION +probable I-EXPLORATION +infiltración I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +posterior I-EXPLORATION +traqueal, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +confirma I-EXPLORATION +al I-EXPLORATION +realizar I-EXPLORATION +broncoscopia. I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT de I-TREATMENT -21 I-TREATMENT -días, I-TREATMENT -y I-TREATMENT -a I-TREATMENT -indicar I-TREATMENT -ácido I-TREATMENT -valproico I-TREATMENT -en I-TREATMENT -vez I-TREATMENT +carcinoma I-TREATMENT +epidermoide I-TREATMENT de I-TREATMENT -fenitoína. I-TREATMENT -Fue B-EVOLUTION -jubilado I-EVOLUTION -por I-EVOLUTION -invalidez I-EVOLUTION -y I-EVOLUTION -vive I-EVOLUTION +esófago I-TREATMENT +moderadamente I-TREATMENT +diferenciado I-TREATMENT +estadio I-TREATMENT +III I-TREATMENT +con I-TREATMENT +infiltración I-TREATMENT +traqueal I-TREATMENT +se I-TREATMENT +inicia I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +quimioterapia I-TREATMENT +sistémica I-TREATMENT +según I-TREATMENT +esquema I-TREATMENT +cisplatino/5-fluouracilo. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +sufre I-EVOLUTION +un I-EVOLUTION +cuadro I-EVOLUTION +compatible I-EVOLUTION con I-EVOLUTION -sus I-EVOLUTION -padres. I-EVOLUTION +broncoaspiración, I-EVOLUTION +presentando I-EVOLUTION +deterioro I-EVOLUTION +clínico I-EVOLUTION +progresivo I-EVOLUTION +produciéndose I-EVOLUTION +finalmente I-EVOLUTION +el I-EVOLUTION +fallecimiento I-EVOLUTION +siete I-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +inicio I-EVOLUTION +del I-EVOLUTION +tratamiento, I-EVOLUTION +poniéndose I-EVOLUTION +en I-EVOLUTION +relación I-EVOLUTION +con I-EVOLUTION +perforación I-EVOLUTION +traqueoesofágica, I-EVOLUTION +bronconeumonía I-EVOLUTION +y I-EVOLUTION +mediastinitis I-EVOLUTION +asociada. I-EVOLUTION I-EVOLUTION -Un B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -natural B-PAST_MEDICAL_HISTORY +47 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +prurito I-PRESENT_ILLNESS +intenso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +piel I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +desemboca I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +aparición I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +eritematosa, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +bordes I-PRESENT_ILLNESS +vesiculosos I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +irregulares I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +superficie I-PRESENT_ILLNESS +ligeramente I-PRESENT_ILLNESS +escamosa I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +brazo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +posteriormente I-PRESENT_ILLNESS +aparecen I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +semejantes I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +resto I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +cuerpo I-PRESENT_ILLNESS +incluyendo I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +cara. I-PRESENT_ILLNESS +Unos B-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +inició I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Brasil, I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +hepatitis I-PAST_MEDICAL_HISTORY +C I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dermatitis I-PAST_MEDICAL_HISTORY -seborreica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -lupus I-PAST_MEDICAL_HISTORY -cutáneo I-PAST_MEDICAL_HISTORY -subagudo, I-PAST_MEDICAL_HISTORY -fue B-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestra I-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -desarrollo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -cuadro I-DERIVED_FROM/TO -cutáneo I-DERIVED_FROM/TO -abrupto I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -semana I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -localizado I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -región I-DERIVED_FROM/TO -centrofacial I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -torácica I-DERIVED_FROM/TO -anterior. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -El B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -aplicado I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -corticoide I-PRESENT_ILLNESS -tópico I-PRESENT_ILLNESS -(mometasona I-PRESENT_ILLNESS -furoato I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -0, I-PRESENT_ILLNESS -1%) I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -veces I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -intentar I-PRESENT_ILLNESS -controlar I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -lesiones. I-PRESENT_ILLNESS -Reseñaba B-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -lesiones I-PAST_MEDICAL_HISTORY -pustulosas I-PAST_MEDICAL_HISTORY -aisladas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -cara I-PAST_MEDICAL_HISTORY -ocasionales I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY +135mg I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -enrojecimiento I-PAST_MEDICAL_HISTORY -facial I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -calor I-PAST_MEDICAL_HISTORY +interferón I-PAST_MEDICAL_HISTORY +alfa-2a I-PAST_MEDICAL_HISTORY +semanalmente, I-PAST_MEDICAL_HISTORY +administrado I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +vía I-PAST_MEDICAL_HISTORY +subcutánea I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -alcohol. I-PAST_MEDICAL_HISTORY +ribavirina, I-PAST_MEDICAL_HISTORY +1.200 I-PAST_MEDICAL_HISTORY +mg/día I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +vía I-PAST_MEDICAL_HISTORY +oral. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -Clínicamente B-EXPLORATION -mostraba, I-EXPLORATION -eritema I-EXPLORATION -facial I-EXPLORATION -y I-EXPLORATION -lesiones I-EXPLORATION -pápulo-pustulosas I-EXPLORATION -localizadas I-EXPLORATION +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +presenta I-EXPLORATION +una I-EXPLORATION +placa I-EXPLORATION +eccematosa, I-EXPLORATION +pruriginosa, I-EXPLORATION en I-EXPLORATION -frente, I-EXPLORATION -mejillas, I-EXPLORATION -región I-EXPLORATION -perioral I-EXPLORATION -y I-EXPLORATION -tórax. I-EXPLORATION -Además I-EXPLORATION -presentaba I-EXPLORATION -ausencia I-EXPLORATION +el I-EXPLORATION +tercio I-EXPLORATION +inferior I-EXPLORATION +del I-EXPLORATION +brazo I-EXPLORATION +izquierdo. I-EXPLORATION +Ver I-EXPLORATION +figura. I-EXPLORATION +Se I-EXPLORATION +observan I-EXPLORATION +lesiones I-EXPLORATION de I-EXPLORATION -comedones I-EXPLORATION -y I-EXPLORATION -padecía I-EXPLORATION -afectación I-EXPLORATION -ocular I-EXPLORATION -con I-EXPLORATION -inyección I-EXPLORATION -conjuntival I-EXPLORATION -acompañado I-EXPLORATION +características I-EXPLORATION +semejantes, I-EXPLORATION de I-EXPLORATION -fotofobia I-EXPLORATION +diversos I-EXPLORATION +tamaños I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +distribuyen I-EXPLORATION +por I-EXPLORATION +los I-EXPLORATION +miembros I-EXPLORATION +inferiores I-EXPLORATION y I-EXPLORATION -lagrimeo. I-EXPLORATION -No I-EXPLORATION -presentaba I-EXPLORATION -fiebre I-EXPLORATION -ni I-EXPLORATION -otra I-EXPLORATION -clínica I-EXPLORATION -sistémica. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -con I-EXPLORATION -bioquímica I-EXPLORATION -general I-EXPLORATION +superiores, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +tórax, I-EXPLORATION +la I-EXPLORATION +cara I-EXPLORATION y I-EXPLORATION +pabellones I-EXPLORATION +auriculares. I-EXPLORATION +El I-EXPLORATION +estado I-EXPLORATION +general I-EXPLORATION +del I-EXPLORATION +paciente I-EXPLORATION +es I-EXPLORATION +bueno, I-EXPLORATION +el I-EXPLORATION hemograma I-EXPLORATION -resultaron I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +bioquímica I-EXPLORATION +sanguínea I-EXPLORATION +son I-EXPLORATION normales. I-EXPLORATION +Se I-EXPLORATION +practica I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +incisional I-EXPLORATION +del I-EXPLORATION +borde I-EXPLORATION +superior I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +ubicada I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +brazo I-EXPLORATION +izquierdo. I-EXPLORATION +El I-EXPLORATION +laboratorio I-EXPLORATION +de I-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +informa I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +trata I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +dermatitis I-EXPLORATION +psoriasiforme I-EXPLORATION +y I-EXPLORATION +espongiótica I-EXPLORATION +con I-EXPLORATION +formación I-EXPLORATION +de I-EXPLORATION +ampolla I-EXPLORATION +intracórnea I-EXPLORATION +con I-EXPLORATION +neutrófilos. I-EXPLORATION I-EXPLORATION -Con B-TREATMENT +Se I-EXPLORATION +establece I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +eccema I-EXPLORATION +nummular I-EXPLORATION +generalizado I-EXPLORATION +secundario I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +ingesta I-EXPLORATION +de I-EXPLORATION +interferón I-EXPLORATION +alfa-2a I-EXPLORATION +y I-EXPLORATION +ribavirina I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +tratamiento I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +hepatitis I-EXPLORATION +C. I-EXPLORATION +Tras B-TREATMENT +consultar I-TREATMENT +con I-TREATMENT el I-TREATMENT -juicio I-TREATMENT -clínico I-TREATMENT +especialista I-TREATMENT de I-TREATMENT -rosácea I-TREATMENT -fulminans I-TREATMENT -con I-TREATMENT -afectación I-TREATMENT -ocular I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -oral I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -40 I-TREATMENT -mg/día, I-TREATMENT -metronidazol I-TREATMENT -500 I-TREATMENT -mg/12 I-TREATMENT -horas, I-TREATMENT -isotretinoína I-TREATMENT -50 I-TREATMENT -mg/día I-TREATMENT -(0, I-TREATMENT -7 I-TREATMENT -mg/kg/día), I-TREATMENT -y I-TREATMENT -lágrimas I-TREATMENT -artificiales. I-TREATMENT -El I-TREATMENT -metronidazol I-TREATMENT -y I-TREATMENT -la I-TREATMENT -prednisona I-TREATMENT +Digestivo I-TREATMENT se I-TREATMENT -suspendieron I-TREATMENT -tras I-TREATMENT -un I-TREATMENT -mes I-TREATMENT -de I-TREATMENT +decide I-TREATMENT +retirar I-TREATMENT +el I-TREATMENT tratamiento I-TREATMENT -(la I-TREATMENT -última I-TREATMENT -en I-TREATMENT -pauta I-TREATMENT -descendente). I-TREATMENT -Por I-TREATMENT -último, I-TREATMENT -la I-TREATMENT -isotretinoína I-TREATMENT -oral I-TREATMENT +y I-TREATMENT se I-TREATMENT -retiró I-TREATMENT -tras I-TREATMENT -tres I-TREATMENT -meses I-TREATMENT -de I-TREATMENT +inicia I-TREATMENT tratamiento I-TREATMENT -realizando I-TREATMENT -descenso I-TREATMENT -progresivo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -dosis. I-TREATMENT +con I-TREATMENT +hidroxicina I-TREATMENT +25 I-TREATMENT +mg I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +horas I-TREATMENT +y I-TREATMENT +beclometasona I-TREATMENT +dipropionato I-TREATMENT +al I-TREATMENT +0, I-TREATMENT +025% I-TREATMENT +tópico I-TREATMENT +cada I-TREATMENT +24 I-TREATMENT +horas I-TREATMENT +sobre I-TREATMENT +las I-TREATMENT +lesiones. I-TREATMENT El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -importante I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -hasta I-EVOLUTION -la I-EVOLUTION -desaparición I-EVOLUTION -completa I-EVOLUTION -tras I-EVOLUTION -los I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -tratamiento. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -recaídas I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad I-EVOLUTION -en I-EVOLUTION +cuadro I-EVOLUTION +cutáneo I-EVOLUTION +se I-EVOLUTION +resuelve I-EVOLUTION +a I-EVOLUTION los I-EVOLUTION -posteriores I-EVOLUTION -seis I-EVOLUTION -meses. I-EVOLUTION +15 I-EVOLUTION +días I-EVOLUTION +sin I-EVOLUTION +complicaciones. I-EVOLUTION I-EVOLUTION +Diagnóstico: B-EXPLORATION +Eccema I-EXPLORATION +nummular I-EXPLORATION +generalizado I-EXPLORATION +secundario I-EXPLORATION +a I-EXPLORATION +interferón I-EXPLORATION +alfa-2a I-EXPLORATION +y I-EXPLORATION +ribavirina I-EXPLORATION + I-EXPLORATION -Paciente B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -38 I-PRESENT_ILLNESS +77 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY +edad I-PRESENT_ILLNESS +remitida B-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +consulta I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Nefrología I-DERIVED_FROM/TO +por B-PRESENT_ILLNESS +creatinina I-PRESENT_ILLNESS +plasmática I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2, I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +mg/dl. I-PRESENT_ILLNESS +Entre B-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +destacaban I-PAST_MEDICAL_HISTORY +diversas I-PAST_MEDICAL_HISTORY +intervenciones I-PAST_MEDICAL_HISTORY +quirúrgicas I-PAST_MEDICAL_HISTORY +(menisco I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +1985; I-PAST_MEDICAL_HISTORY +timoma I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +anatomía I-PAST_MEDICAL_HISTORY +patológica I-PAST_MEDICAL_HISTORY +benigna I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +1999; I-PAST_MEDICAL_HISTORY +pólipos I-PAST_MEDICAL_HISTORY +nasosinusales I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -alcoholismo I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -policonsumo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2008; I-PAST_MEDICAL_HISTORY +varices I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2006; I-PAST_MEDICAL_HISTORY +cistocele I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2008; I-PAST_MEDICAL_HISTORY +fractura I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -drogas, I-PAST_MEDICAL_HISTORY -trastorno I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ánimo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -B I-PAST_MEDICAL_HISTORY +cadera I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +julio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2010); I-PAST_MEDICAL_HISTORY +colangitis I-PAST_MEDICAL_HISTORY +esclerosante I-PAST_MEDICAL_HISTORY +primaria I-PAST_MEDICAL_HISTORY diagnosticada I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -2005. I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +2003, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +ácido I-PAST_MEDICAL_HISTORY +ursodesoxicólico. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +varias I-PAST_MEDICAL_HISTORY +ocasiones I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +realizado I-PAST_MEDICAL_HISTORY +cateterismo I-PAST_MEDICAL_HISTORY +biliar I-PAST_MEDICAL_HISTORY +retrógado I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +esfinterectomía I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +dilatación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +zonas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +estenosis. I-PAST_MEDICAL_HISTORY +También I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +diagnosticado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +inflamatoria I-PAST_MEDICAL_HISTORY +intestinal I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +misma I-PAST_MEDICAL_HISTORY +época; I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +seguimiento I-PAST_MEDICAL_HISTORY +posterior I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +practicaron I-PAST_MEDICAL_HISTORY +varias I-PAST_MEDICAL_HISTORY +colonoscopias I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +unas I-PAST_MEDICAL_HISTORY +ocasiones I-PAST_MEDICAL_HISTORY +eran I-PAST_MEDICAL_HISTORY +normales I-PAST_MEDICAL_HISTORY +y, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +otras, I-PAST_MEDICAL_HISTORY +mostraban I-PAST_MEDICAL_HISTORY +mínimas I-PAST_MEDICAL_HISTORY +ulceraciones I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +nivel I-PAST_MEDICAL_HISTORY +iliocecal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +colon. I-PAST_MEDICAL_HISTORY +Pericarditis I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +etiología I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +filiada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +enero I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2010. I-PAST_MEDICAL_HISTORY +Gonartrosis I-PAST_MEDICAL_HISTORY +bilateral. I-PAST_MEDICAL_HISTORY +Intolerancia I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +hierro I-PAST_MEDICAL_HISTORY +oral. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +hábitos I-PAST_MEDICAL_HISTORY +tóxicos. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Infectología I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -febrero I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2011 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -tumores I-PRESENT_ILLNESS -eritemato-violáceos I-PRESENT_ILLNESS -dolorosos, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +En I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +primer I-PAST_MEDICAL_HISTORY +momento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +vista I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +consulta I-PAST_MEDICAL_HISTORY +externa I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +encontraba I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +zolpidem, I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +mg/día; I-PAST_MEDICAL_HISTORY +ácido I-PAST_MEDICAL_HISTORY +ursodesoxicólico, I-PAST_MEDICAL_HISTORY +1250 I-PAST_MEDICAL_HISTORY +mg/día; I-PAST_MEDICAL_HISTORY +pantoprazol, I-PAST_MEDICAL_HISTORY +40 I-PAST_MEDICAL_HISTORY +mg/día; I-PAST_MEDICAL_HISTORY +mirtazapina, I-PAST_MEDICAL_HISTORY +15 I-PAST_MEDICAL_HISTORY +mg/día; I-PAST_MEDICAL_HISTORY +dextropropoxífeno, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +paracetamol I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +ocasional. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +interrogatorio I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +intenso I-PRESENT_ILLNESS +cansancio, I-PRESENT_ILLNESS +disnea I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -asociados I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS +medianos I-PRESENT_ILLNESS +esfuerzos; I-PRESENT_ILLNESS +disminución I-PRESENT_ILLNESS del I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS +apetito; I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +ocasionales I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +tos; I-PRESENT_ILLNESS +estreñimiento I-PRESENT_ILLNESS +habitual I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS +unas I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +alternaba I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +diarrea I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +día, I-PRESENT_ILLNESS +pero I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +presencia I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +productos I-PRESENT_ILLNESS +patológicos; I-PRESENT_ILLNESS +nicturia I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +veces I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hacía I-PRESENT_ILLNESS +unos I-PRESENT_ILLNESS +meses; I-PRESENT_ILLNESS +micciones I-PRESENT_ILLNESS +diurnas I-PRESENT_ILLNESS +cada I-PRESENT_ILLNESS +3-4 I-PRESENT_ILLNESS +horas; I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +relataba I-PRESENT_ILLNESS +antecedentes I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -nocturna, I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -diarrea. I-PRESENT_ILLNESS -Por B-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -clínico I-EXPLORATION -se I-EXPLORATION -sospechó I-EXPLORATION -inicialmente I-EXPLORATION -sarcoma I-EXPLORATION -de I-EXPLORATION -Kaposi I-EXPLORATION -(SK) I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -ELISA I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION +crisis I-PRESENT_ILLNESS +renoureterales I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +haber I-PRESENT_ILLNESS +tenido I-PRESENT_ILLNESS +hematuria. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-FAMILY_HISTORY +cuanto I-FAMILY_HISTORY +a I-FAMILY_HISTORY +sus I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +familiares, I-FAMILY_HISTORY +padres I-FAMILY_HISTORY +fallecidos I-FAMILY_HISTORY +en I-FAMILY_HISTORY +edad I-FAMILY_HISTORY +avanzada I-FAMILY_HISTORY +y I-FAMILY_HISTORY +tres I-FAMILY_HISTORY +hermanos I-FAMILY_HISTORY +fallecidos I-FAMILY_HISTORY +por I-FAMILY_HISTORY +tumores. I-FAMILY_HISTORY + I-FAMILY_HISTORY +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física: I-EXPLORATION +talla: I-EXPLORATION +159 I-EXPLORATION +cm; I-EXPLORATION +peso: I-EXPLORATION +53 I-EXPLORATION +kg. I-EXPLORATION +Presión I-EXPLORATION +arterial: I-EXPLORATION +137/72 I-EXPLORATION +mmHg; I-EXPLORATION +frecuencia I-EXPLORATION +cardíaca: I-EXPLORATION +95 I-EXPLORATION +lpm. I-EXPLORATION +Sin I-EXPLORATION +ingurgitación I-EXPLORATION +yugular; I-EXPLORATION +carótidas I-EXPLORATION +rítmicas I-EXPLORATION y I-EXPLORATION -confirmado I-EXPLORATION -por I-EXPLORATION +simétricas; I-EXPLORATION +auscultación I-EXPLORATION +cardiopulmonar I-EXPLORATION +normal; I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -Instituto I-EXPLORATION +abdomen I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +hepatomegalia I-EXPLORATION de I-EXPLORATION -Salud I-EXPLORATION -Pública I-EXPLORATION +alrededor I-EXPLORATION de I-EXPLORATION -Chile. I-EXPLORATION - I-EXPLORATION -Dada B-TREATMENT -la I-TREATMENT -extensión I-TREATMENT -de I-TREATMENT -las I-TREATMENT -lesiones I-TREATMENT -cutáneas I-TREATMENT -y I-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -fiebre I-TREATMENT -se I-TREATMENT -hospitalizó I-TREATMENT -para I-TREATMENT -mayor I-TREATMENT -estudio. I-TREATMENT -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION +4 I-EXPLORATION +traveses I-EXPLORATION de I-EXPLORATION -ingreso I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -estaba I-EXPLORATION +dedo I-EXPLORATION +más I-EXPLORATION +evidente I-EXPLORATION en I-EXPLORATION -regulares I-EXPLORATION -condiciones I-EXPLORATION -generales, I-EXPLORATION -hipotenso, I-EXPLORATION -febril, I-EXPLORATION -enflaquecido I-EXPLORATION -(índice I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -corporal I-EXPLORATION -de I-EXPLORATION -17), I-EXPLORATION -con I-EXPLORATION -adenopatías I-EXPLORATION -inguinales I-EXPLORATION -induradas, I-EXPLORATION -indoloras I-EXPLORATION +lóbulo I-EXPLORATION +derecho, I-EXPLORATION +no I-EXPLORATION +dolorosa I-EXPLORATION y I-EXPLORATION -poco I-EXPLORATION -móviles. I-EXPLORATION -Presentaba I-EXPLORATION -tumores I-EXPLORATION -eritemato-violáceos I-EXPLORATION +sin I-EXPLORATION +soplos I-EXPLORATION +abdominales. I-EXPLORATION +Extremidades: I-EXPLORATION +sin I-EXPLORATION +edemas I-EXPLORATION +y I-EXPLORATION +pulsos I-EXPLORATION +distales I-EXPLORATION +presentes. I-EXPLORATION + I-EXPLORATION +Revisada I-EXPLORATION +la I-EXPLORATION +historia I-EXPLORATION +analítica, I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +que I-EXPLORATION +en I-EXPLORATION +noviembre I-EXPLORATION de I-EXPLORATION -hasta I-EXPLORATION +2010 I-EXPLORATION +la I-EXPLORATION +creatinina I-EXPLORATION +plasmática I-EXPLORATION +osciló I-EXPLORATION +entre I-EXPLORATION +2, I-EXPLORATION +4-2, I-EXPLORATION 5 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -supraciliar I-EXPLORATION -derecho, I-EXPLORATION +mg/dl; I-EXPLORATION en I-EXPLORATION -mentón I-EXPLORATION +diciembre I-EXPLORATION +de I-EXPLORATION +2010 I-EXPLORATION +la I-EXPLORATION +creatinina I-EXPLORATION +plasmática I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +2, I-EXPLORATION +9 I-EXPLORATION +mg/dl I-EXPLORATION y I-EXPLORATION en I-EXPLORATION -pierna I-EXPLORATION -izquierda. I-EXPLORATION +enero I-EXPLORATION +de I-EXPLORATION +2011, I-EXPLORATION +de I-EXPLORATION +2, I-EXPLORATION +7 I-EXPLORATION +mg/dl. I-EXPLORATION + I-EXPLORATION En I-EXPLORATION -cara, I-EXPLORATION -paladar, I-EXPLORATION -tronco I-EXPLORATION -y I-EXPLORATION -extremidades I-EXPLORATION -presentaba I-EXPLORATION -múltiples I-EXPLORATION -pápulas I-EXPLORATION -erite-matosas I-EXPLORATION -brillantes I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +complementarias I-EXPLORATION +en I-EXPLORATION +enero I-EXPLORATION y I-EXPLORATION -nódulos I-EXPLORATION -dolorosos I-EXPLORATION -subcutáneos I-EXPLORATION -sin I-EXPLORATION -cambios I-EXPLORATION +febrero I-EXPLORATION de I-EXPLORATION -coloración. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -pesquisó I-EXPLORATION -visceromegalia. I-EXPLORATION -De I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -generales I-EXPLORATION -destacaba: I-EXPLORATION -hematocrito I-EXPLORATION -28, I-EXPLORATION -3%; I-EXPLORATION -leucocitos I-EXPLORATION -6.200 I-EXPLORATION -céls/mm3, I-EXPLORATION -sin I-EXPLORATION -desviación I-EXPLORATION -izquierda; I-EXPLORATION -VHS I-EXPLORATION -100 I-EXPLORATION -mm/h; I-EXPLORATION -PCR I-EXPLORATION -9, I-EXPLORATION -1 I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -1); I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION -normal; I-EXPLORATION -pruebas I-EXPLORATION -hepáticas I-EXPLORATION -normales, I-EXPLORATION -excepto I-EXPLORATION -por I-EXPLORATION +2011, I-EXPLORATION +cabe I-EXPLORATION +destacar: I-EXPLORATION +colesterol: I-EXPLORATION +204 I-EXPLORATION +mg/dl; I-EXPLORATION +GOT I-EXPLORATION +(glutamato-oxalacetato-transaminasa): I-EXPLORATION +37 I-EXPLORATION +U/l; I-EXPLORATION +GPT I-EXPLORATION +(glutamato-piruvato-transaminasa): I-EXPLORATION +23 I-EXPLORATION +U/l; I-EXPLORATION +GGT I-EXPLORATION +(gammaglutamil I-EXPLORATION +transferasa): I-EXPLORATION +431 I-EXPLORATION +U/l; I-EXPLORATION fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -elevada I-EXPLORATION -(211 I-EXPLORATION -U/L); I-EXPLORATION -albúmina I-EXPLORATION -3 I-EXPLORATION -g/dl; I-EXPLORATION +alcalina: I-EXPLORATION +483 I-EXPLORATION +U/l; I-EXPLORATION LDH I-EXPLORATION -159 I-EXPLORATION -U/L. I-EXPLORATION -Del I-EXPLORATION -estudio I-EXPLORATION +(lactatodeshidrogenasa): I-EXPLORATION +646 I-EXPLORATION +U/l; I-EXPLORATION +ferritina: I-EXPLORATION +399 I-EXPLORATION +ng/ml; I-EXPLORATION +índice I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -patología I-EXPLORATION +saturación I-EXPLORATION de I-EXPLORATION -base I-EXPLORATION -tenía I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION +transferrina, I-EXPLORATION +11%. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -875.000 I-EXPLORATION -copias I-EXPLORATION -ARN I-EXPLORATION -viral/ml I-EXPLORATION -y I-EXPLORATION -recuento I-EXPLORATION +la I-EXPLORATION +bioquímica I-EXPLORATION +ordinaria I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +hemograma: I-EXPLORATION +hematocrito: I-EXPLORATION +35, I-EXPLORATION +1%; I-EXPLORATION +hemoglobina: I-EXPLORATION +11, I-EXPLORATION +3 I-EXPLORATION +g/dl; I-EXPLORATION +resto I-EXPLORATION +normal. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -linfocitos I-EXPLORATION -CD4 I-EXPLORATION +coagulación: I-EXPLORATION +tiempo I-EXPLORATION de I-EXPLORATION -87, I-EXPLORATION -6 I-EXPLORATION -céls/ I-EXPLORATION -mm3. I-EXPLORATION -Los I-EXPLORATION -hemocultivos, I-EXPLORATION -urocultivos, I-EXPLORATION -RPR, I-EXPLORATION -PPD I-EXPLORATION +tromboplastina I-EXPLORATION +parcial I-EXPLORATION +activado: I-EXPLORATION +45 I-EXPLORATION +segundos. I-EXPLORATION +Anticardiolipina I-EXPLORATION +IgM I-EXPLORATION +positiva: I-EXPLORATION +21, I-EXPLORATION +80 I-EXPLORATION +U I-EXPLORATION +MPL/ml I-EXPLORATION +(normal: I-EXPLORATION +0, I-EXPLORATION +5-11). I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +análisis I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION +recogida I-EXPLORATION +de I-EXPLORATION +24 I-EXPLORATION +horas: I-EXPLORATION +proteinuria: I-EXPLORATION +0, I-EXPLORATION +53 I-EXPLORATION +g/24 I-EXPLORATION +horas; I-EXPLORATION +aclaramiento I-EXPLORATION +de I-EXPLORATION +creatinina: I-EXPLORATION +17 I-EXPLORATION +ml/min. I-EXPLORATION +El I-EXPLORATION +sistemático I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +inmunológico I-EXPLORATION +mostró I-EXPLORATION +positividad I-EXPLORATION +de I-EXPLORATION +anticuerpos I-EXPLORATION +anticitoplasma I-EXPLORATION +de I-EXPLORATION +neutrófilos I-EXPLORATION +(ANCA) I-EXPLORATION +(anti-MPO I-EXPLORATION y I-EXPLORATION -serología I-EXPLORATION -IgG I-EXPLORATION -para I-EXPLORATION -toxoplasma I-EXPLORATION +Anti-PR3 I-EXPLORATION +negativos); I-EXPLORATION +los I-EXPLORATION +anticuerpos I-EXPLORATION +antinucleares I-EXPLORATION +(ANA), I-EXPLORATION +anti-DNA, I-EXPLORATION +anticuerpos I-EXPLORATION +antimúsculo I-EXPLORATION +liso, I-EXPLORATION +anticuerpos I-EXPLORATION +antimitocondriales I-EXPLORATION fueron I-EXPLORATION negativos. I-EXPLORATION - I-EXPLORATION -Al I-EXPLORATION -reevaluar I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -clínico I-EXPLORATION -se I-EXPLORATION -planteó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +Se I-EXPLORATION +detectó I-EXPLORATION +una I-EXPLORATION +disminución I-EXPLORATION de I-EXPLORATION -AB. I-EXPLORATION -Al B-PAST_MEDICAL_HISTORY -preguntar I-PAST_MEDICAL_HISTORY -dirigidamente I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -refirió I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -viajes I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -extranjero: I-PAST_MEDICAL_HISTORY -Bolivia I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -Perú I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -México I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Además I-PAST_MEDICAL_HISTORY -vivió I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -casa I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -gatos, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -rasguñaban I-PAST_MEDICAL_HISTORY -ocasionalmente. I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -solicitó I-EXPLORATION +inmunoglobulinas: I-EXPLORATION +IgG: I-EXPLORATION +253 I-EXPLORATION +mg/dl I-EXPLORATION +(normal: I-EXPLORATION +751-1560); I-EXPLORATION +IgM: I-EXPLORATION +10 I-EXPLORATION +mg/dl I-EXPLORATION +(normal: I-EXPLORATION +46-304); I-EXPLORATION +IgA I-EXPLORATION +81 I-EXPLORATION +mg/dl I-EXPLORATION +(normal: I-EXPLORATION +82-453). I-EXPLORATION +El I-EXPLORATION +complemento, I-EXPLORATION +factor I-EXPLORATION +reumatoide, I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +y I-EXPLORATION +ceruloplasmina I-EXPLORATION +se I-EXPLORATION +encontraban I-EXPLORATION +en I-EXPLORATION +rango I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION serología I-EXPLORATION de I-EXPLORATION -Bartonella I-EXPLORATION -henselae I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION +virus I-EXPLORATION +de I-EXPLORATION +hepatitis I-EXPLORATION +B I-EXPLORATION +y I-EXPLORATION +C, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +la I-EXPLORATION +de I-EXPLORATION +virus I-EXPLORATION +de I-EXPLORATION +inmunodeficiencia I-EXPLORATION +humana, I-EXPLORATION +fue I-EXPLORATION negativa. I-EXPLORATION -La I-EXPLORATION -nasofibroscopia I-EXPLORATION -informó I-EXPLORATION -lesiones I-EXPLORATION -angiomatosas I-EXPLORATION -en I-EXPLORATION -fosas I-EXPLORATION -nasales, I-EXPLORATION -rinofaringe I-EXPLORATION + I-EXPLORATION +Las I-EXPLORATION +hormonas I-EXPLORATION +tiroideas I-EXPLORATION y I-EXPLORATION -laringe. I-EXPLORATION +anticuerpos I-EXPLORATION +antitiroideos I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION La I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -no I-EXPLORATION -detectó I-EXPLORATION -lesiones. I-EXPLORATION +paratohormona I-EXPLORATION +intacta I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +149 I-EXPLORATION +pg/ml. I-EXPLORATION + I-EXPLORATION La I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION +electroforesis I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION mostró I-EXPLORATION -hígado I-EXPLORATION -normal, I-EXPLORATION -leve I-EXPLORATION -esplenomegalia, I-EXPLORATION -adenopatías I-EXPLORATION -inguinales I-EXPLORATION -izquierdas I-EXPLORATION +una I-EXPLORATION +disminución I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -secundario I-EXPLORATION +inmunoglobulinas, I-EXPLORATION y I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -musculatura I-EXPLORATION -paravertebral I-EXPLORATION -lumbar. I-EXPLORATION +orina, I-EXPLORATION +proteinuria I-EXPLORATION +no I-EXPLORATION +selectiva. I-EXPLORATION La I-EXPLORATION -ecografía I-EXPLORATION -Doppler I-EXPLORATION +proteinuria I-EXPLORATION de I-EXPLORATION -extremidades I-EXPLORATION -superiores I-EXPLORATION -e I-EXPLORATION -inferiores I-EXPLORATION -mostró I-EXPLORATION -nódulos I-EXPLORATION -hipervascularizados I-EXPLORATION -inespecíficos I-EXPLORATION -en I-EXPLORATION -dermis, I-EXPLORATION -tejido I-EXPLORATION -subcutáneo I-EXPLORATION -y I-EXPLORATION -plano I-EXPLORATION -muscular. I-EXPLORATION +Bence-Jones I-EXPLORATION +resultó I-EXPLORATION +negativa. I-EXPLORATION I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION +En I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -lesiones I-EXPLORATION -cutáneas I-EXPLORATION -mostró I-EXPLORATION -orto-queratosis, I-EXPLORATION -hipogranulosis, I-EXPLORATION -atrofia I-EXPLORATION -epidérmica, I-EXPLORATION -exocitosis I-EXPLORATION +imagen I-EXPLORATION +(ecografía I-EXPLORATION +renal): I-EXPLORATION +riñones I-EXPLORATION de I-EXPLORATION -linfocitos I-EXPLORATION -e I-EXPLORATION -hiperpigmentación I-EXPLORATION -basal; I-EXPLORATION -dermis I-EXPLORATION -reticular I-EXPLORATION -con I-EXPLORATION -proliferación I-EXPLORATION -vascular, I-EXPLORATION -nodular, I-EXPLORATION -multifocal, I-EXPLORATION -compuesta I-EXPLORATION -por I-EXPLORATION -vasos I-EXPLORATION -capilares I-EXPLORATION -pequeños, I-EXPLORATION -endotelio I-EXPLORATION -prominente, I-EXPLORATION -con I-EXPLORATION -extravasación I-EXPLORATION +tamaño, I-EXPLORATION +morfología I-EXPLORATION +y I-EXPLORATION +ecogenicidad I-EXPLORATION +normales, I-EXPLORATION +sin I-EXPLORATION +litiasis I-EXPLORATION +ni I-EXPLORATION +dilatación. I-EXPLORATION + I-EXPLORATION +Ante I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -eritrocitos I-EXPLORATION -e I-EXPLORATION -infiltrado I-EXPLORATION -leve I-EXPLORATION -disperso I-EXPLORATION +un I-EXPLORATION +deterioro I-EXPLORATION de I-EXPLORATION -linfocitos, I-EXPLORATION -neutrófilos I-EXPLORATION -y I-EXPLORATION -eritrocitos. I-EXPLORATION -Además, I-EXPLORATION -había I-EXPLORATION -acúmulos I-EXPLORATION -eosinófilos, I-EXPLORATION -extracelulares, I-EXPLORATION -granulares, I-EXPLORATION -multifocales. I-EXPLORATION -La I-EXPLORATION -tinción I-EXPLORATION +función I-EXPLORATION +renal I-EXPLORATION de I-EXPLORATION -Warthin-Starry I-EXPLORATION -mostró I-EXPLORATION -numerosos I-EXPLORATION -bacilos, I-EXPLORATION -siendo I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -compatibles I-EXPLORATION +causa I-EXPLORATION +no I-EXPLORATION +clara I-EXPLORATION +(se I-EXPLORATION +desconocían I-EXPLORATION +valores I-EXPLORATION +de I-EXPLORATION +referencia I-EXPLORATION +previa), I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +biopsia I-EXPLORATION +renal I-EXPLORATION +percutánea I-EXPLORATION con I-EXPLORATION -AB. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -envió I-EXPLORATION -una I-EXPLORATION -muestra I-EXPLORATION +los I-EXPLORATION +siguientes I-EXPLORATION +hallazgos: I-EXPLORATION +4 I-EXPLORATION +glomérulos, I-EXPLORATION +2 I-EXPLORATION de I-EXPLORATION -tejido I-EXPLORATION -al I-EXPLORATION -laboratorio I-EXPLORATION +ellos I-EXPLORATION +completamente I-EXPLORATION +esclerosados I-EXPLORATION +y I-EXPLORATION +los I-EXPLORATION +otros I-EXPLORATION +2 I-EXPLORATION +en I-EXPLORATION +vías I-EXPLORATION de I-EXPLORATION -microbiología I-EXPLORATION +esclerosis. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -Universidad I-EXPLORATION -Católica I-EXPLORATION +inmunofluorescencia I-EXPLORATION +fue I-EXPLORATION +negativo I-EXPLORATION para I-EXPLORATION -realizar I-EXPLORATION -PCR I-EXPLORATION -universal I-EXPLORATION -con I-EXPLORATION -amplificación I-EXPLORATION +IgG, I-EXPLORATION +IgA, I-EXPLORATION +IgM I-EXPLORATION y I-EXPLORATION -secuenciación I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -que I-EXPLORATION -codifica I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -subu-nidad I-EXPLORATION -ribosomal I-EXPLORATION -16S. I-EXPLORATION -La I-EXPLORATION -extracción I-EXPLORATION -del I-EXPLORATION -ADN I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -subcutáneo I-EXPLORATION +C3. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +intersticio I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -utilizando I-EXPLORATION +observaba I-EXPLORATION un I-EXPLORATION -método I-EXPLORATION -comercial I-EXPLORATION -(QIAamp I-EXPLORATION -Tissue I-EXPLORATION -kit, I-EXPLORATION -Qiagen®), I-EXPLORATION -según I-EXPLORATION -las I-EXPLORATION -recomendaciones I-EXPLORATION -del I-EXPLORATION -fabricante. I-EXPLORATION -La I-EXPLORATION -amplificación I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION +denso I-EXPLORATION +infiltrado I-EXPLORATION +linfocitario I-EXPLORATION que I-EXPLORATION -codifica I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -16S I-EXPLORATION -ARNr I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -con I-EXPLORATION -partidores I-EXPLORATION -universales. I-EXPLORATION -Posteriormente, I-EXPLORATION -se I-EXPLORATION -secuenció I-EXPLORATION -el I-EXPLORATION -producto I-EXPLORATION -amplificado I-EXPLORATION +expandía I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -evaluó I-EXPLORATION -en I-EXPLORATION +ocupaba I-EXPLORATION +todo I-EXPLORATION el I-EXPLORATION -analizador I-EXPLORATION -genético I-EXPLORATION -ABI-310 I-EXPLORATION -(Applied-Biosystems, I-EXPLORATION -Foster I-EXPLORATION -City, I-EXPLORATION -CA). I-EXPLORATION -Para I-EXPLORATION +tejido, I-EXPLORATION +destruyendo I-EXPLORATION la I-EXPLORATION -comparación I-EXPLORATION +arquitectura I-EXPLORATION +habitual I-EXPLORATION +del I-EXPLORATION +parénquima I-EXPLORATION +renal. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +valoraba I-EXPLORATION +bien I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION +fibrosis I-EXPLORATION +debido I-EXPLORATION +al I-EXPLORATION +infiltrado I-EXPLORATION +existente. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -secuencia I-EXPLORATION -nucleotídica I-EXPLORATION -obtenida I-EXPLORATION +figura I-EXPLORATION +2 I-EXPLORATION +A I-EXPLORATION +se I-EXPLORATION +muestra I-EXPLORATION +la I-EXPLORATION +inmunohistoquímica I-EXPLORATION con I-EXPLORATION -las I-EXPLORATION -secuencias I-EXPLORATION -depositadas I-EXPLORATION +CD3 I-EXPLORATION +(anticuerpo I-EXPLORATION +monoclonal I-EXPLORATION +que I-EXPLORATION +marca I-EXPLORATION +linfocitos I-EXPLORATION +T I-EXPLORATION en I-EXPLORATION -banco I-EXPLORATION +general) I-EXPLORATION +y I-EXPLORATION +demuestra I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +mayoría I-EXPLORATION +del I-EXPLORATION +infiltrado I-EXPLORATION +es I-EXPLORATION +a I-EXPLORATION +expensas I-EXPLORATION de I-EXPLORATION -genes I-EXPLORATION -Genebank, I-EXPLORATION -se I-EXPLORATION -utilizó I-EXPLORATION -al I-EXPLORATION -programa I-EXPLORATION -BLAST. I-EXPLORATION -Se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -homología I-EXPLORATION +linfocitos I-EXPLORATION +T, I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +figura I-EXPLORATION +2 I-EXPLORATION +B, I-EXPLORATION +la I-EXPLORATION +inmunohistoquímica I-EXPLORATION +con I-EXPLORATION +CD4. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +anatomopatológico I-EXPLORATION +final I-EXPLORATION +fue I-EXPLORATION de I-EXPLORATION -100% I-EXPLORATION -sobre I-EXPLORATION -421 I-EXPLORATION -pares I-EXPLORATION +nefropatía I-EXPLORATION +tubulointersticial I-EXPLORATION +severa I-EXPLORATION +(infiltrado I-EXPLORATION +intersticial I-EXPLORATION de I-EXPLORATION -bases I-EXPLORATION -depositadas I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -especie I-EXPLORATION -B. I-EXPLORATION -quintana I-EXPLORATION -cepa I-EXPLORATION -Toulouse. I-EXPLORATION +predominio I-EXPLORATION +linfocitario I-EXPLORATION +T I-EXPLORATION +CD4 I-EXPLORATION +positivos). I-EXPLORATION I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antiretroviral I-TREATMENT -para I-TREATMENT -el I-TREATMENT -VIH I-TREATMENT -y I-TREATMENT -profilaxis I-TREATMENT -para I-TREATMENT -Pneumocystis I-TREATMENT -jiroveci. I-TREATMENT -Se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT +Con B-TREATMENT +los I-TREATMENT +hallazgos I-TREATMENT de I-TREATMENT la I-TREATMENT -AB I-TREATMENT +biopsia I-TREATMENT +se I-TREATMENT +indicó I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -Azitromicina I-TREATMENT -500 I-TREATMENT -mg/ I-TREATMENT -día I-TREATMENT -vo I-TREATMENT -y I-TREATMENT -Ciprofloxacino I-TREATMENT -500 I-TREATMENT -mg I-TREATMENT -c/12 I-TREATMENT -h I-TREATMENT -vo. I-TREATMENT -El B-EVOLUTION +prednisona, I-TREATMENT +50 I-TREATMENT +mg/día, I-TREATMENT +en I-TREATMENT +pauta I-TREATMENT +descendente. I-TREATMENT + I-TREATMENT +Ocho B-EVOLUTION +meses I-EVOLUTION +después, I-EVOLUTION +la I-EVOLUTION paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente, I-EVOLUTION -con I-EVOLUTION -regresión I-EVOLUTION -progresiva I-EVOLUTION +mantiene I-EVOLUTION +una I-EVOLUTION +función I-EVOLUTION +renal I-EVOLUTION +estabilizada I-EVOLUTION +(creatinina I-EVOLUTION +plasmática I-EVOLUTION de I-EVOLUTION -síntomas I-EVOLUTION -sistémicos I-EVOLUTION +2, I-EVOLUTION +2 I-EVOLUTION +mg/dl, I-EVOLUTION +aclaramiento I-EVOLUTION +de I-EVOLUTION +20 I-EVOLUTION +ml/min I-EVOLUTION y I-EVOLUTION +proteinuria I-EVOLUTION de I-EVOLUTION -lesiones I-EVOLUTION -cutáneas I-EVOLUTION -en I-EVOLUTION -pocos I-EVOLUTION -días. I-EVOLUTION +0, I-EVOLUTION +49 I-EVOLUTION +g/24 I-EVOLUTION +h). I-EVOLUTION +Respecto I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +función I-EVOLUTION +hepática: I-EVOLUTION +GOT: I-EVOLUTION +24 I-EVOLUTION +U/l; I-EVOLUTION +GPT: I-EVOLUTION +18 I-EVOLUTION +U/l; I-EVOLUTION +GGT: I-EVOLUTION +172 I-EVOLUTION +U/l; I-EVOLUTION +fosfatasa I-EVOLUTION +alcalina: I-EVOLUTION +342 I-EVOLUTION +U/l. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -crónico I-PAST_MEDICAL_HISTORY -detenido I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -flegmón I-PAST_MEDICAL_HISTORY -apendicular I-PAST_MEDICAL_HISTORY -operado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -40 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Dos B-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -consultar I-PRESENT_ILLNESS -inició I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -difuso, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS +El B-PRESENT_ILLNESS +cuarto I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -predominio I-PRESENT_ILLNESS -vespertino, I-PRESENT_ILLNESS -postprandiales I-PRESENT_ILLNESS -mediatos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -kilos I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +visual I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +intervención I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -este I-PRESENT_ILLNESS -período. I-PRESENT_ILLNESS -La B-EXPLORATION -endoscopía I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -mostró I-EXPLORATION +cirugía I-PRESENT_ILLNESS +refractiva I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +LASIK I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +antes. I-PRESENT_ILLNESS +Entre B-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +destacaba I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +dudoso I-PAST_MEDICAL_HISTORY +diagnostico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +esclerosis I-PAST_MEDICAL_HISTORY +múltiple I-PAST_MEDICAL_HISTORY +dudosa I-PAST_MEDICAL_HISTORY +realizado I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +pruebas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +imagen I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +constataran. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -pliegues I-EXPLORATION -gástricos I-EXPLORATION -prominentes I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -difusa, I-EXPLORATION -lesiones I-EXPLORATION -solevantadas I-EXPLORATION -sésiles I-EXPLORATION -con I-EXPLORATION -ulceración I-EXPLORATION -central I-EXPLORATION +exploración I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +visión I-EXPLORATION de I-EXPLORATION -fondo I-EXPLORATION -rojo I-EXPLORATION +0, I-EXPLORATION +05 I-EXPLORATION y I-EXPLORATION -lesiones I-EXPLORATION -ulceradas I-EXPLORATION -duodenales, I-EXPLORATION -con I-EXPLORATION -test I-EXPLORATION +movimiento I-EXPLORATION de I-EXPLORATION -ureasa I-EXPLORATION -positivo. I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -biopsias I-EXPLORATION -informadas I-EXPLORATION -como I-EXPLORATION -gastritis I-EXPLORATION -crónica I-EXPLORATION -inespecífica I-EXPLORATION -y I-EXPLORATION -duodenitis. I-EXPLORATION +manos. I-EXPLORATION El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -mostró: I-EXPLORATION -GOT I-EXPLORATION -50 I-EXPLORATION -UI/L, I-EXPLORATION -GPT I-EXPLORATION -56 I-EXPLORATION -UI/L, I-EXPLORATION -GGT I-EXPLORATION -85 I-EXPLORATION -UI/L, I-EXPLORATION -FA I-EXPLORATION -81 I-EXPLORATION -UI/L, I-EXPLORATION -hematocrito I-EXPLORATION -55%, I-EXPLORATION -tiempo I-EXPLORATION +flap I-EXPLORATION de I-EXPLORATION -protrombina I-EXPLORATION -100%, I-EXPLORATION -creatininemia I-EXPLORATION -1, I-EXPLORATION -2 I-EXPLORATION -g/dL, I-EXPLORATION -calcio I-EXPLORATION -total I-EXPLORATION -7, I-EXPLORATION -8 I-EXPLORATION -mg/ I-EXPLORATION -dL, I-EXPLORATION -proteinemia I-EXPLORATION -4, I-EXPLORATION -4 I-EXPLORATION -g/dL, I-EXPLORATION -albuminemia I-EXPLORATION -2, I-EXPLORATION -3 I-EXPLORATION -g/dL I-EXPLORATION -y I-EXPLORATION -LDH I-EXPLORATION -229 I-EXPLORATION -UI/ml. I-EXPLORATION -En I-EXPLORATION la I-EXPLORATION -ecotomografía I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -esteatosis I-EXPLORATION -hepática. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -indicó I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -erradicación I-TREATMENT -para I-TREATMENT -Helicobacter I-TREATMENT -pylori I-TREATMENT -durante I-TREATMENT -14 I-TREATMENT -días, I-TREATMENT -observándose B-EVOLUTION -la I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -vómitos, I-EVOLUTION -con I-EVOLUTION -intolerancia I-EVOLUTION -a I-EVOLUTION -alimentación I-EVOLUTION -oral, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -decidió I-EVOLUTION -hospitalizar I-EVOLUTION -para I-EVOLUTION -manejo I-EVOLUTION -nutricional I-EVOLUTION -y I-EVOLUTION -realización I-EVOLUTION -de I-EVOLUTION -macrobiopsias I-EVOLUTION -gástricas. I-EVOLUTION - I-EVOLUTION -A B-EXPLORATION +intervención I-EXPLORATION +no I-EXPLORATION +presentaba I-EXPLORATION +alteraciones. I-EXPLORATION +Al I-EXPLORATION +explorar I-EXPLORATION su I-EXPLORATION -ingreso I-EXPLORATION -al I-EXPLORATION -servicio I-EXPLORATION +fondo I-EXPLORATION de I-EXPLORATION -Gastroenterología I-EXPLORATION +ojo, I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -nuestro I-EXPLORATION -Hospital I-EXPLORATION -destacaba I-EXPLORATION +fibras I-EXPLORATION +de I-EXPLORATION +mielina I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +nervio I-EXPLORATION +óptico I-EXPLORATION +derecho I-EXPLORATION +y I-EXPLORATION +leve I-EXPLORATION +palidez I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +izquierdo. I-EXPLORATION +La I-EXPLORATION +sospecha I-EXPLORATION +de I-EXPLORATION +simulación I-EXPLORATION +surge I-EXPLORATION +cuando I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION paciente I-EXPLORATION -con I-EXPLORATION -hemodinamia I-EXPLORATION -estable, I-EXPLORATION -afebril, I-EXPLORATION -mesomorfo, I-EXPLORATION -sin I-EXPLORATION -edema, I-EXPLORATION -ni I-EXPLORATION -palidez. I-EXPLORATION -Sin I-EXPLORATION -signos I-EXPLORATION -carenciales I-EXPLORATION +se I-EXPLORATION +desenvuelve I-EXPLORATION +perfectamente I-EXPLORATION en I-EXPLORATION -piel, I-EXPLORATION -mucosas I-EXPLORATION -ni I-EXPLORATION -fanéreos. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION +la I-EXPLORATION +consulta, I-EXPLORATION +llegando I-EXPLORATION +a I-EXPLORATION +enviar I-EXPLORATION +un I-EXPLORATION +mensaje I-EXPLORATION +con I-EXPLORATION +su I-EXPLORATION +móvil. I-EXPLORATION +Refiere I-EXPLORATION +que I-EXPLORATION +trabaja I-EXPLORATION +y I-EXPLORATION +conduce I-EXPLORATION +a I-EXPLORATION +pesar I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -confirmaron I-EXPLORATION -proteínas I-EXPLORATION -totales I-EXPLORATION -3, I-EXPLORATION -5 I-EXPLORATION -g/dL, I-EXPLORATION -albuminemia I-EXPLORATION -1, I-EXPLORATION -9 I-EXPLORATION -g/dL, I-EXPLORATION -proteinuria I-EXPLORATION -negativa I-EXPLORATION +su I-EXPLORATION +supuesta I-EXPLORATION +baja I-EXPLORATION +visión. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +la I-EXPLORATION +visión I-EXPLORATION +binocular I-EXPLORATION y I-EXPLORATION -hemograma I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION - I-EXPLORATION -Evolución I-EXPLORATION +la I-EXPLORATION +estereopsis I-EXPLORATION +fueron I-EXPLORATION +normales I-EXPLORATION +(120"-60"). I-EXPLORATION +Pruebas I-EXPLORATION +específicas I-EXPLORATION +como I-EXPLORATION +la I-EXPLORATION +de I-EXPLORATION +Bravais I-EXPLORATION y I-EXPLORATION -exámenes I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -posteriores I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -efectúa I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -(TAC) I-EXPLORATION -de I-EXPLORATION -abdomen-pelvis I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -pliegues I-EXPLORATION -gástricos I-EXPLORATION -prominentes, I-EXPLORATION -enteroclisis I-EXPLORATION -por I-EXPLORATION -TAC I-EXPLORATION -informó I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -lesiones I-EXPLORATION -radiológicas I-EXPLORATION -en I-EXPLORATION -intestino I-EXPLORATION -delgado. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -endoscopía I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -pliegues I-EXPLORATION -gástricos I-EXPLORATION -difusamente I-EXPLORATION -engrosados, I-EXPLORATION -algunos I-EXPLORATION -erosionados, I-EXPLORATION -test I-EXPLORATION +la I-EXPLORATION +escritura I-EXPLORATION +o I-EXPLORATION +Roth I-EXPLORATION +resultaron I-EXPLORATION +positivas. I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +fue I-EXPLORATION +capaz I-EXPLORATION de I-EXPLORATION -ureasa I-EXPLORATION -negativo. I-EXPLORATION -Las I-EXPLORATION -biopsias I-EXPLORATION -fueron I-EXPLORATION -informadas I-EXPLORATION -como I-EXPLORATION -mucosa I-EXPLORATION -gástrica I-EXPLORATION -con I-EXPLORATION -hiperplasia I-EXPLORATION -foveolar I-EXPLORATION -difusa, I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -atrofia I-EXPLORATION -glandular I-EXPLORATION +escribir I-EXPLORATION +su I-EXPLORATION +nombre I-EXPLORATION con I-EXPLORATION -dilataciones I-EXPLORATION -quísticas I-EXPLORATION +visión I-EXPLORATION +monocular I-EXPLORATION y I-EXPLORATION -células I-EXPLORATION -mucinosas. I-EXPLORATION -Erosión I-EXPLORATION -epitelial I-EXPLORATION -superficial I-EXPLORATION -focal I-EXPLORATION -con I-EXPLORATION -acúmulos I-EXPLORATION +siguiendo I-EXPLORATION +una I-EXPLORATION +línea, I-EXPLORATION +a I-EXPLORATION +pesar I-EXPLORATION de I-EXPLORATION -leucocitos I-EXPLORATION -polimorfonucleares, I-EXPLORATION -lámina I-EXPLORATION -propia I-EXPLORATION -con I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -escaso I-EXPLORATION +interrumpirla I-EXPLORATION +en I-EXPLORATION +medio I-EXPLORATION de I-EXPLORATION -predominio I-EXPLORATION -linfoplasmocitario, I-EXPLORATION -con I-EXPLORATION -algunos I-EXPLORATION -eosinófilos. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -complementó I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -endosonografía I-EXPLORATION -demostrándose I-EXPLORATION -engrosamiento I-EXPLORATION -gástrico I-EXPLORATION -a I-EXPLORATION -expensas I-EXPLORATION +la I-EXPLORATION +tarea. I-EXPLORATION +También I-EXPLORATION +dibujó I-EXPLORATION +una I-EXPLORATION +línea I-EXPLORATION +recta, I-EXPLORATION +reanudando I-EXPLORATION +el I-EXPLORATION +trazo I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +mismo I-EXPLORATION +punto I-EXPLORATION +en I-EXPLORATION +que I-EXPLORATION +lo I-EXPLORATION +había I-EXPLORATION +dejado I-EXPLORATION +tras I-EXPLORATION +distraerla I-EXPLORATION de I-EXPLORATION +forma I-EXPLORATION +intencionada. I-EXPLORATION +Pruebas I-EXPLORATION +complementarias I-EXPLORATION +como I-EXPLORATION la I-EXPLORATION -mucosa I-EXPLORATION -profunda I-EXPLORATION +AFG I-EXPLORATION y I-EXPLORATION -áreas I-EXPLORATION -quísticas. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -extensión I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión, I-TREATMENT -el I-TREATMENT -riesgo I-TREATMENT -de I-TREATMENT -transformación I-TREATMENT -neoplásica I-TREATMENT -y I-TREATMENT -la I-TREATMENT -no I-TREATMENT -disponibilidad I-TREATMENT -de I-TREATMENT -cetuximab, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -tratamiento I-TREATMENT -quirúrgico. I-TREATMENT -Se B-EVOLUTION -solicitó I-EVOLUTION -evaluación I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -equipo I-EVOLUTION -de I-EVOLUTION -nutrición, I-EVOLUTION -demostrándose I-EVOLUTION -preal-búmina, I-EVOLUTION -niveles I-EVOLUTION -de I-EVOLUTION -vitamina I-EVOLUTION -B12 I-EVOLUTION -y I-EVOLUTION -folato I-EVOLUTION -eritrocitario I-EVOLUTION -dentro I-EVOLUTION -de I-EVOLUTION -rangos I-EVOLUTION -normales. I-EVOLUTION -Se B-TREATMENT -controlaron I-TREATMENT -los I-TREATMENT -vómitos I-TREATMENT -con I-TREATMENT -ondasentron, I-TREATMENT -logrando I-TREATMENT -ingesta I-TREATMENT -oral I-TREATMENT -adecuada, I-TREATMENT -se I-TREATMENT -apoyó I-TREATMENT -con I-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -por I-TREATMENT -7 I-TREATMENT -días I-TREATMENT -con I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -aumentó I-TREATMENT -la I-TREATMENT -albuminemia I-TREATMENT -a I-TREATMENT -2, I-TREATMENT -3 I-TREATMENT -gr/dl. I-TREATMENT -A I-TREATMENT -los I-TREATMENT -14 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -su I-TREATMENT -ingreso I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -gastrectomía I-TREATMENT -total, I-TREATMENT -sin I-TREATMENT -incidentes I-TREATMENT -y B-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -favorable. I-EVOLUTION - I-EVOLUTION -En B-EXPLORATION el I-EXPLORATION -análisis I-EXPLORATION -macroscópico I-EXPLORATION +ERG I-EXPLORATION +aportaron I-EXPLORATION +resultados I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +límites I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -pieza I-EXPLORATION -operatoria I-EXPLORATION +normalidad. I-EXPLORATION +En I-EXPLORATION +los I-EXPLORATION +PEV I-EXPLORATION se I-EXPLORATION observó I-EXPLORATION -pared I-EXPLORATION -gástrica I-EXPLORATION -de I-EXPLORATION -espesor I-EXPLORATION -engrosado I-EXPLORATION -homogéneamente, I-EXPLORATION -mucosa I-EXPLORATION -con I-EXPLORATION -pliegues I-EXPLORATION -difusamente I-EXPLORATION -engrosados, I-EXPLORATION -congestivos, I-EXPLORATION -algunos I-EXPLORATION -con I-EXPLORATION -erosión I-EXPLORATION -superficial; I-EXPLORATION -rodete I-EXPLORATION -duodenal I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -centímetros I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -con I-EXPLORATION -lesión I-EXPLORATION -polipoide I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -centímetro I-EXPLORATION +una I-EXPLORATION +disminución I-EXPLORATION +leve I-EXPLORATION de I-EXPLORATION -eje I-EXPLORATION -mayor. I-EXPLORATION -En I-EXPLORATION la I-EXPLORATION -histología I-EXPLORATION -se I-EXPLORATION -confirmaron I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -descritos I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -biopsias I-EXPLORATION -endoscópicas, I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -gástrico I-EXPLORATION -difuso, I-EXPLORATION -y I-EXPLORATION +conducción I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -duodeno I-EXPLORATION -en I-EXPLORATION -zona I-EXPLORATION -descrita I-EXPLORATION +nervio I-EXPLORATION +óptico I-EXPLORATION +izquierdo. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +servicio I-EXPLORATION de I-EXPLORATION -lesión I-EXPLORATION -polipoide I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -metaplasia I-EXPLORATION -fúndica I-EXPLORATION -focal I-EXPLORATION -con I-EXPLORATION -hiperplasia I-EXPLORATION -foveolar I-EXPLORATION -y I-EXPLORATION -atrofia I-EXPLORATION -glandular, I-EXPLORATION +neurología I-EXPLORATION +fue I-EXPLORATION +descartada I-EXPLORATION +la I-EXPLORATION +esclerosis I-EXPLORATION +múltiple, I-EXPLORATION con I-EXPLORATION -dilatación I-EXPLORATION -quística I-EXPLORATION +RM I-EXPLORATION y I-EXPLORATION -células I-EXPLORATION -mucinosas. I-EXPLORATION -Se I-EXPLORATION -concluyó I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Ménétrier I-EXPLORATION -gástrica I-EXPLORATION -difusa I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -duodenal I-EXPLORATION -focal. I-EXPLORATION +punción I-EXPLORATION +lumbar I-EXPLORATION +normales. I-EXPLORATION I-EXPLORATION Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS +59 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -oriundo B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Marchigüe, I-PAST_MEDICAL_HISTORY -VI I-PAST_MEDICAL_HISTORY -Región I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Chile, I-PAST_MEDICAL_HISTORY -quien I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -laboral I-PAST_MEDICAL_HISTORY -trabajó I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -faenador I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -corderos. I-PAST_MEDICAL_HISTORY -Tenía I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY +nacido B-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +Buenos I-PAST_MEDICAL_HISTORY +Aires, I-PAST_MEDICAL_HISTORY +vendedor I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -dislipidemia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY un I-PAST_MEDICAL_HISTORY -quiste I-PAST_MEDICAL_HISTORY -hidatídico I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -operado I-PAST_MEDICAL_HISTORY +comercio I-PAST_MEDICAL_HISTORY +céntrico, I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +efectuado I-PAST_MEDICAL_HISTORY +viajes I-PAST_MEDICAL_HISTORY +fuera I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +ciudad I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -1996. I-PAST_MEDICAL_HISTORY -Quince I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -después, I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -accidente I-PAST_MEDICAL_HISTORY -vascular I-PAST_MEDICAL_HISTORY -encefálico, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -referir I-PAST_MEDICAL_HISTORY -otro I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +últimos I-PAST_MEDICAL_HISTORY +cuatro I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +poseía I-PAST_MEDICAL_HISTORY +mascotas, I-PAST_MEDICAL_HISTORY +realizaba I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +alimentación I-PAST_MEDICAL_HISTORY +balanceada, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +cuatro I-PAST_MEDICAL_HISTORY +comidas I-PAST_MEDICAL_HISTORY +diarias. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -sintomatología I-PAST_MEDICAL_HISTORY -cardiovascular. I-PAST_MEDICAL_HISTORY -Dentro B-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -etiológico I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -ecocardiograma I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -(TAC) I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION +significación. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +Sanatorio I-PRESENT_ILLNESS +IPENSA I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +Plata I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +omalgia I-PRESENT_ILLNESS +derecha I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +realizar I-PRESENT_ILLNESS +abducción, I-PRESENT_ILLNESS +aducción I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +rotación I-PRESENT_ILLNESS +interna, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +data I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +semana. I-PRESENT_ILLNESS +Posteriormente B-EXPLORATION +presentó I-EXPLORATION una I-EXPLORATION -masa I-EXPLORATION -quística I-EXPLORATION +placa I-EXPLORATION +eritematosa I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +torácica I-EXPLORATION +anterior I-EXPLORATION de I-EXPLORATION -4 I-EXPLORATION -x I-EXPLORATION -3 I-EXPLORATION +cuatro I-EXPLORATION cm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo, I-EXPLORATION +de I-EXPLORATION +diámetro, I-EXPLORATION +no I-EXPLORATION +indurada, I-EXPLORATION sin I-EXPLORATION signos I-EXPLORATION +inflamatorios I-EXPLORATION +superficiales. I-EXPLORATION +No I-EXPLORATION +presentaba I-EXPLORATION +fiebre, I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -ruptura. I-EXPLORATION +peso, I-EXPLORATION +hemoptisis, I-EXPLORATION +ni I-EXPLORATION +historia I-EXPLORATION +previa I-EXPLORATION +de I-EXPLORATION +traumatismo. I-EXPLORATION + I-EXPLORATION Se I-EXPLORATION +le I-EXPLORATION realizó I-EXPLORATION -además I-EXPLORATION una I-EXPLORATION -ecotomografía I-EXPLORATION -abdominal I-EXPLORATION +ecografía I-EXPLORATION +de I-EXPLORATION +tejidos I-EXPLORATION +blandos I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION que I-EXPLORATION -descartó I-EXPLORATION +se I-EXPLORATION +visualizó I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +región I-EXPLORATION +anterior I-EXPLORATION +del I-EXPLORATION +hemitórax I-EXPLORATION +derecho I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +heterogénea I-EXPLORATION de I-EXPLORATION -quistes I-EXPLORATION -hepáticos. I-EXPLORATION -Tampoco B-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -síntomas I-PAST_MEDICAL_HISTORY -previos I-PAST_MEDICAL_HISTORY -sugerentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -anafilaxia. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Posteriormente, B-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -dolor I-EVOLUTION -precordial I-EVOLUTION -opresivo I-EVOLUTION -sin I-EVOLUTION -irradiación, I-EVOLUTION +3, I-EXPLORATION +89 I-EXPLORATION +cm, I-EXPLORATION +ubicada I-EXPLORATION +a I-EXPLORATION +2, I-EXPLORATION +46 I-EXPLORATION +cm I-EXPLORATION +bajo I-EXPLORATION +la I-EXPLORATION +piel, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +celulitis. I-EXPLORATION +No I-EXPLORATION +presentaba I-EXPLORATION +lesiones I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +miembro I-EXPLORATION +superior I-EXPLORATION +ipsilateral, I-EXPLORATION +adenopatías, I-EXPLORATION +soplo I-EXPLORATION +cardíaco I-EXPLORATION +ni I-EXPLORATION +dolores I-EXPLORATION +óseos. I-EXPLORATION + I-EXPLORATION +Comenzó B-TREATMENT +con I-TREATMENT +tratamiento I-TREATMENT +antimicrobiano I-TREATMENT +(cefalexina I-TREATMENT +1 I-TREATMENT +gramo I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +hs); I-TREATMENT +a B-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +horas I-EVOLUTION +presentó I-EVOLUTION +un I-EVOLUTION +registro I-EVOLUTION +febril I-EVOLUTION de I-EVOLUTION -intensidad I-EVOLUTION -EVA I-EVOLUTION -6/10. I-EVOLUTION -Evaluado B-TREATMENT -por I-TREATMENT -cardiología I-TREATMENT -en I-TREATMENT -su I-TREATMENT -hospital I-TREATMENT -base I-TREATMENT -se I-TREATMENT -indicó I-TREATMENT -anticoagulación I-TREATMENT -oral I-TREATMENT -siendo B-DERIVED_FROM/TO -derivado I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Instituto I-DERIVED_FROM/TO -Nacional I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Tórax I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -sospecha I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -hidatidosis I-DERIVED_FROM/TO -cardiaca. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO +38, I-EVOLUTION +6°C I-EVOLUTION +y I-EVOLUTION +una I-EVOLUTION +tumoración I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +región I-EVOLUTION +pectoral I-EVOLUTION +derecha. I-EVOLUTION + I-EVOLUTION El B-EXPLORATION -paciente I-EXPLORATION -ingresó I-EXPLORATION +laboratorio I-EXPLORATION +mostró I-EXPLORATION +leucocitos I-EXPLORATION +16.600/mm3 I-EXPLORATION +(81% I-EXPLORATION +neutró I-EXPLORATION +filos I-EXPLORATION +segmentados), I-EXPLORATION +hematocrito I-EXPLORATION +40%, I-EXPLORATION +hemoglobina I-EXPLORATION +12, I-EXPLORATION +3 I-EXPLORATION +g%, I-EXPLORATION +(VCM I-EXPLORATION +89, I-EXPLORATION +7 I-EXPLORATION +fl), I-EXPLORATION +250.000 I-EXPLORATION +plaquetas/mm3, I-EXPLORATION +glicemia I-EXPLORATION +85 I-EXPLORATION +mg/dL, I-EXPLORATION +VHS I-EXPLORATION +110 I-EXPLORATION +mm I-EXPLORATION en I-EXPLORATION -buenas I-EXPLORATION -condiciones I-EXPLORATION -generales, I-EXPLORATION -afebril I-EXPLORATION +la I-EXPLORATION +primer I-EXPLORATION +hora, I-EXPLORATION +TGO I-EXPLORATION +40 I-EXPLORATION +U/L I-EXPLORATION y I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -hemodinámicas, I-EXPLORATION -con I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -de I-EXPLORATION -130/85 I-EXPLORATION -mmHg I-EXPLORATION +TGP I-EXPLORATION +70 I-EXPLORATION +U/L. I-EXPLORATION +La I-EXPLORATION +función I-EXPLORATION +renal I-EXPLORATION y I-EXPLORATION -90 I-EXPLORATION -latidos I-EXPLORATION -por I-EXPLORATION -min. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -ingurgitación I-EXPLORATION -yugular, I-EXPLORATION -roces I-EXPLORATION -ni I-EXPLORATION -soplos I-EXPLORATION -cardiacos I-EXPLORATION -(que I-EXPLORATION +la I-EXPLORATION +creatin-fosfoquinasa I-EXPLORATION +(CPK) I-EXPLORATION fueron I-EXPLORATION -exhaustivamente I-EXPLORATION -buscados) I-EXPLORATION -ni I-EXPLORATION -tampoco I-EXPLORATION -signos I-EXPLORATION +normales. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -insuficiencia I-EXPLORATION -cardiaca. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -pulmonar I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION -reveló I-EXPLORATION +tórax I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +ensanchamiento I-EXPLORATION +mediastinal, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION una I-EXPLORATION -eosinofilia I-EXPLORATION -de I-EXPLORATION -21%, I-EXPLORATION -sin I-EXPLORATION -leucocitosis. I-EXPLORATION -El I-EXPLORATION -perfil I-EXPLORATION -bioquímico I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -anticuerpos I-EXPLORATION -IgG I-EXPLORATION -anti-Echinococcus I-EXPLORATION -granulosus I-EXPLORATION -no I-EXPLORATION -fue I-EXPLORATION -realizada. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION +TAC I-EXPLORATION de I-EXPLORATION tórax I-EXPLORATION -era I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -electrocardiograma I-EXPLORATION -presentaba I-EXPLORATION -ritmo I-EXPLORATION -sinusal, I-EXPLORATION -ondas I-EXPLORATION -T I-EXPLORATION -negativas I-EXPLORATION -en I-EXPLORATION -DII I-EXPLORATION y I-EXPLORATION -alteraciones I-EXPLORATION -inespecíficas I-EXPLORATION +cuello I-EXPLORATION +con I-EXPLORATION +medio I-EXPLORATION +de I-EXPLORATION +contraste I-EXPLORATION +ev I-EXPLORATION +que I-EXPLORATION +demostró I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -repolarización. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -ecocardiografía I-EXPLORATION -realizada I-EXPLORATION -en I-EXPLORATION -nuestro I-EXPLORATION -servicio I-EXPLORATION -evidenció I-EXPLORATION +pared I-EXPLORATION +anterior I-EXPLORATION +del I-EXPLORATION +hemitórax I-EXPLORATION +derecho I-EXPLORATION una I-EXPLORATION -imagen I-EXPLORATION -poliquística, I-EXPLORATION -ovalada I-EXPLORATION -y I-EXPLORATION -adherida I-EXPLORATION -al I-EXPLORATION -macizo I-EXPLORATION +lesión I-EXPLORATION +con I-EXPLORATION +densidad I-EXPLORATION de I-EXPLORATION -músculos I-EXPLORATION -papilares I-EXPLORATION -anterolaterales, I-EXPLORATION +tejidos I-EXPLORATION +blandos, I-EXPLORATION +que I-EXPLORATION +provocaba I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION +del I-EXPLORATION +espesor I-EXPLORATION de I-EXPLORATION -contornos I-EXPLORATION -bien I-EXPLORATION -delimitados I-EXPLORATION +los I-EXPLORATION +músculos I-EXPLORATION +pectorales. I-EXPLORATION +Dicha I-EXPLORATION +lesión I-EXPLORATION +se I-EXPLORATION +extendía I-EXPLORATION +hacia I-EXPLORATION +el I-EXPLORATION +mediastino I-EXPLORATION +anterior I-EXPLORATION +y I-EXPLORATION +superior, I-EXPLORATION en I-EXPLORATION -pared I-EXPLORATION -libre I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo I-EXPLORATION -que I-EXPLORATION -medía I-EXPLORATION -4, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -3, I-EXPLORATION -2 I-EXPLORATION -x I-EXPLORATION -2, I-EXPLORATION -7 I-EXPLORATION -cm, I-EXPLORATION -sin I-EXPLORATION -derrame I-EXPLORATION -pericárdico. I-EXPLORATION -Estos I-EXPLORATION -hallazgos I-EXPLORATION -fueron I-EXPLORATION -confirmados I-EXPLORATION -por I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RNM). I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -preoperatorio I-EXPLORATION -fue I-EXPLORATION -completado I-EXPLORATION +proximidad I-EXPLORATION con I-EXPLORATION -una I-EXPLORATION -coronariografía, I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION +los I-EXPLORATION +grandes I-EXPLORATION +vasos I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +asociaba I-EXPLORATION +a I-EXPLORATION +cambios I-EXPLORATION +densitométricos I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +grasa I-EXPLORATION +mediastinal. I-EXPLORATION I-EXPLORATION -La B-TREATMENT -cirugía I-TREATMENT -se I-TREATMENT +Se B-TREATMENT realizó I-TREATMENT -bajo I-TREATMENT -esternotomía I-TREATMENT -media I-TREATMENT -y I-TREATMENT -circulación I-TREATMENT -extracorpórea, I-TREATMENT -poniendo I-TREATMENT -principal I-TREATMENT -atención I-TREATMENT -en I-TREATMENT -la I-TREATMENT -manipulación I-TREATMENT -cardiaca I-TREATMENT -para I-TREATMENT -no I-TREATMENT -lesionar I-TREATMENT -el I-TREATMENT -quiste. I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -puesto I-TREATMENT -el I-TREATMENT -clamp I-TREATMENT -aórtico, I-TREATMENT -se I-TREATMENT -disecó I-TREATMENT -la I-TREATMENT -superficie I-TREATMENT -del I-TREATMENT -quiste, I-TREATMENT -se I-TREATMENT -aisló I-TREATMENT -el I-TREATMENT -campo I-TREATMENT -con I-TREATMENT -compresas I-TREATMENT -embebidas I-TREATMENT -en I-TREATMENT -cloruro I-TREATMENT +una I-TREATMENT +punción-aspirativa I-TREATMENT +guiada I-TREATMENT +por I-TREATMENT +TAC, I-TREATMENT +obteniéndose I-TREATMENT +25 I-TREATMENT +ml I-TREATMENT +de I-TREATMENT +material I-TREATMENT +purulento I-TREATMENT de I-TREATMENT -sodio I-TREATMENT -al I-TREATMENT -10% I-TREATMENT -y I-TREATMENT -se I-TREATMENT -puncionó I-TREATMENT -el I-TREATMENT -quiste I-TREATMENT -vaciándolo I-TREATMENT -parcialmente I-TREATMENT -e I-TREATMENT -inyectando I-TREATMENT -solución I-TREATMENT -salina I-TREATMENT -hipertónica I-TREATMENT -al I-TREATMENT -30%. I-TREATMENT -Posteriormente, I-TREATMENT -se I-TREATMENT -abrió I-TREATMENT -el I-TREATMENT -quiste I-TREATMENT -hacia I-TREATMENT la I-TREATMENT -cara I-TREATMENT -anterior I-TREATMENT -del I-TREATMENT -ventrículo I-TREATMENT -izquierdo I-TREATMENT -y I-TREATMENT -se I-TREATMENT -vació, I-TREATMENT -retirando I-TREATMENT -las I-TREATMENT -membranas I-TREATMENT +colección I-TREATMENT +parietal I-TREATMENT y I-TREATMENT -vesículas I-TREATMENT -hijas. I-TREATMENT -Se I-TREATMENT -completó I-TREATMENT -el I-TREATMENT -aseo I-TREATMENT +7 I-TREATMENT +ml I-TREATMENT de I-TREATMENT la I-TREATMENT -cavidad I-TREATMENT -con I-TREATMENT -sodio I-TREATMENT -hipertónico I-TREATMENT +mediastinal I-TREATMENT +Se I-TREATMENT +remitieron I-TREATMENT +a I-TREATMENT +estudio I-TREATMENT +microbiológico I-TREATMENT y I-TREATMENT -posteriormente I-TREATMENT se I-TREATMENT -realizó I-TREATMENT -quistectomía I-TREATMENT -parcial I-TREATMENT -y I-TREATMENT -cierre I-TREATMENT -por I-TREATMENT -capitonaje I-TREATMENT -del I-TREATMENT -remanente. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presentó I-EVOLUTION -complicaciones I-EVOLUTION -intraoperatorias I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -fue I-EVOLUTION -favorable. I-EVOLUTION -En I-EVOLUTION -control I-EVOLUTION -ambulatorio I-EVOLUTION -post-quirúrgico, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -mantenido I-EVOLUTION -asintomático, I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION -de I-EVOLUTION -complicaciones I-EVOLUTION -o I-EVOLUTION -recidivas I-EVOLUTION -y B-EXPLORATION +ajustó I-TREATMENT +el I-TREATMENT +esquema I-TREATMENT +anti-infeccioso I-TREATMENT +a I-TREATMENT +vancomicina I-TREATMENT +1 I-TREATMENT +g I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +horas I-TREATMENT +(dosis I-TREATMENT +máxima), I-TREATMENT +clindamicina I-TREATMENT +600 I-TREATMENT +mg I-TREATMENT +cada I-TREATMENT +6 I-TREATMENT +horas I-TREATMENT +y I-TREATMENT +ceftazidima I-TREATMENT +2 I-TREATMENT +g I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +horas I-TREATMENT +ev. I-TREATMENT + I-TREATMENT +Posteriormente I-TREATMENT +se I-TREATMENT +drenó I-TREATMENT +quirúrgicamente I-TREATMENT +el I-TREATMENT +absceso I-TREATMENT +pectoral. I-TREATMENT +En B-EXPLORATION +la I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +Gram I-EXPLORATION se I-EXPLORATION -controlará I-EXPLORATION -semestralmente I-EXPLORATION -con I-EXPLORATION -ecocardiografía I-EXPLORATION +observaron I-EXPLORATION +cocáceas I-EXPLORATION +grampositivas I-EXPLORATION +agrupadas I-EXPLORATION +en I-EXPLORATION +racimos I-EXPLORATION y I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -E. I-EXPLORATION -granulosus. I-EXPLORATION - I-EXPLORATION - -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -índice I-PRESENT_ILLNESS -(PAF19) I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -(2004) I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -anémico. I-PRESENT_ILLNESS -Como B-EXPLORATION -parte I-EXPLORATION +al I-EXPLORATION +tercer I-EXPLORATION +día I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -estudio I-EXPLORATION +tratamiento I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -hallazgos I-EXPLORATION -patológicos I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -colonoscopia I-EXPLORATION -completa I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION +informó I-EXPLORATION la I-EXPLORATION presencia I-EXPLORATION de I-EXPLORATION -múltiples I-EXPLORATION -pólipos I-EXPLORATION -sésiles I-EXPLORATION -(más I-EXPLORATION -de I-EXPLORATION -100) I-EXPLORATION -y I-EXPLORATION -pediculados I-EXPLORATION -(más I-EXPLORATION -de I-EXPLORATION -15), I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -margen I-EXPLORATION -anal I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -ciego. I-EXPLORATION -A I-EXPLORATION -nivel I-EXPLORATION -cecal I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -proliferativa I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -2, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -mayor, I-EXPLORATION -cuya I-EXPLORATION -biopsia I-EXPLORATION -confirmó I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION -tubular I-EXPLORATION -moderadamente I-EXPLORATION -diferenciado. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -preliminar I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -PAF I-EXPLORATION -asociada I-EXPLORATION +S. I-EXPLORATION +aureus I-EXPLORATION +sensible I-EXPLORATION a I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION -cecal. I-EXPLORATION -El B-TREATMENT -estudio I-TREATMENT -de I-TREATMENT -etapificación I-TREATMENT -con I-TREATMENT -TAC I-TREATMENT -(tomografía I-TREATMENT -abdominal I-TREATMENT -computarizada) I-TREATMENT -de I-TREATMENT -abdomen I-TREATMENT -y I-TREATMENT -pelvis I-TREATMENT -no I-TREATMENT -mostró I-TREATMENT -signos I-TREATMENT -de I-TREATMENT -diseminación I-TREATMENT -tumoral, I-TREATMENT -realizándose I-TREATMENT -una I-TREATMENT -colectomía I-TREATMENT -total I-TREATMENT -con I-TREATMENT -íleorrectoanastomosis. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -tumoral I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION +oxacilina, I-EXPLORATION +cefalotina, I-EXPLORATION +eritromicina, I-EXPLORATION +clindamicina, I-EXPLORATION +cotri-moxazol, I-EXPLORATION +vancomicina I-EXPLORATION +y I-EXPLORATION +ciprofloxacina. I-EXPLORATION +Las I-EXPLORATION +tinciones I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION -con I-EXPLORATION -invasión I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -subserosa I-EXPLORATION +Ziehl-Neelsen, I-EXPLORATION +Giemsa I-EXPLORATION y I-EXPLORATION -compromiso I-EXPLORATION -linfonodal. I-EXPLORATION -La I-EXPLORATION -mucosa I-EXPLORATION -del I-EXPLORATION -resto I-EXPLORATION +Gomori-Grocott I-EXPLORATION +resultaron I-EXPLORATION +negativas. I-EXPLORATION +Se B-TREATMENT +modificó I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +antimicrobiano I-TREATMENT +indicado I-TREATMENT +a I-TREATMENT +cefazolina I-TREATMENT +2 I-TREATMENT +g I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +horas I-TREATMENT +ev. I-TREATMENT +Las B-EXPLORATION +serologías I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -pieza I-EXPLORATION -resecada I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -centenar I-EXPLORATION -de I-EXPLORATION -pólipos I-EXPLORATION -sésiles I-EXPLORATION +inmunodeficiencia I-EXPLORATION +humana I-EXPLORATION +(VIH) I-EXPLORATION y I-EXPLORATION -pediculados, I-EXPLORATION -abollonados I-EXPLORATION +VDRL I-EXPLORATION +fueron I-EXPLORATION +no I-EXPLORATION +reactivas. I-EXPLORATION +El I-EXPLORATION +urocultivo, I-EXPLORATION +hemocultivos, I-EXPLORATION +cultivos I-EXPLORATION +para I-EXPLORATION +hongos I-EXPLORATION y I-EXPLORATION -lisos I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -2 I-EXPLORATION -a I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -mayor. I-EXPLORATION -Por B-TREATMENT -tratarse I-TREATMENT -de I-TREATMENT -una I-TREATMENT -paciente I-TREATMENT +micobacterias I-EXPLORATION +del I-EXPLORATION +material I-EXPLORATION +purulento I-EXPLORATION +resultaron I-EXPLORATION +negativos. I-EXPLORATION +Un I-EXPLORATION +ecocardiograma I-EXPLORATION +bidimensional I-EXPLORATION +transtorácico I-EXPLORATION +no I-EXPLORATION +evidenció I-EXPLORATION +vegetaciones I-EXPLORATION +valvulares. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +no I-EXPLORATION +presentó I-EXPLORATION +alteraciones. I-EXPLORATION +Al B-EVOLUTION +cabo I-EVOLUTION +de I-EVOLUTION +72 I-EVOLUTION +hs I-EVOLUTION +se I-EVOLUTION +encontraba I-EVOLUTION +afebril, I-EVOLUTION +con I-EVOLUTION +mejoría I-EVOLUTION +clínica I-EVOLUTION +evidente. I-EVOLUTION +Dada B-TREATMENT +la I-TREATMENT +buena I-TREATMENT +respuesta I-TREATMENT +postquirúrgica I-TREATMENT +y I-TREATMENT +habiendo I-TREATMENT +aislado I-TREATMENT en I-TREATMENT -etapa I-TREATMENT -III I-TREATMENT +todas I-TREATMENT +las I-TREATMENT +muestras I-TREATMENT +S. I-TREATMENT +aureus I-TREATMENT +sensible I-TREATMENT +a I-TREATMENT +meticilina I-TREATMENT se I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT +cambió I-TREATMENT tratamiento I-TREATMENT -con I-TREATMENT -quimioterapia I-TREATMENT -adyuvante I-TREATMENT -en I-TREATMENT -base I-TREATMENT a I-TREATMENT -5-fluorouracilo I-TREATMENT -y I-TREATMENT -leucovorina. I-TREATMENT -Hasta B-EVOLUTION -la I-EVOLUTION -fecha I-EVOLUTION +cefalexina I-TREATMENT +1 I-TREATMENT +g I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +horas I-TREATMENT +vía I-TREATMENT +oral, I-TREATMENT +evolucionando B-EVOLUTION +favorablemente. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +45 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +excepción I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +palpitaciones I-PAST_MEDICAL_HISTORY +ocasionales. I-PAST_MEDICAL_HISTORY +Presentó B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS +súbita I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +malestar I-PRESENT_ILLNESS +general I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +fiebre, I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +disnea, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +diagnosticada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +neumonía I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +ingresada I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +iniciar I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +antibiótico. I-PRESENT_ILLNESS +A B-EVOLUTION +las I-EVOLUTION +24 I-EVOLUTION +horas I-EVOLUTION +del I-EVOLUTION +ingreso I-EVOLUTION +se I-EVOLUTION +agravó I-EVOLUTION +el I-EVOLUTION +cuadro I-EVOLUTION +con I-EVOLUTION +fiebre, I-EVOLUTION +hipoxemia I-EVOLUTION +progresiva I-EVOLUTION +y I-EVOLUTION +oliguria, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +fue I-EVOLUTION +trasladada I-EVOLUTION +a I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION -ha I-EVOLUTION -completado I-EVOLUTION -70 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -sin I-EVOLUTION -evidencia I-EVOLUTION +unidad I-EVOLUTION de I-EVOLUTION -enfermedad. I-EVOLUTION +cuidados I-EVOLUTION +intensivos I-EVOLUTION +(UCI). I-EVOLUTION I-EVOLUTION -Debido B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -historia I-DERIVED_FROM/TO -clínica I-DERIVED_FROM/TO -(poliposis I-DERIVED_FROM/TO -colónica I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -CCR I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -edad I-DERIVED_FROM/TO -temprana), I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -registro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -tumores I-DERIVED_FROM/TO -hereditarios I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -definir I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -estudio I-DERIVED_FROM/TO -genético I-DERIVED_FROM/TO -apropiado. I-DERIVED_FROM/TO -Este I-DERIVED_FROM/TO -registro I-DERIVED_FROM/TO -incorpora I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -pacientes I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -sospecha I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -enfermedades I-DERIVED_FROM/TO -hereditarias I-DERIVED_FROM/TO -(poliposis I-DERIVED_FROM/TO -adenomatosa I-DERIVED_FROM/TO -familiar, I-DERIVED_FROM/TO -síndrome I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Lynch, I-DERIVED_FROM/TO -síndrome I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Peutz-Jeghers, I-DERIVED_FROM/TO -entre I-DERIVED_FROM/TO -otros) I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -finalidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -educar I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -pacientes I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -familiares I-DERIVED_FROM/TO -respecto I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -enfermedad, I-DERIVED_FROM/TO -predisposición I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -desarrollarla I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -transmitirla I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -descendencia, I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -este I-DERIVED_FROM/TO -modo I-DERIVED_FROM/TO -prevenir I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -desarrollo I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -CCR I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -aquellos I-DERIVED_FROM/TO -familiares I-DERIVED_FROM/TO -asintomáticos. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -El B-FAMILY_HISTORY -análisis I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -genealogía I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -índice I-FAMILY_HISTORY -demostró I-FAMILY_HISTORY -consanguinidad I-FAMILY_HISTORY -de I-FAMILY_HISTORY -los I-FAMILY_HISTORY -padres, I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -historia I-FAMILY_HISTORY -de I-FAMILY_HISTORY -poliposis I-FAMILY_HISTORY -o I-FAMILY_HISTORY -CCR I-FAMILY_HISTORY -en I-FAMILY_HISTORY -ellos. I-FAMILY_HISTORY -Además I-FAMILY_HISTORY -permitió I-FAMILY_HISTORY -identificar I-FAMILY_HISTORY -a I-FAMILY_HISTORY -una I-FAMILY_HISTORY -hermana I-FAMILY_HISTORY -(de I-FAMILY_HISTORY -un I-FAMILY_HISTORY -total I-FAMILY_HISTORY -de I-FAMILY_HISTORY -12 I-FAMILY_HISTORY -hermanos) I-FAMILY_HISTORY -que I-FAMILY_HISTORY -presentó I-FAMILY_HISTORY -CCR, I-FAMILY_HISTORY -a I-FAMILY_HISTORY -la I-FAMILY_HISTORY -que I-FAMILY_HISTORY -identificamos I-FAMILY_HISTORY -como I-FAMILY_HISTORY -PAF585. I-FAMILY_HISTORY -Ella I-FAMILY_HISTORY -presentó I-FAMILY_HISTORY -un I-FAMILY_HISTORY -cáncer I-FAMILY_HISTORY -de I-FAMILY_HISTORY -colon I-FAMILY_HISTORY -derecho I-FAMILY_HISTORY -con I-FAMILY_HISTORY -invasión I-FAMILY_HISTORY -hasta I-FAMILY_HISTORY -la I-FAMILY_HISTORY -subserosa I-FAMILY_HISTORY -y I-FAMILY_HISTORY -compromiso I-FAMILY_HISTORY -linfonodal I-FAMILY_HISTORY -a I-FAMILY_HISTORY -los I-FAMILY_HISTORY -53 I-FAMILY_HISTORY -años I-FAMILY_HISTORY -que I-FAMILY_HISTORY -fue I-FAMILY_HISTORY -tratado I-FAMILY_HISTORY -con I-FAMILY_HISTORY -cirugía I-FAMILY_HISTORY -y I-FAMILY_HISTORY -quimioterapia I-FAMILY_HISTORY -adyuvante. I-FAMILY_HISTORY -Un I-FAMILY_HISTORY -año I-FAMILY_HISTORY -después, I-FAMILY_HISTORY -la I-FAMILY_HISTORY -colonoscopia I-FAMILY_HISTORY -de I-FAMILY_HISTORY -control I-FAMILY_HISTORY -mostró I-FAMILY_HISTORY -dos I-FAMILY_HISTORY -nuevos I-FAMILY_HISTORY -tumores I-FAMILY_HISTORY -sincrónicos, I-FAMILY_HISTORY -uno I-FAMILY_HISTORY -en I-FAMILY_HISTORY -colon I-FAMILY_HISTORY -sigmoides I-FAMILY_HISTORY -a I-FAMILY_HISTORY -35 I-FAMILY_HISTORY -cm I-FAMILY_HISTORY -del I-FAMILY_HISTORY -margen I-FAMILY_HISTORY -anal I-FAMILY_HISTORY -y I-FAMILY_HISTORY -otro I-FAMILY_HISTORY -cáncer I-FAMILY_HISTORY -en I-FAMILY_HISTORY -recto I-FAMILY_HISTORY -inferior I-FAMILY_HISTORY -(adenocarcinoma I-FAMILY_HISTORY -tubular I-FAMILY_HISTORY -invasor). I-FAMILY_HISTORY -Cabe I-FAMILY_HISTORY -destacar I-FAMILY_HISTORY -que I-FAMILY_HISTORY -el I-FAMILY_HISTORY -informe I-FAMILY_HISTORY -médico I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -no I-FAMILY_HISTORY -registra I-FAMILY_HISTORY -la I-FAMILY_HISTORY -presencia I-FAMILY_HISTORY -de I-FAMILY_HISTORY -poliposis I-FAMILY_HISTORY -adenomatosa I-FAMILY_HISTORY -colónica. I-FAMILY_HISTORY -La I-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -evolucionó I-FAMILY_HISTORY -tórpidamente I-FAMILY_HISTORY -falleciendo I-FAMILY_HISTORY -a I-FAMILY_HISTORY -los I-FAMILY_HISTORY -4 I-FAMILY_HISTORY -meses I-FAMILY_HISTORY -posterior I-FAMILY_HISTORY -a I-FAMILY_HISTORY -la I-FAMILY_HISTORY -cirugía I-FAMILY_HISTORY -debido I-FAMILY_HISTORY -a I-FAMILY_HISTORY -un I-FAMILY_HISTORY -cuadro I-FAMILY_HISTORY -séptico I-FAMILY_HISTORY -secundario. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Con I-FAMILY_HISTORY -respecto I-FAMILY_HISTORY -a I-FAMILY_HISTORY -los I-FAMILY_HISTORY -demás I-FAMILY_HISTORY -hermanos, I-FAMILY_HISTORY -cinco I-FAMILY_HISTORY -de I-FAMILY_HISTORY -ellos I-FAMILY_HISTORY -fallecieron I-FAMILY_HISTORY -en I-FAMILY_HISTORY -la I-FAMILY_HISTORY -infancia I-FAMILY_HISTORY -por I-FAMILY_HISTORY -accidentes I-FAMILY_HISTORY -y I-FAMILY_HISTORY -enfermedades I-FAMILY_HISTORY -no I-FAMILY_HISTORY -relacionadas I-FAMILY_HISTORY -al I-FAMILY_HISTORY -cáncer. I-FAMILY_HISTORY -En I-FAMILY_HISTORY -los I-FAMILY_HISTORY -cinco I-FAMILY_HISTORY -hermanos I-FAMILY_HISTORY -vivos, I-FAMILY_HISTORY -la I-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -índice I-FAMILY_HISTORY -no I-FAMILY_HISTORY -declara I-FAMILY_HISTORY -más I-FAMILY_HISTORY -casos I-FAMILY_HISTORY -afectados I-FAMILY_HISTORY -de I-FAMILY_HISTORY -poliposis I-FAMILY_HISTORY -o I-FAMILY_HISTORY -CCR, I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -embargo, I-FAMILY_HISTORY -desconocemos I-FAMILY_HISTORY -si I-FAMILY_HISTORY -ellos I-FAMILY_HISTORY -se I-FAMILY_HISTORY -han I-FAMILY_HISTORY -realizado I-FAMILY_HISTORY -estudios I-FAMILY_HISTORY -colonoscópicos. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Estudio B-EXPLORATION -genético I-EXPLORATION - I-EXPLORATION -Obtención I-EXPLORATION -del I-EXPLORATION -ADN I-EXPLORATION -genómico I-EXPLORATION -desde I-EXPLORATION -sangre I-EXPLORATION -periférica: I-EXPLORATION -el I-EXPLORATION -ADN I-EXPLORATION -genómico I-EXPLORATION -fue I-EXPLORATION -aislado I-EXPLORATION -a I-EXPLORATION -partir I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -ml I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -venosa I-EXPLORATION -periférica, I-EXPLORATION -utilizando I-EXPLORATION -el I-EXPLORATION -protocolo I-EXPLORATION -descrito I-EXPLORATION -por I-EXPLORATION -Lahiri I-EXPLORATION -y I-EXPLORATION -Nurnberger I-EXPLORATION -(1991 I-EXPLORATION -) I-EXPLORATION -9. I-EXPLORATION - I-EXPLORATION -Este I-EXPLORATION -ADN I-EXPLORATION -fue I-EXPLORATION -previamente I-EXPLORATION -estudiado I-EXPLORATION +Al B-EXPLORATION +ingreso I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -molecular I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -APC, I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -resultó I-EXPLORATION -negativo8. I-EXPLORATION - I-EXPLORATION -Análisis I-EXPLORATION -mutacional I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -MUTYH: I-EXPLORATION -Los I-EXPLORATION -16 I-EXPLORATION -exones I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -MUTYH I-EXPLORATION -fueron I-EXPLORATION -amplificados I-EXPLORATION -mediante I-EXPLORATION la I-EXPLORATION -técnica I-EXPLORATION +UCI I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +frecuencia I-EXPLORATION +respiratoria I-EXPLORATION +mayor I-EXPLORATION de I-EXPLORATION -PCR I-EXPLORATION -(reacción I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION +40, I-EXPLORATION +saturación I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -polimerasa) I-EXPLORATION -usando I-EXPLORATION -los I-EXPLORATION -partidores I-EXPLORATION -descritos I-EXPLORATION -por I-EXPLORATION -Kim I-EXPLORATION -y I-EXPLORATION -colaboradores, I-EXPLORATION -en I-EXPLORATION -200610. I-EXPLORATION -Reacciones I-EXPLORATION +oxígeno I-EXPLORATION +del I-EXPLORATION +85% I-EXPLORATION +con I-EXPLORATION +reservorio, I-EXPLORATION +frecuencia I-EXPLORATION +cardiaca I-EXPLORATION de I-EXPLORATION -PCR I-EXPLORATION -fueron I-EXPLORATION -realizadas I-EXPLORATION +140 I-EXPLORATION +ppm, I-EXPLORATION +tensión I-EXPLORATION +arterial I-EXPLORATION +120/40 I-EXPLORATION +mmHg, I-EXPLORATION +temp-35º I-EXPLORATION +C. I-EXPLORATION +La I-EXPLORATION +auscultación I-EXPLORATION +cardiopulmonar I-EXPLORATION +mostraba I-EXPLORATION +crepitantes I-EXPLORATION en I-EXPLORATION -un I-EXPLORATION -volumen I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -50 I-EXPLORATION -Ql I-EXPLORATION -que I-EXPLORATION -contiene I-EXPLORATION -100 I-EXPLORATION -ng I-EXPLORATION -de I-EXPLORATION -ADN I-EXPLORATION -genómico, I-EXPLORATION -25 I-EXPLORATION -pmoles I-EXPLORATION -de I-EXPLORATION -cada I-EXPLORATION -partidor, I-EXPLORATION -0, I-EXPLORATION -2 I-EXPLORATION -mM I-EXPLORATION -de I-EXPLORATION -cada I-EXPLORATION -uno I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -dNTPs, I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -mM I-EXPLORATION -MgCl2 I-EXPLORATION -1X I-EXPLORATION -del I-EXPLORATION -amortiguador I-EXPLORATION -suministrado I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -enzima I-EXPLORATION +ambos I-EXPLORATION +hemitorax I-EXPLORATION y I-EXPLORATION -1U I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +destacaba I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION +pulsos I-EXPLORATION +distales I-EXPLORATION +aunque I-EXPLORATION +sin I-EXPLORATION +edemas I-EXPLORATION +en I-EXPLORATION +extremidades. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -enzima I-EXPLORATION -Platinum I-EXPLORATION -Taq I-EXPLORATION -ADN I-EXPLORATION -polimerasa I-EXPLORATION -(Invitrogen, I-EXPLORATION -Sao I-EXPLORATION -Paulo, I-EXPLORATION -Brasil). I-EXPLORATION -La I-EXPLORATION -amplificación I-EXPLORATION -fue I-EXPLORATION +analítica I-EXPLORATION realizada I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -siguiente I-EXPLORATION -protocolo: I-EXPLORATION -una I-EXPLORATION -desnaturación I-EXPLORATION -inicial I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -min I-EXPLORATION -a I-EXPLORATION -95°C, I-EXPLORATION -seguido I-EXPLORATION -por I-EXPLORATION -30 I-EXPLORATION -ciclos I-EXPLORATION -de I-EXPLORATION -30 I-EXPLORATION -seg I-EXPLORATION -a I-EXPLORATION -95°C, I-EXPLORATION -30 I-EXPLORATION -seg I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -temperatura I-EXPLORATION -de I-EXPLORATION -apareamiento I-EXPLORATION +destacaba I-EXPLORATION +leucocitosis I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -partidores I-EXPLORATION -(rango I-EXPLORATION -50-58°C), I-EXPLORATION -30 I-EXPLORATION -seg I-EXPLORATION -a I-EXPLORATION -72°C, I-EXPLORATION +36400, I-EXPLORATION +Glucosa: I-EXPLORATION +266 I-EXPLORATION +mg/dL, I-EXPLORATION +Creatinina: I-EXPLORATION +3, I-EXPLORATION +3 I-EXPLORATION +mg/dL, I-EXPLORATION +AST: I-EXPLORATION +3127 I-EXPLORATION +U/L, I-EXPLORATION +ALT: I-EXPLORATION +3139 I-EXPLORATION +U/L, I-EXPLORATION +Gamma I-EXPLORATION +GT: I-EXPLORATION +86 I-EXPLORATION +U/L I-EXPLORATION y I-EXPLORATION -un I-EXPLORATION -paso I-EXPLORATION +tiempos I-EXPLORATION de I-EXPLORATION -extensión I-EXPLORATION -final I-EXPLORATION +coagulación I-EXPLORATION +ligeramente I-EXPLORATION +elevados. I-EXPLORATION +Gasometría: I-EXPLORATION +PH: I-EXPLORATION +7, I-EXPLORATION +11. I-EXPLORATION +PCO2: I-EXPLORATION +41. I-EXPLORATION +PO2: I-EXPLORATION +44. I-EXPLORATION +Saturación I-EXPLORATION +O2: I-EXPLORATION +63. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +Radiografía I-EXPLORATION de I-EXPLORATION -10 I-EXPLORATION -min I-EXPLORATION -a I-EXPLORATION -72°C. I-EXPLORATION -Los I-EXPLORATION -productos I-EXPLORATION -amplificados I-EXPLORATION -fueron I-EXPLORATION -posteriormente I-EXPLORATION -analizados I-EXPLORATION -mediante I-EXPLORATION -dos I-EXPLORATION -técnicas I-EXPLORATION +tórax I-EXPLORATION +se I-EXPLORATION +apreciaba I-EXPLORATION +infiltrado I-EXPLORATION +alveolo-intersticial I-EXPLORATION +bilateral I-EXPLORATION de I-EXPLORATION -alta I-EXPLORATION -sensibilidad I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -detección I-EXPLORATION +predominio I-EXPLORATION +derecho. I-EXPLORATION +Se B-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +la I-TREATMENT +intubación I-TREATMENT +inmediata I-TREATMENT +y I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +antibióticos I-TREATMENT +de I-TREATMENT +mayor I-TREATMENT +espectro. I-TREATMENT +La B-EXPLORATION +paciente I-EXPLORATION +presentó I-EXPLORATION +un I-EXPLORATION +cuadro I-EXPLORATION de I-EXPLORATION -alteraciones I-EXPLORATION +fracaso I-EXPLORATION +multiorgánico I-EXPLORATION +y I-EXPLORATION en I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +analítica I-EXPLORATION +llamó I-EXPLORATION la I-EXPLORATION -secuencia I-EXPLORATION -del I-EXPLORATION -ADN, I-EXPLORATION -que I-EXPLORATION -incluye I-EXPLORATION +atención I-EXPLORATION la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -SSCP I-EXPLORATION -(single I-EXPLORATION -strand I-EXPLORATION -conformation I-EXPLORATION -polymorphism) I-EXPLORATION -y I-EXPLORATION -secuenciación I-EXPLORATION -de I-EXPLORATION -ADN. I-EXPLORATION -Brevemente, I-EXPLORATION -los I-EXPLORATION -productos I-EXPLORATION +elevación I-EXPLORATION de I-EXPLORATION -PCR I-EXPLORATION -fueron I-EXPLORATION -desnaturados I-EXPLORATION -a I-EXPLORATION -95°C I-EXPLORATION -por I-EXPLORATION -5 I-EXPLORATION -min, I-EXPLORATION -enfriados I-EXPLORATION -en I-EXPLORATION -hielo I-EXPLORATION -por I-EXPLORATION -5 I-EXPLORATION -min, I-EXPLORATION +la I-EXPLORATION +creatinin-fosfoquinasa I-EXPLORATION y I-EXPLORATION -resueltos I-EXPLORATION +troponina, I-EXPLORATION por I-EXPLORATION -electroforesis I-EXPLORATION -en I-EXPLORATION -geles I-EXPLORATION -de I-EXPLORATION -poliacrilamida I-EXPLORATION -MDE I-EXPLORATION -0, I-EXPLORATION -5X I-EXPLORATION - I-EXPLORATION -(FMC I-EXPLORATION -Bioproducts), I-EXPLORATION -aplicando I-EXPLORATION -una I-EXPLORATION -corriente I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -W I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +ecocardiograma I-EXPLORATION +transesofágico, I-EXPLORATION +objetivándose I-EXPLORATION +masa I-EXPLORATION a I-EXPLORATION -18°C I-EXPLORATION -por I-EXPLORATION -12 I-EXPLORATION -h. I-EXPLORATION -Después I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -electroforesis, I-EXPLORATION -los I-EXPLORATION -geles I-EXPLORATION -fueron I-EXPLORATION -teñidos I-EXPLORATION -con I-EXPLORATION -nitrato I-EXPLORATION -de I-EXPLORATION -plata I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -fin I-EXPLORATION -de I-EXPLORATION -visualizar I-EXPLORATION -las I-EXPLORATION -bandas I-EXPLORATION -de I-EXPLORATION -ADN. I-EXPLORATION -Los I-EXPLORATION -productos I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -PCR I-EXPLORATION +cava I-EXPLORATION +superior I-EXPLORATION que I-EXPLORATION -presentaron I-EXPLORATION +llegaba I-EXPLORATION +hasta I-EXPLORATION +la I-EXPLORATION +aurícula I-EXPLORATION +derecha. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -migración I-EXPLORATION -anormal I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -al I-EXPLORATION -control, I-EXPLORATION -fueron I-EXPLORATION -secuenciados. I-EXPLORATION -Las I-EXPLORATION -mutaciones I-EXPLORATION -fueron I-EXPLORATION -analizadas I-EXPLORATION -y I-EXPLORATION -confirmadas I-EXPLORATION -por I-EXPLORATION -dos I-EXPLORATION -reacciones I-EXPLORATION +tomografía I-EXPLORATION +computerizada I-EXPLORATION +(TC) I-EXPLORATION +que I-EXPLORATION +informó I-EXPLORATION de I-EXPLORATION -PCR I-EXPLORATION -independientes I-EXPLORATION +derrame I-EXPLORATION +pleural I-EXPLORATION +bilateral I-EXPLORATION +sin I-EXPLORATION +tromboembolismo I-EXPLORATION +pulmonar, I-EXPLORATION +dilatación I-EXPLORATION y I-EXPLORATION -por I-EXPLORATION -secuenciación I-EXPLORATION +ocupación I-EXPLORATION de I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +cava I-EXPLORATION +inferior I-EXPLORATION +intrahépatica I-EXPLORATION +que I-EXPLORATION +proximalmente I-EXPLORATION +llega I-EXPLORATION +hasta I-EXPLORATION +la I-EXPLORATION +aurícula I-EXPLORATION +derecha I-EXPLORATION +y I-EXPLORATION +distalmente I-EXPLORATION +hasta I-EXPLORATION las I-EXPLORATION -dos I-EXPLORATION -hebras I-EXPLORATION -de I-EXPLORATION -ADN. I-EXPLORATION -La I-EXPLORATION -mutación I-EXPLORATION -se I-EXPLORATION -nombró I-EXPLORATION +venas I-EXPLORATION +renales. I-EXPLORATION +Hipodensidad I-EXPLORATION de I-EXPLORATION -acuerdo I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -nomenclatura I-EXPLORATION -propuesta I-EXPLORATION -por I-EXPLORATION +vena I-EXPLORATION +suprahepática I-EXPLORATION +derecha I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +trombosis I-EXPLORATION +secundaria I-EXPLORATION +y I-EXPLORATION +masa I-EXPLORATION +suprarrenal I-EXPLORATION +derecha I-EXPLORATION +de I-EXPLORATION +4 I-EXPLORATION +cm I-EXPLORATION +hipercaptante, I-EXPLORATION +en I-EXPLORATION +íntimo I-EXPLORATION +contacto I-EXPLORATION +con I-EXPLORATION la I-EXPLORATION -Human I-EXPLORATION -Genome I-EXPLORATION -Variation I-EXPLORATION -Society I-EXPLORATION -(www. I-EXPLORATION -hgvs.org/mutnomen/). I-EXPLORATION +vena I-EXPLORATION +cava I-EXPLORATION +inferior. I-EXPLORATION I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -suspendido I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alergia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -aspirina I-PAST_MEDICAL_HISTORY -caracterizado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -eritema I-PAST_MEDICAL_HISTORY -generalizado I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -edema I-PAST_MEDICAL_HISTORY -glótico. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -primera I-PAST_MEDICAL_HISTORY -ocasión I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -1974 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -vuelve I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -repetir I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -única I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -1983, I-PAST_MEDICAL_HISTORY -motivo I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -cual I-PAST_MEDICAL_HISTORY -nunca I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -vuelve I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -recibir I-PAST_MEDICAL_HISTORY -aspirina. I-PAST_MEDICAL_HISTORY -Ingresa B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -noviembre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2010 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -angina I-PRESENT_ILLNESS -inestable. I-PRESENT_ILLNESS +Habiendo B-DERIVED_FROM/TO +estabilizado I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +UCI I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +4 I-DERIVED_FROM/TO +días I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +ingreso, I-DERIVED_FROM/TO +intubada I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +disfunción I-DERIVED_FROM/TO +multiorgánica, I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +fin I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +planificar I-DERIVED_FROM/TO +tratamiento I-DERIVED_FROM/TO +quirúrgico. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO Se B-EXPLORATION -realiza I-EXPLORATION -coronariografía I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -estenosis I-EXPLORATION -significativa I-EXPLORATION +repite I-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION en I-EXPLORATION -arteria I-EXPLORATION -descendente I-EXPLORATION -anterior, I-EXPLORATION -ante I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -procede I-EXPLORATION -a I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -angioplastía I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +destaca I-EXPLORATION +leucocitosis, I-EXPLORATION +AST: I-EXPLORATION +165 I-EXPLORATION +UI/L, I-EXPLORATION +ALT: I-EXPLORATION +1050 I-EXPLORATION +UI/L I-EXPLORATION con I-EXPLORATION -stent I-EXPLORATION -en I-EXPLORATION -dicho I-EXPLORATION -vaso. I-EXPLORATION -Por B-TREATMENT -antecedentes I-TREATMENT +ionograma I-EXPLORATION +y I-EXPLORATION +creatinina I-EXPLORATION +normales. I-EXPLORATION +Tras B-TREATMENT +valorar I-TREATMENT +las I-TREATMENT +pruebas I-TREATMENT +aportadas, I-TREATMENT +dada I-TREATMENT +la I-TREATMENT +gravedad I-TREATMENT +del I-TREATMENT +cuadro, I-TREATMENT +y I-TREATMENT +puesto I-TREATMENT +que I-TREATMENT +las I-TREATMENT +pruebas I-TREATMENT de I-TREATMENT -alergia I-TREATMENT +imagen I-TREATMENT +realizadas I-TREATMENT +no I-TREATMENT +presentan I-TREATMENT +metástasis I-TREATMENT a I-TREATMENT -la I-TREATMENT -aspirina I-TREATMENT +distancia, I-TREATMENT se I-TREATMENT -deja I-TREATMENT -con I-TREATMENT -clopidogrel I-TREATMENT +planteó I-TREATMENT +un I-TREATMENT +tratamiento I-TREATMENT +quirúrgico I-TREATMENT +urgente. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +realiza I-TREATMENT +una I-TREATMENT +laparatomía I-TREATMENT +subcostal I-TREATMENT +bilateral I-TREATMENT +al I-TREATMENT +mismo I-TREATMENT +tiempo I-TREATMENT +que I-TREATMENT +una I-TREATMENT +esternotomía I-TREATMENT +longitudinal. I-TREATMENT +Se I-TREATMENT +aprecia I-TREATMENT +derrame I-TREATMENT +pleural I-TREATMENT +bilateral, I-TREATMENT +ligero I-TREATMENT +derrame I-TREATMENT +pericárdico I-TREATMENT y I-TREATMENT -cilostazol. I-TREATMENT -Tres B-EVOLUTION -semanas I-EVOLUTION -posterior I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -alta, I-EVOLUTION -presenta I-EVOLUTION -nuevo I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -torácico I-EVOLUTION -retroesternal I-EVOLUTION -opresivo I-EVOLUTION -prolongado I-EVOLUTION -y B-EXPLORATION -la I-EXPLORATION -corona-riografía I-EXPLORATION -demuestra I-EXPLORATION -una I-EXPLORATION -trombosis I-EXPLORATION -intra-stent. I-EXPLORATION -Se B-TREATMENT -trató I-TREATMENT +corazón I-TREATMENT con I-TREATMENT -angioplastía I-TREATMENT +contracción I-TREATMENT +normal I-TREATMENT +en I-TREATMENT +la I-TREATMENT +cavidad I-TREATMENT +torácica, I-TREATMENT +mientras I-TREATMENT +que I-TREATMENT +la I-TREATMENT +laparotomía I-TREATMENT +muestra I-TREATMENT +isquemia I-TREATMENT +de I-TREATMENT +los I-TREATMENT +segmentos I-TREATMENT +6 I-TREATMENT +y I-TREATMENT +7 I-TREATMENT +del I-TREATMENT +hígado I-TREATMENT +y I-TREATMENT +masa I-TREATMENT +suprarrenal I-TREATMENT +derecha. I-TREATMENT + I-TREATMENT +El I-TREATMENT +equipo I-TREATMENT +de I-TREATMENT +Cirugía I-TREATMENT +General I-TREATMENT +realiza I-TREATMENT +hepatectomía I-TREATMENT +anterior I-TREATMENT con I-TREATMENT -bal��n, I-TREATMENT -bajo I-TREATMENT -infusión I-TREATMENT +maniobra I-TREATMENT de I-TREATMENT -tirofibán I-TREATMENT -endovenoso, I-TREATMENT -consiguiendo B-EVOLUTION -un I-EVOLUTION -buen I-EVOLUTION -resultado I-EVOLUTION -clínico. I-EVOLUTION -Posterior B-TREATMENT +Pringle I-TREATMENT +intermitente, I-TREATMENT +sin I-TREATMENT +voltear I-TREATMENT +el I-TREATMENT +hígado, I-TREATMENT +seccionando I-TREATMENT +el I-TREATMENT +hígado I-TREATMENT +hasta I-TREATMENT +llegar I-TREATMENT a I-TREATMENT +cara I-TREATMENT +anterior I-TREATMENT +de I-TREATMENT la I-TREATMENT -intervención I-TREATMENT -se I-TREATMENT +Cava I-TREATMENT +retrohepática. I-TREATMENT +Posteriormente, I-TREATMENT +el I-TREATMENT +equipo I-TREATMENT +de I-TREATMENT +Urología I-TREATMENT +tras I-TREATMENT +descolgar I-TREATMENT +el I-TREATMENT +colon I-TREATMENT +derecho I-TREATMENT realiza I-TREATMENT -protocolo I-TREATMENT +disección I-TREATMENT de I-TREATMENT -desensibilización I-TREATMENT +vena I-TREATMENT +cava I-TREATMENT +hasta I-TREATMENT +iliacas I-TREATMENT +primitivas, I-TREATMENT +ligadura I-TREATMENT +de I-TREATMENT +vena I-TREATMENT +genital I-TREATMENT +derecha, I-TREATMENT +liberación I-TREATMENT +de I-TREATMENT +vena I-TREATMENT +renal I-TREATMENT +y I-TREATMENT +cara I-TREATMENT +anterior I-TREATMENT +de I-TREATMENT +riñón I-TREATMENT +derecho. I-TREATMENT +Se I-TREATMENT +procede I-TREATMENT a I-TREATMENT -aspirina, I-TREATMENT -sin I-TREATMENT -incidentes. I-TREATMENT -Desde I-TREATMENT +la I-TREATMENT +liberación I-TREATMENT +de I-TREATMENT +la I-TREATMENT +glándula I-TREATMENT +suprarrenal I-TREATMENT +derecha, I-TREATMENT +a I-TREATMENT +excepción I-TREATMENT +de I-TREATMENT +su I-TREATMENT +borde I-TREATMENT +superior I-TREATMENT +y I-TREATMENT +medial I-TREATMENT +que I-TREATMENT +está I-TREATMENT +íntimamente I-TREATMENT +unido I-TREATMENT +a I-TREATMENT +la I-TREATMENT +pared I-TREATMENT +derecha I-TREATMENT +de I-TREATMENT +la I-TREATMENT +vena I-TREATMENT +cava. I-TREATMENT +Queda I-TREATMENT +así I-TREATMENT +expuesto I-TREATMENT +el I-TREATMENT +campo I-TREATMENT +para I-TREATMENT +la I-TREATMENT +exéresis I-TREATMENT +de I-TREATMENT +suprarrenal I-TREATMENT +e I-TREATMENT +hígado I-TREATMENT +derecho I-TREATMENT +a I-TREATMENT +falta I-TREATMENT +de I-TREATMENT +cavotomía.. I-TREATMENT + I-TREATMENT +Una I-TREATMENT +vez I-TREATMENT +realizado I-TREATMENT +esto, I-TREATMENT +el I-TREATMENT +equipo I-TREATMENT +de I-TREATMENT +Cirugía I-TREATMENT +Cardiaca I-TREATMENT +comienza I-TREATMENT +la I-TREATMENT +circulación I-TREATMENT +extracorpórea I-TREATMENT +bajando I-TREATMENT +progresivamente I-TREATMENT +la I-TREATMENT +temperatura I-TREATMENT +hasta I-TREATMENT +alcanzar I-TREATMENT +14ºC I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +esofágico I-TREATMENT +y I-TREATMENT +19ºC I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +rectal, I-TREATMENT +tras I-TREATMENT +lo I-TREATMENT +cual I-TREATMENT +se I-TREATMENT +procede I-TREATMENT +a I-TREATMENT +exanguinar I-TREATMENT +a I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +y I-TREATMENT +parar I-TREATMENT +la I-TREATMENT +circulación I-TREATMENT +extracorpórea I-TREATMENT +manteniendo I-TREATMENT +la I-TREATMENT +sangre I-TREATMENT +en I-TREATMENT +un I-TREATMENT +oxigenador. I-TREATMENT +Es I-TREATMENT entonces I-TREATMENT +cuando I-TREATMENT se I-TREATMENT -mantiene I-TREATMENT +procede I-TREATMENT +a I-TREATMENT +realizar I-TREATMENT +una I-TREATMENT +cavotomía I-TREATMENT +inferior I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +de I-TREATMENT +suprarrenal I-TREATMENT +hasta I-TREATMENT +2 I-TREATMENT +cm I-TREATMENT +de I-TREATMENT +diafragma, I-TREATMENT +aurículotomía I-TREATMENT +derecha I-TREATMENT +y I-TREATMENT +retirada I-TREATMENT +del I-TREATMENT +trombo I-TREATMENT +tumoral I-TREATMENT +a I-TREATMENT +través I-TREATMENT +de I-TREATMENT +la I-TREATMENT +incisión I-TREATMENT +realizada I-TREATMENT +en I-TREATMENT +la I-TREATMENT +cava I-TREATMENT +inferior. I-TREATMENT +Se I-TREATMENT +realiza I-TREATMENT +sección I-TREATMENT +de I-TREATMENT +pared I-TREATMENT +lateral I-TREATMENT +derecha I-TREATMENT +de I-TREATMENT +vena I-TREATMENT +cava I-TREATMENT +(desde I-TREATMENT +la I-TREATMENT +vena I-TREATMENT +suprarrenal I-TREATMENT +hasta I-TREATMENT +la I-TREATMENT +vena I-TREATMENT +suprahepática I-TREATMENT +derecha), I-TREATMENT +extrayendo I-TREATMENT +en I-TREATMENT +bloque I-TREATMENT +hígado I-TREATMENT +derecho I-TREATMENT con I-TREATMENT -aspirina I-TREATMENT +venas I-TREATMENT +suprahepática I-TREATMENT y I-TREATMENT -clopidrogel. I-TREATMENT -Completado B-EVOLUTION -1 I-EVOLUTION -año I-EVOLUTION -2 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento, I-EVOLUTION -con I-EVOLUTION +suprarrenal I-TREATMENT +derechas I-TREATMENT +incluidas I-TREATMENT +en I-TREATMENT +dicho I-TREATMENT +parche, I-TREATMENT +suprarrenal I-TREATMENT +derecha I-TREATMENT +y I-TREATMENT +trombo. I-TREATMENT +Se I-TREATMENT +produce I-TREATMENT +rotura I-TREATMENT +del I-TREATMENT +trombo I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +de I-TREATMENT +vena I-TREATMENT +renal, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +en I-TREATMENT +un I-TREATMENT +segundo I-TREATMENT +tiempo I-TREATMENT +se I-TREATMENT +extrae I-TREATMENT +por I-TREATMENT +tracción I-TREATMENT +el I-TREATMENT +trombo I-TREATMENT +desde I-TREATMENT +vena I-TREATMENT +renal I-TREATMENT +hasta I-TREATMENT +iliacas I-TREATMENT +primitivas. I-TREATMENT +Se I-TREATMENT +realiza I-TREATMENT +irrigación I-TREATMENT +de I-TREATMENT +cava I-TREATMENT +y I-TREATMENT +aurícula I-TREATMENT +derecha I-TREATMENT +y, I-TREATMENT +al I-TREATMENT +no I-TREATMENT +observarse I-TREATMENT +restos I-TREATMENT +de I-TREATMENT +trombo I-TREATMENT +ni I-TREATMENT +infiltración I-TREATMENT +de I-TREATMENT +las I-TREATMENT +paredes I-TREATMENT +de I-TREATMENT +cava I-TREATMENT +o I-TREATMENT +aurícula, I-TREATMENT +se I-TREATMENT +procede I-TREATMENT +al I-TREATMENT +cierre I-TREATMENT +de I-TREATMENT +vena I-TREATMENT +cava I-TREATMENT +y I-TREATMENT +orejuela I-TREATMENT +derecha I-TREATMENT +por I-TREATMENT +separado I-TREATMENT +y I-TREATMENT +a I-TREATMENT +la I-TREATMENT +vez I-TREATMENT +mediante I-TREATMENT +sutura I-TREATMENT +continua I-TREATMENT +con I-TREATMENT +monofilamento. I-TREATMENT +Una I-TREATMENT +vez I-TREATMENT +realizado I-TREATMENT +dicho I-TREATMENT +cierre I-TREATMENT +se I-TREATMENT +procede I-TREATMENT +a I-TREATMENT +reperfundir I-TREATMENT +progresivamente I-TREATMENT +a I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +volviendo I-TREATMENT +a I-TREATMENT +entrar I-TREATMENT +en I-TREATMENT +circulación I-TREATMENT +extracorpórea, I-TREATMENT +recalentándola I-TREATMENT +y I-TREATMENT +procediendo I-TREATMENT +a I-TREATMENT +desclampar I-TREATMENT +la I-TREATMENT +aorta I-TREATMENT +y I-TREATMENT +perfundir I-TREATMENT +el I-TREATMENT +corazón I-TREATMENT +al I-TREATMENT +alcanzar I-TREATMENT +una I-TREATMENT +temperatura I-TREATMENT +esofágica I-TREATMENT +de I-TREATMENT +34ºC. I-TREATMENT +El I-TREATMENT +inicio I-TREATMENT +de I-TREATMENT +la I-TREATMENT +función I-TREATMENT +cardiaca I-TREATMENT +permite I-TREATMENT +la I-TREATMENT +salida I-TREATMENT +de I-TREATMENT +circulación I-TREATMENT +extracorpórea. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +colocan I-TREATMENT +drenajes I-TREATMENT +retroesternal, I-TREATMENT +mediastínico, I-TREATMENT +subhepático I-TREATMENT +y I-TREATMENT +retroperitoneal I-TREATMENT +en I-TREATMENT +fosa I-TREATMENT +renal I-TREATMENT +derecha. I-TREATMENT +Durante I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +se I-TREATMENT +transfundieron I-TREATMENT +14 I-TREATMENT +concentrados I-TREATMENT +de I-TREATMENT +hematíes, I-TREATMENT +1200 I-TREATMENT +ml I-TREATMENT +de I-TREATMENT +plasma I-TREATMENT +y I-TREATMENT +2 I-TREATMENT +unidades I-TREATMENT +de I-TREATMENT +plaquetas. I-TREATMENT +Durante B-EVOLUTION +la I-EVOLUTION +estancia I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +UCI I-EVOLUTION +se I-EVOLUTION +realiza I-EVOLUTION +ecografía I-EVOLUTION +abdominal I-EVOLUTION +que I-EVOLUTION +muestras I-EVOLUTION buena I-EVOLUTION -adherencia I-EVOLUTION -a I-EVOLUTION +permeabilidad I-EVOLUTION +del I-EVOLUTION +sistema I-EVOLUTION +venoso I-EVOLUTION +hepático I-EVOLUTION +izquierdo I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +vena I-EVOLUTION +cava. I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +10 I-EVOLUTION +días I-EVOLUTION la I-EVOLUTION -terapia, I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -efectos I-EVOLUTION -adversos, I-EVOLUTION +paciente I-EVOLUTION +es I-EVOLUTION +trasladada I-EVOLUTION +a I-EVOLUTION +planta, I-EVOLUTION +encontrándose I-EVOLUTION +consciente, I-EVOLUTION +orientada I-EVOLUTION y I-EVOLUTION +colaboradora, I-EVOLUTION +aunque I-EVOLUTION +presentando I-EVOLUTION +debilidad I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +cuatro I-EVOLUTION +extremidades. I-EVOLUTION +La B-TREATMENT +paciente I-TREATMENT +permanece I-TREATMENT +ingresada I-TREATMENT +en I-TREATMENT +planta I-TREATMENT +durante I-TREATMENT +20 I-TREATMENT +días I-TREATMENT +recibiendo I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +cinesiterapia I-TREATMENT +generalizada I-TREATMENT +pasiva I-TREATMENT +y I-TREATMENT +asistida. I-TREATMENT +Tras I-TREATMENT +buena I-TREATMENT +evolución I-TREATMENT +en I-TREATMENT +la I-TREATMENT +movilidad I-TREATMENT +es I-TREATMENT +dada I-TREATMENT +de I-TREATMENT +alta, I-TREATMENT +no I-TREATMENT +precisando I-TREATMENT +tratamiento I-TREATMENT +a I-TREATMENT +excepción I-TREATMENT +de I-TREATMENT +heparina I-TREATMENT +de I-TREATMENT +bajo I-TREATMENT +peso I-TREATMENT +molecular. I-TREATMENT + I-TREATMENT +La B-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +informa I-EXPLORATION +de I-EXPLORATION +feocromocitoma I-EXPLORATION +que I-EXPLORATION +afecta I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +glándula I-EXPLORATION +suprarrenal I-EXPLORATION +derecha I-EXPLORATION +cuyo I-EXPLORATION +diámetro I-EXPLORATION +mayor I-EXPLORATION +es I-EXPLORATION +de I-EXPLORATION +2 I-EXPLORATION +cm. I-EXPLORATION +El I-EXPLORATION +tumor I-EXPLORATION +no I-EXPLORATION +está I-EXPLORATION +encapsulado I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +extiende I-EXPLORATION +fuera I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +glándula I-EXPLORATION +suprarrenal, I-EXPLORATION +sin I-EXPLORATION +afectar I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +órganos I-EXPLORATION +adyacentes. I-EXPLORATION +Existe I-EXPLORATION +necrosis I-EXPLORATION +tumoral I-EXPLORATION +extensa. I-EXPLORATION +La I-EXPLORATION +glándula I-EXPLORATION +suprarrenal I-EXPLORATION +no I-EXPLORATION +neoplásica I-EXPLORATION +no I-EXPLORATION +muestra I-EXPLORATION +anomalías. I-EXPLORATION +Los I-EXPLORATION +ganglios I-EXPLORATION +linfáticos I-EXPLORATION +estudiados I-EXPLORATION +no I-EXPLORATION +presentan I-EXPLORATION +tumor. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +parénquima I-EXPLORATION +hepático I-EXPLORATION +hay I-EXPLORATION +extensas I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +hemorragia I-EXPLORATION +centrolobulillar, I-EXPLORATION +con I-EXPLORATION +necrosis I-EXPLORATION +de I-EXPLORATION +hepatocitos I-EXPLORATION +sin I-EXPLORATION +observarse I-EXPLORATION +células I-EXPLORATION +tumorales I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +fragmentos I-EXPLORATION +estudiados I-EXPLORATION +del I-EXPLORATION +parénquima I-EXPLORATION +hepático. I-EXPLORATION +Trombo I-EXPLORATION +infrarrenal I-EXPLORATION +hemático, I-EXPLORATION +sin I-EXPLORATION +evidencia I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +tumorales. I-EXPLORATION + I-EXPLORATION +En B-EVOLUTION +la I-EVOLUTION +revisión I-EVOLUTION +realizada I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +2 I-EVOLUTION +meses, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION se I-EVOLUTION -mantiene I-EVOLUTION -sin I-EVOLUTION -angina I-EVOLUTION +encontraba I-EVOLUTION +asintomática, I-EVOLUTION +realizando I-EVOLUTION +vida I-EVOLUTION +activa I-EVOLUTION y I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION +la I-EVOLUTION +TC I-EVOLUTION +no I-EVOLUTION +mostró I-EVOLUTION +lesiones I-EVOLUTION +sugestivas I-EVOLUTION de I-EVOLUTION -HAAS. I-EVOLUTION +enfermedad I-EVOLUTION +tumoral. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -62 I-PRESENT_ILLNESS +59 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -(20 I-PAST_MEDICAL_HISTORY -paquetes/año) I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +tumoración I-PRESENT_ILLNESS +rectal I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hace I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -Endoscopia B-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -(EDA) I-EXPLORATION -demostró I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -estenosante I-EXPLORATION -del I-EXPLORATION -esófago I-EXPLORATION +que I-PRESENT_ILLNESS +nota I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +tacto I-PRESENT_ILLNESS +rectal I-PRESENT_ILLNESS +debido I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +estreñimiento I-PRESENT_ILLNESS +crónico I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +requería I-PRESENT_ILLNESS +alguna I-PRESENT_ILLNESS +digitalización. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +clínica I-EXPLORATION +y I-EXPLORATION +anuscopia-rectoscopia, I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION +nodular I-EXPLORATION +submucosa I-EXPLORATION +única I-EXPLORATION a I-EXPLORATION -30 I-EXPLORATION +3-4 I-EXPLORATION cm I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -arcada I-EXPLORATION -dentaria. I-EXPLORATION -Biopsia I-EXPLORATION -confirmó I-EXPLORATION -un I-EXPLORATION -carcinoma I-EXPLORATION -escamoso I-EXPLORATION -moderadamente I-EXPLORATION -diferenciado. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION +margen I-EXPLORATION +anal I-EXPLORATION de I-EXPLORATION -etapi-ficación I-EXPLORATION -con I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -(TAC) I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -infiltrante I-EXPLORATION -en I-EXPLORATION -tercio I-EXPLORATION -medio I-EXPLORATION -del I-EXPLORATION -esófago I-EXPLORATION +alrededor I-EXPLORATION de I-EXPLORATION -9 I-EXPLORATION +1 I-EXPLORATION cm I-EXPLORATION de I-EXPLORATION -largo, I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -cayado I-EXPLORATION -aórtico I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -nivel I-EXPLORATION +diámetro, I-EXPLORATION +móvil, I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -venas I-EXPLORATION -pulmonares I-EXPLORATION -derechas; I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION aspecto I-EXPLORATION -posterior I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -que I-EXPLORATION -rodeaba I-EXPLORATION -y I-EXPLORATION -aparentemente I-EXPLORATION -infiltraba I-EXPLORATION -la I-EXPLORATION -aorta I-EXPLORATION +amarillento I-EXPLORATION en I-EXPLORATION -más I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -50% I-EXPLORATION +la I-EXPLORATION +cara I-EXPLORATION +anterior I-EXPLORATION +rectal. I-EXPLORATION +Se B-TREATMENT +realiza I-TREATMENT +una I-TREATMENT +exéresis I-TREATMENT +local I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión, I-TREATMENT +respetando I-TREATMENT +la I-TREATMENT +muscular I-TREATMENT +al I-TREATMENT +no I-TREATMENT +estar I-TREATMENT +adherido I-TREATMENT +a I-TREATMENT +ella. I-TREATMENT +El B-EXPLORATION +informe I-EXPLORATION +anatomopatológico I-EXPLORATION +informa I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -circunferencia. I-EXPLORATION -Presentaba I-EXPLORATION -además I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -pulmonar I-EXPLORATION +tumor I-EXPLORATION +carcinoide I-EXPLORATION +rectal I-EXPLORATION de I-EXPLORATION -1 I-EXPLORATION -x I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION +1, I-EXPLORATION +2 I-EXPLORATION cm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -superior I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -hepático I-EXPLORATION de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -caudado, I-EXPLORATION -compatibles I-EXPLORATION +diámetro, I-EXPLORATION +bien I-EXPLORATION +diferenciado, I-EXPLORATION con I-EXPLORATION -localizaciones I-EXPLORATION -secundarias I-EXPLORATION -(T4NxM1). I-EXPLORATION -Considerando B-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -tenía I-TREATMENT -un I-TREATMENT -cáncer I-TREATMENT -metastásico, I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -paliativo I-TREATMENT -para I-TREATMENT -alivio I-TREATMENT -de I-TREATMENT -su I-TREATMENT -disfagia I-TREATMENT -con I-TREATMENT -QRT I-TREATMENT -concomitante I-TREATMENT -con I-TREATMENT -cisplatino I-TREATMENT -(radioterapia I-TREATMENT -51 I-TREATMENT -Gy I-TREATMENT -en I-TREATMENT -17 I-TREATMENT -fracciones I-TREATMENT -de I-TREATMENT -3 I-TREATMENT -Gy I-TREATMENT -y I-TREATMENT -cisplatino I-TREATMENT -40 I-TREATMENT -mg/ I-TREATMENT -m2 I-TREATMENT -semanales). I-TREATMENT - I-TREATMENT -Dos B-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -completado I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -consultó I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Urgencia I-EVOLUTION -por I-EVOLUTION -presentar I-EVOLUTION -hematemesis; I-EVOLUTION -al I-EVOLUTION -ingreso I-EVOLUTION -hipotenso I-EVOLUTION -y I-EVOLUTION -taquicárdico I-EVOLUTION -recuperando I-EVOLUTION -su I-EVOLUTION -hemodinamia I-EVOLUTION -mediante I-EVOLUTION -aporte I-EVOLUTION -de I-EVOLUTION -cristaloides. I-EVOLUTION -Hematocrito B-EXPLORATION -de I-EXPLORATION -21%. I-EXPLORATION -AngioTAC I-EXPLORATION -mostró I-EXPLORATION -reducción I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION +atipias, I-EXPLORATION +desarrollado I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -masa I-EXPLORATION -tumoral I-EXPLORATION -esofágica I-EXPLORATION -con I-EXPLORATION -componente I-EXPLORATION -necrótico I-EXPLORATION -central I-EXPLORATION -e I-EXPLORATION -infiltración I-EXPLORATION +submucosa. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -anterior I-EXPLORATION +invasión I-EXPLORATION +vascular, I-EXPLORATION +linfática I-EXPLORATION +o I-EXPLORATION +perineural. I-EXPLORATION +En I-EXPLORATION +superficie I-EXPLORATION +aparece I-EXPLORATION +cubierta I-EXPLORATION +por I-EXPLORATION +mucosa I-EXPLORATION +rectal I-EXPLORATION +bien I-EXPLORATION +diferenciada. I-EXPLORATION +En I-EXPLORATION +su I-EXPLORATION +base I-EXPLORATION +muestra I-EXPLORATION +escaso I-EXPLORATION +margen I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -aorta, I-EXPLORATION -sin I-EXPLORATION -evidencias I-EXPLORATION +seguridad I-EXPLORATION +afectando I-EXPLORATION +uno I-EXPLORATION de I-EXPLORATION -sangrado I-EXPLORATION -activo; I-EXPLORATION los I-EXPLORATION -hallazgos I-EXPLORATION -eran I-EXPLORATION -sugerentes I-EXPLORATION +bordes, I-EXPLORATION +si I-EXPLORATION +bien I-EXPLORATION +no I-EXPLORATION +muestra I-EXPLORATION +invasión I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -FAE. I-EXPLORATION -Fue B-TREATMENT -llevado I-TREATMENT -a I-TREATMENT -pabellón I-TREATMENT -donde I-TREATMENT +la I-EXPLORATION +muscular I-EXPLORATION +propia. I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT +este I-TREATMENT +hallazgo I-TREATMENT se I-TREATMENT -implantó I-TREATMENT -una I-TREATMENT -endoprótesis I-TREATMENT -Valiant I-TREATMENT -28 I-TREATMENT -x I-TREATMENT -15 I-TREATMENT -(Medtronic, I-TREATMENT -Minnesota, I-TREATMENT -Estados I-TREATMENT -Unidos I-TREATMENT -de I-TREATMENT -Norteamérica) I-TREATMENT -en I-TREATMENT -aorta I-TREATMENT -torácica I-TREATMENT -descendente I-TREATMENT -proximal, I-TREATMENT -distal I-TREATMENT +propone I-TREATMENT a I-TREATMENT la I-TREATMENT -arteria I-TREATMENT -subclavia I-TREATMENT -izquierda, I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -femoral I-TREATMENT -sin I-TREATMENT -incidentes. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -inició I-TREATMENT -cobertura I-TREATMENT -antibiótica I-TREATMENT -en I-TREATMENT -base I-TREATMENT -a I-TREATMENT -ce-ftriaxona I-TREATMENT +paciente I-TREATMENT +un I-TREATMENT +seguimiento I-TREATMENT +clínico I-TREATMENT y I-TREATMENT -clindamicina. I-TREATMENT -No B-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -presentar I-EVOLUTION -hemorragia I-EVOLUTION -digestiva, I-EVOLUTION -iniciando I-EVOLUTION -alimentación I-EVOLUTION -oral I-EVOLUTION -progresiva I-EVOLUTION -el I-EVOLUTION -4° I-EVOLUTION -día I-EVOLUTION -postoperatorio, I-EVOLUTION -bien I-EVOLUTION -tolerado I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION -de I-EVOLUTION -disfagia. I-EVOLUTION -Fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -8° I-EVOLUTION -día I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -tolerancia I-EVOLUTION -oral I-EVOLUTION -y I-EVOLUTION -afebril. I-EVOLUTION -Completó B-TREATMENT -14 I-TREATMENT -días I-TREATMENT +una I-TREATMENT +biopsia I-TREATMENT de I-TREATMENT -antibióticos I-TREATMENT -endovenosos I-TREATMENT -y I-TREATMENT -luego I-TREATMENT -continuó I-TREATMENT -con I-TREATMENT -amoxicilina/ácido I-TREATMENT -clavulánico I-TREATMENT -oral I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -amoxicilina I-TREATMENT +la I-TREATMENT +cicatriz I-TREATMENT +mucosa I-TREATMENT en I-TREATMENT -forma I-TREATMENT -indefinida. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -controles I-EVOLUTION -ambulatorios I-EVOLUTION -evolucionó I-EVOLUTION -adecuadamente, I-EVOLUTION -sin I-EVOLUTION -disfagia I-EVOLUTION -ni I-EVOLUTION -fiebre I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -aumento I-EVOLUTION -progresivo I-EVOLUTION -del I-EVOLUTION -peso I-EVOLUTION -de I-EVOLUTION -6 I-EVOLUTION -kg. I-EVOLUTION -AngioTAC I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -3 I-EVOLUTION -meses I-EVOLUTION -mostró I-EVOLUTION -adecuada I-EVOLUTION -posición I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -endoprótesis I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION -de I-EVOLUTION -fugas, I-EVOLUTION -pero I-EVOLUTION -con I-EVOLUTION -progresión I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -metástasis I-EVOLUTION -hepática I-EVOLUTION -conocida. I-EVOLUTION -Continuó I-EVOLUTION -con I-EVOLUTION -cuidados I-EVOLUTION -paliativos I-EVOLUTION -y I-EVOLUTION -evolucionó I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION -importantes I-EVOLUTION -hasta I-EVOLUTION -un I-EVOLUTION -control I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -11 I-EVOLUTION -meses I-EVOLUTION -post I-EVOLUTION -procedimiento I-EVOLUTION -en I-EVOLUTION -que I-EVOLUTION -refirió I-EVOLUTION -compromiso I-EVOLUTION -del I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -disfagia I-EVOLUTION -a I-EVOLUTION -sólidos I-EVOLUTION -y I-EVOLUTION -baja I-EVOLUTION -de I-EVOLUTION -peso I-EVOLUTION -de I-EVOLUTION -10 I-EVOLUTION -kilos. I-EVOLUTION -EDA B-EXPLORATION -demostró I-EXPLORATION -lesión I-EXPLORATION -esofágica I-EXPLORATION -estenosante I-EXPLORATION -desde I-EXPLORATION -los I-EXPLORATION -30 I-EXPLORATION -a I-EXPLORATION -35 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arcada I-EXPLORATION -dentaria I-EXPLORATION -con I-EXPLORATION -exposición I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -endoprótesis I-EXPLORATION -aórtica. I-EXPLORATION -Mantuvo B-EVOLUTION -manejo I-EVOLUTION -paliativo, I-EVOLUTION -falleciendo I-EVOLUTION -finalmente I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -13 I-EVOLUTION -meses I-EVOLUTION -post I-EVOLUTION -cirugía I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION -de I-EVOLUTION -sepsis I-EVOLUTION -ni I-EVOLUTION -nuevos I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -sangrado. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -14 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -previamente B-PAST_MEDICAL_HISTORY -sano, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -adenopatías I-PRESENT_ILLNESS -occipitales, I-PRESENT_ILLNESS -yugulares, I-PRESENT_ILLNESS -submandibulares I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -inguinales I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -sensibles, I-PRESENT_ILLNESS -asociadas I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -fatiga, I-PRESENT_ILLNESS -anorexia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -máculo-petequiales I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -dorso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -pies. I-PRESENT_ILLNESS -El B-EXPLORATION -hemograma I-EXPLORATION -mostraba I-EXPLORATION -3.400 I-EXPLORATION -leucocitos I-EXPLORATION -x I-EXPLORATION -mm3, I-EXPLORATION -46% I-EXPLORATION -de I-EXPLORATION -linfo I-EXPLORATION -citos I-EXPLORATION -y I-EXPLORATION -50% I-EXPLORATION -de I-EXPLORATION -neutro I-EXPLORATION -filos. I-EXPLORATION -La I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -(PCR) I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -sedimentación I-EXPLORATION -(VHS) I-EXPLORATION -fueron I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -2 I-EXPLORATION -mg/L I-EXPLORATION -y I-EXPLORATION -28 I-EXPLORATION -mm/h, I-EXPLORATION -respectivamente. I-EXPLORATION -El I-EXPLORATION -perfil I-EXPLORATION -hepático, I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION +tres I-TREATMENT +meses. I-TREATMENT +La B-EXPLORATION +exéresis I-EXPLORATION de I-EXPLORATION -coagulación I-EXPLORATION -y I-EXPLORATION la I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION +mucosa I-EXPLORATION +pericicatricial I-EXPLORATION no I-EXPLORATION -mostraron I-EXPLORATION -alteraciones. I-EXPLORATION +evidencia I-EXPLORATION +restos I-EXPLORATION +tumorales. I-EXPLORATION El I-EXPLORATION estudio I-EXPLORATION -complementario I-EXPLORATION -fue I-EXPLORATION -negativo: I-EXPLORATION -hemocultivos, I-EXPLORATION -urocultivo, I-EXPLORATION -coprocultivo, I-EXPLORATION -inmunofluorescencia I-EXPLORATION -directa I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -respiratorios, I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -Epstein-Barr I-EXPLORATION -(VEB), I-EXPLORATION -Bartonella I-EXPLORATION -hensenlae, I-EXPLORATION -parvovirus I-EXPLORATION -B-19, I-EXPLORATION -citomegalovirus I-EXPLORATION -(CMV), I-EXPLORATION -Toxoplasma I-EXPLORATION -gondii I-EXPLORATION -y I-EXPLORATION -ELISA I-EXPLORATION -para I-EXPLORATION -VIH. I-EXPLORATION -No I-EXPLORATION -hubo I-EXPLORATION -hallazgos I-EXPLORATION -significativos I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -(TAC) I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -eco I-EXPLORATION -cardiografía I-EXPLORATION -transtorácica. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -cervical I-EXPLORATION -mostró I-EXPLORATION -adenopatías I-EXPLORATION -bilaterales, I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -triángulos I-EXPLORATION -cervicales I-EXPLORATION -anteriores I-EXPLORATION -y I-EXPLORATION -posteriores, I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -inespecífico. I-EXPLORATION - I-EXPLORATION -Durante B-EVOLUTION -la I-EVOLUTION -hospitalización I-EVOLUTION -apareció I-EVOLUTION -un I-EVOLUTION -exantema I-EVOLUTION -máculo-papular I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -región I-EVOLUTION -malar, I-EVOLUTION -tronco I-EVOLUTION -y I-EVOLUTION -extremidades I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -artralgias. I-EVOLUTION -Los B-EXPLORATION -anticuerpos I-EXPLORATION -anti-nucleares I-EXPLORATION -(ANA) I-EXPLORATION -y I-EXPLORATION -anti-DNA I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -anticuerpos I-EXPLORATION -anti-antígenos I-EXPLORATION -nucleares I-EXPLORATION -extraíbles I-EXPLORATION -(ENA) I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -factor I-EXPLORATION -reumatoide I-EXPLORATION -(FR) I-EXPLORATION -no I-EXPLORATION -presentaron I-EXPLORATION -alteraciones. I-EXPLORATION -Los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -complemento I-EXPLORATION -C3 I-EXPLORATION -y I-EXPLORATION -C4 I-EXPLORATION -fueron I-EXPLORATION -de I-EXPLORATION -131 I-EXPLORATION -mg/dL I-EXPLORATION -y I-EXPLORATION -45 I-EXPLORATION -mg/dL I-EXPLORATION -respectivamente. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -adenopatía I-EXPLORATION -cervical I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION -distorsión I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arquitectura, I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -necrosis I-EXPLORATION -fibrinoide I-EXPLORATION -y I-EXPLORATION -restos I-EXPLORATION -apoptóticos I-EXPLORATION -rodeados I-EXPLORATION -de I-EXPLORATION -abundantes I-EXPLORATION -histiocitos, I-EXPLORATION -compatible I-EXPLORATION +se I-EXPLORATION +completó I-EXPLORATION con I-EXPLORATION -linfadenitis I-EXPLORATION -necrotizante I-EXPLORATION -histiocitaria. I-EXPLORATION -El B-EVOLUTION -cuadro I-EVOLUTION -se I-EVOLUTION -resolvió I-EVOLUTION -espontáneamente I-EVOLUTION -en I-EVOLUTION -1 I-EVOLUTION -mes I-EVOLUTION -y I-EVOLUTION -tras I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION +una I-EXPLORATION +colonoscopia I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +evidenció I-EXPLORATION +otros I-EXPLORATION +tumores. I-EXPLORATION +Tras B-EVOLUTION +21 I-EVOLUTION +meses I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +está I-EVOLUTION +libre I-EVOLUTION de I-EVOLUTION -seguimiento I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -recurrencias. I-EVOLUTION +enfermedad. I-EVOLUTION I-EVOLUTION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY +37 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +procedente B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -poliartralgias I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -crónico I-PAST_MEDICAL_HISTORY -activo. I-PAST_MEDICAL_HISTORY -Refiere B-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -persistente, I-PRESENT_ILLNESS -sudo-ración I-PRESENT_ILLNESS -nocturna, I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -poliartralgias I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -extremidades I-PRESENT_ILLNESS -inferiores I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -cervical I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -sensible. I-PRESENT_ILLNESS -Relata B-PAST_MEDICAL_HISTORY +Puerto I-PAST_MEDICAL_HISTORY +Aisén, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY antecedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -hermana I-PAST_MEDICAL_HISTORY +tiroidectomía I-PAST_MEDICAL_HISTORY +realizada I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +18 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +edad, I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +causa I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +bocio I-PAST_MEDICAL_HISTORY +difuso I-PAST_MEDICAL_HISTORY +hipertiroideo. I-PAST_MEDICAL_HISTORY +Como I-PAST_MEDICAL_HISTORY +consecuencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +cirugía, I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +desarrolló I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +hipoparatiroidismo I-PAST_MEDICAL_HISTORY +definitivo. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +indicó I-PAST_MEDICAL_HISTORY +suplemento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +calcio I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +vitamina I-PAST_MEDICAL_HISTORY +D, I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +cumplió I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +muy I-PAST_MEDICAL_HISTORY +irregular I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +controles I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +laboratorio. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Quince I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +tarde, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +1999, I-PAST_MEDICAL_HISTORY +consultó I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +nuestro I-PAST_MEDICAL_HISTORY +hospital I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +calambres, I-PAST_MEDICAL_HISTORY +parestesias I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +espasmos I-PAST_MEDICAL_HISTORY +faciales, I-PAST_MEDICAL_HISTORY +además I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +signos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Chvostek I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +Trousseau I-PAST_MEDICAL_HISTORY +manifiestos. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +reinició I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -EKF I-PAST_MEDICAL_HISTORY +calcio I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -contacto I-PAST_MEDICAL_HISTORY -directo I-PAST_MEDICAL_HISTORY +vitamina I-PAST_MEDICAL_HISTORY +D I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +solicitó I-PAST_MEDICAL_HISTORY +exámenes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +calcemia, I-PAST_MEDICAL_HISTORY +T4 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +TSH. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +regresó I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +control. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Reapareció I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +noviembre I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2003, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +tratamiento. I-PAST_MEDICAL_HISTORY +Presentaba I-PAST_MEDICAL_HISTORY +marcado I-PAST_MEDICAL_HISTORY +compromiso I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +estado I-PAST_MEDICAL_HISTORY +general, I-PAST_MEDICAL_HISTORY +astenia, I-PAST_MEDICAL_HISTORY +debilidad I-PAST_MEDICAL_HISTORY +muscular, I-PAST_MEDICAL_HISTORY +calambres, I-PAST_MEDICAL_HISTORY +parestesias I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +cefalea. I-PAST_MEDICAL_HISTORY +Sus I-PAST_MEDICAL_HISTORY +menstruaciones I-PAST_MEDICAL_HISTORY +eran I-PAST_MEDICAL_HISTORY +abundantes. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +examen I-PAST_MEDICAL_HISTORY +físico I-PAST_MEDICAL_HISTORY +destacaban I-PAST_MEDICAL_HISTORY +facies I-PAST_MEDICAL_HISTORY +hipotiroidea, I-PAST_MEDICAL_HISTORY +cicatriz I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +tiroidectomía, I-PAST_MEDICAL_HISTORY +pulso I-PAST_MEDICAL_HISTORY +regular I-PAST_MEDICAL_HISTORY +70x', I-PAST_MEDICAL_HISTORY +presión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +110/70 I-PAST_MEDICAL_HISTORY +mmHg, I-PAST_MEDICAL_HISTORY +palidez I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +signos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Chvostek I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +Trousseau; I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +examen I-PAST_MEDICAL_HISTORY +cardiopulmonar I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +abdominal I-PAST_MEDICAL_HISTORY +eran I-PAST_MEDICAL_HISTORY +normales. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Sus I-PAST_MEDICAL_HISTORY +exámenes I-PAST_MEDICAL_HISTORY +revelaron: I-PAST_MEDICAL_HISTORY +calcemia I-PAST_MEDICAL_HISTORY +7, I-PAST_MEDICAL_HISTORY +98 I-PAST_MEDICAL_HISTORY +mg/dL I-PAST_MEDICAL_HISTORY +(probable I-PAST_MEDICAL_HISTORY +error I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +laboratorio, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +discordancia I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -gato. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias, I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -realizaron I-PRESENT_ILLNESS -ecografía I-PRESENT_ILLNESS -cervical I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -mostraba I-PRESENT_ILLNESS -múltiples I-PRESENT_ILLNESS -linfonodos I-PRESENT_ILLNESS -cervicales I-PRESENT_ILLNESS +la I-PAST_MEDICAL_HISTORY +clínica I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +calcemias I-PAST_MEDICAL_HISTORY +posteriores), I-PAST_MEDICAL_HISTORY +fosfemia I-PAST_MEDICAL_HISTORY +6, I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +mg/dL, I-PAST_MEDICAL_HISTORY +BUN I-PAST_MEDICAL_HISTORY +14 I-PAST_MEDICAL_HISTORY +mg/dL, I-PAST_MEDICAL_HISTORY +proteína I-PAST_MEDICAL_HISTORY +total I-PAST_MEDICAL_HISTORY +6, I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +g/dL, I-PAST_MEDICAL_HISTORY +albuminemia I-PAST_MEDICAL_HISTORY +3, I-PAST_MEDICAL_HISTORY +7 I-PAST_MEDICAL_HISTORY +g/dL, I-PAST_MEDICAL_HISTORY +hematocrito I-PAST_MEDICAL_HISTORY +27%, I-PAST_MEDICAL_HISTORY +hemoglobina I-PAST_MEDICAL_HISTORY +6, I-PAST_MEDICAL_HISTORY +7 I-PAST_MEDICAL_HISTORY +g/dL, I-PAST_MEDICAL_HISTORY +microcitosis I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hipocromía, I-PAST_MEDICAL_HISTORY +TSH I-PAST_MEDICAL_HISTORY +9, I-PAST_MEDICAL_HISTORY +7 I-PAST_MEDICAL_HISTORY +µU/ml I-PAST_MEDICAL_HISTORY +(vn: I-PAST_MEDICAL_HISTORY +0, I-PAST_MEDICAL_HISTORY +4-4, I-PAST_MEDICAL_HISTORY +8). I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Con I-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hipoparatiroidismo I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hipotiroidismo I-PAST_MEDICAL_HISTORY +postiroidectomía I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +anemia I-PAST_MEDICAL_HISTORY +ferropriva, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +indicó I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +Elcal I-PAST_MEDICAL_HISTORY +D I-PAST_MEDICAL_HISTORY +Forte® I-PAST_MEDICAL_HISTORY +(carbonato I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +calcio I-PAST_MEDICAL_HISTORY +1.125 I-PAST_MEDICAL_HISTORY +mg I-PAST_MEDICAL_HISTORY ++ I-PAST_MEDICAL_HISTORY +vitamina I-PAST_MEDICAL_HISTORY +D I-PAST_MEDICAL_HISTORY +175 I-PAST_MEDICAL_HISTORY +UI) I-PAST_MEDICAL_HISTORY +1, I-PAST_MEDICAL_HISTORY +Elcal® I-PAST_MEDICAL_HISTORY +(carbonato I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +calcio I-PAST_MEDICAL_HISTORY +800 I-PAST_MEDICAL_HISTORY +mg) I-PAST_MEDICAL_HISTORY +1, I-PAST_MEDICAL_HISTORY +levotiroxina I-PAST_MEDICAL_HISTORY +50 I-PAST_MEDICAL_HISTORY +µg I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sulfato I-PAST_MEDICAL_HISTORY +ferroso I-PAST_MEDICAL_HISTORY +400 I-PAST_MEDICAL_HISTORY +mg/día. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Dos B-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +después, I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +disnea I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS -Le B-TREATMENT -indicaron I-TREATMENT -amoxicilina-ácido I-TREATMENT -clavulánico I-TREATMENT -durante I-TREATMENT -5 I-TREATMENT -días I-TREATMENT -sin I-TREATMENT -mejoría I-TREATMENT -clínica I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -hospitalizó. I-TREATMENT +mínimos I-PRESENT_ILLNESS +esfuerzos, I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +epigástrico, I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +edema I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +rápida I-PRESENT_ILLNESS +progresión. I-PRESENT_ILLNESS En B-EXPLORATION el I-EXPLORATION examen I-EXPLORATION físico I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -adenopatía I-EXPLORATION -cervical I-EXPLORATION -derecha I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -6 I-EXPLORATION -cm, I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +afebril, I-EXPLORATION +con I-EXPLORATION +frecuencia I-EXPLORATION +cardíaca I-EXPLORATION +70x' I-EXPLORATION +regular, I-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION +100/70 I-EXPLORATION +mmHg, I-EXPLORATION +ortopnea, I-EXPLORATION +edema I-EXPLORATION +generalizado, I-EXPLORATION +ingurgitación I-EXPLORATION +yugular, I-EXPLORATION +estertores I-EXPLORATION +pulmonares, I-EXPLORATION +ruidos I-EXPLORATION +cardíacos I-EXPLORATION +apagados, I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +auscultaron I-EXPLORATION +soplos, I-EXPLORATION +hepatomegalia I-EXPLORATION sensible I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -visceromegalia. I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION -mostró I-EXPLORATION -VHS I-EXPLORATION +4 I-EXPLORATION +cm I-EXPLORATION +bajo I-EXPLORATION +el I-EXPLORATION +reborde I-EXPLORATION +costal. I-EXPLORATION +No I-EXPLORATION +presentaba I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -56 I-EXPLORATION -mm/h I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -PCR I-EXPLORATION -y I-EXPLORATION -ferritina I-EXPLORATION -fueron I-EXPLORATION +trombosis I-EXPLORATION +venosa I-EXPLORATION +profunda. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +indicó I-EXPLORATION +hospitalización. I-EXPLORATION +En I-EXPLORATION +sus I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -77 I-EXPLORATION -mg/L I-EXPLORATION -y I-EXPLORATION -1.789 I-EXPLORATION -ng/mL I-EXPLORATION -respectivamente. I-EXPLORATION -El I-EXPLORATION -TAC I-EXPLORATION +ingreso I-EXPLORATION +destacaba: I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -cuello, I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION +tórax: I-EXPLORATION +cardiomegalia I-EXPLORATION y I-EXPLORATION -pelvis, I-EXPLORATION -además I-EXPLORATION +congestión I-EXPLORATION +pulmonar. I-EXPLORATION +ECG: I-EXPLORATION +ritmo I-EXPLORATION +sinusal, I-EXPLORATION +83x', I-EXPLORATION +bajo I-EXPLORATION +voltaje I-EXPLORATION +generalizado, I-EXPLORATION +intervalo I-EXPLORATION +QT I-EXPLORATION +prolongado I-EXPLORATION +y I-EXPLORATION +alteraciones I-EXPLORATION +inespecíficas I-EXPLORATION de I-EXPLORATION -constatar I-EXPLORATION -adenopatías I-EXPLORATION -cervicales I-EXPLORATION +la I-EXPLORATION +repolarización I-EXPLORATION +ventricular. I-EXPLORATION +Ecocardiograma: I-EXPLORATION +marcada I-EXPLORATION +dilatación, I-EXPLORATION +disfunción I-EXPLORATION +sistólica I-EXPLORATION y I-EXPLORATION -mediastínicas, I-EXPLORATION -reveló I-EXPLORATION -opacidades I-EXPLORATION -pulmonares I-EXPLORATION -en I-EXPLORATION -vidrio I-EXPLORATION -esmerilado. I-EXPLORATION -Paralelamente, I-EXPLORATION -se I-EXPLORATION -descartó I-EXPLORATION -infección I-EXPLORATION -por I-EXPLORATION -VIH, I-EXPLORATION -VEB, I-EXPLORATION -CMV, I-EXPLORATION -virus I-EXPLORATION -hepatitis I-EXPLORATION -B I-EXPLORATION +disfunción I-EXPLORATION +diastólica I-EXPLORATION +de I-EXPLORATION +tipo I-EXPLORATION +restrictivo I-EXPLORATION +del I-EXPLORATION +ventrículo I-EXPLORATION +izquierdo, I-EXPLORATION +severa I-EXPLORATION +insuficiencia I-EXPLORATION +mitral I-EXPLORATION y I-EXPLORATION -C, I-EXPLORATION -sífilis I-EXPLORATION +tricuspídea, I-EXPLORATION +hipertensión I-EXPLORATION +pulmonar I-EXPLORATION +sistólica I-EXPLORATION +moderada, I-EXPLORATION +derrame I-EXPLORATION +pericárdico I-EXPLORATION +moderado I-EXPLORATION y I-EXPLORATION -Toxoplasma I-EXPLORATION -gondii. I-EXPLORATION -La I-EXPLORATION -IgM I-EXPLORATION -para I-EXPLORATION -Bartonella I-EXPLORATION -hensenlae I-EXPLORATION -fue I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +aurícula I-EXPLORATION +izquierda. I-EXPLORATION +Ecotomografía I-EXPLORATION +abdominal: I-EXPLORATION +hepatomegalia I-EXPLORATION +congestiva. I-EXPLORATION +Endoscopia I-EXPLORATION +digestiva I-EXPLORATION +alta: I-EXPLORATION +gastritis I-EXPLORATION +hiperémica. I-EXPLORATION +Calcemia I-EXPLORATION +2, I-EXPLORATION +9 I-EXPLORATION +mg/dL, I-EXPLORATION +parathormona I-EXPLORATION +5, I-EXPLORATION +9 I-EXPLORATION +ng/l I-EXPLORATION +(vn: I-EXPLORATION +10-73), I-EXPLORATION +magnesio I-EXPLORATION +1, I-EXPLORATION +08 I-EXPLORATION +mEq/l I-EXPLORATION +(vn: I-EXPLORATION +1, I-EXPLORATION +4-2, I-EXPLORATION +1), I-EXPLORATION +albúmina I-EXPLORATION +3, I-EXPLORATION +3 I-EXPLORATION +g/dL, I-EXPLORATION +sodio I-EXPLORATION +140 I-EXPLORATION +mEq/l, I-EXPLORATION +potasio I-EXPLORATION +2, I-EXPLORATION +3 I-EXPLORATION +mEq/l, I-EXPLORATION +hematocrito I-EXPLORATION +26%, I-EXPLORATION +hemoglobina I-EXPLORATION +7, I-EXPLORATION +4 I-EXPLORATION +g/dL, I-EXPLORATION +proteinuria I-EXPLORATION +de I-EXPLORATION +24 I-EXPLORATION +h: I-EXPLORATION negativa, I-EXPLORATION -mientras I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -IgG I-EXPLORATION -resultó I-EXPLORATION -positiva I-EXPLORATION -(1/64). I-EXPLORATION -Se I-EXPLORATION -indicó I-EXPLORATION -azitromicina I-EXPLORATION -lg I-EXPLORATION -al I-EXPLORATION -día I-EXPLORATION -durante I-EXPLORATION -6 I-EXPLORATION -días, I-EXPLORATION -sin I-EXPLORATION -respuesta. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunológico I-EXPLORATION -fue I-EXPLORATION -prácticamente I-EXPLORATION -normal, I-EXPLORATION -solamente I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -ANA I-EXPLORATION -positivo I-EXPLORATION -a I-EXPLORATION -título I-EXPLORATION -bajo I-EXPLORATION -(1/40). I-EXPLORATION +bilirrubinemia I-EXPLORATION +total I-EXPLORATION +1, I-EXPLORATION +3 I-EXPLORATION +mg/dL, I-EXPLORATION +transaminasas I-EXPLORATION +glutámico I-EXPLORATION +oxalacéticas I-EXPLORATION +63 I-EXPLORATION +U/l I-EXPLORATION +(vn: I-EXPLORATION +<35), I-EXPLORATION +creatinfosfokinasa I-EXPLORATION +total I-EXPLORATION +1.260 I-EXPLORATION +U/l I-EXPLORATION +(vn: I-EXPLORATION +<70) I-EXPLORATION +(fracción I-EXPLORATION +miocárdica I-EXPLORATION +3%), I-EXPLORATION +TSH I-EXPLORATION +18, I-EXPLORATION +1 I-EXPLORATION +µU/ml. I-EXPLORATION + I-EXPLORATION Se I-EXPLORATION -decidió I-EXPLORATION -realizar I-EXPLORATION -biopsia I-EXPLORATION +planteó I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -adenopatía I-EXPLORATION -cervical. I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -para I-EXPLORATION -hongos I-EXPLORATION +insuficiencia I-EXPLORATION +cardíaca I-EXPLORATION +congestiva I-EXPLORATION +secundaria I-EXPLORATION +a I-EXPLORATION +hipocalcemia I-EXPLORATION +severa, I-EXPLORATION +descompensada I-EXPLORATION +por I-EXPLORATION +sustitución I-EXPLORATION +con I-EXPLORATION +hormona I-EXPLORATION +tiroidea I-EXPLORATION y I-EXPLORATION -bacterias I-EXPLORATION -resultaron I-EXPLORATION -negativos, I-EXPLORATION -mientras I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -reveló I-EXPLORATION -linfadenitis I-EXPLORATION -necrotizante I-EXPLORATION -histiocitaria. I-EXPLORATION +agravada I-EXPLORATION +por I-EXPLORATION +anemia I-EXPLORATION +ferropriva. I-EXPLORATION + I-EXPLORATION Se B-TREATMENT -inició I-TREATMENT -prednisona I-TREATMENT -30 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día I-TREATMENT -durante I-TREATMENT -tres I-TREATMENT -semanas I-TREATMENT +trató I-TREATMENT con I-TREATMENT -disminución I-TREATMENT -progresiva I-TREATMENT +gluconato I-TREATMENT de I-TREATMENT -las I-TREATMENT -dosis I-TREATMENT -completando I-TREATMENT -45 I-TREATMENT -días I-TREATMENT +calcio I-TREATMENT +1 I-TREATMENT +g I-TREATMENT +iv I-TREATMENT +c/12 I-TREATMENT +h, I-TREATMENT +carbonato I-TREATMENT de I-TREATMENT -terapia. I-TREATMENT -Los B-EVOLUTION -síntomas I-EVOLUTION -desaparecen I-EVOLUTION -a I-EVOLUTION +calcio I-TREATMENT +2 I-TREATMENT +g I-TREATMENT +vo, I-TREATMENT +vitamina I-TREATMENT +D I-TREATMENT +175 I-TREATMENT +µ/día, I-TREATMENT +vitamina I-TREATMENT +D I-TREATMENT +300.000 I-TREATMENT +UI I-TREATMENT +por I-TREATMENT +una I-TREATMENT +vez, I-TREATMENT +l-tiroxina I-TREATMENT +100 I-TREATMENT +µg, I-TREATMENT +sulfato I-TREATMENT +ferroso I-TREATMENT +400 I-TREATMENT +mg, I-TREATMENT +furosemida I-TREATMENT +40 I-TREATMENT +mg, I-TREATMENT +cloruro I-TREATMENT +de I-TREATMENT +potasio I-TREATMENT +1, I-TREATMENT +8 I-TREATMENT +g, I-TREATMENT +captopril I-TREATMENT +12, I-TREATMENT +5 I-TREATMENT +mg I-TREATMENT +y I-TREATMENT +digoxina I-TREATMENT +0, I-TREATMENT +125 I-TREATMENT +mg/día. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente, I-EVOLUTION +con I-EVOLUTION +diuresis I-EVOLUTION +intensa I-EVOLUTION +y I-EVOLUTION +mejoría I-EVOLUTION +de I-EVOLUTION las I-EVOLUTION -48 I-EVOLUTION -h I-EVOLUTION +manifestaciones I-EVOLUTION de I-EVOLUTION -tratamiento. I-EVOLUTION -Dos B-EXPLORATION -meses I-EXPLORATION +insuficiencia I-EVOLUTION +cardíaca, I-EVOLUTION +desaparición I-EVOLUTION +del I-EVOLUTION +edema I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +hepatomegalia. I-EVOLUTION +Diez B-EXPLORATION +días I-EXPLORATION después I-EXPLORATION -asiste I-EXPLORATION -a I-EXPLORATION -control I-EXPLORATION -con I-EXPLORATION -TAC I-EXPLORATION +tenía I-EXPLORATION +calcemia I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -que I-EXPLORATION -informó I-EXPLORATION -aumento I-EXPLORATION +6 I-EXPLORATION +mg/dL, I-EXPLORATION +hematocrito I-EXPLORATION de I-EXPLORATION -imágenes I-EXPLORATION -en I-EXPLORATION -vidrio I-EXPLORATION -esmerilado. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -pulmonar I-EXPLORATION -revelando I-EXPLORATION -hallazgos I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -neumonía I-EXPLORATION -intersticial I-EXPLORATION -usual I-EXPLORATION +37% I-EXPLORATION +y I-EXPLORATION en I-EXPLORATION -fase I-EXPLORATION -tardía. I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -sintoma-tología I-EVOLUTION -respiratoria I-EVOLUTION -ni I-EVOLUTION -alteraciones I-EVOLUTION -significativas I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -pruebas I-EVOLUTION -de I-EVOLUTION -función I-EVOLUTION -pulmonar. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -que B-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -con I-EXPLORATION -TAC I-EXPLORATION -mostró I-EXPLORATION -tumor I-EXPLORATION -ovárico I-EXPLORATION -derecho I-EXPLORATION +ecocardiograma I-EXPLORATION de I-EXPLORATION -13 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -ascitis. I-EXPLORATION -Resto I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -Cal25 I-EXPLORATION -= I-EXPLORATION -2.526 I-EXPLORATION -(U/ml). I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -cirugía I-TREATMENT -oncoló I-TREATMENT -gica. I-TREATMENT -Cal25 B-EXPLORATION -post-operatorio I-EXPLORATION -174 I-EXPLORATION -(U/ml). I-EXPLORATION -Biopsia I-EXPLORATION -mostró I-EXPLORATION -adenocarcinoma I-EXPLORATION -endometrioide I-EXPLORATION -Grado I-EXPLORATION -3. I-EXPLORATION -Etapificada I-EXPLORATION -como I-EXPLORATION -IC, I-EXPLORATION +control, I-EXPLORATION se I-EXPLORATION -tomó I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -ascitis I-EXPLORATION -para I-EXPLORATION -block I-EXPLORATION -celular I-EXPLORATION +observó I-EXPLORATION +reducción I-EXPLORATION +del I-EXPLORATION +grado I-EXPLORATION +del I-EXPLORATION +reflujo I-EXPLORATION +mitral I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -cultivó I-EXPLORATION -para I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -QS I-EXPLORATION -in I-EXPLORATION -vitro. I-EXPLORATION -Se B-TREATMENT -administró I-TREATMENT -QMT I-TREATMENT -de I-TREATMENT -carboplatino-paclitaxel, I-TREATMENT -con I-TREATMENT -normalización I-TREATMENT -del I-TREATMENT -Cal25. I-TREATMENT -El B-EVOLUTION -seguimiento I-EVOLUTION -a I-EVOLUTION -tres I-EVOLUTION -años I-EVOLUTION -fue I-EVOLUTION -normal. I-EVOLUTION -Estudio B-EXPLORATION -in I-EXPLORATION -vitro I-EXPLORATION -mostró I-EXPLORATION -nivel I-EXPLORATION +tricuspídeo, I-EXPLORATION +disminución I-EXPLORATION de I-EXPLORATION -citotoxicidad I-EXPLORATION -al I-EXPLORATION -esquema I-EXPLORATION -carboplatino-paclitaxel I-EXPLORATION -mayor I-EXPLORATION -al I-EXPLORATION -70%, I-EXPLORATION -correlacionándose I-EXPLORATION -con I-EXPLORATION la I-EXPLORATION -respuesta I-EXPLORATION -clínica. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -62 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -tratamiento, I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -(IMC I-PAST_MEDICAL_HISTORY -32) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -suspendido. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -distensión I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -persistentes I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -9 I-PRESENT_ILLNESS -kilos I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -ese I-PRESENT_ILLNESS -período. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -hubo I-PRESENT_ILLNESS -evidencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hemorragia I-PRESENT_ILLNESS -gastrointestinal I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -anemia. I-PRESENT_ILLNESS - B-EXPLORATION -La I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -reveló I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -gástrico I-EXPLORATION -submucoso, I-EXPLORATION -localizado I-EXPLORATION -en I-EXPLORATION -antro I-EXPLORATION -en I-EXPLORATION +presión I-EXPLORATION +sistólica I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -curvatura I-EXPLORATION -menor I-EXPLORATION +arteria I-EXPLORATION +pulmonar I-EXPLORATION +de I-EXPLORATION +50 I-EXPLORATION +a I-EXPLORATION +33 I-EXPLORATION +mmHg I-EXPLORATION +(vn: I-EXPLORATION +15-30) I-EXPLORATION y I-EXPLORATION -que I-EXPLORATION -ocupaba I-EXPLORATION -una I-EXPLORATION -importante I-EXPLORATION -parte I-EXPLORATION del I-EXPLORATION -lumen I-EXPLORATION -antral. I-EXPLORATION -La I-EXPLORATION -mucosa, I-EXPLORATION -examinada I-EXPLORATION -por I-EXPLORATION -endoscopia, I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -normal, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION +derrame I-EXPLORATION +pericárdico. I-EXPLORATION +En B-EVOLUTION +controles I-EVOLUTION +posteriores, I-EVOLUTION +hasta I-EVOLUTION +los I-EVOLUTION +18 I-EVOLUTION +meses, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +cumplía I-EVOLUTION +rigurosamente I-EVOLUTION +el I-EVOLUTION +tratamiento, I-EVOLUTION +sólo I-EVOLUTION +presentaba I-EVOLUTION +disnea I-EVOLUTION +a I-EVOLUTION +esfuerzos I-EVOLUTION +medianos I-EVOLUTION +a I-EVOLUTION +mayores, I-EVOLUTION +su B-EXPLORATION +calcemia I-EXPLORATION se I-EXPLORATION -tomaron I-EXPLORATION -biopsias. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -gástrica I-EXPLORATION -homogénea, I-EXPLORATION -hiperecogénica I-EXPLORATION +mantenía I-EXPLORATION +entre I-EXPLORATION +8 I-EXPLORATION y I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -definidos. I-EXPLORATION -El I-EXPLORATION -estudió I-EXPLORATION +8, I-EXPLORATION +5 I-EXPLORATION +mg/dL I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +seguimiento I-EXPLORATION +ecocardiográfico, I-EXPLORATION se I-EXPLORATION -completó I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -con I-EXPLORATION -densidad I-EXPLORATION -grasa, I-EXPLORATION -de I-EXPLORATION -11 I-EXPLORATION -x I-EXPLORATION -6 I-EXPLORATION -cm, I-EXPLORATION -ocupando I-EXPLORATION +observó, I-EXPLORATION +además, I-EXPLORATION una I-EXPLORATION -parte I-EXPLORATION -importante I-EXPLORATION -del I-EXPLORATION -lumen I-EXPLORATION -antral I-EXPLORATION -gástrico, I-EXPLORATION -con I-EXPLORATION -baja I-EXPLORATION -captura I-EXPLORATION +recuperación I-EXPLORATION de I-EXPLORATION -contraste. I-EXPLORATION -La I-EXPLORATION -lesión I-EXPLORATION -fue I-EXPLORATION -sospechosa I-EXPLORATION +la I-EXPLORATION +marcada I-EXPLORATION +disfunción I-EXPLORATION +diastólica I-EXPLORATION +inicial I-EXPLORATION +-evaluada I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +índice I-EXPLORATION +E/A: I-EXPLORATION +relación I-EXPLORATION +entre I-EXPLORATION +fase I-EXPLORATION de I-EXPLORATION -GIST I-EXPLORATION -con I-EXPLORATION -diferenciación I-EXPLORATION -lipomatosa I-EXPLORATION -o I-EXPLORATION -un I-EXPLORATION -lipoma I-EXPLORATION -gástrico. I-EXPLORATION -La I-EXPLORATION -resección I-EXPLORATION -quirúrgica I-EXPLORATION -fue I-EXPLORATION -recomendada. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -gastrectomía I-TREATMENT -subtotal I-TREATMENT -distal I-TREATMENT -laparoscópica. I-TREATMENT -Se I-TREATMENT -utilizaron I-TREATMENT -5 I-TREATMENT -trocares; I-TREATMENT -supraumbilical I-TREATMENT -de I-TREATMENT -12 I-TREATMENT -mm I-TREATMENT -para I-TREATMENT -el I-TREATMENT -laparoscopio, I-TREATMENT -subxifoideo I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -mm I-TREATMENT -para I-TREATMENT -separación I-TREATMENT -hepática I-TREATMENT -y I-TREATMENT -trocares I-TREATMENT -subcostal I-TREATMENT -izquierdo I-TREATMENT -de I-TREATMENT -12 I-TREATMENT -mm, I-TREATMENT -flanco I-TREATMENT -derecho I-TREATMENT -de I-TREATMENT -12 I-TREATMENT -mm I-TREATMENT -y I-TREATMENT -flanco I-TREATMENT -izquierdo I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -mm. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -intraoperatorio, I-TREATMENT -se I-TREATMENT -confirmó I-TREATMENT -una I-TREATMENT -gran I-TREATMENT -masa I-TREATMENT -antral I-TREATMENT -sin I-TREATMENT -compromiso I-TREATMENT -de I-TREATMENT -la I-TREATMENT -serosa. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -endoscopia I-TREATMENT -intraoperatoria I-TREATMENT -para I-TREATMENT -definir I-TREATMENT -el I-TREATMENT -margen I-TREATMENT -proximal I-TREATMENT -de I-TREATMENT -resección. I-TREATMENT -Se I-TREATMENT -seccionó I-TREATMENT -el I-TREATMENT -duodeno I-TREATMENT -y I-TREATMENT -el I-TREATMENT -estómago I-TREATMENT -con I-TREATMENT -cargas I-TREATMENT -lineares I-TREATMENT -de I-TREATMENT -60 I-TREATMENT -mm I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -linfadenectomía I-TREATMENT -D1. I-TREATMENT -La I-TREATMENT -pieza I-TREATMENT -fue I-TREATMENT -extraída I-TREATMENT -por I-TREATMENT -una I-TREATMENT -incisión I-TREATMENT -Pfannenstiel I-TREATMENT -y I-TREATMENT -los I-TREATMENT -márgenes I-TREATMENT -negativos I-TREATMENT -fueron I-TREATMENT -confirmados I-TREATMENT -por I-TREATMENT -biopsia I-TREATMENT -rápida. I-TREATMENT -Se I-TREATMENT -reconstruyó I-TREATMENT -el I-TREATMENT -tránsito I-TREATMENT -con I-TREATMENT -una I-TREATMENT -Y I-TREATMENT -de I-TREATMENT -Roux I-TREATMENT -de I-TREATMENT -50 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -largo, I-TREATMENT -realizando I-TREATMENT -la I-TREATMENT -anastomosis I-TREATMENT -gastro-yeyunal I-TREATMENT -y I-TREATMENT -yeyuno-yeyunal I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -mecánica I-TREATMENT -e I-TREATMENT -intracorpórea. I-TREATMENT -El B-EVOLUTION -tiempo I-EVOLUTION -operatorio I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -5 I-EVOLUTION -h I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -sangrado I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -200 I-EVOLUTION -cc. I-EVOLUTION - I-EVOLUTION -La I-EVOLUTION -recuperación I-EVOLUTION -post I-EVOLUTION -operatoria I-EVOLUTION -fue I-EVOLUTION -sin I-EVOLUTION -incidentes. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -realimentó I-EVOLUTION -con I-EVOLUTION -líquidos I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -5o I-EVOLUTION -día I-EVOLUTION -post I-EVOLUTION -operatorio. I-EVOLUTION - I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -macroscópico I-EXPLORATION +llene I-EXPLORATION +ventricular I-EXPLORATION +rápido I-EXPLORATION +(E) I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +fase I-EXPLORATION de I-EXPLORATION +llene I-EXPLORATION +relacionada I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -lesión I-EXPLORATION -fue I-EXPLORATION -consistente I-EXPLORATION -con I-EXPLORATION -tumor I-EXPLORATION -gástrico I-EXPLORATION -submucoso, I-EXPLORATION +contracción I-EXPLORATION +auricular I-EXPLORATION +(A) I-EXPLORATION +-, I-EXPLORATION +normalización I-EXPLORATION +del I-EXPLORATION +tamaño I-EXPLORATION de I-EXPLORATION -11, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -6x7 I-EXPLORATION -cm, I-EXPLORATION -con I-EXPLORATION -apariencia I-EXPLORATION -lipomatosa. I-EXPLORATION -La I-EXPLORATION -microscopía I-EXPLORATION -fue I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -lipoma I-EXPLORATION -gástrico I-EXPLORATION -benigno I-EXPLORATION -con I-EXPLORATION -márgenes I-EXPLORATION -libres I-EXPLORATION +la I-EXPLORATION +aurícula I-EXPLORATION +izquierda I-EXPLORATION y I-EXPLORATION -15 I-EXPLORATION -linfonodos I-EXPLORATION -perigástricos I-EXPLORATION -normales. I-EXPLORATION +desaparición I-EXPLORATION +del I-EXPLORATION +derrame I-EXPLORATION +pericárdico, I-EXPLORATION +persistiendo I-EXPLORATION +la I-EXPLORATION +dilatación I-EXPLORATION +y I-EXPLORATION +disfunción I-EXPLORATION +sistólica I-EXPLORATION +del I-EXPLORATION +ventrículo I-EXPLORATION +izquierdo, I-EXPLORATION +en I-EXPLORATION +grado I-EXPLORATION +similar I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +observada I-EXPLORATION +en I-EXPLORATION +exámenes I-EXPLORATION +iniciales. I-EXPLORATION I-EXPLORATION Paciente B-PRESENT_ILLNESS @@ -33092,69134 +29256,58415 @@ del I-EVOLUTION dispositivo. I-EVOLUTION I-EVOLUTION -La B-EXPLORATION -isquemia I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -es I-EXPLORATION -una I-EXPLORATION -complicación I-EXPLORATION -a I-EXPLORATION -largo I-EXPLORATION -plazo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -diabetes. I-EXPLORATION -Los I-EXPLORATION -pacientes I-EXPLORATION -evolucionan I-EXPLORATION -con I-EXPLORATION -claudicación I-EXPLORATION -intermitente I-EXPLORATION -y, I-EXPLORATION -posteriormente, I-EXPLORATION -con I-EXPLORATION -dolor I-EXPLORATION -de I-EXPLORATION -reposo I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -alteraciones I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -sensibilidad10, I-EXPLORATION -11. I-EXPLORATION -Pueden I-EXPLORATION -presentar I-EXPLORATION -alteraciones I-EXPLORATION -tróficas I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -extremidades, I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -uñas, I-EXPLORATION -xerosis, I-EXPLORATION -edema, I-EXPLORATION -linfangitis, I-EXPLORATION -pulsos I-EXPLORATION -disminuidos, I-EXPLORATION -piel I-EXPLORATION -fría, I-EXPLORATION -eritema, I-EXPLORATION -palidez I-EXPLORATION -o I-EXPLORATION -cianosis. I-EXPLORATION -Finalmente, I-EXPLORATION -aparecen I-EXPLORATION -úlceras I-EXPLORATION -y I-EXPLORATION -necrosis12, I-EXPLORATION -13. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -Doppler I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -angiografía I-EXPLORATION -permiten I-EXPLORATION -cuantificar I-EXPLORATION -la I-EXPLORATION -magnitud I-EXPLORATION -del I-EXPLORATION -deterioro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -circulación I-EXPLORATION -arterial. I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -incluye I-TREATMENT -ejercicio I-TREATMENT -físico, I-TREATMENT -manejo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -diabetes I-TREATMENT -y I-TREATMENT -de I-TREATMENT -los I-TREATMENT -otros I-TREATMENT -factores I-TREATMENT -de I-TREATMENT -riesgo14. I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -definitivo I-TREATMENT -es I-TREATMENT -la I-TREATMENT -revascularización15. I-TREATMENT - I-TREATMENT - Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -70 I-PRESENT_ILLNESS +83 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -retroesternal I-PRESENT_ILLNESS -opresivo, I-PRESENT_ILLNESS -intensidad I-PRESENT_ILLNESS -10/10, I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -epigastrio, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -min I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -duración, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -profusa I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -palpitaciones. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Refería I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -presentado I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +factores I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +riesgo I-PAST_MEDICAL_HISTORY +vascular I-PAST_MEDICAL_HISTORY +(hipertensión I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +dislipemia). I-PAST_MEDICAL_HISTORY +Entre I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +destacaban: I-PAST_MEDICAL_HISTORY +diverticulosis I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +colon I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +pólipos I-PAST_MEDICAL_HISTORY +adenomatosos I-PAST_MEDICAL_HISTORY +tubulares. I-PAST_MEDICAL_HISTORY +Había I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +intervenida I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +amígdalas, I-PAST_MEDICAL_HISTORY +apéndice I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +eventración I-PAST_MEDICAL_HISTORY +abdominal. I-PAST_MEDICAL_HISTORY +Como B-FAMILY_HISTORY +antecedente I-FAMILY_HISTORY +familiar I-FAMILY_HISTORY +destacaba I-FAMILY_HISTORY +su I-FAMILY_HISTORY +hija I-FAMILY_HISTORY +fallecida I-FAMILY_HISTORY +a I-FAMILY_HISTORY +los I-FAMILY_HISTORY +52 I-FAMILY_HISTORY +años I-FAMILY_HISTORY +de I-FAMILY_HISTORY +cáncer I-FAMILY_HISTORY +gástrico. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Acudió B-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -similares I-PRESENT_ILLNESS -características I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -antes, I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -motivó I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +persistente I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -otro I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS +hemiabdomen I-PRESENT_ILLNESS +superior I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +periumbilical I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -urgencias, I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -evaluada I-PRESENT_ILLNESS +predominio I-PRESENT_ILLNESS +postprandial, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nauseas I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +vómitos. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +ritmo I-PRESENT_ILLNESS +intestinal I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -electrocardiograma I-PRESENT_ILLNESS -(ECG) I-PRESENT_ILLNESS +tendencia I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +estreñimiento I-PRESENT_ILLNESS +exacerbado I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +dicho I-PRESENT_ILLNESS +periodo. I-PRESENT_ILLNESS +Presentaba I-PRESENT_ILLNESS +además I-PRESENT_ILLNESS +anorexia I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -enzimas I-PRESENT_ILLNESS -cardiacas; I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -impresionando I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +ponderal I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -origen I-PRESENT_ILLNESS -coronario, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -derivó I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -domicilio. I-PRESENT_ILLNESS -Dentro B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -destacaba I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -data I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -precisada, I-PAST_MEDICAL_HISTORY +7kg. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Estaba B-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -atenolol I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY +con: I-PAST_MEDICAL_HISTORY +artilog I-PAST_MEDICAL_HISTORY +200 I-PAST_MEDICAL_HISTORY mg I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -día, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cáncer I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mama I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY +0-1-0, I-PAST_MEDICAL_HISTORY +enalapril I-PAST_MEDICAL_HISTORY 20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY +mg I-PAST_MEDICAL_HISTORY +1-0-0, I-PAST_MEDICAL_HISTORY +nerdipina I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +mg I-PAST_MEDICAL_HISTORY +1-0-1, I-PAST_MEDICAL_HISTORY +pantoprazol I-PAST_MEDICAL_HISTORY +40 I-PAST_MEDICAL_HISTORY +mg I-PAST_MEDICAL_HISTORY +1-0-0, I-PAST_MEDICAL_HISTORY +simvastatina I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +mg I-PAST_MEDICAL_HISTORY +0-0-1, I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -radioterapia. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -fumadora I-PAST_MEDICAL_HISTORY -ni B-FAMILY_HISTORY -tenía I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -cardiopatía I-FAMILY_HISTORY -coronaria. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Al B-EXPLORATION -ingreso, I-EXPLORATION +venlafaxina I-PAST_MEDICAL_HISTORY +75 I-PAST_MEDICAL_HISTORY +mg I-PAST_MEDICAL_HISTORY +0-0-1. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +A B-EXPLORATION la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -sudorosa, I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -dolor. I-EXPLORATION -La I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -era I-EXPLORATION -100/60 I-EXPLORATION -mmHg I-EXPLORATION -y I-EXPLORATION -su I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +presentaba: I-EXPLORATION +tensión I-EXPLORATION +arterial: I-EXPLORATION +120/80; I-EXPLORATION frecuencia I-EXPLORATION -cardiaca I-EXPLORATION -87 I-EXPLORATION -lpm. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaban I-EXPLORATION -yugulares I-EXPLORATION -colapsables I-EXPLORATION -en I-EXPLORATION -inspiración, I-EXPLORATION +cardiaca: I-EXPLORATION +81 I-EXPLORATION +latidos/min. I-EXPLORATION +Afebril. I-EXPLORATION +Regular I-EXPLORATION +estado I-EXPLORATION +general. I-EXPLORATION +Bien I-EXPLORATION +hidratada I-EXPLORATION +y I-EXPLORATION +ligera I-EXPLORATION +palidez I-EXPLORATION +mucocutánea. I-EXPLORATION +Nódulo I-EXPLORATION +supraclavicular I-EXPLORATION +izquierdo, I-EXPLORATION +duro I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -auscultación I-EXPLORATION -cardiaca I-EXPLORATION +palpación, I-EXPLORATION +móvil, I-EXPLORATION no I-EXPLORATION -reveló I-EXPLORATION -soplos I-EXPLORATION -ni I-EXPLORATION -galope I-EXPLORATION -y I-EXPLORATION -había I-EXPLORATION -sensibilidad I-EXPLORATION +doloroso. I-EXPLORATION +Auscultación I-EXPLORATION +cardiaca I-EXPLORATION +normal. I-EXPLORATION +Auscultación I-EXPLORATION +pulmonar I-EXPLORATION +sin I-EXPLORATION +hallazgos. I-EXPLORATION +Abdomen I-EXPLORATION +blando, I-EXPLORATION +depresible, I-EXPLORATION +doloroso I-EXPLORATION a I-EXPLORATION la I-EXPLORATION palpación I-EXPLORATION -epigástrica. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -no I-EXPLORATION -era I-EXPLORATION -destacable. I-EXPLORATION -Al B-PRESENT_ILLNESS -interrogatorio, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -similares I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -clara I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -esfuerzos I-PRESENT_ILLNESS -físicos, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -principio I-PRESENT_ILLNESS -eran I-PRESENT_ILLNESS -esporádicos I-PRESENT_ILLNESS -pero I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -última I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -hicieron I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -frecuentes, I-PRESENT_ILLNESS -casi I-PRESENT_ILLNESS -diarios. I-PRESENT_ILLNESS -El B-EXPLORATION -ECG I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -discreto I-EXPLORATION -supradesnivel I-EXPLORATION -del I-EXPLORATION -segmento I-EXPLORATION -ST I-EXPLORATION -(SDST) I-EXPLORATION -anteroseptal I-EXPLORATION -con I-EXPLORATION -inversión I-EXPLORATION +profunda I-EXPLORATION +en I-EXPLORATION +hemiabdomen I-EXPLORATION +superior I-EXPLORATION +y I-EXPLORATION +periumbilical, I-EXPLORATION +sin I-EXPLORATION +masas I-EXPLORATION +ni I-EXPLORATION +megalias, I-EXPLORATION +peristaltismo I-EXPLORATION +disminuido. I-EXPLORATION +Extremidades I-EXPLORATION +inferiores I-EXPLORATION +sin I-EXPLORATION +edemas I-EXPLORATION +ni I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -onda I-EXPLORATION -T I-EXPLORATION +trombosis I-EXPLORATION +venosa I-EXPLORATION +profunda. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +las I-EXPLORATION +exploraciones I-EXPLORATION +complementarias: I-EXPLORATION +radiología I-EXPLORATION +de I-EXPLORATION +tórax: I-EXPLORATION +nódulo I-EXPLORATION +pulmonar I-EXPLORATION de I-EXPLORATION -V1 I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION +LSD. I-EXPLORATION +ECG: I-EXPLORATION +ritmo I-EXPLORATION +sinusal I-EXPLORATION a I-EXPLORATION -V3, I-EXPLORATION -que I-EXPLORATION -ya I-EXPLORATION -era I-EXPLORATION -evidente I-EXPLORATION +86 I-EXPLORATION +latidos/min. I-EXPLORATION +Analítica I-EXPLORATION +de I-EXPLORATION +sangre: I-EXPLORATION +anemia I-EXPLORATION +microcítica I-EXPLORATION +(Hb: I-EXPLORATION +10 I-EXPLORATION +g/dl I-EXPLORATION +(11,9-16,5), I-EXPLORATION +VCM: I-EXPLORATION +77, I-EXPLORATION +4 I-EXPLORATION +(80,2-99,4). I-EXPLORATION +Leucocitosis I-EXPLORATION +con I-EXPLORATION +neutrofilia I-EXPLORATION +(20.000 I-EXPLORATION +leucocitos/ml I-EXPLORATION +(3,5-10,5) I-EXPLORATION +con I-EXPLORATION +84% I-EXPLORATION +de I-EXPLORATION +neutrófilos I-EXPLORATION +(37-73). I-EXPLORATION +VSG I-EXPLORATION +67 I-EXPLORATION +mm/h I-EXPLORATION +(2-10). I-EXPLORATION +PCR I-EXPLORATION +150 I-EXPLORATION +mg/l I-EXPLORATION +(0-10). I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +completó I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +analítico I-EXPLORATION +con I-EXPLORATION +perfil I-EXPLORATION +férrico I-EXPLORATION +completo: I-EXPLORATION +hierro I-EXPLORATION +sérico I-EXPLORATION +14 I-EXPLORATION +µg/dl I-EXPLORATION +(37-145 I-EXPLORATION +µg/dl), I-EXPLORATION +índice I-EXPLORATION +de I-EXPLORATION +saturación I-EXPLORATION +de I-EXPLORATION +transferrina I-EXPLORATION +15% I-EXPLORATION +(20-50%) I-EXPLORATION +y I-EXPLORATION +ferritina I-EXPLORATION +463 I-EXPLORATION +ng/ml I-EXPLORATION +(valores<30ng/ml I-EXPLORATION +implica I-EXPLORATION +ferropenia). I-EXPLORATION +También I-EXPLORATION +se I-EXPLORATION +determinó I-EXPLORATION +antígeno I-EXPLORATION +carcinoembrionario I-EXPLORATION +(CEA) I-EXPLORATION +pensando I-EXPLORATION en I-EXPLORATION -ECG I-EXPLORATION -tomado I-EXPLORATION -2 I-EXPLORATION -días I-EXPLORATION -antes I-EXPLORATION +neoplasias I-EXPLORATION +malignas I-EXPLORATION +gastrointestinales I-EXPLORATION y I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -fue I-EXPLORATION -evolutivo. I-EXPLORATION +anticuerpos I-EXPLORATION +anti-transglutaminasa I-EXPLORATION +siendo I-EXPLORATION +sus I-EXPLORATION +valores I-EXPLORATION +normales. I-EXPLORATION I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION +Ante I-EXPLORATION +la I-EXPLORATION +persistencia I-EXPLORATION +del I-EXPLORATION +dolor I-EXPLORATION +abdominal I-EXPLORATION +que I-EXPLORATION +requería I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -mostró I-EXPLORATION +opiáceos I-EXPLORATION +intravenosos I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -silueta I-EXPLORATION -cardiaca I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +adenopatías I-EXPLORATION +mesentéricas I-EXPLORATION de I-EXPLORATION tamaño I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION +patológico, I-EXPLORATION +completándose I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +tomografia I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +(TAC) I-EXPLORATION +abdomino-pélvica. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +dicha I-EXPLORATION +TAC I-EXPLORATION se I-EXPLORATION -observaban I-EXPLORATION -signos I-EXPLORATION +observó I-EXPLORATION +un I-EXPLORATION +engrosamiento I-EXPLORATION +mural I-EXPLORATION de I-EXPLORATION -congestión I-EXPLORATION -pulmonar. I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -admitida I-TREATMENT -a I-TREATMENT -la I-TREATMENT -unidad I-TREATMENT -coronaria, I-TREATMENT -con I-TREATMENT -terapia I-TREATMENT -de I-TREATMENT -síndrome I-TREATMENT -coronario I-TREATMENT -agudo I-TREATMENT -sin I-TREATMENT -SDST. I-TREATMENT -La B-EXPLORATION -troponina I-EXPLORATION -I I-EXPLORATION +un I-EXPLORATION +segmento I-EXPLORATION de I-EXPLORATION -ingreso I-EXPLORATION -fue I-EXPLORATION +intestino I-EXPLORATION +delgado I-EXPLORATION +proximal I-EXPLORATION de I-EXPLORATION -0, I-EXPLORATION -07 I-EXPLORATION -pg/ml I-EXPLORATION -(valor I-EXPLORATION -normal I-EXPLORATION -< I-EXPLORATION -0, I-EXPLORATION -05) I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -CK I-EXPLORATION -total I-EXPLORATION -fue I-EXPLORATION +unos I-EXPLORATION +4, I-EXPLORATION +4 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -117 I-EXPLORATION -U/L I-EXPLORATION +diámetro I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +acompañaba I-EXPLORATION +de I-EXPLORATION +múltiples I-EXPLORATION +adenopatías I-EXPLORATION +mesentéricas I-EXPLORATION con I-EXPLORATION +centro I-EXPLORATION +hipodenso. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -fracción I-EXPLORATION -MB I-EXPLORATION +enteroscopia I-EXPLORATION +anterógrada I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -25. I-EXPLORATION - I-EXPLORATION -A B-EVOLUTION -las I-EVOLUTION -pocas I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -ingreso I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -crisis I-EVOLUTION -de I-EVOLUTION -angor I-EVOLUTION -intenso, I-EVOLUTION -10/10, I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -disnea, I-EVOLUTION -palpitaciones, I-EVOLUTION -cefalea, I-EVOLUTION -sudoración I-EVOLUTION -y I-EVOLUTION -enrojecimiento I-EVOLUTION -facial. I-EVOLUTION -Se B-EXPLORATION -constató I-EXPLORATION -alza I-EXPLORATION +ángulo I-EXPLORATION de I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION +Treitz, I-EXPLORATION +formación I-EXPLORATION +polipoidea I-EXPLORATION +con I-EXPLORATION +ulceración I-EXPLORATION +de I-EXPLORATION +unos I-EXPLORATION +15 I-EXPLORATION +mm I-EXPLORATION +de I-EXPLORATION +diámetro, I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +tomaron I-EXPLORATION +biopsias. I-EXPLORATION +Se I-EXPLORATION +introdujo I-EXPLORATION +el I-EXPLORATION +endoscopio I-EXPLORATION hasta I-EXPLORATION -260/130 I-EXPLORATION -mmHg I-EXPLORATION +yeyuno I-EXPLORATION +proximal I-EXPLORATION +(50-60 I-EXPLORATION +cm I-EXPLORATION +distales I-EXPLORATION +a I-EXPLORATION +píloro) I-EXPLORATION y I-EXPLORATION -al I-EXPLORATION -monitor I-EXPLORATION se I-EXPLORATION -evidenció I-EXPLORATION -taquicardia I-EXPLORATION -sinusal I-EXPLORATION -con I-EXPLORATION -extrasistolía I-EXPLORATION -supraventricular I-EXPLORATION -y I-EXPLORATION -ventricular I-EXPLORATION -frecuentes, I-EXPLORATION +tomaron I-EXPLORATION +biopsias I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +neoformación I-EXPLORATION +ulcerada, I-EXPLORATION +rígida I-EXPLORATION y I-EXPLORATION -conducción I-EXPLORATION -aberrante I-EXPLORATION -con I-EXPLORATION -morfología I-EXPLORATION +friable, I-EXPLORATION de I-EXPLORATION -bloqueo I-EXPLORATION -completo I-EXPLORATION +unos I-EXPLORATION +4 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -rama I-EXPLORATION -derecha I-EXPLORATION +diámetro I-EXPLORATION +y I-EXPLORATION +que I-EXPLORATION +ocupaba I-EXPLORATION +la I-EXPLORATION +mitad I-EXPLORATION de I-EXPLORATION -aproximadamente I-EXPLORATION -5 I-EXPLORATION -min I-EXPLORATION +la I-EXPLORATION +circunferencia, I-EXPLORATION de I-EXPLORATION -duración. I-EXPLORATION -No I-EXPLORATION -hubo I-EXPLORATION -episodios I-EXPLORATION +unos I-EXPLORATION +4 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -hipotensión I-EXPLORATION -ni I-EXPLORATION -síncope. I-EXPLORATION -Dado I-EXPLORATION -las I-EXPLORATION -características I-EXPLORATION +diámetro, I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +impidió I-EXPLORATION +el I-EXPLORATION +paso I-EXPLORATION del I-EXPLORATION -episodio I-EXPLORATION +endoscopio. I-EXPLORATION +A I-EXPLORATION +unos I-EXPLORATION +30 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +píloro I-EXPLORATION se I-EXPLORATION -sospechó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +observó I-EXPLORATION +otra I-EXPLORATION +zona I-EXPLORATION +ulcerada, I-EXPLORATION +rígida, I-EXPLORATION de I-EXPLORATION -feocromocitoma. I-EXPLORATION -Se B-TREATMENT -suspendió I-TREATMENT -heparina, I-TREATMENT -se I-TREATMENT -aportó I-TREATMENT -solución I-TREATMENT -fisiológica I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -doxazosina I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -1 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -h. I-TREATMENT -Se B-EXPLORATION -midió I-EXPLORATION -durante I-EXPLORATION -la I-EXPLORATION -crisis I-EXPLORATION -catecolaminas I-EXPLORATION -plasmáticas I-EXPLORATION -y I-EXPLORATION -metanefrinas I-EXPLORATION -urinarias I-EXPLORATION -(previo I-EXPLORATION -al I-EXPLORATION -inicio I-EXPLORATION +unos I-EXPLORATION +2 I-EXPLORATION +cms I-EXPLORATION de I-EXPLORATION -doxazosina), I-EXPLORATION +diámetro I-EXPLORATION que I-EXPLORATION -fueron I-EXPLORATION -marcadamente I-EXPLORATION -elevadas. I-EXPLORATION +se I-EXPLORATION +biopsió I-EXPLORATION +(C).. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION +El I-EXPLORATION +análisis I-EXPLORATION +histológico I-EXPLORATION +fue I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +metástasis I-EXPLORATION +yeyunales I-EXPLORATION de I-EXPLORATION -abdomen, I-EXPLORATION -que I-EXPLORATION -confirmó I-EXPLORATION +carcinoma I-EXPLORATION +pobremente I-EXPLORATION +diferenciado. I-EXPLORATION +Tanto I-EXPLORATION +la I-EXPLORATION +morfología I-EXPLORATION +como I-EXPLORATION el I-EXPLORATION -diagnóstico, I-EXPLORATION -evidenciando I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -suprarrenal I-EXPLORATION -derecha I-EXPLORATION +inmunofenotipo I-EXPLORATION +fueron I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +carcinoma I-EXPLORATION de I-EXPLORATION -6 I-EXPLORATION -cm I-EXPLORATION +células I-EXPLORATION +grandes I-EXPLORATION de I-EXPLORATION -diámetro. I-EXPLORATION +pulmón. I-EXPLORATION I-EXPLORATION -El I-EXPLORATION -cintigrama I-EXPLORATION -con I-EXPLORATION -123-I-metaiodobencilguanidina I-EXPLORATION -(MIBG) I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -captación I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -descrita I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -metástasis. I-EXPLORATION +Inmunofenotipo: I-EXPLORATION +citoqueratinas I-EXPLORATION +AE1-AE3: I-EXPLORATION +(+); I-EXPLORATION +S100, I-EXPLORATION +HMB I-EXPLORATION +45: I-EXPLORATION +(-); I-EXPLORATION +citoqueratina I-EXPLORATION +20: I-EXPLORATION +(-), I-EXPLORATION +citoqueratina I-EXPLORATION +7: I-EXPLORATION +(+); I-EXPLORATION +TTF1: I-EXPLORATION +(-); I-EXPLORATION +napsina: I-EXPLORATION +(-); I-EXPLORATION +vimentina: I-EXPLORATION +(+); I-EXPLORATION +p63: I-EXPLORATION +(+); I-EXPLORATION +cd10: I-EXPLORATION +(-); I-EXPLORATION +WT1: I-EXPLORATION +(-) I-EXPLORATION +; I-EXPLORATION +GCDFP I-EXPLORATION +15: I-EXPLORATION +(-); I-EXPLORATION +citoqueratina I-EXPLORATION +19: I-EXPLORATION +(+); I-EXPLORATION +citoqueratina I-EXPLORATION +5-6: I-EXPLORATION +(-), I-EXPLORATION +citoqueratina I-EXPLORATION +34 I-EXPLORATION +beta I-EXPLORATION +12; I-EXPLORATION +CDX2: I-EXPLORATION +(-). I-EXPLORATION I-EXPLORATION -Adicionalmente I-EXPLORATION +Se I-EXPLORATION +completó I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +TAC I-EXPLORATION +torácico I-EXPLORATION +donde I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION +observó I-EXPLORATION un I-EXPLORATION -ecocardiograma I-EXPLORATION -transtorácico, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -hipertrofia I-EXPLORATION -ventricular I-EXPLORATION -izquierda I-EXPLORATION -leve I-EXPLORATION -y I-EXPLORATION -compromiso I-EXPLORATION -leve I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -función I-EXPLORATION -sistólica I-EXPLORATION -global, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -fracción I-EXPLORATION +nódulo I-EXPLORATION +pulmonar I-EXPLORATION +sólido I-EXPLORATION de I-EXPLORATION -eyección I-EXPLORATION -(FE) I-EXPLORATION -estimada I-EXPLORATION -por I-EXPLORATION -Simpson I-EXPLORATION +aspecto I-EXPLORATION +espiculado I-EXPLORATION +en I-EXPLORATION +apex I-EXPLORATION +derecho I-EXPLORATION de I-EXPLORATION -42%, I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -coronariografía I-EXPLORATION -sin I-EXPLORATION -incidentes I-EXPLORATION -durante I-EXPLORATION -el I-EXPLORATION -procedimiento, I-EXPLORATION -que I-EXPLORATION -descartó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +2, I-EXPLORATION +6 I-EXPLORATION +cm, I-EXPLORATION de I-EXPLORATION -enfermedad I-EXPLORATION -coronaria. I-EXPLORATION -La I-EXPLORATION -disfunción I-EXPLORATION -ventricular I-EXPLORATION -fue I-EXPLORATION -asumida I-EXPLORATION +contacto I-EXPLORATION +pleural; I-EXPLORATION +adenopatías I-EXPLORATION +mediastínicas I-EXPLORATION en I-EXPLORATION -contexto I-EXPLORATION +el I-EXPLORATION +compartimento I-EXPLORATION +paratraqueal I-EXPLORATION +superiores I-EXPLORATION +e I-EXPLORATION +inferiores I-EXPLORATION +y I-EXPLORATION +pretraqueales, I-EXPLORATION +hiliares I-EXPLORATION +derechas I-EXPLORATION +y I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -daño I-EXPLORATION -miocárdico I-EXPLORATION -por I-EXPLORATION -catecolaminas. I-EXPLORATION +la I-EXPLORATION +bifurcación I-EXPLORATION +bronquial. I-EXPLORATION +Adenopatías I-EXPLORATION +supraclaviculares I-EXPLORATION +bilaterales. I-EXPLORATION I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -preparó I-TREATMENT -para I-TREATMENT +Dada B-TREATMENT la I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -con I-TREATMENT -bloqueo I-TREATMENT -α I-TREATMENT +edad I-TREATMENT +de I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT y I-TREATMENT -β-adrenérgico I-TREATMENT -escalonado I-TREATMENT -con I-TREATMENT -doxazosina I-TREATMENT -y, I-TREATMENT -luego I-TREATMENT +el I-TREATMENT +estadio I-TREATMENT +avanzado I-TREATMENT de I-TREATMENT -2 I-TREATMENT -días, I-TREATMENT -propanolol. I-TREATMENT -La I-TREATMENT -cirugía I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -11 I-TREATMENT -días I-TREATMENT -después, I-TREATMENT -sin I-TREATMENT -complicaciones I-TREATMENT -hemodinámicas I-TREATMENT -significativas I-TREATMENT +la I-TREATMENT +enfermedad I-TREATMENT y I-TREATMENT -cursó I-TREATMENT -con I-TREATMENT +la I-TREATMENT +presentación I-TREATMENT un I-TREATMENT -postoperatorio I-TREATMENT -favorable. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -4 I-EVOLUTION -días I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones. I-EVOLUTION -Desde I-EVOLUTION -el I-EVOLUTION -punto I-EVOLUTION -de I-EVOLUTION -vista I-EVOLUTION -clínico, I-EVOLUTION -cursó I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -con I-EVOLUTION -disminución I-EVOLUTION -progresiva I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -dosis I-EVOLUTION -de I-EVOLUTION -antihipertensivos I-EVOLUTION -y I-EVOLUTION -normalización I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -ventricular I-EVOLUTION -en I-EVOLUTION -ecocardiografía I-EVOLUTION -de I-EVOLUTION -control. I-EVOLUTION - I-EVOLUTION +ECOG I-TREATMENT +3 I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +tratamiento I-TREATMENT +paliativo, I-TREATMENT +falleciendo I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +a I-TREATMENT +los I-TREATMENT +22 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +su I-TREATMENT +alta I-TREATMENT +hospitalaria. I-TREATMENT + I-TREATMENT -Mujer B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY +y I-PRESENT_ILLNESS +7 I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS +raza B-PAST_MEDICAL_HISTORY +mestiza, I-PAST_MEDICAL_HISTORY +procedente I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +área I-PAST_MEDICAL_HISTORY +rural I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -suspendido, I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -celiaca, I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -luego I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +ciudad I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -iodo I-PAST_MEDICAL_HISTORY -radioactivo I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY +Palmira I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +departamento I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +Valle I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +Cauca I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +Colombia. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +clínico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +consistente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +rechazo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +marcha, I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +bipedestación I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +sedestación, I-PRESENT_ILLNESS +principalmente I-PRESENT_ILLNESS +manifestado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +miembro I-PRESENT_ILLNESS +inferior I-PRESENT_ILLNESS +izquierdo, I-PRESENT_ILLNESS +presentando I-PRESENT_ILLNESS +posteriormente I-PRESENT_ILLNESS +dificultad I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +ponerse I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pie. I-PRESENT_ILLNESS +Afebril I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +toda I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +manifestaciones I-PRESENT_ILLNESS +intermitentes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +cual I-PRESENT_ILLNESS +disminuía I-PRESENT_ILLNESS +parcialmente I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +administración I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +acetaminofeno, I-PRESENT_ILLNESS +15 I-PRESENT_ILLNESS +mg/kg/dosis. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +No B-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +encontraron I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +trauma, I-PAST_MEDICAL_HISTORY enfermedad I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +tejido I-PAST_MEDICAL_HISTORY +conectivo, I-PAST_MEDICAL_HISTORY +hipertensión, I-PAST_MEDICAL_HISTORY +diabetes, I-PAST_MEDICAL_HISTORY +cardiopatía I-PAST_MEDICAL_HISTORY +congénita I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +tuberculosis. I-PAST_MEDICAL_HISTORY +Los I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +perinatales I-PAST_MEDICAL_HISTORY +eran I-PAST_MEDICAL_HISTORY +desconocidos I-PAST_MEDICAL_HISTORY +dado I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +entregada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +adopción I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +encontraba I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +protección I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Graves. I-PAST_MEDICAL_HISTORY +madre I-PAST_MEDICAL_HISTORY +sustituta. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY En B-EXPLORATION -julio I-EXPLORATION -de I-EXPLORATION -2007 I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +inicial I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -vasculitis I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -ANCA I-EXPLORATION -(GPA), I-EXPLORATION +encontraba I-EXPLORATION en I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -compromiso I-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +eutrófica, I-EXPLORATION +hemodinámicamente I-EXPLORATION +estable. I-EXPLORATION +Se I-EXPLORATION +destaca I-EXPLORATION +el I-EXPLORATION +rechazo I-EXPLORATION de I-EXPLORATION -vías I-EXPLORATION -aéreas I-EXPLORATION -superiores I-EXPLORATION -(VAS), I-EXPLORATION -masa I-EXPLORATION -palpable I-EXPLORATION -supraclavicular I-EXPLORATION -derecha I-EXPLORATION +la I-EXPLORATION +bipedestación I-EXPLORATION y I-EXPLORATION -en I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION +marcha, I-EXPLORATION +con I-EXPLORATION +irritabilidad I-EXPLORATION a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -hipogastrio10. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -incluyen I-EXPLORATION -un I-EXPLORATION -valor I-EXPLORATION +la I-EXPLORATION +flexión I-EXPLORATION de I-EXPLORATION -eritrosedimentación I-EXPLORATION -(VSG) I-EXPLORATION -mayor I-EXPLORATION +las I-EXPLORATION +caderas, I-EXPLORATION +dolor I-EXPLORATION a I-EXPLORATION -120 I-EXPLORATION -mm, I-EXPLORATION -ANCA I-EXPLORATION -c I-EXPLORATION -positivos, I-EXPLORATION -el I-EXPLORATION -enzimoinmunoensayo I-EXPLORATION -(ELISA) I-EXPLORATION -reveló I-EXPLORATION -especificidad I-EXPLORATION -para I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +lumbar, I-EXPLORATION +contractura I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +músculos I-EXPLORATION +paraespinosos, I-EXPLORATION +disminución I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lordosis I-EXPLORATION +lumbar I-EXPLORATION +y I-EXPLORATION +localizaba I-EXPLORATION el I-EXPLORATION -antígeno I-EXPLORATION -proteinasa I-EXPLORATION -3 I-EXPLORATION -(PR3), I-EXPLORATION -sin I-EXPLORATION -microhematuria I-EXPLORATION -o I-EXPLORATION -insuficiencia I-EXPLORATION -renal. I-EXPLORATION -Presentó I-EXPLORATION -masa I-EXPLORATION -pulmonar I-EXPLORATION -apical I-EXPLORATION -izquierda I-EXPLORATION -con I-EXPLORATION -necrosis I-EXPLORATION -central I-EXPLORATION -sin I-EXPLORATION -cavitación. I-EXPLORATION -Se I-EXPLORATION -tomó I-EXPLORATION -biopsia I-EXPLORATION +dolor I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +lumbar. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +la I-EXPLORATION +maniobra I-EXPLORATION de I-EXPLORATION -masa I-EXPLORATION -supraclavicular I-EXPLORATION -cuya I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -informó I-EXPLORATION -infamación I-EXPLORATION -granulomatosa I-EXPLORATION -necrotizante. I-EXPLORATION +Gowers, I-EXPLORATION +ni I-EXPLORATION +afectación I-EXPLORATION +neurológica. I-EXPLORATION + I-EXPLORATION En I-EXPLORATION -base I-EXPLORATION +los I-EXPLORATION +estudios I-EXPLORATION +clínicos I-EXPLORATION +iniciales I-EXPLORATION +destacaba I-EXPLORATION +hemograma I-EXPLORATION +normal, I-EXPLORATION +Proteína I-EXPLORATION +C I-EXPLORATION +Reactiva I-EXPLORATION +(PCR) I-EXPLORATION +de I-EXPLORATION +7 I-EXPLORATION +mg/dl I-EXPLORATION +(rango I-EXPLORATION +de I-EXPLORATION +0 I-EXPLORATION a I-EXPLORATION -lo I-EXPLORATION -expuesto I-EXPLORATION -previamente I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +5 I-EXPLORATION +mg/dl), I-EXPLORATION +Velocidad I-EXPLORATION de I-EXPLORATION -GPA I-EXPLORATION -temprana I-EXPLORATION -sistémica I-EXPLORATION -del I-EXPLORATION -EUVAS I-EXPLORATION -(Registro I-EXPLORATION -Europeo I-EXPLORATION +Sedimentación I-EXPLORATION +Globular I-EXPLORATION +(VSG) I-EXPLORATION de I-EXPLORATION -vasculitis) I-EXPLORATION -o I-EXPLORATION -localizada I-EXPLORATION -dado I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION +40 I-EXPLORATION +mm/h), I-EXPLORATION +examen I-EXPLORATION de I-EXPLORATION -compromiso I-EXPLORATION -renal. I-EXPLORATION -Recibió B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ciclofosfamida I-TREATMENT -y I-TREATMENT -prednisolona I-TREATMENT -con I-TREATMENT -mejoría I-TREATMENT -de I-TREATMENT -la I-TREATMENT -clínica. I-TREATMENT - I-TREATMENT -Presentó B-EVOLUTION -recaídas I-EVOLUTION -con I-EVOLUTION -síntomas I-EVOLUTION -respiratorios I-EVOLUTION -y I-EVOLUTION -nódulos I-EVOLUTION -pulmonares, I-EVOLUTION -pero I-EVOLUTION -con I-EVOLUTION -curva I-EVOLUTION -flujo I-EVOLUTION -volumen I-EVOLUTION -(CFV) I-EVOLUTION -normal, I-EVOLUTION -estando I-EVOLUTION -bajo I-EVOLUTION -tratamiento I-EVOLUTION -inmunosupresor I-EVOLUTION -durante I-EVOLUTION -los I-EVOLUTION -años I-EVOLUTION -2008, I-EVOLUTION -2009 I-EVOLUTION -y I-EVOLUTION -2010. I-EVOLUTION -Se B-TREATMENT -interpretó I-TREATMENT -como I-TREATMENT -enfermedad I-TREATMENT -refractaria I-TREATMENT -y I-TREATMENT -se I-TREATMENT -rotó I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -a I-TREATMENT -micofenolato I-TREATMENT -3 I-TREATMENT -g/día I-TREATMENT -que I-TREATMENT -es I-TREATMENT -con I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -está I-TREATMENT -en I-TREATMENT -la I-TREATMENT -actualidad. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -inicios I-EVOLUTION -de I-EVOLUTION -mayo I-EVOLUTION -de I-EVOLUTION -2011 I-EVOLUTION -comenzó I-EVOLUTION -con I-EVOLUTION -disnea I-EVOLUTION -de I-EVOLUTION -esfuerzo, I-EVOLUTION -estridor I-EVOLUTION -inspiratorio, I-EVOLUTION -sibilancias I-EVOLUTION -y I-EVOLUTION -expectoración I-EVOLUTION -hemoptoica. I-EVOLUTION -Presentó B-EXPLORATION -analítica I-EXPLORATION -normal I-EXPLORATION -que I-EXPLORATION -incluyó I-EXPLORATION -VSG I-EXPLORATION -y I-EXPLORATION -ANCA. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -CFV I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -aplanamiento I-EXPLORATION +orina I-EXPLORATION +normal, I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION +función I-EXPLORATION +renal I-EXPLORATION +y I-EXPLORATION +hepática I-EXPLORATION +normales, I-EXPLORATION +antígenos I-EXPLORATION +para I-EXPLORATION +Salmonella I-EXPLORATION +negativos, I-EXPLORATION +Anticuerpos I-EXPLORATION +Antinucleares I-EXPLORATION +(AAN) I-EXPLORATION +negativos, I-EXPLORATION +Creatin I-EXPLORATION +Fosfoquinasa I-EXPLORATION +(CPK) I-EXPLORATION +normal. I-EXPLORATION +Entre I-EXPLORATION los I-EXPLORATION -flujos I-EXPLORATION -inspiratorio I-EXPLORATION +estudios I-EXPLORATION +imagenológicos I-EXPLORATION +destacó I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax, I-EXPLORATION +de I-EXPLORATION +región I-EXPLORATION +lumbosacra I-EXPLORATION y I-EXPLORATION -espiratorio, I-EXPLORATION -descripto I-EXPLORATION +de I-EXPLORATION +caderas I-EXPLORATION +informadas I-EXPLORATION como I-EXPLORATION -curva I-EXPLORATION -cajón. I-EXPLORATION - I-EXPLORATION +normales. I-EXPLORATION La I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -de I-EXPLORATION -laringe I-EXPLORATION -y I-EXPLORATION -tráquea I-EXPLORATION -mostró I-EXPLORATION -ESG I-EXPLORATION +Resonancia I-EXPLORATION +Magnética I-EXPLORATION +(RM) I-EXPLORATION con I-EXPLORATION -indemnidad I-EXPLORATION +contraste I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -anillos I-EXPLORATION -traqueales. I-EXPLORATION -La I-EXPLORATION -fibrobroncoscopía I-EXPLORATION -mostró I-EXPLORATION -indemnidad I-EXPLORATION +pelvis I-EXPLORATION +con I-EXPLORATION +énfasis I-EXPLORATION +en I-EXPLORATION +cadera I-EXPLORATION +izquierda, I-EXPLORATION +evidenció I-EXPLORATION +compromiso I-EXPLORATION +articular I-EXPLORATION +coxofemoral, I-EXPLORATION +con I-EXPLORATION +núcleos I-EXPLORATION de I-EXPLORATION -cuerdas I-EXPLORATION -vocales I-EXPLORATION -y I-EXPLORATION +cabeza I-EXPLORATION +femoral I-EXPLORATION +normales, I-EXPLORATION +acetábulo I-EXPLORATION +adecuado I-EXPLORATION a I-EXPLORATION nivel I-EXPLORATION -sub-glótico I-EXPLORATION -mucosa I-EXPLORATION -friable I-EXPLORATION +de I-EXPLORATION +corte I-EXPLORATION +coronal I-EXPLORATION +y I-EXPLORATION +sagital. I-EXPLORATION +Se I-EXPLORATION +encontró I-EXPLORATION +alteración I-EXPLORATION +del I-EXPLORATION +disco I-EXPLORATION +L5-S1, I-EXPLORATION con I-EXPLORATION -múltiples I-EXPLORATION -granulomas I-EXPLORATION +erosiones I-EXPLORATION +óseas I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +espondilodiscitis. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +búsqueda I-EXPLORATION +intencionada I-EXPLORATION +para I-EXPLORATION +tuberculosis I-EXPLORATION y I-EXPLORATION -signos I-EXPLORATION +descartar I-EXPLORATION +Mal I-EXPLORATION de I-EXPLORATION -actividad I-EXPLORATION -local I-EXPLORATION +Pott I-EXPLORATION +como I-EXPLORATION +diagnóstico I-EXPLORATION +diferencial; I-EXPLORATION con I-EXPLORATION -una I-EXPLORATION -luz I-EXPLORATION +Prueba I-EXPLORATION de I-EXPLORATION -7 I-EXPLORATION -mm. I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION -pesar I-EXPLORATION +Tuberculina I-EXPLORATION +(PPD), I-EXPLORATION +tres I-EXPLORATION +baciloscopias I-EXPLORATION +(BK) I-EXPLORATION +seriados I-EXPLORATION +en I-EXPLORATION +jugo I-EXPLORATION +gástrico, I-EXPLORATION +tres I-EXPLORATION +BK I-EXPLORATION +seriados I-EXPLORATION +en I-EXPLORATION +orina, I-EXPLORATION +TAC I-EXPLORATION de I-EXPLORATION +tórax I-EXPLORATION +simple I-EXPLORATION +y I-EXPLORATION +contrastado, I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +total, I-EXPLORATION +sin I-EXPLORATION encontrarse I-EXPLORATION -con I-EXPLORATION -altas I-EXPLORATION -dosis I-EXPLORATION +alteración I-EXPLORATION +en I-EXPLORATION +estas I-EXPLORATION +ayudas I-EXPLORATION +diagnósticas. I-EXPLORATION + I-EXPLORATION +Durante B-EVOLUTION +la I-EVOLUTION +evolución I-EVOLUTION +clínica I-EVOLUTION +se I-EVOLUTION +documentó I-EVOLUTION +exacerbación I-EVOLUTION +de I-EVOLUTION +dolor I-EVOLUTION +manifestado I-EVOLUTION +en I-EVOLUTION +rechazo I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +bipedestación I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +marcha, I-EVOLUTION +con I-EVOLUTION +irritabilidad I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +flexión I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +caderas. I-EVOLUTION +En I-EVOLUTION +el I-EVOLUTION +seguimiento I-EVOLUTION +con I-EVOLUTION +reactantes I-EVOLUTION +de I-EVOLUTION +fase I-EVOLUTION +aguda I-EVOLUTION +destacó I-EVOLUTION +elevación I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +PCR I-EVOLUTION +a I-EVOLUTION +12 I-EVOLUTION +mg/dl I-EVOLUTION +y I-EVOLUTION +VSG I-EVOLUTION +a I-EVOLUTION +60 I-EVOLUTION +mm/h. I-EVOLUTION + I-EVOLUTION +Se B-EXPLORATION +realizó I-EXPLORATION +exploración I-EXPLORATION +quirúrgica I-EXPLORATION +y I-EXPLORATION +drenaje I-EXPLORATION de I-EXPLORATION -inmunosupresores, I-EXPLORATION -presentó I-EXPLORATION -una I-EXPLORATION -intercurrencia I-EXPLORATION +2 I-EXPLORATION +cc I-EXPLORATION +de I-EXPLORATION +secreción I-EXPLORATION +de I-EXPLORATION +material I-EXPLORATION +purulento, I-EXPLORATION +cultivo I-EXPLORATION +y I-EXPLORATION +biopsia. I-EXPLORATION +La I-EXPLORATION +biopsia I-EXPLORATION +reportó: I-EXPLORATION +Trabécula I-EXPLORATION +ósea I-EXPLORATION +usual I-EXPLORATION +y I-EXPLORATION +medula I-EXPLORATION +ósea I-EXPLORATION con I-EXPLORATION -una I-EXPLORATION -ESG, I-EXPLORATION -siendo I-EXPLORATION -dificultoso I-EXPLORATION -diferenciar, I-EXPLORATION -si I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION +espacio I-EXPLORATION +medular I-EXPLORATION +con I-EXPLORATION +celularidad I-EXPLORATION +del I-EXPLORATION +30%, I-EXPLORATION +conservación I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -recaída I-EXPLORATION -o I-EXPLORATION la I-EXPLORATION -cicatrización I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -prexistente. I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -duda I-TREATMENT +relación I-EXPLORATION +granulo-eritroide, I-EXPLORATION +sin I-EXPLORATION +evidenciarse I-EXPLORATION +inflamación I-EXPLORATION +granulomatosa I-EXPLORATION +o I-EXPLORATION +proceso I-EXPLORATION +neoplásico. I-EXPLORATION +Reporte I-EXPLORATION +negativo I-EXPLORATION +para I-EXPLORATION +cultivos I-EXPLORATION +(incluyendo I-EXPLORATION +estudios I-EXPLORATION +para I-EXPLORATION +Brucella I-EXPLORATION +y I-EXPLORATION +Bartonella), I-EXPLORATION +neoplasia I-EXPLORATION +y I-EXPLORATION +tuberculosis. I-EXPLORATION + I-EXPLORATION +En B-TREATMENT +junta I-TREATMENT +médica I-TREATMENT +interdisciplinaria, I-TREATMENT se I-TREATMENT -instauró I-TREATMENT +decidió I-TREATMENT tratamiento I-TREATMENT +antibiótico I-TREATMENT con I-TREATMENT -tres I-TREATMENT -pulsos I-TREATMENT -de I-TREATMENT -solumedrol I-TREATMENT -de I-TREATMENT -un I-TREATMENT -gramo I-TREATMENT -e I-TREATMENT -inició I-TREATMENT -plasmáferesis I-TREATMENT +Clindamicina I-TREATMENT +40 I-TREATMENT +mg/kg/día I-TREATMENT +y I-TREATMENT +Ceftriaxone I-TREATMENT +100 I-TREATMENT +mg/kg/día I-TREATMENT +endovenoso I-TREATMENT +durante I-TREATMENT +4 I-TREATMENT +semanas I-TREATMENT +y I-TREATMENT +2 I-TREATMENT +semanas I-TREATMENT con I-TREATMENT +Cefalexina I-TREATMENT +100 I-TREATMENT +mg/kg/día I-TREATMENT +vía I-TREATMENT +oral. I-TREATMENT +Para I-TREATMENT el I-TREATMENT -objetivo I-TREATMENT +manejo I-TREATMENT de I-TREATMENT -remover I-TREATMENT -complejos I-TREATMENT -antígeno-anticuerpo. I-TREATMENT -En I-TREATMENT +dolor, I-TREATMENT +recibió I-TREATMENT +Naproxeno I-TREATMENT +y I-TREATMENT +se I-TREATMENT +indicó I-TREATMENT +rehabilitación I-TREATMENT +física, I-TREATMENT +hasta I-TREATMENT la I-TREATMENT -analítica I-TREATMENT -tuvo I-TREATMENT -recuento I-TREATMENT +resolución I-TREATMENT +completa I-TREATMENT +del I-TREATMENT +cuadro I-TREATMENT +clínico, I-TREATMENT +evidenciado I-TREATMENT +en I-TREATMENT +ausencia I-TREATMENT de I-TREATMENT -CD20 I-TREATMENT -normales I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -administraron I-TREATMENT -4 I-TREATMENT -dosis I-TREATMENT +dolor, I-TREATMENT +mejoría I-TREATMENT +en I-TREATMENT +bipedestación, I-TREATMENT +marcha I-TREATMENT +y I-TREATMENT +normalización I-TREATMENT de I-TREATMENT -rituximab I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT +los I-TREATMENT +reactantes I-TREATMENT de I-TREATMENT -375 I-TREATMENT -mg/m2/semana I-TREATMENT -durante I-TREATMENT -4 I-TREATMENT -semanas I-TREATMENT -con I-TREATMENT -excelente I-TREATMENT -tolerancia. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -broncoscopia I-TREATMENT -rígida I-TREATMENT -terapéutica I-TREATMENT -(con I-TREATMENT -dilatación I-TREATMENT -y I-TREATMENT -electrocauterio). I-TREATMENT -Normalizó B-EVOLUTION -la I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -espirometría I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática I-EVOLUTION -a I-EVOLUTION -dos I-EVOLUTION -años I-EVOLUTION -del I-EVOLUTION -evento. I-EVOLUTION - I-EVOLUTION +fase I-TREATMENT +aguda. I-TREATMENT + I-TREATMENT -Paciente B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS +33 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -38 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -multípara B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -5, I-PAST_MEDICAL_HISTORY -IMC I-PAST_MEDICAL_HISTORY -25, I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -kg/m2, I-PAST_MEDICAL_HISTORY -puérpera I-PAST_MEDICAL_HISTORY +edad, I-PRESENT_ILLNESS +de B-PAST_MEDICAL_HISTORY +oficio I-PAST_MEDICAL_HISTORY +clasificador I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -(parto I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cesárea I-PAST_MEDICAL_HISTORY +residuos. I-PAST_MEDICAL_HISTORY +Su I-PAST_MEDICAL_HISTORY +pareja I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -otra I-PAST_MEDICAL_HISTORY -institución), I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY +ese I-PAST_MEDICAL_HISTORY +momento I-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY antecedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -levotiroxina I-PAST_MEDICAL_HISTORY -75 I-PAST_MEDICAL_HISTORY -mcg/día. I-PAST_MEDICAL_HISTORY +infección I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +VIH I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +utilizaba I-PAST_MEDICAL_HISTORY +métodos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +barrera. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -Consulta B-PRESENT_ILLNESS +Consultó B-PRESENT_ILLNESS en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Santiago I-PRESENT_ILLNESS +emergencia I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +líquidas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +7 I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +día, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +sangre, I-PRESENT_ILLNESS +mucus I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +pus; I-PRESENT_ILLNESS +acompañadas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS -retroesternal I-PRESENT_ILLNESS -opresivo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -súbito I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -máxima I-PRESENT_ILLNESS -intensidad. I-PRESENT_ILLNESS -Ingresa B-EXPLORATION -sin I-EXPLORATION -compromiso I-EXPLORATION -hemodinámico, I-EXPLORATION +sin I-PRESENT_ILLNESS +fiebre. I-PRESENT_ILLNESS +Presentaba I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +baja I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +aproximadamente I-PRESENT_ILLNESS +15 I-PRESENT_ILLNESS +kg I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +meses. I-PRESENT_ILLNESS +En B-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +estaba I-EXPLORATION +vigil, I-EXPLORATION afebril, I-EXPLORATION +normotenso I-EXPLORATION +(120/70), I-EXPLORATION con I-EXPLORATION -examen I-EXPLORATION -cardiopulmonar I-EXPLORATION -normal. I-EXPLORATION -Electrocardiograma I-EXPLORATION -(ECG) I-EXPLORATION -muestra I-EXPLORATION -infradesnivel I-EXPLORATION -del I-EXPLORATION -ST I-EXPLORATION -difuso. I-EXPLORATION -Se B-TREATMENT -inicia I-TREATMENT -manejo I-TREATMENT -médico I-TREATMENT -con I-TREATMENT -aspirina, I-TREATMENT -morfina I-TREATMENT -y I-TREATMENT -nitroglicerina I-TREATMENT -sublingual; I-TREATMENT -y B-EXPLORATION -se I-EXPLORATION -solicitan I-EXPLORATION -enzimas I-EXPLORATION -cardíacas I-EXPLORATION +una I-EXPLORATION +FC I-EXPLORATION +de I-EXPLORATION +82 I-EXPLORATION +por I-EXPLORATION +min, I-EXPLORATION +pálido I-EXPLORATION y I-EXPLORATION -dímero I-EXPLORATION -D. I-EXPLORATION -Exámenes I-EXPLORATION +en I-EXPLORATION +mal I-EXPLORATION +estado I-EXPLORATION +general. I-EXPLORATION +A B-EVOLUTION +las I-EVOLUTION +24 I-EVOLUTION +h I-EVOLUTION +presentó I-EVOLUTION +fiebre I-EVOLUTION +de I-EVOLUTION +hasta I-EVOLUTION +38, I-EVOLUTION +5° I-EVOLUTION +C I-EVOLUTION +axilar I-EVOLUTION +y I-EVOLUTION +heces I-EVOLUTION +líquidas I-EVOLUTION +con I-EVOLUTION +sangre I-EVOLUTION +y I-EVOLUTION +mucus I-EVOLUTION +en I-EVOLUTION +varias I-EVOLUTION +oportunidades. I-EVOLUTION +Fue I-EVOLUTION +internado I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +misma I-EVOLUTION +sala I-EVOLUTION +que I-EVOLUTION +el I-EVOLUTION +primer I-EVOLUTION +paciente, I-EVOLUTION +con I-EVOLUTION +diagnóstico I-EVOLUTION +clínico I-EVOLUTION +de I-EVOLUTION +diarrea I-EVOLUTION +en I-EVOLUTION +paciente I-EVOLUTION +con I-EVOLUTION +probable I-EVOLUTION +infección I-EVOLUTION +por I-EVOLUTION +VIH. I-EVOLUTION + I-EVOLUTION +De B-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -ingreso I-EXPLORATION -evidencian: I-EXPLORATION +laboratorio I-EXPLORATION +destacaban: I-EXPLORATION hemoglobina I-EXPLORATION -14, I-EXPLORATION +9, I-EXPLORATION +8 I-EXPLORATION +g/dl; I-EXPLORATION +hematocrito: I-EXPLORATION +28, I-EXPLORATION +3%; I-EXPLORATION +VCM I-EXPLORATION +77, I-EXPLORATION +2 I-EXPLORATION +fl I-EXPLORATION +y I-EXPLORATION +HCM I-EXPLORATION +24, I-EXPLORATION 9 I-EXPLORATION -g/dL, I-EXPLORATION -hematocrito I-EXPLORATION -43, I-EXPLORATION -7%, I-EXPLORATION +pg; I-EXPLORATION +leucocitos: I-EXPLORATION +5.500/mm3; I-EXPLORATION +linfocitos: I-EXPLORATION +750/ I-EXPLORATION +mm3 I-EXPLORATION +(17,1%); I-EXPLORATION recuento I-EXPLORATION de I-EXPLORATION -plaquetas I-EXPLORATION -288.000/uL, I-EXPLORATION -eosinóflos I-EXPLORATION -2, I-EXPLORATION -9%, I-EXPLORATION -VHS I-EXPLORATION -17 I-EXPLORATION -mm/h, I-EXPLORATION -creatinina I-EXPLORATION -0, I-EXPLORATION -43 I-EXPLORATION -mg/dL, I-EXPLORATION -troponina I-EXPLORATION -0, I-EXPLORATION -45 I-EXPLORATION -ng/ml, I-EXPLORATION -creatincinasa I-EXPLORATION -(CK) I-EXPLORATION -72 I-EXPLORATION -U/L, I-EXPLORATION -Ck-mb I-EXPLORATION -2, I-EXPLORATION -8 I-EXPLORATION -U/L; I-EXPLORATION -dímero I-EXPLORATION -D I-EXPLORATION -554 I-EXPLORATION -ng/ml. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicita I-EXPLORATION -AngioTAC I-EXPLORATION +linfocitos I-EXPLORATION +CD4 I-EXPLORATION +150 I-EXPLORATION +céls/ I-EXPLORATION +mm3; I-EXPLORATION +VHS: I-EXPLORATION +69 I-EXPLORATION +mm I-EXPLORATION +en I-EXPLORATION +1° I-EXPLORATION +hora. I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +directo I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -dímero I-EXPLORATION -D I-EXPLORATION -elevado, I-EXPLORATION -que I-EXPLORATION -descarta I-EXPLORATION -tromboembolismo I-EXPLORATION -pulmonar. I-EXPLORATION - I-EXPLORATION -Persiste I-EXPLORATION -con I-EXPLORATION -dolor I-EXPLORATION -y I-EXPLORATION -ECG I-EXPLORATION +deposiciones I-EXPLORATION +mostró I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -control I-EXPLORATION -evidencia I-EXPLORATION -QS I-EXPLORATION -en I-EXPLORATION -AVL, I-EXPLORATION -qR I-EXPLORATION -en I-EXPLORATION -DI I-EXPLORATION +abundantes I-EXPLORATION +PMN I-EXPLORATION y I-EXPLORATION -cambios I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -amplitud I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -onda I-EXPLORATION -R I-EXPLORATION +el I-EXPLORATION +coprocultivo I-EXPLORATION +se I-EXPLORATION +desarrolló I-EXPLORATION +Shigella I-EXPLORATION +sp. I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION en I-EXPLORATION -V4-V6. I-EXPLORATION -Enzimas I-EXPLORATION -cardiacas I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -con I-EXPLORATION -troponina I-EXPLORATION -> I-EXPLORATION -50 I-EXPLORATION -ng/ml, I-EXPLORATION -CK I-EXPLORATION -3.800 I-EXPLORATION -U/L I-EXPLORATION +los I-EXPLORATION +dos I-EXPLORATION +hemocultivos. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +VIH I-EXPLORATION +fue I-EXPLORATION +reactiva I-EXPLORATION y I-EXPLORATION -Ck-mb I-EXPLORATION -> I-EXPLORATION -300 I-EXPLORATION -U/L. I-EXPLORATION -Coronariografía I-EXPLORATION -muestra I-EXPLORATION -disección I-EXPLORATION -de I-EXPLORATION -tronco I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -coronaria I-EXPLORATION -izquierda, I-EXPLORATION -que I-EXPLORATION se I-EXPLORATION -extiende I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -circunfleja I-EXPLORATION -(Cx) I-EXPLORATION -proximal I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -rama I-EXPLORATION -marginal I-EXPLORATION -pequeña. I-EXPLORATION -Arteria I-EXPLORATION -descendente I-EXPLORATION -anterior I-EXPLORATION -(ADA) I-EXPLORATION -y I-EXPLORATION -coronaria I-EXPLORATION -derecha I-EXPLORATION -sin I-EXPLORATION -lesiones. I-EXPLORATION -Se B-TREATMENT -instala I-TREATMENT -balón I-TREATMENT -de I-TREATMENT -contrapulsación I-TREATMENT -aórtica I-TREATMENT -y I-TREATMENT -se I-TREATMENT -traslada I-TREATMENT -a I-TREATMENT -cirugía, I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -bypass I-TREATMENT -con I-TREATMENT -arteria I-TREATMENT -mamaria I-TREATMENT -interna I-TREATMENT -(LIMA) I-TREATMENT -a I-TREATMENT -ADA I-TREATMENT -y I-TREATMENT -puente I-TREATMENT -safeno I-TREATMENT -a I-TREATMENT -lateral I-TREATMENT -Cx, I-TREATMENT -sin I-TREATMENT -incidentes. I-TREATMENT - I-TREATMENT -Evoluciona B-EVOLUTION -favorablemente I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -post I-EVOLUTION -operatorio, I-EVOLUTION -con B-TREATMENT -retiro I-TREATMENT -de I-TREATMENT -drogas I-TREATMENT -vasoactivas I-TREATMENT -y I-TREATMENT -balón I-TREATMENT -de I-TREATMENT -contrapulsación I-TREATMENT -a I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -h. I-TREATMENT - I-TREATMENT -Ecocardiograma B-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -con I-EXPLORATION -acinesia I-EXPLORATION -no I-EXPLORATION -adelgazada I-EXPLORATION -anterolateral I-EXPLORATION -con I-EXPLORATION -fracción I-EXPLORATION +confirmó I-EXPLORATION +por I-EXPLORATION +técnica I-EXPLORATION de I-EXPLORATION -eyección I-EXPLORATION +Western I-EXPLORATION +blot I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +Laboratorio I-EXPLORATION de I-EXPLORATION -42%. I-EXPLORATION -Se B-TREATMENT -optimiza I-TREATMENT -control I-TREATMENT -farmacológico I-TREATMENT -de I-TREATMENT -insuficiencia I-TREATMENT -cardíaca I-TREATMENT -con I-TREATMENT -bisoprolol I-TREATMENT -1, I-TREATMENT -25 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -espironolactona I-TREATMENT -25 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -enalapril I-TREATMENT -5 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -h I-TREATMENT -y I-TREATMENT -atorvastatina I-TREATMENT -40 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día. I-TREATMENT -Se B-DERIVED_FROM/TO -traslada I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -quinto I-DERIVED_FROM/TO -día I-DERIVED_FROM/TO -post I-DERIVED_FROM/TO -cirugía I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -otro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -motivos I-DERIVED_FROM/TO -previsionales. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Se B-EVOLUTION -controla I-EVOLUTION -en I-EVOLUTION -policlínico I-EVOLUTION -15 I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -alta, I-EVOLUTION -encontrándose I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -generales, I-EVOLUTION -asintomática, I-EVOLUTION -sin I-EVOLUTION -angina, I-EVOLUTION -en I-EVOLUTION -capacidad I-EVOLUTION -funcional I-EVOLUTION -I, I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -ya I-EVOLUTION -descrito, I-EVOLUTION -sin I-EVOLUTION -lactancia I-EVOLUTION -materna. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -46 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -debilidad I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -mialgias I-PRESENT_ILLNESS -intensas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -impedían I-PRESENT_ILLNESS -deambular. I-PRESENT_ILLNESS -Destacaba B-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -T4 I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -mcg/día I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -bypass I-PAST_MEDICAL_HISTORY -intestinal I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -mórbida I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -adelgazamiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -70 I-PAST_MEDICAL_HISTORY -Kg I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -ese I-PAST_MEDICAL_HISTORY -entonces. I-PAST_MEDICAL_HISTORY -Desde I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -deposiciones I-PAST_MEDICAL_HISTORY -pastosas I-PAST_MEDICAL_HISTORY -diarias. I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -ingreso I-EXPLORATION +Referencia I-EXPLORATION +Nacional. I-EXPLORATION + I-EXPLORATION +Estudios I-EXPLORATION +bacteriológicos I-EXPLORATION + I-EXPLORATION +Las I-EXPLORATION +cepas I-EXPLORATION se I-EXPLORATION -encontraba I-EXPLORATION -vigil, I-EXPLORATION -eupneica I-EXPLORATION -y I-EXPLORATION -apirética. I-EXPLORATION -Presentaba I-EXPLORATION -adelgazamiento I-EXPLORATION -con I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -corporal I-EXPLORATION -(IMC) I-EXPLORATION -de I-EXPLORATION -19. I-EXPLORATION -Tenía I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION +enviaron I-EXPLORATION +al I-EXPLORATION +Departamento I-EXPLORATION de I-EXPLORATION -hidratación I-EXPLORATION +Bacteriología I-EXPLORATION y I-EXPLORATION -sus I-EXPLORATION -cifras I-EXPLORATION +Virología, I-EXPLORATION +Instituto I-EXPLORATION de I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -(TA) I-EXPLORATION -eran I-EXPLORATION -120/70 I-EXPLORATION -mmHg. I-EXPLORATION +Higiene, I-EXPLORATION +para I-EXPLORATION +completar I-EXPLORATION +su I-EXPLORATION +estudio. I-EXPLORATION La I-EXPLORATION -evaluación I-EXPLORATION -neuromuscular I-EXPLORATION -mostró I-EXPLORATION -hipotonía I-EXPLORATION -generalizada, I-EXPLORATION -paresia I-EXPLORATION +identificación I-EXPLORATION de I-EXPLORATION -cuatro I-EXPLORATION -miembros I-EXPLORATION -sin I-EXPLORATION -fasciculaciones I-EXPLORATION -y I-EXPLORATION -reflejos I-EXPLORATION -osteotendinosos I-EXPLORATION -presentes. I-EXPLORATION -Presentaba I-EXPLORATION -un I-EXPLORATION -potasio I-EXPLORATION -plasmático I-EXPLORATION -(K+pl) I-EXPLORATION +género I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +por I-EXPLORATION +métodos I-EXPLORATION +fenotípicos I-EXPLORATION +convencionales I-EXPLORATION +utilizando I-EXPLORATION +los I-EXPLORATION +siguientes I-EXPLORATION +medios I-EXPLORATION de I-EXPLORATION -1, I-EXPLORATION -1 I-EXPLORATION -mEq/L I-EXPLORATION -y I-EXPLORATION -elevación I-EXPLORATION +identificación: I-EXPLORATION +triple I-EXPLORATION +azúcar I-EXPLORATION +hierro I-EXPLORATION +(TSI), I-EXPLORATION +movilidad-indol-ornitina I-EXPLORATION +decarboxilasa I-EXPLORATION +(MIO), I-EXPLORATION +citrato I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -CK. I-EXPLORATION -La I-EXPLORATION -dosificación I-EXPLORATION +Simmons, I-EXPLORATION +fenilalanina I-EXPLORATION +deaminasa, I-EXPLORATION +agar I-EXPLORATION +hierro-lisina I-EXPLORATION +(LIA), I-EXPLORATION +arginina I-EXPLORATION +dehidrolasa, I-EXPLORATION +utilización I-EXPLORATION de I-EXPLORATION -TSH I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -dentro I-EXPLORATION +mucato, I-EXPLORATION +malonato I-EXPLORATION +y I-EXPLORATION +fermentación I-EXPLORATION de I-EXPLORATION -rango I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -inició I-EXPLORATION -reposición I-EXPLORATION -hidroelectrolítica I-EXPLORATION +carbohidratos I-EXPLORATION +en I-EXPLORATION +caldo I-EXPLORATION con I-EXPLORATION -mejoría I-EXPLORATION +rojo-fenol10. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +serogrupo I-EXPLORATION de I-EXPLORATION +las I-EXPLORATION +cepas I-EXPLORATION +de I-EXPLORATION +Shigella I-EXPLORATION +se I-EXPLORATION +determinó I-EXPLORATION +por I-EXPLORATION la I-EXPLORATION -paresia I-EXPLORATION -muscular, I-EXPLORATION -disminución I-EXPLORATION -progresiva I-EXPLORATION +técnica I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -mialgias I-EXPLORATION +aglutinación I-EXPLORATION +en I-EXPLORATION +lámina I-EXPLORATION +utilizando I-EXPLORATION +antisueros I-EXPLORATION +policlonales I-EXPLORATION +comerciales I-EXPLORATION +(BD, I-EXPLORATION +Difco I-EXPLORATION +TM) I-EXPLORATION y I-EXPLORATION -normalización I-EXPLORATION +el I-EXPLORATION +serotipo I-EXPLORATION +con I-EXPLORATION +antisueros I-EXPLORATION +absorbidos I-EXPLORATION +serotipo-específicos. I-EXPLORATION + I-EXPLORATION +Para I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -valores I-EXPLORATION +la I-EXPLORATION +susceptibilidad I-EXPLORATION +antimicrobiana I-EXPLORATION +se I-EXPLORATION +utilizó I-EXPLORATION +la I-EXPLORATION +técnica I-EXPLORATION de I-EXPLORATION -K+pl I-EXPLORATION +difusión I-EXPLORATION +en I-EXPLORATION +disco I-EXPLORATION +en I-EXPLORATION +agar11. I-EXPLORATION +Los I-EXPLORATION +antibacterianos I-EXPLORATION +ensayados I-EXPLORATION +fueron: I-EXPLORATION +ampicilina, I-EXPLORATION +ampicilina/sulbactam, I-EXPLORATION +cefradina, I-EXPLORATION +cefoxitina, I-EXPLORATION +ceftriaxona, I-EXPLORATION +ácido I-EXPLORATION +nalidíxico, I-EXPLORATION +ciprofloxacina, I-EXPLORATION +tetraciclina I-EXPLORATION y I-EXPLORATION -CK. I-EXPLORATION -La I-EXPLORATION -hipopotasemia I-EXPLORATION +cotrimoxazol I-EXPLORATION +(Oxoid I-EXPLORATION +Ltd., I-EXPLORATION +Basingstoke, I-EXPLORATION +Hampshire, I-EXPLORATION +Inglaterra). I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -atribuyó I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -pérdidas I-EXPLORATION +realizó I-EXPLORATION +evaluación I-EXPLORATION de I-EXPLORATION -origen I-EXPLORATION -digestivo, I-EXPLORATION -secundarias I-EXPLORATION -al I-EXPLORATION -procedimiento I-EXPLORATION -quirúrgico. I-EXPLORATION -Si I-EXPLORATION -bien I-EXPLORATION la I-EXPLORATION -severidad I-EXPLORATION +sensibilidad I-EXPLORATION +a I-EXPLORATION +azitromicina I-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +existen I-EXPLORATION +puntos I-EXPLORATION de I-EXPLORATION +corte I-EXPLORATION +para I-EXPLORATION la I-EXPLORATION -misma I-EXPLORATION -puede I-EXPLORATION -ser I-EXPLORATION -causa I-EXPLORATION +interpretación I-EXPLORATION de I-EXPLORATION las I-EXPLORATION -manifestaciones I-EXPLORATION -neuromusculares, I-EXPLORATION -el I-EXPLORATION -hallazgo I-EXPLORATION -de I-EXPLORATION -niveles I-EXPLORATION -elevados I-EXPLORATION -de I-EXPLORATION -CK I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -RM I-EXPLORATION -asociada. I-EXPLORATION +susceptibilidad I-EXPLORATION +por I-EXPLORATION +esta I-EXPLORATION +técnica I-EXPLORATION +para I-EXPLORATION +azitromicina I-EXPLORATION +en I-EXPLORATION +EUCAST I-EXPLORATION +ni I-EXPLORATION +en I-EXPLORATION +CLSI11. I-EXPLORATION I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -57 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -paresia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -inferiores I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -distal I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -instalación I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -horas. I-PRESENT_ILLNESS -Destacaba B-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -hipertensa I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -enalapril, I-PAST_MEDICAL_HISTORY -atenolol I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -furosemida. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -previo I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -hipopotasemia I-PAST_MEDICAL_HISTORY -asintomática I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -indicó I-PAST_MEDICAL_HISTORY -suplemento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -potasio I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -oral. I-PAST_MEDICAL_HISTORY -Presentaba B-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -apirética I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -TA I-EXPLORATION -de I-EXPLORATION -150/90 I-EXPLORATION -mmHg. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -valoración I-EXPLORATION -neuromuscular I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -cuadriparesia I-EXPLORATION -a I-EXPLORATION -predominio I-EXPLORATION +La I-EXPLORATION +electroforesis I-EXPLORATION en I-EXPLORATION -miembros I-EXPLORATION -inferiores, I-EXPLORATION -con I-EXPLORATION -reflejos I-EXPLORATION -osteotendinosos I-EXPLORATION -conservados. I-EXPLORATION -El I-EXPLORATION -K+pl I-EXPLORATION -era I-EXPLORATION -1, I-EXPLORATION -4 I-EXPLORATION -mEq/L, I-EXPLORATION -con I-EXPLORATION -potasiuria I-EXPLORATION +gel I-EXPLORATION en I-EXPLORATION -muestra I-EXPLORATION -aislada I-EXPLORATION -de I-EXPLORATION -26, I-EXPLORATION -7 I-EXPLORATION -mEq/L I-EXPLORATION -y I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -CK. I-EXPLORATION -Se B-TREATMENT -suspendió I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -diurético I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -reposición I-TREATMENT -hidroelectrolítica I-TREATMENT -obteniéndose B-EVOLUTION -una I-EVOLUTION -rápida I-EVOLUTION -respuesta I-EVOLUTION -clínica I-EVOLUTION -con I-EVOLUTION -normalización I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -valores I-EVOLUTION -de I-EVOLUTION -K+pl I-EVOLUTION -y I-EVOLUTION -CK. I-EVOLUTION -En B-EXPLORATION -este I-EXPLORATION -caso, I-EXPLORATION -a I-EXPLORATION -diferencia I-EXPLORATION +campo I-EXPLORATION +pulsado I-EXPLORATION +(PFGE) I-EXPLORATION de I-EXPLORATION los I-EXPLORATION -anteriores, I-EXPLORATION -el I-EXPLORATION -origen I-EXPLORATION +cuatro I-EXPLORATION +aislados I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -hipopotasemia I-EXPLORATION -fueron I-EXPLORATION -las I-EXPLORATION -pérdidas I-EXPLORATION -renales I-EXPLORATION +Shigella I-EXPLORATION +spp. I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION de I-EXPLORATION -potasio, I-EXPLORATION -secundarias I-EXPLORATION +acuerdo I-EXPLORATION al I-EXPLORATION -tratamiento I-EXPLORATION -con I-EXPLORATION -diuréticos I-EXPLORATION +procedimiento I-EXPLORATION +estándar I-EXPLORATION +del I-EXPLORATION +CDC12. I-EXPLORATION +La I-EXPLORATION +interpretación I-EXPLORATION de I-EXPLORATION -asa. I-EXPLORATION -El I-EXPLORATION -hallazgo I-EXPLORATION +los I-EXPLORATION +patrones I-EXPLORATION de I-EXPLORATION -26, I-EXPLORATION -7 I-EXPLORATION -mEq/L I-EXPLORATION +bandas I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +visualmente I-EXPLORATION +siguiendo I-EXPLORATION +los I-EXPLORATION +criterios I-EXPLORATION de I-EXPLORATION -potasiuria I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -muestra I-EXPLORATION +Tenover I-EXPLORATION +y I-EXPLORATION +cols13. I-EXPLORATION + I-EXPLORATION +Las I-EXPLORATION +cuatro I-EXPLORATION +cepas I-EXPLORATION +correspondieron I-EXPLORATION +a I-EXPLORATION +Shigella I-EXPLORATION +flexneri I-EXPLORATION +del I-EXPLORATION +serotipo I-EXPLORATION +6 I-EXPLORATION +y I-EXPLORATION +presentaron I-EXPLORATION +resistencia I-EXPLORATION +sólo I-EXPLORATION +a I-EXPLORATION +cotrimoxa-zol. I-EXPLORATION +Las I-EXPLORATION +dos I-EXPLORATION +cepas I-EXPLORATION +recuperadas I-EXPLORATION +del I-EXPLORATION +mismo I-EXPLORATION +paciente I-EXPLORATION +(heces I-EXPLORATION +y I-EXPLORATION +sangre) I-EXPLORATION +mostraron I-EXPLORATION +un I-EXPLORATION +patrón I-EXPLORATION de I-EXPLORATION -orina I-EXPLORATION -aislada, I-EXPLORATION -es I-EXPLORATION -concordante I-EXPLORATION +bandas I-EXPLORATION +idéntico I-EXPLORATION +entre I-EXPLORATION +sí I-EXPLORATION +y I-EXPLORATION +muy I-EXPLORATION +similar I-EXPLORATION +al I-EXPLORATION +patrón I-EXPLORATION +obtenido I-EXPLORATION con I-EXPLORATION -el I-EXPLORATION -origen I-EXPLORATION -renal I-EXPLORATION +las I-EXPLORATION +cepas I-EXPLORATION del I-EXPLORATION -disturbio. I-EXPLORATION +otro I-EXPLORATION +paciente. I-EXPLORATION +Las I-EXPLORATION +cepas I-EXPLORATION +se I-EXPLORATION +definieron I-EXPLORATION +como I-EXPLORATION +muy I-EXPLORATION +relacionadas I-EXPLORATION +desde I-EXPLORATION +el I-EXPLORATION +punto I-EXPLORATION +de I-EXPLORATION +vista I-EXPLORATION +genético. I-EXPLORATION I-EXPLORATION - -Mujer, B-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS -Cinco B-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -trató I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cáncer I-PAST_MEDICAL_HISTORY -cervicouterino. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -control I-PRESENT_ILLNESS -rutinario, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encontró I-PRESENT_ILLNESS -hidronefrosis I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -atrofia I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -riñón I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS -Se B-TREATMENT -instalaron I-TREATMENT -catéteres I-TREATMENT -ureterales I-TREATMENT +Tratamiento B-TREATMENT +antimicrobiano I-TREATMENT y I-TREATMENT +evolución I-TREATMENT + I-TREATMENT +El I-TREATMENT +primer I-TREATMENT +paciente I-TREATMENT +recibió I-TREATMENT +cotrimoxazol, I-TREATMENT +800/160 I-TREATMENT +mg, I-TREATMENT +vía I-TREATMENT +oral, I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +h, I-TREATMENT +por I-TREATMENT +48 I-TREATMENT +h. I-TREATMENT +Luego I-TREATMENT +de I-TREATMENT +conocer I-TREATMENT +el I-TREATMENT +resultado I-TREATMENT +bacteriológico I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT se I-TREATMENT -intentó I-TREATMENT -infructuosamente I-TREATMENT -efectuar I-TREATMENT -ureterolisis. I-TREATMENT -La B-EXPLORATION -biopsia I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -retroperitoneal I-EXPLORATION -reveló I-EXPLORATION -FRP I-EXPLORATION -y I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -tumor. I-EXPLORATION -Se B-TREATMENT -prescribió I-TREATMENT -defazacort I-TREATMENT -30 I-TREATMENT -mg/día I-TREATMENT +cambió I-TREATMENT +a I-TREATMENT +ampicilina I-TREATMENT +1 I-TREATMENT +gr I-TREATMENT +iv, I-TREATMENT +4 I-TREATMENT +veces I-TREATMENT +al I-TREATMENT +día, I-TREATMENT +durante I-TREATMENT +6 I-TREATMENT +días, I-TREATMENT y I-TREATMENT -colchicina I-TREATMENT -1, I-TREATMENT -0 I-TREATMENT -mg/día. I-TREATMENT -Al B-EVOLUTION -año I-EVOLUTION -la I-EVOLUTION -masa I-EVOLUTION -retroperitoneal I-EVOLUTION -había I-EVOLUTION -desaparecido I-EVOLUTION -y I-EVOLUTION +luego I-TREATMENT +ciprofloxacina I-TREATMENT +500 I-TREATMENT +mg I-TREATMENT +vía I-TREATMENT +oral, I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +h, I-TREATMENT +hasta I-TREATMENT +completar I-TREATMENT +14 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +tratamiento. I-TREATMENT + I-TREATMENT +El I-TREATMENT +segundo I-TREATMENT +paciente I-TREATMENT +se I-TREATMENT +mantuvo I-TREATMENT +sin I-TREATMENT +tratamiento I-TREATMENT +antimicrobiano I-TREATMENT +hasta I-TREATMENT +el I-TREATMENT +resultado I-TREATMENT +bacteriológico. I-TREATMENT +Recibió I-TREATMENT +ciprofloxacina I-TREATMENT +400 I-TREATMENT +mg I-TREATMENT +iv, I-TREATMENT +dos I-TREATMENT +veces I-TREATMENT +al I-TREATMENT +día, I-TREATMENT +por I-TREATMENT +7 I-TREATMENT +días I-TREATMENT +y I-TREATMENT +luego I-TREATMENT +500 I-TREATMENT +mg I-TREATMENT +vía I-TREATMENT +oral, I-TREATMENT +dos I-TREATMENT +veces I-TREATMENT +al I-TREATMENT +día, I-TREATMENT +hasta I-TREATMENT +completar I-TREATMENT +14 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +tratamiento. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +ambos I-EVOLUTION +casos I-EVOLUTION la I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -era I-EVOLUTION -normal. I-EVOLUTION -A I-EVOLUTION -16 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION +evolución I-EVOLUTION +fue I-EVOLUTION +favorable I-EVOLUTION +con I-EVOLUTION +remisión I-EVOLUTION de I-EVOLUTION -FRP, I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION -estaba I-EVOLUTION -asintomática I-EVOLUTION +sintomatología I-EVOLUTION +digestiva I-EVOLUTION y I-EVOLUTION sin I-EVOLUTION -evidencias I-EVOLUTION +aparición I-EVOLUTION de I-EVOLUTION -cáncer. I-EVOLUTION +otras I-EVOLUTION +complicaciones, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +fueron I-EVOLUTION +dados I-EVOLUTION +de I-EVOLUTION +alta. I-EVOLUTION I-EVOLUTION -Hombre B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -53 I-PRESENT_ILLNESS +71 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -IC I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -2008 I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -dilatación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -VI I-PAST_MEDICAL_HISTORY -(FE I-PAST_MEDICAL_HISTORY -35%) I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -ecocardiograma. I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -coronariografía I-PRESENT_ILLNESS -demostró I-PRESENT_ILLNESS -enfermedad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +perímetro I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +molestias I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +ese I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -vasos, I-PRESENT_ILLNESS -realizándose I-PRESENT_ILLNESS -angioplastía I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS -arteria I-PRESENT_ILLNESS -descendente I-PRESENT_ILLNESS -anterior. I-PRESENT_ILLNESS -En B-EXPLORATION -enero I-EXPLORATION -de I-EXPLORATION -2013 I-EXPLORATION -se I-EXPLORATION -hospitalizó I-EXPLORATION -con I-EXPLORATION -IC I-EXPLORATION -descompensada, I-EXPLORATION -con I-EXPLORATION -FE I-EXPLORATION -20% I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ecocardiograma. I-EXPLORATION -Un I-EXPLORATION -SPECT I-EXPLORATION -miocàrdico I-EXPLORATION -descartó I-EXPLORATION -isquemia. I-EXPLORATION -En B-EVOLUTION -julio I-EVOLUTION -de I-EVOLUTION -2013 I-EVOLUTION -se I-EVOLUTION -re-hospitalizó, I-EVOLUTION -en I-EVOLUTION -CF I-EVOLUTION -IV, I-EVOLUTION -compensándose B-TREATMENT -con I-TREATMENT -infusión I-TREATMENT -de I-TREATMENT -levosimendan I-TREATMENT -0, I-TREATMENT -1 I-TREATMENT -mg/kg/min. I-TREATMENT -En I-TREATMENT -agosto I-TREATMENT -de I-TREATMENT -2013, I-TREATMENT -por I-TREATMENT -la I-TREATMENT -severa I-TREATMENT -disfunción I-TREATMENT -ventricular I-TREATMENT -y I-TREATMENT -escasa I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -trasplante, I-TREATMENT -se I-TREATMENT -implantó I-TREATMENT -un I-TREATMENT -HVAD I-TREATMENT -con I-TREATMENT -técnica I-TREATMENT -mínimamente I-TREATMENT -invasiva. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -post I-EVOLUTION -operatoria I-EVOLUTION -ocurrió I-EVOLUTION -sin I-EVOLUTION -incidentes, I-EVOLUTION -alcanzando I-EVOLUTION -un I-EVOLUTION -índice I-EVOLUTION -cardiaco I-EVOLUTION -de I-EVOLUTION -2, I-EVOLUTION -5 I-EVOLUTION -L/m2 I-EVOLUTION -48 I-EVOLUTION -h I-EVOLUTION -post-implante. I-EVOLUTION -Egresó I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -15 I-EVOLUTION -días I-EVOLUTION -post-cirugía, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -9 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -permanece I-EVOLUTION -en I-EVOLUTION -CF I-EVOLUTION -I. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS -Con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mesenquimopatía I-PAST_MEDICAL_HISTORY -indiferenciada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -nariz I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -silla I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -montar, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -condritis. I-PAST_MEDICAL_HISTORY -Anticuerpos I-PAST_MEDICAL_HISTORY -antinucleares I-PAST_MEDICAL_HISTORY -(ANA) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -anticuerpos I-PAST_MEDICAL_HISTORY -anti-Ro I-PAST_MEDICAL_HISTORY -+. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -alopecia, I-PRESENT_ILLNESS -artritis, I-PRESENT_ILLNESS -úlceras I-PRESENT_ILLNESS -orales I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Presentaba I-PRESENT_ILLNESS +disminución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +cantidad I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -nasales. I-PRESENT_ILLNESS -Presentaba B-EXPLORATION -soplo I-EXPLORATION -aórtico I-EXPLORATION -sistólico I-EXPLORATION -V/VI I-EXPLORATION -irradiado I-EXPLORATION -al I-EXPLORATION -cuello. I-EXPLORATION -Tenía I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -eritrosedimentación I-EXPLORATION -(VHS) I-EXPLORATION -64 I-EXPLORATION -mm/h, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -(PCR) I-EXPLORATION -5 I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -10 I-EXPLORATION -mg/L), I-EXPLORATION -creatininemia I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -mg/dl, I-EXPLORATION -ANA I-EXPLORATION -1/160 I-EXPLORATION -moteado, I-EXPLORATION -anti-Ro I-EXPLORATION -22, I-EXPLORATION -5 I-EXPLORATION -U I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -15), I-EXPLORATION -anti-B2 I-EXPLORATION -glicoproteína I-EXPLORATION -1 I-EXPLORATION -IgM I-EXPLORATION -31, I-EXPLORATION -2 I-EXPLORATION -MPL I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -8) I-EXPLORATION -e I-EXPLORATION -IgG I-EXPLORATION -17 I-EXPLORATION -GPL I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -8), I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -normal. I-EXPLORATION -Ecocardiograma: I-EXPLORATION -aceleración I-EXPLORATION -del I-EXPLORATION -flujo I-EXPLORATION -de I-EXPLORATION -aorta I-EXPLORATION -torácica I-EXPLORATION +consistencia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sus I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +pero I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +frecuencia. I-PRESENT_ILLNESS +En B-FAMILY_HISTORY +sus I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +personales I-FAMILY_HISTORY +destacan: I-FAMILY_HISTORY +alergia I-FAMILY_HISTORY +a I-FAMILY_HISTORY +la I-FAMILY_HISTORY +penicilina, I-FAMILY_HISTORY +hipertensa, I-FAMILY_HISTORY +dislipémica I-FAMILY_HISTORY +y I-FAMILY_HISTORY +asma I-FAMILY_HISTORY +intrínseco. I-FAMILY_HISTORY + I-FAMILY_HISTORY +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +destacaba I-EXPLORATION +gran I-EXPLORATION +tumoración I-EXPLORATION +abdominal I-EXPLORATION +palpable, I-EXPLORATION +dura I-EXPLORATION y I-EXPLORATION -vasos I-EXPLORATION -del I-EXPLORATION -cuello. I-EXPLORATION -aTAC I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -cuello I-EXPLORATION +dolorosa. I-EXPLORATION +La I-EXPLORATION +analítica I-EXPLORATION +fue I-EXPLORATION +normal I-EXPLORATION y I-EXPLORATION -cerebral: I-EXPLORATION -engrosamiento I-EXPLORATION -segmentario I-EXPLORATION +los I-EXPLORATION +marcadores I-EXPLORATION +tumorales I-EXPLORATION +negativos. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION y I-EXPLORATION -realce I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -aórtica I-EXPLORATION +tomografía I-EXPLORATION +computerizada I-EXPLORATION +(TC) I-EXPLORATION +abdómino-pélvica I-EXPLORATION +mostraban I-EXPLORATION +anejos I-EXPLORATION +normales, I-EXPLORATION +endometrio I-EXPLORATION +lineal I-EXPLORATION y I-EXPLORATION -sus I-EXPLORATION -ramas I-EXPLORATION -principales, I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -estenosis I-EXPLORATION -y I-EXPLORATION -dilatación I-EXPLORATION -alternadas. I-EXPLORATION -Estenosis I-EXPLORATION -moderada I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +sólida I-EXPLORATION de I-EXPLORATION -carótida I-EXPLORATION -derecha, I-EXPLORATION -origen I-EXPLORATION -del I-EXPLORATION -tronco I-EXPLORATION -celíaco I-EXPLORATION -y I-EXPLORATION -arteria I-EXPLORATION -mesentérica I-EXPLORATION -superior. I-EXPLORATION -Vasos I-EXPLORATION -cerebrales I-EXPLORATION -normales. I-EXPLORATION +17, I-EXPLORATION +6 I-EXPLORATION +x I-EXPLORATION +17, I-EXPLORATION +6 I-EXPLORATION +x I-EXPLORATION +11 I-EXPLORATION +cm I-EXPLORATION +sin I-EXPLORATION +poder I-EXPLORATION +precisar I-EXPLORATION +origen. I-EXPLORATION + I-EXPLORATION Se B-TREATMENT -trató I-TREATMENT +intervino I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +programada, I-TREATMENT +Servicio I-TREATMENT +de I-TREATMENT +Ginecología, I-TREATMENT +realizando I-TREATMENT +laparotomía I-TREATMENT +media I-TREATMENT +infraumbilical, I-TREATMENT +evidenciando I-TREATMENT +una I-TREATMENT +tumoración I-TREATMENT +de I-TREATMENT +aproximadamente I-TREATMENT +20 I-TREATMENT +cm I-TREATMENT +dependiente I-TREATMENT +de I-TREATMENT +mesenterio I-TREATMENT +adherida I-TREATMENT +a I-TREATMENT +un I-TREATMENT +asa I-TREATMENT +de I-TREATMENT +intestino I-TREATMENT +delgado I-TREATMENT +y I-TREATMENT +a I-TREATMENT +colon I-TREATMENT +sigmoide. I-TREATMENT +Se I-TREATMENT +avisó I-TREATMENT +al I-TREATMENT +cirujano I-TREATMENT +de I-TREATMENT +guardia I-TREATMENT +que I-TREATMENT +realizó I-TREATMENT +exéresis I-TREATMENT +de I-TREATMENT +la I-TREATMENT +tumoración I-TREATMENT con I-TREATMENT -corticoides, I-TREATMENT -hidroxicloroquina I-TREATMENT +resección I-TREATMENT +intestinal I-TREATMENT +de I-TREATMENT +50 I-TREATMENT +cm I-TREATMENT y I-TREATMENT -6 I-TREATMENT -pulsos I-TREATMENT +sutura I-TREATMENT de I-TREATMENT -ciclofosfamida, I-TREATMENT -luego I-TREATMENT -azatioprina I-TREATMENT +área I-TREATMENT +deserosada I-TREATMENT +de I-TREATMENT +colon I-TREATMENT +sigmoide. I-TREATMENT +Al I-TREATMENT +7o I-TREATMENT +día I-TREATMENT +postoperatorio I-TREATMENT +se I-TREATMENT +reintervino I-TREATMENT +de I-TREATMENT +urgencia I-TREATMENT +por I-TREATMENT +presentar I-TREATMENT +abdomen I-TREATMENT +agudo I-TREATMENT +realizando I-TREATMENT +resección I-TREATMENT +de I-TREATMENT +colon I-TREATMENT +sigmoide I-TREATMENT +perforado I-TREATMENT y I-TREATMENT -prednisona. I-TREATMENT -El B-EVOLUTION -control I-EVOLUTION -a I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -demostró I-EVOLUTION -disminución I-EVOLUTION +anastomosis I-TREATMENT +T-T. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +posteriormente I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -inflamación I-EVOLUTION +forma I-EVOLUTION +favorable I-EVOLUTION +siendo I-EVOLUTION +dada I-EVOLUTION de I-EVOLUTION -aorta I-EVOLUTION -abdominal, I-EVOLUTION -tronco I-EVOLUTION -celíaco I-EVOLUTION -y I-EVOLUTION -arteria I-EVOLUTION -mesentérica I-EVOLUTION -superior, I-EVOLUTION -estenosis I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +17 I-EVOLUTION +día I-EVOLUTION +postoperatorio I-EVOLUTION de I-EVOLUTION -50% I-EVOLUTION -del I-EVOLUTION -origen I-EVOLUTION -del I-EVOLUTION -tronco I-EVOLUTION -celíaco I-EVOLUTION -con I-EVOLUTION -dilatación I-EVOLUTION -post I-EVOLUTION -estenótica I-EVOLUTION +la I-EVOLUTION +segunda I-EVOLUTION +intervención. I-EVOLUTION + I-EVOLUTION +La B-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +mostró I-EXPLORATION +proliferación I-EXPLORATION +fusocelular I-EXPLORATION +sin I-EXPLORATION +atipias I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +alguna I-EXPLORATION +mitosis I-EXPLORATION +ocasional. I-EXPLORATION +Las I-EXPLORATION +células I-EXPLORATION +tumorales I-EXPLORATION +son I-EXPLORATION +positivas I-EXPLORATION +con I-EXPLORATION +vimentina I-EXPLORATION +y I-EXPLORATION +CD117 I-EXPLORATION +(C-Kit). I-EXPLORATION +Actualmente, B-EVOLUTION +un I-EVOLUTION +año I-EVOLUTION y I-EVOLUTION -normalización I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -inflamatorios. I-EVOLUTION -A I-EVOLUTION -2 I-EVOLUTION -años I-EVOLUTION +medio I-EVOLUTION +después I-EVOLUTION de I-EVOLUTION -seguimiento I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION +intervención, I-EVOLUTION se I-EVOLUTION encuentra I-EVOLUTION asintomática I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -exámenes I-EVOLUTION -normales. I-EVOLUTION - I-EVOLUTION +y B-TREATMENT +en I-TREATMENT +tratamiento I-TREATMENT +adyuvante I-TREATMENT +con I-TREATMENT +mesilato I-TREATMENT +de I-TREATMENT +imatinib. I-TREATMENT + I-TREATMENT -Hombre B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -37 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -fumador B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -60 I-PAST_MEDICAL_HISTORY -cigarrillos/día I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -adolescencia, I-PAST_MEDICAL_HISTORY -hospitalizado B-PRESENT_ILLNESS +81 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +pluripatológico, B-PAST_MEDICAL_HISTORY +acude B-PRESENT_ILLNESS por I-PRESENT_ILLNESS -síncope I-PRESENT_ILLNESS -recurrente. I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso, I-EXPLORATION -se I-EXPLORATION -registró I-EXPLORATION -TV I-EXPLORATION -monoforma I-EXPLORATION -con I-EXPLORATION -frecuencia I-EXPLORATION -de I-EXPLORATION -233 I-EXPLORATION -lpm I-EXPLORATION -en I-EXPLORATION -trazado I-EXPLORATION -de I-EXPLORATION -monitor, I-EXPLORATION -que I-EXPLORATION -convirtió I-EXPLORATION -espontáneamente I-EXPLORATION -a I-EXPLORATION -ritmo I-EXPLORATION -sinusal. I-EXPLORATION -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -consumidor I-PAST_MEDICAL_HISTORY -ocasional I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cocaína I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ingreso. I-PAST_MEDICAL_HISTORY -Negó B-PRESENT_ILLNESS -tener I-PRESENT_ILLNESS -angina I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -disnea. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -ECG I-EXPLORATION -post-conversión I-EXPLORATION -a I-EXPLORATION -ritmo I-EXPLORATION -sinusal I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -ondas I-EXPLORATION -T I-EXPLORATION -(-) I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -derivaciones I-EXPLORATION -precordiales I-EXPLORATION +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +derecho, I-PRESENT_ILLNESS +fiebre, I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +últimas I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +persistentes. I-PRESENT_ILLNESS +La B-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +mostraba I-EXPLORATION +ictericia I-EXPLORATION +escleral I-EXPLORATION y I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -inferior. I-EXPLORATION -La I-EXPLORATION -troponina I-EXPLORATION -I I-EXPLORATION -alcanzó I-EXPLORATION un I-EXPLORATION -valor I-EXPLORATION -máximo I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -8 I-EXPLORATION -ng/ml I-EXPLORATION -[VN I-EXPLORATION -< I-EXPLORATION -0, I-EXPLORATION -4 I-EXPLORATION -ng/ml]. I-EXPLORATION -Un I-EXPLORATION -ecocardiograma I-EXPLORATION -reveló I-EXPLORATION -leve I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -diámetros I-EXPLORATION -internos I-EXPLORATION -del I-EXPLORATION -VI, I-EXPLORATION -disquinesia I-EXPLORATION -apical I-EXPLORATION -y I-EXPLORATION -lateroapical I-EXPLORATION +abdomen I-EXPLORATION con I-EXPLORATION -función I-EXPLORATION -sistólica I-EXPLORATION -global I-EXPLORATION -levemente I-EXPLORATION -disminuida I-EXPLORATION -[FE I-EXPLORATION -45%, I-EXPLORATION -Simpson]. I-EXPLORATION -En I-EXPLORATION +dolor I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -evaluación I-EXPLORATION -del I-EXPLORATION -VD I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -anormalidades. I-EXPLORATION -Con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -presuntivo I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -coronaria, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -angiográfico I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -arterias I-EXPLORATION -coronarias I-EXPLORATION -normales. I-EXPLORATION -Para I-EXPLORATION -avanzar I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -diagnóstico, I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -RC. I-EXPLORATION -Las I-EXPLORATION -imágenes I-EXPLORATION -con I-EXPLORATION -secuencias I-EXPLORATION -de I-EXPLORATION -eco-gradiente I-EXPLORATION +palpación I-EXPLORATION en I-EXPLORATION -4-cavidades I-EXPLORATION +hipocondrio I-EXPLORATION +derecho I-EXPLORATION +sin I-EXPLORATION +peritonismo. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION y I-EXPLORATION -eje I-EXPLORATION -corto, I-EXPLORATION -mostraron I-EXPLORATION +TAC I-EXPLORATION +Abdominal I-EXPLORATION +evidenciaban I-EXPLORATION dilatación I-EXPLORATION -del I-EXPLORATION -VD I-EXPLORATION -[VDVD/ASC I-EXPLORATION -122/m2] I-EXPLORATION -con I-EXPLORATION -acentuada I-EXPLORATION -disminución I-EXPLORATION -del I-EXPLORATION -espesor I-EXPLORATION -parietal I-EXPLORATION -especialmente I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -lateral, I-EXPLORATION -microaneurismas I-EXPLORATION -(flechas I-EXPLORATION -amarillas), I-EXPLORATION -disquinesia I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -lateral I-EXPLORATION -basal I-EXPLORATION -e I-EXPLORATION -inferior I-EXPLORATION -(flechas I-EXPLORATION -azules) I-EXPLORATION -y I-EXPLORATION -función I-EXPLORATION -global I-EXPLORATION -severamente I-EXPLORATION -disminuida I-EXPLORATION -(FE I-EXPLORATION -19%). I-EXPLORATION -Al I-EXPLORATION -mismo I-EXPLORATION -tiempo, I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -leve I-EXPLORATION -aumento I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -diámetros I-EXPLORATION -internos I-EXPLORATION -del I-EXPLORATION -VI I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +intrahepática I-EXPLORATION con I-EXPLORATION -moderada I-EXPLORATION -diminución I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -función I-EXPLORATION -sistólica I-EXPLORATION -global I-EXPLORATION -(FE I-EXPLORATION -38%), I-EXPLORATION -dos I-EXPLORATION -zonas I-EXPLORATION +aerobilia, I-EXPLORATION +vesícula I-EXPLORATION +mal I-EXPLORATION +delimitada I-EXPLORATION con I-EXPLORATION -disquinesia I-EXPLORATION +litiasis; I-EXPLORATION +gran I-EXPLORATION +cálculo I-EXPLORATION +biliar I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -apical I-EXPLORATION -con I-EXPLORATION -adelgazamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -miocárdica I-EXPLORATION -(flechas I-EXPLORATION -azules) I-EXPLORATION +bulbo I-EXPLORATION +duodenal I-EXPLORATION +que I-EXPLORATION +condiciona I-EXPLORATION +obstrucción I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -zona I-EXPLORATION +dilatación I-EXPLORATION de I-EXPLORATION -aquinesia I-EXPLORATION -con I-EXPLORATION -miocardio I-EXPLORATION -adelgazado I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -lateral I-EXPLORATION -(flecha I-EXPLORATION -roja) I-EXPLORATION -e I-EXPLORATION -infiltración I-EXPLORATION -grasa I-EXPLORATION -adyacente I-EXPLORATION -(flecha I-EXPLORATION -verde). I-EXPLORATION -En I-EXPLORATION la I-EXPLORATION -imagen I-EXPLORATION -axial I-EXPLORATION -potenciada I-EXPLORATION +cámara I-EXPLORATION +gástrica. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +endoscopia I-EXPLORATION +digestiva I-EXPLORATION +alta I-EXPLORATION +observando I-EXPLORATION +contenido I-EXPLORATION +líquido I-EXPLORATION en I-EXPLORATION -T1, I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -infiltración I-EXPLORATION -grasa I-EXPLORATION -subepicárdica I-EXPLORATION +cavidad I-EXPLORATION +gástrica I-EXPLORATION +y, I-EXPLORATION en I-EXPLORATION -pared I-EXPLORATION -lateral I-EXPLORATION -del I-EXPLORATION -VD, I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -lateral I-EXPLORATION -y I-EXPLORATION -ápex I-EXPLORATION -del I-EXPLORATION -VI I-EXPLORATION -(flechas I-EXPLORATION -verdes). I-EXPLORATION -A I-EXPLORATION -su I-EXPLORATION -vez, I-EXPLORATION -la I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -4-cavidades I-EXPLORATION -con I-EXPLORATION -secuencias I-EXPLORATION -de I-EXPLORATION -inversión-recuperación I-EXPLORATION -para I-EXPLORATION -evaluar I-EXPLORATION -viabilidad, I-EXPLORATION -luego I-EXPLORATION -de I-EXPLORATION +bulbo I-EXPLORATION +duodenal I-EXPLORATION +un I-EXPLORATION +gran I-EXPLORATION +cálculo I-EXPLORATION +que I-EXPLORATION +ocupaba I-EXPLORATION la I-EXPLORATION -administración I-EXPLORATION -de I-EXPLORATION -gadolinio I-EXPLORATION -endovenoso, I-EXPLORATION -mostró I-EXPLORATION -extensa I-EXPLORATION -área I-EXPLORATION +práctica I-EXPLORATION +totalidad I-EXPLORATION de I-EXPLORATION -fibrosis I-EXPLORATION -(realce I-EXPLORATION -tardío) I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -pared I-EXPLORATION -lateral I-EXPLORATION -del I-EXPLORATION -VD I-EXPLORATION -y I-EXPLORATION -región I-EXPLORATION -subtricuspídea I-EXPLORATION -(flechas I-EXPLORATION -naranjas). I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -descritos I-EXPLORATION -son I-EXPLORATION -diagnósticos I-EXPLORATION -para I-EXPLORATION -DAVD I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -VI, I-EXPLORATION -en I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -tres I-EXPLORATION -criterios I-EXPLORATION -diagnósticos I-EXPLORATION -mayores: I-EXPLORATION -ondas I-EXPLORATION -T I-EXPLORATION -invertidas I-EXPLORATION -en I-EXPLORATION -derivaciones I-EXPLORATION -precordiales I-EXPLORATION -derechas I-EXPLORATION -(V1 I-EXPLORATION -a I-EXPLORATION -V6) I-EXPLORATION -en I-EXPLORATION -individuo I-EXPLORATION -> I-EXPLORATION -14 I-EXPLORATION -años I-EXPLORATION -sin I-EXPLORATION -bloqueo I-EXPLORATION -de I-EXPLORATION -rama I-EXPLORATION -derecho, I-EXPLORATION -disquinesia I-EXPLORATION -regionales I-EXPLORATION -del I-EXPLORATION -VD I-EXPLORATION -más I-EXPLORATION -cociente I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -telediastólico I-EXPLORATION -del I-EXPLORATION -VD I-EXPLORATION -> I-EXPLORATION -110 I-EXPLORATION -ml/m2 I-EXPLORATION -(varones); I-EXPLORATION -TV I-EXPLORATION -documentada. I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -incluyó I-TREATMENT -la I-TREATMENT -implantación I-TREATMENT +luz. I-EXPLORATION +Con B-TREATMENT +ayuda I-TREATMENT +del I-TREATMENT +endoscopio I-TREATMENT +lateral I-TREATMENT +y I-TREATMENT +litotriptor I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +fragmentación I-TREATMENT +parcial I-TREATMENT +del I-TREATMENT +cálculo, I-TREATMENT +con I-TREATMENT +extracción I-TREATMENT de I-TREATMENT +los I-TREATMENT +mismos, I-TREATMENT +quedando I-TREATMENT +en I-TREATMENT +duodeno I-TREATMENT un I-TREATMENT -CDI. I-TREATMENT - I-TREATMENT +fragmento I-TREATMENT +de I-TREATMENT +aproximadamente I-TREATMENT +2 I-TREATMENT +cm. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +presenta I-EVOLUTION +mejoría I-EVOLUTION +clínica I-EVOLUTION +notable I-EVOLUTION +con I-EVOLUTION +disminución I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +ictericia I-EVOLUTION +y I-EVOLUTION +ausencia I-EVOLUTION +de I-EVOLUTION +dolor I-EVOLUTION +abdominal. I-EVOLUTION +A I-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +horas I-EVOLUTION +se I-EVOLUTION +realizó I-EVOLUTION +endoscopia I-EVOLUTION +de I-EVOLUTION +control I-EVOLUTION +observando I-EVOLUTION +imagen I-EVOLUTION +sugestiva I-EVOLUTION +de I-EVOLUTION +fístula I-EVOLUTION +bilio-duodenal I-EVOLUTION +y I-EVOLUTION +ausencia I-EVOLUTION +del I-EVOLUTION +cálculo I-EVOLUTION +descrito. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +quinto I-EVOLUTION +día I-EVOLUTION +en I-EVOLUTION +buen I-EVOLUTION +estado I-EVOLUTION +clínico I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +mejoría I-EVOLUTION +notable I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +parámetros I-EVOLUTION +de I-EVOLUTION +colestasis. I-EVOLUTION +Dado I-EVOLUTION +el I-EVOLUTION +alto I-EVOLUTION +riesgo I-EVOLUTION +quirúrgico I-EVOLUTION +se I-EVOLUTION +decidió I-EVOLUTION +actitud I-EVOLUTION +expectante, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +está I-EVOLUTION +sintomático I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +12 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +seguimiento. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -coronaria, I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -hemodiálisis I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -uropatía I-PAST_MEDICAL_HISTORY -obstructiva, I-PAST_MEDICAL_HISTORY -portador I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -cistostomía I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -fue B-PRESENT_ILLNESS -hospitalizado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -medicina I-PRESENT_ILLNESS -interna I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -realizar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cambio I-PRESENT_ILLNESS +Hombre B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -catéter I-PRESENT_ILLNESS +28 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +soldado. B-PAST_MEDICAL_HISTORY +Al B-PRESENT_ILLNESS +reiniciar I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +entrenamiento I-PRESENT_ILLNESS +físico I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +intención I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -hemodiálisis, I-PRESENT_ILLNESS +participar I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -contexto I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +triatlón, I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -catéter I-PRESENT_ILLNESS -disfuncional; I-PRESENT_ILLNESS +haber I-PRESENT_ILLNESS +estado I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS sin I-PRESENT_ILLNESS -embargo, I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -llamó I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -atención I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cistostomía I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -estaba I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +actividad I-PRESENT_ILLNESS +física I-PRESENT_ILLNESS +intensa, I-PRESENT_ILLNESS +recorrió I-PRESENT_ILLNESS +45 I-PRESENT_ILLNESS +kilómetros I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -mal I-PRESENT_ILLNESS -estado, I-PRESENT_ILLNESS -objetivándose I-PRESENT_ILLNESS +bicicleta I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +luego I-PRESENT_ILLNESS +ascendió I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -presencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -orina I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -color I-PRESENT_ILLNESS -púrpura I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -bolsa I-PRESENT_ILLNESS -colectora. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Dentro I-PRESENT_ILLNESS +cima I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -medicamentos I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -usaba I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -crónica, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -destacó I-PRESENT_ILLNESS -ninguno I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -pudiese I-PRESENT_ILLNESS -relacionarse I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cambio I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cerro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -coloración I-PRESENT_ILLNESS +1.828 I-PRESENT_ILLNESS +metros, I-PRESENT_ILLNESS +bajo I-PRESENT_ILLNESS +intenso I-PRESENT_ILLNESS +calor I-PRESENT_ILLNESS +ambiental I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +ingiriendo I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +escaso I-PRESENT_ILLNESS +volumen I-PRESENT_ILLNESS de I-PRESENT_ILLNESS +líquidos. I-PRESENT_ILLNESS +Al I-PRESENT_ILLNESS +bajar I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -orina. I-PRESENT_ILLNESS +montaña I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +mareos, I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal, I-PRESENT_ILLNESS +náuseas, I-PRESENT_ILLNESS +vómitos, I-PRESENT_ILLNESS +diarrea, I-PRESENT_ILLNESS I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -en I-EXPLORATION -buenas I-EXPLORATION -condiciones I-EXPLORATION -generales, I-EXPLORATION -afebril, I-EXPLORATION -hemodinámicamente I-EXPLORATION -estable, I-EXPLORATION -con I-EXPLORATION -cistostomía I-EXPLORATION -in I-EXPLORATION -situ, I-EXPLORATION -funcionante, I-EXPLORATION -pero I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION +debilidad I-PRESENT_ILLNESS +muscular I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +calambres I-PRESENT_ILLNESS +musculares I-PRESENT_ILLNESS +intensos I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +extremidades. I-PRESENT_ILLNESS +En B-TREATMENT +el I-TREATMENT +servicio I-TREATMENT +de I-TREATMENT +urgencia I-TREATMENT +se I-TREATMENT +lo I-TREATMENT +hidrató, I-TREATMENT +enviándolo I-TREATMENT +posteriormente I-TREATMENT +a I-TREATMENT +su I-TREATMENT +domicilio. I-TREATMENT +Al B-EVOLUTION +día I-EVOLUTION +subsiguiente I-EVOLUTION +acudió I-EVOLUTION +al I-EVOLUTION +hospital I-EVOLUTION +por I-EVOLUTION +debilidad I-EVOLUTION +muscular, I-EVOLUTION +mialgias I-EVOLUTION +difusas, I-EVOLUTION +calambres I-EVOLUTION +y I-EVOLUTION +malestar I-EVOLUTION +general. I-EVOLUTION +Había I-EVOLUTION +orinado I-EVOLUTION +escasamente I-EVOLUTION +desde I-EVOLUTION +el I-EVOLUTION +día I-EVOLUTION +anterior. I-EVOLUTION +Existía B-EXPLORATION +una I-EXPLORATION +disminución I-EXPLORATION de I-EXPLORATION -deficiente I-EXPLORATION -autocuidado, I-EXPLORATION -sucia I-EXPLORATION +fuerzas I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +extremidades I-EXPLORATION y I-EXPLORATION +dolor I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +muscular. I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -muy I-EXPLORATION -mal I-EXPLORATION -olor. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -un I-EXPLORATION -sedimento I-EXPLORATION -urinario I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -leucocitos I-EXPLORATION -5-10 I-EXPLORATION -x I-EXPLORATION -campo I-EXPLORATION -[valor I-EXPLORATION -normal I-EXPLORATION -(VN): I-EXPLORATION -1-5], I-EXPLORATION -abundantes I-EXPLORATION -bacterias I-EXPLORATION +ingreso I-EXPLORATION +mostraron I-EXPLORATION +azotemia I-EXPLORATION y I-EXPLORATION -fosfatos I-EXPLORATION -amorfos I-EXPLORATION -abundantes I-EXPLORATION -x I-EXPLORATION -campo. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION +elevación I-EXPLORATION de I-EXPLORATION +las I-EXPLORATION +enzimas I-EXPLORATION +musculares. I-EXPLORATION +La I-EXPLORATION orina I-EXPLORATION -completo I-EXPLORATION -destacó I-EXPLORATION -el I-EXPLORATION -color I-EXPLORATION -y I-EXPLORATION -aspecto I-EXPLORATION -turbio, I-EXPLORATION -pH I-EXPLORATION -de I-EXPLORATION -7, I-EXPLORATION -8 I-EXPLORATION -[VN: I-EXPLORATION -4, I-EXPLORATION -5-8, I-EXPLORATION -0] I-EXPLORATION +era I-EXPLORATION +rosada I-EXPLORATION y I-EXPLORATION -nitritos I-EXPLORATION -positivos. I-EXPLORATION -En I-EXPLORATION el I-EXPLORATION -urocultivo I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -un I-EXPLORATION -recuento I-EXPLORATION -mayor I-EXPLORATION -a I-EXPLORATION -100.000 I-EXPLORATION -UFC/ml I-EXPLORATION -de I-EXPLORATION -Citrobacter I-EXPLORATION -freundii I-EXPLORATION -resistente I-EXPLORATION +sedimento I-EXPLORATION +mostró I-EXPLORATION +1 I-EXPLORATION a I-EXPLORATION -cefadroxilo, I-EXPLORATION -ciprofloxacino I-EXPLORATION -y I-EXPLORATION -nitrofurantoína. I-EXPLORATION -Entre I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -sangre, I-EXPLORATION -destacó I-EXPLORATION -una I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -10.600 I-EXPLORATION -x I-EXPLORATION -mm3 I-EXPLORATION -[VN: I-EXPLORATION -4.000-9.000], I-EXPLORATION -una I-EXPLORATION -PCR I-EXPLORATION -de I-EXPLORATION -34 I-EXPLORATION -mg/dL I-EXPLORATION -[VN: I-EXPLORATION -0-5] I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -VHS I-EXPLORATION -de I-EXPLORATION -54 I-EXPLORATION -mm/h I-EXPLORATION -[VN: I-EXPLORATION -2-10]. I-EXPLORATION +2 I-EXPLORATION +eritrocitos I-EXPLORATION +por I-EXPLORATION +campo. I-EXPLORATION Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION +diagnosticó I-EXPLORATION una I-EXPLORATION -ecografía I-EXPLORATION -prostática, I-EXPLORATION -procedimiento I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -técnicamente I-EXPLORATION -limitado I-EXPLORATION -por I-EXPLORATION -parcial I-EXPLORATION -distensión I-EXPLORATION -vesical, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -volumen I-EXPLORATION -al I-EXPLORATION -momento I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION +insuficiencia I-EXPLORATION +renal I-EXPLORATION +aguda I-EXPLORATION +secundaria I-EXPLORATION +a I-EXPLORATION +una I-EXPLORATION +RML I-EXPLORATION de I-EXPLORATION -26 I-EXPLORATION -cc, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -no I-EXPLORATION -fue I-EXPLORATION -posible I-EXPLORATION -evaluar I-EXPLORATION -la I-EXPLORATION -glándula I-EXPLORATION -prostática. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -con I-TREATMENT -ceftriaxona I-TREATMENT -2 I-TREATMENT -g/día I-TREATMENT -endovenoso I-TREATMENT -y I-TREATMENT -se I-TREATMENT -solicitó I-TREATMENT -evaluación I-TREATMENT -por I-TREATMENT -urología, I-TREATMENT -quienes I-TREATMENT -decidieron I-TREATMENT -realizar I-TREATMENT -un I-TREATMENT -recambio I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cistostomía, I-TREATMENT -en I-TREATMENT -contexto I-TREATMENT -de I-TREATMENT -la I-TREATMENT -infección I-TREATMENT -urinaria I-TREATMENT -y I-TREATMENT -el I-TREATMENT -aspecto I-TREATMENT -mal I-TREATMENT -cuidado I-TREATMENT -de I-TREATMENT -ésta. I-TREATMENT - I-TREATMENT -Con B-EVOLUTION -el I-EVOLUTION -transcurso I-EVOLUTION +esfuerzo I-EXPLORATION +y B-EVOLUTION +se I-EVOLUTION +trasladó I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +unidad I-EVOLUTION de I-EVOLUTION +cuidados I-EVOLUTION +intensivos. I-EVOLUTION +Allí B-TREATMENT +recibió I-TREATMENT +solución I-TREATMENT +salina I-TREATMENT +isotónica, I-TREATMENT +bicarbonato I-TREATMENT +y I-TREATMENT +furosemide, I-TREATMENT +recuperando B-EVOLUTION +rápidamente I-EVOLUTION +la I-EVOLUTION +diuresis. I-EVOLUTION +En I-EVOLUTION los I-EVOLUTION -días, I-EVOLUTION +9 I-EVOLUTION +días I-EVOLUTION +siguientes I-EVOLUTION se I-EVOLUTION -observó I-EVOLUTION -un I-EVOLUTION -aclaramiento I-EVOLUTION -progresivo I-EVOLUTION -del I-EVOLUTION -color I-EVOLUTION +obtuvo I-EVOLUTION +una I-EVOLUTION +recuperación I-EVOLUTION +paulatina I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -orina, I-EVOLUTION -retornando I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -color I-EVOLUTION -natural I-EVOLUTION -tras I-EVOLUTION -7 I-EVOLUTION -días I-EVOLUTION +función I-EVOLUTION +renal, I-EVOLUTION +sin I-EVOLUTION +emplearse I-EVOLUTION +diálisis, I-EVOLUTION +persistiendo I-EVOLUTION +las I-EVOLUTION +mialgias, I-EVOLUTION +los I-EVOLUTION +calambres I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +elevación I-EVOLUTION de I-EVOLUTION -antibioterapia. I-EVOLUTION +las I-EVOLUTION +enzimas I-EVOLUTION +musculares. I-EVOLUTION +Fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +décimoprimer I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +hospitalización I-EVOLUTION +con I-EVOLUTION +azotemia I-EVOLUTION +leve I-EVOLUTION +(creatinina I-EVOLUTION +1, I-EVOLUTION +43 I-EVOLUTION +mg/dl, I-EVOLUTION +uremia I-EVOLUTION +51 I-EVOLUTION +mg/dl) I-EVOLUTION +y I-EVOLUTION +persistencia I-EVOLUTION +de I-EVOLUTION +una I-EVOLUTION +creatinquinasa I-EVOLUTION +(CK) I-EVOLUTION +-total I-EVOLUTION +elevada. I-EVOLUTION +Un I-EVOLUTION +mes I-EVOLUTION +después, I-EVOLUTION +estando I-EVOLUTION +con I-EVOLUTION +actividad I-EVOLUTION +física I-EVOLUTION +liviana, I-EVOLUTION +la I-EVOLUTION +función I-EVOLUTION +renal I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +concentración I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +enzimas I-EVOLUTION +musculares I-EVOLUTION +fue I-EVOLUTION +normal. I-EVOLUTION I-EVOLUTION Paciente B-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -52 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -chofer, B-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY +83 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes, I-PAST_MEDICAL_HISTORY +estudiada I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +hemorragia I-PAST_MEDICAL_HISTORY +digestiva I-PAST_MEDICAL_HISTORY +oculta I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -tratamiento. I-PAST_MEDICAL_HISTORY -Consulta B-PRESENT_ILLNESS +la I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +realizó I-PAST_MEDICAL_HISTORY +CE. I-PAST_MEDICAL_HISTORY +Su B-PRESENT_ILLNESS +lectura I-PRESENT_ILLNESS +objetivó I-PRESENT_ILLNESS +detención I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +estenosis. I-PRESENT_ILLNESS +A I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +8 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ingesta, I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS por I-PRESENT_ILLNESS cuadro I-PRESENT_ILLNESS +compatible I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +cierre I-PRESENT_ILLNESS +intestinal I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -pantorrilla I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fosa I-PRESENT_ILLNESS -poplítea I-PRESENT_ILLNESS -izquierda, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -metros I-PRESENT_ILLNESS +8 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -marcha. I-PRESENT_ILLNESS -Sin B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -previa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -claudicación I-PAST_MEDICAL_HISTORY -intermitente. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destaca I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -temperatura I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -de I-EXPLORATION -pierna I-EXPLORATION -y I-EXPLORATION -pie I-EXPLORATION -izquierdo, I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -pulso I-EXPLORATION -poplíteo I-EXPLORATION +evolución. I-PRESENT_ILLNESS +Analítica: B-EXPLORATION +9.400 I-EXPLORATION +leucocitos/µl, I-EXPLORATION +hemoglobina: I-EXPLORATION +11, I-EXPLORATION +2 I-EXPLORATION +g/dl, I-EXPLORATION +plaquetas I-EXPLORATION y I-EXPLORATION -distal I-EXPLORATION -en I-EXPLORATION -esa I-EXPLORATION -extremidad. I-EXPLORATION -En I-EXPLORATION -extremidad I-EXPLORATION -inferior I-EXPLORATION -derecha I-EXPLORATION -pulsos I-EXPLORATION +coagulación I-EXPLORATION normales. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -laboratorio I-EXPLORATION -vascular I-EXPLORATION -no I-EXPLORATION -invasivo I-EXPLORATION -confirma I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -clínico I-EXPLORATION -de I-EXPLORATION -obliteración I-EXPLORATION -femoro-poplítea I-EXPLORATION -izquierda, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -hospitaliza I-EXPLORATION -para I-EXPLORATION -angiografía. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -estudio I-EXPLORATION -angiográfico I-EXPLORATION -; I-EXPLORATION -observándose I-EXPLORATION -en I-EXPLORATION -arteria I-EXPLORATION -poplítea I-EXPLORATION -izquierda I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -segmento I-EXPLORATION -de I-EXPLORATION -45 I-EXPLORATION -mm I-EXPLORATION +Radiografía I-EXPLORATION de I-EXPLORATION -largo, I-EXPLORATION -una I-EXPLORATION -estenosis I-EXPLORATION +abdomen: I-EXPLORATION +dilatación I-EXPLORATION de I-EXPLORATION -hasta I-EXPLORATION -93%, I-EXPLORATION +asas I-EXPLORATION de I-EXPLORATION -superficie I-EXPLORATION -lisa, I-EXPLORATION -que I-EXPLORATION -sugiere I-EXPLORATION -compresión I-EXPLORATION -extrínseca. I-EXPLORATION -Resto I-EXPLORATION -del I-EXPLORATION -árbol I-EXPLORATION -arterial I-EXPLORATION -sano, I-EXPLORATION -sin I-EXPLORATION -imágenes I-EXPLORATION -endoluminales. I-EXPLORATION - I-EXPLORATION -Llama B-EVOLUTION -la I-EVOLUTION -atención I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -pulso I-EVOLUTION -poplíteo I-EVOLUTION -y I-EVOLUTION -distal I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -extremidad I-EVOLUTION -afectada I-EVOLUTION +intestino I-EXPLORATION +delgado I-EXPLORATION +y I-EXPLORATION +artefacto I-EXPLORATION +correspondiente I-EXPLORATION +a I-EXPLORATION +CE. I-EXPLORATION +Tomografía I-EXPLORATION +computerizada I-EXPLORATION +: I-EXPLORATION +obstrucción I-EXPLORATION +intestinal I-EXPLORATION +mecánica I-EXPLORATION +completa I-EXPLORATION +secundaria I-EXPLORATION +a I-EXPLORATION +CE. I-EXPLORATION +Se B-TREATMENT +indicó I-TREATMENT +cirugía I-TREATMENT +abdominal I-TREATMENT +urgente, I-TREATMENT +encontrando I-TREATMENT +una I-TREATMENT +distensión I-TREATMENT +del I-TREATMENT +intestino I-TREATMENT +proximal I-TREATMENT +a I-TREATMENT +4 I-TREATMENT +estenosis I-TREATMENT +de I-TREATMENT +íleon I-TREATMENT +de I-TREATMENT +aspecto I-TREATMENT +inflamatorio, I-TREATMENT +causando I-TREATMENT +una I-TREATMENT +de I-TREATMENT +ellas I-TREATMENT +una I-TREATMENT +obstrucción I-TREATMENT +completa, I-TREATMENT +en I-TREATMENT +cuyo I-TREATMENT +interior I-TREATMENT +se I-TREATMENT +palpaba I-TREATMENT +la I-TREATMENT +CE. I-TREATMENT +Se I-TREATMENT +resecaron I-TREATMENT +30 I-TREATMENT +cm I-TREATMENT +de I-TREATMENT +��leon I-TREATMENT +que I-TREATMENT +incluían I-TREATMENT +3 I-TREATMENT +de I-TREATMENT +las I-TREATMENT +4 I-TREATMENT +estenosis, I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +anastomosis I-TREATMENT +latero-lateral I-TREATMENT +mecánica I-TREATMENT +y I-TREATMENT +estricturoplastia I-TREATMENT +de I-TREATMENT +la I-TREATMENT +estenosis I-TREATMENT +restante. I-TREATMENT +El B-EVOLUTION +postoperatorio I-EVOLUTION +transcurrió I-EVOLUTION +favorablemente, I-EVOLUTION +siendo I-EVOLUTION +alta I-EVOLUTION al I-EVOLUTION +7.o I-EVOLUTION día I-EVOLUTION -siguiente I-EVOLUTION -del I-EVOLUTION -estudio. I-EVOLUTION - I-EVOLUTION -Al I-EVOLUTION -segundo I-EVOLUTION -día I-EVOLUTION -post I-EVOLUTION -angiografía I-EVOLUTION -se I-EVOLUTION -indica I-EVOLUTION -marcha I-EVOLUTION -al I-EVOLUTION -paciente, I-EVOLUTION -reproduciendo I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -pantorrilla I-EVOLUTION -izquierda. I-EVOLUTION -Examinado B-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION -se I-EXPLORATION -pesquisa I-EXPLORATION -nuevamente I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -pulso I-EXPLORATION -poplíteo I-EXPLORATION -y I-EXPLORATION -distal. I-EXPLORATION -Estudio I-EXPLORATION -no I-EXPLORATION -invasivo I-EXPLORATION -PVR I-EXPLORATION -(registro I-EXPLORATION -volumen I-EXPLORATION -de I-EXPLORATION -pulsos) I-EXPLORATION -y I-EXPLORATION -PPG I-EXPLORATION -muestra I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION -morfología I-EXPLORATION +de I-EVOLUTION +la I-EVOLUTION +intervención. I-EVOLUTION +El B-EXPLORATION +resultado I-EXPLORATION +histológico I-EXPLORATION +del I-EXPLORATION +espécimen I-EXPLORATION +fue I-EXPLORATION de I-EXPLORATION -curvas I-EXPLORATION +enfermedad I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -poplítea I-EXPLORATION -a I-EXPLORATION -distal I-EXPLORATION +Crohn. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +parálisis I-PAST_MEDICAL_HISTORY +facial I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +once I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +fumadora I-PAST_MEDICAL_HISTORY +habitual, I-PAST_MEDICAL_HISTORY +dispepsia I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +ulcerosa, I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY +ansioso-depresivo, I-PAST_MEDICAL_HISTORY +menstruaciones I-PAST_MEDICAL_HISTORY +irregulares, I-PAST_MEDICAL_HISTORY +multípara I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +hábitos I-PAST_MEDICAL_HISTORY +tóxicos I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +relaciones I-PAST_MEDICAL_HISTORY +sexuales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +riesgo. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Acude I-PAST_MEDICAL_HISTORY +varias I-PAST_MEDICAL_HISTORY +veces I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +Urgencias I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +cuadro I-PAST_MEDICAL_HISTORY +doloroso I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +hipocondrio I-PAST_MEDICAL_HISTORY +derecho I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +región I-PAST_MEDICAL_HISTORY +lumbar I-PAST_MEDICAL_HISTORY +irradiado I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +genitales I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY +miccional, I-PAST_MEDICAL_HISTORY +siendo I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +varias I-PAST_MEDICAL_HISTORY +veces I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cólico I-PAST_MEDICAL_HISTORY +nefrítico. I-PAST_MEDICAL_HISTORY +Desde B-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +fiebre, I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +diámetro I-PRESENT_ILLNESS +abdominal, I-PRESENT_ILLNESS +dispareunia, I-PRESENT_ILLNESS +leucorrea, I-PRESENT_ILLNESS +disuria, I-PRESENT_ILLNESS +orinas I-PRESENT_ILLNESS +oscuras I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +mugüet I-PRESENT_ILLNESS +oral. I-PRESENT_ILLNESS +Presentando I-PRESENT_ILLNESS +además I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +anorexia, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +transtornos I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +hábito I-PRESENT_ILLNESS +intestinal. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +La B-EXPLORATION +exploración I-EXPLORATION +presenta I-EXPLORATION +abdomen I-EXPLORATION +doloroso I-EXPLORATION con I-EXPLORATION -PPG I-EXPLORATION -plano I-EXPLORATION -en I-EXPLORATION -ortejos.. I-EXPLORATION +puño-percusión I-EXPLORATION +renal I-EXPLORATION +positiva I-EXPLORATION +y I-EXPLORATION +oleada I-EXPLORATION +ascítica. I-EXPLORATION I-EXPLORATION -Con I-EXPLORATION -hipótesis I-EXPLORATION -de I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -atrapamiento I-EXPLORATION -de I-EXPLORATION +Ante I-EXPLORATION la I-EXPLORATION -arteria I-EXPLORATION -poplítea I-EXPLORATION +anamnesis I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +clínica I-EXPLORATION se I-EXPLORATION -realiza I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -muestra I-EXPLORATION -compresión I-EXPLORATION -extrínseca I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -vasos I-EXPLORATION -por I-EXPLORATION -estructura I-EXPLORATION -alguna, I-EXPLORATION -destacando I-EXPLORATION +pensó I-EXPLORATION en I-EXPLORATION -su I-EXPLORATION -pared I-EXPLORATION una I-EXPLORATION -imagen I-EXPLORATION -hiperintensa I-EXPLORATION -en I-EXPLORATION -secuencia I-EXPLORATION -T1que I-EXPLORATION -determina I-EXPLORATION -estenosis I-EXPLORATION -y I-EXPLORATION -sugerente I-EXPLORATION +serie I-EXPLORATION de I-EXPLORATION -hematoma. I-EXPLORATION -Estudio I-EXPLORATION +diagnósticos I-EXPLORATION +diferenciales I-EXPLORATION +tales I-EXPLORATION +como: I-EXPLORATION +carcimomatosis I-EXPLORATION +peritoneal, I-EXPLORATION +hepatopatía, I-EXPLORATION +neoplasia I-EXPLORATION +ovárica, I-EXPLORATION +celiaquía, I-EXPLORATION +tuberculosis I-EXPLORATION +intestinal I-EXPLORATION +y I-EXPLORATION +EPI I-EXPLORATION con I-EXPLORATION -angiografía I-EXPLORATION -por I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION +infección I-EXPLORATION +perihepática I-EXPLORATION +(síndrome I-EXPLORATION de I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -(AngioTC I-EXPLORATION +Fitz-Hugh-Curtis) I-EXPLORATION +por I-EXPLORATION +gonococos I-EXPLORATION +o I-EXPLORATION +chlamidias, I-EXPLORATION +entre I-EXPLORATION +otras I-EXPLORATION +entidades I-EXPLORATION +patológicas. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +analítica I-EXPLORATION +presentó I-EXPLORATION +neutrofilia I-EXPLORATION +sin I-EXPLORATION +leucocitosis, I-EXPLORATION +linfopenia, I-EXPLORATION +anemia I-EXPLORATION +microcítica I-EXPLORATION +hipocrómica, I-EXPLORATION +plaquetas I-EXPLORATION +disminuidas, I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -EEII) I-EXPLORATION -muestra I-EXPLORATION -en I-EXPLORATION -arteria I-EXPLORATION -poplítea I-EXPLORATION -izquierda, I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION +la I-EXPLORATION +VSG I-EXPLORATION +(111 I-EXPLORATION +mm/h, I-EXPLORATION +n I-EXPLORATION +< I-EXPLORATION +10) I-EXPLORATION +y I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -estenosis, I-EXPLORATION +PCR I-EXPLORATION +(182 I-EXPLORATION +mg/l, I-EXPLORATION +n I-EXPLORATION +< I-EXPLORATION +5). I-EXPLORATION +Además I-EXPLORATION +presentaba I-EXPLORATION una I-EXPLORATION -imagen I-EXPLORATION +hipoalbuminemia I-EXPLORATION de I-EXPLORATION -baja I-EXPLORATION -densidad I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -pared, I-EXPLORATION -sin I-EXPLORATION -realce I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -contraste I-EXPLORATION -endovenoso, I-EXPLORATION -que I-EXPLORATION -hace I-EXPLORATION -plantear I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +2 I-EXPLORATION +g/l, I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -degeneración I-EXPLORATION -quística I-EXPLORATION +globulinas, I-EXPLORATION +aumento I-EXPLORATION +discreto I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -poplítea. I-EXPLORATION +bilirrubina. I-EXPLORATION I-EXPLORATION -Intervenido B-TREATMENT -quirúrgicamente I-TREATMENT -mediante I-TREATMENT -abordaje I-TREATMENT -posterior, I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -puente I-TREATMENT -poplíteo I-TREATMENT -con I-TREATMENT -vena I-TREATMENT -safena I-TREATMENT -invertida, I-TREATMENT -resecando I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -poplítea I-TREATMENT -en I-TREATMENT -su I-TREATMENT -tercio I-TREATMENT -medio, I-TREATMENT -la I-TREATMENT -que I-TREATMENT -se I-TREATMENT -aprecia I-TREATMENT -de I-TREATMENT -coloración I-TREATMENT -violácea I-TREATMENT -y I-TREATMENT -contorno I-TREATMENT -irregular. I-TREATMENT -El B-EXPLORATION -informe I-EXPLORATION -de I-EXPLORATION +Se I-EXPLORATION +sometió I-EXPLORATION la I-EXPLORATION -pieza I-EXPLORATION -enviada I-EXPLORATION +paciente I-EXPLORATION a I-EXPLORATION -biopsia I-EXPLORATION -concluye I-EXPLORATION -“degeneración I-EXPLORATION -quística I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION +ginecológico, I-EXPLORATION +resultando I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +prueba I-EXPLORATION de I-EXPLORATION +Mantoux I-EXPLORATION +fue I-EXPLORATION +negativa, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +también I-EXPLORATION +fue I-EXPLORATION +negativa I-EXPLORATION la I-EXPLORATION -media”. I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +Brucella, I-EXPLORATION +Retrovirus, I-EXPLORATION +VHC I-EXPLORATION +y I-EXPLORATION +VHB. I-EXPLORATION +Se I-EXPLORATION +encontró I-EXPLORATION +elevado I-EXPLORATION +el I-EXPLORATION +ADA I-EXPLORATION +(25, I-EXPLORATION +8 I-EXPLORATION +U/l, I-EXPLORATION +n I-EXPLORATION +< I-EXPLORATION +18, I-EXPLORATION +2) I-EXPLORATION +y I-EXPLORATION +muy I-EXPLORATION +elevado I-EXPLORATION +el I-EXPLORATION +antígeno I-EXPLORATION +neoplásico I-EXPLORATION +Ca-125 I-EXPLORATION +(714 I-EXPLORATION +U/ml, I-EXPLORATION +n I-EXPLORATION +< I-EXPLORATION +35). I-EXPLORATION +Se I-EXPLORATION +practicó I-EXPLORATION +un I-EXPLORATION +exudado I-EXPLORATION +faríngeo I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +S. I-EXPLORATION +aureus. I-EXPLORATION +Los I-EXPLORATION +anticuerpos I-EXPLORATION +antigliadina I-EXPLORATION +y I-EXPLORATION +antiendomisio I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -evoluciona I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -generales, I-EVOLUTION -con I-EVOLUTION -pulsos I-EVOLUTION -conservados I-EVOLUTION -y I-EVOLUTION -simétricos I-EVOLUTION -en I-EVOLUTION -ambas I-EVOLUTION -EEII, I-EVOLUTION -sin I-EVOLUTION -claudicación I-EVOLUTION -intermitente I-EVOLUTION -y I-EVOLUTION -pudiendo I-EVOLUTION -reintegrarse I-EVOLUTION -rápidamente I-EVOLUTION -a I-EVOLUTION -sus I-EVOLUTION -labores I-EVOLUTION -habituales. I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -controles I-EVOLUTION -posteriores I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomático, I-EVOLUTION -con I-EVOLUTION -examen I-EVOLUTION -físico I-EVOLUTION -y I-EVOLUTION -estudio I-EVOLUTION -vascular I-EVOLUTION -no I-EVOLUTION -invasivo I-EVOLUTION -normal I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -palpebral I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -sonarse I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -nariz I-PRESENT_ILLNESS -(maniobra I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Valsalva). I-PRESENT_ILLNESS -Esa I-PRESENT_ILLNESS -misma I-PRESENT_ILLNESS -madrugada I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -sufrido I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -caída I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -altura I-PRESENT_ILLNESS -golpeándose I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cara I-PRESENT_ILLNESS -lateral I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -nariz, I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -altura I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -huesos I-PRESENT_ILLNESS -propios, I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -epistaxis I-PRESENT_ILLNESS -leve I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -autolimitada. I-PRESENT_ILLNESS -El B-EXPLORATION -examen I-EXPLORATION -oftalmológico I-EXPLORATION +A I-EXPLORATION +su I-EXPLORATION +vez I-EXPLORATION +el I-EXPLORATION +análisis I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +orina I-EXPLORATION reveló I-EXPLORATION -visión I-EXPLORATION -20/20 I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +bilirrubina I-EXPLORATION +moderado, I-EXPLORATION +indicio I-EXPLORATION +de I-EXPLORATION +cuerpos I-EXPLORATION +cetónicos, I-EXPLORATION +siendo I-EXPLORATION +el I-EXPLORATION +urocultivo I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +análisis I-EXPLORATION +de I-EXPLORATION +heces I-EXPLORATION +fue I-EXPLORATION +negativo I-EXPLORATION +con I-EXPLORATION +respecto I-EXPLORATION +al I-EXPLORATION +cultivo I-EXPLORATION +de I-EXPLORATION +Ziehl-Neelsen I-EXPLORATION +para I-EXPLORATION +BAAR I-EXPLORATION en I-EXPLORATION -cada I-EXPLORATION -ojo, I-EXPLORATION -reflejos I-EXPLORATION -pupilares I-EXPLORATION -normales I-EXPLORATION +dos I-EXPLORATION +ocasiones, I-EXPLORATION y I-EXPLORATION -motilidad I-EXPLORATION -ocular I-EXPLORATION -conservada, I-EXPLORATION -sin I-EXPLORATION -edema I-EXPLORATION -ni I-EXPLORATION -hiperemia I-EXPLORATION -conjuntival, I-EXPLORATION -sólo I-EXPLORATION -discreta I-EXPLORATION -equimosis I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -medial I-EXPLORATION +negativo I-EXPLORATION +también I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +cultivo I-EXPLORATION de I-EXPLORATION +Lowenstein. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +practicó I-EXPLORATION +una I-EXPLORATION +paracentesis I-EXPLORATION +de I-EXPLORATION +líquido I-EXPLORATION +ascítico I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -hemicara I-EXPLORATION -izquierda I-EXPLORATION -acompañada I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +obtuvo I-EXPLORATION +un I-EXPLORATION +líquido I-EXPLORATION +claro I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +cual I-EXPLORATION +destacaba I-EXPLORATION +un I-EXPLORATION +total I-EXPLORATION de I-EXPLORATION +1.476 I-EXPLORATION +células/ml, I-EXPLORATION +siendo I-EXPLORATION +un I-EXPLORATION +80% I-EXPLORATION +polimorfos I-EXPLORATION +nucleares I-EXPLORATION +(n I-EXPLORATION +< I-EXPLORATION +20%), I-EXPLORATION +LDH I-EXPLORATION +muy I-EXPLORATION +elevada, I-EXPLORATION aumento I-EXPLORATION de I-EXPLORATION -volumen I-EXPLORATION -palpebral I-EXPLORATION -crepitante I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación. I-EXPLORATION -El I-EXPLORATION -marco I-EXPLORATION -óseo I-EXPLORATION -orbitario I-EXPLORATION +proteínas I-EXPLORATION y I-EXPLORATION +cultivo I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +S. I-EXPLORATION +haemoliticus, I-EXPLORATION +resultando I-EXPLORATION la I-EXPLORATION -pirámide I-EXPLORATION -nasal I-EXPLORATION -estaban I-EXPLORATION -sin I-EXPLORATION -dolor. I-EXPLORATION -Los I-EXPLORATION -signos I-EXPLORATION -vitales I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -radiológico I-EXPLORATION -cráneo-facial I-EXPLORATION -corroboró I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +Ziehl-Neelsen I-EXPLORATION +negativa. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +radiología I-EXPLORATION +simple I-EXPLORATION de I-EXPLORATION -enfisema I-EXPLORATION -subcutáneo I-EXPLORATION -y I-EXPLORATION -orbitario, I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -fractura I-EXPLORATION +abdomen I-EXPLORATION +podemos I-EXPLORATION +comprobar I-EXPLORATION +una I-EXPLORATION +distribución I-EXPLORATION de I-EXPLORATION +gas I-EXPLORATION +normal I-EXPLORATION +aunque I-EXPLORATION +con I-EXPLORATION +cierta I-EXPLORATION +tendencia I-EXPLORATION +a I-EXPLORATION +situarse I-EXPLORATION +hacia I-EXPLORATION +el I-EXPLORATION +centro, I-EXPLORATION +no I-EXPLORATION +pudiendo I-EXPLORATION +valorarse I-EXPLORATION +adecuadamente I-EXPLORATION +al I-EXPLORATION +no I-EXPLORATION +poder I-EXPLORATION +visualizarse I-EXPLORATION +los I-EXPLORATION +flancos. I-EXPLORATION +En I-EXPLORATION +pelvis I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +signos I-EXPLORATION +que I-EXPLORATION +indican I-EXPLORATION la I-EXPLORATION -lámina I-EXPLORATION -papirácea I-EXPLORATION -del I-EXPLORATION -etmoides I-EXPLORATION -ipsilateral. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -hospitalizado I-EVOLUTION -y I-EVOLUTION -observado I-EVOLUTION -por I-EVOLUTION -24 I-EVOLUTION -h, I-EVOLUTION -posteriormente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -precaución I-EVOLUTION -de I-EVOLUTION -evitar I-EVOLUTION -maniobras I-EVOLUTION -que I-EVOLUTION -pudieran I-EVOLUTION -aumentar I-EVOLUTION -la I-EVOLUTION -presión I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -vía I-EVOLUTION -aérea I-EVOLUTION -superior, I-EVOLUTION -durante I-EVOLUTION -dos I-EVOLUTION -semanas. I-EVOLUTION -El I-EVOLUTION -enfisema I-EVOLUTION -se I-EVOLUTION -resolvió I-EVOLUTION -espontáneamente I-EVOLUTION -dentro I-EVOLUTION -de I-EVOLUTION -5 I-EVOLUTION -días I-EVOLUTION -y I-EVOLUTION -durante I-EVOLUTION -las I-EVOLUTION -dos I-EVOLUTION -semanas I-EVOLUTION -siguientes I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -desarrolló I-EVOLUTION -complicaciones. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -22 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -caucásico, I-PRESENT_ILLNESS -diagnosticado B-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -CUC I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -biopsia I-PAST_MEDICAL_HISTORY -compatible. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -mesalazina I-PAST_MEDICAL_HISTORY -1.000 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -c/8 I-PAST_MEDICAL_HISTORY -h I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -prednisona I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -decrecientes I-PAST_MEDICAL_HISTORY -(5 I-PAST_MEDICAL_HISTORY -mg/día), I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -actividad I-PAST_MEDICAL_HISTORY -inflamatoria I-PAST_MEDICAL_HISTORY -actual. I-PAST_MEDICAL_HISTORY -Tres B-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -intensa I-PRESENT_ILLNESS -persistente, I-PRESENT_ILLNESS -agregándose I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -trastorno I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -lenguaje. I-PRESENT_ILLNESS -Sin I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -fotofobia I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS -visuales. I-PRESENT_ILLNESS -No B-EXPLORATION +presentación I-EXPLORATION +de I-EXPLORATION +líquido I-EXPLORATION +libre. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +nos I-EXPLORATION +muestra I-EXPLORATION +líquido I-EXPLORATION +libre I-EXPLORATION +peritoneal, I-EXPLORATION +no I-EXPLORATION +existiendo I-EXPLORATION +hallazgos I-EXPLORATION +significativos I-EXPLORATION +en I-EXPLORATION +vísceras I-EXPLORATION +abdominales. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION +baritado I-EXPLORATION +gastroduodenal I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -evidenciaba I-EXPLORATION -signología I-EXPLORATION -focal I-EXPLORATION -ni I-EXPLORATION -movimientos I-EXPLORATION -anormales. I-EXPLORATION +comprobó I-EXPLORATION +alteración I-EXPLORATION +del I-EXPLORATION +tránsito I-EXPLORATION +intestinal. I-EXPLORATION I-EXPLORATION -Al I-EXPLORATION -examen, I-EXPLORATION -afebril, I-EXPLORATION -normotenso, I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -98% I-EXPLORATION -ambiental, I-EXPLORATION -con I-EXPLORATION -buena I-EXPLORATION -perfusión. I-EXPLORATION -Ritmo I-EXPLORATION -cardiaco I-EXPLORATION -regular I-EXPLORATION +La I-EXPLORATION +TAC I-EXPLORATION +abominal I-EXPLORATION +informa I-EXPLORATION de I-EXPLORATION -88 I-EXPLORATION -lpm. I-EXPLORATION -Sin I-EXPLORATION -alteraciones I-EXPLORATION -pleuropulmonares. I-EXPLORATION -Abdomen I-EXPLORATION -indoloro. I-EXPLORATION -Neurológicamente I-EXPLORATION -estaba I-EXPLORATION -vigil I-EXPLORATION -pero I-EXPLORATION -confuso, I-EXPLORATION -con I-EXPLORATION -afasia I-EXPLORATION -fluente I-EXPLORATION +abundante I-EXPLORATION +líquido I-EXPLORATION +libre I-EXPLORATION y I-EXPLORATION -déficit I-EXPLORATION -de I-EXPLORATION -comprensión. I-EXPLORATION +engrosamiento I-EXPLORATION +peritoneal I-EXPLORATION +como I-EXPLORATION +signos I-EXPLORATION +más I-EXPLORATION +llamativos. I-EXPLORATION + I-EXPLORATION Sin I-EXPLORATION -alteración I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION +clara I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +patología I-EXPLORATION +principal I-EXPLORATION +que I-EXPLORATION +originó I-EXPLORATION +el I-EXPLORATION +cuadro I-EXPLORATION +y I-EXPLORATION +teniendo I-EXPLORATION en I-EXPLORATION +mente I-EXPLORATION la I-EXPLORATION -oculomotricidad. I-EXPLORATION -Sector I-EXPLORATION -espinal I-EXPLORATION +carcinomatosis I-EXPLORATION +peritoneal, I-EXPLORATION +una I-EXPLORATION +infección I-EXPLORATION +difusa I-EXPLORATION +intraperitoneal I-EXPLORATION y I-EXPLORATION -meníngeo I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION -Valoración I-EXPLORATION -general I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -sin I-EXPLORATION -elementos I-EXPLORATION +la I-EXPLORATION +propia I-EXPLORATION +tuberculosis I-EXPLORATION +peritoneal, I-EXPLORATION +se I-EXPLORATION +ingresó I-EXPLORATION a I-EXPLORATION -destacar. I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +para I-EXPLORATION +ser I-EXPLORATION +sometida I-EXPLORATION +a I-EXPLORATION +una I-EXPLORATION +laparoscopia I-EXPLORATION +diagnóstica I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +reglada. I-EXPLORATION I-EXPLORATION -Tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -(TAC) I-EXPLORATION +Al I-EXPLORATION +entrar I-EXPLORATION +en I-EXPLORATION +cavidad I-EXPLORATION +nos I-EXPLORATION +encontramos I-EXPLORATION +multitud I-EXPLORATION de I-EXPLORATION -encéfalo I-EXPLORATION -mostró I-EXPLORATION -imagen I-EXPLORATION -sugerente I-EXPLORATION +adherencias I-EXPLORATION +y I-EXPLORATION +septos I-EXPLORATION +intraperitoneales I-EXPLORATION +y I-EXPLORATION +entre I-EXPLORATION +los I-EXPLORATION +distintos I-EXPLORATION +órganos I-EXPLORATION +abdominales, I-EXPLORATION +destacando I-EXPLORATION +las I-EXPLORATION +adherencias I-EXPLORATION +hepáticas. I-EXPLORATION +Además I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +siembra I-EXPLORATION +peritoneal I-EXPLORATION +muy I-EXPLORATION +extensa I-EXPLORATION de I-EXPLORATION -trombosis I-EXPLORATION -venosa I-EXPLORATION -cortical I-EXPLORATION -con I-EXPLORATION -infarto I-EXPLORATION -parenquimatoso I-EXPLORATION -temporo-basal I-EXPLORATION -izquierdo. I-EXPLORATION -Resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION +tuberculomas. I-EXPLORATION +Se I-EXPLORATION +tomó I-EXPLORATION +biopsia I-EXPLORATION +peritoneal I-EXPLORATION de I-EXPLORATION -cráneo I-EXPLORATION +tuberculomas I-EXPLORATION +y I-EXPLORATION +hepática, I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +liberaron I-EXPLORATION +las I-EXPLORATION +adherencias I-EXPLORATION +más I-EXPLORATION +llamativas. I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +resultados I-EXPLORATION +de I-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +dieron I-EXPLORATION +a I-EXPLORATION +conocer I-EXPLORATION +una I-EXPLORATION +granulomatosis I-EXPLORATION +peritoneal I-EXPLORATION +de I-EXPLORATION +etiología I-EXPLORATION +sugestivamente I-EXPLORATION +tuberculosa I-EXPLORATION con I-EXPLORATION -angiorresonancia I-EXPLORATION -en I-EXPLORATION -tiempo I-EXPLORATION -venoso I-EXPLORATION -informó I-EXPLORATION -infarto I-EXPLORATION -hemorrágico I-EXPLORATION -temporal I-EXPLORATION -izquierdo I-EXPLORATION +hígado I-EXPLORATION con I-EXPLORATION -trombosis I-EXPLORATION +granulomatosis I-EXPLORATION +capsular I-EXPLORATION de I-EXPLORATION -vena I-EXPLORATION -superficial I-EXPLORATION -y I-EXPLORATION -seno I-EXPLORATION -venoso I-EXPLORATION -sigmoideo I-EXPLORATION -homolateral.. I-EXPLORATION -Exámenes I-EXPLORATION +etiología I-EXPLORATION +sugestivamente I-EXPLORATION +tuberculosa I-EXPLORATION de I-EXPLORATION -búsqueda I-EXPLORATION +alteraciones I-EXPLORATION +inflamatorias I-EXPLORATION +parenquimatosas I-EXPLORATION de I-EXPLORATION -trombofilias I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -(proteínas I-EXPLORATION -C, I-EXPLORATION -S, I-EXPLORATION -antitrombina I-EXPLORATION -III, I-EXPLORATION -resistencia I-EXPLORATION -a I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -activada, I-EXPLORATION -homocisteinemia, I-EXPLORATION -factor I-EXPLORATION -20210A, I-EXPLORATION -FV I-EXPLORATION -Leiden, I-EXPLORATION -metil I-EXPLORATION -tetra I-EXPLORATION -hidro I-EXPLORATION -folato I-EXPLORATION -reductasa, I-EXPLORATION -lipoproteína I-EXPLORATION -(a), I-EXPLORATION -factor I-EXPLORATION -VIII, I-EXPLORATION -anticuerpos I-EXPLORATION -anticardiolipinas, I-EXPLORATION -anti I-EXPLORATION -beta2 I-EXPLORATION -glicoproteína, I-EXPLORATION -inhibidor I-EXPLORATION -lúpico, I-EXPLORATION -inhibidor I-EXPLORATION -del I-EXPLORATION -activador I-EXPLORATION -tisular I-EXPLORATION -del I-EXPLORATION -plasminógeno). I-EXPLORATION -Todos I-EXPLORATION -fueron I-EXPLORATION -solicitados I-EXPLORATION -posteriormente I-EXPLORATION -al I-EXPLORATION -inicio I-EXPLORATION -del I-EXPLORATION -tratamiento I-EXPLORATION -anticoagulante. I-EXPLORATION +carácter I-EXPLORATION +reactivo. I-EXPLORATION I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -anticoagulación I-TREATMENT -con I-TREATMENT -enoxaparina I-TREATMENT -(1 I-TREATMENT -mg/Kg I-TREATMENT -subcutánea I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -h) I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -evolución. I-TREATMENT -Se I-TREATMENT -mantuvo I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -CUC I-TREATMENT -con I-TREATMENT -mesalazina I-TREATMENT -y I-TREATMENT -prednisona. I-TREATMENT -Se B-EVOLUTION -otorgó I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -10º I-EVOLUTION -día, I-EVOLUTION -asintomático, I-EVOLUTION -continuando B-TREATMENT -anticoagulación I-TREATMENT -con I-TREATMENT -enoxaparina I-TREATMENT -subcutánea I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -con I-TREATMENT -dicumarínicos I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral. I-TREATMENT - I-TREATMENT -Paciente B-PAST_MEDICAL_HISTORY +Mujer, B-PRESENT_ILLNESS +26 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -sexo I-PAST_MEDICAL_HISTORY -masculino I-PAST_MEDICAL_HISTORY +tetralogía I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Fallot, I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY +cirugía I-PAST_MEDICAL_HISTORY +correctora I-PAST_MEDICAL_HISTORY +definitiva I-PAST_MEDICAL_HISTORY +consistente I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +cierre I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +comunicación I-PAST_MEDICAL_HISTORY +interventricular I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -crónico I-PAST_MEDICAL_HISTORY +ampliación I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +TSVD I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +anillo I-PAST_MEDICAL_HISTORY +valvular I-PAST_MEDICAL_HISTORY +pulmonar I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +parche I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -alcohol. I-PAST_MEDICAL_HISTORY -Diagnóstico I-PAST_MEDICAL_HISTORY +pericardio, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +infancia. I-PAST_MEDICAL_HISTORY +Desde I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +8 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -cirrosis I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -2002 I-PAST_MEDICAL_HISTORY +edad I-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +episodios I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +TVS I-PAST_MEDICAL_HISTORY +recurrentes, I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -48 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -estudió I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -2004, I-PAST_MEDICAL_HISTORY +pesar I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +farmacológico I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -PCR I-PAST_MEDICAL_HISTORY +amiodarona, I-PAST_MEDICAL_HISTORY +requiriendo I-PAST_MEDICAL_HISTORY +múltiples I-PAST_MEDICAL_HISTORY +hospitalizaciones I-PAST_MEDICAL_HISTORY para I-PAST_MEDICAL_HISTORY -VHC I-PAST_MEDICAL_HISTORY -positiva, I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -carga I-PAST_MEDICAL_HISTORY -viral I-PAST_MEDICAL_HISTORY -280.998 I-PAST_MEDICAL_HISTORY -UI/ml I-PAST_MEDICAL_HISTORY -(Log I-PAST_MEDICAL_HISTORY -5, I-PAST_MEDICAL_HISTORY -45) I-PAST_MEDICAL_HISTORY +antiarrítmicos I-PAST_MEDICAL_HISTORY +intravenosos I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +cardioversión I-PAST_MEDICAL_HISTORY +eléctrica. I-PAST_MEDICAL_HISTORY +Su I-PAST_MEDICAL_HISTORY +seguimiento I-PAST_MEDICAL_HISTORY +ecocardiográfico I-PAST_MEDICAL_HISTORY +mostró I-PAST_MEDICAL_HISTORY +compromiso I-PAST_MEDICAL_HISTORY +moderado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +función I-PAST_MEDICAL_HISTORY +sistólica I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +ventrículo I-PAST_MEDICAL_HISTORY +derecho, I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +pulmonar I-PAST_MEDICAL_HISTORY +libre I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -genotipo I-PAST_MEDICAL_HISTORY -3a. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -tratamiento. I-PAST_MEDICAL_HISTORY -Derivado B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -2005 I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -presencia I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -2 I-DERIVED_FROM/TO -lesiones I-DERIVED_FROM/TO -compatibles I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -hepatocarcinoma. I-DERIVED_FROM/TO -Quimioembolización B-PAST_MEDICAL_HISTORY +dilatación I-PAST_MEDICAL_HISTORY +progresiva I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +TSVD, I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +llegó I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +constituir I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +verdadero I-PAST_MEDICAL_HISTORY +aneurisma, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +cual I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +18 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +sometida I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +nueva I-PAST_MEDICAL_HISTORY +cirugía I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -octubre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2005, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -múltiples I-PAST_MEDICAL_HISTORY -quimioembolizaciones I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +implantó I-PAST_MEDICAL_HISTORY +homoinjerto I-PAST_MEDICAL_HISTORY +valvulado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +arteria I-PAST_MEDICAL_HISTORY +pulmonar I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -alcoholizaciones I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -julio I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +resecó I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +aneurisma I-PAST_MEDICAL_HISTORY +ventricular. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Desde I-PAST_MEDICAL_HISTORY +esta I-PAST_MEDICAL_HISTORY +última I-PAST_MEDICAL_HISTORY +intervención I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +mantuvo I-PAST_MEDICAL_HISTORY +asintomática, I-PAST_MEDICAL_HISTORY +libre I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -2006 I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -trasplantado. I-PAST_MEDICAL_HISTORY -Post B-TREATMENT -trasplante I-TREATMENT +arritmias, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +capacidad I-PAST_MEDICAL_HISTORY +funcional I-PAST_MEDICAL_HISTORY +I. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +mantuvo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +amiodarona I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +suspendió I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +23 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +embarazo. I-PAST_MEDICAL_HISTORY +A B-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +26 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +palpitaciones I-PRESENT_ILLNESS +rápidas, I-PRESENT_ILLNESS +sostenidas. I-PRESENT_ILLNESS +Consultó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +urgencia, I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +documentó I-PRESENT_ILLNESS +taquicardia I-PRESENT_ILLNESS +ventricular I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +frecuencia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +150 I-PRESENT_ILLNESS +latidos I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +minuto I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +imagen I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +bloqueo I-PRESENT_ILLNESS +completo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +rama I-PRESENT_ILLNESS +izquierda I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +eje I-PRESENT_ILLNESS +inferior I-PRESENT_ILLNESS +izquierdo, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +compromiso I-PRESENT_ILLNESS +hemodinámico. I-PRESENT_ILLNESS +Se B-TREATMENT +hospitalizó I-TREATMENT +y I-TREATMENT se I-TREATMENT inició I-TREATMENT -inmunosupresión I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -prednisona I-TREATMENT -y I-TREATMENT -ciclosporina. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -meses I-EVOLUTION -post I-EVOLUTION -trasplante, I-EVOLUTION -con I-EVOLUTION -transaminasas I-EVOLUTION -hasta I-EVOLUTION -12 I-EVOLUTION -veces I-EVOLUTION -el I-EVOLUTION -valor I-EVOLUTION -normal, I-EVOLUTION -se I-EVOLUTION -planteó I-EVOLUTION -rechazo I-EVOLUTION -vs I-EVOLUTION -reactivación I-EVOLUTION -de I-EVOLUTION -VHC. I-EVOLUTION -Se B-TREATMENT -agregó I-TREATMENT -sirolimus. I-TREATMENT -Biopsia B-EXPLORATION -hepática I-EXPLORATION -mostró I-EXPLORATION -esteatosis I-EXPLORATION -y I-EXPLORATION -hepatitis I-EXPLORATION -aguda I-EXPLORATION -leve, I-EXPLORATION -sin I-EXPLORATION -elementos I-EXPLORATION -de I-EXPLORATION -especificidad. I-EXPLORATION -Carga I-EXPLORATION -viral I-EXPLORATION -3.000.694 I-EXPLORATION -UI/ml I-EXPLORATION -(Log I-EXPLORATION -6, I-EXPLORATION -48). I-EXPLORATION -Persistió B-EVOLUTION -con I-EVOLUTION -transaminasas I-EVOLUTION -1, I-EVOLUTION -5 I-EVOLUTION -a I-EVOLUTION -3 I-EVOLUTION -veces I-EVOLUTION -el I-EVOLUTION -valor I-EVOLUTION -normal. I-EVOLUTION -Debido I-EVOLUTION -a I-EVOLUTION -pancitopenia I-EVOLUTION -se I-EVOLUTION -suspendió I-EVOLUTION -sirolimus. I-EVOLUTION -A B-TREATMENT -los I-TREATMENT -3 I-TREATMENT -años I-TREATMENT -y I-TREATMENT -medio I-TREATMENT -post I-TREATMENT -trasplante I-TREATMENT -se I-TREATMENT -vuelve I-TREATMENT +amiodarona I-TREATMENT +intravenosa, I-TREATMENT a I-TREATMENT -plantear I-TREATMENT -tratamiento I-TREATMENT +pesar I-TREATMENT de I-TREATMENT -VHC I-TREATMENT -con B-EXPLORATION -nueva I-EXPLORATION -biopsia I-EXPLORATION -hepática I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -hepatitis I-EXPLORATION -crónica I-EXPLORATION -con I-EXPLORATION -leve I-EXPLORATION -inflamación I-EXPLORATION -portal I-EXPLORATION -de I-EXPLORATION -interfase I-EXPLORATION -y I-EXPLORATION -lobulillar, I-EXPLORATION -fibrosis I-EXPLORATION -perisinusoideal I-EXPLORATION -leve, I-EXPLORATION -colangitis I-EXPLORATION -linfocítica I-EXPLORATION -focal I-EXPLORATION -y I-EXPLORATION -esteatosis I-EXPLORATION -hepática I-EXPLORATION -mínima. I-EXPLORATION -En B-EVOLUTION -ese I-EVOLUTION -momento I-EVOLUTION -evoluciona I-EVOLUTION -con I-EVOLUTION -colestasia, I-EVOLUTION -que I-EVOLUTION -resulta I-EVOLUTION -ser I-EVOLUTION -secundaria I-EVOLUTION -a I-EVOLUTION -estenosis I-EVOLUTION -de I-EVOLUTION -anastomosis I-EVOLUTION -biliar. I-EVOLUTION -Se I-EVOLUTION -controló I-EVOLUTION -con I-EVOLUTION -nueva I-EVOLUTION -carga I-EVOLUTION -viral I-EVOLUTION -con I-EVOLUTION -355.882 I-EVOLUTION -UI/ml I-EVOLUTION -(Log I-EVOLUTION -5, I-EVOLUTION -55) I-EVOLUTION -en I-EVOLUTION -octubre I-EVOLUTION -de I-EVOLUTION -2010. I-EVOLUTION -Con B-EXPLORATION -intención I-EXPLORATION -de I-EXPLORATION -iniciar I-EXPLORATION -tratamiento I-EXPLORATION -en I-EXPLORATION -marzo I-EXPLORATION -de I-EXPLORATION -2011 I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -nueva I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -negativa; I-EXPLORATION -además I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -PCR I-EXPLORATION -para I-EXPLORATION -VHC, I-EXPLORATION -también I-EXPLORATION -negativa, I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -confirma I-EXPLORATION -con I-EXPLORATION -nueva I-EXPLORATION -muestra. I-EXPLORATION -En B-TREATMENT -ese I-TREATMENT -momento I-TREATMENT -perfil I-TREATMENT -hepático I-TREATMENT -normal, I-TREATMENT -recibiendo I-TREATMENT -inmunosupresión I-TREATMENT -con I-TREATMENT -ciclosporina I-TREATMENT -100 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día. I-TREATMENT -Se B-EVOLUTION -interpretó I-EVOLUTION -como I-EVOLUTION -eliminación I-EVOLUTION -espontánea I-EVOLUTION -del I-EVOLUTION -VHC. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -múltiples I-PAST_MEDICAL_HISTORY -lesiones I-PAST_MEDICAL_HISTORY -cutáneas I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cinco I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -que, I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -dos, I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -piodermitis, I-PAST_MEDICAL_HISTORY -sarna I-PAST_MEDICAL_HISTORY -corporis, I-PAST_MEDICAL_HISTORY -candidiasis I-PAST_MEDICAL_HISTORY -esofágica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cinco I-PAST_MEDICAL_HISTORY -cuadros I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -abscesos I-PAST_MEDICAL_HISTORY -cutáneos I-PAST_MEDICAL_HISTORY -ubicados I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -codo I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -ocasiones, I-PAST_MEDICAL_HISTORY -uno I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -dorso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -mano I-PAST_MEDICAL_HISTORY -izquierda, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -cual I-PAST_MEDICAL_HISTORY -deja I-PAST_MEDICAL_HISTORY -secuelas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -movilidad I-PAST_MEDICAL_HISTORY -extensora I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -compromiso I-PAST_MEDICAL_HISTORY -tendinoso, I-PAST_MEDICAL_HISTORY -uno I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dorso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mano I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -uno I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -escapular I-PAST_MEDICAL_HISTORY -izquierda, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -cuales I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -cultivo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -lesiones I-PAST_MEDICAL_HISTORY -resultó I-PAST_MEDICAL_HISTORY -positivo I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -Staphylococcus I-PAST_MEDICAL_HISTORY -aureus I-PAST_MEDICAL_HISTORY -multisensible. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -glúteo I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -se B-TREATMENT -diagnosticó I-TREATMENT -celulitis I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT +lo I-TREATMENT +cual I-TREATMENT +permaneció I-TREATMENT con I-TREATMENT -clindamicina I-TREATMENT -y I-TREATMENT -cefazolina. I-TREATMENT -Al B-EVOLUTION -séptimo I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -presentó I-EVOLUTION -necrosis I-EVOLUTION -distal I-EVOLUTION -del I-EVOLUTION -pulpejo I-EVOLUTION -del I-EVOLUTION -cuarto I-EVOLUTION -dedo I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mano I-EVOLUTION -derecha, I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -dejó I-EVOLUTION -a I-EVOLUTION -evolución I-EVOLUTION -natural I-EVOLUTION -debido I-EVOLUTION -a I-EVOLUTION -encontrarse I-EVOLUTION -fuera I-EVOLUTION -de I-EVOLUTION -alcance I-EVOLUTION -quirúrgico. I-EVOLUTION -Luego B-TREATMENT -de I-TREATMENT -12 I-TREATMENT -días I-TREATMENT +taquicardia, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +cual I-TREATMENT +24 I-TREATMENT +h I-TREATMENT +después I-TREATMENT de I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT +su I-TREATMENT +ingreso I-TREATMENT se I-TREATMENT -cambió I-TREATMENT -esquema I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -mala I-TREATMENT -respuesta I-TREATMENT -clínica, I-TREATMENT -iniciándose I-TREATMENT -metronidazol, I-TREATMENT -ceftriaxona I-TREATMENT -y I-TREATMENT -vancomicina. I-TREATMENT -Se B-EXPLORATION -realizaron I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio, I-EXPLORATION -inmunológicos I-EXPLORATION -e I-EXPLORATION -infecciosos, I-EXPLORATION -en I-EXPLORATION -busca I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -patología I-EXPLORATION -subyacente, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -muestran I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -Tabla I-EXPLORATION -1 I-EXPLORATION -(A), I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -cuales I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION -del I-EXPLORATION -factor I-EXPLORATION -reumatoide, I-EXPLORATION -ANCA-p, I-EXPLORATION -ANCA-c, I-EXPLORATION -anti I-EXPLORATION -ANA, I-EXPLORATION -anti I-EXPLORATION -ENA, I-EXPLORATION -anti-DNA, I-EXPLORATION -anticardiolipina, I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -Coombs I-EXPLORATION -indirecto, I-EXPLORATION -antígenos I-EXPLORATION -de I-EXPLORATION -VHB I-EXPLORATION -y I-EXPLORATION -VHC I-EXPLORATION -fueron I-EXPLORATION -negativos; I-EXPLORATION -destacaron I-EXPLORATION -valores I-EXPLORATION -elevados I-EXPLORATION -de I-EXPLORATION -IgE I-EXPLORATION -sérica I-EXPLORATION -(3.740 I-EXPLORATION -UI/ml) I-EXPLORATION -y I-EXPLORATION -precipitación I-EXPLORATION +realizó I-TREATMENT +cardioversión I-TREATMENT +eléctrica. I-TREATMENT +Su B-EXPLORATION +electrocardiograma I-EXPLORATION en I-EXPLORATION -frío I-EXPLORATION -de I-EXPLORATION -crioglobulinas I-EXPLORATION -positiva. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -además I-EXPLORATION -ecografía I-EXPLORATION -glútea I-EXPLORATION -izquierda, I-EXPLORATION -que I-EXPLORATION +ritmo I-EXPLORATION +sinusal I-EXPLORATION mostró I-EXPLORATION -tejido I-EXPLORATION -celular I-EXPLORATION -subcutáneo I-EXPLORATION +conducción I-EXPLORATION +aurículo-ventricular I-EXPLORATION con I-EXPLORATION -aspecto I-EXPLORATION -inflamatorio, I-EXPLORATION -sin I-EXPLORATION -colecciones. I-EXPLORATION -Tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION +PR I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -sugirió I-EXPLORATION -fibrosis I-EXPLORATION -basal I-EXPLORATION +200 I-EXPLORATION +ms I-EXPLORATION +y I-EXPLORATION +complejos I-EXPLORATION +QRS I-EXPLORATION +ancho I-EXPLORATION con I-EXPLORATION -engrosamiento I-EXPLORATION -pleural I-EXPLORATION -e I-EXPLORATION imagen I-EXPLORATION -nodular I-EXPLORATION -periférica I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -hemitórax. I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -manos, I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -cintura I-EXPLORATION -escapular, I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -dorsolumbar, I-EXPLORATION -radiografía I-EXPLORATION de I-EXPLORATION -codos, I-EXPLORATION -ecografía I-EXPLORATION -abdominal, I-EXPLORATION -TAC I-EXPLORATION +bloqueo I-EXPLORATION +completo I-EXPLORATION de I-EXPLORATION -abdomen I-EXPLORATION +rama I-EXPLORATION +derecha I-EXPLORATION y I-EXPLORATION -ecocardiograma I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION -Biopsia I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -de I-EXPLORATION -zona I-EXPLORATION -medial I-EXPLORATION -del I-EXPLORATION -brazo I-EXPLORATION -derecho I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -dermatitis I-EXPLORATION -crónica I-EXPLORATION -en I-EXPLORATION -granulación I-EXPLORATION -con I-EXPLORATION -calcificación I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -distrófica, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION +240 I-EXPLORATION +ms I-EXPLORATION de I-EXPLORATION -vasculitis. I-EXPLORATION -Una B-EVOLUTION -vez I-EVOLUTION -completado I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -antibiótico I-EVOLUTION -se I-EVOLUTION -dio I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -sospecha I-EVOLUTION -diagnóstica I-EVOLUTION -de I-EVOLUTION -síndrome I-EVOLUTION -de I-EVOLUTION -hiper I-EVOLUTION -IgE I-EVOLUTION -y I-EVOLUTION -crioglobulinemia. I-EVOLUTION - I-EVOLUTION -Un I-EVOLUTION -mes I-EVOLUTION -posterior I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -consultó I-EVOLUTION -por I-EVOLUTION -nuevo I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -5 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -glúteo I-EVOLUTION -izquierdo, I-EVOLUTION -calor I-EVOLUTION -local I-EVOLUTION -y I-EVOLUTION -supuración. I-EVOLUTION -Se B-TREATMENT -realizó I-TREATMENT -drenaje I-TREATMENT -manual I-TREATMENT -y I-TREATMENT -pasivo I-TREATMENT -con I-TREATMENT -penrose. I-TREATMENT -Fue I-TREATMENT -hospitalizado I-TREATMENT +duración. I-EXPLORATION +Estando B-TREATMENT +hospitalizada I-TREATMENT +presentó I-TREATMENT +recurrencia I-TREATMENT +de I-TREATMENT +TVS, I-TREATMENT +apareciendo I-TREATMENT +una I-TREATMENT +segunda I-TREATMENT +morfología, I-TREATMENT por I-TREATMENT -absceso I-TREATMENT -en I-TREATMENT -glúteo I-TREATMENT -izquierdo I-TREATMENT -y I-TREATMENT +lo I-TREATMENT +cual I-TREATMENT se I-TREATMENT -inició I-TREATMENT +decidió I-TREATMENT +intentar I-TREATMENT tratamiento I-TREATMENT -antibiótico I-TREATMENT +mediante I-TREATMENT +fulguración I-TREATMENT con I-TREATMENT -ceftriaxona I-TREATMENT -y I-TREATMENT -clindamicina. I-TREATMENT -Se B-EXPLORATION -realizaron I-EXPLORATION -exámenes I-EXPLORATION +radiofrecuencia. I-TREATMENT +Bajo B-EXPLORATION +sedación I-EXPLORATION +con I-EXPLORATION +midazolam I-EXPLORATION +y I-EXPLORATION +fentanyl, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +electrofisiológico. I-EXPLORATION +Por I-EXPLORATION +vía I-EXPLORATION +venosa I-EXPLORATION +femoral I-EXPLORATION +derecha I-EXPLORATION +se I-EXPLORATION +avanzaron I-EXPLORATION +tres I-EXPLORATION +catéteres I-EXPLORATION +cuadripolares I-EXPLORATION +(Daig®, I-EXPLORATION +St. I-EXPLORATION +Jude I-EXPLORATION +Medical I-EXPLORATION +Inc) I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -muestran I-EXPLORATION +ubicaron I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -Tabla I-EXPLORATION -1 I-EXPLORATION -(B) I-EXPLORATION -donde I-EXPLORATION -nuevamente I-EXPLORATION -destacó I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -IgE I-EXPLORATION -elevados, I-EXPLORATION -una I-EXPLORATION -primera I-EXPLORATION -muestra I-EXPLORATION -con I-EXPLORATION -valores I-EXPLORATION +región I-EXPLORATION +alta I-EXPLORATION de I-EXPLORATION -4.170 I-EXPLORATION -UI/ml I-EXPLORATION +la I-EXPLORATION +aurícula I-EXPLORATION +derecha, I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +His I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -muestra I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -día I-EXPLORATION -siguiente I-EXPLORATION -de I-EXPLORATION -4.210 I-EXPLORATION -UI/ml. I-EXPLORATION -Se I-EXPLORATION -aplicó I-EXPLORATION -la I-EXPLORATION -escala I-EXPLORATION -de I-EXPLORATION -Grimbacher9 I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -consignó I-EXPLORATION +ápex I-EXPLORATION +del I-EXPLORATION +ventrículo I-EXPLORATION +derecho, I-EXPLORATION +para I-EXPLORATION +registrar I-EXPLORATION +potenciales I-EXPLORATION +endocavitarios I-EXPLORATION +y I-EXPLORATION +realizar I-EXPLORATION +estimulación. I-EXPLORATION +Con I-EXPLORATION +estimulación I-EXPLORATION +desde I-EXPLORATION el I-EXPLORATION -valor I-EXPLORATION +ápex I-EXPLORATION +del I-EXPLORATION +ventrículo I-EXPLORATION +derecho I-EXPLORATION +con I-EXPLORATION +ciclo I-EXPLORATION +basal I-EXPLORATION de I-EXPLORATION -IgE, I-EXPLORATION -candidiasis I-EXPLORATION -sistémica, I-EXPLORATION -infecciones I-EXPLORATION -graves, I-EXPLORATION -infecciones I-EXPLORATION -cutáneas I-EXPLORATION -recurrentes, I-EXPLORATION -presencia I-EXPLORATION +550 I-EXPLORATION +ms I-EXPLORATION +e I-EXPLORATION +introduciendo I-EXPLORATION +dos I-EXPLORATION +extraestímulos I-EXPLORATION +se I-EXPLORATION +indujo I-EXPLORATION +fácilmente I-EXPLORATION +las I-EXPLORATION +dos I-EXPLORATION +morfologías I-EXPLORATION de I-EXPLORATION -paladar I-EXPLORATION -alto, I-EXPLORATION -dientes I-EXPLORATION -primarios I-EXPLORATION -retenidos, I-EXPLORATION -hiperextensibilidad I-EXPLORATION -articular, I-EXPLORATION -nariz I-EXPLORATION -amplia I-EXPLORATION +taquicardia. I-EXPLORATION +Mediante I-EXPLORATION +mapeo I-EXPLORATION +durante I-EXPLORATION +estimulación I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +TSVD, I-EXPLORATION con I-EXPLORATION -distancia I-EXPLORATION -interalar I-EXPLORATION -mayor I-EXPLORATION -a I-EXPLORATION -2 I-EXPLORATION -DS I-EXPLORATION +catéter I-EXPLORATION +de I-EXPLORATION +fulguración I-EXPLORATION +EPT I-EXPLORATION +curva I-EXPLORATION +estándar I-EXPLORATION y I-EXPLORATION -facies I-EXPLORATION -característica, I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -dio I-EXPLORATION -un I-EXPLORATION -resultado I-EXPLORATION -total I-EXPLORATION +punta I-EXPLORATION de I-EXPLORATION -50 I-EXPLORATION -puntos, I-EXPLORATION -confirmándose I-EXPLORATION -clínicamente I-EXPLORATION -el I-EXPLORATION -diagnóstico. I-EXPLORATION -Tras B-TREATMENT -21 I-TREATMENT -días I-TREATMENT +4 I-EXPLORATION +mm I-EXPLORATION +(Boston I-EXPLORATION +Scientific® I-EXPLORATION +Corporation) I-EXPLORATION +se I-EXPLORATION +reprodujo I-EXPLORATION +la I-EXPLORATION +morfología I-EXPLORATION +de I-EXPLORATION +ambas I-EXPLORATION +taquicardias, I-EXPLORATION +con I-EXPLORATION +concordancia I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +12 I-EXPLORATION +derivaciones I-EXPLORATION +del I-EXPLORATION +electrocardiograma. I-EXPLORATION +Además B-TREATMENT +se I-TREATMENT +aplicó I-TREATMENT +radiofrecuencia I-TREATMENT +en I-TREATMENT +la I-TREATMENT +región I-TREATMENT +del I-TREATMENT +infundíbulo, I-TREATMENT +identificando I-TREATMENT +zonas I-TREATMENT de I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT +electrogramas I-TREATMENT +fragmentados I-TREATMENT +y I-TREATMENT +potenciales I-TREATMENT +mediodiastólicos I-TREATMENT +durante I-TREATMENT +taquicardia. I-TREATMENT +Se I-TREATMENT +completó I-TREATMENT +un I-TREATMENT +total I-TREATMENT +de I-TREATMENT +46 I-TREATMENT +pulsos I-TREATMENT +de I-TREATMENT +radiofrecuencia. I-TREATMENT +Post-radiofrecuencia I-TREATMENT se I-TREATMENT -dio I-TREATMENT +repitió I-TREATMENT +la I-TREATMENT +estimulación I-TREATMENT +ventricular, I-TREATMENT +introduciendo I-TREATMENT +hasta I-TREATMENT +tres I-TREATMENT +extraestímulos, I-TREATMENT +sin I-TREATMENT +lograr I-TREATMENT +reinducir I-TREATMENT +TVS I-TREATMENT +aun I-TREATMENT +bajo I-TREATMENT +efecto I-TREATMENT de I-TREATMENT -alta, I-TREATMENT -utilizando I-TREATMENT -profilaxis I-TREATMENT -antibiótica I-TREATMENT +infusión I-TREATMENT +de I-TREATMENT +isoproterenol I-TREATMENT +endovenoso. I-TREATMENT + I-TREATMENT +La I-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +dada I-TREATMENT +de I-TREATMENT +alta I-TREATMENT +a I-TREATMENT +las I-TREATMENT +48 I-TREATMENT +h I-TREATMENT con I-TREATMENT -trimetoprim/sulfametoxazol. I-TREATMENT -En B-EVOLUTION -1 I-EVOLUTION +amiodarona I-TREATMENT +100 I-TREATMENT +mg/día. I-TREATMENT +Después B-EVOLUTION +de I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +suspendió I-EVOLUTION +el I-EVOLUTION +antiarrítmico I-EVOLUTION +por I-EVOLUTION +nuevo I-EVOLUTION +embarazo. I-EVOLUTION +A I-EVOLUTION +un I-EVOLUTION año I-EVOLUTION de I-EVOLUTION seguimiento I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -favorable I-EVOLUTION -sin I-EVOLUTION -nuevos I-EVOLUTION -cuadros I-EVOLUTION +se I-EVOLUTION +ha I-EVOLUTION +mantenido I-EVOLUTION +asintomática I-EVOLUTION +y I-EVOLUTION +su I-EVOLUTION +monitorización I-EVOLUTION +con I-EVOLUTION +electrocardiograma I-EVOLUTION de I-EVOLUTION -infecciones I-EVOLUTION -cutáneas, I-EVOLUTION -sistémicas I-EVOLUTION -o I-EVOLUTION -eventos I-EVOLUTION -trombóticos. I-EVOLUTION +24 I-EVOLUTION +h I-EVOLUTION +muestra I-EVOLUTION +sólo I-EVOLUTION +extrasistolia I-EVOLUTION +ventricular I-EVOLUTION +aislada I-EVOLUTION +ocasional I-EVOLUTION +de I-EVOLUTION +morfología I-EVOLUTION +diferente I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +taquicardias I-EVOLUTION +ventriculares I-EVOLUTION +tratadas. I-EVOLUTION I-EVOLUTION -Varón B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS +72 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -previamente B-PAST_MEDICAL_HISTORY -sano, I-PAST_MEDICAL_HISTORY -sin B-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -diabetes, I-FAMILY_HISTORY -comenzó B-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS +entre B-PAST_MEDICAL_HISTORY +cuyos I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +destaca I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +presencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +EPOC I-PAST_MEDICAL_HISTORY +estadio I-PAST_MEDICAL_HISTORY +I, I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +únicamente I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +medidas I-PAST_MEDICAL_HISTORY +dietéticas, I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +beta-talasemia I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +dermatitis I-PAST_MEDICAL_HISTORY +atópica. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +presenta I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +hábito I-PAST_MEDICAL_HISTORY +tabáquico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +30 I-PAST_MEDICAL_HISTORY +paquetes/año I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +otros I-PAST_MEDICAL_HISTORY +hábitos I-PAST_MEDICAL_HISTORY +tóxicos. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +La B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +comienza I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +ser I-PRESENT_ILLNESS +estudiada I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -temblor, I-PRESENT_ILLNESS -sudoración, I-PRESENT_ILLNESS -debilidad I-PRESENT_ILLNESS +cirugía I-PRESENT_ILLNESS +vascular I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +mayo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -extremidades I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -síncope I-PRESENT_ILLNESS +2003 I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +raiz I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +aparición I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -aparecían I-PRESENT_ILLNESS +úlceras I-PRESENT_ILLNESS +profundas, I-PRESENT_ILLNESS +dolorosas, I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -ayunas, I-PRESENT_ILLNESS +ambos I-PRESENT_ILLNESS +miembros I-PRESENT_ILLNESS +inferiores, I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +mayor I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +ellas I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +pierna I-PRESENT_ILLNESS +izquierda, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +mejoría I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ejercicio I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +tratamientos I-PRESENT_ILLNESS +administrados I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -cedían I-PRESENT_ILLNESS +llegándose I-PRESENT_ILLNESS +finalmente I-PRESENT_ILLNESS al I-PRESENT_ILLNESS -comer. I-PRESENT_ILLNESS -Estuvo B-TREATMENT -en I-TREATMENT -control I-TREATMENT -neurológico I-TREATMENT -por I-TREATMENT -probable I-TREATMENT -epilepsia, I-TREATMENT -tratándose I-TREATMENT -con I-TREATMENT -carbamazepina I-TREATMENT -algunas I-TREATMENT -semanas, I-TREATMENT -sin I-TREATMENT -otros I-TREATMENT -fármacos. I-TREATMENT -Por B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -nuevo I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS +diagnóstico I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS +pioderma I-PRESENT_ILLNESS +gangrenoso I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +realización I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +biopsia I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Urgencia I-PRESENT_ILLNESS -pesquisándose I-PRESENT_ILLNESS -hipoglicemia I-PRESENT_ILLNESS -recurrente, I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -menor I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -mg/dl, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -hospitalizado. I-PRESENT_ILLNESS -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -fue I-EXPLORATION -normal, I-EXPLORATION -sin I-EXPLORATION -acantosis I-EXPLORATION -nigricans I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -corporal I-EXPLORATION -de I-EXPLORATION -25, I-EXPLORATION -6 I-EXPLORATION -kg/m2. I-EXPLORATION -La I-EXPLORATION -función I-EXPLORATION -tiroidea I-EXPLORATION +lesión. I-PRESENT_ILLNESS +Ante B-DERIVED_FROM/TO +dicho I-DERIVED_FROM/TO +hallazgo, I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +medicina I-DERIVED_FROM/TO +interna I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +mayo I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +2004 I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +sometida I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +diversas I-DERIVED_FROM/TO +pruebas I-DERIVED_FROM/TO +diagnósticas, I-DERIVED_FROM/TO +destacando I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +normalidad I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +las I-DERIVED_FROM/TO +pruebas I-DERIVED_FROM/TO +realizadas, I-DERIVED_FROM/TO +tanto I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +pruebas I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +imagen, I-DERIVED_FROM/TO +como I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +estudio I-DERIVED_FROM/TO +inmunológico. I-DERIVED_FROM/TO +Así I-DERIVED_FROM/TO +mismo I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +negaba I-DERIVED_FROM/TO +clínica I-DERIVED_FROM/TO +digestiva I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +cualquier I-DERIVED_FROM/TO +índole. I-DERIVED_FROM/TO +Se B-TREATMENT +instaura I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +corticoides I-TREATMENT +y I-TREATMENT +ciclosporina I-TREATMENT +A I-TREATMENT +con I-TREATMENT +muy I-TREATMENT +buena I-TREATMENT +respuesta I-TREATMENT +clínica I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +sigue I-TREATMENT +este I-TREATMENT +tratamiento I-TREATMENT +hasta I-TREATMENT +noviembre I-TREATMENT +de I-TREATMENT +2004 I-TREATMENT +así I-TREATMENT +como I-TREATMENT +curas I-TREATMENT +locales I-TREATMENT +de I-TREATMENT +las I-TREATMENT +lesiones I-TREATMENT +ulcerosas, I-TREATMENT +aunque I-TREATMENT +con I-TREATMENT +persistencia I-TREATMENT +de I-TREATMENT +dichas I-TREATMENT +lesiones. I-TREATMENT + B-EVOLUTION +En I-EVOLUTION +noviembre I-EVOLUTION +de I-EVOLUTION +2004 I-EVOLUTION +comienza I-EVOLUTION +con I-EVOLUTION +clínica I-EVOLUTION +digestiva I-EVOLUTION +inespecífica I-EVOLUTION +consistente I-EVOLUTION +en I-EVOLUTION +molestias I-EVOLUTION +abdominales I-EVOLUTION +difusas I-EVOLUTION +y I-EVOLUTION +alteración I-EVOLUTION +del I-EVOLUTION +ritmo I-EVOLUTION +intestinal, I-EVOLUTION +por B-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +ante I-EXPLORATION +la I-EXPLORATION +clínica I-EXPLORATION y I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -cortisol I-EXPLORATION -matinal I-EXPLORATION -resultaron I-EXPLORATION -normales. I-EXPLORATION -Una I-EXPLORATION -prueba I-EXPLORATION +la I-EXPLORATION +anemia I-EXPLORATION de I-EXPLORATION -tolerancia I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +(en I-EXPLORATION +principio I-EXPLORATION +atribuida I-EXPLORATION a I-EXPLORATION la I-EXPLORATION -glucosa I-EXPLORATION -oral I-EXPLORATION -(PTGO) I-EXPLORATION -informó I-EXPLORATION -glicemia I-EXPLORATION -basal I-EXPLORATION -de I-EXPLORATION -88 I-EXPLORATION +beta-talasemia) I-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +enema I-EXPLORATION +opaco I-EXPLORATION y I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -120 I-EXPLORATION -min I-EXPLORATION -185 I-EXPLORATION -mg/dl, I-EXPLORATION -e I-EXPLORATION -insulinemia I-EXPLORATION -basal I-EXPLORATION +endoscopia I-EXPLORATION +digestiva I-EXPLORATION +baja, I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +apreciaba I-EXPLORATION +en I-EXPLORATION +recto I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +inmediatamente I-EXPLORATION +al I-EXPLORATION +pasar I-EXPLORATION +el I-EXPLORATION +esfinter, I-EXPLORATION de I-EXPLORATION -2.759 I-EXPLORATION +tacto I-EXPLORATION +dura, I-EXPLORATION +mamelonada I-EXPLORATION y I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -120 I-EXPLORATION -min I-EXPLORATION -de I-EXPLORATION -5.942 I-EXPLORATION -µUI/ml I-EXPLORATION -(MEIA, I-EXPLORATION -Axym, I-EXPLORATION -Abbott). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -ayuno I-EXPLORATION -presentando I-EXPLORATION -glicemia I-EXPLORATION -de I-EXPLORATION -46 I-EXPLORATION -mg/dl I-EXPLORATION -e I-EXPLORATION -insulinemia I-EXPLORATION -de I-EXPLORATION -588 I-EXPLORATION -µUI/ml I-EXPLORATION -(RIA, I-EXPLORATION -Diagnostic I-EXPLORATION -Products, I-EXPLORATION -Co I-EXPLORATION -[DPC]) I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -15 I-EXPLORATION -horas I-EXPLORATION +muy I-EXPLORATION +friable, I-EXPLORATION +región I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +toman I-EXPLORATION +biopsias. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +resultado I-EXPLORATION de I-EXPLORATION -ayuno, I-EXPLORATION -con I-EXPLORATION -sintomatología I-EXPLORATION -asociada. I-EXPLORATION -Una I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -(TAC) I-EXPLORATION +la I-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +mostró I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -abdomen I-EXPLORATION -resultó I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -test I-EXPLORATION +adenocarcinoma I-EXPLORATION +mucosecretor I-EXPLORATION +tipo I-EXPLORATION +coloide. I-EXPLORATION +Ante B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +referido I-TREATMENT +se I-TREATMENT +procede I-TREATMENT +a I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +de I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +realizándose I-TREATMENT +una I-TREATMENT +amputación I-TREATMENT +abdomino-perineal I-TREATMENT +y I-TREATMENT +una I-TREATMENT +colostomía I-TREATMENT +terminal I-TREATMENT +izquierda I-TREATMENT +a I-TREATMENT +fecha I-TREATMENT +de I-TREATMENT +enero I-TREATMENT +de I-TREATMENT +2005. I-TREATMENT +El B-EXPLORATION +resultado I-EXPLORATION +anatomopatológico I-EXPLORATION +definitivo I-EXPLORATION +fue I-EXPLORATION de I-EXPLORATION -estimulación I-EXPLORATION -intraarterial I-EXPLORATION -selectiva I-EXPLORATION +adenocarcinoma I-EXPLORATION +mucosecretor I-EXPLORATION +moderadamente I-EXPLORATION +diferenciado I-EXPLORATION con I-EXPLORATION -calcio I-EXPLORATION -para I-EXPLORATION -localización I-EXPLORATION -de I-EXPLORATION -insulinomas I-EXPLORATION -según I-EXPLORATION -protocolo2, I-EXPLORATION +extensas I-EXPLORATION +necrosis I-EXPLORATION +que I-EXPLORATION +infiltraba I-EXPLORATION +todo I-EXPLORATION el I-EXPLORATION -cual I-EXPLORATION -no I-EXPLORATION -permitió I-EXPLORATION +espesor I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -localización I-EXPLORATION -y I-EXPLORATION +pared. I-EXPLORATION +Afectación I-EXPLORATION +por I-EXPLORATION +adenocarcinoma I-EXPLORATION en I-EXPLORATION +cinco I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +nueve I-EXPLORATION +ganglios I-EXPLORATION +aislados. I-EXPLORATION +Márgenes I-EXPLORATION +libres. I-EXPLORATION + I-EXPLORATION +Una I-EXPLORATION +vez I-EXPLORATION +realizada I-EXPLORATION la I-EXPLORATION -arteriografía I-EXPLORATION +cirugía, I-EXPLORATION se I-EXPLORATION -describió I-EXPLORATION -una I-EXPLORATION -posible I-EXPLORATION -lesión I-EXPLORATION -nodular I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cabeza I-EXPLORATION -del I-EXPLORATION -páncreas, I-EXPLORATION +somete I-EXPLORATION +a I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -1, I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -1, I-EXPLORATION -4 I-EXPLORATION -cm, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -laparatomía I-EXPLORATION -exploratoria I-EXPLORATION +extensión, I-EXPLORATION que I-EXPLORATION -no I-EXPLORATION -demostró I-EXPLORATION +pone I-EXPLORATION +de I-EXPLORATION +manifiesto I-EXPLORATION la I-EXPLORATION presencia I-EXPLORATION de I-EXPLORATION -tumor. I-EXPLORATION -Se I-EXPLORATION -midieron I-EXPLORATION -los I-EXPLORATION -anticuerpos I-EXPLORATION -antiinsulina I-EXPLORATION -mediante I-EXPLORATION -inmunoensayo I-EXPLORATION -enzimático I-EXPLORATION -(ELISA) I-EXPLORATION -con I-EXPLORATION -kits I-EXPLORATION -comerciales I-EXPLORATION -Medizym® I-EXPLORATION -(Medipan I-EXPLORATION -GmbH, I-EXPLORATION -Berlín, I-EXPLORATION -Alemania) I-EXPLORATION -que I-EXPLORATION -resultaron I-EXPLORATION -positivos. I-EXPLORATION -Los I-EXPLORATION -anticuerpos I-EXPLORATION -antitiroideos I-EXPLORATION +metástasis I-EXPLORATION +pulmonares I-EXPLORATION +múltiples, I-EXPLORATION y I-EXPLORATION -antinucleares I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -No I-EXPLORATION -presentó I-EXPLORATION -manifestaciones I-EXPLORATION -de I-EXPLORATION -otra I-EXPLORATION -enfermedad I-EXPLORATION -autoinmune. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -trató I-TREATMENT -con I-TREATMENT -dieta I-TREATMENT -restringida I-TREATMENT -en I-TREATMENT -carbohidratos I-TREATMENT -refinados I-TREATMENT -y I-TREATMENT -comidas I-TREATMENT -frecuentes I-TREATMENT +afectación I-EXPLORATION +adenopática I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +mesentérico, I-EXPLORATION +retroperitoneal, I-EXPLORATION +y I-EXPLORATION +pélvico. I-EXPLORATION +Con B-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +adenocarcinoma I-TREATMENT +de I-TREATMENT +recto I-TREATMENT +estadio-IV I-TREATMENT +decidimos I-TREATMENT +iniciar I-TREATMENT +quimioterapia I-TREATMENT +paliativa I-TREATMENT en I-TREATMENT -pequeñas I-TREATMENT -cantidades, I-TREATMENT -manteniéndose I-TREATMENT -asintomático, I-TREATMENT -sin I-TREATMENT -presentar I-TREATMENT -nuevas I-TREATMENT -hipoglicemias. I-TREATMENT -Al B-EVOLUTION -año I-EVOLUTION +régimen I-TREATMENT +FOLFOX-6, I-TREATMENT +tratamiento I-TREATMENT +que I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +inició I-TREATMENT +a I-TREATMENT +finales I-TREATMENT +de I-TREATMENT +febrero I-TREATMENT +de I-TREATMENT +2005. I-TREATMENT +La B-EVOLUTION +respuesta I-EVOLUTION +al I-EVOLUTION +tratamiento I-EVOLUTION +quimioterápico I-EVOLUTION +fue I-EVOLUTION +favorable, I-EVOLUTION +con I-EVOLUTION +respuesta I-EVOLUTION +parcial I-EVOLUTION de I-EVOLUTION -seguimiento I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -PTGO I-EVOLUTION -que I-EVOLUTION -informó I-EVOLUTION -glicemia I-EVOLUTION -basal I-EVOLUTION -84 I-EVOLUTION +las I-EVOLUTION +metástasis I-EVOLUTION +pulmonares I-EVOLUTION y I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -120 I-EVOLUTION -min I-EVOLUTION -240 I-EVOLUTION -mg/dl I-EVOLUTION -e I-EVOLUTION -insulinemia I-EVOLUTION -basal I-EVOLUTION +desaparición I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +afectación I-EVOLUTION +adenopática, I-EVOLUTION +así I-EVOLUTION +como I-EVOLUTION +descenso I-EVOLUTION de I-EVOLUTION -434 I-EVOLUTION -y I-EVOLUTION -a I-EVOLUTION los I-EVOLUTION -120 I-EVOLUTION -min I-EVOLUTION +marcadores I-EVOLUTION +tumorales. I-EVOLUTION +En I-EVOLUTION +cuanto I-EVOLUTION +al I-EVOLUTION +pioderma I-EVOLUTION +gangrenoso I-EVOLUTION +y I-EVOLUTION +ya I-EVOLUTION +sin I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +que I-EVOLUTION +seguía I-EVOLUTION +previamente I-EVOLUTION +para I-EVOLUTION +éste, I-EVOLUTION +la I-EVOLUTION +evolución I-EVOLUTION +fue I-EVOLUTION +hacia I-EVOLUTION +la I-EVOLUTION +desaparición I-EVOLUTION +completa I-EVOLUTION +en I-EVOLUTION +ambas I-EVOLUTION +piernas, I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +ningún I-EVOLUTION +tipo I-EVOLUTION de I-EVOLUTION -793 I-EVOLUTION -µUI/ml I-EVOLUTION -(RIA). I-EVOLUTION -Se I-EVOLUTION -mantenía I-EVOLUTION -asintomático I-EVOLUTION -después I-EVOLUTION +sintomatología I-EVOLUTION +añadida. I-EVOLUTION + I-EVOLUTION +Sin I-EVOLUTION +embargo, I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +curso I-EVOLUTION +del I-EVOLUTION +tratamiento I-EVOLUTION +(finalizado I-EVOLUTION +el I-EVOLUTION +4º I-EVOLUTION +ciclo) I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +acude I-EVOLUTION +al I-EVOLUTION +Servicio I-EVOLUTION de I-EVOLUTION -tres I-EVOLUTION -años I-EVOLUTION +Urgencias I-EVOLUTION +por I-EVOLUTION +un I-EVOLUTION +cuadro I-EVOLUTION +febril I-EVOLUTION de I-EVOLUTION -seguimiento. I-EVOLUTION +39º, I-EVOLUTION +náuseas, I-EVOLUTION +vómitos I-EVOLUTION +y I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +en I-EVOLUTION +hipocondrio I-EVOLUTION +derecho, I-EVOLUTION +destacando I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +pruebas I-EVOLUTION +complementarias I-EVOLUTION +una I-EVOLUTION +neutropenia I-EVOLUTION +grado I-EVOLUTION +IV, I-EVOLUTION +así I-EVOLUTION +como I-EVOLUTION +un I-EVOLUTION +patrón I-EVOLUTION +de I-EVOLUTION +citólisis I-EVOLUTION +hepática, I-EVOLUTION +colestasis I-EVOLUTION +e I-EVOLUTION +insuficiencia I-EVOLUTION +renal. I-EVOLUTION +Ante B-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +shock I-TREATMENT +séptico I-TREATMENT +secundario I-TREATMENT +a I-TREATMENT +una I-TREATMENT +colangitis, I-TREATMENT +se I-TREATMENT +procede I-TREATMENT +a I-TREATMENT +su I-TREATMENT +ingreso I-TREATMENT +en I-TREATMENT +la I-TREATMENT +Unidad I-TREATMENT +de I-TREATMENT +Cuidados I-TREATMENT +Intensivos, I-TREATMENT +donde I-TREATMENT +se I-TREATMENT +instauraron I-TREATMENT +las I-TREATMENT +medidas I-TREATMENT +antibióticas I-TREATMENT +necesarias, I-TREATMENT +así I-TREATMENT +como I-TREATMENT +drogas I-TREATMENT +vasoactivas, I-TREATMENT +sin B-EVOLUTION +conseguir I-EVOLUTION +la I-EVOLUTION +resolución I-EVOLUTION +del I-EVOLUTION +proceso I-EVOLUTION +y I-EVOLUTION +produciéndose I-EVOLUTION +el I-EVOLUTION +éxitus I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +paciente. I-EVOLUTION I-EVOLUTION -Una B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -21 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -previamente B-PAST_MEDICAL_HISTORY -sana I-PAST_MEDICAL_HISTORY -ingresó B-PRESENT_ILLNESS +39 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +diagnosticado B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +SA I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +alteraciones I-PAST_MEDICAL_HISTORY +oculares I-PAST_MEDICAL_HISTORY +(lenticono I-PAST_MEDICAL_HISTORY +anterior I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +retinopatía I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +flecos), I-PAST_MEDICAL_HISTORY +acudió B-PRESENT_ILLNESS por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -alteración I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pruebas I-PRESENT_ILLNESS -hepáticas. I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -decaída I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico. I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -que I-EXPLORATION -mostraron I-EXPLORATION -pancitopenia I-EXPLORATION -(hemoglobina I-EXPLORATION -10 I-EXPLORATION -gr%, I-EXPLORATION -leucocitos I-EXPLORATION -1.900/uL, I-EXPLORATION -plaquetas I-EXPLORATION -43.000/mL) I-EXPLORATION -y I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -pruebas I-EXPLORATION -hepáticas I-EXPLORATION -(GOT I-EXPLORATION -1.800 I-EXPLORATION -U/L, I-EXPLORATION -GPT I-EXPLORATION -1.300 I-EXPLORATION -U/L). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -enfermedades I-EXPLORATION -infecciosas I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -fue I-EXPLORATION -negativo I-EXPLORATION -(hemocultivo, I-EXPLORATION -urocultivo, I-EXPLORATION -virus I-EXPLORATION -hepatotropos, I-EXPLORATION -mycoplasma, I-EXPLORATION -toxoplasma, I-EXPLORATION -leptospira, I-EXPLORATION -bartonella, I-EXPLORATION -brucella, I-EXPLORATION -rubéola, I-EXPLORATION -sarampión, I-EXPLORATION -VIH, I-EXPLORATION -parvovirus I-EXPLORATION -B19, I-EXPLORATION -citomegalovirus I-EXPLORATION -y I-EXPLORATION -Epstein I-EXPLORATION -Barr). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -reumatológico I-EXPLORATION -donde I-EXPLORATION -resultó I-EXPLORATION -ANA I-EXPLORATION -1: I-EXPLORATION -40 I-EXPLORATION -patrón I-EXPLORATION -moteado I-EXPLORATION -y I-EXPLORATION -anti I-EXPLORATION -DNA I-EXPLORATION -por I-EXPLORATION -FARR, I-EXPLORATION -factor I-EXPLORATION -reumatoide I-EXPLORATION -y I-EXPLORATION -perfil I-EXPLORATION -ENA I-EXPLORATION -negativos I-EXPLORATION +baja I-PRESENT_ILLNESS +AV I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +OD. I-PRESENT_ILLNESS +Resultó B-PAST_MEDICAL_HISTORY +intervenido I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cataratas I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +complicaciones I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes. I-PAST_MEDICAL_HISTORY +La B-EXPLORATION +OCT I-EXPLORATION +previa I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +cirugía I-EXPLORATION +detectó I-EXPLORATION +disminución I-EXPLORATION +bilateral I-EXPLORATION +del I-EXPLORATION +espesor I-EXPLORATION +macular, I-EXPLORATION con I-EXPLORATION -complemento I-EXPLORATION -normal. I-EXPLORATION +adelgazamiento I-EXPLORATION +de I-EXPLORATION +capas I-EXPLORATION +internas I-EXPLORATION +retinianas, I-EXPLORATION +fundamentalmente I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +macular I-EXPLORATION +temporal. I-EXPLORATION La I-EXPLORATION -paciente I-EXPLORATION -continuó I-EXPLORATION -con I-EXPLORATION -fiebre I-EXPLORATION -y I-EXPLORATION -pruebas I-EXPLORATION -hepáticas I-EXPLORATION +AV I-EXPLORATION +fue I-EXPLORATION +0, I-EXPLORATION +01 I-EXPLORATION en I-EXPLORATION -deterioro. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -linfonodos I-EXPLORATION -pequeños I-EXPLORATION -difusos, I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -laminar I-EXPLORATION -bilateral I-EXPLORATION +el I-EXPLORATION +OD I-EXPLORATION y I-EXPLORATION -hepatoesplenomegalia. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION +0, I-EXPLORATION +7 I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +OI. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +fondo I-EXPLORATION de I-EXPLORATION -linfonodos I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -adenitis I-EXPLORATION -no I-EXPLORATION -específica. I-EXPLORATION -Los I-EXPLORATION -niveles I-EXPLORATION +ojo I-EXPLORATION +del I-EXPLORATION +OD I-EXPLORATION +se I-EXPLORATION +detectó I-EXPLORATION +un I-EXPLORATION +AM I-EXPLORATION de I-EXPLORATION -ferritina I-EXPLORATION -resultaron I-EXPLORATION -en I-EXPLORATION -23.460 I-EXPLORATION -U/L. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -medular I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -hiperplasia I-EXPLORATION -linfoide I-EXPLORATION -y I-EXPLORATION -presencia I-EXPLORATION +espesor I-EXPLORATION +completo, I-EXPLORATION +comprobado I-EXPLORATION +mediante I-EXPLORATION +OCT, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +diámetro I-EXPLORATION de I-EXPLORATION -abundantes I-EXPLORATION -hemofagocitos. I-EXPLORATION -La B-TREATMENT +1.400µm. I-EXPLORATION +El B-TREATMENT paciente I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -protocolo I-TREATMENT -HLH I-TREATMENT -04 I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -respuesta I-TREATMENT -clínica, I-TREATMENT -con I-TREATMENT -normalización I-TREATMENT -de I-TREATMENT -pruebas I-TREATMENT -hepáticas I-TREATMENT -y I-TREATMENT -descenso I-TREATMENT -de I-TREATMENT -la I-TREATMENT -ferritina I-TREATMENT -hasta I-TREATMENT -valores I-TREATMENT -normales. I-TREATMENT -Al B-EVOLUTION -momento I-EVOLUTION -de I-EVOLUTION -redactar I-EVOLUTION -este I-EVOLUTION -reporte I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -lleva I-EVOLUTION -24 I-EVOLUTION -meses I-EVOLUTION +decidió I-TREATMENT +no I-TREATMENT +ser I-TREATMENT +intervenido, I-TREATMENT +adquiriéndose I-TREATMENT +actitud I-TREATMENT +expectante. I-TREATMENT +Actualmente B-EVOLUTION +persiste I-EVOLUTION +el I-EVOLUTION +AM, I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +diámetro I-EVOLUTION de I-EVOLUTION -tratamiento I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION +2.900µm, I-EVOLUTION +con I-EVOLUTION +pérdida I-EVOLUTION +importante I-EVOLUTION +del I-EVOLUTION +tejido I-EVOLUTION +retiniano I-EVOLUTION y I-EVOLUTION +alteraciones I-EVOLUTION +quísticas. I-EVOLUTION +El I-EVOLUTION +OI I-EVOLUTION +muestra I-EVOLUTION +adelgazamiento I-EVOLUTION +progresivo I-EVOLUTION +similar I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +zona I-EVOLUTION +macular I-EVOLUTION +temporal I-EVOLUTION con I-EVOLUTION -buena I-EVOLUTION -calidad I-EVOLUTION -de I-EVOLUTION -vida. I-EVOLUTION -La I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -dispone I-EVOLUTION +espesores I-EVOLUTION de I-EVOLUTION -hermanos I-EVOLUTION -HLA I-EVOLUTION -compatibles. I-EVOLUTION +164µm. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY +81 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +remitido B-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +Unidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Nutrición I-DERIVED_FROM/TO +desde I-DERIVED_FROM/TO +Medicina I-DERIVED_FROM/TO +Interna I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +estudio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +hipoproteinemia. I-DERIVED_FROM/TO +Como B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -mórbidos; I-PAST_MEDICAL_HISTORY -consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -asintomática I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -muslo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Se B-TREATMENT -trató I-TREATMENT -como I-TREATMENT -piodermia I-TREATMENT -con I-TREATMENT -múltiples I-TREATMENT -antibióticos I-TREATMENT -orales, I-TREATMENT -sin I-TREATMENT -respuesta. I-TREATMENT -Al B-EXPLORATION -examen, I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -eritematoso I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -8 I-EXPLORATION -cm, I-EXPLORATION -con I-EXPLORATION -pequeñas I-EXPLORATION -ulceraciones I-EXPLORATION -y I-EXPLORATION -erosiones. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -compresión I-EXPLORATION -no I-EXPLORATION -hubo I-EXPLORATION -salida I-EXPLORATION -de I-EXPLORATION -exudado I-EXPLORATION -ni I-EXPLORATION -de I-EXPLORATION -granos. I-EXPLORATION -Además, I-EXPLORATION -presentaba I-EXPLORATION -dos I-EXPLORATION -adenopatías I-EXPLORATION -inguinales I-EXPLORATION -ipsilaterales, I-EXPLORATION -no I-EXPLORATION -dolorosas, I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -1 I-EXPLORATION -cm. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -palparon I-EXPLORATION -otras I-EXPLORATION -adenopatías I-EXPLORATION -ni I-EXPLORATION -visceromegalia. I-EXPLORATION -Se I-EXPLORATION -planteó I-EXPLORATION +personales I-PAST_MEDICAL_HISTORY +destacan I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +arritmia I-PAST_MEDICAL_HISTORY +cardíaca I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +fibrilación I-PAST_MEDICAL_HISTORY +auricular I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +respuesta I-PAST_MEDICAL_HISTORY +ventricular I-PAST_MEDICAL_HISTORY +adecuada. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -linfoma I-EXPLORATION -cutáneo I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -actinomicetoma, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION +ecocardiograma I-EXPLORATION se I-EXPLORATION -solicitaron I-EXPLORATION -exámenes I-EXPLORATION -serológicos, I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION +objetiva I-EXPLORATION +insuficiencia I-EXPLORATION +mitral I-EXPLORATION +moderada, I-EXPLORATION +insuficiencia I-EXPLORATION +aórtica I-EXPLORATION +moderada I-EXPLORATION +por I-EXPLORATION +anuloectasia I-EXPLORATION +valvular I-EXPLORATION y I-EXPLORATION -pelvis I-EXPLORATION -(TAC-TAP), I-EXPLORATION -múltiples I-EXPLORATION -cultivos I-EXPLORATION -bacterianos-micológicos I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -piel. I-EXPLORATION -Tenía I-EXPLORATION -hemograma, I-EXPLORATION -deshidrogensa I-EXPLORATION -láctica I-EXPLORATION -(LDH) I-EXPLORATION -y I-EXPLORATION -calcio I-EXPLORATION -sérico I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -rangos I-EXPLORATION -normales; I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -HTLV-1 I-EXPLORATION -negativa. I-EXPLORATION -El I-EXPLORATION -TAC-TAP I-EXPLORATION -mostró I-EXPLORATION -sólo I-EXPLORATION -las I-EXPLORATION -adenopatías I-EXPLORATION -ipsilaterales I-EXPLORATION -pesquisadas I-EXPLORATION -clínicamente. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -histopatología I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -dérmico I-EXPLORATION -ulcerado, I-EXPLORATION -compuesto I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -linfoides I-EXPLORATION -grandes, I-EXPLORATION -con I-EXPLORATION -pleomorfismo I-EXPLORATION -nuclear I-EXPLORATION -y I-EXPLORATION -mitosis I-EXPLORATION -atípicas. I-EXPLORATION -Además, I-EXPLORATION -había I-EXPLORATION -abundantes I-EXPLORATION -eosinófilos. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -(IHQ) I-EXPLORATION -mostró I-EXPLORATION -reacción I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -CD30 I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -grandes I-EXPLORATION -y I-EXPLORATION -reacción I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -ALK-1 I-EXPLORATION -y I-EXPLORATION -CD25. I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -además I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -médula I-EXPLORATION -ósea, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -arquitectura I-EXPLORATION -y I-EXPLORATION -celularidad I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -todos I-EXPLORATION -estos I-EXPLORATION -elementos I-EXPLORATION -se I-EXPLORATION -diagnosticó I-EXPLORATION -un I-EXPLORATION -LACGPC. I-EXPLORATION -Se B-TREATMENT -planteó I-TREATMENT -realizar I-TREATMENT -radioterapia I-TREATMENT -(RT) I-TREATMENT -local, I-TREATMENT -pero I-TREATMENT -cuando I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -volvió I-TREATMENT -a I-TREATMENT -consultar I-TREATMENT -al I-TREATMENT -mes, I-TREATMENT -presentaba I-TREATMENT -clara I-TREATMENT -disminución I-TREATMENT -de I-TREATMENT -tamaño I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -del I-TREATMENT -muslo, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -no I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento. I-TREATMENT -Se B-EVOLUTION -controló I-EVOLUTION -cada I-EVOLUTION -4 I-EVOLUTION -meses I-EVOLUTION -y I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -24 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -se I-EVOLUTION -encontraba I-EVOLUTION -en I-EVOLUTION -regresión I-EVOLUTION -total. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -comunica I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -fumador, I-PRESENT_ILLNESS -evaluado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -sala I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -seca, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -moderada. I-PRESENT_ILLNESS -Sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -asma I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -rinitis I-PAST_MEDICAL_HISTORY -alérgica, I-PAST_MEDICAL_HISTORY -tampoco I-PAST_MEDICAL_HISTORY +dilatación I-EXPLORATION +auricular I-EXPLORATION +sin I-EXPLORATION +hipertensión I-EXPLORATION +pulmonar. I-EXPLORATION +También B-PAST_MEDICAL_HISTORY refiere I-PAST_MEDICAL_HISTORY -uso I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -medicamentos; I-PAST_MEDICAL_HISTORY -familia I-PAST_MEDICAL_HISTORY -niega I-PAST_MEDICAL_HISTORY -uso I-PAST_MEDICAL_HISTORY +Paget I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +hueso, I-PAST_MEDICAL_HISTORY +actualmente I-PAST_MEDICAL_HISTORY +inactiva. I-PAST_MEDICAL_HISTORY +Monorreno I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +hipoplasia I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +riñón I-PAST_MEDICAL_HISTORY +contralateral. I-PAST_MEDICAL_HISTORY +Intervenido I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -antiinflamatorios I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -esteroidales, I-PAST_MEDICAL_HISTORY -antibioterapia I-PAST_MEDICAL_HISTORY -previa I-PAST_MEDICAL_HISTORY +ulcus I-PAST_MEDICAL_HISTORY +gástrico I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +50 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +realizándose I-PAST_MEDICAL_HISTORY +gastrectomía I-PAST_MEDICAL_HISTORY +subtotal I-PAST_MEDICAL_HISTORY +Billroth I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +I I-PAST_MEDICAL_HISTORY +(última I-PAST_MEDICAL_HISTORY +endoscopia I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +meses, I-PAST_MEDICAL_HISTORY +donde I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +objetiva I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +resección I-PAST_MEDICAL_HISTORY +quirúrgica I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -cocaína I-PAST_MEDICAL_HISTORY -u I-PAST_MEDICAL_HISTORY -otras I-PAST_MEDICAL_HISTORY -drogas I-PAST_MEDICAL_HISTORY +gastritis I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +atrófica I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +muñón I-PAST_MEDICAL_HISTORY +gástrico). I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +revisión I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +Servicio I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -abuso. I-PAST_MEDICAL_HISTORY -La B-EXPLORATION -hemodinamia I-EXPLORATION -y I-EXPLORATION -oximetría I-EXPLORATION -se I-EXPLORATION -encontraban I-EXPLORATION -en I-EXPLORATION -rango I-EXPLORATION -normal. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -segmentario I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -crépitos I-EXPLORATION +Nefrología I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +patología I-PAST_MEDICAL_HISTORY +renal, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +proteinuria I-PAST_MEDICAL_HISTORY +significativa. I-PAST_MEDICAL_HISTORY +Perfil I-PAST_MEDICAL_HISTORY +hepático I-PAST_MEDICAL_HISTORY +correcto. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +anamnesis, I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +buen I-PRESENT_ILLNESS +apetito I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +adecuada I-PRESENT_ILLNESS +ingesta, I-PRESENT_ILLNESS +realizando I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +dieta I-PRESENT_ILLNESS +equilibrada. I-PRESENT_ILLNESS +Hábito I-PRESENT_ILLNESS +deposicional I-PRESENT_ILLNESS +conservado. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física, I-EXPLORATION +edemas I-EXPLORATION en I-EXPLORATION -base I-EXPLORATION -pulmonar I-EXPLORATION -izquierda, I-EXPLORATION -sin I-EXPLORATION -sibilancias I-EXPLORATION -ni I-EXPLORATION -otros I-EXPLORATION -ruidos I-EXPLORATION -agregados; I-EXPLORATION -sin I-EXPLORATION -hipocratismo I-EXPLORATION -digital I-EXPLORATION -ni I-EXPLORATION -otros I-EXPLORATION -signos I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -patología I-EXPLORATION -pulmonar I-EXPLORATION -previa I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION +ambas I-EXPLORATION +extremidades I-EXPLORATION +inferiores I-EXPLORATION +e I-EXPLORATION +IMC I-EXPLORATION +contaminado I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -mostró I-EXPLORATION -foco I-EXPLORATION +21, I-EXPLORATION +7 I-EXPLORATION +kg/m2. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +analítica, I-EXPLORATION +hipoalbuminemia I-EXPLORATION de I-EXPLORATION -consolidación I-EXPLORATION -en I-EXPLORATION +2.002 I-EXPLORATION +mg/dl. I-EXPLORATION +Se I-EXPLORATION +inicia I-EXPLORATION +tratamiento I-EXPLORATION +con I-EXPLORATION +nutrición I-EXPLORATION +enteral I-EXPLORATION +domiciliaria I-EXPLORATION +hiperproteica. I-EXPLORATION +En I-EXPLORATION el I-EXPLORATION -lóbulo I-EXPLORATION -inferior I-EXPLORATION -izquierdo I-EXPLORATION -(LII). I-EXPLORATION -Dentro I-EXPLORATION -de I-EXPLORATION -sus I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -destacaba I-EXPLORATION -leucocitosis I-EXPLORATION +siguiente I-EXPLORATION +control, I-EXPLORATION +la I-EXPLORATION +albúmina I-EXPLORATION +ha I-EXPLORATION +disminuido I-EXPLORATION +a I-EXPLORATION +1.930 I-EXPLORATION +mg/dl I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +piensa I-EXPLORATION +en I-EXPLORATION +una I-EXPLORATION +enfermedad I-EXPLORATION +malabsortiva I-EXPLORATION +pese I-EXPLORATION +a I-EXPLORATION +no I-EXPLORATION +referir I-EXPLORATION +clínica I-EXPLORATION de I-EXPLORATION -13.200 I-EXPLORATION -cel/dL, I-EXPLORATION -velocidad I-EXPLORATION +diarrea. I-EXPLORATION +Se I-EXPLORATION +realizan I-EXPLORATION +test I-EXPLORATION de I-EXPLORATION -eritrosedimentación I-EXPLORATION -(VHS) I-EXPLORATION +la I-EXPLORATION +D-xilosa I-EXPLORATION +y I-EXPLORATION +Van I-EXPLORATION de I-EXPLORATION -65 I-EXPLORATION -mm, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION +Kammer, I-EXPLORATION +siendo I-EXPLORATION +ambos I-EXPLORATION +negativos. I-EXPLORATION +Se I-EXPLORATION +descarta I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -15 I-EXPLORATION -(valor I-EXPLORATION -normal I-EXPLORATION -< I-EXPLORATION -5), I-EXPLORATION -perfil I-EXPLORATION -bioquímico I-EXPLORATION +celiaquía I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION +gastroduodenal I-EXPLORATION +que I-EXPLORATION +resulta I-EXPLORATION normal. I-EXPLORATION -Con B-TREATMENT -estos I-TREATMENT -hallazgos I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -hospitalización I-TREATMENT -y I-TREATMENT -se I-TREATMENT -dio I-TREATMENT -inicio I-TREATMENT -a I-TREATMENT -antibioterapia I-TREATMENT -con I-TREATMENT -ceftriaxona I-TREATMENT -2 I-TREATMENT -g/día I-TREATMENT -ev I-TREATMENT -y I-TREATMENT -levofloxacino I-TREATMENT -500 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día I-TREATMENT -vo. I-TREATMENT -Posterior B-EVOLUTION -a I-EVOLUTION -una I-EVOLUTION -semana I-EVOLUTION -de I-EVOLUTION -tratamiento, I-EVOLUTION -no I-EVOLUTION -hubo I-EVOLUTION -mejoría I-EVOLUTION -clínica. I-EVOLUTION -Estudios B-EXPLORATION +La I-EXPLORATION +biopsia I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -con I-EXPLORATION -hemograma I-EXPLORATION -mostraron I-EXPLORATION -hematocrito I-EXPLORATION -38%, I-EXPLORATION -hemoglobina I-EXPLORATION -12 I-EXPLORATION -g/dL, I-EXPLORATION -VCM I-EXPLORATION -89, I-EXPLORATION -leucocitos I-EXPLORATION -12.500 I-EXPLORATION -cel/mm3, I-EXPLORATION -eosinófilos I-EXPLORATION -16, I-EXPLORATION -9%, I-EXPLORATION -plaquetas I-EXPLORATION -234, I-EXPLORATION -000 I-EXPLORATION -cel/mm3, I-EXPLORATION -VHS I-EXPLORATION -35 I-EXPLORATION -mm, I-EXPLORATION -PCR I-EXPLORATION -15 I-EXPLORATION -(límite I-EXPLORATION -< I-EXPLORATION -5) I-EXPLORATION -Ig I-EXPLORATION -E I-EXPLORATION -128, I-EXPLORATION -2 I-EXPLORATION -UI/ml. I-EXPLORATION -Tomografía I-EXPLORATION -computarizada I-EXPLORATION +grasa I-EXPLORATION +subcutánea I-EXPLORATION +no I-EXPLORATION +refleja I-EXPLORATION +amiloidosis. I-EXPLORATION +Ante I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -(TAC) I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -mayor I-EXPLORATION -consolidación I-EXPLORATION +enfermedad I-EXPLORATION +pierde I-EXPLORATION +proteínas, I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +aclaramiento I-EXPLORATION de I-EXPLORATION -LII I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -superior I-EXPLORATION -izquierdo I-EXPLORATION -(LSI), I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -opacidades I-EXPLORATION +A1AT I-EXPLORATION en I-EXPLORATION -vidrio I-EXPLORATION -esmerilado, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -izquierdo I-EXPLORATION -moderado. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -broncoscopia I-EXPLORATION -flexible I-EXPLORATION -con I-EXPLORATION -lavado I-EXPLORATION -broncoalveolar I-EXPLORATION -(LBA) I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -107 I-EXPLORATION -células, I-EXPLORATION +heces I-EXPLORATION con I-EXPLORATION -95% I-EXPLORATION +valor I-EXPLORATION de I-EXPLORATION -eosinófilos I-EXPLORATION -; I-EXPLORATION -los I-EXPLORATION -cultivos, I-EXPLORATION -tanto I-EXPLORATION +218 I-EXPLORATION +ml/día I-EXPLORATION +(> I-EXPLORATION +24ml/día) I-EXPLORATION +[A1AT I-EXPLORATION en I-EXPLORATION -medios I-EXPLORATION -corrientes I-EXPLORATION -como I-EXPLORATION -micobacterias, I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -galactomanano I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -transbronquial I-EXPLORATION -mostró I-EXPLORATION -numerosos I-EXPLORATION -granulocitos I-EXPLORATION -eosinófilos I-EXPLORATION +sangre: I-EXPLORATION +156 I-EXPLORATION +mg/dL; I-EXPLORATION +A1AT I-EXPLORATION en I-EXPLORATION -alvéolos I-EXPLORATION -e I-EXPLORATION -intersticio, I-EXPLORATION -asociado I-EXPLORATION +heces: I-EXPLORATION +1, I-EXPLORATION +53 I-EXPLORATION +mg/g; I-EXPLORATION +peso I-EXPLORATION +heces I-EXPLORATION +en I-EXPLORATION +24 I-EXPLORATION +h: I-EXPLORATION +222, I-EXPLORATION +57 I-EXPLORATION +g] I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +es I-EXPLORATION +diagnosticado I-EXPLORATION +de I-EXPLORATION +esta I-EXPLORATION +patología. I-EXPLORATION +Pese I-EXPLORATION a I-EXPLORATION -cierto I-EXPLORATION -grado I-EXPLORATION +no I-EXPLORATION +observar I-EXPLORATION +otra I-EXPLORATION +causa I-EXPLORATION +subyacente, I-EXPLORATION +no I-EXPLORATION +es I-EXPLORATION +posible I-EXPLORATION +asegurar I-EXPLORATION +que I-EXPLORATION +su I-EXPLORATION +alteración I-EXPLORATION +cardiológica I-EXPLORATION +sea I-EXPLORATION +la I-EXPLORATION +base I-EXPLORATION de I-EXPLORATION -fibrosis I-EXPLORATION -intersticial. I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -pleural I-EXPLORATION -arrojó I-EXPLORATION -1, I-EXPLORATION -2 I-EXPLORATION -x I-EXPLORATION -103 I-EXPLORATION -células, I-EXPLORATION +la I-EXPLORATION +PLE. I-EXPLORATION +En B-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +nutrición I-TREATMENT +enteral I-TREATMENT +domiciliaria, I-TREATMENT +mantiene B-EVOLUTION +cifras I-EVOLUTION +de I-EVOLUTION +albúmina I-EVOLUTION +estables. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +39 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +ingresada I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +quirúrgico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +deformidad I-PRESENT_ILLNESS +dentofacial. I-PRESENT_ILLNESS +Entre B-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +destaca I-PAST_MEDICAL_HISTORY +anemia I-PAST_MEDICAL_HISTORY +ferropénica, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +presentar I-PAST_MEDICAL_HISTORY +ninguna I-PAST_MEDICAL_HISTORY +alergia I-PAST_MEDICAL_HISTORY +medicamentosa I-PAST_MEDICAL_HISTORY +conocida. I-PAST_MEDICAL_HISTORY +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +un I-EXPLORATION +prognatismo I-EXPLORATION +marcado I-EXPLORATION con I-EXPLORATION -85% I-EXPLORATION -de I-EXPLORATION -eosinófilos, I-EXPLORATION -proteínas I-EXPLORATION -4, I-EXPLORATION -1 I-EXPLORATION -mg/dL, I-EXPLORATION -glucosa I-EXPLORATION -75 I-EXPLORATION -mg/dL, I-EXPLORATION -lactato I-EXPLORATION -deshidrogenasa I-EXPLORATION -232 I-EXPLORATION +una I-EXPLORATION +clase I-EXPLORATION +III I-EXPLORATION +molar I-EXPLORATION y I-EXPLORATION -pH I-EXPLORATION -7, I-EXPLORATION -37. I-EXPLORATION - I-EXPLORATION -Dentro I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -complementario, I-EXPLORATION -se I-EXPLORATION -solicitaron I-EXPLORATION -anticuerpo I-EXPLORATION -antinucleares I-EXPLORATION -(ANA), I-EXPLORATION -anti I-EXPLORATION -DNA, I-EXPLORATION -anti-citoplasma I-EXPLORATION -de I-EXPLORATION -neutrófilos I-EXPLORATION -(ANCA), I-EXPLORATION -todos I-EXPLORATION -negativos. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION +pseudohipoplasia I-EXPLORATION de I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana I-EXPLORATION -(VIH) I-EXPLORATION -fue I-EXPLORATION -negativo I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -descarto I-EXPLORATION +maxilar I-EXPLORATION +superior. I-EXPLORATION +A I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -infección I-EXPLORATION -por I-EXPLORATION -parásitos I-EXPLORATION -(Ascaris I-EXPLORATION -lumbricoide, I-EXPLORATION -Trichinella, I-EXPLORATION -Fasciola, I-EXPLORATION -Schistosoma I-EXPLORATION +paciente I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +ortopantomografía I-EXPLORATION y I-EXPLORATION -Strongyloides), I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -Aspergillus I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION -Dado B-TREATMENT -el I-TREATMENT -hallazgo I-TREATMENT +telerradiografía I-EXPLORATION +lateral I-EXPLORATION +de I-EXPLORATION +cráneo, I-EXPLORATION +iniciando I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +cefalométrico I-EXPLORATION +correspondiente. I-EXPLORATION + I-EXPLORATION +Tras B-TREATMENT +tratamiento I-TREATMENT +ortodóncico I-TREATMENT +y I-TREATMENT +extracción I-TREATMENT de I-TREATMENT +los I-TREATMENT +4 I-TREATMENT +cordales I-TREATMENT +se I-TREATMENT +somete I-TREATMENT +a I-TREATMENT la I-TREATMENT -neumonía I-TREATMENT -eosinofílica, I-TREATMENT -asociado I-TREATMENT +paciente I-TREATMENT a I-TREATMENT -al I-TREATMENT -presencia I-TREATMENT +intervención I-TREATMENT de I-TREATMENT -eosinofilia I-TREATMENT -periférica, I-TREATMENT +cirugía I-TREATMENT +ortognática I-TREATMENT +convencional I-TREATMENT +bajo I-TREATMENT +anestesia I-TREATMENT +general I-TREATMENT +e I-TREATMENT +intubación I-TREATMENT +nasotraqueal I-TREATMENT en I-TREATMENT -ausencia I-TREATMENT -de I-TREATMENT -causas I-TREATMENT -infecciosas I-TREATMENT -o I-TREATMENT -secundarias I-TREATMENT -a I-TREATMENT -drogas I-TREATMENT -o I-TREATMENT -fármacos, I-TREATMENT +la I-TREATMENT +que I-TREATMENT se I-TREATMENT -planteó I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT +realiza I-TREATMENT +osteotomía I-TREATMENT +tipo I-TREATMENT +LeFort I-TREATMENT +I I-TREATMENT +fijada I-TREATMENT +con I-TREATMENT +dos I-TREATMENT +placas I-TREATMENT +preformadas I-TREATMENT de I-TREATMENT -NEC, I-TREATMENT -iniciándose I-TREATMENT -prednisona I-TREATMENT -1 I-TREATMENT -mg/kg I-TREATMENT -peso, I-TREATMENT -obteniendo I-TREATMENT -una I-TREATMENT -disminución I-TREATMENT +titanio I-TREATMENT +en I-TREATMENT +ambos I-TREATMENT +arbotantes I-TREATMENT +naso I-TREATMENT +maxilares I-TREATMENT +con I-TREATMENT +avance I-TREATMENT de I-TREATMENT -la I-TREATMENT -fiebre I-TREATMENT -al I-TREATMENT -segundo I-TREATMENT -día I-TREATMENT +7 I-TREATMENT +mm, I-TREATMENT +impactación I-TREATMENT +anterior I-TREATMENT +de I-TREATMENT +3 I-TREATMENT +mm I-TREATMENT y I-TREATMENT -disminución I-TREATMENT +posterior I-TREATMENT de I-TREATMENT -los I-TREATMENT -requerimientos I-TREATMENT +5 I-TREATMENT +mm, I-TREATMENT +rotación I-TREATMENT +izquierda I-TREATMENT de I-TREATMENT -oxígeno I-TREATMENT +1mm, I-TREATMENT +resección I-TREATMENT +parcial I-TREATMENT +inferior I-TREATMENT +de I-TREATMENT +septum I-TREATMENT +nasal, I-TREATMENT +cincha I-TREATMENT +de I-TREATMENT +alares I-TREATMENT +y I-TREATMENT +cierre I-TREATMENT +labial I-TREATMENT +en I-TREATMENT +V-Y. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +y I-EVOLUTION +seguida I-EVOLUTION +en I-EVOLUTION +revisiones I-EVOLUTION +en I-EVOLUTION +consultas I-EVOLUTION +externas I-EVOLUTION +evidenciándose I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION +celulitis I-EVOLUTION +genianas I-EVOLUTION +bilaterales I-EVOLUTION +de I-EVOLUTION +repetición. I-EVOLUTION +Su I-EVOLUTION +inicio I-EVOLUTION +se I-EVOLUTION +produjo I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +6-9 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +intervención I-EVOLUTION +inicial. I-EVOLUTION +Se B-TREATMENT +decide I-TREATMENT +reintervenir I-TREATMENT +a I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +1 I-TREATMENT +año I-TREATMENT +después I-TREATMENT +de I-TREATMENT +la I-TREATMENT +primera I-TREATMENT +intervención I-TREATMENT y I-TREATMENT +retirar I-TREATMENT +el I-TREATMENT +material I-TREATMENT +de I-TREATMENT +osteosíntesis I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT de I-TREATMENT la I-TREATMENT -eosinofilia I-TREATMENT +osteotomía I-TREATMENT +LeFort I-TREATMENT +I I-TREATMENT +tras I-TREATMENT +reapertura I-TREATMENT +del I-TREATMENT +abordaje I-TREATMENT +sublabial I-TREATMENT +superior I-TREATMENT +bilateral I-TREATMENT +previo. I-TREATMENT +Intraoperatoriamente I-TREATMENT +no I-TREATMENT +se I-TREATMENT +objetiva I-TREATMENT +movilidad I-TREATMENT +del I-TREATMENT +tercio I-TREATMENT +medio I-TREATMENT +facial I-TREATMENT a I-TREATMENT -los I-TREATMENT -5 I-TREATMENT -días I-TREATMENT -y I-TREATMENT -una I-TREATMENT -resolución I-TREATMENT +nivel I-TREATMENT de I-TREATMENT -las I-TREATMENT -condensaciones I-TREATMENT -pulmonares I-TREATMENT +la I-TREATMENT +osteotomía I-TREATMENT +tipo I-TREATMENT +LeFort I-TREATMENT +I I-TREATMENT y I-TREATMENT +se I-TREATMENT +cataloga I-TREATMENT +dicho I-TREATMENT +episodio I-TREATMENT +quirúrgico I-TREATMENT +como I-TREATMENT +una I-TREATMENT +intolerancia I-TREATMENT al I-TREATMENT -mes I-TREATMENT -de I-TREATMENT -tratamiento, I-TREATMENT -logrando I-TREATMENT -suspender I-TREATMENT +material I-TREATMENT de I-TREATMENT -manera I-TREATMENT -escalonada I-TREATMENT -los I-TREATMENT -corticoides. I-TREATMENT -Dentro B-EVOLUTION -del I-EVOLUTION -seguimiento, I-EVOLUTION +osteosíntesis. I-TREATMENT + I-TREATMENT +Tras B-EVOLUTION +seguir I-EVOLUTION +revisiones I-EVOLUTION +periódicas I-EVOLUTION +dentro I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +normalidad I-EVOLUTION +tanto I-EVOLUTION +en I-EVOLUTION +nuestras I-EVOLUTION +consultas I-EVOLUTION +externas I-EVOLUTION +como I-EVOLUTION +con I-EVOLUTION el I-EVOLUTION +ortodoncista, I-EVOLUTION +un I-EVOLUTION +año I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +última I-EVOLUTION +intervención I-EVOLUTION +quirúrgica I-EVOLUTION +la I-EVOLUTION paciente I-EVOLUTION -presentó I-EVOLUTION -dos I-EVOLUTION -recurrencias I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -respiratorio, I-EVOLUTION +refiere I-EVOLUTION +disminución I-EVOLUTION de I-EVOLUTION -similares I-EVOLUTION -características, I-EVOLUTION +fuerza I-EVOLUTION con I-EVOLUTION -buena I-EVOLUTION -respuesta I-EVOLUTION -a I-EVOLUTION -tratamiento I-EVOLUTION +la I-EVOLUTION +masticación, I-EVOLUTION +impidiendo I-EVOLUTION +la I-EVOLUTION +práctica I-EVOLUTION +de I-EVOLUTION +una I-EVOLUTION +dieta I-EVOLUTION con I-EVOLUTION -corticoides. I-EVOLUTION -Actualmente B-TREATMENT -se I-TREATMENT -encuentra I-TREATMENT -con I-TREATMENT -dosis I-TREATMENT +alimentos I-EVOLUTION +sólidos. I-EVOLUTION +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +clínica I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +leve I-EXPLORATION +movilidad I-EXPLORATION +del I-EXPLORATION +maxilar I-EXPLORATION +superior I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +LeFort I-EXPLORATION +I, I-EXPLORATION +manteniendo I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +una I-EXPLORATION +oclusión I-EXPLORATION +correcta I-EXPLORATION +en I-EXPLORATION +clase I-EXPLORATION +I. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +TC I-EXPLORATION +de I-EXPLORATION +tercio I-EXPLORATION +medio I-EXPLORATION +facial I-EXPLORATION +solicitado I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +consolidación I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +maxilar I-EXPLORATION +superior I-EXPLORATION +con I-EXPLORATION +solución I-EXPLORATION +de I-EXPLORATION +continuidad I-EXPLORATION +ósea I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +osteotomía I-EXPLORATION +LeFort I-EXPLORATION +I. I-EXPLORATION +Dado B-EVOLUTION +el I-EVOLUTION +tiempo I-EVOLUTION +de I-EVOLUTION +evolución I-EVOLUTION +desde I-EVOLUTION +la I-EVOLUTION +primera I-EVOLUTION +intervención I-EVOLUTION +se I-EVOLUTION +establece I-EVOLUTION +el I-EVOLUTION +diagnóstico I-EVOLUTION +de I-EVOLUTION +presunción I-EVOLUTION +de I-EVOLUTION +pseudoartrosis I-EVOLUTION +de I-EVOLUTION +maxilar I-EVOLUTION +superior I-EVOLUTION +en I-EVOLUTION +dicha I-EVOLUTION +osteotomía. I-EVOLUTION + I-EVOLUTION +Se B-TREATMENT +decide I-TREATMENT +reintervenir I-TREATMENT +a I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +para I-TREATMENT +el I-TREATMENT +manejo I-TREATMENT +definitivo I-TREATMENT de I-TREATMENT -mantención I-TREATMENT +dicha I-TREATMENT +complicación. I-TREATMENT +Tras I-TREATMENT +realizar I-TREATMENT +un I-TREATMENT +bloqueo I-TREATMENT +intermaxilar I-TREATMENT +elástico I-TREATMENT +en I-TREATMENT +clase I-TREATMENT +I I-TREATMENT +y I-TREATMENT +reabrir I-TREATMENT de I-TREATMENT -5 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día I-TREATMENT +nuevo I-TREATMENT +el I-TREATMENT +abordaje I-TREATMENT +sublabial I-TREATMENT +superior I-TREATMENT +previo, I-TREATMENT +se I-TREATMENT +retira I-TREATMENT +el I-TREATMENT +tejido I-TREATMENT +fibroso I-TREATMENT +interpuesto I-TREATMENT +en I-TREATMENT +los I-TREATMENT +márgenes I-TREATMENT +óseos I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT de I-TREATMENT -prednisona, I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -confirma I-TREATMENT +la I-TREATMENT +osteotomía I-TREATMENT +maxilar I-TREATMENT +superior. I-TREATMENT +Se I-TREATMENT +fija I-TREATMENT +la I-TREATMENT +osteotomía I-TREATMENT +maxilar I-TREATMENT +superior I-TREATMENT +mediante I-TREATMENT +dos I-TREATMENT +placas I-TREATMENT +preformadas I-TREATMENT +de I-TREATMENT +titanio I-TREATMENT +con I-TREATMENT el I-TREATMENT -diagnóstico I-TREATMENT +avance I-TREATMENT +inicialmente I-TREATMENT +establecido. I-TREATMENT +Se I-TREATMENT +obtienen I-TREATMENT +injertos I-TREATMENT +óseos I-TREATMENT +esponjosos I-TREATMENT de I-TREATMENT -NEC. I-TREATMENT - I-TREATMENT +tibia I-TREATMENT +derecha I-TREATMENT +a I-TREATMENT +través I-TREATMENT +de I-TREATMENT +un I-TREATMENT +abordaje I-TREATMENT +medial I-TREATMENT +y I-TREATMENT +se I-TREATMENT +colocan I-TREATMENT +los I-TREATMENT +mismos I-TREATMENT +en I-TREATMENT +el I-TREATMENT +gap I-TREATMENT +óseo I-TREATMENT +de I-TREATMENT +la I-TREATMENT +osteotomía I-TREATMENT +Le-Fort I-TREATMENT +I I-TREATMENT +sellando I-TREATMENT +dicho I-TREATMENT +defecto. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +localizado I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +foco I-EXPLORATION +interfracturario I-EXPLORATION +revela I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +cartilaginosas I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +interior I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +tejido I-EXPLORATION +con I-EXPLORATION +predominante I-EXPLORATION +proliferación I-EXPLORATION +fibroblástica. I-EXPLORATION + I-EXPLORATION +Tras B-EVOLUTION +dicha I-EVOLUTION +intervención I-EVOLUTION +es I-EVOLUTION +seguida I-EVOLUTION +en I-EVOLUTION +nuestras I-EVOLUTION +consultas I-EVOLUTION +apreciándose I-EVOLUTION +la I-EVOLUTION +consolidación I-EVOLUTION +a I-EVOLUTION +nivel I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +osteotomía, I-EVOLUTION +sin I-EVOLUTION +movilidad I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +misma, I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +oclusión I-EVOLUTION +estable I-EVOLUTION +y I-EVOLUTION +aspecto I-EVOLUTION +estético I-EVOLUTION +favorable. I-EVOLUTION +Asimismo I-EVOLUTION +no I-EVOLUTION +se I-EVOLUTION +apreciaron I-EVOLUTION +complicaciones I-EVOLUTION +tras I-EVOLUTION +la I-EVOLUTION +toma I-EVOLUTION +del I-EVOLUTION +injerto I-EVOLUTION +tibial, I-EVOLUTION +siendo I-EVOLUTION +favorable I-EVOLUTION +su I-EVOLUTION +Rx I-EVOLUTION +de I-EVOLUTION +control. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Hombre B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS +65 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -chilena, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY +diagnosticado B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Sjögren, I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -únicamente I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -lágrimas I-PAST_MEDICAL_HISTORY -artificiales. I-PAST_MEDICAL_HISTORY -Tiene I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -hijo I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -vitíligo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -hermana I-PAST_MEDICAL_HISTORY +Crohn I-PAST_MEDICAL_HISTORY +cólica I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +11 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +actualmente I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Sjögren. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -medicamentos I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -tabaquismo. I-PAST_MEDICAL_HISTORY -Sin B-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -cáncer I-FAMILY_HISTORY -digestivo. I-FAMILY_HISTORY -Niega B-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hemorragia I-PRESENT_ILLNESS -digestiva, I-PRESENT_ILLNESS +mesalazina, I-PAST_MEDICAL_HISTORY +y B-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -diarrea, I-PRESENT_ILLNESS -fatiga I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +flanco I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +irradiado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +hipogastrio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -Fue B-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -Reumatología I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Dermatología I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -Padre I-DERIVED_FROM/TO -Hurtado I-DERIVED_FROM/TO -debido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -aparición I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -bandas I-DERIVED_FROM/TO -hiperpigmentadas I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -uñas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -pies I-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -hacía I-DERIVED_FROM/TO -5 I-DERIVED_FROM/TO -años, I-DERIVED_FROM/TO -seguidas I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -las I-DERIVED_FROM/TO -uñas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -las I-DERIVED_FROM/TO -manos. I-DERIVED_FROM/TO -Hacía B-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -habían I-PRESENT_ILLNESS -aparecido I-PRESENT_ILLNESS -máculas I-PRESENT_ILLNESS -color I-PRESENT_ILLNESS -café I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -mucosa I-PRESENT_ILLNESS -oral, I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS asociado I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -hiperpigmentación I-PRESENT_ILLNESS -periungueal I-PRESENT_ILLNESS -progresiva. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico, I-EXPLORATION +vómitos I-PRESENT_ILLNESS +esporádicos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +kg I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +apetito. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +este I-PRESENT_ILLNESS +contexto I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +palpa I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +masa I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +dura I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +vacío I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +fosa I-PRESENT_ILLNESS +iliaca I-PRESENT_ILLNESS +derecha. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION -mucosa I-EXPLORATION -oral I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -mácula I-EXPLORATION -café I-EXPLORATION -en I-EXPLORATION -labio I-EXPLORATION -inferior I-EXPLORATION -hacia I-EXPLORATION -comisura I-EXPLORATION -labial I-EXPLORATION -izquierda. I-EXPLORATION -En I-EXPLORATION -uñas I-EXPLORATION -de I-EXPLORATION -manos I-EXPLORATION -y I-EXPLORATION -pies I-EXPLORATION +exploración I-EXPLORATION se I-EXPLORATION -observaban I-EXPLORATION -máculas I-EXPLORATION -café I-EXPLORATION -periungueales I-EXPLORATION -y I-EXPLORATION -melanoniquia. I-EXPLORATION - I-EXPLORATION +palpó I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +pétrea, I-EXPLORATION +no I-EXPLORATION +dolorosa, I-EXPLORATION +desplazable I-EXPLORATION +ligeramente I-EXPLORATION +aunque I-EXPLORATION +adherida I-EXPLORATION +a I-EXPLORATION +planos I-EXPLORATION +profundos. I-EXPLORATION La I-EXPLORATION -histopatología I-EXPLORATION -de I-EXPLORATION -mucosa I-EXPLORATION -oral I-EXPLORATION -mostró I-EXPLORATION -acantosis I-EXPLORATION -leve I-EXPLORATION -e I-EXPLORATION -hipermelanosis. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -unión I-EXPLORATION -dermoepidérmica I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -numerosos I-EXPLORATION -melanófagos, I-EXPLORATION +analítica I-EXPLORATION +detectó I-EXPLORATION +leucocitosis I-EXPLORATION +(16,79x10e9/l) I-EXPLORATION con I-EXPLORATION -capilares I-EXPLORATION -prominentes I-EXPLORATION -en I-EXPLORATION -dermis. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION +neutrofilia I-EXPLORATION +y I-EXPLORATION +hemoglobina I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -mostraron: I-EXPLORATION -Leucopenia I-EXPLORATION -leve I-EXPLORATION -(3, I-EXPLORATION -700/uL I-EXPLORATION -con I-EXPLORATION -1, I-EXPLORATION -370/uL I-EXPLORATION -linfocitos). I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -hemograma, I-EXPLORATION +122.0 I-EXPLORATION +g/l. I-EXPLORATION +Tanto I-EXPLORATION +la I-EXPLORATION velocidad I-EXPLORATION de I-EXPLORATION -eritrosedimentasión, I-EXPLORATION -hormonas I-EXPLORATION -tiroideas, I-EXPLORATION -cortisol I-EXPLORATION -plasmático I-EXPLORATION -y I-EXPLORATION -ACTH I-EXPLORATION +sedimentación I-EXPLORATION +globular I-EXPLORATION +(89, I-EXPLORATION +0 I-EXPLORATION +mm/h) I-EXPLORATION +como I-EXPLORATION +la I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +(38, I-EXPLORATION +6 I-EXPLORATION +mg/l) I-EXPLORATION se I-EXPLORATION encontraban I-EXPLORATION -dentro I-EXPLORATION -del I-EXPLORATION -rango I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -anticuerpos I-EXPLORATION -anti-Ro I-EXPLORATION -(43, I-EXPLORATION -7 I-EXPLORATION -U/mL) I-EXPLORATION -y I-EXPLORATION -anti-La I-EXPLORATION -(> I-EXPLORATION -48 I-EXPLORATION -U/mL) I-EXPLORATION -fueron I-EXPLORATION -positivos, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -también I-EXPLORATION -los I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares I-EXPLORATION -(1/2560) I-EXPLORATION -con I-EXPLORATION -patrón I-EXPLORATION -moteado. I-EXPLORATION +elevadas. I-EXPLORATION Los I-EXPLORATION -anticuerpos I-EXPLORATION -anti-dsDNA, I-EXPLORATION -anti-Sm I-EXPLORATION +marcadores I-EXPLORATION +tumorales I-EXPLORATION +(antígeno I-EXPLORATION +carcinoembrionario, I-EXPLORATION +beta-2-microglobulina, I-EXPLORATION +antígeno I-EXPLORATION +C.A. I-EXPLORATION +15.3, I-EXPLORATION +19.9 I-EXPLORATION y I-EXPLORATION -anticardiolipinas I-EXPLORATION +125) I-EXPLORATION fueron I-EXPLORATION -negativos. I-EXPLORATION -El I-EXPLORATION -factor I-EXPLORATION -reumatoideo, I-EXPLORATION -anticoagulante I-EXPLORATION -lúpico I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -cuantificación I-EXPLORATION -de I-EXPLORATION -inmunoglobulinas I-EXPLORATION -resultaron I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -rangos I-EXPLORATION normales. I-EXPLORATION Se I-EXPLORATION +le I-EXPLORATION realizó I-EXPLORATION -endoscopía I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -y I-EXPLORATION -colonoscopía, I-EXPLORATION +tomografía I-EXPLORATION +computadorizada I-EXPLORATION +abdominal I-EXPLORATION +apreciándose I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +sólida I-EXPLORATION que I-EXPLORATION -no I-EXPLORATION -muestran I-EXPLORATION -presencia I-EXPLORATION +englobaba I-EXPLORATION +al I-EXPLORATION +colon I-EXPLORATION +sigmoideo I-EXPLORATION +(flecha I-EXPLORATION +hueca), I-EXPLORATION +íleon I-EXPLORATION +distal I-EXPLORATION +(flecha I-EXPLORATION +blanca) I-EXPLORATION +y I-EXPLORATION +ciego I-EXPLORATION +(flecha I-EXPLORATION +negra) I-EXPLORATION +asociada I-EXPLORATION +a I-EXPLORATION +múltiples I-EXPLORATION +adenopatías I-EXPLORATION +en I-EXPLORATION +algunos I-EXPLORATION +casos I-EXPLORATION +formando I-EXPLORATION +conglomerados I-EXPLORATION +(asteriscos). I-EXPLORATION +La I-EXPLORATION +biopsia I-EXPLORATION de I-EXPLORATION -pólipos, I-EXPLORATION -hiperpigmentación I-EXPLORATION -u I-EXPLORATION -otros I-EXPLORATION -hallazgos I-EXPLORATION -significativos. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -continúa I-EVOLUTION -en I-EVOLUTION -seguimiento I-EVOLUTION -clínico, I-EVOLUTION -sin I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -nuevas I-EVOLUTION -lesiones. I-EVOLUTION +colon I-EXPLORATION +sigmoideo I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +linfoma I-EXPLORATION +B I-EXPLORATION +difuso I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +grandes, I-EXPLORATION +con I-EXPLORATION +inmunofenotipo I-EXPLORATION +de I-EXPLORATION +tipo I-EXPLORATION +centrogerminal. I-EXPLORATION +Ingresa B-TREATMENT +para I-TREATMENT +tratamiento I-TREATMENT +quimioterápico I-TREATMENT +según I-TREATMENT +protocolo I-TREATMENT +GELTAMO, I-TREATMENT +falleciendo B-EVOLUTION +4 I-EVOLUTION +días I-EVOLUTION +después. I-EVOLUTION I-EVOLUTION Paciente B-PRESENT_ILLNESS -género I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +homosexual I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +49 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -excepción I-PAST_MEDICAL_HISTORY +con I-PRESENT_ILLNESS +antecedentes B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -proctitis I-PAST_MEDICAL_HISTORY -ulcerosa I-PAST_MEDICAL_HISTORY +tuberculosis I-PAST_MEDICAL_HISTORY +pulmonar I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +infancia I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +estreptomicina, I-PAST_MEDICAL_HISTORY +esfinterotomía I-PAST_MEDICAL_HISTORY +lateral I-PAST_MEDICAL_HISTORY +interna I-PAST_MEDICAL_HISTORY +reciente I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +fisura I-PAST_MEDICAL_HISTORY +anal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +pólipos I-PAST_MEDICAL_HISTORY +centinela, I-PAST_MEDICAL_HISTORY +serología I-PAST_MEDICAL_HISTORY +VIH I-PAST_MEDICAL_HISTORY +positiva I-PAST_MEDICAL_HISTORY diagnosticada I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -1994. I-PAST_MEDICAL_HISTORY -Inicialmente B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS +en I-PAST_MEDICAL_HISTORY +enero I-PAST_MEDICAL_HISTORY +2003, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +estadio I-PAST_MEDICAL_HISTORY +C3 I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +neumonía I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +Pneumocystis I-PAST_MEDICAL_HISTORY +carinii. I-PAST_MEDICAL_HISTORY +Último I-PAST_MEDICAL_HISTORY +control I-PAST_MEDICAL_HISTORY +CD I-PAST_MEDICAL_HISTORY +30 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +2.220.000 I-PAST_MEDICAL_HISTORY +copias I-PAST_MEDICAL_HISTORY +virales. I-PAST_MEDICAL_HISTORY +Inicia B-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +lamivudina-zidovudina-ritonavir-lopinavir. I-TREATMENT +Consulta B-PRESENT_ILLNESS por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -líquidas I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -mucosidades. I-PRESENT_ILLNESS +epigástrico I-PRESENT_ILLNESS +intenso I-PRESENT_ILLNESS +postpandrial I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +pirosis. I-PRESENT_ILLNESS En B-EXPLORATION la I-EXPLORATION -colonoscopia I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION se I-EXPLORATION -objetivó I-EXPLORATION +aprecian I-EXPLORATION +lesiones I-EXPLORATION +sobreelevadas I-EXPLORATION +rojovioláceas I-EXPLORATION +en I-EXPLORATION +zona I-EXPLORATION +laterocervical I-EXPLORATION +izquierda I-EXPLORATION +e I-EXPLORATION +inguinal I-EXPLORATION +derecha, I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +mayor I-EXPLORATION de I-EXPLORATION -compromiso I-EXPLORATION -inflamatorio I-EXPLORATION -continuo I-EXPLORATION -del I-EXPLORATION -recto I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -mucosa I-EXPLORATION -friable I-EXPLORATION -y I-EXPLORATION -pequeñas I-EXPLORATION -erosiones I-EXPLORATION -cubiertas I-EXPLORATION -por I-EXPLORATION -fibrina I-EXPLORATION -(Subíndice I-EXPLORATION -Endoscópico I-EXPLORATION -Mayo I-EXPLORATION -2). I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -biopsias I-EXPLORATION -se I-EXPLORATION -apreciaron I-EXPLORATION -signos I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -inflamación I-EXPLORATION -aguda I-EXPLORATION -(criptitis I-EXPLORATION -y I-EXPLORATION -abscesos I-EXPLORATION -crípticos) I-EXPLORATION +diámetro I-EXPLORATION +máximo. I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +endoscopia I-EXPLORATION +oral, I-EXPLORATION +apreciándose I-EXPLORATION +lesiones I-EXPLORATION +eritematosas I-EXPLORATION +en I-EXPLORATION +estómago I-EXPLORATION y I-EXPLORATION -crónica I-EXPLORATION -reflejada I-EXPLORATION -como I-EXPLORATION -alteraciones I-EXPLORATION -estructurales I-EXPLORATION +primeras I-EXPLORATION +porciones I-EXPLORATION +duodenales, I-EXPLORATION +alguna I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -criptas I-EXPLORATION -(acortamiento I-EXPLORATION -y I-EXPLORATION -ramificación I-EXPLORATION +ellas I-EXPLORATION +ulceradas I-EXPLORATION +con I-EXPLORATION +biopsia I-EXPLORATION +positiva I-EXPLORATION +para I-EXPLORATION +sarcoma I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -glándulas I-EXPLORATION -asociadas I-EXPLORATION -a I-EXPLORATION -disminución I-EXPLORATION +Kaposi. I-EXPLORATION +Estudio I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -caliciformes). I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -mesalazina I-TREATMENT -oral I-TREATMENT -(3 I-TREATMENT -g/día) I-TREATMENT -y I-TREATMENT -rectal I-TREATMENT -(supositorios I-TREATMENT +extensión I-EXPLORATION +negativo, I-EXPLORATION +con I-EXPLORATION +TAC I-EXPLORATION +toracabdominal I-EXPLORATION +normal. I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT de I-TREATMENT -500 I-TREATMENT -mg/noche), I-TREATMENT +sarcoma I-TREATMENT +de I-TREATMENT +kaposi I-TREATMENT con I-TREATMENT -remisión I-TREATMENT -clínica I-TREATMENT +afectación I-TREATMENT +visceral I-TREATMENT y I-TREATMENT -endoscópica I-TREATMENT -(curación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -mucosa) I-TREATMENT -(colonoscopia I-TREATMENT -2007, I-TREATMENT -Subíndice I-TREATMENT -Endoscópico I-TREATMENT -Mayo I-TREATMENT -0). I-TREATMENT -Posteriormente, B-EVOLUTION -abandona I-EVOLUTION -tratamiento I-EVOLUTION -y I-EVOLUTION -control, I-EVOLUTION -manteniéndose I-EVOLUTION -asintomática I-EVOLUTION -hasta I-EVOLUTION -agosto I-EVOLUTION +cutánea I-TREATMENT +inicia I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +adriamicina I-TREATMENT +liposomal I-TREATMENT +20 I-TREATMENT +mg/m2 I-TREATMENT +cada I-TREATMENT +3 I-TREATMENT +semanas. I-TREATMENT +Desde B-EVOLUTION +el I-EVOLUTION +primer I-EVOLUTION de I-EVOLUTION -2015 I-EVOLUTION -donde I-EVOLUTION -consulta I-EVOLUTION -por I-EVOLUTION -presentar I-EVOLUTION -desde I-EVOLUTION -hace I-EVOLUTION -un I-EVOLUTION -mes I-EVOLUTION -cuadro I-EVOLUTION +ciclo I-EVOLUTION de I-EVOLUTION -malestar I-EVOLUTION -abdominal I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -deposiciones I-EVOLUTION -líquidas I-EVOLUTION -una I-EVOLUTION -a I-EVOLUTION -dos I-EVOLUTION -veces I-EVOLUTION +tratamiento, I-EVOLUTION +se I-EVOLUTION +produce I-EVOLUTION +la I-EVOLUTION +desaparición I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +afectación I-EVOLUTION +cutánea I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +queda I-EVOLUTION +asintomático, I-EVOLUTION al I-EVOLUTION -día I-EVOLUTION -sin I-EVOLUTION -sangre I-EVOLUTION -ni I-EVOLUTION -mucosidades. I-EVOLUTION -No I-EVOLUTION -refería I-EVOLUTION -compromiso I-EVOLUTION -del I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -fiebre, I-EVOLUTION -baja I-EVOLUTION +tercer I-EVOLUTION +ciclo I-EVOLUTION +se I-EVOLUTION +repite I-EVOLUTION +endoscopia I-EVOLUTION +oral, I-EVOLUTION +mostrando I-EVOLUTION +una I-EVOLUTION +resolución I-EVOLUTION +completa I-EVOLUTION de I-EVOLUTION -peso, I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -y/o I-EVOLUTION -articular. I-EVOLUTION -Sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tabaquismo, I-PAST_MEDICAL_HISTORY -transgresión I-PAST_MEDICAL_HISTORY -alimentaria I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -uso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -fármacos I-PAST_MEDICAL_HISTORY -(específicamente I-PAST_MEDICAL_HISTORY -antiinflamatorios I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -esteroidales, I-PAST_MEDICAL_HISTORY -antibióticos, I-PAST_MEDICAL_HISTORY -inhibidores I-PAST_MEDICAL_HISTORY +la I-EVOLUTION +lesiones. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +16 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +residente B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -bomba I-PAST_MEDICAL_HISTORY +Chimbarongo, I-PAST_MEDICAL_HISTORY +VI I-PAST_MEDICAL_HISTORY +Región. I-PAST_MEDICAL_HISTORY +Tenía I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +padecer I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -protones, I-PAST_MEDICAL_HISTORY -hormonas I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -antidepresivos). I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -solicitaron I-EXPLORATION -exámenes I-EXPLORATION +una I-PAST_MEDICAL_HISTORY +epilepsia, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +fenobarbital. I-PAST_MEDICAL_HISTORY +Ingresó B-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +UCI I-EXPLORATION +del I-EXPLORATION +Hospital I-EXPLORATION +Barros I-EXPLORATION +Luco I-EXPLORATION +Trudeau I-EXPLORATION +(HBLT) I-EXPLORATION +el I-EXPLORATION +día I-EXPLORATION +cuarto I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -que I-EXPLORATION -incluyó I-EXPLORATION -hemograma, I-EXPLORATION -VHS, I-EXPLORATION -PCR I-EXPLORATION -y I-EXPLORATION -perfil I-EXPLORATION -hepático, I-EXPLORATION -todos I-EXPLORATION -normales. I-EXPLORATION -Además, I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -enfermedad I-EXPLORATION -celíaca I-EXPLORATION +evolución I-EXPLORATION con I-EXPLORATION -anticuerpos I-EXPLORATION -anti-transglutaminasa I-EXPLORATION -negativos I-EXPLORATION -e I-EXPLORATION -inmunoglobulina I-EXPLORATION -A I-EXPLORATION -en I-EXPLORATION -valores I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION una I-EXPLORATION -colonoscopia I-EXPLORATION -completa I-EXPLORATION -donde I-EXPLORATION -sólo I-EXPLORATION -se I-EXPLORATION -apreciaron I-EXPLORATION -erosiones I-EXPLORATION -mínimas I-EXPLORATION -e I-EXPLORATION -inespecíficas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -recto. I-EXPLORATION -Se I-EXPLORATION -tomaron I-EXPLORATION -biopsias I-EXPLORATION -escalonadas I-EXPLORATION +historia I-EXPLORATION de I-EXPLORATION -íleon, I-EXPLORATION -colon I-EXPLORATION +tos, I-EXPLORATION +expectoración I-EXPLORATION +hemoptoica, I-EXPLORATION +apremio I-EXPLORATION +respiratorio I-EXPLORATION y I-EXPLORATION -recto I-EXPLORATION -en I-EXPLORATION -frascos I-EXPLORATION -separados I-EXPLORATION -las I-EXPLORATION -cuales I-EXPLORATION -fueron I-EXPLORATION -consistentes I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +epistaxis I-EXPLORATION +anterior. I-EXPLORATION +La I-EXPLORATION +anamnesis I-EXPLORATION +describía I-EXPLORATION +los I-EXPLORATION +primeros I-EXPLORATION +días I-EXPLORATION +un I-EXPLORATION +cuadro I-EXPLORATION +caracterizado I-EXPLORATION +por I-EXPLORATION +fiebre, I-EXPLORATION +compromiso I-EXPLORATION +del I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +mialgia, I-EXPLORATION +cefalea, I-EXPLORATION +vómitos I-EXPLORATION +y I-EXPLORATION +compromiso I-EXPLORATION de I-EXPLORATION -CL I-EXPLORATION -dado I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +conciencia. I-EXPLORATION +Al I-EXPLORATION +segundo I-EXPLORATION +día I-EXPLORATION de I-EXPLORATION -> I-EXPLORATION -40 I-EXPLORATION -linfocitos/100 I-EXPLORATION -células I-EXPLORATION -epiteliales I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -muestras I-EXPLORATION -obtenidas I-EXPLORATION -desde I-EXPLORATION -colon I-EXPLORATION -transverso I-EXPLORATION -a I-EXPLORATION -recto. I-EXPLORATION -Además, I-EXPLORATION +enfermedad I-EXPLORATION se I-EXPLORATION -describieron I-EXPLORATION -alteraciones I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -CU I-EXPLORATION -(leve I-EXPLORATION -distorsión I-EXPLORATION -de I-EXPLORATION -arquitectura I-EXPLORATION -glandular, I-EXPLORATION -criptitis I-EXPLORATION -y I-EXPLORATION -microabscesos) I-EXPLORATION -exclusivamente I-EXPLORATION -en I-EXPLORATION -sigmoides I-EXPLORATION +había I-EXPLORATION +agregado I-EXPLORATION +ictericia I-EXPLORATION +intensa, I-EXPLORATION +coluria I-EXPLORATION y I-EXPLORATION -recto. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT +dolor I-EXPLORATION +abdominal. I-EXPLORATION +Consultó B-DERIVED_FROM/TO +inicialmente I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +Unidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Emergencia I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +Hospital I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Chimbarongo, I-DERIVED_FROM/TO +siendo I-DERIVED_FROM/TO +referido I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +diagnóstico I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +hepatitis I-DERIVED_FROM/TO +aguda I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Hospital I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +San I-DERIVED_FROM/TO +Fernando, I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +estado I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +hipotensión I-DERIVED_FROM/TO +arterial, I-DERIVED_FROM/TO +taquicárdico, I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +epistaxis I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +dolor I-DERIVED_FROM/TO +abdominal I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +hipocondrio I-DERIVED_FROM/TO +derecho; I-DERIVED_FROM/TO +allí B-TREATMENT +fue I-TREATMENT +asistido I-TREATMENT con I-TREATMENT -budesonida I-TREATMENT -9 I-TREATMENT -mg/día, I-TREATMENT -presentando I-TREATMENT -una I-TREATMENT -respuesta I-TREATMENT -favorable I-TREATMENT -a I-TREATMENT -la I-TREATMENT -semana I-TREATMENT +infusión I-TREATMENT de I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -un I-TREATMENT -descenso I-TREATMENT -progresivo I-TREATMENT -del I-TREATMENT -fármaco I-TREATMENT -hasta I-TREATMENT -suspenderlo I-TREATMENT +solución I-TREATMENT +salina I-TREATMENT al I-TREATMENT -tercer I-TREATMENT -mes. I-TREATMENT -Luego B-EVOLUTION -de I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -mantenido I-EVOLUTION -asintomática I-EVOLUTION -(remisión I-EVOLUTION -clínica) I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -control I-EVOLUTION -con I-EVOLUTION -calprotectina I-EVOLUTION -fecal I-EVOLUTION -dentro I-EVOLUTION -de I-EVOLUTION -rango I-EVOLUTION -normal. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dermatitis I-PAST_MEDICAL_HISTORY -seborreica I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cuero I-PAST_MEDICAL_HISTORY -cabelludo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -viaje I-PAST_MEDICAL_HISTORY -reciente I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -Ilhabela, I-PAST_MEDICAL_HISTORY -Brasil. I-PAST_MEDICAL_HISTORY -Después I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -permanecer I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -semana I-PAST_MEDICAL_HISTORY -fuera I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -país, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -retornó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -Chile. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -dermatólogo I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -regreso, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuero I-PRESENT_ILLNESS -cabelludo I-PRESENT_ILLNESS -parieto I-PRESENT_ILLNESS -occipital, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -objetos I-PRESENT_ILLNESS -extraños I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -mueven I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -cabeza. I-PRESENT_ILLNESS +9‰ I-TREATMENT +y I-TREATMENT +dopamina I-TREATMENT +y B-DERIVED_FROM/TO +finalmente I-DERIVED_FROM/TO +enviado I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +HBLT I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +ingresó I-DERIVED_FROM/TO +vigil, I-DERIVED_FROM/TO +orientado I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +tiempo I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +espacio, I-DERIVED_FROM/TO +cooperando. I-DERIVED_FROM/TO Al B-EXPLORATION examen I-EXPLORATION -físico, I-EXPLORATION -se I-EXPLORATION -identificaro I-EXPLORATION -3 I-EXPLORATION -úlceras I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -cm, I-EXPLORATION -aproximadamente, I-EXPLORATION +físico I-EXPLORATION +destacaban I-EXPLORATION +intensa I-EXPLORATION +ictericia I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -cuales I-EXPLORATION -supuraba I-EXPLORATION -abundante I-EXPLORATION -contenido I-EXPLORATION -seropurulento, I-EXPLORATION +piel I-EXPLORATION +y I-EXPLORATION +escleras, I-EXPLORATION +taquicardia, I-EXPLORATION +taquipnea, I-EXPLORATION +normotensión I-EXPLORATION +y I-EXPLORATION +fiebre I-EXPLORATION +(38° I-EXPLORATION +C I-EXPLORATION +axilar), I-EXPLORATION +murmullo I-EXPLORATION +pulmonar I-EXPLORATION +disminuido I-EXPLORATION en I-EXPLORATION -cuyos I-EXPLORATION -fondos I-EXPLORATION -se I-EXPLORATION -apreciaban I-EXPLORATION -múltiples I-EXPLORATION -larvas I-EXPLORATION -vivas I-EXPLORATION +el I-EXPLORATION +hemicampo I-EXPLORATION +inferior I-EXPLORATION +izquierdo I-EXPLORATION y I-EXPLORATION -móviles. I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -extracción I-TREATMENT -manual I-TREATMENT +presente I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +derecho. I-EXPLORATION +Aproximadamente B-TREATMENT +50 I-TREATMENT +minutos I-TREATMENT +más I-TREATMENT +tarde I-TREATMENT +se I-TREATMENT +describió I-TREATMENT en I-TREATMENT -la I-TREATMENT -sala I-TREATMENT +estado I-TREATMENT de I-TREATMENT -atención, I-TREATMENT -mediante I-TREATMENT -pinzas, I-TREATMENT -con I-TREATMENT -bastante I-TREATMENT -facilidad I-TREATMENT -y I-TREATMENT -sin I-TREATMENT -molestias I-TREATMENT -para I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT +shock I-TREATMENT +séptico, I-TREATMENT +debiendo I-TREATMENT +ser I-TREATMENT +intubado, I-TREATMENT +maniobra I-TREATMENT durante I-TREATMENT +la I-TREATMENT +cual I-TREATMENT +eliminó I-TREATMENT +sangre I-TREATMENT +rutilante I-TREATMENT +por I-TREATMENT +la I-TREATMENT +vía I-TREATMENT +aérea, I-TREATMENT +y I-TREATMENT +fue I-TREATMENT +trasladado I-TREATMENT +a I-TREATMENT +UCI. I-TREATMENT +De I-TREATMENT +allí I-TREATMENT +en I-TREATMENT +adelante I-TREATMENT +evolucionó I-TREATMENT +con I-TREATMENT +escasa I-TREATMENT +respiración I-TREATMENT +espontánea I-TREATMENT +debió I-TREATMENT +ser I-TREATMENT +asistido I-TREATMENT +manualmente, I-TREATMENT +presentaba I-TREATMENT +sangramiento I-TREATMENT +por I-TREATMENT el I-TREATMENT -procedimiento, I-TREATMENT -obteniéndose I-TREATMENT -25 I-TREATMENT -especímenes. I-TREATMENT +tubo I-TREATMENT +orotraqueal, I-TREATMENT +ictericia I-TREATMENT +e I-TREATMENT +isocoria I-TREATMENT +reactiva. I-TREATMENT Se I-TREATMENT -indicó I-TREATMENT -ivermectina I-TREATMENT -oral I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -única I-TREATMENT +conectó I-TREATMENT +a I-TREATMENT +ventilación I-TREATMENT +mecánica I-TREATMENT +por I-TREATMENT +una I-TREATMENT +desaturación I-TREATMENT de I-TREATMENT -200 I-TREATMENT -ug/kg. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -presentó I-EVOLUTION -dos I-EVOLUTION -días I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -con I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -sintomatología, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -cirugía I-TREATMENT -exploratoria I-TREATMENT -y I-TREATMENT -aseo I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -local, I-TREATMENT -se I-TREATMENT -logró I-TREATMENT -extraer I-TREATMENT -4 I-TREATMENT -larvas I-TREATMENT -más. I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -ecografía I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas, I-EXPLORATION -no I-EXPLORATION -evidenciándose I-EXPLORATION -más I-EXPLORATION -larvas, I-EXPLORATION -y I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -cráneo, I-EXPLORATION -que I-EXPLORATION -descartó I-EXPLORATION -compromiso I-EXPLORATION -óseo. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT +65%, I-TREATMENT +mientras I-TREATMENT +estaba I-TREATMENT +taquicárdico I-TREATMENT +pero I-TREATMENT con I-TREATMENT -antibioterapia I-TREATMENT -oral I-TREATMENT +normotensión. I-TREATMENT +Fue I-TREATMENT +ingresado I-TREATMENT +con I-TREATMENT +los I-TREATMENT +diagnósticos I-TREATMENT +de: I-TREATMENT +shock I-TREATMENT +séptico, I-TREATMENT +síndrome I-TREATMENT +de I-TREATMENT +distrés I-TREATMENT +respiratorio I-TREATMENT +del I-TREATMENT +adulto I-TREATMENT y I-TREATMENT -curaciones I-TREATMENT +la I-TREATMENT +hipótesis I-TREATMENT de I-TREATMENT -sitio I-TREATMENT -operatorio, I-TREATMENT -presentando B-EVOLUTION -una I-EVOLUTION -rápida I-EVOLUTION -y I-EVOLUTION -favorable I-EVOLUTION -respuesta I-EVOLUTION -clínica, I-EVOLUTION -logrando I-EVOLUTION -cierre I-EVOLUTION -por I-EVOLUTION -segunda I-EVOLUTION -intención I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -heridas I-EVOLUTION +una I-TREATMENT +leptospirosis. I-TREATMENT +Evolucionó B-EVOLUTION +con I-EVOLUTION +PA I-EVOLUTION +0/0 I-EVOLUTION +mm/Hg I-EVOLUTION y I-EVOLUTION -sin I-EVOLUTION -recurrencias I-EVOLUTION -hasta I-EVOLUTION +falleció I-EVOLUTION +a I-EVOLUTION la I-EVOLUTION -fecha. I-EVOLUTION +hora I-EVOLUTION +de I-EVOLUTION +haber I-EVOLUTION +ingresado I-EVOLUTION +en I-EVOLUTION +UCI, I-EVOLUTION +pese I-EVOLUTION +a I-EVOLUTION +maniobras I-EVOLUTION +de I-EVOLUTION +reanimación I-EVOLUTION +avanzada. I-EVOLUTION I-EVOLUTION -Todas B-EXPLORATION -las I-EXPLORATION -larvas I-EXPLORATION -obtenidas I-EXPLORATION -fueron I-EXPLORATION -analizadas I-EXPLORATION +Anatomía B-EXPLORATION +patológica I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +hallazgos I-EXPLORATION +morfológicos I-EXPLORATION +están I-EXPLORATION +relacionados I-EXPLORATION +con I-EXPLORATION +alteraciones I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +microcirculación, I-EXPLORATION +caracterizadas I-EXPLORATION por I-EXPLORATION +una I-EXPLORATION +panvasculitis I-EXPLORATION +venulocapilar I-EXPLORATION +en I-EXPLORATION +todos I-EXPLORATION +los I-EXPLORATION +órganos I-EXPLORATION +y I-EXPLORATION +sistemas9. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION el I-EXPLORATION -Laboratorio I-EXPLORATION -Parasitología I-EXPLORATION -Básico-Clínico I-EXPLORATION -del I-EXPLORATION -Instituto I-EXPLORATION -de I-EXPLORATION -Ciencias I-EXPLORATION -Biomédicas I-EXPLORATION +pulmón I-EXPLORATION +se I-EXPLORATION +apreciaban I-EXPLORATION +macroscópicamente I-EXPLORATION +extensas I-EXPLORATION +áreas I-EXPLORATION de I-EXPLORATION +hemorragia I-EXPLORATION +parenquimatosa I-EXPLORATION +y I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -Facultad I-EXPLORATION -de I-EXPLORATION -Medicina I-EXPLORATION +microscopia I-EXPLORATION +necrosis I-EXPLORATION +alveolar. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +parénquima I-EXPLORATION +hepático I-EXPLORATION +se I-EXPLORATION +observaban I-EXPLORATION +extensas I-EXPLORATION +áreas I-EXPLORATION de I-EXPLORATION +necrosis I-EXPLORATION +hepatocelular I-EXPLORATION +e I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION +linfoplasmocitario I-EXPLORATION +portal. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +miocardio I-EXPLORATION +exhibía I-EXPLORATION +degeneración I-EXPLORATION +miofibrilar I-EXPLORATION +focal I-EXPLORATION +y I-EXPLORATION +extenso I-EXPLORATION +infiltrado I-EXPLORATION +linfoplasmocitario I-EXPLORATION +intersticial. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +parénquima I-EXPLORATION +renal I-EXPLORATION +presentaba I-EXPLORATION +congestión I-EXPLORATION +vascular, I-EXPLORATION +vasculitis I-EXPLORATION +linfoplasmocitaria I-EXPLORATION +y I-EXPLORATION +extensa I-EXPLORATION +necrosis I-EXPLORATION +tubular I-EXPLORATION +aguda. I-EXPLORATION +Con I-EXPLORATION la I-EXPLORATION -Universidad I-EXPLORATION +coloración I-EXPLORATION +argéntica I-EXPLORATION de I-EXPLORATION -Chile, I-EXPLORATION -identificándose I-EXPLORATION -larvas I-EXPLORATION +Warthin-Starry I-EXPLORATION +se I-EXPLORATION +identificaron I-EXPLORATION +formaciones I-EXPLORATION +espirilares I-EXPLORATION +adosadas I-EXPLORATION +al I-EXPLORATION +epitelio I-EXPLORATION +tubular I-EXPLORATION en I-EXPLORATION -estado I-EXPLORATION -L2 I-EXPLORATION -y I-EXPLORATION -L3 I-EXPLORATION +forma I-EXPLORATION de I-EXPLORATION -Cochliomyia I-EXPLORATION -hominivorax. I-EXPLORATION +coma, I-EXPLORATION +características I-EXPLORATION +de I-EXPLORATION +leptospira. I-EXPLORATION +Por I-EXPLORATION +métodos I-EXPLORATION +morfométricos I-EXPLORATION +se I-EXPLORATION +estableció I-EXPLORATION +una I-EXPLORATION +longitud I-EXPLORATION +promedio I-EXPLORATION +de I-EXPLORATION +13 I-EXPLORATION +mµ. I-EXPLORATION + I-EXPLORATION +Diagnósticos I-EXPLORATION +anátomo-patológicos: I-EXPLORATION + I-EXPLORATION +· I-EXPLORATION +Enfermedad I-EXPLORATION +de I-EXPLORATION +Weil I-EXPLORATION +(leptospirosis) I-EXPLORATION +con: I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Hemorragia I-EXPLORATION +pulmonar I-EXPLORATION +parenquimatosa- I-EXPLORATION +alveolitis I-EXPLORATION +necrosante. I-EXPLORATION +- I-EXPLORATION +Panvasculitis I-EXPLORATION +vénulo-capilar. I-EXPLORATION +- I-EXPLORATION +Necrosis I-EXPLORATION +tubular I-EXPLORATION +aguda-nefritis I-EXPLORATION +intersticial I-EXPLORATION +linfo-plasmocitaria. I-EXPLORATION +- I-EXPLORATION +Hepatitis I-EXPLORATION +aguda. I-EXPLORATION +- I-EXPLORATION +Miocarditis I-EXPLORATION +y I-EXPLORATION +pericarditis I-EXPLORATION +linfo-plasmocitaria. I-EXPLORATION +- I-EXPLORATION +Meningitis I-EXPLORATION +linfo-plasmocitaria. I-EXPLORATION I-EXPLORATION -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS +Paciente, B-PRESENT_ILLNESS +mujer, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS +66 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -DM1 I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -edad. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -hemoglobina I-PAST_MEDICAL_HISTORY -glicosilada I-PAST_MEDICAL_HISTORY -(HbA1c) I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY +Crohn I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +prolapso I-PAST_MEDICAL_HISTORY +genital I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -8, I-PAST_MEDICAL_HISTORY -5%. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS +grado I-PAST_MEDICAL_HISTORY +III. I-PAST_MEDICAL_HISTORY +Acude B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución., I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -siete I-PRESENT_ILLNESS -ocasiones I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -Debido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -estaba I-PRESENT_ILLNESS -ingiriendo I-PRESENT_ILLNESS -alimentos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +discreta I-PRESENT_ILLNESS +rigidez I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -cantidad I-PRESENT_ILLNESS -adecuada, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -omitió I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -dosis I-PRESENT_ILLNESS +musculatura I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -insulina I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -mismo I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS +cintura I-PRESENT_ILLNESS +escapular I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +pelviana. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +aquejaba I-PRESENT_ILLNESS +cefalea, I-PRESENT_ILLNESS +síntomas I-PRESENT_ILLNESS +visuales I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +claudicación I-PRESENT_ILLNESS +mandibular. I-PRESENT_ILLNESS +Un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS de I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -consulta. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Dirigidamente, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -ayuno I-PRESENT_ILLNESS -prolongado, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -ingesta I-PRESENT_ILLNESS +visita I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +sido I-PRESENT_ILLNESS +intervenida I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -alcohol I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -riesgo I-PRESENT_ILLNESS +histerectomía I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +colpoperineoplastia I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +prolapso I-PRESENT_ILLNESS +uterino I-PRESENT_ILLNESS +grado I-PRESENT_ILLNESS +III. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +descripción I-PRESENT_ILLNESS +microscópica I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +cuerpo I-PRESENT_ILLNESS +uterino I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +aprecian I-PRESENT_ILLNESS +vasos I-PRESENT_ILLNESS +arteriales I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +esclerosis I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -embarazo I-PRESENT_ILLNESS -previo I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS +pared I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +inflamación I-PRESENT_ILLNESS +granulomatosa I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +células I-PRESENT_ILLNESS +gigantes, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +necrosis, I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -síntomas. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso, I-EXPLORATION +capas I-PRESENT_ILLNESS +media I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +perivascular I-PRESENT_ILLNESS +aconsejándose I-PRESENT_ILLNESS +estudio I-PRESENT_ILLNESS +clínico. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION -paciente I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION se I-EXPLORATION -encontraba I-EXPLORATION -vigil, I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION +observó I-EXPLORATION +paciente I-EXPLORATION con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -leve I-EXPLORATION -déficit I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -extra I-EXPLORATION -celular I-EXPLORATION -(VEC). I-EXPLORATION -Su I-EXPLORATION -Índice I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -corporal I-EXPLORATION -era I-EXPLORATION -29 I-EXPLORATION -Kg/m2. I-EXPLORATION -En I-EXPLORATION -sus I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -al I-EXPLORATION -ingreso, I-EXPLORATION -destacaba: I-EXPLORATION -leucocitosis I-EXPLORATION +coloración I-EXPLORATION de I-EXPLORATION -26.000 I-EXPLORATION -x I-EXPLORATION -mm3, I-EXPLORATION -glicemia I-EXPLORATION -200 I-EXPLORATION -mg/dl, I-EXPLORATION -gases I-EXPLORATION -arteriales I-EXPLORATION -con I-EXPLORATION -acidosis I-EXPLORATION -metabólica I-EXPLORATION -severa I-EXPLORATION -(pH I-EXPLORATION -7, I-EXPLORATION -1 I-EXPLORATION +piel I-EXPLORATION y I-EXPLORATION -bicarbonato I-EXPLORATION +mucosas I-EXPLORATION +normal. I-EXPLORATION +Auscultación I-EXPLORATION +cardíaca I-EXPLORATION +y I-EXPLORATION +pulmonar I-EXPLORATION +anodina. I-EXPLORATION +Abdomen I-EXPLORATION +blando, I-EXPLORATION +depresible, I-EXPLORATION +no I-EXPLORATION +doloroso I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación, I-EXPLORATION +cicatriz I-EXPLORATION de I-EXPLORATION -7 I-EXPLORATION -meq/L), I-EXPLORATION -cetonemia++++++ I-EXPLORATION -(no I-EXPLORATION +histerectomía I-EXPLORATION +con I-EXPLORATION +buen I-EXPLORATION +aspecto. I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -dispone I-EXPLORATION -de I-EXPLORATION -medición I-EXPLORATION -cuantitativa), I-EXPLORATION -cetonuria I-EXPLORATION -+++, I-EXPLORATION -glucosuria. I-EXPLORATION -La I-EXPLORATION -proteína I-EXPLORATION -c I-EXPLORATION -reactiva, I-EXPLORATION -función I-EXPLORATION -renal, I-EXPLORATION -amilasemia I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -electrolitos I-EXPLORATION -plasmáticos I-EXPLORATION +palpan I-EXPLORATION +masas. I-EXPLORATION +No I-EXPLORATION +adenopatías I-EXPLORATION +ni I-EXPLORATION +edemas I-EXPLORATION +maleolares. I-EXPLORATION +Los I-EXPLORATION +pulsos I-EXPLORATION +periféricos I-EXPLORATION estaban I-EXPLORATION -dentro I-EXPLORATION +conservados. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +hemograma, I-EXPLORATION +el I-EXPLORATION +hematocrito I-EXPLORATION +era I-EXPLORATION +del I-EXPLORATION +37, I-EXPLORATION +5% I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +hemoglobina I-EXPLORATION de I-EXPLORATION -límites I-EXPLORATION +11'9 I-EXPLORATION +g/dl, I-EXPLORATION +serie I-EXPLORATION +blanca I-EXPLORATION +y I-EXPLORATION +hemostasia I-EXPLORATION normales. I-EXPLORATION -Una I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION +VSG I-EXPLORATION +52 I-EXPLORATION +mm/1ª I-EXPLORATION +hora I-EXPLORATION +y I-EXPLORATION +PCR I-EXPLORATION +66, I-EXPLORATION +3 I-EXPLORATION +g/dl. I-EXPLORATION +La I-EXPLORATION +bioquímica I-EXPLORATION +y I-EXPLORATION +sedimento I-EXPLORATION de I-EXPLORATION -abdomen I-EXPLORATION +orina I-EXPLORATION +eran I-EXPLORATION +normales. I-EXPLORATION +El I-EXPLORATION +FR, I-EXPLORATION +ANA I-EXPLORATION y I-EXPLORATION -pelvis I-EXPLORATION -resultó I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION +ANCA I-EXPLORATION +negativos. I-EXPLORATION +HLA I-EXPLORATION +B27 I-EXPLORATION +positivo. I-EXPLORATION +Proteinograma I-EXPLORATION +normal. I-EXPLORATION +Mantoux I-EXPLORATION +negativo. I-EXPLORATION +Rx I-EXPLORATION +tórax: I-EXPLORATION +no I-EXPLORATION +cardiomegalia, I-EXPLORATION +campos I-EXPLORATION +pulmonares I-EXPLORATION +normales. I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +practicó I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +arteria I-EXPLORATION +temporal I-EXPLORATION +izquierda I-EXPLORATION +que I-EXPLORATION +es I-EXPLORATION +negativa. I-EXPLORATION I-EXPLORATION -Ingresó B-TREATMENT -a I-TREATMENT -la I-TREATMENT -Unidad I-TREATMENT +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT de I-TREATMENT -Cuidados I-TREATMENT -Intensivos I-TREATMENT -(UCI), I-TREATMENT -iniciándose I-TREATMENT -hidratación I-TREATMENT -parenteral I-TREATMENT -e I-TREATMENT -insulina I-TREATMENT -cristalina I-TREATMENT -endovenosa, I-TREATMENT -en I-TREATMENT -infusión I-TREATMENT -continua. I-TREATMENT -Evolucionó B-EVOLUTION -favorablemente. I-EVOLUTION -Dada I-EVOLUTION -la I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -Cetoacidosis I-EVOLUTION -diabética I-EVOLUTION -(CAD) I-EVOLUTION -sin I-EVOLUTION -un I-EVOLUTION -desencadenante I-EVOLUTION -claro I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -glucosuria I-EVOLUTION -inapropiadamente I-EVOLUTION -alta I-EVOLUTION -para I-EVOLUTION -tal I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -hiperglicemia, I-EVOLUTION -se I-EVOLUTION -reinterroga I-EVOLUTION -a I-EVOLUTION +ACG I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +Prednisona I-TREATMENT +1 I-TREATMENT +mg/kg/día. I-TREATMENT +Dos B-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION la I-EVOLUTION paciente I-EVOLUTION -acerca I-EVOLUTION -del I-EVOLUTION -uso I-EVOLUTION -de I-EVOLUTION -otros I-EVOLUTION -medicamentos; I-EVOLUTION -entonces B-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -iniciado I-PAST_MEDICAL_HISTORY -canaglifozina I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -previo I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -cuadro. I-PAST_MEDICAL_HISTORY -Una B-TREATMENT -vez I-TREATMENT -estabilizada, I-TREATMENT -se I-TREATMENT -reajustó I-TREATMENT -esquema I-TREATMENT -de I-TREATMENT -insulina I-TREATMENT -y I-TREATMENT -fue I-TREATMENT -dada I-TREATMENT -de I-TREATMENT -alta I-TREATMENT -al I-TREATMENT -cuarto I-TREATMENT -día I-TREATMENT +permanecía I-EVOLUTION +asintomática I-EVOLUTION +con B-TREATMENT +dosis I-TREATMENT de I-TREATMENT -hospitalización. I-TREATMENT +20 I-TREATMENT +mg/día. I-TREATMENT I-TREATMENT -Se B-EVOLUTION -realizó I-EVOLUTION -la I-EVOLUTION -notificación I-EVOLUTION -al I-EVOLUTION -Instituto I-EVOLUTION -de I-EVOLUTION -Salud I-EVOLUTION -Pública I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -informó I-EVOLUTION -al I-EVOLUTION -Laboratorio I-EVOLUTION -Janssen I-EVOLUTION -Chile, I-EVOLUTION -constituyéndose I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -primer I-EVOLUTION -caso I-EVOLUTION -descrito I-EVOLUTION -de I-EVOLUTION -CAD I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -uso I-EVOLUTION -de I-EVOLUTION -estos I-EVOLUTION -medicamentos I-EVOLUTION -en I-EVOLUTION -nuestro I-EVOLUTION -país. I-EVOLUTION - I-EVOLUTION -Hombre B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS +43 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY +con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -conocidos, I-PAST_MEDICAL_HISTORY -consulta B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Unidad I-PRESENT_ILLNESS +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +meningitis I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +infancia, I-PAST_MEDICAL_HISTORY +diabetes I-PAST_MEDICAL_HISTORY +mellitus I-PAST_MEDICAL_HISTORY +gestacional I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +colestasis I-PAST_MEDICAL_HISTORY +gravídica. I-PAST_MEDICAL_HISTORY +Diagnosticada B-PRESENT_ILLNESS +previamente I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Emergencia I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +pancreatitis I-PRESENT_ILLNESS +crónica I-PRESENT_ILLNESS +idiopática, I-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS por I-PRESENT_ILLNESS un I-PRESENT_ILLNESS cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS -progresiva, I-PRESENT_ILLNESS -palidez, I-PRESENT_ILLNESS -mialgias, I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -escalofríos. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacan I-EXPLORATION -en I-EXPLORATION -paladar I-EXPLORATION -numerosas I-EXPLORATION -lesiones I-EXPLORATION -herpetiformes, I-EXPLORATION -hemograma I-EXPLORATION -evidencia I-EXPLORATION -pancitopenia, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -hospitalizar. I-EXPLORATION -Se I-EXPLORATION -efectúa I-EXPLORATION -estudio I-EXPLORATION +localización I-PRESENT_ILLNESS +epigástrico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +ictericia I-PRESENT_ILLNESS +obstructiva. I-PRESENT_ILLNESS +Se B-EXPLORATION +realizada I-EXPLORATION +un I-EXPLORATION +TAC I-EXPLORATION +abdominal I-EXPLORATION +helicoidal I-EXPLORATION con I-EXPLORATION -mielograma, I-EXPLORATION -inmunofenotipo I-EXPLORATION -y I-EXPLORATION -cariograma, I-EXPLORATION -diagnosticándose I-EXPLORATION -LMA I-EXPLORATION -indiferenciada I-EXPLORATION +contraste, I-EXPLORATION +identificándose I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +múltiples I-EXPLORATION +calcificaciones I-EXPLORATION +pancreáticas, I-EXPLORATION con I-EXPLORATION -expresión I-EXPLORATION -aberrante I-EXPLORATION -CD7. I-EXPLORATION -Se B-TREATMENT -inicia I-TREATMENT -quimioterapia I-TREATMENT -de I-TREATMENT -inducción I-TREATMENT -con I-TREATMENT -esquema I-TREATMENT -3+7 I-TREATMENT -(daunorrubicina I-TREATMENT -+ I-TREATMENT -citarabina) I-TREATMENT -presentando I-TREATMENT -al I-TREATMENT -cuarto I-TREATMENT -día I-TREATMENT -del I-TREATMENT -primer I-TREATMENT -ciclo I-TREATMENT -diarrea I-TREATMENT -y I-TREATMENT -fiebre, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -toman I-TREATMENT -hemocultivos I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -terapia I-TREATMENT -antibiótica I-TREATMENT -empírica I-TREATMENT -de I-TREATMENT -amplio I-TREATMENT -espectro. I-TREATMENT -Los B-EXPLORATION -hemocultivos I-EXPLORATION -resultaron I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -Klebsiella I-EXPLORATION -pneumoniae I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -cefalosporinas I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -tercera I-EXPLORATION -generación, I-EXPLORATION -manteniéndose I-EXPLORATION -el I-EXPLORATION -tratamiento I-EXPLORATION -antibiótico I-EXPLORATION -inicial. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -persiste I-EVOLUTION -febril I-EVOLUTION -sin I-EVOLUTION -clínica I-EVOLUTION -que I-EVOLUTION -sugiera I-EVOLUTION -el I-EVOLUTION -foco I-EVOLUTION -infeccioso; I-EVOLUTION -cursa I-EVOLUTION -con I-EVOLUTION -neutropenia I-EVOLUTION -grave I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -prolonga I-EVOLUTION -por I-EVOLUTION -20 I-EVOLUTION -días, I-EVOLUTION -con I-EVOLUTION -parámetros I-EVOLUTION -inflamatorios I-EVOLUTION -en I-EVOLUTION -ascenso I-EVOLUTION -y I-EVOLUTION -alteración I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -pruebas I-EVOLUTION -hepáticas I-EVOLUTION -con I-EVOLUTION -patrón I-EVOLUTION -colestásico. I-EVOLUTION -Se B-TREATMENT -decide I-TREATMENT -agregar I-TREATMENT -tratamiento I-TREATMENT -antifúngico I-TREATMENT -empírico I-TREATMENT -con I-TREATMENT -anidulafungina I-TREATMENT -y B-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -tomografia I-EXPLORATION -computada I-EXPLORATION -(TC) I-EXPLORATION +la I-EXPLORATION +cabeza I-EXPLORATION +del I-EXPLORATION +páncreas I-EXPLORATION +(alcanza I-EXPLORATION +los I-EXPLORATION +6 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis I-EXPLORATION -en I-EXPLORATION -que I-EXPLORATION -destaca I-EXPLORATION -hepatoesplenomegalia I-EXPLORATION +diámetro I-EXPLORATION +mayor), I-EXPLORATION con I-EXPLORATION -lesiones I-EXPLORATION -focales I-EXPLORATION -esplénicas I-EXPLORATION -sugerentes I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -compromiso I-EXPLORATION -inflamatorio-infeccioso. I-EXPLORATION -Además I-EXPLORATION -presenta I-EXPLORATION -coriorretinitis I-EXPLORATION -izquierda I-EXPLORATION +los I-EXPLORATION +planos I-EXPLORATION +grasos I-EXPLORATION con I-EXPLORATION -fondo I-EXPLORATION +duodeno. I-EXPLORATION +Existe I-EXPLORATION +una I-EXPLORATION +discreta I-EXPLORATION +dilatación I-EXPLORATION +del I-EXPLORATION +conducto I-EXPLORATION +pancreático I-EXPLORATION +principal, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +gran I-EXPLORATION +cantidad I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION -sugerente I-EXPLORATION +adenopatías I-EXPLORATION +periaorticocavas I-EXPLORATION +y I-EXPLORATION +mesentéricas. I-EXPLORATION +Se I-EXPLORATION +establece I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -micosis. I-EXPLORATION +sospecha I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +inflamatoria I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +contexto I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +pancreatitis I-EXPLORATION +crónica, I-EXPLORATION +sin I-EXPLORATION +poder I-EXPLORATION +descartar I-EXPLORATION +un I-EXPLORATION +adenocarcinoma I-EXPLORATION +de I-EXPLORATION +páncreas. I-EXPLORATION Se I-EXPLORATION realiza I-EXPLORATION -hemocultivo I-EXPLORATION +una I-EXPLORATION +USE, I-EXPLORATION +confirmándose I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -hongos I-EXPLORATION -(medio I-EXPLORATION -Sabourand) I-EXPLORATION -que I-EXPLORATION -resulta I-EXPLORATION -negativos, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -MALDI I-EXPLORATION -TOF I-EXPLORATION -MS I-EXPLORATION -(Matrix-Assisted I-EXPLORATION -Laser I-EXPLORATION -Desorption/Ionization I-EXPLORATION -time I-EXPLORATION -of I-EXPLORATION -flight I-EXPLORATION -mass I-EXPLORATION -espectrometry) I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -resulta I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -S. I-EXPLORATION -capitata, I-EXPLORATION -agregándose I-EXPLORATION -tratamiento I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +en I-EXPLORATION +cabeza I-EXPLORATION +pancreática, I-EXPLORATION +heteroecogénica, I-EXPLORATION +irregular, I-EXPLORATION +mal I-EXPLORATION +delimitada, I-EXPLORATION con I-EXPLORATION -voriconazol I-EXPLORATION -(200 I-EXPLORATION -mg/12 I-EXPLORATION -h). I-EXPLORATION -Por B-TREATMENT -falta I-TREATMENT -de I-TREATMENT -respuesta I-TREATMENT -a I-TREATMENT -la I-TREATMENT -terapia I-TREATMENT -se I-TREATMENT -reemplaza I-TREATMENT -la I-TREATMENT -anidulafungina I-TREATMENT -por I-TREATMENT -anfotericina I-TREATMENT -B I-TREATMENT -liposomal I-TREATMENT -(50 I-TREATMENT -mg/día), I-TREATMENT -se I-TREATMENT -practica I-TREATMENT -ecocardiografía I-TREATMENT -que I-TREATMENT -descarta I-TREATMENT -endocarditis. I-TREATMENT -Nuevo B-EXPLORATION -TC I-EXPLORATION -muestra I-EXPLORATION -múltiples I-EXPLORATION -áreas I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +calcificaciones I-EXPLORATION +dispersas, I-EXPLORATION +tanto I-EXPLORATION en I-EXPLORATION -vidrio I-EXPLORATION -esmerilado I-EXPLORATION +relación I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +como I-EXPLORATION en I-EXPLORATION -ambos I-EXPLORATION -lóbulos I-EXPLORATION -pulmonares I-EXPLORATION -superiores I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +parénquima I-EXPLORATION +pancreático, I-EXPLORATION +que I-EXPLORATION +presenta I-EXPLORATION +un I-EXPLORATION +patrón I-EXPLORATION +lobular, I-EXPLORATION +con I-EXPLORATION +puntos I-EXPLORATION y I-EXPLORATION -lóbulo I-EXPLORATION -medio, I-EXPLORATION -atelectasias I-EXPLORATION -bibasales I-EXPLORATION +bandas I-EXPLORATION +hiperecogénicas I-EXPLORATION +(característico I-EXPLORATION +de I-EXPLORATION +pancreatitis I-EXPLORATION +crónica). I-EXPLORATION +El I-EXPLORATION +conducto I-EXPLORATION +pancreático I-EXPLORATION +principal I-EXPLORATION +se I-EXPLORATION +encuentra I-EXPLORATION +dilatado, I-EXPLORATION +con I-EXPLORATION +pared I-EXPLORATION +hiperecogénica, I-EXPLORATION +patrón I-EXPLORATION +irregular I-EXPLORATION y I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -moderado I-EXPLORATION -izquierdo, I-EXPLORATION -adenopatías I-EXPLORATION -mediastínicas I-EXPLORATION -e I-EXPLORATION -hiliares I-EXPLORATION -bilaterales, I-EXPLORATION -hepatoesplenomagalia I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +colaterales. I-EXPLORATION +La I-EXPLORATION +lesión I-EXPLORATION +pancreática I-EXPLORATION +afecta I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +principal, I-EXPLORATION +con I-EXPLORATION +dilatación I-EXPLORATION +secundaria I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +misma. I-EXPLORATION +Durante I-EXPLORATION +la I-EXPLORATION +realización I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +USE I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +elastográfico. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +basal I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +un I-EXPLORATION +patrón I-EXPLORATION +heterogéneo I-EXPLORATION +de I-EXPLORATION +predominio I-EXPLORATION +verde, I-EXPLORATION y I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -focales I-EXPLORATION -hipovasculares, I-EXPLORATION en I-EXPLORATION -hígado, I-EXPLORATION -bazo I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +elastográfico I-EXPLORATION +de I-EXPLORATION +segunda I-EXPLORATION +generación I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +un I-EXPLORATION +coeficiente I-EXPLORATION +de I-EXPLORATION +elasticidad I-EXPLORATION +de I-EXPLORATION +2, I-EXPLORATION +35 I-EXPLORATION y I-EXPLORATION -riñón. I-EXPLORATION -Los I-EXPLORATION -cultivos I-EXPLORATION -realizados I-EXPLORATION +un I-EXPLORATION +valor I-EXPLORATION de I-EXPLORATION -catéteres I-EXPLORATION -resultados I-EXPLORATION -todos I-EXPLORATION -negativos. I-EXPLORATION -Se B-TREATMENT +A I-EXPLORATION +(lesión I-EXPLORATION +a I-EXPLORATION +estudio) I-EXPLORATION +de I-EXPLORATION +0, I-EXPLORATION +12%. I-EXPLORATION +Finalmente I-EXPLORATION +se I-EXPLORATION +rea-liza I-EXPLORATION +una I-EXPLORATION +punción I-EXPLORATION +aspiración I-EXPLORATION +con I-EXPLORATION +aguja I-EXPLORATION +fina I-EXPLORATION +de I-EXPLORATION +22G, I-EXPLORATION +apreciándose I-EXPLORATION +hallazgos I-EXPLORATION +característicos I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +inflamatoria I-EXPLORATION +en I-EXPLORATION +contexto I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +pancreatitis I-EXPLORATION +crónica I-EXPLORATION +(18). I-EXPLORATION +Finalmente B-TREATMENT +se I-TREATMENT realiza I-TREATMENT -toracocentesis I-TREATMENT -evacuadora I-TREATMENT +una I-TREATMENT +colangiopancreatografía I-TREATMENT +retrógrada I-TREATMENT +endoscópica I-TREATMENT con I-TREATMENT -estudio I-TREATMENT +colocación I-TREATMENT de I-TREATMENT -líquido I-TREATMENT -pleural I-TREATMENT -que I-TREATMENT -muestra I-TREATMENT -exudado I-TREATMENT +una I-TREATMENT +prótesis I-TREATMENT de I-TREATMENT -predominio I-TREATMENT -mononuclear. I-TREATMENT -El B-EVOLUTION +polietileno. I-TREATMENT +La B-EVOLUTION paciente I-EVOLUTION -evoluciona I-EVOLUTION -con I-EVOLUTION -dolor I-EVOLUTION -invalidante I-EVOLUTION -en I-EVOLUTION -hipocondrio I-EVOLUTION -y I-EVOLUTION -flanco I-EVOLUTION -izquierdos, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -realiza I-EVOLUTION -control I-EVOLUTION -radiológico I-EVOLUTION -que I-EVOLUTION -evidencia I-EVOLUTION -regresión I-EVOLUTION -de I-EVOLUTION -lesiones I-EVOLUTION -hepáticas I-EVOLUTION -y I-EVOLUTION -renales, I-EVOLUTION -pero I-EVOLUTION -aumento I-EVOLUTION -del I-EVOLUTION -derrame I-EVOLUTION -pleural I-EVOLUTION -izquierdo I-EVOLUTION -y I-EVOLUTION +evolucionó I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -esplénicas I-EVOLUTION -que I-EVOLUTION -ahora I-EVOLUTION -son I-EVOLUTION +forma I-EVOLUTION +satisfactoria, I-EVOLUTION +encontrándose I-EVOLUTION +tras I-EVOLUTION +tres I-EVOLUTION +meses I-EVOLUTION de I-EVOLUTION -aspecto I-EVOLUTION -hemorrágico. I-EVOLUTION -Analizado B-TREATMENT -el I-TREATMENT -caso I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -multidisciplinaria I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -esplenectomía I-TREATMENT -de I-TREATMENT -desfocamiento I-TREATMENT -y I-TREATMENT -VTC, I-TREATMENT -para I-TREATMENT -evacuación I-TREATMENT -y I-TREATMENT -aseo I-TREATMENT -pleural I-TREATMENT -y, I-TREATMENT -definir I-TREATMENT -diagnóstico I-TREATMENT -diferencial I-TREATMENT -(neoplásico, I-TREATMENT -tuberculoso I-TREATMENT -y I-TREATMENT -micosis I-TREATMENT -invasora). I-TREATMENT -Se I-TREATMENT -efectúa I-TREATMENT -VTC I-TREATMENT -con I-TREATMENT -evacuación I-TREATMENT -de I-TREATMENT -2.000 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -derrame I-TREATMENT -pleural, I-TREATMENT -aseo I-TREATMENT -con I-TREATMENT -solución I-TREATMENT -salina, I-TREATMENT -biopsia I-TREATMENT -pleural I-TREATMENT -y I-TREATMENT -drenaje, I-TREATMENT -observándose B-EXPLORATION +seguimiento, I-EVOLUTION +estable I-EVOLUTION +y I-EVOLUTION +asintomática. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +56 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +malestar I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +astenia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +varios I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +La B-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +no I-EXPLORATION +revela I-EXPLORATION +hallazgos I-EXPLORATION +patológicos. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +analítico I-EXPLORATION +(hematológico I-EXPLORATION +y I-EXPLORATION +bioquímico) I-EXPLORATION +no I-EXPLORATION +presenta I-EXPLORATION +alteraciones. I-EXPLORATION +La I-EXPLORATION +radiología I-EXPLORATION +simple I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +revela I-EXPLORATION +pequeñas I-EXPLORATION +imágenes I-EXPLORATION +radiopacas I-EXPLORATION +de I-EXPLORATION +densidad I-EXPLORATION +cálcica I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +área I-EXPLORATION +hepática, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +corresponden I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -múltiples I-EXPLORATION +ecografía I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +TAC I-EXPLORATION +con I-EXPLORATION +varias I-EXPLORATION lesiones I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -4 I-EXPLORATION -mm I-EXPLORATION -distribuidas I-EXPLORATION -difusamente I-EXPLORATION +hipoecoicas I-EXPLORATION +e I-EXPLORATION +hipodensas I-EXPLORATION en I-EXPLORATION -pleura I-EXPLORATION -parietal, I-EXPLORATION -visceral I-EXPLORATION +ambos I-EXPLORATION +lóbulos I-EXPLORATION +hepáticos, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +tamaño I-EXPLORATION +comprendido I-EXPLORATION +entre I-EXPLORATION +0, I-EXPLORATION +5 I-EXPLORATION y I-EXPLORATION -diafragmática. I-EXPLORATION -Se I-EXPLORATION -efectúa I-EXPLORATION -laparotomía I-EXPLORATION -observándose I-EXPLORATION -esplenomegalia I-EXPLORATION -hemorrágica I-EXPLORATION -más I-EXPLORATION -abscesos I-EXPLORATION -esplénicos, I-EXPLORATION -se B-TREATMENT -practica I-TREATMENT -esplenectomía I-TREATMENT -para I-TREATMENT -limpieza I-TREATMENT -del I-TREATMENT -foco. I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro, I-EXPLORATION +que I-EXPLORATION +fueron I-EXPLORATION +interpretadas I-EXPLORATION +como I-EXPLORATION +metástasis. I-EXPLORATION +Las I-EXPLORATION +exploraciones I-EXPLORATION +para I-EXPLORATION +descartar I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +primario I-EXPLORATION +mamario I-EXPLORATION +y I-EXPLORATION +gastrointestinal I-EXPLORATION +fueron I-EXPLORATION +negativas. I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +se I-EXPLORATION +somete I-EXPLORATION +a I-EXPLORATION +una I-EXPLORATION +laparotomia I-EXPLORATION +exploradora I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +visualizan I-EXPLORATION +varias I-EXPLORATION +lesiones I-EXPLORATION +blanquecinas I-EXPLORATION +que I-EXPLORATION +protuyen I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +superficie I-EXPLORATION +de I-EXPLORATION +ambos I-EXPLORATION +lóbulos I-EXPLORATION +hepáticos, I-EXPLORATION +de I-EXPLORATION +superficie I-EXPLORATION +lisa, I-EXPLORATION de I-EXPLORATION las I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +toman I-EXPLORATION muestras I-EXPLORATION -tomadas I-EXPLORATION -durante I-EXPLORATION +para I-EXPLORATION +estudio I-EXPLORATION +anatomopatológico. I-EXPLORATION + I-EXPLORATION +Estudio I-EXPLORATION +anatomopatológico I-EXPLORATION + I-EXPLORATION +Las I-EXPLORATION +muestras I-EXPLORATION +corresponden I-EXPLORATION +a I-EXPLORATION +dos I-EXPLORATION +fragmentos I-EXPLORATION +cuneiformes I-EXPLORATION +de I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +y I-EXPLORATION +1 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +dimensiones I-EXPLORATION +máximas, I-EXPLORATION +de I-EXPLORATION +color I-EXPLORATION +blanquecino I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -VTC I-EXPLORATION +zona I-EXPLORATION +central I-EXPLORATION y I-EXPLORATION +marrón I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -laparotomía I-EXPLORATION +periferia. I-EXPLORATION +Al I-EXPLORATION +corte I-EXPLORATION se I-EXPLORATION -observaron I-EXPLORATION -hifas I-EXPLORATION -septadas. I-EXPLORATION -Los I-EXPLORATION -cultivos I-EXPLORATION -intraoperatorios I-EXPLORATION -resultaron I-EXPLORATION -positivos I-EXPLORATION +aprecian I-EXPLORATION +dos I-EXPLORATION +lesiones I-EXPLORATION +blanquecinas, I-EXPLORATION +de I-EXPLORATION +límites I-EXPLORATION +definidos I-EXPLORATION +y I-EXPLORATION +consistencia I-EXPLORATION +firme, I-EXPLORATION +rodeadas I-EXPLORATION +de I-EXPLORATION +tejido I-EXPLORATION +de I-EXPLORATION +color I-EXPLORATION +marrón. I-EXPLORATION +Las I-EXPLORATION +muestras I-EXPLORATION +de I-EXPLORATION +tejido I-EXPLORATION +seleccionadas I-EXPLORATION para I-EXPLORATION -S. I-EXPLORATION -capitata I-EXPLORATION +estudio I-EXPLORATION +microscópico I-EXPLORATION +fueron I-EXPLORATION +fijadas I-EXPLORATION +en I-EXPLORATION +formol I-EXPLORATION +acuoso I-EXPLORATION +al I-EXPLORATION +10% I-EXPLORATION +durante I-EXPLORATION +24 I-EXPLORATION +horas I-EXPLORATION +e I-EXPLORATION +incluidas I-EXPLORATION +en I-EXPLORATION +parafina. I-EXPLORATION +Se I-EXPLORATION +obtuvieron I-EXPLORATION +cortes I-EXPLORATION +histológicos I-EXPLORATION +de I-EXPLORATION +3 I-EXPLORATION +micras I-EXPLORATION +de I-EXPLORATION +espesor I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +tiñeron I-EXPLORATION +con I-EXPLORATION +hematoxilina-eosina. I-EXPLORATION +Otros I-EXPLORATION +cortes I-EXPLORATION +se I-EXPLORATION +montaron I-EXPLORATION +sobre I-EXPLORATION +portas I-EXPLORATION +cargados I-EXPLORATION +eléctricamente I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +destinaron I-EXPLORATION a I-EXPLORATION +estudio I-EXPLORATION +inmunohistoquímico, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +automatizada I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +aparato I-EXPLORATION +tipo I-EXPLORATION +ventana. I-EXPLORATION + I-EXPLORATION +Microscópicamente I-EXPLORATION +se I-EXPLORATION +advierte I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +neoplásica I-EXPLORATION +con I-EXPLORATION +patrón I-EXPLORATION +de I-EXPLORATION +crecimiento I-EXPLORATION +sólido I-EXPLORATION +y I-EXPLORATION +márgenes I-EXPLORATION +infiltrativos I-EXPLORATION +que I-EXPLORATION +ocupa I-EXPLORATION +parcial I-EXPLORATION +o I-EXPLORATION +totalmente I-EXPLORATION las I-EXPLORATION -72 I-EXPLORATION -h. I-EXPLORATION -Posterior B-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -evoluciona I-EVOLUTION -favorablemente I-EVOLUTION -y B-TREATMENT -se I-TREATMENT -completan I-TREATMENT -58 I-TREATMENT -días I-TREATMENT -de I-TREATMENT +luces I-EXPLORATION +venulares I-EXPLORATION +y I-EXPLORATION +sinusoidales, I-EXPLORATION +respetando I-EXPLORATION +los I-EXPLORATION +espacios I-EXPLORATION +porta I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +cierta I-EXPLORATION +medida I-EXPLORATION +las I-EXPLORATION +trabéculas I-EXPLORATION +hepáticas I-EXPLORATION +y I-EXPLORATION +conductillos I-EXPLORATION +biliares. I-EXPLORATION +Alternan I-EXPLORATION +áreas I-EXPLORATION +celulares I-EXPLORATION +con I-EXPLORATION +otras I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +fibroso. I-EXPLORATION +Las I-EXPLORATION +células I-EXPLORATION +neoplásicas I-EXPLORATION +dominantes I-EXPLORATION +exhiben I-EXPLORATION +citoplasmas I-EXPLORATION +amplios I-EXPLORATION +y I-EXPLORATION +densos, I-EXPLORATION +de I-EXPLORATION +bordes I-EXPLORATION +bien I-EXPLORATION +definidos, I-EXPLORATION +a I-EXPLORATION +veces I-EXPLORATION +con I-EXPLORATION +vacuolas I-EXPLORATION +únicas I-EXPLORATION +o I-EXPLORATION +múltiples, I-EXPLORATION +ocasionalmente I-EXPLORATION +ocupadas I-EXPLORATION +por I-EXPLORATION +hematíes I-EXPLORATION +y I-EXPLORATION +núcleos I-EXPLORATION +vesiculares I-EXPLORATION +con I-EXPLORATION +nucleolos I-EXPLORATION +evidentes I-EXPLORATION +y I-EXPLORATION +aisladas I-EXPLORATION +mitosis. I-EXPLORATION +La I-EXPLORATION +mayoría I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +tumorales I-EXPLORATION +expresan I-EXPLORATION +inmunopositividad I-EXPLORATION +fuerte I-EXPLORATION +frente I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +marcadores I-EXPLORATION +vasculares I-EXPLORATION +FVIII, I-EXPLORATION +CD I-EXPLORATION +31 I-EXPLORATION +y I-EXPLORATION +CD I-EXPLORATION +34 I-EXPLORATION +y I-EXPLORATION +ocasionalmente I-EXPLORATION +frente I-EXPLORATION +al I-EXPLORATION +anticuerpo I-EXPLORATION +citoqueratina. I-EXPLORATION + I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +no I-TREATMENT +ha I-TREATMENT +recibido I-TREATMENT tratamiento I-TREATMENT -con I-TREATMENT -anfotericina I-TREATMENT -B I-TREATMENT -liposomal I-TREATMENT -(alcanzando I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -acumulada I-TREATMENT -de I-TREATMENT -2, I-TREATMENT -9 I-TREATMENT -g I-TREATMENT -sin I-TREATMENT -manifestar I-TREATMENT -efectos I-TREATMENT -adversos) I-TREATMENT -y I-TREATMENT -80 I-TREATMENT -días I-TREATMENT -con I-TREATMENT -voriconazol I-TREATMENT -(dosis I-TREATMENT -acumulada I-TREATMENT -de I-TREATMENT -32 I-TREATMENT -g I-TREATMENT -sin I-TREATMENT -efectos I-TREATMENT -adversos). I-TREATMENT -Se B-EVOLUTION -da I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones, I-EVOLUTION -finalizando I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -oncológico I-EVOLUTION -manteniéndose I-EVOLUTION -durante I-EVOLUTION -los I-EVOLUTION -ciclos I-EVOLUTION -de I-EVOLUTION -quimioterapia I-EVOLUTION -con I-EVOLUTION -profilaxis I-EVOLUTION -con I-EVOLUTION -voriconazol. I-EVOLUTION -A I-EVOLUTION -más I-EVOLUTION -de I-EVOLUTION -2 I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION +y B-EVOLUTION +las I-EVOLUTION +lesiones I-EVOLUTION +han I-EVOLUTION +permanecido I-EVOLUTION +estables I-EVOLUTION +hasta I-EVOLUTION el I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presenta I-EVOLUTION -evidencia I-EVOLUTION -de I-EVOLUTION -enfermedad. I-EVOLUTION +momento I-EVOLUTION +actual, I-EVOLUTION +año I-EVOLUTION +y I-EVOLUTION +medio I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +diagnóstico. I-EVOLUTION I-EVOLUTION -Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -62 I-PRESENT_ILLNESS +66 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -en B-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -trastorno I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -personalidad I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ánimo, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -intentos I-PAST_MEDICAL_HISTORY -suicidas. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -febrero I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2017 I-PRESENT_ILLNESS -ingirió I-PRESENT_ILLNESS -bupropión I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -dosis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -9, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -g, I-PRESENT_ILLNESS -clorpromazina I-PRESENT_ILLNESS -1, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -g I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -copas I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hace I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +intermitentes I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -vino. I-PRESENT_ILLNESS -Los I-PRESENT_ILLNESS -familiares I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -encontraron I-PRESENT_ILLNESS -alterada I-PRESENT_ILLNESS +melenas. I-PRESENT_ILLNESS +Estudio I-PRESENT_ILLNESS +inicial I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +EDA I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -llevaron I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Salvador, I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -ingresó I-PRESENT_ILLNESS -comprometida I-PRESENT_ILLNESS +colonoscopia I-PRESENT_ILLNESS +normal. I-PRESENT_ILLNESS +Ingresa I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +nuevo I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Glasgow I-PRESENT_ILLNESS -10, I-PRESENT_ILLNESS -presión I-PRESENT_ILLNESS -arterial I-PRESENT_ILLNESS -90/60, I-PRESENT_ILLNESS -taquicárdica I-PRESENT_ILLNESS -115 I-PRESENT_ILLNESS -lpm, I-PRESENT_ILLNESS -electrocardiograma I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -segmento I-PRESENT_ILLNESS -Q-t I-PRESENT_ILLNESS -alargado I-PRESENT_ILLNESS -(550 I-PRESENT_ILLNESS -ms) I-PRESENT_ILLNESS +melenas I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -ácido I-PRESENT_ILLNESS -láctico I-PRESENT_ILLNESS -elevado I-PRESENT_ILLNESS -(32, I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -mg/dl). I-PRESENT_ILLNESS -Dentro B-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -primeras I-EVOLUTION -24 I-EVOLUTION -h I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -ingreso I-EVOLUTION -presentó I-EVOLUTION -dos I-EVOLUTION -breves I-EVOLUTION -episodios I-EVOLUTION -convulsivos, I-EVOLUTION -de I-EVOLUTION -30 I-EVOLUTION -seg I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -menos I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -minuto. I-EVOLUTION -El B-EXPLORATION -electroencefalograma I-EXPLORATION -(EEG) I-EXPLORATION -mostró I-EXPLORATION -actividad I-EXPLORATION -delta-theta I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -voltaje, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION +anemización. I-PRESENT_ILLNESS +Se B-EXPLORATION +realiza I-EXPLORATION de I-EXPLORATION -epilepsia. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION +nuevo I-EXPLORATION +EDA I-EXPLORATION +y I-EXPLORATION +colonoscopia, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +tránsito I-EXPLORATION +intestinal I-EXPLORATION +seguido I-EXPLORATION de I-EXPLORATION -cerebro I-EXPLORATION -(TAC) I-EXPLORATION +cápsula I-EXPLORATION +endoscópica I-EXPLORATION +(CE) I-EXPLORATION sin I-EXPLORATION -contraste I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -tenía I-EXPLORATION -escaza I-EXPLORATION -reactividad I-EXPLORATION -y I-EXPLORATION +hallazgos I-EXPLORATION +reseñables. I-EXPLORATION +Ante I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +clínico I-EXPLORATION +de I-EXPLORATION +HDOO I-EXPLORATION se I-EXPLORATION -mantuvo I-EXPLORATION -alterada I-EXPLORATION +solicita I-EXPLORATION +angioTAC: I-EXPLORATION +"lesión I-EXPLORATION +sólida I-EXPLORATION +hipercaptante I-EXPLORATION de I-EXPLORATION -conciencia, I-EXPLORATION +3, I-EXPLORATION +3 I-EXPLORATION +x I-EXPLORATION +4, I-EXPLORATION +4 I-EXPLORATION +x I-EXPLORATION +4, I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION con I-EXPLORATION -mioclonías I-EXPLORATION -generalizadas I-EXPLORATION -y I-EXPLORATION -movimientos I-EXPLORATION -involuntarios I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -extremidades; I-EXPLORATION -tono I-EXPLORATION -muscular I-EXPLORATION -aumentado, I-EXPLORATION -reflejos I-EXPLORATION -osteotendíneos I-EXPLORATION -(ROT) I-EXPLORATION -policinéticos I-EXPLORATION -y I-EXPLORATION -reflejos I-EXPLORATION -plantares I-EXPLORATION -flexores. I-EXPLORATION -En B-EVOLUTION -la I-EVOLUTION -mañana I-EVOLUTION -del I-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -sufrió I-EVOLUTION -paro I-EVOLUTION -cardiorrespiratorio I-EVOLUTION -por I-EVOLUTION -asistolia, I-EVOLUTION -recibió B-TREATMENT -reanimación I-TREATMENT -inmediata, I-TREATMENT -adrenalina, I-TREATMENT -intubación, I-TREATMENT -luego I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -min I-TREATMENT -logró I-TREATMENT -actividad I-TREATMENT -cardiaca I-TREATMENT -espontánea. I-TREATMENT - I-TREATMENT -Al B-EVOLUTION -día I-EVOLUTION -siguiente I-EVOLUTION -habían I-EVOLUTION -desaparecido I-EVOLUTION -las I-EVOLUTION -mioclonías, I-EVOLUTION -estaba I-EVOLUTION -inconsciente I-EVOLUTION -y I-EVOLUTION -mantenía I-EVOLUTION -una I-EVOLUTION -persistente I-EVOLUTION -apertura I-EVOLUTION -palpebral I-EVOLUTION -con I-EVOLUTION -escaso I-EVOLUTION -pestañeo I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -sobre-elevación I-EVOLUTION -anormal I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -ojos, I-EVOLUTION -como I-EVOLUTION -mirando I-EVOLUTION -hacia I-EVOLUTION -atrás. I-EVOLUTION -Las I-EVOLUTION -pupilas I-EVOLUTION -estaban I-EVOLUTION -iguales I-EVOLUTION -y I-EVOLUTION -reactivas I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -luz, I-EVOLUTION -con I-EVOLUTION -reflejos I-EVOLUTION -oculocefálicos I-EVOLUTION -conservados. I-EVOLUTION -Sus I-EVOLUTION -extremidades I-EVOLUTION -se I-EVOLUTION -mostraban I-EVOLUTION -hipotónicas I-EVOLUTION -y I-EVOLUTION -tenía I-EVOLUTION -los I-EVOLUTION -ROT I-EVOLUTION -exaltados I-EVOLUTION -con I-EVOLUTION -Babinski I-EVOLUTION -bilateral. I-EVOLUTION -Los B-EXPLORATION -estímulos I-EXPLORATION -nociceptivos I-EXPLORATION -desencadenaban I-EXPLORATION -respuestas I-EXPLORATION -extensoras I-EXPLORATION +crecimiento I-EXPLORATION +exofítico I-EXPLORATION +desde I-EXPLORATION +la I-EXPLORATION +luz I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -cuatro I-EXPLORATION -extremidades I-EXPLORATION -y I-EXPLORATION un I-EXPLORATION -simultáneo I-EXPLORATION -cierre I-EXPLORATION -palpebral I-EXPLORATION +asa I-EXPLORATION +yeyunal, I-EXPLORATION con I-EXPLORATION -descenso I-EXPLORATION +hipertrofia I-EXPLORATION +vascular I-EXPLORATION de I-EXPLORATION los I-EXPLORATION -globos I-EXPLORATION -oculares, I-EXPLORATION +vasos I-EXPLORATION +nutricios I-EXPLORATION que I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -reapertura I-EXPLORATION -palpebral I-EXPLORATION -volvían I-EXPLORATION +drenan I-EXPLORATION +directamente I-EXPLORATION a I-EXPLORATION -elevarse I-EXPLORATION -simulando I-EXPLORATION -un I-EXPLORATION -rebote I-EXPLORATION -ocular. I-EXPLORATION -El I-EXPLORATION -fenómeno I-EXPLORATION -se I-EXPLORATION -repetía I-EXPLORATION -con I-EXPLORATION -cualquier I-EXPLORATION -estímulo. I-EXPLORATION -La I-EXPLORATION -RM I-EXPLORATION +ramas I-EXPLORATION +arteriales I-EXPLORATION +mesentéricas, I-EXPLORATION +sugerente I-EXPLORATION de I-EXPLORATION -cerebro I-EXPLORATION -realizada I-EXPLORATION -al I-EXPLORATION -octavo I-EXPLORATION -día, I-EXPLORATION -mostró I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -difusión I-EXPLORATION -imágenes I-EXPLORATION -hiperintensas I-EXPLORATION +GIST, I-EXPLORATION +sin I-EXPLORATION +evidencia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -sustancia I-EXPLORATION -blanca I-EXPLORATION -del I-EXPLORATION -centro I-EXPLORATION -oval I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -cuerpo I-EXPLORATION -calloso I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -secuencia I-EXPLORATION -FLAIR I-EXPLORATION -áreas I-EXPLORATION -menores I-EXPLORATION -hiperintensas I-EXPLORATION -en I-EXPLORATION -ganglios I-EXPLORATION -basales I-EXPLORATION -y I-EXPLORATION -corteza, I-EXPLORATION -compatibles I-EXPLORATION +adenopatías". I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +es I-TREATMENT +intervenida: I-TREATMENT +resección I-TREATMENT +segmentaria I-TREATMENT +de I-TREATMENT +yeyuno I-TREATMENT +medio. I-TREATMENT +Estudio B-EXPLORATION +histológico I-EXPLORATION +e I-EXPLORATION +inmunohistoquímico: I-EXPLORATION +GIST I-EXPLORATION +de I-EXPLORATION +bajo I-EXPLORATION +grado I-EXPLORATION +de I-EXPLORATION +malignidad: I-EXPLORATION +tamaño I-EXPLORATION +< I-EXPLORATION +5 I-EXPLORATION +cm, I-EXPLORATION +< I-EXPLORATION +1 I-EXPLORATION +mitosis/10 I-EXPLORATION +campos I-EXPLORATION +de I-EXPLORATION +gran I-EXPLORATION +aumento, I-EXPLORATION +diferenciación I-EXPLORATION +muscular I-EXPLORATION +e I-EXPLORATION +índice I-EXPLORATION +proliferativo I-EXPLORATION +< I-EXPLORATION +1 I-EXPLORATION +%, I-EXPLORATION +medido I-EXPLORATION con I-EXPLORATION -una I-EXPLORATION -encefalopatía I-EXPLORATION -hipóxico-isquémica. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -supraversión I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mirada I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -al I-EVOLUTION -menos I-EVOLUTION -diez I-EVOLUTION -días, I-EVOLUTION -luego I-EVOLUTION -la I-EVOLUTION -mirada I-EVOLUTION -se I-EVOLUTION -hizo I-EVOLUTION -central, I-EVOLUTION -mientras I-EVOLUTION +el I-EXPLORATION +anticuerpo I-EXPLORATION +monoclonal I-EXPLORATION +KI67. I-EXPLORATION +La B-TREATMENT +resección I-TREATMENT +completa I-TREATMENT +del I-TREATMENT +tumor I-TREATMENT +sin I-TREATMENT +afectación I-TREATMENT +metastásica I-TREATMENT +determina I-TREATMENT +la I-TREATMENT +ausencia I-TREATMENT +de I-TREATMENT +necesidad I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +farmacológico I-TREATMENT +posterior I-TREATMENT +con I-TREATMENT +inhibidores I-TREATMENT +de I-TREATMENT +la I-TREATMENT +tirosin I-TREATMENT +quinasa I-TREATMENT +(imatinib). I-TREATMENT +Tres B-EVOLUTION +meses I-EVOLUTION +después, I-EVOLUTION la I-EVOLUTION paciente I-EVOLUTION -seguía I-EVOLUTION -en I-EVOLUTION -coma I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -variaciones I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +asintomática. I-EVOLUTION + I-EVOLUTION + +Recientemente, B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +43 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +colecistectomizada I-PRESENT_ILLNESS +se B-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +CPRE I-EXPLORATION +por I-EXPLORATION +coledocolitiasis. I-EXPLORATION +Horas B-EVOLUTION después I-EVOLUTION de I-EVOLUTION -un I-EVOLUTION -mes. I-EVOLUTION -Las I-EVOLUTION -pupilas I-EVOLUTION -se I-EVOLUTION -mantenían I-EVOLUTION -iguales I-EVOLUTION -con I-EVOLUTION -respuesta I-EVOLUTION -a I-EVOLUTION la I-EVOLUTION -luz I-EVOLUTION -y I-EVOLUTION -reflejos I-EVOLUTION -oculocefálicos I-EVOLUTION -conservados, I-EVOLUTION -los I-EVOLUTION -ROT I-EVOLUTION -estaban I-EVOLUTION -vivos I-EVOLUTION +misma, I-EVOLUTION +comenzó I-EVOLUTION con I-EVOLUTION -reflejos I-EVOLUTION -plantares I-EVOLUTION -extensores. I-EVOLUTION -Los I-EVOLUTION -estímulos I-EVOLUTION -nociseptivos I-EVOLUTION -seguían I-EVOLUTION -generando I-EVOLUTION -respuestas I-EVOLUTION -extensoras. I-EVOLUTION -El I-EVOLUTION -EEG I-EVOLUTION -estaba I-EVOLUTION -prácticamente I-EVOLUTION -plano. I-EVOLUTION -La B-EXPLORATION -RM I-EXPLORATION +dolor I-EVOLUTION +abdominal I-EVOLUTION +en I-EVOLUTION +hipocondrio I-EVOLUTION +derecho I-EVOLUTION +y I-EVOLUTION +anemización. I-EVOLUTION +Se B-EXPLORATION +solicitó I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION de I-EXPLORATION -control I-EXPLORATION +abdomen I-EXPLORATION +que I-EXPLORATION mostró I-EXPLORATION -una I-EXPLORATION -definida I-EXPLORATION -atrofia I-EXPLORATION -cerebral, I-EXPLORATION -con I-EXPLORATION -hiperintensidades I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -núcleos I-EXPLORATION +un I-EXPLORATION +hematoma I-EXPLORATION +subcapsular I-EXPLORATION +hepático I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION +16 I-EXPLORATION +x I-EXPLORATION +7 I-EXPLORATION +x I-EXPLORATION +16 I-EXPLORATION +cm, I-EXPLORATION +el I-EXPLORATION +cual I-EXPLORATION +comprimía I-EXPLORATION y I-EXPLORATION -en I-EXPLORATION -distintas I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION +desplazaba I-EXPLORATION +hacia I-EXPLORATION la I-EXPLORATION -corteza I-EXPLORATION -cerebral I-EXPLORATION -y I-EXPLORATION -cerebelosa. I-EXPLORATION -Había B-EVOLUTION -desaparecido I-EVOLUTION -la I-EVOLUTION -hiperintensidad I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -substancia I-EVOLUTION -blanca. I-EVOLUTION -La I-EVOLUTION -paciente I-EVOLUTION -falleció I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -47 I-EVOLUTION -días. I-EVOLUTION - I-EVOLUTION - -Ingresa B-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -Hematología I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -masculino I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -16 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -LLA I-PAST_MEDICAL_HISTORY -común, I-PAST_MEDICAL_HISTORY -(Philadelphia I-PAST_MEDICAL_HISTORY -negativo). I-PAST_MEDICAL_HISTORY -Inducción B-TREATMENT -con I-TREATMENT -esquema I-TREATMENT -LLA I-TREATMENT -15-30 I-TREATMENT -según I-TREATMENT -protocolo, I-TREATMENT -con I-TREATMENT -rápida I-TREATMENT -respuesta I-TREATMENT -y I-TREATMENT -remisión I-TREATMENT -completa. I-TREATMENT -En I-TREATMENT +línea I-EXPLORATION +media I-EXPLORATION +el I-EXPLORATION +parénquima I-EXPLORATION +hepático. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +a I-EXPLORATION +continuación I-EXPLORATION +angio-TC, I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION +extravasación I-EXPLORATION +del I-EXPLORATION +contraste. I-EXPLORATION + I-EXPLORATION +Dada B-TREATMENT la I-TREATMENT -etapa I-TREATMENT +estabilidad I-TREATMENT +clínica I-TREATMENT +y I-TREATMENT +ausencia I-TREATMENT de I-TREATMENT -consolidación I-TREATMENT +sangrado I-TREATMENT +activo, I-TREATMENT se I-TREATMENT -inició I-TREATMENT -QI I-TREATMENT -triple I-TREATMENT -(Metrotrexato I-TREATMENT -15 I-TREATMENT -mg, I-TREATMENT -Citarabina I-TREATMENT -50 I-TREATMENT -mg, I-TREATMENT -Betametasona I-TREATMENT -4 I-TREATMENT -mg). I-TREATMENT -Durante B-EVOLUTION -esta I-EVOLUTION -etapa I-EVOLUTION -apareció I-EVOLUTION -neutropenia I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -mielograma I-EVOLUTION -mostró I-EVOLUTION -71% I-EVOLUTION -de I-EVOLUTION -linfoblastos I-EVOLUTION -y I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -blastos I-EVOLUTION -en I-EVOLUTION -LCR, I-EVOLUTION -sin I-EVOLUTION -síntomas I-EVOLUTION -neurológicos. I-EVOLUTION -Se I-EVOLUTION -definió I-EVOLUTION -como I-EVOLUTION -una I-EVOLUTION -recaída I-EVOLUTION -combinada I-EVOLUTION -precoz. I-EVOLUTION -En B-TREATMENT +optó I-TREATMENT +por I-TREATMENT +un I-TREATMENT +manejo I-TREATMENT +conservador I-TREATMENT +con I-TREATMENT +vigilancia I-TREATMENT +en I-TREATMENT la I-TREATMENT -terapia I-TREATMENT -de I-TREATMENT -rescate, I-TREATMENT -recibió I-TREATMENT -seis I-TREATMENT -pulsos I-TREATMENT -de I-TREATMENT -QI, I-TREATMENT -lográndose I-TREATMENT -remisión I-TREATMENT -completa I-TREATMENT -y I-TREATMENT -desaparición I-TREATMENT +Unidad I-TREATMENT de I-TREATMENT -los I-TREATMENT -blastos I-TREATMENT -del I-TREATMENT -LCR. I-TREATMENT -Al I-TREATMENT -octavo I-TREATMENT -mes I-TREATMENT +Cuidados I-TREATMENT +Intensivos I-TREATMENT +(UCI), I-TREATMENT +donde I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT se I-TREATMENT -continuó I-TREATMENT -con I-TREATMENT -block I-TREATMENT -R2. I-TREATMENT -Después B-EVOLUTION -del I-EVOLUTION -primer I-EVOLUTION -procedimiento I-EVOLUTION -intratecal I-EVOLUTION -inició I-EVOLUTION -inestabilidad I-EVOLUTION +mantuvo I-TREATMENT +hemodinámicamente I-TREATMENT +estable. I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +diez I-EVOLUTION +días, I-EVOLUTION +un I-EVOLUTION +TC I-EVOLUTION +de I-EVOLUTION +control I-EVOLUTION +mostró I-EVOLUTION +persistencia I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -marcha. I-EVOLUTION -El B-EXPLORATION -examen I-EXPLORATION -neurológico I-EXPLORATION -mostró I-EXPLORATION +colección, I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +efectuó I-TREATMENT +drenaje I-TREATMENT +percutáneo I-TREATMENT +en I-TREATMENT +el I-TREATMENT +cual I-TREATMENT +se I-TREATMENT +extrajeron I-TREATMENT +1.000 I-TREATMENT +ml I-TREATMENT +de I-TREATMENT +contenido I-TREATMENT +hemático. I-TREATMENT +La B-EVOLUTION +evolución I-EVOLUTION +fue I-EVOLUTION +favorable, I-EVOLUTION +con I-EVOLUTION +alta I-EVOLUTION +12 I-EVOLUTION +días I-EVOLUTION +después. I-EVOLUTION +No B-TREATMENT +obstante, I-TREATMENT +fue I-TREATMENT +necesario I-TREATMENT +un I-TREATMENT +nuevo I-TREATMENT +drenaje I-TREATMENT +de I-TREATMENT +unos I-TREATMENT +1.100 I-TREATMENT +ml I-TREATMENT +días I-TREATMENT +más I-TREATMENT +tarde, I-TREATMENT +tras B-EVOLUTION +el I-EVOLUTION +cual I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +permaneció I-EVOLUTION +asintomática. I-EVOLUTION + I-EVOLUTION + +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +68 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +distensión I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +intenso, I-PRESENT_ILLNESS +rectorragia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +En B-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +último I-PAST_MEDICAL_HISTORY +mes I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +presentado I-PAST_MEDICAL_HISTORY +dolor I-PAST_MEDICAL_HISTORY +abdominal I-PAST_MEDICAL_HISTORY +cólico I-PAST_MEDICAL_HISTORY +recidivante. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +médicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +alteraciones I-PAST_MEDICAL_HISTORY +analíticas I-PAST_MEDICAL_HISTORY +relevantes. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION un I-EXPLORATION -paciente I-EXPLORATION -vigil, I-EXPLORATION -orientado, I-EXPLORATION +abdomen I-EXPLORATION +distendido, I-EXPLORATION +timpanizado, I-EXPLORATION +doloroso I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación, I-EXPLORATION sin I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -pares I-EXPLORATION -craneanos, I-EXPLORATION -ni I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -potencia I-EXPLORATION -muscular, I-EXPLORATION -ROT I-EXPLORATION -preservados, I-EXPLORATION -marcha I-EXPLORATION -insegura, I-EXPLORATION -Romberg I-EXPLORATION -positivo I-EXPLORATION +peritonismo. I-EXPLORATION +El I-EXPLORATION +tacto I-EXPLORATION +rectal I-EXPLORATION +mostró I-EXPLORATION +restos I-EXPLORATION +hemáticos. I-EXPLORATION +La I-EXPLORATION +colonoscopia I-EXPLORATION +objetivó I-EXPLORATION +una I-EXPLORATION +formación I-EXPLORATION +friable I-EXPLORATION y I-EXPLORATION -alteración I-EXPLORATION -propioceptiva I-EXPLORATION +violácea, I-EXPLORATION en I-EXPLORATION -las I-EXPLORATION -EEII, I-EXPLORATION -prueba I-EXPLORATION -índice-nariz I-EXPLORATION +válvula I-EXPLORATION +ileocecal, I-EXPLORATION +con I-EXPLORATION +aspecto I-EXPLORATION +de I-EXPLORATION +rotación I-EXPLORATION +o I-EXPLORATION +invaginación. I-EXPLORATION +El I-EXPLORATION +TAC I-EXPLORATION +evidenció I-EXPLORATION +una I-EXPLORATION +invaginación I-EXPLORATION +ileo-cólica I-EXPLORATION +de I-EXPLORATION +12 I-EXPLORATION +cm I-EXPLORATION +con I-EXPLORATION +sus I-EXPLORATION +paredes I-EXPLORATION +engrosadas I-EXPLORATION y I-EXPLORATION -talón-rodilla I-EXPLORATION -normales. I-EXPLORATION +sin I-EXPLORATION +obstrucción I-EXPLORATION +intestinal. I-EXPLORATION Se B-TREATMENT -suspendió I-TREATMENT -quimioterapia, I-TREATMENT -iniciándose I-TREATMENT -Tiamina I-TREATMENT -90 I-TREATMENT -mg I-TREATMENT -c/12 I-TREATMENT -h, I-TREATMENT -Piridoxina I-TREATMENT -150 I-TREATMENT -mg I-TREATMENT -c/12 I-TREATMENT -h, I-TREATMENT -Leucovorina I-TREATMENT -50 I-TREATMENT -mg I-TREATMENT -c/12 I-TREATMENT -h, I-TREATMENT -Cianocobalamina I-TREATMENT -2 I-TREATMENT -ampollas I-TREATMENT +decidió I-TREATMENT +tratamiento I-TREATMENT +quirúrgico, I-TREATMENT +objetivando I-TREATMENT +la I-TREATMENT +invaginación I-TREATMENT +ileocecal I-TREATMENT y I-TREATMENT -c/24 I-TREATMENT -h I-TREATMENT -Meteonina I-TREATMENT -S-adenosylmetionina. I-TREATMENT - I-TREATMENT -Dos B-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -paciente I-EVOLUTION -vigil I-EVOLUTION -con I-EVOLUTION -funciones I-EVOLUTION -superiores I-EVOLUTION -preservadas, I-EVOLUTION -había I-EVOLUTION -progresado I-EVOLUTION -la I-EVOLUTION -inestabilidad I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -marcha, I-EVOLUTION -agregándose I-EVOLUTION -hipostesia I-EVOLUTION -táctil, I-EVOLUTION -dificultad I-EVOLUTION -para I-EVOLUTION -la I-EVOLUTION -bipedestación I-EVOLUTION -por I-EVOLUTION -debilidad I-EVOLUTION -proximal I-EVOLUTION -de I-EVOLUTION -EEII, I-EVOLUTION -hiperreflexia, I-EVOLUTION -Babinski I-EVOLUTION -e I-EVOLUTION -incontinencia I-EVOLUTION -urinaria. I-EVOLUTION -RM B-EXPLORATION +un I-TREATMENT +pequeño I-TREATMENT +deserosamiento I-TREATMENT +de I-TREATMENT +ciego. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +resección I-TREATMENT +ampliada I-TREATMENT +de I-TREATMENT +ciego I-TREATMENT +con I-TREATMENT +anastomosis I-TREATMENT +ileocólica I-TREATMENT +mecánica. I-TREATMENT +El B-EXPLORATION +diagnóstico I-EXPLORATION +anatomopatológico I-EXPLORATION +fue I-EXPLORATION de I-EXPLORATION -médula I-EXPLORATION -mostró I-EXPLORATION -aumento I-EXPLORATION +invaginación I-EXPLORATION +del I-EXPLORATION +intestino I-EXPLORATION +delgado I-EXPLORATION +con I-EXPLORATION +lesión I-EXPLORATION +polipoide I-EXPLORATION +formada I-EXPLORATION +por I-EXPLORATION +adipocitos I-EXPLORATION +maduros I-EXPLORATION +sin I-EXPLORATION +lipoblastos, I-EXPLORATION +que I-EXPLORATION +es I-EXPLORATION +la I-EXPLORATION +causa I-EXPLORATION de I-EXPLORATION -señal I-EXPLORATION -en I-EXPLORATION -cordones I-EXPLORATION -posteriores I-EXPLORATION -desde I-EXPLORATION -cervical I-EXPLORATION -a I-EXPLORATION -T11. I-EXPLORATION - I-EXPLORATION -Al B-EVOLUTION -sexto I-EVOLUTION -día I-EVOLUTION -aumentó I-EVOLUTION -la I-EVOLUTION -debilidad I-EVOLUTION -en I-EVOLUTION -EEII I-EVOLUTION -y I-EVOLUTION -pared I-EVOLUTION -abdominal, I-EVOLUTION -ROT I-EVOLUTION -apagados, I-EVOLUTION -Babinski, I-EVOLUTION -las I-EVOLUTION -alteraciones I-EVOLUTION -propioceptivas I-EVOLUTION -persistían, I-EVOLUTION -tenía I-EVOLUTION -preservada I-EVOLUTION -la I-EVOLUTION -sensibilidad I-EVOLUTION -dolorosa, I-EVOLUTION -sin I-EVOLUTION -compromiso I-EVOLUTION -en I-EVOLUTION -EESS. I-EVOLUTION -En I-EVOLUTION -el I-EVOLUTION -día I-EVOLUTION -decimosegundo I-EVOLUTION -tenía I-EVOLUTION -paraplejia I-EVOLUTION -fláccida, I-EVOLUTION -ROT I-EVOLUTION -abolidos, I-EVOLUTION -sin I-EVOLUTION -nivel I-EVOLUTION -sensitivo. I-EVOLUTION -Un I-EVOLUTION -hemograma I-EVOLUTION -con I-EVOLUTION -recaída I-EVOLUTION -leucémica I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -día I-EVOLUTION -decimonono I-EVOLUTION -obligó I-EVOLUTION -a I-EVOLUTION -continuar I-EVOLUTION -con I-EVOLUTION -cuidados I-EVOLUTION -paliativos I-EVOLUTION -en I-EVOLUTION -su I-EVOLUTION -domicilio. I-EVOLUTION -El I-EVOLUTION -compromiso I-EVOLUTION -neurológico I-EVOLUTION -no I-EVOLUTION -progresó, I-EVOLUTION -falleciendo I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -LLA. I-EVOLUTION +la I-EXPLORATION +zona I-EXPLORATION +invaginada. I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +buena I-EVOLUTION +evolución I-EVOLUTION +postoperatoria. I-EVOLUTION I-EVOLUTION -Mujer, B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -21 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -hijos. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -17 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -diagnosticó I-PAST_MEDICAL_HISTORY -DM I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -presentar I-PAST_MEDICAL_HISTORY -polidipsia I-PAST_MEDICAL_HISTORY +57 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -poliuria, I-PAST_MEDICAL_HISTORY -asociada I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -glicemia I-PAST_MEDICAL_HISTORY +Hepatitis I-PAST_MEDICAL_HISTORY +C. I-PAST_MEDICAL_HISTORY +Diagnosticado I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -ayunas I-PAST_MEDICAL_HISTORY -130 I-PAST_MEDICAL_HISTORY -mg/dl, I-PAST_MEDICAL_HISTORY -confirmada I-PAST_MEDICAL_HISTORY +plasmocitoma I-PAST_MEDICAL_HISTORY +óseo I-PAST_MEDICAL_HISTORY +solitario I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +undécima I-PAST_MEDICAL_HISTORY +costilla, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +evolucionó I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +Mieloma I-PAST_MEDICAL_HISTORY +Múltiple I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +Bence I-PAST_MEDICAL_HISTORY +Jones I-PAST_MEDICAL_HISTORY +Lambda. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -prueba I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tolerancia I-PAST_MEDICAL_HISTORY +diálisis I-PAST_MEDICAL_HISTORY +peritoneal I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -glucosa I-PAST_MEDICAL_HISTORY -oral I-PAST_MEDICAL_HISTORY -(PTGO) I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -75 I-PAST_MEDICAL_HISTORY -g: I-PAST_MEDICAL_HISTORY -116 I-PAST_MEDICAL_HISTORY -mg/dl I-PAST_MEDICAL_HISTORY -ayunas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -234 I-PAST_MEDICAL_HISTORY -mg/dl I-PAST_MEDICAL_HISTORY -post I-PAST_MEDICAL_HISTORY -carga. I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -descartó I-EXPLORATION -DM1 I-EXPLORATION -por I-EXPLORATION -autoanticuerpos I-EXPLORATION -negativos I-EXPLORATION -y I-EXPLORATION -péptido I-EXPLORATION -C I-EXPLORATION -normal, I-EXPLORATION -HbA1c I-EXPLORATION -6, I-EXPLORATION -8% I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -y I-EXPLORATION -orina I-EXPLORATION -sin I-EXPLORATION -glucosuria. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -no I-EXPLORATION +nefropatía I-PAST_MEDICAL_HISTORY +asociada I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +Mieloma I-PAST_MEDICAL_HISTORY +Múltiple. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Consulta B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +varias I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +lengua I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +labio I-PRESENT_ILLNESS +inferior I-PRESENT_ILLNESS +izquierdo, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +producían I-PRESENT_ILLNESS +importante I-PRESENT_ILLNESS +escozor. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION se I-EXPLORATION -encontraron I-EXPLORATION -signos I-EXPLORATION +observan I-EXPLORATION +cinco I-EXPLORATION +lesiones I-EXPLORATION +nodulares I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -RI, I-EXPLORATION -talla I-EXPLORATION -1, I-EXPLORATION -56 I-EXPLORATION -m I-EXPLORATION -y I-EXPLORATION -peso I-EXPLORATION -44, I-EXPLORATION -5 I-EXPLORATION -kg, I-EXPLORATION -IMC I-EXPLORATION -18 I-EXPLORATION -kg/m2. I-EXPLORATION -Se B-TREATMENT -indicó I-TREATMENT -tratamiento I-TREATMENT -no I-TREATMENT -farmacológico I-TREATMENT -y I-TREATMENT -metformina I-TREATMENT -850 I-TREATMENT -mg/2 I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día. I-TREATMENT -Evolucionó B-EVOLUTION -satisfactoriamente I-EVOLUTION -durante I-EVOLUTION -4 I-EVOLUTION -años, I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -complicaciones, I-EVOLUTION -mantuvo I-EVOLUTION -HbA1c I-EVOLUTION -entre I-EVOLUTION -6-7%. I-EVOLUTION -En B-TREATMENT -enero I-TREATMENT -de I-TREATMENT -2015 I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -la I-TREATMENT -metformina I-TREATMENT -por I-TREATMENT -intolerancia I-TREATMENT -gástrica I-TREATMENT -y I-TREATMENT -considerando I-TREATMENT -la I-TREATMENT -evolución I-TREATMENT -y B-FAMILY_HISTORY -los I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -DM, I-FAMILY_HISTORY -se B-TREATMENT -planteó I-TREATMENT -que I-TREATMENT -podría I-TREATMENT -presentar I-TREATMENT -MODY. I-TREATMENT - I-TREATMENT -Se B-FAMILY_HISTORY -estudió I-FAMILY_HISTORY -la I-FAMILY_HISTORY -DM I-FAMILY_HISTORY -en I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -con I-FAMILY_HISTORY -PTGO, I-FAMILY_HISTORY -pesquisándose I-FAMILY_HISTORY -DM I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -padre. I-FAMILY_HISTORY -Su I-FAMILY_HISTORY -hermano I-FAMILY_HISTORY -presentaba I-FAMILY_HISTORY -anormalidad I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -glicemia. I-FAMILY_HISTORY -La I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -no I-FAMILY_HISTORY -tenía I-FAMILY_HISTORY -DM. I-FAMILY_HISTORY - I-FAMILY_HISTORY -*Rango I-FAMILY_HISTORY -normal: I-FAMILY_HISTORY -1, I-FAMILY_HISTORY -1 I-FAMILY_HISTORY -– I-FAMILY_HISTORY -4, I-FAMILY_HISTORY -4 I-FAMILY_HISTORY -ng/ml. I-FAMILY_HISTORY - I-FAMILY_HISTORY -De I-FAMILY_HISTORY -la I-FAMILY_HISTORY -anamnesis I-FAMILY_HISTORY -familiar I-FAMILY_HISTORY -destaca I-FAMILY_HISTORY -una I-FAMILY_HISTORY -fuerte I-FAMILY_HISTORY -presencia I-FAMILY_HISTORY -de I-FAMILY_HISTORY -DM I-FAMILY_HISTORY -por I-FAMILY_HISTORY -la I-FAMILY_HISTORY -línea I-FAMILY_HISTORY -paterna, I-FAMILY_HISTORY -donde I-FAMILY_HISTORY -8 I-FAMILY_HISTORY -de I-FAMILY_HISTORY -9 I-FAMILY_HISTORY -hermanos I-FAMILY_HISTORY -del I-FAMILY_HISTORY -padre I-FAMILY_HISTORY -del I-FAMILY_HISTORY -caso I-FAMILY_HISTORY -índice, I-FAMILY_HISTORY -están I-FAMILY_HISTORY -diagnosticados I-FAMILY_HISTORY -con I-FAMILY_HISTORY -DM2, I-FAMILY_HISTORY -además I-FAMILY_HISTORY -de I-FAMILY_HISTORY -ambos I-FAMILY_HISTORY -abuelos. I-FAMILY_HISTORY -Por I-FAMILY_HISTORY -la I-FAMILY_HISTORY -línea I-FAMILY_HISTORY -materna, I-FAMILY_HISTORY -solamente I-FAMILY_HISTORY -la I-FAMILY_HISTORY -abuela I-FAMILY_HISTORY -y I-FAMILY_HISTORY -una I-FAMILY_HISTORY -tía I-FAMILY_HISTORY -tienen I-FAMILY_HISTORY -DM2. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Se B-EXPLORATION -utilizó I-EXPLORATION -la I-EXPLORATION -aplicación I-EXPLORATION +punta I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -Universidad I-EXPLORATION +lengua, I-EXPLORATION +cara I-EXPLORATION +lateral I-EXPLORATION de I-EXPLORATION -Exeter5, I-EXPLORATION -estimándose I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -presenta I-EXPLORATION -MODY I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -probabilidad I-EXPLORATION +esta I-EXPLORATION +y I-EXPLORATION +labio I-EXPLORATION +izquierdo. I-EXPLORATION +Tres I-EXPLORATION de I-EXPLORATION -75, I-EXPLORATION -5%. I-EXPLORATION -Se I-EXPLORATION -decide I-EXPLORATION -realizar I-EXPLORATION +los I-EXPLORATION +nódulos, I-EXPLORATION +presentaban I-EXPLORATION un I-EXPLORATION -estudio I-EXPLORATION -genético I-EXPLORATION -familiar, I-EXPLORATION -para I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -contaba I-EXPLORATION +color I-EXPLORATION +violáceo I-EXPLORATION con I-EXPLORATION el I-EXPLORATION -consentimiento I-EXPLORATION -informado I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -participantes I-EXPLORATION +centro I-EXPLORATION +ligeramente I-EXPLORATION +blanquecino I-EXPLORATION y I-EXPLORATION +los I-EXPLORATION +otros I-EXPLORATION +dos, I-EXPLORATION +más I-EXPLORATION +claros, I-EXPLORATION +sin I-EXPLORATION +tonalidad I-EXPLORATION +violácea. I-EXPLORATION +La I-EXPLORATION +consistencia I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -aprobación I-EXPLORATION -del I-EXPLORATION -Comité I-EXPLORATION +palpación I-EXPLORATION +era I-EXPLORATION +algo I-EXPLORATION +indurada. I-EXPLORATION +El I-EXPLORATION +nódulo I-EXPLORATION de I-EXPLORATION -Ética I-EXPLORATION -del I-EXPLORATION -Hospital I-EXPLORATION -San I-EXPLORATION -Juan I-EXPLORATION +la I-EXPLORATION +cara I-EXPLORATION +lateral I-EXPLORATION de I-EXPLORATION -Dios. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION +la I-EXPLORATION +lengua I-EXPLORATION +presentaba I-EXPLORATION un I-EXPLORATION -análisis I-EXPLORATION -genético-molecular I-EXPLORATION -(Laboratorio I-EXPLORATION +diámetro I-EXPLORATION +mayor I-EXPLORATION de I-EXPLORATION -Genética I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +cm, I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +labio, I-EXPLORATION +el I-EXPLORATION +mayor I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -Red I-EXPLORATION -UC-Christus I-EXPLORATION -Santiago, I-EXPLORATION -Chile) I-EXPLORATION +ellos, I-EXPLORATION +tenía I-EXPLORATION +1, I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +tamaño I-EXPLORATION +del I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION los I-EXPLORATION -exones I-EXPLORATION -1 I-EXPLORATION +nódulos I-EXPLORATION +era I-EXPLORATION +inferior I-EXPLORATION a I-EXPLORATION -10 I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -GCK I-EXPLORATION -mediante I-EXPLORATION -secuenciación I-EXPLORATION -directa I-EXPLORATION +estas I-EXPLORATION +medidas. I-EXPLORATION +Al B-EVOLUTION +mes I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +exploración I-EVOLUTION +oral, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +acude I-EVOLUTION +de I-EVOLUTION +nuevo, I-EVOLUTION +presentando I-EVOLUTION +lesiones I-EVOLUTION +de I-EVOLUTION +color I-EVOLUTION +púrpura I-EVOLUTION +perioculares I-EVOLUTION +bilaterales. I-EVOLUTION + I-EVOLUTION +Se B-EXPLORATION +procede I-EXPLORATION +a I-EXPLORATION +realizar I-EXPLORATION +un I-EXPLORATION +total I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -regiones I-EXPLORATION -codificantes I-EXPLORATION +3 I-EXPLORATION +biopsias, I-EXPLORATION +una I-EXPLORATION +del I-EXPLORATION +labio I-EXPLORATION y I-EXPLORATION +dos I-EXPLORATION de I-EXPLORATION las I-EXPLORATION -uniones I-EXPLORATION -intrón-exón. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -presentó I-EXPLORATION -una I-EXPLORATION -mutación I-EXPLORATION -en I-EXPLORATION +lesiones I-EXPLORATION +linguales. I-EXPLORATION +Dichas I-EXPLORATION +biopsias I-EXPLORATION +se I-EXPLORATION +describien I-EXPLORATION +como I-EXPLORATION +depósitos I-EXPLORATION +densos I-EXPLORATION +de I-EXPLORATION +material I-EXPLORATION +hialino, I-EXPLORATION +acelular, I-EXPLORATION +homogéneo I-EXPLORATION +que I-EXPLORATION +ocupa I-EXPLORATION +toda I-EXPLORATION la I-EXPLORATION -posición I-EXPLORATION -1343 I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -exón I-EXPLORATION -10 I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -GCK, I-EXPLORATION -correspondiente I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -cambio I-EXPLORATION +submucosa I-EXPLORATION +separando I-EXPLORATION +haces I-EXPLORATION +musculares I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +afectación I-EXPLORATION de I-EXPLORATION -guanina I-EXPLORATION -por I-EXPLORATION -adenina I-EXPLORATION -(1343 I-EXPLORATION -G>A); I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -otro I-EXPLORATION -alelo I-EXPLORATION -no I-EXPLORATION +paredes I-EXPLORATION +vasculares. I-EXPLORATION +Estos I-EXPLORATION +depósitos I-EXPLORATION se I-EXPLORATION -encontró I-EXPLORATION -dicha I-EXPLORATION -mutación I-EXPLORATION -(paciente I-EXPLORATION -heterocigota). I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -padre I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -hermano I-EXPLORATION -presentan I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -mutación I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -GCK I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -heterocigota. I-EXPLORATION -La I-EXPLORATION -madre I-EXPLORATION -mostró I-EXPLORATION -ambos I-EXPLORATION -alelos I-EXPLORATION -silvestres, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -no I-EXPLORATION -es I-EXPLORATION -MODY2 I-EXPLORATION -ni I-EXPLORATION -tiene I-EXPLORATION -DM. I-EXPLORATION -La I-EXPLORATION -variante I-EXPLORATION -encontrada I-EXPLORATION -probablemente I-EXPLORATION -es I-EXPLORATION -patogénica, I-EXPLORATION -pues I-EXPLORATION -genera I-EXPLORATION -un I-EXPLORATION -cambio I-EXPLORATION -no I-EXPLORATION -sinónimo I-EXPLORATION -o I-EXPLORATION -missense I-EXPLORATION -del I-EXPLORATION -aminoácido I-EXPLORATION -(aa) I-EXPLORATION -glicina I-EXPLORATION -por I-EXPLORATION -ácido I-EXPLORATION -aspártico I-EXPLORATION -(Gly448Asp) I-EXPLORATION -en I-EXPLORATION +tiñen I-EXPLORATION +con I-EXPLORATION la I-EXPLORATION -enzima I-EXPLORATION -glucoquinasa I-EXPLORATION -(GCK). I-EXPLORATION -Estos I-EXPLORATION -resultados I-EXPLORATION -permiten I-EXPLORATION -establecer I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +Rojo I-EXPLORATION +Congo I-EXPLORATION +presentado I-EXPLORATION +una I-EXPLORATION +birrefringencia I-EXPLORATION +verde I-EXPLORATION +manzana. I-EXPLORATION +Además I-EXPLORATION +con I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +tinción I-EXPLORATION de I-EXPLORATION -MODY2 I-EXPLORATION -en I-EXPLORATION +tioflavina I-EXPLORATION +T I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION una I-EXPLORATION -familia I-EXPLORATION -chilena I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION +fluorescencia I-EXPLORATION +verde-amarillenta. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +mucosa I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION una I-EXPLORATION -mutación I-EXPLORATION -no I-EXPLORATION -descrita I-EXPLORATION -previamente. I-EXPLORATION +ligera I-EXPLORATION +acantosis I-EXPLORATION +con I-EXPLORATION +paraqueratosis I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +leve I-EXPLORATION +infiltrado I-EXPLORATION +linfoplasmocitario. I-EXPLORATION I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -obesidad, I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -(HTA), I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -asociada I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -subclínico. I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -71 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -evaluó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -mal I-PRESENT_ILLNESS -control I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -HTA I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -diabetes I-PRESENT_ILLNESS -mellitus. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION +Ante I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +observados, I-EXPLORATION se I-EXPLORATION -observaba I-EXPLORATION -facies I-EXPLORATION -cushingoide I-EXPLORATION -y I-EXPLORATION -relleno I-EXPLORATION -de I-EXPLORATION -huecos I-EXPLORATION -supraclaviculares. I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -cortisol I-EXPLORATION -libre I-EXPLORATION -urinario I-EXPLORATION -(CLU): I-EXPLORATION -236 I-EXPLORATION -ug/24 I-EXPLORATION -h I-EXPLORATION -(VN I-EXPLORATION -hasta I-EXPLORATION -100 I-EXPLORATION -ug/24 I-EXPLORATION -h), I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -Nugent I-EXPLORATION -o I-EXPLORATION +solicita I-EXPLORATION +la I-EXPLORATION +realización I-EXPLORATION de I-EXPLORATION -supresión I-EXPLORATION -nocturna I-EXPLORATION +una I-EXPLORATION +Puncion I-EXPLORATION +aspiración I-EXPLORATION con I-EXPLORATION -dexametasona I-EXPLORATION -(Dx) I-EXPLORATION -1 I-EXPLORATION -mg: I-EXPLORATION -11, I-EXPLORATION -1 I-EXPLORATION -ug/dl I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -1, I-EXPLORATION -8 I-EXPLORATION -ug/dl), I-EXPLORATION -ACTH I-EXPLORATION -32, I-EXPLORATION -1pg/ml I-EXPLORATION -(VN I-EXPLORATION -hasta I-EXPLORATION -46 I-EXPLORATION -pg/ml). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -funcional: I-EXPLORATION -test I-EXPLORATION +aguja I-EXPLORATION +fina I-EXPLORATION +(PAAF) I-EXPLORATION de I-EXPLORATION -Dx/ I-EXPLORATION -desmopresina, I-EXPLORATION +grasa I-EXPLORATION +abdominal, I-EXPLORATION que I-EXPLORATION -mostró I-EXPLORATION -respuesta I-EXPLORATION +resulto I-EXPLORATION +positiva I-EXPLORATION +para I-EXPLORATION +material I-EXPLORATION +amiloide I-EXPLORATION +con I-EXPLORATION +tinción I-EXPLORATION de I-EXPLORATION -cortisol I-EXPLORATION -postestímulo, I-EXPLORATION -sugiriendo I-EXPLORATION -origen I-EXPLORATION -hipofisiario. I-EXPLORATION +Rojo I-EXPLORATION +Congo. I-EXPLORATION Se I-EXPLORATION -solicitó I-EXPLORATION -RM I-EXPLORATION +confirma I-EXPLORATION +con I-EXPLORATION +esto I-EXPLORATION +el I-EXPLORATION +diagnostico I-EXPLORATION de I-EXPLORATION -silla I-EXPLORATION -turca I-EXPLORATION +Amiloidosis I-EXPLORATION +Sistémica, I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +realizan I-EXPLORATION +diferentes I-EXPLORATION +pruebas I-EXPLORATION que I-EXPLORATION -demostró I-EXPLORATION -adenoma I-EXPLORATION -posterolateral I-EXPLORATION -izquierdo I-EXPLORATION +objetivan I-EXPLORATION +una I-EXPLORATION +alteración I-EXPLORATION +multiorgánica, I-EXPLORATION +con I-EXPLORATION +afectación I-EXPLORATION de I-EXPLORATION -6 I-EXPLORATION -mm, I-EXPLORATION -que I-EXPLORATION -determina I-EXPLORATION -leve I-EXPLORATION -remodelación I-EXPLORATION -del I-EXPLORATION -piso I-EXPLORATION -selar. I-EXPLORATION -Por B-TREATMENT -distintas I-TREATMENT -razones, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -no I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -cirugía. I-TREATMENT -En B-EXPLORATION -controles I-EXPLORATION -sucesivos I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -normalización I-EXPLORATION -del I-EXPLORATION -CLU I-EXPLORATION -sin I-EXPLORATION -mediar I-EXPLORATION -tratamiento. I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -3 I-EXPLORATION -años I-EXPLORATION -tuvo I-EXPLORATION -un I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -Nugent I-EXPLORATION -de I-EXPLORATION -3, I-EXPLORATION -5 I-EXPLORATION -ng/dl, I-EXPLORATION -ACTH: I-EXPLORATION -54, I-EXPLORATION -8 I-EXPLORATION -pg/ml I-EXPLORATION -y I-EXPLORATION -CLU: I-EXPLORATION -50, I-EXPLORATION -1 I-EXPLORATION -ug/24 I-EXPLORATION -h. I-EXPLORATION -Una I-EXPLORATION -nueva I-EXPLORATION -RM I-EXPLORATION -de I-EXPLORATION -silla I-EXPLORATION -turca I-EXPLORATION -mostró I-EXPLORATION -adenoma I-EXPLORATION -de I-EXPLORATION -similares I-EXPLORATION -características, I-EXPLORATION -sin I-EXPLORATION -evidencias I-EXPLORATION -de I-EXPLORATION -hemorragia I-EXPLORATION -intratumoral. I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -7 I-EXPLORATION -años I-EXPLORATION -tiene I-EXPLORATION -CLU I-EXPLORATION -28, I-EXPLORATION -8 I-EXPLORATION -ug/24 I-EXPLORATION -h, I-EXPLORATION -la I-EXPLORATION -diabetes I-EXPLORATION -mellitus I-EXPLORATION -mantiene I-EXPLORATION -un I-EXPLORATION -control I-EXPLORATION -adecuado I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -edad I-EXPLORATION -(HbA1c: I-EXPLORATION -7, I-EXPLORATION -6%) I-EXPLORATION +piel, I-EXPLORATION +tejido I-EXPLORATION +nervioso, I-EXPLORATION +aparato I-EXPLORATION +gastrointestinal, I-EXPLORATION +corazón I-EXPLORATION y I-EXPLORATION -ha I-EXPLORATION -disminuido I-EXPLORATION -10 I-EXPLORATION -kilos I-EXPLORATION -de I-EXPLORATION -peso I-EXPLORATION -desde I-EXPLORATION -su I-EXPLORATION -evaluación I-EXPLORATION -inicial. I-EXPLORATION +riñón. I-EXPLORATION I-EXPLORATION -Ambas B-EVOLUTION -pacientes I-EVOLUTION -aún I-EVOLUTION -sobreviven, I-EVOLUTION -a I-EVOLUTION +A B-EVOLUTION los I-EVOLUTION -82 I-EVOLUTION -y I-EVOLUTION -88 I-EVOLUTION -años, I-EVOLUTION -respectivamente I-EVOLUTION -y I-EVOLUTION -no I-EVOLUTION -manifiestan I-EVOLUTION -clínica I-EVOLUTION +15 I-EVOLUTION +meses I-EVOLUTION +del I-EVOLUTION +diagnostico I-EVOLUTION de I-EVOLUTION -hiperfunción I-EVOLUTION -endocrina. I-EVOLUTION +la I-EVOLUTION +Amiloidosis, I-EVOLUTION +fallece I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +como I-EVOLUTION +consecuencia I-EVOLUTION +de I-EVOLUTION +un I-EVOLUTION +megacolon I-EVOLUTION +y I-EVOLUTION +por I-EVOLUTION +fallo I-EVOLUTION +multiorgánico. I-EVOLUTION I-EVOLUTION -Hombre B-PRESENT_ILLNESS +Niño B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -66 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -zurdo, B-PAST_MEDICAL_HISTORY -hipertenso, I-PAST_MEDICAL_HISTORY -despertó I-PAST_MEDICAL_HISTORY -desorientado I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -disártrico, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -déficit I-PAST_MEDICAL_HISTORY -sensitivo-motor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -extremidades I-PAST_MEDICAL_HISTORY -derechas. I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -vigilia, I-PRESENT_ILLNESS -cumplía I-PRESENT_ILLNESS -órdenes I-PRESENT_ILLNESS -simples, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -embargo, I-PRESENT_ILLNESS -mantenía I-PRESENT_ILLNESS -cerrados I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -ojos, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -apertura I-PRESENT_ILLNESS -mecánica I-PRESENT_ILLNESS +siete I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS los I-PRESENT_ILLNESS -párpados I-PRESENT_ILLNESS -mostró I-PRESENT_ILLNESS -pupilas I-PRESENT_ILLNESS -iguales, I-PRESENT_ILLNESS -oculomotilidad I-PRESENT_ILLNESS -conservada I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -mirada I-PRESENT_ILLNESS -preferencial I-PRESENT_ILLNESS +15 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nacido I-PRESENT_ILLNESS +placa I-PRESENT_ILLNESS +violácea I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +crecimiento I-PRESENT_ILLNESS +progresivo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ocupaba I-PRESENT_ILLNESS +gran I-PRESENT_ILLNESS +parte I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +punta I-PRESENT_ILLNESS +nasal; I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +valorada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +pediatra I-PRESENT_ILLNESS +quien I-PRESENT_ILLNESS +mantiene I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +expectante I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +observar I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +continuaba I-PRESENT_ILLNESS +progresando, I-PRESENT_ILLNESS +ocasionándole I-PRESENT_ILLNESS +deformidad I-PRESENT_ILLNESS +facial, I-PRESENT_ILLNESS +decide I-PRESENT_ILLNESS +remitirla I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -izquierda, I-PRESENT_ILLNESS -hemiplejia I-PRESENT_ILLNESS -faciobraquiocrural I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -hemianopsia. I-PRESENT_ILLNESS -La B-EXPLORATION -TC I-EXPLORATION -de I-EXPLORATION -cerebro I-EXPLORATION -mostró I-EXPLORATION -hematoma I-EXPLORATION -fronto-parietal I-EXPLORATION -izquierdo. I-EXPLORATION -Al B-TREATMENT -segundo I-TREATMENT -día, I-TREATMENT -debido I-TREATMENT -al I-TREATMENT -progresivo I-TREATMENT -deterioro I-TREATMENT -clínico, I-TREATMENT -fue I-TREATMENT -necesario I-TREATMENT -drenar I-TREATMENT -el I-TREATMENT -hematoma, I-TREATMENT -que B-EVOLUTION -evolucionó I-EVOLUTION -sin I-EVOLUTION -complicaciones. I-EVOLUTION -Permaneció I-EVOLUTION -comprometido I-EVOLUTION -de I-EVOLUTION -conciencia I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -sexto I-EVOLUTION -día. I-EVOLUTION -Cuando I-EVOLUTION -recuperó I-EVOLUTION -la I-EVOLUTION -vigilancia I-EVOLUTION -podía I-EVOLUTION -apretar I-EVOLUTION -la I-EVOLUTION -mano I-EVOLUTION -izquierda, I-EVOLUTION -pero I-EVOLUTION -era I-EVOLUTION -incapaz I-EVOLUTION -de I-EVOLUTION -abrir I-EVOLUTION -voluntariamente I-EVOLUTION -los I-EVOLUTION -ojos, I-EVOLUTION -se I-EVOLUTION -pudo I-EVOLUTION -comprobar I-EVOLUTION -que I-EVOLUTION -conservaba I-EVOLUTION -la I-EVOLUTION -oculomotilidad I-EVOLUTION -voluntaria I-EVOLUTION -y I-EVOLUTION -dirigía I-EVOLUTION -la I-EVOLUTION -mirada I-EVOLUTION +nuestro I-PRESENT_ILLNESS +servicio. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Al B-EXPLORATION +ser I-EXPLORATION +valorada, I-EXPLORATION +detectamos I-EXPLORATION +deformidad I-EXPLORATION +del I-EXPLORATION +cartílago I-EXPLORATION +y I-EXPLORATION +discreta I-EXPLORATION +dificultad I-EXPLORATION +respiratoria. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +inicia I-TREATMENT +tratamiento I-TREATMENT +esclerosante I-TREATMENT +con I-TREATMENT +Betametazona I-TREATMENT +4 I-TREATMENT +mg I-TREATMENT +intralesional, I-TREATMENT +cuando I-TREATMENT +se I-TREATMENT +logró I-TREATMENT +la I-TREATMENT +fibrosis I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +su I-TREATMENT +exéresis I-TREATMENT +quirúrgica I-TREATMENT +de I-TREATMENT +la I-TREATMENT +misma I-TREATMENT +por I-TREATMENT +una I-TREATMENT +incisión I-TREATMENT +en I-TREATMENT +ala I-TREATMENT +de I-TREATMENT +gaviota I-TREATMENT +invertida. I-TREATMENT + I-TREATMENT +Paciente B-EVOLUTION a I-EVOLUTION -la I-EVOLUTION -orden. I-EVOLUTION -Desde I-EVOLUTION -el I-EVOLUTION -octavo I-EVOLUTION -día I-EVOLUTION -inició I-EVOLUTION -apertura I-EVOLUTION -palpebral I-EVOLUTION -parcial I-EVOLUTION -y I-EVOLUTION -transitoria I-EVOLUTION -del I-EVOLUTION -ojo I-EVOLUTION -izquierdo. I-EVOLUTION -En I-EVOLUTION los I-EVOLUTION -días I-EVOLUTION -subsiguientes I-EVOLUTION -lograba I-EVOLUTION -la I-EVOLUTION -elevación I-EVOLUTION -transitoria I-EVOLUTION -de I-EVOLUTION -ambos I-EVOLUTION -párpados, I-EVOLUTION -notándose I-EVOLUTION -al I-EVOLUTION -decimosegundo I-EVOLUTION -día I-EVOLUTION -mayor I-EVOLUTION -apertura I-EVOLUTION -del I-EVOLUTION -ojo I-EVOLUTION -derecho. I-EVOLUTION -Después I-EVOLUTION -del I-EVOLUTION -decimotercer I-EVOLUTION -día I-EVOLUTION -tenía I-EVOLUTION -elevación I-EVOLUTION -persistente I-EVOLUTION +tres I-EVOLUTION +meses I-EVOLUTION de I-EVOLUTION -ambos I-EVOLUTION -párpados. I-EVOLUTION +la I-EVOLUTION +intervención I-EVOLUTION +quirúrgica. I-EVOLUTION I-EVOLUTION -Hombre B-PRESENT_ILLNESS +Niña B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS +cinco I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY +que I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +quística I-PRESENT_ILLNESS +sobreelevada I-PRESENT_ILLNESS +azulada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +cm I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +diámetro I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +raíz I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cuero I-PRESENT_ILLNESS +cabelludo, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tamaño I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +sucesivas I-PRESENT_ILLNESS +visitas. I-PRESENT_ILLNESS +Según B-EXPLORATION +el I-EXPLORATION +especialista, I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +sugiere I-EXPLORATION +un I-EXPLORATION +pilomatricoma I-EXPLORATION +o I-EXPLORATION +epitelioma I-EXPLORATION +calcificante I-EXPLORATION +de I-EXPLORATION +Malherbe I-EXPLORATION +(puede I-EXPLORATION +ser I-EXPLORATION +azulado I-EXPLORATION +por I-EXPLORATION +su I-EXPLORATION +componente I-EXPLORATION +cálcico). I-EXPLORATION +Recomienda B-TREATMENT +la I-TREATMENT +extirpación I-TREATMENT +quirúrgica I-TREATMENT +como I-TREATMENT +actuación I-TREATMENT +diagnóstico-terapéutica. I-TREATMENT + I-TREATMENT + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +69 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que, B-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY +personales, I-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +adenocarcinoma I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -EF, I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -miocardiopatía. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -inicia I-PAST_MEDICAL_HISTORY -crisis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -quemante I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -manos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pies I-PAST_MEDICAL_HISTORY -desencadenadas I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -ejercicio, I-PAST_MEDICAL_HISTORY -exposición I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -sol I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fiebre. I-PAST_MEDICAL_HISTORY -Desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY +próstata I-PAST_MEDICAL_HISTORY +bien I-PAST_MEDICAL_HISTORY +diferenciado I-PAST_MEDICAL_HISTORY +tratado I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -disminución I-PAST_MEDICAL_HISTORY -progresiva I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -crisis. I-PAST_MEDICAL_HISTORY -Ocasionalmente I-PAST_MEDICAL_HISTORY -sensación I-PAST_MEDICAL_HISTORY +análogos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -mareo I-PAST_MEDICAL_HISTORY -subjetivo I-PAST_MEDICAL_HISTORY +LHRH I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -estitiquez-diarrea. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -42 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -parte I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -estudio I-PAST_MEDICAL_HISTORY -familiar I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -medición I-PAST_MEDICAL_HISTORY +mielolipoma I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -niveles I-PAST_MEDICAL_HISTORY -enzimáticos. I-PAST_MEDICAL_HISTORY -Inició I-PAST_MEDICAL_HISTORY -terapia I-PAST_MEDICAL_HISTORY +glándula I-PAST_MEDICAL_HISTORY +suprarrenal I-PAST_MEDICAL_HISTORY +derecha I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -reemplazo I-PAST_MEDICAL_HISTORY -enzimático I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -45 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -52 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -diagnostica I-PRESENT_ILLNESS -miocardiopatía I-PRESENT_ILLNESS -hipertrófica I-PRESENT_ILLNESS -y B-TREATMENT -se I-TREATMENT -instala I-TREATMENT -marcapaso. I-TREATMENT -Escasos B-EXPLORATION -angioqueratomas. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -clínico I-EXPLORATION -neurológico I-EXPLORATION -mostro I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -polineuropatía I-EXPLORATION -sensitiva I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION -neurofisiológica I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -polineuropatía I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -sensitivo I-EXPLORATION -axonal I-EXPLORATION -de I-EXPLORATION -fibras I-EXPLORATION -mielínicas I-EXPLORATION -gruesas I-EXPLORATION -y I-EXPLORATION -severo I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -fibras I-EXPLORATION -mielínicas I-EXPLORATION -delgadas I-EXPLORATION -y I-EXPLORATION -amielínicas, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -radiculopatía I-EXPLORATION -L5-S1 I-EXPLORATION -izquierda. I-EXPLORATION -Ausencia I-EXPLORATION -generalizada I-EXPLORATION -de I-EXPLORATION -RSC. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -evaluación I-EXPLORATION -intervalo I-EXPLORATION -R-R, I-EXPLORATION -debido I-EXPLORATION -al I-EXPLORATION -uso I-EXPLORATION -de I-EXPLORATION -marcapasos. I-EXPLORATION - I-EXPLORATION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -inicia I-PRESENT_ILLNESS +2, I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +cm I-PAST_MEDICAL_HISTORY +diagnosticado I-PAST_MEDICAL_HISTORY +casualmente I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +TAC I-PAST_MEDICAL_HISTORY +realizado I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +atrás. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Acudió B-PRESENT_ILLNESS a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -crisis I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -quemante I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -manos I-PRESENT_ILLNESS +astenia, I-PRESENT_ILLNESS +anorexia, I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +38, I-PRESENT_ILLNESS +0º I-PRESENT_ILLNESS +C, I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -pies, I-PRESENT_ILLNESS -desencadenados I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ejercicio, I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -calor I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -frío. I-PRESENT_ILLNESS -Refiere I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -pies I-PRESENT_ILLNESS -congelados, I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -pone I-PRESENT_ILLNESS -pies I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -agua I-PRESENT_ILLNESS -tibia I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -abriga. I-PRESENT_ILLNESS -Ocasionalmente I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -pinchazos. I-PRESENT_ILLNESS -Distensión I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +coincidiendo, I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +inicio I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +cuadro, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +caída I-PRESENT_ILLNESS +accidental I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -ocasional. I-PRESENT_ILLNESS -Escasos B-EXPLORATION -angioqueratomas. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION +cama. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración, I-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION -reciente I-EXPLORATION +paciente I-EXPLORATION +presentaba I-EXPLORATION +regular I-EXPLORATION +estado I-EXPLORATION +general I-EXPLORATION +aunque I-EXPLORATION +hemodinámica I-EXPLORATION +estable. I-EXPLORATION +El I-EXPLORATION +abdomen I-EXPLORATION +era I-EXPLORATION +globuloso I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +ligeramente I-EXPLORATION +distendido. I-EXPLORATION +A I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +dolor I-EXPLORATION en I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -estudio I-EXPLORATION -familiar, I-EXPLORATION +el I-EXPLORATION +hipocondrio I-EXPLORATION +derecho I-EXPLORATION con I-EXPLORATION -niveles I-EXPLORATION +signo I-EXPLORATION de I-EXPLORATION -enzimáticos. I-EXPLORATION -Inicio B-TREATMENT -reciente I-TREATMENT -de I-TREATMENT -terapia I-TREATMENT -de I-TREATMENT -remplazo I-TREATMENT -enzimática. I-TREATMENT -Evaluación B-EXPLORATION -clínica I-EXPLORATION -y I-EXPLORATION -neurofisiológica I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -neuropático I-EXPLORATION +Murphy I-EXPLORATION +positivo. I-EXPLORATION +La I-EXPLORATION +auscultación I-EXPLORATION +cardio I-EXPLORATION +respiratoria I-EXPLORATION +resultó I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +hemograma I-EXPLORATION +mostraba I-EXPLORATION +leucocitosis I-EXPLORATION de I-EXPLORATION -fibras I-EXPLORATION -mielínicas I-EXPLORATION -delgadas I-EXPLORATION +13.800 I-EXPLORATION +*10e9/L I-EXPLORATION y I-EXPLORATION -amielínicas. I-EXPLORATION -Ausencia I-EXPLORATION -generalizada I-EXPLORATION +neutrofilia I-EXPLORATION +(83%), I-EXPLORATION +hemoglobina I-EXPLORATION de I-EXPLORATION -RSC I-EXPLORATION +110 I-EXPLORATION +g/l I-EXPLORATION y I-EXPLORATION -evaluación I-EXPLORATION +bilirrubina I-EXPLORATION de I-EXPLORATION -intervalo I-EXPLORATION -R-R I-EXPLORATION -en I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -71 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -trasladado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -UCI I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -disnea, I-PRESENT_ILLNESS -hipotensión I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -desaturación, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -39.5°C. I-PRESENT_ILLNESS -Se B-EXPLORATION -diagnostica I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +mg/dl I-EXPLORATION +a I-EXPLORATION +expensas I-EXPLORATION de I-EXPLORATION -shock I-EXPLORATION -séptico I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -colitis I-EXPLORATION -infecciosa. I-EXPLORATION -A B-TREATMENT -su I-TREATMENT -ingreso I-TREATMENT -en I-TREATMENT -la I-TREATMENT -unidad I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -drogas I-TREATMENT -vasoactivas I-TREATMENT -(noradrenalina I-TREATMENT -a I-TREATMENT -0.1 I-TREATMENT -ugr/kg/min I-TREATMENT -y I-TREATMENT -dopamina I-TREATMENT -a I-TREATMENT -6 I-TREATMENT -ugr/kg/min) I-TREATMENT -y I-TREATMENT -cobertura I-TREATMENT -con I-TREATMENT -antibióticos I-TREATMENT -de I-TREATMENT -amplio I-TREATMENT -espectro. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -pocas I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -llegada I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -UCI, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -comienza I-EVOLUTION -a I-EVOLUTION -realizar I-EVOLUTION -deposiciones I-EVOLUTION -con I-EVOLUTION -aspecto I-EVOLUTION -melénico I-EVOLUTION -en I-EVOLUTION -cantidad I-EVOLUTION -abundante. I-EVOLUTION -Para B-EXPLORATION -facilitar I-EXPLORATION la I-EXPLORATION -valoración I-EXPLORATION -exacta I-EXPLORATION -del I-EXPLORATION -volumen I-EXPLORATION +indirecta I-EXPLORATION +(0, I-EXPLORATION +9 I-EXPLORATION +mg/dl). I-EXPLORATION + I-EXPLORATION +Fue I-EXPLORATION +realizada I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -heces, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -el I-EXPLORATION -aspecto I-EXPLORATION +urgencia I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +gran I-EXPLORATION +masa I-EXPLORATION +heterogénea I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -mismas I-EXPLORATION -se I-EXPLORATION -coloca I-EXPLORATION -un I-EXPLORATION -dispositivo I-EXPLORATION +16 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -incontinencia I-EXPLORATION -fecal I-EXPLORATION -Flexi-Seal I-EXPLORATION -FMS. I-EXPLORATION -Dicho I-EXPLORATION -dispositivo I-EXPLORATION -se I-EXPLORATION -mantuvo I-EXPLORATION -colocado I-EXPLORATION -durante I-EXPLORATION -6 I-EXPLORATION -días I-EXPLORATION -sin I-EXPLORATION -la I-EXPLORATION -aparición I-EXPLORATION +diámetro I-EXPLORATION +dependiente I-EXPLORATION de I-EXPLORATION -ninguna I-EXPLORATION -complicación, I-EXPLORATION -procediéndose I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -retirada I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -disminución I-EXPLORATION -del I-EXPLORATION -volumen I-EXPLORATION +glándula I-EXPLORATION +suprarrenal I-EXPLORATION +derecha I-EXPLORATION +con I-EXPLORATION +compresión I-EXPLORATION de I-EXPLORATION -heces, I-EXPLORATION -así I-EXPLORATION +vena I-EXPLORATION +cava, I-EXPLORATION +sin I-EXPLORATION +poder I-EXPLORATION +discernir I-EXPLORATION +si I-EXPLORATION +se I-EXPLORATION +trataba I-EXPLORATION +de I-EXPLORATION +hematoma I-EXPLORATION +o I-EXPLORATION +absceso. I-EXPLORATION +La I-EXPLORATION +TAC I-EXPLORATION +confirmó I-EXPLORATION +tal I-EXPLORATION +hallazgo, I-EXPLORATION +informándolo I-EXPLORATION como I-EXPLORATION -el I-EXPLORATION -aumento I-EXPLORATION +hematoma I-EXPLORATION +con I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -consistencia I-EXPLORATION +sangrado I-EXPLORATION +activo, I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -mismas. I-EXPLORATION -En B-TREATMENT -su I-TREATMENT -8º I-TREATMENT -día I-TREATMENT +16 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +que I-EXPLORATION +comprimía I-EXPLORATION +y I-EXPLORATION +desplazaba I-EXPLORATION +vena I-EXPLORATION +cava. I-EXPLORATION +Se B-TREATMENT +indicó I-TREATMENT +laparotomía I-TREATMENT +urgente I-TREATMENT en I-TREATMENT la I-TREATMENT -unidad I-TREATMENT +que I-TREATMENT se I-TREATMENT -inicia I-TREATMENT -aporte I-TREATMENT -nutricional I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -enteral, I-TREATMENT -con I-TREATMENT -una I-TREATMENT -mala I-TREATMENT -tolerancia I-TREATMENT -por I-TREATMENT -parte I-TREATMENT +realizó I-TREATMENT +suprarrenalectomía I-TREATMENT +derecha I-TREATMENT +y I-TREATMENT +exéresis I-TREATMENT del I-TREATMENT -paciente, I-TREATMENT -realizando I-TREATMENT -varias I-TREATMENT -deposiciones I-TREATMENT -diarias I-TREATMENT -aunque I-TREATMENT -en I-TREATMENT -escasa I-TREATMENT -cantidad. I-TREATMENT -Además, I-TREATMENT -una I-TREATMENT -vez I-TREATMENT -solucionado I-TREATMENT -el I-TREATMENT -episodio I-TREATMENT -de I-TREATMENT -sangrado I-TREATMENT -digestivo I-TREATMENT -se I-TREATMENT -inicio I-TREATMENT -profilaxis I-TREATMENT -antitrombótica I-TREATMENT -con I-TREATMENT -enoxaparina I-TREATMENT -40 I-TREATMENT -mg/día I-TREATMENT -subcutáneo. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -día I-EVOLUTION -25º I-EVOLUTION -tras I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -retirada I-EVOLUTION -del I-EVOLUTION -dispositivo, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -comienza I-EVOLUTION -de I-EVOLUTION -manera I-EVOLUTION -brusca I-EVOLUTION -con I-EVOLUTION -dos I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -rectorragia I-EVOLUTION -importante, I-EVOLUTION +hematoma. I-TREATMENT +El B-EVOLUTION +postoperatorio I-EVOLUTION +transcurrió I-EVOLUTION sin I-EVOLUTION -producirse I-EVOLUTION -inestabilización I-EVOLUTION -hemodinámica. I-EVOLUTION -Se B-EXPLORATION -le I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -colonoscopia I-EXPLORATION -urgente I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -mucosa I-EXPLORATION -normal I-EXPLORATION -hasta I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -recto I-EXPLORATION -distal, I-EXPLORATION -lugar I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -una I-EXPLORATION -ulceración I-EXPLORATION -que I-EXPLORATION -abarca I-EXPLORATION -la I-EXPLORATION -mitad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -circunferencia, I-EXPLORATION -existiendo I-EXPLORATION -además I-EXPLORATION -depósitos I-EXPLORATION -de I-EXPLORATION -fibrina I-EXPLORATION -y I-EXPLORATION -zonas I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -necrótico, I-EXPLORATION -que I-EXPLORATION -impresiona I-EXPLORATION -de I-EXPLORATION -ulceración I-EXPLORATION -por I-EXPLORATION -sonda. I-EXPLORATION - I-EXPLORATION +incidencias I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +décimo I-EVOLUTION +día. I-EVOLUTION + I-EVOLUTION -Niña B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -natural B-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -procedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -municipio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Puerto I-PAST_MEDICAL_HISTORY -Guzmán, I-PAST_MEDICAL_HISTORY -Putumayo, I-PAST_MEDICAL_HISTORY -llevada B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -supurante I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -cuello I-PRESENT_ILLNESS -presente I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS +74 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ingresó I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +HLC I-PRESENT_ILLNESS el I-PRESENT_ILLNESS -nacimiento, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -cedió I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -antibióticos. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -que I-EXPLORATION -sugería I-EXPLORATION -una I-EXPLORATION -fístula, I-EXPLORATION -según I-EXPLORATION -lo I-EXPLORATION -referido I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -historia I-EXPLORATION -clínica. I-EXPLORATION -Con B-TREATMENT -este I-TREATMENT -diagnóstico I-TREATMENT -se I-TREATMENT -programó I-TREATMENT -para I-TREATMENT -cirugía. I-TREATMENT -En B-EXPLORATION -exámenes I-EXPLORATION -prequirúrgicos I-EXPLORATION -se I-EXPLORATION -reportó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -tripomastigotes I-EXPLORATION -de I-EXPLORATION -T. I-EXPLORATION -cruzi I-EXPLORATION -en I-EXPLORATION -extendido I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -periférica. I-EXPLORATION -Se B-TREATMENT -prescribió I-TREATMENT -tratamiento I-TREATMENT -etiológico I-TREATMENT -con I-TREATMENT -benzonidazol I-TREATMENT -por I-TREATMENT -60 I-TREATMENT -días. I-TREATMENT -El B-EXPLORATION -diagnóstico I-EXPLORATION -fue I-EXPLORATION -confirmado I-EXPLORATION -mediante I-EXPLORATION -aislamiento, I-EXPLORATION -cultivo, I-EXPLORATION -isoenzimas, I-EXPLORATION -inoculación I-EXPLORATION -en I-EXPLORATION -ratón I-EXPLORATION -y I-EXPLORATION -PCR. I-EXPLORATION - I-EXPLORATION - -Hombre B-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -16 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -procedente B-PAST_MEDICAL_HISTORY +junio I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +2007. I-PRESENT_ILLNESS +Tenía B-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +mórbidos I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +haber I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +colecistectomizado I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +operado I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY +hernia I-PAST_MEDICAL_HISTORY +inguinal. I-PAST_MEDICAL_HISTORY +Era I-PAST_MEDICAL_HISTORY +casado, I-PAST_MEDICAL_HISTORY +jubilado I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +trabajado, I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +mayor I-PAST_MEDICAL_HISTORY +parte I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +vida, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +criaderos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +aves I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +zonas I-PAST_MEDICAL_HISTORY +rurales I-PAST_MEDICAL_HISTORY del I-PAST_MEDICAL_HISTORY -municipio I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -Peñón, I-PAST_MEDICAL_HISTORY -Santander. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS +Área I-PAST_MEDICAL_HISTORY +Metropolitana. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Su B-PRESENT_ILLNESS cuadro I-PRESENT_ILLNESS +clínico I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +iniciado I-PRESENT_ILLNESS +aproximadamente I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +compromiso I-PRESENT_ILLNESS +moderado I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +estado I-PRESENT_ILLNESS +general, I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +vespertina I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -consistente I-PRESENT_ILLNESS +peso, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -eritema I-PRESENT_ILLNESS +ese I-PRESENT_ILLNESS +momento I-PRESENT_ILLNESS +cuantificaba I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +diez I-PRESENT_ILLNESS +kilos. I-PRESENT_ILLNESS +Consultó I-PRESENT_ILLNESS +médico I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS +ambulatoria I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +varias I-PRESENT_ILLNESS +oportunidades I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -palpebral I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +realizaron I-PRESENT_ILLNESS +diversos I-PRESENT_ILLNESS +exámenes I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +llegar I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -secreción I-PRESENT_ILLNESS -ocular I-PRESENT_ILLNESS -purulenta. I-PRESENT_ILLNESS -En B-EXPLORATION +un I-PRESENT_ILLNESS +diagnóstico. I-PRESENT_ILLNESS +Destacaban I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +ecograñay I-PRESENT_ILLNESS +tomograña I-PRESENT_ILLNESS +axial I-PRESENT_ILLNESS +computariza-da I-PRESENT_ILLNESS +(TAC) I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +abdomen I-PRESENT_ILLNESS +"sin I-PRESENT_ILLNESS +hallazgos I-PRESENT_ILLNESS +significativos" I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +ecocardiograma I-PRESENT_ILLNESS +trans-torácico I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +informaba I-PRESENT_ILLNESS +insuficiencia I-PRESENT_ILLNESS +aórtica I-PRESENT_ILLNESS +leve I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dilatación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cavidades I-PRESENT_ILLNESS +izquierdas. I-PRESENT_ILLNESS +Fue B-DERIVED_FROM/TO +derivado I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +HLC I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +completar I-DERIVED_FROM/TO +estudio. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Al B-EXPLORATION +ingreso I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +no I-EXPLORATION +refería I-EXPLORATION +molestias I-EXPLORATION +específicas I-EXPLORATION +y I-EXPLORATION el I-EXPLORATION examen I-EXPLORATION físico I-EXPLORATION +no I-EXPLORATION +contribuía I-EXPLORATION +para I-EXPLORATION +orientar I-EXPLORATION +el I-EXPLORATION +diagnóstico. I-EXPLORATION +No I-EXPLORATION +tenía I-EXPLORATION +soplo I-EXPLORATION +cardíaco, I-EXPLORATION +visceromegalia, I-EXPLORATION +lesiones I-EXPLORATION +cutáneas I-EXPLORATION +ni I-EXPLORATION +mucosas, I-EXPLORATION +alteraciones I-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +pulmonar I-EXPLORATION +ni I-EXPLORATION +de I-EXPLORATION +otros I-EXPLORATION +sistemas. I-EXPLORATION +Sólo I-EXPLORATION se I-EXPLORATION -encontró I-EXPLORATION -edema I-EXPLORATION -palpebral I-EXPLORATION -y I-EXPLORATION -conjuntiva I-EXPLORATION -izquierda I-EXPLORATION -hiperémica I-EXPLORATION -sin I-EXPLORATION -secreciones. I-EXPLORATION -Se B-TREATMENT -hizo I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -celulitis I-TREATMENT -periorbitaria I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -manejo I-TREATMENT -antibiótico I-TREATMENT -ambulatorio. I-TREATMENT -Un B-EVOLUTION -año I-EVOLUTION -después I-EVOLUTION -consultó I-EVOLUTION -por I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -tres I-EVOLUTION -días I-EVOLUTION -consistente I-EVOLUTION -en I-EVOLUTION -debilidad, I-EVOLUTION -fiebre I-EVOLUTION -subjetiva, I-EVOLUTION -disnea, I-EVOLUTION -cefalea, I-EVOLUTION -malestar I-EVOLUTION -general I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -faríngeo. I-EVOLUTION -En B-EXPLORATION +verificó I-EXPLORATION la I-EXPLORATION -ficha I-EXPLORATION -epide-miológica I-EXPLORATION -se I-EXPLORATION -consignó I-EXPLORATION -signo I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -Romaña I-EXPLORATION -positivo I-EXPLORATION -(probablemente I-EXPLORATION -en I-EXPLORATION -retrospectiva). I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -pruebas I-EXPLORATION -serológicas, I-EXPLORATION -reportadas I-EXPLORATION -como I-EXPLORATION -Elisa I-EXPLORATION -positivo I-EXPLORATION -e I-EXPLORATION -IFI I-EXPLORATION -reactivo I-EXPLORATION -con I-EXPLORATION -título I-EXPLORATION +fiebre I-EXPLORATION +irregular, I-EXPLORATION +alrededor I-EXPLORATION de I-EXPLORATION -1: I-EXPLORATION -32, I-EXPLORATION -por I-EXPLORATION -parte I-EXPLORATION +38°C, I-EXPLORATION +y I-EXPLORATION +decaimiento. I-EXPLORATION +Se I-EXPLORATION +inició I-EXPLORATION +estudio I-EXPLORATION del I-EXPLORATION -Laboratorio I-EXPLORATION -Departamental I-EXPLORATION +síndrome I-EXPLORATION +febril I-EXPLORATION +prolongado. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +hemograma I-EXPLORATION +mostraba I-EXPLORATION +anemia I-EXPLORATION +moderada I-EXPLORATION +(hematocrito I-EXPLORATION +34, I-EXPLORATION +1%, I-EXPLORATION +hemoglobina I-EXPLORATION +11, I-EXPLORATION +3 I-EXPLORATION +gr%), I-EXPLORATION +leucocitos I-EXPLORATION +en I-EXPLORATION +rango I-EXPLORATION +normal, I-EXPLORATION +neutrofilia I-EXPLORATION de I-EXPLORATION -Salud I-EXPLORATION -Pública I-EXPLORATION +76%) I-EXPLORATION +sin I-EXPLORATION +desviación I-EXPLORATION +a I-EXPLORATION +izquierda I-EXPLORATION +y I-EXPLORATION +VHS I-EXPLORATION de I-EXPLORATION -Santander. I-EXPLORATION -Se B-TREATMENT -administró I-TREATMENT -tratamiento I-TREATMENT -etiológico I-TREATMENT -con I-TREATMENT -benzonidazol I-TREATMENT -a I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -250 I-TREATMENT -mg/día I-TREATMENT -durante I-TREATMENT -60 I-TREATMENT -días. I-TREATMENT -El B-EXPLORATION -diagnóstico I-EXPLORATION -fue I-EXPLORATION -confirmado I-EXPLORATION -mediante I-EXPLORATION -serología I-EXPLORATION -por I-EXPLORATION -IFI I-EXPLORATION +36 I-EXPLORATION +mm/h. I-EXPLORATION +La I-EXPLORATION +función I-EXPLORATION +hepática I-EXPLORATION +y I-EXPLORATION +renal I-EXPLORATION +estaban I-EXPLORATION +normales, I-EXPLORATION +la I-EXPLORATION +albuminemia I-EXPLORATION +disminuida I-EXPLORATION +(3, I-EXPLORATION +3 I-EXPLORATION +gr%), I-EXPLORATION +la I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION reactiva I-EXPLORATION -1: I-EXPLORATION -64 I-EXPLORATION -en I-EXPLORATION +moderadamente I-EXPLORATION +elevada I-EXPLORATION +y I-EXPLORATION el I-EXPLORATION -INS. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -envió I-EXPLORATION -muestra I-EXPLORATION +examen I-EXPLORATION de I-EXPLORATION -sangre I-EXPLORATION -para I-EXPLORATION -cultivo. I-EXPLORATION - I-EXPLORATION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -procedente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -municipio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Carepa, I-PAST_MEDICAL_HISTORY -quien B-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -llevada I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -rinorrea I-PRESENT_ILLNESS -hialina I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -diarreicas I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -moco I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -sangre. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -anterior I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -epistaxis. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -hipoactiva, I-EXPLORATION -con I-EXPLORATION -palidez I-EXPLORATION -generalizada I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION -epistaxis I-EXPLORATION -reciente I-EXPLORATION +orina I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +no I-EXPLORATION +evidenciaba I-EXPLORATION +alteraciones I-EXPLORATION +del I-EXPLORATION +parénquima I-EXPLORATION +pulmonar I-EXPLORATION +ni I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +silueta I-EXPLORATION +cardíaca. I-EXPLORATION +Tanto I-EXPLORATION en I-EXPLORATION -narina I-EXPLORATION -derecha, I-EXPLORATION -temperatura I-EXPLORATION -axilar I-EXPLORATION +la I-EXPLORATION +ecograña I-EXPLORATION +abdominal I-EXPLORATION +como I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +TAC I-EXPLORATION de I-EXPLORATION -37, I-EXPLORATION -5 I-EXPLORATION -°C, I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION +abdomen, I-EXPLORATION +realizadas I-EXPLORATION +durante I-EXPLORATION +su I-EXPLORATION +hospitalización, I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +nodulos I-EXPLORATION +espíemeos. I-EXPLORATION +Estaba I-EXPLORATION +solicitado I-EXPLORATION +un I-EXPLORATION +ecocardiograma I-EXPLORATION +trans-esofágico. I-EXPLORATION +Por I-EXPLORATION +no I-EXPLORATION +presentar I-EXPLORATION +expectoración, I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +hicieron I-EXPLORATION +baciloscopias I-EXPLORATION de I-EXPLORATION -96 I-EXPLORATION -por I-EXPLORATION -minuto I-EXPLORATION +contenido I-EXPLORATION +gástrico I-EXPLORATION +que I-EXPLORATION +resultaron I-EXPLORATION +negativas. I-EXPLORATION +El I-EXPLORATION +urocultivo I-EXPLORATION +también I-EXPLORATION +fue I-EXPLORATION +negativo I-EXPLORATION y I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION +los I-EXPLORATION +hemocultivos I-EXPLORATION +tomados I-EXPLORATION +al I-EXPLORATION +ingreso, I-EXPLORATION +no I-EXPLORATION +presentaron I-EXPLORATION +desarrollo. I-EXPLORATION +Como I-EXPLORATION +parte I-EXPLORATION +del I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -32 I-EXPLORATION -por I-EXPLORATION -minuto. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -abdomen I-EXPLORATION +un I-EXPLORATION +síndrome I-EXPLORATION +febril I-EXPLORATION +prolongado I-EXPLORATION se I-EXPLORATION -encontró I-EXPLORATION -hepatoesplenomegalia. I-EXPLORATION -Con B-TREATMENT -esta I-TREATMENT -historia I-TREATMENT -se I-TREATMENT -hizo I-TREATMENT -una I-TREATMENT -impresión I-TREATMENT -diagnóstica I-TREATMENT -de I-TREATMENT -dengue I-TREATMENT -con I-TREATMENT -manifestaciones I-TREATMENT -hemorrágicas I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -líquidos I-TREATMENT -y I-TREATMENT -antipiréticos. I-TREATMENT - I-TREATMENT -Los B-EXPLORATION +solicitaron I-EXPLORATION +también I-EXPLORATION exámenes I-EXPLORATION -paraclínicos I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -reportaron I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -hemoglobina I-EXPLORATION -6, I-EXPLORATION -5 I-EXPLORATION -g/dl, I-EXPLORATION -hematocrito I-EXPLORATION -18, I-EXPLORATION -4%, I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -leucocitos I-EXPLORATION -8.600/ml, I-EXPLORATION -recuento I-EXPLORATION +inmunológicos: I-EXPLORATION +anticuerpos I-EXPLORATION +antinucleares, I-EXPLORATION +factor I-EXPLORATION +reumatold I-EXPLORATION +eo, I-EXPLORATION +cuantificación I-EXPLORATION de I-EXPLORATION -plaquetas I-EXPLORATION -30.000/µl, I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -2, I-EXPLORATION -2 I-EXPLORATION -mg/dl I-EXPLORATION +C3 I-EXPLORATION y I-EXPLORATION -bilirrubina I-EXPLORATION -directa I-EXPLORATION -0, I-EXPLORATION -7 I-EXPLORATION -mg/dl. I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -hospitalización, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -persistió I-EVOLUTION -con I-EVOLUTION -fiebre I-EVOLUTION -por B-EXPLORATION +C4, I-EXPLORATION +anticuerpos I-EXPLORATION +anti-cardiolipina, I-EXPLORATION +todo I-EXPLORATION lo I-EXPLORATION -que I-EXPLORATION +cual I-EXPLORATION +resultó I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +electroforesis I-EXPLORATION +de I-EXPLORATION +proteínas I-EXPLORATION +demostró I-EXPLORATION +una I-EXPLORATION +discreta I-EXPLORATION +hipoalbuminemia I-EXPLORATION +e I-EXPLORATION +hipergamaglobulinemia I-EXPLORATION +difusa I-EXPLORATION +moderada. I-EXPLORATION + I-EXPLORATION +Al I-EXPLORATION +11° I-EXPLORATION +día I-EXPLORATION +de I-EXPLORATION +hospitalización, I-EXPLORATION se I-EXPLORATION -solicitó I-EXPLORATION -gota I-EXPLORATION -gruesa, I-EXPLORATION +constató I-EXPLORATION la I-EXPLORATION -cual I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -P. I-EXPLORATION -vivax. I-EXPLORATION +aparición I-EXPLORATION +de I-EXPLORATION +petequias I-EXPLORATION +subconjuntivales. I-EXPLORATION Con B-TREATMENT este I-TREATMENT -resultado I-TREATMENT +nuevo I-TREATMENT +hallazgo I-TREATMENT +al I-TREATMENT +examen I-TREATMENT +físico, I-TREATMENT +se I-TREATMENT +planteó I-TREATMENT +la I-TREATMENT +hipótesis I-TREATMENT +diagnóstica I-TREATMENT +de I-TREATMENT +endocarditis I-TREATMENT +infecciosa I-TREATMENT +y, I-TREATMENT +previa I-TREATMENT +toma I-TREATMENT +de I-TREATMENT +nueva I-TREATMENT +serie I-TREATMENT +de I-TREATMENT +hemocultivos, I-TREATMENT se I-TREATMENT inició I-TREATMENT tratamiento I-TREATMENT con I-TREATMENT -cloroquina. I-TREATMENT -La B-EVOLUTION +penicilina I-TREATMENT +y I-TREATMENT +gentamicina I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +endovenosa. I-TREATMENT +El B-EVOLUTION paciente I-EVOLUTION -presentó I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION +se I-EVOLUTION +mantuvo I-EVOLUTION +estable I-EVOLUTION +en I-EVOLUTION su I-EVOLUTION -cuadro I-EVOLUTION -febril. I-EVOLUTION -A B-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -su I-TREATMENT -estado I-TREATMENT -hematológico, I-TREATMENT -no I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -ninguna I-TREATMENT -intervención. I-TREATMENT -Al B-EVOLUTION -sexto I-EVOLUTION -día I-EVOLUTION +condición, I-EVOLUTION +con I-EVOLUTION +fiebre I-EVOLUTION +irregular I-EVOLUTION +y, I-EVOLUTION +posteriormente, I-EVOLUTION se I-EVOLUTION -dio I-EVOLUTION -de I-EVOLUTION -alta. I-EVOLUTION +pesquisó I-EVOLUTION +un I-EVOLUTION +soplo I-EVOLUTION +cardíaco. I-EVOLUTION I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -realizó I-PRESENT_ILLNESS -múltiples I-PRESENT_ILLNESS -consultas I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -largo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -debido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -oído I-PRESENT_ILLNESS -tapado I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hipoacusia I-PRESENT_ILLNESS -ligera, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -lado I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -manejada I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -tapón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cerumen I-PRESENT_ILLNESS -repetidamente I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -medicina I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -lavados I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -oído. I-PRESENT_ILLNESS -Sin I-PRESENT_ILLNESS -embargo, I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -incrementaron I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -profundizó I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -hipoacusia I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -llegar I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -sordera I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conducción I-PRESENT_ILLNESS -definida I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -otorrinolaringólogo. I-PRESENT_ILLNESS -En B-EXPLORATION +Al B-EXPLORATION +14° I-EXPLORATION +día I-EXPLORATION +se I-EXPLORATION +detectó I-EXPLORATION +crecimiento I-EXPLORATION +bacteriano I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +hemocultivos I-EXPLORATION +tomados I-EXPLORATION +al I-EXPLORATION +paciente I-EXPLORATION +tres I-EXPLORATION +días I-EXPLORATION +antes. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -consulta I-EXPLORATION -con I-EXPLORATION -este I-EXPLORATION -especialista, I-EXPLORATION -también I-EXPLORATION +primera I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +Gram I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -pequeña I-EXPLORATION -masa I-EXPLORATION +realizó I-EXPLORATION +directamente I-EXPLORATION +del I-EXPLORATION +vial I-EXPLORATION de I-EXPLORATION -apariencia I-EXPLORATION -tumoral I-EXPLORATION +cultivo, I-EXPLORATION +se I-EXPLORATION +visualizaron I-EXPLORATION +cocobacilos I-EXPLORATION +grampositivos. I-EXPLORATION +Posteriormente I-EXPLORATION +se I-EXPLORATION +aclaró I-EXPLORATION que I-EXPLORATION -protruía I-EXPLORATION +se I-EXPLORATION +trataba I-EXPLORATION +de I-EXPLORATION +cocobacilos I-EXPLORATION +gramnegativos I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +17° I-EXPLORATION +día I-EXPLORATION +de I-EXPLORATION +ingresado I-EXPLORATION +se I-EXPLORATION +emitió I-EXPLORATION +un I-EXPLORATION +pre-informe I-EXPLORATION +dando I-EXPLORATION +cuenta I-EXPLORATION del I-EXPLORATION -oído I-EXPLORATION -medio I-EXPLORATION -con I-EXPLORATION -lesión I-EXPLORATION -parcial I-EXPLORATION +desarrollo I-EXPLORATION de I-EXPLORATION +un I-EXPLORATION +bacilo I-EXPLORATION +gramnegativo, I-EXPLORATION +probablemente I-EXPLORATION +del I-EXPLORATION +grupo I-EXPLORATION +HACEK. I-EXPLORATION +Por I-EXPLORATION la I-EXPLORATION -membrana I-EXPLORATION -timpánica. I-EXPLORATION -Fue B-TREATMENT -llevada I-TREATMENT -a I-TREATMENT -cirugía I-TREATMENT -para I-TREATMENT -resección-biopsia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -y I-TREATMENT -se I-TREATMENT -obtuvieron, I-TREATMENT -mediante I-TREATMENT -miringotomía, I-TREATMENT -múltiples I-TREATMENT -fragmentos I-TREATMENT -de I-TREATMENT -tejido I-TREATMENT -de I-TREATMENT -consistencia I-TREATMENT -firme, I-TREATMENT +dificultad I-EXPLORATION +en I-EXPLORATION +llegar I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +diagnóstico I-EXPLORATION +microbiológico I-EXPLORATION +exacto, I-EXPLORATION +se I-EXPLORATION +envió I-EXPLORATION +la I-EXPLORATION +cepa I-EXPLORATION +al I-EXPLORATION +ISP I-EXPLORATION +para I-EXPLORATION +identificación. I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +resultado I-TREATMENT de I-TREATMENT -color I-TREATMENT -parduzco, I-TREATMENT -con I-TREATMENT -escaso I-TREATMENT -sangrado. I-TREATMENT -No I-TREATMENT +este I-TREATMENT +examen I-TREATMENT se I-TREATMENT -mencionó I-TREATMENT -por I-TREATMENT -parte I-TREATMENT -del I-TREATMENT -especialista I-TREATMENT +cambió I-TREATMENT el I-TREATMENT -compromiso I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cadena I-TREATMENT -de I-TREATMENT -huesecillos I-TREATMENT -ni I-TREATMENT -del I-TREATMENT -nervio I-TREATMENT -facial. I-TREATMENT +esquema I-TREATMENT +antimicrobiano I-TREATMENT +a I-TREATMENT +ampicilina, I-TREATMENT +gentamicina I-TREATMENT +y I-TREATMENT +ceftriaxona. I-TREATMENT I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -histológico, I-EXPLORATION +El B-EXPLORATION +22° I-EXPLORATION +día I-EXPLORATION +de I-EXPLORATION +hospitalización I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -fragmento I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +ecocardiograma I-EXPLORATION +trans-esofágico I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +servicio I-EXPLORATION de I-EXPLORATION -tejido I-EXPLORATION -recubierto I-EXPLORATION -por I-EXPLORATION -epitelio I-EXPLORATION -escamoso I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -epitelial I-EXPLORATION -benigno I-EXPLORATION -de I-EXPLORATION -crecimiento I-EXPLORATION -expansivo, I-EXPLORATION -compuesto I-EXPLORATION -por I-EXPLORATION -estructuras I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -de I-EXPLORATION -trabécula I-EXPLORATION -y I-EXPLORATION -tubulares I-EXPLORATION -revestidas I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -capa I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -rectangulares I-EXPLORATION -sin I-EXPLORATION -atipias I-EXPLORATION -ni I-EXPLORATION -mitosis, I-EXPLORATION -con I-EXPLORATION -secreción I-EXPLORATION +cardiología I-EXPLORATION +del I-EXPLORATION +Hospital I-EXPLORATION +Barros I-EXPLORATION +Luco I-EXPLORATION +Trudeau. I-EXPLORATION +En I-EXPLORATION +dicho I-EXPLORATION +examen I-EXPLORATION +se I-EXPLORATION +visualizaron I-EXPLORATION +múltiples I-EXPLORATION +vegetaciones I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -luz, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -áreas I-EXPLORATION -sólidas I-EXPLORATION -compuestas I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -escaso I-EXPLORATION -citoplasma I-EXPLORATION -y I-EXPLORATION -núcleo I-EXPLORATION -pequeño I-EXPLORATION -hipercromático. I-EXPLORATION -El I-EXPLORATION -estroma I-EXPLORATION -estaba I-EXPLORATION -ricamente I-EXPLORATION -irrigado. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -estudios I-EXPLORATION -de I-EXPLORATION -histoquímica I-EXPLORATION +válvula I-EXPLORATION +aórtica I-EXPLORATION con I-EXPLORATION -coloraciones I-EXPLORATION -de I-EXPLORATION -ácido I-EXPLORATION -peryódico I-EXPLORATION +formación I-EXPLORATION de I-EXPLORATION -Schiff I-EXPLORATION -(PAS), I-EXPLORATION -Ziehl-Nielsen I-EXPLORATION -(ZN) I-EXPLORATION +absceso I-EXPLORATION y I-EXPLORATION -azul I-EXPLORATION -alciano I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Laboratorio I-EXPLORATION -de I-EXPLORATION -Patología I-EXPLORATION -Interfacultades I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Universidad I-EXPLORATION -Nacional I-EXPLORATION -de I-EXPLORATION -Colombia, I-EXPLORATION -acorde I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -metodología I-EXPLORATION -adaptada I-EXPLORATION +dilatación I-EXPLORATION +aneurismática I-EXPLORATION del I-EXPLORATION -Armed I-EXPLORATION -Forces I-EXPLORATION -Institute I-EXPLORATION -of I-EXPLORATION -Pathology I-EXPLORATION -(AFIP) I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -Estados I-EXPLORATION -Unidos I-EXPLORATION -(10), I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -secreción I-EXPLORATION -de I-EXPLORATION -mucoproteínas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION +seno I-EXPLORATION +coronario I-EXPLORATION +derecho, I-EXPLORATION +insuficiencia I-EXPLORATION +aórtica, I-EXPLORATION +dilatación I-EXPLORATION +auricular I-EXPLORATION +izquierda, I-EXPLORATION +ventrículo I-EXPLORATION +izquierdo I-EXPLORATION +con I-EXPLORATION +hipertrofia I-EXPLORATION +excéntrica I-EXPLORATION +dilatada I-EXPLORATION y I-EXPLORATION -mínimo I-EXPLORATION -componente I-EXPLORATION -intracitoplasmático I-EXPLORATION -; I-EXPLORATION -igualmente, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -pigmento I-EXPLORATION -pardo I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -citoplasma I-EXPLORATION -celular. I-EXPLORATION +disfunción I-EXPLORATION +sistólica I-EXPLORATION +leve. I-EXPLORATION I-EXPLORATION -Para I-EXPLORATION -las I-EXPLORATION -tinciones I-EXPLORATION +Ese B-DERIVED_FROM/TO +mismo I-DERIVED_FROM/TO +día I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +trasladado I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Instituto I-DERIVED_FROM/TO +Nacional I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Enfermedades I-DERIVED_FROM/TO +Respiratorias I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +Cirugía I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Tórax I-DERIVED_FROM/TO +(INERYCT) I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +tratamiento I-DERIVED_FROM/TO +quirúrgico. I-DERIVED_FROM/TO +Al B-EVOLUTION +ingreso I-EVOLUTION +a I-EVOLUTION +dicho I-EVOLUTION +centro I-EVOLUTION +asistencial I-EVOLUTION +se I-EVOLUTION +verificó I-EVOLUTION +un I-EVOLUTION +paciente I-EVOLUTION +tranquilo I-EVOLUTION +que I-EVOLUTION +no I-EVOLUTION +refería I-EVOLUTION +molestias I-EVOLUTION +específicas, I-EVOLUTION +enflaquecido, I-EVOLUTION +he-modinámicamente I-EVOLUTION +estable, I-EVOLUTION +sin I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +insuficiencia I-EVOLUTION +cardíaca, I-EVOLUTION +con I-EVOLUTION +soplo I-EVOLUTION +cardíaco I-EVOLUTION +4/6 I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +foco I-EVOLUTION +aórtico. I-EVOLUTION +A I-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +horas, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +agravó I-EVOLUTION +bruscamente I-EVOLUTION +presentando I-EVOLUTION +dolor I-EVOLUTION +retro-esternal, I-EVOLUTION +disnea, I-EVOLUTION +ingurgitación I-EVOLUTION +yugular, I-EVOLUTION +hipotensión, I-EVOLUTION +shock I-EVOLUTION +y I-EVOLUTION +compromiso I-EVOLUTION +de I-EVOLUTION +conciencia. I-EVOLUTION +Fue B-TREATMENT +trasladado I-TREATMENT +a I-TREATMENT +la I-TREATMENT +unidad I-TREATMENT +de I-TREATMENT +cuidados I-TREATMENT +intensivos I-TREATMENT +y, I-TREATMENT +al I-TREATMENT +día I-TREATMENT +siguiente, I-TREATMENT +fue I-TREATMENT +sometido I-TREATMENT +a I-TREATMENT +cirugía I-TREATMENT +de I-TREATMENT +urgencia. I-TREATMENT +En I-TREATMENT +el I-TREATMENT +acto I-TREATMENT +quirúrgico I-TREATMENT +se I-TREATMENT +verificó I-TREATMENT +la I-TREATMENT +existencia I-TREATMENT +de I-TREATMENT +una I-TREATMENT +válvula I-TREATMENT +aórtica I-TREATMENT +bicúspide I-TREATMENT +con I-TREATMENT +gran I-TREATMENT +destrucción I-TREATMENT +de I-TREATMENT +los I-TREATMENT +velos I-TREATMENT +coronarios I-TREATMENT +y I-TREATMENT +del I-TREATMENT +anillo, I-TREATMENT +con I-TREATMENT +una I-TREATMENT +cavidad I-TREATMENT +de I-TREATMENT +2 I-TREATMENT +por I-TREATMENT +3 I-TREATMENT +cm I-TREATMENT +en I-TREATMENT +relación I-TREATMENT +al I-TREATMENT +seno I-TREATMENT +coronario I-TREATMENT +izquierdo I-TREATMENT +y I-TREATMENT +gran I-TREATMENT +cantidad I-TREATMENT +de I-TREATMENT +vegetaciones. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +un I-TREATMENT +reemplazo I-TREATMENT +valvular, I-TREATMENT +con I-TREATMENT +prótesis I-TREATMENT +Edwards I-TREATMENT +Lifesciences I-TREATMENT +de I-TREATMENT +23 I-TREATMENT +mm, I-TREATMENT +y I-TREATMENT +reparación I-TREATMENT +del I-TREATMENT +anillo I-TREATMENT +con I-TREATMENT +parche I-TREATMENT +de I-TREATMENT +pericardio I-TREATMENT +bovino. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +el I-EVOLUTION +post-operatorio I-EVOLUTION +se I-EVOLUTION +mantuvo I-EVOLUTION +muy I-EVOLUTION +grave I-EVOLUTION +durante I-EVOLUTION +cuatro I-EVOLUTION +a I-EVOLUTION +cinco I-EVOLUTION +días, I-EVOLUTION +debió B-TREATMENT +ser I-TREATMENT +re-intervenido I-TREATMENT +por I-TREATMENT +sangrado I-TREATMENT +local, I-TREATMENT +presentó B-EVOLUTION +insuficiencia I-EVOLUTION +renal I-EVOLUTION +aguda, I-EVOLUTION +fibrilación I-EVOLUTION +auricular I-EVOLUTION +paroxística, I-EVOLUTION +estuvo B-TREATMENT +conectado I-TREATMENT +a I-TREATMENT +ventilación I-TREATMENT +mecánica I-TREATMENT +invasora I-TREATMENT +durante I-TREATMENT +cinco I-TREATMENT +días, I-TREATMENT +recibió I-TREATMENT +aminas I-TREATMENT +vasoactivas I-TREATMENT +y I-TREATMENT +tratamiento I-TREATMENT +antimicrobiano I-TREATMENT +con I-TREATMENT +ceftriaxona I-TREATMENT +y I-TREATMENT +cloxacilina I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +endovenosa. I-TREATMENT + I-TREATMENT +El B-EXPLORATION +33° I-EXPLORATION +día I-EXPLORATION de I-EXPLORATION -inmunohistoquímica, I-EXPLORATION +internado I-EXPLORATION se I-EXPLORATION -empleó I-EXPLORATION +conoció I-EXPLORATION la I-EXPLORATION -metodología I-EXPLORATION -propia I-EXPLORATION +identificación I-EXPLORATION del I-EXPLORATION -Laboratorio I-EXPLORATION -de I-EXPLORATION -Patología I-EXPLORATION -Interfacultades I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Universidad I-EXPLORATION -Nacional I-EXPLORATION -de I-EXPLORATION -Colombia, I-EXPLORATION -adaptada I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -insertos I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -reactivos. I-EXPLORATION -Previa I-EXPLORATION -inhibición I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -actividad I-EXPLORATION -peroxidasa I-EXPLORATION -endógena I-EXPLORATION -con I-EXPLORATION -H2O2 I-EXPLORATION -al I-EXPLORATION -3%, I-EXPLORATION -se I-EXPLORATION -hizo I-EXPLORATION -la I-EXPLORATION -recuperación I-EXPLORATION -antigénica I-EXPLORATION +bacilo I-EXPLORATION +gramnegativo I-EXPLORATION +aislado I-EXPLORATION en I-EXPLORATION -Target I-EXPLORATION -10x I-EXPLORATION -(Dako®) I-EXPLORATION -y I-EXPLORATION -lavados I-EXPLORATION -seriados I-EXPLORATION -con I-EXPLORATION -TBS, I-EXPLORATION -se I-EXPLORATION -incubó I-EXPLORATION -por I-EXPLORATION -30 I-EXPLORATION -minutos I-EXPLORATION -con I-EXPLORATION -cromogranín I-EXPLORATION -A I-EXPLORATION +los I-EXPLORATION +hemocultivos I-EXPLORATION en I-EXPLORATION -dilución I-EXPLORATION -1: I-EXPLORATION -200 I-EXPLORATION -(Novocastra®) I-EXPLORATION -y I-EXPLORATION -RTU-S100p I-EXPLORATION -prediluida I-EXPLORATION -(Novocastra®), I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -valoró I-EXPLORATION -la I-EXPLORATION -reactividad I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -sistema I-EXPLORATION -de I-EXPLORATION -estreptavidina-HRP I-EXPLORATION -(Dako®), I-EXPLORATION -para I-EXPLORATION el I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -usó I-EXPLORATION -como I-EXPLORATION -cromógeno I-EXPLORATION -diaminobencidina I-EXPLORATION -(DAB). I-EXPLORATION -Luego I-EXPLORATION -del I-EXPLORATION -montaje I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -láminas, I-EXPLORATION +HLC; I-EXPLORATION se I-EXPLORATION -pudo I-EXPLORATION -demostrar I-EXPLORATION -la I-EXPLORATION -positividad, I-EXPLORATION -tanto I-EXPLORATION +trataba I-EXPLORATION de I-EXPLORATION -cromogranina I-EXPLORATION -como I-EXPLORATION +Brucella I-EXPLORATION +abortus. I-EXPLORATION +En B-TREATMENT +ese I-TREATMENT +momento I-TREATMENT +se I-TREATMENT +cambió I-TREATMENT +el I-TREATMENT +esquema I-TREATMENT +antimicrobiano I-TREATMENT +a I-TREATMENT +doxiciclina I-TREATMENT +más I-TREATMENT +rifampicina I-TREATMENT +y I-TREATMENT +gentamicina. I-TREATMENT +El B-EXPLORATION +cultivo I-EXPLORATION de I-EXPLORATION -S100 I-EXPLORATION -con I-EXPLORATION -intensidad I-EXPLORATION -leve I-EXPLORATION -a I-EXPLORATION -moderada, I-EXPLORATION -en I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -patrones I-EXPLORATION -observados I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -lesión. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -mioepiteliales I-EXPLORATION -con I-EXPLORATION -S100. I-EXPLORATION +pieza I-EXPLORATION +operatoria I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +en I-EVOLUTION +forma I-EVOLUTION +tórpida I-EVOLUTION +pero I-EVOLUTION +con I-EVOLUTION +tendencia I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +mejoría I-EVOLUTION +progresiva I-EVOLUTION +de I-EVOLUTION +modo I-EVOLUTION +que, I-EVOLUTION +cumplidos I-EVOLUTION +54 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +hospitalización, I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +en I-EVOLUTION +relativa I-EVOLUTION +buenas I-EVOLUTION +condiciones I-EVOLUTION +y B-TREATMENT +con I-TREATMENT +indicación I-TREATMENT +de I-TREATMENT +continuar I-TREATMENT +tratamiento I-TREATMENT +antimicrobiano I-TREATMENT +con I-TREATMENT +doxiciclina I-TREATMENT +y I-TREATMENT +rifampicina. I-TREATMENT + I-TREATMENT +El B-EVOLUTION +día I-EVOLUTION +88° I-EVOLUTION +desde I-EVOLUTION +su I-EVOLUTION +ingreso I-EVOLUTION +fue I-EVOLUTION +controlado I-EVOLUTION +por I-EVOLUTION +cardio-cirujano I-EVOLUTION +encontrándose I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +en I-EVOLUTION +buenas I-EVOLUTION +condiciones I-EVOLUTION +generales. I-EVOLUTION +Se B-EXPLORATION +le I-EXPLORATION +solicitó I-EXPLORATION +ecocardiograma I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +y B-TREATMENT +se I-TREATMENT +le I-TREATMENT +suspendieron I-TREATMENT +los I-TREATMENT +antimicrobianos. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +cinco I-EVOLUTION +meses I-EVOLUTION +post I-EVOLUTION +alta I-EVOLUTION +fue I-EVOLUTION +evaluado I-EVOLUTION +en I-EVOLUTION +HLC. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +estaba I-EVOLUTION +asintomático, I-EVOLUTION +en I-EVOLUTION +muy I-EVOLUTION +buen I-EVOLUTION +estado I-EVOLUTION +general, I-EVOLUTION +sin I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +insuficiencia I-EVOLUTION +cardíaca. I-EVOLUTION +Traía B-EXPLORATION +exámenes I-EXPLORATION +obtenidos I-EXPLORATION +un I-EXPLORATION +mes I-EXPLORATION +antes: I-EXPLORATION +creatininemia: I-EXPLORATION +1, I-EXPLORATION +01 I-EXPLORATION +mg/dL, I-EXPLORATION +albuminemia: I-EXPLORATION +4, I-EXPLORATION +62 I-EXPLORATION +g/%, I-EXPLORATION +VHS: I-EXPLORATION +15 I-EXPLORATION +mm/h, I-EXPLORATION +orina I-EXPLORATION +completa: I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +hemograma I-EXPLORATION +reciente I-EXPLORATION +indicaba I-EXPLORATION +un I-EXPLORATION +hematocrito I-EXPLORATION +de I-EXPLORATION +36, I-EXPLORATION +4%, I-EXPLORATION +hemoglobina I-EXPLORATION +12, I-EXPLORATION +5 I-EXPLORATION +g/% I-EXPLORATION +y I-EXPLORATION +leucocitos I-EXPLORATION +9.500/mm3. I-EXPLORATION +Se B-DERIVED_FROM/TO +le I-DERIVED_FROM/TO +derivó I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +seguimiento I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +cardiólogo. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +En B-EVOLUTION +controles I-EVOLUTION +posteriores I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +INERYCT I-EVOLUTION +se I-EVOLUTION +pesquisaron I-EVOLUTION +síntomas I-EVOLUTION +y I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +insuficiencia I-EVOLUTION +cardíaca I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +ecocardiograña I-EVOLUTION +evidenció I-EVOLUTION +reflujo I-EVOLUTION +a I-EVOLUTION +través I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +válvula I-EVOLUTION +protésica. I-EVOLUTION + I-EVOLUTION -El B-PRESENT_ILLNESS -primer I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS +Niño B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS años I-PRESENT_ILLNESS +cuyos I-PRESENT_ILLNESS +padres I-PRESENT_ILLNESS +consultaron I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +revisión I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -licor I-PAST_MEDICAL_HISTORY -cada I-PAST_MEDICAL_HISTORY -fin I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -semana I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -embriaguez, I-PAST_MEDICAL_HISTORY -cuatro B-PRESENT_ILLNESS -días I-PRESENT_ILLNESS +salud I-PRESENT_ILLNESS +porque I-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +diario I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +sueño I-PRESENT_ILLNESS +muy I-PRESENT_ILLNESS +inquieto I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +ronquido I-PRESENT_ILLNESS +continuo, I-PRESENT_ILLNESS +respiración I-PRESENT_ILLNESS +bucal, I-PRESENT_ILLNESS +sudoración I-PRESENT_ILLNESS +profusa I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +frecuentes I-PRESENT_ILLNESS +despertares I-PRESENT_ILLNESS +nocturnos. I-PRESENT_ILLNESS +Sus I-PRESENT_ILLNESS +ronquidos I-PRESENT_ILLNESS +eran I-PRESENT_ILLNESS +muy I-PRESENT_ILLNESS +ruidosos, I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +modificaban I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +cambiar I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS +postura I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +acentuaban I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -expectoración I-PRESENT_ILLNESS -purulenta, I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +cuadros I-PRESENT_ILLNESS +catarrales. I-PRESENT_ILLNESS +Los I-PRESENT_ILLNESS +padres I-PRESENT_ILLNESS +dudaban I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -moderados I-PRESENT_ILLNESS -esfuerzos, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +pudiera I-PRESENT_ILLNESS +tener I-PRESENT_ILLNESS +apneas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +negaban I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +presencia I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -38, I-PRESENT_ILLNESS -5°C, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -pleurítico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS +cianosis. I-PRESENT_ILLNESS +Durante I-PRESENT_ILLNESS el I-PRESENT_ILLNESS -hemitórax I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +niño I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +mostraba I-PRESENT_ILLNESS +cansado, I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +quejaba I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS +matutina I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS +habitual I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -automedicación I-PRESENT_ILLNESS +tenía I-PRESENT_ILLNESS +poco I-PRESENT_ILLNESS +apetito. I-PRESENT_ILLNESS +Durante I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +periodo I-PRESENT_ILLNESS +escolar I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +padecido I-PRESENT_ILLNESS +infecciones I-PRESENT_ILLNESS +respiratorias I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS +repetida. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +colegio, I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +maestra I-PRESENT_ILLNESS +les I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +comentado I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +prestaba I-PRESENT_ILLNESS +atención I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +jugaba I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -dosis I-PRESENT_ILLNESS +poco I-PRESENT_ILLNESS +entusiasmo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +energía. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dexametasona I-PRESENT_ILLNESS +dormir I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +niño I-PRESENT_ILLNESS +afectaba I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +calidad I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -mg I-PRESENT_ILLNESS -intramuscular I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS +vida I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -admisión. I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +padres, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +lograban I-PRESENT_ILLNESS +conseguir I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +sueño I-PRESENT_ILLNESS +reparador I-PRESENT_ILLNESS +debido I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +continuas I-PRESENT_ILLNESS +interrupciones I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +mostraban I-PRESENT_ILLNESS +preocupados I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +rendidos. I-PRESENT_ILLNESS I-PRESENT_ILLNESS -Ingresó B-EXPLORATION -febril, I-EXPLORATION -taquicárdico, I-EXPLORATION -taquipneico, I-EXPLORATION -hipo-xémico I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION +En B-EXPLORATION la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -presentaba I-EXPLORATION -signos I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +se I-EXPLORATION +detectó I-EXPLORATION +un I-EXPLORATION +estancamiento I-EXPLORATION +importante I-EXPLORATION +y I-EXPLORATION +progresivo I-EXPLORATION de I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION +la I-EXPLORATION +curva I-EXPLORATION +ponderoestatural I-EXPLORATION +desde I-EXPLORATION +los I-EXPLORATION +18 I-EXPLORATION +meses. I-EXPLORATION +Presentaba I-EXPLORATION +facies I-EXPLORATION +adenoidea I-EXPLORATION +con I-EXPLORATION +hipertofia I-EXPLORATION +amigdalar I-EXPLORATION +grado I-EXPLORATION +IV/IV I-EXPLORATION y I-EXPLORATION -consolidación I-EXPLORATION +respiración I-EXPLORATION +oral. I-EXPLORATION +La I-EXPLORATION +tensión I-EXPLORATION +arterial I-EXPLORATION +era I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +practicó I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION +polisomnográfico I-EXPLORATION +nocturno I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -base I-EXPLORATION -derecha. I-EXPLORATION -La I-EXPLORATION -evaluación I-EXPLORATION +Unidad I-EXPLORATION +del I-EXPLORATION +Sueño I-EXPLORATION +que I-EXPLORATION +confirmó I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -muestra I-EXPLORATION -leucocitosis I-EXPLORATION +sospecha I-EXPLORATION de I-EXPLORATION -14.500 I-EXPLORATION -por I-EXPLORATION -mm3, I-EXPLORATION -neutrofilia I-EXPLORATION +SAOS I-EXPLORATION +infantil I-EXPLORATION +con I-EXPLORATION +predominio I-EXPLORATION +obstructivo. I-EXPLORATION +Los I-EXPLORATION +datos I-EXPLORATION +registrados I-EXPLORATION +pusieron I-EXPLORATION de I-EXPLORATION -96%, I-EXPLORATION -hiperglucemia I-EXPLORATION +manifiesto I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -638 I-EXPLORATION -mg/dl, I-EXPLORATION -hiperazoemia I-EXPLORATION -(nitrógeno I-EXPLORATION -ureico I-EXPLORATION +un I-EXPLORATION +sueño I-EXPLORATION +anómalo, I-EXPLORATION +fragmentado I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +dificultad I-EXPLORATION +para I-EXPLORATION +su I-EXPLORATION +mantenimiento I-EXPLORATION +por I-EXPLORATION +eventos I-EXPLORATION +respiratorios I-EXPLORATION +obstructivos I-EXPLORATION en I-EXPLORATION -sangre I-EXPLORATION -de I-EXPLORATION -27, I-EXPLORATION -45 I-EXPLORATION -mg/dl). I-EXPLORATION +número I-EXPLORATION +patológico. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +tratamiento I-TREATMENT +quirúrgico I-TREATMENT +consistente I-TREATMENT +en I-TREATMENT +adenoidectomía I-TREATMENT +y I-TREATMENT +radiofrecuencia I-TREATMENT +inducida I-TREATMENT +amigdalar. I-TREATMENT El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -hospitalizado I-EVOLUTION -con I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -neumonía I-EVOLUTION -grave I-EVOLUTION -extrahospitalaria I-EVOLUTION -IIIA, I-EVOLUTION -según I-EVOLUTION -las I-EVOLUTION -guías I-EVOLUTION -nacionales I-EVOLUTION +niño I-EVOLUTION +mejoró, I-EVOLUTION +presentando I-EVOLUTION +remisión I-EVOLUTION de I-EVOLUTION -manejo I-EVOLUTION +los I-EVOLUTION +síntomas I-EVOLUTION +nocturnos I-EVOLUTION +y I-EVOLUTION +diurnos I-EVOLUTION de I-EVOLUTION -esta I-EVOLUTION -enfermedad I-EVOLUTION -(6). I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -progresó I-EVOLUTION -rápidamente I-EVOLUTION -a I-EVOLUTION -falla I-EVOLUTION -respiratoria I-EVOLUTION -hipoxémica, I-EVOLUTION +forma I-EVOLUTION +inmediata. I-EVOLUTION +En I-EVOLUTION +los I-EVOLUTION +siguientes I-EVOLUTION +seis I-EVOLUTION +meses I-EVOLUTION +recuperó I-EVOLUTION +un I-EVOLUTION +crecimiento I-EVOLUTION +y I-EVOLUTION +ganancia I-EVOLUTION +ponderal I-EVOLUTION +adecuados I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +vio I-EVOLUTION +libre I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +procesos I-EVOLUTION +respiratorios I-EVOLUTION +de I-EVOLUTION +repetición I-EVOLUTION +que I-EVOLUTION +venía I-EVOLUTION +padeciendo I-EVOLUTION con I-EVOLUTION -choque I-EVOLUTION -séptico I-EVOLUTION +anterioridad. I-EVOLUTION +La I-EVOLUTION +familia I-EVOLUTION +manifestó I-EVOLUTION +estar I-EVOLUTION +muy I-EVOLUTION +contenta I-EVOLUTION +con I-EVOLUTION +la I-EVOLUTION +evolución I-EVOLUTION +del I-EVOLUTION +niño I-EVOLUTION y, I-EVOLUTION -posteriormente, I-EVOLUTION -disfunción I-EVOLUTION -orgánica I-EVOLUTION -múltiple. I-EVOLUTION -Se B-DERIVED_FROM/TO -trasladó I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cuidados I-DERIVED_FROM/TO -intensivos, I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se B-TREATMENT -inició I-TREATMENT -manejo I-TREATMENT -antibiótico I-TREATMENT +lo I-EVOLUTION +que I-EVOLUTION +también I-EVOLUTION +es I-EVOLUTION +importante, I-EVOLUTION +todos I-EVOLUTION +habían I-EVOLUTION +vuelto I-EVOLUTION +a I-EVOLUTION +dormir I-EVOLUTION +bien. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +49 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +asma I-PAST_MEDICAL_HISTORY +bronquial. I-PAST_MEDICAL_HISTORY +En B-TREATMENT +revisión I-TREATMENT +ginecológica I-TREATMENT +periódica I-TREATMENT +se I-TREATMENT +le I-TREATMENT +diagnostica I-TREATMENT +carcinoma I-TREATMENT +ductal I-TREATMENT +infiltrante I-TREATMENT +de I-TREATMENT +mama I-TREATMENT +izquierda I-TREATMENT +y I-TREATMENT +es I-TREATMENT +sometida I-TREATMENT +a I-TREATMENT +mastectomía I-TREATMENT +radical I-TREATMENT +modificada I-TREATMENT con I-TREATMENT -ceftriaxona, I-TREATMENT -2 I-TREATMENT -g I-TREATMENT -endovenosos I-TREATMENT -al I-TREATMENT -día, I-TREATMENT +vaciamiento I-TREATMENT +axilar I-TREATMENT +por I-TREATMENT +el I-TREATMENT +Servicio I-TREATMENT +de I-TREATMENT +Cirugía I-TREATMENT +General, I-TREATMENT +recibiendo I-TREATMENT +tratamiento I-TREATMENT +adyuvante I-TREATMENT +con I-TREATMENT +radioterapia I-TREATMENT y I-TREATMENT -claritromicina, I-TREATMENT -500 I-TREATMENT -mg I-TREATMENT -endovenosos I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas. I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computadorizada I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -consolidación I-EXPLORATION -multilobar I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -lóbulos I-EXPLORATION -inferiores I-EXPLORATION -con I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -bilateral, I-EXPLORATION -no I-EXPLORATION -libre I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION -derecha. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudió I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -pleural I-EXPLORATION -indicó I-EXPLORATION -empiema I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION +quimioterapia. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -cocos I-EXPLORATION -Gram I-EXPLORATION -positivos. I-EXPLORATION -Requirió B-TREATMENT -toracostomía I-TREATMENT +extensión I-EXPLORATION +resultó I-EXPLORATION +negativo I-EXPLORATION +para I-EXPLORATION +adenopatías I-EXPLORATION +locorregionales I-EXPLORATION +y I-EXPLORATION +metástasis I-EXPLORATION +a I-EXPLORATION +distancia I-EXPLORATION +(pT3pN0M0). I-EXPLORATION +Al B-DERIVED_FROM/TO +finalizar I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +tratamiento I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +solicita I-DERIVED_FROM/TO +reconstrucción I-DERIVED_FROM/TO +mamaria, I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +lo I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Cirugía I-DERIVED_FROM/TO +Plástica. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +A B-TREATMENT +los I-TREATMENT +4 I-TREATMENT +años I-TREATMENT de I-TREATMENT -drenaje I-TREATMENT -cerrado I-TREATMENT +la I-TREATMENT +mastectomía I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +la I-TREATMENT +reconstrucción I-TREATMENT +mamaria I-TREATMENT +con I-TREATMENT +diversos I-TREATMENT +procedimientos I-TREATMENT +que I-TREATMENT +describimos I-TREATMENT +a I-TREATMENT +continuación. I-TREATMENT +En I-TREATMENT +primer I-TREATMENT +lugar I-TREATMENT +reconstrucción I-TREATMENT +de I-TREATMENT +mama I-TREATMENT +izquierda I-TREATMENT +con I-TREATMENT +colgajo I-TREATMENT +miocutáneo I-TREATMENT +de I-TREATMENT +recto I-TREATMENT +abdominal I-TREATMENT +transverso I-TREATMENT +(TRAM), I-TREATMENT +sufriendo I-TREATMENT +pérdida I-TREATMENT +parcial I-TREATMENT +del I-TREATMENT +mismo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +resolvió I-TREATMENT +con I-TREATMENT +desbridamiento I-TREATMENT y I-TREATMENT +cierre I-TREATMENT +directo. I-TREATMENT +Dos I-TREATMENT +años I-TREATMENT +después I-TREATMENT se I-TREATMENT -indicó I-TREATMENT -posteriormente I-TREATMENT -toracotomía I-TREATMENT -más I-TREATMENT -decorticación. I-TREATMENT -Durante B-EVOLUTION -las I-EVOLUTION -primeras I-EVOLUTION -72 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -postoperatorio, I-EVOLUTION -persistieron I-EVOLUTION -los I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -respuesta I-EVOLUTION -inflamatoria I-EVOLUTION -sistémica. I-EVOLUTION -Ante B-TREATMENT -el I-TREATMENT -deterioro I-TREATMENT +colocó I-TREATMENT +prótesis I-TREATMENT +expansora I-TREATMENT de I-TREATMENT -la I-TREATMENT -función I-TREATMENT -renal, I-TREATMENT -requirió I-TREATMENT -soporte I-TREATMENT -dialítico I-TREATMENT +Becker I-TREATMENT +subTRAM I-TREATMENT y I-TREATMENT +finalmente, I-TREATMENT se I-TREATMENT -cambió I-TREATMENT -el I-TREATMENT -antibiótico I-TREATMENT -a I-TREATMENT -linezolide. I-TREATMENT -Posterior B-EVOLUTION -al I-EVOLUTION -cambio I-EVOLUTION +realizó I-TREATMENT +recambio I-TREATMENT +del I-TREATMENT +expansor I-TREATMENT +por I-TREATMENT +prótesis I-TREATMENT +mamaria I-TREATMENT +definitiva I-TREATMENT +y I-TREATMENT +mastopexia I-TREATMENT +simetrizadora I-TREATMENT +de I-TREATMENT +mama I-TREATMENT +contralateral, I-TREATMENT +quedando I-TREATMENT +pendiente I-TREATMENT +de I-TREATMENT +completar I-TREATMENT +la I-TREATMENT +reconstrucción I-TREATMENT +del I-TREATMENT +complejo I-TREATMENT +areola I-TREATMENT +pezón I-TREATMENT +(CAP). I-TREATMENT +En B-EVOLUTION +el I-EVOLUTION +postoperatorio I-EVOLUTION de I-EVOLUTION -antimicrobiano I-EVOLUTION -su I-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -adecuada, I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -permitió I-EVOLUTION -retirarlo I-EVOLUTION +la I-EVOLUTION +última I-EVOLUTION +intervención I-EVOLUTION +comienza I-EVOLUTION +la I-EVOLUTION +aparición I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +zona I-EVOLUTION +periareolar I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +mama I-EVOLUTION +derecha I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +centro I-EVOLUTION del I-EVOLUTION -respirador I-EVOLUTION -sin I-EVOLUTION -necesidad I-EVOLUTION +colgajo I-EVOLUTION de I-EVOLUTION -soporte I-EVOLUTION -vasopresor. I-EVOLUTION -Se I-EVOLUTION -completaron I-EVOLUTION -21 I-EVOLUTION -días I-EVOLUTION +la I-EVOLUTION +mama I-EVOLUTION +izquierda I-EVOLUTION de I-EVOLUTION -tratamiento I-EVOLUTION +pequeñas I-EVOLUTION +lesiones I-EVOLUTION +pustulosas I-EVOLUTION con I-EVOLUTION -respuesta I-EVOLUTION -satisfactoria I-EVOLUTION +posterior I-EVOLUTION +desarrollo I-EVOLUTION +de I-EVOLUTION +úlceras I-EVOLUTION +dolorosas I-EVOLUTION +de I-EVOLUTION +borde I-EVOLUTION +violáceo I-EVOLUTION y I-EVOLUTION -sin I-EVOLUTION -necesidad I-EVOLUTION +fondo I-EVOLUTION +con I-EVOLUTION +tejido I-EVOLUTION de I-EVOLUTION -terapia I-EVOLUTION -antimicrobiana I-EVOLUTION -ambulatoria I-EVOLUTION -adicional. I-EVOLUTION +granulación,. I-EVOLUTION I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -manejo I-PAST_MEDICAL_HISTORY -farmacológico, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -alcoholismo, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -clínico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -inicio I-PAST_MEDICAL_HISTORY -súbito I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sensación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mareo; I-PAST_MEDICAL_HISTORY -cuatro B-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -disartria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -hemiparesia I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Consultó B-EXPLORATION -al I-EXPLORATION -servicio I-EXPLORATION +Con B-EXPLORATION +el I-EXPLORATION +presunto I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -urgencias I-EXPLORATION -donde I-EXPLORATION +dehiscencia I-EXPLORATION +de I-EXPLORATION +herida I-EXPLORATION +quirúrgica I-EXPLORATION se I-EXPLORATION -le I-EXPLORATION -encontró I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION +realiza I-EXPLORATION +biopsia I-EXPLORATION +que I-EXPLORATION +informa I-EXPLORATION de I-EXPLORATION -120/70 I-EXPLORATION -mm I-EXPLORATION -Hg I-EXPLORATION -y I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION +tejido I-EXPLORATION de I-EXPLORATION -100 I-EXPLORATION -por I-EXPLORATION -minuto; I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -general I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -Estaba I-EXPLORATION -alerta, I-EXPLORATION -orientado I-EXPLORATION -en I-EXPLORATION -persona, I-EXPLORATION -tiempo I-EXPLORATION +granulación, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +es I-TREATMENT +sometida I-TREATMENT +a I-TREATMENT +curas I-TREATMENT +con I-TREATMENT +desbridamiento I-TREATMENT +durante I-TREATMENT +más I-TREATMENT +de I-TREATMENT +12 I-TREATMENT +meses. I-TREATMENT +Dada B-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +mala I-DERIVED_FROM/TO +evolución, I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +decide I-DERIVED_FROM/TO +interconsulta I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Dermatología, I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +ante I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +sospecha I-DERIVED_FROM/TO +inicial I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +pioderma I-DERIVED_FROM/TO +gangrenoso, I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +realiza I-DERIVED_FROM/TO +estudio I-DERIVED_FROM/TO +exhaustivo I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +descartar I-DERIVED_FROM/TO +otros I-DERIVED_FROM/TO +procesos. I-DERIVED_FROM/TO +Se B-EXPLORATION +solicitaron I-EXPLORATION +las I-EXPLORATION +siguientes I-EXPLORATION +pruebas: I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Analítica, I-EXPLORATION +incluyendo I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +autoinmunidad I-EXPLORATION +(ANAs I-EXPLORATION y I-EXPLORATION -espacio, I-EXPLORATION -con I-EXPLORATION -disartria, I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -esfera I-EXPLORATION -mental, I-EXPLORATION +ENAs) I-EXPLORATION +y I-EXPLORATION +proteinograma: I-EXPLORATION sin I-EXPLORATION -signos I-EXPLORATION -meníngeos; I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION alteraciones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cráneo I-EXPLORATION -ni I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -columna I-EXPLORATION -vertebral; I-EXPLORATION -había I-EXPLORATION -isocoria I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -mm I-EXPLORATION +patológicas. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Serología I-EXPLORATION +luética, I-EXPLORATION +virus I-EXPLORATION +hepatitis I-EXPLORATION +B I-EXPLORATION +y I-EXPLORATION +C, I-EXPLORATION +VIH: I-EXPLORATION +negativa. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Mantoux: I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Radiografía I-EXPLORATION de I-EXPLORATION -diámetro, I-EXPLORATION -pupila I-EXPLORATION +tórax: I-EXPLORATION +engrosamiento I-EXPLORATION +difuso I-EXPLORATION de I-EXPLORATION -Argyll I-EXPLORATION -Robertson, I-EXPLORATION -parálisis I-EXPLORATION -facial I-EXPLORATION -izquierda, I-EXPLORATION +las I-EXPLORATION +paredes I-EXPLORATION +bronquiales; I-EXPLORATION +cambios I-EXPLORATION +quirúrgicos I-EXPLORATION +en I-EXPLORATION +mama I-EXPLORATION +izquierda I-EXPLORATION con I-EXPLORATION -escasa I-EXPLORATION -elevación I-EXPLORATION -del I-EXPLORATION -velo I-EXPLORATION -del I-EXPLORATION -paladar I-EXPLORATION -y I-EXPLORATION -trastornos I-EXPLORATION -dinámicos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -deglución, I-EXPLORATION -sin I-EXPLORATION -otras I-EXPLORATION -alteraciones I-EXPLORATION +grapas I-EXPLORATION en I-EXPLORATION -los I-EXPLORATION -nervios I-EXPLORATION -craneales. I-EXPLORATION +región I-EXPLORATION +axilar. I-EXPLORATION I-EXPLORATION -Presentaba I-EXPLORATION -hemiparesia I-EXPLORATION -izquierda, I-EXPLORATION +- I-EXPLORATION +Biopsia I-EXPLORATION con I-EXPLORATION -disminución I-EXPLORATION +técnicas I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -fuerza I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -miembro I-EXPLORATION -superior I-EXPLORATION -(3/5) I-EXPLORATION +PAS, I-EXPLORATION +Grocott I-EXPLORATION y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -inferior I-EXPLORATION -(4/5), I-EXPLORATION -con I-EXPLORATION -hiperreflexia I-EXPLORATION -generalizada I-EXPLORATION -simétrica, I-EXPLORATION +Ziehl- I-EXPLORATION +Neelsen: I-EXPLORATION +ulceración I-EXPLORATION +epidérmica I-EXPLORATION +focal I-EXPLORATION con I-EXPLORATION -respuesta I-EXPLORATION -plantar I-EXPLORATION -izquierda I-EXPLORATION -neutra I-EXPLORATION +abscesificación I-EXPLORATION +dérmica I-EXPLORATION y I-EXPLORATION -de I-EXPLORATION -flexión I-EXPLORATION -contralateral; I-EXPLORATION -además, I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -temblor I-EXPLORATION -de I-EXPLORATION -acción I-EXPLORATION +folicular, I-EXPLORATION +inflamación I-EXPLORATION +crónica I-EXPLORATION +linfohistiocitaria I-EXPLORATION y I-EXPLORATION -postural I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mano I-EXPLORATION -derecha, I-EXPLORATION -sin I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -sensibilidad. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computadorizada I-EXPLORATION -(TC) I-EXPLORATION -de I-EXPLORATION -cráneo I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -hipodensa, I-EXPLORATION -lacunar, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cápsula I-EXPLORATION -interna. I-EXPLORATION -Ese I-EXPLORATION -mismo I-EXPLORATION -día I-EXPLORATION -se I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -cerebral I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -un I-EXPLORATION -infarto I-EXPLORATION -póntico I-EXPLORATION -extenso, I-EXPLORATION -con I-EXPLORATION -estenosis I-EXPLORATION -crítica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -basilar I-EXPLORATION +plasmocitaria I-EXPLORATION +adyacente I-EXPLORATION y I-EXPLORATION -trombosis I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -vertebral I-EXPLORATION -izquierda, I-EXPLORATION -sin I-EXPLORATION -lesiones I-EXPLORATION +distribución I-EXPLORATION +perivascular I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -circulación I-EXPLORATION -anterior. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -sometió I-TREATMENT -a I-TREATMENT -tratamiento I-TREATMENT -endovascular I-TREATMENT -en I-TREATMENT -el I-TREATMENT -que I-TREATMENT -se I-TREATMENT -encontró I-TREATMENT -estenosis I-TREATMENT -completa I-TREATMENT -del I-TREATMENT -tercio I-TREATMENT -inferior I-TREATMENT -de I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -basilar, I-TREATMENT -sin I-TREATMENT -flujo I-TREATMENT -distal, I-TREATMENT -y I-TREATMENT -se I-TREATMENT -colocó I-TREATMENT -un I-TREATMENT -stent I-TREATMENT -sin I-TREATMENT -complicaciones, I-TREATMENT -quedando I-TREATMENT -con I-TREATMENT -una I-TREATMENT -estenosis I-TREATMENT -residual I-TREATMENT -de I-TREATMENT -24 I-TREATMENT -%. I-TREATMENT - I-TREATMENT -Durante B-EXPLORATION -la I-EXPLORATION -hospitalización I-EXPLORATION -se I-EXPLORATION -hicieron I-EXPLORATION -estudios I-EXPLORATION -para I-EXPLORATION -accidente I-EXPLORATION -cerebrovascular I-EXPLORATION +dermis I-EXPLORATION +superficial I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -era I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -VIH, I-EXPLORATION -el I-EXPLORATION -VDRL I-EXPLORATION -en I-EXPLORATION -suero I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -(1:256) I-EXPLORATION -con I-EXPLORATION -FTA-ABS, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -compromiso I-EXPLORATION -del I-EXPLORATION -sistema I-EXPLORATION -nervioso I-EXPLORATION -central. I-EXPLORATION -Se I-EXPLORATION -encontró I-EXPLORATION -pleocitosis I-EXPLORATION -de I-EXPLORATION -65 I-EXPLORATION -leucocitos I-EXPLORATION -por I-EXPLORATION -mm3 I-EXPLORATION +profunda. I-EXPLORATION +Hallazgos I-EXPLORATION +histopatológicos I-EXPLORATION +compatibles I-EXPLORATION con I-EXPLORATION -10 I-EXPLORATION -% I-EXPLORATION -de I-EXPLORATION -polimorfonucleares I-EXPLORATION -y I-EXPLORATION -90 I-EXPLORATION -% I-EXPLORATION -de I-EXPLORATION -mononucleares, I-EXPLORATION -glucosa I-EXPLORATION -de I-EXPLORATION -71 I-EXPLORATION -mg/dl, I-EXPLORATION -proteínas I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION +clínica I-EXPLORATION de I-EXPLORATION -33 I-EXPLORATION -mg/dl I-EXPLORATION +pioderma I-EXPLORATION +gangrenoso I-EXPLORATION +clásico I-EXPLORATION +o I-EXPLORATION +ulcerado. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Cultivo I-EXPLORATION +biopsia I-EXPLORATION +(aerobio, I-EXPLORATION +anaerobio, I-EXPLORATION +hongos I-EXPLORATION y I-EXPLORATION -un I-EXPLORATION -VDRL I-EXPLORATION -reactivo I-EXPLORATION -(1:2). I-EXPLORATION +micobacterias): I-EXPLORATION +negativo. I-EXPLORATION I-EXPLORATION -Con B-TREATMENT -estos I-TREATMENT -hallazgos I-TREATMENT -se I-TREATMENT -confirmó I-TREATMENT +Tras B-TREATMENT el I-TREATMENT diagnóstico I-TREATMENT de I-TREATMENT -neurosífilis I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT +exclusión I-TREATMENT +de I-TREATMENT +pioderma I-TREATMENT +gangrenoso I-TREATMENT +clásico, I-TREATMENT +iniciamos I-TREATMENT tratamiento I-TREATMENT con I-TREATMENT -24 I-TREATMENT -millones I-TREATMENT +prednisona I-TREATMENT +oral I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT de I-TREATMENT -unidades I-TREATMENT +60 I-TREATMENT +mg/día I-TREATMENT +asociando I-TREATMENT +propionato I-TREATMENT de I-TREATMENT -penicilina I-TREATMENT -cristalina I-TREATMENT -al I-TREATMENT -día I-TREATMENT +clobetasol I-TREATMENT +0, I-TREATMENT +05% I-TREATMENT +tópico I-TREATMENT durante I-TREATMENT -21 I-TREATMENT -días. I-TREATMENT -Durante I-TREATMENT -su I-TREATMENT -estadía I-TREATMENT -en I-TREATMENT +3 I-TREATMENT +meses. I-TREATMENT +Al I-TREATMENT +reducir I-TREATMENT +la I-TREATMENT +pauta I-TREATMENT +esteroidea I-TREATMENT +a I-TREATMENT +30 I-TREATMENT +mg/día I-TREATMENT la I-TREATMENT -unidad I-TREATMENT -de I-TREATMENT -cuidados I-TREATMENT -intensivos, I-TREATMENT -el I-TREATMENT paciente I-TREATMENT -requirió I-TREATMENT -intubación I-TREATMENT -orotraqueal I-TREATMENT +comenzó I-TREATMENT +con I-TREATMENT +un I-TREATMENT +rebrote I-TREATMENT +de I-TREATMENT +las I-TREATMENT +lesiones, I-TREATMENT por I-TREATMENT -riesgo I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +decidimos I-TREATMENT +asociar I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +ciclosporina I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT de I-TREATMENT -compromiso I-TREATMENT +4 I-TREATMENT +mg/Kg I-TREATMENT de I-TREATMENT +peso, I-TREATMENT +sustituir I-TREATMENT +los I-TREATMENT +corticoides I-TREATMENT +tópicos I-TREATMENT +por I-TREATMENT +tacrolimus I-TREATMENT +0, I-TREATMENT +1% I-TREATMENT +tópico I-TREATMENT +y I-TREATMENT +reducir I-TREATMENT +también I-TREATMENT +paulatinamente I-TREATMENT la I-TREATMENT -vía I-TREATMENT -aérea I-TREATMENT -debido I-TREATMENT -a I-TREATMENT +prednisona I-TREATMENT +hasta I-TREATMENT su I-TREATMENT -infarto I-TREATMENT -en I-TREATMENT -el I-TREATMENT -tallo I-TREATMENT -cerebral. I-TREATMENT -Presentó B-EVOLUTION -una I-EVOLUTION -neumonía I-EVOLUTION -tardía I-EVOLUTION -asociada I-EVOLUTION -al I-EVOLUTION -respirador I-EVOLUTION -por I-EVOLUTION -Serratia I-EVOLUTION -marcescens, I-EVOLUTION -para B-TREATMENT -la I-TREATMENT -cual I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -antibiótico, I-TREATMENT -sin I-TREATMENT -complicaciones. I-TREATMENT +suspensión I-TREATMENT +durante I-TREATMENT +un I-TREATMENT +periodo I-TREATMENT +de I-TREATMENT +mes I-TREATMENT +y I-TREATMENT +medio. I-TREATMENT I-TREATMENT -Durante B-EVOLUTION -su I-EVOLUTION -hospitalización, I-EVOLUTION -no I-EVOLUTION -recuperó I-EVOLUTION +Inicialmente, B-EVOLUTION la I-EVOLUTION -funcionalidad I-EVOLUTION +paciente I-EVOLUTION +experimenta I-EVOLUTION +una I-EVOLUTION +evolución I-EVOLUTION +favorable I-EVOLUTION +salvo I-EVOLUTION +hipertensión I-EVOLUTION +controlada I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +diurético I-EVOLUTION +tiazídico I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +consigue I-EVOLUTION +una I-EVOLUTION +buena I-EVOLUTION +reepitelización I-EVOLUTION de I-EVOLUTION -los I-EVOLUTION -nervios I-EVOLUTION -craneales I-EVOLUTION -bulbares, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -fue I-TREATMENT -necesario I-TREATMENT -practicar I-TREATMENT -traqueostomía I-TREATMENT -y I-TREATMENT -gastrostomía. I-TREATMENT -Antes B-EXPLORATION -de I-EXPLORATION -dar I-EXPLORATION -de I-EXPLORATION -alta I-EXPLORATION -al I-EXPLORATION -paciente, I-EXPLORATION -se I-EXPLORATION -hizo I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -importante I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pleocitosis I-EXPLORATION -y I-EXPLORATION -proteinorraquia; I-EXPLORATION -sin I-EXPLORATION -embargo, I-EXPLORATION -el I-EXPLORATION -VDRL I-EXPLORATION -fue I-EXPLORATION -reactivo I-EXPLORATION -(1:8), I-EXPLORATION -probablemente I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -reacción I-EXPLORATION -inflamatoria I-EXPLORATION -posterior I-EXPLORATION -al I-EXPLORATION -tratamiento. I-EXPLORATION - I-EXPLORATION -Fue B-EVOLUTION -dado I-EVOLUTION +las I-EVOLUTION +lesiones; I-EVOLUTION +pero I-EVOLUTION +tras I-EVOLUTION +2 I-EVOLUTION +meses I-EVOLUTION de I-EVOLUTION -alta I-EVOLUTION +tratamiento I-EVOLUTION con I-EVOLUTION -disartria, I-EVOLUTION -parálisis I-EVOLUTION -supranuclear I-EVOLUTION -de I-EVOLUTION +ciclosporina I-EVOLUTION +comienza I-EVOLUTION +con I-EVOLUTION +efectos I-EVOLUTION +secundarios I-EVOLUTION +muy I-EVOLUTION +molestos: I-EVOLUTION +hiperplasia I-EVOLUTION +gingival, I-EVOLUTION +hipertricosis, I-EVOLUTION +hirsutismo I-EVOLUTION +y I-EVOLUTION +disestesias I-EVOLUTION +que I-EVOLUTION +nos I-EVOLUTION +obligan I-EVOLUTION +a I-EVOLUTION la I-EVOLUTION -mirada, I-EVOLUTION -hemiparesia I-EVOLUTION -izquierda, I-EVOLUTION -traqueostomía, I-EVOLUTION -gastrostomía I-EVOLUTION -percutánea I-EVOLUTION -y B-TREATMENT -manejo I-TREATMENT -ambulatorio I-TREATMENT -dual I-TREATMENT +reducción I-EVOLUTION +progresiva I-EVOLUTION +de I-EVOLUTION +este I-EVOLUTION +tratamiento, I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +tiene I-EVOLUTION +como I-EVOLUTION +consecuencia I-EVOLUTION +un I-EVOLUTION +nuevo I-EVOLUTION +rebrote I-EVOLUTION +de I-EVOLUTION +pequeñas I-EVOLUTION +lesiones I-EVOLUTION +pustulosas I-EVOLUTION +que B-TREATMENT +infiltramos I-TREATMENT con I-TREATMENT -antiagregación I-TREATMENT -plaquetaria. I-TREATMENT +triamcinolona I-TREATMENT +a I-TREATMENT +la I-TREATMENT +vez I-TREATMENT +que I-TREATMENT +retiramos I-TREATMENT +el I-TREATMENT +tacrolimus I-TREATMENT +tópico. I-TREATMENT +La I-TREATMENT +intolerancia I-TREATMENT +de I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +a I-TREATMENT +los I-TREATMENT +efectos I-TREATMENT +secundarios I-TREATMENT +de I-TREATMENT +la I-TREATMENT +ciclosporina, I-TREATMENT +nos I-TREATMENT +obligó I-TREATMENT +a I-TREATMENT +su I-TREATMENT +suspensión I-TREATMENT +completa I-TREATMENT +tras I-TREATMENT +4 I-TREATMENT +meses I-TREATMENT +de I-TREATMENT +tratamiento. I-TREATMENT I-TREATMENT - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -71 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -proveniente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Palmira I-PAST_MEDICAL_HISTORY -(población I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -suroccidente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Colombia I-PAST_MEDICAL_HISTORY -cerca I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -Costa I-PAST_MEDICAL_HISTORY -Pacífica), I-PAST_MEDICAL_HISTORY -referida B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Clínica I-DERIVED_FROM/TO -Sebastián I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Belalcázar I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cali, I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -historia I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -20 I-DERIVED_FROM/TO -días I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -fiebre I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -tos I-DERIVED_FROM/TO -productiva, I-DERIVED_FROM/TO -asociada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -pérdida I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -peso I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -seis I-DERIVED_FROM/TO -meses I-DERIVED_FROM/TO -(4 I-DERIVED_FROM/TO -kg) I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -infección I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -vías I-DERIVED_FROM/TO -aéreas I-DERIVED_FROM/TO -superiores I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -antibiótico I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -tórpida. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -hepatoesplenomegalia I-EXPLORATION -y I-EXPLORATION -adenopatía I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -axila I-EXPLORATION -derecha; I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -manifestaciones I-EXPLORATION -cutáneas. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -hemático I-EXPLORATION -inicialmente I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -anemia I-EXPLORATION -y I-EXPLORATION -leucopenia, I-EXPLORATION -seguidas I-EXPLORATION -por I-EXPLORATION -leucocitosis, I-EXPLORATION -linfocitosis I-EXPLORATION -(11.000/mm I-EXPLORATION -3 I-EXPLORATION -) I-EXPLORATION -y I-EXPLORATION -neutropenia I-EXPLORATION -absoluta. I-EXPLORATION -Se I-EXPLORATION -encontraron I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -deshigrogenasa I-EXPLORATION -láctica I-EXPLORATION -de I-EXPLORATION -300 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -calcio I-EXPLORATION -sérico I-EXPLORATION -de I-EXPLORATION -7, I-EXPLORATION -1 I-EXPLORATION -mg/dl. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -obtuvieron I-EXPLORATION -biopsias I-EXPLORATION -de I-EXPLORATION -ganglio I-EXPLORATION -linfático I-EXPLORATION -y I-EXPLORATION -médula I-EXPLORATION -ósea I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -fin I-EXPLORATION -de I-EXPLORATION -descartar I-EXPLORATION -un I-EXPLORATION -linfoma. I-EXPLORATION -Estos I-EXPLORATION -dos I-EXPLORATION -tejidos I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -sangre I-EXPLORATION -estaban I-EXPLORATION -infiltrados I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -neoplasia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -T I-EXPLORATION -con I-EXPLORATION -importante I-EXPLORATION -pleomorfismo I-EXPLORATION -nuclear. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -extendidos I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -"células I-EXPLORATION -flor" I-EXPLORATION -( I-EXPLORATION -flower I-EXPLORATION -cells I-EXPLORATION -) I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -identificó I-EXPLORATION -un I-EXPLORATION -fenotipo I-EXPLORATION -CD3+, I-EXPLORATION -CD2+, I-EXPLORATION -CD4+, I-EXPLORATION -CD5+, I-EXPLORATION -CD7-, I-EXPLORATION -CD8-, I-EXPLORATION -CD56- I-EXPLORATION -y I-EXPLORATION -TdTen I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -tumorales, I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -ganglio I-EXPLORATION -linfático I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -de I-EXPLORATION -médula I-EXPLORATION -ósea I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -citometría I-EXPLORATION -de I-EXPLORATION -flujo I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -periférica. I-EXPLORATION - I-EXPLORATION -Teniendo I-EXPLORATION -en I-EXPLORATION -cuenta I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -anteriores, I-EXPLORATION -se I-EXPLORATION -sospechó I-EXPLORATION -una I-EXPLORATION -leucemia/linfoma I-EXPLORATION -de I-EXPLORATION -célula I-EXPLORATION -T I-EXPLORATION -del I-EXPLORATION -adulto; I-EXPLORATION -por I-EXPLORATION -consiguiente, I-EXPLORATION -se I-EXPLORATION -solicitaron I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -ELISA I-EXPLORATION -y I-EXPLORATION -Western I-EXPLORATION -Blot I-EXPLORATION -para I-EXPLORATION -HTLV I-EXPLORATION -1-2, I-EXPLORATION -las I-EXPLORATION -cuales I-EXPLORATION -resultaron I-EXPLORATION -positivas, I-EXPLORATION -confirmando I-EXPLORATION -el I-EXPLORATION -diagnóstico. I-EXPLORATION -El I-EXPLORATION -resultado I-EXPLORATION -del I-EXPLORATION -Western I-EXPLORATION -blot I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -HTLV-1 I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -bandas I-EXPLORATION -p19, I-EXPLORATION -GD21 I-EXPLORATION -y I-EXPLORATION -rgp46-I. I-EXPLORATION +Finalmente, I-TREATMENT +ante I-TREATMENT +la I-TREATMENT +aparición I-TREATMENT +de I-TREATMENT +nuevas I-TREATMENT +lesiones I-TREATMENT +y I-TREATMENT +la I-TREATMENT +mala I-TREATMENT +tolerancia I-TREATMENT +a I-TREATMENT +los I-TREATMENT +tratamientos I-TREATMENT +previos, I-TREATMENT +optamos I-TREATMENT +por I-TREATMENT +iniciar I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +infliximab I-TREATMENT +(agente I-TREATMENT +anti-TNF), I-TREATMENT +comenzando I-TREATMENT +con I-TREATMENT +una I-TREATMENT +terapia I-TREATMENT +de I-TREATMENT +inducción I-TREATMENT +de I-TREATMENT +5 I-TREATMENT +mg/kg I-TREATMENT +a I-TREATMENT +las I-TREATMENT +0, I-TREATMENT +2 I-TREATMENT +y I-TREATMENT +6 I-TREATMENT +semanas I-TREATMENT +similar I-TREATMENT +a I-TREATMENT +la I-TREATMENT +empleada I-TREATMENT +en I-TREATMENT +la I-TREATMENT +enfermedad I-TREATMENT +inflamatoria I-TREATMENT +intestinal I-TREATMENT +o I-TREATMENT +en I-TREATMENT +la I-TREATMENT +psoriasis, I-TREATMENT +continuando I-TREATMENT +con I-TREATMENT +infusiones I-TREATMENT +de I-TREATMENT +mantenimiento I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +semanas. I-TREATMENT La B-EVOLUTION -forma I-EVOLUTION -de I-EVOLUTION -leucemia I-EVOLUTION -identificada I-EVOLUTION -correspondió I-EVOLUTION -a I-EVOLUTION -leucemia I-EVOLUTION -aguda. I-EVOLUTION -La I-EVOLUTION paciente I-EVOLUTION -falleció I-EVOLUTION -antes I-EVOLUTION +evolucionó I-EVOLUTION de I-EVOLUTION -iniciar I-EVOLUTION -el I-EVOLUTION -tratamiento. I-EVOLUTION - I-EVOLUTION +forma I-EVOLUTION +satisfactoria I-EVOLUTION +con I-EVOLUTION +reepitelización I-EVOLUTION +completa I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +2 I-EVOLUTION +meses I-EVOLUTION +del I-EVOLUTION +nuevo I-EVOLUTION +tratamiento, I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +decidimos I-TREATMENT +mantener I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +similar I-TREATMENT +al I-TREATMENT +de I-TREATMENT +otras I-TREATMENT +dermatosis I-TREATMENT +inflamatorias I-TREATMENT +hasta I-TREATMENT +objetivar I-TREATMENT +estabilización I-TREATMENT +de I-TREATMENT +la I-TREATMENT +enfermedad, I-TREATMENT +tras I-TREATMENT +lo I-TREATMENT +cual I-TREATMENT +nos I-TREATMENT +plantearemos I-TREATMENT +reducir, I-TREATMENT +con I-TREATMENT +espaciamiento I-TREATMENT +progresivo I-TREATMENT +de I-TREATMENT +las I-TREATMENT +dosis. I-TREATMENT + I-TREATMENT -Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -61 I-PRESENT_ILLNESS +62 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS +referir I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +testicular I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +acompañado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +termometrada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +40ºC, I-PRESENT_ILLNESS +junto I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -lumbar I-PRESENT_ILLNESS +escalofríos I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -cervical I-PRESENT_ILLNESS -posterior, I-PRESENT_ILLNESS -cuya I-PRESENT_ILLNESS -intensidad I-PRESENT_ILLNESS -aumentó I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -dificultar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -marcha. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente, I-PRESENT_ILLNESS -además, I-PRESENT_ILLNESS -tuvo I-PRESENT_ILLNESS -picos I-PRESENT_ILLNESS -febriles I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -cuantificados, I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -retroocular I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +miccional I-PRESENT_ILLNESS +acompañante I-PRESENT_ILLNESS +(disuria, I-PRESENT_ILLNESS +polaquiuria, I-PRESENT_ILLNESS +tenesmo I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -entró I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -estupor I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS +urgencia I-PRESENT_ILLNESS +miccional), I-PRESENT_ILLNESS +ausencia I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -ingresar I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias. I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +lumbar. I-PRESENT_ILLNESS I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION +Durante B-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +anamnesis I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +revela I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +profesión, I-PAST_MEDICAL_HISTORY +veterinario, I-PAST_MEDICAL_HISTORY +profesión I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +riesgo I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +ciertas I-PAST_MEDICAL_HISTORY +patologías I-PAST_MEDICAL_HISTORY +infecciosas I-PAST_MEDICAL_HISTORY +(brucelosis, I-PAST_MEDICAL_HISTORY +triquinosis I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +algunas I-PAST_MEDICAL_HISTORY +parasitosis). I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION se I-EXPLORATION -registró I-EXPLORATION +objetiva I-EXPLORATION un I-EXPLORATION -soplo I-EXPLORATION -sistólico I-EXPLORATION -mitral I-EXPLORATION +teste I-EXPLORATION +derecho I-EXPLORATION de I-EXPLORATION -grado I-EXPLORATION -II/IV, I-EXPLORATION -rigidez I-EXPLORATION +características I-EXPLORATION +normales, I-EXPLORATION +y, I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -nuca I-EXPLORATION -y I-EXPLORATION +el I-EXPLORATION +teste I-EXPLORATION +izquierdo, I-EXPLORATION +se I-EXPLORATION +visualiza I-EXPLORATION un I-EXPLORATION -puntaje I-EXPLORATION -de I-EXPLORATION -8/15 I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -escala I-EXPLORATION -de I-EXPLORATION -coma I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -Glasgow. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -ordenaron I-EXPLORATION -tomografías I-EXPLORATION -computadorizadas I-EXPLORATION -(TC), I-EXPLORATION -una I-EXPLORATION -cerebral I-EXPLORATION -simple I-EXPLORATION +tamaño I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +eritema I-EXPLORATION y I-EXPLORATION -otra I-EXPLORATION -contrastada, I-EXPLORATION +dolor I-EXPLORATION +al I-EXPLORATION +tacto I-EXPLORATION +sin I-EXPLORATION +fluctuación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +afecta I-EXPLORATION +aunque I-EXPLORATION con I-EXPLORATION -resultados I-EXPLORATION -normales. I-EXPLORATION -Debido I-EXPLORATION +dolor I-EXPLORATION a I-EXPLORATION la I-EXPLORATION -sospecha I-EXPLORATION +movilización I-EXPLORATION +testicular. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +tacto I-EXPLORATION +rectal I-EXPLORATION +resulta I-EXPLORATION +sin I-EXPLORATION +hallazgos I-EXPLORATION +patológicos I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +abdominal I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +la I-EXPLORATION +percusión I-EXPLORATION +renal I-EXPLORATION +también I-EXPLORATION +descartó I-EXPLORATION +afecciones I-EXPLORATION +acompañantes I-EXPLORATION +al I-EXPLORATION +ser I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +Analíticamente I-EXPLORATION +destaca I-EXPLORATION +leucocitosis I-EXPLORATION de I-EXPLORATION -meningitis I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -hizo I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION +22.240 I-EXPLORATION con I-EXPLORATION -análisis I-EXPLORATION -citoquímico I-EXPLORATION +neutrofilia I-EXPLORATION +(neutrófilos I-EXPLORATION +90%). I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +Ecografía I-EXPLORATION +testicular I-EXPLORATION +realizada I-EXPLORATION +previa I-EXPLORATION +al I-EXPLORATION +ingreso I-EXPLORATION +muestra I-EXPLORATION +aumentos I-EXPLORATION +homogéneos I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +ecogenicidad I-EXPLORATION del I-EXPLORATION -líquido I-EXPLORATION -cefalorraquídeo, I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -mostró I-EXPLORATION -aumento I-EXPLORATION +testículo I-EXPLORATION +afecto, I-EXPLORATION +sin I-EXPLORATION +afectación I-EXPLORATION del I-EXPLORATION -número I-EXPLORATION +epidídimo. I-EXPLORATION +Engrosamiento I-EXPLORATION de I-EXPLORATION -células, I-EXPLORATION -hipoglucorraquia I-EXPLORATION -e I-EXPLORATION -hiperproteinorraquia, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +partes I-EXPLORATION +blandas I-EXPLORATION +con I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -cocos I-EXPLORATION -Gram I-EXPLORATION -positivos. I-EXPLORATION +absceso I-EXPLORATION +testicular. I-EXPLORATION +Imágenes I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +orquitis I-EXPLORATION +sin I-EXPLORATION +afectación I-EXPLORATION +del I-EXPLORATION +epidídimo. I-EXPLORATION I-EXPLORATION Se B-TREATMENT -inició I-TREATMENT +realiza I-TREATMENT el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +orquitis I-TREATMENT +infecciosa, I-TREATMENT +procediéndose I-TREATMENT +a I-TREATMENT +su I-TREATMENT +ingreso I-TREATMENT +con I-TREATMENT +un I-TREATMENT tratamiento I-TREATMENT antibiótico I-TREATMENT -con I-TREATMENT -ceftriaxona I-TREATMENT -(2 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas), I-TREATMENT -vancomicina I-TREATMENT -(1 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas) I-TREATMENT +que I-TREATMENT +comprendió I-TREATMENT +Doxiciclina, I-TREATMENT +Imipenem I-TREATMENT y I-TREATMENT -dexametasona I-TREATMENT -(8 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -6 I-TREATMENT -horas I-TREATMENT -por I-TREATMENT -4 I-TREATMENT -días). I-TREATMENT -En B-EXPLORATION -dos I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION +Teicoplanina, I-TREATMENT +asociando I-TREATMENT +Corticoides I-TREATMENT +y I-TREATMENT +terapia I-TREATMENT +analgésica. I-TREATMENT + I-TREATMENT +Dos B-EXPLORATION +días I-EXPLORATION +tras I-EXPLORATION el I-EXPLORATION -cultivo I-EXPLORATION +ingresse I-EXPLORATION +realiza I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +ecografía, I-EXPLORATION +objetivándose I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -líquido I-EXPLORATION -cefalorraquídeo, I-EXPLORATION -se I-EXPLORATION -aisló I-EXPLORATION -Streptococcus I-EXPLORATION -pneumoniae, I-EXPLORATION -serotipo I-EXPLORATION -18C, I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -24 I-EXPLORATION -horas, I-EXPLORATION +la I-EXPLORATION +ecogenicidad I-EXPLORATION +homogénea I-EXPLORATION +similar I-EXPLORATION +al I-EXPLORATION +contralateral, I-EXPLORATION +afectación I-EXPLORATION +epididimaria. I-EXPLORATION +Engrosamiento I-EXPLORATION +de I-EXPLORATION +partes I-EXPLORATION +blandas I-EXPLORATION con I-EXPLORATION -concentración I-EXPLORATION -inhibitoria I-EXPLORATION -mínima I-EXPLORATION -(CIM) I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -0, I-EXPLORATION -06 I-EXPLORATION -µg/ml I-EXPLORATION -para I-EXPLORATION -penicilina I-EXPLORATION -y I-EXPLORATION -eritromicina, I-EXPLORATION +absceso I-EXPLORATION +testicular. I-EXPLORATION +Se I-EXPLORATION +termina I-EXPLORATION de I-EXPLORATION -0, I-EXPLORATION -03 I-EXPLORATION -µg/ml I-EXPLORATION -para I-EXPLORATION -ceftriaxona I-EXPLORATION -y I-EXPLORATION +filiar I-EXPLORATION +el I-EXPLORATION +cuadro I-EXPLORATION +sindrómico: I-EXPLORATION +Orquiepididimitis I-EXPLORATION +infecciosa. I-EXPLORATION + I-EXPLORATION +Para I-EXPLORATION +averiguar I-EXPLORATION +la I-EXPLORATION +causa I-EXPLORATION de I-EXPLORATION -0, I-EXPLORATION -05 I-EXPLORATION -µg/ml I-EXPLORATION -para I-EXPLORATION -trimetoprim- I-EXPLORATION -sulfametoxazol I-EXPLORATION -y I-EXPLORATION -vancomicina, I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION +la I-EXPLORATION +patología I-EXPLORATION que I-EXPLORATION +presenta I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION se I-EXPLORATION -trataba I-EXPLORATION +hace I-EXPLORATION +necesaria I-EXPLORATION +la I-EXPLORATION +realización I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -microorganismo I-EXPLORATION -sensible I-EXPLORATION +pruebas I-EXPLORATION +que I-EXPLORATION +permitan I-EXPLORATION +conocer I-EXPLORATION +el I-EXPLORATION +germen I-EXPLORATION +causante. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +urocultivo I-EXPLORATION +resulta I-EXPLORATION +ser I-EXPLORATION +negativo, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +la I-EXPLORATION +aglutinación I-EXPLORATION +específica I-EXPLORATION +de I-EXPLORATION +Brucella. I-EXPLORATION +Sin I-EXPLORATION +embargo I-EXPLORATION +la I-EXPLORATION +seroaglutinación I-EXPLORATION +de I-EXPLORATION +Rosa I-EXPLORATION +de I-EXPLORATION +Bengala I-EXPLORATION +resulta I-EXPLORATION +positiva, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +los I-EXPLORATION +hemocultivos, I-EXPLORATION +que I-EXPLORATION +son I-EXPLORATION +positivos I-EXPLORATION a I-EXPLORATION -varios I-EXPLORATION -antibióticos. I-EXPLORATION +Brucella I-EXPLORATION +spp. I-EXPLORATION +(los I-EXPLORATION +tres). I-EXPLORATION I-EXPLORATION -Con B-TREATMENT -base I-TREATMENT -en I-TREATMENT -estos I-TREATMENT -resultados, I-TREATMENT -al I-TREATMENT -cuarto I-TREATMENT -día I-TREATMENT -de I-TREATMENT -tra I-TREATMENT -tamiento I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -suspender I-TREATMENT +Ante B-TREATMENT la I-TREATMENT -administración I-TREATMENT +confirmación I-TREATMENT +del I-TREATMENT +diagnóstico I-TREATMENT de I-TREATMENT -vancomicina I-TREATMENT -y I-TREATMENT +orquiepididimitis I-TREATMENT +brucelar I-TREATMENT se I-TREATMENT -continuó I-TREATMENT +decide I-TREATMENT +mantener I-TREATMENT el I-TREATMENT -manejo I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -ceftriaxona I-TREATMENT -dirigido I-TREATMENT -específicamente I-TREATMENT -al I-TREATMENT -microorganismo I-TREATMENT -aislado. I-TREATMENT +Doxiciclina I-TREATMENT +y I-TREATMENT +ciprofloxacino. I-TREATMENT I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -del I-EVOLUTION +El B-EVOLUTION paciente I-EVOLUTION -siguió I-EVOLUTION -siendo I-EVOLUTION -irregular, I-EVOLUTION +evoluciona I-EVOLUTION +favorablemente I-EVOLUTION con I-EVOLUTION -picos I-EVOLUTION -febriles I-EVOLUTION -durante I-EVOLUTION -su I-EVOLUTION -estancia I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -unidad I-EVOLUTION -de I-EVOLUTION -cuidados I-EVOLUTION -intensivos, I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -leucocitosis, I-EVOLUTION -neutrófilos I-EVOLUTION -en I-EVOLUTION -cayado I-EVOLUTION -y I-EVOLUTION -elevación I-EVOLUTION -constante I-EVOLUTION +remisión I-EVOLUTION +completa I-EVOLUTION de I-EVOLUTION los I-EVOLUTION -reactantes I-EVOLUTION -de I-EVOLUTION -fase I-EVOLUTION -aguda. I-EVOLUTION -Los B-EXPLORATION -hemocultivos I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -para I-EXPLORATION -bacterias I-EXPLORATION -y I-EXPLORATION -hongos I-EXPLORATION -fueron I-EXPLORATION -negativos, I-EXPLORATION -sin I-EXPLORATION -embargo, I-EXPLORATION -al I-EXPLORATION -octavo I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -hospitalización I-EXPLORATION -se I-EXPLORATION -registró I-EXPLORATION -hipoventilación I-EXPLORATION -bilateral I-EXPLORATION -y I-EXPLORATION -estertores I-EXPLORATION -basales I-EXPLORATION -en I-EXPLORATION -pulmón I-EXPLORATION -derecho; I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -infiltrados I-EXPLORATION -alveolares I-EXPLORATION -basales I-EXPLORATION -en I-EXPLORATION -dicho I-EXPLORATION -pulmón I-EXPLORATION -y I-EXPLORATION -broncograma I-EXPLORATION -aéreo. I-EXPLORATION -Dado B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -neumonía I-TREATMENT -asociada I-TREATMENT -y I-TREATMENT -la I-TREATMENT -deficiente I-TREATMENT -progresión I-TREATMENT -clínica, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -comenzar I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -cefepime I-TREATMENT -(2 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas) I-TREATMENT -y I-TREATMENT -linezolid I-TREATMENT -(600 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas). I-TREATMENT - I-TREATMENT -Ante B-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -del I-EXPLORATION -soplo I-EXPLORATION -cardiaco I-EXPLORATION -mitral, I-EXPLORATION -se I-EXPLORATION -obtuvo I-EXPLORATION -un I-EXPLORATION -ecocardiograma I-EXPLORATION -transesofágico, I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -evidenció I-EXPLORATION -insuficiencia I-EXPLORATION -mitral I-EXPLORATION -grave I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -ruptura I-EXPLORATION -del I-EXPLORATION -festón I-EXPLORATION -medial I-EXPLORATION -posterior I-EXPLORATION +síntomas. I-EVOLUTION + I-EVOLUTION + +Presentamos B-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +recién I-PRESENT_ILLNESS +nacido I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +vida I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +38, I-PRESENT_ILLNESS +5ºC I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +hora I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +rechazo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +alimentación. I-PRESENT_ILLNESS +Como B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +destacaban I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +embarazo I-PAST_MEDICAL_HISTORY +controlado I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +normal; I-PAST_MEDICAL_HISTORY +serologías I-PAST_MEDICAL_HISTORY +negativas I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +virus I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +hepatitis I-PAST_MEDICAL_HISTORY +B I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +C, I-PAST_MEDICAL_HISTORY +virus I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +inmunodeficiencia I-PAST_MEDICAL_HISTORY +humana, I-PAST_MEDICAL_HISTORY +sífilis I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +toxoplasma; I-PAST_MEDICAL_HISTORY +frotis I-PAST_MEDICAL_HISTORY +vaginal I-PAST_MEDICAL_HISTORY +negativo I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +Streptococcus I-PAST_MEDICAL_HISTORY +grupo I-PAST_MEDICAL_HISTORY +B; I-PAST_MEDICAL_HISTORY +ruptura I-PAST_MEDICAL_HISTORY +espontánea I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +membranas I-PAST_MEDICAL_HISTORY +intraparto, I-PAST_MEDICAL_HISTORY +parto I-PAST_MEDICAL_HISTORY +instrumental I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +fórceps I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +41 I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +gestación I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +peso I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +nacimiento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +3880 I-PAST_MEDICAL_HISTORY +g. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +prueba I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Apgar I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +minuto I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +8 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +minutos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +9, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +requerir I-PAST_MEDICAL_HISTORY +reanimación. I-PAST_MEDICAL_HISTORY +Comenzó I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +esquema I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +inmunización. I-PAST_MEDICAL_HISTORY +Alimentación I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +lactancia I-PAST_MEDICAL_HISTORY +materna I-PAST_MEDICAL_HISTORY +exclusiva. I-PAST_MEDICAL_HISTORY +Respecto B-FAMILY_HISTORY +a I-FAMILY_HISTORY +los I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +familiares, I-FAMILY_HISTORY +los I-FAMILY_HISTORY +padres I-FAMILY_HISTORY +refirieron I-FAMILY_HISTORY +haber I-FAMILY_HISTORY +padecido I-FAMILY_HISTORY +amigdalitis I-FAMILY_HISTORY +los I-FAMILY_HISTORY +días I-FAMILY_HISTORY +previos. I-FAMILY_HISTORY +La B-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +mostró I-EXPLORATION +decaimiento I-EXPLORATION y I-EXPLORATION -su I-EXPLORATION -subsiguiente I-EXPLORATION -prolapso, I-EXPLORATION +regular I-EXPLORATION +perfusión I-EXPLORATION +periférica I-EXPLORATION con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -cuatro I-EXPLORATION -vegetaciones I-EXPLORATION -sobre I-EXPLORATION -la I-EXPLORATION -cara I-EXPLORATION -auricular I-EXPLORATION +constantes I-EXPLORATION +vitales I-EXPLORATION +normales, I-EXPLORATION +sin I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +objetivasen I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -valva I-EXPLORATION -posterior, I-EXPLORATION +foco. I-EXPLORATION +La I-EXPLORATION +analítica I-EXPLORATION +inicial I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +determinación I-EXPLORATION de I-EXPLORATION -20 I-EXPLORATION -x I-EXPLORATION -5 I-EXPLORATION -mm, I-EXPLORATION -11 I-EXPLORATION -x I-EXPLORATION -3 I-EXPLORATION -mm, I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -2 I-EXPLORATION -mm I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +cuantitativa I-EXPLORATION +(PC-R) I-EXPLORATION +133, I-EXPLORATION +4 I-EXPLORATION +mg/L, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +hemograma I-EXPLORATION +coagulado I-EXPLORATION y I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -2 I-EXPLORATION -mm. I-EXPLORATION -Ante B-TREATMENT -el I-TREATMENT -hallazgo I-TREATMENT +un I-EXPLORATION +sedimento I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +punción I-EXPLORATION +lumbar I-EXPLORATION +resultó I-EXPLORATION +hemorrágica. I-EXPLORATION +Ingresó B-TREATMENT +con I-TREATMENT +diagnóstico I-TREATMENT de I-TREATMENT -endocarditis I-TREATMENT -sobre I-TREATMENT -válvula I-TREATMENT -mitral I-TREATMENT -nativa, I-TREATMENT +síndrome I-TREATMENT +febril I-TREATMENT +sin I-TREATMENT +foco I-TREATMENT +y I-TREATMENT se I-TREATMENT -decidió I-TREATMENT -continuar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -durante I-TREATMENT -6 I-TREATMENT -semanas I-TREATMENT -más I-TREATMENT -y B-DERIVED_FROM/TO -remitir I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -institución I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -IV I-DERIVED_FROM/TO -nivel I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -reemplazo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -válvula. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -El B-EVOLUTION -paciente I-EVOLUTION -ingresó I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -unidad I-EVOLUTION -de I-EVOLUTION -cuidados I-EVOLUTION -intensivos I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -institución I-EVOLUTION -de I-EVOLUTION -nivel I-EVOLUTION -IV I-EVOLUTION -en I-EVOLUTION -malas I-EVOLUTION -condiciones I-EVOLUTION -generales, I-EVOLUTION -estaba I-EVOLUTION -hipotenso I-EVOLUTION -y B-TREATMENT -hubo I-TREATMENT -necesidad I-TREATMENT -de I-TREATMENT -administrarle I-TREATMENT -vasopresores I-TREATMENT +inició I-TREATMENT +antibioterapia I-TREATMENT +empírica I-TREATMENT +con I-TREATMENT +ampicilina I-TREATMENT y I-TREATMENT -utilizar I-TREATMENT -catéter I-TREATMENT +cefotaxima I-TREATMENT +intravenosas I-TREATMENT +tras I-TREATMENT +la I-TREATMENT +toma I-TREATMENT de I-TREATMENT -Swan-Ganz I-TREATMENT -; I-TREATMENT -presentó B-EVOLUTION -tres I-EVOLUTION -paros I-EVOLUTION -cardiorrespiratorios I-EVOLUTION -en I-EVOLUTION +cultivos. I-TREATMENT +En B-EXPLORATION +el I-EXPLORATION +hemograma I-EXPLORATION +repetido I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +5800 I-EXPLORATION +leucocitos/mm3, I-EXPLORATION +con I-EXPLORATION +fórmula I-EXPLORATION +normal, I-EXPLORATION +13, I-EXPLORATION +4 I-EXPLORATION +g/dl I-EXPLORATION +de I-EXPLORATION +hemoglobina, I-EXPLORATION +32 I-EXPLORATION +000 I-EXPLORATION +plaquetas/mm3. I-EXPLORATION +A B-EVOLUTION las I-EVOLUTION -primeras I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -(ritmo I-EVOLUTION -de I-EVOLUTION -paro: I-EVOLUTION -actividad I-EVOLUTION -eléctrica I-EVOLUTION -sin I-EVOLUTION -pulso). I-EVOLUTION -Presentaba, B-TREATMENT -además, I-TREATMENT -signos I-TREATMENT -clínicos I-TREATMENT +18 I-EVOLUTION +h I-EVOLUTION +del I-EVOLUTION +ingreso I-EVOLUTION +empeoró I-EVOLUTION +su I-EVOLUTION +estado I-EVOLUTION +general I-EVOLUTION +y I-EVOLUTION +presentó I-EVOLUTION +crisis I-EVOLUTION +convulsivas I-EVOLUTION +generalizadas I-EVOLUTION +que B-TREATMENT +requirieron I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +fenobarbital I-TREATMENT y I-TREATMENT -paraclínicos I-TREATMENT +perfusión I-TREATMENT de I-TREATMENT -hipoperfusión, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -le I-TREATMENT -administró I-TREATMENT -inotrópico, I-TREATMENT -y I-TREATMENT -nuevamente I-TREATMENT -se I-TREATMENT -intensificó I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antibiótico, I-TREATMENT -administrando I-TREATMENT -vancomicina I-TREATMENT -(1 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas) I-TREATMENT +midazolam. I-TREATMENT +En B-EVOLUTION +la I-EVOLUTION +evolución I-EVOLUTION +desarrolló I-EVOLUTION +afectación I-EVOLUTION +sistémica I-EVOLUTION +con I-EVOLUTION +hipotensión I-EVOLUTION +arterial, I-EVOLUTION +acidosis I-EVOLUTION +metabólica, I-EVOLUTION +hiponatremia, I-EVOLUTION +oliguria I-EVOLUTION +y I-EVOLUTION +plaquetopenia I-EVOLUTION +grave; I-EVOLUTION +requirió B-TREATMENT +ventilación I-TREATMENT +mecánica I-TREATMENT +convencional, I-TREATMENT +transfusión I-TREATMENT +de I-TREATMENT +hemoderivados, I-TREATMENT +soporte I-TREATMENT +inotrópico I-TREATMENT +con I-TREATMENT +dopamina I-TREATMENT y I-TREATMENT -meropenem I-TREATMENT -(1 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas). I-TREATMENT - I-TREATMENT -Se B-EXPLORATION -hizo, I-EXPLORATION -igualmente, I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -cerebral I-EXPLORATION -contrastada, I-EXPLORATION -mediante I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION +diurético I-TREATMENT +con I-TREATMENT +furosemida. I-TREATMENT +El B-EXPLORATION +tercer I-EXPLORATION +día I-EXPLORATION +del I-EXPLORATION +ingreso I-EXPLORATION se I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -focos I-EXPLORATION -isquémicos I-EXPLORATION +informó I-EXPLORATION +el I-EXPLORATION +aislamiento I-EXPLORATION en I-EXPLORATION -varios I-EXPLORATION -terri I-EXPLORATION -torios I-EXPLORATION -vasculares I-EXPLORATION -supratentoriales I-EXPLORATION -e I-EXPLORATION -infratentoriales, I-EXPLORATION -los I-EXPLORATION -cuales I-EXPLORATION -se I-EXPLORATION -consideran I-EXPLORATION -indicativos I-EXPLORATION +el I-EXPLORATION +hemocultivo I-EXPLORATION de I-EXPLORATION -embolia. I-EXPLORATION - I-EXPLORATION -Gradualmente B-EVOLUTION -se I-EVOLUTION -logró I-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -neurológica I-EVOLUTION -parcial, I-EVOLUTION -lo B-TREATMENT +Streptococcus I-EXPLORATION +pyogenes I-EXPLORATION +sensible I-EXPLORATION +a I-EXPLORATION +penicilina, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT que I-TREATMENT -posibilitó I-TREATMENT -retirarle I-TREATMENT -el I-TREATMENT -tubo I-TREATMENT -de I-TREATMENT -tórax I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT +la I-TREATMENT +ampicilina I-TREATMENT y I-TREATMENT -el I-TREATMENT -medicamento I-TREATMENT -vasoactivo, I-TREATMENT -pero I-TREATMENT se I-TREATMENT mantuvo I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -del I-TREATMENT -inotrópico I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -la I-TREATMENT -persis I-TREATMENT -tencia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -disfunción I-TREATMENT -cardiaca I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -compromiso I-TREATMENT -grave I-TREATMENT -de I-TREATMENT -la I-TREATMENT -válvula I-TREATMENT -mitral. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Neurología I-EVOLUTION -se I-EVOLUTION -evaluó I-EVOLUTION -al I-EVOLUTION -paciente I-EVOLUTION -cinco I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION +cefotaxima I-TREATMENT +intravenosa. I-TREATMENT +Tras B-EVOLUTION su I-EVOLUTION -ingreso I-EVOLUTION +estabilización I-EVOLUTION +presentó I-EVOLUTION +mejoría I-EVOLUTION +clínica I-EVOLUTION y I-EVOLUTION -se I-EVOLUTION -encontró I-EVOLUTION -que I-EVOLUTION -su I-EVOLUTION -estado I-EVOLUTION -de I-EVOLUTION -conciencia I-EVOLUTION -era I-EVOLUTION -adecuado, I-EVOLUTION -sin I-EVOLUTION -deficiencias I-EVOLUTION -neurológicas I-EVOLUTION -focalizadas; I-EVOLUTION -finalmente, B-TREATMENT +analítica, I-EVOLUTION +que B-TREATMENT +permitió I-TREATMENT +suspender I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +inotrópico I-TREATMENT +a I-TREATMENT +las I-TREATMENT +48 I-TREATMENT +h I-TREATMENT +y I-TREATMENT +realizar I-TREATMENT +extubación I-TREATMENT al I-TREATMENT -décimo I-TREATMENT -día I-TREATMENT -de I-TREATMENT -hospitalización, I-TREATMENT -se I-TREATMENT -reemplazó I-TREATMENT -la I-TREATMENT -válvula I-TREATMENT -mitral I-TREATMENT -por I-TREATMENT -una I-TREATMENT -prótesis I-TREATMENT -mecánica I-TREATMENT -#27. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -inicial I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION -fue I-EVOLUTION -estable I-EVOLUTION -y I-EVOLUTION -no I-EVOLUTION -requirió I-EVOLUTION -de I-EVOLUTION -medicamento I-EVOLUTION -vasopresor I-EVOLUTION -o I-EVOLUTION -inotrópico; I-EVOLUTION -la I-EVOLUTION -única I-EVOLUTION -complicación I-EVOLUTION -que I-EVOLUTION +cuarto I-TREATMENT +día. I-TREATMENT +No B-EVOLUTION se I-EVOLUTION -presentó I-EVOLUTION -fue I-EVOLUTION -una I-EVOLUTION -coagulopatía I-EVOLUTION -secundaria I-EVOLUTION -al I-EVOLUTION -uso I-EVOLUTION -de I-EVOLUTION -bomba I-EVOLUTION -extracorpórea, I-EVOLUTION -la B-TREATMENT +repitieron I-EVOLUTION +las I-EVOLUTION +crisis I-EVOLUTION +clínicas I-EVOLUTION +y B-EXPLORATION +el I-EXPLORATION +electroencefalograma I-EXPLORATION +fue I-EXPLORATION +normal, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT cual I-TREATMENT se I-TREATMENT -corrigió I-TREATMENT -con I-TREATMENT -transfusión I-TREATMENT -de I-TREATMENT -hemocomponentes. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -histopatológico I-EXPLORATION -de I-EXPLORATION +suspendió I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +anticomicial. I-TREATMENT +Se B-EXPLORATION +repitió I-EXPLORATION la I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION +punción I-EXPLORATION +lumbar I-EXPLORATION +sin I-EXPLORATION +éxito. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +cerebral I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -válvula I-EXPLORATION -mitral I-EXPLORATION -nativa I-EXPLORATION -se I-EXPLORATION -reportó I-EXPLORATION -endocarditis I-EXPLORATION -aguda, I-EXPLORATION -en I-EXPLORATION -tanto I-EXPLORATION -que I-EXPLORATION +angiorresonancia I-EXPLORATION +iniciales I-EXPLORATION +mostraron I-EXPLORATION +hemorragia I-EXPLORATION +intraventricular I-EXPLORATION +con I-EXPLORATION +discreta I-EXPLORATION +ventriculomegalia I-EXPLORATION +y I-EXPLORATION +lesiones I-EXPLORATION +hemisféricas I-EXPLORATION +cortico-subcorticales I-EXPLORATION +bilaterales, I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +meningoencefalitis. I-EXPLORATION +No I-EXPLORATION +superó I-EXPLORATION +el I-EXPLORATION +tamizaje I-EXPLORATION +auditivo I-EXPLORATION +realizado I-EXPLORATION +durante I-EXPLORATION +el I-EXPLORATION +ingreso I-EXPLORATION +mediante I-EXPLORATION la I-EXPLORATION -tinción I-EXPLORATION +técnica I-EXPLORATION de I-EXPLORATION -Gram I-EXPLORATION -no I-EXPLORATION -evidenció I-EXPLORATION -bacterias I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -cultivos I-EXPLORATION -definitivos I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION +exploración I-EXPLORATION +de I-EXPLORATION +potenciales I-EXPLORATION +provocados I-EXPLORATION +auditivos I-EXPLORATION +de I-EXPLORATION +tronco I-EXPLORATION +cerebral I-EXPLORATION +automatizados I-EXPLORATION +(PEATC-A I-EXPLORATION +> I-EXPLORATION +40 I-EXPLORATION +dB). I-EXPLORATION +En I-EXPLORATION +las I-EXPLORATION +ecografías I-EXPLORATION +cerebrales I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +presentó I-EXPLORATION +buena I-EXPLORATION +evolución I-EXPLORATION +sin I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +dilatación I-EXPLORATION +ventricular. I-EXPLORATION I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -siguió I-EVOLUTION -hospitalizado I-EVOLUTION -para I-EVOLUTION -optimizar I-EVOLUTION -la I-EVOLUTION -anticoagulación. I-EVOLUTION -Diez I-EVOLUTION +A B-EVOLUTION +los I-EVOLUTION +34 I-EVOLUTION días I-EVOLUTION +de I-EVOLUTION +vida, I-EVOLUTION después I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION -presentó I-EVOLUTION -deterioro I-EVOLUTION -clínico, I-EVOLUTION +completar I-EVOLUTION +21 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION con I-EVOLUTION -inestabilidad I-EVOLUTION -hemodinámica I-EVOLUTION -y I-EVOLUTION -falla I-EVOLUTION -respiratoria. I-EVOLUTION -Se B-TREATMENT -documentó I-TREATMENT -bacteriemia I-TREATMENT -por I-TREATMENT -Klebsiella I-TREATMENT -pneumoniae I-TREATMENT -positiva I-TREATMENT -para I-TREATMENT -betalactamasa I-TREATMENT -de I-TREATMENT -espectro I-TREATMENT -extendido I-TREATMENT -(BLEE), I-TREATMENT -ante I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -administró I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -con I-TREATMENT -meropenem I-TREATMENT -y I-TREATMENT -vancomicina. I-TREATMENT -En B-EXPLORATION -un I-EXPLORATION -nuevo I-EXPLORATION -ecocardiograma I-EXPLORATION -transesofágico I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -prótesis I-EXPLORATION -mecánica I-EXPLORATION -en I-EXPLORATION -posición I-EXPLORATION -mitral I-EXPLORATION -funcio I-EXPLORATION -naba I-EXPLORATION -normalmente. I-EXPLORATION -Se I-EXPLORATION -decidió I-EXPLORATION -hacer I-EXPLORATION -estudios I-EXPLORATION -de I-EXPLORATION -extensión I-EXPLORATION -ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humoral I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -al I-EXPLORATION -haber I-EXPLORATION -presentado I-EXPLORATION -dos I-EXPLORATION -bacteriemias I-EXPLORATION -por I-EXPLORATION -bacterias I-EXPLORATION -encapsuladas, I-EXPLORATION -sin I-EXPLORATION -embargo, I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -inmunoglobulinas I-EXPLORATION -estaban I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -rangos I-EXPLORATION -normales. I-EXPLORATION -Al B-TREATMENT -completarse I-TREATMENT -una I-TREATMENT -semana I-TREATMENT -de I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -meropenem I-TREATMENT -se I-TREATMENT -comenzó I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -ceftriaxona I-TREATMENT -con I-TREATMENT -la I-TREATMENT -intención I-TREATMENT -de I-TREATMENT -completar I-TREATMENT -otra I-TREATMENT -semana I-TREATMENT -más, I-TREATMENT -suspender I-TREATMENT -y I-TREATMENT -continuar I-TREATMENT -después I-TREATMENT -solo I-TREATMENT -con I-TREATMENT -vancomicina I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -las I-TREATMENT -seis I-TREATMENT -semanas I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -para I-TREATMENT -endocarditis. I-TREATMENT - I-TREATMENT -Finalmente, B-EVOLUTION +cefotaxima, I-EVOLUTION +se I-EVOLUTION +otorgó I-EVOLUTION el I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION alta I-EVOLUTION -sin I-EVOLUTION -secuelas I-EVOLUTION -neurológicas I-EVOLUTION -evidentes I-EVOLUTION -y I-EVOLUTION +hospitalaria I-EVOLUTION con I-EVOLUTION -fracción I-EVOLUTION +una I-EVOLUTION +exploración I-EVOLUTION +neurológica I-EVOLUTION +normal, I-EVOLUTION +excepto I-EVOLUTION +una I-EVOLUTION +leve I-EVOLUTION +hipotonía I-EVOLUTION de I-EVOLUTION -eyección I-EVOLUTION -preservada I-EVOLUTION -(60-65 I-EVOLUTION -%), I-EVOLUTION -cavidades I-EVOLUTION -izquierda I-EVOLUTION -y I-EVOLUTION -derecha I-EVOLUTION +eje. I-EVOLUTION +Se I-EVOLUTION +realizó I-EVOLUTION +seguimiento I-EVOLUTION +por I-EVOLUTION +especialistas I-EVOLUTION de I-EVOLUTION -tamaño I-EVOLUTION -y I-EVOLUTION -contractilidad I-EVOLUTION -normales, I-EVOLUTION -prótesis I-EVOLUTION -mecánica I-EVOLUTION -mitral I-EVOLUTION -con I-EVOLUTION -función I-EVOLUTION -normal I-EVOLUTION -y I-EVOLUTION -gradiente I-EVOLUTION -medio I-EVOLUTION -(6 I-EVOLUTION -mm I-EVOLUTION -Hg), I-EVOLUTION -y I-EVOLUTION -ausencia I-EVOLUTION +las I-EVOLUTION +unidades I-EVOLUTION de I-EVOLUTION -imágenes I-EVOLUTION -sugestivas I-EVOLUTION +rehabilitación, I-EVOLUTION +otorrinolaringología I-EVOLUTION +y I-EVOLUTION +neurología; I-EVOLUTION +al I-EVOLUTION +año I-EVOLUTION de I-EVOLUTION -vegetaciones. I-EVOLUTION +vida, I-EVOLUTION +no I-EVOLUTION +presentaba I-EVOLUTION +patología I-EVOLUTION +auditiva I-EVOLUTION +ni I-EVOLUTION +neurológica I-EVOLUTION +residual. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -ni B-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés, I-FAMILY_HISTORY remitido B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -externa I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO de I-DERIVED_FROM/TO -urología I-DERIVED_FROM/TO -ante I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -hallazgo I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -ecografía I-DERIVED_FROM/TO -abdominal, I-DERIVED_FROM/TO -realizada I-DERIVED_FROM/TO +urgencias I-DERIVED_FROM/TO por I-DERIVED_FROM/TO -síntomas I-DERIVED_FROM/TO -digestivos I-DERIVED_FROM/TO -inespecíficos, I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -tumoración I-DERIVED_FROM/TO -suprarrenal I-DERIVED_FROM/TO -derecha I-DERIVED_FROM/TO -sólida I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -6 I-DERIVED_FROM/TO -cm I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -diámetro. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -La B-EXPLORATION -anamnesis I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -no I-EXPLORATION -revelaron I-EXPLORATION -síntomas I-EXPLORATION -ni I-EXPLORATION -signos I-EXPLORATION -que I-EXPLORATION -orientaran I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -endocrinopatía, I-EXPLORATION -ni I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -primario. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -procedió, I-EXPLORATION -mediante I-EXPLORATION -estudio I-EXPLORATION -endocrinológico, I-EXPLORATION -a I-EXPLORATION -establecer I-EXPLORATION -el I-EXPLORATION -carácter I-EXPLORATION -funcionante I-EXPLORATION -o I-EXPLORATION -no I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tumoración I-EXPLORATION -suprarrenal. I-EXPLORATION -Se I-EXPLORATION -determinaron: I-EXPLORATION -cortisol I-EXPLORATION -libre I-EXPLORATION -en I-EXPLORATION -orina; I-EXPLORATION -cortisol I-EXPLORATION -en I-EXPLORATION -orina I-EXPLORATION -de I-EXPLORATION -24 I-EXPLORATION -horas; I-EXPLORATION -supresión I-EXPLORATION -con I-EXPLORATION -1 I-EXPLORATION -mgr I-EXPLORATION -de I-EXPLORATION -dexametasona; I-EXPLORATION -cortisol I-EXPLORATION -basal I-EXPLORATION -en I-EXPLORATION -sangre; I-EXPLORATION -ACTH; I-EXPLORATION -aldosterona I-EXPLORATION -en I-EXPLORATION -sangre; I-EXPLORATION -DHEA-sulfato; I-EXPLORATION -catecolaminas I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -(noradrenalina, I-EXPLORATION -adrenalina) I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -orina, I-EXPLORATION -y I-EXPLORATION -sus I-EXPLORATION -metabolitos I-EXPLORATION -(vanilmandélico, I-EXPLORATION -metanefrinas). I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -parámetros I-EXPLORATION -analíticos I-EXPLORATION -practicados I-EXPLORATION -fueron I-EXPLORATION -todos I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -demuestra I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -suprarrenal I-EXPLORATION -derecha I-EXPLORATION -sólida, I-EXPLORATION -de I-EXPLORATION -contornos I-EXPLORATION -bien I-EXPLORATION -definidos I-EXPLORATION -y I-EXPLORATION -densidad I-EXPLORATION -heterogénea, I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -hipodensas I-EXPLORATION -e I-EXPLORATION -imágenes I-EXPLORATION -de I-EXPLORATION -densidad I-EXPLORATION -calcio I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior, I-EXPLORATION -que I-EXPLORATION -mide I-EXPLORATION -6, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -3 I-EXPLORATION -cm. I-EXPLORATION -La I-EXPLORATION -Resonancia I-EXPLORATION -Magnética I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -ovalada I-EXPLORATION -y I-EXPLORATION -bien I-EXPLORATION -definida, I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -mayor, I-EXPLORATION -isointensa I-EXPLORATION -respecto I-EXPLORATION -al I-EXPLORATION -bazo I-EXPLORATION -en I-EXPLORATION -T1 I-EXPLORATION -y I-EXPLORATION -T2, I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -irregulares I-EXPLORATION -hiperintensas I-EXPLORATION -en I-EXPLORATION -T2. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -concluyó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -suprarrenal I-EXPLORATION -derecha I-EXPLORATION -sólida, I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -funcionante. I-EXPLORATION -Con B-TREATMENT -este I-TREATMENT -diagnóstico, I-TREATMENT -y I-TREATMENT -apoyados I-TREATMENT -fundamentalmente I-TREATMENT -en I-TREATMENT -el I-TREATMENT -tamaño I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tumoración, I-TREATMENT -así I-TREATMENT -como I-TREATMENT -en I-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -calcificaciones I-TREATMENT -irregulares I-TREATMENT -en I-TREATMENT -su I-TREATMENT -interior, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -quirúrgica I-TREATMENT -de I-TREATMENT -la I-TREATMENT -misma I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -que I-TREATMENT -se I-TREATMENT -tratara I-TREATMENT -de I-TREATMENT -un I-TREATMENT -carcinoma I-TREATMENT -suprarrenal. I-TREATMENT -Se I-TREATMENT -practicó I-TREATMENT -suprarrenalectomía I-TREATMENT -derecha I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -lumbotomía. I-TREATMENT - I-TREATMENT -Macroscópicamente, I-TREATMENT -la I-TREATMENT -pieza I-TREATMENT -de I-TREATMENT -suprarrenalectomía I-TREATMENT -midió I-TREATMENT -8 I-TREATMENT -x I-TREATMENT -6, I-TREATMENT -5 I-TREATMENT -x I-TREATMENT -3 I-TREATMENT -cm. I-TREATMENT -La B-EXPLORATION -tumoración I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -superficie I-EXPLORATION -multinodular, I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -tejido I-EXPLORATION -homogéneo, I-EXPLORATION -blanquecino-grisáceo I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -fasciculado. I-EXPLORATION -Microscópicamente, I-EXPLORATION -el I-EXPLORATION -tumor I-EXPLORATION -está I-EXPLORATION -constituido I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -Schwann I-EXPLORATION -dispuestas I-EXPLORATION -en I-EXPLORATION -pequeños I-EXPLORATION -fascículos I-EXPLORATION -entrelazados I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -estroma I-EXPLORATION -mixoide I-EXPLORATION -y I-EXPLORATION -grupos I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -ganglionares I-EXPLORATION -maduras. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -para I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -proteína I-EXPLORATION -S-100, I-EXPLORATION -observándose I-EXPLORATION -intensa I-EXPLORATION -y I-EXPLORATION -generalizada I-EXPLORATION -inmunoreacción I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -neoplásicas. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -ganglioneuroma I-EXPLORATION -suprarrenal. I-EXPLORATION - I-EXPLORATION -Tras B-EVOLUTION -2 I-EVOLUTION -años I-EVOLUTION +su I-DERIVED_FROM/TO +psiquiatra I-DERIVED_FROM/TO +habitual I-DERIVED_FROM/TO +debido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +alteraciones I-DERIVED_FROM/TO +conductuales I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +entorno I-DERIVED_FROM/TO +familiar. I-DERIVED_FROM/TO +Ha B-PRESENT_ILLNESS +venido I-PRESENT_ILLNESS +desarrollando I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +últimos I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +unos I-PRESENT_ILLNESS +hábitos I-PRESENT_ILLNESS +alimentarios I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +han I-PRESENT_ILLNESS +puesto I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +peligro I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +salud, I-PRESENT_ILLNESS +rechazando I-PRESENT_ILLNESS +algunos I-PRESENT_ILLNESS +alimentos I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +considerar I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +estaban I-PRESENT_ILLNESS +"contaminados". I-PRESENT_ILLNESS +Cuando I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +ha I-PRESENT_ILLNESS +tratado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +modificar I-PRESENT_ILLNESS +estas I-PRESENT_ILLNESS +conductas, I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +ha I-PRESENT_ILLNESS +mostrado I-PRESENT_ILLNESS +irritado I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +agresividad I-PRESENT_ILLNESS +hacia I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +madre I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +hermano I-PRESENT_ILLNESS +menor. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +entrevista I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +mostró I-PRESENT_ILLNESS +colaborador, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +aspecto I-PRESENT_ILLNESS +descuidado I-PRESENT_ILLNESS +debido I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +falta I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +higiene. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +contacto I-PRESENT_ILLNESS +era I-PRESENT_ILLNESS +peculiar, I-PRESENT_ILLNESS +mostrando I-PRESENT_ILLNESS +sonrisas I-PRESENT_ILLNESS +inapropiadas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +alta I-PRESENT_ILLNESS +latencia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +respuesta I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +discurso. I-PRESENT_ILLNESS +Negaba I-PRESENT_ILLNESS +alteraciones I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +sensopercepción I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +pensamiento. I-PRESENT_ILLNESS +Refirió B-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +crisis I-PAST_MEDICAL_HISTORY +epilépticas I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +buena I-PAST_MEDICAL_HISTORY +evolución I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +infancia. I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +18 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +acudió I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +consulta I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +psiquiatría I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +problemas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +conducta; I-PAST_MEDICAL_HISTORY +allí I-PAST_MEDICAL_HISTORY +recibió I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Asperger. I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +pesar I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +refirió I-PAST_MEDICAL_HISTORY +sintomatología I-PAST_MEDICAL_HISTORY +psicótica I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +aquella I-PAST_MEDICAL_HISTORY +ocasión, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +pautó I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +neuroléptico I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +abandonó I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +reacción I-PAST_MEDICAL_HISTORY +adversa. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +momento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +valoración I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +encontraba I-PAST_MEDICAL_HISTORY +bajo I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +psiquiátrico. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +ingreso, I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +mostraba I-PRESENT_ILLNESS +tranquilo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +colaborador. I-PRESENT_ILLNESS +En B-EVOLUTION +la I-EVOLUTION +primera I-EVOLUTION +consulta, I-EVOLUTION +solicitó I-EVOLUTION +un I-EVOLUTION +tiempo I-EVOLUTION +previo I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +entrevista I-EVOLUTION +para I-EVOLUTION +poder I-EVOLUTION +realizar I-EVOLUTION +un I-EVOLUTION +paseo I-EVOLUTION +por I-EVOLUTION +los I-EVOLUTION +pasillos I-EVOLUTION de I-EVOLUTION -seguimiento I-EVOLUTION +la I-EVOLUTION +planta, I-EVOLUTION +ya I-EVOLUTION +que I-EVOLUTION +esto I-EVOLUTION +le I-EVOLUTION +ayudaba I-EVOLUTION +a I-EVOLUTION +calmarse. I-EVOLUTION +Cuando I-EVOLUTION +se I-EVOLUTION +exploró I-EVOLUTION el I-EVOLUTION -paciente I-EVOLUTION +motivo I-EVOLUTION +del I-EVOLUTION +ingreso, I-EVOLUTION +mostró I-EVOLUTION +escasa I-EVOLUTION +conciencia I-EVOLUTION +de I-EVOLUTION +enfermedad, I-EVOLUTION +refiriendo I-EVOLUTION +encontrarse I-EVOLUTION +en I-EVOLUTION +desacuerdo I-EVOLUTION +con I-EVOLUTION +la I-EVOLUTION +necesidad I-EVOLUTION +del I-EVOLUTION +mismo. I-EVOLUTION +Sin I-EVOLUTION +embargo, I-EVOLUTION +no I-EVOLUTION +mostraba I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +desconfianza, I-EVOLUTION +presentando I-EVOLUTION +buena I-EVOLUTION +disposición I-EVOLUTION +a I-EVOLUTION +recibir I-EVOLUTION +tratamiento. I-EVOLUTION +Su B-PAST_MEDICAL_HISTORY +madre I-PAST_MEDICAL_HISTORY +refirió I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +primera I-PAST_MEDICAL_HISTORY +infancia I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +notado I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +algo I-PAST_MEDICAL_HISTORY +era I-PAST_MEDICAL_HISTORY +diferente I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +paciente, I-PAST_MEDICAL_HISTORY +si I-PAST_MEDICAL_HISTORY +bien I-PAST_MEDICAL_HISTORY +reconocía I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +recibió I-PAST_MEDICAL_HISTORY +información I-PAST_MEDICAL_HISTORY +sobre I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Asperger I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +mayor I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +edad. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +comentaba I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +compañeros I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +colegio I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +reían I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +él I-PAST_MEDICAL_HISTORY +porque I-PAST_MEDICAL_HISTORY +utilizaba I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +vocabulario I-PAST_MEDICAL_HISTORY +muy I-PAST_MEDICAL_HISTORY +formal. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +rendimiento I-PAST_MEDICAL_HISTORY +académico I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +excelente I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +bachillerato, I-PAST_MEDICAL_HISTORY +momento I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +comenzó I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +suspender I-PAST_MEDICAL_HISTORY +asignaturas I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +pesar I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +contar I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +capacidad I-PAST_MEDICAL_HISTORY +intelectual I-PAST_MEDICAL_HISTORY +superior I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +media. I-PAST_MEDICAL_HISTORY +Hasta I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +momento I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +ingreso I-PAST_MEDICAL_HISTORY +pasaba I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +mayor I-PAST_MEDICAL_HISTORY +parte I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +tiempo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +casa, I-PAST_MEDICAL_HISTORY +donde I-PAST_MEDICAL_HISTORY +convivía I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +madre I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +hermano I-PAST_MEDICAL_HISTORY +menor. I-PAST_MEDICAL_HISTORY +Comentaba I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +menudo I-PAST_MEDICAL_HISTORY +solía I-PAST_MEDICAL_HISTORY +dar I-PAST_MEDICAL_HISTORY +largos I-PAST_MEDICAL_HISTORY +paseos I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +desplazaba I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +autobús, I-PAST_MEDICAL_HISTORY +actividades I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +realizaba I-PAST_MEDICAL_HISTORY +siempre I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +solitario. I-PAST_MEDICAL_HISTORY +Refería I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +fuerte I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +ciencias I-PAST_MEDICAL_HISTORY +naturales. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Al B-EVOLUTION +avanzar I-EVOLUTION +el I-EVOLUTION +ingreso, I-EVOLUTION se I-EVOLUTION -encuentra I-EVOLUTION -asintomático I-EVOLUTION +le I-EVOLUTION +observaba I-EVOLUTION +más I-EVOLUTION +distendido, I-EVOLUTION +con I-EVOLUTION +menor I-EVOLUTION +rigidez I-EVOLUTION +postural I-EVOLUTION y I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION +menor I-EVOLUTION +latencia I-EVOLUTION de I-EVOLUTION -recidiva I-EVOLUTION +respuesta I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +discurso. I-EVOLUTION +También I-EVOLUTION +se I-EVOLUTION +redujeron I-EVOLUTION +las I-EVOLUTION +sonrisas I-EVOLUTION +inmotivadas, I-EVOLUTION +las I-EVOLUTION +cuales I-EVOLUTION +reaparecían I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +contexto I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -lesión. I-EVOLUTION +interacción I-EVOLUTION +con I-EVOLUTION +personas I-EVOLUTION +desconocidas. I-EVOLUTION +El B-TREATMENT +tratamiento I-TREATMENT +antipsicótico I-TREATMENT +se I-TREATMENT +mostró I-TREATMENT +eficaz I-TREATMENT +en I-TREATMENT +la I-TREATMENT +reducción I-TREATMENT +de I-TREATMENT +la I-TREATMENT +irritabilidad I-TREATMENT +del I-TREATMENT +paciente. I-TREATMENT +La B-EVOLUTION +rigidez I-EVOLUTION +en I-EVOLUTION +relación I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +ideas I-EVOLUTION +sobre I-EVOLUTION +la I-EVOLUTION +alimentación I-EVOLUTION +y I-EVOLUTION +los I-EVOLUTION +hábitos I-EVOLUTION +de I-EVOLUTION +higiene I-EVOLUTION +y I-EVOLUTION +sueño I-EVOLUTION +continuaron I-EVOLUTION +al I-EVOLUTION +alta. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -prostático I-PRESENT_ILLNESS -leve I-PRESENT_ILLNESS +Lactante B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +34 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +revisión. I-PRESENT_ILLNESS +Primer I-PRESENT_ILLNESS +hijo, I-PRESENT_ILLNESS +fruto I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -IPSS I-PRESENT_ILLNESS +embarazo I-PRESENT_ILLNESS +controlado. I-PRESENT_ILLNESS +Varicela I-PRESENT_ILLNESS +materna I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +26 I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -PSA: I-PRESENT_ILLNESS -0, I-PRESENT_ILLNESS -91. I-PRESENT_ILLNESS -A B-EXPLORATION +gestación. I-PRESENT_ILLNESS +Parto B-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +semana I-PAST_MEDICAL_HISTORY +35 I-PAST_MEDICAL_HISTORY ++ I-PAST_MEDICAL_HISTORY +6, I-PAST_MEDICAL_HISTORY +vaginal, I-PAST_MEDICAL_HISTORY +instrumentado I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +ventosa. I-PAST_MEDICAL_HISTORY +Apgar I-PAST_MEDICAL_HISTORY +9/10. I-PAST_MEDICAL_HISTORY +Somatometría I-PAST_MEDICAL_HISTORY +adecuada I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +nacimiento I-PAST_MEDICAL_HISTORY +(perímetro I-PAST_MEDICAL_HISTORY +cefálico: I-PAST_MEDICAL_HISTORY +33 I-PAST_MEDICAL_HISTORY +cm, I-PAST_MEDICAL_HISTORY +percentil I-PAST_MEDICAL_HISTORY +50-75 I-PAST_MEDICAL_HISTORY +[P50-75]). I-PAST_MEDICAL_HISTORY +No B-FAMILY_HISTORY +refieren I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +interés. I-FAMILY_HISTORY +En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION física I-EXPLORATION -destaca I-EXPLORATION -un I-EXPLORATION -tacto I-EXPLORATION -rectal I-EXPLORATION -encontrando I-EXPLORATION -un I-EXPLORATION -adenoma I-EXPLORATION -grado I-EXPLORATION -1, I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION +escafocefalia I-EXPLORATION y I-EXPLORATION +se I-EXPLORATION +palpa I-EXPLORATION una I-EXPLORATION -masa I-EXPLORATION -en I-EXPLORATION -hemiescroto I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -lisa, I-EXPLORATION -dura, I-EXPLORATION -no I-EXPLORATION -adherida I-EXPLORATION -a I-EXPLORATION -planos I-EXPLORATION -profundos, I-EXPLORATION -blanquecina I-EXPLORATION -e I-EXPLORATION -indolora I-EXPLORATION +cresta I-EXPLORATION +ósea I-EXPLORATION a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -exploración. I-EXPLORATION -El B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -demanda I-PRESENT_ILLNESS -cirugía I-PRESENT_ILLNESS -aduciendo I-PRESENT_ILLNESS -problemas I-PRESENT_ILLNESS -estéticos. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Se B-TREATMENT -realiza I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -masa I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -local I-TREATMENT -sin I-TREATMENT -incidencias. I-TREATMENT -Macroscópicamente B-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION +sutura I-EXPLORATION +sagital. I-EXPLORATION +Este I-EXPLORATION +hallazgo I-EXPLORATION +se I-EXPLORATION +interpreta I-EXPLORATION +como I-EXPLORATION +un I-EXPLORATION +posible I-EXPLORATION +acabalgamiento I-EXPLORATION +de I-EXPLORATION +suturas. I-EXPLORATION +La I-EXPLORATION +exploración I-EXPLORATION +neurológica I-EXPLORATION +era I-EXPLORATION +adecuada I-EXPLORATION +a I-EXPLORATION +su I-EXPLORATION +edad. I-EXPLORATION +A I-EXPLORATION +los I-EXPLORATION +dos I-EXPLORATION +meses I-EXPLORATION presenta I-EXPLORATION -coloración I-EXPLORATION -blanquecina I-EXPLORATION -y I-EXPLORATION -consistencia I-EXPLORATION -firme I-EXPLORATION +deformidad I-EXPLORATION +craneal I-EXPLORATION +más I-EXPLORATION +manifiesta, I-EXPLORATION con I-EXPLORATION -un I-EXPLORATION -tamaño I-EXPLORATION +persistencia I-EXPLORATION de I-EXPLORATION -1, I-EXPLORATION -7 I-EXPLORATION -cm, I-EXPLORATION la I-EXPLORATION -superficie I-EXPLORATION +prominencia I-EXPLORATION +ósea I-EXPLORATION +sagital. I-EXPLORATION +Se I-EXPLORATION +palpa I-EXPLORATION +fontanela I-EXPLORATION +anterior I-EXPLORATION +a I-EXPLORATION +punta I-EXPLORATION de I-EXPLORATION -corte I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -sólida, I-EXPLORATION -amarillenta I-EXPLORATION +dedo. I-EXPLORATION +Mantiene I-EXPLORATION +desarrollo I-EXPLORATION +neurológico I-EXPLORATION +adecuado I-EXPLORATION +y I-EXPLORATION +crecimiento I-EXPLORATION +del I-EXPLORATION +perímetro I-EXPLORATION +cefálico I-EXPLORATION +(perímetro I-EXPLORATION +cefálico: I-EXPLORATION +40 I-EXPLORATION +cm, I-EXPLORATION +P75). I-EXPLORATION +Ante I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -arremolinado. I-EXPLORATION - I-EXPLORATION -Microscópicamente I-EXPLORATION +craneosinostosis I-EXPLORATION se I-EXPLORATION -describe I-EXPLORATION +realiza I-EXPLORATION una I-EXPLORATION -neoformación I-EXPLORATION -mesenquimal I-EXPLORATION -relativamente I-EXPLORATION -bien I-EXPLORATION -delimitada, I-EXPLORATION -no I-EXPLORATION -encapsulada, I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -haces I-EXPLORATION +Rx I-EXPLORATION +simple I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION +cráneo, I-EXPLORATION +informada I-EXPLORATION +como I-EXPLORATION +probable I-EXPLORATION +cierre I-EXPLORATION +precoz I-EXPLORATION de I-EXPLORATION -estirpe I-EXPLORATION -muscular I-EXPLORATION -lisa I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -marcada I-EXPLORATION -positividad I-EXPLORATION -citoplasmática I-EXPLORATION -con I-EXPLORATION -actina, I-EXPLORATION -desmina I-EXPLORATION +sutura I-EXPLORATION +sagital I-EXPLORATION y I-EXPLORATION -focal I-EXPLORATION -con I-EXPLORATION -CD I-EXPLORATION -68. I-EXPLORATION -No I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION -atipia I-EXPLORATION -citológica. I-EXPLORATION -La I-EXPLORATION -actividad I-EXPLORATION -mitótica I-EXPLORATION -es I-EXPLORATION -muy I-EXPLORATION -baja I-EXPLORATION -(0, I-EXPLORATION -5 I-EXPLORATION -mitosis I-EXPLORATION -por I-EXPLORATION -50 I-EXPLORATION -HPF), I-EXPLORATION -no I-EXPLORATION -observándose I-EXPLORATION -áreas I-EXPLORATION +deriva I-EXPLORATION +a I-EXPLORATION +Cirugía I-EXPLORATION +Pediátrica. I-EXPLORATION +Con I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +probable I-EXPLORATION de I-EXPLORATION -hemorragia I-EXPLORATION -ni I-EXPLORATION -necrosis. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -diagnóstico I-EVOLUTION -fue I-EVOLUTION +craneosinostosis I-EXPLORATION +sagital I-EXPLORATION +y I-EXPLORATION +lambdoidea, I-EXPLORATION +solicitaron I-EXPLORATION +una I-EXPLORATION +TC I-EXPLORATION +craneal I-EXPLORATION +tridimensional I-EXPLORATION +que I-EXPLORATION +confirmó I-EXPLORATION +el I-EXPLORATION +cierre I-EXPLORATION +parcial I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +sutura I-EXPLORATION +sagital. I-EXPLORATION +Se B-EVOLUTION +derivó I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +Unidad I-EVOLUTION de I-EVOLUTION -leiomioma I-EVOLUTION -escrotal. I-EVOLUTION -Tras I-EVOLUTION -dos I-EVOLUTION -años I-EVOLUTION +Neurocirugía I-EVOLUTION de I-EVOLUTION -evolución I-EVOLUTION -no I-EVOLUTION -hay I-EVOLUTION -evidencia I-EVOLUTION +referencia I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +seis I-EVOLUTION +meses I-EVOLUTION de I-EVOLUTION -recidiva I-EVOLUTION -local. I-EVOLUTION +edad. I-EVOLUTION I-EVOLUTION Paciente B-PRESENT_ILLNESS +femenina I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -69 I-PRESENT_ILLNESS +84 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad I-PRESENT_ILLNESS -que, B-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales, I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -adenocarcinoma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -próstata I-PAST_MEDICAL_HISTORY -bien I-PAST_MEDICAL_HISTORY -diferenciado I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -análogos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -LHRH I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -mielolipoma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -glándula I-PAST_MEDICAL_HISTORY -suprarrenal I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -casualmente I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -TAC I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -atrás. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acudió B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -anorexia, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -38, I-PRESENT_ILLNESS -0º I-PRESENT_ILLNESS -C, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -coincidiendo, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -cuadro, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -caída I-PRESENT_ILLNESS -accidental I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cama. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -regular I-EXPLORATION -estado I-EXPLORATION -general I-EXPLORATION -aunque I-EXPLORATION -hemodinámica I-EXPLORATION -estable. I-EXPLORATION -El I-EXPLORATION -abdomen I-EXPLORATION -era I-EXPLORATION -globuloso I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -ligeramente I-EXPLORATION -distendido. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION +que B-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Estomatología I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +Cirugía I-DERIVED_FROM/TO +Oral I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +Universidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Cartagena I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +presentar I-DERIVED_FROM/TO +molestia I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +cavidad I-DERIVED_FROM/TO +oral. I-DERIVED_FROM/TO +Al B-EXPLORATION +examen I-EXPLORATION +clínico I-EXPLORATION se I-EXPLORATION -objetivó I-EXPLORATION -dolor I-EXPLORATION +observan I-EXPLORATION +múltiples I-EXPLORATION +placas, I-EXPLORATION +manchas I-EXPLORATION +y I-EXPLORATION +verrugosidades I-EXPLORATION +distribuidas I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -hipocondrio I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -signo I-EXPLORATION -de I-EXPLORATION -Murphy I-EXPLORATION -positivo. I-EXPLORATION -La I-EXPLORATION -auscultación I-EXPLORATION -cardio I-EXPLORATION -respiratoria I-EXPLORATION -resultó I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION -mostraba I-EXPLORATION -leucocitosis I-EXPLORATION +forma I-EXPLORATION +irregular I-EXPLORATION de I-EXPLORATION -13.800 I-EXPLORATION -*10e9/L I-EXPLORATION +todo I-EXPLORATION +el I-EXPLORATION +paladar I-EXPLORATION +duro I-EXPLORATION +comprometiendo I-EXPLORATION +tercio I-EXPLORATION +anterior I-EXPLORATION y I-EXPLORATION -neutrofilia I-EXPLORATION -(83%), I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -110 I-EXPLORATION -g/l I-EXPLORATION +medio, I-EXPLORATION +del I-EXPLORATION +lado I-EXPLORATION +izquierdo I-EXPLORATION y I-EXPLORATION -bilirrubina I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -mg/dl I-EXPLORATION -a I-EXPLORATION -expensas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -indirecta I-EXPLORATION -(0, I-EXPLORATION -9 I-EXPLORATION -mg/dl). I-EXPLORATION - I-EXPLORATION -Fue I-EXPLORATION -realizada I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION +derecho; I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +coloración I-EXPLORATION de I-EXPLORATION -urgencia I-EXPLORATION +tonalidad I-EXPLORATION +variante I-EXPLORATION +desde I-EXPLORATION +un I-EXPLORATION +blanco I-EXPLORATION +grisáceo I-EXPLORATION +hasta I-EXPLORATION +un I-EXPLORATION +blanco I-EXPLORATION +amarillo; I-EXPLORATION +tamaño I-EXPLORATION que I-EXPLORATION -mostró I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION -heterogénea I-EXPLORATION -de I-EXPLORATION -16 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -dependiente I-EXPLORATION -de I-EXPLORATION -glándula I-EXPLORATION -suprarrenal I-EXPLORATION -derecha I-EXPLORATION -con I-EXPLORATION -compresión I-EXPLORATION +oscila I-EXPLORATION +aproximadamente I-EXPLORATION +sobre I-EXPLORATION +3×5 I-EXPLORATION +cm, I-EXPLORATION +forma I-EXPLORATION +variada I-EXPLORATION de I-EXPLORATION -vena I-EXPLORATION -cava, I-EXPLORATION -sin I-EXPLORATION -poder I-EXPLORATION -discernir I-EXPLORATION -si I-EXPLORATION +superficie I-EXPLORATION +verrugosa I-EXPLORATION +y I-EXPLORATION +consistencia I-EXPLORATION +blanda, I-EXPLORATION +bordes I-EXPLORATION +definidos, I-EXPLORATION +asintomática; I-EXPLORATION +no I-EXPLORATION +desprende I-EXPLORATION +al I-EXPLORATION +raspado I-EXPLORATION +e I-EXPLORATION +imperceptible I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +misma. I-EXPLORATION +La B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +reporta I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +fumadora I-PAST_MEDICAL_HISTORY +invertida I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +40 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +refiere I-PAST_MEDICAL_HISTORY +fumar I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +cigarrillos I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +día. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +esta I-EXPLORATION +paciente I-EXPLORATION se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -hematoma I-EXPLORATION -o I-EXPLORATION -absceso. I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -confirmó I-EXPLORATION -tal I-EXPLORATION -hallazgo, I-EXPLORATION -informándolo I-EXPLORATION -como I-EXPLORATION -hematoma I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -sangrado I-EXPLORATION -activo, I-EXPLORATION -de I-EXPLORATION -16 I-EXPLORATION -cm I-EXPLORATION +da I-EXPLORATION +una I-EXPLORATION +impresión I-EXPLORATION +clínica I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION -que I-EXPLORATION -comprimía I-EXPLORATION -y I-EXPLORATION -desplazaba I-EXPLORATION -vena I-EXPLORATION -cava. I-EXPLORATION -Se B-TREATMENT -indicó I-TREATMENT -laparotomía I-TREATMENT -urgente I-TREATMENT +leucoplasia I-EXPLORATION +homogénea I-EXPLORATION +y, I-EXPLORATION +para I-EXPLORATION +realizar I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +definitivo, I-EXPLORATION +se I-EXPLORATION +programó I-EXPLORATION +biopsia I-EXPLORATION +incisional. I-EXPLORATION + I-EXPLORATION +Procedimiento B-TREATMENT + I-TREATMENT +Previo I-TREATMENT +consentimiento I-TREATMENT +informado, I-TREATMENT +se I-TREATMENT +aplica I-TREATMENT +técnica I-TREATMENT +anestésica I-TREATMENT +nasopalatina I-TREATMENT +y I-TREATMENT +palatina I-TREATMENT +anterior I-TREATMENT +bilateral, I-TREATMENT +utilizando I-TREATMENT +lidocaína I-TREATMENT +con I-TREATMENT +epinefrina I-TREATMENT +al I-TREATMENT +2%; I-TREATMENT +luego I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +incisión I-TREATMENT +romboidal I-TREATMENT +con I-TREATMENT +hoja I-TREATMENT +de I-TREATMENT +bisturí I-TREATMENT +número I-TREATMENT +15 I-TREATMENT en I-TREATMENT +borde I-TREATMENT +anterior I-TREATMENT +de I-TREATMENT +paladar I-TREATMENT +duro I-TREATMENT +del I-TREATMENT +lado I-TREATMENT +derecho, I-TREATMENT +seguido I-TREATMENT +de I-TREATMENT la I-TREATMENT -que I-TREATMENT +disección I-TREATMENT +del I-TREATMENT +tejido, I-TREATMENT +el I-TREATMENT +cual I-TREATMENT se I-TREATMENT -realizó I-TREATMENT -suprarrenalectomía I-TREATMENT -derecha I-TREATMENT +tomó I-TREATMENT +con I-TREATMENT +pinza I-TREATMENT +Alix I-TREATMENT +para I-TREATMENT +proteger I-TREATMENT y I-TREATMENT -exéresis I-TREATMENT -del I-TREATMENT -hematoma. I-TREATMENT -El B-EVOLUTION -postoperatorio I-EVOLUTION -transcurrió I-EVOLUTION -sin I-EVOLUTION -incidencias I-EVOLUTION +manipular I-TREATMENT +mejor I-TREATMENT +la I-TREATMENT +muestra I-TREATMENT +de I-TREATMENT +tejido, I-TREATMENT +se I-TREATMENT +hace I-TREATMENT +hemostasia I-TREATMENT +con I-TREATMENT +una I-TREATMENT +torunda I-TREATMENT +de I-TREATMENT +gasa I-TREATMENT +estéril, I-TREATMENT +tomando I-TREATMENT +cuatro I-TREATMENT +puntos I-TREATMENT +de I-TREATMENT +sutura I-TREATMENT +con I-TREATMENT +seda I-TREATMENT +3/0, I-TREATMENT +lavado I-TREATMENT +y I-TREATMENT +secado I-TREATMENT +de I-TREATMENT +la I-TREATMENT +zona. I-TREATMENT +Se I-TREATMENT +dieron I-TREATMENT +indicaciones I-TREATMENT +a I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +verbal I-TREATMENT +y I-TREATMENT +por I-TREATMENT +escrito. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +regresa I-EVOLUTION +a I-EVOLUTION +un I-EVOLUTION +control I-EVOLUTION +posquirúrgico I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +7 I-EVOLUTION +días I-EVOLUTION +observándose I-EVOLUTION +tejidos I-EVOLUTION +en I-EVOLUTION +buen I-EVOLUTION +estado I-EVOLUTION y I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION +en I-EVOLUTION +proceso I-EVOLUTION de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -décimo I-EVOLUTION -día. I-EVOLUTION +cicatrización. I-EVOLUTION +El B-EXPLORATION +reporte I-EXPLORATION +histopatológico I-EXPLORATION +indica I-EXPLORATION +mucosa I-EXPLORATION +palatina I-EXPLORATION +con I-EXPLORATION +marcada I-EXPLORATION +queratosis I-EXPLORATION +sin I-EXPLORATION +"displasia". I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizan I-EXPLORATION +controles I-EXPLORATION +mensuales I-EXPLORATION +observando I-EXPLORATION +la I-EXPLORATION +desaparición I-EXPLORATION +casi I-EXPLORATION +total I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +patología; I-EXPLORATION +sin B-EVOLUTION +embargo I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +reporta I-EVOLUTION +que I-EVOLUTION +ha I-EVOLUTION +iniciado I-EVOLUTION +otra I-EVOLUTION +vez I-EVOLUTION +el I-EVOLUTION +hábito I-EVOLUTION +de I-EVOLUTION +fumar I-EVOLUTION +invertido I-EVOLUTION +y, I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +último I-EVOLUTION +control, I-EVOLUTION +se I-EVOLUTION +observa I-EVOLUTION +aparición I-EVOLUTION +nuevamente I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +placas I-EVOLUTION +blancas. I-EVOLUTION +Observamos I-EVOLUTION +entonces I-EVOLUTION +una I-EVOLUTION +fuerte I-EVOLUTION +asociación I-EVOLUTION +entre I-EVOLUTION +el I-EVOLUTION +fumar I-EVOLUTION +invertido I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +aparición I-EVOLUTION +de I-EVOLUTION +lesiones I-EVOLUTION +premalignas. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Lactante B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +46 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY +fruto B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +embarazo I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY -excepción I-PAST_MEDICAL_HISTORY +término, I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -palpitaciones I-PAST_MEDICAL_HISTORY -ocasionales. I-PAST_MEDICAL_HISTORY -Presentó B-PRESENT_ILLNESS +peso I-PAST_MEDICAL_HISTORY +adecuado I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +edad I-PAST_MEDICAL_HISTORY +gestacional. I-PAST_MEDICAL_HISTORY +Embarazo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +riesgo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +controlado I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +antecedente B-FAMILY_HISTORY +de I-FAMILY_HISTORY +lupus I-FAMILY_HISTORY +eritematoso I-FAMILY_HISTORY +sistémico I-FAMILY_HISTORY +(LES) I-FAMILY_HISTORY +materno I-FAMILY_HISTORY +en I-FAMILY_HISTORY +tratamiento I-FAMILY_HISTORY +con I-FAMILY_HISTORY +cloroquina, I-FAMILY_HISTORY +siendo I-FAMILY_HISTORY +negativos I-FAMILY_HISTORY +los I-FAMILY_HISTORY +marcadores I-FAMILY_HISTORY +maternos I-FAMILY_HISTORY +para I-FAMILY_HISTORY +LES I-FAMILY_HISTORY +en I-FAMILY_HISTORY +el I-FAMILY_HISTORY +momento I-FAMILY_HISTORY +de I-FAMILY_HISTORY +la I-FAMILY_HISTORY +concepción; I-FAMILY_HISTORY +exámenes B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +rutina I-PAST_MEDICAL_HISTORY +normales. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +El B-PRESENT_ILLNESS +lactante I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -súbita I-PRESENT_ILLNESS un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -disnea, I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +ocasiones, I-PRESENT_ILLNESS +mientras I-PRESENT_ILLNESS +estaba I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +lactancia I-PRESENT_ILLNESS +mixta, I-PRESENT_ILLNESS al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS +41.º I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -diagnosticada I-PRESENT_ILLNESS +vida I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -neumonía I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -ingresada I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -iniciar I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -antibiótico. I-PRESENT_ILLNESS -A B-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -del I-EVOLUTION -ingreso I-EVOLUTION -se I-EVOLUTION -agravó I-EVOLUTION -el I-EVOLUTION -cuadro I-EVOLUTION -con I-EVOLUTION -fiebre, I-EVOLUTION -hipoxemia I-EVOLUTION -progresiva I-EVOLUTION -y I-EVOLUTION -oliguria, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -trasladada I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -unidad I-EVOLUTION -de I-EVOLUTION -cuidados I-EVOLUTION -intensivos I-EVOLUTION -(UCI). I-EVOLUTION - I-EVOLUTION -Al B-EXPLORATION -ingreso I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -UCI I-EXPLORATION -presentaba I-EXPLORATION +nuevo I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +este I-PRESENT_ILLNESS +motivo, I-PRESENT_ILLNESS +realizándose B-EXPLORATION una I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION -mayor I-EXPLORATION -de I-EXPLORATION -40, I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -oxígeno I-EXPLORATION -del I-EXPLORATION -85% I-EXPLORATION -con I-EXPLORATION -reservorio, I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION -de I-EXPLORATION -140 I-EXPLORATION -ppm, I-EXPLORATION -tensión I-EXPLORATION -arterial I-EXPLORATION -120/40 I-EXPLORATION -mmHg, I-EXPLORATION -temp-35º I-EXPLORATION -C. I-EXPLORATION -La I-EXPLORATION -auscultación I-EXPLORATION -cardiopulmonar I-EXPLORATION -mostraba I-EXPLORATION -crepitantes I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -hemitorax I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destacaba I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -pulsos I-EXPLORATION -distales I-EXPLORATION -aunque I-EXPLORATION -sin I-EXPLORATION -edemas I-EXPLORATION -en I-EXPLORATION -extremidades. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION analítica I-EXPLORATION -realizada I-EXPLORATION -destacaba I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -36400, I-EXPLORATION -Glucosa: I-EXPLORATION -266 I-EXPLORATION -mg/dL, I-EXPLORATION -Creatinina: I-EXPLORATION -3, I-EXPLORATION -3 I-EXPLORATION -mg/dL, I-EXPLORATION -AST: I-EXPLORATION -3127 I-EXPLORATION -U/L, I-EXPLORATION -ALT: I-EXPLORATION -3139 I-EXPLORATION -U/L, I-EXPLORATION -Gamma I-EXPLORATION -GT: I-EXPLORATION -86 I-EXPLORATION -U/L I-EXPLORATION -y I-EXPLORATION -tiempos I-EXPLORATION -de I-EXPLORATION -coagulación I-EXPLORATION -ligeramente I-EXPLORATION -elevados. I-EXPLORATION -Gasometría: I-EXPLORATION -PH: I-EXPLORATION -7, I-EXPLORATION -11. I-EXPLORATION -PCO2: I-EXPLORATION -41. I-EXPLORATION -PO2: I-EXPLORATION -44. I-EXPLORATION -Saturación I-EXPLORATION -O2: I-EXPLORATION -63. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -infiltrado I-EXPLORATION -alveolo-intersticial I-EXPLORATION -bilateral I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -derecho. I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -intubación I-TREATMENT -inmediata I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -antibióticos I-TREATMENT -de I-TREATMENT -mayor I-TREATMENT -espectro. I-TREATMENT -La B-EXPLORATION -paciente I-EXPLORATION -presentó I-EXPLORATION -un I-EXPLORATION -cuadro I-EXPLORATION -de I-EXPLORATION -fracaso I-EXPLORATION -multiorgánico I-EXPLORATION -y I-EXPLORATION en I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -analítica I-EXPLORATION -llamó I-EXPLORATION -la I-EXPLORATION -atención I-EXPLORATION -la I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -creatinin-fosfoquinasa I-EXPLORATION -y I-EXPLORATION -troponina, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -ecocardiograma I-EXPLORATION -transesofágico, I-EXPLORATION -objetivándose I-EXPLORATION -masa I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -cava I-EXPLORATION -superior I-EXPLORATION -que I-EXPLORATION -llegaba I-EXPLORATION -hasta I-EXPLORATION la I-EXPLORATION -aurícula I-EXPLORATION -derecha. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION que I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -bilateral I-EXPLORATION -sin I-EXPLORATION -tromboembolismo I-EXPLORATION -pulmonar, I-EXPLORATION -dilatación I-EXPLORATION -y I-EXPLORATION -ocupación I-EXPLORATION +presentó I-EXPLORATION +9.220 I-EXPLORATION +leucocitos I-EXPLORATION +con I-EXPLORATION +11, I-EXPLORATION +9% I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -cava I-EXPLORATION -inferior I-EXPLORATION -intrahépatica I-EXPLORATION -que I-EXPLORATION -proximalmente I-EXPLORATION -llega I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -aurícula I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -distalmente I-EXPLORATION -hasta I-EXPLORATION -las I-EXPLORATION -venas I-EXPLORATION -renales. I-EXPLORATION -Hipodensidad I-EXPLORATION +eosinófilos, I-EXPLORATION +hemograma, I-EXPLORATION +sedimento I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -suprahepática I-EXPLORATION -derecha I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -trombosis I-EXPLORATION -secundaria I-EXPLORATION +orina I-EXPLORATION y I-EXPLORATION -masa I-EXPLORATION -suprarrenal I-EXPLORATION -derecha I-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION -hipercaptante, I-EXPLORATION -en I-EXPLORATION -íntimo I-EXPLORATION -contacto I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -cava I-EXPLORATION -inferior. I-EXPLORATION - I-EXPLORATION -Habiendo B-DERIVED_FROM/TO -estabilizado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO +urocultivo I-EXPLORATION +negativos. I-EXPLORATION +Ante B-DERIVED_FROM/TO la I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO +presencia I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +eosinofilia I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO la I-DERIVED_FROM/TO -UCI I-DERIVED_FROM/TO +analítica I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +clínica I-DERIVED_FROM/TO de I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO +vómitos I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +le I-DERIVED_FROM/TO +diagnostica I-DERIVED_FROM/TO +intolerancia I-DERIVED_FROM/TO a I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -4 I-DERIVED_FROM/TO -días I-DERIVED_FROM/TO +proteínas I-DERIVED_FROM/TO de I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -ingreso, I-DERIVED_FROM/TO -intubada I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -disfunción I-DERIVED_FROM/TO -multiorgánica, I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -fin I-DERIVED_FROM/TO +leche I-DERIVED_FROM/TO de I-DERIVED_FROM/TO -planificar I-DERIVED_FROM/TO +vaca, I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +lo I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +especialista I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Alergología. I-DERIVED_FROM/TO +Con B-EVOLUTION +46 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +vida I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +acude I-EVOLUTION +a I-EVOLUTION +consulta I-EVOLUTION +con I-EVOLUTION +máculas I-EVOLUTION +anulares, I-EVOLUTION +policíclicas, I-EVOLUTION +localizadas I-EVOLUTION +en I-EVOLUTION +cabeza I-EVOLUTION +y I-EVOLUTION +zona I-EVOLUTION +anterior I-EVOLUTION +del I-EVOLUTION +tronco I-EVOLUTION +y I-EVOLUTION +pubis. I-EVOLUTION +Ante B-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +duda I-DERIVED_FROM/TO +diagnóstica I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +afectación I-DERIVED_FROM/TO +lúpica I-DERIVED_FROM/TO +o I-DERIVED_FROM/TO +bien I-DERIVED_FROM/TO +posible I-DERIVED_FROM/TO +reacción I-DERIVED_FROM/TO +adversa I-DERIVED_FROM/TO +medicamentosa I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +cloroquina, I-DERIVED_FROM/TO tratamiento I-DERIVED_FROM/TO -quirúrgico. I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +LES I-DERIVED_FROM/TO +materno, I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +hospital I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +referencia I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +le I-DERIVED_FROM/TO +cita I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +biopsia I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +las I-DERIVED_FROM/TO +lesiones I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +analítica. I-DERIVED_FROM/TO I-DERIVED_FROM/TO -Se B-EXPLORATION -repite I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION +La B-EXPLORATION +biopsia I-EXPLORATION +realizada I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -destaca I-EXPLORATION -leucocitosis, I-EXPLORATION -AST: I-EXPLORATION -165 I-EXPLORATION -UI/L, I-EXPLORATION -ALT: I-EXPLORATION -1050 I-EXPLORATION -UI/L I-EXPLORATION +región I-EXPLORATION +suprapúbica, I-EXPLORATION +junto I-EXPLORATION con I-EXPLORATION -ionograma I-EXPLORATION +los I-EXPLORATION +resultados I-EXPLORATION +analíticos I-EXPLORATION +de I-EXPLORATION +anticuerpos I-EXPLORATION +anti-La I-EXPLORATION y I-EXPLORATION -creatinina I-EXPLORATION -normales. I-EXPLORATION -Tras B-TREATMENT -valorar I-TREATMENT -las I-TREATMENT -pruebas I-TREATMENT -aportadas, I-TREATMENT -dada I-TREATMENT -la I-TREATMENT -gravedad I-TREATMENT -del I-TREATMENT -cuadro, I-TREATMENT -y I-TREATMENT -puesto I-TREATMENT -que I-TREATMENT -las I-TREATMENT -pruebas I-TREATMENT -de I-TREATMENT -imagen I-TREATMENT -realizadas I-TREATMENT -no I-TREATMENT -presentan I-TREATMENT -metástasis I-TREATMENT -a I-TREATMENT -distancia, I-TREATMENT +anti-Ro I-EXPLORATION +positivos I-EXPLORATION +confirman I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +en I-EXPLORATION +nuestro I-EXPLORATION +caso. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +ECG I-EXPLORATION +fue I-EXPLORATION +normal, I-EXPLORATION +descartándose I-EXPLORATION +la I-EXPLORATION +afectación I-EXPLORATION +cardíaca. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +hemograma I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +anemia I-EXPLORATION +de I-EXPLORATION +tipo I-EXPLORATION +ferropénica, I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +fórmula I-EXPLORATION +leucocitaria I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +neutropenia. I-EXPLORATION + I-EXPLORATION +Al B-TREATMENT +momento I-TREATMENT +del I-TREATMENT +diagnóstico I-TREATMENT se I-TREATMENT -planteó I-TREATMENT -un I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -urgente. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -realiza I-TREATMENT -una I-TREATMENT -laparatomía I-TREATMENT -subcostal I-TREATMENT -bilateral I-TREATMENT +le I-TREATMENT +indicó I-TREATMENT al I-TREATMENT -mismo I-TREATMENT -tiempo I-TREATMENT -que I-TREATMENT -una I-TREATMENT -esternotomía I-TREATMENT -longitudinal. I-TREATMENT -Se I-TREATMENT -aprecia I-TREATMENT -derrame I-TREATMENT -pleural I-TREATMENT -bilateral, I-TREATMENT -ligero I-TREATMENT -derrame I-TREATMENT -pericárdico I-TREATMENT -y I-TREATMENT -corazón I-TREATMENT -con I-TREATMENT -contracción I-TREATMENT -normal I-TREATMENT -en I-TREATMENT -la I-TREATMENT -cavidad I-TREATMENT -torácica, I-TREATMENT -mientras I-TREATMENT -que I-TREATMENT -la I-TREATMENT -laparotomía I-TREATMENT -muestra I-TREATMENT -isquemia I-TREATMENT -de I-TREATMENT -los I-TREATMENT -segmentos I-TREATMENT -6 I-TREATMENT -y I-TREATMENT -7 I-TREATMENT -del I-TREATMENT -hígado I-TREATMENT -y I-TREATMENT -masa I-TREATMENT -suprarrenal I-TREATMENT -derecha. I-TREATMENT - I-TREATMENT -El I-TREATMENT -equipo I-TREATMENT -de I-TREATMENT -Cirugía I-TREATMENT -General I-TREATMENT -realiza I-TREATMENT -hepatectomía I-TREATMENT -anterior I-TREATMENT +paciente I-TREATMENT +fotoprotección; I-TREATMENT +metilprednisolona I-TREATMENT +oral, I-TREATMENT con I-TREATMENT -maniobra I-TREATMENT -de I-TREATMENT -Pringle I-TREATMENT -intermitente, I-TREATMENT -sin I-TREATMENT -voltear I-TREATMENT -el I-TREATMENT -hígado, I-TREATMENT -seccionando I-TREATMENT -el I-TREATMENT -hígado I-TREATMENT -hasta I-TREATMENT -llegar I-TREATMENT -a I-TREATMENT -cara I-TREATMENT -anterior I-TREATMENT -de I-TREATMENT -la I-TREATMENT -Cava I-TREATMENT -retrohepática. I-TREATMENT -Posteriormente, I-TREATMENT -el I-TREATMENT -equipo I-TREATMENT -de I-TREATMENT -Urología I-TREATMENT -tras I-TREATMENT -descolgar I-TREATMENT +protección I-TREATMENT +gástrica I-TREATMENT +por I-TREATMENT el I-TREATMENT -colon I-TREATMENT -derecho I-TREATMENT -realiza I-TREATMENT -disección I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -cava I-TREATMENT -hasta I-TREATMENT -iliacas I-TREATMENT -primitivas, I-TREATMENT -ligadura I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -genital I-TREATMENT -derecha, I-TREATMENT -liberación I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -renal I-TREATMENT -y I-TREATMENT -cara I-TREATMENT -anterior I-TREATMENT -de I-TREATMENT -riñón I-TREATMENT -derecho. I-TREATMENT -Se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -la I-TREATMENT -liberación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -glándula I-TREATMENT -suprarrenal I-TREATMENT -derecha, I-TREATMENT -a I-TREATMENT -excepción I-TREATMENT +antecedente I-TREATMENT de I-TREATMENT -su I-TREATMENT -borde I-TREATMENT -superior I-TREATMENT +vómitos; I-TREATMENT y I-TREATMENT -medial I-TREATMENT -que I-TREATMENT -está I-TREATMENT -íntimamente I-TREATMENT -unido I-TREATMENT -a I-TREATMENT -la I-TREATMENT -pared I-TREATMENT -derecha I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -cava. I-TREATMENT -Queda I-TREATMENT -así I-TREATMENT -expuesto I-TREATMENT -el I-TREATMENT -campo I-TREATMENT +sulfato I-TREATMENT +ferroso I-TREATMENT para I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -suprarrenal I-TREATMENT -e I-TREATMENT -hígado I-TREATMENT -derecho I-TREATMENT -a I-TREATMENT -falta I-TREATMENT -de I-TREATMENT -cavotomía.. I-TREATMENT +corregir I-TREATMENT +su I-TREATMENT +anemia. I-TREATMENT I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -realizado I-TREATMENT -esto, I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +2 I-EVOLUTION +meses I-EVOLUTION +y I-EVOLUTION +medio I-EVOLUTION +de I-EVOLUTION +vida I-EVOLUTION +las I-EVOLUTION +lesiones I-EVOLUTION +habían I-EVOLUTION +remitido, I-EVOLUTION +suspendiéndose B-TREATMENT el I-TREATMENT -equipo I-TREATMENT -de I-TREATMENT -Cirugía I-TREATMENT -Cardiaca I-TREATMENT -comienza I-TREATMENT -la I-TREATMENT -circulación I-TREATMENT -extracorpórea I-TREATMENT -bajando I-TREATMENT -progresivamente I-TREATMENT -la I-TREATMENT -temperatura I-TREATMENT -hasta I-TREATMENT -alcanzar I-TREATMENT -14ºC I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -esofágico I-TREATMENT -y I-TREATMENT -19ºC I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -rectal, I-TREATMENT -tras I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -exanguinar I-TREATMENT +tratamiento I-TREATMENT +corticoideo I-TREATMENT a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT +los I-TREATMENT +3 I-TREATMENT +meses I-TREATMENT y I-TREATMENT -parar I-TREATMENT -la I-TREATMENT -circulación I-TREATMENT -extracorpórea I-TREATMENT -manteniendo I-TREATMENT -la I-TREATMENT -sangre I-TREATMENT -en I-TREATMENT -un I-TREATMENT -oxigenador. I-TREATMENT -Es I-TREATMENT -entonces I-TREATMENT -cuando I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT +medio. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +5 I-EVOLUTION +meses I-EVOLUTION +se I-EVOLUTION +habían I-EVOLUTION +negativizado I-EVOLUTION +los I-EVOLUTION +anticuerpos I-EVOLUTION +lúpicos I-EVOLUTION +maternos I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +niño I-EVOLUTION +y I-EVOLUTION +había I-EVOLUTION +desaparecido I-EVOLUTION +la I-EVOLUTION +neutropenia, I-EVOLUTION +persistiendo I-EVOLUTION +la I-EVOLUTION +anemia. I-EVOLUTION + I-EVOLUTION + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +72 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +diagnosticado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cirrosis I-PRESENT_ILLNESS +hepática I-PRESENT_ILLNESS +secundaria I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +infección I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +VHC I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +seguimiento I-PRESENT_ILLNESS +estrecho I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +consultas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Hepatología I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +2000. I-PRESENT_ILLNESS +Estaba B-PAST_MEDICAL_HISTORY +infectado I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +genotipo I-PAST_MEDICAL_HISTORY +1b I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +recibido I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +antiviral I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +pasado I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +rechazo I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +parte I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +recibir I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +interferón. I-PAST_MEDICAL_HISTORY +Entre I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +otros I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +médicos I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +relevantes I-PAST_MEDICAL_HISTORY +destacaba I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +intervención I-PAST_MEDICAL_HISTORY +quirúrgica I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +infancia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +ductus I-PAST_MEDICAL_HISTORY +arterioso I-PAST_MEDICAL_HISTORY +persistente, I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +presencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +fibrilación I-PAST_MEDICAL_HISTORY +auricular I-PAST_MEDICAL_HISTORY +paroxística, I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +colocación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +stents I-PAST_MEDICAL_HISTORY +coronarios I-PAST_MEDICAL_HISTORY +convencionales I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2004 I-PAST_MEDICAL_HISTORY +indicados I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +cardiopatía I-PAST_MEDICAL_HISTORY +isquémica I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +cirugía I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +recambio I-PAST_MEDICAL_HISTORY +valvular I-PAST_MEDICAL_HISTORY +aórtico I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2013 I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +prótesis I-PAST_MEDICAL_HISTORY +metálica, I-PAST_MEDICAL_HISTORY +requiriendo I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +entonces I-PAST_MEDICAL_HISTORY +anticoagulación I-PAST_MEDICAL_HISTORY +oral I-PAST_MEDICAL_HISTORY +(Eliquis®). I-PAST_MEDICAL_HISTORY +Además, I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +presentado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +2007 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +2013 I-PAST_MEDICAL_HISTORY +episodios I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +accidentes I-PAST_MEDICAL_HISTORY +cerebrovasculares I-PAST_MEDICAL_HISTORY +agudos I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +secuelas I-PAST_MEDICAL_HISTORY +posteriores I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +estaba I-PAST_MEDICAL_HISTORY +diagnosticado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +pulmonar I-PAST_MEDICAL_HISTORY +obstructiva I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +afectación I-PAST_MEDICAL_HISTORY +moderada. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +mayo I-EXPLORATION +de I-EXPLORATION +2014, I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +contexto I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +prueba I-EXPLORATION +de I-EXPLORATION +cribado I-EXPLORATION +de I-EXPLORATION +hepatocarcinoma, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +hepática I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +de I-EXPLORATION +25 I-EXPLORATION +x I-EXPLORATION +17 I-EXPLORATION +milímetros I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +segmento I-EXPLORATION +VI I-EXPLORATION +hepático I-EXPLORATION +sugerente I-EXPLORATION +de I-EXPLORATION +carcinoma I-EXPLORATION +hepatocelular. I-EXPLORATION +Se B-TREATMENT +optó I-TREATMENT +por I-TREATMENT realizar I-TREATMENT -una I-TREATMENT -cavotomía I-TREATMENT -inferior I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -suprarrenal I-TREATMENT -hasta I-TREATMENT -2 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -diafragma, I-TREATMENT -aurículotomía I-TREATMENT -derecha I-TREATMENT -y I-TREATMENT -retirada I-TREATMENT -del I-TREATMENT -trombo I-TREATMENT -tumoral I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -la I-TREATMENT -incisión I-TREATMENT -realizada I-TREATMENT +ablación I-TREATMENT +mediante I-TREATMENT +radiofrecuencia I-TREATMENT +como I-TREATMENT +tratamiento, I-TREATMENT +lográndose I-TREATMENT +respuesta I-TREATMENT +completa I-TREATMENT +radiológica I-TREATMENT en I-TREATMENT la I-TREATMENT -cava I-TREATMENT -inferior. I-TREATMENT -Se I-TREATMENT -realiza I-TREATMENT -sección I-TREATMENT -de I-TREATMENT -pared I-TREATMENT -lateral I-TREATMENT -derecha I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -cava I-TREATMENT -(desde I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -suprarrenal I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -suprahepática I-TREATMENT -derecha), I-TREATMENT -extrayendo I-TREATMENT -en I-TREATMENT -bloque I-TREATMENT -hígado I-TREATMENT -derecho I-TREATMENT -con I-TREATMENT -venas I-TREATMENT -suprahepática I-TREATMENT -y I-TREATMENT -suprarrenal I-TREATMENT -derechas I-TREATMENT -incluidas I-TREATMENT -en I-TREATMENT -dicho I-TREATMENT -parche, I-TREATMENT -suprarrenal I-TREATMENT -derecha I-TREATMENT -y I-TREATMENT -trombo. I-TREATMENT -Se I-TREATMENT -produce I-TREATMENT -rotura I-TREATMENT -del I-TREATMENT -trombo I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -renal, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -en I-TREATMENT -un I-TREATMENT -segundo I-TREATMENT -tiempo I-TREATMENT -se I-TREATMENT -extrae I-TREATMENT -por I-TREATMENT -tracción I-TREATMENT +resonancia I-TREATMENT +magnética I-TREATMENT +realizada I-TREATMENT +cuatro I-TREATMENT +semanas I-TREATMENT +tras I-TREATMENT el I-TREATMENT -trombo I-TREATMENT -desde I-TREATMENT -vena I-TREATMENT -renal I-TREATMENT -hasta I-TREATMENT -iliacas I-TREATMENT -primitivas. I-TREATMENT -Se I-TREATMENT -realiza I-TREATMENT -irrigación I-TREATMENT -de I-TREATMENT -cava I-TREATMENT -y I-TREATMENT -aurícula I-TREATMENT -derecha I-TREATMENT -y, I-TREATMENT -al I-TREATMENT -no I-TREATMENT -observarse I-TREATMENT -restos I-TREATMENT -de I-TREATMENT -trombo I-TREATMENT -ni I-TREATMENT -infiltración I-TREATMENT -de I-TREATMENT -las I-TREATMENT -paredes I-TREATMENT -de I-TREATMENT -cava I-TREATMENT -o I-TREATMENT -aurícula, I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -al I-TREATMENT -cierre I-TREATMENT +tratamiento. I-TREATMENT +Se B-EVOLUTION +sometió I-EVOLUTION +al I-EVOLUTION +paciente I-EVOLUTION +a I-EVOLUTION +continuación I-EVOLUTION +a I-EVOLUTION +seguimiento I-EVOLUTION +clínico I-EVOLUTION +y I-EVOLUTION +radiológico I-EVOLUTION +realizando I-EVOLUTION +pruebas I-EVOLUTION +de I-EVOLUTION +imagen I-EVOLUTION +cada I-EVOLUTION +tres I-EVOLUTION +meses I-EVOLUTION +sin I-EVOLUTION +objetivarse I-EVOLUTION +recidiva I-EVOLUTION +tumoral. I-EVOLUTION +En B-TREATMENT +mayo I-TREATMENT de I-TREATMENT -vena I-TREATMENT -cava I-TREATMENT -y I-TREATMENT -orejuela I-TREATMENT -derecha I-TREATMENT -por I-TREATMENT -separado I-TREATMENT -y I-TREATMENT -a I-TREATMENT -la I-TREATMENT -vez I-TREATMENT -mediante I-TREATMENT -sutura I-TREATMENT -continua I-TREATMENT +2015, I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +comenzó I-TREATMENT +tratamiento I-TREATMENT +antiviral I-TREATMENT con I-TREATMENT -monofilamento. I-TREATMENT -Una I-TREATMENT +ledipasvir/sofosbuvir I-TREATMENT +90/400 I-TREATMENT +mg I-TREATMENT +(Harvoni®) I-TREATMENT +una I-TREATMENT vez I-TREATMENT -realizado I-TREATMENT -dicho I-TREATMENT -cierre I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -reperfundir I-TREATMENT -progresivamente I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -volviendo I-TREATMENT -a I-TREATMENT -entrar I-TREATMENT -en I-TREATMENT -circulación I-TREATMENT -extracorpórea, I-TREATMENT -recalentándola I-TREATMENT -y I-TREATMENT -procediendo I-TREATMENT -a I-TREATMENT -desclampar I-TREATMENT -la I-TREATMENT -aorta I-TREATMENT -y I-TREATMENT -perfundir I-TREATMENT -el I-TREATMENT -corazón I-TREATMENT al I-TREATMENT -alcanzar I-TREATMENT -una I-TREATMENT -temperatura I-TREATMENT -esofágica I-TREATMENT -de I-TREATMENT -34ºC. I-TREATMENT -El I-TREATMENT -inicio I-TREATMENT -de I-TREATMENT -la I-TREATMENT -función I-TREATMENT -cardiaca I-TREATMENT -permite I-TREATMENT -la I-TREATMENT -salida I-TREATMENT -de I-TREATMENT -circulación I-TREATMENT -extracorpórea. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -colocan I-TREATMENT -drenajes I-TREATMENT -retroesternal, I-TREATMENT -mediastínico, I-TREATMENT -subhepático I-TREATMENT -y I-TREATMENT -retroperitoneal I-TREATMENT -en I-TREATMENT -fosa I-TREATMENT -renal I-TREATMENT -derecha. I-TREATMENT -Durante I-TREATMENT +día I-TREATMENT +durante I-TREATMENT +12 I-TREATMENT +semanas, I-TREATMENT +tras I-TREATMENT +documentarse I-TREATMENT la I-TREATMENT -intervención I-TREATMENT -se I-TREATMENT -transfundieron I-TREATMENT -14 I-TREATMENT -concentrados I-TREATMENT -de I-TREATMENT -hematíes, I-TREATMENT -1200 I-TREATMENT -ml I-TREATMENT +ausencia I-TREATMENT de I-TREATMENT -plasma I-TREATMENT -y I-TREATMENT -2 I-TREATMENT -unidades I-TREATMENT +enfermedad I-TREATMENT +tumoral I-TREATMENT +mediante I-TREATMENT +una I-TREATMENT +resonancia I-TREATMENT +magnética I-TREATMENT +hepática I-TREATMENT +dos I-TREATMENT +días I-TREATMENT +antes I-TREATMENT de I-TREATMENT -plaquetas. I-TREATMENT -Durante B-EVOLUTION -la I-EVOLUTION -estancia I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -UCI I-EVOLUTION -se I-EVOLUTION -realiza I-EVOLUTION -ecografía I-EVOLUTION -abdominal I-EVOLUTION -que I-EVOLUTION -muestras I-EVOLUTION -buena I-EVOLUTION -permeabilidad I-EVOLUTION -del I-EVOLUTION -sistema I-EVOLUTION -venoso I-EVOLUTION -hepático I-EVOLUTION -izquierdo I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -vena I-EVOLUTION -cava. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -días I-EVOLUTION -la I-EVOLUTION +empezar I-TREATMENT +el I-TREATMENT +tratamiento. I-TREATMENT +El B-EVOLUTION paciente I-EVOLUTION -es I-EVOLUTION -trasladada I-EVOLUTION -a I-EVOLUTION -planta, I-EVOLUTION -encontrándose I-EVOLUTION -consciente, I-EVOLUTION -orientada I-EVOLUTION +finalizó I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +sin I-EVOLUTION +presentar I-EVOLUTION +eventos I-EVOLUTION +adversos I-EVOLUTION +ni I-EVOLUTION +complicaciones I-EVOLUTION y I-EVOLUTION -colaboradora, I-EVOLUTION -aunque I-EVOLUTION -presentando I-EVOLUTION -debilidad I-EVOLUTION -en I-EVOLUTION +logrando I-EVOLUTION +alcanzar I-EVOLUTION +respuesta I-EVOLUTION +virológica I-EVOLUTION +sostenida I-EVOLUTION +a I-EVOLUTION las I-EVOLUTION -cuatro I-EVOLUTION -extremidades. I-EVOLUTION -La B-TREATMENT -paciente I-TREATMENT -permanece I-TREATMENT -ingresada I-TREATMENT -en I-TREATMENT -planta I-TREATMENT -durante I-TREATMENT -20 I-TREATMENT -días I-TREATMENT -recibiendo I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -cinesiterapia I-TREATMENT -generalizada I-TREATMENT -pasiva I-TREATMENT -y I-TREATMENT -asistida. I-TREATMENT -Tras I-TREATMENT -buena I-TREATMENT -evolución I-TREATMENT -en I-TREATMENT -la I-TREATMENT -movilidad I-TREATMENT -es I-TREATMENT -dada I-TREATMENT -de I-TREATMENT -alta, I-TREATMENT -no I-TREATMENT -precisando I-TREATMENT -tratamiento I-TREATMENT -a I-TREATMENT -excepción I-TREATMENT -de I-TREATMENT -heparina I-TREATMENT -de I-TREATMENT -bajo I-TREATMENT -peso I-TREATMENT -molecular. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -informa I-EXPLORATION +12 I-EVOLUTION +y I-EVOLUTION +24 I-EVOLUTION +semanas I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +finalizar I-EVOLUTION +el I-EVOLUTION +tratamiento. I-EVOLUTION + I-EVOLUTION +En B-EXPLORATION +octubre I-EXPLORATION de I-EXPLORATION -feocromocitoma I-EXPLORATION +2015 I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +hepática I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +el I-EXPLORATION +área I-EXPLORATION +del I-EXPLORATION +tumor I-EXPLORATION +hepático I-EXPLORATION +tratado I-EXPLORATION +con I-EXPLORATION +radiofrecuencia I-EXPLORATION +sin I-EXPLORATION +captación I-EXPLORATION +de I-EXPLORATION +contraste I-EXPLORATION +y I-EXPLORATION +sin I-EXPLORATION +otros I-EXPLORATION +datos I-EXPLORATION que I-EXPLORATION -afecta I-EXPLORATION +orientaran I-EXPLORATION a I-EXPLORATION +recidiva I-EXPLORATION +tumoral. I-EXPLORATION +No I-EXPLORATION +obstante, I-EXPLORATION +tres I-EXPLORATION +meses I-EXPLORATION +después I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION +realizar I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +resonancia I-EXPLORATION +magnética, I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -glándula I-EXPLORATION -suprarrenal I-EXPLORATION -derecha I-EXPLORATION -cuyo I-EXPLORATION -diámetro I-EXPLORATION -mayor I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm. I-EXPLORATION -El I-EXPLORATION -tumor I-EXPLORATION -no I-EXPLORATION -está I-EXPLORATION -encapsulado I-EXPLORATION +cual I-EXPLORATION +aparecieron I-EXPLORATION +múltiples I-EXPLORATION +lesiones I-EXPLORATION +hipointensas I-EXPLORATION +en I-EXPLORATION +T1 I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -fuera I-EXPLORATION +ligeramente I-EXPLORATION +hiperintensas I-EXPLORATION +en I-EXPLORATION +T2 I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -glándula I-EXPLORATION -suprarrenal, I-EXPLORATION -sin I-EXPLORATION -afectar I-EXPLORATION +pequeño I-EXPLORATION +tamaño I-EXPLORATION a I-EXPLORATION -los I-EXPLORATION -órganos I-EXPLORATION -adyacentes. I-EXPLORATION -Existe I-EXPLORATION -necrosis I-EXPLORATION -tumoral I-EXPLORATION -extensa. I-EXPLORATION -La I-EXPLORATION -glándula I-EXPLORATION -suprarrenal I-EXPLORATION -no I-EXPLORATION -neoplásica I-EXPLORATION -no I-EXPLORATION -muestra I-EXPLORATION -anomalías. I-EXPLORATION -Los I-EXPLORATION -ganglios I-EXPLORATION -linfáticos I-EXPLORATION -estudiados I-EXPLORATION -no I-EXPLORATION -presentan I-EXPLORATION -tumor. I-EXPLORATION -En I-EXPLORATION +lo I-EXPLORATION +largo I-EXPLORATION +de I-EXPLORATION +todo I-EXPLORATION el I-EXPLORATION parénquima I-EXPLORATION -hepático I-EXPLORATION -hay I-EXPLORATION -extensas I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -hemorragia I-EXPLORATION -centrolobulillar, I-EXPLORATION -con I-EXPLORATION -necrosis I-EXPLORATION +hepático, I-EXPLORATION +algunas I-EXPLORATION de I-EXPLORATION -hepatocitos I-EXPLORATION -sin I-EXPLORATION -observarse I-EXPLORATION -células I-EXPLORATION -tumorales I-EXPLORATION +las I-EXPLORATION +cuales I-EXPLORATION +presentaban I-EXPLORATION +realce I-EXPLORATION +periférico I-EXPLORATION en I-EXPLORATION -los I-EXPLORATION -fragmentos I-EXPLORATION -estudiados I-EXPLORATION +anillo, I-EXPLORATION +siendo I-EXPLORATION +sugerentes I-EXPLORATION +como I-EXPLORATION +primera I-EXPLORATION +posibilidad I-EXPLORATION +de I-EXPLORATION +metástasis I-EXPLORATION +hepáticas. I-EXPLORATION +La I-EXPLORATION +zona I-EXPLORATION del I-EXPLORATION -parénquima I-EXPLORATION -hepático. I-EXPLORATION -Trombo I-EXPLORATION -infrarrenal I-EXPLORATION -hemático, I-EXPLORATION +segmento I-EXPLORATION +VI I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +había I-EXPLORATION +aplicado I-EXPLORATION +radiofrecuencia I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +pasado I-EXPLORATION +se I-EXPLORATION +mantenía I-EXPLORATION sin I-EXPLORATION -evidencia I-EXPLORATION +signos I-EXPLORATION +radiológicos I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -tumorales. I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -la I-EVOLUTION -revisión I-EVOLUTION -realizada I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -meses, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encontraba I-EVOLUTION -asintomática, I-EVOLUTION -realizando I-EVOLUTION -vida I-EVOLUTION -activa I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -TC I-EVOLUTION -no I-EVOLUTION -mostró I-EVOLUTION -lesiones I-EVOLUTION -sugestivas I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -tumoral. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -quirúrgicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -sala I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -traumatología I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -diagnostico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -lumbalgia I-PRESENT_ILLNESS -rebelde I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -domiciliario. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Se B-EXPLORATION -realizó I-EXPLORATION -TAC I-EXPLORATION -abdominopélvico I-EXPLORATION -en I-EXPLORATION +recidiva I-EXPLORATION +tumoral. I-EXPLORATION +En I-EXPLORATION +ese I-EXPLORATION +momento, I-EXPLORATION +la I-EXPLORATION +hipótesis I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +posible I-EXPLORATION +recidiva I-EXPLORATION +tumoral I-EXPLORATION +de I-EXPLORATION +comportamiento I-EXPLORATION +agresivo I-EXPLORATION +del I-EXPLORATION +hepatocarcinoma I-EXPLORATION +previo I-EXPLORATION +era I-EXPLORATION +uno I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +diagnósticos I-EXPLORATION +más I-EXPLORATION +probables, I-EXPLORATION +aunque I-EXPLORATION el I-EXPLORATION +comportamiento I-EXPLORATION +radiológico I-EXPLORATION +también I-EXPLORATION +hacía I-EXPLORATION +sospechar I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -aprecia I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION -retroperitoneal I-EXPLORATION -(paraaórtica) I-EXPLORATION -que I-EXPLORATION +tratara I-EXPLORATION +de I-EXPLORATION +metástasis I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +primario I-EXPLORATION +no I-EXPLORATION +conocido I-EXPLORATION +y I-EXPLORATION +originado I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +extrahepático. I-EXPLORATION +Por I-EXPLORATION +ello, I-EXPLORATION se I-EXPLORATION -continua I-EXPLORATION +decidió I-EXPLORATION +realizar I-EXPLORATION +una I-EXPLORATION +punción-aspiración I-EXPLORATION con I-EXPLORATION -la I-EXPLORATION -cadena I-EXPLORATION -iliaca I-EXPLORATION -primitiva I-EXPLORATION -y I-EXPLORATION +aguja I-EXPLORATION +fina I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +de I-EXPLORATION las I-EXPLORATION -cadenas I-EXPLORATION -iliacas, I-EXPLORATION -sobre I-EXPLORATION -todo I-EXPLORATION -la I-EXPLORATION -externa I-EXPLORATION -en I-EXPLORATION +lesiones I-EXPLORATION +hepáticas I-EXPLORATION +para I-EXPLORATION +análisis I-EXPLORATION +citológico, I-EXPLORATION el I-EXPLORATION -lado I-EXPLORATION -izquierdo I-EXPLORATION +cual I-EXPLORATION +mostró I-EXPLORATION +células I-EXPLORATION +metastásicas I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -cavidad I-EXPLORATION -abdominopelviana I-EXPLORATION -(9¥28 I-EXPLORATION -cm). I-EXPLORATION -La I-EXPLORATION -tumoración I-EXPLORATION -es I-EXPLORATION -sólida I-EXPLORATION -con I-EXPLORATION -pequeñas I-EXPLORATION -áreas I-EXPLORATION +un I-EXPLORATION +carcinoma I-EXPLORATION +neuroendocrino I-EXPLORATION de I-EXPLORATION -necrosis. I-EXPLORATION -El I-EXPLORATION -TAC I-EXPLORATION -cervicotorácico I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION +célula I-EXPLORATION +pequeña I-EXPLORATION +(CD56+; I-EXPLORATION +sinaptofisina+ I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +inmunohistoquímico). I-EXPLORATION I-EXPLORATION Se I-EXPLORATION -practicó I-EXPLORATION -punción I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -siendo I-EXPLORATION +realizó I-EXPLORATION +a I-EXPLORATION +continuación I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +cérvico-tóraco-abdominal I-EXPLORATION +para I-EXPLORATION +completar I-EXPLORATION el I-EXPLORATION -resultado I-EXPLORATION -anatomopatológico I-EXPLORATION +estudio, I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +visualizaron I-EXPLORATION +lesiones I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -tumor I-EXPLORATION +cuerpos I-EXPLORATION +vertebrales I-EXPLORATION +dorsales I-EXPLORATION +y I-EXPLORATION +lumbosacros, I-EXPLORATION +siendo I-EXPLORATION +sugerentes I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -germinales I-EXPLORATION -tipo I-EXPLORATION -seminoma. I-EXPLORATION - I-EXPLORATION +enfermedad I-EXPLORATION +metastásica. I-EXPLORATION La I-EXPLORATION -exploración I-EXPLORATION -testicular I-EXPLORATION -bilateral I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION +gammagrafía I-EXPLORATION +ósea I-EXPLORATION y I-EXPLORATION la I-EXPLORATION -ecografía I-EXPLORATION -testicular I-EXPLORATION -informó I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION de I-EXPLORATION -múltiples I-EXPLORATION -imágenes I-EXPLORATION -ecogénicas I-EXPLORATION -puntiformes I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -testículos I-EXPLORATION -(mas I-EXPLORATION -llamativas I-EXPLORATION -y I-EXPLORATION -extensas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -teste I-EXPLORATION -izquierdo), I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -masa I-EXPLORATION -clara. I-EXPLORATION -Ante I-EXPLORATION -estos I-EXPLORATION +columna I-EXPLORATION +realizadas I-EXPLORATION +posteriormente I-EXPLORATION +confirmaron I-EXPLORATION +los I-EXPLORATION hallazgos I-EXPLORATION -ecográficos, I-EXPLORATION -se I-EXPLORATION -practicó I-EXPLORATION -biopsia I-EXPLORATION -testicular I-EXPLORATION -bilateral. I-EXPLORATION -En I-EXPLORATION -ambos I-EXPLORATION -testes I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -atrofia I-EXPLORATION -testicular I-EXPLORATION -con I-EXPLORATION -patrón I-EXPLORATION de I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -"solo I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -Sertoli", I-EXPLORATION -hialinización I-EXPLORATION -tubular I-EXPLORATION -y I-EXPLORATION -microlitiasis. I-EXPLORATION +la I-EXPLORATION +tomografía. I-EXPLORATION I-EXPLORATION -En I-EXPLORATION +Hasta I-EXPLORATION la I-EXPLORATION -analítica I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -practicada I-EXPLORATION -al I-EXPLORATION -paciente I-EXPLORATION -llamaba I-EXPLORATION +fecha, I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +ha I-EXPLORATION +logrado I-EXPLORATION +encontrar I-EXPLORATION la I-EXPLORATION -atención I-EXPLORATION -una I-EXPLORATION -LDH I-EXPLORATION +localización I-EXPLORATION +primaria I-EXPLORATION +del I-EXPLORATION +tumor, I-EXPLORATION +si I-EXPLORATION +bien I-EXPLORATION +la I-EXPLORATION +hipótesis I-EXPLORATION de I-EXPLORATION -1903 I-EXPLORATION -y I-EXPLORATION -b-HCG I-EXPLORATION +un I-EXPLORATION +carcinoma I-EXPLORATION +microcítico I-EXPLORATION de I-EXPLORATION -23, I-EXPLORATION -8, I-EXPLORATION +pulmón I-EXPLORATION con I-EXPLORATION -α-fetoproteína I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT +afectación I-EXPLORATION +metastásica I-EXPLORATION +es I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +más I-EXPLORATION +probable. I-EXPLORATION +En B-TREATMENT +el I-TREATMENT +momento I-TREATMENT +actual I-TREATMENT +el I-TREATMENT paciente I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT +está I-TREATMENT +recibiendo I-TREATMENT quimioterapia I-TREATMENT -CTEP I-TREATMENT -(Cisplatino I-TREATMENT +basada I-TREATMENT +en I-TREATMENT +un I-TREATMENT +régimen I-TREATMENT +consistente I-TREATMENT +en I-TREATMENT +carboplatino I-TREATMENT y I-TREATMENT -Etopósido). I-TREATMENT -Después B-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -ciclos I-EXPLORATION -se I-EXPLORATION -practicó I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -control, I-EXPLORATION -observándose I-EXPLORATION +etopósido I-TREATMENT +y I-TREATMENT +ha I-TREATMENT +recibido I-TREATMENT +radioterapia I-TREATMENT +paliativa I-TREATMENT +para I-TREATMENT +control I-TREATMENT +del I-TREATMENT +dolor I-TREATMENT +secundario I-TREATMENT +a I-TREATMENT +las I-TREATMENT +metástasis I-TREATMENT +óseas I-TREATMENT +de I-TREATMENT +columna, I-TREATMENT +presentando I-TREATMENT +buena I-TREATMENT +respuesta I-TREATMENT +clínica. I-TREATMENT +En B-EXPLORATION la I-EXPLORATION -total I-EXPLORATION -desaparición I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +tóraco-abdominal I-EXPLORATION +realizada I-EXPLORATION +seis I-EXPLORATION +meses I-EXPLORATION +después I-EXPLORATION de I-EXPLORATION +comenzar I-EXPLORATION +el I-EXPLORATION +tratamiento I-EXPLORATION +quimioterápico I-EXPLORATION +han I-EXPLORATION +desaparecido I-EXPLORATION la I-EXPLORATION -masa I-EXPLORATION -retroperitoneal, I-EXPLORATION -quedando I-EXPLORATION -tan I-EXPLORATION -solo I-EXPLORATION -dos I-EXPLORATION -adenopatías I-EXPLORATION -paraaórticas I-EXPLORATION -izquierdas I-EXPLORATION -y I-EXPLORATION -otra I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -iliaca I-EXPLORATION -izquierda I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -cada I-EXPLORATION -una, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -dos I-TREATMENT -ciclos I-TREATMENT -mas I-TREATMENT -de I-TREATMENT -CTEP, I-TREATMENT -sin B-EVOLUTION -conseguirse I-EVOLUTION -reducción I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -tamaño I-EVOLUTION -de I-EVOLUTION -dichas I-EVOLUTION -adenopatías. I-EVOLUTION - I-EVOLUTION -Con B-TREATMENT -la I-TREATMENT -intención I-TREATMENT -de I-TREATMENT -extirpar I-TREATMENT -la I-TREATMENT -masa I-TREATMENT -tumoral I-TREATMENT -restante I-TREATMENT -tras I-TREATMENT -la I-TREATMENT -quimioterapia, I-TREATMENT -se I-TREATMENT -practicó I-TREATMENT -laparotomía I-TREATMENT -media I-TREATMENT -con I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -las I-TREATMENT -adenopatías I-TREATMENT -y I-TREATMENT -orquiectomía I-TREATMENT -bilateral. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION +mayoría I-EXPLORATION de I-EXPLORATION las I-EXPLORATION -adenopatías I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -fibroso I-EXPLORATION -con I-EXPLORATION -infiltrado I-EXPLORATION -linfoide I-EXPLORATION -disperso I-EXPLORATION +lesiones I-EXPLORATION +hepáticas I-EXPLORATION y I-EXPLORATION -necrosis I-EXPLORATION -sin I-EXPLORATION -observarse I-EXPLORATION -tumor. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -testículos I-EXPLORATION -informo I-EXPLORATION -de I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION +óseas I-EXPLORATION +metastásicas, I-EXPLORATION +persistiendo I-EXPLORATION solo I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -Sertoli, I-EXPLORATION -con I-EXPLORATION -importante I-EXPLORATION -atrofia I-EXPLORATION -tubular, I-EXPLORATION -hialinosis, I-EXPLORATION -calcificaciones I-EXPLORATION -y I-EXPLORATION -microlitiasis I-EXPLORATION -sin I-EXPLORATION -observarse I-EXPLORATION -tumor. I-EXPLORATION - I-EXPLORATION -Tras B-EVOLUTION -doce I-EVOLUTION -meses I-EVOLUTION +algunos I-EXPLORATION +nódulos I-EXPLORATION +milimétricos I-EXPLORATION +hepáticos. I-EXPLORATION +Dada B-EVOLUTION +la I-EVOLUTION +buena I-EVOLUTION +respuesta, I-EVOLUTION +se I-EVOLUTION +ha I-EVOLUTION +reiniciado I-EVOLUTION +un I-EVOLUTION +nuevo I-EVOLUTION +ciclo I-EVOLUTION de I-EVOLUTION -seguimiento, I-EVOLUTION +tratamiento I-EVOLUTION +oncológico I-EVOLUTION +cuyos I-EVOLUTION +resultados I-EVOLUTION +serán I-EVOLUTION +evaluados I-EVOLUTION +en I-EVOLUTION el I-EVOLUTION -paciente I-EVOLUTION -está I-EVOLUTION -clínicamente I-EVOLUTION -asintomático I-EVOLUTION -con B-TREATMENT -tratamiento I-TREATMENT -hormonal I-TREATMENT -sustitutivo I-TREATMENT -y B-EVOLUTION -sin I-EVOLUTION -recidiva I-EVOLUTION -radiológica I-EVOLUTION -ni I-EVOLUTION -analítica. I-EVOLUTION +futuro I-EVOLUTION +próximo. I-EVOLUTION I-EVOLUTION Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS un I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS +65 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +fumador B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +40 I-PAST_MEDICAL_HISTORY +paquetes/año, I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +buen I-PAST_MEDICAL_HISTORY +control I-PAST_MEDICAL_HISTORY +farmacológico, I-PAST_MEDICAL_HISTORY +miopía I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +intervenido I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +catarata I-PAST_MEDICAL_HISTORY +ojo I-PAST_MEDICAL_HISTORY +derecho I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes, I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +destacables. I-PAST_MEDICAL_HISTORY +El B-PRESENT_ILLNESS +motivo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -hipo I-PRESENT_ILLNESS -persistente, I-PRESENT_ILLNESS -dispepsia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -plenitud I-PRESENT_ILLNESS -postprandrial. I-PRESENT_ILLNESS -Entre B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -laparotomía I-PAST_MEDICAL_HISTORY -exploradora I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -14 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -traumatismo I-PAST_MEDICAL_HISTORY -abdominal, I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -cual I-PAST_MEDICAL_HISTORY -desconocemos I-PAST_MEDICAL_HISTORY -datos I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -haberse I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -otro I-PAST_MEDICAL_HISTORY -centro. I-PAST_MEDICAL_HISTORY +oftalmología I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +hospital, I-PRESENT_ILLNESS +consistió I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +escotoma I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +central I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +derecho. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +síntomas I-PRESENT_ILLNESS +respiratorios, I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +constitucional. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION +oftalmoscópica I-EXPLORATION se I-EXPLORATION -objetivó I-EXPLORATION +identificaba I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +porción I-EXPLORATION +más I-EXPLORATION +superior I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +papila, I-EXPLORATION una I-EXPLORATION -ocupación I-EXPLORATION +imagen I-EXPLORATION de I-EXPLORATION -todo I-EXPLORATION +despigmentación, I-EXPLORATION +con I-EXPLORATION +áreas I-EXPLORATION +pigmentadas I-EXPLORATION +anaranjadas I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -hemiabdomen I-EXPLORATION -derecho I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION +centro, I-EXPLORATION de I-EXPLORATION -consistencia I-EXPLORATION -elástica, I-EXPLORATION -a I-EXPLORATION -tensión, I-EXPLORATION -indolora I-EXPLORATION +un I-EXPLORATION +tamaño I-EXPLORATION +de I-EXPLORATION +4-5 I-EXPLORATION +diámetros I-EXPLORATION +papilares I-EXPLORATION y I-EXPLORATION -mate I-EXPLORATION -a I-EXPLORATION +levantamiento I-EXPLORATION +exudativo I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +bordes. I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +angiografía I-EXPLORATION +fluoresceínica I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -percusión I-EXPLORATION que I-EXPLORATION -sobrepasaba I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -media. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION +se I-EXPLORATION +reconoce I-EXPLORATION de I-EXPLORATION -rutina I-EXPLORATION -que I-EXPLORATION -puso I-EXPLORATION +nuevo I-EXPLORATION +esta I-EXPLORATION +misma I-EXPLORATION +lesión I-EXPLORATION +descrita I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +retinografía, I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +descartó I-EXPLORATION de I-EXPLORATION -manifiesto I-EXPLORATION un I-EXPLORATION -recuento I-EXPLORATION +hematoma I-EXPLORATION +o I-EXPLORATION +hemangioma. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +orbitaria I-EXPLORATION +mostraba I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION de I-EXPLORATION -7, I-EXPLORATION -13 I-EXPLORATION +7 I-EXPLORATION x I-EXPLORATION -106 I-EXPLORATION -hematíes, I-EXPLORATION -20.5 I-EXPLORATION -g/dl I-EXPLORATION -de I-EXPLORATION -hemoglobina I-EXPLORATION -y I-EXPLORATION -hematocrito I-EXPLORATION +3 I-EXPLORATION +milímetros I-EXPLORATION +(mm) I-EXPLORATION de I-EXPLORATION -65.9%, I-EXPLORATION +diámetro, I-EXPLORATION con I-EXPLORATION -cifras I-EXPLORATION -similares I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -preoperatorio I-EXPLORATION -inmediato. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -mostró I-EXPLORATION una I-EXPLORATION -hidronefrosis I-EXPLORATION -masiva I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION -derecho. I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +elevación I-EXPLORATION de I-EXPLORATION -ectasia I-EXPLORATION -pielocalicial I-EXPLORATION -masiva I-EXPLORATION -con I-EXPLORATION -prácticamente I-EXPLORATION -ausencia I-EXPLORATION +3 I-EXPLORATION +mm. I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +una I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +nuclear I-EXPLORATION de I-EXPLORATION -cortical, I-EXPLORATION +la I-EXPLORATION +órbita, I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION que I-EXPLORATION -ocupaba I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +un I-EXPLORATION +mínimo I-EXPLORATION +engrosamiento I-EXPLORATION +focal I-EXPLORATION +retiniano I-EXPLORATION +inmediatamente I-EXPLORATION +adyacente I-EXPLORATION +y I-EXPLORATION +lateral I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -totalidad I-EXPLORATION -del I-EXPLORATION -hemiabdomen I-EXPLORATION -derecho, I-EXPLORATION -sobrepasando I-EXPLORATION +papila, I-EXPLORATION +sin I-EXPLORATION +hiperseñal I-EXPLORATION +ni I-EXPLORATION +realce I-EXPLORATION +tras I-EXPLORATION la I-EXPLORATION -línea I-EXPLORATION -media I-EXPLORATION -hasta I-EXPLORATION -contactar I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -polo I-EXPLORATION -inferior I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION -izquierdo, I-EXPLORATION -sugestivo I-EXPLORATION +administración I-EXPLORATION de I-EXPLORATION -riñón I-EXPLORATION +contraste. I-EXPLORATION +Un I-EXPLORATION +mes I-EXPLORATION +después I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +retinografía I-EXPLORATION +y I-EXPLORATION +ecografía I-EXPLORATION +orbitaria, I-EXPLORATION en I-EXPLORATION -herradura I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -practicó, I-TREATMENT -por I-TREATMENT -lumbotomía, I-TREATMENT -nefrectomía I-TREATMENT -derecha I-TREATMENT -de I-TREATMENT -un I-TREATMENT -gran I-TREATMENT -riñón I-TREATMENT -hidronefrótico I-TREATMENT -secundario I-TREATMENT -a I-TREATMENT -estenosis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -unión I-TREATMENT -pieloureteral, I-TREATMENT -cursando I-TREATMENT -el I-TREATMENT -postoperatorio I-TREATMENT -sin I-TREATMENT -incidencias. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -riñón I-EXPLORATION -hidronefrótico I-EXPLORATION -con I-EXPLORATION -atrofia I-EXPLORATION -cortical I-EXPLORATION -marcada. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION -al I-EXPLORATION -segundo I-EXPLORATION -día I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +un I-EXPLORATION +claro I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -cirugía I-EXPLORATION -presentaba I-EXPLORATION +lesión I-EXPLORATION +retiniana, I-EXPLORATION +llegando I-EXPLORATION +a I-EXPLORATION una I-EXPLORATION -Hemoglobina I-EXPLORATION +dimensión I-EXPLORATION de I-EXPLORATION -15 I-EXPLORATION -g/dl, I-EXPLORATION -4, I-EXPLORATION +9, I-EXPLORATION 6 I-EXPLORATION -millones I-EXPLORATION -de I-EXPLORATION -eritrocitos I-EXPLORATION -y I-EXPLORATION -43, I-EXPLORATION -7% I-EXPLORATION +x I-EXPLORATION +3, I-EXPLORATION +9 I-EXPLORATION +mm. I-EXPLORATION +La I-EXPLORATION +aproximación I-EXPLORATION +diagnóstica I-EXPLORATION +fue I-EXPLORATION de I-EXPLORATION -hematocrito. I-EXPLORATION +tumor I-EXPLORATION +retiniano, I-EXPLORATION +posiblemente I-EXPLORATION +metastásico. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -otro I-EXPLORATION -hemograma I-EXPLORATION -10 I-EXPLORATION -meses I-EXPLORATION -después I-EXPLORATION -evidenciándose I-EXPLORATION -una I-EXPLORATION -normalización I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +general I-EXPLORATION +de I-EXPLORATION +búsqueda I-EXPLORATION del I-EXPLORATION -recuento I-EXPLORATION -eritrocitario. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -63 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -compatible I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -Pielonefritis I-PRESENT_ILLNESS -aguda I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -Antecedentes B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cólicos I-PAST_MEDICAL_HISTORY -nefríticos I-PAST_MEDICAL_HISTORY -izquierdos I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -estudiados I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -juventud. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -destaca I-EXPLORATION +tumor I-EXPLORATION +primario, I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION una I-EXPLORATION -puñopercusión I-EXPLORATION -renal I-EXPLORATION -izquierda I-EXPLORATION -positiva I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -tacto I-EXPLORATION -rectal I-EXPLORATION -con I-EXPLORATION -hipertrofia I-EXPLORATION -prostática I-EXPLORATION -volumen I-EXPLORATION -III/IV, I-EXPLORATION -fibroadenomatosa I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -nódulos. I-EXPLORATION -Analítica I-EXPLORATION -sanguínea I-EXPLORATION -con I-EXPLORATION -bioquímica I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computerizada I-EXPLORATION +(TC) I-EXPLORATION +toracoabdominopélvica I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -normalidad, I-EXPLORATION -PSA I-EXPLORATION -de I-EXPLORATION -3, I-EXPLORATION -4 I-EXPLORATION -ng/ml I-EXPLORATION -y I-EXPLORATION -formula I-EXPLORATION -sanguínea I-EXPLORATION -con I-EXPLORATION -leucocitosis I-EXPLORATION -y I-EXPLORATION -desviación I-EXPLORATION -izquierda. I-EXPLORATION -Analítica I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -con I-EXPLORATION -nitritos I-EXPLORATION -positivos I-EXPLORATION -y I-EXPLORATION -leucocituria. I-EXPLORATION -Urocultivos I-EXPLORATION -y I-EXPLORATION -Hemocultivos I-EXPLORATION -positivos I-EXPLORATION -a I-EXPLORATION -E. I-EXPLORATION -Coli. I-EXPLORATION -Rx I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -aparato I-EXPLORATION -urinario I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -patológicos I-EXPLORATION -significativos. I-EXPLORATION -Ecografía I-EXPLORATION -con I-EXPLORATION -ectasia I-EXPLORATION -renal I-EXPLORATION -izquierda I-EXPLORATION -grado I-EXPLORATION -II-III. I-EXPLORATION -La I-EXPLORATION -UIV I-EXPLORATION -realizada I-EXPLORATION -muestra I-EXPLORATION -vía I-EXPLORATION -urinaria I-EXPLORATION -alta I-EXPLORATION -derecha I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad I-EXPLORATION -y I-EXPLORATION -retraso I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -captación I-EXPLORATION -y I-EXPLORATION -eliminación I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION +lóbulo I-EXPLORATION +superior I-EXPLORATION izquierdo I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +de I-EXPLORATION +2, I-EXPLORATION +2 I-EXPLORATION +cm, I-EXPLORATION que I-EXPLORATION -persiste I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -dos I-EXPLORATION -horas. I-EXPLORATION -Se I-EXPLORATION -procede I-EXPLORATION -a I-EXPLORATION +engloba I-EXPLORATION la I-EXPLORATION -realización I-EXPLORATION +salida I-EXPLORATION +del I-EXPLORATION +bronquio I-EXPLORATION +del I-EXPLORATION +lóbulo I-EXPLORATION +superior, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +adenopatías I-EXPLORATION +mediastínicas I-EXPLORATION de I-EXPLORATION -nefrostomía I-EXPLORATION -derivativa I-EXPLORATION -izquierda I-EXPLORATION +tamaño I-EXPLORATION +superior I-EXPLORATION +a I-EXPLORATION +2 I-EXPLORATION +centímetros I-EXPLORATION +(cm) I-EXPLORATION +prevasculares, I-EXPLORATION +pretraqueales I-EXPLORATION +derechas, I-EXPLORATION +ventana I-EXPLORATION +aortopulmonar I-EXPLORATION y I-EXPLORATION -posterior I-EXPLORATION -pielografía I-EXPLORATION -anterógrada, I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -demuestra I-EXPLORATION -defecto I-EXPLORATION -de I-EXPLORATION -repleción I-EXPLORATION -en I-EXPLORATION -uréter I-EXPLORATION -iliaco I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -tumoración I-EXPLORATION -ureteral I-EXPLORATION +subcarinales. I-EXPLORATION +A I-EXPLORATION +nivel I-EXPLORATION +abdominal I-EXPLORATION +destacan I-EXPLORATION +nódulos I-EXPLORATION +suprarrenales I-EXPLORATION +bilaterales I-EXPLORATION de I-EXPLORATION -3-4 I-EXPLORATION +2 I-EXPLORATION cm I-EXPLORATION -y I-EXPLORATION -uréter I-EXPLORATION en I-EXPLORATION -anzuelo. I-EXPLORATION -Citología I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -nefrostomía I-EXPLORATION -negativa I-EXPLORATION +el I-EXPLORATION +izquierdo I-EXPLORATION y I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION +derecho. I-EXPLORATION +La I-EXPLORATION +Tomografía I-EXPLORATION +por I-EXPLORATION +emisión I-EXPLORATION de I-EXPLORATION -extensión I-EXPLORATION +positrones I-EXPLORATION +(PET) I-EXPLORATION +mostraba I-EXPLORATION +múltiples I-EXPLORATION +focos I-EXPLORATION +de I-EXPLORATION +elevada I-EXPLORATION +actividad I-EXPLORATION +metabólica I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +paratraqueal I-EXPLORATION +derecho, I-EXPLORATION +mediastínico I-EXPLORATION +y I-EXPLORATION +región I-EXPLORATION +hiliar I-EXPLORATION +y I-EXPLORATION +parahiliar I-EXPLORATION +izquierdo, I-EXPLORATION +región I-EXPLORATION +suprarrenal I-EXPLORATION +derecha, I-EXPLORATION +todo I-EXPLORATION +ello I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -TAC I-EXPLORATION -objetivaba I-EXPLORATION -dicha I-EXPLORATION -lesión I-EXPLORATION -como I-EXPLORATION -confinada I-EXPLORATION -al I-EXPLORATION -órgano I-EXPLORATION -origen. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -Nefroureterectomía I-TREATMENT -izquierda I-TREATMENT -previa I-TREATMENT -desinserción I-TREATMENT -endoscópica, I-TREATMENT -siendo I-TREATMENT +afectación I-EXPLORATION +tumoral I-EXPLORATION +maligna. I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +mediastinoscopia I-EXPLORATION +para I-EXPLORATION +toma I-EXPLORATION +de I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +adenopatía I-EXPLORATION +paratraqueal I-EXPLORATION +derecha, I-EXPLORATION +cuyo I-EXPLORATION +resultado I-EXPLORATION +fue I-EXPLORATION +metástasis I-EXPLORATION +de I-EXPLORATION +adenocarcinoma. I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT el I-TREATMENT -resultado I-TREATMENT -anatomopatológico I-TREATMENT +diagnóstico I-TREATMENT de I-TREATMENT -Papiloma I-TREATMENT -invertido I-TREATMENT +metástasis I-TREATMENT +retiniana I-TREATMENT +derecha I-TREATMENT +y I-TREATMENT +suprarrenal I-TREATMENT de I-TREATMENT -uréter I-TREATMENT +adenocarcinoma I-TREATMENT +de I-TREATMENT +pulmón, I-TREATMENT +comienza I-TREATMENT +tratamiento I-TREATMENT +quimioterápico I-TREATMENT +con I-TREATMENT +esquema I-TREATMENT +docetaxel I-TREATMENT y I-TREATMENT -riñón I-TREATMENT -izquierdo I-TREATMENT +cisplatino, I-TREATMENT +mostrando I-TREATMENT +tras I-TREATMENT +dos I-TREATMENT +ciclos I-TREATMENT +una I-TREATMENT +respuesta I-TREATMENT +parcial I-TREATMENT +de I-TREATMENT +la I-TREATMENT +enfermedad I-TREATMENT +medible I-TREATMENT +y I-TREATMENT +una I-TREATMENT +aparente I-TREATMENT +mejoría I-TREATMENT +de I-TREATMENT +la I-TREATMENT +formación I-TREATMENT +retiniana, I-TREATMENT +aunque I-TREATMENT +posteriormente, I-TREATMENT +se I-TREATMENT +complicó I-TREATMENT con I-TREATMENT -pielonefritis I-TREATMENT -crónica. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -años I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -sufre I-EVOLUTION -una I-EVOLUTION -RAO I-EVOLUTION -que I-EVOLUTION -aconseja I-EVOLUTION -la I-EVOLUTION -realización I-EVOLUTION -de I-EVOLUTION -Adenomectomía I-EVOLUTION -Retropúbica I-EVOLUTION -y I-EVOLUTION -posteriormente I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -4 I-EVOLUTION -y I-EVOLUTION -5 I-EVOLUTION -años I-EVOLUTION -presenta I-EVOLUTION -sendas I-EVOLUTION -recidivas I-EVOLUTION -vesicales I-EVOLUTION -de I-EVOLUTION -Carcinoma I-EVOLUTION -transicional I-EVOLUTION -de I-EVOLUTION -vejiga I-EVOLUTION -T1GII. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -sigue I-EVOLUTION -vivo I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -urotelial I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -años I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -PI. I-EVOLUTION - I-EVOLUTION +un I-TREATMENT +desprendimiento I-TREATMENT +de I-TREATMENT +retina I-TREATMENT +leve I-TREATMENT +y I-TREATMENT +tuvo I-TREATMENT +que I-TREATMENT +ser I-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +radioterapia. I-TREATMENT + I-TREATMENT -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urología I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -nódulo I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -2, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -cm. I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -paratesticular I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -Tres B-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -ingresado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -nuestro I-PAST_MEDICAL_HISTORY -hospital I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -ACVA I-PAST_MEDICAL_HISTORY -parietal I-PAST_MEDICAL_HISTORY -izquierdo I-PAST_MEDICAL_HISTORY -presentando I-PAST_MEDICAL_HISTORY -pérdida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -fuerza I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -hemicuerpo I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dificultad I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -habla. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -tomografía I-PAST_MEDICAL_HISTORY -axial I-PAST_MEDICAL_HISTORY -computerizada I-PAST_MEDICAL_HISTORY -(TAC) I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cráneo I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -apreció I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -hipodensa I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -brazo I-PAST_MEDICAL_HISTORY -anterior I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cápsula I-PAST_MEDICAL_HISTORY -blanca I-PAST_MEDICAL_HISTORY -interna I-PAST_MEDICAL_HISTORY -izquierda, I-PAST_MEDICAL_HISTORY -así I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -también I-PAST_MEDICAL_HISTORY -otras I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -sutiles I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -fronto-parietal I-PAST_MEDICAL_HISTORY -izquierda. I-PAST_MEDICAL_HISTORY -Tras I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -administración I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -contraste I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -apreciaron I-PAST_MEDICAL_HISTORY -imágenes I-PAST_MEDICAL_HISTORY -compatibles I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -aneurisma, I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -observó I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -tortuosidad I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -arteria I-PAST_MEDICAL_HISTORY -cerebral I-PAST_MEDICAL_HISTORY -media I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -podría I-PAST_MEDICAL_HISTORY -corresponder I-PAST_MEDICAL_HISTORY -bien I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -trombo I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -efecto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -volumen I-PAST_MEDICAL_HISTORY -parcial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -contexto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -vaso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -morfología I-PAST_MEDICAL_HISTORY -tortuosa. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -angio-resonancia I-PAST_MEDICAL_HISTORY -magnética I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -observó I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -arterias I-PAST_MEDICAL_HISTORY -cerebrales I-PAST_MEDICAL_HISTORY -medias I-PAST_MEDICAL_HISTORY -eran I-PAST_MEDICAL_HISTORY -asimétricas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -cuanto I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -señal, I-PAST_MEDICAL_HISTORY -presentando I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -disminución I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -señal I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -todo I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -trayecto, I-PAST_MEDICAL_HISTORY +51 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +fumadora, B-PAST_MEDICAL_HISTORY sin I-PAST_MEDICAL_HISTORY -estenosis. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -electrocardiograma I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -mostró I-PAST_MEDICAL_HISTORY -alteraciones. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -ecografía I-PAST_MEDICAL_HISTORY -carotídea, I-PAST_MEDICAL_HISTORY -arteriografía I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -troncos I-PAST_MEDICAL_HISTORY -cerebrales I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -supraórticos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -ecocardiograma I-PAST_MEDICAL_HISTORY -transesofágico I-PAST_MEDICAL_HISTORY -fueron I-PAST_MEDICAL_HISTORY -también I-PAST_MEDICAL_HISTORY -normales. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -determinaciones I-PAST_MEDICAL_HISTORY -analíticas I-PAST_MEDICAL_HISTORY -sanguíneas, I-PAST_MEDICAL_HISTORY -todos I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -parámetros I-PAST_MEDICAL_HISTORY -fueron I-PAST_MEDICAL_HISTORY -normales, I-PAST_MEDICAL_HISTORY -incluidos I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -estudios I-PAST_MEDICAL_HISTORY -realizados I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -llegar I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -etiológico I-PAST_MEDICAL_HISTORY -como: I-PAST_MEDICAL_HISTORY -anticoagulante I-PAST_MEDICAL_HISTORY -lúpico, I-PAST_MEDICAL_HISTORY -homocisteína, I-PAST_MEDICAL_HISTORY -anticuerpos I-PAST_MEDICAL_HISTORY -anticardiolipina, I-PAST_MEDICAL_HISTORY -(α2 I-PAST_MEDICAL_HISTORY -antiplasmina, I-PAST_MEDICAL_HISTORY -anticuerpos I-PAST_MEDICAL_HISTORY -anti-proteinasa-3, I-PAST_MEDICAL_HISTORY -anticuerpos I-PAST_MEDICAL_HISTORY -anti-mieloperoxidasa, I-PAST_MEDICAL_HISTORY -proteína I-PAST_MEDICAL_HISTORY -S, I-PAST_MEDICAL_HISTORY -actividad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -proteína I-PAST_MEDICAL_HISTORY -C, I-PAST_MEDICAL_HISTORY -RPR, I-PAST_MEDICAL_HISTORY -anticuerpos I-PAST_MEDICAL_HISTORY -antinucleares, I-PAST_MEDICAL_HISTORY -anticuerpos I-PAST_MEDICAL_HISTORY -anticitoplasma I-PAST_MEDICAL_HISTORY +alergias I-PAST_MEDICAL_HISTORY +medicamentosas I-PAST_MEDICAL_HISTORY +conocidas, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -neutrófilos I-PAST_MEDICAL_HISTORY -(ANCA), I-PAST_MEDICAL_HISTORY -anticuerpos I-PAST_MEDICAL_HISTORY -anti I-PAST_MEDICAL_HISTORY -SSA I-PAST_MEDICAL_HISTORY -Ro I-PAST_MEDICAL_HISTORY +colon I-PAST_MEDICAL_HISTORY +irritable, I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY +depresivo I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -anti I-PAST_MEDICAL_HISTORY -SSB I-PAST_MEDICAL_HISTORY -LA. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -definitiva, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -trata I-PAST_MEDICAL_HISTORY +migrañas, I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY un I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -joven I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -presenta I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY +carcinoma I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -ACVA I-PAST_MEDICAL_HISTORY +cuello I-PAST_MEDICAL_HISTORY +uterino I-PAST_MEDICAL_HISTORY +aparentemente I-PAST_MEDICAL_HISTORY +localizado I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -territorio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cerebral I-PAST_MEDICAL_HISTORY -media I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY +julio I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -etiología I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -filiada. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -actual I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -pétrea I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -paratesticular I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS +2012. I-PAST_MEDICAL_HISTORY +Se B-TREATMENT +realizó I-TREATMENT +histerectomía, I-TREATMENT +doble I-TREATMENT +annexectomía I-TREATMENT +y I-TREATMENT +estadificación I-TREATMENT +ganglionar I-TREATMENT +quirúrgica I-TREATMENT +retroperitoneal. I-TREATMENT +La B-EXPLORATION +estadificación I-EXPLORATION +final I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +pT3N1 I-EXPLORATION +(ganglios I-EXPLORATION +pélvicos). I-EXPLORATION +A B-TREATMENT +continuación I-TREATMENT +recibió I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +cisplatino I-TREATMENT +(40 I-TREATMENT +mg/m2 I-TREATMENT +semanales) I-TREATMENT +concomitante I-TREATMENT +a I-TREATMENT +radioterapia. I-TREATMENT +Por I-TREATMENT +alta I-TREATMENT +probabilidad I-TREATMENT +de I-TREATMENT +recaída I-TREATMENT +recibió I-TREATMENT +posteriormente I-TREATMENT +quimioterapia I-TREATMENT +con I-TREATMENT +el I-TREATMENT +esquema I-TREATMENT +carboplatino I-TREATMENT +(5 I-TREATMENT +mg/AUC) I-TREATMENT +y I-TREATMENT +paclitaxel I-TREATMENT +(175 I-TREATMENT +mg/m2), I-TREATMENT +recibiendo I-TREATMENT +cinco I-TREATMENT +ciclos I-TREATMENT +en I-TREATMENT +total I-TREATMENT +con I-TREATMENT +varias I-TREATMENT +reducciones I-TREATMENT +de I-TREATMENT +dosis I-TREATMENT +por I-TREATMENT +diferentes I-TREATMENT +toxicidades I-TREATMENT +(plaquetopenia I-TREATMENT +grado I-TREATMENT +IV, I-TREATMENT +oclusión I-TREATMENT +intestinal I-TREATMENT +y I-TREATMENT +neurotoxicidad I-TREATMENT +grado I-TREATMENT +II). I-TREATMENT +Permaneció B-EVOLUTION +libre I-EVOLUTION +de I-EVOLUTION +enfermedad I-EVOLUTION +hasta I-EVOLUTION +octubre I-EVOLUTION +de I-EVOLUTION +2014, I-EVOLUTION +fecha I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +detecta I-EVOLUTION +progresión I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +enfermedad I-EVOLUTION +en I-EVOLUTION +forma I-EVOLUTION +de I-EVOLUTION +implantes I-EVOLUTION +peritoneales I-EVOLUTION +e I-EVOLUTION +implantes I-EVOLUTION +metastásicos I-EVOLUTION +esplénicos. I-EVOLUTION +Inicia B-TREATMENT +tratamiento I-TREATMENT +quimioterápico I-TREATMENT +con I-TREATMENT +el I-TREATMENT +esquema I-TREATMENT +bevacizumab I-TREATMENT +(15 I-TREATMENT +mg/kg), I-TREATMENT +cisplatino I-TREATMENT +(50 I-TREATMENT +mg/m2) I-TREATMENT +y I-TREATMENT +paclitaxel I-TREATMENT +(175 I-TREATMENT +mg/m2), I-TREATMENT +cada I-TREATMENT +21 I-TREATMENT +días. I-TREATMENT +El B-EVOLUTION +día I-EVOLUTION +posterior I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +primera I-EVOLUTION +administración I-EVOLUTION +acude I-EVOLUTION +a I-EVOLUTION +urgencias I-EVOLUTION +con I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +agudo I-EVOLUTION +y I-EVOLUTION +náuseas I-EVOLUTION +sin I-EVOLUTION +vómitos, I-EVOLUTION +no I-EVOLUTION +presentado I-EVOLUTION +fiebre. I-EVOLUTION En B-EXPLORATION la I-EXPLORATION -ecografía I-EXPLORATION -testicular I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION -un I-EXPLORATION -engrosamiento I-EXPLORATION -del I-EXPLORATION -cordón I-EXPLORATION -espermático I-EXPLORATION -izquierdo. I-EXPLORATION -Los I-EXPLORATION -testículos I-EXPLORATION -son I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -y I-EXPLORATION -morfología I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION +detecta I-EXPLORATION +abdomen I-EXPLORATION +doloroso I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -Resonacia I-EXPLORATION -Magnética I-EXPLORATION -objetivándose I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cordón I-EXPLORATION -espermático I-EXPLORATION -izquierdo I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -comporta I-EXPLORATION +palpación, I-EXPLORATION +diseminado I-EXPLORATION +tanto I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +superficial I-EXPLORATION +como I-EXPLORATION +profundo, I-EXPLORATION con I-EXPLORATION -alta I-EXPLORATION -señal I-EXPLORATION -en I-EXPLORATION -secuencias I-EXPLORATION -T1 I-EXPLORATION -y I-EXPLORATION -T2. I-EXPLORATION -Tras I-EXPLORATION -la I-EXPLORATION -administración I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -contraste I-EXPLORATION -se I-EXPLORATION -produce I-EXPLORATION -un I-EXPLORATION -realce I-EXPLORATION -periférico I-EXPLORATION -del I-EXPLORATION -mismo I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -zona I-EXPLORATION -hipointensa I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -centro I-EXPLORATION -que I-EXPLORATION -representa I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -zona I-EXPLORATION -avascular I-EXPLORATION +peritonismo. I-EXPLORATION +En I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -necrosis. I-EXPLORATION -Las I-EXPLORATION -posibilidades I-EXPLORATION -diagnósticas I-EXPLORATION -fueron I-EXPLORATION -dos: I-EXPLORATION -liposarcoma I-EXPLORATION -del I-EXPLORATION -cordón I-EXPLORATION -espermático I-EXPLORATION -o I-EXPLORATION -vasculitis. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -realiza I-TREATMENT -biopsia I-TREATMENT -de I-TREATMENT -cordón I-TREATMENT -espermático I-TREATMENT -y I-TREATMENT -testículo. I-TREATMENT -Macroscópicamente B-EXPLORATION +imagen I-EXPLORATION se I-EXPLORATION observa I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -nodular, I-EXPLORATION -sólida I-EXPLORATION -y I-EXPLORATION +perforación I-EXPLORATION de I-EXPLORATION -coloración I-EXPLORATION -blanquecina, I-EXPLORATION -con I-EXPLORATION -zona I-EXPLORATION -irregulares I-EXPLORATION -amarillentas I-EXPLORATION -que I-EXPLORATION -medía I-EXPLORATION -4 I-EXPLORATION -x I-EXPLORATION -2, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -cm. I-EXPLORATION -Histológicamente I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -vasculitis I-EXPLORATION -granulomatosa I-EXPLORATION -necrotizante I-EXPLORATION -que I-EXPLORATION -afectaba I-EXPLORATION -fundamentalmente I-EXPLORATION +implante I-EXPLORATION +peritoneal I-EXPLORATION a I-EXPLORATION -vasos I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -mediano I-EXPLORATION -tamaño I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -zona I-EXPLORATION -centra I-EXPLORATION -irregular I-EXPLORATION +sigma, I-EXPLORATION con I-EXPLORATION -necrosis. I-EXPLORATION -El I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -es I-EXPLORATION -transmural I-EXPLORATION -y I-EXPLORATION -ocasiona I-EXPLORATION -una I-EXPLORATION -obliteración I-EXPLORATION -prácticamente I-EXPLORATION -total I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -vascular. I-EXPLORATION -Periféricamente I-EXPLORATION +burbujas I-EXPLORATION +aéreas I-EXPLORATION en I-EXPLORATION -las I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -adyacentes I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -marcada I-EXPLORATION -fibrosis, I-EXPLORATION -necrosis I-EXPLORATION -grasa I-EXPLORATION +hemiabdomen I-EXPLORATION +superior I-EXPLORATION e I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -agudo I-EXPLORATION -y I-EXPLORATION -crónico. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -tinción I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -Ziehl-Neelsen I-EXPLORATION +inferior, I-EXPLORATION y I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -bacilos I-EXPLORATION -alcohol I-EXPLORATION -resistentes. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -anatomo I-EXPLORATION -patológico I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -vasculitis I-EXPLORATION -granulomatosa I-EXPLORATION -necrotizante I-EXPLORATION -en I-EXPLORATION -zona I-EXPLORATION -paratesticular. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -testículo I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -identifican I-EXPLORATION -alteraciones I-EXPLORATION -significativas. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presentó I-EVOLUTION -complicaciones I-EVOLUTION -postoperatorias I-EVOLUTION -y B-TREATMENT -fue I-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -Deflazacort I-TREATMENT +peritonitis I-EXPLORATION +fecaloidea. I-EXPLORATION +Se B-TREATMENT +procede I-TREATMENT a I-TREATMENT -dosis I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +urgente I-TREATMENT +(sigmoidectomía I-TREATMENT +y I-TREATMENT +colostomía I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT de I-TREATMENT -30 I-TREATMENT -mg/día. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -momento I-EVOLUTION -actual I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -16 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presenta I-EVOLUTION -ninguna I-EVOLUTION -sintomatología I-EVOLUTION -y I-EVOLUTION -sigue I-EVOLUTION -con I-EVOLUTION -dosis I-EVOLUTION -de I-EVOLUTION -mantenimiento I-EVOLUTION -(6 I-EVOLUTION -mg/día). I-EVOLUTION - I-EVOLUTION +ciego). I-TREATMENT + I-TREATMENT -Paciente B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS +78 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad, I-PRESENT_ILLNESS sin B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -salvo I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -cesáreas, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -remitida I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -fosa I-PRESENT_ILLNESS -renal I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION +reseñables, I-PAST_MEDICAL_HISTORY +remitido B-DERIVED_FROM/TO +desde I-DERIVED_FROM/TO +otorrinolaringología I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +sensación I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +cuerpo I-DERIVED_FROM/TO +extraño I-DERIVED_FROM/TO +faringo-laríngeo I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +descartar I-DERIVED_FROM/TO +reflujo I-DERIVED_FROM/TO +gastroesofágico. I-DERIVED_FROM/TO +El B-EXPLORATION +EGD I-EXPLORATION +reveló I-EXPLORATION la I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -evidencia I-EXPLORATION una I-EXPLORATION -litiasis I-EXPLORATION -renal I-EXPLORATION -derecha I-EXPLORATION +imagen I-EXPLORATION +sacular I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +epifrénica, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +endoscópicamente. I-EXPLORATION + I-EXPLORATION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +55 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +diagnóstico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +carcinoma I-PRESENT_ILLNESS +basocelular I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +canto I-PRESENT_ILLNESS +interno I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +derecho. I-PRESENT_ILLNESS +La B-TREATMENT +resección I-TREATMENT +se I-TREATMENT +hizo I-TREATMENT +con I-TREATMENT +margen I-TREATMENT +sano I-TREATMENT +de I-TREATMENT +0.5 I-TREATMENT +cm I-TREATMENT +también I-TREATMENT +confirmado I-TREATMENT +mediante I-TREATMENT +biopsia I-TREATMENT +por I-TREATMENT +congelación. I-TREATMENT +Cobertura I-TREATMENT +del I-TREATMENT +defecto I-TREATMENT +con I-TREATMENT +la I-TREATMENT +técnica I-TREATMENT +descrita. I-TREATMENT + I-TREATMENT + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +concurre I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +consultorio I-PRESENT_ILLNESS +luego I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +interpretado, I-PRESENT_ILLNESS +doce I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +antes, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +urgencia, I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +broncoobstrucción I-PRESENT_ILLNESS +aguda I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +trató I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +salbutamol I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +prednisolona. I-PRESENT_ILLNESS +El B-PAST_MEDICAL_HISTORY +niño I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +eutrófico, I-PAST_MEDICAL_HISTORY +recién I-PAST_MEDICAL_HISTORY +nacido I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +término, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +destacar. I-PAST_MEDICAL_HISTORY +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +presenta I-EXPLORATION +regular I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +fiebre I-EXPLORATION +de I-EXPLORATION +38, I-EXPLORATION +2ºC, I-EXPLORATION +tumoración I-EXPLORATION +bilateral I-EXPLORATION +en I-EXPLORATION +cuello, I-EXPLORATION +blanda, I-EXPLORATION +dolorosa I-EXPLORATION y I-EXPLORATION +con I-EXPLORATION +crepitación I-EXPLORATION +localizada I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -urografía I-EXPLORATION -intravenosa I-EXPLORATION -una I-EXPLORATION -acodadura I-EXPLORATION +zona I-EXPLORATION +submandibular. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION del I-EXPLORATION -uréter I-EXPLORATION -derecho I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -tercio I-EXPLORATION -superior I-EXPLORATION +examen I-EXPLORATION +es I-EXPLORATION +normal, I-EXPLORATION +a I-EXPLORATION +excepción I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +otitis I-EXPLORATION +media I-EXPLORATION +aguda I-EXPLORATION +(OMA) I-EXPLORATION +congestiva I-EXPLORATION +izquierda. I-EXPLORATION +Al I-EXPLORATION +examen I-EXPLORATION +respiratorio I-EXPLORATION +presenta I-EXPLORATION +tos I-EXPLORATION +húmeda I-EXPLORATION +leve, I-EXPLORATION sin I-EXPLORATION -otros I-EXPLORATION -hallazgos I-EXPLORATION -significativos. I-EXPLORATION -Asintomática, B-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta. I-EVOLUTION -A B-EXPLORATION -los I-EXPLORATION -dos I-EXPLORATION -meses, I-EXPLORATION -nuevo I-EXPLORATION -ingreso I-EXPLORATION +disnea I-EXPLORATION +ni I-EXPLORATION +polipnea; I-EXPLORATION +frecuencia I-EXPLORATION +respiratoria I-EXPLORATION +30 I-EXPLORATION por I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -clínica I-EXPLORATION -y I-EXPLORATION -nueva I-EXPLORATION -batería I-EXPLORATION -de I-EXPLORATION -pruebas: I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION +minuto, I-EXPLORATION +sin I-EXPLORATION +tiraje; I-EXPLORATION +buena I-EXPLORATION +entrada I-EXPLORATION de I-EXPLORATION -abdomen I-EXPLORATION +aire I-EXPLORATION +bilateral; I-EXPLORATION +rales I-EXPLORATION +subcrepitantes I-EXPLORATION +diseminados. I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -comprueba I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -litiasis I-EXPLORATION +auscultan I-EXPLORATION +roncus I-EXPLORATION +o I-EXPLORATION +sibilancias I-EXPLORATION +(última I-EXPLORATION +nebulización I-EXPLORATION +con I-EXPLORATION +salbutamol I-EXPLORATION +hacía I-EXPLORATION +7 I-EXPLORATION +h). I-EXPLORATION +Se I-EXPLORATION +interpreta I-EXPLORATION +el I-EXPLORATION +cuadro I-EXPLORATION +como I-EXPLORATION +enfisema I-EXPLORATION +subcutáneo I-EXPLORATION +secundario I-EXPLORATION a I-EXPLORATION -nivel I-EXPLORATION +acceso I-EXPLORATION de I-EXPLORATION -uréter I-EXPLORATION -distal I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -pequeñas I-EXPLORATION -calcificaciones I-EXPLORATION -en I-EXPLORATION -riñón I-EXPLORATION -derecho; I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -confirma I-EXPLORATION -lo I-EXPLORATION -hallado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION +tos I-EXPLORATION +intensa I-EXPLORATION y I-EXPLORATION -además I-EXPLORATION -descarta I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -uropatía I-EXPLORATION -obstructiva. I-EXPLORATION -En I-EXPLORATION -todo I-EXPLORATION -momento I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION se I-EXPLORATION -encuentran I-EXPLORATION -dentro I-EXPLORATION +solicitan I-EXPLORATION +radiografías I-EXPLORATION +con I-EXPLORATION +nota I-EXPLORATION +al I-EXPLORATION +Servicio I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION +Urgencias I-EXPLORATION +para I-EXPLORATION +eventual I-EXPLORATION +internación. I-EXPLORATION I-EXPLORATION -Se B-TREATMENT -trata I-TREATMENT -la I-TREATMENT -litiasis I-TREATMENT -ureteral I-TREATMENT -mediante I-TREATMENT -ureteroscopia I-TREATMENT -y I-TREATMENT -lasertricia I-TREATMENT -persistiendo I-TREATMENT -la I-TREATMENT -clínica I-TREATMENT -a I-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -la I-TREATMENT -eficacia I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -motiva I-TREATMENT -nuevo I-TREATMENT -ingreso I-TREATMENT -unos I-TREATMENT -meses I-TREATMENT -más I-TREATMENT -tarde. I-TREATMENT -Se B-EXPLORATION -realiza I-EXPLORATION -UIV I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -ectasia I-EXPLORATION -ureteropielocalicial I-EXPLORATION -derecha I-EXPLORATION -hasta I-EXPLORATION -cresta I-EXPLORATION -iliaca. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -TC I-EXPLORATION -los I-EXPLORATION -riñones I-EXPLORATION -son I-EXPLORATION -normales I-EXPLORATION -pero I-EXPLORATION -el I-EXPLORATION -uréter I-EXPLORATION -derecho I-EXPLORATION -está I-EXPLORATION -discretamente I-EXPLORATION -dilatado I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -tercio I-EXPLORATION -distal I-EXPLORATION -donde I-EXPLORATION +Se I-EXPLORATION +interna I-EXPLORATION +y I-EXPLORATION se I-EXPLORATION -identifica I-EXPLORATION -un I-EXPLORATION -quiste I-EXPLORATION -ovárico I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -cm, I-EXPLORATION -que I-EXPLORATION -pudiera I-EXPLORATION -estar I-EXPLORATION -comprimiendo I-EXPLORATION -parcialmente I-EXPLORATION -el I-EXPLORATION -tercio I-EXPLORATION -distal I-EXPLORATION -del I-EXPLORATION -uréter I-EXPLORATION -(vista I-EXPLORATION +realiza: I-EXPLORATION +saturometría I-EXPLORATION +O2 I-EXPLORATION +(FIO2 I-EXPLORATION +aire I-EXPLORATION +ambiental): I-EXPLORATION +97%, I-EXPLORATION +hemograma: I-EXPLORATION +glóbulos I-EXPLORATION +blancos: I-EXPLORATION +6.000 I-EXPLORATION por I-EXPLORATION -el I-EXPLORATION -servicio I-EXPLORATION -de I-EXPLORATION -ginecología I-EXPLORATION -no I-EXPLORATION -precisa I-EXPLORATION -tratamiento I-EXPLORATION -alguno, I-EXPLORATION -solamente I-EXPLORATION -revisiones I-EXPLORATION -periódicas). I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -pielografía I-EXPLORATION -ascendente I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION +mm3, I-EXPLORATION +hemoglobina: I-EXPLORATION +11 I-EXPLORATION +g%, I-EXPLORATION +fórmula I-EXPLORATION +leucocitaria: I-EXPLORATION +6/72/2/0/16/4; I-EXPLORATION +proteína I-EXPLORATION +C-reactiva: I-EXPLORATION +45 I-EXPLORATION +mg/dl; I-EXPLORATION +medio I-EXPLORATION +interno I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +bacterias I-EXPLORATION +atípicas. I-EXPLORATION +Se I-EXPLORATION realiza I-EXPLORATION -se I-EXPLORATION -ve I-EXPLORATION -la I-EXPLORATION -ectasia I-EXPLORATION -ureteropielocalicial I-EXPLORATION -sin I-EXPLORATION -observar I-EXPLORATION -claramente I-EXPLORATION -una I-EXPLORATION -estenosis I-EXPLORATION -ureteral; I-EXPLORATION -se B-TREATMENT -coloca I-TREATMENT -un I-TREATMENT -catéter I-TREATMENT -doble I-TREATMENT -J I-TREATMENT -que I-TREATMENT -es I-TREATMENT -retirado I-TREATMENT -a I-TREATMENT -las I-TREATMENT -8 I-TREATMENT -semanas I-TREATMENT -sin I-TREATMENT -apreciar I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -mejoría I-TREATMENT -clínica. I-TREATMENT -Se B-EXPLORATION -decide I-EXPLORATION -hacer I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION -(RMN) I-EXPLORATION -que I-EXPLORATION -nos I-EXPLORATION -pueda I-EXPLORATION -aportar I-EXPLORATION -algún I-EXPLORATION -dato I-EXPLORATION -nuevo I-EXPLORATION -que I-EXPLORATION -justifique I-EXPLORATION -los I-EXPLORATION -síntomas; I-EXPLORATION -dicha I-EXPLORATION -RMN I-EXPLORATION -nos I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -ectasia I-EXPLORATION -ureteral I-EXPLORATION -derecha I-EXPLORATION +TAC. I-EXPLORATION +Se I-EXPLORATION +interna I-EXPLORATION por I-EXPLORATION -un I-EXPLORATION -posible I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -ovárica. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -programa I-TREATMENT -para I-TREATMENT -intervención I-TREATMENT -quirúrgica: I-TREATMENT -ligadura I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -ovárica I-TREATMENT -más I-TREATMENT -ureterolisis I-TREATMENT -derecha I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -laparoscópica I-TREATMENT -transabdominal. I-TREATMENT -La I-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -colocada I-TREATMENT -en I-TREATMENT -ligero I-TREATMENT -decúbito I-TREATMENT -lateral I-TREATMENT -izquierdo. I-TREATMENT -Insuflación I-TREATMENT -abdominal I-TREATMENT -con I-TREATMENT -CO2 I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -una I-TREATMENT -aguja I-TREATMENT -de I-TREATMENT -Veress I-TREATMENT -y I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -cuatro I-TREATMENT -trócares, I-TREATMENT -2 I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -mm I-TREATMENT -- I-TREATMENT -(uno I-TREATMENT -subesternal I-TREATMENT -y I-TREATMENT -otro I-TREATMENT -en I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -lumbar I-TREATMENT -entre I-TREATMENT -la I-TREATMENT -cresta I-TREATMENT -iliaca I-TREATMENT -y I-TREATMENT -la I-TREATMENT -12ª I-TREATMENT -costilla) I-TREATMENT -- I-TREATMENT -y I-TREATMENT -2 I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -mm I-TREATMENT -- I-TREATMENT -(uno I-TREATMENT -en I-TREATMENT -el I-TREATMENT -ombligo, I-TREATMENT -donde I-TREATMENT +72 I-EXPLORATION +h, I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +constatan I-EXPLORATION +sibilancias I-EXPLORATION +ni I-EXPLORATION +espiración I-EXPLORATION +prolongada I-EXPLORATION +y B-TREATMENT se I-TREATMENT -coloca I-TREATMENT -la I-TREATMENT -óptica, I-TREATMENT -y I-TREATMENT -el I-TREATMENT -otro I-TREATMENT -suprapúbico) I-TREATMENT --. I-TREATMENT -Tras I-TREATMENT -la I-TREATMENT -incisión I-TREATMENT -de I-TREATMENT -la I-TREATMENT -línea I-TREATMENT +da I-TREATMENT +tratamiento I-TREATMENT de I-TREATMENT -Toldt I-TREATMENT -y I-TREATMENT -decolación I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -la I-TREATMENT -identificación I-TREATMENT -del I-TREATMENT -uréter I-TREATMENT -lumbar I-TREATMENT -y I-TREATMENT -seguimiento I-TREATMENT -del I-TREATMENT -mismo I-TREATMENT -hasta I-TREATMENT -observar I-TREATMENT -su I-TREATMENT -paso I-TREATMENT -entre I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -iliaca I-TREATMENT -y I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -ovárica, I-TREATMENT -ésta I-TREATMENT -última I-TREATMENT -cruza I-TREATMENT +sostén I-TREATMENT +con I-TREATMENT +analgesia, I-TREATMENT +O2 I-TREATMENT por I-TREATMENT -encima I-TREATMENT -del I-TREATMENT -uréter I-TREATMENT +cánula I-TREATMENT +nasal I-TREATMENT y I-TREATMENT -se I-TREATMENT -bifurca I-TREATMENT -en I-TREATMENT -2 I-TREATMENT -ramas I-TREATMENT -que I-TREATMENT -actúan I-TREATMENT -a I-TREATMENT -modo I-TREATMENT -de I-TREATMENT -pinza I-TREATMENT -comprimiendo I-TREATMENT -el I-TREATMENT -uréter. I-TREATMENT -Se I-TREATMENT -libera I-TREATMENT +amoxicilina I-TREATMENT +para I-TREATMENT la I-TREATMENT -vena I-TREATMENT -ovárica I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT +OMA. I-TREATMENT +Presenta B-EVOLUTION +buena I-EVOLUTION +evolución I-EVOLUTION +clínica I-EVOLUTION +con I-EVOLUTION +disminución I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +tumoración I-EVOLUTION +cervical, I-EVOLUTION +el I-EVOLUTION +dolor I-EVOLUTION +cervical I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +fiebre. I-EVOLUTION +La B-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +al I-EXPLORATION +alta I-EXPLORATION +es I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Al I-EXPLORATION +5 I-EXPLORATION +to I-EXPLORATION +día I-EXPLORATION +de I-EXPLORATION +evolución, I-EXPLORATION +ya I-EXPLORATION +en I-EXPLORATION +seguimiento I-EXPLORATION +ambulatorio, I-EXPLORATION +se I-EXPLORATION +recibe I-EXPLORATION +serología: I-EXPLORATION +IgM I-EXPLORATION +e I-EXPLORATION +IgG I-EXPLORATION +anti-Clamidia I-EXPLORATION +e I-EXPLORATION +IgM I-EXPLORATION +anti-Mycoplasma I-EXPLORATION +pneumoniae: I-EXPLORATION +negativos. I-EXPLORATION +La I-EXPLORATION +IgG I-EXPLORATION +anti-Mycoplasma I-EXPLORATION +pneumoniae I-EXPLORATION +fue I-EXPLORATION +positiva: I-EXPLORATION +1/80 I-EXPLORATION +por I-EXPLORATION +inmunofluorescencia I-EXPLORATION +indirecta. I-EXPLORATION +Se B-TREATMENT +decide I-TREATMENT +rotar I-TREATMENT la I-TREATMENT -ligadura I-TREATMENT +amoxicilina I-TREATMENT +por I-TREATMENT +claritromicina I-TREATMENT y I-TREATMENT -sección I-TREATMENT -de I-TREATMENT -la I-TREATMENT -misma. I-TREATMENT -Para I-TREATMENT -finalizar, I-TREATMENT -colocamos I-TREATMENT -un I-TREATMENT -drenaje I-TREATMENT -tipo I-TREATMENT -Redon I-TREATMENT -sin I-TREATMENT -aspiración I-TREATMENT +repetir I-TREATMENT +serología I-TREATMENT a I-TREATMENT -través I-TREATMENT -del I-TREATMENT -trócar I-TREATMENT -lateral, I-TREATMENT -se I-TREATMENT -confirma I-TREATMENT -la I-TREATMENT -hemostasia, I-TREATMENT -se I-TREATMENT -evacúa I-TREATMENT -el I-TREATMENT -CO2 I-TREATMENT -y I-TREATMENT -se I-TREATMENT -suturan I-TREATMENT los I-TREATMENT -puertos I-TREATMENT +15 I-TREATMENT +días I-TREATMENT de I-TREATMENT -entrada. I-TREATMENT -El B-EVOLUTION -postoperatorio I-EVOLUTION -cursa I-EVOLUTION -sin I-EVOLUTION -incidencias I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -es I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -segundo I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -revisiones I-EVOLUTION -posteriores, I-EVOLUTION -a I-EVOLUTION +evolución. I-TREATMENT +A B-EVOLUTION los I-EVOLUTION -3 I-EVOLUTION -y I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION +15 I-EVOLUTION +d I-EVOLUTION +ías I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -cirugía, I-EVOLUTION +evolución I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION se I-EVOLUTION encuentra I-EVOLUTION -totalmente I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -UIV I-EVOLUTION +asintomático. I-EVOLUTION +Serología: B-EXPLORATION +IgM I-EXPLORATION +anti-Mycoplasma: I-EXPLORATION +negativa I-EXPLORATION +e I-EXPLORATION +IgG I-EXPLORATION +anti-Mycoplasma: I-EXPLORATION +positiva I-EXPLORATION +1/64 I-EXPLORATION +(IFI). I-EXPLORATION +IgA: I-EXPLORATION +108 I-EXPLORATION +mg/dl, I-EXPLORATION +IgE: I-EXPLORATION +31, I-EXPLORATION +1 I-EXPLORATION +UI/ml I-EXPLORATION +(vn: I-EXPLORATION +60-144), I-EXPLORATION +IgG: I-EXPLORATION +818 I-EXPLORATION +mg/dl I-EXPLORATION +(vn: I-EXPLORATION +315-1236), I-EXPLORATION +IgM: I-EXPLORATION +72 I-EXPLORATION +mg/dl I-EXPLORATION +(vn: I-EXPLORATION +43-207), I-EXPLORATION +proteinograma: I-EXPLORATION +proteínas I-EXPLORATION +totales: I-EXPLORATION +7, I-EXPLORATION +51, I-EXPLORATION +albúmina: I-EXPLORATION +4, I-EXPLORATION +49, I-EXPLORATION +alfa I-EXPLORATION +1: I-EXPLORATION +0, I-EXPLORATION +27, I-EXPLORATION +alfa I-EXPLORATION +2: I-EXPLORATION +101 I-EXPLORATION +(elevada), I-EXPLORATION +β-globulina: I-EXPLORATION +0, I-EXPLORATION +90, I-EXPLORATION +gamma: I-EXPLORATION +0, I-EXPLORATION +84. I-EXPLORATION +Relación I-EXPLORATION +albúmina-globulina: I-EXPLORATION +1, I-EXPLORATION +49 I-EXPLORATION +(normal). I-EXPLORATION +Luego B-EVOLUTION de I-EVOLUTION -control I-EVOLUTION -ha I-EVOLUTION -desaparecido I-EVOLUTION -la I-EVOLUTION -ectasia I-EVOLUTION +tres I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +evolución, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +sigue I-EVOLUTION +asintomático I-EVOLUTION y I-EVOLUTION -acodadura I-EVOLUTION -del I-EVOLUTION -uréter I-EVOLUTION -derecho. I-EVOLUTION +sin I-EVOLUTION +presentar I-EVOLUTION +recurrencias. I-EVOLUTION I-EVOLUTION -Hermanos B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS +47 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +hábitos I-PAST_MEDICAL_HISTORY +tóxicos I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +alergias I-PAST_MEDICAL_HISTORY +conocidas I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +fármacos, I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +enfermedades I-PAST_MEDICAL_HISTORY +médicas I-PAST_MEDICAL_HISTORY +relevantes. I-PAST_MEDICAL_HISTORY +Acudió B-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +enero I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2010 I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +tobillo I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +aumentaba I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +carga I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +acompañaba I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -casados B-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -hijos, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -infertilidad I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sinusitis I-PAST_MEDICAL_HISTORY -frecuentes I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -infecciones I-PAST_MEDICAL_HISTORY -respiratorias I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -repetición I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -muchos I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -aunque I-PAST_MEDICAL_HISTORY -niegan I-PAST_MEDICAL_HISTORY -haberlas I-PAST_MEDICAL_HISTORY -padecido I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia. I-PAST_MEDICAL_HISTORY -Madre B-FAMILY_HISTORY -y I-FAMILY_HISTORY -hermana I-FAMILY_HISTORY -presentan I-FAMILY_HISTORY -broncopatía I-FAMILY_HISTORY -crónica I-FAMILY_HISTORY -no I-FAMILY_HISTORY -filiada. I-FAMILY_HISTORY -Padre I-FAMILY_HISTORY -sano I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -afectación I-FAMILY_HISTORY -pulmonar I-FAMILY_HISTORY -o I-FAMILY_HISTORY -sinusal. I-FAMILY_HISTORY -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -hermanos, I-EXPLORATION -hermana, I-EXPLORATION +signos I-PRESENT_ILLNESS +flogóticos. I-PRESENT_ILLNESS +Se B-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +gammagrafía I-EXPLORATION +ósea I-EXPLORATION y I-EXPLORATION +una I-EXPLORATION +RMN I-EXPLORATION +que I-EXPLORATION +objetivó I-EXPLORATION +un I-EXPLORATION +intenso I-EXPLORATION +edema I-EXPLORATION +óseo I-EXPLORATION +con I-EXPLORATION +severa I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -madre, I-EXPLORATION -sólo I-EXPLORATION -destaca I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -roncus I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -auscultación I-EXPLORATION -pulmonar. I-EXPLORATION -No B-FAMILY_HISTORY -se I-FAMILY_HISTORY -pudieron I-FAMILY_HISTORY -obtener I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -clínicos I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -ascendencia I-FAMILY_HISTORY -tanto I-FAMILY_HISTORY -paterna I-FAMILY_HISTORY -como I-FAMILY_HISTORY -materna. I-FAMILY_HISTORY -Bioquímica B-EXPLORATION -ordinaria I-EXPLORATION -normal, I-EXPLORATION -incluyendo I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION -y I-EXPLORATION -renal. I-EXPLORATION -Alfa-1-anti-tripsina I-EXPLORATION -normal. I-EXPLORATION -Proteinograma I-EXPLORATION -e I-EXPLORATION -inmunoglobulinas I-EXPLORATION -normales. I-EXPLORATION -Hormonas I-EXPLORATION -tiroideas I-EXPLORATION -normales. I-EXPLORATION -Marcadores I-EXPLORATION -del I-EXPLORATION -virus I-EXPLORATION -B I-EXPLORATION +densidad I-EXPLORATION +mineral, I-EXPLORATION +sugestivo I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -hepatitis I-EXPLORATION -y I-EXPLORATION +osteonecrosis I-EXPLORATION del I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana I-EXPLORATION -negativos. I-EXPLORATION -Anticuerpos I-EXPLORATION -antinucleares, I-EXPLORATION -pruebas I-EXPLORATION -reumáticas, I-EXPLORATION -fracción I-EXPLORATION -C3 I-EXPLORATION -y I-EXPLORATION -C4 I-EXPLORATION -negativos. I-EXPLORATION -Gasometría I-EXPLORATION -arterial I-EXPLORATION -basal I-EXPLORATION -y I-EXPLORATION -bicarbonato I-EXPLORATION -normal. I-EXPLORATION -Espirometría I-EXPLORATION -normal. I-EXPLORATION -Saturación I-EXPLORATION -Hb I-EXPLORATION -normal. I-EXPLORATION -Radiografía I-EXPLORATION +astrágalo I-EXPLORATION +con I-EXPLORATION +derrame I-EXPLORATION +articular I-EXPLORATION +asociado. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +pamidronato I-TREATMENT +intravenoso, I-TREATMENT +pero I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +presentó I-TREATMENT +fiebre I-TREATMENT +alta I-TREATMENT +tras I-TREATMENT +la I-TREATMENT +infusión I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT +su I-TREATMENT +administración. I-TREATMENT +Se I-TREATMENT +pautó I-TREATMENT +tramadol, I-TREATMENT +diclofenaco I-TREATMENT +y I-TREATMENT +tratamiento I-TREATMENT +rehabilitador, I-TREATMENT +sin I-TREATMENT +evidente I-TREATMENT +mejoría I-TREATMENT +del I-TREATMENT +dolor. I-TREATMENT +En B-EVOLUTION +septiembre I-EVOLUTION +de I-EVOLUTION +2010 I-EVOLUTION +refiere I-EVOLUTION +dolor I-EVOLUTION +intenso I-EVOLUTION +en I-EVOLUTION +región I-EVOLUTION +inguinal I-EVOLUTION +derecha, I-EVOLUTION +que I-EVOLUTION +aumentaba I-EVOLUTION +con I-EVOLUTION +la I-EVOLUTION +deambulación. I-EVOLUTION +Se B-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +RMN I-EXPLORATION +de I-EXPLORATION +ambas I-EXPLORATION +caderas I-EXPLORATION +observándose I-EXPLORATION +una I-EXPLORATION +necrosis I-EXPLORATION +avascular I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -normal. I-EXPLORATION -Tanto I-EXPLORATION -los I-EXPLORATION -hermanos I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -hermana I-EXPLORATION -y I-EXPLORATION la I-EXPLORATION -madre I-EXPLORATION -rehusaron I-EXPLORATION -hacer I-EXPLORATION -biopsia I-EXPLORATION +cabeza I-EXPLORATION +femoral I-EXPLORATION +derecha, I-EXPLORATION +estadío I-EXPLORATION +I-II I-EXPLORATION de I-EXPLORATION -mucosa I-EXPLORATION -respiratoria I-EXPLORATION -para I-EXPLORATION -estudio I-EXPLORATION -ultraestructural I-EXPLORATION +la I-EXPLORATION +clasificación I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -cilios. I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION +FICAT. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +gabapentina I-TREATMENT +oral I-TREATMENT +(600 I-TREATMENT +mg/8 I-TREATMENT +horas), I-TREATMENT +y B-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +remitió I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +unidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +metabolismo I-DERIVED_FROM/TO +óseo. I-DERIVED_FROM/TO +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +en I-EXPLORATION +nuestra I-EXPLORATION +consulta I-EXPLORATION +llamaba I-EXPLORATION +la I-EXPLORATION +atención I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -semen I-EXPLORATION -indica I-EXPLORATION -astenozoospermia I-EXPLORATION -total I-EXPLORATION +escleras I-EXPLORATION +azuladas. I-EXPLORATION +Reinterrogada B-FAMILY_HISTORY +la I-FAMILY_HISTORY +paciente, I-FAMILY_HISTORY +señalaba I-FAMILY_HISTORY +que I-FAMILY_HISTORY +su I-FAMILY_HISTORY +madre I-FAMILY_HISTORY +había I-FAMILY_HISTORY +presentado I-FAMILY_HISTORY +múltiples I-FAMILY_HISTORY +fracturas I-FAMILY_HISTORY +desde I-FAMILY_HISTORY +los I-FAMILY_HISTORY +49 I-FAMILY_HISTORY +años, I-FAMILY_HISTORY +que I-FAMILY_HISTORY +la I-FAMILY_HISTORY +mantenían I-FAMILY_HISTORY +inmovilizada. I-FAMILY_HISTORY +Un I-FAMILY_HISTORY +hermano I-FAMILY_HISTORY +y I-FAMILY_HISTORY +dos I-FAMILY_HISTORY +tías I-FAMILY_HISTORY +maternas I-FAMILY_HISTORY +también I-FAMILY_HISTORY +habían I-FAMILY_HISTORY +padecido I-FAMILY_HISTORY +fracturas I-FAMILY_HISTORY +de I-FAMILY_HISTORY +cadera I-FAMILY_HISTORY +precoces. I-FAMILY_HISTORY +La B-EXPLORATION +densitometría I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +osteoporosis I-EXPLORATION +grave I-EXPLORATION en I-EXPLORATION +las I-EXPLORATION +tres I-EXPLORATION +localizaciones I-EXPLORATION +habituales I-EXPLORATION +(columna I-EXPLORATION +lumbar: I-EXPLORATION +T-score=-3, I-EXPLORATION +Z-score=-1, I-EXPLORATION +8; I-EXPLORATION +cuello I-EXPLORATION +femoral: I-EXPLORATION +T-score=-3, I-EXPLORATION +1, I-EXPLORATION +Z-score=-2, I-EXPLORATION 3 I-EXPLORATION -seminogramas I-EXPLORATION -diferentes I-EXPLORATION -realizados I-EXPLORATION -a I-EXPLORATION -ambos I-EXPLORATION -hermanos, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -concentración I-EXPLORATION -espermática I-EXPLORATION -media I-EXPLORATION +y I-EXPLORATION +cadera I-EXPLORATION +total: I-EXPLORATION +T-score=-2, I-EXPLORATION +7, I-EXPLORATION +Z-score= I-EXPLORATION +-2, I-EXPLORATION +0). I-EXPLORATION +La I-EXPLORATION +calciuria I-EXPLORATION +era I-EXPLORATION de I-EXPLORATION -23 I-EXPLORATION -millones/ml, I-EXPLORATION -un I-EXPLORATION -porcentaje I-EXPLORATION +336 I-EXPLORATION +mg/dl, I-EXPLORATION +los I-EXPLORATION +niveles I-EXPLORATION de I-EXPLORATION -formas I-EXPLORATION -normales I-EXPLORATION -por I-EXPLORATION -criterios I-EXPLORATION +25 I-EXPLORATION +(OH) I-EXPLORATION +vitamina I-EXPLORATION +D I-EXPLORATION de I-EXPLORATION -Kruger I-EXPLORATION -del I-EXPLORATION -6% I-EXPLORATION +11 I-EXPLORATION +ng/ml I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -viabilidad I-EXPLORATION -del I-EXPLORATION -95%. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -ultraestructural I-EXPLORATION -del I-EXPLORATION -flagelo I-EXPLORATION -espermático I-EXPLORATION -por I-EXPLORATION -microscopía I-EXPLORATION -electrónica I-EXPLORATION -indica I-EXPLORATION -que I-EXPLORATION -los I-EXPLORATION -dos I-EXPLORATION -hermanos I-EXPLORATION -tienen I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -anomalía. I-EXPLORATION -En I-EXPLORATION la I-EXPLORATION -mayoría I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -secciones I-EXPLORATION -transversales I-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -ausencia I-EXPLORATION +PTH I-EXPLORATION +intacta, I-EXPLORATION de I-EXPLORATION -ambos I-EXPLORATION -brazos I-EXPLORATION +49 I-EXPLORATION +pg/ml. I-EXPLORATION +Los I-EXPLORATION +marcadores I-EXPLORATION de I-EXPLORATION -dineína. I-EXPLORATION -El I-EXPLORATION -filamento I-EXPLORATION +remodelado I-EXPLORATION +óseo I-EXPLORATION +estaban I-EXPLORATION +elevados I-EXPLORATION de I-EXPLORATION -nexina I-EXPLORATION -está I-EXPLORATION -presente, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -las I-EXPLORATION -fibras I-EXPLORATION -radiales I-EXPLORATION +forma I-EXPLORATION +franca I-EXPLORATION +(CTX: I-EXPLORATION +1, I-EXPLORATION +036 I-EXPLORATION +ng/ml). I-EXPLORATION +Dados I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +clínicos I-EXPLORATION y I-EXPLORATION +los I-EXPLORATION +antecedentes I-EXPLORATION +familiares, I-EXPLORATION +se I-EXPLORATION +estableció I-EXPLORATION el I-EXPLORATION -par I-EXPLORATION -central. I-EXPLORATION -En I-EXPLORATION -espermatozoides I-EXPLORATION -aislados, I-EXPLORATION -coincidiendo I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION +osteogénesis I-EXPLORATION +imperfecta I-EXPLORATION +tipo I-EXPLORATION +I. I-EXPLORATION +La I-EXPLORATION +audiometría I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +mínima I-EXPLORATION +caída I-EXPLORATION +en I-EXPLORATION los I-EXPLORATION -brazos I-EXPLORATION +tonos I-EXPLORATION +agudos. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +calcio I-TREATMENT +(1.000 I-TREATMENT +mg/día), I-TREATMENT +vitamina I-TREATMENT +D I-TREATMENT +(800 I-TREATMENT +UI/día) I-TREATMENT +y I-TREATMENT +risedronato I-TREATMENT +(35 I-TREATMENT +mg/semana), I-TREATMENT +en I-TREATMENT +enero I-TREATMENT +de I-TREATMENT +2011. I-TREATMENT +En I-TREATMENT +marzo I-TREATMENT +de I-TREATMENT +ese I-TREATMENT +año, I-TREATMENT +se I-TREATMENT +cambió I-TREATMENT +el I-TREATMENT +risedronato I-TREATMENT +por I-TREATMENT +teriparatida I-TREATMENT +subcutánea I-TREATMENT +(20 I-TREATMENT +mcg/día) I-TREATMENT +debido I-TREATMENT +a I-TREATMENT +intolerancia I-TREATMENT +digestiva. I-TREATMENT +En B-EXPLORATION +mayo I-EXPLORATION de I-EXPLORATION -dineína, I-EXPLORATION -hay I-EXPLORATION -también I-EXPLORATION -pérdida I-EXPLORATION +2011, I-EXPLORATION +una I-EXPLORATION +RMN I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +franca I-EXPLORATION +disminución I-EXPLORATION del I-EXPLORATION -par I-EXPLORATION -central. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -anomalía I-EXPLORATION +edema I-EXPLORATION +óseo I-EXPLORATION +y I-EXPLORATION +del I-EXPLORATION +derrame I-EXPLORATION +articular I-EXPLORATION +del I-EXPLORATION +tobillo I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +del I-EXPLORATION +edema I-EXPLORATION +medular I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -vaina I-EXPLORATION -fibrosa, I-EXPLORATION -ni I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -fibras I-EXPLORATION -densas. I-EXPLORATION -La I-EXPLORATION -pieza I-EXPLORATION -intermedia I-EXPLORATION -en I-EXPLORATION +cadera I-EXPLORATION +derecha. I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +cumplió I-EVOLUTION +24 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +teriparatida I-EVOLUTION +sin I-EVOLUTION +complicaciones I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +progresiva I-EVOLUTION +mejoría I-EVOLUTION +clínica. I-EVOLUTION +Los I-EVOLUTION +marcadores I-EVOLUTION +de I-EVOLUTION +formación I-EVOLUTION +se I-EVOLUTION +mantuvieron I-EVOLUTION +elevados I-EVOLUTION +durante I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +(propéptido I-EVOLUTION +aminoterminal I-EVOLUTION +del I-EVOLUTION +procolágeno I-EVOLUTION +tipo I-EVOLUTION +1 I-EVOLUTION +-PINP-: I-EVOLUTION +45 I-EVOLUTION +ng/ml; I-EVOLUTION +osteocalcina: I-EVOLUTION +>100 I-EVOLUTION +ng/ml), I-EVOLUTION +así I-EVOLUTION +como I-EVOLUTION +los I-EVOLUTION +niveles I-EVOLUTION +de I-EVOLUTION +25 I-EVOLUTION +(OH) I-EVOLUTION +vitamina I-EVOLUTION +D. I-EVOLUTION +En B-TREATMENT +marzo I-TREATMENT +de I-TREATMENT +2013 I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +denosumab I-TREATMENT +(60 I-TREATMENT +mg/6 I-TREATMENT +meses), I-TREATMENT +presentando B-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +una I-EVOLUTION +evolución I-EVOLUTION +clínica I-EVOLUTION +y I-EVOLUTION +radiológica I-EVOLUTION +satisfactoria. I-EVOLUTION +En B-EXPLORATION la I-EXPLORATION -mitad I-EXPLORATION -aproximadamente I-EXPLORATION +última I-EXPLORATION +consulta, I-EXPLORATION +en I-EXPLORATION +enero I-EXPLORATION de I-EXPLORATION +2015, I-EXPLORATION los I-EXPLORATION -casos I-EXPLORATION -tenía I-EXPLORATION -disminución I-EXPLORATION -del I-EXPLORATION -número I-EXPLORATION +marcadores I-EXPLORATION de I-EXPLORATION -mitocondrias I-EXPLORATION +remodelado I-EXPLORATION +estaban I-EXPLORATION +suprimidos I-EXPLORATION +(PINP: I-EXPLORATION +5, I-EXPLORATION +8 I-EXPLORATION +ng/ml; I-EXPLORATION +telopéptido I-EXPLORATION +carboxiterminal I-EXPLORATION +del I-EXPLORATION +colágeno I-EXPLORATION +tipo I-EXPLORATION +1 I-EXPLORATION +-CTX-: I-EXPLORATION +<0, I-EXPLORATION +030 I-EXPLORATION +ng/ml) I-EXPLORATION y I-EXPLORATION -mitocondrias I-EXPLORATION -extras I-EXPLORATION +los I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +25 I-EXPLORATION +(OH) I-EXPLORATION +vitamina I-EXPLORATION +D I-EXPLORATION +son I-EXPLORATION +de I-EXPLORATION +31 I-EXPLORATION +ng/ml. I-EXPLORATION +La I-EXPLORATION +densidad I-EXPLORATION +mineral I-EXPLORATION +ósea I-EXPLORATION +(DMO) I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION no I-EXPLORATION -alineadas. I-EXPLORATION -Otros I-EXPLORATION -datos I-EXPLORATION -añadidos I-EXPLORATION -fueron I-EXPLORATION +se I-EXPLORATION +redujo I-EXPLORATION +significativamente I-EXPLORATION +respecto I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -microtúbulos I-EXPLORATION -extra I-EXPLORATION -periféricos I-EXPLORATION -al I-EXPLORATION -axonema. I-EXPLORATION +basal I-EXPLORATION +(columna I-EXPLORATION +lumbar: I-EXPLORATION +T-score=-3, I-EXPLORATION +1 I-EXPLORATION +y I-EXPLORATION +Z-score=-1, I-EXPLORATION +5; I-EXPLORATION +cuello I-EXPLORATION +femoral: I-EXPLORATION +T-score=-3, I-EXPLORATION +2 I-EXPLORATION +y I-EXPLORATION +Z-score=-2; I-EXPLORATION +cadera I-EXPLORATION +total: I-EXPLORATION +T-score=-3 I-EXPLORATION +y I-EXPLORATION +Z-score=-2), I-EXPLORATION +pero I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +no I-EXPLORATION +había I-EXPLORATION +sufrido I-EXPLORATION +ninguna I-EXPLORATION +fractura I-EXPLORATION +ni I-EXPLORATION +osteonecrosis I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +seguimiento. I-EXPLORATION I-EXPLORATION -Varón B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -25 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +43 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +alergias I-PAST_MEDICAL_HISTORY +medicamentosas I-PAST_MEDICAL_HISTORY +conocidas I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +hábitos I-PAST_MEDICAL_HISTORY +tóxicos, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hace I-PRESENT_ILLNESS +8 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +historia I-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -diagnosticado B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vejiga I-PAST_MEDICAL_HISTORY -hiperrefléxica I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -sección I-PAST_MEDICAL_HISTORY -medular I-PAST_MEDICAL_HISTORY -traumática I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -disparos I-PRESENT_ILLNESS -miccionales I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -incontinencia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cuadros I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +sacro I-PRESENT_ILLNESS +incapacitante, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -pielonefritis I-PRESENT_ILLNESS +manera I-PRESENT_ILLNESS +continua I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +cierta I-PRESENT_ILLNESS +irradiación I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +porción I-PRESENT_ILLNESS +posterior I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +muslo I-PRESENT_ILLNESS +izquierdo. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +apreciaba I-PRESENT_ILLNESS +alteraciones I-PRESENT_ILLNESS +sensitivas I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +control I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -repetición. I-PRESENT_ILLNESS -En B-EXPLORATION +esfínteres. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Por I-PRESENT_ILLNESS +dicho I-PRESENT_ILLNESS +motivo I-PRESENT_ILLNESS +realizó I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +múltiples I-PRESENT_ILLNESS +hospitales. I-PRESENT_ILLNESS +Se B-EXPLORATION +le I-EXPLORATION +practicaron I-EXPLORATION +una I-EXPLORATION +TC I-EXPLORATION +lumbar I-EXPLORATION +que I-EXPLORATION +puso I-EXPLORATION +de I-EXPLORATION +relieve I-EXPLORATION +un I-EXPLORATION +hemangioma I-EXPLORATION +en I-EXPLORATION +L5, I-EXPLORATION +una I-EXPLORATION +RMN I-EXPLORATION +de I-EXPLORATION +pelvis I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -cistografía I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION evidenció I-EXPLORATION +rotura I-EXPLORATION +muscular I-EXPLORATION +grado I-EXPLORATION +I I-EXPLORATION +del I-EXPLORATION +glúteo I-EXPLORATION +mayor I-EXPLORATION +izquierdo I-EXPLORATION +y I-EXPLORATION una I-EXPLORATION -vejiga I-EXPLORATION -de I-EXPLORATION -escasa I-EXPLORATION -capacidad, I-EXPLORATION -sin I-EXPLORATION -reflujo I-EXPLORATION -vesicoureteral. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -urodinámico I-EXPLORATION +estructura I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -apreció I-EXPLORATION -un I-EXPLORATION -disparo I-EXPLORATION -miccional I-EXPLORATION -desde I-EXPLORATION -los I-EXPLORATION -60cc I-EXPLORATION +interpretó I-EXPLORATION +como I-EXPLORATION +quiste I-EXPLORATION de I-EXPLORATION -llenado I-EXPLORATION -con I-EXPLORATION -altas I-EXPLORATION -presiones I-EXPLORATION -vesicales I-EXPLORATION -que I-EXPLORATION -había I-EXPLORATION -resultado I-EXPLORATION -refractario I-EXPLORATION -al I-EXPLORATION -tratamiento I-EXPLORATION -conservador. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -enterocistoplastia I-TREATMENT -de I-TREATMENT -ampliación I-TREATMENT -laparoscópica I-TREATMENT -con I-TREATMENT -un I-TREATMENT -segmento I-TREATMENT -ileal I-TREATMENT -de I-TREATMENT -25 I-TREATMENT -cm I-TREATMENT -plegado I-TREATMENT -en I-TREATMENT -U. I-TREATMENT -La I-TREATMENT -duración I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cirugía I-TREATMENT -fue I-TREATMENT -de I-TREATMENT -4, I-TREATMENT -5 I-TREATMENT -horas I-TREATMENT +Tarlov I-EXPLORATION +sacro. I-EXPLORATION +Recibió B-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT +paracetamol, I-TREATMENT +nolotil, I-TREATMENT +tramadol I-TREATMENT +y I-TREATMENT +gabapentina I-TREATMENT +sin I-TREATMENT +mejoría. I-TREATMENT +Se I-TREATMENT +le I-TREATMENT +realizaron I-TREATMENT +dos I-TREATMENT +bloqueos I-TREATMENT +facetarios I-TREATMENT +e I-TREATMENT +incluso I-TREATMENT un I-TREATMENT -sangrado I-TREATMENT -mínimo. I-TREATMENT -Durante B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -constipación, I-EVOLUTION -que I-EVOLUTION -ya I-EVOLUTION -presentaba I-EVOLUTION -ocasionalmente I-EVOLUTION -antes I-EVOLUTION -de I-EVOLUTION +bloqueo I-TREATMENT +del I-TREATMENT +músculo I-TREATMENT +piriforme I-TREATMENT +izquierdo, I-TREATMENT +todo I-TREATMENT +ello I-TREATMENT +sin I-TREATMENT +resultados. I-TREATMENT +En B-EVOLUTION +este I-EVOLUTION +último I-EVOLUTION la I-EVOLUTION -cirugía. I-EVOLUTION -Se I-EVOLUTION -procedió I-EVOLUTION -al I-EVOLUTION -alta I-EVOLUTION -hospitalaria I-EVOLUTION -al I-EVOLUTION -duodécimo I-EVOLUTION -día I-EVOLUTION -postoperatorio. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -seguimiento I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -de I-EVOLUTION -6 I-EVOLUTION -meses. I-EVOLUTION -El I-EVOLUTION paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -en I-EVOLUTION -programa I-EVOLUTION -de I-EVOLUTION -autocateterismos, I-EVOLUTION -continente I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -nuevos I-EVOLUTION -episodios I-EVOLUTION +quedó I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +hipoestesia I-EVOLUTION de I-EVOLUTION -infección I-EVOLUTION -urinaria. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -destacando B-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -II I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -insulina, I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -miopía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cataratas. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestra I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -craurosis I-PRESENT_ILLNESS -prepucial I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -impide I-PRESENT_ILLNESS -retracción I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -prepucio. I-PRESENT_ILLNESS -A B-EXPLORATION +la I-EVOLUTION +extremidad I-EVOLUTION +inferior I-EVOLUTION +izquierda I-EVOLUTION +residual. I-EVOLUTION +Fue B-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +valoración I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +dolor I-DERIVED_FROM/TO +ante I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +sospecha I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +este I-DERIVED_FROM/TO +pudiera I-DERIVED_FROM/TO +ser I-DERIVED_FROM/TO +causado I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +hemangioma I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +L5. I-DERIVED_FROM/TO +La B-EXPLORATION +paciente I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +momento I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION +estaba I-EXPLORATION +consciente I-EXPLORATION +y I-EXPLORATION +orientada. I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -palpa I-EXPLORATION -debajo I-EXPLORATION +apreciaron I-EXPLORATION +alteraciones I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lenguaje. I-EXPLORATION +La I-EXPLORATION +función I-EXPLORATION de I-EXPLORATION -prepucio I-EXPLORATION +los I-EXPLORATION +pares I-EXPLORATION +craneales I-EXPLORATION +era I-EXPLORATION +normal. I-EXPLORATION +Presentaba I-EXPLORATION +un I-EXPLORATION +dolor I-EXPLORATION +muy I-EXPLORATION +importante I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +sacra I-EXPLORATION +8/10 I-EXPLORATION +según I-EXPLORATION +la I-EXPLORATION +escala I-EXPLORATION +EVA, I-EXPLORATION +aproximadamente I-EXPLORATION a I-EXPLORATION nivel I-EXPLORATION -del I-EXPLORATION -glande I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION de I-EXPLORATION -unos I-EXPLORATION -tres I-EXPLORATION -centímetros I-EXPLORATION -no I-EXPLORATION -doloroso I-EXPLORATION +S2 I-EXPLORATION y I-EXPLORATION -muy I-EXPLORATION -consistente. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION +una I-EXPLORATION +discreta I-EXPLORATION +disminución I-EXPLORATION de I-EXPLORATION -carcinoma I-EXPLORATION +fuerza I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +extremidad I-EXPLORATION +inferior I-EXPLORATION +izquierda I-EXPLORATION de I-EXPLORATION -pene, I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION +4/5, I-EXPLORATION con I-EXPLORATION -anestesia I-EXPLORATION -local I-EXPLORATION -incisión I-EXPLORATION -prepucial I-EXPLORATION -encontrándonos I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -de I-EXPLORATION -cuatro I-EXPLORATION -centímetros I-EXPLORATION +déficit I-EXPLORATION de I-EXPLORATION -diámetro, I-EXPLORATION +flexo-extensión I-EXPLORATION +distal. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -color I-EXPLORATION -rojo I-EXPLORATION -amarillento, I-EXPLORATION -algo I-EXPLORATION -rugoso, I-EXPLORATION -consistente I-EXPLORATION -al I-EXPLORATION -tacto I-EXPLORATION -y I-EXPLORATION -situado I-EXPLORATION +extremidades I-EXPLORATION +la I-EXPLORATION +fuerza I-EXPLORATION +era I-EXPLORATION +5/5. I-EXPLORATION +Se I-EXPLORATION +advirtió I-EXPLORATION +una I-EXPLORATION +hipoestesia I-EXPLORATION en I-EXPLORATION -cara I-EXPLORATION -lateral I-EXPLORATION +territorio I-EXPLORATION +de I-EXPLORATION +L5. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +evidenció I-EXPLORATION +signo I-EXPLORATION de I-EXPLORATION -glande. I-EXPLORATION +Babinsky. I-EXPLORATION +La I-EXPLORATION +deambulación I-EXPLORATION +era I-EXPLORATION +dificultosa. I-EXPLORATION Se I-EXPLORATION -tomó I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -cuña I-EXPLORATION -profunda I-EXPLORATION -del I-EXPLORATION -nódulo I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -envió I-EXPLORATION -para I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -no I-TREATMENT -realizar I-TREATMENT -circuncisión I-TREATMENT -ni I-TREATMENT -exéresis I-TREATMENT -del I-TREATMENT -nódulo I-TREATMENT -a I-TREATMENT -la I-TREATMENT -espera I-TREATMENT -del I-TREATMENT -resultado. I-TREATMENT -Aunque I-TREATMENT -con I-TREATMENT -la I-TREATMENT -incisión I-TREATMENT -prepucial I-TREATMENT -el I-TREATMENT -glande I-TREATMENT -pudo I-TREATMENT -ser I-TREATMENT -exteriorizado I-TREATMENT -y I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -higiene I-TREATMENT -adecuada. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -resultado I-EXPLORATION -histológico I-EXPLORATION -es I-EXPLORATION -informado I-EXPLORATION -como I-EXPLORATION -amiloidosis I-EXPLORATION -nodular. I-EXPLORATION -Es B-EVOLUTION -curioso I-EVOLUTION -señalar I-EVOLUTION -que I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -tiempo I-EVOLUTION -transcurrido I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -espera I-EVOLUTION -del I-EVOLUTION -resultado I-EVOLUTION -histológico, I-EVOLUTION -al I-EVOLUTION -poder I-EVOLUTION -realizar I-EVOLUTION -una I-EVOLUTION -higiene I-EVOLUTION -adecuada, I-EVOLUTION -el I-EVOLUTION -aspecto I-EVOLUTION -del I-EVOLUTION -nódulo I-EVOLUTION -mejoró. I-EVOLUTION - I-EVOLUTION -De B-TREATMENT -forma I-TREATMENT -reglada I-TREATMENT -realizamos I-TREATMENT -circuncisión I-TREATMENT -y I-TREATMENT -exéresis I-TREATMENT -completa I-TREATMENT -del I-TREATMENT -nódulo, I-TREATMENT -confirmando B-EXPLORATION -este I-EXPLORATION -segundo I-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -nódulo I-EXPLORATION -amiloidótico. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -tinción I-EXPLORATION -con I-EXPLORATION -permanganato I-EXPLORATION -potásico I-EXPLORATION +analítica I-EXPLORATION +general I-EXPLORATION que I-EXPLORATION -permitió I-EXPLORATION -diferenciar I-EXPLORATION -el I-EXPLORATION -amiloide I-EXPLORATION -tipo I-EXPLORATION -AA I-EXPLORATION -del I-EXPLORATION -AL, I-EXPLORATION -éste I-EXPLORATION -último I-EXPLORATION -característico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -forma I-EXPLORATION -primaria I-EXPLORATION -y I-EXPLORATION no I-EXPLORATION -sensible I-EXPLORATION -al I-EXPLORATION -permanganato. I-EXPLORATION -La I-EXPLORATION -muestra I-EXPLORATION -tisular I-EXPLORATION +mostró I-EXPLORATION +alteraciones I-EXPLORATION +destacables. I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +practicó I-EXPLORATION +una I-EXPLORATION +RM I-EXPLORATION +(Philips I-EXPLORATION +Medical I-EXPLORATION +Systems) I-EXPLORATION +lumbosacra I-EXPLORATION +en I-EXPLORATION +donde I-EXPLORATION se I-EXPLORATION -tiñó I-EXPLORATION -con I-EXPLORATION -Rojo I-EXPLORATION -Congo I-EXPLORATION +visualizaban I-EXPLORATION +hemangiomas I-EXPLORATION +vertebrales I-EXPLORATION +en I-EXPLORATION +L2 I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -examinó I-EXPLORATION -con I-EXPLORATION -luz I-EXPLORATION -polarizada I-EXPLORATION -observándose I-EXPLORATION -la I-EXPLORATION -típica I-EXPLORATION -birrefrigencia I-EXPLORATION -verde. I-EXPLORATION -Después I-EXPLORATION +L5, I-EXPLORATION +advirtiéndose I-EXPLORATION +claramente I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +quística I-EXPLORATION de I-EXPLORATION -haber I-EXPLORATION -identificado I-EXPLORATION -el I-EXPLORATION -amiloide, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION +localización I-EXPLORATION +central I-EXPLORATION +y I-EXPLORATION +lateral I-EXPLORATION +derecha I-EXPLORATION +en I-EXPLORATION +canal I-EXPLORATION +espinal I-EXPLORATION +sacro I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +altura I-EXPLORATION de I-EXPLORATION -proteínas I-EXPLORATION -e I-EXPLORATION -inmunohistoquímica. I-EXPLORATION -El I-EXPLORATION -componente I-EXPLORATION -amiloide I-EXPLORATION -lo I-EXPLORATION -constituía I-EXPLORATION +la I-EXPLORATION +transición I-EXPLORATION +S2-S3. I-EXPLORATION +Esta I-EXPLORATION +estructura I-EXPLORATION +ocupaba I-EXPLORATION +la I-EXPLORATION +práctica I-EXPLORATION +totalidad I-EXPLORATION +del I-EXPLORATION +canal I-EXPLORATION +y I-EXPLORATION +remodelaba I-EXPLORATION +parcialmente I-EXPLORATION el I-EXPLORATION -tipo I-EXPLORATION -AL, I-EXPLORATION -característico I-EXPLORATION +contorno I-EXPLORATION +posterior I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -amiloidosis I-EXPLORATION -primaria I-EXPLORATION +dichos I-EXPLORATION +cuerpos I-EXPLORATION +vertebrales I-EXPLORATION y I-EXPLORATION -amiloidosis I-EXPLORATION -local. I-EXPLORATION -Este I-EXPLORATION -componente I-EXPLORATION -fibrilar I-EXPLORATION +elementos I-EXPLORATION +posteriores. I-EXPLORATION +Esta I-EXPLORATION +formación I-EXPLORATION se I-EXPLORATION -caracteriza I-EXPLORATION -por I-EXPLORATION -tener I-EXPLORATION -un I-EXPLORATION -depósito I-EXPLORATION -mayor I-EXPLORATION -de I-EXPLORATION -inmunoglobulinas I-EXPLORATION -Kappa I-EXPLORATION -o I-EXPLORATION -lambda. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -complementario I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -amiloidosis I-EXPLORATION -generalizada I-EXPLORATION -consistente I-EXPLORATION +encontraba I-EXPLORATION en I-EXPLORATION -hemograma, I-EXPLORATION -bioquímica, I-EXPLORATION -proteinograma, I-EXPLORATION -PSA, I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION +íntimo I-EXPLORATION +contacto I-EXPLORATION +con I-EXPLORATION +ambas I-EXPLORATION +raíces I-EXPLORATION +S3 I-EXPLORATION y I-EXPLORATION -biopsia I-EXPLORATION +S4 I-EXPLORATION +sin I-EXPLORATION +englobarlas. I-EXPLORATION +Su I-EXPLORATION +morfología I-EXPLORATION +era I-EXPLORATION +ovalada I-EXPLORATION +y I-EXPLORATION +los I-EXPLORATION +contornos I-EXPLORATION +nítidos I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +tamaño I-EXPLORATION +máximo I-EXPLORATION +aproximado I-EXPLORATION de I-EXPLORATION -mucosa I-EXPLORATION -rectal. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -presentó I-EXPLORATION -síndrome I-EXPLORATION -nefrótico I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -creímos I-EXPLORATION -oportuno I-EXPLORATION -realizar I-EXPLORATION -biopsia I-EXPLORATION -renal. I-EXPLORATION -Tampoco I-EXPLORATION -presentaba I-EXPLORATION -artritis, I-EXPLORATION -insuficiencia I-EXPLORATION -cardíaca, I-EXPLORATION -hipotensión I-EXPLORATION -ni I-EXPLORATION -neuropatía. I-EXPLORATION -Todas I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -presentaron I-EXPLORATION -unos I-EXPLORATION -resultados I-EXPLORATION -normales I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -descartó I-EXPLORATION -amiloidosis I-EXPLORATION -generalizada. I-EXPLORATION - I-EXPLORATION -Dos B-EVOLUTION -años I-EVOLUTION -después, I-EVOLUTION +22 I-EXPLORATION +X I-EXPLORATION +19 I-EXPLORATION +X I-EXPLORATION +14 I-EXPLORATION +mm. I-EXPLORATION +Según I-EXPLORATION +la I-EXPLORATION +clasificación I-EXPLORATION +de I-EXPLORATION +Nabors I-EXPLORATION +correspondía I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +meningocele I-EXPLORATION +intrasacro I-EXPLORATION +oculto. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +punción I-TREATMENT +(Needle I-TREATMENT +Ostycut I-TREATMENT +150 I-TREATMENT +mm I-TREATMENT +13G I-TREATMENT +Angiomed) I-TREATMENT +y I-TREATMENT +evacuación I-TREATMENT +del I-TREATMENT +quiste I-TREATMENT +sacro I-TREATMENT +guiado I-TREATMENT +por I-TREATMENT +TC I-TREATMENT +(GE I-TREATMENT +Medical I-TREATMENT +Systems I-TREATMENT +BrightSpeed) I-TREATMENT +obteniéndose I-TREATMENT +unos I-TREATMENT +2 I-TREATMENT +cc I-TREATMENT +de I-TREATMENT +un I-TREATMENT +líquido I-TREATMENT +hemático. I-TREATMENT +El B-EXPLORATION +examen I-EXPLORATION +citológico I-EXPLORATION +describió I-EXPLORATION +una I-EXPLORATION +celularidad I-EXPLORATION +benigna. I-EXPLORATION +La B-EVOLUTION +evolución I-EVOLUTION +posterior I-EVOLUTION +fue I-EVOLUTION +de I-EVOLUTION +mejoría I-EVOLUTION +notable I-EVOLUTION +del I-EVOLUTION +dolor I-EVOLUTION +sacro I-EVOLUTION +que I-EVOLUTION +en I-EVOLUTION la I-EVOLUTION -lesión I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -recidivado I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION +escala I-EVOLUTION +de I-EVOLUTION +EVA I-EVOLUTION +era I-EVOLUTION +de I-EVOLUTION +3/10 I-EVOLUTION +reiniciando I-EVOLUTION +la I-EVOLUTION +deambulación I-EVOLUTION +sin I-EVOLUTION +dificultad, I-EVOLUTION no I-EVOLUTION -ha I-EVOLUTION -desarrollado I-EVOLUTION -amiloidosis I-EVOLUTION -generalizada. I-EVOLUTION +presentando I-EVOLUTION +debilidad I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +pierna I-EVOLUTION +izquierda I-EVOLUTION +ni I-EVOLUTION +hipoestesia. I-EVOLUTION I-EVOLUTION -Varón B-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -62 I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +46 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS que I-PRESENT_ILLNESS consultó I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS +reiterada I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -edemas I-PRESENT_ILLNESS -progresivos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ambas I-PRESENT_ILLNESS -extremidades I-PRESENT_ILLNESS -inferiores, I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -genital I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -inguinal I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal, I-PRESENT_ILLNESS +diarrea I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -siete I-PRESENT_ILLNESS +peso. I-PRESENT_ILLNESS +Era B-PAST_MEDICAL_HISTORY +natural I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Ecuador I-PAST_MEDICAL_HISTORY +pero I-PAST_MEDICAL_HISTORY +llevaba I-PAST_MEDICAL_HISTORY +9 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +viviendo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +España, I-PAST_MEDICAL_HISTORY +actualmente I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +Murcia. I-PAST_MEDICAL_HISTORY +Como I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +destacaba I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +cirugía I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +resección I-PAST_MEDICAL_HISTORY +intestinal I-PAST_MEDICAL_HISTORY +realizada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +país I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +colelitiasis I-PAST_MEDICAL_HISTORY +pendiente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +intervención. I-PAST_MEDICAL_HISTORY +Refería B-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +epigástrico I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +periumbilical I-PRESENT_ILLNESS +irradiado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +ingesta, I-PRESENT_ILLNESS +además I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +verdosas I-PRESENT_ILLNESS +abundantes, I-PRESENT_ILLNESS sin I-PRESENT_ILLNESS -ninguna I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -acompañante. I-PRESENT_ILLNESS -Entre B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -sólo I-PAST_MEDICAL_HISTORY -constaban I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cólicos I-PAST_MEDICAL_HISTORY -nefríticos I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -complicados. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-EXPLORATION +productos I-PRESENT_ILLNESS +patológicos, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +respetaban I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +descanso I-PRESENT_ILLNESS +nocturno, I-PRESENT_ILLNESS +junto I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +importante, I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +cuantificada. I-PRESENT_ILLNESS +A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -física I-EXPLORATION -llamaba I-EXPLORATION -la I-EXPLORATION -atención I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -edema I-EXPLORATION +destacaba I-EXPLORATION +palidez I-EXPLORATION de I-EXPLORATION -consistencia I-EXPLORATION -dura I-EXPLORATION -en I-EXPLORATION -zona I-EXPLORATION -púbica, I-EXPLORATION -incluyendo I-EXPLORATION -pene, I-EXPLORATION -escroto I-EXPLORATION +piel I-EXPLORATION y I-EXPLORATION -región I-EXPLORATION -inguinal, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extendía I-EXPLORATION -por I-EXPLORATION -ambas I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -siendo I-EXPLORATION -más I-EXPLORATION -evidente I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -izquierda, I-EXPLORATION -sin I-EXPLORATION -fovea. I-EXPLORATION -No I-EXPLORATION -existían I-EXPLORATION -lesiones I-EXPLORATION -cutáneas, I-EXPLORATION -ni I-EXPLORATION -adenopatías I-EXPLORATION -laterocervicales I-EXPLORATION -o I-EXPLORATION -axilares. I-EXPLORATION -Palpación I-EXPLORATION +mucosas, I-EXPLORATION +caquexia, I-EXPLORATION +distensión I-EXPLORATION +abdominal I-EXPLORATION +y I-EXPLORATION +dolor I-EXPLORATION de I-EXPLORATION -probables I-EXPLORATION -adenopatías I-EXPLORATION -inguinales. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -tacto I-EXPLORATION -rectal I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION +forma I-EXPLORATION +difusa I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +presentaba I-EXPLORATION una I-EXPLORATION -próstata I-EXPLORATION -aumentada I-EXPLORATION +anemia I-EXPLORATION +microcítica I-EXPLORATION +(hemoglobina I-EXPLORATION +7 I-EXPLORATION +g/dl, I-EXPLORATION +VCM I-EXPLORATION +67 I-EXPLORATION +nm), I-EXPLORATION +leucocitos I-EXPLORATION +totales I-EXPLORATION +normales I-EXPLORATION +pero I-EXPLORATION +con I-EXPLORATION +discreta I-EXPLORATION +elevación I-EXPLORATION de I-EXPLORATION -tamaño, I-EXPLORATION -dura I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -dolorosa. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -incluyendo I-EXPLORATION -bioquímica, I-EXPLORATION -hemograma, I-EXPLORATION -proteinograma, I-EXPLORATION -coagulación I-EXPLORATION +eosinófilos I-EXPLORATION y I-EXPLORATION -estudio I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -orina I-EXPLORATION -con I-EXPLORATION -proteinuria I-EXPLORATION +los I-EXPLORATION +reactantes I-EXPLORATION de I-EXPLORATION -24 I-EXPLORATION -horas I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -estrictamente I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -solicitaron I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -destacando I-EXPLORATION -un I-EXPLORATION -PSA I-EXPLORATION +fase I-EXPLORATION +aguda. I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION +abdominal I-EXPLORATION +era I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +suboclusión I-EXPLORATION +intestinal I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -100 I-EXPLORATION -microgramos/l. I-EXPLORATION - I-EXPLORATION -Tanto I-EXPLORATION +abundantes I-EXPLORATION +niveles I-EXPLORATION +hidroaéreos. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -ecografía I-EXPLORATION -como I-EXPLORATION -el I-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -objetivaron I-EXPLORATION -múltiples I-EXPLORATION -adenopatías I-EXPLORATION -retroperitoneales I-EXPLORATION -paraaórticas I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -ambas I-EXPLORATION -cadenas I-EXPLORATION -ilíacas I-EXPLORATION -así I-EXPLORATION +endoscopia I-EXPLORATION +digestiva I-EXPLORATION +alta I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +bulboduodenitis, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +tomaron I-EXPLORATION +biopsias I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +informaron I-EXPLORATION como I-EXPLORATION -una I-EXPLORATION -próstata I-EXPLORATION -aumentada I-EXPLORATION -de I-EXPLORATION -tamaño. I-EXPLORATION -Se I-EXPLORATION -consultó I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -Servicio I-EXPLORATION +inflamación I-EXPLORATION +inespecífica I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -Urología I-EXPLORATION +atrofia I-EXPLORATION +vellositaria, I-EXPLORATION y I-EXPLORATION +gastritis I-EXPLORATION +erosiva. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +tránsito I-EXPLORATION +del I-EXPLORATION +intestino I-EXPLORATION +delgado I-EXPLORATION se I-EXPLORATION -llevó I-EXPLORATION +vio I-EXPLORATION +pérdida I-EXPLORATION +de I-EXPLORATION +válvulas I-EXPLORATION +conniventes I-EXPLORATION a I-EXPLORATION -cabo I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -prostática I-EXPLORATION -concluyente I-EXPLORATION -para I-EXPLORATION -adenocarcinoma I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -próstata I-EXPLORATION +duodeno I-EXPLORATION y I-EXPLORATION +yeyuno I-EXPLORATION +y I-EXPLORATION +otros I-EXPLORATION +signos I-EXPLORATION +radiológicos I-EXPLORATION +sugestivos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -adenopatía I-EXPLORATION -inguinal I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -invasión I-EXPLORATION -por I-EXPLORATION -adenocarcinoma I-EXPLORATION -prostático. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -una I-EXPLORATION -intensa I-EXPLORATION -positividad I-EXPLORATION +malabsorción, I-EXPLORATION +siendo I-EXPLORATION +las I-EXPLORATION +determinaciones I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -población I-EXPLORATION -neoplásica I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -prostática, I-EXPLORATION -el I-EXPLORATION -antígeno I-EXPLORATION -prostático I-EXPLORATION -específico I-EXPLORATION -(PSA) I-EXPLORATION +D-xilosa I-EXPLORATION +negativas I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION y I-EXPLORATION -para I-EXPLORATION -los I-EXPLORATION -receptores I-EXPLORATION +orina. I-EXPLORATION +En I-EXPLORATION +una I-EXPLORATION de I-EXPLORATION -andrógenos. I-EXPLORATION -La I-EXPLORATION -gammagrafía I-EXPLORATION -ósea I-EXPLORATION -mostró I-EXPLORATION -aumento I-EXPLORATION +las I-EXPLORATION +muestras I-EXPLORATION de I-EXPLORATION -captación I-EXPLORATION -retroauricular I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -apófisis I-EXPLORATION -espinosa I-EXPLORATION -y I-EXPLORATION -carilla I-EXPLORATION -auricular I-EXPLORATION +heces I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +envió I-EXPLORATION +a I-EXPLORATION +microbiología, I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +larvas I-EXPLORATION de I-EXPLORATION -C3. I-EXPLORATION - I-EXPLORATION +primera I-EXPLORATION +fase I-EXPLORATION +o I-EXPLORATION +rabditiformes I-EXPLORATION +de I-EXPLORATION +Strongyloides I-EXPLORATION +stercolaris. I-EXPLORATION Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -hormonal I-TREATMENT -con I-TREATMENT -antiandrógenos I-TREATMENT -y I-TREATMENT -análogos I-TREATMENT -de I-TREATMENT -LHRH. I-TREATMENT -Ante I-TREATMENT +trató I-TREATMENT la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -metástasis I-TREATMENT -óseas, I-TREATMENT -se I-TREATMENT -añadió I-TREATMENT -ácido I-TREATMENT -zoledrónico. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -nueve I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -tratamiento, I-EVOLUTION -el I-EVOLUTION +infección I-TREATMENT +con I-TREATMENT +ivermectina I-TREATMENT +6 I-TREATMENT +g I-TREATMENT +al I-TREATMENT +día I-TREATMENT +durante I-TREATMENT +dos I-TREATMENT +días I-TREATMENT +consecutivos, I-TREATMENT +quedando B-EVOLUTION +la I-EVOLUTION paciente I-EVOLUTION -se I-EVOLUTION -hallaba I-EVOLUTION -estable I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -punto I-EVOLUTION -de I-EVOLUTION -vista I-EVOLUTION -clínico I-EVOLUTION +asintomática I-EVOLUTION y I-EVOLUTION -sin I-EVOLUTION -cambios I-EVOLUTION +no I-EVOLUTION +visualizándose I-EVOLUTION +el I-EVOLUTION +parásito I-EVOLUTION en I-EVOLUTION -la I-EVOLUTION -exploración I-EVOLUTION -física. I-EVOLUTION -El I-EVOLUTION -PSA I-EVOLUTION -fue I-EVOLUTION +muestras I-EVOLUTION de I-EVOLUTION -4, I-EVOLUTION -6 I-EVOLUTION -microgramos/l. I-EVOLUTION +heces I-EVOLUTION +sucesivas I-EVOLUTION +tras I-EVOLUTION +el I-EVOLUTION +final I-EVOLUTION +del I-EVOLUTION +tratamiento. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Escolar B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -es B-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -completar I-DERIVED_FROM/TO -estudio I-DERIVED_FROM/TO -tras I-DERIVED_FROM/TO -acudir I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -especialidades I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -tumoración I-DERIVED_FROM/TO -indolora I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -testículo I-DERIVED_FROM/TO -izquierdo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -mes I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -sin I-DERIVED_FROM/TO -otra I-DERIVED_FROM/TO -sintomatología. I-DERIVED_FROM/TO -Se B-EXPLORATION -le I-EXPLORATION -detecta I-EXPLORATION +11 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +género I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hospitalizaciones I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +patología I-PAST_MEDICAL_HISTORY +crónica, I-PAST_MEDICAL_HISTORY +Un B-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +previo I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +hospitalización I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +recibido I-PRESENT_ILLNESS +flucloxacilina I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +impétigo. I-PRESENT_ILLNESS +Su B-FAMILY_HISTORY +madre I-FAMILY_HISTORY +era I-FAMILY_HISTORY +portadora I-FAMILY_HISTORY +de I-FAMILY_HISTORY +un I-FAMILY_HISTORY +lupus I-FAMILY_HISTORY +eritematoso I-FAMILY_HISTORY +sistémico, I-FAMILY_HISTORY +dueña I-FAMILY_HISTORY +de I-FAMILY_HISTORY +casa I-FAMILY_HISTORY +y I-FAMILY_HISTORY +su I-FAMILY_HISTORY +padre, I-FAMILY_HISTORY +trabajador I-FAMILY_HISTORY +en I-FAMILY_HISTORY +servicios I-FAMILY_HISTORY +de I-FAMILY_HISTORY +correo I-FAMILY_HISTORY +internacional. I-FAMILY_HISTORY +La B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +sufrió I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +caída I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +Unidad I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Emergencia I-PRESENT_ILLNESS +(UE) I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +rodilla I-PRESENT_ILLNESS +derecha. I-PRESENT_ILLNESS +Se I-PRESENT_ILLNESS +diagnosticó I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +contusión I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +manejó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS +ambulatoria I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +inmovilización I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +analgesia. I-PRESENT_ILLNESS +Dada I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +persistencia I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +vuelve I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +consultar I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +después. I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +presentaba I-EXPLORATION +dolor I-EXPLORATION +espontáneo I-EXPLORATION +intenso I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -ecografía I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realiza I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -centro I-EXPLORATION +rodilla I-EXPLORATION +derecha, I-EXPLORATION +dolor I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION de I-EXPLORATION -especialidades I-EXPLORATION -un I-EXPLORATION -testículo I-EXPLORATION -izquierdo I-EXPLORATION -hipogénico I-EXPLORATION -y I-EXPLORATION -disminuido I-EXPLORATION +la I-EXPLORATION +metáfisis I-EXPLORATION +proximal I-EXPLORATION de I-EXPLORATION -tamaño I-EXPLORATION -que I-EXPLORATION -dificulta I-EXPLORATION -su I-EXPLORATION -valoración, I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -testículo I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -parénquima I-EXPLORATION -heterogéneo I-EXPLORATION -sospechoso I-EXPLORATION -de I-EXPLORATION -neoplasia. I-EXPLORATION - I-EXPLORATION -No B-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -medicamentosas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tampoco I-PAST_MEDICAL_HISTORY -tiene I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A B-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -palpa I-EXPLORATION -un I-EXPLORATION -teste I-EXPLORATION -izquierdo I-EXPLORATION -hipotrófico. I-EXPLORATION -El I-EXPLORATION -teste I-EXPLORATION -derecho I-EXPLORATION -se I-EXPLORATION -presenta I-EXPLORATION -algo I-EXPLORATION -aumentado I-EXPLORATION -de I-EXPLORATION -tamaño. I-EXPLORATION -Ambos I-EXPLORATION -no I-EXPLORATION -dolorosos, I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION +tibia I-EXPLORATION +derecha I-EXPLORATION +con I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -superficie I-EXPLORATION -regulares. I-EXPLORATION -Epidídimos I-EXPLORATION +volumen I-EXPLORATION y I-EXPLORATION -cordones I-EXPLORATION +temperatura I-EXPLORATION +local, I-EXPLORATION sin I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -solicitan I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -que I-EXPLORATION -resultan I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -alfa-feto I-EXPLORATION -proteína I-EXPLORATION -de I-EXPLORATION -2.7 I-EXPLORATION -ng/ml I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -beta-hCG I-EXPLORATION +fiebre, I-EXPLORATION +sin I-EXPLORATION +compromiso I-EXPLORATION +hemodinámico, I-EXPLORATION +ni I-EXPLORATION +del I-EXPLORATION +estado I-EXPLORATION +general. I-EXPLORATION +En I-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -4.2 I-EXPLORATION -mUI/ml. I-EXPLORATION - I-EXPLORATION -Durante I-EXPLORATION -el I-EXPLORATION ingreso I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -nuevas I-EXPLORATION -exploraciones I-EXPLORATION -complementarias, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -con I-EXPLORATION -flujo I-EXPLORATION -Doppler I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION +destacaba I-EXPLORATION un I-EXPLORATION -teste I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -49mm I-EXPLORATION -x I-EXPLORATION -36mm I-EXPLORATION -x I-EXPLORATION -26mm I-EXPLORATION +hemograma I-EXPLORATION con I-EXPLORATION -lesión I-EXPLORATION -hipoecoica, I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -lobulados, I-EXPLORATION -heterogénea, I-EXPLORATION -que I-EXPLORATION -ocupa I-EXPLORATION -prácticamente I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -testículo, I-EXPLORATION +leucocitosis I-EXPLORATION y I-EXPLORATION -que I-EXPLORATION -presenta I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -flujo I-EXPLORATION -Doppler. I-EXPLORATION -Y I-EXPLORATION +desviación I-EXPLORATION +a I-EXPLORATION +izquierda I-EXPLORATION +(24% I-EXPLORATION +baciliformes), I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +(PCR) I-EXPLORATION +270 I-EXPLORATION +mg/L I-EXPLORATION +y I-EXPLORATION +VHS I-EXPLORATION +101 I-EXPLORATION +mm/h. I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION +mostró I-EXPLORATION un I-EXPLORATION -teste I-EXPLORATION -izquierdo I-EXPLORATION +discreto I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -32 I-EXPLORATION -mm I-EXPLORATION -x I-EXPLORATION -22 I-EXPLORATION -mm I-EXPLORATION -x I-EXPLORATION -20 I-EXPLORATION -mm I-EXPLORATION -hetrogéneo I-EXPLORATION -con I-EXPLORATION +tejidos I-EXPLORATION +blandos I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +rodilla I-EXPLORATION +derecha, I-EXPLORATION +sin I-EXPLORATION lesión I-EXPLORATION -focal I-EXPLORATION -ligeramente I-EXPLORATION -hipoecoica I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -9 I-EXPLORATION -mm I-EXPLORATION +ósea I-EXPLORATION +asociada. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +aseo I-EXPLORATION +quirúrgico I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +inició I-EXPLORATION +tratamiento I-EXPLORATION +antimicrobiano I-EXPLORATION con I-EXPLORATION -sutil I-EXPLORATION -flujo I-EXPLORATION -Doppler. I-EXPLORATION -Además, I-EXPLORATION -microlitiasis I-EXPLORATION -testiculares I-EXPLORATION -bilaterales. I-EXPLORATION - I-EXPLORATION +cloxacilina I-EXPLORATION +iv I-EXPLORATION +(185 I-EXPLORATION +mg/kg/día) I-EXPLORATION +cada I-EXPLORATION +6 I-EXPLORATION +h. I-EXPLORATION Al I-EXPLORATION -TAC I-EXPLORATION -toraco-abdomino-pélvico I-EXPLORATION +tercer I-EXPLORATION +día I-EXPLORATION +post-operatorio, I-EXPLORATION +persistió I-EXPLORATION con I-EXPLORATION -contraste, I-EXPLORATION -donde I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -identificaron I-EXPLORATION -adenopatías I-EXPLORATION -ni I-EXPLORATION -metástasis I-EXPLORATION -en I-EXPLORATION -ninguno I-EXPLORATION +dolor I-EXPLORATION +intenso I-EXPLORATION +y I-EXPLORATION +comenzó I-EXPLORATION +con I-EXPLORATION +fiebre I-EXPLORATION +y I-EXPLORATION +compromiso I-EXPLORATION +del I-EXPLORATION +estado I-EXPLORATION +general. I-EXPLORATION +Los I-EXPLORATION +dos I-EXPLORATION +hemocultivos I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +cultivo I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -territorios I-EXPLORATION -visualizados. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT +tejido I-EXPLORATION +óseo I-EXPLORATION +fueron I-EXPLORATION +positivos I-EXPLORATION +para I-EXPLORATION +SARM, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +vancomicina, I-TREATMENT +aislamiento I-TREATMENT de I-TREATMENT -tumor I-TREATMENT -testicular I-TREATMENT -bilateral, I-TREATMENT +contacto I-TREATMENT +según I-TREATMENT +la I-TREATMENT +norma I-TREATMENT +institucional I-TREATMENT +y I-TREATMENT se I-TREATMENT -le I-TREATMENT realizó I-TREATMENT -una I-TREATMENT -orquiectomía I-TREATMENT -bilateral I-TREATMENT -vía I-TREATMENT -inguinal. I-TREATMENT -Al I-TREATMENT -mismo I-TREATMENT -tiempo I-TREATMENT -comenzó I-TREATMENT -tratamiento I-TREATMENT -hormonal I-TREATMENT -sustitutivo. I-TREATMENT - I-TREATMENT -En B-EXPLORATION +un I-TREATMENT +nuevo I-TREATMENT +aseo I-TREATMENT +quirúrgico. I-TREATMENT +Dada B-EXPLORATION la I-EXPLORATION -Anatomía I-EXPLORATION -patológica I-EXPLORATION -informan I-EXPLORATION -de I-EXPLORATION -testículo I-EXPLORATION -izquierdo I-EXPLORATION -atrófico I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -focos I-EXPLORATION -microscópicos I-EXPLORATION -de I-EXPLORATION -Seminoma I-EXPLORATION -clásico I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -amplias I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -Neoplasia I-EXPLORATION -Intratubular I-EXPLORATION -de I-EXPLORATION -Células I-EXPLORATION -Germinales I-EXPLORATION -(NICG) I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -infiltración I-EXPLORATION -tumoral I-EXPLORATION -en I-EXPLORATION -albugínea, I-EXPLORATION -rete I-EXPLORATION -testis, I-EXPLORATION -epidídimo I-EXPLORATION -o I-EXPLORATION -infiltración I-EXPLORATION -vascular. I-EXPLORATION -El I-EXPLORATION -testículo I-EXPLORATION -derecho I-EXPLORATION -presenta I-EXPLORATION -tumoración I-EXPLORATION -con I-EXPLORATION -características I-EXPLORATION +persistencia I-EXPLORATION de I-EXPLORATION -Seminoma I-EXPLORATION -clásico I-EXPLORATION -que I-EXPLORATION -ocupa I-EXPLORATION -prácticamente I-EXPLORATION -todo I-EXPLORATION +la I-EXPLORATION +fiebre I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +cintigrama I-EXPLORATION +óseo I-EXPLORATION +trifásico, I-EXPLORATION el I-EXPLORATION -parénquima, I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -Neoplasia I-EXPLORATION -Intratubular I-EXPLORATION -de I-EXPLORATION -Células I-EXPLORATION -Germinales I-EXPLORATION -(NICG) I-EXPLORATION -y I-EXPLORATION -focos I-EXPLORATION +cual I-EXPLORATION +demostró I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -atrofia I-EXPLORATION +la I-EXPLORATION +actividad I-EXPLORATION +osteoblástica I-EXPLORATION +localizado I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -testículo I-EXPLORATION -restante. I-EXPLORATION -Túnica I-EXPLORATION -albugínea, I-EXPLORATION -rete I-EXPLORATION -testis, I-EXPLORATION -epidídimo I-EXPLORATION -y I-EXPLORATION -borde I-EXPLORATION -quirúrgico I-EXPLORATION -libres I-EXPLORATION +la I-EXPLORATION +metáfisis I-EXPLORATION de I-EXPLORATION -tumor. I-EXPLORATION - I-EXPLORATION +la I-EXPLORATION +tibia I-EXPLORATION +proximal I-EXPLORATION +derecha. I-EXPLORATION +La B-EVOLUTION +evolución I-EVOLUTION +fue I-EVOLUTION +tórpida, I-EVOLUTION +con I-EVOLUTION +persistencia I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +fiebre I-EVOLUTION +hasta I-EVOLUTION +15 I-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +haber I-EVOLUTION +iniciado I-EVOLUTION +vancomicina, I-EVOLUTION +requiriendo I-EVOLUTION +múltiples I-EVOLUTION +aseos I-EVOLUTION +quirúrgicos I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +encontraron I-EVOLUTION +colecciones I-EVOLUTION +y I-EVOLUTION +daño I-EVOLUTION +articular. I-EVOLUTION +Los I-EVOLUTION +cultivos I-EVOLUTION +intraoperatorios I-EVOLUTION +persistieron I-EVOLUTION +positivos I-EVOLUTION +hasta I-EVOLUTION +12 I-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +haber I-EVOLUTION +iniciado I-EVOLUTION +vancomicina. I-EVOLUTION +Por I-EVOLUTION +la I-EVOLUTION +persistencia I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +fiebre I-EVOLUTION +se I-EVOLUTION +descartaron I-EVOLUTION +focos I-EVOLUTION +secundarios I-EVOLUTION +u I-EVOLUTION +otra I-EVOLUTION +infección. I-EVOLUTION +Se B-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION +inmunológico I-EXPLORATION +básico I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +normal. I-EXPLORATION El B-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -completó I-TREATMENT -con I-TREATMENT -dos I-TREATMENT -ciclos I-TREATMENT +día I-TREATMENT +18 I-TREATMENT de I-TREATMENT -quimioterapia I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -carboplatino. I-TREATMENT - I-TREATMENT -Actualmente B-EVOLUTION -lleva I-EVOLUTION -aproximadamente I-EVOLUTION -3 I-EVOLUTION -años I-EVOLUTION +vancomicina I-TREATMENT +presentó I-TREATMENT +un I-TREATMENT +exantema I-TREATMENT +máculo-papular I-TREATMENT +morbiliforme, I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +considerada I-TREATMENT +como I-TREATMENT +una I-TREATMENT +reacción I-TREATMENT +adversa I-TREATMENT +a I-TREATMENT +fármacos, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +cambió I-TREATMENT +la I-TREATMENT +terapia I-TREATMENT +a I-TREATMENT +clindamicina I-TREATMENT +iv. I-TREATMENT +Evolucionó B-EVOLUTION +afebril I-EVOLUTION y I-EVOLUTION -medio I-EVOLUTION -libre I-EVOLUTION +sin I-EVOLUTION +dolor I-EVOLUTION +local, I-EVOLUTION +completando I-EVOLUTION +en I-EVOLUTION +total I-EVOLUTION +56 I-EVOLUTION +días I-EVOLUTION de I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -fumadora B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -cigarrillos/día, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -poliquistosis I-PAST_MEDICAL_HISTORY -hepatorrenal I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -estadio I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -(con I-PAST_MEDICAL_HISTORY -aclaramiento I-PAST_MEDICAL_HISTORY -creatinina I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -ml/min I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -proteinuria). I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -ningún I-PAST_MEDICAL_HISTORY -otro I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -patológico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -enfermedad I-PRESENT_ILLNESS -actual I-PRESENT_ILLNESS -comienza I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -lumbar I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -requiere I-PRESENT_ILLNESS -ingreso. I-PRESENT_ILLNESS -Inicialmente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -orienta I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -crisis I-PRESENT_ILLNESS -quística. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Se B-EXPLORATION -realiza I-EXPLORATION -ecografía I-EXPLORATION -reno-vesical I-EXPLORATION -en I-EXPLORATION +tratamiento I-EVOLUTION +antibacteriano: I-EVOLUTION +17 B-TREATMENT +días I-TREATMENT +de I-TREATMENT +vancomicina I-TREATMENT +y I-TREATMENT +39 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +clindamicina. I-TREATMENT +Fue B-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +con I-EVOLUTION +parámetros I-EVOLUTION +inflamatorios I-EVOLUTION +en I-EVOLUTION +descenso I-EVOLUTION +(VHS I-EVOLUTION +28 I-EVOLUTION +mm/h I-EVOLUTION +y I-EVOLUTION +PCR I-EVOLUTION +19, I-EVOLUTION +2 I-EVOLUTION +mg/L), I-EVOLUTION +y I-EVOLUTION +tratamiento I-EVOLUTION +con I-EVOLUTION +linezolid I-EVOLUTION +vía I-EVOLUTION +oral I-EVOLUTION +(300 I-EVOLUTION +mg, I-EVOLUTION +dos I-EVOLUTION +veces I-EVOLUTION +al I-EVOLUTION +día), I-EVOLUTION +por I-EVOLUTION +20 I-EVOLUTION +días. I-EVOLUTION +El B-EXPLORATION +ISP I-EXPLORATION +confirmó I-EXPLORATION +que I-EXPLORATION la I-EXPLORATION -que, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -contexto I-EXPLORATION +cepa I-EXPLORATION +fue I-EXPLORATION +SARM, I-EXPLORATION +PVL I-EXPLORATION +negativa. I-EXPLORATION +Además, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -poliquistosis I-EXPLORATION -hepatorrenal, I-EXPLORATION +portación I-EXPLORATION +nasal I-EXPLORATION +familiar I-EXPLORATION +en I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +madre I-EXPLORATION +resultó I-EXPLORATION +ser I-EXPLORATION +positiva I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -aprecia I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -desestructuración I-EXPLORATION -parenquimatosa I-EXPLORATION -renal I-EXPLORATION -por I-EXPLORATION -quistes, I-EXPLORATION -preferentemente I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lado I-EXPLORATION -izquierdo, I-EXPLORATION +decolonización I-EXPLORATION con I-EXPLORATION -aumento I-EXPLORATION +mupirocina I-EXPLORATION +tópica. I-EXPLORATION +El I-EXPLORATION +análisis I-EXPLORATION +genético I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +caracterización I-EXPLORATION +molecular I-EXPLORATION +de I-EXPLORATION +ambas I-EXPLORATION +cepas I-EXPLORATION +demostró I-EXPLORATION +la I-EXPLORATION +ausencia I-EXPLORATION del I-EXPLORATION -tamaño I-EXPLORATION -respecto I-EXPLORATION -al I-EXPLORATION -contralateral, I-EXPLORATION -Existe I-EXPLORATION -una I-EXPLORATION -ecogenicidad I-EXPLORATION -heterogénea I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -parénquima I-EXPLORATION -preservado I-EXPLORATION -que I-EXPLORATION -sugiere I-EXPLORATION -turgencia I-EXPLORATION -parenquimatosa I-EXPLORATION +marcador I-EXPLORATION +PV-L I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -desdibujamiento I-EXPLORATION -sinusal I-EXPLORATION -izquierdo I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION -presencia I-EXPLORATION +determinaron I-EXPLORATION +un I-EXPLORATION +mismo I-EXPLORATION +subtipo I-EXPLORATION +genético I-EXPLORATION +por I-EXPLORATION +PFGE I-EXPLORATION +(CL-SAU-COM-SMA-017) I-EXPLORATION +y I-EXPLORATION +por I-EXPLORATION +MLST I-EXPLORATION +al I-EXPLORATION +tipo I-EXPLORATION de I-EXPLORATION +secuencia I-EXPLORATION +ST8. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +62 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tabaquismo I-PAST_MEDICAL_HISTORY +(20 I-PAST_MEDICAL_HISTORY +paquetes/año) I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +disfagia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +baja I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso. I-PRESENT_ILLNESS +Endoscopia B-EXPLORATION +digestiva I-EXPLORATION +alta I-EXPLORATION +(EDA) I-EXPLORATION +demostró I-EXPLORATION un I-EXPLORATION -tejido I-EXPLORATION -ecogénico I-EXPLORATION -que I-EXPLORATION -ejerce I-EXPLORATION -efecto I-EXPLORATION +tumor I-EXPLORATION +estenosante I-EXPLORATION +del I-EXPLORATION +esófago I-EXPLORATION +a I-EXPLORATION +30 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -masa I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -proyecta I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -pelvis I-EXPLORATION -renal. I-EXPLORATION -Dada I-EXPLORATION la I-EXPLORATION -poca I-EXPLORATION -especificidad I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -ecográficos I-EXPLORATION -se I-EXPLORATION -completa I-EXPLORATION -el I-EXPLORATION +arcada I-EXPLORATION +dentaria. I-EXPLORATION +Biopsia I-EXPLORATION +confirmó I-EXPLORATION +un I-EXPLORATION +carcinoma I-EXPLORATION +escamoso I-EXPLORATION +moderadamente I-EXPLORATION +diferenciado. I-EXPLORATION +El I-EXPLORATION estudio I-EXPLORATION -mediante I-EXPLORATION -TC I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -nuevamente I-EXPLORATION -desestructuración I-EXPLORATION -renal I-EXPLORATION -bilateral I-EXPLORATION -por I-EXPLORATION -poliquistosis, I-EXPLORATION +de I-EXPLORATION +etapi-ficación I-EXPLORATION con I-EXPLORATION -algunos I-EXPLORATION -quistes I-EXPLORATION -hiperdensos I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -basal I-EXPLORATION -realizado I-EXPLORATION -sin I-EXPLORATION -contraste I-EXPLORATION -endovenoso. I-EXPLORATION -La I-EXPLORATION -afectación I-EXPLORATION -es I-EXPLORATION -asimétrica, I-EXPLORATION -más I-EXPLORATION -intensa I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computada I-EXPLORATION +(TAC) I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +infiltrante I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -lado I-EXPLORATION -izquierdo, I-EXPLORATION -siendo I-EXPLORATION -dicho I-EXPLORATION -riñón I-EXPLORATION +tercio I-EXPLORATION +medio I-EXPLORATION +del I-EXPLORATION +esófago I-EXPLORATION de I-EXPLORATION -mayor I-EXPLORATION -tamaño. I-EXPLORATION -La I-EXPLORATION -región I-EXPLORATION -piélica I-EXPLORATION -izquierda I-EXPLORATION -está I-EXPLORATION -ocupada I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -tejido I-EXPLORATION +9 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -densidad I-EXPLORATION +largo, I-EXPLORATION +desde I-EXPLORATION +el I-EXPLORATION +cayado I-EXPLORATION +aórtico I-EXPLORATION +hasta I-EXPLORATION +el I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION +las I-EXPLORATION +venas I-EXPLORATION +pulmonares I-EXPLORATION +derechas; I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +aspecto I-EXPLORATION +posterior I-EXPLORATION +se I-EXPLORATION +apreciaba I-EXPLORATION que I-EXPLORATION -muestra I-EXPLORATION -un I-EXPLORATION -realce I-EXPLORATION -moderado I-EXPLORATION -tras I-EXPLORATION +rodeaba I-EXPLORATION +y I-EXPLORATION +aparentemente I-EXPLORATION +infiltraba I-EXPLORATION la I-EXPLORATION -administración I-EXPLORATION -endovenosa I-EXPLORATION +aorta I-EXPLORATION +en I-EXPLORATION +más I-EXPLORATION de I-EXPLORATION -contraste, I-EXPLORATION -sin I-EXPLORATION -definición I-EXPLORATION -clara I-EXPLORATION +un I-EXPLORATION +50% I-EXPLORATION de I-EXPLORATION -sus I-EXPLORATION -límites. I-EXPLORATION -Funcionalmente I-EXPLORATION -existe I-EXPLORATION +su I-EXPLORATION +circunferencia. I-EXPLORATION +Presentaba I-EXPLORATION +además I-EXPLORATION un I-EXPLORATION -evidente I-EXPLORATION -retraso I-EXPLORATION +nódulo I-EXPLORATION +pulmonar I-EXPLORATION +de I-EXPLORATION +1 I-EXPLORATION +x I-EXPLORATION +0, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -lado I-EXPLORATION -izquierdo I-EXPLORATION +lóbulo I-EXPLORATION +superior I-EXPLORATION +derecho I-EXPLORATION y I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -eliminación I-EXPLORATION -del I-EXPLORATION -contraste I-EXPLORATION -endovenoso I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -secciones I-EXPLORATION -realizadas I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -retardada. I-EXPLORATION -El I-EXPLORATION -conjunto I-EXPLORATION -de I-EXPLORATION -hallazgos I-EXPLORATION -sugiere I-EXPLORATION -ocupación I-EXPLORATION -tumoral I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +hepático I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -pelvis I-EXPLORATION -renal I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -poliquistosis I-EXPLORATION +lóbulo I-EXPLORATION +caudado, I-EXPLORATION +compatibles I-EXPLORATION con I-EXPLORATION -alteración I-EXPLORATION -funcional I-EXPLORATION -secundaria. I-EXPLORATION -Se I-EXPLORATION -observan I-EXPLORATION -ganglios I-EXPLORATION -retroperitoneales I-EXPLORATION -no I-EXPLORATION -aumentados I-EXPLORATION -significativamente I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -en I-EXPLORATION -situación I-EXPLORATION -interaortocava I-EXPLORATION -y I-EXPLORATION -retroaórtica. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT +localizaciones I-EXPLORATION +secundarias I-EXPLORATION +(T4NxM1). I-EXPLORATION +Considerando B-TREATMENT +que I-TREATMENT el I-TREATMENT -diagnóstico I-TREATMENT -clínico I-TREATMENT +paciente I-TREATMENT +tenía I-TREATMENT +un I-TREATMENT +cáncer I-TREATMENT +metastásico, I-TREATMENT +recibió I-TREATMENT +tratamiento I-TREATMENT +paliativo I-TREATMENT +para I-TREATMENT +alivio I-TREATMENT de I-TREATMENT -masa I-TREATMENT -renal I-TREATMENT -compatible I-TREATMENT +su I-TREATMENT +disfagia I-TREATMENT con I-TREATMENT -proceso I-TREATMENT -neoformativo, I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -nefrectomía I-TREATMENT -radical I-TREATMENT -izquierda, I-TREATMENT +QRT I-TREATMENT +concomitante I-TREATMENT con I-TREATMENT -suprarrenalectomía I-TREATMENT -izquierda I-TREATMENT -más I-TREATMENT -linfadenectomía I-TREATMENT -aortocava, I-TREATMENT -sin I-TREATMENT -incidencias I-TREATMENT -ni I-TREATMENT -complicaciones I-TREATMENT -inmediatas. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -no I-EVOLUTION -surgen I-EVOLUTION -complicaciones, I-EVOLUTION -con I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -estable. I-EVOLUTION -Un I-EVOLUTION -mes I-EVOLUTION +cisplatino I-TREATMENT +(radioterapia I-TREATMENT +51 I-TREATMENT +Gy I-TREATMENT +en I-TREATMENT +17 I-TREATMENT +fracciones I-TREATMENT +de I-TREATMENT +3 I-TREATMENT +Gy I-TREATMENT +y I-TREATMENT +cisplatino I-TREATMENT +40 I-TREATMENT +mg/ I-TREATMENT +m2 I-TREATMENT +semanales). I-TREATMENT + I-TREATMENT +Dos B-EVOLUTION +meses I-EVOLUTION después I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -nefrectomía, I-EVOLUTION +completado I-EVOLUTION el I-EVOLUTION -aclaramiento I-EVOLUTION -de I-EVOLUTION -creatinina I-EVOLUTION -fue I-EVOLUTION +tratamiento I-EVOLUTION +consultó I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +Servicio I-EVOLUTION de I-EVOLUTION -52 I-EVOLUTION -ml/min I-EVOLUTION +Urgencia I-EVOLUTION +por I-EVOLUTION +presentar I-EVOLUTION +hematemesis; I-EVOLUTION +al I-EVOLUTION +ingreso I-EVOLUTION +hipotenso I-EVOLUTION y I-EVOLUTION -aparece I-EVOLUTION -proteinuria I-EVOLUTION -de I-EVOLUTION -0, I-EVOLUTION -16 I-EVOLUTION -g/24 I-EVOLUTION -h. I-EVOLUTION - I-EVOLUTION -En B-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -anátomo-patológico I-EXPLORATION +taquicárdico I-EVOLUTION +recuperando I-EVOLUTION +su I-EVOLUTION +hemodinamia I-EVOLUTION +mediante I-EVOLUTION +aporte I-EVOLUTION +de I-EVOLUTION +cristaloides. I-EVOLUTION +Hematocrito B-EXPLORATION +de I-EXPLORATION +21%. I-EXPLORATION +AngioTAC I-EXPLORATION +mostró I-EXPLORATION +reducción I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -pieza, I-EXPLORATION -macroscópicamente I-EXPLORATION -destaca I-EXPLORATION -una I-EXPLORATION masa I-EXPLORATION -renal I-EXPLORATION -blanquecina, I-EXPLORATION -firme, I-EXPLORATION +tumoral I-EXPLORATION +esofágica I-EXPLORATION +con I-EXPLORATION +componente I-EXPLORATION +necrótico I-EXPLORATION +central I-EXPLORATION +e I-EXPLORATION +infiltración I-EXPLORATION de I-EXPLORATION -9 I-EXPLORATION -x I-EXPLORATION -8, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -5 I-EXPLORATION -cm., I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +anterior I-EXPLORATION de I-EXPLORATION -bordes I-EXPLORATION -mal I-EXPLORATION -definidos, I-EXPLORATION -que I-EXPLORATION -presenta I-EXPLORATION -un I-EXPLORATION -área I-EXPLORATION -central I-EXPLORATION +la I-EXPLORATION +aorta, I-EXPLORATION +sin I-EXPLORATION +evidencias I-EXPLORATION de I-EXPLORATION -necrosis. I-EXPLORATION -Está I-EXPLORATION -situada I-EXPLORATION +sangrado I-EXPLORATION +activo; I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +eran I-EXPLORATION +sugerentes I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +FAE. I-EXPLORATION +Fue B-TREATMENT +llevado I-TREATMENT +a I-TREATMENT +pabellón I-TREATMENT +donde I-TREATMENT +se I-TREATMENT +implantó I-TREATMENT +una I-TREATMENT +endoprótesis I-TREATMENT +Valiant I-TREATMENT +28 I-TREATMENT +x I-TREATMENT +15 I-TREATMENT +(Medtronic, I-TREATMENT +Minnesota, I-TREATMENT +Estados I-TREATMENT +Unidos I-TREATMENT +de I-TREATMENT +Norteamérica) I-TREATMENT +en I-TREATMENT +aorta I-TREATMENT +torácica I-TREATMENT +descendente I-TREATMENT +proximal, I-TREATMENT +distal I-TREATMENT +a I-TREATMENT +la I-TREATMENT +arteria I-TREATMENT +subclavia I-TREATMENT +izquierda, I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +femoral I-TREATMENT +sin I-TREATMENT +incidentes. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +inició I-TREATMENT +cobertura I-TREATMENT +antibiótica I-TREATMENT +en I-TREATMENT +base I-TREATMENT +a I-TREATMENT +ce-ftriaxona I-TREATMENT +y I-TREATMENT +clindamicina. I-TREATMENT +No B-EVOLUTION +volvió I-EVOLUTION +a I-EVOLUTION +presentar I-EVOLUTION +hemorragia I-EVOLUTION +digestiva, I-EVOLUTION +iniciando I-EVOLUTION +alimentación I-EVOLUTION +oral I-EVOLUTION +progresiva I-EVOLUTION +el I-EVOLUTION +4° I-EVOLUTION +día I-EVOLUTION +postoperatorio, I-EVOLUTION +bien I-EVOLUTION +tolerado I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +evidencias I-EVOLUTION +de I-EVOLUTION +disfagia. I-EVOLUTION +Fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +8° I-EVOLUTION +día I-EVOLUTION +con I-EVOLUTION +buena I-EVOLUTION +tolerancia I-EVOLUTION +oral I-EVOLUTION +y I-EVOLUTION +afebril. I-EVOLUTION +Completó B-TREATMENT +14 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +antibióticos I-TREATMENT +endovenosos I-TREATMENT +y I-TREATMENT +luego I-TREATMENT +continuó I-TREATMENT +con I-TREATMENT +amoxicilina/ácido I-TREATMENT +clavulánico I-TREATMENT +oral I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +amoxicilina I-TREATMENT +en I-TREATMENT +forma I-TREATMENT +indefinida. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +controles I-EVOLUTION +ambulatorios I-EVOLUTION +evolucionó I-EVOLUTION +adecuadamente, I-EVOLUTION +sin I-EVOLUTION +disfagia I-EVOLUTION +ni I-EVOLUTION +fiebre I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +aumento I-EVOLUTION +progresivo I-EVOLUTION +del I-EVOLUTION +peso I-EVOLUTION +de I-EVOLUTION +6 I-EVOLUTION +kg. I-EVOLUTION +AngioTAC I-EVOLUTION +de I-EVOLUTION +control I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +3 I-EVOLUTION +meses I-EVOLUTION +mostró I-EVOLUTION +adecuada I-EVOLUTION +posición I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +endoprótesis I-EVOLUTION +sin I-EVOLUTION +evidencias I-EVOLUTION +de I-EVOLUTION +fugas, I-EVOLUTION +pero I-EVOLUTION +con I-EVOLUTION +progresión I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +metástasis I-EVOLUTION +hepática I-EVOLUTION +conocida. I-EVOLUTION +Continuó I-EVOLUTION +con I-EVOLUTION +cuidados I-EVOLUTION +paliativos I-EVOLUTION +y I-EVOLUTION +evolucionó I-EVOLUTION +sin I-EVOLUTION +complicaciones I-EVOLUTION +importantes I-EVOLUTION +hasta I-EVOLUTION +un I-EVOLUTION +control I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +11 I-EVOLUTION +meses I-EVOLUTION +post I-EVOLUTION +procedimiento I-EVOLUTION +en I-EVOLUTION +que I-EVOLUTION +refirió I-EVOLUTION +compromiso I-EVOLUTION +del I-EVOLUTION +estado I-EVOLUTION +general, I-EVOLUTION +disfagia I-EVOLUTION +a I-EVOLUTION +sólidos I-EVOLUTION +y I-EVOLUTION +baja I-EVOLUTION +de I-EVOLUTION +peso I-EVOLUTION +de I-EVOLUTION +10 I-EVOLUTION +kilos. I-EVOLUTION +EDA B-EXPLORATION +demostró I-EXPLORATION +lesión I-EXPLORATION +esofágica I-EXPLORATION +estenosante I-EXPLORATION +desde I-EXPLORATION +los I-EXPLORATION +30 I-EXPLORATION +a I-EXPLORATION +35 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arcada I-EXPLORATION +dentaria I-EXPLORATION +con I-EXPLORATION +exposición I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +endoprótesis I-EXPLORATION +aórtica. I-EXPLORATION +Mantuvo B-EVOLUTION +manejo I-EVOLUTION +paliativo, I-EVOLUTION +falleciendo I-EVOLUTION +finalmente I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +13 I-EVOLUTION +meses I-EVOLUTION +post I-EVOLUTION +cirugía I-EVOLUTION +sin I-EVOLUTION +evidencias I-EVOLUTION +de I-EVOLUTION +sepsis I-EVOLUTION +ni I-EVOLUTION +nuevos I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION +sangrado. I-EVOLUTION + I-EVOLUTION + +JRA. B-PRESENT_ILLNESS +Varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +16 I-PRESENT_ILLNESS +años. I-PRESENT_ILLNESS +Sobrino. I-PRESENT_ILLNESS +Sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés. I-PAST_MEDICAL_HISTORY +Asintomático. B-EXPLORATION +Erupciones I-EXPLORATION +cutáneas I-EXPLORATION +generalizadas, I-EXPLORATION +especialmente I-EXPLORATION en I-EXPLORATION +cara, I-EXPLORATION +brazos I-EXPLORATION +y I-EXPLORATION +piernas, I-EXPLORATION +muy I-EXPLORATION +pruriginosas I-EXPLORATION +desde I-EXPLORATION la I-EXPLORATION -porción I-EXPLORATION -central I-EXPLORATION -renal, I-EXPLORATION -afectando I-EXPLORATION +infancia, I-EXPLORATION +diagnosticado I-EXPLORATION +de I-EXPLORATION +dermatitis I-EXPLORATION +herpetiforme I-EXPLORATION +(DH). I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -práctica I-EXPLORATION -totalidad I-EXPLORATION +analítica I-EXPLORATION +destaca I-EXPLORATION +una I-EXPLORATION +ligera I-EXPLORATION +leucopenia I-EXPLORATION +(4.800), I-EXPLORATION +con I-EXPLORATION +descenso I-EXPLORATION del I-EXPLORATION -parénquima, I-EXPLORATION -alcanzando I-EXPLORATION -el I-EXPLORATION -tejido I-EXPLORATION -adiposo I-EXPLORATION -perirrenal I-EXPLORATION +colesterol I-EXPLORATION +total I-EXPLORATION +(116 I-EXPLORATION +mg/dl). I-EXPLORATION +La I-EXPLORATION +TTG I-EXPLORATION +fue I-EXPLORATION +normal I-EXPLORATION +(0, I-EXPLORATION +88 I-EXPLORATION +U/ml). I-EXPLORATION +Es I-EXPLORATION +DQ2 I-EXPLORATION +(-) I-EXPLORATION y I-EXPLORATION -rodeando I-EXPLORATION +DQ8 I-EXPLORATION +(+). I-EXPLORATION +Las I-EXPLORATION +biopsias I-EXPLORATION +duodenales I-EXPLORATION +fueron I-EXPLORATION +normales I-EXPLORATION +(estadio I-EXPLORATION +0 I-EXPLORATION +de I-EXPLORATION +Marsh). I-EXPLORATION +Se B-TREATMENT +le I-TREATMENT +puso I-TREATMENT +a I-TREATMENT +DSG I-TREATMENT +hace I-TREATMENT +10 I-TREATMENT +meses, I-TREATMENT +con B-EVOLUTION +buena I-EVOLUTION +respuesta I-EVOLUTION +clínica I-EVOLUTION +y I-EVOLUTION +analítica, I-EVOLUTION +con I-EVOLUTION +desaparición I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +lesiones I-EVOLUTION +cutáneas. I-EVOLUTION + I-EVOLUTION + +Un B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +39 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +no B-PAST_MEDICAL_HISTORY +fumador, I-PAST_MEDICAL_HISTORY +originario I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Perú, I-PAST_MEDICAL_HISTORY +residente I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +España I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +últimos I-PAST_MEDICAL_HISTORY +8 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +médicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +presentaba B-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tumefacción I-PRESENT_ILLNESS +dolorosa I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +color I-PRESENT_ILLNESS +violáceo I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +dorso I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +miembro I-PRESENT_ILLNESS +inferior I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +progresó I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +cara I-PRESENT_ILLNESS +anterior I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +pierna I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +traumatismo I-PRESENT_ILLNESS +mínimo I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +zona. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +mejoró I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +pesar I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +antibiótico I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +antiinflamatorio. I-PRESENT_ILLNESS +Una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +comenzó I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +mismos I-PRESENT_ILLNESS +síntomas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +miembro I-PRESENT_ILLNESS +inferior I-PRESENT_ILLNESS +derecho, I-PRESENT_ILLNESS +añadiéndose I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +termometrada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +39oC. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION -glándula I-EXPLORATION -suprarrenal. I-EXPLORATION -En I-EXPLORATION +exploración I-EXPLORATION el I-EXPLORATION -hilio I-EXPLORATION -renal I-EXPLORATION +paciente I-EXPLORATION se I-EXPLORATION -identifican I-EXPLORATION -cuatro I-EXPLORATION -ganglios I-EXPLORATION -linfáticos. I-EXPLORATION -El I-EXPLORATION -parénquima I-EXPLORATION -renal I-EXPLORATION +encontraba I-EXPLORATION +afebril, I-EXPLORATION no I-EXPLORATION -tumoral I-EXPLORATION -está I-EXPLORATION -totalmente I-EXPLORATION -desestructurado I-EXPLORATION +se I-EXPLORATION +palpaban I-EXPLORATION +adenopatías, I-EXPLORATION +la I-EXPLORATION +auscultación I-EXPLORATION +pulmonar I-EXPLORATION y I-EXPLORATION -sustituido I-EXPLORATION -por I-EXPLORATION -múltiples I-EXPLORATION -quistes I-EXPLORATION -de I-EXPLORATION -hasta I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION +cardíaca I-EXPLORATION +eran I-EXPLORATION +normales, I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +abdomen I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +apreciaban I-EXPLORATION +datos I-EXPLORATION de I-EXPLORATION -diámetro, I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -afectan I-EXPLORATION -tanto I-EXPLORATION -corteza I-EXPLORATION -como I-EXPLORATION -médula I-EXPLORATION -renal. I-EXPLORATION -Histológicamente, I-EXPLORATION +interés. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -tumoración I-EXPLORATION -está I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION +exploración I-EXPLORATION de I-EXPLORATION -citoplasma I-EXPLORATION -amplio I-EXPLORATION +las I-EXPLORATION +extremidades I-EXPLORATION +inferiores I-EXPLORATION +destacaba I-EXPLORATION +un I-EXPLORATION +eritema I-EXPLORATION y I-EXPLORATION -eosinófilo, I-EXPLORATION -con I-EXPLORATION -núcleos I-EXPLORATION -redondeados I-EXPLORATION -con I-EXPLORATION -marcada I-EXPLORATION -atipia, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -organizan I-EXPLORATION +edema I-EXPLORATION +de I-EXPLORATION +borde I-EXPLORATION +no I-EXPLORATION +definido I-EXPLORATION en I-EXPLORATION -un I-EXPLORATION -patrón I-EXPLORATION -sólido I-EXPLORATION -cohesivo, I-EXPLORATION -característico I-EXPLORATION +cara I-EXPLORATION +anterior I-EXPLORATION +y I-EXPLORATION +lateral I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -carcinoma I-EXPLORATION -escamoso I-EXPLORATION -pobremente I-EXPLORATION -diferenciado. I-EXPLORATION -Son I-EXPLORATION -extensas I-EXPLORATION +ambos I-EXPLORATION +miembros I-EXPLORATION +hasta I-EXPLORATION las I-EXPLORATION -áreas I-EXPLORATION +rodillas, I-EXPLORATION +más I-EXPLORATION +evidente I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +izquierdo, I-EXPLORATION +doloroso I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +presión I-EXPLORATION +y I-EXPLORATION +sin I-EXPLORATION +inflamación I-EXPLORATION +articular. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +una I-EXPLORATION +leucocitosis I-EXPLORATION de I-EXPLORATION -necrosis I-EXPLORATION -tumoral. I-EXPLORATION -El I-EXPLORATION -tumor I-EXPLORATION -afecta I-EXPLORATION -uréter I-EXPLORATION -proximal, I-EXPLORATION -pelvis I-EXPLORATION -renal, I-EXPLORATION -parénquima I-EXPLORATION -renal I-EXPLORATION +21.000 I-EXPLORATION +/ I-EXPLORATION +ml I-EXPLORATION +con I-EXPLORATION +neutrofilia I-EXPLORATION y I-EXPLORATION -tejido I-EXPLORATION -adiposo I-EXPLORATION -tanto I-EXPLORATION -perirrenal I-EXPLORATION -como I-EXPLORATION -perihiliar. I-EXPLORATION -Se I-EXPLORATION -objetiva I-EXPLORATION -infiltración I-EXPLORATION -tumoral I-EXPLORATION +linfopenia, I-EXPLORATION +velocidad I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -renal I-EXPLORATION +sedimentación: I-EXPLORATION +67 I-EXPLORATION +mm I-EXPLORATION +/ I-EXPLORATION +h, I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva: I-EXPLORATION +24, I-EXPLORATION +48 I-EXPLORATION +mg I-EXPLORATION +/ I-EXPLORATION +dl I-EXPLORATION y I-EXPLORATION -extensa I-EXPLORATION -infiltración I-EXPLORATION -tumoral I-EXPLORATION -perineural I-EXPLORATION -con I-EXPLORATION -afectación I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -ganglios I-EXPLORATION -simpáticos I-EXPLORATION -del I-EXPLORATION -hilio I-EXPLORATION -renal. I-EXPLORATION +los I-EXPLORATION +reactantes I-EXPLORATION +de I-EXPLORATION +fase I-EXPLORATION +aguda. I-EXPLORATION La I-EXPLORATION -masa I-EXPLORATION -tumoral I-EXPLORATION -está I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -carcinoma I-EXPLORATION -escamoso, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -seno I-EXPLORATION +radiografía I-EXPLORATION +postero-anterior I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -cual, I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -un I-EXPLORATION -área I-EXPLORATION +tórax I-EXPLORATION +revelaba I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +nodular I-EXPLORATION de I-EXPLORATION -carcinoma I-EXPLORATION -urotelial I-EXPLORATION -papilar I-EXPLORATION -intraureteral. I-EXPLORATION -Se I-EXPLORATION -identifica I-EXPLORATION -metástasis I-EXPLORATION -del I-EXPLORATION -carcinoma I-EXPLORATION -en I-EXPLORATION -dos I-EXPLORATION +2, I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -cuatro I-EXPLORATION -ganglios I-EXPLORATION -linfáticos I-EXPLORATION -hiliares I-EXPLORATION -identificados I-EXPLORATION +diámetro I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -pieza. I-EXPLORATION -Los I-EXPLORATION -márgenes I-EXPLORATION -de I-EXPLORATION -resección I-EXPLORATION -quirúrgica I-EXPLORATION +hilio I-EXPLORATION +izquierdo, I-EXPLORATION +sugestiva I-EXPLORATION de I-EXPLORATION +adenopatía I-EXPLORATION +hiliar. I-EXPLORATION +Los I-EXPLORATION +hemocultivos I-EXPLORATION +y I-EXPLORATION +urocultivos I-EXPLORATION +fueron I-EXPLORATION +negativos, I-EXPLORATION la I-EXPLORATION -pieza, I-EXPLORATION -son I-EXPLORATION -negativos. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -linfadenectomía I-EXPLORATION -paraórtica I-EXPLORATION -se I-EXPLORATION -identifican I-EXPLORATION -6 I-EXPLORATION -ganglios I-EXPLORATION -linfáticos I-EXPLORATION -libres I-EXPLORATION +serología I-EXPLORATION +a I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION -infiltración I-EXPLORATION -neoplásica. I-EXPLORATION -En I-EXPLORATION -resumen, I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -anátomo-patológico I-EXPLORATION +Hepatitis I-EXPLORATION +A, I-EXPLORATION +B I-EXPLORATION +y I-EXPLORATION +C, I-EXPLORATION +borrelia, I-EXPLORATION +rickettsia I-EXPLORATION +conorii, I-EXPLORATION +coxiella, I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -es I-EXPLORATION +Epstein I-EXPLORATION +Barr, I-EXPLORATION +y I-EXPLORATION +citomegalovirus I-EXPLORATION +no I-EXPLORATION +aportaba I-EXPLORATION +datos I-EXPLORATION +concordantes I-EXPLORATION +con I-EXPLORATION +infección I-EXPLORATION +aguda. I-EXPLORATION +Los I-EXPLORATION +BAAR I-EXPLORATION +y I-EXPLORATION +cultivos I-EXPLORATION de I-EXPLORATION -carcinoma I-EXPLORATION -escamoso I-EXPLORATION -pobremente I-EXPLORATION -diferenciado I-EXPLORATION -originado I-EXPLORATION +esputo I-EXPLORATION en I-EXPLORATION -pelvis I-EXPLORATION -renal I-EXPLORATION +medios I-EXPLORATION +habituales I-EXPLORATION y I-EXPLORATION -uréter, I-EXPLORATION -categoría I-EXPLORATION -pT4pN2, I-EXPLORATION +el I-EXPLORATION +Mantoux I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +TC I-EXPLORATION +toraco-abdomino-pélvico I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -contexto I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +pusieron I-EXPLORATION de I-EXPLORATION -enfermedad I-EXPLORATION -renal I-EXPLORATION -poliquística I-EXPLORATION -autosómico-dominante I-EXPLORATION -(riñón I-EXPLORATION -poliquístico I-EXPLORATION -del I-EXPLORATION -adulto). I-EXPLORATION - B-TREATMENT -En I-TREATMENT -la I-TREATMENT -actualidad, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -sigue I-TREATMENT -tratamiento I-TREATMENT -oncológico. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -reseñables, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -macrohematuria I-PRESENT_ILLNESS -asintomática I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física, I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION +manifiesto I-EXPLORATION +adenopatías I-EXPLORATION +mediastínicas I-EXPLORATION de I-EXPLORATION -laboratorio, I-EXPLORATION -la I-EXPLORATION -citología I-EXPLORATION -urinaria I-EXPLORATION +tamaño I-EXPLORATION +significativo I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +paratraqueal I-EXPLORATION +derecho, I-EXPLORATION +pretraqueal I-EXPLORATION y I-EXPLORATION +perivascular I-EXPLORATION +e I-EXPLORATION +hiliar I-EXPLORATION +bilateral I-EXPLORATION +de I-EXPLORATION +naturaleza I-EXPLORATION +indeterminada. I-EXPLORATION +Adyacente I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -cistoscopia I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -urografía I-EXPLORATION -intravenosa I-EXPLORATION +cúpula I-EXPLORATION +diafragmática I-EXPLORATION +y I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +segmentos I-EXPLORATION +basales I-EXPLORATION +del I-EXPLORATION +LII, I-EXPLORATION se I-EXPLORATION -evidenciaba I-EXPLORATION -un I-EXPLORATION -efecto I-EXPLORATION -masa I-EXPLORATION -en I-EXPLORATION -polo I-EXPLORATION -inferior I-EXPLORATION +observó I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +pseudonodular I-EXPLORATION de I-EXPLORATION -riñón I-EXPLORATION -derecho, I-EXPLORATION +unos I-EXPLORATION +2, I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +anteroposterior, I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +inflamatorio, I-EXPLORATION +sin I-EXPLORATION +poderse I-EXPLORATION +descartar I-EXPLORATION +otras I-EXPLORATION +posibilidades. I-EXPLORATION +Ambas I-EXPLORATION +cisuras I-EXPLORATION +mayores I-EXPLORATION +presentaban I-EXPLORATION +aspecto I-EXPLORATION +engrosado I-EXPLORATION con I-EXPLORATION -desplazamiento I-EXPLORATION -craneal I-EXPLORATION -del I-EXPLORATION -sistema I-EXPLORATION -colector. I-EXPLORATION +pequeña I-EXPLORATION +cuña I-EXPLORATION +de I-EXPLORATION +líquido I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lado I-EXPLORATION +derecho. I-EXPLORATION I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +fibroboncoscopia I-EXPLORATION +con I-EXPLORATION +toma I-EXPLORATION +de I-EXPLORATION +broncoaspirado I-EXPLORATION +(BAS), I-EXPLORATION +lavado I-EXPLORATION +broncoalveolar I-EXPLORATION +(LBA), I-EXPLORATION +biopsia I-EXPLORATION +bronquial I-EXPLORATION +y I-EXPLORATION +transbronquial. I-EXPLORATION El I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -mostraba I-EXPLORATION +LBA I-EXPLORATION +revelo I-EXPLORATION una I-EXPLORATION -masa I-EXPLORATION -renal I-EXPLORATION -derecha I-EXPLORATION -heterogénea I-EXPLORATION +celularidad I-EXPLORATION de I-EXPLORATION -10 I-EXPLORATION -cm, I-EXPLORATION -en I-EXPLORATION -polo I-EXPLORATION -inferior, I-EXPLORATION +predominio I-EXPLORATION +linfocitario I-EXPLORATION con I-EXPLORATION -realce I-EXPLORATION -periférico, I-EXPLORATION -áreas I-EXPLORATION -hipodensas I-EXPLORATION -centrales I-EXPLORATION +un I-EXPLORATION +cociente I-EXPLORATION +CD4/CD8 I-EXPLORATION +> I-EXPLORATION +3, I-EXPLORATION +5 I-EXPLORATION y I-EXPLORATION -calcificaciones. I-EXPLORATION -Se I-EXPLORATION -observaban I-EXPLORATION -asimismo I-EXPLORATION -adenopatías I-EXPLORATION -látero-cava, I-EXPLORATION -retrocava I-EXPLORATION -e I-EXPLORATION -interaorto-cava, I-EXPLORATION -siendo I-EXPLORATION la I-EXPLORATION +biopsia I-EXPLORATION +bronquial I-EXPLORATION +y I-EXPLORATION +transbronquial I-EXPLORATION +reveló I-EXPLORATION +un I-EXPLORATION +epitelio I-EXPLORATION +respiratorio I-EXPLORATION +maduro, I-EXPLORATION +con I-EXPLORATION +glándulas I-EXPLORATION +mucosas I-EXPLORATION +y I-EXPLORATION +acúmulos I-EXPLORATION +linfoides I-EXPLORATION +aislados I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +lámina I-EXPLORATION +propia. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +encontraron I-EXPLORATION +elementos I-EXPLORATION +granulomatosos I-EXPLORATION +ni I-EXPLORATION +sugerentes I-EXPLORATION +de I-EXPLORATION +malignidad. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +mediastinoscopia I-EXPLORATION +con I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +adenopatía I-EXPLORATION +paratraqueal I-EXPLORATION +derecha I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +glanglio I-EXPLORATION +linfático I-EXPLORATION +ocupado I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION mayor I-EXPLORATION +parte I-EXPLORATION +por I-EXPLORATION +granulomas I-EXPLORATION de I-EXPLORATION -4 I-EXPLORATION -cm. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -practicó I-TREATMENT -nefrectomía I-TREATMENT -radical I-TREATMENT -derecha I-TREATMENT -y I-TREATMENT -linfadenectomía I-TREATMENT -retroperitoneal, I-TREATMENT -mediante I-TREATMENT -abordaje I-TREATMENT -abdominal I-TREATMENT -anterior. I-TREATMENT -El I-TREATMENT -estudio I-TREATMENT -anatomopatológico I-TREATMENT -reveló I-TREATMENT -la I-TREATMENT -existencia I-TREATMENT -de I-TREATMENT -un I-TREATMENT -adenocarcinoma I-TREATMENT -renal I-TREATMENT -de I-TREATMENT -células I-TREATMENT -claras I-TREATMENT -de I-TREATMENT -10, I-TREATMENT -5 I-TREATMENT -x I-TREATMENT -9 I-TREATMENT -cm I-TREATMENT -y I-TREATMENT -afectación I-TREATMENT -metastásica I-TREATMENT -de I-TREATMENT -9 I-TREATMENT -de I-TREATMENT -los I-TREATMENT -12 I-TREATMENT -ganglios I-TREATMENT -linfáticos I-TREATMENT -aislados, I-TREATMENT -cuyo I-TREATMENT -tamaño I-TREATMENT -oscilaba I-TREATMENT -entre I-TREATMENT -0, I-TREATMENT -3 I-TREATMENT -y I-TREATMENT -6 I-TREATMENT -cm. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -postoperatorio I-EVOLUTION -transcurrió I-EVOLUTION -con I-EVOLUTION -normalidad I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -4º I-EVOLUTION -día, I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -la I-EVOLUTION -salida I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -líquido I-EVOLUTION -lechoso I-EVOLUTION -y I-EVOLUTION -denso I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -catéter I-EVOLUTION -de I-EVOLUTION -drenaje. I-EVOLUTION -El B-EXPLORATION -cultivo I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -era I-EXPLORATION -estéril I-EXPLORATION +tipo I-EXPLORATION +sarcoideo, I-EXPLORATION +pequeños I-EXPLORATION y I-EXPLORATION -su I-EXPLORATION -análisis I-EXPLORATION -bioquímico I-EXPLORATION +coalescentes, I-EXPLORATION +con I-EXPLORATION +densa I-EXPLORATION +corona I-EXPLORATION +linfocitaria I-EXPLORATION y I-EXPLORATION -citológico I-EXPLORATION -era I-EXPLORATION +sin I-EXPLORATION +necrosis I-EXPLORATION +central, I-EXPLORATION +no I-EXPLORATION +objetivándose I-EXPLORATION +estructuras I-EXPLORATION +bacilares, I-EXPLORATION compatible I-EXPLORATION con I-EXPLORATION -quilo: I-EXPLORATION -pH: I-EXPLORATION -7, I-EXPLORATION -581, I-EXPLORATION -7600 I-EXPLORATION -células I-EXPLORATION -nucleadas/mm3 I-EXPLORATION -(82% I-EXPLORATION -mononucleares, I-EXPLORATION -18% I-EXPLORATION -polinucleares), I-EXPLORATION -colesterol: I-EXPLORATION -352 I-EXPLORATION -mg/dl, I-EXPLORATION -triglicéridos: I-EXPLORATION -3920 I-EXPLORATION -mg/dl. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -con I-EXPLORATION -Sudan I-EXPLORATION -III I-EXPLORATION -se I-EXPLORATION -visualizaban I-EXPLORATION -abundantes I-EXPLORATION -gotas I-EXPLORATION -de I-EXPLORATION -grasa I-EXPLORATION -neutra. I-EXPLORATION - I-EXPLORATION +linfadenitis I-EXPLORATION +granulomatosa, I-EXPLORATION +sarcoidosis. I-EXPLORATION Se I-EXPLORATION -realizó I-EXPLORATION -TAC I-EXPLORATION -abdominal, I-EXPLORATION -observando I-EXPLORATION +tomó I-EXPLORATION una I-EXPLORATION -colección I-EXPLORATION -líquida I-EXPLORATION +muestra I-EXPLORATION de I-EXPLORATION -10 I-EXPLORATION -cm I-EXPLORATION +piel, I-EXPLORATION +cuya I-EXPLORATION +histología I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +inflamatorio I-EXPLORATION en I-EXPLORATION -porción I-EXPLORATION -izquierda I-EXPLORATION -del I-EXPLORATION -mesenterio, I-EXPLORATION +tejido I-EXPLORATION +celular I-EXPLORATION +subcutáneo I-EXPLORATION +constituido I-EXPLORATION +por I-EXPLORATION +histiocitos, I-EXPLORATION +algunos I-EXPLORATION +con I-EXPLORATION +aspecto I-EXPLORATION +epitelioide, I-EXPLORATION +polimorfonucleares, I-EXPLORATION +neutrófilos I-EXPLORATION +y I-EXPLORATION +linfocitos I-EXPLORATION +aislados, I-EXPLORATION compatible I-EXPLORATION con I-EXPLORATION -linfocele. I-EXPLORATION +eritema I-EXPLORATION +nodoso. I-EXPLORATION +La I-EXPLORATION +espirometría I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +difusión I-EXPLORATION +pulmonar I-EXPLORATION +fueron I-EXPLORATION +normales I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +el I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo. I-EXPLORATION I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -ascitis I-TREATMENT -quilosa I-TREATMENT -se I-TREATMENT -instauró I-TREATMENT -tratamiento I-TREATMENT -consistente I-TREATMENT -en I-TREATMENT -suspensión I-TREATMENT -de I-TREATMENT -dieta I-TREATMENT -oral I-TREATMENT +Ante B-TREATMENT +los I-TREATMENT +hallazgos I-TREATMENT +clínicos I-TREATMENT y I-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -total. I-TREATMENT -Ante I-TREATMENT -el I-TREATMENT -incremento I-TREATMENT -del I-TREATMENT -débito I-TREATMENT -de I-TREATMENT la I-TREATMENT -fístula I-TREATMENT -quilosa I-TREATMENT -en I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -horas I-TREATMENT -siguientes I-TREATMENT -al I-TREATMENT -inicio I-TREATMENT -del I-TREATMENT -tratamiento, I-TREATMENT +biopsia I-TREATMENT +compatible I-TREATMENT +con I-TREATMENT +granuloma I-TREATMENT +sarcoideo I-TREATMENT se I-TREATMENT -añadió I-TREATMENT -octreótide I-TREATMENT -(0, I-TREATMENT -1 I-TREATMENT -mg/8h, I-TREATMENT -subcutáneo), I-TREATMENT -observándose I-TREATMENT -un I-TREATMENT -descenso I-TREATMENT -manifiesto I-TREATMENT -del I-TREATMENT -drenaje I-TREATMENT -quiloso. I-TREATMENT +instauró I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +corticoides. I-TREATMENT I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -linfografía I-EXPLORATION -isotópica I-EXPLORATION -(99mTc) I-EXPLORATION + +Un B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +61 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +emesis I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +algunos I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +arcadas. I-PRESENT_ILLNESS +Tenía B-PAST_MEDICAL_HISTORY +cirrosis I-PAST_MEDICAL_HISTORY +hepática I-PAST_MEDICAL_HISTORY +pero I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +hemorragias I-PAST_MEDICAL_HISTORY +previas. I-PAST_MEDICAL_HISTORY +Una B-EXPLORATION +endoscopia I-EXPLORATION +alta I-EXPLORATION +reveló I-EXPLORATION +un I-EXPLORATION +desgarro I-EXPLORATION +amplio I-EXPLORATION +de I-EXPLORATION +10 I-EXPLORATION +cm I-EXPLORATION +que I-EXPLORATION +afectaba I-EXPLORATION a I-EXPLORATION -los I-EXPLORATION -12 I-EXPLORATION +la I-EXPLORATION +mucosa I-EXPLORATION y I-EXPLORATION -24 I-EXPLORATION -días I-EXPLORATION -del I-EXPLORATION -inicio I-EXPLORATION -de I-EXPLORATION la I-EXPLORATION -fístula, I-EXPLORATION -observando I-EXPLORATION +submucosa I-EXPLORATION +del I-EXPLORATION +esófago I-EXPLORATION +distal, I-EXPLORATION +respetando I-EXPLORATION un I-EXPLORATION -acúmulo I-EXPLORATION +segmento I-EXPLORATION de I-EXPLORATION -trazador I-EXPLORATION -medial I-EXPLORATION -a I-EXPLORATION -cadena I-EXPLORATION -ilíaca I-EXPLORATION -derecha, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -linfonodo, I-EXPLORATION -sin I-EXPLORATION -objetivarse I-EXPLORATION -fuga I-EXPLORATION -linfática I-EXPLORATION -alguna. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -TAC I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -control, I-EXPLORATION -tras I-EXPLORATION -9 I-EXPLORATION -días I-EXPLORATION -sin I-EXPLORATION -débito I-EXPLORATION -fistuloso, I-EXPLORATION -se I-EXPLORATION -comprobó I-EXPLORATION +largo I-EXPLORATION +proximal I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -persistencia I-EXPLORATION -del I-EXPLORATION -quilocele I-EXPLORATION -retroperitoneal, I-EXPLORATION -procediendo B-TREATMENT -a I-TREATMENT -realizar I-TREATMENT -drenaje I-TREATMENT -TAC-dirigido I-TREATMENT -del I-TREATMENT -mismo. I-TREATMENT -El I-TREATMENT -drenaje I-TREATMENT +línea I-EXPLORATION +Z. I-EXPLORATION +La B-TREATMENT +laceración I-TREATMENT +presentaba I-TREATMENT +una I-TREATMENT +hemorragia I-TREATMENT +rezumante I-TREATMENT +lenta I-TREATMENT +que I-TREATMENT +se I-TREATMENT +detuvo I-TREATMENT +con I-TREATMENT +la I-TREATMENT +inyección I-TREATMENT +de I-TREATMENT +6 I-TREATMENT +cc I-TREATMENT de I-TREATMENT +adrenalina I-TREATMENT +al I-TREATMENT +1: I-TREATMENT +10000 I-TREATMENT +y I-TREATMENT la I-TREATMENT -colección I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -hasta I-TREATMENT -los I-TREATMENT -7 I-TREATMENT -días, I-TREATMENT -tras I-TREATMENT -4 I-TREATMENT +aplicación I-TREATMENT +de I-TREATMENT +17 I-TREATMENT +endoclips I-TREATMENT +para I-TREATMENT +cerrar I-TREATMENT +la I-TREATMENT +laceración. I-TREATMENT +La I-TREATMENT +recurrencia I-TREATMENT +de I-TREATMENT +la I-TREATMENT +hemorragia I-TREATMENT +8 I-TREATMENT días I-TREATMENT -sin I-TREATMENT -débito. I-TREATMENT - I-TREATMENT -El I-TREATMENT -paciente I-TREATMENT -permaneció I-TREATMENT -en I-TREATMENT -dieta I-TREATMENT -absoluta I-TREATMENT -y I-TREATMENT -con I-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -total I-TREATMENT -durante I-TREATMENT -15 I-TREATMENT -días. I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -octreótide I-TREATMENT +después I-TREATMENT se I-TREATMENT -mantuvo I-TREATMENT -22 I-TREATMENT -días. I-TREATMENT - I-TREATMENT -Cinco B-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -quirúrgica I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -permanece I-EVOLUTION -clínica I-EVOLUTION +controló I-TREATMENT +con I-TREATMENT +la I-TREATMENT +aplicación I-TREATMENT +de I-TREATMENT +otros I-TREATMENT +4 I-TREATMENT +endoclips. I-TREATMENT +No B-EVOLUTION +hubo I-EVOLUTION +ninguna I-EVOLUTION +otra I-EVOLUTION +recurrencia I-EVOLUTION +hemorrágica I-EVOLUTION y I-EVOLUTION -radiológicamente I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION +se I-EVOLUTION +repitió I-EVOLUTION +la I-EVOLUTION +endoscopia I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +semana I-EVOLUTION +6 I-EVOLUTION y I-EVOLUTION -sin I-EVOLUTION -evidencia I-EVOLUTION -de I-EVOLUTION -fuga I-EVOLUTION -quilosa. I-EVOLUTION +la I-EVOLUTION +semana I-EVOLUTION +24, I-EVOLUTION +no I-EVOLUTION +observándose I-EVOLUTION +lesión I-EVOLUTION +alguna. I-EVOLUTION I-EVOLUTION Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS sexo I-PRESENT_ILLNESS masculino, I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -presentando B-PAST_MEDICAL_HISTORY +55 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -atraso I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -desarrollo I-PAST_MEDICAL_HISTORY -psico-motor, I-PAST_MEDICAL_HISTORY -trombocitopenia I-PAST_MEDICAL_HISTORY -auto-inmune, I-PAST_MEDICAL_HISTORY -neumonía I-PAST_MEDICAL_HISTORY -linfocítica I-PAST_MEDICAL_HISTORY -granulomatosa I-PAST_MEDICAL_HISTORY -difusa, I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -anti-fosfolipídeo, I-PAST_MEDICAL_HISTORY -esplenomegalia, I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -central, I-PAST_MEDICAL_HISTORY -soriasis I-PAST_MEDICAL_HISTORY -inversa I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -psicosis. I-PAST_MEDICAL_HISTORY -Medicado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -alendronato I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sodio, I-PAST_MEDICAL_HISTORY -haloperidol, I-PAST_MEDICAL_HISTORY -lorazepam, I-PAST_MEDICAL_HISTORY -trihexifenidilo, I-PAST_MEDICAL_HISTORY -omeprazol, I-PAST_MEDICAL_HISTORY -carbonato I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -calcio I-PAST_MEDICAL_HISTORY +tabaquismo I-PAST_MEDICAL_HISTORY +crónico I-PAST_MEDICAL_HISTORY +detenido I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -hierro I-PAST_MEDICAL_HISTORY -oral. I-PAST_MEDICAL_HISTORY -Enviado B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS +flegmón I-PAST_MEDICAL_HISTORY +apendicular I-PAST_MEDICAL_HISTORY +operado I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +40 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Dos B-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -urología I-PRESENT_ILLNESS +consultar I-PRESENT_ILLNESS +inició I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +difuso, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -genitales I-PRESENT_ILLNESS -externos. I-PRESENT_ILLNESS -Refería I-PRESENT_ILLNESS -tumefacción I-PRESENT_ILLNESS -generalizada I-PRESENT_ILLNESS +predominio I-PRESENT_ILLNESS +vespertino, I-PRESENT_ILLNESS +postprandiales I-PRESENT_ILLNESS +mediatos I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -difusa I-PRESENT_ILLNESS +baja I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -piel I-PRESENT_ILLNESS -escrotal, I-PRESENT_ILLNESS -condicionando I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -miccional, I-PRESENT_ILLNESS +15 I-PRESENT_ILLNESS +kilos I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -marcha I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -higiene I-PRESENT_ILLNESS -deficiente. I-PRESENT_ILLNESS -Negaba B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -quirúrgicos I-PAST_MEDICAL_HISTORY -genitales, I-PAST_MEDICAL_HISTORY -inguinales I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -pélvicos. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -radioterapia I-PAST_MEDICAL_HISTORY -inguinal I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -pélvica. I-PAST_MEDICAL_HISTORY -Negaba I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -países I-PAST_MEDICAL_HISTORY -asociados I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -filariosis I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -cuadros I-PAST_MEDICAL_HISTORY -compatibles I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -erisipela I-PAST_MEDICAL_HISTORY -inguinal/genital. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -objetivo I-EXPLORATION -presentaba I-EXPLORATION -marcado I-EXPLORATION -espesamiento I-EXPLORATION -de I-EXPLORATION +peso I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +este I-PRESENT_ILLNESS +período. I-PRESENT_ILLNESS +La B-EXPLORATION +endoscopía I-EXPLORATION +digestiva I-EXPLORATION +alta I-EXPLORATION +mostró I-EXPLORATION la I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -túnicas I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -genitales I-EXPLORATION -externos, I-EXPLORATION -endurecido, I-EXPLORATION -indoloro, I-EXPLORATION +pliegues I-EXPLORATION +gástricos I-EXPLORATION +prominentes I-EXPLORATION +en I-EXPLORATION +forma I-EXPLORATION +difusa, I-EXPLORATION +lesiones I-EXPLORATION +solevantadas I-EXPLORATION +sésiles I-EXPLORATION +con I-EXPLORATION +ulceración I-EXPLORATION +central I-EXPLORATION de I-EXPLORATION -límites I-EXPLORATION -mal I-EXPLORATION -definidos, I-EXPLORATION -envolviendo I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -circunferencia I-EXPLORATION +fondo I-EXPLORATION +rojo I-EXPLORATION y I-EXPLORATION -hasta I-EXPLORATION -peniana, I-EXPLORATION -mimetizando I-EXPLORATION -edema I-EXPLORATION -penoescrotal I-EXPLORATION -masivo. I-EXPLORATION -Aparentemente I-EXPLORATION -las I-EXPLORATION -porciones I-EXPLORATION -dorsales I-EXPLORATION +lesiones I-EXPLORATION +ulceradas I-EXPLORATION +duodenales, I-EXPLORATION +con I-EXPLORATION +test I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -escrotal I-EXPLORATION -no I-EXPLORATION -estaban I-EXPLORATION -envueltas I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -proceso. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -las I-EXPLORATION -túnicas I-EXPLORATION -eran I-EXPLORATION -perfectamente I-EXPLORATION -móviles I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -planos I-EXPLORATION -profundos, I-EXPLORATION -tales I-EXPLORATION +ureasa I-EXPLORATION +positivo. I-EXPLORATION +Se I-EXPLORATION +realizaron I-EXPLORATION +biopsias I-EXPLORATION +informadas I-EXPLORATION como I-EXPLORATION -los I-EXPLORATION -cuerpos I-EXPLORATION -cavernosos I-EXPLORATION +gastritis I-EXPLORATION +crónica I-EXPLORATION +inespecífica I-EXPLORATION y I-EXPLORATION -glande, I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -presentaban I-EXPLORATION -alteraciones. I-EXPLORATION -Adicionalmente I-EXPLORATION -presentaba I-EXPLORATION -lesiones I-EXPLORATION +duodenitis. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -tipo I-EXPLORATION -psoriásico I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -interna I-EXPLORATION +laboratorio I-EXPLORATION +mostró: I-EXPLORATION +GOT I-EXPLORATION +50 I-EXPLORATION +UI/L, I-EXPLORATION +GPT I-EXPLORATION +56 I-EXPLORATION +UI/L, I-EXPLORATION +GGT I-EXPLORATION +85 I-EXPLORATION +UI/L, I-EXPLORATION +FA I-EXPLORATION +81 I-EXPLORATION +UI/L, I-EXPLORATION +hematocrito I-EXPLORATION +55%, I-EXPLORATION +tiempo I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -muslos I-EXPLORATION +protrombina I-EXPLORATION +100%, I-EXPLORATION +creatininemia I-EXPLORATION +1, I-EXPLORATION +2 I-EXPLORATION +g/dL, I-EXPLORATION +calcio I-EXPLORATION +total I-EXPLORATION +7, I-EXPLORATION +8 I-EXPLORATION +mg/ I-EXPLORATION +dL, I-EXPLORATION +proteinemia I-EXPLORATION +4, I-EXPLORATION +4 I-EXPLORATION +g/dL, I-EXPLORATION +albuminemia I-EXPLORATION +2, I-EXPLORATION +3 I-EXPLORATION +g/dL I-EXPLORATION y I-EXPLORATION -peri-umbilical, I-EXPLORATION -con I-EXPLORATION -aspectos I-EXPLORATION +LDH I-EXPLORATION +229 I-EXPLORATION +UI/ml. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +ecotomografía I-EXPLORATION +abdominal I-EXPLORATION +se I-EXPLORATION +informó I-EXPLORATION +esteatosis I-EXPLORATION +hepática. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +indicó I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +erradicación I-TREATMENT +para I-TREATMENT +Helicobacter I-TREATMENT +pylori I-TREATMENT +durante I-TREATMENT +14 I-TREATMENT +días, I-TREATMENT +observándose B-EVOLUTION +la I-EVOLUTION +persistencia I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +vómitos, I-EVOLUTION +con I-EVOLUTION +intolerancia I-EVOLUTION +a I-EVOLUTION +alimentación I-EVOLUTION +oral, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +decidió I-EVOLUTION +hospitalizar I-EVOLUTION +para I-EVOLUTION +manejo I-EVOLUTION +nutricional I-EVOLUTION +y I-EVOLUTION +realización I-EVOLUTION +de I-EVOLUTION +macrobiopsias I-EVOLUTION +gástricas. I-EVOLUTION + I-EVOLUTION +A B-EXPLORATION +su I-EXPLORATION +ingreso I-EXPLORATION +al I-EXPLORATION +servicio I-EXPLORATION de I-EXPLORATION -maceración I-EXPLORATION -y I-EXPLORATION -exudado I-EXPLORATION -importantes. I-EXPLORATION -La I-EXPLORATION -palpación I-EXPLORATION +Gastroenterología I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -regiones I-EXPLORATION -inguinales I-EXPLORATION -no I-EXPLORATION -ponía I-EXPLORATION -en I-EXPLORATION -evidencia I-EXPLORATION -adenopatías I-EXPLORATION -sospechosas. I-EXPLORATION -Miembros I-EXPLORATION -inferiores I-EXPLORATION -sin I-EXPLORATION -edemas. I-EXPLORATION -Tacto I-EXPLORATION -rectal I-EXPLORATION +nuestro I-EXPLORATION +Hospital I-EXPLORATION +destacaba I-EXPLORATION +paciente I-EXPLORATION +con I-EXPLORATION +hemodinamia I-EXPLORATION +estable, I-EXPLORATION +afebril, I-EXPLORATION +mesomorfo, I-EXPLORATION sin I-EXPLORATION -masas I-EXPLORATION -anormales. I-EXPLORATION +edema, I-EXPLORATION +ni I-EXPLORATION +palidez. I-EXPLORATION Sin I-EXPLORATION -adenopatías I-EXPLORATION -periféricas. I-EXPLORATION +signos I-EXPLORATION +carenciales I-EXPLORATION +en I-EXPLORATION +piel, I-EXPLORATION +mucosas I-EXPLORATION +ni I-EXPLORATION +fanéreos. I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +confirmaron I-EXPLORATION +proteínas I-EXPLORATION +totales I-EXPLORATION +3, I-EXPLORATION +5 I-EXPLORATION +g/dL, I-EXPLORATION +albuminemia I-EXPLORATION +1, I-EXPLORATION +9 I-EXPLORATION +g/dL, I-EXPLORATION +proteinuria I-EXPLORATION +negativa I-EXPLORATION +y I-EXPLORATION +hemograma I-EXPLORATION +sin I-EXPLORATION +alteraciones. I-EXPLORATION I-EXPLORATION -En I-EXPLORATION -términos I-EXPLORATION -analíticos I-EXPLORATION -únicamente I-EXPLORATION -era I-EXPLORATION -notoria I-EXPLORATION -una I-EXPLORATION -trombocitopenia I-EXPLORATION -discreta I-EXPLORATION -(123.000/mL), I-EXPLORATION -no I-EXPLORATION -registrándose I-EXPLORATION -cualquier I-EXPLORATION -otra I-EXPLORATION -alteración I-EXPLORATION -como I-EXPLORATION -leucocitosis I-EXPLORATION -o I-EXPLORATION -eosinofília. I-EXPLORATION +Evolución I-EXPLORATION +y I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +posteriores I-EXPLORATION I-EXPLORATION -Para I-EXPLORATION -descartar I-EXPLORATION -neoformaciones/adenopatías I-EXPLORATION -pélvicas I-EXPLORATION -o I-EXPLORATION -inguinales, I-EXPLORATION -fue I-EXPLORATION -pedido I-EXPLORATION -TAC I-EXPLORATION -pélvico I-EXPLORATION +Se I-EXPLORATION +efectúa I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computada I-EXPLORATION +(TAC) I-EXPLORATION +de I-EXPLORATION +abdomen-pelvis I-EXPLORATION que I-EXPLORATION -no I-EXPLORATION -reveló I-EXPLORATION -cualquier I-EXPLORATION -anomalía, I-EXPLORATION -excepto I-EXPLORATION -un I-EXPLORATION -marcadísimo I-EXPLORATION -espesamiento I-EXPLORATION +muestra I-EXPLORATION +pliegues I-EXPLORATION +gástricos I-EXPLORATION +prominentes, I-EXPLORATION +enteroclisis I-EXPLORATION +por I-EXPLORATION +TAC I-EXPLORATION +informó I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -túnicas I-EXPLORATION -genitales. I-EXPLORATION +lesiones I-EXPLORATION +radiológicas I-EXPLORATION +en I-EXPLORATION +intestino I-EXPLORATION +delgado. I-EXPLORATION I-EXPLORATION -Sin I-EXPLORATION -antecedentes I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +endoscopía I-EXPLORATION +digestiva I-EXPLORATION +alta I-EXPLORATION que I-EXPLORATION -permitieran I-EXPLORATION -orientar I-EXPLORATION -para I-EXPLORATION -otro I-EXPLORATION -tipo I-EXPLORATION +mostró I-EXPLORATION +pliegues I-EXPLORATION +gástricos I-EXPLORATION +difusamente I-EXPLORATION +engrosados, I-EXPLORATION +algunos I-EXPLORATION +erosionados, I-EXPLORATION +test I-EXPLORATION de I-EXPLORATION -diagnóstico, I-EXPLORATION -fue I-EXPLORATION -adelantado I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +ureasa I-EXPLORATION +negativo. I-EXPLORATION +Las I-EXPLORATION +biopsias I-EXPLORATION +fueron I-EXPLORATION +informadas I-EXPLORATION +como I-EXPLORATION +mucosa I-EXPLORATION +gástrica I-EXPLORATION +con I-EXPLORATION +hiperplasia I-EXPLORATION +foveolar I-EXPLORATION +difusa, I-EXPLORATION +asociada I-EXPLORATION +a I-EXPLORATION +atrofia I-EXPLORATION +glandular I-EXPLORATION +con I-EXPLORATION +dilataciones I-EXPLORATION +quísticas I-EXPLORATION +y I-EXPLORATION +células I-EXPLORATION +mucinosas. I-EXPLORATION +Erosión I-EXPLORATION +epitelial I-EXPLORATION +superficial I-EXPLORATION +focal I-EXPLORATION +con I-EXPLORATION +acúmulos I-EXPLORATION de I-EXPLORATION -linfedema I-EXPLORATION -idiopático I-EXPLORATION -genital, I-EXPLORATION -en I-EXPLORATION -este I-EXPLORATION -caso I-EXPLORATION -linfedema I-EXPLORATION -praecox, I-EXPLORATION -dada I-EXPLORATION -la I-EXPLORATION -edad I-EXPLORATION +leucocitos I-EXPLORATION +polimorfonucleares, I-EXPLORATION +lámina I-EXPLORATION +propia I-EXPLORATION +con I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION +escaso I-EXPLORATION de I-EXPLORATION -presentación. I-EXPLORATION +predominio I-EXPLORATION +linfoplasmocitario, I-EXPLORATION +con I-EXPLORATION +algunos I-EXPLORATION +eosinófilos. I-EXPLORATION I-EXPLORATION -Con B-TREATMENT +Se I-EXPLORATION +complementó I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +endosonografía I-EXPLORATION +demostrándose I-EXPLORATION +engrosamiento I-EXPLORATION +gástrico I-EXPLORATION +a I-EXPLORATION +expensas I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +mucosa I-EXPLORATION +profunda I-EXPLORATION +y I-EXPLORATION +áreas I-EXPLORATION +quísticas. I-EXPLORATION + I-EXPLORATION +Ante B-TREATMENT la I-TREATMENT -intención I-TREATMENT +extensión I-TREATMENT de I-TREATMENT -mejorar I-TREATMENT +la I-TREATMENT +lesión, I-TREATMENT el I-TREATMENT -trofismo I-TREATMENT +riesgo I-TREATMENT de I-TREATMENT -la I-TREATMENT -piel I-TREATMENT -circundante I-TREATMENT +transformación I-TREATMENT +neoplásica I-TREATMENT y I-TREATMENT la I-TREATMENT -sintomatología I-TREATMENT -urinaria, I-TREATMENT -fue I-TREATMENT -colocada I-TREATMENT -cistostomía I-TREATMENT -percutánea I-TREATMENT -y I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -terapéutica I-TREATMENT -antibiótica I-TREATMENT -y I-TREATMENT -anti-fúngica I-TREATMENT -durante I-TREATMENT -dos I-TREATMENT -semanas. I-TREATMENT +no I-TREATMENT +disponibilidad I-TREATMENT +de I-TREATMENT +cetuximab, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +tratamiento I-TREATMENT +quirúrgico. I-TREATMENT Se B-EVOLUTION -verificó I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -acentuada I-EVOLUTION +solicitó I-EVOLUTION +evaluación I-EVOLUTION +por I-EVOLUTION +el I-EVOLUTION +equipo I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -cutáneas I-EVOLUTION -exudativas, I-EVOLUTION -sin I-EVOLUTION -modificación I-EVOLUTION +nutrición, I-EVOLUTION +demostrándose I-EVOLUTION +preal-búmina, I-EVOLUTION +niveles I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -áreas I-EVOLUTION -propiamente I-EVOLUTION -afectadas I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION -En B-TREATMENT -ese I-TREATMENT -momento I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -de I-TREATMENT -la I-TREATMENT -situación. I-TREATMENT -Este I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -toda I-TREATMENT -la I-TREATMENT -piel I-TREATMENT -macroscópicamente I-TREATMENT -afectada, I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -injertos I-TREATMENT -cutáneos I-TREATMENT -para I-TREATMENT -cobertura I-TREATMENT -de I-TREATMENT -la I-TREATMENT -hasta I-TREATMENT -peniana I-TREATMENT -y I-TREATMENT -confección I-TREATMENT -de I-TREATMENT -neo-escroto I-TREATMENT +vitamina I-EVOLUTION +B12 I-EVOLUTION +y I-EVOLUTION +folato I-EVOLUTION +eritrocitario I-EVOLUTION +dentro I-EVOLUTION +de I-EVOLUTION +rangos I-EVOLUTION +normales. I-EVOLUTION +Se B-TREATMENT +controlaron I-TREATMENT +los I-TREATMENT +vómitos I-TREATMENT con I-TREATMENT -colgajos I-TREATMENT -cutáneos I-TREATMENT -de I-TREATMENT -piel I-TREATMENT -vecina. I-TREATMENT -En I-TREATMENT -primer I-TREATMENT -lugar I-TREATMENT -fue I-TREATMENT -realizada I-TREATMENT -una I-TREATMENT -circuncisión, I-TREATMENT -seguida I-TREATMENT -de I-TREATMENT -incisión I-TREATMENT -peniana I-TREATMENT -dorsal I-TREATMENT -longitudinal I-TREATMENT -de I-TREATMENT -la I-TREATMENT -piel I-TREATMENT -y I-TREATMENT -túnicas I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -profundidad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fáscia I-TREATMENT -de I-TREATMENT -Buck, I-TREATMENT +ondasentron, I-TREATMENT +logrando I-TREATMENT +ingesta I-TREATMENT +oral I-TREATMENT +adecuada, I-TREATMENT +se I-TREATMENT +apoyó I-TREATMENT con I-TREATMENT -disección I-TREATMENT -circunferencial I-TREATMENT -de I-TREATMENT -la I-TREATMENT -totalidad I-TREATMENT -del I-TREATMENT -hasta I-TREATMENT -peniana I-TREATMENT -llegando I-TREATMENT -a I-TREATMENT +nutrición I-TREATMENT +parenteral I-TREATMENT +por I-TREATMENT +7 I-TREATMENT +días I-TREATMENT +con I-TREATMENT +lo I-TREATMENT +cual I-TREATMENT +aumentó I-TREATMENT la I-TREATMENT -base I-TREATMENT -del I-TREATMENT -pene. I-TREATMENT -A I-TREATMENT -continuación I-TREATMENT -fue I-TREATMENT -realizada I-TREATMENT -una I-TREATMENT -incisión I-TREATMENT -arciforme I-TREATMENT +albuminemia I-TREATMENT a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -ambas I-TREATMENT -regiones I-TREATMENT -inguinales, I-TREATMENT -teniendo I-TREATMENT -como I-TREATMENT -centro I-TREATMENT -la I-TREATMENT -base I-TREATMENT -del I-TREATMENT -pene. I-TREATMENT +2, I-TREATMENT +3 I-TREATMENT +gr/dl. I-TREATMENT A I-TREATMENT -partir I-TREATMENT -de I-TREATMENT -la I-TREATMENT -misma I-TREATMENT -fueron I-TREATMENT -aislados I-TREATMENT los I-TREATMENT -cordones I-TREATMENT -inguinales, I-TREATMENT -exteriorizados I-TREATMENT -los I-TREATMENT -testículos I-TREATMENT -y I-TREATMENT -realizada I-TREATMENT -inversión I-TREATMENT -de I-TREATMENT -la I-TREATMENT -túnica I-TREATMENT -vaginal. I-TREATMENT -Bajo I-TREATMENT -control I-TREATMENT -de I-TREATMENT -todas I-TREATMENT -las I-TREATMENT -estructuras I-TREATMENT -importantes, I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -piel I-TREATMENT -afectada. I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -que I-TREATMENT -la I-TREATMENT -porción I-TREATMENT -dorsal I-TREATMENT -de I-TREATMENT -la I-TREATMENT -piel I-TREATMENT -escrotal I-TREATMENT -no I-TREATMENT -se I-TREATMENT -encontraba I-TREATMENT -aparentemente I-TREATMENT -afectada I-TREATMENT -(como I-TREATMENT -de I-TREATMENT -resto I-TREATMENT -es I-TREATMENT -típico I-TREATMENT -en I-TREATMENT -las I-TREATMENT -situaciones I-TREATMENT -de I-TREATMENT -linfedema), I-TREATMENT -esta I-TREATMENT -no I-TREATMENT -fue I-TREATMENT -retirada, I-TREATMENT -permitiendo I-TREATMENT -tener I-TREATMENT -así I-TREATMENT -piel I-TREATMENT -suficiente I-TREATMENT -para I-TREATMENT -confeccionar I-TREATMENT -un I-TREATMENT -neo-escroto I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -la I-TREATMENT -rotación I-TREATMENT -anterior I-TREATMENT -de I-TREATMENT -la I-TREATMENT -misma. I-TREATMENT -Las I-TREATMENT -incisiones I-TREATMENT -inguinales I-TREATMENT -y I-TREATMENT -el I-TREATMENT -escroto I-TREATMENT -fueron I-TREATMENT -cerrados I-TREATMENT -después I-TREATMENT -de I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT +14 I-TREATMENT +días I-TREATMENT de I-TREATMENT -drenos I-TREATMENT -aspirativos. I-TREATMENT -Para I-TREATMENT -cobertura I-TREATMENT -del I-TREATMENT -hasta I-TREATMENT -peniana I-TREATMENT +su I-TREATMENT +ingreso I-TREATMENT se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -recogida I-TREATMENT -de I-TREATMENT -injertos I-TREATMENT -cutáneos I-TREATMENT -de I-TREATMENT -piel I-TREATMENT -parcial I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -del I-TREATMENT -muslo I-TREATMENT -que I-TREATMENT -fueron I-TREATMENT -colocados I-TREATMENT -directamente I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -fascia I-TREATMENT -de I-TREATMENT -Buck, I-TREATMENT -en I-TREATMENT -disposición I-TREATMENT -helicoidal. I-TREATMENT -Los I-TREATMENT -drenos I-TREATMENT -fueron I-TREATMENT -retirados I-TREATMENT -el I-TREATMENT -segundo I-TREATMENT -día I-TREATMENT -postoperatorio I-TREATMENT -y I-TREATMENT -el I-TREATMENT -apósito I-TREATMENT -compresivo I-TREATMENT -el I-TREATMENT -quinto I-TREATMENT -día I-TREATMENT -verificándose I-TREATMENT -viabilidad I-TREATMENT -total I-TREATMENT -del I-TREATMENT -material I-TREATMENT -injertado. I-TREATMENT - I-TREATMENT -Durante I-TREATMENT -el I-TREATMENT -acto I-TREATMENT -quirúrgico I-TREATMENT -era I-TREATMENT -notoria I-TREATMENT -la I-TREATMENT -consistencia I-TREATMENT -gelatinosa I-TREATMENT -acentuada I-TREATMENT -de I-TREATMENT -las I-TREATMENT -túnicas, I-TREATMENT -con I-TREATMENT -aparente I-TREATMENT -aspecto I-TREATMENT -translúcido I-TREATMENT -y I-TREATMENT -exudación I-TREATMENT -acentuada. I-TREATMENT -La I-TREATMENT -pieza I-TREATMENT -quirúrgica I-TREATMENT -comprendiendo I-TREATMENT -piel I-TREATMENT -peniana I-TREATMENT -y I-TREATMENT -escrotal I-TREATMENT -afectada I-TREATMENT -totalizaba I-TREATMENT -1, I-TREATMENT -05 I-TREATMENT -Kg. I-TREATMENT -El B-EXPLORATION -resultado I-EXPLORATION -anatomo-patológico I-EXPLORATION -puso I-EXPLORATION -en I-EXPLORATION -evidencia I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -mixoide I-EXPLORATION -hipocelular I-EXPLORATION +realizó I-TREATMENT +una I-TREATMENT +gastrectomía I-TREATMENT +total, I-TREATMENT +sin I-TREATMENT +incidentes I-TREATMENT +y B-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +en I-EVOLUTION +forma I-EVOLUTION +favorable. I-EVOLUTION + I-EVOLUTION +En B-EXPLORATION +el I-EXPLORATION +análisis I-EXPLORATION +macroscópico I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +operatoria I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +pared I-EXPLORATION +gástrica I-EXPLORATION +de I-EXPLORATION +espesor I-EXPLORATION +engrosado I-EXPLORATION +homogéneamente, I-EXPLORATION +mucosa I-EXPLORATION con I-EXPLORATION -abundante I-EXPLORATION -estroma I-EXPLORATION -y I-EXPLORATION -células I-EXPLORATION -fusiformes, I-EXPLORATION +pliegues I-EXPLORATION +difusamente I-EXPLORATION +engrosados, I-EXPLORATION +congestivos, I-EXPLORATION +algunos I-EXPLORATION con I-EXPLORATION -ausencia I-EXPLORATION +erosión I-EXPLORATION +superficial; I-EXPLORATION +rodete I-EXPLORATION +duodenal I-EXPLORATION de I-EXPLORATION -atipia I-EXPLORATION -celular I-EXPLORATION -y I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +centímetros I-EXPLORATION de I-EXPLORATION -mitosis, I-EXPLORATION -infiltrante I-EXPLORATION -y I-EXPLORATION +diámetro, I-EXPLORATION con I-EXPLORATION -componente I-EXPLORATION -prominente I-EXPLORATION +lesión I-EXPLORATION +polipoide I-EXPLORATION de I-EXPLORATION -vasos I-EXPLORATION +1 I-EXPLORATION +centímetro I-EXPLORATION de I-EXPLORATION -calibre I-EXPLORATION -variado I-EXPLORATION +eje I-EXPLORATION +mayor. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +histología I-EXPLORATION +se I-EXPLORATION +confirmaron I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +descritos I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +biopsias I-EXPLORATION +endoscópicas, I-EXPLORATION +con I-EXPLORATION +compromiso I-EXPLORATION +gástrico I-EXPLORATION +difuso, I-EXPLORATION y I-EXPLORATION -ectasiados. I-EXPLORATION -Inmunohistoquímica: I-EXPLORATION -vimentina I-EXPLORATION -+; I-EXPLORATION -CD I-EXPLORATION -34 I-EXPLORATION -+; I-EXPLORATION -desmina I-EXPLORATION -e I-EXPLORATION -actina I-EXPLORATION -negativos. I-EXPLORATION -Conclusión: I-EXPLORATION -aspectos I-EXPLORATION -compatibles I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +duodeno I-EXPLORATION +en I-EXPLORATION +zona I-EXPLORATION +descrita I-EXPLORATION +de I-EXPLORATION +lesión I-EXPLORATION +polipoide I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +metaplasia I-EXPLORATION +fúndica I-EXPLORATION +focal I-EXPLORATION +con I-EXPLORATION +hiperplasia I-EXPLORATION +foveolar I-EXPLORATION +y I-EXPLORATION +atrofia I-EXPLORATION +glandular, I-EXPLORATION +con I-EXPLORATION +dilatación I-EXPLORATION +quística I-EXPLORATION +y I-EXPLORATION +células I-EXPLORATION +mucinosas. I-EXPLORATION +Se I-EXPLORATION +concluyó I-EXPLORATION +enfermedad I-EXPLORATION +de I-EXPLORATION +Ménétrier I-EXPLORATION +gástrica I-EXPLORATION +difusa I-EXPLORATION con I-EXPLORATION -angiomixoma I-EXPLORATION -agresivo. I-EXPLORATION +compromiso I-EXPLORATION +duodenal I-EXPLORATION +focal. I-EXPLORATION I-EXPLORATION -Después B-EVOLUTION -de I-EVOLUTION -13 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -bien, I-EVOLUTION -sin I-EVOLUTION -evidencia I-EVOLUTION -clínica I-EVOLUTION -de I-EVOLUTION -recidiva I-EVOLUTION -y I-EVOLUTION -satisfecho I-EVOLUTION -del I-EVOLUTION -punto I-EVOLUTION -de I-EVOLUTION -vista I-EVOLUTION -estético. I-EVOLUTION - I-EVOLUTION -Hombre B-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +pancreatitis I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +calcificante I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +reagudizaciones I-PAST_MEDICAL_HISTORY +frecuentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +origen I-PAST_MEDICAL_HISTORY +enólico. I-PAST_MEDICAL_HISTORY +Tras B-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +ingesta I-PRESENT_ILLNESS +abundante I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +alcohol I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS -suprapúbico, I-PRESENT_ILLNESS -polaquiuria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -nicturia. I-PRESENT_ILLNESS -Sin B-EXPLORATION -hallazgos I-EXPLORATION -de I-EXPLORATION -laboratorio. I-EXPLORATION -En I-EXPLORATION +epigástrico I-PRESENT_ILLNESS +intenso I-PRESENT_ILLNESS +irradiado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +cinturón I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +aumenta I-PRESENT_ILLNESS +progresivamente. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +A B-EXPLORATION la I-EXPLORATION -cistoscopía I-EXPLORATION +exploración, I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION se I-EXPLORATION -evidencian I-EXPLORATION -glomerulaciones I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -distención I-EXPLORATION -vesical. I-EXPLORATION -Una I-EXPLORATION -biopsia I-EXPLORATION -vesical I-EXPLORATION -randomizadas I-EXPLORATION -revela I-EXPLORATION -mucosa I-EXPLORATION -vesical I-EXPLORATION -con I-EXPLORATION -infiltrado I-EXPLORATION -perivascular I-EXPLORATION +encuentra I-EXPLORATION +pálido, I-EXPLORATION +sudoroso I-EXPLORATION y I-EXPLORATION -múltiples I-EXPLORATION -eosinófilos. I-EXPLORATION -Se I-EXPLORATION -diagnóstica I-EXPLORATION -cistitis I-EXPLORATION -eosinofílica. I-EXPLORATION -Inicialmente B-TREATMENT -se I-TREATMENT -trató I-TREATMENT -con I-TREATMENT -instilaciones I-TREATMENT -vesicales I-TREATMENT -de I-TREATMENT -heparina I-TREATMENT -y I-TREATMENT -corticoides, I-TREATMENT -sin I-TREATMENT -embargo I-TREATMENT -persistió I-TREATMENT -con I-TREATMENT -frecuencia I-TREATMENT -miccional I-TREATMENT -de I-TREATMENT -20/6. I-TREATMENT -Posteriormente I-TREATMENT -se I-TREATMENT -uso I-TREATMENT -amitriptilina, I-TREATMENT -oxibutinina I-TREATMENT -y I-TREATMENT -teltoridona I-TREATMENT -sin I-TREATMENT -respuesta. I-TREATMENT -Estudio B-EXPLORATION -urodinamico I-EXPLORATION -revela I-EXPLORATION -vejiga I-EXPLORATION -inestable I-EXPLORATION -sensitiva I-EXPLORATION -durante I-EXPLORATION -fase I-EXPLORATION +taquicárdico. I-EXPLORATION +Palpación I-EXPLORATION +abdominal I-EXPLORATION +dolorosa I-EXPLORATION +en I-EXPLORATION +epigastrio I-EXPLORATION +e I-EXPLORATION +hipocondrios. I-EXPLORATION +En I-EXPLORATION +estudio I-EXPLORATION +analítico I-EXPLORATION +destacan I-EXPLORATION +hemoglobina I-EXPLORATION de I-EXPLORATION -continencia. I-EXPLORATION +7, I-EXPLORATION +8 I-EXPLORATION +g/dl, I-EXPLORATION +hematocrito I-EXPLORATION +del I-EXPLORATION +23, I-EXPLORATION +5% I-EXPLORATION +y I-EXPLORATION +amilasa I-EXPLORATION +aumentada I-EXPLORATION +(338 I-EXPLORATION +U/l). I-EXPLORATION Se I-EXPLORATION -repite I-EXPLORATION -cistoscopía I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -significativos. I-EXPLORATION -Una I-EXPLORATION -nueva I-EXPLORATION -biopsia I-EXPLORATION -revela I-EXPLORATION -inflamación I-EXPLORATION -inespecífica. I-EXPLORATION -Se B-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -Hidroxicina I-TREATMENT -20 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas I-TREATMENT -más I-TREATMENT -Diclofenaco I-TREATMENT -sódico I-TREATMENT -50 I-TREATMENT -mg. I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -h, I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -respuesta. I-TREATMENT -El B-EVOLUTION -dolor I-EVOLUTION -cedió I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -frecuencia I-EVOLUTION -miccional I-EVOLUTION -disminuyó I-EVOLUTION -a I-EVOLUTION -6/0, I-EVOLUTION -con I-EVOLUTION -mayor I-EVOLUTION -volumen I-EVOLUTION -miccional. I-EVOLUTION -Por B-TREATMENT -somnolencia I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -antihistamínico I-TREATMENT +realizaron I-EXPLORATION +ecografía I-EXPLORATION +y I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION +abdominal I-EXPLORATION +con I-EXPLORATION +contraste I-EXPLORATION +intravenoso I-EXPLORATION +en I-EXPLORATION +fases I-EXPLORATION +arterial I-EXPLORATION +tardía I-EXPLORATION +y I-EXPLORATION +portal I-EXPLORATION +que I-EXPLORATION +mostraron I-EXPLORATION +páncreas I-EXPLORATION +atrófico I-EXPLORATION +con I-EXPLORATION +calcificaciones I-EXPLORATION +dispersas, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +un I-EXPLORATION +pseudoquiste I-EXPLORATION +en I-EXPLORATION +hilio I-EXPLORATION +esplénico, I-EXPLORATION +el I-EXPLORATION +cual I-EXPLORATION +se I-EXPLORATION +extiende I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +cara I-EXPLORATION +visceral I-EXPLORATION +hacia I-EXPLORATION +el I-EXPLORATION +parénquima I-EXPLORATION +del I-EXPLORATION +bazo. I-EXPLORATION +Produce I-EXPLORATION +una I-EXPLORATION +sección I-EXPLORATION +del I-EXPLORATION +mismo I-EXPLORATION +que I-EXPLORATION +comunica I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +gran I-EXPLORATION +hematoma I-EXPLORATION +subcapsular. I-EXPLORATION + I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +sometido I-TREATMENT a I-TREATMENT -Cetirizina, I-TREATMENT -con I-TREATMENT -igual I-TREATMENT -respuesta. I-TREATMENT - I-TREATMENT +punción-drenaje I-TREATMENT +guiado I-TREATMENT +por I-TREATMENT +TC I-TREATMENT +del I-TREATMENT +hematoma I-TREATMENT +periesplénico, I-TREATMENT +evolucionando B-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +favorable. I-EVOLUTION + I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +18 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +vida I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -acude B-PRESENT_ILLNESS +ser I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +nacida I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +término I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +cesárea, I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +embarazo I-PAST_MEDICAL_HISTORY +fisiológico. I-PAST_MEDICAL_HISTORY +Sus B-PRESENT_ILLNESS +padres I-PRESENT_ILLNESS +consultaron I-PRESENT_ILLNESS a I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -8-10 I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS +Unidad I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -hematuria I-PRESENT_ILLNESS -macroscópica, I-PRESENT_ILLNESS -indolora I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -coágulos. I-PRESENT_ILLNESS -Asimismo I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS +Ginecología I-PRESENT_ILLNESS +Infantil I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +presencia I-PRESENT_ILLNESS de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +abertura I-PRESENT_ILLNESS +entre I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -frecuencia I-PRESENT_ILLNESS -miccional, I-PRESENT_ILLNESS -escozor I-PRESENT_ILLNESS -miccional I-PRESENT_ILLNESS +vagina I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -tenesmo I-PRESENT_ILLNESS -vesical, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS +ano I-PRESENT_ILLNESS +detectada I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +nacimiento I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -seguido I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -ciprofloxacino I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -Diclofenaco I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -evidenciar I-PRESENT_ILLNESS -mejoría. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -no I-EXPLORATION -evidencia I-EXPLORATION -ningún I-EXPLORATION -signo I-EXPLORATION -de I-EXPLORATION -interés I-EXPLORATION -(trayectos I-EXPLORATION -uretero-renales I-EXPLORATION -no I-EXPLORATION -dolorosos, I-EXPLORATION -puño I-EXPLORATION -percusión I-EXPLORATION -bilateral I-EXPLORATION -negativa). I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -ecografía I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -intravesical I-EXPLORATION -de I-EXPLORATION -35, I-EXPLORATION -7 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -máximo, I-EXPLORATION -con I-EXPLORATION -unos I-EXPLORATION -riñones I-EXPLORATION -ecográficamente I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -cistoscopia I-EXPLORATION -flexible, I-EXPLORATION -que I-EXPLORATION -pone I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION +evolucionó I-PRESENT_ILLNESS +asintomática. I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +general I-EXPLORATION +se I-EXPLORATION +constató I-EXPLORATION una I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION -bilobulada I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -posterior I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -infiltrante I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -parcialmente I-EXPLORATION -necróticas I-EXPLORATION +paciente I-EXPLORATION en I-EXPLORATION -su I-EXPLORATION -superficie. I-EXPLORATION - I-EXPLORATION -Posteriormente I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -Tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION -tóraco-abdominal, I-EXPLORATION -gammagrafía I-EXPLORATION -ósea I-EXPLORATION -y I-EXPLORATION -Resección I-EXPLORATION -trans-uretral I-EXPLORATION -(RTU) I-EXPLORATION -biopsia I-EXPLORATION -para I-EXPLORATION -establecer I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION +nutricional I-EXPLORATION y I-EXPLORATION -valorar I-EXPLORATION -la I-EXPLORATION -extensión I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -enfermedad. I-EXPLORATION -La I-EXPLORATION -TC I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -vesical I-EXPLORATION -de I-EXPLORATION -8, I-EXPLORATION -5 I-EXPLORATION -cm. I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -máximo, I-EXPLORATION -bien I-EXPLORATION -definida I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -grasa I-EXPLORATION -perivesical, I-EXPLORATION -ni I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -adenopatías I-EXPLORATION +evaluación I-EXPLORATION +dirigida I-EXPLORATION de I-EXPLORATION -tamaño I-EXPLORATION -significativo. I-EXPLORATION - I-EXPLORATION +los I-EXPLORATION +genitales I-EXPLORATION +destacaron I-EXPLORATION +los I-EXPLORATION +labios I-EXPLORATION +mayores I-EXPLORATION +prominentes, I-EXPLORATION +himen I-EXPLORATION +rosado I-EXPLORATION +redundante I-EXPLORATION +y I-EXPLORATION +permeable. I-EXPLORATION El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -extensión I-EXPLORATION -se I-EXPLORATION -completó I-EXPLORATION -con I-EXPLORATION +periné I-EXPLORATION +presentaba I-EXPLORATION una I-EXPLORATION -gammagrafía I-EXPLORATION -ósea I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -RTU I-EXPLORATION -muestra I-EXPLORATION +lesión I-EXPLORATION +lineal I-EXPLORATION +entre I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -mesenquimal, I-EXPLORATION -fusocelular, I-EXPLORATION -con I-EXPLORATION -haces I-EXPLORATION -largos I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -fusiformes I-EXPLORATION +horquilla I-EXPLORATION +vulvar I-EXPLORATION y I-EXPLORATION -frecuentes I-EXPLORATION -mitosis. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -intensa I-EXPLORATION -inmunorreactividad I-EXPLORATION +el I-EXPLORATION +ano, I-EXPLORATION con I-EXPLORATION -vimentina I-EXPLORATION -y I-EXPLORATION -actina I-EXPLORATION -muscular I-EXPLORATION -específica. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -leiomiosarcoma I-TREATMENT -vesical I-TREATMENT -clínicamente I-TREATMENT -localizado I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -exenteración I-TREATMENT -pélvica I-TREATMENT -anterior I-TREATMENT -(cistectomía I-TREATMENT -radical, I-TREATMENT -histerectomía I-TREATMENT -más I-TREATMENT -doble I-TREATMENT -anexectomía I-TREATMENT -y I-TREATMENT -derivación I-TREATMENT -urinaria I-TREATMENT -ileal). I-TREATMENT - I-TREATMENT -El B-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION +el I-EXPLORATION +aspecto I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -reveló I-EXPLORATION una I-EXPLORATION -tumoración I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -posterior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vejiga I-EXPLORATION +lesión I-EXPLORATION +cortante I-EXPLORATION +cubierta I-EXPLORATION +por I-EXPLORATION +mucosa I-EXPLORATION +eritematosa I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +orificio I-EXPLORATION +anal I-EXPLORATION de I-EXPLORATION -crecimiento I-EXPLORATION -exofítico I-EXPLORATION +aspecto I-EXPLORATION y I-EXPLORATION -consistencia I-EXPLORATION -elástica I-EXPLORATION -de I-EXPLORATION -8, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -6 I-EXPLORATION -x I-EXPLORATION -4 I-EXPLORATION -cm, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -pedículo I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro. I-EXPLORATION - I-EXPLORATION -Era I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -mesenquimal I-EXPLORATION -maligno I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -alargadas, I-EXPLORATION -de I-EXPLORATION -nucleolos I-EXPLORATION -longilíneos I-EXPLORATION -bordes I-EXPLORATION -romos I-EXPLORATION -y I-EXPLORATION -citoplasmas I-EXPLORATION -fibrilares. I-EXPLORATION -En I-EXPLORATION -algunas I-EXPLORATION -zonas I-EXPLORATION -se I-EXPLORATION -muestran I-EXPLORATION -figuras I-EXPLORATION -de I-EXPLORATION -mitosis I-EXPLORATION -(20 I-EXPLORATION -mitosis I-EXPLORATION -por I-EXPLORATION -10 I-EXPLORATION -campos I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -aumento). I-EXPLORATION -El I-EXPLORATION -tumor I-EXPLORATION -se I-EXPLORATION -alojaba I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -vesical, I-EXPLORATION +posición I-EXPLORATION +normal. I-EXPLORATION +Se I-EXPLORATION +palpó I-EXPLORATION +botón I-EXPLORATION +mamario I-EXPLORATION sin I-EXPLORATION -infiltrar I-EXPLORATION -el I-EXPLORATION -urotelio I-EXPLORATION -de I-EXPLORATION -superficie, I-EXPLORATION -ni I-EXPLORATION -la I-EXPLORATION -capa I-EXPLORATION -muscular I-EXPLORATION -propia I-EXPLORATION -vesical, I-EXPLORATION -presentando I-EXPLORATION -su I-EXPLORATION -origen I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -capa I-EXPLORATION -muscular I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -submucosa I-EXPLORATION -(Muscularis I-EXPLORATION -Mucosae). I-EXPLORATION - I-EXPLORATION -Tanto I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -ganglios I-EXPLORATION -iliacos I-EXPLORATION -e I-EXPLORATION -ilio-obturatrices, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -grasa I-EXPLORATION -perivesical I-EXPLORATION +galactorrea I-EXPLORATION y I-EXPLORATION el I-EXPLORATION resto I-EXPLORATION +del I-EXPLORATION +examen I-EXPLORATION +general I-EXPLORATION +estaba I-EXPLORATION +dentro I-EXPLORATION de I-EXPLORATION -estructuras I-EXPLORATION -estudiadas, I-EXPLORATION -no I-EXPLORATION -mostraron I-EXPLORATION -ninguna I-EXPLORATION -alteración. I-EXPLORATION - I-EXPLORATION -Tras B-EVOLUTION -un I-EVOLUTION -postoperatorio I-EVOLUTION -sin I-EVOLUTION -incidencias I-EVOLUTION -relevantes, I-EVOLUTION -se B-TREATMENT -decidió I-TREATMENT -completar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -quimioterapia I-TREATMENT -adyuvante I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente, I-TREATMENT +límites I-EXPLORATION +normales. I-EXPLORATION +Se B-TREATMENT +indicó I-TREATMENT +aseo I-TREATMENT con I-TREATMENT -Adriamicina I-TREATMENT -e I-TREATMENT -Ifosfamida I-TREATMENT -realizó I-TREATMENT -en I-TREATMENT -su I-TREATMENT -Centro I-TREATMENT -de I-TREATMENT -referencia, I-TREATMENT -recibiendo I-TREATMENT -un I-TREATMENT -total I-TREATMENT -de I-TREATMENT -6 I-TREATMENT -ciclos I-TREATMENT -(1 I-TREATMENT -mensual) I-TREATMENT +agua I-TREATMENT +y I-TREATMENT +lubricación I-TREATMENT con I-TREATMENT -buena I-TREATMENT -tolerancia. I-TREATMENT -Se I-TREATMENT -retrasó I-TREATMENT -el I-TREATMENT -inicio I-TREATMENT -del I-TREATMENT -ciclo I-TREATMENT +vaselina I-TREATMENT +sólida I-TREATMENT en I-TREATMENT -una I-TREATMENT -ocasión I-TREATMENT -por I-TREATMENT -fiebre. I-TREATMENT - I-TREATMENT -Al B-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -finalizar I-EVOLUTION +cada I-TREATMENT +muda. I-TREATMENT +En B-EVOLUTION el I-EVOLUTION -tratamiento I-EVOLUTION -complementario I-EVOLUTION +control I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +4 I-EVOLUTION +meses I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -recidiva I-EVOLUTION -locorregional I-EVOLUTION -en I-EVOLUTION -una I-EVOLUTION -T.C. I-EVOLUTION -realizada I-EVOLUTION -durante I-EVOLUTION -una I-EVOLUTION -revisión. I-EVOLUTION -Por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -extirpación I-TREATMENT -de I-TREATMENT +madre I-EVOLUTION +señaló I-EVOLUTION +que I-EVOLUTION +la I-EVOLUTION +lesión I-EVOLUTION +había I-EVOLUTION +evolucionado I-EVOLUTION +sin I-EVOLUTION +complicaciones I-EVOLUTION +y B-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +se I-EXPLORATION +constató I-EXPLORATION +epitelización I-EXPLORATION +del I-EXPLORATION +surco I-EXPLORATION +perineal. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +47 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +junio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2010 I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +hepatitis I-PRESENT_ILLNESS +aguda I-PRESENT_ILLNESS +colestásica I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +probable I-PRESENT_ILLNESS +origen I-PRESENT_ILLNESS +etílico. I-PRESENT_ILLNESS +Tenía B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +esquizofrenia I-PAST_MEDICAL_HISTORY +paranoide I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +olanzapina I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +mg/24 I-PAST_MEDICAL_HISTORY +h I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +11 I-PAST_MEDICAL_HISTORY +meses. I-PAST_MEDICAL_HISTORY +Aunque B-EXPLORATION +la I-EXPLORATION +evolución I-EXPLORATION +inicial I-EXPLORATION +del I-EXPLORATION +cuadro I-EXPLORATION +clínico I-EXPLORATION +era I-EXPLORATION +favorable, I-EXPLORATION +con I-EXPLORATION +normalización I-EXPLORATION +paulatina I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +parámetros I-EXPLORATION +de I-EXPLORATION +función I-EXPLORATION +hepática I-EXPLORATION +(bilirrubina I-EXPLORATION +y I-EXPLORATION +coagulación), I-EXPLORATION +cada I-EXPLORATION +vez I-EXPLORATION +estaba I-EXPLORATION +más I-EXPLORATION +acentuada I-EXPLORATION +la I-EXPLORATION +citolisis. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +etiológico I-EXPLORATION +completo I-EXPLORATION +(virus, I-EXPLORATION +autoanticuerpos, I-EXPLORATION +fármacos, I-EXPLORATION +etc.) I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION +Al B-TREATMENT +haber I-TREATMENT +casos I-TREATMENT +descritos I-TREATMENT +en I-TREATMENT la I-TREATMENT -lesión, I-TREATMENT -con I-TREATMENT -informe I-TREATMENT -anatomopatológico I-TREATMENT -de I-TREATMENT -leiomiosarcoma I-TREATMENT -de I-TREATMENT -6, I-TREATMENT -5 I-TREATMENT -cms. I-TREATMENT +literatura I-TREATMENT de I-TREATMENT -diámetro I-TREATMENT -con I-TREATMENT -un I-TREATMENT -borde I-TREATMENT -afecto. I-TREATMENT -Se I-TREATMENT -decidió I-TREATMENT -completar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -quicio-radioterapia I-TREATMENT -adyuvante, I-TREATMENT -con I-TREATMENT -régimen I-TREATMENT -quimioterápico I-TREATMENT -basado I-TREATMENT -en I-TREATMENT -Ifosfamida I-TREATMENT +hepatotoxicidad I-TREATMENT a I-TREATMENT -altas I-TREATMENT -dosis I-TREATMENT -(3.520 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -24 I-TREATMENT -horas I-TREATMENT -por I-TREATMENT -5 I-TREATMENT -días), I-TREATMENT -de I-TREATMENT -los I-TREATMENT -cuales I-TREATMENT +olanzapina, I-TREATMENT se I-TREATMENT -ha I-TREATMENT -administrado I-TREATMENT -6 I-TREATMENT -ciclos, I-TREATMENT -uno I-TREATMENT -mensual. I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -completados I-TREATMENT -los I-TREATMENT -2 I-TREATMENT -primeros I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -quimioterapia, I-TREATMENT -recibió I-TREATMENT -radioterapia I-TREATMENT -externa, I-TREATMENT -a I-TREATMENT -razón I-TREATMENT -de I-TREATMENT -1, I-TREATMENT -8 I-TREATMENT -Gy/día, I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -total I-TREATMENT -de I-TREATMENT -45 I-TREATMENT -Gy I-TREATMENT -sobre I-TREATMENT -lecho I-TREATMENT -tumoral I-TREATMENT +suspende I-TREATMENT +el I-TREATMENT +fármaco I-TREATMENT y I-TREATMENT -posteriormente I-TREATMENT -una I-TREATMENT -sobreimpresión I-TREATMENT -pélvica I-TREATMENT -con I-TREATMENT -16 I-TREATMENT -Gy I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -pélvica I-TREATMENT +se I-TREATMENT +sustituye I-TREATMENT +por I-TREATMENT +haloperidol, I-TREATMENT +existiendo I-TREATMENT +mejoría I-TREATMENT +evidente I-TREATMENT de I-TREATMENT -61 I-TREATMENT -Gy. I-TREATMENT -Posteriormente B-EVOLUTION -pasó I-EVOLUTION -a I-EVOLUTION -revisiones I-EVOLUTION -periódicas. I-EVOLUTION +la I-TREATMENT +citolisis I-TREATMENT +hasta B-EVOLUTION +su I-EVOLUTION +total I-EVOLUTION +normalización. I-EVOLUTION I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -ocho I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -haber I-EVOLUTION -finalizado I-EVOLUTION -el I-EVOLUTION -segundo I-EVOLUTION -tratamiento I-EVOLUTION -adyuvante, I-EVOLUTION -32 I-EVOLUTION -meses I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -diagnóstico, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -vuelve I-EVOLUTION -a I-EVOLUTION -presentar I-EVOLUTION -una I-EVOLUTION -recidiva I-EVOLUTION -pélvica I-EVOLUTION -de I-EVOLUTION -5 I-EVOLUTION -x I-EVOLUTION -5, I-EVOLUTION -8 I-EVOLUTION -cm., I-EVOLUTION -con I-EVOLUTION -probable I-EVOLUTION -infiltración I-EVOLUTION -de I-EVOLUTION -recto-sigma I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -vejiga I-EVOLUTION -ileal. I-EVOLUTION -Se B-TREATMENT -realiza I-TREATMENT -rectosigmoidoscopia I-TREATMENT -con I-TREATMENT -punción I-TREATMENT -aspiración I-TREATMENT -con I-TREATMENT -aguja I-TREATMENT -fina, I-TREATMENT -con I-TREATMENT -resultado I-TREATMENT -anatomopatológico I-TREATMENT -de I-TREATMENT -citología I-TREATMENT -maligna, I-TREATMENT -sarcoma I-TREATMENT -fusocelular I-TREATMENT -compatible I-TREATMENT -con I-TREATMENT -leiomiosarcoma. I-TREATMENT -Se B-EXPLORATION -ha I-EXPLORATION -realizado I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -con I-EXPLORATION -anticuerpos I-EXPLORATION -frente I-EXPLORATION -a I-EXPLORATION -Caldesmón I-EXPLORATION -y I-EXPLORATION -Miosina I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +31 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +diestra, B-PAST_MEDICAL_HISTORY +soltera, I-PAST_MEDICAL_HISTORY +médico I-PAST_MEDICAL_HISTORY +ortopedista. I-PAST_MEDICAL_HISTORY +Padecimiento B-PRESENT_ILLNESS +actual I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +punzante I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +inicio I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +frontal I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +lado I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +irradiado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +temporal I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +mismo I-PRESENT_ILLNESS +lado I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +periorbitario I-PRESENT_ILLNESS +intenso, I-PRESENT_ILLNESS +intermitente, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +alteraciones I-PRESENT_ILLNESS +sensitivas. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +limitaba I-PRESENT_ILLNESS +sueño I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +bajado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +causa I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +mismo. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +dolor I-EXPLORATION +en I-EXPLORATION +apófisis I-EXPLORATION +espinosas I-EXPLORATION de I-EXPLORATION -músculo I-EXPLORATION -liso, I-EXPLORATION -observándose I-EXPLORATION -inmunorreactividad I-EXPLORATION -intensa I-EXPLORATION +C2, I-EXPLORATION +C3 I-EXPLORATION +y I-EXPLORATION +punto I-EXPLORATION +doloroso I-EXPLORATION +occipital I-EXPLORATION +izquierdo. I-EXPLORATION +Las I-EXPLORATION +radiografías I-EXPLORATION +mostraban I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -tumorales I-EXPLORATION -frente I-EXPLORATION -a I-EXPLORATION -ambos I-EXPLORATION -anticuerpos. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT +la I-EXPLORATION +lordosis I-EXPLORATION +cervical. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +bloqueo I-TREATMENT +desinflamatorio I-TREATMENT de I-TREATMENT -segunda I-TREATMENT -recidiva I-TREATMENT -se I-TREATMENT -recomendó I-TREATMENT -realizar I-TREATMENT -resección I-TREATMENT -quirúrgica I-TREATMENT -con I-TREATMENT -consolidación I-TREATMENT +C2 I-TREATMENT +y I-TREATMENT +C3 I-TREATMENT +izquierdos I-TREATMENT con I-TREATMENT -braquiterapia. I-TREATMENT -La I-TREATMENT -paciente I-TREATMENT -desestimó I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -cirugía I-TREATMENT +lidocaína I-TREATMENT +al I-TREATMENT +1% I-TREATMENT +simple I-TREATMENT con I-TREATMENT -braquiterapia I-TREATMENT -por I-TREATMENT -miedo I-TREATMENT -a I-TREATMENT -las I-TREATMENT -complicaciones I-TREATMENT -de I-TREATMENT -la I-TREATMENT -braquiterapia, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -intervenida I-TREATMENT +mejoría I-TREATMENT +del I-TREATMENT +80% I-TREATMENT en I-TREATMENT -otro I-TREATMENT -centro, I-TREATMENT -realizando I-TREATMENT -exenteración I-TREATMENT -pélvica I-TREATMENT -posterior. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -primer I-EVOLUTION -control I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -cirugía, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -misma I-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -presentar I-EVOLUTION -una I-EVOLUTION -nueva I-EVOLUTION -recidiva, I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -incisión, I-EVOLUTION -realizándose B-TREATMENT -resección I-TREATMENT +sintomatología, I-TREATMENT +se I-TREATMENT +inicia I-TREATMENT +gabapentina I-TREATMENT +300 I-TREATMENT +mg I-TREATMENT +c-12 I-TREATMENT +hrs. I-TREATMENT +Se I-TREATMENT +dio I-TREATMENT +manejo I-TREATMENT +para I-TREATMENT +patología I-TREATMENT +cervical I-TREATMENT +por I-TREATMENT +parte I-TREATMENT del I-TREATMENT -mismo. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -la I-EVOLUTION -actualidad, I-EVOLUTION -y I-EVOLUTION -41 I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -inicial, I-EVOLUTION -la I-EVOLUTION +servicio I-TREATMENT +de I-TREATMENT +columna, I-TREATMENT +no I-TREATMENT +hubo I-TREATMENT +necesidad I-TREATMENT +de I-TREATMENT +aplicar I-TREATMENT +nuevos I-TREATMENT +bloqueos I-TREATMENT +cervicales. I-TREATMENT +La B-EVOLUTION paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática, I-EVOLUTION -en I-EVOLUTION -controles I-EVOLUTION -periódicos I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -evidencia I-EVOLUTION -de I-EVOLUTION -enfermedad. I-EVOLUTION +permanece I-EVOLUTION +asintomática I-EVOLUTION +3 I-EVOLUTION +años I-EVOLUTION +después. I-EVOLUTION I-EVOLUTION Paciente B-PRESENT_ILLNESS varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS +78 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad, I-PRESENT_ILLNESS -con B-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -corporal I-EXPLORATION -(IMC) I-EXPLORATION -de I-EXPLORATION -31, I-EXPLORATION -2, I-EXPLORATION -que B-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS diagnosticado I-PRESENT_ILLNESS de I-PRESENT_ILLNESS cáncer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -próstata I-PRESENT_ILLNESS +vejiga I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +metástasis, I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -estadio I-PRESENT_ILLNESS -T2a I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +Durogesic® I-PRESENT_ILLNESS +75 I-PRESENT_ILLNESS +μg/h I-PRESENT_ILLNESS durante I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -examen I-PRESENT_ILLNESS -(antígeno I-PRESENT_ILLNESS -prostático I-PRESENT_ILLNESS -específico I-PRESENT_ILLNESS -[PSA], I-PRESENT_ILLNESS -3, I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -ng/ml). I-PRESENT_ILLNESS -Tenía B-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -anterior I-PAST_MEDICAL_HISTORY +2 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +buena I-PRESENT_ILLNESS +eficacia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +seguridad. I-PRESENT_ILLNESS +En B-TREATMENT +oncología I-TREATMENT +se I-TREATMENT +cambia I-TREATMENT +por I-TREATMENT +fentanilo I-TREATMENT +genérico, I-TREATMENT +notándose I-TREATMENT +un I-TREATMENT +empeoramiento I-TREATMENT +del I-TREATMENT +cuadro I-TREATMENT +doloroso. I-TREATMENT +Se B-EVOLUTION +vuelve I-EVOLUTION +a I-EVOLUTION +cambiar I-EVOLUTION +a I-EVOLUTION +Durogesic®, I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +nuevo I-EVOLUTION +se I-EVOLUTION +estabiliza I-EVOLUTION +la I-EVOLUTION +analgesia. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +58 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -hipertensión, I-PAST_MEDICAL_HISTORY -diabetes, I-PAST_MEDICAL_HISTORY -hiperlipemia, I-PAST_MEDICAL_HISTORY -miocardiopatía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cirrosis. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Antes B-TREATMENT +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +crónica, I-PAST_MEDICAL_HISTORY +quistes I-PAST_MEDICAL_HISTORY +renales I-PAST_MEDICAL_HISTORY +bilaterales, I-PAST_MEDICAL_HISTORY +hemorragia I-PAST_MEDICAL_HISTORY +digestiva I-PAST_MEDICAL_HISTORY +alta I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +úlcera I-PAST_MEDICAL_HISTORY +duodenal, I-PAST_MEDICAL_HISTORY +dislipemia, I-PAST_MEDICAL_HISTORY +obesidad I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +I I-PAST_MEDICAL_HISTORY +(índice I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +masa I-PAST_MEDICAL_HISTORY +corporal I-PAST_MEDICAL_HISTORY +33, I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +kg/m2) I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +intervenido I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +prolactinoma. I-PAST_MEDICAL_HISTORY +Presenta B-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +tumoración I-PRESENT_ILLNESS +suprarrenal I-PRESENT_ILLNESS +izquierda I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +funcionante I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +gran I-PRESENT_ILLNESS +tamaño, I-PRESENT_ILLNESS +diagnosticada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +TC I-PRESENT_ILLNESS +abdominal. I-PRESENT_ILLNESS +Se B-TREATMENT +efectuó I-TREATMENT +un I-TREATMENT +abordaje I-TREATMENT +laparoscópico, I-TREATMENT +con I-TREATMENT +liberación I-TREATMENT +del I-TREATMENT +ángulo I-TREATMENT +esplénico I-TREATMENT +del I-TREATMENT +colon I-TREATMENT +y I-TREATMENT +movilización I-TREATMENT +medial I-TREATMENT +espleno-pancreática; I-TREATMENT +sección I-TREATMENT de I-TREATMENT la I-TREATMENT -cirugía, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -tenía I-TREATMENT -vendaje I-TREATMENT -espiral I-TREATMENT +vena I-TREATMENT +principal I-TREATMENT +adrenal I-TREATMENT +izquierda I-TREATMENT y I-TREATMENT -dispositivos I-TREATMENT -de I-TREATMENT -compresión I-TREATMENT -intermitente I-TREATMENT -en I-TREATMENT -ambas I-TREATMENT -extremidades I-TREATMENT -inferiores I-TREATMENT -para I-TREATMENT -prevenir I-TREATMENT -trombosis I-TREATMENT -venosa I-TREATMENT -profunda I-TREATMENT -(TVP). I-TREATMENT -Tras I-TREATMENT -administrar I-TREATMENT -anestesia I-TREATMENT -combinada I-TREATMENT -general-espinal, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -colocado I-TREATMENT -en I-TREATMENT -posición I-TREATMENT de I-TREATMENT -Trendelenburg I-TREATMENT +los I-TREATMENT +vasos I-TREATMENT +accesorios I-TREATMENT +venosos I-TREATMENT y I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -una I-TREATMENT -PRL I-TREATMENT -extraperitoneal, I-TREATMENT -con I-TREATMENT -preservación I-TREATMENT -nerviosa I-TREATMENT -bilateral. I-TREATMENT -Su I-TREATMENT -presión I-TREATMENT -sanguínea I-TREATMENT -en I-TREATMENT -el I-TREATMENT -momento I-TREATMENT +arteriales; I-TREATMENT +exéresis I-TREATMENT +completa I-TREATMENT de I-TREATMENT -administrar I-TREATMENT la I-TREATMENT -anestesia I-TREATMENT -era I-TREATMENT +glándula I-TREATMENT +adrenal I-TREATMENT +tumoral, I-TREATMENT +revisión I-TREATMENT de I-TREATMENT -150/80 I-TREATMENT -mmHg I-TREATMENT +la I-TREATMENT +hemostasia I-TREATMENT y I-TREATMENT -permaneció I-TREATMENT -por I-TREATMENT -debajo I-TREATMENT +extracción I-TREATMENT de I-TREATMENT -este I-TREATMENT -nivel I-TREATMENT -durante I-TREATMENT -todo I-TREATMENT -el I-TREATMENT -procedimiento. I-TREATMENT -La I-TREATMENT -operación I-TREATMENT -duró I-TREATMENT -360 I-TREATMENT -min I-TREATMENT -y I-TREATMENT la I-TREATMENT -pérdida I-TREATMENT -de I-TREATMENT -sangre I-TREATMENT -fue I-TREATMENT -de I-TREATMENT -1.000 I-TREATMENT -ml. I-TREATMENT -El I-TREATMENT -sangrado I-TREATMENT -ocurrió I-TREATMENT -durante I-TREATMENT -el I-TREATMENT -control I-TREATMENT +pieza I-TREATMENT +en I-TREATMENT +una I-TREATMENT +bolsa I-TREATMENT +preformada I-TREATMENT +a I-TREATMENT +través I-TREATMENT de I-TREATMENT -pedículos I-TREATMENT -vasculares I-TREATMENT -y I-TREATMENT -la I-TREATMENT -disección I-TREATMENT -del I-TREATMENT -paquete I-TREATMENT -neurovascular. I-TREATMENT -La B-EXPLORATION -patología I-EXPLORATION -quirúrgica I-EXPLORATION -reveló I-EXPLORATION +una I-TREATMENT +minilaparotomía I-TREATMENT +transversa. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +evidenció I-EXPLORATION una I-EXPLORATION -próstata I-EXPLORATION +lesión I-EXPLORATION de I-EXPLORATION -55 I-EXPLORATION -g, I-EXPLORATION +carácter I-EXPLORATION +heterogéneo, I-EXPLORATION con I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION -en I-EXPLORATION -estadio I-EXPLORATION -T2a I-EXPLORATION +áreas I-EXPLORATION +hemorrágicas, I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +coloración I-EXPLORATION +parduzcas, I-EXPLORATION +áreas I-EXPLORATION +amarillentas I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -puntuación I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -escala I-EXPLORATION +extensas I-EXPLORATION +áreas I-EXPLORATION de I-EXPLORATION -Gleason I-EXPLORATION -6 I-EXPLORATION +necrosis I-EXPLORATION +hemorrágicas; I-EXPLORATION +también I-EXPLORATION +se I-EXPLORATION +identificaron I-EXPLORATION +septos I-EXPLORATION con I-EXPLORATION -márgenes I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -el I-EVOLUTION -primer I-EVOLUTION -día I-EVOLUTION -posquirúrgico, I-EVOLUTION -comenzó I-EVOLUTION -a I-EVOLUTION -quejarse I-EVOLUTION -de I-EVOLUTION -entumecimiento I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -pierna I-EVOLUTION -derecha, I-EVOLUTION -que I-EVOLUTION -estaba I-EVOLUTION -inflamada I-EVOLUTION -y I-EVOLUTION -blanda I-EVOLUTION -al I-EVOLUTION -tacto. I-EVOLUTION -Los B-EXPLORATION -pulsos I-EXPLORATION -pedios I-EXPLORATION -estaban I-EXPLORATION -presentes I-EXPLORATION +focos I-EXPLORATION de I-EXPLORATION -forma I-EXPLORATION -bilateral. I-EXPLORATION -Sospechamos I-EXPLORATION -una I-EXPLORATION -TVP I-EXPLORATION -y I-EXPLORATION -pedimos I-EXPLORATION -una I-EXPLORATION -prueba I-EXPLORATION -Doppler, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -permeabilidad I-EXPLORATION -del I-EXPLORATION -sistema I-EXPLORATION -venoso I-EXPLORATION -profundo. I-EXPLORATION -Su I-EXPLORATION -creatinina I-EXPLORATION -sérica I-EXPLORATION +calcificación. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +definitivo I-EXPLORATION fue I-EXPLORATION de I-EXPLORATION -3, I-EXPLORATION -2 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -creatina I-EXPLORATION -fosfocinasa I-EXPLORATION -llegó I-EXPLORATION -hasta I-EXPLORATION -23.000 I-EXPLORATION -U/l. I-EXPLORATION -Aunque B-TREATMENT -el I-TREATMENT -Doppler I-TREATMENT -fue I-TREATMENT -normal, I-TREATMENT -se I-TREATMENT -diagnosticó I-TREATMENT -una I-TREATMENT -TVP I-TREATMENT -con I-TREATMENT -rabdomiólisis I-TREATMENT -secundaria I-TREATMENT -y I-TREATMENT -fallo I-TREATMENT -renal I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -base I-TREATMENT -de I-TREATMENT -los I-TREATMENT -resultados I-TREATMENT -clínicos, I-TREATMENT -y I-TREATMENT -se I-TREATMENT -comenzó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -heparina. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -posquirúrgicos I-EVOLUTION -siguientes, I-EVOLUTION -aunque I-EVOLUTION -los I-EVOLUTION -pulsos I-EVOLUTION -pedios I-EVOLUTION -seguían I-EVOLUTION -siendo I-EVOLUTION -palpables I-EVOLUTION -y I-EVOLUTION -los I-EVOLUTION -valores I-EVOLUTION -de I-EVOLUTION -creatinina I-EVOLUTION -sérica I-EVOLUTION -y I-EVOLUTION -creatina I-EVOLUTION -fosfocinasa I-EVOLUTION -mejoraban, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentaba I-EVOLUTION -un I-EVOLUTION -empeoramiento I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -intermitente. I-EVOLUTION -Se B-EXPLORATION -repitieron I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -Doppler, I-EXPLORATION -que I-EXPLORATION -excluyeron I-EXPLORATION -TVP I-EXPLORATION -y I-EXPLORATION -mostraron I-EXPLORATION -un I-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -alta I-EXPLORATION -resistencia I-EXPLORATION +adenoma I-EXPLORATION +cortical I-EXPLORATION +suprarrenal I-EXPLORATION +(14 I-EXPLORATION +x I-EXPLORATION +12 I-EXPLORATION +x I-EXPLORATION +11, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -arterias I-EXPLORATION -tibiales I-EXPLORATION -derechas. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -una I-TREATMENT -fasciotomía I-TREATMENT -de I-TREATMENT -cuatro I-TREATMENT -compartimentos I-TREATMENT -por I-TREATMENT -el I-TREATMENT -SC I-TREATMENT -de I-TREATMENT -la I-TREATMENT -pierna. I-TREATMENT -Los I-TREATMENT -músculos I-TREATMENT -sobresalían I-TREATMENT -fácilmente I-TREATMENT -a I-TREATMENT -medida I-TREATMENT -que I-TREATMENT -se I-TREATMENT -seccionaba I-TREATMENT -la I-TREATMENT -fascia I-TREATMENT -suprayacente. I-TREATMENT -Había I-TREATMENT -áreas I-TREATMENT -de I-TREATMENT -necrosis I-TREATMENT -focal I-TREATMENT -que I-TREATMENT -fueron I-TREATMENT -eliminadas. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -postoperatorio, I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -fue I-EVOLUTION -remitiendo I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -capaz I-EVOLUTION -de I-EVOLUTION -caminar I-EVOLUTION -con I-EVOLUTION -ayuda. I-EVOLUTION -Las I-EVOLUTION -heridas I-EVOLUTION -se I-EVOLUTION -cerraron I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -14 I-EVOLUTION -días I-EVOLUTION -posteriores I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -fasciotomía. I-EVOLUTION - I-EVOLUTION -Seis I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -PRL, I-EVOLUTION -el I-EVOLUTION +diámetro). I-EXPLORATION +El B-EVOLUTION paciente I-EVOLUTION -se I-EVOLUTION -recuperó I-EVOLUTION -y I-EVOLUTION fue I-EVOLUTION -capaz I-EVOLUTION +dado I-EVOLUTION de I-EVOLUTION -caminar I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +tercer I-EVOLUTION +día I-EVOLUTION sin I-EVOLUTION -ayuda, I-EVOLUTION -pero I-EVOLUTION -aún I-EVOLUTION -presenta I-EVOLUTION -dolor I-EVOLUTION -neuropático I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -empeine I-EVOLUTION -del I-EVOLUTION -pie I-EVOLUTION -derecho. I-EVOLUTION -Su I-EVOLUTION -PSA I-EVOLUTION -estaba I-EVOLUTION -por I-EVOLUTION -debajo I-EVOLUTION -de I-EVOLUTION -0, I-EVOLUTION -04 I-EVOLUTION -ng/ml, I-EVOLUTION -usaba I-EVOLUTION -pañal I-EVOLUTION -diario I-EVOLUTION -por I-EVOLUTION -una I-EVOLUTION -leve I-EVOLUTION -incontinencia I-EVOLUTION -por I-EVOLUTION -esfuerzo I-EVOLUTION -y I-EVOLUTION -aún I-EVOLUTION -no I-EVOLUTION -había I-EVOLUTION -recuperado I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -sexual. I-EVOLUTION +complicaciones. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS -varón, I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS +34 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -derivado B-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cirugía I-DERIVED_FROM/TO -plástica I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -reconstrucción I-DERIVED_FROM/TO -escrotal I-DERIVED_FROM/TO -después I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -inicial I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -urología I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -desbridamiento I-DERIVED_FROM/TO -quirúrgico I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -soporte I-DERIVED_FROM/TO -médico I-DERIVED_FROM/TO -durante I-DERIVED_FROM/TO -2 I-DERIVED_FROM/TO -semanas. I-DERIVED_FROM/TO -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -antecedentes: I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -mal I-PAST_MEDICAL_HISTORY -controlada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -16 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -terminal I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -necesidad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hemodiálisis I-PAST_MEDICAL_HISTORY +embarazada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +semanas, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +cavernomatosis I-PRESENT_ILLNESS +portal I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +7años. I-PRESENT_ILLNESS +Durante B-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +adolescencia I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY tres I-PAST_MEDICAL_HISTORY -veces I-PAST_MEDICAL_HISTORY +episodios I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hemorragia I-PAST_MEDICAL_HISTORY +digestiva I-PAST_MEDICAL_HISTORY +alta I-PAST_MEDICAL_HISTORY +secundarios I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +varices I-PAST_MEDICAL_HISTORY +esofágicas I-PAST_MEDICAL_HISTORY +(VE). I-PAST_MEDICAL_HISTORY +Anticoagulada I-PAST_MEDICAL_HISTORY por I-PAST_MEDICAL_HISTORY -semana. I-PAST_MEDICAL_HISTORY -Había B-PRESENT_ILLNESS -sido I-PRESENT_ILLNESS -sometido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -amputación I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -miembro I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -isquemia. I-PRESENT_ILLNESS -El B-TREATMENT -colgajo I-TREATMENT -pediculado I-TREATMENT -fasciocutáneo I-TREATMENT -del I-TREATMENT -muslo I-TREATMENT -fue I-TREATMENT -usado I-TREATMENT -con I-TREATMENT -buenos I-TREATMENT -resultados I-TREATMENT -para I-TREATMENT +trombosis I-PAST_MEDICAL_HISTORY +venosa I-PAST_MEDICAL_HISTORY +mesentérica I-PAST_MEDICAL_HISTORY +aguda. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +primer I-PAST_MEDICAL_HISTORY +trimestre I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +embarazo I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +retiraron I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +beta-bloqueantes I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +anticoagulantes I-PAST_MEDICAL_HISTORY +orales, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +pasó I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +heparina I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +bajo I-PAST_MEDICAL_HISTORY +peso. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +gastroscopia I-EXPLORATION +realizada I-EXPLORATION +para I-EXPLORATION +control I-EXPLORATION +de I-EXPLORATION +varices I-EXPLORATION +esofágicas I-EXPLORATION +6 I-EXPLORATION +días I-EXPLORATION +antes I-EXPLORATION +del I-EXPLORATION +evento, I-EXPLORATION +se I-EXPLORATION +objetivaron I-EXPLORATION +VE I-EXPLORATION +grado I-EXPLORATION +I I-EXPLORATION +y I-EXPLORATION +II I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +rojos. I-EXPLORATION + I-EXPLORATION +Acudió I-EXPLORATION +a I-EXPLORATION +urgencias I-EXPLORATION +por I-EXPLORATION +melenas I-EXPLORATION +e I-EXPLORATION +hipotensión I-EXPLORATION +arterial. I-EXPLORATION +En I-EXPLORATION +analítica I-EXPLORATION +destacaba I-EXPLORATION +hemoglobina I-EXPLORATION +7, I-EXPLORATION +1 I-EXPLORATION +g/dl. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +gastroscopia I-TREATMENT +urgente I-TREATMENT +en I-TREATMENT la I-TREATMENT -reconstrucción I-TREATMENT -del I-TREATMENT -escroto. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -posoperatorio I-TREATMENT -(al I-TREATMENT -4.o I-TREATMENT -día), I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -desarrolló I-TREATMENT -un I-TREATMENT -edema I-TREATMENT -agudo I-TREATMENT -de I-TREATMENT -pulmón, I-TREATMENT que I-TREATMENT se I-TREATMENT -resolvió I-TREATMENT +observaron I-TREATMENT +VE I-TREATMENT +grado I-TREATMENT +II I-TREATMENT con I-TREATMENT -tratamiento I-TREATMENT -médico. I-TREATMENT -No B-EVOLUTION -hubo I-EVOLUTION -necrosis I-EVOLUTION -del I-EVOLUTION -colgajo I-EVOLUTION -ni I-EVOLUTION -se I-EVOLUTION -produjeron I-EVOLUTION -infecciones. I-EVOLUTION -Fue B-TREATMENT -necesario I-TREATMENT -proceder I-TREATMENT -a I-TREATMENT -la I-TREATMENT -remodelación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -porción I-TREATMENT -inferomedial I-TREATMENT -del I-TREATMENT -colgajo I-TREATMENT +puntos I-TREATMENT +rojos I-TREATMENT +y I-TREATMENT +sangrado I-TREATMENT +activo, I-TREATMENT por I-TREATMENT -dehiscencia I-TREATMENT -parcial I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +ligadura I-TREATMENT +con I-TREATMENT +bandas I-TREATMENT +elásticas. I-TREATMENT +Se I-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +cesárea I-TREATMENT +urgente I-TREATMENT +para I-TREATMENT +extracción I-TREATMENT +fetal I-TREATMENT +por I-TREATMENT +shock I-TREATMENT +hipovolémico I-TREATMENT de I-TREATMENT la I-TREATMENT -sutura. I-TREATMENT -Se B-EVOLUTION -dio I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -paciente I-EVOLUTION -del I-EVOLUTION -servicio I-EVOLUTION -después I-EVOLUTION +paciente I-TREATMENT +y I-TREATMENT +a I-TREATMENT +continuación I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +somatostatina I-TREATMENT +y I-TREATMENT +se I-TREATMENT +revisó I-TREATMENT +endoscópicamente, I-TREATMENT +objetivando I-TREATMENT +el I-TREATMENT +cese I-TREATMENT +del I-TREATMENT +sangrado. I-TREATMENT +La B-EVOLUTION +recién I-EVOLUTION +nacida I-EVOLUTION +requirió I-EVOLUTION +cuidados I-EVOLUTION +en I-EVOLUTION +incubadora I-EVOLUTION +y I-EVOLUTION +tras I-EVOLUTION +unos I-EVOLUTION +días I-EVOLUTION de I-EVOLUTION -2 I-EVOLUTION -semanas I-EVOLUTION +ingreso I-EVOLUTION +ambas I-EVOLUTION +fueron I-EVOLUTION +dadas I-EVOLUTION de I-EVOLUTION -internamiento. I-EVOLUTION +alta. I-EVOLUTION I-EVOLUTION -Masculino B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -14 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sentado I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -cinturón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -seguridad I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -parte I-PRESENT_ILLNESS -trasera I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -automóvil, I-PRESENT_ILLNESS -participó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -accidente I-PRESENT_ILLNESS -automovilístico. I-PRESENT_ILLNESS -Se I-PRESENT_ILLNESS -mantuvo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -asiento I-PRESENT_ILLNESS -posterior I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -evento I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -conocimiento I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -arribo I-PRESENT_ILLNESS +Un B-PRESENT_ILLNESS +hombre I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -paramédicos. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -accidente I-PRESENT_ILLNESS -ocurrió I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -área I-PRESENT_ILLNESS -rural I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -traslado I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -DUP I-PRESENT_ILLNESS -duró I-PRESENT_ILLNESS -aprox. I-PRESENT_ILLNESS -90min. I-PRESENT_ILLNESS -Fue I-PRESENT_ILLNESS -transportado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -collarín I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -inmovilizado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -decúbito I-PRESENT_ILLNESS -dorsal I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -tabla I-PRESENT_ILLNESS +50 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -protección. I-PRESENT_ILLNESS -Los B-EXPLORATION -signos I-EXPLORATION -vitales I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -llegada: I-EXPLORATION -temperatura, I-EXPLORATION -36, I-EXPLORATION -5oC; I-EXPLORATION -pulso, I-EXPLORATION -84/min; I-EXPLORATION -PA, I-EXPLORATION -110/63mm I-EXPLORATION -Hg I-EXPLORATION +edad I-PRESENT_ILLNESS +fue B-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestra I-DERIVED_FROM/TO +Unidad I-DERIVED_FROM/TO +ya I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +desde I-DERIVED_FROM/TO +hacía I-DERIVED_FROM/TO +dos I-DERIVED_FROM/TO +años I-DERIVED_FROM/TO +tenía I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +concentración I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +ferritina I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +suero I-DERIVED_FROM/TO +superior I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +1.000 I-DERIVED_FROM/TO +µg/l I-DERIVED_FROM/TO +(rango I-DERIVED_FROM/TO +normal, I-DERIVED_FROM/TO +26-370). I-DERIVED_FROM/TO +El B-EXPLORATION +paciente I-EXPLORATION +tenía I-EXPLORATION +la I-EXPLORATION +ferritina I-EXPLORATION +sérica I-EXPLORATION +(1.277 I-EXPLORATION +µg/l) I-EXPLORATION y I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION -14. I-EXPLORATION -A I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -(EF) I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -DUP I-EXPLORATION -presentó I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -leve, I-EXPLORATION -escoriaciones I-EXPLORATION -en I-EXPLORATION -diferentes I-EXPLORATION -partes I-EXPLORATION +γGT I-EXPLORATION +(116 I-EXPLORATION +U/L; I-EXPLORATION +rango I-EXPLORATION +normal, I-EXPLORATION +10-60) I-EXPLORATION +aumentadas, I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION del I-EXPLORATION -cuerpo, I-EXPLORATION -sin I-EXPLORATION -embargo I-EXPLORATION -el I-EXPLORATION -ultrasonido I-EXPLORATION -inicial I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION +hígado I-EXPLORATION +nos I-EXPLORATION +llevó I-EXPLORATION +a I-EXPLORATION +sospechar I-EXPLORATION +posible I-EXPLORATION +hígado I-EXPLORATION +graso. I-EXPLORATION +Las I-EXPLORATION +pruebas I-EXPLORATION +analíticas I-EXPLORATION y I-EXPLORATION +serológicas I-EXPLORATION +complementarias I-EXPLORATION +no I-EXPLORATION +revelaron I-EXPLORATION +ninguna I-EXPLORATION +anomalía. I-EXPLORATION +El I-EXPLORATION +paciente I-EXPLORATION +estaba I-EXPLORATION +asintomático. I-EXPLORATION +No B-PAST_MEDICAL_HISTORY +bebía I-PAST_MEDICAL_HISTORY +alcohol I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +consumía I-PAST_MEDICAL_HISTORY +tabaco. I-PAST_MEDICAL_HISTORY +Su B-FAMILY_HISTORY +historia I-FAMILY_HISTORY +clínica I-FAMILY_HISTORY +personal I-FAMILY_HISTORY +y I-FAMILY_HISTORY +familiar, I-FAMILY_HISTORY +y I-FAMILY_HISTORY +el I-FAMILY_HISTORY +examen I-FAMILY_HISTORY +físico I-FAMILY_HISTORY +no I-FAMILY_HISTORY +reflejaban I-FAMILY_HISTORY +nada I-FAMILY_HISTORY +destacable. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Analizamos B-EXPLORATION los I-EXPLORATION -rayos I-EXPLORATION -X I-EXPLORATION -solo I-EXPLORATION -evidenciaron I-EXPLORATION -rectificación I-EXPLORATION +marcadores I-EXPLORATION +del I-EXPLORATION +metabolismo I-EXPLORATION +del I-EXPLORATION +hierro I-EXPLORATION +(niveles I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -columna I-EXPLORATION -cervical. I-EXPLORATION -Estudios I-EXPLORATION +hierro I-EXPLORATION +en I-EXPLORATION +suero, I-EXPLORATION +ferritina, I-EXPLORATION +receptor I-EXPLORATION +soluble I-EXPLORATION de I-EXPLORATION -laboratorio: I-EXPLORATION -niveles I-EXPLORATION +transferrina I-EXPLORATION +e I-EXPLORATION +índice I-EXPLORATION de I-EXPLORATION -hemoglobina I-EXPLORATION +saturación I-EXPLORATION +de I-EXPLORATION +transferrina), I-EXPLORATION y I-EXPLORATION -creatinina I-EXPLORATION -normales; I-EXPLORATION -examen I-EXPLORATION +la I-EXPLORATION +concentración I-EXPLORATION de I-EXPLORATION -orina: I-EXPLORATION -microhematuria. I-EXPLORATION -Después B-EVOLUTION -de I-EVOLUTION -algunas I-EVOLUTION -horas, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -hemotórax I-EVOLUTION -y I-EVOLUTION -continúo I-EVOLUTION -con I-EVOLUTION -dolor I-EVOLUTION -abdominal. I-EVOLUTION -Se B-TREATMENT -le I-TREATMENT -colocó I-TREATMENT -sonda I-TREATMENT -en I-TREATMENT -tórax I-TREATMENT -en I-TREATMENT -el I-TREATMENT -hemitórax I-TREATMENT -izquierdo I-TREATMENT -y B-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -contrastada. I-EXPLORATION -Al I-EXPLORATION -valorar I-EXPLORATION +hierro I-EXPLORATION +hepático I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -TAC, I-EXPLORATION -el I-EXPLORATION -caso I-EXPLORATION -fue I-EXPLORATION -comentado I-EXPLORATION -con I-EXPLORATION -nuestro I-EXPLORATION -departamento. I-EXPLORATION -En I-EXPLORATION -este I-EXPLORATION -momento I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -contaba I-EXPLORATION +arquitectura I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +hepático I-EXPLORATION +mediante I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +del I-EXPLORATION +hígado. I-EXPLORATION +Las I-EXPLORATION +secciones I-EXPLORATION +de I-EXPLORATION +tejido I-EXPLORATION +hepático I-EXPLORATION +de I-EXPLORATION +cinco I-EXPLORATION +micrómetros I-EXPLORATION +se I-EXPLORATION +tiñeron I-EXPLORATION con I-EXPLORATION -8hrs I-EXPLORATION -en I-EXPLORATION -observación. I-EXPLORATION -En I-EXPLORATION -nuestra I-EXPLORATION -evaluación, I-EXPLORATION -observamos I-EXPLORATION -equimosis I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -flanco I-EXPLORATION -izquierdo I-EXPLORATION +hematoxilina-eosina, I-EXPLORATION y I-EXPLORATION -drenaje I-EXPLORATION -escaso I-EXPLORATION -por I-EXPLORATION +azul I-EXPLORATION +Prusia I-EXPLORATION +de I-EXPLORATION +Perls I-EXPLORATION +para I-EXPLORATION +detectar I-EXPLORATION la I-EXPLORATION -sonda I-EXPLORATION -en I-EXPLORATION -tórax. I-EXPLORATION -En I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +hierro. I-EXPLORATION +Se I-EXPLORATION +estudió I-EXPLORATION la I-EXPLORATION -TAC I-EXPLORATION +imagen I-EXPLORATION +obtenida I-EXPLORATION +mediante I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +del I-EXPLORATION +hígado I-EXPLORATION +(MRI). I-EXPLORATION +También I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION +buscaron I-EXPLORATION +las I-EXPLORATION +variaciones I-EXPLORATION +alélicas I-EXPLORATION +c.845G>A I-EXPLORATION +(p.C282Y) I-EXPLORATION +y I-EXPLORATION +c.187C>G I-EXPLORATION +(p.H63D) I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION +gen I-EXPLORATION +HFE. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +ADN I-EXPLORATION +genómico I-EXPLORATION +se I-EXPLORATION +extrajo I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +muestra I-EXPLORATION +de I-EXPLORATION +sangre I-EXPLORATION +periférica, I-EXPLORATION +la I-EXPLORATION +reacción I-EXPLORATION +en I-EXPLORATION +cadena I-EXPLORATION +de I-EXPLORATION +polimerasa I-EXPLORATION +(PCR) I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +mediante I-EXPLORATION +oligonucleótidos I-EXPLORATION +específicos I-EXPLORATION +para I-EXPLORATION +amplificar I-EXPLORATION +las I-EXPLORATION +regiones I-EXPLORATION +codificantes, I-EXPLORATION +las I-EXPLORATION +regiones I-EXPLORATION +intrónicas I-EXPLORATION +adyacentes, I-EXPLORATION +y I-EXPLORATION +las I-EXPLORATION +regiones I-EXPLORATION sin I-EXPLORATION -captación I-EXPLORATION +traducir I-EXPLORATION +5 I-EXPLORATION +' I-EXPLORATION +y I-EXPLORATION +3 I-EXPLORATION +' I-EXPLORATION +(UTR) I-EXPLORATION de I-EXPLORATION -medio I-EXPLORATION +los I-EXPLORATION +genes: I-EXPLORATION +HFE, I-EXPLORATION +hemojuvelina I-EXPLORATION +(HJV), I-EXPLORATION +hepcidina I-EXPLORATION +(HAMP), I-EXPLORATION +receptor I-EXPLORATION +2 I-EXPLORATION de I-EXPLORATION -contraste I-EXPLORATION +transferrina I-EXPLORATION +(TFR2) I-EXPLORATION y I-EXPLORATION -un I-EXPLORATION -pequeño I-EXPLORATION -hematoma I-EXPLORATION -esplénico. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -manejar I-TREATMENT -conservadoramente. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -egresado I-EVOLUTION -6 I-EVOLUTION -días I-EVOLUTION -después. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución, I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -controlado. I-PAST_MEDICAL_HISTORY -Como I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -patológico I-PAST_MEDICAL_HISTORY -relevante I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -habia I-PAST_MEDICAL_HISTORY -advertido I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -masa I-PAST_MEDICAL_HISTORY -abdominal I-PAST_MEDICAL_HISTORY -palpable I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pulsátil I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -mes. I-PAST_MEDICAL_HISTORY -Diez B-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -intenso. I-PRESENT_ILLNESS -La B-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -abdominal I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +ferroportina I-EXPLORATION +(SLC40A1). I-EXPLORATION +Los I-EXPLORATION +productos I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -aneurisma I-EXPLORATION +PCR I-EXPLORATION +se I-EXPLORATION +secuenciaron I-EXPLORATION +bidireccionalmente I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +secuenciador I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -aorta I-EXPLORATION -infrarrenal, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -proceso I-EXPLORATION -inflamatorio I-EXPLORATION -que I-EXPLORATION -involucra I-EXPLORATION +ADN I-EXPLORATION +ABI I-EXPLORATION +Prism I-EXPLORATION +3130x1, I-EXPLORATION y I-EXPLORATION -lo I-EXPLORATION -adhiere I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -tercera I-EXPLORATION -porción I-EXPLORATION +las I-EXPLORATION +secuencias I-EXPLORATION +se I-EXPLORATION +compararon I-EXPLORATION +con I-EXPLORATION +las I-EXPLORATION +de I-EXPLORATION +referencia I-EXPLORATION +(números I-EXPLORATION +de I-EXPLORATION +accesión I-EXPLORATION del I-EXPLORATION -duodeno. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -solicitó I-TREATMENT -el I-TREATMENT -alta I-TREATMENT -voluntaria I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -propuesta I-TREATMENT -quirúrgica. I-TREATMENT -Cinco B-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -reingresó I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Terapia I-EVOLUTION -Intensiva I-EVOLUTION -por I-EVOLUTION -presentar I-EVOLUTION -hemorragia I-EVOLUTION -digestiva I-EVOLUTION -alta I-EVOLUTION -manifestada I-EVOLUTION -por I-EVOLUTION -hematemesis I-EVOLUTION -y I-EVOLUTION -melena I-EVOLUTION -de I-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -evolución, I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -shock I-EVOLUTION -hipovolémico, I-EVOLUTION -tensión I-EVOLUTION -arterial I-EVOLUTION -media I-EVOLUTION -(TAM) I-EVOLUTION -30 I-EVOLUTION -mmHg, I-EVOLUTION -frecuencia I-EVOLUTION -cardíaca I-EVOLUTION -(FC): I-EVOLUTION -140 I-EVOLUTION -lpm I-EVOLUTION -y I-EVOLUTION -hematocrito I-EVOLUTION -del I-EVOLUTION -18%. I-EVOLUTION -Una B-EXPLORATION -vez I-EXPLORATION -compensado I-EXPLORATION +GenBank: I-EXPLORATION +NG_008720.1, I-EXPLORATION +NG_011568.1, I-EXPLORATION +NG_011563.1, I-EXPLORATION +NM_003227.3 I-EXPLORATION +y I-EXPLORATION +NG_009027.1, I-EXPLORATION +respectivamente, I-EXPLORATION +para I-EXPLORATION +los I-EXPLORATION +genes I-EXPLORATION +mencionados). I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +obtuvo I-EXPLORATION el I-EXPLORATION -trastorno I-EXPLORATION -hemodinámico, I-EXPLORATION +consentimiento I-EXPLORATION +informado I-EXPLORATION +del I-EXPLORATION +paciente I-EXPLORATION +según I-EXPLORATION +las I-EXPLORATION +recomendaciones I-EXPLORATION +locales I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +genético I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +del I-EXPLORATION +hígado. I-EXPLORATION +El I-EXPLORATION +protocolo I-EXPLORATION +de I-EXPLORATION +estudio I-EXPLORATION se I-EXPLORATION realizó I-EXPLORATION -fibroendoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta, I-EXPLORATION -constatándose I-EXPLORATION -sangrado I-EXPLORATION -activo I-EXPLORATION +de I-EXPLORATION +acuerdo I-EXPLORATION +con I-EXPLORATION +los I-EXPLORATION +principios I-EXPLORATION +éticos I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +declaración I-EXPLORATION +de I-EXPLORATION +Helsinki I-EXPLORATION +(2008). I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +parámetros I-EXPLORATION +de I-EXPLORATION +hierro I-EXPLORATION +del I-EXPLORATION +paciente I-EXPLORATION +fueron: I-EXPLORATION +ferritina I-EXPLORATION en I-EXPLORATION -cara I-EXPLORATION -posterior I-EXPLORATION +suero, I-EXPLORATION +1.070 I-EXPLORATION +µg/l I-EXPLORATION +(rango I-EXPLORATION +normal, I-EXPLORATION +26-370 I-EXPLORATION +µg/l); I-EXPLORATION +hierro I-EXPLORATION +en I-EXPLORATION +suero, I-EXPLORATION +160 I-EXPLORATION +µg/dl I-EXPLORATION +(rango I-EXPLORATION +normal, I-EXPLORATION +59-158 I-EXPLORATION +µg/dl); I-EXPLORATION +índice I-EXPLORATION +de I-EXPLORATION +saturación I-EXPLORATION +de I-EXPLORATION +transferrina, I-EXPLORATION +48% I-EXPLORATION +(rango I-EXPLORATION +normal, I-EXPLORATION +20-45%); I-EXPLORATION +y I-EXPLORATION +receptor I-EXPLORATION +soluble I-EXPLORATION +de I-EXPLORATION +transferrina, I-EXPLORATION +0, I-EXPLORATION +90 I-EXPLORATION +mg/l I-EXPLORATION +(rango I-EXPLORATION +normal, I-EXPLORATION +1, I-EXPLORATION +76 I-EXPLORATION +± I-EXPLORATION +0, I-EXPLORATION +83 I-EXPLORATION +mg/l). I-EXPLORATION +La I-EXPLORATION +imagen I-EXPLORATION +de I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +hepática I-EXPLORATION +mostró I-EXPLORATION +anomalías I-EXPLORATION +difusas I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -tercera I-EXPLORATION -porción I-EXPLORATION -duodenal. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -entonces I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -por I-TREATMENT -resangrado I-TREATMENT -masivo, I-TREATMENT +intensidad I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +parénquima, I-EXPLORATION +asociadas I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +hierro; I-EXPLORATION +el I-EXPLORATION +contenido I-EXPLORATION +de I-EXPLORATION +hierro I-EXPLORATION +hepático I-EXPLORATION +fue I-EXPLORATION +estimado I-EXPLORATION +en I-EXPLORATION +160 I-EXPLORATION +µmol/g I-EXPLORATION +(valores I-EXPLORATION +normales, I-EXPLORATION +< I-EXPLORATION +36 I-EXPLORATION +µmol/g). I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +hepática I-EXPLORATION +percutánea I-EXPLORATION +guiada I-EXPLORATION +por I-EXPLORATION +ecografía. I-EXPLORATION +La I-EXPLORATION +evaluación I-EXPLORATION +histopatológica I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +arquitectura I-EXPLORATION +lobular I-EXPLORATION +normal, I-EXPLORATION +estrechos I-EXPLORATION +espacios I-EXPLORATION +portales I-EXPLORATION +sin I-EXPLORATION +inflamación I-EXPLORATION +o I-EXPLORATION +fibrosis I-EXPLORATION +y I-EXPLORATION +sin I-EXPLORATION +lesiones I-EXPLORATION +vasculares I-EXPLORATION +o I-EXPLORATION +ductales. I-EXPLORATION +El I-EXPLORATION +lóbulo I-EXPLORATION +estaba I-EXPLORATION +compuesto I-EXPLORATION +por I-EXPLORATION +hepatocitos I-EXPLORATION +con I-EXPLORATION +morfología I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +depósitos I-EXPLORATION +de I-EXPLORATION +baja I-EXPLORATION +intensidad I-EXPLORATION +de I-EXPLORATION +hemosiderina, I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +patrón I-EXPLORATION +típico I-EXPLORATION +de I-EXPLORATION +hemocromatosis, I-EXPLORATION +es I-EXPLORATION +decir, I-EXPLORATION +depósitos I-EXPLORATION +de I-EXPLORATION +hierro I-EXPLORATION +localizados I-EXPLORATION +casi I-EXPLORATION +exclusivamente I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +parenquimatosas I-EXPLORATION +en I-EXPLORATION +áreas I-EXPLORATION +periportales, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +patrón I-EXPLORATION +granular I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +distribución I-EXPLORATION +pericanalicular. I-EXPLORATION + I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +sometido I-TREATMENT +a I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -el I-TREATMENT -hallazgo I-TREATMENT -intraoperatorio I-TREATMENT -de I-TREATMENT -aneurisma I-TREATMENT +flebotomías I-TREATMENT +y, I-TREATMENT +después I-TREATMENT de I-TREATMENT -aorta I-TREATMENT -abdominal I-TREATMENT -infrarrenal I-TREATMENT -sacular I-TREATMENT -adherido I-TREATMENT -a I-TREATMENT -la I-TREATMENT -cara I-TREATMENT -posterior I-TREATMENT +20 I-TREATMENT +flebotomías I-TREATMENT +quincenales, I-TREATMENT +se I-TREATMENT +eliminaron I-TREATMENT +más I-TREATMENT de I-TREATMENT -la I-TREATMENT -tercera I-TREATMENT -porción I-TREATMENT -duodenal I-TREATMENT -con I-TREATMENT -comunicación I-TREATMENT -a I-TREATMENT -la I-TREATMENT -luz I-TREATMENT +5 I-TREATMENT +g I-TREATMENT de I-TREATMENT -dicho I-TREATMENT -órgano I-TREATMENT -por I-TREATMENT -un I-TREATMENT -orificio I-TREATMENT +hierro, I-TREATMENT +y I-TREATMENT +las I-TREATMENT +concentraciones I-TREATMENT de I-TREATMENT -unos I-TREATMENT -4 I-TREATMENT -cm I-TREATMENT +γGT I-TREATMENT +y I-TREATMENT +ferritina I-TREATMENT +volvieron I-TREATMENT +a I-TREATMENT +valores I-TREATMENT +normales. I-TREATMENT +Actualmente I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +se I-TREATMENT +somete I-TREATMENT +a I-TREATMENT +flebotomías I-TREATMENT de I-TREATMENT -diámetro. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT -by-pass I-TREATMENT -aorto-bifemoral. I-TREATMENT -Debido B-EVOLUTION -al I-EVOLUTION -grave I-EVOLUTION -compromiso I-EVOLUTION -hemodinámico I-EVOLUTION -presentó I-EVOLUTION -paro I-EVOLUTION -cardiorrespiratorio I-EVOLUTION -en I-EVOLUTION -quirófano, I-EVOLUTION -falleciendo I-EVOLUTION -pocas I-EVOLUTION -horas I-EVOLUTION -después I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Terapia I-EVOLUTION -Intensiva. I-EVOLUTION - I-EVOLUTION +mantenimiento I-TREATMENT +dos I-TREATMENT +veces I-TREATMENT +al I-TREATMENT +año. I-TREATMENT + I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +molecular I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +genes I-EXPLORATION +implicados I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +metabolismo I-EXPLORATION +del I-EXPLORATION +hierro I-EXPLORATION +mostró I-EXPLORATION +las I-EXPLORATION +siguientes I-EXPLORATION +variantes I-EXPLORATION +alélicas I-EXPLORATION +en I-EXPLORATION +estado I-EXPLORATION +heterocigoto: I-EXPLORATION +c.187C>G I-EXPLORATION +(p.H63D) I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +gen I-EXPLORATION +HFE I-EXPLORATION +y I-EXPLORATION +c.840C>G I-EXPLORATION +(p.F280L) I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +gen I-EXPLORATION +TFR2. I-EXPLORATION + I-EXPLORATION -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -51 I-PRESENT_ILLNESS +44 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -disección I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -aorta I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -B I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -clasificación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Stanford, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -colocación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -prótesis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -teflón, I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -consulta. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Una B-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -previa I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS +interés, I-PAST_MEDICAL_HISTORY +diagnosticado B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +colitis I-PRESENT_ILLNESS +ulcerosa I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +intervenido, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +colectomía I-PRESENT_ILLNESS +total I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +ileostomía I-PRESENT_ILLNESS +terminal, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +megacolon I-PRESENT_ILLNESS +tóxico. I-PRESENT_ILLNESS +Acude I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -Terapia I-PRESENT_ILLNESS -Intensiva I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +difuso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -melena I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -lipotimia. I-PRESENT_ILLNESS -Ingresó I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +cólico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +18 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -hematemesis I-PRESENT_ILLNESS -abundante I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -melena I-PRESENT_ILLNESS +varias I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +líquidas I-PRESENT_ILLNESS +inicialmente, I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -shock I-PRESENT_ILLNESS -hipovolémico, I-PRESENT_ILLNESS -siendo B-TREATMENT -estabilizado I-TREATMENT -con I-TREATMENT -fluidos. I-TREATMENT -Un B-EVOLUTION -nuevo I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -hematemesis I-EVOLUTION -masiva I-EVOLUTION -lo I-EVOLUTION -lleva I-EVOLUTION -al I-EVOLUTION -paro I-EVOLUTION -cardiorrespiratorio I-EVOLUTION -y B-TREATMENT -tras I-TREATMENT -una I-TREATMENT -adecuada I-TREATMENT -resucitación I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT +cierre I-PRESENT_ILLNESS +intestinal I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +últimas I-PRESENT_ILLNESS +horas. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración, I-EXPLORATION +abdomen I-EXPLORATION +distendido I-EXPLORATION +y I-EXPLORATION +doloroso, I-EXPLORATION +con I-EXPLORATION +ruidos I-EXPLORATION +hidroaéreos I-EXPLORATION +ausentes. I-EXPLORATION +Ileostomía I-EXPLORATION +terminal I-EXPLORATION +iliaca I-EXPLORATION +derecha I-EXPLORATION +con I-EXPLORATION +escaso I-EXPLORATION +débito I-EXPLORATION +y I-EXPLORATION +hernia I-EXPLORATION +paraileostómica I-EXPLORATION +no I-EXPLORATION +reductible. I-EXPLORATION +Analíticamente, I-EXPLORATION +presentaba I-EXPLORATION +hemograma I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +bioquímica I-EXPLORATION +con I-EXPLORATION +glucosa I-EXPLORATION +388 I-EXPLORATION +mg/dl, I-EXPLORATION +urea I-EXPLORATION +98 I-EXPLORATION +mg/dl, I-EXPLORATION +GOT I-EXPLORATION +50 I-EXPLORATION +U/l, I-EXPLORATION +GPT I-EXPLORATION +52 I-EXPLORATION +U/l, I-EXPLORATION +LDH I-EXPLORATION +556 I-EXPLORATION +U/l, I-EXPLORATION +GGT I-EXPLORATION +159 I-EXPLORATION +U/l, I-EXPLORATION +CK I-EXPLORATION +41 I-EXPLORATION +U/l, I-EXPLORATION +TG I-EXPLORATION +358 I-EXPLORATION +mg/dl, I-EXPLORATION +PT I-EXPLORATION +5, I-EXPLORATION +2 I-EXPLORATION +g/l I-EXPLORATION +y I-EXPLORATION +PCR I-EXPLORATION +63 I-EXPLORATION +mg/l. I-EXPLORATION +La I-EXPLORATION +gasometría I-EXPLORATION +venosa, I-EXPLORATION +ionograma I-EXPLORATION +y I-EXPLORATION +coagulación I-EXPLORATION +eran I-EXPLORATION +normales I-EXPLORATION +con I-EXPLORATION +fibrinógeno I-EXPLORATION +de I-EXPLORATION +891 I-EXPLORATION +mg/dl. I-EXPLORATION +La I-EXPLORATION +radiología I-EXPLORATION +simple I-EXPLORATION +y I-EXPLORATION +TAC I-EXPLORATION +abdominal I-EXPLORATION +eran I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +oclusión I-EXPLORATION +intestinal. I-EXPLORATION +Ante B-TREATMENT la I-TREATMENT -intervención I-TREATMENT -quirúrgica, I-TREATMENT -con I-TREATMENT -el I-TREATMENT -hallazgo I-TREATMENT -quirúrgico I-TREATMENT +falta I-TREATMENT de I-TREATMENT -FAE I-TREATMENT +respuesta I-TREATMENT al I-TREATMENT -nivel I-TREATMENT +tratamiento I-TREATMENT +médico, I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +tratamiento I-TREATMENT +quirúrgico I-TREATMENT de I-TREATMENT la I-TREATMENT -tercera I-TREATMENT -porción I-TREATMENT -duodenal, I-TREATMENT -y I-TREATMENT -un I-TREATMENT -orificio I-TREATMENT -de I-TREATMENT +hernia I-TREATMENT +paraileostómica I-TREATMENT +presentando B-EVOLUTION +posteriormente I-EVOLUTION +empeoramiento I-EVOLUTION +del I-EVOLUTION +estado I-EVOLUTION +general, I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +sepsis I-EVOLUTION +y I-EVOLUTION +celulitis I-EVOLUTION +de I-EVOLUTION +piel I-EVOLUTION +y I-EVOLUTION +tejido I-EVOLUTION +celular I-EVOLUTION +subcutáneo I-EVOLUTION +abdominal I-EVOLUTION +circundante I-EVOLUTION +al I-EVOLUTION +ostoma, I-EVOLUTION +reinterviniéndose B-TREATMENT +en I-TREATMENT +otras I-TREATMENT 2 I-TREATMENT -x I-TREATMENT -1, I-TREATMENT -5 I-TREATMENT +ocasiones, I-TREATMENT +con I-TREATMENT +resección I-TREATMENT +de I-TREATMENT +50 I-TREATMENT cm I-TREATMENT de I-TREATMENT -diámetro. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -cierre I-TREATMENT -simple, I-TREATMENT -gastroyeyuno I-TREATMENT -anastomosis I-TREATMENT +intestino I-TREATMENT +delgado I-TREATMENT +cada I-TREATMENT +una, I-TREATMENT +presentando I-TREATMENT +ulceraciones I-TREATMENT +profundas, I-TREATMENT +perforaciones I-TREATMENT y I-TREATMENT -anastomosis I-TREATMENT -coledocoduodenal. I-TREATMENT -Falleció B-EVOLUTION -en I-EVOLUTION +pequeños I-TREATMENT +abscesos I-TREATMENT +adyacentes I-TREATMENT +al I-TREATMENT +ostoma. I-TREATMENT +Durante B-EVOLUTION el I-EVOLUTION -postoperatorio I-EVOLUTION -inmediato. I-EVOLUTION - I-EVOLUTION - -Niño B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -13 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -febril I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -9 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -sugerente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -viriasis, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -edemas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -superiores I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -oligoanuria I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -presenta I-EXPLORATION -mal I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -obnubilación, I-EXPLORATION -hipotensión, I-EXPLORATION -taquicardia I-EXPLORATION -y I-EXPLORATION -taquipnea, I-EXPLORATION -junto I-EXPLORATION +postoperatorio, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +comienza I-EVOLUTION +con I-EVOLUTION +sangrado I-EVOLUTION +difuso I-EVOLUTION +por I-EVOLUTION +el I-EVOLUTION +orificio I-EVOLUTION +de I-EVOLUTION +ileostomía I-EVOLUTION +y I-EVOLUTION +necrosis I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +últimos I-EVOLUTION +centímetros I-EVOLUTION +de I-EVOLUTION +esta. I-EVOLUTION +La B-EXPLORATION +endoscopia I-EXPLORATION +alta, I-EXPLORATION +hasta I-EXPLORATION +segunda I-EXPLORATION +porción I-EXPLORATION +duodenal I-EXPLORATION +era I-EXPLORATION +normal. I-EXPLORATION +Ante I-EXPLORATION +estos I-EXPLORATION +hallazgos, I-EXPLORATION +se I-EXPLORATION +procede I-EXPLORATION a I-EXPLORATION -lesiones I-EXPLORATION -petequiales I-EXPLORATION -en I-EXPLORATION -hombros, I-EXPLORATION -espalda I-EXPLORATION -y I-EXPLORATION -miembros I-EXPLORATION -superiores. I-EXPLORATION -En I-EXPLORATION la I-EXPLORATION -analítica I-EXPLORATION -destacan: I-EXPLORATION -plaquetopenia I-EXPLORATION -(13.000/mm3); I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -28 I-EXPLORATION -mg/dl; I-EXPLORATION -coagulopatía I-EXPLORATION -con I-EXPLORATION -tiempo I-EXPLORATION +reapertura I-EXPLORATION de I-EXPLORATION -tromboplastina I-EXPLORATION -parcial I-EXPLORATION -activado: I-EXPLORATION -47 I-EXPLORATION -seg I-EXPLORATION -(control: I-EXPLORATION -30 I-EXPLORATION -seg), I-EXPLORATION -tiempo I-EXPLORATION +la I-EXPLORATION +herida I-EXPLORATION +quirúrgica, I-EXPLORATION +apreciándose I-EXPLORATION +necrosis I-EXPLORATION de I-EXPLORATION -protrombina: I-EXPLORATION -20 I-EXPLORATION -seg I-EXPLORATION -(control: I-EXPLORATION -11 I-EXPLORATION -seg), I-EXPLORATION -índice I-EXPLORATION +los I-EXPLORATION +últimos I-EXPLORATION +centímetros I-EXPLORATION +del I-EXPLORATION +asa I-EXPLORATION de I-EXPLORATION -Quick: I-EXPLORATION -60%, I-EXPLORATION -fibrinógeno: I-EXPLORATION -332 I-EXPLORATION -mg/dl; I-EXPLORATION -actividad I-EXPLORATION +ileostomía, I-EXPLORATION +sangrado I-EXPLORATION +activo I-EXPLORATION de I-EXPLORATION -antitrombina-III: I-EXPLORATION -38%, I-EXPLORATION -Na+: I-EXPLORATION -117mEq/l, I-EXPLORATION -K+: I-EXPLORATION -6, I-EXPLORATION -7 I-EXPLORATION -mEq/l, I-EXPLORATION -creatinina I-EXPLORATION -0, I-EXPLORATION -7 I-EXPLORATION -mg/dl; I-EXPLORATION -urea I-EXPLORATION -69 I-EXPLORATION -mg/dl, I-EXPLORATION +ulceraciones I-EXPLORATION +profundas I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +mucosa I-EXPLORATION y I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION +perforaciones I-EXPLORATION +cubiertas I-EXPLORATION con I-EXPLORATION -30 I-EXPLORATION -leucocitos/mm3 I-EXPLORATION -y I-EXPLORATION -proteínas I-EXPLORATION +coágulos I-EXPLORATION +intraluminales, I-EXPLORATION +resecándose I-EXPLORATION +nuevamente I-EXPLORATION +50 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -95 I-EXPLORATION -mg/dl. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -con I-TREATMENT -expansión, I-TREATMENT -perfusión I-TREATMENT +intestino I-EXPLORATION +afectado. I-EXPLORATION +La I-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +resulta I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +enfermedad I-EXPLORATION +de I-EXPLORATION +Crohn. I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +continuó I-EVOLUTION +con I-EVOLUTION +hemorragia I-EVOLUTION +digestiva I-EVOLUTION +persistente I-EVOLUTION +y I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +inestabilidad I-EVOLUTION +hemodinámica, I-EVOLUTION +requiriendo B-TREATMENT +transfusión I-TREATMENT de I-TREATMENT -noradrenalina I-TREATMENT -a I-TREATMENT -0, I-TREATMENT -2 I-TREATMENT -µg/kg/min, I-TREATMENT -y I-TREATMENT -cefotaxima. I-TREATMENT -Se I-TREATMENT -inicia I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT +10 I-TREATMENT +concentrados I-TREATMENT +de I-TREATMENT +hematíes I-TREATMENT y I-TREATMENT -diálisis I-TREATMENT -peritoneal I-TREATMENT +2 I-TREATMENT +de I-TREATMENT +fibrinógeno, I-TREATMENT +sin I-TREATMENT +respuesta I-TREATMENT +a I-TREATMENT +corticoterapia I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT +plenas, I-TREATMENT por I-TREATMENT -insuficiencia I-TREATMENT -renal I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +inicia I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +infliximab I-TREATMENT +previa I-TREATMENT +realización I-TREATMENT +de I-TREATMENT +placa I-TREATMENT +de I-TREATMENT +tórax, I-TREATMENT +mantoux I-TREATMENT +negativo I-TREATMENT y I-TREATMENT -alteraciones I-TREATMENT -iónicas. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -5 I-EVOLUTION -horas I-EVOLUTION +TAC I-TREATMENT +toracoabdominal I-TREATMENT +que I-TREATMENT +descartó I-TREATMENT +procesos I-TREATMENT +infecciosos. I-TREATMENT +Cinco B-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION de I-EVOLUTION -su I-EVOLUTION -ingreso I-EVOLUTION -presenta I-EVOLUTION -parada I-EVOLUTION -cardiorrespiratoria I-EVOLUTION -por I-EVOLUTION -fibrilación I-EVOLUTION -ventricular I-EVOLUTION -refractaria I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -medidas I-EVOLUTION +la I-EVOLUTION +primera I-EVOLUTION +dosis I-EVOLUTION +de I-EVOLUTION +infliximab, I-EVOLUTION +el I-EVOLUTION +sangrado I-EVOLUTION +remite I-EVOLUTION +y I-EVOLUTION +tres I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +asintomático, I-EVOLUTION +con I-EVOLUTION +terapia I-EVOLUTION +de I-EVOLUTION +mantenimiento I-EVOLUTION +con I-EVOLUTION +infliximab I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +enteroscopia I-EVOLUTION de I-EVOLUTION -reanimación. I-EVOLUTION +control, I-EVOLUTION +se I-EVOLUTION +observa I-EVOLUTION +mucosa I-EVOLUTION +intestinal I-EVOLUTION +sin I-EVOLUTION +ulceraciones. I-EVOLUTION I-EVOLUTION -Los B-EXPLORATION -cultivos I-EXPLORATION -fueron I-EXPLORATION -negativos, I-EXPLORATION -salvo I-EXPLORATION -el I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -de I-EXPLORATION -petequia I-EXPLORATION -cutánea I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -aisló I-EXPLORATION -S. I-EXPLORATION -pyogenes I-EXPLORATION -serotipo I-EXPLORATION -M1T1. I-EXPLORATION - I-EXPLORATION -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS +16 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -que B-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY +(sin B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -asma I-PAST_MEDICAL_HISTORY -bronquial I-PAST_MEDICAL_HISTORY -extrínseco I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -eco-transtorácico I-PAST_MEDICAL_HISTORY -(ETT) I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -miocardiopatía I-PAST_MEDICAL_HISTORY -hipertrófica I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -obstructiva, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -mitral I-PAST_MEDICAL_HISTORY -leve-moderada. I-PAST_MEDICAL_HISTORY -Realizaba I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -activa I-PAST_MEDICAL_HISTORY -encontrándose I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -grado I-PAST_MEDICAL_HISTORY -funcional I-PAST_MEDICAL_HISTORY -I. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acudió B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -precordial I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -realizar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -esfuerzo I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -posterior I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -palpitaciones. I-PRESENT_ILLNESS -En B-EXPLORATION -un I-EXPLORATION -primer I-EXPLORATION -electrocardiograma I-EXPLORATION -(ECG) I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -una I-EXPLORATION -taquicardia I-EXPLORATION -regular I-EXPLORATION -con I-EXPLORATION -QRS I-EXPLORATION -ancho I-EXPLORATION -a I-EXPLORATION -210 I-EXPLORATION -lpm, I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -respondió I-EXPLORATION -al I-EXPLORATION -tratamiento I-EXPLORATION -con I-EXPLORATION -adenosina I-EXPLORATION -ni I-EXPLORATION -a I-EXPLORATION -maniobras I-EXPLORATION -vagales. I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -cardioversión I-TREATMENT -eléctrica I-TREATMENT -con I-TREATMENT -100 I-TREATMENT -J I-TREATMENT -que I-TREATMENT -derivó I-TREATMENT -en I-TREATMENT -fibrilación I-TREATMENT -ventricular I-TREATMENT -(FV) I-TREATMENT -revertida I-TREATMENT -con I-TREATMENT -dos I-TREATMENT -choques I-TREATMENT -de I-TREATMENT -360 I-TREATMENT -J. I-TREATMENT -Se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -amiodarona I-TREATMENT -intravenosa, I-TREATMENT -pero I-TREATMENT -fue I-TREATMENT -preciso I-TREATMENT -suspenderla I-TREATMENT -poco I-TREATMENT -después I-TREATMENT -por I-TREATMENT -la I-TREATMENT -aparición I-TREATMENT -de I-TREATMENT -disfunción I-TREATMENT -sinusal, I-TREATMENT -con I-TREATMENT -ritmo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -unión I-TREATMENT -a I-TREATMENT -40 I-TREATMENT -latidos/ I-TREATMENT -minuto. I-TREATMENT -Se I-TREATMENT -le I-TREATMENT -administró I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -empírica I-TREATMENT -sulfato I-TREATMENT -de I-TREATMENT -magnesio I-TREATMENT -y I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -ingresó I-TREATMENT -en I-TREATMENT -la I-TREATMENT -Unidad I-TREATMENT -Coronaria. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION +interés), I-PAST_MEDICAL_HISTORY +derivada B-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +prurito I-DERIVED_FROM/TO +generalizado, I-DERIVED_FROM/TO +tinte I-DERIVED_FROM/TO +ictérico, I-DERIVED_FROM/TO +coluria I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +heces I-DERIVED_FROM/TO +acólicas. I-DERIVED_FROM/TO +La B-EXPLORATION exploración I-EXPLORATION física I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -sistémica I-EXPLORATION -de I-EXPLORATION -130/70 I-EXPLORATION -mmHg. I-EXPLORATION -Se I-EXPLORATION -auscultaba I-EXPLORATION -un I-EXPLORATION -soplo I-EXPLORATION -sistólico, I-EXPLORATION -en I-EXPLORATION -ápex I-EXPLORATION -y I-EXPLORATION -borde I-EXPLORATION -esternal I-EXPLORATION -izquierdo, I-EXPLORATION +mostraba I-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +ictericia I-EXPLORATION +cutaneomucosa, I-EXPLORATION y I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -congestión I-EXPLORATION -pulmonar. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -ECG I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -disfunción I-EXPLORATION -sinusal, I-EXPLORATION -QRS I-EXPLORATION -ancho I-EXPLORATION -con I-EXPLORATION -morfología I-EXPLORATION +hepatomegalia I-EXPLORATION de I-EXPLORATION -bloqueo I-EXPLORATION -completo I-EXPLORATION +2 I-EXPLORATION +traveses. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -rama I-EXPLORATION -izquierda I-EXPLORATION -e I-EXPLORATION -intervalo I-EXPLORATION -QT I-EXPLORATION -normal. I-EXPLORATION -En I-EXPLORATION la I-EXPLORATION -analítica I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -30 I-EXPLORATION -horas I-EXPLORATION -de I-EXPLORATION -evolución I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -síntomas I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -CPK I-EXPLORATION -total I-EXPLORATION +anamnesis I-EXPLORATION +por I-EXPLORATION +aparatos I-EXPLORATION +resultó I-EXPLORATION +normal. I-EXPLORATION +Bioquímica: I-EXPLORATION +bilirrubina I-EXPLORATION +directa I-EXPLORATION +22, I-EXPLORATION +13 I-EXPLORATION +mg/dl, I-EXPLORATION +GOT I-EXPLORATION +66 I-EXPLORATION +UI/l, I-EXPLORATION +GPT I-EXPLORATION +91 I-EXPLORATION +UI/l, I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina I-EXPLORATION +1838 I-EXPLORATION +UI/l, I-EXPLORATION +GGT I-EXPLORATION +37 I-EXPLORATION +UI/l. I-EXPLORATION +Antígeno I-EXPLORATION +CA I-EXPLORATION +19-9 I-EXPLORATION +86 I-EXPLORATION +UI/l I-EXPLORATION +(0-37), I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -2.657 I-EXPLORATION -U/l I-EXPLORATION +parámetros I-EXPLORATION +bioquímicos I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -troponina I-EXPLORATION -I I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -2, I-EXPLORATION -21 I-EXPLORATION -ng/ml. I-EXPLORATION -Los I-EXPLORATION -iones I-EXPLORATION -séricos I-EXPLORATION +coagulación I-EXPLORATION fueron I-EXPLORATION normales. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -ecocardiograma I-EXPLORATION -realizado I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -equipo I-EXPLORATION -portátil I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -apreció I-EXPLORATION -un I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo I-EXPLORATION -(VI) I-EXPLORATION -muy I-EXPLORATION -dilatado I-EXPLORATION +objetivó I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +intra-extrahepática I-EXPLORATION +sin I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +litiasis. I-EXPLORATION +La I-EXPLORATION +TAC I-EXPLORATION y I-EXPLORATION -globalmente I-EXPLORATION -hipoquinético, I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -miocardio I-EXPLORATION -muy I-EXPLORATION -hipertrófico, I-EXPLORATION -con I-EXPLORATION -trabeculaciones. I-EXPLORATION - I-EXPLORATION -Como I-EXPLORATION -parte I-EXPLORATION +colangio I-EXPLORATION +RMN I-EXPLORATION +mostraron I-EXPLORATION +hepatomegalia, I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +intra-extrahepática, I-EXPLORATION +dilatación I-EXPLORATION del I-EXPLORATION -protocolo I-EXPLORATION +conducto I-EXPLORATION de I-EXPLORATION -estudio I-EXPLORATION +Wirsung, I-EXPLORATION +desestructuración I-EXPLORATION +y I-EXPLORATION +aumento I-EXPLORATION +del I-EXPLORATION +tamaño I-EXPLORATION +del I-EXPLORATION +proceso I-EXPLORATION +uncinado I-EXPLORATION +y I-EXPLORATION +cabeza I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -taquicardias I-EXPLORATION -ventriculares I-EXPLORATION -(TV), I-EXPLORATION -con I-EXPLORATION -sospecha I-EXPLORATION -clínica I-EXPLORATION +páncreas, I-EXPLORATION +sugestivas I-EXPLORATION de I-EXPLORATION -miocardiopatía I-EXPLORATION -dilatada, I-EXPLORATION +neoplasia. I-EXPLORATION +Se B-TREATMENT +decidió I-TREATMENT +colocar I-TREATMENT +percutáneamente I-TREATMENT +un I-TREATMENT +drenaje I-TREATMENT +biliar I-TREATMENT +externo-interno I-TREATMENT +para I-TREATMENT +resolver I-TREATMENT +la I-TREATMENT +ictericia I-TREATMENT +obstructiva. I-TREATMENT +Bajo I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +neoplasia I-TREATMENT +pancreática, I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +se I-TREATMENT +intervino I-TREATMENT +quirúrgicamente; I-TREATMENT +la I-TREATMENT +exploración I-TREATMENT +intraoperatoria I-TREATMENT +mostraba I-TREATMENT +induración I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cabeza I-TREATMENT +del I-TREATMENT +páncreas I-TREATMENT +y I-TREATMENT +adenopatías I-TREATMENT +hiliares; I-TREATMENT +de B-EXPLORATION +ambas, I-EXPLORATION se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION +tomaron I-EXPLORATION +biopsias I-EXPLORATION +intraoperatorias I-EXPLORATION +que I-EXPLORATION +informaron I-EXPLORATION +de I-EXPLORATION +fibrosis I-EXPLORATION +intersticial I-EXPLORATION +y I-EXPLORATION +negativas I-EXPLORATION +para I-EXPLORATION +neoplasia I-EXPLORATION +respectivamente. I-EXPLORATION +Fue B-TREATMENT +practicada I-TREATMENT +duodenopancreatectomía I-TREATMENT +cefálica I-TREATMENT +con I-TREATMENT +preservación I-TREATMENT +pilórica. I-TREATMENT +El B-EXPLORATION estudio I-EXPLORATION -hemodinámico. I-EXPLORATION -La I-EXPLORATION -ventriculografía I-EXPLORATION -izquierda I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -ventrículo I-EXPLORATION -con I-EXPLORATION -fracción I-EXPLORATION +anatomopatológico I-EXPLORATION +informó I-EXPLORATION de I-EXPLORATION -eyección I-EXPLORATION -(FE) I-EXPLORATION -del I-EXPLORATION -20%, I-EXPLORATION -con I-EXPLORATION -defectos I-EXPLORATION -generalizados I-EXPLORATION +pancreatitis I-EXPLORATION +crónica I-EXPLORATION +obstructiva I-EXPLORATION +fibrosante I-EXPLORATION +e I-EXPLORATION +hiperplasia I-EXPLORATION +ductal I-EXPLORATION +inflamatoria I-EXPLORATION +de I-EXPLORATION +conducto I-EXPLORATION +pancreático. I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +duodécimo I-EVOLUTION +día I-EVOLUTION +postoperatorio I-EVOLUTION +sin I-EVOLUTION +complicaciones. I-EVOLUTION +Fue B-EXPLORATION +realizado, I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +6º I-EXPLORATION +mes I-EXPLORATION +postoperatorio, I-EXPLORATION +estudio I-EXPLORATION +genético I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -contractilidad I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION +mutación I-EXPLORATION +N34S I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +gen I-EXPLORATION +SPINK1, I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +negativa. I-EXPLORATION +Dos B-EVOLUTION +años I-EVOLUTION +después I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +asintomática I-EVOLUTION +y I-EVOLUTION +libre I-EVOLUTION +de I-EVOLUTION +enfermedad. I-EVOLUTION + I-EVOLUTION +La B-EXPLORATION +IFP I-EXPLORATION +es I-EXPLORATION una I-EXPLORATION -imagen I-EXPLORATION +rara I-EXPLORATION +causa I-EXPLORATION de I-EXPLORATION -importante I-EXPLORATION -trabeculación I-EXPLORATION -que I-EXPLORATION -sugirió I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +pancreatitis I-EXPLORATION +crónica I-EXPLORATION +en I-EXPLORATION +niños. I-EXPLORATION +El I-EXPLORATION +rango I-EXPLORATION +de I-EXPLORATION +edad I-EXPLORATION +es I-EXPLORATION +de I-EXPLORATION +4 I-EXPLORATION +meses I-EXPLORATION +a I-EXPLORATION +20 I-EXPLORATION +años I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +edad I-EXPLORATION +media I-EXPLORATION de I-EXPLORATION -miocardiopatía I-EXPLORATION -no I-EXPLORATION -compactada I-EXPLORATION -(MNC) I-EXPLORATION -o I-EXPLORATION -miocardiopatía I-EXPLORATION -espongiforme I-EXPLORATION -(ME). I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -detectó I-EXPLORATION -insuficiencia I-EXPLORATION -mitral I-EXPLORATION -angiográficamente I-EXPLORATION -significativa. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -cateterismo I-EXPLORATION -derecho I-EXPLORATION -las I-EXPLORATION -presiones I-EXPLORATION -fueron: I-EXPLORATION -aurícula I-EXPLORATION -derecha I-EXPLORATION -(AD) I-EXPLORATION 10 I-EXPLORATION -mmHg, I-EXPLORATION -ventrículo I-EXPLORATION -derecho I-EXPLORATION -(VD) I-EXPLORATION -70/4 I-EXPLORATION -mmHg, I-EXPLORATION -arteria I-EXPLORATION -pulmonar I-EXPLORATION -(AP) I-EXPLORATION -70/15 I-EXPLORATION -mmHg, I-EXPLORATION -enclavamiento I-EXPLORATION -capilar I-EXPLORATION -pulmonar I-EXPLORATION -(PECP) I-EXPLORATION -15 I-EXPLORATION -mmHg. I-EXPLORATION -Índice I-EXPLORATION -cardíaco I-EXPLORATION -2 I-EXPLORATION -litros/minuto/m2; I-EXPLORATION -presión I-EXPLORATION -telediastólica I-EXPLORATION -VI I-EXPLORATION -(PTDVI) I-EXPLORATION -30 I-EXPLORATION -mmHg; I-EXPLORATION -gradiente I-EXPLORATION -mitral I-EXPLORATION -invertido I-EXPLORATION -(PTDVI I-EXPLORATION -> I-EXPLORATION -PECP). I-EXPLORATION -La I-EXPLORATION -coronariografía I-EXPLORATION -mostró I-EXPLORATION -unas I-EXPLORATION -arterias I-EXPLORATION -epicárdicas I-EXPLORATION -angiográficamente I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION +años I-EXPLORATION +(1). I-EXPLORATION +Hasta I-EXPLORATION la I-EXPLORATION -sospecha I-EXPLORATION -diagnóstica I-EXPLORATION -de I-EXPLORATION -MNC I-EXPLORATION -al I-EXPLORATION -paciente I-EXPLORATION +fecha I-EXPLORATION +sólo I-EXPLORATION +44 I-EXPLORATION +casos I-EXPLORATION +han I-EXPLORATION +sido I-EXPLORATION +publicados I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +literatura. I-EXPLORATION +La I-EXPLORATION +etiología I-EXPLORATION +es I-EXPLORATION +desconocida, I-EXPLORATION +aunque I-EXPLORATION se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -ecocardiografía I-EXPLORATION +ha I-EXPLORATION +asociado I-EXPLORATION +a I-EXPLORATION +determinadas I-EXPLORATION +alteraciones I-EXPLORATION +genéticas I-EXPLORATION +(CFTR, I-EXPLORATION +PRSS1), I-EXPLORATION +destacando I-EXPLORATION por I-EXPLORATION -personal I-EXPLORATION -especializado. I-EXPLORATION -La I-EXPLORATION -ecocardiografía-2D I-EXPLORATION -confirmó I-EXPLORATION +su I-EXPLORATION +frecuencia I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -marcada I-EXPLORATION -trabeculación I-EXPLORATION +mutación I-EXPLORATION +N34S I-EXPLORATION del I-EXPLORATION -VI, I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -ápex I-EXPLORATION -y I-EXPLORATION -segmentos I-EXPLORATION -medios I-EXPLORATION +gen I-EXPLORATION +SPINK1, I-EXPLORATION +que I-EXPLORATION +también I-EXPLORATION +se I-EXPLORATION +ha I-EXPLORATION +relacionado I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +pancreatitis I-EXPLORATION +juvenil I-EXPLORATION +tropical I-EXPLORATION +(1,3,4). I-EXPLORATION +A I-EXPLORATION +diferencia I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -pared I-EXPLORATION -lateral I-EXPLORATION -e I-EXPLORATION -inferior, I-EXPLORATION +pancreatitis I-EXPLORATION +hereditaria I-EXPLORATION +autonómica I-EXPLORATION +dominante, I-EXPLORATION +los I-EXPLORATION +pacientes I-EXPLORATION con I-EXPLORATION -una I-EXPLORATION -relación I-EXPLORATION -telesistólica I-EXPLORATION +IFP I-EXPLORATION +no I-EXPLORATION +presentan I-EXPLORATION +antecedentes I-EXPLORATION +familiares. I-EXPLORATION +La I-EXPLORATION +forma I-EXPLORATION de I-EXPLORATION -2, I-EXPLORATION -5 I-EXPLORATION -entre I-EXPLORATION -la I-EXPLORATION -gruesa I-EXPLORATION -capa I-EXPLORATION -interna I-EXPLORATION +presentación I-EXPLORATION +más I-EXPLORATION +frecuente I-EXPLORATION de I-EXPLORATION -miocardio I-EXPLORATION -no I-EXPLORATION -compactado I-EXPLORATION -(NC) I-EXPLORATION -y I-EXPLORATION la I-EXPLORATION -fina I-EXPLORATION -capa I-EXPLORATION -externa I-EXPLORATION -de I-EXPLORATION -miocardio I-EXPLORATION -compactado I-EXPLORATION -(NC/C I-EXPLORATION -> I-EXPLORATION -2). I-EXPLORATION -Con I-EXPLORATION -doppler I-EXPLORATION -color I-EXPLORATION -se I-EXPLORATION -visualizó I-EXPLORATION -el I-EXPLORATION -flujo I-EXPLORATION +IFP I-EXPLORATION +es I-EXPLORATION +la I-EXPLORATION +ictericia I-EXPLORATION +obstructiva I-EXPLORATION +y I-EXPLORATION +las I-EXPLORATION +crisis I-EXPLORATION de I-EXPLORATION -sangre I-EXPLORATION -en I-EXPLORATION -comunicación I-EXPLORATION -entre I-EXPLORATION +dolor I-EXPLORATION +abdominal I-EXPLORATION +recidivante I-EXPLORATION +(1,2,5,6,). I-EXPLORATION +Analíticamente, I-EXPLORATION los I-EXPLORATION -profundos I-EXPLORATION -recesos I-EXPLORATION -intertrabeculares I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -cavidad I-EXPLORATION -ventricular. I-EXPLORATION -El I-EXPLORATION -flujo I-EXPLORATION -diastólico I-EXPLORATION -mitral I-EXPLORATION -mostró I-EXPLORATION +pacientes I-EXPLORATION +con I-EXPLORATION +IFP, I-EXPLORATION +presentan I-EXPLORATION un I-EXPLORATION patrón I-EXPLORATION -restrictivo. I-EXPLORATION -El I-EXPLORATION -VI I-EXPLORATION -tenía I-EXPLORATION -morfología I-EXPLORATION -esferoidal I-EXPLORATION -y I-EXPLORATION -medía I-EXPLORATION -en I-EXPLORATION -telediástole I-EXPLORATION -70 I-EXPLORATION -mm, I-EXPLORATION +colestásico, I-EXPLORATION +citolítico I-EXPLORATION +y, I-EXPLORATION +ocasionalmente, I-EXPLORATION +una I-EXPLORATION +leve I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -aurícula I-EXPLORATION -izquierda I-EXPLORATION -47 I-EXPLORATION -mm I-EXPLORATION +amilasa I-EXPLORATION +sérica I-EXPLORATION y I-EXPLORATION +urinaria. I-EXPLORATION +Respecto I-EXPLORATION +al I-EXPLORATION +diagnóstico, I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +de I-EXPLORATION +imagen I-EXPLORATION +son I-EXPLORATION +útiles I-EXPLORATION +para I-EXPLORATION +objetivar I-EXPLORATION el I-EXPLORATION -VD I-EXPLORATION -30 I-EXPLORATION -mm. I-EXPLORATION -Un I-EXPLORATION -flujo I-EXPLORATION +origen I-EXPLORATION +pancreático I-EXPLORATION de I-EXPLORATION -regurgitación I-EXPLORATION -mitral I-EXPLORATION -fue I-EXPLORATION -valorado I-EXPLORATION -como I-EXPLORATION -insuficiencia I-EXPLORATION -mitral I-EXPLORATION -moderada, I-EXPLORATION -y I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -insuficiencia I-EXPLORATION -tricuspídea I-EXPLORATION -permitió I-EXPLORATION -calcular I-EXPLORATION -un I-EXPLORATION -gradiente I-EXPLORATION -AD-VD I-EXPLORATION -de I-EXPLORATION -55 I-EXPLORATION -mmHg, I-EXPLORATION -estimándose I-EXPLORATION -una I-EXPLORATION -presión I-EXPLORATION +obstrucción I-EXPLORATION de I-EXPLORATION -AP I-EXPLORATION +vía I-EXPLORATION +biliar. I-EXPLORATION +La I-EXPLORATION +TAC I-EXPLORATION +y I-EXPLORATION +colangioRMN I-EXPLORATION +permiten, I-EXPLORATION +como I-EXPLORATION +sucedió I-EXPLORATION +en I-EXPLORATION +nuestro I-EXPLORATION +caso, I-EXPLORATION +visualizar I-EXPLORATION +con I-EXPLORATION +mayor I-EXPLORATION +nitidez I-EXPLORATION +el I-EXPLORATION +páncreas, I-EXPLORATION +cuya I-EXPLORATION +cabeza I-EXPLORATION +usualmente I-EXPLORATION +estará I-EXPLORATION +aumentada I-EXPLORATION de I-EXPLORATION -65 I-EXPLORATION -mmHg. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -detectaron I-EXPLORATION -anomalías I-EXPLORATION -valvulares I-EXPLORATION -estructurales. I-EXPLORATION -No I-EXPLORATION +tamaño I-EXPLORATION +y I-EXPLORATION +desestructurada. I-EXPLORATION +El I-EXPLORATION +Wirsung I-EXPLORATION +puede I-EXPLORATION +presentar I-EXPLORATION +dilatación I-EXPLORATION +preestenótica. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +definitivo I-EXPLORATION se I-EXPLORATION -consideró I-EXPLORATION -necesario I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -ecocardiografía I-EXPLORATION +consigue I-EXPLORATION +por I-EXPLORATION +exclusión I-EXPLORATION +de I-EXPLORATION +otras I-EXPLORATION +patologías I-EXPLORATION +más I-EXPLORATION +frecuentes I-EXPLORATION +y I-EXPLORATION con I-EXPLORATION -contraste I-EXPLORATION -dada I-EXPLORATION -la I-EXPLORATION -buena I-EXPLORATION -calidad I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION +(biopsia I-EXPLORATION +o I-EXPLORATION +cirugía). I-EXPLORATION +Histológicamente I-EXPLORATION +el I-EXPLORATION +páncreas I-EXPLORATION +muestra I-EXPLORATION +bandas I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -imágenes I-EXPLORATION +tejido I-EXPLORATION +colagenizado I-EXPLORATION +envolviendo I-EXPLORATION +acinos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -bidimensional1. I-EXPLORATION - I-EXPLORATION -Con B-EVOLUTION -estos I-EVOLUTION -hallazgos I-EVOLUTION -ecocardiográficos I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -MNC I-EVOLUTION -según I-EVOLUTION -los I-EVOLUTION -criterios I-EVOLUTION -de I-EVOLUTION -Jenni, I-EVOLUTION -por I-EVOLUTION -ausencia I-EVOLUTION -de I-EVOLUTION -compactación I-EVOLUTION -del I-EVOLUTION -miocardio I-EVOLUTION -ventricular I-EVOLUTION -izquierdo I-EVOLUTION -sin I-EVOLUTION -otras I-EVOLUTION -anomalías I-EVOLUTION -cardíacas I-EVOLUTION -asociadas2, I-EVOLUTION -3. I-EVOLUTION -Aunque I-EVOLUTION -hubiera I-EVOLUTION -sido I-EVOLUTION -interesante I-EVOLUTION -una I-EVOLUTION -cardiorresonancia, I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -pudo I-EVOLUTION -realizar I-EVOLUTION -por I-EVOLUTION -no I-EVOLUTION -disponer I-EVOLUTION -de I-EVOLUTION -esta I-EVOLUTION -técnica I-EVOLUTION -en I-EVOLUTION -nuestro I-EVOLUTION -hospital4, I-EVOLUTION -5. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -sufrió I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -accidente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -coche. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -valoración I-EXPLORATION -inicial I-EXPLORATION -estaba I-EXPLORATION -estable I-EXPLORATION -hemodinámicamente. I-EXPLORATION -La I-EXPLORATION -TACHT I-EXPLORATION -corporal I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -mostraba: I-EXPLORATION -seudoaneurisma I-EXPLORATION +apariencia I-EXPLORATION +normal. I-EXPLORATION +El I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION +acompañante I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -aorta I-EXPLORATION -torácica I-EXPLORATION -distal I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -subclavia I-EXPLORATION -izquierda I-EXPLORATION -con I-EXPLORATION -sangrado I-EXPLORATION -periaórtico. I-EXPLORATION -Ingresó B-TREATMENT +proliferación I-EXPLORATION +fibrosante I-EXPLORATION +no I-EXPLORATION +suele I-EXPLORATION +ser I-EXPLORATION +prominente I-EXPLORATION +(1,6,). I-EXPLORATION +El B-TREATMENT +tratamiento I-TREATMENT +debe I-TREATMENT +comenzar I-TREATMENT +por, I-TREATMENT en I-TREATMENT +caso I-TREATMENT +de I-TREATMENT +existir, I-TREATMENT +resolver I-TREATMENT la I-TREATMENT -UCI, I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -médico. I-TREATMENT -A I-TREATMENT +ictericia I-TREATMENT +obstructiva, I-TREATMENT +en I-TREATMENT +espera I-TREATMENT +del I-TREATMENT +procedimiento I-TREATMENT +quirúrgico I-TREATMENT +definitivo. I-TREATMENT +El I-TREATMENT +drenaje I-TREATMENT +percutáneo I-TREATMENT +de I-TREATMENT +vía I-TREATMENT +biliar I-TREATMENT +o I-TREATMENT +la I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +stent I-TREATMENT +por I-TREATMENT +CPRE I-TREATMENT +son I-TREATMENT las I-TREATMENT -36 I-TREATMENT -horas I-TREATMENT +técnicas I-TREATMENT +de I-TREATMENT +elección I-TREATMENT +(1,6,). I-TREATMENT +El I-TREATMENT +tratamiento I-TREATMENT +quirúrgico I-TREATMENT +es I-TREATMENT +controvertido I-TREATMENT +y I-TREATMENT +podemos I-TREATMENT +clasificarlos I-TREATMENT +en I-TREATMENT +derivativos I-TREATMENT +y I-TREATMENT +resectivos. I-TREATMENT +Los I-TREATMENT +primeros I-TREATMENT +(coledocoduodenostomía I-TREATMENT +y I-TREATMENT +coledocoyeyunostomía I-TREATMENT +en I-TREATMENT +Y I-TREATMENT +de I-TREATMENT +Roux) I-TREATMENT se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -reparación I-TREATMENT -quirúrgica I-TREATMENT -con I-TREATMENT -endoprótesis I-TREATMENT +encuentran I-TREATMENT en I-TREATMENT +desuso I-TREATMENT +porque I-TREATMENT +no I-TREATMENT +resuelven I-TREATMENT la I-TREATMENT -aorta I-TREATMENT -torácica I-TREATMENT -descendente I-TREATMENT +obstrucción I-TREATMENT +del I-TREATMENT +Wirsung, I-TREATMENT +persistiendo I-TREATMENT +el I-TREATMENT +dolor I-TREATMENT +abdominal I-TREATMENT +o I-TREATMENT +la I-TREATMENT +evolución I-TREATMENT +a I-TREATMENT +insuficiencia I-TREATMENT +pancreática I-TREATMENT +exo-endocrina I-TREATMENT +(1). I-TREATMENT +Entre I-TREATMENT +los I-TREATMENT +procedimientos I-TREATMENT +resectivos I-TREATMENT +destaca I-TREATMENT +la I-TREATMENT +DPC I-TREATMENT +con I-TREATMENT +preservación I-TREATMENT +pilórica. I-TREATMENT +Algunos I-TREATMENT +autores I-TREATMENT +la I-TREATMENT +desanconsejan I-TREATMENT por I-TREATMENT la I-TREATMENT -vía I-TREATMENT -femoral I-TREATMENT -izquierda. I-TREATMENT -Hubo I-TREATMENT -una I-TREATMENT -oclusión I-TREATMENT -asintomática I-TREATMENT +alta I-TREATMENT +frecuencia I-TREATMENT de I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -subclavia I-TREATMENT -izquierda. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -TACHT I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -6 I-EXPLORATION -días I-EXPLORATION -mostraba I-EXPLORATION -una I-EXPLORATION -correcta I-EXPLORATION -localización I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -endoprótesis. I-EXPLORATION -Al B-EVOLUTION -décimo I-EVOLUTION -día I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -pericarditis I-EVOLUTION -aguda I-EVOLUTION +diabetes I-TREATMENT +y I-TREATMENT +mala I-TREATMENT +digestión I-TREATMENT +posoperatoria, I-TREATMENT +así I-TREATMENT +como I-TREATMENT +el I-TREATMENT +escaso I-TREATMENT +alivio I-TREATMENT +del I-TREATMENT +dolor I-TREATMENT +a I-TREATMENT +largo I-TREATMENT +plazo. I-TREATMENT +Fue I-TREATMENT +la I-TREATMENT +técnica I-TREATMENT +utilizada I-TREATMENT +en I-TREATMENT +nuestro I-TREATMENT +caso I-TREATMENT +y B-EVOLUTION +24 I-EVOLUTION +meses I-EVOLUTION +después, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +permanece I-EVOLUTION +asintomática I-EVOLUTION y I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION +libre I-EVOLUTION de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -decimosexto I-EVOLUTION -día, I-EVOLUTION -asintomático. I-EVOLUTION - I-EVOLUTION +enfermedad, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +no I-EVOLUTION +podemos I-EVOLUTION +apoyar I-EVOLUTION +dicha I-EVOLUTION +afirmación. I-EVOLUTION +La B-TREATMENT +pancreatectomía I-TREATMENT +cefálica I-TREATMENT +con I-TREATMENT +preservación I-TREATMENT +duodenal I-TREATMENT +(DPPHR) I-TREATMENT +elimina I-TREATMENT +las I-TREATMENT +complicaciones I-TREATMENT +de I-TREATMENT +las I-TREATMENT +pancreatitis I-TREATMENT +crónicas I-TREATMENT +y I-TREATMENT +proporciona I-TREATMENT +alivio I-TREATMENT +del I-TREATMENT +dolor I-TREATMENT +a I-TREATMENT +largo I-TREATMENT +plazo I-TREATMENT +en I-TREATMENT +más I-TREATMENT +del I-TREATMENT +80% I-TREATMENT +de I-TREATMENT +los I-TREATMENT +pacientes I-TREATMENT +(1). I-TREATMENT + I-TREATMENT +G. I-TREATMENT +Suárez I-TREATMENT +Artacho, I-TREATMENT +J. I-TREATMENT +Rodríguez I-TREATMENT +Muñoz, I-TREATMENT +M. I-TREATMENT +A. I-TREATMENT +Gómez I-TREATMENT +Bravo, I-TREATMENT +F. I-TREATMENT +Docobo I-TREATMENT +Durántez, I-TREATMENT +R. I-TREATMENT +García I-TREATMENT +Lozano I-TREATMENT +y I-TREATMENT +S. I-TREATMENT +P. I-TREATMENT +Alconchel I-TREATMENT +Gonzaga I-TREATMENT + I-TREATMENT +Servicio I-TREATMENT +de I-TREATMENT +Cirugía I-TREATMENT +General I-TREATMENT +y I-TREATMENT +Aparato I-TREATMENT +Digestivo. I-TREATMENT +Hospital I-TREATMENT +Universitario I-TREATMENT +Virgen I-TREATMENT +del I-TREATMENT +Rocío. I-TREATMENT +Sevilla. I-TREATMENT + I-TREATMENT -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -76 I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino, I-PRESENT_ILLNESS +38 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Crohn I-PAST_MEDICAL_HISTORY +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +de B-PAST_MEDICAL_HISTORY +nacionalidad I-PAST_MEDICAL_HISTORY +chilena, I-PAST_MEDICAL_HISTORY +residente I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -prednisona I-PAST_MEDICAL_HISTORY -(30mg I-PAST_MEDICAL_HISTORY -diarios) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -mesazalina, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS +Italia I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +aproximadamente. I-PAST_MEDICAL_HISTORY +Presentó B-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +mayo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -otro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS +2011 I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS cuadro I-PRESENT_ILLNESS -febril I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -artralgias I-PRESENT_ILLNESS -generalizadas. I-PRESENT_ILLNESS -Ante B-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -hipotensión I-TREATMENT -con I-TREATMENT -una I-TREATMENT -presión I-TREATMENT -arterial I-TREATMENT -media I-TREATMENT -(PAM) I-TREATMENT -<55mmHg I-TREATMENT -e I-TREATMENT -hiponatremia I-TREATMENT -(129mEq/l) I-TREATMENT -se I-TREATMENT -sospecha I-TREATMENT -insuficiencia I-TREATMENT -suprarrenal I-TREATMENT -por I-TREATMENT -deprivación I-TREATMENT -(abandono I-TREATMENT -de I-TREATMENT -la I-TREATMENT -prednisona I-TREATMENT -48h I-TREATMENT -antes) I-TREATMENT -y I-TREATMENT -se I-TREATMENT -administran I-TREATMENT -60mg I-TREATMENT -de I-TREATMENT -metilprednisolona, I-TREATMENT -con I-TREATMENT -mejoría I-TREATMENT -hemodinámica. I-TREATMENT -Las B-EXPLORATION -artralgias I-EXPLORATION -se I-EXPLORATION -atribuyen I-EXPLORATION -también I-EXPLORATION -a I-EXPLORATION +coxalgia I-PRESENT_ILLNESS +derecha, I-PRESENT_ILLNESS +realizándose B-EXPLORATION un I-EXPLORATION -brote I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +tejido I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -enfermedad I-EXPLORATION -inflamatoria I-EXPLORATION -intestinal I-EXPLORATION -por I-EXPLORATION +neo-formación I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -cese I-EXPLORATION -brusco I-EXPLORATION +ala I-EXPLORATION +ilíaca I-EXPLORATION +derecha, I-EXPLORATION +con I-EXPLORATION +infiltración I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +muscular I-EXPLORATION +adyacente. I-EXPLORATION +Una I-EXPLORATION +biopsia I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -medicación. I-EXPLORATION +lesión I-EXPLORATION +fue I-EXPLORATION +informada I-EXPLORATION +como I-EXPLORATION +linfoma I-EXPLORATION +no-Hodgkin, I-EXPLORATION +isotipo I-EXPLORATION +linfo-plasmocitario. I-EXPLORATION +Asociado I-EXPLORATION +a I-EXPLORATION +esto, I-EXPLORATION +se I-EXPLORATION +evidenció I-EXPLORATION +una I-EXPLORATION +falla I-EXPLORATION +renal I-EXPLORATION +aguda I-EXPLORATION +con I-EXPLORATION +hipercalcemia I-EXPLORATION +y I-EXPLORATION +proteinuria, I-EXPLORATION +principalmente I-EXPLORATION +de I-EXPLORATION +tipo I-EXPLORATION +Bence I-EXPLORATION +Jones, I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +componente I-EXPLORATION +monoclonal I-EXPLORATION +tipo I-EXPLORATION +IgD-lambda. I-EXPLORATION I-EXPLORATION En B-EVOLUTION -las I-EVOLUTION -siguientes I-EVOLUTION -24h I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -refiere I-EVOLUTION -disnea I-EVOLUTION -con I-EVOLUTION -desaturación I-EVOLUTION -progresiva I-EVOLUTION -(hasta I-EVOLUTION -el I-EVOLUTION -76%) I-EVOLUTION -sin I-EVOLUTION -oxigenoterapia. I-EVOLUTION -Se B-EXPLORATION -realiza I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -torácica, I-EXPLORATION -que I-EXPLORATION -observa I-EXPLORATION -patrón I-EXPLORATION -en I-EXPLORATION -vidrio I-EXPLORATION -deslustrado I-EXPLORATION -inespecífico I-EXPLORATION -bilateral. I-EXPLORATION -La B-TREATMENT -sospecha I-TREATMENT -diagnóstica I-TREATMENT -en I-TREATMENT -ese I-TREATMENT -momento I-TREATMENT -corresponde I-TREATMENT -a I-TREATMENT -enfermedad I-TREATMENT -pulmonar I-TREATMENT -intersticial I-TREATMENT -versus I-TREATMENT -neumonía I-TREATMENT -adquirida I-TREATMENT -en I-TREATMENT -la I-TREATMENT -comunidad, I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -oxigenoterapia, I-TREATMENT -levofloxacino I-TREATMENT -y I-TREATMENT -metilprednisolona. I-TREATMENT - I-TREATMENT -El B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -trasladó I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -principal I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -insuficiencia I-DERIVED_FROM/TO -respiratoria I-DERIVED_FROM/TO -hipoxémica I-DERIVED_FROM/TO -aguda. I-DERIVED_FROM/TO -Al B-TREATMENT -presentar I-TREATMENT -4 I-TREATMENT -signos I-TREATMENT -de I-TREATMENT -gravedad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -British I-TREATMENT -Thoracic I-TREATMENT -Society4 I-TREATMENT -para I-TREATMENT -neumonía I-TREATMENT -adquirida I-TREATMENT -en I-TREATMENT -la I-TREATMENT -comunidad I-TREATMENT -ingresó I-TREATMENT -en I-TREATMENT -nuestra I-TREATMENT -Unidad I-TREATMENT +junio I-EVOLUTION +del I-EVOLUTION +año I-EVOLUTION +2011 I-EVOLUTION +ingresó I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +Unidad I-EVOLUTION +de I-EVOLUTION +Hemato-Oncología I-EVOLUTION +del I-EVOLUTION +Hospital I-EVOLUTION +de I-EVOLUTION +Lucca, I-EVOLUTION +Italia, I-EVOLUTION +iniciándose B-TREATMENT +esquema I-TREATMENT de I-TREATMENT -Cuidados I-TREATMENT -Críticos: I-TREATMENT -taquipnea I-TREATMENT ->30 I-TREATMENT -respiraciones I-TREATMENT -por I-TREATMENT -minuto, I-TREATMENT -urea I-TREATMENT ->42mg/dl, I-TREATMENT -enfermedad I-TREATMENT -preexistente, I-TREATMENT -edad I-TREATMENT -superior I-TREATMENT +quimioterapia I-TREATMENT +con I-TREATMENT +bortezomib I-TREATMENT +más I-TREATMENT +dexame-tasona, I-TREATMENT +asociado I-TREATMENT a I-TREATMENT -50 I-TREATMENT -años I-TREATMENT -y I-TREATMENT -afectación I-TREATMENT -pulmonar I-TREATMENT -bilateral I-TREATMENT -en I-TREATMENT -la I-TREATMENT -radiografía I-TREATMENT -de I-TREATMENT -tórax. I-TREATMENT +ácido I-TREATMENT +zolendrónico. I-TREATMENT I-TREATMENT En B-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -presentó I-EXPLORATION -cuadro I-EXPLORATION -indicativo I-EXPLORATION +julio I-EXPLORATION de I-EXPLORATION -neumonía I-EXPLORATION -intersticial I-EXPLORATION -bilateral I-EXPLORATION -difusa, I-EXPLORATION -que I-EXPLORATION +2011 I-EXPLORATION se I-EXPLORATION -acompañó I-EXPLORATION -de I-EXPLORATION -extensas I-EXPLORATION -manifestaciones I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +biopsia I-EXPLORATION +renal I-EXPLORATION +debido I-EXPLORATION +al I-EXPLORATION +deterioro I-EXPLORATION de I-EXPLORATION -alveolitis I-EXPLORATION -exudativa I-EXPLORATION -con I-EXPLORATION -ensanchamiento I-EXPLORATION -mediastínico I-EXPLORATION -superior, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -adenopatías I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -cadenas I-EXPLORATION -paratraqueales I-EXPLORATION -derecha I-EXPLORATION -e I-EXPLORATION -izquierda. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -hemograma I-EXPLORATION -no I-EXPLORATION -había I-EXPLORATION -eosinofilia I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -fórmula I-EXPLORATION -leucocitaria I-EXPLORATION -ni I-EXPLORATION -leucocitosis, I-EXPLORATION -esperable I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -infección I-EXPLORATION -parasitaria; I-EXPLORATION -además, I-EXPLORATION -el I-EXPLORATION -recuento I-EXPLORATION +función I-EXPLORATION +renal, I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +nefropatía I-EXPLORATION +tubulo-intersticial, I-EXPLORATION +comenzando I-EXPLORATION +con I-EXPLORATION +terapia I-EXPLORATION de I-EXPLORATION -leucocitos I-EXPLORATION -tampoco I-EXPLORATION -fue I-EXPLORATION -llamativo. I-EXPLORATION -Se I-EXPLORATION -observó I-EXPLORATION -antígeno I-EXPLORATION -para I-EXPLORATION -neumococo I-EXPLORATION -positivo I-EXPLORATION +sustitución I-EXPLORATION +renal I-EXPLORATION en I-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -y B-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -linezolid, I-TREATMENT -cefotaxima I-TREATMENT -y I-TREATMENT -fluconazol, I-TREATMENT -ventilación I-TREATMENT -no I-TREATMENT -invasiva I-TREATMENT -con I-TREATMENT -ventilación I-TREATMENT -con I-TREATMENT -presión I-TREATMENT -positiva I-TREATMENT -continua I-TREATMENT -de I-TREATMENT -+7 I-TREATMENT -cmH2O I-TREATMENT -y I-TREATMENT -asistencia I-TREATMENT -inspiratoria I-TREATMENT +el I-EXPLORATION +mismo I-EXPLORATION +centro. I-EXPLORATION + I-EXPLORATION +En B-EVOLUTION +agosto I-EVOLUTION +de I-EVOLUTION +2011 I-EVOLUTION +se I-EVOLUTION +reevaluó I-EVOLUTION +al I-EVOLUTION +paciente, I-EVOLUTION +el I-EVOLUTION +que I-EVOLUTION +presentó I-EVOLUTION +un I-EVOLUTION +aumento I-EVOLUTION +del I-EVOLUTION +tamaño I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +lesión, I-EVOLUTION +siendo I-EVOLUTION +internado I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +unidad I-EVOLUTION +de I-EVOLUTION +Hematología I-EVOLUTION +del I-EVOLUTION +Hospital I-EVOLUTION +Universitario I-EVOLUTION +de I-EVOLUTION +Pisa. I-EVOLUTION +Se B-TREATMENT +le I-TREATMENT +indicó I-TREATMENT +un I-TREATMENT +esquema I-TREATMENT de I-TREATMENT -+15cm I-TREATMENT -H2O I-TREATMENT +quimioterapia I-TREATMENT +VDT-PACE I-TREATMENT +(bortezomib, I-TREATMENT +talidomida, I-TREATMENT +dexametasona, I-TREATMENT +cisplatino, I-TREATMENT +doxorrubicina, I-TREATMENT +ciclofosfamida I-TREATMENT y I-TREATMENT -FiO2 I-TREATMENT -al I-TREATMENT -60%, I-TREATMENT -que I-TREATMENT -se I-TREATMENT -alternó I-TREATMENT -con I-TREATMENT -períodos I-TREATMENT -de I-TREATMENT -oxigenoterapia I-TREATMENT +etopósido). I-TREATMENT +Previo B-EVOLUTION +a I-EVOLUTION +esto, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +habría I-EVOLUTION +sufrido I-EVOLUTION +una I-EVOLUTION +gastrectomía I-EVOLUTION +parcial I-EVOLUTION +debido I-EVOLUTION +a I-EVOLUTION +una I-EVOLUTION +úlcera I-EVOLUTION +péptica I-EVOLUTION +perforada. I-EVOLUTION + I-EVOLUTION +Se B-TREATMENT +decidió I-TREATMENT +luego I-TREATMENT +continuar I-TREATMENT con I-TREATMENT -Ventimask. I-TREATMENT -Progresivamente, B-EVOLUTION +un I-TREATMENT +esquema I-TREATMENT +CHOP I-TREATMENT +(ciclofosfamida, I-TREATMENT +doxirrubicinada, I-TREATMENT +vincristina, I-TREATMENT +prednisona), I-TREATMENT +recibiendo I-TREATMENT +el I-TREATMENT +primer I-TREATMENT +ciclo I-TREATMENT +en I-TREATMENT +el I-TREATMENT +mismo I-TREATMENT +centro. I-TREATMENT +En B-EXPLORATION +evaluaciones I-EXPLORATION +sucesivas I-EXPLORATION +durante I-EXPLORATION +su I-EXPLORATION +hospitalización, I-EXPLORATION +la I-EXPLORATION +ecotomografía I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +mostró I-EXPLORATION +compromiso I-EXPLORATION +infiltrativo I-EXPLORATION +desde I-EXPLORATION +el I-EXPLORATION +ala I-EXPLORATION +ilíaca I-EXPLORATION +derecha I-EXPLORATION +hasta I-EXPLORATION +las I-EXPLORATION +asas I-EXPLORATION +intestinales, I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +tamizaje I-EXPLORATION +con I-EXPLORATION +hisopado I-EXPLORATION +rectal I-EXPLORATION +mostró I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +Klebsiella I-EXPLORATION +pneumoniae I-EXPLORATION +multi-resistente. I-EXPLORATION + I-EXPLORATION +Estando B-EVOLUTION +en I-EVOLUTION +su I-EVOLUTION +domicilio I-EVOLUTION +en I-EVOLUTION +Italia, I-EVOLUTION el I-EVOLUTION paciente I-EVOLUTION presentó I-EVOLUTION -un I-EVOLUTION -deterioro I-EVOLUTION -general I-EVOLUTION -con I-EVOLUTION -sepsis I-EVOLUTION -grave I-EVOLUTION -y I-EVOLUTION -disfunción I-EVOLUTION -multiorgánica, I-EVOLUTION -con I-EVOLUTION +varias I-EVOLUTION +crisis I-EVOLUTION +convulsivas I-EVOLUTION +que I-EVOLUTION +fueron I-EVOLUTION +atribuidas I-EVOLUTION +a I-EVOLUTION +trastornos I-EVOLUTION +metabólicos. I-EVOLUTION +Se I-EVOLUTION +descartó I-EVOLUTION la I-EVOLUTION presencia I-EVOLUTION de I-EVOLUTION -shock, I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -inotropos I-EVOLUTION -y I-EVOLUTION -vasopresores I-EVOLUTION -para I-EVOLUTION -conseguir I-EVOLUTION -una I-EVOLUTION -PAM I-EVOLUTION ->60mmHg, I-EVOLUTION -insuficiencia I-EVOLUTION -renal I-EVOLUTION -aguda I-EVOLUTION -que B-TREATMENT -requirió I-TREATMENT -hemodiafiltración I-TREATMENT -venovenosa I-TREATMENT -continua I-TREATMENT -e I-TREATMENT -insuficiencia I-TREATMENT -respiratoria I-TREATMENT -con I-TREATMENT -necesidad I-TREATMENT -de I-TREATMENT -intubación I-TREATMENT -orotraqueal I-TREATMENT +lesiones I-EVOLUTION +intracerebrales. I-EVOLUTION +Fue B-DERIVED_FROM/TO +referido I-DERIVED_FROM/TO +entonces I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Hospital I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Versilia, I-DERIVED_FROM/TO +Italia; I-DERIVED_FROM/TO +recibió B-TREATMENT +allí I-TREATMENT +un I-TREATMENT +segundo I-TREATMENT y I-TREATMENT -ventilación I-TREATMENT -mecánica. I-TREATMENT -Ante I-TREATMENT -este I-TREATMENT -deterioro, I-TREATMENT -se I-TREATMENT -sospechó I-TREATMENT -de I-TREATMENT -la I-TREATMENT -existencia I-TREATMENT +tercer I-TREATMENT +ciclo I-TREATMENT de I-TREATMENT -una I-TREATMENT -sobreinfección I-TREATMENT -bacteriana I-TREATMENT -o I-TREATMENT -por I-TREATMENT -hongos I-TREATMENT -concomitantes, I-TREATMENT -lo I-TREATMENT +quimioterapia I-TREATMENT +con I-TREATMENT +esquema I-TREATMENT +CHOP, I-TREATMENT +el I-TREATMENT +22.12.2011 I-TREATMENT +y I-TREATMENT +el I-TREATMENT +19.01.2012, I-TREATMENT +respectivamente, I-TREATMENT +presentando I-TREATMENT +aplasia I-TREATMENT +medular I-TREATMENT +secundaria I-TREATMENT que I-TREATMENT -llevó I-TREATMENT -al I-TREATMENT -cambio I-TREATMENT +requirió I-TREATMENT +apoyo I-TREATMENT +con I-TREATMENT +estimulador I-TREATMENT de I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -(imipenem, I-TREATMENT -linezolid I-TREATMENT -y I-TREATMENT -anidulofungina) I-TREATMENT -y I-TREATMENT -extracción I-TREATMENT +colonia I-TREATMENT de I-TREATMENT -nuevas I-TREATMENT -muestras I-TREATMENT -microbiológicas: I-TREATMENT -broncoaspirado I-TREATMENT -(BAS), I-TREATMENT -hemocultivo I-TREATMENT +granulocitos I-TREATMENT y I-TREATMENT -urinocultivo. I-TREATMENT -Fue I-TREATMENT -en I-TREATMENT -este I-TREATMENT -último I-TREATMENT -BAS I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -observaron I-TREATMENT -larvas I-TREATMENT -de I-TREATMENT -Ss, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -añadió I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -ivermectina I-TREATMENT -(16,5mg/24h) I-TREATMENT -por I-TREATMENT -sonda I-TREATMENT -nasogástrica I-TREATMENT -(SNG). I-TREATMENT -Tras I-TREATMENT -repetir I-TREATMENT +eritropoyetina. I-TREATMENT + I-TREATMENT +Viajó I-TREATMENT +desde I-TREATMENT +Italia I-TREATMENT a I-TREATMENT -las I-TREATMENT -48h I-TREATMENT -los I-TREATMENT -cultivos I-TREATMENT -biológicos I-TREATMENT -y I-TREATMENT -mostrar I-TREATMENT -la I-TREATMENT -presencia I-TREATMENT +Chile, I-TREATMENT +ingresando I-TREATMENT +directamente I-TREATMENT +desde I-TREATMENT +el I-TREATMENT +aeropuerto I-TREATMENT de I-TREATMENT -larvas I-TREATMENT +Santiago I-TREATMENT +el I-TREATMENT +día I-TREATMENT +28.02.2012 I-TREATMENT +al I-TREATMENT +Servicio I-TREATMENT de I-TREATMENT -Ss I-TREATMENT -aún I-TREATMENT -activas I-TREATMENT -en I-TREATMENT -BAS, I-TREATMENT -jugo I-TREATMENT -gástrico I-TREATMENT +Medicina I-TREATMENT +del I-TREATMENT +Hospital I-TREATMENT +Clínico I-TREATMENT +San I-TREATMENT +Borja I-TREATMENT +Arriarán, I-TREATMENT +para I-TREATMENT +coordinar I-TREATMENT +la I-TREATMENT +hemodiálisis I-TREATMENT y I-TREATMENT -heces, I-TREATMENT -se I-TREATMENT -asoció I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -albendazol I-TREATMENT -(400mg/24h) I-TREATMENT +evaluación I-TREATMENT por I-TREATMENT -SNG. I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -posterior I-EXPLORATION -control I-EXPLORATION -microbiológico I-EXPLORATION -tras I-EXPLORATION -48h I-EXPLORATION +el I-TREATMENT +equipo I-TREATMENT +de I-TREATMENT +hemato-oncología I-TREATMENT +para I-TREATMENT +eventual I-TREATMENT +quimioterapia I-TREATMENT +paliativa. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +el I-TREATMENT +primer I-TREATMENT +procedimiento I-TREATMENT +de I-TREATMENT +hemodiálisis I-TREATMENT +el I-TREATMENT +día I-TREATMENT +01.03.2012 I-TREATMENT +presentando B-EVOLUTION +fiebre I-EVOLUTION +por B-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +obtuvo I-EXPLORATION +hemocultivos I-EXPLORATION +con I-EXPLORATION +tiempo I-EXPLORATION +diferencial I-EXPLORATION +para I-EXPLORATION +descartar I-EXPLORATION +una I-EXPLORATION +infección I-EXPLORATION del I-EXPLORATION -tratamiento I-EXPLORATION -combinado, I-EXPLORATION +tracto I-EXPLORATION +sanguíneo I-EXPLORATION +asociada I-EXPLORATION +a I-EXPLORATION +catéter I-EXPLORATION +venoso I-EXPLORATION +central, I-EXPLORATION y I-EXPLORATION +urocultivo. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +6 I-EXPLORATION +de I-EXPLORATION +marzo I-EXPLORATION +de I-EXPLORATION +2012 I-EXPLORATION se I-EXPLORATION -observaron I-EXPLORATION +aisló I-EXPLORATION +desde I-EXPLORATION +el I-EXPLORATION +urocultivo I-EXPLORATION +una I-EXPLORATION +cepa I-EXPLORATION +de I-EXPLORATION +K. I-EXPLORATION +pneumoniae I-EXPLORATION +resistente I-EXPLORATION +a I-EXPLORATION +todos I-EXPLORATION +los I-EXPLORATION +ami-noglucósidos, I-EXPLORATION +quinolonas, I-EXPLORATION +β-lactámicos, I-EXPLORATION +cefalosporinas I-EXPLORATION +y I-EXPLORATION +carbapenémicos I-EXPLORATION +con I-EXPLORATION +halo I-EXPLORATION +de I-EXPLORATION +6 I-EXPLORATION +mm I-EXPLORATION +(de I-EXPLORATION +contacto) I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +retuvo I-EXPLORATION +el I-EXPLORATION +resultado I-EXPLORATION +dado I-EXPLORATION +el I-EXPLORATION +perfil I-EXPLORATION +de I-EXPLORATION +susceptibilidad I-EXPLORATION +no I-EXPLORATION +descrito I-EXPLORATION +antes I-EXPLORATION en I-EXPLORATION -BAS I-EXPLORATION -Ss I-EXPLORATION -inactivos. I-EXPLORATION -Sin B-EVOLUTION -embargo, I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -síndrome I-EVOLUTION -de I-EVOLUTION -distrés I-EVOLUTION -respiratorio I-EVOLUTION -agudo I-EVOLUTION -(SDRA) I-EVOLUTION -con I-EVOLUTION -hipoxemia I-EVOLUTION -grave I-EVOLUTION -y I-EVOLUTION -shock I-EVOLUTION -séptico I-EVOLUTION -refractario I-EVOLUTION -al I-EVOLUTION -soporte I-EVOLUTION -vasoconstrictor I-EVOLUTION -e I-EVOLUTION -inotropo. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -falleció I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -17 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -ingreso I-EVOLUTION -en I-EVOLUTION -nuestra I-EVOLUTION -unidad. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -describe I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Valme I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ideación I-PRESENT_ILLNESS -autolítica I-PRESENT_ILLNESS -persistente I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -alucinaciones I-PRESENT_ILLNESS -auditivas. I-PRESENT_ILLNESS -En B-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -psiquiátricos, I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -ingresado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Unidad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Agudos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Salud I-PAST_MEDICAL_HISTORY -Mental I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -diversas I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2007, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -orientación I-PAST_MEDICAL_HISTORY -diagnóstica, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -depresivo I-PAST_MEDICAL_HISTORY -moderado I-PAST_MEDICAL_HISTORY -(F32.1 I-PAST_MEDICAL_HISTORY -CIE-10). I-PAST_MEDICAL_HISTORY -Estaba I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -risperidona I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -mg/24h, I-PAST_MEDICAL_HISTORY -ac. I-PAST_MEDICAL_HISTORY -valproico I-PAST_MEDICAL_HISTORY -1500 I-PAST_MEDICAL_HISTORY -mg/24h, I-PAST_MEDICAL_HISTORY -citalopram I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -mg/24h I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -flunitrazepam I-PAST_MEDICAL_HISTORY -1mg/24h. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -actual I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -contexto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -duelo I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -fallecimiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -hija, I-PRESENT_ILLNESS -relataba I-PRESENT_ILLNESS -incremento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -ansiedad, I-PRESENT_ILLNESS -tristeza, I-PRESENT_ILLNESS -anhedonia, I-PRESENT_ILLNESS -apatía, I-PRESENT_ILLNESS -abandono I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -actividades, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -alucinaciones I-PRESENT_ILLNESS -auditivas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -espacio I-PRESENT_ILLNESS -externo. I-PRESENT_ILLNESS -Eran I-PRESENT_ILLNESS -voces I-PRESENT_ILLNESS -imperativas I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -insultantes I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -tenían I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -él I-PRESENT_ILLNESS -importante I-PRESENT_ILLNESS -repercusión I-PRESENT_ILLNESS -conductual I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -afectiva: I-PRESENT_ILLNESS -"Empezó I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -rumor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ahora I-PRESENT_ILLNESS -son I-PRESENT_ILLNESS -claras, I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -si I-PRESENT_ILLNESS -alguien I-PRESENT_ILLNESS -me I-PRESENT_ILLNESS -hablara. I-PRESENT_ILLNESS -Se I-PRESENT_ILLNESS -hacen I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -fuertes I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -puedo I-PRESENT_ILLNESS -controlarlas, I-PRESENT_ILLNESS -me I-PRESENT_ILLNESS -dicen I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -me I-PRESENT_ILLNESS -haga I-PRESENT_ILLNESS -daño, I-PRESENT_ILLNESS -también I-PRESENT_ILLNESS -me I-PRESENT_ILLNESS -insultan.". I-PRESENT_ILLNESS -Estaba B-EXPLORATION -consciente, I-EXPLORATION -orientado I-EXPLORATION -auto I-EXPLORATION -y I-EXPLORATION -alopsíquicamente, I-EXPLORATION -euproséxico. I-EXPLORATION -Su I-EXPLORATION -actitud I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -colaboración I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -alteraciones I-EXPLORATION -groseras I-EXPLORATION -en I-EXPLORATION -funciones I-EXPLORATION -superiores. I-EXPLORATION -El I-EXPLORATION -lenguaje I-EXPLORATION -era I-EXPLORATION -fluido, I-EXPLORATION -espontáneo I-EXPLORATION -y I-EXPLORATION -coherente. I-EXPLORATION -Refería I-EXPLORATION -sentimientos I-EXPLORATION +nuestro I-EXPLORATION +país. I-EXPLORATION +Además I-EXPLORATION de I-EXPLORATION -culpa I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -reciente I-EXPLORATION -muerte I-EXPLORATION +lo I-EXPLORATION +anterior, I-EXPLORATION +se I-EXPLORATION +aisló I-EXPLORATION +a I-EXPLORATION +partir I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -hija, I-EXPLORATION -desconfianza I-EXPLORATION +dos I-EXPLORATION +series I-EXPLORATION de I-EXPLORATION -todos I-EXPLORATION -aquellos I-EXPLORATION -que I-EXPLORATION -le I-EXPLORATION -rodeaban, I-EXPLORATION -y I-EXPLORATION -desamparo I-EXPLORATION -y I-EXPLORATION -soledad I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -situación I-EXPLORATION -vital. I-EXPLORATION -Tenía I-EXPLORATION -ideas I-EXPLORATION +hemocultivos I-EXPLORATION de I-EXPLORATION -muerte I-EXPLORATION -y I-EXPLORATION -autolisis. I-EXPLORATION -Se I-EXPLORATION -quejaba I-EXPLORATION +tiempo I-EXPLORATION de I-EXPLORATION -insomnio I-EXPLORATION -con I-EXPLORATION -despertares I-EXPLORATION -intermitentes I-EXPLORATION -y I-EXPLORATION -frecuentes I-EXPLORATION -pesadillas. I-EXPLORATION -Disponía I-EXPLORATION +positividad I-EXPLORATION +diferencial I-EXPLORATION +un I-EXPLORATION +bacilo I-EXPLORATION +gramnegativo I-EXPLORATION +no I-EXPLORATION +fermen-tador I-EXPLORATION +que I-EXPLORATION +posteriormente I-EXPLORATION +el I-EXPLORATION +Laboratorio I-EXPLORATION de I-EXPLORATION -nulo I-EXPLORATION -soporte I-EXPLORATION -familiar I-EXPLORATION -y I-EXPLORATION -social I-EXPLORATION -y I-EXPLORATION -había I-EXPLORATION -abandonado I-EXPLORATION -progresivamente I-EXPLORATION -su I-EXPLORATION -trabajo. I-EXPLORATION - I-EXPLORATION -Datos B-PAST_MEDICAL_HISTORY -biográficos I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Niñez I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -adolescencia I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Siendo I-PAST_MEDICAL_HISTORY -muy I-PAST_MEDICAL_HISTORY -pequeño I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -padres I-PAST_MEDICAL_HISTORY -emigraron I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -él, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -mayor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -seis I-PAST_MEDICAL_HISTORY -hermanos, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -quedó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -España, I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -cuidado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -abuelos I-PAST_MEDICAL_HISTORY -paternos. I-PAST_MEDICAL_HISTORY -Recuerda I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -feliz, I-PAST_MEDICAL_HISTORY -protegido I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -arropado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -ellos, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -llegó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -considerar I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -padres. I-PAST_MEDICAL_HISTORY -Definía I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -abuelo I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -persona, I-PAST_MEDICAL_HISTORY -responsable I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -trabajador. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -abuela, I-PAST_MEDICAL_HISTORY -"Una I-PAST_MEDICAL_HISTORY -santa, I-PAST_MEDICAL_HISTORY -volcada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -mi I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -todos.". I-PAST_MEDICAL_HISTORY -Con I-PAST_MEDICAL_HISTORY -ellos I-PAST_MEDICAL_HISTORY -vivía I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -tía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -hijo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ésta, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -compartió I-PAST_MEDICAL_HISTORY -juegos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -afecto. I-PAST_MEDICAL_HISTORY -Paso I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -adolescencia I-PAST_MEDICAL_HISTORY -separado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -padres. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -pesar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -estos I-PAST_MEDICAL_HISTORY -regresaron I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -país I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -emigraron, I-PAST_MEDICAL_HISTORY -nunca I-PAST_MEDICAL_HISTORY -consiguió I-PAST_MEDICAL_HISTORY -integrarse I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -familia I-PAST_MEDICAL_HISTORY -nuclear. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -entender I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -qué, I-PAST_MEDICAL_HISTORY -comentaba I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -sentido I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -culpa I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -ello. I-PAST_MEDICAL_HISTORY -Describía I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -distante I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -egoísta; I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -padre I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -afectuoso, I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -ambos, I-PAST_MEDICAL_HISTORY -"Incapaces I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hacer I-PAST_MEDICAL_HISTORY -nada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -mí". I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -crió I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -mayor I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -económico I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -hermanos, I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -despertó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -éstos I-PAST_MEDICAL_HISTORY -recelos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -críticas I-PAST_MEDICAL_HISTORY -constantes I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -él, I-PAST_MEDICAL_HISTORY -clara I-PAST_MEDICAL_HISTORY -desconfianza I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -relación. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -colegio I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -instituto I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -ejemplar, I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -buenas I-PAST_MEDICAL_HISTORY -notas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -nunca I-PAST_MEDICAL_HISTORY -tuvo I-PAST_MEDICAL_HISTORY -problemas I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -compañeros I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -profesores. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -aquella I-PAST_MEDICAL_HISTORY -época, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -describía I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -sí I-PAST_MEDICAL_HISTORY -mismo I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -"Trabajador, I-PAST_MEDICAL_HISTORY -guasón, I-PAST_MEDICAL_HISTORY -amable I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -entregado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -todos...". I-PAST_MEDICAL_HISTORY -Cursó I-PAST_MEDICAL_HISTORY -estudios I-PAST_MEDICAL_HISTORY -superiores, I-PAST_MEDICAL_HISTORY -ejerciendo I-PAST_MEDICAL_HISTORY -posteriormente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -profesión I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -éxito I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Vida I-PAST_MEDICAL_HISTORY -adulta I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Después I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -noviazgo I-PAST_MEDICAL_HISTORY -normalizado I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -casó I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tuvo I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -hijos: I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -niña I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -niño, I-PAST_MEDICAL_HISTORY -seis I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -menor. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -matrimonio I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -bien, I-PAST_MEDICAL_HISTORY -sentía I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -esposa I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -aliada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sólo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -escasas I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -podía I-PAST_MEDICAL_HISTORY -imponer I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -criterio. I-PAST_MEDICAL_HISTORY -Su I-PAST_MEDICAL_HISTORY -hija, I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -él, I-PAST_MEDICAL_HISTORY -"La I-PAST_MEDICAL_HISTORY -única I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -mundo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -me I-PAST_MEDICAL_HISTORY -defendía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -apoyaba I-PAST_MEDICAL_HISTORY -ante I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -críticas". I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -primer I-PAST_MEDICAL_HISTORY -conflicto I-PAST_MEDICAL_HISTORY -relevante I-PAST_MEDICAL_HISTORY -surgió I-PAST_MEDICAL_HISTORY -quince I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -atrás I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -morir I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -abuelos. I-PAST_MEDICAL_HISTORY -Por I-PAST_MEDICAL_HISTORY -cuestiones I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -herencia, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -sintió I-PAST_MEDICAL_HISTORY -duramente I-PAST_MEDICAL_HISTORY -criticado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -padres I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -hermanos, I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -llamaron I-PAST_MEDICAL_HISTORY -entonces I-PAST_MEDICAL_HISTORY -"Niño I-PAST_MEDICAL_HISTORY -rico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -aprovechado.". I-PAST_MEDICAL_HISTORY -Dos I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -comentado, I-PAST_MEDICAL_HISTORY -tuvo I-PAST_MEDICAL_HISTORY -importantes I-PAST_MEDICAL_HISTORY -problemas I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -laboral; I-PAST_MEDICAL_HISTORY -tema I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -generó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -él I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -profundo I-PAST_MEDICAL_HISTORY -malestar; I-PAST_MEDICAL_HISTORY -comenzó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -sentirse I-PAST_MEDICAL_HISTORY -intensamente I-PAST_MEDICAL_HISTORY -inseguro I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -desconfiado, I-PAST_MEDICAL_HISTORY -reduciendo I-PAST_MEDICAL_HISTORY -progresivamente I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -labor I-PAST_MEDICAL_HISTORY -profesional. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -hizo I-PAST_MEDICAL_HISTORY -entonces I-PAST_MEDICAL_HISTORY -patente I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -conflictiva I-PAST_MEDICAL_HISTORY -conyugal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -separación I-PAST_MEDICAL_HISTORY -matrimonial, I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ingreso, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -hija I-PAST_MEDICAL_HISTORY -mayor I-PAST_MEDICAL_HISTORY -enfermó I-PAST_MEDICAL_HISTORY -gravemente I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -falleció I-PAST_MEDICAL_HISTORY -seis I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -después. I-PAST_MEDICAL_HISTORY -Ahora I-PAST_MEDICAL_HISTORY -vivía I-PAST_MEDICAL_HISTORY -sólo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -mantenía I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -vecinos I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -barrio I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -residía. I-PAST_MEDICAL_HISTORY -Disfrutaba I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pequeñas I-PAST_MEDICAL_HISTORY -tertulias I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -bares I-PAST_MEDICAL_HISTORY -cercanos I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -abandonando I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -irritabilidad I-PAST_MEDICAL_HISTORY -creciente, I-PAST_MEDICAL_HISTORY -facilitada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -abusivo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcohol. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Psicoterapia B-TREATMENT -breve I-TREATMENT - I-TREATMENT -Se I-TREATMENT -propuso I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -una I-TREATMENT -psicoterapia I-TREATMENT -dinámica I-TREATMENT -breve I-TREATMENT -durante I-TREATMENT -su I-TREATMENT -ingreso I-TREATMENT -en I-TREATMENT -la I-TREATMENT -Unidad I-TREATMENT -de I-TREATMENT -Agudos. I-TREATMENT -El I-TREATMENT -número I-TREATMENT -de I-TREATMENT -sesiones I-TREATMENT -no I-TREATMENT -se I-TREATMENT -concretó I-TREATMENT -al I-TREATMENT -inicio, I-TREATMENT -quedando I-TREATMENT -esto I-TREATMENT -a I-TREATMENT -expensas I-TREATMENT -de I-TREATMENT -la I-TREATMENT -evolución I-TREATMENT -y I-TREATMENT -tiempo I-TREATMENT -del I-TREATMENT -ingreso. I-TREATMENT -Se I-TREATMENT -realizaron I-TREATMENT -doce I-TREATMENT -sesiones I-TREATMENT -de I-TREATMENT -cuarenta I-TREATMENT -minutos I-TREATMENT -de I-TREATMENT -duración. I-TREATMENT -Como I-TREATMENT -criterios I-TREATMENT -de I-TREATMENT -inclusión I-TREATMENT -se I-TREATMENT -tuvieron I-TREATMENT -en I-TREATMENT -cuenta: I-TREATMENT -la I-TREATMENT -capacidad I-TREATMENT -que I-TREATMENT -presentaba I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -para I-TREATMENT -pensar I-TREATMENT -sobre I-TREATMENT -sus I-TREATMENT -sentimientos, I-TREATMENT -la I-TREATMENT -existencia I-TREATMENT -de I-TREATMENT -varias I-TREATMENT -relaciones I-TREATMENT -significativas I-TREATMENT -en I-TREATMENT -el I-TREATMENT -pasado I-TREATMENT -y I-TREATMENT -la I-TREATMENT -buena I-TREATMENT -capacidad I-TREATMENT -de I-TREATMENT -vinculación I-TREATMENT -con I-TREATMENT -el I-TREATMENT -terapeuta. I-TREATMENT - I-TREATMENT -Hipótesis B-EXPLORATION -Psicodinámica I-EXPLORATION -Inicial I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -mecanismos I-EXPLORATION -adaptativos I-EXPLORATION +Microbiología I-EXPLORATION del I-EXPLORATION -yo I-EXPLORATION -desplegados I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -infancia I-EXPLORATION +Hospital I-EXPLORATION +Clínico I-EXPLORATION +Universidad I-EXPLORATION +de I-EXPLORATION +Chile I-EXPLORATION +identificó I-EXPLORATION como I-EXPLORATION -la I-EXPLORATION -constancia, I-EXPLORATION -capacidad I-EXPLORATION +Achromobacter I-EXPLORATION +denitrificans I-EXPLORATION +realizándose I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +clínico I-EXPLORATION de I-EXPLORATION -trabajo, I-EXPLORATION -responsabilidad, I-EXPLORATION -entrega I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -demás I-EXPLORATION -y I-EXPLORATION -calidez I-EXPLORATION -afectiva I-EXPLORATION -proporcionaron I-EXPLORATION -al I-EXPLORATION -paciente I-EXPLORATION +ITS/CVC I-EXPLORATION +e I-EXPLORATION +interpretándose I-EXPLORATION +el I-EXPLORATION +urocultivo I-EXPLORATION +como I-EXPLORATION una I-EXPLORATION -adecuada I-EXPLORATION -imagen I-EXPLORATION -del I-EXPLORATION -sí I-EXPLORATION -durante I-EXPLORATION -años. I-EXPLORATION -Ninguna I-EXPLORATION +bacteriuria I-EXPLORATION +asintomática. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +8 I-EXPLORATION de I-EXPLORATION -estas I-EXPLORATION -cualidades I-EXPLORATION -habían I-EXPLORATION -logrado I-EXPLORATION -mantenerse I-EXPLORATION -tras I-EXPLORATION +marzo I-EXPLORATION +de I-EXPLORATION +2012, I-EXPLORATION el I-EXPLORATION -duro I-EXPLORATION -golpe I-EXPLORATION +Laboratorio I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -muerte I-EXPLORATION +Microbiología I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +equipo I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -hija I-EXPLORATION -(factor I-EXPLORATION -desencadenante). I-EXPLORATION -Debilitado I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -emocional I-EXPLORATION -por I-EXPLORATION +Control I-EXPLORATION +de I-EXPLORATION +Infecciones I-EXPLORATION +obtuvieron I-EXPLORATION el I-EXPLORATION -fracaso I-EXPLORATION +antecedente I-EXPLORATION +epidemiológico I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -relación I-EXPLORATION -conyugal, I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -profesional I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -conflicto I-EXPLORATION -laboral I-EXPLORATION -y I-EXPLORATION -aislado I-EXPLORATION -socialmente I-EXPLORATION -por I-EXPLORATION -las I-EXPLORATION -consecuencias I-EXPLORATION +procedencia I-EXPLORATION del I-EXPLORATION -consumo I-EXPLORATION -excesivo I-EXPLORATION -de I-EXPLORATION -alcohol, I-EXPLORATION -fue I-EXPLORATION -invadido I-EXPLORATION -por I-EXPLORATION -sentimientos I-EXPLORATION -reactivados I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -pasado, I-EXPLORATION -surgidos I-EXPLORATION +paciente I-EXPLORATION +(hospital I-EXPLORATION en I-EXPLORATION -etapas I-EXPLORATION -no I-EXPLORATION -resueltas I-EXPLORATION -del I-EXPLORATION -desarrollo I-EXPLORATION -infantil, I-EXPLORATION -cuando I-EXPLORATION -fue I-EXPLORATION -excluido I-EXPLORATION -de I-EXPLORATION +Italia). I-EXPLORATION +Frente I-EXPLORATION +a I-EXPLORATION +dicho I-EXPLORATION +antecedente I-EXPLORATION +se I-EXPLORATION +sospechó I-EXPLORATION la I-EXPLORATION -familia I-EXPLORATION -nuclear I-EXPLORATION -(conflicto I-EXPLORATION -nuclear). I-EXPLORATION -Sentimientos I-EXPLORATION +posible I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -culpa, I-EXPLORATION -desconfianza, I-EXPLORATION -desamparo I-EXPLORATION -y I-EXPLORATION -soledad, I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION +carbapenemasa I-EXPLORATION +KPC I-EXPLORATION +importada, I-EXPLORATION +indicándose I-EXPLORATION el I-EXPLORATION -presente I-EXPLORATION -provocaron I-EXPLORATION -una I-EXPLORATION -importante I-EXPLORATION -quiebra I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -imagen I-EXPLORATION +estudio I-EXPLORATION +microbiológico I-EXPLORATION de I-EXPLORATION -sí, I-EXPLORATION +portación I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -límites I-EXPLORATION -del I-EXPLORATION -yo I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -sentido I-EXPLORATION +KPC I-EXPLORATION +mediante I-EXPLORATION +hisopado I-EXPLORATION +rectal. I-EXPLORATION +Se I-EXPLORATION +repitió I-EXPLORATION +el I-EXPLORATION +urocultivo, I-EXPLORATION +se I-EXPLORATION +iniciaron I-EXPLORATION +las I-EXPLORATION +medidas I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -realidad. I-EXPLORATION -Vencido I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -puesta I-EXPLORATION -en I-EXPLORATION -marcha I-EXPLORATION +contención I-EXPLORATION de I-EXPLORATION -mecanismos I-EXPLORATION -defensivos I-EXPLORATION -como I-EXPLORATION la I-EXPLORATION -introyección, I-EXPLORATION -interiorizando I-EXPLORATION -el I-EXPLORATION -objeto I-EXPLORATION -persecutorio, I-EXPLORATION -las I-EXPLORATION -voces I-EXPLORATION +transmisión I-EXPLORATION y I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION la I-EXPLORATION -identificación I-EXPLORATION +primera I-EXPLORATION +comunicación I-EXPLORATION +vía I-EXPLORATION +correo I-EXPLORATION +electrónico I-EXPLORATION con I-EXPLORATION el I-EXPLORATION -objeto I-EXPLORATION -idealizado, I-EXPLORATION -las I-EXPLORATION -figuras I-EXPLORATION -de I-EXPLORATION +médico I-EXPLORATION +tratante I-EXPLORATION +italiano I-EXPLORATION +para I-EXPLORATION +consultarle I-EXPLORATION +si I-EXPLORATION la I-EXPLORATION -abuela I-EXPLORATION -e I-EXPLORATION -hija, I-EXPLORATION -deseando I-EXPLORATION -morir I-EXPLORATION -como I-EXPLORATION -ellas, I-EXPLORATION +K. I-EXPLORATION +pneumoniae I-EXPLORATION +multi-resistente I-EXPLORATION +indicada I-EXPLORATION +en I-EXPLORATION +resumen I-EXPLORATION +de I-EXPLORATION +traslado I-EXPLORATION se I-EXPLORATION -mostraba I-EXPLORATION -incapaz I-EXPLORATION +trataba I-EXPLORATION de I-EXPLORATION -enfrentar I-EXPLORATION -su I-EXPLORATION -propio I-EXPLORATION -sustento I-EXPLORATION -y I-EXPLORATION -destino. I-EXPLORATION +una I-EXPLORATION +poseedora I-EXPLORATION +de I-EXPLORATION +BLEE I-EXPLORATION +o I-EXPLORATION +KPC. I-EXPLORATION I-EXPLORATION -Trabajo B-TREATMENT -en I-TREATMENT -el I-TREATMENT -Foco I-TREATMENT - I-TREATMENT -Teniendo I-TREATMENT -en I-TREATMENT -cuenta I-TREATMENT -la I-TREATMENT -hipótesis I-TREATMENT -psicodinámica I-TREATMENT -inicial, I-TREATMENT -se I-TREATMENT -seleccionaron I-TREATMENT -los I-TREATMENT -sentimientos I-TREATMENT -de I-TREATMENT -culpa, I-TREATMENT -desconfianza, I-TREATMENT -desamparo I-TREATMENT -y I-TREATMENT -soledad I-TREATMENT -como I-TREATMENT -foco I-TREATMENT -terapéutico. I-TREATMENT -Estos I-TREATMENT -sentimientos I-TREATMENT -se I-TREATMENT -abordaron I-TREATMENT -desde I-TREATMENT -una I-TREATMENT -perspectiva I-TREATMENT -cognitiva, I-TREATMENT -emocional I-TREATMENT -y I-TREATMENT -conductual, I-TREATMENT -intentando I-TREATMENT -facilitar I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -su I-TREATMENT -identificación, I-TREATMENT -expresión, I-TREATMENT -regulación I-TREATMENT -y I-TREATMENT -transformación: I-TREATMENT - I-TREATMENT -Sentimiento I-TREATMENT -de I-TREATMENT -culpa: I-TREATMENT -se I-TREATMENT -sentía I-TREATMENT -terriblemente I-TREATMENT -culpable I-TREATMENT -de I-TREATMENT -la I-TREATMENT -enfermedad I-TREATMENT -y I-TREATMENT -posterior I-TREATMENT -fallecimiento I-TREATMENT -de I-TREATMENT -su I-TREATMENT -hija. I-TREATMENT -Se I-TREATMENT -facilitó I-TREATMENT -la I-TREATMENT -expresión I-TREATMENT -de I-TREATMENT -este I-TREATMENT -sentimiento, I-TREATMENT -aumentando I-TREATMENT -la I-TREATMENT -conciencia I-TREATMENT -de I-TREATMENT -su I-TREATMENT -presencia I-TREATMENT -en I-TREATMENT +El I-EXPLORATION +equipo I-EXPLORATION +de I-EXPLORATION +hemato-oncología I-EXPLORATION +solicitó I-EXPLORATION +un I-EXPLORATION +nuevo I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +etapificación I-EXPLORATION +con I-EXPLORATION +imágenes I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +compromiso I-EXPLORATION +óseo I-EXPLORATION +difuso I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +extensa I-EXPLORATION +lesión I-EXPLORATION +lítica I-EXPLORATION +del I-EXPLORATION +ilíaco I-EXPLORATION +derecho I-EXPLORATION +con I-EXPLORATION +tumoración I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +tejidos I-EXPLORATION +blandos. I-EXPLORATION +Desde B-TREATMENT el I-TREATMENT -pasado. I-TREATMENT -Se I-TREATMENT -abordaron I-TREATMENT -las I-TREATMENT -fantasías I-TREATMENT -de I-TREATMENT -omnipotencia I-TREATMENT -y I-TREATMENT -creencias I-TREATMENT -mágicas, I-TREATMENT -la I-TREATMENT -aceptación I-TREATMENT +punto I-TREATMENT de I-TREATMENT -los I-TREATMENT -límites I-TREATMENT -propios I-TREATMENT -y I-TREATMENT +vista I-TREATMENT +hemato-oncológico, I-TREATMENT el I-TREATMENT -reconocimiento I-TREATMENT -de I-TREATMENT -los I-TREATMENT -límites I-TREATMENT -de I-TREATMENT -la I-TREATMENT -naturaleza I-TREATMENT -humana. I-TREATMENT -Para I-TREATMENT -favorecer I-TREATMENT -la I-TREATMENT -reparación I-TREATMENT -del I-TREATMENT -daño I-TREATMENT -y I-TREATMENT -la I-TREATMENT -transformación I-TREATMENT -del I-TREATMENT -sentimiento, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -animó I-TREATMENT -a I-TREATMENT -la I-TREATMENT -conducta I-TREATMENT -de I-TREATMENT -ayuda I-TREATMENT -y I-TREATMENT -entrega I-TREATMENT +paciente I-TREATMENT +sería I-TREATMENT +candidato I-TREATMENT a I-TREATMENT -los I-TREATMENT -demás I-TREATMENT -pacientes, I-TREATMENT -personas I-TREATMENT -necesitadas I-TREATMENT -como I-TREATMENT -él. I-TREATMENT - I-TREATMENT -Sentimiento I-TREATMENT -de I-TREATMENT -desconfianza: I-TREATMENT -sentimiento I-TREATMENT -que I-TREATMENT -emergió I-TREATMENT -tras I-TREATMENT -la I-TREATMENT -conflictiva I-TREATMENT -familiar I-TREATMENT -y I-TREATMENT -laboral. I-TREATMENT -Con I-TREATMENT -la I-TREATMENT -intención I-TREATMENT -de I-TREATMENT -trabajar I-TREATMENT -la I-TREATMENT -confianza I-TREATMENT -en I-TREATMENT -sí I-TREATMENT -mismo, I-TREATMENT -base I-TREATMENT -de I-TREATMENT -la I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -confiar I-TREATMENT -en I-TREATMENT -los I-TREATMENT -demás, I-TREATMENT -se I-TREATMENT -hizo I-TREATMENT -un I-TREATMENT -intento I-TREATMENT -de I-TREATMENT -reestructurar I-TREATMENT -la I-TREATMENT -imagen I-TREATMENT -de I-TREATMENT -sí I-TREATMENT -y I-TREATMENT -la I-TREATMENT -autoestima I-TREATMENT -perdida, I-TREATMENT -ofreciéndole I-TREATMENT -una I-TREATMENT -experiencia I-TREATMENT -emocional I-TREATMENT -correctiva, I-TREATMENT -en I-TREATMENT +tratamiento I-TREATMENT +paliativo I-TREATMENT +dado I-TREATMENT el I-TREATMENT -contexto I-TREATMENT +estadio I-TREATMENT +actual I-TREATMENT de I-TREATMENT la I-TREATMENT -relación I-TREATMENT -terapéutica, I-TREATMENT -al I-TREATMENT -valorarle I-TREATMENT -y I-TREATMENT -reforzar I-TREATMENT -con I-TREATMENT -frecuencia I-TREATMENT -sus I-TREATMENT -cualidades, I-TREATMENT -entre I-TREATMENT -ellas, I-TREATMENT -su I-TREATMENT -generosidad, I-TREATMENT -entrega I-TREATMENT -y I-TREATMENT -capacidad I-TREATMENT -de I-TREATMENT -apego. I-TREATMENT -Además I-TREATMENT -se I-TREATMENT -le I-TREATMENT -instó I-TREATMENT -a I-TREATMENT -contactar I-TREATMENT -con I-TREATMENT -su I-TREATMENT -tía I-TREATMENT -y I-TREATMENT -primo I-TREATMENT -que I-TREATMENT -residían I-TREATMENT -ahora I-TREATMENT -en I-TREATMENT -otra I-TREATMENT -ciudad, I-TREATMENT -con I-TREATMENT -los I-TREATMENT -que I-TREATMENT -había I-TREATMENT -mantenido I-TREATMENT -una I-TREATMENT -relación I-TREATMENT -de I-TREATMENT -confianza I-TREATMENT -y I-TREATMENT -apego. I-TREATMENT - I-TREATMENT -Sentimiento I-TREATMENT -de I-TREATMENT -desamparo I-TREATMENT -y I-TREATMENT -soledad: I-TREATMENT -La I-TREATMENT -muerte I-TREATMENT +enfermedad I-TREATMENT de I-TREATMENT -sus I-TREATMENT -abuelos I-TREATMENT -y I-TREATMENT -su I-TREATMENT -hija, I-TREATMENT -el I-TREATMENT -divorcio I-TREATMENT -y I-TREATMENT -el I-TREATMENT -aislamiento I-TREATMENT -social I-TREATMENT -favorecieron I-TREATMENT -ambos I-TREATMENT -sentimientos. I-TREATMENT -Se I-TREATMENT -trabajó I-TREATMENT -la I-TREATMENT -resolución I-TREATMENT -del I-TREATMENT -duelo, I-TREATMENT -facilitando I-TREATMENT -la I-TREATMENT -identificación I-TREATMENT +base I-TREATMENT y I-TREATMENT -expresión I-TREATMENT -de I-TREATMENT -la I-TREATMENT -rabia I-TREATMENT -por I-TREATMENT -la I-TREATMENT -muerte I-TREATMENT -de I-TREATMENT sus I-TREATMENT -seres I-TREATMENT -más I-TREATMENT -queridos I-TREATMENT -y I-TREATMENT -señalando I-TREATMENT -la I-TREATMENT -permanencia I-TREATMENT -de I-TREATMENT -las I-TREATMENT -relaciones I-TREATMENT -de I-TREATMENT -objeto I-TREATMENT -en I-TREATMENT -el I-TREATMENT -interior. I-TREATMENT -Además, I-TREATMENT -se I-TREATMENT -destacó I-TREATMENT -la I-TREATMENT -importancia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -ayuda I-TREATMENT -recibida I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -exterior, I-TREATMENT -de I-TREATMENT -la I-TREATMENT -institución I-TREATMENT -sanitaria. I-TREATMENT -Tomó I-TREATMENT -en I-TREATMENT -aquel I-TREATMENT -momento I-TREATMENT -conciencia I-TREATMENT -del I-TREATMENT -miedo I-TREATMENT -a I-TREATMENT -enfrentar I-TREATMENT -su I-TREATMENT -situación, I-TREATMENT -a I-TREATMENT -vivir I-TREATMENT -en I-TREATMENT -soledad I-TREATMENT -y I-TREATMENT -se I-TREATMENT -le I-TREATMENT -propuso I-TREATMENT -entonces I-TREATMENT -reiniciar I-TREATMENT -el I-TREATMENT -contacto I-TREATMENT -telefónico I-TREATMENT -con I-TREATMENT -amigos I-TREATMENT -y I-TREATMENT -compañeros. I-TREATMENT +magras I-TREATMENT +condiciones I-TREATMENT +generales. I-TREATMENT I-TREATMENT +El B-EXPLORATION +11 I-EXPLORATION +de I-EXPLORATION +marzo I-EXPLORATION +se I-EXPLORATION +recibió I-EXPLORATION +confirmación I-EXPLORATION +desde I-EXPLORATION +Italia I-EXPLORATION +del I-EXPLORATION +antecedente I-EXPLORATION +de I-EXPLORATION +KPC. I-EXPLORATION +Se I-EXPLORATION +logró I-EXPLORATION +identificar I-EXPLORATION +nuevamente I-EXPLORATION +una I-EXPLORATION +K. I-EXPLORATION +pneumoniae I-EXPLORATION +resistente I-EXPLORATION +a I-EXPLORATION +todos I-EXPLORATION +los I-EXPLORATION +antimicrobianos I-EXPLORATION +excepto I-EXPLORATION +colistin I-EXPLORATION +y I-EXPLORATION +tigeciclina I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +urocultivo I-EXPLORATION +e I-EXPLORATION +hisopado I-EXPLORATION +rectal, I-EXPLORATION +los I-EXPLORATION +que I-EXPLORATION +fueron I-EXPLORATION +estudiados I-EXPLORATION +con I-EXPLORATION +batería I-EXPLORATION +bioquímica I-EXPLORATION +convencional I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +identificación I-EXPLORATION +de I-EXPLORATION +especie I-EXPLORATION +y I-EXPLORATION +antibio-grama I-EXPLORATION +por I-EXPLORATION +difusión I-EXPLORATION +con I-EXPLORATION +discos I-EXPLORATION +de I-EXPLORATION +acuerdo I-EXPLORATION +a I-EXPLORATION +estándares I-EXPLORATION +CLSI6. I-EXPLORATION +Siguiendo I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +protocolo I-EXPLORATION +de I-EXPLORATION +vigilancia I-EXPLORATION +acordado I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +Grupo I-EXPLORATION +Colaborativo I-EXPLORATION +de I-EXPLORATION +Resistencia I-EXPLORATION +de I-EXPLORATION +Chile I-EXPLORATION +(datos I-EXPLORATION +no I-EXPLORATION +publicados I-EXPLORATION +Reunión-Curso I-EXPLORATION +de I-EXPLORATION +Resistencia I-EXPLORATION +Santa I-EXPLORATION +Cruz I-EXPLORATION +2009), I-EXPLORATION +la I-EXPLORATION +cepa I-EXPLORATION +fue I-EXPLORATION +derivada I-EXPLORATION +al I-EXPLORATION +Laboratorio I-EXPLORATION +de I-EXPLORATION +Microbiología I-EXPLORATION +Molecular I-EXPLORATION +del I-EXPLORATION +Departamento I-EXPLORATION +de I-EXPLORATION +Laboratorios I-EXPLORATION +Clínicos I-EXPLORATION +Pontificia I-EXPLORATION +Universidad I-EXPLORATION +de I-EXPLORATION +Chile I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +molecular I-EXPLORATION +de I-EXPLORATION +genes I-EXPLORATION +de I-EXPLORATION +resistencia I-EXPLORATION +antimicrobiana. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +día I-EXPLORATION +12 I-EXPLORATION +de I-EXPLORATION +marzo I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +la I-EXPLORATION +determinación I-EXPLORATION +de I-EXPLORATION +susceptibilidad I-EXPLORATION +in I-EXPLORATION +vitro I-EXPLORATION +por I-EXPLORATION +CIM I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +cepa I-EXPLORATION +de I-EXPLORATION +K. I-EXPLORATION +pneumoniae I-EXPLORATION +y I-EXPLORATION +los I-EXPLORATION +test I-EXPLORATION +fenotípicos6 I-EXPLORATION +de I-EXPLORATION +Hodge I-EXPLORATION +y I-EXPLORATION +ácido I-EXPLORATION +borónico, I-EXPLORATION +de I-EXPLORATION +acuerdo I-EXPLORATION +a I-EXPLORATION +estándares I-EXPLORATION +CLSI. I-EXPLORATION +Se I-EXPLORATION +obtuvo I-EXPLORATION +el I-EXPLORATION +resultado I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +ambos I-EXPLORATION +test I-EXPLORATION +fenotípicos I-EXPLORATION +confirmándose I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +blaKPC I-EXPLORATION +(grupo I-EXPLORATION +KPC-2/ I-EXPLORATION +KPC-3), I-EXPLORATION +blaTEM I-EXPLORATION +y I-EXPLORATION +bla I-EXPLORATION +Se I-EXPLORATION +descartaron I-EXPLORATION +β-lactamasas I-EXPLORATION +tipo I-EXPLORATION +CTX-M, I-EXPLORATION +β-lactamasas I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +familia I-EXPLORATION +AmpC, I-EXPLORATION +metalo-β-lactamasas I-EXPLORATION +(blaIMI I-EXPLORATION +blaVIM I-EXPLORATION +blaNDM-1), I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +car I-EXPLORATION +bapenemasas I-EXPLORATION +del I-EXPLORATION +grupo I-EXPLORATION +A I-EXPLORATION +(blaGES I-EXPLORATION +blaIMI I-EXPLORATION +blaSME). I-EXPLORATION + I-EXPLORATION +Finalmente, I-EXPLORATION +el I-EXPLORATION +Instituto I-EXPLORATION +de I-EXPLORATION +Salud I-EXPLORATION +Pública, I-EXPLORATION +confirmó I-EXPLORATION +el I-EXPLORATION +hallazgo I-EXPLORATION +de I-EXPLORATION +KPC I-EXPLORATION +(KPC-2/KPC-3) I-EXPLORATION +el I-EXPLORATION +día I-EXPLORATION +13 I-EXPLORATION +de I-EXPLORATION +marzo. I-EXPLORATION + I-EXPLORATION -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS +68 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -remitido B-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -urgencias I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -psiquiatra I-DERIVED_FROM/TO -habitual I-DERIVED_FROM/TO -debido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -alteraciones I-DERIVED_FROM/TO -conductuales I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -entorno I-DERIVED_FROM/TO -familiar. I-DERIVED_FROM/TO -Ha B-PRESENT_ILLNESS -venido I-PRESENT_ILLNESS -desarrollando I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -hábitos I-PRESENT_ILLNESS -alimentarios I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -han I-PRESENT_ILLNESS -puesto I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -peligro I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -salud, I-PRESENT_ILLNESS -rechazando I-PRESENT_ILLNESS -algunos I-PRESENT_ILLNESS -alimentos I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -considerar I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -estaban I-PRESENT_ILLNESS -"contaminados". I-PRESENT_ILLNESS -Cuando I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -tratado I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +crónica, I-PAST_MEDICAL_HISTORY +con B-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -modificar I-PRESENT_ILLNESS -estas I-PRESENT_ILLNESS -conductas, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -mostrado I-PRESENT_ILLNESS -irritado I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -agresividad I-PRESENT_ILLNESS -hacia I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -madre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -hermano I-PRESENT_ILLNESS -menor. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -entrevista I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -mostró I-PRESENT_ILLNESS -colaborador, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -aspecto I-PRESENT_ILLNESS -descuidado I-PRESENT_ILLNESS -debido I-PRESENT_ILLNESS +disfagia I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -falta I-PRESENT_ILLNESS +sólidos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +líquidos I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -higiene. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -contacto I-PRESENT_ILLNESS -era I-PRESENT_ILLNESS -peculiar, I-PRESENT_ILLNESS -mostrando I-PRESENT_ILLNESS -sonrisas I-PRESENT_ILLNESS -inapropiadas I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -alta I-PRESENT_ILLNESS -latencia I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -respuesta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -discurso. I-PRESENT_ILLNESS -Negaba I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS +broncoaspiración. I-PRESENT_ILLNESS +El B-EXPLORATION +EGD I-EXPLORATION +sugería I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +contracciones I-EXPLORATION +terciarias I-EXPLORATION +en I-EXPLORATION +tercio I-EXPLORATION +medio I-EXPLORATION +inferior, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +un I-EXPLORATION +divertículo I-EXPLORATION +en I-EXPLORATION +cara I-EXPLORATION +posterior I-EXPLORATION +derecha I-EXPLORATION +inferior I-EXPLORATION +de I-EXPLORATION +2, I-EXPLORATION +9x2, I-EXPLORATION +8 I-EXPLORATION +cm I-EXPLORATION +diámetro I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +endoscópico. I-EXPLORATION + I-EXPLORATION + +Hermanos B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -sensopercepción I-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -pensamiento. I-PRESENT_ILLNESS -Refirió B-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -crisis I-PAST_MEDICAL_HISTORY -epilépticas I-PAST_MEDICAL_HISTORY +30 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +casados B-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +hijos, I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -acudió I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -consulta I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -psiquiatría I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -problemas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -conducta; I-PAST_MEDICAL_HISTORY -allí I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Asperger. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -pesar I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -refirió I-PAST_MEDICAL_HISTORY -sintomatología I-PAST_MEDICAL_HISTORY -psicótica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -aquella I-PAST_MEDICAL_HISTORY -ocasión, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -pautó I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -neuroléptico I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -abandonó I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -reacción I-PAST_MEDICAL_HISTORY -adversa. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY +infertilidad I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sinusitis I-PAST_MEDICAL_HISTORY +frecuentes I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +infecciones I-PAST_MEDICAL_HISTORY +respiratorias I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -valoración I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontraba I-PAST_MEDICAL_HISTORY -bajo I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -psiquiátrico. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ingreso, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -mostraba I-PRESENT_ILLNESS -tranquilo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -colaborador. I-PRESENT_ILLNESS -En B-EVOLUTION -la I-EVOLUTION -primera I-EVOLUTION -consulta, I-EVOLUTION -solicitó I-EVOLUTION -un I-EVOLUTION -tiempo I-EVOLUTION -previo I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -entrevista I-EVOLUTION -para I-EVOLUTION -poder I-EVOLUTION -realizar I-EVOLUTION -un I-EVOLUTION -paseo I-EVOLUTION -por I-EVOLUTION -los I-EVOLUTION -pasillos I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -planta, I-EVOLUTION -ya I-EVOLUTION -que I-EVOLUTION -esto I-EVOLUTION -le I-EVOLUTION -ayudaba I-EVOLUTION -a I-EVOLUTION -calmarse. I-EVOLUTION -Cuando I-EVOLUTION -se I-EVOLUTION -exploró I-EVOLUTION -el I-EVOLUTION -motivo I-EVOLUTION -del I-EVOLUTION -ingreso, I-EVOLUTION -mostró I-EVOLUTION -escasa I-EVOLUTION -conciencia I-EVOLUTION -de I-EVOLUTION -enfermedad, I-EVOLUTION -refiriendo I-EVOLUTION -encontrarse I-EVOLUTION -en I-EVOLUTION -desacuerdo I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -necesidad I-EVOLUTION -del I-EVOLUTION -mismo. I-EVOLUTION -Sin I-EVOLUTION -embargo, I-EVOLUTION -no I-EVOLUTION -mostraba I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -desconfianza, I-EVOLUTION -presentando I-EVOLUTION -buena I-EVOLUTION -disposición I-EVOLUTION -a I-EVOLUTION -recibir I-EVOLUTION -tratamiento. I-EVOLUTION -Su B-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -refirió I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY +repetición I-PAST_MEDICAL_HISTORY desde I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -primera I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -notado I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -algo I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -diferente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -paciente, I-PAST_MEDICAL_HISTORY -si I-PAST_MEDICAL_HISTORY -bien I-PAST_MEDICAL_HISTORY -reconocía I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -información I-PAST_MEDICAL_HISTORY -sobre I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Asperger I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -mayor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -comentaba I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -compañeros I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -colegio I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -reían I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -él I-PAST_MEDICAL_HISTORY -porque I-PAST_MEDICAL_HISTORY -utilizaba I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -vocabulario I-PAST_MEDICAL_HISTORY -muy I-PAST_MEDICAL_HISTORY -formal. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -rendimiento I-PAST_MEDICAL_HISTORY -académico I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -excelente I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -bachillerato, I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +muchos I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +aunque I-PAST_MEDICAL_HISTORY +niegan I-PAST_MEDICAL_HISTORY +haberlas I-PAST_MEDICAL_HISTORY +padecido I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -comenzó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -suspender I-PAST_MEDICAL_HISTORY -asignaturas I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -pesar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -contar I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -capacidad I-PAST_MEDICAL_HISTORY -intelectual I-PAST_MEDICAL_HISTORY -superior I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -media. I-PAST_MEDICAL_HISTORY -Hasta I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -pasaba I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -mayor I-PAST_MEDICAL_HISTORY -parte I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -tiempo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -casa, I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -convivía I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -hermano I-PAST_MEDICAL_HISTORY -menor. I-PAST_MEDICAL_HISTORY -Comentaba I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -menudo I-PAST_MEDICAL_HISTORY -solía I-PAST_MEDICAL_HISTORY -dar I-PAST_MEDICAL_HISTORY -largos I-PAST_MEDICAL_HISTORY -paseos I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -desplazaba I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -autobús, I-PAST_MEDICAL_HISTORY -actividades I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -realizaba I-PAST_MEDICAL_HISTORY -siempre I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -solitario. I-PAST_MEDICAL_HISTORY -Refería I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -fuerte I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -ciencias I-PAST_MEDICAL_HISTORY -naturales. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al B-EVOLUTION -avanzar I-EVOLUTION -el I-EVOLUTION -ingreso, I-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -observaba I-EVOLUTION -más I-EVOLUTION -distendido, I-EVOLUTION -con I-EVOLUTION -menor I-EVOLUTION -rigidez I-EVOLUTION -postural I-EVOLUTION -y I-EVOLUTION -menor I-EVOLUTION -latencia I-EVOLUTION -de I-EVOLUTION -respuesta I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -discurso. I-EVOLUTION -También I-EVOLUTION -se I-EVOLUTION -redujeron I-EVOLUTION -las I-EVOLUTION -sonrisas I-EVOLUTION -inmotivadas, I-EVOLUTION -las I-EVOLUTION -cuales I-EVOLUTION -reaparecían I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -contexto I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -interacción I-EVOLUTION -con I-EVOLUTION -personas I-EVOLUTION -desconocidas. I-EVOLUTION -El B-TREATMENT -tratamiento I-TREATMENT -antipsicótico I-TREATMENT -se I-TREATMENT -mostró I-TREATMENT -eficaz I-TREATMENT -en I-TREATMENT -la I-TREATMENT -reducción I-TREATMENT -de I-TREATMENT -la I-TREATMENT -irritabilidad I-TREATMENT -del I-TREATMENT -paciente. I-TREATMENT -La B-EVOLUTION -rigidez I-EVOLUTION -en I-EVOLUTION -relación I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -ideas I-EVOLUTION -sobre I-EVOLUTION -la I-EVOLUTION -alimentación I-EVOLUTION -y I-EVOLUTION -los I-EVOLUTION -hábitos I-EVOLUTION -de I-EVOLUTION -higiene I-EVOLUTION -y I-EVOLUTION -sueño I-EVOLUTION -continuaron I-EVOLUTION -al I-EVOLUTION -alta. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que B-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -urgencias I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -alteraciones I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -conducta I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -vía I-DERIVED_FROM/TO -pública. I-DERIVED_FROM/TO -Sus B-PRESENT_ILLNESS -padres I-PRESENT_ILLNESS -referían I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -ido I-PRESENT_ILLNESS -disminuyendo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sueño, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -verbalizado I-PRESENT_ILLNESS -ideas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -carácter I-PRESENT_ILLNESS -mesiánico. I-PRESENT_ILLNESS -Parecía I-PRESENT_ILLNESS -llevar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -desorganizada I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -descuido I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -tareas I-PRESENT_ILLNESS -básicas, I-PRESENT_ILLNESS -dedicación I-PRESENT_ILLNESS -excesiva I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -videojuegos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -deficiente I-PRESENT_ILLNESS -alimentación. I-PRESENT_ILLNESS +infancia. I-PAST_MEDICAL_HISTORY +Madre B-FAMILY_HISTORY +y I-FAMILY_HISTORY +hermana I-FAMILY_HISTORY +presentan I-FAMILY_HISTORY +broncopatía I-FAMILY_HISTORY +crónica I-FAMILY_HISTORY +no I-FAMILY_HISTORY +filiada. I-FAMILY_HISTORY +Padre I-FAMILY_HISTORY +sano I-FAMILY_HISTORY +sin I-FAMILY_HISTORY +afectación I-FAMILY_HISTORY +pulmonar I-FAMILY_HISTORY +o I-FAMILY_HISTORY +sinusal. I-FAMILY_HISTORY En B-EXPLORATION -la I-EXPLORATION -entrevista I-EXPLORATION -se I-EXPLORATION -mostró I-EXPLORATION -hostil, I-EXPLORATION -suspicaz, I-EXPLORATION -e I-EXPLORATION -interpretativo I-EXPLORATION -con I-EXPLORATION el I-EXPLORATION -entorno, I-EXPLORATION -especialmente I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -colores, I-EXPLORATION -llegando I-EXPLORATION -a I-EXPLORATION -referir I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -"sentía" I-EXPLORATION -azul. I-EXPLORATION -Negó I-EXPLORATION -alteraciones I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +de I-EXPLORATION +ambos I-EXPLORATION +hermanos, I-EXPLORATION +hermana, I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +madre, I-EXPLORATION +sólo I-EXPLORATION +destaca I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +roncus I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -esfera I-EXPLORATION -sensoperceptiva. I-EXPLORATION -Desde B-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontraba I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -psiquiatría I-PAST_MEDICAL_HISTORY -debido I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -varios I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -psicóticos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -afectivos, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -respuesta I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -psicofarmacológico, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -abandonado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -meses. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Ya B-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -unidad, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -mostró I-EVOLUTION -tranquilo, I-EVOLUTION -pero I-EVOLUTION -muy I-EVOLUTION -desconfiado. I-EVOLUTION -Explicó I-EVOLUTION -lo I-EVOLUTION -sucedido I-EVOLUTION -como I-EVOLUTION -resultado I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -percepción I-EVOLUTION -de I-EVOLUTION -"pistas I-EVOLUTION -falsas" I-EVOLUTION -que I-EVOLUTION -le I-EVOLUTION -llevaron I-EVOLUTION -a I-EVOLUTION -alertar I-EVOLUTION -a I-EVOLUTION -determinadas I-EVOLUTION -personas I-EVOLUTION -de I-EVOLUTION -que I-EVOLUTION -estaban I-EVOLUTION -en I-EVOLUTION -peligro. I-EVOLUTION -Su B-FAMILY_HISTORY -madre I-FAMILY_HISTORY -refirió I-FAMILY_HISTORY -llevar I-FAMILY_HISTORY -varios I-FAMILY_HISTORY -años I-FAMILY_HISTORY -en I-FAMILY_HISTORY -tratamiento I-FAMILY_HISTORY -psiquiátrico I-FAMILY_HISTORY -por I-FAMILY_HISTORY -distimia, I-FAMILY_HISTORY -mientras I-FAMILY_HISTORY -que I-FAMILY_HISTORY -el I-FAMILY_HISTORY -padre I-FAMILY_HISTORY -había I-FAMILY_HISTORY -recibido I-FAMILY_HISTORY -un I-FAMILY_HISTORY -diagnóstico I-FAMILY_HISTORY +auscultación I-EXPLORATION +pulmonar. I-EXPLORATION +No B-FAMILY_HISTORY +se I-FAMILY_HISTORY +pudieron I-FAMILY_HISTORY +obtener I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +clínicos I-FAMILY_HISTORY de I-FAMILY_HISTORY -trastorno I-FAMILY_HISTORY -obsesivo I-FAMILY_HISTORY -compulsivo I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -pasado. I-FAMILY_HISTORY -Los B-EXPLORATION -familiares I-EXPLORATION -no I-EXPLORATION -refirieron I-EXPLORATION -ninguna I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -desarrollo I-EXPLORATION +la I-FAMILY_HISTORY +ascendencia I-FAMILY_HISTORY +tanto I-FAMILY_HISTORY +paterna I-FAMILY_HISTORY +como I-FAMILY_HISTORY +materna. I-FAMILY_HISTORY +Bioquímica B-EXPLORATION +ordinaria I-EXPLORATION +normal, I-EXPLORATION +incluyendo I-EXPLORATION +pruebas I-EXPLORATION +de I-EXPLORATION +función I-EXPLORATION +hepática I-EXPLORATION +y I-EXPLORATION +renal. I-EXPLORATION +Alfa-1-anti-tripsina I-EXPLORATION +normal. I-EXPLORATION +Proteinograma I-EXPLORATION +e I-EXPLORATION +inmunoglobulinas I-EXPLORATION +normales. I-EXPLORATION +Hormonas I-EXPLORATION +tiroideas I-EXPLORATION +normales. I-EXPLORATION +Marcadores I-EXPLORATION del I-EXPLORATION -paciente, I-EXPLORATION -si I-EXPLORATION -bien I-EXPLORATION -él I-EXPLORATION -mismo I-EXPLORATION -reconoció I-EXPLORATION -que I-EXPLORATION -siempre I-EXPLORATION -se I-EXPLORATION -había I-EXPLORATION -sentido I-EXPLORATION -un I-EXPLORATION -"bicho I-EXPLORATION -raro". I-EXPLORATION -Recordaba I-EXPLORATION -la I-EXPLORATION -etapa I-EXPLORATION -escolar I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -"infierno", I-EXPLORATION -presentando I-EXPLORATION -un I-EXPLORATION -mal I-EXPLORATION -manejo I-EXPLORATION +virus I-EXPLORATION +B I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -relaciones I-EXPLORATION -interpersonales, I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -punto I-EXPLORATION +la I-EXPLORATION +hepatitis I-EXPLORATION +y I-EXPLORATION +del I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION -reconocer I-EXPLORATION -que I-EXPLORATION -le I-EXPLORATION -daba I-EXPLORATION -"fobia" I-EXPLORATION la I-EXPLORATION -cara I-EXPLORATION +inmunodeficiencia I-EXPLORATION +humana I-EXPLORATION +negativos. I-EXPLORATION +Anticuerpos I-EXPLORATION +antinucleares, I-EXPLORATION +pruebas I-EXPLORATION +reumáticas, I-EXPLORATION +fracción I-EXPLORATION +C3 I-EXPLORATION +y I-EXPLORATION +C4 I-EXPLORATION +negativos. I-EXPLORATION +Gasometría I-EXPLORATION +arterial I-EXPLORATION +basal I-EXPLORATION +y I-EXPLORATION +bicarbonato I-EXPLORATION +normal. I-EXPLORATION +Espirometría I-EXPLORATION +normal. I-EXPLORATION +Saturación I-EXPLORATION +Hb I-EXPLORATION +normal. I-EXPLORATION +Radiografía I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -personas. I-EXPLORATION -Es I-EXPLORATION -por I-EXPLORATION -esta I-EXPLORATION -razón I-EXPLORATION -por I-EXPLORATION +tórax I-EXPLORATION +normal. I-EXPLORATION +Tanto I-EXPLORATION +los I-EXPLORATION +hermanos I-EXPLORATION +como I-EXPLORATION la I-EXPLORATION -que I-EXPLORATION -desde I-EXPLORATION +hermana I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -adolescencia I-EXPLORATION -mantenía I-EXPLORATION -contacto I-EXPLORATION -interpersonal I-EXPLORATION -casi I-EXPLORATION +madre I-EXPLORATION +rehusaron I-EXPLORATION +hacer I-EXPLORATION +biopsia I-EXPLORATION de I-EXPLORATION -manera I-EXPLORATION -exclusiva I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION +mucosa I-EXPLORATION +respiratoria I-EXPLORATION +para I-EXPLORATION +estudio I-EXPLORATION +ultraestructural I-EXPLORATION de I-EXPLORATION -juegos I-EXPLORATION +los I-EXPLORATION +cilios. I-EXPLORATION +El I-EXPLORATION +análisis I-EXPLORATION de I-EXPLORATION -ordenador I-EXPLORATION +semen I-EXPLORATION +indica I-EXPLORATION +astenozoospermia I-EXPLORATION +total I-EXPLORATION en I-EXPLORATION -línea. I-EXPLORATION - I-EXPLORATION -A B-EVOLUTION -medida I-EVOLUTION -que I-EVOLUTION -avanzó I-EVOLUTION -el I-EVOLUTION -ingreso I-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -observaba I-EVOLUTION -más I-EVOLUTION -distendido, I-EVOLUTION -si I-EVOLUTION -bien I-EVOLUTION -refería I-EVOLUTION -sentirse I-EVOLUTION -incómodo I-EVOLUTION -rodeado I-EVOLUTION -de I-EVOLUTION -gente. I-EVOLUTION -También I-EVOLUTION -comentó I-EVOLUTION -que I-EVOLUTION -le I-EVOLUTION -molestaba I-EVOLUTION -el I-EVOLUTION -sonido I-EVOLUTION -del I-EVOLUTION -tubo I-EVOLUTION -del I-EVOLUTION -televisor I-EVOLUTION -situado I-EVOLUTION -en I-EVOLUTION -una I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -salas I-EVOLUTION -comunes I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -unidad, I-EVOLUTION -el I-EVOLUTION -cual I-EVOLUTION -percibía I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -nítida. I-EVOLUTION -Como I-EVOLUTION -estrategia I-EVOLUTION -de I-EVOLUTION -afrontamiento I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -momentos I-EVOLUTION -de I-EVOLUTION -estrés, I-EVOLUTION -deambulaba I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -pasillo I-EVOLUTION -siguiendo I-EVOLUTION -una I-EVOLUTION -secuencia I-EVOLUTION -rutinaria I-EVOLUTION -que I-EVOLUTION -podía I-EVOLUTION -durar I-EVOLUTION -varias I-EVOLUTION -horas I-EVOLUTION -y I-EVOLUTION -que, I-EVOLUTION -según I-EVOLUTION -decía, I-EVOLUTION -le I-EVOLUTION -ayudaba I-EVOLUTION -a I-EVOLUTION -relajarse. I-EVOLUTION -Mencionó B-EXPLORATION -tener I-EXPLORATION -habitualmente I-EXPLORATION -"paranoias" I-EXPLORATION -que I-EXPLORATION -asociaba I-EXPLORATION -con I-EXPLORATION -su I-EXPLORATION -comportamiento I-EXPLORATION -anterior I-EXPLORATION -al I-EXPLORATION -ingreso. I-EXPLORATION -Relacionó I-EXPLORATION -el I-EXPLORATION -episodio I-EXPLORATION -conductual I-EXPLORATION +3 I-EXPLORATION +seminogramas I-EXPLORATION +diferentes I-EXPLORATION +realizados I-EXPLORATION +a I-EXPLORATION +ambos I-EXPLORATION +hermanos, I-EXPLORATION con I-EXPLORATION +una I-EXPLORATION +concentración I-EXPLORATION +espermática I-EXPLORATION +media I-EXPLORATION +de I-EXPLORATION +23 I-EXPLORATION +millones/ml, I-EXPLORATION un I-EXPLORATION -sentimiento I-EXPLORATION -profundo I-EXPLORATION +porcentaje I-EXPLORATION de I-EXPLORATION -soledad I-EXPLORATION -y I-EXPLORATION -frustración I-EXPLORATION +formas I-EXPLORATION +normales I-EXPLORATION por I-EXPLORATION -su I-EXPLORATION -incapacidad I-EXPLORATION -para I-EXPLORATION -mantener I-EXPLORATION -relaciones I-EXPLORATION -interpersonales I-EXPLORATION -estables. I-EXPLORATION -Al I-EXPLORATION -ser I-EXPLORATION -preguntado I-EXPLORATION +criterios I-EXPLORATION +de I-EXPLORATION +Kruger I-EXPLORATION +del I-EXPLORATION +6% I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +viabilidad I-EXPLORATION +del I-EXPLORATION +95%. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +ultraestructural I-EXPLORATION +del I-EXPLORATION +flagelo I-EXPLORATION +espermático I-EXPLORATION por I-EXPLORATION +microscopía I-EXPLORATION +electrónica I-EXPLORATION +indica I-EXPLORATION +que I-EXPLORATION +los I-EXPLORATION +dos I-EXPLORATION +hermanos I-EXPLORATION +tienen I-EXPLORATION la I-EXPLORATION -relación I-EXPLORATION -entre I-EXPLORATION -percepción I-EXPLORATION -y I-EXPLORATION -color I-EXPLORATION -manifestada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -servicio I-EXPLORATION +misma I-EXPLORATION +anomalía. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +mayoría I-EXPLORATION de I-EXPLORATION -urgencias, I-EXPLORATION -respondió I-EXPLORATION -que I-EXPLORATION +las I-EXPLORATION +secciones I-EXPLORATION +transversales I-EXPLORATION se I-EXPLORATION -trataba I-EXPLORATION +encuentra I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -letra I-EXPLORATION -traducida I-EXPLORATION +ambos I-EXPLORATION +brazos I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -canción I-EXPLORATION -(en I-EXPLORATION -inglés I-EXPLORATION -la I-EXPLORATION -palabra I-EXPLORATION -"blue" I-EXPLORATION -presenta I-EXPLORATION -dos I-EXPLORATION -significados: I-EXPLORATION -azul I-EXPLORATION +dineína. I-EXPLORATION +El I-EXPLORATION +filamento I-EXPLORATION +de I-EXPLORATION +nexina I-EXPLORATION +está I-EXPLORATION +presente, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +las I-EXPLORATION +fibras I-EXPLORATION +radiales I-EXPLORATION y I-EXPLORATION -triste. I-EXPLORATION -Al I-EXPLORATION -decir I-EXPLORATION -sentirse I-EXPLORATION -azul I-EXPLORATION el I-EXPLORATION -paciente I-EXPLORATION -realmente I-EXPLORATION -expresaba I-EXPLORATION -un I-EXPLORATION -sentimiento I-EXPLORATION -de I-EXPLORATION -tristeza). I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -presentó I-TREATMENT -buena I-TREATMENT -respuesta I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -antipsicótico, I-TREATMENT -si B-EVOLUTION -bien I-EVOLUTION -tanto I-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -afectivos I-EVOLUTION -como I-EVOLUTION -la I-EVOLUTION -rigidez I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -pensamiento I-EVOLUTION -nunca I-EVOLUTION -desaparecieron. I-EVOLUTION - I-EVOLUTION -La B-EXPLORATION -tabla I-EXPLORATION -1 I-EXPLORATION -muestra I-EXPLORATION +par I-EXPLORATION +central. I-EXPLORATION +En I-EXPLORATION +espermatozoides I-EXPLORATION +aislados, I-EXPLORATION +coincidiendo I-EXPLORATION +con I-EXPLORATION la I-EXPLORATION -comparación I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION los I-EXPLORATION -resultados I-EXPLORATION +brazos I-EXPLORATION +de I-EXPLORATION +dineína, I-EXPLORATION +hay I-EXPLORATION +también I-EXPLORATION +pérdida I-EXPLORATION +del I-EXPLORATION +par I-EXPLORATION +central. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +anomalía I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -Escala I-EXPLORATION +vaina I-EXPLORATION +fibrosa, I-EXPLORATION +ni I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -Inteligencia I-EXPLORATION -Wechsler I-EXPLORATION -para I-EXPLORATION -Adultos I-EXPLORATION -(WAIS) I-EXPLORATION -(30), I-EXPLORATION +fibras I-EXPLORATION +densas. I-EXPLORATION +La I-EXPLORATION +pieza I-EXPLORATION +intermedia I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -Escala I-EXPLORATION -de I-EXPLORATION -Síndromes I-EXPLORATION -Positivos I-EXPLORATION -y I-EXPLORATION -Negativos I-EXPLORATION -(PANSS) I-EXPLORATION -(32) I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -Cociente I-EXPLORATION +mitad I-EXPLORATION +aproximadamente I-EXPLORATION de I-EXPLORATION -Espectro I-EXPLORATION -Autista I-EXPLORATION -(AQ) I-EXPLORATION -(31) I-EXPLORATION -en I-EXPLORATION los I-EXPLORATION -tres I-EXPLORATION -pacientes. I-EXPLORATION -La I-EXPLORATION -tabla I-EXPLORATION -2 I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -comparación I-EXPLORATION -entre I-EXPLORATION -los I-EXPLORATION -criterios I-EXPLORATION +casos I-EXPLORATION +tenía I-EXPLORATION +disminución I-EXPLORATION +del I-EXPLORATION +número I-EXPLORATION de I-EXPLORATION -esquizofrenia I-EXPLORATION +mitocondrias I-EXPLORATION y I-EXPLORATION -autismo I-EXPLORATION -compartidos I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -tres I-EXPLORATION -casos I-EXPLORATION -descritos. I-EXPLORATION +mitocondrias I-EXPLORATION +extras I-EXPLORATION +no I-EXPLORATION +alineadas. I-EXPLORATION +Otros I-EXPLORATION +datos I-EXPLORATION +añadidos I-EXPLORATION +fueron I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +microtúbulos I-EXPLORATION +extra I-EXPLORATION +periféricos I-EXPLORATION +al I-EXPLORATION +axonema. I-EXPLORATION I-EXPLORATION -Paciente B-PRESENT_ILLNESS +Hombre B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS +73 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY hipertensión I-PAST_MEDICAL_HISTORY arterial I-PAST_MEDICAL_HISTORY -(HTA) I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -difícil I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY +valsartán I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hidroclorotiazida I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -mala I-PAST_MEDICAL_HISTORY -cumplimiento I-PAST_MEDICAL_HISTORY -terapéutico. I-PAST_MEDICAL_HISTORY -Había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2008 I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -probable I-PAST_MEDICAL_HISTORY -nefroangiosclerosis. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -implanta I-PAST_MEDICAL_HISTORY -catéter I-PAST_MEDICAL_HISTORY -peritoneal I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -diciembre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2009, I-PAST_MEDICAL_HISTORY -iniciando I-PAST_MEDICAL_HISTORY -DP I-PAST_MEDICAL_HISTORY -continua I-PAST_MEDICAL_HISTORY -ambulatoria I-PAST_MEDICAL_HISTORY -15 I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -tarde I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -incidencias I-PAST_MEDICAL_HISTORY -destacables. I-PAST_MEDICAL_HISTORY -Un B-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -disfunción I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -catéter I-PRESENT_ILLNESS -peritoneal, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -importante I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -drenaje. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -hipoventilación I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -campo I-EXPLORATION -medio I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -pulmón I-EXPLORATION -derecho. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -refiere I-EXPLORATION -disnea, I-EXPLORATION -aunque I-EXPLORATION -con I-EXPLORATION -buena I-EXPLORATION -saturación I-EXPLORATION +trombocitemia I-PAST_MEDICAL_HISTORY +esencial I-PAST_MEDICAL_HISTORY +bajo I-PAST_MEDICAL_HISTORY +terapia I-PAST_MEDICAL_HISTORY +inicialmente I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +hidroxiurea I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +luego I-PAST_MEDICAL_HISTORY +anagrelide. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +A B-PRESENT_ILLNESS +mediados I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +diciembre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2007 I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +porque I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hacía I-PRESENT_ILLNESS +8 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS +fatigabilidad, I-PRESENT_ILLNESS +astenia, I-PRESENT_ILLNESS +adinamia, I-PRESENT_ILLNESS +sudoración I-PRESENT_ILLNESS +nocturna, I-PRESENT_ILLNESS +disnea I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +esfuerzo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +seca I-PRESENT_ILLNESS +frecuente I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +productiva. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +tenido I-PRESENT_ILLNESS +fiebre, I-PRESENT_ILLNESS +baja I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +prurito. I-PRESENT_ILLNESS +El B-EXPLORATION +electrocardiograma I-EXPLORATION +y I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -oxígeno, I-EXPLORATION -con I-EXPLORATION -evidencia I-EXPLORATION +tórax I-EXPLORATION +fueron I-EXPLORATION +normales, I-EXPLORATION +salvo I-EXPLORATION +elongación I-EXPLORATION +aórtica I-EXPLORATION +moderada I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +ecocardiograma I-EXPLORATION +mostró I-EXPLORATION +insuficiencia I-EXPLORATION +aórtica I-EXPLORATION +leve, I-EXPLORATION +aurícula I-EXPLORATION +y I-EXPLORATION +ventrículo I-EXPLORATION +izquierdo I-EXPLORATION de I-EXPLORATION -importante I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -derecho I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION +tamaño I-EXPLORATION +y I-EXPLORATION +función I-EXPLORATION +conservada. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +hemograma I-EXPLORATION +destacaba I-EXPLORATION +hematocrito I-EXPLORATION de I-EXPLORATION -tórax. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION +29%, I-EXPLORATION +macrocitosis, I-EXPLORATION +rouleaux I-EXPLORATION +++, I-EXPLORATION +VHS I-EXPLORATION +49 I-EXPLORATION +mm/hora I-EXPLORATION +y I-EXPLORATION +plaquetas I-EXPLORATION de I-EXPLORATION -hidrotórax I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION -DP I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -toracocentesis I-EXPLORATION -diagnóstica, I-EXPLORATION -obteniendo I-EXPLORATION +717.000 I-EXPLORATION +mm3. I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION +generales I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +Una B-EVOLUTION +semana I-EVOLUTION +después I-EVOLUTION +presentó I-EVOLUTION +esputo I-EVOLUTION +hemoptoico I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +hospitalizado I-EVOLUTION +por I-EVOLUTION +sospecha I-EVOLUTION +de I-EVOLUTION +embolia I-EVOLUTION +pulmonar. I-EVOLUTION +Se B-EXPLORATION +realizó I-EXPLORATION un I-EXPLORATION -líquido I-EXPLORATION -pleural I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -datos: I-EXPLORATION -leucocitos I-EXPLORATION -200. I-EXPLORATION -Glucosa I-EXPLORATION -418. I-EXPLORATION -Proteínas I-EXPLORATION -<1, I-EXPLORATION -LDH I-EXPLORATION -42. I-EXPLORATION - I-EXPLORATION -Dado B-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -negaba I-TREATMENT -a I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -hemodiálisis, I-TREATMENT -tras I-TREATMENT -unos I-TREATMENT -días I-TREATMENT -de I-TREATMENT -reposo I-TREATMENT -peritoneal I-TREATMENT -con I-TREATMENT -los I-TREATMENT -que I-TREATMENT -se I-TREATMENT -consiguió I-TREATMENT -la I-TREATMENT -normalización I-TREATMENT -de I-TREATMENT -la I-TREATMENT -radiografía I-TREATMENT -de I-TREATMENT -tórax, I-TREATMENT -se I-TREATMENT -intenta I-TREATMENT -realizar I-TREATMENT -DP I-TREATMENT -automática I-TREATMENT -con I-TREATMENT -bajo I-TREATMENT -volumen I-TREATMENT -y I-TREATMENT -cabecera I-TREATMENT -a I-TREATMENT -45o, I-TREATMENT -sin I-TREATMENT -conseguir I-TREATMENT -un I-TREATMENT -buen I-TREATMENT -funcionamiento I-TREATMENT -del I-TREATMENT -catéter I-TREATMENT -por I-TREATMENT -importante I-TREATMENT -dificultad I-TREATMENT -para I-TREATMENT -el I-TREATMENT -drenaje I-TREATMENT -y I-TREATMENT -con I-TREATMENT -nueva I-TREATMENT -aparición I-TREATMENT -de I-TREATMENT -hidrotórax. I-TREATMENT -Finalmente, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -aceptó I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -HD I-TREATMENT -que I-TREATMENT -en I-TREATMENT -el I-TREATMENT -momento I-TREATMENT -actual I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -sin I-TREATMENT -incidencias I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -FAV I-TREATMENT -radiocefálica I-TREATMENT -izquierda. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -77 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -remitida B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Nefrología I-DERIVED_FROM/TO -por B-PRESENT_ILLNESS -creatinina I-PRESENT_ILLNESS -plasmática I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2, I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -mg/dl. I-PRESENT_ILLNESS -Entre B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destacaban I-PAST_MEDICAL_HISTORY -diversas I-PAST_MEDICAL_HISTORY -intervenciones I-PAST_MEDICAL_HISTORY -quirúrgicas I-PAST_MEDICAL_HISTORY -(menisco I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1985; I-PAST_MEDICAL_HISTORY -timoma I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -anatomía I-PAST_MEDICAL_HISTORY -patológica I-PAST_MEDICAL_HISTORY -benigna I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1999; I-PAST_MEDICAL_HISTORY -pólipos I-PAST_MEDICAL_HISTORY -nasosinusales I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2008; I-PAST_MEDICAL_HISTORY -varices I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2006; I-PAST_MEDICAL_HISTORY -cistocele I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2008; I-PAST_MEDICAL_HISTORY -fractura I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cadera I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -julio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2010); I-PAST_MEDICAL_HISTORY -colangitis I-PAST_MEDICAL_HISTORY -esclerosante I-PAST_MEDICAL_HISTORY -primaria I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2003, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -ácido I-PAST_MEDICAL_HISTORY -ursodesoxicólico. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -cateterismo I-PAST_MEDICAL_HISTORY -biliar I-PAST_MEDICAL_HISTORY -retrógado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -esfinterectomía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dilatación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -zonas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -estenosis. I-PAST_MEDICAL_HISTORY -También I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -inflamatoria I-PAST_MEDICAL_HISTORY -intestinal I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -misma I-PAST_MEDICAL_HISTORY -época; I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -posterior I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -practicaron I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -colonoscopias I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -unas I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -eran I-PAST_MEDICAL_HISTORY -normales I-PAST_MEDICAL_HISTORY -y, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -otras, I-PAST_MEDICAL_HISTORY -mostraban I-PAST_MEDICAL_HISTORY -mínimas I-PAST_MEDICAL_HISTORY -ulceraciones I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -iliocecal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -colon. I-PAST_MEDICAL_HISTORY -Pericarditis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -etiología I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -filiada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -enero I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2010. I-PAST_MEDICAL_HISTORY -Gonartrosis I-PAST_MEDICAL_HISTORY -bilateral. I-PAST_MEDICAL_HISTORY -Intolerancia I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -hierro I-PAST_MEDICAL_HISTORY -oral. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -primer I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -vista I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -consulta I-PAST_MEDICAL_HISTORY -externa I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontraba I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -zolpidem, I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -mg/día; I-PAST_MEDICAL_HISTORY -ácido I-PAST_MEDICAL_HISTORY -ursodesoxicólico, I-PAST_MEDICAL_HISTORY -1250 I-PAST_MEDICAL_HISTORY -mg/día; I-PAST_MEDICAL_HISTORY -pantoprazol, I-PAST_MEDICAL_HISTORY -40 I-PAST_MEDICAL_HISTORY -mg/día; I-PAST_MEDICAL_HISTORY -mirtazapina, I-PAST_MEDICAL_HISTORY -15 I-PAST_MEDICAL_HISTORY -mg/día; I-PAST_MEDICAL_HISTORY -dextropropoxífeno, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -paracetamol I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -ocasional. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -interrogatorio I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -cansancio, I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -medianos I-PRESENT_ILLNESS -esfuerzos; I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -apetito; I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -ocasionales I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -tos; I-PRESENT_ILLNESS -estreñimiento I-PRESENT_ILLNESS -habitual I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -unas I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -alternaba I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -día, I-PRESENT_ILLNESS -pero I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -presencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -productos I-PRESENT_ILLNESS -patológicos; I-PRESENT_ILLNESS -nicturia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -veces I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -meses; I-PRESENT_ILLNESS -micciones I-PRESENT_ILLNESS -diurnas I-PRESENT_ILLNESS -cada I-PRESENT_ILLNESS -3-4 I-PRESENT_ILLNESS -horas; I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -relataba I-PRESENT_ILLNESS -antecedentes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -crisis I-PRESENT_ILLNESS -renoureterales I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -tenido I-PRESENT_ILLNESS -hematuria. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-FAMILY_HISTORY -cuanto I-FAMILY_HISTORY -a I-FAMILY_HISTORY -sus I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares, I-FAMILY_HISTORY -padres I-FAMILY_HISTORY -fallecidos I-FAMILY_HISTORY -en I-FAMILY_HISTORY -edad I-FAMILY_HISTORY -avanzada I-FAMILY_HISTORY -y I-FAMILY_HISTORY -tres I-FAMILY_HISTORY -hermanos I-FAMILY_HISTORY -fallecidos I-FAMILY_HISTORY -por I-FAMILY_HISTORY -tumores. I-FAMILY_HISTORY - I-FAMILY_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física: I-EXPLORATION -talla: I-EXPLORATION -159 I-EXPLORATION -cm; I-EXPLORATION -peso: I-EXPLORATION -53 I-EXPLORATION -kg. I-EXPLORATION -Presión I-EXPLORATION -arterial: I-EXPLORATION -137/72 I-EXPLORATION -mmHg; I-EXPLORATION -frecuencia I-EXPLORATION -cardíaca: I-EXPLORATION -95 I-EXPLORATION -lpm. I-EXPLORATION -Sin I-EXPLORATION -ingurgitación I-EXPLORATION -yugular; I-EXPLORATION -carótidas I-EXPLORATION -rítmicas I-EXPLORATION -y I-EXPLORATION -simétricas; I-EXPLORATION -auscultación I-EXPLORATION -cardiopulmonar I-EXPLORATION -normal; I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -abdomen I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -hepatomegalia I-EXPLORATION -de I-EXPLORATION -alrededor I-EXPLORATION +AngioTAC I-EXPLORATION de I-EXPLORATION -4 I-EXPLORATION -traveses I-EXPLORATION +tórax I-EXPLORATION +que I-EXPLORATION +descartó I-EXPLORATION +trombos I-EXPLORATION +pero I-EXPLORATION +mostró I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION de I-EXPLORATION -dedo I-EXPLORATION -más I-EXPLORATION -evidente I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -derecho, I-EXPLORATION -no I-EXPLORATION -dolorosa I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -soplos I-EXPLORATION -abdominales. I-EXPLORATION -Extremidades: I-EXPLORATION -sin I-EXPLORATION -edemas I-EXPLORATION -y I-EXPLORATION -pulsos I-EXPLORATION -distales I-EXPLORATION -presentes. I-EXPLORATION - I-EXPLORATION -Revisada I-EXPLORATION la I-EXPLORATION -historia I-EXPLORATION -analítica, I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION +aorta I-EXPLORATION +ascendente, I-EXPLORATION +sobre I-EXPLORATION +el I-EXPLORATION +plano I-EXPLORATION +valvular I-EXPLORATION +aórtico, I-EXPLORATION +estaba I-EXPLORATION +cubierta I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +tejido I-EXPLORATION +hipodenso, I-EXPLORATION que I-EXPLORATION -en I-EXPLORATION -noviembre I-EXPLORATION -de I-EXPLORATION -2010 I-EXPLORATION +se I-EXPLORATION +extendía I-EXPLORATION +por I-EXPLORATION la I-EXPLORATION -creatinina I-EXPLORATION -plasmática I-EXPLORATION -osciló I-EXPLORATION -entre I-EXPLORATION -2, I-EXPLORATION -4-2, I-EXPLORATION -5 I-EXPLORATION -mg/dl; I-EXPLORATION -en I-EXPLORATION -diciembre I-EXPLORATION -de I-EXPLORATION -2010 I-EXPLORATION +aorta I-EXPLORATION +abdominal I-EXPLORATION +hasta I-EXPLORATION la I-EXPLORATION -creatinina I-EXPLORATION -plasmática I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -9 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -enero I-EXPLORATION -de I-EXPLORATION -2011, I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -7 I-EXPLORATION -mg/dl. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION +arteria I-EXPLORATION +mesentérica I-EXPLORATION +inferior. I-EXPLORATION +También I-EXPLORATION +presentaban I-EXPLORATION +un I-EXPLORATION +halo I-EXPLORATION +similar I-EXPLORATION las I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -en I-EXPLORATION -enero I-EXPLORATION -y I-EXPLORATION -febrero I-EXPLORATION -de I-EXPLORATION -2011, I-EXPLORATION -cabe I-EXPLORATION -destacar: I-EXPLORATION -colesterol: I-EXPLORATION -204 I-EXPLORATION -mg/dl; I-EXPLORATION -GOT I-EXPLORATION -(glutamato-oxalacetato-transaminasa): I-EXPLORATION -37 I-EXPLORATION -U/l; I-EXPLORATION -GPT I-EXPLORATION -(glutamato-piruvato-transaminasa): I-EXPLORATION -23 I-EXPLORATION -U/l; I-EXPLORATION -GGT I-EXPLORATION -(gammaglutamil I-EXPLORATION -transferasa): I-EXPLORATION -431 I-EXPLORATION -U/l; I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina: I-EXPLORATION -483 I-EXPLORATION -U/l; I-EXPLORATION -LDH I-EXPLORATION -(lactatodeshidrogenasa): I-EXPLORATION -646 I-EXPLORATION -U/l; I-EXPLORATION -ferritina: I-EXPLORATION -399 I-EXPLORATION -ng/ml; I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -transferrina, I-EXPLORATION -11%. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -bioquímica I-EXPLORATION -ordinaria I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -hemograma: I-EXPLORATION -hematocrito: I-EXPLORATION -35, I-EXPLORATION -1%; I-EXPLORATION -hemoglobina: I-EXPLORATION -11, I-EXPLORATION -3 I-EXPLORATION -g/dl; I-EXPLORATION -resto I-EXPLORATION -normal. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -coagulación: I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -tromboplastina I-EXPLORATION -parcial I-EXPLORATION -activado: I-EXPLORATION -45 I-EXPLORATION -segundos. I-EXPLORATION -Anticardiolipina I-EXPLORATION -IgM I-EXPLORATION -positiva: I-EXPLORATION -21, I-EXPLORATION -80 I-EXPLORATION -U I-EXPLORATION -MPL/ml I-EXPLORATION -(normal: I-EXPLORATION -0, I-EXPLORATION -5-11). I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -recogida I-EXPLORATION -de I-EXPLORATION -24 I-EXPLORATION -horas: I-EXPLORATION -proteinuria: I-EXPLORATION -0, I-EXPLORATION -53 I-EXPLORATION -g/24 I-EXPLORATION -horas; I-EXPLORATION -aclaramiento I-EXPLORATION -de I-EXPLORATION -creatinina: I-EXPLORATION -17 I-EXPLORATION -ml/min. I-EXPLORATION -El I-EXPLORATION -sistemático I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunológico I-EXPLORATION -mostró I-EXPLORATION -positividad I-EXPLORATION -de I-EXPLORATION -anticuerpos I-EXPLORATION -anticitoplasma I-EXPLORATION -de I-EXPLORATION -neutrófilos I-EXPLORATION -(ANCA) I-EXPLORATION -(anti-MPO I-EXPLORATION +arterias I-EXPLORATION +subclavia I-EXPLORATION +izquierda, I-EXPLORATION +renales I-EXPLORATION y I-EXPLORATION -Anti-PR3 I-EXPLORATION -negativos); I-EXPLORATION -los I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares I-EXPLORATION -(ANA), I-EXPLORATION -anti-DNA, I-EXPLORATION -anticuerpos I-EXPLORATION -antimúsculo I-EXPLORATION -liso, I-EXPLORATION -anticuerpos I-EXPLORATION -antimitocondriales I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Se I-EXPLORATION -detectó I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -inmunoglobulinas: I-EXPLORATION -IgG: I-EXPLORATION -253 I-EXPLORATION -mg/dl I-EXPLORATION -(normal: I-EXPLORATION -751-1560); I-EXPLORATION -IgM: I-EXPLORATION -10 I-EXPLORATION -mg/dl I-EXPLORATION -(normal: I-EXPLORATION -46-304); I-EXPLORATION -IgA I-EXPLORATION -81 I-EXPLORATION -mg/dl I-EXPLORATION -(normal: I-EXPLORATION -82-453). I-EXPLORATION -El I-EXPLORATION -complemento, I-EXPLORATION -factor I-EXPLORATION -reumatoide, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION +mesentérica I-EXPLORATION +superior I-EXPLORATION +(AMS). I-EXPLORATION +Las I-EXPLORATION +arterias I-EXPLORATION +renales I-EXPLORATION y I-EXPLORATION -ceruloplasmina I-EXPLORATION -se I-EXPLORATION -encontraban I-EXPLORATION -en I-EXPLORATION -rango I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -de I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -hepatitis I-EXPLORATION -B I-EXPLORATION +mesentéricas I-EXPLORATION +estaban I-EXPLORATION +estenosadas, I-EXPLORATION +el I-EXPLORATION +tronco I-EXPLORATION +celíaco I-EXPLORATION +presentaba I-EXPLORATION +dilatación I-EXPLORATION +post-estenótica I-EXPLORATION y I-EXPLORATION -C, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION +el I-EXPLORATION +flujo I-EXPLORATION +sanguíneo I-EXPLORATION +por I-EXPLORATION la I-EXPLORATION +AMS I-EXPLORATION +era I-EXPLORATION +filiforme. I-EXPLORATION +Existía I-EXPLORATION +un I-EXPLORATION +leve I-EXPLORATION +derrame I-EXPLORATION +pericárdico, I-EXPLORATION +esplenomegalia I-EXPLORATION de I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana, I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION - I-EXPLORATION -Las I-EXPLORATION -hormonas I-EXPLORATION -tiroideas I-EXPLORATION +15 I-EXPLORATION +cm I-EXPLORATION y I-EXPLORATION -anticuerpos I-EXPLORATION -antitiroideos I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -paratohormona I-EXPLORATION -intacta I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -149 I-EXPLORATION -pg/ml. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -electroforesis I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION +edema I-EXPLORATION +perinéfrico I-EXPLORATION +bilateral. I-EXPLORATION +El I-EXPLORATION +cintigrama I-EXPLORATION +renal I-EXPLORATION mostró I-EXPLORATION -una I-EXPLORATION disminución I-EXPLORATION de I-EXPLORATION -inmunoglobulinas, I-EXPLORATION +la I-EXPLORATION +perfusión I-EXPLORATION y I-EXPLORATION +función I-EXPLORATION +del I-EXPLORATION +riñón I-EXPLORATION +izquierdo I-EXPLORATION +(RD I-EXPLORATION +62%, I-EXPLORATION +RI I-EXPLORATION +38%). I-EXPLORATION +Los I-EXPLORATION +vasos I-EXPLORATION +del I-EXPLORATION +cuello I-EXPLORATION +eran I-EXPLORATION +normales I-EXPLORATION en I-EXPLORATION -orina, I-EXPLORATION -proteinuria I-EXPLORATION -no I-EXPLORATION -selectiva. I-EXPLORATION -La I-EXPLORATION -proteinuria I-EXPLORATION -de I-EXPLORATION -Bence-Jones I-EXPLORATION -resultó I-EXPLORATION -negativa. I-EXPLORATION - I-EXPLORATION +la I-EXPLORATION +ecografía. I-EXPLORATION En I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION -(ecografía I-EXPLORATION -renal): I-EXPLORATION -riñones I-EXPLORATION -de I-EXPLORATION -tamaño, I-EXPLORATION -morfología I-EXPLORATION -y I-EXPLORATION -ecogenicidad I-EXPLORATION -normales, I-EXPLORATION -sin I-EXPLORATION -litiasis I-EXPLORATION -ni I-EXPLORATION -dilatación. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -deterioro I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION -de I-EXPLORATION -causa I-EXPLORATION -no I-EXPLORATION -clara I-EXPLORATION -(se I-EXPLORATION -desconocían I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -referencia I-EXPLORATION -previa), I-EXPLORATION +angioresonancia I-EXPLORATION +el I-EXPLORATION +tejido I-EXPLORATION +periaórtico I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -renal I-EXPLORATION -percutánea I-EXPLORATION +reforzó I-EXPLORATION con I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -hallazgos: I-EXPLORATION -4 I-EXPLORATION -glomérulos, I-EXPLORATION -2 I-EXPLORATION -de I-EXPLORATION -ellos I-EXPLORATION -completamente I-EXPLORATION -esclerosados I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -otros I-EXPLORATION -2 I-EXPLORATION -en I-EXPLORATION -vías I-EXPLORATION -de I-EXPLORATION -esclerosis. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION +gadolinio I-EXPLORATION +concluyéndose I-EXPLORATION +que I-EXPLORATION +era I-EXPLORATION +un I-EXPLORATION +tejido I-EXPLORATION +inflamatorio-fibroso. I-EXPLORATION +La I-EXPLORATION +estenosis I-EXPLORATION de I-EXPLORATION -inmunofluorescencia I-EXPLORATION -fue I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -IgG, I-EXPLORATION -IgA, I-EXPLORATION -IgM I-EXPLORATION +AMS I-EXPLORATION +era I-EXPLORATION +crítica; I-EXPLORATION +las I-EXPLORATION +dos I-EXPLORATION +arterias I-EXPLORATION +renales I-EXPLORATION +izquierdas I-EXPLORATION y I-EXPLORATION -C3. I-EXPLORATION -En I-EXPLORATION el I-EXPLORATION -intersticio I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -un I-EXPLORATION -denso I-EXPLORATION -infiltrado I-EXPLORATION -linfocitario I-EXPLORATION -que I-EXPLORATION -expandía I-EXPLORATION +tronco I-EXPLORATION +celíaco I-EXPLORATION +presentaban I-EXPLORATION +estenosis I-EXPLORATION +de I-EXPLORATION +70% I-EXPLORATION y I-EXPLORATION -ocupaba I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -tejido, I-EXPLORATION -destruyendo I-EXPLORATION -la I-EXPLORATION -arquitectura I-EXPLORATION -habitual I-EXPLORATION -del I-EXPLORATION -parénquima I-EXPLORATION -renal. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -valoraba I-EXPLORATION -bien I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION +arteria I-EXPLORATION +renal I-EXPLORATION +derecha I-EXPLORATION +y I-EXPLORATION +mesentérica I-EXPLORATION +inferior, I-EXPLORATION +estenosis I-EXPLORATION de I-EXPLORATION -fibrosis I-EXPLORATION -debido I-EXPLORATION -al I-EXPLORATION -infiltrado I-EXPLORATION -existente. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -figura I-EXPLORATION -2 I-EXPLORATION -A I-EXPLORATION -se I-EXPLORATION -muestra I-EXPLORATION -la I-EXPLORATION -inmunohistoquímica I-EXPLORATION -con I-EXPLORATION -CD3 I-EXPLORATION -(anticuerpo I-EXPLORATION -monoclonal I-EXPLORATION -que I-EXPLORATION -marca I-EXPLORATION -linfocitos I-EXPLORATION -T I-EXPLORATION -en I-EXPLORATION -general) I-EXPLORATION +50%. I-EXPLORATION +Los I-EXPLORATION +senos I-EXPLORATION +renales I-EXPLORATION y I-EXPLORATION -demuestra I-EXPLORATION +áreas I-EXPLORATION +perinéfricas I-EXPLORATION +estaban I-EXPLORATION +ocupados I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +tejido I-EXPLORATION que I-EXPLORATION -la I-EXPLORATION -mayoría I-EXPLORATION -del I-EXPLORATION -infiltrado I-EXPLORATION -es I-EXPLORATION +envolvía I-EXPLORATION a I-EXPLORATION -expensas I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -T, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -figura I-EXPLORATION -2 I-EXPLORATION -B, I-EXPLORATION la I-EXPLORATION -inmunohistoquímica I-EXPLORATION -con I-EXPLORATION -CD4. I-EXPLORATION +aorta. I-EXPLORATION +Se B-TREATMENT +instaló I-TREATMENT +stents I-TREATMENT +en I-TREATMENT +AMS I-TREATMENT +y I-TREATMENT +en I-TREATMENT +ambas I-TREATMENT +arterias I-TREATMENT +renales, I-TREATMENT +mejorando B-EVOLUTION +la I-EVOLUTION +perfusión. I-EVOLUTION +El B-EXPLORATION +radiólogo I-EXPLORATION +planteó I-EXPLORATION +ECD. I-EXPLORATION El I-EXPLORATION -diagnóstico I-EXPLORATION -anatomopatológico I-EXPLORATION -final I-EXPLORATION +cintigrama I-EXPLORATION +óseo I-EXPLORATION fue I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +dicho I-EXPLORATION +diagnóstico I-EXPLORATION +al I-EXPLORATION +mostrar I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -nefropatía I-EXPLORATION -tubulointersticial I-EXPLORATION -severa I-EXPLORATION -(infiltrado I-EXPLORATION -intersticial I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -linfocitario I-EXPLORATION -T I-EXPLORATION -CD4 I-EXPLORATION -positivos). I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -los I-TREATMENT -hallazgos I-TREATMENT -de I-TREATMENT -la I-TREATMENT -biopsia I-TREATMENT -se I-TREATMENT -indicó I-TREATMENT +captación I-EXPLORATION +en I-EXPLORATION +fémures I-EXPLORATION +y I-EXPLORATION +tibias. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT tratamiento I-TREATMENT con I-TREATMENT -prednisona, I-TREATMENT -50 I-TREATMENT -mg/día, I-TREATMENT +prednisona I-TREATMENT +60 I-TREATMENT +mg/día I-TREATMENT +y I-TREATMENT +metotrexato I-TREATMENT +10 I-TREATMENT +mg I-TREATMENT +semanales, I-TREATMENT +con B-EVOLUTION +mejoría I-EVOLUTION +sintomática I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +redujo I-TREATMENT en I-TREATMENT -pauta I-TREATMENT -descendente. I-TREATMENT - I-TREATMENT -Ocho B-EVOLUTION +forma I-TREATMENT +gradual I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +corticoides I-TREATMENT +hasta I-TREATMENT +10 I-TREATMENT +mg. I-TREATMENT +Tres B-EVOLUTION meses I-EVOLUTION -después, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -mantiene I-EVOLUTION -una I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -estabilizada I-EVOLUTION -(creatinina I-EVOLUTION -plasmática I-EVOLUTION +después I-EVOLUTION +(marzo I-EVOLUTION de I-EVOLUTION -2, I-EVOLUTION -2 I-EVOLUTION -mg/dl, I-EVOLUTION -aclaramiento I-EVOLUTION +2008) I-EVOLUTION +fue I-EVOLUTION +hospitalizado I-EVOLUTION +por I-EVOLUTION +neumonía I-EVOLUTION +y I-EVOLUTION +tuvo I-EVOLUTION +una I-EVOLUTION +buena I-EVOLUTION +respuesta I-EVOLUTION +al I-EVOLUTION +tratamiento I-EVOLUTION +antibiótico. I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +12 I-EVOLUTION +meses I-EVOLUTION +del I-EVOLUTION +diagnóstico I-EVOLUTION +(diciembre I-EVOLUTION de I-EVOLUTION -20 I-EVOLUTION -ml/min I-EVOLUTION +2008) I-EVOLUTION y I-EVOLUTION -proteinuria I-EVOLUTION +estando I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +prácticamente I-EVOLUTION +asintomático, I-EVOLUTION +salvo I-EVOLUTION +edema I-EVOLUTION de I-EVOLUTION -0, I-EVOLUTION -49 I-EVOLUTION -g/24 I-EVOLUTION -h). I-EVOLUTION -Respecto I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -hepática: I-EVOLUTION -GOT: I-EVOLUTION -24 I-EVOLUTION -U/l; I-EVOLUTION -GPT: I-EVOLUTION -18 I-EVOLUTION -U/l; I-EVOLUTION -GGT: I-EVOLUTION -172 I-EVOLUTION -U/l; I-EVOLUTION -fosfatasa I-EVOLUTION -alcalina: I-EVOLUTION -342 I-EVOLUTION -U/l. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -28 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -ingresado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -fosas I-PRESENT_ILLNESS -lumbares, I-PRESENT_ILLNESS -fatiga I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -náuseas, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -diuresis I-PRESENT_ILLNESS -conservada. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cocaína I-PAST_MEDICAL_HISTORY -intranasal I-PAST_MEDICAL_HISTORY -(1 I-PAST_MEDICAL_HISTORY -g) I-PAST_MEDICAL_HISTORY -cinco I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -admisión. I-PAST_MEDICAL_HISTORY -Negó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -todo I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -ingesta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -antiinflamatorios I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -esteroideos I-PRESENT_ILLNESS -u I-PRESENT_ILLNESS -otros I-PRESENT_ILLNESS -medicamentos. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -con I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -ligeramente I-EXPLORATION -elevada I-EXPLORATION -de I-EXPLORATION -147/97 I-EXPLORATION -mmHg, I-EXPLORATION -sin I-EXPLORATION -fiebre, I-EXPLORATION -erupción I-EXPLORATION -cutánea I-EXPLORATION -o I-EXPLORATION -artralgias. I-EXPLORATION - I-EXPLORATION -Las I-EXPLORATION -exploraciones I-EXPLORATION -cardiovascular I-EXPLORATION +piernas I-EVOLUTION +atribuido I-EVOLUTION +al I-EVOLUTION +uso I-EVOLUTION +de I-EVOLUTION +anagrelide, I-EVOLUTION +persistía I-EVOLUTION +anémico I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +leucocitosis. I-EVOLUTION +Un B-EXPLORATION +scanner I-EXPLORATION +mostró I-EXPLORATION +aumento I-EXPLORATION +del I-EXPLORATION +grosor I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +periaórtico I-EXPLORATION +tanto I-EXPLORATION +en I-EXPLORATION +aorta I-EXPLORATION +ascendente I-EXPLORATION +como I-EXPLORATION +descendente I-EXPLORATION y I-EXPLORATION -respiratoria I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -El I-EXPLORATION -abdomen I-EXPLORATION -era I-EXPLORATION -blando, I-EXPLORATION -depresible I-EXPLORATION -e I-EXPLORATION -indoloro, I-EXPLORATION +prolongación I-EXPLORATION +hasta I-EXPLORATION el I-EXPLORATION -hígado I-EXPLORATION -era I-EXPLORATION -palpable I-EXPLORATION -a I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION +inicio I-EXPLORATION +de I-EXPLORATION +arterias I-EXPLORATION +ilíacas I-EXPLORATION +primitivas. I-EXPLORATION +A I-EXPLORATION +los I-EXPLORATION +18 I-EXPLORATION +meses I-EXPLORATION +(julio I-EXPLORATION +de I-EXPLORATION +2009), I-EXPLORATION por I-EXPLORATION -debajo I-EXPLORATION -del I-EXPLORATION -reborde I-EXPLORATION -costal I-EXPLORATION -y I-EXPLORATION -presentaba I-EXPLORATION -discreto I-EXPLORATION dolor I-EXPLORATION -a I-EXPLORATION +en I-EXPLORATION +rodillas I-EXPLORATION +se I-EXPLORATION +tomó I-EXPLORATION +radiografías I-EXPLORATION +que I-EXPLORATION +mostraron I-EXPLORATION +osteoesclerosis I-EXPLORATION +en I-EXPLORATION +fémures I-EXPLORATION +y I-EXPLORATION +tibias I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -palpación I-EXPLORATION -lumbar I-EXPLORATION -bilateral. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -inicial I-EXPLORATION -mostraba I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -anodino I-EXPLORATION -(sin I-EXPLORATION -eosinofilia), I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION -normales I-EXPLORATION +misma I-EXPLORATION +localización I-EXPLORATION +que I-EXPLORATION +las I-EXPLORATION +alteraciones I-EXPLORATION +del I-EXPLORATION +cintigrama I-EXPLORATION +óseo I-EXPLORATION y I-EXPLORATION -albúmina I-EXPLORATION -dentro I-EXPLORATION +calcificaciones I-EXPLORATION del I-EXPLORATION -rango I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad; I-EXPLORATION -creatinina I-EXPLORATION -sérica: I-EXPLORATION -160 I-EXPLORATION -μmol/l; I-EXPLORATION -urea: I-EXPLORATION -7, I-EXPLORATION -5 I-EXPLORATION -mmol/l; I-EXPLORATION -potasio: I-EXPLORATION -3, I-EXPLORATION -9 I-EXPLORATION -mmol/l; I-EXPLORATION -sodio: I-EXPLORATION -139 I-EXPLORATION -mmol/l; I-EXPLORATION -cloruro: I-EXPLORATION -101 I-EXPLORATION -mmol/l. I-EXPLORATION -La I-EXPLORATION -creatina I-EXPLORATION -cinasa I-EXPLORATION -total I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -(3, I-EXPLORATION -3 I-EXPLORATION -μkat/l), I-EXPLORATION +cartílago I-EXPLORATION +compatibles I-EXPLORATION con I-EXPLORATION -una I-EXPLORATION -fracción I-EXPLORATION -MB I-EXPLORATION -normal. I-EXPLORATION -El I-EXPLORATION -sedimento I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION +condrocalcinosis. I-EXPLORATION +Un I-EXPLORATION +nuevo I-EXPLORATION +scanner, I-EXPLORATION mostró I-EXPLORATION -2 I-EXPLORATION -leucocitos I-EXPLORATION -y I-EXPLORATION -3 I-EXPLORATION -hematíes I-EXPLORATION -por I-EXPLORATION -campo I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -hematíes I-EXPLORATION -dismórficos I-EXPLORATION -ni I-EXPLORATION -eosinófilos. I-EXPLORATION -Bioquímica I-EXPLORATION -orina: I-EXPLORATION -sodio: I-EXPLORATION -46 I-EXPLORATION -mmol/l, I-EXPLORATION -potasio: I-EXPLORATION -33 I-EXPLORATION -mmol/l I-EXPLORATION -y I-EXPLORATION -cloruro: I-EXPLORATION -63 I-EXPLORATION -mmol/l, I-EXPLORATION -cociente I-EXPLORATION -proteína: I-EXPLORATION -creatinina I-EXPLORATION -en I-EXPLORATION -5 I-EXPLORATION -g/mol; I-EXPLORATION -urocultivo I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -Proteinograma I-EXPLORATION -electroforético, I-EXPLORATION -inmunoglobulinas, I-EXPLORATION -complemento, I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -enzima I-EXPLORATION -convertidora I-EXPLORATION +persistencia I-EXPLORATION de I-EXPLORATION -angiotensina I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +previos I-EXPLORATION y I-EXPLORATION -títulos I-EXPLORATION -de I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION +aumento I-EXPLORATION +(70%) I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +estenosis I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana, I-EXPLORATION -virus I-EXPLORATION +arteria I-EXPLORATION +mesentérica I-EXPLORATION +inferior. I-EXPLORATION +A B-EVOLUTION +28 I-EVOLUTION +meses I-EVOLUTION +del I-EVOLUTION +diagnóstico I-EVOLUTION +(abril I-EVOLUTION +de I-EVOLUTION +2010), I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +comenzó I-EVOLUTION +a I-EVOLUTION +presentar I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +insuficiencia I-EVOLUTION +cardiaca I-EVOLUTION +congestiva. I-EVOLUTION +El B-EXPLORATION +scanner I-EXPLORATION +mostró I-EXPLORATION +acentuación I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +perirrenal, I-EXPLORATION +engrosamiento I-EXPLORATION de I-EXPLORATION -Epstein-Barr, I-EXPLORATION -citomegalovirus, I-EXPLORATION -hepatitis I-EXPLORATION -A, I-EXPLORATION -B, I-EXPLORATION -y I-EXPLORATION -C I-EXPLORATION +las I-EXPLORATION +pleuras I-EXPLORATION +bibasales I-EXPLORATION y I-EXPLORATION -micoplasma I-EXPLORATION -no I-EXPLORATION -detectó I-EXPLORATION -infección I-EXPLORATION -activa. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -demostró I-EXPLORATION -unos I-EXPLORATION -riñones I-EXPLORATION +aumento I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cantidad I-EXPLORATION de I-EXPLORATION -tamaño I-EXPLORATION -normal, I-EXPLORATION -difusamente I-EXPLORATION -ecogénicos I-EXPLORATION +líquido I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +pericardio. I-EXPLORATION +El I-EXPLORATION +ecocardiograma I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +gran I-EXPLORATION +derrame I-EXPLORATION +pericárdico I-EXPLORATION con I-EXPLORATION -flujo I-EXPLORATION -arterial I-EXPLORATION +signos I-EXPLORATION +iniciales I-EXPLORATION +de I-EXPLORATION +taponamiento I-EXPLORATION y I-EXPLORATION -venoso I-EXPLORATION -apropiado. I-EXPLORATION - I-EXPLORATION +superficie I-EXPLORATION +pericárdica I-EXPLORATION +irregular I-EXPLORATION +sugerente I-EXPLORATION +de I-EXPLORATION +infiltración I-EXPLORATION +tumoral. I-EXPLORATION El I-EXPLORATION electrocardiograma I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION mostró I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION -cardiotorácico I-EXPLORATION -< I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -y I-EXPLORATION -unos I-EXPLORATION -campos I-EXPLORATION -pulmonares I-EXPLORATION -sin I-EXPLORATION -infiltrados. I-EXPLORATION - I-EXPLORATION -Después B-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -admisión, I-EVOLUTION -el I-EVOLUTION -débito I-EVOLUTION -urinario I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -en I-EVOLUTION -50 I-EVOLUTION -a I-EVOLUTION -75 I-EVOLUTION -ml/h I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -creatinina I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -sin I-EVOLUTION -cambios. I-EVOLUTION +bajo I-EXPLORATION +voltaje. I-EXPLORATION +Fue B-TREATMENT +hospitalizado I-TREATMENT +efectuándose I-TREATMENT +una I-TREATMENT +ventana I-TREATMENT +pleuro-pericárdica. I-TREATMENT +Durante I-TREATMENT +la I-TREATMENT +operación I-TREATMENT +se I-TREATMENT +encontró I-TREATMENT +el I-TREATMENT +pericardio I-TREATMENT +a I-TREATMENT +tensión I-TREATMENT +drenando I-TREATMENT +1.200 I-TREATMENT +ml I-TREATMENT +de I-TREATMENT +un I-TREATMENT +líquido I-TREATMENT +amarillo I-TREATMENT +pardusco. I-TREATMENT El B-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -sometió I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -renal. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -histológicos I-EXPLORATION -son I-EXPLORATION -los I-EXPLORATION -siguientes: I-EXPLORATION -la I-EXPLORATION -microscopía I-EXPLORATION -óptica I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -total I-EXPLORATION +pericardio I-EXPLORATION +parietal I-EXPLORATION +era I-EXPLORATION de I-EXPLORATION -13 I-EXPLORATION -glomérulos, I-EXPLORATION -todos I-EXPLORATION -ellos I-EXPLORATION -normales, I-EXPLORATION -sin I-EXPLORATION -esclerosis, I-EXPLORATION -proliferación I-EXPLORATION -o I-EXPLORATION -lesiones I-EXPLORATION -necróticas. I-EXPLORATION -Las I-EXPLORATION -membranas I-EXPLORATION -basales I-EXPLORATION +aspecto I-EXPLORATION +normal I-EXPLORATION y I-EXPLORATION el I-EXPLORATION -mesangio I-EXPLORATION -glomerular I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -El I-EXPLORATION -intersticio I-EXPLORATION -mostraba I-EXPLORATION -moderado I-EXPLORATION +visceral I-EXPLORATION +estaba I-EXPLORATION infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -mononuclear I-EXPLORATION -con I-EXPLORATION +difusamente I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +tejido I-EXPLORATION +duro. I-EXPLORATION +El I-EXPLORATION +líquido I-EXPLORATION +pericárdico I-EXPLORATION +tenía I-EXPLORATION abundantes I-EXPLORATION -eosinófilos, I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -tubulitis I-EXPLORATION -focal I-EXPLORATION -y I-EXPLORATION -atrofia. I-EXPLORATION -Las I-EXPLORATION -arteriolas I-EXPLORATION -no I-EXPLORATION -presentaban I-EXPLORATION -lesiones I-EXPLORATION -destacables I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -existían I-EXPLORATION -depósitos I-EXPLORATION -inmunes I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -inmunofluorescencia. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -fueron I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION +histiocitos I-EXPLORATION +al I-EXPLORATION +igual I-EXPLORATION +que I-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION -patológico I-EXPLORATION +tejido I-EXPLORATION +pericárdico I-EXPLORATION +parietal I-EXPLORATION +resecado, I-EXPLORATION +que I-EXPLORATION +tenía I-EXPLORATION +infiltración I-EXPLORATION +por I-EXPLORATION +células I-EXPLORATION de I-EXPLORATION -nefritis I-EXPLORATION -tubulointersticial I-EXPLORATION -aguda I-EXPLORATION -(NIA). I-EXPLORATION - I-EXPLORATION -Este I-EXPLORATION -hecho, I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -las I-EXPLORATION -características I-EXPLORATION -clínicas I-EXPLORATION +citoplasma I-EXPLORATION +granular I-EXPLORATION +y I-EXPLORATION +espumoso I-EXPLORATION y I-EXPLORATION el I-EXPLORATION -consumo I-EXPLORATION -reciente I-EXPLORATION -de I-EXPLORATION -cocaína, I-EXPLORATION -nos I-EXPLORATION -llevó I-EXPLORATION +análisis I-EXPLORATION +inmunohistoquímico I-EXPLORATION +confirmó I-EXPLORATION +que I-EXPLORATION +dichas I-EXPLORATION +células I-EXPLORATION +correspondían I-EXPLORATION a I-EXPLORATION -definir I-EXPLORATION -este I-EXPLORATION -caso I-EXPLORATION -como I-EXPLORATION -NIA I-EXPLORATION -inducida I-EXPLORATION -por I-EXPLORATION -cocaína. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -obviamente I-TREATMENT -interrumpió I-TREATMENT -el I-TREATMENT -consumo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -droga I-TREATMENT -y I-TREATMENT -se I-TREATMENT -trató I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -oral I-TREATMENT -(1 I-TREATMENT -mg/kg/día I-TREATMENT -dosis I-TREATMENT -inicial), I-TREATMENT -que I-TREATMENT -se I-TREATMENT -disminuyó I-TREATMENT -progresivamente I-TREATMENT -y I-TREATMENT -se I-TREATMENT -interrumpió I-TREATMENT -después I-TREATMENT -de I-TREATMENT -12 I-TREATMENT -semanas. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -seguimiento I-EVOLUTION -posterior I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -una I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -con I-EVOLUTION +histiocitos, I-EXPLORATION +CD68 I-EXPLORATION +(+), I-EXPLORATION +CD1a I-EXPLORATION +(-) I-EXPLORATION +y I-EXPLORATION +proteína I-EXPLORATION +S100 I-EXPLORATION +(-), I-EXPLORATION +confirmando I-EXPLORATION +la I-EXPLORATION +ECD. I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +clara I-EVOLUTION mejoría I-EVOLUTION -progresiva I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -hasta I-EVOLUTION -la I-EVOLUTION -recuperación I-EVOLUTION -completa I-EVOLUTION -ya I-EVOLUTION +sintomatología I-EVOLUTION +posterior I-EVOLUTION al I-EVOLUTION -mes I-EVOLUTION -del I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -tratamiento. I-EVOLUTION +procedimiento. I-EVOLUTION I-EVOLUTION -Varón B-PRESENT_ILLNESS +El B-PRESENT_ILLNESS +segundo I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -60 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -mórbida I-PAST_MEDICAL_HISTORY -(IMC I-PAST_MEDICAL_HISTORY -47 I-PAST_MEDICAL_HISTORY -kg/m2), I-PAST_MEDICAL_HISTORY -HTA, I-PAST_MEDICAL_HISTORY -DM I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2, I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY +30 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +presentando I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +intenso I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +cerrar I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +boca. I-PRESENT_ILLNESS +El B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +valorado I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +pediatría I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +diagnosticado I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +luxación I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +ATM, I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +lo I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +referido I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +cirujano I-DERIVED_FROM/TO +maxilofacial I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +guardia. I-DERIVED_FROM/TO +En B-EXPLORATION +el I-EXPLORATION +momento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +valoración I-EXPLORATION +el I-EXPLORATION +niño I-EXPLORATION +estaba I-EXPLORATION +inquieto I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +boca I-EXPLORATION +semiabierta, I-EXPLORATION +sin I-EXPLORATION +embargo I-EXPLORATION +al I-EXPLORATION +forzar I-EXPLORATION +el I-EXPLORATION +cierre I-EXPLORATION +la I-EXPLORATION +oclusión I-EXPLORATION +dentaria I-EXPLORATION +era I-EXPLORATION +buena I-EXPLORATION +aunque I-EXPLORATION +muy I-EXPLORATION +dolorosa. I-EXPLORATION +El I-EXPLORATION +paciente I-EXPLORATION +no I-EXPLORATION +tenía I-EXPLORATION +fiebre I-EXPLORATION +ni I-EXPLORATION +supuración I-EXPLORATION +de I-EXPLORATION +oídos. I-EXPLORATION +En B-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +clínica I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +refería I-PAST_MEDICAL_HISTORY +ningún I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -apnea I-PAST_MEDICAL_HISTORY -obstructiva I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -sueño I-PAST_MEDICAL_HISTORY -(SAOS), I-PAST_MEDICAL_HISTORY -hipercolesterolemia I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -isquémica I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -infarto I-PAST_MEDICAL_HISTORY -agudo I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +duración I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -miocardio I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -stent I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -angioplastia I-PAST_MEDICAL_HISTORY -coronaria I-PAST_MEDICAL_HISTORY -transluminal I-PAST_MEDICAL_HISTORY -percutánea-stent. I-PAST_MEDICAL_HISTORY -Se B-DERIVED_FROM/TO -derivó I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -realización I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cirugía I-DERIVED_FROM/TO -bariátrica, I-DERIVED_FROM/TO -técnica I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -gastrectomía I-DERIVED_FROM/TO -tubular I-DERIVED_FROM/TO -laparoscópica. I-DERIVED_FROM/TO -Al B-TREATMENT -alta, I-TREATMENT -su I-TREATMENT +los I-PAST_MEDICAL_HISTORY +síntomas I-PAST_MEDICAL_HISTORY +era I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +unas I-PAST_MEDICAL_HISTORY +horas, I-PAST_MEDICAL_HISTORY +pues I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +acompañaba I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +maestra I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +guardería. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +interrogó I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +maestra I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +busca I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +infecciosos I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +traumáticos, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +nos I-PAST_MEDICAL_HISTORY +informó I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +habían I-PAST_MEDICAL_HISTORY +faltado I-PAST_MEDICAL_HISTORY +varios I-PAST_MEDICAL_HISTORY +niños I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +últimos I-PAST_MEDICAL_HISTORY +días I-PAST_MEDICAL_HISTORY +porque I-PAST_MEDICAL_HISTORY +estaban I-PAST_MEDICAL_HISTORY +enfermos. I-PAST_MEDICAL_HISTORY +Se B-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +ortopantomografía, I-EXPLORATION +sin I-EXPLORATION +evidenciarse I-EXPLORATION +patología I-EXPLORATION +articular. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +definitivo I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +tras I-EXPLORATION +la I-EXPLORATION +otoscopia I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +apreciaron I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +otitis I-EXPLORATION +externa I-EXPLORATION +aguda. I-EXPLORATION +Tras B-TREATMENT +el I-TREATMENT tratamiento I-TREATMENT -incluyó I-TREATMENT -ramipril I-TREATMENT -10 I-TREATMENT -mg/24 I-TREATMENT -horas, I-TREATMENT -bisoprolol/hidroclorotiazida I-TREATMENT -10/25 I-TREATMENT -mg/24 I-TREATMENT -horas, I-TREATMENT -atorvastatina I-TREATMENT -10 I-TREATMENT -mg/24 I-TREATMENT -horas, I-TREATMENT -barnidipino I-TREATMENT -20 I-TREATMENT -mg/24 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -metformina I-TREATMENT -1/8 I-TREATMENT -horas. I-TREATMENT -Tras B-EVOLUTION +adecuado I-TREATMENT +se B-EVOLUTION +produjo I-EVOLUTION la I-EVOLUTION -intervención I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -refirió I-EVOLUTION -escasa I-EVOLUTION -ingesta I-EVOLUTION -hidroalimentaria, I-EVOLUTION -episodios I-EVOLUTION -ocasionales I-EVOLUTION -de I-EVOLUTION -mareo I-EVOLUTION -y I-EVOLUTION -pérdida I-EVOLUTION -de I-EVOLUTION -20 I-EVOLUTION -kg I-EVOLUTION +resolución I-EVOLUTION de I-EVOLUTION -peso I-EVOLUTION -en I-EVOLUTION -un I-EVOLUTION -mes. I-EVOLUTION -Ante I-EVOLUTION -el I-EVOLUTION -empeoramiento I-EVOLUTION -clínico I-EVOLUTION -progresivo I-EVOLUTION -y I-EVOLUTION la I-EVOLUTION -asociación I-EVOLUTION -de I-EVOLUTION -síndrome I-EVOLUTION -diarreico, I-EVOLUTION -acudió I-EVOLUTION -a I-EVOLUTION -Urgencias, I-EVOLUTION -donde I-EVOLUTION -se I-EVOLUTION -constató I-EVOLUTION -mal I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -bradipsiquia, I-EVOLUTION -sequedad I-EVOLUTION -de I-EVOLUTION -piel I-EVOLUTION -y I-EVOLUTION -mucosas, I-EVOLUTION -y I-EVOLUTION -presión I-EVOLUTION -arterial I-EVOLUTION -(PA) I-EVOLUTION -92/65 I-EVOLUTION -mmHg. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -analítica: I-EXPLORATION -glucosa I-EXPLORATION -214 I-EXPLORATION -mg/dl, I-EXPLORATION -urea I-EXPLORATION -403 I-EXPLORATION -mg/dl, I-EXPLORATION -creatinina I-EXPLORATION -(Cr) I-EXPLORATION -9, I-EXPLORATION -2 I-EXPLORATION -mg/dl, I-EXPLORATION -Na I-EXPLORATION -151 I-EXPLORATION -mmol/l, I-EXPLORATION -Cl I-EXPLORATION -113 I-EXPLORATION -mmol/l, I-EXPLORATION -K I-EXPLORATION -4 I-EXPLORATION -mmol/l; I-EXPLORATION -hemograma: I-EXPLORATION -hemoglobina I-EXPLORATION -(Hb) I-EXPLORATION -15, I-EXPLORATION -4 I-EXPLORATION -g/dl, I-EXPLORATION -VH I-EXPLORATION -44, I-EXPLORATION -5%; I-EXPLORATION -leucocitos I-EXPLORATION -18800/uL; I-EXPLORATION -plaquetas I-EXPLORATION -287000/uL; I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION +situación I-EVOLUTION +clínica. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +reconocimiento I-PRESENT_ILLNESS +médico I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +abril I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2015. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +- B-PAST_MEDICAL_HISTORY +Antecedentes I-PAST_MEDICAL_HISTORY +personales: I-PAST_MEDICAL_HISTORY +alergia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +gramíneas, I-PAST_MEDICAL_HISTORY +condromalacia I-PAST_MEDICAL_HISTORY +bilateral, I-PAST_MEDICAL_HISTORY +lumbalgia I-PAST_MEDICAL_HISTORY +(RMN I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2015: I-PAST_MEDICAL_HISTORY +prolapso I-PAST_MEDICAL_HISTORY +discal), I-PAST_MEDICAL_HISTORY +contracturas I-PAST_MEDICAL_HISTORY +cervicodorsales, I-PAST_MEDICAL_HISTORY +urticaria I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2011que I-PAST_MEDICAL_HISTORY +duró I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +causa I-PAST_MEDICAL_HISTORY +probada I-PAST_MEDICAL_HISTORY +(tratada I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +Xazal I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +remisión). I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Hace I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +apareció I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +lesión I-PAST_MEDICAL_HISTORY +pigmentada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY +dorsal, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +eccema I-PAST_MEDICAL_HISTORY +inespecífico I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +corticoides I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +último I-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +unos I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +(por I-PAST_MEDICAL_HISTORY +dermatólogo) I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +notalgia I-PAST_MEDICAL_HISTORY +parestestica. I-PAST_MEDICAL_HISTORY +Habitualmente B-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +contracturas I-PRESENT_ILLNESS +cervicodorsales I-PRESENT_ILLNESS +tensionales I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +relación I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +estrés. I-PRESENT_ILLNESS +Refiere I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +piel I-PRESENT_ILLNESS +mejoró I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +relajantes I-PRESENT_ILLNESS +muscularespor I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +lumbalgia I-PRESENT_ILLNESS +aguda. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +relaciona I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +aparición I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +ninguna I-PRESENT_ILLNESS +situación I-PRESENT_ILLNESS +especial, I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +otros I-PRESENT_ILLNESS +casos I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +familiares. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +- I-PRESENT_ILLNESS +Exploración B-EXPLORATION +física: I-EXPLORATION +mácula I-EXPLORATION +hiperpigmentada I-EXPLORATION en I-EXPLORATION -orina: I-EXPLORATION -urea I-EXPLORATION -239 I-EXPLORATION -mg/dl, I-EXPLORATION -Cr I-EXPLORATION -339 I-EXPLORATION -mg/dl, I-EXPLORATION -Na I-EXPLORATION -52 I-EXPLORATION -mmol/l, I-EXPLORATION -K I-EXPLORATION -9, I-EXPLORATION -1 I-EXPLORATION -mmol/l, I-EXPLORATION -excreción I-EXPLORATION -fraccional I-EXPLORATION +zona I-EXPLORATION +dorsal I-EXPLORATION +media I-EXPLORATION +y I-EXPLORATION +lateral I-EXPLORATION +derecha, I-EXPLORATION +contracturas I-EXPLORATION +musculares I-EXPLORATION +en I-EXPLORATION +zona I-EXPLORATION de I-EXPLORATION -sodio I-EXPLORATION -(EF I-EXPLORATION -Na) I-EXPLORATION -0, I-EXPLORATION -9%; I-EXPLORATION -gasometría I-EXPLORATION -venosa: I-EXPLORATION -pH I-EXPLORATION -7, I-EXPLORATION -33, I-EXPLORATION -bicarbonato I-EXPLORATION -11, I-EXPLORATION -1 I-EXPLORATION -mmol/l, I-EXPLORATION -pCO2 I-EXPLORATION -21 I-EXPLORATION -mmHg. I-EXPLORATION -Se B-TREATMENT -ingresó I-TREATMENT -en I-TREATMENT -Nefrología I-TREATMENT -con I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -IRA I-TREATMENT -prerrenal, I-TREATMENT -hipernatremia I-TREATMENT -e I-TREATMENT -infección I-TREATMENT -urinaria, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT +ambos I-EXPLORATION +trapecios I-EXPLORATION +y I-EXPLORATION +músculos I-EXPLORATION +paravertebrales I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +cervicodorsal. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Síntomas: I-EXPLORATION +prurito. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Tratamiento: B-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +refiere I-TREATMENT +que I-TREATMENT +los I-TREATMENT +dermatólogos I-TREATMENT +que I-TREATMENT +lo I-TREATMENT +habían I-TREATMENT +visto I-TREATMENT +inicialmente I-TREATMENT +lo I-TREATMENT +diagnosticaban I-TREATMENT +más I-TREATMENT +como I-TREATMENT +un I-TREATMENT +eczema I-TREATMENT +inespecífico I-TREATMENT y I-TREATMENT -reposición I-TREATMENT -hidroelectrolítica I-TREATMENT -controlada I-TREATMENT +lo I-TREATMENT +trataron I-TREATMENT con I-TREATMENT -buena I-TREATMENT -respuesta, I-TREATMENT -siendo I-TREATMENT +corticoides I-TREATMENT +tópicos, I-TREATMENT +que I-TREATMENT +remitían I-TREATMENT +parcialmente I-TREATMENT la I-TREATMENT -creatinina I-TREATMENT -al I-TREATMENT -alta I-TREATMENT +sintomatología, I-TREATMENT +con I-TREATMENT +recaídas I-TREATMENT +continuadas I-TREATMENT +tras I-TREATMENT +cese I-TREATMENT de I-TREATMENT -0, I-TREATMENT -86 I-TREATMENT -mg/dl. I-TREATMENT +tratamiento. I-TREATMENT +Los I-TREATMENT +síntomas I-TREATMENT +mejoran I-TREATMENT +con I-TREATMENT +crema I-TREATMENT +hidratante I-TREATMENT +tipo I-TREATMENT +urea; I-TREATMENT +el I-TREATMENT +rascado I-TREATMENT +empeora I-TREATMENT +los I-TREATMENT +síntomas I-TREATMENT +y I-TREATMENT +provoca I-TREATMENT +aumento I-TREATMENT +de I-TREATMENT +tamaño I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión. I-TREATMENT I-TREATMENT -Varón B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -IRC B-PAST_MEDICAL_HISTORY -terminal I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nefropatía I-PAST_MEDICAL_HISTORY -diabética I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -sustitutivo I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hemodiálisis, I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -isquémica I-PAST_MEDICAL_HISTORY -crónica, I-PAST_MEDICAL_HISTORY -miocardiopatía I-PAST_MEDICAL_HISTORY -dilatada I-PAST_MEDICAL_HISTORY +sexo I-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS +11 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -isquémico, I-PAST_MEDICAL_HISTORY -retinopatía I-PAST_MEDICAL_HISTORY -diabética, I-PAST_MEDICAL_HISTORY -accidente I-PAST_MEDICAL_HISTORY -vascular I-PAST_MEDICAL_HISTORY -cerebral I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -años; I-PAST_MEDICAL_HISTORY -ingresa B-PRESENT_ILLNESS +tiroiditis I-PAST_MEDICAL_HISTORY +autoinmune I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +pesquisada I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +bocio I-PAST_MEDICAL_HISTORY +difuso I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +antecedente B-FAMILY_HISTORY +familiar I-FAMILY_HISTORY +de I-FAMILY_HISTORY +carcinoma I-FAMILY_HISTORY +papilar I-FAMILY_HISTORY +en I-FAMILY_HISTORY +primo, I-FAMILY_HISTORY +abuela I-FAMILY_HISTORY +y I-FAMILY_HISTORY +bisabuela. I-FAMILY_HISTORY + I-FAMILY_HISTORY +A B-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS +control I-PRESENT_ILLNESS +ecográfico I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +pesquisó I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +nódulo I-PRESENT_ILLNESS +tiroideo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -medicina I-PRESENT_ILLNESS -interna I-PRESENT_ILLNESS +1, I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS +0, I-PRESENT_ILLNESS +9 I-PRESENT_ILLNESS +cm, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -cetoacidosis I-PRESENT_ILLNESS -diabética. I-PRESENT_ILLNESS -Durante B-EXPLORATION -el I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -detectan I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -maculopapulosas, I-EXPLORATION -eritematosas, I-EXPLORATION +bordes I-PRESENT_ILLNESS +mal I-PRESENT_ILLNESS +limitados, I-PRESENT_ILLNESS +heterogéneo, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +calcificaciones I-PRESENT_ILLNESS +múltiples I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +interior, I-PRESENT_ILLNESS +se B-EXPLORATION +realizó I-EXPLORATION +biopsia I-EXPLORATION +por I-EXPLORATION +punción I-EXPLORATION con I-EXPLORATION -zona I-EXPLORATION -descamativa I-EXPLORATION -hiperqueratósica I-EXPLORATION -central, I-EXPLORATION +aguja I-EXPLORATION +fina I-EXPLORATION +cuya I-EXPLORATION +histología I-EXPLORATION +fue I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +carcinoma I-EXPLORATION +papilar, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +tiroidectomia I-TREATMENT +total I-TREATMENT +con I-TREATMENT +vaciamiento I-TREATMENT +ganglionar I-TREATMENT +cervical I-TREATMENT +anterior. I-TREATMENT +La B-EXPLORATION +biopsia I-EXPLORATION +confirmó I-EXPLORATION +un I-EXPLORATION +Carcinoma I-EXPLORATION +papilar I-EXPLORATION de I-EXPLORATION -distribución I-EXPLORATION -universal. I-EXPLORATION -Se B-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -dermatología, I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -realiza I-DERIVED_FROM/TO -biopsia I-DERIVED_FROM/TO -cutánea I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -las I-DERIVED_FROM/TO -lesiones I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -diagnostica I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -enfermedad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Kyrle. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO +tiroides I-EXPLORATION +unifocal, I-EXPLORATION +variedad I-EXPLORATION +usual, I-EXPLORATION +sin I-EXPLORATION +infiltración I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +peritiroideo, I-EXPLORATION +sin I-EXPLORATION +permeaciones I-EXPLORATION +linfovasculares I-EXPLORATION +ni I-EXPLORATION +compromiso I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +linfonodos I-EXPLORATION +evaluados, I-EXPLORATION +bordes I-EXPLORATION +quirúrgicos I-EXPLORATION +negativos I-EXPLORATION +y I-EXPLORATION +resto I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +tiroideo I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +tiroiditis I-EXPLORATION +crónica I-EXPLORATION +difusa. I-EXPLORATION +De B-TREATMENT +acuerdo I-TREATMENT +a I-TREATMENT +protocolo I-TREATMENT +a I-TREATMENT +continuación I-TREATMENT +de I-TREATMENT +la I-TREATMENT +tiroidectomía I-TREATMENT +se I-TREATMENT +aplicó I-TREATMENT +Radio I-TREATMENT +yodo I-TREATMENT +100 I-TREATMENT +mCi I-TREATMENT +a I-TREATMENT +los I-TREATMENT +25 I-TREATMENT +días I-TREATMENT +post I-TREATMENT +cirugía I-TREATMENT +con I-TREATMENT +rastreo I-TREATMENT +terapéutico I-TREATMENT +posterior I-TREATMENT +negativo. I-TREATMENT +Permanece B-EVOLUTION +sin I-EVOLUTION +evidencias I-EVOLUTION +de I-EVOLUTION +recidiva, I-EVOLUTION +con I-EVOLUTION +Tiroglobulinas I-EVOLUTION +< I-EVOLUTION +0, I-EVOLUTION +2 I-EVOLUTION +ng/ml I-EVOLUTION +en I-EVOLUTION +controles I-EVOLUTION +posteriores I-EVOLUTION +con I-EVOLUTION +1 I-EVOLUTION +año I-EVOLUTION +4 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +seguimiento. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Neonato B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -en B-PAST_MEDICAL_HISTORY -DP I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -octubre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2012 I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +11 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +vida, I-PRESENT_ILLNESS +nacida B-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +parto I-PAST_MEDICAL_HISTORY +vaginal I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY +término I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nefropatía I-PAST_MEDICAL_HISTORY -diabética. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS +peso I-PAST_MEDICAL_HISTORY +adecuado I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +edad I-PAST_MEDICAL_HISTORY +gestacional, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +Apgar I-PAST_MEDICAL_HISTORY +7/9, I-PAST_MEDICAL_HISTORY +de B-FAMILY_HISTORY +padres I-FAMILY_HISTORY +sanos, I-FAMILY_HISTORY +no I-FAMILY_HISTORY +consanguíneos. I-FAMILY_HISTORY +Tiene I-FAMILY_HISTORY +tres I-FAMILY_HISTORY +hermanos I-FAMILY_HISTORY +vivos I-FAMILY_HISTORY +y I-FAMILY_HISTORY +sanos. I-FAMILY_HISTORY +Sin I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +de I-FAMILY_HISTORY +abortos I-FAMILY_HISTORY +maternos. I-FAMILY_HISTORY +Consulta B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +ampollas, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +presentaron I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +nacimiento, I-PRESENT_ILLNESS +dispuestas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +miembro I-PRESENT_ILLNESS +inferior I-PRESENT_ILLNESS +(MI) I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +siguiendo I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +líneas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS +Blaschko, I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -líquido I-PRESENT_ILLNESS -peritoneal I-PRESENT_ILLNESS -turbio, I-PRESENT_ILLNESS -refiriendo I-PRESENT_ILLNESS -descenso I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +correr I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -ultrafiltración. I-PRESENT_ILLNESS -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -neoformación I-PAST_MEDICAL_HISTORY -nasal. I-PAST_MEDICAL_HISTORY -Los B-EXPLORATION -resultados I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -eran: I-EXPLORATION -aspecto I-EXPLORATION -turbio, I-EXPLORATION -700 I-EXPLORATION -leucocitos/μl I-EXPLORATION -(mononucleares I-EXPLORATION -80% I-EXPLORATION +los I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +aumentaron I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +número. I-PRESENT_ILLNESS +Recibe B-TREATMENT +cefotaxima-oxacilina I-TREATMENT +parenteral I-TREATMENT +(VP) I-TREATMENT +por I-TREATMENT +dos I-TREATMENT +días, I-TREATMENT +con I-TREATMENT +mejoría. I-TREATMENT +Es B-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +afebril, I-EVOLUTION +con I-EVOLUTION +buen I-EVOLUTION +estado I-EVOLUTION +general I-EVOLUTION +e I-EVOLUTION +indicación I-EVOLUTION +de I-EVOLUTION +continuar I-EVOLUTION +con I-EVOLUTION +cefixima I-EVOLUTION +oral I-EVOLUTION +(VO). I-EVOLUTION +Dos I-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +alta I-EVOLUTION +aparecen I-EVOLUTION +nuevas I-EVOLUTION +lesiones I-EVOLUTION +de I-EVOLUTION +iguales I-EVOLUTION +características I-EVOLUTION +en I-EVOLUTION +MI I-EVOLUTION +derecho I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +miembro I-EVOLUTION +superior I-EVOLUTION +(MS) I-EVOLUTION +izquierdo, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +queda I-EVOLUTION +internada. I-EVOLUTION +Se B-TREATMENT +reinicia I-TREATMENT +cefotaxima-oxacilina I-TREATMENT +VP, I-TREATMENT +se B-EXPLORATION +solicitan I-EXPLORATION +frotis I-EXPLORATION y I-EXPLORATION -polimorfonucleares I-EXPLORATION -20%), I-EXPLORATION -a I-EXPLORATION -pesar I-EXPLORATION -del I-EXPLORATION -predominio I-EXPLORATION +cultivo I-EXPLORATION de I-EXPLORATION -mononucleares I-EXPLORATION -se I-EXPLORATION -inició I-EXPLORATION -terapia I-EXPLORATION -antibiótica I-EXPLORATION -empírica I-EXPLORATION -con I-EXPLORATION -vancomicina I-EXPLORATION +lesiones, I-EXPLORATION y I-EXPLORATION -ceftazidima I-EXPLORATION -intraperitoneal. I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION -abdominal I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -signos I-EXPLORATION +VDRL. I-EXPLORATION +Con I-EXPLORATION +resultados I-EXPLORATION de I-EXPLORATION -irritación I-EXPLORATION -peritoneal I-EXPLORATION -ni I-EXPLORATION -masas; I-EXPLORATION +los I-EXPLORATION +estudios I-EXPLORATION +negativos I-EXPLORATION +se B-EVOLUTION +decide I-EVOLUTION +el I-EVOLUTION +alta I-EVOLUTION +y B-TREATMENT +se I-TREATMENT +indica I-TREATMENT +aplicar I-TREATMENT +ácido I-TREATMENT +fusídico I-TREATMENT +tópico I-TREATMENT +sobre I-TREATMENT +las I-TREATMENT +vesículas I-TREATMENT +cutáneas I-TREATMENT +y I-TREATMENT +continuar I-TREATMENT +con I-TREATMENT +cefixima I-TREATMENT +VO. I-TREATMENT +Dos B-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +alta I-EVOLUTION +consulta I-EVOLUTION +a I-EVOLUTION +nuestro I-EVOLUTION +servicio I-EVOLUTION +por I-EVOLUTION +persistencia I-EVOLUTION +de I-EVOLUTION +lesiones. I-EVOLUTION +El B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +general I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +límites I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +normalidad. I-EXPLORATION +En I-EXPLORATION el I-EXPLORATION -orificio I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +dermatológico I-EXPLORATION +se I-EXPLORATION +constatan I-EXPLORATION +múltiples I-EXPLORATION +vesículas, I-EXPLORATION +firmes, I-EXPLORATION +amarillentas, I-EXPLORATION +sobre I-EXPLORATION +una I-EXPLORATION +base I-EXPLORATION +inflamatoria, I-EXPLORATION de I-EXPLORATION -salida I-EXPLORATION -del I-EXPLORATION -catéter I-EXPLORATION -peritoneal I-EXPLORATION +distribución I-EXPLORATION +lineal I-EXPLORATION +que I-EXPLORATION +afectan I-EXPLORATION +MS I-EXPLORATION +izquierdo I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -túnel I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -datos I-EXPLORATION -analíticos I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -destacaban: I-EXPLORATION -leucocitos I-EXPLORATION -37000/mm3, I-EXPLORATION -plaquetas I-EXPLORATION -640000/mm3, I-EXPLORATION -hemoglobina I-EXPLORATION -10, I-EXPLORATION -3g/dl, I-EXPLORATION -creatinina I-EXPLORATION -5, I-EXPLORATION -4mg/dl, I-EXPLORATION -urea I-EXPLORATION -180mg/dl, I-EXPLORATION -Na I-EXPLORATION -138mEq/l, I-EXPLORATION -K I-EXPLORATION -4mEq/l, I-EXPLORATION -calcio I-EXPLORATION -9, I-EXPLORATION -5mg/dl, I-EXPLORATION -fósforo I-EXPLORATION -4, I-EXPLORATION -8mg/dl, I-EXPLORATION -albúmina I-EXPLORATION -3, I-EXPLORATION -9mg/dl. I-EXPLORATION -Los I-EXPLORATION -cultivos I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -días I-EXPLORATION -después I-EXPLORATION -resultaron I-EXPLORATION -negativos. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION +ambos I-EXPLORATION +MI. I-EXPLORATION +El I-EXPLORATION +tamaño I-EXPLORATION de I-EXPLORATION -cráneo, I-EXPLORATION -tórax I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +es I-EXPLORATION +variable, I-EXPLORATION +con I-EXPLORATION +diámetros I-EXPLORATION +que I-EXPLORATION +oscilan I-EXPLORATION +entre I-EXPLORATION +0, I-EXPLORATION +1-1 I-EXPLORATION +cm. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +constató I-EXPLORATION +afectación I-EXPLORATION +ungueal. I-EXPLORATION +Se B-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +remite I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +neurólogo I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +oftalmólogo, I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +descartan I-DERIVED_FROM/TO +afectación I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +tales I-DERIVED_FROM/TO +áreas. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Métodos B-EXPLORATION +auxiliares I-EXPLORATION +de I-EXPLORATION +diagnóstico: I-EXPLORATION +hemograma: I-EXPLORATION +Hb: I-EXPLORATION +15, I-EXPLORATION +4 I-EXPLORATION +g/dl; I-EXPLORATION +leucocitos: I-EXPLORATION +16 I-EXPLORATION +700 I-EXPLORATION +cél./mm3; I-EXPLORATION +N: I-EXPLORATION +68%; I-EXPLORATION +L: I-EXPLORATION +20%; I-EXPLORATION +Eo: I-EXPLORATION +10%; I-EXPLORATION +plaquetas: I-EXPLORATION +330 I-EXPLORATION +000 I-EXPLORATION +cél./mm3. I-EXPLORATION +Examen I-EXPLORATION +directo I-EXPLORATION y I-EXPLORATION -abdomen I-EXPLORATION +cultivo: I-EXPLORATION +negativo I-EXPLORATION para I-EXPLORATION -completar I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION +hongos I-EXPLORATION +y I-EXPLORATION +bacterias. I-EXPLORATION +Dos I-EXPLORATION +hemocultivos: I-EXPLORATION +negativos. I-EXPLORATION +VDRL: I-EXPLORATION +no I-EXPLORATION +reactiva. I-EXPLORATION +Biopsia I-EXPLORATION +cutánea: I-EXPLORATION +Se I-EXPLORATION +efectúa I-EXPLORATION +biopsia I-EXPLORATION +cutánea I-EXPLORATION +incisional I-EXPLORATION de I-EXPLORATION -masa I-EXPLORATION -nasal I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -días I-EXPLORATION -siguientes, I-EXPLORATION -siendo I-EXPLORATION -informado I-EXPLORATION +una I-EXPLORATION de I-EXPLORATION -adenopatías I-EXPLORATION -mediastínicas I-EXPLORATION +las I-EXPLORATION +vesículas I-EXPLORATION +de I-EXPLORATION +MI, I-EXPLORATION +se I-EXPLORATION +fija I-EXPLORATION +en I-EXPLORATION +formol I-EXPLORATION +neutro I-EXPLORATION +tamponado I-EXPLORATION +al I-EXPLORATION +10% I-EXPLORATION y I-EXPLORATION -retroperitoneales I-EXPLORATION -diseminadas. I-EXPLORATION +se I-EXPLORATION +procesa I-EXPLORATION +de I-EXPLORATION +manera I-EXPLORATION +convencional. I-EXPLORATION +Se I-EXPLORATION +efectúa I-EXPLORATION +coloración I-EXPLORATION +HE. I-EXPLORATION La I-EXPLORATION anatomía I-EXPLORATION patológica I-EXPLORATION +informa: I-EXPLORATION +dermatitis I-EXPLORATION +psoriasiforme I-EXPLORATION +perivascular I-EXPLORATION +superficial, I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -nasal I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -como I-EXPLORATION -linfoma I-EXPLORATION -no-Hodgkin I-EXPLORATION +marcada I-EXPLORATION +espongiosis I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +tercio I-EXPLORATION +inferior I-EXPLORATION +del I-EXPLORATION +epitelio I-EXPLORATION +con I-EXPLORATION +exocitosis I-EXPLORATION +eosinofílica I-EXPLORATION +y I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION células I-EXPLORATION -B I-EXPLORATION -grandes I-EXPLORATION +disqueratósicas. I-EXPLORATION +En I-EXPLORATION +dermis I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +un I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION +perivascular I-EXPLORATION +superficial I-EXPLORATION +de I-EXPLORATION +linfocitos I-EXPLORATION +con I-EXPLORATION +eosinófilos I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -citología I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -demostró I-EXPLORATION -linfocitos I-EXPLORATION -atípicos. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -inició I-TREATMENT -su I-TREATMENT -tratamiento I-TREATMENT -quimioterápico I-TREATMENT +edema. I-EXPLORATION + I-EXPLORATION +Diagnóstico I-EXPLORATION +anatomopatológico I-EXPLORATION +final: I-EXPLORATION +incontinentia I-EXPLORATION +pigmenti I-EXPLORATION +estadio I-EXPLORATION +eritemato-ampollar. I-EXPLORATION +Evolución B-TREATMENT y I-TREATMENT -permaneció I-TREATMENT -en I-TREATMENT +tratamiento: I-TREATMENT +Se I-TREATMENT +higienizan I-TREATMENT +las I-TREATMENT +lesiones I-TREATMENT +con I-TREATMENT +infusión I-TREATMENT +de I-TREATMENT +manzanilla I-TREATMENT +fría I-TREATMENT +y I-TREATMENT +pasta I-TREATMENT +al I-TREATMENT +agua I-TREATMENT +luego I-TREATMENT +de I-TREATMENT la I-TREATMENT -técnica I-TREATMENT +higiene, I-TREATMENT +dos I-TREATMENT +veces I-TREATMENT +por I-TREATMENT +día, I-TREATMENT +hasta I-TREATMENT +la I-TREATMENT +desaparición I-TREATMENT de I-TREATMENT -DP I-TREATMENT -sin I-TREATMENT -más I-TREATMENT -incidencias I-TREATMENT -dialíticas. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -clínica I-EXPLORATION -de I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -turbio I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -paciente I-EXPLORATION -en I-EXPLORATION -DP I-EXPLORATION -generalmente I-EXPLORATION -se I-EXPLORATION -asocia I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -peritonitis. I-EXPLORATION -Para I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -peritonitis I-EXPLORATION -bacteriana I-EXPLORATION +las I-TREATMENT +ampollas. I-TREATMENT +Acude B-EVOLUTION +a I-EVOLUTION +control I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +15 I-EVOLUTION +días, I-EVOLUTION +con I-EVOLUTION +marcada I-EVOLUTION +desaparición I-EVOLUTION +de I-EVOLUTION +ampollas I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +aparición I-EVOLUTION +de I-EVOLUTION +nuevas I-EVOLUTION +lesiones. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +67 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +portadora I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +prótesis I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +rodilla I-PRESENT_ILLNESS +y B-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +colecistectomía I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +herniorrafia I-PAST_MEDICAL_HISTORY +umbilical, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +tumoración I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +geniana I-PRESENT_ILLNESS +izquierda I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +unos I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ha I-PRESENT_ILLNESS +ido I-PRESENT_ILLNESS +disminuyendo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tamaño I-PRESENT_ILLNESS +muy I-PRESENT_ILLNESS +lentamente. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +única I-PRESENT_ILLNESS +sintomatología I-PRESENT_ILLNESS +referida I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +derivada I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +tamaño I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +tumor. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION se I-EXPLORATION -requieren I-EXPLORATION -al I-EXPLORATION -menos I-EXPLORATION +aprecian I-EXPLORATION dos I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -tres I-EXPLORATION -condiciones: I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -solo I-EXPLORATION -o I-EXPLORATION -acompañado I-EXPLORATION -de I-EXPLORATION -otros I-EXPLORATION -síntomas I-EXPLORATION -abdominales, I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -con I-EXPLORATION -más I-EXPLORATION -de I-EXPLORATION -100 I-EXPLORATION -leucocitos/μl, I-EXPLORATION -siendo I-EXPLORATION -más I-EXPLORATION -del I-EXPLORATION -50% I-EXPLORATION -polimorfonucleares, I-EXPLORATION +tumoraciones, I-EXPLORATION +aparentemente I-EXPLORATION +independientes I-EXPLORATION +entre I-EXPLORATION +sí I-EXPLORATION y I-EXPLORATION -cultivo I-EXPLORATION -o I-EXPLORATION -tinción I-EXPLORATION de I-EXPLORATION -Gram I-EXPLORATION -que I-EXPLORATION -demuestre I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION +parótida, I-EXPLORATION +de I-EXPLORATION +unos I-EXPLORATION +2 I-EXPLORATION +ó I-EXPLORATION +3 I-EXPLORATION +cm, I-EXPLORATION +móviles, I-EXPLORATION +bien I-EXPLORATION +definidas I-EXPLORATION +y I-EXPLORATION de I-EXPLORATION -microorganismos1. I-EXPLORATION +consistencia I-EXPLORATION +elástica. I-EXPLORATION I-EXPLORATION -Es I-EXPLORATION -difícil I-EXPLORATION -diferenciar I-EXPLORATION -una I-EXPLORATION -infección I-EXPLORATION -peritoneal I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +PAAF I-EXPLORATION +preoperatoria I-EXPLORATION +que I-EXPLORATION +muestra I-EXPLORATION +un I-EXPLORATION +frotis I-EXPLORATION con I-EXPLORATION -cultivo I-EXPLORATION -negativo I-EXPLORATION +cuadro I-EXPLORATION +citológico I-EXPLORATION +sugestivo I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -inflamación I-EXPLORATION -peritoneal I-EXPLORATION -no I-EXPLORATION -infecciosa I-EXPLORATION -(peritonitis I-EXPLORATION -estéril). I-EXPLORATION -Un I-EXPLORATION -cultivo I-EXPLORATION -peritoneal I-EXPLORATION -negativo I-EXPLORATION -generalmente I-EXPLORATION -se I-EXPLORATION -debe I-EXPLORATION -a I-EXPLORATION -fallos I-EXPLORATION -técnicos I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -procesamiento I-EXPLORATION +tumor I-EXPLORATION +mixto I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -muestras, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -manejo I-EXPLORATION -resulta I-EXPLORATION -complicado, I-EXPLORATION -dado I-EXPLORATION +glándula I-EXPLORATION +salival. I-EXPLORATION +Dado I-EXPLORATION que I-EXPLORATION -existen I-EXPLORATION -peritonitis I-EXPLORATION -infecciosas I-EXPLORATION -sin I-EXPLORATION -crecimiento I-EXPLORATION -bacteriano I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -cultivo. I-EXPLORATION -Se I-EXPLORATION -aconseja I-EXPLORATION -revisar I-EXPLORATION la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -cultivo I-EXPLORATION -cuando I-EXPLORATION -estos I-EXPLORATION -sean I-EXPLORATION -negativos I-EXPLORATION +exploración I-EXPLORATION +la I-EXPLORATION +tumoración I-EXPLORATION +se I-EXPLORATION +localiza, I-EXPLORATION en I-EXPLORATION -más I-EXPLORATION -del I-EXPLORATION -20% I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -ocasiones I-EXPLORATION -e I-EXPLORATION -interrogar I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -uso I-EXPLORATION +principio, I-EXPLORATION +independiente I-EXPLORATION de I-EXPLORATION -antibióticos I-EXPLORATION -previos I-EXPLORATION -al I-EXPLORATION -paciente2. I-EXPLORATION -Para I-EXPLORATION -lograr I-EXPLORATION +la I-EXPLORATION +parótida I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION una I-EXPLORATION -rapidez I-EXPLORATION -diagnóstica I-EXPLORATION +localización I-EXPLORATION +poco I-EXPLORATION +frecuente I-EXPLORATION +para I-EXPLORATION +un I-EXPLORATION +adenoma I-EXPLORATION +pleomorfo, I-EXPLORATION +se I-EXPLORATION +decide I-EXPLORATION +realizar I-EXPLORATION +RNM. I-EXPLORATION +Esta I-EXPLORATION +evidencia I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +ocupante I-EXPLORATION +de I-EXPLORATION +espacio I-EXPLORATION en I-EXPLORATION -casos I-EXPLORATION +partes I-EXPLORATION +blandas I-EXPLORATION de I-EXPLORATION -peritonitis I-EXPLORATION -estéril, I-EXPLORATION -las I-EXPLORATION -guías I-EXPLORATION +la I-EXPLORATION +mejilla I-EXPLORATION +izquierda, I-EXPLORATION de I-EXPLORATION -DP I-EXPLORATION -españolas I-EXPLORATION -esquematizan I-EXPLORATION -teniendo I-EXPLORATION +señal I-EXPLORATION +homogénea, I-EXPLORATION +hipointensa I-EXPLORATION en I-EXPLORATION -cuenta I-EXPLORATION +T1 I-EXPLORATION +y I-EXPLORATION +marcadamente I-EXPLORATION +hiperintensa I-EXPLORATION +en I-EXPLORATION +T2. I-EXPLORATION +Esta I-EXPLORATION +imagen I-EXPLORATION +es I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +linfangioma, I-EXPLORATION +que I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +parte I-EXPLORATION +craneal I-EXPLORATION +se I-EXPLORATION +extiende I-EXPLORATION +hasta I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -o I-EXPLORATION -ausencia I-EXPLORATION +altura I-EXPLORATION +del I-EXPLORATION +límite I-EXPLORATION +superior I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION +la I-EXPLORATION +órbita I-EXPLORATION +y I-EXPLORATION +desciende I-EXPLORATION en I-EXPLORATION +contacto I-EXPLORATION +con I-EXPLORATION el I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION +borde I-EXPLORATION +externo I-EXPLORATION +del I-EXPLORATION +masetero I-EXPLORATION +hasta I-EXPLORATION +la I-EXPLORATION +altura I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +cavidad I-EXPLORATION +bucal I-EXPLORATION +donde I-EXPLORATION +lo I-EXPLORATION +bordea I-EXPLORATION +anteriormente I-EXPLORATION y I-EXPLORATION +se I-EXPLORATION +introduce I-EXPLORATION +medialmente I-EXPLORATION +contactando I-EXPLORATION +con I-EXPLORATION el I-EXPLORATION -tipo I-EXPLORATION -de I-EXPLORATION -células. I-EXPLORATION -Un I-EXPLORATION -aumento I-EXPLORATION +maxilar I-EXPLORATION +superior I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +externa I-EXPLORATION +del I-EXPLORATION +seno I-EXPLORATION +maxilar. I-EXPLORATION + I-EXPLORATION +Tras B-TREATMENT +realizar I-TREATMENT +preoperatorio, I-TREATMENT +se I-TREATMENT +practica I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +mediante I-TREATMENT +un I-TREATMENT +abordaje I-TREATMENT +intraoral. I-TREATMENT +Al B-EXPLORATION +incidir I-EXPLORATION +la I-EXPLORATION +mucosa I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +una I-EXPLORATION +formación I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +hernia, I-EXPLORATION +y I-EXPLORATION +que I-EXPLORATION +resulta I-EXPLORATION +fácil I-EXPLORATION de I-EXPLORATION -polimorfornucleares I-EXPLORATION -puede I-EXPLORATION -ser I-EXPLORATION -por I-EXPLORATION -inflamación I-EXPLORATION +separar I-EXPLORATION de I-EXPLORATION -víscera I-EXPLORATION -intraperitoneal I-EXPLORATION -o I-EXPLORATION -yuxtaperitoneal, I-EXPLORATION -medicamentos I-EXPLORATION -o I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -contaminado I-EXPLORATION -por I-EXPLORATION -endotoxinas. I-EXPLORATION -Si I-EXPLORATION -están I-EXPLORATION -aumentados I-EXPLORATION los I-EXPLORATION -eosinófilos, I-EXPLORATION -se I-EXPLORATION -sospechará I-EXPLORATION -reacción I-EXPLORATION -alérgica I-EXPLORATION -al I-EXPLORATION -material I-EXPLORATION +tejidos I-EXPLORATION +circundantes I-EXPLORATION +mediante I-EXPLORATION +disección I-EXPLORATION +roma. I-EXPLORATION +El I-EXPLORATION +resultado I-EXPLORATION +final I-EXPLORATION +nos I-EXPLORATION +muestra I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION de I-EXPLORATION -diálisis, I-EXPLORATION -medicamentos, I-EXPLORATION -irritación I-EXPLORATION -peritoneal I-EXPLORATION -por I-EXPLORATION -sangre I-EXPLORATION -retrógrada I-EXPLORATION -o I-EXPLORATION -tras I-EXPLORATION -peritonitis I-EXPLORATION -por I-EXPLORATION -hongos I-EXPLORATION +2 I-EXPLORATION +x I-EXPLORATION +7 I-EXPLORATION +cm, I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +quístico I-EXPLORATION y I-EXPLORATION -parásitos. I-EXPLORATION +forma I-EXPLORATION +tubular I-EXPLORATION +arrosariada. I-EXPLORATION + I-EXPLORATION El I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -mononucleares I-EXPLORATION -puede I-EXPLORATION -asociarse I-EXPLORATION -a I-EXPLORATION -icodextrina, I-EXPLORATION -infección I-EXPLORATION -por I-EXPLORATION -micobacterias, I-EXPLORATION -hongos. I-EXPLORATION -Si I-EXPLORATION -además I-EXPLORATION -hay I-EXPLORATION -hematíes, I-EXPLORATION -se I-EXPLORATION -ha I-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION de I-EXPLORATION -considerar: I-EXPLORATION -ovulación, I-EXPLORATION -menstruación I-EXPLORATION -retrógrada, I-EXPLORATION -rotura I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +extirpada I-EXPLORATION +muestra I-EXPLORATION +macroscópicamente I-EXPLORATION +una I-EXPLORATION +formación I-EXPLORATION +elongada, I-EXPLORATION +cilíndrica, I-EXPLORATION de I-EXPLORATION -quiste I-EXPLORATION -ovárico, I-EXPLORATION -líquido I-EXPLORATION -hipertónico, I-EXPLORATION -adherencias I-EXPLORATION -peritoneales, I-EXPLORATION -ejercicio I-EXPLORATION -físico I-EXPLORATION -y I-EXPLORATION -trauma I-EXPLORATION +unos I-EXPLORATION +11 I-EXPLORATION +x I-EXPLORATION +1, I-EXPLORATION +7 I-EXPLORATION +cm I-EXPLORATION +cubierta I-EXPLORATION por I-EXPLORATION -catéter. I-EXPLORATION -Con I-EXPLORATION -elevados I-EXPLORATION -mononucleares I-EXPLORATION -y I-EXPLORATION -células I-EXPLORATION -malignas, I-EXPLORATION -hay I-EXPLORATION -que I-EXPLORATION -pensar I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -linfoma I-EXPLORATION -o I-EXPLORATION -metástasis I-EXPLORATION -peritoneales. I-EXPLORATION -Por I-EXPLORATION -otra I-EXPLORATION -parte, I-EXPLORATION +una I-EXPLORATION +cápsula I-EXPLORATION +con I-EXPLORATION +vasos I-EXPLORATION +prominentes I-EXPLORATION en I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -puede I-EXPLORATION -ser I-EXPLORATION -debido I-EXPLORATION +superficie I-EXPLORATION +y I-EXPLORATION +estructuras I-EXPLORATION +cilíndricas I-EXPLORATION +adheridas I-EXPLORATION a I-EXPLORATION -un I-EXPLORATION -incremento I-EXPLORATION +la I-EXPLORATION +formación I-EXPLORATION +principal. I-EXPLORATION +Al I-EXPLORATION +corte I-EXPLORATION +presenta I-EXPLORATION +áreas I-EXPLORATION de I-EXPLORATION -fibrina I-EXPLORATION -o I-EXPLORATION +aspecto I-EXPLORATION +fibroso I-EXPLORATION +denso, I-EXPLORATION +hialinizado, I-EXPLORATION +alternando I-EXPLORATION +con I-EXPLORATION +zonas I-EXPLORATION de I-EXPLORATION -triglicéridos3, I-EXPLORATION -4. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -literatura I-EXPLORATION -se I-EXPLORATION -describen I-EXPLORATION -algunos I-EXPLORATION -casos I-EXPLORATION +aspecto I-EXPLORATION +más I-EXPLORATION +laxo. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +microscópico I-EXPLORATION +reveló I-EXPLORATION +una I-EXPLORATION +proliferación I-EXPLORATION de I-EXPLORATION -sospecha I-EXPLORATION +células I-EXPLORATION +con I-EXPLORATION +citoplasma I-EXPLORATION +eosinófilo, I-EXPLORATION de I-EXPLORATION -peritonitis I-EXPLORATION +bordes I-EXPLORATION +mal I-EXPLORATION +definidos, I-EXPLORATION +con I-EXPLORATION +núcleos I-EXPLORATION +fusiformes I-EXPLORATION +con I-EXPLORATION +sus I-EXPLORATION +extremos I-EXPLORATION +elongados, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +disponen I-EXPLORATION en I-EXPLORATION -DP I-EXPLORATION -asociadas I-EXPLORATION +haces I-EXPLORATION +adquiriendo I-EXPLORATION a I-EXPLORATION -procesos I-EXPLORATION -tumorales, I-EXPLORATION -entre I-EXPLORATION -ellos, I-EXPLORATION -un I-EXPLORATION -paciente I-EXPLORATION -con I-EXPLORATION +veces I-EXPLORATION un I-EXPLORATION -carcinoma I-EXPLORATION +aspecto I-EXPLORATION +serpenteante I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -renales I-EXPLORATION -recurrente I-EXPLORATION -diagnosticado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -citología I-EXPLORATION +las I-EXPLORATION +células. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +figuras I-EXPLORATION de I-EXPLORATION -líquido I-EXPLORATION -peritoneal5. I-EXPLORATION -Otro I-EXPLORATION -paciente I-EXPLORATION -presentó I-EXPLORATION -una I-EXPLORATION -peritonitis I-EXPLORATION -estéril I-EXPLORATION +mitosis. I-EXPLORATION +La I-EXPLORATION +tumoración I-EXPLORATION +presenta I-EXPLORATION +zonas I-EXPLORATION +más I-EXPLORATION +densas I-EXPLORATION +que I-EXPLORATION +alternan I-EXPLORATION con I-EXPLORATION -un I-EXPLORATION -antecedente I-EXPLORATION +otras I-EXPLORATION +mucho I-EXPLORATION +más I-EXPLORATION +laxas, I-EXPLORATION +contiene I-EXPLORATION +vasos I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -linfoma I-EXPLORATION -diagnosticado I-EXPLORATION -diez I-EXPLORATION -años I-EXPLORATION -antes. I-EXPLORATION +paredes I-EXPLORATION +a I-EXPLORATION +veces I-EXPLORATION +hialinizadas, I-EXPLORATION +en I-EXPLORATION +general I-EXPLORATION +finas I-EXPLORATION +y I-EXPLORATION +algunas I-EXPLORATION +dilatadas I-EXPLORATION +quísticamente. I-EXPLORATION La I-EXPLORATION -citología I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -permitió I-EXPLORATION -observar I-EXPLORATION -los I-EXPLORATION -linfocitos I-EXPLORATION -atípicos I-EXPLORATION -y, I-EXPLORATION -al I-EXPLORATION -igual I-EXPLORATION -que I-EXPLORATION +tumoración I-EXPLORATION +aparece I-EXPLORATION +bien I-EXPLORATION +delimitada I-EXPLORATION +y I-EXPLORATION en I-EXPLORATION -nuestro I-EXPLORATION -caso, I-EXPLORATION -a I-EXPLORATION -pesar I-EXPLORATION -de I-EXPLORATION la I-EXPLORATION -invasión I-EXPLORATION -peritoneal, I-EXPLORATION -continuó I-EXPLORATION +cápsula I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +fascículos I-EXPLORATION +nerviosos, I-EXPLORATION +algunos I-EXPLORATION con I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION +comienzo I-EXPLORATION de I-EXPLORATION -DP6. I-EXPLORATION - I-EXPLORATION -Como I-EXPLORATION -conclusión I-EXPLORATION -del I-EXPLORATION -caso, I-EXPLORATION -debemos I-EXPLORATION -señalar I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION +proliferación. I-EXPLORATION +El I-EXPLORATION diagnóstico I-EXPLORATION -diferencial I-EXPLORATION +anatomopatológico I-EXPLORATION +definitivo I-EXPLORATION +fue I-EXPLORATION +el I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -peritonitis I-EXPLORATION -estériles I-EXPLORATION +neurofibroma I-EXPLORATION +plexiforme. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +nuestro I-EXPLORATION +caso I-EXPLORATION no I-EXPLORATION -debemos I-EXPLORATION -olvidar I-EXPLORATION -la I-EXPLORATION -posible I-EXPLORATION -existencia I-EXPLORATION +encontramos I-EXPLORATION +ningún I-EXPLORATION +hallazgo I-EXPLORATION +clínico I-EXPLORATION +ni I-EXPLORATION +antecedente I-EXPLORATION +personal I-EXPLORATION +ó I-EXPLORATION +familiar I-EXPLORATION +sugestivo I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -proceso I-EXPLORATION -neoplásico. I-EXPLORATION +neurofibromatosis I-EXPLORATION +tipo I-EXPLORATION +I I-EXPLORATION +ó I-EXPLORATION +de I-EXPLORATION +síndrome I-EXPLORATION +poliglandular I-EXPLORATION +MEN I-EXPLORATION +III I-EXPLORATION +(MEN I-EXPLORATION +IIb) I-EXPLORATION +y I-EXPLORATION +parece I-EXPLORATION +confirmar I-EXPLORATION +que I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +aisladas I-EXPLORATION +son I-EXPLORATION +independientes I-EXPLORATION +de I-EXPLORATION +estos I-EXPLORATION +síndromes. I-EXPLORATION I-EXPLORATION +En B-EVOLUTION +la I-EVOLUTION +actualidad, I-EVOLUTION +dos I-EVOLUTION +años I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +intervención, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +ha I-EVOLUTION +presentado I-EVOLUTION +ningún I-EVOLUTION +signo I-EVOLUTION +de I-EVOLUTION +recidiva I-EVOLUTION +tumoral I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +sucesivas I-EVOLUTION +revisiones. I-EVOLUTION + I-EVOLUTION -Paciente B-DERIVED_FROM/TO +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +remitido B-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +disminución I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +nivel I-DERIVED_FROM/TO de I-DERIVED_FROM/TO -48 I-DERIVED_FROM/TO -años I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO +conciencia I-DERIVED_FROM/TO tras I-DERIVED_FROM/TO -detectarse I-DERIVED_FROM/TO -ambulatoriamente I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -creatinina I-DERIVED_FROM/TO -sérica I-DERIVED_FROM/TO +consumo I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +heroína I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +depresión I-DERIVED_FROM/TO +respiratoria I-DERIVED_FROM/TO +(presión I-DERIVED_FROM/TO +parcial I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +O2 I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +sangre I-DERIVED_FROM/TO +arterial: I-DERIVED_FROM/TO +73 I-DERIVED_FROM/TO +mmHg I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +fracción I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +oxígeno I-DERIVED_FROM/TO +inspirado I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +50%), I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +revierte I-DERIVED_FROM/TO +tras I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +oxigenoterapia I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +naloxona. I-DERIVED_FROM/TO +Presenta I-DERIVED_FROM/TO +tumefacción I-DERIVED_FROM/TO de I-DERIVED_FROM/TO -7, I-DERIVED_FROM/TO -56mg/dl. I-DERIVED_FROM/TO +brazo I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +glúteo I-DERIVED_FROM/TO +derechos I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +anuria. I-DERIVED_FROM/TO I-DERIVED_FROM/TO En B-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -destacaba: I-EXPLORATION -tensión I-EXPLORATION -arterial: I-EXPLORATION -163/111mmHg, I-EXPLORATION -peso: I-EXPLORATION -105kg, I-EXPLORATION -talla: I-EXPLORATION -190cm, I-EXPLORATION -índice I-EXPLORATION +analítica I-EXPLORATION de I-EXPLORATION -masa I-EXPLORATION -corporal: I-EXPLORATION -29kg/m2. I-EXPLORATION -Leve I-EXPLORATION -déficit I-EXPLORATION -cognitivo. I-EXPLORATION -Fenotipo I-EXPLORATION -corporal I-EXPLORATION -corpulento. I-EXPLORATION -Facies I-EXPLORATION -con I-EXPLORATION -prognatismo I-EXPLORATION +ingreso I-EXPLORATION +destacan I-EXPLORATION +los I-EXPLORATION +siguientes I-EXPLORATION +datos: I-EXPLORATION +GOT: I-EXPLORATION +1.212 I-EXPLORATION +UI/l, I-EXPLORATION +GPT: I-EXPLORATION +343 I-EXPLORATION +UI/l, I-EXPLORATION +CPK I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +pocas I-EXPLORATION +horas I-EXPLORATION +del I-EXPLORATION +ingreso: I-EXPLORATION +47.876 I-EXPLORATION +UI/l, I-EXPLORATION +creatinina: I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +mg/dl I-EXPLORATION y I-EXPLORATION -macroglosia. I-EXPLORATION -Labios I-EXPLORATION -gruesos, I-EXPLORATION -arcos I-EXPLORATION -superciliares I-EXPLORATION -prominentes, I-EXPLORATION -voz I-EXPLORATION -grave. I-EXPLORATION -Auscultación I-EXPLORATION -normal. I-EXPLORATION -Fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -normal. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -refería I-EXPLORATION -cambios I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -morfología I-EXPLORATION -corporal. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -mostraba I-EXPLORATION -riñones I-EXPLORATION -de I-EXPLORATION -dimensiones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -límite I-EXPLORATION -inferior I-EXPLORATION +potasio: I-EXPLORATION +6, I-EXPLORATION +1 I-EXPLORATION +mmol/l. I-EXPLORATION +A I-EXPLORATION +tenor I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -normalidad, I-EXPLORATION -con I-EXPLORATION -espesor I-EXPLORATION -del I-EXPLORATION -parénquima I-EXPLORATION -renal I-EXPLORATION -bilateral I-EXPLORATION -marcadamente I-EXPLORATION -adelgazado, I-EXPLORATION -prácticamente I-EXPLORATION -inexistente. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -presentaba I-EXPLORATION -parámetros I-EXPLORATION -bioquímicos I-EXPLORATION -propios I-EXPLORATION +los I-EXPLORATION +datos I-EXPLORATION +se I-EXPLORATION +diagnostica I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -uremia I-EXPLORATION +posible I-EXPLORATION +síndrome I-EXPLORATION +compartimental I-EXPLORATION con I-EXPLORATION -serologías I-EXPLORATION -víricas I-EXPLORATION -negativas I-EXPLORATION -y I-EXPLORATION -pruebas I-EXPLORATION -inmunológicas I-EXPLORATION -normales. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -practicaron I-EXPLORATION -determinaciones I-EXPLORATION -hormonales: I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Cortisol: I-EXPLORATION -23mcg/dl I-EXPLORATION -(6-28), I-EXPLORATION -TSH: I-EXPLORATION -1, I-EXPLORATION -01mcUI/ml I-EXPLORATION -(0,27-4,2). I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Renina: I-EXPLORATION -29, I-EXPLORATION -7microUI/ml I-EXPLORATION -(2,8-39,9). I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Aldosterona: I-EXPLORATION -152, I-EXPLORATION -8pg/ml I-EXPLORATION -(10-160). I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -FSH: I-EXPLORATION -12, I-EXPLORATION -4mUI/ml I-EXPLORATION -(1,5-12,4), I-EXPLORATION -LH: I-EXPLORATION -8, I-EXPLORATION -4mUI/ml I-EXPLORATION -(1,7-8,6). I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Prolactina: I-EXPLORATION -553mUI/l I-EXPLORATION -(86-324), I-EXPLORATION -testosterona I-EXPLORATION -total: I-EXPLORATION -1, I-EXPLORATION -99ng/ml I-EXPLORATION -(2,5-8,4). I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -GH: I-EXPLORATION -4, I-EXPLORATION -24ng/ml I-EXPLORATION -(0-1). I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Somatomedina I-EXPLORATION -C I-EXPLORATION -(IGF1): I-EXPLORATION -670ng/ml I-EXPLORATION -(100-358). I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -IGF1-BP3: I-EXPLORATION -7, I-EXPLORATION -59micro/ml I-EXPLORATION -(3,3-6,7). I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -ACTH: I-EXPLORATION -39pg/ml I-EXPLORATION -(8-46). I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -hipertensión I-TREATMENT +rabdomiolisis I-EXPLORATION +e I-EXPLORATION +IRA I-EXPLORATION +secundaria. I-EXPLORATION +Se B-TREATMENT +decide I-TREATMENT +su I-TREATMENT +paso I-TREATMENT +a I-TREATMENT +quirófano I-TREATMENT +donde I-TREATMENT se I-TREATMENT -controló I-TREATMENT -con I-TREATMENT -tratamiento I-TREATMENT -médico. I-TREATMENT -Ante I-TREATMENT -el I-TREATMENT -deterioro I-TREATMENT +realizan I-TREATMENT +fasciotomías I-TREATMENT de I-TREATMENT -la I-TREATMENT -función I-TREATMENT -renal, I-TREATMENT -cuya I-TREATMENT -etiología I-TREATMENT -no I-TREATMENT -se I-TREATMENT -pudo I-TREATMENT -filiar, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -mediante I-TREATMENT -hemodiálisis I-TREATMENT -crónica. I-TREATMENT - I-TREATMENT -Se B-EXPLORATION -practicó I-EXPLORATION -un I-EXPLORATION -primer I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -sobrecarga I-EXPLORATION -oral I-EXPLORATION -a I-EXPLORATION -glucosa I-EXPLORATION -(TSOG). I-EXPLORATION - I-EXPLORATION -Llegados I-EXPLORATION -a I-EXPLORATION -este I-EXPLORATION -punto, I-EXPLORATION -los I-EXPLORATION -clínicos I-EXPLORATION -sospechábamos, I-EXPLORATION -en I-EXPLORATION -función I-EXPLORATION -del I-EXPLORATION -fenotipo I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -perfil I-EXPLORATION -hormonal I-EXPLORATION -(aumento I-EXPLORATION -de I-EXPLORATION -GH, I-EXPLORATION -IGF-1 I-EXPLORATION -y I-EXPLORATION -IGF1-BP3; I-EXPLORATION -TSOG I-EXPLORATION -sin I-EXPLORATION -supresión I-EXPLORATION -clara I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -GH), I-EXPLORATION -una I-EXPLORATION -acromegalia. I-EXPLORATION -No B-TREATMENT -pudo I-TREATMENT -practicarse I-TREATMENT -una I-TREATMENT -resonancia I-TREATMENT -magnética I-TREATMENT -nuclear I-TREATMENT -(RMN) I-TREATMENT -hipofisaria I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -negativa I-TREATMENT -del I-TREATMENT -paciente I-TREATMENT +tríceps I-TREATMENT y I-TREATMENT -su I-TREATMENT -familia. I-TREATMENT - I-TREATMENT -Cuatro I-TREATMENT -meses I-TREATMENT -después I-TREATMENT +glúteo I-TREATMENT +derechos, I-TREATMENT se I-TREATMENT -realizó I-TREATMENT -finalmente I-TREATMENT +inicia I-TREATMENT +perfusión I-TREATMENT +de I-TREATMENT +dopamina I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT +pre-ß, I-TREATMENT +manitol I-TREATMENT +a I-TREATMENT +0, I-TREATMENT +5 I-TREATMENT +g/kg I-TREATMENT +y I-TREATMENT +corrección I-TREATMENT +de I-TREATMENT la I-TREATMENT -RMN I-TREATMENT -sin I-TREATMENT -contraste I-TREATMENT -paramagnético. I-TREATMENT -La B-EXPLORATION -hipófisis I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -tamaño I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -límites I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -tallo I-EXPLORATION -hipofisario I-EXPLORATION -centrado. I-EXPLORATION -Se B-TREATMENT -practicó I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -TSOG, I-TREATMENT -mostrando I-TREATMENT -una I-TREATMENT -GH I-TREATMENT -basal I-TREATMENT -normal, I-TREATMENT +hiperpotasemia I-TREATMENT con I-TREATMENT -aumento I-TREATMENT -paradójico I-TREATMENT -a I-TREATMENT -los I-TREATMENT -30 I-TREATMENT -minutos, I-TREATMENT -pero I-TREATMENT +la I-TREATMENT +terapia I-TREATMENT +habitual: I-TREATMENT +sueros I-TREATMENT +glucosados I-TREATMENT con I-TREATMENT -adecuada I-TREATMENT -supresión I-TREATMENT -a I-TREATMENT -las I-TREATMENT -dos I-TREATMENT -horas. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -esa I-EXPLORATION -fecha I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -IGF-1 I-EXPLORATION -(340 I-EXPLORATION -ng/ml) I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -IGF1-BP3 I-EXPLORATION -(6, I-EXPLORATION -3 I-EXPLORATION -µg/ml) I-EXPLORATION -se I-EXPLORATION -habían I-EXPLORATION -normalizado I-EXPLORATION -también. I-EXPLORATION -La I-EXPLORATION -prolactina I-EXPLORATION -continuaba I-EXPLORATION -elevada I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -testosterona I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -Actualmente B-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -sigue I-EVOLUTION -controles I-EVOLUTION -periódicos I-EVOLUTION -en I-EVOLUTION -endocrinología I-EVOLUTION -y I-EVOLUTION -continúa I-EVOLUTION -en I-EVOLUTION -hemodiálisis. I-EVOLUTION +insulina I-TREATMENT +y I-TREATMENT +bicarbonato. I-TREATMENT +Durante B-EVOLUTION +su I-EVOLUTION +evolución I-EVOLUTION +presenta I-EVOLUTION +un I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +edema I-EVOLUTION +agudo I-EVOLUTION +de I-EVOLUTION +pulmón I-EVOLUTION +por I-EVOLUTION +sobrecarga I-EVOLUTION +hídrica I-EVOLUTION +que I-EVOLUTION +responde I-EVOLUTION +bien I-EVOLUTION +al I-EVOLUTION +tratamiento. I-EVOLUTION +Es I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +sin I-EVOLUTION +secuelas. I-EVOLUTION I-EVOLUTION -Varón B-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -hialinosis I-PRESENT_ILLNESS -segmentaria I-PRESENT_ILLNESS -focal I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -respuesta I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +diestro, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +54 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +mórbidos. I-PAST_MEDICAL_HISTORY +Ingresó B-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +h I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +iniciar I-PRESENT_ILLNESS +disartria I-PRESENT_ILLNESS +severa, I-PRESENT_ILLNESS +desviación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +mirada I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -esteroides, I-PRESENT_ILLNESS -ciclofosfamida I-PRESENT_ILLNESS +derecha, I-PRESENT_ILLNESS +hemiplejia I-PRESENT_ILLNESS +facio-braquio-crural, I-PRESENT_ILLNESS +hemianestesia I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -vincristina. I-PRESENT_ILLNESS -Comenzó I-PRESENT_ILLNESS -DP I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -1990. I-PRESENT_ILLNESS -Durante B-TREATMENT -los I-TREATMENT -siguientes I-TREATMENT -11 I-TREATMENT -años I-TREATMENT -recibió I-TREATMENT -3 I-TREATMENT -trasplantes I-TREATMENT -renales, I-TREATMENT +hemianopsia I-PRESENT_ILLNESS +izquierda. I-PRESENT_ILLNESS +El B-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +examen I-EXPLORATION +no I-EXPLORATION +evidenciaba I-EXPLORATION +otras I-EXPLORATION +alteraciones. I-EXPLORATION +La I-EXPLORATION +TC I-EXPLORATION +mostró I-EXPLORATION +signos I-EXPLORATION +precoces I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +IMACM I-EXPLORATION +derecho. I-EXPLORATION +Se B-TREATMENT +discutió I-TREATMENT con I-TREATMENT -un I-TREATMENT -tiempo I-TREATMENT -total I-TREATMENT -fuera I-TREATMENT +la I-TREATMENT +familia I-TREATMENT +la I-TREATMENT +posibilidad I-TREATMENT de I-TREATMENT -diálisis I-TREATMENT +una I-TREATMENT +progresión I-TREATMENT +a I-TREATMENT +un I-TREATMENT +IMACM I-TREATMENT +y I-TREATMENT +la I-TREATMENT +eventual I-TREATMENT +necesidad I-TREATMENT de I-TREATMENT -5 I-TREATMENT -años. I-TREATMENT -Fue I-TREATMENT -paratiroidectomizado I-TREATMENT -por I-TREATMENT -hiperparatiroidismo I-TREATMENT -grave. I-TREATMENT +una I-TREATMENT +HD. I-TREATMENT +La I-TREATMENT +familia I-TREATMENT +comprendió I-TREATMENT +y I-TREATMENT +aceptó I-TREATMENT +la I-TREATMENT +intervención. I-TREATMENT I-TREATMENT -El B-EVOLUTION -transporte I-EVOLUTION -peritoneal I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -como I-EVOLUTION -medio-alto I-EVOLUTION -con I-EVOLUTION -tendencia I-EVOLUTION -al I-EVOLUTION -alza. I-EVOLUTION -Con B-TREATMENT -el I-TREATMENT -tiempo I-TREATMENT -se I-TREATMENT -redujo I-TREATMENT +Su B-EXPLORATION +estudio I-EXPLORATION +etiológico I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION +A I-EXPLORATION +las I-EXPLORATION +24 I-EXPLORATION +h, I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +estaba I-EXPLORATION +en I-EXPLORATION +sopor I-EXPLORATION +superficial I-EXPLORATION +sin I-EXPLORATION +midriasis I-EXPLORATION +ni I-EXPLORATION +aparición I-EXPLORATION +de I-EXPLORATION +Babinski I-EXPLORATION +a I-EXPLORATION +derecha. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +TC. I-EXPLORATION +Debido B-TREATMENT +a I-TREATMENT la I-TREATMENT -ultrafiltración I-TREATMENT +progresión I-TREATMENT +del I-TREATMENT +cuadro I-TREATMENT +clínico I-TREATMENT y I-TREATMENT -aumentaron I-TREATMENT -las I-TREATMENT -necesidades I-TREATMENT -osmóticas I-TREATMENT de I-TREATMENT -las I-TREATMENT -soluciones. I-TREATMENT -Medimos B-EXPLORATION -CA-125 I-EXPLORATION -en I-EXPLORATION -efluente I-EXPLORATION -en I-EXPLORATION -diferentes I-EXPLORATION -momentos, I-EXPLORATION -encontrándose I-EXPLORATION -un I-EXPLORATION -progresivo I-EXPLORATION -descenso. I-EXPLORATION -Sufrió B-EVOLUTION -12 I-EVOLUTION -peritonitis, I-EVOLUTION -todas I-EVOLUTION -por I-EVOLUTION -gérmenes I-EVOLUTION -Gram I-EVOLUTION -positivos. I-EVOLUTION -Se I-EVOLUTION -insistió I-EVOLUTION -al I-EVOLUTION +la I-TREATMENT +TC, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +la I-TREATMENT +HD, I-TREATMENT +la I-TREATMENT +cual I-TREATMENT +se I-TREATMENT +efectuó I-TREATMENT +sin I-TREATMENT +complicaciones. I-TREATMENT + I-TREATMENT +El B-EVOLUTION paciente I-EVOLUTION +recuperó I-EVOLUTION +conciencia I-EVOLUTION +antes I-EVOLUTION +de I-EVOLUTION +24 I-EVOLUTION +h I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +extubado I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +h. I-EVOLUTION +No I-EVOLUTION +presentó I-EVOLUTION +complicaciones. I-EVOLUTION +Recuperó I-EVOLUTION +la I-EVOLUTION +movilidad I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -necesidad I-EVOLUTION +pierna I-EVOLUTION +izquierda, I-EVOLUTION +logró I-EVOLUTION +deglución I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION de I-EVOLUTION -ser I-EVOLUTION -transferido I-EVOLUTION +alta I-EVOLUTION a I-EVOLUTION -HD, I-EVOLUTION -circunstancia I-EVOLUTION -que I-EVOLUTION -trataba I-EVOLUTION -de I-EVOLUTION -evitar; I-EVOLUTION -finalmente I-EVOLUTION -inició I-EVOLUTION -HD I-EVOLUTION +los I-EVOLUTION +22 I-EVOLUTION +días. I-EVOLUTION +Desde B-TREATMENT +el I-TREATMENT +séptimo I-TREATMENT +día I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +aspirina I-TREATMENT +(325 I-TREATMENT +mg/día). I-TREATMENT +Se I-TREATMENT +mantuvo I-TREATMENT +en I-TREATMENT +neurorrehabilitación I-TREATMENT +en I-TREATMENT +su I-TREATMENT +domicilio, I-TREATMENT +logrando B-EVOLUTION +marcha I-EVOLUTION en I-EVOLUTION -2011. I-EVOLUTION +3 I-EVOLUTION +meses. I-EVOLUTION I-EVOLUTION -Seis I-EVOLUTION +Al B-TREATMENT +cuarto I-TREATMENT +mes I-TREATMENT +se I-TREATMENT +instaló I-TREATMENT +la I-TREATMENT +plaqueta I-TREATMENT +ósea, I-TREATMENT +siendo B-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +quinto I-EVOLUTION +día. I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +8 I-EVOLUTION meses I-EVOLUTION -después, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -ingresó I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +crisis I-EVOLUTION +convulsiva, I-EVOLUTION +se B-TREATMENT +inició I-TREATMENT +fenitoína I-TREATMENT +(300 I-TREATMENT +mg/día). I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +2 I-EVOLUTION +años I-EVOLUTION +realiza I-EVOLUTION +una I-EVOLUTION +vida I-EVOLUTION +independiente I-EVOLUTION +pero I-EVOLUTION +limitada I-EVOLUTION +a I-EVOLUTION +su I-EVOLUTION +casa: I-EVOLUTION +camina I-EVOLUTION +ayudado I-EVOLUTION +de I-EVOLUTION +un I-EVOLUTION +bastón, I-EVOLUTION +come I-EVOLUTION +solo, I-EVOLUTION +se I-EVOLUTION +viste I-EVOLUTION +y I-EVOLUTION +va I-EVOLUTION +al I-EVOLUTION +baño I-EVOLUTION +ayudado I-EVOLUTION por I-EVOLUTION -dolor I-EVOLUTION +su I-EVOLUTION +señora I-EVOLUTION +(escala I-EVOLUTION +modificada I-EVOLUTION +de I-EVOLUTION +Rankin= I-EVOLUTION +3). I-EVOLUTION + I-EVOLUTION +Al I-EVOLUTION +preguntarle I-EVOLUTION +a I-EVOLUTION +ambos I-EVOLUTION +pacientes I-EVOLUTION y I-EVOLUTION -distensión I-EVOLUTION -abdominal. I-EVOLUTION -Una B-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -evidenció I-EXPLORATION -dilatación I-EXPLORATION -gástrica I-EXPLORATION -y I-EXPLORATION -duodenal I-EXPLORATION -con I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -loculado, I-EXPLORATION -y I-EXPLORATION -asas I-EXPLORATION -edematosas. I-EXPLORATION -Se I-EXPLORATION -obtuvo I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -del I-EXPLORATION -peritoneo: I-EXPLORATION -proliferación I-EXPLORATION -de I-EXPLORATION -pequeños I-EXPLORATION -vasos, I-EXPLORATION -celularidad I-EXPLORATION -inflamatoria I-EXPLORATION -y I-EXPLORATION -fibrosis. I-EXPLORATION -Se B-TREATMENT -diagnosticó I-TREATMENT -de I-TREATMENT -EPE, I-TREATMENT -comenzando I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -y I-TREATMENT -tamoxifeno. I-TREATMENT -Tras B-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION +sus I-EVOLUTION +familias, I-EVOLUTION +individualmente, I-EVOLUTION +si I-EVOLUTION +volverían I-EVOLUTION +a I-EVOLUTION +realizar I-EVOLUTION la I-EVOLUTION -colección I-EVOLUTION -había I-EVOLUTION -disminuido I-EVOLUTION -de I-EVOLUTION -tamaño, I-EVOLUTION -no I-EVOLUTION -observándose I-EVOLUTION -dilatación I-EVOLUTION +cirugía I-EVOLUTION +después I-EVOLUTION de I-EVOLUTION -asas. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -sufrió I-EVOLUTION -más I-EVOLUTION -complicaciones. I-EVOLUTION -Se B-TREATMENT -encuentra I-TREATMENT -en I-TREATMENT -HD I-TREATMENT -y I-TREATMENT -continúa I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -tamoxifeno. I-TREATMENT - I-TREATMENT +haber I-EVOLUTION +sufrido I-EVOLUTION +la I-EVOLUTION +experiencia, I-EVOLUTION +respondieron I-EVOLUTION +afirmativamente. I-EVOLUTION + I-EVOLUTION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS +26 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY +ERC I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +glomerulonefritis I-PAST_MEDICAL_HISTORY +proliferativa I-PAST_MEDICAL_HISTORY +extracapilar I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +I. I-PAST_MEDICAL_HISTORY +Fumadora I-PAST_MEDICAL_HISTORY +activa, I-PAST_MEDICAL_HISTORY +Hipertensa I-PAST_MEDICAL_HISTORY +aunque I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +precisa I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +farmacológico I-PAST_MEDICAL_HISTORY +actualmente. I-PAST_MEDICAL_HISTORY +Presenta I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -ansioso-depresivo I-PAST_MEDICAL_HISTORY +Darier I-PAST_MEDICAL_HISTORY +cutánea. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Recibió I-PAST_MEDICAL_HISTORY +14 I-PAST_MEDICAL_HISTORY +sesiones I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +plasmaféresis I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2006. I-PAST_MEDICAL_HISTORY +Posteriormente I-PAST_MEDICAL_HISTORY +abandonó I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +revisiones I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +consulta I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY +finalmente I-PAST_MEDICAL_HISTORY +acudió I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +urgencias I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +después I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia, I-PAST_MEDICAL_HISTORY -remitida B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -aumento I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -tamaño I-DERIVED_FROM/TO -tiroideo I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -adenopatías I-DERIVED_FROM/TO -laterocervicales. I-DERIVED_FROM/TO -La B-EXPLORATION -punción- I-EXPLORATION -aspiración I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -adenopatía I-EXPLORATION -fue I-EXPLORATION -sospechosa I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -papilar I-EXPLORATION -de I-EXPLORATION -tiroides I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -remitida I-EXPLORATION -al I-EXPLORATION -Servicio I-EXPLORATION -de I-EXPLORATION -Cirugía I-EXPLORATION -para I-EXPLORATION -su I-EXPLORATION -tratamiento. I-EXPLORATION -Fue B-TREATMENT -intervenida I-TREATMENT -realizándose I-TREATMENT -tiroidectomía I-TREATMENT -total I-TREATMENT -con I-TREATMENT -vaciamiento I-TREATMENT -cervical I-TREATMENT -funcional I-TREATMENT -bilateral I-TREATMENT -(niveles I-TREATMENT -II, I-TREATMENT -III, I-TREATMENT -IV I-TREATMENT -y I-TREATMENT -V) I-TREATMENT -y I-TREATMENT -del I-TREATMENT -compartimento I-TREATMENT -central I-TREATMENT -del I-TREATMENT -cuello. I-TREATMENT -Se I-TREATMENT -conservaron I-TREATMENT -ambos I-TREATMENT -nervios I-TREATMENT -recurrentes, I-TREATMENT -se I-TREATMENT -reimplantaron I-TREATMENT -las I-TREATMENT -dos I-TREATMENT -paratiroides I-TREATMENT -inferiores I-TREATMENT +situación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +uremia I-PAST_MEDICAL_HISTORY +terminal I-PAST_MEDICAL_HISTORY +iniciando I-PAST_MEDICAL_HISTORY +diálisis. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +La B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +da I-PRESENT_ILLNESS +consentimiento I-PRESENT_ILLNESS +expreso I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +exposición I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +caso. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Historia I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +acceso I-PRESENT_ILLNESS +vascular I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +• B-TREATMENT +Varios I-TREATMENT +intentos I-TREATMENT +de I-TREATMENT +Fístula I-TREATMENT +Arteriovenosa I-TREATMENT +(FAV), I-TREATMENT +todos I-TREATMENT +ellos I-TREATMENT +infructuosos: I-TREATMENT +FAV I-TREATMENT +radio-cefálica I-TREATMENT +izquierda I-TREATMENT +en I-TREATMENT +01-2009, I-TREATMENT +húmero-cefálica I-TREATMENT +izquierda I-TREATMENT +en I-TREATMENT +03-09, I-TREATMENT +radio-cefálica I-TREATMENT +derecha I-TREATMENT +en I-TREATMENT +04-09 I-TREATMENT y I-TREATMENT -se I-TREATMENT -ligo I-TREATMENT -el I-TREATMENT -conducto I-TREATMENT -torácico. I-TREATMENT -Como B-EVOLUTION -complicación I-EVOLUTION -postquirúrgica I-EVOLUTION -inmediata I-EVOLUTION -presentó I-EVOLUTION -hipocalcemia I-EVOLUTION -transitoria. I-EVOLUTION -Fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION - B-EXPLORATION -El I-EXPLORATION -resultado I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION +húmero-cefálica I-TREATMENT +derecha I-TREATMENT +en I-TREATMENT +05-11. I-TREATMENT +Se B-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION un I-EXPLORATION -carcinoma I-EXPLORATION -papilar I-EXPLORATION -multifocal I-EXPLORATION -con I-EXPLORATION -metástasis I-EXPLORATION -de I-EXPLORATION -ganglios I-EXPLORATION -linfáticos I-EXPLORATION +mapa I-EXPLORATION +vascular I-EXPLORATION en I-EXPLORATION -ambas I-EXPLORATION -regiones I-EXPLORATION -cervicales I-EXPLORATION -y I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +evidenció I-EXPLORATION +ninguna I-EXPLORATION +vena I-EXPLORATION +apta I-EXPLORATION en I-EXPLORATION -cadena I-EXPLORATION -recurrencial. I-EXPLORATION +MMSS. I-EXPLORATION I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -diez I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presentó, I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -brusca, I-EVOLUTION -tumefacción I-EVOLUTION -en I-EVOLUTION -región I-EVOLUTION -cervical I-EVOLUTION -izquierda I-EVOLUTION -con I-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -hacia I-EVOLUTION -la I-EVOLUTION -región I-EVOLUTION -anterior I-EVOLUTION -y I-EVOLUTION -cervical I-EVOLUTION -derecha. I-EVOLUTION -No I-EVOLUTION -presentaba I-EVOLUTION -signos I-EVOLUTION -inflamatorios. I-EVOLUTION -Fue B-TREATMENT -valorada I-TREATMENT +• B-TREATMENT +Catéter I-TREATMENT +venoso I-TREATMENT +permanente I-TREATMENT +yugular I-TREATMENT +derecho, I-TREATMENT +implantado I-TREATMENT +el I-TREATMENT +14/01/09 I-TREATMENT +y I-TREATMENT +retirado I-TREATMENT +el I-TREATMENT +05/11/09 I-TREATMENT +por I-TREATMENT +Endocarditis I-TREATMENT +Tricuspídea I-TREATMENT +secundaria I-TREATMENT +a I-TREATMENT +MARS. I-TREATMENT + I-TREATMENT +• I-TREATMENT +Varios I-TREATMENT +catéteres I-TREATMENT +temporales I-TREATMENT +en I-TREATMENT +ambas I-TREATMENT +venas I-TREATMENT +femorales I-TREATMENT +retirados I-TREATMENT por I-TREATMENT +trombosis I-TREATMENT +o I-TREATMENT +disfunción. I-TREATMENT + I-TREATMENT +• I-TREATMENT +Catéter I-TREATMENT +permanente I-TREATMENT +yugular I-TREATMENT +izquierdo I-TREATMENT +colocado I-TREATMENT el I-TREATMENT -Servicio I-TREATMENT -de I-TREATMENT -Cirugía I-TREATMENT -decidiéndose I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -un I-TREATMENT -drenaje I-TREATMENT -aspirativo I-TREATMENT +16/11/09 I-TREATMENT +y I-TREATMENT +retirado I-TREATMENT +el I-TREATMENT +21/06/10 I-TREATMENT +por I-TREATMENT +trombosis I-TREATMENT de I-TREATMENT -baja I-TREATMENT -presión I-TREATMENT -ante I-TREATMENT la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -fístula I-TREATMENT -de I-TREATMENT -conducto I-TREATMENT -torácico. I-TREATMENT -La B-EXPLORATION -salida I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -lechoso I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -concentración I-EXPLORATION -de I-EXPLORATION -triglicéridos I-EXPLORATION -de I-EXPLORATION -1410 I-EXPLORATION -mg/dl I-EXPLORATION -confirmo I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -clínica I-EXPLORATION -siendo I-EXPLORATION -remitido I-EXPLORATION -a I-EXPLORATION -nuestras I-EXPLORATION -consultas I-EXPLORATION -para I-EXPLORATION -tratamiento I-EXPLORATION -dietético. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -consulta I-EXPLORATION +vena I-TREATMENT +yugular I-TREATMENT +izquierda. I-TREATMENT + I-TREATMENT +• I-TREATMENT +Catéter I-TREATMENT +permanente I-TREATMENT +femoral I-TREATMENT +derecho I-TREATMENT +colocado I-TREATMENT +el I-TREATMENT +21/06/10 I-TREATMENT +y I-TREATMENT +retirado I-TREATMENT +4 I-TREATMENT +días I-TREATMENT +después I-TREATMENT +por I-TREATMENT +disfunción I-TREATMENT +persistente. I-TREATMENT + I-TREATMENT +• B-EXPLORATION +Tras I-EXPLORATION +ello I-EXPLORATION se I-EXPLORATION +le I-EXPLORATION realizó I-EXPLORATION -una I-EXPLORATION -valoración I-EXPLORATION -antropométrica I-EXPLORATION -básica I-EXPLORATION -y I-EXPLORATION -analítica, I-EXPLORATION -objetivándose I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION +endovascular I-EXPLORATION que I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -estaba I-EXPLORATION -normonutrida I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -complicaciones I-EXPLORATION -metabólicas I-EXPLORATION -derivadas I-EXPLORATION +mostraba I-EXPLORATION +oclusión I-EXPLORATION +completa I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -fístula. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -prescripción I-TREATMENT -yeducación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -de I-TREATMENT -una I-TREATMENT -dieta I-TREATMENT -baja I-TREATMENT -en I-TREATMENT -LCT. I-TREATMENT -Se I-TREATMENT -le I-TREATMENT -dieron I-TREATMENT -instrucciones I-TREATMENT -dietéticas I-TREATMENT -escritas I-TREATMENT -(tabla I-TREATMENT -I) I-TREATMENT -y I-TREATMENT -se I-TREATMENT -suplementó I-TREATMENT -con I-TREATMENT -aceite I-TREATMENT -MCT I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -40 I-TREATMENT -cc/día. I-TREATMENT - I-TREATMENT -Entre B-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -y I-EXPLORATION -antropometría I-EXPLORATION -pretratamiento I-EXPLORATION -dietético I-EXPLORATION +vena I-EXPLORATION +iliaca I-EXPLORATION +izquierda I-EXPLORATION y I-EXPLORATION -las I-EXPLORATION -realizadas I-EXPLORATION -dos I-EXPLORATION -semanas I-EXPLORATION -después I-EXPLORATION -no I-EXPLORATION -hubo I-EXPLORATION -diferencias I-EXPLORATION -significativas I-EXPLORATION -sin I-EXPLORATION -objetivarse I-EXPLORATION -complicaciones I-EXPLORATION -metabólicas I-EXPLORATION -características I-EXPLORATION -de I-EXPLORATION -esta I-EXPLORATION -patolología. I-EXPLORATION - I-EXPLORATION -Antes I-EXPLORATION de I-EXPLORATION -iniciar I-EXPLORATION -el I-EXPLORATION -tratamiento I-EXPLORATION -dietético I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -drenaje I-EXPLORATION -diario I-EXPLORATION -máximo I-EXPLORATION -de I-EXPLORATION -400 I-EXPLORATION -cc I-EXPLORATION -de I-EXPLORATION -linfa. I-EXPLORATION -Al I-EXPLORATION -segundo I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -tratamiento I-EXPLORATION -el I-EXPLORATION -líquido I-EXPLORATION -obtenido I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -drenaje I-EXPLORATION -disminuyó I-EXPLORATION +cava I-EXPLORATION +inferior, I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +inhabilitaba I-EXPLORATION +los I-EXPLORATION +accesos I-EXPLORATION +femorales. I-EXPLORATION +En I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +respecta I-EXPLORATION a I-EXPLORATION -100-200 I-EXPLORATION -cc I-EXPLORATION -diario I-EXPLORATION -y I-EXPLORATION -fue I-EXPLORATION -variando I-EXPLORATION -sus I-EXPLORATION -características I-EXPLORATION -macroscópicas I-EXPLORATION -haciéndose I-EXPLORATION -más I-EXPLORATION -claro, I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -más I-EXPLORATION -serohemático I-EXPLORATION -y I-EXPLORATION -menos I-EXPLORATION -quiloso. I-EXPLORATION -Se B-TREATMENT -mantuvo I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -dietético I-TREATMENT -y I-TREATMENT -el I-TREATMENT -drenaje I-TREATMENT -percutáneo I-TREATMENT -hasta I-TREATMENT -el I-TREATMENT -día I-TREATMENT -14 I-TREATMENT -tras I-TREATMENT -lo I-TREATMENT -cual, I-TREATMENT -al I-TREATMENT -observarse I-TREATMENT -mínima I-TREATMENT -salida I-TREATMENT -de I-TREATMENT -fluido I-TREATMENT -y I-TREATMENT -ausencia I-TREATMENT -de I-TREATMENT -características I-TREATMENT -quilosas I-TREATMENT -se I-TREATMENT -retiró I-TREATMENT -el I-TREATMENT -acceso I-TREATMENT -percutáneo. I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -dietético I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -4 I-TREATMENT -días I-TREATMENT -más I-TREATMENT -para I-TREATMENT -observar I-TREATMENT -la I-TREATMENT -evolución I-TREATMENT -tras I-TREATMENT -la I-TREATMENT -retirada I-TREATMENT -del I-TREATMENT -drenaje I-TREATMENT -y B-EVOLUTION -ante I-EVOLUTION -la I-EVOLUTION -ausencia I-EVOLUTION -de I-EVOLUTION -signos I-EVOLUTION -que I-EVOLUTION -sugirieran I-EVOLUTION -recidiva I-EVOLUTION -se I-EVOLUTION -liberalizó I-EVOLUTION -la I-EVOLUTION -dieta, I-EVOLUTION -encontrándose I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -dieta I-EVOLUTION -libre. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -sangrado I-PRESENT_ILLNESS -postmenopáusico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -diagnosticada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -legrado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -adenocarcinoma I-PRESENT_ILLNESS -velloglandular I-PRESENT_ILLNESS -bien I-PRESENT_ILLNESS -diferenciado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -extensa I-PRESENT_ILLNESS -diferenciación I-PRESENT_ILLNESS -escamosa I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -epidermoide. I-PRESENT_ILLNESS -Se B-TREATMENT -intervino I-TREATMENT -quirúrgicamente I-TREATMENT -realizando I-TREATMENT -histerectomía I-TREATMENT -y I-TREATMENT -doble I-TREATMENT -anexectomía, I-TREATMENT -linfadenectomía I-TREATMENT -pélvica I-TREATMENT -y I-TREATMENT -lavado I-TREATMENT -peritoneal. I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -espesor I-EXPLORATION -miometrial, I-EXPLORATION -la I-EXPLORATION -serosa I-EXPLORATION -uterina, I-EXPLORATION -el I-EXPLORATION -epitelio I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -estroma I-EXPLORATION -cervical, I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -de I-EXPLORATION +los I-EXPLORATION +troncos I-EXPLORATION +superiores I-EXPLORATION la I-EXPLORATION -Trompa I-EXPLORATION +situación I-EXPLORATION +no I-EXPLORATION +es I-EXPLORATION +mejor I-EXPLORATION +pues I-EXPLORATION +existe I-EXPLORATION +oclusión I-EXPLORATION de I-EXPLORATION -Falopio I-EXPLORATION -derecha I-EXPLORATION +venas I-EXPLORATION +subclavias, I-EXPLORATION +yugular I-EXPLORATION +derecha, I-EXPLORATION +tronco I-EXPLORATION +braquio-cefálico I-EXPLORATION +izquierdo I-EXPLORATION y I-EXPLORATION -los I-EXPLORATION -vasos I-EXPLORATION -linfáticos I-EXPLORATION -del I-EXPLORATION -cuerpo I-EXPLORATION -uterino I-EXPLORATION -(estadio I-EXPLORATION -IIIa I-EXPLORATION -GIII). I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -tratar I-TREATMENT -con I-TREATMENT -radioquimioterapia I-TREATMENT -concurrente. I-TREATMENT -Se I-TREATMENT -administraron I-TREATMENT -46 I-TREATMENT -Gy I-TREATMENT -con I-TREATMENT -fraccionamiento I-TREATMENT -clásico I-TREATMENT -(5 I-TREATMENT -x I-TREATMENT -200 I-TREATMENT -cGy) I-TREATMENT -junto I-TREATMENT -con I-TREATMENT -cinco I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -Cisplatino I-TREATMENT -(40 I-TREATMENT -mg/semanales). I-TREATMENT -Tras I-TREATMENT -finalizar I-TREATMENT -ambos I-TREATMENT -tratamiento I-TREATMENT -la I-TREATMENT -enferma I-TREATMENT -recibió I-TREATMENT -radioterapia I-TREATMENT -endocavitaria I-TREATMENT -mediante I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -molde I-TREATMENT -de I-TREATMENT -Chassagne I-TREATMENT -con I-TREATMENT -tres I-TREATMENT -fuentes I-TREATMENT -radioactivas I-TREATMENT -de I-TREATMENT -Cesio-137 I-TREATMENT -de I-TREATMENT -baja I-TREATMENT -tasa I-TREATMENT -de I-TREATMENT -dosis. I-TREATMENT -Recibió I-TREATMENT -además I-TREATMENT -tratamiento I-TREATMENT -oral I-TREATMENT -con I-TREATMENT -Tegafur. I-TREATMENT - I-TREATMENT -Tres B-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -terminado I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -ingresó I-EVOLUTION -por I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -suboclusión I-EVOLUTION -intestinal I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -manejó I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -conservadora. I-EVOLUTION -Presentó I-EVOLUTION -varios I-EVOLUTION -episodios I-EVOLUTION -similares I-EVOLUTION -con I-EVOLUTION -posterioridad I-EVOLUTION -y I-EVOLUTION -una I-EVOLUTION -pérdida I-EVOLUTION -de I-EVOLUTION -aproximadamente I-EVOLUTION -30 I-EVOLUTION -kg I-EVOLUTION -de I-EVOLUTION -peso. I-EVOLUTION -Fue B-TREATMENT -valorada I-TREATMENT +cava I-EXPLORATION +superior. I-EXPLORATION +Ante B-TREATMENT +esta I-TREATMENT +situación I-TREATMENT +se I-TREATMENT +colocó I-TREATMENT +catéter I-TREATMENT +permanente I-TREATMENT por I-TREATMENT -la I-TREATMENT -Unidad I-TREATMENT +abordaje I-TREATMENT +transhepático I-TREATMENT +a I-TREATMENT +través I-TREATMENT de I-TREATMENT -Nutrición I-TREATMENT -Clínica I-TREATMENT -que I-TREATMENT -recomendó I-TREATMENT -una I-TREATMENT -dieta I-TREATMENT -pobre I-TREATMENT +vena I-TREATMENT +suprahepática I-TREATMENT +derecha, I-TREATMENT +con I-TREATMENT +extremo I-TREATMENT en I-TREATMENT -grasas I-TREATMENT -y I-TREATMENT -residuos I-TREATMENT -y I-TREATMENT -suplementos I-TREATMENT -hipercalóricos I-TREATMENT +aurícula I-TREATMENT +derecha9. I-TREATMENT +Se I-TREATMENT +recambió I-TREATMENT +el I-TREATMENT +03/07/2012 I-TREATMENT por I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -sin I-TREATMENT -respuesta. I-TREATMENT -Ingresó B-EVOLUTION -para I-EVOLUTION -rehabilitación I-EVOLUTION -intestinal I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -peso I-EVOLUTION -de I-EVOLUTION -26 I-EVOLUTION -kg I-EVOLUTION -y I-EVOLUTION -una I-EVOLUTION -talla I-EVOLUTION +disfunción. I-TREATMENT +Desde B-EVOLUTION +entonces I-EVOLUTION +ha I-EVOLUTION +sufrido I-EVOLUTION +continuas I-EVOLUTION +infecciones I-EVOLUTION +que I-EVOLUTION +han I-EVOLUTION +obligado I-EVOLUTION +a I-EVOLUTION +instaurar I-EVOLUTION +tratamiento I-EVOLUTION +antibiótico I-EVOLUTION +casi I-EVOLUTION de I-EVOLUTION -148 I-EVOLUTION -cm. I-EVOLUTION -IMC: I-EVOLUTION -11, I-EVOLUTION -9 I-EVOLUTION -kg/m2. I-EVOLUTION -El B-EXPLORATION +manera I-EVOLUTION +continua. I-EVOLUTION + I-EVOLUTION +• I-EVOLUTION +En I-EVOLUTION +12/2012 I-EVOLUTION +sufre I-EVOLUTION +extrusión I-EVOLUTION +espontánea I-EVOLUTION +colocándose B-TREATMENT +catéter I-TREATMENT +femoral I-TREATMENT +provisional I-TREATMENT +izquierdo. I-TREATMENT + I-TREATMENT +• B-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +nuevo I-EXPLORATION estudio I-EXPLORATION -realizado I-EXPLORATION -durante I-EXPLORATION -el I-EXPLORATION -ingreso I-EXPLORATION -permitió I-EXPLORATION -descartar I-EXPLORATION -recidiva I-EXPLORATION -tumoral I-EXPLORATION +de I-EXPLORATION +troncos I-EXPLORATION +venosos I-EXPLORATION encontrando I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -tránsito I-EXPLORATION -digestivo I-EXPLORATION -superior I-EXPLORATION -una I-EXPLORATION -marcada I-EXPLORATION -dilatación I-EXPLORATION +oclusión I-EXPLORATION de I-EXPLORATION -duodeno I-EXPLORATION -y I-EXPLORATION -porción I-EXPLORATION -proximal I-EXPLORATION +vena I-EXPLORATION +iliaca I-EXPLORATION +con I-EXPLORATION +desviación I-EXPLORATION +del I-EXPLORATION +flujo I-EXPLORATION +por I-EXPLORATION +rama I-EXPLORATION +hipogástrica I-EXPLORATION +hasta I-EXPLORATION +iliaca I-EXPLORATION +común, I-EXPLORATION de I-EXPLORATION -yeyuno I-EXPLORATION -que I-EXPLORATION -llega I-EXPLORATION -a I-EXPLORATION -medir I-EXPLORATION -como I-EXPLORATION -diámetro I-EXPLORATION -máximo I-EXPLORATION -10 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -yeyuno I-EXPLORATION -proximal. I-EXPLORATION -Tránsito I-EXPLORATION -intestinal I-EXPLORATION -muy I-EXPLORATION -prolongado I-EXPLORATION +modo I-EXPLORATION que I-EXPLORATION -llega I-EXPLORATION -a I-EXPLORATION -demorarse I-EXPLORATION -alrededor I-EXPLORATION +no I-EXPLORATION +es I-EXPLORATION +subsidiaria I-EXPLORATION de I-EXPLORATION -48 I-EXPLORATION -horas I-EXPLORATION -desde I-EXPLORATION -que I-EXPLORATION +catéter I-EXPLORATION +de I-EXPLORATION +diálisis I-EXPLORATION +permanente I-EXPLORATION +por I-EXPLORATION +este I-EXPLORATION +acceso. I-EXPLORATION +La I-EXPLORATION +vena I-EXPLORATION +femoral I-EXPLORATION +común I-EXPLORATION +derecha I-EXPLORATION se I-EXPLORATION -administró I-EXPLORATION -el I-EXPLORATION -contraste I-EXPLORATION -hasta I-EXPLORATION -que I-EXPLORATION -alcanzó I-EXPLORATION -ciego I-EXPLORATION -y I-EXPLORATION -colon I-EXPLORATION -ascendente. I-EXPLORATION -En I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION +encontró I-EXPLORATION +permeable I-EXPLORATION +pero I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION -dilatación I-EXPLORATION -masiva I-EXPLORATION -de I-EXPLORATION -asas I-EXPLORATION +detectó I-EXPLORATION +flujo I-EXPLORATION +doppler I-EXPLORATION +en I-EXPLORATION +vena I-EXPLORATION +iliaca, I-EXPLORATION +probablemente I-EXPLORATION +por I-EXPLORATION +trombosis. I-EXPLORATION +Se I-EXPLORATION +realizaron I-EXPLORATION +flebografías I-EXPLORATION de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION +ambos I-EXPLORATION +brazos I-EXPLORATION +encontrando I-EXPLORATION que I-EXPLORATION -ocupan I-EXPLORATION -todo I-EXPLORATION el I-EXPLORATION -abdomen. I-EXPLORATION -Discreto I-EXPLORATION -engrosamiento I-EXPLORATION +flujo I-EXPLORATION +va I-EXPLORATION +por I-EXPLORATION +colaterales I-EXPLORATION +a I-EXPLORATION +intercostales I-EXPLORATION +hasta I-EXPLORATION +acigos-hemiacigos I-EXPLORATION de I-EXPLORATION +forma I-EXPLORATION +bilateral I-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -pared I-EXPLORATION +oclusión I-EXPLORATION de I-EXPLORATION las I-EXPLORATION -asas. I-EXPLORATION +venas I-EXPLORATION +subclavias. I-EXPLORATION Se I-EXPLORATION -realizó I-EXPLORATION +descartó I-EXPLORATION +colocar I-EXPLORATION un I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -hidrógeno I-EXPLORATION -espirado I-EXPLORATION -con I-EXPLORATION -lactosa I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION -malabsorción I-EXPLORATION +catéter I-EXPLORATION +por I-EXPLORATION +subclavia. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +ecografía I-EXPLORATION +doppler I-EXPLORATION de I-EXPLORATION +ambas I-EXPLORATION +yugulares I-EXPLORATION +visualizando I-EXPLORATION la I-EXPLORATION -misma. I-EXPLORATION -Una I-EXPLORATION -colonoscopia I-EXPLORATION -realizada I-EXPLORATION -en I-EXPLORATION -ese I-EXPLORATION -momento I-EXPLORATION -mostró I-EXPLORATION -signos I-EXPLORATION +vena I-EXPLORATION +yugular I-EXPLORATION +izquierda I-EXPLORATION +permeable I-EXPLORATION +aunque I-EXPLORATION +es I-EXPLORATION +muy I-EXPLORATION +probable I-EXPLORATION +estenosis I-EXPLORATION +central I-EXPLORATION +del I-EXPLORATION +tronco I-EXPLORATION +braquiocefálico I-EXPLORATION +venoso I-EXPLORATION +izquierdo I-EXPLORATION +dada I-EXPLORATION +la I-EXPLORATION +flebografía I-EXPLORATION de I-EXPLORATION -colitis I-EXPLORATION -distal I-EXPLORATION -que I-EXPLORATION -histológicamente I-EXPLORATION -correspondían I-EXPLORATION -a I-EXPLORATION -colitis I-EXPLORATION +ese I-EXPLORATION +miembro I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +yugular I-EXPLORATION +derecha I-EXPLORATION +ocluida I-EXPLORATION crónica I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -cambios I-EXPLORATION -postradioterapia. I-EXPLORATION -Se B-TREATMENT -colocó I-TREATMENT -una I-TREATMENT -sonda I-TREATMENT -nasogástrica I-TREATMENT -para I-TREATMENT -nutrición I-TREATMENT -enteral I-TREATMENT -continua I-TREATMENT -con I-TREATMENT -incapacidad I-TREATMENT -para I-TREATMENT -progresar I-TREATMENT +(no I-EXPLORATION +visible I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +ecografía). I-EXPLORATION + I-EXPLORATION +• B-TREATMENT +El I-TREATMENT +17/01/2013 I-TREATMENT +se I-TREATMENT +le I-TREATMENT +implantó I-TREATMENT +nuevo I-TREATMENT +catéter I-TREATMENT +transhepático I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +recambiado I-TREATMENT +el I-TREATMENT +20/03/2013 I-TREATMENT por I-TREATMENT -encima I-TREATMENT -de I-TREATMENT -30 I-TREATMENT -ml/hora I-TREATMENT -de I-TREATMENT -una I-TREATMENT -fórmula I-TREATMENT -polimérica I-TREATMENT -normocalórica, I-TREATMENT -y I-TREATMENT -sin I-TREATMENT -respuesta I-TREATMENT -a I-TREATMENT +disfunción. I-TREATMENT +Este B-EVOLUTION +es I-EVOLUTION +su I-EVOLUTION +acceso I-EVOLUTION +actual I-EVOLUTION +y I-EVOLUTION +probablemente I-EVOLUTION +el I-EVOLUTION +único I-EVOLUTION +posible. I-EVOLUTION + I-EVOLUTION +A I-EVOLUTION +todos I-EVOLUTION +estos I-EVOLUTION +problemas I-EVOLUTION +vasculares I-EVOLUTION +que I-EVOLUTION +ponen I-EVOLUTION +en I-EVOLUTION +riesgo I-EVOLUTION +su I-EVOLUTION +supervivencia I-EVOLUTION +se I-EVOLUTION +suma I-EVOLUTION +la I-EVOLUTION +situación I-EVOLUTION +social I-EVOLUTION +complicadísima I-EVOLUTION +que I-EVOLUTION +vive I-EVOLUTION +la I-EVOLUTION +paciente, I-EVOLUTION +ya I-EVOLUTION +que I-EVOLUTION +no I-EVOLUTION +recibe I-EVOLUTION +ningún I-EVOLUTION +apoyo I-EVOLUTION +familiar I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +totalmente I-EVOLUTION +desmotivada I-EVOLUTION +presentando I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +mayoría I-EVOLUTION +de I-EVOLUTION +ocasiones I-EVOLUTION +un I-EVOLUTION +comportamiento I-EVOLUTION +rebelde I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +rechazo I-EVOLUTION +a I-EVOLUTION +cualquier I-EVOLUTION +cambio I-EVOLUTION +en I-EVOLUTION +sus I-EVOLUTION +opciones I-EVOLUTION +de I-EVOLUTION +tratamiento, I-EVOLUTION +hecho I-EVOLUTION +que I-EVOLUTION +dificulta I-EVOLUTION +enormemente I-EVOLUTION +la I-EVOLUTION +labor I-EVOLUTION +de I-EVOLUTION +enfermería I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +ámbito I-EVOLUTION +de I-EVOLUTION +educación I-EVOLUTION +para I-EVOLUTION +la I-EVOLUTION +salud. I-EVOLUTION + I-EVOLUTION +Cabe B-TREATMENT +reseñar I-TREATMENT +que I-TREATMENT la I-TREATMENT -adición I-TREATMENT +paciente I-TREATMENT +rechaza I-TREATMENT +iniciar I-TREATMENT +cualquier I-TREATMENT +tipo I-TREATMENT de I-TREATMENT -procinéticos. I-TREATMENT +tratamiento I-TREATMENT +anticoagulante I-TREATMENT +(se I-TREATMENT +le I-TREATMENT +ha I-TREATMENT +propuesto I-TREATMENT +tomar I-TREATMENT +sintrom® I-TREATMENT +en I-TREATMENT +muchas I-TREATMENT +ocasiones). I-TREATMENT + I-TREATMENT Por I-TREATMENT -este I-TREATMENT -motivo I-TREATMENT -se I-TREATMENT -colocó I-TREATMENT -un I-TREATMENT -catéter I-TREATMENT -venoso I-TREATMENT -central I-TREATMENT -tunelizado I-TREATMENT -y I-TREATMENT +otra I-TREATMENT +parte I-TREATMENT se I-TREATMENT -incluyó I-TREATMENT +descartó I-TREATMENT +su I-TREATMENT +inclusión I-TREATMENT en I-TREATMENT -el I-TREATMENT -programa I-TREATMENT +la I-TREATMENT +lista I-TREATMENT de I-TREATMENT -NPD I-TREATMENT +trasplante I-TREATMENT +al I-TREATMENT +no I-TREATMENT +acudir I-TREATMENT +a I-TREATMENT +las I-TREATMENT +reiteradas I-TREATMENT +citas, I-TREATMENT +autoexcluyéndose I-TREATMENT +además I-TREATMENT +como I-TREATMENT +candidata I-TREATMENT +a I-TREATMENT +diálisis I-TREATMENT +peritoneal I-TREATMENT +dada I-TREATMENT +su I-TREATMENT +negativa I-TREATMENT +a I-TREATMENT +cumplir I-TREATMENT +con I-TREATMENT +las I-TREATMENT +pautas I-TREATMENT de I-TREATMENT -nuestro I-TREATMENT -centro. I-TREATMENT -Su I-TREATMENT -NP I-TREATMENT -inicial I-TREATMENT -consistía I-TREATMENT -en I-TREATMENT -1.250 I-TREATMENT -ml I-TREATMENT +tratamiento I-TREATMENT +propuestas I-TREATMENT +por I-TREATMENT +el I-TREATMENT +personal I-TREATMENT +médico I-TREATMENT +y I-TREATMENT de I-TREATMENT -volumen I-TREATMENT +enfermería. I-TREATMENT + I-TREATMENT +En I-TREATMENT +las I-TREATMENT +figuras I-TREATMENT +1 I-TREATMENT y I-TREATMENT -1.440 I-TREATMENT -kcal, I-TREATMENT -infundida I-TREATMENT -a I-TREATMENT -lo I-TREATMENT -largo I-TREATMENT +2 I-TREATMENT +se I-TREATMENT +muestra I-TREATMENT +el I-TREATMENT +acceso I-TREATMENT +actual I-TREATMENT de I-TREATMENT -10 I-TREATMENT -horas, I-TREATMENT -7 I-TREATMENT -días I-TREATMENT -a I-TREATMENT la I-TREATMENT -semana. I-TREATMENT +paciente: I-TREATMENT +el I-TREATMENT +catéter I-TREATMENT +transhepático. I-TREATMENT I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -inicial I-EVOLUTION -fue I-EVOLUTION -buena I-EVOLUTION -con I-EVOLUTION -progresiva I-EVOLUTION -recuperación I-EVOLUTION -del I-EVOLUTION -peso I-EVOLUTION -y I-EVOLUTION -buena I-EVOLUTION -tolerancia I-EVOLUTION +Cuidados I-TREATMENT +de I-TREATMENT +enfermería I-TREATMENT + I-TREATMENT +En B-EVOLUTION +cada I-EVOLUTION +sesión I-EVOLUTION +se I-EVOLUTION +informa I-EVOLUTION a I-EVOLUTION la I-EVOLUTION -NPD. I-EVOLUTION -Sin I-EVOLUTION -embargo, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -primer I-EVOLUTION -ingreso I-EVOLUTION -por I-EVOLUTION -una I-EVOLUTION -bacteriemia I-EVOLUTION -asociada I-EVOLUTION -a I-EVOLUTION -catéter. I-EVOLUTION -En I-EVOLUTION +paciente I-EVOLUTION +de I-EVOLUTION los I-EVOLUTION -siguientes I-EVOLUTION -14 I-EVOLUTION -meses I-EVOLUTION -fue I-EVOLUTION -ingresada I-EVOLUTION +cuidados I-EVOLUTION +que I-EVOLUTION +debe I-EVOLUTION +tener I-EVOLUTION +para I-EVOLUTION +cuidar I-EVOLUTION +al I-EVOLUTION +máximo I-EVOLUTION +su I-EVOLUTION +AV I-EVOLUTION +haciendo I-EVOLUTION +especial I-EVOLUTION +hincapié I-EVOLUTION en I-EVOLUTION -2 I-EVOLUTION -ocasiones I-EVOLUTION -por I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -deshidratación I-EVOLUTION -con I-EVOLUTION -afectación I-EVOLUTION -de I-EVOLUTION la I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -(insuficiencia I-EVOLUTION -renal I-EVOLUTION -prerrenal) I-EVOLUTION -secundarias I-EVOLUTION -a I-EVOLUTION -pérdidas I-EVOLUTION -aumentadas I-EVOLUTION -por I-EVOLUTION -vómitos I-EVOLUTION +importancia I-EVOLUTION +de I-EVOLUTION +mantener I-EVOLUTION +el I-EVOLUTION +apósito I-EVOLUTION +seco I-EVOLUTION y I-EVOLUTION -en I-EVOLUTION -9 I-EVOLUTION -por I-EVOLUTION -infecciones I-EVOLUTION -por I-EVOLUTION -diversos I-EVOLUTION -gérmenes I-EVOLUTION -Gram I-EVOLUTION -positivos, I-EVOLUTION -Gram I-EVOLUTION -negativos I-EVOLUTION +limpio I-EVOLUTION y I-EVOLUTION -hongos I-EVOLUTION +de I-EVOLUTION +informar I-EVOLUTION +al I-EVOLUTION +personal I-EVOLUTION +de I-EVOLUTION +enfermería I-EVOLUTION +acerca I-EVOLUTION +de I-EVOLUTION +cualquier I-EVOLUTION +incidencia I-EVOLUTION que I-EVOLUTION -obligaron I-EVOLUTION -a I-EVOLUTION -recambiar I-EVOLUTION -el I-EVOLUTION -catéter I-EVOLUTION +note, I-EVOLUTION +especialmente I-EVOLUTION +si I-EVOLUTION +aparece I-EVOLUTION +dolor I-EVOLUTION +o I-EVOLUTION +calor I-EVOLUTION en I-EVOLUTION -3 I-EVOLUTION -ocasiones. I-EVOLUTION -En I-EVOLUTION -todos I-EVOLUTION +la I-EVOLUTION +zona I-EVOLUTION +de I-EVOLUTION +inserción I-EVOLUTION +y I-EVOLUTION +fiebre. I-EVOLUTION + I-EVOLUTION +Todo I-EVOLUTION +el I-EVOLUTION +equipo I-EVOLUTION +de I-EVOLUTION +enfermería I-EVOLUTION +cumple I-EVOLUTION +con I-EVOLUTION los I-EVOLUTION -ingresos I-EVOLUTION -se I-EVOLUTION -hizo I-EVOLUTION -revisión I-EVOLUTION +protocolos I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -pautas I-EVOLUTION +cura I-EVOLUTION +del I-EVOLUTION +orificio I-EVOLUTION de I-EVOLUTION -manejo I-EVOLUTION +salida I-EVOLUTION del I-EVOLUTION -catéter I-EVOLUTION -venoso I-EVOLUTION -central I-EVOLUTION +catéter, I-EVOLUTION +conexión I-EVOLUTION y I-EVOLUTION +desconexión I-EVOLUTION +según I-EVOLUTION +los I-EVOLUTION +criterios I-EVOLUTION +aceptados I-EVOLUTION +en I-EVOLUTION +nuestra I-EVOLUTION +unidad I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -NPD I-EVOLUTION -sin I-EVOLUTION -poder I-EVOLUTION -constatar I-EVOLUTION -que I-EVOLUTION -hubiera I-EVOLUTION -quebrantamiento I-EVOLUTION -del I-EVOLUTION -protocolo. I-EVOLUTION -A B-TREATMENT -la I-TREATMENT -vista I-TREATMENT +diálisis: I-EVOLUTION + I-EVOLUTION +• B-TREATMENT +La I-TREATMENT +cura I-TREATMENT +del I-TREATMENT +orificio I-TREATMENT de I-TREATMENT -la I-TREATMENT -mala I-TREATMENT -evolución I-TREATMENT -clínica I-TREATMENT +salida I-TREATMENT +del I-TREATMENT +catéter I-TREATMENT +(OSC) I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +aséptica I-TREATMENT +con I-TREATMENT +cloruro I-TREATMENT +sódico I-TREATMENT +al I-TREATMENT +20%, I-TREATMENT +clorhexidina I-TREATMENT +alcohólica I-TREATMENT +al I-TREATMENT +2% I-TREATMENT y I-TREATMENT -a I-TREATMENT -la I-TREATMENT -remisión I-TREATMENT -completa I-TREATMENT +gasas I-TREATMENT +estériles, I-TREATMENT +observando I-TREATMENT de I-TREATMENT +forma I-TREATMENT +exhaustiva I-TREATMENT la I-TREATMENT -enfermedad I-TREATMENT -tumoral I-TREATMENT +zona I-TREATMENT +para I-TREATMENT +detectar I-TREATMENT +precozmente I-TREATMENT +la I-TREATMENT +aparición I-TREATMENT +de I-TREATMENT +eritema, I-TREATMENT +secreción, I-TREATMENT +etc. I-TREATMENT +Después I-TREATMENT se I-TREATMENT -decidió I-TREATMENT -plantear I-TREATMENT -una I-TREATMENT -solución I-TREATMENT -quirúrgica I-TREATMENT -alternativa. I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -nuevo I-EXPLORATION -tránsito I-EXPLORATION -digestivo I-EXPLORATION -con I-EXPLORATION -hallazgos I-EXPLORATION -similares I-EXPLORATION -al I-EXPLORATION -realizado I-EXPLORATION -dos I-EXPLORATION -años I-EXPLORATION -antes I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -enema I-EXPLORATION -opaco I-EXPLORATION -en I-EXPLORATION +cubre I-TREATMENT +el I-TREATMENT +orificio I-TREATMENT +con I-TREATMENT +un I-TREATMENT +apósito I-TREATMENT +estéril. I-TREATMENT + I-TREATMENT +• I-TREATMENT +El I-TREATMENT +sellado I-TREATMENT +de I-TREATMENT +las I-TREATMENT +ramas I-TREATMENT +del I-TREATMENT +catéter I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +con I-TREATMENT +Taurolock® I-TREATMENT +y I-TREATMENT +tapones I-TREATMENT +tipo I-TREATMENT +luer-lock. I-TREATMENT +Desde I-TREATMENT +el I-TREATMENT +último I-TREATMENT +recambio I-TREATMENT +del I-TREATMENT +catéter I-TREATMENT +transhepático I-TREATMENT +en I-TREATMENT +la I-TREATMENT +primera I-TREATMENT +sesión I-TREATMENT +de I-TREATMENT +diálisis I-TREATMENT +semanal I-TREATMENT +se I-TREATMENT +sella I-TREATMENT +con I-TREATMENT +Urokinasa I-TREATMENT +50.000 I-TREATMENT +UI/rama I-TREATMENT +como I-TREATMENT +terapia I-TREATMENT +fibrinolítica I-TREATMENT +intraluminal I-TREATMENT +según I-TREATMENT +protocolo I-TREATMENT +de I-TREATMENT +nuestra I-TREATMENT +unidad. I-TREATMENT + I-TREATMENT +Se B-EXPLORATION +valora I-EXPLORATION el I-EXPLORATION -que I-EXPLORATION +funcionamiento I-EXPLORATION +adecuado I-EXPLORATION +del I-EXPLORATION +catéter I-EXPLORATION +en I-EXPLORATION +cada I-EXPLORATION +sesión I-EXPLORATION +de I-EXPLORATION +hemodiálisis I-EXPLORATION +alcanzando I-EXPLORATION +flujos I-EXPLORATION +sanguíneos I-EXPLORATION +adecuados I-EXPLORATION +superiores I-EXPLORATION +a I-EXPLORATION +300 I-EXPLORATION +ml/min I-EXPLORATION +y I-EXPLORATION +Kt I-EXPLORATION +mayor I-EXPLORATION +de I-EXPLORATION +45 I-EXPLORATION +L. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +figura I-EXPLORATION +3 I-EXPLORATION se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION +muestran I-EXPLORATION +los I-EXPLORATION +datos I-EXPLORATION +obtenidos I-EXPLORATION de I-EXPLORATION -calibre I-EXPLORATION -en I-EXPLORATION +las I-EXPLORATION +sesiones I-EXPLORATION +de I-EXPLORATION +diálisis I-EXPLORATION +desde I-EXPLORATION +enero I-EXPLORATION +de I-EXPLORATION +2013. I-EXPLORATION + I-EXPLORATION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +20 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +mórbidos. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +cutánea I-PRESENT_ILLNESS +dolorosa I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +pápula, I-PRESENT_ILLNESS +pardo-negruzca, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +bordes I-PRESENT_ILLNESS +eritematosos, I-PRESENT_ILLNESS +ubicada I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +pulpejo I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +segundo I-PRESENT_ILLNESS +ortejo I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +pie I-PRESENT_ILLNESS +izquierdo. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION -porción I-EXPLORATION -más I-EXPLORATION -distal I-EXPLORATION +superficie I-EXPLORATION de I-EXPLORATION -sigma, I-EXPLORATION -aunque I-EXPLORATION -permite I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +múltiples I-EXPLORATION +huevecillos I-EXPLORATION +de I-EXPLORATION +color I-EXPLORATION +blanco, I-EXPLORATION +de I-EXPLORATION +menos I-EXPLORATION +de I-EXPLORATION +1 I-EXPLORATION +mm I-EXPLORATION +de I-EXPLORATION +diámetro. I-EXPLORATION +La B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +regresado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +viaje I-PAST_MEDICAL_HISTORY +turístico I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +Paraguay I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +días I-PAST_MEDICAL_HISTORY +antes. I-PAST_MEDICAL_HISTORY +Se B-TREATMENT +realizó I-TREATMENT +la I-TREATMENT +extracción I-TREATMENT +quirúrgica I-TREATMENT +de I-TREATMENT +los I-TREATMENT +parásitos. I-TREATMENT +Además I-TREATMENT +se I-TREATMENT +indicaron I-TREATMENT +antibacterianos I-TREATMENT +tópicos I-TREATMENT +y I-TREATMENT +profilaxis I-TREATMENT +antitetánica, I-TREATMENT +con B-EVOLUTION +resolución I-EVOLUTION +total I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +lesiones. I-EVOLUTION + I-EVOLUTION + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +herida I-PAST_MEDICAL_HISTORY +corneal I-PAST_MEDICAL_HISTORY +postraumática I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +ojo I-PAST_MEDICAL_HISTORY +izquierdo I-PAST_MEDICAL_HISTORY +(OI), I-PAST_MEDICAL_HISTORY +suturada I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +mismo I-PAST_MEDICAL_HISTORY +día I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +accidente, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +cuerpo I-PAST_MEDICAL_HISTORY +extraño I-PAST_MEDICAL_HISTORY +intraocular, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +antibióticos, I-PAST_MEDICAL_HISTORY +ciclopléjicos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +esteroides I-PAST_MEDICAL_HISTORY +tópicos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sistémicos. I-PAST_MEDICAL_HISTORY +Al B-DERIVED_FROM/TO +suspender I-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +esteroides, I-DERIVED_FROM/TO +presentó I-DERIVED_FROM/TO +disminución I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +agudeza I-DERIVED_FROM/TO +visual I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +ojo I-DERIVED_FROM/TO +no I-DERIVED_FROM/TO +traumatizado, I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +lo I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +reinició I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +administración I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +prednisona I-DERIVED_FROM/TO +vía I-DERIVED_FROM/TO +oral I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +envió I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestra I-DERIVED_FROM/TO +institución I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +diagnóstico I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +oftalmía I-DERIVED_FROM/TO +simpática. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +A B-EXPLORATION +su I-EXPLORATION +ingreso, I-EXPLORATION +un I-EXPLORATION +mes I-EXPLORATION +y I-EXPLORATION +medio I-EXPLORATION +después I-EXPLORATION +del I-EXPLORATION +traumatismo, I-EXPLORATION el I-EXPLORATION -paso I-EXPLORATION +paciente I-EXPLORATION +refería I-EXPLORATION +disminución I-EXPLORATION de I-EXPLORATION -papilla I-EXPLORATION -sin I-EXPLORATION -ninguna I-EXPLORATION -dificultad: I-EXPLORATION -no I-EXPLORATION -hay I-EXPLORATION -áreas I-EXPLORATION +la I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +(AV) I-EXPLORATION +del I-EXPLORATION +ojo I-EXPLORATION +derecho I-EXPLORATION +(OD) I-EXPLORATION de I-EXPLORATION -estenosis. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION +21 I-EXPLORATION +días I-EXPLORATION +de I-EXPLORATION +evolución I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +escotoma I-EXPLORATION +central I-EXPLORATION +relativo I-EXPLORATION +en I-EXPLORATION +AO. I-EXPLORATION +A I-EXPLORATION la I-EXPLORATION -laparotomía I-EXPLORATION -media I-EXPLORATION -supra I-EXPLORATION -e I-EXPLORATION -infraumbilical I-EXPLORATION +exploración I-EXPLORATION +oftalmológica I-EXPLORATION se I-EXPLORATION encontró I-EXPLORATION una I-EXPLORATION -gran I-EXPLORATION -dilatación I-EXPLORATION +AV I-EXPLORATION de I-EXPLORATION -duodeno I-EXPLORATION +20/60 I-EXPLORATION +OD I-EXPLORATION y I-EXPLORATION +20/400 I-EXPLORATION +OI, I-EXPLORATION +presión I-EXPLORATION +intraocular I-EXPLORATION de I-EXPLORATION -delgado I-EXPLORATION -hasta I-EXPLORATION -llegar I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -grupo I-EXPLORATION +11 I-EXPLORATION +mmHg I-EXPLORATION +OD I-EXPLORATION +y I-EXPLORATION +12 I-EXPLORATION +mmHg I-EXPLORATION +OI. I-EXPLORATION +El I-EXPLORATION +OD I-EXPLORATION +presentaba I-EXPLORATION +además I-EXPLORATION +células I-EXPLORATION de I-EXPLORATION -asas I-EXPLORATION -yeyunoileales I-EXPLORATION -adheridas I-EXPLORATION -entre I-EXPLORATION -sí I-EXPLORATION +pigmento I-EXPLORATION +1/2 I-EXPLORATION ++ I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cámara I-EXPLORATION +anterior, I-EXPLORATION +sin I-EXPLORATION +flare. I-EXPLORATION +El I-EXPLORATION +segmento I-EXPLORATION +anterior I-EXPLORATION +del I-EXPLORATION +OI I-EXPLORATION +presentaba I-EXPLORATION +conjuntiva I-EXPLORATION +hiperémica, I-EXPLORATION +herida I-EXPLORATION +corneal I-EXPLORATION +suturada I-EXPLORATION +con I-EXPLORATION +leucoma I-EXPLORATION +temporal, I-EXPLORATION +sinequias I-EXPLORATION +posteriores I-EXPLORATION y I-EXPLORATION -a I-EXPLORATION +opacidad I-EXPLORATION +subcapsular I-EXPLORATION +posterior I-EXPLORATION ++. I-EXPLORATION +La I-EXPLORATION +funduscopia I-EXPLORATION +del I-EXPLORATION +OD I-EXPLORATION +mostraba I-EXPLORATION +pliegues I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -pelvis I-EXPLORATION +mácula I-EXPLORATION +y I-EXPLORATION +dos I-EXPLORATION +lesiones I-EXPLORATION +blanco I-EXPLORATION +amarillentas I-EXPLORATION con I-EXPLORATION -un I-EXPLORATION -colon I-EXPLORATION +líquido I-EXPLORATION +subretiniano; I-EXPLORATION +el I-EXPLORATION +OI I-EXPLORATION +tenía I-EXPLORATION +tres I-EXPLORATION +lesiones I-EXPLORATION de I-EXPLORATION -calibre I-EXPLORATION -normal. I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -liberar I-TREATMENT -las I-TREATMENT -asas I-TREATMENT -afectadas I-TREATMENT -y I-TREATMENT -resecar I-TREATMENT -20 I-TREATMENT -cm I-TREATMENT +características I-EXPLORATION +similares, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +panuveítis I-EXPLORATION +bilateral. I-EXPLORATION +El B-TREATMENT +tratamiento I-TREATMENT +que I-TREATMENT +recibía I-TREATMENT +consistía I-TREATMENT +en I-TREATMENT +prednisona I-TREATMENT +75 I-TREATMENT +mg/día I-TREATMENT +po, I-TREATMENT +acetato I-TREATMENT de I-TREATMENT -yeyunoíleon I-TREATMENT -incluyendo I-TREATMENT -el I-TREATMENT -segmento I-TREATMENT -patológico, I-TREATMENT -con I-TREATMENT -una I-TREATMENT -anastomosis I-TREATMENT -laterolateral. I-TREATMENT +prednisolona I-TREATMENT +1% I-TREATMENT +cada I-TREATMENT +2 I-TREATMENT +h, I-TREATMENT +ciclopentolato I-TREATMENT +1% I-TREATMENT +bid, I-TREATMENT +fenilefrina I-TREATMENT +10% I-TREATMENT +bid. I-TREATMENT + I-TREATMENT El B-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION +aspecto I-EXPLORATION +clínico I-EXPLORATION +hizo I-EXPLORATION +sospechar I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +CSC. I-EXPLORATION +Se I-EXPLORATION +solicitaron I-EXPLORATION +ecografía I-EXPLORATION +y I-EXPLORATION +estudio I-EXPLORATION +angiográfico. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +evidenció I-EXPLORATION +un I-EXPLORATION +desprendimiento I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -pieza: I-EXPLORATION -"intestino I-EXPLORATION -con I-EXPLORATION -atrofia I-EXPLORATION -parcial I-EXPLORATION +hialoides I-EXPLORATION +posterior I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +OD I-EXPLORATION +y I-EXPLORATION +DRS I-EXPLORATION +en I-EXPLORATION +área I-EXPLORATION +macular I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +OI; I-EXPLORATION +el I-EXPLORATION +grosor I-EXPLORATION +coroideo I-EXPLORATION +era I-EXPLORATION +normal I-EXPLORATION +en I-EXPLORATION +AO. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +angiográfico I-EXPLORATION +mostró I-EXPLORATION +dos I-EXPLORATION +zonas I-EXPLORATION de I-EXPLORATION -vellosidades I-EXPLORATION +hiperfluorescencia I-EXPLORATION +que I-EXPLORATION +aumentaban I-EXPLORATION +progresivamente I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +OD I-EXPLORATION y I-EXPLORATION -fibrosis I-EXPLORATION -subserosa I-EXPLORATION -con I-EXPLORATION -adherencias, I-EXPLORATION -propio I-EXPLORATION +tres I-EXPLORATION +lesiones I-EXPLORATION +similares I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +OI. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +definitivo I-EXPLORATION +fue I-EXPLORATION de I-EXPLORATION -cambios I-EXPLORATION -postradioterapia". I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -tuvo I-EVOLUTION -una I-EVOLUTION -excelente I-EVOLUTION -recuperación, I-EVOLUTION -con I-EVOLUTION -tolerancia I-EVOLUTION -alimentaria I-EVOLUTION -y I-EVOLUTION -tránsito I-EVOLUTION -intestinal I-EVOLUTION -normal. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION +CSC I-EXPLORATION +bilateral I-EXPLORATION +de I-EXPLORATION +focos I-EXPLORATION +múltiples. I-EXPLORATION +Se B-TREATMENT +suspendió I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +ciclopléjicos I-TREATMENT +y I-TREATMENT +se I-TREATMENT +redujeron I-TREATMENT +rápidamente I-TREATMENT +los I-TREATMENT +esteroides I-TREATMENT +tópicos I-TREATMENT +y I-TREATMENT +sistémicos. I-TREATMENT +Un B-EVOLUTION +mes I-EVOLUTION +más I-EVOLUTION +tarde I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION -lleva I-EVOLUTION -una I-EVOLUTION -vida I-EVOLUTION -normal, I-EVOLUTION -es I-EVOLUTION -capaz I-EVOLUTION -de I-EVOLUTION -tolerar I-EVOLUTION -una I-EVOLUTION -dieta I-EVOLUTION -variada I-EVOLUTION -con I-EVOLUTION -restricción I-EVOLUTION +agudeza I-EVOLUTION +visual I-EVOLUTION +era I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -lactosa I-EVOLUTION +1 I-EVOLUTION +OD I-EVOLUTION y I-EVOLUTION -había I-EVOLUTION -recuperado I-EVOLUTION +0, I-EVOLUTION +2 I-EVOLUTION +OI; I-EVOLUTION el I-EVOLUTION -peso I-EVOLUTION -anterior I-EVOLUTION -al I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -radioterapia. I-EVOLUTION +aspecto I-EVOLUTION +clínico I-EVOLUTION +del I-EVOLUTION +fondo I-EVOLUTION +de I-EVOLUTION +ojo I-EVOLUTION +mostraba I-EVOLUTION +las I-EVOLUTION +lesiones I-EVOLUTION +pigmentadas I-EVOLUTION +sin I-EVOLUTION +líquido I-EVOLUTION +subretiniano I-EVOLUTION +en I-EVOLUTION +AO. I-EVOLUTION I-EVOLUTION -Varón B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -42 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -primer B-PAST_MEDICAL_HISTORY -hijo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -padres I-PAST_MEDICAL_HISTORY -sanos I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -consanguíneos, I-PAST_MEDICAL_HISTORY -diagnosticado B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ecografía I-PRESENT_ILLNESS -prenatal I-PRESENT_ILLNESS +14 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -ureterohidronefrosis I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dilatación I-PRESENT_ILLNESS -gástrica. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -período I-EXPLORATION -neonatal I-EXPLORATION -precoz I-EXPLORATION -únicamente I-EXPLORATION -llamó I-EXPLORATION -la I-EXPLORATION -atención, I-EXPLORATION -un I-EXPLORATION -abdomen I-EXPLORATION -globuloso I-EXPLORATION -y I-EXPLORATION +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +salud I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +febril I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +39 I-PRESENT_ILLNESS +oC I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +tos, I-PRESENT_ILLNESS +mocos, I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +líquidas I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +frecuentes, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +inapetencia I-PRESENT_ILLNESS +parcial. I-PRESENT_ILLNESS +A B-EXPLORATION la I-EXPLORATION -primera I-EXPLORATION -deposición I-EXPLORATION -meconial I-EXPLORATION -al I-EXPLORATION -4º I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -vida, I-EXPLORATION +exploración, I-EXPLORATION +destaca I-EXPLORATION +eritema I-EXPLORATION +amigdalar I-EXPLORATION con I-EXPLORATION -ausencia I-EXPLORATION -absoluta I-EXPLORATION -posterior I-EXPLORATION -de I-EXPLORATION -deposiciones. I-EXPLORATION -Un I-EXPLORATION -enema I-EXPLORATION -opaco I-EXPLORATION -evidenció I-EXPLORATION -microcolon I-EXPLORATION -y I-EXPLORATION -malrotación I-EXPLORATION -intestinal, I-EXPLORATION -corrigiéndose I-EXPLORATION -éstaúltima I-EXPLORATION -quirúrgicamente. I-EXPLORATION -Una I-EXPLORATION -biopsia I-EXPLORATION -rectal I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -enolasa I-EXPLORATION -neuronal I-EXPLORATION +exudado I-EXPLORATION +escaso, I-EXPLORATION +moco I-EXPLORATION +en I-EXPLORATION +cavum, I-EXPLORATION +eritema I-EXPLORATION +timpánico I-EXPLORATION +sin I-EXPLORATION +otros I-EXPLORATION +signos I-EXPLORATION y I-EXPLORATION -descartó I-EXPLORATION -aganglionismo. I-EXPLORATION +eritema I-EXPLORATION +conjuntival I-EXPLORATION +sin I-EXPLORATION +otras I-EXPLORATION +alteraciones. I-EXPLORATION Se B-TREATMENT -mantuvo I-TREATMENT -en I-TREATMENT -todo I-TREATMENT -momento I-TREATMENT -con I-TREATMENT -nutrición I-TREATMENT -parenteral, I-TREATMENT -con I-TREATMENT -intentos I-TREATMENT -de I-TREATMENT -ingesta I-TREATMENT -oral I-TREATMENT -que I-TREATMENT -toleró I-TREATMENT -finalmente I-TREATMENT -a I-TREATMENT -los I-TREATMENT -2 I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -vida I-TREATMENT -con I-TREATMENT -un I-TREATMENT -volumen I-TREATMENT -máximo I-TREATMENT +diagnostica I-TREATMENT de I-TREATMENT -7 I-TREATMENT -ml/h. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -siempre I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -diuresis I-EVOLUTION -adecuada, I-EVOLUTION -aunque I-EVOLUTION -mantenía I-EVOLUTION -las I-EVOLUTION -cifras I-EVOLUTION -de I-EVOLUTION -creatinina I-EVOLUTION -en I-EVOLUTION -límites I-EVOLUTION -altos I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -normalidad. I-EVOLUTION -Posteriormente B-TREATMENT +viriasis I-TREATMENT +y I-TREATMENT se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -pieloureterostomía I-TREATMENT -bilateral I-TREATMENT -mejorando I-TREATMENT -su I-TREATMENT -función I-TREATMENT -renal. I-TREATMENT +recomienda I-TREATMENT +tratamiento I-TREATMENT +sintomático. I-TREATMENT + I-TREATMENT A B-EVOLUTION los I-EVOLUTION -20 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -sepsis I-EVOLUTION -nosocomial I-EVOLUTION -relacionada I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -catéter I-EVOLUTION -por I-EVOLUTION -Staphylococcus I-EVOLUTION -epidermidis, I-EVOLUTION -tratada B-TREATMENT -con I-TREATMENT -teicoplanina I-TREATMENT -y I-TREATMENT -cefotaxima I-TREATMENT -con B-EVOLUTION -buena I-EVOLUTION -respuesta9. I-EVOLUTION -Estos I-EVOLUTION -datos I-EVOLUTION -amplían I-EVOLUTION -lo I-EVOLUTION -ya I-EVOLUTION -publicado I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -año I-EVOLUTION -2004 I-EVOLUTION +tres I-EVOLUTION +días, I-EVOLUTION +acude I-EVOLUTION +al I-EVOLUTION +hospital I-EVOLUTION por I-EVOLUTION -parte I-EVOLUTION -del I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Neonatología I-EVOLUTION -y I-EVOLUTION -del I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Cirugía I-EVOLUTION -Pediátrica I-EVOLUTION -del I-EVOLUTION -Hospital I-EVOLUTION -Universitario I-EVOLUTION -Central I-EVOLUTION +aparición I-EVOLUTION de I-EVOLUTION -Asturias10. I-EVOLUTION - I-EVOLUTION -Actualmente I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -buen I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -ureterostomía I-EVOLUTION -cutánea I-EVOLUTION -bilateral, I-EVOLUTION -peristaltismo I-EVOLUTION -y I-EVOLUTION -hábito I-EVOLUTION -intestinal I-EVOLUTION -conservados, I-EVOLUTION -relativamente I-EVOLUTION -bien I-EVOLUTION -nutrido I-EVOLUTION +lesiones I-EVOLUTION +purpúricas I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +miembros I-EVOLUTION +inferiores I-EVOLUTION y I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -aceptable I-EVOLUTION +los I-EVOLUTION +pabellones I-EVOLUTION +auriculares, I-EVOLUTION y I-EVOLUTION -progresivo I-EVOLUTION -desarrollo I-EVOLUTION -ponderal: I-EVOLUTION -percentil I-EVOLUTION -10 I-EVOLUTION +edema I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +dorso I-EVOLUTION de I-EVOLUTION -peso I-EVOLUTION +manos I-EVOLUTION y I-EVOLUTION -talla, I-EVOLUTION -índice I-EVOLUTION -de I-EVOLUTION -Waterlow I-EVOLUTION -del I-EVOLUTION -96%. I-EVOLUTION +pies. I-EVOLUTION +Se B-EXPLORATION +ingresa I-EXPLORATION +durante I-EXPLORATION +cinco I-EXPLORATION +días I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +púrpura I-EXPLORATION +de I-EXPLORATION +Schönlein-Henoch I-EXPLORATION +con I-EXPLORATION +estudio I-EXPLORATION +analítico I-EXPLORATION +sanguíneo I-EXPLORATION +con I-EXPLORATION +coagulación I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION +(tanto I-EXPLORATION +en I-EXPLORATION +fase I-EXPLORATION +aguda I-EXPLORATION +como I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +dos I-EXPLORATION +meses I-EXPLORATION +posteriores) I-EXPLORATION +sin I-EXPLORATION +proteinuria I-EXPLORATION +ni I-EXPLORATION +hematuria. I-EXPLORATION Recibe B-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -(NP) I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -tercer I-TREATMENT -día I-TREATMENT -de I-TREATMENT -vida I-TREATMENT -y I-TREATMENT -actualmente I-TREATMENT -en I-TREATMENT -régimen I-TREATMENT -ambulatorio, I-TREATMENT -suplementada I-TREATMENT -con I-TREATMENT -aportes I-TREATMENT -orales I-TREATMENT -a I-TREATMENT -débito I-TREATMENT -continuo, I-TREATMENT -desde I-TREATMENT -que I-TREATMENT -inició I-TREATMENT -tolerancia I-TREATMENT -a I-TREATMENT -los I-TREATMENT -mismos. I-TREATMENT -La I-TREATMENT -composición I-TREATMENT -de I-TREATMENT -la I-TREATMENT -NP I-TREATMENT +penicilina I-TREATMENT +oral I-TREATMENT por I-TREATMENT -kg I-TREATMENT -de I-TREATMENT -peso I-TREATMENT -y I-TREATMENT -día I-TREATMENT -es I-TREATMENT -de I-TREATMENT -1, I-TREATMENT -8 I-TREATMENT -g I-TREATMENT -de I-TREATMENT -aminoácidos, I-TREATMENT -8, I-TREATMENT -6 I-TREATMENT -g I-TREATMENT -de I-TREATMENT -glucosa, I-TREATMENT -1, I-TREATMENT -4 I-TREATMENT -g I-TREATMENT -lípidos, I-TREATMENT -Na I-TREATMENT -3, I-TREATMENT -7 I-TREATMENT -mEq, I-TREATMENT -k I-TREATMENT -1, I-TREATMENT -4 I-TREATMENT -mEq, I-TREATMENT -Ca I-TREATMENT -0, I-TREATMENT -7 I-TREATMENT -mEq, I-TREATMENT -Cl I-TREATMENT -4, I-TREATMENT -4 I-TREATMENT -mEq, I-TREATMENT -P I-TREATMENT -0, I-TREATMENT -2 I-TREATMENT -mEq, I-TREATMENT -Mg I-TREATMENT -0, I-TREATMENT -3 I-TREATMENT -mEq, I-TREATMENT -contiene I-TREATMENT -55, I-TREATMENT -7 I-TREATMENT -kcal I-TREATMENT -totales I-TREATMENT -y I-TREATMENT -un I-TREATMENT -volumen I-TREATMENT -total I-TREATMENT +sospecha I-TREATMENT de I-TREATMENT -1.295 I-TREATMENT -ml. I-TREATMENT -La I-TREATMENT -NP I-TREATMENT -es I-TREATMENT -perfundida I-TREATMENT -durante I-TREATMENT -17 I-TREATMENT -horas, I-TREATMENT -en I-TREATMENT -pases I-TREATMENT -de I-TREATMENT -40 I-TREATMENT -ml/hora, I-TREATMENT -con I-TREATMENT -ascenso I-TREATMENT -y I-TREATMENT -descenso I-TREATMENT +etiología I-TREATMENT +estreptocócica, I-TREATMENT +encontrándose I-TREATMENT en I-TREATMENT -una I-TREATMENT -hora, I-TREATMENT -siendo I-TREATMENT el I-TREATMENT -tiempo I-TREATMENT -de I-TREATMENT -reposo I-TREATMENT -sin I-TREATMENT -NPD I-TREATMENT -de I-TREATMENT -7 I-TREATMENT -horas. I-TREATMENT -Recibe I-TREATMENT +cultivo I-TREATMENT +del I-TREATMENT +frotis I-TREATMENT +faríngeo I-TREATMENT +un I-TREATMENT +S. I-TREATMENT +pyogenes I-TREATMENT +del I-TREATMENT +grupo I-TREATMENT +A. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +nueve I-EVOLUTION +días I-EVOLUTION +del I-EVOLUTION +ingreso, I-EVOLUTION +acude I-EVOLUTION +al I-EVOLUTION +centro I-EVOLUTION +de I-EVOLUTION +salud, I-EVOLUTION +donde I-EVOLUTION +se I-EVOLUTION +objetivan I-EVOLUTION +lesiones I-EVOLUTION +residuales I-EVOLUTION +de I-EVOLUTION +púrpura, I-EVOLUTION +sin I-EVOLUTION +edema I-EVOLUTION +articular. I-EVOLUTION +Se B-EXPLORATION +realiza I-EXPLORATION +un I-EXPLORATION +nuevo I-EXPLORATION +frotis I-EXPLORATION +faríngeo, I-EXPLORATION +que I-EXPLORATION +resulta I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION + +Una B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +sana I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +74 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +acude B-DERIVED_FROM/TO +referida I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +oftalmólogo I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +evaluación I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +tratamiento I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +ojo I-DERIVED_FROM/TO +rojo I-DERIVED_FROM/TO +doloroso I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +aproximadamente I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +mes I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +evolución. I-DERIVED_FROM/TO +No B-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +excepción I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cirugía I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +catarata I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +complicada I-PAST_MEDICAL_HISTORY +(facoemulsificación) I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +ese I-PAST_MEDICAL_HISTORY +mismo I-PAST_MEDICAL_HISTORY +ojo I-PAST_MEDICAL_HISTORY +unos I-PAST_MEDICAL_HISTORY +cuatro I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +antes. I-PAST_MEDICAL_HISTORY +La B-EXPLORATION +exploración I-EXPLORATION +oftalmológica I-EXPLORATION +reveló I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +sobreelevada I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +limbo I-EXPLORATION +superonasal I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +ojo I-EXPLORATION +izquierdo I-EXPLORATION +(próxima I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +incisión I-EXPLORATION +quirúrgica) I-EXPLORATION +asociada I-EXPLORATION +a I-EXPLORATION +múltiples I-EXPLORATION +microinfiltrados I-EXPLORATION +corneales, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +ingurgitación I-EXPLORATION +vascular I-EXPLORATION +conjuntival I-EXPLORATION +y I-EXPLORATION +del I-EXPLORATION +plexo I-EXPLORATION +escleral I-EXPLORATION +profundo. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT tratamiento I-TREATMENT -profiláctico I-TREATMENT -frente I-TREATMENT -al I-TREATMENT -sobrecrecimiento I-TREATMENT -bacteriano I-TREATMENT -intestinal I-TREATMENT con I-TREATMENT -metronidazol, I-TREATMENT +colirios I-TREATMENT +antibióticos I-TREATMENT +de I-TREATMENT +amplio I-TREATMENT +espectro, I-TREATMENT +añadiéndose I-TREATMENT además I-TREATMENT +instilaciones I-TREATMENT de I-TREATMENT -trimetropim, I-TREATMENT -fenobarbital, I-TREATMENT -hierro, I-TREATMENT -ácido I-TREATMENT -ursodesoxicólico, I-TREATMENT -ranitidina, I-TREATMENT -eritromicina, I-TREATMENT -vitamina I-TREATMENT -E, I-TREATMENT -vitamina I-TREATMENT -D3 I-TREATMENT +colirios I-TREATMENT +de I-TREATMENT +suero I-TREATMENT +autólogo I-TREATMENT y I-TREATMENT -darbepoetina. I-TREATMENT -Mensualmente, B-EXPLORATION +medroxiprogesterona. I-TREATMENT + I-TREATMENT +Debido B-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +escasa I-EXPLORATION +respuesta I-EXPLORATION +al I-EXPLORATION +tratamiento, I-EXPLORATION se I-EXPLORATION -realiza I-EXPLORATION -control I-EXPLORATION -clínico, I-EXPLORATION -analítico I-EXPLORATION -(bioquímica I-EXPLORATION -completa, I-EXPLORATION -función I-EXPLORATION -renal, I-EXPLORATION -hemograma I-EXPLORATION -y I-EXPLORATION +solicitaron I-EXPLORATION +diversas I-EXPLORATION +pruebas I-EXPLORATION +serológicas I-EXPLORATION +(incluyendo I-EXPLORATION +bioquímica, I-EXPLORATION +hemograma, I-EXPLORATION reactantes I-EXPLORATION de I-EXPLORATION fase I-EXPLORATION -aguda) I-EXPLORATION -y I-EXPLORATION -control I-EXPLORATION -microbiológico I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -de I-EXPLORATION -ostomías I-EXPLORATION +aguda I-EXPLORATION y I-EXPLORATION +marcadores I-EXPLORATION de I-EXPLORATION -catéter I-EXPLORATION -Hickman. I-EXPLORATION -Ha B-EVOLUTION -presentado I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -obstrucción I-EVOLUTION -abdominal, I-EVOLUTION -uno B-TREATMENT -de I-TREATMENT -los I-TREATMENT -cuales, I-TREATMENT -secundario I-TREATMENT -a I-TREATMENT -bridas I-TREATMENT -intestinales, I-TREATMENT -requirió I-TREATMENT -intervención I-TREATMENT -quirúrgica. I-TREATMENT -Las B-EVOLUTION -complicaciones I-EVOLUTION -relacionadas I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -NP I-EVOLUTION -han I-EVOLUTION -sido I-EVOLUTION -dos: I-EVOLUTION -citolisis I-EVOLUTION -hepática I-EVOLUTION -transitoria, I-EVOLUTION -que B-TREATMENT -remitió I-TREATMENT -tras I-TREATMENT -normalizar I-TREATMENT -la I-TREATMENT -relación I-TREATMENT -de I-TREATMENT -calorías I-TREATMENT -procedentes I-TREATMENT -de I-TREATMENT -hidratos I-TREATMENT -de I-TREATMENT -carbono I-TREATMENT -frente I-TREATMENT -a I-TREATMENT -grasas I-TREATMENT -(60/40) I-TREATMENT -(durante I-TREATMENT -este I-TREATMENT -período I-TREATMENT -tenía I-TREATMENT -niveles I-TREATMENT -elevados I-TREATMENT -de I-TREATMENT -GOT, I-TREATMENT -GPT, I-TREATMENT -fosfatasa I-TREATMENT -alcalina I-TREATMENT -y I-TREATMENT -bilirrubina, I-TREATMENT -que I-TREATMENT +autoinmunidad). I-EXPLORATION +Paralelamente B-TREATMENT se I-TREATMENT -normalizaron) I-TREATMENT -y B-EVOLUTION -una I-EVOLUTION -sepsis I-EVOLUTION -nosocomial I-EVOLUTION -relacionada I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -catéter I-EVOLUTION -por I-EVOLUTION -Staphylococcus I-EVOLUTION -epidermidis, I-EVOLUTION -que B-TREATMENT -respondió I-TREATMENT -adecuadamente I-TREATMENT -a I-TREATMENT +inició I-TREATMENT tratamiento I-TREATMENT -antibiótico. I-TREATMENT - I-TREATMENT - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -86 I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -enero I-PRESENT_ILLNESS -2008 I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hipoglucemia I-PRESENT_ILLNESS -secundaria I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -antidiabéticos I-PRESENT_ILLNESS -orales, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -demencia I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -ingesta, I-PRESENT_ILLNESS -se B-TREATMENT -decide I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -sonda I-TREATMENT -nasogástrica I-TREATMENT -(SNG) I-TREATMENT -para I-TREATMENT -alimentación I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -enteral, I-TREATMENT -tras I-TREATMENT -presentar I-TREATMENT -varios I-TREATMENT -episodios I-TREATMENT +con I-TREATMENT +corticoides I-TREATMENT +sistémicos I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT de I-TREATMENT -arrancamiento I-TREATMENT +1 I-TREATMENT +mg/kg. I-TREATMENT +Además I-TREATMENT +decidimos I-TREATMENT +tomar I-TREATMENT +una I-TREATMENT +muestra I-TREATMENT +escleroconjuntival, I-TREATMENT +previa I-TREATMENT +resección I-TREATMENT de I-TREATMENT -sonda, I-TREATMENT -se I-TREATMENT -practicó I-TREATMENT -gastrostomía I-TREATMENT -radiológica I-TREATMENT -percutánea I-TREATMENT -(GRP). I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -acude I-EVOLUTION -al I-EVOLUTION -servicio I-EVOLUTION -de I-EVOLUTION -urgencias I-EVOLUTION -por I-EVOLUTION -arrancamiento I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sonda I-EVOLUTION -de I-EVOLUTION -gastrostomía, I-EVOLUTION -ante B-TREATMENT la I-TREATMENT -ausencia I-TREATMENT -de I-TREATMENT -sondas I-TREATMENT +conjuntiva I-TREATMENT +adyacente, I-TREATMENT +con I-TREATMENT +posterior I-TREATMENT +implante I-TREATMENT de I-TREATMENT -recambio, I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -colocación I-TREATMENT +membrana I-TREATMENT +amniótica I-TREATMENT +(técnica I-TREATMENT +«inlay») I-TREATMENT +unido I-TREATMENT +a I-TREATMENT +la I-TREATMENT +aplicación I-TREATMENT de I-TREATMENT -sonda I-TREATMENT -Foley I-TREATMENT +adhesivo I-TREATMENT +biológico I-TREATMENT +(Fibrin I-TREATMENT +Glue®) I-TREATMENT +sobre I-TREATMENT +el I-TREATMENT +área I-TREATMENT de I-TREATMENT -14 I-TREATMENT -french, I-TREATMENT -desde B-EVOLUTION -entonces I-EVOLUTION -son I-EVOLUTION -múltiples I-EVOLUTION -las I-EVOLUTION -visitas I-EVOLUTION -al I-EVOLUTION -servicio I-EVOLUTION -de I-EVOLUTION -urgencias I-EVOLUTION -con I-EVOLUTION -problemas I-EVOLUTION -en I-EVOLUTION -relación I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -sonda. I-EVOLUTION -Es I-EVOLUTION -ingresado I-EVOLUTION -por I-EVOLUTION -vómitos I-EVOLUTION -e I-EVOLUTION -intolerancia I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -nutrición I-EVOLUTION -enteral. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -abundante I-EVOLUTION -residuo I-EVOLUTION -bilioso I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -sonda I-EVOLUTION -Foley. I-EVOLUTION -Se B-EXPLORATION -decide I-EXPLORATION -realizar I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -radiológico I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -radiológico I-EXPLORATION +lesión. I-TREATMENT +La B-EXPLORATION +biopsia I-EXPLORATION +fue I-EXPLORATION +diagnóstica I-EXPLORATION +de I-EXPLORATION +granulomatosis I-EXPLORATION +necrotizante I-EXPLORATION +asociada I-EXPLORATION a I-EXPLORATION -través I-EXPLORATION +hiperplasia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -sonda, I-EXPLORATION -ante I-EXPLORATION -la I-EXPLORATION -mala I-EXPLORATION -tolerancia I-EXPLORATION -enteral I-EXPLORATION -y I-EXPLORATION -ausencia I-EXPLORATION +células I-EXPLORATION +plasmáticas I-EXPLORATION +sin I-EXPLORATION +indicios I-EXPLORATION de I-EXPLORATION -alteraciones I-EXPLORATION -radiológicas I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -intestinal, I-EXPLORATION -observándose I-EXPLORATION -como I-EXPLORATION -se I-EXPLORATION -puede I-EXPLORATION -ver I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -figura I-EXPLORATION -1 I-EXPLORATION -el I-EXPLORATION -paso I-EXPLORATION -directo I-EXPLORATION -del I-EXPLORATION -contraste I-EXPLORATION -directamente I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -intestinal. I-EXPLORATION -Se B-TREATMENT -extrajo I-TREATMENT +vasculitis I-EXPLORATION +acompañante. I-EXPLORATION +Los I-EXPLORATION +resultados I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +serológicas I-EXPLORATION +realizadas I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +Considerando B-TREATMENT la I-TREATMENT -sonda I-TREATMENT -Foley I-TREATMENT -por I-TREATMENT -el I-TREATMENT -servicio I-TREATMENT +posibilidad I-TREATMENT de I-TREATMENT -cirugía I-TREATMENT -sin I-TREATMENT -presentar I-TREATMENT -complicaciones I-TREATMENT -y I-TREATMENT +ENIC, I-TREATMENT se I-TREATMENT -colocó I-TREATMENT -sonda I-TREATMENT -de I-TREATMENT -gastrostomía I-TREATMENT +decidió I-TREATMENT +instaurar I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +Ciclosporina I-TREATMENT +A I-TREATMENT +(3 I-TREATMENT +mg/kg/día) I-TREATMENT +unido I-TREATMENT +a I-TREATMENT +los I-TREATMENT +corticosteroides I-TREATMENT +orales I-TREATMENT +(1 I-TREATMENT +mg/kg/día), I-TREATMENT +pero I-TREATMENT +unas I-TREATMENT +ocho I-TREATMENT +semanas I-TREATMENT +tras I-TREATMENT +su I-TREATMENT +inicio I-TREATMENT +el I-TREATMENT +cuadro I-TREATMENT +inflamatorio I-TREATMENT +persistía I-TREATMENT +y, I-TREATMENT +dada I-TREATMENT +su I-TREATMENT +severidad, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +sustituir I-TREATMENT +Ciclosporina I-TREATMENT por I-TREATMENT -parte I-TREATMENT -del I-TREATMENT -servicio I-TREATMENT -de I-TREATMENT -radiología I-TREATMENT -intervencionista, I-TREATMENT -siendo B-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con B-TREATMENT -nutrición I-TREATMENT -enteral I-TREATMENT -en I-TREATMENT -bolos. I-TREATMENT +Azatioprina I-TREATMENT +(100 I-TREATMENT +mg/día) I-TREATMENT +manteniendo I-TREATMENT +los I-TREATMENT +corticosteroides I-TREATMENT +orales. I-TREATMENT I-TREATMENT +Este B-EVOLUTION +régimen I-EVOLUTION +terapéutico I-EVOLUTION +consiguió I-EVOLUTION +progresivamente I-EVOLUTION +controlar I-EVOLUTION +el I-EVOLUTION +proceso I-EVOLUTION +inflamatorio. I-EVOLUTION +Siete I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +inicio I-EVOLUTION +del I-EVOLUTION +cuadro I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +permanece I-EVOLUTION +asintomática I-EVOLUTION +y I-EVOLUTION +continúa I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +tratamiento. I-EVOLUTION + I-EVOLUTION -Varón B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -81 I-PRESENT_ILLNESS +56 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -remitido B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Nutrición I-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -Medicina I-DERIVED_FROM/TO -Interna I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -estudio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -hipoproteinemia. I-DERIVED_FROM/TO -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destacan I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -arritmia I-PAST_MEDICAL_HISTORY -cardíaca I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -fibrilación I-PAST_MEDICAL_HISTORY -auricular I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -respuesta I-PAST_MEDICAL_HISTORY -ventricular I-PAST_MEDICAL_HISTORY -adecuada. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -el I-EXPLORATION -ecocardiograma I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -insuficiencia I-EXPLORATION -mitral I-EXPLORATION -moderada, I-EXPLORATION -insuficiencia I-EXPLORATION -aórtica I-EXPLORATION -moderada I-EXPLORATION -por I-EXPLORATION -anuloectasia I-EXPLORATION -valvular I-EXPLORATION -y I-EXPLORATION -dilatación I-EXPLORATION -auricular I-EXPLORATION -sin I-EXPLORATION -hipertensión I-EXPLORATION -pulmonar. I-EXPLORATION -También B-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Paget I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -hueso, I-PAST_MEDICAL_HISTORY -actualmente I-PAST_MEDICAL_HISTORY -inactiva. I-PAST_MEDICAL_HISTORY -Monorreno I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -hipoplasia I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -riñón I-PAST_MEDICAL_HISTORY -contralateral. I-PAST_MEDICAL_HISTORY -Intervenido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ulcus I-PAST_MEDICAL_HISTORY -gástrico I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -realizándose I-PAST_MEDICAL_HISTORY -gastrectomía I-PAST_MEDICAL_HISTORY -subtotal I-PAST_MEDICAL_HISTORY -Billroth I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -I I-PAST_MEDICAL_HISTORY -(última I-PAST_MEDICAL_HISTORY -endoscopia I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -meses, I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -objetiva I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -resección I-PAST_MEDICAL_HISTORY -quirúrgica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -gastritis I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -atrófica I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -muñón I-PAST_MEDICAL_HISTORY -gástrico). I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -revisión I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -Servicio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Nefrología I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -patología I-PAST_MEDICAL_HISTORY -renal, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -proteinuria I-PAST_MEDICAL_HISTORY -significativa. I-PAST_MEDICAL_HISTORY -Perfil I-PAST_MEDICAL_HISTORY -hepático I-PAST_MEDICAL_HISTORY -correcto. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -anamnesis, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -buen I-PRESENT_ILLNESS -apetito I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -adecuada I-PRESENT_ILLNESS -ingesta, I-PRESENT_ILLNESS -realizando I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -dieta I-PRESENT_ILLNESS -equilibrada. I-PRESENT_ILLNESS -Hábito I-PRESENT_ILLNESS -deposicional I-PRESENT_ILLNESS -conservado. I-PRESENT_ILLNESS -En B-EXPLORATION +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +extracción I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +resto I-PRESENT_ILLNESS +radicular. I-PRESENT_ILLNESS +Durante B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -física, I-EXPLORATION -edemas I-EXPLORATION +clínica I-EXPLORATION +se I-EXPLORATION +descubren I-EXPLORATION +múltiples I-EXPLORATION +lesiones I-EXPLORATION +papulares I-EXPLORATION en I-EXPLORATION -ambas I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -e I-EXPLORATION -IMC I-EXPLORATION -contaminado I-EXPLORATION +encías, I-EXPLORATION +con I-EXPLORATION +tendencia I-EXPLORATION +a I-EXPLORATION +confluir, I-EXPLORATION +que I-EXPLORATION +adquieren I-EXPLORATION +aspecto I-EXPLORATION de I-EXPLORATION -21, I-EXPLORATION -7 I-EXPLORATION -kg/m2. I-EXPLORATION -En I-EXPLORATION +empedrado. I-EXPLORATION +La I-EXPLORATION +mucosa I-EXPLORATION +labial I-EXPLORATION +inferior I-EXPLORATION +tiene I-EXPLORATION +una I-EXPLORATION +disposición I-EXPLORATION +coarrugada I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -analítica, I-EXPLORATION -hipoalbuminemia I-EXPLORATION +lengua I-EXPLORATION +aparecen I-EXPLORATION +gran I-EXPLORATION +número I-EXPLORATION de I-EXPLORATION -2.002 I-EXPLORATION -mg/dl. I-EXPLORATION -Se I-EXPLORATION -inicia I-EXPLORATION -tratamiento I-EXPLORATION -con I-EXPLORATION -nutrición I-EXPLORATION -enteral I-EXPLORATION -domiciliaria I-EXPLORATION -hiperproteica. I-EXPLORATION +pápulas I-EXPLORATION +que I-EXPLORATION +confieren I-EXPLORATION +a I-EXPLORATION +ésta, I-EXPLORATION +aspecto I-EXPLORATION +moriforme. I-EXPLORATION En I-EXPLORATION -el I-EXPLORATION -siguiente I-EXPLORATION -control, I-EXPLORATION la I-EXPLORATION -albúmina I-EXPLORATION -ha I-EXPLORATION -disminuido I-EXPLORATION -a I-EXPLORATION -1.930 I-EXPLORATION -mg/dl I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -piensa I-EXPLORATION -en I-EXPLORATION +mucosa I-EXPLORATION +yugal I-EXPLORATION +aparece I-EXPLORATION una I-EXPLORATION -enfermedad I-EXPLORATION -malabsortiva I-EXPLORATION -pese I-EXPLORATION +lesión I-EXPLORATION +polipoide I-EXPLORATION +que I-EXPLORATION +extirpamos I-EXPLORATION a I-EXPLORATION -no I-EXPLORATION -referir I-EXPLORATION -clínica I-EXPLORATION -de I-EXPLORATION -diarrea. I-EXPLORATION -Se I-EXPLORATION -realizan I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -D-xilosa I-EXPLORATION -y I-EXPLORATION -Van I-EXPLORATION -de I-EXPLORATION -Kammer, I-EXPLORATION -siendo I-EXPLORATION -ambos I-EXPLORATION -negativos. I-EXPLORATION -Se I-EXPLORATION -descarta I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -celiaquía I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -gastroduodenal I-EXPLORATION +vez I-EXPLORATION que I-EXPLORATION -resulta I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION +realizamos I-EXPLORATION +una I-EXPLORATION biopsia I-EXPLORATION de I-EXPLORATION -grasa I-EXPLORATION -subcutánea I-EXPLORATION -no I-EXPLORATION -refleja I-EXPLORATION -amiloidosis. I-EXPLORATION -Ante I-EXPLORATION la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -pierde I-EXPLORATION -proteínas, I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -aclaramiento I-EXPLORATION -de I-EXPLORATION -A1AT I-EXPLORATION -en I-EXPLORATION -heces I-EXPLORATION -con I-EXPLORATION -valor I-EXPLORATION -de I-EXPLORATION -218 I-EXPLORATION -ml/día I-EXPLORATION -(> I-EXPLORATION -24ml/día) I-EXPLORATION -[A1AT I-EXPLORATION -en I-EXPLORATION -sangre: I-EXPLORATION -156 I-EXPLORATION -mg/dL; I-EXPLORATION -A1AT I-EXPLORATION -en I-EXPLORATION -heces: I-EXPLORATION -1, I-EXPLORATION -53 I-EXPLORATION -mg/g; I-EXPLORATION -peso I-EXPLORATION -heces I-EXPLORATION -en I-EXPLORATION -24 I-EXPLORATION -h: I-EXPLORATION -222, I-EXPLORATION -57 I-EXPLORATION -g] I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -diagnosticado I-EXPLORATION -de I-EXPLORATION -esta I-EXPLORATION -patología. I-EXPLORATION -Pese I-EXPLORATION -a I-EXPLORATION -no I-EXPLORATION -observar I-EXPLORATION -otra I-EXPLORATION -causa I-EXPLORATION -subyacente, I-EXPLORATION -no I-EXPLORATION +encía I-EXPLORATION +cuyo I-EXPLORATION +resultado I-EXPLORATION es I-EXPLORATION -posible I-EXPLORATION -asegurar I-EXPLORATION -que I-EXPLORATION -su I-EXPLORATION -alteración I-EXPLORATION -cardiológica I-EXPLORATION -sea I-EXPLORATION +hiperplasia I-EXPLORATION +inflamatoria I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -base I-EXPLORATION +lesión I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -PLE. I-EXPLORATION -En B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -nutrición I-TREATMENT -enteral I-TREATMENT -domiciliaria, I-TREATMENT -mantiene B-EVOLUTION -cifras I-EVOLUTION -de I-EVOLUTION -albúmina I-EVOLUTION -estables. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS +mucosa I-EXPLORATION +yugal, I-EXPLORATION +pólipo I-EXPLORATION +fibroepitelial. I-EXPLORATION + I-EXPLORATION +En B-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +anamnesis I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +haber I-PRESENT_ILLNESS +sido I-PRESENT_ILLNESS +operada I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -15 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -EPOC I-PAST_MEDICAL_HISTORY -grado I-PAST_MEDICAL_HISTORY -II. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -mayo I-EXPLORATION -de I-EXPLORATION -2012 I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -donde I-EXPLORATION +bocio I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +ocasiones, I-PRESENT_ILLNESS +así I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +quistes I-PRESENT_ILLNESS +mamarios I-PRESENT_ILLNESS +bilaterales. I-PRESENT_ILLNESS +Padece I-PRESENT_ILLNESS +ulcera I-PRESENT_ILLNESS +gástrica, I-PRESENT_ILLNESS +esofagitis I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +pólipos I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +colon. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +varias I-PRESENT_ILLNESS +ocasiones I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +han I-PRESENT_ILLNESS +extirpado I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +cutáneas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +brazos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +plantas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +pies. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Ante B-PAST_MEDICAL_HISTORY +esta I-PAST_MEDICAL_HISTORY +patología I-PAST_MEDICAL_HISTORY +tan I-PAST_MEDICAL_HISTORY +florida I-PAST_MEDICAL_HISTORY +solicitamos I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +clínica I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +archivo I-PAST_MEDICAL_HISTORY +central I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +nuestro I-PAST_MEDICAL_HISTORY +hospital I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +referencia I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +realizando I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +resumen I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ésta, I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +enferma I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +han I-PAST_MEDICAL_HISTORY +extirpado I-PAST_MEDICAL_HISTORY +nódulos I-PAST_MEDICAL_HISTORY +coloides I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tiroides, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +ha I-PAST_MEDICAL_HISTORY +operado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +ocasiones I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +fibroquística I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +mama, I-PAST_MEDICAL_HISTORY +presenta I-PAST_MEDICAL_HISTORY +ulcus I-PAST_MEDICAL_HISTORY +gástrico I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +varias I-PAST_MEDICAL_HISTORY +ocasiones I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +han I-PAST_MEDICAL_HISTORY +extirpado I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +vía I-PAST_MEDICAL_HISTORY +endoscópica I-PAST_MEDICAL_HISTORY +pólipos I-PAST_MEDICAL_HISTORY +gástricos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +colon. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Las I-PAST_MEDICAL_HISTORY +lesiones I-PAST_MEDICAL_HISTORY +extirpadas I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +brazo I-PAST_MEDICAL_HISTORY +resultaron I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +hiperplasias I-PAST_MEDICAL_HISTORY +reactivas I-PAST_MEDICAL_HISTORY +inflamatorias I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Ackerman, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +pies I-PAST_MEDICAL_HISTORY +verrugas I-PAST_MEDICAL_HISTORY +plantares. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Ante B-EXPLORATION +estos I-EXPLORATION +hallazgos I-EXPLORATION +realizamos I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +afectación I-EXPLORATION +oral I-EXPLORATION +de I-EXPLORATION +Síndrome I-EXPLORATION +de I-EXPLORATION +Cowden. I-EXPLORATION + I-EXPLORATION + +Presentamos B-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +nuevo I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evisceración I-PRESENT_ILLNESS +vaginal I-PRESENT_ILLNESS +espontánea I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +posmenopáusica. I-PRESENT_ILLNESS +Se I-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +77 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +histerectomía I-PAST_MEDICAL_HISTORY +vaginal I-PAST_MEDICAL_HISTORY +13 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes, B-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +salida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +asas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +intestino I-PRESENT_ILLNESS +delgado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +través I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +vagina I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +hora I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +ataque I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +risa I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +domicilio. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION +aprecia I-EXPLORATION +evisceración I-EXPLORATION de I-EXPLORATION -27 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -superior I-EXPLORATION -derecho, I-EXPLORATION -con I-EXPLORATION -probable I-EXPLORATION -infiltración I-EXPLORATION +aproximadamente I-EXPLORATION +1 I-EXPLORATION +metro I-EXPLORATION de I-EXPLORATION -primera I-EXPLORATION -costilla. I-EXPLORATION -Fue I-EXPLORATION -diagnosticada I-EXPLORATION +asas I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION +intestino I-EXPLORATION +delgado I-EXPLORATION de I-EXPLORATION -Pancoast I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -estadiaje I-EXPLORATION -inicial I-EXPLORATION -T4N0M0. I-EXPLORATION -En B-TREATMENT -julio I-TREATMENT -de I-TREATMENT -2012 I-TREATMENT -recibió I-TREATMENT -quimioterapia I-TREATMENT -y I-TREATMENT -radioterapia I-TREATMENT -concomitante. I-TREATMENT -Presentó B-EVOLUTION -una I-EVOLUTION -respuesta I-EVOLUTION -completa I-EVOLUTION -y, B-TREATMENT -en I-TREATMENT -octubre I-TREATMENT -de I-TREATMENT -2012, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -lobectomía I-TREATMENT -superior I-TREATMENT -derecha I-TREATMENT -videotoracoscópica I-TREATMENT -y I-TREATMENT -linfadenectomía. I-TREATMENT -El B-EVOLUTION -postoperatorio I-EVOLUTION -fue I-EVOLUTION -tórpido, I-EVOLUTION -con I-EVOLUTION -shock I-EVOLUTION -séptico I-EVOLUTION -de I-EVOLUTION -origen I-EVOLUTION -respiratorio, I-EVOLUTION -insuficiencia I-EVOLUTION -cardiaca, I-EVOLUTION -fracaso I-EVOLUTION -renal I-EVOLUTION -agudo I-EVOLUTION -y B-TREATMENT -requirió I-TREATMENT -ingreso I-TREATMENT -en I-TREATMENT -UVI I-TREATMENT -por I-TREATMENT -insuficiencia I-TREATMENT -respiratoria, I-TREATMENT -precisando I-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -total I-TREATMENT -(NPT). I-TREATMENT -Allí B-EVOLUTION -permaneció I-EVOLUTION -ingresada I-EVOLUTION -2 I-EVOLUTION -meses, I-EVOLUTION -hasta I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -trasladada I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -planta, I-EVOLUTION -donde I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -abdomen I-EVOLUTION -agudo, I-EVOLUTION -practicándose I-EVOLUTION -una I-EVOLUTION -laparotomía I-EVOLUTION -exploradora. I-EVOLUTION -Tras B-TREATMENT -observarse I-TREATMENT -una I-TREATMENT -ileítis I-TREATMENT -con I-TREATMENT -componente I-TREATMENT -infeccioso I-TREATMENT -y I-TREATMENT -necrótico I-TREATMENT -junto I-TREATMENT -con I-TREATMENT -asas I-TREATMENT -isquémicas I-TREATMENT -y I-TREATMENT -abundante I-TREATMENT -líquido I-TREATMENT -libre I-TREATMENT -de I-TREATMENT -aspecto I-TREATMENT -hemático I-TREATMENT -antiguo I-TREATMENT -y I-TREATMENT -fecaloideo, I-TREATMENT +aspecto I-EXPLORATION +congestivo I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION +de I-EXPLORATION +vagina, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +indica I-EXPLORATION +intervención I-EXPLORATION +quirúrgica I-EXPLORATION +urgente. I-EXPLORATION + I-EXPLORATION +La B-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +urgente I-TREATMENT se I-TREATMENT -practicó I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -aproximadamente I-TREATMENT -60 I-TREATMENT -cm I-TREATMENT +realiza I-TREATMENT de I-TREATMENT -íleon I-TREATMENT -terminal I-TREATMENT -hasta I-TREATMENT -válvula I-TREATMENT -cecal I-TREATMENT -y I-TREATMENT -se I-TREATMENT -dejó I-TREATMENT -ileostomía I-TREATMENT -terminal I-TREATMENT -en I-TREATMENT -fosa I-TREATMENT -ilíaca I-TREATMENT -derecha. I-TREATMENT -Los B-EXPLORATION -cultivos I-EXPLORATION -fueron I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -estafilococos I-EXPLORATION -y I-EXPLORATION -bacilos I-EXPLORATION -gram I-EXPLORATION -positivos, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -intravenoso I-TREATMENT -empírico I-TREATMENT +forma I-TREATMENT +conjunta I-TREATMENT con I-TREATMENT -piperacilina-tazobactam I-TREATMENT -4 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -vancomicina I-TREATMENT -1 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas I-TREATMENT -durante I-TREATMENT -14 I-TREATMENT -días. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con B-TREATMENT -dieta I-TREATMENT -oral, I-TREATMENT -suplementos I-TREATMENT -hiperproteicos I-TREATMENT +el I-TREATMENT +servicio I-TREATMENT de I-TREATMENT -nutrición I-TREATMENT -enteral I-TREATMENT -y I-TREATMENT -complejo I-TREATMENT -polivitamínico I-TREATMENT +ginecología I-TREATMENT con I-TREATMENT -minerales. I-TREATMENT - I-TREATMENT -Un B-EVOLUTION -mes I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -alta, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -acudir I-EVOLUTION -al I-EVOLUTION -hospital I-EVOLUTION -por I-EVOLUTION -disnea, I-EVOLUTION -fiebre, I-EVOLUTION -náuseas, I-EVOLUTION -vómitos I-EVOLUTION -alimentarios, I-EVOLUTION -febrícula, I-EVOLUTION -astenia, I-EVOLUTION -hiporexia I-EVOLUTION -y I-EVOLUTION -decaimiento I-EVOLUTION -importantes, I-EVOLUTION -acompañados I-EVOLUTION -de I-EVOLUTION -débito I-EVOLUTION -elevado I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -ileostomia I-EVOLUTION -(1.500-2.000 I-EVOLUTION -mL/día). I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -TC, I-EXPLORATION -observándose I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -postquirúrgica I-EXPLORATION -abundante I-EXPLORATION -en I-EXPLORATION -hemitórax I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -probable I-EXPLORATION -fístula I-EXPLORATION -broncopleural, I-EXPLORATION -ingresando I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Servicio I-EXPLORATION -de I-EXPLORATION -Cirugía I-EXPLORATION -Torácica. I-EXPLORATION -Se B-TREATMENT -sospechó I-TREATMENT -empiema I-TREATMENT +un I-TREATMENT +abordaje I-TREATMENT +combinado I-TREATMENT +abdominal I-TREATMENT y I-TREATMENT +vaginal. I-TREATMENT +Mediante I-TREATMENT +laparotomía I-TREATMENT +media I-TREATMENT +infraumbilical I-TREATMENT se I-TREATMENT -colocaron I-TREATMENT -dos I-TREATMENT -drenajes I-TREATMENT -"pigtail". I-TREATMENT -Se I-TREATMENT -inició I-TREATMENT -antibioterapia I-TREATMENT -con I-TREATMENT -piperacilina-tazobactam I-TREATMENT -4 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -vancomicina I-TREATMENT -1 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas I-TREATMENT +evidencia I-TREATMENT +la I-TREATMENT +cúpula I-TREATMENT +vaginal I-TREATMENT +abierta I-TREATMENT a I-TREATMENT través I-TREATMENT de I-TREATMENT -catéter I-TREATMENT -central I-TREATMENT -de I-TREATMENT -inserción I-TREATMENT -periférica I-TREATMENT -(PICC) I-TREATMENT -en I-TREATMENT -miembro I-TREATMENT -superior I-TREATMENT -izquierdo. I-TREATMENT -No I-TREATMENT -era I-TREATMENT -posible I-TREATMENT -otro I-TREATMENT -acceso I-TREATMENT -central, I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -presentaba I-TREATMENT -trombosis I-TREATMENT -completa I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -yugular I-TREATMENT -derecha I-TREATMENT -por I-TREATMENT -su I-TREATMENT -larga I-TREATMENT -estancia I-TREATMENT -en I-TREATMENT la I-TREATMENT -UVI. I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -bioquímica I-EXPLORATION -general I-EXPLORATION -destacaba I-EXPLORATION -hipocalcemia I-EXPLORATION -(pese I-EXPLORATION -a I-EXPLORATION -tratamiento I-EXPLORATION -con I-EXPLORATION -Natecal® I-EXPLORATION -2 I-EXPLORATION -comprimidos I-EXPLORATION -al I-EXPLORATION -día), I-EXPLORATION -hipopotasemia I-EXPLORATION -e I-EXPLORATION -hipomagnesemia I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -previamente. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -intravenoso I-TREATMENT -con I-TREATMENT -gluconato I-TREATMENT -cálcico I-TREATMENT -1 I-TREATMENT -ampolla I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -mL I-TREATMENT -al I-TREATMENT -10% I-TREATMENT -cada I-TREATMENT -6 I-TREATMENT -horas, I-TREATMENT -sulfato I-TREATMENT -de I-TREATMENT -magnesio I-TREATMENT -2 I-TREATMENT -gramos I-TREATMENT -cada I-TREATMENT -24 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -suplementos I-TREATMENT -orales I-TREATMENT -de I-TREATMENT -potasio I-TREATMENT -(1 I-TREATMENT -Boi-K® I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas), I-TREATMENT -calcio I-TREATMENT -(Natecal® I-TREATMENT -2 I-TREATMENT -comprimidos I-TREATMENT -al I-TREATMENT -día) I-TREATMENT -y I-TREATMENT -magnesio I-TREATMENT -(2 I-TREATMENT -comprimidos I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas), I-TREATMENT -solicitándose I-TREATMENT -consulta I-TREATMENT -al I-TREATMENT -Servicio I-TREATMENT -de I-TREATMENT -Nutrición. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -continuaba I-EVOLUTION -con I-EVOLUTION -diarrea I-EVOLUTION -líquida I-EVOLUTION -abundante I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -ileostomía I-EVOLUTION -(más I-EVOLUTION -de I-EVOLUTION -1500 I-EVOLUTION -mL/día), I-EVOLUTION -refería I-EVOLUTION -anorexia, I-EVOLUTION -astenia, I-EVOLUTION -decaimiento I-EVOLUTION -y I-EVOLUTION -calambres. I-EVOLUTION -Pese I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -suplementacion I-EVOLUTION -oral, I-EVOLUTION -continuaba I-EVOLUTION -con I-EVOLUTION -niveles I-EVOLUTION -indectables I-EVOLUTION -de I-EVOLUTION -magnesio I-EVOLUTION -(< I-EVOLUTION -0, I-EVOLUTION -6 I-EVOLUTION -mg/dL). I-EVOLUTION -Dada B-TREATMENT +que I-TREATMENT +se I-TREATMENT +introduce I-TREATMENT +el I-TREATMENT +intestino I-TREATMENT +delgado I-TREATMENT +eviscerado I-TREATMENT +que I-TREATMENT +correspondía I-TREATMENT +a I-TREATMENT +íleon. I-TREATMENT +Se I-TREATMENT +reduce I-TREATMENT +el I-TREATMENT +intestino I-TREATMENT +delgado I-TREATMENT +a I-TREATMENT la I-TREATMENT -baja I-TREATMENT -ingesta I-TREATMENT +cavidad I-TREATMENT +abdominal I-TREATMENT +comprobando I-TREATMENT +su I-TREATMENT +viabilidad I-TREATMENT y I-TREATMENT -la I-TREATMENT -mala I-TREATMENT -tolerancia I-TREATMENT -oral I-TREATMENT -a I-TREATMENT -los I-TREATMENT -suplementos I-TREATMENT -de I-TREATMENT -magnesio, I-TREATMENT se I-TREATMENT -decidió I-TREATMENT -iniciar I-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -central I-TREATMENT -por I-TREATMENT +cierra I-TREATMENT el I-TREATMENT -PICC. I-TREATMENT - I-TREATMENT -Tras I-TREATMENT +defecto I-TREATMENT +vaginal I-TREATMENT +con I-TREATMENT +material I-TREATMENT +irreabsorbible. I-TREATMENT +Se I-TREATMENT +utiliza I-TREATMENT +una I-TREATMENT +malla I-TREATMENT +Dual I-TREATMENT +Mesh I-TREATMENT +para I-TREATMENT +reforzar I-TREATMENT la I-TREATMENT -normalización I-TREATMENT -hidroelectrolítica I-TREATMENT +sutura I-TREATMENT +vaginal I-TREATMENT y I-TREATMENT -un I-TREATMENT -correcto I-TREATMENT -aporte I-TREATMENT -nutricional, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -intervenida I-TREATMENT -para I-TREATMENT +se I-TREATMENT +cierra I-TREATMENT el I-TREATMENT -cierre I-TREATMENT +peritoneo I-TREATMENT +del I-TREATMENT +fondo I-TREATMENT de I-TREATMENT -la I-TREATMENT -fístula I-TREATMENT -broncopleural. I-TREATMENT -Una B-EVOLUTION -semana I-EVOLUTION -después I-EVOLUTION +saco I-TREATMENT +de I-TREATMENT +Douglas. I-TREATMENT + I-TREATMENT +El B-EVOLUTION +postoperatorio I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -cirugía, I-EVOLUTION -la I-EVOLUTION paciente I-EVOLUTION -tomaba I-EVOLUTION -suplementos I-EVOLUTION -nutricionales I-EVOLUTION -y I-EVOLUTION -dieta I-EVOLUTION -por I-EVOLUTION -vía I-EVOLUTION -oral, I-EVOLUTION -mejorando I-EVOLUTION -los I-EVOLUTION -calambres I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -estado I-EVOLUTION -anímico, I-EVOLUTION -sin I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -antidepresivo. I-EVOLUTION -La I-EVOLUTION -hipomagnesemia I-EVOLUTION -aislada I-EVOLUTION -tardó I-EVOLUTION -7 I-EVOLUTION -días I-EVOLUTION -en I-EVOLUTION -recuperarse, I-EVOLUTION +fue I-EVOLUTION +satisfactorio I-EVOLUTION siendo I-EVOLUTION dada I-EVOLUTION de I-EVOLUTION alta I-EVOLUTION -con B-TREATMENT -suplementos I-TREATMENT -nutricionales I-TREATMENT -orales I-TREATMENT -y I-TREATMENT -magnesio I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -1 I-TREATMENT -comprimido I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas. I-TREATMENT -Al I-TREATMENT -no I-TREATMENT -normalizarse I-TREATMENT -completamente I-TREATMENT -las I-TREATMENT -cifras I-TREATMENT -de I-TREATMENT -magnesio I-TREATMENT -y I-TREATMENT -dada I-TREATMENT -la I-TREATMENT -buena I-TREATMENT -tolerancia, I-TREATMENT -se I-TREATMENT -aumentó I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -a I-TREATMENT -2 I-TREATMENT -comprimidos I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas, I-TREATMENT -consiguiendo B-EVOLUTION -remontar I-EVOLUTION +a I-EVOLUTION los I-EVOLUTION -niveles I-EVOLUTION -hasta I-EVOLUTION -límites I-EVOLUTION -dentro I-EVOLUTION +5 I-EVOLUTION +días I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -normalidad. I-EVOLUTION -Quedaron I-EVOLUTION -descartadas I-EVOLUTION -las I-EVOLUTION -pérdidas I-EVOLUTION -urinarias, I-EVOLUTION -con I-EVOLUTION -unos I-EVOLUTION -niveles I-EVOLUTION -magnesio I-EVOLUTION -en I-EVOLUTION -orina I-EVOLUTION -indetectables I-EVOLUTION -(< I-EVOLUTION -1, I-EVOLUTION -81 I-EVOLUTION -mg/dL), I-EVOLUTION -confirmando I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION +cirugía. I-EVOLUTION +Tras I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION de I-EVOLUTION -malabsorción I-EVOLUTION -intestinal. I-EVOLUTION +la I-EVOLUTION +cirugía I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +permanece I-EVOLUTION +asintomática. I-EVOLUTION I-EVOLUTION Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -44 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS +33 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +adicto I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +drogas I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +vía I-PRESENT_ILLNESS +parenteral, I-PRESENT_ILLNESS diagnosticado I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Enfermedad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Huntington, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -deterioro I-PRESENT_ILLNESS -cognitivo I-PRESENT_ILLNESS -severo, I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -neurogénica, I-PRESENT_ILLNESS -broncoaspiraciones I-PRESENT_ILLNESS +infección I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +VIH I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -desnutrición, I-PRESENT_ILLNESS -motivo B-TREATMENT -por I-TREATMENT -el I-TREATMENT -que I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -GEP I-TREATMENT -para I-TREATMENT -nutrición I-TREATMENT -enteral I-TREATMENT -domiciliaria. I-TREATMENT -Durante I-TREATMENT -el I-TREATMENT -procedimiento, I-TREATMENT -por I-TREATMENT -imposibilidad I-TREATMENT -de I-TREATMENT -obtener I-TREATMENT -un I-TREATMENT -punto I-TREATMENT -de I-TREATMENT -contacto I-TREATMENT -entre I-TREATMENT -estómago I-TREATMENT -y I-TREATMENT -pared I-TREATMENT -abdominal I-TREATMENT -por I-TREATMENT -transiluminación I-TREATMENT -y I-TREATMENT -digitopresión, I-TREATMENT -se I-TREATMENT -añadió I-TREATMENT -la I-TREATMENT -asistencia I-TREATMENT -de I-TREATMENT -laparoscópia I-TREATMENT -para I-TREATMENT -concluir I-TREATMENT -el I-TREATMENT -procedimiento I-TREATMENT -de I-TREATMENT -inserción I-TREATMENT -de I-TREATMENT -la I-TREATMENT -sonda I-TREATMENT -de I-TREATMENT -gastrostomía. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -44 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -hábito I-PAST_MEDICAL_HISTORY -tabáquico, I-PAST_MEDICAL_HISTORY -hipercolesterolemia I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -irregular I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -dieta I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipocolesterolemiantes, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -isquémica I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -(con I-PAST_MEDICAL_HISTORY -infarto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -miocardio I-PAST_MEDICAL_HISTORY -diafragmático I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1985). I-PAST_MEDICAL_HISTORY -Ingresa B-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -estudio I-PRESENT_ILLNESS -angiográfico I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +dejado I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +antirretroviral I-PRESENT_ILLNESS +hacía I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +meses. I-PRESENT_ILLNESS +Ingresa I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -crisis I-PRESENT_ILLNESS +odinofagia I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dudosa I-PRESENT_ILLNESS +disfagia, I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -angor, I-PRESENT_ILLNESS -tanto I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +importante I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +diarrea I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -esfuerzo I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +deposiciones/día I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -reposo, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -pesar I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -B-bloqueantes, I-PRESENT_ILLNESS -nitratos, I-PRESENT_ILLNESS -antiagregantes I-PRESENT_ILLNESS -plaquetarios, I-PRESENT_ILLNESS -calcioantagonistas, I-PRESENT_ILLNESS -etc. I-PRESENT_ILLNESS -Tras B-EXPLORATION +heces I-PRESENT_ILLNESS +líquidas. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION -realización I-EXPLORATION -del I-EXPLORATION -cateterismo I-EXPLORATION -arterial I-EXPLORATION -y I-EXPLORATION -coronariografía I-EXPLORATION -sin I-EXPLORATION -incidencias I-EXPLORATION -(se I-EXPLORATION -constató I-EXPLORATION -Enfermedad I-EXPLORATION -de I-EXPLORATION -Tres I-EXPLORATION -Vasos) I-EXPLORATION -fue B-EVOLUTION -remitido I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -domicilio I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -y I-EVOLUTION -12 I-EVOLUTION -horas I-EVOLUTION -después I-EVOLUTION -inicia I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -disestesias I-EVOLUTION -con I-EVOLUTION -dolor I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -ambas I-EVOLUTION -pantorrillas I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -incrementando I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -días I-EVOLUTION -siguientes I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -acudió I-EVOLUTION -al I-EVOLUTION -servicio I-EVOLUTION -de I-EVOLUTION -urgencias I-EVOLUTION -del I-EVOLUTION -hospital I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -remitido I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -domicilio I-EVOLUTION -con B-TREATMENT -medicación I-TREATMENT -analgésica. I-TREATMENT -Acude B-EVOLUTION -nuevamente I-EVOLUTION -a I-EVOLUTION -dicho I-EVOLUTION -servicio I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -después I-EVOLUTION -por I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -múltiples I-EVOLUTION -lesiones I-EVOLUTION -eritematosas I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -piel I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mitad I-EVOLUTION -inferior I-EVOLUTION -del I-EVOLUTION -abdomen I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -extremidades I-EVOLUTION -inferiores. I-EVOLUTION -Ingresa I-EVOLUTION -para I-EVOLUTION -estudio. I-EVOLUTION -Exploración B-EXPLORATION -física: I-EXPLORATION -Varón, I-EXPLORATION -44 I-EXPLORATION -años, I-EXPLORATION -normolineo; I-EXPLORATION -afebril; I-EXPLORATION -buena I-EXPLORATION -coloración I-EXPLORATION +exploración I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +importante I-EXPLORATION +desnutrición I-EXPLORATION +con I-EXPLORATION +muguet I-EXPLORATION +orofaríngeo. I-EXPLORATION +Hepatomegalia I-EXPLORATION de I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -mucosas; I-EXPLORATION -xantelasma I-EXPLORATION -bilateral. I-EXPLORATION -PA: I-EXPLORATION -105/65. I-EXPLORATION -ACP: I-EXPLORATION -Frecuencia I-EXPLORATION -central I-EXPLORATION -rítmica I-EXPLORATION -a I-EXPLORATION -62 I-EXPLORATION -ppm. I-EXPLORATION -Abdomen: I-EXPLORATION -Blando, I-EXPLORATION -indoloro I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION a I-EXPLORATION -la I-EXPLORATION -palpación, I-EXPLORATION -sin I-EXPLORATION -visceromegalias I-EXPLORATION -ni I-EXPLORATION -masas. I-EXPLORATION -Extremidades I-EXPLORATION +expensas I-EXPLORATION +lóbulo I-EXPLORATION +hepático I-EXPLORATION +derecho I-EXPLORATION sin I-EXPLORATION -edemas, I-EXPLORATION -con I-EXPLORATION -masas I-EXPLORATION -gemelares I-EXPLORATION -dolorosas I-EXPLORATION -a I-EXPLORATION +esplenomegalia. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -palpación. I-EXPLORATION -Pulsos I-EXPLORATION -femoral, I-EXPLORATION -tibial I-EXPLORATION -posterior I-EXPLORATION -y I-EXPLORATION -pedio I-EXPLORATION -palpables I-EXPLORATION -y I-EXPLORATION -siméticos. I-EXPLORATION -A I-EXPLORATION -nivel I-EXPLORATION -cutáneo I-EXPLORATION -(en I-EXPLORATION -mitad I-EXPLORATION -inferior I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -extremidades I-EXPLORATION -inferiores) I-EXPLORATION -se I-EXPLORATION -aprecian I-EXPLORATION -lesiones I-EXPLORATION -eritematosas I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -livedo I-EXPLORATION -reticularis I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -dedos I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -pies I-EXPLORATION -coloración I-EXPLORATION -púrpura I-EXPLORATION +analítica I-EXPLORATION +presentaba I-EXPLORATION +6.830 I-EXPLORATION +leucocitos I-EXPLORATION con I-EXPLORATION -temperatura I-EXPLORATION -local I-EXPLORATION -normal. I-EXPLORATION -Pruebas I-EXPLORATION -complementarias. I-EXPLORATION -Hemograma: I-EXPLORATION -Leucocitos I-EXPLORATION -10800 I-EXPLORATION -(Seg I-EXPLORATION -43%, I-EXPLORATION -L I-EXPLORATION -36%, I-EXPLORATION -M I-EXPLORATION -6, I-EXPLORATION -1%, I-EXPLORATION -Eosinófilos I-EXPLORATION -13%) I-EXPLORATION -Hgb: I-EXPLORATION -13, I-EXPLORATION -9 I-EXPLORATION -g/dl, I-EXPLORATION -Hct: I-EXPLORATION -42, I-EXPLORATION -7%, I-EXPLORATION -Plaquetas I-EXPLORATION -203.000. I-EXPLORATION -VSG: I-EXPLORATION -16. I-EXPLORATION -Bioquímica: I-EXPLORATION -Glu I-EXPLORATION -129 I-EXPLORATION -mg/dl, I-EXPLORATION -Urea I-EXPLORATION -30 I-EXPLORATION -mg/dl, I-EXPLORATION -Cre I-EXPLORATION -1, I-EXPLORATION -1 I-EXPLORATION -mg/dl, I-EXPLORATION -Na I-EXPLORATION -138 I-EXPLORATION -mEq/l, I-EXPLORATION -K I-EXPLORATION -4, I-EXPLORATION -4 I-EXPLORATION -mEq/l, I-EXPLORATION -GOT I-EXPLORATION -25, I-EXPLORATION -GPT I-EXPLORATION -31, I-EXPLORATION -CK I-EXPLORATION -50, I-EXPLORATION -LDH I-EXPLORATION -337, I-EXPLORATION -Aldolasa I-EXPLORATION -<8 I-EXPLORATION -U/l, I-EXPLORATION -Colesterol I-EXPLORATION -total I-EXPLORATION -232, I-EXPLORATION -HDL I-EXPLORATION -28, I-EXPLORATION -LDL I-EXPLORATION -168, I-EXPLORATION -TG I-EXPLORATION -179, I-EXPLORATION -APO I-EXPLORATION -B/ I-EXPLORATION -APO I-EXPLORATION -A1: I-EXPLORATION ->1.51. I-EXPLORATION -Hemostasia: I-EXPLORATION -Quick I-EXPLORATION -100%, I-EXPLORATION -Fibrinógeno I-EXPLORATION -335. I-EXPLORATION -Orina: I-EXPLORATION -25 I-EXPLORATION -leucos/ I-EXPLORATION -campo. I-EXPLORATION -PTG: I-EXPLORATION -Prot I-EXPLORATION -total I-EXPLORATION -6, I-EXPLORATION -3 I-EXPLORATION -g/l, I-EXPLORATION -Alb I-EXPLORATION -64%, I-EXPLORATION -Alfa I-EXPLORATION -1-G I-EXPLORATION -3, I-EXPLORATION -5%, I-EXPLORATION -Alfa I-EXPLORATION -2-G I-EXPLORATION -9, I-EXPLORATION -8%, I-EXPLORATION -Beta-G I-EXPLORATION -11, I-EXPLORATION -2%, I-EXPLORATION -Gamma-G I-EXPLORATION -12, I-EXPLORATION -8%. I-EXPLORATION -Complemento: I-EXPLORATION -C3 I-EXPLORATION -111 I-EXPLORATION -(83-177 I-EXPLORATION -mg/dl), I-EXPLORATION -C4 I-EXPLORATION -27 I-EXPLORATION -(15-45). I-EXPLORATION -Detección I-EXPLORATION -de I-EXPLORATION -anticuerpos I-EXPLORATION -antitejido: I-EXPLORATION -Negativa. I-EXPLORATION -Complejos I-EXPLORATION -inmunocirculantes: I-EXPLORATION -Positivos I-EXPLORATION -para I-EXPLORATION -Ig I-EXPLORATION -M. I-EXPLORATION -Radiografía I-EXPLORATION -tórax/abdomen: I-EXPLORATION -Sin I-EXPLORATION -hallazgos. I-EXPLORATION -Eco-Doppler I-EXPLORATION -MMII: I-EXPLORATION -Venas I-EXPLORATION -ilíacas, I-EXPLORATION -femorales I-EXPLORATION -y I-EXPLORATION -poplíteas I-EXPLORATION -permeables, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -trombosis I-EXPLORATION +7, I-EXPLORATION +2% I-EXPLORATION +linfocitos I-EXPLORATION y I-EXPLORATION -con I-EXPLORATION -flujo I-EXPLORATION -normal. I-EXPLORATION -ECG: I-EXPLORATION -RS I-EXPLORATION -a I-EXPLORATION -62 I-EXPLORATION -ppm, I-EXPLORATION -BCRDHH, I-EXPLORATION -necrosis I-EXPLORATION -de I-EXPLORATION -cara I-EXPLORATION -inferior I-EXPLORATION -residual. I-EXPLORATION -Examen I-EXPLORATION -oftalmológico: I-EXPLORATION -Normal. I-EXPLORATION -EMG I-EXPLORATION -(realizado I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -21 I-EXPLORATION -días): I-EXPLORATION -Se I-EXPLORATION -apreció I-EXPLORATION -lesión I-EXPLORATION -radicular I-EXPLORATION -irritativa I-EXPLORATION -en I-EXPLORATION -evolución I-EXPLORATION -S1 I-EXPLORATION -derecha I-EXPLORATION -leve. I-EXPLORATION +86, I-EXPLORATION +7% I-EXPLORATION +neutrófilos. I-EXPLORATION +CD4 I-EXPLORATION +10 I-EXPLORATION +cel/µl. I-EXPLORATION Se I-EXPLORATION +le I-EXPLORATION realizó I-EXPLORATION una I-EXPLORATION -biopsia I-EXPLORATION -cutánea I-EXPLORATION -de I-EXPLORATION -cara I-EXPLORATION -lateral I-EXPLORATION -de I-EXPLORATION -pie I-EXPLORATION -derecho I-EXPLORATION +esofagogastrocopia I-EXPLORATION que I-EXPLORATION -reveló I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +demostró I-EXPLORATION a I-EXPLORATION nivel I-EXPLORATION de I-EXPLORATION -pequeñas I-EXPLORATION -arteriolas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -dermis I-EXPLORATION -media I-EXPLORATION -y I-EXPLORATION -profunda I-EXPLORATION -de I-EXPLORATION -cristales I-EXPLORATION +segunda I-EXPLORATION +porción I-EXPLORATION de I-EXPLORATION -colesterol I-EXPLORATION -enclavado I-EXPLORATION -intraluminalmente I-EXPLORATION +duodeno I-EXPLORATION +una I-EXPLORATION +mucosa I-EXPLORATION con I-EXPLORATION +aspecto I-EXPLORATION +velloso, I-EXPLORATION +blanquecino, I-EXPLORATION +irregular I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +tomaron I-EXPLORATION +biopsias. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +endoscopia I-EXPLORATION +oral I-EXPLORATION +no I-EXPLORATION +presentó I-EXPLORATION +alteraciones. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +demostró I-EXPLORATION +la I-EXPLORATION presencia I-EXPLORATION de I-EXPLORATION -ocasionales I-EXPLORATION -células I-EXPLORATION -gigantes I-EXPLORATION -fagocitando I-EXPLORATION +Leishmania I-EXPLORATION +amastigotes I-EXPLORATION en I-EXPLORATION -parte I-EXPLORATION -estos I-EXPLORATION -cristales. I-EXPLORATION -La B-EVOLUTION -evolución I-EVOLUTION -del I-EVOLUTION -enfermo I-EVOLUTION -fue I-EVOLUTION -satisfactoria, I-EVOLUTION -sin I-EVOLUTION -afectación I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -desaparición I-EVOLUTION -del I-EVOLUTION -livedo I-EVOLUTION -reticularis I-EVOLUTION +el I-EXPLORATION +interior I-EXPLORATION +de I-EXPLORATION +histiocitos. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +amfotericina I-TREATMENT +B I-TREATMENT +mejorando B-EVOLUTION y I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -coloración I-EVOLUTION -violácea I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION de I-EVOLUTION -los I-EVOLUTION -dedos. I-EVOLUTION -Se B-TREATMENT -siguió I-TREATMENT -un I-TREATMENT +alta. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +acudió I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +sucesivas I-EVOLUTION +revisiones. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +41 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +fumador, B-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +26 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +diagnosticado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +EC I-PAST_MEDICAL_HISTORY +íleo-cólica. I-PAST_MEDICAL_HISTORY +Durante I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +seguimiento I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +fístula I-PAST_MEDICAL_HISTORY +perianal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +cuadro I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +suboclusión I-PAST_MEDICAL_HISTORY +-intestinal I-PAST_MEDICAL_HISTORY +secundario I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +brote I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +EC, I-PAST_MEDICAL_HISTORY +objetivando I-PAST_MEDICAL_HISTORY +fístula I-PAST_MEDICAL_HISTORY +entero-vesical, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +requirió I-PAST_MEDICAL_HISTORY +intervención I-PAST_MEDICAL_HISTORY +quirúrgica I-PAST_MEDICAL_HISTORY +(resección I-PAST_MEDICAL_HISTORY +íleo-cólica). I-PAST_MEDICAL_HISTORY +Coincidiendo I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +cuadro I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +suboclusión I-PAST_MEDICAL_HISTORY +comenzó I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +edemas I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +miembros I-PAST_MEDICAL_HISTORY +inferiores, I-PAST_MEDICAL_HISTORY +deterioro I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +función I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +proteinuria I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +rango I-PAST_MEDICAL_HISTORY +nefrótico, I-PAST_MEDICAL_HISTORY +realizándosele I-PAST_MEDICAL_HISTORY +biopsia I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +confirmó I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +sospecha I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +AA I-PAST_MEDICAL_HISTORY +renal. I-PAST_MEDICAL_HISTORY +Recibió B-TREATMENT tratamiento I-TREATMENT -sintomático I-TREATMENT -(con I-TREATMENT -analgesia I-TREATMENT +con I-TREATMENT +colchicina I-TREATMENT +con I-TREATMENT +mejoría I-TREATMENT +clínica I-TREATMENT y I-TREATMENT -su I-TREATMENT -tratamiento I-TREATMENT de I-TREATMENT la I-TREATMENT -cardiopatía I-TREATMENT -isquémica) I-TREATMENT -y I-TREATMENT -fue I-TREATMENT -dado I-TREATMENT +función I-TREATMENT +renal. I-TREATMENT +La I-TREATMENT +EC I-TREATMENT +recidivó I-TREATMENT +en I-TREATMENT +la I-TREATMENT +anastomosis I-TREATMENT +siendo I-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +azatioprina, I-TREATMENT +con B-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +ha I-EVOLUTION +controlado I-EVOLUTION +la I-EVOLUTION +enfermedad I-EVOLUTION +intestinal, I-EVOLUTION +aunque I-EVOLUTION +persiste I-EVOLUTION +la I-EVOLUTION +fístula I-EVOLUTION +perianal I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +oligosintomática. I-EVOLUTION +En B-TREATMENT +la I-TREATMENT +actualidad I-TREATMENT +mantiene I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +azatioprina I-TREATMENT +más I-TREATMENT +mesalacina, I-TREATMENT +presentando I-TREATMENT +función I-TREATMENT +renal I-TREATMENT +normal, I-TREATMENT +con I-TREATMENT +persistencia I-TREATMENT de I-TREATMENT -alta I-TREATMENT -siguiéndose I-TREATMENT -su I-TREATMENT -evolución I-TREATMENT +proteinuria I-TREATMENT en I-TREATMENT -consultas I-TREATMENT -externas. I-TREATMENT +rango I-TREATMENT +no I-TREATMENT +nefrótico. I-TREATMENT I-TREATMENT -Varón B-PRESENT_ILLNESS +Escolar B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -64 I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY +portador B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Dermatología I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -cuadro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -unos I-DERIVED_FROM/TO -45 I-DERIVED_FROM/TO -días I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -nódulos I-DERIVED_FROM/TO -cutáneos I-DERIVED_FROM/TO -recidivantes, I-DERIVED_FROM/TO -indoloros I-DERIVED_FROM/TO -e I-DERIVED_FROM/TO -indurados I-DERIVED_FROM/TO -localizados I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -miembros I-DERIVED_FROM/TO -inferiores. I-DERIVED_FROM/TO -No B-EXPLORATION -impresionaba I-EXPLORATION -de I-EXPLORATION -enfermedad, I-EXPLORATION -ni I-EXPLORATION -refería I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -peso, I-EXPLORATION -fiebre, I-EXPLORATION -ni I-EXPLORATION -síndrome I-EXPLORATION -constitucional. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destacaban I-EXPLORATION -varias I-EXPLORATION -lesiones I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -de I-EXPLORATION -placas I-EXPLORATION -nodulares I-EXPLORATION -subcutáneas I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION +una I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +reflujo I-PAST_MEDICAL_HISTORY +vesicoureteral I-PAST_MEDICAL_HISTORY +grado I-PAST_MEDICAL_HISTORY +5, I-PAST_MEDICAL_HISTORY +bilateral, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +hidronefrosis I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +desnutrición I-PAST_MEDICAL_HISTORY +grave. I-PAST_MEDICAL_HISTORY +Recibía I-PAST_MEDICAL_HISTORY +profilaxis I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +ITU I-PAST_MEDICAL_HISTORY +recurrentes I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +cotrimoxazol I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +exposición I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +varios I-PAST_MEDICAL_HISTORY +antibacterianos I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +últimos I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +(cefuroximo, I-PAST_MEDICAL_HISTORY +ceftriaxona I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +ciprofloxacina). I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Ingresó B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +UCI I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +pielonefritis I-PRESENT_ILLNESS +aguda I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +insuficiencia I-PRESENT_ILLNESS +renal I-PRESENT_ILLNESS +crónica I-PRESENT_ILLNESS +reagudizada. I-PRESENT_ILLNESS +El B-EXPLORATION +urocultivo I-EXPLORATION +realizado I-EXPLORATION +al I-EXPLORATION +ingreso I-EXPLORATION +fue I-EXPLORATION +positivo I-EXPLORATION a I-EXPLORATION -3 I-EXPLORATION -cm. I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -eritemato-violáceas, I-EXPLORATION -simétricas, I-EXPLORATION -duras I-EXPLORATION -e I-EXPLORATION -indoloras, I-EXPLORATION -localizadas I-EXPLORATION -en I-EXPLORATION -ambas I-EXPLORATION -caras I-EXPLORATION -internas I-EXPLORATION -de I-EXPLORATION -muslos, I-EXPLORATION -pantorrilla, I-EXPLORATION -abdomen I-EXPLORATION +E.coli I-EXPLORATION +(cepa I-EXPLORATION +ITU1) I-EXPLORATION +sensible I-EXPLORATION +a I-EXPLORATION +ampicilina, I-EXPLORATION +cefalotina, I-EXPLORATION +cefuroximo, I-EXPLORATION +ceftriaxona I-EXPLORATION y I-EXPLORATION -hombro I-EXPLORATION -izquierdo. I-EXPLORATION -No I-EXPLORATION -presentaba I-EXPLORATION -adenopatías I-EXPLORATION -ni I-EXPLORATION -visceromegalias I-EXPLORATION +gentamicina; I-EXPLORATION +resistente I-EXPLORATION +a I-EXPLORATION +ciprofloxacina I-EXPLORATION y I-EXPLORATION +cotrimoxazol. I-EXPLORATION +Recibió B-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +cefuroximo I-TREATMENT +iv I-TREATMENT +150 I-TREATMENT +mg/kg/día. I-TREATMENT +Al B-EVOLUTION +sexto I-EVOLUTION +día I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +sepsis I-EVOLUTION +de I-EVOLUTION +foco I-EVOLUTION +urinario. I-EVOLUTION +Se B-TREATMENT +cambió I-TREATMENT +tratamiento I-TREATMENT +a I-TREATMENT +ceftriaxona I-TREATMENT +iv I-TREATMENT +a I-TREATMENT +100 I-TREATMENT +mg/ I-TREATMENT +kg/día I-TREATMENT +previa I-TREATMENT +toma I-TREATMENT +de I-TREATMENT +urocultivo. I-TREATMENT +A B-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +h I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +persistía I-EVOLUTION +febril. I-EVOLUTION +El B-EXPLORATION +urocultivo I-EXPLORATION se I-EXPLORATION -apreciaban I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -tromboflebitis I-EXPLORATION -superficial I-EXPLORATION -en I-EXPLORATION -miembro I-EXPLORATION -inferior I-EXPLORATION -derecho. I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -se I-EXPLORATION -objetivó: I-EXPLORATION -leucocitos I-EXPLORATION -12, I-EXPLORATION -3 I-EXPLORATION -x I-EXPLORATION -109/L I-EXPLORATION -(neutrófilos I-EXPLORATION -6, I-EXPLORATION -8, I-EXPLORATION -linfocitos I-EXPLORATION -1, I-EXPLORATION -1, I-EXPLORATION -monocitos I-EXPLORATION -4.3, I-EXPLORATION -eosinófilos I-EXPLORATION -0, I-EXPLORATION -1), I-EXPLORATION -Hb I-EXPLORATION -120 I-EXPLORATION -g/L, I-EXPLORATION -VCM I-EXPLORATION -109, I-EXPLORATION -8 I-EXPLORATION -fL; I-EXPLORATION -Hto. I-EXPLORATION -32%; I-EXPLORATION -plaquetas I-EXPLORATION -133 I-EXPLORATION -x I-EXPLORATION -109/L. I-EXPLORATION -Se I-EXPLORATION -observaban I-EXPLORATION -algunos I-EXPLORATION -granulocitos I-EXPLORATION +informó I-EXPLORATION +con I-EXPLORATION +> I-EXPLORATION +105 I-EXPLORATION +UFC/ml I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -pelgueroide I-EXPLORATION -(núcleo I-EXPLORATION -no I-EXPLORATION -segmentado I-EXPLORATION -o I-EXPLORATION -hiposegmentado) I-EXPLORATION +E. I-EXPLORATION +coli I-EXPLORATION +(cepa I-EXPLORATION +ITU2) I-EXPLORATION +sensible I-EXPLORATION +a I-EXPLORATION +imipenem, I-EXPLORATION +meropenem, I-EXPLORATION +amikacina I-EXPLORATION y I-EXPLORATION -anisocitosis I-EXPLORATION -discreta. I-EXPLORATION -Reticulocitos: I-EXPLORATION -2, I-EXPLORATION -4% I-EXPLORATION -(totales I-EXPLORATION -86, I-EXPLORATION -4 I-EXPLORATION -x I-EXPLORATION -109/L), I-EXPLORATION -VSG I-EXPLORATION -60 I-EXPLORATION -mm/h; I-EXPLORATION -inmunoglobulinas, I-EXPLORATION -proteinograma, I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -hemostasia, I-EXPLORATION -orina I-EXPLORATION +gentamicina; I-EXPLORATION +resistente I-EXPLORATION +a I-EXPLORATION +ampicilina, I-EXPLORATION +cefalotina, I-EXPLORATION +cefuroximo, I-EXPLORATION +ceftriaxona, I-EXPLORATION +ciprofloxacina I-EXPLORATION y I-EXPLORATION -sedimento, I-EXPLORATION -estudio I-EXPLORATION -del I-EXPLORATION -hierro, I-EXPLORATION -vitamina I-EXPLORATION -B12 I-EXPLORATION +cotrimoxazol. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +meropenem I-TREATMENT +iv I-TREATMENT +60 I-TREATMENT +mg/kg/día, I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +evolución I-TREATMENT +clínica I-TREATMENT +y I-TREATMENT +urocultivo I-TREATMENT +de I-TREATMENT +control, I-TREATMENT +intra-tratamiento, I-TREATMENT +sin I-TREATMENT +desarrollo I-TREATMENT +bacteriano. I-TREATMENT + I-TREATMENT +Tipificación B-EXPLORATION +molecular I-EXPLORATION y I-EXPLORATION -ácido I-EXPLORATION -fólico, I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -Eco-doppler I-EXPLORATION -de I-EXPLORATION -miembros I-EXPLORATION -inferiores, I-EXPLORATION -demostrándose I-EXPLORATION -una I-EXPLORATION -tromboflebitis I-EXPLORATION -superficial I-EXPLORATION -de I-EXPLORATION -safena I-EXPLORATION -interna I-EXPLORATION -del I-EXPLORATION -miembro I-EXPLORATION -inferior I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -trombosis I-EXPLORATION -de I-EXPLORATION -dicha I-EXPLORATION -vena I-EXPLORATION -e I-EXPLORATION -importante I-EXPLORATION -componente I-EXPLORATION -edematoso I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -graso I-EXPLORATION -circundante, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION +mecanismo I-EXPLORATION de I-EXPLORATION -trombosis I-EXPLORATION -venosa I-EXPLORATION -profunda. I-EXPLORATION -En I-EXPLORATION -varios I-EXPLORATION -hemogramas I-EXPLORATION -posteriores I-EXPLORATION +resistencia: I-EXPLORATION +Mediante I-EXPLORATION +EFCP I-EXPLORATION se I-EXPLORATION -mantuvo I-EXPLORATION -significativamente I-EXPLORATION -elevada I-EXPLORATION -la I-EXPLORATION -cifra I-EXPLORATION -de I-EXPLORATION -monocitos I-EXPLORATION -en I-EXPLORATION -sangre. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -cutánea I-EXPLORATION +confirmó I-EXPLORATION que I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -en I-EXPLORATION -tejido I-EXPLORATION -celular I-EXPLORATION -subcutáneo I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -paniculitis I-EXPLORATION -granulomatosa I-EXPLORATION -panlobular I-EXPLORATION -con I-EXPLORATION -necrosis I-EXPLORATION -lobulillar I-EXPLORATION -tipo I-EXPLORATION -eritema I-EXPLORATION -indurado I-EXPLORATION -de I-EXPLORATION -Bazin I-EXPLORATION -o I-EXPLORATION -vasculitis I-EXPLORATION -nodular, I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -trombosis I-EXPLORATION -venosa I-EXPLORATION -organizada. I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION +ambas I-EXPLORATION +cepas I-EXPLORATION +eran I-EXPLORATION +genéticamente I-EXPLORATION +indistinguibles. I-EXPLORATION +La I-EXPLORATION +cepa I-EXPLORATION +ITU2 I-EXPLORATION +presentaba I-EXPLORATION una I-EXPLORATION -batería I-EXPLORATION -de I-EXPLORATION -pruebas I-EXPLORATION -diagnósticas I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -causas I-EXPLORATION -Infecciosas I-EXPLORATION -(BK, I-EXPLORATION -cultivo I-EXPLORATION -y I-EXPLORATION -análisis I-EXPLORATION -por I-EXPLORATION -PCR I-EXPLORATION -para I-EXPLORATION -Mycobacterium I-EXPLORATION -tuberculosis: I-EXPLORATION -negativos; I-EXPLORATION -serologías I-EXPLORATION -para I-EXPLORATION -infección I-EXPLORATION -reciente I-EXPLORATION -por I-EXPLORATION -Toxoplasma, I-EXPLORATION -Legionela, I-EXPLORATION -Mycoplasma I-EXPLORATION -pneumoniae I-EXPLORATION -y I-EXPLORATION -para I-EXPLORATION -fiebre I-EXPLORATION -Q: I-EXPLORATION -negativas; I-EXPLORATION -ASLO, I-EXPLORATION -negativo; I-EXPLORATION -Singer I-EXPLORATION -Plotz I-EXPLORATION -y I-EXPLORATION -VDRL, I-EXPLORATION -negativos), I-EXPLORATION -causas I-EXPLORATION -neoplásicas I-EXPLORATION -(alfa-feto-proteína, I-EXPLORATION -antígeno I-EXPLORATION -carcinoembrionario, I-EXPLORATION -b2-microglobulina, I-EXPLORATION -Ca-19.9, I-EXPLORATION -PSA: I-EXPLORATION -normales; I-EXPLORATION -TAC I-EXPLORATION -abdominopélvico: I-EXPLORATION -moderado I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -densidad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -grasa I-EXPLORATION -del I-EXPLORATION -mesenterio I-EXPLORATION +BLEE I-EXPLORATION +SHV-5 I-EXPLORATION +codificada I-EXPLORATION en I-EXPLORATION -flanco I-EXPLORATION -derecho I-EXPLORATION -que I-EXPLORATION -impronta I-EXPLORATION -asas I-EXPLORATION -intestinales, I-EXPLORATION +un I-EXPLORATION +plásmido I-EXPLORATION +conjugativo I-EXPLORATION +del I-EXPLORATION +grupo I-EXPLORATION +IncFIB, I-EXPLORATION +ausente I-EXPLORATION en I-EXPLORATION -probable I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -paniculitis) I-EXPLORATION -y I-EXPLORATION -enfermedades I-EXPLORATION -sistémicas I-EXPLORATION -(factor I-EXPLORATION -reumatoideo I-EXPLORATION -y I-EXPLORATION -anticuerpos I-EXPLORATION -antinúcleo I-EXPLORATION -negativos; I-EXPLORATION -niveles I-EXPLORATION -normales I-EXPLORATION +la I-EXPLORATION +cepa I-EXPLORATION +ITU1. I-EXPLORATION + I-EXPLORATION + +RNT B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +gestación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +38 I-PRESENT_ILLNESS +semanas, I-PRESENT_ILLNESS +AEG, I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nacimiento I-PRESENT_ILLNESS +3.510 I-PRESENT_ILLNESS +gr I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +talla I-PRESENT_ILLNESS +50 I-PRESENT_ILLNESS +cm. I-PRESENT_ILLNESS +Apgar B-PAST_MEDICAL_HISTORY +9-10, I-PAST_MEDICAL_HISTORY +segunda I-PAST_MEDICAL_HISTORY +hija I-PAST_MEDICAL_HISTORY +de B-FAMILY_HISTORY +padres I-FAMILY_HISTORY +sanos. I-FAMILY_HISTORY +Nació B-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +cesárea I-PAST_MEDICAL_HISTORY +electiva I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +cesárea I-PAST_MEDICAL_HISTORY +anterior. I-PAST_MEDICAL_HISTORY +La B-FAMILY_HISTORY +madre I-FAMILY_HISTORY +tenía I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +de I-FAMILY_HISTORY +un I-FAMILY_HISTORY +embarazo I-FAMILY_HISTORY +fisiológico, I-FAMILY_HISTORY +una I-FAMILY_HISTORY +infección I-FAMILY_HISTORY +urinaria I-FAMILY_HISTORY +en I-FAMILY_HISTORY +el I-FAMILY_HISTORY +primer I-FAMILY_HISTORY +trimestre I-FAMILY_HISTORY +de I-FAMILY_HISTORY +gestación I-FAMILY_HISTORY +y I-FAMILY_HISTORY +detección I-FAMILY_HISTORY +de I-FAMILY_HISTORY +portación I-FAMILY_HISTORY +recto-vaginal I-FAMILY_HISTORY +de I-FAMILY_HISTORY +Streptococcus I-FAMILY_HISTORY +agalactiae I-FAMILY_HISTORY +en I-FAMILY_HISTORY +el I-FAMILY_HISTORY +tercer I-FAMILY_HISTORY +trimestre I-FAMILY_HISTORY +del I-FAMILY_HISTORY +embarazo. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Inició B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +25 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +vida, I-PRESENT_ILLNESS +movimientos I-PRESENT_ILLNESS +mioclónicos I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +hemicuerpo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +estando I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +vigilia; I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +madre I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +notó I-PRESENT_ILLNESS +somnolienta I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +disminución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +demanda I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +alimentos. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Fue I-PRESENT_ILLNESS +llevada I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +urgencia I-PRESENT_ILLNESS +(SU) I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +evaluación. I-PRESENT_ILLNESS +Al B-EXPLORATION +ingreso I-EXPLORATION +estaba I-EXPLORATION +febril, I-EXPLORATION +en I-EXPLORATION +relativas I-EXPLORATION +buenas I-EXPLORATION +condiciones I-EXPLORATION +generales, I-EXPLORATION +sin I-EXPLORATION +movimientos I-EXPLORATION +anormales, I-EXPLORATION +fontanela I-EXPLORATION +con I-EXPLORATION +tensión I-EXPLORATION +normal, I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -C3 I-EXPLORATION +lesiones I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +piel I-EXPLORATION y I-EXPLORATION -C4, I-EXPLORATION -proteína I-EXPLORATION +mucosas I-EXPLORATION +y I-EXPLORATION +su I-EXPLORATION +examen I-EXPLORATION +segmentario I-EXPLORATION +era I-EXPLORATION +normal. I-EXPLORATION +Signos I-EXPLORATION +vitales: I-EXPLORATION +FC I-EXPLORATION +177 I-EXPLORATION +por I-EXPLORATION +min, I-EXPLORATION +FR I-EXPLORATION +52 I-EXPLORATION +por I-EXPLORATION +min, I-EXPLORATION +T° I-EXPLORATION +38, I-EXPLORATION +3° I-EXPLORATION C I-EXPLORATION -reactiva, I-EXPLORATION -enzima I-EXPLORATION -convertidor I-EXPLORATION +axilar, I-EXPLORATION +P. I-EXPLORATION +arterial I-EXPLORATION +91/55 I-EXPLORATION +mm/Hg, I-EXPLORATION +P. I-EXPLORATION +arterial I-EXPLORATION +media I-EXPLORATION +62 I-EXPLORATION +mm/Hg, I-EXPLORATION +saturación I-EXPLORATION de I-EXPLORATION -angiotensina I-EXPLORATION +O2 I-EXPLORATION +97%. I-EXPLORATION +Exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +iniciales: I-EXPLORATION +leucocitos I-EXPLORATION +6.800/mm3 I-EXPLORATION +(52% I-EXPLORATION +linfocitos), I-EXPLORATION +hematocrito I-EXPLORATION +40, I-EXPLORATION +7%, I-EXPLORATION +PCR: I-EXPLORATION +0 I-EXPLORATION +mg/L, I-EXPLORATION +perfil I-EXPLORATION +bioquímico I-EXPLORATION +con I-EXPLORATION +leve I-EXPLORATION +hiperbilirrubinemia I-EXPLORATION +de I-EXPLORATION +predominio I-EXPLORATION +indirecto. I-EXPLORATION +Examen I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION y I-EXPLORATION -alfa-1 I-EXPLORATION -antitripsina). I-EXPLORATION -La I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +normales. I-EXPLORATION +Durante B-EVOLUTION +la I-EVOLUTION +observación I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +SU I-EVOLUTION +evolucionó I-EVOLUTION +con I-EVOLUTION +respiración I-EVOLUTION +irregular, I-EVOLUTION +piel I-EVOLUTION +reticulada I-EVOLUTION +y I-EVOLUTION +movimientos I-EVOLUTION +mioclónicos I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +hemicuerpo I-EVOLUTION +derecho I-EVOLUTION +que I-EVOLUTION +no I-EVOLUTION +cedían I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +contención. I-EVOLUTION +Por B-TREATMENT +su I-TREATMENT +condición I-TREATMENT +clínica I-TREATMENT +se I-TREATMENT +le I-TREATMENT +indicó I-TREATMENT +apoyo I-TREATMENT +con I-TREATMENT +oxígeno, I-TREATMENT +solución I-TREATMENT +salina I-TREATMENT +isotónica I-TREATMENT +(NaCl I-TREATMENT +9%) I-TREATMENT +20 I-TREATMENT +ml/kg I-TREATMENT +en I-TREATMENT +bolo, I-TREATMENT +lorazepam I-TREATMENT +0. I-TREATMENT +1 I-TREATMENT +mg/kg I-TREATMENT +i.v., I-TREATMENT +iniciándose I-TREATMENT +tratamiento I-TREATMENT +antimicrobiano I-TREATMENT +empírico I-TREATMENT +con I-TREATMENT +ampicilina I-TREATMENT ++ I-TREATMENT +cefotaxima I-TREATMENT +i.v. I-TREATMENT +luego I-TREATMENT +de I-TREATMENT +obtener I-TREATMENT +hemocultivos I-TREATMENT +y I-TREATMENT +las I-TREATMENT +muestras I-TREATMENT +de I-TREATMENT +LCR. I-TREATMENT +El B-EXPLORATION +análisis I-EXPLORATION +citoquímico I-EXPLORATION +del I-EXPLORATION +LCR I-EXPLORATION +fue I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION tinción I-EXPLORATION de I-EXPLORATION -Ziehl-Neelsen I-EXPLORATION -en I-EXPLORATION +Gram I-EXPLORATION +directa I-EXPLORATION +no I-EXPLORATION +evidenció I-EXPLORATION la I-EXPLORATION -muestra I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -biopsia I-EXPLORATION -cutánea I-EXPLORATION -(pues I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -diferencial I-EXPLORATION +bacterias I-EXPLORATION +(muestra I-EXPLORATION +1, I-EXPLORATION +Tabla I-EXPLORATION +1). I-EXPLORATION +Un I-EXPLORATION +ml I-EXPLORATION +adicional I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -microscópica I-EXPLORATION -observada I-EXPLORATION -debe I-EXPLORATION -establecerse I-EXPLORATION -principalmente I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -infección I-EXPLORATION -cutánea I-EXPLORATION -por I-EXPLORATION -micobacterias) I-EXPLORATION -fue I-EXPLORATION -así I-EXPLORATION -mismo I-EXPLORATION -negativa. I-EXPLORATION +LCR I-EXPLORATION +se I-EXPLORATION +guardó I-EXPLORATION +a I-EXPLORATION +4°C I-EXPLORATION +para I-EXPLORATION +estudios I-EXPLORATION +posteriores I-EXPLORATION +de I-EXPLORATION +biología I-EXPLORATION +molecular. I-EXPLORATION I-EXPLORATION -La B-DERIVED_FROM/TO -presencia I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -sangre I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -formas I-DERIVED_FROM/TO -granulocíticas I-DERIVED_FROM/TO -displásicas I-DERIVED_FROM/TO -motivó I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fuera I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO +Se B-DERIVED_FROM/TO +trasladó I-DERIVED_FROM/TO a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -Servicio, I-DERIVED_FROM/TO -en B-EXPLORATION -el I-EXPLORATION +la I-DERIVED_FROM/TO +Unidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Cuidados I-DERIVED_FROM/TO +Intensivos I-DERIVED_FROM/TO +Neonatales I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +monitorización. I-DERIVED_FROM/TO +A B-EVOLUTION +las I-EVOLUTION +24 I-EVOLUTION +h I-EVOLUTION +de I-EVOLUTION +internación, I-EVOLUTION +nuevamente I-EVOLUTION +presentó I-EVOLUTION +fiebre, I-EVOLUTION +hiporreactividad, I-EVOLUTION +y I-EVOLUTION +un I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +fijación I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +mirada I-EVOLUTION +con I-EVOLUTION +repetición I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +crisis I-EVOLUTION +convulsiva I-EVOLUTION +focal. I-EVOLUTION +Se B-EXPLORATION +plantearon I-EXPLORATION +como I-EXPLORATION +posibles I-EXPLORATION +diagnósticos I-EXPLORATION +una I-EXPLORATION +meningitis I-EXPLORATION +bacteriana I-EXPLORATION +aguda I-EXPLORATION +inicial I-EXPLORATION +o I-EXPLORATION +una I-EXPLORATION +encefalitis I-EXPLORATION +herpética I-EXPLORATION +por I-EXPLORATION +los I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -aspirado I-EXPLORATION -medular, I-EXPLORATION -observándose I-EXPLORATION -una I-EXPLORATION -médula I-EXPLORATION -ósea I-EXPLORATION -hipercelular I-EXPLORATION +decidió I-EXPLORATION +repetir I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +del I-EXPLORATION +LCR I-EXPLORATION +y B-TREATMENT +adicionar I-TREATMENT +a I-TREATMENT +la I-TREATMENT +terapia I-TREATMENT +antimicrobiana, I-TREATMENT +aciclovir I-TREATMENT +i.v. I-TREATMENT +60 I-TREATMENT +mg/kg/día I-TREATMENT +fraccionado I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +h. I-TREATMENT +En B-EXPLORATION +el I-EXPLORATION +análisis I-EXPLORATION +citoquímico I-EXPLORATION +del I-EXPLORATION +segundo I-EXPLORATION +LCR I-EXPLORATION +destacó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +190 I-EXPLORATION +leucocitos/mm3 I-EXPLORATION con I-EXPLORATION -megacariocitos I-EXPLORATION -conservados I-EXPLORATION +predominio I-EXPLORATION +mononuclear I-EXPLORATION +(79%), I-EXPLORATION +170 I-EXPLORATION +eritrocitos/mm3, I-EXPLORATION +glucorraquia I-EXPLORATION y I-EXPLORATION -algún I-EXPLORATION -micromegacariocito I-EXPLORATION -ocasionalmente, I-EXPLORATION -destacando I-EXPLORATION -una I-EXPLORATION -hiperplasia I-EXPLORATION +proteínorraquia I-EXPLORATION +normales. I-EXPLORATION +La I-EXPLORATION +tinción I-EXPLORATION de I-EXPLORATION +Gram I-EXPLORATION +directa I-EXPLORATION +no I-EXPLORATION +evidenció I-EXPLORATION la I-EXPLORATION -serie I-EXPLORATION -monocítica I-EXPLORATION -(21% I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -celularidad I-EXPLORATION -medular I-EXPLORATION -global, I-EXPLORATION -entre I-EXPLORATION -promonocitos I-EXPLORATION -y I-EXPLORATION -monocitos) I-EXPLORATION -e I-EXPLORATION -hipoplasia I-EXPLORATION -moderada I-EXPLORATION +bacterias I-EXPLORATION +(muestra I-EXPLORATION +2, I-EXPLORATION +Tabla I-EXPLORATION +1). I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +una I-EXPLORATION +RPC I-EXPLORATION de I-EXPLORATION +LCR I-EXPLORATION +cualitativa I-EXPLORATION +para I-EXPLORATION +VHS I-EXPLORATION +tipos I-EXPLORATION +1 I-EXPLORATION +y I-EXPLORATION +2 I-EXPLORATION +(herpes I-EXPLORATION +simplex I-EXPLORATION +virus I-EXPLORATION +1/2 I-EXPLORATION +Real I-EXPLORATION +Time I-EXPLORATION +PCR I-EXPLORATION +kit, I-EXPLORATION +InsideGen® I-EXPLORATION +Bioscan, I-EXPLORATION +Chile) I-EXPLORATION +sin I-EXPLORATION +lograrse I-EXPLORATION la I-EXPLORATION -serie I-EXPLORATION -roja I-EXPLORATION -(13%) I-EXPLORATION -con I-EXPLORATION -displasia I-EXPLORATION -leve I-EXPLORATION -(puentes I-EXPLORATION -intercitoplasmáticos I-EXPLORATION +detección I-EXPLORATION +de I-EXPLORATION +ADN I-EXPLORATION +viral. I-EXPLORATION +Pese B-TREATMENT +al I-TREATMENT +resultado I-TREATMENT +negativo I-TREATMENT +de I-TREATMENT +RPC-TR I-TREATMENT +a I-TREATMENT +las I-TREATMENT +24 I-TREATMENT +h I-TREATMENT +de I-TREATMENT +iniciado I-TREATMENT +el I-TREATMENT +cuadro I-TREATMENT +clínico, I-TREATMENT +se I-TREATMENT +mantuvo I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +aciclovir I-TREATMENT +1. I-TREATMENT +v. I-TREATMENT +ya I-TREATMENT +que I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +permanecía I-TREATMENT +con I-TREATMENT +compromiso I-TREATMENT +de I-TREATMENT +conciencia I-TREATMENT +y I-TREATMENT +crisis I-TREATMENT +focales. I-TREATMENT + I-TREATMENT +Una B-EXPLORATION +TAC I-EXPLORATION +cerebral, I-EXPLORATION +al I-EXPLORATION +segundo I-EXPLORATION +día I-EXPLORATION +de I-EXPLORATION +hospitalización, I-EXPLORATION +fue I-EXPLORATION +normal I-EXPLORATION y I-EXPLORATION -algunas I-EXPLORATION -formas I-EXPLORATION -gigantes), I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +electroencefalograma I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +lentitud I-EXPLORATION +hipovoltada I-EXPLORATION +difusa I-EXPLORATION y I-EXPLORATION -sobre I-EXPLORATION -todo I-EXPLORATION +ocasionales I-EXPLORATION +paroxismos I-EXPLORATION +agudos I-EXPLORATION +multifocales. I-EXPLORATION +Se B-TREATMENT +le I-TREATMENT +administró I-TREATMENT +fenobarbital I-TREATMENT +15 I-TREATMENT +mg/ I-TREATMENT +kg I-TREATMENT +i.v. I-TREATMENT +y I-TREATMENT +luego I-TREATMENT +5 I-TREATMENT +mg/kg/día I-TREATMENT +v.o. I-TREATMENT +como I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +mantención. I-TREATMENT +Los B-EXPLORATION +cultivos I-EXPLORATION +bacteriológicos I-EXPLORATION +del I-EXPLORATION +primer I-EXPLORATION +y I-EXPLORATION +segundo I-EXPLORATION +LCR I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +sangre I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION + I-EXPLORATION +Evolucionó B-EVOLUTION +con I-EVOLUTION +persistencia I-EVOLUTION +del I-EVOLUTION +compromiso I-EVOLUTION +de I-EVOLUTION +conciencia, I-EVOLUTION +posturas I-EVOLUTION +anormales I-EVOLUTION +en I-EVOLUTION +reposo, I-EVOLUTION +crisis I-EVOLUTION +clónicas I-EVOLUTION +multifocales I-EVOLUTION +múltiples I-EVOLUTION +y B-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +alta I-EXPLORATION +sospecha I-EXPLORATION +clínica I-EXPLORATION +de I-EXPLORATION +encefalitis I-EXPLORATION +herpética, I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION +realizar I-EXPLORATION una I-EXPLORATION -disgranulopoyesis I-EXPLORATION -significativa I-EXPLORATION -(citoplasmas I-EXPLORATION -francamente I-EXPLORATION -agranulares, I-EXPLORATION -frecuentes I-EXPLORATION -elementos I-EXPLORATION +tercera I-EXPLORATION +RPC-TR I-EXPLORATION +en I-EXPLORATION +LCR I-EXPLORATION +para I-EXPLORATION +VHS I-EXPLORATION +1 I-EXPLORATION +y I-EXPLORATION +2 I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +48 I-EXPLORATION +h I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -pelgueroide, I-EXPLORATION -asincronismo I-EXPLORATION -madurativo I-EXPLORATION -núcleo-citoplasmático I-EXPLORATION +iniciado I-EXPLORATION +el I-EXPLORATION +cuadro I-EXPLORATION +clínico I-EXPLORATION y I-EXPLORATION -predominio I-EXPLORATION +a I-EXPLORATION +24 I-EXPLORATION +h I-EXPLORATION de I-EXPLORATION -formas I-EXPLORATION -madurativas I-EXPLORATION -intermedias); I-EXPLORATION +comenzar I-EXPLORATION +el I-EXPLORATION +tratamiento I-EXPLORATION +con I-EXPLORATION +aciclovir, I-EXPLORATION la I-EXPLORATION -blastosis I-EXPLORATION -constituía I-EXPLORATION -sólo I-EXPLORATION -un I-EXPLORATION -3%. I-EXPLORATION -El I-EXPLORATION -cariotipo I-EXPLORATION +que I-EXPLORATION fue I-EXPLORATION -normal, I-EXPLORATION -46XY. I-EXPLORATION -Con I-EXPLORATION -todo I-EXPLORATION -ello I-EXPLORATION +positiva I-EXPLORATION +para I-EXPLORATION +VHS I-EXPLORATION +1 I-EXPLORATION +(muestra I-EXPLORATION +3, I-EXPLORATION +Tabla I-EXPLORATION +1). I-EXPLORATION + I-EXPLORATION +Las I-EXPLORATION +funciones I-EXPLORATION +hepática I-EXPLORATION +y I-EXPLORATION +renal I-EXPLORATION +fueron I-EXPLORATION +normales, I-EXPLORATION +al I-EXPLORATION +igual I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +evaluación I-EXPLORATION +oftalmológica. I-EXPLORATION +Las B-EVOLUTION +manifestaciones I-EVOLUTION +convulsivas I-EVOLUTION +persistieron I-EVOLUTION +hasta I-EVOLUTION +el I-EVOLUTION +tercer I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +hospitalización. I-EVOLUTION +De I-EVOLUTION +allí I-EVOLUTION +en I-EVOLUTION +adelante, I-EVOLUTION +se I-EVOLUTION +le I-EVOLUTION +apreció I-EVOLUTION +alerta, I-EVOLUTION +con I-EVOLUTION +succión I-EVOLUTION +vigorosa, I-EVOLUTION +sin I-EVOLUTION +nuevas I-EVOLUTION +crisis, I-EVOLUTION +destacando I-EVOLUTION +sólo I-EVOLUTION +un I-EVOLUTION +síndrome I-EVOLUTION +tembloroso I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +extremidad I-EVOLUTION +superior I-EVOLUTION +izquierda. I-EVOLUTION + I-EVOLUTION +Una B-EXPLORATION +RM I-EXPLORATION +de I-EXPLORATION +cerebro I-EXPLORATION +efectuada I-EXPLORATION +al I-EXPLORATION +día I-EXPLORATION +10 I-EXPLORATION +de I-EXPLORATION +internación I-EXPLORATION +evidenció I-EXPLORATION +lesiones I-EXPLORATION +hiperintensas I-EXPLORATION +subcorticales I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +peri-rolándica I-EXPLORATION +bilateral, I-EXPLORATION +frontomedial I-EXPLORATION +e I-EXPLORATION +insular I-EXPLORATION +derecha, I-EXPLORATION +con I-EXPLORATION +impregnación I-EXPLORATION +leptomeníngea I-EXPLORATION +focal, I-EXPLORATION +hallazgos I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +meningo-encefalitis. I-EXPLORATION + I-EXPLORATION +Al I-EXPLORATION +obtener I-EXPLORATION el I-EXPLORATION -enfermo I-EXPLORATION +resultado I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +RPC-TR I-EXPLORATION +positiva I-EXPLORATION +para I-EXPLORATION +VHS I-EXPLORATION +1, I-EXPLORATION se I-EXPLORATION -diagnosticó I-EXPLORATION +reinterrogó I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +madre I-EXPLORATION +dirigidamente I-EXPLORATION +quien I-EXPLORATION +relató I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +padre I-EXPLORATION +habría I-EXPLORATION +presentado I-EXPLORATION +una I-EXPLORATION +erupción I-EXPLORATION +labial I-EXPLORATION +sugerente I-EXPLORATION de I-EXPLORATION -LMMC I-EXPLORATION -con I-EXPLORATION -afectación I-EXPLORATION -cutánea I-EXPLORATION -inespecífica I-EXPLORATION -tipo I-EXPLORATION -paniculitis I-EXPLORATION -lobulillar. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -corticoides I-TREATMENT -orales I-TREATMENT -(prednisona I-TREATMENT -30 I-TREATMENT -mg/día, I-TREATMENT -con I-TREATMENT -pauta I-TREATMENT -de I-TREATMENT -descenso I-TREATMENT -semanal), I-TREATMENT -resolviéndose I-TREATMENT -las I-TREATMENT -lesiones I-TREATMENT -cutáneas I-TREATMENT -pocos I-TREATMENT +herpes I-EXPLORATION +labial I-EXPLORATION +dos I-EXPLORATION +semanas I-EXPLORATION +antes I-EXPLORATION +de I-EXPLORATION +enfermar I-EXPLORATION +la I-EXPLORATION +niña I-EXPLORATION +y I-EXPLORATION +tenía I-EXPLORATION +recurrencia I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +misma. I-EXPLORATION + I-EXPLORATION +A I-EXPLORATION +los I-EXPLORATION +20 I-EXPLORATION +días I-EXPLORATION +de I-EXPLORATION +tratamiento I-EXPLORATION +antiviral I-EXPLORATION +se I-EXPLORATION +controló I-EXPLORATION +el I-EXPLORATION +LCR I-EXPLORATION +certificándose I-EXPLORATION +la I-EXPLORATION +negatividad I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +RPC-TR I-EXPLORATION +para I-EXPLORATION +VHS I-EXPLORATION +1 I-EXPLORATION +y I-EXPLORATION +2 I-EXPLORATION +en I-EXPLORATION +LCR. I-EXPLORATION +Completó B-TREATMENT +21 I-TREATMENT días I-TREATMENT -después I-TREATMENT -de I-TREATMENT -comenzar I-TREATMENT -este I-TREATMENT -tratamiento. I-TREATMENT -En B-EVOLUTION +con I-TREATMENT +aciclovir, I-TREATMENT +sin I-TREATMENT +complicaciones. I-TREATMENT + I-TREATMENT +Desde B-EVOLUTION +su I-EVOLUTION +alta, I-EVOLUTION la I-EVOLUTION -actualidad, I-EVOLUTION -tres I-EVOLUTION -años I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -tratamiento I-EVOLUTION -desde I-EVOLUTION -entonces, I-EVOLUTION +paciente I-EVOLUTION se I-EVOLUTION -encuentra I-EVOLUTION -asintomático, I-EVOLUTION -con I-EVOLUTION -anemia I-EVOLUTION -leve, I-EVOLUTION -VCM I-EVOLUTION -110.9 I-EVOLUTION -fL, I-EVOLUTION -plaquetas I-EVOLUTION -143 I-EVOLUTION -x I-EVOLUTION -109/L, I-EVOLUTION -y I-EVOLUTION -monocitosis I-EVOLUTION -de I-EVOLUTION -2, I-EVOLUTION -3 I-EVOLUTION -x I-EVOLUTION -109/L I-EVOLUTION +controló I-EVOLUTION en I-EVOLUTION -sangre, I-EVOLUTION -haciéndose I-EVOLUTION -controles I-EVOLUTION -trimestrales; I-EVOLUTION +forma I-EVOLUTION +sistemática I-EVOLUTION en I-EVOLUTION -médula I-EVOLUTION -ósea I-EVOLUTION -persiste I-EVOLUTION -la I-EVOLUTION -displasia I-EVOLUTION -trilineal I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -blastosis I-EVOLUTION -del I-EVOLUTION -6% I-EVOLUTION +las I-EVOLUTION +Policlínicas I-EVOLUTION +de I-EVOLUTION +Infectología I-EVOLUTION y I-EVOLUTION +Neurología I-EVOLUTION +infantil. I-EVOLUTION +En I-EVOLUTION +nuestra I-EVOLUTION +última I-EVOLUTION +evaluación, I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +5 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +vida, I-EVOLUTION +se I-EVOLUTION +constató I-EVOLUTION +una I-EVOLUTION +lactante I-EVOLUTION +eutrófica I-EVOLUTION +con I-EVOLUTION un I-EVOLUTION -componente I-EVOLUTION -monocítico I-EVOLUTION +significativo I-EVOLUTION +retraso I-EVOLUTION del I-EVOLUTION -25%. I-EVOLUTION +desarrollo I-EVOLUTION +psicomotor. I-EVOLUTION I-EVOLUTION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -57 I-PRESENT_ILLNESS +64 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -colecistectomía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -artrosis I-PAST_MEDICAL_HISTORY -poliarticular I-PAST_MEDICAL_HISTORY +intervenida B-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY +nuestro I-PAST_MEDICAL_HISTORY +centro I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +sarcoma I-PAST_MEDICAL_HISTORY +esternal; I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +realizó I-PAST_MEDICAL_HISTORY +esternectomía I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +reconstrucción I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -ibuprofeno. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -acuosa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -este I-PRESENT_ILLNESS -tiempo. I-PRESENT_ILLNESS -Exploración B-EXPLORATION -física: I-EXPLORATION -anodina. I-EXPLORATION -Pruebas I-EXPLORATION -complementarias: I-EXPLORATION -hematimetría, I-EXPLORATION -coagulación, I-EXPLORATION -bioquímica I-EXPLORATION -completa I-EXPLORATION -con I-EXPLORATION -ionograma, I-EXPLORATION -transaminasas I-EXPLORATION -hepáticas, I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -y I-EXPLORATION -bilirrubina I-EXPLORATION -total: I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION -TSH I-EXPLORATION -y I-EXPLORATION -hormonas I-EXPLORATION -tiroideas: I-EXPLORATION -valores I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION -Niveles I-EXPLORATION -plasmáticos I-EXPLORATION -de I-EXPLORATION -péptido I-EXPLORATION -intestinal I-EXPLORATION -vasoactivo I-EXPLORATION -(VIP): I-EXPLORATION -5 I-EXPLORATION -pg/ml I-EXPLORATION -(valores I-EXPLORATION -normales: I-EXPLORATION -0-70 I-EXPLORATION -pg/ml). I-EXPLORATION -Niveles I-EXPLORATION -de I-EXPLORATION -ácido I-EXPLORATION -5-hidroxindol-acético I-EXPLORATION -(5HIAA) I-EXPLORATION -en I-EXPLORATION -orina I-EXPLORATION -de I-EXPLORATION -24 I-EXPLORATION -horas: I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -mg/24 I-EXPLORATION -horas I-EXPLORATION -(las I-EXPLORATION -cifras I-EXPLORATION -normales I-EXPLORATION -son I-EXPLORATION -inferiores I-EXPLORATION -a I-EXPLORATION -10 I-EXPLORATION -mg/24 I-EXPLORATION -horas). I-EXPLORATION -PCR: I-EXPLORATION -1, I-EXPLORATION -2 I-EXPLORATION -mg/dl I-EXPLORATION -(cifras I-EXPLORATION -normales I-EXPLORATION -en I-EXPLORATION -nuestro I-EXPLORATION -laboratorio I-EXPLORATION -hasta I-EXPLORATION -0, I-EXPLORATION -8 I-EXPLORATION -mg/dl), I-EXPLORATION -VSG: I-EXPLORATION -46 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -1ª I-EXPLORATION -hora. I-EXPLORATION -Anticuerpos I-EXPLORATION -antiendomisio I-EXPLORATION -y I-EXPLORATION -antigliadina I-EXPLORATION -negativos I-EXPLORATION -Leucocitos I-EXPLORATION -en I-EXPLORATION -heces: I-EXPLORATION -negativos. I-EXPLORATION -Coprocultivos, I-EXPLORATION -e I-EXPLORATION -investigación I-EXPLORATION -de I-EXPLORATION -Cl I-EXPLORATION -difficile, I-EXPLORATION -de I-EXPLORATION -parásitos I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -huevos I-EXPLORATION -de I-EXPLORATION -estos I-EXPLORATION -en I-EXPLORATION -heces: I-EXPLORATION -negativos. I-EXPLORATION -Tránsito I-EXPLORATION -esófago-gastro-duodenal I-EXPLORATION -(TEGD): I-EXPLORATION -normal. I-EXPLORATION -Ecografía I-EXPLORATION -abdominal: I-EXPLORATION -normal I-EXPLORATION -salvo I-EXPLORATION -aerobilia I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -vesícula I-EXPLORATION -biliar. I-EXPLORATION -Colonoscopia I-EXPLORATION -e I-EXPLORATION -ileoscopia: I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -macroscópicas. I-EXPLORATION -Se I-EXPLORATION -toman I-EXPLORATION -6 I-EXPLORATION -biopsias I-EXPLORATION -a I-EXPLORATION -lo I-EXPLORATION -largo I-EXPLORATION -de I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -colon I-EXPLORATION -(incluido I-EXPLORATION -sigma I-EXPLORATION -y I-EXPLORATION -recto), I-EXPLORATION -observándose I-EXPLORATION -en I-EXPLORATION -todas I-EXPLORATION -ellas I-EXPLORATION -un I-EXPLORATION -importante I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -con I-EXPLORATION -gran I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -intraepiteliales. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -74 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pérdida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY +placa I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -kg I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY +metacrilato I-PAST_MEDICAL_HISTORY +colocada I-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -así I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -artralgias I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hombros I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -rodillas. I-PAST_MEDICAL_HISTORY -Había B-PRESENT_ILLNESS -presentado I-PRESENT_ILLNESS -brotes I-PRESENT_ILLNESS +arcos I-PAST_MEDICAL_HISTORY +costales I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +sutura I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +labrar I-PAST_MEDICAL_HISTORY +orificios I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +bordes. I-PAST_MEDICAL_HISTORY +La B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -episódica I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -productos I-PRESENT_ILLNESS -patológicos I-PRESENT_ILLNESS +malestar I-PRESENT_ILLNESS +general, I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -anorexia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -febrícula. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -advirtió I-EXPLORATION -una I-EXPLORATION -hiperpigmentación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -desnutrición I-EXPLORATION -importante. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -básica I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -anemia I-EXPLORATION -microcítica, I-EXPLORATION -eosinofilia I-EXPLORATION -en I-EXPLORATION -sangre, I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -sedimentación I-EXPLORATION -globular I-EXPLORATION -(VSG) I-EXPLORATION -57 I-EXPLORATION -seg, I-EXPLORATION -albúmina I-EXPLORATION -2, I-EXPLORATION -46 I-EXPLORATION -g/dl, I-EXPLORATION -colesterol I-EXPLORATION -82mg/dl, I-EXPLORATION -sideremia I-EXPLORATION -12 I-EXPLORATION -mcg/dl, I-EXPLORATION -ferritina I-EXPLORATION -12 I-EXPLORATION -ng/ml, I-EXPLORATION -Van I-EXPLORATION -de I-EXPLORATION -Kamer I-EXPLORATION -9, I-EXPLORATION -2 I-EXPLORATION -g I-EXPLORATION -de I-EXPLORATION -grasa/día. I-EXPLORATION -La I-EXPLORATION +fiebre I-PRESENT_ILLNESS +intermitente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +últimos I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +meses. I-PRESENT_ILLNESS +La B-EXPLORATION tomografía I-EXPLORATION -axial I-EXPLORATION computerizada I-EXPLORATION (TAC) I-EXPLORATION mostró I-EXPLORATION -gran I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -adenopatías I-EXPLORATION -retroperitoneales I-EXPLORATION -y I-EXPLORATION -mesentéricas I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -significativo. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -endoscopia I-EXPLORATION -oral I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION una I-EXPLORATION -imagen I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -gastritis I-EXPLORATION -crónica I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -punteado I-EXPLORATION -blanquecino I-EXPLORATION -en I-EXPLORATION -segunda I-EXPLORATION -porción I-EXPLORATION -duodenal. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -duodenal I-EXPLORATION -demostró I-EXPLORATION -macrófagos I-EXPLORATION -positivos I-EXPLORATION -al I-EXPLORATION -ácido I-EXPLORATION -peryódico I-EXPLORATION +colección I-EXPLORATION de I-EXPLORATION -Schiff I-EXPLORATION -(PAS) I-EXPLORATION -y I-EXPLORATION -tinción I-EXPLORATION +material I-EXPLORATION +líquido I-EXPLORATION +bajo I-EXPLORATION +la I-EXPLORATION +placa I-EXPLORATION de I-EXPLORATION -Ziehl I-EXPLORATION -negativa, I-EXPLORATION +metacrilato, I-EXPLORATION compatible I-EXPLORATION con I-EXPLORATION -la I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Whipple. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -empezó I-TREATMENT -a I-TREATMENT -tratar I-TREATMENT -con I-TREATMENT -penicilina I-TREATMENT -y I-TREATMENT -estreptomicina I-TREATMENT -15 I-TREATMENT -días I-TREATMENT +empiema. I-EXPLORATION + I-EXPLORATION +Decidimos B-TREATMENT +intervenir I-TREATMENT y I-TREATMENT -luego I-TREATMENT -trimetroprim-sulfametoxazol I-TREATMENT -(TM-SF) I-TREATMENT -pero I-TREATMENT -presentó I-TREATMENT -una I-TREATMENT -reacción I-TREATMENT -urticarial, I-TREATMENT -por I-TREATMENT +retirar I-TREATMENT la I-TREATMENT -cual I-TREATMENT -hubo I-TREATMENT -que I-TREATMENT -suspender I-TREATMENT -este I-TREATMENT -último, I-TREATMENT -pasando I-TREATMENT -a I-TREATMENT -doxiciclina. I-TREATMENT -Tuvo B-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION +placa I-TREATMENT +de I-TREATMENT +material I-TREATMENT +aloplástico. I-TREATMENT +Bajo I-TREATMENT +la I-TREATMENT +misma I-TREATMENT +encontramos I-TREATMENT +abundante I-TREATMENT +material I-TREATMENT +purulento, I-TREATMENT +en I-TREATMENT +cuyo I-TREATMENT +cultivo I-TREATMENT +se I-TREATMENT +aisló I-TREATMENT +un I-TREATMENT +microorganismo I-TREATMENT +anaerobio. I-TREATMENT +La I-TREATMENT +reconstrucción I-TREATMENT +se I-TREATMENT +efectuó I-TREATMENT +con I-TREATMENT +colgajo I-TREATMENT +de I-TREATMENT +epiplon I-TREATMENT +basado I-TREATMENT +en I-TREATMENT +los I-TREATMENT +vasos I-TREATMENT +gastroepiploicos I-TREATMENT +derecho I-TREATMENT +e I-TREATMENT +izquierdo I-TREATMENT +cubierto I-TREATMENT +con I-TREATMENT +un I-TREATMENT +injerto I-TREATMENT +de I-TREATMENT +piel I-TREATMENT +mallada. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +sin I-EVOLUTION +incidencias I-EVOLUTION y I-EVOLUTION -aumentó I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION de I-EVOLUTION -peso, I-EVOLUTION -pero I-EVOLUTION -al I-EVOLUTION -persistir I-EVOLUTION +alta I-EVOLUTION +a I-EVOLUTION los I-EVOLUTION -macrófagos I-EVOLUTION -PAS I-EVOLUTION -positivos I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -biopsia, I-EVOLUTION -se I-EVOLUTION -repiten I-EVOLUTION -hasta I-EVOLUTION -dos I-EVOLUTION -ciclos I-EVOLUTION -más I-EVOLUTION -de I-EVOLUTION -15 I-EVOLUTION +6 I-EVOLUTION días I-EVOLUTION de I-EVOLUTION -penicilina I-EVOLUTION -y I-EVOLUTION -estreptomicina. I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -tuvo I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -inestabilidad I-EVOLUTION -de I-EVOLUTION la I-EVOLUTION -marcha I-EVOLUTION +intervención. I-EVOLUTION +No I-EVOLUTION +hubo I-EVOLUTION +recidiva I-EVOLUTION +tumoral I-EVOLUTION +local I-EVOLUTION y I-EVOLUTION -sensación I-EVOLUTION -de I-EVOLUTION -mareo I-EVOLUTION -secundarios I-EVOLUTION -a I-EVOLUTION -toxicidad I-EVOLUTION -laberíntica I-EVOLUTION -por I-EVOLUTION -estreptomicina, I-EVOLUTION -que I-EVOLUTION -inicialmente I-EVOLUTION -planteó I-EVOLUTION -diagnóstico I-EVOLUTION -diferencial I-EVOLUTION -con I-EVOLUTION -afectación I-EVOLUTION -neurológica I-EVOLUTION +las I-EVOLUTION +biopsias I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -enfermedad. I-EVOLUTION -Se B-TREATMENT -retiró I-TREATMENT -entonces I-TREATMENT -la I-TREATMENT -doxiciclina, I-TREATMENT -por I-TREATMENT -asociarse I-TREATMENT -a I-TREATMENT -mayor I-TREATMENT -número I-TREATMENT -de I-TREATMENT -recidivas, I-TREATMENT -y I-TREATMENT -se I-TREATMENT -trató I-TREATMENT -con I-TREATMENT -cefixima. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -cumplió I-EVOLUTION -dos I-EVOLUTION -años I-EVOLUTION +los I-EVOLUTION +bordes I-EVOLUTION +fueron I-EVOLUTION +negativas. I-EVOLUTION +Las I-EVOLUTION +revisiones I-EVOLUTION +son I-EVOLUTION +satisfactorias I-EVOLUTION +desde I-EVOLUTION +entonces, I-EVOLUTION +cumpliendo I-EVOLUTION +18 I-EVOLUTION +meses I-EVOLUTION de I-EVOLUTION -tratamiento I-EVOLUTION -antibiótico I-EVOLUTION -estando I-EVOLUTION -asintomático I-EVOLUTION +evolución I-EVOLUTION en I-EVOLUTION -la I-EVOLUTION -actualidad. I-EVOLUTION +el I-EVOLUTION +momento I-EVOLUTION +de I-EVOLUTION +redactar I-EVOLUTION +este I-EVOLUTION +trabajo. I-EVOLUTION I-EVOLUTION -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -torácico. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -recurrentes I-PRESENT_ILLNESS -similares I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS -En B-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -ocasión I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -diagnosticó I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -probable I-PAST_MEDICAL_HISTORY -abdomen I-PAST_MEDICAL_HISTORY -agudo, I-PAST_MEDICAL_HISTORY -habiendo I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -punto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -laparotomizado. I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -actual I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -39, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -ºC, I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -pleurítico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hemitórax I-PRESENT_ILLNESS +epigástrico I-PRESENT_ILLNESS +irradiado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS derecho I-PRESENT_ILLNESS de I-PRESENT_ILLNESS 24 I-PRESENT_ILLNESS horas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -abdomen I-EXPLORATION -doloroso, I-EXPLORATION -sobre I-EXPLORATION -todo I-EXPLORATION -en I-EXPLORATION -fosa I-EXPLORATION -iliaca I-EXPLORATION -derecha, I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION +evolución, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos. I-PRESENT_ILLNESS +Analítica: B-EXPLORATION +leucocitosis I-EXPLORATION de I-EXPLORATION -irritación I-EXPLORATION -peritoneal. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -destacaba I-EXPLORATION -PCR I-EXPLORATION -25 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -leucocitos I-EXPLORATION -18.109/ml I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION +17.500/mm3, I-EXPLORATION +PMN I-EXPLORATION +75%, I-EXPLORATION +amilasa I-EXPLORATION +1.956 I-EXPLORATION +U/L, I-EXPLORATION +AST: I-EXPLORATION +89U/L, I-EXPLORATION +ALT I-EXPLORATION +120U/L. I-EXPLORATION +Ecografía I-EXPLORATION +abdominal: I-EXPLORATION +dilatación I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -no I-EXPLORATION -evidenció I-EXPLORATION -datos I-EXPLORATION -sugestivos I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +extrahepática I-EXPLORATION +con I-EXPLORATION +defectos I-EXPLORATION de I-EXPLORATION -apendicitis I-EXPLORATION -aguda. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -analgésico I-TREATMENT -con I-TREATMENT -remisión I-TREATMENT -del I-TREATMENT -cuadro I-TREATMENT -en I-TREATMENT -24 I-TREATMENT -horas, I-TREATMENT -siendo I-TREATMENT -dado I-TREATMENT -de I-TREATMENT -alta. I-TREATMENT -Posteriormente B-EXPLORATION -se I-EXPLORATION +repleción. I-EXPLORATION +Se I-EXPLORATION realizó I-EXPLORATION -estudio I-EXPLORATION -ambulatorio I-EXPLORATION +CPRE: I-EXPLORATION +colédoco I-EXPLORATION +dilatado I-EXPLORATION con I-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -fibrocolonoscopia I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -remisión I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -clínica, I-EXPLORATION -los I-EXPLORATION -antecedentes I-EXPLORATION -de I-EXPLORATION -episodios I-EXPLORATION -recurrentes I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -negatividad I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -practicadas I-EXPLORATION -se I-EXPLORATION -orientó I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -posible I-EXPLORATION -FMF, I-EXPLORATION -procediéndose I-EXPLORATION -a I-EXPLORATION -estudio I-EXPLORATION -genético. I-EXPLORATION -Este I-EXPLORATION -mostró I-EXPLORATION -dos I-EXPLORATION -mutaciones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -gen I-EXPLORATION -MEFV: I-EXPLORATION una I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -exón I-EXPLORATION -2, I-EXPLORATION -detectándose I-EXPLORATION -la I-EXPLORATION -sustitución I-EXPLORATION -del I-EXPLORATION -nucleótido I-EXPLORATION -guanina I-EXPLORATION -por I-EXPLORATION -citosina I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -posición I-EXPLORATION -del I-EXPLORATION -triplete I-EXPLORATION -148, I-EXPLORATION -dando I-EXPLORATION -lugar I-EXPLORATION -al I-EXPLORATION -cambio I-EXPLORATION -de I-EXPLORATION -aminoácido I-EXPLORATION -glutámico I-EXPLORATION -por I-EXPLORATION -glutamina. I-EXPLORATION -Dicha I-EXPLORATION -mutuación I-EXPLORATION -recibe I-EXPLORATION -el I-EXPLORATION -nombre I-EXPLORATION +imagen I-EXPLORATION de I-EXPLORATION -E148Q, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -detectó I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -solo I-EXPLORATION -alelo, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -es I-EXPLORATION -heterozigoto I-EXPLORATION -para I-EXPLORATION -esta I-EXPLORATION -mutuación. I-EXPLORATION -Se I-EXPLORATION -detectó I-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -mutuación I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -exón I-EXPLORATION -10, I-EXPLORATION -que I-EXPLORATION -consistía I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -sustitución I-EXPLORATION -del I-EXPLORATION -nucleótido I-EXPLORATION -guanina I-EXPLORATION -por I-EXPLORATION -adenina I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tercera I-EXPLORATION -posición I-EXPLORATION -del I-EXPLORATION -triplete I-EXPLORATION -694, I-EXPLORATION -dando I-EXPLORATION -lugar I-EXPLORATION -al I-EXPLORATION -cambio I-EXPLORATION +defecto I-EXPLORATION de I-EXPLORATION -aminoácido I-EXPLORATION -metionina I-EXPLORATION -por I-EXPLORATION -isoleucina. I-EXPLORATION -Dicha I-EXPLORATION -mutuación I-EXPLORATION -recibe I-EXPLORATION -el I-EXPLORATION -nombre I-EXPLORATION +repleción I-EXPLORATION de I-EXPLORATION -M694I I-EXPLORATION -y I-EXPLORATION -también I-EXPLORATION -se I-EXPLORATION -detectó I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -solo I-EXPLORATION -alelo, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION +aspecto I-EXPLORATION +filiforme, I-EXPLORATION +plegada I-EXPLORATION +sobre I-EXPLORATION +sí I-EXPLORATION +misma I-EXPLORATION que I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -es I-EXPLORATION -también I-EXPLORATION -heterozigoto I-EXPLORATION -para I-EXPLORATION -esta I-EXPLORATION -mutuación. I-EXPLORATION -Ambas I-EXPLORATION -mutaciones I-EXPLORATION -están I-EXPLORATION -descritas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -FMF. I-EXPLORATION -Asimismo I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -del I-EXPLORATION -exón I-EXPLORATION -3 I-EXPLORATION -de I-EXPLORATION +ocupaba I-EXPLORATION +toda I-EXPLORATION la I-EXPLORATION -proteina I-EXPLORATION -sérica I-EXPLORATION -del I-EXPLORATION -amiloide I-EXPLORATION -SAA-1, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -genotipo I-EXPLORATION -alfa/beta, I-EXPLORATION -considerado I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -riesgo I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -desarrollo I-EXPLORATION -de I-EXPLORATION -amiloidosis. I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +extrahepática. I-EXPLORATION Se B-TREATMENT -inició I-TREATMENT +realizó I-TREATMENT +limpieza I-TREATMENT +de I-TREATMENT +la I-TREATMENT +vía I-TREATMENT +biliar I-TREATMENT +con I-TREATMENT +balón I-TREATMENT +Fogarty, I-TREATMENT +extrayéndose I-TREATMENT +un I-TREATMENT +gusano I-TREATMENT +cilíndrico I-TREATMENT +de I-TREATMENT +23 I-TREATMENT +cm, I-TREATMENT +barro I-TREATMENT +biliar I-TREATMENT +y I-TREATMENT +dos I-TREATMENT +cálculos I-TREATMENT +menores I-TREATMENT +de I-TREATMENT +10 I-TREATMENT +mm. I-TREATMENT +Se I-TREATMENT +lavó I-TREATMENT +la I-TREATMENT +vía I-TREATMENT +biliar I-TREATMENT +con I-TREATMENT +suero I-TREATMENT +fisiológico I-TREATMENT +y I-TREATMENT +se I-TREATMENT +pautó I-TREATMENT tratamiento I-TREATMENT con I-TREATMENT -colchicina I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT +400 I-TREATMENT +mg I-TREATMENT de I-TREATMENT -1 I-TREATMENT -mg/día I-TREATMENT -con B-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -y I-EVOLUTION -desaparición I-EVOLUTION -paulatina I-EVOLUTION +albendazol I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT +durante I-TREATMENT +4 I-TREATMENT +días. I-TREATMENT +Fue B-EVOLUTION +dada I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -crisis. I-EVOLUTION +alta, I-EVOLUTION +asintomática, I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +7 I-EVOLUTION +días I-EVOLUTION +del I-EVOLUTION +ingreso. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +pediátrica I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -mestiza, B-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -ingresó I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -primera I-PAST_MEDICAL_HISTORY -vez I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -febrero I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -1999 I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -nuestro I-PAST_MEDICAL_HISTORY -hospital. I-PAST_MEDICAL_HISTORY -Desde I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -diez I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -comenzado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -presentar I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -rodillas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tobillos, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -aparentes I-PAST_MEDICAL_HISTORY -signos I-PAST_MEDICAL_HISTORY -inflamatorios, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -aliviaban I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -Indometacina I-PAST_MEDICAL_HISTORY -y, I-PAST_MEDICAL_HISTORY -además I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -acompañaba I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -astenia. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -provincia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -ingresado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -llegara I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -etiológico. I-PAST_MEDICAL_HISTORY -Este B-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -articular I-PRESENT_ILLNESS -evolucionaba I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS +15 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -episodios, I-PRESENT_ILLNESS -acompañándose I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +diagnosticada I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -anemia I-PRESENT_ILLNESS -comprobada. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -sólo I-EXPLORATION -mostró I-EXPLORATION -palidez I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -mucosas, I-EXPLORATION -ligero I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -tobillos, I-EXPLORATION -adenopatía I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -cm, I-EXPLORATION -movible I-EXPLORATION +púrpura I-PRESENT_ILLNESS +fulminans I-PRESENT_ILLNESS +secundaria I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +infección I-PRESENT_ILLNESS +meningocóccica I-PRESENT_ILLNESS +grave I-PRESENT_ILLNESS +complicada I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +fallo I-PRESENT_ILLNESS +multiorgánico, I-PRESENT_ILLNESS +shock I-PRESENT_ILLNESS +séptico, I-PRESENT_ILLNESS +edema I-PRESENT_ILLNESS +agudo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pulmón I-PRESENT_ILLNESS +complicado I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +neumonía I-PRESENT_ILLNESS +nosocomial I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +requirió I-PRESENT_ILLNESS +soporte I-PRESENT_ILLNESS +ventilatorio I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +grave I-PRESENT_ILLNESS +necrosis I-PRESENT_ILLNESS +isquémica I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +CID I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +extremidades I-PRESENT_ILLNESS +inferiores. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +A B-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +4 I-DERIVED_FROM/TO +días I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +ingreso I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +Unidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Cuidados I-DERIVED_FROM/TO +Intensivos I-DERIVED_FROM/TO +(UCI) I-DERIVED_FROM/TO +pediátrica, I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +pide I-DERIVED_FROM/TO +consulta I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +valoración I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +las I-DERIVED_FROM/TO +lesiones I-DERIVED_FROM/TO +cutáneas. I-DERIVED_FROM/TO +Apreciamos B-EXPLORATION +flictenas I-EXPLORATION y I-EXPLORATION -elástica I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -inguinal I-EXPLORATION -derecha. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION +sufrimiento I-EXPLORATION +cutáneo I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -primer I-EXPLORATION -ingreso I-EXPLORATION -fueron I-EXPLORATION -los I-EXPLORATION -siguientes: I-EXPLORATION -hemoglobina I-EXPLORATION -98 I-EXPLORATION -g/l, I-EXPLORATION -hematocrito I-EXPLORATION -30 I-EXPLORATION -vol%, I-EXPLORATION -leucograma I-EXPLORATION -y I-EXPLORATION -plaquetas I-EXPLORATION -normales, I-EXPLORATION -reticolocitos, I-EXPLORATION -glucemias, I-EXPLORATION -creatinina, I-EXPLORATION -TGO I-EXPLORATION -y I-EXPLORATION -TGP, I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina, I-EXPLORATION -TP I-EXPLORATION +miembro I-EXPLORATION +superior I-EXPLORATION +derecho I-EXPLORATION +(MSD) I-EXPLORATION y I-EXPLORATION -TPT, I-EXPLORATION -todos I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -electroforesis I-EXPLORATION +principalmente, I-EXPLORATION +en I-EXPLORATION +miembros I-EXPLORATION +inferiores I-EXPLORATION +(MMII), I-EXPLORATION +acompañados I-EXPLORATION de I-EXPLORATION -proteínas I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -hipergammaglobulinemia I-EXPLORATION -32, I-EXPLORATION -85 I-EXPLORATION -g/l, I-EXPLORATION -eritrosedimentación I-EXPLORATION -115 I-EXPLORATION -mm/h I-EXPLORATION +lesiones I-EXPLORATION +purpúricas I-EXPLORATION y I-EXPLORATION -106 I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -segunda I-EXPLORATION -oportunidad. I-EXPLORATION -El I-EXPLORATION -ultrasonido I-EXPLORATION +necrosis I-EXPLORATION +irreversibles I-EXPLORATION de I-EXPLORATION -hemiabdomen I-EXPLORATION -superior I-EXPLORATION -no I-EXPLORATION -demostró I-EXPLORATION -ninguna I-EXPLORATION -alteración. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -sin I-EVOLUTION -diagnóstico I-EVOLUTION -preciso. I-EVOLUTION -Reingresa I-EVOLUTION -en I-EVOLUTION -enero I-EVOLUTION -del I-EVOLUTION -2004 I-EVOLUTION -por I-EVOLUTION -astenia I-EVOLUTION -y I-EVOLUTION -fiebre I-EVOLUTION -de I-EVOLUTION -38 I-EVOLUTION -a I-EVOLUTION -39 I-EVOLUTION -ºC I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -periódica I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -semana I-EVOLUTION -de I-EVOLUTION -duración I-EVOLUTION +los I-EXPLORATION +dedos I-EXPLORATION +de I-EXPLORATION +ambos I-EXPLORATION +pies. I-EXPLORATION +Dada B-TREATMENT +la I-TREATMENT +evolución I-TREATMENT +tórpida I-TREATMENT +y I-TREATMENT +la I-TREATMENT +extensión I-TREATMENT +de I-TREATMENT +las I-TREATMENT +lesiones, I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +17 I-TREATMENT +días I-TREATMENT +después. I-TREATMENT + I-TREATMENT +Realizamos I-TREATMENT +desbridamiento I-TREATMENT +superficial I-TREATMENT +para I-TREATMENT +demarcar I-TREATMENT +la I-TREATMENT +zona I-TREATMENT +de I-TREATMENT +necrosis I-TREATMENT +profunda I-TREATMENT +y I-TREATMENT +colocamos I-TREATMENT +Biobrane® I-TREATMENT +(Biobrane, I-TREATMENT +Smith I-TREATMENT +& I-TREATMENT +Nephew I-TREATMENT +B.V., I-TREATMENT +Barcelona, I-TREATMENT +España). I-TREATMENT +Las B-EVOLUTION +zonas I-EVOLUTION +intervenidas I-EVOLUTION +se I-EVOLUTION +curaron I-EVOLUTION con I-EVOLUTION -intervalos I-EVOLUTION -de I-EVOLUTION -remisiones I-EVOLUTION -espontáneas I-EVOLUTION -cada I-EVOLUTION -dos I-EVOLUTION -o I-EVOLUTION -tres I-EVOLUTION -meses. I-EVOLUTION -Mantenía I-EVOLUTION -dolores I-EVOLUTION -articulares I-EVOLUTION -en I-EVOLUTION -rodillas I-EVOLUTION +sulfadiazina I-EVOLUTION +argéntica I-EVOLUTION +antes I-EVOLUTION y I-EVOLUTION -tobillos I-EVOLUTION -que I-EVOLUTION -mejoraban I-EVOLUTION -con I-EVOLUTION -medicamentos I-EVOLUTION -antinflamatorios I-EVOLUTION -no I-EVOLUTION -esteroideos. I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +cirugía. I-EVOLUTION I-EVOLUTION -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -demostró I-EXPLORATION -una I-EXPLORATION -adenopatía I-EXPLORATION +Ante B-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +mala I-DERIVED_FROM/TO +evolución I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +las I-DERIVED_FROM/TO +heridas, I-DERIVED_FROM/TO +contactamos I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Traumatología I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +nueva I-DERIVED_FROM/TO +valoración. I-DERIVED_FROM/TO +Se B-EXPLORATION +realizaron I-EXPLORATION +2 I-EXPLORATION +gammagrafías I-EXPLORATION +óseas I-EXPLORATION en I-EXPLORATION -región I-EXPLORATION -supraclavicular I-EXPLORATION -derecha I-EXPLORATION +un I-EXPLORATION +intervalo I-EXPLORATION de I-EXPLORATION -unos I-EXPLORATION -2 I-EXPLORATION -cm, I-EXPLORATION +15 I-EXPLORATION +días I-EXPLORATION +para I-EXPLORATION +valorar I-EXPLORATION +el I-EXPLORATION +estado I-EXPLORATION de I-EXPLORATION -consistencia I-EXPLORATION -elástica I-EXPLORATION +ambos I-EXPLORATION +MMII I-EXPLORATION y I-EXPLORATION -fija I-EXPLORATION -a I-EXPLORATION -planos I-EXPLORATION -profundos. I-EXPLORATION - I-EXPLORATION -Exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio: I-EXPLORATION -hemoglobina I-EXPLORATION -110 I-EXPLORATION -g/l, I-EXPLORATION -eritrosedimentación I-EXPLORATION -130 I-EXPLORATION -mm/h, I-EXPLORATION -hipergammaglobulinemia I-EXPLORATION -policlonal I-EXPLORATION -de I-EXPLORATION -36 I-EXPLORATION -g/l; I-EXPLORATION -medulograma: I-EXPLORATION -médula I-EXPLORATION -reactiva I-EXPLORATION -con I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -plasmocitos. I-EXPLORATION -Ultrasonido I-EXPLORATION -de I-EXPLORATION -abdomen: I-EXPLORATION -ligera I-EXPLORATION -hepatomegalia I-EXPLORATION -difusa I-EXPLORATION -con I-EXPLORATION -aumento I-EXPLORATION +ambas I-EXPLORATION +informaron I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -ecorrefringencia; I-EXPLORATION -placa I-EXPLORATION -de I-EXPLORATION -tórax: I-EXPLORATION -ensanchamiento I-EXPLORATION -del I-EXPLORATION -contorno I-EXPLORATION -superior I-EXPLORATION -derecho I-EXPLORATION -del I-EXPLORATION -mediastino; I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -mediastino: I-EXPLORATION -adenomegalia I-EXPLORATION -en I-EXPLORATION -mediastino I-EXPLORATION -superior I-EXPLORATION -derecho, I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -diámetro, I-EXPLORATION +tejido I-EXPLORATION +óseo I-EXPLORATION sin I-EXPLORATION -alteraciones I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -campos I-EXPLORATION -pulmonares. I-EXPLORATION - I-EXPLORATION -Biopsia I-EXPLORATION -de I-EXPLORATION -ganglio I-EXPLORATION -linfático I-EXPLORATION -cervical: I-EXPLORATION -pérdida I-EXPLORATION -parcial I-EXPLORATION +captación I-EXPLORATION +desde I-EXPLORATION +aproximadamente I-EXPLORATION +el I-EXPLORATION +1/3 I-EXPLORATION +proximal I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -arquitectura I-EXPLORATION -con I-EXPLORATION -hiperplasia I-EXPLORATION -linfoide I-EXPLORATION -focal I-EXPLORATION -marcada I-EXPLORATION -y I-EXPLORATION -expansión I-EXPLORATION +tibia. I-EXPLORATION +Dada B-TREATMENT +la I-TREATMENT +gangrena I-TREATMENT +establecida, I-TREATMENT +con I-TREATMENT +necrosis I-TREATMENT +irreversible I-TREATMENT +evidente I-TREATMENT +y I-TREATMENT +mal I-TREATMENT +olor, I-TREATMENT +los I-TREATMENT +traumatólogos I-TREATMENT +pediátricos I-TREATMENT +deciden, I-TREATMENT +de I-TREATMENT +acuerdo I-TREATMENT +con I-TREATMENT +la I-TREATMENT +familia, I-TREATMENT +proceder I-TREATMENT +a I-TREATMENT +practicar I-TREATMENT +amputación I-TREATMENT +infrarrotuliana I-TREATMENT +bilateral I-TREATMENT +para I-TREATMENT +conservar I-TREATMENT +la I-TREATMENT +máxima I-TREATMENT +movilidad I-TREATMENT +ulterior I-TREATMENT +de I-TREATMENT +la I-TREATMENT +paciente. I-TREATMENT + I-TREATMENT +El B-EXPLORATION +resultado I-EXPLORATION +anatomopatológico I-EXPLORATION +diferido I-EXPLORATION +informó I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -interfolicular, I-EXPLORATION -ocupada I-EXPLORATION -por I-EXPLORATION -abundantes I-EXPLORATION -plasmocitos I-EXPLORATION +trombosis I-EXPLORATION +vascular I-EXPLORATION +múltiple I-EXPLORATION y I-EXPLORATION -cuerpos I-EXPLORATION -de I-EXPLORATION -Russel. I-EXPLORATION - I-EXPLORATION -Inmunohistoquímica: I-EXPLORATION -CD20 I-EXPLORATION -positivo I-EXPLORATION +necrosis I-EXPLORATION +abscesificante I-EXPLORATION en I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -linfoides I-EXPLORATION -T, I-EXPLORATION -kappa I-EXPLORATION +piel I-EXPLORATION y I-EXPLORATION -lambda I-EXPLORATION -positivo I-EXPLORATION -en I-EXPLORATION -plasmocitos. I-EXPLORATION +tejidos I-EXPLORATION +blandos. I-EXPLORATION I-EXPLORATION -Conclusiones: I-EXPLORATION -EC I-EXPLORATION -plasmocelular. I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -consistió I-TREATMENT +Durante B-EVOLUTION +el I-EVOLUTION +postoperatorio, I-EVOLUTION +se I-EVOLUTION +delimitó I-EVOLUTION +aún I-EVOLUTION +más I-EVOLUTION +la I-EVOLUTION +necrosis I-EVOLUTION +de I-EVOLUTION +tejidos I-EVOLUTION +blandos I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +zona I-EVOLUTION +de I-EVOLUTION +cobertura I-EVOLUTION +de I-EVOLUTION +ambos I-EVOLUTION +muñones I-EVOLUTION +de I-EVOLUTION +amputación, I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +produjo I-EVOLUTION +una I-EVOLUTION +exposición I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +segmentos I-EVOLUTION +tibial I-EVOLUTION +y I-EVOLUTION +peroneo I-EVOLUTION +de I-EVOLUTION +ambas I-EVOLUTION +extremidades. I-EVOLUTION +Debido I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +corta I-EVOLUTION +longitud I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +muñones, I-EVOLUTION +no I-EVOLUTION +se I-EVOLUTION +podía I-EVOLUTION +proceder I-EVOLUTION +a I-EVOLUTION +una I-EVOLUTION +nueva I-EVOLUTION +amputación I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +segmentos I-EVOLUTION +y I-EVOLUTION +cobertura I-EVOLUTION +con I-EVOLUTION +tejido I-EVOLUTION +proximal, I-EVOLUTION +pues I-EVOLUTION +no I-EVOLUTION +garantizaría I-EVOLUTION +la I-EVOLUTION +posible I-EVOLUTION +colocaci��n I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +futuro I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +prótesis. I-EVOLUTION +Por B-TREATMENT +tanto, I-TREATMENT +optamos I-TREATMENT +por I-TREATMENT +iniciar I-TREATMENT +terapia I-TREATMENT +de I-TREATMENT +presión I-TREATMENT +negativa I-TREATMENT +con I-TREATMENT +sistema I-TREATMENT +VAC® I-TREATMENT +para I-TREATMENT +favorecer I-TREATMENT +el I-TREATMENT +crecimiento I-TREATMENT +tisular I-TREATMENT +y I-TREATMENT +la I-TREATMENT +eliminación I-TREATMENT +del I-TREATMENT +exudado I-TREATMENT +de I-TREATMENT +las I-TREATMENT +heridas. I-TREATMENT + I-TREATMENT +Procedimos I-TREATMENT +en I-TREATMENT +primer I-TREATMENT +lugar I-TREATMENT +a I-TREATMENT +lavar I-TREATMENT +las I-TREATMENT +extremidades I-TREATMENT +con I-TREATMENT +una I-TREATMENT +solución I-TREATMENT +de I-TREATMENT +clorhexidina I-TREATMENT +jabonosa I-TREATMENT +al I-TREATMENT +0, I-TREATMENT +4% I-TREATMENT +y I-TREATMENT +suero I-TREATMENT +fisiológico. I-TREATMENT +Luego I-TREATMENT +colocamos I-TREATMENT +los I-TREATMENT +apósitos I-TREATMENT +VAC-Granufoam I-TREATMENT +® I-TREATMENT +según I-TREATMENT +la I-TREATMENT +guía I-TREATMENT +clínica I-TREATMENT +de I-TREATMENT +la I-TREATMENT +terapia I-TREATMENT +VAC®. I-TREATMENT +Al I-TREATMENT +principio I-TREATMENT +utilizamos I-TREATMENT +los I-TREATMENT +apósitos I-TREATMENT +medianos I-TREATMENT +según I-TREATMENT +el I-TREATMENT +modelo I-TREATMENT +Pitta-VAC® I-TREATMENT +(10,11), I-TREATMENT +dividiendo I-TREATMENT en I-TREATMENT +dos I-TREATMENT +mitades I-TREATMENT +el I-TREATMENT +apósito, I-TREATMENT +de I-TREATMENT +manera I-TREATMENT +que I-TREATMENT +cada I-TREATMENT +una I-TREATMENT +de I-TREATMENT +ellas I-TREATMENT +es I-TREATMENT +separada I-TREATMENT +parcialmente I-TREATMENT +para I-TREATMENT +ser I-TREATMENT +colocada I-TREATMENT +sobre I-TREATMENT +la I-TREATMENT +zona I-TREATMENT +a I-TREATMENT +tratar, I-TREATMENT +como I-TREATMENT +si I-TREATMENT +fuera I-TREATMENT un I-TREATMENT -esquema I-TREATMENT +guante. I-TREATMENT +Esta B-EVOLUTION +técnica I-EVOLUTION +está I-EVOLUTION +descrita I-EVOLUTION +como I-EVOLUTION +rápida I-EVOLUTION +en I-EVOLUTION +su I-EVOLUTION +diseño I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +su I-EVOLUTION +ejecución. I-EVOLUTION +No I-EVOLUTION +obstante, I-EVOLUTION +en I-EVOLUTION +zonas I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +que I-EVOLUTION +la I-EVOLUTION +necrosis I-EVOLUTION +es I-EVOLUTION +parcheada, I-EVOLUTION +hemos I-EVOLUTION +notado I-EVOLUTION +que I-EVOLUTION +este I-EVOLUTION +sistema I-EVOLUTION +macera I-EVOLUTION +la I-EVOLUTION +piel I-EVOLUTION +sana I-EVOLUTION +si I-EVOLUTION +ésta I-EVOLUTION +entra I-EVOLUTION +en I-EVOLUTION +contacto I-EVOLUTION +directo I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +apósito I-EVOLUTION +de I-EVOLUTION +poliuretano I-EVOLUTION +reticulado, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +es I-EVOLUTION +necesario I-EVOLUTION +colocar I-EVOLUTION +apósitos I-EVOLUTION +hidrocoloides I-EVOLUTION +recortados I-EVOLUTION +bajo I-EVOLUTION +la I-EVOLUTION +esponja I-EVOLUTION +para I-EVOLUTION +evitarlo, I-EVOLUTION +lo I-EVOLUTION +cual I-EVOLUTION +hace I-EVOLUTION +más I-EVOLUTION +engorrosa I-EVOLUTION +la I-EVOLUTION +cura. I-EVOLUTION +Decidimos B-TREATMENT +por I-TREATMENT +tanto I-TREATMENT +volver I-TREATMENT +a I-TREATMENT +la I-TREATMENT +colocación I-TREATMENT +clásica I-TREATMENT de I-TREATMENT -poliquimioterapia I-TREATMENT -con I-TREATMENT -adriamicina, I-TREATMENT -vincristina, I-TREATMENT -bleomicina I-TREATMENT +los I-TREATMENT +apósitos: I-TREATMENT +pequeños I-TREATMENT +fragmentos I-TREATMENT +recortados I-TREATMENT +sobre I-TREATMENT +las I-TREATMENT +pérdidas I-TREATMENT +de I-TREATMENT +sustancia I-TREATMENT +conectados I-TREATMENT +entre I-TREATMENT +sí I-TREATMENT +mediante I-TREATMENT +íntimo I-TREATMENT +contacto I-TREATMENT +en I-TREATMENT +alguna I-TREATMENT +de I-TREATMENT +sus I-TREATMENT +partes. I-TREATMENT +La I-TREATMENT +presión I-TREATMENT +utilizada I-TREATMENT +fue I-TREATMENT +de I-TREATMENT +-125 I-TREATMENT +mmHg I-TREATMENT y I-TREATMENT -prednisona I-TREATMENT -y B-EVOLUTION +en I-TREATMENT +modo I-TREATMENT +continuo. I-TREATMENT +La B-EVOLUTION +granulación I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +lecho I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +mejoría I-EVOLUTION +fueron I-EVOLUTION +evidentes. I-EVOLUTION + I-EVOLUTION +Tras I-EVOLUTION +40 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +terapia, I-EVOLUTION +conseguimos I-EVOLUTION +el I-EVOLUTION +recubrimiento I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +segmentos I-EVOLUTION +óseos I-EVOLUTION +expuestos I-EVOLUTION +y I-EVOLUTION +tras I-EVOLUTION +la I-EVOLUTION +colocación I-EVOLUTION +de I-EVOLUTION +láminas I-EVOLUTION +regeneradoras I-EVOLUTION +dérmicas I-EVOLUTION +Integra® I-EVOLUTION +(Integra, I-EVOLUTION +San I-EVOLUTION +Priest, I-EVOLUTION +Francia) I-EVOLUTION +durante I-EVOLUTION +1 I-EVOLUTION +mes, I-EVOLUTION +logramos I-EVOLUTION +la I-EVOLUTION +cobertura I-EVOLUTION +definitiva I-EVOLUTION +mediante I-EVOLUTION +injertos I-EVOLUTION +de I-EVOLUTION +piel I-EVOLUTION +parcial I-EVOLUTION +mallados I-EVOLUTION +1: I-EVOLUTION +1, I-EVOLUTION +5 I-EVOLUTION +tomados I-EVOLUTION +del I-EVOLUTION +muslo I-EVOLUTION +izquierdo. I-EVOLUTION + I-EVOLUTION +La I-EVOLUTION +evolución I-EVOLUTION fue I-EVOLUTION -egresada I-EVOLUTION -para I-EVOLUTION +satisfactoria, I-EVOLUTION +con I-EVOLUTION +epitelización I-EVOLUTION +completa I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +muñones I-EVOLUTION +de I-EVOLUTION +amputación, I-EVOLUTION +procediéndose I-EVOLUTION +al I-EVOLUTION +alta I-EVOLUTION +hospitalaria I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +tras I-EVOLUTION +exactamente I-EVOLUTION +4 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +ingreso I-EVOLUTION +hospitalario. I-EVOLUTION +Mantuvimos I-EVOLUTION seguimiento I-EVOLUTION -ambulatorio. I-EVOLUTION +ambulatorio I-EVOLUTION +durante I-EVOLUTION +3 I-EVOLUTION +semanas I-EVOLUTION +más. I-EVOLUTION +Tras I-EVOLUTION +2 I-EVOLUTION +años I-EVOLUTION +del I-EVOLUTION +suceso, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +en I-EVOLUTION +proceso I-EVOLUTION +de I-EVOLUTION +rehabilitación I-EVOLUTION +de I-EVOLUTION +sus I-EVOLUTION +secuelas I-EVOLUTION +neurológicas, I-EVOLUTION +control I-EVOLUTION +del I-EVOLUTION +tronco I-EVOLUTION +y I-EVOLUTION +adaptación I-EVOLUTION +a I-EVOLUTION +prótesis I-EVOLUTION +infracondíleas. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Escolar B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +nueve I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -usuaria B-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -drogas I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -parenteral, I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +proveniente B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -infección I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -VIH I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -VHC I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -seguía I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -antirretroviral I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +provincia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -resolución. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -(hacía I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -mes), I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY +Buenos I-PAST_MEDICAL_HISTORY +Aires, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -droga I-PAST_MEDICAL_HISTORY -(heroína), I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY +cría I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -foliculitis I-PAST_MEDICAL_HISTORY -candidiásica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -costocondritis I-PAST_MEDICAL_HISTORY +animales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -2º I-PAST_MEDICAL_HISTORY -arco I-PAST_MEDICAL_HISTORY -costal I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -respectivamente. I-PAST_MEDICAL_HISTORY -Fue I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -fluconazol I-PAST_MEDICAL_HISTORY -400 I-PAST_MEDICAL_HISTORY -mg/día I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -precisando, I-PAST_MEDICAL_HISTORY -además, I-PAST_MEDICAL_HISTORY +granja I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -resección I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -cartílago I-PAST_MEDICAL_HISTORY -costal I-PAST_MEDICAL_HISTORY +faenamiento. I-PAST_MEDICAL_HISTORY +Fue B-DERIVED_FROM/TO +derivado I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +sospecha I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +tumor I-DERIVED_FROM/TO +quístico I-DERIVED_FROM/TO +supratentorial. I-DERIVED_FROM/TO +Tenía B-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vómitos I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -trayecto I-PAST_MEDICAL_HISTORY -fistuloso. I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -anamnesis, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -explicaba I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -productiva I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -expectoración I-PRESENT_ILLNESS -purulenta, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -torácico I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -características I-PRESENT_ILLNESS -pleuríticas, I-PRESENT_ILLNESS -adelgazamiento I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -cuantificado I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -localizado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -dorsal I-PRESENT_ILLNESS -bajo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -característica I-PRESENT_ILLNESS -mecánicas. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración, I-EXPLORATION -no I-EXPLORATION -impresionaba I-EXPLORATION -de I-EXPLORATION -afectada, I-EXPLORATION -destacando I-EXPLORATION -semiología I-EXPLORATION +cefalea I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cuatro I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +evolución. I-PAST_MEDICAL_HISTORY +Se B-EXPLORATION +realizó I-EXPLORATION +RM I-EXPLORATION de I-EXPLORATION -neumonía I-EXPLORATION -en I-EXPLORATION -1/3 I-EXPLORATION -inferior I-EXPLORATION +cerebro I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +informó I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -hemotórax I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -dolor I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +quística I-EXPLORATION a I-EXPLORATION +nivel I-EXPLORATION +supratentorial I-EXPLORATION +periventricular I-EXPLORATION +derecha I-EXPLORATION +que I-EXPLORATION +desplazaba I-EXPLORATION la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -apófisis I-EXPLORATION -espinosas I-EXPLORATION +línea I-EXPLORATION +media. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION de I-EXPLORATION -última I-EXPLORATION -vértebra I-EXPLORATION -dorsal I-EXPLORATION -y I-EXPLORATION -primeras I-EXPLORATION -lumbares. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -datos I-EXPLORATION -complementarios: I-EXPLORATION -leucocitos I-EXPLORATION -11.800 I-EXPLORATION -(67%N), I-EXPLORATION -hemoglobina I-EXPLORATION -10, I-EXPLORATION -6, I-EXPLORATION -hematocrito I-EXPLORATION -34, I-EXPLORATION -VCM I-EXPLORATION -123 I-EXPLORATION +abdomen I-EXPLORATION y I-EXPLORATION -plaquetas I-EXPLORATION -normales. I-EXPLORATION -VSG I-EXPLORATION -de I-EXPLORATION -117 I-EXPLORATION -mm I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -primera I-EXPLORATION -hora. I-EXPLORATION -Los I-EXPLORATION -parámetros I-EXPLORATION -bioquímicos I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -rutina, I-EXPLORATION -coagulación I-EXPLORATION +tórax I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +La I-EXPLORATION +serología I-EXPLORATION +por I-EXPLORATION +HAI I-EXPLORATION +para I-EXPLORATION +hidatidosis I-EXPLORATION +fue I-EXPLORATION +negativa. I-EXPLORATION +El I-EXPLORATION +hemograma I-EXPLORATION +no I-EXPLORATION +mostraba I-EXPLORATION +alteración I-EXPLORATION +significativa. I-EXPLORATION +Recibió B-TREATMENT +tratamiento I-TREATMENT +pre I-TREATMENT +y I-TREATMENT +postquirúrgico I-TREATMENT +con I-TREATMENT +albendazol. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +la I-TREATMENT +exéresis I-TREATMENT +del I-TREATMENT +quiste I-TREATMENT +sin I-TREATMENT +complicaciones. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +describió I-EXPLORATION +una I-EXPLORATION +estructura I-EXPLORATION +quística I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +pared I-EXPLORATION +con I-EXPLORATION +capa I-EXPLORATION +celular I-EXPLORATION +eosinófila I-EXPLORATION +(cutícula), I-EXPLORATION +germinativa I-EXPLORATION y I-EXPLORATION +abundantes I-EXPLORATION +escólices. I-EXPLORATION + I-EXPLORATION + +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +niño I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +7 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +citopatía I-PAST_MEDICAL_HISTORY +mitocondrial I-PAST_MEDICAL_HISTORY +(déficit I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +complejos I-PAST_MEDICAL_HISTORY +I-III-IV I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +cadena I-PAST_MEDICAL_HISTORY +respiratoria) I-PAST_MEDICAL_HISTORY +en B-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +vitaminas I-PRESENT_ILLNESS +B1 I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +B6, I-PRESENT_ILLNESS +carnitina, I-PRESENT_ILLNESS +coenzima I-PRESENT_ILLNESS +Q, I-PRESENT_ILLNESS +clobazam I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +fenobarbital. I-PRESENT_ILLNESS +El B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +consulta I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Gastroenterología I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +Nutrición I-DERIVED_FROM/TO +Infantil I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +valoración I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +episodios I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +atragantamiento I-DERIVED_FROM/TO +durante I-DERIVED_FROM/TO +las I-DERIVED_FROM/TO +comidas I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +varios I-DERIVED_FROM/TO +ingresos I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +neumonía. I-DERIVED_FROM/TO +En B-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +anamnesis I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +padres I-PRESENT_ILLNESS +referían I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +era I-PRESENT_ILLNESS +alimentado I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +purés, I-PRESENT_ILLNESS +pero I-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS +accesos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +carraspeo I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +tragar. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION el I-EXPLORATION -análisis I-EXPLORATION -elemental I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -no I-EXPLORATION -mostraron I-EXPLORATION -alteraciones. I-EXPLORATION -Las I-EXPLORATION -determinaciones I-EXPLORATION +paciente I-EXPLORATION +tenía I-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -subpoblaciones I-EXPLORATION -linfocitarias I-EXPLORATION -CD4 I-EXPLORATION -fueron I-EXPLORATION +deshidratación I-EXPLORATION +ni I-EXPLORATION de I-EXPLORATION -944/mm3 I-EXPLORATION +desnutrición, I-EXPLORATION +con I-EXPLORATION +datos I-EXPLORATION +antropométricos I-EXPLORATION +en I-EXPLORATION +percentiles I-EXPLORATION +adecuados I-EXPLORATION +para I-EXPLORATION +su I-EXPLORATION +edad I-EXPLORATION +y I-EXPLORATION +sexo. I-EXPLORATION +Como I-EXPLORATION +hallazgos I-EXPLORATION +patológicos I-EXPLORATION +presentaba I-EXPLORATION +hipotonía I-EXPLORATION +generalizada, I-EXPLORATION +apraxia I-EXPLORATION +fonoarticulatoria I-EXPLORATION y I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION +deglución, I-EXPLORATION +e I-EXPLORATION +hipotonía I-EXPLORATION de I-EXPLORATION -VIH I-EXPLORATION -indetectable. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION -microbiológicos, I-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION la I-EXPLORATION -serología I-EXPLORATION +musculatura I-EXPLORATION +oral I-EXPLORATION +con I-EXPLORATION +babeo I-EXPLORATION +constante. I-EXPLORATION +Resto I-EXPLORATION de I-EXPLORATION -brucella I-EXPLORATION -fueron I-EXPLORATION -negativas. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -constataron I-EXPLORATION -vegetaciones I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -ecocardiográfica. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION +sin I-EXPLORATION +alteraciones. I-EXPLORATION + I-EXPLORATION +Con I-EXPLORATION +todos I-EXPLORATION +los I-EXPLORATION +datos I-EXPLORATION +previos I-EXPLORATION se I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION +estableció I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION de I-EXPLORATION -radioopacidad I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -inferior I-EXPLORATION -izquierdo I-EXPLORATION -con I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -asociado. I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -microbiológicos I-EXPLORATION +disfagia I-EXPLORATION +orofaríngea, I-EXPLORATION +y I-EXPLORATION +ante I-EXPLORATION +la I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -esputo I-EXPLORATION -resultaron I-EXPLORATION -estériles I-EXPLORATION -con I-EXPLORATION -negatividad I-EXPLORATION -para I-EXPLORATION -BAAR I-EXPLORATION -y, I-EXPLORATION +videofluoroscopia I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -líquido I-EXPLORATION -pleural I-EXPLORATION -(exudado I-EXPLORATION +momento I-EXPLORATION +del I-EXPLORATION +estudio I-EXPLORATION +en I-EXPLORATION +nuestro I-EXPLORATION +centro, I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +fibroendoscopia I-EXPLORATION de I-EXPLORATION -predominio I-EXPLORATION -mononuclear) I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -candida I-EXPLORATION -albicans. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION la I-EXPLORATION -Tac I-EXPLORATION +deglución I-EXPLORATION +(FEES) I-EXPLORATION +durante I-EXPLORATION +el I-EXPLORATION +test I-EXPLORATION de I-EXPLORATION -columna I-EXPLORATION -dorso-lumbar I-EXPLORATION +deglución I-EXPLORATION +con I-EXPLORATION +diferentes I-EXPLORATION +volúmenes/texturas. I-EXPLORATION +En I-EXPLORATION +reposo I-EXPLORATION se I-EXPLORATION -hallaron I-EXPLORATION -signos I-EXPLORATION -radiológicos I-EXPLORATION +apreciaban I-EXPLORATION +secreciones I-EXPLORATION +en I-EXPLORATION +vallécula, I-EXPLORATION +faringe I-EXPLORATION +y I-EXPLORATION +senos I-EXPLORATION +piriformes; I-EXPLORATION +tras I-EXPLORATION +administrar I-EXPLORATION +distintas I-EXPLORATION +consistencias I-EXPLORATION +y I-EXPLORATION +volúmenes I-EXPLORATION +teñidos I-EXPLORATION +con I-EXPLORATION +azul I-EXPLORATION de I-EXPLORATION -espondilodiscitis I-EXPLORATION +metileno I-EXPLORATION +se I-EXPLORATION +concluyó I-EXPLORATION +que I-EXPLORATION con I-EXPLORATION -afectación I-EXPLORATION -tanto I-EXPLORATION +5 I-EXPLORATION +cc I-EXPLORATION de I-EXPLORATION -cuerpos I-EXPLORATION -vertebrales I-EXPLORATION -D-11, I-EXPLORATION -D-12 I-EXPLORATION +textura I-EXPLORATION +néctar I-EXPLORATION +había I-EXPLORATION +reflejo I-EXPLORATION +deglutorio I-EXPLORATION +enlentecido I-EXPLORATION y I-EXPLORATION -L-1, I-EXPLORATION -como I-EXPLORATION +muy I-EXPLORATION +fraccionado I-EXPLORATION +sin I-EXPLORATION +reflejo I-EXPLORATION +tusígeno; I-EXPLORATION +el I-EXPLORATION +alimento I-EXPLORATION +se I-EXPLORATION +quedaba I-EXPLORATION +inicialmente I-EXPLORATION +en I-EXPLORATION +vallécula, I-EXPLORATION +faringe I-EXPLORATION +y I-EXPLORATION +senos I-EXPLORATION +piriformes I-EXPLORATION +(pasando I-EXPLORATION +posteriormente I-EXPLORATION +a I-EXPLORATION +esófago I-EXPLORATION +por I-EXPLORATION +gravedad). I-EXPLORATION +Con I-EXPLORATION +5 I-EXPLORATION +cc I-EXPLORATION de I-EXPLORATION -espacios I-EXPLORATION -intervertebrales I-EXPLORATION -D10-D11, I-EXPLORATION -D11-D12 I-EXPLORATION +pudding I-EXPLORATION +(más I-EXPLORATION +espeso) I-EXPLORATION +se I-EXPLORATION +apreciaba I-EXPLORATION +penetración I-EXPLORATION +sin I-EXPLORATION +reflejo I-EXPLORATION +tusígeno; I-EXPLORATION +deglución I-EXPLORATION +fraccionada I-EXPLORATION +con I-EXPLORATION +acumulación I-EXPLORATION +en I-EXPLORATION +vallécula, I-EXPLORATION +faringe I-EXPLORATION y I-EXPLORATION -D12-L1, I-EXPLORATION -además I-EXPLORATION +senos I-EXPLORATION +piriformes; I-EXPLORATION +enlentecimiento I-EXPLORATION +del I-EXPLORATION +paso I-EXPLORATION +a I-EXPLORATION +esófago I-EXPLORATION +y I-EXPLORATION +déficit I-EXPLORATION de I-EXPLORATION -presencia I-EXPLORATION +apertura I-EXPLORATION +del I-EXPLORATION +esfínter I-EXPLORATION +esofágico I-EXPLORATION +superior. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +este I-EXPLORATION +paciente, I-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION +su I-EXPLORATION +patología I-EXPLORATION +neurológica I-EXPLORATION de I-EXPLORATION -masa I-EXPLORATION +base, I-EXPLORATION +también I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +manometría I-EXPLORATION de I-EXPLORATION -tejidos I-EXPLORATION -blandos I-EXPLORATION -paravertebral I-EXPLORATION +alta I-EXPLORATION +resolución I-EXPLORATION +para I-EXPLORATION +valorar I-EXPLORATION +la I-EXPLORATION +motilidad I-EXPLORATION +esofágica. I-EXPLORATION +Con I-EXPLORATION +dicha I-EXPLORATION +prueba I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +hallazgos I-EXPLORATION +sugerentes I-EXPLORATION +de I-EXPLORATION +esfínter I-EXPLORATION +esofágico I-EXPLORATION +superior I-EXPLORATION +hipertenso I-EXPLORATION +con I-EXPLORATION +pobre I-EXPLORATION +bomba I-EXPLORATION +faríngea I-EXPLORATION y I-EXPLORATION -afectación I-EXPLORATION -intrarraquídea I-EXPLORATION +ondas I-EXPLORATION +peristálticas I-EXPLORATION +normales I-EXPLORATION +alternando I-EXPLORATION +con I-EXPLORATION +contracciones I-EXPLORATION de I-EXPLORATION -localización I-EXPLORATION -epidural I-EXPLORATION -anterior. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -punción I-EXPLORATION -directa I-EXPLORATION +muy I-EXPLORATION +baja I-EXPLORATION +amplitud. I-EXPLORATION +La I-EXPLORATION +presión I-EXPLORATION de I-EXPLORATION +reposo I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +cuerpo I-EXPLORATION +esofágico I-EXPLORATION +era I-EXPLORATION +normal I-EXPLORATION +mientras I-EXPLORATION +que I-EXPLORATION la I-EXPLORATION -masa I-EXPLORATION -paravertebral. I-EXPLORATION -Se I-EXPLORATION -obtuvo I-EXPLORATION -material I-EXPLORATION -purulento I-EXPLORATION -y I-EXPLORATION +del I-EXPLORATION +esfínter I-EXPLORATION +esofágico I-EXPLORATION +inferior I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION -microbiológico I-EXPLORATION +límite I-EXPLORATION +bajo I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -determinación I-EXPLORATION +normalidad. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +estableció I-EXPLORATION +el I-EXPLORATION +diagnostico I-EXPLORATION de I-EXPLORATION -BAAR I-EXPLORATION -fue I-EXPLORATION -negativa I-EXPLORATION +disfagia I-EXPLORATION +orofaríngea I-EXPLORATION +de I-EXPLORATION +etiología I-EXPLORATION +neurógena I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -Candida I-EXPLORATION -albicans. I-EXPLORATION +se I-EXPLORATION +procedió I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +abordaje I-EXPLORATION +multidisciplinar. I-EXPLORATION Se B-TREATMENT -establecieron I-TREATMENT -medidas I-TREATMENT -ortésicas I-TREATMENT +prescribió I-TREATMENT +espesante I-TREATMENT +para I-TREATMENT +líquidos I-TREATMENT y I-TREATMENT -tratamiento I-TREATMENT -secuencial I-TREATMENT -con I-TREATMENT -anfotericina I-TREATMENT -B I-TREATMENT -liposomal I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT +dieta I-TREATMENT +hipercalórica I-TREATMENT +en I-TREATMENT +forma I-TREATMENT de I-TREATMENT -150 I-TREATMENT -mg/día I-TREATMENT -durante I-TREATMENT -20 I-TREATMENT -días, I-TREATMENT -seguido I-TREATMENT +textura I-TREATMENT +néctar, I-TREATMENT +administrándolos I-TREATMENT +en I-TREATMENT +pequeños I-TREATMENT +volúmenes, I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +mostró I-TREATMENT +menor I-TREATMENT +riesgo I-TREATMENT de I-TREATMENT -fluconazol I-TREATMENT -400 I-TREATMENT -mg/día I-TREATMENT +aspiración I-TREATMENT +en I-TREATMENT +las I-TREATMENT +pruebas I-TREATMENT +de I-TREATMENT +deglución I-TREATMENT +realizadas. I-TREATMENT +Se I-TREATMENT +recomendaron I-TREATMENT +medidas I-TREATMENT +generales I-TREATMENT +como I-TREATMENT +evitar I-TREATMENT +dobles I-TREATMENT +texturas I-TREATMENT +y I-TREATMENT +posturar I-TREATMENT +al I-TREATMENT +paciente I-TREATMENT durante I-TREATMENT -un I-TREATMENT -total I-TREATMENT +las I-TREATMENT +comidas I-TREATMENT +(tronco I-TREATMENT +erguido, I-TREATMENT +hombros I-TREATMENT +simétricos, I-TREATMENT +cabeza I-TREATMENT +ligeramente I-TREATMENT +flexionada), I-TREATMENT +y I-TREATMENT +también I-TREATMENT +se I-TREATMENT +solicitó I-TREATMENT +interconsulta I-TREATMENT +a I-TREATMENT +Logopedia I-TREATMENT +para I-TREATMENT +ejercicios I-TREATMENT de I-TREATMENT -6 I-TREATMENT -meses, I-TREATMENT -evolucionando B-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -radiológica I-EVOLUTION -(tanto I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION +rehabilitación I-TREATMENT +de I-TREATMENT +la I-TREATMENT +deglución. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +evolución I-EVOLUTION +en I-EVOLUTION +años I-EVOLUTION +posteriores I-EVOLUTION +ha I-EVOLUTION +sido I-EVOLUTION +favorable; I-EVOLUTION +presenta I-EVOLUTION +atragantamientos I-EVOLUTION +leves I-EVOLUTION +pero I-EVOLUTION +no I-EVOLUTION +ha I-EVOLUTION +vuelto I-EVOLUTION +a I-EVOLUTION +ingresar I-EVOLUTION +por I-EVOLUTION neumonía I-EVOLUTION +aspirativa I-EVOLUTION +ni I-EVOLUTION +ha I-EVOLUTION +presentado I-EVOLUTION +otras I-EVOLUTION +complicaciones I-EVOLUTION como I-EVOLUTION -del I-EVOLUTION -derrame I-EVOLUTION -pleural I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -de I-EVOLUTION -espondilodiscitis I-EVOLUTION -con I-EVOLUTION -afectación I-EVOLUTION -de I-EVOLUTION -cuerpos I-EVOLUTION -vertebrales). I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -Tabla I-EVOLUTION -I I-EVOLUTION +deshidratación I-EVOLUTION +o I-EVOLUTION +desnutrición, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +no I-EVOLUTION se I-EVOLUTION -exponen I-EVOLUTION -diversas I-EVOLUTION -características I-EVOLUTION +ha I-EVOLUTION +considerado I-EVOLUTION +la I-EVOLUTION +realización I-EVOLUTION de I-EVOLUTION -ambos I-EVOLUTION -casos. I-EVOLUTION +una I-EVOLUTION +gastrostomía. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -31 I-PRESENT_ILLNESS +83 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -fumadora B-PAST_MEDICAL_HISTORY +con B-PAST_MEDICAL_HISTORY +DM I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +II, I-PAST_MEDICAL_HISTORY +intervenido I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +ocasiones I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -paquetes/año, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +carcinoma I-PAST_MEDICAL_HISTORY +urotelial I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vejiga I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +RTU, I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +cual I-PAST_MEDICAL_HISTORY +recibió I-PAST_MEDICAL_HISTORY tratamiento I-PAST_MEDICAL_HISTORY +adyuvante I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -anticonceptivos I-PAST_MEDICAL_HISTORY -orales I-PAST_MEDICAL_HISTORY +mitomicina I-PAST_MEDICAL_HISTORY +intravesical I-PAST_MEDICAL_HISTORY +semanal, I-PAST_MEDICAL_HISTORY +seguido I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -intermitente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -octubre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1997 I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS +tratamiento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +mantenimiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +instilaciones I-PAST_MEDICAL_HISTORY +vesicales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +mitomicina I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +dosis I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +40 I-PAST_MEDICAL_HISTORY +mg I-PAST_MEDICAL_HISTORY +mensuales. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Tras B-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +quinta I-PRESENT_ILLNESS +instilación I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS +mantenimiento, I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +dilatación I-PRESENT_ILLNESS +uretral, I-PRESENT_ILLNESS +asociada I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +intensa I-PRESENT_ILLNESS +reacción I-PRESENT_ILLNESS +cutánea I-PRESENT_ILLNESS +genital I-PRESENT_ILLNESS +así I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +toxicodermia I-PRESENT_ILLNESS +sistémica, I-PRESENT_ILLNESS +siendo I-PRESENT_ILLNESS +diagnosticado I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -progresiva, I-PRESENT_ILLNESS -náuseas, I-PRESENT_ILLNESS -orinas I-PRESENT_ILLNESS -colúricas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -heces I-PRESENT_ILLNESS -acólicas. I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +posible I-PRESENT_ILLNESS +reacción I-PRESENT_ILLNESS +alérgica I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +mitomicina. I-PRESENT_ILLNESS +Se B-TREATMENT +le I-TREATMENT +pautó I-TREATMENT +tratamiento I-TREATMENT +sintomático I-TREATMENT +con I-TREATMENT +corticoides, I-TREATMENT +siendo B-DERIVED_FROM/TO +referido I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +dermatología I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +hospital, I-DERIVED_FROM/TO +desde I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +realizó I-DERIVED_FROM/TO +seguimiento I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +evolución. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Dos B-EVOLUTION +meses I-EVOLUTION +después, I-EVOLUTION +tras I-EVOLUTION +un I-EVOLUTION +periodo I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +cual I-EVOLUTION +la I-EVOLUTION +erupción I-EVOLUTION +había I-EVOLUTION +mostrado I-EVOLUTION +un I-EVOLUTION +progreso I-EVOLUTION +favorable, I-EVOLUTION +aunque I-EVOLUTION +sin I-EVOLUTION +llegar I-EVOLUTION +a I-EVOLUTION +resolverse I-EVOLUTION +por I-EVOLUTION +completo, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +acudió I-EVOLUTION +al I-EVOLUTION +servicio I-EVOLUTION +de I-EVOLUTION +urgencias I-EVOLUTION +por I-EVOLUTION +un I-EVOLUTION +empeoramiento I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +lesiones, I-EVOLUTION +siendo I-EVOLUTION +diagnosticado I-EVOLUTION +de I-EVOLUTION +una I-EVOLUTION +sobreinfección I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +mismas. I-EVOLUTION +Se B-TREATMENT +comenzó I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +sistémico I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +empírica I-TREATMENT +(ciprofloxacino I-TREATMENT +500mg I-TREATMENT +v.o. I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas), I-TREATMENT +asociado I-TREATMENT +a I-TREATMENT +la I-TREATMENT +administración I-TREATMENT +de I-TREATMENT +corticoides I-TREATMENT +tópicos. I-TREATMENT +Pese B-EVOLUTION +al I-EVOLUTION +tratamiento, I-EVOLUTION +tres I-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +volvió I-EVOLUTION +a I-EVOLUTION +acudir I-EVOLUTION +a I-EVOLUTION +urgencias I-EVOLUTION +por I-EVOLUTION +un I-EVOLUTION +aumento I-EVOLUTION +del I-EVOLUTION +eritema I-EVOLUTION +con I-EVOLUTION +enrojecimiento I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +zona I-EVOLUTION +genital, I-EVOLUTION +así I-EVOLUTION +como I-EVOLUTION +incremento I-EVOLUTION +del I-EVOLUTION +perímetro I-EVOLUTION +de I-EVOLUTION +ambos I-EVOLUTION +miembros I-EVOLUTION +inferiores. I-EVOLUTION En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION física I-EXPLORATION se I-EXPLORATION -evidenció I-EXPLORATION -eritema I-EXPLORATION -palmar I-EXPLORATION -bilateral, I-EXPLORATION -ictericia I-EXPLORATION -y I-EXPLORATION -hepatomegalia. I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION -(ecografía I-EXPLORATION +detectó I-EXPLORATION +una I-EXPLORATION +úlcera I-EXPLORATION +extensa I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cara I-EXPLORATION +posterior I-EXPLORATION +del I-EXPLORATION +pene I-EXPLORATION y I-EXPLORATION -TAC I-EXPLORATION -abdominal) I-EXPLORATION -se I-EXPLORATION -puso I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cara I-EXPLORATION +anterior I-EXPLORATION +del I-EXPLORATION +escroto, I-EXPLORATION +con I-EXPLORATION +elevación I-EXPLORATION de I-EXPLORATION -manifiesto I-EXPLORATION -una I-EXPLORATION -hepatomegalia I-EXPLORATION -homogénea. I-EXPLORATION -Los I-EXPLORATION -análisis I-EXPLORATION -practicados I-EXPLORATION -demostraron: I-EXPLORATION -GOT I-EXPLORATION -384 I-EXPLORATION -UI/L, I-EXPLORATION -GPT I-EXPLORATION -496 I-EXPLORATION -UI/L, I-EXPLORATION -GGT I-EXPLORATION -78 I-EXPLORATION -UI/L, I-EXPLORATION -FA I-EXPLORATION -553 I-EXPLORATION -UI/L I-EXPLORATION -y I-EXPLORATION -bilirrubina I-EXPLORATION -11, I-EXPLORATION -5 I-EXPLORATION -mg/dl I-EXPLORATION -(directa I-EXPLORATION -4, I-EXPLORATION -8 I-EXPLORATION -mg/dl), I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -hipergammaglobulinemia I-EXPLORATION -policlonal, I-EXPLORATION -con I-EXPLORATION -3030 I-EXPLORATION -mg/dl I-EXPLORATION -de I-EXPLORATION -IgG. I-EXPLORATION -Las I-EXPLORATION -serologías I-EXPLORATION -a I-EXPLORATION -VHA, I-EXPLORATION -VHB I-EXPLORATION -y I-EXPLORATION -VHC I-EXPLORATION -resultaron I-EXPLORATION -negativas. I-EXPLORATION -Los I-EXPLORATION -ANA I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Los I-EXPLORATION -AMA I-EXPLORATION -resultaron I-EXPLORATION -positivos I-EXPLORATION -(1/1280), I-EXPLORATION +la I-EXPLORATION +temperatura I-EXPLORATION +local I-EXPLORATION así I-EXPLORATION como I-EXPLORATION -los I-EXPLORATION -ASMA I-EXPLORATION -(1/320), I-EXPLORATION -Anti-LKM1 I-EXPLORATION -(1/640) I-EXPLORATION -y I-EXPLORATION -ANCA I-EXPLORATION -(1/40). I-EXPLORATION -Se I-EXPLORATION -procedió I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -hepática I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -leve I-EXPLORATION -distorsión I-EXPLORATION -focal I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -bandas I-EXPLORATION -fibrosas I-EXPLORATION -porto-portales I-EXPLORATION -ocasionales, I-EXPLORATION -con I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -linfocitario I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -espacios I-EXPLORATION -porta I-EXPLORATION -formando I-EXPLORATION -folículos I-EXPLORATION -linfoides, I-EXPLORATION -en I-EXPLORATION -ocasiones I-EXPLORATION -alrededor I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -ductos I-EXPLORATION -biliares. I-EXPLORATION -Dicho I-EXPLORATION -infiltrado I-EXPLORATION -traspasaba I-EXPLORATION -los I-EXPLORATION -límites I-EXPLORATION -del I-EXPLORATION -espacio I-EXPLORATION -porta, I-EXPLORATION -observándose I-EXPLORATION -necrosis I-EXPLORATION -"piecemeal" I-EXPLORATION -moderada/severa. I-EXPLORATION -Se I-EXPLORATION -apreciaron I-EXPLORATION -hepatocitos I-EXPLORATION -alrededor I-EXPLORATION -del I-EXPLORATION -espacio I-EXPLORATION -porta I-EXPLORATION -con I-EXPLORATION -acúmulo I-EXPLORATION -de I-EXPLORATION -proteína I-EXPLORATION -transportadora I-EXPLORATION -de I-EXPLORATION -cobre, I-EXPLORATION -e I-EXPLORATION -incremento I-EXPLORATION +bordes I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -celularidad I-EXPLORATION -inflamatoria I-EXPLORATION +piel I-EXPLORATION +necrótica I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -lobulillo, I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -sinusoides I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION +pene; I-EXPLORATION el I-EXPLORATION -parénquima, I-EXPLORATION -con I-EXPLORATION -citolisis I-EXPLORATION -e I-EXPLORATION -incremento I-EXPLORATION +paciente I-EXPLORATION +presentaba I-EXPLORATION +edema I-EXPLORATION +(con I-EXPLORATION +fóvea) I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +miembros I-EXPLORATION +inferiores I-EXPLORATION +hasta I-EXPLORATION +la I-EXPLORATION +altura I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -trama I-EXPLORATION -fibrosa I-EXPLORATION -intersticial. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -30 I-TREATMENT -mg I-TREATMENT +rodilla. I-EXPLORATION + I-EXPLORATION +Tras B-TREATMENT +valoración I-TREATMENT +del I-TREATMENT +servicio I-TREATMENT de I-TREATMENT -prednisona I-TREATMENT +Cirugía I-TREATMENT +Plástica, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +una I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +para I-TREATMENT +desbridar I-TREATMENT +el I-TREATMENT +tejido I-TREATMENT +necrotizado. I-TREATMENT +Durante B-EVOLUTION +el I-EVOLUTION +ingreso I-EVOLUTION +se I-EVOLUTION +registraron I-EVOLUTION +varios I-EVOLUTION +picos I-EVOLUTION +febriles, I-EVOLUTION +siendo B-TREATMENT +reintervenido I-TREATMENT +en I-TREATMENT +varias I-TREATMENT +ocasiones I-TREATMENT +para I-TREATMENT +desbridar I-TREATMENT +más I-TREATMENT +tejido I-TREATMENT +fibrótico-granulomatoso, I-TREATMENT +hasta I-TREATMENT +albugínea I-TREATMENT +testicular I-TREATMENT +y I-TREATMENT +cuerpos I-TREATMENT +cavernosos, I-TREATMENT +recibiendo I-TREATMENT +curas I-TREATMENT +periódicas I-TREATMENT +de I-TREATMENT +las I-TREATMENT +lesiones I-TREATMENT +durante I-TREATMENT +un I-TREATMENT +mes. I-TREATMENT +El B-EXPLORATION +cultivo I-EXPLORATION +microbiológico I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +herida I-EXPLORATION +reveló I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +sobreinfección I-EXPLORATION +se I-EXPLORATION +debía I-EXPLORATION +a I-EXPLORATION +Enterococcus I-EXPLORATION +tecalis, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +tratado I-TREATMENT con I-TREATMENT -posterior I-TREATMENT -reducción I-TREATMENT +fosfomicina I-TREATMENT +oral I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT de I-TREATMENT -su I-TREATMENT -dosis, I-TREATMENT -50 I-TREATMENT +1.000 I-TREATMENT mg I-TREATMENT +cada I-TREATMENT +6 I-TREATMENT +horas I-TREATMENT +durante I-TREATMENT +24 I-TREATMENT +días. I-TREATMENT + I-TREATMENT +Tras I-TREATMENT +la I-TREATMENT +resolución I-TREATMENT de I-TREATMENT -azatioprina I-TREATMENT +la I-TREATMENT +sobreinfección, I-TREATMENT +se I-TREATMENT +programó I-TREATMENT +una I-TREATMENT +cirugía I-TREATMENT +plástica I-TREATMENT +de I-TREATMENT +reconstrucción, I-TREATMENT +utilizando I-TREATMENT +piel I-TREATMENT +sana I-TREATMENT +del I-TREATMENT +escroto I-TREATMENT +para I-TREATMENT +cubrir I-TREATMENT +las I-TREATMENT +zonas I-TREATMENT +desprovistas I-TREATMENT +en I-TREATMENT +pene I-TREATMENT y I-TREATMENT -ácido I-TREATMENT -ursodesoxicólico. I-TREATMENT -Se B-EVOLUTION -produjo I-EVOLUTION -la I-EVOLUTION -resolución I-EVOLUTION -completa I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -clínico I-EVOLUTION -con I-EVOLUTION -normalización I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -análisis, I-EVOLUTION -persistiendo I-EVOLUTION -discretamente I-EVOLUTION -elevadas, I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -seis I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -evolución, I-EVOLUTION -la I-EVOLUTION -FA I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -GGT. I-EVOLUTION - I-EVOLUTION +testículos; I-TREATMENT +así I-TREATMENT +mismo, I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +uretroplastia I-TREATMENT +para I-TREATMENT +reconstruir I-TREATMENT +la I-TREATMENT +parte I-TREATMENT +de I-TREATMENT +la I-TREATMENT +uretra I-TREATMENT +que I-TREATMENT +había I-TREATMENT +sido I-TREATMENT +dañada. I-TREATMENT + I-TREATMENT -Mujer B-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +75 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -que B-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -cuando I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -le I-DERIVED_FROM/TO -detectó I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -bloqueo I-DERIVED_FROM/TO -auriculoventricular I-DERIVED_FROM/TO +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +colecistectomía, I-PAST_MEDICAL_HISTORY +hallux I-PAST_MEDICAL_HISTORY +valgus, I-PAST_MEDICAL_HISTORY +úlcera I-PAST_MEDICAL_HISTORY +gástrica I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +neuralgia I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +quinto I-PAST_MEDICAL_HISTORY +par I-PAST_MEDICAL_HISTORY +izquierdo. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Presentaba B-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +territorio I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +trigémino I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +lado I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +comenzó I-PRESENT_ILLNESS +hacía I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +mantenido I-PRESENT_ILLNESS +controlado I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +gabapentina. I-PRESENT_ILLNESS +Desde I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +últimos I-PRESENT_ILLNESS +18 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +era I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +intensidad I-PRESENT_ILLNESS +severa, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +respuesta I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +farmacológico. I-PRESENT_ILLNESS +La B-DERIVED_FROM/TO +falta I-DERIVED_FROM/TO de I-DERIVED_FROM/TO -tercer I-DERIVED_FROM/TO -grado I-DERIVED_FROM/TO -durante I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -examen I-DERIVED_FROM/TO -rutinario. I-DERIVED_FROM/TO -La B-TREATMENT -paciente I-TREATMENT -quedó I-TREATMENT -ingresada I-TREATMENT -y I-TREATMENT -se I-TREATMENT -implantó I-TREATMENT -un I-TREATMENT -marcapasos I-TREATMENT -temporal I-TREATMENT -endovenoso I-TREATMENT -7F I-TREATMENT -(electrodos I-TREATMENT -de I-TREATMENT -platino) I-TREATMENT +control I-DERIVED_FROM/TO +motivó I-DERIVED_FROM/TO +ingreso I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +carácter I-DERIVED_FROM/TO +urgente I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Neurología, I-DERIVED_FROM/TO +desde I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +solicitaron I-DERIVED_FROM/TO +colaboración I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +Unidad I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +Dolor. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +En B-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +anamnesis I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +fronto-parietal I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +irradiado I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +paladar, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +sensación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +descargas I-PRESENT_ILLNESS +eléctricas I-PRESENT_ILLNESS +muy I-PRESENT_ILLNESS +frecuentes I-PRESENT_ILLNESS +(en I-PRESENT_ILLNESS +torno I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +diarias), I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +intensidad I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +EVA I-PRESENT_ILLNESS +9-10. I-PRESENT_ILLNESS +En B-TREATMENT +ese I-TREATMENT +momento I-TREATMENT +estaba I-TREATMENT en I-TREATMENT -el I-TREATMENT -ventrículo I-TREATMENT -derecho I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -yugular I-TREATMENT -interna I-TREATMENT -derecha. I-TREATMENT -Fue I-TREATMENT -necesario I-TREATMENT -recolocarlo I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +metamizol I-TREATMENT +(8 I-TREATMENT +gr/24 I-TREATMENT +horas) I-TREATMENT +y I-TREATMENT +tramadol I-TREATMENT +(300 I-TREATMENT +mgr/24 I-TREATMENT +horas) I-TREATMENT +intravenoso I-TREATMENT en I-TREATMENT -cinco I-TREATMENT -ocasiones I-TREATMENT -durante I-TREATMENT -las I-TREATMENT -primeras I-TREATMENT -24 I-TREATMENT +perfusión I-TREATMENT +continua, I-TREATMENT +gabapentina I-TREATMENT +(1.200 I-TREATMENT +mgr/8 I-TREATMENT +horas) I-TREATMENT +y I-TREATMENT +topiramato I-TREATMENT +(25 I-TREATMENT +mgr/12 I-TREATMENT horas I-TREATMENT -debido I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +oral), I-TREATMENT +buprenorfina I-TREATMENT +transdérmica I-TREATMENT +(35 I-TREATMENT +µgr/hora) I-TREATMENT +y I-TREATMENT +petidina I-TREATMENT +intravenosa I-TREATMENT +de I-TREATMENT +rescate I-TREATMENT +(100 I-TREATMENT +mgr/8 I-TREATMENT +horas). I-TREATMENT + I-TREATMENT +Se I-TREATMENT +llevó I-TREATMENT a I-TREATMENT -un I-TREATMENT -insuficiente I-TREATMENT -sensado I-TREATMENT -auricular. I-TREATMENT -El I-TREATMENT -tercer I-TREATMENT -día I-TREATMENT +cabo I-TREATMENT +bloqueo I-TREATMENT +nervioso I-TREATMENT de I-TREATMENT -ingreso I-TREATMENT +1ª I-TREATMENT +y I-TREATMENT +2ª I-TREATMENT +ramas I-TREATMENT +izquierdas I-TREATMENT +del I-TREATMENT +quinto I-TREATMENT +par I-TREATMENT +con I-TREATMENT +bupivacaína I-TREATMENT +0, I-TREATMENT +5%, I-TREATMENT +con B-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +logró I-EVOLUTION +una I-EVOLUTION +buena I-EVOLUTION +analgesia I-EVOLUTION +superficial I-EVOLUTION +(EVA I-EVOLUTION +4), I-EVOLUTION +aunque I-EVOLUTION +persistía I-EVOLUTION +el I-EVOLUTION +dolor I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +paladar. I-EVOLUTION +Se B-TREATMENT +ajustó I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +farmacológico I-TREATMENT +asociando I-TREATMENT +oxcarbacepina I-TREATMENT +300 I-TREATMENT +mgr/12 I-TREATMENT +horas I-TREATMENT +y I-TREATMENT se I-TREATMENT -colocó I-TREATMENT -un I-TREATMENT -marcapasos I-TREATMENT -permanente I-TREATMENT -VDD I-TREATMENT -a I-TREATMENT -través I-TREATMENT +suspendió I-TREATMENT +topiramato I-TREATMENT +y I-TREATMENT de I-TREATMENT +manera I-TREATMENT +progresiva I-TREATMENT la I-TREATMENT -vía I-TREATMENT -subclavia I-TREATMENT -izquierda I-TREATMENT -sin I-TREATMENT -incidencias. I-TREATMENT -Al B-EVOLUTION -día I-EVOLUTION -siguiente I-EVOLUTION +buprenorfina. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +10 I-EVOLUTION +días, I-EVOLUTION +dada I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION -tuvo I-EVOLUTION -febrícula I-EVOLUTION -y B-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT -ambulatoriamente I-TREATMENT -con I-TREATMENT -cloxacilina. I-TREATMENT -Los B-EXPLORATION -hemocultivos I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Diez B-EVOLUTION -días I-EVOLUTION -mas I-EVOLUTION -tarde, I-EVOLUTION -ingresó I-EVOLUTION +buena I-EVOLUTION +evolución I-EVOLUTION de I-EVOLUTION -nuevo I-EVOLUTION +la I-EVOLUTION +paciente, I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta, I-EVOLUTION +presentando I-EVOLUTION +entonces I-EVOLUTION +EVA I-EVOLUTION +0 I-EVOLUTION +(incluso I-EVOLUTION +el I-EVOLUTION +dolor I-EVOLUTION en I-EVOLUTION +paladar). I-EVOLUTION +La I-EVOLUTION +cifra I-EVOLUTION +de I-EVOLUTION +sodio I-EVOLUTION +al I-EVOLUTION +abandonar I-EVOLUTION el I-EVOLUTION hospital I-EVOLUTION -debido I-EVOLUTION -a I-EVOLUTION -febrícula I-EVOLUTION -intermitente, I-EVOLUTION -disnea, I-EVOLUTION -tos I-EVOLUTION -no I-EVOLUTION -productiva I-EVOLUTION +estaba I-EVOLUTION +dentro I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +límites I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +normalidad, I-EVOLUTION +según I-EVOLUTION +una I-EVOLUTION +analítica I-EVOLUTION +realizada I-EVOLUTION +durante I-EVOLUTION +su I-EVOLUTION +ingreso. I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +dolor I-EVOLUTION +se I-EVOLUTION +mantuvo I-EVOLUTION +controlado I-EVOLUTION y I-EVOLUTION +en I-EVOLUTION +una I-EVOLUTION +revisión I-EVOLUTION +efectuada I-EVOLUTION +4 I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +ingreso I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +refirió I-EVOLUTION +ausencia I-EVOLUTION +de I-EVOLUTION +crisis I-EVOLUTION +de I-EVOLUTION dolor I-EVOLUTION -pleurítico I-EVOLUTION en I-EVOLUTION -hemitórax I-EVOLUTION -derecho. I-EVOLUTION -La B-EXPLORATION -herida I-EXPLORATION -quirúrgica I-EXPLORATION -estaba I-EXPLORATION -limpia I-EXPLORATION -e I-EXPLORATION -indolora. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -reveló I-EXPLORATION -cardiomegalia I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -derecho. I-EXPLORATION -El I-EXPLORATION -ECG I-EXPLORATION -mostraba I-EXPLORATION +ese I-EVOLUTION +tiempo. I-EVOLUTION +En B-EXPLORATION +esa I-EXPLORATION +misma I-EXPLORATION +visita I-EXPLORATION +se I-EXPLORATION +comprueba I-EXPLORATION +que I-EXPLORATION +en I-EXPLORATION un I-EXPLORATION -bloqueo I-EXPLORATION -auriculoventricular I-EXPLORATION -de I-EXPLORATION -tercer I-EXPLORATION -grado I-EXPLORATION -con I-EXPLORATION -ritmo I-EXPLORATION +análisis I-EXPLORATION +realizado I-EXPLORATION +unos I-EXPLORATION +días I-EXPLORATION +antes I-EXPLORATION +aparece I-EXPLORATION +una I-EXPLORATION +cifra I-EXPLORATION de I-EXPLORATION -escape I-EXPLORATION +sodio I-EXPLORATION de I-EXPLORATION -marcapasos. I-EXPLORATION -No B-TREATMENT +125 I-EXPLORATION +mgr/dl. I-EXPLORATION +Hacía B-TREATMENT +más I-TREATMENT +de I-TREATMENT +un I-TREATMENT +mes I-TREATMENT había I-TREATMENT -sensado I-TREATMENT +comenzado I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +un I-TREATMENT +antihipertensivo I-TREATMENT +que I-TREATMENT +combina I-TREATMENT +un I-TREATMENT +inhibidor I-TREATMENT +de I-TREATMENT +los I-TREATMENT +receptores I-TREATMENT +de I-TREATMENT +angiotensina I-TREATMENT +II I-TREATMENT +y I-TREATMENT +un I-TREATMENT +diurético I-TREATMENT +tiazídico I-TREATMENT +(hidroclorotiazida). I-TREATMENT +La I-TREATMENT +paciente I-TREATMENT +no I-TREATMENT +presentaba I-TREATMENT +síntomas I-TREATMENT +atribuibles I-TREATMENT +a I-TREATMENT +dicha I-TREATMENT +hiponatremia. I-TREATMENT + I-TREATMENT +Debido I-TREATMENT +a I-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT de I-TREATMENT la I-TREATMENT -onda I-TREATMENT -P, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT +contribución I-TREATMENT +tanto I-TREATMENT +de I-TREATMENT +hidroclorotiazida I-TREATMENT +como I-TREATMENT +oxcarbacepina I-TREATMENT +en I-TREATMENT +la I-TREATMENT +hiponatremia, I-TREATMENT se I-TREATMENT -aumentó I-TREATMENT +retiró, I-TREATMENT +de I-TREATMENT +acuerdo I-TREATMENT +con I-TREATMENT +su I-TREATMENT +médico I-TREATMENT +de I-TREATMENT +cabecera, I-TREATMENT la I-TREATMENT -sensibilidad I-TREATMENT -del I-TREATMENT -electrodo I-TREATMENT -auricular I-TREATMENT -y I-TREATMENT -el I-TREATMENT -dispositivo I-TREATMENT -funcionó I-TREATMENT -adecuadamente. I-TREATMENT -Al B-EVOLUTION -día I-EVOLUTION -siguiente I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -tenía I-EVOLUTION -mayor I-EVOLUTION -disnea, I-EVOLUTION -ingurgitación I-EVOLUTION -yugular I-EVOLUTION -y I-EVOLUTION -edemas I-EVOLUTION -en I-EVOLUTION -miembros I-EVOLUTION -inferiores. I-EVOLUTION -Se B-EXPLORATION -auscultó I-EXPLORATION -por I-EXPLORATION -primera I-EXPLORATION -vez I-EXPLORATION +hidroclorotiazida. I-TREATMENT +En B-EXPLORATION un I-EXPLORATION -fuerte I-EXPLORATION -roce I-EXPLORATION -pericárdico I-EXPLORATION -sobre I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -precordial. I-EXPLORATION -En I-EXPLORATION +ionograma I-EXPLORATION +solicitado I-EXPLORATION +15 I-EXPLORATION +días I-EXPLORATION +después, I-EXPLORATION el I-EXPLORATION -ecocardiograma I-EXPLORATION -se I-EXPLORATION -vio I-EXPLORATION -un I-EXPLORATION -derrame I-EXPLORATION -pericárdico I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -mm I-EXPLORATION -sin I-EXPLORATION -colapso I-EXPLORATION -ventricular I-EXPLORATION -derecho. I-EXPLORATION -El I-EXPLORATION -cable I-EXPLORATION -del I-EXPLORATION -electrodo I-EXPLORATION -estaba I-EXPLORATION -dentro I-EXPLORATION -del I-EXPLORATION -tracto I-EXPLORATION -de I-EXPLORATION -salida I-EXPLORATION +valor I-EXPLORATION del I-EXPLORATION -ventrículo I-EXPLORATION -derecho. I-EXPLORATION -La I-EXPLORATION -proteína I-EXPLORATION -C-reactiva I-EXPLORATION +sodio I-EXPLORATION era I-EXPLORATION de I-EXPLORATION -153 I-EXPLORATION -mg/dl, I-EXPLORATION -el I-EXPLORATION -fibrinógeno I-EXPLORATION -de I-EXPLORATION -659 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -VSG I-EXPLORATION -de I-EXPLORATION -57 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -hora. I-EXPLORATION -Los I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares, I-EXPLORATION -anticuerpos I-EXPLORATION -antimúsculo I-EXPLORATION -cardiaco, I-EXPLORATION -complemento I-EXPLORATION -y I-EXPLORATION -factor I-EXPLORATION -reumatoide I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Los I-EXPLORATION -anticuerpos I-EXPLORATION -frente I-EXPLORATION -Coxsackie I-EXPLORATION -B1 I-EXPLORATION -a I-EXPLORATION -B6 I-EXPLORATION +143 I-EXPLORATION +mgr/dl, I-EXPLORATION +con I-EXPLORATION +normalidad I-EXPLORATION +del I-EXPLORATION +potasio I-EXPLORATION y I-EXPLORATION -Echovirus I-EXPLORATION -fueron I-EXPLORATION -también I-EXPLORATION -negativos. I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT -con I-TREATMENT -diuréticos I-TREATMENT -y I-TREATMENT -prednisona I-TREATMENT -(30 I-TREATMENT -mg/día). I-TREATMENT -Su B-EVOLUTION -estado I-EVOLUTION -mejoró I-EVOLUTION -rápidamente. I-EVOLUTION -Dos I-EVOLUTION -semanas I-EVOLUTION -después, I-EVOLUTION +cloro. I-EXPLORATION + I-EXPLORATION +Dos B-EVOLUTION +meses I-EVOLUTION +más I-EVOLUTION +tarde I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +ingresada I-EVOLUTION +en I-EVOLUTION el I-EVOLUTION -roce I-EVOLUTION -pericárdico I-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Urgencias I-EVOLUTION +con I-EVOLUTION +clínica I-EVOLUTION +de I-EVOLUTION +intensa I-EVOLUTION +astenia I-EVOLUTION y I-EVOLUTION -el I-EVOLUTION -derrame I-EVOLUTION -pleural I-EVOLUTION -habían I-EVOLUTION -desaparecido I-EVOLUTION +debilidad I-EVOLUTION +muscular I-EVOLUTION y I-EVOLUTION -los I-EVOLUTION -marcadores I-EVOLUTION -inflamatorios I-EVOLUTION -se I-EVOLUTION -habían I-EVOLUTION -normalizado. I-EVOLUTION -La B-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -prednisona I-TREATMENT -fue I-TREATMENT -reduciéndose I-TREATMENT -gradualmente I-TREATMENT -a I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -meses I-TREATMENT -hasta I-TREATMENT -suspender, I-TREATMENT -con I-TREATMENT -recurrencia I-TREATMENT -de I-TREATMENT -los I-TREATMENT -síntomas I-TREATMENT -(dolor I-TREATMENT -torácico I-TREATMENT -pleurítico I-TREATMENT -y I-TREATMENT -elevación I-TREATMENT -de I-TREATMENT -los I-TREATMENT -marcadores I-TREATMENT -de I-TREATMENT -inflamación) I-TREATMENT -dos I-TREATMENT -meses I-TREATMENT -después. I-TREATMENT -Se I-TREATMENT -trató I-TREATMENT -con I-TREATMENT +una I-EVOLUTION +cifra I-EVOLUTION +de I-EVOLUTION +sodio I-EVOLUTION +de I-EVOLUTION +120 I-EVOLUTION +mgr/dl. I-EVOLUTION +Nuevamente B-TREATMENT +había I-TREATMENT +comenzado, I-TREATMENT +hacía I-TREATMENT un I-TREATMENT -nuevo I-TREATMENT -curso I-TREATMENT +mes, I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +hidroclorotiazida I-TREATMENT +debido I-TREATMENT +al I-TREATMENT +mal I-TREATMENT +control I-TREATMENT de I-TREATMENT -prednisona I-TREATMENT -sin I-TREATMENT -recurrencias I-TREATMENT -posteriores. I-TREATMENT +su I-TREATMENT +presión I-TREATMENT +arterial. I-TREATMENT I-TREATMENT +Ante B-EVOLUTION +la I-EVOLUTION +buena I-EVOLUTION +evolución, I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +últimos I-EVOLUTION +meses, I-EVOLUTION +del I-EVOLUTION +cuadro I-EVOLUTION +doloroso I-EVOLUTION +se B-TREATMENT +decidió I-TREATMENT +retirar I-TREATMENT +la I-TREATMENT +oxcarbacepina I-TREATMENT +y I-TREATMENT +dejar I-TREATMENT +a I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +únicamente I-TREATMENT +con I-TREATMENT +gabapentina I-TREATMENT +para I-TREATMENT +control I-TREATMENT +de I-TREATMENT +su I-TREATMENT +dolor I-TREATMENT +neuropático. I-TREATMENT +En B-EVOLUTION +esta I-EVOLUTION +ocasión I-EVOLUTION +se I-EVOLUTION +mantuvo I-EVOLUTION +la I-EVOLUTION +dosis I-EVOLUTION +de I-EVOLUTION +hidroclorotiazida. I-EVOLUTION +Los I-EVOLUTION +síntomas I-EVOLUTION +atribuibles I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +hiponatremia I-EVOLUTION +mejoraron I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +inmediata I-EVOLUTION +al I-EVOLUTION +retirar I-EVOLUTION +oxcarbacepina. I-EVOLUTION +En B-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +analítica I-EXPLORATION +solicitada I-EXPLORATION +8 I-EXPLORATION +días I-EXPLORATION +después I-EXPLORATION +del I-EXPLORATION +ingreso I-EXPLORATION +el I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +sodio I-EXPLORATION +fue I-EXPLORATION +140 I-EXPLORATION +mg/dl. I-EXPLORATION + I-EXPLORATION -Mujer B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -63 I-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -esencial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -valsartan I-PAST_MEDICAL_HISTORY -(80 I-PAST_MEDICAL_HISTORY -mg/día), I-PAST_MEDICAL_HISTORY -temblor I-PAST_MEDICAL_HISTORY -esencial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -propanolol I-PAST_MEDICAL_HISTORY -(80 I-PAST_MEDICAL_HISTORY -mg/día), I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -venosa I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -miembros I-PAST_MEDICAL_HISTORY -inferiores I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -medidas I-PAST_MEDICAL_HISTORY -higiénico-posturales, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS +urgencia I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +volumen I-PRESENT_ILLNESS +palpebral I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +sonarse I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -externa I-PRESENT_ILLNESS +nariz I-PRESENT_ILLNESS +(maniobra I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Medicina I-PRESENT_ILLNESS -Interna I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -valoración I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -seguimiento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS +Valsalva). I-PRESENT_ILLNESS +Esa I-PRESENT_ILLNESS +misma I-PRESENT_ILLNESS +madrugada I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +sufrido I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +caída I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -insuficiencia I-PRESENT_ILLNESS -venosa I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS +altura I-PRESENT_ILLNESS +golpeándose I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -inferiores, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -referir I-PRESENT_ILLNESS -ninguna I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -sintomatología. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -estaba I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad, I-EXPLORATION -salvo I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -soplo I-EXPLORATION -sistólico I-EXPLORATION -grado I-EXPLORATION -II/VI I-EXPLORATION -en I-EXPLORATION -borde I-EXPLORATION -esternal I-EXPLORATION -izquierdo I-EXPLORATION +la I-PRESENT_ILLNESS +cara I-PRESENT_ILLNESS +lateral I-PRESENT_ILLNESS +izquierda I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +nariz, I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +altura I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +huesos I-PRESENT_ILLNESS +propios, I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +cual I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +epistaxis I-PRESENT_ILLNESS +leve I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +autolimitada. I-PRESENT_ILLNESS +El B-EXPLORATION +examen I-EXPLORATION +oftalmológico I-EXPLORATION +reveló I-EXPLORATION +visión I-EXPLORATION +20/20 I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -auscultación I-EXPLORATION -cardiaca I-EXPLORATION +cada I-EXPLORATION +ojo, I-EXPLORATION +reflejos I-EXPLORATION +pupilares I-EXPLORATION +normales I-EXPLORATION y I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -insuficiencia I-EXPLORATION -venosa I-EXPLORATION -crónica I-EXPLORATION +motilidad I-EXPLORATION +ocular I-EXPLORATION +conservada, I-EXPLORATION +sin I-EXPLORATION +edema I-EXPLORATION +ni I-EXPLORATION +hiperemia I-EXPLORATION +conjuntival, I-EXPLORATION +sólo I-EXPLORATION +discreta I-EXPLORATION +equimosis I-EXPLORATION en I-EXPLORATION -miembros I-EXPLORATION -inferiores. I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -exploraciones I-EXPLORATION -complementarias I-EXPLORATION -destacaba I-EXPLORATION -hemograma, I-EXPLORATION -VSG, I-EXPLORATION -coagulación, I-EXPLORATION -bioquímica I-EXPLORATION -y I-EXPLORATION -orina I-EXPLORATION -normales. I-EXPLORATION -ECG: I-EXPLORATION -normal. I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -tórax: I-EXPLORATION -imagen I-EXPLORATION -vascular I-EXPLORATION -bien I-EXPLORATION -delimitada I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -mediastino I-EXPLORATION -superior I-EXPLORATION -izquierdo. I-EXPLORATION -Ecocardiografía I-EXPLORATION -doppler: I-EXPLORATION -normal. I-EXPLORATION -TAC I-EXPLORATION -torácica I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -intravenoso: I-EXPLORATION -dilatación I-EXPLORATION -aneurismática I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +medial I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -arteria I-EXPLORATION -pulmonar I-EXPLORATION +hemicara I-EXPLORATION izquierda I-EXPLORATION +acompañada I-EXPLORATION de I-EXPLORATION -47x75 I-EXPLORATION -mm I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -diámetro, I-EXPLORATION -sin I-EXPLORATION -otros I-EXPLORATION -hallazgos. I-EXPLORATION -Cateterismo I-EXPLORATION -cardiaco I-EXPLORATION -con I-EXPLORATION -angiografía I-EXPLORATION -pulmonar I-EXPLORATION +volumen I-EXPLORATION +palpebral I-EXPLORATION +crepitante I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación. I-EXPLORATION +El I-EXPLORATION +marco I-EXPLORATION +óseo I-EXPLORATION +orbitario I-EXPLORATION y I-EXPLORATION -coronaria: I-EXPLORATION -coronarias I-EXPLORATION +la I-EXPLORATION +pirámide I-EXPLORATION +nasal I-EXPLORATION +estaban I-EXPLORATION sin I-EXPLORATION -lesiones I-EXPLORATION -y I-EXPLORATION -dilatación I-EXPLORATION -aneurismática I-EXPLORATION -del I-EXPLORATION -tronco I-EXPLORATION -de I-EXPLORATION +dolor. I-EXPLORATION +Los I-EXPLORATION +signos I-EXPLORATION +vitales I-EXPLORATION +eran I-EXPLORATION +normales. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +radiológico I-EXPLORATION +cráneo-facial I-EXPLORATION +corroboró I-EXPLORATION la I-EXPLORATION -arteria I-EXPLORATION -pulmonar I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +enfisema I-EXPLORATION +subcutáneo I-EXPLORATION y I-EXPLORATION +orbitario, I-EXPLORATION +asociado I-EXPLORATION +a I-EXPLORATION +fractura I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -arteria I-EXPLORATION -pulmonar I-EXPLORATION -izquierda. I-EXPLORATION -La B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -Cardiovascular I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -referencia, I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -sometida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -intervención I-DERIVED_FROM/TO -quirúrgica, I-DERIVED_FROM/TO -objetivándose B-TREATMENT -en I-TREATMENT -el I-TREATMENT -acto I-TREATMENT -quirúrgico I-TREATMENT -una I-TREATMENT -arteria I-TREATMENT -pulmonar I-TREATMENT -derecha I-TREATMENT -de I-TREATMENT -calibre I-TREATMENT -normal I-TREATMENT -y I-TREATMENT -realizándose I-TREATMENT -resección I-TREATMENT -parcial I-TREATMENT -y I-TREATMENT -plicatura I-TREATMENT -de I-TREATMENT -las I-TREATMENT -arterias I-TREATMENT -pulmonares I-TREATMENT -común I-TREATMENT -e I-TREATMENT -izquierda I-TREATMENT -hasta I-TREATMENT -reducir I-TREATMENT -a I-TREATMENT -un I-TREATMENT -diámetro I-TREATMENT -de I-TREATMENT -2-3 I-TREATMENT -centímetros, I-TREATMENT -cursando B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION +lámina I-EXPLORATION +papirácea I-EXPLORATION +del I-EXPLORATION +etmoides I-EXPLORATION +ipsilateral. I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +hospitalizado I-EVOLUTION y I-EVOLUTION -permaneciendo I-EVOLUTION -asintomática I-EVOLUTION -tras I-EVOLUTION +observado I-EVOLUTION +por I-EVOLUTION +24 I-EVOLUTION +h, I-EVOLUTION +posteriormente I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +con I-EVOLUTION la I-EVOLUTION -cirugía. I-EVOLUTION +precaución I-EVOLUTION +de I-EVOLUTION +evitar I-EVOLUTION +maniobras I-EVOLUTION +que I-EVOLUTION +pudieran I-EVOLUTION +aumentar I-EVOLUTION +la I-EVOLUTION +presión I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +vía I-EVOLUTION +aérea I-EVOLUTION +superior, I-EVOLUTION +durante I-EVOLUTION +dos I-EVOLUTION +semanas. I-EVOLUTION +El I-EVOLUTION +enfisema I-EVOLUTION +se I-EVOLUTION +resolvió I-EVOLUTION +espontáneamente I-EVOLUTION +dentro I-EVOLUTION +de I-EVOLUTION +5 I-EVOLUTION +días I-EVOLUTION +y I-EVOLUTION +durante I-EVOLUTION +las I-EVOLUTION +dos I-EVOLUTION +semanas I-EVOLUTION +siguientes I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +desarrolló I-EVOLUTION +complicaciones. I-EVOLUTION I-EVOLUTION -Dos B-PRESENT_ILLNESS -pacientes I-PRESENT_ILLNESS -varones I-PRESENT_ILLNESS -A I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -B, I-PRESENT_ILLNESS -diagnosticados I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -enfermedad I-PRESENT_ILLNESS -inflamatoria I-PRESENT_ILLNESS -intestinal I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presentaron I-PRESENT_ILLNESS -urticaria I-PRESENT_ILLNESS -generalizada I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -varios I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -mesalazina. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS el I-PRESENT_ILLNESS caso I-PRESENT_ILLNESS -A, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -31 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -presentado I-PRESENT_ILLNESS -urticaria I-PRESENT_ILLNESS -generalizada I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -toma I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -mesalazina I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -así B-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -reacciones I-PAST_MEDICAL_HISTORY -previas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -urticaria I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -angioedema I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -toma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -AAS I-PAST_MEDICAL_HISTORY -(ácido I-PAST_MEDICAL_HISTORY -acetilsalicílico). I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -B, I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS +37 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -mesalazina, I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -rash I-PRESENT_ILLNESS -maculopapuloso I-PRESENT_ILLNESS -generalizado, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -retira. I-PRESENT_ILLNESS -Seis I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -tarde I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -reinicia I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -mesalazina, I-PRESENT_ILLNESS -aunque I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -introducido I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -budesonida I-PRESENT_ILLNESS -vía I-PRESENT_ILLNESS -oral I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -rectal. I-PRESENT_ILLNESS -Tras I-PRESENT_ILLNESS -otros I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -todo I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -anterior I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -retirada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -corticoides, I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -urticaria I-PRESENT_ILLNESS -generalizada. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Test B-EXPLORATION -cutáneos I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -pruebas I-EXPLORATION -cutáneas I-EXPLORATION -según I-EXPLORATION -las I-EXPLORATION -recomendaciones I-EXPLORATION +remitida B-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +desde I-DERIVED_FROM/TO +otro I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +hospitalario I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +presentar I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +pérdida I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +sustancia I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +dorso I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +mano I-DERIVED_FROM/TO +izquierda I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +2 I-DERIVED_FROM/TO +días I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +evolución I-DERIVED_FROM/TO +tras I-DERIVED_FROM/TO +sufrir I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +accidente I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +tráfico. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +A B-EXPLORATION +la I-EXPLORATION +exploración, I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +una I-EXPLORATION +pérdida I-EXPLORATION +cutánea I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +dorso I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -Academia I-EXPLORATION -Europea I-EXPLORATION +mano I-EXPLORATION +izquierda I-EXPLORATION de I-EXPLORATION -Alergología I-EXPLORATION -e I-EXPLORATION -Inmunología I-EXPLORATION -Clínica I-EXPLORATION -(EAACI) I-EXPLORATION -(5). I-EXPLORATION -Prick I-EXPLORATION -a I-EXPLORATION -1/10 I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -1/1 I-EXPLORATION -con I-EXPLORATION -mesalazina I-EXPLORATION -(10 I-EXPLORATION -mg/ml I-EXPLORATION +7 I-EXPLORATION +x I-EXPLORATION +7 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -Claversal®) I-EXPLORATION +diámetro I-EXPLORATION +con I-EXPLORATION +bordes I-EXPLORATION +muy I-EXPLORATION +contundidos I-EXPLORATION y I-EXPLORATION -sulfasalazina I-EXPLORATION -(10 I-EXPLORATION -mg/ml I-EXPLORATION +que I-EXPLORATION +sobrepasaba I-EXPLORATION +la I-EXPLORATION +articulación I-EXPLORATION +metacarpofalangica I-EXPLORATION +del I-EXPLORATION +2º I-EXPLORATION +dedo. I-EXPLORATION +Asimismo, I-EXPLORATION +encontramos I-EXPLORATION +una I-EXPLORATION +exposición I-EXPLORATION de I-EXPLORATION -Salazopyrina®). I-EXPLORATION -Se I-EXPLORATION -usó I-EXPLORATION -histamina I-EXPLORATION -a I-EXPLORATION -1/10 I-EXPLORATION +los I-EXPLORATION +tendones I-EXPLORATION +extensores I-EXPLORATION +del I-EXPLORATION +2º I-EXPLORATION y I-EXPLORATION -1/1 I-EXPLORATION -como I-EXPLORATION -control I-EXPLORATION -positivo. I-EXPLORATION -El I-EXPLORATION -suero I-EXPLORATION -salino I-EXPLORATION -en I-EXPLORATION -prick I-EXPLORATION -se I-EXPLORATION -utilizó I-EXPLORATION +3º I-EXPLORATION +dedos I-EXPLORATION +con I-EXPLORATION +ruptura I-EXPLORATION +del I-EXPLORATION +extensor I-EXPLORATION +del I-EXPLORATION +2º, I-EXPLORATION +así I-EXPLORATION como I-EXPLORATION -control I-EXPLORATION -negativo. I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION -se I-EXPLORATION -consideran I-EXPLORATION -negativos I-EXPLORATION -cuando I-EXPLORATION -la I-EXPLORATION -pápula I-EXPLORATION -obtenida I-EXPLORATION -es I-EXPLORATION -< I-EXPLORATION -o I-EXPLORATION -igual I-EXPLORATION -a I-EXPLORATION -3 I-EXPLORATION -mm I-EXPLORATION -o I-EXPLORATION -menor I-EXPLORATION -que I-EXPLORATION +exposición I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -histamina. I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -prick I-EXPLORATION -en I-EXPLORATION -10 I-EXPLORATION -pacientes I-EXPLORATION -sanos I-EXPLORATION -no I-EXPLORATION -expuestos I-EXPLORATION -a I-EXPLORATION -5-ASA I-EXPLORATION -previamente. I-EXPLORATION - I-EXPLORATION -Provocación I-EXPLORATION -oral I-EXPLORATION -controlada I-EXPLORATION -con I-EXPLORATION -placebo I-EXPLORATION -a I-EXPLORATION -simple I-EXPLORATION -ciego I-EXPLORATION +musculatura I-EXPLORATION +interósea I-EXPLORATION +dorsal I-EXPLORATION +de I-EXPLORATION +1º I-EXPLORATION +y I-EXPLORATION +2º I-EXPLORATION +dedos. I-EXPLORATION +No I-EXPLORATION +había I-EXPLORATION +déficit I-EXPLORATION +neurovascular I-EXPLORATION +ni I-EXPLORATION +fracturas I-EXPLORATION +asociadas. I-EXPLORATION I-EXPLORATION Tras B-TREATMENT -la I-TREATMENT -toma I-TREATMENT -de I-TREATMENT -un I-TREATMENT -placebo, I-TREATMENT -se I-TREATMENT -administran I-TREATMENT -dosis I-TREATMENT -crecientes I-TREATMENT -del I-TREATMENT -fármaco I-TREATMENT -implicado I-TREATMENT -en I-TREATMENT una I-TREATMENT -reacción I-TREATMENT -durante I-TREATMENT -un I-TREATMENT -tiempo I-TREATMENT -determinado, I-TREATMENT +primera I-TREATMENT +cura I-TREATMENT +realizada I-TREATMENT a I-TREATMENT -partir I-TREATMENT +su I-TREATMENT +ingreso, I-TREATMENT +con I-TREATMENT +retirada I-TREATMENT +de I-TREATMENT +tejidos I-TREATMENT +desvitalizados I-TREATMENT +y I-TREATMENT +reparación I-TREATMENT del I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -llega I-TREATMENT -a I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -deseada I-TREATMENT -para I-TREATMENT -el I-TREATMENT -tratamiento, I-TREATMENT +tendón I-TREATMENT +extensor I-TREATMENT +del I-TREATMENT +2º I-TREATMENT +dedo, I-TREATMENT +nos I-TREATMENT +planteamos I-TREATMENT +cómo I-TREATMENT +realizar I-TREATMENT la I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -mantiene I-TREATMENT -desde I-TREATMENT -entonces. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -deben I-TREATMENT -descartar I-TREATMENT -enfermedades I-TREATMENT -o I-TREATMENT -tratamientos I-TREATMENT -que I-TREATMENT -contraindiquen I-TREATMENT -el I-TREATMENT -uso I-TREATMENT +cobertura I-TREATMENT +del I-TREATMENT +defecto, I-TREATMENT +optando I-TREATMENT +por I-TREATMENT +una I-TREATMENT +reconstrucción I-TREATMENT +mediante I-TREATMENT +un I-TREATMENT +colgajo I-TREATMENT +interóseo I-TREATMENT +posterior I-TREATMENT de I-TREATMENT -adrenalina, I-TREATMENT -o I-TREATMENT -enfermedades I-TREATMENT -mal I-TREATMENT -controladas I-TREATMENT -(hipertensión I-TREATMENT -arterial, I-TREATMENT -diabetes). I-TREATMENT - I-TREATMENT -Se I-TREATMENT -deben I-TREATMENT -suspender I-TREATMENT -medicaciones I-TREATMENT -que I-TREATMENT -puedan I-TREATMENT -interferir I-TREATMENT +transferencia I-TREATMENT +libre. I-TREATMENT +Los I-TREATMENT +motivos I-TREATMENT +de I-TREATMENT +esta I-TREATMENT +elección I-TREATMENT los I-TREATMENT -resultados I-TREATMENT +presentamos I-TREATMENT +en I-TREATMENT +el I-TREATMENT +apartado I-TREATMENT de I-TREATMENT -las I-TREATMENT -pruebas I-TREATMENT -(corticoides, I-TREATMENT -antihistamínicos, I-TREATMENT -etc.). I-TREATMENT +Discusión. I-TREATMENT I-TREATMENT -Si I-TREATMENT -aparecen I-TREATMENT -reacciones I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -administración, I-TREATMENT -como I-TREATMENT -urticaria, I-TREATMENT -angioedema, I-TREATMENT -etc., I-TREATMENT -se I-TREATMENT -le I-TREATMENT -administra I-TREATMENT + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +58 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +diagnosticado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +LLC I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +B I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +evidencia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +progresión I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +enfermedad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +cinco I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +crecimiento I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +progresión I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +adenopatías I-PRESENT_ILLNESS +inguinales, I-PRESENT_ILLNESS +axiales I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cervicales. I-PRESENT_ILLNESS +Recibe B-TREATMENT +6 I-TREATMENT +ciclos I-TREATMENT +con I-TREATMENT el I-TREATMENT -tratamiento I-TREATMENT -preciso I-TREATMENT -para I-TREATMENT -revertirlas I-TREATMENT -en I-TREATMENT -cada I-TREATMENT -caso I-TREATMENT +esquema I-TREATMENT +rituximab I-TREATMENT +(375 I-TREATMENT +mg/m2 I-TREATMENT +IV I-TREATMENT +de I-TREATMENT +inicio, I-TREATMENT +500 I-TREATMENT +mg/m2 I-TREATMENT +IV I-TREATMENT +dosis I-TREATMENT +sucesivas), I-TREATMENT +fludarabina I-TREATMENT +(25 I-TREATMENT +mg/m2 I-TREATMENT +IV) I-TREATMENT y I-TREATMENT -se I-TREATMENT -suspende I-TREATMENT -la I-TREATMENT -provocación. I-TREATMENT - I-TREATMENT -"Desensibilización" I-TREATMENT -a I-TREATMENT -mesalazina I-TREATMENT - I-TREATMENT -Se I-TREATMENT -pide I-TREATMENT -consentimiento I-TREATMENT -informado I-TREATMENT -firmado I-TREATMENT -por I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -para I-TREATMENT +ciclofosfamida I-TREATMENT +(250 I-TREATMENT +mg/m2 I-TREATMENT +i.v.), I-TREATMENT +alcanzando I-TREATMENT +remisión I-TREATMENT +parcial I-TREATMENT +con I-TREATMENT +persistencia I-TREATMENT +de I-TREATMENT la I-TREATMENT -realización I-TREATMENT +enfermedad, I-TREATMENT +presencia I-TREATMENT de I-TREATMENT -pruebas I-TREATMENT -cutáneas I-TREATMENT +cariotipo I-TREATMENT +complejo I-TREATMENT y I-TREATMENT +aparición I-TREATMENT de I-TREATMENT -provocación I-TREATMENT -oral. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -llevó I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -ambulatoria I-TREATMENT -el I-TREATMENT -protocolo I-TREATMENT +deleción I-TREATMENT +del I-TREATMENT +gen I-TREATMENT +p53. I-TREATMENT +Por I-TREATMENT +estas I-TREATMENT +características I-TREATMENT +inicia I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +idelalisib I-TREATMENT +(150 I-TREATMENT +mg/12 I-TREATMENT +horas I-TREATMENT +v.o.) I-TREATMENT +combinado I-TREATMENT +con I-TREATMENT +rituximab I-TREATMENT +(dosis I-TREATMENT +inicial I-TREATMENT de I-TREATMENT -desensibilización, I-TREATMENT -elaborado I-TREATMENT -en I-TREATMENT -nuestro I-TREATMENT -Servicio I-TREATMENT +375 I-TREATMENT +mg/m2 I-TREATMENT +IV, I-TREATMENT +dosis I-TREATMENT +posteriores I-TREATMENT de I-TREATMENT -Alergia I-TREATMENT -como I-TREATMENT +500 I-TREATMENT +mg/m2 I-TREATMENT +IV). I-TREATMENT + I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +tres I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +inicio I-EVOLUTION +del I-EVOLUTION +tratamiento I-EVOLUTION +ingresa I-EVOLUTION +por I-EVOLUTION +diarrea I-EVOLUTION +líquida I-EVOLUTION +de I-EVOLUTION +4 I-EVOLUTION +días I-EVOLUTION +evolución, I-EVOLUTION +con I-EVOLUTION +7-8 I-EVOLUTION +deposiciones I-EVOLUTION +al I-EVOLUTION +día, I-EVOLUTION +sin I-EVOLUTION +productos I-EVOLUTION +patológicos, I-EVOLUTION +acompañada I-EVOLUTION +de I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +mesogástrico I-EVOLUTION +continuo I-EVOLUTION +que I-EVOLUTION +cede I-EVOLUTION +parcialmente I-EVOLUTION +con I-EVOLUTION +la I-EVOLUTION +deposición, I-EVOLUTION +con I-EVOLUTION +febrícula I-EVOLUTION +pero I-EVOLUTION +sin I-EVOLUTION +náuseas I-EVOLUTION +ni I-EVOLUTION +vómitos. I-EVOLUTION +Los B-EXPLORATION +resultados I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +coprocultivos I-EXPLORATION +y I-EXPLORATION +hemocultivos I-EXPLORATION +realizados I-EXPLORATION +son I-EXPLORATION +negativos. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +TAC I-EXPLORATION +abdominal I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +asas I-EXPLORATION +de I-EXPLORATION +colon I-EXPLORATION +ascendente I-EXPLORATION +de I-EXPLORATION +calibre I-EXPLORATION +aumentado, I-EXPLORATION +engrosamiento I-EXPLORATION +mural I-EXPLORATION +y I-EXPLORATION +realce I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +colitis I-EXPLORATION +inflamatoria. I-EXPLORATION +Se I-EXPLORATION +suspende I-EXPLORATION +el I-EXPLORATION +tratamiento I-EXPLORATION +con I-EXPLORATION +idelalisib I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +inicia I-EXPLORATION +sueroterapia I-EXPLORATION +y I-EXPLORATION +analgesia. I-EXPLORATION +Evoluciona B-TREATMENT +con I-TREATMENT +pico I-TREATMENT +febril I-TREATMENT +y I-TREATMENT +deterioro I-TREATMENT +general, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT se I-TREATMENT -puede I-TREATMENT -observar I-TREATMENT -en I-TREATMENT -la I-TREATMENT -Tabla I-TREATMENT -I. I-TREATMENT +añade I-TREATMENT +ciprofloxacino I-TREATMENT +(400 I-TREATMENT +mg/12 I-TREATMENT +h I-TREATMENT +IV), I-TREATMENT +sustituyéndose I-TREATMENT +posteriormente I-TREATMENT +por I-TREATMENT +piperacilina/tazobactam I-TREATMENT +(4 I-TREATMENT +g/6 I-TREATMENT +h I-TREATMENT +IV). I-TREATMENT I-TREATMENT -En I-TREATMENT -el I-TREATMENT -caso I-TREATMENT -B, I-TREATMENT +Como B-EVOLUTION +complicaciones I-EVOLUTION +derivadas I-EVOLUTION +del I-EVOLUTION +ingreso, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +desarrolla I-EVOLUTION +un I-EVOLUTION +neumotórax I-EVOLUTION +durante I-EVOLUTION +la I-EVOLUTION +canalización I-EVOLUTION +de I-EVOLUTION +una I-EVOLUTION +vía I-EVOLUTION +central I-EVOLUTION +y, I-EVOLUTION +durante I-EVOLUTION +dos I-EVOLUTION +días I-EVOLUTION +en I-EVOLUTION +UCI, I-EVOLUTION +presenta I-EVOLUTION +diarrea I-EVOLUTION +cuantiosa I-EVOLUTION +con I-EVOLUTION +alteraciones I-EVOLUTION +hidroelectrolíticas I-EVOLUTION +que I-EVOLUTION +requieren I-EVOLUTION +reposición I-EVOLUTION +volémica I-EVOLUTION +y I-EVOLUTION +electrolítica I-EVOLUTION +y I-EVOLUTION +aporte I-EVOLUTION +de I-EVOLUTION +nutrición I-EVOLUTION +parenteral. I-EVOLUTION + I-EVOLUTION +A B-TREATMENT +la I-TREATMENT +semana I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT se I-TREATMENT -suspendió I-TREATMENT +origina I-TREATMENT +alteración I-TREATMENT +de I-TREATMENT la I-TREATMENT -budesonida I-TREATMENT -en I-TREATMENT -enemas I-TREATMENT -7 I-TREATMENT -días I-TREATMENT -antes I-TREATMENT +función I-TREATMENT +renal I-TREATMENT +y, I-TREATMENT +debido I-TREATMENT +al I-TREATMENT +deterioro I-TREATMENT +clínico I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +digestivo, I-TREATMENT +recibe I-TREATMENT +corticoides I-TREATMENT +(budesónida I-TREATMENT +9 I-TREATMENT +mg/24 I-TREATMENT +h I-TREATMENT +VO I-TREATMENT +que I-TREATMENT +es I-TREATMENT +sustituida I-TREATMENT +por I-TREATMENT +metilprednisolona I-TREATMENT +60 I-TREATMENT +mg/24 I-TREATMENT +h I-TREATMENT +IV I-TREATMENT +por I-TREATMENT +persistencia I-TREATMENT de I-TREATMENT -iniciar I-TREATMENT la I-TREATMENT -desensibilización. I-TREATMENT - I-TREATMENT -Con I-TREATMENT -este I-TREATMENT -protocolo I-TREATMENT +diarrea) I-TREATMENT +y I-TREATMENT +rifaximina I-TREATMENT +(200 I-TREATMENT +mg/6 I-TREATMENT +h I-TREATMENT +VO). I-TREATMENT +Tras B-EVOLUTION +siete I-EVOLUTION +días I-EVOLUTION +con I-EVOLUTION +corticoides I-EVOLUTION +sistémicos I-EVOLUTION +se I-EVOLUTION +observa I-EVOLUTION +una I-EVOLUTION +mejoría I-EVOLUTION +del I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +(llegando I-EVOLUTION +a I-EVOLUTION +desaparecer), I-EVOLUTION +con I-EVOLUTION +disminución I-EVOLUTION +del I-EVOLUTION +número I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +cantidad I-EVOLUTION +de I-EVOLUTION +deposiciones I-EVOLUTION +y I-EVOLUTION +recuperación I-EVOLUTION +del I-EVOLUTION +estado I-EVOLUTION +general. I-EVOLUTION +En B-TREATMENT +el I-TREATMENT +momento I-TREATMENT +del I-TREATMENT +alta I-TREATMENT +hospitalaria I-TREATMENT se I-TREATMENT -administran I-TREATMENT -en I-TREATMENT -17 I-TREATMENT -días I-TREATMENT -dosis I-TREATMENT -(mg) I-TREATMENT -crecientes I-TREATMENT +mantiene I-TREATMENT +prednisona I-TREATMENT +(50 I-TREATMENT +mg/24 I-TREATMENT +h I-TREATMENT +VO) I-TREATMENT +hasta I-TREATMENT +resolución I-TREATMENT +completa I-TREATMENT de I-TREATMENT -mesalazina, I-TREATMENT -con I-TREATMENT -varias I-TREATMENT -dosis I-TREATMENT -diarias, I-TREATMENT +los I-TREATMENT +síntomas. I-TREATMENT + I-TREATMENT +A I-TREATMENT +los I-TREATMENT +dos I-TREATMENT +meses I-TREATMENT +del I-TREATMENT +alta I-TREATMENT +hospitalaria I-TREATMENT +reanuda I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT +idelalisib I-TREATMENT +(100 I-TREATMENT +mg/12 I-TREATMENT +h I-TREATMENT +VO) I-TREATMENT +y I-TREATMENT +dos I-TREATMENT +meses I-TREATMENT +después I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +reingresa I-TREATMENT +por I-TREATMENT un I-TREATMENT -intervalo I-TREATMENT +nuevo I-TREATMENT +episodio I-TREATMENT de I-TREATMENT -tiempo I-TREATMENT +colitis, I-TREATMENT +aunque I-TREATMENT +más I-TREATMENT +leve I-TREATMENT que I-TREATMENT -va I-TREATMENT -aumentando I-TREATMENT -cada I-TREATMENT -día I-TREATMENT -(45 I-TREATMENT -minutos, I-TREATMENT -1 I-TREATMENT -hora I-TREATMENT -y I-TREATMENT -8 I-TREATMENT -horas). I-TREATMENT -Se I-TREATMENT -administran I-TREATMENT -dosis I-TREATMENT -hasta I-TREATMENT -alcanzar I-TREATMENT -la I-TREATMENT -tolerancia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -terapéutica I-TREATMENT -requerida I-TREATMENT -por I-TREATMENT el I-TREATMENT -paciente. I-TREATMENT +primero. I-TREATMENT Se I-TREATMENT -señala I-TREATMENT -en I-TREATMENT -la I-TREATMENT -tabla I-TREATMENT -I I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -diaria I-TREATMENT -tolerada I-TREATMENT +suspende I-TREATMENT +idelalisib I-TREATMENT +definitivamente I-TREATMENT y I-TREATMENT -la I-TREATMENT -acumulada I-TREATMENT -(la I-TREATMENT -suma I-TREATMENT +se I-TREATMENT +inicia I-TREATMENT +sueroterapia I-TREATMENT de I-TREATMENT -los I-TREATMENT -miligramos I-TREATMENT -tolerados I-TREATMENT +soporte. I-TREATMENT +A I-TREATMENT +las I-TREATMENT +24 I-TREATMENT +h I-TREATMENT +continúa I-TREATMENT +con I-TREATMENT +diarrea I-TREATMENT +profusa I-TREATMENT +(10 I-TREATMENT +deposiciones I-TREATMENT +líquidas I-TREATMENT +diarias) I-TREATMENT +y I-TREATMENT +pico I-TREATMENT +febril, I-TREATMENT por I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -hasta I-TREATMENT -ese I-TREATMENT -momento). I-TREATMENT - I-TREATMENT -El I-TREATMENT -día I-TREATMENT -17 I-TREATMENT +lo I-TREATMENT +que I-TREATMENT se I-TREATMENT -administran I-TREATMENT -finalmente I-TREATMENT -1.000 I-TREATMENT -mg/1.000 I-TREATMENT -mg/1.000 I-TREATMENT -mg I-TREATMENT +inicia I-TREATMENT +antibioterapia I-TREATMENT +con I-TREATMENT +levofloxacino I-TREATMENT +(500 I-TREATMENT +mg/24 I-TREATMENT +h I-TREATMENT +IV), I-TREATMENT +que I-TREATMENT +es I-TREATMENT +sustituido I-TREATMENT +por I-TREATMENT +meropenem I-TREATMENT +(1 I-TREATMENT +g/8h I-TREATMENT +IV). I-TREATMENT +Los B-EXPLORATION +coprocultivos I-EXPLORATION +y I-EXPLORATION +hemocultivos I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Después B-TREATMENT de I-TREATMENT -mesalazina I-TREATMENT -(3.000 I-TREATMENT -mg I-TREATMENT +una I-TREATMENT +semana I-TREATMENT +con I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +se I-TREATMENT +inicia I-TREATMENT +terapia I-TREATMENT +con I-TREATMENT +corticoides I-TREATMENT +sistémicos I-TREATMENT +a I-TREATMENT +1 I-TREATMENT +mg/kg/día, I-TREATMENT +presentando I-TREATMENT +mejoría I-TREATMENT +del I-TREATMENT +estado I-TREATMENT +general, I-TREATMENT +con I-TREATMENT +disminución I-TREATMENT +del I-TREATMENT +número I-TREATMENT +de I-TREATMENT +deposiciones I-TREATMENT al I-TREATMENT -día). I-TREATMENT +cabo I-TREATMENT +de I-TREATMENT +una I-TREATMENT +semana I-TREATMENT +de I-TREATMENT +tratamiento, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +es I-TREATMENT +dado I-TREATMENT +de I-TREATMENT +alta I-TREATMENT +hospitalaria I-TREATMENT +con I-TREATMENT +prednisona I-TREATMENT +oral I-TREATMENT +hasta I-TREATMENT +resolución I-TREATMENT +completa I-TREATMENT +de I-TREATMENT +los I-TREATMENT +síntomas. I-TREATMENT I-TREATMENT -Prick B-EXPLORATION -a I-EXPLORATION -1/10 I-EXPLORATION + +Presentamos B-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +47 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +remitido B-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +dolor I-DERIVED_FROM/TO +abdominal I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +anemia I-DERIVED_FROM/TO +(Hb I-DERIVED_FROM/TO +11, I-DERIVED_FROM/TO +4 I-DERIVED_FROM/TO +mg/dl I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +hierro I-DERIVED_FROM/TO +sérico I-DERIVED_FROM/TO +15 I-DERIVED_FROM/TO +µg/dl) I-DERIVED_FROM/TO +asociada I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +hiperferritinemia I-DERIVED_FROM/TO +(707 I-DERIVED_FROM/TO +ng/ml). I-DERIVED_FROM/TO +La B-EXPLORATION +gastroscopia, I-EXPLORATION +colonoscopia, I-EXPLORATION +ecografía I-EXPLORATION +y I-EXPLORATION +tránsito I-EXPLORATION +gastrointestinal I-EXPLORATION +descartaron I-EXPLORATION +afectación I-EXPLORATION +inflamatoria. I-EXPLORATION +A I-EXPLORATION +pesar I-EXPLORATION +de I-EXPLORATION +presentar I-EXPLORATION +un I-EXPLORATION +índice I-EXPLORATION +de I-EXPLORATION +saturación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +transferrina I-EXPLORATION +bajo I-EXPLORATION +(3, I-EXPLORATION +7 I-EXPLORATION +%) I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +genético I-EXPLORATION +de I-EXPLORATION +hemocromatosis I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION +Dada I-EXPLORATION +la I-EXPLORATION +normalidad I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +la I-EXPLORATION +ceruloplasmina I-EXPLORATION y I-EXPLORATION +estudio I-EXPLORATION +del I-EXPLORATION +metabolismo I-EXPLORATION +del I-EXPLORATION +cobre, I-EXPLORATION +que I-EXPLORATION +confirmaron I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +aceruloplasminemia: I-EXPLORATION +ceruloplasmina I-EXPLORATION +inferior I-EXPLORATION a I-EXPLORATION -1/1 I-EXPLORATION -con I-EXPLORATION -mesalazina I-EXPLORATION +7 I-EXPLORATION +mg/dl I-EXPLORATION +(rango I-EXPLORATION +normal, I-EXPLORATION +22-61 I-EXPLORATION +mg/dl), I-EXPLORATION +cobre I-EXPLORATION +sérico I-EXPLORATION +13 I-EXPLORATION +µg/dl I-EXPLORATION +(rango I-EXPLORATION +normal, I-EXPLORATION +70-150 I-EXPLORATION +µg/dl) I-EXPLORATION y I-EXPLORATION -sulfasalazina I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION +cobre I-EXPLORATION en I-EXPLORATION -ambos I-EXPLORATION -pacientes I-EXPLORATION -y I-EXPLORATION +orina I-EXPLORATION +de I-EXPLORATION +24 I-EXPLORATION +horas I-EXPLORATION +normal. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +test I-EXPLORATION +genético I-EXPLORATION +por I-EXPLORATION +no I-EXPLORATION +encontrarse I-EXPLORATION +disponible I-EXPLORATION en I-EXPLORATION -los I-EXPLORATION -controles. I-EXPLORATION -Provocación I-EXPLORATION -oral I-EXPLORATION +nuestro I-EXPLORATION +centro. I-EXPLORATION +La I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RM) I-EXPLORATION +abdominal I-EXPLORATION +identificó I-EXPLORATION +baja I-EXPLORATION +intensidad I-EXPLORATION +de I-EXPLORATION +señal I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -A I-EXPLORATION -con I-EXPLORATION -ácido I-EXPLORATION -acetilsalicílico I-EXPLORATION -hasta I-EXPLORATION -500 I-EXPLORATION -mg, I-EXPLORATION +T1 I-EXPLORATION +y I-EXPLORATION +T2 I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -urticaria I-EXPLORATION -localizada I-EXPLORATION +depósito I-EXPLORATION +hepático I-EXPLORATION +de I-EXPLORATION +hierro I-EXPLORATION +sin I-EXPLORATION +observar I-EXPLORATION +alteraciones I-EXPLORATION en I-EXPLORATION -cara. I-EXPLORATION -"Desensibilización" B-TREATMENT -a I-TREATMENT -mesalazina I-TREATMENT -desarrollado I-TREATMENT -en I-TREATMENT -17 I-TREATMENT -días, I-TREATMENT -con I-TREATMENT -tolerancia I-TREATMENT -de I-TREATMENT -1.000 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -mesalazina I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas I-TREATMENT -(3.000 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día) I-TREATMENT -en I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -A I-TREATMENT -y I-TREATMENT -B. I-TREATMENT -Desde B-EVOLUTION -entonces, I-EVOLUTION -y I-EVOLUTION -durante I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -existe I-EVOLUTION -buena I-EVOLUTION -tolerancia I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -mesalazina I-EVOLUTION -y I-EVOLUTION -mantienen I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -misma I-EVOLUTION -dosis I-EVOLUTION -tolerada I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -continuada, I-EVOLUTION -para I-EVOLUTION -evitar I-EVOLUTION -la I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -nuevas I-EVOLUTION -reacciones. I-EVOLUTION - I-EVOLUTION +la I-EXPLORATION +RM I-EXPLORATION +cerebral I-EXPLORATION +ni I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +oftalmológico. I-EXPLORATION + I-EXPLORATION Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -76 I-PRESENT_ILLNESS +67 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -fumador B-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -60 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -cesó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -este I-PAST_MEDICAL_HISTORY -hábito, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY +edad I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -EPOC I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -habitual. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS +espasmo I-PAST_MEDICAL_HISTORY +hemifacial I-PAST_MEDICAL_HISTORY +izquierdo, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS -pleurítico I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -lado I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS +epigastrio I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +derecho, I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -expectoración I-PRESENT_ILLNESS -habituales. I-PRESENT_ILLNESS -En B-EXPLORATION +coluria I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hace I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +años. I-PRESENT_ILLNESS +A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -se I-EXPLORATION -apreciaron I-EXPLORATION -una I-EXPLORATION -temperatura I-EXPLORATION -corporal I-EXPLORATION +física, I-EXPLORATION +dolor I-EXPLORATION +en I-EXPLORATION +hipocondrio I-EXPLORATION +derecho I-EXPLORATION +con I-EXPLORATION +Murphy I-EXPLORATION +negativo I-EXPLORATION +con I-EXPLORATION +leve I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -38 I-EXPLORATION -ºC I-EXPLORATION -y I-EXPLORATION +transaminasas I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +analítica. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +objetiva I-EXPLORATION una I-EXPLORATION -disminución I-EXPLORATION -difusa I-EXPLORATION +imagen I-EXPLORATION +quística I-EXPLORATION +de I-EXPLORATION +4 I-EXPLORATION +cm I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION del I-EXPLORATION -murmullo I-EXPLORATION -vesicular I-EXPLORATION +hilio I-EXPLORATION +hepático. I-EXPLORATION +El I-EXPLORATION +TAC I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +manifiesta I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION con I-EXPLORATION -crepitantes I-EXPLORATION -y I-EXPLORATION -sibilancias I-EXPLORATION +lesión I-EXPLORATION +hipodensa I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION -pulmonar I-EXPLORATION -izda. I-EXPLORATION +el I-EXPLORATION +hilio I-EXPLORATION +hepático. I-EXPLORATION En I-EXPLORATION la I-EXPLORATION -analítica I-EXPLORATION -general I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -destacaron I-EXPLORATION -18.600 I-EXPLORATION -leucocitos/mm3, I-EXPLORATION -92% I-EXPLORATION -neutrófilos, I-EXPLORATION -y I-EXPLORATION +RMN I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +hilio I-EXPLORATION +hepático I-EXPLORATION una I-EXPLORATION -gasometría I-EXPLORATION -con I-EXPLORATION -pCO2 I-EXPLORATION +lesión I-EXPLORATION +quística I-EXPLORATION de I-EXPLORATION -27 I-EXPLORATION -mm I-EXPLORATION -Hg, I-EXPLORATION -pO2 I-EXPLORATION -56, I-EXPLORATION -8, I-EXPLORATION -pH I-EXPLORATION -7, I-EXPLORATION -48 I-EXPLORATION -y I-EXPLORATION -HCO3 I-EXPLORATION -23, I-EXPLORATION 6 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro, I-EXPLORATION +polilobulada I-EXPLORATION con I-EXPLORATION -una I-EXPLORATION -saturación I-EXPLORATION +compresión I-EXPLORATION de I-EXPLORATION -O2 I-EXPLORATION -del I-EXPLORATION -92%. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -torácica I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -alveolar I-EXPLORATION -en I-EXPLORATION -LII, I-EXPLORATION -LSI I-EXPLORATION -y I-EXPLORATION -língula I-EXPLORATION -y I-EXPLORATION -cardiomegalia. I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -al I-TREATMENT -ingreso I-TREATMENT -del I-TREATMENT -paciente I-TREATMENT -iniciando I-TREATMENT -oxigenoterapia, I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -broncodilatadores I-TREATMENT -inhalados, I-TREATMENT -heparina I-TREATMENT -de I-TREATMENT -bajo I-TREATMENT -peso I-TREATMENT -molecular I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -profiláctica I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -con I-TREATMENT -levofloxacino I-TREATMENT -intravenoso I-TREATMENT -(500 I-TREATMENT -mg/24 I-TREATMENT -horas). I-TREATMENT -El B-EVOLUTION -cuadro I-EVOLUTION -evolucionó I-EVOLUTION -lentamente, I-EVOLUTION -manteniéndose I-EVOLUTION -la I-EVOLUTION -febrícula I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -insuficiencia I-EVOLUTION -respiratoria I-EVOLUTION -y B-EXPLORATION -las I-EXPLORATION -muestras I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +intrahepática I-EXPLORATION +sin I-EXPLORATION +realce I-EXPLORATION +tras I-EXPLORATION +la I-EXPLORATION +captación I-EXPLORATION de I-EXPLORATION -esputo I-EXPLORATION -para I-EXPLORATION -tinción I-EXPLORATION +contraste. I-EXPLORATION + I-EXPLORATION +Dados I-EXPLORATION +los I-EXPLORATION +episodios I-EXPLORATION de I-EXPLORATION -Gram I-EXPLORATION +colangitis I-EXPLORATION +se I-EXPLORATION +diagnostica I-EXPLORATION +como I-EXPLORATION +enfermedad I-EXPLORATION +de I-EXPLORATION +Caroli I-EXPLORATION y I-EXPLORATION -cultivo I-EXPLORATION -no I-EXPLORATION -fueron I-EXPLORATION -valorables, I-EXPLORATION -resultando I-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION -negativos. I-EXPLORATION -Por I-EXPLORATION -todo I-EXPLORATION -ello, I-EXPLORATION -6 I-EXPLORATION -días I-EXPLORATION -después I-EXPLORATION -del I-EXPLORATION -ingreso I-EXPLORATION se I-EXPLORATION decide I-EXPLORATION -realizar I-EXPLORATION +laparotomía I-EXPLORATION +exploradora, I-EXPLORATION +apreciándose I-EXPLORATION una I-EXPLORATION -fibrobroncoscopia. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -muestra I-EXPLORATION -del I-EXPLORATION -aspirado I-EXPLORATION -bronquial I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -abundantes I-EXPLORATION -polimorfonucleares I-EXPLORATION -(> I-EXPLORATION -25 I-EXPLORATION -PMN/c I-EXPLORATION -x100) I-EXPLORATION -y I-EXPLORATION -bacilos I-EXPLORATION -gram I-EXPLORATION -positivos I-EXPLORATION -difterimorfos I-EXPLORATION -extra I-EXPLORATION -e I-EXPLORATION -intracelulares, I-EXPLORATION -creciendo I-EXPLORATION -posteriormente I-EXPLORATION +tumoración I-EXPLORATION +quística I-EXPLORATION +intrahepática I-EXPLORATION en I-EXPLORATION -cultivo I-EXPLORATION -puro I-EXPLORATION -C. I-EXPLORATION -pseudodiphteriticum I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -clindamicina, I-EXPLORATION -eritromicina I-EXPLORATION -y I-EXPLORATION -ciprofloxacina I-EXPLORATION -y I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -penilina, I-EXPLORATION -amoxicilina-clavulánico, I-EXPLORATION -cefalosporinas I-EXPLORATION +los I-EXPLORATION +segmentos I-EXPLORATION +IV-III I-EXPLORATION +que, I-EXPLORATION +tras I-EXPLORATION +una I-EXPLORATION +colangiografía I-EXPLORATION +intraoperatoria, I-EXPLORATION +presenta I-EXPLORATION +comunicación I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +principal. I-EXPLORATION +Se B-TREATMENT +realiza I-TREATMENT +una I-TREATMENT +colecistectomía I-TREATMENT +y I-TREATMENT +hepatectomía I-TREATMENT +izquierda I-TREATMENT +reglada, I-TREATMENT +siendo B-EVOLUTION +la I-EVOLUTION +evolución I-EVOLUTION +postoperatoria I-EVOLUTION +favorable. I-EVOLUTION + I-EVOLUTION +La B-EXPLORATION +histología I-EXPLORATION +describe I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +constituida I-EXPLORATION +por I-EXPLORATION +múltiples I-EXPLORATION +quistes I-EXPLORATION de I-EXPLORATION -2ª I-EXPLORATION -y I-EXPLORATION -3ª I-EXPLORATION -generación I-EXPLORATION +pared I-EXPLORATION +fibrosa, I-EXPLORATION +revestidas I-EXPLORATION +por I-EXPLORATION +epitelio I-EXPLORATION +mucosecretor I-EXPLORATION +con I-EXPLORATION +zonas I-EXPLORATION +planas, I-EXPLORATION +proyecciones I-EXPLORATION +papilares, I-EXPLORATION +atipia I-EXPLORATION +citológica I-EXPLORATION y I-EXPLORATION -glicopéptidos. I-EXPLORATION -El I-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -frotis I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +sólido I-EXPLORATION +con I-EXPLORATION +infiltración I-EXPLORATION +focal I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION del I-EXPLORATION -exudado I-EXPLORATION -bronquial I-EXPLORATION -como I-EXPLORATION -proceso I-EXPLORATION -inflamatorio I-EXPLORATION -agudo I-EXPLORATION +quiste, I-EXPLORATION sin I-EXPLORATION +alcanzar I-EXPLORATION +el I-EXPLORATION +parénquima I-EXPLORATION +hepático I-EXPLORATION +ni I-EXPLORATION +bordes I-EXPLORATION +quirúrgicos. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION evidencia I-EXPLORATION +estroma I-EXPLORATION +ovárico. I-EXPLORATION +Todo I-EXPLORATION +ello I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +diagnostico I-EXPLORATION de I-EXPLORATION -otras I-EXPLORATION -lesiones. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -neumonía I-TREATMENT -por I-TREATMENT -C. I-TREATMENT -pseudodiphteriticum I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -a I-TREATMENT -amoxicilina-clavulánico I-TREATMENT -2 I-TREATMENT -g/ I-TREATMENT -8 I-TREATMENT -h I-TREATMENT -i.v., I-TREATMENT -evolucionando B-EVOLUTION +cistoadenocarcinoma I-EXPLORATION +hepático. I-EXPLORATION + I-EXPLORATION +Cinco B-EVOLUTION +años I-EVOLUTION +después, I-EVOLUTION el I-EVOLUTION paciente I-EVOLUTION +está I-EVOLUTION +asintomático I-EVOLUTION +sin I-EVOLUTION +signos I-EVOLUTION +radiológicos I-EVOLUTION de I-EVOLUTION -forma I-EVOLUTION -favorable. I-EVOLUTION +recidiva. I-EVOLUTION I-EVOLUTION -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +Lactante B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS un I-PRESENT_ILLNESS mes I-PRESENT_ILLNESS -adenopatías I-PRESENT_ILLNESS -laterocervicales I-PRESENT_ILLNESS -izquierdas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -odinofagia. I-PRESENT_ILLNESS -Los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -asoció I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -mialgias I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS +20 I-PRESENT_ILLNESS +días, I-PRESENT_ILLNESS +hijo B-PAST_MEDICAL_HISTORY +único, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -salvo I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +Atención I-PRESENT_ILLNESS +Primaria I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +secreción I-PRESENT_ILLNESS +blanquecina I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +conducto I-PRESENT_ILLNESS +auditivo I-PRESENT_ILLNESS +externo I-PRESENT_ILLNESS +(CAE). I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Se B-EXPLORATION +realiza I-EXPLORATION +un I-EXPLORATION +cultivo I-EXPLORATION de I-EXPLORATION -fiebre I-EXPLORATION -(38 I-EXPLORATION -ºC), I-EXPLORATION -conglomerado I-EXPLORATION -adenopático I-EXPLORATION -látero-cervical I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -mínimas I-EXPLORATION -adenopatías I-EXPLORATION -latero-cervicales I-EXPLORATION -derechas. I-EXPLORATION +dicha I-EXPLORATION +secreción, I-EXPLORATION +que I-EXPLORATION +resulta I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +SAMR. I-EXPLORATION Se I-EXPLORATION -le I-EXPLORATION -practicó I-EXPLORATION +realiza I-EXPLORATION un I-EXPLORATION -TAC I-EXPLORATION -cervical I-EXPLORATION +estudio I-EXPLORATION +familiar, I-EXPLORATION +obteniéndose I-EXPLORATION +cultivo I-EXPLORATION +nasal I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +padres, I-EXPLORATION que I-EXPLORATION -mostraba I-EXPLORATION -adenopatías I-EXPLORATION -cervicales, I-EXPLORATION -analítica I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -con I-EXPLORATION -leucopenia I-EXPLORATION -y I-EXPLORATION -trombopenia I-EXPLORATION -y I-EXPLORATION -biopsia I-EXPLORATION -ganglionar I-EXPLORATION -informada I-EXPLORATION -de I-EXPLORATION -linfadenitis I-EXPLORATION -aguda. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -destacaba: I-EXPLORATION -leucocitos I-EXPLORATION -2.500 I-EXPLORATION -con I-EXPLORATION -26% I-EXPLORATION -linfocitos, I-EXPLORATION -plaquetas I-EXPLORATION -57.000 I-EXPLORATION -y I-EXPLORATION -LDH I-EXPLORATION -816 I-EXPLORATION -U/L. I-EXPLORATION +resulta I-EXPLORATION +negativo. I-EXPLORATION I-EXPLORATION -La I-EXPLORATION -PPD I-EXPLORATION -5U I-EXPLORATION -fue I-EXPLORATION -negativa I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -hemocultivos, I-EXPLORATION -coprocultivo I-EXPLORATION -RPR I-EXPLORATION -y I-EXPLORATION -serologías I-EXPLORATION -frente I-EXPLORATION -a I-EXPLORATION -CMV, I-EXPLORATION -VEB, I-EXPLORATION -Brucella, I-EXPLORATION -Leptospira, I-EXPLORATION -Francisella I-EXPLORATION -tularensis I-EXPLORATION -y I-EXPLORATION -Bartonella I-EXPLORATION -fueron I-EXPLORATION -así I-EXPLORATION -mismo I-EXPLORATION -negativas. I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -fiebre I-EXPLORATION +Al B-FAMILY_HISTORY +analizar I-FAMILY_HISTORY +la I-FAMILY_HISTORY +historia I-FAMILY_HISTORY +familiar, I-FAMILY_HISTORY +tenemos I-FAMILY_HISTORY +conocimiento I-FAMILY_HISTORY +de I-FAMILY_HISTORY +que I-FAMILY_HISTORY +la I-FAMILY_HISTORY +madre I-FAMILY_HISTORY +había I-FAMILY_HISTORY +presentado I-FAMILY_HISTORY +una I-FAMILY_HISTORY +herida I-FAMILY_HISTORY +quirúrgica I-FAMILY_HISTORY +en I-FAMILY_HISTORY +el I-FAMILY_HISTORY +momento I-FAMILY_HISTORY +del I-FAMILY_HISTORY +parto, I-FAMILY_HISTORY +cuyo I-FAMILY_HISTORY +cultivo I-FAMILY_HISTORY +fue I-FAMILY_HISTORY +positivo I-FAMILY_HISTORY +para I-FAMILY_HISTORY +SARM I-FAMILY_HISTORY +con I-FAMILY_HISTORY +el I-FAMILY_HISTORY +mismo I-FAMILY_HISTORY +antibiograma I-FAMILY_HISTORY +que I-FAMILY_HISTORY +el I-FAMILY_HISTORY +hallado I-FAMILY_HISTORY +en I-FAMILY_HISTORY +el I-FAMILY_HISTORY +niño I-FAMILY_HISTORY +en I-FAMILY_HISTORY +el I-FAMILY_HISTORY +CAE, I-FAMILY_HISTORY +por I-FAMILY_HISTORY +lo I-FAMILY_HISTORY +que I-FAMILY_HISTORY +suponemos I-FAMILY_HISTORY +que I-FAMILY_HISTORY +se I-FAMILY_HISTORY +ha I-FAMILY_HISTORY +producido I-FAMILY_HISTORY +una I-FAMILY_HISTORY +transmisión I-FAMILY_HISTORY +vertical I-FAMILY_HISTORY +de I-FAMILY_HISTORY +dicho I-FAMILY_HISTORY +germen. I-FAMILY_HISTORY +Tras B-EXPLORATION +realizar I-EXPLORATION +estas I-EXPLORATION +investigaciones, I-EXPLORATION se I-EXPLORATION -practicó I-EXPLORATION -nueva I-EXPLORATION -biopsia I-EXPLORATION -cervical I-EXPLORATION -observándose I-EXPLORATION +vuelve I-EXPLORATION a I-EXPLORATION -nivel I-EXPLORATION -cortical-paracortical I-EXPLORATION +tomar I-EXPLORATION una I-EXPLORATION -linfadenitis I-EXPLORATION -necrotizante I-EXPLORATION -parcheada, I-EXPLORATION -con I-EXPLORATION -abundantes I-EXPLORATION -restos I-EXPLORATION -celulares I-EXPLORATION -y I-EXPLORATION -rodeada I-EXPLORATION -por I-EXPLORATION -linfocitos I-EXPLORATION -T I-EXPLORATION -CD4+, I-EXPLORATION -histiocitos I-EXPLORATION -CD68, I-EXPLORATION -escasos I-EXPLORATION -polimorfonucleares I-EXPLORATION -y I-EXPLORATION -células I-EXPLORATION -plasmáticas.; I-EXPLORATION -características I-EXPLORATION -histopatológicas I-EXPLORATION -que I-EXPLORATION -definen I-EXPLORATION -la I-EXPLORATION -enfermedad I-EXPLORATION +muestra I-EXPLORATION +del I-EXPLORATION +CAE I-EXPLORATION +del I-EXPLORATION +niño, I-EXPLORATION +siendo I-EXPLORATION de I-EXPLORATION -Kikuchi. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT +nuevo I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +SARM, I-EXPLORATION +cuyo I-EXPLORATION +antibiograma I-EXPLORATION +se I-EXPLORATION +muestra I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +tabla I-EXPLORATION +1. I-EXPLORATION + I-EXPLORATION +Dado B-TREATMENT +que I-TREATMENT +este I-TREATMENT +segundo I-TREATMENT +cultivo I-TREATMENT +es I-TREATMENT +sensible I-TREATMENT +a I-TREATMENT +ciprofloxacino, I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT tratamiento I-TREATMENT +local I-TREATMENT con I-TREATMENT -antiinflamatorios I-TREATMENT -no I-TREATMENT -esteroides I-TREATMENT -con B-EVOLUTION -desaparición I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -fiebre. I-EVOLUTION -Año I-EVOLUTION -y I-EVOLUTION -medio I-EVOLUTION -después I-EVOLUTION -sigue I-EVOLUTION -asintomático. I-EVOLUTION - I-EVOLUTION +esa I-TREATMENT +quinolona I-TREATMENT +siendo I-TREATMENT +el I-TREATMENT +cultivo I-TREATMENT +de I-TREATMENT +control I-TREATMENT +negativo. I-TREATMENT + I-TREATMENT -Niña B-PRESENT_ILLNESS +Prescolar B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +asfixia I-PAST_MEDICAL_HISTORY +neonatal I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +circular I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +cuello, I-PAST_MEDICAL_HISTORY +bronconeumonía I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +virus I-PAST_MEDICAL_HISTORY +respiratorio I-PAST_MEDICAL_HISTORY +sincicial I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vida I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +calendario I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vacunación I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +programa I-PAST_MEDICAL_HISTORY +nacional I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +inmunizaciones I-PAST_MEDICAL_HISTORY +completo I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +edad. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +El B-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +clínico I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +inició I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -remitida B-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -pediatra I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -estudio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -adenopatía I-DERIVED_FROM/TO -cervical I-DERIVED_FROM/TO -dolorosa I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -semana I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución, I-DERIVED_FROM/TO -sin I-DERIVED_FROM/TO -respuesta I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -amoxicilina-clavulánico. I-DERIVED_FROM/TO -No B-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -anorexia I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -asociada. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION +su I-PRESENT_ILLNESS +diagnóstico, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +síntomas I-PRESENT_ILLNESS +gastrointestinales I-PRESENT_ILLNESS +caracterizados I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +constipación, I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +difuso, I-PRESENT_ILLNESS +intermitente, I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +intensificó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +siguientes. I-PRESENT_ILLNESS +Consultó B-TREATMENT +reiteradamente I-TREATMENT +a I-TREATMENT +pediatra I-TREATMENT +y I-TREATMENT +gastroenterólogo I-TREATMENT +infantil, I-TREATMENT +indicándose I-TREATMENT +dieta I-TREATMENT +y I-TREATMENT +lactulosa; I-TREATMENT +además B-EXPLORATION se I-EXPLORATION -apreciaron I-EXPLORATION -adenopatías I-EXPLORATION -laterocervicales I-EXPLORATION -izquierdas I-EXPLORATION -menores I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +eco-grafía I-EXPLORATION +abdominal I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +normal. I-EXPLORATION +A B-EVOLUTION +las I-EVOLUTION +tres I-EVOLUTION +semanas I-EVOLUTION +se I-EVOLUTION +agregó I-EVOLUTION +decaimiento, I-EVOLUTION +irritabilidad I-EVOLUTION +nocturna, I-EVOLUTION +dolor I-EVOLUTION +lumbar I-EVOLUTION +y I-EVOLUTION +posteriormente I-EVOLUTION +postración I-EVOLUTION +relativa I-EVOLUTION +(no I-EVOLUTION +caminaba, I-EVOLUTION +no I-EVOLUTION +jugaba) I-EVOLUTION +y I-EVOLUTION +dificultad I-EVOLUTION +para I-EVOLUTION +mantenerse I-EVOLUTION +sentado. I-EVOLUTION +Se B-EXPLORATION +le I-EXPLORATION +solicitó I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION +columna I-EXPLORATION +lumbar I-EXPLORATION +con I-EXPLORATION +resultado I-EXPLORATION +normal. I-EXPLORATION +Por B-TREATMENT +persistencia I-TREATMENT +de I-TREATMENT +sintomatología, I-TREATMENT +fue I-TREATMENT +hospitalizada I-TREATMENT +con I-TREATMENT +la I-TREATMENT +hipótesis I-TREATMENT +de I-TREATMENT +síndrome I-TREATMENT +de I-TREATMENT +Guillain I-TREATMENT +Barré. I-TREATMENT +Una B-EXPLORATION +segunda I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +columna I-EXPLORATION +lumbar I-EXPLORATION y I-EXPLORATION -adenopatía I-EXPLORATION -laterocervical I-EXPLORATION -inferior I-EXPLORATION +evaluación I-EXPLORATION +neurológica I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +Hemograma I-EXPLORATION +con I-EXPLORATION +hematocrito I-EXPLORATION de I-EXPLORATION -3, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION +37, I-EXPLORATION +7%, I-EXPLORATION +recuento I-EXPLORATION de I-EXPLORATION -consistencia I-EXPLORATION -dura, I-EXPLORATION -no I-EXPLORATION -adherida, I-EXPLORATION +leucocitos I-EXPLORATION +9.300/mm3, I-EXPLORATION sin I-EXPLORATION -signos I-EXPLORATION -inflamatorios I-EXPLORATION -asociados. I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -destacaba I-EXPLORATION -hemograma, I-EXPLORATION -bioquímica I-EXPLORATION -y I-EXPLORATION -coagulación I-EXPLORATION -normales, I-EXPLORATION -VSG I-EXPLORATION -30 I-EXPLORATION -mm, I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares I-EXPLORATION +desviación I-EXPLORATION +a I-EXPLORATION +izquierda, I-EXPLORATION +plaquetas I-EXPLORATION +en I-EXPLORATION +rango I-EXPLORATION +normal I-EXPLORATION y I-EXPLORATION -factor I-EXPLORATION -reumatoideo I-EXPLORATION -negativos. I-EXPLORATION -PPD I-EXPLORATION -5U I-EXPLORATION -negativo. I-EXPLORATION -Serología I-EXPLORATION -Herpesvirus I-EXPLORATION -6 I-EXPLORATION -IgM I-EXPLORATION -positiva. I-EXPLORATION -Serologías I-EXPLORATION -CMV, I-EXPLORATION -VEB, I-EXPLORATION VHS I-EXPLORATION -I I-EXPLORATION -- I-EXPLORATION -II, I-EXPLORATION -Hepatitis I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C, I-EXPLORATION -VIH, I-EXPLORATION -Toxoplasma I-EXPLORATION -gondii, I-EXPLORATION -Bartonella I-EXPLORATION -henselae, I-EXPLORATION -Parvovirus I-EXPLORATION -B19 I-EXPLORATION -y I-EXPLORATION -Salmonella I-EXPLORATION -typhi I-EXPLORATION -negativas. I-EXPLORATION -La I-EXPLORATION -Rx I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -cervical I-EXPLORATION -se I-EXPLORATION -confirmaron I-EXPLORATION -las I-EXPLORATION -adenopatías. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -persistencia I-EXPLORATION +48 I-EXPLORATION +mm/hora, I-EXPLORATION +con I-EXPLORATION +PCR I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -adenopatías I-EXPLORATION -se I-EXPLORATION -practicó I-EXPLORATION -biopsia I-EXPLORATION -abierta I-EXPLORATION +6, I-EXPLORATION +5 I-EXPLORATION +mg/dL I-EXPLORATION +(normal: I-EXPLORATION +0-1). I-EXPLORATION +Un I-EXPLORATION +cintigrama I-EXPLORATION +óseo I-EXPLORATION +mostró I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +captación I-EXPLORATION a I-EXPLORATION -los I-EXPLORATION -18 I-EXPLORATION -días I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -evolución. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -mostró I-EXPLORATION -focos I-EXPLORATION +L2-L3. I-EXPLORATION +En I-EXPLORATION +virtud I-EXPLORATION de I-EXPLORATION -necrosis I-EXPLORATION -paracortical, I-EXPLORATION -rodeados I-EXPLORATION -por I-EXPLORATION -linfocitos I-EXPLORATION -T I-EXPLORATION -CD4 I-EXPLORATION -y I-EXPLORATION -CD8 I-EXPLORATION -+ I-EXPLORATION -y I-EXPLORATION -abundantes I-EXPLORATION -histiocitos I-EXPLORATION -CD68+, I-EXPLORATION -entremezclados I-EXPLORATION +este I-EXPLORATION +hallazgo, I-EXPLORATION +se I-EXPLORATION +reevaluó I-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +columna I-EXPLORATION +obtenida I-EXPLORATION con I-EXPLORATION -células I-EXPLORATION -plasmocitoides I-EXPLORATION -y I-EXPLORATION -ausencia I-EXPLORATION -significativa I-EXPLORATION +anterioridad, I-EXPLORATION +evidenciándose I-EXPLORATION +disminución I-EXPLORATION +del I-EXPLORATION +espacio I-EXPLORATION +intervertebral I-EXPLORATION +L2-L3. I-EXPLORATION +Una I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RM) I-EXPLORATION de I-EXPLORATION -neutrófilos. I-EXPLORATION +columna I-EXPLORATION +fue I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +espondilodiscitis. I-EXPLORATION La I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Auramina, I-EXPLORATION +punción I-EXPLORATION +del I-EXPLORATION +disco I-EXPLORATION +vertebral I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +L2- I-EXPLORATION +L3 I-EXPLORATION +bajo I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +(TC), I-EXPLORATION +mostró I-EXPLORATION +líquido I-EXPLORATION +con I-EXPLORATION +abundantes I-EXPLORATION +polimorfonucleares. I-EXPLORATION +Se I-EXPLORATION +envió I-EXPLORATION +a I-EXPLORATION +cultivo I-EXPLORATION +corriente, I-EXPLORATION cultivo I-EXPLORATION -para I-EXPLORATION -micobacterias, I-EXPLORATION -PCR I-EXPLORATION de I-EXPLORATION -Enterovirus, I-EXPLORATION -HSV, I-EXPLORATION -VVZ, I-EXPLORATION -CMV, I-EXPLORATION -VEB I-EXPLORATION -y I-EXPLORATION -Herpesvirus I-EXPLORATION -tipos I-EXPLORATION -6, I-EXPLORATION -7 I-EXPLORATION +Koch I-EXPLORATION y I-EXPLORATION -8 I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -ganglionar I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -El B-EVOLUTION -curso I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad I-EVOLUTION -fue I-EVOLUTION -favorable I-EVOLUTION -y I-EVOLUTION -autolimitado. I-EVOLUTION -Dos I-EVOLUTION -años I-EVOLUTION -después I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -73 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antidiabéticos I-PAST_MEDICAL_HISTORY -orales, I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -isquémica, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fibrilación I-PAST_MEDICAL_HISTORY -auricular I-PAST_MEDICAL_HISTORY -paroxística I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -amiodarona, I-PAST_MEDICAL_HISTORY -calcioantagonistas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -antiagregantes I-PAST_MEDICAL_HISTORY -plaquetarios. I-PAST_MEDICAL_HISTORY -Refería B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tos, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -disnea. I-PRESENT_ILLNESS -En B-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -destacaban I-EXPLORATION -anemia I-EXPLORATION -normocítica, I-EXPLORATION -hipoxemia, I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -reactantes I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +reacción I-EXPLORATION de I-EXPLORATION -fase I-EXPLORATION -aguda I-EXPLORATION -e I-EXPLORATION -infiltrados I-EXPLORATION -"parcheados" I-EXPLORATION +polimerasa I-EXPLORATION en I-EXPLORATION -ambos I-EXPLORATION -hemitórax I-EXPLORATION -con I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -derecho. I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -múltiples I-EXPLORATION -estudios I-EXPLORATION -microbiológicos, I-EXPLORATION -serológicos, I-EXPLORATION -citológicos I-EXPLORATION -y I-EXPLORATION +cadena I-EXPLORATION +(RPC) I-EXPLORATION +para I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -imagen I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION -o I-EXPLORATION -normales. I-EXPLORATION +ARN I-EXPLORATION +16S I-EXPLORATION +universal. I-EXPLORATION Se B-TREATMENT -estableció I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -presunción I-TREATMENT -bronquiolitis I-TREATMENT -obliterante I-TREATMENT -con I-TREATMENT -neumonía I-TREATMENT -organizada I-TREATMENT -(BONO) I-TREATMENT +tomaron I-TREATMENT +hemocultivos I-TREATMENT +que I-TREATMENT +resultaron I-TREATMENT +negativos I-TREATMENT y I-TREATMENT se I-TREATMENT inició I-TREATMENT tratamiento I-TREATMENT +antimicrobiano I-TREATMENT +empírico I-TREATMENT +iv I-TREATMENT con I-TREATMENT -prednisona I-TREATMENT -60 I-TREATMENT -mg/día I-TREATMENT -con I-TREATMENT -desaparición I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fiebre I-TREATMENT -y I-TREATMENT -mejoría I-TREATMENT -de I-TREATMENT -los I-TREATMENT -síntomas I-TREATMENT -respiratorios, I-TREATMENT -de I-TREATMENT -la I-TREATMENT -anemia I-TREATMENT +cloxacilina I-TREATMENT y I-TREATMENT +cefotaxima, I-TREATMENT +además I-TREATMENT de I-TREATMENT -los I-TREATMENT -reactantes I-TREATMENT -de I-TREATMENT -fase I-TREATMENT -aguda. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -ingresada I-EVOLUTION -de I-EVOLUTION -nuevo I-EVOLUTION -un I-EVOLUTION -mes I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -por I-EVOLUTION -disnea I-EVOLUTION -de I-EVOLUTION -reposo, I-EVOLUTION -edemas I-EVOLUTION +analgesia I-TREATMENT +con I-TREATMENT +ketoprofeno. I-TREATMENT +Evolucionó B-EVOLUTION +favorablemente, I-EVOLUTION +afebril I-EVOLUTION y I-EVOLUTION -oliguria. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -destacaban I-EXPLORATION -taquipnea, I-EXPLORATION -taquicardia I-EXPLORATION -rítmica I-EXPLORATION -sin I-EXPLORATION -soplos, I-EXPLORATION -disminución I-EXPLORATION -global I-EXPLORATION -del I-EXPLORATION -murmullo I-EXPLORATION -vesicular I-EXPLORATION -con I-EXPLORATION -crepitantes I-EXPLORATION -en I-EXPLORATION -bases I-EXPLORATION -y I-EXPLORATION -edemas I-EXPLORATION -en I-EXPLORATION -extremidades I-EXPLORATION -inferiores. I-EXPLORATION -Entre I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -destacaban I-EXPLORATION -20.600 I-EXPLORATION -leucocitos/mm3, I-EXPLORATION -con I-EXPLORATION -85% I-EXPLORATION -polimorfonucleares, I-EXPLORATION -LDH I-EXPLORATION -537 I-EXPLORATION -U/L, I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -249 I-EXPLORATION -U/L, I-EXPLORATION -albúmina I-EXPLORATION -2, I-EXPLORATION -3 I-EXPLORATION -g/dL, I-EXPLORATION -pO2 I-EXPLORATION -58 I-EXPLORATION -mmHg I-EXPLORATION -y I-EXPLORATION -CA I-EXPLORATION -19.9 I-EXPLORATION -214 I-EXPLORATION -U/L I-EXPLORATION -(normal I-EXPLORATION -0-27 I-EXPLORATION -U/L). I-EXPLORATION -Eran I-EXPLORATION -normales I-EXPLORATION -las I-EXPLORATION -cifras I-EXPLORATION +con I-EVOLUTION +disminución I-EVOLUTION +del I-EVOLUTION +dolor. I-EVOLUTION +Los B-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -hemoglobina, I-EXPLORATION -plaquetas, I-EXPLORATION -glucemia, I-EXPLORATION -bilirrubina, I-EXPLORATION -función I-EXPLORATION -renal, I-EXPLORATION -calcio, I-EXPLORATION -electrolitos, I-EXPLORATION -antígeno I-EXPLORATION -carcinoembrionario, I-EXPLORATION -CA I-EXPLORATION -125 I-EXPLORATION -y I-EXPLORATION -determinación I-EXPLORATION +control I-EXPLORATION +mostraron I-EXPLORATION +lenta I-EXPLORATION +regresión I-EXPLORATION de I-EXPLORATION -hormonas I-EXPLORATION -tiroideas. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION +los I-EXPLORATION +parámetros I-EXPLORATION +infecciosos I-EXPLORATION +inflamatorios, I-EXPLORATION +con I-EXPLORATION +8.900 I-EXPLORATION +leucocitos/mm3 I-EXPLORATION +sin I-EXPLORATION +desviación I-EXPLORATION +a I-EXPLORATION +izquierda, I-EXPLORATION +VHS I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -torácica I-EXPLORATION -se I-EXPLORATION -observaban I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -bilateral I-EXPLORATION +35 I-EXPLORATION +mm/hora I-EXPLORATION y I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -densidad I-EXPLORATION -bilateral I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -parénquima I-EXPLORATION -pulmonar, I-EXPLORATION +PCR I-EXPLORATION de I-EXPLORATION -predominio I-EXPLORATION -perihiliar. I-EXPLORATION +4, I-EXPLORATION +4 I-EXPLORATION +mg/dL. I-EXPLORATION El I-EXPLORATION -mediastino I-EXPLORATION -era I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -había I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -embolismo I-EXPLORATION -pulmonar I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -angio-TC. I-EXPLORATION -Un I-EXPLORATION -ecocardiograma I-EXPLORATION -transtorácico I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -toracocentesis I-EXPLORATION -bilateral I-EXPLORATION -obteniendo I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -casos I-EXPLORATION -un I-EXPLORATION +cultivo I-EXPLORATION +del I-EXPLORATION líquido I-EXPLORATION -pleural I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -lechoso, I-EXPLORATION -con I-EXPLORATION -características I-EXPLORATION -de I-EXPLORATION -exudado, I-EXPLORATION -concentración I-EXPLORATION -de I-EXPLORATION -triglicéridos I-EXPLORATION -de I-EXPLORATION -433 I-EXPLORATION -mg/dL I-EXPLORATION -y I-EXPLORATION -163 I-EXPLORATION -mg/dL I-EXPLORATION -respectivamente, I-EXPLORATION -y I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -quilomicrones. I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -citológicos I-EXPLORATION +articular I-EXPLORATION +resultó I-EXPLORATION +negativo I-EXPLORATION y I-EXPLORATION -microbiológicos I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -líquidos I-EXPLORATION -pleurales I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -broncoscopia I-EXPLORATION -con I-EXPLORATION -biopsia I-EXPLORATION -transbronquial I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -una I-EXPLORATION -mucosa I-EXPLORATION -bronquial I-EXPLORATION -infiltrada I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -proliferación I-EXPLORATION -neoplásica I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION +RPC I-EXPLORATION +universal I-EXPLORATION +demostró I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -adenocarcinoma. I-EXPLORATION -Las I-EXPLORATION -citologías I-EXPLORATION -y I-EXPLORATION -estudios I-EXPLORATION -microbiológicos I-EXPLORATION -del I-EXPLORATION -broncoaspirado I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -lavado I-EXPLORATION -broncoalveolar I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Se B-TREATMENT -incrementó I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT +K. I-EXPLORATION +kingae. I-EXPLORATION + I-EXPLORATION +Una B-TREATMENT +vez I-TREATMENT +completado I-TREATMENT +los I-TREATMENT +10 I-TREATMENT +días I-TREATMENT de I-TREATMENT -esteroides I-TREATMENT +tratamiento I-TREATMENT +iv, I-TREATMENT y I-TREATMENT +dada I-TREATMENT +la I-TREATMENT +buena I-TREATMENT +evolución I-TREATMENT +tanto I-TREATMENT +clínica I-TREATMENT +como I-TREATMENT +de I-TREATMENT +laboratorio, I-TREATMENT se I-TREATMENT -realizó I-TREATMENT -tratamiento I-TREATMENT +decidió I-TREATMENT +dar I-TREATMENT +el I-TREATMENT +alta, I-TREATMENT con I-TREATMENT -tubo I-TREATMENT +inmovilización I-TREATMENT +a I-TREATMENT +través I-TREATMENT de I-TREATMENT -drenaje I-TREATMENT -torácico I-TREATMENT -bilateral I-TREATMENT +un I-TREATMENT +corset I-TREATMENT y I-TREATMENT -nutrición I-TREATMENT -parenteral. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -se I-EVOLUTION -caracterizó I-EVOLUTION -por I-EVOLUTION -una I-EVOLUTION -insuficiencia I-EVOLUTION -respiratoria I-EVOLUTION -progresiva I-EVOLUTION -que I-EVOLUTION -condujo I-EVOLUTION -al I-EVOLUTION -fallecimiento I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -necropsia I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -linfangitis I-EXPLORATION -carcinomatosa I-EXPLORATION -diseminada I-EXPLORATION -con I-EXPLORATION -afectación I-EXPLORATION -de I-EXPLORATION -pulmones, I-EXPLORATION -hígado, I-EXPLORATION -pericardio, I-EXPLORATION -páncreas I-EXPLORATION -y I-EXPLORATION -suprarrenales, I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -adenocarcinoma I-EXPLORATION -de I-EXPLORATION -primario I-EXPLORATION -desconocido. I-EXPLORATION - I-EXPLORATION +con I-TREATMENT +indicación I-TREATMENT +de I-TREATMENT +completar I-TREATMENT +cuatro I-TREATMENT +semanas I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT +con I-TREATMENT +amoxicilina. I-TREATMENT + I-TREATMENT -Paciente, B-PRESENT_ILLNESS -mujer, I-PRESENT_ILLNESS +Dos B-PRESENT_ILLNESS +pacientes I-PRESENT_ILLNESS +varones I-PRESENT_ILLNESS +A I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +B, I-PRESENT_ILLNESS +diagnosticados I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -66 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +enfermedad I-PRESENT_ILLNESS +inflamatoria I-PRESENT_ILLNESS +intestinal I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presentaron I-PRESENT_ILLNESS +urticaria I-PRESENT_ILLNESS +generalizada I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +varios I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY +tratamiento I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +mesalazina. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +A, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +31 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +presentado I-PRESENT_ILLNESS +urticaria I-PRESENT_ILLNESS +generalizada I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +toma I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +mesalazina I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS +así B-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +reacciones I-PAST_MEDICAL_HISTORY +previas I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Crohn I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY +urticaria I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -prolapso I-PAST_MEDICAL_HISTORY -genital I-PAST_MEDICAL_HISTORY +angioedema I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +toma I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -grado I-PAST_MEDICAL_HISTORY -III. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS +AAS I-PAST_MEDICAL_HISTORY +(ácido I-PAST_MEDICAL_HISTORY +acetilsalicílico). I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +B, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución., I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -discreta I-PRESENT_ILLNESS -rigidez I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -musculatura I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cintura I-PRESENT_ILLNESS -escapular I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pelviana. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -aquejaba I-PRESENT_ILLNESS -cefalea, I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -visuales I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -claudicación I-PRESENT_ILLNESS -mandibular. I-PRESENT_ILLNESS -Un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -visita I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -sido I-PRESENT_ILLNESS -intervenida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -histerectomía I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -colpoperineoplastia I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +mesalazina, I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +rash I-PRESENT_ILLNESS +maculopapuloso I-PRESENT_ILLNESS +generalizado, I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -prolapso I-PRESENT_ILLNESS -uterino I-PRESENT_ILLNESS -grado I-PRESENT_ILLNESS -III. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -descripción I-PRESENT_ILLNESS -microscópica I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -cuerpo I-PRESENT_ILLNESS -uterino I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS se I-PRESENT_ILLNESS -aprecian I-PRESENT_ILLNESS -vasos I-PRESENT_ILLNESS -arteriales I-PRESENT_ILLNESS +retira. I-PRESENT_ILLNESS +Seis I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +tarde I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +reinicia I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -esclerosis I-PRESENT_ILLNESS +mesalazina, I-PRESENT_ILLNESS +aunque I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +introducido I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +budesonida I-PRESENT_ILLNESS +vía I-PRESENT_ILLNESS +oral I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +rectal. I-PRESENT_ILLNESS +Tras I-PRESENT_ILLNESS +otros I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -pared I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -inflamación I-PRESENT_ILLNESS -granulomatosa I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -células I-PRESENT_ILLNESS -gigantes, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -necrosis, I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -capas I-PRESENT_ILLNESS -media I-PRESENT_ILLNESS +todo I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +anterior I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -perivascular I-PRESENT_ILLNESS -aconsejándose I-PRESENT_ILLNESS -estudio I-PRESENT_ILLNESS -clínico. I-PRESENT_ILLNESS -En B-EXPLORATION +dos I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +retirada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +corticoides, I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +urticaria I-PRESENT_ILLNESS +generalizada. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Test B-EXPLORATION +cutáneos I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizaron I-EXPLORATION +pruebas I-EXPLORATION +cutáneas I-EXPLORATION +según I-EXPLORATION +las I-EXPLORATION +recomendaciones I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -paciente I-EXPLORATION -con I-EXPLORATION -coloración I-EXPLORATION +Academia I-EXPLORATION +Europea I-EXPLORATION de I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -mucosas I-EXPLORATION -normal. I-EXPLORATION -Auscultación I-EXPLORATION -cardíaca I-EXPLORATION +Alergología I-EXPLORATION +e I-EXPLORATION +Inmunología I-EXPLORATION +Clínica I-EXPLORATION +(EAACI) I-EXPLORATION +(5). I-EXPLORATION +Prick I-EXPLORATION +a I-EXPLORATION +1/10 I-EXPLORATION y I-EXPLORATION -pulmonar I-EXPLORATION -anodina. I-EXPLORATION -Abdomen I-EXPLORATION -blando, I-EXPLORATION -depresible, I-EXPLORATION -no I-EXPLORATION -doloroso I-EXPLORATION a I-EXPLORATION -la I-EXPLORATION -palpación, I-EXPLORATION -cicatriz I-EXPLORATION -de I-EXPLORATION -histerectomía I-EXPLORATION +1/1 I-EXPLORATION con I-EXPLORATION -buen I-EXPLORATION -aspecto. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -palpan I-EXPLORATION -masas. I-EXPLORATION -No I-EXPLORATION -adenopatías I-EXPLORATION -ni I-EXPLORATION -edemas I-EXPLORATION -maleolares. I-EXPLORATION -Los I-EXPLORATION -pulsos I-EXPLORATION -periféricos I-EXPLORATION -estaban I-EXPLORATION -conservados. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -hemograma, I-EXPLORATION -el I-EXPLORATION -hematocrito I-EXPLORATION -era I-EXPLORATION -del I-EXPLORATION -37, I-EXPLORATION -5% I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -hemoglobina I-EXPLORATION +mesalazina I-EXPLORATION +(10 I-EXPLORATION +mg/ml I-EXPLORATION de I-EXPLORATION -11'9 I-EXPLORATION -g/dl, I-EXPLORATION -serie I-EXPLORATION -blanca I-EXPLORATION -y I-EXPLORATION -hemostasia I-EXPLORATION -normales. I-EXPLORATION -VSG I-EXPLORATION -52 I-EXPLORATION -mm/1ª I-EXPLORATION -hora I-EXPLORATION -y I-EXPLORATION -PCR I-EXPLORATION -66, I-EXPLORATION -3 I-EXPLORATION -g/dl. I-EXPLORATION -La I-EXPLORATION -bioquímica I-EXPLORATION +Claversal®) I-EXPLORATION y I-EXPLORATION -sedimento I-EXPLORATION +sulfasalazina I-EXPLORATION +(10 I-EXPLORATION +mg/ml I-EXPLORATION de I-EXPLORATION -orina I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION -El I-EXPLORATION -FR, I-EXPLORATION -ANA I-EXPLORATION +Salazopyrina®). I-EXPLORATION +Se I-EXPLORATION +usó I-EXPLORATION +histamina I-EXPLORATION +a I-EXPLORATION +1/10 I-EXPLORATION y I-EXPLORATION -ANCA I-EXPLORATION -negativos. I-EXPLORATION -HLA I-EXPLORATION -B27 I-EXPLORATION +1/1 I-EXPLORATION +como I-EXPLORATION +control I-EXPLORATION positivo. I-EXPLORATION -Proteinograma I-EXPLORATION -normal. I-EXPLORATION -Mantoux I-EXPLORATION +El I-EXPLORATION +suero I-EXPLORATION +salino I-EXPLORATION +en I-EXPLORATION +prick I-EXPLORATION +se I-EXPLORATION +utilizó I-EXPLORATION +como I-EXPLORATION +control I-EXPLORATION negativo. I-EXPLORATION -Rx I-EXPLORATION -tórax: I-EXPLORATION -no I-EXPLORATION -cardiomegalia, I-EXPLORATION -campos I-EXPLORATION -pulmonares I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -practicó I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -arteria I-EXPLORATION -temporal I-EXPLORATION -izquierda I-EXPLORATION -que I-EXPLORATION +Los I-EXPLORATION +resultados I-EXPLORATION +se I-EXPLORATION +consideran I-EXPLORATION +negativos I-EXPLORATION +cuando I-EXPLORATION +la I-EXPLORATION +pápula I-EXPLORATION +obtenida I-EXPLORATION es I-EXPLORATION -negativa. I-EXPLORATION +< I-EXPLORATION +o I-EXPLORATION +igual I-EXPLORATION +a I-EXPLORATION +3 I-EXPLORATION +mm I-EXPLORATION +o I-EXPLORATION +menor I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +histamina. I-EXPLORATION +Se I-EXPLORATION +realizaron I-EXPLORATION +prick I-EXPLORATION +en I-EXPLORATION +10 I-EXPLORATION +pacientes I-EXPLORATION +sanos I-EXPLORATION +no I-EXPLORATION +expuestos I-EXPLORATION +a I-EXPLORATION +5-ASA I-EXPLORATION +previamente. I-EXPLORATION I-EXPLORATION -Con B-TREATMENT +Provocación I-EXPLORATION +oral I-EXPLORATION +controlada I-EXPLORATION +con I-EXPLORATION +placebo I-EXPLORATION +a I-EXPLORATION +simple I-EXPLORATION +ciego I-EXPLORATION + I-EXPLORATION +Tras B-TREATMENT +la I-TREATMENT +toma I-TREATMENT +de I-TREATMENT +un I-TREATMENT +placebo, I-TREATMENT +se I-TREATMENT +administran I-TREATMENT +dosis I-TREATMENT +crecientes I-TREATMENT +del I-TREATMENT +fármaco I-TREATMENT +implicado I-TREATMENT +en I-TREATMENT +una I-TREATMENT +reacción I-TREATMENT +durante I-TREATMENT +un I-TREATMENT +tiempo I-TREATMENT +determinado, I-TREATMENT +a I-TREATMENT +partir I-TREATMENT +del I-TREATMENT +cual I-TREATMENT +se I-TREATMENT +llega I-TREATMENT +a I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT +deseada I-TREATMENT +para I-TREATMENT el I-TREATMENT -diagnóstico I-TREATMENT +tratamiento, I-TREATMENT +la I-TREATMENT +cual I-TREATMENT +se I-TREATMENT +mantiene I-TREATMENT +desde I-TREATMENT +entonces. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +deben I-TREATMENT +descartar I-TREATMENT +enfermedades I-TREATMENT +o I-TREATMENT +tratamientos I-TREATMENT +que I-TREATMENT +contraindiquen I-TREATMENT +el I-TREATMENT +uso I-TREATMENT de I-TREATMENT -ACG I-TREATMENT +adrenalina, I-TREATMENT +o I-TREATMENT +enfermedades I-TREATMENT +mal I-TREATMENT +controladas I-TREATMENT +(hipertensión I-TREATMENT +arterial, I-TREATMENT +diabetes). I-TREATMENT + I-TREATMENT +Se I-TREATMENT +deben I-TREATMENT +suspender I-TREATMENT +medicaciones I-TREATMENT +que I-TREATMENT +puedan I-TREATMENT +interferir I-TREATMENT +los I-TREATMENT +resultados I-TREATMENT +de I-TREATMENT +las I-TREATMENT +pruebas I-TREATMENT +(corticoides, I-TREATMENT +antihistamínicos, I-TREATMENT +etc.). I-TREATMENT + I-TREATMENT +Si I-TREATMENT +aparecen I-TREATMENT +reacciones I-TREATMENT +durante I-TREATMENT +la I-TREATMENT +administración, I-TREATMENT +como I-TREATMENT +urticaria, I-TREATMENT +angioedema, I-TREATMENT +etc., I-TREATMENT se I-TREATMENT -inició I-TREATMENT +le I-TREATMENT +administra I-TREATMENT +el I-TREATMENT tratamiento I-TREATMENT +preciso I-TREATMENT +para I-TREATMENT +revertirlas I-TREATMENT +en I-TREATMENT +cada I-TREATMENT +caso I-TREATMENT +y I-TREATMENT +se I-TREATMENT +suspende I-TREATMENT +la I-TREATMENT +provocación. I-TREATMENT + I-TREATMENT +"Desensibilización" I-TREATMENT +a I-TREATMENT +mesalazina I-TREATMENT + I-TREATMENT +Se I-TREATMENT +pide I-TREATMENT +consentimiento I-TREATMENT +informado I-TREATMENT +firmado I-TREATMENT +por I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +para I-TREATMENT +la I-TREATMENT +realización I-TREATMENT +de I-TREATMENT +pruebas I-TREATMENT +cutáneas I-TREATMENT +y I-TREATMENT +de I-TREATMENT +provocación I-TREATMENT +oral. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +llevó I-TREATMENT +a I-TREATMENT +cabo I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +ambulatoria I-TREATMENT +el I-TREATMENT +protocolo I-TREATMENT +de I-TREATMENT +desensibilización, I-TREATMENT +elaborado I-TREATMENT +en I-TREATMENT +nuestro I-TREATMENT +Servicio I-TREATMENT +de I-TREATMENT +Alergia I-TREATMENT +como I-TREATMENT +se I-TREATMENT +puede I-TREATMENT +observar I-TREATMENT +en I-TREATMENT +la I-TREATMENT +Tabla I-TREATMENT +I. I-TREATMENT + I-TREATMENT +En I-TREATMENT +el I-TREATMENT +caso I-TREATMENT +B, I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT +la I-TREATMENT +budesonida I-TREATMENT +en I-TREATMENT +enemas I-TREATMENT +7 I-TREATMENT +días I-TREATMENT +antes I-TREATMENT +de I-TREATMENT +iniciar I-TREATMENT +la I-TREATMENT +desensibilización. I-TREATMENT + I-TREATMENT +Con I-TREATMENT +este I-TREATMENT +protocolo I-TREATMENT +se I-TREATMENT +administran I-TREATMENT +en I-TREATMENT +17 I-TREATMENT +días I-TREATMENT +dosis I-TREATMENT +(mg) I-TREATMENT +crecientes I-TREATMENT +de I-TREATMENT +mesalazina, I-TREATMENT con I-TREATMENT -Prednisona I-TREATMENT +varias I-TREATMENT +dosis I-TREATMENT +diarias, I-TREATMENT +con I-TREATMENT +un I-TREATMENT +intervalo I-TREATMENT +de I-TREATMENT +tiempo I-TREATMENT +que I-TREATMENT +va I-TREATMENT +aumentando I-TREATMENT +cada I-TREATMENT +día I-TREATMENT +(45 I-TREATMENT +minutos, I-TREATMENT 1 I-TREATMENT -mg/kg/día. I-TREATMENT -Dos B-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -permanecía I-EVOLUTION -asintomática I-EVOLUTION -con B-TREATMENT +hora I-TREATMENT +y I-TREATMENT +8 I-TREATMENT +horas). I-TREATMENT +Se I-TREATMENT +administran I-TREATMENT dosis I-TREATMENT +hasta I-TREATMENT +alcanzar I-TREATMENT +la I-TREATMENT +tolerancia I-TREATMENT de I-TREATMENT -20 I-TREATMENT -mg/día. I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT +terapéutica I-TREATMENT +requerida I-TREATMENT +por I-TREATMENT +el I-TREATMENT +paciente. I-TREATMENT +Se I-TREATMENT +señala I-TREATMENT +en I-TREATMENT +la I-TREATMENT +tabla I-TREATMENT +I I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT +diaria I-TREATMENT +tolerada I-TREATMENT +y I-TREATMENT +la I-TREATMENT +acumulada I-TREATMENT +(la I-TREATMENT +suma I-TREATMENT +de I-TREATMENT +los I-TREATMENT +miligramos I-TREATMENT +tolerados I-TREATMENT +por I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +hasta I-TREATMENT +ese I-TREATMENT +momento). I-TREATMENT I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -49 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -consultado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -varias I-PRESENT_ILLNESS -ocasiones I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -familia I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -38º I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -acompañada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nauseas, I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -kilogramos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -exfumador, I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hepatopatía I-PAST_MEDICAL_HISTORY -criptogenética, I-PAST_MEDICAL_HISTORY -taquicardia I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -aberrante I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -ablación I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -atrás, I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -angor I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -coronariografía I-PAST_MEDICAL_HISTORY -normal, I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -ansioso-depresivo I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ulcus I-PAST_MEDICAL_HISTORY -duodenal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -apendicitis. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -viajes I-PAST_MEDICAL_HISTORY -recientemente I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -refería I-PAST_MEDICAL_HISTORY -prácticas I-PAST_MEDICAL_HISTORY -sexuales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -riesgo. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -clínico I-EXPLORATION -se I-EXPLORATION -objetivaba I-EXPLORATION -una I-EXPLORATION -temperatura I-EXPLORATION -de I-EXPLORATION -39, I-EXPLORATION -7 I-EXPLORATION -ºC, I-EXPLORATION -se I-EXPLORATION -palpaba I-EXPLORATION -hepatomegalia I-EXPLORATION +El I-TREATMENT +día I-TREATMENT +17 I-TREATMENT +se I-TREATMENT +administran I-TREATMENT +finalmente I-TREATMENT +1.000 I-TREATMENT +mg/1.000 I-TREATMENT +mg/1.000 I-TREATMENT +mg I-TREATMENT +de I-TREATMENT +mesalazina I-TREATMENT +(3.000 I-TREATMENT +mg I-TREATMENT +al I-TREATMENT +día). I-TREATMENT + I-TREATMENT +Prick B-EXPLORATION a I-EXPLORATION -unos I-EXPLORATION -3-4 I-EXPLORATION -centímetros I-EXPLORATION -del I-EXPLORATION -reborde I-EXPLORATION -costal, I-EXPLORATION -siendo I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -normal. I-EXPLORATION -En I-EXPLORATION -cuanto I-EXPLORATION +1/10 I-EXPLORATION +y I-EXPLORATION a I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -destacaban I-EXPLORATION -15.900/mm3 I-EXPLORATION -leucocitos I-EXPLORATION +1/1 I-EXPLORATION con I-EXPLORATION -desviación I-EXPLORATION -izquierda, I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -10.5 I-EXPLORATION -g/dl I-EXPLORATION +mesalazina I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -VSG I-EXPLORATION -de I-EXPLORATION -101 I-EXPLORATION -mm. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -bioquímica I-EXPLORATION -existía I-EXPLORATION -una I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION +sulfasalazina I-EXPLORATION +fueron I-EXPLORATION +negativos I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +pacientes I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION los I-EXPLORATION -parámetros I-EXPLORATION -hepáticos: I-EXPLORATION -GOT I-EXPLORATION -101 I-EXPLORATION -U/l, I-EXPLORATION -GPT I-EXPLORATION -128 I-EXPLORATION -U/l, I-EXPLORATION -FA I-EXPLORATION -208 I-EXPLORATION -U/l, I-EXPLORATION -GGT I-EXPLORATION -172 I-EXPLORATION -U/l, I-EXPLORATION -LDH I-EXPLORATION -1366 I-EXPLORATION -UI/l. I-EXPLORATION -La I-EXPLORATION -PCR I-EXPLORATION +controles. I-EXPLORATION +Provocación I-EXPLORATION +oral I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +A I-EXPLORATION +con I-EXPLORATION +ácido I-EXPLORATION +acetilsalicílico I-EXPLORATION +hasta I-EXPLORATION +500 I-EXPLORATION +mg, I-EXPLORATION +con I-EXPLORATION +urticaria I-EXPLORATION +localizada I-EXPLORATION +en I-EXPLORATION +cara. I-EXPLORATION +"Desensibilización" B-TREATMENT +a I-TREATMENT +mesalazina I-TREATMENT +desarrollado I-TREATMENT +en I-TREATMENT +17 I-TREATMENT +días, I-TREATMENT +con I-TREATMENT +tolerancia I-TREATMENT +de I-TREATMENT +1.000 I-TREATMENT +mg I-TREATMENT +de I-TREATMENT +mesalazina I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +horas I-TREATMENT +(3.000 I-TREATMENT +mg I-TREATMENT +al I-TREATMENT +día) I-TREATMENT +en I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +A I-TREATMENT +y I-TREATMENT +B. I-TREATMENT +Desde B-EVOLUTION +entonces, I-EVOLUTION +y I-EVOLUTION +durante I-EVOLUTION +seis I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +existe I-EVOLUTION +buena I-EVOLUTION +tolerancia I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +mesalazina I-EVOLUTION +y I-EVOLUTION +mantienen I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +con I-EVOLUTION +la I-EVOLUTION +misma I-EVOLUTION +dosis I-EVOLUTION +tolerada I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +continuada, I-EVOLUTION +para I-EVOLUTION +evitar I-EVOLUTION +la I-EVOLUTION +aparición I-EVOLUTION +de I-EVOLUTION +nuevas I-EVOLUTION +reacciones. I-EVOLUTION + I-EVOLUTION + +Se B-PRESENT_ILLNESS +reporta I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +género I-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +23 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +unidad I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tercer I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +sangrado I-PRESENT_ILLNESS +vaginal, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +antecedente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +previo. I-PRESENT_ILLNESS +No B-PAST_MEDICAL_HISTORY +hay I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +abuso I-PAST_MEDICAL_HISTORY +sexual I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +trauma I-PAST_MEDICAL_HISTORY +genital. I-PAST_MEDICAL_HISTORY +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION se I-EXPLORATION -encontraba I-EXPLORATION -asimismo I-EXPLORATION -elevada. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -sistemático I-EXPLORATION +evidenció I-EXPLORATION +abundante I-EXPLORATION +sangrado I-EXPLORATION +genital I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +consideraron I-EXPLORATION +dentro I-EXPLORATION de I-EXPLORATION -orina I-EXPLORATION +sus I-EXPLORATION +diagnósticos I-EXPLORATION +diferenciales: I-EXPLORATION +trauma, I-EXPLORATION +abuso I-EXPLORATION +sexual I-EXPLORATION +y I-EXPLORATION +maltrato I-EXPLORATION +infantil, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION que I-EXPLORATION -fue I-EXPLORATION -normal, I-EXPLORATION -Mantoux I-EXPLORATION -negativo. I-EXPLORATION -Serologías I-EXPLORATION +el I-EXPLORATION +caso I-EXPLORATION +es I-EXPLORATION +reportado I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +autoridad, I-EXPLORATION +quienes I-EXPLORATION +por I-EXPLORATION +medio I-EXPLORATION de I-EXPLORATION -Brucella, I-EXPLORATION -Leishmania, I-EXPLORATION -C. I-EXPLORATION -Burnetti, I-EXPLORATION -lúes, I-EXPLORATION -Salmonella, I-EXPLORATION -virus I-EXPLORATION +un I-EXPLORATION +grupo I-EXPLORATION +élite I-EXPLORATION de I-EXPLORATION +manejo I-EXPLORATION +de I-EXPLORATION +delitos I-EXPLORATION +sexuales, I-EXPLORATION +deciden I-EXPLORATION +remitir I-EXPLORATION +para I-EXPLORATION +examen I-EXPLORATION +médico-legal. I-EXPLORATION + I-EXPLORATION +Durante I-EXPLORATION la I-EXPLORATION -hepatitis I-EXPLORATION -A, I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C I-EXPLORATION +anamnesis, I-EXPLORATION +el I-EXPLORATION +médico I-EXPLORATION +especialista I-EXPLORATION +forense I-EXPLORATION +tomó I-EXPLORATION +toda I-EXPLORATION +la I-EXPLORATION +información I-EXPLORATION +disponible I-EXPLORATION y I-EXPLORATION -VIH I-EXPLORATION -negativos. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -realizaron I-EXPLORATION -serologías I-EXPLORATION -de I-EXPLORATION -citomegalovirus, I-EXPLORATION -virus I-EXPLORATION +ante I-EXPLORATION +la I-EXPLORATION +información I-EXPLORATION +aportada I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +madre, I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +recalcaba I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +sospechaba I-EXPLORATION de I-EXPLORATION -Epstein-Barr I-EXPLORATION -y I-EXPLORATION -toxoplasma I-EXPLORATION +abuso I-EXPLORATION +sexual, I-EXPLORATION +prosiguió I-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +genital, I-EXPLORATION +encontrando I-EXPLORATION que I-EXPLORATION -fueron I-EXPLORATION -IgG I-EXPLORATION -+ I-EXPLORATION -y I-EXPLORATION -IgM I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -Hemocultivos I-EXPLORATION -durante I-EXPLORATION +la I-EXPLORATION +menor I-EXPLORATION +presentaba I-EXPLORATION +genitales I-EXPLORATION +femeninos I-EXPLORATION +infantiles I-EXPLORATION +normoconfigurados I-EXPLORATION +con I-EXPLORATION +hematoma I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION -ambulatorio I-EXPLORATION -y I-EXPLORATION -hospitalizado I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION +meridiano I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION +las I-EXPLORATION +12 I-EXPLORATION +de I-EXPLORATION +0.3 I-EXPLORATION +x I-EXPLORATION +0.3 I-EXPLORATION +cm I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +permitía I-EXPLORATION +ver I-EXPLORATION +el I-EXPLORATION +borde I-EXPLORATION +libre I-EXPLORATION +del I-EXPLORATION +himen, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION que I-EXPLORATION +no I-EXPLORATION fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -donde I-EXPLORATION +posible I-EXPLORATION +descartar I-EXPLORATION +desgarros I-EXPLORATION +a I-EXPLORATION +éste I-EXPLORATION +nivel, I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -hígado, I-EXPLORATION -vía I-EXPLORATION -biliar, I-EXPLORATION -vesícula, I-EXPLORATION -porción I-EXPLORATION -visible I-EXPLORATION -de I-EXPLORATION -retroperitoneo I-EXPLORATION -superior I-EXPLORATION +evidenció I-EXPLORATION +sangrado I-EXPLORATION +reciente I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +vaginal, I-EXPLORATION +pañal I-EXPLORATION y I-EXPLORATION -porta I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -ecográficos I-EXPLORATION -significativos. I-EXPLORATION -Posteriormente I-EXPLORATION +pantalón. I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -efectúo I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION +observaron I-EXPLORATION +otras I-EXPLORATION +lesiones. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +grupo I-EXPLORATION +élite I-EXPLORATION +de I-EXPLORATION +manejo I-EXPLORATION +de I-EXPLORATION +delitos I-EXPLORATION +sexuales I-EXPLORATION +entregó I-EXPLORATION +al I-EXPLORATION +médico I-EXPLORATION +especialista I-EXPLORATION +forense I-EXPLORATION +muestras I-EXPLORATION +que I-EXPLORATION +fueron I-EXPLORATION +tomadas I-EXPLORATION en I-EXPLORATION +el I-EXPLORATION +centro I-EXPLORATION +hospitalario I-EXPLORATION +donde I-EXPLORATION +fue I-EXPLORATION +inicialmente I-EXPLORATION +valorada I-EXPLORATION la I-EXPLORATION +menor, I-EXPLORATION +muestras I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -un I-EXPLORATION -extenso I-EXPLORATION -engrosamiento I-EXPLORATION -mamelonado I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION +ante I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +físico, I-EXPLORATION +el I-EXPLORATION +médico I-EXPLORATION +especialista I-EXPLORATION +forense I-EXPLORATION +consideró I-EXPLORATION +pertinente I-EXPLORATION +enviar I-EXPLORATION +al I-EXPLORATION +laboratorio I-EXPLORATION de I-EXPLORATION -colon I-EXPLORATION -transverso I-EXPLORATION -y I-EXPLORATION +biología I-EXPLORATION del I-EXPLORATION -ángulo I-EXPLORATION -hepático I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -12 I-EXPLORATION -cm I-EXPLORATION +Instituto I-EXPLORATION +Nacional I-EXPLORATION de I-EXPLORATION -longitud, I-EXPLORATION -sugestivo I-EXPLORATION +Medicina I-EXPLORATION +Legal I-EXPLORATION +y I-EXPLORATION +Ciencias I-EXPLORATION +Forenses I-EXPLORATION +para I-EXPLORATION +búsqueda I-EXPLORATION de I-EXPLORATION -neoplasia I-EXPLORATION +evidencia I-EXPLORATION +traza I-EXPLORATION +(espermatozoides I-EXPLORATION +y I-EXPLORATION +ADN) I-EXPLORATION +bajo I-EXPLORATION +cadena I-EXPLORATION de I-EXPLORATION -colon; I-EXPLORATION -gran I-EXPLORATION +custodia. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +conclusión, I-EXPLORATION +el I-EXPLORATION +médico I-EXPLORATION +especialista I-EXPLORATION +forense I-EXPLORATION +asocia I-EXPLORATION +la I-EXPLORATION lesión I-EXPLORATION -sólida I-EXPLORATION +encontrada I-EXPLORATION con I-EXPLORATION -captación I-EXPLORATION -heterogénea I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -hepático I-EXPLORATION -izquierdo I-EXPLORATION -segmento I-EXPLORATION -IV, I-EXPLORATION -sugestiva I-EXPLORATION -de I-EXPLORATION -metástasis. I-EXPLORATION -Ante I-EXPLORATION -estos I-EXPLORATION +trauma I-EXPLORATION +genital I-EXPLORATION +y I-EXPLORATION +describe I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +es I-EXPLORATION +posible I-EXPLORATION +con I-EXPLORATION +los I-EXPLORATION hallazgos I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -enema I-EXPLORATION -opaco I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -defecto I-EXPLORATION -de I-EXPLORATION -repleción I-EXPLORATION -en I-EXPLORATION -"corazón I-EXPLORATION -de I-EXPLORATION -manzana" I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -unión I-EXPLORATION +determinar I-EXPLORATION +si I-EXPLORATION +es I-EXPLORATION de I-EXPLORATION -colon I-EXPLORATION -transverso I-EXPLORATION -con I-EXPLORATION -ángulo I-EXPLORATION -hepático I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -tramo I-EXPLORATION -aproximadamente I-EXPLORATION +origen I-EXPLORATION +accidental I-EXPLORATION +o I-EXPLORATION +no. I-EXPLORATION + I-EXPLORATION +Posterior B-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +examen I-DERIVED_FROM/TO +médico-legal, I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +menor I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +Hospital I-DERIVED_FROM/TO +Infantil, I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +gran I-DERIVED_FROM/TO +experiencia I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +manejo I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +abuso I-DERIVED_FROM/TO +sexual I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +maltrato I-DERIVED_FROM/TO +infantil. I-DERIVED_FROM/TO +El B-EXPLORATION +personal I-EXPLORATION +médico I-EXPLORATION de I-EXPLORATION -12 I-EXPLORATION -centímetros. I-EXPLORATION -Además I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -colonoscopia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION +dicho I-EXPLORATION +Hospital I-EXPLORATION +solicita I-EXPLORATION una I-EXPLORATION -neoplasia I-EXPLORATION -circunferencial I-EXPLORATION -a I-EXPLORATION -110 I-EXPLORATION -cm I-EXPLORATION -del I-EXPLORATION -ano I-EXPLORATION -que I-EXPLORATION -impedía I-EXPLORATION +nueva I-EXPLORATION +valoración I-EXPLORATION +por I-EXPLORATION +otro I-EXPLORATION +médico I-EXPLORATION +especialista I-EXPLORATION +forense, I-EXPLORATION +quien I-EXPLORATION +acude I-EXPLORATION +al I-EXPLORATION +Hospital I-EXPLORATION +para I-EXPLORATION +un I-EXPLORATION +nuevo I-EXPLORATION +examen. I-EXPLORATION +Dicho I-EXPLORATION +examen I-EXPLORATION +es I-EXPLORATION +realizado I-EXPLORATION +bajo I-EXPLORATION +sedación, I-EXPLORATION +utilizando I-EXPLORATION +lupa I-EXPLORATION +durante I-EXPLORATION el I-EXPLORATION -paso I-EXPLORATION -del I-EXPLORATION -endoscopio, I-EXPLORATION -tomándose I-EXPLORATION -biopsias. I-EXPLORATION -La I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -fue I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -tejido I-EXPLORATION -de I-EXPLORATION -granulación I-EXPLORATION -y I-EXPLORATION -tejido I-EXPLORATION -conectivo I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -apreciaban I-EXPLORATION -densos I-EXPLORATION -infiltrados I-EXPLORATION -linfocitarios I-EXPLORATION -con I-EXPLORATION -predominio I-EXPLORATION -CD20+ I-EXPLORATION +examen I-EXPLORATION +genital, I-EXPLORATION +encontrando I-EXPLORATION que I-EXPLORATION -con I-EXPLORATION -frecuencia I-EXPLORATION -expresaban I-EXPLORATION -tinción I-EXPLORATION -nuclear I-EXPLORATION -bcl-6. I-EXPLORATION -Los I-EXPLORATION -cambios I-EXPLORATION -morfológicos I-EXPLORATION -sugerían I-EXPLORATION -un I-EXPLORATION -linfoma I-EXPLORATION -tipo I-EXPLORATION -B I-EXPLORATION -aunque I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +descrita I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +primer I-EXPLORATION +médico I-EXPLORATION no I-EXPLORATION era I-EXPLORATION -concluyente I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION +más I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -PAAF I-EXPLORATION -hepática I-EXPLORATION -confirmando I-EXPLORATION +mucosa I-EXPLORATION +uretral I-EXPLORATION +prolapsada, I-EXPLORATION +que I-EXPLORATION +simulaba I-EXPLORATION +un I-EXPLORATION +hematoma I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION +meridiano I-EXPLORATION de I-EXPLORATION -linfoma I-EXPLORATION +las I-EXPLORATION +12 I-EXPLORATION +horas. I-EXPLORATION +Se I-EXPLORATION +hace I-EXPLORATION +entonces I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -grandes I-EXPLORATION -difuso I-EXPLORATION -tipo I-EXPLORATION -B. I-EXPLORATION - I-EXPLORATION -Posteriormente B-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -hematología, I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -inició I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -quimioterapia I-DERIVED_FROM/TO -siguiendo I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -esquema I-DERIVED_FROM/TO -CHOP I-DERIVED_FROM/TO -(ciclofosfamida, I-DERIVED_FROM/TO -doxorrubicina, I-DERIVED_FROM/TO -vincristina I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -prednisona) I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -momento I-DERIVED_FROM/TO -no I-DERIVED_FROM/TO -tenemos I-DERIVED_FROM/TO -datos I-DERIVED_FROM/TO -sobre I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -eventual I-DERIVED_FROM/TO -respuesta I-DERIVED_FROM/TO -tumoral. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO +prolapso I-EXPLORATION +uretral. I-EXPLORATION +La B-EVOLUTION +menor I-EVOLUTION +es I-EVOLUTION +llevada I-EVOLUTION +a I-EVOLUTION +manejo I-EVOLUTION +quirúrgico I-EVOLUTION +con I-EVOLUTION +corrección I-EVOLUTION +del I-EVOLUTION +prolapso. I-EVOLUTION + I-EVOLUTION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS +56 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cefaleas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tabaquismo. I-PAST_MEDICAL_HISTORY -Desde B-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -visión I-PRESENT_ILLNESS -borrosa, I-PRESENT_ILLNESS -notando I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -alguna I-PRESENT_ILLNESS -ocasión I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -visual I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hemicampo I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -acompañándose I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cefaleas I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -cedían I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -analgésico. I-PRESENT_ILLNESS -Hace I-PRESENT_ILLNESS -nueve I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -ictal I-PRESENT_ILLNESS -transitorio I-PRESENT_ILLNESS -hemisférico I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -desapareció I-PRESENT_ILLNESS -pasados I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -minutos. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +maculosa I-PRESENT_ILLNESS +adyacente I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -mañana I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -presente I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -notó I-PRESENT_ILLNESS -torpeza I-PRESENT_ILLNESS +columna, I-PRESENT_ILLNESS en I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -mano I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -desviación I-PRESENT_ILLNESS +zona I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -comisura I-PRESENT_ILLNESS -bucal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -articulación I-PRESENT_ILLNESS +D5-D7, I-PRESENT_ILLNESS +levemente I-PRESENT_ILLNESS +pruriginosa, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -palabra. I-PRESENT_ILLNESS -Por I-PRESENT_ILLNESS -este I-PRESENT_ILLNESS -motivo I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -valorada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -neurólogo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -objetivó I-PRESENT_ILLNESS -paresia I-PRESENT_ILLNESS -facial I-PRESENT_ILLNESS -supranuclear I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -leve I-PRESENT_ILLNESS -disartria, I-PRESENT_ILLNESS -inestabilidad I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -miembro I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -torpeza I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -movimientos I-PRESENT_ILLNESS -finos I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hipoestesia I-PRESENT_ILLNESS -táctil I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -algésica I-PRESENT_ILLNESS -facio-braquial I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS En B-EXPLORATION -urgencias I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -ECG, I-EXPLORATION -en I-EXPLORATION -ritmo I-EXPLORATION -sinusal, I-EXPLORATION -TAC I-EXPLORATION -craneal I-EXPLORATION -que I-EXPLORATION -inicialmente I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -infarto I-EXPLORATION -y I-EXPLORATION -Doppler I-EXPLORATION -de I-EXPLORATION -troncos I-EXPLORATION -supraaórticos I-EXPLORATION -y I-EXPLORATION -transcraneal I-EXPLORATION -que I-EXPLORATION -resultaron I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -decidió I-EXPLORATION -ingreso I-EXPLORATION -en I-EXPLORATION -planta, I-EXPLORATION -solicitándose I-EXPLORATION -perfiles I-EXPLORATION -analíticos I-EXPLORATION -completos I-EXPLORATION -incluyendo I-EXPLORATION -estudios I-EXPLORATION -de I-EXPLORATION -hipercoagulabilidad, I-EXPLORATION -ANAS, I-EXPLORATION -c-ANCA, I-EXPLORATION -p-ANCA, I-EXPLORATION -DNA I-EXPLORATION -nativo I-EXPLORATION -y I-EXPLORATION -anticuerpos I-EXPLORATION -antimitocondriales. I-EXPLORATION -También I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen: I-EXPLORATION -RNM I-EXPLORATION -cerebral I-EXPLORATION -y I-EXPLORATION -ecocardiografía. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -RNM I-EXPLORATION -mostró I-EXPLORATION -infarto I-EXPLORATION -isquémico I-EXPLORATION -agudo I-EXPLORATION -en I-EXPLORATION -territorio I-EXPLORATION -silviano I-EXPLORATION -superior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -cerebral I-EXPLORATION -media I-EXPLORATION -izquierda. I-EXPLORATION -Los I-EXPLORATION -anticuerpos I-EXPLORATION -antineutrófilos, I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares, I-EXPLORATION -anticentrómero I-EXPLORATION -y I-EXPLORATION -antimitocondrias I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -trombofilia I-EXPLORATION -tan I-EXPLORATION -sólo I-EXPLORATION -detectó I-EXPLORATION -ligera I-EXPLORATION -hiperfibrinogenemia. I-EXPLORATION - I-EXPLORATION -Finalmente I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION la I-EXPLORATION -ecocardiografía, I-EXPLORATION -prueba I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -crucial I-EXPLORATION -al I-EXPLORATION -proporcionar I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo, I-EXPLORATION -observándose I-EXPLORATION +exploración I-EXPLORATION +neurológica, I-EXPLORATION +como I-EXPLORATION +única I-EXPLORATION +alteración I-EXPLORATION +presentaba I-EXPLORATION una I-EXPLORATION -masa I-EXPLORATION -pedunculada I-EXPLORATION +hiperestesia I-EXPLORATION +al I-EXPLORATION +pinchazo I-EXPLORATION +justo I-EXPLORATION en I-EXPLORATION -AI I-EXPLORATION -que I-EXPLORATION -prolapsaba I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION +el I-EXPLORATION +área I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -válvula I-EXPLORATION -mitral I-EXPLORATION -en I-EXPLORATION -diástole, I-EXPLORATION -correspondiente I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -mixoma I-EXPLORATION -(35 I-EXPLORATION -x I-EXPLORATION -26 I-EXPLORATION -mm), I-EXPLORATION -con I-EXPLORATION -pedículo I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION +lesión. I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +RMN I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -fosa I-EXPLORATION -oval. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -programó I-TREATMENT -para I-TREATMENT -cirugía I-TREATMENT -realizándose I-TREATMENT -previamente I-TREATMENT -RNM I-TREATMENT -cardiaca I-TREATMENT -para I-TREATMENT -determinar I-TREATMENT -con I-TREATMENT -mayor I-TREATMENT -precisión I-TREATMENT -las I-TREATMENT -características I-TREATMENT -morfológicas I-TREATMENT -de I-TREATMENT -la I-TREATMENT -masa I-TREATMENT -auricular. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -atriotomía I-TREATMENT -izquierda, I-TREATMENT -extrayéndose I-TREATMENT -el I-TREATMENT -tumor I-TREATMENT -en I-TREATMENT -su I-TREATMENT -totalidad, I-TREATMENT -siendo I-TREATMENT -éste I-TREATMENT -de I-TREATMENT -aspecto I-TREATMENT -morulado. I-TREATMENT -Se I-TREATMENT -abrió I-TREATMENT -también I-TREATMENT -aurícula I-TREATMENT -derecha I-TREATMENT -y I-TREATMENT -se I-TREATMENT -resecó I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -de I-TREATMENT -implantación, I-TREATMENT -cerrándose I-TREATMENT -posteriormente I-TREATMENT -la I-TREATMENT -comunicación I-TREATMENT -interauricular I-TREATMENT -creada. I-TREATMENT +columna I-EXPLORATION +dorsal I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +Tampoco B-TREATMENT +requirió I-TREATMENT +tratamiento I-TREATMENT +farmacológico. I-TREATMENT I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -posquirúrgica I-EVOLUTION -resultó I-EVOLUTION -muy I-EVOLUTION -satisfactoria, I-EVOLUTION -siendo I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -sin I-EVOLUTION -déficit I-EVOLUTION -neurológico. I-EVOLUTION - I-EVOLUTION -Varón B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -60 I-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sana, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY +mórbidos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -EPOC I-PAST_MEDICAL_HISTORY -moderado, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS +importancia, I-PAST_MEDICAL_HISTORY +en B-PRESENT_ILLNESS +proceso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +amamantamiento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +hijo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +meses. I-PRESENT_ILLNESS +Procedente B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY +suburbana I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Villa I-PAST_MEDICAL_HISTORY +Alemana, I-PAST_MEDICAL_HISTORY +Región I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Valparaíso. I-PAST_MEDICAL_HISTORY +Vive I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +casa I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +dispone I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +agua I-PAST_MEDICAL_HISTORY +potable I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +alcantarillado; I-PAST_MEDICAL_HISTORY +posee I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +perro, I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +gatos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +conejo I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +mascotas. I-PAST_MEDICAL_HISTORY +Como I-PAST_MEDICAL_HISTORY +dueña I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +casa, I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +ella I-PAST_MEDICAL_HISTORY +quien I-PAST_MEDICAL_HISTORY +prepara I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +alimentos. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +último I-PAST_MEDICAL_HISTORY +mes, I-PAST_MEDICAL_HISTORY +separado I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +quince I-PAST_MEDICAL_HISTORY +dias, I-PAST_MEDICAL_HISTORY +habia I-PAST_MEDICAL_HISTORY +efectuado I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +viajes I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +ciudad I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Talcahuano, I-PAST_MEDICAL_HISTORY +Concepción, I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +consecuencias I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +desastre I-PAST_MEDICAL_HISTORY +ocurrido I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +casa I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +familiar I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +terremoto I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tsunami I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +febrero I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2010. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +La B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Consultorio I-PRESENT_ILLNESS +Periférico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Villa I-PRESENT_ILLNESS +Alemana I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +ejemplares I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +gusanos I-PRESENT_ILLNESS +eliminados I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -incremento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -perímetro I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -previos I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +boca I-PRESENT_ILLNESS +hacia I-PRESENT_ILLNESS +siete I-PRESENT_ILLNESS +dias. I-PRESENT_ILLNESS +Relató I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +encontraba I-PRESENT_ILLNESS +durmiendo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +despertó I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +sentir I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +sensación I-PRESENT_ILLNESS +muy I-PRESENT_ILLNESS +extraña I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +garganta I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +luego I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +boca; I-PRESENT_ILLNESS +frente I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +movimiento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuerpo I-PRESENT_ILLNESS +extraño I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +boca, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +lengua I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +aprisionó I-PRESENT_ILLNESS +contra I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +paladar I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +retirarlo I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +sus I-PRESENT_ILLNESS +dedos. I-PRESENT_ILLNESS +Lo I-PRESENT_ILLNESS +dejó I-PRESENT_ILLNESS +sobre I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +velador I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +observó I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +enroscaba. I-PRESENT_ILLNESS +Posteriormente I-PRESENT_ILLNESS +eliminó I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +segundo I-PRESENT_ILLNESS +ejemplar; I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +ambos I-PRESENT_ILLNESS +casos I-PRESENT_ILLNESS sin I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -acompañante. I-PRESENT_ILLNESS -En B-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -solicitadas I-EXPLORATION -el I-EXPLORATION -hemograma I-EXPLORATION -y I-EXPLORATION -coagulación I-EXPLORATION -son I-EXPLORATION -normales. I-EXPLORATION -Glucosa, I-EXPLORATION -urea, I-EXPLORATION -ácido I-EXPLORATION -úrico, I-EXPLORATION -creatinina, I-EXPLORATION -calcio I-EXPLORATION -total, I-EXPLORATION -fósforo, I-EXPLORATION -triglicéridos, I-EXPLORATION -colesterol I-EXPLORATION -LDL, I-EXPLORATION -bilirrubina I-EXPLORATION -total, I-EXPLORATION -GOT, I-EXPLORATION -GPT, I-EXPLORATION -GGT, I-EXPLORATION -LDH, I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina, I-EXPLORATION -amilasa, I-EXPLORATION -proteínas I-EXPLORATION -totales, I-EXPLORATION -albúmina, I-EXPLORATION -sodio, I-EXPLORATION -potasio, I-EXPLORATION -cloro, I-EXPLORATION -ferritina, I-EXPLORATION -transferrina, I-EXPLORATION -vitamina I-EXPLORATION -B12 I-EXPLORATION -y I-EXPLORATION -folato I-EXPLORATION -normales. I-EXPLORATION -Colesterol I-EXPLORATION -total I-EXPLORATION -243 I-EXPLORATION -mg/dl I-EXPLORATION -(110-200), I-EXPLORATION -colesterol I-EXPLORATION -HDL I-EXPLORATION -120 I-EXPLORATION -mg/dl I-EXPLORATION -(42-68), I-EXPLORATION -hierro I-EXPLORATION -44 I-EXPLORATION -microg/dl I-EXPLORATION -(65-165); I-EXPLORATION -Ca I-EXPLORATION -19, I-EXPLORATION -9, I-EXPLORATION -82, I-EXPLORATION -03 I-EXPLORATION -U/l I-EXPLORATION -(< I-EXPLORATION -40). I-EXPLORATION -CEA, I-EXPLORATION -PSA I-EXPLORATION -y I-EXPLORATION -alfa-fetoproteína I-EXPLORATION -normales. I-EXPLORATION -Velocidad I-EXPLORATION +tos, I-PRESENT_ILLNESS +expectoración I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +vómito. I-PRESENT_ILLNESS +Durante I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +dia I-PRESENT_ILLNESS +habia I-PRESENT_ILLNESS +presentado I-PRESENT_ILLNESS +malestar I-PRESENT_ILLNESS +general, I-PRESENT_ILLNESS +náuseas, I-PRESENT_ILLNESS +diarrea I-PRESENT_ILLNESS +acuosa, I-PRESENT_ILLNESS +hiporexia, I-PRESENT_ILLNESS +dispepsia, I-PRESENT_ILLNESS +meteorismo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +fiebre. I-PRESENT_ILLNESS +Relató I-PRESENT_ILLNESS +haber I-PRESENT_ILLNESS +consumido I-PRESENT_ILLNESS +merluza I-PRESENT_ILLNESS +cruda I-PRESENT_ILLNESS +(cebiche) I-PRESENT_ILLNESS +once I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +atrás I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +negó I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +consumo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +verduras I-PRESENT_ILLNESS +crudas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +familia. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +familia I-PRESENT_ILLNESS +integrada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +seis I-PRESENT_ILLNESS +componentes: I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +esposo, I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +hermana I-PRESENT_ILLNESS +(18 I-PRESENT_ILLNESS +años), I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +hijos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nueve I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cinco I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +menor I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +presentaron I-PRESENT_ILLNESS +signos I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +síntomas. I-PRESENT_ILLNESS +El B-TREATMENT +médico I-TREATMENT +tratante I-TREATMENT +le I-TREATMENT +indicó I-TREATMENT +terapia I-TREATMENT +con I-TREATMENT +mebendazol I-TREATMENT +100 I-TREATMENT +mg, I-TREATMENT +dos I-TREATMENT +veces I-TREATMENT +al I-TREATMENT +día, I-TREATMENT +por I-TREATMENT +tres I-TREATMENT +días. I-TREATMENT + I-TREATMENT +En I-TREATMENT +el I-TREATMENT +laboratorio I-TREATMENT +del I-TREATMENT +consultorio, I-TREATMENT +por I-TREATMENT +las I-TREATMENT +características I-TREATMENT +morfométricas I-TREATMENT +se I-TREATMENT +sospechó I-TREATMENT +que I-TREATMENT +los I-TREATMENT +ejemplares I-TREATMENT +correspondían I-TREATMENT +a I-TREATMENT +A. I-TREATMENT +lumbricoides I-TREATMENT +en I-TREATMENT +estado I-TREATMENT +juvenil. I-TREATMENT +Por B-EXPLORATION +igual I-EXPLORATION +motivo I-EXPLORATION +se I-EXPLORATION +efectuó I-EXPLORATION +examen I-EXPLORATION +copro-parasitario I-EXPLORATION +seriado, I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION +Uno I-EXPLORATION de I-EXPLORATION -sedimentación I-EXPLORATION -globular I-EXPLORATION -41 I-EXPLORATION -mm I-EXPLORATION -(< I-EXPLORATION -14). I-EXPLORATION -En I-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -determinación I-EXPLORATION +los I-EXPLORATION +ejemplares I-EXPLORATION de I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -Ca I-EXPLORATION -19, I-EXPLORATION -9, I-EXPLORATION -91, I-EXPLORATION -23 I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -normales. I-EXPLORATION -Resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -abdomino-pelvica: I-EXPLORATION -presencia I-EXPLORATION +los I-EXPLORATION +gusanos I-EXPLORATION +eliminados I-EXPLORATION +fue I-EXPLORATION +derivado I-EXPLORATION +al I-EXPLORATION +laboratorio I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION -multilobulada I-EXPLORATION -abdomino I-EXPLORATION -pelvica, I-EXPLORATION -cuya I-EXPLORATION -señal I-EXPLORATION -a I-EXPLORATION -excepción I-EXPLORATION +Parasitología I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -tabiques I-EXPLORATION -es I-EXPLORATION -preferentemente I-EXPLORATION -grasa. I-EXPLORATION -Las I-EXPLORATION -dimensiones I-EXPLORATION -máximas I-EXPLORATION +la I-EXPLORATION +Escuela I-EXPLORATION +de I-EXPLORATION +Medicina I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -masa I-EXPLORATION -son I-EXPLORATION +Universidad I-EXPLORATION de I-EXPLORATION -26 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION +Valparaíso I-EXPLORATION +para I-EXPLORATION +comprobar I-EXPLORATION el I-EXPLORATION -eje I-EXPLORATION -cráneo I-EXPLORATION -caudal, I-EXPLORATION -24, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION +diagnóstico. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION el I-EXPLORATION -eje I-EXPLORATION -transverso I-EXPLORATION -y I-EXPLORATION +estudio I-EXPLORATION +morfométrico, I-EXPLORATION +destacando I-EXPLORATION +su I-EXPLORATION +color I-EXPLORATION +amarillento, I-EXPLORATION +una I-EXPLORATION +forma I-EXPLORATION +cilíndrica I-EXPLORATION de I-EXPLORATION -21 I-EXPLORATION +extremos I-EXPLORATION +aguzados I-EXPLORATION +rojizos, I-EXPLORATION +de I-EXPLORATION +3, I-EXPLORATION +9 I-EXPLORATION cm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -eje I-EXPLORATION -anteroposterior. I-EXPLORATION -Cruza I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -media I-EXPLORATION -y I-EXPLORATION -produce I-EXPLORATION -importante I-EXPLORATION -efecto I-EXPLORATION de I-EXPLORATION -masa I-EXPLORATION -sobre I-EXPLORATION -el I-EXPLORATION -riñón I-EXPLORATION -izquierdo, I-EXPLORATION -al I-EXPLORATION -que I-EXPLORATION -rota I-EXPLORATION +longitud I-EXPLORATION y I-EXPLORATION -desplaza I-EXPLORATION -cranealmente, I-EXPLORATION -sin I-EXPLORATION -observarse I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -uropatía I-EXPLORATION -obstructiva. I-EXPLORATION -También I-EXPLORATION -ejerce I-EXPLORATION -efecto I-EXPLORATION +1, I-EXPLORATION +0 I-EXPLORATION +mm I-EXPLORATION de I-EXPLORATION -masa I-EXPLORATION -sobre I-EXPLORATION -el I-EXPLORATION -colon I-EXPLORATION -transverso I-EXPLORATION -izquierdo, I-EXPLORATION -desplazándolo I-EXPLORATION -contra I-EXPLORATION +ancho. I-EXPLORATION +Microscópicamente, I-EXPLORATION +se I-EXPLORATION +comprobó I-EXPLORATION la I-EXPLORATION -pared I-EXPLORATION -abdominal. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -son I-EXPLORATION -muy I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -liposarcoma. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -mediante I-TREATMENT -laparotomía I-TREATMENT -media I-TREATMENT -suprainfraumbilical I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -encontró I-TREATMENT -una I-TREATMENT -gran I-TREATMENT -masa I-TREATMENT -de I-TREATMENT -aspecto I-TREATMENT -lipomatoso I-TREATMENT -desde I-TREATMENT -la I-TREATMENT -celda I-TREATMENT -renal I-TREATMENT -izquierda I-TREATMENT -hasta I-TREATMENT -espacio I-TREATMENT -retrovesical. I-TREATMENT -Se I-TREATMENT -intentó I-TREATMENT -extirpación I-TREATMENT -en I-TREATMENT -bloque I-TREATMENT -con I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -fibras I-TREATMENT -del I-TREATMENT -psoas I-TREATMENT -izquierdo I-TREATMENT -infiltrado. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -extraída I-EXPLORATION -fue I-EXPLORATION +tres I-EXPLORATION +labios I-EXPLORATION en I-EXPLORATION -su I-EXPLORATION -descripción I-EXPLORATION -macroscópica: I-EXPLORATION -Pieza I-EXPLORATION -de I-EXPLORATION -45 I-EXPLORATION -x I-EXPLORATION -40 I-EXPLORATION -x I-EXPLORATION -15 I-EXPLORATION -cm. I-EXPLORATION +el I-EXPLORATION +extremo I-EXPLORATION +anterior; I-EXPLORATION +uno I-EXPLORATION +dorsal I-EXPLORATION con I-EXPLORATION -un I-EXPLORATION -peso I-EXPLORATION -de I-EXPLORATION -6.300 I-EXPLORATION -gr. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION -presenta I-EXPLORATION -una I-EXPLORATION -coloración I-EXPLORATION -amarillenta, I-EXPLORATION +dos I-EXPLORATION +papilas I-EXPLORATION y I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -sección I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -que I-EXPLORATION -mantiene I-EXPLORATION -esta I-EXPLORATION -coloración I-EXPLORATION con I-EXPLORATION -finos I-EXPLORATION -tractos I-EXPLORATION -conectivos, I-EXPLORATION -sin I-EXPLORATION -apreciarse I-EXPLORATION -de I-EXPLORATION -manera I-EXPLORATION -clara I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -necrosis I-EXPLORATION -y I-EXPLORATION -sí I-EXPLORATION +sólo I-EXPLORATION una I-EXPLORATION -distribución I-EXPLORATION +cada I-EXPLORATION +uno I-EXPLORATION en I-EXPLORATION -lóbulos. I-EXPLORATION -En I-EXPLORATION +los I-EXPLORATION +dos I-EXPLORATION +labios I-EXPLORATION +ventrolaterales3 I-EXPLORATION +rodeando I-EXPLORATION la I-EXPLORATION -descripción I-EXPLORATION -microscópica I-EXPLORATION +cavidad I-EXPLORATION +oral. I-EXPLORATION + I-EXPLORATION +Con I-EXPLORATION +el I-EXPLORATION +objeto I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +mejor I-EXPLORATION +observación I-EXPLORATION +de I-EXPLORATION las I-EXPLORATION -secciones I-EXPLORATION -histológicas I-EXPLORATION -muestran I-EXPLORATION -todas I-EXPLORATION -ellas I-EXPLORATION -un I-EXPLORATION -mismo I-EXPLORATION -aspecto: I-EXPLORATION +características I-EXPLORATION +del I-EXPLORATION +gusano, I-EXPLORATION +el I-EXPLORATION +ejemplar I-EXPLORATION +fue I-EXPLORATION +sometido I-EXPLORATION +a I-EXPLORATION +diafanización I-EXPLORATION en I-EXPLORATION -su I-EXPLORATION -mayor I-EXPLORATION -parte I-EXPLORATION -están I-EXPLORATION -constituidas I-EXPLORATION -por I-EXPLORATION -tejido I-EXPLORATION -adiposo I-EXPLORATION -con I-EXPLORATION -células I-EXPLORATION -adiposas I-EXPLORATION -con I-EXPLORATION -tamaño I-EXPLORATION -grande I-EXPLORATION +lactofenol I-EXPLORATION de I-EXPLORATION -vacuola I-EXPLORATION -grande I-EXPLORATION -y I-EXPLORATION -aspecto I-EXPLORATION -maduro. I-EXPLORATION -Se I-EXPLORATION -observa I-EXPLORATION -también I-EXPLORATION +Amann. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +fue I-EXPLORATION +corroborado I-EXPLORATION +al I-EXPLORATION +visualizar I-EXPLORATION +microscópicamente I-EXPLORATION +los I-EXPLORATION +tres I-EXPLORATION +labios I-EXPLORATION +que I-EXPLORATION +rodean I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -núcleos I-EXPLORATION -atípicos I-EXPLORATION -de I-EXPLORATION -manera I-EXPLORATION -focal, I-EXPLORATION -con I-EXPLORATION -citoplasma I-EXPLORATION -vacuolado. I-EXPLORATION -Estas I-EXPLORATION -zonas I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -maduro I-EXPLORATION -están I-EXPLORATION -distribuidas I-EXPLORATION -de I-EXPLORATION -manera I-EXPLORATION -difusa I-EXPLORATION +cavidad I-EXPLORATION +oral I-EXPLORATION +triangular I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +extremo I-EXPLORATION +anterior, I-EXPLORATION +y I-EXPLORATION +por I-EXPLORATION +las I-EXPLORATION +características I-EXPLORATION +del I-EXPLORATION +tubo I-EXPLORATION +digestivo I-EXPLORATION por I-EXPLORATION +transparencia I-EXPLORATION +(esófago I-EXPLORATION +corto, I-EXPLORATION +intestino I-EXPLORATION +aplanado I-EXPLORATION +recorriendo I-EXPLORATION toda I-EXPLORATION la I-EXPLORATION -neoplasia, I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -focos I-EXPLORATION -con I-EXPLORATION -núcleos I-EXPLORATION -atípicos, I-EXPLORATION +longitud I-EXPLORATION +del I-EXPLORATION +cuerpo, I-EXPLORATION +terminado I-EXPLORATION en I-EXPLORATION -ocasiones I-EXPLORATION -hipercromáticos I-EXPLORATION -se I-EXPLORATION -muestran I-EXPLORATION -de I-EXPLORATION -manera I-EXPLORATION -aislada. I-EXPLORATION -Diagnóstico: I-EXPLORATION -Liposarcoma I-EXPLORATION -bien I-EXPLORATION -diferenciado. I-EXPLORATION -Una I-EXPLORATION -nueva I-EXPLORATION -determinación I-EXPLORATION +recto). I-EXPLORATION + I-EXPLORATION +Obtenido I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -Ca I-EXPLORATION -19, I-EXPLORATION -9, I-EXPLORATION -posterior I-EXPLORATION -a I-EXPLORATION +certeza, I-EXPLORATION +se I-EXPLORATION +sostuvo I-EXPLORATION +entrevista I-EXPLORATION +telefónica I-EXPLORATION +con I-EXPLORATION la I-EXPLORATION -intervención I-EXPLORATION -quirúrgica I-EXPLORATION -presenta I-EXPLORATION -normalización I-EXPLORATION -de I-EXPLORATION +paciente: I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +indicó I-EXPLORATION +las I-EXPLORATION +medidas I-EXPLORATION +profilácticas I-EXPLORATION +para I-EXPLORATION +evitar I-EXPLORATION la I-EXPLORATION -misma I-EXPLORATION -(24, I-EXPLORATION -17 I-EXPLORATION -U/l), I-EXPLORATION -manteniéndose I-EXPLORATION +reinfección I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +sugirió I-EXPLORATION +control I-EXPLORATION +mediante I-EXPLORATION +examen I-EXPLORATION +copro-parasitario I-EXPLORATION +seriado, I-EXPLORATION el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -normales. I-EXPLORATION -Posteriormente B-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -radioterapia I-TREATMENT -complementaria, I-TREATMENT -presentando I-TREATMENT -una I-TREATMENT -evolución I-TREATMENT -favorable I-TREATMENT -y I-TREATMENT -permaneciendo I-TREATMENT -asintomático. I-TREATMENT -La B-EXPLORATION -RM I-EXPLORATION -abdominopélvica I-EXPLORATION +que I-EXPLORATION +reveló I-EXPLORATION +formas I-EXPLORATION +vacuoladas I-EXPLORATION de I-EXPLORATION -control I-EXPLORATION -realizada I-EXPLORATION +Blastocystis I-EXPLORATION +hominis. I-EXPLORATION +Como I-EXPLORATION +investigación I-EXPLORATION +complementaria I-EXPLORATION +se I-EXPLORATION +efectuó I-EXPLORATION +examen I-EXPLORATION +copro-parasitario I-EXPLORATION +seriado I-EXPLORATION a I-EXPLORATION los I-EXPLORATION -cinco I-EXPLORATION -meses I-EXPLORATION +integrantes I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -intervención I-EXPLORATION -quirurgica I-EXPLORATION -presenta I-EXPLORATION -un I-EXPLORATION -estado I-EXPLORATION -postoperatorio I-EXPLORATION -del I-EXPLORATION -liposarcoma I-EXPLORATION -retroperitoneal, I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -macroscópica I-EXPLORATION +su I-EXPLORATION +grupo I-EXPLORATION +familiar, I-EXPLORATION +evidenciándose I-EXPLORATION +formas I-EXPLORATION +vacuoladas I-EXPLORATION de I-EXPLORATION -lesión. I-EXPLORATION -Así B-EVOLUTION -este I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -favorable, I-EVOLUTION -permaneciendo I-EVOLUTION -asintomático I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -transcurriendo I-EVOLUTION -más I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -desde I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -quirúrgica. I-EVOLUTION - I-EVOLUTION +B. I-EXPLORATION +hominis I-EXPLORATION +y I-EXPLORATION +quistes I-EXPLORATION +de I-EXPLORATION +Entamoeba I-EXPLORATION +coli I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +hermana; I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +integrantes I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION -Mujer B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY +7 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +infección I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +VIH I-PAST_MEDICAL_HISTORY +adquirida I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +transmisión I-PAST_MEDICAL_HISTORY +vertical, I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS +edad. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -artritis. I-PRESENT_ILLNESS -Tres B-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -comienza I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -fiebre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -39º I-PAST_MEDICAL_HISTORY -C I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -carácter I-PAST_MEDICAL_HISTORY -intermitente I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -artralgias I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tumefacción I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ambos I-PAST_MEDICAL_HISTORY -tobillos, I-PAST_MEDICAL_HISTORY -rodillas, I-PAST_MEDICAL_HISTORY -codos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -muñecas. I-PAST_MEDICAL_HISTORY -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destaca I-EXPLORATION -palidez I-EXPLORATION +lesiones I-PRESENT_ILLNESS +cutáneas I-PRESENT_ILLNESS +maculares I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +necrótico. I-PRESENT_ILLNESS +Posteriormente, I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +agregó I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cefaleas I-PRESENT_ILLNESS +intensas I-PRESENT_ILLNESS +asociadas I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +fiebre. I-PRESENT_ILLNESS +Fue I-PRESENT_ILLNESS +internado I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +diagnóstico I-PRESENT_ILLNESS +probable I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +meningitis. I-PRESENT_ILLNESS +Dentro B-EXPLORATION +del I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +líquido I-EXPLORATION +céfalo-raquídeo I-EXPLORATION +(LCR) I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +tinción I-EXPLORATION +con I-EXPLORATION +tinta I-EXPLORATION +china I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +positiva I-EXPLORATION y I-EXPLORATION -discreto I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -difuso I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -profunda. I-EXPLORATION -Datos I-EXPLORATION -analíticos: I-EXPLORATION -Hb I-EXPLORATION -9, I-EXPLORATION -6 I-EXPLORATION -mg/dL; I-EXPLORATION -HTO I-EXPLORATION -31%, I-EXPLORATION -VCM I-EXPLORATION -65 I-EXPLORATION -mm, I-EXPLORATION -660.000 I-EXPLORATION -plaquetas/mL, I-EXPLORATION -ferritina I-EXPLORATION -65 I-EXPLORATION -ng/mL, I-EXPLORATION -Fe I-EXPLORATION -15 I-EXPLORATION -microg/dL, I-EXPLORATION -fibrinógeno I-EXPLORATION -644 I-EXPLORATION -mg/dL, I-EXPLORATION -PCR I-EXPLORATION -55 I-EXPLORATION -mg/dL. I-EXPLORATION -Resto I-EXPLORATION +el I-EXPLORATION +cultivo I-EXPLORATION +hubo I-EXPLORATION +aislamiento I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION -bioquímicos, I-EXPLORATION -serológicos I-EXPLORATION -e I-EXPLORATION -inmunológicos I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Ecografía I-EXPLORATION -abdominal I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION +Cryptococcus I-EXPLORATION +neoformans. I-EXPLORATION En I-EXPLORATION -el I-EXPLORATION -enema I-EXPLORATION -opaco I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -afectación I-EXPLORATION -del I-EXPLORATION -colon I-EXPLORATION -sigmoide I-EXPLORATION -hasta I-EXPLORATION -ciego, I-EXPLORATION -observándose I-EXPLORATION -úlceras I-EXPLORATION -transversales I-EXPLORATION -y I-EXPLORATION -longitudinales I-EXPLORATION -del I-EXPLORATION -colon. I-EXPLORATION -La I-EXPLORATION -colonoscopia I-EXPLORATION -demuestra I-EXPLORATION -en I-EXPLORATION -colon I-EXPLORATION -descendente I-EXPLORATION -y I-EXPLORATION -sigmoide, I-EXPLORATION -una I-EXPLORATION -mucosa I-EXPLORATION -eritematosa I-EXPLORATION -y I-EXPLORATION -edematosa, I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -ulceraciones I-EXPLORATION -y I-EXPLORATION -pseudopólipos I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -anatomopatológicos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -son I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -enfermedad I-EXPLORATION +ese I-EXPLORATION +momento, I-EXPLORATION +tenía I-EXPLORATION +linfocitos I-EXPLORATION +CD4 I-EXPLORATION de I-EXPLORATION -Crohn. I-EXPLORATION - I-EXPLORATION -Curso B-EVOLUTION -evolutivo: I-EVOLUTION -la I-EVOLUTION -enferma I-EVOLUTION -cursó I-EVOLUTION -posteriormente I-EVOLUTION -con I-EVOLUTION -diarrea I-EVOLUTION -con I-EVOLUTION -2-3 I-EVOLUTION -deposiciones I-EVOLUTION -líquidas I-EVOLUTION -diarias I-EVOLUTION -sin I-EVOLUTION -productos I-EVOLUTION -patológicos I-EVOLUTION -y I-EVOLUTION -lesiones I-EVOLUTION -cutáneas I-EVOLUTION +158 I-EXPLORATION +céls/mm3 I-EXPLORATION +(9%). I-EXPLORATION +Recibió B-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +anfotericina I-TREATMENT +B I-TREATMENT +deoxicolato I-TREATMENT +i.v I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +fluconazol I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +evolución. I-TREATMENT +Se I-TREATMENT +mantuvo I-TREATMENT +hospitalizado I-TREATMENT +con I-TREATMENT +tratamiento I-TREATMENT +antifúngico I-TREATMENT +durante I-TREATMENT +42 I-TREATMENT +días. I-TREATMENT +Tres I-TREATMENT +meses I-TREATMENT +después I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +monoterapia I-TREATMENT +con I-TREATMENT +zidovudina I-TREATMENT +(AZT), I-TREATMENT +que I-TREATMENT +luego I-TREATMENT +de I-TREATMENT +8 I-TREATMENT +meses I-TREATMENT +se I-TREATMENT +cambió I-TREATMENT +a I-TREATMENT +didanosina I-TREATMENT +(ddI). I-TREATMENT +Posteriormente, I-TREATMENT +recibió I-TREATMENT +biterapia I-TREATMENT +con I-TREATMENT +ddI I-TREATMENT +y I-TREATMENT +ritonavir. I-TREATMENT +Falleció B-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +8 I-EVOLUTION +años I-EVOLUTION de I-EVOLUTION -eritema I-EVOLUTION -nodoso. I-EVOLUTION +edad. I-EVOLUTION I-EVOLUTION -Varón B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS +74 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -diagnosticado B-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Cowden I-PAST_MEDICAL_HISTORY +en B-PAST_MEDICAL_HISTORY +1997, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +consulta I-PAST_MEDICAL_HISTORY por I-PAST_MEDICAL_HISTORY -presentar I-PAST_MEDICAL_HISTORY -múltiples I-PAST_MEDICAL_HISTORY -formaciones I-PAST_MEDICAL_HISTORY -papilomatosas I-PAST_MEDICAL_HISTORY +tumoración I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -dorso I-PAST_MEDICAL_HISTORY +mama I-PAST_MEDICAL_HISTORY +izquierda I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -lengua I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +cm I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +adenopatía I-PAST_MEDICAL_HISTORY +palpable. I-PAST_MEDICAL_HISTORY +Estudio I-PAST_MEDICAL_HISTORY +radiológico I-PAST_MEDICAL_HISTORY +compatible I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +carcinoma. I-PAST_MEDICAL_HISTORY +Es I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +mastectomía I-PAST_MEDICAL_HISTORY +radical I-PAST_MEDICAL_HISTORY +modificada I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +Madden I-PAST_MEDICAL_HISTORY +previa I-PAST_MEDICAL_HISTORY +biopsia I-PAST_MEDICAL_HISTORY +intraoperatoria I-PAST_MEDICAL_HISTORY +positiva I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +carcinoma. I-PAST_MEDICAL_HISTORY +Informe I-PAST_MEDICAL_HISTORY +anatomopatológico: I-PAST_MEDICAL_HISTORY +Carcinoma I-PAST_MEDICAL_HISTORY +ductal I-PAST_MEDICAL_HISTORY +infiltrante I-PAST_MEDICAL_HISTORY +mucinoso I-PAST_MEDICAL_HISTORY +(coloide) I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -tamaño I-PAST_MEDICAL_HISTORY -variable, I-PAST_MEDICAL_HISTORY -macroglosia I-PAST_MEDICAL_HISTORY -saburral I-PAST_MEDICAL_HISTORY +3.2 I-PAST_MEDICAL_HISTORY +cm I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +eje I-PAST_MEDICAL_HISTORY +máximo I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -pápulas I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +adenopatía I-PAST_MEDICAL_HISTORY +positiva I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -color I-PAST_MEDICAL_HISTORY -piel I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -mucosa I-PAST_MEDICAL_HISTORY -lingual I-PAST_MEDICAL_HISTORY +22 I-PAST_MEDICAL_HISTORY +ganglios I-PAST_MEDICAL_HISTORY +axilares I-PAST_MEDICAL_HISTORY +aislados. I-PAST_MEDICAL_HISTORY +Recibe I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +complementario I-PAST_MEDICAL_HISTORY +tamoxifeno I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY -modo I-PAST_MEDICAL_HISTORY +dosis I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -empedrado. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -resultado I-PAST_MEDICAL_HISTORY -anatomopatoógico I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +mg I-PAST_MEDICAL_HISTORY +diarios. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +realizan I-PAST_MEDICAL_HISTORY +controles I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -pólipos I-PAST_MEDICAL_HISTORY -fibroepiteliales I-PAST_MEDICAL_HISTORY -(12). I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Tras I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -dermatológico I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -inició I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -estudio I-PAST_MEDICAL_HISTORY +rastreo I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -extensión: I-PAST_MEDICAL_HISTORY -a) I-PAST_MEDICAL_HISTORY -tránsito I-PAST_MEDICAL_HISTORY -EGD I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -enema I-PAST_MEDICAL_HISTORY -opaco I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -evidencian I-PAST_MEDICAL_HISTORY -numerosos I-PAST_MEDICAL_HISTORY -pólipos I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antro I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -ampolla I-PAST_MEDICAL_HISTORY -rectal; I-PAST_MEDICAL_HISTORY -b) I-PAST_MEDICAL_HISTORY -endoscopias I-PAST_MEDICAL_HISTORY -digestivas I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -baja: I-PAST_MEDICAL_HISTORY -parcheado I-PAST_MEDICAL_HISTORY -difuso I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -esófago I-PAST_MEDICAL_HISTORY -cervical I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -cardias I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -histológicamente I-PAST_MEDICAL_HISTORY -coincide I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -acantosis I-PAST_MEDICAL_HISTORY -glucogénica; I-PAST_MEDICAL_HISTORY -pólipos I-PAST_MEDICAL_HISTORY -sésiles I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -alguno I-PAST_MEDICAL_HISTORY -pediculado I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -estómago I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -ampolla I-PAST_MEDICAL_HISTORY -rectal I-PAST_MEDICAL_HISTORY +tumor I-PAST_MEDICAL_HISTORY que I-PAST_MEDICAL_HISTORY -corresponden I-PAST_MEDICAL_HISTORY -histológicamente I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -pólipos I-PAST_MEDICAL_HISTORY -hamartomatosos; I-PAST_MEDICAL_HISTORY -c) I-PAST_MEDICAL_HISTORY -ecografía I-PAST_MEDICAL_HISTORY -tiroidea: I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -nódulos I-PAST_MEDICAL_HISTORY -sólidos, I-PAST_MEDICAL_HISTORY -uno I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -cada I-PAST_MEDICAL_HISTORY -lóbulo. I-PAST_MEDICAL_HISTORY -Tras I-PAST_MEDICAL_HISTORY -punción I-PAST_MEDICAL_HISTORY -(PAAF) I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -diagnostica I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -bocio I-PAST_MEDICAL_HISTORY -coloidal; I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -d) I-PAST_MEDICAL_HISTORY +resultan I-PAST_MEDICAL_HISTORY +negativos. I-PAST_MEDICAL_HISTORY +Así I-PAST_MEDICAL_HISTORY +mismo I-PAST_MEDICAL_HISTORY se I-PAST_MEDICAL_HISTORY -realizó I-PAST_MEDICAL_HISTORY -tomografía I-PAST_MEDICAL_HISTORY -computerizada I-PAST_MEDICAL_HISTORY -craneal I-PAST_MEDICAL_HISTORY +realizan I-PAST_MEDICAL_HISTORY +ecografías I-PAST_MEDICAL_HISTORY +ginecológicas I-PAST_MEDICAL_HISTORY +anuales I-PAST_MEDICAL_HISTORY que I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -demostró I-PAST_MEDICAL_HISTORY -alteraciones I-PAST_MEDICAL_HISTORY -significativas. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY +son I-PAST_MEDICAL_HISTORY +normales. I-PAST_MEDICAL_HISTORY En B-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -actualidad I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS +Mayo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2001 I-PRESENT_ILLNESS consulta I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -cefalea. I-PRESENT_ILLNESS -Dada B-EXPLORATION -su I-EXPLORATION -enfermedad I-EXPLORATION +metrorragia I-PRESENT_ILLNESS +postmenopáusica. I-PRESENT_ILLNESS +Se B-EXPLORATION +realiza I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +vaginal I-EXPLORATION +que I-EXPLORATION +resulta I-EXPLORATION +ser I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +"pólipo I-EXPLORATION +endometrial" I-EXPLORATION de I-EXPLORATION -base I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION +19*16 I-EXPLORATION +mm. I-EXPLORATION +Se I-EXPLORATION realiza I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION -demostrándose I-EXPLORATION una I-EXPLORATION -lesión I-EXPLORATION +Histeroscopia I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +una I-EXPLORATION +formación I-EXPLORATION +excrecente I-EXPLORATION en I-EXPLORATION -hemisferio I-EXPLORATION -cerebeloso I-EXPLORATION -derecho I-EXPLORATION -descrita I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +cara I-EXPLORATION +anterior I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -mal I-EXPLORATION -delimitada I-EXPLORATION +vagina I-EXPLORATION que I-EXPLORATION -muestra I-EXPLORATION -discreta I-EXPLORATION -hipodensidad I-EXPLORATION -de I-EXPLORATION -señal I-EXPLORATION -T1 I-EXPLORATION -y I-EXPLORATION -discreta I-EXPLORATION -hiperdensidad I-EXPLORATION -de I-EXPLORATION -señal I-EXPLORATION -T2 I-EXPLORATION +es I-EXPLORATION +biopsiada I-EXPLORATION y I-EXPLORATION -FLAIR I-EXPLORATION -que I-EXPLORATION -afecta I-EXPLORATION a I-EXPLORATION +nivel I-EXPLORATION +intrauterino I-EXPLORATION +una I-EXPLORATION +formación I-EXPLORATION +polipoidea I-EXPLORATION +con I-EXPLORATION +vasos I-EXPLORATION +anómalos, I-EXPLORATION +altamente I-EXPLORATION +sospechosa I-EXPLORATION +que I-EXPLORATION +es I-EXPLORATION +igualmente I-EXPLORATION +biopsiada. I-EXPLORATION +El I-EXPLORATION +informe I-EXPLORATION +anatomopatológico I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -cortical I-EXPLORATION -cerebelosa I-EXPLORATION +zona I-EXPLORATION en I-EXPLORATION -región I-EXPLORATION -posterolateral I-EXPLORATION +vagina I-EXPLORATION +se I-EXPLORATION +informa I-EXPLORATION +como I-EXPLORATION +carcinoma I-EXPLORATION +pobremente I-EXPLORATION +diferenciado I-EXPLORATION y I-EXPLORATION -que I-EXPLORATION -condiciona I-EXPLORATION -un I-EXPLORATION -leve I-EXPLORATION -desplazamiento I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -izquierda I-EXPLORATION -del I-EXPLORATION -IV I-EXPLORATION -ventrículo I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -hidrocefalia I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -supratentorial. I-EXPLORATION -Tras I-EXPLORATION la I-EXPLORATION -administración I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -paramagnético I-EXPLORATION +formación I-EXPLORATION +polipoidea I-EXPLORATION +como I-EXPLORATION +atipia I-EXPLORATION +celular I-EXPLORATION no I-EXPLORATION -se I-EXPLORATION -visualiza I-EXPLORATION -captación I-EXPLORATION -significativa I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -parece I-EXPLORATION -tratarse I-EXPLORATION +filiada. I-EXPLORATION + B-TREATMENT +Se I-TREATMENT +realiza I-TREATMENT +una I-TREATMENT +histerectomía I-TREATMENT +total I-TREATMENT +con I-TREATMENT +doble I-TREATMENT +anexectomía, I-TREATMENT +manguito I-TREATMENT +vaginal I-TREATMENT +y I-TREATMENT +linfadenectomía. I-TREATMENT +Informe B-EXPLORATION +anatomopatológico: I-EXPLORATION +Lavado I-EXPLORATION +peritoneal I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +células I-EXPLORATION +malignas. I-EXPLORATION +Tumor I-EXPLORATION +intracavitario I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -gangliocitoma I-EXPLORATION -displásico I-EXPLORATION -cerebeloso I-EXPLORATION +6 I-EXPLORATION +cm, I-EXPLORATION +Tumor I-EXPLORATION +Mülleriano I-EXPLORATION +Mixto I-EXPLORATION +Maligno I-EXPLORATION +Heterólogo I-EXPLORATION con I-EXPLORATION -engrosamiento I-EXPLORATION +extensa I-EXPLORATION +permeación I-EXPLORATION +vascular I-EXPLORATION +linfática. I-EXPLORATION +Metástasis I-EXPLORATION +múltiples I-EXPLORATION +en I-EXPLORATION +miometrio, I-EXPLORATION +trompa I-EXPLORATION +y I-EXPLORATION +ovarios I-EXPLORATION +y I-EXPLORATION +metástasis I-EXPLORATION +ganglionares. I-EXPLORATION +La I-EXPLORATION +formación I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -capas I-EXPLORATION -del I-EXPLORATION -cerebelo I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -produce I-EXPLORATION -un I-EXPLORATION -aparente I-EXPLORATION -laminado I-EXPLORATION +vagina I-EXPLORATION +es I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -cortical. I-EXPLORATION - I-EXPLORATION +un I-EXPLORATION +carcinoma I-EXPLORATION +pobremente I-EXPLORATION +diferenciado I-EXPLORATION +probablemente I-EXPLORATION +metástasis I-EXPLORATION +del I-EXPLORATION +tumor I-EXPLORATION +Mülleriano I-EXPLORATION +mixto I-EXPLORATION +descrito I-EXPLORATION +(Estadio I-EXPLORATION +III). I-EXPLORATION +Realiza B-TREATMENT +tratamiento I-TREATMENT +complementario I-TREATMENT +con I-TREATMENT +Taxol, I-TREATMENT +que I-TREATMENT +tolera I-TREATMENT +mal, I-TREATMENT +y I-TREATMENT +radioterapia, I-TREATMENT +falleciendo I-TREATMENT +al I-TREATMENT +año I-TREATMENT +de I-TREATMENT +este I-TREATMENT +proceso. I-TREATMENT + I-TREATMENT -Paciente B-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +clínico I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +miembro I-PRESENT_ILLNESS +fantasma I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +muñón I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +extremidad I-PRESENT_ILLNESS +inferior I-PRESENT_ILLNESS +derecha I-PRESENT_ILLNESS +(EID) I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +1/3 I-PRESENT_ILLNESS +medio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +muslo I-PRESENT_ILLNESS +refractario I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +analgésico I-PRESENT_ILLNESS +vía I-PRESENT_ILLNESS +oral, I-PRESENT_ILLNESS +remitido B-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +Unidad I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +Dolor I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +decide I-DERIVED_FROM/TO +colocación I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +bomba I-DERIVED_FROM/TO +intratecal I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +ziconotide. I-DERIVED_FROM/TO +Como B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +presenta: I-PAST_MEDICAL_HISTORY +obesidad, I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY +ansioso-depresivo, I-PAST_MEDICAL_HISTORY +neumonía I-PAST_MEDICAL_HISTORY +izquierda I-PAST_MEDICAL_HISTORY +atípica I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +abril I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -vivido I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY +2007 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +alergia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +ciprofloxacino, I-PAST_MEDICAL_HISTORY +castaña, I-PAST_MEDICAL_HISTORY +kiwi I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +látex. I-PAST_MEDICAL_HISTORY +Respecto I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +traumatológica, I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +sufre I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +fractura I-PAST_MEDICAL_HISTORY +espiroidea I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tercio I-PAST_MEDICAL_HISTORY +distal I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tibia I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +maleolo I-PAST_MEDICAL_HISTORY +peroneo I-PAST_MEDICAL_HISTORY +derechos I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -Amazonas I-PAST_MEDICAL_HISTORY -(desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -28 I-PAST_MEDICAL_HISTORY +mayo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2000 I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +accidente I-PAST_MEDICAL_HISTORY +laboral, I-PAST_MEDICAL_HISTORY +siendo I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +osteosíntesis I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +tornillos I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -35 I-PAST_MEDICAL_HISTORY -años), I-PAST_MEDICAL_HISTORY +placa I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -profesión I-PAST_MEDICAL_HISTORY -médica, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -dispepsia I-PAST_MEDICAL_HISTORY +neutralización. I-PAST_MEDICAL_HISTORY +Tras I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +curso I-PAST_MEDICAL_HISTORY +postoperatorio I-PAST_MEDICAL_HISTORY sin I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -regular. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consulta B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -nocturna I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Niega B-EXPLORATION -fiebre, I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -peso, I-EXPLORATION -tabaquismo, I-EXPLORATION -consumo I-EXPLORATION -de I-EXPLORATION -fármacos I-EXPLORATION -o I-EXPLORATION -drogas I-EXPLORATION -ilícitas. I-EXPLORATION - I-EXPLORATION -No I-EXPLORATION -presentaba I-EXPLORATION -datos I-EXPLORATION -significativos I-EXPLORATION -al I-EXPLORATION -exámen I-EXPLORATION -físico. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -laboratorio, I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -eritrosedimentación I-EXPLORATION -globular I-EXPLORATION -(VSG), I-EXPLORATION -hormonas I-EXPLORATION -tiroideas, I-EXPLORATION -proteinograma I-EXPLORATION -electroforético I-EXPLORATION -y I-EXPLORATION -complemento, I-EXPLORATION -encontrándose I-EXPLORATION -todos I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -cultivos I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -orina I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION -(3 I-EXPLORATION -pares I-EXPLORATION -de I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -2 I-EXPLORATION -cultivos I-EXPLORATION -de I-EXPLORATION -orina). I-EXPLORATION -Reacción I-EXPLORATION -de I-EXPLORATION -Mantoux I-EXPLORATION -y I-EXPLORATION -serologías I-EXPLORATION -virales, I-EXPLORATION -bacterianas I-EXPLORATION -y I-EXPLORATION -parasitarias I-EXPLORATION -negativas. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -agregaron I-EXPLORATION -factor I-EXPLORATION -reumatoideo, I-EXPLORATION -factor I-EXPLORATION -antinuclear, I-EXPLORATION -ANCA I-EXPLORATION -C I-EXPLORATION -y I-EXPLORATION -P, I-EXPLORATION -siendo I-EXPLORATION -todos I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -no I-EXPLORATION -evidenció I-EXPLORATION -patología. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -dispepsia I-EXPLORATION -y I-EXPLORATION -pirosis, I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -sugiere I-EXPLORATION -enfermedad I-EXPLORATION -por I-EXPLORATION -RGE I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -esofagitis I-EXPLORATION -grado I-EXPLORATION -dos. I-EXPLORATION -Inició B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -omeprazol I-TREATMENT -40 I-TREATMENT -mg/día, I-TREATMENT -desapareciendo B-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -también I-EVOLUTION -la I-EVOLUTION -sudoración I-EVOLUTION -nocturna, I-EVOLUTION -y I-EVOLUTION -reapareciendo I-EVOLUTION -esta I-EVOLUTION -última I-EVOLUTION -al I-EVOLUTION -suspender I-EVOLUTION -el I-EVOLUTION -fármaco. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -pHmetría I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -no I-EXPLORATION -demostrando I-EXPLORATION -reflujo. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY +complicaciones I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +dada I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -leve, I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -celiaca, I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY +alta. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +comienza I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +presentar I-PAST_MEDICAL_HISTORY +dolor I-PAST_MEDICAL_HISTORY +espontáneo, I-PAST_MEDICAL_HISTORY +punzante I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tobillo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +cara I-PAST_MEDICAL_HISTORY +anterior I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Graves I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +pierna I-PAST_MEDICAL_HISTORY que I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY +aumenta I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -drogas I-PAST_MEDICAL_HISTORY -anti-tiroideas, I-PAST_MEDICAL_HISTORY -posterior I-PAST_MEDICAL_HISTORY -tiroidectomía I-PAST_MEDICAL_HISTORY -total I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +palpación I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -vasculitis I-PAST_MEDICAL_HISTORY -ANCA I-PAST_MEDICAL_HISTORY -C I-PAST_MEDICAL_HISTORY -positiva I-PAST_MEDICAL_HISTORY -(enfermedad I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +cargar I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +miembro I-PAST_MEDICAL_HISTORY +cuando I-PAST_MEDICAL_HISTORY +intenta I-PAST_MEDICAL_HISTORY +caminar, I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +cual I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +añade I-PAST_MEDICAL_HISTORY +edema I-PAST_MEDICAL_HISTORY +severo I-PAST_MEDICAL_HISTORY +infracondíleo, I-PAST_MEDICAL_HISTORY +palidez, I-PAST_MEDICAL_HISTORY +frialdad I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hiperhidrosis I-PAST_MEDICAL_HISTORY +diagnosticándose I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Wegener I-PAST_MEDICAL_HISTORY -limitada). I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY +Distrofia I-PAST_MEDICAL_HISTORY +Simpático I-PAST_MEDICAL_HISTORY +Refleja I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +EID. I-PAST_MEDICAL_HISTORY +Es I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +técnicas I-PAST_MEDICAL_HISTORY +regionales I-PAST_MEDICAL_HISTORY +asociadas I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY tratamiento I-PAST_MEDICAL_HISTORY +médico I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +fracasaron, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +finalmente, I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +sufrir I-PAST_MEDICAL_HISTORY +varias I-PAST_MEDICAL_HISTORY +intervenciones I-PAST_MEDICAL_HISTORY +(simpatectomía I-PAST_MEDICAL_HISTORY +lumbar, I-PAST_MEDICAL_HISTORY +absceso, I-PAST_MEDICAL_HISTORY +celulitis) I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +decide I-PAST_MEDICAL_HISTORY +amputación I-PAST_MEDICAL_HISTORY +infracondílea I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +EID. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +posteriori, I-PAST_MEDICAL_HISTORY +evolución I-PAST_MEDICAL_HISTORY +desfavorable, I-PAST_MEDICAL_HISTORY +realizándose I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +nueva I-PAST_MEDICAL_HISTORY +amputación I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +1/3 I-PAST_MEDICAL_HISTORY +medio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +muslo I-PAST_MEDICAL_HISTORY +EID I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +marzo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2004. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Seguidamente I-PAST_MEDICAL_HISTORY +continúa I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -meprednisona I-PAST_MEDICAL_HISTORY -60 I-PAST_MEDICAL_HISTORY -mg/día I-PAST_MEDICAL_HISTORY +dolor I-PAST_MEDICAL_HISTORY +intenso I-PAST_MEDICAL_HISTORY +continuo I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +nivel I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tobillo, I-PAST_MEDICAL_HISTORY +pie I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -ciclofosfamida I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -mg/kg/día I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -mes I-PAST_MEDICAL_HISTORY -previo I-PAST_MEDICAL_HISTORY +rodilla I-PAST_MEDICAL_HISTORY +amputados I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +decide I-PAST_MEDICAL_HISTORY +implantación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +catéter I-PAST_MEDICAL_HISTORY +epidural I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +ambulatorio I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +analgesia I-PAST_MEDICAL_HISTORY +epidural I-PAST_MEDICAL_HISTORY +controlada I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +(PCEA) I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +13 I-PAST_MEDICAL_HISTORY +abril I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2004, I-PAST_MEDICAL_HISTORY +asociado I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +bajada I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +dosis I-PAST_MEDICAL_HISTORY +importante I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +farmacológico I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +venía I-PAST_MEDICAL_HISTORY +tomando I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +anterioridad I-PAST_MEDICAL_HISTORY +(antidepresivos I-PAST_MEDICAL_HISTORY +tricíclicos, I-PAST_MEDICAL_HISTORY +benzodiacepinas, I-PAST_MEDICAL_HISTORY +mórficos, I-PAST_MEDICAL_HISTORY +AINEs, I-PAST_MEDICAL_HISTORY +etc.). I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +evolución I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +favorable I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2005 I-PAST_MEDICAL_HISTORY +sufre I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +accidente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tráfico I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +arrancamiento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +catéter I-PAST_MEDICAL_HISTORY +epidural, I-PAST_MEDICAL_HISTORY +contractura I-PAST_MEDICAL_HISTORY +cervical I-PAST_MEDICAL_HISTORY +muscular I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +cuadro I-PAST_MEDICAL_HISTORY +vertiginoso I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +empeoramiento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY su I-PAST_MEDICAL_HISTORY -internación. I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -UTI I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -súbita I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -estridor I-PRESENT_ILLNESS -laríngeo I-PRESENT_ILLNESS -inspiratorio, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -sibilancias. I-PRESENT_ILLNESS -Presentó I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -crisis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diez I-PRESENT_ILLNESS -minutos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -horas, I-PRESENT_ILLNESS -permaneciendo I-PRESENT_ILLNESS -asintomática I-PRESENT_ILLNESS -intercrisis. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -fibrolaringoscopía I-EXPLORATION -hasta I-EXPLORATION -cuarto I-EXPLORATION -anillo I-EXPLORATION -traqueal I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -lesiones I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -movilidad I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -cuerdas I-EXPLORATION -impresionó I-EXPLORATION -normal I-EXPLORATION -fuera I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -crisis. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -cuello I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -disminución I-EXPLORATION -del I-EXPLORATION -calibre I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -glótica I-EXPLORATION -en I-EXPLORATION -inspiración I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -simétrica I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -traquea I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -presentó I-EXPLORATION -clínica I-EXPLORATION -de I-EXPLORATION -RGE I-EXPLORATION -y I-EXPLORATION -este I-EXPLORATION -se I-EXPLORATION -diagnóstico I-EXPLORATION -mediante I-EXPLORATION -SEGD. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -EFR I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -obstrucción I-EXPLORATION -moderada I-EXPLORATION -fija, I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -curva I-EXPLORATION -inspiratoria. I-EXPLORATION -Permanece B-TREATMENT -en I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -corticoides, I-TREATMENT -beta I-TREATMENT -2 I-TREATMENT -inhalados I-TREATMENT -de I-TREATMENT -larga I-TREATMENT -duración I-TREATMENT -y I-TREATMENT -omeprazol I-TREATMENT -40 I-TREATMENT -mg/día. I-TREATMENT -No I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -tratamiento I-TREATMENT -psicológico I-TREATMENT -ni I-TREATMENT -fonoudiológico. I-TREATMENT -Se B-EVOLUTION -encuentra I-EVOLUTION -asintomática I-EVOLUTION -desde I-EVOLUTION -hace I-EVOLUTION -4 I-EVOLUTION -meses. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -leucoderma, I-PRESENT_ILLNESS -fue B-DERIVED_FROM/TO -enviado I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Ambulatorio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Estomatología I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Clínicas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Porto I-DERIVED_FROM/TO -Alegre I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -Cirujano I-DERIVED_FROM/TO -Dentista I-DERIVED_FROM/TO -debido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -múltiples I-DERIVED_FROM/TO -lesiones I-DERIVED_FROM/TO -papilomatosas I-DERIVED_FROM/TO -dispersas I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -mucosa I-DERIVED_FROM/TO -bucal. I-DERIVED_FROM/TO -La B-FAMILY_HISTORY -madre I-FAMILY_HISTORY -del I-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -relató I-FAMILY_HISTORY -que I-FAMILY_HISTORY -la I-FAMILY_HISTORY -hermana I-FAMILY_HISTORY -del I-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -presentaba I-FAMILY_HISTORY -lesiones I-FAMILY_HISTORY -semejantes, I-FAMILY_HISTORY -las I-FAMILY_HISTORY -cuales I-FAMILY_HISTORY -fueron I-FAMILY_HISTORY -tratadas I-FAMILY_HISTORY -por I-FAMILY_HISTORY -cauterización. I-FAMILY_HISTORY -En B-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -físico I-EXPLORATION -intraoral, I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -papilomatosas, I-EXPLORATION -algunas I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -nodular, I-EXPLORATION -otras I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -de I-EXPLORATION -verrugas, I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -coloración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -bucal I-EXPLORATION -e I-EXPLORATION -indoloras. I-EXPLORATION -Las I-EXPLORATION -lesiones I-EXPLORATION -se I-EXPLORATION -localizaban I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -comisura I-EXPLORATION -labial I-EXPLORATION -bilateral, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -retrocomisural, I-EXPLORATION -bilateral, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -del I-EXPLORATION -labio I-EXPLORATION -superior I-EXPLORATION -e I-EXPLORATION -inferior, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -borde I-EXPLORATION -anterior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lengua I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -1/3 I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -palato I-EXPLORATION -duro, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -mediana. I-EXPLORATION -El I-EXPLORATION -tamaño I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -variaba I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -a I-EXPLORATION -5 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro. I-EXPLORATION -La I-EXPLORATION -sospecha I-EXPLORATION -clínica I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -Hiperplasia I-EXPLORATION -Focal I-EXPLORATION -del I-EXPLORATION -Epitelio. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -excisional I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones, I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -comisura I-EXPLORATION -labial I-EXPLORATION -lado I-EXPLORATION -derecho. I-EXPLORATION -El I-EXPLORATION -aspecto I-EXPLORATION -histopatológico I-EXPLORATION -demostró I-EXPLORATION -acantosis I-EXPLORATION -del I-EXPLORATION -epitelio, I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -crestas I-EXPLORATION -interpapilares I-EXPLORATION -ensanchadas, I-EXPLORATION -coilocitosis I-EXPLORATION -y I-EXPLORATION -alteración I-EXPLORATION -nuclear, I-EXPLORATION -conocida I-EXPLORATION -como I-EXPLORATION -figura I-EXPLORATION -mitosoide. I-EXPLORATION -La I-EXPLORATION -presencia I-EXPLORATION -del I-EXPLORATION -virus I-EXPLORATION -del I-EXPLORATION -HPV I-EXPLORATION -13 I-EXPLORATION -fue I-EXPLORATION -comprobada I-EXPLORATION -por I-EXPLORATION -análisis I-EXPLORATION -inmunohistoquímica. I-EXPLORATION -Esas I-EXPLORATION -características I-EXPLORATION -llevan I-EXPLORATION -al I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo I-EXPLORATION -de I-EXPLORATION -Hiperplasia I-EXPLORATION -Focal I-EXPLORATION -del I-EXPLORATION -Epitelio. I-EXPLORATION -A B-EVOLUTION -la I-EVOLUTION -madre I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -informó I-EVOLUTION -sobre I-EVOLUTION -las I-EVOLUTION -características I-EVOLUTION -de I-EVOLUTION -benignidad I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad I-EVOLUTION -y, I-EVOLUTION -se I-EVOLUTION -espera I-EVOLUTION -que I-EVOLUTION -disminuyan I-EVOLUTION -las I-EVOLUTION -lesiones. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -está I-EVOLUTION -en I-EVOLUTION -acompañamiento I-EVOLUTION -semestral. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -femenina I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -84 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que B-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Estomatología I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -Oral I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Universidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cartagena I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -presentar I-DERIVED_FROM/TO -molestia I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -cavidad I-DERIVED_FROM/TO -oral. I-DERIVED_FROM/TO -Al B-EXPLORATION -examen I-EXPLORATION -clínico I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -múltiples I-EXPLORATION -placas, I-EXPLORATION -manchas I-EXPLORATION -y I-EXPLORATION -verrugosidades I-EXPLORATION -distribuidas I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -irregular I-EXPLORATION -de I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -paladar I-EXPLORATION -duro I-EXPLORATION -comprometiendo I-EXPLORATION -tercio I-EXPLORATION -anterior I-EXPLORATION -y I-EXPLORATION -medio, I-EXPLORATION -del I-EXPLORATION -lado I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -derecho; I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -coloración I-EXPLORATION -de I-EXPLORATION -tonalidad I-EXPLORATION -variante I-EXPLORATION -desde I-EXPLORATION -un I-EXPLORATION -blanco I-EXPLORATION -grisáceo I-EXPLORATION -hasta I-EXPLORATION -un I-EXPLORATION -blanco I-EXPLORATION -amarillo; I-EXPLORATION -tamaño I-EXPLORATION -que I-EXPLORATION -oscila I-EXPLORATION -aproximadamente I-EXPLORATION -sobre I-EXPLORATION -3×5 I-EXPLORATION -cm, I-EXPLORATION -forma I-EXPLORATION -variada I-EXPLORATION -de I-EXPLORATION -superficie I-EXPLORATION -verrugosa I-EXPLORATION -y I-EXPLORATION -consistencia I-EXPLORATION -blanda, I-EXPLORATION -bordes I-EXPLORATION -definidos, I-EXPLORATION -asintomática; I-EXPLORATION -no I-EXPLORATION -desprende I-EXPLORATION -al I-EXPLORATION -raspado I-EXPLORATION -e I-EXPLORATION -imperceptible I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -misma. I-EXPLORATION -La B-PAST_MEDICAL_HISTORY +cuadro I-PAST_MEDICAL_HISTORY +depresivo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +doloroso. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY paciente I-PAST_MEDICAL_HISTORY -reporta I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -fumadora I-PAST_MEDICAL_HISTORY -invertida I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -40 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY +intentó I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +adaptación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +prótesis I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +poder I-PAST_MEDICAL_HISTORY +caminar I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +sesiones I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +rehabilitación, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +éxito I-PAST_MEDICAL_HISTORY +debido I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +secuela I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +dolor I-PAST_MEDICAL_HISTORY +crónico I-PAST_MEDICAL_HISTORY +consistente I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +flexo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cadera I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +EID I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +impidió I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +adaptación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +prótesis I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -fumar I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -cigarrillos I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -día. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -esta I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -da I-EXPLORATION -una I-EXPLORATION -impresión I-EXPLORATION -clínica I-EXPLORATION -de I-EXPLORATION -leucoplasia I-EXPLORATION -homogénea I-EXPLORATION -y, I-EXPLORATION -para I-EXPLORATION -realizar I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo, I-EXPLORATION -se I-EXPLORATION -programó I-EXPLORATION -biopsia I-EXPLORATION -incisional. I-EXPLORATION - I-EXPLORATION -Procedimiento B-TREATMENT - I-TREATMENT -Previo I-TREATMENT -consentimiento I-TREATMENT -informado, I-TREATMENT -se I-TREATMENT -aplica I-TREATMENT -t��cnica I-TREATMENT -anestésica I-TREATMENT -nasopalatina I-TREATMENT -y I-TREATMENT -palatina I-TREATMENT -anterior I-TREATMENT -bilateral, I-TREATMENT -utilizando I-TREATMENT -lidocaína I-TREATMENT -con I-TREATMENT -epinefrina I-TREATMENT -al I-TREATMENT -2%; I-TREATMENT -luego I-TREATMENT +como I-PAST_MEDICAL_HISTORY +consecuencia, I-PAST_MEDICAL_HISTORY +caminar I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +normalidad. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-TREATMENT +enero I-TREATMENT +de I-TREATMENT +2008 I-TREATMENT +acude I-TREATMENT +a I-TREATMENT +nuestra I-TREATMENT +Unidad I-TREATMENT +del I-TREATMENT +Dolor I-TREATMENT +donde I-TREATMENT se I-TREATMENT -realizó I-TREATMENT -incisión I-TREATMENT -romboidal I-TREATMENT -con I-TREATMENT -hoja I-TREATMENT +le I-TREATMENT +propone I-TREATMENT +la I-TREATMENT +implantación I-TREATMENT de I-TREATMENT -bisturí I-TREATMENT -número I-TREATMENT -15 I-TREATMENT -en I-TREATMENT -borde I-TREATMENT -anterior I-TREATMENT +bomba I-TREATMENT de I-TREATMENT -paladar I-TREATMENT -duro I-TREATMENT -del I-TREATMENT -lado I-TREATMENT -derecho, I-TREATMENT -seguido I-TREATMENT +infusión I-TREATMENT +continua I-TREATMENT de I-TREATMENT +Ziconotide I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +intratecal, I-TREATMENT +que I-TREATMENT la I-TREATMENT -disección I-TREATMENT +paciente I-TREATMENT +acepta I-TREATMENT +tras I-TREATMENT +ser I-TREATMENT +informada I-TREATMENT del I-TREATMENT -tejido, I-TREATMENT -el I-TREATMENT -cual I-TREATMENT +procedimiento, I-TREATMENT +posibles I-TREATMENT +resultados, I-TREATMENT +complicaciones I-TREATMENT +y I-TREATMENT +efectos I-TREATMENT +adversos. I-TREATMENT +Se I-TREATMENT +entrega I-TREATMENT +consentimiento I-TREATMENT +informado I-TREATMENT +y I-TREATMENT se I-TREATMENT -tomó I-TREATMENT -con I-TREATMENT -pinza I-TREATMENT -Alix I-TREATMENT +cita I-TREATMENT para I-TREATMENT -proteger I-TREATMENT +el I-TREATMENT +20/2/2008 I-TREATMENT +para I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +bomba. I-TREATMENT + I-TREATMENT +Colocación I-TREATMENT +de I-TREATMENT +bomba I-TREATMENT +intratecal I-TREATMENT +de I-TREATMENT +ziconotide I-TREATMENT y I-TREATMENT -manipular I-TREATMENT -mejor I-TREATMENT +evolución I-TREATMENT +posterior I-TREATMENT + I-TREATMENT +Con I-TREATMENT la I-TREATMENT -muestra I-TREATMENT -de I-TREATMENT -tejido, I-TREATMENT +paciente I-TREATMENT +en I-TREATMENT +decúbito I-TREATMENT +lateral I-TREATMENT se I-TREATMENT hace I-TREATMENT -hemostasia I-TREATMENT +incisión I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +de I-TREATMENT +abdomen I-TREATMENT +para I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +la I-TREATMENT +bomba I-TREATMENT +de I-TREATMENT +infusión I-TREATMENT +subcutánea. I-TREATMENT +Posteriormente I-TREATMENT +se I-TREATMENT +localiza I-TREATMENT +espacio I-TREATMENT +intradural I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +L4-L5 I-TREATMENT +donde I-TREATMENT +se I-TREATMENT +introduce I-TREATMENT +catéter I-TREATMENT +de I-TREATMENT +infusión I-TREATMENT +continua. I-TREATMENT +Dicho I-TREATMENT +catéter I-TREATMENT +se I-TREATMENT +tuneliza I-TREATMENT +vía I-TREATMENT +subcutánea I-TREATMENT +hasta I-TREATMENT +la I-TREATMENT +unión I-TREATMENT con I-TREATMENT -una I-TREATMENT -torunda I-TREATMENT +la I-TREATMENT +bomba I-TREATMENT de I-TREATMENT -gasa I-TREATMENT -estéril, I-TREATMENT -tomando I-TREATMENT -cuatro I-TREATMENT -puntos I-TREATMENT +infusión. I-TREATMENT +Cierre I-TREATMENT de I-TREATMENT -sutura I-TREATMENT +incisiones I-TREATMENT con I-TREATMENT -seda I-TREATMENT -3/0, I-TREATMENT -lavado I-TREATMENT -y I-TREATMENT -secado I-TREATMENT +sutura. I-TREATMENT +Programación I-TREATMENT de I-TREATMENT la I-TREATMENT -zona. I-TREATMENT -Se I-TREATMENT -dieron I-TREATMENT -indicaciones I-TREATMENT +bomba I-TREATMENT +de I-TREATMENT +ziconotide. I-TREATMENT +La I-TREATMENT +dosis I-TREATMENT +inicial I-TREATMENT +fue I-TREATMENT +de I-TREATMENT +1, I-TREATMENT +2 I-TREATMENT +microg/día I-TREATMENT +de I-TREATMENT +ziconotide I-TREATMENT +que I-TREATMENT a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT +lo I-TREATMENT +largo I-TREATMENT de I-TREATMENT -forma I-TREATMENT -verbal I-TREATMENT -y I-TREATMENT -por I-TREATMENT -escrito. I-TREATMENT +13 I-TREATMENT +meses I-TREATMENT +se I-TREATMENT +aumentó I-TREATMENT +a I-TREATMENT +7, I-TREATMENT +8 I-TREATMENT +microg/día. I-TREATMENT I-TREATMENT -La B-EVOLUTION +El B-EVOLUTION +estado I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION paciente I-EVOLUTION -regresa I-EVOLUTION +cuando I-EVOLUTION +acudió I-EVOLUTION +por I-EVOLUTION +primera I-EVOLUTION +vez I-EVOLUTION a I-EVOLUTION -un I-EVOLUTION -control I-EVOLUTION -posquirúrgico I-EVOLUTION +la I-EVOLUTION +Unidad I-EVOLUTION +era I-EVOLUTION +muy I-EVOLUTION +desfavorable: I-EVOLUTION +EVA I-EVOLUTION +8/10, I-EVOLUTION +imposibilidad I-EVOLUTION +de I-EVOLUTION +sueño I-EVOLUTION +reparador I-EVOLUTION +por I-EVOLUTION +despertares I-EVOLUTION +frecuentes I-EVOLUTION +por I-EVOLUTION +dolor, I-EVOLUTION +estreñimiento I-EVOLUTION +moderado I-EVOLUTION +debido I-EVOLUTION a I-EVOLUTION los I-EVOLUTION -7 I-EVOLUTION -días I-EVOLUTION -observándose I-EVOLUTION -tejidos I-EVOLUTION -en I-EVOLUTION -buen I-EVOLUTION +opiodes, I-EVOLUTION +falta I-EVOLUTION +de I-EVOLUTION +apetito, I-EVOLUTION +incapacidad I-EVOLUTION +de I-EVOLUTION +realizar I-EVOLUTION +actividad I-EVOLUTION +normal I-EVOLUTION +por I-EVOLUTION +dolor I-EVOLUTION +y I-EVOLUTION estado I-EVOLUTION +depresivo I-EVOLUTION +grave. I-EVOLUTION +Los I-EVOLUTION +requerimientos I-EVOLUTION +analgésicos I-EVOLUTION +eran I-EVOLUTION +altos I-EVOLUTION +con I-EVOLUTION +dosis I-EVOLUTION +muy I-EVOLUTION +elevada I-EVOLUTION +de I-EVOLUTION +opioides I-EVOLUTION y I-EVOLUTION -en I-EVOLUTION -proceso I-EVOLUTION +necesidad I-EVOLUTION de I-EVOLUTION -cicatrización. I-EVOLUTION -El B-EXPLORATION -reporte I-EXPLORATION -histopatológico I-EXPLORATION -indica I-EXPLORATION -mucosa I-EXPLORATION -palatina I-EXPLORATION -con I-EXPLORATION -marcada I-EXPLORATION -queratosis I-EXPLORATION -sin I-EXPLORATION -"displasia". I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizan I-EXPLORATION -controles I-EXPLORATION -mensuales I-EXPLORATION -observando I-EXPLORATION -la I-EXPLORATION -desaparición I-EXPLORATION -casi I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -patología; I-EXPLORATION -sin B-EVOLUTION -embargo I-EVOLUTION +rescates I-EVOLUTION +frecuentes I-EVOLUTION +(cada I-EVOLUTION +2 I-EVOLUTION +horas). I-EVOLUTION +Durante I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION -reporta I-EVOLUTION -que I-EVOLUTION -ha I-EVOLUTION -iniciado I-EVOLUTION -otra I-EVOLUTION -vez I-EVOLUTION -el I-EVOLUTION -hábito I-EVOLUTION +subida I-EVOLUTION +progresiva I-EVOLUTION de I-EVOLUTION -fumar I-EVOLUTION -invertido I-EVOLUTION -y, I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -último I-EVOLUTION -control, I-EVOLUTION +la I-EVOLUTION +bomba I-EVOLUTION +de I-EVOLUTION +ziconotide I-EVOLUTION se I-EVOLUTION -observa I-EVOLUTION -aparición I-EVOLUTION -nuevamente I-EVOLUTION +consiguió I-EVOLUTION +disminuir I-EVOLUTION +su I-EVOLUTION +tratamiento I-EVOLUTION +antiálgico I-EVOLUTION +y I-EVOLUTION +mejorar I-EVOLUTION +notablemente I-EVOLUTION +su I-EVOLUTION +dolor I-EVOLUTION +pasando I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -placas I-EVOLUTION -blancas. I-EVOLUTION -Observamos I-EVOLUTION -entonces I-EVOLUTION -una I-EVOLUTION -fuerte I-EVOLUTION -asociación I-EVOLUTION -entre I-EVOLUTION +8/10 I-EVOLUTION +a I-EVOLUTION +4/10 I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +escala I-EVOLUTION +EVA, I-EVOLUTION +además I-EVOLUTION +de I-EVOLUTION +un I-EVOLUTION +mayor I-EVOLUTION +descanso I-EVOLUTION +nocturno I-EVOLUTION +(durmiendo I-EVOLUTION +más I-EVOLUTION +de I-EVOLUTION +6 I-EVOLUTION +horas I-EVOLUTION +sin I-EVOLUTION +despertar I-EVOLUTION +por I-EVOLUTION el I-EVOLUTION -fumar I-EVOLUTION -invertido I-EVOLUTION +dolor), I-EVOLUTION +recuperar I-EVOLUTION +apetito, I-EVOLUTION +eliminar I-EVOLUTION +estreñimiento, I-EVOLUTION +volver I-EVOLUTION +a I-EVOLUTION +su I-EVOLUTION +vida I-EVOLUTION +cotidiana I-EVOLUTION y I-EVOLUTION +elevar I-EVOLUTION +su I-EVOLUTION +estado I-EVOLUTION +de I-EVOLUTION +ánimo. I-EVOLUTION +En I-EVOLUTION +este I-EVOLUTION +tiempo I-EVOLUTION +de I-EVOLUTION +adaptación I-EVOLUTION +dosis/efecto, I-EVOLUTION la I-EVOLUTION -aparición I-EVOLUTION +paciente I-EVOLUTION +tuvo I-EVOLUTION +periodos I-EVOLUTION +limitados I-EVOLUTION de I-EVOLUTION -lesiones I-EVOLUTION -premalignas. I-EVOLUTION +mareo, I-EVOLUTION +sensación I-EVOLUTION +de I-EVOLUTION +embotamiento I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +cabeza, I-EVOLUTION +acúfenos I-EVOLUTION +y I-EVOLUTION +cefalea I-EVOLUTION +que I-EVOLUTION +remitieron I-EVOLUTION +con I-EVOLUTION +tratamiento I-EVOLUTION +sintomático I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +paso I-EVOLUTION +del I-EVOLUTION +tiempo. I-EVOLUTION + I-EVOLUTION +Actualmente, I-EVOLUTION +continúa I-EVOLUTION +en I-EVOLUTION +seguimiento I-EVOLUTION +en I-EVOLUTION +nuestra I-EVOLUTION +unidad I-EVOLUTION +sin I-EVOLUTION +presentar I-EVOLUTION +recaída I-EVOLUTION +del I-EVOLUTION +dolor. I-EVOLUTION I-EVOLUTION Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -17 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino; I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -reiterados I-PRESENT_ILLNESS -accesos I-PRESENT_ILLNESS -dolorosos I-PRESENT_ILLNESS -caracterizados I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hemicrania I-PRESENT_ILLNESS -pulsátil, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -urente I-PRESENT_ILLNESS +70 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +cirrosis I-PAST_MEDICAL_HISTORY +hepática I-PAST_MEDICAL_HISTORY +virus I-PAST_MEDICAL_HISTORY +C I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +portal, I-PAST_MEDICAL_HISTORY +estadio I-PAST_MEDICAL_HISTORY +B I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Child-Pugh, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +episodios I-PAST_MEDICAL_HISTORY +previos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hemorragia I-PAST_MEDICAL_HISTORY +digestiva I-PAST_MEDICAL_HISTORY +alta I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +varices I-PAST_MEDICAL_HISTORY +esofágicas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +descompensación I-PAST_MEDICAL_HISTORY +edemoascítica. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Estando B-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +lista I-PRESENT_ILLNESS +activa I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -neurálgico I-PRESENT_ILLNESS +trasplante I-PRESENT_ILLNESS +hepático, I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -área I-PRESENT_ILLNESS -frontal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -retroorbitaria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fenómenos I-PRESENT_ILLNESS -productivos I-PRESENT_ILLNESS -autonómicos I-PRESENT_ILLNESS -homolaterales I-PRESENT_ILLNESS -(rinorrea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -lagrimeo). I-PRESENT_ILLNESS -Los I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -eran I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +control I-PRESENT_ILLNESS +ecográfico I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +cribado I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -corta I-PRESENT_ILLNESS -duración I-PRESENT_ILLNESS -(de I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS -segundos I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -minutos), I-PRESENT_ILLNESS -reiterados, I-PRESENT_ILLNESS -subintrantes, I-PRESENT_ILLNESS -postraban I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -deterioraban I-PRESENT_ILLNESS -sensiblemente I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -actividad I-PRESENT_ILLNESS -diaria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -vigilia. I-PRESENT_ILLNESS -Ocasionalmente I-PRESENT_ILLNESS +carcinoma I-PRESENT_ILLNESS +hepatocelular, I-PRESENT_ILLNESS se I-PRESENT_ILLNESS -acompañaban I-PRESENT_ILLNESS +detectan I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +LOES I-PRESENT_ILLNESS +hepáticas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -Este I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -presentaba, I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +1, I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +cm, I-PRESENT_ILLNESS +compatibles I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +hepatocarcinoma I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio, I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +técnicas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución; I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -analgésico I-PRESENT_ILLNESS +imagen I-PRESENT_ILLNESS +(ecografía I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +contraste I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -antimigrañoso I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -sido I-PRESENT_ILLNESS -totalmente I-PRESENT_ILLNESS -ineficaz. I-PRESENT_ILLNESS -Examen B-EXPLORATION -neurológico I-EXPLORATION -intercrítico I-EXPLORATION -normal. I-EXPLORATION -Valoración I-EXPLORATION -oftalmológica I-EXPLORATION -y I-EXPLORATION -otorrinolaringológica I-EXPLORATION -normales. I-EXPLORATION -Psicodiagnóstico I-EXPLORATION -y I-EXPLORATION -perfil I-EXPLORATION -de I-EXPLORATION -personalidad I-EXPLORATION -sin I-EXPLORATION -elementos I-EXPLORATION -remarcables. I-EXPLORATION -Se I-EXPLORATION -efectuaron I-EXPLORATION -neuroimágenes I-EXPLORATION -(RMN/RMN I-EXPLORATION -angiográfica), I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Se B-TREATMENT -empleó I-TREATMENT -indometacina, I-TREATMENT -con I-TREATMENT -muy I-TREATMENT -pobres I-TREATMENT -resultados. I-TREATMENT -Los B-EVOLUTION -indicadores I-EVOLUTION -de I-EVOLUTION -calidad I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -calendario I-EVOLUTION -de I-EVOLUTION -cefaleas I-EVOLUTION -mostraban I-EVOLUTION -un I-EVOLUTION -importante I-EVOLUTION -deterioro. I-EVOLUTION - I-EVOLUTION -Se B-TREATMENT -decidió I-TREATMENT -usar I-TREATMENT -entonces I-TREATMENT -alguno I-TREATMENT -de I-TREATMENT -los I-TREATMENT -fármacos I-TREATMENT -que I-TREATMENT -cumplen I-TREATMENT -un I-TREATMENT -rol I-TREATMENT -de I-TREATMENT -estabilizadores I-TREATMENT -de I-TREATMENT -membrana, I-TREATMENT -como I-TREATMENT -el I-TREATMENT -grupo I-TREATMENT -de I-TREATMENT -drogas I-TREATMENT -antiepilépticas I-TREATMENT -(DAE) I-TREATMENT -relativamente I-TREATMENT -nuevas, I-TREATMENT -entre I-TREATMENT -las I-TREATMENT -cuales I-TREATMENT -se I-TREATMENT -eligió I-TREATMENT -el I-TREATMENT -topiramato I-TREATMENT -(TPM). I-TREATMENT -Tal I-TREATMENT -decisión I-TREATMENT -tuvo I-TREATMENT -en I-TREATMENT -cuenta I-TREATMENT -informes I-TREATMENT -sobre I-TREATMENT -indicios I-TREATMENT -de I-TREATMENT -eficacia I-TREATMENT -en I-TREATMENT -el I-TREATMENT +TAC I-PRESENT_ILLNESS +abdominal). I-PRESENT_ILLNESS +Iniciamos B-TREATMENT tratamiento I-TREATMENT -del I-TREATMENT -SUNCT8 I-TREATMENT -y I-TREATMENT -su I-TREATMENT -mejor I-TREATMENT -perfil I-TREATMENT +percutáneo I-TREATMENT +mediante I-TREATMENT +etanolización I-TREATMENT de I-TREATMENT -bioseguridad, I-TREATMENT -respecto I-TREATMENT +la I-TREATMENT +LOE I-TREATMENT de I-TREATMENT -los I-TREATMENT -otros I-TREATMENT -agentes I-TREATMENT -(gabapentín, I-TREATMENT -lamotrigina). I-TREATMENT -Se I-TREATMENT -comenzó I-TREATMENT -con I-TREATMENT -25 I-TREATMENT -mg/d I-TREATMENT -en I-TREATMENT -una I-TREATMENT -sola I-TREATMENT -toma I-TREATMENT -nocturna I-TREATMENT -hasta I-TREATMENT -llegar I-TREATMENT -a I-TREATMENT -75 I-TREATMENT -mg/d I-TREATMENT -con I-TREATMENT -idéntica I-TREATMENT -posología. I-TREATMENT -La B-EVOLUTION -introducción I-EVOLUTION -del I-EVOLUTION -TPM I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -esquema I-EVOLUTION -redundó I-EVOLUTION -en I-EVOLUTION -una I-EVOLUTION -reducción I-EVOLUTION -parcial I-EVOLUTION -importante I-EVOLUTION -(50-75%, I-EVOLUTION -no I-EVOLUTION -completa) I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -episodios, I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -evidente I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -calidad I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -documentada I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -MIDAS, I-EVOLUTION -instrumento I-EVOLUTION -que I-EVOLUTION -si I-EVOLUTION -bien I-EVOLUTION -no I-EVOLUTION -fue I-EVOLUTION -desarrollado I-EVOLUTION -específicamente I-EVOLUTION -para I-EVOLUTION -el I-EVOLUTION -seguimiento I-EVOLUTION -de I-EVOLUTION -este I-EVOLUTION -cuadro I-EVOLUTION -permite I-EVOLUTION -valorar, I-EVOLUTION -mediante I-EVOLUTION -una I-EVOLUTION -escala I-EVOLUTION -global, I-EVOLUTION -el I-EVOLUTION -compromiso I-EVOLUTION -diario I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -afectado. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -niño I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -relevantes, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -comienza I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -febril I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -foco I-PRESENT_ILLNESS -detectable. I-PRESENT_ILLNESS -A B-EXPLORATION -las I-EXPLORATION -72 I-EXPLORATION -h I-EXPLORATION +mayor I-TREATMENT +tamaño, I-TREATMENT +realizando I-TREATMENT +tres I-TREATMENT +sesiones. I-TREATMENT + I-TREATMENT +En B-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION de I-EXPLORATION -iniciado I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -clínico, I-EXPLORATION -el I-EXPLORATION -niño I-EXPLORATION -refiere I-EXPLORATION -dolor I-EXPLORATION -e I-EXPLORATION -impotencia I-EXPLORATION -funcional I-EXPLORATION -en I-EXPLORATION -hombro I-EXPLORATION -derecho, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION +control, I-EXPLORATION +tras I-EXPLORATION +tres I-EXPLORATION +días I-EXPLORATION +desde I-EXPLORATION de I-EXPLORATION -flogosis I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico. I-EXPLORATION -En I-EXPLORATION la I-EXPLORATION -evaluación I-EXPLORATION -inicial I-EXPLORATION +última I-EXPLORATION +etanolización, I-EXPLORATION se I-EXPLORATION -solicitó I-EXPLORATION +observa I-EXPLORATION una I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION +trombosis I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +tronco I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +porta I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION +ramas I-EXPLORATION +principales, I-EXPLORATION +que I-EXPLORATION +exploramos I-EXPLORATION +con I-EXPLORATION ecografía I-EXPLORATION -del I-EXPLORATION -hombro I-EXPLORATION -afectado, I-EXPLORATION -ambos I-EXPLORATION -estudios I-EXPLORATION +abdominal I-EXPLORATION con I-EXPLORATION -resultados I-EXPLORATION -normales. I-EXPLORATION -Luego I-EXPLORATION +contraste I-EXPLORATION +(SonoVue®), I-EXPLORATION +sin I-EXPLORATION +apreciar I-EXPLORATION +captación I-EXPLORATION +en I-EXPLORATION +fase I-EXPLORATION +arterial I-EXPLORATION +ni I-EXPLORATION +posteriores, I-EXPLORATION +característica I-EXPLORATION +sugestiva I-EXPLORATION de I-EXPLORATION -presentar I-EXPLORATION -fiebre I-EXPLORATION -elevada I-EXPLORATION -y I-EXPLORATION -persistente I-EXPLORATION -durante I-EXPLORATION -6 I-EXPLORATION -días, I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -detecta I-EXPLORATION -eritema I-EXPLORATION +benignidad. I-EXPLORATION +La I-EXPLORATION +TAC I-EXPLORATION y I-EXPLORATION -edema I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -región I-EXPLORATION -esternoclavicular I-EXPLORATION -derecha, I-EXPLORATION -motivo I-EXPLORATION -por I-EXPLORATION +PAAF I-EXPLORATION +realizadas I-EXPLORATION +posteriormente, I-EXPLORATION +confirman I-EXPLORATION el I-EXPLORATION -cual I-EXPLORATION +origen I-EXPLORATION +benigno I-EXPLORATION +del I-EXPLORATION +trombo. I-EXPLORATION +Dado I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -decide I-EXPLORATION -su I-EXPLORATION -internación. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -iniciales I-EXPLORATION -revelan I-EXPLORATION -leucocitosis I-EXPLORATION -(GB: I-EXPLORATION -19.890/mm3 I-EXPLORATION -) I-EXPLORATION -con I-EXPLORATION -neutrofilia I-EXPLORATION -(85%) I-EXPLORATION -proteína I-EXPLORATION -C-reactiva I-EXPLORATION -(PC-R: I-EXPLORATION -90) I-EXPLORATION -y I-EXPLORATION -eritrosedimentación I-EXPLORATION -elevadas I-EXPLORATION -(ERS: I-EXPLORATION -57 I-EXPLORATION -mm). I-EXPLORATION -La I-EXPLORATION -CPK I-EXPLORATION -informa I-EXPLORATION -valores I-EXPLORATION -normales I-EXPLORATION -(50 I-EXPLORATION -UI/L). I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION +trata I-EXPLORATION de I-EXPLORATION un I-EXPLORATION -foco I-EXPLORATION -profundo I-EXPLORATION -de I-EXPLORATION -infección, I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION +hallazgo I-EXPLORATION +no I-EXPLORATION +presente I-EXPLORATION +en I-EXPLORATION +ecografías I-EXPLORATION +ni I-EXPLORATION +TAC I-EXPLORATION +abdominales I-EXPLORATION +previas, I-EXPLORATION +detectado I-EXPLORATION +en I-EXPLORATION una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RMN) I-EXPLORATION -que I-EXPLORATION -evidencia I-EXPLORATION -un I-EXPLORATION -intenso I-EXPLORATION -mioedema I-EXPLORATION -que I-EXPLORATION -compromete I-EXPLORATION -los I-EXPLORATION -músculos I-EXPLORATION -trapecio I-EXPLORATION -y I-EXPLORATION -pectoral I-EXPLORATION -mayor I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizan I-EXPLORATION -dos I-EXPLORATION -hemocultivos I-EXPLORATION -y B-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -cefalotina I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -parenteral. I-TREATMENT -Luego B-EVOLUTION -de I-EVOLUTION -48 I-EVOLUTION -h I-EVOLUTION -de I-EVOLUTION -iniciado I-EVOLUTION -el I-EVOLUTION -tratamiento, I-EVOLUTION -el I-EVOLUTION -niño I-EVOLUTION -continúa I-EVOLUTION -febril; I-EVOLUTION -además, I-EVOLUTION -presenta I-EVOLUTION -aumento I-EVOLUTION -del I-EVOLUTION -eritema I-EVOLUTION -y I-EVOLUTION -edema I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -zona I-EVOLUTION -afectada. I-EVOLUTION -Se B-EXPLORATION -reciben I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION -tomados I-EXPLORATION +ecografía I-EXPLORATION +posterior I-EXPLORATION al I-EXPLORATION -ingreso, I-EXPLORATION -que I-EXPLORATION -resultan I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -SAMRC I-EXPLORATION -(resistente I-EXPLORATION -a I-EXPLORATION -clindamicina); I-EXPLORATION -se B-TREATMENT -modifica I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT -terapéutico I-TREATMENT -y I-TREATMENT -se I-TREATMENT -indica I-TREATMENT -vancomicina I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -endovenosa I-TREATMENT -y I-TREATMENT -rifampicina I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral. I-TREATMENT -Dos B-EVOLUTION -días I-EVOLUTION -más I-EVOLUTION -tarde, I-EVOLUTION -la I-EVOLUTION -fiebre I-EVOLUTION -comienza I-EVOLUTION -a I-EVOLUTION -disminuir I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -lesión I-EVOLUTION -se I-EVOLUTION -torna I-EVOLUTION -circunscripta I-EVOLUTION -y I-EVOLUTION -fluctuante. I-EVOLUTION -Aparece I-EVOLUTION -además I-EVOLUTION -un I-EVOLUTION -exantema I-EVOLUTION -cutáneo I-EVOLUTION -eritematopustuloso I-EVOLUTION -con I-EVOLUTION -descamación I-EVOLUTION -que I-EVOLUTION -predomina I-EVOLUTION -en I-EVOLUTION -tronco I-EVOLUTION -y I-EVOLUTION -axila. I-EVOLUTION -Se B-EXPLORATION -realiza I-EXPLORATION -hisopado I-EXPLORATION -nasal, I-EXPLORATION -axilar I-EXPLORATION -y I-EXPLORATION -anal, I-EXPLORATION +tratamiento I-EXPLORATION +percutáneo I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -obtiene I-EXPLORATION el I-EXPLORATION -germen I-EXPLORATION -aislado I-EXPLORATION -previamente I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -nasal. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -RMN, I-EXPLORATION -se I-EXPLORATION -comprueba I-EXPLORATION -mayor I-EXPLORATION -jerarquía I-EXPLORATION -del I-EXPLORATION -edema I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -músculos I-EXPLORATION -trapecio I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +SonoVue®, I-EXPLORATION +TAC I-EXPLORATION y I-EXPLORATION -pectoral I-EXPLORATION -mayor I-EXPLORATION -derecho, I-EXPLORATION -extendiéndose I-EXPLORATION +PAAF I-EXPLORATION +confirman I-EXPLORATION el I-EXPLORATION -proceso I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -músculos I-EXPLORATION -pectoral I-EXPLORATION -menor, I-EXPLORATION -subclavio, I-EXPLORATION -romboides I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -tejido I-EXPLORATION -blando I-EXPLORATION -adyacente. I-EXPLORATION -Formación I-EXPLORATION -de I-EXPLORATION +origen I-EXPLORATION +benigno I-EXPLORATION +del I-EXPLORATION +trombo I-EXPLORATION +portal, I-EXPLORATION +se I-EXPLORATION +considera I-EXPLORATION +como I-EXPLORATION una I-EXPLORATION -colección I-EXPLORATION -líquida I-EXPLORATION -que I-EXPLORATION -rodea I-EXPLORATION -el I-EXPLORATION -tercio I-EXPLORATION -proximal I-EXPLORATION +complicación I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -clavícula I-EXPLORATION -derecha. I-EXPLORATION - I-EXPLORATION -Posteriormente, B-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -el I-TREATMENT -drenaje I-TREATMENT -del I-TREATMENT -absceso I-TREATMENT -por I-TREATMENT -punción I-TREATMENT -y I-TREATMENT -se I-TREATMENT -solicita I-TREATMENT -un I-TREATMENT -centellograma I-TREATMENT +etanolización. I-EXPLORATION +Iniciamos B-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +heparina I-TREATMENT +de I-TREATMENT +bajo I-TREATMENT +peso I-TREATMENT +molecular I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +1 I-TREATMENT +mg/kg/día I-TREATMENT +subcutánea, I-TREATMENT +comprobando I-TREATMENT +en I-TREATMENT +controles I-TREATMENT +ecográficos I-TREATMENT +posteriores I-TREATMENT que I-TREATMENT -descarta I-TREATMENT -el I-TREATMENT -compromiso I-TREATMENT -óseo. I-TREATMENT -El B-EVOLUTION -niño I-EVOLUTION -evoluciona I-EVOLUTION -favorablemente I-EVOLUTION -y B-TREATMENT -completa I-TREATMENT -diez I-TREATMENT +la I-TREATMENT +trombosis I-TREATMENT +ha I-TREATMENT +mejorado, I-TREATMENT +ya I-TREATMENT +que I-TREATMENT +tras I-TREATMENT +22 I-TREATMENT días I-TREATMENT de I-TREATMENT tratamiento I-TREATMENT -con I-TREATMENT -vancomicina I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -parenteral I-TREATMENT -y I-TREATMENT -luego, I-TREATMENT -veinte I-TREATMENT -días I-TREATMENT -con I-TREATMENT -trimetroprimasulfametoxasol I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral. I-TREATMENT +tan I-TREATMENT +sólo I-TREATMENT +está I-TREATMENT +presente I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +parcial I-TREATMENT +en I-TREATMENT +la I-TREATMENT +rama I-TREATMENT +portal I-TREATMENT +izquierda. I-TREATMENT I-TREATMENT +Finalmente B-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +es I-EVOLUTION +trasplantado, I-EVOLUTION +sin I-EVOLUTION +complicaciones I-EVOLUTION +hasta I-EVOLUTION +la I-EVOLUTION +actualidad. I-EVOLUTION + I-EVOLUTION -Niña B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS +62 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -patología I-PAST_MEDICAL_HISTORY -alérgica, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS un I-PRESENT_ILLNESS cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -urticaria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -angioedema I-PRESENT_ILLNESS -intratable I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -14 I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Pese B-TREATMENT -a I-TREATMENT -utilizarse I-TREATMENT -dosis I-TREATMENT -máximas I-TREATMENT -de I-TREATMENT -varios I-TREATMENT -antihistamínicos I-TREATMENT -combinados, I-TREATMENT -antileucotrienos I-TREATMENT -y I-TREATMENT -esteroides I-TREATMENT -orales I-TREATMENT -no I-TREATMENT -se I-TREATMENT -observó I-TREATMENT -respuesta I-TREATMENT -al I-TREATMENT -tratamiento. I-TREATMENT - I-TREATMENT -El B-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -repercutía I-PRESENT_ILLNESS -sobremanera I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -calidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -niña, I-PRESENT_ILLNESS -tanto I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -prurito I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -continuo I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -múltiples I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -placa I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -angioedema I-PRESENT_ILLNESS -claramente I-PRESENT_ILLNESS -visibles, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -afectan I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -sueño, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -escolaridad I-PRESENT_ILLNESS +disfagia I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +sólidos I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -interpersonal. I-PRESENT_ILLNESS -El B-EXPLORATION -laboratorio I-EXPLORATION -presentaba, I-EXPLORATION +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +kg I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso. I-PRESENT_ILLNESS +El B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +padecía I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +cirrosis I-PAST_MEDICAL_HISTORY +hepática I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +origen I-PAST_MEDICAL_HISTORY +etílico I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +estadio I-PAST_MEDICAL_HISTORY +B8 I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Child-Pugh. I-PAST_MEDICAL_HISTORY +Se B-EXPLORATION +realizó I-EXPLORATION +gastroscopia I-EXPLORATION +encontrando I-EXPLORATION +dilatación I-EXPLORATION +y I-EXPLORATION +atonía I-EXPLORATION +del I-EXPLORATION +cuerpo I-EXPLORATION +esofágico, I-EXPLORATION +así I-EXPLORATION como I-EXPLORATION -datos I-EXPLORATION -positivos: I-EXPLORATION -PCR, I-EXPLORATION -21; I-EXPLORATION -factor I-EXPLORATION -reumatoideo, I-EXPLORATION -24 I-EXPLORATION -UI/ml I-EXPLORATION -(normal I-EXPLORATION -hasta I-EXPLORATION -20). I-EXPLORATION -Se I-EXPLORATION -descartaron I-EXPLORATION -posibles I-EXPLORATION -causas I-EXPLORATION -infecciosas. I-EXPLORATION - I-EXPLORATION -Una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -no I-EXPLORATION -reveló I-EXPLORATION -signos I-EXPLORATION +tres I-EXPLORATION +cordones I-EXPLORATION +varicosos I-EXPLORATION de I-EXPLORATION -vasculitis. I-EXPLORATION -Se I-EXPLORATION -efectuaron I-EXPLORATION -dietas I-EXPLORATION +mediano I-EXPLORATION +tamaño I-EXPLORATION +en I-EXPLORATION +tercio I-EXPLORATION +inferior. I-EXPLORATION +Un I-EXPLORATION +tránsito I-EXPLORATION +baritado I-EXPLORATION +mostró I-EXPLORATION +dilatación I-EXPLORATION +esofágica I-EXPLORATION +con I-EXPLORATION +afilamiento I-EXPLORATION +distal. I-EXPLORATION +La I-EXPLORATION +manometría I-EXPLORATION +constató I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -exclusión I-EXPLORATION +peristaltismo I-EXPLORATION +en I-EXPLORATION +cuerpo I-EXPLORATION +esofágico. I-EXPLORATION +Un I-EXPLORATION +TC I-EXPLORATION +toraco-abdominal I-EXPLORATION +descartó I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -alimentos, I-EXPLORATION -aditivos I-EXPLORATION -y I-EXPLORATION -colorantes, I-EXPLORATION -sin I-EXPLORATION -mejoría I-EXPLORATION -sintomática. I-EXPLORATION +neoplasia I-EXPLORATION +regional. I-EXPLORATION Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -prueba I-EXPLORATION +obtuvo I-EXPLORATION +6 I-EXPLORATION +sobre I-EXPLORATION +un I-EXPLORATION +score I-EXPLORATION de I-EXPLORATION -suero I-EXPLORATION -autólogo, I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -hasta I-EXPLORATION -una I-EXPLORATION -dilución I-EXPLORATION -1: I-EXPLORATION -100, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -estableció I-EXPLORATION +disfagia I-EXPLORATION +de I-EXPLORATION +9 I-EXPLORATION +puntos I-EXPLORATION +(2). I-EXPLORATION +Con I-EXPLORATION el I-EXPLORATION diagnóstico I-EXPLORATION de I-EXPLORATION -urticaria I-EXPLORATION -crónica I-EXPLORATION -autoinmunitaria. I-EXPLORATION -Previamente B-TREATMENT -a I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -omalizumab I-TREATMENT -se I-TREATMENT -evaluaron I-TREATMENT -los I-TREATMENT -beneficios I-TREATMENT -y I-TREATMENT -riesgos I-TREATMENT -de I-TREATMENT -otros I-TREATMENT -tratamientos, I-TREATMENT -como I-TREATMENT -ciclosporina I-TREATMENT -o I-TREATMENT -gammaglobulina I-TREATMENT -intravenosa, I-TREATMENT -y I-TREATMENT -dadas I-TREATMENT +acalasia I-EXPLORATION +y B-TREATMENT +tras I-TREATMENT +valorar I-TREATMENT las I-TREATMENT -potenciales I-TREATMENT -y I-TREATMENT -mayores I-TREATMENT -complicaciones I-TREATMENT -y I-TREATMENT -riesgos I-TREATMENT -de I-TREATMENT -estos I-TREATMENT -tratamientos, I-TREATMENT +diferentes I-TREATMENT +opciones I-TREATMENT +terapéuticas I-TREATMENT se I-TREATMENT decidió I-TREATMENT -iniciar I-TREATMENT -omalizumab I-TREATMENT +realizar I-TREATMENT +ITB I-TREATMENT +guiada I-TREATMENT +por I-TREATMENT +ecoendoscopia. I-TREATMENT +Mediante I-TREATMENT +ecoendoscopio I-TREATMENT +Pentax I-TREATMENT +EG-3830UT I-TREATMENT +se I-TREATMENT +localizó I-TREATMENT +el I-TREATMENT +EEI I-TREATMENT +como I-TREATMENT +área I-TREATMENT +hipoecoica I-TREATMENT +engrosada I-TREATMENT +(7 I-TREATMENT +mm) I-TREATMENT en I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -calculada I-TREATMENT +continuidad I-TREATMENT +con I-TREATMENT +la I-TREATMENT +capa I-TREATMENT +muscular I-TREATMENT +propia I-TREATMENT de I-TREATMENT -acuerdo I-TREATMENT -al I-TREATMENT -valor I-TREATMENT +la I-TREATMENT +pared I-TREATMENT +esofágica. I-TREATMENT +En I-TREATMENT +dicha I-TREATMENT +zona I-TREATMENT +se I-TREATMENT +inyectó I-TREATMENT +mediante I-TREATMENT +aguja I-TREATMENT de I-TREATMENT -IgE I-TREATMENT -total I-TREATMENT -y I-TREATMENT -del I-TREATMENT -peso I-TREATMENT -corporal, I-TREATMENT -según I-TREATMENT +ecoendoscopio I-TREATMENT +de I-TREATMENT +22 I-TREATMENT +G I-TREATMENT +EchoTip I-TREATMENT +Ultra I-TREATMENT +(COOK I-TREATMENT +Medical), I-TREATMENT +un I-TREATMENT +ml I-TREATMENT +de I-TREATMENT +toxina I-TREATMENT +botulínica I-TREATMENT +(20 I-TREATMENT +UI) I-TREATMENT +(BoTox; I-TREATMENT +Inc., I-TREATMENT +Irvine, I-TREATMENT +Calif.) I-TREATMENT +diluida I-TREATMENT +a I-TREATMENT +1/5 I-TREATMENT +por I-TREATMENT +cuadrante I-TREATMENT +evitando I-TREATMENT la I-TREATMENT -dosificación I-TREATMENT -aprobada I-TREATMENT -para I-TREATMENT -asma I-TREATMENT -bronquial I-TREATMENT -(150 I-TREATMENT -mg I-TREATMENT -subcutáneos I-TREATMENT -mensuales). I-TREATMENT -Luego B-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -primera I-EVOLUTION -dosis I-EVOLUTION -recrudecieron I-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -por I-EVOLUTION -3 I-EVOLUTION -días I-EVOLUTION -y, I-EVOLUTION -posteriormente, I-EVOLUTION -la I-EVOLUTION -urticaria I-EVOLUTION -permaneció I-EVOLUTION -activa, I-EVOLUTION -pero I-EVOLUTION -estable. I-EVOLUTION -Luego I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -segunda I-EVOLUTION -dosis I-EVOLUTION -se I-EVOLUTION -repite I-EVOLUTION -el I-EVOLUTION -patrón, I-EVOLUTION -pero I-EVOLUTION -posteriormente I-EVOLUTION -comienza I-EVOLUTION -a I-EVOLUTION -disminuir I-EVOLUTION -la I-EVOLUTION -intensidad I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -pápulas I-EVOLUTION +inyección I-TREATMENT +intravariz. I-TREATMENT +No B-EVOLUTION +hubo I-EVOLUTION +complicaciones I-EVOLUTION y I-EVOLUTION -del I-EVOLUTION -angioedema; I-EVOLUTION -esta I-EVOLUTION -mejoría I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -torna I-EVOLUTION -más I-EVOLUTION -notable I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -tercera I-EVOLUTION -dosis, I-EVOLUTION -al I-EVOLUTION -cuarto I-EVOLUTION -mes I-EVOLUTION -(cuarta I-EVOLUTION -dosis) I-EVOLUTION -llega I-EVOLUTION -a I-EVOLUTION -una I-EVOLUTION -aparente I-EVOLUTION -remisión, I-EVOLUTION -hecho B-TREATMENT -que I-TREATMENT -permite I-TREATMENT -suspender I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -sucesiva I-TREATMENT -el I-TREATMENT -montelukast I-TREATMENT -y I-TREATMENT -la I-TREATMENT -ranitidina, I-TREATMENT -y I-TREATMENT -reducir I-TREATMENT -a I-TREATMENT -la I-TREATMENT -mitad I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -hidroxicina I-TREATMENT -sin I-TREATMENT -signos I-TREATMENT -de I-TREATMENT -recaída. I-TREATMENT -Hacia B-EVOLUTION el I-EVOLUTION -quinto I-EVOLUTION -mes, I-EVOLUTION -la I-EVOLUTION paciente I-EVOLUTION -se I-EVOLUTION -encontraba I-EVOLUTION -por I-EVOLUTION -completo I-EVOLUTION -asintomática, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -suspenden I-TREATMENT -los I-TREATMENT -antihistamínicos I-TREATMENT -remanentes. I-TREATMENT -Al B-EXPLORATION -sexto I-EXPLORATION -mes, I-EXPLORATION -se I-EXPLORATION -repite I-EXPLORATION -la I-EXPLORATION -prueba I-EXPLORATION -del I-EXPLORATION -suero I-EXPLORATION -autólogo, I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -negativa; I-EXPLORATION -se I-EXPLORATION -verifica I-EXPLORATION -normalización I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -PCR I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -factor I-EXPLORATION -reumatoideo. I-EXPLORATION -Posteriormente B-EVOLUTION -se I-EVOLUTION -completan I-EVOLUTION -12 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -omalizumab. I-EVOLUTION -Seis I-EVOLUTION +toleró I-EVOLUTION +dieta I-EVOLUTION +sólida I-EVOLUTION +en I-EVOLUTION +72 I-EVOLUTION +horas. I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +9 I-EVOLUTION meses I-EVOLUTION -después I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -suspensión I-EVOLUTION -del I-EVOLUTION -tratamiento, I-EVOLUTION -la I-EVOLUTION +evolución I-EVOLUTION +el I-EVOLUTION paciente I-EVOLUTION -continuó I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -alteraciones I-EVOLUTION -del I-EVOLUTION -laboratorio. I-EVOLUTION +solo I-EVOLUTION +refiere I-EVOLUTION +disfagia I-EVOLUTION +ocasional, I-EVOLUTION +puntuando I-EVOLUTION +1 I-EVOLUTION +sobre I-EVOLUTION +9 I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +score I-EVOLUTION +de I-EVOLUTION +disfagia. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -concurre I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -consultorio I-PRESENT_ILLNESS -luego I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS +Un B-PRESENT_ILLNESS +RN I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -interpretado, I-PRESENT_ILLNESS -doce I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -antes, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS +21 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -urgencia, I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +de B-PAST_MEDICAL_HISTORY +raza I-PAST_MEDICAL_HISTORY +negra I-PAST_MEDICAL_HISTORY +y B-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino, I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -broncoobstrucción I-PRESENT_ILLNESS -aguda I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -trató I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -salbutamol I-PRESENT_ILLNESS +urgencia I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +38, I-PRESENT_ILLNESS +5°C, I-PRESENT_ILLNESS +rechazo I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +pecho I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -prednisolona. I-PRESENT_ILLNESS -El B-PAST_MEDICAL_HISTORY -niño I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -eutrófico, I-PAST_MEDICAL_HISTORY -recién I-PAST_MEDICAL_HISTORY -nacido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -término, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY +manifestaciones I-PRESENT_ILLNESS +catarrales I-PRESENT_ILLNESS +respiratorias. I-PRESENT_ILLNESS +Los B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -destacar. I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +embarazo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +parto I-PAST_MEDICAL_HISTORY +-ocurrido I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +39 I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +gestación- I-PAST_MEDICAL_HISTORY +eran I-PAST_MEDICAL_HISTORY +normales; I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +puntaje I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Apgar I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +9-9 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +pesó I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +nacer I-PAST_MEDICAL_HISTORY +2.880 I-PAST_MEDICAL_HISTORY +g. I-PAST_MEDICAL_HISTORY +Egresó I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +hospital I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +lactancia I-PAST_MEDICAL_HISTORY +materna I-PAST_MEDICAL_HISTORY +exclusiva. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY Al B-EXPLORATION examen I-EXPLORATION físico I-EXPLORATION -presenta I-EXPLORATION -regular I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -fiebre I-EXPLORATION de I-EXPLORATION -38, I-EXPLORATION -2ºC, I-EXPLORATION -tumoración I-EXPLORATION -bilateral I-EXPLORATION -en I-EXPLORATION -cuello, I-EXPLORATION -blanda, I-EXPLORATION -dolorosa I-EXPLORATION +reingreso I-EXPLORATION +se I-EXPLORATION +constató I-EXPLORATION +buena I-EXPLORATION +vitalidad I-EXPLORATION +y I-EXPLORATION +coloración, I-EXPLORATION +pesaba I-EXPLORATION +3.580 I-EXPLORATION +g, I-EXPLORATION +tenía I-EXPLORATION +escasa I-EXPLORATION +rinorrea I-EXPLORATION +serosa I-EXPLORATION y I-EXPLORATION -con I-EXPLORATION -crepitación I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -zona I-EXPLORATION -submandibular. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -es I-EXPLORATION -normal, I-EXPLORATION -a I-EXPLORATION -excepción I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -otitis I-EXPLORATION -media I-EXPLORATION -aguda I-EXPLORATION -(OMA) I-EXPLORATION -congestiva I-EXPLORATION -izquierda. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -respiratorio I-EXPLORATION -presenta I-EXPLORATION -tos I-EXPLORATION -húmeda I-EXPLORATION -leve, I-EXPLORATION -sin I-EXPLORATION -disnea I-EXPLORATION -ni I-EXPLORATION -polipnea; I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION -30 I-EXPLORATION -por I-EXPLORATION -minuto, I-EXPLORATION sin I-EXPLORATION -tiraje; I-EXPLORATION -buena I-EXPLORATION -entrada I-EXPLORATION +otros I-EXPLORATION +hallazgos I-EXPLORATION +significativos. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +evaluación I-EXPLORATION +para I-EXPLORATION +pesquisa I-EXPLORATION de I-EXPLORATION -aire I-EXPLORATION -bilateral; I-EXPLORATION -rales I-EXPLORATION -subcrepitantes I-EXPLORATION -diseminados. I-EXPLORATION -No I-EXPLORATION +sepsis I-EXPLORATION se I-EXPLORATION -auscultan I-EXPLORATION -roncus I-EXPLORATION -o I-EXPLORATION -sibilancias I-EXPLORATION -(última I-EXPLORATION -nebulización I-EXPLORATION -con I-EXPLORATION -salbutamol I-EXPLORATION -hacía I-EXPLORATION -7 I-EXPLORATION -h). I-EXPLORATION -Se I-EXPLORATION -interpreta I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -como I-EXPLORATION -enfisema I-EXPLORATION -subcutáneo I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION -acceso I-EXPLORATION +estableció: I-EXPLORATION +leucocitos I-EXPLORATION de I-EXPLORATION -tos I-EXPLORATION -intensa I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -solicitan I-EXPLORATION -radiografías I-EXPLORATION -con I-EXPLORATION -nota I-EXPLORATION -al I-EXPLORATION -Servicio I-EXPLORATION +8.500/mm3 I-EXPLORATION +(PMN I-EXPLORATION +68%), I-EXPLORATION +VHS I-EXPLORATION +26 I-EXPLORATION +mm/h, I-EXPLORATION +examen I-EXPLORATION de I-EXPLORATION -Urgencias I-EXPLORATION -para I-EXPLORATION -eventual I-EXPLORATION -internación. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -interna I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realiza: I-EXPLORATION -saturometría I-EXPLORATION -O2 I-EXPLORATION -(FIO2 I-EXPLORATION -aire I-EXPLORATION -ambiental): I-EXPLORATION -97%, I-EXPLORATION -hemograma: I-EXPLORATION -glóbulos I-EXPLORATION -blancos: I-EXPLORATION -6.000 I-EXPLORATION -por I-EXPLORATION -mm3, I-EXPLORATION -hemoglobina: I-EXPLORATION -11 I-EXPLORATION -g%, I-EXPLORATION -fórmula I-EXPLORATION -leucocitaria: I-EXPLORATION -6/72/2/0/16/4; I-EXPLORATION +orina I-EXPLORATION +normal, I-EXPLORATION +examen I-EXPLORATION +citoquímico I-EXPLORATION +del I-EXPLORATION +LCR I-EXPLORATION +con I-EXPLORATION +6 I-EXPLORATION +leucocitos/mm3, I-EXPLORATION +86 I-EXPLORATION +hematíes I-EXPLORATION +/mm3, I-EXPLORATION proteína I-EXPLORATION -C-reactiva: I-EXPLORATION -45 I-EXPLORATION -mg/dl; I-EXPLORATION -medio I-EXPLORATION -interno I-EXPLORATION -normal I-EXPLORATION +60 I-EXPLORATION +mg/dl I-EXPLORATION y I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -bacterias I-EXPLORATION -atípicas. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -TAC. I-EXPLORATION -Se I-EXPLORATION -interna I-EXPLORATION -por I-EXPLORATION -72 I-EXPLORATION -h, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -constatan I-EXPLORATION -sibilancias I-EXPLORATION -ni I-EXPLORATION -espiración I-EXPLORATION -prolongada I-EXPLORATION -y B-TREATMENT +glucosa I-EXPLORATION +26 I-EXPLORATION +mg/dl; I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +sin I-EXPLORATION +alteraciones I-EXPLORATION +pleuro-pulmonares. I-EXPLORATION +Por B-TREATMENT +sus I-TREATMENT +buenas I-TREATMENT +condiciones I-TREATMENT +clínicas I-TREATMENT +y I-TREATMENT +exámenes I-TREATMENT +de I-TREATMENT +laboratorio I-TREATMENT +dentro I-TREATMENT +de I-TREATMENT +rangos I-TREATMENT +normales, I-TREATMENT se I-TREATMENT -da I-TREATMENT +ingresó I-TREATMENT +sin I-TREATMENT tratamiento I-TREATMENT -de I-TREATMENT -sostén I-TREATMENT -con I-TREATMENT -analgesia, I-TREATMENT -O2 I-TREATMENT -por I-TREATMENT -cánula I-TREATMENT -nasal I-TREATMENT -y I-TREATMENT -amoxicilina I-TREATMENT -para I-TREATMENT +antimicrobiano. I-TREATMENT + I-TREATMENT +Al I-TREATMENT +segundo I-TREATMENT +día I-TREATMENT +reapareció I-TREATMENT la I-TREATMENT -OMA. I-TREATMENT -Presenta B-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION +fiebre, I-TREATMENT +hasta I-TREATMENT +38, I-TREATMENT +0 I-TREATMENT +°C I-TREATMENT +y I-TREATMENT +se I-TREATMENT +informó I-TREATMENT +un I-TREATMENT +resultado I-TREATMENT +positivo I-TREATMENT +en I-TREATMENT +el I-TREATMENT +urocultivo, I-TREATMENT +(más I-TREATMENT +tarde, I-TREATMENT +se I-TREATMENT +identificó I-TREATMENT +una I-TREATMENT +Serratia I-TREATMENT +sp), I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +gentamicina I-TREATMENT +(7 I-TREATMENT +mg/kg/día) I-TREATMENT +ev. I-TREATMENT +El B-EXPLORATION +cultivo I-EXPLORATION +del I-EXPLORATION +LCR I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION +Entre B-EVOLUTION +el I-EVOLUTION +tercer I-EVOLUTION +y I-EVOLUTION +cuarto I-EVOLUTION +día I-EVOLUTION +apareció I-EVOLUTION +deterioro I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +condición I-EVOLUTION +clínica, I-EVOLUTION con I-EVOLUTION -disminución I-EVOLUTION +quejido, I-EVOLUTION +rechazo I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -tumoración I-EVOLUTION -cervical, I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -cervical I-EVOLUTION +lactancia I-EVOLUTION +materna, I-EVOLUTION +adinamia I-EVOLUTION +e I-EVOLUTION +hiporreflexia, I-EVOLUTION +somnolencia I-EVOLUTION +con I-EVOLUTION +irritabilidad, I-EVOLUTION +distensión I-EVOLUTION +abdominal I-EVOLUTION y I-EVOLUTION -la I-EVOLUTION -fiebre. I-EVOLUTION -La B-EXPLORATION +vómitos, I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +dificultad I-EVOLUTION +respiratoria, I-EVOLUTION +palidez, I-EVOLUTION +cianosis I-EVOLUTION +distal, I-EVOLUTION +taquicardia, I-EVOLUTION +oligoanuria I-EVOLUTION +y I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +hipoperfusión I-EVOLUTION +tisular, I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +aspecto I-EVOLUTION +tóxico-infeccioso, I-EVOLUTION +presentando I-EVOLUTION +convulsiones I-EVOLUTION +y I-EVOLUTION +bregma I-EVOLUTION +nor-motenso. I-EVOLUTION +Reevaluado B-EXPLORATION +con I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio, I-EXPLORATION +se I-EXPLORATION +encontró: I-EXPLORATION +leucocitos I-EXPLORATION +12.300/mm3 I-EXPLORATION +(PMN I-EXPLORATION +34% I-EXPLORATION +con I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +granulaciones I-EXPLORATION +tóxicas), I-EXPLORATION +VHS I-EXPLORATION +16 I-EXPLORATION +mm/h, I-EXPLORATION +plaquetas I-EXPLORATION +de I-EXPLORATION +110.000/mm3, I-EXPLORATION +gasometría I-EXPLORATION +con I-EXPLORATION +acidosis I-EXPLORATION +metabólica; I-EXPLORATION +examen I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION +normal, I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION radiografía I-EXPLORATION de I-EXPLORATION tórax I-EXPLORATION -al I-EXPLORATION -alta I-EXPLORATION -es I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Al I-EXPLORATION -5 I-EXPLORATION -to I-EXPLORATION -día I-EXPLORATION +aparecieron I-EXPLORATION +imágenes I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +síndrome I-EXPLORATION de I-EXPLORATION -evolución, I-EXPLORATION -ya I-EXPLORATION -en I-EXPLORATION -seguimiento I-EXPLORATION -ambulatorio, I-EXPLORATION -se I-EXPLORATION -recibe I-EXPLORATION -serología: I-EXPLORATION -IgM I-EXPLORATION -e I-EXPLORATION -IgG I-EXPLORATION -anti-Clamidia I-EXPLORATION -e I-EXPLORATION -IgM I-EXPLORATION -anti-Mycoplasma I-EXPLORATION -pneumoniae: I-EXPLORATION -negativos. I-EXPLORATION -La I-EXPLORATION -IgG I-EXPLORATION -anti-Mycoplasma I-EXPLORATION -pneumoniae I-EXPLORATION -fue I-EXPLORATION -positiva: I-EXPLORATION -1/80 I-EXPLORATION -por I-EXPLORATION -inmunofluorescencia I-EXPLORATION -indirecta. I-EXPLORATION -Se B-TREATMENT -decide I-TREATMENT -rotar I-TREATMENT -la I-TREATMENT -amoxicilina I-TREATMENT -por I-TREATMENT -claritromicina I-TREATMENT +dificultad I-EXPLORATION +respiratoria I-EXPLORATION +del I-EXPLORATION +adulto. I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +apoyado I-TREATMENT +con I-TREATMENT +cuidados I-TREATMENT +intensivos: I-TREATMENT +reposición I-TREATMENT +de I-TREATMENT +volumen, I-TREATMENT +inotrópicos, I-TREATMENT +ventilación I-TREATMENT +mecánica, I-TREATMENT +inmuno-moduladores I-TREATMENT +(inmunoglobulina I-TREATMENT +IV I-TREATMENT y I-TREATMENT -repetir I-TREATMENT -serología I-TREATMENT -a I-TREATMENT -los I-TREATMENT -15 I-TREATMENT -días I-TREATMENT +corticosteroides) I-TREATMENT +y I-TREATMENT +recibió I-TREATMENT +fenobarbital. I-TREATMENT +Se I-TREATMENT +indicó I-TREATMENT +penicilina I-TREATMENT +G I-TREATMENT +sódica I-TREATMENT +(200.000 I-TREATMENT +U/kg/día) I-TREATMENT +ev I-TREATMENT +al I-TREATMENT +conocerse I-TREATMENT +resultado I-TREATMENT +del I-TREATMENT +hemocultivo I-TREATMENT de I-TREATMENT -evolución. I-TREATMENT +ingreso I-TREATMENT +positivo I-TREATMENT +a I-TREATMENT +S. I-TREATMENT +pyogenes. I-TREATMENT A B-EVOLUTION -los I-EVOLUTION -15 I-EVOLUTION -d I-EVOLUTION -ías I-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +horas I-EVOLUTION de I-EVOLUTION -evolución I-EVOLUTION +iniciado I-EVOLUTION el I-EVOLUTION -paciente I-EVOLUTION +tratamiento I-EVOLUTION +antimicrobiano I-EVOLUTION se I-EVOLUTION -encuentra I-EVOLUTION -asintomático. I-EVOLUTION -Serología: B-EXPLORATION -IgM I-EXPLORATION -anti-Mycoplasma: I-EXPLORATION -negativa I-EXPLORATION -e I-EXPLORATION -IgG I-EXPLORATION -anti-Mycoplasma: I-EXPLORATION -positiva I-EXPLORATION -1/64 I-EXPLORATION -(IFI). I-EXPLORATION -IgA: I-EXPLORATION -108 I-EXPLORATION -mg/dl, I-EXPLORATION -IgE: I-EXPLORATION -31, I-EXPLORATION -1 I-EXPLORATION -UI/ml I-EXPLORATION -(vn: I-EXPLORATION -60-144), I-EXPLORATION -IgG: I-EXPLORATION -818 I-EXPLORATION -mg/dl I-EXPLORATION -(vn: I-EXPLORATION -315-1236), I-EXPLORATION -IgM: I-EXPLORATION -72 I-EXPLORATION -mg/dl I-EXPLORATION -(vn: I-EXPLORATION -43-207), I-EXPLORATION -proteinograma: I-EXPLORATION -proteínas I-EXPLORATION -totales: I-EXPLORATION -7, I-EXPLORATION -51, I-EXPLORATION -albúmina: I-EXPLORATION -4, I-EXPLORATION -49, I-EXPLORATION -alfa I-EXPLORATION -1: I-EXPLORATION -0, I-EXPLORATION -27, I-EXPLORATION -alfa I-EXPLORATION -2: I-EXPLORATION -101 I-EXPLORATION -(elevada), I-EXPLORATION -β-globulina: I-EXPLORATION -0, I-EXPLORATION -90, I-EXPLORATION -gamma: I-EXPLORATION -0, I-EXPLORATION -84. I-EXPLORATION -Relación I-EXPLORATION -albúmina-globulina: I-EXPLORATION -1, I-EXPLORATION -49 I-EXPLORATION -(normal). I-EXPLORATION -Luego B-EVOLUTION -de I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -evolución, I-EVOLUTION +repitió I-EVOLUTION +la I-EVOLUTION +punción I-EVOLUTION +lumbar I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +informó I-EVOLUTION el I-EVOLUTION -paciente I-EVOLUTION -sigue I-EVOLUTION -asintomático I-EVOLUTION +examen I-EVOLUTION +citoquímico I-EVOLUTION +del I-EVOLUTION +LCR I-EVOLUTION +con I-EVOLUTION +47 I-EVOLUTION +leucocitos/mm3, I-EVOLUTION +2.304 I-EVOLUTION +hematíes/mm3, I-EVOLUTION +proteína I-EVOLUTION +87 I-EVOLUTION +mg/dl I-EVOLUTION y I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -recurrencias. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -salud I-PAST_MEDICAL_HISTORY -relevantes, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -Universitario I-PRESENT_ILLNESS -Austral I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tumefacción I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -pie I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Se B-EXPLORATION -encontraba I-EXPLORATION -en I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -normotenso I-EXPLORATION -y I-EXPLORATION -afebril; I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -placa I-EXPLORATION -eritematosa I-EXPLORATION -y I-EXPLORATION -dolorosa I-EXPLORATION -en I-EXPLORATION -planta I-EXPLORATION -izquierda. I-EXPLORATION -Por B-EVOLUTION -sospecha I-EVOLUTION +glucosa I-EVOLUTION +18 I-EVOLUTION +mg/dl. I-EVOLUTION +El I-EVOLUTION +cultivo I-EVOLUTION +del I-EVOLUTION +LCR I-EVOLUTION de I-EVOLUTION +la I-EVOLUTION +segunda I-EVOLUTION +punción I-EVOLUTION +lumbar I-EVOLUTION +resultó I-EVOLUTION +negativo. I-EVOLUTION + I-EVOLUTION +En I-EVOLUTION +los I-EVOLUTION +días I-EVOLUTION +posteriores, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION un I-EVOLUTION -proceso I-EVOLUTION -infeccioso I-EVOLUTION -se I-EVOLUTION -decidió I-EVOLUTION -su I-EVOLUTION -internación. I-EVOLUTION -Se B-EXPLORATION -realizaron I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -que I-EXPLORATION -demostraron I-EXPLORATION -leucocitosis I-EXPLORATION -leve I-EXPLORATION -y I-EXPLORATION -eritrosedimentación I-EXPLORATION -elevada; I-EXPLORATION -dos I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -punción I-EXPLORATION -por I-EXPLORATION -piel I-EXPLORATION -sana, I-EXPLORATION -todos I-EXPLORATION -ellos I-EXPLORATION -negativos. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -solicitaron: I-EXPLORATION -radiografía, I-EXPLORATION -centellografía I-EXPLORATION -y I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION -del I-EXPLORATION -miembro I-EXPLORATION -afectado, I-EXPLORATION -descartándose I-EXPLORATION -compromiso I-EXPLORATION -óseo. I-EXPLORATION -Se B-TREATMENT -indicaron I-TREATMENT -ibuprofeno I-TREATMENT -400 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -6 I-TREATMENT -h I-TREATMENT -y I-TREATMENT -cefalotina I-TREATMENT -100 I-TREATMENT -mg/kg/día I-TREATMENT -cada I-TREATMENT -6 I-TREATMENT -h I-TREATMENT -asociada I-TREATMENT -a I-TREATMENT -gentamicina I-TREATMENT -5 I-TREATMENT -mg/kg/día I-TREATMENT -por I-TREATMENT -3 I-TREATMENT -días. I-TREATMENT -Por I-TREATMENT -evolución I-TREATMENT -desfavorable I-TREATMENT -se I-TREATMENT -rotó I-TREATMENT -a I-TREATMENT -clindamicina, I-TREATMENT -40 I-TREATMENT -mg/kg/día I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -h I-TREATMENT -asociada I-TREATMENT -a I-TREATMENT -rifampicina, I-TREATMENT -20 I-TREATMENT -mg/kg/día I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -h. I-TREATMENT -Al B-EVOLUTION -sexto I-EVOLUTION -día I-EVOLUTION +deterioro I-EVOLUTION +clínico I-EVOLUTION +progresivo I-EVOLUTION +con I-EVOLUTION +aparición I-EVOLUTION de I-EVOLUTION -internación, I-EVOLUTION +convulsiones, I-EVOLUTION por I-EVOLUTION -aparición I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +incrementó I-EVOLUTION +la I-EVOLUTION +dosis I-EVOLUTION de I-EVOLUTION -nódulos I-EVOLUTION +anticon-vulsivantes, I-EVOLUTION +cayó I-EVOLUTION en I-EVOLUTION -miembros I-EVOLUTION -superiores, I-EVOLUTION -fiebre I-EVOLUTION +coma I-EVOLUTION +profundo, I-EVOLUTION +con I-EVOLUTION +midriasis I-EVOLUTION y I-EVOLUTION -artralgias I-EVOLUTION -de I-EVOLUTION -tobillos I-EVOLUTION +respuesta I-EVOLUTION +pupilar I-EVOLUTION +débil, I-EVOLUTION +postura I-EVOLUTION +de I-EVOLUTION +descerebración I-EVOLUTION y I-EVOLUTION -muñecas I-EVOLUTION +bregma I-EVOLUTION +tenso. I-EVOLUTION +En I-EVOLUTION +el I-EVOLUTION +ultrasonido I-EVOLUTION +cerebral I-EVOLUTION se I-EVOLUTION -realizó I-EVOLUTION +apreciaba I-EVOLUTION una I-EVOLUTION -interconsulta I-EVOLUTION -con I-EVOLUTION +hemorragia I-EVOLUTION +periventricular I-EVOLUTION +e I-EVOLUTION +intraventricular. I-EVOLUTION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +para I-TREATMENT +la I-TREATMENT +hipertensión I-TREATMENT +intracraneal I-TREATMENT +y I-TREATMENT +se I-TREATMENT +cambió I-TREATMENT +los I-TREATMENT +antimicrobianos I-TREATMENT +iniciales I-TREATMENT +por I-TREATMENT +ceftriaxona I-TREATMENT +(130 I-TREATMENT +mg/kg/día) I-TREATMENT +ev. I-TREATMENT +Sin B-EVOLUTION +embargo, I-EVOLUTION el I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Dermatología. I-EVOLUTION +RN I-EVOLUTION +falleció. I-EVOLUTION En B-EXPLORATION -esa I-EXPLORATION -oportunidad, I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION +la I-EXPLORATION +necropsia I-EXPLORATION se I-EXPLORATION -observaron I-EXPLORATION -múltiples I-EXPLORATION -nódulos I-EXPLORATION -eritematosos, I-EXPLORATION -dolorosos, I-EXPLORATION -de I-EXPLORATION -1-2 I-EXPLORATION -cm, I-EXPLORATION -agrupados I-EXPLORATION -en I-EXPLORATION -miembros I-EXPLORATION -superiores I-EXPLORATION -e I-EXPLORATION -inferiores; I-EXPLORATION -otros I-EXPLORATION -nódulos I-EXPLORATION -eritematopurpúricos, I-EXPLORATION -de I-EXPLORATION -mayor I-EXPLORATION -tiempo I-EXPLORATION +comprobaron I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -evolución I-EXPLORATION -en I-EXPLORATION -arco I-EXPLORATION -interno I-EXPLORATION +meningitis I-EXPLORATION +con I-EXPLORATION +hemorragias I-EXPLORATION +y I-EXPLORATION +daño I-EXPLORATION +cerebral I-EXPLORATION +grave, I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -pie I-EXPLORATION -izquierdo I-EXPLORATION +shock I-EXPLORATION +séptico I-EXPLORATION y I-EXPLORATION -otro I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -posterior I-EXPLORATION +pulmones I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +síndrome I-EXPLORATION de I-EXPLORATION -tobillo I-EXPLORATION -derecho. I-EXPLORATION +dificultad I-EXPLORATION +respiratoria I-EXPLORATION +del I-EXPLORATION +adulto. I-EXPLORATION I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -palpaban I-EXPLORATION -adenomegalias I-EXPLORATION -ni I-EXPLORATION -se I-EXPLORATION -evidenciaban I-EXPLORATION -livedo I-EXPLORATION -reticular, I-EXPLORATION -ulceraciones I-EXPLORATION -u I-EXPLORATION -otros I-EXPLORATION -signos I-EXPLORATION -cutáneos. I-EXPLORATION -Con I-EXPLORATION -diagnósticos I-EXPLORATION -presuntivos I-EXPLORATION -de I-EXPLORATION -panarteritis I-EXPLORATION -nudosa I-EXPLORATION -cutánea I-EXPLORATION -(PANC), I-EXPLORATION -eritema I-EXPLORATION -nudoso I-EXPLORATION -atípico I-EXPLORATION -u I-EXPLORATION -otras I-EXPLORATION -paniculitis, I-EXPLORATION -se I-EXPLORATION -solicitaron I-EXPLORATION -estudios I-EXPLORATION -complementarios: I-EXPLORATION -recuento I-EXPLORATION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +39 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +trece I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cefalea I-PAST_MEDICAL_HISTORY +progresiva I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +intensidad I-PAST_MEDICAL_HISTORY +y, I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +ingreso I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +nuestra I-PAST_MEDICAL_HISTORY +institución, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +obstrucción I-PAST_MEDICAL_HISTORY +nasal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +anosmia I-PAST_MEDICAL_HISTORY +derechas. I-PAST_MEDICAL_HISTORY +Durante B-PRESENT_ILLNESS +todo I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +padecimiento I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +proptosis I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +derecho, I-PRESENT_ILLNESS +junto I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +diplopia I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +mirada I-PRESENT_ILLNESS +extrema. I-PRESENT_ILLNESS +La B-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +reveló I-EXPLORATION +proptosis I-EXPLORATION +derecha, I-EXPLORATION +con I-EXPLORATION +leve I-EXPLORATION +asimetría I-EXPLORATION +facial I-EXPLORATION +por I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -glóbulos I-EXPLORATION -blancos, I-EXPLORATION -10.900 I-EXPLORATION -(neutrófilos I-EXPLORATION -61%; I-EXPLORATION -linfocitos I-EXPLORATION -29%); I-EXPLORATION -hemoglobina, I-EXPLORATION -13, I-EXPLORATION -5 I-EXPLORATION -mg/dl; I-EXPLORATION -hematocrito, I-EXPLORATION -40%; I-EXPLORATION -plaquetas, I-EXPLORATION -292.000/ I-EXPLORATION -mm3; I-EXPLORATION -ESD I-EXPLORATION -32 I-EXPLORATION -mm/h, I-EXPLORATION -tiempo I-EXPLORATION +volumen I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -protrombina, I-EXPLORATION -96%; I-EXPLORATION -KPTT I-EXPLORATION -36 I-EXPLORATION -seg; I-EXPLORATION -ASTO I-EXPLORATION -400 I-EXPLORATION -UI/ml I-EXPLORATION -(VN<200 I-EXPLORATION -UI/ I-EXPLORATION -ml); I-EXPLORATION -complemento: I-EXPLORATION -C3 I-EXPLORATION -214 I-EXPLORATION -(VN: I-EXPLORATION -90-180); I-EXPLORATION -C4 I-EXPLORATION -45, I-EXPLORATION -3 I-EXPLORATION -(VN: I-EXPLORATION -10-40); I-EXPLORATION -FAN, I-EXPLORATION -ANCA, I-EXPLORATION -FR, I-EXPLORATION -serologías I-EXPLORATION -para I-EXPLORATION -VHB, I-EXPLORATION -VHC, I-EXPLORATION -Bartonella, I-EXPLORATION -Mycoplasma I-EXPLORATION +mejilla I-EXPLORATION +ipsilateral. I-EXPLORATION +La I-EXPLORATION +rinoscopía I-EXPLORATION +mostró I-EXPLORATION +abombamiento I-EXPLORATION +septal I-EXPLORATION +con I-EXPLORATION +convexidad I-EXPLORATION +izquierda I-EXPLORATION y I-EXPLORATION -EBV: I-EXPLORATION -negativas. I-EXPLORATION -Cultivo I-EXPLORATION -de I-EXPLORATION -fauces: I-EXPLORATION -negativo. I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +tumoral I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +área I-EXPLORATION +coanal I-EXPLORATION +derecha. I-EXPLORATION La I-EXPLORATION -PPD I-EXPLORATION -2 I-EXPLORATION -UT I-EXPLORATION +exploración I-EXPLORATION +neurológica I-EXPLORATION fue I-EXPLORATION -no I-EXPLORATION -reactiva. I-EXPLORATION -Además, I-EXPLORATION -se I-EXPLORATION -realizaron I-EXPLORATION -estudios I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -compromiso I-EXPLORATION -sistémico: I-EXPLORATION -hepatograma, I-EXPLORATION -urea, I-EXPLORATION -creatinina, I-EXPLORATION -ionograma, I-EXPLORATION -gases I-EXPLORATION -en I-EXPLORATION -sangre, I-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -orina, I-EXPLORATION -fondo I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +computada I-EXPLORATION +(TC) I-EXPLORATION +demostró I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +hipodensa, I-EXPLORATION +ovoidea, I-EXPLORATION +ocupando I-EXPLORATION +la I-EXPLORATION +fosa I-EXPLORATION +infratemporal, I-EXPLORATION +seno I-EXPLORATION +esfenoidal, I-EXPLORATION +espacio I-EXPLORATION +parafaríngeo I-EXPLORATION +y I-EXPLORATION +fosa I-EXPLORATION +nasal I-EXPLORATION +derechos, I-EXPLORATION +provocando I-EXPLORATION +compresión I-EXPLORATION +y I-EXPLORATION +desplazamientos I-EXPLORATION +rostral I-EXPLORATION de I-EXPLORATION -ojo, I-EXPLORATION -presión I-EXPLORATION -ocular, I-EXPLORATION -ecocardiografía I-EXPLORATION -Doppler, I-EXPLORATION -radiografía I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +caudal I-EXPLORATION +del I-EXPLORATION +seno I-EXPLORATION +maxilar, I-EXPLORATION +caudal I-EXPLORATION de I-EXPLORATION -tórax, I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION +la I-EXPLORATION +apófisis I-EXPLORATION +pterigoides I-EXPLORATION y I-EXPLORATION -ecografía I-EXPLORATION -Doppler I-EXPLORATION -de I-EXPLORATION -miembros I-EXPLORATION -inferiores, I-EXPLORATION -sin I-EXPLORATION -evidenciarse I-EXPLORATION -alteraciones. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION +dorsal I-EXPLORATION +del I-EXPLORATION +piso I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -biopsia I-EXPLORATION +órbita, I-EXPLORATION +contactando I-EXPLORATION +incluso I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +clivus; I-EXPLORATION +tras I-EXPLORATION +la I-EXPLORATION +administración I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -del I-EXPLORATION -miembro I-EXPLORATION -inferior I-EXPLORATION -demostró I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION +material I-EXPLORATION de I-EXPLORATION +contraste I-EXPLORATION +mostró I-EXPLORATION +escasa I-EXPLORATION +captación. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -interfaz I-EXPLORATION -dermohipodérmica I-EXPLORATION -y, I-EXPLORATION +imagen I-EXPLORATION +de I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(IRM) I-EXPLORATION +se I-EXPLORATION +mostró I-EXPLORATION +hipointensa I-EXPLORATION en I-EXPLORATION -hipodermis, I-EXPLORATION -compromiso I-EXPLORATION -inflamatorio I-EXPLORATION -neutrofílico I-EXPLORATION -y I-EXPLORATION -material I-EXPLORATION -fibrinoide I-EXPLORATION +T1 I-EXPLORATION +e I-EXPLORATION +hiperintensa I-EXPLORATION en I-EXPLORATION -las I-EXPLORATION -paredes I-EXPLORATION +T2, I-EXPLORATION +realzándose I-EXPLORATION +intensamente I-EXPLORATION +con I-EXPLORATION +gadolinio. I-EXPLORATION +Sus I-EXPLORATION +bordes I-EXPLORATION +aparecían I-EXPLORATION +bien I-EXPLORATION +definidos I-EXPLORATION +y, I-EXPLORATION +además I-EXPLORATION de I-EXPLORATION los I-EXPLORATION -vasos I-EXPLORATION -y I-EXPLORATION -arterias I-EXPLORATION +desplazamientos I-EXPLORATION +ya I-EXPLORATION +escritos I-EXPLORATION de I-EXPLORATION -pequeño I-EXPLORATION -calibre, I-EXPLORATION -con I-EXPLORATION -oclusión I-EXPLORATION -luminal I-EXPLORATION -focal I-EXPLORATION +la I-EXPLORATION +TC, I-EXPLORATION +se I-EXPLORATION +evidenció I-EXPLORATION +moldeamiento I-EXPLORATION +del I-EXPLORATION +paladar I-EXPLORATION +blando I-EXPLORATION y I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -algunos I-EXPLORATION -linfocitos I-EXPLORATION +duro I-EXPLORATION y I-EXPLORATION -numerosos I-EXPLORATION -eosinófilos. I-EXPLORATION -Estos I-EXPLORATION -hallazgos I-EXPLORATION -histopatológicos I-EXPLORATION -permiten I-EXPLORATION -arribar I-EXPLORATION -al I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -vasculitis I-EXPLORATION -de I-EXPLORATION -pequeños I-EXPLORATION -vasos I-EXPLORATION -dermohipodérmicos I-EXPLORATION +del I-EXPLORATION +septum I-EXPLORATION +nasal. I-EXPLORATION +También I-EXPLORATION +observamos I-EXPLORATION +adelgazamiento I-EXPLORATION y I-EXPLORATION -de I-EXPLORATION -arterias I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -calibre. I-EXPLORATION - I-EXPLORATION +deformidad I-EXPLORATION +del I-EXPLORATION +piso I-EXPLORATION +medio, I-EXPLORATION +lo I-EXPLORATION +cual I-EXPLORATION +hacía I-EXPLORATION +difícil I-EXPLORATION +determinar I-EXPLORATION +si I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +se I-EXPLORATION +originaba I-EXPLORATION +en I-EXPLORATION +dicha I-EXPLORATION +área, I-EXPLORATION +o I-EXPLORATION +era I-EXPLORATION +una I-EXPLORATION +extensión I-EXPLORATION +desde I-EXPLORATION +la I-EXPLORATION +fosa I-EXPLORATION +infratemporal. I-EXPLORATION Por I-EXPLORATION -las I-EXPLORATION -manifestaciones I-EXPLORATION -cutáneas I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION -de I-EXPLORATION +lo I-EXPLORATION +tanto, I-EXPLORATION los I-EXPLORATION -estudios I-EXPLORATION -complementarios I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +diagnósticos I-EXPLORATION +probables I-EXPLORATION +fueron I-EXPLORATION de I-EXPLORATION -PANC. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -la I-TREATMENT -suspensión I-TREATMENT +neurinoma I-EXPLORATION +y I-EXPLORATION +papiloma I-EXPLORATION +invertido I-EXPLORATION +del I-EXPLORATION +seno I-EXPLORATION +esfenoidal. I-EXPLORATION + I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +sometida I-TREATMENT +a I-TREATMENT +cirugía I-TREATMENT +mediante I-TREATMENT +incisión I-TREATMENT +sublabial I-TREATMENT +con I-TREATMENT +abordaje I-TREATMENT +intercartilaginoso I-TREATMENT +centrofacial I-TREATMENT +transmaxilar, I-TREATMENT +replegamiento I-TREATMENT del I-TREATMENT -antibiótico I-TREATMENT +colgajo I-TREATMENT +miocutáneo I-TREATMENT y I-TREATMENT -comenzar I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -meprednisona I-TREATMENT -1 I-TREATMENT -mg/kg/día, I-TREATMENT -dosis I-TREATMENT -diaria I-TREATMENT -total I-TREATMENT +abordaje I-TREATMENT +transmaxilar. I-TREATMENT +Se I-TREATMENT +halló I-TREATMENT +una I-TREATMENT +tumoración I-TREATMENT de I-TREATMENT -40 I-TREATMENT -mg I-TREATMENT -y I-TREATMENT -penicilina I-TREATMENT -profiláctica, I-TREATMENT -por I-TREATMENT -el I-TREATMENT -antecedente I-TREATMENT +bastante I-TREATMENT +consistencia I-TREATMENT +encapsulada I-TREATMENT +(como I-TREATMENT +tela I-TREATMENT de I-TREATMENT -un I-TREATMENT -ASTO I-TREATMENT -positivo. I-TREATMENT -Hubo B-EVOLUTION -mejoría I-EVOLUTION -parcial I-EVOLUTION -al I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -tratamiento, I-EVOLUTION -pero I-EVOLUTION -debido I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -lesiones, I-EVOLUTION -fiebre I-EVOLUTION -y I-EVOLUTION -artralgias, I-EVOLUTION -se B-TREATMENT -aumentó I-TREATMENT +hule) I-TREATMENT +de I-TREATMENT +coloración I-TREATMENT +grisácea, I-TREATMENT +escasamente I-TREATMENT +vascularizada I-TREATMENT +que I-TREATMENT +desplazaba I-TREATMENT +estructuras I-TREATMENT +vecinas. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT la I-TREATMENT -dosis I-TREATMENT +exéresis I-TREATMENT +intracapsular I-TREATMENT de I-TREATMENT -meprednisona I-TREATMENT -a I-TREATMENT -60 I-TREATMENT -mg/día I-TREATMENT -a I-TREATMENT -los I-TREATMENT -ocho I-TREATMENT -días I-TREATMENT -con B-EVOLUTION -respuesta I-EVOLUTION -favorable I-EVOLUTION -y I-EVOLUTION +la I-TREATMENT +lesión, I-TREATMENT +sin I-TREATMENT +incidentes. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +histopatológico I-EXPLORATION +reveló I-EXPLORATION +schwannoma. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +postoperatorio I-EVOLUTION +cursó I-EVOLUTION sin I-EVOLUTION -evidencia I-EVOLUTION -de I-EVOLUTION -rebrote I-EVOLUTION -en I-EVOLUTION +complicaciones I-EVOLUTION +y I-EVOLUTION +a I-EVOLUTION los I-EVOLUTION -controles I-EVOLUTION -posteriores. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -derivada B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -guardia I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -sanatorio I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -celulitis I-DERIVED_FROM/TO -orbitaria I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -internación, I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -antibiótico I-DERIVED_FROM/TO -endovenoso I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -evaluación I-DERIVED_FROM/TO -urgente I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -oftalmología. I-DERIVED_FROM/TO -Datos B-EXPLORATION -positivos I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico: I-EXPLORATION -eritema I-EXPLORATION -y I-EXPLORATION -edema I-EXPLORATION -de I-EXPLORATION -párpado I-EXPLORATION -superior I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -12 I-EXPLORATION -h I-EXPLORATION +tres I-EVOLUTION +meses I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +asintomática I-EVOLUTION +con I-EVOLUTION +mejoría I-EVOLUTION +notable I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +proptosis. I-EVOLUTION +La B-EXPLORATION +TC I-EXPLORATION de I-EXPLORATION -evolución I-EXPLORATION -que I-EXPLORATION -dificultaba I-EXPLORATION -la I-EXPLORATION -apertura I-EXPLORATION -ocular, I-EXPLORATION -limitación I-EXPLORATION +control I-EXPLORATION +mostró I-EXPLORATION +exéresis I-EXPLORATION +completa I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -mirada I-EXPLORATION -vertical, I-EXPLORATION -prurito I-EXPLORATION -y I-EXPLORATION -crepitación I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -del I-EXPLORATION -párpado. I-EXPLORATION -Se I-EXPLORATION -encontraba I-EXPLORATION -en I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general I-EXPLORATION -y I-EXPLORATION -afebril. I-EXPLORATION +lesión. I-EXPLORATION I-EXPLORATION -Al B-PAST_MEDICAL_HISTORY -profundizar I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -interrogatorio, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -descubre I-PAST_MEDICAL_HISTORY -mínimo I-PAST_MEDICAL_HISTORY -traumatismo I-PAST_MEDICAL_HISTORY + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +36 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -cara I-PAST_MEDICAL_HISTORY -ocurrido I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -h I-PAST_MEDICAL_HISTORY -previas I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -consulta I-PAST_MEDICAL_HISTORY +tabaquismo I-PAST_MEDICAL_HISTORY +leve, I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +celiaca, I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Graves I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +recibió I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +drogas I-PAST_MEDICAL_HISTORY +anti-tiroideas, I-PAST_MEDICAL_HISTORY +posterior I-PAST_MEDICAL_HISTORY +tiroidectomía I-PAST_MEDICAL_HISTORY +total I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hipotiroidismo I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY +vasculitis I-PAST_MEDICAL_HISTORY +ANCA I-PAST_MEDICAL_HISTORY +C I-PAST_MEDICAL_HISTORY +positiva I-PAST_MEDICAL_HISTORY +(enfermedad I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -estornudo I-PAST_MEDICAL_HISTORY -inmediatamente I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -inicio I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -clínico. I-PAST_MEDICAL_HISTORY -Con B-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -enfisema I-EXPLORATION -subcutáneo I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION -fractura I-EXPLORATION -de I-EXPLORATION -seno I-EXPLORATION -etmoidal I-EXPLORATION +Wegener I-PAST_MEDICAL_HISTORY +limitada). I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +meprednisona I-PAST_MEDICAL_HISTORY +60 I-PAST_MEDICAL_HISTORY +mg/día I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +ciclofosfamida I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +mg/kg/día I-PAST_MEDICAL_HISTORY +1 I-PAST_MEDICAL_HISTORY +mes I-PAST_MEDICAL_HISTORY +previo I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +internación. I-PAST_MEDICAL_HISTORY +Ingresó B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +UTI I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +disnea I-PRESENT_ILLNESS +súbita I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +estridor I-PRESENT_ILLNESS +laríngeo I-PRESENT_ILLNESS +inspiratorio, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +sibilancias. I-PRESENT_ILLNESS +Presentó I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +crisis I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +diez I-PRESENT_ILLNESS +minutos I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +aproximadamente I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +horas, I-PRESENT_ILLNESS +permaneciendo I-PRESENT_ILLNESS +asintomática I-PRESENT_ILLNESS +intercrisis. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +fibrolaringoscopía I-EXPLORATION +hasta I-EXPLORATION +cuarto I-EXPLORATION +anillo I-EXPLORATION +traqueal I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -solicita: I-EXPLORATION -Rx I-EXPLORATION +observaron I-EXPLORATION +lesiones I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +movilidad I-EXPLORATION de I-EXPLORATION -senos I-EXPLORATION -paranasales I-EXPLORATION -(velamiento I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -derecho), I-EXPLORATION +las I-EXPLORATION +cuerdas I-EXPLORATION +impresionó I-EXPLORATION +normal I-EXPLORATION +fuera I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +crisis. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION TAC I-EXPLORATION de I-EXPLORATION -orbita I-EXPLORATION +cuello I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +disminución I-EXPLORATION +del I-EXPLORATION +calibre I-EXPLORATION en I-EXPLORATION -cortes I-EXPLORATION -axiales I-EXPLORATION -y I-EXPLORATION -coronales I-EXPLORATION -(zona I-EXPLORATION -de I-EXPLORATION -hipodensidad I-EXPLORATION +región I-EXPLORATION +glótica I-EXPLORATION en I-EXPLORATION -párpado I-EXPLORATION -superior I-EXPLORATION -derecho, I-EXPLORATION -zona I-EXPLORATION -de I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -derecho I-EXPLORATION -levemente I-EXPLORATION -hiperdensa, I-EXPLORATION -desplazamiento I-EXPLORATION -del I-EXPLORATION -globo I-EXPLORATION -ocular I-EXPLORATION -derecho I-EXPLORATION -hacia I-EXPLORATION -abajo). I-EXPLORATION -Lámpara I-EXPLORATION -de I-EXPLORATION -hendidura, I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION +inspiración I-EXPLORATION +en I-EXPLORATION +forma I-EXPLORATION +simétrica I-EXPLORATION y I-EXPLORATION -fondo I-EXPLORATION +la I-EXPLORATION +traquea I-EXPLORATION +era I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +no I-EXPLORATION +presentó I-EXPLORATION +clínica I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION -normales. I-EXPLORATION +RGE I-EXPLORATION +y I-EXPLORATION +este I-EXPLORATION +se I-EXPLORATION +diagnóstico I-EXPLORATION +mediante I-EXPLORATION +SEGD. I-EXPLORATION Se I-EXPLORATION -diagnostica I-EXPLORATION -fractura I-EXPLORATION +realizó I-EXPLORATION +EFR I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +obstrucción I-EXPLORATION +moderada I-EXPLORATION +fija, I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +alteración I-EXPLORATION de I-EXPLORATION -lámina I-EXPLORATION -papirácea I-EXPLORATION -del I-EXPLORATION -etmoides. I-EXPLORATION -El B-EVOLUTION -enfisema I-EVOLUTION -subcutáneo I-EVOLUTION -secundario I-EVOLUTION -se I-EVOLUTION -reabsorbe I-EVOLUTION -espontáneamente I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -completa I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -4 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -evolución. I-EVOLUTION -Recibió B-TREATMENT +la I-EXPLORATION +curva I-EXPLORATION +inspiratoria. I-EXPLORATION +Permanece B-TREATMENT +en I-TREATMENT tratamiento I-TREATMENT -profiláctico I-TREATMENT con I-TREATMENT -amoxicilina/clavulánico I-TREATMENT +corticoides, I-TREATMENT +beta I-TREATMENT +2 I-TREATMENT +inhalados I-TREATMENT +de I-TREATMENT +larga I-TREATMENT +duración I-TREATMENT y I-TREATMENT +omeprazol I-TREATMENT +40 I-TREATMENT +mg/día. I-TREATMENT +No I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT tratamiento I-TREATMENT -sintomático. I-TREATMENT - I-TREATMENT +psicológico I-TREATMENT +ni I-TREATMENT +fonoudiológico. I-TREATMENT +Se B-EVOLUTION +encuentra I-EVOLUTION +asintomática I-EVOLUTION +desde I-EVOLUTION +hace I-EVOLUTION +4 I-EVOLUTION +meses. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS +Niña B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -(39 I-PRESENT_ILLNESS -ºC) I-PRESENT_ILLNESS +cuando I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +inicia I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +cuadro. I-PRESENT_ILLNESS +Presenta I-PRESENT_ILLNESS +esguince I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS +tobillo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +desarrollo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +SDRC I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tobillo I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal. I-PRESENT_ILLNESS -Antecedentes B-PAST_MEDICAL_HISTORY -personales: I-PAST_MEDICAL_HISTORY -recién I-PAST_MEDICAL_HISTORY -nacido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -gesta I-PAST_MEDICAL_HISTORY -1, I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -controlado, I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -normal, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -término I-PAST_MEDICAL_HISTORY -(40 I-PAST_MEDICAL_HISTORY -semanas), I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -adecuado I-PAST_MEDICAL_HISTORY -(3360 I-PAST_MEDICAL_HISTORY -kg). I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -diagnosticaron I-PAST_MEDICAL_HISTORY -miopía, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encuentra I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -oftalmología. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -infección I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -tracto I-PAST_MEDICAL_HISTORY -urinario I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -Escherichia I-PAST_MEDICAL_HISTORY -coli, I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -ambulatorio, I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -realizaron I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -posteriores I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -esta I-PAST_MEDICAL_HISTORY -patología. I-PAST_MEDICAL_HISTORY -Refiere I-PAST_MEDICAL_HISTORY -poliuria I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -polidipsia I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -temprana I-PAST_MEDICAL_HISTORY -edad. I-PAST_MEDICAL_HISTORY -Antecedentes B-FAMILY_HISTORY -familiares: I-FAMILY_HISTORY -abuela I-FAMILY_HISTORY -paterna I-FAMILY_HISTORY -hipoacúsica, I-FAMILY_HISTORY -primo I-FAMILY_HISTORY -paterno I-FAMILY_HISTORY -con I-FAMILY_HISTORY -litiasis I-FAMILY_HISTORY -renal, I-FAMILY_HISTORY -padre I-FAMILY_HISTORY -con I-FAMILY_HISTORY -microhematuria. I-FAMILY_HISTORY -Al B-EXPLORATION -ingreso, I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -eutrófica I-EXPLORATION -(peso: I-EXPLORATION -17.400 I-EXPLORATION -kg, I-EXPLORATION -talla: I-EXPLORATION -104 I-EXPLORATION -cm), I-EXPLORATION -en I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -febril, I-EXPLORATION -normotensa. I-EXPLORATION -Por I-EXPLORATION -presentar I-EXPLORATION -orina I-EXPLORATION -patológica I-EXPLORATION -se I-EXPLORATION -solicitan: I-EXPLORATION -urocultivo, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -informa I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -Escherichia I-EXPLORATION -coli, I-EXPLORATION -y I-EXPLORATION -ecografía I-EXPLORATION -renal I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -evidencian I-EXPLORATION -imágenes I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -nefrocalcinosis. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -calcificaciones I-EXPLORATION -renales. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -manifestaron I-EXPLORATION -insuficiencia I-EXPLORATION -renal I-EXPLORATION -(depuración I-EXPLORATION -de I-EXPLORATION -creatinina I-EXPLORATION -50 I-EXPLORATION -ml/min/1, I-EXPLORATION -73, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -calculó I-EXPLORATION -por I-EXPLORATION -fórmula), I-EXPLORATION -hipercalciuria I-EXPLORATION -(13 I-EXPLORATION -mg/kg/d), I-EXPLORATION -hipomagnesemia, I-EXPLORATION -hipermagnesuria, I-EXPLORATION -anemia I-EXPLORATION -y I-EXPLORATION -acidosis. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -evaluación I-EXPLORATION -cardiológica I-EXPLORATION -y I-EXPLORATION -otorrinolaringológica I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -En I-EXPLORATION -oftalmología I-EXPLORATION -se I-EXPLORATION -diagnosticó I-EXPLORATION -"coriorretinitis I-EXPLORATION -cicatrizal I-EXPLORATION -macular, I-EXPLORATION -coriopatía I-EXPLORATION -miópica". I-EXPLORATION -Se I-EXPLORATION -arriba I-EXPLORATION -al I-EXPLORATION -diagnóstico I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -hipercalciuria, I-EXPLORATION -nefrocalcinosis, I-EXPLORATION -hipomagnesemia, I-EXPLORATION -hipermagnesuria I-EXPLORATION -e I-EXPLORATION -insuficiencia I-EXPLORATION -renal, I-EXPLORATION -asociadas I-EXPLORATION -a I-EXPLORATION -patología I-EXPLORATION -ocular I-EXPLORATION -y I-EXPLORATION -antecedentes I-EXPLORATION -personales I-EXPLORATION -y I-EXPLORATION -familiares I-EXPLORATION -compatibles. I-EXPLORATION -Cumplió B-TREATMENT +pie I-PRESENT_ILLNESS +izquierdo. I-PRESENT_ILLNESS +Es B-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +Unidad I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +Dolor I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Reumatología I-DERIVED_FROM/TO +Pediátrica I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +cuatro I-DERIVED_FROM/TO +años I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +diagnóstico. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Se B-TREATMENT +le I-TREATMENT +administra I-TREATMENT tratamiento I-TREATMENT -para I-TREATMENT -infección I-TREATMENT -urinaria. I-TREATMENT -Se I-TREATMENT -indicó I-TREATMENT -citrato I-TREATMENT +farmacológico I-TREATMENT +más I-TREATMENT +aplicación I-TREATMENT de I-TREATMENT -potasio, I-TREATMENT -amiloride-hidroclorotiazida I-TREATMENT -25 I-TREATMENT -mg/día, I-TREATMENT -pidolato I-TREATMENT +parche I-TREATMENT de I-TREATMENT -magnesio I-TREATMENT -1, I-TREATMENT -5 I-TREATMENT -g/ I-TREATMENT -día, I-TREATMENT -ácido I-TREATMENT -fólico I-TREATMENT -5 I-TREATMENT -mg/día, I-TREATMENT -sulfato I-TREATMENT -ferroso I-TREATMENT -3 I-TREATMENT -mg/ I-TREATMENT -kg/día, I-TREATMENT -dieta I-TREATMENT -hiposódica I-TREATMENT -controlada I-TREATMENT +capsaicina I-TREATMENT +al I-TREATMENT +8 I-TREATMENT +% I-TREATMENT +sin I-TREATMENT +remisión I-TREATMENT +del I-TREATMENT +cuadro. I-TREATMENT +Colocación I-TREATMENT en I-TREATMENT -proteínas I-TREATMENT +quirófano, I-TREATMENT +bajo I-TREATMENT +anestesia I-TREATMENT +general I-TREATMENT y I-TREATMENT -líquidos I-TREATMENT +previo I-TREATMENT +consentimiento I-TREATMENT +paterno, I-TREATMENT +de I-TREATMENT +un I-TREATMENT +catéter I-TREATMENT +epidural I-TREATMENT +lumbar I-TREATMENT +y I-TREATMENT +conexión I-TREATMENT a I-TREATMENT -demanda. I-TREATMENT -Durante B-EVOLUTION -su I-EVOLUTION -evolución I-EVOLUTION -presentó I-EVOLUTION -nueva I-EVOLUTION -infección I-EVOLUTION -urinaria I-EVOLUTION -a I-EVOLUTION -E. I-EVOLUTION -coli, I-EVOLUTION -se B-EXPLORATION -realizó I-EXPLORATION -cistouretrografía I-EXPLORATION -miccional, I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal, I-EXPLORATION -y B-TREATMENT +una I-TREATMENT +bomba I-TREATMENT +externa I-TREATMENT +para I-TREATMENT +administración I-TREATMENT +de I-TREATMENT +una I-TREATMENT +infusión I-TREATMENT +continúa I-TREATMENT +de I-TREATMENT +bupivacaína I-TREATMENT +durante I-TREATMENT +dos I-TREATMENT +semanas. I-TREATMENT +Retirada I-TREATMENT +del I-TREATMENT +catéter I-TREATMENT +pasado I-TREATMENT +ese I-TREATMENT +tiempo. I-TREATMENT +Remisión B-EVOLUTION +completa I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +síntomas. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +46 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +diagnosticada B-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +14 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +PQH I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +poliquistosis I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sometida I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +ocasiones I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +drenaje I-PAST_MEDICAL_HISTORY +percutáneo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +quistes I-PAST_MEDICAL_HISTORY +hepáticos. I-PAST_MEDICAL_HISTORY +La B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +incluida I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +lista I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +espera I-PRESENT_ILLNESS +(LE) I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +trasplante I-PRESENT_ILLNESS +hepático I-PRESENT_ILLNESS +(TH) I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +diagnóstico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +PQH I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +criterios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hepatomegalia I-PRESENT_ILLNESS +gigantesca, I-PRESENT_ILLNESS +caquexia, I-PRESENT_ILLNESS +hipertensión I-PRESENT_ILLNESS +portal, I-PRESENT_ILLNESS +ascitis, I-PRESENT_ILLNESS +minusvalía I-PRESENT_ILLNESS +física I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +social I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +insuficiencia I-PRESENT_ILLNESS +renal I-PRESENT_ILLNESS +crónica I-PRESENT_ILLNESS +grado I-PRESENT_ILLNESS +II I-PRESENT_ILLNESS +(creatinemia I-PRESENT_ILLNESS +2, I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +mg/dl). I-PRESENT_ILLNESS +La B-EXPLORATION +puntuación I-EXPLORATION +MELD I-EXPLORATION +era I-EXPLORATION +de I-EXPLORATION +23. I-EXPLORATION +El B-TREATMENT +TH I-TREATMENT se I-TREATMENT -inició I-TREATMENT -profilaxis I-TREATMENT -antibiótica I-TREATMENT +realizó I-TREATMENT con I-TREATMENT -nitrofurantoína. I-TREATMENT -Se I-TREATMENT -suspendió I-TREATMENT la I-TREATMENT -hidroclorotiazida I-TREATMENT -a I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -meses I-TREATMENT +técnica I-TREATMENT de I-TREATMENT -tratamiento I-TREATMENT -por I-TREATMENT -brusco I-TREATMENT -aumento I-TREATMENT +la I-TREATMENT +preservación I-TREATMENT de I-TREATMENT -urea I-TREATMENT +la I-TREATMENT +vena I-TREATMENT +cava I-TREATMENT +inferior I-TREATMENT +(técnica I-TREATMENT +de I-TREATMENT +piggy-back), I-TREATMENT +sin I-TREATMENT +by-pass I-TREATMENT +veno-venoso I-TREATMENT y I-TREATMENT -creatinina, I-TREATMENT -con I-TREATMENT -mejoría I-TREATMENT -posterior I-TREATMENT +reconstrucción I-TREATMENT +biliar I-TREATMENT +mediante I-TREATMENT +colédoco-yeyunostomía I-TREATMENT +sobre I-TREATMENT +asa I-TREATMENT +desfuncionalizada I-TREATMENT +en I-TREATMENT +Y I-TREATMENT +de I-TREATMENT +Roux. I-TREATMENT +El I-TREATMENT +injerto I-TREATMENT +se I-TREATMENT +perfundió I-TREATMENT y I-TREATMENT -mantenimiento I-TREATMENT +almacenó I-TREATMENT +con I-TREATMENT +la I-TREATMENT +solución I-TREATMENT de I-TREATMENT -valores I-TREATMENT +preservación I-TREATMENT de I-TREATMENT -calciuria I-TREATMENT -dentro I-TREATMENT +Celsior. I-TREATMENT +Tiempo I-TREATMENT +de I-TREATMENT +isquemia I-TREATMENT +fría: I-TREATMENT +5 I-TREATMENT +h I-TREATMENT +50 I-TREATMENT +min. I-TREATMENT +Peso I-TREATMENT de I-TREATMENT la I-TREATMENT -normalidad. I-TREATMENT -Se B-EVOLUTION -mantiene I-EVOLUTION -hasta I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -el I-EVOLUTION -resto I-EVOLUTION +pieza I-TREATMENT +de I-TREATMENT +hepatectomía: I-TREATMENT +14 I-TREATMENT +kg. I-TREATMENT +No I-TREATMENT +se I-TREATMENT +presentó I-TREATMENT +síndrome I-TREATMENT +de I-TREATMENT +reperfusión. I-TREATMENT +Duración I-TREATMENT +de I-TREATMENT +la I-TREATMENT +intervención: I-TREATMENT +6 I-TREATMENT +h I-TREATMENT +25 I-TREATMENT +min. I-TREATMENT +Transfusión: I-TREATMENT +2.620 I-TREATMENT +cc I-TREATMENT +de I-TREATMENT +concentrados I-TREATMENT +de I-TREATMENT +hematíes I-TREATMENT +y I-TREATMENT +2.370 I-TREATMENT +cc I-TREATMENT +de I-TREATMENT +plasma. I-TREATMENT +Debido I-TREATMENT +a I-TREATMENT +la I-TREATMENT +insuficiencia I-TREATMENT +renal, I-TREATMENT +la I-TREATMENT +inducción I-TREATMENT +de I-TREATMENT +la I-TREATMENT +inmunosupresión I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +con I-TREATMENT +basiliximab I-TREATMENT +y I-TREATMENT +corticoides; I-TREATMENT +al I-TREATMENT +4º I-TREATMENT +día I-TREATMENT +del I-TREATMENT +trasplante, I-TREATMENT +siendo I-TREATMENT +normal I-TREATMENT +la I-TREATMENT +creatinina I-TREATMENT +(1 I-TREATMENT +mg/dl), I-TREATMENT +se I-TREATMENT +introdujo I-TREATMENT +tacrolimus. I-TREATMENT +La B-EVOLUTION +estancia I-EVOLUTION +en I-EVOLUTION +UCI I-EVOLUTION +fue I-EVOLUTION +de I-EVOLUTION +4 I-EVOLUTION +días. I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +14 I-EVOLUTION +días I-EVOLUTION +del I-EVOLUTION +TH I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION de I-EVOLUTION +alta I-EVOLUTION +hospitalaria. I-EVOLUTION +Actualmente I-EVOLUTION +han I-EVOLUTION +transcurrido I-EVOLUTION +5 I-EVOLUTION +años I-EVOLUTION +y I-EVOLUTION +medio I-EVOLUTION +desde I-EVOLUTION +el I-EVOLUTION +TH, I-EVOLUTION la I-EVOLUTION -medicación. I-EVOLUTION +enferma I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +bien, I-EVOLUTION +hace I-EVOLUTION +vida I-EVOLUTION +normal I-EVOLUTION +y I-EVOLUTION +las I-EVOLUTION +pruebas I-EVOLUTION +de I-EVOLUTION +función I-EVOLUTION +hepática I-EVOLUTION +son I-EVOLUTION +normales. I-EVOLUTION I-EVOLUTION -Embarazada B-PRESENT_ILLNESS +Niña B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -28 I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad, I-PRESENT_ILLNESS -procedente B-FAMILY_HISTORY -de I-FAMILY_HISTORY -Embarcación I-FAMILY_HISTORY -(Salta), I-FAMILY_HISTORY -que I-FAMILY_HISTORY -cursaba I-FAMILY_HISTORY -su I-FAMILY_HISTORY -segunda I-FAMILY_HISTORY -gesta I-FAMILY_HISTORY -en I-FAMILY_HISTORY -semana I-FAMILY_HISTORY -38 I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -patológicos. I-FAMILY_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -(39,4°C), I-PRESENT_ILLNESS -mialgias I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +patología I-PAST_MEDICAL_HISTORY +alérgica, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +urticaria I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS +angioedema I-PRESENT_ILLNESS +intratable I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS +14 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Pese B-TREATMENT +a I-TREATMENT +utilizarse I-TREATMENT +dosis I-TREATMENT +máximas I-TREATMENT +de I-TREATMENT +varios I-TREATMENT +antihistamínicos I-TREATMENT +combinados, I-TREATMENT +antileucotrienos I-TREATMENT +y I-TREATMENT +esteroides I-TREATMENT +orales I-TREATMENT +no I-TREATMENT +se I-TREATMENT +observó I-TREATMENT +respuesta I-TREATMENT +al I-TREATMENT +tratamiento. I-TREATMENT + I-TREATMENT +El B-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +repercutía I-PRESENT_ILLNESS +sobremanera I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +calidad I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +vida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +niña, I-PRESENT_ILLNESS +tanto I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +prurito I-PRESENT_ILLNESS +intenso I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +continuo I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +múltiples I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +placa I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +angioedema I-PRESENT_ILLNESS +claramente I-PRESENT_ILLNESS +visibles, I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -internó I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -estudio I-PRESENT_ILLNESS +afectan I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +sueño, I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +escolaridad I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -tratamiento. I-PRESENT_ILLNESS -Al B-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -comenzó I-EVOLUTION -con I-EVOLUTION -sangrado I-EVOLUTION -de I-EVOLUTION -mucosas, I-EVOLUTION -en I-EVOLUTION -zonas I-EVOLUTION -de I-EVOLUTION -venopuntura I-EVOLUTION -y I-EVOLUTION -deterioro I-EVOLUTION -progresivo I-EVOLUTION -del I-EVOLUTION -estado I-EVOLUTION -general. I-EVOLUTION -Veinticuatro B-TREATMENT -horas I-TREATMENT -más I-TREATMENT -tarde I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -cesárea I-TREATMENT -de I-TREATMENT -urgencia I-TREATMENT -por I-TREATMENT -sufrimiento I-TREATMENT -fetal I-TREATMENT -agudo, I-TREATMENT -con I-TREATMENT -una I-TREATMENT -grave I-TREATMENT -metrorragia I-TREATMENT -posparto. I-TREATMENT -La B-EVOLUTION -madre I-EVOLUTION -recibió I-EVOLUTION -tratamiento I-EVOLUTION -de I-EVOLUTION -sostén I-EVOLUTION -que I-EVOLUTION -requirió I-EVOLUTION -múltiples I-EVOLUTION -transfusiones I-EVOLUTION -sanguíneas. I-EVOLUTION -Se I-EVOLUTION -recuperó I-EVOLUTION -favorablemente I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -72 I-EVOLUTION -h I-EVOLUTION -posparto. I-EVOLUTION -El I-EVOLUTION -niño I-EVOLUTION -nació I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -38 I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -edad I-EVOLUTION -gestacional, I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -peso I-EVOLUTION -de I-EVOLUTION -3900 I-EVOLUTION -g I-EVOLUTION -y I-EVOLUTION -puntaje I-EVOLUTION -de I-EVOLUTION -Apgar I-EVOLUTION -4/4. I-EVOLUTION -Durante I-EVOLUTION -la I-EVOLUTION -internación I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -Unidad I-EVOLUTION -de I-EVOLUTION -cuidado I-EVOLUTION -intensivo I-EVOLUTION -neonatal I-EVOLUTION -requirió I-EVOLUTION -asistencia I-EVOLUTION -respiratoria I-EVOLUTION -mecánica I-EVOLUTION -por I-EVOLUTION -un I-EVOLUTION -síndrome I-EVOLUTION -de I-EVOLUTION -aspiración I-EVOLUTION -meconial I-EVOLUTION -e I-EVOLUTION -hipertensión I-EVOLUTION -pulmonar I-EVOLUTION -y I-EVOLUTION -luminoterapia I-EVOLUTION -por I-EVOLUTION -su I-EVOLUTION -ictericia. I-EVOLUTION -Al I-EVOLUTION -5to I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -vida, I-EVOLUTION -el I-EVOLUTION -niño I-EVOLUTION -comenzó I-EVOLUTION -con I-EVOLUTION -fiebre I-EVOLUTION -(39°C), I-EVOLUTION -hepatomegalia I-EVOLUTION -y I-EVOLUTION -un I-EVOLUTION -exantema I-EVOLUTION -evanescente I-EVOLUTION -generalizado. I-EVOLUTION -Pasadas I-EVOLUTION -24 I-EVOLUTION -h I-EVOLUTION -se I-EVOLUTION -agregaron I-EVOLUTION -hemorragias I-EVOLUTION -por I-EVOLUTION -sonda I-EVOLUTION -nasogástrica I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -venopunturas. I-EVOLUTION +la I-PRESENT_ILLNESS +relación I-PRESENT_ILLNESS +interpersonal. I-PRESENT_ILLNESS El B-EXPLORATION -hemograma I-EXPLORATION -presentó I-EXPLORATION -5800 I-EXPLORATION -glóbulos I-EXPLORATION -blancos I-EXPLORATION -(linfocitos I-EXPLORATION -43%, I-EXPLORATION -neutrófilos I-EXPLORATION -segmentados I-EXPLORATION -47%, I-EXPLORATION -monocitos I-EXPLORATION -6%, I-EXPLORATION -basófilos I-EXPLORATION -4%), I-EXPLORATION -hematócrito I-EXPLORATION -34%, I-EXPLORATION -hemoglobina I-EXPLORATION -11, I-EXPLORATION -2 I-EXPLORATION -mg% I-EXPLORATION -y I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -plaquetas I-EXPLORATION -de I-EXPLORATION -13 I-EXPLORATION -000/mm³. I-EXPLORATION -Con I-EXPLORATION -diagnóstico I-EXPLORATION -presuntivo I-EXPLORATION +laboratorio I-EXPLORATION +presentaba, I-EXPLORATION +como I-EXPLORATION +datos I-EXPLORATION +positivos: I-EXPLORATION +PCR, I-EXPLORATION +21; I-EXPLORATION +factor I-EXPLORATION +reumatoideo, I-EXPLORATION +24 I-EXPLORATION +UI/ml I-EXPLORATION +(normal I-EXPLORATION +hasta I-EXPLORATION +20). I-EXPLORATION +Se I-EXPLORATION +descartaron I-EXPLORATION +posibles I-EXPLORATION +causas I-EXPLORATION +infecciosas. I-EXPLORATION + I-EXPLORATION +Una I-EXPLORATION +biopsia I-EXPLORATION de I-EXPLORATION -sepsis I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizaron I-EXPLORATION -hemocultivos, I-EXPLORATION -urocultivo I-EXPLORATION -y I-EXPLORATION -punción I-EXPLORATION -lumbar. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -solicitó I-EXPLORATION -detección I-EXPLORATION +piel I-EXPLORATION +no I-EXPLORATION +reveló I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -anticuerpos I-EXPLORATION -IgM I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -dengue. I-EXPLORATION +vasculitis. I-EXPLORATION Se I-EXPLORATION -le I-EXPLORATION -indicaron I-EXPLORATION -antibióticos I-EXPLORATION -y I-EXPLORATION -transfusiones I-EXPLORATION +efectuaron I-EXPLORATION +dietas I-EXPLORATION de I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -plaquetas. I-EXPLORATION -Los I-EXPLORATION -cultivos I-EXPLORATION -para I-EXPLORATION -gérmenes I-EXPLORATION -comunes I-EXPLORATION +exclusión I-EXPLORATION +de I-EXPLORATION +alimentos, I-EXPLORATION +aditivos I-EXPLORATION y I-EXPLORATION -hongos I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -El I-EXPLORATION -laboratorio I-EXPLORATION -informó I-EXPLORATION -IgM I-EXPLORATION -por I-EXPLORATION -técnica I-EXPLORATION +colorantes, I-EXPLORATION +sin I-EXPLORATION +mejoría I-EXPLORATION +sintomática. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +prueba I-EXPLORATION de I-EXPLORATION -ELISA I-EXPLORATION +suero I-EXPLORATION +autólogo, I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION positiva I-EXPLORATION -para I-EXPLORATION -dengue. I-EXPLORATION -Para I-EXPLORATION -la I-EXPLORATION -confirmación I-EXPLORATION -del I-EXPLORATION -resultado I-EXPLORATION -se I-EXPLORATION -envió I-EXPLORATION -la I-EXPLORATION -muestra I-EXPLORATION -al I-EXPLORATION -Instituto I-EXPLORATION -Nacional I-EXPLORATION -de I-EXPLORATION -Enfermedades I-EXPLORATION -Virales I-EXPLORATION -Humanas I-EXPLORATION -de I-EXPLORATION -Pergamino, I-EXPLORATION -quienes I-EXPLORATION -certificaron I-EXPLORATION +hasta I-EXPLORATION +una I-EXPLORATION +dilución I-EXPLORATION +1: I-EXPLORATION +100, I-EXPLORATION por I-EXPLORATION -pruebas I-EXPLORATION -serológicas I-EXPLORATION +lo I-EXPLORATION +cual I-EXPLORATION +se I-EXPLORATION +estableció I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -ELISA, I-EXPLORATION -neutralización I-EXPLORATION -y I-EXPLORATION -detección I-EXPLORATION -molecular I-EXPLORATION -del I-EXPLORATION -genoma I-EXPLORATION -viral I-EXPLORATION -(RT-PCR), I-EXPLORATION -la I-EXPLORATION -infección I-EXPLORATION -por I-EXPLORATION -serotipo I-EXPLORATION -DEN-1. I-EXPLORATION -Se B-EVOLUTION -administró I-EVOLUTION -oxígeno I-EVOLUTION -hasta I-EVOLUTION -los I-EVOLUTION -26 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -vida. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -7 I-EVOLUTION -días I-EVOLUTION -del I-EVOLUTION -comienzo I-EVOLUTION +urticaria I-EXPLORATION +crónica I-EXPLORATION +autoinmunitaria. I-EXPLORATION +Previamente B-TREATMENT +a I-TREATMENT +la I-TREATMENT +administración I-TREATMENT +de I-TREATMENT +omalizumab I-TREATMENT +se I-TREATMENT +evaluaron I-TREATMENT +los I-TREATMENT +beneficios I-TREATMENT +y I-TREATMENT +riesgos I-TREATMENT +de I-TREATMENT +otros I-TREATMENT +tratamientos, I-TREATMENT +como I-TREATMENT +ciclosporina I-TREATMENT +o I-TREATMENT +gammaglobulina I-TREATMENT +intravenosa, I-TREATMENT +y I-TREATMENT +dadas I-TREATMENT +las I-TREATMENT +potenciales I-TREATMENT +y I-TREATMENT +mayores I-TREATMENT +complicaciones I-TREATMENT +y I-TREATMENT +riesgos I-TREATMENT +de I-TREATMENT +estos I-TREATMENT +tratamientos, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +iniciar I-TREATMENT +omalizumab I-TREATMENT +en I-TREATMENT +una I-TREATMENT +dosis I-TREATMENT +calculada I-TREATMENT +de I-TREATMENT +acuerdo I-TREATMENT +al I-TREATMENT +valor I-TREATMENT +de I-TREATMENT +IgE I-TREATMENT +total I-TREATMENT +y I-TREATMENT +del I-TREATMENT +peso I-TREATMENT +corporal, I-TREATMENT +según I-TREATMENT +la I-TREATMENT +dosificación I-TREATMENT +aprobada I-TREATMENT +para I-TREATMENT +asma I-TREATMENT +bronquial I-TREATMENT +(150 I-TREATMENT +mg I-TREATMENT +subcutáneos I-TREATMENT +mensuales). I-TREATMENT +Luego B-EVOLUTION de I-EVOLUTION +la I-EVOLUTION +primera I-EVOLUTION +dosis I-EVOLUTION +recrudecieron I-EVOLUTION los I-EVOLUTION síntomas I-EVOLUTION -se I-EVOLUTION -normalizó I-EVOLUTION -el I-EVOLUTION -recuento I-EVOLUTION +por I-EVOLUTION +3 I-EVOLUTION +días I-EVOLUTION +y, I-EVOLUTION +posteriormente, I-EVOLUTION +la I-EVOLUTION +urticaria I-EVOLUTION +permaneció I-EVOLUTION +activa, I-EVOLUTION +pero I-EVOLUTION +estable. I-EVOLUTION +Luego I-EVOLUTION de I-EVOLUTION -plaquetas. I-EVOLUTION -La I-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -fue I-EVOLUTION -favorable I-EVOLUTION -y I-EVOLUTION +la I-EVOLUTION +segunda I-EVOLUTION +dosis I-EVOLUTION se I-EVOLUTION -dio I-EVOLUTION +repite I-EVOLUTION el I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION -vida. I-EVOLUTION -Como I-EVOLUTION -consecuencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -asfixia I-EVOLUTION -perinatal I-EVOLUTION -relacionada I-EVOLUTION +patrón, I-EVOLUTION +pero I-EVOLUTION +posteriormente I-EVOLUTION +comienza I-EVOLUTION a I-EVOLUTION +disminuir I-EVOLUTION la I-EVOLUTION -forma I-EVOLUTION +intensidad I-EVOLUTION de I-EVOLUTION -dengue I-EVOLUTION -grave I-EVOLUTION +las I-EVOLUTION +pápulas I-EVOLUTION +y I-EVOLUTION +del I-EVOLUTION +angioedema; I-EVOLUTION +esta I-EVOLUTION +mejoría I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +torna I-EVOLUTION +más I-EVOLUTION +notable I-EVOLUTION +después I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -madre, I-EVOLUTION -el I-EVOLUTION -niño I-EVOLUTION -presentó I-EVOLUTION -encefalopatía I-EVOLUTION -hipóxico-isquémica I-EVOLUTION -y I-EVOLUTION -compromiso I-EVOLUTION -respiratorio I-EVOLUTION -secuelar. I-EVOLUTION -Se I-EVOLUTION -le I-EVOLUTION -realizaron I-EVOLUTION -controles I-EVOLUTION -clínicos I-EVOLUTION -y I-EVOLUTION -serológicos I-EVOLUTION +tercera I-EVOLUTION +dosis, I-EVOLUTION +al I-EVOLUTION +cuarto I-EVOLUTION +mes I-EVOLUTION +(cuarta I-EVOLUTION +dosis) I-EVOLUTION +llega I-EVOLUTION a I-EVOLUTION -los I-EVOLUTION -8 I-EVOLUTION -y I-EVOLUTION -13 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -vida, I-EVOLUTION -con I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -títulos I-EVOLUTION -de I-EVOLUTION -anticuerpos I-EVOLUTION -IgG I-EVOLUTION -antidengue, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -cual I-EVOLUTION -se I-EVOLUTION -confirmó I-EVOLUTION +una I-EVOLUTION +aparente I-EVOLUTION +remisión, I-EVOLUTION +hecho B-TREATMENT +que I-TREATMENT +permite I-TREATMENT +suspender I-TREATMENT +en I-TREATMENT +forma I-TREATMENT +sucesiva I-TREATMENT +el I-TREATMENT +montelukast I-TREATMENT +y I-TREATMENT +la I-TREATMENT +ranitidina, I-TREATMENT +y I-TREATMENT +reducir I-TREATMENT +a I-TREATMENT +la I-TREATMENT +mitad I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +hidroxicina I-TREATMENT +sin I-TREATMENT +signos I-TREATMENT +de I-TREATMENT +recaída. I-TREATMENT +Hacia B-EVOLUTION el I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -infección I-EVOLUTION -congénita. I-EVOLUTION -Los B-EXPLORATION -resultados I-EXPLORATION -serológicos I-EXPLORATION -mediante I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -ELISA I-EXPLORATION -mostraron I-EXPLORATION -títulos I-EXPLORATION -positivos I-EXPLORATION -elevados, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -RP I-EXPLORATION -1, I-EXPLORATION -92 I-EXPLORATION -y I-EXPLORATION +quinto I-EVOLUTION +mes, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encontraba I-EVOLUTION +por I-EVOLUTION +completo I-EVOLUTION +asintomática, I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +suspenden I-TREATMENT +los I-TREATMENT +antihistamínicos I-TREATMENT +remanentes. I-TREATMENT +Al B-EXPLORATION +sexto I-EXPLORATION +mes, I-EXPLORATION +se I-EXPLORATION +repite I-EXPLORATION +la I-EXPLORATION +prueba I-EXPLORATION +del I-EXPLORATION +suero I-EXPLORATION +autólogo, I-EXPLORATION +que I-EXPLORATION +es I-EXPLORATION +negativa; I-EXPLORATION +se I-EXPLORATION +verifica I-EXPLORATION +normalización I-EXPLORATION de I-EXPLORATION -1, I-EXPLORATION -37 I-EXPLORATION -para I-EXPLORATION -dengue I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -8 I-EXPLORATION +la I-EXPLORATION +PCR I-EXPLORATION y I-EXPLORATION -13 I-EXPLORATION -meses, I-EXPLORATION -respectivamente. I-EXPLORATION -Actualmente, B-EVOLUTION -el I-EVOLUTION -niño I-EVOLUTION -realiza I-EVOLUTION -estimulación I-EVOLUTION -neurológica I-EVOLUTION -y I-EVOLUTION +del I-EXPLORATION +factor I-EXPLORATION +reumatoideo. I-EXPLORATION +Posteriormente B-EVOLUTION +se I-EVOLUTION +completan I-EVOLUTION +12 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION tratamiento I-EVOLUTION -preventivo I-EVOLUTION -respiratorio I-EVOLUTION -con I-EVOLUTION -corticoides I-EVOLUTION -inhalatorios, I-EVOLUTION con I-EVOLUTION -buena I-EVOLUTION -evolución. I-EVOLUTION +omalizumab. I-EVOLUTION +Seis I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +suspensión I-EVOLUTION +del I-EVOLUTION +tratamiento, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +continuó I-EVOLUTION +asintomática I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +alteraciones I-EVOLUTION +del I-EVOLUTION +laboratorio. I-EVOLUTION I-EVOLUTION -Neonato B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida, I-PRESENT_ILLNESS -nacida B-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -vaginal I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -término I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -adecuado I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -gestacional, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -Apgar I-PAST_MEDICAL_HISTORY -7/9, I-PAST_MEDICAL_HISTORY -de B-FAMILY_HISTORY -padres I-FAMILY_HISTORY -sanos, I-FAMILY_HISTORY -no I-FAMILY_HISTORY -consanguíneos. I-FAMILY_HISTORY -Tiene I-FAMILY_HISTORY -tres I-FAMILY_HISTORY -hermanos I-FAMILY_HISTORY -vivos I-FAMILY_HISTORY -y I-FAMILY_HISTORY -sanos. I-FAMILY_HISTORY -Sin I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -de I-FAMILY_HISTORY -abortos I-FAMILY_HISTORY -maternos. I-FAMILY_HISTORY -Consulta B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ampollas, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presentaron I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -nacimiento, I-PRESENT_ILLNESS -dispuestas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -miembro I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -(MI) I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -siguiendo I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -líneas I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Blaschko, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS +85 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -correr I-PRESENT_ILLNESS +historia I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -aumentaron I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -número. I-PRESENT_ILLNESS -Recibe B-TREATMENT -cefotaxima-oxacilina I-TREATMENT -parenteral I-TREATMENT -(VP) I-TREATMENT -por I-TREATMENT -dos I-TREATMENT -días, I-TREATMENT -con I-TREATMENT -mejoría. I-TREATMENT -Es B-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -afebril, I-EVOLUTION -con I-EVOLUTION -buen I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION -e I-EVOLUTION -indicación I-EVOLUTION -de I-EVOLUTION -continuar I-EVOLUTION -con I-EVOLUTION -cefixima I-EVOLUTION -oral I-EVOLUTION -(VO). I-EVOLUTION -Dos I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -aparecen I-EVOLUTION -nuevas I-EVOLUTION -lesiones I-EVOLUTION -de I-EVOLUTION -iguales I-EVOLUTION -características I-EVOLUTION -en I-EVOLUTION -MI I-EVOLUTION -derecho I-EVOLUTION +carcinoma I-PRESENT_ILLNESS +basocelular I-PRESENT_ILLNESS +recidivado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +pabellón I-PRESENT_ILLNESS +auricular I-PRESENT_ILLNESS +derecho. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +El B-TREATMENT +tratamiento I-TREATMENT +inicial, I-TREATMENT +realizado I-TREATMENT +en I-TREATMENT +mayo I-TREATMENT +de I-TREATMENT +2001, I-TREATMENT +consistió I-TREATMENT +en I-TREATMENT +una I-TREATMENT +extirpación I-TREATMENT +local I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +siguió I-EVOLUTION +revisiones I-EVOLUTION +periódicas I-EVOLUTION y I-EVOLUTION -en I-EVOLUTION -miembro I-EVOLUTION -superior I-EVOLUTION -(MS) I-EVOLUTION -izquierdo, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -queda I-EVOLUTION -internada. I-EVOLUTION -Se B-TREATMENT -reinicia I-TREATMENT -cefotaxima-oxacilina I-TREATMENT -VP, I-TREATMENT -se B-EXPLORATION -solicitan I-EXPLORATION -frotis I-EXPLORATION -y I-EXPLORATION -cultivo I-EXPLORATION +a I-EVOLUTION +los I-EVOLUTION +2 I-EVOLUTION +años I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +recidiva I-EVOLUTION +local I-EVOLUTION +más I-EVOLUTION +una I-EVOLUTION +tumoración I-EVOLUTION +a I-EVOLUTION +nivel I-EVOLUTION +submandibular I-EVOLUTION +derecho. I-EVOLUTION +Se B-EXPLORATION +solicitó I-EXPLORATION +citología I-EXPLORATION de I-EXPLORATION -lesiones, I-EXPLORATION -y I-EXPLORATION -VDRL. I-EXPLORATION -Con I-EXPLORATION -resultados I-EXPLORATION +la I-EXPLORATION +tumoración I-EXPLORATION +mediante I-EXPLORATION +punción I-EXPLORATION +aspiración I-EXPLORATION +con I-EXPLORATION +aguja I-EXPLORATION +fina, I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +informada I-EXPLORATION +como I-EXPLORATION +positiva I-EXPLORATION +para I-EXPLORATION +células I-EXPLORATION +malignas, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +metástasis I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION -negativos I-EXPLORATION -se B-EVOLUTION -decide I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -y B-TREATMENT -se I-TREATMENT -indica I-TREATMENT -aplicar I-TREATMENT -ácido I-TREATMENT -fusídico I-TREATMENT -tópico I-TREATMENT -sobre I-TREATMENT -las I-TREATMENT -vesículas I-TREATMENT -cutáneas I-TREATMENT -y I-TREATMENT -continuar I-TREATMENT -con I-TREATMENT -cefixima I-TREATMENT -VO. I-TREATMENT -Dos B-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -consulta I-EVOLUTION -a I-EVOLUTION -nuestro I-EVOLUTION -servicio I-EVOLUTION -por I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -lesiones. I-EVOLUTION -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -general I-EXPLORATION +carcinoma I-EXPLORATION +basocelular. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +Tomografía I-EXPLORATION +Axial I-EXPLORATION +Computerizada I-EXPLORATION +(TAC) I-EXPLORATION se I-EXPLORATION -encontraba I-EXPLORATION -dentro I-EXPLORATION +aprecia I-EXPLORATION +un I-EXPLORATION +engrosamiento I-EXPLORATION de I-EXPLORATION los I-EXPLORATION -límites I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION -En I-EXPLORATION +tejidos I-EXPLORATION +blandos I-EXPLORATION +del I-EXPLORATION +pabellón I-EXPLORATION +auricular I-EXPLORATION +derecho I-EXPLORATION +en I-EXPLORATION +relación I-EXPLORATION +con I-EXPLORATION el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -dermatológico I-EXPLORATION +antecedente I-EXPLORATION +de I-EXPLORATION +neoplasia I-EXPLORATION +previa. I-EXPLORATION +También I-EXPLORATION se I-EXPLORATION -constatan I-EXPLORATION -múltiples I-EXPLORATION -vesículas, I-EXPLORATION -firmes, I-EXPLORATION -amarillentas, I-EXPLORATION -sobre I-EXPLORATION +objetiva I-EXPLORATION una I-EXPLORATION -base I-EXPLORATION -inflamatoria, I-EXPLORATION -de I-EXPLORATION -distribución I-EXPLORATION -lineal I-EXPLORATION -que I-EXPLORATION -afectan I-EXPLORATION -MS I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -ambos I-EXPLORATION -MI. I-EXPLORATION -El I-EXPLORATION -tamaño I-EXPLORATION +imagen I-EXPLORATION +nodular I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -es I-EXPLORATION -variable, I-EXPLORATION -con I-EXPLORATION -diámetros I-EXPLORATION -que I-EXPLORATION -oscilan I-EXPLORATION -entre I-EXPLORATION -0, I-EXPLORATION -1-1 I-EXPLORATION +1.5 I-EXPLORATION cm. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -afectación I-EXPLORATION -ungueal. I-EXPLORATION -Se B-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -remite I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -neurólogo I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -oftalmólogo, I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -descartan I-DERIVED_FROM/TO -afectación I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -tales I-DERIVED_FROM/TO -áreas. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Métodos B-EXPLORATION -auxiliares I-EXPLORATION de I-EXPLORATION -diagnóstico: I-EXPLORATION -hemograma: I-EXPLORATION -Hb: I-EXPLORATION -15, I-EXPLORATION -4 I-EXPLORATION -g/dl; I-EXPLORATION -leucocitos: I-EXPLORATION -16 I-EXPLORATION -700 I-EXPLORATION -cél./mm3; I-EXPLORATION -N: I-EXPLORATION -68%; I-EXPLORATION -L: I-EXPLORATION -20%; I-EXPLORATION -Eo: I-EXPLORATION -10%; I-EXPLORATION -plaquetas: I-EXPLORATION -330 I-EXPLORATION -000 I-EXPLORATION -cél./mm3. I-EXPLORATION -Examen I-EXPLORATION -directo I-EXPLORATION -y I-EXPLORATION -cultivo: I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -hongos I-EXPLORATION +diámetro I-EXPLORATION +situada I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +infraparotídeo, I-EXPLORATION +con I-EXPLORATION +necrosis I-EXPLORATION +central I-EXPLORATION y I-EXPLORATION -bacterias. I-EXPLORATION -Dos I-EXPLORATION -hemocultivos: I-EXPLORATION -negativos. I-EXPLORATION -VDRL: I-EXPLORATION -no I-EXPLORATION -reactiva. I-EXPLORATION -Biopsia I-EXPLORATION -cutánea: I-EXPLORATION -Se I-EXPLORATION -efectúa I-EXPLORATION -biopsia I-EXPLORATION -cutánea I-EXPLORATION -incisional I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -vesículas I-EXPLORATION +que I-EXPLORATION +impresiona I-EXPLORATION de I-EXPLORATION -MI, I-EXPLORATION -se I-EXPLORATION -fija I-EXPLORATION -en I-EXPLORATION -formol I-EXPLORATION -neutro I-EXPLORATION -tamponado I-EXPLORATION -al I-EXPLORATION -10% I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -procesa I-EXPLORATION +adenopatía I-EXPLORATION +locoregional. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -manera I-EXPLORATION -convencional. I-EXPLORATION -Se I-EXPLORATION -efectúa I-EXPLORATION -coloración I-EXPLORATION -HE. I-EXPLORATION -La I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +En B-TREATMENT +junio I-TREATMENT +del I-TREATMENT +2003 I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +resección I-TREATMENT +parcial I-TREATMENT +del I-TREATMENT +lóbulo I-TREATMENT +superficial I-TREATMENT +de I-TREATMENT +la I-TREATMENT +parótida, I-TREATMENT +un I-TREATMENT +vaciamiento I-TREATMENT +cervical I-TREATMENT +derecho I-TREATMENT +selectivo I-TREATMENT +confinado I-TREATMENT +a I-TREATMENT +las I-TREATMENT +zonas I-TREATMENT +2 I-TREATMENT +y I-TREATMENT +3 I-TREATMENT +y I-TREATMENT +extirpación I-TREATMENT +de I-TREATMENT +la I-TREATMENT +mitad I-TREATMENT +inferior I-TREATMENT +del I-TREATMENT +pabellón I-TREATMENT +auricular I-TREATMENT +que I-TREATMENT +incluía I-TREATMENT +la I-TREATMENT +recidiva I-TREATMENT +local. I-TREATMENT + I-TREATMENT +La B-EXPLORATION anatomía I-EXPLORATION patológica I-EXPLORATION -informa: I-EXPLORATION -dermatitis I-EXPLORATION -psoriasiforme I-EXPLORATION -perivascular I-EXPLORATION -superficial, I-EXPLORATION -presencia I-EXPLORATION +final I-EXPLORATION +informó I-EXPLORATION +la I-EXPLORATION +tumoración I-EXPLORATION +como I-EXPLORATION +una I-EXPLORATION +metástasis I-EXPLORATION de I-EXPLORATION -marcada I-EXPLORATION -espongiosis I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -tercio I-EXPLORATION -inferior I-EXPLORATION -del I-EXPLORATION -epitelio I-EXPLORATION +carcinoma I-EXPLORATION +basocelular I-EXPLORATION +de I-EXPLORATION +subtipo I-EXPLORATION +infiltrante I-EXPLORATION +que I-EXPLORATION +afectaba I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +glándula I-EXPLORATION +parótida I-EXPLORATION con I-EXPLORATION -exocitosis I-EXPLORATION -eosinofílica I-EXPLORATION -y I-EXPLORATION -presencia I-EXPLORATION +márgenes I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -disqueratósicas. I-EXPLORATION +resección I-EXPLORATION +libres. I-EXPLORATION + I-EXPLORATION En I-EXPLORATION -dermis I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -perivascular I-EXPLORATION -superficial I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +del I-EXPLORATION +vaciamiento I-EXPLORATION +cervical, I-EXPLORATION de I-EXPLORATION -linfocitos I-EXPLORATION +los I-EXPLORATION +10 I-EXPLORATION +ganglios I-EXPLORATION +cervicales I-EXPLORATION +aislados, I-EXPLORATION +2 I-EXPLORATION +estaban I-EXPLORATION +afectados. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +recidiva I-EXPLORATION +local I-EXPLORATION +del I-EXPLORATION +pabellón I-EXPLORATION +auricular I-EXPLORATION +también I-EXPLORATION +se I-EXPLORATION +informó I-EXPLORATION +como I-EXPLORATION +epitelioma I-EXPLORATION +basocelular I-EXPLORATION +infiltrante I-EXPLORATION con I-EXPLORATION -eosinófilos I-EXPLORATION -y I-EXPLORATION -edema. I-EXPLORATION +márgenes I-EXPLORATION +libres. I-EXPLORATION I-EXPLORATION -Diagnóstico I-EXPLORATION -anatomopatológico I-EXPLORATION -final: I-EXPLORATION -incontinentia I-EXPLORATION -pigmenti I-EXPLORATION -estadio I-EXPLORATION -eritemato-ampollar. I-EXPLORATION -Evolución B-TREATMENT -y I-TREATMENT -tratamiento: I-TREATMENT -Se I-TREATMENT -higienizan I-TREATMENT -las I-TREATMENT -lesiones I-TREATMENT +La B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +remitida I-TREATMENT +para I-TREATMENT +tratamiento I-TREATMENT +complementario I-TREATMENT con I-TREATMENT -infusión I-TREATMENT -de I-TREATMENT -manzanilla I-TREATMENT -fría I-TREATMENT -y I-TREATMENT -pasta I-TREATMENT -al I-TREATMENT -agua I-TREATMENT -luego I-TREATMENT -de I-TREATMENT -la I-TREATMENT -higiene, I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -por I-TREATMENT -día, I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -desaparición I-TREATMENT -de I-TREATMENT -las I-TREATMENT -ampollas. I-TREATMENT -Acude B-EVOLUTION -a I-EVOLUTION -control I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -15 I-EVOLUTION -días, I-EVOLUTION -con I-EVOLUTION -marcada I-EVOLUTION -desaparición I-EVOLUTION +radioterapia, I-TREATMENT +a I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +negó. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +el I-EVOLUTION +momento I-EVOLUTION de I-EVOLUTION -ampollas I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -aparición I-EVOLUTION +esta I-EVOLUTION +publicación I-EVOLUTION +no I-EVOLUTION +existe I-EVOLUTION +evidencia I-EVOLUTION de I-EVOLUTION -nuevas I-EVOLUTION -lesiones. I-EVOLUTION +recurrencia I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +sigue I-EVOLUTION +viva. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS +84 I-PRESENT_ILLNESS +enviada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +recidiva I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -producto B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -tercera I-PAST_MEDICAL_HISTORY -gestación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -34 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -padre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -40 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -consanguíneos; I-PAST_MEDICAL_HISTORY -con B-FAMILY_HISTORY -dos I-FAMILY_HISTORY -hermanos I-FAMILY_HISTORY -aparentemente I-FAMILY_HISTORY -sanos; I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -importancia. I-FAMILY_HISTORY -Durante I-FAMILY_HISTORY -todo I-FAMILY_HISTORY -el I-FAMILY_HISTORY -embarazo I-FAMILY_HISTORY -la I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -cursó I-FAMILY_HISTORY -con I-FAMILY_HISTORY -tos I-FAMILY_HISTORY -productiva, I-FAMILY_HISTORY -persistente, I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -predominio I-FAMILY_HISTORY -de I-FAMILY_HISTORY -horario, I-FAMILY_HISTORY -tratada I-FAMILY_HISTORY -con I-FAMILY_HISTORY -nebulizaciones I-FAMILY_HISTORY -con I-FAMILY_HISTORY -salbutamol I-FAMILY_HISTORY -y, I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -segundo I-FAMILY_HISTORY -trimestre I-FAMILY_HISTORY -de I-FAMILY_HISTORY -gestación, I-FAMILY_HISTORY -con I-FAMILY_HISTORY -infecciones I-FAMILY_HISTORY -vaginales I-FAMILY_HISTORY -reiteradas I-FAMILY_HISTORY -cuyo I-FAMILY_HISTORY -manejo I-FAMILY_HISTORY -se I-FAMILY_HISTORY -desconoce. I-FAMILY_HISTORY -El B-PAST_MEDICAL_HISTORY -producto I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -obtenido I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cesárea I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -36 I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -gestación; I-PAST_MEDICAL_HISTORY -peso: I-PAST_MEDICAL_HISTORY -2800 I-PAST_MEDICAL_HISTORY -g, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -atresia I-PAST_MEDICAL_HISTORY -bilateral I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -coanas I-PAST_MEDICAL_HISTORY -(ABC), I-PAST_MEDICAL_HISTORY -encefalocele, I-PAST_MEDICAL_HISTORY -hidrocefalia, I-PAST_MEDICAL_HISTORY -microftalmía I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -restos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -bandas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -constricción I-PAST_MEDICAL_HISTORY -oscuras I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dedos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -manos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pies; I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -datos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -características I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -placenta. I-PAST_MEDICAL_HISTORY -Al I-PAST_MEDICAL_HISTORY -5to I-PAST_MEDICAL_HISTORY -día I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -colocó I-PAST_MEDICAL_HISTORY -válvula I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -derivación I-PAST_MEDICAL_HISTORY -ventriculoperitoneal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -realizó I-PAST_MEDICAL_HISTORY -plastia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -encefalocele; I-PAST_MEDICAL_HISTORY -a B-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -desarrolla I-PRESENT_ILLNESS -neumonía I-PRESENT_ILLNESS -nosocomial. I-PRESENT_ILLNESS -A B-EXPLORATION +carcinoma I-PRESENT_ILLNESS +epidermoide I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +preauricular I-PRESENT_ILLNESS +derecha, I-PRESENT_ILLNESS +tratada I-PRESENT_ILLNESS +previamente I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +cirugía I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +RT. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -actual, I-EXPLORATION -peso: I-EXPLORATION -3150 I-EXPLORATION -g I-EXPLORATION -(percentil I-EXPLORATION -3); I-EXPLORATION -talla: I-EXPLORATION -52 I-EXPLORATION -cm I-EXPLORATION -(percentil I-EXPLORATION -20); I-EXPLORATION -plagiocefalia I-EXPLORATION -frontotemporal I-EXPLORATION -izquierda, I-EXPLORATION -dolicocefalia, I-EXPLORATION -cicatriz I-EXPLORATION -de I-EXPLORATION -plastia I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -occipital I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -longitud I-EXPLORATION -y I-EXPLORATION -válvula I-EXPLORATION -de I-EXPLORATION -pudens I-EXPLORATION +TC I-EXPLORATION +facial I-EXPLORATION +aparece I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION en I-EXPLORATION región I-EXPLORATION -temporal I-EXPLORATION -derecha, I-EXPLORATION -frontal I-EXPLORATION -prominente; I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -cejas; I-EXPLORATION -microftalmía I-EXPLORATION -derecha; I-EXPLORATION -puente I-EXPLORATION -nasal I-EXPLORATION -deprimido; I-EXPLORATION -hiperplasia I-EXPLORATION -gingival; I-EXPLORATION -paladar I-EXPLORATION -ojival; I-EXPLORATION -pectus I-EXPLORATION -excavatum; I-EXPLORATION -hernia I-EXPLORATION -umbilical; I-EXPLORATION -marca I-EXPLORATION +preauricular I-EXPLORATION +derecha I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +extiende I-EXPLORATION +hacia I-EXPLORATION +las I-EXPLORATION +partes I-EXPLORATION +blandas I-EXPLORATION de I-EXPLORATION -constricción I-EXPLORATION -circular I-EXPLORATION -por I-EXPLORATION -bandas I-EXPLORATION -en I-EXPLORATION +la I-EXPLORATION región I-EXPLORATION -distal I-EXPLORATION -de I-EXPLORATION -antebrazo I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -dedos I-EXPLORATION -2, I-EXPLORATION -3 I-EXPLORATION -y I-EXPLORATION -4; I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -aplasia I-EXPLORATION -ungueal I-EXPLORATION -y I-EXPLORATION -acrosindactilia I-EXPLORATION -de I-EXPLORATION -éstos; I-EXPLORATION -mano I-EXPLORATION -izquierda I-EXPLORATION +malar, I-EXPLORATION +contactando I-EXPLORATION con I-EXPLORATION -marca I-EXPLORATION -de I-EXPLORATION -constricción I-EXPLORATION -circular I-EXPLORATION -por I-EXPLORATION -bandas I-EXPLORATION -en I-EXPLORATION -4to I-EXPLORATION -dedo I-EXPLORATION +el I-EXPLORATION +músculo I-EXPLORATION +masetero I-EXPLORATION y I-EXPLORATION -acrosindactilia I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -ungueal I-EXPLORATION +la I-EXPLORATION +glándula I-EXPLORATION +parótida. I-EXPLORATION +El I-EXPLORATION +tratamiento I-EXPLORATION +quirúrgico I-EXPLORATION +consistió I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +extirpación I-EXPLORATION de I-EXPLORATION -dedos I-EXPLORATION -2do I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +incluyendo I-EXPLORATION +el I-EXPLORATION +pabellón I-EXPLORATION +auricular I-EXPLORATION +derecho, I-EXPLORATION +CAE I-EXPLORATION y I-EXPLORATION -3ro; I-EXPLORATION -pie I-EXPLORATION -derecho I-EXPLORATION +parotidectomía I-EXPLORATION +total I-EXPLORATION +radical. I-EXPLORATION +La I-EXPLORATION +reconstrucción I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION con I-EXPLORATION -acrosindactilia I-EXPLORATION +colgajo I-EXPLORATION de I-EXPLORATION -dedos I-EXPLORATION -2do I-EXPLORATION -y I-EXPLORATION -3ro; I-EXPLORATION -pie I-EXPLORATION -izquierdo I-EXPLORATION -ausencia I-EXPLORATION +músculo I-EXPLORATION +temporal I-EXPLORATION +que I-EXPLORATION +desinsertado I-EXPLORATION de I-EXPLORATION -dedos I-EXPLORATION -1ro, I-EXPLORATION -2do I-EXPLORATION -y I-EXPLORATION -3ro, I-EXPLORATION -acrosindactilia I-EXPLORATION +la I-EXPLORATION +cresta I-EXPLORATION +temporal I-EXPLORATION y I-EXPLORATION -marca I-EXPLORATION -de I-EXPLORATION -banda I-EXPLORATION -de I-EXPLORATION -constricción I-EXPLORATION +pediculado I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +coronoides, I-EXPLORATION +fue I-EXPLORATION +rotado I-EXPLORATION +en I-EXPLORATION +dirección I-EXPLORATION +caudal I-EXPLORATION +para I-EXPLORATION +cubrir I-EXPLORATION +el I-EXPLORATION +defecto. I-EXPLORATION +La I-EXPLORATION +porción I-EXPLORATION +inferior I-EXPLORATION de I-EXPLORATION -5to I-EXPLORATION -dedo. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION +la I-EXPLORATION +fascia I-EXPLORATION +temporal I-EXPLORATION +profunda I-EXPLORATION +fue I-EXPLORATION +disecada I-EXPLORATION +y I-EXPLORATION +dividida I-EXPLORATION +en I-EXPLORATION +dos I-EXPLORATION +láminas I-EXPLORATION +cuyos I-EXPLORATION +extremos I-EXPLORATION +libres I-EXPLORATION +fueron I-EXPLORATION +suturados I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +comisura I-EXPLORATION +y I-EXPLORATION +musculatura I-EXPLORATION +del I-EXPLORATION +labio I-EXPLORATION +superior. I-EXPLORATION +El I-EXPLORATION +músculo I-EXPLORATION +temporal I-EXPLORATION +traspuesto I-EXPLORATION se I-EXPLORATION -encontraron I-EXPLORATION -dentro I-EXPLORATION +cubrió I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +injerto I-EXPLORATION +parcial I-EXPLORATION de I-EXPLORATION -parámetros I-EXPLORATION -normales; I-EXPLORATION -el I-EXPLORATION -cariotipo I-EXPLORATION +piel. I-EXPLORATION +A B-EVOLUTION +los I-EVOLUTION +dos I-EVOLUTION +meses I-EVOLUTION +postoperatorio I-EVOLUTION +se I-EVOLUTION +observa I-EVOLUTION +cómo I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +consigue I-EVOLUTION +elevar I-EVOLUTION +la I-EVOLUTION +comisura I-EVOLUTION +bucal I-EVOLUTION +y I-EVOLUTION +una I-EVOLUTION +estética I-EVOLUTION +aceptable I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +zona I-EVOLUTION +reconstruida. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +alergias I-PAST_MEDICAL_HISTORY +conocidas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés. I-PAST_MEDICAL_HISTORY +Valorada B-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +consultas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Traumatología I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hombro I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +En B-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +profesión I-PAST_MEDICAL_HISTORY +realiza I-PAST_MEDICAL_HISTORY +esfuerzos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +repetición I-PAST_MEDICAL_HISTORY +y B-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +limitación I-PRESENT_ILLNESS +funcional I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +actividades I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +vida I-PRESENT_ILLNESS +diaria I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +miembro I-PRESENT_ILLNESS +superior I-PRESENT_ILLNESS +izquierdo. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +destacaba I-EXPLORATION +dolor I-EXPLORATION +en I-EXPLORATION +espacio I-EXPLORATION +subacromial, I-EXPLORATION con I-EXPLORATION -resolución I-EXPLORATION +movilidad I-EXPLORATION +completa I-EXPLORATION de I-EXPLORATION -550 I-EXPLORATION -bandas I-EXPLORATION +hombro, I-EXPLORATION +signo I-EXPLORATION +de I-EXPLORATION +Yocum I-EXPLORATION +positivo I-EXPLORATION y I-EXPLORATION -técnica I-EXPLORATION +test I-EXPLORATION de I-EXPLORATION -bandeo I-EXPLORATION -G I-EXPLORATION -en I-EXPLORATION -40 I-EXPLORATION -metafases I-EXPLORATION -se I-EXPLORATION -informó: I-EXPLORATION -46, I-EXPLORATION -XY; I-EXPLORATION +Jobe I-EXPLORATION +positivo. I-EXPLORATION +Además, I-EXPLORATION +el I-EXPLORATION +antebrazo I-EXPLORATION +izquierdo I-EXPLORATION +presentaba I-EXPLORATION +un I-EXPLORATION +bloqueo I-EXPLORATION en I-EXPLORATION -las I-EXPLORATION -radiografías I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -ausencia I-EXPLORATION +pronación I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -2da I-EXPLORATION -falange I-EXPLORATION -distal I-EXPLORATION +unos I-EXPLORATION +50o, I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +limitación I-EXPLORATION de I-EXPLORATION -mano I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION +los I-EXPLORATION +movimientos I-EXPLORATION de I-EXPLORATION -2da I-EXPLORATION +pronación I-EXPLORATION y I-EXPLORATION -3era I-EXPLORATION -falanges I-EXPLORATION -distales I-EXPLORATION -en I-EXPLORATION -mano I-EXPLORATION -izquierda; I-EXPLORATION -pie I-EXPLORATION -derecho, I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -falanges I-EXPLORATION -medias I-EXPLORATION +supinación, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +compensaban I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +movilización I-EXPLORATION +del I-EXPLORATION +hombro, I-EXPLORATION y I-EXPLORATION -distales; I-EXPLORATION -en I-EXPLORATION -pie I-EXPLORATION -izquierdo I-EXPLORATION -ausencia I-EXPLORATION +una I-EXPLORATION +flexoextensión I-EXPLORATION +completa I-EXPLORATION de I-EXPLORATION -todas I-EXPLORATION +codo. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +radiográfico I-EXPLORATION +del I-EXPLORATION +codo I-EXPLORATION +mostró I-EXPLORATION las I-EXPLORATION -falanges I-EXPLORATION -distales. I-EXPLORATION -Ecocardiograma I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -simple I-EXPLORATION +siguientes I-EXPLORATION +imágenes. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -cráneo I-EXPLORATION -reveló: I-EXPLORATION -microftalmía I-EXPLORATION -derecha, I-EXPLORATION -encefalocele I-EXPLORATION -frontoparietal I-EXPLORATION -y I-EXPLORATION -megaventrículo I-EXPLORATION -derecho. I-EXPLORATION -La I-EXPLORATION -ABC I-EXPLORATION -con I-EXPLORATION -placa I-EXPLORATION -atrésica I-EXPLORATION -mixta I-EXPLORATION +articulaciones I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -confirmó I-EXPLORATION -por I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada, I-EXPLORATION -realizándose I-EXPLORATION -corrección I-EXPLORATION -vía I-EXPLORATION -endoscópica I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -10 I-EXPLORATION -meses I-EXPLORATION +apreciaron I-EXPLORATION +deformidades I-EXPLORATION +óseas, I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -edad. I-EXPLORATION +exploración I-EXPLORATION +por I-EXPLORATION +aparatos I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION I-EXPLORATION +Diagnóstico: B-EVOLUTION +sinostosis I-EVOLUTION +radiocubital I-EVOLUTION +proximal I-EVOLUTION +congénita I-EVOLUTION +"enfermedad I-EVOLUTION +de I-EVOLUTION +lennoire" I-EVOLUTION + I-EVOLUTION -Presentamos B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -recién I-PRESENT_ILLNESS -nacido I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -38, I-PRESENT_ILLNESS -5ºC I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -hora I-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -rechazo I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -alimentación. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY +43 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -destacaban I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -controlado I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -normal; I-PAST_MEDICAL_HISTORY -serologías I-PAST_MEDICAL_HISTORY -negativas I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -virus I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -B I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -C, I-PAST_MEDICAL_HISTORY -virus I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -inmunodeficiencia I-PAST_MEDICAL_HISTORY -humana, I-PAST_MEDICAL_HISTORY -sífilis I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -toxoplasma; I-PAST_MEDICAL_HISTORY -frotis I-PAST_MEDICAL_HISTORY -vaginal I-PAST_MEDICAL_HISTORY -negativo I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -Streptococcus I-PAST_MEDICAL_HISTORY -grupo I-PAST_MEDICAL_HISTORY -B; I-PAST_MEDICAL_HISTORY -ruptura I-PAST_MEDICAL_HISTORY -espontánea I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -membranas I-PAST_MEDICAL_HISTORY -intraparto, I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -instrumental I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -fórceps I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -41 I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -gestación I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -nacimiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -3880 I-PAST_MEDICAL_HISTORY -g. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -prueba I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Apgar I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -minuto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -minutos I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -9, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -requerir I-PAST_MEDICAL_HISTORY -reanimación. I-PAST_MEDICAL_HISTORY -Comenzó I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -esquema I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -inmunización. I-PAST_MEDICAL_HISTORY -Alimentación I-PAST_MEDICAL_HISTORY +cólicos I-PAST_MEDICAL_HISTORY +biliares I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -lactancia I-PAST_MEDICAL_HISTORY -materna I-PAST_MEDICAL_HISTORY -exclusiva. I-PAST_MEDICAL_HISTORY -Respecto B-FAMILY_HISTORY -a I-FAMILY_HISTORY -los I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares, I-FAMILY_HISTORY -los I-FAMILY_HISTORY -padres I-FAMILY_HISTORY -refirieron I-FAMILY_HISTORY -haber I-FAMILY_HISTORY -padecido I-FAMILY_HISTORY -amigdalitis I-FAMILY_HISTORY -los I-FAMILY_HISTORY -días I-FAMILY_HISTORY -previos. I-FAMILY_HISTORY -La B-EXPLORATION +colelitiasis I-PAST_MEDICAL_HISTORY +conocida, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +localizado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +vómitos. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION exploración I-EXPLORATION -física I-EXPLORATION -mostró I-EXPLORATION -decaimiento I-EXPLORATION +clínica I-EXPLORATION +destacaban I-EXPLORATION +dolor I-EXPLORATION y I-EXPLORATION -regular I-EXPLORATION -perfusión I-EXPLORATION -periférica I-EXPLORATION +defensa I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +en I-EXPLORATION +hipocondrio I-EXPLORATION +derecho, I-EXPLORATION con I-EXPLORATION -constantes I-EXPLORATION -vitales I-EXPLORATION -normales, I-EXPLORATION -sin I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -objetivasen I-EXPLORATION -signos I-EXPLORATION +signo I-EXPLORATION de I-EXPLORATION -foco. I-EXPLORATION -La I-EXPLORATION +Murphy I-EXPLORATION +positivo. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION analítica I-EXPLORATION -inicial I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -determinación I-EXPLORATION +solicitada, I-EXPLORATION +el I-EXPLORATION +rango I-EXPLORATION de I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -cuantitativa I-EXPLORATION -(PC-R) I-EXPLORATION -133, I-EXPLORATION -4 I-EXPLORATION -mg/L, I-EXPLORATION +leucocitos I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +6, I-EXPLORATION +7x103/µL I-EXPLORATION +(referencia: I-EXPLORATION +4-10, I-EXPLORATION +5 I-EXPLORATION +103/µL), I-EXPLORATION con I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -coagulado I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -sedimento I-EXPLORATION +neutrofilia I-EXPLORATION +asociada. I-EXPLORATION +Bilirrubina I-EXPLORATION +total I-EXPLORATION +0, I-EXPLORATION +6 I-EXPLORATION +mg/dl I-EXPLORATION +(referencia: I-EXPLORATION +0, I-EXPLORATION +2-1, I-EXPLORATION +10 I-EXPLORATION +mg/dl), I-EXPLORATION +AST I-EXPLORATION +66 I-EXPLORATION +mg/dl I-EXPLORATION +(referencia I-EXPLORATION +8-40 I-EXPLORATION +mg/dl), I-EXPLORATION +amilasa I-EXPLORATION +43 I-EXPLORATION +mg/dl I-EXPLORATION +(referencia: I-EXPLORATION +25-115 I-EXPLORATION +mg/dl), I-EXPLORATION +PCR I-EXPLORATION +15, I-EXPLORATION +84 I-EXPLORATION +mg/dl I-EXPLORATION +(referencia I-EXPLORATION +inferior I-EXPLORATION +a I-EXPLORATION +5 I-EXPLORATION +mg/dl). I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +ecografía I-EXPLORATION de I-EXPLORATION -orina I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -resultó I-EXPLORATION -hemorrágica. I-EXPLORATION -Ingresó B-TREATMENT -con I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -síndrome I-TREATMENT -febril I-TREATMENT -sin I-TREATMENT -foco I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -antibioterapia I-TREATMENT -empírica I-TREATMENT -con I-TREATMENT -ampicilina I-TREATMENT -y I-TREATMENT -cefotaxima I-TREATMENT -intravenosas I-TREATMENT -tras I-TREATMENT -la I-TREATMENT -toma I-TREATMENT -de I-TREATMENT -cultivos. I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -hemograma I-EXPLORATION -repetido I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -5800 I-EXPLORATION -leucocitos/mm3, I-EXPLORATION +abdomen I-EXPLORATION +urgente I-EXPLORATION con I-EXPLORATION -fórmula I-EXPLORATION -normal, I-EXPLORATION -13, I-EXPLORATION -4 I-EXPLORATION -g/dl I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION de I-EXPLORATION -hemoglobina, I-EXPLORATION -32 I-EXPLORATION -000 I-EXPLORATION -plaquetas/mm3. I-EXPLORATION -A B-EVOLUTION -las I-EVOLUTION -18 I-EVOLUTION -h I-EVOLUTION -del I-EVOLUTION -ingreso I-EVOLUTION -empeoró I-EVOLUTION -su I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION -y I-EVOLUTION -presentó I-EVOLUTION -crisis I-EVOLUTION -convulsivas I-EVOLUTION -generalizadas I-EVOLUTION -que B-TREATMENT -requirieron I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -fenobarbital I-TREATMENT -y I-TREATMENT -perfusión I-TREATMENT +vesícula I-EXPLORATION +biliar I-EXPLORATION +distendida, I-EXPLORATION +con I-EXPLORATION +edema I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +pared I-EXPLORATION +y I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +colelitiasis. I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT de I-TREATMENT -midazolam. I-TREATMENT -En B-EVOLUTION +colecistitis I-TREATMENT +aguda, I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +sometido I-TREATMENT +a I-TREATMENT +una I-TREATMENT +colecistectomía I-TREATMENT +laparoscópica I-TREATMENT +urgente I-TREATMENT +tras B-EVOLUTION la I-EVOLUTION -evolución I-EVOLUTION -desarrolló I-EVOLUTION -afectación I-EVOLUTION -sistémica I-EVOLUTION -con I-EVOLUTION -hipotensión I-EVOLUTION -arterial, I-EVOLUTION -acidosis I-EVOLUTION -metabólica, I-EVOLUTION -hiponatremia, I-EVOLUTION -oliguria I-EVOLUTION +cual I-EVOLUTION +tuvo I-EVOLUTION +una I-EVOLUTION +recuperación I-EVOLUTION +postoperatoria I-EVOLUTION +favorable I-EVOLUTION y I-EVOLUTION -plaquetopenia I-EVOLUTION -grave; I-EVOLUTION -requirió B-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -convencional, I-TREATMENT -transfusión I-TREATMENT -de I-TREATMENT -hemoderivados, I-TREATMENT -soporte I-TREATMENT -inotrópico I-TREATMENT -con I-TREATMENT -dopamina I-TREATMENT -y I-TREATMENT -diurético I-TREATMENT -con I-TREATMENT -furosemida. I-TREATMENT +sin I-EVOLUTION +complicaciones. I-EVOLUTION El B-EXPLORATION -tercer I-EXPLORATION -día I-EXPLORATION +resultado I-EXPLORATION del I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -el I-EXPLORATION -aislamiento I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hemocultivo I-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION de I-EXPLORATION -Streptococcus I-EXPLORATION -pyogenes I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -penicilina, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -la I-TREATMENT -ampicilina I-TREATMENT -y I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -cefotaxima I-TREATMENT -intravenosa. I-TREATMENT -Tras B-EVOLUTION -su I-EVOLUTION -estabilización I-EVOLUTION -presentó I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -analítica, I-EVOLUTION -que B-TREATMENT -permitió I-TREATMENT -suspender I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -inotrópico I-TREATMENT -a I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -h I-TREATMENT -y I-TREATMENT -realizar I-TREATMENT -extubación I-TREATMENT -al I-TREATMENT -cuarto I-TREATMENT -día. I-TREATMENT -No B-EVOLUTION -se I-EVOLUTION -repitieron I-EVOLUTION -las I-EVOLUTION -crisis I-EVOLUTION -clínicas I-EVOLUTION -y B-EXPLORATION -el I-EXPLORATION -electroencefalograma I-EXPLORATION -fue I-EXPLORATION -normal, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -anticomicial. I-TREATMENT -Se B-EXPLORATION -repitió I-EXPLORATION -la I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -sin I-EXPLORATION -éxito. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -cerebral I-EXPLORATION -y I-EXPLORATION la I-EXPLORATION -angiorresonancia I-EXPLORATION -iniciales I-EXPLORATION -mostraron I-EXPLORATION -hemorragia I-EXPLORATION -intraventricular I-EXPLORATION -con I-EXPLORATION -discreta I-EXPLORATION -ventriculomegalia I-EXPLORATION -y I-EXPLORATION -lesiones I-EXPLORATION -hemisféricas I-EXPLORATION -cortico-subcorticales I-EXPLORATION -bilaterales, I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -meningoencefalitis. I-EXPLORATION -No I-EXPLORATION -superó I-EXPLORATION -el I-EXPLORATION -tamizaje I-EXPLORATION -auditivo I-EXPLORATION -realizado I-EXPLORATION -durante I-EXPLORATION -el I-EXPLORATION -ingreso I-EXPLORATION -mediante I-EXPLORATION +pieza I-EXPLORATION +reveló I-EXPLORATION la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -exploración I-EXPLORATION -de I-EXPLORATION -potenciales I-EXPLORATION -provocados I-EXPLORATION -auditivos I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -tronco I-EXPLORATION -cerebral I-EXPLORATION -automatizados I-EXPLORATION -(PEATC-A I-EXPLORATION -> I-EXPLORATION -40 I-EXPLORATION -dB). I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -ecografías I-EXPLORATION -cerebrales I-EXPLORATION +colecistitis I-EXPLORATION +crónica I-EXPLORATION +y I-EXPLORATION de I-EXPLORATION -control I-EXPLORATION -presentó I-EXPLORATION -buena I-EXPLORATION -evolución I-EXPLORATION -sin I-EXPLORATION -aumento I-EXPLORATION +tejido I-EXPLORATION +pancreático I-EXPLORATION +ectópico I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -dilatación I-EXPLORATION -ventricular. I-EXPLORATION +vesícula I-EXPLORATION +biliar. I-EXPLORATION I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -34 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -vida, I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -completar I-EVOLUTION -21 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -cefotaxima, I-EVOLUTION -se I-EVOLUTION -otorgó I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -hospitalaria I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -exploración I-EVOLUTION -neurológica I-EVOLUTION -normal, I-EVOLUTION -excepto I-EVOLUTION -una I-EVOLUTION -leve I-EVOLUTION -hipotonía I-EVOLUTION -de I-EVOLUTION -eje. I-EVOLUTION -Se I-EVOLUTION -realizó I-EVOLUTION -seguimiento I-EVOLUTION -por I-EVOLUTION -especialistas I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -unidades I-EVOLUTION -de I-EVOLUTION -rehabilitación, I-EVOLUTION -otorrinolaringología I-EVOLUTION -y I-EVOLUTION -neurología; I-EVOLUTION -al I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -vida, I-EVOLUTION -no I-EVOLUTION -presentaba I-EVOLUTION -patología I-EVOLUTION -auditiva I-EVOLUTION -ni I-EVOLUTION -neurológica I-EVOLUTION -residual. I-EVOLUTION - I-EVOLUTION Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -16 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS +11 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS sin B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -importancia, I-PAST_MEDICAL_HISTORY +salud I-PAST_MEDICAL_HISTORY +relevantes, I-PAST_MEDICAL_HISTORY que B-PRESENT_ILLNESS -comienza I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -adinamia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS al I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -agrega I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -atrás I-PRESENT_ILLNESS -erección I-PRESENT_ILLNESS -peneana I-PRESENT_ILLNESS -persistente, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -moderado, I-PRESENT_ILLNESS +Hospital I-PRESENT_ILLNESS +Universitario I-PRESENT_ILLNESS +Austral I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -zonal, I-PRESENT_ILLNESS -donde B-TREATMENT -le I-TREATMENT -indican I-TREATMENT -analgésicos I-TREATMENT -y I-TREATMENT -medios I-TREATMENT -físicos I-TREATMENT -citándose I-TREATMENT -a I-TREATMENT -las I-TREATMENT -24 I-TREATMENT -h I-TREATMENT -para I-TREATMENT -control. I-TREATMENT -Al B-EVOLUTION -día I-EVOLUTION -siguiente I-EVOLUTION -concurre I-EVOLUTION -a I-EVOLUTION -dicho I-EVOLUTION -hospital, I-EVOLUTION -donde I-EVOLUTION -por I-EVOLUTION -continuar I-EVOLUTION -con I-EVOLUTION -erección I-EVOLUTION -peneana I-EVOLUTION -y I-EVOLUTION -palidez I-EVOLUTION -generalizada I-EVOLUTION -deciden B-EXPLORATION -realizar I-EXPLORATION -estudios I-EXPLORATION +dolor I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +tumefacción I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +pie I-PRESENT_ILLNESS +izquierdo, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +15 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Se B-EXPLORATION +encontraba I-EXPLORATION +en I-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +normotenso I-EXPLORATION +y I-EXPLORATION +afebril; I-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +placa I-EXPLORATION +eritematosa I-EXPLORATION +y I-EXPLORATION +dolorosa I-EXPLORATION +en I-EXPLORATION +planta I-EXPLORATION +izquierda. I-EXPLORATION +Por B-EVOLUTION +sospecha I-EVOLUTION +de I-EVOLUTION +un I-EVOLUTION +proceso I-EVOLUTION +infeccioso I-EVOLUTION +se I-EVOLUTION +decidió I-EVOLUTION +su I-EVOLUTION +internación. I-EVOLUTION +Se B-EXPLORATION +realizaron I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION laboratorio I-EXPLORATION que I-EXPLORATION -muestran: I-EXPLORATION -plaquetopenia I-EXPLORATION -(plaquetas I-EXPLORATION -60 I-EXPLORATION -000/mm3), I-EXPLORATION -anemia I-EXPLORATION -(hematócrito I-EXPLORATION -12%) I-EXPLORATION -e I-EXPLORATION -hiperleucocitosis I-EXPLORATION -(glóbulos I-EXPLORATION -blancos I-EXPLORATION -312 I-EXPLORATION -000/mm3) I-EXPLORATION +demostraron I-EXPLORATION +leucocitosis I-EXPLORATION +leve I-EXPLORATION y I-EXPLORATION -LDH I-EXPLORATION -2056 I-EXPLORATION -UI/ml, I-EXPLORATION +eritrosedimentación I-EXPLORATION +elevada; I-EXPLORATION +dos I-EXPLORATION +hemocultivos I-EXPLORATION +y I-EXPLORATION +punción I-EXPLORATION por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION +piel I-EXPLORATION +sana, I-EXPLORATION +todos I-EXPLORATION +ellos I-EXPLORATION +negativos. I-EXPLORATION +También I-EXPLORATION se I-EXPLORATION -decide I-EXPLORATION -su I-EXPLORATION -internación I-EXPLORATION -y B-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -solicita I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -derivación I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -mayor I-DERIVED_FROM/TO -complejidad. I-DERIVED_FROM/TO -A B-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -al I-EXPLORATION -Hospital I-EXPLORATION -Posadas I-EXPLORATION -se I-EXPLORATION -constata I-EXPLORATION -paciente I-EXPLORATION -en I-EXPLORATION -regular I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -palidez I-EXPLORATION -cutáneomucosa, I-EXPLORATION -fiebre I-EXPLORATION -y I-EXPLORATION -equimosis I-EXPLORATION -en I-EXPLORATION -miembros I-EXPLORATION -inferiores. I-EXPLORATION -Se I-EXPLORATION -palpa I-EXPLORATION -esplenomegalia. I-EXPLORATION -Se I-EXPLORATION -observa I-EXPLORATION -pene I-EXPLORATION -erecto I-EXPLORATION -con I-EXPLORATION -cambios I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -coloración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -del I-EXPLORATION -cuerpo, I-EXPLORATION -palidez I-EXPLORATION +solicitaron: I-EXPLORATION +radiografía, I-EXPLORATION +centellografía I-EXPLORATION y I-EXPLORATION -leve I-EXPLORATION -cianosis I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +nuclear I-EXPLORATION del I-EXPLORATION -glande. I-EXPLORATION +miembro I-EXPLORATION +afectado, I-EXPLORATION +descartándose I-EXPLORATION +compromiso I-EXPLORATION +óseo. I-EXPLORATION Se B-TREATMENT -realiza I-TREATMENT -interconsulta I-TREATMENT -con I-TREATMENT -urología, I-TREATMENT -quien I-TREATMENT -realiza I-TREATMENT -drenaje I-TREATMENT -de I-TREATMENT -cuerpos I-TREATMENT -cavernosos I-TREATMENT -con I-TREATMENT -solución I-TREATMENT -fisiológica I-TREATMENT -y I-TREATMENT -adrenalina; I-TREATMENT -el I-TREATMENT -procedimiento I-TREATMENT -arroja I-TREATMENT -sangre I-TREATMENT -oscura I-TREATMENT +indicaron I-TREATMENT +ibuprofeno I-TREATMENT +400 I-TREATMENT +mg I-TREATMENT +cada I-TREATMENT +6 I-TREATMENT +h I-TREATMENT y I-TREATMENT -coagulada. I-TREATMENT -Por B-EVOLUTION -presentar I-EVOLUTION -registro I-EVOLUTION -febril, I-EVOLUTION -se B-EXPLORATION -realizan I-EXPLORATION -hemocultivos I-EXPLORATION -x I-EXPLORATION -2 I-EXPLORATION -y B-TREATMENT +cefalotina I-TREATMENT +100 I-TREATMENT +mg/kg/día I-TREATMENT +cada I-TREATMENT +6 I-TREATMENT +h I-TREATMENT +asociada I-TREATMENT +a I-TREATMENT +gentamicina I-TREATMENT +5 I-TREATMENT +mg/kg/día I-TREATMENT +por I-TREATMENT +3 I-TREATMENT +días. I-TREATMENT +Por I-TREATMENT +evolución I-TREATMENT +desfavorable I-TREATMENT se I-TREATMENT -decide I-TREATMENT -iniciar I-TREATMENT -tratamiento I-TREATMENT -empírico I-TREATMENT -con I-TREATMENT -ceftazidima-amikacina I-TREATMENT -y I-TREATMENT -transfundir I-TREATMENT -glóbulos I-TREATMENT -rojos I-TREATMENT -desplasmatizados. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -evoluciona I-EVOLUTION -en I-EVOLUTION -mal I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -con I-EVOLUTION -dificultad I-EVOLUTION -respiratoria I-EVOLUTION -creciente, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -cual I-EVOLUTION -se I-EVOLUTION -lo I-EVOLUTION -traslada I-EVOLUTION -a I-EVOLUTION -terapia I-EVOLUTION -intensiva. I-EVOLUTION -Se I-EVOLUTION -realiza I-EVOLUTION -diagnóstico I-EVOLUTION +rotó I-TREATMENT +a I-TREATMENT +clindamicina, I-TREATMENT +40 I-TREATMENT +mg/kg/día I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +h I-TREATMENT +asociada I-TREATMENT +a I-TREATMENT +rifampicina, I-TREATMENT +20 I-TREATMENT +mg/kg/día I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +h. I-TREATMENT +Al B-EVOLUTION +sexto I-EVOLUTION +día I-EVOLUTION de I-EVOLUTION -leucemia I-EVOLUTION -mieloide I-EVOLUTION -crónica I-EVOLUTION +internación, I-EVOLUTION por I-EVOLUTION -biopsia I-EVOLUTION -de I-EVOLUTION -medula I-EVOLUTION -ósea I-EVOLUTION -y I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -blastos I-EVOLUTION -en I-EVOLUTION -sangre I-EVOLUTION -periférica. I-EVOLUTION -Se I-EVOLUTION -descartan I-EVOLUTION -otros I-EVOLUTION -diagnósticos, I-EVOLUTION -como I-EVOLUTION -la I-EVOLUTION -anemia I-EVOLUTION +aparición I-EVOLUTION de I-EVOLUTION -células I-EVOLUTION -falciforme, I-EVOLUTION -por I-EVOLUTION -no I-EVOLUTION -presentar I-EVOLUTION -depranocitos I-EVOLUTION +nódulos I-EVOLUTION en I-EVOLUTION -frotis I-EVOLUTION -de I-EVOLUTION -sangre I-EVOLUTION -periférica; I-EVOLUTION -causa I-EVOLUTION -medicamentosa, I-EVOLUTION -por I-EVOLUTION -no I-EVOLUTION -presentar I-EVOLUTION -ingesta I-EVOLUTION -de I-EVOLUTION -medicamentos; I-EVOLUTION -causa I-EVOLUTION -traumática, I-EVOLUTION -por I-EVOLUTION -falta I-EVOLUTION +miembros I-EVOLUTION +superiores, I-EVOLUTION +fiebre I-EVOLUTION +y I-EVOLUTION +artralgias I-EVOLUTION de I-EVOLUTION -traumatismos I-EVOLUTION -previos I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -pene; I-EVOLUTION -asimismo, I-EVOLUTION -se I-EVOLUTION -descartan I-EVOLUTION -tumores I-EVOLUTION -sólidos I-EVOLUTION -genitourinarios I-EVOLUTION +tobillos I-EVOLUTION y I-EVOLUTION -enfermedades I-EVOLUTION -neurológicas I-EVOLUTION -e I-EVOLUTION -infecciosas. I-EVOLUTION -Actualmente, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION +muñecas I-EVOLUTION se I-EVOLUTION -encuentra I-EVOLUTION +realizó I-EVOLUTION +una I-EVOLUTION +interconsulta I-EVOLUTION con I-EVOLUTION -disfunción I-EVOLUTION -eréctil I-EVOLUTION -secundaria I-EVOLUTION -a I-EVOLUTION -priapismo I-EVOLUTION -y I-EVOLUTION -permanece I-EVOLUTION -en I-EVOLUTION -tratamiento I-EVOLUTION -oncológico I-EVOLUTION -por I-EVOLUTION -su I-EVOLUTION -patología I-EVOLUTION +el I-EVOLUTION +Servicio I-EVOLUTION de I-EVOLUTION -base. I-EVOLUTION - I-EVOLUTION - -Una B-PRESENT_ILLNESS -niña I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -9 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -cirrosis I-PRESENT_ILLNESS -fue B-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -evaluación I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -trasplante I-DERIVED_FROM/TO -hepático. I-DERIVED_FROM/TO -Se B-EXPLORATION -presentó I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -cuadro I-EXPLORATION -referido I-EXPLORATION -como I-EXPLORATION -de I-EXPLORATION -reciente I-EXPLORATION -comienzo, I-EXPLORATION -aunque I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION +Dermatología. I-EVOLUTION +En B-EXPLORATION +esa I-EXPLORATION +oportunidad, I-EXPLORATION +al I-EXPLORATION examen I-EXPLORATION físico I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +múltiples I-EXPLORATION +nódulos I-EXPLORATION +eritematosos, I-EXPLORATION +dolorosos, I-EXPLORATION +de I-EXPLORATION +1-2 I-EXPLORATION +cm, I-EXPLORATION +agrupados I-EXPLORATION +en I-EXPLORATION +miembros I-EXPLORATION +superiores I-EXPLORATION +e I-EXPLORATION +inferiores; I-EXPLORATION +otros I-EXPLORATION +nódulos I-EXPLORATION +eritematopurpúricos, I-EXPLORATION +de I-EXPLORATION +mayor I-EXPLORATION +tiempo I-EXPLORATION +de I-EXPLORATION +evolución I-EXPLORATION +en I-EXPLORATION +arco I-EXPLORATION +interno I-EXPLORATION +de I-EXPLORATION +pie I-EXPLORATION +izquierdo I-EXPLORATION y I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION +otro I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +posterior I-EXPLORATION de I-EXPLORATION -estudios I-EXPLORATION +tobillo I-EXPLORATION +derecho. I-EXPLORATION + I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -hepatopatía I-EXPLORATION -crónica. I-EXPLORATION -Presentaba I-EXPLORATION -estigmas I-EXPLORATION +palpaban I-EXPLORATION +adenomegalias I-EXPLORATION +ni I-EXPLORATION +se I-EXPLORATION +evidenciaban I-EXPLORATION +livedo I-EXPLORATION +reticular, I-EXPLORATION +ulceraciones I-EXPLORATION +u I-EXPLORATION +otros I-EXPLORATION +signos I-EXPLORATION +cutáneos. I-EXPLORATION +Con I-EXPLORATION +diagnósticos I-EXPLORATION +presuntivos I-EXPLORATION de I-EXPLORATION -cronicidad I-EXPLORATION -como I-EXPLORATION +panarteritis I-EXPLORATION +nudosa I-EXPLORATION +cutánea I-EXPLORATION +(PANC), I-EXPLORATION eritema I-EXPLORATION -palmar, I-EXPLORATION -telangiectasias, I-EXPLORATION -circulación I-EXPLORATION -colateral I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION +nudoso I-EXPLORATION +atípico I-EXPLORATION +u I-EXPLORATION +otras I-EXPLORATION +paniculitis, I-EXPLORATION +se I-EXPLORATION +solicitaron I-EXPLORATION +estudios I-EXPLORATION +complementarios: I-EXPLORATION +recuento I-EXPLORATION +de I-EXPLORATION +glóbulos I-EXPLORATION +blancos, I-EXPLORATION +10.900 I-EXPLORATION +(neutrófilos I-EXPLORATION +61%; I-EXPLORATION +linfocitos I-EXPLORATION +29%); I-EXPLORATION +hemoglobina, I-EXPLORATION +13, I-EXPLORATION +5 I-EXPLORATION +mg/dl; I-EXPLORATION +hematocrito, I-EXPLORATION +40%; I-EXPLORATION +plaquetas, I-EXPLORATION +292.000/ I-EXPLORATION +mm3; I-EXPLORATION +ESD I-EXPLORATION +32 I-EXPLORATION +mm/h, I-EXPLORATION +tiempo I-EXPLORATION +de I-EXPLORATION +protrombina, I-EXPLORATION +96%; I-EXPLORATION +KPTT I-EXPLORATION +36 I-EXPLORATION +seg; I-EXPLORATION +ASTO I-EXPLORATION +400 I-EXPLORATION +UI/ml I-EXPLORATION +(VN<200 I-EXPLORATION +UI/ I-EXPLORATION +ml); I-EXPLORATION +complemento: I-EXPLORATION +C3 I-EXPLORATION +214 I-EXPLORATION +(VN: I-EXPLORATION +90-180); I-EXPLORATION +C4 I-EXPLORATION +45, I-EXPLORATION +3 I-EXPLORATION +(VN: I-EXPLORATION +10-40); I-EXPLORATION +FAN, I-EXPLORATION +ANCA, I-EXPLORATION +FR, I-EXPLORATION +serologías I-EXPLORATION +para I-EXPLORATION +VHB, I-EXPLORATION +VHC, I-EXPLORATION +Bartonella, I-EXPLORATION +Mycoplasma I-EXPLORATION y I-EXPLORATION -esplenomegalia. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION +EBV: I-EXPLORATION +negativas. I-EXPLORATION +Cultivo I-EXPLORATION +de I-EXPLORATION +fauces: I-EXPLORATION +negativo. I-EXPLORATION +La I-EXPLORATION +PPD I-EXPLORATION +2 I-EXPLORATION +UT I-EXPLORATION +fue I-EXPLORATION +no I-EXPLORATION +reactiva. I-EXPLORATION +Además, I-EXPLORATION se I-EXPLORATION -constató I-EXPLORATION -un I-EXPLORATION -hígado I-EXPLORATION +realizaron I-EXPLORATION +estudios I-EXPLORATION +para I-EXPLORATION +descartar I-EXPLORATION +compromiso I-EXPLORATION +sistémico: I-EXPLORATION +hepatograma, I-EXPLORATION +urea, I-EXPLORATION +creatinina, I-EXPLORATION +ionograma, I-EXPLORATION +gases I-EXPLORATION +en I-EXPLORATION +sangre, I-EXPLORATION +análisis I-EXPLORATION de I-EXPLORATION -pequeño I-EXPLORATION -tamaño I-EXPLORATION -con I-EXPLORATION -heterogeneidad I-EXPLORATION +orina, I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo, I-EXPLORATION +presión I-EXPLORATION +ocular, I-EXPLORATION +ecocardiografía I-EXPLORATION +Doppler, I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax, I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION y I-EXPLORATION -bazo I-EXPLORATION -con I-EXPLORATION -diámetro I-EXPLORATION -longitudinal I-EXPLORATION -aumentado. I-EXPLORATION -No B-TREATMENT -recibía I-TREATMENT -medicación I-TREATMENT -antes I-TREATMENT -de I-TREATMENT -la I-TREATMENT -admisión I-TREATMENT -en I-TREATMENT -nuestro I-TREATMENT -hospital. I-TREATMENT -En B-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -contexto I-PAST_MEDICAL_HISTORY -social I-PAST_MEDICAL_HISTORY -complejo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -poca I-PAST_MEDICAL_HISTORY -percepción I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -enfermedad, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -familia I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -consultado I-PAST_MEDICAL_HISTORY -previamente. I-PAST_MEDICAL_HISTORY -Tampoco I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -periódico I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -salud. I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -ingreso, I-EXPLORATION -el I-EXPLORATION -puntaje I-EXPLORATION +ecografía I-EXPLORATION +Doppler I-EXPLORATION de I-EXPLORATION -gravedad I-EXPLORATION -PELD I-EXPLORATION -(Pediatric I-EXPLORATION -End-Stage I-EXPLORATION -Liver I-EXPLORATION -Disease, I-EXPLORATION -hepatopatía I-EXPLORATION -terminal I-EXPLORATION -pediátrica) I-EXPLORATION -era I-EXPLORATION +miembros I-EXPLORATION +inferiores, I-EXPLORATION +sin I-EXPLORATION +evidenciarse I-EXPLORATION +alteraciones. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +histopatológico I-EXPLORATION de I-EXPLORATION -24, I-EXPLORATION -con I-EXPLORATION -bilirrubina I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION de I-EXPLORATION -15 I-EXPLORATION -mg/dl, I-EXPLORATION un I-EXPLORATION -valor I-EXPLORATION +nódulo I-EXPLORATION +del I-EXPLORATION +miembro I-EXPLORATION +inferior I-EXPLORATION +demostró I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -relación I-EXPLORATION -internacional I-EXPLORATION -normalizada I-EXPLORATION -(RIN) I-EXPLORATION +la I-EXPLORATION +interfaz I-EXPLORATION +dermohipodérmica I-EXPLORATION +y, I-EXPLORATION +en I-EXPLORATION +hipodermis, I-EXPLORATION +compromiso I-EXPLORATION +inflamatorio I-EXPLORATION +neutrofílico I-EXPLORATION +y I-EXPLORATION +material I-EXPLORATION +fibrinoide I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +paredes I-EXPLORATION de I-EXPLORATION -2, I-EXPLORATION -5, I-EXPLORATION -albúmina I-EXPLORATION +los I-EXPLORATION +vasos I-EXPLORATION +y I-EXPLORATION +arterias I-EXPLORATION de I-EXPLORATION -2, I-EXPLORATION -5 I-EXPLORATION -g/dl; I-EXPLORATION -su I-EXPLORATION -peso I-EXPLORATION +pequeño I-EXPLORATION +calibre, I-EXPLORATION +con I-EXPLORATION +oclusión I-EXPLORATION +luminal I-EXPLORATION +focal I-EXPLORATION y I-EXPLORATION -talla I-EXPLORATION -eran I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -30 I-EXPLORATION -kg I-EXPLORATION +algunos I-EXPLORATION +linfocitos I-EXPLORATION y I-EXPLORATION -127 I-EXPLORATION -cm, I-EXPLORATION -respectivamente. I-EXPLORATION -Mientras B-EVOLUTION -esperaba I-EVOLUTION -en I-EVOLUTION -lista I-EVOLUTION -de I-EVOLUTION -trasplante I-EVOLUTION -hepático, I-EVOLUTION -desarrolló I-EVOLUTION -encefalopatía I-EVOLUTION -hepática I-EVOLUTION -espontánea, I-EVOLUTION -de I-EVOLUTION -tipo I-EVOLUTION -C, I-EVOLUTION -grado I-EVOLUTION -II-III1 I-EVOLUTION -con I-EVOLUTION -períodos I-EVOLUTION -de I-EVOLUTION -conducta I-EVOLUTION -inapropiada I-EVOLUTION -que I-EVOLUTION -alternaban I-EVOLUTION -con I-EVOLUTION -confusión I-EVOLUTION -y I-EVOLUTION -excitación. I-EVOLUTION -Previamente, I-EVOLUTION -no I-EVOLUTION -había I-EVOLUTION -presentado I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -encefalopatía. I-EVOLUTION -Su B-EXPLORATION -amonio I-EXPLORATION -sérico I-EXPLORATION -aumentó I-EXPLORATION +numerosos I-EXPLORATION +eosinófilos. I-EXPLORATION +Estos I-EXPLORATION +hallazgos I-EXPLORATION +histopatológicos I-EXPLORATION +permiten I-EXPLORATION +arribar I-EXPLORATION +al I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -139 I-EXPLORATION -µg% I-EXPLORATION -a I-EXPLORATION -324 I-EXPLORATION -µg% I-EXPLORATION -(valor I-EXPLORATION -normal I-EXPLORATION +vasculitis I-EXPLORATION de I-EXPLORATION -referencia I-EXPLORATION -19-82 I-EXPLORATION -µg%). I-EXPLORATION -Se I-EXPLORATION -descartaron I-EXPLORATION -factores I-EXPLORATION -precipitantes I-EXPLORATION -conocidos I-EXPLORATION +pequeños I-EXPLORATION +vasos I-EXPLORATION +dermohipodérmicos I-EXPLORATION +y I-EXPLORATION de I-EXPLORATION -encefalopatía I-EXPLORATION -hepática, I-EXPLORATION -como I-EXPLORATION -medicaciones, I-EXPLORATION -sangrado I-EXPLORATION -gastrointestinal, I-EXPLORATION -infecciones I-EXPLORATION -bacterianas, I-EXPLORATION -constipación, I-EXPLORATION -fallo I-EXPLORATION -renal, I-EXPLORATION -desequilibrios I-EXPLORATION -electrolíticos, I-EXPLORATION -hipovolemia I-EXPLORATION -o I-EXPLORATION -hipoxemia. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -tenía I-EXPLORATION -antecedentes I-EXPLORATION +arterias I-EXPLORATION de I-EXPLORATION -ascitis I-EXPLORATION +pequeño I-EXPLORATION +calibre. I-EXPLORATION + I-EXPLORATION +Por I-EXPLORATION +las I-EXPLORATION +manifestaciones I-EXPLORATION +cutáneas I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -abdominal. I-EXPLORATION +los I-EXPLORATION +resultados I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +estudios I-EXPLORATION +complementarios I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +PANC. I-EXPLORATION Se B-TREATMENT -indicó I-TREATMENT -una I-TREATMENT -dieta I-TREATMENT +decidió I-TREATMENT +la I-TREATMENT +suspensión I-TREATMENT +del I-TREATMENT +antibiótico I-TREATMENT +y I-TREATMENT +comenzar I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -restricción I-TREATMENT +meprednisona I-TREATMENT +1 I-TREATMENT +mg/kg/día, I-TREATMENT +dosis I-TREATMENT +diaria I-TREATMENT +total I-TREATMENT de I-TREATMENT -proteínas I-TREATMENT -(0, I-TREATMENT -8 I-TREATMENT -g/kg/día) I-TREATMENT +40 I-TREATMENT +mg I-TREATMENT y I-TREATMENT -lactulosa I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -(40 I-TREATMENT -ml/día, I-TREATMENT -divididos I-TREATMENT -en I-TREATMENT -4 I-TREATMENT -tomas), I-TREATMENT -logrando I-TREATMENT -3-4 I-TREATMENT -deposiciones I-TREATMENT -blandas I-TREATMENT -por I-TREATMENT -día. I-TREATMENT -A B-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -estas I-EVOLUTION -medidas, I-EVOLUTION -el I-EVOLUTION -estado I-EVOLUTION -neurológico I-EVOLUTION -no I-EVOLUTION -mejoró I-EVOLUTION -luego I-EVOLUTION -de I-EVOLUTION -4 I-EVOLUTION -días. I-EVOLUTION -Sobre B-TREATMENT -la I-TREATMENT -base I-TREATMENT -de I-TREATMENT -experiencias I-TREATMENT -en I-TREATMENT -pacientes I-TREATMENT -adultos, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -agregar I-TREATMENT -rifaximina I-TREATMENT -(20 I-TREATMENT -mg/kg/día, I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -divididos I-TREATMENT -en I-TREATMENT -dos I-TREATMENT -tomas), I-TREATMENT -con I-TREATMENT -previa I-TREATMENT -firma I-TREATMENT -del I-TREATMENT -consentimiento I-TREATMENT -informado I-TREATMENT +penicilina I-TREATMENT +profiláctica, I-TREATMENT por I-TREATMENT -parte I-TREATMENT +el I-TREATMENT +antecedente I-TREATMENT de I-TREATMENT -los I-TREATMENT -padres. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -mostró I-EVOLUTION +un I-TREATMENT +ASTO I-TREATMENT +positivo. I-TREATMENT +Hubo B-EVOLUTION mejoría I-EVOLUTION -clínica I-EVOLUTION -en I-EVOLUTION -3 I-EVOLUTION -días, I-EVOLUTION -sin I-EVOLUTION -confusión I-EVOLUTION -ni I-EVOLUTION -excitación I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -ritmo I-EVOLUTION -sueño/ I-EVOLUTION -vigilia I-EVOLUTION -normal. I-EVOLUTION -La I-EVOLUTION -concentración I-EVOLUTION +parcial I-EVOLUTION +al I-EVOLUTION +inicio I-EVOLUTION +del I-EVOLUTION +tratamiento, I-EVOLUTION +pero I-EVOLUTION +debido I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +persistencia I-EVOLUTION de I-EVOLUTION -amonio I-EVOLUTION -descendió I-EVOLUTION -gradualmente I-EVOLUTION -(236 I-EVOLUTION -µg% I-EVOLUTION +lesiones, I-EVOLUTION +fiebre I-EVOLUTION y I-EVOLUTION -162 I-EVOLUTION -µg%, I-EVOLUTION -4 I-EVOLUTION +artralgias, I-EVOLUTION +se B-TREATMENT +aumentó I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +meprednisona I-TREATMENT +a I-TREATMENT +60 I-TREATMENT +mg/día I-TREATMENT +a I-TREATMENT +los I-TREATMENT +ocho I-TREATMENT +días I-TREATMENT +con B-EVOLUTION +respuesta I-EVOLUTION +favorable I-EVOLUTION y I-EVOLUTION -10 I-EVOLUTION -días I-EVOLUTION -luego I-EVOLUTION +sin I-EVOLUTION +evidencia I-EVOLUTION de I-EVOLUTION -iniciado I-EVOLUTION -el I-EVOLUTION -tratamiento, I-EVOLUTION -respectivamente). I-EVOLUTION -No I-EVOLUTION -presentó I-EVOLUTION -cefaleas, I-EVOLUTION -dolor I-EVOLUTION -abdominal, I-EVOLUTION -náuseas I-EVOLUTION -ni I-EVOLUTION -vómitos I-EVOLUTION -relacionados I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -rifaximina. I-EVOLUTION -Finalmente, B-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -trasplante I-TREATMENT -hepático I-TREATMENT -pasado I-TREATMENT -un I-TREATMENT -mes I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -rifaximina, I-TREATMENT -sin I-TREATMENT -complicaciones. I-TREATMENT - I-TREATMENT +rebrote I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +controles I-EVOLUTION +posteriores. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Niña B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -internada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +traída I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -siete I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +deformidad I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +2o I-PRESENT_ILLNESS +dedo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -según I-PRESENT_ILLNESS -referencia I-PRESENT_ILLNESS -materna I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -frontoparietal I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -empeoró I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -previas I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -ingreso. I-PRESENT_ILLNESS -Antecedentes: B-PAST_MEDICAL_HISTORY -recién I-PAST_MEDICAL_HISTORY -nacida I-PAST_MEDICAL_HISTORY +la I-PRESENT_ILLNESS +mano I-PRESENT_ILLNESS +derecha. I-PRESENT_ILLNESS +La B-PAST_MEDICAL_HISTORY +familia I-PAST_MEDICAL_HISTORY +refiere I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +1 I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +sufrió I-PAST_MEDICAL_HISTORY +caída I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +altura I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -término, I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +cm. I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -adecuado I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -gestacional. I-PAST_MEDICAL_HISTORY -Tuvo I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -progresión I-PAST_MEDICAL_HISTORY -ponderal I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -ictericia I-PAST_MEDICAL_HISTORY -clínica. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -refirió I-PAST_MEDICAL_HISTORY -ictericia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -siete I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY +aplastamiento I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +antes. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Como I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +destaca I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +estudio I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -vida. I-PAST_MEDICAL_HISTORY -Evolución: B-EVOLUTION -al I-EVOLUTION -ingreso I-EVOLUTION -presentaba I-EVOLUTION -sopor, I-EVOLUTION -ictericia I-EVOLUTION -generalizada, I-EVOLUTION -hepatomegalia I-EVOLUTION -y I-EVOLUTION -tumoración I-EVOLUTION -frontoparietal I-EVOLUTION -izquierda. I-EVOLUTION -Laboratorio B-EXPLORATION -de I-EXPLORATION -ingreso: I-EXPLORATION -GOT I-EXPLORATION -262 I-EXPLORATION -UI/L, I-EXPLORATION -GPT I-EXPLORATION -143 I-EXPLORATION -UI/L, I-EXPLORATION -FAL I-EXPLORATION -2289 I-EXPLORATION -UI/L, I-EXPLORATION -bilirrubinemia I-EXPLORATION -total I-EXPLORATION -12, I-EXPLORATION -3 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -directa I-EXPLORATION -8, I-EXPLORATION -6 I-EXPLORATION -mg/ I-EXPLORATION -dl, I-EXPLORATION -coagulograma I-EXPLORATION -informado I-EXPLORATION -como I-EXPLORATION -"no I-EXPLORATION -coagula". I-EXPLORATION -TC: I-EXPLORATION -hemorragia I-EXPLORATION +cariotipo I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +resultado I-PAST_MEDICAL_HISTORY +normal I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +contexto I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alteraciones I-PAST_MEDICAL_HISTORY +electroencefalográficas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +plagiocefalia I-PAST_MEDICAL_HISTORY +parietooccipital I-PAST_MEDICAL_HISTORY +resueltas. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +realizada I-EXPLORATION +en I-EXPLORATION +Urgencias I-EXPLORATION +observamos I-EXPLORATION +ensanchamiento I-EXPLORATION de I-EXPLORATION -ventrículos I-EXPLORATION -laterales I-EXPLORATION -e I-EXPLORATION -intraparenquimatosa I-EXPLORATION -temporal I-EXPLORATION -derecha. I-EXPLORATION -Fue B-DERIVED_FROM/TO -evaluada I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -Neurocirugía I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -indicación I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -conducta I-DERIVED_FROM/TO -expectante. I-DERIVED_FROM/TO -Recibió B-EXPLORATION -vitamina I-EXPLORATION -K I-EXPLORATION -5 I-EXPLORATION -mg I-EXPLORATION -diarios I-EXPLORATION -por I-EXPLORATION -48 I-EXPLORATION -h I-EXPLORATION -como I-EXPLORATION -único I-EXPLORATION -tratamiento I-EXPLORATION -corrector I-EXPLORATION +la I-EXPLORATION +base I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -coagulopatía I-EXPLORATION -con I-EXPLORATION -laboratorio I-EXPLORATION +la I-EXPLORATION +falange I-EXPLORATION +media I-EXPLORATION +del I-EXPLORATION +2o I-EXPLORATION +dedo I-EXPLORATION de I-EXPLORATION -control I-EXPLORATION -normal: I-EXPLORATION -tiempo I-EXPLORATION +la I-EXPLORATION +mano I-EXPLORATION +derecha I-EXPLORATION +y I-EXPLORATION +alteración I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +flexión I-EXPLORATION de I-EXPLORATION -protrombina I-EXPLORATION -100%, I-EXPLORATION -KPTT I-EXPLORATION -45 I-EXPLORATION -segundos, I-EXPLORATION -fibrinógeno I-EXPLORATION -274 I-EXPLORATION -mg/dl. I-EXPLORATION -El I-EXPLORATION -centellograma I-EXPLORATION -con I-EXPLORATION -HIDA I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -captación I-EXPLORATION -hepática I-EXPLORATION -del I-EXPLORATION -contraste, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -visualizó I-EXPLORATION la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -intrahepática I-EXPLORATION -ni I-EXPLORATION -extrahepática, I-EXPLORATION -ni I-EXPLORATION -pasaje I-EXPLORATION -al I-EXPLORATION -intestino I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -24 I-EXPLORATION -h. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -portoentero-anastomosis, I-TREATMENT -después I-TREATMENT -de I-TREATMENT -confirmar I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -atresia I-TREATMENT -de I-TREATMENT -vías I-TREATMENT -biliares I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -cirugía. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -seguimiento I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -presentaba I-EVOLUTION -valoración I-EVOLUTION -clínico-neurológica I-EVOLUTION -normal I-EVOLUTION -y I-EVOLUTION -recibió I-EVOLUTION -trasplante I-EVOLUTION -de I-EVOLUTION -hígado I-EVOLUTION -al I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -edad. I-EVOLUTION - I-EVOLUTION - -Un B-PRESENT_ILLNESS -lactante I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vacunación I-PAST_MEDICAL_HISTORY -según I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -calendario I-PAST_MEDICAL_HISTORY -(primera I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -HBV), I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -después B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -recibir I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -vacuna I-PRESENT_ILLNESS -correspondiente I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -subsector I-PRESENT_ILLNESS -privado I-PRESENT_ILLNESS -(vacuna I-PRESENT_ILLNESS -séxtuple I-PRESENT_ILLNESS -[DTPa, I-PRESENT_ILLNESS -Hib, I-PRESENT_ILLNESS -IPV, I-PRESENT_ILLNESS -HB] I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -meningocócica I-PRESENT_ILLNESS -C), I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -llevado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -instauración I-PRESENT_ILLNESS -brusca I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -palidez I-PRESENT_ILLNESS -cutánea I-PRESENT_ILLNESS -acompañada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hipotonía I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hiporreactividad. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -se I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -regular I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -con I-EXPLORATION -cianosis I-EXPLORATION -y I-EXPLORATION -frialdad I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -extremidades, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -hipotonía I-EXPLORATION -y I-EXPLORATION -escasa I-EXPLORATION -respuesta I-EXPLORATION -a I-EXPLORATION +articulación I-EXPLORATION +interfalángica I-EXPLORATION +proximal, I-EXPLORATION +que I-EXPLORATION +alcanza I-EXPLORATION los I-EXPLORATION -estímulos. I-EXPLORATION -Las I-EXPLORATION -constantes I-EXPLORATION -vitales I-EXPLORATION -(frecuencia I-EXPLORATION -cardíaca, I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria, I-EXPLORATION -tensión I-EXPLORATION -arterial) I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -saturación I-EXPLORATION +50 I-EXPLORATION +grados I-EXPLORATION de I-EXPLORATION -oxígeno I-EXPLORATION -respirando I-EXPLORATION -aire I-EXPLORATION -ambiente I-EXPLORATION -se I-EXPLORATION -encontraban I-EXPLORATION +flexión I-EXPLORATION +máxima. I-EXPLORATION +La I-EXPLORATION +exploración I-EXPLORATION +neurovascular I-EXPLORATION +no I-EXPLORATION +determinó I-EXPLORATION +hallazgos I-EXPLORATION +patológicos I-EXPLORATION +de I-EXPLORATION +interés. I-EXPLORATION +Efectuamos I-EXPLORATION +también I-EXPLORATION +exploraciones I-EXPLORATION +radiológicas I-EXPLORATION +del I-EXPLORATION +2o I-EXPLORATION +dedo I-EXPLORATION en I-EXPLORATION -rangos I-EXPLORATION -normales; I-EXPLORATION +proyecciones I-EXPLORATION +anteroposterior I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +perfil, I-EXPLORATION +que I-EXPLORATION +determinan I-EXPLORATION la I-EXPLORATION -temperatura I-EXPLORATION -rectal I-EXPLORATION -era I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -38, I-EXPLORATION -6ºC. I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -inicial I-TREATMENT -de I-TREATMENT -un I-TREATMENT -cuadro I-TREATMENT -séptico, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -expansión I-TREATMENT -volumétrica I-TREATMENT -y, I-TREATMENT -después I-TREATMENT -de I-TREATMENT -practicar I-TREATMENT -un I-TREATMENT -estudio I-TREATMENT -analítico I-TREATMENT -y I-TREATMENT -de I-TREATMENT -obtener I-TREATMENT -muestras I-TREATMENT -para I-TREATMENT -cultivo, I-TREATMENT -se I-TREATMENT -comenzó I-TREATMENT -con I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -empírico. I-TREATMENT -En B-EVOLUTION -las I-EVOLUTION -dos I-EVOLUTION -horas I-EVOLUTION -sucesivas I-EVOLUTION -al I-EVOLUTION -ingreso, I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -llamativa, I-EVOLUTION -con I-EVOLUTION -recuperación I-EVOLUTION -del I-EVOLUTION -tono I-EVOLUTION -muscular I-EVOLUTION -y I-EVOLUTION -reactividad I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -estímulos I-EVOLUTION -normales, I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -buena I-EVOLUTION -perfusión I-EVOLUTION -tisular, I-EVOLUTION -observándose I-EVOLUTION -un I-EVOLUTION -lactante I-EVOLUTION -asintomático I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -examen I-EVOLUTION -físico I-EVOLUTION -normal. I-EVOLUTION -Tanto B-EXPLORATION -el I-EXPLORATION -despistaje I-EXPLORATION -infeccioso I-EXPLORATION -inicial I-EXPLORATION -como I-EXPLORATION -los I-EXPLORATION -diversos I-EXPLORATION -cultivos I-EXPLORATION -obtenidos I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -sangre, I-EXPLORATION +base I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -orina I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -líquido I-EXPLORATION -cefalorraquídeo I-EXPLORATION -resultaron I-EXPLORATION -negativos, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -replanteó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -inicial I-EXPLORATION +falange I-EXPLORATION +media I-EXPLORATION de I-EXPLORATION -sepsis I-EXPLORATION -y I-EXPLORATION +dicho I-EXPLORATION +dedo I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +volar. I-EXPLORATION + I-EXPLORATION +La B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +diagnosticada I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +subluxación I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +consultas I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Traumatología I-DERIVED_FROM/TO +Infantil I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +control I-DERIVED_FROM/TO +radiográfico. I-DERIVED_FROM/TO +Allí B-EXPLORATION se I-EXPLORATION -atribuyó I-EXPLORATION -el I-EXPLORATION -episodio I-EXPLORATION +objetiva I-EXPLORATION a I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION un I-EXPLORATION -posible I-EXPLORATION -efecto I-EXPLORATION -adverso I-EXPLORATION +aumento I-EXPLORATION +macroscópico I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -vacuna I-EXPLORATION -acelular I-EXPLORATION -contra I-EXPLORATION -la I-EXPLORATION -tos I-EXPLORATION -ferina. I-EXPLORATION -Siguiendo B-TREATMENT -las I-TREATMENT -recomendaciones I-TREATMENT -del I-TREATMENT -Comité I-TREATMENT -de I-TREATMENT -Enfermedades I-TREATMENT -Infecciosas I-TREATMENT -de I-TREATMENT -la I-TREATMENT -Academia I-TREATMENT -Estadounidense I-TREATMENT -de I-TREATMENT -Pediatría I-TREATMENT -y, I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -ausencia I-TREATMENT -de I-TREATMENT -contraindicaciones I-TREATMENT -absolutas, I-TREATMENT -se I-TREATMENT -administró I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -correspondiente I-TREATMENT -a I-TREATMENT -la I-TREATMENT -vacunación I-TREATMENT -de I-TREATMENT -los I-TREATMENT -4 I-TREATMENT -meses I-TREATMENT -bajo I-TREATMENT -observación I-TREATMENT -hospitalaria, I-TREATMENT -sin I-TREATMENT -que I-TREATMENT -se I-TREATMENT -presentaran I-TREATMENT -manifestaciones I-TREATMENT -clínicas I-TREATMENT -en I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -horas I-TREATMENT -siguientes. I-TREATMENT - I-TREATMENT - -Niño B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -eritematosas, I-PRESENT_ILLNESS -redondeadas, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -bordes I-PRESENT_ILLNESS -definidos, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -pálido I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -rostro, I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -superiores, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aspecto I-PRESENT_ILLNESS -reticulado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -inferiores I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dorso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Hepatoesplenomegalia. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Madre B-FAMILY_HISTORY -y I-FAMILY_HISTORY -abuela I-FAMILY_HISTORY -materna I-FAMILY_HISTORY -con I-FAMILY_HISTORY -diagnóstico I-FAMILY_HISTORY -de I-FAMILY_HISTORY -Lupus I-FAMILY_HISTORY -Eritematoso I-FAMILY_HISTORY -sistémico I-FAMILY_HISTORY -(LES) I-FAMILY_HISTORY - I-FAMILY_HISTORY -Exámenes B-EXPLORATION -complementarios: I-EXPLORATION -Hb I-EXPLORATION -10g/dl, I-EXPLORATION -Hto I-EXPLORATION -30%, I-EXPLORATION -GPT I-EXPLORATION -78 I-EXPLORATION -UI/L, I-EXPLORATION -C3 I-EXPLORATION -53 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -C4 I-EXPLORATION -3mg/dl, I-EXPLORATION -FAN+ I-EXPLORATION -1/100, I-EXPLORATION -acs. I-EXPLORATION -anti I-EXPLORATION -Ro, I-EXPLORATION -anti I-EXPLORATION -La, I-EXPLORATION -anti I-EXPLORATION -Sm I-EXPLORATION -y I-EXPLORATION -anti I-EXPLORATION -U1RNP I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -Estudio I-EXPLORATION -histopatológico: I-EXPLORATION -hiperqueratosis, I-EXPLORATION -atrofia I-EXPLORATION -epidérmica, I-EXPLORATION -vacuolización I-EXPLORATION +base I-EXPLORATION de I-EXPLORATION -queratinocitos I-EXPLORATION -basales I-EXPLORATION -e I-EXPLORATION -infiltrado I-EXPLORATION -difuso I-EXPLORATION -mononuclear I-EXPLORATION -en I-EXPLORATION -dermis I-EXPLORATION -superficial. I-EXPLORATION -Inmunofluorescencia I-EXPLORATION -directa I-EXPLORATION -(IFD): I-EXPLORATION -banda I-EXPLORATION -segmentaria I-EXPLORATION -dermoepidérmica I-EXPLORATION +la I-EXPLORATION +falange I-EXPLORATION +media I-EXPLORATION +del I-EXPLORATION +2o I-EXPLORATION +dedo I-EXPLORATION de I-EXPLORATION -disposición I-EXPLORATION -granular I-EXPLORATION -fina I-EXPLORATION -IgG+ I-EXPLORATION +la I-EXPLORATION +mano I-EXPLORATION +derecha, I-EXPLORATION y I-EXPLORATION -C3+. I-EXPLORATION - I-EXPLORATION -Valoración I-EXPLORATION -cardiológica I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Tratamiento: B-TREATMENT -hidrocortisona I-TREATMENT -1% I-TREATMENT -crema. I-TREATMENT - I-TREATMENT -Resolución B-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -cutáneas, I-EVOLUTION -negativización I-EVOLUTION -del I-EVOLUTION -FAN I-EVOLUTION -y I-EVOLUTION -normalización I-EVOLUTION -del I-EVOLUTION -hepatograma I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -vida. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -32 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -hermano I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -anterior, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -revisión. I-PRESENT_ILLNESS -Refiere I-PRESENT_ILLNESS -hemeralopia I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -tiene I-PRESENT_ILLNESS -conocimiento I-PRESENT_ILLNESS -y, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -tiempos, I-PRESENT_ILLNESS -ligera I-PRESENT_ILLNESS -fotodisforia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -leve I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -agudeza I-PRESENT_ILLNESS -visual. I-PRESENT_ILLNESS -La B-EXPLORATION -visión I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -0 I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -ojos; I-EXPLORATION -tanto I-EXPLORATION -el I-EXPLORATION -fondo I-EXPLORATION +limitación I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION -como I-EXPLORATION la I-EXPLORATION -angiografía I-EXPLORATION -son I-EXPLORATION -similares I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION +flexión I-EXPLORATION +interfalángica I-EXPLORATION +proximal, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +máximo I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -hermano, I-EXPLORATION -aunque I-EXPLORATION +50 I-EXPLORATION +grados. I-EXPLORATION +Acude I-EXPLORATION con I-EXPLORATION -menores I-EXPLORATION -alteraciones I-EXPLORATION -maculares I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -EPR. I-EXPLORATION +radiografía I-EXPLORATION +control. I-EXPLORATION + I-EXPLORATION En I-EXPLORATION la I-EXPLORATION -campimetría I-EXPLORATION -aparece I-EXPLORATION -un I-EXPLORATION -estotoma I-EXPLORATION -central. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizan I-EXPLORATION -sendos I-EXPLORATION -estudios I-EXPLORATION -electrofisiológicos I-EXPLORATION -no I-EXPLORATION -estandarizados I-EXPLORATION -consistentes I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -primer I-EXPLORATION -electrorretinograma I-EXPLORATION -(ERG) I-EXPLORATION -basal I-EXPLORATION -y I-EXPLORATION +radiografía I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION un I-EXPLORATION -segundo I-EXPLORATION -realizado I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -180 I-EXPLORATION -minutos I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -adaptación I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -oscuridad. I-EXPLORATION -En I-EXPLORATION -ambos I-EXPLORATION -casos, I-EXPLORATION -el I-EXPLORATION -ERG I-EXPLORATION -basal I-EXPLORATION -revela I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -evidente I-EXPLORATION +porción I-EXPLORATION +palmar I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -amplitud I-EXPLORATION +base I-EXPLORATION de I-EXPLORATION -todas I-EXPLORATION -las I-EXPLORATION -ondas. I-EXPLORATION -Tras I-EXPLORATION la I-EXPLORATION -adaptación I-EXPLORATION +falange I-EXPLORATION +media I-EXPLORATION +con I-EXPLORATION +borramiento I-EXPLORATION +del I-EXPLORATION +cartílago I-EXPLORATION +de I-EXPLORATION +crecimiento I-EXPLORATION a I-EXPLORATION +ese I-EXPLORATION +nivel; I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -oscuridad, I-EXPLORATION +proyección I-EXPLORATION +anteroposterior I-EXPLORATION se I-EXPLORATION -pone I-EXPLORATION +evidencia I-EXPLORATION +superposición I-EXPLORATION +ósea. I-EXPLORATION +Se I-EXPLORATION +postula I-EXPLORATION +como I-EXPLORATION +posible I-EXPLORATION +diagnóstico I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -manifiesto I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -primer I-EXPLORATION -caso I-EXPLORATION una I-EXPLORATION -tendencia I-EXPLORATION -a I-EXPLORATION +fractura I-EXPLORATION +antigua I-EXPLORATION +de I-EXPLORATION +falange I-EXPLORATION +media I-EXPLORATION +con I-EXPLORATION +callo I-EXPLORATION +de I-EXPLORATION +fractura I-EXPLORATION +prominente I-EXPLORATION +y I-EXPLORATION +epifisiodesis. I-EXPLORATION +La B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +Unidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +mano I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Cirugía I-DERIVED_FROM/TO +Plástica I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +Reparadora I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +valoración I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +secuela I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +fractura. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +En B-EXPLORATION la I-EXPLORATION -normalización I-EXPLORATION -del I-EXPLORATION -flash I-EXPLORATION +primera I-EXPLORATION +consulta I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +Servicio I-EXPLORATION +de I-EXPLORATION +Cirugía I-EXPLORATION +Plástica I-EXPLORATION y I-EXPLORATION -escotópico, I-EXPLORATION +Reparadora I-EXPLORATION no I-EXPLORATION -modificándose I-EXPLORATION -ni I-EXPLORATION -el I-EXPLORATION -flicker I-EXPLORATION -ni I-EXPLORATION -el I-EXPLORATION -fotópico. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -segundo I-EXPLORATION -caso, I-EXPLORATION +se I-EXPLORATION +aprecian I-EXPLORATION +cambios I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -adaptación I-EXPLORATION +exploración I-EXPLORATION +respecto I-EXPLORATION a I-EXPLORATION -la I-EXPLORATION -oscuridad I-EXPLORATION -normaliza I-EXPLORATION +los I-EXPLORATION +descritos I-EXPLORATION +por I-EXPLORATION +Traumatología I-EXPLORATION +Infantil. I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +no I-EXPLORATION +aporta I-EXPLORATION las I-EXPLORATION -ondas, I-EXPLORATION -incluido I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -conos I-EXPLORATION +radiografías I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -queda I-EXPLORATION +le I-EXPLORATION +habían I-EXPLORATION +sido I-EXPLORATION +entregadas I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -límite I-EXPLORATION -inferior I-EXPLORATION +mano I-EXPLORATION +en I-EXPLORATION +Urgencias I-EXPLORATION +y I-EXPLORATION +Traumatología I-EXPLORATION +Infantil I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +cita I-EXPLORATION +nuevamente I-EXPLORATION +para I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION +control I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +insiste I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -normalidad I-EXPLORATION -para I-EXPLORATION -su I-EXPLORATION -edad. I-EXPLORATION +necesidad I-EXPLORATION +de I-EXPLORATION +que I-EXPLORATION +aporte I-EXPLORATION +las I-EXPLORATION +radiografías I-EXPLORATION +previas. I-EXPLORATION +Osteocondroma I-EXPLORATION +gigante I-EXPLORATION +de I-EXPLORATION +falange I-EXPLORATION +en I-EXPLORATION +paciente I-EXPLORATION +pediátrico I-EXPLORATION +Cirugía I-EXPLORATION I-EXPLORATION - -La B-PRESENT_ILLNESS -paciente, I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -niña I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -estudiada B-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -retraso I-DERIVED_FROM/TO -psicomotor, I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -sección I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -motilidad I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -déficit I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -fijación I-DERIVED_FROM/TO -ocular. I-DERIVED_FROM/TO -Se B-EXPLORATION -observaba I-EXPLORATION -que, I-EXPLORATION -para I-EXPLORATION -cambiar I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +acude I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +cita I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +2 I-EVOLUTION +años I-EVOLUTION +siguientes. I-EVOLUTION +Pasado I-EVOLUTION +este I-EVOLUTION +tiempo, I-EVOLUTION +solicita I-EVOLUTION +nuevamente I-EVOLUTION +cita I-EVOLUTION +en I-EVOLUTION +consulta I-EVOLUTION +de I-EVOLUTION +Cirugía I-EVOLUTION +Plástica I-EVOLUTION +y I-EVOLUTION +Reparadora I-EVOLUTION +por I-EVOLUTION +aumento I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +deformidad I-EVOLUTION +del I-EVOLUTION +dedo. I-EVOLUTION +A B-EXPLORATION la I-EXPLORATION -dirección I-EXPLORATION +exploración I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +un I-EXPLORATION +notable I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -mirada, I-EXPLORATION +base I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -niña I-EXPLORATION -se I-EXPLORATION -veía I-EXPLORATION -obligada I-EXPLORATION -a I-EXPLORATION -realizar I-EXPLORATION -unos I-EXPLORATION -movimientos I-EXPLORATION -bruscos I-EXPLORATION -laterales I-EXPLORATION +falange I-EXPLORATION +media I-EXPLORATION +del I-EXPLORATION +2o I-EXPLORATION +dedo I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -cabeza I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -que I-EXPLORATION -arrastraba I-EXPLORATION -sus I-EXPLORATION -ojos I-EXPLORATION -al I-EXPLORATION -nuevo I-EXPLORATION -objeto. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION +mano I-EXPLORATION +derecha I-EXPLORATION +(macrodactilia). I-EXPLORATION +La I-EXPLORATION +alteración I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -habitual I-EXPLORATION -para I-EXPLORATION -buscar I-EXPLORATION -alteraciones I-EXPLORATION -que I-EXPLORATION -justificasen I-EXPLORATION -esa I-EXPLORATION -dificultad: I-EXPLORATION +flexión I-EXPLORATION +es I-EXPLORATION +mayor, I-EXPLORATION +alcanzando I-EXPLORATION +los I-EXPLORATION +20 I-EXPLORATION +grados I-EXPLORATION +de I-EXPLORATION +flexión I-EXPLORATION +máxima. I-EXPLORATION +Solicitamos I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +control. I-EXPLORATION + I-EXPLORATION +Observamos I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +radiografías, I-EXPLORATION +en I-EXPLORATION +proyección I-EXPLORATION +de I-EXPLORATION +perfil, I-EXPLORATION la I-EXPLORATION -motilidad I-EXPLORATION -ocular, I-EXPLORATION -BMC I-EXPLORATION -y I-EXPLORATION -F.O. I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -siguió I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +lobulado, I-EXPLORATION con I-EXPLORATION +distintas I-EXPLORATION +densidades, I-EXPLORATION +que I-EXPLORATION +parece I-EXPLORATION +provenir I-EXPLORATION +del I-EXPLORATION +tercio I-EXPLORATION +inferior I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -neurooftalmológica: I-EXPLORATION +falange I-EXPLORATION +media I-EXPLORATION +del I-EXPLORATION +2o I-EXPLORATION +dedo. I-EXPLORATION +La I-EXPLORATION +masa I-EXPLORATION +alcanza I-EXPLORATION el I-EXPLORATION -reflejo I-EXPLORATION -optocinético I-EXPLORATION -aparecía I-EXPLORATION -alterado I-EXPLORATION +tercio I-EXPLORATION +superior I-EXPLORATION +de I-EXPLORATION +partes I-EXPLORATION +blandas I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +falange I-EXPLORATION +proximal. I-EXPLORATION +Asimismo I-EXPLORATION +destaca I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +muesca I-EXPLORATION en I-EXPLORATION su I-EXPLORATION -fase I-EXPLORATION -rápida I-EXPLORATION -(disminuida I-EXPLORATION -o I-EXPLORATION -ausente) I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -plano I-EXPLORATION -horizontal. I-EXPLORATION -Los I-EXPLORATION -potenciales I-EXPLORATION -evocados I-EXPLORATION -visuales I-EXPLORATION -(P.E.V.) I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -electrorretinograma I-EXPLORATION -(ERG) I-EXPLORATION -dada I-EXPLORATION +porción I-EXPLORATION +superior. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -corta I-EXPLORATION -edad I-EXPLORATION +proyección I-EXPLORATION +anteroposterior I-EXPLORATION +apreciamos I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +masa I-EXPLORATION +sobrepasa I-EXPLORATION +la I-EXPLORATION +extensión I-EXPLORATION +de I-EXPLORATION +anchura I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -paciente. I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION -neurológica I-EXPLORATION -evidenciaba I-EXPLORATION -hipertonía I-EXPLORATION +segunda I-EXPLORATION +falange. I-EXPLORATION + I-EXPLORATION +Ante I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION de I-EXPLORATION -miembros I-EXPLORATION -inferiores I-EXPLORATION +osteocondroma/encondroma I-EXPLORATION +solicitamos I-EXPLORATION +RM I-EXPLORATION +que I-EXPLORATION +informa I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +exóstosis I-EXPLORATION +lobulada I-EXPLORATION +de I-EXPLORATION +12 I-EXPLORATION +mm I-EXPLORATION +de I-EXPLORATION +espesor, I-EXPLORATION con I-EXPLORATION -hiperreflexia. I-EXPLORATION -Las I-EXPLORATION -exploraciones I-EXPLORATION -encaminadas I-EXPLORATION +base I-EXPLORATION +de I-EXPLORATION +20x20 I-EXPLORATION +mm, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +extiende I-EXPLORATION +proximalmente I-EXPLORATION +afectando I-EXPLORATION a I-EXPLORATION -detectar I-EXPLORATION -procesos I-EXPLORATION -neurológicos I-EXPLORATION -o I-EXPLORATION -sistémicos I-EXPLORATION -(EEG, I-EXPLORATION -RM I-EXPLORATION -cerebral, I-EXPLORATION -aminoácidos I-EXPLORATION -en I-EXPLORATION -sangre, I-EXPLORATION -orina I-EXPLORATION -y I-EXPLORATION -LCR, I-EXPLORATION -amoníaco, I-EXPLORATION -ácido I-EXPLORATION -pirúvico I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION +la I-EXPLORATION +placa I-EXPLORATION +volar I-EXPLORATION +de I-EXPLORATION +inserción I-EXPLORATION +del I-EXPLORATION +sistema I-EXPLORATION +flexor I-EXPLORATION +superficial, I-EXPLORATION +con I-EXPLORATION +desplazamiento I-EXPLORATION +del I-EXPLORATION +tendón I-EXPLORATION +flexor I-EXPLORATION +profundo I-EXPLORATION y I-EXPLORATION -LCR, I-EXPLORATION -ácidos I-EXPLORATION -grasos I-EXPLORATION +del I-EXPLORATION +sistema I-EXPLORATION de I-EXPLORATION -cadena I-EXPLORATION -larga, I-EXPLORATION -serología I-EXPLORATION -TORCH) I-EXPLORATION -resultaron I-EXPLORATION -normales. I-EXPLORATION -Sólo I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -ácido I-EXPLORATION -láctico I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -proteínas I-EXPLORATION -en I-EXPLORATION -LCR I-EXPLORATION -levemente I-EXPLORATION -altas, I-EXPLORATION -sin I-EXPLORATION -demostrarse I-EXPLORATION -enfermedad. I-EXPLORATION -Por I-EXPLORATION -PCR I-EXPLORATION -se I-EXPLORATION -amplificó I-EXPLORATION -virus I-EXPLORATION -del I-EXPLORATION -herpes I-EXPLORATION -humano I-EXPLORATION -tipo I-EXPLORATION -6 I-EXPLORATION -(HHV-6), I-EXPLORATION -del I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -han I-EXPLORATION -descrito I-EXPLORATION -asociaciones I-EXPLORATION -con I-EXPLORATION -apraxia I-EXPLORATION -oculomotora. I-EXPLORATION - I-EXPLORATION -Fue I-EXPLORATION -diagnosticada I-EXPLORATION +anclaje I-EXPLORATION de I-EXPLORATION -C.O.M.A. I-EXPLORATION +poleas, I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -afectación I-EXPLORATION -piramidal I-EXPLORATION -bilateral I-EXPLORATION -inespecífica. I-EXPLORATION +osteocondroma. I-EXPLORATION I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -74 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -epífora I-PRESENT_ILLNESS -bilateral, I-PRESENT_ILLNESS -mayor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -(OI), I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dacriocistitis I-PRESENT_ILLNESS -aguda. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -presenta I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -drenaje I-PAST_MEDICAL_HISTORY -quirúrgico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -senos I-PAST_MEDICAL_HISTORY -etmoidales I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -sinusitis I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -juventud. I-PAST_MEDICAL_HISTORY -Presenta B-EXPLORATION -una I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -(AV) I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -3 I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -ojos. I-EXPLORATION -Esta I-EXPLORATION -visión I-EXPLORATION -estaba I-EXPLORATION -justificada I-EXPLORATION -por I-EXPLORATION +Estadiamos I-EXPLORATION +el I-EXPLORATION +tumor I-EXPLORATION +empleando I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION +clasificación I-EXPLORATION de I-EXPLORATION -cataratas I-EXPLORATION +Enneking I-EXPLORATION y I-EXPLORATION -además I-EXPLORATION -tenía I-EXPLORATION -una I-EXPLORATION -obstrucción I-EXPLORATION -bilateral I-EXPLORATION +determinamos I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +trataba I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -lagrimal. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -dacriocistografía I-TREATMENT -izquierda I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -se I-TREATMENT -le I-TREATMENT -implantó I-TREATMENT -una I-TREATMENT -prótesis I-TREATMENT -recta I-TREATMENT -de I-TREATMENT -Wacrees I-TREATMENT -sin I-TREATMENT -complicaciones. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -comienzó I-EVOLUTION -una I-EVOLUTION -inflamación I-EVOLUTION -palpebral I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -región I-EVOLUTION -orbitaria I-EVOLUTION -izquierda. I-EVOLUTION -Tras I-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION -refirió I-EVOLUTION -pérdida I-EVOLUTION -brusca I-EVOLUTION -de I-EVOLUTION -agudeza I-EVOLUTION -visual I-EVOLUTION -del I-EVOLUTION -OI I-EVOLUTION -con I-EVOLUTION -mal I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION -y I-EVOLUTION -febrícula I-EVOLUTION -(37,6º). I-EVOLUTION -A I-EVOLUTION -las I-EVOLUTION -72 I-EVOLUTION -horas I-EVOLUTION -acudió I-EVOLUTION -a I-EVOLUTION -urgencias, I-EVOLUTION -presentando I-EVOLUTION -una I-EVOLUTION -visión I-EVOLUTION -de I-EVOLUTION -movimiento I-EVOLUTION -de I-EVOLUTION -manos I-EVOLUTION -a I-EVOLUTION -50 I-EVOLUTION -cms, I-EVOLUTION -marcado I-EVOLUTION -exoftalmos I-EVOLUTION -con I-EVOLUTION -clínica I-EVOLUTION -inflamatoria I-EVOLUTION -periocular, I-EVOLUTION -oftalmoplejia I-EVOLUTION -con I-EVOLUTION -dolor I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -movimientos I-EVOLUTION -oculares I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -biomicroscopía I-EVOLUTION -midriasis I-EVOLUTION -paralítica I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -OI I-EVOLUTION -con I-EVOLUTION -anestesia I-EVOLUTION -corneal. I-EVOLUTION -Oftalmoscópicamente B-EXPLORATION -la I-EXPLORATION -papila I-EXPLORATION -era I-EXPLORATION +un I-EXPLORATION +estadio I-EXPLORATION +III, I-EXPLORATION +lesión I-EXPLORATION +benigna I-EXPLORATION +agresiva: I-EXPLORATION +lesión I-EXPLORATION +benigna I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -normal I-EXPLORATION +baja I-EXPLORATION +agresividad I-EXPLORATION +(G0), I-EXPLORATION con I-EXPLORATION -pulso I-EXPLORATION -venoso I-EXPLORATION -espontáneo I-EXPLORATION -negativo. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -hemograma I-EXPLORATION +afectación I-EXPLORATION de I-EXPLORATION -urgencias I-EXPLORATION -presentaba I-EXPLORATION -leucocitosis I-EXPLORATION -con I-EXPLORATION -desviación I-EXPLORATION -izquierda. I-EXPLORATION -El I-EXPLORATION -TAC I-EXPLORATION -craneal I-EXPLORATION -realizado I-EXPLORATION -era I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -celulitis I-EXPLORATION -orbitaria I-EXPLORATION -OI. I-EXPLORATION -Asimismo I-EXPLORATION la I-EXPLORATION -paciente I-EXPLORATION -tenía I-EXPLORATION -una I-EXPLORATION -neuritis I-EXPLORATION -óptica I-EXPLORATION -izquierda I-EXPLORATION -por I-EXPLORATION -compresión I-EXPLORATION -intraorbitaria. I-EXPLORATION +inserción I-EXPLORATION +perióstica I-EXPLORATION +del I-EXPLORATION +extensor I-EXPLORATION +superficial I-EXPLORATION +(extracompartimental) I-EXPLORATION +(T2) I-EXPLORATION +y I-EXPLORATION +sin I-EXPLORATION +metástasis I-EXPLORATION +(M0). I-EXPLORATION I-EXPLORATION -Se B-TREATMENT -instaura I-TREATMENT +Dada B-TREATMENT +la I-TREATMENT +alteración I-TREATMENT +funcional I-TREATMENT +que I-TREATMENT +presentaba I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +y I-TREATMENT +el I-TREATMENT +tamaño I-TREATMENT +de I-TREATMENT +la I-TREATMENT +masa I-TREATMENT +tumoral, I-TREATMENT +decidimos I-TREATMENT +llevar I-TREATMENT +a I-TREATMENT +cabo I-TREATMENT tratamiento I-TREATMENT -sistémico I-TREATMENT -con I-TREATMENT -metil-prednisolona I-TREATMENT -(250 I-TREATMENT -mgr/iv/6 I-TREATMENT -h), I-TREATMENT -ceftriaxona I-TREATMENT -(2 I-TREATMENT -gr/iv/12 I-TREATMENT -h) I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión. I-TREATMENT + I-TREATMENT +En I-TREATMENT +la I-TREATMENT +cirugía I-TREATMENT +efectuamos I-TREATMENT +acceso I-TREATMENT +a I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +mediante I-TREATMENT +técnica I-TREATMENT +de I-TREATMENT +Brunner I-TREATMENT +en I-TREATMENT +zig-zag I-TREATMENT +evitando I-TREATMENT +así I-TREATMENT +la I-TREATMENT +sección I-TREATMENT +transversal I-TREATMENT +de I-TREATMENT +los I-TREATMENT +pliegues I-TREATMENT +palmares I-TREATMENT +que I-TREATMENT +pudiera I-TREATMENT +generar I-TREATMENT +futuras I-TREATMENT +retracciones. I-TREATMENT +Localizamos I-TREATMENT +el I-TREATMENT +tendón I-TREATMENT +flexor I-TREATMENT +superficial I-TREATMENT y I-TREATMENT -Vancomicina I-TREATMENT -(1 I-TREATMENT -gr/iv/12 I-TREATMENT -h), I-TREATMENT +colocamos I-TREATMENT +la I-TREATMENT +articulación I-TREATMENT +metacarpofalángica I-TREATMENT +del I-TREATMENT +2o I-TREATMENT +dedo, I-TREATMENT así I-TREATMENT como I-TREATMENT -tratamiento I-TREATMENT -tópico I-TREATMENT +la I-TREATMENT +muñeca, I-TREATMENT en I-TREATMENT -OI. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -cuadro I-EVOLUTION -inflamatorio I-EVOLUTION -periocular I-EVOLUTION -mejoró I-EVOLUTION -notablemente I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -primeras I-EVOLUTION -24 I-EVOLUTION -horas, I-EVOLUTION -pero I-EVOLUTION -no I-EVOLUTION -la I-EVOLUTION -agudeza I-EVOLUTION -visual, I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -limitaba I-EVOLUTION -a I-EVOLUTION -percepción I-EVOLUTION -de I-EVOLUTION -colores I-EVOLUTION -parcheados I-EVOLUTION -(azul, I-EVOLUTION -marrón). I-EVOLUTION - I-EVOLUTION -Transcurrida B-EXPLORATION -1 I-EXPLORATION -semana I-EXPLORATION -se I-EXPLORATION -retiró I-EXPLORATION -la I-EXPLORATION -prótesis I-EXPLORATION -lacrimonasal, I-EXPLORATION -a I-EXPLORATION -pesar I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -buena I-EXPLORATION -localización I-EXPLORATION -y I-EXPLORATION -funcionamiento, I-EXPLORATION -haciéndose I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -microbiológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -y I-EXPLORATION -aislándose I-EXPLORATION -tres I-EXPLORATION -gérmenes: I-EXPLORATION -Streptococcus I-EXPLORATION -mitis, I-EXPLORATION -Staphylococcus I-EXPLORATION -epidérmidis I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -bacilo I-EXPLORATION -gram I-EXPLORATION -negativo I-EXPLORATION -oxidasa I-EXPLORATION -positivo I-EXPLORATION -(sin I-EXPLORATION -determinar). I-EXPLORATION - I-EXPLORATION -Durante B-TREATMENT +flexión I-TREATMENT +máxima I-TREATMENT +para I-TREATMENT +alcanzar I-TREATMENT la I-TREATMENT -evolución I-TREATMENT -se I-TREATMENT -desarrolló I-TREATMENT -un I-TREATMENT -piocele I-TREATMENT -que I-TREATMENT -precisó I-TREATMENT -dacriocistectomía I-TREATMENT -izquierda. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -OI I-EVOLUTION -una I-EVOLUTION -visión I-EVOLUTION -de I-EVOLUTION -percepción I-EVOLUTION -de I-EVOLUTION -luz, I-EVOLUTION -con I-EVOLUTION -leve I-EVOLUTION -midriasis I-EVOLUTION -arreactiva I-EVOLUTION -y I-EVOLUTION -atrofia I-EVOLUTION -óptica I-EVOLUTION -izquierda. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -angiografía I-EXPLORATION -fluoresceínica I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -hipofluorescencia I-EXPLORATION -papilar I-EXPLORATION -durante I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -angiograma I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -RMN I-EXPLORATION -un I-EXPLORATION -dudoso I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -señal I-EXPLORATION -tardío I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -nervio I-EXPLORATION -óptico. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -artritis I-PAST_MEDICAL_HISTORY -reumatoide I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -leflunomida, I-PAST_MEDICAL_HISTORY -deflazacort I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -antiinflamatorios I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -esteroideos I-PAST_MEDICAL_HISTORY -(AINEs), I-PAST_MEDICAL_HISTORY -es B-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Inflamación I-DERIVED_FROM/TO -Ocular I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -cuadro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -ojo I-DERIVED_FROM/TO -derecho I-DERIVED_FROM/TO -rojo I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -doloroso I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -dos I-DERIVED_FROM/TO -semanas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -asociado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -empeoramiento I-DERIVED_FROM/TO -clínico I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -laboratorio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -enfermedad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -base. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -La B-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -inicial I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -6 I-EXPLORATION -en I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -(OD) I-EXPLORATION -y I-EXPLORATION -1 I-EXPLORATION -en I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION -(OI). I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -biomicroscopía I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -ingurgitación I-EXPLORATION -vascular I-EXPLORATION -con I-EXPLORATION -edema I-EXPLORATION -y I-EXPLORATION -engrosamiento I-EXPLORATION -escleral I-EXPLORATION -temporal I-EXPLORATION -superior I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OD I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -escleritis I-EXPLORATION -anterior I-EXPLORATION -difusa I-EXPLORATION -severa. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -en I-EXPLORATION -AO. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -esteroideo I-TREATMENT -oral I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT +porción I-TREATMENT +más I-TREATMENT +proximal I-TREATMENT +del I-TREATMENT +tendón I-TREATMENT +flexor I-TREATMENT +superficial. I-TREATMENT +Lo I-TREATMENT +seccionamos, I-TREATMENT +elegiendo I-TREATMENT +realizar I-TREATMENT +dicha I-TREATMENT +sección I-TREATMENT a I-TREATMENT -dosis I-TREATMENT +nivel I-TREATMENT +proximal I-TREATMENT +para I-TREATMENT +prevenir I-TREATMENT +la I-TREATMENT +aparición I-TREATMENT +del I-TREATMENT +fenómeno I-TREATMENT +conocido I-TREATMENT +como I-TREATMENT +Cuádriga I-TREATMENT de I-TREATMENT -1 I-TREATMENT -mg/kg/día, I-TREATMENT -manteniendo I-TREATMENT -el I-TREATMENT -resto I-TREATMENT +Verdán, I-TREATMENT +entendido I-TREATMENT +como I-TREATMENT +alteración I-TREATMENT +de I-TREATMENT +la I-TREATMENT +flexión I-TREATMENT +de I-TREATMENT +la I-TREATMENT +articulación I-TREATMENT +metacarpofalángica I-TREATMENT +por I-TREATMENT +adhesión I-TREATMENT +en I-TREATMENT +una I-TREATMENT +articulación I-TREATMENT del I-TREATMENT -tratamiento, I-TREATMENT -sin I-TREATMENT -obtener I-TREATMENT -mejoría I-TREATMENT -clínica I-TREATMENT +cabo I-TREATMENT +proximal I-TREATMENT +de I-TREATMENT +un I-TREATMENT +tendón I-TREATMENT tras I-TREATMENT -tres I-TREATMENT -semanas I-TREATMENT +su I-TREATMENT +sección. I-TREATMENT +Mediante I-TREATMENT +escoplo, I-TREATMENT +escindimos I-TREATMENT +la I-TREATMENT +porción I-TREATMENT de I-TREATMENT -seguimiento. I-TREATMENT -Una B-EXPLORATION -vez I-EXPLORATION -realizadas I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -Mantoux I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -negativos, I-EXPLORATION -se B-TREATMENT -decidió I-TREATMENT la I-TREATMENT -administración I-TREATMENT +tumoración I-TREATMENT +que I-TREATMENT +sobresalía I-TREATMENT +de I-TREATMENT +la I-TREATMENT +falange I-TREATMENT +sana I-TREATMENT +y I-TREATMENT +una I-TREATMENT +porción I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cortical I-TREATMENT +adyacente. I-TREATMENT +Seguidamente I-TREATMENT +practicamos I-TREATMENT +curetaje I-TREATMENT +mediante I-TREATMENT +cucharilla I-TREATMENT +de I-TREATMENT +la I-TREATMENT +médula I-TREATMENT +y I-TREATMENT +del I-TREATMENT +tejido I-TREATMENT +óseo I-TREATMENT +de I-TREATMENT +la I-TREATMENT +superficie I-TREATMENT +dorsal. I-TREATMENT + I-TREATMENT +Para I-TREATMENT +la I-TREATMENT +reconstrucción: I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cavidad I-TREATMENT +generada I-TREATMENT +empleamos I-TREATMENT +material I-TREATMENT +osteoconductor I-TREATMENT +(Actifuse I-TREATMENT +Abx I-TREATMENT +Silicated I-TREATMENT +Calcium I-TREATMENT +Phosphate®, I-TREATMENT +BioSurgery, I-TREATMENT +EE. I-TREATMENT +UU). I-TREATMENT +Efectuamos I-TREATMENT +inmovilización I-TREATMENT +mediante I-TREATMENT +férula I-TREATMENT +dorsal I-TREATMENT +de I-TREATMENT +yeso I-TREATMENT +desde I-TREATMENT +tercio I-TREATMENT +proximal I-TREATMENT +del I-TREATMENT +antebrazo I-TREATMENT +hasta I-TREATMENT +final I-TREATMENT de I-TREATMENT -Infliximab I-TREATMENT -(Remicade®, I-TREATMENT -Schering-Plough, I-TREATMENT -Welwyn I-TREATMENT -Garden I-TREATMENT -City, I-TREATMENT -UK) I-TREATMENT +los I-TREATMENT +dedos, I-TREATMENT +con I-TREATMENT +muñeca I-TREATMENT en I-TREATMENT -tres I-TREATMENT -dosis I-TREATMENT -intravenosas I-TREATMENT +40o I-TREATMENT de I-TREATMENT -3 I-TREATMENT -mg/kg/día I-TREATMENT +flexión I-TREATMENT +palmar, I-TREATMENT +articulaciones I-TREATMENT +metacarpofalángicas I-TREATMENT en I-TREATMENT -las I-TREATMENT -semanas I-TREATMENT -0, I-TREATMENT -2 I-TREATMENT +90o I-TREATMENT y I-TREATMENT -6. I-TREATMENT -Tras B-EVOLUTION -la I-EVOLUTION -segunda I-EVOLUTION -dosis I-EVOLUTION -se I-EVOLUTION -objetivó I-EVOLUTION -una I-EVOLUTION -reducción I-EVOLUTION -de I-EVOLUTION +articulaciones I-TREATMENT +interfalángicas I-TREATMENT +en I-TREATMENT +extensión. I-TREATMENT +Mantuvimos B-EVOLUTION la I-EVOLUTION -ingurgitación I-EVOLUTION -vascular I-EVOLUTION -y I-EVOLUTION -del I-EVOLUTION -edema I-EVOLUTION -escleral I-EVOLUTION -y I-EVOLUTION +inmovilización I-EVOLUTION +durante I-EVOLUTION +3 I-EVOLUTION +semanas, I-EVOLUTION tras I-EVOLUTION +las I-EVOLUTION +cuales I-EVOLUTION +no I-EVOLUTION +fue I-EVOLUTION +necesaria I-EVOLUTION la I-EVOLUTION -tercera I-EVOLUTION -se I-EVOLUTION -obtuvo I-EVOLUTION -una I-EVOLUTION -desaparición I-EVOLUTION -completa I-EVOLUTION -de I-EVOLUTION +rehabilitación I-EVOLUTION +dada I-EVOLUTION la I-EVOLUTION -inflamación I-EVOLUTION -escleral, I-EVOLUTION -quedando I-EVOLUTION -un I-EVOLUTION -cierto I-EVOLUTION -adelgazamiento I-EVOLUTION -residual I-EVOLUTION -con I-EVOLUTION -transparencia I-EVOLUTION -del I-EVOLUTION -tejido I-EVOLUTION -uveal I-EVOLUTION -subyacente. I-EVOLUTION -Paralelamente, I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -signos I-EVOLUTION -y I-EVOLUTION -síntomas I-EVOLUTION -articulares, I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -disminución I-EVOLUTION +edad I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -actividad I-EVOLUTION -global I-EVOLUTION -de I-EVOLUTION +paciente I-EVOLUTION +y I-EVOLUTION la I-EVOLUTION -enfermedad I-EVOLUTION -representada I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -Disease I-EVOLUTION -Activity I-EVOLUTION -Score I-EVOLUTION -(DAS I-EVOLUTION -28), I-EVOLUTION -obteniéndose I-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -40% I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -DAS I-EVOLUTION -28. I-EVOLUTION +buena I-EVOLUTION +movilidad I-EVOLUTION +postoperatoria I-EVOLUTION +que I-EVOLUTION +presentaba. I-EVOLUTION I-EVOLUTION -Tras I-EVOLUTION -un I-EVOLUTION -período I-EVOLUTION +Practicamos I-EVOLUTION +radiografía I-EVOLUTION de I-EVOLUTION -seguimiento I-EVOLUTION +control I-EVOLUTION +anual I-EVOLUTION +sin I-EVOLUTION +evidencias I-EVOLUTION de I-EVOLUTION -6 I-EVOLUTION +recidiva I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +movilidad I-EVOLUTION +completa I-EVOLUTION +tras I-EVOLUTION +3 I-EVOLUTION +años I-EVOLUTION +y I-EVOLUTION +8 I-EVOLUTION meses I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -han I-EVOLUTION -detectado I-EVOLUTION -recidivas I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -inflamación I-EVOLUTION -escleral. I-EVOLUTION -La B-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -ojos I-EXPLORATION -(AO). I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -sigue I-TREATMENT -en I-TREATMENT -la I-TREATMENT -actualidad I-TREATMENT -tratamiento I-TREATMENT -sistémico I-TREATMENT -únicamente I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -7, I-TREATMENT -5 I-TREATMENT -mg/día, I-TREATMENT -leflunomida I-TREATMENT -y I-TREATMENT -AINEs. I-TREATMENT - I-TREATMENT +de I-EVOLUTION +seguimiento I-EVOLUTION +postoperatorio. I-EVOLUTION + I-EVOLUTION -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS +Niña B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS +22 I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS +de B-PAST_MEDICAL_HISTORY +origen I-PAST_MEDICAL_HISTORY +chino, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +haber I-PRESENT_ILLNESS +presentado I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +minutos I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -herida I-PAST_MEDICAL_HISTORY -corneal I-PAST_MEDICAL_HISTORY -postraumática I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ojo I-PAST_MEDICAL_HISTORY -izquierdo I-PAST_MEDICAL_HISTORY -(OI), I-PAST_MEDICAL_HISTORY -suturada I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -mismo I-PAST_MEDICAL_HISTORY -día I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -accidente, I-PAST_MEDICAL_HISTORY +movimientos I-PRESENT_ILLNESS +tónico-clónicos I-PRESENT_ILLNESS +generalizados, I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +conciencia I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +incontinencia I-PRESENT_ILLNESS +esfinteriana I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +unos I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +minutos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +duración I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +cedió I-PRESENT_ILLNESS +espontáneamente. I-PRESENT_ILLNESS +Desde I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +previas I-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +líquidas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos. I-PRESENT_ILLNESS +Estaba I-PRESENT_ILLNESS +afebril. I-PRESENT_ILLNESS +Antecedentes B-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +y B-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY sin I-PAST_MEDICAL_HISTORY -cuerpo I-PAST_MEDICAL_HISTORY -extraño I-PAST_MEDICAL_HISTORY -intraocular, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antibióticos, I-PAST_MEDICAL_HISTORY -ciclopléjicos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -esteroides I-PAST_MEDICAL_HISTORY -tópicos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sistémicos. I-PAST_MEDICAL_HISTORY -Al B-DERIVED_FROM/TO -suspender I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -esteroides, I-DERIVED_FROM/TO -presentó I-DERIVED_FROM/TO -disminución I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -agudeza I-DERIVED_FROM/TO -visual I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -ojo I-DERIVED_FROM/TO -no I-DERIVED_FROM/TO -traumatizado, I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -lo I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -reinició I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -administración I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -prednisona I-DERIVED_FROM/TO -vía I-DERIVED_FROM/TO -oral I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -envió I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestra I-DERIVED_FROM/TO -institución I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -oftalmía I-DERIVED_FROM/TO -simpática. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -A B-EXPLORATION -su I-EXPLORATION -ingreso, I-EXPLORATION -un I-EXPLORATION -mes I-EXPLORATION -y I-EXPLORATION -medio I-EXPLORATION -después I-EXPLORATION -del I-EXPLORATION -traumatismo, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -refería I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -(AV) I-EXPLORATION -del I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -(OD) I-EXPLORATION -de I-EXPLORATION -21 I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -evolución I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -escotoma I-EXPLORATION -central I-EXPLORATION -relativo I-EXPLORATION -en I-EXPLORATION -AO. I-EXPLORATION -A I-EXPLORATION +interés. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -oftalmológica I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION +física I-EXPLORATION +únicamente I-EXPLORATION +destacaba I-EXPLORATION una I-EXPLORATION -AV I-EXPLORATION -de I-EXPLORATION -20/60 I-EXPLORATION -OD I-EXPLORATION -y I-EXPLORATION -20/400 I-EXPLORATION -OI, I-EXPLORATION -presión I-EXPLORATION -intraocular I-EXPLORATION -de I-EXPLORATION -11 I-EXPLORATION -mmHg I-EXPLORATION -OD I-EXPLORATION -y I-EXPLORATION -12 I-EXPLORATION -mmHg I-EXPLORATION -OI. I-EXPLORATION -El I-EXPLORATION -OD I-EXPLORATION -presentaba I-EXPLORATION -además I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -pigmento I-EXPLORATION -1/2 I-EXPLORATION -+ I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cámara I-EXPLORATION -anterior, I-EXPLORATION -sin I-EXPLORATION -flare. I-EXPLORATION -El I-EXPLORATION -segmento I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -OI I-EXPLORATION -presentaba I-EXPLORATION -conjuntiva I-EXPLORATION -hiperémica, I-EXPLORATION -herida I-EXPLORATION -corneal I-EXPLORATION -suturada I-EXPLORATION -con I-EXPLORATION -leucoma I-EXPLORATION -temporal, I-EXPLORATION -sinequias I-EXPLORATION -posteriores I-EXPLORATION -y I-EXPLORATION -opacidad I-EXPLORATION -subcapsular I-EXPLORATION -posterior I-EXPLORATION -+. I-EXPLORATION -La I-EXPLORATION -funduscopia I-EXPLORATION -del I-EXPLORATION -OD I-EXPLORATION -mostraba I-EXPLORATION -pliegues I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mácula I-EXPLORATION -y I-EXPLORATION -dos I-EXPLORATION -lesiones I-EXPLORATION -blanco I-EXPLORATION -amarillentas I-EXPLORATION -con I-EXPLORATION -líquido I-EXPLORATION -subretiniano; I-EXPLORATION -el I-EXPLORATION -OI I-EXPLORATION -tenía I-EXPLORATION -tres I-EXPLORATION -lesiones I-EXPLORATION -de I-EXPLORATION -características I-EXPLORATION -similares, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -panuveítis I-EXPLORATION -bilateral. I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -que I-TREATMENT -recibía I-TREATMENT -consistía I-TREATMENT -en I-TREATMENT -prednisona I-TREATMENT -75 I-TREATMENT -mg/día I-TREATMENT -po, I-TREATMENT -acetato I-TREATMENT -de I-TREATMENT -prednisolona I-TREATMENT -1% I-TREATMENT -cada I-TREATMENT -2 I-TREATMENT -h, I-TREATMENT -ciclopentolato I-TREATMENT -1% I-TREATMENT -bid, I-TREATMENT -fenilefrina I-TREATMENT -10% I-TREATMENT -bid. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -aspecto I-EXPLORATION -clínico I-EXPLORATION -hizo I-EXPLORATION -sospechar I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +leve I-EXPLORATION +sequedad I-EXPLORATION de I-EXPLORATION -CSC. I-EXPLORATION +mucosas. I-EXPLORATION Se I-EXPLORATION -solicitaron I-EXPLORATION -ecografía I-EXPLORATION -y I-EXPLORATION -estudio I-EXPLORATION -angiográfico. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -evidenció I-EXPLORATION -un I-EXPLORATION -desprendimiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -hialoides I-EXPLORATION -posterior I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OD I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +hemograma, I-EXPLORATION +bioquímica I-EXPLORATION y I-EXPLORATION -DRS I-EXPLORATION -en I-EXPLORATION -área I-EXPLORATION -macular I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OI; I-EXPLORATION -el I-EXPLORATION -grosor I-EXPLORATION -coroideo I-EXPLORATION -era I-EXPLORATION -normal I-EXPLORATION -en I-EXPLORATION -AO. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -angiográfico I-EXPLORATION -mostró I-EXPLORATION -dos I-EXPLORATION -zonas I-EXPLORATION -de I-EXPLORATION -hiperfluorescencia I-EXPLORATION +gasometría I-EXPLORATION +venosa, I-EXPLORATION que I-EXPLORATION -aumentaban I-EXPLORATION -progresivamente I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OD I-EXPLORATION -y I-EXPLORATION -tres I-EXPLORATION -lesiones I-EXPLORATION -similares I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OI. I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -CSC I-EXPLORATION -bilateral I-EXPLORATION -de I-EXPLORATION -focos I-EXPLORATION -múltiples. I-EXPLORATION -Se B-TREATMENT -suspendió I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ciclopléjicos I-TREATMENT -y I-TREATMENT -se I-TREATMENT -redujeron I-TREATMENT -rápidamente I-TREATMENT -los I-TREATMENT -esteroides I-TREATMENT -tópicos I-TREATMENT -y I-TREATMENT -sistémicos. I-TREATMENT -Un B-EVOLUTION -mes I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -la I-EVOLUTION -agudeza I-EVOLUTION -visual I-EVOLUTION -era I-EVOLUTION -de I-EVOLUTION -1 I-EVOLUTION -OD I-EVOLUTION -y I-EVOLUTION -0, I-EVOLUTION -2 I-EVOLUTION -OI; I-EVOLUTION -el I-EVOLUTION -aspecto I-EVOLUTION -clínico I-EVOLUTION -del I-EVOLUTION -fondo I-EVOLUTION -de I-EVOLUTION -ojo I-EVOLUTION -mostraba I-EVOLUTION +En B-EVOLUTION las I-EVOLUTION -lesiones I-EVOLUTION -pigmentadas I-EVOLUTION -sin I-EVOLUTION -líquido I-EVOLUTION -subretiniano I-EVOLUTION -en I-EVOLUTION -AO. I-EVOLUTION - I-EVOLUTION - -Niño B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -enviado I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -evaluar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -exoftalmos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -(OD) I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -visita I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -pediátrica I-EXPLORATION -general I-EXPLORATION -era I-EXPLORATION -buena I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -presentó I-EXPLORATION -anomalías I-EXPLORATION -neurológicas. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica, I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -proptosis I-EXPLORATION -e I-EXPLORATION -hipertropia I-EXPLORATION -del I-EXPLORATION -OD I-EXPLORATION -con I-EXPLORATION -franca I-EXPLORATION -asimetría I-EXPLORATION -facial. I-EXPLORATION -Con I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -fronto-temporal I-EXPLORATION -el I-EXPLORATION -niño I-EXPLORATION -tenía I-EXPLORATION -dolor. I-EXPLORATION -El I-EXPLORATION -segmento I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -OD I-EXPLORATION -explorado I-EXPLORATION -con I-EXPLORATION -linterna I-EXPLORATION -era I-EXPLORATION -aparentemente I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -motilidad I-EXPLORATION -intrínseca I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -mientras I-EXPLORATION -la I-EXPLORATION -motilidad I-EXPLORATION -extrínseca I-EXPLORATION -presentaba I-EXPLORATION -limitación I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -abducción I-EXPLORATION -y I-EXPLORATION -descenso I-EXPLORATION -del I-EXPLORATION -OD. I-EXPLORATION -La I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION -(RMN) I-EXPLORATION -demostró I-EXPLORATION +siguientes I-EVOLUTION +ocho I-EVOLUTION +horas, I-EVOLUTION +presenta I-EVOLUTION +tres I-EVOLUTION +nuevas I-EVOLUTION +crisis I-EVOLUTION +de I-EVOLUTION +similares I-EVOLUTION +características I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +inicial, I-EVOLUTION +que B-TREATMENT +ceden I-TREATMENT +con I-TREATMENT +diazepam I-TREATMENT +intravenoso I-TREATMENT +(IV) I-TREATMENT +y/o I-TREATMENT +ácido I-TREATMENT +valproico I-TREATMENT +IV I-TREATMENT +en I-TREATMENT +cinco I-TREATMENT +minutos. I-TREATMENT +Se B-EXPLORATION +realizaron I-EXPLORATION una I-EXPLORATION -lesión I-EXPLORATION -infiltrante I-EXPLORATION -que I-EXPLORATION -desplazaba I-EXPLORATION -el I-EXPLORATION -globo I-EXPLORATION -ocular I-EXPLORATION -hacia I-EXPLORATION -arriba I-EXPLORATION -con I-EXPLORATION -destrucción I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -orbitaria I-EXPLORATION -lateral I-EXPLORATION -y I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -en I-EXPLORATION -sacabocado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -calota I-EXPLORATION -craneal. I-EXPLORATION -Otros I-EXPLORATION -estudios I-EXPLORATION -radiológicos I-EXPLORATION -demostraron I-EXPLORATION -lesiones I-EXPLORATION -semejantes I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -vértebras I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -huesos I-EXPLORATION -largos I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -piernas. I-EXPLORATION -Las I-EXPLORATION -pruebas I-EXPLORATION -hematológicas I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION y I-EXPLORATION -bioquímicas I-EXPLORATION -mostraron I-EXPLORATION -valores I-EXPLORATION +un I-EXPLORATION +electroencefalograma, I-EXPLORATION +que I-EXPLORATION +fueron I-EXPLORATION normales. I-EXPLORATION -Una I-EXPLORATION -biopsia I-EXPLORATION -ósea I-EXPLORATION -del I-EXPLORATION -fémur I-EXPLORATION -demostró I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -Langerhans I-EXPLORATION -con I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -y I-EXPLORATION +Permaneció B-EVOLUTION +hospitalizada I-EVOLUTION +durante I-EVOLUTION +cuatro I-EVOLUTION +días I-EVOLUTION +sin I-EVOLUTION +presentar I-EVOLUTION +nuevas I-EVOLUTION +crisis. I-EVOLUTION +En B-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION -immunohistológico I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -proteína I-EXPLORATION -S100 I-EXPLORATION -(indica I-EXPLORATION -su I-EXPLORATION -origen I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cresta I-EXPLORATION -neural) I-EXPLORATION -y I-EXPLORATION -para I-EXPLORATION -las I-EXPLORATION -proteínas I-EXPLORATION -de I-EXPLORATION -superficie I-EXPLORATION -CD68 I-EXPLORATION -(proteína I-EXPLORATION -lisosomal I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -expresa I-EXPLORATION -en I-EXPLORATION -macrófagos I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -células I-EXPLORATION -dendríticas I-EXPLORATION -inmaduras) I-EXPLORATION -y I-EXPLORATION -CD1a I-EXPLORATION -(glicoproteína I-EXPLORATION -de I-EXPLORATION -membrana I-EXPLORATION -de I-EXPLORATION -49 I-EXPLORATION -KDa I-EXPLORATION -que I-EXPLORATION +coprocultivo I-EXPLORATION se I-EXPLORATION -expresa I-EXPLORATION -en I-EXPLORATION -asociación I-EXPLORATION -a I-EXPLORATION -ß2 I-EXPLORATION -microglobulinas) I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -histiocitosis I-EXPLORATION -de I-EXPLORATION -Langerhans. I-EXPLORATION -Dos B-EVOLUTION -meses I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -el I-EVOLUTION -niño I-EVOLUTION -estaba I-EVOLUTION -hipersomnoliento I-EVOLUTION -día I-EVOLUTION +aisló I-EXPLORATION +rotavirus. I-EXPLORATION +Su B-EVOLUTION +evolución I-EVOLUTION +posterior I-EVOLUTION +ha I-EVOLUTION +sido I-EVOLUTION +favorable, I-EVOLUTION +sin I-EVOLUTION +crisis I-EVOLUTION y I-EVOLUTION -noche I-EVOLUTION con I-EVOLUTION -ingesta I-EVOLUTION -excesiva I-EVOLUTION -de I-EVOLUTION -líquidos. I-EVOLUTION -En B-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -RMN I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -infiltrante I-EXPLORATION -que I-EXPLORATION -afectaba I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -hipotálamo-hipofisaria I-EXPLORATION -con I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -añadió I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -diabetes I-EXPLORATION -insípida. I-EXPLORATION - I-EXPLORATION +desarrollo I-EVOLUTION +psicomotor I-EVOLUTION +normal. I-EVOLUTION + I-EVOLUTION -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -53 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -miope B-PAST_MEDICAL_HISTORY -magna, I-PAST_MEDICAL_HISTORY -intervenida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cristalino I-PAST_MEDICAL_HISTORY -transparente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ambos I-PAST_MEDICAL_HISTORY -ojos, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -junio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2000. I-PAST_MEDICAL_HISTORY -Un I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -realizó I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -capsulotomía I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -ojo I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -láser I-PAST_MEDICAL_HISTORY -YAG. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -2003 I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -DR I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -OD, I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -vitrectomía I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -inyección I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -aceite I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -silicona I-PAST_MEDICAL_HISTORY -(AS), I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -retiró I-PAST_MEDICAL_HISTORY -seis I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -después. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -mayo I-PRESENT_ILLNESS +Un B-PRESENT_ILLNESS +joven I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -2004 I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS +15 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +manifestó I-PRESENT_ILLNESS +haber I-PRESENT_ILLNESS +sido I-PRESENT_ILLNESS +agredido I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS +cocodrilo. I-PRESENT_ILLNESS +Se I-PRESENT_ILLNESS +encontró I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS -brusca I-PRESENT_ILLNESS +pie I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +estado I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -visión I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS +shock I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +01: I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +h I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -OD. I-PRESENT_ILLNESS -En B-EXPLORATION -urgencias I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -una I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -(AV) I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -1, I-EXPLORATION -un I-EXPLORATION -tyndall I-EXPLORATION -de I-EXPLORATION -3+, I-EXPLORATION -una I-EXPLORATION -cámara I-EXPLORATION -anterior I-EXPLORATION -amplia I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -presión I-EXPLORATION -intraocular I-EXPLORATION -(PIO) I-EXPLORATION -de I-EXPLORATION -48 I-EXPLORATION -mmHg. I-EXPLORATION -En I-EXPLORATION +las I-PRESENT_ILLNESS +inmediaciones I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +campo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +golf I-PRESENT_ILLNESS +Marina I-PRESENT_ILLNESS +Vallarta I-PRESENT_ILLNESS +(la I-PRESENT_ILLNESS +zona I-PRESENT_ILLNESS +está I-PRESENT_ILLNESS +limitada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +cerca I-PRESENT_ILLNESS +perimetral I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +alambre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +púas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +tiene I-PRESENT_ILLNESS +letreros I-PRESENT_ILLNESS +informativos I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +prohíben I-PRESENT_ILLNESS +ingresar I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +zona I-PRESENT_ILLNESS +privada I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +alertan I-PRESENT_ILLNESS +sobre I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +presencia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cocodrilos). I-PRESENT_ILLNESS +La B-EXPLORATION +víctima I-EXPLORATION +tenía I-EXPLORATION +amputado I-EXPLORATION +el I-EXPLORATION +brazo I-EXPLORATION +izquierdo, I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -del I-EXPLORATION -fondo I-EXPLORATION +altura I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION la I-EXPLORATION -retina I-EXPLORATION -estaba I-EXPLORATION -aplicada, I-EXPLORATION -la I-EXPLORATION -excavación I-EXPLORATION -papilar I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -8, I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -había I-EXPLORATION -restos I-EXPLORATION -de I-EXPLORATION -silicona I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -polo I-EXPLORATION -posterior. I-EXPLORATION -Se B-TREATMENT -pautó I-TREATMENT +porción I-EXPLORATION +anterior I-EXPLORATION +del I-EXPLORATION +húmero. I-EXPLORATION +Fue B-TREATMENT +asistido I-TREATMENT +en I-TREATMENT +primera I-TREATMENT +instancia I-TREATMENT +por I-TREATMENT +elementos I-TREATMENT +de I-TREATMENT +la I-TREATMENT +policía I-TREATMENT +municipal I-TREATMENT +y, I-TREATMENT +posteriormente, I-TREATMENT +recibió I-TREATMENT +atención I-TREATMENT +de I-TREATMENT +socorristas I-TREATMENT +de I-TREATMENT +un I-TREATMENT +hospital I-TREATMENT +privado, I-TREATMENT +quienes I-TREATMENT +le I-TREATMENT +aplicaron I-TREATMENT +sedantes. I-TREATMENT +Se I-TREATMENT +le I-TREATMENT +trasladó I-TREATMENT +al I-TREATMENT +nosocomio, I-TREATMENT +donde I-TREATMENT +se I-TREATMENT +le I-TREATMENT +práctico I-TREATMENT +la I-TREATMENT +amputación I-TREATMENT +total I-TREATMENT +del I-TREATMENT +brazo I-TREATMENT +izquierdo I-TREATMENT +y I-TREATMENT +se I-TREATMENT +le I-TREATMENT +administró I-TREATMENT +como I-TREATMENT tratamiento I-TREATMENT -con I-TREATMENT -dexametasona I-TREATMENT -alcohol I-TREATMENT -(maxidex®; I-TREATMENT -Alcon I-TREATMENT -Cusí, I-TREATMENT -S. I-TREATMENT -A.; I-TREATMENT -Barcelona; I-TREATMENT -España) I-TREATMENT +de I-TREATMENT +inicio I-TREATMENT +100 I-TREATMENT +mg I-TREATMENT +de I-TREATMENT +Pentamin, I-TREATMENT 1 I-TREATMENT -gota I-TREATMENT -cada I-TREATMENT +g I-TREATMENT +de I-TREATMENT +Amikasina, I-TREATMENT 2 I-TREATMENT -horas, I-TREATMENT -atropina I-TREATMENT -1% I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas, I-TREATMENT -maleato I-TREATMENT +g I-TREATMENT de I-TREATMENT -timolol I-TREATMENT -0, I-TREATMENT -5% I-TREATMENT -(timoftol® I-TREATMENT -0, I-TREATMENT -5%; I-TREATMENT -Merck I-TREATMENT -Sharp I-TREATMENT -& I-TREATMENT -Dohme, I-TREATMENT -S.A.; I-TREATMENT -Madrid; I-TREATMENT -España) I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas I-TREATMENT +Rosephin® I-TREATMENT y I-TREATMENT -acetazolamida I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -(edemox®; I-TREATMENT -Chiesi I-TREATMENT -Wasserman I-TREATMENT -S. I-TREATMENT -A.; I-TREATMENT -Barcelona; I-TREATMENT -España) I-TREATMENT -250 I-TREATMENT +500 I-TREATMENT mg I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas. I-TREATMENT - I-TREATMENT -Una B-EVOLUTION -semana I-EVOLUTION -después I-EVOLUTION -acudió I-EVOLUTION -a I-EVOLUTION -nuestra I-EVOLUTION -consulta I-EVOLUTION -sin I-EVOLUTION -mejoría I-EVOLUTION -a I-EVOLUTION -pesar I-EVOLUTION -del I-EVOLUTION -tratamiento. I-EVOLUTION -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -la I-EXPLORATION -AV I-EXPLORATION -se I-EXPLORATION -mantenía I-EXPLORATION -en I-EXPLORATION -0, I-EXPLORATION -1 I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -PIO I-EXPLORATION -en I-EXPLORATION -33 I-EXPLORATION -mmHg. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -figura I-EXPLORATION -1 I-EXPLORATION -se I-EXPLORATION -muestra I-EXPLORATION -el I-EXPLORATION -aspecto I-EXPLORATION -del I-EXPLORATION -segmento I-EXPLORATION -anterior. I-EXPLORATION -Lo I-EXPLORATION -que I-EXPLORATION -inicialmente I-EXPLORATION -se I-EXPLORATION -habían I-EXPLORATION -identificado I-EXPLORATION -como I-EXPLORATION -células I-EXPLORATION -inflamatorias I-EXPLORATION -resultaron I-EXPLORATION -ser I-EXPLORATION -microburbujas I-EXPLORATION -de I-EXPLORATION -aceite I-EXPLORATION -de I-EXPLORATION -silicona I-EXPLORATION -emulsificadas I-EXPLORATION -en I-EXPLORATION -cámara I-EXPLORATION -anterior, I-EXPLORATION -responsables I-EXPLORATION -del I-EXPLORATION -glaucoma I-EXPLORATION -secundario. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -falta I-TREATMENT de I-TREATMENT -respuesta I-TREATMENT -al I-TREATMENT +Histaline. I-TREATMENT +Como I-TREATMENT tratamiento I-TREATMENT -médico I-TREATMENT +de I-TREATMENT +mantenimiento, I-TREATMENT se I-TREATMENT -planteó I-TREATMENT -la I-TREATMENT -implantación I-TREATMENT +le I-TREATMENT +aplicó I-TREATMENT +una I-TREATMENT +ámpula I-TREATMENT +de I-TREATMENT +Pantosin I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +h, I-TREATMENT +1 I-TREATMENT +g I-TREATMENT +cada I-TREATMENT +24 I-TREATMENT +h I-TREATMENT +vía I-TREATMENT +intravenosa I-TREATMENT +de I-TREATMENT +Amikasina, I-TREATMENT +30 I-TREATMENT +mg I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +h I-TREATMENT +vía I-TREATMENT +intravenosa I-TREATMENT +de I-TREATMENT +Ketorolaco, I-TREATMENT +una I-TREATMENT +ámpula I-TREATMENT de I-TREATMENT +Pantozol® I-TREATMENT +cada I-TREATMENT +24 I-TREATMENT +h I-TREATMENT +vía I-TREATMENT +intravenosa, I-TREATMENT +una I-TREATMENT +ámpula I-TREATMENT +de I-TREATMENT +Stadium® I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +h I-TREATMENT +vía I-TREATMENT +intravenosa, I-TREATMENT un I-TREATMENT -dispositivo I-TREATMENT +ámpula I-TREATMENT de I-TREATMENT -drenaje I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -rechazó, I-TREATMENT -no I-TREATMENT -acudiendo I-TREATMENT -a I-TREATMENT -las I-TREATMENT -revisiones I-TREATMENT -citadas I-TREATMENT -posteriormente. I-TREATMENT +toxoide I-TREATMENT +tetánico I-TREATMENT +y I-TREATMENT +una I-TREATMENT +tableta I-TREATMENT +de I-TREATMENT +Gabapentina; I-TREATMENT +además I-TREATMENT +de I-TREATMENT +solución I-TREATMENT +Hartmann I-TREATMENT +y I-TREATMENT +solución I-TREATMENT +salina I-TREATMENT +0.9% I-TREATMENT +alternadas. I-TREATMENT I-TREATMENT - -Mujer B-PRESENT_ILLNESS +La B-PRESENT_ILLNESS +víctima, I-PRESENT_ILLNESS +residente I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -61 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -proptosis I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -(OI) I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -infiltración I-PRESENT_ILLNESS -palpebral I-PRESENT_ILLNESS -dolorosa, I-PRESENT_ILLNESS -caliente I-PRESENT_ILLNESS +Guadalajara, I-PRESENT_ILLNESS +Jalisco, I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +entrevistada I-PRESENT_ILLNESS y I-PRESENT_ILLNESS +relató I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +recordar I-PRESENT_ILLNESS +lapsos I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +incidente. I-PRESENT_ILLNESS +Sin I-PRESENT_ILLNESS +embargo, I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +pesar I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +esto I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +declararse I-PRESENT_ILLNESS +también I-PRESENT_ILLNESS +desorientada I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +ataque, I-PRESENT_ILLNESS +recuerda I-PRESENT_ILLNESS +encontrarse I-PRESENT_ILLNESS +dentro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +trampas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +agua I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +campo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -consistencia I-PRESENT_ILLNESS -dura, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -limitación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS +golf I-PRESENT_ILLNESS +(cercana I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -mirada I-PRESENT_ILLNESS -vertical I-PRESENT_ILLNESS +playa). I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +este I-PRESENT_ILLNESS +espacio, I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +arremetida I-PRESENT_ILLNESS +varias I-PRESENT_ILLNESS +veces I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +mordeduras I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +sacudidas I-PRESENT_ILLNESS +(giros) I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +cocodrilo I-PRESENT_ILLNESS +(presentó I-PRESENT_ILLNESS +heridas I-PRESENT_ILLNESS +avulsivas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +cara I-PRESENT_ILLNESS +exterior I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +interior I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +muslo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +porción I-PRESENT_ILLNESS +izquierda I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +pecho, I-PRESENT_ILLNESS +así I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +escoriaciones I-PRESENT_ILLNESS +leves I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +genitales). I-PRESENT_ILLNESS +Comenta I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +joven I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +golpeó I-PRESENT_ILLNESS +repetidamente I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +cabeza I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +rocas, I-PRESENT_ILLNESS +además I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sentir I-PRESENT_ILLNESS +cómo I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +reptil I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +sujetaba I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +pierna, I-PRESENT_ILLNESS +mientras I-PRESENT_ILLNESS +luchaba I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +mantenerse I-PRESENT_ILLNESS +asido I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +mano I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +ramas I-PRESENT_ILLNESS +cercanas I-PRESENT_ILLNESS +(no I-PRESENT_ILLNESS +recuerda I-PRESENT_ILLNESS +si I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +ese I-PRESENT_ILLNESS +momento, I-PRESENT_ILLNESS +ya I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +perdido I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +brazo). I-PRESENT_ILLNESS +Una I-PRESENT_ILLNESS +vez I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +cocodrilo I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +soltó, I-PRESENT_ILLNESS +logró I-PRESENT_ILLNESS +llegar I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +orilla I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +perdió I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +conocimiento I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS dos I-PRESENT_ILLNESS -meses. I-PRESENT_ILLNESS +ocasiones. I-PRESENT_ILLNESS +Ingresó I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nuevo I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +trampa I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +agua, I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +llegar I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +edificio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +condominios I-PRESENT_ILLNESS +aledaño I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +campo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +golf I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +asistido I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +condóminos I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +llegada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +policía I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +socorristas. I-PRESENT_ILLNESS I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -antecedentes, I-PAST_MEDICAL_HISTORY -refería I-PAST_MEDICAL_HISTORY -carcinoma I-PAST_MEDICAL_HISTORY -mixto I-PAST_MEDICAL_HISTORY -ductal I-PAST_MEDICAL_HISTORY -lobulillar I-PAST_MEDICAL_HISTORY -infiltrante I-PAST_MEDICAL_HISTORY -multifocal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -multicéntrico I-PAST_MEDICAL_HISTORY -(carcinoma I-PAST_MEDICAL_HISTORY -escirro, I-PAST_MEDICAL_HISTORY -T4 I-PAST_MEDICAL_HISTORY -N3 I-PAST_MEDICAL_HISTORY -M0) I-PAST_MEDICAL_HISTORY + +Hombre B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +33 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -mama I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY -siete I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -sometida I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -mastectomía I-PAST_MEDICAL_HISTORY -radical I-PAST_MEDICAL_HISTORY -modificada I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -Madden, I-PAST_MEDICAL_HISTORY -disección I-PAST_MEDICAL_HISTORY -axilar, I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +fumador I-PAST_MEDICAL_HISTORY +(20 I-PAST_MEDICAL_HISTORY +cig/día) I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -ciclos I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +episodio I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -quimioterapia I-PAST_MEDICAL_HISTORY -(Epirrubicina I-PAST_MEDICAL_HISTORY -75 I-PAST_MEDICAL_HISTORY -mg/m2), I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY +urolitiasis I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY los I-PAST_MEDICAL_HISTORY -cuales I-PAST_MEDICAL_HISTORY -remitió I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -encontrándose I-PAST_MEDICAL_HISTORY -restos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -misma I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -estudios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -extensión. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La B-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -era I-EXPLORATION -7/10 I-EXPLORATION -con I-EXPLORATION -ambos I-EXPLORATION -ojos, I-EXPLORATION -cataratas I-EXPLORATION -nucleares I-EXPLORATION -+, I-EXPLORATION +27 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +intenso I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +flanco I-PRESENT_ILLNESS +derecho, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +inicio I-PRESENT_ILLNESS +súbito, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +irradiación, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómito I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +ocasión I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +cede I-PRESENT_ILLNESS +espontáneamente. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +repitió I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +h I-PRESENT_ILLNESS +después, I-PRESENT_ILLNESS +siendo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +similares I-PRESENT_ILLNESS +características I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +anterior. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +No B-EXPLORATION +presentó I-EXPLORATION +fiebre I-EXPLORATION +y I-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION presión I-EXPLORATION -intraocular I-EXPLORATION -OI I-EXPLORATION +arterial I-EXPLORATION de I-EXPLORATION -24 I-EXPLORATION +140/82 I-EXPLORATION mmHg I-EXPLORATION y I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -14 I-EXPLORATION -mmHg. I-EXPLORATION -Fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -normal I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -ojos. I-EXPLORATION -Presentaba I-EXPLORATION -un I-EXPLORATION -exoftalmos I-EXPLORATION -unilateral I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -mm I-EXPLORATION +dolor I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION en I-EXPLORATION -OI. I-EXPLORATION +fosa I-EXPLORATION +ilíaca I-EXPLORATION +derecha I-EXPLORATION +(FID). I-EXPLORATION I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computerizada I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -densidad I-EXPLORATION -difusa I-EXPLORATION +Dentro I-EXPLORATION de I-EXPLORATION -partes I-EXPLORATION -blandas, I-EXPLORATION -afectación I-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -pared I-EXPLORATION -ósea, I-EXPLORATION -que I-EXPLORATION -desplazaba I-EXPLORATION -el I-EXPLORATION -nervio I-EXPLORATION -óptico I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -globo I-EXPLORATION -ocular. I-EXPLORATION -La I-EXPLORATION -lesión I-EXPLORATION +laboratorio I-EXPLORATION se I-EXPLORATION -realzaba I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -administración I-EXPLORATION -de I-EXPLORATION -contraste. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -gammagrafía I-EXPLORATION -ósea I-EXPLORATION +encontró I-EXPLORATION +orina I-EXPLORATION +completa I-EXPLORATION +sin I-EXPLORATION +hematuria, I-EXPLORATION +hemogra-ma I-EXPLORATION con I-EXPLORATION -Tecnecio I-EXPLORATION -99 I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -múltiples I-EXPLORATION -metástasis I-EXPLORATION -por I-EXPLORATION -acúmulo I-EXPLORATION +leucocitosis I-EXPLORATION +(17.200 I-EXPLORATION +x I-EXPLORATION +mm3), I-EXPLORATION +creatininemia I-EXPLORATION de I-EXPLORATION -radiotrazador I-EXPLORATION -en I-EXPLORATION -calota, I-EXPLORATION -raquis, I-EXPLORATION -parrilla I-EXPLORATION -costal, I-EXPLORATION -húmeros I-EXPLORATION +1, I-EXPLORATION +2 I-EXPLORATION +mg/dl I-EXPLORATION y I-EXPLORATION -pelvis. I-EXPLORATION -Ante I-EXPLORATION -el I-EXPLORATION -mal I-EXPLORATION -estado I-EXPLORATION -general I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -rehusó I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION +LDH I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -diagnóstica. I-EXPLORATION +1.457 I-EXPLORATION +UI/1. I-EXPLORATION I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -quimioterapia, I-TREATMENT -tres I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -Taxotere I-TREATMENT -100 I-TREATMENT -mg/m2, I-TREATMENT -un I-TREATMENT -ciclo I-TREATMENT -de I-TREATMENT -Mitoxantrone I-TREATMENT -12 I-TREATMENT -mg/m2 I-TREATMENT -y I-TREATMENT -dos I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -Vinorelbina I-TREATMENT -25 I-TREATMENT -mg/m2, I-TREATMENT -y I-TREATMENT -esteroides I-TREATMENT -(6-metil-prednisolona) I-TREATMENT -(1 I-TREATMENT -mg/m2) I-TREATMENT -con I-TREATMENT -el I-TREATMENT -fin I-TREATMENT -de I-TREATMENT -reducir I-TREATMENT -el I-TREATMENT -edema I-TREATMENT -y I-TREATMENT -la I-TREATMENT -congestión I-TREATMENT -orbitaria. I-TREATMENT -Pese B-EVOLUTION -al I-EVOLUTION -tratamiento, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -falleció I-EVOLUTION -dos I-EVOLUTION -meses I-EVOLUTION -más I-EVOLUTION -tarde. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -37 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -antecedentes B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia I-PAST_MEDICAL_HISTORY -quien B-PRESENT_ILLNESS -desarrolló I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -conjuntival I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -(OD) I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Clínicamente B-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -pigmentada I-EXPLORATION -sobre I-EXPLORATION -la I-EXPLORATION -conjuntiva I-EXPLORATION -nasal I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +pieloTC I-EXPLORATION que I-EXPLORATION -invadía I-EXPLORATION -parte I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -córnea I-EXPLORATION -pero I-EXPLORATION -no I-EXPLORATION -afectaba I-EXPLORATION -el I-EXPLORATION -eje I-EXPLORATION -visual. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -inicial, I-EXPLORATION -tenía I-EXPLORATION -una I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION +resultó I-EXPLORATION +ser I-EXPLORATION +negativa I-EXPLORATION +para I-EXPLORATION +urolitiasis, I-EXPLORATION +prosiguiéndose I-EXPLORATION +con I-EXPLORATION +TC I-EXPLORATION de I-EXPLORATION -20/20 I-EXPLORATION +abdomen I-EXPLORATION y I-EXPLORATION +pelvis, I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION una I-EXPLORATION -presión I-EXPLORATION -intraocular I-EXPLORATION +extensa I-EXPLORATION +área I-EXPLORATION +hipodensa I-EXPLORATION de I-EXPLORATION -12 I-EXPLORATION -mmHg I-EXPLORATION +aspecto I-EXPLORATION +cuneiforme I-EXPLORATION en I-EXPLORATION -ambos I-EXPLORATION -ojos. I-EXPLORATION -Tanto I-EXPLORATION -la I-EXPLORATION -biomicroscopía I-EXPLORATION -como I-EXPLORATION la I-EXPLORATION -oftalmoscopía I-EXPLORATION -indirecta I-EXPLORATION +cara I-EXPLORATION +posterior I-EXPLORATION del I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION -(OI) I-EXPLORATION +parénquima I-EXPLORATION +renal I-EXPLORATION +derecho, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +infarto I-EXPLORATION +parcial I-EXPLORATION +renal I-EXPLORATION +derecho. I-EXPLORATION + I-EXPLORATION +Se B-EVOLUTION +hospitalizó I-EVOLUTION +al I-EVOLUTION +paciente. I-EVOLUTION +Se B-EXPLORATION +tomaron I-EXPLORATION +exámenes I-EXPLORATION +para I-EXPLORATION +trombofilia, I-EXPLORATION +cuyos I-EXPLORATION +resultados I-EXPLORATION fueron I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -biomicroscopía I-EXPLORATION -del I-EXPLORATION -OD I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -densamente I-EXPLORATION -pigmentada, I-EXPLORATION -elevada, I-EXPLORATION -de I-EXPLORATION -9 I-EXPLORATION -x I-EXPLORATION -4 I-EXPLORATION -mm., I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -bien I-EXPLORATION -delimitados, I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -sector I-EXPLORATION -nasal I-EXPLORATION +normales, I-EXPLORATION +previo I-EXPLORATION +al I-EXPLORATION +inicio I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -conjuntiva I-EXPLORATION -bulbar I-EXPLORATION +anticoagulación I-EXPLORATION +(Fragmin I-EXPLORATION y I-EXPLORATION +Neosintrón I-EXPLORATION +). I-EXPLORATION +Además I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +ecocardiografía I-EXPLORATION +transesofágica I-EXPLORATION que I-EXPLORATION -invadía I-EXPLORATION -parte I-EXPLORATION -de I-EXPLORATION +resultó I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +angioTC I-EXPLORATION +que I-EXPLORATION +reveló I-EXPLORATION la I-EXPLORATION -córnea. I-EXPLORATION -La I-EXPLORATION -masa I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -rodeada I-EXPLORATION -por I-EXPLORATION -algunos I-EXPLORATION -vasos I-EXPLORATION -nutricios I-EXPLORATION -prominentes. I-EXPLORATION -No I-EXPLORATION -hubo I-EXPLORATION -evidencia I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -melanosis I-EXPLORATION -adquirida I-EXPLORATION -primaria I-EXPLORATION -adyacente I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -lesión. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION +una I-EXPLORATION +arteria I-EXPLORATION +renal I-EXPLORATION +derecha I-EXPLORATION +dominante I-EXPLORATION +(AD) I-EXPLORATION +y I-EXPLORATION +otra I-EXPLORATION +polar I-EXPLORATION +de I-EXPLORATION +menor I-EXPLORATION +calibre I-EXPLORATION +con I-EXPLORATION +trayecto I-EXPLORATION +normal, I-EXPLORATION +e I-EXPLORATION +imagen I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +alteración I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica, I-EXPLORATION -incluyendo I-EXPLORATION -la I-EXPLORATION -fundoscopía, I-EXPLORATION -resultó I-EXPLORATION -normal. I-EXPLORATION +pared I-EXPLORATION +arterial I-EXPLORATION +con I-EXPLORATION +infarto I-EXPLORATION +renal. I-EXPLORATION I-EXPLORATION Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -escisión I-EXPLORATION -completa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION +prosiguió I-EXPLORATION con I-EXPLORATION -márgenes I-EXPLORATION -quirúrgicos I-EXPLORATION -amplios. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -macroscópico I-EXPLORATION +estudio I-EXPLORATION +angiográfico, I-EXPLORATION +el I-EXPLORATION +cual I-EXPLORATION reveló I-EXPLORATION una I-EXPLORATION -lesión I-EXPLORATION -con I-EXPLORATION -dimensiones I-EXPLORATION -de I-EXPLORATION -8 I-EXPLORATION -x I-EXPLORATION -4 I-EXPLORATION -x I-EXPLORATION -3 I-EXPLORATION -mm, I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -nodular, I-EXPLORATION -superficie I-EXPLORATION -externa I-EXPLORATION -lisa, I-EXPLORATION -multilobulada, I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -café I-EXPLORATION -negruzco I-EXPLORATION +aortografía I-EXPLORATION +normal, I-EXPLORATION +alteración I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +perfusión I-EXPLORATION +del I-EXPLORATION +polo I-EXPLORATION +superior, I-EXPLORATION +cara I-EXPLORATION +anterior I-EXPLORATION y I-EXPLORATION -aspecto I-EXPLORATION -mucoso. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -histopatológico I-EXPLORATION -demostró I-EXPLORATION -epitelio I-EXPLORATION -de I-EXPLORATION -revestimiento I-EXPLORATION -conjuntival I-EXPLORATION -con I-EXPLORATION -cambios I-EXPLORATION +posterior I-EXPLORATION +del I-EXPLORATION +riñon I-EXPLORATION +derecho, I-EXPLORATION +sin I-EXPLORATION +compromiso I-EXPLORATION de I-EXPLORATION -papilomatosis I-EXPLORATION -y I-EXPLORATION -acantosis I-EXPLORATION +la I-EXPLORATION +perfusión I-EXPLORATION +del I-EXPLORATION +polo I-EXPLORATION +inferior I-EXPLORATION +dado I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +polar I-EXPLORATION +secundaria. I-EXPLORATION +La I-EXPLORATION +arteria I-EXPLORATION +renal I-EXPLORATION +dominante I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION irregular, I-EXPLORATION -esta I-EXPLORATION -última I-EXPLORATION +dilatada I-EXPLORATION a I-EXPLORATION -expensas I-EXPLORATION -de I-EXPLORATION -proliferación I-EXPLORATION +partir I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -basaloides, I-EXPLORATION -mismas I-EXPLORATION +su I-EXPLORATION +tercio I-EXPLORATION +medio I-EXPLORATION que I-EXPLORATION -estaban I-EXPLORATION -mezcladas I-EXPLORATION -con I-EXPLORATION -pequeños I-EXPLORATION -grupos I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -escamosas I-EXPLORATION -y I-EXPLORATION -algunos I-EXPLORATION -melanocitos I-EXPLORATION -dendríticos. I-EXPLORATION -La I-EXPLORATION -sustancia I-EXPLORATION -propia I-EXPLORATION -presentaba I-EXPLORATION -además, I-EXPLORATION -áreas I-EXPLORATION -con I-EXPLORATION -degeneración I-EXPLORATION -elastótica, I-EXPLORATION -vasos I-EXPLORATION -sanguíneos I-EXPLORATION +además I-EXPLORATION +presentó I-EXPLORATION +un I-EXPLORATION +flap I-EXPLORATION de I-EXPLORATION -pequeño I-EXPLORATION -calibre I-EXPLORATION -dilatados I-EXPLORATION -y I-EXPLORATION -cúmulos I-EXPLORATION -variables I-EXPLORATION +disección I-EXPLORATION +que I-EXPLORATION +comprometió I-EXPLORATION +el I-EXPLORATION +origen I-EXPLORATION de I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -formados I-EXPLORATION -por I-EXPLORATION -linfocitos I-EXPLORATION -maduros, I-EXPLORATION -células I-EXPLORATION -plasmáticas I-EXPLORATION -y I-EXPLORATION -algunos I-EXPLORATION -melanófagos. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION -se I-EXPLORATION -estableció I-EXPLORATION +las I-EXPLORATION +ramas I-EXPLORATION +interlobares, I-EXPLORATION +limitando I-EXPLORATION +así I-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION +flujo I-EXPLORATION +distal. I-EXPLORATION +El I-EXPLORATION +flap I-EXPLORATION de I-EXPLORATION -queratosis I-EXPLORATION -seborreica I-EXPLORATION -(QS) I-EXPLORATION +disección I-EXPLORATION +fue I-EXPLORATION +descrito I-EXPLORATION +como I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -conjuntiva. I-EXPLORATION +alta I-EXPLORATION +complejidad I-EXPLORATION +sin I-EXPLORATION +posibilidades I-EXPLORATION +de I-EXPLORATION +maniobras I-EXPLORATION +endovasculares. I-EXPLORATION + I-EXPLORATION +Dos B-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +presentó I-EVOLUTION +nuevo I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +dolor I-EVOLUTION +en I-EVOLUTION +flanco I-EVOLUTION +derecho. I-EVOLUTION +Nuevo B-EXPLORATION +angioTC I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +clara I-EXPLORATION +progresión I-EXPLORATION +del I-EXPLORATION +infarto I-EXPLORATION +renal I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +2/3 I-EXPLORATION +superiores I-EXPLORATION +del I-EXPLORATION +riñon I-EXPLORATION +derecho. I-EXPLORATION I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +con I-EVOLUTION +presiones I-EVOLUTION +arteriales I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +rango I-EVOLUTION +de I-EVOLUTION +160/100 I-EVOLUTION +mmHg I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +deterioro I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +función I-EVOLUTION +renal I-EVOLUTION +(creatininemia I-EVOLUTION +1, I-EVOLUTION +2 I-EVOLUTION +mg/dl). I-EVOLUTION +Fue B-TREATMENT +dado I-TREATMENT +de I-TREATMENT +alta I-TREATMENT +con I-TREATMENT +terapia I-TREATMENT +antihipertensiva I-TREATMENT +(Blox I-TREATMENT +4 I-TREATMENT +mg/día) I-TREATMENT +en I-TREATMENT +buenas I-TREATMENT +condiciones I-TREATMENT +generales I-TREATMENT +para I-TREATMENT +su I-TREATMENT +manejo I-TREATMENT +ambulatorio. I-TREATMENT +En B-EVOLUTION +control I-EVOLUTION +ambulatorio I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +dos I-EVOLUTION +y I-EVOLUTION +diecisiete I-EVOLUTION +días I-EVOLUTION +posterior I-EVOLUTION +al I-EVOLUTION +alta I-EVOLUTION +se I-EVOLUTION +encontró I-EVOLUTION +al I-EVOLUTION +paciente I-EVOLUTION +asintomático, I-EVOLUTION +normotenso I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +resto I-EVOLUTION +del I-EVOLUTION +examen I-EVOLUTION +físico I-EVOLUTION +sin I-EVOLUTION +hallazgos I-EVOLUTION +patológicos. I-EVOLUTION + I-EVOLUTION Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -51 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS +8 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +clínicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS al I-PRESENT_ILLNESS servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS +urgencia I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -agudeza I-PRESENT_ILLNESS -visual I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -insulino I-PAST_MEDICAL_HISTORY -dependiente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -seis I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución, I-PAST_MEDICAL_HISTORY -así I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -padecido I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -traumatismo I-PAST_MEDICAL_HISTORY -contuso I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -mismo I-PAST_MEDICAL_HISTORY -ojo I-PAST_MEDICAL_HISTORY -15 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Refería B-PRESENT_ILLNESS un I-PRESENT_ILLNESS cuadro I-PRESENT_ILLNESS +clínico I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -visión I-PRESENT_ILLNESS -asintomático I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +39, I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +°C I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS +14 I-PRESENT_ILLNESS días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +asociada I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +escalofríos, I-PRESENT_ILLNESS +palidez I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -izquierdo. I-PRESENT_ILLNESS -La B-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -(AV) I-EXPLORATION -tomada I-EXPLORATION -mediante I-EXPLORATION -el I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -Snellen I-EXPLORATION -era I-EXPLORATION -1 I-EXPLORATION -para I-EXPLORATION -su I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -para I-EXPLORATION -su I-EXPLORATION -ojo I-EXPLORATION -izquierdo, I-EXPLORATION -mejorando I-EXPLORATION -este I-EXPLORATION -último I-EXPLORATION -a I-EXPLORATION -1 I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -corrección I-EXPLORATION -esférica I-EXPLORATION -de I-EXPLORATION -+1, I-EXPLORATION -5D. I-EXPLORATION - I-EXPLORATION -Tanto I-EXPLORATION +piel, I-PRESENT_ILLNESS +adenopatías I-PRESENT_ILLNESS +cervicales I-PRESENT_ILLNESS +bilaterales, I-PRESENT_ILLNESS +decaimiento I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +inapetencia. I-PRESENT_ILLNESS +Había I-PRESENT_ILLNESS +sido I-PRESENT_ILLNESS +tratado I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +azitromicina I-PRESENT_ILLNESS +500 I-PRESENT_ILLNESS +mg I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +día, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cinco I-PRESENT_ILLNESS +días. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION -motilidad I-EXPLORATION -ocular I-EXPLORATION -intrínseca I-EXPLORATION -como I-EXPLORATION -extrínseca, I-EXPLORATION -biomicroscopía I-EXPLORATION -anterior I-EXPLORATION -y I-EXPLORATION -tonometría I-EXPLORATION -del I-EXPLORATION -paciente I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -funduscopia I-EXPLORATION -del I-EXPLORATION -ojo I-EXPLORATION -a I-EXPLORATION -estudio I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -yuxtapapilar I-EXPLORATION +exploración I-EXPLORATION +física, I-EXPLORATION +destacaba I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -color I-EXPLORATION -rojo-anaranjado I-EXPLORATION -brillante, I-EXPLORATION -sobreelevada, I-EXPLORATION -bien I-EXPLORATION -delimitada. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -una I-EXPLORATION -alteración I-EXPLORATION -del I-EXPLORATION -epitelio I-EXPLORATION -pigmentario I-EXPLORATION +un I-EXPLORATION +soplo I-EXPLORATION +sistólico I-EXPLORATION +grado I-EXPLORATION +II/III I-EXPLORATION en I-EXPLORATION -región I-EXPLORATION -macular I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -alteración I-EXPLORATION +el I-EXPLORATION +foco I-EXPLORATION +auscultatorio I-EXPLORATION +correspondiente I-EXPLORATION +al I-EXPLORATION +ventrículo I-EXPLORATION +izquierdo. I-EXPLORATION +El I-EXPLORATION +electroencefalograma I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax, I-EXPLORATION +no I-EXPLORATION +evidenciaron I-EXPLORATION +hallazgos I-EXPLORATION +patológicos. I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION +laboratorio I-EXPLORATION +mostraron I-EXPLORATION la I-EXPLORATION -capa I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -fibras I-EXPLORATION -nerviosas I-EXPLORATION -superiores I-EXPLORATION -e I-EXPLORATION -inferiores. I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION -oftalmoscópica I-EXPLORATION -del I-EXPLORATION -ojo I-EXPLORATION -adelfo I-EXPLORATION -presentaba I-EXPLORATION -asimismo I-EXPLORATION -una I-EXPLORATION -leve I-EXPLORATION -alteración I-EXPLORATION +marcadores I-EXPLORATION +inflamatorios: I-EXPLORATION +leucocitos I-EXPLORATION de I-EXPLORATION -epitelio I-EXPLORATION -pigmentario. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION +10.500 I-EXPLORATION +céls/ml, I-EXPLORATION una I-EXPLORATION -angiografía I-EXPLORATION -fluoresceínica I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION -el I-EXPLORATION -relleno I-EXPLORATION +neutrofilia I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -árbol I-EXPLORATION -vascular I-EXPLORATION -intratumoral I-EXPLORATION -compuesto I-EXPLORATION +70% I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +PCR I-EXPLORATION +elevada I-EXPLORATION +(119 I-EXPLORATION +mg/L). I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +cefotaxima I-TREATMENT +i.v. I-TREATMENT +200 I-TREATMENT +mg/kg/día I-TREATMENT +previa I-TREATMENT +toma I-TREATMENT +de I-TREATMENT +hemocultivos I-TREATMENT +seriados I-TREATMENT +en I-TREATMENT +dos I-TREATMENT +días I-TREATMENT +consecutivos. I-TREATMENT +A B-EXPLORATION +las I-EXPLORATION +24 I-EXPLORATION +h I-EXPLORATION de I-EXPLORATION -finos I-EXPLORATION -capilares I-EXPLORATION -con I-EXPLORATION -exudación I-EXPLORATION -en I-EXPLORATION -tiempos I-EXPLORATION -tardíos, I-EXPLORATION -confirmando I-EXPLORATION +incubación, I-EXPLORATION +ambos I-EXPLORATION +hemocultivos I-EXPLORATION +fueron I-EXPLORATION +positivos. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -primera I-EXPLORATION -sospecha I-EXPLORATION +tinción I-EXPLORATION de I-EXPLORATION -hemangioma I-EXPLORATION -capilar I-EXPLORATION -yuxtapapilar. I-EXPLORATION -Se I-EXPLORATION +Gram I-EXPLORATION +se I-EXPLORATION observaron I-EXPLORATION -puntos I-EXPLORATION -de I-EXPLORATION -fuga I-EXPLORATION +bacilos I-EXPLORATION +grampositivos I-EXPLORATION +pleomórficos I-EXPLORATION en I-EXPLORATION -polo I-EXPLORATION -posterior I-EXPLORATION +forma I-EXPLORATION de I-EXPLORATION -ambos I-EXPLORATION -ojos, I-EXPLORATION -sugestivos I-EXPLORATION +"V". I-EXPLORATION +La I-EXPLORATION +identificación I-EXPLORATION +directa I-EXPLORATION +del I-EXPLORATION +microorganismo I-EXPLORATION +a I-EXPLORATION +partir I-EXPLORATION de I-EXPLORATION -retinopatía I-EXPLORATION -central I-EXPLORATION -serosa. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION +los I-EXPLORATION +hemocultivos I-EXPLORATION +positivos I-EXPLORATION +mediante I-EXPLORATION +espectrometría I-EXPLORATION +de I-EXPLORATION +masas I-EXPLORATION +MALDI-TOF I-EXPLORATION +fue I-EXPLORATION +C. I-EXPLORATION +pseudodiphtheriticum. I-EXPLORATION +En I-EXPLORATION +este I-EXPLORATION +contexto, I-EXPLORATION +se I-EXPLORATION realizó I-EXPLORATION -un I-EXPLORATION -campo I-EXPLORATION -visual I-EXPLORATION -SITA- I-EXPLORATION -Standard I-EXPLORATION -24-2 I-EXPLORATION -(Zeiss-Humphrey I-EXPLORATION -Instruments, I-EXPLORATION -Dublin, I-EXPLORATION -CA) I-EXPLORATION -con I-EXPLORATION -visión I-EXPLORATION -corregida, I-EXPLORATION -estímulo I-EXPLORATION -III, I-EXPLORATION -hallándose I-EXPLORATION -un I-EXPLORATION -defecto I-EXPLORATION -infero-nasal I-EXPLORATION -del I-EXPLORATION -ojo I-EXPLORATION -izquierdo. I-EXPLORATION - I-EXPLORATION -Cuatro I-EXPLORATION -semanas I-EXPLORATION -más I-EXPLORATION -tarde, I-EXPLORATION +una I-EXPLORATION +ecocardiografía I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -visión I-EXPLORATION -del I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -6 I-EXPLORATION -corregida I-EXPLORATION -(+0.5 I-EXPLORATION -esf I-EXPLORATION -+ I-EXPLORATION -1 I-EXPLORATION -x I-EXPLORATION -48 I-EXPLORATION -cil) I-EXPLORATION -1; I-EXPLORATION -mientras I-EXPLORATION que I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION la I-EXPLORATION -visión I-EXPLORATION -del I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -fue I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -0, I-EXPLORATION -4 I-EXPLORATION -corregida I-EXPLORATION -(+0.5 I-EXPLORATION -esf I-EXPLORATION -+0.25 I-EXPLORATION -x I-EXPLORATION -170 I-EXPLORATION -cil) I-EXPLORATION -0, I-EXPLORATION -6. I-EXPLORATION -Una I-EXPLORATION -nueva I-EXPLORATION -angiografía I-EXPLORATION -fluoresceínica I-EXPLORATION -demostró I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -disminución I-EXPLORATION +una I-EXPLORATION +formación I-EXPLORATION +vegetativa I-EXPLORATION de I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION +10 I-EXPLORATION +mm I-EXPLORATION del I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -se I-EXPLORATION -debía I-EXPLORATION -a I-EXPLORATION -retinopatía I-EXPLORATION -central I-EXPLORATION -serosa. I-EXPLORATION - I-EXPLORATION -Ocho B-EVOLUTION -semanas I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -se I-EVOLUTION -encontró I-EVOLUTION -una I-EVOLUTION -regresión I-EVOLUTION -espontánea I-EVOLUTION -tanto I-EVOLUTION -del I-EVOLUTION -hemangioma I-EVOLUTION -capilar I-EVOLUTION -yuxtapapilar I-EVOLUTION -como I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -retinopatía I-EVOLUTION -central I-EVOLUTION -serosa I-EVOLUTION -bilateral, I-EVOLUTION -regresando I-EVOLUTION -la I-EVOLUTION -AV I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -1 I-EVOLUTION -difícil I-EVOLUTION -en I-EVOLUTION -ambos I-EVOLUTION -ojos. I-EVOLUTION - I-EVOLUTION - -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -13 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -AV I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -ojos I-PRESENT_ILLNESS -(0, I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -OD I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -0, I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -OI I-PRESENT_ILLNESS -). I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION +lado I-EXPLORATION +ventricular I-EXPLORATION +izquierdo, I-EXPLORATION +provocando I-EXPLORATION +insuficiencia I-EXPLORATION +moderada, I-EXPLORATION +sin I-EXPLORATION +repercusión I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +hemodinamia I-EXPLORATION +y I-EXPLORATION +función I-EXPLORATION +cardíaca. I-EXPLORATION +Asimismo, I-EXPLORATION se I-EXPLORATION -objetivó I-EXPLORATION +constató I-EXPLORATION la I-EXPLORATION presencia I-EXPLORATION de I-EXPLORATION -EMQ I-EXPLORATION -bilateral. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -angiografía I-EXPLORATION -fluoresceínica I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -epiteliopatía I-EXPLORATION -pigmentaria I-EXPLORATION -difusa I-EXPLORATION -con I-EXPLORATION -edema I-EXPLORATION -exudativo I-EXPLORATION -y I-EXPLORATION -desprendimientos I-EXPLORATION -retinianos I-EXPLORATION -serosos I-EXPLORATION -secundarios. I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -5 I-EXPLORATION -meses I-EXPLORATION -de I-EXPLORATION -edad, I-EXPLORATION -había I-EXPLORATION -sido I-EXPLORATION -tratada I-EXPLORATION -con I-EXPLORATION -éxito I-EXPLORATION -de I-EXPLORATION una I-EXPLORATION -histiocitosis I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -Langerhans, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -sistémico I-EXPLORATION -completo, I-EXPLORATION -incluidas I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION -craneal I-EXPLORATION -y I-EXPLORATION -orbitarias. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -ningún I-EXPLORATION -hallazgo I-EXPLORATION -significativo. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -terapia I-TREATMENT -con I-TREATMENT -corticosteroides I-TREATMENT -tópicos, I-TREATMENT -peribulbares I-TREATMENT -y I-TREATMENT -orales. I-TREATMENT - I-TREATMENT -Las I-TREATMENT -inyecciones I-TREATMENT +valvulopatía I-EXPLORATION +aórtica I-EXPLORATION +bicúspide. I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT de I-TREATMENT -triamcinolona I-TREATMENT -peribulbar I-TREATMENT +una I-TREATMENT +endocarditis I-TREATMENT +infecciosa I-TREATMENT se I-TREATMENT -repitieron I-TREATMENT -en I-TREATMENT -cuatro I-TREATMENT -ocasiones I-TREATMENT +agregó I-TREATMENT +gentamicina I-TREATMENT +(6 I-TREATMENT +mg/kg/día) I-TREATMENT a I-TREATMENT -lo I-TREATMENT -largo I-TREATMENT -del I-TREATMENT -siguiente I-TREATMENT -año, I-TREATMENT -logrando I-TREATMENT -sólo I-TREATMENT -mejorías I-TREATMENT -transitorias I-TREATMENT -del I-TREATMENT -edema I-TREATMENT -macular I-TREATMENT -y I-TREATMENT -los I-TREATMENT -desprendimientos I-TREATMENT -serosos. I-TREATMENT -En I-TREATMENT -septiembre I-TREATMENT -de I-TREATMENT -2002, I-TREATMENT -comenzó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ciclosporina I-TREATMENT -oral I-TREATMENT -y I-TREATMENT -en I-TREATMENT -marzo I-TREATMENT -de I-TREATMENT -2003 I-TREATMENT -se I-TREATMENT -añadió I-TREATMENT -azatioprina, I-TREATMENT -debido I-TREATMENT +la I-TREATMENT +terapia I-TREATMENT a I-TREATMENT la I-TREATMENT -persistencia I-TREATMENT -del I-TREATMENT -EMQ. I-TREATMENT -Finalmente, I-TREATMENT -se I-TREATMENT -inyectaron I-TREATMENT -4 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -triamcinolona I-TREATMENT -intravítrea I-TREATMENT -en I-TREATMENT -ambos I-TREATMENT -ojos I-TREATMENT -en I-TREATMENT -julio I-TREATMENT +espera I-TREATMENT de I-TREATMENT -2003 I-TREATMENT -con I-TREATMENT -mejoría I-TREATMENT -inicial I-TREATMENT +la I-TREATMENT +identificación I-TREATMENT +definitiva I-TREATMENT del I-TREATMENT -EMQ I-TREATMENT +microorganismo I-TREATMENT y I-TREATMENT +su I-TREATMENT +perfil I-TREATMENT de I-TREATMENT -la I-TREATMENT -AV. I-TREATMENT -Se I-TREATMENT -repitieron I-TREATMENT -las I-TREATMENT -inyecciones I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -en I-TREATMENT -el I-TREATMENT -OD I-TREATMENT -y I-TREATMENT -una I-TREATMENT -vez I-TREATMENT -más I-TREATMENT -en I-TREATMENT -el I-TREATMENT -OI. I-TREATMENT -En B-EXPLORATION -diciembre I-EXPLORATION +susceptibilidad I-TREATMENT +antimicrobiana. I-TREATMENT +A B-EXPLORATION +las I-EXPLORATION +24 I-EXPLORATION +h I-EXPLORATION de I-EXPLORATION -2004, I-EXPLORATION -se I-EXPLORATION -registraron I-EXPLORATION -PIO I-EXPLORATION +incubación I-EXPLORATION +en I-EXPLORATION +medios I-EXPLORATION de I-EXPLORATION -27 I-EXPLORATION -mmHg I-EXPLORATION -OD I-EXPLORATION -y I-EXPLORATION -26 I-EXPLORATION -mmHg I-EXPLORATION -OI, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION +cultivo I-EXPLORATION +sólidos I-EXPLORATION se I-EXPLORATION -indica I-EXPLORATION -terapia I-EXPLORATION -tópica I-EXPLORATION -con I-EXPLORATION -timolol I-EXPLORATION -0, I-EXPLORATION -5% I-EXPLORATION -y I-EXPLORATION -dorzolamida I-EXPLORATION -0, I-EXPLORATION -02% I-EXPLORATION -(Cosopt®). I-EXPLORATION -En I-EXPLORATION -marzo I-EXPLORATION +observó I-EXPLORATION +el I-EXPLORATION +crecimiento I-EXPLORATION de I-EXPLORATION -2005, I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -presenta I-EXPLORATION -pérdida I-EXPLORATION +colonias I-EXPLORATION +grises I-EXPLORATION +en I-EXPLORATION +placas I-EXPLORATION de I-EXPLORATION -AV I-EXPLORATION -severa I-EXPLORATION -bilateral I-EXPLORATION -(<0,05) I-EXPLORATION -por I-EXPLORATION -desarrollo I-EXPLORATION +agar I-EXPLORATION +sangre, I-EXPLORATION +catalasa I-EXPLORATION +positivas. I-EXPLORATION +La I-EXPLORATION +identificación I-EXPLORATION +mediante I-EXPLORATION +secuenciación I-EXPLORATION +del I-EXPLORATION +gen I-EXPLORATION +ARN I-EXPLORATION +16S I-EXPLORATION +confirmó I-EXPLORATION +el I-EXPLORATION +aislamiento I-EXPLORATION de I-EXPLORATION -cataratas I-EXPLORATION -intumescentes. I-EXPLORATION -Tras B-EVOLUTION -cirugía I-EVOLUTION +C. I-EXPLORATION +pseudodiphtheriticum. I-EXPLORATION +El I-EXPLORATION +antibiograma I-EXPLORATION +con I-EXPLORATION +epsilometría I-EXPLORATION +(E-test) I-EXPLORATION +mostró I-EXPLORATION +resistencia I-EXPLORATION +a I-EXPLORATION +azitromicina I-EXPLORATION +(CIM I-EXPLORATION +> I-EXPLORATION +256 I-EXPLORATION +μg/ml) I-EXPLORATION +y I-EXPLORATION +sensibilidad I-EXPLORATION +(CIM) I-EXPLORATION +a I-EXPLORATION +amoxicilina/ác. I-EXPLORATION +clavulánico I-EXPLORATION +(0, I-EXPLORATION +016 I-EXPLORATION +μg/ml), I-EXPLORATION +cefotaxima I-EXPLORATION +(0, I-EXPLORATION +38 I-EXPLORATION +μg/ml), I-EXPLORATION +ciprofloxacina I-EXPLORATION +(0, I-EXPLORATION +5 I-EXPLORATION +μg/ I-EXPLORATION +ml), I-EXPLORATION +linezolid I-EXPLORATION +(0, I-EXPLORATION +016 I-EXPLORATION +μg/ml), I-EXPLORATION +penicilina I-EXPLORATION +G I-EXPLORATION +(0, I-EXPLORATION +25 I-EXPLORATION +μg/ml) I-EXPLORATION +y I-EXPLORATION +vancomicina I-EXPLORATION +(0, I-EXPLORATION +38 I-EXPLORATION +μg/ml). I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +evolución I-EVOLUTION +clínica I-EVOLUTION +favorable, I-EVOLUTION +remitiendo I-EVOLUTION +su I-EVOLUTION +cuadro I-EVOLUTION +febril I-EVOLUTION +antes I-EVOLUTION de I-EVOLUTION -facoextracción I-EVOLUTION -con I-EVOLUTION -implantación I-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +h I-EVOLUTION de I-EVOLUTION -lente I-EVOLUTION -intraocular I-EVOLUTION -sin I-EVOLUTION -complicaciones, I-EVOLUTION +iniciada I-EVOLUTION la I-EVOLUTION -AV I-EVOLUTION -es I-EVOLUTION +terapia I-EVOLUTION +antimicrobiana I-EVOLUTION +combinada. I-EVOLUTION +Dada B-TREATMENT +su I-TREATMENT +buena I-TREATMENT +evolución, I-TREATMENT +habiendo I-TREATMENT +negativizado I-TREATMENT +los I-TREATMENT +hemocultivos I-TREATMENT +y I-TREATMENT +sin I-TREATMENT +cambios I-TREATMENT +imagenológicos I-TREATMENT +no I-TREATMENT +se I-TREATMENT +planteó I-TREATMENT +una I-TREATMENT +cirugía I-TREATMENT +cardíaca I-TREATMENT +en I-TREATMENT +ese I-TREATMENT +momento, I-TREATMENT +salvo I-TREATMENT +que I-TREATMENT +hubiera I-TREATMENT +algún I-TREATMENT +deterioro I-TREATMENT +clínico. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +16 I-EVOLUTION +días I-EVOLUTION de I-EVOLUTION -0, I-EVOLUTION -3 I-EVOLUTION -en I-EVOLUTION -ambos I-EVOLUTION -ojos. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -remitida B-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -Medicina I-DERIVED_FROM/TO -Interna I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -estudio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -fondo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -ojo I-DERIVED_FROM/TO -por B-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -midriasis I-PRESENT_ILLNESS -media I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -cefalea, I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -visión, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION +internación, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +nuevamente I-EVOLUTION +fiebre I-EVOLUTION +asociada I-EVOLUTION +a I-EVOLUTION +cefalea I-EVOLUTION +frontal, I-EVOLUTION +desorientación I-EVOLUTION +y I-EVOLUTION +escaso I-EVOLUTION +tono I-EVOLUTION +motor I-EVOLUTION +que I-EVOLUTION +evolucionó I-EVOLUTION +a I-EVOLUTION +una I-EVOLUTION +paresia I-EVOLUTION +braquial I-EVOLUTION +derecha, I-EVOLUTION +hemicara I-EVOLUTION +derecha I-EVOLUTION +y I-EVOLUTION +afasia. I-EVOLUTION +El I-EVOLUTION +cuadro I-EVOLUTION +se I-EVOLUTION +interpretó I-EVOLUTION +como I-EVOLUTION +una I-EVOLUTION +embolia I-EVOLUTION +séptica I-EVOLUTION +cerebral. I-EVOLUTION +Se B-TREATMENT +agregó I-TREATMENT +linezolid I-TREATMENT +al I-TREATMENT +tratamiento I-TREATMENT +antimicrobiano I-TREATMENT +por I-TREATMENT +una I-TREATMENT +eventual I-TREATMENT +sobreinfección I-TREATMENT +por I-TREATMENT +microorganismos I-TREATMENT +resistentes I-TREATMENT +en I-TREATMENT +algún I-TREATMENT +otro I-TREATMENT +foco. I-TREATMENT +Ante I-TREATMENT +el I-TREATMENT +riesgo I-TREATMENT +de I-TREATMENT +un I-TREATMENT +nuevo I-TREATMENT +embolismo, I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +cirugía I-TREATMENT +cardíaca I-TREATMENT +sobre I-TREATMENT +el I-TREATMENT +territorio I-TREATMENT +valvular I-TREATMENT +aórtico I-TREATMENT +(procedimiento I-TREATMENT +Ross) I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +superada I-TREATMENT +con I-TREATMENT +éxito. I-TREATMENT +En B-EVOLUTION +el I-EVOLUTION +tercer I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +post-operatorio I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +con I-EVOLUTION +hipertensión I-EVOLUTION +intracraneal. I-EVOLUTION +Se B-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +cerebral I-EXPLORATION +que I-EXPLORATION +reveló I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -0, I-EXPLORATION -8 I-EXPLORATION +un I-EXPLORATION +infarto I-EXPLORATION +isquémico I-EXPLORATION +por I-EXPLORATION +oclusión I-EXPLORATION en I-EXPLORATION -ambos I-EXPLORATION -ojos I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -midriasis I-EXPLORATION -bilateral I-EXPLORATION -arreactiva; I-EXPLORATION el I-EXPLORATION -resto I-EXPLORATION +origen I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -exploración, I-EXPLORATION -incluídas I-EXPLORATION -las I-EXPLORATION -papilas, I-EXPLORATION -es I-EXPLORATION -normal, I-EXPLORATION -salvo I-EXPLORATION -que I-EXPLORATION -presenta I-EXPLORATION -cámaras I-EXPLORATION -anteriores I-EXPLORATION -estrechas I-EXPLORATION -y I-EXPLORATION -unas I-EXPLORATION -presiones I-EXPLORATION -intraoculares I-EXPLORATION +arteria I-EXPLORATION +cerebral I-EXPLORATION +media I-EXPLORATION +izquierda. I-EXPLORATION +Debido B-EVOLUTION +a I-EVOLUTION +su I-EVOLUTION +gravedad, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +falleció I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +días I-EVOLUTION +posteriores. I-EVOLUTION +Los B-EXPLORATION +resultados I-EXPLORATION +microbiológicos I-EXPLORATION +finales I-EXPLORATION +confirmaron I-EXPLORATION +nuevamente I-EXPLORATION +el I-EXPLORATION +aislamiento I-EXPLORATION de I-EXPLORATION -65 I-EXPLORATION -y I-EXPLORATION -58 I-EXPLORATION -mm I-EXPLORATION -Hg I-EXPLORATION -en I-EXPLORATION -cada I-EXPLORATION -ojo. I-EXPLORATION -Ante I-EXPLORATION -este I-EXPLORATION -cuadro I-EXPLORATION -se I-EXPLORATION -procede I-EXPLORATION -a I-EXPLORATION -tomar I-EXPLORATION -imágenes I-EXPLORATION -del I-EXPLORATION -polo I-EXPLORATION -anterior I-EXPLORATION -con I-EXPLORATION -OCT I-EXPLORATION -y I-EXPLORATION -BMU, I-EXPLORATION -mostrando I-EXPLORATION -un I-EXPLORATION -cierre I-EXPLORATION -angular I-EXPLORATION +C. I-EXPLORATION +pseudodiphtheriticum I-EXPLORATION en I-EXPLORATION los I-EXPLORATION -360º I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -bilateral. I-EXPLORATION -Con B-TREATMENT -estos I-TREATMENT -datos, I-TREATMENT -se I-TREATMENT -establece I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -ataque I-TREATMENT -agudo I-TREATMENT -de I-TREATMENT -glaucoma I-TREATMENT -bilateral, I-TREATMENT -se I-TREATMENT -prescribe I-TREATMENT -tratamiento I-TREATMENT -médico I-TREATMENT -para I-TREATMENT -dicho I-TREATMENT -cuadro I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realizan I-TREATMENT -iridotomías I-TREATMENT -bilaterales I-TREATMENT -que I-TREATMENT -resultan I-TREATMENT -permeables I-TREATMENT -como I-TREATMENT -muestran I-TREATMENT -las I-TREATMENT -imágenes I-TREATMENT -del I-TREATMENT -OCT, I-TREATMENT -ampliándose I-TREATMENT -la I-TREATMENT -profundidad I-TREATMENT -camerular I-TREATMENT -en I-TREATMENT -ambos I-TREATMENT -ojos. I-TREATMENT - I-TREATMENT +hemocultivos. I-EXPLORATION + I-EXPLORATION -Varón B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS +14 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -que B-DERIVED_FROM/TO -acude I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -optometrista I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -valorar I-DERIVED_FROM/TO -tumoración I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nivel I-DERIVED_FROM/TO -iridiano I-DERIVED_FROM/TO -sin I-DERIVED_FROM/TO -repercusión I-DERIVED_FROM/TO -funcional. I-DERIVED_FROM/TO -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -una I-EXPLORATION -formación I-EXPLORATION -sobreelevada I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -quístico I-EXPLORATION -y I-EXPLORATION -contenido I-EXPLORATION -lechoso I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -iris, I-EXPLORATION -cerca I-EXPLORATION -del I-EXPLORATION -reborde I-EXPLORATION -pupilar. I-EXPLORATION -No B-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -ningún I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -oftalmológico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -obtienen I-EXPLORATION -imágenes I-EXPLORATION -con I-EXPLORATION -BMU I-EXPLORATION -y I-EXPLORATION -OCT I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -establece I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -quiste I-EXPLORATION -estromal I-EXPLORATION -primario I-EXPLORATION -de I-EXPLORATION -iris. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -casos I-EXPLORATION -anteriormente I-EXPLORATION -mencionados, I-EXPLORATION -el I-EXPLORATION -tiempo I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -exploración I-EXPLORATION -utilizando I-EXPLORATION -ambos I-EXPLORATION -instrumentes I-EXPLORATION -varío I-EXPLORATION -considerablemente, I-EXPLORATION -de I-EXPLORATION -esta I-EXPLORATION -forma, I-EXPLORATION -mediante I-EXPLORATION -el I-EXPLORATION -OCT I-EXPLORATION -se I-EXPLORATION -lograron I-EXPLORATION -exploraciones I-EXPLORATION -completas I-EXPLORATION -del I-EXPLORATION -segmento I-EXPLORATION -anterior I-EXPLORATION -en I-EXPLORATION -tiempos I-EXPLORATION -inferiores I-EXPLORATION -a I-EXPLORATION -5 I-EXPLORATION -minutos. I-EXPLORATION -En I-EXPLORATION -cambio, I-EXPLORATION -la I-EXPLORATION -BMU, I-EXPLORATION -fundamentalmente I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -preparación I-EXPLORATION -previa I-EXPLORATION -que I-EXPLORATION -conlleva, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -mayor I-EXPLORATION -dificultad I-EXPLORATION -para I-EXPLORATION -localizar I-EXPLORATION -la I-EXPLORATION -lesiones I-EXPLORATION -a I-EXPLORATION -estudiar I-EXPLORATION -implicó I-EXPLORATION -tiempos I-EXPLORATION -de I-EXPLORATION -exploración I-EXPLORATION -superiores I-EXPLORATION -a I-EXPLORATION -10 I-EXPLORATION -minutos. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -63 I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +con B-FAMILY_HISTORY +antecedente I-FAMILY_HISTORY +familiar I-FAMILY_HISTORY +de I-FAMILY_HISTORY +madre I-FAMILY_HISTORY +con I-FAMILY_HISTORY +carcinoma I-FAMILY_HISTORY +papilar I-FAMILY_HISTORY +de I-FAMILY_HISTORY +tiroides I-FAMILY_HISTORY +operado. I-FAMILY_HISTORY +A B-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +13 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +realizó I-PRESENT_ILLNESS +ecografía I-PRESENT_ILLNESS +tiroídea I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +bocio I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS +describe I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +sugerente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +neoplasia I-PRESENT_ILLNESS +tiroídea I-PRESENT_ILLNESS +extensa I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS +compromiso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -lagrimeo, I-PRESENT_ILLNESS -conjuntivitis I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS +mayor I-PRESENT_ILLNESS +parte I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +glándula, I-PRESENT_ILLNESS +nódulo I-PRESENT_ILLNESS +dominante I-PRESENT_ILLNESS +lóbulo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -congestión I-PRESENT_ILLNESS -nasal. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -biomicroscópica I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -conjuntivocalasia I-EXPLORATION -bilateral I-EXPLORATION -marcada I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -aclaramiento I-EXPLORATION -de I-EXPLORATION -fluoresceína I-EXPLORATION -(FCT) I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -secreción I-EXPLORATION -basal I-EXPLORATION -elevada, I-EXPLORATION -un I-EXPLORATION -aclaramiento I-EXPLORATION -de I-EXPLORATION -fluoresceína I-EXPLORATION -enlentecido I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -secreción I-EXPLORATION -lagrimal I-EXPLORATION -refleja I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -instaura I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -lágrimas I-TREATMENT -artificiales I-TREATMENT +adenopatías I-PRESENT_ILLNESS +supraclaviculares I-PRESENT_ILLNESS +izquierdas. I-PRESENT_ILLNESS +Teniendo B-TREATMENT +en I-TREATMENT +cuenta I-TREATMENT +sus I-TREATMENT +antecedentes I-TREATMENT +familiares, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +una I-TREATMENT +tiroidectomía I-TREATMENT +total I-TREATMENT sin I-TREATMENT -conservantes, I-TREATMENT -limpieza I-TREATMENT -palpebral I-TREATMENT -diaria I-TREATMENT +punción I-TREATMENT +tiroídea I-TREATMENT +previa, I-TREATMENT +cuya I-TREATMENT +biopsia I-TREATMENT +contemporánea I-TREATMENT y I-TREATMENT -oclusión I-TREATMENT -ocular I-TREATMENT -sin I-TREATMENT -objetivarse I-TREATMENT -mejoría I-TREATMENT -sintomática. I-TREATMENT -Se I-TREATMENT -añade I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -colirio I-TREATMENT -de I-TREATMENT -metilprednisolona I-TREATMENT -al I-TREATMENT -0, I-TREATMENT -5% I-TREATMENT -sin I-TREATMENT -conservantes I-TREATMENT -3 I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día I-TREATMENT -durante I-TREATMENT -2 I-TREATMENT -semanas. I-TREATMENT -Se B-EVOLUTION -produce I-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -sintomática I-EVOLUTION -transitoria, I-EVOLUTION -ya I-EVOLUTION -que I-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -reaparecen I-EVOLUTION -al I-EVOLUTION -interrumpir I-EVOLUTION -el I-EVOLUTION -tratamiento. I-EVOLUTION - I-EVOLUTION -Debido B-TREATMENT -a I-TREATMENT -la I-TREATMENT -persistencia I-TREATMENT +definitiva I-TREATMENT +confirmaron I-TREATMENT +carcinoma I-TREATMENT +papilar I-TREATMENT de I-TREATMENT -estos I-TREATMENT -síntomas, I-TREATMENT -se I-TREATMENT -sugiere I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -bilateral, I-TREATMENT +tiroides I-TREATMENT +en I-TREATMENT +lóbulo I-TREATMENT +izquierdo, I-TREATMENT +itsmo I-TREATMENT +y I-TREATMENT +lóbulo I-TREATMENT +derecho, I-TREATMENT +variante I-TREATMENT +esclerosante I-TREATMENT +difusa I-TREATMENT que I-TREATMENT -se I-TREATMENT -lleva I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -según I-TREATMENT -la I-TREATMENT -técnica I-TREATMENT -descrita I-TREATMENT -por I-TREATMENT -Tseng. I-TREATMENT -Bajo I-TREATMENT -anestesia I-TREATMENT -tópica, I-TREATMENT -se I-TREATMENT -extirpa I-TREATMENT +infiltraba I-TREATMENT el I-TREATMENT -exceso I-TREATMENT -conjuntival. I-TREATMENT -La I-TREATMENT -esclera I-TREATMENT -expuesta I-TREATMENT -se I-TREATMENT -recubre I-TREATMENT -con I-TREATMENT -membrana I-TREATMENT -amniótica I-TREATMENT -orientada I-TREATMENT +tejido I-TREATMENT +peritiroideo I-TREATMENT con I-TREATMENT -la I-TREATMENT -membrana I-TREATMENT -basal I-TREATMENT -hacia I-TREATMENT -arriba. I-TREATMENT -Se I-TREATMENT -pliega I-TREATMENT -la I-TREATMENT -membrana I-TREATMENT -amniótica I-TREATMENT -sobre I-TREATMENT -sí I-TREATMENT -misma I-TREATMENT -para I-TREATMENT -distribuir I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -componentes I-TREATMENT -del I-TREATMENT -pegamento I-TREATMENT -de I-TREATMENT -fibrinógeno I-TREATMENT -(Tissucol®) I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -esclera I-TREATMENT +múltiples I-TREATMENT +permeaciones I-TREATMENT +vasculares I-TREATMENT y I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -cara I-TREATMENT -estromal I-TREATMENT +compromiso I-TREATMENT +ganglionar. I-TREATMENT + I-TREATMENT +A I-TREATMENT +continuación I-TREATMENT de I-TREATMENT la I-TREATMENT -membrana I-TREATMENT -amniótica. I-TREATMENT -El I-TREATMENT -pegamento I-TREATMENT +Tiroidectomía I-TREATMENT se I-TREATMENT -distribuye I-TREATMENT -en I-TREATMENT -pequeñas I-TREATMENT -gotas I-TREATMENT +trató I-TREATMENT +a I-TREATMENT +los I-TREATMENT +30 I-TREATMENT +días I-TREATMENT con I-TREATMENT -ayuda I-TREATMENT -de I-TREATMENT -una I-TREATMENT -cánula I-TREATMENT -de I-TREATMENT -cámara I-TREATMENT -anterior. I-TREATMENT -Se I-TREATMENT -estira I-TREATMENT -bien I-TREATMENT -la I-TREATMENT -membrana I-TREATMENT -amniótica I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -esclera I-TREATMENT -para I-TREATMENT +radio I-TREATMENT +yodo I-TREATMENT +150 I-TREATMENT +mCi; I-TREATMENT +el B-EXPLORATION +rastreo I-EXPLORATION +sistémico I-EXPLORATION +terapéutico I-EXPLORATION +mostró I-EXPLORATION +sólo I-EXPLORATION +tejido I-EXPLORATION +captante I-EXPLORATION +en I-EXPLORATION +remanente I-EXPLORATION +tiroideo. I-EXPLORATION +Sin I-EXPLORATION +embargo, I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +3 I-EXPLORATION +meses I-EXPLORATION +post I-EXPLORATION +tiroidectomía I-EXPLORATION +se I-EXPLORATION +pesquisó I-EXPLORATION +clínicamente I-EXPLORATION +y I-EXPLORATION +mediante I-EXPLORATION +ecografía, I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +en I-EXPLORATION +lecho I-EXPLORATION +tiroideo I-EXPLORATION +derecho I-EXPLORATION +con I-EXPLORATION +recidiva I-EXPLORATION +ganglionar I-EXPLORATION +cervical, I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +mediante I-EXPLORATION +biopsia I-EXPLORATION +por I-EXPLORATION +punción I-EXPLORATION +metástasis I-EXPLORATION +de I-EXPLORATION +carcinoma I-EXPLORATION +papilar I-EXPLORATION +en I-EXPLORATION +ganglios I-EXPLORATION +del I-EXPLORATION +grupo I-EXPLORATION +IIA, I-EXPLORATION +II, I-EXPLORATION +IV, I-EXPLORATION +VD, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT que I-TREATMENT se I-TREATMENT -produzca I-TREATMENT -una I-TREATMENT -buena I-TREATMENT -adhesión I-TREATMENT -de I-TREATMENT -ambos I-TREATMENT -tejidos I-TREATMENT -y I-TREATMENT -se I-TREATMENT -reseca I-TREATMENT -el I-TREATMENT -exceso I-TREATMENT -de I-TREATMENT -membrana I-TREATMENT -amniótica. I-TREATMENT -La I-TREATMENT -conjuntiva I-TREATMENT -residual I-TREATMENT -se I-TREATMENT -pega I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -membrana. I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -postoperatorio I-TREATMENT -consiste I-TREATMENT -en I-TREATMENT -colirio I-TREATMENT -metilprednisolona I-TREATMENT -sin I-TREATMENT -conservantes I-TREATMENT -al I-TREATMENT -0, I-TREATMENT -5% I-TREATMENT -3 I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día I-TREATMENT -y I-TREATMENT -colirio I-TREATMENT -de I-TREATMENT -ofloxacino I-TREATMENT -2 I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día I-TREATMENT -durante I-TREATMENT -15 I-TREATMENT -días I-TREATMENT -sin I-TREATMENT -necesidad I-TREATMENT -de I-TREATMENT -llevar I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT +realizó I-TREATMENT una I-TREATMENT -oclusión I-TREATMENT -postoperatoria. I-TREATMENT -La B-EVOLUTION -mejoría I-EVOLUTION -biomicroscópica I-EVOLUTION -y I-EVOLUTION -sintomática I-EVOLUTION +reintervención I-TREATMENT +quirúrgica. I-TREATMENT +Evoluciona I-TREATMENT +con I-TREATMENT +persistencia I-TREATMENT +imagenológica B-EVOLUTION +de I-EVOLUTION +lesión I-EVOLUTION +ganglionar I-EVOLUTION +cervical I-EVOLUTION +sospechosa I-EVOLUTION +de I-EVOLUTION +recidiva I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +9 I-EVOLUTION +meses I-EVOLUTION +postiroidectomia I-EVOLUTION se I-EVOLUTION -evidencia I-EVOLUTION +decidió I-EVOLUTION +aplicar I-EVOLUTION +una I-EVOLUTION +segunda I-EVOLUTION +dosis I-EVOLUTION +de I-EVOLUTION +radio I-EVOLUTION +yodo I-EVOLUTION +150 I-EVOLUTION +mCi I-EVOLUTION +con I-EVOLUTION +exploración I-EVOLUTION +sistémica I-EVOLUTION +terapéutica I-EVOLUTION +que I-EVOLUTION +mostró I-EVOLUTION +aumento I-EVOLUTION +de I-EVOLUTION +captación I-EVOLUTION en I-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -inmediato, I-EVOLUTION -manteniéndose I-EVOLUTION +región I-EVOLUTION +cervical I-EVOLUTION +anterior I-EVOLUTION +compatible I-EVOLUTION +con I-EVOLUTION +la I-EVOLUTION +lesión I-EVOLUTION +nodular I-EVOLUTION +visible I-EVOLUTION +ecográficamente. I-EVOLUTION +Esta I-EVOLUTION +lesión I-EVOLUTION +ha I-EVOLUTION +disminuido I-EVOLUTION +de I-EVOLUTION +tamaño I-EVOLUTION en I-EVOLUTION -los I-EVOLUTION +controles I-EVOLUTION +posteriores I-EVOLUTION +con I-EVOLUTION +1 I-EVOLUTION +año I-EVOLUTION +3 I-EVOLUTION meses I-EVOLUTION de I-EVOLUTION -seguimiento. I-EVOLUTION - I-EVOLUTION +seguimiento I-EVOLUTION +y B-TREATMENT +persiste I-TREATMENT +con I-TREATMENT +Tiroglobulinas I-TREATMENT +< I-TREATMENT +0, I-TREATMENT +5 I-TREATMENT +ng/ml. I-TREATMENT + I-TREATMENT -Mujer B-PRESENT_ILLNESS +Hombre B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS +34 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -agudeza I-PRESENT_ILLNESS -visual I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -izquierdo. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -destacaba I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -estrías I-PAST_MEDICAL_HISTORY -angioides I-PAST_MEDICAL_HISTORY -cinco I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION +dolor I-PRESENT_ILLNESS +suprapúbico, I-PRESENT_ILLNESS +polaquiuria I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +nicturia. I-PRESENT_ILLNESS +Sin B-EXPLORATION +hallazgos I-EXPLORATION +de I-EXPLORATION +laboratorio. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION +cistoscopía I-EXPLORATION se I-EXPLORATION -objetivó I-EXPLORATION -una I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -lejana I-EXPLORATION +evidencian I-EXPLORATION +glomerulaciones I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +distención I-EXPLORATION +vesical. I-EXPLORATION +Una I-EXPLORATION +biopsia I-EXPLORATION +vesical I-EXPLORATION +randomizadas I-EXPLORATION +revela I-EXPLORATION +mucosa I-EXPLORATION +vesical I-EXPLORATION +con I-EXPLORATION +infiltrado I-EXPLORATION +perivascular I-EXPLORATION +y I-EXPLORATION +múltiples I-EXPLORATION +eosinófilos. I-EXPLORATION +Se I-EXPLORATION +diagnóstica I-EXPLORATION +cistitis I-EXPLORATION +eosinofílica. I-EXPLORATION +Inicialmente B-TREATMENT +se I-TREATMENT +trató I-TREATMENT +con I-TREATMENT +instilaciones I-TREATMENT +vesicales I-TREATMENT +de I-TREATMENT +heparina I-TREATMENT +y I-TREATMENT +corticoides, I-TREATMENT +sin I-TREATMENT +embargo I-TREATMENT +persistió I-TREATMENT +con I-TREATMENT +frecuencia I-TREATMENT +miccional I-TREATMENT +de I-TREATMENT +20/6. I-TREATMENT +Posteriormente I-TREATMENT +se I-TREATMENT +uso I-TREATMENT +amitriptilina, I-TREATMENT +oxibutinina I-TREATMENT +y I-TREATMENT +teltoridona I-TREATMENT +sin I-TREATMENT +respuesta. I-TREATMENT +Estudio B-EXPLORATION +urodinamico I-EXPLORATION +revela I-EXPLORATION +vejiga I-EXPLORATION +inestable I-EXPLORATION +sensitiva I-EXPLORATION +durante I-EXPLORATION +fase I-EXPLORATION de I-EXPLORATION -unidad I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION +continencia. I-EXPLORATION +Se I-EXPLORATION +repite I-EXPLORATION +cistoscopía I-EXPLORATION +sin I-EXPLORATION +hallazgos I-EXPLORATION +significativos. I-EXPLORATION +Una I-EXPLORATION +nueva I-EXPLORATION +biopsia I-EXPLORATION +revela I-EXPLORATION +inflamación I-EXPLORATION +inespecífica. I-EXPLORATION +Se B-TREATMENT +inicia I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +Hidroxicina I-TREATMENT +20 I-TREATMENT +mg I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +horas I-TREATMENT +más I-TREATMENT +Diclofenaco I-TREATMENT +sódico I-TREATMENT +50 I-TREATMENT +mg. I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +h, I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +respuesta. I-TREATMENT +El B-EVOLUTION +dolor I-EVOLUTION +cedió I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +frecuencia I-EVOLUTION +miccional I-EVOLUTION +disminuyó I-EVOLUTION +a I-EVOLUTION +6/0, I-EVOLUTION +con I-EVOLUTION +mayor I-EVOLUTION +volumen I-EVOLUTION +miccional. I-EVOLUTION +Por B-TREATMENT +somnolencia I-TREATMENT +se I-TREATMENT +cambió I-TREATMENT +antihistamínico I-TREATMENT +a I-TREATMENT +Cetirizina, I-TREATMENT +con I-TREATMENT +igual I-TREATMENT +respuesta. I-TREATMENT + I-TREATMENT + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +36 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +importancia, I-PAST_MEDICAL_HISTORY +hospitalizada B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +peritonitis I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +origen I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +precisado. I-PRESENT_ILLNESS +Consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +7 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +distensión I-PRESENT_ILLNESS +abdominal, I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos. I-PRESENT_ILLNESS +La B-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION +fue I-EXPLORATION +131/76, I-EXPLORATION +frecuencia I-EXPLORATION +cardiaca I-EXPLORATION +de I-EXPLORATION +126 I-EXPLORATION +x' I-EXPLORATION y I-EXPLORATION +38, I-EXPLORATION +9eC I-EXPLORATION de I-EXPLORATION -«contar I-EXPLORATION -dedos» I-EXPLORATION +temperatura I-EXPLORATION +rectal. I-EXPLORATION +El I-EXPLORATION +abdomen I-EXPLORATION +estaba I-EXPLORATION +distendido, I-EXPLORATION +mate I-EXPLORATION a I-EXPLORATION -dos I-EXPLORATION -metros I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ojo I-EXPLORATION -izquierdo. I-EXPLORATION -La I-EXPLORATION -tensión I-EXPLORATION -ocular I-EXPLORATION -y I-EXPLORATION la I-EXPLORATION -biomicroscopía I-EXPLORATION -estaban I-EXPLORATION -dentro I-EXPLORATION +palpación I-EXPLORATION +y I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -parámetros I-EXPLORATION -normales. I-EXPLORATION +ruidos I-EXPLORATION +intestinales I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +auscultación. I-EXPLORATION La I-EXPLORATION -oftalmoscopia I-EXPLORATION -bajo I-EXPLORATION -dilatación I-EXPLORATION -mostró, I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -ojos, I-EXPLORATION +evaluación I-EXPLORATION +ginecológica I-EXPLORATION +fue I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -lesiones I-EXPLORATION -lineales I-EXPLORATION -serpenteantes I-EXPLORATION -radiales I-EXPLORATION +ecografía I-EXPLORATION +reveló I-EXPLORATION +líquido I-EXPLORATION +libre I-EXPLORATION +intraperitoneal I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +estructura I-EXPLORATION +quística I-EXPLORATION +adyacente I-EXPLORATION al I-EXPLORATION -disco I-EXPLORATION -óptico I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extendían I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -periferia. I-EXPLORATION -Además, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ojo I-EXPLORATION -izquierdo, I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION +intestino I-EXPLORATION +delgado. I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +abdominal I-EXPLORATION +(TAC), I-EXPLORATION +demostró I-EXPLORATION +algunas I-EXPLORATION +asas I-EXPLORATION +de I-EXPLORATION +intestino I-EXPLORATION +delgado I-EXPLORATION +rodeando I-EXPLORATION una I-EXPLORATION -lesión I-EXPLORATION -cicatricial I-EXPLORATION +estructura I-EXPLORATION +tubular I-EXPLORATION +quística I-EXPLORATION +y I-EXPLORATION +líquido I-EXPLORATION +libre I-EXPLORATION +peritoneal. I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -gran I-EXPLORATION -tamaño I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION +laboratorio I-EXPLORATION +revelaron I-EXPLORATION +leucocitosis I-EXPLORATION de I-EXPLORATION -movilización I-EXPLORATION +25.700 I-EXPLORATION +x I-EXPLORATION +mm3 I-EXPLORATION +y I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION de I-EXPLORATION -pigmento I-EXPLORATION +356, I-EXPLORATION +06 I-EXPLORATION +mg/dl. I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +tumor I-TREATMENT +quístico I-TREATMENT +intestinal I-TREATMENT +complicado I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +operada. I-TREATMENT +La B-EXPLORATION +cavidad I-EXPLORATION +abdominal I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +llena I-EXPLORATION +de I-EXPLORATION +líquido I-EXPLORATION +seroso I-EXPLORATION +del I-EXPLORATION +cual I-EXPLORATION +se I-EXPLORATION +tomaron I-EXPLORATION +muestras I-EXPLORATION +para I-EXPLORATION +citología I-EXPLORATION y I-EXPLORATION -fibrosis I-EXPLORATION -que I-EXPLORATION -englobaba I-EXPLORATION -toda I-EXPLORATION -el I-EXPLORATION -área I-EXPLORATION -macular. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -angiografía I-EXPLORATION -fluoresceínica I-EXPLORATION -(AGF) I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -resultados: I-EXPLORATION +cultivo. I-EXPLORATION +La I-EXPLORATION +exploración I-EXPLORATION +reveló I-EXPLORATION +múltiples I-EXPLORATION +implantes I-EXPLORATION +tumorales I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -se I-EXPLORATION -apreciaron I-EXPLORATION -unas I-EXPLORATION -líneas I-EXPLORATION -hipo I-EXPLORATION +peritoneo I-EXPLORATION +parietal I-EXPLORATION +y I-EXPLORATION +visceral, I-EXPLORATION e I-EXPLORATION -hiperfluorescentes I-EXPLORATION -con I-EXPLORATION -movilización I-EXPLORATION -de I-EXPLORATION -pigmento I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -macular I-EXPLORATION -sin I-EXPLORATION -difusión I-EXPLORATION +infiltración I-EXPLORATION +extensa I-EXPLORATION +del I-EXPLORATION +epiplón I-EXPLORATION +mayor, I-EXPLORATION +se I-EXPLORATION +tomaron I-EXPLORATION +muestras I-EXPLORATION de I-EXPLORATION -contraste. I-EXPLORATION +estos I-EXPLORATION +implantes I-EXPLORATION +para I-EXPLORATION +biopsia. I-EXPLORATION En I-EXPLORATION el I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION +mesenterio I-EXPLORATION +del I-EXPLORATION +íleon I-EXPLORATION se I-EXPLORATION -observaron I-EXPLORATION -la I-EXPLORATION -mismas I-EXPLORATION -lesiones I-EXPLORATION -lineales I-EXPLORATION -acompañadas I-EXPLORATION -de I-EXPLORATION +encontró I-EXPLORATION un I-EXPLORATION -área I-EXPLORATION -hipo I-EXPLORATION -e I-EXPLORATION -hiperfluorescente I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -macular I-EXPLORATION -sin I-EXPLORATION -difusión I-EXPLORATION +tumor I-EXPLORATION +quístico I-EXPLORATION +tubular I-EXPLORATION +blanquecino I-EXPLORATION +rodeado I-EXPLORATION de I-EXPLORATION -contraste I-EXPLORATION -en I-EXPLORATION -tiempos I-EXPLORATION -tardíos I-EXPLORATION -siendo I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -estrías I-EXPLORATION -angioides I-EXPLORATION -bilaterales I-EXPLORATION -y I-EXPLORATION -además, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ojo I-EXPLORATION -izquierdo, I-EXPLORATION -complicadas I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -membrana I-EXPLORATION -neovascular I-EXPLORATION -subretiniana I-EXPLORATION -no I-EXPLORATION -susceptible I-EXPLORATION +asas I-EXPLORATION +intestinales, I-EXPLORATION +que I-EXPLORATION +medía I-EXPLORATION +12 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -tratamiento. I-EXPLORATION -Se B-EVOLUTION -aconsejó I-EVOLUTION -el I-EVOLUTION -seguimiento I-EVOLUTION -clínico I-EVOLUTION -periódico. I-EVOLUTION - I-EVOLUTION -Dos I-EVOLUTION -meses I-EVOLUTION +diámetro I-EXPLORATION +por I-EXPLORATION +15 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +longitud. I-EXPLORATION +Se B-TREATMENT +abrió I-TREATMENT +el I-TREATMENT +tumor I-TREATMENT +aspirándose I-TREATMENT +un I-TREATMENT +líquido I-TREATMENT +oscuro I-TREATMENT +y I-TREATMENT +espeso I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +enviado I-TREATMENT +a I-TREATMENT +citología. I-TREATMENT +Se I-TREATMENT +resecó I-TREATMENT +la I-TREATMENT +mayor I-TREATMENT +cantidad I-TREATMENT +posible I-TREATMENT +de I-TREATMENT +pared I-TREATMENT +tumoral I-TREATMENT +quedando I-TREATMENT +una I-TREATMENT +parte I-TREATMENT +adherida I-TREATMENT +al I-TREATMENT +mesenterio, I-TREATMENT +la I-TREATMENT +resección I-TREATMENT +completa I-TREATMENT +del I-TREATMENT +tumor I-TREATMENT +no I-TREATMENT +fue I-TREATMENT +posible I-TREATMENT +por I-TREATMENT +la I-TREATMENT +diseminación I-TREATMENT +peritoneal I-TREATMENT +y I-TREATMENT +su I-TREATMENT +localización I-TREATMENT +en I-TREATMENT +el I-TREATMENT +mesenterio I-TREATMENT +del I-TREATMENT +íleon. I-TREATMENT +La B-EVOLUTION +recuperación I-EVOLUTION +postoperatoria I-EVOLUTION +fue I-EVOLUTION +satisfactoria I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +complicaciones. I-EVOLUTION +Sin I-EVOLUTION +embargo, I-EVOLUTION +treinta I-EVOLUTION +y I-EVOLUTION +cuatro I-EVOLUTION +días I-EVOLUTION después I-EVOLUTION la I-EVOLUTION paciente I-EVOLUTION -acudió I-EVOLUTION -refiriendo I-EVOLUTION -empeoramiento I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -agudeza I-EVOLUTION -visual, I-EVOLUTION -esta I-EVOLUTION -vez, I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -ojo I-EVOLUTION -derecho. I-EVOLUTION +falleció. I-EVOLUTION La B-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -de I-EXPLORATION -unidad I-EXPLORATION -con I-EXPLORATION -dificultad I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION +muestras I-EXPLORATION +citológicas I-EXPLORATION +tomadas I-EXPLORATION +del I-EXPLORATION +líquido I-EXPLORATION +peritoneal I-EXPLORATION y I-EXPLORATION +del I-EXPLORATION +contenido I-EXPLORATION +tumoral I-EXPLORATION +fueron I-EXPLORATION +positivas I-EXPLORATION +para I-EXPLORATION +células I-EXPLORATION +neoplásicas. I-EXPLORATION +La I-EXPLORATION +histopatología I-EXPLORATION +del I-EXPLORATION +tumor I-EXPLORATION +demostró I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -«contar I-EXPLORATION -dedos» I-EXPLORATION -a I-EXPLORATION -dos I-EXPLORATION -metros I-EXPLORATION +arquitectura I-EXPLORATION +típica I-EXPLORATION +de I-EXPLORATION +pared I-EXPLORATION +intestinal, I-EXPLORATION en I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +se I-EXPLORATION +reconocían I-EXPLORATION +capas I-EXPLORATION +de I-EXPLORATION +músculo I-EXPLORATION +liso I-EXPLORATION +circular I-EXPLORATION +y I-EXPLORATION +longitudinal I-EXPLORATION +bien I-EXPLORATION +organizadas, I-EXPLORATION +identificándose I-EXPLORATION +plexos I-EXPLORATION +nerviosos I-EXPLORATION +mientéricos I-EXPLORATION +entre I-EXPLORATION +ambas I-EXPLORATION +capas I-EXPLORATION +musculares. I-EXPLORATION +La I-EXPLORATION +superficie I-EXPLORATION +interna I-EXPLORATION +estaba I-EXPLORATION +revestida I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +adeno I-EXPLORATION +carcinoma I-EXPLORATION +mucosecretor I-EXPLORATION +moderadamente I-EXPLORATION +diferenciado I-EXPLORATION +que I-EXPLORATION +infiltraba I-EXPLORATION +todo I-EXPLORATION el I-EXPLORATION -ojo I-EXPLORATION -izquierdo. I-EXPLORATION -Funduscópicamente, I-EXPLORATION +espesor I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -ojo I-EXPLORATION -derecho, I-EXPLORATION +varias I-EXPLORATION +partes I-EXPLORATION +y I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -apreció I-EXPLORATION -una I-EXPLORATION -pequeña I-EXPLORATION -hemorragia I-EXPLORATION +extendió I-EXPLORATION +superficialmente I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +serosa. I-EXPLORATION +Los I-EXPLORATION +hallazgos I-EXPLORATION +intraoperatorios I-EXPLORATION y I-EXPLORATION -movilización I-EXPLORATION +el I-EXPLORATION +informe I-EXPLORATION +histopatológico I-EXPLORATION +confirmaron I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -pigmento I-EXPLORATION -en I-EXPLORATION -polo I-EXPLORATION -posterior I-EXPLORATION -con I-EXPLORATION -estrías I-EXPLORATION -anaranjadas, I-EXPLORATION -ya I-EXPLORATION -presentes I-EXPLORATION +adenocarcinoma I-EXPLORATION en I-EXPLORATION -exploraciones I-EXPLORATION -previas. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION una I-EXPLORATION -nueva I-EXPLORATION -AGF I-EXPLORATION -del I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -que I-EXPLORATION -puso I-EXPLORATION +duplicación I-EXPLORATION +intestinal I-EXPLORATION de I-EXPLORATION -manifiesto I-EXPLORATION una I-EXPLORATION -hiperfluorescencia I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -macular I-EXPLORATION -desde I-EXPLORATION -tiempos I-EXPLORATION -iniciales I-EXPLORATION -rodeada I-EXPLORATION +paciente I-EXPLORATION +adulta. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +neonato I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +8 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +vida I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +sufre I-PRESENT_ILLNESS +cefalohematoma I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +parto I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +fórceps. I-PRESENT_ILLNESS +La B-DERIVED_FROM/TO +Unidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Neonatología I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +hospitalario I-DERIVED_FROM/TO +solicita I-DERIVED_FROM/TO +valoración I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +Cirugía I-DERIVED_FROM/TO +Plástica. I-DERIVED_FROM/TO +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +clínica I-EXPLORATION +observamos I-EXPLORATION +tejido I-EXPLORATION +necrótico I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -halo I-EXPLORATION -hipofluorescente I-EXPLORATION -con I-EXPLORATION -aumento I-EXPLORATION +aproximadamente I-EXPLORATION +3x4 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -fluorescencia I-EXPLORATION -hacia I-EXPLORATION -tiempos I-EXPLORATION -tardíos I-EXPLORATION -y I-EXPLORATION -mínima I-EXPLORATION -difusión, I-EXPLORATION -no I-EXPLORATION -existente I-EXPLORATION -en I-EXPLORATION -AGF I-EXPLORATION -previas, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -membrana I-EXPLORATION -neovascular I-EXPLORATION -subfoveal. I-EXPLORATION -Se I-EXPLORATION -estableció, I-EXPLORATION -por I-EXPLORATION -tanto, I-EXPLORATION -un I-EXPLORATION -nuevo I-EXPLORATION -diagnóstico, I-EXPLORATION -estrías I-EXPLORATION -angioides I-EXPLORATION -complicadas I-EXPLORATION -con I-EXPLORATION -membrana I-EXPLORATION -neovascular I-EXPLORATION -subfoveal I-EXPLORATION +diámetro I-EXPLORATION en I-EXPLORATION -ojo I-EXPLORATION -derecho. I-EXPLORATION -Se B-TREATMENT -le I-TREATMENT -planteó I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -TFD I-TREATMENT +la I-EXPLORATION +región I-EXPLORATION +occipital. I-EXPLORATION + I-EXPLORATION +Procedimos B-TREATMENT +a I-TREATMENT +desbridamientos I-TREATMENT +seriados I-TREATMENT +que I-TREATMENT +se I-TREATMENT +llevaron I-TREATMENT +a I-TREATMENT +cabo I-TREATMENT +a I-TREATMENT +los I-TREATMENT +8 I-TREATMENT y I-TREATMENT -tras I-TREATMENT +15 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +vida I-TREATMENT +de I-TREATMENT la I-TREATMENT -primera I-TREATMENT -sesión I-TREATMENT -se I-TREATMENT -produjo I-TREATMENT +paciente. I-TREATMENT +En I-TREATMENT +esa I-TREATMENT +segunda I-TREATMENT +intervención, I-TREATMENT +optamos I-TREATMENT +por I-TREATMENT la I-TREATMENT -reabsorción I-TREATMENT -parcial I-TREATMENT +colocación I-TREATMENT de I-TREATMENT -la I-TREATMENT -hemorragia I-TREATMENT -con I-TREATMENT -mantenimiento I-TREATMENT +un I-TREATMENT +sistema I-TREATMENT de I-TREATMENT -la I-TREATMENT -pigmentación I-TREATMENT -central. I-TREATMENT -Dichos I-TREATMENT -hallazgos I-TREATMENT -se I-TREATMENT -confirmaron I-TREATMENT +terapia I-TREATMENT +de I-TREATMENT +vacío I-TREATMENT +(Renasys®, I-TREATMENT +Smith&Nephew®, I-TREATMENT +Londres, I-TREATMENT +Reino I-TREATMENT +Unido) I-TREATMENT +de I-TREATMENT +modo I-TREATMENT +continuo, I-TREATMENT +a I-TREATMENT +120 I-TREATMENT +mmHg I-TREATMENT +durante I-TREATMENT +20 I-TREATMENT +días, I-TREATMENT con I-TREATMENT -la I-TREATMENT -AGF I-TREATMENT -que I-TREATMENT -reveló I-TREATMENT -una I-TREATMENT -ligera I-TREATMENT -difusión I-TREATMENT +cambios I-TREATMENT de I-TREATMENT -contraste I-TREATMENT -en I-TREATMENT -tiempos I-TREATMENT -tardíos. I-TREATMENT -Por I-TREATMENT -ello, I-TREATMENT +apósitos I-TREATMENT +cada I-TREATMENT +72 I-TREATMENT +horas. I-TREATMENT +Con I-TREATMENT +este I-TREATMENT +tratamiento I-TREATMENT +observamos I-TREATMENT +contracción I-TREATMENT +del I-TREATMENT +defecto I-TREATMENT +original, I-TREATMENT +procediendo I-TREATMENT a I-TREATMENT -pesar I-TREATMENT +realizar I-TREATMENT +colgajos I-TREATMENT +rotacionales I-TREATMENT +para I-TREATMENT +el I-TREATMENT +cierre I-TREATMENT +definitivo I-TREATMENT de I-TREATMENT la I-TREATMENT -recuperación I-TREATMENT -visual, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -aplicar I-TREATMENT -dos I-TREATMENT -sesiones I-TREATMENT -más I-TREATMENT -de I-TREATMENT -TFD. I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -última I-EXPLORATION -revisión I-EXPLORATION -la I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -se I-EXPLORATION -mantenía I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -unidad I-EXPLORATION -y I-EXPLORATION -angiográficamente I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -hipo I-EXPLORATION -e I-EXPLORATION -hiperfluorescente I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -cicatricial I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -área I-EXPLORATION -macular. I-EXPLORATION -En I-EXPLORATION -tiempos I-EXPLORATION -angiográficos I-EXPLORATION -medios I-EXPLORATION -aparecía I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -hiperfluorescencia I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -mantenía I-EXPLORATION -en I-EXPLORATION -tiempos I-EXPLORATION -tardíos, I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -difusión I-EXPLORATION -de I-EXPLORATION -contraste. I-EXPLORATION - I-EXPLORATION +herida. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +4o I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +postoperatorio, I-EVOLUTION +sin I-EVOLUTION +mayores I-EVOLUTION +incidencias. I-EVOLUTION +La I-EVOLUTION +última I-EVOLUTION +valoración I-EVOLUTION +fue I-EVOLUTION +realizada I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +18 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +postoperatorio, I-EVOLUTION +observando I-EVOLUTION +solo I-EVOLUTION +una I-EVOLUTION +pequeña I-EVOLUTION +zona I-EVOLUTION +de I-EVOLUTION +alopecia I-EVOLUTION +cicatricial I-EVOLUTION +así I-EVOLUTION +como I-EVOLUTION +una I-EVOLUTION +brida I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +región I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +nuca, I-EVOLUTION +susceptibles I-EVOLUTION +de I-EVOLUTION +nuevas I-EVOLUTION +intervenciones I-EVOLUTION +quirúrgicas I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +futuro I-EVOLUTION +si I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +o I-EVOLUTION +la I-EVOLUTION +familia I-EVOLUTION +lo I-EVOLUTION +requieren. I-EVOLUTION + I-EVOLUTION -Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS +40 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -fáquico, I-PRESENT_ILLNESS -diagnosticado I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +sufre I-PRESENT_ILLNESS +herida I-PRESENT_ILLNESS +traumática I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +dorso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -degeneración I-PRESENT_ILLNESS -macular I-PRESENT_ILLNESS -asociada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -exudativa I-PRESENT_ILLNESS -(DMAE) I-PRESENT_ILLNESS +mano I-PRESENT_ILLNESS +derecha I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +quedar I-PRESENT_ILLNESS +atrapada I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -al B-TREATMENT -que I-TREATMENT -se I-TREATMENT -le I-TREATMENT -realiza I-TREATMENT -terapia I-TREATMENT -fotodinámica I-TREATMENT -(TFD). I-TREATMENT -48 I-TREATMENT -horas I-TREATMENT -después I-TREATMENT -se I-TREATMENT -le I-TREATMENT -inyecta I-TREATMENT -en I-TREATMENT -cámara I-TREATMENT -vítrea I-TREATMENT -20 I-TREATMENT -mg I-TREATMENT -en I-TREATMENT -0, I-TREATMENT -1 I-TREATMENT -ml I-TREATMENT +una I-PRESENT_ILLNESS +cinta I-PRESENT_ILLNESS +transportadora I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +empresa I-PRESENT_ILLNESS +cárnica, I-PRESENT_ILLNESS +presentando I-PRESENT_ILLNESS +importante I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +piel I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +arrancamiento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +tendones I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +músculo I-PRESENT_ILLNESS +extensor I-PRESENT_ILLNESS +común I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +unión I-PRESENT_ILLNESS +miotendinosa. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-TREATMENT +un I-TREATMENT +primer I-TREATMENT +acto I-TREATMENT +quirúrgico I-TREATMENT de I-TREATMENT -acetato I-TREATMENT +urgencia I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +limpieza I-TREATMENT +exhaustiva, I-TREATMENT +cierre I-TREATMENT de I-TREATMENT -triamcinolona I-TREATMENT -obtenida I-TREATMENT -mediante I-TREATMENT la I-TREATMENT -técnica I-TREATMENT +herida I-TREATMENT +y I-TREATMENT +cobertura I-TREATMENT +antibiótica, I-TREATMENT +postponiendo I-TREATMENT +la I-TREATMENT +cirugía I-TREATMENT +reconstructiva I-TREATMENT +dado I-TREATMENT +el I-TREATMENT +alto I-TREATMENT +riesgo I-TREATMENT de I-TREATMENT -sedimentación. I-TREATMENT - I-TREATMENT -La I-TREATMENT -operación I-TREATMENT +infección. I-TREATMENT +Tras B-EVOLUTION +una I-EVOLUTION +semana I-EVOLUTION +y I-EVOLUTION +a I-EVOLUTION +pesar I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +medidas I-EVOLUTION +profilácticas, I-EVOLUTION +la I-EVOLUTION +herida I-EVOLUTION +sufrió I-EVOLUTION +una I-EVOLUTION +infección I-EVOLUTION +por I-EVOLUTION +microorganismos I-EVOLUTION +anaerobios I-EVOLUTION +que B-TREATMENT se I-TREATMENT -realizó I-TREATMENT +trató I-TREATMENT +con I-TREATMENT +desbridamiento I-TREATMENT +quirúrgico, I-TREATMENT +antibiotepia I-TREATMENT +y I-TREATMENT +cámara I-TREATMENT +hiperbárica I-TREATMENT +durante I-TREATMENT +3 I-TREATMENT +semanas. I-TREATMENT +Una I-TREATMENT +vez I-TREATMENT +resuelta I-TREATMENT +la I-TREATMENT +infección I-TREATMENT +se I-TREATMENT +programó I-TREATMENT +para I-TREATMENT +transferencia I-TREATMENT +tendinosa, I-TREATMENT +pero I-TREATMENT en I-TREATMENT el I-TREATMENT -quirófano I-TREATMENT -bajo I-TREATMENT -medidas I-TREATMENT -asépticas. I-TREATMENT -La I-TREATMENT -inyección I-TREATMENT +acto I-TREATMENT +quirúrgico I-TREATMENT se I-TREATMENT -hizo I-TREATMENT -con I-TREATMENT -aguja I-TREATMENT +encontró I-TREATMENT +necrosis I-TREATMENT de I-TREATMENT -27 I-TREATMENT -G I-TREATMENT -a I-TREATMENT -4 I-TREATMENT -mm I-TREATMENT -del I-TREATMENT -limbo I-TREATMENT -en I-TREATMENT -el I-TREATMENT -cuadrante I-TREATMENT -temporo-inferior I-TREATMENT -ayudado I-TREATMENT +los I-TREATMENT +tendones I-TREATMENT +extensores I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +resecar I-TREATMENT +hasta I-TREATMENT +tejido I-TREATMENT +viable I-TREATMENT +y I-TREATMENT +utilizar I-TREATMENT +varillas I-TREATMENT de I-TREATMENT +silicona I-TREATMENT +en I-TREATMENT un I-TREATMENT -blefarostato. I-TREATMENT -Durante I-TREATMENT -el I-TREATMENT -procedimiento, I-TREATMENT -y I-TREATMENT -coincidiendo I-TREATMENT +primer I-TREATMENT +tiempo I-TREATMENT con I-TREATMENT +vistas I-TREATMENT +a I-TREATMENT un I-TREATMENT -intento I-TREATMENT +posterior I-TREATMENT +injerto I-TREATMENT +tendinoso. I-TREATMENT + I-TREATMENT +Al B-EVOLUTION +mes I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +implantación I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +varillas, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presentaba I-EVOLUTION +una I-EVOLUTION +severa I-EVOLUTION +limitación I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +movilidad I-EVOLUTION +que I-EVOLUTION +contraindicaba I-EVOLUTION +el I-EVOLUTION +injerto I-EVOLUTION +tendinoso, I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +tras I-TREATMENT +confirmar I-TREATMENT +mediante I-TREATMENT +doppler I-TREATMENT +la I-TREATMENT +permeabilidad I-TREATMENT +tanto I-TREATMENT de I-TREATMENT -cierre I-TREATMENT -forzado I-TREATMENT +la I-TREATMENT +arteria I-TREATMENT +tibial I-TREATMENT +posterior I-TREATMENT +como I-TREATMENT de I-TREATMENT -los I-TREATMENT -párpados, I-TREATMENT +la I-TREATMENT +tibial I-TREATMENT +anterior, I-TREATMENT se I-TREATMENT -observó I-TREATMENT -con I-TREATMENT +decidió I-TREATMENT +utilizar I-TREATMENT el I-TREATMENT -microscopio I-TREATMENT -cómo I-TREATMENT -parte I-TREATMENT +colgajo I-TREATMENT +vascularizado I-TREATMENT de I-TREATMENT +dorsalis I-TREATMENT +pedis I-TREATMENT +para I-TREATMENT la I-TREATMENT -sustancia I-TREATMENT -lechosa I-TREATMENT -pasaba I-TREATMENT -a I-TREATMENT -cámara I-TREATMENT -anterior. I-TREATMENT - I-TREATMENT +reconstrucción I-TREATMENT +funcional I-TREATMENT +completa. I-TREATMENT Se I-TREATMENT -decidió I-TREATMENT -actuar I-TREATMENT +realizó I-TREATMENT +anastomosis I-TREATMENT de I-TREATMENT -forma I-TREATMENT -expectante I-TREATMENT -instilando I-TREATMENT -colirio I-TREATMENT +la I-TREATMENT +arteria I-TREATMENT +dorsal I-TREATMENT +del I-TREATMENT +pie I-TREATMENT +a I-TREATMENT +la I-TREATMENT +radial, I-TREATMENT de I-TREATMENT -ciprofloxacino I-TREATMENT +la I-TREATMENT +vena I-TREATMENT +safena I-TREATMENT +a I-TREATMENT +una I-TREATMENT +vena I-TREATMENT +superficial I-TREATMENT +del I-TREATMENT +antebrazo, I-TREATMENT y I-TREATMENT -observando I-TREATMENT -el I-TREATMENT -pulso I-TREATMENT -arterial I-TREATMENT -espontáneo. I-TREATMENT -Al B-EVOLUTION -día I-EVOLUTION -siguiente I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentaba I-EVOLUTION -la I-EVOLUTION -triamcinolona I-EVOLUTION -precipitada I-EVOLUTION -en I-EVOLUTION -cámara I-EVOLUTION -anterior I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -cámara I-EVOLUTION -vítrea I-EVOLUTION -sin I-EVOLUTION -otros I-EVOLUTION -signos I-EVOLUTION -inflamatorios. I-EVOLUTION -La B-TREATMENT -PIO I-TREATMENT -era I-TREATMENT +la I-TREATMENT +correspondiente I-TREATMENT +sutura I-TREATMENT +tendinosa. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +inmovilizó I-TREATMENT +la I-TREATMENT +zona I-TREATMENT +donante I-TREATMENT +durante I-TREATMENT +10 I-TREATMENT +días I-TREATMENT +con I-TREATMENT +férula I-TREATMENT de I-TREATMENT -25 I-TREATMENT -mm I-TREATMENT -Hg, I-TREATMENT -por I-TREATMENT +yeso, I-TREATMENT lo I-TREATMENT +suficiente I-TREATMENT +para I-TREATMENT que I-TREATMENT -se I-TREATMENT -prescribió I-TREATMENT -maleato I-TREATMENT -de I-TREATMENT -timolol I-TREATMENT -al I-TREATMENT -0, I-TREATMENT -5% I-TREATMENT -en I-TREATMENT -colirio I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas. I-TREATMENT - I-TREATMENT -Se B-EVOLUTION -le I-EVOLUTION -realizaron I-EVOLUTION -controles I-EVOLUTION -periódicos I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -detectó I-EVOLUTION +el I-TREATMENT +injerto I-TREATMENT +prendiera. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +comenzó I-EVOLUTION +entonces I-EVOLUTION +a I-EVOLUTION +deambular I-EVOLUTION +libremente I-EVOLUTION +con I-EVOLUTION un I-EVOLUTION -descenso I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -PIO I-EVOLUTION -hasta I-EVOLUTION -valores I-EVOLUTION -normales, I-EVOLUTION -una I-EVOLUTION -reabsorción I-EVOLUTION -progresiva I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -triamcinolona I-EVOLUTION +vendaje I-EVOLUTION +simple I-EVOLUTION +del I-EVOLUTION +área I-EVOLUTION y I-EVOLUTION -la I-EVOLUTION -córnea I-EVOLUTION -transparente I-EVOLUTION -sin I-EVOLUTION -reacción I-EVOLUTION -inflamatoria. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION +no I-EVOLUTION +sufrió I-EVOLUTION +complicaciones. I-EVOLUTION +Tras I-EVOLUTION +6 I-EVOLUTION meses I-EVOLUTION -quedaban I-EVOLUTION -escasos I-EVOLUTION -restos I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sustancia, I-EVOLUTION -la I-EVOLUTION -PIO I-EVOLUTION -era I-EVOLUTION de I-EVOLUTION -17 I-EVOLUTION -mm I-EVOLUTION -Hg I-EVOLUTION -sin I-EVOLUTION -tratamiento I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -biomicroscopía I-EVOLUTION -endotelial I-EVOLUTION -resultó I-EVOLUTION -un I-EVOLUTION -recuento I-EVOLUTION -celular I-EVOLUTION -normal I-EVOLUTION -e I-EVOLUTION -igual I-EVOLUTION -que I-EVOLUTION +postoperatorio, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +refería I-EVOLUTION +anestesia I-EVOLUTION +exclusivamente I-EVOLUTION en I-EVOLUTION el I-EVOLUTION -ojo I-EVOLUTION -contralateral. I-EVOLUTION +área I-EVOLUTION +donante I-EVOLUTION +del I-EVOLUTION +colgajo. I-EVOLUTION + I-EVOLUTION +La B-TREATMENT +mano I-TREATMENT +se I-TREATMENT +inmovilizó I-TREATMENT +durante I-TREATMENT +4 I-TREATMENT +semanas I-TREATMENT +y I-TREATMENT +se I-TREATMENT +llevó I-TREATMENT +a I-TREATMENT +cabo I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +rehabilitación I-TREATMENT +con I-TREATMENT +ejercicios I-TREATMENT +activos I-TREATMENT +protegidos I-TREATMENT +durante I-TREATMENT +8 I-TREATMENT +semanas, I-TREATMENT +obteniendo I-TREATMENT +un I-TREATMENT +resultado I-TREATMENT +funcional I-TREATMENT +satisfactorio I-TREATMENT +y B-EVOLUTION +reincorporación I-EVOLUTION +del I-EVOLUTION +paciente I-EVOLUTION +al I-EVOLUTION +trabajo I-EVOLUTION +3 I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +intervención. I-EVOLUTION I-EVOLUTION -Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -sufrir I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -agresión I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -párpado I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -objeto I-PRESENT_ILLNESS -metálico, I-PRESENT_ILLNESS -fino I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -largo, I-PRESENT_ILLNESS -mientras I-PRESENT_ILLNESS -deambulaba I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -calle. I-PRESENT_ILLNESS -Presentaba I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -importante I-PRESENT_ILLNESS -fétor I-PRESENT_ILLNESS -etílico I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -inestabilidad I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -marcha. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -(AV) I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION -(OI) I-EXPLORATION -poco I-EXPLORATION -fiable I-EXPLORATION -por I-EXPLORATION +63 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +exfumador, B-PAST_MEDICAL_HISTORY +asintomático, I-PAST_MEDICAL_HISTORY +remitido B-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +julio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +2001 I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +hepatomegalia I-DERIVED_FROM/TO +(de I-DERIVED_FROM/TO +4 I-DERIVED_FROM/TO +cm I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +expensas I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +lóbulo I-DERIVED_FROM/TO +hepático I-DERIVED_FROM/TO +derecho) I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +colestasis I-DERIVED_FROM/TO +disociada I-DERIVED_FROM/TO +-fosfatasa I-DERIVED_FROM/TO +alcalina I-DERIVED_FROM/TO +(FA) I-DERIVED_FROM/TO +873 I-DERIVED_FROM/TO +IU/L I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +gamma-glutaryl I-DERIVED_FROM/TO +transpeptidasa I-DERIVED_FROM/TO +(GGT) I-DERIVED_FROM/TO +637 I-DERIVED_FROM/TO +IU/L- I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +analítica I-DERIVED_FROM/TO +rutinaria. I-DERIVED_FROM/TO +El B-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +parámetros, I-EXPLORATION +incluyendo I-EXPLORATION +ANA I-EXPLORATION +(anticuerpos I-EXPLORATION +antinucleares), I-EXPLORATION +AMA I-EXPLORATION +(anticuerpos I-EXPLORATION +antimitocondriales), I-EXPLORATION +ASMA I-EXPLORATION +(anticuerpos I-EXPLORATION +anti-músculo I-EXPLORATION +liso) I-EXPLORATION +y I-EXPLORATION +LKM I-EXPLORATION +(anticuerpos I-EXPLORATION +anti I-EXPLORATION +anti-antígenos I-EXPLORATION +microsomales I-EXPLORATION +de I-EXPLORATION +hígado I-EXPLORATION +y I-EXPLORATION +riñón), I-EXPLORATION +porfirias, I-EXPLORATION +ceruloplasmina, I-EXPLORATION +alfa-fetoproteína, I-EXPLORATION +beta2-microglobulina, I-EXPLORATION +antígeno I-EXPLORATION +carcinoembrionario, I-EXPLORATION +virus I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -pésima I-EXPLORATION -colaboración I-EXPLORATION -del I-EXPLORATION -paciente, I-EXPLORATION -pero I-EXPLORATION -que I-EXPLORATION -al I-EXPLORATION -menos I-EXPLORATION -era I-EXPLORATION +hepatitis I-EXPLORATION +B I-EXPLORATION +(VHB), I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION -0, I-EXPLORATION -7. I-EXPLORATION -La I-EXPLORATION -motilidad I-EXPLORATION -ocular I-EXPLORATION -intrínseca I-EXPLORATION +la I-EXPLORATION +hepatitis I-EXPLORATION +C I-EXPLORATION +(VHC) I-EXPLORATION y I-EXPLORATION -extrínseca I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION -No I-EXPLORATION -refería I-EXPLORATION -diplopía I-EXPLORATION -en I-EXPLORATION -ninguna I-EXPLORATION -posición I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -mirada. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -objetivaba I-EXPLORATION -un I-EXPLORATION -hematoma I-EXPLORATION -palpebral I-EXPLORATION -superior I-EXPLORATION -con I-EXPLORATION +inmunodeficiencia I-EXPLORATION +humana I-EXPLORATION +(VIH) I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +inmunoglobulinas I-EXPLORATION +destacaba I-EXPLORATION una I-EXPLORATION -pequeña I-EXPLORATION -herida I-EXPLORATION -inciso-contusa, I-EXPLORATION -superficial, I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -precisó I-EXPLORATION -ser I-EXPLORATION -suturada. I-EXPLORATION +IgG I-EXPLORATION +1.900 I-EXPLORATION +mg/dl I-EXPLORATION +(690-1400), I-EXPLORATION +en I-EXPLORATION +relación I-EXPLORATION +con I-EXPLORATION +gammapatía I-EXPLORATION +monoclonal I-EXPLORATION +sin I-EXPLORATION +datos I-EXPLORATION +de I-EXPLORATION +mieloma I-EXPLORATION +tras I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +médula I-EXPLORATION +ósea. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +diátesis I-EXPLORATION +protrombótica I-EXPLORATION +también I-EXPLORATION +resultó I-EXPLORATION +negativo. I-EXPLORATION I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +ecográfico I-EXPLORATION +no I-EXPLORATION +aportó I-EXPLORATION +datos I-EXPLORATION +relevantes. I-EXPLORATION La I-EXPLORATION -biomicroscopía, I-EXPLORATION -tensión I-EXPLORATION -ocular I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION +abdominal I-EXPLORATION +insinuó I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +subdiafragmática, I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +segmentos I-EXPLORATION +VIII I-EXPLORATION y I-EXPLORATION -fondo I-EXPLORATION +IV, I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -dejó I-EXPLORATION -al I-EXPLORATION -paciente I-EXPLORATION -en I-EXPLORATION -observación, I-EXPLORATION -presentando I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -horas I-EXPLORATION -siguientes I-EXPLORATION -un I-EXPLORATION -deterioro I-EXPLORATION -neurológico I-EXPLORATION -progresivo, I-EXPLORATION -consistente I-EXPLORATION +contorno I-EXPLORATION +mal I-EXPLORATION +definido, I-EXPLORATION +hipodensa, I-EXPLORATION +a I-EXPLORATION +ambos I-EXPLORATION +lados I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +suprahepática I-EXPLORATION +media. I-EXPLORATION +La I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RM) I-EXPLORATION +hepática I-EXPLORATION +objetivó I-EXPLORATION +dos I-EXPLORATION +lesiones I-EXPLORATION +hepáticas I-EXPLORATION +de I-EXPLORATION +3 I-EXPLORATION +× I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION +y I-EXPLORATION +3 I-EXPLORATION +× I-EXPLORATION +2 I-EXPLORATION +cm, I-EXPLORATION en I-EXPLORATION -desorientación I-EXPLORATION -temporoespacial, I-EXPLORATION -respuestas I-EXPLORATION -incoherentes, I-EXPLORATION -somnolencia I-EXPLORATION -progresiva I-EXPLORATION +los I-EXPLORATION +segmentos I-EXPLORATION +IV-VIII I-EXPLORATION y I-EXPLORATION -vómitos I-EXPLORATION -de I-EXPLORATION -repetición, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION +II-III I-EXPLORATION +respectivamente, I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION +encajaban I-EXPLORATION la I-EXPLORATION -Escala I-EXPLORATION -del I-EXPLORATION -Coma I-EXPLORATION +vena I-EXPLORATION +suprahepática I-EXPLORATION +media I-EXPLORATION +y I-EXPLORATION +desplazaban I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +suprahepática I-EXPLORATION +derecha, I-EXPLORATION +sin I-EXPLORATION +apreciarse I-EXPLORATION +trombosis I-EXPLORATION +intravascular, I-EXPLORATION +ni I-EXPLORATION +otras I-EXPLORATION +lesiones I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -Glasgow I-EXPLORATION -(GCS), I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +extrahepática, I-EXPLORATION +junto I-EXPLORATION +con I-EXPLORATION +esplenomegalia I-EXPLORATION +e I-EXPLORATION +hipoplasia I-EXPLORATION +del I-EXPLORATION +lóbulo I-EXPLORATION +hepático I-EXPLORATION +izquierdo. I-EXPLORATION + I-EXPLORATION +Ante I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION de I-EXPLORATION -12, I-EXPLORATION -una I-EXPLORATION -TC I-EXPLORATION -orbitaria, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION un I-EXPLORATION -aumento I-EXPLORATION +colangiocarcinoma I-EXPLORATION +y I-EXPLORATION +menos I-EXPLORATION +probablemente I-EXPLORATION de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -periorbitario I-EXPLORATION -izquierdo I-EXPLORATION -correspondiente I-EXPLORATION -a I-EXPLORATION un I-EXPLORATION -hematoma I-EXPLORATION -y I-EXPLORATION +hepatocarcinoma I-EXPLORATION +sobre I-EXPLORATION un I-EXPLORATION -fragmento I-EXPLORATION -óseo I-EXPLORATION +hígado I-EXPLORATION +no I-EXPLORATION +cirrótico, I-EXPLORATION +se I-EXPLORATION +desestimó I-EXPLORATION +la I-EXPLORATION +PAAF I-EXPLORATION +(punción-aspiración I-EXPLORATION con I-EXPLORATION -fractura I-EXPLORATION -asociado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -margen I-EXPLORATION -superoposterior I-EXPLORATION +aguja I-EXPLORATION +fina) I-EXPLORATION y I-EXPLORATION -lateral I-EXPLORATION -de I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION la I-EXPLORATION -órbita I-EXPLORATION -izquierda, I-EXPLORATION -y I-EXPLORATION +realización I-EXPLORATION +de I-EXPLORATION una I-EXPLORATION -TC I-EXPLORATION -cerebral, I-EXPLORATION -que I-EXPLORATION -mostraba I-EXPLORATION +laparotomía I-EXPLORATION +diagnóstico-terapéutica, I-EXPLORATION +observándose I-EXPLORATION un I-EXPLORATION -hematoma I-EXPLORATION -agudo I-EXPLORATION -intraparenquimatoso I-EXPLORATION -frontal I-EXPLORATION -izquierdo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -abría I-EXPLORATION -al I-EXPLORATION -asta I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -lateral I-EXPLORATION -adyacente I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -sistema I-EXPLORATION -ventricular I-EXPLORATION +hígado I-EXPLORATION +de I-EXPLORATION +superficie I-EXPLORATION +lisa I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -hemorragia I-EXPLORATION -subaracnoidea I-EXPLORATION +brillante, I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -cisura I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION de I-EXPLORATION -Silvio I-EXPLORATION -izquierda, I-EXPLORATION -surcos I-EXPLORATION +aspecto I-EXPLORATION +quístico, I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -convexidad I-EXPLORATION -izquierda, I-EXPLORATION -cisterna I-EXPLORATION -supraselar I-EXPLORATION -y I-EXPLORATION -perimesencefálicas. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -analítica, I-EXPLORATION que I-EXPLORATION -descartó I-EXPLORATION -cualquier I-EXPLORATION -tendencia I-EXPLORATION -hemorrágica I-EXPLORATION -del I-EXPLORATION -paciente I-EXPLORATION -(tiempo I-EXPLORATION -de I-EXPLORATION -sangrado, I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -protrombina, I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -tromboplastina I-EXPLORATION -parcial I-EXPLORATION -activada, I-EXPLORATION -fibrinógeno I-EXPLORATION -y I-EXPLORATION -plaquetas I-EXPLORATION -normales). I-EXPLORATION +se I-EXPLORATION +obtuvieron I-EXPLORATION +biopsias I-EXPLORATION +en I-EXPLORATION +cuña. I-EXPLORATION I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -posibilidad I-EXPLORATION +El I-EXPLORATION +informe I-EXPLORATION +histopatológico I-EXPLORATION +intraoperatorio I-EXPLORATION +fue I-EXPLORATION de I-EXPLORATION un I-EXPLORATION -vaso I-EXPLORATION -sangrante I-EXPLORATION -activo I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION +proceso I-EXPLORATION +fibro-inflamatorio I-EXPLORATION +con I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -posible I-EXPLORATION -daño I-EXPLORATION -arterial, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -arteriografía I-EXPLORATION -por I-EXPLORATION -sustracción I-EXPLORATION -digital I-EXPLORATION -(ASD) I-EXPLORATION -cerebral, I-EXPLORATION +agregados I-EXPLORATION +linfoides, I-EXPLORATION +hialinización I-EXPLORATION +vascular, I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -ingresado I-TREATMENT -en I-TREATMENT +ausencia I-EXPLORATION +de I-EXPLORATION +microorganismos I-EXPLORATION +y I-EXPLORATION +atipia, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +pseudotumor I-EXPLORATION +inflamatorio I-EXPLORATION +hepático. I-EXPLORATION +Dado B-TREATMENT +que I-TREATMENT la I-TREATMENT -Unidad I-TREATMENT +lesión I-TREATMENT +no I-TREATMENT +cumplía I-TREATMENT +criterios I-TREATMENT de I-TREATMENT -Cuidados I-TREATMENT -Intensivos. I-TREATMENT -Durante B-EVOLUTION -el I-EVOLUTION -ingreso I-EVOLUTION -se I-EVOLUTION -realizaron I-EVOLUTION -TC I-EVOLUTION -y I-EVOLUTION -ASD I-EVOLUTION +malignidad I-TREATMENT +y I-TREATMENT +dada I-TREATMENT +la I-TREATMENT +alta I-TREATMENT +morbimortalidad I-TREATMENT +asociada, I-TREATMENT +se I-TREATMENT +desestimó I-TREATMENT +su I-TREATMENT +resección I-TREATMENT +y I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +y I-TREATMENT +esteroideo, I-TREATMENT +sin I-TREATMENT +respuesta. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +enero I-EVOLUTION de I-EVOLUTION -control I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -1, I-EVOLUTION -2, I-EVOLUTION -3, I-EVOLUTION -7 I-EVOLUTION -y I-EVOLUTION -14, I-EVOLUTION -que I-EVOLUTION -descartaron I-EVOLUTION -nuevos I-EVOLUTION -resangrados I-EVOLUTION -ó I-EVOLUTION -lesiones I-EVOLUTION -vasculares. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION +2006 I-EVOLUTION +presentó I-EVOLUTION +un I-EVOLUTION +episodio I-EVOLUTION de I-EVOLUTION +hemorragia I-EVOLUTION +digestiva I-EVOLUTION alta I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -GCS I-EVOLUTION +autolimitada, I-EVOLUTION +seguido I-EVOLUTION de I-EVOLUTION -15. I-EVOLUTION -La B-EXPLORATION -TC I-EXPLORATION -al I-EXPLORATION -alta I-EXPLORATION -mostraba I-EXPLORATION -un I-EXPLORATION -hematoma I-EXPLORATION -frontal I-EXPLORATION -izquierdo I-EXPLORATION -en I-EXPLORATION -resolución I-EXPLORATION -con I-EXPLORATION -pequeño I-EXPLORATION -componente I-EXPLORATION -intraventricular I-EXPLORATION -lateral I-EXPLORATION -frontal I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -restos I-EXPLORATION -hemáticos I-EXPLORATION -isodensos I-EXPLORATION -en I-EXPLORATION +un I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +fiebre, I-EVOLUTION +astenia, I-EVOLUTION +hiporexia I-EVOLUTION +y I-EVOLUTION +alteración I-EVOLUTION +del I-EVOLUTION +comportamiento. I-EVOLUTION +En B-EXPLORATION la I-EXPLORATION -cisura I-EXPLORATION -de I-EXPLORATION -Silvio I-EXPLORATION -izquierda. I-EXPLORATION - I-EXPLORATION - -Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -refiriendo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -tenía I-PRESENT_ILLNESS -«el I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -hundido» I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -aportaba I-PRESENT_ILLNESS -fotografías I-PRESENT_ILLNESS -anteriores I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -problema I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -evidenciar I-PRESENT_ILLNESS -ese I-PRESENT_ILLNESS -cambio I-PRESENT_ILLNESS -facial I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -sufrido. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -No B-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La B-EXPLORATION exploración I-EXPLORATION -oftalmológica I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +subictericia I-EXPLORATION +cutáneo-mucosa, I-EXPLORATION +bradipsiquia, I-EXPLORATION +flapping I-EXPLORATION +tardío, I-EXPLORATION +hepatomegalia I-EXPLORATION +y I-EXPLORATION +ascitis. I-EXPLORATION +Analíticamente I-EXPLORATION +destacaba I-EXPLORATION +anemia I-EXPLORATION de I-EXPLORATION +procesos I-EXPLORATION +crónicos I-EXPLORATION +(hemoglobina I-EXPLORATION +9, I-EXPLORATION 1 I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -ojos I-EXPLORATION -sin I-EXPLORATION -corrección I-EXPLORATION -con I-EXPLORATION -motilidad I-EXPLORATION -ocular I-EXPLORATION -intrínseca I-EXPLORATION +g/dl, I-EXPLORATION +hematocrito I-EXPLORATION +26, I-EXPLORATION +3%, I-EXPLORATION +VCM I-EXPLORATION +95), I-EXPLORATION +ligera I-EXPLORATION +trombopenia I-EXPLORATION +(116.000), I-EXPLORATION +bilirrubina I-EXPLORATION +total I-EXPLORATION +4, I-EXPLORATION +3 I-EXPLORATION +mg/dl I-EXPLORATION +(bilirrubina I-EXPLORATION +conjugada: I-EXPLORATION +3, I-EXPLORATION +8 I-EXPLORATION +mg/dl) I-EXPLORATION +GOT I-EXPLORATION +56 I-EXPLORATION +UI/l, I-EXPLORATION +GPT I-EXPLORATION +106 I-EXPLORATION +UI/l, I-EXPLORATION +GGT I-EXPLORATION +335 I-EXPLORATION +UI/l, I-EXPLORATION +FA I-EXPLORATION +700 I-EXPLORATION +UI/l. I-EXPLORATION +Gamma I-EXPLORATION +30, I-EXPLORATION +7% I-EXPLORATION +(10,5-19,5), I-EXPLORATION +leucocitos I-EXPLORATION +7.700 I-EXPLORATION y I-EXPLORATION -extrínseca I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -exoftalmometría I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -12, I-EXPLORATION +800 I-EXPLORATION +linfocitos. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +del I-EXPLORATION +líquido I-EXPLORATION +ascítico I-EXPLORATION +reveló I-EXPLORATION +900 I-EXPLORATION +células I-EXPLORATION +(> I-EXPLORATION +250 I-EXPLORATION +polimorfonucleares/mm3), I-EXPLORATION +albúmina I-EXPLORATION +0, I-EXPLORATION 5 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION +g/dl, I-EXPLORATION +proteínas I-EXPLORATION +totales I-EXPLORATION +0, I-EXPLORATION +6 I-EXPLORATION +g/dl, I-EXPLORATION +GASA I-EXPLORATION +> I-EXPLORATION +1, I-EXPLORATION +1. I-EXPLORATION y I-EXPLORATION -de I-EXPLORATION -16 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -ojo I-EXPLORATION -izquierdo. I-EXPLORATION -Se I-EXPLORATION -apreciaba I-EXPLORATION -un I-EXPLORATION -desplazamiento I-EXPLORATION -inferior I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -mm I-EXPLORATION -del I-EXPLORATION -globo I-EXPLORATION -ocular I-EXPLORATION -derecho. I-EXPLORATION -Había I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -surco I-EXPLORATION -palpebral I-EXPLORATION -superior, I-EXPLORATION -con I-EXPLORATION -retracción I-EXPLORATION -palpebral I-EXPLORATION -superior I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -mirada I-EXPLORATION -inferior. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION +cultivo I-EXPLORATION +negativo. I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +peritonitis I-TREATMENT +bacteriana I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +(cefalosporina I-TREATMENT +de I-TREATMENT +tercera I-TREATMENT +generación) I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +respuesta I-TREATMENT +clínico-analítica. I-TREATMENT +En I-TREATMENT +la I-TREATMENT +gastroscopia I-TREATMENT +se I-TREATMENT +observaron I-TREATMENT +varices I-TREATMENT +esofágicas I-TREATMENT +grado I-TREATMENT +II/III, I-TREATMENT +iniciándose I-TREATMENT +tratamiento I-TREATMENT +beta-bloqueante. I-TREATMENT +Se B-EXPLORATION realizó I-EXPLORATION una I-EXPLORATION -TAC I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION +nueva I-EXPLORATION +RM, I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION +describía I-EXPLORATION un I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -derecho I-EXPLORATION -colapsado, I-EXPLORATION +hígado I-EXPLORATION con I-EXPLORATION -un I-EXPLORATION -descenso I-EXPLORATION -de I-EXPLORATION -volumen, I-EXPLORATION -una I-EXPLORATION -retracción I-EXPLORATION -interna I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -paredes I-EXPLORATION +hepatopatía I-EXPLORATION +crónica I-EXPLORATION y I-EXPLORATION -un I-EXPLORATION -adelgazamiento I-EXPLORATION +cómo I-EXPLORATION +el I-EXPLORATION +PTI I-EXPLORATION +comprimía I-EXPLORATION y I-EXPLORATION -desplazamiento I-EXPLORATION -inferior I-EXPLORATION -del I-EXPLORATION -suelo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -órbita. I-EXPLORATION -El I-EXPLORATION -proceso I-EXPLORATION -uncinado I-EXPLORATION -estaba I-EXPLORATION -retraído I-EXPLORATION -hacia I-EXPLORATION +colapsaba I-EXPLORATION la I-EXPLORATION -pared I-EXPLORATION -orbitaria, I-EXPLORATION -obstruyendo I-EXPLORATION -el I-EXPLORATION -infundíbulo I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -maxilar. I-EXPLORATION - I-EXPLORATION +vena I-EXPLORATION +cava I-EXPLORATION +inferior I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +trayecto I-EXPLORATION +intrahepático. I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +síndrome I-TREATMENT +de I-TREATMENT +Budd-Chiari I-TREATMENT +subagudo I-TREATMENT +secundario I-TREATMENT +al I-TREATMENT +PTI I-TREATMENT +hepático, I-TREATMENT +se I-TREATMENT +colocó I-TREATMENT +un I-TREATMENT +TIPS I-TREATMENT +(anastomosis I-TREATMENT +porto-sistémica I-TREATMENT +transyugular I-TREATMENT +tipo I-TREATMENT +Wallstent I-TREATMENT +autoexpandible I-TREATMENT +de I-TREATMENT +10 I-TREATMENT +mm I-TREATMENT +de I-TREATMENT +calibre) I-TREATMENT +con I-TREATMENT +buenos I-TREATMENT +resultados I-TREATMENT +durante I-TREATMENT +los I-TREATMENT +cinco I-TREATMENT +años I-TREATMENT +de I-TREATMENT +seguimiento. I-TREATMENT + I-TREATMENT -Varón B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS +76 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -diagnosticado B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Sturge-Weber I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -glaucoma I-PRESENT_ILLNESS -agudo I-PRESENT_ILLNESS -secundario I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -luxación I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -cristalino I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -cámara I-PRESENT_ILLNESS -anterior I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -bloqueo I-PRESENT_ILLNESS -pupilar, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -intervenido I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +ingresada I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -urgencia. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -evidenciaba I-EXPLORATION +Cirugía I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +anemia, I-PRESENT_ILLNESS +ascitis, I-PRESENT_ILLNESS +debilidad I-PRESENT_ILLNESS +generalizada, I-PRESENT_ILLNESS +neurológicamente I-PRESENT_ILLNESS +estuporosa I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +masa I-PRESENT_ILLNESS +rectal I-PRESENT_ILLNESS +prolapsada I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +irreductible. I-PRESENT_ILLNESS +La B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +ha I-PAST_MEDICAL_HISTORY +venido I-PAST_MEDICAL_HISTORY +presentado I-PAST_MEDICAL_HISTORY +diarrea I-PAST_MEDICAL_HISTORY +mucosa, I-PAST_MEDICAL_HISTORY +sangrado I-PAST_MEDICAL_HISTORY +rectal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +prolapso I-PAST_MEDICAL_HISTORY +rectal I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +El B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +evidenció I-EXPLORATION una I-EXPLORATION -mancha I-EXPLORATION -en I-EXPLORATION -«vino I-EXPLORATION -de I-EXPLORATION -Oporto» I-EXPLORATION -hemifacial I-EXPLORATION -izquierda, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -territorio I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -y I-EXPLORATION -segunda I-EXPLORATION -ramas I-EXPLORATION -trigeminales, I-EXPLORATION -exoftalmos I-EXPLORATION -severo I-EXPLORATION -con I-EXPLORATION -rechazo I-EXPLORATION -ínfero-temporal I-EXPLORATION -del I-EXPLORATION -globo I-EXPLORATION -ocular I-EXPLORATION +masa I-EXPLORATION +rectal I-EXPLORATION +prolapsada I-EXPLORATION e I-EXPLORATION -ingurgitación I-EXPLORATION -marcada I-EXPLORATION +incarcerada I-EXPLORATION de I-EXPLORATION -vasos I-EXPLORATION -epiesclerales I-EXPLORATION -inferiores I-EXPLORATION -«en I-EXPLORATION -cabeza I-EXPLORATION +10 I-EXPLORATION +centímetros I-EXPLORATION de I-EXPLORATION -Medusa». I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -con I-EXPLORATION -lámpara I-EXPLORATION +longitud I-EXPLORATION +que I-EXPLORATION +secretaba I-EXPLORATION +abundante I-EXPLORATION +cantidad I-EXPLORATION de I-EXPLORATION -hendidura I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -una I-EXPLORATION -catarata I-EXPLORATION -madura I-EXPLORATION -totalmente I-EXPLORATION -luxada I-EXPLORATION -a I-EXPLORATION +moco. I-EXPLORATION +Analíticamente I-EXPLORATION la I-EXPLORATION -cámara I-EXPLORATION -anterior I-EXPLORATION -en I-EXPLORATION -contacto I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -endotelio I-EXPLORATION -corneal I-EXPLORATION +paciente I-EXPLORATION +estaba I-EXPLORATION +anémica I-EXPLORATION con I-EXPLORATION -bloqueo I-EXPLORATION -pupilar I-EXPLORATION +hemoglobina I-EXPLORATION +6 I-EXPLORATION +g/dl, I-EXPLORATION +hematocrito I-EXPLORATION +18 I-EXPLORATION +%, I-EXPLORATION y I-EXPLORATION -presión I-EXPLORATION -intraocular I-EXPLORATION -de I-EXPLORATION -60 I-EXPLORATION -mm I-EXPLORATION -Hg, I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -mostraba I-EXPLORATION -un I-EXPLORATION -desprendimiento I-EXPLORATION -de I-EXPLORATION -retina I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -polo I-EXPLORATION -posterior I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -subyacente I-EXPLORATION -hiperecogénica. I-EXPLORATION - I-EXPLORATION -Tras B-TREATMENT -un I-TREATMENT -infructuoso I-TREATMENT -tratamiento I-TREATMENT -médico I-TREATMENT -hipotensor, I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -la I-TREATMENT -intervención, I-TREATMENT -realizándose I-TREATMENT -extracción I-TREATMENT -intracapsular I-TREATMENT -de I-TREATMENT -cristalino. I-TREATMENT -El B-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -coroidea I-EXPLORATION -peripapilar I-EXPLORATION -nasal I-EXPLORATION -superior I-EXPLORATION -con I-EXPLORATION -desprendimiento I-EXPLORATION +datos I-EXPLORATION de I-EXPLORATION -retina I-EXPLORATION -exudativo I-EXPLORATION -asociado. I-EXPLORATION - I-EXPLORATION +insuficiencia I-EXPLORATION +renal I-EXPLORATION +aguda I-EXPLORATION +(urea I-EXPLORATION +158 I-EXPLORATION +mg/dl, I-EXPLORATION +creatinina I-EXPLORATION +1, I-EXPLORATION +94 I-EXPLORATION +mg/dl), I-EXPLORATION +hiponatrémica I-EXPLORATION +e I-EXPLORATION +hipopotasémica I-EXPLORATION +(sodio, I-EXPLORATION +126 I-EXPLORATION +mEq/ I-EXPLORATION +l; I-EXPLORATION +potasio, I-EXPLORATION +2, I-EXPLORATION +6 I-EXPLORATION +mEq/l). I-EXPLORATION Se I-EXPLORATION -realizó I-EXPLORATION +realiza I-EXPLORATION una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION -(RMN) I-EXPLORATION +tomografía I-EXPLORATION +computerizada I-EXPLORATION +(TC) I-EXPLORATION +abdominal I-EXPLORATION +urgente I-EXPLORATION que I-EXPLORATION -mostró I-EXPLORATION -lesiones I-EXPLORATION -hiperintensas I-EXPLORATION -en I-EXPLORATION -T1 I-EXPLORATION -y I-EXPLORATION -T2 I-EXPLORATION -en I-EXPLORATION -leptomeninges I-EXPLORATION -de I-EXPLORATION -región I-EXPLORATION -frontoparietal I-EXPLORATION -izquierda I-EXPLORATION -con I-EXPLORATION -calcificaciones I-EXPLORATION -y I-EXPLORATION -atrofia I-EXPLORATION -del I-EXPLORATION -lóbulo I-EXPLORATION -frontal. I-EXPLORATION -Una I-EXPLORATION -lesión I-EXPLORATION -coroidea I-EXPLORATION -y I-EXPLORATION -dos I-EXPLORATION -lesiones I-EXPLORATION -orbitarias I-EXPLORATION -extraconales I-EXPLORATION -en I-EXPLORATION -cuadrante I-EXPLORATION -nasal I-EXPLORATION -superior I-EXPLORATION -y I-EXPLORATION -temporal I-EXPLORATION -superior, I-EXPLORATION -bien I-EXPLORATION -delimitadas, I-EXPLORATION -asociadas I-EXPLORATION -a I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -vena I-EXPLORATION -oftálmica I-EXPLORATION -superior. I-EXPLORATION -Todas I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -eran I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -hemangiomas I-EXPLORATION -cavernosos. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -presión I-EXPLORATION -intraocular I-EXPLORATION -tras I-EXPLORATION +informa I-EXPLORATION la I-EXPLORATION -cirugía I-EXPLORATION -se I-EXPLORATION -mantuvo I-EXPLORATION -entre I-EXPLORATION -10 I-EXPLORATION -y I-EXPLORATION -16 I-EXPLORATION -mm I-EXPLORATION -Hg I-EXPLORATION -sin I-EXPLORATION -necesidad I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -tratamiento I-EXPLORATION -antihipertensivo I-EXPLORATION +una I-EXPLORATION +gran I-EXPLORATION +masa I-EXPLORATION +rectal I-EXPLORATION +prolapsada, I-EXPLORATION +ascitis I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -final I-EXPLORATION -fue I-EXPLORATION -menor I-EXPLORATION -de I-EXPLORATION -20/200 I-EXPLORATION -(visión I-EXPLORATION +metástasis I-EXPLORATION +hepáticas I-EXPLORATION +múltiples I-EXPLORATION +algunas I-EXPLORATION de I-EXPLORATION -bultos). I-EXPLORATION -En B-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION +ellas I-EXPLORATION +necrosadas. I-EXPLORATION +Debido B-TREATMENT +al I-TREATMENT +intenso I-TREATMENT +dolor I-TREATMENT +que I-TREATMENT +le I-TREATMENT +causaba I-TREATMENT +la I-TREATMENT +tumoración I-TREATMENT +prolapsada I-TREATMENT +y I-TREATMENT +a I-TREATMENT +la I-TREATMENT +profusa I-TREATMENT +mucorrea I-TREATMENT +y I-TREATMENT +rectorragia, I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +intervenida I-TREATMENT +quirúrgicamente, I-TREATMENT +una I-TREATMENT +vez I-TREATMENT +corregida I-TREATMENT +la I-TREATMENT +insuficiencia I-TREATMENT +renal, I-TREATMENT +realizándose I-TREATMENT +una I-TREATMENT +resección I-TREATMENT +transanal I-TREATMENT +con I-TREATMENT +carácter I-TREATMENT +paliativo. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +falleció I-EVOLUTION +a I-EVOLUTION las I-EVOLUTION -lesiones I-EVOLUTION -coroideas I-EVOLUTION -y I-EVOLUTION -orbitarias I-EVOLUTION -siguen I-EVOLUTION -estables, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -precisan I-EVOLUTION -tratamiento. I-EVOLUTION +24 I-EVOLUTION +horas I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +intervención I-EVOLUTION +debido I-EVOLUTION +a I-EVOLUTION +complicaciones I-EVOLUTION +cardiorrespiratorias. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -38 I-PRESENT_ILLNESS +76 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -periorbitario I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS +Cardiología I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +infarto I-PRESENT_ILLNESS +agudo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -diplopía I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -últimas I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -motora I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -paresia I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -músculos I-EXPLORATION -recto I-EXPLORATION -superior I-EXPLORATION -e I-EXPLORATION -interno I-EXPLORATION -y I-EXPLORATION -ptosis I-EXPLORATION -moderada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ojo I-EXPLORATION -izquierdo. I-EXPLORATION -No I-EXPLORATION -hubo I-EXPLORATION -otros I-EXPLORATION -hallazgos I-EXPLORATION -oculares I-EXPLORATION -o I-EXPLORATION -neurológicos. I-EXPLORATION -La I-EXPLORATION -resonancia I-EXPLORATION -nuclear I-EXPLORATION -magnética I-EXPLORATION -(RNM) I-EXPLORATION -craneal I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION +miocardio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +localización I-PRESENT_ILLNESS +anterior I-PRESENT_ILLNESS +complicado I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +insuficiencia I-PRESENT_ILLNESS +cardiaca. I-PRESENT_ILLNESS Se B-TREATMENT -diagnosticó I-TREATMENT +decide I-TREATMENT +la I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT un I-TREATMENT -síndrome I-TREATMENT +catéter I-TREATMENT +venoso I-TREATMENT +central I-TREATMENT +accediendo I-TREATMENT +a I-TREATMENT +través I-TREATMENT de I-TREATMENT -Tolosa-Hunt I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -corticoides. I-TREATMENT -Dos B-EVOLUTION -días I-EVOLUTION -después, I-EVOLUTION -la I-EVOLUTION -oftalmoplejía I-EVOLUTION -dolorosa I-EVOLUTION -persistía I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -comenzó I-EVOLUTION -a I-EVOLUTION -referir I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -agudeza I-EVOLUTION -visual I-EVOLUTION -próxima. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION +la I-TREATMENT +vena I-TREATMENT +subclavia I-TREATMENT +derecha. I-TREATMENT + I-TREATMENT +La B-EXPLORATION +radiografía I-EXPLORATION +simple I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -midriasis I-EXPLORATION -izquierda. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -RNM I-EXPLORATION -orbitaria I-EXPLORATION +tórax I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +muestra I-EXPLORATION +un I-EXPLORATION +trayecto I-EXPLORATION +anómalo I-EXPLORATION +del I-EXPLORATION +catéter I-EXPLORATION que I-EXPLORATION -mostró I-EXPLORATION -en I-EXPLORATION -T2 I-EXPLORATION +desciende I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +lado I-EXPLORATION +derecho I-EXPLORATION +del I-EXPLORATION +mediastino I-EXPLORATION +para I-EXPLORATION +desviarse I-EXPLORATION +posteriormente I-EXPLORATION +siguiendo I-EXPLORATION un I-EXPLORATION -aneurisma I-EXPLORATION +perfil I-EXPLORATION +cardiaco I-EXPLORATION +izquierdo. I-EXPLORATION + I-EXPLORATION +Con I-EXPLORATION +el I-EXPLORATION +objetivo I-EXPLORATION de I-EXPLORATION +descartar I-EXPLORATION la I-EXPLORATION +canulación I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +vaso I-EXPLORATION +arterial I-EXPLORATION +(subclavia I-EXPLORATION +o I-EXPLORATION carótida I-EXPLORATION -interna-comunicante I-EXPLORATION -posterior I-EXPLORATION -(CI-CP) I-EXPLORATION -parcialmente I-EXPLORATION -trombosado. I-EXPLORATION -La I-EXPLORATION -angio-tomografía I-EXPLORATION -axial I-EXPLORATION -computerizada I-EXPLORATION -(angio-TAC) I-EXPLORATION -mostró I-EXPLORATION +común I-EXPLORATION +derechas), I-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +una I-EXPLORATION +gasometría I-EXPLORATION +(pH: I-EXPLORATION +7, I-EXPLORATION +35, I-EXPLORATION +pO2: I-EXPLORATION +40, I-EXPLORATION +pCO2: I-EXPLORATION +48) I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +registra I-EXPLORATION +la I-EXPLORATION +curva I-EXPLORATION +de I-EXPLORATION +presión I-EXPLORATION +intraluminal I-EXPLORATION +(15 I-EXPLORATION +mmHg). I-EXPLORATION +Ambas I-EXPLORATION +demuestran I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION un I-EXPLORATION -aneurisma I-EXPLORATION -CI-CP I-EXPLORATION -izquierdo I-EXPLORATION -multilobulado I-EXPLORATION +flujo I-EXPLORATION +venoso I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION de I-EXPLORATION -10x5 I-EXPLORATION -mm. I-EXPLORATION -Se B-TREATMENT -realizaron I-TREATMENT -angiografía I-TREATMENT -cerebral I-TREATMENT -y I-TREATMENT -embolización, I-TREATMENT -siendo I-TREATMENT -rellenado I-TREATMENT -completamente I-TREATMENT -el I-TREATMENT -aneurisma I-TREATMENT -con I-TREATMENT -Hydrocoil I-TREATMENT -(MicroVention, I-TREATMENT -Aliso I-TREATMENT -Viejo, I-TREATMENT -CA) I-TREATMENT -Cerecyte® I-TREATMENT -(Micrus, I-TREATMENT -Sunnyvale, I-TREATMENT -CA). I-TREATMENT -El B-EVOLUTION -tamaño I-EVOLUTION -pupilar I-EVOLUTION -se I-EVOLUTION -normalizó I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -ptosis I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -adducción I-EVOLUTION -mejoraron I-EVOLUTION -completamente I-EVOLUTION -dos I-EVOLUTION -semanas I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -embolización. I-EVOLUTION -Ocho I-EVOLUTION -meses I-EVOLUTION -tras I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -persistía I-EVOLUTION -un I-EVOLUTION -ligero I-EVOLUTION -déficit I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -elevación, I-EVOLUTION -sin I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -refiriese I-EVOLUTION -diplopía. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -80 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -conocida I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -servicio, I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -traumático I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -(OI). I-PRESENT_ILLNESS -Entre B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -destacamos I-PAST_MEDICAL_HISTORY -conjuntivitis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -repetición I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia, I-PAST_MEDICAL_HISTORY -artrosis I-PAST_MEDICAL_HISTORY -senil I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -hijos I-PAST_MEDICAL_HISTORY -sanos. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -observamos I-EXPLORATION -una I-EXPLORATION -abrasión I-EXPLORATION -corneal I-EXPLORATION -en I-EXPLORATION -OI, I-EXPLORATION -que B-TREATMENT -curará I-TREATMENT -con I-TREATMENT -oclusión I-TREATMENT -y I-TREATMENT -pomada I-TREATMENT -epitelizante I-TREATMENT +vía. I-EXPLORATION + I-EXPLORATION +A B-TREATMENT +continuación, I-TREATMENT +se I-TREATMENT +implanta I-TREATMENT +un I-TREATMENT +catéter I-TREATMENT +de I-TREATMENT +Swan-Ganz I-TREATMENT en I-TREATMENT -1 I-TREATMENT -semana. I-TREATMENT -Además B-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -ojos I-EXPLORATION -(AO) I-EXPLORATION +la I-TREATMENT +rama I-TREATMENT +principal I-TREATMENT +derecha I-TREATMENT +de I-TREATMENT +la I-TREATMENT +arteria I-TREATMENT +pulmonar, I-TREATMENT +también I-TREATMENT +a I-TREATMENT +través I-TREATMENT +de I-TREATMENT +la I-TREATMENT +vena I-TREATMENT +subclavia I-TREATMENT +derecha. I-TREATMENT +Se B-EXPLORATION +realiza I-EXPLORATION un I-EXPLORATION -iris I-EXPLORATION -atrófico, I-EXPLORATION -desdoblado, I-EXPLORATION -desflecado I-EXPLORATION -con I-EXPLORATION -atrofia I-EXPLORATION -en I-EXPLORATION -sector I-EXPLORATION -inferior, I-EXPLORATION -más I-EXPLORATION -en I-EXPLORATION -OI I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -reducción I-EXPLORATION +ecocardiograma I-EXPLORATION +que I-EXPLORATION +muestra I-EXPLORATION +dilatación I-EXPLORATION +del I-EXPLORATION +seno I-EXPLORATION +coronario I-EXPLORATION +(diámetro I-EXPLORATION de I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +cm). I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +interior I-EXPLORATION +del I-EXPLORATION +seno I-EXPLORATION +coronario I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +el I-EXPLORATION +catéter I-EXPLORATION +abocando I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -cámara I-EXPLORATION -anterior I-EXPLORATION -visible I-EXPLORATION -también I-EXPLORATION -en I-EXPLORATION +aurícula I-EXPLORATION +derecha, I-EXPLORATION +al I-EXPLORATION +ventrículo I-EXPLORATION +derecho I-EXPLORATION +y, I-EXPLORATION +finalmente, I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -gonioscopia. I-EXPLORATION -Presenta I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -tensión I-EXPLORATION -ocular I-EXPLORATION -de I-EXPLORATION -24 I-EXPLORATION -mm I-EXPLORATION -Hg. I-EXPLORATION -en I-EXPLORATION -AO, I-EXPLORATION +arteria I-EXPLORATION +pulmonar. I-EXPLORATION +Ninguna I-EXPLORATION +otra I-EXPLORATION +vena I-EXPLORATION +conecta I-EXPLORATION con I-EXPLORATION -un I-EXPLORATION -campo I-EXPLORATION -visual I-EXPLORATION -(Humphrey I-EXPLORATION -30-2) I-EXPLORATION +la I-EXPLORATION +aurícula I-EXPLORATION +derecha. I-EXPLORATION + I-EXPLORATION +Todos I-EXPLORATION +estos I-EXPLORATION +datos I-EXPLORATION +son I-EXPLORATION +compatibles I-EXPLORATION con I-EXPLORATION una I-EXPLORATION -reducción I-EXPLORATION -general I-EXPLORATION +malformación I-EXPLORATION +venosa I-EXPLORATION +que I-EXPLORATION +consiste I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +persistencia I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -sensibilidad. I-EXPLORATION -Explorando I-EXPLORATION +VCSI I-EXPLORATION +con I-EXPLORATION +desembocadura I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -fondo I-EXPLORATION +seno I-EXPLORATION +coronario, I-EXPLORATION +asociada I-EXPLORATION +a I-EXPLORATION +permeabilidad I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION -encontramos I-EXPLORATION -lesiones I-EXPLORATION -hiperpigmentadas I-EXPLORATION -y I-EXPLORATION -atróficas I-EXPLORATION -(en I-EXPLORATION -«sal I-EXPLORATION -y I-EXPLORATION -pimienta»). I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION +la I-EXPLORATION +anastomosis I-EXPLORATION +entre I-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -presunción I-EXPLORATION -de I-EXPLORATION -sífilis I-EXPLORATION -congénita, I-EXPLORATION -aún I-EXPLORATION -sin I-EXPLORATION -leucomas I-EXPLORATION -propios I-EXPLORATION -de I-EXPLORATION -queratitis I-EXPLORATION -intersticial I-EXPLORATION -antigua, I-EXPLORATION -solicitamos I-EXPLORATION -pruebas I-EXPLORATION -serológicas I-EXPLORATION -para I-EXPLORATION -lues I-EXPLORATION -obteniendo I-EXPLORATION -resultados I-EXPLORATION -positivos I-EXPLORATION -en I-EXPLORATION -test I-EXPLORATION -treponémicos I-EXPLORATION -(TPHA, I-EXPLORATION -FTA I-EXPLORATION -abs) I-EXPLORATION +sistema I-EXPLORATION +venoso I-EXPLORATION +derecho I-EXPLORATION y I-EXPLORATION -negativos I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -no I-EXPLORATION -treponémicos I-EXPLORATION -(RPR). I-EXPLORATION +el I-EXPLORATION +izquierdo. I-EXPLORATION I-EXPLORATION -En B-PAST_MEDICAL_HISTORY -este I-PAST_MEDICAL_HISTORY -punto I-PAST_MEDICAL_HISTORY + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +21 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que B-PAST_MEDICAL_HISTORY +presenta I-PAST_MEDICAL_HISTORY +elefantiasis I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -evaluada I-PAST_MEDICAL_HISTORY +extremidad I-PAST_MEDICAL_HISTORY +inferior I-PAST_MEDICAL_HISTORY +izquierda I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +linfedema I-PAST_MEDICAL_HISTORY +congénito I-PAST_MEDICAL_HISTORY +primario I-PAST_MEDICAL_HISTORY por I-PAST_MEDICAL_HISTORY -medicina I-PAST_MEDICAL_HISTORY -interna I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -averiguamos I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -desconoce I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -causa I-PAST_MEDICAL_HISTORY -real I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -conjuntivitis, I-PAST_MEDICAL_HISTORY -aunque I-PAST_MEDICAL_HISTORY -relata, I-PAST_MEDICAL_HISTORY +agenesia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -detallada: I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -tratamientos I-PAST_MEDICAL_HISTORY -recibidos I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -9 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY +vasos I-PAST_MEDICAL_HISTORY +linfáticos I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -plena I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -preantibiótica, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -neobismuto I-PAST_MEDICAL_HISTORY -oral, I-PAST_MEDICAL_HISTORY -que B-FAMILY_HISTORY -su I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -«soltera» I-FAMILY_HISTORY -muere I-FAMILY_HISTORY -joven I-FAMILY_HISTORY -«deformada» I-FAMILY_HISTORY -y B-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY +hemicuerpo I-PAST_MEDICAL_HISTORY +izquierdo. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +diagnostica I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -60, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -problemas I-PAST_MEDICAL_HISTORY -inespecíficos I-PAST_MEDICAL_HISTORY -articulares, I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -pautaron I-PAST_MEDICAL_HISTORY -unas I-PAST_MEDICAL_HISTORY -inyecciones I-PAST_MEDICAL_HISTORY -semanales I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -mensuales I-PAST_MEDICAL_HISTORY -(penicilina I-PAST_MEDICAL_HISTORY -probablemente). I-PAST_MEDICAL_HISTORY -Hallazgos I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +primera I-PAST_MEDICAL_HISTORY +infancia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +raíz I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -anamnesis I-PAST_MEDICAL_HISTORY -compatible I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -sífilis I-PAST_MEDICAL_HISTORY -congénita I-PAST_MEDICAL_HISTORY -tardía, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -queratitis I-PAST_MEDICAL_HISTORY -intersticial I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -éxito, I-PAST_MEDICAL_HISTORY -pues I-PAST_MEDICAL_HISTORY -carece I-PAST_MEDICAL_HISTORY +observación I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +aumento I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +perímetro I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -leucomas. I-PAST_MEDICAL_HISTORY -Adquirida I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -infección I-PAST_MEDICAL_HISTORY -trasplacentaria: I-PAST_MEDICAL_HISTORY -madre B-FAMILY_HISTORY -con I-FAMILY_HISTORY -artropatía I-FAMILY_HISTORY -severa I-FAMILY_HISTORY -compatible I-FAMILY_HISTORY -con I-FAMILY_HISTORY -sífilis I-FAMILY_HISTORY -secundaria. I-FAMILY_HISTORY -Y B-PAST_MEDICAL_HISTORY -curada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -resultado I-PAST_MEDICAL_HISTORY -negativo I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +extremidad I-PAST_MEDICAL_HISTORY +respecto I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +contralateral, I-PAST_MEDICAL_HISTORY +iniciándose I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -test I-PAST_MEDICAL_HISTORY -RPR. I-PAST_MEDICAL_HISTORY +ese I-PAST_MEDICAL_HISTORY +momento I-PAST_MEDICAL_HISTORY +medidas I-PAST_MEDICAL_HISTORY +físicas I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +control I-PAST_MEDICAL_HISTORY +local I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +patología. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY - -Niña B-PRESENT_ILLNESS +Ya I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +pubertad, I-PAST_MEDICAL_HISTORY +evoluciona I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +elefantiasis I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +importante I-PAST_MEDICAL_HISTORY +limitación I-PAST_MEDICAL_HISTORY +funcional I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +imposibilita I-PAST_MEDICAL_HISTORY +deambular, I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +preciso I-PAST_MEDICAL_HISTORY +iniciar I-PAST_MEDICAL_HISTORY +tandas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +antibioticoterapia I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +menos I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +vez I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +cuadros I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +linfangitis. I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +periodo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -remitida B-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -dermatólogo I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -IP, I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -descartar I-DERIVED_FROM/TO -patología I-DERIVED_FROM/TO -ocular I-DERIVED_FROM/TO -asociada. I-DERIVED_FROM/TO -En B-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -se I-EXPLORATION -observaban I-EXPLORATION -lesiones I-EXPLORATION -típicas I-EXPLORATION -de I-EXPLORATION -esta I-EXPLORATION -enfermedad, I-EXPLORATION -las I-EXPLORATION -denominadas I-EXPLORATION -líneas I-EXPLORATION +3 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +llega I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +sufrir I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +perímetro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +pierna I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +102 I-PRESENT_ILLNESS +cm, I-PRESENT_ILLNESS +llegando I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +último I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +180 I-PRESENT_ILLNESS +cm, I-PRESENT_ILLNESS +momento I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +constata I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +frecuencia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +linfangitis I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +aparición I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +mínimo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +mensual, I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +finalmente I-PRESENT_ILLNESS +obliga I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +replantear I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +tratamiento. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +La B-EXPLORATION +evaluación I-EXPLORATION +radiológica I-EXPLORATION +mediante I-EXPLORATION +linfografía I-EXPLORATION +demuestra I-EXPLORATION +ausencia I-EXPLORATION +total I-EXPLORATION de I-EXPLORATION -Blaschko. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -ocular I-EXPLORATION -realizada I-EXPLORATION +drenaje I-EXPLORATION +linfático I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -consulta I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -buen I-EXPLORATION -comportamiento I-EXPLORATION -visual I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -ojos I-EXPLORATION -(AO), I-EXPLORATION -segmento I-EXPLORATION -anterior I-EXPLORATION -normal, I-EXPLORATION -motilidad I-EXPLORATION -ocular I-EXPLORATION -intrínseca I-EXPLORATION -y I-EXPLORATION -extrínseca I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION -de I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -(FO) I-EXPLORATION -con I-EXPLORATION -oftalmoscopio I-EXPLORATION -indirecto I-EXPLORATION -era I-EXPLORATION -normal I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -(OD) I-EXPLORATION +extremidad I-EXPLORATION +inferior I-EXPLORATION +izquierda I-EXPLORATION y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION -(OI) I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -tenue I-EXPLORATION -hemorragia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -parte I-EXPLORATION -nasal. I-EXPLORATION -Dada I-EXPLORATION -la I-EXPLORATION dificultad I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -exploración, I-EXPLORATION -por I-EXPLORATION -movimientos I-EXPLORATION -continuos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -paciente, I-EXPLORATION -se I-EXPLORATION -programó I-EXPLORATION -nueva I-EXPLORATION -exploración I-EXPLORATION -del I-EXPLORATION -FO I-EXPLORATION -bajo I-EXPLORATION -narcosis I-EXPLORATION -y I-EXPLORATION -angiografía I-EXPLORATION -fluoresceinica I-EXPLORATION -ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -lesiones I-EXPLORATION -vasculares I-EXPLORATION -ocultas. I-EXPLORATION -En I-EXPLORATION -dicha I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -nueva I-EXPLORATION -exploración I-EXPLORATION -del I-EXPLORATION -FO I-EXPLORATION -con I-EXPLORATION -oftalmoscopio I-EXPLORATION -indirecto I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -Retcam I-EXPLORATION -II I-EXPLORATION -(Massie I-EXPLORATION -Lab.) I-EXPLORATION -que I-EXPLORATION -permite I-EXPLORATION -archivar I-EXPLORATION -las I-EXPLORATION -imágenes I-EXPLORATION -en I-EXPLORATION -formato I-EXPLORATION -digital, I-EXPLORATION para I-EXPLORATION -su I-EXPLORATION -ulterior I-EXPLORATION -análisis I-EXPLORATION -detallado. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -OD I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -hipopigmentada I-EXPLORATION -paramacular I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -discreta I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -trayecto I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -vaso I-EXPLORATION -en I-EXPLORATION -extrema I-EXPLORATION -periferia I-EXPLORATION -temporal. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -OI I-EXPLORATION -se I-EXPLORATION -comprobó I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -hemorragia I-EXPLORATION -lineal I-EXPLORATION -en I-EXPLORATION -periferia I-EXPLORATION -nasal I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -otros I-EXPLORATION -hallazgos. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -angiografía I-EXPLORATION -fluoresceinica, I-EXPLORATION -inyectando I-EXPLORATION -vía I-EXPLORATION -intravenosa I-EXPLORATION -5 I-EXPLORATION -ml I-EXPLORATION -de I-EXPLORATION -fluoresceína I-EXPLORATION -sódica I-EXPLORATION -por I-EXPLORATION -kilogramo I-EXPLORATION -de I-EXPLORATION -peso, I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -nuestro I-EXPLORATION -caso I-EXPLORATION -fueron I-EXPLORATION -0, I-EXPLORATION -35 I-EXPLORATION -ml. I-EXPLORATION -Se I-EXPLORATION -tomaron I-EXPLORATION -fotografías I-EXPLORATION -seriadas I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -Retcam I-EXPLORATION -II I-EXPLORATION -que I-EXPLORATION -pusieron I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -lesiones I-EXPLORATION -no I-EXPLORATION -observadas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -oftalmoscopia I-EXPLORATION -previa. I-EXPLORATION -En I-EXPLORATION el I-EXPLORATION -OD I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -exudación I-EXPLORATION -puntiforme I-EXPLORATION +drenaje I-EXPLORATION +linfático I-EXPLORATION en I-EXPLORATION -extrema I-EXPLORATION -periferia I-EXPLORATION -temporal. I-EXPLORATION -En I-EXPLORATION -OI I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -la I-EXPLORATION -no I-EXPLORATION -perfusión I-EXPLORATION -de I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -periferia I-EXPLORATION -nasal. I-EXPLORATION -Se B-TREATMENT -trató I-TREATMENT -con I-TREATMENT -láser I-TREATMENT -de I-TREATMENT -diodo I-TREATMENT -toda I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -nasal I-TREATMENT -afectada I-TREATMENT -del I-TREATMENT -OI I-TREATMENT -(1.200 I-TREATMENT -impactos, I-TREATMENT -300 I-TREATMENT -mW, I-TREATMENT -300 I-TREATMENT -ms). I-TREATMENT - I-TREATMENT - -Una B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -sana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -74 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -acude B-DERIVED_FROM/TO -referida I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -oftalmólogo I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -evaluación I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -ojo I-DERIVED_FROM/TO -rojo I-DERIVED_FROM/TO -doloroso I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -aproximadamente I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -mes I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución. I-DERIVED_FROM/TO -No B-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -excepción I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -catarata I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -complicada I-PAST_MEDICAL_HISTORY -(facoemulsificación) I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ese I-PAST_MEDICAL_HISTORY -mismo I-PAST_MEDICAL_HISTORY -ojo I-PAST_MEDICAL_HISTORY -unos I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes. I-PAST_MEDICAL_HISTORY -La B-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -sobreelevada I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -limbo I-EXPLORATION -superonasal I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION -(próxima I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -incisión I-EXPLORATION -quirúrgica) I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -múltiples I-EXPLORATION -microinfiltrados I-EXPLORATION -corneales, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -ingurgitación I-EXPLORATION -vascular I-EXPLORATION -conjuntival I-EXPLORATION -y I-EXPLORATION +extremidad I-EXPLORATION +superior I-EXPLORATION +izquierda. I-EXPLORATION +La I-EXPLORATION +tomografia I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION +muestra I-EXPLORATION +hipertrofia I-EXPLORATION del I-EXPLORATION -plexo I-EXPLORATION -escleral I-EXPLORATION -profundo. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -colirios I-TREATMENT -antibióticos I-TREATMENT -de I-TREATMENT -amplio I-TREATMENT -espectro, I-TREATMENT -añadiéndose I-TREATMENT -además I-TREATMENT -instilaciones I-TREATMENT -de I-TREATMENT -colirios I-TREATMENT +tejido I-EXPLORATION +subcutáneo. I-EXPLORATION + I-EXPLORATION +Una B-TREATMENT +vez I-TREATMENT +constatado I-TREATMENT +el I-TREATMENT +avanzado I-TREATMENT +estado I-TREATMENT +clínico I-TREATMENT +y I-TREATMENT +radiológico I-TREATMENT de I-TREATMENT -suero I-TREATMENT -autólogo I-TREATMENT +la I-TREATMENT +patología I-TREATMENT y I-TREATMENT -medroxiprogesterona. I-TREATMENT - I-TREATMENT -Debido B-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -escasa I-EXPLORATION -respuesta I-EXPLORATION -al I-EXPLORATION -tratamiento, I-EXPLORATION -se I-EXPLORATION -solicitaron I-EXPLORATION -diversas I-EXPLORATION -pruebas I-EXPLORATION -serológicas I-EXPLORATION -(incluyendo I-EXPLORATION -bioquímica, I-EXPLORATION -hemograma, I-EXPLORATION -reactantes I-EXPLORATION -de I-EXPLORATION -fase I-EXPLORATION -aguda I-EXPLORATION -y I-EXPLORATION -marcadores I-EXPLORATION -de I-EXPLORATION -autoinmunidad). I-EXPLORATION -Paralelamente B-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -corticoides I-TREATMENT -sistémicos I-TREATMENT +ante I-TREATMENT +la I-TREATMENT +ausencia I-TREATMENT +de I-TREATMENT +respuesta I-TREATMENT +clínica I-TREATMENT a I-TREATMENT -dosis I-TREATMENT +las I-TREATMENT +medidas I-TREATMENT +conservadoras, I-TREATMENT +se I-TREATMENT +propone I-TREATMENT +practicar I-TREATMENT +cirugía I-TREATMENT +escisional I-TREATMENT +según I-TREATMENT +la I-TREATMENT +técnica I-TREATMENT de I-TREATMENT -1 I-TREATMENT -mg/kg. I-TREATMENT -Además I-TREATMENT -decidimos I-TREATMENT -tomar I-TREATMENT +Charles. I-TREATMENT + I-TREATMENT +En I-TREATMENT +un I-TREATMENT +primer I-TREATMENT +tiempo I-TREATMENT +quirúrgico I-TREATMENT +realizamos I-TREATMENT una I-TREATMENT -muestra I-TREATMENT -escleroconjuntival, I-TREATMENT -previa I-TREATMENT -resección I-TREATMENT +escisión I-TREATMENT +completa I-TREATMENT de I-TREATMENT +piel I-TREATMENT +y I-TREATMENT +tejido I-TREATMENT +celular I-TREATMENT +subcutáneo I-TREATMENT +en I-TREATMENT +todo I-TREATMENT +su I-TREATMENT +espesor, I-TREATMENT +respetando I-TREATMENT la I-TREATMENT -conjuntiva I-TREATMENT -adyacente, I-TREATMENT -con I-TREATMENT -posterior I-TREATMENT -implante I-TREATMENT +fascia I-TREATMENT +muscular, I-TREATMENT +desde I-TREATMENT +el I-TREATMENT +tobillo I-TREATMENT +hasta I-TREATMENT +la I-TREATMENT +raíz I-TREATMENT +del I-TREATMENT +muslo I-TREATMENT +y I-TREATMENT +cobertura I-TREATMENT +mediante I-TREATMENT +autoinjertos I-TREATMENT de I-TREATMENT -membrana I-TREATMENT -amniótica I-TREATMENT -(técnica I-TREATMENT -«inlay») I-TREATMENT -unido I-TREATMENT -a I-TREATMENT +espesor I-TREATMENT +parcial I-TREATMENT +mallados I-TREATMENT +1: I-TREATMENT +1.5 I-TREATMENT +aprovechando I-TREATMENT la I-TREATMENT -aplicación I-TREATMENT +piel I-TREATMENT +del I-TREATMENT +mismo I-TREATMENT +muslo I-TREATMENT +izquierdo. I-TREATMENT +Tras I-TREATMENT +20 I-TREATMENT +días I-TREATMENT de I-TREATMENT -adhesivo I-TREATMENT -biológico I-TREATMENT -(Fibrin I-TREATMENT -Glue®) I-TREATMENT -sobre I-TREATMENT +ingreso I-TREATMENT +hospitalario I-TREATMENT +y I-TREATMENT +curas, I-TREATMENT +realizamos I-TREATMENT +una I-TREATMENT +segunda I-TREATMENT +intervención I-TREATMENT +para I-TREATMENT +cubrir I-TREATMENT +las I-TREATMENT +zonas I-TREATMENT +cruentas I-TREATMENT +dispersas I-TREATMENT +residuales I-TREATMENT +en I-TREATMENT el I-TREATMENT -área I-TREATMENT -de I-TREATMENT -lesión. I-TREATMENT -La B-EXPLORATION -biopsia I-EXPLORATION -fue I-EXPLORATION -diagnóstica I-EXPLORATION -de I-EXPLORATION -granulomatosis I-EXPLORATION -necrotizante I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -hiperplasia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -plasmáticas I-EXPLORATION -sin I-EXPLORATION -indicios I-EXPLORATION -de I-EXPLORATION -vasculitis I-EXPLORATION -acompañante. I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -serológicas I-EXPLORATION -realizadas I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Considerando B-TREATMENT -la I-TREATMENT -posibilidad I-TREATMENT +3% I-TREATMENT de I-TREATMENT -ENIC, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -instaurar I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -Ciclosporina I-TREATMENT -A I-TREATMENT -(3 I-TREATMENT -mg/kg/día) I-TREATMENT -unido I-TREATMENT -a I-TREATMENT +superficie I-TREATMENT +corporal I-TREATMENT +total. I-TREATMENT +Obtuvimos I-TREATMENT los I-TREATMENT -corticosteroides I-TREATMENT -orales I-TREATMENT -(1 I-TREATMENT -mg/kg/día), I-TREATMENT -pero I-TREATMENT -unas I-TREATMENT -ocho I-TREATMENT -semanas I-TREATMENT -tras I-TREATMENT -su I-TREATMENT -inicio I-TREATMENT -el I-TREATMENT -cuadro I-TREATMENT -inflamatorio I-TREATMENT -persistía I-TREATMENT -y, I-TREATMENT -dada I-TREATMENT -su I-TREATMENT -severidad, I-TREATMENT +injertos I-TREATMENT +del I-TREATMENT +muslo I-TREATMENT +derecho, I-TREATMENT +que I-TREATMENT se I-TREATMENT -decidió I-TREATMENT -sustituir I-TREATMENT -Ciclosporina I-TREATMENT -por I-TREATMENT -Azatioprina I-TREATMENT -(100 I-TREATMENT -mg/día) I-TREATMENT -manteniendo I-TREATMENT -los I-TREATMENT -corticosteroides I-TREATMENT -orales. I-TREATMENT - I-TREATMENT -Este B-EVOLUTION -régimen I-EVOLUTION -terapéutico I-EVOLUTION -consiguió I-EVOLUTION -progresivamente I-EVOLUTION -controlar I-EVOLUTION +aplicaron I-TREATMENT +mallados I-TREATMENT +1: I-TREATMENT +1.5. I-TREATMENT +En B-EVOLUTION +una I-EVOLUTION +semana, I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +31 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +ingreso, I-EVOLUTION el I-EVOLUTION -proceso I-EVOLUTION -inflamatorio. I-EVOLUTION -Siete I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -la I-EVOLUTION paciente I-EVOLUTION -permanece I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -continúa I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION con I-EVOLUTION -el I-EVOLUTION -tratamiento. I-EVOLUTION +los I-EVOLUTION +injertos I-EVOLUTION +prendidos I-EVOLUTION +en I-EVOLUTION +su I-EVOLUTION +mayoría, I-EVOLUTION +quedando I-EVOLUTION +aun I-EVOLUTION +así I-EVOLUTION +zonas I-EVOLUTION +residuales I-EVOLUTION +dispersas I-EVOLUTION +en I-EVOLUTION +una I-EVOLUTION +superficie I-EVOLUTION +inferior I-EVOLUTION +al I-EVOLUTION +0.5%. I-EVOLUTION I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -traumatismo I-PRESENT_ILLNESS -craneoencefálico I-PRESENT_ILLNESS -presenta, I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -después, I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -medular I-PRESENT_ILLNESS -incompleto I-PRESENT_ILLNESS -sensitivo I-PRESENT_ILLNESS -motor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -par I-PRESENT_ILLNESS -VI I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -(OI) I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -produce I-PRESENT_ILLNESS -diplopía I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -todas I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -posiciones I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mirada. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -motora I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -limitación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -abducción I-EXPLORATION -de I-EXPLORATION --3, I-EXPLORATION -tortícolis I-EXPLORATION -cara I-EXPLORATION -izquierda I-EXPLORATION -de I-EXPLORATION -10o, I-EXPLORATION -endotropía I-EXPLORATION -de I-EXPLORATION -45 I-EXPLORATION -r I-EXPLORATION -en I-EXPLORATION -posición I-EXPLORATION -primaria I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mirada I-EXPLORATION -con I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -(OD) I-EXPLORATION -fijador. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -sensorial, I-EXPLORATION -la I-EXPLORATION -prueba I-EXPLORATION -de I-EXPLORATION -Worth I-EXPLORATION -muestra I-EXPLORATION -supresión I-EXPLORATION -intermitente I-EXPLORATION -de I-EXPLORATION -OI. I-EXPLORATION -La I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -(AV) I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -OD I-EXPLORATION -1 I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -OI I-EXPLORATION -1. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -es I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -dos I-TREATMENT -inyecciones I-TREATMENT +La I-EVOLUTION +evolución I-EVOLUTION +del I-EVOLUTION +área I-EVOLUTION +tratada I-EVOLUTION +tras I-EVOLUTION +el I-EVOLUTION +alta I-EVOLUTION +hospitalaria I-EVOLUTION +fue I-EVOLUTION +muy I-EVOLUTION +favorable, I-EVOLUTION +con I-EVOLUTION +resolución I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +zonas I-EVOLUTION +cruentas I-EVOLUTION +residuales I-EVOLUTION +en I-EVOLUTION +3 I-EVOLUTION +semanas. I-EVOLUTION +Iniciamos B-TREATMENT +presoterapia I-TREATMENT +un I-TREATMENT +mes I-TREATMENT +después I-TREATMENT de I-TREATMENT -toxina I-TREATMENT -botulínica I-TREATMENT -5 I-TREATMENT -UI I-TREATMENT -en I-TREATMENT -recto I-TREATMENT -medio I-TREATMENT -del I-TREATMENT -OI, I-TREATMENT -con I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -disminuyó I-TREATMENT -la I-TREATMENT -endotropía I-TREATMENT -a I-TREATMENT -30 I-TREATMENT -r I-TREATMENT -sin I-TREATMENT -mejorar I-TREATMENT la I-TREATMENT -abducción. I-TREATMENT - I-TREATMENT -A I-TREATMENT -los I-TREATMENT -6 I-TREATMENT -meses I-TREATMENT +cirugía I-TREATMENT +y I-TREATMENT se I-TREATMENT -realiza I-TREATMENT -TRV I-TREATMENT -con I-TREATMENT -fijación I-TREATMENT -escleral I-TREATMENT +mantuvo I-TREATMENT en I-TREATMENT -OI I-TREATMENT -con I-TREATMENT -anestesia I-TREATMENT -general. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -inmediato I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -exotropía I-EVOLUTION -consecutiva I-EVOLUTION +todo I-TREATMENT +momento I-TREATMENT +la I-TREATMENT +fisioterapia. I-TREATMENT +Sin B-EVOLUTION +embargo, I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +3 I-EVOLUTION +meses I-EVOLUTION +observamos I-EVOLUTION +un I-EVOLUTION +aumento I-EVOLUTION +progresivo I-EVOLUTION de I-EVOLUTION -45 I-EVOLUTION -r, I-EVOLUTION -inversión I-EVOLUTION -del I-EVOLUTION -tortícolis, I-EVOLUTION -limitación I-EVOLUTION +volumen I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +dorso I-EVOLUTION +del I-EVOLUTION +pie I-EVOLUTION +izquierdo, I-EVOLUTION +además I-EVOLUTION de I-EVOLUTION +pequeñas I-EVOLUTION +erosiones I-EVOLUTION +cutáneas I-EVOLUTION +debidas I-EVOLUTION +a I-EVOLUTION la I-EVOLUTION -aducción I-EVOLUTION -de I-EVOLUTION --1 I-EVOLUTION -y I-EVOLUTION +fricción I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -abducción I-EVOLUTION +las I-EVOLUTION +prendas I-EVOLUTION de I-EVOLUTION --1 I-EVOLUTION -del I-EVOLUTION -ojo I-EVOLUTION -afectado I-EVOLUTION -y I-EVOLUTION -diplopía. I-EVOLUTION - I-EVOLUTION -A B-TREATMENT +presoterapia, I-EVOLUTION +que I-EVOLUTION +evolucionaron I-EVOLUTION +favorablemente I-EVOLUTION +con B-TREATMENT +curas I-TREATMENT +tópicas. I-TREATMENT + I-TREATMENT +A I-TREATMENT los I-TREATMENT -15 I-TREATMENT -días I-TREATMENT -se I-TREATMENT -inyectan I-TREATMENT -5 I-TREATMENT -U I-TREATMENT +7 I-TREATMENT +meses I-TREATMENT de I-TREATMENT -toxina I-TREATMENT -botulínica I-TREATMENT -en I-TREATMENT -recto I-TREATMENT -lateral I-TREATMENT -del I-TREATMENT -OI I-TREATMENT -sin I-TREATMENT -que I-TREATMENT -se I-TREATMENT -modificase I-TREATMENT +la I-TREATMENT +primera I-TREATMENT +cirugía I-TREATMENT +procedimos I-TREATMENT +a I-TREATMENT +intervenir I-TREATMENT +quirúrgicamente I-TREATMENT +de I-TREATMENT +nuevo I-TREATMENT +para I-TREATMENT +tratar I-TREATMENT el I-TREATMENT -resultado, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT +linfedema I-TREATMENT +residual I-TREATMENT +del I-TREATMENT +dorso I-TREATMENT +del I-TREATMENT +pie. I-TREATMENT +De I-TREATMENT +igual I-TREATMENT +modo, I-TREATMENT +llevaremos I-TREATMENT a I-TREATMENT -los I-TREATMENT -2 I-TREATMENT -meses I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -retirar I-TREATMENT +cabo I-TREATMENT +según I-TREATMENT la I-TREATMENT -fijación I-TREATMENT -escleral, I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -técnicamente I-TREATMENT -imposible I-TREATMENT -por I-TREATMENT -las I-TREATMENT -adherencias I-TREATMENT -encontradas. I-TREATMENT -Se I-TREATMENT -reinterviene I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -realizando I-TREATMENT -una I-TREATMENT -resección I-TREATMENT -del I-TREATMENT -recto I-TREATMENT -medio I-TREATMENT +técnica I-TREATMENT de I-TREATMENT -OI I-TREATMENT +Charles I-TREATMENT +escisión I-TREATMENT +completa I-TREATMENT de I-TREATMENT -7 I-TREATMENT -mm I-TREATMENT +piel I-TREATMENT y I-TREATMENT -se I-TREATMENT -inyectan I-TREATMENT -5 I-TREATMENT -U I-TREATMENT +tejido I-TREATMENT +subcutáneo I-TREATMENT +del I-TREATMENT +dorso I-TREATMENT +del I-TREATMENT +pie I-TREATMENT +izquierdo, I-TREATMENT +preservando I-TREATMENT +la I-TREATMENT +fascia I-TREATMENT +profunda, I-TREATMENT +y I-TREATMENT +cobertura I-TREATMENT +del I-TREATMENT +área I-TREATMENT +cruenta I-TREATMENT +mediante I-TREATMENT +autoinjertos I-TREATMENT de I-TREATMENT -toxina I-TREATMENT -botulínica I-TREATMENT -en I-TREATMENT -recto I-TREATMENT -lateral I-TREATMENT +espesor I-TREATMENT +parcial I-TREATMENT +mallados I-TREATMENT +1: I-TREATMENT +1.5 I-TREATMENT +obtenidos I-TREATMENT del I-TREATMENT -OI I-TREATMENT -intraoperatoriamente. I-TREATMENT -El B-EVOLUTION +muslo I-TREATMENT +derecho. I-TREATMENT +En B-EVOLUTION +6 I-EVOLUTION +días I-EVOLUTION +los I-EVOLUTION +injertos I-EVOLUTION +estaban I-EVOLUTION +prendidos I-EVOLUTION +y I-EVOLUTION +estables I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION paciente I-EVOLUTION -quedó I-EVOLUTION +recibió I-EVOLUTION +el I-EVOLUTION +alta I-EVOLUTION +hospitalaria. I-EVOLUTION + I-EVOLUTION +Pasados I-EVOLUTION +3 I-EVOLUTION +años I-EVOLUTION con I-EVOLUTION -tortícolis I-EVOLUTION +controles I-EVOLUTION en I-EVOLUTION -la I-EVOLUTION -cara I-EVOLUTION -derecha I-EVOLUTION -de I-EVOLUTION -10o, I-EVOLUTION -limitación I-EVOLUTION +consulta I-EVOLUTION +ambulatoria I-EVOLUTION +en I-EVOLUTION +intervalos I-EVOLUTION de I-EVOLUTION +aproximadamente I-EVOLUTION +2 I-EVOLUTION +meses, I-EVOLUTION +persiste I-EVOLUTION la I-EVOLUTION -abducción I-EVOLUTION -de I-EVOLUTION --1, I-EVOLUTION -exotropía I-EVOLUTION -de I-EVOLUTION -10-15 I-EVOLUTION -r I-EVOLUTION -en I-EVOLUTION -posición I-EVOLUTION -primaria I-EVOLUTION +aparición I-EVOLUTION +errática I-EVOLUTION de I-EVOLUTION +áreas I-EVOLUTION +cruentas I-EVOLUTION +irritativas I-EVOLUTION +con I-EVOLUTION +exudado I-EVOLUTION +no I-EVOLUTION +purulento I-EVOLUTION +que B-TREATMENT +se I-TREATMENT +van I-TREATMENT +controlando I-TREATMENT +con I-TREATMENT +curas I-TREATMENT +tópicas I-TREATMENT +en I-TREATMENT +las I-TREATMENT +que I-TREATMENT +se I-TREATMENT +alterna I-TREATMENT +sulfadiazina I-TREATMENT +argéntica, I-TREATMENT +nitrofurazona I-TREATMENT +y I-TREATMENT +solución I-TREATMENT +yodada. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +presenta I-EVOLUTION +una I-EVOLUTION +extremidad I-EVOLUTION +funcional I-EVOLUTION +con I-EVOLUTION +dimensiones I-EVOLUTION +muy I-EVOLUTION +cercanas I-EVOLUTION +a I-EVOLUTION la I-EVOLUTION -mirada I-EVOLUTION -(PPM) I-EVOLUTION +contralateral I-EVOLUTION +sana I-EVOLUTION +y I-EVOLUTION sin I-EVOLUTION -diplopía. I-EVOLUTION -A I-EVOLUTION +nuevos I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION +linfangitis I-EVOLUTION +hasta I-EVOLUTION +la I-EVOLUTION +fecha. I-EVOLUTION +Sigue B-TREATMENT +realizando I-TREATMENT +presoterapia, I-TREATMENT +rehabilitación I-TREATMENT +y I-TREATMENT +medidas I-TREATMENT +higiénicas. I-TREATMENT + I-TREATMENT +A B-EVOLUTION los I-EVOLUTION -2 I-EVOLUTION +4 I-EVOLUTION años I-EVOLUTION -vuelve I-EVOLUTION -a I-EVOLUTION -presentar I-EVOLUTION -diplopía, I-EVOLUTION -exotropÍa I-EVOLUTION -de I-EVOLUTION -20-30 I-EVOLUTION -r I-EVOLUTION -en I-EVOLUTION -PPM, I-EVOLUTION -limitación I-EVOLUTION de I-EVOLUTION +seguimiento, I-EVOLUTION +el I-EVOLUTION +aspecto I-EVOLUTION +es I-EVOLUTION +muy I-EVOLUTION +bueno, I-EVOLUTION la I-EVOLUTION -abducción I-EVOLUTION -de I-EVOLUTION --1, I-EVOLUTION -limitación I-EVOLUTION -de I-EVOLUTION +pierna I-EVOLUTION +afectada I-EVOLUTION +mantiene I-EVOLUTION +un I-EVOLUTION +diámetro I-EVOLUTION +igual I-EVOLUTION +o I-EVOLUTION +incluso I-EVOLUTION +menor I-EVOLUTION +que I-EVOLUTION la I-EVOLUTION -aducción I-EVOLUTION +extremidad I-EVOLUTION +sana; I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +calidad I-EVOLUTION de I-EVOLUTION --1 I-EVOLUTION -y I-EVOLUTION -tortícolis I-EVOLUTION +los I-EVOLUTION +injertos I-EVOLUTION +aceptable, I-EVOLUTION +con I-EVOLUTION +tejido I-EVOLUTION +fibrótico I-EVOLUTION en I-EVOLUTION la I-EVOLUTION -cara I-EVOLUTION -derecha I-EVOLUTION +pierna, I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +presencia I-EVOLUTION de I-EVOLUTION -20o. I-EVOLUTION - I-EVOLUTION -Se B-TREATMENT -decide I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -nueva I-TREATMENT -resección I-TREATMENT -del I-TREATMENT -recto I-TREATMENT -medio I-TREATMENT -del I-TREATMENT -OI I-TREATMENT -de I-TREATMENT -6 I-TREATMENT -mm. I-TREATMENT - I-TREATMENT -Un B-EVOLUTION -año I-EVOLUTION -después I-EVOLUTION +linforrea I-EVOLUTION +ocasional I-EVOLUTION +que I-EVOLUTION +causa I-EVOLUTION +procesos I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -última I-EVOLUTION -cirugía I-EVOLUTION -presenta: I-EVOLUTION -limitación I-EVOLUTION +irritación I-EVOLUTION +cutánea I-EVOLUTION +que I-EVOLUTION +generan I-EVOLUTION +un I-EVOLUTION +proceso I-EVOLUTION +crónico I-EVOLUTION de I-EVOLUTION +fibrosis. I-EVOLUTION +En I-EVOLUTION +el I-EVOLUTION +muslo I-EVOLUTION +no I-EVOLUTION +aparece I-EVOLUTION +linforrea, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION la I-EVOLUTION -abducción I-EVOLUTION +zona I-EVOLUTION +injertada I-EVOLUTION +del I-EVOLUTION +mismo I-EVOLUTION +presenta I-EVOLUTION +mejor I-EVOLUTION +aspecto I-EVOLUTION +que I-EVOLUTION +los I-EVOLUTION +injertos I-EVOLUTION de I-EVOLUTION --1, I-EVOLUTION -tortícolis I-EVOLUTION -en I-EVOLUTION la I-EVOLUTION -cara I-EVOLUTION -derecha I-EVOLUTION -de I-EVOLUTION -5o, I-EVOLUTION -exotropía I-EVOLUTION -de I-EVOLUTION -10-15 I-EVOLUTION -r I-EVOLUTION -en I-EVOLUTION -PPM I-EVOLUTION -sin I-EVOLUTION -diplopía. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -está I-EVOLUTION -satisfecho I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -resultado. I-EVOLUTION +pierna. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -65 I-PRESENT_ILLNESS +59 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -diagnosticada I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -hepatitis I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +raza I-PRESENT_ILLNESS +blanca, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -virus I-PRESENT_ILLNESS -C I-PRESENT_ILLNESS -genotipo I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS una I-PRESENT_ILLNESS -carga I-PRESENT_ILLNESS -viral I-PRESENT_ILLNESS +masa I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -4.300.000 I-PRESENT_ILLNESS -copias/ml I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hipertensión I-PRESENT_ILLNESS -arterial I-PRESENT_ILLNESS -(HTA). I-PRESENT_ILLNESS -Se B-TREATMENT -instauró I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -IFN I-TREATMENT -pegilado I-TREATMENT -alpha-2b I-TREATMENT -(180µg/semana) I-TREATMENT -junto I-TREATMENT -a I-TREATMENT -ribavirina I-TREATMENT -(800mg/día). I-TREATMENT -Dados B-EXPLORATION -sus I-EXPLORATION -antecedentes I-EXPLORATION -de I-EXPLORATION -HTA I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION +crecimiento I-PRESENT_ILLNESS +lento, I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +localizada I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +glándula I-PRESENT_ILLNESS +parótida I-PRESENT_ILLNESS +izquierda. I-PRESENT_ILLNESS +No B-PAST_MEDICAL_HISTORY +existían I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +y B-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +masa I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +motivó I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +era I-PRESENT_ILLNESS +asintomática. I-PRESENT_ILLNESS +La B-EXPLORATION exploración I-EXPLORATION -oftalmológica I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -15 I-EXPLORATION -días I-EXPLORATION -del I-EXPLORATION -inicio I-EXPLORATION -del I-EXPLORATION -tratamiento. I-EXPLORATION -Presentó I-EXPLORATION +física I-EXPLORATION +permitió I-EXPLORATION +detectar I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION una I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -(AV) I-EXPLORATION +tumoración I-EXPLORATION de I-EXPLORATION -10/10 I-EXPLORATION -con I-EXPLORATION -corrección I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -ojos I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -fondo I-EXPLORATION +3, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION -(FO): I-EXPLORATION -papilas I-EXPLORATION -y I-EXPLORATION -máculas I-EXPLORATION -normales. I-EXPLORATION -Esclerosis I-EXPLORATION -arterial I-EXPLORATION -y I-EXPLORATION -tortuosidad I-EXPLORATION -venosa I-EXPLORATION -con I-EXPLORATION -cruces I-EXPLORATION -arterio-venosos I-EXPLORATION -patológicos. I-EXPLORATION - I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -3 I-EVOLUTION -meses, I-EVOLUTION -y I-EVOLUTION -estando I-EVOLUTION -asintomática, I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -nuevo I-EVOLUTION -valorada. I-EVOLUTION -Presentó B-EXPLORATION +diámetro, I-EXPLORATION +insensible I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -misma I-EXPLORATION -AV I-EXPLORATION -pero I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -FO I-EXPLORATION -aparecían I-EXPLORATION -múltiples I-EXPLORATION -exudados I-EXPLORATION -algodonosos I-EXPLORATION -en I-EXPLORATION -arcadas I-EXPLORATION +palpación I-EXPLORATION y I-EXPLORATION -polo I-EXPLORATION -posterior, I-EXPLORATION +cubierta I-EXPLORATION +por I-EXPLORATION +una I-EXPLORATION +piel I-EXPLORATION +de I-EXPLORATION +apariencia I-EXPLORATION +normal, I-EXPLORATION +desplazable I-EXPLORATION con I-EXPLORATION -respeto I-EXPLORATION +respecto I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +tejidos I-EXPLORATION +profundos. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -área I-EXPLORATION -macular, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -alguna I-EXPLORATION -microhemorragia I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +cervicocefálica I-EXPLORATION +fue I-EXPLORATION +normal, I-EXPLORATION +no I-EXPLORATION +habiéndose I-EXPLORATION +detectado I-EXPLORATION +adenomegalias I-EXPLORATION +cervicales. I-EXPLORATION +Se I-EXPLORATION +practicaron I-EXPLORATION +estudios I-EXPLORATION +rutinarios I-EXPLORATION +(radiografías I-EXPLORATION +torácicas I-EXPLORATION y I-EXPLORATION -microaneurisma. I-EXPLORATION -Se B-TREATMENT -etiquetó I-TREATMENT -de I-TREATMENT -retinopatía I-TREATMENT -por I-TREATMENT -IFN I-TREATMENT -y I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -continuar I-TREATMENT -con I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -dada I-TREATMENT -la I-TREATMENT -nula I-TREATMENT -repercusión I-TREATMENT +analítica I-EXPLORATION +sistemática) I-EXPLORATION +que I-EXPLORATION +resultaron I-EXPLORATION +libres I-EXPLORATION +de I-EXPLORATION +hallazgos I-EXPLORATION +patológicos. I-EXPLORATION +La B-TREATMENT +tumoración I-TREATMENT +fue I-TREATMENT +extirpada I-TREATMENT +mediante I-TREATMENT +una I-TREATMENT +parotidectomía I-TREATMENT +extrafacial, I-TREATMENT +observándose, I-TREATMENT en I-TREATMENT +el I-TREATMENT +transcurso I-TREATMENT +de I-TREATMENT la I-TREATMENT -AV, I-TREATMENT +misma, I-TREATMENT +que I-TREATMENT la I-TREATMENT -carga I-TREATMENT -viral I-TREATMENT -alta I-TREATMENT +lesión I-TREATMENT +mostraba I-TREATMENT +un I-TREATMENT +aspecto I-TREATMENT +bien I-TREATMENT +delimitado, I-TREATMENT +un I-TREATMENT +color I-TREATMENT +amarillento I-TREATMENT +grisáceo I-TREATMENT y I-TREATMENT la I-TREATMENT -posibilidad I-TREATMENT +presencia I-TREATMENT de I-TREATMENT un I-TREATMENT -seguimiento I-TREATMENT -estrecho. I-TREATMENT - I-TREATMENT -La I-TREATMENT -respuesta I-TREATMENT -virológica I-TREATMENT -fue I-TREATMENT -tardía I-TREATMENT -en I-TREATMENT -la I-TREATMENT -semana I-TREATMENT -24, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -prolongó I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -72 I-TREATMENT -semanas I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -respuesta. I-TREATMENT -Durante I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -produjo I-TREATMENT -neutropenia I-TREATMENT -que I-TREATMENT -como I-TREATMENT -máximo I-TREATMENT -llegó I-TREATMENT -a I-TREATMENT -ser I-TREATMENT -de I-TREATMENT -600/mm3 I-TREATMENT -y I-TREATMENT -anemia I-TREATMENT -como I-TREATMENT -máximo I-TREATMENT -de I-TREATMENT -8, I-TREATMENT -5g/dl I-TREATMENT -de I-TREATMENT -hemoglobina, I-TREATMENT -pero I-TREATMENT -no I-TREATMENT -se I-TREATMENT -modificaron I-TREATMENT -las I-TREATMENT -dosis I-TREATMENT +tejido I-TREATMENT +salival I-TREATMENT +circundante I-TREATMENT de I-TREATMENT -IFN. I-TREATMENT +apariencia I-TREATMENT +normal. I-TREATMENT I-TREATMENT -En B-EVOLUTION -los I-EVOLUTION -sucesivos I-EVOLUTION -controles I-EVOLUTION -siempre I-EVOLUTION -mantuvo I-EVOLUTION -la I-EVOLUTION -misma I-EVOLUTION -AV, I-EVOLUTION -los I-EVOLUTION -exudados I-EVOLUTION +El B-EXPLORATION +procesamiento I-EXPLORATION +histológico I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +quirúrgica I-EXPLORATION +fue I-EXPLORATION +rutinario, I-EXPLORATION +practicándose I-EXPLORATION +secciones I-EXPLORATION +de I-EXPLORATION +5 I-EXPLORATION +mm I-EXPLORATION +de I-EXPLORATION +espesor I-EXPLORATION +que I-EXPLORATION +fueron I-EXPLORATION +teñidas I-EXPLORATION +con I-EXPLORATION +hematoxilina-eosina. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +mismas I-EXPLORATION +permitió I-EXPLORATION +constatar I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +lesión, I-EXPLORATION +que I-EXPLORATION +estaba I-EXPLORATION +rodeada I-EXPLORATION +por I-EXPLORATION +una I-EXPLORATION +cápsula I-EXPLORATION +incompletamente I-EXPLORATION +formada, I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +constituida I-EXPLORATION +por I-EXPLORATION +masas I-EXPLORATION +sólidas I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +epiteliales I-EXPLORATION +estrechamente I-EXPLORATION +asociadas I-EXPLORATION +a I-EXPLORATION +conductos I-EXPLORATION +tapizados I-EXPLORATION +por I-EXPLORATION +dos I-EXPLORATION +capas I-EXPLORATION +de I-EXPLORATION +células, I-EXPLORATION +y I-EXPLORATION +amplias I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +diferenciación I-EXPLORATION +sebácea. I-EXPLORATION +En I-EXPLORATION +ocasiones, I-EXPLORATION +las I-EXPLORATION +estructuras I-EXPLORATION +ductales I-EXPLORATION +mostraban I-EXPLORATION +proliferaciones I-EXPLORATION +de I-EXPLORATION +apariencia I-EXPLORATION +quística I-EXPLORATION +cuyas I-EXPLORATION +luces I-EXPLORATION +estaban I-EXPLORATION +ocupadas I-EXPLORATION +por I-EXPLORATION +material I-EXPLORATION +sebáceo I-EXPLORATION +y I-EXPLORATION +ocasionales I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +metaplasia I-EXPLORATION +oncocítica. I-EXPLORATION +Tras B-EVOLUTION +cinco I-EVOLUTION +años I-EVOLUTION +de I-EVOLUTION +seguimiento, I-EVOLUTION +no I-EVOLUTION se I-EVOLUTION -fueron I-EVOLUTION -reabsorbiendo I-EVOLUTION -y I-EVOLUTION -quedó I-EVOLUTION -sólo I-EVOLUTION +ha I-EVOLUTION +producido I-EVOLUTION una I-EVOLUTION -microhemorragia I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -arcada I-EVOLUTION -vascular I-EVOLUTION -temporal I-EVOLUTION -superior I-EVOLUTION -del I-EVOLUTION -ojo I-EVOLUTION -derecho. I-EVOLUTION +recidiva I-EVOLUTION +lesional. I-EVOLUTION I-EVOLUTION -El B-PRESENT_ILLNESS -cuarto I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS +57 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -visual I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -intervención I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +paresia I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -cirugía I-PRESENT_ILLNESS -refractiva I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -LASIK I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -antes. I-PRESENT_ILLNESS -Entre B-PAST_MEDICAL_HISTORY +miembros I-PRESENT_ILLNESS +inferiores I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +inicio I-PRESENT_ILLNESS +distal I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +instalación I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +horas. I-PRESENT_ILLNESS +Destacaba B-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY sus I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destacaba I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -dudoso I-PAST_MEDICAL_HISTORY -diagnostico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -esclerosis I-PAST_MEDICAL_HISTORY -múltiple I-PAST_MEDICAL_HISTORY -dudosa I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -pruebas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -imagen I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +hipertensa I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +enalapril, I-PAST_MEDICAL_HISTORY +atenolol I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +furosemida. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +previo I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +hipopotasemia I-PAST_MEDICAL_HISTORY +asintomática I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY lo I-PAST_MEDICAL_HISTORY -constataran. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -visión I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -05 I-EXPLORATION +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +indicó I-PAST_MEDICAL_HISTORY +suplemento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +potasio I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +vía I-PAST_MEDICAL_HISTORY +oral. I-PAST_MEDICAL_HISTORY +Presentaba B-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +apirética I-EXPLORATION y I-EXPLORATION -movimiento I-EXPLORATION -de I-EXPLORATION -manos. I-EXPLORATION -El I-EXPLORATION -flap I-EXPLORATION +con I-EXPLORATION +TA I-EXPLORATION de I-EXPLORATION +150/90 I-EXPLORATION +mmHg. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -intervención I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -alteraciones. I-EXPLORATION -Al I-EXPLORATION -explorar I-EXPLORATION -su I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo, I-EXPLORATION +valoración I-EXPLORATION +neuromuscular I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -fibras I-EXPLORATION -de I-EXPLORATION -mielina I-EXPLORATION +constató I-EXPLORATION +cuadriparesia I-EXPLORATION +a I-EXPLORATION +predominio I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -nervio I-EXPLORATION -óptico I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -leve I-EXPLORATION -palidez I-EXPLORATION +miembros I-EXPLORATION +inferiores, I-EXPLORATION +con I-EXPLORATION +reflejos I-EXPLORATION +osteotendinosos I-EXPLORATION +conservados. I-EXPLORATION +El I-EXPLORATION +K+pl I-EXPLORATION +era I-EXPLORATION +1, I-EXPLORATION +4 I-EXPLORATION +mEq/L, I-EXPLORATION +con I-EXPLORATION +potasiuria I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -izquierdo. I-EXPLORATION -La I-EXPLORATION -sospecha I-EXPLORATION +muestra I-EXPLORATION +aislada I-EXPLORATION +de I-EXPLORATION +26, I-EXPLORATION +7 I-EXPLORATION +mEq/L I-EXPLORATION +y I-EXPLORATION +elevación I-EXPLORATION de I-EXPLORATION -simulación I-EXPLORATION -surge I-EXPLORATION -cuando I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -desenvuelve I-EXPLORATION -perfectamente I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -consulta, I-EXPLORATION -llegando I-EXPLORATION -a I-EXPLORATION -enviar I-EXPLORATION -un I-EXPLORATION -mensaje I-EXPLORATION -con I-EXPLORATION -su I-EXPLORATION -móvil. I-EXPLORATION -Refiere I-EXPLORATION -que I-EXPLORATION -trabaja I-EXPLORATION -y I-EXPLORATION -conduce I-EXPLORATION +CK. I-EXPLORATION +Se B-TREATMENT +suspendió I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +diurético I-TREATMENT +y I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +reposición I-TREATMENT +hidroelectrolítica I-TREATMENT +obteniéndose B-EVOLUTION +una I-EVOLUTION +rápida I-EVOLUTION +respuesta I-EVOLUTION +clínica I-EVOLUTION +con I-EVOLUTION +normalización I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +valores I-EVOLUTION +de I-EVOLUTION +K+pl I-EVOLUTION +y I-EVOLUTION +CK. I-EVOLUTION +En B-EXPLORATION +este I-EXPLORATION +caso, I-EXPLORATION a I-EXPLORATION -pesar I-EXPLORATION +diferencia I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +anteriores, I-EXPLORATION +el I-EXPLORATION +origen I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -supuesta I-EXPLORATION -baja I-EXPLORATION -visión. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -la I-EXPLORATION -visión I-EXPLORATION -binocular I-EXPLORATION -y I-EXPLORATION la I-EXPLORATION -estereopsis I-EXPLORATION +hipopotasemia I-EXPLORATION fueron I-EXPLORATION -normales I-EXPLORATION -(120"-60"). I-EXPLORATION -Pruebas I-EXPLORATION -específicas I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION +las I-EXPLORATION +pérdidas I-EXPLORATION +renales I-EXPLORATION de I-EXPLORATION -Bravais I-EXPLORATION -y I-EXPLORATION +potasio, I-EXPLORATION +secundarias I-EXPLORATION +al I-EXPLORATION +tratamiento I-EXPLORATION +con I-EXPLORATION +diuréticos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -escritura I-EXPLORATION -o I-EXPLORATION -Roth I-EXPLORATION -resultaron I-EXPLORATION -positivas. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -fue I-EXPLORATION -capaz I-EXPLORATION +asa. I-EXPLORATION +El I-EXPLORATION +hallazgo I-EXPLORATION de I-EXPLORATION -escribir I-EXPLORATION -su I-EXPLORATION -nombre I-EXPLORATION -con I-EXPLORATION -visión I-EXPLORATION -monocular I-EXPLORATION -y I-EXPLORATION -siguiendo I-EXPLORATION -una I-EXPLORATION -línea, I-EXPLORATION -a I-EXPLORATION -pesar I-EXPLORATION +26, I-EXPLORATION +7 I-EXPLORATION +mEq/L I-EXPLORATION de I-EXPLORATION -interrumpirla I-EXPLORATION +potasiuria I-EXPLORATION en I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tarea. I-EXPLORATION -También I-EXPLORATION -dibujó I-EXPLORATION una I-EXPLORATION -línea I-EXPLORATION -recta, I-EXPLORATION -reanudando I-EXPLORATION -el I-EXPLORATION -trazo I-EXPLORATION -en I-EXPLORATION +muestra I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION +aislada, I-EXPLORATION +es I-EXPLORATION +concordante I-EXPLORATION +con I-EXPLORATION el I-EXPLORATION -mismo I-EXPLORATION -punto I-EXPLORATION +origen I-EXPLORATION +renal I-EXPLORATION +del I-EXPLORATION +disturbio. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +es B-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +completar I-DERIVED_FROM/TO +estudio I-DERIVED_FROM/TO +tras I-DERIVED_FROM/TO +acudir I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +especialidades I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +tumoración I-DERIVED_FROM/TO +indolora I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +testículo I-DERIVED_FROM/TO +izquierdo I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +mes I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +evolución I-DERIVED_FROM/TO +sin I-DERIVED_FROM/TO +otra I-DERIVED_FROM/TO +sintomatología. I-DERIVED_FROM/TO +Se B-EXPLORATION +le I-EXPLORATION +detecta I-EXPLORATION en I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION que I-EXPLORATION -lo I-EXPLORATION -había I-EXPLORATION -dejado I-EXPLORATION -tras I-EXPLORATION -distraerla I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +realiza I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +centro I-EXPLORATION de I-EXPLORATION -forma I-EXPLORATION -intencionada. I-EXPLORATION -Pruebas I-EXPLORATION -complementarias I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -AFG I-EXPLORATION +especialidades I-EXPLORATION +un I-EXPLORATION +testículo I-EXPLORATION +izquierdo I-EXPLORATION +hipogénico I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -ERG I-EXPLORATION -aportaron I-EXPLORATION -resultados I-EXPLORATION -dentro I-EXPLORATION +disminuido I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -límites I-EXPLORATION +tamaño I-EXPLORATION +que I-EXPLORATION +dificulta I-EXPLORATION +su I-EXPLORATION +valoración, I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +testículo I-EXPLORATION +derecho I-EXPLORATION +con I-EXPLORATION +parénquima I-EXPLORATION +heterogéneo I-EXPLORATION +sospechoso I-EXPLORATION de I-EXPLORATION +neoplasia. I-EXPLORATION + I-EXPLORATION +No B-PAST_MEDICAL_HISTORY +refiere I-PAST_MEDICAL_HISTORY +alergias I-PAST_MEDICAL_HISTORY +medicamentosas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tampoco I-PAST_MEDICAL_HISTORY +tiene I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +A B-EXPLORATION la I-EXPLORATION -normalidad. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -PEV I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -leve I-EXPLORATION +palpa I-EXPLORATION +un I-EXPLORATION +teste I-EXPLORATION +izquierdo I-EXPLORATION +hipotrófico. I-EXPLORATION +El I-EXPLORATION +teste I-EXPLORATION +derecho I-EXPLORATION +se I-EXPLORATION +presenta I-EXPLORATION +algo I-EXPLORATION +aumentado I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -conducción I-EXPLORATION +tamaño. I-EXPLORATION +Ambos I-EXPLORATION +no I-EXPLORATION +dolorosos, I-EXPLORATION +de I-EXPLORATION +consistencia I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +superficie I-EXPLORATION +regulares. I-EXPLORATION +Epidídimos I-EXPLORATION +y I-EXPLORATION +cordones I-EXPLORATION +sin I-EXPLORATION +hallazgos I-EXPLORATION +patológicos. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +solicitan I-EXPLORATION +marcadores I-EXPLORATION +tumorales I-EXPLORATION +que I-EXPLORATION +resultan I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -nervio I-EXPLORATION -óptico I-EXPLORATION -izquierdo. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -servicio I-EXPLORATION +una I-EXPLORATION +alfa-feto I-EXPLORATION +proteína I-EXPLORATION de I-EXPLORATION -neurología I-EXPLORATION -fue I-EXPLORATION -descartada I-EXPLORATION -la I-EXPLORATION -esclerosis I-EXPLORATION -múltiple, I-EXPLORATION +2.7 I-EXPLORATION +ng/ml I-EXPLORATION con I-EXPLORATION -RM I-EXPLORATION -y I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -normales. I-EXPLORATION +una I-EXPLORATION +beta-hCG I-EXPLORATION +de I-EXPLORATION +4.2 I-EXPLORATION +mUI/ml. I-EXPLORATION I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -diagnosticado B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -SA I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -alteraciones I-PAST_MEDICAL_HISTORY -oculares I-PAST_MEDICAL_HISTORY -(lenticono I-PAST_MEDICAL_HISTORY -anterior I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -retinopatía I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -flecos), I-PAST_MEDICAL_HISTORY -acudió B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -AV I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -OD. I-PRESENT_ILLNESS -Resultó B-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cataratas I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -complicaciones I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes. I-PAST_MEDICAL_HISTORY -La B-EXPLORATION -OCT I-EXPLORATION -previa I-EXPLORATION -a I-EXPLORATION +Durante I-EXPLORATION +el I-EXPLORATION +ingreso I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +nuevas I-EXPLORATION +exploraciones I-EXPLORATION +complementarias, I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -cirugía I-EXPLORATION -detectó I-EXPLORATION -disminución I-EXPLORATION -bilateral I-EXPLORATION +ecografía I-EXPLORATION +con I-EXPLORATION +flujo I-EXPLORATION +Doppler I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +un I-EXPLORATION +teste I-EXPLORATION +derecho I-EXPLORATION +de I-EXPLORATION +49mm I-EXPLORATION +x I-EXPLORATION +36mm I-EXPLORATION +x I-EXPLORATION +26mm I-EXPLORATION +con I-EXPLORATION +lesión I-EXPLORATION +hipoecoica, I-EXPLORATION +de I-EXPLORATION +bordes I-EXPLORATION +lobulados, I-EXPLORATION +heterogénea, I-EXPLORATION +que I-EXPLORATION +ocupa I-EXPLORATION +prácticamente I-EXPLORATION +todo I-EXPLORATION +el I-EXPLORATION +testículo, I-EXPLORATION +y I-EXPLORATION +que I-EXPLORATION +presenta I-EXPLORATION +aumento I-EXPLORATION del I-EXPLORATION -espesor I-EXPLORATION -macular, I-EXPLORATION +flujo I-EXPLORATION +Doppler. I-EXPLORATION +Y I-EXPLORATION +un I-EXPLORATION +teste I-EXPLORATION +izquierdo I-EXPLORATION +de I-EXPLORATION +32 I-EXPLORATION +mm I-EXPLORATION +x I-EXPLORATION +22 I-EXPLORATION +mm I-EXPLORATION +x I-EXPLORATION +20 I-EXPLORATION +mm I-EXPLORATION +hetrogéneo I-EXPLORATION con I-EXPLORATION -adelgazamiento I-EXPLORATION +lesión I-EXPLORATION +focal I-EXPLORATION +ligeramente I-EXPLORATION +hipoecoica I-EXPLORATION de I-EXPLORATION -capas I-EXPLORATION -internas I-EXPLORATION -retinianas, I-EXPLORATION -fundamentalmente I-EXPLORATION +aproximadamente I-EXPLORATION +9 I-EXPLORATION +mm I-EXPLORATION +con I-EXPLORATION +sutil I-EXPLORATION +flujo I-EXPLORATION +Doppler. I-EXPLORATION +Además, I-EXPLORATION +microlitiasis I-EXPLORATION +testiculares I-EXPLORATION +bilaterales. I-EXPLORATION + I-EXPLORATION +Al I-EXPLORATION +TAC I-EXPLORATION +toraco-abdomino-pélvico I-EXPLORATION +con I-EXPLORATION +contraste, I-EXPLORATION +donde I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +identificaron I-EXPLORATION +adenopatías I-EXPLORATION +ni I-EXPLORATION +metástasis I-EXPLORATION en I-EXPLORATION +ninguno I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +territorios I-EXPLORATION +visualizados. I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +tumor I-TREATMENT +testicular I-TREATMENT +bilateral, I-TREATMENT +se I-TREATMENT +le I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +orquiectomía I-TREATMENT +bilateral I-TREATMENT +vía I-TREATMENT +inguinal. I-TREATMENT +Al I-TREATMENT +mismo I-TREATMENT +tiempo I-TREATMENT +comenzó I-TREATMENT +tratamiento I-TREATMENT +hormonal I-TREATMENT +sustitutivo. I-TREATMENT + I-TREATMENT +En B-EXPLORATION la I-EXPLORATION -región I-EXPLORATION -macular I-EXPLORATION -temporal. I-EXPLORATION -La I-EXPLORATION -AV I-EXPLORATION -fue I-EXPLORATION -0, I-EXPLORATION -01 I-EXPLORATION +Anatomía I-EXPLORATION +patológica I-EXPLORATION +informan I-EXPLORATION +de I-EXPLORATION +testículo I-EXPLORATION +izquierdo I-EXPLORATION +atrófico I-EXPLORATION +con I-EXPLORATION +múltiples I-EXPLORATION +focos I-EXPLORATION +microscópicos I-EXPLORATION +de I-EXPLORATION +Seminoma I-EXPLORATION +clásico I-EXPLORATION +asociado I-EXPLORATION +a I-EXPLORATION +amplias I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +Neoplasia I-EXPLORATION +Intratubular I-EXPLORATION +de I-EXPLORATION +Células I-EXPLORATION +Germinales I-EXPLORATION +(NICG) I-EXPLORATION +con I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +infiltración I-EXPLORATION +tumoral I-EXPLORATION en I-EXPLORATION +albugínea, I-EXPLORATION +rete I-EXPLORATION +testis, I-EXPLORATION +epidídimo I-EXPLORATION +o I-EXPLORATION +infiltración I-EXPLORATION +vascular. I-EXPLORATION +El I-EXPLORATION +testículo I-EXPLORATION +derecho I-EXPLORATION +presenta I-EXPLORATION +tumoración I-EXPLORATION +con I-EXPLORATION +características I-EXPLORATION +de I-EXPLORATION +Seminoma I-EXPLORATION +clásico I-EXPLORATION +que I-EXPLORATION +ocupa I-EXPLORATION +prácticamente I-EXPLORATION +todo I-EXPLORATION el I-EXPLORATION -OD I-EXPLORATION +parénquima, I-EXPLORATION +asociado I-EXPLORATION +a I-EXPLORATION +focos I-EXPLORATION +de I-EXPLORATION +Neoplasia I-EXPLORATION +Intratubular I-EXPLORATION +de I-EXPLORATION +Células I-EXPLORATION +Germinales I-EXPLORATION +(NICG) I-EXPLORATION y I-EXPLORATION -0, I-EXPLORATION -7 I-EXPLORATION +focos I-EXPLORATION +de I-EXPLORATION +atrofia I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -OI. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -del I-EXPLORATION -OD I-EXPLORATION -se I-EXPLORATION -detectó I-EXPLORATION -un I-EXPLORATION -AM I-EXPLORATION -de I-EXPLORATION -espesor I-EXPLORATION -completo, I-EXPLORATION -comprobado I-EXPLORATION -mediante I-EXPLORATION -OCT, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -diámetro I-EXPLORATION +testículo I-EXPLORATION +restante. I-EXPLORATION +Túnica I-EXPLORATION +albugínea, I-EXPLORATION +rete I-EXPLORATION +testis, I-EXPLORATION +epidídimo I-EXPLORATION +y I-EXPLORATION +borde I-EXPLORATION +quirúrgico I-EXPLORATION +libres I-EXPLORATION de I-EXPLORATION -1.400µm. I-EXPLORATION +tumor. I-EXPLORATION + I-EXPLORATION El B-TREATMENT -paciente I-TREATMENT -decidió I-TREATMENT -no I-TREATMENT -ser I-TREATMENT -intervenido, I-TREATMENT -adquiriéndose I-TREATMENT -actitud I-TREATMENT -expectante. I-TREATMENT +tratamiento I-TREATMENT +se I-TREATMENT +completó I-TREATMENT +con I-TREATMENT +dos I-TREATMENT +ciclos I-TREATMENT +de I-TREATMENT +quimioterapia I-TREATMENT +con I-TREATMENT +carboplatino. I-TREATMENT + I-TREATMENT Actualmente B-EVOLUTION -persiste I-EVOLUTION -el I-EVOLUTION -AM, I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -diámetro I-EVOLUTION -de I-EVOLUTION -2.900µm, I-EVOLUTION -con I-EVOLUTION -pérdida I-EVOLUTION -importante I-EVOLUTION -del I-EVOLUTION -tejido I-EVOLUTION -retiniano I-EVOLUTION +lleva I-EVOLUTION +aproximadamente I-EVOLUTION +3 I-EVOLUTION +años I-EVOLUTION y I-EVOLUTION -alteraciones I-EVOLUTION -quísticas. I-EVOLUTION -El I-EVOLUTION -OI I-EVOLUTION -muestra I-EVOLUTION -adelgazamiento I-EVOLUTION -progresivo I-EVOLUTION -similar I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -zona I-EVOLUTION -macular I-EVOLUTION -temporal I-EVOLUTION -con I-EVOLUTION -espesores I-EVOLUTION +medio I-EVOLUTION +libre I-EVOLUTION de I-EVOLUTION -164µm. I-EVOLUTION +enfermedad. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Adolescente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS sexo I-PRESENT_ILLNESS femenino, I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS +14 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -raza B-PAST_MEDICAL_HISTORY -mestiza, I-PAST_MEDICAL_HISTORY -procedente I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -área I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -ciudad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Palmira I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -departamento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -Valle I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -Cauca I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Colombia. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +edad. I-PRESENT_ILLNESS +Durante I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +campamento I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -consistente I-PRESENT_ILLNESS +verano I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -rechazo I-PRESENT_ILLNESS +carpa I-PRESENT_ILLNESS +junto I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +familia, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +localidad I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +Quisco, I-PRESENT_ILLNESS +Vª I-PRESENT_ILLNESS +Región, I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +agachó I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +recoger I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +pelota I-PRESENT_ILLNESS +bajo I-PRESENT_ILLNESS +unos I-PRESENT_ILLNESS +matorrales. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +ese I-PRESENT_ILLNESS +momento I-PRESENT_ILLNESS +sintió I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +algo I-PRESENT_ILLNESS +apretaba I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +mano I-PRESENT_ILLNESS +izquierda. I-PRESENT_ILLNESS +Al I-PRESENT_ILLNESS +retirar I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +mano I-PRESENT_ILLNESS +vio I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +gran I-PRESENT_ILLNESS +culebra I-PRESENT_ILLNESS +prendada I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +zona I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +dorso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -marcha, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS +mano, I-PRESENT_ILLNESS +entre I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +dedos I-PRESENT_ILLNESS +pulgar I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +índice. I-PRESENT_ILLNESS +Ella I-PRESENT_ILLNESS +cogió I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +cabeza I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +culebra I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +detrás, I-PRESENT_ILLNESS con I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -bipedestación I-PRESENT_ILLNESS +mano I-PRESENT_ILLNESS +libre I-PRESENT_ILLNESS y I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +cabo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +algunos I-PRESENT_ILLNESS +segundos I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +reptil I-PRESENT_ILLNESS +soltó I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -sedestación, I-PRESENT_ILLNESS -principalmente I-PRESENT_ILLNESS -manifestado I-PRESENT_ILLNESS +mano, I-PRESENT_ILLNESS +alcanzando I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +enrollarse I-PRESENT_ILLNESS +alrededor I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +brazo I-PRESENT_ILLNESS +izquierdo. I-PRESENT_ILLNESS +Para I-PRESENT_ILLNESS +evitar I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +culebra I-PRESENT_ILLNESS +escapara, I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +padres I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +mataron I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +guardaron I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -miembro I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -presentando I-PRESENT_ILLNESS -posteriormente I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -ponerse I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +recipiente. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +culebra I-PRESENT_ILLNESS +medía I-PRESENT_ILLNESS +137 I-PRESENT_ILLNESS +cm I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -pie. I-PRESENT_ILLNESS -Afebril I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -toda I-PRESENT_ILLNESS +longitud, I-PRESENT_ILLNESS +siendo I-PRESENT_ILLNESS su I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -manifestaciones I-PRESENT_ILLNESS -intermitentes I-PRESENT_ILLNESS +cola I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +35 I-PRESENT_ILLNESS +cm. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +zona I-PRESENT_ILLNESS +dorsal I-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +franja I-PRESENT_ILLNESS +oscura I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +flanqueada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +franjas I-PRESENT_ILLNESS +claras I-PRESENT_ILLNESS +laterales. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +logró I-PRESENT_ILLNESS +encontrar I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +dientes I-PRESENT_ILLNESS +inocu-ladores I-PRESENT_ILLNESS +posteriores. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +mordedura I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +provocó I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +momento I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +accidente I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +logró I-PRESENT_ILLNESS +apreciar I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +sitio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS +inoculación. I-PRESENT_ILLNESS +Aproximadamente I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +cabo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +minutos, I-PRESENT_ILLNESS +inició I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +intenso I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +volumen I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS el I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -disminuía I-PRESENT_ILLNESS -parcialmente I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -administración I-PRESENT_ILLNESS +sitio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -acetaminofeno, I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -mg/kg/dosis. I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +mordedura. I-PRESENT_ILLNESS I-PRESENT_ILLNESS -No B-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontraron I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -trauma, I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -tejido I-PAST_MEDICAL_HISTORY -conectivo, I-PAST_MEDICAL_HISTORY -hipertensión, I-PAST_MEDICAL_HISTORY -diabetes, I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -congénita I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -tuberculosis. I-PAST_MEDICAL_HISTORY -Los I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -perinatales I-PAST_MEDICAL_HISTORY -eran I-PAST_MEDICAL_HISTORY -desconocidos I-PAST_MEDICAL_HISTORY -dado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -entregada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -adopción I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontraba I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -protección I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -sustituta. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY +Fue I-PRESENT_ILLNESS +llevada I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +urgencia I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +Carlos I-PRESENT_ILLNESS +van I-PRESENT_ILLNESS +Buren, I-PRESENT_ILLNESS +Valparaíso, I-PRESENT_ILLNESS +Vª I-PRESENT_ILLNESS +Región. I-PRESENT_ILLNESS En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION +la I-EXPLORATION +evaluación I-EXPLORATION inicial I-EXPLORATION se I-EXPLORATION -encontraba I-EXPLORATION -en I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -eutrófica, I-EXPLORATION -hemodinámicamente I-EXPLORATION -estable. I-EXPLORATION -Se I-EXPLORATION -destaca I-EXPLORATION -el I-EXPLORATION -rechazo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -bipedestación I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION +encontró I-EXPLORATION +un I-EXPLORATION +edema I-EXPLORATION +circunferencial I-EXPLORATION +que I-EXPLORATION +abarcaba I-EXPLORATION +hasta I-EXPLORATION la I-EXPLORATION -marcha, I-EXPLORATION +unión I-EXPLORATION +del I-EXPLORATION +tercio I-EXPLORATION +medio I-EXPLORATION +inferior I-EXPLORATION +del I-EXPLORATION +brazo, I-EXPLORATION con I-EXPLORATION -irritabilidad I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -flexión I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -caderas, I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION +una I-EXPLORATION +herida I-EXPLORATION +puntiforme I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -palpación I-EXPLORATION +mano I-EXPLORATION +izquierda I-EXPLORATION +y I-EXPLORATION +erosión I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -región I-EXPLORATION -lumbar, I-EXPLORATION -contractura I-EXPLORATION -de I-EXPLORATION +zona I-EXPLORATION +vecina, I-EXPLORATION los I-EXPLORATION -músculos I-EXPLORATION -paraespinosos, I-EXPLORATION -disminución I-EXPLORATION +dedos I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -lordosis I-EXPLORATION -lumbar I-EXPLORATION -y I-EXPLORATION -localizaba I-EXPLORATION -el I-EXPLORATION -dolor I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -lumbar. I-EXPLORATION -No I-EXPLORATION +extremidad I-EXPLORATION +afectada I-EXPLORATION se I-EXPLORATION -encontró I-EXPLORATION -la I-EXPLORATION -maniobra I-EXPLORATION -de I-EXPLORATION -Gowers, I-EXPLORATION -ni I-EXPLORATION -afectación I-EXPLORATION -neurológica. I-EXPLORATION +encontraban I-EXPLORATION +fríos, I-EXPLORATION +no I-EXPLORATION +refería I-EXPLORATION +mialgias. I-EXPLORATION I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION -clínicos I-EXPLORATION -iniciales I-EXPLORATION -destacaba I-EXPLORATION -hemograma I-EXPLORATION -normal, I-EXPLORATION -Proteína I-EXPLORATION -C I-EXPLORATION -Reactiva I-EXPLORATION -(PCR) I-EXPLORATION -de I-EXPLORATION -7 I-EXPLORATION -mg/dl I-EXPLORATION -(rango I-EXPLORATION -de I-EXPLORATION -0 I-EXPLORATION -a I-EXPLORATION -5 I-EXPLORATION -mg/dl), I-EXPLORATION -Velocidad I-EXPLORATION -de I-EXPLORATION -Sedimentación I-EXPLORATION -Globular I-EXPLORATION -(VSG) I-EXPLORATION -de I-EXPLORATION -40 I-EXPLORATION -mm/h), I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -normal, I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION -y I-EXPLORATION -hepática I-EXPLORATION -normales, I-EXPLORATION -antígenos I-EXPLORATION -para I-EXPLORATION -Salmonella I-EXPLORATION -negativos, I-EXPLORATION -Anticuerpos I-EXPLORATION -Antinucleares I-EXPLORATION -(AAN) I-EXPLORATION -negativos, I-EXPLORATION -Creatin I-EXPLORATION -Fosfoquinasa I-EXPLORATION -(CPK) I-EXPLORATION -normal. I-EXPLORATION -Entre I-EXPLORATION +Fue B-TREATMENT +hospitalizada I-TREATMENT +con I-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +mordedura I-TREATMENT +por I-TREATMENT +ofidio I-TREATMENT +y I-TREATMENT +observación I-TREATMENT +de I-TREATMENT +un I-TREATMENT +síndrome I-TREATMENT +com-partamental. I-TREATMENT +Se I-TREATMENT +indicó I-TREATMENT +como I-TREATMENT +tratamiento I-TREATMENT +corticoste-roides I-TREATMENT +y I-TREATMENT +anti-histamínicos I-TREATMENT +endovenosos, I-TREATMENT +analgésicos I-TREATMENT +tipo I-TREATMENT +AINE I-TREATMENT +y I-TREATMENT +ampicilina I-TREATMENT +parenteral. I-TREATMENT +Las I-TREATMENT +medidas I-TREATMENT +locales I-TREATMENT +indicadas I-TREATMENT +fueron I-TREATMENT +brazo I-TREATMENT +en I-TREATMENT +alto I-TREATMENT +y I-TREATMENT +aplicación I-TREATMENT +de I-TREATMENT +hielo. I-TREATMENT + I-TREATMENT +De B-EXPLORATION los I-EXPLORATION -estudios I-EXPLORATION -imagenológicos I-EXPLORATION -destacó I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -región I-EXPLORATION -lumbosacra I-EXPLORATION -y I-EXPLORATION +laboratorio I-EXPLORATION +solicitados I-EXPLORATION +destacaban: I-EXPLORATION +protrombinemia: I-EXPLORATION +57% I-EXPLORATION +(VN= I-EXPLORATION +70-100%), I-EXPLORATION +TTPK: I-EXPLORATION +41 I-EXPLORATION +seg I-EXPLORATION +(VN= I-EXPLORATION +26-36 I-EXPLORATION +seg), I-EXPLORATION +recuento I-EXPLORATION de I-EXPLORATION -caderas I-EXPLORATION -informadas I-EXPLORATION -como I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -Resonancia I-EXPLORATION -Magnética I-EXPLORATION -(RM) I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION +plaquetas: I-EXPLORATION +300.000 I-EXPLORATION +(VN= I-EXPLORATION +150.000-400.000/mm3), I-EXPLORATION +hematocrito: I-EXPLORATION +44% I-EXPLORATION +(VN= I-EXPLORATION +34-44%); I-EXPLORATION +hemoglobinemia: I-EXPLORATION +14, I-EXPLORATION +6 I-EXPLORATION +gr/dL I-EXPLORATION +(VN= I-EXPLORATION +11, I-EXPLORATION +6-15 I-EXPLORATION +gr/ I-EXPLORATION +dL). I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +recuento I-EXPLORATION de I-EXPLORATION -pelvis I-EXPLORATION -con I-EXPLORATION -énfasis I-EXPLORATION +leucocitos. I-EXPLORATION + I-EXPLORATION +Evolucionó B-EVOLUTION +en I-EVOLUTION +regulares I-EVOLUTION +condiciones I-EVOLUTION +generales I-EVOLUTION +las I-EVOLUTION +primeras I-EVOLUTION +24 I-EVOLUTION +horas, I-EVOLUTION +sin I-EVOLUTION +fiebre, I-EVOLUTION +pero I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +intenso I-EVOLUTION +dolor I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +extremidad I-EVOLUTION +superior I-EVOLUTION +izquierda. I-EVOLUTION +El I-EVOLUTION +edema I-EVOLUTION +se I-EVOLUTION +extendió I-EVOLUTION +hasta I-EVOLUTION +la I-EVOLUTION +región I-EVOLUTION +del I-EVOLUTION +hombro I-EVOLUTION +y I-EVOLUTION +zona I-EVOLUTION +pectoral I-EVOLUTION +y I-EVOLUTION +los I-EVOLUTION +dedos I-EVOLUTION +tomaron I-EVOLUTION +un I-EVOLUTION +aspecto I-EVOLUTION +equimótico. I-EVOLUTION +Destacó B-EXPLORATION en I-EXPLORATION -cadera I-EXPLORATION -izquierda, I-EXPLORATION -evidenció I-EXPLORATION -compromiso I-EXPLORATION -articular I-EXPLORATION -coxofemoral, I-EXPLORATION -con I-EXPLORATION -núcleos I-EXPLORATION -de I-EXPLORATION -cabeza I-EXPLORATION -femoral I-EXPLORATION -normales, I-EXPLORATION -acetábulo I-EXPLORATION -adecuado I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +el I-EXPLORATION +dolor I-EXPLORATION a I-EXPLORATION -nivel I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION de I-EXPLORATION -corte I-EXPLORATION -coronal I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +afectada I-EXPLORATION y I-EXPLORATION -sagital. I-EXPLORATION -Se I-EXPLORATION -encontró I-EXPLORATION -alteración I-EXPLORATION +la I-EXPLORATION +consistencia I-EXPLORATION +acartonada I-EXPLORATION del I-EXPLORATION -disco I-EXPLORATION -L5-S1, I-EXPLORATION -con I-EXPLORATION -erosiones I-EXPLORATION -óseas I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -espondilodiscitis. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -búsqueda I-EXPLORATION -intencionada I-EXPLORATION -para I-EXPLORATION -tuberculosis I-EXPLORATION +edema. I-EXPLORATION +Presentó I-EXPLORATION +cefalea I-EXPLORATION +intensa, I-EXPLORATION +náuseas I-EXPLORATION y I-EXPLORATION -descartar I-EXPLORATION -Mal I-EXPLORATION -de I-EXPLORATION -Pott I-EXPLORATION -como I-EXPLORATION -diagnóstico I-EXPLORATION -diferencial; I-EXPLORATION -con I-EXPLORATION -Prueba I-EXPLORATION +febrículas, I-EXPLORATION +sin I-EXPLORATION +evidencias I-EXPLORATION de I-EXPLORATION -Tuberculina I-EXPLORATION -(PPD), I-EXPLORATION -tres I-EXPLORATION -baciloscopias I-EXPLORATION -(BK) I-EXPLORATION -seriados I-EXPLORATION -en I-EXPLORATION -jugo I-EXPLORATION -gástrico, I-EXPLORATION -tres I-EXPLORATION -BK I-EXPLORATION -seriados I-EXPLORATION -en I-EXPLORATION -orina, I-EXPLORATION -TAC I-EXPLORATION +sangramientos. I-EXPLORATION +La I-EXPLORATION +orina I-EXPLORATION +fue I-EXPLORATION +evaluada I-EXPLORATION +diariamente I-EXPLORATION +por I-EXPLORATION +colorometría I-EXPLORATION +a I-EXPLORATION +ojo I-EXPLORATION +desnudo, I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +detección I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -simple I-EXPLORATION -y I-EXPLORATION -contrastado, I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -total, I-EXPLORATION -sin I-EXPLORATION -encontrarse I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION -estas I-EXPLORATION -ayudas I-EXPLORATION -diagnósticas. I-EXPLORATION +hemoglobinuria. I-EXPLORATION I-EXPLORATION -Durante B-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -se I-EVOLUTION -documentó I-EVOLUTION -exacerbación I-EVOLUTION +Se B-TREATMENT +mantuvo I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +analgésicos I-TREATMENT +y I-TREATMENT +corti-costeroides I-TREATMENT +endovenosos I-TREATMENT +y I-TREATMENT +el I-TREATMENT +edema I-TREATMENT +del I-TREATMENT +antebrazo I-TREATMENT +y I-TREATMENT +brazo I-TREATMENT +comenzó I-TREATMENT +a I-TREATMENT +disminuir. I-TREATMENT +A B-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +horas I-EVOLUTION de I-EVOLUTION -dolor I-EVOLUTION -manifestado I-EVOLUTION +evolución I-EVOLUTION +aparecieron I-EVOLUTION +bulas I-EVOLUTION +serohemorrágicas I-EVOLUTION en I-EVOLUTION -rechazo I-EVOLUTION -de I-EVOLUTION la I-EVOLUTION -bipedestación I-EVOLUTION +zona I-EVOLUTION +del I-EVOLUTION +pliegue I-EVOLUTION +del I-EVOLUTION +codo I-EVOLUTION +derecho, I-EVOLUTION +disminuyó I-EVOLUTION +la I-EVOLUTION +cefalea, I-EVOLUTION +desaparecieron I-EVOLUTION +las I-EVOLUTION +náuseas I-EVOLUTION y I-EVOLUTION -de I-EVOLUTION la I-EVOLUTION -marcha, I-EVOLUTION +fiebre, I-EVOLUTION con I-EVOLUTION -irritabilidad I-EVOLUTION -a I-EVOLUTION +persistencia I-EVOLUTION +del I-EVOLUTION +dolor I-EVOLUTION +en I-EVOLUTION la I-EVOLUTION -flexión I-EVOLUTION +extremidad. I-EVOLUTION +La I-EVOLUTION +movilidad I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -caderas. I-EVOLUTION -En I-EVOLUTION -el I-EVOLUTION -seguimiento I-EVOLUTION +los I-EVOLUTION +dedos I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +muñeca I-EVOLUTION +estaban I-EVOLUTION +limitadas, I-EVOLUTION +pero I-EVOLUTION con I-EVOLUTION -reactantes I-EVOLUTION +palpación I-EVOLUTION de I-EVOLUTION -fase I-EVOLUTION -aguda I-EVOLUTION -destacó I-EVOLUTION -elevación I-EVOLUTION +pulsos I-EVOLUTION +arteriales I-EVOLUTION +normales. I-EVOLUTION +Los I-EVOLUTION +cirujanos I-EVOLUTION +descartaron I-EVOLUTION +un I-EVOLUTION +síndrome I-EVOLUTION +compartamental. I-EVOLUTION + I-EVOLUTION +A I-EVOLUTION +las I-EVOLUTION +72 I-EVOLUTION +horas I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -PCR I-EVOLUTION -a I-EVOLUTION -12 I-EVOLUTION -mg/dl I-EVOLUTION +evolución, I-EVOLUTION +tanto I-EVOLUTION +el I-EVOLUTION +edema I-EVOLUTION +como I-EVOLUTION +el I-EVOLUTION +dolor I-EVOLUTION +se I-EVOLUTION +encontraban I-EVOLUTION +en I-EVOLUTION +franca I-EVOLUTION +regresión I-EVOLUTION y I-EVOLUTION -VSG I-EVOLUTION -a I-EVOLUTION -60 I-EVOLUTION -mm/h. I-EVOLUTION - I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -exploración I-EXPLORATION -quirúrgica I-EXPLORATION -y I-EXPLORATION -drenaje I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cc I-EXPLORATION -de I-EXPLORATION -secreción I-EXPLORATION -de I-EXPLORATION -material I-EXPLORATION -purulento, I-EXPLORATION -cultivo I-EXPLORATION -y I-EXPLORATION -biopsia. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -reportó: I-EXPLORATION -Trabécula I-EXPLORATION -ósea I-EXPLORATION -usual I-EXPLORATION -y I-EXPLORATION -medula I-EXPLORATION -ósea I-EXPLORATION -con I-EXPLORATION -espacio I-EXPLORATION -medular I-EXPLORATION -con I-EXPLORATION -celularidad I-EXPLORATION -del I-EXPLORATION -30%, I-EXPLORATION -conservación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -relación I-EXPLORATION -granulo-eritroide, I-EXPLORATION -sin I-EXPLORATION -evidenciarse I-EXPLORATION -inflamación I-EXPLORATION -granulomatosa I-EXPLORATION -o I-EXPLORATION -proceso I-EXPLORATION -neoplásico. I-EXPLORATION -Reporte I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -cultivos I-EXPLORATION -(incluyendo I-EXPLORATION -estudios I-EXPLORATION -para I-EXPLORATION -Brucella I-EXPLORATION -y I-EXPLORATION -Bartonella), I-EXPLORATION -neoplasia I-EXPLORATION -y I-EXPLORATION -tuberculosis. I-EXPLORATION - I-EXPLORATION -En B-TREATMENT -junta I-TREATMENT -médica I-TREATMENT -interdisciplinaria, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT +se I-EVOLUTION +suspendieron I-EVOLUTION +los I-EVOLUTION +corticosteroides I-EVOLUTION +y I-EVOLUTION +anti-histamínicos. I-EVOLUTION +Al I-EVOLUTION +cuarto I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +evolución I-EVOLUTION +se I-EVOLUTION +dio I-EVOLUTION +de I-EVOLUTION +alta, I-EVOLUTION +casi I-EVOLUTION +sin I-EVOLUTION +molestias, I-EVOLUTION +con B-TREATMENT +indicación I-TREATMENT +de I-TREATMENT +completar I-TREATMENT tratamiento I-TREATMENT -antibiótico I-TREATMENT con I-TREATMENT -Clindamicina I-TREATMENT -40 I-TREATMENT -mg/kg/día I-TREATMENT -y I-TREATMENT -Ceftriaxone I-TREATMENT -100 I-TREATMENT -mg/kg/día I-TREATMENT -endovenoso I-TREATMENT +predni-sona I-TREATMENT durante I-TREATMENT -4 I-TREATMENT -semanas I-TREATMENT +dos I-TREATMENT +días I-TREATMENT y I-TREATMENT -2 I-TREATMENT -semanas I-TREATMENT -con I-TREATMENT -Cefalexina I-TREATMENT -100 I-TREATMENT -mg/kg/día I-TREATMENT -vía I-TREATMENT -oral. I-TREATMENT -Para I-TREATMENT el I-TREATMENT -manejo I-TREATMENT -de I-TREATMENT -dolor, I-TREATMENT -recibió I-TREATMENT -Naproxeno I-TREATMENT -y I-TREATMENT -se I-TREATMENT -indicó I-TREATMENT -rehabilitación I-TREATMENT -física, I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -resolución I-TREATMENT -completa I-TREATMENT -del I-TREATMENT -cuadro I-TREATMENT -clínico, I-TREATMENT -evidenciado I-TREATMENT -en I-TREATMENT -ausencia I-TREATMENT -de I-TREATMENT -dolor, I-TREATMENT -mejoría I-TREATMENT -en I-TREATMENT -bipedestación, I-TREATMENT -marcha I-TREATMENT -y I-TREATMENT -normalización I-TREATMENT -de I-TREATMENT -los I-TREATMENT -reactantes I-TREATMENT -de I-TREATMENT -fase I-TREATMENT -aguda. I-TREATMENT +tratamiento I-TREATMENT +antimicrobiano I-TREATMENT +por I-TREATMENT +seis I-TREATMENT +días. I-TREATMENT I-TREATMENT -Escolar B-PRESENT_ILLNESS +Presentamos B-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +caso I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +niña I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +diez I-PAST_MEDICAL_HISTORY +días I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vida, I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +origen I-PAST_MEDICAL_HISTORY +chino, I-PAST_MEDICAL_HISTORY +con B-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -13 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -controles I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -policlínico I-PRESENT_ILLNESS +38 I-PRESENT_ILLNESS +°C I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -broncopulmonar, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY +tres I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +otra I-PRESENT_ILLNESS +sintomatología. I-PRESENT_ILLNESS +Alimentada I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +lactancia I-PRESENT_ILLNESS +artificial. I-PRESENT_ILLNESS +Sin B-FAMILY_HISTORY +ambiente I-FAMILY_HISTORY +epidémico I-FAMILY_HISTORY +familiar. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Como B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY +personales, I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +gestación I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +mantenido I-PAST_MEDICAL_HISTORY +controles I-PAST_MEDICAL_HISTORY +normales; I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +parto I-PAST_MEDICAL_HISTORY +eutócico I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +factores I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -cuadros I-PAST_MEDICAL_HISTORY -bronquiales I-PAST_MEDICAL_HISTORY -obstructivos I-PAST_MEDICAL_HISTORY -frecuentes I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -infecciones I-PAST_MEDICAL_HISTORY -respiratorias I-PAST_MEDICAL_HISTORY -recurrentes, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -respuesta I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -convencional. I-PAST_MEDICAL_HISTORY +riesgo I-PAST_MEDICAL_HISTORY +infeccioso, I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +precisó I-PAST_MEDICAL_HISTORY +reanimación I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +nacimiento I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +pruebas I-PAST_MEDICAL_HISTORY +metabólicas I-PAST_MEDICAL_HISTORY +estaban I-PAST_MEDICAL_HISTORY +pendientes I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +ese I-PAST_MEDICAL_HISTORY +momento. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -Por B-EXPLORATION -referir I-EXPLORATION -dolor I-EXPLORATION -torácico I-EXPLORATION -se I-EXPLORATION -efectuó I-EXPLORATION -un I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -que I-EXPLORATION -pesquisó I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -superior I-EXPLORATION -derecho I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -SP I-EXPLORATION -intralobar. I-EXPLORATION -Fue I-EXPLORATION -evaluado I-EXPLORATION -con I-EXPLORATION -electrocardiograma I-EXPLORATION -y I-EXPLORATION -ecocardiograma I-EXPLORATION -resultando I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -hemodinámico I-EXPLORATION -para I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -usó I-EXPLORATION -sedación I-EXPLORATION -y I-EXPLORATION -anestesia I-EXPLORATION -local I-EXPLORATION -con I-EXPLORATION -lidocaína, I-EXPLORATION -se I-EXPLORATION -cateterizó I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -femoral I-EXPLORATION -derecha I-EXPLORATION -con I-EXPLORATION -introductor I-EXPLORATION -5 I-EXPLORATION -French. I-EXPLORATION -Se I-EXPLORATION -efectuó I-EXPLORATION -una I-EXPLORATION -aortografía I-EXPLORATION -torácica I-EXPLORATION -con I-EXPLORATION -catéter I-EXPLORATION -Pig I-EXPLORATION -Tail I-EXPLORATION -5 I-EXPLORATION -French I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -pesquisó, I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION +A B-EXPLORATION la I-EXPLORATION -aorta I-EXPLORATION -torácica, I-EXPLORATION -un I-EXPLORATION -vaso I-EXPLORATION -aberrante I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -calibre I-EXPLORATION -que I-EXPLORATION -nacía I-EXPLORATION -de I-EXPLORATION -ésta I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -dirigía I-EXPLORATION -al I-EXPLORATION -lóbulo I-EXPLORATION -superior I-EXPLORATION -del I-EXPLORATION -pulmón I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -diámetro I-EXPLORATION -mínimo I-EXPLORATION -2 I-EXPLORATION -mm I-EXPLORATION -y I-EXPLORATION -máximo I-EXPLORATION -6 I-EXPLORATION -mm. I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +presentaba I-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +sin I-EXPLORATION +aspecto I-EXPLORATION +séptico, I-EXPLORATION +siendo I-EXPLORATION +normal I-EXPLORATION +por I-EXPLORATION +aparatos. I-EXPLORATION I-EXPLORATION -Posteriormente, B-TREATMENT -con I-TREATMENT -catéter I-TREATMENT -multipropósito I-TREATMENT -5 I-TREATMENT -French I-TREATMENT -se I-TREATMENT -canalizó I-TREATMENT -el I-TREATMENT -vaso I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -al I-TREATMENT -cambio I-TREATMENT -de I-TREATMENT -introductor I-TREATMENT -N° I-TREATMENT -6 I-TREATMENT -French I-TREATMENT -y I-TREATMENT -por I-TREATMENT -medio I-TREATMENT -de I-TREATMENT -un I-TREATMENT -catéter I-TREATMENT -multipropósito I-TREATMENT -se I-TREATMENT -ubicó I-TREATMENT -una I-TREATMENT -guía I-TREATMENT -de I-TREATMENT -intercambio I-TREATMENT -a I-TREATMENT -distal I-TREATMENT -de I-TREATMENT -vasos I-TREATMENT -que I-TREATMENT -nutrían I-TREATMENT -el I-TREATMENT -secuestro I-TREATMENT -por I-TREATMENT -el I-TREATMENT -cual I-TREATMENT +En B-TREATMENT +Urgencias I-TREATMENT se I-TREATMENT -introdujo I-TREATMENT -catéter I-TREATMENT -largo I-TREATMENT +inicia I-TREATMENT +protocolo I-TREATMENT de I-TREATMENT -6 I-TREATMENT -French I-TREATMENT +fiebre I-TREATMENT +sin I-TREATMENT +foco I-TREATMENT +en I-TREATMENT +paciente I-TREATMENT +neonatal I-TREATMENT +(analítica I-TREATMENT +sanguínea, I-TREATMENT +urinaria I-TREATMENT y I-TREATMENT -por I-TREATMENT -medio I-TREATMENT -de I-TREATMENT -este I-TREATMENT -se I-TREATMENT -implantó I-TREATMENT -un I-TREATMENT -dispositivo I-TREATMENT -AVP I-TREATMENT -II I-TREATMENT -(AmplatzerR) I-TREATMENT de I-TREATMENT -dimensiones I-TREATMENT -4/6 I-TREATMENT -mm, I-TREATMENT -posterior I-TREATMENT -a I-TREATMENT -su I-TREATMENT -ubicación I-TREATMENT +líquido I-TREATMENT +cefalorraquídeo I-TREATMENT +normales) I-TREATMENT y I-TREATMENT -comprobando I-TREATMENT -su I-TREATMENT -estabilidad I-TREATMENT se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -su I-TREATMENT -liberación, I-TREATMENT -obteniendo I-TREATMENT -oclusión I-TREATMENT -total I-TREATMENT -del I-TREATMENT -vaso I-TREATMENT -a I-TREATMENT -la I-TREATMENT -angiografía I-TREATMENT -de I-TREATMENT -control. I-TREATMENT +pauta I-TREATMENT +antibioterapia I-TREATMENT +empírica. I-TREATMENT I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION +Permanece B-EVOLUTION +afebril I-EVOLUTION +desde I-EVOLUTION +las I-EVOLUTION +24 I-EVOLUTION +horas I-EVOLUTION de I-EVOLUTION -alta I-EVOLUTION +ingreso I-EVOLUTION +y I-EVOLUTION +hasta I-EVOLUTION +el I-EVOLUTION +alta, I-EVOLUTION +sin I-EVOLUTION +incidencias I-EVOLUTION +salvo I-EVOLUTION +por I-EVOLUTION +aparición I-EVOLUTION +de I-EVOLUTION +exantema I-EVOLUTION +maculopapular I-EVOLUTION al I-EVOLUTION +segundo I-EVOLUTION día I-EVOLUTION -siguiente I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -controlado I-EVOLUTION -con I-EVOLUTION -radiografía I-EVOLUTION de I-EVOLUTION -tórax I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION +ingreso, I-EVOLUTION que I-EVOLUTION -se I-EVOLUTION -evidenció I-EVOLUTION -dispositivo I-EVOLUTION -in I-EVOLUTION -situ I-EVOLUTION -y I-EVOLUTION -campos I-EVOLUTION -pulmonares I-EVOLUTION -libres. I-EVOLUTION -Fue I-EVOLUTION -controlado I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -semana, I-EVOLUTION -mes, I-EVOLUTION +remite I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +espontánea I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +siguientes I-EVOLUTION +24-48 I-EVOLUTION +horas. I-EVOLUTION +Ante B-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +viriasis, I-TREATMENT +y I-TREATMENT +una I-TREATMENT +vez I-TREATMENT +que I-TREATMENT +se I-TREATMENT +confirman I-TREATMENT +los I-TREATMENT +resultados I-TREATMENT +definitivos I-TREATMENT +de I-TREATMENT +los I-TREATMENT +cultivos I-TREATMENT +(negativos), I-TREATMENT +se I-TREATMENT +suspende I-TREATMENT +la I-TREATMENT +antibioterapia. I-TREATMENT +Se B-EVOLUTION +decide I-EVOLUTION +el I-EVOLUTION +alta I-EVOLUTION a I-EVOLUTION los I-EVOLUTION -6 I-EVOLUTION -meses, I-EVOLUTION +15 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +vida. I-EVOLUTION + I-EVOLUTION +Dos I-EVOLUTION +días I-EVOLUTION +después, I-EVOLUTION +acude I-EVOLUTION al I-EVOLUTION -año I-EVOLUTION -y I-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Urgencias I-EVOLUTION +por I-EVOLUTION +un I-EVOLUTION +exantema I-EVOLUTION +de I-EVOLUTION +un I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +evolución, I-EVOLUTION +generalizado, I-EVOLUTION a I-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -años, I-EVOLUTION -encontrándose I-EVOLUTION -en I-EVOLUTION -todos I-EVOLUTION -sus I-EVOLUTION -controles I-EVOLUTION -asintomático I-EVOLUTION +expensas I-EVOLUTION +de I-EVOLUTION +elementos I-EVOLUTION +“en I-EVOLUTION +diana” I-EVOLUTION +con I-EVOLUTION +aclaramiento I-EVOLUTION +central, I-EVOLUTION +sobreelevados I-EVOLUTION y I-EVOLUTION -en I-EVOLUTION -excelentes I-EVOLUTION -condiciones. I-EVOLUTION - I-EVOLUTION - -Recién B-PRESENT_ILLNESS -nacido I-PRESENT_ILLNESS -hijo B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -primigesta I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -36 I-PAST_MEDICAL_HISTORY -semanas, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -prenatal I-PAST_MEDICAL_HISTORY -irregular, I-PAST_MEDICAL_HISTORY -quien I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -vaginal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -líquido I-PAST_MEDICAL_HISTORY -amniótico I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -meconio. I-PAST_MEDICAL_HISTORY -Pesó I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -nacer I-PAST_MEDICAL_HISTORY -1.240 I-PAST_MEDICAL_HISTORY -g I-PAST_MEDICAL_HISTORY -(< I-PAST_MEDICAL_HISTORY -p I-PAST_MEDICAL_HISTORY -3), I-PAST_MEDICAL_HISTORY -midió I-PAST_MEDICAL_HISTORY -41 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -(< I-PAST_MEDICAL_HISTORY -p I-PAST_MEDICAL_HISTORY -3), I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -apgar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -9. I-PAST_MEDICAL_HISTORY -Presentó I-PAST_MEDICAL_HISTORY -dificultad I-PAST_MEDICAL_HISTORY -respiratoria I-PAST_MEDICAL_HISTORY -temprana I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -requirió I-PAST_MEDICAL_HISTORY -soporte I-PAST_MEDICAL_HISTORY -ventilatorio I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -surfactante I-PAST_MEDICAL_HISTORY -pulmonar, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -adecuada I-PAST_MEDICAL_HISTORY -respuesta. I-PAST_MEDICAL_HISTORY -Se B-DERIVED_FROM/TO -logró I-DERIVED_FROM/TO -extubación I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -CPAP, I-DERIVED_FROM/TO -pero I-DERIVED_FROM/TO -presentó I-DERIVED_FROM/TO -taquicardia I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -taquipnea I-DERIVED_FROM/TO -persistente, I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -lo I-DERIVED_FROM/TO -cual I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -realizó I-DERIVED_FROM/TO -ecocardiograma I-DERIVED_FROM/TO -sugestivo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -coartación I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -aorta I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -lo I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -derivado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -mayor I-DERIVED_FROM/TO -complejidad, I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -13 I-DERIVED_FROM/TO -días I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -vida. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -A B-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -institución I-EXPLORATION -se I-EXPLORATION -tomó I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION +confluyentes. I-EVOLUTION +Leve B-EXPLORATION +coloración I-EXPLORATION +amoratada, I-EXPLORATION +más I-EXPLORATION +intensa I-EXPLORATION en I-EXPLORATION -cuatro I-EXPLORATION -extremidades: I-EXPLORATION -Miembros I-EXPLORATION -superiores I-EXPLORATION -derecho I-EXPLORATION -e I-EXPLORATION -izquierdo I-EXPLORATION -88/49 I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -media I-EXPLORATION -(PAM) I-EXPLORATION -62 I-EXPLORATION -y I-EXPLORATION -90/52 I-EXPLORATION -PAM I-EXPLORATION -63, I-EXPLORATION miembros I-EXPLORATION -inferiores I-EXPLORATION -derecho I-EXPLORATION -e I-EXPLORATION -izquierdo I-EXPLORATION -86/43 I-EXPLORATION -PAM I-EXPLORATION -61, I-EXPLORATION -78/44 I-EXPLORATION -PAM I-EXPLORATION -53, I-EXPLORATION -frecuencia I-EXPLORATION -cardíaca I-EXPLORATION -180 I-EXPLORATION -y I-EXPLORATION -respiratoria I-EXPLORATION -65 I-EXPLORATION -x I-EXPLORATION -min. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -segmentario I-EXPLORATION -destacaba I-EXPLORATION -hepatomegalia, I-EXPLORATION -frialdad I-EXPLORATION -distal, I-EXPLORATION -taquicardia, I-EXPLORATION -soplo I-EXPLORATION -en I-EXPLORATION -foco I-EXPLORATION -pulmonar I-EXPLORATION -II/VI, I-EXPLORATION -pulsos I-EXPLORATION -femorales I-EXPLORATION -presentes, I-EXPLORATION -retracción I-EXPLORATION -subcostal, I-EXPLORATION -temblor I-EXPLORATION -distal I-EXPLORATION -fino, I-EXPLORATION -exoftalmo I-EXPLORATION -marcado I-EXPLORATION -y I-EXPLORATION -precordio I-EXPLORATION -hiperdinámico. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -Ecocardiograma I-EXPLORATION -que I-EXPLORATION -descartó I-EXPLORATION -coartación I-EXPLORATION -aórtica, I-EXPLORATION -pero I-EXPLORATION -mostró I-EXPLORATION -disfunción I-EXPLORATION -miocárdica I-EXPLORATION -que I-EXPLORATION -requirió I-EXPLORATION -soporte I-EXPLORATION -inotrópico. I-EXPLORATION -Ecografía I-EXPLORATION -transfontanelar I-EXPLORATION -y I-EXPLORATION -abdominal I-EXPLORATION -normales. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -iníciales I-EXPLORATION -destacaron I-EXPLORATION -alteraciones I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -hepática, I-EXPLORATION -bilirrubina I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -8 I-EXPLORATION -mg% I-EXPLORATION -(directa I-EXPLORATION -de I-EXPLORATION -5, I-EXPLORATION -3 I-EXPLORATION -mg%). I-EXPLORATION - I-EXPLORATION -Al B-FAMILY_HISTORY -evaluar I-FAMILY_HISTORY -a I-FAMILY_HISTORY -la I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -se I-FAMILY_HISTORY -observó I-FAMILY_HISTORY -fenotipo I-FAMILY_HISTORY -sugestivo I-FAMILY_HISTORY -de I-FAMILY_HISTORY -hipertiroidismo, I-FAMILY_HISTORY -con I-FAMILY_HISTORY -delgadez I-FAMILY_HISTORY -marcada I-FAMILY_HISTORY -y I-FAMILY_HISTORY -exoftalmo, I-FAMILY_HISTORY -por I-FAMILY_HISTORY -lo I-FAMILY_HISTORY -que I-FAMILY_HISTORY -se I-FAMILY_HISTORY -sospechó I-FAMILY_HISTORY -enfermedad I-FAMILY_HISTORY -tiroidea I-FAMILY_HISTORY -no I-FAMILY_HISTORY -tratada. I-FAMILY_HISTORY -Debido B-EXPLORATION -a I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -hipertiroidismo I-EXPLORATION -neonatal, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -perfil I-EXPLORATION -tiroideo, I-EXPLORATION +inferiores, I-EXPLORATION que I-EXPLORATION -mostró I-EXPLORATION -TSH I-EXPLORATION -0, I-EXPLORATION -01 I-EXPLORATION -uUI/ml I-EXPLORATION -y I-EXPLORATION -T4 I-EXPLORATION -Libre I-EXPLORATION -de I-EXPLORATION -7, I-EXPLORATION -7 I-EXPLORATION -(valores I-EXPLORATION -de I-EXPLORATION -referencia I-EXPLORATION -0, I-EXPLORATION -71-1, I-EXPLORATION -85 I-EXPLORATION -ng/dl). I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -además I-EXPLORATION -anticuerpos I-EXPLORATION -antimicrosomales, I-EXPLORATION -los I-EXPLORATION -cuales I-EXPLORATION -fueron I-EXPLORATION -negativos, I-EXPLORATION -pero I-EXPLORATION -no I-EXPLORATION se I-EXPLORATION -pudo I-EXPLORATION -realizar I-EXPLORATION -anticuerpos I-EXPLORATION -estimulantes I-EXPLORATION -del I-EXPLORATION -receptor I-EXPLORATION -de I-EXPLORATION -tirotropina I-EXPLORATION -(TRAab). I-EXPLORATION +borra I-EXPLORATION +parcialmente I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +presión, I-EXPLORATION +sin I-EXPLORATION +petequias. I-EXPLORATION +Como I-EXPLORATION +única I-EXPLORATION +clínica I-EXPLORATION +acompañante, I-EXPLORATION +presentaba I-EXPLORATION +deposiciones I-EXPLORATION +líquidas I-EXPLORATION +escasas. I-EXPLORATION I-EXPLORATION -Al I-EXPLORATION -reevaluar I-EXPLORATION -al I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -bocio I-EXPLORATION -difuso I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -con I-EXPLORATION -ecografía. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -metimazol I-TREATMENT -1 I-TREATMENT -mg/kg/día I-TREATMENT -dividido I-TREATMENT -en I-TREATMENT -3 I-TREATMENT -dosis, I-TREATMENT -propanolol I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -1 I-TREATMENT -mg/kg/día I-TREATMENT -dividido I-TREATMENT -en I-TREATMENT -2 I-TREATMENT -dosis, I-TREATMENT -logrando I-TREATMENT -mejoría I-TREATMENT -de I-TREATMENT -la I-TREATMENT -taquicardia. I-TREATMENT -Sin B-EVOLUTION -embargo, I-EVOLUTION -se I-EVOLUTION -notó I-EVOLUTION -poca I-EVOLUTION -ganancia I-EVOLUTION -de I-EVOLUTION -peso I-EVOLUTION +Se B-EVOLUTION +mantuvo I-EVOLUTION en I-EVOLUTION -los I-EVOLUTION -primeros I-EVOLUTION -días I-EVOLUTION +observación I-EVOLUTION +durante I-EVOLUTION +24 I-EVOLUTION +horas I-EVOLUTION +y, I-EVOLUTION +ante I-EVOLUTION +la I-EVOLUTION +no I-EVOLUTION +progresión I-EVOLUTION de I-EVOLUTION -manejo, I-EVOLUTION -situación I-EVOLUTION -revertida I-EVOLUTION -después I-EVOLUTION +las I-EVOLUTION +lesiones I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +buen I-EVOLUTION +estado I-EVOLUTION +general, I-EVOLUTION +se I-EVOLUTION +decidió I-EVOLUTION +el I-EVOLUTION +alta. I-EVOLUTION + I-EVOLUTION +Tras I-EVOLUTION +dos I-EVOLUTION +días I-EVOLUTION +en I-EVOLUTION +domicilio, I-EVOLUTION +acude I-EVOLUTION +nuevamente I-EVOLUTION +por I-EVOLUTION +shock I-EVOLUTION +hipovolémico I-EVOLUTION +secundario I-EVOLUTION +a I-EVOLUTION +un I-EVOLUTION +cuadro I-EVOLUTION de I-EVOLUTION -una I-EVOLUTION -semana I-EVOLUTION +diarrea I-EVOLUTION +abundante I-EVOLUTION +desde I-EVOLUTION +18 I-EVOLUTION +horas I-EVOLUTION +antes, I-EVOLUTION +sin I-EVOLUTION +vómitos I-EVOLUTION +ni I-EVOLUTION +rechazo I-EVOLUTION de I-EVOLUTION -tratamiento. I-EVOLUTION -Se B-TREATMENT -logró I-TREATMENT -retiro I-TREATMENT -de I-TREATMENT -oxígeno, I-TREATMENT -resolución I-TREATMENT -de I-TREATMENT -hepatomegalia I-TREATMENT -y B-EVOLUTION -después I-EVOLUTION +tomas. I-EVOLUTION +Las B-EXPLORATION +lesiones I-EXPLORATION +cutáneas I-EXPLORATION +habían I-EXPLORATION +desaparecido. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +coprocultivo I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +aisló I-EXPLORATION +germen I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +virología I-EXPLORATION +fecal I-EXPLORATION +fue I-EXPLORATION +negativa. I-EXPLORATION +Recibió B-TREATMENT +reposición I-TREATMENT +con I-TREATMENT +fluidoterapia I-TREATMENT +intravenosa, I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +retirándose I-TREATMENT +según I-TREATMENT +mejoraba I-TREATMENT +la I-TREATMENT +tolerancia I-TREATMENT +oral I-TREATMENT +con I-TREATMENT +leche I-TREATMENT +hidrolizada I-TREATMENT +y I-TREATMENT +tras I-TREATMENT +descartar I-TREATMENT +afectación I-TREATMENT +intestinal. I-TREATMENT +Las B-EVOLUTION +deposiciones I-EVOLUTION +mejoraron I-EVOLUTION +progresivamente I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +dio I-EVOLUTION de I-EVOLUTION -1 I-EVOLUTION -semana I-EVOLUTION +alta I-EVOLUTION +asintomática. I-EVOLUTION + I-EVOLUTION +En I-EVOLUTION +controles I-EVOLUTION +sucesivos I-EVOLUTION +en I-EVOLUTION +consulta I-EVOLUTION +ha I-EVOLUTION +presentado I-EVOLUTION +adecuada I-EVOLUTION +ganancia I-EVOLUTION +ponderoestatural, I-EVOLUTION +con I-EVOLUTION +deposiciones I-EVOLUTION de I-EVOLUTION -tratamiento I-EVOLUTION +consistencia I-EVOLUTION +normal. I-EVOLUTION +Mantuvo I-EVOLUTION la I-EVOLUTION -T4 I-EVOLUTION -Libre I-EVOLUTION -descendió I-EVOLUTION -hasta I-EVOLUTION -3, I-EVOLUTION -1 I-EVOLUTION -mg/dl, I-EVOLUTION -persistiendo I-EVOLUTION +alimentación I-EVOLUTION +con I-EVOLUTION +fórmula I-EVOLUTION +hidrolizada I-EVOLUTION +durante I-EVOLUTION +unas I-EVOLUTION +semanas, I-EVOLUTION con I-EVOLUTION -supresión I-EVOLUTION +posterior I-EVOLUTION +tolerancia I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -TSH I-EVOLUTION -(0, I-EVOLUTION -015 I-EVOLUTION -uUI/ml) I-EVOLUTION -al I-EVOLUTION -momento I-EVOLUTION +fórmula I-EVOLUTION +artificial, I-EVOLUTION +sin I-EVOLUTION +aparición I-EVOLUTION de I-EVOLUTION -su I-EVOLUTION -egreso. I-EVOLUTION +nuevas I-EVOLUTION +lesiones I-EVOLUTION +cutáneas. I-EVOLUTION I-EVOLUTION -En B-TREATMENT + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +55 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +tumor I-PRESENT_ILLNESS +parietal I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +costillas I-PRESENT_ILLNESS +cuarta, I-PRESENT_ILLNESS +quinta I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +sexta, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +línea I-PRESENT_ILLNESS +media I-PRESENT_ILLNESS +anterior I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +hemitórax I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +asociada I-PRESENT_ILLNESS +bajo I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +margen I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +esternón I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +recidiva I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +carcinoma I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +mama, I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +mastectomía I-PRESENT_ILLNESS +izquierda. I-PRESENT_ILLNESS +El B-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +extensión I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION +Realizamos B-TREATMENT +resección I-TREATMENT +de I-TREATMENT +las I-TREATMENT +costillas I-TREATMENT +afectadas I-TREATMENT +con I-TREATMENT +margen I-TREATMENT +de I-TREATMENT +seguridad I-TREATMENT +de I-TREATMENT +4 I-TREATMENT +cm. I-TREATMENT +Realizamos I-TREATMENT la I-TREATMENT -semana I-TREATMENT -13 I-TREATMENT +restitución I-TREATMENT +parietal I-TREATMENT +con I-TREATMENT +una I-TREATMENT +membrana I-TREATMENT de I-TREATMENT -evolución I-TREATMENT +Gore-tex® I-TREATMENT +sobre I-TREATMENT +la I-TREATMENT +que I-TREATMENT se I-TREATMENT -normalizaron I-TREATMENT -las I-TREATMENT -pruebas I-TREATMENT +repusieron I-TREATMENT +dos I-TREATMENT +arcos I-TREATMENT +costales I-TREATMENT +realizados I-TREATMENT +son I-TREATMENT +tubos I-TREATMENT de I-TREATMENT -función I-TREATMENT -tiroidea, I-TREATMENT -retirándose I-TREATMENT +Gore-tex® I-TREATMENT +rellenos I-TREATMENT +de I-TREATMENT +Craneoplastic® I-TREATMENT +para I-TREATMENT +reconstrucción I-TREATMENT +costal. I-TREATMENT +Finalmente I-TREATMENT +efectuamos I-TREATMENT la I-TREATMENT -medicación I-TREATMENT -antitiroidea. I-TREATMENT -Durante B-EVOLUTION -el I-EVOLUTION -seguimiento, I-EVOLUTION -el I-EVOLUTION -lactante I-EVOLUTION -permaneció I-EVOLUTION -en I-EVOLUTION -condición I-EVOLUTION -eutiroidea, I-EVOLUTION -sin I-EVOLUTION -alteraciones I-EVOLUTION -cardiovasculares I-EVOLUTION -ni I-EVOLUTION -del I-EVOLUTION -neurodesarrollo. I-EVOLUTION -La I-EVOLUTION -madre I-EVOLUTION +reconstrucción I-TREATMENT +con I-TREATMENT +un I-TREATMENT +colgajo I-TREATMENT +de I-TREATMENT +músculo I-TREATMENT +recto I-TREATMENT +abdominal I-TREATMENT +pediculado, I-TREATMENT +contralateral. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION fue I-EVOLUTION -referida I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +UCI I-EVOLUTION a I-EVOLUTION -endocrinología I-EVOLUTION -para I-EVOLUTION -manejo I-EVOLUTION -y I-EVOLUTION -asesoría I-EVOLUTION -para I-EVOLUTION -futuros I-EVOLUTION -embarazos. I-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +horas I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +intervención, I-EVOLUTION +sin I-EVOLUTION +incidencias. I-EVOLUTION +Permanece I-EVOLUTION +asintomática I-EVOLUTION +2 I-EVOLUTION +años I-EVOLUTION +después, I-EVOLUTION +sin I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +recidiva I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +enfermedad. I-EVOLUTION I-EVOLUTION -Varón B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -9 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -remitido B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -urgencias I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -dolor I-DERIVED_FROM/TO -precordial I-DERIVED_FROM/TO -intermitente I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -1 I-DERIVED_FROM/TO -mes I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución, I-DERIVED_FROM/TO -asociado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -alteración I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -electrocardiograma I-DERIVED_FROM/TO -(ECG): I-DERIVED_FROM/TO -atenuación I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -QRS I-DERIVED_FROM/TO -e I-DERIVED_FROM/TO -inversión I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -onda I-DERIVED_FROM/TO -T I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -derivaciones I-DERIVED_FROM/TO -precordiales. I-DERIVED_FROM/TO -No B-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -palpitaciones, I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -vegetativos I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -sincopales. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS +63 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +úlcera I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +encía I-PRESENT_ILLNESS +adherida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +molar I-PRESENT_ILLNESS +superior I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +cedido I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +conservador. I-PRESENT_ILLNESS A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -física I-EXPLORATION +oral I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION presentaba I-EXPLORATION -buen I-EXPLORATION -aspecto I-EXPLORATION -general, I-EXPLORATION -manteniéndose I-EXPLORATION -hemodinámicamente I-EXPLORATION -estable, I-EXPLORATION -destacando I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION +una I-EXPLORATION +úlcera I-EXPLORATION a I-EXPLORATION nivel I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -musculatura I-EXPLORATION -torácica I-EXPLORATION -izquierda I-EXPLORATION -que I-EXPLORATION -aumentaba I-EXPLORATION +zona I-EXPLORATION +molar I-EXPLORATION +superior I-EXPLORATION +izquierda, I-EXPLORATION con I-EXPLORATION -la I-EXPLORATION -inspiración I-EXPLORATION +fondo I-EXPLORATION +necrótico I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -movilización I-EXPLORATION +bordes I-EXPLORATION +sobreelevados I-EXPLORATION +y I-EXPLORATION +eritematosos I-EXPLORATION de I-EXPLORATION -miembros I-EXPLORATION -superiores. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -auscultación I-EXPLORATION -cardíaca I-EXPLORATION -se I-EXPLORATION -escuchaba I-EXPLORATION -aumento I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -ruidos I-EXPLORATION -cardíacos I-EXPLORATION +diámetro I-EXPLORATION +mayor, I-EXPLORATION +junto I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +abombamiento I-EXPLORATION en I-EXPLORATION -precordio I-EXPLORATION -derecho I-EXPLORATION +fondo I-EXPLORATION +vestibular I-EXPLORATION +superior I-EXPLORATION +izquierdo I-EXPLORATION y I-EXPLORATION -atenuados I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -izquierdo. I-EXPLORATION - I-EXPLORATION -Dado I-EXPLORATION -el I-EXPLORATION -tiempo I-EXPLORATION +paladar I-EXPLORATION +duro I-EXPLORATION +(lado I-EXPLORATION +izquierdo). I-EXPLORATION +Como B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +era I-PAST_MEDICAL_HISTORY +fumador I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +bebedor I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +refería I-PAST_MEDICAL_HISTORY +haber I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +operado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +adenocarcinoma I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +esófago I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +1/3 I-PAST_MEDICAL_HISTORY +distal I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +cuatro I-PAST_MEDICAL_HISTORY +meses. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +trataba I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +adenocarcinoma I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +esófago I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +enteroide, I-PAST_MEDICAL_HISTORY +pobremente I-PAST_MEDICAL_HISTORY +diferenciado, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +infiltración I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +tejido I-PAST_MEDICAL_HISTORY +adiposo I-PAST_MEDICAL_HISTORY +periesofágico, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +escasa I-PAST_MEDICAL_HISTORY +reacción I-PAST_MEDICAL_HISTORY +fibroblastica I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +linfoide I-PAST_MEDICAL_HISTORY +peritumoral, I-PAST_MEDICAL_HISTORY +así I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +metástasis I-PAST_MEDICAL_HISTORY +ganglionar, I-PAST_MEDICAL_HISTORY +presentando I-PAST_MEDICAL_HISTORY +extensión I-PAST_MEDICAL_HISTORY +extracapsular, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +atipias I-PAST_MEDICAL_HISTORY +intensas, I-PAST_MEDICAL_HISTORY +índice I-PAST_MEDICAL_HISTORY +mitótico I-PAST_MEDICAL_HISTORY +elevado I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +necrosis I-PAST_MEDICAL_HISTORY +moderada. I-PAST_MEDICAL_HISTORY +El B-TREATMENT +paciente I-TREATMENT +no I-TREATMENT +recibió I-TREATMENT +tratamiento I-TREATMENT +complementario I-TREATMENT +con I-TREATMENT +quimioterapia I-TREATMENT +ni I-TREATMENT +radioterapia I-TREATMENT +postoperatoria I-TREATMENT +debido I-TREATMENT +a I-TREATMENT +que I-TREATMENT +en I-TREATMENT +el I-TREATMENT +postoperatorio I-TREATMENT +inmediato I-TREATMENT +sufrió I-TREATMENT +dehiscencia I-TREATMENT +de I-TREATMENT +la I-TREATMENT +sutura I-TREATMENT +gastroesofágica I-TREATMENT +y I-TREATMENT +fistula I-TREATMENT +gastrocutánea I-TREATMENT +que I-TREATMENT +cedió I-TREATMENT +tras I-TREATMENT +nutricion I-TREATMENT +parenteral. I-TREATMENT + I-TREATMENT +Se B-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +radiológico I-EXPLORATION +simple I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION de I-EXPLORATION -evolución I-EXPLORATION -del I-EXPLORATION -dolor I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -alteración I-EXPLORATION -electrocardiográfica I-EXPLORATION -referida, I-EXPLORATION -se I-EXPLORATION -repitió I-EXPLORATION -ECG, I-EXPLORATION -persistiendo I-EXPLORATION -eje I-EXPLORATION -QRS I-EXPLORATION +ortopantomografía I-EXPLORATION y I-EXPLORATION -onda I-EXPLORATION -P I-EXPLORATION +Waters I-EXPLORATION +apreciando I-EXPLORATION +imagen I-EXPLORATION de I-EXPLORATION -+150°, I-EXPLORATION -QRS I-EXPLORATION -estrecho I-EXPLORATION +osteolisis I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -voltaje I-EXPLORATION -atenuado I-EXPLORATION -en I-EXPLORATION -precordiales I-EXPLORATION -V3-V6 I-EXPLORATION -y I-EXPLORATION -ondas I-EXPLORATION -T I-EXPLORATION -negativas I-EXPLORATION +hueso I-EXPLORATION +maxilar I-EXPLORATION +superior I-EXPLORATION +izquierdo I-EXPLORATION +e I-EXPLORATION +imagen I-EXPLORATION +de I-EXPLORATION +ocupación I-EXPLORATION en I-EXPLORATION -V1-V4 I-EXPLORATION -y I-EXPLORATION -aVL. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION +seno I-EXPLORATION +maxilar I-EXPLORATION +izquierdo. I-EXPLORATION +Se I-EXPLORATION +procedió I-EXPLORATION +a I-EXPLORATION +toma I-EXPLORATION +de I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -radiografía I-EXPLORATION +lesión I-EXPLORATION +intraoral, I-EXPLORATION +informando I-EXPLORATION +el I-EXPLORATION +anatomopatólogo I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION +metástasis I-EXPLORATION +de I-EXPLORATION +adenocarcinoma I-EXPLORATION +de I-EXPLORATION +esófago. I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +ingresado I-EVOLUTION +para I-EVOLUTION +descartar I-EVOLUTION +que I-EVOLUTION +presentase I-EVOLUTION +más I-EVOLUTION +metástasis I-EVOLUTION +y I-EVOLUTION +delimitar I-EVOLUTION +la I-EVOLUTION +extensión I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +metástasis I-EVOLUTION +de I-EVOLUTION +hueso I-EVOLUTION +maxilar. I-EVOLUTION +La B-EXPLORATION +exploración I-EXPLORATION +cervical I-EXPLORATION +para I-EXPLORATION +valorar I-EXPLORATION +el I-EXPLORATION +estado I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +cadenas I-EXPLORATION +ganglionares I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +TAC I-EXPLORATION +orofacial, I-EXPLORATION +apreciando I-EXPLORATION +destrucción I-EXPLORATION +de I-EXPLORATION +maxilar I-EXPLORATION +superior I-EXPLORATION +izquierdo I-EXPLORATION +con I-EXPLORATION +afectación I-EXPLORATION +de I-EXPLORATION +paladar I-EXPLORATION +duro, I-EXPLORATION +apófisis I-EXPLORATION +pterigoides, I-EXPLORATION +seno I-EXPLORATION +maxilar I-EXPLORATION +izquierdo, I-EXPLORATION +con I-EXPLORATION +rotura I-EXPLORATION +de I-EXPLORATION +pared I-EXPLORATION +posterior I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +pared I-EXPLORATION +interna I-EXPLORATION +de I-EXPLORATION +seno I-EXPLORATION +maxilar I-EXPLORATION +izquierdo, I-EXPLORATION +existiendo I-EXPLORATION +afectación I-EXPLORATION +del I-EXPLORATION +espacio I-EXPLORATION +masticador I-EXPLORATION +izquierdo, I-EXPLORATION +y I-EXPLORATION +estando I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +lesión I-EXPLORATION +tumoral I-EXPLORATION +muy I-EXPLORATION +próximo I-EXPLORATION +al I-EXPLORATION +suelo I-EXPLORATION de I-EXPLORATION -dextrocardia, I-EXPLORATION -además I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -burbuja I-EXPLORATION -gástrica I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -derecha I-EXPLORATION +órbita I-EXPLORATION +izquierda. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +ecográfico I-EXPLORATION +abdominal I-EXPLORATION y I-EXPLORATION -sombra I-EXPLORATION -hepática I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -izquierda, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -sospechó I-EXPLORATION -situs I-EXPLORATION -inversus, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -en I-EXPLORATION -ecografía I-EXPLORATION -abdominal. I-EXPLORATION +estudio I-EXPLORATION +radiológico I-EXPLORATION +simple I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +siendo I-EXPLORATION +informado I-EXPLORATION +como I-EXPLORATION +normal. I-EXPLORATION I-EXPLORATION -El B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -Cardiología I-DERIVED_FROM/TO -Infantil I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -realizó I-DERIVED_FROM/TO -ecocardiografía I-DERIVED_FROM/TO -evidenciándose I-DERIVED_FROM/TO -dextrocardia I-DERIVED_FROM/TO -especular I-DERIVED_FROM/TO -clásica I-DERIVED_FROM/TO -sin I-DERIVED_FROM/TO -malformaciones I-DERIVED_FROM/TO -cardíacas I-DERIVED_FROM/TO -asociadas. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Ante B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -etiología I-TREATMENT -músculo-esquelética, I-TREATMENT -el I-TREATMENT -dolor I-TREATMENT -torácico I-TREATMENT -se I-TREATMENT -trató I-TREATMENT -con I-TREATMENT -antiinflamatorios I-TREATMENT -con B-EVOLUTION -mejoría I-EVOLUTION -progresiva, I-EVOLUTION -encontrándose I-EVOLUTION -asintomático I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -momento I-EVOLUTION -de I-EVOLUTION -acudir I-EVOLUTION -a I-EVOLUTION -control. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tiroiditis I-PAST_MEDICAL_HISTORY -autoinmune I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -pesquisada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -bocio I-PAST_MEDICAL_HISTORY -difuso I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -antecedente B-FAMILY_HISTORY -familiar I-FAMILY_HISTORY -de I-FAMILY_HISTORY -carcinoma I-FAMILY_HISTORY -papilar I-FAMILY_HISTORY -en I-FAMILY_HISTORY -primo, I-FAMILY_HISTORY -abuela I-FAMILY_HISTORY -y I-FAMILY_HISTORY -bisabuela. I-FAMILY_HISTORY - I-FAMILY_HISTORY -A B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -control I-PRESENT_ILLNESS -ecográfico I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -pesquisó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -nódulo I-PRESENT_ILLNESS -tiroideo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1, I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -0, I-PRESENT_ILLNESS -9 I-PRESENT_ILLNESS -cm, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -bordes I-PRESENT_ILLNESS -mal I-PRESENT_ILLNESS -limitados, I-PRESENT_ILLNESS -heterogéneo, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -calcificaciones I-PRESENT_ILLNESS -múltiples I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -interior, I-PRESENT_ILLNESS -se B-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -por I-EXPLORATION -punción I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina I-EXPLORATION -cuya I-EXPLORATION -histología I-EXPLORATION -fue I-EXPLORATION -compatible I-EXPLORATION +Se I-EXPLORATION +completó I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION con I-EXPLORATION -carcinoma I-EXPLORATION -papilar, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -tiroidectomia I-TREATMENT -total I-TREATMENT -con I-TREATMENT -vaciamiento I-TREATMENT -ganglionar I-TREATMENT -cervical I-TREATMENT -anterior. I-TREATMENT -La B-EXPLORATION -biopsia I-EXPLORATION -confirmó I-EXPLORATION -un I-EXPLORATION -Carcinoma I-EXPLORATION -papilar I-EXPLORATION -de I-EXPLORATION -tiroides I-EXPLORATION -unifocal, I-EXPLORATION -variedad I-EXPLORATION -usual, I-EXPLORATION -sin I-EXPLORATION -infiltración I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -peritiroideo, I-EXPLORATION -sin I-EXPLORATION -permeaciones I-EXPLORATION -linfovasculares I-EXPLORATION -ni I-EXPLORATION -compromiso I-EXPLORATION +gammagrafía I-EXPLORATION +ósea, I-EXPLORATION +apreciando I-EXPLORATION +lesiones I-EXPLORATION +óseas I-EXPLORATION +sugerentes I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -linfonodos I-EXPLORATION -evaluados, I-EXPLORATION -bordes I-EXPLORATION -quirúrgicos I-EXPLORATION -negativos I-EXPLORATION +malignidad I-EXPLORATION +en I-EXPLORATION +hueso I-EXPLORATION +maxilar I-EXPLORATION +superior I-EXPLORATION +izquierdo, I-EXPLORATION +pelvis I-EXPLORATION +derecha, I-EXPLORATION +séptima I-EXPLORATION +vértebra I-EXPLORATION +dorsal I-EXPLORATION y I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -tiroideo I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -tiroiditis I-EXPLORATION -crónica I-EXPLORATION -difusa. I-EXPLORATION -De B-TREATMENT -acuerdo I-TREATMENT -a I-TREATMENT -protocolo I-TREATMENT -a I-TREATMENT -continuación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tiroidectomía I-TREATMENT -se I-TREATMENT -aplicó I-TREATMENT -Radio I-TREATMENT -yodo I-TREATMENT -100 I-TREATMENT -mCi I-TREATMENT -a I-TREATMENT -los I-TREATMENT -25 I-TREATMENT -días I-TREATMENT -post I-TREATMENT -cirugía I-TREATMENT -con I-TREATMENT -rastreo I-TREATMENT -terapéutico I-TREATMENT -posterior I-TREATMENT -negativo. I-TREATMENT -Permanece B-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION +parrilla I-EXPLORATION +costal I-EXPLORATION +derecha. I-EXPLORATION +Cuando B-EVOLUTION +se I-EVOLUTION +terminó I-EVOLUTION de I-EVOLUTION -recidiva, I-EVOLUTION -con I-EVOLUTION -Tiroglobulinas I-EVOLUTION -< I-EVOLUTION -0, I-EVOLUTION -2 I-EVOLUTION -ng/ml I-EVOLUTION +completar I-EVOLUTION +el I-EVOLUTION +estudio I-EVOLUTION +(dos I-EVOLUTION +semanas I-EVOLUTION +de I-EVOLUTION +duración I-EVOLUTION +desde I-EVOLUTION +la I-EVOLUTION +primera I-EVOLUTION +consulta I-EVOLUTION +y I-EVOLUTION +toma I-EVOLUTION +de I-EVOLUTION +biopsia I-EVOLUTION +intraoral), I-EVOLUTION +la I-EVOLUTION +lesión I-EVOLUTION +intraoral I-EVOLUTION +había I-EVOLUTION +crecido I-EVOLUTION +enormemente, I-EVOLUTION +presentando I-EVOLUTION +áreas I-EVOLUTION +necróticas I-EVOLUTION +y I-EVOLUTION +afectando I-EVOLUTION +a I-EVOLUTION +todo I-EVOLUTION +el I-EVOLUTION +fondo I-EVOLUTION +vestibular I-EVOLUTION +superior I-EVOLUTION +izquierdo, I-EVOLUTION +encía I-EVOLUTION +y I-EVOLUTION +paladar I-EVOLUTION +duro I-EVOLUTION +izquierdo, I-EVOLUTION +presentando I-EVOLUTION +así I-EVOLUTION +mismo I-EVOLUTION +impotencia I-EVOLUTION +funcional I-EVOLUTION en I-EVOLUTION -controles I-EVOLUTION -posteriores I-EVOLUTION -con I-EVOLUTION -1 I-EVOLUTION -año I-EVOLUTION -4 I-EVOLUTION -meses I-EVOLUTION +pierna I-EVOLUTION +derecha I-EVOLUTION +que I-EVOLUTION +le I-EVOLUTION +impedía I-EVOLUTION +una I-EVOLUTION +correcta I-EVOLUTION +deambulación. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +murió I-EVOLUTION de I-EVOLUTION -seguimiento. I-EVOLUTION +forma I-EVOLUTION +repentina I-EVOLUTION +tras I-EVOLUTION +presentar I-EVOLUTION +hemorragia I-EVOLUTION +masiva I-EVOLUTION +por I-EVOLUTION +cavidad I-EVOLUTION +oral. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -14 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-FAMILY_HISTORY -antecedente I-FAMILY_HISTORY -familiar I-FAMILY_HISTORY -de I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -con I-FAMILY_HISTORY -carcinoma I-FAMILY_HISTORY -papilar I-FAMILY_HISTORY -de I-FAMILY_HISTORY -tiroides I-FAMILY_HISTORY -operado. I-FAMILY_HISTORY -A B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -13 I-PRESENT_ILLNESS +43 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -realizó I-PRESENT_ILLNESS -ecografía I-PRESENT_ILLNESS -tiroídea I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -bocio I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -describe I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -sugerente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -neoplasia I-PRESENT_ILLNESS -tiroídea I-PRESENT_ILLNESS -extensa I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +hipogástrico, I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +diarrea I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -mayor I-PRESENT_ILLNESS -parte I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -glándula, I-PRESENT_ILLNESS -nódulo I-PRESENT_ILLNESS -dominante I-PRESENT_ILLNESS -lóbulo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -adenopatías I-PRESENT_ILLNESS -supraclaviculares I-PRESENT_ILLNESS -izquierdas. I-PRESENT_ILLNESS -Teniendo B-TREATMENT -en I-TREATMENT -cuenta I-TREATMENT -sus I-TREATMENT -antecedentes I-TREATMENT -familiares, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -tiroidectomía I-TREATMENT -total I-TREATMENT -sin I-TREATMENT -punción I-TREATMENT -tiroídea I-TREATMENT -previa, I-TREATMENT -cuya I-TREATMENT -biopsia I-TREATMENT -contemporánea I-TREATMENT -y I-TREATMENT -definitiva I-TREATMENT -confirmaron I-TREATMENT -carcinoma I-TREATMENT -papilar I-TREATMENT -de I-TREATMENT -tiroides I-TREATMENT -en I-TREATMENT -lóbulo I-TREATMENT -izquierdo, I-TREATMENT -itsmo I-TREATMENT -y I-TREATMENT -lóbulo I-TREATMENT -derecho, I-TREATMENT -variante I-TREATMENT -esclerosante I-TREATMENT -difusa I-TREATMENT -que I-TREATMENT -infiltraba I-TREATMENT -el I-TREATMENT -tejido I-TREATMENT -peritiroideo I-TREATMENT -con I-TREATMENT -múltiples I-TREATMENT -permeaciones I-TREATMENT -vasculares I-TREATMENT -y I-TREATMENT -compromiso I-TREATMENT -ganglionar. I-TREATMENT - I-TREATMENT -A I-TREATMENT -continuación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -Tiroidectomía I-TREATMENT -se I-TREATMENT -trató I-TREATMENT -a I-TREATMENT -los I-TREATMENT -30 I-TREATMENT -días I-TREATMENT -con I-TREATMENT -radio I-TREATMENT -yodo I-TREATMENT -150 I-TREATMENT -mCi; I-TREATMENT -el B-EXPLORATION -rastreo I-EXPLORATION -sistémico I-EXPLORATION -terapéutico I-EXPLORATION -mostró I-EXPLORATION -sólo I-EXPLORATION -tejido I-EXPLORATION -captante I-EXPLORATION -en I-EXPLORATION -remanente I-EXPLORATION -tiroideo. I-EXPLORATION -Sin I-EXPLORATION -embargo, I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION +evolución. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +presenta I-EXPLORATION +una I-EXPLORATION +temperatura I-EXPLORATION +de I-EXPLORATION +37, I-EXPLORATION 3 I-EXPLORATION -meses I-EXPLORATION -post I-EXPLORATION -tiroidectomía I-EXPLORATION -se I-EXPLORATION -pesquisó I-EXPLORATION -clínicamente I-EXPLORATION +ºC, I-EXPLORATION +115 I-EXPLORATION +lat./min, I-EXPLORATION +tensión I-EXPLORATION +arterial I-EXPLORATION +130/80 I-EXPLORATION +mmHg, I-EXPLORATION +dolor I-EXPLORATION +hipogástrico I-EXPLORATION y I-EXPLORATION -mediante I-EXPLORATION -ecografía, I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +irritación I-EXPLORATION +peritoneal. I-EXPLORATION +Analítica: I-EXPLORATION +leucocitos I-EXPLORATION +18.000µ/l I-EXPLORATION +y I-EXPLORATION +fibrinógeno I-EXPLORATION +939, I-EXPLORATION +9 I-EXPLORATION +mg/dl. I-EXPLORATION + I-EXPLORATION +TAC I-EXPLORATION +abdominal: I-EXPLORATION +el I-EXPLORATION +duodeno I-EXPLORATION +presenta I-EXPLORATION +malrotación, I-EXPLORATION +haciendo I-EXPLORATION un I-EXPLORATION -nódulo I-EXPLORATION -en I-EXPLORATION -lecho I-EXPLORATION -tiroideo I-EXPLORATION -derecho I-EXPLORATION +tirabuzón I-EXPLORATION +alrededor I-EXPLORATION +del I-EXPLORATION +eje I-EXPLORATION +venoso I-EXPLORATION +mesentérico. I-EXPLORATION +Se I-EXPLORATION +observa I-EXPLORATION +una I-EXPLORATION +colección I-EXPLORATION con I-EXPLORATION -recidiva I-EXPLORATION -ganglionar I-EXPLORATION -cervical, I-EXPLORATION +burbujas I-EXPLORATION +de I-EXPLORATION +gas I-EXPLORATION +y I-EXPLORATION +líquido I-EXPLORATION +que I-EXPLORATION +engloba I-EXPLORATION +asas I-EXPLORATION +de I-EXPLORATION +intestino I-EXPLORATION +delgado I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -mediante I-EXPLORATION -biopsia I-EXPLORATION -por I-EXPLORATION -punción I-EXPLORATION -metástasis I-EXPLORATION +proximidad I-EXPLORATION +al I-EXPLORATION +fundus I-EXPLORATION +uterino I-EXPLORATION +y I-EXPLORATION +receso I-EXPLORATION +vesicouterino, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +apéndice I-EXPLORATION +inflamado I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +afectación I-EXPLORATION de I-EXPLORATION -carcinoma I-EXPLORATION -papilar I-EXPLORATION +la I-EXPLORATION +grasa I-EXPLORATION +periapendicular I-EXPLORATION en I-EXPLORATION -ganglios I-EXPLORATION -del I-EXPLORATION -grupo I-EXPLORATION -IIA, I-EXPLORATION -II, I-EXPLORATION -IV, I-EXPLORATION -VD, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT +el I-EXPLORATION +cuadrante I-EXPLORATION +inferior I-EXPLORATION +izquierdo. I-EXPLORATION + I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +es I-TREATMENT +intervenida I-TREATMENT +quirúrgicamente, I-TREATMENT +encontrándose I-TREATMENT +la I-TREATMENT +malrotación I-TREATMENT +intestinal I-TREATMENT +descrita I-TREATMENT +con I-TREATMENT +el I-TREATMENT +duodeno I-TREATMENT +en I-TREATMENT +el I-TREATMENT +lado I-TREATMENT +derecho I-TREATMENT +y I-TREATMENT +el I-TREATMENT +ciego I-TREATMENT +descansando I-TREATMENT +en I-TREATMENT +el I-TREATMENT +cuadrante I-TREATMENT +superior I-TREATMENT +izquierdo I-TREATMENT +del I-TREATMENT +abdomen. I-TREATMENT +El I-TREATMENT +apéndice I-TREATMENT se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -reintervención I-TREATMENT -quirúrgica. I-TREATMENT -Evoluciona I-TREATMENT +encuentra I-TREATMENT +inflamado I-TREATMENT con I-TREATMENT -persistencia I-TREATMENT -imagenológica B-EVOLUTION -de I-EVOLUTION -lesión I-EVOLUTION -ganglionar I-EVOLUTION -cervical I-EVOLUTION -sospechosa I-EVOLUTION -de I-EVOLUTION -recidiva I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -9 I-EVOLUTION -meses I-EVOLUTION -postiroidectomia I-EVOLUTION +un I-TREATMENT +importante I-TREATMENT +absceso I-TREATMENT +pélvico I-TREATMENT +asociado. I-TREATMENT +Realizamos I-TREATMENT +apendicectomía, I-TREATMENT +drenaje I-TREATMENT +de I-TREATMENT +absceso I-TREATMENT +pélvico I-TREATMENT +y I-TREATMENT +liberación I-TREATMENT +de I-TREATMENT +asas I-TREATMENT +de I-TREATMENT +intestino I-TREATMENT +delgado I-TREATMENT +previa I-TREATMENT +sección I-TREATMENT +de I-TREATMENT +las I-TREATMENT +bandas I-TREATMENT +de I-TREATMENT +Ladd. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION se I-EVOLUTION -decidió I-EVOLUTION -aplicar I-EVOLUTION +recupera I-EVOLUTION +satisfactoriamente I-EVOLUTION +tras I-EVOLUTION una I-EVOLUTION -segunda I-EVOLUTION -dosis I-EVOLUTION -de I-EVOLUTION -radio I-EVOLUTION -yodo I-EVOLUTION -150 I-EVOLUTION -mCi I-EVOLUTION -con I-EVOLUTION -exploración I-EVOLUTION -sistémica I-EVOLUTION -terapéutica I-EVOLUTION -que I-EVOLUTION -mostró I-EVOLUTION -aumento I-EVOLUTION -de I-EVOLUTION -captación I-EVOLUTION -en I-EVOLUTION -región I-EVOLUTION -cervical I-EVOLUTION -anterior I-EVOLUTION -compatible I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -lesión I-EVOLUTION -nodular I-EVOLUTION -visible I-EVOLUTION -ecográficamente. I-EVOLUTION -Esta I-EVOLUTION -lesión I-EVOLUTION -ha I-EVOLUTION -disminuido I-EVOLUTION -de I-EVOLUTION -tamaño I-EVOLUTION -en I-EVOLUTION -controles I-EVOLUTION -posteriores I-EVOLUTION -con I-EVOLUTION -1 I-EVOLUTION -año I-EVOLUTION -3 I-EVOLUTION -meses I-EVOLUTION +semana I-EVOLUTION de I-EVOLUTION -seguimiento I-EVOLUTION -y B-TREATMENT -persiste I-TREATMENT -con I-TREATMENT -Tiroglobulinas I-TREATMENT -< I-TREATMENT -0, I-TREATMENT -5 I-TREATMENT -ng/ml. I-TREATMENT +ingreso I-EVOLUTION +con B-TREATMENT +tratamiento I-TREATMENT +antibiótico. I-TREATMENT I-TREATMENT -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -previamente B-PAST_MEDICAL_HISTORY -sana, I-PAST_MEDICAL_HISTORY -tercera I-PAST_MEDICAL_HISTORY -hija I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -matrimonio I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -consanguíneo, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -familiares I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -epilepsia I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -AE. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY +En B-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +2001, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +produce I-PAST_MEDICAL_HISTORY un I-PAST_MEDICAL_HISTORY -ruido I-PAST_MEDICAL_HISTORY -fuerte, I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY +altercado I-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY un I-PAST_MEDICAL_HISTORY -evento I-PAST_MEDICAL_HISTORY -descrito I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -llanto I-PAST_MEDICAL_HISTORY -intenso, I-PAST_MEDICAL_HISTORY -persistente, I-PAST_MEDICAL_HISTORY -apnea I-PAST_MEDICAL_HISTORY -espiratoria, I-PAST_MEDICAL_HISTORY -cianosis, I-PAST_MEDICAL_HISTORY -desviación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY +agente I-PAST_MEDICAL_HISTORY +policial I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +joven I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -mirada I-PAST_MEDICAL_HISTORY -pérdida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -conciencia I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipotonía. I-PAST_MEDICAL_HISTORY -Remitió I-PAST_MEDICAL_HISTORY -espontáneamente I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY +localidad I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -unos I-PAST_MEDICAL_HISTORY -segundos I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -vigilia I-PAST_MEDICAL_HISTORY -normal I-PAST_MEDICAL_HISTORY -luego I-PAST_MEDICAL_HISTORY +Bilbao. I-PAST_MEDICAL_HISTORY +Como I-PAST_MEDICAL_HISTORY +consecuencia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY este I-PAST_MEDICAL_HISTORY -evento. I-PAST_MEDICAL_HISTORY -Estos I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -continuaron I-PAST_MEDICAL_HISTORY -haciéndose I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -frecuentes I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -intensos, I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -3-5 I-PAST_MEDICAL_HISTORY +altercado I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +joven I-PAST_MEDICAL_HISTORY +sufre I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +herida I-PAST_MEDICAL_HISTORY por I-PAST_MEDICAL_HISTORY -día I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -seguidos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -compromiso I-PAST_MEDICAL_HISTORY +arma I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -conciencia I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipotonía, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -consultó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -neurología I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -realizó I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -EEG I-PAST_MEDICAL_HISTORY -estándar I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY +fuego I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +nalga I-PAST_MEDICAL_HISTORY +izquierda. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +disparo I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +producido I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +arma I-PAST_MEDICAL_HISTORY +reglamentaria I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +agente I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +munición I-PAST_MEDICAL_HISTORY +utilizada I-PAST_MEDICAL_HISTORY fue I-PAST_MEDICAL_HISTORY -informado I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -normal. I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +único I-PAST_MEDICAL_HISTORY +proyectil I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +9 I-PAST_MEDICAL_HISTORY +mm I-PAST_MEDICAL_HISTORY +Parabellum I-PAST_MEDICAL_HISTORY +Sako-Luger I-PAST_MEDICAL_HISTORY +KPO I-PAST_MEDICAL_HISTORY +[1]. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY +Las I-PAST_MEDICAL_HISTORY +declaraciones I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +agente I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +lesionado I-PAST_MEDICAL_HISTORY +fueron I-PAST_MEDICAL_HISTORY +contradictorias. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +agente I-PAST_MEDICAL_HISTORY +relató I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +joven, I-PAST_MEDICAL_HISTORY +sentado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +asiento I-PAST_MEDICAL_HISTORY +posterior I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +dentro I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +turismo, I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +encaró I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +arma I-PAST_MEDICAL_HISTORY +hallándose I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +agente I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +exterior I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +vehículo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +puerta I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +mismo I-PAST_MEDICAL_HISTORY +abierta. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY una I-PAST_MEDICAL_HISTORY -caída I-PAST_MEDICAL_HISTORY +actitud I-PAST_MEDICAL_HISTORY +defensiva, I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +agente I-PAST_MEDICAL_HISTORY +relata I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +disparó I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +lesionado I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +hallaba I-PAST_MEDICAL_HISTORY +dentro I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +vehículo I-PAST_MEDICAL_HISTORY +y, I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +disparo, I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +arrastró I-PAST_MEDICAL_HISTORY +fuera I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +turismo. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +momento I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +disparo I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY el I-PAST_MEDICAL_HISTORY -piso, I-PAST_MEDICAL_HISTORY -nuevamente I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -llanto, I-PAST_MEDICAL_HISTORY -apnea I-PAST_MEDICAL_HISTORY -espiratoria, I-PAST_MEDICAL_HISTORY -cianosis I-PAST_MEDICAL_HISTORY -seguida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pérdida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -conciencia, I-PAST_MEDICAL_HISTORY -hipotonía I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY +escenario I-PAST_MEDICAL_HISTORY +nº I-PAST_MEDICAL_HISTORY +1, I-PAST_MEDICAL_HISTORY +correspondiente I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +declaraciones I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +agente, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +esquematiza I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY +imagen I-PAST_MEDICAL_HISTORY +nº I-PAST_MEDICAL_HISTORY +1. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +declaraciones I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +lesionado I-PAST_MEDICAL_HISTORY +indicó I-PAST_MEDICAL_HISTORY que I-PAST_MEDICAL_HISTORY +hallándose I-PAST_MEDICAL_HISTORY +sentado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +asiento I-PAST_MEDICAL_HISTORY +trasero I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +vehículo, I-PAST_MEDICAL_HISTORY se I-PAST_MEDICAL_HISTORY -agregó I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -crisis I-PAST_MEDICAL_HISTORY -tónico I-PAST_MEDICAL_HISTORY -clónica I-PAST_MEDICAL_HISTORY -generalizada I-PAST_MEDICAL_HISTORY +abrió I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +puerta I-PAST_MEDICAL_HISTORY +posterior I-PAST_MEDICAL_HISTORY +izquierda I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +mismo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +arrastrado I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +asfalto I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -min I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +carretera I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +agente I-PAST_MEDICAL_HISTORY +policial, I-PAST_MEDICAL_HISTORY +cayendo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +él I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +decúbito I-PAST_MEDICAL_HISTORY +prono I-PAST_MEDICAL_HISTORY +sobre I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +manos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +quedando I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +pies I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +interior I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +turismo. I-PAST_MEDICAL_HISTORY +Una I-PAST_MEDICAL_HISTORY +vez I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +suelo, I-PAST_MEDICAL_HISTORY +escuchó I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sintió I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +disparo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +región I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -duración. I-PAST_MEDICAL_HISTORY -Ingresó B-EXPLORATION -al I-EXPLORATION -servicio I-EXPLORATION -de I-EXPLORATION -urgencia I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -lactante I-EXPLORATION -vigil, I-EXPLORATION -con I-EXPLORATION -buen I-EXPLORATION -desarrollo I-EXPLORATION -psicomotor. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -hemograma I-EXPLORATION -que I-EXPLORATION -descartó I-EXPLORATION -anemia, I-EXPLORATION -sin I-EXPLORATION -microcitosis, I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -cinética I-EXPLORATION -de I-EXPLORATION -fierro I-EXPLORATION -normal, I-EXPLORATION -electroencefalograma I-EXPLORATION -(EEG) I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -de I-EXPLORATION -cerebro I-EXPLORATION -normal. I-EXPLORATION -Se B-EVOLUTION -dió I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -apnea I-EVOLUTION -emotiva I-EVOLUTION -cianótica I-EVOLUTION -grave. I-EVOLUTION -Se I-EVOLUTION -solicitó I-EVOLUTION -controles I-EVOLUTION -ambulatorios. I-EVOLUTION - I-EVOLUTION -Posterior I-EVOLUTION -al I-EVOLUTION -alta I-EVOLUTION -persistió I-EVOLUTION -con I-EVOLUTION -AE I-EVOLUTION -de I-EVOLUTION -frecuencia I-EVOLUTION -diaria, I-EVOLUTION -con I-EVOLUTION -intensidades I-EVOLUTION -de I-EVOLUTION -leves I-EVOLUTION -a I-EVOLUTION -graves. I-EVOLUTION -El B-TREATMENT -estudio I-TREATMENT -de I-TREATMENT -cinética I-TREATMENT -de I-TREATMENT -fierro I-TREATMENT -fue I-TREATMENT -normal, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -piracetam I-TREATMENT -dosis I-TREATMENT -40 I-TREATMENT -mg/kg I-TREATMENT -día I-TREATMENT -fraccionado I-TREATMENT -en I-TREATMENT -dos I-TREATMENT -dosis I-TREATMENT -por I-TREATMENT -4 I-TREATMENT -meses. I-TREATMENT -En B-EVOLUTION -controles I-EVOLUTION -posteriores I-EVOLUTION -se I-EVOLUTION -pudo I-EVOLUTION -verificar I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -frecuencia I-EVOLUTION -e I-EVOLUTION -intensidad I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -crisis, I-EVOLUTION -con I-EVOLUTION -sólo I-EVOLUTION -2 I-EVOLUTION -apneas I-EVOLUTION -emotivas I-EVOLUTION -con I-EVOLUTION -leve I-EVOLUTION -cianosis I-EVOLUTION -y I-EVOLUTION -recuperación I-EVOLUTION -espontánea. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -nacida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -término I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cesárea, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -fisiológico. I-PAST_MEDICAL_HISTORY -Sus B-PRESENT_ILLNESS -padres I-PRESENT_ILLNESS -consultaron I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Unidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Ginecología I-PRESENT_ILLNESS -Infantil I-PRESENT_ILLNESS +la I-PAST_MEDICAL_HISTORY +nalga I-PAST_MEDICAL_HISTORY +izquierda. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +momento I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +disparo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +escenario I-PAST_MEDICAL_HISTORY +nº I-PAST_MEDICAL_HISTORY +2, I-PAST_MEDICAL_HISTORY +correspondiente I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +declaraciones I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +lesionado, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +recoge I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +imagen I-PAST_MEDICAL_HISTORY +nº I-PAST_MEDICAL_HISTORY +2. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +HALLAZGOS B-PRESENT_ILLNESS +EXPLORATORIOS I-PRESENT_ILLNESS +Y I-PRESENT_ILLNESS +PRUEBAS I-PRESENT_ILLNESS +COMPLEMENTARIAS: I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +lesionado I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +visto I-PRESENT_ILLNESS por I-PRESENT_ILLNESS +primera I-PRESENT_ILLNESS +vez I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -presencia I-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS +médico I-PRESENT_ILLNESS +forense I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -abertura I-PRESENT_ILLNESS -entre I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -vagina I-PRESENT_ILLNESS +Bilbao I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +hechos, I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +estancia I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +hospitalario I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -ano I-PRESENT_ILLNESS -detectada I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -nacimiento I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +asistencia I-PRESENT_ILLNESS +urgente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -evolucionó I-PRESENT_ILLNESS -asintomática. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -general I-EXPLORATION +no I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +realizó I-PRESENT_ILLNESS +extracción I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +proyectil. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +en I-EXPLORATION +esta I-EXPLORATION +clínica I-EXPLORATION +médico I-EXPLORATION +forense I-EXPLORATION se I-EXPLORATION -constató I-EXPLORATION -una I-EXPLORATION -paciente I-EXPLORATION +apreciaba I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +cicatriz I-EXPLORATION +oval I-EXPLORATION +de I-EXPLORATION +1 I-EXPLORATION +x I-EXPLORATION +1.5 I-EXPLORATION +cms I-EXPLORATION en I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -nutricional I-EXPLORATION -y I-EXPLORATION +flanco I-EXPLORATION +posterior I-EXPLORATION +izquierdo I-EXPLORATION +(imagen I-EXPLORATION +3). I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +estudios I-EXPLORATION +radiográficos I-EXPLORATION +realizados I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION -dirigida I-EXPLORATION +su I-EXPLORATION +asistencia I-EXPLORATION +en I-EXPLORATION +urgencias I-EXPLORATION +(radiografías I-EXPLORATION +simples I-EXPLORATION +AP I-EXPLORATION +y I-EXPLORATION +laterales I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -genitales I-EXPLORATION -destacaron I-EXPLORATION -los I-EXPLORATION -labios I-EXPLORATION -mayores I-EXPLORATION -prominentes, I-EXPLORATION -himen I-EXPLORATION -rosado I-EXPLORATION -redundante I-EXPLORATION +pelvis I-EXPLORATION y I-EXPLORATION -permeable. I-EXPLORATION -El I-EXPLORATION -periné I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -lineal I-EXPLORATION -entre I-EXPLORATION +TAC I-EXPLORATION +pélvico) I-EXPLORATION +indicaban I-EXPLORATION la I-EXPLORATION -horquilla I-EXPLORATION -vulvar I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -ano, I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -aspecto I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -cortante I-EXPLORATION -cubierta I-EXPLORATION -por I-EXPLORATION -mucosa I-EXPLORATION -eritematosa I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -orificio I-EXPLORATION -anal I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -y I-EXPLORATION -posición I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -palpó I-EXPLORATION -botón I-EXPLORATION -mamario I-EXPLORATION -sin I-EXPLORATION -galactorrea I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -general I-EXPLORATION -estaba I-EXPLORATION -dentro I-EXPLORATION +varios I-EXPLORATION +fragmentos I-EXPLORATION +radiopacos I-EXPLORATION +irregulares I-EXPLORATION de I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION -Se B-TREATMENT -indicó I-TREATMENT -aseo I-TREATMENT -con I-TREATMENT -agua I-TREATMENT -y I-TREATMENT -lubricación I-TREATMENT -con I-TREATMENT -vaselina I-TREATMENT -sólida I-TREATMENT -en I-TREATMENT -cada I-TREATMENT -muda. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -control I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -4 I-EVOLUTION -meses I-EVOLUTION -la I-EVOLUTION -madre I-EVOLUTION -señaló I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -lesión I-EVOLUTION -había I-EVOLUTION -evolucionado I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION -y B-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION +diversos I-EXPLORATION +tamaños I-EXPLORATION +localizados I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +glútea I-EXPLORATION +izquierda I-EXPLORATION +(imagen I-EXPLORATION +4). I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -constató I-EXPLORATION -epitelización I-EXPLORATION -del I-EXPLORATION -surco I-EXPLORATION -perineal. I-EXPLORATION +apreciaban I-EXPLORATION +lesiones I-EXPLORATION +óseas I-EXPLORATION +asociadas. I-EXPLORATION I-EXPLORATION - -Escolar B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -junto I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -madre I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ardor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -área I-PRESENT_ILLNESS -genital I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -perineal I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -secreción I-PRESENT_ILLNESS -blanca, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -mal I-PRESENT_ILLNESS -olor, I-PRESENT_ILLNESS -diariamente I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -aproximadamente. I-PRESENT_ILLNESS -Tenía B-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -presentado I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -fisura I-PAST_MEDICAL_HISTORY -anogenital I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -período I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -lactante I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -mantuvo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -observación I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -período I-PAST_MEDICAL_HISTORY -breve I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -completar I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -alta. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -realizaba I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -aseo I-PAST_MEDICAL_HISTORY -genital I-PAST_MEDICAL_HISTORY -diariamente I-PAST_MEDICAL_HISTORY -sólo I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -agua I-PAST_MEDICAL_HISTORY -presentado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -sangrado I-PAST_MEDICAL_HISTORY -escaso I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -secar I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -perineal. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -infección I-PAST_MEDICAL_HISTORY -urinaria, I-PAST_MEDICAL_HISTORY -constipación, I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -desarrollo I-PAST_MEDICAL_HISTORY -puberal. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION +Dos B-TREATMENT +años I-TREATMENT +después I-TREATMENT +de I-TREATMENT +los I-TREATMENT +hechos, I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +la I-TREATMENT +extracción I-TREATMENT +quirúrgica I-TREATMENT +de I-TREATMENT +dos I-TREATMENT +fragmentos I-TREATMENT +de I-TREATMENT +proyectil I-TREATMENT +de I-TREATMENT +la I-TREATMENT +nalga I-TREATMENT +izquierda. I-TREATMENT +El I-TREATMENT +médico I-TREATMENT +forense I-TREATMENT +se I-TREATMENT +halla I-TREATMENT +presente I-TREATMENT +en I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +y I-TREATMENT +los I-TREATMENT +fragmentos I-TREATMENT +son I-TREATMENT +recogidos I-TREATMENT +y, I-TREATMENT +sin I-TREATMENT +manipulación I-TREATMENT +previa, I-TREATMENT +remitidos I-TREATMENT +para I-TREATMENT +estudio I-TREATMENT +balístico. I-TREATMENT + I-TREATMENT +Se B-EXPLORATION +practicaron I-EXPLORATION +diversas I-EXPLORATION +pruebas I-EXPLORATION +complementarias: I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Estudio I-EXPLORATION +criminalístico I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +prendas I-EXPLORATION +del I-EXPLORATION +lesionado: I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -eutrófica, I-EXPLORATION +camiseta I-EXPLORATION +del I-EXPLORATION +lesionado I-EXPLORATION +indicó I-EXPLORATION +que I-EXPLORATION +existía I-EXPLORATION +un I-EXPLORATION +orifico I-EXPLORATION +de I-EXPLORATION +disparo I-EXPLORATION con I-EXPLORATION -mamas I-EXPLORATION +dos I-EXPLORATION +grandes I-EXPLORATION +desgarros I-EXPLORATION +radiales, I-EXPLORATION +ahumamiento I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +bordes I-EXPLORATION +(imagen I-EXPLORATION +5) I-EXPLORATION y I-EXPLORATION -vello I-EXPLORATION -púbico I-EXPLORATION -en I-EXPLORATION -Tanner I-EXPLORATION -I. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -genital I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION +con I-EXPLORATION un I-EXPLORATION -himen I-EXPLORATION -redundante I-EXPLORATION -permeable, I-EXPLORATION -rojo, I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +residuos I-EXPLORATION +de I-EXPLORATION +plomo, I-EXPLORATION +bario I-EXPLORATION y I-EXPLORATION -un I-EXPLORATION -surco I-EXPLORATION -mucoso I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -horquilla I-EXPLORATION -vulvar I-EXPLORATION -hasta I-EXPLORATION +antimomio I-EXPLORATION +que I-EXPLORATION +indicaron I-EXPLORATION +que I-EXPLORATION el I-EXPLORATION -ano, I-EXPLORATION -sensible I-EXPLORATION -al I-EXPLORATION -tacto. I-EXPLORATION -Se I-EXPLORATION -diagnosticó I-EXPLORATION -un I-EXPLORATION -surco I-EXPLORATION -perineal I-EXPLORATION -asociado I-EXPLORATION +disparo I-EXPLORATION +pudo I-EXPLORATION +ser I-EXPLORATION +producido I-EXPLORATION a I-EXPLORATION -una I-EXPLORATION -vulvovaginitis I-EXPLORATION -inespecífica. I-EXPLORATION -Se I-EXPLORATION -tomaron I-EXPLORATION -muestras I-EXPLORATION -para I-EXPLORATION -cultivo I-EXPLORATION -vaginal I-EXPLORATION -cuyo I-EXPLORATION -resultado I-EXPLORATION -arrojó I-EXPLORATION -flora I-EXPLORATION -comensal. I-EXPLORATION -Se B-TREATMENT -sugirió I-TREATMENT -resección I-TREATMENT -quirúrgica I-TREATMENT -del I-TREATMENT -surco, I-TREATMENT -pero I-TREATMENT -la I-TREATMENT -familia I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -prueba I-TREATMENT -terapéutica I-TREATMENT -con I-TREATMENT -lubricantes I-TREATMENT -tópicos, I-TREATMENT -dado I-TREATMENT -que I-TREATMENT -entendió I-TREATMENT -el I-TREATMENT -carácter I-TREATMENT -benigno I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión. I-TREATMENT - I-TREATMENT - -Recién B-PRESENT_ILLNESS -nacido I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -cesárea I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -38 I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -gestacional I-PRESENT_ILLNESS -debido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -cardiopatía I-PRESENT_ILLNESS -compleja; I-PRESENT_ILLNESS -peso B-EXPLORATION +cañón I-EXPLORATION +tocante I-EXPLORATION +o I-EXPLORATION +a I-EXPLORATION +muy I-EXPLORATION +corta I-EXPLORATION +distancia I-EXPLORATION de I-EXPLORATION -nacimiento I-EXPLORATION -2.860 I-EXPLORATION -g I-EXPLORATION -(p15), I-EXPLORATION -longitud I-EXPLORATION -44 I-EXPLORATION -cm I-EXPLORATION -(p3), I-EXPLORATION -perímetro I-EXPLORATION -cefálico I-EXPLORATION -33 I-EXPLORATION -cm I-EXPLORATION -(p I-EXPLORATION -3). I-EXPLORATION -Padres B-FAMILY_HISTORY -no I-FAMILY_HISTORY -consanguíneos I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -personales I-FAMILY_HISTORY -ni I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -importancia, I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -primigesta I-FAMILY_HISTORY -de I-FAMILY_HISTORY -19 I-FAMILY_HISTORY -años. I-FAMILY_HISTORY - I-FAMILY_HISTORY -A B-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -gestación I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontró I-PAST_MEDICAL_HISTORY -translucencia I-PAST_MEDICAL_HISTORY -nucal I-PAST_MEDICAL_HISTORY -mayor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -p95, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -realizó I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cariotipo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -biopsia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vellosidades I-PAST_MEDICAL_HISTORY -coriales I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -mostró I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -resultado I-PAST_MEDICAL_HISTORY -46, I-PAST_MEDICAL_HISTORY -XY; I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -ecografía I-PAST_MEDICAL_HISTORY -evidenció I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -compleja, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -canal I-PAST_MEDICAL_HISTORY -aurículoventricular I-PAST_MEDICAL_HISTORY -completo, I-PAST_MEDICAL_HISTORY -mientras I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -ecografía I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tercer I-PAST_MEDICAL_HISTORY -trimestre I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -huesos I-PAST_MEDICAL_HISTORY -largos I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontraban I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -p5. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al B-DERIVED_FROM/TO -nacimiento I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -hospitalizado I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cuidados I-DERIVED_FROM/TO -intensivos I-DERIVED_FROM/TO -neonatal. I-DERIVED_FROM/TO -Evaluado B-EXPLORATION -por I-EXPLORATION -genetista I-EXPLORATION -clínico, I-EXPLORATION -quien I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -dismorfológico I-EXPLORATION -describió: I-EXPLORATION -microcefalia, I-EXPLORATION -orejas I-EXPLORATION +la I-EXPLORATION +camiseta. I-EXPLORATION +El I-EXPLORATION +orificio I-EXPLORATION +se I-EXPLORATION +hallaba I-EXPLORATION +situado I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +parte I-EXPLORATION +posterior I-EXPLORATION de I-EXPLORATION -implantación I-EXPLORATION -baja I-EXPLORATION -con I-EXPLORATION -rotación I-EXPLORATION -hacia I-EXPLORATION -atrás, I-EXPLORATION -puente I-EXPLORATION -nasal I-EXPLORATION -deprimido, I-EXPLORATION -pliegue I-EXPLORATION -epicántico I-EXPLORATION -interno, I-EXPLORATION -estrabismo I-EXPLORATION -convergente, I-EXPLORATION +la I-EXPLORATION +camiseta, I-EXPLORATION en I-EXPLORATION -boca I-EXPLORATION -labio I-EXPLORATION -superior I-EXPLORATION -corto I-EXPLORATION -unido I-EXPLORATION -por I-EXPLORATION -frenillos I-EXPLORATION -al I-EXPLORATION -reborde I-EXPLORATION -alveolar, I-EXPLORATION -extremidades I-EXPLORATION -con I-EXPLORATION -huesos I-EXPLORATION -largos I-EXPLORATION -cortos, I-EXPLORATION -rizomelia, I-EXPLORATION -manos I-EXPLORATION -pequeñas, I-EXPLORATION -braquidactilia, I-EXPLORATION -pliegue I-EXPLORATION -palmar I-EXPLORATION -único, I-EXPLORATION -polidactilia I-EXPLORATION -post I-EXPLORATION -axial I-EXPLORATION +su I-EXPLORATION +cuadrante I-EXPLORATION +inferior I-EXPLORATION +izquierdo. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Estudio I-EXPLORATION +del I-EXPLORATION +arma I-EXPLORATION +reglamentaria I-EXPLORATION +utilizada: I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +del I-EXPLORATION +arma I-EXPLORATION +no I-EXPLORATION +permite I-EXPLORATION +identificar I-EXPLORATION +ninguna I-EXPLORATION +anomalía I-EXPLORATION en I-EXPLORATION -miembros I-EXPLORATION -superiores, I-EXPLORATION -polisindactilia I-EXPLORATION -preaxial I-EXPLORATION -bilateral I-EXPLORATION +esta I-EXPLORATION +que I-EXPLORATION +pudiese I-EXPLORATION +haber I-EXPLORATION +producido I-EXPLORATION +alteraciones I-EXPLORATION en I-EXPLORATION -miembros I-EXPLORATION -inferiores I-EXPLORATION -y I-EXPLORATION -uñas I-EXPLORATION -hipoplásicas. I-EXPLORATION +el I-EXPLORATION +proyectil I-EXPLORATION +[2]. I-EXPLORATION I-EXPLORATION -El I-EXPLORATION -ecocardiograma I-EXPLORATION -mostró I-EXPLORATION -canal I-EXPLORATION -aurículo-ventricular, I-EXPLORATION -estenosis I-EXPLORATION -aórtica, I-EXPLORATION -hipoplasia I-EXPLORATION -del I-EXPLORATION -arco I-EXPLORATION -aórtico, I-EXPLORATION -ductus I-EXPLORATION -arterioso I-EXPLORATION -e I-EXPLORATION -hipoplasia I-EXPLORATION -leve I-EXPLORATION +- I-EXPLORATION +Estudio I-EXPLORATION de I-EXPLORATION -arteria I-EXPLORATION -pulmonar I-EXPLORATION -derecha, I-EXPLORATION -también I-EXPLORATION +los I-EXPLORATION +dos I-EXPLORATION +fragmentos I-EXPLORATION +de I-EXPLORATION +proyectil I-EXPLORATION +extraídos I-EXPLORATION +del I-EXPLORATION +cuerpo I-EXPLORATION +del I-EXPLORATION +lesionado: I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -ecografía I-EXPLORATION -transfontanelar I-EXPLORATION +identifican I-EXPLORATION +ambos I-EXPLORATION +fragmentos, I-EXPLORATION +deformados I-EXPLORATION +y I-EXPLORATION +correspondientes I-EXPLORATION +con I-EXPLORATION +los I-EXPLORATION +extremos I-EXPLORATION +del I-EXPLORATION +culote I-EXPLORATION y I-EXPLORATION -renal I-EXPLORATION -que I-EXPLORATION -resultaron I-EXPLORATION -normales; I-EXPLORATION -radiografías I-EXPLORATION de I-EXPLORATION -miembros I-EXPLORATION -inferiores I-EXPLORATION -mostraron I-EXPLORATION -fémur I-EXPLORATION +la I-EXPLORATION +punta I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +proyectil I-EXPLORATION +camisado I-EXPLORATION +tipo I-EXPLORATION +9 I-EXPLORATION +mm. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +superficie I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +fragmentos I-EXPLORATION +se I-EXPLORATION +encuentran I-EXPLORATION +residuos I-EXPLORATION +químicos I-EXPLORATION +de I-EXPLORATION +tejidos I-EXPLORATION +biológicos I-EXPLORATION y I-EXPLORATION +algún I-EXPLORATION +desinfectante, I-EXPLORATION +pero I-EXPLORATION +no I-EXPLORATION +restos I-EXPLORATION +de I-EXPLORATION +silicio. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -tibia I-EXPLORATION -cortos I-EXPLORATION -con I-EXPLORATION -adecuada I-EXPLORATION -osificación, I-EXPLORATION -en I-EXPLORATION -radiografía I-EXPLORATION -toracoabdominal I-EXPLORATION +misma I-EXPLORATION +superficie, I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -tórax I-EXPLORATION -estrecho I-EXPLORATION -al I-EXPLORATION -comparar I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -abdomen I-EXPLORATION +encuentran I-EXPLORATION +surcos I-EXPLORATION +irregulares I-EXPLORATION +y I-EXPLORATION +signos I-EXPLORATION +del I-EXPLORATION +labrado I-EXPLORATION +del I-EXPLORATION +ánima I-EXPLORATION +del I-EXPLORATION +arma. I-EXPLORATION +La I-EXPLORATION +conclusión I-EXPLORATION +del I-EXPLORATION +estudio I-EXPLORATION +indica I-EXPLORATION +que I-EXPLORATION +ha I-EXPLORATION +existido I-EXPLORATION +fragmentación I-EXPLORATION y I-EXPLORATION +rebote I-EXPLORATION +del I-EXPLORATION +proyectil I-EXPLORATION +camisado I-EXPLORATION +9 I-EXPLORATION +mm I-EXPLORATION +contra I-EXPLORATION una I-EXPLORATION -silueta I-EXPLORATION -cardíaca I-EXPLORATION -aumentada I-EXPLORATION +superficie I-EXPLORATION +irregular. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Estudio I-EXPLORATION de I-EXPLORATION -tamaño I-EXPLORATION -al I-EXPLORATION -comparar I-EXPLORATION -con I-EXPLORATION +la I-EXPLORATION +escena I-EXPLORATION +descrita I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -tórax I-EXPLORATION -; I-EXPLORATION +atestado I-EXPLORATION +policial: I-EXPLORATION +según I-EXPLORATION +los I-EXPLORATION +datos I-EXPLORATION +del I-EXPLORATION +atestado I-EXPLORATION +policial, I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -columna I-EXPLORATION +el I-EXPLORATION +lugar I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +hechos I-EXPLORATION no I-EXPLORATION se I-EXPLORATION -observaron I-EXPLORATION -alteraciones I-EXPLORATION -vertebrales. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -suma I-EXPLORATION +apreciaron I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -hallazgos I-EXPLORATION -permitió I-EXPLORATION -diagnosticar I-EXPLORATION +impactos I-EXPLORATION +de I-EXPLORATION +proyectil I-EXPLORATION +ni I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -síndrome I-EXPLORATION +vehículo I-EXPLORATION +ni I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +entorno. I-EXPLORATION +Se I-EXPLORATION +encuentra I-EXPLORATION +un I-EXPLORATION +casquillo I-EXPLORATION de I-EXPLORATION -Ellis I-EXPLORATION -Van I-EXPLORATION -Creveld. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -tuvo I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -desfavorable I-EVOLUTION -falleciendo I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -8 I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -nacido, I-EVOLUTION -por I-EVOLUTION -problemas I-EVOLUTION -secundarios I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -cardiopatía I-EVOLUTION -compleja. I-EVOLUTION - I-EVOLUTION - -Primera B-PRESENT_ILLNESS -hija I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -padres I-PRESENT_ILLNESS -sanos I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -consanguíneos, I-PRESENT_ILLNESS -sin B-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -de I-FAMILY_HISTORY -epilepsia I-FAMILY_HISTORY -en I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -primer I-FAMILY_HISTORY -grado, I-FAMILY_HISTORY -debutó B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -CF I-PRESENT_ILLNESS -hemiclónica I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -min I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -duración, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -paresia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Todd I-PRESENT_ILLNESS -posterior. I-PRESENT_ILLNESS -Las I-PRESENT_ILLNESS -recurrencias I-PRESENT_ILLNESS -fueron I-PRESENT_ILLNESS -frecuentes, I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -focal I-PRESENT_ILLNESS -compleja I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -hemiclónicas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -min I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -menos I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -SE I-PRESENT_ILLNESS -febriles I-PRESENT_ILLNESS -entre I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -mes, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -examen I-PRESENT_ILLNESS -normal I-PRESENT_ILLNESS -post I-PRESENT_ILLNESS -crisis. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La B-EXPLORATION -RM I-EXPLORATION -cerebral3 I-EXPLORATION -fueron I-EXPLORATION -normal, I-EXPLORATION -al I-EXPLORATION -igual I-EXPLORATION +proyectil I-EXPLORATION +sobre I-EXPLORATION +el I-EXPLORATION +asfalto I-EXPLORATION que I-EXPLORATION -múltiples I-EXPLORATION -EEG I-EXPLORATION -standard, I-EXPLORATION -la I-EXPLORATION -cuantificación I-EXPLORATION -de I-EXPLORATION -aminoácidos I-EXPLORATION -en I-EXPLORATION -sangre, I-EXPLORATION -líquido I-EXPLORATION -cefalorraquídeo, I-EXPLORATION -ácidos I-EXPLORATION -orgánicos I-EXPLORATION +coincide I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +supuestamente I-EXPLORATION +disparado I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +agente. I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +estudios I-EXPLORATION +criminalísticos I-EXPLORATION +practicados I-EXPLORATION y I-EXPLORATION -ultramicroscopía I-EXPLORATION +el I-EXPLORATION +análisis I-EXPLORATION de I-EXPLORATION -piel. I-EXPLORATION -A I-EXPLORATION los I-EXPLORATION -6 I-EXPLORATION -meses I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -estudio I-EXPLORATION -molecular I-EXPLORATION +datos I-EXPLORATION +derivados I-EXPLORATION del I-EXPLORATION -gen I-EXPLORATION -SCN1A I-EXPLORATION -confirmándose I-EXPLORATION -mutación I-EXPLORATION -c.5347G>A I-EXPLORATION -(p.Ala1783Thr) I-EXPLORATION -en I-EXPLORATION -estado I-EXPLORATION -heterocigoto I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -exón I-EXPLORATION -26 I-EXPLORATION +examen I-EXPLORATION del I-EXPLORATION -gen. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -molecular I-EXPLORATION +atestado, I-EXPLORATION de I-EXPLORATION -ambos I-EXPLORATION -padres I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -uso I-TREATMENT -de I-TREATMENT -fenobarbital, I-TREATMENT -clobazam, I-TREATMENT -levetiracetam I-TREATMENT -y I-TREATMENT -topiramato, I-TREATMENT -no I-TREATMENT -logró I-TREATMENT -control I-TREATMENT -de I-TREATMENT -crisis. I-TREATMENT -A I-TREATMENT -los I-TREATMENT -9 I-TREATMENT -meses I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -stiripentol I-TREATMENT -dosis I-TREATMENT -50 I-TREATMENT -mg I-TREATMENT -kp I-TREATMENT -día, I-TREATMENT -asociado I-TREATMENT -a I-TREATMENT -topiramato I-TREATMENT -y I-TREATMENT -ácido I-TREATMENT -valproico I-TREATMENT -sin I-TREATMENT -resultados. I-TREATMENT -Entre B-EVOLUTION -los I-EVOLUTION -12-18 I-EVOLUTION -meses I-EVOLUTION -los I-EVOLUTION -múltiples I-EVOLUTION -SE I-EVOLUTION -y I-EVOLUTION -crisis I-EVOLUTION -frecuentes I-EVOLUTION -deterioraron I-EVOLUTION -su I-EVOLUTION -desarrollo I-EVOLUTION -perdiendo I-EVOLUTION -marcha, I-EVOLUTION -control I-EVOLUTION -de I-EVOLUTION -tronco I-EVOLUTION -y I-EVOLUTION -control I-EVOLUTION -cefálico. I-EVOLUTION -Se B-TREATMENT -inició I-TREATMENT -dieta I-TREATMENT -cetogénica I-TREATMENT -la I-TREATMENT -que I-TREATMENT -se I-TREATMENT -asoció I-TREATMENT -a I-TREATMENT -una I-TREATMENT -pancreatitis I-TREATMENT -grave I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -discontinuó. I-TREATMENT - I-TREATMENT -La I-TREATMENT -certificación I-TREATMENT -de I-TREATMENT -alteración I-TREATMENT -deglución I-TREATMENT -y I-TREATMENT -cuadros I-TREATMENT -respiratorios I-TREATMENT -recurrentes I-TREATMENT -febriles I-TREATMENT -que I-TREATMENT -precipitaban I-TREATMENT -los I-TREATMENT -SE I-TREATMENT -plantearon I-TREATMENT -gastrostomía I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -logró I-TREATMENT -disminución I-TREATMENT -de I-TREATMENT -episodios I-TREATMENT -febriles I-TREATMENT -y I-TREATMENT -mejor I-TREATMENT -manejo I-TREATMENT -de I-TREATMENT -las I-TREATMENT -crisis. I-TREATMENT - I-TREATMENT -Posterior I-TREATMENT -a I-TREATMENT -una I-TREATMENT -serie I-TREATMENT -de I-TREATMENT -adecuaciones I-TREATMENT -de I-TREATMENT -fármacos I-TREATMENT -antiepilépticos I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -triasociado I-TREATMENT -con I-TREATMENT -clobazam, I-TREATMENT -topiramato I-TREATMENT -y I-TREATMENT -lacosamida I-TREATMENT -permitió I-TREATMENT -un I-TREATMENT -control I-TREATMENT -parcial I-TREATMENT -de I-TREATMENT -crisis, I-TREATMENT -sin I-TREATMENT -SE I-TREATMENT -en I-TREATMENT -18 I-TREATMENT -meses, I-TREATMENT -con I-TREATMENT -crisis I-TREATMENT -de I-TREATMENT -corta I-TREATMENT -duración I-TREATMENT -(segundos) I-TREATMENT -3-5 I-TREATMENT -por I-TREATMENT -semana I-TREATMENT -que I-TREATMENT -no I-TREATMENT -requerían I-TREATMENT -uso I-TREATMENT -diazepam I-TREATMENT -ni I-TREATMENT -provocaban I-TREATMENT -alteración I-TREATMENT -en I-TREATMENT -actividades I-TREATMENT -de I-TREATMENT -vida I-TREATMENT -diaria. I-TREATMENT - I-TREATMENT - -Tercera B-PRESENT_ILLNESS -hija, I-PRESENT_ILLNESS -embarazo B-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -normal, I-PAST_MEDICAL_HISTORY -sin B-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -de I-FAMILY_HISTORY -epilepsia I-FAMILY_HISTORY -en I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -primer I-FAMILY_HISTORY -grado. I-FAMILY_HISTORY -Inició B-PRESENT_ILLNESS -CF I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -prolongadas, I-PRESENT_ILLNESS -focales, I-PRESENT_ILLNESS -clonías I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hemicara I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -SE I-PRESENT_ILLNESS -febriles I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -mulitples I-PRESENT_ILLNESS -EEG I-PRESENT_ILLNESS -standard I-PRESENT_ILLNESS -normales. I-PRESENT_ILLNESS -A I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -agregan I-PRESENT_ILLNESS -crisis I-PRESENT_ILLNESS -afebriles I-PRESENT_ILLNESS -pero I-PRESENT_ILLNESS -gatilladas I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadros I-PRESENT_ILLNESS -infecciosos. I-PRESENT_ILLNESS -Posterior I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -persistió I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -múltiples I-PRESENT_ILLNESS -crisis I-PRESENT_ILLNESS -afebriles I-PRESENT_ILLNESS -hemigeneralizadas, I-PRESENT_ILLNESS -mioclónicas, I-PRESENT_ILLNESS -ausencias I-PRESENT_ILLNESS -atípicas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tónicas I-PRESENT_ILLNESS -clónicas I-PRESENT_ILLNESS -generalizadas I-PRESENT_ILLNESS -precipitadas I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -foto I-PRESENT_ILLNESS -estimulación. I-PRESENT_ILLNESS -Entre I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -primer I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -segundo I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -SE I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -requirieron I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Unidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuidados I-PRESENT_ILLNESS -intensivos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -hospitalizaciones I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -crisis I-PRESENT_ILLNESS -prolongadas. I-PRESENT_ILLNESS -La B-TREATMENT -triasociación I-TREATMENT -de I-TREATMENT -fenobarbital, I-TREATMENT -ácido I-TREATMENT -valproico I-TREATMENT -y I-TREATMENT -levetiracetam I-TREATMENT -no I-TREATMENT -logró I-TREATMENT -control I-TREATMENT -de I-TREATMENT -crisis. I-TREATMENT -La B-EXPLORATION -RM I-EXPLORATION -cerebral I-EXPLORATION +las I-EXPLORATION +heridas I-EXPLORATION y I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION estudios I-EXPLORATION -metabólicos I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Evolucionó B-EVOLUTION -con I-EVOLUTION -retraso I-EVOLUTION -de I-EVOLUTION -lenguaje, I-EVOLUTION -compromiso I-EVOLUTION -motor I-EVOLUTION -de I-EVOLUTION -menor I-EVOLUTION -cuantía I-EVOLUTION -y I-EVOLUTION -microcefalia. I-EVOLUTION -A B-EXPLORATION -la I-EXPLORATION -edad I-EXPLORATION de I-EXPLORATION -3 I-EXPLORATION -años I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -estudio I-EXPLORATION -molecular I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -SCN1A I-EXPLORATION +imagen, I-EXPLORATION +permitieron I-EXPLORATION +establecer I-EXPLORATION que I-EXPLORATION -confirmó I-EXPLORATION +el I-EXPLORATION +disparo I-EXPLORATION +practicado I-EXPLORATION +había I-EXPLORATION +presentado I-EXPLORATION +las I-EXPLORATION +siguientes I-EXPLORATION +características I-EXPLORATION +generales: I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Disparo I-EXPLORATION +a I-EXPLORATION +cañón I-EXPLORATION +tocante I-EXPLORATION +o I-EXPLORATION +muy I-EXPLORATION +próximo I-EXPLORATION +al I-EXPLORATION +contacto I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -mutación I-EXPLORATION -c.3311C>A I-EXPLORATION -(p.Ser1104X) I-EXPLORATION -exón I-EXPLORATION -16 I-EXPLORATION +camiseta. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Penetración I-EXPLORATION +de I-EXPLORATION +fragmentos I-EXPLORATION +como I-EXPLORATION +orificio I-EXPLORATION +único I-EXPLORATION en I-EXPLORATION -estado I-EXPLORATION -heterocigoto I-EXPLORATION -para I-EXPLORATION el I-EXPLORATION -gen. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -molecular I-EXPLORATION +cuerpo I-EXPLORATION de I-EXPLORATION -ambos I-EXPLORATION -padres I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -topiramato, I-TREATMENT -clobazam I-TREATMENT -y I-TREATMENT -Levetiracetam I-TREATMENT -permitió I-TREATMENT -controlar I-TREATMENT -crisis I-TREATMENT -prolongadas. I-TREATMENT -Sin B-EVOLUTION -SE I-EVOLUTION -desde I-EVOLUTION -9 I-EVOLUTION -meses I-EVOLUTION -pero I-EVOLUTION -ha I-EVOLUTION -persistido I-EVOLUTION -con I-EVOLUTION -5-7 I-EVOLUTION -crisis I-EVOLUTION -semanales I-EVOLUTION -de I-EVOLUTION -corta I-EVOLUTION -duración I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -requieren I-EVOLUTION -uso I-EVOLUTION -de I-EVOLUTION -benzodiacepinas. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -previamente I-PRESENT_ILLNESS -sano, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -controlado, I-PAST_MEDICAL_HISTORY -nacido I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -término I-PAST_MEDICAL_HISTORY -38 I-PAST_MEDICAL_HISTORY -semanas, I-PAST_MEDICAL_HISTORY -pequeña I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -gestacional I-PAST_MEDICAL_HISTORY -(2.670 I-PAST_MEDICAL_HISTORY -kg). I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -47 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -coluria, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -buen I-PRESENT_ILLNESS -incremento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -derivada I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -regional I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -estudio. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Exámenes B-EXPLORATION +la I-EXPLORATION +víctima I-EXPLORATION con I-EXPLORATION -patrón I-EXPLORATION -colestásico, I-EXPLORATION +trayectoria I-EXPLORATION +descrita I-EXPLORATION en I-EXPLORATION -los I-EXPLORATION -cuales I-EXPLORATION -destacaba I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -(BT), I-EXPLORATION -a I-EXPLORATION -expensas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -bilirrubina I-EXPLORATION -directa I-EXPLORATION -(BD) I-EXPLORATION -(12, I-EXPLORATION -75 I-EXPLORATION -mg/dl-10, I-EXPLORATION -18 I-EXPLORATION -mg/dl) I-EXPLORATION -y I-EXPLORATION -pruebas I-EXPLORATION -hepáticas I-EXPLORATION -elevadas, I-EXPLORATION -sobre I-EXPLORATION -todo I-EXPLORATION -la I-EXPLORATION -gamma I-EXPLORATION -glutamil I-EXPLORATION -transpeptidasa I-EXPLORATION -(GGT) I-EXPLORATION +imágenes I-EXPLORATION +6 I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -(FA). I-EXPLORATION +7. I-EXPLORATION I-EXPLORATION -En I-EXPLORATION -Hospital I-EXPLORATION -regional I-EXPLORATION -se I-EXPLORATION -sospechó I-EXPLORATION -hepatitis I-EXPLORATION -viral, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -tomó I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -hepatitis I-EXPLORATION -A, I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C I-EXPLORATION -que I-EXPLORATION -resultaron I-EXPLORATION -negativas. I-EXPLORATION -Evolucionó B-EVOLUTION -favorablemente I-EVOLUTION -pero I-EVOLUTION -se I-EVOLUTION -constataron I-EVOLUTION -deposiciones I-EVOLUTION -acólicas. I-EVOLUTION -Se B-DERIVED_FROM/TO -derivó I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -gastroenterología I-DERIVED_FROM/TO -previos B-EXPLORATION -exámenes I-EXPLORATION +- I-EXPLORATION +Ausencia I-EXPLORATION de I-EXPLORATION -control I-EXPLORATION -que I-EXPLORATION -mantenían I-EXPLORATION -patrón I-EXPLORATION -colestásico I-EXPLORATION +lesiones I-EXPLORATION +óseas I-EXPLORATION +de I-EXPLORATION +tipo I-EXPLORATION +fracturas I-EXPLORATION +o I-EXPLORATION +fisuras I-EXPLORATION +evidenciables I-EXPLORATION con I-EXPLORATION -elevación I-EXPLORATION +estudios I-EXPLORATION +radiográficos. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Proyectil I-EXPLORATION +9 I-EXPLORATION +mm I-EXPLORATION +Pb I-EXPLORATION +KPO I-EXPLORATION +Sako. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Análisis I-EXPLORATION +balístico I-EXPLORATION +con I-EXPLORATION +datos I-EXPLORATION de I-EXPLORATION +rebote I-EXPLORATION +(ricochet) I-EXPLORATION +sobre I-EXPLORATION +una I-EXPLORATION +superficie I-EXPLORATION +irregular. I-EXPLORATION +Se I-EXPLORATION +descarta I-EXPLORATION +una I-EXPLORATION +superficie I-EXPLORATION +metálica I-EXPLORATION +o I-EXPLORATION +pulida I-EXPLORATION +por I-EXPLORATION la I-EXPLORATION -BD I-EXPLORATION -y I-EXPLORATION +irregularidad I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -transaminasas: I-EXPLORATION -BT I-EXPLORATION -10, I-EXPLORATION -58, I-EXPLORATION -BD I-EXPLORATION -7, I-EXPLORATION -88, I-EXPLORATION -GOT I-EXPLORATION -204, I-EXPLORATION -GPT I-EXPLORATION -109, I-EXPLORATION -GGT I-EXPLORATION -550. I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION los I-EXPLORATION -52 I-EXPLORATION -días I-EXPLORATION +surcos. I-EXPLORATION +La I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -vida I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION +silicio I-EXPLORATION +sobre I-EXPLORATION +los I-EXPLORATION +restos I-EXPLORATION +recogidos I-EXPLORATION +no I-EXPLORATION +permite I-EXPLORATION +confirmar I-EXPLORATION +impactos I-EXPLORATION +sobre I-EXPLORATION +asfalto. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Ausencia I-EXPLORATION +de I-EXPLORATION +datos I-EXPLORATION +de I-EXPLORATION +anomalías I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +arma I-EXPLORATION que I-EXPLORATION -mostró I-EXPLORATION -dilatación I-EXPLORATION -arrosariada I-EXPLORATION +pudieran I-EXPLORATION +sugerir I-EXPLORATION +alteraciones I-EXPLORATION +del I-EXPLORATION +proyectil I-EXPLORATION +antes I-EXPLORATION de I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -intrahepática I-EXPLORATION +la I-EXPLORATION +salida I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +boca I-EXPLORATION +del I-EXPLORATION +cañón I-EXPLORATION +que I-EXPLORATION +simulasen I-EXPLORATION +un I-EXPLORATION +rebote I-EXPLORATION y I-EXPLORATION -vesícula I-EXPLORATION -biliar I-EXPLORATION -presente I-EXPLORATION -pero I-EXPLORATION -colapsada I-EXPLORATION -a I-EXPLORATION -pesar I-EXPLORATION +fragmentación I-EXPLORATION del I-EXPLORATION -ayuno. I-EXPLORATION +proyectil I-EXPLORATION +[2]. I-EXPLORATION I-EXPLORATION -Por I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +- I-EXPLORATION +Ausencia I-EXPLORATION de I-EXPLORATION +elementos I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -vesícula I-EXPLORATION +indumentaria I-EXPLORATION +del I-EXPLORATION +lesionado I-EXPLORATION +que I-EXPLORATION +pudieran I-EXPLORATION +haber I-EXPLORATION +actuado I-EXPLORATION +como I-EXPLORATION +punto I-EXPLORATION +de I-EXPLORATION +impacto I-EXPLORATION +intermedio, I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -gran I-EXPLORATION -dilatación I-EXPLORATION +fuente I-EXPLORATION de I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -intrahepática, I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -diferir I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -hepática I-EXPLORATION +fragmentación I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION +rebote, I-EXPLORATION +entre I-EXPLORATION +el I-EXPLORATION +arma I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +piel I-EXPLORATION +del I-EXPLORATION +lesionado. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +hombre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +63 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +disnea I-PRESENT_ILLNESS +progresiva, I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +fiebre. I-PRESENT_ILLNESS +Como B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +hábito I-PAST_MEDICAL_HISTORY +tabáquico, I-PAST_MEDICAL_HISTORY +alcoholismo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +pancreatitis I-PAST_MEDICAL_HISTORY +crónica. I-PAST_MEDICAL_HISTORY +Se B-EXPLORATION realizó I-EXPLORATION -una I-EXPLORATION -colangio-resonancia. I-EXPLORATION -Esta I-EXPLORATION -mostró I-EXPLORATION +radiografía I-EXPLORATION +simple I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +en I-EXPLORATION +urgencias I-EXPLORATION +que I-EXPLORATION +reveló I-EXPLORATION un I-EXPLORATION -hígado I-EXPLORATION -normal I-EXPLORATION +derrame I-EXPLORATION +pleural I-EXPLORATION +izquierdo I-EXPLORATION +masivo. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +toracocentesis I-EXPLORATION +siendo I-EXPLORATION +el I-EXPLORATION +cultivo I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +misma I-EXPLORATION +negativo, I-EXPLORATION con I-EXPLORATION -parénquima I-EXPLORATION -conservado, I-EXPLORATION -leve I-EXPLORATION -dilatación I-EXPLORATION +criterios I-EXPLORATION de I-EXPLORATION -ductos I-EXPLORATION -biliares I-EXPLORATION -intrahepáticos I-EXPLORATION -hasta I-EXPLORATION -nivel I-EXPLORATION +exudado I-EXPLORATION +con I-EXPLORATION +60 I-EXPLORATION +% I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -confluencia, I-EXPLORATION -hacia I-EXPLORATION -distal I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -logró I-EXPLORATION -visualizar I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -extrahepática. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -resultado I-TREATMENT -de I-TREATMENT -la I-TREATMENT -colangio-resonancia I-TREATMENT -se I-TREATMENT -sospechó I-TREATMENT -atresia I-TREATMENT -de I-TREATMENT -vía I-TREATMENT -biliar I-TREATMENT -y I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -cirugía I-TREATMENT -de I-TREATMENT -derivación I-TREATMENT -bilio-digestiva I-TREATMENT -(Kasai). I-TREATMENT -Llamaba B-EXPLORATION -la I-EXPLORATION -atención I-EXPLORATION +polimorfonucleares, I-EXPLORATION +destacando I-EXPLORATION +12.400 I-EXPLORATION +UI/L I-EXPLORATION +de I-EXPLORATION +amilasa I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +líquido I-EXPLORATION +pleural. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +TAC I-EXPLORATION +torácico, I-EXPLORATION que I-EXPLORATION +mostraba I-EXPLORATION +infiltrado I-EXPLORATION en I-EXPLORATION -exámenes I-EXPLORATION -seriados I-EXPLORATION -la I-EXPLORATION -bilirrubina I-EXPLORATION -había I-EXPLORATION -ido I-EXPLORATION +LII I-EXPLORATION +y I-EXPLORATION +pequeñas I-EXPLORATION +alteraciones I-EXPLORATION en I-EXPLORATION -disminución I-EXPLORATION -al I-EXPLORATION -igual I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -ictericia. I-EXPLORATION -Por I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -deposiciones I-EXPLORATION -acólicas I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -exploración I-EXPLORATION -quirúrgica. I-EXPLORATION - I-EXPLORATION -Durante I-EXPLORATION -la I-EXPLORATION -cirugía I-EXPLORATION -se I-EXPLORATION -visualizó I-EXPLORATION -superficie I-EXPLORATION -hepática I-EXPLORATION -lisa, I-EXPLORATION -hígado I-EXPLORATION -congestivo I-EXPLORATION -(confirmado I-EXPLORATION -por I-EXPLORATION -biopsia), I-EXPLORATION -vesícula I-EXPLORATION -biliar I-EXPLORATION -presente, I-EXPLORATION +vidrio I-EXPLORATION +deslustrado. I-EXPLORATION +Con B-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +derrame I-TREATMENT +paraneumónico I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +médico. I-TREATMENT +Sin B-EXPLORATION +embargo, I-EXPLORATION +el I-EXPLORATION +derrame I-EXPLORATION +empeoró, I-EXPLORATION +realizándose I-EXPLORATION +nueva I-EXPLORATION +toracocentesis I-EXPLORATION +diagnóstica I-EXPLORATION +y I-EXPLORATION +evacuadora, I-EXPLORATION con I-EXPLORATION -lumen I-EXPLORATION +citología I-EXPLORATION +negativa I-EXPLORATION +para I-EXPLORATION +células I-EXPLORATION +malignas, I-EXPLORATION +cultivo I-EXPLORATION +negativo I-EXPLORATION y I-EXPLORATION -bilis I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior. I-EXPLORATION -Se I-EXPLORATION +biopsia I-EXPLORATION +pleural I-EXPLORATION +sin I-EXPLORATION +evidencia I-EXPLORATION +de I-EXPLORATION +tumor, I-EXPLORATION +destacando I-EXPLORATION +nuevamente I-EXPLORATION +amilasa I-EXPLORATION +elevada, I-EXPLORATION +con I-EXPLORATION +10.156 I-EXPLORATION +UL/L. I-EXPLORATION +Ante I-EXPLORATION +el I-EXPLORATION +derrame I-EXPLORATION +pleural I-EXPLORATION +recidivante I-EXPLORATION +se I-EXPLORATION realizó I-EXPLORATION -colangiografía I-EXPLORATION -intraoperatoria I-EXPLORATION -donde I-EXPLORATION +un I-EXPLORATION +TAC I-EXPLORATION +toraco-abdominal, I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -visualizó I-EXPLORATION +evidenciaba I-EXPLORATION +un I-EXPLORATION +pseudoquiste I-EXPLORATION +pancreático I-EXPLORATION +de I-EXPLORATION +28 I-EXPLORATION +mm I-EXPLORATION +comunicado I-EXPLORATION +con I-EXPLORATION una I-EXPLORATION -zona I-EXPLORATION -estenótica I-EXPLORATION -crítica I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -conducto I-EXPLORATION -hepático I-EXPLORATION -común I-EXPLORATION -logrando I-EXPLORATION -paso I-EXPLORATION +colección I-EXPLORATION +líquida I-EXPLORATION de I-EXPLORATION -contraste I-EXPLORATION -hacia I-EXPLORATION -proximal I-EXPLORATION -y I-EXPLORATION -distal I-EXPLORATION -(intra I-EXPLORATION -y I-EXPLORATION -extra I-EXPLORATION -hepático), I-EXPLORATION +2 I-EXPLORATION +x I-EXPLORATION +5, I-EXPLORATION +5 I-EXPLORATION +x I-EXPLORATION +7 I-EXPLORATION +cm I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +extendía I-EXPLORATION +desde I-EXPLORATION +el I-EXPLORATION +páncreas I-EXPLORATION +hasta I-EXPLORATION +el I-EXPLORATION +espacio I-EXPLORATION +subfrénico, I-EXPLORATION +asociado I-EXPLORATION +a I-EXPLORATION +derrame I-EXPLORATION +pleural I-EXPLORATION +izquierdo I-EXPLORATION +masivo, I-EXPLORATION +siendo I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -intrahepática I-EXPLORATION -dilatada. I-EXPLORATION +fístula I-EXPLORATION +pleuropancreática. I-EXPLORATION I-EXPLORATION Se B-TREATMENT -realizó I-TREATMENT -colecistectomía I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +médico I-TREATMENT +con I-TREATMENT +dieta I-TREATMENT +absoluta, I-TREATMENT +nutrición I-TREATMENT +parenteral I-TREATMENT +total, I-TREATMENT +drenaje I-TREATMENT +torácico I-TREATMENT +con I-TREATMENT +tubo I-TREATMENT y I-TREATMENT -disección I-TREATMENT -de I-TREATMENT -conducto I-TREATMENT -hepático I-TREATMENT -común I-TREATMENT -demostrando I-TREATMENT -una I-TREATMENT -estenosis I-TREATMENT +octeótrido I-TREATMENT a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -éste, I-TREATMENT -causado I-TREATMENT -por I-TREATMENT -un I-TREATMENT -anillo I-TREATMENT -vascular I-TREATMENT -proveniente I-TREATMENT +dosis I-TREATMENT de I-TREATMENT -arteria I-TREATMENT -hepática I-TREATMENT -derecha. I-TREATMENT -Se I-TREATMENT -seccionó I-TREATMENT +100 I-TREATMENT +µg I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +horas I-TREATMENT +subcutáneo, I-TREATMENT +duplicando I-TREATMENT la I-TREATMENT -vía I-TREATMENT -biliar I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -proximal I-TREATMENT +dosis I-TREATMENT +ante I-TREATMENT +el I-TREATMENT +alto I-TREATMENT +débito. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +CPRE I-TREATMENT +con I-TREATMENT +intento I-TREATMENT +de I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +stent I-TREATMENT +en I-TREATMENT +el I-TREATMENT +conducto I-TREATMENT +pancreático I-TREATMENT +principal, I-TREATMENT +que I-TREATMENT +no I-TREATMENT +fue I-TREATMENT +posible I-TREATMENT +técnicamente I-TREATMENT +al I-TREATMENT +encontrarse I-TREATMENT +el I-TREATMENT +origen I-TREATMENT de I-TREATMENT la I-TREATMENT -estenosis I-TREATMENT -realizando I-TREATMENT -una I-TREATMENT -hepático-duodeno I-TREATMENT -anastomosis. I-TREATMENT -Se I-TREATMENT -dejó I-TREATMENT -drenaje I-TREATMENT -abdominal I-TREATMENT -y I-TREATMENT -sonda I-TREATMENT -nasogástrica I-TREATMENT -instalada. I-TREATMENT - B-EVOLUTION -La I-EVOLUTION +fístula I-TREATMENT +en I-TREATMENT +pseudoquiste I-TREATMENT +pancreático I-TREATMENT +situado I-TREATMENT +en I-TREATMENT +la I-TREATMENT +cola I-TREATMENT +del I-TREATMENT +páncreas. I-TREATMENT +Pese I-TREATMENT +al I-TREATMENT +tratamiento I-TREATMENT +médico I-TREATMENT +inicial, I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +no I-TREATMENT +presentó I-TREATMENT +mejoría, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +finalmente I-TREATMENT +fue I-TREATMENT +intervenido I-TREATMENT +tras I-TREATMENT +dos I-TREATMENT +meses I-TREATMENT +de I-TREATMENT +iniciado I-TREATMENT +el I-TREATMENT +tratamiento, I-TREATMENT +evidenciando I-TREATMENT +un I-TREATMENT +orifico I-TREATMENT +en I-TREATMENT +el I-TREATMENT +diafragma I-TREATMENT +de I-TREATMENT +2 I-TREATMENT +cm I-TREATMENT +que I-TREATMENT +comunicaba I-TREATMENT +el I-TREATMENT +pseudoquiste I-TREATMENT +con I-TREATMENT +la I-TREATMENT +cavidad I-TREATMENT +pleural I-TREATMENT +y I-TREATMENT +que I-TREATMENT +determinaba I-TREATMENT +la I-TREATMENT +fístula I-TREATMENT +pleuropancreática. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +pancreatectomía I-TREATMENT +distal, I-TREATMENT +no I-TREATMENT +pudiendo I-TREATMENT +respetar I-TREATMENT +el I-TREATMENT +bazo I-TREATMENT +por I-TREATMENT +la I-TREATMENT +gran I-TREATMENT +inflamación I-TREATMENT +presente, I-TREATMENT +así I-TREATMENT +como I-TREATMENT +cierre I-TREATMENT +del I-TREATMENT +orificio I-TREATMENT +diafragmático I-TREATMENT +y I-TREATMENT +drenaje I-TREATMENT +pleural I-TREATMENT +izquierdo, I-TREATMENT +con I-TREATMENT +derivación I-TREATMENT +de I-TREATMENT +conducto I-TREATMENT +de I-TREATMENT +Wirsung I-TREATMENT +distal I-TREATMENT +término-lateral I-TREATMENT +en I-TREATMENT +Y I-TREATMENT +de I-TREATMENT +Roux I-TREATMENT +retrocólica-transmesocólica I-TREATMENT +tras I-TREATMENT +extracción I-TREATMENT +de I-TREATMENT +cálculos. I-TREATMENT +El B-EVOLUTION paciente I-EVOLUTION evolucionó I-EVOLUTION -favorablemente, I-EVOLUTION -con I-EVOLUTION -débito I-EVOLUTION -en I-EVOLUTION -disminución I-EVOLUTION -por I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +satisfactoria, I-EVOLUTION +siendo I-EVOLUTION +retirado I-EVOLUTION el I-EVOLUTION drenaje I-EVOLUTION -retirándose I-EVOLUTION +pleural I-EVOLUTION al I-EVOLUTION -6 I-EVOLUTION +tercer I-EVOLUTION día I-EVOLUTION +sin I-EVOLUTION +recidiva I-EVOLUTION +del I-EVOLUTION +derrame I-EVOLUTION y I-EVOLUTION -alimentándose I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -4 I-EVOLUTION -días. I-EVOLUTION -Se I-EVOLUTION -dio I-EVOLUTION +dado I-EVOLUTION de I-EVOLUTION alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -8 I-EVOLUTION -días I-EVOLUTION -post I-EVOLUTION -operatorio I-EVOLUTION -con I-EVOLUTION -pruebas I-EVOLUTION -hepáticas I-EVOLUTION -en I-EVOLUTION -disminución I-EVOLUTION -(BT I-EVOLUTION -3, I-EVOLUTION -98, I-EVOLUTION -BD I-EVOLUTION -3, I-EVOLUTION -46, I-EVOLUTION -GOT I-EVOLUTION -266, I-EVOLUTION -GPT I-EVOLUTION -134, I-EVOLUTION -FA I-EVOLUTION -431, I-EVOLUTION -GGT I-EVOLUTION -586). I-EVOLUTION -En I-EVOLUTION -controles I-EVOLUTION -ambulatorios I-EVOLUTION -la I-EVOLUTION +al I-EVOLUTION +sexto I-EVOLUTION +día I-EVOLUTION +post-operatorio. I-EVOLUTION +El I-EVOLUTION paciente I-EVOLUTION -se I-EVOLUTION -encontraba I-EVOLUTION -asintomática, I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -tolerancia I-EVOLUTION -oral, I-EVOLUTION -deposiciones I-EVOLUTION -teñidas I-EVOLUTION -y I-EVOLUTION -exámenes I-EVOLUTION -hepáticos I-EVOLUTION -y I-EVOLUTION -generales I-EVOLUTION -normalizados. I-EVOLUTION +continúa I-EVOLUTION +asintomático I-EVOLUTION +dos I-EVOLUTION +años I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +intervención. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +hiperemia I-PRESENT_ILLNESS +conjuntival I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +lagrimeo I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -mejilla I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -asimetría I-PRESENT_ILLNESS -facial, I-PRESENT_ILLNESS -descenso I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -comisura I-PRESENT_ILLNESS -oral I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -esqueletal, I-PRESENT_ILLNESS -cuya I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -radiología I-PRESENT_ILLNESS -era I-PRESENT_ILLNESS -compatible I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -ML. I-PRESENT_ILLNESS -La B-EXPLORATION -ecografía I-EXPLORATION -facial, I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -18 I-EXPLORATION -meses I-EXPLORATION -de I-EXPLORATION -edad, I-EXPLORATION -realizada I-EXPLORATION -con I-EXPLORATION -transductor I-EXPLORATION -lineal I-EXPLORATION +una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Entre B-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +destacables I-PAST_MEDICAL_HISTORY +constan I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +alergia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +ácaros, I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +asma I-PAST_MEDICAL_HISTORY +bronquial I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +rinitis I-PAST_MEDICAL_HISTORY +alérgica I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +crónico I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +budesonida I-PAST_MEDICAL_HISTORY +inhalada I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +terbutalina I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +demanda. I-PAST_MEDICAL_HISTORY +No B-FAMILY_HISTORY +presenta I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +interés. I-FAMILY_HISTORY +Se B-TREATMENT +inicia I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +tópico, I-TREATMENT +acudiendo B-EVOLUTION +de I-EVOLUTION +nuevo I-EVOLUTION +al I-EVOLUTION +cabo I-EVOLUTION +de I-EVOLUTION +cuatro I-EVOLUTION +semanas I-EVOLUTION +por I-EVOLUTION +persistencia I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +clínica I-EVOLUTION +bilateral, I-EVOLUTION +sin I-EVOLUTION +secreción I-EVOLUTION +purulenta. I-EVOLUTION +Durante I-EVOLUTION +los I-EVOLUTION +siete I-EVOLUTION +meses I-EVOLUTION +posteriores I-EVOLUTION +persiste I-EVOLUTION +la I-EVOLUTION +sintomatología I-EVOLUTION +intermitente I-EVOLUTION +a I-EVOLUTION +pesar I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION +con I-EVOLUTION +antihistáminicos I-EVOLUTION +orales I-EVOLUTION +y I-EVOLUTION +oftálmicos, I-EVOLUTION +asociando I-EVOLUTION +además I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +últimos I-EVOLUTION +días I-EVOLUTION +tumefacción I-EVOLUTION +palpebral I-EVOLUTION +con I-EVOLUTION +fotofobia I-EVOLUTION +e I-EVOLUTION +hiperemia I-EVOLUTION +conjuntival I-EVOLUTION +bilateral I-EVOLUTION +matutina, I-EVOLUTION +sin I-EVOLUTION +prurito, I-EVOLUTION +estornudos, I-EVOLUTION +cuadro I-EVOLUTION +catarral I-EVOLUTION +ni I-EVOLUTION +fiebre. I-EVOLUTION +Ante B-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +escasa I-DERIVED_FROM/TO +respuesta I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +tratamientos I-DERIVED_FROM/TO +habituales, I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +decide I-DERIVED_FROM/TO +derivar I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Oftalmología. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +oftalmológica I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +queratitis I-EXPLORATION +bilateral I-EXPLORATION de I-EXPLORATION -alta I-EXPLORATION -resolución, I-EXPLORATION -mostraba I-EXPLORATION -lesión I-EXPLORATION -predominantemente I-EXPLORATION -micro I-EXPLORATION -quística, I-EXPLORATION -con I-EXPLORATION -algunos I-EXPLORATION -quistes I-EXPLORATION +posible I-EXPLORATION +etiología I-EXPLORATION +herpética, I-EXPLORATION +pautándose B-TREATMENT +terapia I-TREATMENT +antiviral, I-TREATMENT +ciclopléjico I-TREATMENT +y I-TREATMENT +antibiótico I-TREATMENT +tópicos, I-TREATMENT +sin I-TREATMENT +apreciar I-TREATMENT +mejoría. I-TREATMENT +Dada B-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +persistencia I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +cuadro, I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +sospecha I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +queratitis I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +exposición I-DERIVED_FROM/TO +nocturna I-DERIVED_FROM/TO +secundaria I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +exoftalmos I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +deriva I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +endocrinología I-DERIVED_FROM/TO +pediátrica I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +estudio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +función I-DERIVED_FROM/TO +tiroidea, I-DERIVED_FROM/TO +alcanzando I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +diagnóstico I-DERIVED_FROM/TO +final I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +hipertiroidismo I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +causa I-DERIVED_FROM/TO +autoinmune I-DERIVED_FROM/TO +o I-DERIVED_FROM/TO +enfermedad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Graves I-DERIVED_FROM/TO +(EG). I-DERIVED_FROM/TO + I-DERIVED_FROM/TO + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +inercia I-PAST_MEDICAL_HISTORY +colónica. I-PAST_MEDICAL_HISTORY +En B-TREATMENT +mayo I-TREATMENT +de I-TREATMENT +2003, I-TREATMENT +a I-TREATMENT +los I-TREATMENT +46 I-TREATMENT +años, I-TREATMENT +se I-TREATMENT +le I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +colectomía I-TREATMENT +total I-TREATMENT +laparoscópica I-TREATMENT +con I-TREATMENT +anastomosis I-TREATMENT +ileorrectal I-TREATMENT +sin I-TREATMENT +incidentes. I-TREATMENT +Durante B-EVOLUTION +el I-EVOLUTION +postoperatorio I-EVOLUTION +evolucionó I-EVOLUTION +con I-EVOLUTION +taquicardia, I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +e I-EVOLUTION +hipotensión. I-EVOLUTION +Se B-EXPLORATION +practicó I-EXPLORATION +una I-EXPLORATION +laparotomía I-EXPLORATION +exploradora I-EXPLORATION que I-EXPLORATION -superaban I-EXPLORATION -los I-EXPLORATION -15 I-EXPLORATION -mm I-EXPLORATION +evidenció I-EXPLORATION +necrosis I-EXPLORATION de I-EXPLORATION -diámetro. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -planificó I-TREATMENT -realizar I-TREATMENT -esclerosis I-TREATMENT -seriada I-TREATMENT +yeyuno I-EXPLORATION +distal I-EXPLORATION +e I-EXPLORATION +ileon, I-EXPLORATION +realizándose I-EXPLORATION +resección I-EXPLORATION +del I-EXPLORATION +intestino I-EXPLORATION +desde I-EXPLORATION +los I-EXPLORATION +120 I-EXPLORATION +cm I-EXPLORATION +distales I-EXPLORATION +al I-EXPLORATION +Treitz, I-EXPLORATION +además B-TREATMENT de I-TREATMENT -la I-TREATMENT -lesión, I-TREATMENT -para I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -utilizó I-TREATMENT -en I-TREATMENT -2 I-TREATMENT -ocasiones I-TREATMENT -+ I-TREATMENT -OK-432 I-TREATMENT +una I-TREATMENT +yeyunostomía I-TREATMENT +terminal I-TREATMENT y I-TREATMENT -en I-TREATMENT -las I-TREATMENT -2 I-TREATMENT -siguientes I-TREATMENT -Bleomicina. I-TREATMENT -Todas I-TREATMENT -se I-TREATMENT -realizaron I-TREATMENT +cierre I-TREATMENT +del I-TREATMENT +muñón I-TREATMENT +rectal. I-TREATMENT +La B-EXPLORATION +biopsia I-EXPLORATION +informó I-EXPLORATION +segmento I-EXPLORATION +de I-EXPLORATION +intestino I-EXPLORATION +delgado I-EXPLORATION +con I-EXPLORATION +hallazgos I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +enteropatía I-EXPLORATION +isquémica I-EXPLORATION +aguda. I-EXPLORATION +Evolucionó B-EVOLUTION +con I-EVOLUTION +fujos I-EVOLUTION +de I-EVOLUTION +4.500 I-EVOLUTION +cc/día I-EVOLUTION +por I-EVOLUTION +yeyunostomía I-EVOLUTION +y I-EVOLUTION +desnutrición I-EVOLUTION +calórico-proteica. I-EVOLUTION +Manejada B-TREATMENT +inicialmente I-TREATMENT con I-TREATMENT -6-8 I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -intervalo I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general. I-TREATMENT -El I-TREATMENT -procedimiento I-TREATMENT -consistió I-TREATMENT +NPTC, I-TREATMENT en I-TREATMENT el I-TREATMENT -aspirado I-TREATMENT -del I-TREATMENT -contenido I-TREATMENT -de I-TREATMENT -los I-TREATMENT -quistes I-TREATMENT -de I-TREATMENT -mayor I-TREATMENT -tamaño I-TREATMENT -e I-TREATMENT -inyección I-TREATMENT -de I-TREATMENT -OK I-TREATMENT -432, I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -0, I-TREATMENT -1 I-TREATMENT -mg I-TREATMENT -disueltos I-TREATMENT +día I-TREATMENT +12 I-TREATMENT +post I-TREATMENT +operatorio I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +alimentación I-TREATMENT +por I-TREATMENT +sonda I-TREATMENT +nasoenteral I-TREATMENT +y I-TREATMENT en I-TREATMENT -10 I-TREATMENT -cc I-TREATMENT -de I-TREATMENT -volumen I-TREATMENT -total. I-TREATMENT -Durante B-EVOLUTION -el I-EVOLUTION -primer I-EVOLUTION -procedimiento, I-EVOLUTION -al I-EVOLUTION -4° I-EVOLUTION -día I-EVOLUTION +el I-TREATMENT +día I-TREATMENT +50 I-TREATMENT +se I-TREATMENT +logró I-TREATMENT +alimentación I-TREATMENT +oral I-TREATMENT +exclusiva. I-TREATMENT +Al B-EVOLUTION +alta I-EVOLUTION +toleró I-EVOLUTION +bien I-EVOLUTION +régimen I-EVOLUTION +oral I-EVOLUTION +con I-EVOLUTION +suplementos I-EVOLUTION +nutricionales. I-EVOLUTION +Hasta I-EVOLUTION +junio I-EVOLUTION +2008 I-EVOLUTION presentó I-EVOLUTION -un I-EVOLUTION -importante I-EVOLUTION -aumento I-EVOLUTION -de I-EVOLUTION -volumen I-EVOLUTION -e I-EVOLUTION -inició I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION +17 I-EVOLUTION +hospitalizaciones, I-EVOLUTION +4 I-EVOLUTION +por I-EVOLUTION +cuadros I-EVOLUTION de I-EVOLUTION -escarlatina, I-EVOLUTION -evolucionando I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -disminución I-EVOLUTION +íleo I-EVOLUTION +mecánico, I-EVOLUTION +todos B-TREATMENT +resueltos I-TREATMENT +sin I-TREATMENT +necesidad I-TREATMENT +de I-TREATMENT +cirugía, I-TREATMENT +y B-EVOLUTION +13 I-EVOLUTION +por I-EVOLUTION +episodios I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -proyección I-EVOLUTION +deshidratación I-EVOLUTION +moderada I-EVOLUTION +secundaria I-EVOLUTION +a I-EVOLUTION +altos I-EVOLUTION +débitos I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -mejilla I-EVOLUTION -e I-EVOLUTION -induración I-EVOLUTION -local. I-EVOLUTION -Similar B-TREATMENT -procedimiento I-TREATMENT +ostomía, I-EVOLUTION +los I-EVOLUTION +que B-TREATMENT se I-TREATMENT -realizó I-TREATMENT +manejaron I-TREATMENT con I-TREATMENT -la I-TREATMENT -Bleomicina I-TREATMENT -cuyas I-TREATMENT -dosis I-TREATMENT -no I-TREATMENT -sobrepasaban I-TREATMENT -0, I-TREATMENT -3-1 I-TREATMENT -mg/kg I-TREATMENT +reposición I-TREATMENT +hidroelectrolítica I-TREATMENT +y I-TREATMENT +ajuste I-TREATMENT +de I-TREATMENT +fármacos I-TREATMENT +para I-TREATMENT +disminuir I-TREATMENT +fujo I-TREATMENT por I-TREATMENT -sesión. I-TREATMENT -En I-TREATMENT -las I-TREATMENT -posteriores I-TREATMENT -infiltraciones, I-TREATMENT -presentó I-TREATMENT -aumento I-TREATMENT +yeyunostomía I-TREATMENT +logrando B-EVOLUTION +volumen I-EVOLUTION +de I-EVOLUTION +deposiciones I-EVOLUTION +de I-EVOLUTION +2.000-3.000 I-EVOLUTION +cc/día. I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +26/06/08 I-EVOLUTION +ingresó I-EVOLUTION +nuevamente I-EVOLUTION +por I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +deshidratación I-EVOLUTION +grave. I-EVOLUTION +Se I-EVOLUTION +constató I-EVOLUTION +creatininemia I-EVOLUTION +de I-EVOLUTION +4, I-EVOLUTION +39 I-EVOLUTION +mg/dl, I-EVOLUTION +objetivándose I-EVOLUTION +clearence I-EVOLUTION +de I-EVOLUTION +creatinina I-EVOLUTION +de I-EVOLUTION +30 I-EVOLUTION +ml/min. I-EVOLUTION +Dado B-TREATMENT +el I-TREATMENT +deterioro I-TREATMENT de I-TREATMENT -volumen I-TREATMENT -más I-TREATMENT -discreto I-TREATMENT +la I-TREATMENT +función I-TREATMENT +renal I-TREATMENT y I-TREATMENT +compromiso I-TREATMENT +nutricional I-TREATMENT +de I-TREATMENT +predominio I-TREATMENT +calórico I-TREATMENT con I-TREATMENT -menor I-TREATMENT -reacción I-TREATMENT -local. I-TREATMENT - I-TREATMENT -A I-TREATMENT -la I-TREATMENT -edad I-TREATMENT +IMC I-TREATMENT de I-TREATMENT +14, I-TREATMENT 2 I-TREATMENT -años I-TREATMENT -4 I-TREATMENT -meses, I-TREATMENT -con I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -más I-TREATMENT -circunscrita, I-TREATMENT -se I-TREATMENT -consideró I-TREATMENT -que I-TREATMENT -no I-TREATMENT -tenía I-TREATMENT -mayor I-TREATMENT -beneficio I-TREATMENT -continuar I-TREATMENT -con I-TREATMENT -las I-TREATMENT -esclerosis I-TREATMENT +kg/m2 I-TREATMENT y I-TREATMENT -se I-TREATMENT -planificó I-TREATMENT -extirpación I-TREATMENT -quirúrgica I-TREATMENT -intralesional. I-TREATMENT -Se I-TREATMENT -utilizó I-TREATMENT -abordaje I-TREATMENT -externo I-TREATMENT -submandibular I-TREATMENT -derecho, I-TREATMENT -con I-TREATMENT -resección I-TREATMENT -parcial I-TREATMENT +albúmina I-TREATMENT de I-TREATMENT -la I-TREATMENT -lesión, I-TREATMENT -la I-TREATMENT -que I-TREATMENT -comprometía I-TREATMENT -espesor I-TREATMENT -completo I-TREATMENT +ingreso I-TREATMENT de I-TREATMENT +3, I-TREATMENT +1 I-TREATMENT +gr/dl, I-TREATMENT +se I-TREATMENT +planteó I-TREATMENT la I-TREATMENT -mejilla I-TREATMENT -incluyendo I-TREATMENT -musculatura I-TREATMENT -facial I-TREATMENT +realización I-TREATMENT +de I-TREATMENT +un I-TREATMENT +procedimiento I-TREATMENT +de I-TREATMENT +elongación I-TREATMENT +intestinal I-TREATMENT y I-TREATMENT -mucosa I-TREATMENT -vestibular. I-TREATMENT -A I-TREATMENT -los I-TREATMENT -15 I-TREATMENT -días I-TREATMENT -post I-TREATMENT -operatorio I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -compresivo I-TREATMENT -elástico I-TREATMENT +reconstitución I-TREATMENT +del I-TREATMENT +tránsito I-TREATMENT +para I-TREATMENT +mejorar I-TREATMENT +la I-TREATMENT +condición I-TREATMENT +clínica I-TREATMENT y I-TREATMENT -masoterapia, I-TREATMENT -intentándose I-TREATMENT -compresión I-TREATMENT -externa I-TREATMENT -con I-TREATMENT -máscara I-TREATMENT +calidad I-TREATMENT +de I-TREATMENT +vida I-TREATMENT de I-TREATMENT -acrílico I-TREATMENT -pero I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -mal I-TREATMENT -tolerada I-TREATMENT -por I-TREATMENT la I-TREATMENT paciente. I-TREATMENT I-TREATMENT -La B-EXPLORATION -biopsia I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +El B-EXPLORATION +estudio I-EXPLORATION +preoperatorio I-EXPLORATION +incluyó I-EXPLORATION +una I-EXPLORATION +rectoscopia I-EXPLORATION +rígida I-EXPLORATION +que I-EXPLORATION +evidenció I-EXPLORATION +un I-EXPLORATION +muñón I-EXPLORATION +rectal I-EXPLORATION de I-EXPLORATION -ML I-EXPLORATION -microquístico I-EXPLORATION -con I-EXPLORATION -intersticio I-EXPLORATION -fibroso I-EXPLORATION -e I-EXPLORATION -infiltración I-EXPLORATION -inflamatoria I-EXPLORATION -linfocitaria. I-EXPLORATION -Seis B-TREATMENT -meses I-TREATMENT -después I-TREATMENT +12 I-EXPLORATION +cm. I-EXPLORATION +El I-EXPLORATION +tránsito I-EXPLORATION +intestinal I-EXPLORATION +demostró I-EXPLORATION +140 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +intestino I-EXPLORATION +delgado I-EXPLORATION +sin I-EXPLORATION +estrecheces I-EXPLORATION +y I-EXPLORATION +leve I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +asas. I-EXPLORATION +Por I-EXPLORATION +sospecha I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +tomografía I-EXPLORATION +computada I-EXPLORATION +de I-EXPLORATION +compromiso I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +mesentérica I-EXPLORATION +superior I-EXPLORATION +(AMS), I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +ecografía I-EXPLORATION +Doppler I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +estenosis I-EXPLORATION +signifcativa I-EXPLORATION +(70%) I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +AMS, I-EXPLORATION +que B-TREATMENT se I-TREATMENT -planificó I-TREATMENT -nueva I-TREATMENT -resección I-TREATMENT -utilizando I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -abordaje I-TREATMENT +resolvió I-TREATMENT +mediante I-TREATMENT +angioplastía I-TREATMENT y I-TREATMENT -extirpando I-TREATMENT -lesión I-TREATMENT -remanente I-TREATMENT -hacia I-TREATMENT -cefálico. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -post I-EVOLUTION -operatorio I-EVOLUTION -se I-EVOLUTION -mantuvieron I-EVOLUTION -las I-EVOLUTION -medidas I-EVOLUTION -de I-EVOLUTION -compresión I-EVOLUTION -facial I-EVOLUTION -previas I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -cirugía. I-EVOLUTION - I-EVOLUTION -Después I-EVOLUTION -de I-EVOLUTION -varios I-EVOLUTION -años I-EVOLUTION -comenzó I-EVOLUTION -a I-EVOLUTION -presentar I-EVOLUTION -molestias I-EVOLUTION -en I-EVOLUTION -relación I-EVOLUTION -a I-EVOLUTION -lesiones I-EVOLUTION -vesiculares I-EVOLUTION -en I-EVOLUTION -vestíbulo I-EVOLUTION -oral I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -mordía I-EVOLUTION -con I-EVOLUTION -frecuencia, I-EVOLUTION -siendo I-EVOLUTION -interpretadas I-EVOLUTION -como I-EVOLUTION -recidiva I-EVOLUTION -local I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -ML. I-EVOLUTION -A B-TREATMENT -los I-TREATMENT -9 I-TREATMENT -años I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +endoprótesis. I-TREATMENT +Con I-TREATMENT +aporte I-TREATMENT de I-TREATMENT -edad, I-TREATMENT +régimen I-TREATMENT +hipercalórico-hiperproteico I-TREATMENT +y I-TREATMENT +NPTC I-TREATMENT se I-TREATMENT -realizó I-TREATMENT -exéresis I-TREATMENT +logró I-TREATMENT +optimización I-TREATMENT +de I-TREATMENT +parámetros I-TREATMENT +nutricionales I-TREATMENT +(albúmina: I-TREATMENT +3, I-TREATMENT +8 I-TREATMENT +mg/dl). I-TREATMENT + I-TREATMENT +Cinco I-TREATMENT +semanas I-TREATMENT +luego I-TREATMENT de I-TREATMENT la I-TREATMENT -lesión I-TREATMENT -con I-TREATMENT -abordaje I-TREATMENT -intraoral, I-TREATMENT -cuya I-TREATMENT -biopsia I-TREATMENT -mostraba I-TREATMENT -ML I-TREATMENT -con I-TREATMENT -fibrosis I-TREATMENT -difusa. I-TREATMENT -Dado B-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -difícil I-DERIVED_FROM/TO -manejo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -cicatrización I-DERIVED_FROM/TO -intraoral I-DERIVED_FROM/TO -ya I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -mordía I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -frecuencia I-DERIVED_FROM/TO -presentando I-DERIVED_FROM/TO -sangramiento I-DERIVED_FROM/TO -e I-DERIVED_FROM/TO -inflamación I-DERIVED_FROM/TO -local, I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -derivó I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -ortodoncia I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -manejo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -anomalía I-DERIVED_FROM/TO -dentomaxilar I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -confección I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -plano I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -apoyo I-DERIVED_FROM/TO -intraoral. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Se B-TREATMENT -diseñó I-TREATMENT -un I-TREATMENT -aparato I-TREATMENT -intraoral I-TREATMENT -con I-TREATMENT -prolongación I-TREATMENT -vestibular I-TREATMENT -completa I-TREATMENT -que I-TREATMENT -proporcionaba I-TREATMENT -un I-TREATMENT -buen I-TREATMENT -plano I-TREATMENT +colocación I-TREATMENT de I-TREATMENT -apoyo I-TREATMENT -intraoral I-TREATMENT -que I-TREATMENT -potenciaba I-TREATMENT la I-TREATMENT -compresión I-TREATMENT -externa, I-TREATMENT -Además I-TREATMENT +endoprótesis I-TREATMENT se I-TREATMENT -instaló I-TREATMENT -aparatología I-TREATMENT -ortodóncica I-TREATMENT -fija I-TREATMENT -en I-TREATMENT +decidió I-TREATMENT +operar I-TREATMENT +a I-TREATMENT la I-TREATMENT -zona I-TREATMENT -dentaria I-TREATMENT -anterosuperior I-TREATMENT -para I-TREATMENT -alinear I-TREATMENT -y I-TREATMENT -nivelar I-TREATMENT +paciente. I-TREATMENT +En I-TREATMENT el I-TREATMENT -sector I-TREATMENT -incisivo. I-TREATMENT -La I-TREATMENT -compresión I-TREATMENT -interna/externa I-TREATMENT +intraoperatorio I-TREATMENT se I-TREATMENT -indicó I-TREATMENT -por I-TREATMENT -15 I-TREATMENT -h I-TREATMENT -diarias, I-TREATMENT -con I-TREATMENT -controles I-TREATMENT -del I-TREATMENT -aparato I-TREATMENT +midió I-TREATMENT +intestino I-TREATMENT +remanente I-TREATMENT +con-frmando I-TREATMENT +una I-TREATMENT +longitud I-TREATMENT +de I-TREATMENT +140 I-TREATMENT +cm. I-TREATMENT +Se I-TREATMENT +desmanteló I-TREATMENT +la I-TREATMENT +yeyunostomía I-TREATMENT y I-TREATMENT -rebasado I-TREATMENT +se I-TREATMENT +practicó I-TREATMENT +una I-TREATMENT +anastomosis I-TREATMENT +mecánica I-TREATMENT +término-terminal I-TREATMENT +yeyunorectal. I-TREATMENT +Luego I-TREATMENT +se I-TREATMENT +hicieron I-TREATMENT +15 I-TREATMENT +secciones I-TREATMENT +transversas I-TREATMENT +parciales I-TREATMENT +con I-TREATMENT +cargas I-TREATMENT +lineales I-TREATMENT de I-TREATMENT -acrílico I-TREATMENT +3, I-TREATMENT +5 I-TREATMENT +mm I-TREATMENT +para I-TREATMENT +seccionar I-TREATMENT +la I-TREATMENT +mitad I-TREATMENT +del I-TREATMENT +lumen I-TREATMENT +del I-TREATMENT +intestino I-TREATMENT +en I-TREATMENT +forma I-TREATMENT de I-TREATMENT -acuerdo I-TREATMENT -al I-TREATMENT -espacio I-TREATMENT +zig-zag I-TREATMENT +según I-TREATMENT +lo I-TREATMENT +descrito I-TREATMENT +por I-TREATMENT +Kim9. I-TREATMENT +La I-TREATMENT +longitud I-TREATMENT +fnal I-TREATMENT +del I-TREATMENT +intestino I-TREATMENT +delgado I-TREATMENT +fue I-TREATMENT +de I-TREATMENT +180 I-TREATMENT +cm, I-TREATMENT +lo I-TREATMENT que I-TREATMENT -se I-TREATMENT -iba I-TREATMENT -produciendo I-TREATMENT -en I-TREATMENT +sumado I-TREATMENT +al I-TREATMENT +muñón I-TREATMENT +rectal I-TREATMENT +da I-TREATMENT +una I-TREATMENT +longitud I-TREATMENT +de I-TREATMENT +190 I-TREATMENT +cm I-TREATMENT +hasta I-TREATMENT el I-TREATMENT -vestíbulo. I-TREATMENT +ano. I-TREATMENT I-TREATMENT -Dado I-TREATMENT +Dentro B-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +eventos I-EVOLUTION +del I-EVOLUTION +postoperatorio I-EVOLUTION +destacó I-EVOLUTION +la I-EVOLUTION +formación I-EVOLUTION +de I-EVOLUTION +colecciones I-EVOLUTION +hemáticas I-EVOLUTION +intraabdominales, I-EVOLUTION +sin I-EVOLUTION +evidencias I-EVOLUTION +de I-EVOLUTION +fltración. I-EVOLUTION +Por B-EXPLORATION +persistencia I-EXPLORATION +de I-EXPLORATION +episodios I-EXPLORATION +febriles, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +eco-cardiograma I-EXPLORATION +que I-EXPLORATION +evidenció I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +trombo I-EXPLORATION +séptico I-EXPLORATION +en I-EXPLORATION +aurícula I-EXPLORATION +derecha I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT que I-TREATMENT -el I-TREATMENT -seguimiento I-TREATMENT -de I-TREATMENT -los I-TREATMENT -últimos I-TREATMENT -4 I-TREATMENT -años I-TREATMENT -no I-TREATMENT -mostró I-TREATMENT -recidiva I-TREATMENT -local I-TREATMENT -y I-TREATMENT -la I-TREATMENT -comisura I-TREATMENT -oral I-TREATMENT -derecha I-TREATMENT -se I-TREATMENT -encontraba I-TREATMENT -descendida I-TREATMENT -e I-TREATMENT -inanimada, I-TREATMENT se I-TREATMENT -programó I-TREATMENT -una I-TREATMENT -nueva I-TREATMENT -cirugía I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT para I-TREATMENT -suspender I-TREATMENT +endocarditis I-TREATMENT +bacteriana. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +afebril, I-EVOLUTION +con I-EVOLUTION +aumento I-EVOLUTION +progresivo I-EVOLUTION +del I-EVOLUTION +aporte I-EVOLUTION +por I-EVOLUTION +vía I-EVOLUTION +oral. I-EVOLUTION +El B-TREATMENT +día I-TREATMENT +34 I-TREATMENT +del I-TREATMENT +post I-TREATMENT +operatorio I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT la I-TREATMENT -comisura I-TREATMENT -derecha, I-TREATMENT -ayudado I-TREATMENT +NPTC, I-TREATMENT +logrando I-TREATMENT +balance I-TREATMENT +hidroelectrolitico I-TREATMENT +y I-TREATMENT +nutricional I-TREATMENT +adecuado I-TREATMENT +exclusivamente I-TREATMENT por I-TREATMENT -el I-TREATMENT -soporte I-TREATMENT -intraoral I-TREATMENT -al I-TREATMENT -que I-TREATMENT -se I-TREATMENT -le I-TREATMENT -rebasa I-TREATMENT -material I-TREATMENT -semanalmente I-TREATMENT -agregando I-TREATMENT -una I-TREATMENT -zona I-TREATMENT -más I-TREATMENT -alta I-TREATMENT -que I-TREATMENT -levanta I-TREATMENT +vía I-TREATMENT +oral. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +tránsito I-EXPLORATION +intestinal I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +98 I-EXPLORATION +días I-EXPLORATION +post I-EXPLORATION +cirugía I-EXPLORATION +no I-EXPLORATION +demostró I-EXPLORATION +evidencias I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +enterotomías. I-EXPLORATION + I-EXPLORATION +Actualmente B-TREATMENT +en I-TREATMENT +control I-TREATMENT +ambulatorio, I-TREATMENT +en I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +loperamida I-TREATMENT y I-TREATMENT -da I-TREATMENT -soporte I-TREATMENT -a I-TREATMENT -la I-TREATMENT -comisura. I-TREATMENT +suplementos I-TREATMENT +nutricionales, I-TREATMENT +logrando I-TREATMENT +adecuado I-TREATMENT +balance I-TREATMENT +hidroelectrolítico, I-TREATMENT +aumento I-TREATMENT +de I-TREATMENT +peso I-TREATMENT +y I-TREATMENT +con I-TREATMENT +una I-TREATMENT +frecuencia I-TREATMENT +de I-TREATMENT +deposiciones I-TREATMENT +de I-TREATMENT +5 I-TREATMENT +veces I-TREATMENT +por I-TREATMENT +día I-TREATMENT +con I-TREATMENT +escurrimiento I-TREATMENT +escaso. I-TREATMENT I-TREATMENT -Lactante B-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alergia I-PAST_MEDICAL_HISTORY +53 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +desplazado B-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -proteína I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -leche I-PAST_MEDICAL_HISTORY +Haití I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +octubre I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -vaca, I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY +2013 I-PAST_MEDICAL_HISTORY por I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -compatible I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -contrapruebas I-PAST_MEDICAL_HISTORY -positivas, I-PAST_MEDICAL_HISTORY -alimentada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -lactancia I-PAST_MEDICAL_HISTORY -materna I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dieta I-PAST_MEDICAL_HISTORY -hipoalergénica. I-PAST_MEDICAL_HISTORY -Tuvo I-PAST_MEDICAL_HISTORY -adecuado I-PAST_MEDICAL_HISTORY -incremento I-PAST_MEDICAL_HISTORY -pondoestatural I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -9 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -(P/T I-PAST_MEDICAL_HISTORY -–0, I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -DS I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -T/E I-PAST_MEDICAL_HISTORY -–0, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -DS), I-PAST_MEDICAL_HISTORY +motivos I-PAST_MEDICAL_HISTORY +laborales. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Entre I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY +destaca I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +baja I-PAST_MEDICAL_HISTORY +laboral I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +contingencia I-PAST_MEDICAL_HISTORY +común I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -evolucionó I-PAST_MEDICAL_HISTORY +febrero I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2014 I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +dengue I-PAST_MEDICAL_HISTORY +confirmada, I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -estacionario I-PAST_MEDICAL_HISTORY +recuperación I-PAST_MEDICAL_HISTORY +clínica I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -caída I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY +reincorporación I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY su I-PAST_MEDICAL_HISTORY -curva I-PAST_MEDICAL_HISTORY +puesto I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY +trabajo. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +mayo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2014, I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +sufrir I-PAST_MEDICAL_HISTORY +abundantes I-PAST_MEDICAL_HISTORY +picaduras I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +mosquito, I-PAST_MEDICAL_HISTORY +inició I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +brusca I-PAST_MEDICAL_HISTORY +fiebre I-PAST_MEDICAL_HISTORY +alta I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -talla I-PAST_MEDICAL_HISTORY -(P/T I-PAST_MEDICAL_HISTORY -–0, I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -DS I-PAST_MEDICAL_HISTORY +odinofagia I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +posterior I-PAST_MEDICAL_HISTORY +rash I-PAST_MEDICAL_HISTORY +cutáneo I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -T/E I-PAST_MEDICAL_HISTORY -–0, I-PAST_MEDICAL_HISTORY -8). I-PAST_MEDICAL_HISTORY -Por B-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -modo I-PRESENT_ILLNESS -intercurrente I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -alta I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -solicitaron I-PRESENT_ILLNESS -exámenes I-PRESENT_ILLNESS -generales I-PRESENT_ILLNESS +poliartralgias. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +descartó I-PAST_MEDICAL_HISTORY +infección I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +dengue. I-PAST_MEDICAL_HISTORY +Regresó B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +España, I-PRESENT_ILLNESS +causó I-PRESENT_ILLNESS +baja I-PRESENT_ILLNESS +laboral I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +contingencia I-PRESENT_ILLNESS +común I-PRESENT_ILLNESS y I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +estudiado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -orina, I-PRESENT_ILLNESS -compatibles I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -infección I-PRESENT_ILLNESS +Enfermedades I-PRESENT_ILLNESS +Tropicales I-PRESENT_ILLNESS del I-PRESENT_ILLNESS -tracto I-PRESENT_ILLNESS -urinario. I-PRESENT_ILLNESS -Los B-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -mostraron I-EXPLORATION -leucocitosis I-EXPLORATION -con I-EXPLORATION -desviación I-EXPLORATION -a I-EXPLORATION -izquierda I-EXPLORATION +Hospital I-PRESENT_ILLNESS +Clínic I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Barcelona. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +hiperemia I-EXPLORATION +orofaringea I-EXPLORATION y I-EXPLORATION -elevación I-EXPLORATION -severa I-EXPLORATION +rash I-EXPLORATION +cutáneo I-EXPLORATION +que I-EXPLORATION +evolucionaron I-EXPLORATION +favorablemente I-EXPLORATION +al I-EXPLORATION +igual I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +fiebre; I-EXPLORATION +persistiendo I-EXPLORATION +las I-EXPLORATION +poliartralgias I-EXPLORATION +acompañadas I-EXPLORATION de I-EXPLORATION +astenia I-EXPLORATION +intensa. I-EXPLORATION + I-EXPLORATION +A I-EXPLORATION +destacar I-EXPLORATION +entre I-EXPLORATION las I-EXPLORATION -FA I-EXPLORATION -(4.552 I-EXPLORATION -UI/l), I-EXPLORATION -calcio, I-EXPLORATION -fósforo I-EXPLORATION +exploraciones I-EXPLORATION +complementarias I-EXPLORATION +practicadas I-EXPLORATION +leve I-EXPLORATION +leucopenia, I-EXPLORATION +serología I-EXPLORATION +Chikungunya I-EXPLORATION +IgM I-EXPLORATION +e I-EXPLORATION +IgG I-EXPLORATION y I-EXPLORATION -enzimas I-EXPLORATION -hepáticas I-EXPLORATION -en I-EXPLORATION -rango I-EXPLORATION -normal. I-EXPLORATION +determinación I-EXPLORATION +de I-EXPLORATION +ARN I-EXPLORATION +viral I-EXPLORATION +por I-EXPLORATION +RT-PCR I-EXPLORATION +positivas. I-EXPLORATION +PCR I-EXPLORATION +dengue I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION Se I-EXPLORATION -solicitaron I-EXPLORATION -isoenzimas I-EXPLORATION -que I-EXPLORATION -revelaron I-EXPLORATION -predominio I-EXPLORATION +diagnosticó I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -fracción I-EXPLORATION -ósea I-EXPLORATION -sobre I-EXPLORATION -la I-EXPLORATION -hepática I-EXPLORATION +Fiebre I-EXPLORATION +por I-EXPLORATION +virus I-EXPLORATION +Chikungunya I-EXPLORATION +no I-EXPLORATION +complicada I-EXPLORATION +adquirida I-EXPLORATION +en I-EXPLORATION +Haití I-EXPLORATION +y I-EXPLORATION +artralgias I-EXPLORATION +reactivas I-EXPLORATION +al I-EXPLORATION +proceso I-EXPLORATION +infeccioso, I-EXPLORATION +al I-EXPLORATION +cumplir I-EXPLORATION +criterios I-EXPLORATION +epidemiológicos, I-EXPLORATION +clínicos I-EXPLORATION +y I-EXPLORATION de I-EXPLORATION -96, I-EXPLORATION -3% I-EXPLORATION -a I-EXPLORATION -3, I-EXPLORATION -7% I-EXPLORATION -respectivamente. I-EXPLORATION -Evolucionó B-EVOLUTION +laboratorio. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +siguió I-EVOLUTION +control I-EVOLUTION +médico I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +Servicio I-EVOLUTION +Público I-EVOLUTION +de I-EVOLUTION +Salud I-EVOLUTION +y I-EVOLUTION +desde I-EVOLUTION +julio I-EVOLUTION +de I-EVOLUTION +2014 I-EVOLUTION con I-EVOLUTION -normalización I-EVOLUTION +Mutua I-EVOLUTION +FREMAP, I-EVOLUTION +al I-EVOLUTION +tener I-EVOLUTION +la I-EVOLUTION +empresa I-EVOLUTION +concertada I-EVOLUTION +la I-EVOLUTION +cobertura I-EVOLUTION de I-EVOLUTION -los I-EVOLUTION -niveles I-EVOLUTION +la I-EVOLUTION +contingencia I-EVOLUTION +común I-EVOLUTION +con I-EVOLUTION +esta I-EVOLUTION +entidad10. I-EVOLUTION +El I-EVOLUTION +16 I-EVOLUTION de I-EVOLUTION -FA I-EVOLUTION -a I-EVOLUTION -269 I-EVOLUTION -UI/l I-EVOLUTION +octubre I-EVOLUTION +aportó I-EVOLUTION a I-EVOLUTION los I-EVOLUTION -3 I-EVOLUTION -meses I-EVOLUTION +Servicios I-EVOLUTION +Médicos I-EVOLUTION de I-EVOLUTION -seguimiento I-EVOLUTION +FREMAP I-EVOLUTION +una I-EVOLUTION +solicitud I-EVOLUTION +de I-EVOLUTION +determinación I-EVOLUTION +de I-EVOLUTION +contingencia I-EVOLUTION +indicando I-EVOLUTION +le I-EVOLUTION +fuera I-EVOLUTION +reconocida I-EVOLUTION +dicha I-EVOLUTION +baja I-EVOLUTION +como I-EVOLUTION +laboral. I-EVOLUTION +Tras I-EVOLUTION +la I-EVOLUTION +valoración I-EVOLUTION +global I-EVOLUTION +del I-EVOLUTION +proceso I-EVOLUTION +desde I-EVOLUTION +el I-EVOLUTION +punto I-EVOLUTION +de I-EVOLUTION +vista I-EVOLUTION +epidemiológico, I-EVOLUTION +médico I-EVOLUTION y I-EVOLUTION -recuperación I-EVOLUTION +laboral I-EVOLUTION +se I-EVOLUTION +aceptó I-EVOLUTION +el I-EVOLUTION +cambio I-EVOLUTION de I-EVOLUTION -curva I-EVOLUTION -pondoestatural. I-EVOLUTION +contingencia I-EVOLUTION +a I-EVOLUTION +Accidente I-EVOLUTION +de I-EVOLUTION +Trabajo. I-EVOLUTION I-EVOLUTION - -Lactante B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -previamente I-PRESENT_ILLNESS -sana, I-PRESENT_ILLNESS -buen I-PRESENT_ILLNESS -incremento I-PRESENT_ILLNESS -pondoestatural I-PRESENT_ILLNESS -(P/T I-PRESENT_ILLNESS -–0, I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -DS I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -T/E I-PRESENT_ILLNESS -0, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -DS), I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -curso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -febril I-PRESENT_ILLNESS -prolongado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -inapetencia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -se B-EXPLORATION -solicitaron I-EXPLORATION -exámenes I-EXPLORATION -que I-EXPLORATION -mostraron I-EXPLORATION -elevación I-EXPLORATION -severa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -actividad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -FA I-EXPLORATION -(5.553 I-EXPLORATION -UI/l), I-EXPLORATION -la I-EXPLORATION -medición I-EXPLORATION -de I-EXPLORATION -isoenzimas I-EXPLORATION -evidenció I-EXPLORATION -predominio I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -fracción I-EXPLORATION -ósea I-EXPLORATION -—75%— I-EXPLORATION -sobre I-EXPLORATION -la I-EXPLORATION -hepática I-EXPLORATION -—24%—. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -alteración I-EXPLORATION -hepática, I-EXPLORATION -ni I-EXPLORATION -ósea, I-EXPLORATION +La I-EVOLUTION +evolución I-EVOLUTION +clínica I-EVOLUTION +fue I-EVOLUTION +lenta I-EVOLUTION +y I-EVOLUTION +fluctuante, I-EVOLUTION +con I-EVOLUTION +persistencia I-EVOLUTION +de I-EVOLUTION +astenia I-EVOLUTION +y I-EVOLUTION +poliartralgias I-EVOLUTION +limitantes, I-EVOLUTION +de I-EVOLUTION +predominio I-EVOLUTION +en I-EVOLUTION +carpo I-EVOLUTION +y I-EVOLUTION +manos. I-EVOLUTION +Descartada B-TREATMENT +artritis I-TREATMENT +siguió I-TREATMENT +tratamiento I-TREATMENT +sintomático. I-TREATMENT +En B-EVOLUTION +marzo I-EVOLUTION +de I-EVOLUTION +2015 I-EVOLUTION +manifestó I-EVOLUTION +una I-EVOLUTION +franca I-EVOLUTION +mejoría I-EVOLUTION +coincidiendo I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +cambio I-EVOLUTION +estacional. I-EVOLUTION +Se B-EXPLORATION +solicitó I-EXPLORATION +control I-EXPLORATION +analítico I-EXPLORATION con I-EXPLORATION -hemograma, I-EXPLORATION -VHS, I-EXPLORATION -transaminasas, I-EXPLORATION -calcio, I-EXPLORATION -fósforo, I-EXPLORATION -hormona I-EXPLORATION -paratiroidea I-EXPLORATION -(PTH), I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -25-OH I-EXPLORATION -vit. I-EXPLORATION -D3 I-EXPLORATION +hemograma I-EXPLORATION y I-EXPLORATION -cintigrafía I-EXPLORATION -ósea I-EXPLORATION -normales. I-EXPLORATION +bioquímica I-EXPLORATION +incluyendo I-EXPLORATION +VSG, I-EXPLORATION +PCR I-EXPLORATION +e I-EXPLORATION +interleucina I-EXPLORATION +6, I-EXPLORATION +sin I-EXPLORATION +mostrar I-EXPLORATION +alteraciones I-EXPLORATION +significativas. I-EXPLORATION + I-EXPLORATION El B-EVOLUTION -seguimiento I-EVOLUTION +14 I-EVOLUTION de I-EVOLUTION -los I-EVOLUTION -niveles I-EVOLUTION +abril I-EVOLUTION de I-EVOLUTION -FA I-EVOLUTION -al I-EVOLUTION -mes I-EVOLUTION -mostraron I-EVOLUTION -un I-EVOLUTION -leve I-EVOLUTION -ascenso I-EVOLUTION -con I-EVOLUTION -respecto I-EVOLUTION -al I-EVOLUTION -valor I-EVOLUTION -previo I-EVOLUTION -(5.857 I-EVOLUTION -UI/l), I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION +2015 I-EVOLUTION +se I-EVOLUTION +extendió I-EVOLUTION +el I-EVOLUTION +alta I-EVOLUTION +laboral I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +julio I-EVOLUTION +se I-EVOLUTION +realizó I-EVOLUTION +control I-EVOLUTION +ratificando I-EVOLUTION +la I-EVOLUTION recuperación I-EVOLUTION -clínica I-EVOLUTION -de I-EVOLUTION -cuadro I-EVOLUTION -febril I-EVOLUTION -intercurrente; I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -3 I-EVOLUTION -meses I-EVOLUTION -los I-EVOLUTION -valores I-EVOLUTION -disminuyeron I-EVOLUTION -a I-EVOLUTION -631 I-EVOLUTION -UI/l, I-EVOLUTION -normalizándose I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -valor I-EVOLUTION -de I-EVOLUTION -297 I-EVOLUTION -U/l. I-EVOLUTION +clínica. I-EVOLUTION +Hasta I-EVOLUTION +la I-EVOLUTION +fecha I-EVOLUTION +no I-EVOLUTION +ha I-EVOLUTION +solicitado I-EVOLUTION +nueva I-EVOLUTION +visita. I-EVOLUTION I-EVOLUTION -Prees B-PAST_MEDICAL_HISTORY -colar I-PAST_MEDICAL_HISTORY -femenino B-PRESENT_ILLNESS +Escolar B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS +13 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -portador B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cromosomopatia I-PAST_MEDICAL_HISTORY -compleja I-PAST_MEDICAL_HISTORY -46XX I-PAST_MEDICAL_HISTORY -add I-PAST_MEDICAL_HISTORY -(8). I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -placas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ampollas I-PRESENT_ILLNESS -localizadas I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -dorso I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -posterior I-PRESENT_ILLNESS -mente I-PRESENT_ILLNESS +controles I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -extremidades, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -alta, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -respuesta I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -antibiótico I-PRESENT_ILLNESS -indicado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -sospecha I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +policlínico I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -impetigo I-PRESENT_ILLNESS -ampollar. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -presentaba I-EXPLORATION -múltiples I-EXPLORATION -placas I-EXPLORATION -eritemato-violáceas, I-EXPLORATION -con I-EXPLORATION -centro I-EXPLORATION -ampollar I-EXPLORATION -en I-EXPLORATION -dorso, I-EXPLORATION -extremidades I-EXPLORATION -superiores I-EXPLORATION -e I-EXPLORATION -inferiores, I-EXPLORATION -junto I-EXPLORATION -a I-EXPLORATION -placas I-EXPLORATION -y I-EXPLORATION -nódulos I-EXPLORATION -eritematosos I-EXPLORATION -en I-EXPLORATION -brazo I-EXPLORATION -y I-EXPLORATION -muslo I-EXPLORATION -izquierdo. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION +broncopulmonar, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cuadros I-PAST_MEDICAL_HISTORY +bronquiales I-PAST_MEDICAL_HISTORY +obstructivos I-PAST_MEDICAL_HISTORY +frecuentes I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +infecciones I-PAST_MEDICAL_HISTORY +respiratorias I-PAST_MEDICAL_HISTORY +recurrentes, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +buena I-PAST_MEDICAL_HISTORY +respuesta I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +convencional. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Por B-EXPLORATION +referir I-EXPLORATION +dolor I-EXPLORATION +torácico I-EXPLORATION +se I-EXPLORATION +efectuó I-EXPLORATION +un I-EXPLORATION +TAC I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -destacó I-EXPLORATION -leucocitosis I-EXPLORATION +tórax I-EXPLORATION +que I-EXPLORATION +pesquisó I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lóbulo I-EXPLORATION +superior I-EXPLORATION +derecho I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -neutrofilia I-EXPLORATION -(RAN I-EXPLORATION -45954/mm3) I-EXPLORATION +SP I-EXPLORATION +intralobar. I-EXPLORATION +Fue I-EXPLORATION +evaluado I-EXPLORATION +con I-EXPLORATION +electrocardiograma I-EXPLORATION y I-EXPLORATION -PCR I-EXPLORATION -elevada I-EXPLORATION -(347 I-EXPLORATION -mg/L). I-EXPLORATION +ecocardiograma I-EXPLORATION +resultando I-EXPLORATION +normales. I-EXPLORATION Se I-EXPLORATION realizó I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -lesiones I-EXPLORATION -cutáneas I-EXPLORATION +estudio I-EXPLORATION +hemodinámico I-EXPLORATION +para I-EXPLORATION +lo I-EXPLORATION +cual I-EXPLORATION +se I-EXPLORATION +usó I-EXPLORATION +sedación I-EXPLORATION +y I-EXPLORATION +anestesia I-EXPLORATION +local I-EXPLORATION con I-EXPLORATION -hallazgos I-EXPLORATION -histopatológicos I-EXPLORATION -compatibles I-EXPLORATION +lidocaína, I-EXPLORATION +se I-EXPLORATION +cateterizó I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +femoral I-EXPLORATION +derecha I-EXPLORATION con I-EXPLORATION -Síndrome I-EXPLORATION +introductor I-EXPLORATION +5 I-EXPLORATION +French. I-EXPLORATION +Se I-EXPLORATION +efectuó I-EXPLORATION +una I-EXPLORATION +aortografía I-EXPLORATION +torácica I-EXPLORATION +con I-EXPLORATION +catéter I-EXPLORATION +Pig I-EXPLORATION +Tail I-EXPLORATION +5 I-EXPLORATION +French I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +pesquisó, I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -Sweet. I-EXPLORATION -Se B-TREATMENT -indicó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -1 I-TREATMENT -mg/ I-TREATMENT -kg/día, I-TREATMENT +la I-EXPLORATION +aorta I-EXPLORATION +torácica, I-EXPLORATION +un I-EXPLORATION +vaso I-EXPLORATION +aberrante I-EXPLORATION +de I-EXPLORATION +gran I-EXPLORATION +calibre I-EXPLORATION +que I-EXPLORATION +nacía I-EXPLORATION +de I-EXPLORATION +ésta I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +dirigía I-EXPLORATION +al I-EXPLORATION +lóbulo I-EXPLORATION +superior I-EXPLORATION +del I-EXPLORATION +pulmón I-EXPLORATION +derecho I-EXPLORATION +con I-EXPLORATION +diámetro I-EXPLORATION +mínimo I-EXPLORATION +2 I-EXPLORATION +mm I-EXPLORATION +y I-EXPLORATION +máximo I-EXPLORATION +6 I-EXPLORATION +mm. I-EXPLORATION + I-EXPLORATION +Posteriormente, B-TREATMENT con I-TREATMENT -buena I-TREATMENT -respuesta I-TREATMENT -clínica. I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -2 I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -presentaba I-EVOLUTION -placas I-EVOLUTION -costrosas I-EVOLUTION +catéter I-TREATMENT +multipropósito I-TREATMENT +5 I-TREATMENT +French I-TREATMENT +se I-TREATMENT +canalizó I-TREATMENT +el I-TREATMENT +vaso I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +al I-TREATMENT +cambio I-TREATMENT +de I-TREATMENT +introductor I-TREATMENT +N° I-TREATMENT +6 I-TREATMENT +French I-TREATMENT +y I-TREATMENT +por I-TREATMENT +medio I-TREATMENT +de I-TREATMENT +un I-TREATMENT +catéter I-TREATMENT +multipropósito I-TREATMENT +se I-TREATMENT +ubicó I-TREATMENT +una I-TREATMENT +guía I-TREATMENT +de I-TREATMENT +intercambio I-TREATMENT +a I-TREATMENT +distal I-TREATMENT +de I-TREATMENT +vasos I-TREATMENT +que I-TREATMENT +nutrían I-TREATMENT +el I-TREATMENT +secuestro I-TREATMENT +por I-TREATMENT +el I-TREATMENT +cual I-TREATMENT +se I-TREATMENT +introdujo I-TREATMENT +catéter I-TREATMENT +largo I-TREATMENT +de I-TREATMENT +6 I-TREATMENT +French I-TREATMENT +y I-TREATMENT +por I-TREATMENT +medio I-TREATMENT +de I-TREATMENT +este I-TREATMENT +se I-TREATMENT +implantó I-TREATMENT +un I-TREATMENT +dispositivo I-TREATMENT +AVP I-TREATMENT +II I-TREATMENT +(AmplatzerR) I-TREATMENT +de I-TREATMENT +dimensiones I-TREATMENT +4/6 I-TREATMENT +mm, I-TREATMENT +posterior I-TREATMENT +a I-TREATMENT +su I-TREATMENT +ubicación I-TREATMENT +y I-TREATMENT +comprobando I-TREATMENT +su I-TREATMENT +estabilidad I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +su I-TREATMENT +liberación, I-TREATMENT +obteniendo I-TREATMENT +oclusión I-TREATMENT +total I-TREATMENT +del I-TREATMENT +vaso I-TREATMENT +a I-TREATMENT +la I-TREATMENT +angiografía I-TREATMENT +de I-TREATMENT +control. I-TREATMENT + I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION de I-EVOLUTION -menor I-EVOLUTION -tamaño, I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +día I-EVOLUTION +siguiente I-EVOLUTION sin I-EVOLUTION -lesiones I-EVOLUTION -ampollares. I-EVOLUTION +complicaciones I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +controlado I-EVOLUTION +con I-EVOLUTION +radiografía I-EVOLUTION +de I-EVOLUTION +tórax I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +evidenció I-EVOLUTION +dispositivo I-EVOLUTION +in I-EVOLUTION +situ I-EVOLUTION +y I-EVOLUTION +campos I-EVOLUTION +pulmonares I-EVOLUTION +libres. I-EVOLUTION +Fue I-EVOLUTION +controlado I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +semana, I-EVOLUTION +mes, I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +6 I-EVOLUTION +meses, I-EVOLUTION +al I-EVOLUTION +año I-EVOLUTION +y I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +dos I-EVOLUTION +años, I-EVOLUTION +encontrándose I-EVOLUTION +en I-EVOLUTION +todos I-EVOLUTION +sus I-EVOLUTION +controles I-EVOLUTION +asintomático I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +excelentes I-EVOLUTION +condiciones. I-EVOLUTION I-EVOLUTION -Recién B-PRESENT_ILLNESS -nacido I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS +41 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad I-PRESENT_ILLNESS -gestacional, I-PRESENT_ILLNESS -nacido B-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -cesárea I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -sepsis I-PAST_MEDICAL_HISTORY -materna. I-PAST_MEDICAL_HISTORY -Madre B-FAMILY_HISTORY -de I-FAMILY_HISTORY -19 I-FAMILY_HISTORY -años I-FAMILY_HISTORY -de I-FAMILY_HISTORY -edad I-FAMILY_HISTORY -falleció I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -puerperio I-FAMILY_HISTORY -inme I-FAMILY_HISTORY -diato I-FAMILY_HISTORY -por I-FAMILY_HISTORY -sepsis I-FAMILY_HISTORY -grave, I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -de I-FAMILY_HISTORY -consanguinidad, I-FAMILY_HISTORY -el B-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -controlado, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -reporte I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -ultrasonidos I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -gestación I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -mostró I-PAST_MEDICAL_HISTORY -signos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hidrops I-PAST_MEDICAL_HISTORY -(derrame I-PAST_MEDICAL_HISTORY -pleural, I-PAST_MEDICAL_HISTORY -derrame I-PAST_MEDICAL_HISTORY -pericárdico I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -asci I-PAST_MEDICAL_HISTORY -tis). I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -nacimiento I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2090g, I-PAST_MEDICAL_HISTORY -APGAR I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -minuto I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -minutos. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -examen I-PAST_MEDICAL_HISTORY -clínico I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -mostró I-PAST_MEDICAL_HISTORY -fenotipo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -sugiera I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -genético. I-PAST_MEDICAL_HISTORY -Dos B-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -nacimiento I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -taquipnea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cianosis I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -respiratoria I-PRESENT_ILLNESS -grave. I-PRESENT_ILLNESS -Fue B-TREATMENT -tratado I-TREATMENT +gastrectomía I-PRESENT_ILLNESS +total I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +reconstrucción I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +Y I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Roux I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +adenocarcinoma I-PRESENT_ILLNESS +gástrico I-PRESENT_ILLNESS +pobremente I-PRESENT_ILLNESS +diferenciado I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +antes. I-PRESENT_ILLNESS +Se B-TREATMENT +asoció I-TREATMENT +quimioterapia I-TREATMENT con I-TREATMENT -surfactante I-TREATMENT -exógeno I-TREATMENT -de I-TREATMENT -rescate I-TREATMENT -por I-TREATMENT la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -signos I-TREATMENT +pauta I-TREATMENT +cisplatino I-TREATMENT +e I-TREATMENT +iridotecán, I-TREATMENT y I-TREATMENT -síntomas I-TREATMENT +se I-TREATMENT +administraron I-TREATMENT +12 I-TREATMENT +ciclos. I-TREATMENT +Requirió I-TREATMENT +cirugía I-TREATMENT de I-TREATMENT -síndrome I-TREATMENT +rescate I-TREATMENT +18 I-TREATMENT +meses I-TREATMENT +después I-TREATMENT de I-TREATMENT -dificultad I-TREATMENT -respiratoria, I-TREATMENT -catecolaminas, I-TREATMENT -antibióticos I-TREATMENT -y I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -por I-TREATMENT -22 I-TREATMENT -días; I-TREATMENT la I-TREATMENT -ventilación I-TREATMENT -convencional I-TREATMENT +1ª I-TREATMENT +cirugía I-TREATMENT +por I-TREATMENT +recidiva I-TREATMENT +tumoral I-TREATMENT +extraluminal I-TREATMENT +local: I-TREATMENT +anastomosis I-TREATMENT +terminolateral I-TREATMENT con I-TREATMENT -presión I-TREATMENT -media I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vía I-TREATMENT -aérea I-TREATMENT -máxima I-TREATMENT -de I-TREATMENT -16 I-TREATMENT -cm I-TREATMENT -H2O, I-TREATMENT -seguida I-TREATMENT +nueva I-TREATMENT +reconstrucción I-TREATMENT +en I-TREATMENT +Y I-TREATMENT de I-TREATMENT -VAFO I-TREATMENT -por I-TREATMENT -acidosis I-TREATMENT -respiratoria I-TREATMENT -e I-TREATMENT -hipoxemia I-TREATMENT -refrac I-TREATMENT -taria I-TREATMENT -(pCO2 I-TREATMENT -75 I-TREATMENT -mmHg I-TREATMENT +Roux I-TREATMENT y I-TREATMENT -pO2 I-TREATMENT -45 I-TREATMENT -mmHg). I-TREATMENT - I-TREATMENT -La B-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -mostró I-EXPLORATION +colectomía I-TREATMENT +subtotal I-TREATMENT +con I-TREATMENT +anastomosis I-TREATMENT +ileocólica I-TREATMENT +terminolateral I-TREATMENT +con I-TREATMENT +ileostomía I-TREATMENT +asociada. I-TREATMENT +En B-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +quirúrgica I-EXPLORATION +se I-EXPLORATION +pudo I-EXPLORATION +comprobar I-EXPLORATION infiltración I-EXPLORATION -reticular I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -pulmones I-EXPLORATION -y I-EXPLORATION -sobre I-EXPLORATION -distención I-EXPLORATION -pulmonar I-EXPLORATION -sin I-EXPLORATION -consolidaciones. I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -describió I-EXPLORATION -cambios I-EXPLORATION -reticulares I-EXPLORATION -en I-EXPLORATION -todas I-EXPLORATION -las I-EXPLORATION -zonas, I-EXPLORATION -engrosamiento I-EXPLORATION -intersticial, I-EXPLORATION -múltiples I-EXPLORATION -bullas I-EXPLORATION +peritoneo, I-EXPLORATION +colon, I-EXPLORATION +asa I-EXPLORATION +intestinal I-EXPLORATION +ascendida I-EXPLORATION +previamente I-EXPLORATION y I-EXPLORATION -atrapamiento I-EXPLORATION -de I-EXPLORATION -aire I-EXPLORATION -en I-EXPLORATION -pulmón I-EXPLORATION -izquierdo, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -neumonía I-EXPLORATION -derecha I-EXPLORATION -(Fi I-EXPLORATION -gura I-EXPLORATION -2). I-EXPLORATION -Se I-EXPLORATION -descartó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -linfangiectasia I-EXPLORATION en I-EXPLORATION -otros I-EXPLORATION -órganos I-EXPLORATION -por I-EXPLORATION -TAC I-EXPLORATION -abdominal. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -pulmonar I-EXPLORATION -y I-EXPLORATION -por I-EXPLORATION -indicación I-EXPLORATION -de I-EXPLORATION -cirugía I-EXPLORATION -pediátrica I-EXPLORATION -lobectomía I-EXPLORATION -inferior I-EXPLORATION -izquierda. I-EXPLORATION -En I-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -dilatación I-EXPLORATION -quística I-EXPLORATION +rodete I-EXPLORATION +esofágico I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -canales I-EXPLORATION -linfáti I-EXPLORATION -cos I-EXPLORATION -broncovasculares,. I-EXPLORATION -Por I-EXPLORATION -ecocardiografía I-EXPLORATION +la I-EXPLORATION +resección. I-EXPLORATION + I-EXPLORATION +Es B-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Aparato I-DERIVED_FROM/TO +Digestivo I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +disfagia I-DERIVED_FROM/TO +progresiva I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +2 I-DERIVED_FROM/TO +meses I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +cirugía, I-DERIVED_FROM/TO +acompañada I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +pérdida I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +peso. I-DERIVED_FROM/TO +Se B-EXPLORATION +realizó I-EXPLORATION +esofagograma I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -diagnosticó I-EXPLORATION -comunicación I-EXPLORATION -interauricular I-EXPLORATION -(CIA) I-EXPLORATION +apreciaba I-EXPLORATION +estenosis I-EXPLORATION +esofágica I-EXPLORATION +distal I-EXPLORATION y I-EXPLORATION -persistencia I-EXPLORATION +posteriormente, I-EXPLORATION +se I-EXPLORATION +hizo I-EXPLORATION +una I-EXPLORATION +endoscopia I-EXPLORATION +digestiva I-EXPLORATION +alta: I-EXPLORATION +estenosis I-EXPLORATION +esofágica I-EXPLORATION +distal I-EXPLORATION +con I-EXPLORATION +mucosa I-EXPLORATION +normal, I-EXPLORATION +con I-EXPLORATION +biopsias I-EXPLORATION +negativas I-EXPLORATION +para I-EXPLORATION +malignidad; I-EXPLORATION +además I-EXPLORATION +había I-EXPLORATION +puntos I-EXPLORATION de I-EXPLORATION -conducto I-EXPLORATION -arterioso I-EXPLORATION -(PCA) I-EXPLORATION +sutura I-EXPLORATION y I-EXPLORATION -fueron I-EXPLORATION -corregidas I-EXPLORATION -quirúrgicamente I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -30 I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -vida I-EXPLORATION -extra I-EXPLORATION -uterina. I-EXPLORATION -La B-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -satisfactoria, I-EVOLUTION -el I-EVOLUTION -seguimiento I-EVOLUTION -pediátrico I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -19 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -edad I-EVOLUTION -reportó I-EVOLUTION -peso I-EVOLUTION +grapas I-EXPLORATION +quirúrgicas. I-EXPLORATION +Se B-TREATMENT +optó I-TREATMENT +por I-TREATMENT +retirar I-TREATMENT +los I-TREATMENT +puntos I-TREATMENT +de I-TREATMENT +sutura I-TREATMENT +y I-TREATMENT +se I-TREATMENT +hicieron I-TREATMENT +6 I-TREATMENT +sesiones I-TREATMENT +de I-TREATMENT +dilatación I-TREATMENT +neumática, I-TREATMENT +siendo I-TREATMENT +ineficaces. I-TREATMENT +Ante I-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +infiltración I-TREATMENT +neoplásica I-TREATMENT +transmural I-TREATMENT +y I-TREATMENT +el I-TREATMENT +mantenimiento I-TREATMENT +de I-TREATMENT +la I-TREATMENT +disfagia, I-TREATMENT +se I-TREATMENT +colocó I-TREATMENT +una I-TREATMENT +prótesis I-TREATMENT +esofágica I-TREATMENT +no I-TREATMENT +recubierta I-TREATMENT +de I-TREATMENT +7 I-TREATMENT +cm. I-TREATMENT +Al B-EXPLORATION +expandirse I-EXPLORATION +la I-EXPLORATION +prótesis, I-EXPLORATION +permitió I-EXPLORATION +ver I-EXPLORATION +la I-EXPLORATION +infiltración I-EXPLORATION +neoplásica. I-EXPLORATION +A B-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +horas I-EVOLUTION +pudo I-EVOLUTION +tomar I-EVOLUTION +dieta I-EVOLUTION +blanda, I-EVOLUTION y I-EVOLUTION -talla I-EVOLUTION -adecuados I-EVOLUTION -para I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +franca I-EVOLUTION +mejoría I-EVOLUTION +de I-EVOLUTION su I-EVOLUTION -edad, I-EVOLUTION -desarrollo I-EVOLUTION -psicomotor I-EVOLUTION -nor I-EVOLUTION -mal, I-EVOLUTION -sin I-EVOLUTION -cuadros I-EVOLUTION -infecciosos I-EVOLUTION +disfagia. I-EVOLUTION +La B-TREATMENT +paciente I-TREATMENT +ha I-TREATMENT +recibido I-TREATMENT +ciclos I-TREATMENT +de I-TREATMENT +quimioterapia I-TREATMENT +paliativos I-TREATMENT +asociados. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +8 I-EVOLUTION +meses I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -vía I-EVOLUTION -respiratoria I-EVOLUTION -in I-EVOLUTION -ferior, I-EVOLUTION -no I-EVOLUTION -requirió I-EVOLUTION -oxigeno I-EVOLUTION -suplementario; I-EVOLUTION -la I-EVOLUTION -TAC I-EVOLUTION +colocación I-EVOLUTION de I-EVOLUTION -tórax I-EVOLUTION +la I-EVOLUTION +prótesis, I-EVOLUTION +aparece I-EVOLUTION de I-EVOLUTION -control I-EVOLUTION -informó I-EVOLUTION -con I-EVOLUTION -engrosamiento I-EVOLUTION -intersti I-EVOLUTION -cial, I-EVOLUTION -bullas I-EVOLUTION -enfisematosas I-EVOLUTION -difusas I-EVOLUTION -pequeñas I-EVOLUTION +nuevo I-EVOLUTION +disfagia I-EVOLUTION y I-EVOLUTION -mejoría I-EVOLUTION -con I-EVOLUTION -respecto I-EVOLUTION +pérdida I-EVOLUTION +de I-EVOLUTION +peso. I-EVOLUTION +En B-EXPLORATION +la I-EXPLORATION +endoscopia I-EXPLORATION +realizada I-EXPLORATION +se I-EXPLORATION +vio I-EXPLORATION +crecimiento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +neoplasia I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +prótesis I-EXPLORATION +; I-EXPLORATION +se B-TREATMENT +decidió I-TREATMENT +la I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +una I-TREATMENT +prótesis I-TREATMENT +esofágica I-TREATMENT +recubierta I-TREATMENT +de I-TREATMENT +10 I-TREATMENT +cm I-TREATMENT +de I-TREATMENT +longitud. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +vuelve I-EVOLUTION a I-EVOLUTION +reiniciar I-EVOLUTION la I-EVOLUTION -TAC I-EVOLUTION -inicial,. I-EVOLUTION +alimentación I-EVOLUTION +oral, I-EVOLUTION +mejorando I-EVOLUTION +su I-EVOLUTION +disfagia. I-EVOLUTION +Falleció I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +por I-EVOLUTION +invasión I-EVOLUTION +tumoral I-EVOLUTION +sistémica. I-EVOLUTION I-EVOLUTION Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS +50 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -cursando B-PAST_MEDICAL_HISTORY -escarlatina, I-PAST_MEDICAL_HISTORY -quien B-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -ictericia, I-PRESENT_ILLNESS -coluria I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +dedicado B-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +construcción, I-PAST_MEDICAL_HISTORY +originario I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Guanajuato, I-PAST_MEDICAL_HISTORY +Gto., I-PAST_MEDICAL_HISTORY +sin B-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +o B-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +importantes. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +verrugosa I-PRESENT_ILLNESS +nodular I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +nariz I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +crecimiento I-PRESENT_ILLNESS +gradual I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +últimos I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +meses. I-PRESENT_ILLNESS +Un I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +presentado I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +abscesos I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +brazo I-PRESENT_ILLNESS +derecho, I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +cuales I-PRESENT_ILLNESS +fueron I-PRESENT_ILLNESS +drenados, I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -apetito. I-PRESENT_ILLNESS -Los B-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -revelaron I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -transaminasas I-EXPLORATION +dos I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +notó I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +tercer I-PRESENT_ILLNESS +absceso I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +brazo. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +periorbitaria I-EXPLORATION y I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION +antecubital I-EXPLORATION +derecho I-EXPLORATION +placas I-EXPLORATION +nodulares I-EXPLORATION +verrugosas, I-EXPLORATION +edematosas I-EXPLORATION y I-EXPLORATION -directa, I-EXPLORATION +cubiertas I-EXPLORATION +por I-EXPLORATION +costras I-EXPLORATION +hemáticas. I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +directo I-EXPLORATION y I-EXPLORATION -estudios I-EXPLORATION -vira I-EXPLORATION -les I-EXPLORATION -negativos I-EXPLORATION +cultivo I-EXPLORATION +fueron I-EXPLORATION +positivos I-EXPLORATION para I-EXPLORATION -Hepatitis I-EXPLORATION -A, I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C, I-EXPLORATION -Virus I-EXPLORATION -de I-EXPLORATION -Epstein I-EXPLORATION -Barr, I-EXPLORATION -Parvovirus I-EXPLORATION -B19, I-EXPLORATION -Citomegalovirus, I-EXPLORATION -Virus I-EXPLORATION -Herpes I-EXPLORATION -6 I-EXPLORATION -y I-EXPLORATION -Herpes I-EXPLORATION -simplex I-EXPLORATION -1 I-EXPLORATION -y I-EXPLORATION -2. I-EXPLORATION -Ecografía I-EXPLORATION -abdominal I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION +Coccidioides I-EXPLORATION +spp. I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +coccidioidomicosis I-TREATMENT +cutánea I-TREATMENT +recibió I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +itraconazol I-TREATMENT +oral I-TREATMENT +400 I-TREATMENT +mg I-TREATMENT +al I-TREATMENT +día. I-TREATMENT + I-TREATMENT -Niño B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -previamente B-PAST_MEDICAL_HISTORY -sano. I-PAST_MEDICAL_HISTORY -Comenzó B-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dermato I-PRESENT_ILLNESS -sis I-PRESENT_ILLNESS -generalizada I-PRESENT_ILLNESS +45 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +residente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +área I-PRESENT_ILLNESS +urbana I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Santiago I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Cali I-PRESENT_ILLNESS +(Valle I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +Cauca, I-PRESENT_ILLNESS +Colombia), I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +estrato I-PRESENT_ILLNESS +socioeconómico I-PRESENT_ILLNESS +bajo, I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -máximo I-PRESENT_ILLNESS -lesional I-PRESENT_ILLNESS +ocupación I-PRESENT_ILLNESS +"vendedora I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dulces" I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -umbilical, I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +calle. I-PRESENT_ILLNESS +Tenía B-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +gastritis I-PAST_MEDICAL_HISTORY +crónica, I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +desnutrición I-PAST_MEDICAL_HISTORY +grave, I-PAST_MEDICAL_HISTORY +cuatro I-PAST_MEDICAL_HISTORY +embarazos I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +hijos I-PAST_MEDICAL_HISTORY +vivos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +cirugía I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ligadura I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +trompas I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +16 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Sin I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +diabetes I-PAST_MEDICAL_HISTORY +mellitus, I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +tabaquismo. I-PAST_MEDICAL_HISTORY +Presentaba I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +hábito I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ingerir I-PAST_MEDICAL_HISTORY +agua I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +potable. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +El B-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +clínico I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +inició I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +hospitalario, I-PRESENT_ILLNESS +consistente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +mesogastrio, I-PRESENT_ILLNESS +astenia, I-PRESENT_ILLNESS +adinamia I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -genitales, I-PRESENT_ILLNESS -caracterizada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ampollas, I-PRESENT_ILLNESS -algunas I-PRESENT_ILLNESS -denudadas I-PRESENT_ILLNESS +edema I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +extremidades I-PRESENT_ILLNESS +inferiores, I-PRESENT_ILLNESS +evolucionando I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -sangrado I-PRESENT_ILLNESS -fácil, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -mucoso I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -Se B-TREATMENT -diagnosticó I-TREATMENT -impétigo I-TREATMENT -bulloso I-TREATMENT -y I-TREATMENT -se I-TREATMENT -indicó I-TREATMENT -antibioticoterapia I-TREATMENT -tópica I-TREATMENT -y I-TREATMENT -sistémica I-TREATMENT -sin I-TREATMENT -mejoría I-TREATMENT -clínica. I-TREATMENT -Evolucionó B-EVOLUTION -con I-EVOLUTION -extensión I-EVOLUTION -lesional, I-EVOLUTION -con I-EVOLUTION -compromiso I-EVOLUTION -de I-EVOLUTION -mucosas I-EVOLUTION -oral I-EVOLUTION -y I-EVOLUTION -anal. I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -e I-EXPLORATION -inmunohistoquí- I-EXPLORATION -mico I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -perilesional I-EXPLORATION -confirmó I-EXPLORATION -pénfigo I-EXPLORATION -vulgar. I-EXPLORATION +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +diarrea I-PRESENT_ILLNESS +fétida, I-PRESENT_ILLNESS +emesis, I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +apetito I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +últimos I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +hemoptoica. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Consultó I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +salud I-PRESENT_ILLNESS +periférico I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +evidenciaron I-PRESENT_ILLNESS +larvas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +S. I-PRESENT_ILLNESS +stercolaris I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +examen I-PRESENT_ILLNESS +directo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +solución I-PRESENT_ILLNESS +salina I-PRESENT_ILLNESS +fisiológica I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +0, I-PRESENT_ILLNESS +9% I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +lugol. I-PRESENT_ILLNESS Se B-TREATMENT inició I-TREATMENT tratamiento I-TREATMENT -corticoideo I-TREATMENT -e I-TREATMENT -inmunomodulador I-TREATMENT +médico I-TREATMENT con I-TREATMENT -buena I-TREATMENT -respuesta. I-TREATMENT - I-TREATMENT - -Recién B-PRESENT_ILLNESS -nacido I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -término I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -semanas, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -mascu I-PRESENT_ILLNESS -lino, I-PRESENT_ILLNESS -embarazo B-PAST_MEDICAL_HISTORY -controlado, I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -eutócico, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -perinatales. I-PAST_MEDICAL_HISTORY -Derivado B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -dermatología I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -placa I-DERIVED_FROM/TO -eritematosa I-DERIVED_FROM/TO -levemente I-DERIVED_FROM/TO -infiltrada I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -región I-DERIVED_FROM/TO -peri I-DERIVED_FROM/TO -e I-DERIVED_FROM/TO -infraumbilical I-DERIVED_FROM/TO -presente I-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -nacimiento, I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -bordes I-DERIVED_FROM/TO -bien I-DERIVED_FROM/TO -definidos I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -descamación I-DERIVED_FROM/TO -amarillenta I-DERIVED_FROM/TO -superficial I-DERIVED_FROM/TO -adherente I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -polo I-DERIVED_FROM/TO -inferior, I-DERIVED_FROM/TO -sin I-DERIVED_FROM/TO -otros I-DERIVED_FROM/TO -signos I-DERIVED_FROM/TO -inflamatorios I-DERIVED_FROM/TO -locales. I-DERIVED_FROM/TO -Estudio B-EXPLORATION -ecográfico I-EXPLORATION -cutáneo I-EXPLORATION -reveló I-EXPLORATION -lesión I-EXPLORATION -dermoepidérmica I-EXPLORATION -hipoecogénica I-EXPLORATION -homogénea, I-EXPLORATION -con I-EXPLORATION -extensión I-EXPLORATION -leve I-EXPLORATION -a I-EXPLORATION -tejido I-EXPLORATION -subcutáneo I-EXPLORATION +ivermectina I-TREATMENT +durante I-TREATMENT +dos I-TREATMENT +días I-TREATMENT +(200 I-TREATMENT +μg/kg/día) I-TREATMENT +y I-TREATMENT +albendazol I-TREATMENT +(400 I-TREATMENT +mg/día). I-TREATMENT +Entre B-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +albúmina I-EXPLORATION +de I-EXPLORATION +0, I-EXPLORATION +5 I-EXPLORATION +g/dL, I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +VIH I-EXPLORATION +negativa I-EXPLORATION y I-EXPLORATION -escasos I-EXPLORATION -vasos I-EXPLORATION -sinuosos I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -segmento I-EXPLORATION -más I-EXPLORATION -profundo. I-EXPLORATION - I-EXPLORATION -Dado I-EXPLORATION -las I-EXPLORATION -características I-EXPLORATION -clínicas, I-EXPLORATION +para I-EXPLORATION +HTLV I-EXPLORATION +I-II I-EXPLORATION +positiva. I-EXPLORATION +La I-EXPLORATION +TSH I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -incisional I-EXPLORATION -profunda I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -proliferación I-EXPLORATION +encontraba I-EXPLORATION +normal. I-EXPLORATION +Siete I-EXPLORATION +días I-EXPLORATION +después I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +se I-EXPLORATION +remitió I-EXPLORATION +a I-EXPLORATION +una I-EXPLORATION +Unidad I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -fusiformes I-EXPLORATION -delgadas I-EXPLORATION -en I-EXPLORATION -dermis I-EXPLORATION -e I-EXPLORATION -hipodermis, I-EXPLORATION +Cuidados I-EXPLORATION +Intensivos I-EXPLORATION +(UCI) I-EXPLORATION +extrainstitucional I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +cuadro I-EXPLORATION de I-EXPLORATION -morfología I-EXPLORATION -bifásica I-EXPLORATION -con I-EXPLORATION +dificultad I-EXPLORATION +respiratoria. I-EXPLORATION +Los I-EXPLORATION +diagnósticos I-EXPLORATION +presuntivos I-EXPLORATION +fueron I-EXPLORATION un I-EXPLORATION -segmento I-EXPLORATION -dispuesto I-EXPLORATION -en I-EXPLORATION +trombo-embolismo I-EXPLORATION +pulmonar I-EXPLORATION +(TEP), I-EXPLORATION un I-EXPLORATION -patrón I-EXPLORATION -arremolinado I-EXPLORATION -infiltrante I-EXPLORATION -y I-EXPLORATION -otro I-EXPLORATION -con I-EXPLORATION -bandas I-EXPLORATION +síndrome I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -fusadas I-EXPLORATION -con I-EXPLORATION -hábitos I-EXPLORATION -fibroblástico I-EXPLORATION -y I-EXPLORATION -miofibroblástico, I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION +Lóeffler I-EXPLORATION +o I-EXPLORATION +una I-EXPLORATION +neumonía I-EXPLORATION +bacteriana. I-EXPLORATION + I-EXPLORATION +Ingresó B-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +UCI I-EVOLUTION +consciente, I-EVOLUTION +con I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +dificultad I-EVOLUTION +respiratoria, I-EVOLUTION +taquicárdica, I-EVOLUTION +afebril, I-EVOLUTION +con I-EVOLUTION +saturación I-EVOLUTION +arterial I-EVOLUTION +de I-EVOLUTION +oxígeno I-EVOLUTION +(SaO2) I-EVOLUTION +por I-EVOLUTION +oximetría I-EVOLUTION +de I-EVOLUTION +pulso I-EVOLUTION +de I-EVOLUTION +87%, I-EVOLUTION +con I-EVOLUTION +soporte I-EVOLUTION +de I-EVOLUTION +oxígeno I-EVOLUTION +(FiO2 I-EVOLUTION +50%). I-EVOLUTION +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +destacaba I-EXPLORATION +estertores I-EXPLORATION +finos I-EXPLORATION +pulmonares I-EXPLORATION +bibasales, I-EXPLORATION +abdomen I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -zona I-EXPLORATION +irritación I-EXPLORATION +peritoneal, I-EXPLORATION +edema I-EXPLORATION +grado I-EXPLORATION +III I-EXPLORATION +en I-EXPLORATION +extremidades I-EXPLORATION +inferiores I-EXPLORATION +y, I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -Grenz. I-EXPLORATION -En I-EXPLORATION -profundidad, I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -componente I-EXPLORATION +lesiones I-EXPLORATION +eritematosas, I-EXPLORATION +pruriginosas, I-EXPLORATION +no I-EXPLORATION +descamativas I-EXPLORATION +en I-EXPLORATION +piel, I-EXPLORATION +predominantemente I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +muslos. I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -tejido I-EXPLORATION -adiposo I-EXPLORATION -maduro, I-EXPLORATION +ingreso I-EXPLORATION +evidenciaban I-EXPLORATION +leucocitos I-EXPLORATION +de I-EXPLORATION +26.200/mm3, I-EXPLORATION +hemoglobina I-EXPLORATION +9, I-EXPLORATION +1 I-EXPLORATION +g/dL, I-EXPLORATION +neutrófilos I-EXPLORATION +86%, I-EXPLORATION +eosinófilos I-EXPLORATION +2%, I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +(PCR) I-EXPLORATION +18 I-EXPLORATION +mg/dL, I-EXPLORATION +electrolitos I-EXPLORATION +y I-EXPLORATION +creatinina I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +rangos I-EXPLORATION +normales, I-EXPLORATION +hipoxemia I-EXPLORATION +grave I-EXPLORATION sin I-EXPLORATION -signos I-EXPLORATION +trastorno I-EXPLORATION +ácido-base. I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -atipía. I-EXPLORATION -Epidermis I-EXPLORATION -madura, I-EXPLORATION -parcialmente I-EXPLORATION -atrófica. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -necrosis I-EXPLORATION -ni I-EXPLORATION -mitosis I-EXPLORATION -atípicas. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION +tórax I-EXPLORATION +mostró I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -tumorales I-EXPLORATION -mos I-EXPLORATION -tró I-EXPLORATION -positividad I-EXPLORATION -intensa I-EXPLORATION -y I-EXPLORATION -difusa I-EXPLORATION -a I-EXPLORATION -CD34 I-EXPLORATION +infiltrados I-EXPLORATION +mixtos I-EXPLORATION +de I-EXPLORATION +predominio I-EXPLORATION +alveolar I-EXPLORATION +de I-EXPLORATION +distribución I-EXPLORATION +difusa. I-EXPLORATION + I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +con I-EVOLUTION +dificultad I-EVOLUTION +respiratoria I-EVOLUTION +progresiva, I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +requirió I-TREATMENT +finalmente I-TREATMENT +ventilación I-TREATMENT +mecánica I-TREATMENT +invasora, I-TREATMENT +sin I-TREATMENT +necesidad I-TREATMENT +de I-TREATMENT +parámetros I-TREATMENT +ventilatorios I-TREATMENT +altos. I-TREATMENT +Además I-TREATMENT +requirió I-TREATMENT +soporte I-TREATMENT +vasoactivo I-TREATMENT +con I-TREATMENT +norepinefrina I-TREATMENT +por I-TREATMENT +una I-TREATMENT +hipotensión I-TREATMENT +arterial I-TREATMENT +persistente. I-TREATMENT +En B-EVOLUTION +su I-EVOLUTION +evolución I-EVOLUTION +clínica I-EVOLUTION +presentó I-EVOLUTION +secreciones I-EVOLUTION +respiratorias I-EVOLUTION +hemáticas I-EVOLUTION +constantes I-EVOLUTION +con I-EVOLUTION +descenso I-EVOLUTION +significativo I-EVOLUTION + I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +hemoglobina, I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +requirió I-TREATMENT +transfusión I-TREATMENT +de I-TREATMENT +glóbulos I-TREATMENT +rojos. I-TREATMENT +Ante I-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +una I-TREATMENT +neumonía I-TREATMENT +bacteriana I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +cobertura I-TREATMENT +antibacteriana I-TREATMENT +de I-TREATMENT +amplio I-TREATMENT +espectro I-TREATMENT +con I-TREATMENT +piperacilina/tazobactam. I-TREATMENT +Posteriormente B-EXPLORATION +se I-EXPLORATION +informaron I-EXPLORATION +hemocultivos I-EXPLORATION y I-EXPLORATION -focal I-EXPLORATION +urocultivo I-EXPLORATION +positivos I-EXPLORATION para I-EXPLORATION -FXIIIa, I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION +Escherichia I-EXPLORATION +coli I-EXPLORATION +productora I-EXPLORATION de I-EXPLORATION -inmunoreactividad I-EXPLORATION -a I-EXPLORATION -actina, I-EXPLORATION -desmina, I-EXPLORATION -MyoD1, I-EXPLORATION -S100, I-EXPLORATION -HMB45, I-EXPLORATION -MelanA I-EXPLORATION -y I-EXPLORATION -EMA. I-EXPLORATION -Índice I-EXPLORATION +betalactamasas I-EXPLORATION de I-EXPLORATION -proliferación I-EXPLORATION -con I-EXPLORATION -Ki67 I-EXPLORATION -moderado, I-EXPLORATION -con I-EXPLORATION -positividad I-EXPLORATION +espectro I-EXPLORATION +extendido I-EXPLORATION +(BLEE), I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +cambió I-TREATMENT +tratamiento I-TREATMENT +a I-TREATMENT +meropenem. I-TREATMENT +Ante B-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +estrongiloidosis I-EXPLORATION +pulmonar I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +microscopía I-EXPLORATION en I-EXPLORATION -aproximadamente I-EXPLORATION -el I-EXPLORATION -20% I-EXPLORATION +fresco I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -células. I-EXPLORATION -Se I-EXPLORATION -complementó I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -FISH I-EXPLORATION -para I-EXPLORATION -PDGF I-EXPLORATION -beta I-EXPLORATION -y I-EXPLORATION -ETV6, I-EXPLORATION -los I-EXPLORATION -que I-EXPLORATION -resultaron I-EXPLORATION -negativos, I-EXPLORATION -excluyendo I-EXPLORATION -los I-EXPLORATION -diagnósticos I-EXPLORATION -diferenciales I-EXPLORATION +una I-EXPLORATION +muestra I-EXPLORATION de I-EXPLORATION -dermatofobrosarcoma I-EXPLORATION -protuberans I-EXPLORATION -congénito I-EXPLORATION -y I-EXPLORATION -fibrosarcoma I-EXPLORATION -infantil, I-EXPLORATION -respec I-EXPLORATION -tivamente. I-EXPLORATION -Estos I-EXPLORATION -antecedentes, I-EXPLORATION -sumados I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -histológicos, I-EXPLORATION -fueron I-EXPLORATION -compatibles I-EXPLORATION +secreción I-EXPLORATION +orotraqueal, I-EXPLORATION +observándose I-EXPLORATION +larvas I-EXPLORATION +de I-EXPLORATION +S. I-EXPLORATION +stercoralis, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +cual I-TREATMENT +se I-TREATMENT +administró I-TREATMENT +una I-TREATMENT +nueva I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +ivermectina I-TREATMENT +(200 I-TREATMENT +μg/kg) I-TREATMENT +y I-TREATMENT +se I-TREATMENT +continuó I-TREATMENT +con I-TREATMENT +albendazol I-TREATMENT +oral I-TREATMENT +(400 I-TREATMENT +mg, I-TREATMENT +dos I-TREATMENT +veces I-TREATMENT +al I-TREATMENT +día). I-TREATMENT +También B-EXPLORATION +se I-EXPLORATION +descartó I-EXPLORATION +una I-EXPLORATION +tuberculosis I-EXPLORATION +pulmonar I-EXPLORATION con I-EXPLORATION +baciloscopias I-EXPLORATION +seriadas I-EXPLORATION +negativas. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +colonoscopia, I-EXPLORATION +cuyo I-EXPLORATION +informe I-EXPLORATION +anatomopatológico I-EXPLORATION +fue I-EXPLORATION +una I-EXPLORATION +colitis I-EXPLORATION +crónica I-EXPLORATION +leve I-EXPLORATION +inespecífica. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +realizaron I-EXPLORATION +pruebas I-EXPLORATION +inmunológicas I-EXPLORATION +para I-EXPLORATION el I-EXPLORATION diagnóstico I-EXPLORATION de I-EXPLORATION -HFI. I-EXPLORATION +estrongiloidosis. I-EXPLORATION I-EXPLORATION Se B-TREATMENT realizó I-TREATMENT -extirpación I-TREATMENT -quirúrgica I-TREATMENT -por I-TREATMENT -equipo I-TREATMENT +el I-TREATMENT +proceso I-TREATMENT de I-TREATMENT -ci I-TREATMENT -rugía I-TREATMENT -pediátrica, I-TREATMENT -con I-TREATMENT -readecuación I-TREATMENT -umbilical I-TREATMENT -mediante I-TREATMENT -colgajos I-TREATMENT +desvinculación I-TREATMENT +progresiva I-TREATMENT +del I-TREATMENT +soporte I-TREATMENT +ventilatorio, I-TREATMENT +logrando I-TREATMENT +la I-TREATMENT +extubación I-TREATMENT +al I-TREATMENT +quinto I-TREATMENT +día I-TREATMENT de I-TREATMENT -rotación I-TREATMENT -laterales. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -e I-EXPLORATION -inmunohistoquímico I-EXPLORATION -sostuvo I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -descritos I-EXPLORATION -previamente, I-EXPLORATION -comprometiendo I-EXPLORATION -márgenes I-EXPLORATION -de I-EXPLORATION -resección I-EXPLORATION -quirúrgica. I-EXPLORATION -Evolucionó B-EVOLUTION -sin I-EVOLUTION -signos I-EVOLUTION +ventilación I-TREATMENT +mecánica I-TREATMENT +invasora. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +completó I-EVOLUTION +una I-EVOLUTION +estancia I-EVOLUTION +hospitalaria I-EVOLUTION de I-EVOLUTION -recidiva I-EVOLUTION +12 I-EVOLUTION +días, I-EVOLUTION +período I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +cual I-EVOLUTION +presentó I-EVOLUTION +episodios I-EVOLUTION +repetitivos I-EVOLUTION +de I-EVOLUTION +tos I-EVOLUTION +seca. I-EVOLUTION +En I-EVOLUTION +el I-EVOLUTION +seguimiento I-EVOLUTION +clínico I-EVOLUTION +el I-EVOLUTION +estudio I-EVOLUTION +coproscópico I-EVOLUTION +no I-EVOLUTION +evidenció I-EVOLUTION +parásitos I-EVOLUTION +intestinales, I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +radiografía I-EVOLUTION +de I-EVOLUTION +tórax I-EVOLUTION a I-EVOLUTION los I-EVOLUTION -7 I-EVOLUTION -meses I-EVOLUTION +15 I-EVOLUTION +días I-EVOLUTION +evidenció I-EVOLUTION +una I-EVOLUTION +resolución I-EVOLUTION +significativa I-EVOLUTION +del I-EVOLUTION +infiltrado I-EVOLUTION +pulmonar. I-EVOLUTION +Completó B-TREATMENT +10 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +antihelmíntico I-TREATMENT +con I-TREATMENT +albendazol. I-TREATMENT +La B-EVOLUTION +hemoglobina I-EVOLUTION de I-EVOLUTION -seguimiento. I-EVOLUTION +egreso I-EVOLUTION +fue I-EVOLUTION +de I-EVOLUTION +9, I-EVOLUTION +9 I-EVOLUTION +g/dL. I-EVOLUTION + I-EVOLUTION +Durante B-TREATMENT +la I-TREATMENT +permanencia I-TREATMENT +en I-TREATMENT +la I-TREATMENT +institución I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +recibió I-TREATMENT +manejo I-TREATMENT +de I-TREATMENT +fisioterapia, I-TREATMENT +donde B-EVOLUTION +se I-EVOLUTION +observó I-EVOLUTION +una I-EVOLUTION +evolución I-EVOLUTION +favorable I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +condición I-EVOLUTION +cardiorrespiratoria I-EVOLUTION +y I-EVOLUTION +nivel I-EVOLUTION +de I-EVOLUTION +funcionalidad. I-EVOLUTION I-EVOLUTION Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS una I-PRESENT_ILLNESS -joven I-PRESENT_ILLNESS +niña I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -17 I-PRESENT_ILLNESS +nueve I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -lograr I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mejoría I-PRESENT_ILLNESS -estético I-PRESENT_ILLNESS -funcional I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS de I-PRESENT_ILLNESS su I-PRESENT_ILLNESS -dedo I-PRESENT_ILLNESS -pulgar I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mano I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -Había B-PAST_MEDICAL_HISTORY -nacido I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -dedo I-PAST_MEDICAL_HISTORY -pulgar I-PAST_MEDICAL_HISTORY -pequeño I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -función, I-PAST_MEDICAL_HISTORY -unido I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -resto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -mano I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -través I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY +salud I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +tumoración I-PRESENT_ILLNESS +cervical I-PRESENT_ILLNESS +izquierda I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +fiebre. I-PRESENT_ILLNESS +Como B-PAST_MEDICAL_HISTORY +antecedente, I-PAST_MEDICAL_HISTORY +destaca I-PAST_MEDICAL_HISTORY un I-PAST_MEDICAL_HISTORY -pequeño I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -delgado I-PAST_MEDICAL_HISTORY -tubo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -piel; I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -lactancia, I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY +traumatismo I-PAST_MEDICAL_HISTORY +directo I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +misma I-PAST_MEDICAL_HISTORY +región I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +semana I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY el I-PAST_MEDICAL_HISTORY -Hospital I-PAST_MEDICAL_HISTORY -Infantil I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -habían I-PAST_MEDICAL_HISTORY -únicamente I-PAST_MEDICAL_HISTORY -extirpado I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -área I-PAST_MEDICAL_HISTORY -cutánea I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -pequeño I-PAST_MEDICAL_HISTORY -tubo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -unión I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -fin I-PAST_MEDICAL_HISTORY +manillar I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -lograr I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -implantación I-PAST_MEDICAL_HISTORY -directa I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -apéndice I-PAST_MEDICAL_HISTORY -pulgar I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -mano. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Cuando B-EXPLORATION -acude I-EXPLORATION -a I-EXPLORATION -nuestra I-EXPLORATION -consulta I-EXPLORATION +un I-PAST_MEDICAL_HISTORY +patinete. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION presenta I-EXPLORATION -un I-EXPLORATION -pulgar I-EXPLORATION -con I-EXPLORATION -implantación I-EXPLORATION -distal I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -articulación I-EXPLORATION -metacarpofalangica I-EXPLORATION -del I-EXPLORATION -índice, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -primer I-EXPLORATION -espacio I-EXPLORATION -estrecho, I-EXPLORATION +4 I-EXPLORATION +cm, I-EXPLORATION +blanda I-EXPLORATION +y I-EXPLORATION +móvil, I-EXPLORATION sin I-EXPLORATION -capacidad I-EXPLORATION -motora I-EXPLORATION -de I-EXPLORATION -oposición I-EXPLORATION -ni I-EXPLORATION -flexo-extensión, I-EXPLORATION -pero I-EXPLORATION -con I-EXPLORATION -buena I-EXPLORATION -sensibilidad I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -bordes I-EXPLORATION -del I-EXPLORATION -mismo. I-EXPLORATION -No I-EXPLORATION -presentaba I-EXPLORATION -eminencia I-EXPLORATION -tenar I-EXPLORATION +signos I-EXPLORATION +inflamatorios I-EXPLORATION +adyacentes I-EXPLORATION y I-EXPLORATION -no I-EXPLORATION +dolorosa I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación. I-EXPLORATION +Es B-TREATMENT +diagnosticada I-TREATMENT +de I-TREATMENT +adenitis I-TREATMENT +laterocervical, I-TREATMENT +iniciando I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +amoxicilina-clavulánico I-TREATMENT +oral. I-TREATMENT + I-TREATMENT +Tras B-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +semana I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +revisada I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +consulta, I-DERIVED_FROM/TO +persistiendo I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +dolor I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +tumoración, I-DERIVED_FROM/TO +esta I-DERIVED_FROM/TO +vez I-DERIVED_FROM/TO +indurada, I-DERIVED_FROM/TO +sin I-DERIVED_FROM/TO +otros I-DERIVED_FROM/TO +síntomas I-DERIVED_FROM/TO +acompañantes, I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +lo I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +derivada I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +Urgencias I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +hospital I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +referencia, I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +le I-DERIVED_FROM/TO +realiza I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +ecografía I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +visualiza I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +lesión I-DERIVED_FROM/TO +abscesificada I-DERIVED_FROM/TO +subyacente I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +músculo I-DERIVED_FROM/TO +esternocleidomastoideo I-DERIVED_FROM/TO +(ECM), I-DERIVED_FROM/TO +decidiéndose I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +ingreso I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +administrar I-DERIVED_FROM/TO +tratamiento I-DERIVED_FROM/TO +antibiótico I-DERIVED_FROM/TO +intravenoso. I-DERIVED_FROM/TO +Reexplorando B-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +paciente, I-EXPLORATION se I-EXPLORATION -palpaba I-EXPLORATION +palpa I-EXPLORATION el I-EXPLORATION -primer I-EXPLORATION -metacarpiano; I-EXPLORATION -además I-EXPLORATION -tenía I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -pulso I-EXPLORATION -radial I-EXPLORATION -pero I-EXPLORATION -sí I-EXPLORATION +músculo I-EXPLORATION +ECM I-EXPLORATION +izquierdo I-EXPLORATION +engrosado I-EXPLORATION +en I-EXPLORATION +toda I-EXPLORATION +su I-EXPLORATION +extensión, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -palpaba I-EXPLORATION -adecuadamente I-EXPLORATION -el I-EXPLORATION -pulso I-EXPLORATION -cubital. I-EXPLORATION -La I-EXPLORATION -parte I-EXPLORATION -funcional I-EXPLORATION -compensatoria I-EXPLORATION +decide I-EXPLORATION +repetir I-EXPLORATION la I-EXPLORATION -realizaba I-EXPLORATION -con I-EXPLORATION -alguna I-EXPLORATION -dificultad I-EXPLORATION -mediante I-EXPLORATION -una I-EXPLORATION -pinza I-EXPLORATION -dígito-digital I-EXPLORATION -lateral I-EXPLORATION -entre I-EXPLORATION -el I-EXPLORATION -índice I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -medio. I-EXPLORATION -Se I-EXPLORATION -solicitaron I-EXPLORATION -estudios I-EXPLORATION -radiológicos I-EXPLORATION -que I-EXPLORATION -evidenciaron I-EXPLORATION -hipoplasia I-EXPLORATION -y I-EXPLORATION -fusión I-EXPLORATION +ecografía I-EXPLORATION +cervical I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -falanges, I-EXPLORATION -agenesia I-EXPLORATION -del I-EXPLORATION -primer I-EXPLORATION -metacarpiano, I-EXPLORATION -atrofia I-EXPLORATION -del I-EXPLORATION -trapecio I-EXPLORATION -y I-EXPLORATION -resto I-EXPLORATION +forma I-EXPLORATION +bilateral. I-EXPLORATION +El I-EXPLORATION +informe I-EXPLORATION +indica I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -huesos I-EXPLORATION -del I-EXPLORATION -carpo, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -también I-EXPLORATION -atrofia I-EXPLORATION +un I-EXPLORATION +engrosamiento I-EXPLORATION del I-EXPLORATION -radio; I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION +músculo I-EXPLORATION +ECM I-EXPLORATION +izquierdo I-EXPLORATION con I-EXPLORATION -doppler I-EXPLORATION -color I-EXPLORATION -revelo I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -radial I-EXPLORATION +respecto I-EXPLORATION +al I-EXPLORATION +derecho, I-EXPLORATION con I-EXPLORATION -dilatación I-EXPLORATION -compensatoria I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -ulnar. I-EXPLORATION -Con I-EXPLORATION -este I-EXPLORATION -examen I-EXPLORATION -clínico I-EXPLORATION -se I-EXPLORATION -diagnosticó I-EXPLORATION -un I-EXPLORATION -típico I-EXPLORATION -pulgar I-EXPLORATION -flotante I-EXPLORATION -izquierdo I-EXPLORATION -parcialmente I-EXPLORATION -tratado. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -su I-EXPLORATION -mano I-EXPLORATION -derecha I-EXPLORATION -dominante I-EXPLORATION -presentaba I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -pulgar I-EXPLORATION -las I-EXPLORATION -siguientes I-EXPLORATION -anomalías: I-EXPLORATION -primer I-EXPLORATION -espacio I-EXPLORATION -estrecho, I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -pliegues I-EXPLORATION -de I-EXPLORATION -flexión, I-EXPLORATION -ausencia I-EXPLORATION +alteración I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -eminencia I-EXPLORATION -tenar, I-EXPLORATION -imposibilidad I-EXPLORATION -para I-EXPLORATION -flexionar I-EXPLORATION -la I-EXPLORATION -articulación I-EXPLORATION -metacarpofalángica I-EXPLORATION -pero I-EXPLORATION +ecogenicidad, I-EXPLORATION +visualizándose I-EXPLORATION +dos I-EXPLORATION +focos I-EXPLORATION +hipoecoicos I-EXPLORATION +intramusculares I-EXPLORATION +compatibles I-EXPLORATION con I-EXPLORATION -buena I-EXPLORATION -movilidad I-EXPLORATION -pasiva I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma, I-EXPLORATION -anquílosis I-EXPLORATION -de I-EXPLORATION +piomiositis, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION la I-EXPLORATION -articulación I-EXPLORATION -interfalángica; I-EXPLORATION -a I-EXPLORATION -pesar I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -todo I-EXPLORATION -esto I-EXPLORATION -había I-EXPLORATION -buena I-EXPLORATION -función I-EXPLORATION -del I-EXPLORATION -mismo. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -radiológico I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -doppler I-EXPLORATION -color I-EXPLORATION -no I-EXPLORATION -evidenciaron I-EXPLORATION -anomalías I-EXPLORATION -óseas I-EXPLORATION -o I-EXPLORATION -vasculares. I-EXPLORATION -Con I-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION -podríamos I-EXPLORATION -clasificar I-EXPLORATION -el I-EXPLORATION -pulgar I-EXPLORATION -derecho I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -grupo I-EXPLORATION -I I-EXPLORATION +un I-EXPLORATION +absceso I-EXPLORATION +subyacente I-EXPLORATION de I-EXPLORATION -Blauth. I-EXPLORATION - I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -detectaron I-EXPLORATION -otras I-EXPLORATION -anomalías I-EXPLORATION -corporales I-EXPLORATION -congénitas. I-EXPLORATION +1, I-EXPLORATION +6 I-EXPLORATION +× I-EXPLORATION +2, I-EXPLORATION +7 I-EXPLORATION +cm. I-EXPLORATION I-EXPLORATION -Tratamiento B-TREATMENT -y I-TREATMENT -resultados I-TREATMENT - I-TREATMENT -Al I-TREATMENT -reconstruir I-TREATMENT -un I-TREATMENT -pulgar I-TREATMENT -se I-TREATMENT -deben I-TREATMENT -tener I-TREATMENT -bien I-TREATMENT -claros I-TREATMENT -algunos I-TREATMENT -objetivos I-TREATMENT -generales I-TREATMENT -que I-TREATMENT -ayudarán I-TREATMENT -a I-TREATMENT -la I-TREATMENT -funcionabilidad I-TREATMENT -del I-TREATMENT -mismo, I-TREATMENT -como I-TREATMENT -son I-TREATMENT -lograr I-TREATMENT -estabilidad, I-TREATMENT -oposición, I-TREATMENT -sensibilidad, I-TREATMENT -darle I-TREATMENT -una I-TREATMENT -longitud I-TREATMENT -adecuada, I-TREATMENT -darle I-TREATMENT -movilidad I-TREATMENT -en I-TREATMENT -lo I-TREATMENT -posible I-TREATMENT -y I-TREATMENT -un I-TREATMENT -buen I-TREATMENT -aspecto I-TREATMENT -estético. I-TREATMENT - I-TREATMENT -En I-TREATMENT -la I-TREATMENT -reconstrucción I-TREATMENT -de I-TREATMENT -un I-TREATMENT -pulgar I-TREATMENT -flotante I-TREATMENT -existen I-TREATMENT -dos I-TREATMENT -conductas I-TREATMENT -básicamente I-TREATMENT -opuestas, I-TREATMENT -que I-TREATMENT -deben I-TREATMENT -discutirse I-TREATMENT -ampliamente I-TREATMENT -con I-TREATMENT -los I-TREATMENT -padres I-TREATMENT -y I-TREATMENT -con I-TREATMENT -el I-TREATMENT +La B-TREATMENT paciente I-TREATMENT -si I-TREATMENT -éste I-TREATMENT -se I-TREATMENT -encuentra I-TREATMENT -en I-TREATMENT -una I-TREATMENT -edad I-TREATMENT -de I-TREATMENT -comprender. I-TREATMENT - I-TREATMENT -Desde I-TREATMENT -el I-TREATMENT -punto I-TREATMENT -de I-TREATMENT -vista I-TREATMENT -práctico I-TREATMENT -se I-TREATMENT -trata I-TREATMENT -de I-TREATMENT -decidir I-TREATMENT -entre I-TREATMENT -una I-TREATMENT -de I-TREATMENT -las I-TREATMENT -siguientes I-TREATMENT -actitudes I-TREATMENT -terapéuticas: I-TREATMENT - I-TREATMENT -Amputación I-TREATMENT -y I-TREATMENT -reconstrucción: I-TREATMENT - I-TREATMENT -La I-TREATMENT -amputación I-TREATMENT -del I-TREATMENT -pulgar I-TREATMENT -flotante I-TREATMENT -conducirá I-TREATMENT -a I-TREATMENT -una I-TREATMENT -aplasia I-TREATMENT -que I-TREATMENT -necesitará I-TREATMENT -una I-TREATMENT -reconstrucción I-TREATMENT -con I-TREATMENT -técnicas I-TREATMENT -microquirúrgicas I-TREATMENT -tales I-TREATMENT -como I-TREATMENT -pulgarización I-TREATMENT -del I-TREATMENT -índice I-TREATMENT -que I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -con I-TREATMENT -buenos I-TREATMENT -resultados I-TREATMENT -desde I-TREATMENT -1964 I-TREATMENT -( I-TREATMENT -3, I-TREATMENT -4), I-TREATMENT -o I-TREATMENT -la I-TREATMENT -transferencia I-TREATMENT -de I-TREATMENT -un I-TREATMENT -ortejo, I-TREATMENT -técnica I-TREATMENT -que I-TREATMENT -conlleva I-TREATMENT -muchos I-TREATMENT -riesgos I-TREATMENT -sobre I-TREATMENT -todo I-TREATMENT -cuando I-TREATMENT -no I-TREATMENT -se I-TREATMENT -tiene I-TREATMENT -un I-TREATMENT -buen I-TREATMENT -entrenamiento I-TREATMENT +permanece I-TREATMENT en I-TREATMENT -microcirugía I-TREATMENT -(5,6) I-TREATMENT -o I-TREATMENT -no I-TREATMENT -se I-TREATMENT -cuenta I-TREATMENT +tratamiento I-TREATMENT +intravenoso I-TREATMENT con I-TREATMENT -la I-TREATMENT -infraestructura I-TREATMENT -idonea. I-TREATMENT -En I-TREATMENT -teoría, I-TREATMENT -son I-TREATMENT -las I-TREATMENT -técnicas I-TREATMENT -que I-TREATMENT -mejor I-TREATMENT -resultado I-TREATMENT -estético-funcional I-TREATMENT -producen. I-TREATMENT - I-TREATMENT -Conservación I-TREATMENT +cloxacilina I-TREATMENT y I-TREATMENT -estabilización: I-TREATMENT - I-TREATMENT -Son I-TREATMENT -posibles I-TREATMENT -tres I-TREATMENT -tipos I-TREATMENT -de I-TREATMENT -conducta I-TREATMENT -dependiendo I-TREATMENT -del I-TREATMENT -tipo I-TREATMENT -de I-TREATMENT -patología I-TREATMENT -según I-TREATMENT -la I-TREATMENT -clasificación I-TREATMENT -de I-TREATMENT -Blauth I-TREATMENT - I-TREATMENT --Estabilización I-TREATMENT -de I-TREATMENT -la I-TREATMENT -articulación I-TREATMENT -metacarpofalángica. I-TREATMENT --Estabilización I-TREATMENT -de I-TREATMENT -la I-TREATMENT -metacarpofalángica I-TREATMENT -más I-TREATMENT -una I-TREATMENT -transferencia I-TREATMENT -de I-TREATMENT -oposición. I-TREATMENT -- I-TREATMENT -Reconstrucción I-TREATMENT -del I-TREATMENT -metacarpiano I-TREATMENT -con I-TREATMENT -una I-TREATMENT -transferencia I-TREATMENT -ósea I-TREATMENT -vascularizada I-TREATMENT -o I-TREATMENT -no. I-TREATMENT - I-TREATMENT -En I-TREATMENT -nuestra I-TREATMENT -paciente, I-TREATMENT +clindamicina I-TREATMENT +durante I-TREATMENT +siete I-TREATMENT +días, I-TREATMENT +presentando I-TREATMENT una I-TREATMENT -vez I-TREATMENT -hecho I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -e I-TREATMENT -identificados I-TREATMENT -los I-TREATMENT -problemas, I-TREATMENT -se I-TREATMENT -plantearon I-TREATMENT -a I-TREATMENT -la I-TREATMENT -madre I-TREATMENT -y I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -las I-TREATMENT -conductas I-TREATMENT -quirúrgicas I-TREATMENT -presentadas I-TREATMENT -anteriormente, I-TREATMENT -pero I-TREATMENT -en I-TREATMENT -definitiva I-TREATMENT -fue I-TREATMENT -sumamente I-TREATMENT -difícil I-TREATMENT -convencerlas I-TREATMENT +mejoría I-TREATMENT +progresiva I-TREATMENT de I-TREATMENT -amputar I-TREATMENT -el I-TREATMENT -pulgar I-TREATMENT -vestigial I-TREATMENT -y I-TREATMENT -reconstruirlo I-TREATMENT -con I-TREATMENT -una I-TREATMENT -pulgarización I-TREATMENT -del I-TREATMENT -índice, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -tomó I-TREATMENT la I-TREATMENT -decisión I-TREATMENT -de I-TREATMENT -reconstrucción I-TREATMENT +clínica, I-TREATMENT y I-TREATMENT -estabilización I-TREATMENT -del I-TREATMENT -metacarpiano. I-TREATMENT - I-TREATMENT -Debido I-TREATMENT -a I-TREATMENT -que I-TREATMENT -la I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -efectuar, I-TREATMENT -por I-TREATMENT -ejemplo, I-TREATMENT -una I-TREATMENT -transferencia I-TREATMENT -con I-TREATMENT -colgajo I-TREATMENT -óseo I-TREATMENT -del I-TREATMENT -tercio I-TREATMENT -distal I-TREATMENT -del I-TREATMENT -radio I-TREATMENT -nutrido I-TREATMENT -por I-TREATMENT -la I-TREATMENT -rama I-TREATMENT -perforante I-TREATMENT -superior I-TREATMENT -de I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -ínterósea I-TREATMENT -anterior I-TREATMENT -a I-TREATMENT -flujo I-TREATMENT -retrogrado I-TREATMENT -(7), I-TREATMENT -no I-TREATMENT -era I-TREATMENT -viable I-TREATMENT -por I-TREATMENT -las I-TREATMENT -anomalías I-TREATMENT -vasculares I-TREATMENT -observadas I-TREATMENT -con I-TREATMENT -el I-TREATMENT -doppler, I-TREATMENT -se I-TREATMENT -optó I-TREATMENT -por I-TREATMENT -la I-TREATMENT -toma I-TREATMENT -de I-TREATMENT -un I-TREATMENT -injerto I-TREATMENT -óseo I-TREATMENT -convencional I-TREATMENT -a I-TREATMENT -pesar I-TREATMENT -del I-TREATMENT -riesgo I-TREATMENT -de I-TREATMENT -reabsorción I-TREATMENT -que I-TREATMENT -puede I-TREATMENT -presentarse I-TREATMENT -a I-TREATMENT -largo I-TREATMENT -plazo. I-TREATMENT -Para I-TREATMENT -no I-TREATMENT -cambiar I-TREATMENT -de I-TREATMENT -campo I-TREATMENT -operatorio I-TREATMENT -se I-TREATMENT -cosechó I-TREATMENT -el I-TREATMENT -injerto I-TREATMENT -óseo I-TREATMENT -del I-TREATMENT -olécranon I-TREATMENT -ipsilateral; I-TREATMENT -después I-TREATMENT se I-TREATMENT -estabilizó I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -del I-TREATMENT -trapecio I-TREATMENT -vestigial I-TREATMENT -con I-TREATMENT -una I-TREATMENT -miniplaca I-TREATMENT -y I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT +da I-TREATMENT de I-TREATMENT -las I-TREATMENT -falanges I-TREATMENT -con I-TREATMENT -alambre, I-TREATMENT -logrando I-TREATMENT -darle I-TREATMENT -al I-TREATMENT -neo-pulgar I-TREATMENT -orientación I-TREATMENT +alta I-TREATMENT en I-TREATMENT -oposición. I-TREATMENT -Para I-TREATMENT -mantener I-TREATMENT -estable I-TREATMENT -esta I-TREATMENT -posición I-TREATMENT -y I-TREATMENT -evitar I-TREATMENT -futuros I-TREATMENT -desplazamientos I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -efectuar I-TREATMENT -la I-TREATMENT -transferencia I-TREATMENT -del I-TREATMENT -músculo I-TREATMENT -abductor I-TREATMENT -del I-TREATMENT -meñique I-TREATMENT -para I-TREATMENT -fijarlo I-TREATMENT -al I-TREATMENT -neo-metacarpiano I-TREATMENT -y I-TREATMENT -reforzar I-TREATMENT -o I-TREATMENT -estabilizar I-TREATMENT -la I-TREATMENT -oposición I-TREATMENT -del I-TREATMENT -pulgar, I-TREATMENT -así I-TREATMENT -como I-TREATMENT -para I-TREATMENT -tratar I-TREATMENT -de I-TREATMENT -aumentar I-TREATMENT -el I-TREATMENT -volumen I-TREATMENT -y I-TREATMENT -por I-TREATMENT -ende I-TREATMENT -la I-TREATMENT -estética I-TREATMENT -del I-TREATMENT -área I-TREATMENT -tenar. I-TREATMENT -La I-TREATMENT -cirugía I-TREATMENT -se I-TREATMENT -efectuó I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -un I-TREATMENT -bloqueo I-TREATMENT -regional I-TREATMENT -bajo I-TREATMENT -torniquete I-TREATMENT -neumático. I-TREATMENT +clindamicina I-TREATMENT +oral. I-TREATMENT I-TREATMENT -No B-EVOLUTION -se I-EVOLUTION -presentaron I-EVOLUTION -complicaciones I-EVOLUTION -postoperatorias I-EVOLUTION - I-EVOLUTION -La B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Fisioterapia I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -diseño I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -ortesis I-DERIVED_FROM/TO -funcional I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -posteriormente, I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -inicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -reeducación I-DERIVED_FROM/TO -funcional. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Psicológicamente B-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -ha I-EVOLUTION -respondido I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -positiva I-EVOLUTION -ya I-EVOLUTION -que I-EVOLUTION -ha I-EVOLUTION -logrado I-EVOLUTION -darle I-EVOLUTION -utilidad I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -nuevo I-EVOLUTION -pulgar I-EVOLUTION -y I-EVOLUTION -éste I-EVOLUTION -ha I-EVOLUTION -mejorado I-EVOLUTION -en I-EVOLUTION -su I-EVOLUTION -aspecto I-EVOLUTION -estético, I-EVOLUTION -aunque I-EVOLUTION -no I-EVOLUTION -es I-EVOLUTION -el I-EVOLUTION -aspecto I-EVOLUTION -que I-EVOLUTION -sus I-EVOLUTION -expectativas, I-EVOLUTION -normales I-EVOLUTION -o I-EVOLUTION -no, I-EVOLUTION -le I-EVOLUTION -hicieron I-EVOLUTION -desear. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -85 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -basocelular I-PRESENT_ILLNESS -recidivado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -pabellón I-PRESENT_ILLNESS -auricular I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El B-TREATMENT -tratamiento I-TREATMENT -inicial, I-TREATMENT -realizado I-TREATMENT -en I-TREATMENT -mayo I-TREATMENT -de I-TREATMENT -2001, I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -una I-TREATMENT -extirpación I-TREATMENT -local I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -siguió I-EVOLUTION -revisiones I-EVOLUTION -periódicas I-EVOLUTION -y I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -años I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -recidiva I-EVOLUTION -local I-EVOLUTION -más I-EVOLUTION -una I-EVOLUTION -tumoración I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -submandibular I-EVOLUTION -derecho. I-EVOLUTION -Se B-EXPLORATION -solicitó I-EXPLORATION -citología I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tumoración I-EXPLORATION -mediante I-EXPLORATION -punción I-EXPLORATION -aspiración I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina, I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -células I-EXPLORATION -malignas, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -metástasis I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -basocelular. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -Tomografía I-EXPLORATION -Axial I-EXPLORATION -Computerizada I-EXPLORATION -(TAC) I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -un I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -tejidos I-EXPLORATION -blandos I-EXPLORATION -del I-EXPLORATION -pabellón I-EXPLORATION -auricular I-EXPLORATION -derecho I-EXPLORATION +La B-EXPLORATION +paciente I-EXPLORATION +es I-EXPLORATION +nuevamente I-EXPLORATION +revisada I-EXPLORATION en I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -antecedente I-EXPLORATION -de I-EXPLORATION -neoplasia I-EXPLORATION -previa. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -nodular I-EXPLORATION -de I-EXPLORATION -1.5 I-EXPLORATION -cm. I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -situada I-EXPLORATION +consulta I-EXPLORATION +15 I-EXPLORATION +días I-EXPLORATION +después, I-EXPLORATION +presentando I-EXPLORATION a I-EXPLORATION -nivel I-EXPLORATION -infraparotídeo, I-EXPLORATION -con I-EXPLORATION -necrosis I-EXPLORATION -central I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -impresiona I-EXPLORATION -de I-EXPLORATION -adenopatía I-EXPLORATION -locoregional. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -En B-TREATMENT -junio I-TREATMENT -del I-TREATMENT -2003 I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -resección I-TREATMENT -parcial I-TREATMENT -del I-TREATMENT -lóbulo I-TREATMENT -superficial I-TREATMENT -de I-TREATMENT -la I-TREATMENT -parótida, I-TREATMENT -un I-TREATMENT -vaciamiento I-TREATMENT -cervical I-TREATMENT -derecho I-TREATMENT -selectivo I-TREATMENT -confinado I-TREATMENT -a I-TREATMENT -las I-TREATMENT -zonas I-TREATMENT -2 I-TREATMENT -y I-TREATMENT -3 I-TREATMENT -y I-TREATMENT -extirpación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -mitad I-TREATMENT -inferior I-TREATMENT -del I-TREATMENT -pabellón I-TREATMENT -auricular I-TREATMENT -que I-TREATMENT -incluía I-TREATMENT -la I-TREATMENT -recidiva I-TREATMENT -local. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -final I-EXPLORATION -informó I-EXPLORATION la I-EXPLORATION -tumoración I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -metástasis I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -basocelular I-EXPLORATION +persistencia I-EXPLORATION de I-EXPLORATION -subtipo I-EXPLORATION -infiltrante I-EXPLORATION -que I-EXPLORATION -afectaba I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -glándula I-EXPLORATION -parótida I-EXPLORATION -con I-EXPLORATION -márgenes I-EXPLORATION +tumoración I-EXPLORATION +cervical I-EXPLORATION +izquierda, I-EXPLORATION +aunque I-EXPLORATION de I-EXPLORATION -resección I-EXPLORATION -libres. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -del I-EXPLORATION -vaciamiento I-EXPLORATION -cervical, I-EXPLORATION +menor I-EXPLORATION +tamaño. I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +realiza I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +ecografía I-EXPLORATION +cervical I-EXPLORATION +bilateral I-EXPLORATION +donde I-EXPLORATION +ya I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +datos I-EXPLORATION +sugestivos I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -10 I-EXPLORATION -ganglios I-EXPLORATION -cervicales I-EXPLORATION -aislados, I-EXPLORATION -2 I-EXPLORATION -estaban I-EXPLORATION -afectados. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -recidiva I-EXPLORATION -local I-EXPLORATION +piomiositis, I-EXPLORATION +pero I-EXPLORATION +sí I-EXPLORATION +la I-EXPLORATION +persistencia I-EXPLORATION del I-EXPLORATION -pabellón I-EXPLORATION -auricular I-EXPLORATION -también I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -como I-EXPLORATION -epitelioma I-EXPLORATION -basocelular I-EXPLORATION -infiltrante I-EXPLORATION +absceso I-EXPLORATION +subyacente I-EXPLORATION +al I-EXPLORATION +músculo, I-EXPLORATION +aunque I-EXPLORATION con I-EXPLORATION -márgenes I-EXPLORATION -libres. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -remitida I-TREATMENT -para I-TREATMENT -tratamiento I-TREATMENT -complementario I-TREATMENT -con I-TREATMENT -radioterapia, I-TREATMENT -a I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -negó. I-TREATMENT - I-TREATMENT -En B-EVOLUTION +una I-EXPLORATION +reducción I-EXPLORATION +significativa I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +tamaño. I-EXPLORATION +Se B-EVOLUTION +mantiene I-EVOLUTION el I-EVOLUTION -momento I-EVOLUTION -de I-EVOLUTION -esta I-EVOLUTION -publicación I-EVOLUTION -no I-EVOLUTION -existe I-EVOLUTION -evidencia I-EVOLUTION -de I-EVOLUTION -recurrencia I-EVOLUTION -y I-EVOLUTION +tratamiento I-EVOLUTION +durante I-EVOLUTION +cuatro I-EVOLUTION +semanas, I-EVOLUTION +presentando I-EVOLUTION +buena I-EVOLUTION +evolución I-EVOLUTION +hasta I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION -sigue I-EVOLUTION -viva. I-EVOLUTION +total I-EVOLUTION +resolución I-EVOLUTION +del I-EVOLUTION +cuadro. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +36 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS con B-PAST_MEDICAL_HISTORY -artritis I-PAST_MEDICAL_HISTORY -reumatoide I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -larga I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +radiculo-patía I-PAST_MEDICAL_HISTORY +lumbar I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +trastorno I-PAST_MEDICAL_HISTORY +depresivo I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY tratamiento I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -corticoides I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -tumefacción I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -largo I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -2º I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -3er. I-PRESENT_ILLNESS -radios I-PRESENT_ILLNESS +carbamazepina I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +clomipramina I-PAST_MEDICAL_HISTORY +iniciado I-PAST_MEDICAL_HISTORY +seis I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +ingreso. I-PAST_MEDICAL_HISTORY +Ingresó B-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mano I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS +siete I-PRESENT_ILLNESS días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -punción I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -aguja I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +39 I-PRESENT_ILLNESS +°C I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +calofríos, I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS +intensa, I-PRESENT_ILLNESS +compromiso I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +estado I-PRESENT_ILLNESS +general I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal, I-PRESENT_ILLNESS +principalmente I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -palma I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mano. I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +derecho. I-PRESENT_ILLNESS A B-EXPLORATION +su I-EXPLORATION +ingreso I-EXPLORATION +estaba I-EXPLORATION +lúcido, I-EXPLORATION +febril, I-EXPLORATION +taquicárdico I-EXPLORATION +e I-EXPLORATION +hipertenso. I-EXPLORATION +Al I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +destacaba I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +volumen I-EXPLORATION +facial, I-EXPLORATION +sin I-EXPLORATION +compromiso I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -dolor I-EXPLORATION +mucosa I-EXPLORATION +oral, I-EXPLORATION +asociado I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +púrpura I-EXPLORATION +no I-EXPLORATION +palpable I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +parte I-EXPLORATION +superior I-EXPLORATION +del I-EXPLORATION +tórax, I-EXPLORATION +con I-EXPLORATION +sensibilidad I-EXPLORATION a I-EXPLORATION la I-EXPLORATION palpación I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -trayecto I-EXPLORATION -flexor I-EXPLORATION -del I-EXPLORATION -2º I-EXPLORATION +hipocondrio I-EXPLORATION +derecho, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +irritación I-EXPLORATION +peritoneal I-EXPLORATION y I-EXPLORATION -3er. I-EXPLORATION -radios I-EXPLORATION +sin I-EXPLORATION +ade-nopatías I-EXPLORATION +cervicales, I-EXPLORATION +axilares I-EXPLORATION +o I-EXPLORATION +inguinales I-EXPLORATION +palpables. I-EXPLORATION +En I-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +ingreso I-EXPLORATION +presentaba I-EXPLORATION +un I-EXPLORATION +hemograma I-EXPLORATION +con I-EXPLORATION +discreto I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +eosinófilos I-EXPLORATION +(6% I-EXPLORATION +de I-EXPLORATION +3.300 I-EXPLORATION +leucocitos) I-EXPLORATION y I-EXPLORATION +escasos I-EXPLORATION +linfocitos I-EXPLORATION +atípicos I-EXPLORATION +(menos I-EXPLORATION +de I-EXPLORATION +1%), I-EXPLORATION +creatinina I-EXPLORATION +1 I-EXPLORATION +mg/dL, I-EXPLORATION +LDH I-EXPLORATION +172 I-EXPLORATION +U/L, I-EXPLORATION +además I-EXPLORATION +de I-EXPLORATION una I-EXPLORATION -actitud I-EXPLORATION +alteración I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -dedos I-EXPLORATION -en I-EXPLORATION -hiperextensión, I-EXPLORATION -por I-EXPLORATION -probable I-EXPLORATION -rotura I-EXPLORATION -tendinosa. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -ecográficos I-EXPLORATION -revelaron I-EXPLORATION -un I-EXPLORATION -área I-EXPLORATION -hipoecogénica I-EXPLORATION -rodeando I-EXPLORATION -los I-EXPLORATION -tendones I-EXPLORATION -flexores I-EXPLORATION -a I-EXPLORATION -lo I-EXPLORATION -largo I-EXPLORATION -del I-EXPLORATION -2º I-EXPLORATION +pruebas I-EXPLORATION +hepáticas I-EXPLORATION +con I-EXPLORATION +patrón I-EXPLORATION +mixto I-EXPLORATION +de I-EXPLORATION +predominio I-EXPLORATION +colestásico I-EXPLORATION +(GPT: I-EXPLORATION +215 I-EXPLORATION +U/L, I-EXPLORATION +GOT: I-EXPLORATION +64 I-EXPLORATION +U/L, I-EXPLORATION +GGT: I-EXPLORATION +598 I-EXPLORATION +U/L, I-EXPLORATION +FA: I-EXPLORATION +257 I-EXPLORATION +U/L, I-EXPLORATION +bilirrubina I-EXPLORATION +total: I-EXPLORATION +0, I-EXPLORATION +72 I-EXPLORATION +mg/dL, I-EXPLORATION +INR: I-EXPLORATION +1, I-EXPLORATION +5) I-EXPLORATION y I-EXPLORATION -3er. I-EXPLORATION -radio I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -articulación I-EXPLORATION -metacarpofalángica I-EXPLORATION -hasta I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -falange I-EXPLORATION -distal, I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva: I-EXPLORATION +22, I-EXPLORATION +2 I-EXPLORATION +mg/dL I-EXPLORATION +(Valor I-EXPLORATION +normal I-EXPLORATION +< I-EXPLORATION +0, I-EXPLORATION +5). I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -desestructuración I-EXPLORATION -del I-EXPLORATION -flexor I-EXPLORATION -profundo I-EXPLORATION -y I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +que I-EXPLORATION +evidenció I-EXPLORATION una I-EXPLORATION -sinovial I-EXPLORATION -engrosada I-EXPLORATION -hipervascularizada I-EXPLORATION -en I-EXPLORATION +hepato-esplenomegalia I-EXPLORATION +asociada I-EXPLORATION +a I-EXPLORATION +una I-EXPLORATION +hiperecogenicidad I-EXPLORATION +de I-EXPLORATION +espacios I-EXPLORATION +portales. I-EXPLORATION +Una I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computada I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +y I-EXPLORATION +pelvis I-EXPLORATION +corroboró I-EXPLORATION +la I-EXPLORATION +hepato-esplenomegalia I-EXPLORATION +y I-EXPLORATION +evidenció I-EXPLORATION +adenopatías I-EXPLORATION +peri-portales. I-EXPLORATION +Se I-EXPLORATION +ingresó I-EXPLORATION +con I-EXPLORATION el I-EXPLORATION -doppler I-EXPLORATION -color. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -drenaje I-TREATMENT -abierto I-TREATMENT -de I-TREATMENT -gran I-TREATMENT -cantidad I-TREATMENT -de I-TREATMENT -pus I-TREATMENT -mediante I-TREATMENT -incisiones I-TREATMENT -volares I-TREATMENT -tipo I-TREATMENT -Brunner. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -cuyo I-PRESENT_ILLNESS -aspecto I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -muestra I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Figura I-PRESENT_ILLNESS -1; I-PRESENT_ILLNESS -además I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS -dermatológicas, I-PRESENT_ILLNESS -marcado I-PRESENT_ILLNESS -plexo I-PRESENT_ILLNESS -venoso I-PRESENT_ILLNESS -subdérmico I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -asimetría I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -molestias I-PRESENT_ILLNESS -físicas, I-PRESENT_ILLNESS -psíquicas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dificultades I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -vestirse I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -realizar I-PRESENT_ILLNESS -ejercicios I-PRESENT_ILLNESS -físicos, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -hacían I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -situación I-PRESENT_ILLNESS -insostenible I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -desarrollo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -cotidiana. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Se B-EXPLORATION -practicó I-EXPLORATION -examen I-EXPLORATION -anatomopatológico I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -biopsia I-EXPLORATION -obtenida I-EXPLORATION -por I-EXPLORATION -punción I-EXPLORATION -aspiración, I-EXPLORATION -encontrando I-EXPLORATION una I-EXPLORATION -proliferación I-EXPLORATION -mamaria I-EXPLORATION -tisular I-EXPLORATION -tanto I-EXPLORATION -del I-EXPLORATION -estroma I-EXPLORATION -como I-EXPLORATION -del I-EXPLORATION -epitelio, I-EXPLORATION -con I-EXPLORATION -dificultad I-EXPLORATION +hepatitis I-EXPLORATION +en I-EXPLORATION +estudio; I-EXPLORATION +probablemente I-EXPLORATION +secundaria I-EXPLORATION +a I-EXPLORATION +medicamentos I-EXPLORATION +o I-EXPLORATION +de I-EXPLORATION +etiología I-EXPLORATION +infecciosa. I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +un I-EXPLORATION +extenso I-EXPLORATION +estudio I-EXPLORATION +etiológico. I-EXPLORATION +Los I-EXPLORATION +hemocultivos I-EXPLORATION +y I-EXPLORATION +urocultivo I-EXPLORATION +resultaron I-EXPLORATION +negativos. I-EXPLORATION +Las I-EXPLORATION +serologías I-EXPLORATION +IgM I-EXPLORATION para I-EXPLORATION -diferenciarla I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -patrones I-EXPLORATION +hepatitis I-EXPLORATION +A, I-EXPLORATION +antígeno I-EXPLORATION de I-EXPLORATION -fibroadenoma I-EXPLORATION -filoides I-EXPLORATION -Las B-TREATMENT -propuestas I-TREATMENT -terapéuticas I-TREATMENT -hormonales I-TREATMENT -se I-TREATMENT -excluyeron, I-TREATMENT -como I-TREATMENT -ya I-TREATMENT -hemos I-TREATMENT -explicado, I-TREATMENT -por I-TREATMENT -sus I-TREATMENT -posibles I-TREATMENT -efectos I-TREATMENT -secundarios. I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -realizado I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -una I-TREATMENT -mamoplastia I-TREATMENT -reductora I-TREATMENT -siguiendo I-TREATMENT -el I-TREATMENT -patrón I-TREATMENT -de I-TREATMENT -Wise I-TREATMENT -en I-TREATMENT -el I-TREATMENT -marcaje I-TREATMENT -dérmico; I-TREATMENT -tallamos I-TREATMENT -un I-TREATMENT -amplio I-TREATMENT -colgajo I-TREATMENT -horizontal I-TREATMENT -bipediculado I-TREATMENT -cuya I-TREATMENT -desepidermización I-TREATMENT -se I-TREATMENT -aprovechó I-TREATMENT -para I-TREATMENT -disminuir I-TREATMENT -el I-TREATMENT -tamaño I-TREATMENT -de I-TREATMENT -las I-TREATMENT -areolas, I-TREATMENT -que I-TREATMENT -trasladamos I-TREATMENT -a I-TREATMENT -su I-TREATMENT -nueva I-TREATMENT -ubicación I-TREATMENT -conservando I-TREATMENT -la I-TREATMENT -sensibilidad I-TREATMENT -y I-TREATMENT -evitando I-TREATMENT -así I-TREATMENT -el I-TREATMENT -injerto I-TREATMENT -libre I-TREATMENT -tipo I-TREATMENT -Thoreck. I-TREATMENT - I-TREATMENT -Empleamos I-TREATMENT -el I-TREATMENT -material I-TREATMENT -autólogo I-TREATMENT -de I-TREATMENT -los I-TREATMENT -colgajos I-TREATMENT -a I-TREATMENT -modo I-TREATMENT -de I-TREATMENT -relleno, I-TREATMENT -evitando I-TREATMENT -de I-TREATMENT -esta I-TREATMENT -manera I-TREATMENT -también I-TREATMENT -el I-TREATMENT -uso I-TREATMENT -de I-TREATMENT -prótesis. I-TREATMENT - I-TREATMENT -La I-TREATMENT -resección I-TREATMENT -en I-TREATMENT -la I-TREATMENT -mama I-TREATMENT -derecha I-TREATMENT -fue I-TREATMENT -de I-TREATMENT -1.050 I-TREATMENT -gr. I-TREATMENT -de I-TREATMENT -peso I-TREATMENT -y I-TREATMENT -en I-TREATMENT -la I-TREATMENT -izquierda I-TREATMENT -llegó I-TREATMENT -a I-TREATMENT -los I-TREATMENT -1.800 I-TREATMENT -gr. I-TREATMENT - I-TREATMENT -Colocamos I-TREATMENT -drenajes I-TREATMENT -en I-TREATMENT -ambas I-TREATMENT -mamas I-TREATMENT -que I-TREATMENT -fueron I-TREATMENT -retirados I-TREATMENT -a I-TREATMENT -las I-TREATMENT -48h. I-TREATMENT -y B-EVOLUTION -la I-EVOLUTION +superficie I-EXPLORATION +para I-EXPLORATION +virus I-EXPLORATION +hepatitis I-EXPLORATION +B, I-EXPLORATION +anticuerpos I-EXPLORATION +de I-EXPLORATION +virus I-EXPLORATION +hepatitis I-EXPLORATION +C, I-EXPLORATION +IgM I-EXPLORATION +VCA I-EXPLORATION +de I-EXPLORATION +virus I-EXPLORATION +de I-EXPLORATION +Epstein I-EXPLORATION +Barr I-EXPLORATION +(VEB), I-EXPLORATION +citomegalovirus I-EXPLORATION +y I-EXPLORATION +VIH, I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Se I-EXPLORATION +complementó I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +RPR, I-EXPLORATION +IgM I-EXPLORATION +Toxoplasma I-EXPLORATION +gondii, I-EXPLORATION +IgM I-EXPLORATION +e I-EXPLORATION +IgG I-EXPLORATION +Leptospira I-EXPLORATION +spp., I-EXPLORATION +IgM I-EXPLORATION +sarampión, I-EXPLORATION +reacción I-EXPLORATION +de I-EXPLORATION +aglutinación I-EXPLORATION +para I-EXPLORATION +Brucella I-EXPLORATION +abortus/melitensis, I-EXPLORATION +IgG I-EXPLORATION +Brucella I-EXPLORATION +canis, I-EXPLORATION +IgG I-EXPLORATION +Bartonella I-EXPLORATION +hensenlae, I-EXPLORATION +IgG I-EXPLORATION +e I-EXPLORATION +IgM I-EXPLORATION +Borrelia I-EXPLORATION +burgorferi, I-EXPLORATION +IgM I-EXPLORATION +Myco-plasma I-EXPLORATION +pneumoniae I-EXPLORATION +fueron I-EXPLORATION +todas I-EXPLORATION +negativas. I-EXPLORATION +Además I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +panel I-EXPLORATION +molecular I-EXPLORATION +de I-EXPLORATION +virus I-EXPLORATION +respiratorios I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +negativo. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +reumatológico I-EXPLORATION +con I-EXPLORATION +anticuerpos I-EXPLORATION +anti-nucleares, I-EXPLORATION +anti-citoplasmáticos, I-EXPLORATION +anti-músculo I-EXPLORATION +liso, I-EXPLORATION +anti-mitocondriales, I-EXPLORATION +anti-endomisio, I-EXPLORATION +factor I-EXPLORATION +reumatoideo, I-EXPLORATION +y I-EXPLORATION +antitransglutaminasa I-EXPLORATION +tisular I-EXPLORATION +resultó I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -hospitalaria I-EVOLUTION +evolucionó I-EVOLUTION con I-EVOLUTION -una I-EVOLUTION -buena I-EVOLUTION -evolución, I-EVOLUTION +estabilidad I-EVOLUTION +clínica, I-EVOLUTION sin I-EVOLUTION -complicaciones I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -mismo I-EVOLUTION -diagnóstico I-EVOLUTION -anatomopatológico I-EVOLUTION -de I-EVOLUTION -hipertrofia I-EVOLUTION -con I-EVOLUTION -patrón I-EVOLUTION -proliferativo I-EVOLUTION -del I-EVOLUTION -estroma I-EVOLUTION -y I-EVOLUTION -epitelio I-EVOLUTION -a I-EVOLUTION -modo I-EVOLUTION -de I-EVOLUTION -fibroadenoma I-EVOLUTION -filoides. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -aspecto I-EVOLUTION -del I-EVOLUTION -resultado I-EVOLUTION -reciente, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -pocos I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención, I-EVOLUTION -podemos I-EVOLUTION -verlo I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -Figuras I-EVOLUTION -3: I-EVOLUTION -en I-EVOLUTION -él I-EVOLUTION -se I-EVOLUTION -aprecian I-EVOLUTION -unas I-EVOLUTION -mamas I-EVOLUTION -voluminosas I-EVOLUTION -aun I-EVOLUTION -para I-EVOLUTION -el I-EVOLUTION -tamaño I-EVOLUTION -y I-EVOLUTION -edad I-EVOLUTION +signos I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -paciente, I-EVOLUTION +insuficiencia I-EVOLUTION +hepática, I-EVOLUTION pero I-EVOLUTION con I-EVOLUTION -una I-EVOLUTION -diferencia I-EVOLUTION -notable I-EVOLUTION -respecto I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -situación I-EVOLUTION -previa. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -resultado I-EVOLUTION -más I-EVOLUTION -tardío, I-EVOLUTION -ya I-EVOLUTION -con I-EVOLUTION -17 I-EVOLUTION -años I-EVOLUTION +fiebre I-EVOLUTION +persistente I-EVOLUTION y I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -edad I-EVOLUTION +aparición I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -paciente, I-EVOLUTION -presenta I-EVOLUTION -un I-EVOLUTION -tamaño I-EVOLUTION +cefalea I-EVOLUTION y I-EVOLUTION -una I-EVOLUTION -forma I-EVOLUTION +un I-EVOLUTION +exantema I-EVOLUTION +máculo-papular I-EVOLUTION +morbiliforme I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -mamas I-EVOLUTION -más I-EVOLUTION -proporcionados I-EVOLUTION -a I-EVOLUTION +predominio I-EVOLUTION +perifolicular, I-EVOLUTION +en I-EVOLUTION la I-EVOLUTION -edad I-EVOLUTION +cara I-EVOLUTION y I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -circunstancias I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente; I-EVOLUTION -ha I-EVOLUTION -mejorado I-EVOLUTION el I-EVOLUTION -aspecto I-EVOLUTION -dérmico I-EVOLUTION -y I-EVOLUTION -vascular I-EVOLUTION -de I-EVOLUTION -sus I-EVOLUTION -mamas I-EVOLUTION -y I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -habido I-EVOLUTION -recurrencia I-EVOLUTION -del I-EVOLUTION -cuadro, I-EVOLUTION -mantiene I-EVOLUTION -la I-EVOLUTION -sensibilidad I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -complejos I-EVOLUTION -areolares, I-EVOLUTION -las I-EVOLUTION -cicatrices I-EVOLUTION -son I-EVOLUTION -muy I-EVOLUTION -aceptables I-EVOLUTION -por I-EVOLUTION -su I-EVOLUTION -discreción I-EVOLUTION +cuello, I-EVOLUTION +con I-EVOLUTION +posterior I-EVOLUTION +extensión I-EVOLUTION +hacia I-EVOLUTION +el I-EVOLUTION +tórax, I-EVOLUTION +dorso, I-EVOLUTION +abdomen I-EVOLUTION y I-EVOLUTION -la I-EVOLUTION -satisfacción I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -le I-EVOLUTION -lleva I-EVOLUTION +extremidades, I-EVOLUTION +asociado I-EVOLUTION a I-EVOLUTION -rechazar I-EVOLUTION -cualquier I-EVOLUTION -retoque I-EVOLUTION -de I-EVOLUTION -mejora. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -35 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -abuso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcohol I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -otra I-PAST_MEDICAL_HISTORY -patología I-PAST_MEDICAL_HISTORY -asociada. I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Cirugía I-PRESENT_ILLNESS -Plástica I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -Reparadora I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -Carlos I-PRESENT_ILLNESS -Haya I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Málaga I-PRESENT_ILLNESS -(España) I-PRESENT_ILLNESS -presentando I-PRESENT_ILLNESS -masas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hombros, I-PRESENT_ILLNESS -mamas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -flancos I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -habían I-PRESENT_ILLNESS -aumentado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tamaño I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -rápida I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -medio, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -dificultaban I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -movilidad I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -tanto I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -actividad I-PRESENT_ILLNESS -laboral. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -reveló I-EXPLORATION -masas I-EXPLORATION -no I-EXPLORATION -dolorosas I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -blanda, I-EXPLORATION -sin I-EXPLORATION -bordes I-EXPLORATION -bien I-EXPLORATION -definidos, I-EXPLORATION -localizadas I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -hombros, I-EXPLORATION -mamas, I-EXPLORATION -fosas I-EXPLORATION -lumbares I-EXPLORATION -y I-EXPLORATION -flancos I-EXPLORATION -sin I-EXPLORATION -afectación I-EXPLORATION -cervical I-EXPLORATION -(Collar I-EXPLORATION -de I-EXPLORATION -Madelung). I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -radiológico I-EXPLORATION -mediante I-EXPLORATION -secuencias I-EXPLORATION -axiales I-EXPLORATION -de I-EXPLORATION -Tomografía I-EXPLORATION -Axial I-EXPLORATION -Computerizada I-EXPLORATION -(TAC) I-EXPLORATION +púrpura I-EVOLUTION +no I-EVOLUTION +palpable I-EVOLUTION +en I-EVOLUTION +extremidades I-EVOLUTION +inferiores. I-EVOLUTION +Dado B-EXPLORATION +que I-EXPLORATION +durante I-EXPLORATION +su I-EXPLORATION +evolución I-EXPLORATION +la I-EXPLORATION +cefalea I-EXPLORATION se I-EXPLORATION -apreciaba I-EXPLORATION +fue I-EXPLORATION +intensificando, I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION +realizar I-EXPLORATION +una I-EXPLORATION +punción I-EXPLORATION +lumbar, I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +dio I-EXPLORATION +salida I-EXPLORATION +a I-EXPLORATION un I-EXPLORATION -exceso I-EXPLORATION -de I-EXPLORATION -depósito I-EXPLORATION -graso I-EXPLORATION -de I-EXPLORATION -distribución I-EXPLORATION -homogénea I-EXPLORATION -no I-EXPLORATION -encapsulada I-EXPLORATION -(difusa) I-EXPLORATION -sobre I-EXPLORATION -los I-EXPLORATION -hombros, I-EXPLORATION -mamas I-EXPLORATION -y I-EXPLORATION -cintura I-EXPLORATION -abdominal, I-EXPLORATION -sin I-EXPLORATION -afectación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -estructuras I-EXPLORATION -profundas. I-EXPLORATION -Asimismo, I-EXPLORATION -no I-EXPLORATION +líquido I-EXPLORATION +cefalo-raquídeo I-EXPLORATION +(LCR) I-EXPLORATION +incoloro, I-EXPLORATION +transparente, I-EXPLORATION +en I-EXPLORATION +cuyo I-EXPLORATION +análisis I-EXPLORATION se I-EXPLORATION encontraron I-EXPLORATION -depósitos I-EXPLORATION -grasos I-EXPLORATION -de I-EXPLORATION -localización I-EXPLORATION -mesentérica I-EXPLORATION -o I-EXPLORATION -mediastínica, I-EXPLORATION -ni I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -cervical I-EXPLORATION -anterior I-EXPLORATION -o I-EXPLORATION -posterior. I-EXPLORATION -Dado I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -había I-EXPLORATION -sido I-EXPLORATION -intervenido I-EXPLORATION +30 I-EXPLORATION +células/mm3, I-EXPLORATION +100% I-EXPLORATION +mononucleares, I-EXPLORATION +con I-EXPLORATION +glucosa I-EXPLORATION +y I-EXPLORATION +proteínas I-EXPLORATION +normales, I-EXPLORATION +tinción I-EXPLORATION de I-EXPLORATION -hernia I-EXPLORATION -inguinal I-EXPLORATION +Gram I-EXPLORATION +sin I-EXPLORATION +bacterias I-EXPLORATION y I-EXPLORATION -eventración I-EXPLORATION -se I-EXPLORATION +látex I-EXPLORATION +bacteriano I-EXPLORATION +negativo. I-EXPLORATION +El I-EXPLORATION +cultivo I-EXPLORATION +corriente I-EXPLORATION +también I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION +Se I-EXPLORATION realizó I-EXPLORATION una I-EXPLORATION -Resonancia I-EXPLORATION -Magnética I-EXPLORATION -Nuclear I-EXPLORATION -(RMN) I-EXPLORATION -abdominal I-EXPLORATION -para I-EXPLORATION -valorar I-EXPLORATION -la I-EXPLORATION -integridad I-EXPLORATION +reacción I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -abdominal. I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -cortes I-EXPLORATION +polimerasa I-EXPLORATION en I-EXPLORATION -los I-EXPLORATION -tres I-EXPLORATION -planos I-EXPLORATION -del I-EXPLORATION -espacio I-EXPLORATION -con I-EXPLORATION -secuencias I-EXPLORATION -potenciadas I-EXPLORATION +cadena I-EXPLORATION +(RPC) I-EXPLORATION en I-EXPLORATION -SE I-EXPLORATION -T1, I-EXPLORATION -TSE I-EXPLORATION -T2 I-EXPLORATION +LCR I-EXPLORATION +para I-EXPLORATION +enterovirus, I-EXPLORATION +virus I-EXPLORATION +herpes I-EXPLORATION +simplex I-EXPLORATION +1-2 I-EXPLORATION y I-EXPLORATION -Stir, I-EXPLORATION -visualizándose I-EXPLORATION -una I-EXPLORATION -correcta I-EXPLORATION -disposición I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -musculatura I-EXPLORATION -abdominal, I-EXPLORATION -un I-EXPLORATION -importante I-EXPLORATION -aumento I-EXPLORATION -difuso I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -celular I-EXPLORATION -subcutáneo I-EXPLORATION -adiposo I-EXPLORATION -abdominal I-EXPLORATION +virus I-EXPLORATION +varicela I-EXPLORATION +zoster I-EXPLORATION +que I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Con I-EXPLORATION +estos I-EXPLORATION +hallazgos I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION +realizar I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +RPC I-EXPLORATION +cualitativa I-EXPLORATION +para I-EXPLORATION +VHH-6 I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION y I-EXPLORATION -ausencia I-EXPLORATION +LCR, I-EXPLORATION +que I-EXPLORATION +resultaron I-EXPLORATION +ambas I-EXPLORATION +positivas I-EXPLORATION +para I-EXPLORATION +VHH-6. I-EXPLORATION +Para I-EXPLORATION +completar I-EXPLORATION +el I-EXPLORATION +estudio, I-EXPLORATION +se I-EXPLORATION +tomaron I-EXPLORATION +biopsias I-EXPLORATION de I-EXPLORATION -grasa I-EXPLORATION -intrabdominal. I-EXPLORATION - I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +cutáneas. I-EXPLORATION El I-EXPLORATION estudio I-EXPLORATION histopatológico I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -depósitos I-EXPLORATION -grasos I-EXPLORATION -no I-EXPLORATION -encapsulados I-EXPLORATION +demostró I-EXPLORATION +una I-EXPLORATION +dermatitis I-EXPLORATION +perivascular I-EXPLORATION +superficial I-EXPLORATION +y I-EXPLORATION +perifolicular I-EXPLORATION +liquenoide I-EXPLORATION con I-EXPLORATION -adipocitos I-EXPLORATION -no I-EXPLORATION -patológicos. I-EXPLORATION - I-EXPLORATION -Tras I-EXPLORATION -completar I-EXPLORATION -estos I-EXPLORATION -datos I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +eosinófilos, I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION +una I-EXPLORATION +reacción I-EXPLORATION +adversa I-EXPLORATION +a I-EXPLORATION +medicamentos. I-EXPLORATION +Dada I-EXPLORATION la I-EXPLORATION -anamnesis I-EXPLORATION +presentación I-EXPLORATION +clínica, I-EXPLORATION +hallazgos I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física, I-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo I-EXPLORATION -fue I-EXPLORATION +antecedente I-EXPLORATION de I-EXPLORATION -Enfermedad I-EXPLORATION +uso I-EXPLORATION +reciente I-EXPLORATION de I-EXPLORATION -Madelung I-EXPLORATION -o I-EXPLORATION -Lipomatosis I-EXPLORATION -Simétrica I-EXPLORATION -Benigna I-EXPLORATION -tipo I-EXPLORATION -II. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -propuesto I-TREATMENT -fue I-TREATMENT -la I-TREATMENT -liposucción I-TREATMENT -de I-TREATMENT -los I-TREATMENT -cúmulos I-TREATMENT -grasos I-TREATMENT -localizados I-TREATMENT -en I-TREATMENT -abdomen, I-TREATMENT -área I-TREATMENT -lumbar I-TREATMENT -y I-TREATMENT -hombros I-TREATMENT -y I-TREATMENT -la I-TREATMENT -dermolipectomía I-TREATMENT -en I-TREATMENT -ambas I-TREATMENT -mamas. I-TREATMENT -El I-TREATMENT -paciente I-TREATMENT -rehusó I-TREATMENT -ambos I-TREATMENT -procedimientos, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -le I-TREATMENT -aconsejó I-TREATMENT -entonces I-TREATMENT -la I-TREATMENT -pérdida I-TREATMENT -de I-TREATMENT -peso I-TREATMENT -y I-TREATMENT -la I-TREATMENT -abstinencia I-TREATMENT -alcohólica, I-TREATMENT -aún I-TREATMENT -conociendo I-TREATMENT -sus I-TREATMENT -limitados I-TREATMENT -beneficios. I-TREATMENT - I-TREATMENT - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -37 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -remitida B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -otro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -hospitalario I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -presentar I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -pérdida I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -sustancia I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -dorso I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -mano I-DERIVED_FROM/TO -izquierda I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -2 I-DERIVED_FROM/TO -días I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -tras I-DERIVED_FROM/TO -sufrir I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -accidente I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -tráfico. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -A B-EXPLORATION -la I-EXPLORATION -exploración, I-EXPLORATION +carbamazepina, I-EXPLORATION +fármaco I-EXPLORATION +frecuentemente I-EXPLORATION +asociado I-EXPLORATION +a I-EXPLORATION +cuadros I-EXPLORATION +de I-EXPLORATION +hipersensibilidad, I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -pérdida I-EXPLORATION -cutánea I-EXPLORATION -en I-EXPLORATION +estableció I-EXPLORATION el I-EXPLORATION -dorso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mano I-EXPLORATION -izquierda I-EXPLORATION -de I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -7 I-EXPLORATION -cm I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION +síndrome I-EXPLORATION +DRESS I-EXPLORATION +en I-EXPLORATION +concomitancia I-EXPLORATION con I-EXPLORATION -bordes I-EXPLORATION -muy I-EXPLORATION -contundidos I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -sobrepasaba I-EXPLORATION -la I-EXPLORATION -articulación I-EXPLORATION -metacarpofalangica I-EXPLORATION -del I-EXPLORATION -2º I-EXPLORATION -dedo. I-EXPLORATION -Asimismo, I-EXPLORATION -encontramos I-EXPLORATION una I-EXPLORATION -exposición I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -tendones I-EXPLORATION -extensores I-EXPLORATION -del I-EXPLORATION -2º I-EXPLORATION -y I-EXPLORATION -3º I-EXPLORATION -dedos I-EXPLORATION -con I-EXPLORATION -ruptura I-EXPLORATION -del I-EXPLORATION -extensor I-EXPLORATION -del I-EXPLORATION -2º, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -exposición I-EXPLORATION +meningoencefalitis I-EXPLORATION +aguda I-EXPLORATION +secundaria I-EXPLORATION +a I-EXPLORATION +una I-EXPLORATION +infección I-EXPLORATION +por I-EXPLORATION +VHH-6. I-EXPLORATION +En I-EXPLORATION +este I-EXPLORATION +caso I-EXPLORATION +se I-EXPLORATION +estableció I-EXPLORATION +un I-EXPLORATION +diagnóstico I-EXPLORATION +definitivo I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -musculatura I-EXPLORATION -interósea I-EXPLORATION -dorsal I-EXPLORATION +DRESS I-EXPLORATION de I-EXPLORATION -1º I-EXPLORATION +acuerdo I-EXPLORATION +a I-EXPLORATION +criterios I-EXPLORATION +RegiSCAR I-EXPLORATION y I-EXPLORATION -2º I-EXPLORATION -dedos. I-EXPLORATION -No I-EXPLORATION -había I-EXPLORATION -déficit I-EXPLORATION -neurovascular I-EXPLORATION -ni I-EXPLORATION -fracturas I-EXPLORATION -asociadas. I-EXPLORATION - I-EXPLORATION -Tras B-TREATMENT -una I-TREATMENT -primera I-TREATMENT -cura I-TREATMENT -realizada I-TREATMENT -a I-TREATMENT -su I-TREATMENT -ingreso, I-TREATMENT +DRESS I-EXPLORATION +atípico I-EXPLORATION +según I-EXPLORATION +criterios I-EXPLORATION +JSCAR. I-EXPLORATION +Tras B-EVOLUTION +la I-EVOLUTION +suspensión I-EVOLUTION +del I-EVOLUTION +fármaco I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +espontáneamente I-EVOLUTION +con I-EVOLUTION +mejoría I-EVOLUTION +clínica I-EVOLUTION +y I-EVOLUTION +desaparición I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +cefalea. I-EVOLUTION +El B-TREATMENT +compromiso I-TREATMENT +cutáneo I-TREATMENT +disminuyó I-TREATMENT con I-TREATMENT -retirada I-TREATMENT -de I-TREATMENT -tejidos I-TREATMENT -desvitalizados I-TREATMENT -y I-TREATMENT -reparación I-TREATMENT -del I-TREATMENT -tendón I-TREATMENT -extensor I-TREATMENT -del I-TREATMENT -2º I-TREATMENT -dedo, I-TREATMENT -nos I-TREATMENT -planteamos I-TREATMENT -cómo I-TREATMENT -realizar I-TREATMENT -la I-TREATMENT -cobertura I-TREATMENT -del I-TREATMENT -defecto, I-TREATMENT -optando I-TREATMENT -por I-TREATMENT -una I-TREATMENT -reconstrucción I-TREATMENT -mediante I-TREATMENT -un I-TREATMENT -colgajo I-TREATMENT -interóseo I-TREATMENT -posterior I-TREATMENT -de I-TREATMENT -transferencia I-TREATMENT -libre. I-TREATMENT -Los I-TREATMENT -motivos I-TREATMENT -de I-TREATMENT -esta I-TREATMENT -elección I-TREATMENT -los I-TREATMENT -presentamos I-TREATMENT -en I-TREATMENT el I-TREATMENT -apartado I-TREATMENT +uso I-TREATMENT de I-TREATMENT -Discusión. I-TREATMENT - I-TREATMENT +hidrocortisona I-TREATMENT +tópica, I-TREATMENT +sin I-TREATMENT +requerir I-TREATMENT +corticoesteroides I-TREATMENT +sistémicos. I-TREATMENT +Los B-EVOLUTION +exámenes I-EVOLUTION +de I-EVOLUTION +laboratorio I-EVOLUTION +fueron I-EVOLUTION +mejorando I-EVOLUTION +gradualmente, I-EVOLUTION +llegando I-EVOLUTION +a I-EVOLUTION +tener I-EVOLUTION +pruebas I-EVOLUTION +hepáticas I-EVOLUTION +normales I-EVOLUTION +al I-EVOLUTION +mes I-EVOLUTION +y I-EVOLUTION +medio I-EVOLUTION +desde I-EVOLUTION +el I-EVOLUTION +inicio I-EVOLUTION +del I-EVOLUTION +cuadro. I-EVOLUTION +No I-EVOLUTION +se I-EVOLUTION +encontró I-EVOLUTION +eosinofilia I-EVOLUTION +ni I-EVOLUTION +linfoci-tosis I-EVOLUTION +atípica I-EVOLUTION +> I-EVOLUTION +5%. I-EVOLUTION +Debido B-TREATMENT +a I-TREATMENT +su I-TREATMENT +buena I-TREATMENT +evolución I-TREATMENT +y I-TREATMENT +siendo I-TREATMENT +inmunocompetente I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +no I-TREATMENT +dar I-TREATMENT +tratamiento I-TREATMENT +antiviral, I-TREATMENT +siendo B-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +tras I-EVOLUTION +nueve I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +hospitalización I-EVOLUTION +para I-EVOLUTION +ser I-EVOLUTION +observado I-EVOLUTION +en I-EVOLUTION +forma I-EVOLUTION +ambulatoria. I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +dos I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +alta, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +ha I-EVOLUTION +permanecido I-EVOLUTION +estable, I-EVOLUTION +sin I-EVOLUTION +recurrencia I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +síntomas. I-EVOLUTION + I-EVOLUTION -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS paciente I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -fumadora, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY +54 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +entre B-PAST_MEDICAL_HISTORY +cuyos I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mielomelingocele I-PAST_MEDICAL_HISTORY -congénito I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -paraplejia I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -nefrostomía I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +únicamente I-PAST_MEDICAL_HISTORY +destacaba I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +amigdalectomizado I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -infancia. I-PAST_MEDICAL_HISTORY -Había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -operada I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY +infancia I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +ingreso I-PAST_MEDICAL_HISTORY +varios I-PAST_MEDICAL_HISTORY años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -nuestro I-PAST_MEDICAL_HISTORY -Servicio I-PAST_MEDICAL_HISTORY +atrás I-PAST_MEDICAL_HISTORY por I-PAST_MEDICAL_HISTORY -presentar I-PAST_MEDICAL_HISTORY una I-PAST_MEDICAL_HISTORY -úlcera I-PAST_MEDICAL_HISTORY -sacra, I-PAST_MEDICAL_HISTORY -realizándose I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -colgajo I-PAST_MEDICAL_HISTORY -glúteo. I-PAST_MEDICAL_HISTORY -Desde I-PAST_MEDICAL_HISTORY -entonces I-PAST_MEDICAL_HISTORY +neumonía I-PAST_MEDICAL_HISTORY +adquirida I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +comunidad. I-PAST_MEDICAL_HISTORY +Es I-PAST_MEDICAL_HISTORY +fumador I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +cigarrillos I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +día, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +otros I-PAST_MEDICAL_HISTORY +hábitos I-PAST_MEDICAL_HISTORY +tóxicos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY no I-PAST_MEDICAL_HISTORY +seguía I-PAST_MEDICAL_HISTORY +ningún I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +crónico. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Presentaba I-PAST_MEDICAL_HISTORY +dolores I-PAST_MEDICAL_HISTORY +abdominales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +repetición, I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY había I-PAST_MEDICAL_HISTORY -presentado I-PAST_MEDICAL_HISTORY -ninguna I-PAST_MEDICAL_HISTORY -recidiva I-PAST_MEDICAL_HISTORY -debido I-PAST_MEDICAL_HISTORY +supuesto I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +ingresos I-PAST_MEDICAL_HISTORY +hospitalarios I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +cifras I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +amilasa I-PAST_MEDICAL_HISTORY +elevadas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +pancreatitis I-PAST_MEDICAL_HISTORY +aguda, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +pudiera I-PAST_MEDICAL_HISTORY +alcanzar I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +etiológico. I-PAST_MEDICAL_HISTORY +Por I-PAST_MEDICAL_HISTORY +ello I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +estaba I-PAST_MEDICAL_HISTORY +realizando I-PAST_MEDICAL_HISTORY +estudio I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +consultas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +gastroenterología. I-PAST_MEDICAL_HISTORY +Durante I-PAST_MEDICAL_HISTORY +este I-PAST_MEDICAL_HISTORY +seguimiento I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +realizaron I-PAST_MEDICAL_HISTORY +varias I-PAST_MEDICAL_HISTORY +analíticas I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +cifras I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +calcio I-PAST_MEDICAL_HISTORY +plasmático I-PAST_MEDICAL_HISTORY +rondaban I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +límites I-PAST_MEDICAL_HISTORY +superiores I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +normalidad I-PAST_MEDICAL_HISTORY +(considerando I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +rangos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +normalidad I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +calcio I-PAST_MEDICAL_HISTORY +sérico I-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY +8, I-PAST_MEDICAL_HISTORY +4-10, I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +mg/dl), I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +llegar I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -higiene I-PAST_MEDICAL_HISTORY -postural I-PAST_MEDICAL_HISTORY -domiciliaria. I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +francamente I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +ningún I-PAST_MEDICAL_HISTORY +caso. I-PAST_MEDICAL_HISTORY +Es I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +destacar I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +ingresos I-PAST_MEDICAL_HISTORY +previos I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +pancreatitis I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +cifras I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +calcio I-PAST_MEDICAL_HISTORY +fueron I-PAST_MEDICAL_HISTORY +siempre I-PAST_MEDICAL_HISTORY +normales. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -Seis B-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -acudir I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuevo I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -Servicio, I-PRESENT_ILLNESS -sufrió I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -fractura I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fémur, I-PRESENT_ILLNESS +Ingresa B-PRESENT_ILLNESS +nuevamente I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -tuvo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -portar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -férula I-PRESENT_ILLNESS -pelvi-pédica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -yeso. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -imposibilidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -movilización I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -cambios I-PRESENT_ILLNESS -posturales I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -realizaba I-PRESENT_ILLNESS -habitualmente I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal, I-PRESENT_ILLNESS +localizado I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -domicilio, I-PRESENT_ILLNESS +epigastrio I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +irradiación I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +ambos I-PRESENT_ILLNESS +hipocondrios. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +era I-PRESENT_ILLNESS +continuo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS le I-PRESENT_ILLNESS -ocasionaron I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -gran I-PRESENT_ILLNESS -úlcera I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS +limitaba I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -sacra, I-PRESENT_ILLNESS -motivo I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -remitida I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestra I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -valoración. I-PRESENT_ILLNESS -Presentaba B-EXPLORATION -en I-EXPLORATION -ese I-EXPLORATION -momento I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -úlcera I-EXPLORATION -isquiotroncantéreo-sacra I-EXPLORATION +ingesta. I-PRESENT_ILLNESS +Analíticamente B-EXPLORATION +destacaba I-EXPLORATION +a I-EXPLORATION +su I-EXPLORATION +recepción: I-EXPLORATION + I-EXPLORATION +-Hb: I-EXPLORATION +13, I-EXPLORATION +8 I-EXPLORATION +g/dl; I-EXPLORATION +Hcto: I-EXPLORATION +40%; I-EXPLORATION +leucocitos: I-EXPLORATION +13400 I-EXPLORATION +(81% I-EXPLORATION +neutrófilos). I-EXPLORATION + I-EXPLORATION +-Glucosa: I-EXPLORATION +99 I-EXPLORATION +mg/dl; I-EXPLORATION +urea: I-EXPLORATION +33 I-EXPLORATION +mg/dl; I-EXPLORATION +creatinina: I-EXPLORATION +1, I-EXPLORATION +03 I-EXPLORATION +mg/dl. I-EXPLORATION + I-EXPLORATION +-Amilasa I-EXPLORATION +plasmática: I-EXPLORATION +1980 I-EXPLORATION +U/l; I-EXPLORATION +lipasa: I-EXPLORATION +630 I-EXPLORATION +U/l. I-EXPLORATION + I-EXPLORATION +-Colesterol: I-EXPLORATION +210 I-EXPLORATION +mg/dl; I-EXPLORATION +triglicéridos: I-EXPLORATION +98 I-EXPLORATION +mg/dl. I-EXPLORATION + I-EXPLORATION +-Proteínas: I-EXPLORATION +7, I-EXPLORATION +1 I-EXPLORATION +g/dl; I-EXPLORATION +albúmina: I-EXPLORATION +4, I-EXPLORATION +5 I-EXPLORATION +g/dl. I-EXPLORATION + I-EXPLORATION +-Calcio: I-EXPLORATION +11, I-EXPLORATION +7 I-EXPLORATION +mg I-EXPLORATION +mg/dl; I-EXPLORATION +ácido I-EXPLORATION +úrico: I-EXPLORATION +6, I-EXPLORATION +9 I-EXPLORATION +mg/dl. I-EXPLORATION + I-EXPLORATION +Con I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -unos I-EXPLORATION -20 I-EXPLORATION -x I-EXPLORATION -25 I-EXPLORATION -cm, I-EXPLORATION -con I-EXPLORATION -trayecto I-EXPLORATION -fistuloso I-EXPLORATION -hacia I-EXPLORATION -pala I-EXPLORATION -iliaca I-EXPLORATION +pancreatitis I-EXPLORATION +aguda I-EXPLORATION +se I-EXPLORATION +realizan I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +primero, I-EXPLORATION y I-EXPLORATION +una I-EXPLORATION +ecoendoscopia I-EXPLORATION +posteriormente, I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION que I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +evidencia I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +litiasis, I-EXPLORATION +microlitiasis I-EXPLORATION +ni I-EXPLORATION +barro I-EXPLORATION en I-EXPLORATION -algunas I-EXPLORATION -zonas I-EXPLORATION -profundizaba I-EXPLORATION -hasta I-EXPLORATION -plano I-EXPLORATION -óseo I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar. I-EXPLORATION +El I-EXPLORATION +TAC I-EXPLORATION +abdominal I-EXPLORATION +puso I-EXPLORATION +de I-EXPLORATION +manifiesto I-EXPLORATION +un I-EXPLORATION +páncreas I-EXPLORATION +edematoso I-EXPLORATION +y I-EXPLORATION +desestructurado, I-EXPLORATION +sin I-EXPLORATION +más I-EXPLORATION +hallazgos. I-EXPLORATION + I-EXPLORATION +Ante I-EXPLORATION +la I-EXPLORATION +negatividad I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +exploraciones I-EXPLORATION +en I-EXPLORATION +cuanto I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +etiología I-EXPLORATION +del I-EXPLORATION +cuadro I-EXPLORATION +de I-EXPLORATION +pancreatitis, I-EXPLORATION +se I-EXPLORATION +postuló I-EXPLORATION +una I-EXPLORATION +posible I-EXPLORATION +relación I-EXPLORATION +del I-EXPLORATION +mismo I-EXPLORATION con I-EXPLORATION -exposición I-EXPLORATION +la I-EXPLORATION +hipercalcemia I-EXPLORATION +objetivada I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +rutinaria I-EXPLORATION del I-EXPLORATION -sacro. I-EXPLORATION -Se B-EVOLUTION -recomendó I-EVOLUTION -ingreso I-EVOLUTION -hospitalario I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION +paciente I-EXPLORATION +a I-EXPLORATION +su I-EXPLORATION +ingreso. I-EXPLORATION +Así, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +determinación I-EXPLORATION +de I-EXPLORATION +calcio I-EXPLORATION +plasmático I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +paratohormona I-EXPLORATION +intacta I-EXPLORATION +(PTHi), I-EXPLORATION +cuyos I-EXPLORATION +valores I-EXPLORATION +fueron I-EXPLORATION +respectivamente I-EXPLORATION +de I-EXPLORATION +11, I-EXPLORATION +9 I-EXPLORATION +mg/dl I-EXPLORATION +y I-EXPLORATION +451 I-EXPLORATION +pg/ml I-EXPLORATION +(valores I-EXPLORATION +normales I-EXPLORATION +por I-EXPLORATION +debajo I-EXPLORATION +de I-EXPLORATION +9 I-EXPLORATION +pg/ml), I-EXPLORATION +confirmándose I-EXPLORATION +la I-EXPLORATION +hipercalcemia I-EXPLORATION +secundaria I-EXPLORATION +a I-EXPLORATION +hiperparatiroidismo. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION paciente I-EVOLUTION -rechazó I-EVOLUTION -por I-EVOLUTION -motivos I-EVOLUTION -personales, I-EVOLUTION -acudiendo I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente I-EVOLUTION de I-EVOLUTION -nuevo I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -3 I-EVOLUTION -semanas, I-EVOLUTION -momento I-EVOLUTION +su I-EVOLUTION +pancreatitis I-EVOLUTION en I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -úlcera I-EVOLUTION -medía I-EVOLUTION -ya I-EVOLUTION -24 I-EVOLUTION -x I-EVOLUTION -30 I-EVOLUTION -cm. I-EVOLUTION - I-EVOLUTION -Durante B-TREATMENT -el I-TREATMENT -ingreso I-TREATMENT -y I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -la I-TREATMENT -gran I-TREATMENT -úlcera I-TREATMENT -que I-TREATMENT -presentaba I-TREATMENT -se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -colostomía. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -tenía I-EVOLUTION -un I-EVOLUTION -mal I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION +los I-EVOLUTION +días I-EVOLUTION +ulteriores, I-EVOLUTION con I-EVOLUTION -alteraciones I-EVOLUTION -analíticas I-EVOLUTION -importantes I-EVOLUTION -tanto I-EVOLUTION -en I-EVOLUTION +normalización I-EVOLUTION +de I-EVOLUTION las I-EVOLUTION cifras I-EVOLUTION de I-EVOLUTION -hematocrito I-EVOLUTION -como I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION +amilasa I-EVOLUTION +y I-EVOLUTION +lipasa, I-EVOLUTION +obtención I-EVOLUTION de I-EVOLUTION -proteínas I-EVOLUTION -totales, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -tuvo I-EVOLUTION -que I-EVOLUTION -iniciar I-EVOLUTION -nutrición I-EVOLUTION -parenteral I-EVOLUTION -para I-EVOLUTION -remontar I-EVOLUTION -su I-EVOLUTION -estado I-EVOLUTION -general. I-EVOLUTION - I-EVOLUTION -Para B-TREATMENT -cerrar I-TREATMENT +una I-EVOLUTION +correcta I-EVOLUTION +tolerancia I-EVOLUTION +oral I-EVOLUTION +y I-EVOLUTION +desaparición I-EVOLUTION +del I-EVOLUTION +dolor. I-EVOLUTION +Cuando B-EXPLORATION +se I-EXPLORATION +hubo I-EXPLORATION +resuelto I-EXPLORATION +por I-EXPLORATION +completo I-EXPLORATION +el I-EXPLORATION +cuadro I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +gammagrafía I-EXPLORATION +con I-EXPLORATION +Tc99-Sestamibi, I-EXPLORATION +que I-EXPLORATION +puso I-EXPLORATION +de I-EXPLORATION +manifiesto I-EXPLORATION +una I-EXPLORATION +captación I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +adenoma I-EXPLORATION +paratiroideo I-EXPLORATION +inferior I-EXPLORATION +derecho. I-EXPLORATION +Días B-TREATMENT +más I-TREATMENT +tarde I-TREATMENT el I-TREATMENT -gran I-TREATMENT -defecto I-TREATMENT -que I-TREATMENT -presentaba I-TREATMENT -fue I-TREATMENT -intervenida I-TREATMENT -y I-TREATMENT +paciente I-TREATMENT se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT -colgajo I-TREATMENT -póstero-medial I-TREATMENT -de I-TREATMENT -muslo, I-TREATMENT -para I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -procedimos I-TREATMENT -a I-TREATMENT -desbridar I-TREATMENT -la I-TREATMENT -úlcera I-TREATMENT +intervino I-TREATMENT +quirúrgicamente, I-TREATMENT +hallándose I-TREATMENT +dicha I-TREATMENT +lesión I-TREATMENT y I-TREATMENT -cubrirla I-TREATMENT -posteriormente I-TREATMENT -mediante I-TREATMENT -el I-TREATMENT -colgajo I-TREATMENT -anteriormente I-TREATMENT -descrito I-TREATMENT -como I-TREATMENT -alternativa I-TREATMENT +procediéndose I-TREATMENT a I-TREATMENT -la I-TREATMENT -desarticulación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cadera. I-TREATMENT - I-TREATMENT -La I-TREATMENT -intervención I-TREATMENT -duró I-TREATMENT -unas I-TREATMENT -5 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -se I-TREATMENT -desarrolló I-TREATMENT -sin I-TREATMENT -contratiempos. I-TREATMENT -La I-TREATMENT -zona I-TREATMENT -donante I-TREATMENT -del I-TREATMENT -colgajo I-TREATMENT -se I-TREATMENT -cerró I-TREATMENT -directamente I-TREATMENT -en I-TREATMENT su I-TREATMENT -mayor I-TREATMENT -parte, I-TREATMENT -teniendo I-TREATMENT -que I-TREATMENT -cubrir I-TREATMENT -solo I-TREATMENT -la I-TREATMENT -porción I-TREATMENT -distal I-TREATMENT -con I-TREATMENT -un I-TREATMENT -injerto I-TREATMENT -de I-TREATMENT -piel I-TREATMENT -parcial I-TREATMENT -tomado I-TREATMENT -del I-TREATMENT -muslo I-TREATMENT -contralateral. I-TREATMENT -Durante B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -permaneció I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -UCI I-EVOLUTION -2 I-EVOLUTION -días I-EVOLUTION -para I-EVOLUTION -control I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -situación I-EVOLUTION -metabólica, I-EVOLUTION -tras I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -trasladada I-EVOLUTION -de I-EVOLUTION -nuevo I-EVOLUTION -a I-EVOLUTION -planta I-EVOLUTION -hospitalaria. I-EVOLUTION - I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -15 I-EVOLUTION -días, I-EVOLUTION -el I-EVOLUTION -colgajo I-EVOLUTION -presentaba I-EVOLUTION -buen I-EVOLUTION -estado, I-EVOLUTION -con I-EVOLUTION -adecuado I-EVOLUTION -relleno I-EVOLUTION -capilar. I-EVOLUTION -A I-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -ello, I-EVOLUTION +extirpación. I-TREATMENT +Se B-EXPLORATION +comprobó I-EXPLORATION +intraoperatoriamente I-EXPLORATION +el I-EXPLORATION +descenso I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +cifras I-EXPLORATION +de I-EXPLORATION +PTHi. I-EXPLORATION +La I-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +confirmó I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +trataba I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +adenoma I-EXPLORATION +paratiroideo. I-EXPLORATION + I-EXPLORATION +Tras B-EVOLUTION +este I-EVOLUTION +episodio I-EVOLUTION el I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION paciente I-EVOLUTION -empezó I-EVOLUTION -a I-EVOLUTION -deteriorarse. I-EVOLUTION -Comenzó I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -insuficiencia I-EVOLUTION -hepato-renal I-EVOLUTION -progresiva I-EVOLUTION -que I-EVOLUTION -tras I-EVOLUTION -un I-EVOLUTION -diagnóstico I-EVOLUTION -exhaustivo I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Medicina I-EVOLUTION -Interna I-EVOLUTION -se I-EVOLUTION -catalogó I-EVOLUTION -como I-EVOLUTION -secundaria I-EVOLUTION +no I-EVOLUTION +volvió I-EVOLUTION a I-EVOLUTION -alteraciones I-EVOLUTION -biliopancreáticas I-EVOLUTION -derivadas I-EVOLUTION +referir I-EVOLUTION +más I-EVOLUTION +cuadros I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -nutrición I-EVOLUTION -parenteral. I-EVOLUTION -Tras B-TREATMENT -valoración I-TREATMENT -por I-TREATMENT +dolor I-EVOLUTION +abdominal I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +revisiones I-EVOLUTION +posteriores. I-EVOLUTION + I-EVOLUTION + +Secundigesta B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +40 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +natural B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Colombia, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +embarazo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +parto I-PAST_MEDICAL_HISTORY +anterior I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +complicaciones I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +presenta I-PAST_MEDICAL_HISTORY +obesidad I-PAST_MEDICAL_HISTORY +mórbida I-PAST_MEDICAL_HISTORY +(IMC I-PAST_MEDICAL_HISTORY +43) I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +cólicos I-PAST_MEDICAL_HISTORY +biliares I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +repetición. I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +30+ I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +gestación I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +prurito I-PRESENT_ILLNESS +generalizado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +pseudogripal I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +febrícula, I-PRESENT_ILLNESS +artromialgias I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +malestar I-PRESENT_ILLNESS +general. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +clínica I-EXPLORATION +se I-EXPLORATION +objetivaron I-EXPLORATION +lesiones I-EXPLORATION +de I-EXPLORATION +rascado I-EXPLORATION +sin I-EXPLORATION +lesiones I-EXPLORATION +urticariformes I-EXPLORATION +y I-EXPLORATION +febrícula I-EXPLORATION +de I-EXPLORATION +37oC. I-EXPLORATION +Se I-EXPLORATION +constató I-EXPLORATION +el I-EXPLORATION +bienestar I-EXPLORATION +fetal I-EXPLORATION +mediante I-EXPLORATION +ecografía I-EXPLORATION +obstétrica I-EXPLORATION +(feto I-EXPLORATION +en I-EXPLORATION +cefálica I-EXPLORATION +dorso I-EXPLORATION +anterior, I-EXPLORATION +placenta I-EXPLORATION +posterior I-EXPLORATION +normoinserta, I-EXPLORATION +y I-EXPLORATION +líquido I-EXPLORATION +amniótico I-EXPLORATION +normal) I-EXPLORATION +y I-EXPLORATION +registro I-EXPLORATION +cardiotocográfico I-EXPLORATION +(patrón I-EXPLORATION +reactivo, I-EXPLORATION +adinamia). I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +hemograma I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +evidenció I-EXPLORATION +alteraciones I-EXPLORATION +significativas, I-EXPLORATION +excepto I-EXPLORATION +anemia I-EXPLORATION +moderada I-EXPLORATION +(Hb I-EXPLORATION +10 I-EXPLORATION +g/dl), I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION +transaminasas I-EXPLORATION +(AST I-EXPLORATION +y I-EXPLORATION +ALT I-EXPLORATION +208 I-EXPLORATION +y I-EXPLORATION +238 I-EXPLORATION +U/L) I-EXPLORATION +y I-EXPLORATION +ácidos I-EXPLORATION +biliares I-EXPLORATION +56, I-EXPLORATION +9 I-EXPLORATION +µmol/L. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +coagulación I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +Se B-TREATMENT +decidió I-TREATMENT el I-TREATMENT -Servicio I-TREATMENT +ingreso I-TREATMENT de I-TREATMENT -Nefrología, I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +por I-TREATMENT +colestasis I-TREATMENT +gravídica I-TREATMENT +y I-TREATMENT se I-TREATMENT inició I-TREATMENT tratamiento I-TREATMENT con I-TREATMENT -diálisis, I-TREATMENT -que I-TREATMENT -mejoró I-TREATMENT -las I-TREATMENT -cifras I-TREATMENT +ácido I-TREATMENT +ursodesoxicólico I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT de I-TREATMENT -creatinina I-TREATMENT -aunque I-TREATMENT -se I-TREATMENT -manifestó I-TREATMENT -una I-TREATMENT -hipoproteinemia I-TREATMENT -severa I-TREATMENT -que I-TREATMENT -no I-TREATMENT -se I-TREATMENT -consiguió I-TREATMENT -remontar. I-TREATMENT +13 I-TREATMENT +mg/kg/día, I-TREATMENT +loratadina I-TREATMENT +10 I-TREATMENT +mg/ I-TREATMENT +24h I-TREATMENT +y I-TREATMENT +colestiramina I-TREATMENT +3 I-TREATMENT +gr/ I-TREATMENT +8h. I-TREATMENT A B-EVOLUTION -la I-EVOLUTION -cuarta I-EVOLUTION -semana I-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +horas I-EVOLUTION de I-EVOLUTION -postoperatorio, I-EVOLUTION +su I-EVOLUTION +ingreso I-EVOLUTION la I-EVOLUTION paciente I-EVOLUTION -presentó I-EVOLUTION +comenzó I-EVOLUTION +con I-EVOLUTION fiebre I-EVOLUTION -alta I-EVOLUTION de I-EVOLUTION -origen I-EVOLUTION -desconocido I-EVOLUTION -que I-EVOLUTION -evolucionó I-EVOLUTION -a I-EVOLUTION -sepsis I-EVOLUTION +hasta I-EVOLUTION +38, I-EVOLUTION +6 I-EVOLUTION +oC, I-EVOLUTION +tos I-EVOLUTION +no I-EVOLUTION +productiva, I-EVOLUTION +disnea I-EVOLUTION y I-EVOLUTION -fracaso I-EVOLUTION -multiorgánico I-EVOLUTION -que I-EVOLUTION -provocaron I-EVOLUTION -el I-EVOLUTION -fallecimiento. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -tumoral I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aspecto I-PRESENT_ILLNESS -esclerodermiforme I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -central I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -párpado I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -deja I-PRESENT_ILLNESS -libre I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -borde I-PRESENT_ILLNESS -palpebral. I-PRESENT_ILLNESS -Bajo B-TREATMENT -anestesia I-TREATMENT -local I-TREATMENT -y I-TREATMENT -sedación I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -exéresis I-TREATMENT -amplia I-TREATMENT +otalgia, I-EVOLUTION +siendo I-EVOLUTION +la I-EVOLUTION +auscultación I-EVOLUTION +broncopulmonar I-EVOLUTION +normal I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +saturación I-EVOLUTION +de I-EVOLUTION +98%. I-EVOLUTION +Se B-TREATMENT +solicitó I-TREATMENT +radiografía I-TREATMENT de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -cutánea I-TREATMENT -respetando I-TREATMENT -la I-TREATMENT -lamela I-TREATMENT -interna I-TREATMENT +tórax, I-TREATMENT +hemocultivos I-TREATMENT y I-TREATMENT -reconstrucción I-TREATMENT -mediante I-TREATMENT -colgajo I-TREATMENT -miocutáneo I-TREATMENT -del I-TREATMENT -músculo I-TREATMENT -orbicular I-TREATMENT -en I-TREATMENT -isla I-TREATMENT +frotis I-TREATMENT +nasofaríngeo I-TREATMENT +(PCR I-TREATMENT +gripe) I-TREATMENT +y I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +empírico I-TREATMENT con I-TREATMENT -unas I-TREATMENT -dimensiones I-TREATMENT -de I-TREATMENT -25 I-TREATMENT -x I-TREATMENT -17 I-TREATMENT -mm. I-TREATMENT -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -basocelular. I-EXPLORATION -En B-EVOLUTION -las I-EVOLUTION -Fig. I-EVOLUTION -4 I-EVOLUTION -y I-EVOLUTION -5 I-EVOLUTION -presentamos I-EVOLUTION -el I-EVOLUTION -resultado I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -12 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -y B-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -previos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Diez B-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -comenzó I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -inflamación I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -pero I-PRESENT_ILLNESS -indolora I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cuarto I-PRESENT_ILLNESS -dedo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mano I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -inflamación I-PRESENT_ILLNESS -dio I-PRESENT_ILLNESS -lugar I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -déficit I-PRESENT_ILLNESS -funcional, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -imposibilidad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -realizar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -flexoextensión I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -dedo I-PRESENT_ILLNESS -afectado. I-PRESENT_ILLNESS -El B-EXPLORATION -estudio I-EXPLORATION -radiográfico I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -definición I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cortical I-EXPLORATION -anterior I-EXPLORATION -en I-EXPLORATION +ampicilina I-TREATMENT +2g/4h, I-TREATMENT +gentamicina I-TREATMENT +240 I-TREATMENT +mg/24h I-TREATMENT +y I-TREATMENT +oseltamivir I-TREATMENT +75 I-TREATMENT +mg. I-TREATMENT +Al B-EXPLORATION +mismo I-EXPLORATION +tiempo, I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +ecografía I-EXPLORATION +abdominal, I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +normal, I-EXPLORATION +para I-EXPLORATION +descartar I-EXPLORATION +colelitiasis/colecistitis I-EXPLORATION +dada I-EXPLORATION la I-EXPLORATION -base I-EXPLORATION +frecuente I-EXPLORATION +asociación I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -falange I-EXPLORATION -proximal I-EXPLORATION -del I-EXPLORATION -cuarto I-EXPLORATION -dedo, I-EXPLORATION -junto I-EXPLORATION +ambos I-EXPLORATION +procesos I-EXPLORATION con I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -que I-EXPLORATION -parecía I-EXPLORATION -presentar I-EXPLORATION -una I-EXPLORATION -incipiente I-EXPLORATION -calcificación I-EXPLORATION +colestasis, I-EXPLORATION +sobre I-EXPLORATION +todo I-EXPLORATION +en I-EXPLORATION +mujeres I-EXPLORATION +obesas I-EXPLORATION +y I-EXPLORATION +multíparas, I-EXPLORATION +condiciones I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -extendía I-EXPLORATION -distalmente I-EXPLORATION -por I-EXPLORATION +cumplía I-EXPLORATION la I-EXPLORATION -cara I-EXPLORATION -palmar I-EXPLORATION -de I-EXPLORATION +paciente. I-EXPLORATION +Ante I-EXPLORATION la I-EXPLORATION -falange; I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -vio I-EXPLORATION -lesión I-EXPLORATION -intramedular. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -biopsia I-EXPLORATION -incisional, I-EXPLORATION -cuyo I-EXPLORATION -diagnóstico I-EXPLORATION -anatomopatológico I-EXPLORATION -fue I-EXPLORATION +evolución I-EXPLORATION +analítica I-EXPLORATION +y I-EXPLORATION +los I-EXPLORATION +antecedentes I-EXPLORATION de I-EXPLORATION -periostitis I-EXPLORATION -reactiva I-EXPLORATION -florida. I-EXPLORATION - I-EXPLORATION -El B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -comprobó I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -existencia I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -masa I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -falange I-DERIVED_FROM/TO -proximal I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -cuarto I-DERIVED_FROM/TO -dedo I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -inflamación I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -tumefacción. I-DERIVED_FROM/TO -No B-EXPLORATION +cólicos I-EXPLORATION +biliares, I-EXPLORATION se I-EXPLORATION -encontraron I-EXPLORATION -signos I-EXPLORATION -locorregionales I-EXPLORATION -de I-EXPLORATION -infección. I-EXPLORATION -La I-EXPLORATION -movilidad I-EXPLORATION -en I-EXPLORATION -todas I-EXPLORATION -las I-EXPLORATION -articulaciones I-EXPLORATION -del I-EXPLORATION -dedo I-EXPLORATION -estaba I-EXPLORATION -afectada, I-EXPLORATION -existiendo I-EXPLORATION +solicitó I-EXPLORATION una I-EXPLORATION -impotencia I-EXPLORATION -funcional I-EXPLORATION -absoluta. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -refería I-EXPLORATION -dolor I-EXPLORATION -con I-EXPLORATION -parestesias I-EXPLORATION +segunda I-EXPLORATION +ecografía I-EXPLORATION +que, I-EXPLORATION en I-EXPLORATION +esta I-EXPLORATION +ocasión, I-EXPLORATION +confirmó I-EXPLORATION el I-EXPLORATION -territorio I-EXPLORATION -del I-EXPLORATION -nervio I-EXPLORATION -colateral I-EXPLORATION -cubital. I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +colelitiasis. I-EXPLORATION I-EXPLORATION El I-EXPLORATION -estudio I-EXPLORATION -radiográfico I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -estadio I-EXPLORATION -evolutivo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -con I-EXPLORATION -respecto I-EXPLORATION -al I-EXPLORATION -primer I-EXPLORATION -estudio, I-EXPLORATION +frotis I-EXPLORATION +nasofaríngeo I-EXPLORATION +para I-EXPLORATION +gripe I-EXPLORATION +resultó I-EXPLORATION +negativo I-EXPLORATION +y I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -calcificación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -palmar I-EXPLORATION -de I-EXPLORATION -falange I-EXPLORATION -proximal I-EXPLORATION +hemocultivo I-EXPLORATION se I-EXPLORATION -había I-EXPLORATION -hecho I-EXPLORATION -más I-EXPLORATION -ostensible, I-EXPLORATION -extendiéndose I-EXPLORATION +aisló I-EXPLORATION +Listeria I-EXPLORATION +monocytogenes I-EXPLORATION +sensible I-EXPLORATION a I-EXPLORATION -lo I-EXPLORATION -largo I-EXPLORATION +ampicilina, I-EXPLORATION +gentamicina I-EXPLORATION +y I-EXPLORATION +penicilina I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT +oseltamivir I-TREATMENT +y I-TREATMENT +se I-TREATMENT +continuó I-TREATMENT +con I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +pautado. I-TREATMENT +Así I-TREATMENT +mismo, I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +preparados I-TREATMENT +orales I-TREATMENT +de I-TREATMENT +hierro. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +evolución I-EVOLUTION +tórpida I-EVOLUTION +del I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +colestasis I-EVOLUTION +con I-EVOLUTION +descenso I-EVOLUTION +parcial I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +transaminasas I-EVOLUTION +y I-EVOLUTION +episodios I-EVOLUTION +aislados I-EVOLUTION +de I-EVOLUTION +prurito I-EVOLUTION +a I-EVOLUTION +pesar I-EVOLUTION +del I-EVOLUTION +tratamiento. I-EVOLUTION + I-EVOLUTION +Las I-EVOLUTION +determinaciones I-EVOLUTION +analíticas I-EVOLUTION +sucesivas I-EVOLUTION +evidenciaron I-EVOLUTION +modificaciones I-EVOLUTION +con I-EVOLUTION +elevaciones I-EVOLUTION +y I-EVOLUTION +descensos I-EVOLUTION +de I-EVOLUTION +transaminasas I-EVOLUTION +y I-EVOLUTION +ácidos I-EVOLUTION +biliares, I-EVOLUTION +tal I-EVOLUTION +y I-EVOLUTION +como I-EVOLUTION +se I-EVOLUTION +recoge I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +tabla I-EVOLUTION +1. I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +listeriosis I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +evolución I-EVOLUTION +favorable, I-EVOLUTION +permaneciendo I-EVOLUTION +apirética I-EVOLUTION +y I-EVOLUTION +evidenciándose I-EVOLUTION +el I-EVOLUTION +descenso I-EVOLUTION +paulatino I-EVOLUTION +de I-EVOLUTION +PCR I-EVOLUTION +desde I-EVOLUTION +el I-EVOLUTION +inicio I-EVOLUTION +del I-EVOLUTION +tratamiento I-EVOLUTION +antibiótico. I-EVOLUTION + I-EVOLUTION +Se B-EXPLORATION +realizó I-EXPLORATION +control I-EXPLORATION de I-EXPLORATION +bienestar I-EXPLORATION +fetal I-EXPLORATION +seriado I-EXPLORATION +mediante I-EXPLORATION +ecografía I-EXPLORATION +obstétrica I-EXPLORATION +y I-EXPLORATION +registro I-EXPLORATION +cardiotocográfico I-EXPLORATION +hasta I-EXPLORATION la I-EXPLORATION -falange. I-EXPLORATION -Aparecía I-EXPLORATION -una I-EXPLORATION -clara I-EXPLORATION -reacción I-EXPLORATION -perióstica I-EXPLORATION +semana I-EXPLORATION +32+ I-EXPLORATION +4, I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -base I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -falange I-EXPLORATION -que I-EXPLORATION -parecía I-EXPLORATION -conectar I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -calcificación I-EXPLORATION -pero I-EXPLORATION -que I-EXPLORATION -además, I-EXPLORATION -se I-EXPLORATION -extendía I-EXPLORATION -al I-EXPLORATION -lado I-EXPLORATION -opuesto. I-EXPLORATION -Es I-EXPLORATION -interesante I-EXPLORATION -señalar I-EXPLORATION -también I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -apreciaba I-EXPLORATION -una I-EXPLORATION -reacción I-EXPLORATION -perióstica I-EXPLORATION -sólida I-EXPLORATION +inició I-EXPLORATION de I-EXPLORATION -borde I-EXPLORATION -irregular I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -falange I-EXPLORATION -media. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION +forma I-EXPLORATION +espontánea I-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION -radiográfico I-EXPLORATION -preoperatorio I-EXPLORATION -la I-EXPLORATION -calcificación I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION +trabajo I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -falange I-EXPLORATION -media I-EXPLORATION -se I-EXPLORATION -volvió I-EXPLORATION -más I-EXPLORATION -definida I-EXPLORATION -y I-EXPLORATION -grande, I-EXPLORATION -abarcando I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -extensión I-EXPLORATION +parto I-EXPLORATION +tras I-EXPLORATION +completar I-EXPLORATION +14 I-EXPLORATION +días I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -falange. I-EXPLORATION +tratamiento I-EXPLORATION +con I-EXPLORATION +ampicilina I-EXPLORATION +y I-EXPLORATION +7 I-EXPLORATION +días I-EXPLORATION +con I-EXPLORATION +gentamicina, I-EXPLORATION +ambas I-EXPLORATION +por I-EXPLORATION +vía I-EXPLORATION +endovenosa. I-EXPLORATION I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION +Se I-EXPLORATION +comprobó I-EXPLORATION +bienestar I-EXPLORATION +fetal I-EXPLORATION +intraparto I-EXPLORATION mediante I-EXPLORATION -Resonancia I-EXPLORATION -Magnética I-EXPLORATION -(RM) I-EXPLORATION -permitió I-EXPLORATION -apreciar I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION +monitorización I-EXPLORATION +maternofetal, I-EXPLORATION +objetivando I-EXPLORATION +líquido I-EXPLORATION +amniótico I-EXPLORATION +meconial. I-EXPLORATION +El B-EVOLUTION +parto I-EVOLUTION +fue I-EVOLUTION +eutócico, I-EVOLUTION +obteniendo I-EVOLUTION +una I-EVOLUTION +niña I-EVOLUTION +de I-EVOLUTION +2.225 I-EVOLUTION +g I-EVOLUTION +de I-EVOLUTION +peso, I-EVOLUTION +test I-EVOLUTION +de I-EVOLUTION +Apgar I-EVOLUTION +9/10 I-EVOLUTION +y I-EVOLUTION +pH I-EVOLUTION +de I-EVOLUTION +cordón I-EVOLUTION +7, I-EVOLUTION +36 I-EVOLUTION +arterial I-EVOLUTION +y I-EVOLUTION +7, I-EVOLUTION +37 I-EVOLUTION +venoso. I-EVOLUTION + I-EVOLUTION +La I-EVOLUTION +RN I-EVOLUTION +ingresó I-EVOLUTION +en I-EVOLUTION +neonatología I-EVOLUTION +por I-EVOLUTION +prematuridad I-EVOLUTION +y I-EVOLUTION +antecedente I-EVOLUTION +de I-EVOLUTION +listeriosis I-EVOLUTION +materna. I-EVOLUTION +Los B-EXPLORATION +cultivos I-EXPLORATION que I-EXPLORATION -englobaba I-EXPLORATION -los I-EXPLORATION -tendones I-EXPLORATION -flexores I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +realizaron I-EXPLORATION +(frotis I-EXPLORATION +faríngeo, I-EXPLORATION +vermis, I-EXPLORATION +umbilical, I-EXPLORATION +hemocultivo, I-EXPLORATION +urocultivo I-EXPLORATION y I-EXPLORATION -contactaba I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -periostio I-EXPLORATION +coprocultivo) I-EXPLORATION +fueron I-EXPLORATION +negativos, I-EXPLORATION +siendo I-EXPLORATION +dada I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -falange I-EXPLORATION -proximal. I-EXPLORATION -Era I-EXPLORATION -hipointensa I-EXPLORATION -en I-EXPLORATION -T1, I-EXPLORATION -hiperintensa I-EXPLORATION -en I-EXPLORATION -T2 I-EXPLORATION -y I-EXPLORATION -realzaba I-EXPLORATION +alta I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +10 I-EXPLORATION +días I-EXPLORATION de I-EXPLORATION -forma I-EXPLORATION -homogénea I-EXPLORATION -con I-EXPLORATION -Gadolinio. I-EXPLORATION -En I-EXPLORATION -su I-EXPLORATION -margen I-EXPLORATION -palmar I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -reborde I-EXPLORATION -hipointenso I-EXPLORATION -que I-EXPLORATION -pudiera I-EXPLORATION -representar I-EXPLORATION -calcificación. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -apreciaron I-EXPLORATION -vacíos I-EXPLORATION -de I-EXPLORATION -señal I-EXPLORATION -internos, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -calcificación I-EXPLORATION -debería I-EXPLORATION -ir I-EXPLORATION -unido I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -matriz I-EXPLORATION -celular I-EXPLORATION -(lo I-EXPLORATION -que I-EXPLORATION -sugiere I-EXPLORATION -tumor I-EXPLORATION -o I-EXPLORATION -psedotumor). I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -márgenes I-EXPLORATION -laterales I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -falange I-EXPLORATION -se I-EXPLORATION -visualizaron I-EXPLORATION -levantamientos I-EXPLORATION -periostios, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -componente I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -que I-EXPLORATION -desplazaba I-EXPLORATION -al I-EXPLORATION -tendón I-EXPLORATION -extensor. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -cortes I-EXPLORATION -sagitales I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -medular I-EXPLORATION -ósea I-EXPLORATION -estaba I-EXPLORATION -respetada I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -cortical I-EXPLORATION -anterior I-EXPLORATION -no I-EXPLORATION -estaba I-EXPLORATION -infiltrada I-EXPLORATION -pero I-EXPLORATION -si I-EXPLORATION -mostraba I-EXPLORATION -un I-EXPLORATION -ligero I-EXPLORATION -festoneado I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -superficie I-EXPLORATION -externa. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -lesión I-TREATMENT -fue I-TREATMENT -extirpada I-TREATMENT -realizando I-TREATMENT -una I-TREATMENT -amputación I-TREATMENT -estética I-TREATMENT -del I-TREATMENT -4º I-TREATMENT -radio I-TREATMENT -de I-TREATMENT -la I-TREATMENT -mano I-TREATMENT -derecha I-TREATMENT -por I-TREATMENT -el I-TREATMENT -déficit I-TREATMENT -funcional I-TREATMENT -del I-TREATMENT -dedo. I-TREATMENT - I-TREATMENT +vida. I-EXPLORATION +La B-EVOLUTION +evolución I-EVOLUTION +puerperal I-EVOLUTION +fue I-EVOLUTION +normal I-EVOLUTION +con I-EVOLUTION +alta I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +horas I-EVOLUTION +del I-EVOLUTION +parto. I-EVOLUTION + I-EVOLUTION El B-EXPLORATION -estudio I-EXPLORATION +examen I-EXPLORATION anatomopatológico I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -pieza I-EXPLORATION -de I-EXPLORATION -amputación I-EXPLORATION -señaló I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -entre I-EXPLORATION -el I-EXPLORATION -tendón I-EXPLORATION -flexor I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -falange, I-EXPLORATION -de I-EXPLORATION -hueso I-EXPLORATION -maduro I-EXPLORATION +placenta I-EXPLORATION +evidenció I-EXPLORATION +múltiples I-EXPLORATION +infartos I-EXPLORATION +«sépticos» I-EXPLORATION con I-EXPLORATION -intensos I-EXPLORATION -fenómenos I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -remodelación. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -centro I-EXPLORATION -del I-EXPLORATION -mencionado I-EXPLORATION -hueso I-EXPLORATION -existía I-EXPLORATION -una I-EXPLORATION -proliferación I-EXPLORATION -fibroblástica I-EXPLORATION +aisladas I-EXPLORATION +formaciones I-EXPLORATION +bacilares I-EXPLORATION +Gram I-EXPLORATION +positivas, I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -casi I-EXPLORATION -total I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -mitosis, I-EXPLORATION -que I-EXPLORATION -diferenciaba I-EXPLORATION -pequeñas I-EXPLORATION -cantidades I-EXPLORATION +estado I-EXPLORATION de I-EXPLORATION -osteoide. I-EXPLORATION -Al I-EXPLORATION -comparar I-EXPLORATION -esta I-EXPLORATION -biopsia I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -previa I-EXPLORATION -o I-EXPLORATION -diagnóstica, I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -mayor I-EXPLORATION -celularidad, I-EXPLORATION -con I-EXPLORATION -discreta I-EXPLORATION -atipia I-EXPLORATION -celular I-EXPLORATION -y I-EXPLORATION -mayor I-EXPLORATION -actividad I-EXPLORATION -mitótica. I-EXPLORATION - B-EVOLUTION -La I-EVOLUTION -evolución I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -satisfactoria I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -lesión I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -recidivado I-EVOLUTION -tras I-EVOLUTION -8 I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento, I-EVOLUTION -conservando I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -una I-EVOLUTION -buena I-EVOLUTION -función I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mano. I-EVOLUTION - I-EVOLUTION +infección I-EXPLORATION +por I-EXPLORATION +Listeria. I-EXPLORATION + I-EXPLORATION -Varón B-PRESENT_ILLNESS +Niña B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +intervenida I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -basocelular I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -canto I-PRESENT_ILLNESS -interno I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS -La B-TREATMENT -resección I-TREATMENT -se I-TREATMENT -hizo I-TREATMENT -con I-TREATMENT -margen I-TREATMENT -sano I-TREATMENT -de I-TREATMENT -0.5 I-TREATMENT -cm I-TREATMENT -también I-TREATMENT -confirmado I-TREATMENT -mediante I-TREATMENT -biopsia I-TREATMENT -por I-TREATMENT -congelación. I-TREATMENT -Cobertura I-TREATMENT -del I-TREATMENT -defecto I-TREATMENT -con I-TREATMENT -la I-TREATMENT -técnica I-TREATMENT -descrita. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS +vida I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +atresia I-PRESENT_ILLNESS +esofágica I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +long-gap, I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -tumor I-PRESENT_ILLNESS -parietal I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS +realización I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -costillas I-PRESENT_ILLNESS -cuarta, I-PRESENT_ILLNESS -quinta I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sexta, I-PRESENT_ILLNESS +gastrostomía I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -línea I-PRESENT_ILLNESS -media I-PRESENT_ILLNESS -anterior I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -hemitórax I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -asociada I-PRESENT_ILLNESS -bajo I-PRESENT_ILLNESS el I-PRESENT_ILLNESS -margen I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -esternón I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -recidiva I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -mama, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -mastectomía I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -El B-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -extensión I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION -Realizamos B-TREATMENT -resección I-TREATMENT +mismo I-PRESENT_ILLNESS +acto I-PRESENT_ILLNESS +quirúrgico. I-PRESENT_ILLNESS +A B-TREATMENT +los I-TREATMENT +2 I-TREATMENT +meses I-TREATMENT de I-TREATMENT -las I-TREATMENT -costillas I-TREATMENT -afectadas I-TREATMENT -con I-TREATMENT -margen I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +(4 I-TREATMENT +meses I-TREATMENT de I-TREATMENT -seguridad I-TREATMENT +vida) I-TREATMENT +requiere I-TREATMENT +dilatación I-TREATMENT +esofágica I-TREATMENT +con I-TREATMENT +balón I-TREATMENT +hidroneumático I-TREATMENT +por I-TREATMENT +estenosis I-TREATMENT de I-TREATMENT -4 I-TREATMENT -cm. I-TREATMENT -Realizamos I-TREATMENT la I-TREATMENT -restitución I-TREATMENT -parietal I-TREATMENT +zona I-TREATMENT +anastomótica. I-TREATMENT +Tras I-TREATMENT +una I-TREATMENT +buena I-TREATMENT +respuesta I-TREATMENT +inicial I-TREATMENT +se I-TREATMENT +produjo I-TREATMENT +una I-TREATMENT +reestenosis I-TREATMENT +a I-TREATMENT +las I-TREATMENT +4 I-TREATMENT +semanas I-TREATMENT +motivo I-TREATMENT +por I-TREATMENT +el I-TREATMENT +que I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +una I-TREATMENT +segunda I-TREATMENT +dilatación. I-TREATMENT +Desde I-TREATMENT +ese I-TREATMENT +momento I-TREATMENT +se I-TREATMENT +hicieron I-TREATMENT +dilataciones I-TREATMENT +sucesivas I-TREATMENT con I-TREATMENT una I-TREATMENT -membrana I-TREATMENT +periodicidad I-TREATMENT +que I-TREATMENT +oscila I-TREATMENT +entre I-TREATMENT +4 I-TREATMENT +y I-TREATMENT +8 I-TREATMENT +semanas I-TREATMENT +(excepto I-TREATMENT +en I-TREATMENT +una I-TREATMENT +ocasión I-TREATMENT +que I-TREATMENT +precisó I-TREATMENT +dilatación I-TREATMENT +a I-TREATMENT +las I-TREATMENT +2 I-TREATMENT +semanas I-TREATMENT de I-TREATMENT -Gore-tex® I-TREATMENT -sobre I-TREATMENT la I-TREATMENT +previa I-TREATMENT +y I-TREATMENT +otra I-TREATMENT +ocasión I-TREATMENT +en I-TREATMENT que I-TREATMENT -se I-TREATMENT -repusieron I-TREATMENT -dos I-TREATMENT -arcos I-TREATMENT -costales I-TREATMENT -realizados I-TREATMENT -son I-TREATMENT -tubos I-TREATMENT +no I-TREATMENT +precisó I-TREATMENT +dilataciones I-TREATMENT +por I-TREATMENT +ausencia I-TREATMENT de I-TREATMENT -Gore-tex® I-TREATMENT -rellenos I-TREATMENT +reestenosis I-TREATMENT +en I-TREATMENT +un I-TREATMENT +periodo I-TREATMENT de I-TREATMENT -Craneoplastic® I-TREATMENT -para I-TREATMENT -reconstrucción I-TREATMENT -costal. I-TREATMENT -Finalmente I-TREATMENT -efectuamos I-TREATMENT +7 I-TREATMENT +meses). I-TREATMENT +Además B-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +nacimiento I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +marcada I-PAST_MEDICAL_HISTORY +traqueomalacia I-PAST_MEDICAL_HISTORY +asociada, I-PAST_MEDICAL_HISTORY +lo B-TREATMENT +que I-TREATMENT +condicionaba I-TREATMENT +una I-TREATMENT +intubación I-TREATMENT +nasotraqueal I-TREATMENT +compleja I-TREATMENT +y I-TREATMENT +ciertos I-TREATMENT +problemas I-TREATMENT +en I-TREATMENT la I-TREATMENT -reconstrucción I-TREATMENT -con I-TREATMENT -un I-TREATMENT -colgajo I-TREATMENT +extubación I-TREATMENT +tras I-TREATMENT +cada I-TREATMENT +proceso I-TREATMENT de I-TREATMENT -músculo I-TREATMENT -recto I-TREATMENT -abdominal I-TREATMENT -pediculado, I-TREATMENT -contralateral. I-TREATMENT +dilatación I-TREATMENT +esofágica. I-TREATMENT I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION +Tras I-TREATMENT +un I-TREATMENT +total I-TREATMENT +de I-TREATMENT +14 I-TREATMENT +dilataciones I-TREATMENT +hidroneumáticas I-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +una I-TREATMENT +sesión I-TREATMENT +de I-TREATMENT +MC I-TREATMENT +(con I-TREATMENT +2 I-TREATMENT +años I-TREATMENT +y I-TREATMENT +6 I-TREATMENT +meses I-TREATMENT +de I-TREATMENT +vida). I-TREATMENT +Se B-EVOLUTION +produjo I-EVOLUTION +una I-EVOLUTION +respuesta I-EVOLUTION +muy I-EVOLUTION +favorable I-EVOLUTION +pues I-EVOLUTION +tras I-EVOLUTION +una I-EVOLUTION +sesión, I-EVOLUTION +no I-EVOLUTION +ha I-EVOLUTION +precisado I-EVOLUTION +nuevas I-EVOLUTION +dilataciones I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +últimos I-EVOLUTION +19 I-EVOLUTION +meses I-EVOLUTION +ni I-EVOLUTION +ha I-EVOLUTION +mostrado I-EVOLUTION +ningún I-EVOLUTION +tipo I-EVOLUTION de I-EVOLUTION -alta I-EVOLUTION +clínica I-EVOLUTION +digestiva I-EVOLUTION +ni I-EVOLUTION +respiratoria I-EVOLUTION +en I-EVOLUTION +este I-EVOLUTION +periodo. I-EVOLUTION + I-EVOLUTION +Análisis B-TREATMENT +de I-TREATMENT +la I-TREATMENT +serie I-TREATMENT + I-TREATMENT +En I-TREATMENT +total I-TREATMENT +se I-TREATMENT +han I-TREATMENT +puesto I-TREATMENT +5 I-TREATMENT +prótesis I-TREATMENT +en I-TREATMENT +4 I-TREATMENT +pacientes I-TREATMENT +(en I-TREATMENT +1 I-TREATMENT +caso I-TREATMENT +se I-TREATMENT +han I-TREATMENT +usado I-TREATMENT +2 I-TREATMENT +prótesis). I-TREATMENT +Se B-EVOLUTION +ha I-EVOLUTION +conseguido I-EVOLUTION +el I-EVOLUTION +objetivo I-EVOLUTION de I-EVOLUTION +solucionar I-EVOLUTION la I-EVOLUTION -UCI I-EVOLUTION -a I-EVOLUTION +estenosis I-EVOLUTION +en I-EVOLUTION +2 I-EVOLUTION +casos, I-EVOLUTION +ha I-EVOLUTION +habido I-EVOLUTION +respuesta I-EVOLUTION +parcial I-EVOLUTION +temporal I-EVOLUTION +en I-EVOLUTION +3 I-EVOLUTION +casos I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +un I-EVOLUTION +paciente I-EVOLUTION +un I-EVOLUTION +empeoramiento I-EVOLUTION +clínico I-EVOLUTION +(por I-EVOLUTION +presentar I-EVOLUTION +una I-EVOLUTION +úlcera I-EVOLUTION +esofágica). I-EVOLUTION +Tres I-EVOLUTION +han I-EVOLUTION +sido I-EVOLUTION +customizadas I-EVOLUTION +y I-EVOLUTION +2 I-EVOLUTION +comercializadas I-EVOLUTION +(todas I-EVOLUTION +del I-EVOLUTION +menor I-EVOLUTION +calibre I-EVOLUTION +23/18/23). I-EVOLUTION +Tres I-EVOLUTION +han I-EVOLUTION +sido I-EVOLUTION +no I-EVOLUTION +recubiertas, I-EVOLUTION +una I-EVOLUTION +parcialmente I-EVOLUTION +cubierta I-EVOLUTION +y I-EVOLUTION +otra I-EVOLUTION +completamente I-EVOLUTION +cubierta. I-EVOLUTION +De I-EVOLUTION las I-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION +dos I-EVOLUTION +fístulas I-EVOLUTION +ha I-EVOLUTION +sido I-EVOLUTION +efectiva I-EVOLUTION +la I-EVOLUTION de I-EVOLUTION +prótesis I-EVOLUTION +cubierta I-EVOLUTION +y I-EVOLUTION +falló I-EVOLUTION la I-EVOLUTION -intervención, I-EVOLUTION -sin I-EVOLUTION -incidencias. I-EVOLUTION -Permanece I-EVOLUTION -asintomática I-EVOLUTION +parcialmente I-EVOLUTION +cubierta. I-EVOLUTION + I-EVOLUTION +Al I-EVOLUTION +analizar I-EVOLUTION +las I-EVOLUTION +complicaciones I-EVOLUTION +observadas I-EVOLUTION +con I-EVOLUTION +las I-EVOLUTION +PD I-EVOLUTION +hemos I-EVOLUTION +visto I-EVOLUTION +como I-EVOLUTION +la I-EVOLUTION +más I-EVOLUTION +frecuente I-EVOLUTION +el I-EVOLUTION +dolor I-EVOLUTION +significativo I-EVOLUTION +(necesidad I-EVOLUTION +de I-EVOLUTION +analgesia I-EVOLUTION +mantenida I-EVOLUTION +más I-EVOLUTION +de I-EVOLUTION +5 I-EVOLUTION +días) I-EVOLUTION +en I-EVOLUTION 2 I-EVOLUTION -años I-EVOLUTION -después, I-EVOLUTION -sin I-EVOLUTION -signos I-EVOLUTION +casos I-EVOLUTION +(2/5, I-EVOLUTION +40%), I-EVOLUTION +hiperplasia I-EVOLUTION +grave I-EVOLUTION +(que I-EVOLUTION +ha I-EVOLUTION +requerido I-EVOLUTION +dilatación I-EVOLUTION +específica I-EVOLUTION +en I-EVOLUTION +2 I-EVOLUTION +casos I-EVOLUTION +(2/5, I-EVOLUTION +40%), I-EVOLUTION +hiperplasia I-EVOLUTION +leve I-EVOLUTION +(no I-EVOLUTION +precisa I-EVOLUTION +dilatación) I-EVOLUTION +en I-EVOLUTION +2 I-EVOLUTION +casos I-EVOLUTION +(2/5, I-EVOLUTION +40%), I-EVOLUTION +migración I-EVOLUTION de I-EVOLUTION -recidiva I-EVOLUTION +la I-EVOLUTION +prótesis I-EVOLUTION +en I-EVOLUTION +1 I-EVOLUTION +caso I-EVOLUTION +(1/5, I-EVOLUTION +20%), I-EVOLUTION +aunque I-EVOLUTION +se I-EVOLUTION +pudo I-EVOLUTION +recolocar I-EVOLUTION +y I-EVOLUTION +una I-EVOLUTION +úlcera I-EVOLUTION +penetrante I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +borde I-EVOLUTION +superior I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -64 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -intervenida B-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -nuestro I-PAST_MEDICAL_HISTORY -centro I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -sarcoma I-PAST_MEDICAL_HISTORY -esternal; I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -realizó I-PAST_MEDICAL_HISTORY -esternectomía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -reconstrucción I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -placa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -metacrilato I-PAST_MEDICAL_HISTORY -colocada I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -arcos I-PAST_MEDICAL_HISTORY -costales I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -sutura I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -labrar I-PAST_MEDICAL_HISTORY -orificios I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -bordes. I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -intermitente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -meses. I-PRESENT_ILLNESS -La B-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TAC) I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -de I-EXPLORATION -material I-EXPLORATION -líquido I-EXPLORATION -bajo I-EXPLORATION -la I-EXPLORATION -placa I-EXPLORATION -de I-EXPLORATION -metacrilato, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -empiema. I-EXPLORATION - I-EXPLORATION -Decidimos B-TREATMENT -intervenir I-TREATMENT -y I-TREATMENT -retirar I-TREATMENT -la I-TREATMENT -placa I-TREATMENT -de I-TREATMENT -material I-TREATMENT -aloplástico. I-TREATMENT -Bajo I-TREATMENT -la I-TREATMENT -misma I-TREATMENT -encontramos I-TREATMENT -abundante I-TREATMENT -material I-TREATMENT -purulento, I-TREATMENT -en I-TREATMENT -cuyo I-TREATMENT -cultivo I-TREATMENT -se I-TREATMENT -aisló I-TREATMENT -un I-TREATMENT -microorganismo I-TREATMENT -anaerobio. I-TREATMENT -La I-TREATMENT -reconstrucción I-TREATMENT -se I-TREATMENT -efectuó I-TREATMENT -con I-TREATMENT -colgajo I-TREATMENT -de I-TREATMENT -epiplon I-TREATMENT -basado I-TREATMENT -en I-TREATMENT -los I-TREATMENT -vasos I-TREATMENT -gastroepiploicos I-TREATMENT -derecho I-TREATMENT -e I-TREATMENT -izquierdo I-TREATMENT -cubierto I-TREATMENT -con I-TREATMENT -un I-TREATMENT -injerto I-TREATMENT -de I-TREATMENT -piel I-TREATMENT -mallada. I-TREATMENT -La B-EVOLUTION +prótesis I-EVOLUTION +en I-EVOLUTION +un I-EVOLUTION paciente I-EVOLUTION -evolucionó I-EVOLUTION -sin I-EVOLUTION -incidencias I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION +(1/5, I-EVOLUTION +20%). I-EVOLUTION +Todas I-EVOLUTION +han I-EVOLUTION +podido I-EVOLUTION +ser I-EVOLUTION +resueltas I-EVOLUTION de I-EVOLUTION -alta I-EVOLUTION +forma I-EVOLUTION +conservadora. I-EVOLUTION + I-EVOLUTION +Con I-EVOLUTION +respecto I-EVOLUTION a I-EVOLUTION -los I-EVOLUTION +la I-EVOLUTION +MC I-EVOLUTION +se I-EVOLUTION +han I-EVOLUTION +hecho I-EVOLUTION +5 I-EVOLUTION +terapias I-EVOLUTION +en I-EVOLUTION 6 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION +enfermos, I-EVOLUTION +con I-EVOLUTION +2 I-EVOLUTION +en I-EVOLUTION +4 I-EVOLUTION +enfermos I-EVOLUTION +y I-EVOLUTION +1 I-EVOLUTION +sesión I-EVOLUTION +en I-EVOLUTION +uno. I-EVOLUTION +Se I-EVOLUTION +ha I-EVOLUTION +solucionado I-EVOLUTION la I-EVOLUTION -intervención. I-EVOLUTION -No I-EVOLUTION -hubo I-EVOLUTION -recidiva I-EVOLUTION -tumoral I-EVOLUTION -local I-EVOLUTION +estenosis I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +definitiva I-EVOLUTION +en I-EVOLUTION +3 I-EVOLUTION +casos I-EVOLUTION +(60%) I-EVOLUTION y I-EVOLUTION +en I-EVOLUTION +otros I-EVOLUTION +dos I-EVOLUTION +no I-EVOLUTION +ha I-EVOLUTION +sido I-EVOLUTION +efectiva I-EVOLUTION +(40%). I-EVOLUTION + I-EVOLUTION +No I-EVOLUTION +hemos I-EVOLUTION +detectado I-EVOLUTION +efectos I-EVOLUTION +secundarios I-EVOLUTION +al I-EVOLUTION +uso I-EVOLUTION +de I-EVOLUTION +MC. I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +tiempo I-EVOLUTION +medio I-EVOLUTION +dedicado I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +técnica I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +MC I-EVOLUTION +ha I-EVOLUTION +sido I-EVOLUTION +de I-EVOLUTION +28, I-EVOLUTION +7 I-EVOLUTION +minutos I-EVOLUTION +(16-75). I-EVOLUTION + I-EVOLUTION +En I-EVOLUTION +cuanto I-EVOLUTION +al I-EVOLUTION +cómputo I-EVOLUTION +total I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +serie I-EVOLUTION +manejando I-EVOLUTION +ambas I-EVOLUTION +técnicas, I-EVOLUTION +podemos I-EVOLUTION +decir I-EVOLUTION +que I-EVOLUTION +hemos I-EVOLUTION +solucionado I-EVOLUTION las I-EVOLUTION -biopsias I-EVOLUTION +estenosis I-EVOLUTION +en I-EVOLUTION +5 I-EVOLUTION de I-EVOLUTION -los I-EVOLUTION -bordes I-EVOLUTION -fueron I-EVOLUTION -negativas. I-EVOLUTION -Las I-EVOLUTION -revisiones I-EVOLUTION -son I-EVOLUTION -satisfactorias I-EVOLUTION -desde I-EVOLUTION -entonces, I-EVOLUTION -cumpliendo I-EVOLUTION -18 I-EVOLUTION -meses I-EVOLUTION +6 I-EVOLUTION +casos I-EVOLUTION de I-EVOLUTION -evolución I-EVOLUTION +EER I-EVOLUTION +(83,3%) I-EVOLUTION +y I-EVOLUTION en I-EVOLUTION -el I-EVOLUTION -momento I-EVOLUTION +1 I-EVOLUTION de I-EVOLUTION -redactar I-EVOLUTION -este I-EVOLUTION -trabajo. I-EVOLUTION +2 I-EVOLUTION +fístulas I-EVOLUTION +(50%); I-EVOLUTION +la I-EVOLUTION +fístula I-EVOLUTION +que I-EVOLUTION +fracasó I-EVOLUTION +tuvo I-EVOLUTION +que I-EVOLUTION +reintervenirse. I-EVOLUTION +De I-EVOLUTION +los I-EVOLUTION +dos I-EVOLUTION +fracasos I-EVOLUTION +uno I-EVOLUTION +presenta I-EVOLUTION +un I-EVOLUTION +cierre I-EVOLUTION +completo I-EVOLUTION +esofágico I-EVOLUTION +que I-EVOLUTION +ha I-EVOLUTION +obligado I-EVOLUTION +a I-EVOLUTION +replantear I-EVOLUTION +cirugía I-EVOLUTION +reparadora I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +otro I-EVOLUTION +persiste I-EVOLUTION +con I-EVOLUTION +dieta I-EVOLUTION +oral I-EVOLUTION +mediante I-EVOLUTION +dilataciones I-EVOLUTION +quincenales. I-EVOLUTION I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -basocelular I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ceja I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -defecto I-PRESENT_ILLNESS +El I-EVOLUTION +seguimiento I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +casos I-EVOLUTION +tras I-EVOLUTION +la I-EVOLUTION +prótesis I-EVOLUTION +o I-EVOLUTION +mitomicina I-EVOLUTION +final I-EVOLUTION +(último I-EVOLUTION +caso I-EVOLUTION +incluido) I-EVOLUTION +osciló I-EVOLUTION +entre I-EVOLUTION +los I-EVOLUTION +8 I-EVOLUTION +meses I-EVOLUTION +y I-EVOLUTION +2 I-EVOLUTION +años. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -7x5 I-PRESENT_ILLNESS -cm. I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -resección I-PRESENT_ILLNESS -tumoral. I-PRESENT_ILLNESS -Realizamos B-TREATMENT -un I-TREATMENT -colgajo I-TREATMENT +78 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +62 B-TREATMENT +kg, I-TREATMENT en I-TREATMENT -isla I-TREATMENT -de I-TREATMENT -arteria I-TREATMENT -temporal I-TREATMENT -para I-TREATMENT -reconstrucción I-TREATMENT -completa I-TREATMENT -de I-TREATMENT -la I-TREATMENT -ceja I-TREATMENT -con I-TREATMENT -piel I-TREATMENT -con I-TREATMENT -pelo. I-TREATMENT -Posteriormente I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -depilación I-TREATMENT -con I-TREATMENT -láser I-TREATMENT -para I-TREATMENT -lograr I-TREATMENT -simetría I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT +Durogesic® I-TREATMENT +100 I-TREATMENT +μg/h. I-TREATMENT +Se I-TREATMENT +cambia I-TREATMENT la I-TREATMENT -ceja I-TREATMENT -contralateral. I-TREATMENT - I-TREATMENT +prescripción I-TREATMENT +a I-TREATMENT +fentanilo I-TREATMENT +genérico I-TREATMENT +100 I-TREATMENT +μg. I-TREATMENT +Pérdida B-EVOLUTION +de I-EVOLUTION +eficacia I-EVOLUTION +analgésica. I-EVOLUTION +Se B-TREATMENT +restaura I-TREATMENT +Durogesic® I-TREATMENT +100 I-TREATMENT +μg/h. I-TREATMENT +Mejoría B-EVOLUTION +clínica. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -fractura I-PRESENT_ILLNESS -abierta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tibia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -peroné I-PRESENT_ILLNESS -tratada I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -placa I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fijador I-PRESENT_ILLNESS -externo, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sustancia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -exposición I-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -material I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -osteosíntesis. I-PRESENT_ILLNESS -Se B-TREATMENT -practica I-TREATMENT -desbridamiento I-TREATMENT -y I-TREATMENT -limpieza I-TREATMENT +35 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +hábitos I-PAST_MEDICAL_HISTORY +tóxicos I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +familiares I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +CEP I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2010. I-PAST_MEDICAL_HISTORY +Tras B-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +se I-EXPLORATION +estudió I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +asociación I-EXPLORATION +con I-EXPLORATION +CU I-EXPLORATION +mediante I-EXPLORATION +endoscopia I-EXPLORATION +digestiva I-EXPLORATION +baja I-EXPLORATION +completa I-EXPLORATION +sin I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +objetivaran I-EXPLORATION +alteraciones I-EXPLORATION +macroscópicas I-EXPLORATION +ni I-EXPLORATION +histológicas. I-EXPLORATION +En B-TREATMENT +2013 I-TREATMENT +fue I-TREATMENT +sometida I-TREATMENT +a I-TREATMENT +trasplante I-TREATMENT +hepático I-TREATMENT +cadavérico I-TREATMENT +por I-TREATMENT +insuficiencia I-TREATMENT +hepatocelular I-TREATMENT y I-TREATMENT -se I-TREATMENT -coloca I-TREATMENT -sistema I-TREATMENT -Renasys® I-TREATMENT -a-125 I-TREATMENT -mm I-TREATMENT -Hg. I-TREATMENT -Tras B-EVOLUTION -12 I-EVOLUTION -días I-EVOLUTION +colangitis I-TREATMENT +de I-TREATMENT +repetición. I-TREATMENT +No B-EVOLUTION +presentó I-EVOLUTION +complicaciones I-EVOLUTION +inmediatas I-EVOLUTION +postrasplante, I-EVOLUTION +con I-EVOLUTION +buena I-EVOLUTION +función I-EVOLUTION +del I-EVOLUTION +injerto I-EVOLUTION +y I-EVOLUTION +régimen I-EVOLUTION de I-EVOLUTION -su I-EVOLUTION -aplicación, I-EVOLUTION -se I-EVOLUTION -consigue I-EVOLUTION -un I-EVOLUTION -lecho I-EVOLUTION -limpio I-EVOLUTION +inmunosupresión I-EVOLUTION +basado I-EVOLUTION +en I-EVOLUTION +tacrolimus I-EVOLUTION +de I-EVOLUTION +liberación I-EVOLUTION +prolongada. I-EVOLUTION +Nueve I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +trasplante, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +debutó I-EVOLUTION con I-EVOLUTION -tejido I-EVOLUTION +cuadro I-EVOLUTION de I-EVOLUTION -granulación I-EVOLUTION -sano. I-EVOLUTION -Finalmente B-TREATMENT +diarrea I-EVOLUTION +sanguinolenta, I-EVOLUTION +con I-EVOLUTION +diagnóstico I-EVOLUTION +de I-EVOLUTION +CU I-EVOLUTION +de I-EVOLUTION +localización I-EVOLUTION +extensa I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +actividad I-EVOLUTION +clínica I-EVOLUTION +y I-EVOLUTION +endoscópica I-EVOLUTION +moderada. I-EVOLUTION +Desde I-EVOLUTION +los I-EVOLUTION +primeros I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +diagnóstico I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +CU, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +cumplió I-EVOLUTION +criterios I-EVOLUTION +de I-EVOLUTION +corticodependencia. I-EVOLUTION +Ante B-TREATMENT +la I-TREATMENT +presencia I-TREATMENT +de I-TREATMENT +discreta I-TREATMENT +leucopenia, I-TREATMENT +no I-TREATMENT se I-TREATMENT -realiza I-TREATMENT -cobertura I-TREATMENT +optó I-TREATMENT +por I-TREATMENT +azatioprina I-TREATMENT +y I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +tratamiento I-TREATMENT +biológico I-TREATMENT +anti-TNFα I-TREATMENT con I-TREATMENT -colgajo I-TREATMENT -anterolateral I-TREATMENT +golimumab I-TREATMENT +subcutáneo I-TREATMENT +(dosis I-TREATMENT de I-TREATMENT -muslo. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -80 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -afecto B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -leucemia I-PAST_MEDICAL_HISTORY -linfática I-PAST_MEDICAL_HISTORY -crónica, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -epidermoide I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuero I-PRESENT_ILLNESS -cabelludo. I-PRESENT_ILLNESS -El B-TREATMENT -tumor I-TREATMENT -infiltra I-TREATMENT -localmente I-TREATMENT -sin I-TREATMENT -llegar I-TREATMENT -a I-TREATMENT -afectar I-TREATMENT +inducción I-TREATMENT +habitual I-TREATMENT +200 I-TREATMENT +mg I-TREATMENT +sc I-TREATMENT +inicialmente, I-TREATMENT +100 I-TREATMENT +mg I-TREATMENT a I-TREATMENT -la I-TREATMENT -duramadre. I-TREATMENT -Se I-TREATMENT -realiza I-TREATMENT -exéresis I-TREATMENT +las I-TREATMENT +dos I-TREATMENT +semanas) I-TREATMENT +y I-TREATMENT +50 I-TREATMENT +mg I-TREATMENT +mensualmente I-TREATMENT +de I-TREATMENT +mantenimiento I-TREATMENT +(peso I-TREATMENT de I-TREATMENT la I-TREATMENT -lesión I-TREATMENT -y I-TREATMENT -colgajo I-TREATMENT +paciente I-TREATMENT +61 I-TREATMENT +kg). I-TREATMENT +La I-TREATMENT +respuesta I-TREATMENT +a I-TREATMENT +golimumab I-TREATMENT +fue I-TREATMENT +solo I-TREATMENT +parcial, I-TREATMENT +precisando I-TREATMENT de I-TREATMENT -periostio I-TREATMENT -que I-TREATMENT -se I-TREATMENT -complica I-TREATMENT -con I-TREATMENT -necrosis. I-TREATMENT -Se I-TREATMENT -decide I-TREATMENT -entonces I-TREATMENT -colocar I-TREATMENT -sistema I-TREATMENT +intensificación I-TREATMENT +a I-TREATMENT +100 I-TREATMENT +mg I-TREATMENT +mensuales I-TREATMENT +desde I-TREATMENT +el I-TREATMENT +segundo I-TREATMENT +mes I-TREATMENT de I-TREATMENT -terapia I-TREATMENT -Renasys® I-TREATMENT +tratamiento I-TREATMENT +y I-TREATMENT +no I-TREATMENT +consiguiendo I-TREATMENT +suspender I-TREATMENT +los I-TREATMENT +esteroides I-TREATMENT +orales, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT a I-TREATMENT --50 I-TREATMENT -mm I-TREATMENT -Hg. I-TREATMENT -Tras I-TREATMENT -3 I-TREATMENT -semanas I-TREATMENT +los I-TREATMENT +cuatro I-TREATMENT +meses I-TREATMENT de I-TREATMENT tratamiento I-TREATMENT +con I-TREATMENT +golimumab I-TREATMENT se I-TREATMENT -observa I-TREATMENT -reducción I-TREATMENT +cambia I-TREATMENT +a I-TREATMENT +un I-TREATMENT +agente I-TREATMENT +anti-TNF I-TREATMENT +intravenoso: I-TREATMENT +infliximab I-TREATMENT +(IFX). I-TREATMENT +Tras B-EVOLUTION +iniciar I-EVOLUTION +IFX I-EVOLUTION +a I-EVOLUTION +dosis I-EVOLUTION +de I-EVOLUTION +inducción I-EVOLUTION +convencionales I-EVOLUTION +(5 I-EVOLUTION +mg/kg I-EVOLUTION +intravenoso I-EVOLUTION +[iv], I-EVOLUTION +semanas I-EVOLUTION +0, I-EVOLUTION +2 I-EVOLUTION +y I-EVOLUTION +6), I-EVOLUTION +no I-EVOLUTION +se I-EVOLUTION +alcanzó I-EVOLUTION +respuesta I-EVOLUTION +clínica I-EVOLUTION +ni I-EVOLUTION +suspensión I-EVOLUTION +de I-EVOLUTION +esteroides I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +seis I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +tratamiento, I-EVOLUTION +pese I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +intensificación I-EVOLUTION +precoz I-EVOLUTION +(5 I-EVOLUTION +mg/kg I-EVOLUTION +iv I-EVOLUTION +cada I-EVOLUTION +cuatro I-EVOLUTION +semanas) I-EVOLUTION +a I-EVOLUTION +partir I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +quinta I-EVOLUTION +infusión. I-EVOLUTION +La B-EXPLORATION +monitorización I-EXPLORATION +de I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +IFX I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +demostró I-EXPLORATION +que I-EXPLORATION +estaban I-EXPLORATION +en I-EXPLORATION +rango I-EXPLORATION +terapéutico. I-EXPLORATION +Ello, I-EXPLORATION +junto I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +anticuerpos I-EXPLORATION +anti-infliximab I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +infección I-EXPLORATION +entérica I-EXPLORATION +concomitante I-EXPLORATION +o I-EXPLORATION +sobreinfección I-EXPLORATION +por I-EXPLORATION +citomegalovirus I-EXPLORATION +(CMV), I-EXPLORATION +hizo I-EXPLORATION +cambiar I-EXPLORATION +de I-EXPLORATION +diana I-EXPLORATION +terapéutica. I-EXPLORATION +En B-TREATMENT +diciembre I-TREATMENT +de I-TREATMENT +2016 I-TREATMENT +(35 I-TREATMENT +meses I-TREATMENT +después I-TREATMENT del I-TREATMENT -diámetro I-TREATMENT +trasplante), I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +iniciar I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +vedolizumab I-TREATMENT +(VDZ), I-TREATMENT +según I-TREATMENT +pauta I-TREATMENT de I-TREATMENT -la I-TREATMENT -herida I-TREATMENT +inducción I-TREATMENT +habitual I-TREATMENT +(300 I-TREATMENT +mg I-TREATMENT +iv I-TREATMENT +en I-TREATMENT +semanas I-TREATMENT +0, I-TREATMENT +2 I-TREATMENT y I-TREATMENT -granulación I-TREATMENT -sobre I-TREATMENT +6), I-TREATMENT +y I-TREATMENT +mantenimiento I-TREATMENT +con I-TREATMENT +300 I-TREATMENT +mg I-TREATMENT +VDZ I-TREATMENT +iv I-TREATMENT +cada I-TREATMENT +ocho I-TREATMENT +semanas. I-TREATMENT +Justo I-TREATMENT +antes I-TREATMENT +del I-TREATMENT +inicio I-TREATMENT +de I-TREATMENT +VDZ, I-TREATMENT la I-TREATMENT -duramadre. I-TREATMENT -Posteriormente, I-TREATMENT +paciente I-TREATMENT +presentaba I-TREATMENT +un I-TREATMENT +índice I-TREATMENT +de I-TREATMENT +Mayo I-TREATMENT +total I-TREATMENT +de I-TREATMENT +7. I-TREATMENT +Tras B-EVOLUTION +la I-EVOLUTION +segunda I-EVOLUTION +infusión I-EVOLUTION +se I-EVOLUTION +asistió I-EVOLUTION +a I-EVOLUTION +un I-EVOLUTION +respuesta I-EVOLUTION +clínica I-EVOLUTION +con I-EVOLUTION +normalización I-EVOLUTION +del I-EVOLUTION +hábito I-EVOLUTION +deposicional I-EVOLUTION +pero I-EVOLUTION +manteniendo I-EVOLUTION +parámetros I-EVOLUTION +de I-EVOLUTION +actividad I-EVOLUTION +biológica I-EVOLUTION +elevados I-EVOLUTION +(calprotectina I-EVOLUTION +fecal I-EVOLUTION +805 I-EVOLUTION +mcg/g I-EVOLUTION +y I-EVOLUTION +proteína I-EVOLUTION +C I-EVOLUTION +reactiva I-EVOLUTION +[PCR] I-EVOLUTION +8 I-EVOLUTION +mg/l). I-EVOLUTION +A B-TREATMENT +los I-TREATMENT +tres I-TREATMENT +meses I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT se I-TREATMENT -realiza I-TREATMENT -cierre I-TREATMENT +logró I-TREATMENT +suspender I-TREATMENT +los I-TREATMENT +esteroides, I-TREATMENT +y I-TREATMENT +un I-TREATMENT +mes I-TREATMENT +después I-TREATMENT de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT +su I-TREATMENT +retirada I-TREATMENT +fue I-TREATMENT +precisa I-TREATMENT +una I-TREATMENT +intensificación I-TREATMENT +del I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -triple I-TREATMENT -colgajo I-TREATMENT +VDZ, I-TREATMENT +acortando I-TREATMENT +el I-TREATMENT +intervalo I-TREATMENT de I-TREATMENT -Guillis. I-TREATMENT - I-TREATMENT +infusiones I-TREATMENT +a I-TREATMENT +cuatro I-TREATMENT +semanas. I-TREATMENT +Al B-EVOLUTION +año I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION +su I-EVOLUTION +puntuación I-EVOLUTION +de I-EVOLUTION +Mayo I-EVOLUTION +total I-EVOLUTION +fue I-EVOLUTION +de I-EVOLUTION +4 I-EVOLUTION +(subpuntuación I-EVOLUTION +endoscópica I-EVOLUTION +1), I-EVOLUTION +la I-EVOLUTION +calprotectina I-EVOLUTION +descendió I-EVOLUTION +a I-EVOLUTION +270 I-EVOLUTION +mcg/g I-EVOLUTION +y I-EVOLUTION +los I-EVOLUTION +niveles I-EVOLUTION +de I-EVOLUTION +PCR I-EVOLUTION +se I-EVOLUTION +normalizaron. I-EVOLUTION +Los I-EVOLUTION +niveles I-EVOLUTION +de I-EVOLUTION +tacrolimus I-EVOLUTION +permanecieron I-EVOLUTION +estables, I-EVOLUTION +dentro I-EVOLUTION +del I-EVOLUTION +rango I-EVOLUTION +pretendido I-EVOLUTION +(5-10 I-EVOLUTION +ng/ml) I-EVOLUTION +y B-TREATMENT +sin I-TREATMENT +requerir I-TREATMENT +ajustes I-TREATMENT +de I-TREATMENT +dosis. I-TREATMENT +La B-EVOLUTION +bioquímica I-EVOLUTION +hepática I-EVOLUTION +se I-EVOLUTION +ha I-EVOLUTION +mantenido I-EVOLUTION +estable I-EVOLUTION +durante I-EVOLUTION +todo I-EVOLUTION +este I-EVOLUTION +periodo. I-EVOLUTION +No I-EVOLUTION +se I-EVOLUTION +han I-EVOLUTION +registrado I-EVOLUTION +hasta I-EVOLUTION +la I-EVOLUTION +fecha I-EVOLUTION +efectos I-EVOLUTION +adversos I-EVOLUTION +infecciosos I-EVOLUTION +ni I-EVOLUTION +interacciones I-EVOLUTION +farmacológicas. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS +32 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +japonesa, B-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +médico-quirúrgicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +fumadora I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +bebedora, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS acude I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Cirugía I-PRESENT_ILLNESS -Plástica I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Octubre I-PRESENT_ILLNESS -(Madrid, I-PRESENT_ILLNESS -España) I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -sufrido I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -penectomía I-PRESENT_ILLNESS -subtotal I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -epidermoide I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -precisó I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -oncológico I-PRESENT_ILLNESS -coadyuvante I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -solicita I-PRESENT_ILLNESS -reconstrucción I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +tumoración I-PRESENT_ILLNESS +maxilar I-PRESENT_ILLNESS +indolora I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -pene. I-PRESENT_ILLNESS -Tras B-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION +varios I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +A B-EXPLORATION la I-EXPLORATION -historia I-EXPLORATION -clínica, I-EXPLORATION exploración I-EXPLORATION -y I-EXPLORATION -documentación I-EXPLORATION -fotográfica I-EXPLORATION -pertinentes I-EXPLORATION -para I-EXPLORATION -su I-EXPLORATION -estudio, I-EXPLORATION se I-EXPLORATION -decide I-EXPLORATION -demorar I-EXPLORATION -la I-EXPLORATION -cirugía I-EXPLORATION -hasta I-EXPLORATION -transcurridos I-EXPLORATION -al I-EXPLORATION -menos I-EXPLORATION -6 I-EXPLORATION -meses I-EXPLORATION -desde I-EXPLORATION +aprecia I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION +de I-EXPLORATION +unos I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +que I-EXPLORATION +hace I-EXPLORATION +prominencia I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -extirpación I-EXPLORATION -tumoral I-EXPLORATION -para I-EXPLORATION -confirmar I-EXPLORATION +zona I-EXPLORATION +vestibular I-EXPLORATION +premolar I-EXPLORATION +izquierda I-EXPLORATION +del I-EXPLORATION +maxilar I-EXPLORATION +superior, I-EXPLORATION +manteniéndose I-EXPLORATION la I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -recurrencia I-EXPLORATION +integridad I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -enfermedad I-EXPLORATION -local. I-EXPLORATION -Se I-EXPLORATION -confirma I-EXPLORATION +mucosa. I-EXPLORATION +No I-EXPLORATION +presenta I-EXPLORATION +alteraciones I-EXPLORATION +sensitivas I-EXPLORATION +asociadas I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION +exploración I-EXPLORATION +cervical I-EXPLORATION +es I-EXPLORATION +negativa. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION +panorámica I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +mixta I-EXPLORATION +radioopaca-radiolúcida I-EXPLORATION +con I-EXPLORATION +aspecto I-EXPLORATION de I-EXPLORATION -arcos I-EXPLORATION -vasculares I-EXPLORATION -palmares I-EXPLORATION -superficial I-EXPLORATION +"panal I-EXPLORATION +de I-EXPLORATION +abejas" I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +expande I-EXPLORATION +entre I-EXPLORATION +el I-EXPLORATION +canino I-EXPLORATION y I-EXPLORATION -profundo I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -del I-EXPLORATION -test I-EXPLORATION +el I-EXPLORATION +primer I-EXPLORATION +bicúspide I-EXPLORATION +superior I-EXPLORATION +izquierdo I-EXPLORATION +y I-EXPLORATION +que I-EXPLORATION +origina I-EXPLORATION +una I-EXPLORATION +gran I-EXPLORATION +separación I-EXPLORATION +entre I-EXPLORATION +las I-EXPLORATION +raíces I-EXPLORATION de I-EXPLORATION -Allen I-EXPLORATION +esas I-EXPLORATION +piezas I-EXPLORATION +dentarias, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +un I-EXPLORATION +ligero I-EXPLORATION +desplazamiento I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +límites I-EXPLORATION +del I-EXPLORATION +seno I-EXPLORATION +maxilar I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION +escotadura I-EXPLORATION +piriforme. I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +(TAC) I-EXPLORATION +delimita I-EXPLORATION con I-EXPLORATION -sonda I-EXPLORATION -doppler I-EXPLORATION +mayor I-EXPLORATION +precisión I-EXPLORATION +los I-EXPLORATION +bordes I-EXPLORATION de I-EXPLORATION -8Mhz, I-EXPLORATION +esta I-EXPLORATION +tumoración, I-EXPLORATION que I-EXPLORATION -permiten I-EXPLORATION +se I-EXPLORATION +extiende I-EXPLORATION +por I-EXPLORATION la I-EXPLORATION -elección I-EXPLORATION -de I-EXPLORATION +región I-EXPLORATION +palatina I-EXPLORATION +sin I-EXPLORATION +llegar I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +línea I-EXPLORATION +media; I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +zona I-EXPLORATION +central I-EXPLORATION +presenta I-EXPLORATION +una I-EXPLORATION +clara I-EXPLORATION +imagen I-EXPLORATION +radiolúcida I-EXPLORATION +rodeada I-EXPLORATION +por I-EXPLORATION un I-EXPLORATION -colgajo I-EXPLORATION -libre I-EXPLORATION -radial I-EXPLORATION -para I-EXPLORATION +punteado I-EXPLORATION +de I-EXPLORATION +imágenes I-EXPLORATION +alternantes I-EXPLORATION +radiolúcidas I-EXPLORATION +y I-EXPLORATION +radioopacas I-EXPLORATION +que I-EXPLORATION +configuran I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -reconstrucción I-EXPLORATION -peneana, I-EXPLORATION +masa I-EXPLORATION +tumoral. I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +diagnósticos I-EXPLORATION +diferenciales I-EXPLORATION +barajados, I-EXPLORATION +en I-EXPLORATION +espera I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +confirmación I-EXPLORATION +histológica, I-EXPLORATION +fueron: I-EXPLORATION +lesión I-EXPLORATION +fibroósea I-EXPLORATION +benigna, I-EXPLORATION +sarcoma I-EXPLORATION +osteogénico, I-EXPLORATION +tumor I-EXPLORATION +epitelial I-EXPLORATION +calcificante, I-EXPLORATION +etc. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +primera I-EXPLORATION +biopsia I-EXPLORATION +realizada I-EXPLORATION +fue I-EXPLORATION +informada I-EXPLORATION +como I-EXPLORATION +ameloblastoma, I-EXPLORATION +pero I-EXPLORATION +la I-EXPLORATION +falta I-EXPLORATION +de I-EXPLORATION +concordancia I-EXPLORATION +clínico-radiológica I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +ameloblastoma I-EXPLORATION +común I-EXPLORATION +apoyó I-EXPLORATION +la I-EXPLORATION +indicación I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +segunda I-EXPLORATION +biopsia. I-EXPLORATION +En I-EXPLORATION +esta I-EXPLORATION +se I-EXPLORATION +podían I-EXPLORATION +observar I-EXPLORATION +con I-EXPLORATION +mayor I-EXPLORATION +claridad I-EXPLORATION +escasos I-EXPLORATION +nidos I-EXPLORATION +y I-EXPLORATION +cordones I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +basaloides, I-EXPLORATION sin I-EXPLORATION -compromiso I-EXPLORATION -vascular I-EXPLORATION +atipia, I-EXPLORATION +dispuestas I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +estroma I-EXPLORATION +fibroso I-EXPLORATION +densamente I-EXPLORATION +colagenizado, I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +consideró I-EXPLORATION +característico I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +variante I-EXPLORATION +desmoplásica I-EXPLORATION del I-EXPLORATION -miembro I-EXPLORATION -superior I-EXPLORATION -derecho. I-EXPLORATION -El B-TREATMENT -día I-TREATMENT -previo I-TREATMENT -a I-TREATMENT -la I-TREATMENT -intervención, I-TREATMENT +ameloblastoma. I-EXPLORATION + I-EXPLORATION +Bajo B-TREATMENT +anestesia I-TREATMENT +general I-TREATMENT se I-TREATMENT realiza I-TREATMENT -una I-TREATMENT -cistostomía I-TREATMENT -suprapúbica. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -21 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tumoración I-PAST_MEDICAL_HISTORY -(osteosarcoma) I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -rodilla I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad. I-PAST_MEDICAL_HISTORY -Tras B-TREATMENT -recibir I-TREATMENT -múltiples I-TREATMENT -tratamientos I-TREATMENT -de I-TREATMENT -elongación I-TREATMENT -ósea, I-TREATMENT -fue I-TREATMENT -necesario I-TREATMENT -colocar I-TREATMENT -una I-TREATMENT -prótesis I-TREATMENT -total I-TREATMENT -de I-TREATMENT -rodilla. I-TREATMENT -Debido I-TREATMENT -a I-TREATMENT la I-TREATMENT -existencia I-TREATMENT +disección I-TREATMENT de I-TREATMENT -múltiples I-TREATMENT -cicatrices, I-TREATMENT -la I-TREATMENT -piel I-TREATMENT -se I-TREATMENT -necrosó I-TREATMENT +un I-TREATMENT +colgajo I-TREATMENT +mucoso I-TREATMENT +palatino I-TREATMENT y I-TREATMENT +vestibular I-TREATMENT +en I-TREATMENT la I-TREATMENT -prótesis I-TREATMENT -resultó I-TREATMENT -expuesta, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -necesario I-TREATMENT -cubrirla I-TREATMENT -con I-TREATMENT -2 I-TREATMENT -colgajos I-TREATMENT +zona I-TREATMENT +peritumoral, I-TREATMENT +así I-TREATMENT +como I-TREATMENT +la I-TREATMENT +separación I-TREATMENT de I-TREATMENT -gemelos I-TREATMENT -según I-TREATMENT la I-TREATMENT -técnica I-TREATMENT +mucosa I-TREATMENT +nasal I-TREATMENT +y I-TREATMENT +del I-TREATMENT +seno I-TREATMENT +maxilar, I-TREATMENT que I-TREATMENT -hemos I-TREATMENT -descrito. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -27 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -queja I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -aspecto I-PRESENT_ILLNESS -inestético I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -labio I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -comenzó I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -notar I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS -Refiere I-PRESENT_ILLNESS -gran I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -social, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pareja. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La B-FAMILY_HISTORY -historia I-FAMILY_HISTORY -clínica I-FAMILY_HISTORY -familiar I-FAMILY_HISTORY -no I-FAMILY_HISTORY -reveló I-FAMILY_HISTORY -la I-FAMILY_HISTORY -existencia I-FAMILY_HISTORY -de I-FAMILY_HISTORY -casos I-FAMILY_HISTORY -semejantes. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Presentaba B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -pronunciado I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -labio I-PRESENT_ILLNESS -superior, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -mucho I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -evidente I-PRESENT_ILLNESS -cuando I-PRESENT_ILLNESS -sonreía, I-PRESENT_ILLNESS -junto I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -presencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -retracción I-PRESENT_ILLNESS -central. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El B-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT +en I-TREATMENT +ningún I-TREATMENT +momento I-TREATMENT se I-TREATMENT -realizó I-TREATMENT -bajo I-TREATMENT -bloqueo I-TREATMENT -anestésico I-TREATMENT -de I-TREATMENT -ambos I-TREATMENT -nervios I-TREATMENT -infraorbitarios. I-TREATMENT -Marcamos I-TREATMENT +encontraban I-TREATMENT +adheridas I-TREATMENT +al I-TREATMENT +tumor. I-TREATMENT +Expuesta I-TREATMENT la I-TREATMENT zona I-TREATMENT -quirúrgica I-TREATMENT -con I-TREATMENT -azul I-TREATMENT -de I-TREATMENT -metileno I-TREATMENT +a I-TREATMENT +resecar, I-TREATMENT +y I-TREATMENT +siguiendo I-TREATMENT +los I-TREATMENT +límites I-TREATMENT +macroscópicos I-TREATMENT +del I-TREATMENT +tumor, I-TREATMENT +se I-TREATMENT +practica I-TREATMENT +una I-TREATMENT +maxilectomía I-TREATMENT en I-TREATMENT -forma I-TREATMENT +bloque I-TREATMENT +que I-TREATMENT +abarca I-TREATMENT +desde I-TREATMENT +distal I-TREATMENT +del I-TREATMENT +incisivo I-TREATMENT +lateral, I-TREATMENT +hasta I-TREATMENT +mesial I-TREATMENT +del I-TREATMENT +segundo I-TREATMENT +molar, I-TREATMENT +incluyendo I-TREATMENT +en I-TREATMENT +la I-TREATMENT +pieza I-TREATMENT +la I-TREATMENT +pared I-TREATMENT +lateral I-TREATMENT de I-TREATMENT -dos I-TREATMENT -elipses I-TREATMENT -tranversas I-TREATMENT -con I-TREATMENT -una I-TREATMENT -"z" I-TREATMENT -central. I-TREATMENT -Resecamos I-TREATMENT +la I-TREATMENT +fosa I-TREATMENT +nasal I-TREATMENT +izquierda, I-TREATMENT el I-TREATMENT -exceso I-TREATMENT -de I-TREATMENT -tejido I-TREATMENT -mucoso I-TREATMENT -y I-TREATMENT -submucoso I-TREATMENT -labial I-TREATMENT -con I-TREATMENT -excisiones I-TREATMENT -elípticas I-TREATMENT +suelo I-TREATMENT +del I-TREATMENT +seno I-TREATMENT +maxilar I-TREATMENT +izquierdo I-TREATMENT y I-TREATMENT la I-TREATMENT -brida I-TREATMENT -central I-TREATMENT +porción I-TREATMENT +palatina I-TREATMENT +afectada. I-TREATMENT +Una I-TREATMENT +vez I-TREATMENT +retirado I-TREATMENT +el I-TREATMENT +bloque I-TREATMENT +tumoral I-TREATMENT se I-TREATMENT -corrigió I-TREATMENT -con I-TREATMENT -una I-TREATMENT -z-plastia I-TREATMENT +amplían I-TREATMENT +los I-TREATMENT +límites I-TREATMENT de I-TREATMENT -acuerdo I-TREATMENT -con I-TREATMENT -el I-TREATMENT -marcaje I-TREATMENT -realizado. I-TREATMENT -La I-TREATMENT -cirugía I-TREATMENT -finalizó I-TREATMENT -con I-TREATMENT +seguridad I-TREATMENT +de I-TREATMENT +la I-TREATMENT +resección I-TREATMENT +sobre I-TREATMENT +hueso I-TREATMENT +clínicamente I-TREATMENT +sano. I-TREATMENT +En I-TREATMENT el I-TREATMENT -cierre I-TREATMENT +mismo I-TREATMENT +acto I-TREATMENT +operatorio I-TREATMENT +se I-TREATMENT +procede I-TREATMENT +a I-TREATMENT +la I-TREATMENT +reconstrucción I-TREATMENT +del I-TREATMENT +defecto I-TREATMENT +resultante I-TREATMENT mediante I-TREATMENT -suturas I-TREATMENT -simples I-TREATMENT +interposición I-TREATMENT +de I-TREATMENT +un I-TREATMENT +bloque I-TREATMENT +de I-TREATMENT +autoinjerto I-TREATMENT +córtico-esponjoso I-TREATMENT +libre I-TREATMENT +de I-TREATMENT +cadera, I-TREATMENT +fijándolo I-TREATMENT con I-TREATMENT -hilo I-TREATMENT -sintético I-TREATMENT -reabsorbible I-TREATMENT +miniplacas I-TREATMENT de I-TREATMENT -poliglactin I-TREATMENT -6-0. I-TREATMENT +osteosíntesis I-TREATMENT +al I-TREATMENT +hueso I-TREATMENT +maxilar. I-TREATMENT I-TREATMENT -La B-EVOLUTION -herida I-EVOLUTION -quirúrgica I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -edema I-EVOLUTION -local I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -resolvió I-EVOLUTION -al I-EVOLUTION -final I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -segunda I-EVOLUTION -semana I-EVOLUTION -de I-EVOLUTION -postoperatorio. I-EVOLUTION -Dos I-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -en I-EVOLUTION -revisión I-EVOLUTION -en I-EVOLUTION -consulta I-EVOLUTION -ambulatoria, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -estaba I-EVOLUTION -plenamente I-EVOLUTION -satisfecha I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -resultado I-EVOLUTION -obtenido, I-EVOLUTION -contando I-EVOLUTION -incluso I-EVOLUTION -que I-EVOLUTION -había I-EVOLUTION -vuelto I-EVOLUTION -a I-EVOLUTION -frecuentar I-EVOLUTION -relaciones I-EVOLUTION -sociales I-EVOLUTION -en I-EVOLUTION -compañía I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -pareja. I-EVOLUTION -Tras I-EVOLUTION -18 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento, I-EVOLUTION -no I-EVOLUTION -hay I-EVOLUTION -señales I-EVOLUTION -de I-EVOLUTION -recidiva I-EVOLUTION -o I-EVOLUTION -complicaciones I-EVOLUTION -tardías. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -pediátrica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -diagnosticada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -púrpura I-PRESENT_ILLNESS -fulminans I-PRESENT_ILLNESS -secundaria I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -infección I-PRESENT_ILLNESS -meningocóccica I-PRESENT_ILLNESS -grave I-PRESENT_ILLNESS -complicada I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -fallo I-PRESENT_ILLNESS -multiorgánico, I-PRESENT_ILLNESS -shock I-PRESENT_ILLNESS -séptico, I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -agudo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pulmón I-PRESENT_ILLNESS -complicado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -neumonía I-PRESENT_ILLNESS -nosocomial I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -requirió I-PRESENT_ILLNESS -soporte I-PRESENT_ILLNESS -ventilatorio I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -grave I-PRESENT_ILLNESS -necrosis I-PRESENT_ILLNESS -isquémica I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -CID I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -extremidades I-PRESENT_ILLNESS -inferiores. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -4 I-DERIVED_FROM/TO -días I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -ingreso I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cuidados I-DERIVED_FROM/TO -Intensivos I-DERIVED_FROM/TO -(UCI) I-DERIVED_FROM/TO -pediátrica, I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -pide I-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -valoración I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -las I-DERIVED_FROM/TO -lesiones I-DERIVED_FROM/TO -cutáneas. I-DERIVED_FROM/TO -Apreciamos B-EXPLORATION -flictenas I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION +El B-EXPLORATION +estudio I-EXPLORATION +macroscópico I-EXPLORATION de I-EXPLORATION -sufrimiento I-EXPLORATION -cutáneo I-EXPLORATION -en I-EXPLORATION -miembro I-EXPLORATION -superior I-EXPLORATION -derecho I-EXPLORATION -(MSD) I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +de I-EXPLORATION +resección I-EXPLORATION +mostraba I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION +que I-EXPLORATION +medía I-EXPLORATION +3 I-EXPLORATION +x I-EXPLORATION +3 I-EXPLORATION y I-EXPLORATION -principalmente, I-EXPLORATION +5 I-EXPLORATION +x I-EXPLORATION +2, I-EXPLORATION +5 I-EXPLORATION +cm, I-EXPLORATION +relativamente I-EXPLORATION +bien I-EXPLORATION +delimitada I-EXPLORATION +aunque I-EXPLORATION +infiltrante I-EXPLORATION en I-EXPLORATION -miembros I-EXPLORATION -inferiores I-EXPLORATION -(MMII), I-EXPLORATION -acompañados I-EXPLORATION +el I-EXPLORATION +hueso I-EXPLORATION +maxilar, I-EXPLORATION +y I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +extendía I-EXPLORATION +al I-EXPLORATION +hueso I-EXPLORATION +limítrofe. I-EXPLORATION +Histológicamente I-EXPLORATION +la I-EXPLORATION +tumoración I-EXPLORATION +estaba I-EXPLORATION +constituida I-EXPLORATION +por I-EXPLORATION +nidos I-EXPLORATION +irregulares I-EXPLORATION de I-EXPLORATION -lesiones I-EXPLORATION -purpúricas I-EXPLORATION +células I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +basaloide, I-EXPLORATION +con I-EXPLORATION +escaso I-EXPLORATION +citoplasma I-EXPLORATION y I-EXPLORATION -necrosis I-EXPLORATION -irreversibles I-EXPLORATION +núcleos I-EXPLORATION +monomorfos I-EXPLORATION +carentes I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -dedos I-EXPLORATION +atipia. I-EXPLORATION +Los I-EXPLORATION +nidos I-EXPLORATION +celulares I-EXPLORATION +estaban I-EXPLORATION +dispuestos I-EXPLORATION de I-EXPLORATION -ambos I-EXPLORATION -pies. I-EXPLORATION -Dada B-TREATMENT -la I-TREATMENT -evolución I-TREATMENT -tórpida I-TREATMENT -y I-TREATMENT +manera I-EXPLORATION +salpicada I-EXPLORATION +sobre I-EXPLORATION +un I-EXPLORATION +abundante I-EXPLORATION +estroma I-EXPLORATION +muy I-EXPLORATION +colagenizado. I-EXPLORATION +Se I-EXPLORATION +emitió I-EXPLORATION +un I-EXPLORATION +informe I-EXPLORATION +de I-EXPLORATION +ameloblastoma I-EXPLORATION +variante I-EXPLORATION +desmoplásica I-EXPLORATION +que I-EXPLORATION +respetaba I-EXPLORATION +los I-EXPLORATION +bordes I-EXPLORATION +óseos. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +postoperatorio I-EVOLUTION +inmediato I-EVOLUTION +cursa I-EVOLUTION +sin I-EVOLUTION +complicaciones; I-EVOLUTION +se B-TREATMENT +procedió I-TREATMENT +a I-TREATMENT la I-TREATMENT -extensión I-TREATMENT +colocación I-TREATMENT de I-TREATMENT -las I-TREATMENT -lesiones, I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -17 I-TREATMENT -días I-TREATMENT -después. I-TREATMENT - I-TREATMENT -Realizamos I-TREATMENT -desbridamiento I-TREATMENT -superficial I-TREATMENT -para I-TREATMENT -demarcar I-TREATMENT -la I-TREATMENT -zona I-TREATMENT +una I-TREATMENT +prótesis I-TREATMENT +dentaria I-TREATMENT +provisional I-TREATMENT +removible I-TREATMENT +al I-TREATMENT +cabo I-TREATMENT de I-TREATMENT -necrosis I-TREATMENT -profunda I-TREATMENT -y I-TREATMENT -colocamos I-TREATMENT -Biobrane® I-TREATMENT -(Biobrane, I-TREATMENT -Smith I-TREATMENT -& I-TREATMENT -Nephew I-TREATMENT -B.V., I-TREATMENT -Barcelona, I-TREATMENT -España). I-TREATMENT -Las B-EVOLUTION -zonas I-EVOLUTION -intervenidas I-EVOLUTION -se I-EVOLUTION -curaron I-EVOLUTION -con I-EVOLUTION -sulfadiazina I-EVOLUTION -argéntica I-EVOLUTION -antes I-EVOLUTION -y I-EVOLUTION -después I-EVOLUTION +unas I-TREATMENT +semanas. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +el I-EVOLUTION +último I-EVOLUTION +control I-EVOLUTION +clínico-radiológico I-EVOLUTION +realizado I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +4 I-EVOLUTION +años I-EVOLUTION +no I-EVOLUTION +existen I-EVOLUTION +signos I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -cirugía. I-EVOLUTION - I-EVOLUTION -Ante B-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -mala I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -las I-DERIVED_FROM/TO -heridas, I-DERIVED_FROM/TO -contactamos I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Traumatología I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -nueva I-DERIVED_FROM/TO -valoración. I-DERIVED_FROM/TO -Se B-EXPLORATION -realizaron I-EXPLORATION -2 I-EXPLORATION -gammagrafías I-EXPLORATION -óseas I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -intervalo I-EXPLORATION +recidiva; I-EVOLUTION +un B-EXPLORATION +año I-EXPLORATION +y I-EXPLORATION +medio I-EXPLORATION +después I-EXPLORATION de I-EXPLORATION -15 I-EXPLORATION -días I-EXPLORATION +la I-EXPLORATION +intervención I-EXPLORATION +se I-EXPLORATION +realizó, I-EXPLORATION para I-EXPLORATION -valorar I-EXPLORATION -el I-EXPLORATION -estado I-EXPLORATION +mayor I-EXPLORATION +seguridad, I-EXPLORATION +un I-EXPLORATION +examen I-EXPLORATION +histológico I-EXPLORATION +del I-EXPLORATION +hueso I-EXPLORATION +remanente I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +distal I-EXPLORATION +del I-EXPLORATION +incisivo I-EXPLORATION +lateral I-EXPLORATION +por I-EXPLORATION +hallarse I-EXPLORATION +la I-EXPLORATION +línea I-EXPLORATION de I-EXPLORATION -ambos I-EXPLORATION -MMII I-EXPLORATION +resección I-EXPLORATION +muy I-EXPLORATION +próxima I-EXPLORATION y I-EXPLORATION -ambas I-EXPLORATION -informaron I-EXPLORATION +el I-EXPLORATION +resultado I-EXPLORATION +fue I-EXPLORATION +negativo I-EXPLORATION +para I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION +tumor I-EXPLORATION +residual. I-EXPLORATION +Se B-EVOLUTION +mantienen I-EVOLUTION +revisiones I-EVOLUTION +periódicas. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +54 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +hipertenso, B-PAST_MEDICAL_HISTORY +diabético I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +II I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +cirrosis I-PAST_MEDICAL_HISTORY +hepática I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +origen I-PAST_MEDICAL_HISTORY +alcohólico, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +estadio I-PAST_MEDICAL_HISTORY +C I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Child, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +portal. I-PAST_MEDICAL_HISTORY +Presentaba I-PAST_MEDICAL_HISTORY +varices I-PAST_MEDICAL_HISTORY +esofágicas I-PAST_MEDICAL_HISTORY +grado I-PAST_MEDICAL_HISTORY +II I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +requerido I-PAST_MEDICAL_HISTORY +ingresos I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +sangrado I-PAST_MEDICAL_HISTORY +digestivo. I-PAST_MEDICAL_HISTORY +Acudió B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hematemesis I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +rectorragia. I-PRESENT_ILLNESS +Se B-EXPLORATION +realizó I-EXPLORATION +gastroscopia I-EXPLORATION +urgente I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +tres I-EXPLORATION +cordones I-EXPLORATION +varicosos I-EXPLORATION de I-EXPLORATION -tejido I-EXPLORATION -óseo I-EXPLORATION +mediano-pequeño I-EXPLORATION +tamaño, I-EXPLORATION +con I-EXPLORATION +signos I-EXPLORATION +rojos I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +pared I-EXPLORATION +que I-EXPLORATION +afectaban I-EXPLORATION +a I-EXPLORATION +tercio I-EXPLORATION +inferior I-EXPLORATION +del I-EXPLORATION +esófago, I-EXPLORATION sin I-EXPLORATION -captación I-EXPLORATION -desde I-EXPLORATION -aproximadamente I-EXPLORATION +evidencia I-EXPLORATION +de I-EXPLORATION +sangrado I-EXPLORATION +activo I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -1/3 I-EXPLORATION -proximal I-EXPLORATION +momento I-EXPLORATION de I-EXPLORATION +realizar I-EXPLORATION la I-EXPLORATION -tibia. I-EXPLORATION -Dada B-TREATMENT -la I-TREATMENT -gangrena I-TREATMENT -establecida, I-TREATMENT -con I-TREATMENT -necrosis I-TREATMENT -irreversible I-TREATMENT -evidente I-TREATMENT -y I-TREATMENT -mal I-TREATMENT -olor, I-TREATMENT -los I-TREATMENT -traumatólogos I-TREATMENT -pediátricos I-TREATMENT -deciden, I-TREATMENT -de I-TREATMENT -acuerdo I-TREATMENT -con I-TREATMENT -la I-TREATMENT -familia, I-TREATMENT -proceder I-TREATMENT -a I-TREATMENT -practicar I-TREATMENT -amputación I-TREATMENT -infrarrotuliana I-TREATMENT -bilateral I-TREATMENT -para I-TREATMENT -conservar I-TREATMENT -la I-TREATMENT -máxima I-TREATMENT -movilidad I-TREATMENT -ulterior I-TREATMENT +exploración. I-EXPLORATION +Se B-TREATMENT +colocaron I-TREATMENT +dos I-TREATMENT +bandas I-TREATMENT de I-TREATMENT -la I-TREATMENT -paciente. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -resultado I-EXPLORATION -anatomopatológico I-EXPLORATION -diferido I-EXPLORATION -informó I-EXPLORATION +ligadura. I-TREATMENT +Una B-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +reveló I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -trombosis I-EXPLORATION -vascular I-EXPLORATION -múltiple I-EXPLORATION +hepatopatía I-EXPLORATION +crónica I-EXPLORATION +con I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +hipertensión I-EXPLORATION +portal, I-EXPLORATION +flujo I-EXPLORATION +portal I-EXPLORATION +hepatófugo I-EXPLORATION y I-EXPLORATION -necrosis I-EXPLORATION -abscesificante I-EXPLORATION +ascitis. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +evidenció I-EXPLORATION +sangrado I-EXPLORATION +activo I-EXPLORATION +ni I-EXPLORATION +lesiones I-EXPLORATION +potencialmente I-EXPLORATION +sangrantes I-EXPLORATION en I-EXPLORATION -piel I-EXPLORATION +estómago I-EXPLORATION +ni I-EXPLORATION +en I-EXPLORATION +duodeno. I-EXPLORATION +Posteriormente B-EVOLUTION +presentó I-EVOLUTION +un I-EVOLUTION +nuevo I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +deposiciones I-EVOLUTION +melénicas, I-EVOLUTION +realizándose B-EXPLORATION +endoscopia I-EXPLORATION +que I-EXPLORATION +observó I-EXPLORATION +tres I-EXPLORATION +cordones I-EXPLORATION +varicosos I-EXPLORATION +pequeños I-EXPLORATION +con I-EXPLORATION +2 I-EXPLORATION +escaras I-EXPLORATION +en I-EXPLORATION +tercio I-EXPLORATION +distal I-EXPLORATION y I-EXPLORATION -tejidos I-EXPLORATION -blandos. I-EXPLORATION - I-EXPLORATION -Durante B-EVOLUTION +cierto I-EXPLORATION +edema. I-EXPLORATION +En I-EXPLORATION +estómago I-EXPLORATION +sangre I-EXPLORATION +roja I-EXPLORATION +en I-EXPLORATION +curvatura I-EXPLORATION +mayor. I-EXPLORATION +En I-EXPLORATION +duodeno I-EXPLORATION +presentaba I-EXPLORATION +variz I-EXPLORATION +duodenal I-EXPLORATION +en I-EXPLORATION +segunda I-EXPLORATION +porción I-EXPLORATION +con I-EXPLORATION +pezón I-EXPLORATION +de I-EXPLORATION +fibrina. I-EXPLORATION +Se B-TREATMENT +inyectó I-TREATMENT +1 I-TREATMENT +cc I-TREATMENT +de I-TREATMENT +cianoacrilato I-TREATMENT +y I-TREATMENT +4 I-TREATMENT +cc I-TREATMENT +de I-TREATMENT +etoxiesclerol. I-TREATMENT +Tras B-EVOLUTION el I-EVOLUTION -postoperatorio, I-EVOLUTION -se I-EVOLUTION -delimitó I-EVOLUTION -aún I-EVOLUTION -más I-EVOLUTION -la I-EVOLUTION -necrosis I-EVOLUTION -de I-EVOLUTION -tejidos I-EVOLUTION -blandos I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -zona I-EVOLUTION -de I-EVOLUTION -cobertura I-EVOLUTION +tratamiento I-EVOLUTION +endoscópico I-EVOLUTION +no I-EVOLUTION +presentó I-EVOLUTION +nuevos I-EVOLUTION +episodios I-EVOLUTION de I-EVOLUTION -ambos I-EVOLUTION -muñones I-EVOLUTION +exteriorización I-EVOLUTION de I-EVOLUTION -amputación, I-EVOLUTION +sangrado I-EVOLUTION +ni I-EVOLUTION +anemización I-EVOLUTION +por I-EVOLUTION lo I-EVOLUTION que I-EVOLUTION -produjo I-EVOLUTION -una I-EVOLUTION -exposición I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -segmentos I-EVOLUTION -tibial I-EVOLUTION -y I-EVOLUTION -peroneo I-EVOLUTION +es I-EVOLUTION +dado I-EVOLUTION de I-EVOLUTION -ambas I-EVOLUTION -extremidades. I-EVOLUTION -Debido I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -corta I-EVOLUTION -longitud I-EVOLUTION +alta. I-EVOLUTION +Tras I-EVOLUTION +trece I-EVOLUTION +meses I-EVOLUTION de I-EVOLUTION -los I-EVOLUTION -muñones, I-EVOLUTION +seguimiento, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION no I-EVOLUTION -se I-EVOLUTION -podía I-EVOLUTION -proceder I-EVOLUTION +ha I-EVOLUTION +presentado I-EVOLUTION +hasta I-EVOLUTION +el I-EVOLUTION +momento I-EVOLUTION +nuevos I-EVOLUTION +ingresos I-EVOLUTION +por I-EVOLUTION +hemorragia I-EVOLUTION +digestiva I-EVOLUTION +alta I-EVOLUTION +secundaria I-EVOLUTION a I-EVOLUTION -una I-EVOLUTION -nueva I-EVOLUTION -amputación I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -segmentos I-EVOLUTION -y I-EVOLUTION -cobertura I-EVOLUTION -con I-EVOLUTION -tejido I-EVOLUTION -proximal, I-EVOLUTION -pues I-EVOLUTION -no I-EVOLUTION -garantizaría I-EVOLUTION -la I-EVOLUTION -posible I-EVOLUTION -colocación I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -futuro I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -prótesis. I-EVOLUTION -Por B-TREATMENT -tanto, I-TREATMENT -optamos I-TREATMENT -por I-TREATMENT -iniciar I-TREATMENT -terapia I-TREATMENT -de I-TREATMENT -presión I-TREATMENT -negativa I-TREATMENT -con I-TREATMENT -sistema I-TREATMENT -VAC® I-TREATMENT -para I-TREATMENT -favorecer I-TREATMENT -el I-TREATMENT -crecimiento I-TREATMENT -tisular I-TREATMENT -y I-TREATMENT -la I-TREATMENT -eliminación I-TREATMENT -del I-TREATMENT -exudado I-TREATMENT -de I-TREATMENT -las I-TREATMENT -heridas. I-TREATMENT - I-TREATMENT -Procedimos I-TREATMENT -en I-TREATMENT -primer I-TREATMENT -lugar I-TREATMENT -a I-TREATMENT -lavar I-TREATMENT -las I-TREATMENT -extremidades I-TREATMENT -con I-TREATMENT -una I-TREATMENT -solución I-TREATMENT -de I-TREATMENT -clorhexidina I-TREATMENT -jabonosa I-TREATMENT -al I-TREATMENT -0, I-TREATMENT -4% I-TREATMENT -y I-TREATMENT -suero I-TREATMENT -fisiológico. I-TREATMENT -Luego I-TREATMENT -colocamos I-TREATMENT -los I-TREATMENT -apósitos I-TREATMENT -VAC-Granufoam I-TREATMENT -® I-TREATMENT -según I-TREATMENT -la I-TREATMENT -guía I-TREATMENT -clínica I-TREATMENT -de I-TREATMENT -la I-TREATMENT -terapia I-TREATMENT -VAC®. I-TREATMENT -Al I-TREATMENT -principio I-TREATMENT -utilizamos I-TREATMENT -los I-TREATMENT -apósitos I-TREATMENT -medianos I-TREATMENT -según I-TREATMENT -el I-TREATMENT -modelo I-TREATMENT -Pitta-VAC® I-TREATMENT -(10,11), I-TREATMENT -dividiendo I-TREATMENT -en I-TREATMENT -dos I-TREATMENT -mitades I-TREATMENT -el I-TREATMENT -apósito, I-TREATMENT -de I-TREATMENT -manera I-TREATMENT -que I-TREATMENT -cada I-TREATMENT -una I-TREATMENT -de I-TREATMENT -ellas I-TREATMENT -es I-TREATMENT -separada I-TREATMENT -parcialmente I-TREATMENT -para I-TREATMENT -ser I-TREATMENT -colocada I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -a I-TREATMENT -tratar, I-TREATMENT -como I-TREATMENT -si I-TREATMENT -fuera I-TREATMENT -un I-TREATMENT -guante. I-TREATMENT -Esta B-EVOLUTION -técnica I-EVOLUTION -está I-EVOLUTION -descrita I-EVOLUTION -como I-EVOLUTION -rápida I-EVOLUTION -en I-EVOLUTION -su I-EVOLUTION -diseño I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -su I-EVOLUTION -ejecución. I-EVOLUTION -No I-EVOLUTION -obstante, I-EVOLUTION -en I-EVOLUTION -zonas I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -necrosis I-EVOLUTION -es I-EVOLUTION -parcheada, I-EVOLUTION -hemos I-EVOLUTION -notado I-EVOLUTION -que I-EVOLUTION -este I-EVOLUTION -sistema I-EVOLUTION -macera I-EVOLUTION -la I-EVOLUTION -piel I-EVOLUTION -sana I-EVOLUTION -si I-EVOLUTION -ésta I-EVOLUTION -entra I-EVOLUTION -en I-EVOLUTION -contacto I-EVOLUTION -directo I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -apósito I-EVOLUTION -de I-EVOLUTION -poliuretano I-EVOLUTION -reticulado, I-EVOLUTION +sangrado I-EVOLUTION por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -es I-EVOLUTION -necesario I-EVOLUTION -colocar I-EVOLUTION -apósitos I-EVOLUTION -hidrocoloides I-EVOLUTION -recortados I-EVOLUTION -bajo I-EVOLUTION -la I-EVOLUTION -esponja I-EVOLUTION -para I-EVOLUTION -evitarlo, I-EVOLUTION -lo I-EVOLUTION -cual I-EVOLUTION -hace I-EVOLUTION -más I-EVOLUTION -engorrosa I-EVOLUTION -la I-EVOLUTION -cura. I-EVOLUTION -Decidimos B-TREATMENT -por I-TREATMENT -tanto I-TREATMENT -volver I-TREATMENT -a I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -clásica I-TREATMENT -de I-TREATMENT -los I-TREATMENT -apósitos: I-TREATMENT -pequeños I-TREATMENT -fragmentos I-TREATMENT -recortados I-TREATMENT -sobre I-TREATMENT -las I-TREATMENT -pérdidas I-TREATMENT -de I-TREATMENT -sustancia I-TREATMENT -conectados I-TREATMENT -entre I-TREATMENT -sí I-TREATMENT -mediante I-TREATMENT -íntimo I-TREATMENT -contacto I-TREATMENT -en I-TREATMENT -alguna I-TREATMENT -de I-TREATMENT -sus I-TREATMENT -partes. I-TREATMENT -La I-TREATMENT -presión I-TREATMENT -utilizada I-TREATMENT -fue I-TREATMENT -de I-TREATMENT --125 I-TREATMENT -mmHg I-TREATMENT -y I-TREATMENT -en I-TREATMENT -modo I-TREATMENT -continuo. I-TREATMENT -La B-EVOLUTION -granulación I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -lecho I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -mejoría I-EVOLUTION -fueron I-EVOLUTION -evidentes. I-EVOLUTION - I-EVOLUTION -Tras I-EVOLUTION -40 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -terapia, I-EVOLUTION -conseguimos I-EVOLUTION -el I-EVOLUTION -recubrimiento I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -segmentos I-EVOLUTION -óseos I-EVOLUTION -expuestos I-EVOLUTION -y I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -colocación I-EVOLUTION -de I-EVOLUTION -láminas I-EVOLUTION -regeneradoras I-EVOLUTION -dérmicas I-EVOLUTION -Integra® I-EVOLUTION -(Integra, I-EVOLUTION -San I-EVOLUTION -Priest, I-EVOLUTION -Francia) I-EVOLUTION -durante I-EVOLUTION -1 I-EVOLUTION -mes, I-EVOLUTION -logramos I-EVOLUTION -la I-EVOLUTION -cobertura I-EVOLUTION -definitiva I-EVOLUTION -mediante I-EVOLUTION -injertos I-EVOLUTION -de I-EVOLUTION -piel I-EVOLUTION -parcial I-EVOLUTION -mallados I-EVOLUTION -1: I-EVOLUTION -1, I-EVOLUTION -5 I-EVOLUTION -tomados I-EVOLUTION -del I-EVOLUTION -muslo I-EVOLUTION -izquierdo. I-EVOLUTION - I-EVOLUTION -La I-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -satisfactoria, I-EVOLUTION -con I-EVOLUTION -epitelización I-EVOLUTION -completa I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -muñones I-EVOLUTION -de I-EVOLUTION -amputación, I-EVOLUTION -procediéndose I-EVOLUTION -al I-EVOLUTION -alta I-EVOLUTION -hospitalaria I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -tras I-EVOLUTION -exactamente I-EVOLUTION -4 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -ingreso I-EVOLUTION -hospitalario. I-EVOLUTION -Mantuvimos I-EVOLUTION -seguimiento I-EVOLUTION -ambulatorio I-EVOLUTION -durante I-EVOLUTION -3 I-EVOLUTION -semanas I-EVOLUTION -más. I-EVOLUTION -Tras I-EVOLUTION -2 I-EVOLUTION -años I-EVOLUTION -del I-EVOLUTION -suceso, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -en I-EVOLUTION -proceso I-EVOLUTION -de I-EVOLUTION -rehabilitación I-EVOLUTION -de I-EVOLUTION -sus I-EVOLUTION -secuelas I-EVOLUTION -neurológicas, I-EVOLUTION -control I-EVOLUTION -del I-EVOLUTION -tronco I-EVOLUTION -y I-EVOLUTION -adaptación I-EVOLUTION -a I-EVOLUTION -prótesis I-EVOLUTION -infracondíleas. I-EVOLUTION +variz I-EVOLUTION +duodenal. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS +27 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY +que I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +hemoptisis. I-PRESENT_ILLNESS +Entre B-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +destacan I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +episodios I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY +neumonía I-PAST_MEDICAL_HISTORY +bilateral I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +último I-PAST_MEDICAL_HISTORY +año, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +resolución I-PAST_MEDICAL_HISTORY +clínica I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY +mejoría I-PAST_MEDICAL_HISTORY +radiológica I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +convencional, I-PAST_MEDICAL_HISTORY +aunque I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +persistencia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY un I-PAST_MEDICAL_HISTORY -hijo I-PAST_MEDICAL_HISTORY +infiltrado I-PAST_MEDICAL_HISTORY +alveolar I-PAST_MEDICAL_HISTORY +izquierdo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +radiografías I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY +tórax I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -edad, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -valorar I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -mamario I-PRESENT_ILLNESS -bilateral. I-PRESENT_ILLNESS -Presenta B-EXPLORATION -atrofia I-EXPLORATION -mamaria I-EXPLORATION -moderada I-EXPLORATION -con I-EXPLORATION -ptosis I-EXPLORATION -muy I-EXPLORATION -leve. I-EXPLORATION -La I-EXPLORATION -piel I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -buena I-EXPLORATION -calidad, I-EXPLORATION -hidratada I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -estrías. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -palpan I-EXPLORATION -nódulos I-EXPLORATION -mamarios I-EXPLORATION +control. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +presenta I-PAST_MEDICAL_HISTORY +factores I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +riesgo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +VIH, I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +inmunosupresión. I-PAST_MEDICAL_HISTORY +Trabaja I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +mecánico I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +contacto I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +ambientes I-PAST_MEDICAL_HISTORY +donde I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +usan I-PAST_MEDICAL_HISTORY +soldaduras, I-PAST_MEDICAL_HISTORY +grasas, I-PAST_MEDICAL_HISTORY +ácidos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +otros I-PAST_MEDICAL_HISTORY +irritantes. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +La B-EXPLORATION +exploración I-EXPLORATION +física, I-EXPLORATION +analítica I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -refiere I-EXPLORATION -ningún I-EXPLORATION -antecedente I-EXPLORATION -patológico I-EXPLORATION -mamario I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -relevancia. I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -mamografías I-EXPLORATION -recientes I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -detectó I-EXPLORATION -ninguna I-EXPLORATION -patología. I-EXPLORATION - I-EXPLORATION -Tras B-TREATMENT -la I-TREATMENT -consulta I-TREATMENT -y I-TREATMENT -exploración I-TREATMENT -clínica I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -llevar I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -una I-TREATMENT -cirugía I-TREATMENT -de I-TREATMENT -aumento I-TREATMENT -mamario I-TREATMENT -bilateral I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -periareolar I-TREATMENT -inferior, I-TREATMENT -con I-TREATMENT -disección I-TREATMENT -de I-TREATMENT -bolsillo I-TREATMENT -subpectoral I-TREATMENT -y I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -prótesis I-TREATMENT -anatómicas I-TREATMENT -de I-TREATMENT -gel I-TREATMENT -de I-TREATMENT -silicona I-TREATMENT -(McGhan® I-TREATMENT -Style I-TREATMENT -140 I-TREATMENT -MM I-TREATMENT -de I-TREATMENT -320 I-TREATMENT -cc.). I-TREATMENT - I-TREATMENT -La I-TREATMENT -intervención I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general I-TREATMENT -y I-TREATMENT -transcurrió I-TREATMENT -sin I-TREATMENT -incidencias; I-TREATMENT -la B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -día I-EVOLUTION -siguiente. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -7 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -postoperatorio I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -bien, I-EVOLUTION -el I-EVOLUTION -aspecto I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -mamas I-EVOLUTION -es I-EVOLUTION -normal, I-EVOLUTION -la I-EVOLUTION -simetría I-EVOLUTION -es I-EVOLUTION -adecuada I-EVOLUTION -y I-EVOLUTION -las I-EVOLUTION -molestias I-EVOLUTION -son I-EVOLUTION -de I-EVOLUTION -escasa I-EVOLUTION -relevancia. I-EVOLUTION -La I-EVOLUTION -paciente I-EVOLUTION -refiere I-EVOLUTION -que I-EVOLUTION -nota I-EVOLUTION -tensión I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -mamas, I-EVOLUTION -pero I-EVOLUTION -sin I-EVOLUTION -dolor I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -palpación. I-EVOLUTION -La B-EXPLORATION -cicatrización I-EXPLORATION -es I-EXPLORATION -correcta. I-EXPLORATION +función I-EXPLORATION +respiratoria I-EXPLORATION +son I-EXPLORATION +normales. I-EXPLORATION I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -15 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -postoperatorio I-EVOLUTION -acude I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -consulta I-EVOLUTION -presentando I-EVOLUTION -aumento I-EVOLUTION -simétrico I-EVOLUTION -del I-EVOLUTION -volumen I-EVOLUTION -mamario I-EVOLUTION -y I-EVOLUTION -drenaje I-EVOLUTION -espontáneo I-EVOLUTION -de I-EVOLUTION -material I-EVOLUTION -líquido I-EVOLUTION -de I-EVOLUTION -coloración I-EVOLUTION -blanquecina I-EVOLUTION -a I-EVOLUTION -través I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -pequeña I-EVOLUTION -dehiscencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -herida I-EVOLUTION -periareolar I-EVOLUTION -derecha. I-EVOLUTION -No B-EXPLORATION -ha I-EXPLORATION -presentado I-EXPLORATION -fiebre I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -mamas I-EXPLORATION -no I-EXPLORATION -muestran I-EXPLORATION -signos I-EXPLORATION -inflamatorios. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -margen I-EXPLORATION -lateral I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -cicatriz I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION +tórax I-EXPLORATION +que I-EXPLORATION +revela I-EXPLORATION un I-EXPLORATION -pequeño I-EXPLORATION +infiltrado I-EXPLORATION +alveolar I-EXPLORATION +bilateral I-EXPLORATION +similar I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +radiografías I-EXPLORATION +anteriores. I-EXPLORATION +Se I-EXPLORATION +decide I-EXPLORATION +entonces I-EXPLORATION +hacer I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +torácica I-EXPLORATION +con I-EXPLORATION +cortes I-EXPLORATION de I-EXPLORATION -fecto I-EXPLORATION +alta I-EXPLORATION +resolución, I-EXPLORATION +que I-EXPLORATION +consiste I-EXPLORATION +en I-EXPLORATION +cortes I-EXPLORATION +finos I-EXPLORATION de I-EXPLORATION -2 I-EXPLORATION -mm. I-EXPLORATION -por I-EXPLORATION +1mm I-EXPLORATION +de I-EXPLORATION +colimación I-EXPLORATION +a I-EXPLORATION +intervalos I-EXPLORATION +de I-EXPLORATION +10 I-EXPLORATION +mm I-EXPLORATION +del I-EXPLORATION +parénquima I-EXPLORATION +pulmonar, I-EXPLORATION +en I-EXPLORATION +inspiración I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION el I-EXPLORATION -que I-EXPLORATION -drena I-EXPLORATION -material, I-EXPLORATION -que I-EXPLORATION -al I-EXPLORATION -exprimir I-EXPLORATION -la I-EXPLORATION -mama I-EXPLORATION -aumenta I-EXPLORATION -su I-EXPLORATION -caudal. I-EXPLORATION -Sospechando B-TREATMENT -la I-TREATMENT -existencia I-TREATMENT -de I-TREATMENT -un I-TREATMENT -absceso I-TREATMENT -retroareolar I-TREATMENT -y I-TREATMENT -decidimos I-TREATMENT -dilatar I-TREATMENT -dicho I-TREATMENT -defecto I-TREATMENT -usando I-TREATMENT -una I-TREATMENT -pinza I-TREATMENT -de I-TREATMENT -hemostasia, I-TREATMENT -momento I-TREATMENT -en I-TREATMENT -el I-TREATMENT -que I-TREATMENT -se I-TREATMENT -produce I-TREATMENT -el I-TREATMENT -drenaje I-TREATMENT -espontáneo I-TREATMENT -de I-TREATMENT -una I-TREATMENT -gran I-TREATMENT -cantidad I-TREATMENT -del I-TREATMENT -citado I-TREATMENT -material. I-TREATMENT -Al I-TREATMENT -proceder I-TREATMENT -a I-TREATMENT -la I-TREATMENT -expresión I-TREATMENT -de I-TREATMENT -la I-TREATMENT -mama I-TREATMENT -se I-TREATMENT -aprecia I-TREATMENT -igualmente I-TREATMENT -que I-TREATMENT -el I-TREATMENT -material I-TREATMENT -drena I-TREATMENT -por I-TREATMENT -el I-TREATMENT -pezón I-TREATMENT -y I-TREATMENT -al I-TREATMENT -hacer I-TREATMENT -la I-TREATMENT -misma I-TREATMENT -maniobra I-TREATMENT -en I-TREATMENT -la I-TREATMENT -mama I-TREATMENT -izquierda, I-TREATMENT -se I-TREATMENT -aprecia I-TREATMENT -también I-TREATMENT -este I-TREATMENT -drenaje I-TREATMENT -por I-TREATMENT -el I-TREATMENT -pezón. I-TREATMENT -Tomamos B-EXPLORATION +paciente I-EXPLORATION +en I-EXPLORATION +decúbito I-EXPLORATION +supino. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION muestra I-EXPLORATION -para I-EXPLORATION -cultivo, I-EXPLORATION -siendo I-EXPLORATION -el I-EXPLORATION -resultado I-EXPLORATION -negativo. I-EXPLORATION -Ante I-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION -pensamos I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -tumefacción I-EXPLORATION +áreas I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -mamas I-EXPLORATION -se I-EXPLORATION -debe I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -producción I-EXPLORATION +opacificación I-EXPLORATION +alveolar I-EXPLORATION +en I-EXPLORATION +vidrio I-EXPLORATION +deslustrado I-EXPLORATION +dispersos I-EXPLORATION +con I-EXPLORATION +superposición I-EXPLORATION de I-EXPLORATION -leche. I-EXPLORATION +un I-EXPLORATION +engrosamiento I-EXPLORATION +liso I-EXPLORATION +lineal I-EXPLORATION +septal I-EXPLORATION +inter I-EXPLORATION +e I-EXPLORATION +intralobular, I-EXPLORATION +conocido I-EXPLORATION +como I-EXPLORATION +patrón I-EXPLORATION +'crazy-paving' I-EXPLORATION +o I-EXPLORATION +en I-EXPLORATION +empedrado, I-EXPLORATION +con I-EXPLORATION +extensa I-EXPLORATION +afectación I-EXPLORATION +dispersa I-EXPLORATION +y I-EXPLORATION +parcheada I-EXPLORATION +del I-EXPLORATION +pulmón I-EXPLORATION +izquierdo I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +perihiliar I-EXPLORATION +y I-EXPLORATION +del I-EXPLORATION +lóbulo I-EXPLORATION +medio I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lado I-EXPLORATION +derecho. I-EXPLORATION I-EXPLORATION -Recomendamos I-EXPLORATION -a I-EXPLORATION +Teniendo I-EXPLORATION +en I-EXPLORATION +cuenta I-EXPLORATION +el I-EXPLORATION +patrón I-EXPLORATION +radiológico I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -paciente I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -analítica I-EXPLORATION -para I-EXPLORATION -estudiar I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -prolactina I-EXPLORATION -(PRL) I-EXPLORATION +TCAR I-EXPLORATION y I-EXPLORATION +la I-EXPLORATION +exposición I-EXPLORATION +a I-EXPLORATION +agentes I-EXPLORATION +tóxicos I-EXPLORATION +inhalados, I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +diferencial I-EXPLORATION se I-EXPLORATION +reduce I-EXPLORATION +a I-EXPLORATION +PAP I-EXPLORATION +y I-EXPLORATION +a I-EXPLORATION +neumonía I-EXPLORATION +lipoidea. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION realiza I-EXPLORATION -consulta I-EXPLORATION +entonces I-EXPLORATION +fibrobroncoscopia I-EXPLORATION con I-EXPLORATION -Ginecología I-EXPLORATION +BAL, I-EXPLORATION que I-EXPLORATION -recomienda I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -mamaria I-EXPLORATION -bilateral, I-EXPLORATION -TAC I-EXPLORATION -craneal I-EXPLORATION -y I-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -hormonas I-EXPLORATION -tiroideas I-EXPLORATION -y I-EXPLORATION -suprarrenales. I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION -de I-EXPLORATION -todas I-EXPLORATION -estas I-EXPLORATION -pruebas I-EXPLORATION no I-EXPLORATION -mostraron I-EXPLORATION -signos I-EXPLORATION -patológicos. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -mamaria I-EXPLORATION -reveló I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -densidad I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -mamario I-EXPLORATION +resulta I-EXPLORATION +concluyente, I-EXPLORATION y I-EXPLORATION -no I-EXPLORATION se I-EXPLORATION -apreció I-EXPLORATION -líquido I-EXPLORATION +completa I-EXPLORATION +con I-EXPLORATION +biopsia I-EXPLORATION +transbronquial; I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +ultraestructural I-EXPLORATION +identifica I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -bolsillo I-EXPLORATION -que I-EXPLORATION -alojaba I-EXPLORATION +interior I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +alvéolos I-EXPLORATION +un I-EXPLORATION +material I-EXPLORATION +granular I-EXPLORATION +amorfo I-EXPLORATION +eosinófilo I-EXPLORATION +PAS I-EXPLORATION +positivo I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -prótesis. I-EXPLORATION -Aún B-TREATMENT -así I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -instaurar I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -bromocriptina I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -empírica, I-TREATMENT -a I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -inicial I-TREATMENT -de I-TREATMENT -1, I-TREATMENT -25 I-TREATMENT -mg., I-TREATMENT -3 I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día. I-TREATMENT -Después I-TREATMENT -de I-TREATMENT -una I-TREATMENT -semana I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -y I-TREATMENT -al I-TREATMENT -no I-TREATMENT -obtener I-TREATMENT -respuesta, I-TREATMENT -se I-TREATMENT -aumentó I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -hasta I-TREATMENT -2, I-TREATMENT -5 I-TREATMENT -mg. I-TREATMENT -3 I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día. I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -mantendría I-TREATMENT -hasta I-TREATMENT -2 I-TREATMENT -semanas I-TREATMENT -después I-TREATMENT -del I-TREATMENT -cese I-TREATMENT -de I-TREATMENT -la I-TREATMENT -secreción. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -pesar I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -tórpida I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -galactorrea I-EVOLUTION -no I-EVOLUTION -cesó, I-EVOLUTION -continuando I-EVOLUTION -el I-EVOLUTION -drenaje I-EVOLUTION -de I-EVOLUTION -leche I-EVOLUTION -a I-EVOLUTION -través I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -herida I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mama I-EVOLUTION -derecha. I-EVOLUTION -Ambas I-EVOLUTION -mamas I-EVOLUTION -continuaban I-EVOLUTION -turgentes. I-EVOLUTION -Se B-TREATMENT -mantiene I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -con I-TREATMENT -vendajes I-TREATMENT -moderadamente I-TREATMENT -compresivos I-TREATMENT -considerando I-TREATMENT -que I-TREATMENT -el I-TREATMENT -drenaje I-TREATMENT -continuo I-TREATMENT -de I-TREATMENT -leche I-TREATMENT -por I-TREATMENT -la I-TREATMENT -fístula I-TREATMENT -de I-TREATMENT -la I-TREATMENT -herida I-TREATMENT -puede I-TREATMENT -ser I-TREATMENT -un I-TREATMENT -estímulo I-TREATMENT -mantenido I-TREATMENT -para I-TREATMENT -la I-TREATMENT -lactancia, I-TREATMENT -así I-TREATMENT -como I-TREATMENT -para I-TREATMENT -sellar I-TREATMENT -posibles I-TREATMENT -espacios I-TREATMENT -muertos I-TREATMENT -en I-TREATMENT -el I-TREATMENT -bolsillo I-TREATMENT -o I-TREATMENT -en I-TREATMENT -el I-TREATMENT -tejido I-TREATMENT -mamario. I-TREATMENT - I-TREATMENT -Al B-EVOLUTION -cabo I-EVOLUTION -de I-EVOLUTION -2 I-EVOLUTION -meses I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -sometida I-EVOLUTION -a I-EVOLUTION -revisiones I-EVOLUTION -y I-EVOLUTION -curas I-EVOLUTION -semanales, I-EVOLUTION -el I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -galactorrea I-EVOLUTION -cesó, I-EVOLUTION -deteniéndose I-EVOLUTION -el I-EVOLUTION -drenaje I-EVOLUTION -de I-EVOLUTION -leche I-EVOLUTION -a I-EVOLUTION -través I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -herida I-EVOLUTION -y I-EVOLUTION -disminuyendo I-EVOLUTION -la I-EVOLUTION -turgencia I-EVOLUTION -en I-EVOLUTION -ambas I-EVOLUTION -mamas. I-EVOLUTION - I-EVOLUTION -Sin I-EVOLUTION -embargo, I-EVOLUTION -2 I-EVOLUTION -semanas I-EVOLUTION -después I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -acude I-EVOLUTION -de I-EVOLUTION -nuevo I-EVOLUTION -presentando I-EVOLUTION -en I-EVOLUTION -esta I-EVOLUTION -ocasión I-EVOLUTION -aumento I-EVOLUTION -de I-EVOLUTION -volumen I-EVOLUTION -mamario I-EVOLUTION -unilateral I-EVOLUTION -derecho. I-EVOLUTION +pared I-EXPLORATION +alveolar I-EXPLORATION +algún I-EXPLORATION +lipófago I-EXPLORATION +con I-EXPLORATION +microvacuolas, I-EXPLORATION +llegando I-EXPLORATION +al I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +PAP. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +33 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +infección I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +VIH, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +tuberculosis I-PAST_MEDICAL_HISTORY +pulmonar I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +momento I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +diagnóstico. I-PAST_MEDICAL_HISTORY +Recibió I-PAST_MEDICAL_HISTORY +terapia I-PAST_MEDICAL_HISTORY +anti-retroviral I-PAST_MEDICAL_HISTORY +(TARV) I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +buena I-PAST_MEDICAL_HISTORY +adherencia I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +ocho I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +respuesta I-PAST_MEDICAL_HISTORY +inmunológica I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +virológica I-PAST_MEDICAL_HISTORY +favorable, I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +abandonó, I-PAST_MEDICAL_HISTORY +según I-PAST_MEDICAL_HISTORY +refirió, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +mejoría I-PAST_MEDICAL_HISTORY +clínica. I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +abandono, I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +nuevamente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tuberculosis, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +compromiso I-PAST_MEDICAL_HISTORY +ganglionar I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +multirresistencia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +fármacos I-PAST_MEDICAL_HISTORY +antituberculosos. I-PAST_MEDICAL_HISTORY +Había I-PAST_MEDICAL_HISTORY +recibido I-PAST_MEDICAL_HISTORY +terapia I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +régimen I-PAST_MEDICAL_HISTORY +individualizado I-PAST_MEDICAL_HISTORY +(amikacina, I-PAST_MEDICAL_HISTORY +pirazinamida, I-PAST_MEDICAL_HISTORY +cicloserina, I-PAST_MEDICAL_HISTORY +etionamida I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +levofloxacina) I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +siete I-PAST_MEDICAL_HISTORY +meses, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +reinicio I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +cuatro I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +TARV I-PAST_MEDICAL_HISTORY +previa I-PAST_MEDICAL_HISTORY +(tenofovir, I-PAST_MEDICAL_HISTORY +lamivudina, I-PAST_MEDICAL_HISTORY +efavirenz). I-PAST_MEDICAL_HISTORY +Sin I-PAST_MEDICAL_HISTORY +embargo, I-PAST_MEDICAL_HISTORY +finalmente I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +abandonado I-PAST_MEDICAL_HISTORY +ambos I-PAST_MEDICAL_HISTORY +esquemas I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +intolerancia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +medicación. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Además, I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +haber I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +empírica I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +encefalitis I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +Toxoplasma I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +cotrimoxazol I-PAST_MEDICAL_HISTORY +(5 I-PAST_MEDICAL_HISTORY +mg/kg/día I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +trimetoprim, I-PAST_MEDICAL_HISTORY +fraccionado I-PAST_MEDICAL_HISTORY +cada I-PAST_MEDICAL_HISTORY +12 I-PAST_MEDICAL_HISTORY +h) I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +seis I-PAST_MEDICAL_HISTORY +semanas, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +respuesta I-PAST_MEDICAL_HISTORY +favorable I-PAST_MEDICAL_HISTORY +clínica I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +control I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +imágenes I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +resonancia I-PAST_MEDICAL_HISTORY +magnética I-PAST_MEDICAL_HISTORY +(RM). I-PAST_MEDICAL_HISTORY +Al I-PAST_MEDICAL_HISTORY +alta, I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +reiniciado I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +antituberculoso, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +continuado I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +cotrimoxazol, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +dosis I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +mantención I-PAST_MEDICAL_HISTORY +(160/800 I-PAST_MEDICAL_HISTORY +mg, I-PAST_MEDICAL_HISTORY +cada I-PAST_MEDICAL_HISTORY +24 I-PAST_MEDICAL_HISTORY +h); I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +adherencia I-PAST_MEDICAL_HISTORY +regular. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Tres B-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +reingresó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Emergencias I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +neurológico, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +aproximadamente I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +paraparesia I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +miembros I-PRESENT_ILLNESS +inferiores, I-PRESENT_ILLNESS +retención I-PRESENT_ILLNESS +urinaria I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +compromiso I-PRESENT_ILLNESS +sensitivo I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +T8. I-PRESENT_ILLNESS Se B-EXPLORATION -realiza I-EXPLORATION -nueva I-EXPLORATION -ecografía I-EXPLORATION -mamaria I-EXPLORATION -que I-EXPLORATION -revela I-EXPLORATION +realizó I-EXPLORATION +RM I-EXPLORATION +de I-EXPLORATION +columna I-EXPLORATION +y I-EXPLORATION +médula I-EXPLORATION +espinal I-EXPLORATION +revelando I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -seroma I-EXPLORATION -intracapsular I-EXPLORATION -derecho. I-EXPLORATION -Se B-TREATMENT -procede I-TREATMENT -al I-TREATMENT -drenaje I-TREATMENT -del I-TREATMENT -mismo I-TREATMENT -bajo I-TREATMENT -condiciones I-TREATMENT -de I-TREATMENT -asepsia I-TREATMENT -y I-TREATMENT -éste I-TREATMENT -se I-TREATMENT -resuelve I-TREATMENT -en I-TREATMENT -7 I-TREATMENT -días; I-TREATMENT -pero B-EVOLUTION -la I-EVOLUTION -morfología I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mama I-EVOLUTION -comienza I-EVOLUTION -a I-EVOLUTION -verse I-EVOLUTION -afectada I-EVOLUTION -de I-EVOLUTION -tal I-EVOLUTION -forma I-EVOLUTION -que I-EVOLUTION -el I-EVOLUTION -trayecto I-EVOLUTION -a I-EVOLUTION -través I-EVOLUTION -del I-EVOLUTION -cual I-EVOLUTION -drenaba I-EVOLUTION -la I-EVOLUTION -leche I-EVOLUTION -se I-EVOLUTION -retrae I-EVOLUTION -deformando I-EVOLUTION -la I-EVOLUTION -areola. I-EVOLUTION -Se I-EVOLUTION -constata I-EVOLUTION -también I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -mama I-EVOLUTION -desarrolla I-EVOLUTION -un I-EVOLUTION -grado I-EVOLUTION -incipiente I-EVOLUTION -de I-EVOLUTION -contractura I-EVOLUTION -capsular. I-EVOLUTION -Optamos B-TREATMENT -por I-TREATMENT -llevar I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -revisión I-TREATMENT -quirúrgica I-TREATMENT -debido I-TREATMENT -sobre I-TREATMENT -todo I-TREATMENT -a I-TREATMENT -la I-TREATMENT -deformidad I-TREATMENT -provocada I-TREATMENT -por I-TREATMENT -la I-TREATMENT -fístula I-TREATMENT -areolar. I-TREATMENT - I-TREATMENT -La I-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -intervenida I-TREATMENT -procediendo I-TREATMENT -a I-TREATMENT -la I-TREATMENT -revisión I-TREATMENT -del I-TREATMENT -bolsillo I-TREATMENT -en I-TREATMENT -el I-TREATMENT -que I-TREATMENT -no I-TREATMENT -se I-TREATMENT -aprecia I-TREATMENT -la I-TREATMENT -existencia I-TREATMENT -de I-TREATMENT -ninguna I-TREATMENT -colección I-TREATMENT -líquida, I-TREATMENT -tan I-TREATMENT -solo I-TREATMENT -escasos I-TREATMENT -depósitos I-TREATMENT -blanquecinos I-TREATMENT -que I-TREATMENT -se I-TREATMENT -analizan I-TREATMENT -Practicamos I-TREATMENT -capsulotomías, I-TREATMENT -recolocación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -prótesis I-TREATMENT -que I-TREATMENT -permanecía I-TREATMENT -intacta I-TREATMENT -y I-TREATMENT -sin I-TREATMENT -depósitos I-TREATMENT -en I-TREATMENT -su I-TREATMENT -superficie I-TREATMENT -y I-TREATMENT -reparación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -retracción I-TREATMENT -areolar. I-TREATMENT -El B-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +intramedular I-EXPLORATION +captadora I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -depósitos I-EXPLORATION -blanquecinos I-EXPLORATION -hallados I-EXPLORATION -describe I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION +contraste I-EXPLORATION +en I-EXPLORATION +anillo I-EXPLORATION +(0, I-EXPLORATION +9 I-EXPLORATION +cm I-EXPLORATION +x I-EXPLORATION +2, I-EXPLORATION +6 I-EXPLORATION +cm) I-EXPLORATION +con I-EXPLORATION +edema I-EXPLORATION +perilesional, I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -fibrosis I-EXPLORATION -hialinizada I-EXPLORATION +T8. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +líquido I-EXPLORATION +cefalorraquídeo I-EXPLORATION +(LCR) I-EXPLORATION +mostró I-EXPLORATION +20 I-EXPLORATION +células I-EXPLORATION +a I-EXPLORATION +predominio I-EXPLORATION +linfomononuclear I-EXPLORATION +(90%), I-EXPLORATION +hiperproteinorraquia I-EXPLORATION +(247 I-EXPLORATION +mg/dL), I-EXPLORATION +glucorraquia I-EXPLORATION +y I-EXPLORATION +prueba I-EXPLORATION +de I-EXPLORATION +ADA I-EXPLORATION +(adenosina I-EXPLORATION +deaminasa) I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +límites I-EXPLORATION +normales. I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION +microbiológicos I-EXPLORATION +en I-EXPLORATION +LCR I-EXPLORATION +para I-EXPLORATION +bacterias I-EXPLORATION +(tinción I-EXPLORATION +Gram I-EXPLORATION +y I-EXPLORATION +cultivo), I-EXPLORATION +hongos I-EXPLORATION +(tinta I-EXPLORATION +china I-EXPLORATION +y I-EXPLORATION +antígeno I-EXPLORATION +para I-EXPLORATION +Cryptococcus) I-EXPLORATION +y I-EXPLORATION +micobacterias I-EXPLORATION +(baciloscopias I-EXPLORATION +y I-EXPLORATION +GeneXpert I-EXPLORATION +MTB/RIF) I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +RPC I-EXPLORATION +para I-EXPLORATION +Toxoplasma I-EXPLORATION +en I-EXPLORATION +LCR, I-EXPLORATION +y I-EXPLORATION +las I-EXPLORATION +cargas I-EXPLORATION +virales I-EXPLORATION +para I-EXPLORATION +CMV I-EXPLORATION +y I-EXPLORATION +VEB I-EXPLORATION +séricas I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +LCR I-EXPLORATION +fueron I-EXPLORATION +indetectables. I-EXPLORATION +El I-EXPLORATION +recuento I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +T I-EXPLORATION +CD4+ I-EXPLORATION +fue I-EXPLORATION +11 I-EXPLORATION +céls/mm3, I-EXPLORATION con I-EXPLORATION -infiltración I-EXPLORATION -crónica I-EXPLORATION -granulomatosa I-EXPLORATION -e I-EXPLORATION -infiltrado I-EXPLORATION +carga I-EXPLORATION +viral I-EXPLORATION +VIH I-EXPLORATION de I-EXPLORATION -histiocitos. I-EXPLORATION +548.800 I-EXPLORATION +copias I-EXPLORATION +ARN/ml; I-EXPLORATION +los I-EXPLORATION +títulos I-EXPLORATION +séricos I-EXPLORATION +de I-EXPLORATION +IgG I-EXPLORATION +para I-EXPLORATION +Toxoplasma I-EXPLORATION +fueron I-EXPLORATION +positivos I-EXPLORATION +en I-EXPLORATION +4, I-EXPLORATION +37 I-EXPLORATION +(< I-EXPLORATION +0, I-EXPLORATION +8 I-EXPLORATION += I-EXPLORATION +negativo) I-EXPLORATION +obtenidos I-EXPLORATION +mediante I-EXPLORATION +inmunoanálisis I-EXPLORATION +quimioluminiscente I-EXPLORATION +de I-EXPLORATION +partículas I-EXPLORATION +(CMIA). I-EXPLORATION I-EXPLORATION -Durante B-EVOLUTION -este I-EVOLUTION -segundo I-EVOLUTION -postoperatorio I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -desarrolla I-EVOLUTION -galactorrea I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -recupera I-EVOLUTION -sin I-EVOLUTION -incidencias. I-EVOLUTION -Sin I-EVOLUTION -embargo, I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -1 I-EVOLUTION -año I-EVOLUTION -la I-EVOLUTION -mama I-EVOLUTION -derecha I-EVOLUTION -desarrolla I-EVOLUTION -contractura I-EVOLUTION -capsular I-EVOLUTION -grado I-EVOLUTION -III I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -reintervenir I-TREATMENT -nuevamente, I-TREATMENT -realizando I-TREATMENT -capsulectomía I-TREATMENT -parcial I-TREATMENT +Se B-TREATMENT +reinició I-TREATMENT +terapia I-TREATMENT +empírica, I-TREATMENT debido I-TREATMENT a I-TREATMENT que I-TREATMENT -los I-TREATMENT -tegumentos I-TREATMENT -se I-TREATMENT -han I-TREATMENT -adelgazado I-TREATMENT -y I-TREATMENT +no I-TREATMENT se I-TREATMENT -considera I-TREATMENT -el I-TREATMENT -riesgo I-TREATMENT +pudo I-TREATMENT +realizar I-TREATMENT +una I-TREATMENT +biopsia I-TREATMENT de I-TREATMENT -afectar I-TREATMENT la I-TREATMENT -integridad I-TREATMENT +lesión I-TREATMENT +intramedular, I-TREATMENT +con I-TREATMENT +cotrimoxazol I-TREATMENT +i.v. I-TREATMENT +(5 I-TREATMENT +mg/kg I-TREATMENT de I-TREATMENT -la I-TREATMENT -piel I-TREATMENT +trimetoprim, I-TREATMENT +dos I-TREATMENT +veces I-TREATMENT +al I-TREATMENT +día), I-TREATMENT durante I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -una I-TREATMENT -capsulectomia I-TREATMENT -total, I-TREATMENT -y I-TREATMENT -capsulorrafia I-TREATMENT -medial I-TREATMENT +cuatro I-TREATMENT +semanas I-TREATMENT +asociado I-TREATMENT +a I-TREATMENT +dexametasona I-TREATMENT +i.v. I-TREATMENT +8 I-TREATMENT +mg, I-TREATMENT +fraccionado I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +h, I-TREATMENT por I-TREATMENT -ser I-TREATMENT -esta I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -en I-TREATMENT -la I-TREATMENT -que I-TREATMENT -el I-TREATMENT -adelgazamiento I-TREATMENT -de I-TREATMENT -los I-TREATMENT -tejidos I-TREATMENT -es I-TREATMENT -mayor. I-TREATMENT -Cambiamos I-TREATMENT +siete I-TREATMENT +días. I-TREATMENT +Posteriormente I-TREATMENT +continuó I-TREATMENT +dos I-TREATMENT +semanas I-TREATMENT +con I-TREATMENT +cotrimoxazol I-TREATMENT +a I-TREATMENT la I-TREATMENT -prótesis I-TREATMENT +misma I-TREATMENT +dosis I-TREATMENT por I-TREATMENT -otra I-TREATMENT +vía I-TREATMENT +oral, I-TREATMENT +y I-TREATMENT +reducción I-TREATMENT +semanal I-TREATMENT +progresiva I-TREATMENT de I-TREATMENT -idénticas I-TREATMENT -carácterísticas. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION +corticoesteroides I-TREATMENT +con I-TREATMENT +prednisona, I-TREATMENT +hasta I-TREATMENT +completar I-TREATMENT +seis I-TREATMENT +semanas. I-TREATMENT +Tuvo B-EVOLUTION +control I-EVOLUTION +imagenológico I-EVOLUTION +cuatro I-EVOLUTION +semanas I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +tratamiento, I-EVOLUTION +evidenciándose I-EVOLUTION +mejoría I-EVOLUTION de I-EVOLUTION -esta I-EVOLUTION -nueva I-EVOLUTION -intervención I-EVOLUTION -detectamos I-EVOLUTION -como I-EVOLUTION -única I-EVOLUTION -complicación I-EVOLUTION -un I-EVOLUTION -síndrome I-EVOLUTION +lesión I-EVOLUTION +intramedular, I-EVOLUTION +con I-EVOLUTION +evidente I-EVOLUTION +disminución I-EVOLUTION de I-EVOLUTION -Mondor I-EVOLUTION -en I-EVOLUTION +tamaño I-EVOLUTION +y I-EVOLUTION +menor I-EVOLUTION +realce I-EVOLUTION +al I-EVOLUTION +contraste. I-EVOLUTION +Clínicamente I-EVOLUTION +a I-EVOLUTION la I-EVOLUTION -mama I-EVOLUTION -derecha. I-EVOLUTION - I-EVOLUTION -Al I-EVOLUTION -cabo I-EVOLUTION +semana I-EVOLUTION de I-EVOLUTION -2 I-EVOLUTION -años I-EVOLUTION +tratamiento I-EVOLUTION +empírico, I-EVOLUTION +comenzó I-EVOLUTION +a I-EVOLUTION +evidenciarse I-EVOLUTION +una I-EVOLUTION +mejoría I-EVOLUTION de I-EVOLUTION -postoperatorio I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -nuevamente I-EVOLUTION -signos I-EVOLUTION -compatibles I-EVOLUTION -con I-EVOLUTION -contractura I-EVOLUTION -capsular I-EVOLUTION -recidivada I-EVOLUTION -en I-EVOLUTION la I-EVOLUTION -mama I-EVOLUTION -derecha, I-EVOLUTION -con I-EVOLUTION -notable I-EVOLUTION -afectación I-EVOLUTION -estética I-EVOLUTION +sensibilidad I-EVOLUTION +discriminatoria I-EVOLUTION y I-EVOLUTION -de I-EVOLUTION -aparición I-EVOLUTION -más I-EVOLUTION -lenta I-EVOLUTION -en I-EVOLUTION la I-EVOLUTION -mama I-EVOLUTION -izquierda. I-EVOLUTION -El B-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -que I-TREATMENT -podría I-TREATMENT -plantearse I-TREATMENT -en I-TREATMENT -esta I-TREATMENT -ocasión I-TREATMENT -sería: I-TREATMENT -en I-TREATMENT -la I-TREATMENT -mama I-TREATMENT -derecha I-TREATMENT -nueva I-TREATMENT -capsulectomía, I-TREATMENT -si I-TREATMENT -los I-TREATMENT -tegumentos I-TREATMENT -lo I-TREATMENT -permiten, I-TREATMENT -pudiendo I-TREATMENT -precisar I-TREATMENT -de I-TREATMENT -refuerzo I-TREATMENT -mediante I-TREATMENT -malla I-TREATMENT -de I-TREATMENT -material I-TREATMENT -sintético I-TREATMENT -o I-TREATMENT -biológico I-TREATMENT -en I-TREATMENT -la I-TREATMENT -región I-TREATMENT -ínferomedial, I-TREATMENT -y I-TREATMENT -en I-TREATMENT +fuerza I-EVOLUTION +muscular; I-EVOLUTION +sin I-EVOLUTION +embargo, I-EVOLUTION +persistió I-EVOLUTION +con I-EVOLUTION +compromiso I-EVOLUTION +del I-EVOLUTION +esfínter I-EVOLUTION +urinario I-EVOLUTION +(retención I-EVOLUTION +urinaria). I-EVOLUTION +Ante B-TREATMENT la I-TREATMENT -mama I-TREATMENT -izquierda I-TREATMENT -capsulectomía I-TREATMENT +mejoría I-TREATMENT +inicial, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +continuar I-TREATMENT +con I-TREATMENT +tratamiento I-TREATMENT +para I-TREATMENT +toxoplasmosis I-TREATMENT +(durante I-TREATMENT +seis I-TREATMENT +semanas), I-TREATMENT y I-TREATMENT -recambio I-TREATMENT +terapia I-TREATMENT de I-TREATMENT -prótesis. I-TREATMENT -No I-TREATMENT +rehabilitación I-TREATMENT +física. I-TREATMENT +Previo I-TREATMENT +al I-TREATMENT +alta I-TREATMENT se I-TREATMENT -descarta I-TREATMENT +reinició I-TREATMENT la I-TREATMENT -necesidad I-TREATMENT +TARV I-TREATMENT +con I-TREATMENT +mismo I-TREATMENT +esquema I-TREATMENT +recibido I-TREATMENT +previamente. I-TREATMENT +Finalmente, I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +continuó I-TREATMENT +la I-TREATMENT +terapia I-TREATMENT +antituberculosa I-TREATMENT de I-TREATMENT -añadir I-TREATMENT -procedimientos I-TREATMENT +manera I-TREATMENT +regular I-TREATMENT +y I-TREATMENT +con I-TREATMENT +dosis I-TREATMENT de I-TREATMENT -mastopexia I-TREATMENT -para I-TREATMENT -corregir I-TREATMENT -la I-TREATMENT -posición I-TREATMENT -del I-TREATMENT -complejo I-TREATMENT -teloareolar. I-TREATMENT +mantención I-TREATMENT +con I-TREATMENT +cotrimoxazol I-TREATMENT +160/800 I-TREATMENT +mg, I-TREATMENT +fraccionado I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +h. I-TREATMENT I-TREATMENT -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +67 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +diestra, I-PRESENT_ILLNESS +viuda, I-PRESENT_ILLNESS +ocupación: I-PRESENT_ILLNESS +hogar. I-PRESENT_ILLNESS +Padecimiento I-PRESENT_ILLNESS +actual I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS de I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +toque I-PRESENT_ILLNESS +eléctrico I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +descargas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS región I-PRESENT_ILLNESS -maseterina I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS +frontal, I-PRESENT_ILLNESS +temporal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +periorbitaria I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +lado I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS varios I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +segundos I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +minuto I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS +duración, I-PRESENT_ILLNESS +muy I-PRESENT_ILLNESS +intenso, I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -mayor I-PRESENT_ILLNESS -tamaño I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -músculo I-PRESENT_ILLNESS -masetero I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -lado I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +ocasiones I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +día, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +períodos I-PRESENT_ILLNESS +libres I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +entre I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +descargas I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +alteraciones I-PRESENT_ILLNESS +sensitivas, I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -motivó I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta. I-PRESENT_ILLNESS -En B-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY +se I-PRESENT_ILLNESS +producía I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +hablar I-PRESENT_ILLNESS +o I-PRESENT_ILLNESS +comer. I-PRESENT_ILLNESS +Cuatro B-TREATMENT +años I-TREATMENT +previos I-TREATMENT +a I-TREATMENT +su I-TREATMENT +llegada I-TREATMENT +a I-TREATMENT +nuestra I-TREATMENT +clínica I-TREATMENT +del I-TREATMENT +dolor I-TREATMENT +se I-TREATMENT +le I-TREATMENT +había I-TREATMENT +realizado I-TREATMENT +una I-TREATMENT +compresión I-TREATMENT +con I-TREATMENT +balón I-TREATMENT +en I-TREATMENT +ganglio I-TREATMENT +de I-TREATMENT +Gasser I-TREATMENT +izquierdo I-TREATMENT +y I-TREATMENT +había I-TREATMENT +sido I-TREATMENT +tratada I-TREATMENT +con I-TREATMENT +carbamacepina I-TREATMENT +por I-TREATMENT +otros I-TREATMENT +médicos, I-TREATMENT +con I-TREATMENT +éxito I-TREATMENT +durante I-TREATMENT +un I-TREATMENT +año, I-TREATMENT +posterior I-TREATMENT +al I-TREATMENT +cual I-TREATMENT +reinicio I-TREATMENT +cuadro I-TREATMENT +de I-TREATMENT +mismas I-TREATMENT +característica. I-TREATMENT +La B-PAST_MEDICAL_HISTORY paciente I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -estar I-PAST_MEDICAL_HISTORY -asintomático, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -patologías I-PAST_MEDICAL_HISTORY -agregadas, I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +contaba I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -malos I-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -dietéticos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -bruxismo I-PAST_MEDICAL_HISTORY -diurno I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -nocturno. I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -en I-EXPLORATION -marzo I-EXPLORATION -del I-EXPLORATION -2008 I-EXPLORATION -mediante I-EXPLORATION -Tomografía I-EXPLORATION -Axial I-EXPLORATION -Computerizada I-EXPLORATION -(TAC) I-EXPLORATION -simple I-EXPLORATION -y I-EXPLORATION -contrastada I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -patología I-EXPLORATION -de I-EXPLORATION -tejidos I-EXPLORATION -blandos I-EXPLORATION -y I-EXPLORATION -duros I-EXPLORATION -tipo I-EXPLORATION -neoplasia, I-EXPLORATION -proceso I-EXPLORATION -infeccioso I-EXPLORATION -crónico I-EXPLORATION -o I-EXPLORATION -crecimiento I-EXPLORATION -óseo. I-EXPLORATION -Se I-EXPLORATION -diagnosticó I-EXPLORATION -finalmente I-EXPLORATION -como I-EXPLORATION -hipertrofia I-EXPLORATION -del I-EXPLORATION -músculo I-EXPLORATION -masetero I-EXPLORATION -bilateral, I-EXPLORATION -mayor I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lado I-EXPLORATION -izquierdo. I-EXPLORATION - I-EXPLORATION -Tomamos I-EXPLORATION -medidas I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -músculos I-EXPLORATION -maseteros I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -cortes I-EXPLORATION -tomográficos, I-EXPLORATION -de I-EXPLORATION -anterior I-EXPLORATION -a I-EXPLORATION -posterior I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -músculos I-EXPLORATION -maseteros I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -diámetro I-EXPLORATION -transverso I-EXPLORATION +historia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +trauma I-PAST_MEDICAL_HISTORY +craneal, I-PAST_MEDICAL_HISTORY +cambios I-PAST_MEDICAL_HISTORY +visuales, I-PAST_MEDICAL_HISTORY +tinnitus, I-PAST_MEDICAL_HISTORY +vértigo I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +pérdida I-PAST_MEDICAL_HISTORY +auditiva. I-PAST_MEDICAL_HISTORY +Había I-PAST_MEDICAL_HISTORY +perdido I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +kg I-PAST_MEDICAL_HISTORY +debido I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +disminución I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +ingesta I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alimentos I-PAST_MEDICAL_HISTORY +secundario I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +dolor. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +importancia. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +enfermedades I-PAST_MEDICAL_HISTORY +crónico-degenerativas. I-PAST_MEDICAL_HISTORY +La B-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +inicial I-EXPLORATION +era I-EXPLORATION +esencialmente I-EXPLORATION +normal. I-EXPLORATION +Contaba I-EXPLORATION con I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -resultados: I-EXPLORATION -1.40 I-EXPLORATION -cm, I-EXPLORATION -1.60 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -0.95 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -masetero I-EXPLORATION -derecho; I-EXPLORATION -1.83 I-EXPLORATION -cm, I-EXPLORATION -1.53 I-EXPLORATION -y I-EXPLORATION -1.13 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -músculo I-EXPLORATION -masetero I-EXPLORATION -izquierdo, I-EXPLORATION -ambos I-EXPLORATION -mayores I-EXPLORATION +exámenes I-EXPLORATION +generales I-EXPLORATION +normales, I-EXPLORATION +TAC I-EXPLORATION de I-EXPLORATION -lo I-EXPLORATION +cráneo I-EXPLORATION normal. I-EXPLORATION -Iniciamos B-TREATMENT -tratamiento I-TREATMENT -a I-TREATMENT -base I-TREATMENT -de I-TREATMENT -guarda I-TREATMENT -oclusal I-TREATMENT -nocturna I-TREATMENT -y I-TREATMENT -aplicación I-TREATMENT -de I-TREATMENT -toxina I-TREATMENT -botulínica I-TREATMENT -en I-TREATMENT -noviembre I-TREATMENT -del I-TREATMENT -2009, I-TREATMENT -de I-TREATMENT -acuerdo I-TREATMENT -al I-TREATMENT -protocolo I-TREATMENT -seleccionado. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -propuso I-TREATMENT -la I-TREATMENT -aplicación I-TREATMENT -de I-TREATMENT -toxina I-TREATMENT -botulínica. I-TREATMENT -La I-TREATMENT -Primera I-TREATMENT -aplicación I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -50 I-TREATMENT -U, I-TREATMENT -25 I-TREATMENT -de I-TREATMENT -las I-TREATMENT -cuales I-TREATMENT -se I-TREATMENT -aplicaron I-TREATMENT -en I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -de I-TREATMENT -mayor I-TREATMENT -hipertrofia I-TREATMENT -(zona I-TREATMENT -IV I-TREATMENT -descrita I-TREATMENT -por I-TREATMENT -Da-Hye I-TREATMENT -Kim), I-TREATMENT -15 I-TREATMENT -U I-TREATMENT -en I-TREATMENT -dirección I-TREATMENT -al I-TREATMENT -borde I-TREATMENT -inferior I-TREATMENT -mandibular I-TREATMENT -y I-TREATMENT -10 I-TREATMENT -U I-TREATMENT -por I-TREATMENT -encima I-TREATMENT -de I-TREATMENT -la I-TREATMENT -aplicación I-TREATMENT -previa I-TREATMENT -(correspondiente I-TREATMENT -a I-TREATMENT -zona I-TREATMENT -V I-TREATMENT -de I-TREATMENT -Da-Hye I-TREATMENT -Kim). I-TREATMENT -Con I-TREATMENT -esta I-TREATMENT -distribución I-TREATMENT -de I-TREATMENT -aplicación I-TREATMENT -en I-TREATMENT -los I-TREATMENT -puntos I-TREATMENT -propuestos I-TREATMENT -por I-TREATMENT -Nam-Ho I-TREATMENT -Kim I-TREATMENT -que I-TREATMENT -mejoran I-TREATMENT -el I-TREATMENT -contorno I-TREATMENT -mandibular, I-TREATMENT -se I-TREATMENT +Se B-TREATMENT realizó I-TREATMENT -marcaje I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -piel I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -ambos I-TREATMENT -músculos I-TREATMENT -maseteros I-TREATMENT -(5). I-TREATMENT -Para I-TREATMENT -la I-TREATMENT -preparación I-TREATMENT -del I-TREATMENT -producto I-TREATMENT -se I-TREATMENT -utilizó I-TREATMENT -una I-TREATMENT -aguja I-TREATMENT -gruesa I-TREATMENT -(18G) I-TREATMENT -con I-TREATMENT -el I-TREATMENT -fin I-TREATMENT -de I-TREATMENT -evitar I-TREATMENT -la I-TREATMENT -formación I-TREATMENT -de I-TREATMENT -turbulencias. I-TREATMENT -El I-TREATMENT -alcohol, I-TREATMENT -usado I-TREATMENT -ya I-TREATMENT -sea I-TREATMENT -en I-TREATMENT -el I-TREATMENT -tapón I-TREATMENT -del I-TREATMENT -vial I-TREATMENT -o I-TREATMENT -bien I-TREATMENT -en I-TREATMENT -la I-TREATMENT -piel I-TREATMENT -del I-TREATMENT -paciente, I-TREATMENT -debe I-TREATMENT -evaporarse I-TREATMENT -completamente I-TREATMENT -antes I-TREATMENT -de I-TREATMENT -aplicar I-TREATMENT -la I-TREATMENT -toxina I-TREATMENT -dado I-TREATMENT -que I-TREATMENT -también I-TREATMENT -puede I-TREATMENT -inactivarla. I-TREATMENT -A I-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -que I-TREATMENT -el I-TREATMENT -vial I-TREATMENT -puede I-TREATMENT -reconstituirse I-TREATMENT -a I-TREATMENT -una I-TREATMENT -dilución I-TREATMENT -de I-TREATMENT -8 I-TREATMENT -cc/100 I-TREATMENT -U, I-TREATMENT -preferimos I-TREATMENT -la I-TREATMENT -dilución I-TREATMENT -en I-TREATMENT -4 I-TREATMENT -cc. I-TREATMENT -a I-TREATMENT -fin I-TREATMENT -de I-TREATMENT -conseguir I-TREATMENT -una I-TREATMENT -dosificación I-TREATMENT -de I-TREATMENT -2.5 I-TREATMENT -U/0.1 I-TREATMENT -cc. I-TREATMENT -El I-TREATMENT -obtener I-TREATMENT -de I-TREATMENT -esta I-TREATMENT -forma I-TREATMENT -un I-TREATMENT -volumen I-TREATMENT -menor, I-TREATMENT -limitará I-TREATMENT -la I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -que I-TREATMENT -la I-TREATMENT -toxina I-TREATMENT -difunda I-TREATMENT -hacia I-TREATMENT -las I-TREATMENT -zonas I-TREATMENT -adyacentes. I-TREATMENT -Es I-TREATMENT -importante I-TREATMENT -recordar I-TREATMENT -que I-TREATMENT -una I-TREATMENT -vez I-TREATMENT -realizada I-TREATMENT -la I-TREATMENT -reconstitución, I-TREATMENT -el I-TREATMENT -producto I-TREATMENT -deberá I-TREATMENT -utilizarse I-TREATMENT -en I-TREATMENT -el I-TREATMENT -plazo I-TREATMENT -de I-TREATMENT -las I-TREATMENT -4 I-TREATMENT -horas I-TREATMENT -siguientes I-TREATMENT -para I-TREATMENT -evitar I-TREATMENT -pérdida I-TREATMENT +bloqueo I-TREATMENT de I-TREATMENT -eficacia, I-TREATMENT -aunque I-TREATMENT -algunos I-TREATMENT -autores I-TREATMENT -señalan I-TREATMENT -que I-TREATMENT -se I-TREATMENT -puede I-TREATMENT -utilizar I-TREATMENT -sin I-TREATMENT -disminuir I-TREATMENT -su I-TREATMENT -eficacia I-TREATMENT -dentro I-TREATMENT +ganglio I-TREATMENT de I-TREATMENT -los I-TREATMENT -3 I-TREATMENT -a I-TREATMENT -7 I-TREATMENT -días I-TREATMENT -posteriores. I-TREATMENT - I-TREATMENT -Para I-TREATMENT -disminuir I-TREATMENT -las I-TREATMENT -molestias I-TREATMENT -y I-TREATMENT -que I-TREATMENT -la I-TREATMENT -aplicación I-TREATMENT -sea I-TREATMENT -segura I-TREATMENT -utilizamos I-TREATMENT -una I-TREATMENT -aguja I-TREATMENT -fina I-TREATMENT -(30G). I-TREATMENT -Es I-TREATMENT -importante I-TREATMENT -insistir I-TREATMENT -en I-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -no I-TREATMENT -debe I-TREATMENT -tomar I-TREATMENT -medicamentos I-TREATMENT -que I-TREATMENT -interfieran I-TREATMENT +Gasser I-TREATMENT con I-TREATMENT -la I-TREATMENT -coagulación I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -a I-TREATMENT -14 I-TREATMENT -días I-TREATMENT -antes I-TREATMENT -de I-TREATMENT -la I-TREATMENT -inyección I-TREATMENT -para I-TREATMENT -evitar I-TREATMENT -equímosis. I-TREATMENT -También I-TREATMENT -solicitamos I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -la I-TREATMENT -correspondiente I-TREATMENT -autorización I-TREATMENT -para I-TREATMENT -llevar I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -el I-TREATMENT -procedimiento I-TREATMENT -mediante I-TREATMENT -un I-TREATMENT -consentimiento I-TREATMENT -informado I-TREATMENT -específico, I-TREATMENT -tal I-TREATMENT +fenol I-TREATMENT y I-TREATMENT -como I-TREATMENT -habitualmente I-TREATMENT -hacemos I-TREATMENT +se I-TREATMENT +inicio I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -cualquier I-TREATMENT -procedimiento I-TREATMENT -invasivo. I-TREATMENT - I-TREATMENT -Para I-TREATMENT -las I-TREATMENT -aplicaciones I-TREATMENT -posteriores I-TREATMENT -citamos I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -semanas I-TREATMENT -(3 I-TREATMENT -meses), I-TREATMENT -utilizando I-TREATMENT -la I-TREATMENT -misma I-TREATMENT -técnica I-TREATMENT +carbamacepina I-TREATMENT +200 I-TREATMENT +mg I-TREATMENT +c-12 I-TREATMENT +hrs I-TREATMENT y I-TREATMENT -completando I-TREATMENT -hasta I-TREATMENT -un I-TREATMENT -total I-TREATMENT -de I-TREATMENT -4 I-TREATMENT -aplicaciones. I-TREATMENT -Se I-TREATMENT -sabe I-TREATMENT -que I-TREATMENT -al I-TREATMENT -utilizar I-TREATMENT -toxina I-TREATMENT -botulínica I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -repetitiva I-TREATMENT -se I-TREATMENT -causa I-TREATMENT -atrofia I-TREATMENT -en I-TREATMENT -los I-TREATMENT -grupos I-TREATMENT -musculares I-TREATMENT -infiltrados, I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -hace I-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -presente I-TREATMENT +gabapentina I-TREATMENT +300 I-TREATMENT +mg I-TREATMENT +c-12 I-TREATMENT +hrs, I-TREATMENT +presentó I-TREATMENT mejoría I-TREATMENT -clínica. I-TREATMENT -También I-TREATMENT -se I-TREATMENT -indicó I-TREATMENT -continuar I-TREATMENT -con I-TREATMENT -el I-TREATMENT -uso I-TREATMENT -de I-TREATMENT -la I-TREATMENT -guarda I-TREATMENT -oclusal I-TREATMENT -nocturna I-TREATMENT -para I-TREATMENT -controlar I-TREATMENT -el I-TREATMENT -bruxismo. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -sufre I-PRESENT_ILLNESS -herida I-PRESENT_ILLNESS -traumática I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -dorso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mano I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -quedar I-PRESENT_ILLNESS -atrapada I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -cinta I-PRESENT_ILLNESS -transportadora I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -empresa I-PRESENT_ILLNESS -cárnica, I-PRESENT_ILLNESS -presentando I-PRESENT_ILLNESS -importante I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -piel I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -arrancamiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -tendones I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -músculo I-PRESENT_ILLNESS -extensor I-PRESENT_ILLNESS -común I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -unión I-PRESENT_ILLNESS -miotendinosa. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-TREATMENT -un I-TREATMENT -primer I-TREATMENT -acto I-TREATMENT -quirúrgico I-TREATMENT -de I-TREATMENT -urgencia I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -limpieza I-TREATMENT -exhaustiva, I-TREATMENT -cierre I-TREATMENT -de I-TREATMENT -la I-TREATMENT -herida I-TREATMENT +24 I-TREATMENT +hrs I-TREATMENT y I-TREATMENT -cobertura I-TREATMENT -antibiótica, I-TREATMENT -postponiendo I-TREATMENT -la I-TREATMENT -cirugía I-TREATMENT -reconstructiva I-TREATMENT -dado I-TREATMENT -el I-TREATMENT -alto I-TREATMENT -riesgo I-TREATMENT -de I-TREATMENT -infección. I-TREATMENT -Tras B-EVOLUTION -una I-EVOLUTION -semana I-EVOLUTION +reinició I-TREATMENT +sintomatología. I-TREATMENT +Evolucionó B-EVOLUTION +sin I-EVOLUTION +control I-EVOLUTION +y I-EVOLUTION +al I-EVOLUTION +reexplorar I-EVOLUTION +se I-EVOLUTION +encontró I-EVOLUTION +punto I-EVOLUTION +doloroso I-EVOLUTION +bajo I-EVOLUTION +mastoides I-EVOLUTION +del I-EVOLUTION +lado I-EVOLUTION +izquierdo I-EVOLUTION y I-EVOLUTION +dolor I-EVOLUTION +exacerbado I-EVOLUTION a I-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -medidas I-EVOLUTION -profilácticas, I-EVOLUTION -la I-EVOLUTION -herida I-EVOLUTION -sufrió I-EVOLUTION -una I-EVOLUTION -infección I-EVOLUTION -por I-EVOLUTION -microorganismos I-EVOLUTION -anaerobios I-EVOLUTION -que B-TREATMENT -se I-TREATMENT -trató I-TREATMENT -con I-TREATMENT -desbridamiento I-TREATMENT -quirúrgico, I-TREATMENT -antibiotepia I-TREATMENT -y I-TREATMENT -cámara I-TREATMENT -hiperbárica I-TREATMENT -durante I-TREATMENT -3 I-TREATMENT -semanas. I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -resuelta I-TREATMENT -la I-TREATMENT -infección I-TREATMENT -se I-TREATMENT -programó I-TREATMENT -para I-TREATMENT -transferencia I-TREATMENT -tendinosa, I-TREATMENT -pero I-TREATMENT -en I-TREATMENT -el I-TREATMENT -acto I-TREATMENT -quirúrgico I-TREATMENT -se I-TREATMENT -encontró I-TREATMENT -necrosis I-TREATMENT -de I-TREATMENT -los I-TREATMENT -tendones I-TREATMENT -extensores I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -resecar I-TREATMENT -hasta I-TREATMENT -tejido I-TREATMENT -viable I-TREATMENT -y I-TREATMENT -utilizar I-TREATMENT -varillas I-TREATMENT -de I-TREATMENT -silicona I-TREATMENT -en I-TREATMENT -un I-TREATMENT -primer I-TREATMENT -tiempo I-TREATMENT -con I-TREATMENT -vistas I-TREATMENT -a I-TREATMENT -un I-TREATMENT -posterior I-TREATMENT -injerto I-TREATMENT -tendinoso. I-TREATMENT - I-TREATMENT -Al B-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION la I-EVOLUTION -implantación I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -varillas, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentaba I-EVOLUTION -una I-EVOLUTION -severa I-EVOLUTION -limitación I-EVOLUTION +flexión I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -movilidad I-EVOLUTION -que I-EVOLUTION -contraindicaba I-EVOLUTION -el I-EVOLUTION -injerto I-EVOLUTION -tendinoso, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -tras I-TREATMENT -confirmar I-TREATMENT -mediante I-TREATMENT -doppler I-TREATMENT -la I-TREATMENT -permeabilidad I-TREATMENT -tanto I-TREATMENT -de I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -tibial I-TREATMENT -posterior I-TREATMENT -como I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tibial I-TREATMENT -anterior, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -utilizar I-TREATMENT -el I-TREATMENT -colgajo I-TREATMENT -vascularizado I-TREATMENT -de I-TREATMENT -dorsalis I-TREATMENT -pedis I-TREATMENT -para I-TREATMENT -la I-TREATMENT -reconstrucción I-TREATMENT -funcional I-TREATMENT -completa. I-TREATMENT -Se I-TREATMENT +cuello. I-EVOLUTION +Se B-TREATMENT realizó I-TREATMENT -anastomosis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -dorsal I-TREATMENT -del I-TREATMENT -pie I-TREATMENT -a I-TREATMENT -la I-TREATMENT -radial, I-TREATMENT +bloqueo I-TREATMENT de I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -safena I-TREATMENT -a I-TREATMENT -una I-TREATMENT -vena I-TREATMENT +plexo I-TREATMENT +cervical I-TREATMENT superficial I-TREATMENT -del I-TREATMENT -antebrazo, I-TREATMENT +con I-TREATMENT +lidocaína I-TREATMENT +al I-TREATMENT +2% I-TREATMENT +simple I-TREATMENT y I-TREATMENT -la I-TREATMENT -correspondiente I-TREATMENT -sutura I-TREATMENT -tendinosa. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -inmovilizó I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -donante I-TREATMENT -durante I-TREATMENT -10 I-TREATMENT -días I-TREATMENT +C2 I-TREATMENT +izquierdo I-TREATMENT con I-TREATMENT -férula I-TREATMENT -de I-TREATMENT -yeso, I-TREATMENT -lo I-TREATMENT -suficiente I-TREATMENT -para I-TREATMENT -que I-TREATMENT -el I-TREATMENT -injerto I-TREATMENT -prendiera. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -comenzó I-EVOLUTION -entonces I-EVOLUTION -a I-EVOLUTION -deambular I-EVOLUTION -libremente I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -vendaje I-EVOLUTION -simple I-EVOLUTION -del I-EVOLUTION -área I-EVOLUTION -y I-EVOLUTION -no I-EVOLUTION -sufrió I-EVOLUTION -complicaciones. I-EVOLUTION -Tras I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -postoperatorio, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -refería I-EVOLUTION -anestesia I-EVOLUTION -exclusivamente I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -área I-EVOLUTION -donante I-EVOLUTION -del I-EVOLUTION -colgajo. I-EVOLUTION - I-EVOLUTION -La B-TREATMENT -mano I-TREATMENT -se I-TREATMENT -inmovilizó I-TREATMENT -durante I-TREATMENT -4 I-TREATMENT -semanas I-TREATMENT +lidocaína I-TREATMENT +al I-TREATMENT +1% I-TREATMENT +simple I-TREATMENT y I-TREATMENT -se I-TREATMENT -llevó I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -rehabilitación I-TREATMENT +alcohol I-TREATMENT +puro I-TREATMENT con I-TREATMENT -ejercicios I-TREATMENT -activos I-TREATMENT -protegidos I-TREATMENT -durante I-TREATMENT -8 I-TREATMENT -semanas, I-TREATMENT -obteniendo I-TREATMENT -un I-TREATMENT -resultado I-TREATMENT -funcional I-TREATMENT -satisfactorio I-TREATMENT -y B-EVOLUTION -reincorporación I-EVOLUTION -del I-EVOLUTION +mejoría I-TREATMENT +inmediata, I-TREATMENT +desapareciendo I-TREATMENT +el I-TREATMENT +dolor. I-TREATMENT +La B-EXPLORATION +RMN I-EXPLORATION +mostró I-EXPLORATION +estenosis I-EXPLORATION +del I-EXPLORATION +conducto I-EXPLORATION +cervical. I-EXPLORATION +La B-EVOLUTION paciente I-EVOLUTION -al I-EVOLUTION -trabajo I-EVOLUTION -3 I-EVOLUTION +permanece I-EVOLUTION +asintomática I-EVOLUTION +7 I-EVOLUTION meses I-EVOLUTION después I-EVOLUTION +al I-EVOLUTION +procedimiento, I-EVOLUTION +hasta I-EVOLUTION +el I-EVOLUTION +momento I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION - I-EVOLUTION +éste I-EVOLUTION +reporte I-EVOLUTION +sin I-EVOLUTION +necesidad I-EVOLUTION +de I-EVOLUTION +realizar I-EVOLUTION +nuevo I-EVOLUTION +bloqueo. I-EVOLUTION +La B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +enviada I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +columna I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +completar I-DERIVED_FROM/TO +tratamiento. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO -Varón B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -37 I-PRESENT_ILLNESS +52 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY +sin B-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +interés I-FAMILY_HISTORY +oncológico I-FAMILY_HISTORY +y B-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY personales I-PAST_MEDICAL_HISTORY -de B-PRESENT_ILLNESS -interés, I-PRESENT_ILLNESS -remitido I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS +había I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +intervenida I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +túnel I-PAST_MEDICAL_HISTORY +carpiano I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +mano I-PAST_MEDICAL_HISTORY +izquierda I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +nódulos I-PAST_MEDICAL_HISTORY +mamarios I-PAST_MEDICAL_HISTORY +benignos. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +momento I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +diagnostico I-PAST_MEDICAL_HISTORY +estaba I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +suplementos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +calcio I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +calcitonina I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +osteoporosis. I-PAST_MEDICAL_HISTORY +Desde B-PRESENT_ILLNESS +noviembre I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS +1999 I-PRESENT_ILLNESS +notaba I-PRESENT_ILLNESS +perdida I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS +visión I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -compartimento I-PRESENT_ILLNESS -posterior I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -miembro I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -dolorosa I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -últimas I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -cuando I-PRESENT_ILLNESS -comienza I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +izquierdo, I-PRESENT_ILLNESS +junto I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -dolor, I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -velocidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -crecimiento, I-PRESENT_ILLNESS -impotencia I-PRESENT_ILLNESS -funcional I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +ocular I-PRESENT_ILLNESS +ocasional I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -parestesias. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION +conjuntivitis I-PRESENT_ILLNESS +bilateral. I-PRESENT_ILLNESS +Vista B-EXPLORATION +por I-EXPLORATION +oftalmología I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -región I-EXPLORATION -posterior I-EXPLORATION +exploración I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -pierna I-EXPLORATION -izquierda I-EXPLORATION +fondo I-EXPLORATION de I-EXPLORATION -aproximadamente I-EXPLORATION -15 I-EXPLORATION -cm I-EXPLORATION +ojo I-EXPLORATION +"edema I-EXPLORATION de I-EXPLORATION -diámetro, I-EXPLORATION -con I-EXPLORATION -distensión I-EXPLORATION +papila" I-EXPLORATION +unilateral I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -compartimentos I-EXPLORATION -posteriores I-EXPLORATION -y I-EXPLORATION -laterales. I-EXPLORATION -Asimismo, I-EXPLORATION -refería I-EXPLORATION -parestesias I-EXPLORATION -discontinuas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -extremidad I-EXPLORATION -afecta I-EXPLORATION -e I-EXPLORATION -hiperestesia I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -pulpejo I-EXPLORATION -del I-EXPLORATION -primer I-EXPLORATION -dedo I-EXPLORATION -del I-EXPLORATION -pie I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -peronea. I-EXPLORATION -La I-EXPLORATION -vascularización I-EXPLORATION -del I-EXPLORATION -miembro I-EXPLORATION -estaba I-EXPLORATION -indemne, I-EXPLORATION -presentando I-EXPLORATION -pulsos I-EXPLORATION -poplíteos, I-EXPLORATION -tibial I-EXPLORATION -posterior I-EXPLORATION -y I-EXPLORATION -pedio I-EXPLORATION -conservados. I-EXPLORATION +ojo I-EXPLORATION +izquierdo. I-EXPLORATION No I-EXPLORATION -obstante, I-EXPLORATION -constatamos I-EXPLORATION -una I-EXPLORATION -mayor I-EXPLORATION -frialdad I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +alteración I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -pie I-EXPLORATION -izquierdo I-EXPLORATION -con I-EXPLORATION -respecto I-EXPLORATION -al I-EXPLORATION -contralateral. I-EXPLORATION - I-EXPLORATION -Realizamos I-EXPLORATION -Trucut I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -con I-EXPLORATION -resultado I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -sarcoma I-EXPLORATION -fusocelular I-EXPLORATION -de I-EXPLORATION -alto I-EXPLORATION -grado I-EXPLORATION -(sarcoma I-EXPLORATION -sinovial). I-EXPLORATION -La I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION -(RMN) I-EXPLORATION -informó I-EXPLORATION +los I-EXPLORATION +movimientos I-EXPLORATION +oculares I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +ambas I-EXPLORATION +órbitas. I-EXPLORATION +Se I-EXPLORATION +realizaron I-EXPLORATION +las I-EXPLORATION +siguientes I-EXPLORATION +exploraciones I-EXPLORATION +complementarias. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +TC I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION +órbita: I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -pierna I-EXPLORATION +vértice I-EXPLORATION +de I-EXPLORATION +órbita I-EXPLORATION izquierda I-EXPLORATION -que I-EXPLORATION -afectaba I-EXPLORATION -a I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -espesor I-EXPLORATION -del I-EXPLORATION -músculo I-EXPLORATION -sóleo, I-EXPLORATION -marcadamente I-EXPLORATION -heterogénea, I-EXPLORATION -multinodular I-EXPLORATION y I-EXPLORATION -polilobulada, I-EXPLORATION +en I-EXPLORATION +íntimo I-EXPLORATION +contacto I-EXPLORATION +con I-EXPLORATION +nervio I-EXPLORATION +óptico, I-EXPLORATION +se I-EXPLORATION +visualiza I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION de I-EXPLORATION -14x10x7 I-EXPLORATION +1 I-EXPLORATION cm I-EXPLORATION de I-EXPLORATION diámetro I-EXPLORATION -máximo, I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -sangrado I-EXPLORATION -reciente. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -parte I-EXPLORATION -posterior, I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -comprime I-EXPLORATION -y I-EXPLORATION -desplaza I-EXPLORATION -los I-EXPLORATION -vientres I-EXPLORATION -musculares I-EXPLORATION +mayor I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -gemelos I-EXPLORATION -interno I-EXPLORATION -y I-EXPLORATION -externo, I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION +localización I-EXPLORATION +intraconal I-EXPLORATION que I-EXPLORATION -contacta I-EXPLORATION -sin I-EXPLORATION -planos I-EXPLORATION -grasos, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -parte I-EXPLORATION -anterior I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -poplíteo, I-EXPLORATION -tibial I-EXPLORATION -posterior I-EXPLORATION +captaba I-EXPLORATION +contraste I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +intensa I-EXPLORATION y I-EXPLORATION -flexor I-EXPLORATION -común I-EXPLORATION +homogénea, I-EXPLORATION +observándose I-EXPLORATION +un I-EXPLORATION +engrosamiento I-EXPLORATION +difuso I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -dedos. I-EXPLORATION -Anterocaudalmente, I-EXPLORATION la I-EXPLORATION -masa I-EXPLORATION -infiltra I-EXPLORATION -el I-EXPLORATION -polo I-EXPLORATION -superior I-EXPLORATION -del I-EXPLORATION -flexor I-EXPLORATION +vaina I-EXPLORATION del I-EXPLORATION -primer I-EXPLORATION -dedo. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -respecto I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -estructuras I-EXPLORATION -óseas I-EXPLORATION -observamos I-EXPLORATION +nervio I-EXPLORATION +óptico I-EXPLORATION +formando I-EXPLORATION una I-EXPLORATION -estrecha I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -diáfisis I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tibia I-EXPLORATION -y, I-EXPLORATION -aunque I-EXPLORATION -se I-EXPLORATION -mantienen I-EXPLORATION -los I-EXPLORATION -planos I-EXPLORATION -grasos, I-EXPLORATION -el I-EXPLORATION -espesor I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -interpuesto I-EXPLORATION -entre I-EXPLORATION -ambas I-EXPLORATION -estructuras I-EXPLORATION -es I-EXPLORATION -inferior I-EXPLORATION -a I-EXPLORATION -1cm. I-EXPLORATION -En I-EXPLORATION -cuanto I-EXPLORATION -al I-EXPLORATION -peroné, I-EXPLORATION -el I-EXPLORATION -tumor I-EXPLORATION -lo I-EXPLORATION -engloba I-EXPLORATION -semicircularmente I-EXPLORATION +imagen I-EXPLORATION en I-EXPLORATION -una I-EXPLORATION -extensión I-EXPLORATION +"railes I-EXPLORATION de I-EXPLORATION -unos I-EXPLORATION -12 I-EXPLORATION -cm. I-EXPLORATION -A I-EXPLORATION -pesar I-EXPLORATION +tranvía". I-EXPLORATION +No I-EXPLORATION +había I-EXPLORATION +evidencia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -estrecha I-EXPLORATION -relación I-EXPLORATION +agrandamiento I-EXPLORATION del I-EXPLORATION -tumor I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -tibia I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -peroné, I-EXPLORATION +agujero I-EXPLORATION +óptico I-EXPLORATION +ni I-EXPLORATION +invasión I-EXPLORATION +intracraneal; I-EXPLORATION no I-EXPLORATION -observamos I-EXPLORATION -signos I-EXPLORATION -sugestivos I-EXPLORATION +se I-EXPLORATION +aprecian I-EXPLORATION +erosiones I-EXPLORATION +óseas. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +RMN I-EXPLORATION +cerebral I-EXPLORATION +y I-EXPLORATION de I-EXPLORATION -infiltración I-EXPLORATION -ósea. I-EXPLORATION -En I-EXPLORATION -relación I-EXPLORATION -a I-EXPLORATION +órbita: I-EXPLORATION +masa I-EXPLORATION +de I-EXPLORATION +señal I-EXPLORATION +isointensa I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +parénquima I-EXPLORATION +cerebral I-EXPLORATION +en I-EXPLORATION +todas I-EXPLORATION las I-EXPLORATION -estructuras I-EXPLORATION -vasculares, I-EXPLORATION -apreciamos I-EXPLORATION -cómo I-EXPLORATION +secuencias I-EXPLORATION +que I-EXPLORATION +ocupa I-EXPLORATION el I-EXPLORATION -polo I-EXPLORATION -superior I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -llega I-EXPLORATION -a I-EXPLORATION -contactar I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -poplítea I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION +agujero I-EXPLORATION +óptico I-EXPLORATION +izquierdo I-EXPLORATION +y I-EXPLORATION +que I-EXPLORATION +mostraba I-EXPLORATION +captación I-EXPLORATION +intensa I-EXPLORATION +y I-EXPLORATION +homogénea I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -bifurcación I-EXPLORATION +contraste. I-EXPLORATION +La I-EXPLORATION +lesión I-EXPLORATION +englobaba I-EXPLORATION +el I-EXPLORATION +nervio I-EXPLORATION +óptico I-EXPLORATION +izquierdo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +encuentra I-EXPLORATION +discretamente I-EXPLORATION +comprimido. I-EXPLORATION +El I-EXPLORATION +tamaño I-EXPLORATION +aproximado I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -salida I-EXPLORATION -del I-EXPLORATION -tronco I-EXPLORATION -tibial I-EXPLORATION -anterior, I-EXPLORATION -pasando I-EXPLORATION -a I-EXPLORATION -englobar I-EXPLORATION -distalmente I-EXPLORATION -al I-EXPLORATION -tronco I-EXPLORATION -tibio-peroneo I-EXPLORATION -con I-EXPLORATION -repermeabilización I-EXPLORATION -distal I-EXPLORATION +lesión I-EXPLORATION +era I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -vasos I-EXPLORATION -peroneos. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -resumen, I-EXPLORATION +2x1x1 I-EXPLORATION +cm. I-EXPLORATION +Los I-EXPLORATION +hallazgos I-EXPLORATION +radiológicos I-EXPLORATION +sugerían I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +meningioma I-EXPLORATION +aunque I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -trata I-EXPLORATION +podían I-EXPLORATION +descartar I-EXPLORATION +otras I-EXPLORATION +posibilidades I-EXPLORATION +como I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION +la I-EXPLORATION +vaina I-EXPLORATION +nerviosa. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Estudio I-EXPLORATION +oftalmológico: I-EXPLORATION +mostró I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -musculatura I-EXPLORATION -sólea I-EXPLORATION -izquierda I-EXPLORATION -de I-EXPLORATION -14 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -máximo I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -sarcoma I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +una I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -infiltración I-EXPLORATION -vascular I-EXPLORATION +la I-EXPLORATION +visión I-EXPLORATION +a I-EXPLORATION +1/10 I-EXPLORATION y I-EXPLORATION -de I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +campimétrico I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +déficit I-EXPLORATION +en I-EXPLORATION +ojo I-EXPLORATION +izquierdo I-EXPLORATION +conservando I-EXPLORATION +parcialmente I-EXPLORATION la I-EXPLORATION -musculatura I-EXPLORATION -adyacente. I-EXPLORATION +visión I-EXPLORATION +en I-EXPLORATION +cuadrante I-EXPLORATION +superior I-EXPLORATION +interno. I-EXPLORATION I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -intervenido I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general I-TREATMENT -y I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -fue I-TREATMENT -realizada I-TREATMENT +Valorado B-TREATMENT por I-TREATMENT -un I-TREATMENT -único I-TREATMENT -equipo I-TREATMENT -quirúrgico I-TREATMENT -que I-TREATMENT -practicó I-TREATMENT -tanto I-TREATMENT -la I-TREATMENT -resección I-TREATMENT -tumoral I-TREATMENT -como I-TREATMENT -la I-TREATMENT -posterior I-TREATMENT -reconstrucción. I-TREATMENT - I-TREATMENT -Comenzamos I-TREATMENT -con I-TREATMENT el I-TREATMENT -colgajo I-TREATMENT -plantar I-TREATMENT -disecando I-TREATMENT +Comité I-TREATMENT +de I-TREATMENT +Radiocirugía I-TREATMENT +(RC) I-TREATMENT +se I-TREATMENT +aceptó I-TREATMENT +el I-TREATMENT +caso I-TREATMENT +para I-TREATMENT +RTEF, I-TREATMENT +siendo I-TREATMENT +irradiado I-TREATMENT +con I-TREATMENT un I-TREATMENT -colgajo I-TREATMENT -fileteado I-TREATMENT -B3 I-TREATMENT +Acelerador I-TREATMENT +Lineal I-TREATMENT +con I-TREATMENT +fotones I-TREATMENT de I-TREATMENT -Künstcher I-TREATMENT -(6) I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT +6 I-TREATMENT +Mv, I-TREATMENT con I-TREATMENT -la I-TREATMENT -amputación I-TREATMENT -infracondilea I-TREATMENT -incluyendo I-TREATMENT -la I-TREATMENT -cortical I-TREATMENT -posterior I-TREATMENT +colimadores I-TREATMENT +cónicos I-TREATMENT de I-TREATMENT -la I-TREATMENT -tibia. I-TREATMENT -Realizamos I-TREATMENT -anastomosis I-TREATMENT -términoterminales I-TREATMENT -(T-T) I-TREATMENT -a I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -poplítea I-TREATMENT -y I-TREATMENT -a I-TREATMENT -ambas I-TREATMENT -safenas I-TREATMENT +10 I-TREATMENT y I-TREATMENT -neurorrafia I-TREATMENT -entre I-TREATMENT -ciático I-TREATMENT -poplíteo I-TREATMENT -externo I-TREATMENT +25 I-TREATMENT +mm, I-TREATMENT +con I-TREATMENT +2 I-TREATMENT +isocentros, I-TREATMENT +administrándose I-TREATMENT +8 I-TREATMENT +arcos I-TREATMENT +esterotáxicos I-TREATMENT y I-TREATMENT -tibial I-TREATMENT -posterior. I-TREATMENT - B-EVOLUTION -En I-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -inmediato I-EVOLUTION -el I-EVOLUTION +una I-TREATMENT +dosis I-TREATMENT +total I-TREATMENT +de I-TREATMENT +52, I-TREATMENT +2 I-TREATMENT +Gy I-TREATMENT +en I-TREATMENT +fracciones I-TREATMENT +de I-TREATMENT +1, I-TREATMENT +8 I-TREATMENT +Gy, I-TREATMENT +hasta I-TREATMENT +un I-TREATMENT +total I-TREATMENT +de I-TREATMENT +29 I-TREATMENT +fracciones. I-TREATMENT +Se I-TREATMENT +eligió I-TREATMENT +como I-TREATMENT +referencia I-TREATMENT +la I-TREATMENT +Isodosis I-TREATMENT +de I-TREATMENT +Cubrimiento I-TREATMENT +del I-TREATMENT +80%. I-TREATMENT + I-TREATMENT +La B-EVOLUTION paciente I-EVOLUTION -no I-EVOLUTION -presentó I-EVOLUTION -alteración I-EVOLUTION -hemodinámica I-EVOLUTION -alguna I-EVOLUTION +respondió I-EVOLUTION +clínicamente I-EVOLUTION +con I-EVOLUTION +la I-EVOLUTION +desaparición I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +sintomatología I-EVOLUTION +dolorosa I-EVOLUTION +orbitaria I-EVOLUTION y I-EVOLUTION el I-EVOLUTION -colgajo I-EVOLUTION -evolucionó I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -favorable I-EVOLUTION -sin I-EVOLUTION -necesidad I-EVOLUTION +exoftalmos I-EVOLUTION +ya I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +primer I-EVOLUTION +control I-EVOLUTION +semestral. I-EVOLUTION +Las I-EVOLUTION +exploraciones I-EVOLUTION +con I-EVOLUTION +RMN I-EVOLUTION +confirmaron I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +primer I-EVOLUTION +control I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +seis I-EVOLUTION +meses I-EVOLUTION +una I-EVOLUTION +evolución I-EVOLUTION +favorable, I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +disminución I-EVOLUTION +significativa I-EVOLUTION +del I-EVOLUTION +tamaño I-EVOLUTION +tumoral, I-EVOLUTION +quedando I-EVOLUTION +zonas I-EVOLUTION de I-EVOLUTION -revisión I-EVOLUTION -microquirúrgica I-EVOLUTION +captación I-EVOLUTION +alrededor I-EVOLUTION del I-EVOLUTION -mismo I-EVOLUTION +agujero I-EVOLUTION +óptico, I-EVOLUTION +sugestivas I-EVOLUTION +de I-EVOLUTION +restos I-EVOLUTION +tumorales I-EVOLUTION +de I-EVOLUTION +meningioma I-EVOLUTION +que I-EVOLUTION +han I-EVOLUTION +permanecido I-EVOLUTION +estables I-EVOLUTION en I-EVOLUTION los I-EVOLUTION -días I-EVOLUTION -posteriores I-EVOLUTION +controles I-EVOLUTION +posteriores. I-EVOLUTION +Los I-EVOLUTION +estudios I-EVOLUTION +oftalmológicos I-EVOLUTION +demostraron I-EVOLUTION +mejora I-EVOLUTION +de I-EVOLUTION +cierto I-EVOLUTION +grado I-EVOLUTION +de I-EVOLUTION +visión, I-EVOLUTION +situación I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +ha I-EVOLUTION +mantenido I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +paso I-EVOLUTION +del I-EVOLUTION +tiempo. I-EVOLUTION +La I-EVOLUTION +paciente I-EVOLUTION +ha I-EVOLUTION +sido I-EVOLUTION +etiquetada I-EVOLUTION +en I-EVOLUTION +remisión I-EVOLUTION +clínica I-EVOLUTION +parcial/completa. I-EVOLUTION +No I-EVOLUTION +ha I-EVOLUTION +presentado I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +toxicidad I-EVOLUTION a I-EVOLUTION +nivel I-EVOLUTION +de I-EVOLUTION la I-EVOLUTION -intervención. I-EVOLUTION +vía I-EVOLUTION +óptica I-EVOLUTION +hasta I-EVOLUTION +el I-EVOLUTION +momento I-EVOLUTION +actual. I-EVOLUTION I-EVOLUTION -El B-EXPLORATION -resultado I-EXPLORATION -anatomopatológico I-EXPLORATION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +62 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +edemas I-PRESENT_ILLNESS +progresivos I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +ambas I-PRESENT_ILLNESS +extremidades I-PRESENT_ILLNESS +inferiores, I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +genital I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +inguinal I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +aproximadamente I-PRESENT_ILLNESS +siete I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +ninguna I-PRESENT_ILLNESS +otra I-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS +acompañante. I-PRESENT_ILLNESS +Entre B-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +sólo I-PAST_MEDICAL_HISTORY +constaban I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +cólicos I-PAST_MEDICAL_HISTORY +nefríticos I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +complicados. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +llamaba I-EXPLORATION +la I-EXPLORATION +atención I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +edema I-EXPLORATION de I-EXPLORATION +consistencia I-EXPLORATION +dura I-EXPLORATION +en I-EXPLORATION +zona I-EXPLORATION +púbica, I-EXPLORATION +incluyendo I-EXPLORATION +pene, I-EXPLORATION +escroto I-EXPLORATION +y I-EXPLORATION +región I-EXPLORATION +inguinal, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +extendía I-EXPLORATION +por I-EXPLORATION +ambas I-EXPLORATION +extremidades I-EXPLORATION +inferiores I-EXPLORATION +siendo I-EXPLORATION +más I-EXPLORATION +evidente I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -pieza I-EXPLORATION -extirpada I-EXPLORATION -resultó I-EXPLORATION -ser I-EXPLORATION +izquierda, I-EXPLORATION +sin I-EXPLORATION +fovea. I-EXPLORATION +No I-EXPLORATION +existían I-EXPLORATION +lesiones I-EXPLORATION +cutáneas, I-EXPLORATION +ni I-EXPLORATION +adenopatías I-EXPLORATION +laterocervicales I-EXPLORATION +o I-EXPLORATION +axilares. I-EXPLORATION +Palpación I-EXPLORATION de I-EXPLORATION -sarcoma I-EXPLORATION -sinovial I-EXPLORATION -bifásico I-EXPLORATION +probables I-EXPLORATION +adenopatías I-EXPLORATION +inguinales. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +tacto I-EXPLORATION +rectal I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +próstata I-EXPLORATION +aumentada I-EXPLORATION de I-EXPLORATION -alto I-EXPLORATION -grado I-EXPLORATION +tamaño, I-EXPLORATION +dura I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +dolorosa. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +analítica I-EXPLORATION +incluyendo I-EXPLORATION +bioquímica, I-EXPLORATION +hemograma, I-EXPLORATION +proteinograma, I-EXPLORATION +coagulación I-EXPLORATION +y I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -15 I-EXPLORATION -cm I-EXPLORATION +orina I-EXPLORATION +con I-EXPLORATION +proteinuria I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION -máximo I-EXPLORATION -en I-EXPLORATION +24 I-EXPLORATION +horas I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +estrictamente I-EXPLORATION +normal. I-EXPLORATION +Se I-EXPLORATION +solicitaron I-EXPLORATION +marcadores I-EXPLORATION +tumorales I-EXPLORATION +destacando I-EXPLORATION +un I-EXPLORATION +PSA I-EXPLORATION +de I-EXPLORATION +100 I-EXPLORATION +microgramos/l. I-EXPLORATION + I-EXPLORATION +Tanto I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +como I-EXPLORATION el I-EXPLORATION -espesor I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -muscular, I-EXPLORATION +TC I-EXPLORATION +abdominal I-EXPLORATION +objetivaron I-EXPLORATION +múltiples I-EXPLORATION +adenopatías I-EXPLORATION +retroperitoneales I-EXPLORATION +paraaórticas I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +ambas I-EXPLORATION +cadenas I-EXPLORATION +ilíacas I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +una I-EXPLORATION +próstata I-EXPLORATION +aumentada I-EXPLORATION +de I-EXPLORATION +tamaño. I-EXPLORATION +Se I-EXPLORATION +consultó I-EXPLORATION con I-EXPLORATION -bordes I-EXPLORATION -quirúrgicos I-EXPLORATION -respetados I-EXPLORATION -(tumor I-EXPLORATION -a I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -del I-EXPLORATION -borde I-EXPLORATION -quirúrgico I-EXPLORATION -proximal I-EXPLORATION +el I-EXPLORATION +Servicio I-EXPLORATION de I-EXPLORATION -partes I-EXPLORATION -blandas). I-EXPLORATION -No I-EXPLORATION +Urología I-EXPLORATION +y I-EXPLORATION se I-EXPLORATION -evidenció I-EXPLORATION -infiltración I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -óseo. I-EXPLORATION +llevó I-EXPLORATION +a I-EXPLORATION +cabo I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +prostática I-EXPLORATION +concluyente I-EXPLORATION +para I-EXPLORATION +adenocarcinoma I-EXPLORATION +de I-EXPLORATION +próstata I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +adenopatía I-EXPLORATION +inguinal I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +invasión I-EXPLORATION +por I-EXPLORATION +adenocarcinoma I-EXPLORATION +prostático. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +inmunohistoquímico I-EXPLORATION +puso I-EXPLORATION +de I-EXPLORATION +manifiesto I-EXPLORATION +una I-EXPLORATION +intensa I-EXPLORATION +positividad I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +población I-EXPLORATION +neoplásica I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina I-EXPLORATION +prostática, I-EXPLORATION +el I-EXPLORATION +antígeno I-EXPLORATION +prostático I-EXPLORATION +específico I-EXPLORATION +(PSA) I-EXPLORATION +y I-EXPLORATION +para I-EXPLORATION +los I-EXPLORATION +receptores I-EXPLORATION +de I-EXPLORATION +andrógenos. I-EXPLORATION +La I-EXPLORATION +gammagrafía I-EXPLORATION +ósea I-EXPLORATION +mostró I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +captación I-EXPLORATION +retroauricular I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +apófisis I-EXPLORATION +espinosa I-EXPLORATION +y I-EXPLORATION +carilla I-EXPLORATION +auricular I-EXPLORATION +de I-EXPLORATION +C3. I-EXPLORATION I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -siguió I-EVOLUTION -un I-EVOLUTION -postoperatorio I-EVOLUTION -favorable, I-EVOLUTION -siendo I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -domicilio I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -30 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION -Llevamos B-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -un I-TREATMENT -seguimiento I-TREATMENT -semanal I-TREATMENT -del I-TREATMENT -mismo I-TREATMENT -hasta I-TREATMENT -obtener I-TREATMENT -una I-TREATMENT -cicatrización I-TREATMENT -óptima I-TREATMENT -para I-TREATMENT -comenzar I-TREATMENT -con I-TREATMENT -el I-TREATMENT +Se B-TREATMENT +inició I-TREATMENT tratamiento I-TREATMENT -ortopédico. I-TREATMENT +hormonal I-TREATMENT +con I-TREATMENT +antiandrógenos I-TREATMENT +y I-TREATMENT +análogos I-TREATMENT +de I-TREATMENT +LHRH. I-TREATMENT +Ante I-TREATMENT +la I-TREATMENT +presencia I-TREATMENT +de I-TREATMENT +metástasis I-TREATMENT +óseas, I-TREATMENT +se I-TREATMENT +añadió I-TREATMENT +ácido I-TREATMENT +zoledrónico. I-TREATMENT A B-EVOLUTION los I-EVOLUTION -60 I-EVOLUTION -días I-EVOLUTION +nueve I-EVOLUTION +meses I-EVOLUTION +del I-EVOLUTION +tratamiento, I-EVOLUTION el I-EVOLUTION paciente I-EVOLUTION -deambulaba I-EVOLUTION -con I-EVOLUTION -prótesis I-EVOLUTION -transtibial I-EVOLUTION -tipo I-EVOLUTION -PTB I-EVOLUTION -(patellartendon-bearing I-EVOLUTION -prosthesis) I-EVOLUTION -con I-EVOLUTION -sistema I-EVOLUTION -endoesquelético I-EVOLUTION -y I-EVOLUTION -pie I-EVOLUTION -dinámico I-EVOLUTION -con I-EVOLUTION -sensibilidad I-EVOLUTION -completa I-EVOLUTION -en I-EVOLUTION +se I-EVOLUTION +hallaba I-EVOLUTION +estable I-EVOLUTION +desde I-EVOLUTION el I-EVOLUTION -muñón I-EVOLUTION +punto I-EVOLUTION de I-EVOLUTION -amputación. I-EVOLUTION +vista I-EVOLUTION +clínico I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +cambios I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +exploración I-EVOLUTION +física. I-EVOLUTION El I-EVOLUTION -seguimiento I-EVOLUTION -total I-EVOLUTION -por I-EVOLUTION -nuestra I-EVOLUTION -parte I-EVOLUTION +PSA I-EVOLUTION fue I-EVOLUTION de I-EVOLUTION -7 I-EVOLUTION -meses I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -cirugía. I-EVOLUTION -Dos B-TREATMENT -años I-TREATMENT -después I-TREATMENT -de I-TREATMENT -la I-TREATMENT -intervención, I-TREATMENT -continúa I-TREATMENT -en I-TREATMENT -seguimiento I-TREATMENT -por I-TREATMENT -parte I-TREATMENT -de I-TREATMENT -los I-TREATMENT -Servicios I-TREATMENT -de I-TREATMENT -Oncología I-TREATMENT -y I-TREATMENT -Rehabilitación I-TREATMENT -de I-TREATMENT -nuestro I-TREATMENT -hospital, I-TREATMENT -que I-TREATMENT -procederán I-TREATMENT -al I-TREATMENT -recambio I-TREATMENT -protésico I-TREATMENT -según I-TREATMENT -su I-TREATMENT -protocolo I-TREATMENT -cada I-TREATMENT -2 I-TREATMENT -años. I-TREATMENT -Hasta B-EVOLUTION -la I-EVOLUTION -fecha, I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -han I-EVOLUTION -encontrado I-EVOLUTION -evidencias I-EVOLUTION -de I-EVOLUTION -recurrencia I-EVOLUTION -local. I-EVOLUTION +4, I-EVOLUTION +6 I-EVOLUTION +microgramos/l. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -37 I-PRESENT_ILLNESS +41 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -que B-PAST_MEDICAL_HISTORY -acude I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY +edad I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -infiltración I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -material I-PAST_MEDICAL_HISTORY -desconocido I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +(HTA) I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +difícil I-PAST_MEDICAL_HISTORY +control I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +mala I-PAST_MEDICAL_HISTORY +cumplimiento I-PAST_MEDICAL_HISTORY +terapéutico. I-PAST_MEDICAL_HISTORY +Había I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +diagnosticado I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -ambas I-PAST_MEDICAL_HISTORY -mamas I-PAST_MEDICAL_HISTORY -16 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY +2008 I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -aproximadamente I-PAST_MEDICAL_HISTORY -200 I-PAST_MEDICAL_HISTORY -cc I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +probable I-PAST_MEDICAL_HISTORY +nefroangiosclerosis. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +implanta I-PAST_MEDICAL_HISTORY +catéter I-PAST_MEDICAL_HISTORY +peritoneal I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -cada I-PAST_MEDICAL_HISTORY -lado, I-PAST_MEDICAL_HISTORY -presentando B-PRESENT_ILLNESS -dolor, I-PRESENT_ILLNESS -deformidad I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cambios I-PRESENT_ILLNESS -tróficos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -piel I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -afectada. I-PRESENT_ILLNESS -A B-EXPLORATION +diciembre I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2009, I-PAST_MEDICAL_HISTORY +iniciando I-PAST_MEDICAL_HISTORY +DP I-PAST_MEDICAL_HISTORY +continua I-PAST_MEDICAL_HISTORY +ambulatoria I-PAST_MEDICAL_HISTORY +15 I-PAST_MEDICAL_HISTORY +días I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +tarde I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +incidencias I-PAST_MEDICAL_HISTORY +destacables. I-PAST_MEDICAL_HISTORY +Un B-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +disfunción I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +catéter I-PRESENT_ILLNESS +peritoneal, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +importante I-PRESENT_ILLNESS +dificultad I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +drenaje. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION +física I-EXPLORATION se I-EXPLORATION -palpa I-EXPLORATION -tejido I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -pétrea I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -retroareolar I-EXPLORATION -que I-EXPLORATION -involucra I-EXPLORATION -prácticamente I-EXPLORATION -al I-EXPLORATION -80 I-EXPLORATION -% I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -glándula I-EXPLORATION -mamaria. I-EXPLORATION -Se B-TREATMENT -decide I-TREATMENT -iniciar I-TREATMENT -tratamiento I-TREATMENT -médico I-TREATMENT -a I-TREATMENT -base I-TREATMENT -de I-TREATMENT -esteroides, I-TREATMENT -metrotexate I-TREATMENT -y I-TREATMENT -antiinflamatorios I-TREATMENT -no I-TREATMENT -esteroideos I-TREATMENT -por I-TREATMENT -parte I-TREATMENT -del I-TREATMENT -Servicio I-TREATMENT -de I-TREATMENT -Reumatología I-TREATMENT -de I-TREATMENT -nuestro I-TREATMENT -hospital I-TREATMENT -y I-TREATMENT -se I-TREATMENT -programa I-TREATMENT -para I-TREATMENT -mastectomía I-TREATMENT -y I-TREATMENT -reconstrucción I-TREATMENT -mediante I-TREATMENT -colgajo I-TREATMENT -TRAM I-TREATMENT -pediculado I-TREATMENT -bilateral, I-TREATMENT -procedimiento I-TREATMENT -que I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -sin I-TREATMENT -complicaciones I-TREATMENT -ni I-TREATMENT -incidentes. I-TREATMENT -Queda I-TREATMENT -pendiente I-TREATMENT -de I-TREATMENT -la I-TREATMENT -reconstrucción I-TREATMENT -bilateral I-TREATMENT -del I-TREATMENT -complejo I-TREATMENT -pezón-areola. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -único I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -médico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia, I-PAST_MEDICAL_HISTORY -remitido B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestra I-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -tumoración I-DERIVED_FROM/TO -premaxilar I-DERIVED_FROM/TO -izquierda, I-DERIVED_FROM/TO -blanda, I-DERIVED_FROM/TO -móvil I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -no I-DERIVED_FROM/TO -adherida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -planos I-DERIVED_FROM/TO -profundos I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -exploración, I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -unos I-DERIVED_FROM/TO -4cm. I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -diámetro I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -6 I-DERIVED_FROM/TO -meses I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución, I-DERIVED_FROM/TO -sin I-DERIVED_FROM/TO -otra I-DERIVED_FROM/TO -sintomatología I-DERIVED_FROM/TO -asociada, I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -ha I-DERIVED_FROM/TO -presentado I-DERIVED_FROM/TO -crecimiento I-DERIVED_FROM/TO -lento I-DERIVED_FROM/TO -durante I-DERIVED_FROM/TO -este I-DERIVED_FROM/TO -tiempo. I-DERIVED_FROM/TO -A B-EXPLORATION -simple I-EXPLORATION -vista I-EXPLORATION -impresiona I-EXPLORATION -de I-EXPLORATION -lesión I-EXPLORATION -quística I-EXPLORATION -o I-EXPLORATION -lipoma, I-EXPLORATION -pero I-EXPLORATION +objetiva I-EXPLORATION +hipoventilación I-EXPLORATION +hasta I-EXPLORATION +el I-EXPLORATION +campo I-EXPLORATION +medio I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -su I-EXPLORATION -localización I-EXPLORATION -y I-EXPLORATION -su I-EXPLORATION -consistencia I-EXPLORATION -blanda, I-EXPLORATION -elástica I-EXPLORATION -y I-EXPLORATION -móvil I-EXPLORATION -hacen I-EXPLORATION -sospechar I-EXPLORATION -que I-EXPLORATION -pueda I-EXPLORATION -tratarse I-EXPLORATION -de I-EXPLORATION -otro I-EXPLORATION -tipo I-EXPLORATION -de I-EXPLORATION -lesión. I-EXPLORATION - I-EXPLORATION +el I-EXPLORATION +pulmón I-EXPLORATION +derecho. I-EXPLORATION El I-EXPLORATION paciente I-EXPLORATION -aporta I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION -(RMN) I-EXPLORATION -realizada I-EXPLORATION -en I-EXPLORATION -otro I-EXPLORATION -centro, I-EXPLORATION +refiere I-EXPLORATION +disnea, I-EXPLORATION +aunque I-EXPLORATION con I-EXPLORATION -informe I-EXPLORATION +buena I-EXPLORATION +saturación I-EXPLORATION de I-EXPLORATION -nódulo I-EXPLORATION +oxígeno, I-EXPLORATION +con I-EXPLORATION +evidencia I-EXPLORATION de I-EXPLORATION -25mm. I-EXPLORATION +importante I-EXPLORATION +derrame I-EXPLORATION +pleural I-EXPLORATION +derecho I-EXPLORATION en I-EXPLORATION -tejido I-EXPLORATION -celular I-EXPLORATION -subcutáneo I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -afecta I-EXPLORATION -a I-EXPLORATION -hueso I-EXPLORATION -maxilar I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -naturaleza I-EXPLORATION -inespecífica, I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -posibilidad I-EXPLORATION -de I-EXPLORATION -tumor I-EXPLORATION -fibroso I-EXPLORATION -o I-EXPLORATION -hematoma, I-EXPLORATION -a I-EXPLORATION -pesar I-EXPLORATION -de I-EXPLORATION -no I-EXPLORATION -existir I-EXPLORATION -antecedentes I-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -traumatismo I-EXPLORATION -facial. I-EXPLORATION +tórax. I-EXPLORATION I-EXPLORATION Ante I-EXPLORATION -esta I-EXPLORATION -sospecha I-EXPLORATION -diagnóstica I-EXPLORATION -programamos I-EXPLORATION -al I-EXPLORATION -paciente I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -biopsia I-EXPLORATION -en I-EXPLORATION -quirófano, I-EXPLORATION -bajo I-EXPLORATION -anestesia I-EXPLORATION -local, I-EXPLORATION -durante I-EXPLORATION la I-EXPLORATION -cual I-EXPLORATION -encontramos I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -friabilidad I-EXPLORATION -y I-EXPLORATION -sangrado I-EXPLORATION -en I-EXPLORATION -sábana I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -que I-EXPLORATION -impresiona I-EXPLORATION -de I-EXPLORATION -lesión I-EXPLORATION +sospecha I-EXPLORATION de I-EXPLORATION -naturaleza I-EXPLORATION -vascular, I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -posteriormente I-EXPLORATION +hidrotórax I-EXPLORATION +secundario I-EXPLORATION +a I-EXPLORATION +DP I-EXPLORATION se I-EXPLORATION -confirma I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION -que I-EXPLORATION -refiere: I-EXPLORATION -tumoración I-EXPLORATION -mesenquimal I-EXPLORATION -vascular I-EXPLORATION -cuya I-EXPLORATION -morfología I-EXPLORATION -y I-EXPLORATION -perfil I-EXPLORATION -inmunohistoquímico I-EXPLORATION -es I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -patrón I-EXPLORATION -observado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hemangiopericitoma. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -resultado: I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -CD99 I-EXPLORATION -(difuso), I-EXPLORATION -BCL2, I-EXPLORATION -Betacatenina I-EXPLORATION -(focal I-EXPLORATION -intracitoplasmática) I-EXPLORATION -y I-EXPLORATION -CD34 I-EXPLORATION -(focal I-EXPLORATION -citoplasmática), I-EXPLORATION -y I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -S100, I-EXPLORATION -GLUT-1, I-EXPLORATION -WT1, I-EXPLORATION -AE1, I-EXPLORATION -CD31 I-EXPLORATION -y I-EXPLORATION -Factor I-EXPLORATION -VIII. I-EXPLORATION -El I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -proliferación I-EXPLORATION -celular I-EXPLORATION -Ki I-EXPLORATION -67 I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -5%. I-EXPLORATION - I-EXPLORATION -Tras I-EXPLORATION -la I-EXPLORATION -confirmación I-EXPLORATION -diagnóstica I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -haberse I-EXPLORATION -realizado I-EXPLORATION -la I-EXPLORATION -RMN I-EXPLORATION -inicial I-EXPLORATION -en I-EXPLORATION -otro I-EXPLORATION -centro, I-EXPLORATION -el I-EXPLORATION -Servicio I-EXPLORATION -de I-EXPLORATION -Radiología I-EXPLORATION -de I-EXPLORATION -nuestro I-EXPLORATION -hospital I-EXPLORATION -nos I-EXPLORATION -recomienda I-EXPLORATION -realizar I-EXPLORATION +realiza I-EXPLORATION +toracocentesis I-EXPLORATION +diagnóstica, I-EXPLORATION +obteniendo I-EXPLORATION un I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION -adicional I-EXPLORATION -con I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -con I-EXPLORATION -mayor I-EXPLORATION -certeza I-EXPLORATION -la I-EXPLORATION -afectación I-EXPLORATION -ósea I-EXPLORATION -de I-EXPLORATION -cara I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -cirugía; I-EXPLORATION -este I-EXPLORATION -estudio I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -hipervascular I-EXPLORATION -en I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -premaxilar I-EXPLORATION -izquierda, I-EXPLORATION +líquido I-EXPLORATION +pleural I-EXPLORATION con I-EXPLORATION -afectación I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -celular I-EXPLORATION -subcutáneo I-EXPLORATION -y I-EXPLORATION -extensión I-EXPLORATION -en I-EXPLORATION -profundidad I-EXPLORATION -hacia I-EXPLORATION -planos I-EXPLORATION -musculares, I-EXPLORATION -sin I-EXPLORATION -datos I-EXPLORATION -de I-EXPLORATION -afectación I-EXPLORATION -de I-EXPLORATION -estructuras I-EXPLORATION -óseas I-EXPLORATION -vecinas.. I-EXPLORATION +los I-EXPLORATION +siguientes I-EXPLORATION +datos: I-EXPLORATION +leucocitos I-EXPLORATION +200. I-EXPLORATION +Glucosa I-EXPLORATION +418. I-EXPLORATION +Proteínas I-EXPLORATION +<1, I-EXPLORATION +LDH I-EXPLORATION +42. I-EXPLORATION I-EXPLORATION -Bajo B-TREATMENT -ese I-TREATMENT -diagnóstico I-TREATMENT -final, I-TREATMENT -intervenimos I-TREATMENT -quirúrgicamente I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general I-TREATMENT -empleando I-TREATMENT -visión I-TREATMENT +Dado B-TREATMENT +que I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +se I-TREATMENT +negaba I-TREATMENT +a I-TREATMENT +la I-TREATMENT +realización I-TREATMENT de I-TREATMENT -aumento I-TREATMENT -con I-TREATMENT -gafas I-TREATMENT -lupa I-TREATMENT -(x4.3); I-TREATMENT -realizamos I-TREATMENT -extirpación I-TREATMENT +hemodiálisis, I-TREATMENT +tras I-TREATMENT +unos I-TREATMENT +días I-TREATMENT de I-TREATMENT -la I-TREATMENT -tumoración I-TREATMENT -en I-TREATMENT -bloque I-TREATMENT +reposo I-TREATMENT +peritoneal I-TREATMENT con I-TREATMENT -margen I-TREATMENT -de I-TREATMENT -seguridad I-TREATMENT +los I-TREATMENT +que I-TREATMENT +se I-TREATMENT +consiguió I-TREATMENT +la I-TREATMENT +normalización I-TREATMENT de I-TREATMENT -aproximadamente I-TREATMENT -2, I-TREATMENT -5cm. I-TREATMENT -e I-TREATMENT -incluyendo I-TREATMENT la I-TREATMENT -musculatura I-TREATMENT -afectada: I-TREATMENT -porción I-TREATMENT -orbitaria I-TREATMENT -del I-TREATMENT -músculo I-TREATMENT -orbicular I-TREATMENT -mayor I-TREATMENT -inferior I-TREATMENT -izquierdo I-TREATMENT +radiografía I-TREATMENT +de I-TREATMENT +tórax, I-TREATMENT +se I-TREATMENT +intenta I-TREATMENT +realizar I-TREATMENT +DP I-TREATMENT +automática I-TREATMENT +con I-TREATMENT +bajo I-TREATMENT +volumen I-TREATMENT y I-TREATMENT -parcialmente I-TREATMENT +cabecera I-TREATMENT +a I-TREATMENT +45o, I-TREATMENT +sin I-TREATMENT +conseguir I-TREATMENT +un I-TREATMENT +buen I-TREATMENT +funcionamiento I-TREATMENT +del I-TREATMENT +catéter I-TREATMENT +por I-TREATMENT +importante I-TREATMENT +dificultad I-TREATMENT +para I-TREATMENT el I-TREATMENT -músculo I-TREATMENT -cigomático I-TREATMENT -menor I-TREATMENT +drenaje I-TREATMENT y I-TREATMENT +con I-TREATMENT +nueva I-TREATMENT +aparición I-TREATMENT +de I-TREATMENT +hidrotórax. I-TREATMENT +Finalmente, I-TREATMENT el I-TREATMENT -elevador I-TREATMENT -del I-TREATMENT -labio I-TREATMENT -superior, I-TREATMENT -incluidos I-TREATMENT -en I-TREATMENT -el I-TREATMENT -tumor. I-TREATMENT -Identificamos I-TREATMENT +paciente I-TREATMENT +aceptó I-TREATMENT la I-TREATMENT -rama I-TREATMENT -angular I-TREATMENT +realización I-TREATMENT de I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -facial, I-TREATMENT +HD I-TREATMENT que I-TREATMENT -se I-TREATMENT -introduce I-TREATMENT en I-TREATMENT el I-TREATMENT -seno I-TREATMENT +momento I-TREATMENT +actual I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +sin I-TREATMENT +incidencias I-TREATMENT +a I-TREATMENT +través I-TREATMENT de I-TREATMENT -la I-TREATMENT -tumoración, I-TREATMENT -y I-TREATMENT -que I-TREATMENT -ligamos, I-TREATMENT -así I-TREATMENT -como I-TREATMENT -las I-TREATMENT -ramas I-TREATMENT -cigomáticas I-TREATMENT -del I-TREATMENT -nervio I-TREATMENT -facial I-TREATMENT -que I-TREATMENT -quedan I-TREATMENT -en I-TREATMENT +FAV I-TREATMENT +radiocefálica I-TREATMENT +izquierda. I-TREATMENT + I-TREATMENT + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +diagnosticada B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +EW I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +12 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +cirrosis I-PAST_MEDICAL_HISTORY +hepática I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +portal, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +afectación I-PAST_MEDICAL_HISTORY +neuropsiquiátrica. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +D-penicilamina I-PAST_MEDICAL_HISTORY +(350 I-PAST_MEDICAL_HISTORY +mg/8 I-PAST_MEDICAL_HISTORY +horas I-PAST_MEDICAL_HISTORY +v.o.) I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +diagnóstico. I-PAST_MEDICAL_HISTORY +Consulta B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +flexibilidad I-PRESENT_ILLNESS +cutánea, I-PRESENT_ILLNESS +aparición I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pápulas I-PRESENT_ILLNESS +blanquecinas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +piel I-PRESENT_ILLNESS +redundante I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +cervical I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +axilar. I-PRESENT_ILLNESS +Se B-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +pseudo-pseudoxantoma I-EXPLORATION +elástico I-EXPLORATION +(PPXE) I-EXPLORATION +secundario I-EXPLORATION +al I-EXPLORATION +tratamiento I-EXPLORATION +con I-EXPLORATION +D-penicilamina. I-EXPLORATION +Ante B-TREATMENT +este I-TREATMENT +hallazgo I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT el I-TREATMENT -lecho I-TREATMENT -quirúrgico I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +D-penicilamina I-TREATMENT y I-TREATMENT -que I-TREATMENT se I-TREATMENT -preservan I-TREATMENT -en I-TREATMENT -su I-TREATMENT -totalidad. I-TREATMENT - I-TREATMENT -Realizamos I-TREATMENT -la I-TREATMENT -reconstrucción I-TREATMENT -del I-TREATMENT -defecto I-TREATMENT -quirúrgico I-TREATMENT -con I-TREATMENT -un I-TREATMENT -colgajo I-TREATMENT -de I-TREATMENT -avance I-TREATMENT -de I-TREATMENT -mejilla I-TREATMENT +inició I-TREATMENT +acetato I-TREATMENT de I-TREATMENT -base I-TREATMENT -ínfero-lateral. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -postoperatoria I-EVOLUTION -fue I-EVOLUTION -favorable, I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION -sin I-EVOLUTION -complicaciones. I-EVOLUTION - I-EVOLUTION -El B-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION -final I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -hemangiopericitoma I-EXPLORATION -que I-EXPLORATION -respeta I-EXPLORATION -los I-EXPLORATION -bordes I-EXPLORATION -quirúrgicos I-EXPLORATION -de I-EXPLORATION -resección, I-EXPLORATION -con I-EXPLORATION -inflamación I-EXPLORATION -gigantocelular I-EXPLORATION -de I-EXPLORATION -cuerpo I-EXPLORATION -extraño I-EXPLORATION -acompañante. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -definitivo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -de I-EXPLORATION -resección I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -CD34 I-EXPLORATION -difuso, I-EXPLORATION -CD99 I-EXPLORATION -focal, I-EXPLORATION +zinc I-TREATMENT +(50 I-TREATMENT +mg/8 I-TREATMENT +horas I-TREATMENT +v.o.). I-TREATMENT +Así B-EXPLORATION +mismo, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +examen I-EXPLORATION +oftalmológico I-EXPLORATION y I-EXPLORATION -negativo I-EXPLORATION +ecocardiográfico I-EXPLORATION para I-EXPLORATION -S-100, I-EXPLORATION -CD31 I-EXPLORATION -y I-EXPLORATION -factor I-EXPLORATION -VIII, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -proliferación I-EXPLORATION -celular I-EXPLORATION -Ki-67 I-EXPLORATION +descartar I-EXPLORATION +afectación I-EXPLORATION del I-EXPLORATION -5%. I-EXPLORATION +tejido I-EXPLORATION +elástico I-EXPLORATION +a I-EXPLORATION +otro I-EXPLORATION +nivel, I-EXPLORATION +siendo I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +negativo. I-EXPLORATION I-EXPLORATION -Presentamos B-TREATMENT -el I-TREATMENT -caso I-TREATMENT -en I-TREATMENT -el I-TREATMENT -Comité I-TREATMENT -de I-TREATMENT -Tumores I-TREATMENT -del I-TREATMENT -hospital, I-TREATMENT -donde I-TREATMENT -en I-TREATMENT -función I-TREATMENT -de I-TREATMENT -los I-TREATMENT -resultados I-TREATMENT -postoperatorios, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -que I-TREATMENT -no I-TREATMENT -era I-TREATMENT -necesario I-TREATMENT -realizar I-TREATMENT -ningún I-TREATMENT -tratamiento I-TREATMENT -complementario, I-TREATMENT -solo I-TREATMENT -un I-TREATMENT -seguimiento I-TREATMENT -periódico I-TREATMENT -del I-TREATMENT -paciente. I-TREATMENT -Tras B-EVOLUTION -2 I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -postoperatorio, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -favorable, I-EVOLUTION -con I-EVOLUTION -buen I-EVOLUTION -resultado I-EVOLUTION -estético I-EVOLUTION -y I-EVOLUTION -funcional, I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -datos I-EVOLUTION -de I-EVOLUTION -recurrencia I-EVOLUTION -ni I-EVOLUTION -clínica I-EVOLUTION -ni I-EVOLUTION -radiológica I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -controles I-EVOLUTION -postoperatorios I-EVOLUTION -realizados I-EVOLUTION -hasta I-EVOLUTION -la I-EVOLUTION -fecha. I-EVOLUTION - I-EVOLUTION -Niña B-PRESENT_ILLNESS +Hombre B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS +56 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -traída I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -deformidad I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -2o I-PRESENT_ILLNESS -dedo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mano I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS -La B-PAST_MEDICAL_HISTORY -familia I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -sufrió I-PAST_MEDICAL_HISTORY -caída I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -altura I-PAST_MEDICAL_HISTORY +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -cm. I-PAST_MEDICAL_HISTORY +EF, I-PAST_MEDICAL_HISTORY +hipotiroidismo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY +miocardiopatía. I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -aplastamiento I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Como I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -estudio I-PAST_MEDICAL_HISTORY +edad I-PAST_MEDICAL_HISTORY +inicia I-PAST_MEDICAL_HISTORY +crisis I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -cariotipo I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -resultado I-PAST_MEDICAL_HISTORY -normal I-PAST_MEDICAL_HISTORY +dolor I-PAST_MEDICAL_HISTORY +quemante I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -contexto I-PAST_MEDICAL_HISTORY +manos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +pies I-PAST_MEDICAL_HISTORY +desencadenadas I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +ejercicio, I-PAST_MEDICAL_HISTORY +exposición I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +sol I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +fiebre. I-PAST_MEDICAL_HISTORY +Desde I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +disminución I-PAST_MEDICAL_HISTORY +progresiva I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -alteraciones I-PAST_MEDICAL_HISTORY -electroencefalográficas I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +crisis. I-PAST_MEDICAL_HISTORY +Ocasionalmente I-PAST_MEDICAL_HISTORY +sensación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +mareo I-PAST_MEDICAL_HISTORY +subjetivo I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -plagiocefalia I-PAST_MEDICAL_HISTORY -parietooccipital I-PAST_MEDICAL_HISTORY -resueltas. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -realizada I-EXPLORATION -en I-EXPLORATION -Urgencias I-EXPLORATION -observamos I-EXPLORATION -ensanchamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -falange I-EXPLORATION -media I-EXPLORATION -del I-EXPLORATION -2o I-EXPLORATION -dedo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mano I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -flexión I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -articulación I-EXPLORATION -interfalángica I-EXPLORATION -proximal, I-EXPLORATION -que I-EXPLORATION -alcanza I-EXPLORATION -los I-EXPLORATION -50 I-EXPLORATION -grados I-EXPLORATION -de I-EXPLORATION -flexión I-EXPLORATION -máxima. I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION -neurovascular I-EXPLORATION -no I-EXPLORATION -determinó I-EXPLORATION -hallazgos I-EXPLORATION -patológicos I-EXPLORATION +episodios I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +estitiquez-diarrea. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +42 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +parte I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +estudio I-PAST_MEDICAL_HISTORY +familiar I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +medición I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +niveles I-PAST_MEDICAL_HISTORY +enzimáticos. I-PAST_MEDICAL_HISTORY +Inició I-PAST_MEDICAL_HISTORY +terapia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +reemplazo I-PAST_MEDICAL_HISTORY +enzimático I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +45 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +A B-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +52 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +diagnostica I-PRESENT_ILLNESS +miocardiopatía I-PRESENT_ILLNESS +hipertrófica I-PRESENT_ILLNESS +y B-TREATMENT +se I-TREATMENT +instala I-TREATMENT +marcapaso. I-TREATMENT +Escasos B-EXPLORATION +angioqueratomas. I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +clínico I-EXPLORATION +neurológico I-EXPLORATION +mostro I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -interés. I-EXPLORATION -Efectuamos I-EXPLORATION -también I-EXPLORATION -exploraciones I-EXPLORATION -radiológicas I-EXPLORATION -del I-EXPLORATION -2o I-EXPLORATION -dedo I-EXPLORATION -en I-EXPLORATION -proyecciones I-EXPLORATION -anteroposterior I-EXPLORATION +polineuropatía I-EXPLORATION +sensitiva I-EXPLORATION y I-EXPLORATION -de I-EXPLORATION -perfil, I-EXPLORATION -que I-EXPLORATION -determinan I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION +evaluación I-EXPLORATION +neurofisiológica I-EXPLORATION +evidenció I-EXPLORATION +una I-EXPLORATION +polineuropatía I-EXPLORATION +con I-EXPLORATION +compromiso I-EXPLORATION +sensitivo I-EXPLORATION +axonal I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION +fibras I-EXPLORATION +mielínicas I-EXPLORATION +gruesas I-EXPLORATION +y I-EXPLORATION +severo I-EXPLORATION +compromiso I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION +fibras I-EXPLORATION +mielínicas I-EXPLORATION +delgadas I-EXPLORATION +y I-EXPLORATION +amielínicas, I-EXPLORATION +además I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -falange I-EXPLORATION -media I-EXPLORATION +una I-EXPLORATION +radiculopatía I-EXPLORATION +L5-S1 I-EXPLORATION +izquierda. I-EXPLORATION +Ausencia I-EXPLORATION +generalizada I-EXPLORATION de I-EXPLORATION -dicho I-EXPLORATION -dedo I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -volar. I-EXPLORATION - I-EXPLORATION -La B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -diagnosticada I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -subluxación I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -consultas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Traumatología I-DERIVED_FROM/TO -Infantil I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -control I-DERIVED_FROM/TO -radiográfico. I-DERIVED_FROM/TO -Allí B-EXPLORATION +RSC. I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -objetiva I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -macroscópico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION +realizó I-EXPLORATION +evaluación I-EXPLORATION +intervalo I-EXPLORATION +R-R, I-EXPLORATION +debido I-EXPLORATION +al I-EXPLORATION +uso I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -falange I-EXPLORATION -media I-EXPLORATION -del I-EXPLORATION -2o I-EXPLORATION -dedo I-EXPLORATION +marcapasos. I-EXPLORATION + I-EXPLORATION + +Sexo B-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +25 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +VIH B-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +2000, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +enfermedades I-PAST_MEDICAL_HISTORY +marcadoras I-PAST_MEDICAL_HISTORY +etapa I-PAST_MEDICAL_HISTORY +SIDA, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +terapia I-PAST_MEDICAL_HISTORY +antirretroviral I-PAST_MEDICAL_HISTORY +(TARV) I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +1 I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +con: I-PAST_MEDICAL_HISTORY +zidovudina, I-PAST_MEDICAL_HISTORY +lamivudina, I-PAST_MEDICAL_HISTORY +indinavir/ritonavir, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +migraña. I-PAST_MEDICAL_HISTORY +Cuarenta B-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +ocho I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +previas I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +consulta, I-PRESENT_ILLNESS +comenzó I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +características I-PRESENT_ILLNESS +tensionales, I-PRESENT_ILLNESS +automedicándose I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +ibuprofeno/ergotamina I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +agregando I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +horas: I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +intenso, I-PRESENT_ILLNESS +parestesias I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +edema I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tercio I-PRESENT_ILLNESS +inferior I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +ambos I-PRESENT_ILLNESS +miembros I-PRESENT_ILLNESS +inferiores. I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +presentaba: I-EXPLORATION +palidez I-EXPLORATION +cutánea I-EXPLORATION +alternante I-EXPLORATION +con I-EXPLORATION +áreas I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -mano I-EXPLORATION -derecha, I-EXPLORATION +cianosis I-EXPLORATION y I-EXPLORATION -limitación I-EXPLORATION +frialdad I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -flexión I-EXPLORATION -interfalángica I-EXPLORATION -proximal, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -máximo I-EXPLORATION +tobillos I-EXPLORATION +junto I-EXPLORATION +a I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -50 I-EXPLORATION -grados. I-EXPLORATION -Acude I-EXPLORATION -con I-EXPLORATION -radiografía I-EXPLORATION -control. I-EXPLORATION +pulso I-EXPLORATION +tibial I-EXPLORATION +posterior I-EXPLORATION +y I-EXPLORATION +pedio.. I-EXPLORATION I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +persona I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +49 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +nacido B-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +aldea I-PAST_MEDICAL_HISTORY +asturiana I-PAST_MEDICAL_HISTORY +cuya I-PAST_MEDICAL_HISTORY +familia I-PAST_MEDICAL_HISTORY +vive I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +campo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +ganadería. I-PAST_MEDICAL_HISTORY +Sus B-FAMILY_HISTORY +padres, I-FAMILY_HISTORY +sin I-FAMILY_HISTORY +estudios, I-FAMILY_HISTORY +fallecen I-FAMILY_HISTORY +él I-FAMILY_HISTORY +por I-FAMILY_HISTORY +patología I-FAMILY_HISTORY +tumoral, I-FAMILY_HISTORY +y I-FAMILY_HISTORY +ella I-FAMILY_HISTORY +por I-FAMILY_HISTORY +cardiopatía I-FAMILY_HISTORY +y I-FAMILY_HISTORY +diabetes. I-FAMILY_HISTORY +Es B-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +último I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cinco I-PAST_MEDICAL_HISTORY +hermanos. I-PAST_MEDICAL_HISTORY +Escolarizado I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +15 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +comienza I-PAST_MEDICAL_HISTORY +luego I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +trabajar I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +peón I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +posteriormente I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +minería. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +reconoce I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +persona I-PAST_MEDICAL_HISTORY +alegre, I-PAST_MEDICAL_HISTORY +amigo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +fiestas, I-PAST_MEDICAL_HISTORY +trabajador, I-PAST_MEDICAL_HISTORY +activo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +colaborador. I-PAST_MEDICAL_HISTORY +Dos B-FAMILY_HISTORY +de I-FAMILY_HISTORY +sus I-FAMILY_HISTORY +hermanas I-FAMILY_HISTORY +emigran I-FAMILY_HISTORY +a I-FAMILY_HISTORY +Europa I-FAMILY_HISTORY +por I-FAMILY_HISTORY +motivos I-FAMILY_HISTORY +laborales. I-FAMILY_HISTORY +Una I-FAMILY_HISTORY +de I-FAMILY_HISTORY +ellas, I-FAMILY_HISTORY +la I-FAMILY_HISTORY +mayor, I-FAMILY_HISTORY +se I-FAMILY_HISTORY +suicida I-FAMILY_HISTORY +a I-FAMILY_HISTORY +los I-FAMILY_HISTORY +48 I-FAMILY_HISTORY +años. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Poco B-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +diagnosticado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +esquizofrenia I-PAST_MEDICAL_HISTORY +paranoide I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +1982, I-PAST_MEDICAL_HISTORY +contrajo I-PAST_MEDICAL_HISTORY +matrimonio I-PAST_MEDICAL_HISTORY +aunque I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +mujer I-PAST_MEDICAL_HISTORY +pidió I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +separación I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +pocos I-PAST_MEDICAL_HISTORY +meses. I-PAST_MEDICAL_HISTORY +Recibe I-PAST_MEDICAL_HISTORY +atención I-PAST_MEDICAL_HISTORY +ambulatoria I-PAST_MEDICAL_HISTORY +haciendo I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +cumplimiento I-PAST_MEDICAL_HISTORY +irregular I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +farmacológico I-PAST_MEDICAL_HISTORY +evitando I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +tomas I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +engaño, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +1984 I-PAST_MEDICAL_HISTORY +abandona I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +tratamiento. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Cuatro I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +tarde I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +detenido I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +acusado I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +doble I-PAST_MEDICAL_HISTORY +intento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +homicidio I-PAST_MEDICAL_HISTORY +contra I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +matrimonio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vecinos, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +siempre I-PAST_MEDICAL_HISTORY +mantuvo I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +excelente I-PAST_MEDICAL_HISTORY +relación. I-PAST_MEDICAL_HISTORY +Según I-PAST_MEDICAL_HISTORY +él, I-PAST_MEDICAL_HISTORY +esas I-PAST_MEDICAL_HISTORY +personas I-PAST_MEDICAL_HISTORY +"ponían I-PAST_MEDICAL_HISTORY +cirios" I-PAST_MEDICAL_HISTORY +(hacían I-PAST_MEDICAL_HISTORY +ofrendas) I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +cosas I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +fueran I-PAST_MEDICAL_HISTORY +mal. I-PAST_MEDICAL_HISTORY +Es I-PAST_MEDICAL_HISTORY +encarcelado, I-PAST_MEDICAL_HISTORY +ingresado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +UHP I-PAST_MEDICAL_HISTORY +(unidad I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hospitalización I-PAST_MEDICAL_HISTORY +psiquiátrica) I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +posteriormente I-PAST_MEDICAL_HISTORY +trasladado I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +hospital I-PAST_MEDICAL_HISTORY +psiquiátrico I-PAST_MEDICAL_HISTORY +penitenciario. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +1996 I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +retornado I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +Asturias, I-PAST_MEDICAL_HISTORY +permaneciendo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +diferentes I-PAST_MEDICAL_HISTORY +unidades I-PAST_MEDICAL_HISTORY +cerradas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +Servicios I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Salud I-PAST_MEDICAL_HISTORY +Mental I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +mayo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2000 I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +ingresa I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +Casita. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +caracteriza I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +tener I-PAST_MEDICAL_HISTORY +conciencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +psiquiátrica I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +somática, I-PAST_MEDICAL_HISTORY +ya I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +padece I-PAST_MEDICAL_HISTORY +diabetes I-PAST_MEDICAL_HISTORY +mellitus I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +insulino-dependiente, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +manifiesta I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +claro I-PAST_MEDICAL_HISTORY +rechazo I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +aunque I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +toma I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +condición I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +permanecer I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +hogar I-PAST_MEDICAL_HISTORY +tutelado. I-PAST_MEDICAL_HISTORY +Posee I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +alto I-PAST_MEDICAL_HISTORY +nivel I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +conservación I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +actividades I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +vida I-PAST_MEDICAL_HISTORY +diaria I-PAST_MEDICAL_HISTORY +(AVDs) I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +goza I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +buena I-PAST_MEDICAL_HISTORY +capacidad I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +comunicación I-PAST_MEDICAL_HISTORY +verbal. I-PAST_MEDICAL_HISTORY +Ha I-PAST_MEDICAL_HISTORY +perdido I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +contacto I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +entorno I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +consecuencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +casi I-PAST_MEDICAL_HISTORY +15 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +lleva I-PAST_MEDICAL_HISTORY +institucionalizado I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +aunque I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +tiene I-PAST_MEDICAL_HISTORY +problemas I-PAST_MEDICAL_HISTORY +económicos, I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +soporte I-PAST_MEDICAL_HISTORY +familiar I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +suficiente I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +permanecer I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +casa. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +A B-EXPLORATION +su I-EXPLORATION +ingreso, I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -porción I-EXPLORATION -palmar I-EXPLORATION -de I-EXPLORATION +hace I-EXPLORATION la I-EXPLORATION -base I-EXPLORATION +valoración I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -falange I-EXPLORATION -media I-EXPLORATION -con I-EXPLORATION -borramiento I-EXPLORATION -del I-EXPLORATION -cartílago I-EXPLORATION +enfermería I-EXPLORATION +usando I-EXPLORATION +el I-EXPLORATION +protocolo I-EXPLORATION de I-EXPLORATION -crecimiento I-EXPLORATION +salud I-EXPLORATION +mental4, I-EXPLORATION +procediendo I-EXPLORATION a I-EXPLORATION -ese I-EXPLORATION -nivel; I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -proyección I-EXPLORATION -anteroposterior I-EXPLORATION -se I-EXPLORATION -evidencia I-EXPLORATION -superposición I-EXPLORATION -ósea. I-EXPLORATION -Se I-EXPLORATION -postula I-EXPLORATION -como I-EXPLORATION -posible I-EXPLORATION -diagnóstico I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -fractura I-EXPLORATION -antigua I-EXPLORATION -de I-EXPLORATION -falange I-EXPLORATION -media I-EXPLORATION -con I-EXPLORATION -callo I-EXPLORATION +detección I-EXPLORATION de I-EXPLORATION -fractura I-EXPLORATION -prominente I-EXPLORATION +patrones I-EXPLORATION +alterados I-EXPLORATION +según I-EXPLORATION +Gordon5, I-EXPLORATION y I-EXPLORATION -epifisiodesis. I-EXPLORATION -La B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -mano I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -Plástica I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -Reparadora I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -valoración I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -secuela I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -fractura. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -En B-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -consulta I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Servicio I-EXPLORATION -de I-EXPLORATION -Cirugía I-EXPLORATION -Plástica I-EXPLORATION +utilizando I-EXPLORATION +diagnósticos I-EXPLORATION +NANDA I-EXPLORATION +2001-20026. I-EXPLORATION +Se I-EXPLORATION +aplican I-EXPLORATION +también I-EXPLORATION +dos I-EXPLORATION +escalas I-EXPLORATION y I-EXPLORATION -Reparadora I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -aprecian I-EXPLORATION -cambios I-EXPLORATION +un I-EXPLORATION +cuestionario I-EXPLORATION +cuyos I-EXPLORATION +resultados I-EXPLORATION +están I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -respecto I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -descritos I-EXPLORATION -por I-EXPLORATION -Traumatología I-EXPLORATION -Infantil. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -aporta I-EXPLORATION -las I-EXPLORATION -radiografías I-EXPLORATION -que I-EXPLORATION -le I-EXPLORATION -habían I-EXPLORATION -sido I-EXPLORATION -entregadas I-EXPLORATION -en I-EXPLORATION -mano I-EXPLORATION -en I-EXPLORATION -Urgencias I-EXPLORATION -y I-EXPLORATION -Traumatología I-EXPLORATION -Infantil I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -cita I-EXPLORATION -nuevamente I-EXPLORATION -para I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION +tabla I-EXPLORATION +1 I-EXPLORATION y I-EXPLORATION +posteriormente I-EXPLORATION se I-EXPLORATION -insiste I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -necesidad I-EXPLORATION -de I-EXPLORATION -que I-EXPLORATION -aporte I-EXPLORATION -las I-EXPLORATION -radiografías I-EXPLORATION -previas. I-EXPLORATION -Osteocondroma I-EXPLORATION -gigante I-EXPLORATION -de I-EXPLORATION -falange I-EXPLORATION -en I-EXPLORATION -paciente I-EXPLORATION -pediátrico I-EXPLORATION -Cirugía I-EXPLORATION +evalúa I-EXPLORATION +por I-EXPLORATION +objetivos. I-EXPLORATION I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -acude I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -cita I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -años I-EVOLUTION -siguientes. I-EVOLUTION -Pasado I-EVOLUTION -este I-EVOLUTION -tiempo, I-EVOLUTION -solicita I-EVOLUTION -nuevamente I-EVOLUTION -cita I-EVOLUTION -en I-EVOLUTION -consulta I-EVOLUTION -de I-EVOLUTION -Cirugía I-EVOLUTION -Plástica I-EVOLUTION -y I-EVOLUTION -Reparadora I-EVOLUTION -por I-EVOLUTION -aumento I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -deformidad I-EVOLUTION -del I-EVOLUTION -dedo. I-EVOLUTION -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -un I-EXPLORATION -notable I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -falange I-EXPLORATION -media I-EXPLORATION -del I-EXPLORATION -2o I-EXPLORATION -dedo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mano I-EXPLORATION -derecha I-EXPLORATION -(macrodactilia). I-EXPLORATION -La I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -flexión I-EXPLORATION -es I-EXPLORATION -mayor, I-EXPLORATION -alcanzando I-EXPLORATION +En I-EXPLORATION +cuanto I-EXPLORATION +a I-EXPLORATION los I-EXPLORATION -20 I-EXPLORATION -grados I-EXPLORATION -de I-EXPLORATION -flexión I-EXPLORATION -máxima. I-EXPLORATION -Solicitamos I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -control. I-EXPLORATION - I-EXPLORATION -Observamos I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -radiografías, I-EXPLORATION -en I-EXPLORATION -proyección I-EXPLORATION -de I-EXPLORATION -perfil, I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -lobulado, I-EXPLORATION -con I-EXPLORATION -distintas I-EXPLORATION -densidades, I-EXPLORATION -que I-EXPLORATION -parece I-EXPLORATION -provenir I-EXPLORATION -del I-EXPLORATION -tercio I-EXPLORATION -inferior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -falange I-EXPLORATION -media I-EXPLORATION -del I-EXPLORATION -2o I-EXPLORATION -dedo. I-EXPLORATION -La I-EXPLORATION -masa I-EXPLORATION -alcanza I-EXPLORATION -el I-EXPLORATION -tercio I-EXPLORATION -superior I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -falange I-EXPLORATION -proximal. I-EXPLORATION -Asimismo I-EXPLORATION -destaca I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +patrones I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -muesca I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -porción I-EXPLORATION -superior. I-EXPLORATION +salud, I-EXPLORATION +hay I-EXPLORATION +cuatro I-EXPLORATION +claramente I-EXPLORATION +disfuncionales. I-EXPLORATION En I-EXPLORATION la I-EXPLORATION -proyección I-EXPLORATION -anteroposterior I-EXPLORATION -apreciamos I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -sobrepasa I-EXPLORATION -la I-EXPLORATION -extensión I-EXPLORATION -de I-EXPLORATION -anchura I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -segunda I-EXPLORATION -falange. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -osteocondroma/encondroma I-EXPLORATION -solicitamos I-EXPLORATION -RM I-EXPLORATION -que I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -exóstosis I-EXPLORATION -lobulada I-EXPLORATION -de I-EXPLORATION -12 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -espesor, I-EXPLORATION -con I-EXPLORATION -base I-EXPLORATION -de I-EXPLORATION -20x20 I-EXPLORATION -mm, I-EXPLORATION -que I-EXPLORATION +tabla I-EXPLORATION +2 I-EXPLORATION se I-EXPLORATION -extiende I-EXPLORATION -proximalmente I-EXPLORATION -afectando I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -placa I-EXPLORATION -volar I-EXPLORATION -de I-EXPLORATION -inserción I-EXPLORATION -del I-EXPLORATION -sistema I-EXPLORATION -flexor I-EXPLORATION -superficial, I-EXPLORATION -con I-EXPLORATION -desplazamiento I-EXPLORATION -del I-EXPLORATION -tendón I-EXPLORATION -flexor I-EXPLORATION -profundo I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -sistema I-EXPLORATION -de I-EXPLORATION -anclaje I-EXPLORATION -de I-EXPLORATION -poleas, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -osteocondroma. I-EXPLORATION - I-EXPLORATION -Estadiamos I-EXPLORATION -el I-EXPLORATION -tumor I-EXPLORATION -empleando I-EXPLORATION -la I-EXPLORATION -clasificación I-EXPLORATION -de I-EXPLORATION -Enneking I-EXPLORATION +comentan I-EXPLORATION +dichos I-EXPLORATION +patrones I-EXPLORATION y I-EXPLORATION -determinamos I-EXPLORATION -que I-EXPLORATION se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -estadio I-EXPLORATION -III, I-EXPLORATION -lesión I-EXPLORATION -benigna I-EXPLORATION -agresiva: I-EXPLORATION -lesión I-EXPLORATION -benigna I-EXPLORATION -de I-EXPLORATION -baja I-EXPLORATION -agresividad I-EXPLORATION -(G0), I-EXPLORATION -con I-EXPLORATION -afectación I-EXPLORATION +muestran I-EXPLORATION +los I-EXPLORATION +diagnósticos I-EXPLORATION +seleccionados I-EXPLORATION +para I-EXPLORATION +cada I-EXPLORATION +uno I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -inserción I-EXPLORATION -perióstica I-EXPLORATION -del I-EXPLORATION -extensor I-EXPLORATION -superficial I-EXPLORATION -(extracompartimental) I-EXPLORATION -(T2) I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -metástasis I-EXPLORATION -(M0). I-EXPLORATION - I-EXPLORATION -Dada B-TREATMENT -la I-TREATMENT -alteración I-TREATMENT -funcional I-TREATMENT -que I-TREATMENT -presentaba I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT +ellos. I-EXPLORATION +Una B-TREATMENT +vez I-TREATMENT +examinados I-TREATMENT +los I-TREATMENT +patrones I-TREATMENT y I-TREATMENT -el I-TREATMENT -tamaño I-TREATMENT +seleccionados I-TREATMENT +los I-TREATMENT +diagnósticos, I-TREATMENT +se I-TREATMENT +establecen I-TREATMENT +diferentes I-TREATMENT +grupos I-TREATMENT de I-TREATMENT -la I-TREATMENT -masa I-TREATMENT -tumoral, I-TREATMENT -decidimos I-TREATMENT -llevar I-TREATMENT +objetivos I-TREATMENT a I-TREATMENT -cabo I-TREATMENT -tratamiento I-TREATMENT +partir I-TREATMENT de I-TREATMENT +los I-TREATMENT +cuales I-TREATMENT +se I-TREATMENT +diseñaran I-TREATMENT +actividades I-TREATMENT +para I-TREATMENT la I-TREATMENT -lesión. I-TREATMENT +consecución I-TREATMENT +de I-TREATMENT +los I-TREATMENT +mismos. I-TREATMENT I-TREATMENT -En I-TREATMENT -la I-TREATMENT -cirugía I-TREATMENT -efectuamos I-TREATMENT -acceso I-TREATMENT -a I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -mediante I-TREATMENT -técnica I-TREATMENT +Manejo I-TREATMENT +inefectivo I-TREATMENT +del I-TREATMENT +régimen I-TREATMENT +terapéutico. I-TREATMENT +Respecto I-TREATMENT +al I-TREATMENT +primer I-TREATMENT +diagnóstico, I-TREATMENT +se I-TREATMENT +establecen I-TREATMENT +tres I-TREATMENT +grupos I-TREATMENT de I-TREATMENT -Brunner I-TREATMENT +objetivos: I-TREATMENT +objetivos I-TREATMENT +iniciales; I-TREATMENT +objetivos I-TREATMENT +a I-TREATMENT +los I-TREATMENT +seis I-TREATMENT +meses I-TREATMENT +y I-TREATMENT +a I-TREATMENT +los I-TREATMENT +dos I-TREATMENT +años. I-TREATMENT +Los I-TREATMENT +objetivos I-TREATMENT +iniciales I-TREATMENT +son I-TREATMENT +aquellos I-TREATMENT +que I-TREATMENT +se I-TREATMENT +deben I-TREATMENT +cumplir I-TREATMENT +desde I-TREATMENT +un I-TREATMENT +primer I-TREATMENT +momento. I-TREATMENT +Tienen I-TREATMENT +que I-TREATMENT +ver I-TREATMENT +con I-TREATMENT +cuestiones I-TREATMENT +básicas I-TREATMENT +del I-TREATMENT +funcionamiento I-TREATMENT +del I-TREATMENT +dispositivo I-TREATMENT +que I-TREATMENT +el I-TREATMENT +sujeto I-TREATMENT +debe I-TREATMENT +asumir I-TREATMENT +para I-TREATMENT +poder I-TREATMENT +permanecer I-TREATMENT en I-TREATMENT -zig-zag I-TREATMENT -evitando I-TREATMENT -así I-TREATMENT -la I-TREATMENT -sección I-TREATMENT -transversal I-TREATMENT -de I-TREATMENT +el I-TREATMENT +hogar I-TREATMENT +tutelado. I-TREATMENT +Son I-TREATMENT los I-TREATMENT -pliegues I-TREATMENT -palmares I-TREATMENT +siguientes: I-TREATMENT +1) I-TREATMENT que I-TREATMENT -pudiera I-TREATMENT -generar I-TREATMENT -futuras I-TREATMENT -retracciones. I-TREATMENT -Localizamos I-TREATMENT +tome I-TREATMENT +su I-TREATMENT +medicación I-TREATMENT +desde I-TREATMENT el I-TREATMENT -tendón I-TREATMENT -flexor I-TREATMENT -superficial I-TREATMENT +primer I-TREATMENT +día; I-TREATMENT +2) I-TREATMENT +que I-TREATMENT +acuda I-TREATMENT +acompañado I-TREATMENT +a I-TREATMENT +las I-TREATMENT +citas I-TREATMENT +en I-TREATMENT +el I-TREATMENT +centro I-TREATMENT +de I-TREATMENT +atención I-TREATMENT +primaria I-TREATMENT +(CAP); I-TREATMENT +3) I-TREATMENT +someterse I-TREATMENT +a I-TREATMENT +los I-TREATMENT +controles I-TREATMENT +analíticos I-TREATMENT +pertinentes, I-TREATMENT y I-TREATMENT -colocamos I-TREATMENT -la I-TREATMENT -articulación I-TREATMENT -metacarpofalángica I-TREATMENT -del I-TREATMENT -2o I-TREATMENT -dedo, I-TREATMENT -así I-TREATMENT -como I-TREATMENT +4) I-TREATMENT +aceptar I-TREATMENT la I-TREATMENT -muñeca, I-TREATMENT -en I-TREATMENT -flexión I-TREATMENT -máxima I-TREATMENT -para I-TREATMENT +dieta I-TREATMENT +antiglucemiante. I-TREATMENT + I-TREATMENT +El I-TREATMENT +segundo I-TREATMENT +grupo I-TREATMENT +de I-TREATMENT +objetivos, I-TREATMENT +es I-TREATMENT +decir, I-TREATMENT +los I-TREATMENT +que I-TREATMENT +se I-TREATMENT +deben I-TREATMENT alcanzar I-TREATMENT -la I-TREATMENT -porción I-TREATMENT -más I-TREATMENT -proximal I-TREATMENT -del I-TREATMENT -tendón I-TREATMENT -flexor I-TREATMENT -superficial. I-TREATMENT -Lo I-TREATMENT -seccionamos, I-TREATMENT -elegiendo I-TREATMENT -realizar I-TREATMENT -dicha I-TREATMENT -sección I-TREATMENT a I-TREATMENT -nivel I-TREATMENT -proximal I-TREATMENT -para I-TREATMENT -prevenir I-TREATMENT -la I-TREATMENT -aparición I-TREATMENT -del I-TREATMENT -fenómeno I-TREATMENT -conocido I-TREATMENT -como I-TREATMENT -Cuádriga I-TREATMENT +los I-TREATMENT +seis I-TREATMENT +meses, I-TREATMENT +son: I-TREATMENT +1) I-TREATMENT +que I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +tenga I-TREATMENT +una I-TREATMENT +noción I-TREATMENT +básica I-TREATMENT de I-TREATMENT -Verdán, I-TREATMENT -entendido I-TREATMENT -como I-TREATMENT -alteración I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +son I-TREATMENT +los I-TREATMENT +fármacos, I-TREATMENT +pudiendo I-TREATMENT +enumerar I-TREATMENT +tres I-TREATMENT +beneficios I-TREATMENT +y I-TREATMENT +tres I-TREATMENT +efectos I-TREATMENT +secundarios; I-TREATMENT +2) I-TREATMENT +que I-TREATMENT +pueda I-TREATMENT +autoadministrase I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +bajo I-TREATMENT +supervisión; I-TREATMENT +3) I-TREATMENT +será I-TREATMENT +capaz I-TREATMENT de I-TREATMENT +acudir I-TREATMENT +a I-TREATMENT la I-TREATMENT -flexión I-TREATMENT +farmacia I-TREATMENT +sin I-TREATMENT +acompañamiento; I-TREATMENT +4) I-TREATMENT +podrá I-TREATMENT +reconocer I-TREATMENT +y I-TREATMENT +nombrar I-TREATMENT +al I-TREATMENT +menos I-TREATMENT +doce I-TREATMENT +alimentos I-TREATMENT +habituales I-TREATMENT +contraindicados I-TREATMENT +y I-TREATMENT +5) I-TREATMENT +conocerá I-TREATMENT +los I-TREATMENT +riesgos I-TREATMENT de I-TREATMENT -la I-TREATMENT -articulación I-TREATMENT -metacarpofalángica I-TREATMENT -por I-TREATMENT -adhesión I-TREATMENT -en I-TREATMENT -una I-TREATMENT -articulación I-TREATMENT -del I-TREATMENT -cabo I-TREATMENT -proximal I-TREATMENT +ser I-TREATMENT +gran I-TREATMENT +fumador I-TREATMENT +describiendo I-TREATMENT +tres I-TREATMENT +enfermedades I-TREATMENT +graves I-TREATMENT +y I-TREATMENT +tres I-TREATMENT +beneficios I-TREATMENT de I-TREATMENT -un I-TREATMENT -tendón I-TREATMENT -tras I-TREATMENT -su I-TREATMENT -sección. I-TREATMENT -Mediante I-TREATMENT -escoplo, I-TREATMENT -escindimos I-TREATMENT -la I-TREATMENT -porción I-TREATMENT +no I-TREATMENT +fumar. I-TREATMENT + I-TREATMENT +Los I-TREATMENT +objetivos I-TREATMENT +a I-TREATMENT +conseguir I-TREATMENT +a I-TREATMENT +los I-TREATMENT +dos I-TREATMENT +años, I-TREATMENT +son I-TREATMENT +el I-TREATMENT +tercer I-TREATMENT +grupo I-TREATMENT de I-TREATMENT -la I-TREATMENT -tumoración I-TREATMENT +los I-TREATMENT que I-TREATMENT -sobresalía I-TREATMENT -de I-TREATMENT -la I-TREATMENT -falange I-TREATMENT -sana I-TREATMENT +corresponden I-TREATMENT +al I-TREATMENT +primer I-TREATMENT +diagnóstico I-TREATMENT y I-TREATMENT -una I-TREATMENT -porción I-TREATMENT +contemplan: I-TREATMENT +1) I-TREATMENT +que I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +se I-TREATMENT +autoadministre I-TREATMENT +su I-TREATMENT +medicación I-TREATMENT +preparándola I-TREATMENT +él I-TREATMENT +mismo I-TREATMENT +y I-TREATMENT +sin I-TREATMENT +triturar, I-TREATMENT +incluso I-TREATMENT +estando I-TREATMENT +fuera; I-TREATMENT +2) I-TREATMENT +irá I-TREATMENT +solo I-TREATMENT +al I-TREATMENT +CAP I-TREATMENT +y I-TREATMENT +usará I-TREATMENT +su I-TREATMENT +tarjeta I-TREATMENT de I-TREATMENT +crónicos I-TREATMENT +para I-TREATMENT +obtener I-TREATMENT +las I-TREATMENT +recetas; I-TREATMENT +3) I-TREATMENT +sellará I-TREATMENT +sus I-TREATMENT +recetas I-TREATMENT +en I-TREATMENT la I-TREATMENT -cortical I-TREATMENT -adyacente. I-TREATMENT -Seguidamente I-TREATMENT -practicamos I-TREATMENT -curetaje I-TREATMENT -mediante I-TREATMENT -cucharilla I-TREATMENT -de I-TREATMENT +inspección I-TREATMENT +médica I-TREATMENT +sin I-TREATMENT +acompañamiento; I-TREATMENT +4) I-TREATMENT +si I-TREATMENT +come I-TREATMENT +fuera I-TREATMENT +podrá I-TREATMENT +elegir I-TREATMENT +platos I-TREATMENT +adecuados I-TREATMENT +sin I-TREATMENT +apoyo; I-TREATMENT +5) I-TREATMENT +habrá I-TREATMENT +reducido I-TREATMENT la I-TREATMENT -médula I-TREATMENT -y I-TREATMENT -del I-TREATMENT -tejido I-TREATMENT -óseo I-TREATMENT +dosis/día I-TREATMENT de I-TREATMENT -la I-TREATMENT -superficie I-TREATMENT -dorsal. I-TREATMENT +cigarrillos I-TREATMENT +a I-TREATMENT +10 I-TREATMENT +como I-TREATMENT +máximo. I-TREATMENT I-TREATMENT -Para I-TREATMENT +Después I-TREATMENT +se I-TREATMENT +da I-TREATMENT +paso I-TREATMENT +a I-TREATMENT la I-TREATMENT -reconstrucción: I-TREATMENT +programación I-TREATMENT de I-TREATMENT -la I-TREATMENT -cavidad I-TREATMENT -generada I-TREATMENT -empleamos I-TREATMENT -material I-TREATMENT -osteoconductor I-TREATMENT -(Actifuse I-TREATMENT -Abx I-TREATMENT -Silicated I-TREATMENT -Calcium I-TREATMENT -Phosphate®, I-TREATMENT -BioSurgery, I-TREATMENT -EE. I-TREATMENT -UU). I-TREATMENT -Efectuamos I-TREATMENT -inmovilización I-TREATMENT -mediante I-TREATMENT -férula I-TREATMENT -dorsal I-TREATMENT +actividades I-TREATMENT +dirigidas I-TREATMENT +al I-TREATMENT +logro I-TREATMENT de I-TREATMENT -yeso I-TREATMENT -desde I-TREATMENT -tercio I-TREATMENT -proximal I-TREATMENT -del I-TREATMENT -antebrazo I-TREATMENT -hasta I-TREATMENT -final I-TREATMENT +cada I-TREATMENT +uno I-TREATMENT de I-TREATMENT los I-TREATMENT -dedos, I-TREATMENT -con I-TREATMENT -muñeca I-TREATMENT -en I-TREATMENT -40o I-TREATMENT +tres I-TREATMENT +grupos I-TREATMENT de I-TREATMENT -flexión I-TREATMENT -palmar, I-TREATMENT -articulaciones I-TREATMENT -metacarpofalángicas I-TREATMENT +objetivos. I-TREATMENT +Para I-TREATMENT +los I-TREATMENT +objetivos I-TREATMENT +iniciales, I-TREATMENT +se I-TREATMENT +trabajó I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +de I-TREATMENT +entrevista I-TREATMENT +paciente-tutor I-TREATMENT en I-TREATMENT -90o I-TREATMENT +el I-TREATMENT +momento I-TREATMENT +del I-TREATMENT +ingreso. I-TREATMENT +Se I-TREATMENT +informa I-TREATMENT +al I-TREATMENT +paciente I-TREATMENT +de I-TREATMENT +las I-TREATMENT +normas I-TREATMENT +a I-TREATMENT +seguir, I-TREATMENT +de I-TREATMENT +la I-TREATMENT +importancia I-TREATMENT +de I-TREATMENT +la I-TREATMENT +medicación I-TREATMENT y I-TREATMENT -articulaciones I-TREATMENT -interfalángicas I-TREATMENT +controles I-TREATMENT +que I-TREATMENT +debe I-TREATMENT +asumir, I-TREATMENT +mostrándole I-TREATMENT +las I-TREATMENT +ventajas I-TREATMENT +y I-TREATMENT +los I-TREATMENT +lugares I-TREATMENT en I-TREATMENT -extensión. I-TREATMENT -Mantuvimos B-EVOLUTION -la I-EVOLUTION -inmovilización I-EVOLUTION -durante I-EVOLUTION -3 I-EVOLUTION -semanas, I-EVOLUTION -tras I-EVOLUTION -las I-EVOLUTION -cuales I-EVOLUTION -no I-EVOLUTION -fue I-EVOLUTION -necesaria I-EVOLUTION -la I-EVOLUTION -rehabilitación I-EVOLUTION -dada I-EVOLUTION -la I-EVOLUTION -edad I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -buena I-EVOLUTION -movilidad I-EVOLUTION -postoperatoria I-EVOLUTION -que I-EVOLUTION -presentaba. I-EVOLUTION - I-EVOLUTION -Practicamos I-EVOLUTION -radiografía I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -anual I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION -de I-EVOLUTION -recidiva I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -movilidad I-EVOLUTION -completa I-EVOLUTION -tras I-EVOLUTION -3 I-EVOLUTION -años I-EVOLUTION -y I-EVOLUTION -8 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -postoperatorio. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -49 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -asma I-PAST_MEDICAL_HISTORY -bronquial. I-PAST_MEDICAL_HISTORY -En B-TREATMENT -revisión I-TREATMENT -ginecológica I-TREATMENT -periódica I-TREATMENT +que I-TREATMENT se I-TREATMENT +va I-TREATMENT +a I-TREATMENT +realizar. I-TREATMENT +Se I-TREATMENT le I-TREATMENT -diagnostica I-TREATMENT -carcinoma I-TREATMENT -ductal I-TREATMENT -infiltrante I-TREATMENT -de I-TREATMENT -mama I-TREATMENT -izquierda I-TREATMENT +acompaña I-TREATMENT +al I-TREATMENT +CAP I-TREATMENT y I-TREATMENT -es I-TREATMENT -sometida I-TREATMENT +se I-TREATMENT +le I-TREATMENT +presenta I-TREATMENT a I-TREATMENT -mastectomía I-TREATMENT -radical I-TREATMENT -modificada I-TREATMENT -con I-TREATMENT -vaciamiento I-TREATMENT -axilar I-TREATMENT -por I-TREATMENT +los I-TREATMENT +profesionales I-TREATMENT +que I-TREATMENT +le I-TREATMENT +van I-TREATMENT +a I-TREATMENT +atender. I-TREATMENT +Se I-TREATMENT +le I-TREATMENT +pide I-TREATMENT el I-TREATMENT -Servicio I-TREATMENT -de I-TREATMENT -Cirugía I-TREATMENT -General, I-TREATMENT -recibiendo I-TREATMENT -tratamiento I-TREATMENT -adyuvante I-TREATMENT -con I-TREATMENT -radioterapia I-TREATMENT +consentimiento I-TREATMENT +expreso I-TREATMENT y I-TREATMENT -quimioterapia. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -extensión I-EXPLORATION -resultó I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -adenopatías I-EXPLORATION -locorregionales I-EXPLORATION -y I-EXPLORATION -metástasis I-EXPLORATION -a I-EXPLORATION -distancia I-EXPLORATION -(pT3pN0M0). I-EXPLORATION -Al B-DERIVED_FROM/TO -finalizar I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -solicita I-DERIVED_FROM/TO -reconstrucción I-DERIVED_FROM/TO -mamaria, I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -lo I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -Plástica. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -A B-TREATMENT -los I-TREATMENT -4 I-TREATMENT -años I-TREATMENT +la I-TREATMENT +aceptación I-TREATMENT +voluntaria I-TREATMENT de I-TREATMENT la I-TREATMENT -mastectomía I-TREATMENT +normativa I-TREATMENT +de I-TREATMENT +funcionamiento I-TREATMENT +de I-TREATMENT +La I-TREATMENT +Casita. I-TREATMENT + I-TREATMENT +De I-TREATMENT +entre I-TREATMENT +las I-TREATMENT +actividades I-TREATMENT +que I-TREATMENT se I-TREATMENT -procedió I-TREATMENT +realizaron I-TREATMENT +para I-TREATMENT +la I-TREATMENT +consecución I-TREATMENT +de I-TREATMENT +los I-TREATMENT +objetivos I-TREATMENT +a I-TREATMENT +los I-TREATMENT +seis I-TREATMENT +meses I-TREATMENT +y I-TREATMENT a I-TREATMENT +los I-TREATMENT +dos I-TREATMENT +años, I-TREATMENT +se I-TREATMENT +destaca I-TREATMENT la I-TREATMENT -reconstrucción I-TREATMENT -mamaria I-TREATMENT +inclusión I-TREATMENT +del I-TREATMENT +paciente I-TREATMENT +en I-TREATMENT +un I-TREATMENT +programa I-TREATMENT +de I-TREATMENT +automedicación I-TREATMENT +que I-TREATMENT +se I-TREATMENT +desarrolla I-TREATMENT con I-TREATMENT -diversos I-TREATMENT -procedimientos I-TREATMENT +formato I-TREATMENT +de I-TREATMENT +taller I-TREATMENT +y I-TREATMENT que I-TREATMENT -describimos I-TREATMENT -a I-TREATMENT -continuación. I-TREATMENT -En I-TREATMENT -primer I-TREATMENT -lugar I-TREATMENT -reconstrucción I-TREATMENT +integra I-TREATMENT +también I-TREATMENT +actividades I-TREATMENT +individuales I-TREATMENT +como I-TREATMENT +elaboración I-TREATMENT de I-TREATMENT -mama I-TREATMENT -izquierda I-TREATMENT -con I-TREATMENT -colgajo I-TREATMENT -miocutáneo I-TREATMENT +fichas I-TREATMENT de I-TREATMENT -recto I-TREATMENT -abdominal I-TREATMENT -transverso I-TREATMENT -(TRAM), I-TREATMENT -sufriendo I-TREATMENT -pérdida I-TREATMENT -parcial I-TREATMENT -del I-TREATMENT -mismo I-TREATMENT +los I-TREATMENT +fármacos I-TREATMENT que I-TREATMENT +está I-TREATMENT +tomando, I-TREATMENT +posters I-TREATMENT +y I-TREATMENT +puestas I-TREATMENT +en I-TREATMENT +común I-TREATMENT +sobre I-TREATMENT +el I-TREATMENT +tema. I-TREATMENT +Se I-TREATMENT +refuerza I-TREATMENT +continuamente I-TREATMENT +su I-TREATMENT +colaboración I-TREATMENT +y I-TREATMENT +aceptación I-TREATMENT +del I-TREATMENT +tratamiento I-TREATMENT +y I-TREATMENT se I-TREATMENT -resolvió I-TREATMENT +le I-TREATMENT +anima I-TREATMENT +a I-TREATMENT +que I-TREATMENT +vaya I-TREATMENT +preparando I-TREATMENT +la I-TREATMENT +medicación. I-TREATMENT +En I-TREATMENT +la I-TREATMENT +entrevista I-TREATMENT +semanal I-TREATMENT con I-TREATMENT -desbridamiento I-TREATMENT +el I-TREATMENT +tutor I-TREATMENT +se I-TREATMENT +tratan I-TREATMENT +los I-TREATMENT +problemas I-TREATMENT +surgidos I-TREATMENT +al I-TREATMENT +respecto. I-TREATMENT +Se I-TREATMENT +acompaña I-TREATMENT +al I-TREATMENT +paciente I-TREATMENT +a I-TREATMENT +la I-TREATMENT +farmacia, I-TREATMENT +a I-TREATMENT +la I-TREATMENT +inspección I-TREATMENT y I-TREATMENT -cierre I-TREATMENT -directo. I-TREATMENT -Dos I-TREATMENT -años I-TREATMENT -después I-TREATMENT +al I-TREATMENT +CAP I-TREATMENT +para I-TREATMENT +que I-TREATMENT +aprenda I-TREATMENT +el I-TREATMENT +proceso. I-TREATMENT +Se I-TREATMENT +refuerza I-TREATMENT +la I-TREATMENT +abstinencia I-TREATMENT +del I-TREATMENT +tabaco, I-TREATMENT se I-TREATMENT -colocó I-TREATMENT -prótesis I-TREATMENT -expansora I-TREATMENT +restringe I-TREATMENT +su I-TREATMENT +uso I-TREATMENT +a I-TREATMENT +determinados I-TREATMENT +espacios I-TREATMENT de I-TREATMENT -Becker I-TREATMENT -subTRAM I-TREATMENT +la I-TREATMENT +casa I-TREATMENT y I-TREATMENT -finalmente, I-TREATMENT se I-TREATMENT -realizó I-TREATMENT -recambio I-TREATMENT -del I-TREATMENT -expansor I-TREATMENT -por I-TREATMENT -prótesis I-TREATMENT -mamaria I-TREATMENT -definitiva I-TREATMENT -y I-TREATMENT -mastopexia I-TREATMENT -simetrizadora I-TREATMENT -de I-TREATMENT -mama I-TREATMENT -contralateral, I-TREATMENT -quedando I-TREATMENT -pendiente I-TREATMENT +colocan I-TREATMENT +señales I-TREATMENT de I-TREATMENT -completar I-TREATMENT -la I-TREATMENT -reconstrucción I-TREATMENT -del I-TREATMENT -complejo I-TREATMENT -areola I-TREATMENT -pezón I-TREATMENT -(CAP). I-TREATMENT +advertencia. I-TREATMENT +Se I-TREATMENT +hacen I-TREATMENT +además I-TREATMENT +sesiones I-TREATMENT +para I-TREATMENT +debatir I-TREATMENT +sobre I-TREATMENT +el I-TREATMENT +hábito I-TREATMENT +tabáquico. I-TREATMENT + I-TREATMENT En B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -última I-EVOLUTION -intervención I-EVOLUTION -comienza I-EVOLUTION la I-EVOLUTION -aparición I-EVOLUTION -en I-EVOLUTION +evaluación, I-EVOLUTION +decir I-EVOLUTION +que I-EVOLUTION +tanto I-EVOLUTION +los I-EVOLUTION +objetivos I-EVOLUTION +inmediatos I-EVOLUTION +como I-EVOLUTION +los I-EVOLUTION +que I-EVOLUTION +van I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +seis I-EVOLUTION +meses I-EVOLUTION +se I-EVOLUTION +han I-EVOLUTION +conseguido. I-EVOLUTION +No I-EVOLUTION +ocurre I-EVOLUTION +los I-EVOLUTION +mismo I-EVOLUTION +con I-EVOLUTION +los I-EVOLUTION +programados I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +dos I-EVOLUTION +años, I-EVOLUTION +ya I-EVOLUTION +que I-EVOLUTION +los I-EVOLUTION +objetivos I-EVOLUTION +1, I-EVOLUTION +4 I-EVOLUTION +y I-EVOLUTION +5 I-EVOLUTION +referentes I-EVOLUTION +a I-EVOLUTION la I-EVOLUTION -zona I-EVOLUTION -periareolar I-EVOLUTION -de I-EVOLUTION +autoadministración I-EVOLUTION +farmacológica, I-EVOLUTION la I-EVOLUTION -mama I-EVOLUTION -derecha I-EVOLUTION +dieta I-EVOLUTION +antiglucemiante I-EVOLUTION y I-EVOLUTION -en I-EVOLUTION el I-EVOLUTION -centro I-EVOLUTION -del I-EVOLUTION -colgajo I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mama I-EVOLUTION -izquierda I-EVOLUTION -de I-EVOLUTION -pequeñas I-EVOLUTION -lesiones I-EVOLUTION -pustulosas I-EVOLUTION -con I-EVOLUTION -posterior I-EVOLUTION -desarrollo I-EVOLUTION -de I-EVOLUTION -úlceras I-EVOLUTION -dolorosas I-EVOLUTION -de I-EVOLUTION -borde I-EVOLUTION -violáceo I-EVOLUTION +tabaco I-EVOLUTION +no I-EVOLUTION +se I-EVOLUTION +lograron. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +sigue I-EVOLUTION +fumando I-EVOLUTION +>40 I-EVOLUTION +cigarrillos/día, I-EVOLUTION y I-EVOLUTION -fondo I-EVOLUTION -con I-EVOLUTION -tejido I-EVOLUTION -de I-EVOLUTION -granulación,. I-EVOLUTION +si I-EVOLUTION +no I-EVOLUTION +está I-EVOLUTION +bajo I-EVOLUTION +supervisión I-EVOLUTION +no I-EVOLUTION +toma I-EVOLUTION +su I-EVOLUTION +medicación I-EVOLUTION +ni I-EVOLUTION +tampoco I-EVOLUTION +respeta I-EVOLUTION +la I-EVOLUTION +dieta. I-EVOLUTION I-EVOLUTION -Con B-EXPLORATION -el I-EXPLORATION -presunto I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -dehiscencia I-EXPLORATION -de I-EXPLORATION -herida I-EXPLORATION -quirúrgica I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -biopsia I-EXPLORATION -que I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -de I-EXPLORATION -granulación, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT +Trastornos B-TREATMENT +de I-TREATMENT +los I-TREATMENT +procesos I-TREATMENT +del I-TREATMENT +pensamiento I-TREATMENT +y I-TREATMENT +Trastorno I-TREATMENT +de I-TREATMENT la I-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -sometida I-TREATMENT -a I-TREATMENT -curas I-TREATMENT +percepción I-TREATMENT +sensorial I-TREATMENT +auditiva. I-TREATMENT +Continuando I-TREATMENT con I-TREATMENT -desbridamiento I-TREATMENT -durante I-TREATMENT -más I-TREATMENT +los I-TREATMENT +dos I-TREATMENT +siguientes I-TREATMENT +diagnósticos, I-TREATMENT +se I-TREATMENT +presentaron I-TREATMENT +dos I-TREATMENT +grupos I-TREATMENT de I-TREATMENT -12 I-TREATMENT -meses. I-TREATMENT -Dada B-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -mala I-DERIVED_FROM/TO -evolución, I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -decide I-DERIVED_FROM/TO -interconsulta I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Dermatología, I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -ante I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -sospecha I-DERIVED_FROM/TO -inicial I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -pioderma I-DERIVED_FROM/TO -gangrenoso, I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -realiza I-DERIVED_FROM/TO -estudio I-DERIVED_FROM/TO -exhaustivo I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -descartar I-DERIVED_FROM/TO -otros I-DERIVED_FROM/TO -procesos. I-DERIVED_FROM/TO -Se B-EXPLORATION -solicitaron I-EXPLORATION -las I-EXPLORATION -siguientes I-EXPLORATION -pruebas: I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Analítica, I-EXPLORATION -incluyendo I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -autoinmunidad I-EXPLORATION -(ANAs I-EXPLORATION -y I-EXPLORATION -ENAs) I-EXPLORATION -y I-EXPLORATION -proteinograma: I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -patológicas. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Serología I-EXPLORATION -luética, I-EXPLORATION -virus I-EXPLORATION -hepatitis I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C, I-EXPLORATION -VIH: I-EXPLORATION -negativa. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Mantoux: I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -tórax: I-EXPLORATION -engrosamiento I-EXPLORATION -difuso I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -paredes I-EXPLORATION -bronquiales; I-EXPLORATION -cambios I-EXPLORATION -quirúrgicos I-EXPLORATION -en I-EXPLORATION -mama I-EXPLORATION -izquierda I-EXPLORATION -con I-EXPLORATION -grapas I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -axilar. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Biopsia I-EXPLORATION -con I-EXPLORATION -técnicas I-EXPLORATION -de I-EXPLORATION -PAS, I-EXPLORATION -Grocott I-EXPLORATION -y I-EXPLORATION -Ziehl- I-EXPLORATION -Neelsen: I-EXPLORATION -ulceración I-EXPLORATION -epidérmica I-EXPLORATION -focal I-EXPLORATION -con I-EXPLORATION -abscesificación I-EXPLORATION -dérmica I-EXPLORATION -y I-EXPLORATION -folicular, I-EXPLORATION -inflamación I-EXPLORATION -crónica I-EXPLORATION -linfohistiocitaria I-EXPLORATION -y I-EXPLORATION -plasmocitaria I-EXPLORATION -adyacente I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -distribución I-EXPLORATION -perivascular I-EXPLORATION -en I-EXPLORATION -dermis I-EXPLORATION -superficial I-EXPLORATION -y I-EXPLORATION -profunda. I-EXPLORATION -Hallazgos I-EXPLORATION -histopatológicos I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -clínica I-EXPLORATION -de I-EXPLORATION -pioderma I-EXPLORATION -gangrenoso I-EXPLORATION -clásico I-EXPLORATION -o I-EXPLORATION -ulcerado. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Cultivo I-EXPLORATION -biopsia I-EXPLORATION -(aerobio, I-EXPLORATION -anaerobio, I-EXPLORATION -hongos I-EXPLORATION -y I-EXPLORATION -micobacterias): I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -Tras B-TREATMENT +objetivos: I-TREATMENT +unos I-TREATMENT +permanentes I-TREATMENT +y I-TREATMENT +otros I-TREATMENT +a I-TREATMENT +los I-TREATMENT +dos I-TREATMENT +años. I-TREATMENT + I-TREATMENT +Los I-TREATMENT +permanentes I-TREATMENT +fueron: I-TREATMENT +1) I-TREATMENT +conocer I-TREATMENT +los I-TREATMENT +síntomas I-TREATMENT +psicopatológicos I-TREATMENT +que I-TREATMENT +presenta I-TREATMENT el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -exclusión I-TREATMENT -de I-TREATMENT -pioderma I-TREATMENT -gangrenoso I-TREATMENT -clásico, I-TREATMENT -iniciamos I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -oral I-TREATMENT +paciente I-TREATMENT +en I-TREATMENT +cuanto I-TREATMENT a I-TREATMENT -dosis I-TREATMENT +alteraciones I-TREATMENT +del I-TREATMENT +pensamiento I-TREATMENT +y I-TREATMENT +en I-TREATMENT +lo I-TREATMENT +cognitivo-perceptivo, I-TREATMENT +y I-TREATMENT +2) I-TREATMENT +evitar I-TREATMENT +episodios I-TREATMENT de I-TREATMENT -60 I-TREATMENT -mg/día I-TREATMENT -asociando I-TREATMENT -propionato I-TREATMENT +héteroagresividad I-TREATMENT +y I-TREATMENT +aparición I-TREATMENT de I-TREATMENT -clobetasol I-TREATMENT -0, I-TREATMENT -05% I-TREATMENT -tópico I-TREATMENT -durante I-TREATMENT -3 I-TREATMENT -meses. I-TREATMENT -Al I-TREATMENT -reducir I-TREATMENT -la I-TREATMENT -pauta I-TREATMENT -esteroidea I-TREATMENT +crisis. I-TREATMENT +El I-TREATMENT +objetivo I-TREATMENT a I-TREATMENT -30 I-TREATMENT -mg/día I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -comenzó I-TREATMENT +los I-TREATMENT +dos I-TREATMENT +años, I-TREATMENT +indica I-TREATMENT +que I-TREATMENT +el I-TREATMENT +sujeto I-TREATMENT +habrá I-TREATMENT +eliminado I-TREATMENT +las I-TREATMENT +expresiones I-TREATMENT +verbales I-TREATMENT +agresivas I-TREATMENT +y I-TREATMENT con I-TREATMENT -un I-TREATMENT -rebrote I-TREATMENT +contenido I-TREATMENT de I-TREATMENT +muerte I-TREATMENT +hacia I-TREATMENT +otras I-TREATMENT +personas. I-TREATMENT + I-TREATMENT +Siguiendo I-TREATMENT +con I-TREATMENT +el I-TREATMENT +proceso, I-TREATMENT +se I-TREATMENT +realizan I-TREATMENT las I-TREATMENT -lesiones, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT +actividades I-TREATMENT +acordadas I-TREATMENT que I-TREATMENT -decidimos I-TREATMENT -asociar I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ciclosporina I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -4 I-TREATMENT -mg/Kg I-TREATMENT +incluyen I-TREATMENT +en I-TREATMENT +primer I-TREATMENT +lugar I-TREATMENT +el I-TREATMENT +registro I-TREATMENT de I-TREATMENT -peso, I-TREATMENT -sustituir I-TREATMENT los I-TREATMENT -corticoides I-TREATMENT -tópicos I-TREATMENT -por I-TREATMENT -tacrolimus I-TREATMENT -0, I-TREATMENT -1% I-TREATMENT -tópico I-TREATMENT -y I-TREATMENT -reducir I-TREATMENT -también I-TREATMENT -paulatinamente I-TREATMENT +datos I-TREATMENT +recogidos I-TREATMENT +sobre I-TREATMENT la I-TREATMENT -prednisona I-TREATMENT -hasta I-TREATMENT -su I-TREATMENT -suspensión I-TREATMENT -durante I-TREATMENT +ideación I-TREATMENT +delirante I-TREATMENT +y I-TREATMENT +conducta I-TREATMENT +del I-TREATMENT +paciente. I-TREATMENT +Se I-TREATMENT +procura I-TREATMENT +generar I-TREATMENT +y I-TREATMENT +mantener I-TREATMENT un I-TREATMENT -periodo I-TREATMENT -de I-TREATMENT -mes I-TREATMENT +espacio I-TREATMENT +común I-TREATMENT +para I-TREATMENT +la I-TREATMENT +convivencia I-TREATMENT y I-TREATMENT -medio. I-TREATMENT +la I-TREATMENT +tolerancia, I-TREATMENT +fomentando I-TREATMENT +el I-TREATMENT +respeto I-TREATMENT +a I-TREATMENT +las I-TREATMENT +personas. I-TREATMENT +En I-TREATMENT +las I-TREATMENT +entrevistas I-TREATMENT +que I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +mantiene I-TREATMENT +con I-TREATMENT +el I-TREATMENT +tutor, I-TREATMENT +se I-TREATMENT +analizan I-TREATMENT +las I-TREATMENT +conductas I-TREATMENT +inapropiadas, I-TREATMENT +presentando I-TREATMENT +alternativas I-TREATMENT +que I-TREATMENT +cuando I-TREATMENT +se I-TREATMENT +reproducen I-TREATMENT +son I-TREATMENT +reforzadas I-TREATMENT +mediante I-TREATMENT +elogios. I-TREATMENT +También I-TREATMENT +se I-TREATMENT +solicita I-TREATMENT +presencia I-TREATMENT +del I-TREATMENT +clínico, I-TREATMENT +a I-TREATMENT +parte I-TREATMENT +de I-TREATMENT +las I-TREATMENT +consultas, I-TREATMENT +para I-TREATMENT +las I-TREATMENT +entrevistas I-TREATMENT +cuando I-TREATMENT +el I-TREATMENT +tutor I-TREATMENT +lo I-TREATMENT +valora. I-TREATMENT I-TREATMENT -Inicialmente, B-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -experimenta I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -favorable I-EVOLUTION -salvo I-EVOLUTION -hipertensión I-EVOLUTION -controlada I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -diurético I-EVOLUTION -tiazídico I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -consigue I-EVOLUTION -una I-EVOLUTION -buena I-EVOLUTION -reepitelización I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones; I-EVOLUTION -pero I-EVOLUTION -tras I-EVOLUTION -2 I-EVOLUTION -meses I-EVOLUTION +Los B-EVOLUTION +tres I-EVOLUTION +objetivos I-EVOLUTION +que I-EVOLUTION +acabamos I-EVOLUTION de I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -ciclosporina I-EVOLUTION -comienza I-EVOLUTION -con I-EVOLUTION -efectos I-EVOLUTION -secundarios I-EVOLUTION -muy I-EVOLUTION -molestos: I-EVOLUTION -hiperplasia I-EVOLUTION -gingival, I-EVOLUTION -hipertricosis, I-EVOLUTION -hirsutismo I-EVOLUTION +exponer, I-EVOLUTION +dos I-EVOLUTION +permanentes I-EVOLUTION y I-EVOLUTION -disestesias I-EVOLUTION -que I-EVOLUTION -nos I-EVOLUTION -obligan I-EVOLUTION +uno I-EVOLUTION a I-EVOLUTION -la I-EVOLUTION -reducción I-EVOLUTION -progresiva I-EVOLUTION -de I-EVOLUTION -este I-EVOLUTION -tratamiento, I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -tiene I-EVOLUTION -como I-EVOLUTION -consecuencia I-EVOLUTION -un I-EVOLUTION -nuevo I-EVOLUTION -rebrote I-EVOLUTION -de I-EVOLUTION -pequeñas I-EVOLUTION -lesiones I-EVOLUTION -pustulosas I-EVOLUTION -que B-TREATMENT -infiltramos I-TREATMENT -con I-TREATMENT -triamcinolona I-TREATMENT -a I-TREATMENT +los I-EVOLUTION +dos I-EVOLUTION +años, I-EVOLUTION +fueron I-EVOLUTION +conseguidos I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +plazos I-EVOLUTION +previstos. I-EVOLUTION + I-EVOLUTION +Deterioro B-TREATMENT +de I-TREATMENT la I-TREATMENT -vez I-TREATMENT +interacción I-TREATMENT +social. I-TREATMENT +Para I-TREATMENT +trabajar I-TREATMENT +la I-TREATMENT +problemática I-TREATMENT que I-TREATMENT -retiramos I-TREATMENT +presenta I-TREATMENT el I-TREATMENT -tacrolimus I-TREATMENT -tópico. I-TREATMENT -La I-TREATMENT -intolerancia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT +cuarto I-TREATMENT +diagnóstico I-TREATMENT +se I-TREATMENT +establecen I-TREATMENT +cuatro I-TREATMENT +objetivos I-TREATMENT a I-TREATMENT los I-TREATMENT -efectos I-TREATMENT -secundarios I-TREATMENT +seis I-TREATMENT +meses I-TREATMENT +y I-TREATMENT +dos I-TREATMENT +a I-TREATMENT +los I-TREATMENT +dos I-TREATMENT +años. I-TREATMENT +Los I-TREATMENT +cuatro I-TREATMENT +primeros I-TREATMENT +son: I-TREATMENT +1) I-TREATMENT +visitar I-TREATMENT +e I-TREATMENT +informar I-TREATMENT +a I-TREATMENT +los I-TREATMENT +vecinos I-TREATMENT de I-TREATMENT -la I-TREATMENT -ciclosporina, I-TREATMENT -nos I-TREATMENT -obligó I-TREATMENT +su I-TREATMENT +pueblo; I-TREATMENT +2) I-TREATMENT +entrevistarse I-TREATMENT +con I-TREATMENT +las I-TREATMENT +personas I-TREATMENT +agredidas; I-TREATMENT +3) I-TREATMENT +que I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +haga I-TREATMENT +visitas I-TREATMENT +programadas I-TREATMENT a I-TREATMENT su I-TREATMENT -suspensión I-TREATMENT -completa I-TREATMENT -tras I-TREATMENT -4 I-TREATMENT -meses I-TREATMENT +casa I-TREATMENT +siendo I-TREATMENT +acompañado I-TREATMENT +por I-TREATMENT +personal I-TREATMENT +enfermero I-TREATMENT +y I-TREATMENT +4) I-TREATMENT +se I-TREATMENT +informará I-TREATMENT +a I-TREATMENT +las I-TREATMENT +fuerzas I-TREATMENT +del I-TREATMENT +orden I-TREATMENT +público I-TREATMENT de I-TREATMENT -tratamiento. I-TREATMENT +dicha I-TREATMENT +actividad. I-TREATMENT I-TREATMENT -Finalmente, I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -aparición I-TREATMENT -de I-TREATMENT -nuevas I-TREATMENT -lesiones I-TREATMENT -y I-TREATMENT -la I-TREATMENT -mala I-TREATMENT -tolerancia I-TREATMENT +Los I-TREATMENT +dos I-TREATMENT +objetivos I-TREATMENT +siguientes, I-TREATMENT +a I-TREATMENT +conseguir I-TREATMENT a I-TREATMENT los I-TREATMENT -tratamientos I-TREATMENT -previos, I-TREATMENT -optamos I-TREATMENT -por I-TREATMENT -iniciar I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -infliximab I-TREATMENT -(agente I-TREATMENT -anti-TNF), I-TREATMENT -comenzando I-TREATMENT -con I-TREATMENT +dos I-TREATMENT +años, I-TREATMENT +son: I-TREATMENT +1) I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +desarrollará I-TREATMENT una I-TREATMENT -terapia I-TREATMENT -de I-TREATMENT -inducción I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -mg/kg I-TREATMENT -a I-TREATMENT +actividad I-TREATMENT +normal I-TREATMENT +durante I-TREATMENT las I-TREATMENT -0, I-TREATMENT -2 I-TREATMENT +visitas, I-TREATMENT +relacionándose I-TREATMENT +con I-TREATMENT +parientes I-TREATMENT y I-TREATMENT -6 I-TREATMENT -semanas I-TREATMENT -similar I-TREATMENT -a I-TREATMENT -la I-TREATMENT -empleada I-TREATMENT -en I-TREATMENT -la I-TREATMENT -enfermedad I-TREATMENT -inflamatoria I-TREATMENT -intestinal I-TREATMENT -o I-TREATMENT +vecinos I-TREATMENT en I-TREATMENT la I-TREATMENT -psoriasis, I-TREATMENT -continuando I-TREATMENT -con I-TREATMENT -infusiones I-TREATMENT +mediada I-TREATMENT de I-TREATMENT -mantenimiento I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -semanas. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -satisfactoria I-EVOLUTION -con I-EVOLUTION -reepitelización I-EVOLUTION -completa I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -nuevo I-EVOLUTION -tratamiento, I-EVOLUTION -por B-TREATMENT lo I-TREATMENT -que I-TREATMENT -decidimos I-TREATMENT -mantener I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -similar I-TREATMENT -al I-TREATMENT -de I-TREATMENT -otras I-TREATMENT -dermatosis I-TREATMENT -inflamatorias I-TREATMENT -hasta I-TREATMENT -objetivar I-TREATMENT -estabilización I-TREATMENT -de I-TREATMENT +posible I-TREATMENT +y I-TREATMENT +2) I-TREATMENT +su I-TREATMENT +presencia I-TREATMENT +en I-TREATMENT la I-TREATMENT -enfermedad, I-TREATMENT -tras I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -nos I-TREATMENT -plantearemos I-TREATMENT -reducir, I-TREATMENT -con I-TREATMENT -espaciamiento I-TREATMENT -progresivo I-TREATMENT +zona I-TREATMENT +no I-TREATMENT +será I-TREATMENT +causa I-TREATMENT de I-TREATMENT -las I-TREATMENT -dosis. I-TREATMENT +temor I-TREATMENT +o I-TREATMENT +alarma I-TREATMENT +social. I-TREATMENT I-TREATMENT - -Paciente B-PRESENT_ILLNESS -neonato I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -sufre I-PRESENT_ILLNESS -cefalohematoma I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -parto I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -fórceps. I-PRESENT_ILLNESS -La B-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Neonatología I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -hospitalario I-DERIVED_FROM/TO -solicita I-DERIVED_FROM/TO -valoración I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -Plástica. I-DERIVED_FROM/TO -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -clínica I-EXPLORATION -observamos I-EXPLORATION -tejido I-EXPLORATION -necrótico I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -3x4 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -occipital. I-EXPLORATION - I-EXPLORATION -Procedimos B-TREATMENT -a I-TREATMENT -desbridamientos I-TREATMENT -seriados I-TREATMENT -que I-TREATMENT +Para I-TREATMENT +lograr I-TREATMENT +estos I-TREATMENT +objetivos I-TREATMENT se I-TREATMENT -llevaron I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT +fueron I-TREATMENT +realizando I-TREATMENT a I-TREATMENT +lo I-TREATMENT +largo I-TREATMENT +de I-TREATMENT los I-TREATMENT -8 I-TREATMENT +meses I-TREATMENT +numerosas I-TREATMENT +entrevistas I-TREATMENT +con I-TREATMENT +vecinos I-TREATMENT +del I-TREATMENT +pueblo I-TREATMENT y I-TREATMENT -15 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -vida I-TREATMENT -de I-TREATMENT +familiares, I-TREATMENT +con I-TREATMENT la I-TREATMENT +persona I-TREATMENT +agredida I-TREATMENT +(la I-TREATMENT +otra I-TREATMENT +falleció) I-TREATMENT +y I-TREATMENT +con I-TREATMENT +el I-TREATMENT +cura I-TREATMENT +amenazado I-TREATMENT +por I-TREATMENT +nuestro I-TREATMENT paciente. I-TREATMENT En I-TREATMENT -esa I-TREATMENT -segunda I-TREATMENT -intervención, I-TREATMENT -optamos I-TREATMENT -por I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -un I-TREATMENT -sistema I-TREATMENT -de I-TREATMENT -terapia I-TREATMENT +estos I-TREATMENT +encuentros I-TREATMENT +se I-TREATMENT +informó I-TREATMENT de I-TREATMENT -vacío I-TREATMENT -(Renasys®, I-TREATMENT -Smith&Nephew®, I-TREATMENT -Londres, I-TREATMENT -Reino I-TREATMENT -Unido) I-TREATMENT +las I-TREATMENT +características I-TREATMENT +del I-TREATMENT +programa I-TREATMENT de I-TREATMENT -modo I-TREATMENT -continuo, I-TREATMENT -a I-TREATMENT -120 I-TREATMENT -mmHg I-TREATMENT -durante I-TREATMENT -20 I-TREATMENT -días, I-TREATMENT -con I-TREATMENT -cambios I-TREATMENT +visitas I-TREATMENT +y I-TREATMENT +se I-TREATMENT +procuró I-TREATMENT +reforzar I-TREATMENT +la I-TREATMENT +idea I-TREATMENT de I-TREATMENT -apósitos I-TREATMENT -cada I-TREATMENT -72 I-TREATMENT -horas. I-TREATMENT -Con I-TREATMENT -este I-TREATMENT -tratamiento I-TREATMENT -observamos I-TREATMENT -contracción I-TREATMENT -del I-TREATMENT -defecto I-TREATMENT -original, I-TREATMENT -procediendo I-TREATMENT -a I-TREATMENT -realizar I-TREATMENT -colgajos I-TREATMENT -rotacionales I-TREATMENT +que I-TREATMENT +dichas I-TREATMENT +visitas I-TREATMENT +no I-TREATMENT +alterarían I-TREATMENT +en I-TREATMENT +absoluto I-TREATMENT +el I-TREATMENT +orden I-TREATMENT +público I-TREATMENT +ni I-TREATMENT +supondrían I-TREATMENT +riesgo I-TREATMENT para I-TREATMENT +nadie. I-TREATMENT +Además I-TREATMENT +se I-TREATMENT +dejó I-TREATMENT +perfectamente I-TREATMENT +claro I-TREATMENT +que I-TREATMENT el I-TREATMENT -cierre I-TREATMENT -definitivo I-TREATMENT +paciente I-TREATMENT +siempre I-TREATMENT +estaría I-TREATMENT +acompañado I-TREATMENT de I-TREATMENT -la I-TREATMENT -herida. I-TREATMENT +personal I-TREATMENT +sanitario. I-TREATMENT +La I-TREATMENT +Guardia I-TREATMENT +Civil I-TREATMENT +también I-TREATMENT +fue I-TREATMENT +puntualmente I-TREATMENT +informada. I-TREATMENT I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -4o I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -postoperatorio, I-EVOLUTION -sin I-EVOLUTION -mayores I-EVOLUTION -incidencias. I-EVOLUTION -La I-EVOLUTION -última I-EVOLUTION -valoración I-EVOLUTION -fue I-EVOLUTION -realizada I-EVOLUTION +Dichas B-EVOLUTION +actividades I-EVOLUTION +condujeron I-EVOLUTION a I-EVOLUTION -los I-EVOLUTION -18 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -postoperatorio, I-EVOLUTION -observando I-EVOLUTION -solo I-EVOLUTION -una I-EVOLUTION -pequeña I-EVOLUTION -zona I-EVOLUTION -de I-EVOLUTION -alopecia I-EVOLUTION -cicatricial I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -una I-EVOLUTION -brida I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -región I-EVOLUTION -de I-EVOLUTION la I-EVOLUTION -nuca, I-EVOLUTION -susceptibles I-EVOLUTION -de I-EVOLUTION -nuevas I-EVOLUTION -intervenciones I-EVOLUTION -quirúrgicas I-EVOLUTION +consecución I-EVOLUTION +satisfactoria I-EVOLUTION en I-EVOLUTION -el I-EVOLUTION -futuro I-EVOLUTION -si I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -o I-EVOLUTION -la I-EVOLUTION -familia I-EVOLUTION -lo I-EVOLUTION -requieren. I-EVOLUTION +tiempo I-EVOLUTION +y I-EVOLUTION +forma I-EVOLUTION +de I-EVOLUTION +todos I-EVOLUTION +los I-EVOLUTION +objetivos I-EVOLUTION +propuestos. I-EVOLUTION I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -recién I-PRESENT_ILLNESS -nacido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -gestación, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -Pediatría I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -presentar I-DERIVED_FROM/TO -malformación I-DERIVED_FROM/TO -linfática I-DERIVED_FROM/TO -microquística I-DERIVED_FROM/TO -cérvicoescápulo- I-DERIVED_FROM/TO -humeral. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -A B-TREATMENT +Afrontamiento B-TREATMENT +familiar I-TREATMENT +comprometido. I-TREATMENT +El I-TREATMENT +quinto I-TREATMENT +y I-TREATMENT +último I-TREATMENT +de I-TREATMENT los I-TREATMENT -7 I-TREATMENT -días I-TREATMENT +diagnósticos I-TREATMENT +exige I-TREATMENT de I-TREATMENT -vida I-TREATMENT -se I-TREATMENT -le I-TREATMENT -realiza I-TREATMENT -la I-TREATMENT -punción I-TREATMENT -y I-TREATMENT -evacuación I-TREATMENT -del I-TREATMENT -linfangioma I-TREATMENT -con I-TREATMENT -posterior I-TREATMENT -instilación I-TREATMENT +nuevo I-TREATMENT +el I-TREATMENT +planteamiento I-TREATMENT de I-TREATMENT -polidocanol I-TREATMENT -y I-TREATMENT -etanol. I-TREATMENT -Se I-TREATMENT -repitió I-TREATMENT +tres I-TREATMENT +grupos I-TREATMENT +de I-TREATMENT +objetivos. I-TREATMENT +Un I-TREATMENT +primer I-TREATMENT +objetivo I-TREATMENT +permanente, I-TREATMENT el I-TREATMENT -tratamiento I-TREATMENT -5 I-TREATMENT -días I-TREATMENT -después. I-TREATMENT -De I-TREATMENT +segundo I-TREATMENT +grupo I-TREATMENT +compuesto I-TREATMENT +por I-TREATMENT +tres I-TREATMENT +objetivos I-TREATMENT +a I-TREATMENT +cumplir I-TREATMENT +a I-TREATMENT los I-TREATMENT -7 I-TREATMENT -drenajes I-TREATMENT -colocados, I-TREATMENT -1 I-TREATMENT -de I-TREATMENT -localización I-TREATMENT -axilar I-TREATMENT -fue I-TREATMENT -retirado I-TREATMENT +seis I-TREATMENT +meses I-TREATMENT +y I-TREATMENT +dos I-TREATMENT +más I-TREATMENT +que I-TREATMENT +deberían I-TREATMENT +lograrse I-TREATMENT a I-TREATMENT los I-TREATMENT -3 I-TREATMENT -días I-TREATMENT -por I-TREATMENT -aparente I-TREATMENT -sufrimiento I-TREATMENT -cutáneo. I-TREATMENT +dos I-TREATMENT +años. I-TREATMENT I-TREATMENT -Tras B-EVOLUTION -la I-EVOLUTION -segunda I-EVOLUTION -infiltración I-EVOLUTION -observamos I-EVOLUTION -herida I-EVOLUTION -superficial I-EVOLUTION -de I-EVOLUTION -3x10 I-EVOLUTION -cm I-EVOLUTION -de I-EVOLUTION -diámetro, I-EVOLUTION -que I-EVOLUTION -afecta I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -región I-EVOLUTION -humeral I-EVOLUTION -y I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -superficie I-EVOLUTION -anterior I-EVOLUTION -del I-EVOLUTION -tórax, I-EVOLUTION -secundaria I-EVOLUTION -a I-EVOLUTION -extravasación I-EVOLUTION -por I-EVOLUTION -punta I-EVOLUTION -del I-EVOLUTION -catéter I-EVOLUTION -de I-EVOLUTION -instilación I-EVOLUTION -de I-EVOLUTION -polidocanol. I-EVOLUTION -La B-TREATMENT -lesión I-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT -con I-TREATMENT -curas I-TREATMENT -con I-TREATMENT -apósitos I-TREATMENT +El I-TREATMENT +objetivo I-TREATMENT +permanente, I-TREATMENT +es I-TREATMENT +que I-TREATMENT +su I-TREATMENT +familia I-TREATMENT +reciba I-TREATMENT +información I-TREATMENT +del I-TREATMENT +proyecto I-TREATMENT +rehabilitador I-TREATMENT +y I-TREATMENT +evolución I-TREATMENT +del I-TREATMENT +paciente I-TREATMENT de I-TREATMENT -hidrocoloide. I-TREATMENT -Una I-TREATMENT -semana I-TREATMENT -después, I-TREATMENT -procedimos I-TREATMENT +forma I-TREATMENT +sostenida, I-TREATMENT a I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT +través I-TREATMENT +del I-TREATMENT +contacto I-TREATMENT +y I-TREATMENT +entrevistas I-TREATMENT +con I-TREATMENT +el I-TREATMENT +tutor. I-TREATMENT +En I-TREATMENT +los I-TREATMENT +objetivos I-TREATMENT +a I-TREATMENT +los I-TREATMENT +seis I-TREATMENT +meses, I-TREATMENT +se I-TREATMENT +incluyen: I-TREATMENT +1) I-TREATMENT un I-TREATMENT -sistema I-TREATMENT -de I-TREATMENT -terapia I-TREATMENT +mayor I-TREATMENT +protagonismo I-TREATMENT de I-TREATMENT -vacío I-TREATMENT -(Renasys®, I-TREATMENT -Smith&Nephew®, I-TREATMENT -Londres, I-TREATMENT -Reino I-TREATMENT -Unido) I-TREATMENT -a I-TREATMENT -100 I-TREATMENT -mmHg, I-TREATMENT +esta I-TREATMENT +familia I-TREATMENT en I-TREATMENT -modo I-TREATMENT -continuo, I-TREATMENT -con I-TREATMENT -la I-TREATMENT -finalidad I-TREATMENT -de I-TREATMENT -acelerar I-TREATMENT el I-TREATMENT -cierre I-TREATMENT -de I-TREATMENT -la I-TREATMENT -herida I-TREATMENT +proceso I-TREATMENT +terapéutico; I-TREATMENT +2) I-TREATMENT +visitas I-TREATMENT +programadas I-TREATMENT +semanales I-TREATMENT +al I-TREATMENT +paciente I-TREATMENT +para I-TREATMENT +llevarlo I-TREATMENT +a I-TREATMENT +comer I-TREATMENT +fuera, I-TREATMENT y I-TREATMENT -controlar I-TREATMENT -la I-TREATMENT -linforrea. I-TREATMENT -Los I-TREATMENT -cambios I-TREATMENT +3) I-TREATMENT +hacerse I-TREATMENT +cargo I-TREATMENT +del I-TREATMENT +lavado I-TREATMENT de I-TREATMENT -apósitos I-TREATMENT -se I-TREATMENT -realizaron I-TREATMENT -cada I-TREATMENT -72 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -la I-TREATMENT -terapia I-TREATMENT +su I-TREATMENT +ropa I-TREATMENT +a I-TREATMENT +cambio I-TREATMENT de I-TREATMENT -vacío I-TREATMENT +una I-TREATMENT +contraprestación I-TREATMENT +económica I-TREATMENT +pactada. I-TREATMENT +A I-TREATMENT +los I-TREATMENT +dos I-TREATMENT +años I-TREATMENT se I-TREATMENT -utilizó I-TREATMENT -durante I-TREATMENT -21 I-TREATMENT -días. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -permaneció I-EVOLUTION -hospitalizado I-EVOLUTION -hasta I-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con B-TREATMENT -curas I-TREATMENT -domiciliarias I-TREATMENT -con I-TREATMENT -Aquacel® I-TREATMENT -Ag I-TREATMENT -(ConvaTec®, I-TREATMENT -Reino I-TREATMENT -Unido), I-TREATMENT -hasta I-TREATMENT -lograr I-TREATMENT +establecen I-TREATMENT +como I-TREATMENT +objetivos, I-TREATMENT +por I-TREATMENT +una I-TREATMENT +parte: I-TREATMENT +1) I-TREATMENT +que I-TREATMENT +su I-TREATMENT +hermano I-TREATMENT +sea I-TREATMENT +capaz I-TREATMENT +de I-TREATMENT +verbalizar I-TREATMENT +elogios I-TREATMENT +hacia I-TREATMENT el I-TREATMENT -cierre I-TREATMENT -total I-TREATMENT +paciente I-TREATMENT +por I-TREATMENT +su I-TREATMENT +progresos I-TREATMENT y I-TREATMENT -estable I-TREATMENT -de I-TREATMENT -la I-TREATMENT -herida I-TREATMENT -de I-TREATMENT -manera I-TREATMENT -ambulatoria. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -11 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -presenta I-EVOLUTION -una I-EVOLUTION -masa I-EVOLUTION -persistente, I-EVOLUTION -fundamentalmente I-EVOLUTION -a I-EVOLUTION -expensas I-EVOLUTION -de I-EVOLUTION -hipertrofia I-EVOLUTION -del I-EVOLUTION -tejido I-EVOLUTION -celular I-EVOLUTION -subcutáneo, I-EVOLUTION -con I-EVOLUTION -lesiones I-EVOLUTION -quísticas I-EVOLUTION -residuales I-EVOLUTION -de I-EVOLUTION -predominio I-EVOLUTION -microquístico I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -superficie I-EVOLUTION -medial I-EVOLUTION -del I-EVOLUTION -brazo I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -pared I-EVOLUTION -torácica. I-EVOLUTION -Dado B-TREATMENT +en I-TREATMENT +su I-TREATMENT +presencia I-TREATMENT +y I-TREATMENT +por I-TREATMENT +otro I-TREATMENT +lado: I-TREATMENT +2) I-TREATMENT que I-TREATMENT el I-TREATMENT paciente I-TREATMENT -está I-TREATMENT -asintomático, I-TREATMENT -tras I-TREATMENT -consultar I-TREATMENT -con I-TREATMENT +respete I-TREATMENT la I-TREATMENT -familia I-TREATMENT -decidimos I-TREATMENT -mantener I-TREATMENT +opinión I-TREATMENT +de I-TREATMENT +sus I-TREATMENT +familiares I-TREATMENT +omitiendo I-TREATMENT +expresiones I-TREATMENT +desautorizantes I-TREATMENT +o I-TREATMENT +insultantes. I-TREATMENT + I-TREATMENT +El I-TREATMENT +diseño I-TREATMENT +de I-TREATMENT +actividades I-TREATMENT +para I-TREATMENT +estos I-TREATMENT +objetivos I-TREATMENT +incluyó I-TREATMENT +en I-TREATMENT un I-TREATMENT -tratamiento I-TREATMENT -conservador I-TREATMENT +primer I-TREATMENT +momento I-TREATMENT +una I-TREATMENT +serie I-TREATMENT +de I-TREATMENT +entrevistas I-TREATMENT +programadas I-TREATMENT +entre I-TREATMENT +familiares, I-TREATMENT +paciente I-TREATMENT y I-TREATMENT -valorar I-TREATMENT -su I-TREATMENT +tutor I-TREATMENT +a I-TREATMENT +fin I-TREATMENT +de I-TREATMENT +aclarar I-TREATMENT +todos I-TREATMENT +los I-TREATMENT +aspectos I-TREATMENT +concernientes I-TREATMENT +al I-TREATMENT +proyecto I-TREATMENT +terapéutico I-TREATMENT +del I-TREATMENT +paciente, I-TREATMENT +normas I-TREATMENT +de I-TREATMENT +funcionamiento, I-TREATMENT +actividades I-TREATMENT +dentro I-TREATMENT +y I-TREATMENT +fuera I-TREATMENT +del I-TREATMENT +dispositivo I-TREATMENT +y I-TREATMENT +colaboración I-TREATMENT +necesaria I-TREATMENT +de I-TREATMENT +la I-TREATMENT +familia. I-TREATMENT +A I-TREATMENT +lo I-TREATMENT +largo I-TREATMENT +del I-TREATMENT +tiempo I-TREATMENT +se I-TREATMENT +les I-TREATMENT +fue I-TREATMENT +informando I-TREATMENT +de I-TREATMENT +la I-TREATMENT evolución I-TREATMENT -con I-TREATMENT +del I-TREATMENT +paciente, I-TREATMENT +de I-TREATMENT la I-TREATMENT -edad. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -resección I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dorso I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -paredes I-PRESENT_ILLNESS -laterales I-PRESENT_ILLNESS -nasales I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -basocelular I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -múltiples I-PRESENT_ILLNESS -focos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dorso I-PRESENT_ILLNESS -nasal. I-PRESENT_ILLNESS -Reconstrucción B-TREATMENT -con I-TREATMENT -colgajo I-TREATMENT -frontal I-TREATMENT -paramediano I-TREATMENT -con I-TREATMENT -base I-TREATMENT -estrecha I-TREATMENT -después I-TREATMENT +autonomía I-TREATMENT +que I-TREATMENT +conseguía I-TREATMENT +y I-TREATMENT de I-TREATMENT -conocer I-TREATMENT +todos I-TREATMENT los I-TREATMENT -límites I-TREATMENT -quirúrgicos I-TREATMENT -negativos I-TREATMENT +avances I-TREATMENT +y I-TREATMENT +obstáculos. I-TREATMENT +Se I-TREATMENT +anima I-TREATMENT +en I-TREATMENT +las I-TREATMENT +entrevistas I-TREATMENT +a I-TREATMENT +verbalizar I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +piensan I-TREATMENT +unos I-TREATMENT de I-TREATMENT -la I-TREATMENT -biopsia I-TREATMENT -por I-TREATMENT -congelación. I-TREATMENT -Autonomización B-EVOLUTION -del I-EVOLUTION -colgajo I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -3 I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -postoperatorio. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -49 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -remitida B-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Dermatología I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -carcinoma I-DERIVED_FROM/TO -basocelular I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -columela I-DERIVED_FROM/TO -nasal I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -2 I-DERIVED_FROM/TO -años I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución. I-DERIVED_FROM/TO -Tras B-TREATMENT -resección I-TREATMENT -tumoral I-TREATMENT +otros I-TREATMENT con I-TREATMENT -límites I-TREATMENT -negativos I-TREATMENT -en I-TREATMENT -la I-TREATMENT -biopsia I-TREATMENT -por I-TREATMENT -congelación, I-TREATMENT +corrección I-TREATMENT +y I-TREATMENT +respeto, I-TREATMENT se I-TREATMENT -hizo I-TREATMENT -reconstrucción I-TREATMENT -con I-TREATMENT -colgajo I-TREATMENT -frontal I-TREATMENT -paramediano I-TREATMENT -izquierdo I-TREATMENT +enseña I-TREATMENT +al I-TREATMENT +paciente I-TREATMENT +a I-TREATMENT +que I-TREATMENT +respete I-TREATMENT +las I-TREATMENT +opiniones I-TREATMENT +y I-TREATMENT +los I-TREATMENT +turnos I-TREATMENT de I-TREATMENT -base I-TREATMENT -estrecha I-TREATMENT -prolongado I-TREATMENT -hacia I-TREATMENT +intervención I-TREATMENT +de I-TREATMENT +los I-TREATMENT +demás I-TREATMENT +y I-TREATMENT +se I-TREATMENT +consensuan I-TREATMENT +acuerdos I-TREATMENT +para I-TREATMENT el I-TREATMENT -mismo I-TREATMENT -lado. I-TREATMENT +funcionamiento I-TREATMENT +diario, I-TREATMENT +visitas I-TREATMENT +de I-TREATMENT +la I-TREATMENT +familia, I-TREATMENT +salidas I-TREATMENT +a I-TREATMENT +comer I-TREATMENT +fuera, I-TREATMENT +día I-TREATMENT +de I-TREATMENT +recogida I-TREATMENT +de I-TREATMENT +la I-TREATMENT +ropa I-TREATMENT +sucia, I-TREATMENT +etc. I-TREATMENT I-TREATMENT -El B-EVOLUTION -colgajo I-EVOLUTION -quedó I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -ligera I-EVOLUTION -tensión, I-EVOLUTION -pero I-EVOLUTION -esto I-EVOLUTION +La B-EVOLUTION +evaluación I-EVOLUTION +evidencia I-EVOLUTION +que I-EVOLUTION +tanto I-EVOLUTION +el I-EVOLUTION +objetivo I-EVOLUTION +permanente I-EVOLUTION +como I-EVOLUTION +los I-EVOLUTION +referidos I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +seis I-EVOLUTION +meses I-EVOLUTION +se I-EVOLUTION +consiguieron I-EVOLUTION +correctamente, I-EVOLUTION no I-EVOLUTION -produjo I-EVOLUTION -ningún I-EVOLUTION -sufrimiento I-EVOLUTION -ni I-EVOLUTION -necrosis I-EVOLUTION -del I-EVOLUTION -mismo. I-EVOLUTION -Se I-EVOLUTION -autonomizó I-EVOLUTION +así I-EVOLUTION +los I-EVOLUTION +objetivos I-EVOLUTION +propuestos I-EVOLUTION a I-EVOLUTION -las I-EVOLUTION -3 I-EVOLUTION -semanas I-EVOLUTION -y I-EVOLUTION +los I-EVOLUTION +dos I-EVOLUTION +años. I-EVOLUTION +El I-EVOLUTION +hermano I-EVOLUTION +del I-EVOLUTION +paciente I-EVOLUTION a I-EVOLUTION -pesar I-EVOLUTION +penas I-EVOLUTION +si I-EVOLUTION +ha I-EVOLUTION +sido I-EVOLUTION +capaz I-EVOLUTION de I-EVOLUTION -quedar I-EVOLUTION -un I-EVOLUTION -poco I-EVOLUTION -redundante, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -mostró I-EVOLUTION -satisfecha I-EVOLUTION +elogiar I-EVOLUTION +los I-EVOLUTION +evidentes I-EVOLUTION +avances I-EVOLUTION +del I-EVOLUTION +paciente, I-EVOLUTION +ni I-EVOLUTION +éste I-EVOLUTION +último I-EVOLUTION +ha I-EVOLUTION +podido I-EVOLUTION +eliminar I-EVOLUTION +determinadas I-EVOLUTION +expresiones I-EVOLUTION +inapropiadas I-EVOLUTION +hacia I-EVOLUTION +su I-EVOLUTION +familia, I-EVOLUTION +en I-EVOLUTION +especial I-EVOLUTION +hacia I-EVOLUTION +su I-EVOLUTION +hermano, I-EVOLUTION +aunque I-EVOLUTION +si I-EVOLUTION +disminuyeron I-EVOLUTION +en I-EVOLUTION +tono I-EVOLUTION y I-EVOLUTION -no I-EVOLUTION -quiso I-EVOLUTION -otro I-EVOLUTION -procedimiento. I-EVOLUTION +frecuencia. I-EVOLUTION I-EVOLUTION Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -21 I-PRESENT_ILLNESS +20 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad I-PRESENT_ILLNESS -que B-PAST_MEDICAL_HISTORY -presenta I-PAST_MEDICAL_HISTORY -elefantiasis I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -extremidad I-PAST_MEDICAL_HISTORY -inferior I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -linfedema I-PAST_MEDICAL_HISTORY -congénito I-PAST_MEDICAL_HISTORY -primario I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -agenesia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vasos I-PAST_MEDICAL_HISTORY -linfáticos I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -hemicuerpo I-PAST_MEDICAL_HISTORY -izquierdo. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -diagnostica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -primera I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -raíz I-PAST_MEDICAL_HISTORY +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +reflujo I-PRESENT_ILLNESS +gastroesofágico I-PRESENT_ILLNESS +severo I-PRESENT_ILLNESS +resistente I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +altas I-PRESENT_ILLNESS +dosis I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +omeprazol I-PRESENT_ILLNESS +(60 I-PRESENT_ILLNESS +mg/día) I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -observación I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -aumento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -perímetro I-PAST_MEDICAL_HISTORY +consumo I-PAST_MEDICAL_HISTORY +habitual I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -extremidad I-PAST_MEDICAL_HISTORY -respecto I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -contralateral, I-PAST_MEDICAL_HISTORY -iniciándose I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ese I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -medidas I-PAST_MEDICAL_HISTORY -físicas I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -local I-PAST_MEDICAL_HISTORY +cocaína I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +grandes I-PAST_MEDICAL_HISTORY +cantidades I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -patología. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Ya I-PAST_MEDICAL_HISTORY +alcohol I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -pubertad, I-PAST_MEDICAL_HISTORY -evoluciona I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -elefantiasis I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -importante I-PAST_MEDICAL_HISTORY -limitación I-PAST_MEDICAL_HISTORY -funcional I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -imposibilita I-PAST_MEDICAL_HISTORY -deambular, I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -preciso I-PAST_MEDICAL_HISTORY -iniciar I-PAST_MEDICAL_HISTORY -tandas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -antibioticoterapia I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -menos I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -vez I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cuadros I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +fines I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -linfangitis. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -periodo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -llega I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -sufrir I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -perímetro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -pierna I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -102 I-PRESENT_ILLNESS -cm, I-PRESENT_ILLNESS -llegando I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -180 I-PRESENT_ILLNESS -cm, I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -constata I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -frecuencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -linfangitis I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -mínimo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -mensual, I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -finalmente I-PRESENT_ILLNESS -obliga I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -replantear I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -tratamiento. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La B-EXPLORATION -evaluación I-EXPLORATION -radiológica I-EXPLORATION -mediante I-EXPLORATION -linfografía I-EXPLORATION -demuestra I-EXPLORATION -ausencia I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -drenaje I-EXPLORATION -linfático I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -extremidad I-EXPLORATION -inferior I-EXPLORATION -izquierda I-EXPLORATION -y I-EXPLORATION -dificultad I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -drenaje I-EXPLORATION -linfático I-EXPLORATION -en I-EXPLORATION +semana. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION la I-EXPLORATION -extremidad I-EXPLORATION +endoscopia I-EXPLORATION +de I-EXPLORATION +tracto I-EXPLORATION +digestivo I-EXPLORATION superior I-EXPLORATION -izquierda. I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +esofagitis I-EXPLORATION +grave I-EXPLORATION +e I-EXPLORATION +imágenes I-EXPLORATION +sugestivas I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +esófago I-EXPLORATION +de I-EXPLORATION +Barret. I-EXPLORATION La I-EXPLORATION -tomografia I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -muestra I-EXPLORATION -hipertrofia I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -subcutáneo. I-EXPLORATION +pHmetría I-EXPLORATION +esofágica I-EXPLORATION +puso I-EXPLORATION +de I-EXPLORATION +manifiesto I-EXPLORATION +un I-EXPLORATION +intenso I-EXPLORATION +RGE I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +puntuación I-EXPLORATION +de I-EXPLORATION +DeMeester I-EXPLORATION +de I-EXPLORATION +193 I-EXPLORATION +(rango I-EXPLORATION +normal I-EXPLORATION +< I-EXPLORATION +14, I-EXPLORATION +72) I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +manometría I-EXPLORATION +demostró I-EXPLORATION +un I-EXPLORATION +esfínter I-EXPLORATION +esofágico I-EXPLORATION +inferior I-EXPLORATION +hipotónico I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +presión I-EXPLORATION +de I-EXPLORATION +3 I-EXPLORATION +mmHg I-EXPLORATION +(rango I-EXPLORATION +normal I-EXPLORATION +8-25 I-EXPLORATION +mmHg). I-EXPLORATION I-EXPLORATION -Una B-TREATMENT -vez I-TREATMENT -constatado I-TREATMENT +Con B-TREATMENT +estas I-TREATMENT +pruebas I-TREATMENT el I-TREATMENT -avanzado I-TREATMENT -estado I-TREATMENT -clínico I-TREATMENT -y I-TREATMENT -radiológico I-TREATMENT -de I-TREATMENT -la I-TREATMENT -patología I-TREATMENT -y I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -ausencia I-TREATMENT -de I-TREATMENT -respuesta I-TREATMENT -clínica I-TREATMENT -a I-TREATMENT -las I-TREATMENT -medidas I-TREATMENT -conservadoras, I-TREATMENT -se I-TREATMENT -propone I-TREATMENT -practicar I-TREATMENT -cirugía I-TREATMENT -escisional I-TREATMENT -según I-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +propuesto I-TREATMENT +para I-TREATMENT la I-TREATMENT -técnica I-TREATMENT +realización I-TREATMENT de I-TREATMENT -Charles. I-TREATMENT - I-TREATMENT -En I-TREATMENT -un I-TREATMENT -primer I-TREATMENT -tiempo I-TREATMENT -quirúrgico I-TREATMENT -realizamos I-TREATMENT una I-TREATMENT -escisión I-TREATMENT -completa I-TREATMENT +funduplicatura I-TREATMENT de I-TREATMENT -piel I-TREATMENT -y I-TREATMENT -tejido I-TREATMENT -celular I-TREATMENT -subcutáneo I-TREATMENT -en I-TREATMENT -todo I-TREATMENT -su I-TREATMENT -espesor, I-TREATMENT -respetando I-TREATMENT -la I-TREATMENT -fascia I-TREATMENT -muscular, I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -tobillo I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -raíz I-TREATMENT +Nissen I-TREATMENT +laparoscópica. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +profilaxis I-TREATMENT del I-TREATMENT -muslo I-TREATMENT -y I-TREATMENT -cobertura I-TREATMENT -mediante I-TREATMENT -autoinjertos I-TREATMENT +tromboembolismo I-TREATMENT +con I-TREATMENT +2.500 I-TREATMENT +U.I. I-TREATMENT de I-TREATMENT -espesor I-TREATMENT -parcial I-TREATMENT -mallados I-TREATMENT -1: I-TREATMENT -1.5 I-TREATMENT -aprovechando I-TREATMENT -la I-TREATMENT -piel I-TREATMENT -del I-TREATMENT -mismo I-TREATMENT -muslo I-TREATMENT -izquierdo. I-TREATMENT -Tras I-TREATMENT -20 I-TREATMENT -días I-TREATMENT +heparina I-TREATMENT de I-TREATMENT -ingreso I-TREATMENT -hospitalario I-TREATMENT -y I-TREATMENT -curas, I-TREATMENT -realizamos I-TREATMENT +bajo I-TREATMENT +peso I-TREATMENT +molecular I-TREATMENT +(Clexane®, I-TREATMENT +Aventis I-TREATMENT +Pharma, I-TREATMENT +España) I-TREATMENT una I-TREATMENT -segunda I-TREATMENT +dosis I-TREATMENT +2 I-TREATMENT +horas I-TREATMENT +antes I-TREATMENT +de I-TREATMENT +la I-TREATMENT intervención I-TREATMENT -para I-TREATMENT -cubrir I-TREATMENT -las I-TREATMENT -zonas I-TREATMENT -cruentas I-TREATMENT -dispersas I-TREATMENT -residuales I-TREATMENT +y I-TREATMENT +una I-TREATMENT +dosis I-TREATMENT +diaria I-TREATMENT en I-TREATMENT -el I-TREATMENT -3% I-TREATMENT +los I-TREATMENT +tres I-TREATMENT +primeros I-TREATMENT +días I-TREATMENT +postoperatorios. I-TREATMENT +El I-TREATMENT +neumoperitoneo I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +con I-TREATMENT +CO2 I-TREATMENT +a I-TREATMENT +una I-TREATMENT +presión I-TREATMENT +máxima I-TREATMENT +controlada I-TREATMENT de I-TREATMENT -superficie I-TREATMENT -corporal I-TREATMENT -total. I-TREATMENT -Obtuvimos I-TREATMENT +14 I-TREATMENT +mmHg. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +funduplicatura I-TREATMENT +de I-TREATMENT +Nissen I-TREATMENT +con I-TREATMENT +material I-TREATMENT +irreabsorbible, I-TREATMENT +suturándose I-TREATMENT los I-TREATMENT -injertos I-TREATMENT -del I-TREATMENT -muslo I-TREATMENT -derecho, I-TREATMENT +pilares I-TREATMENT +diafragmáticos. I-TREATMENT +No I-TREATMENT +hubo I-TREATMENT +incidencias I-TREATMENT +durante I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT que I-TREATMENT -se I-TREATMENT -aplicaron I-TREATMENT -mallados I-TREATMENT -1: I-TREATMENT -1.5. I-TREATMENT -En B-EVOLUTION -una I-EVOLUTION -semana, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -31 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -ingreso, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION +duró I-TREATMENT +105 I-TREATMENT +minutos. I-TREATMENT +El B-EVOLUTION +postoperatorio I-EVOLUTION +transcurrió I-EVOLUTION +sin I-EVOLUTION +complicaciones I-EVOLUTION +durante I-EVOLUTION +las I-EVOLUTION +primeras I-EVOLUTION +72 I-EVOLUTION +horas, I-EVOLUTION +y I-EVOLUTION fue I-EVOLUTION dado I-EVOLUTION de I-EVOLUTION alta I-EVOLUTION -con I-EVOLUTION -los I-EVOLUTION -injertos I-EVOLUTION -prendidos I-EVOLUTION -en I-EVOLUTION -su I-EVOLUTION -mayoría, I-EVOLUTION -quedando I-EVOLUTION -aun I-EVOLUTION -así I-EVOLUTION -zonas I-EVOLUTION -residuales I-EVOLUTION -dispersas I-EVOLUTION -en I-EVOLUTION -una I-EVOLUTION -superficie I-EVOLUTION -inferior I-EVOLUTION -al I-EVOLUTION -0.5%. I-EVOLUTION +asintomático. I-EVOLUTION I-EVOLUTION -La I-EVOLUTION -evolución I-EVOLUTION -del I-EVOLUTION -área I-EVOLUTION -tratada I-EVOLUTION -tras I-EVOLUTION +En I-EVOLUTION el I-EVOLUTION -alta I-EVOLUTION -hospitalaria I-EVOLUTION -fue I-EVOLUTION -muy I-EVOLUTION -favorable, I-EVOLUTION -con I-EVOLUTION -resolución I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -zonas I-EVOLUTION -cruentas I-EVOLUTION -residuales I-EVOLUTION -en I-EVOLUTION -3 I-EVOLUTION -semanas. I-EVOLUTION -Iniciamos B-TREATMENT -presoterapia I-TREATMENT -un I-TREATMENT -mes I-TREATMENT -después I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cirugía I-TREATMENT -y I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -en I-TREATMENT -todo I-TREATMENT -momento I-TREATMENT -la I-TREATMENT -fisioterapia. I-TREATMENT -Sin B-EVOLUTION -embargo, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -3 I-EVOLUTION -meses I-EVOLUTION -observamos I-EVOLUTION -un I-EVOLUTION -aumento I-EVOLUTION -progresivo I-EVOLUTION +séptimo I-EVOLUTION +día I-EVOLUTION +postoperatorio, I-EVOLUTION +tras I-EVOLUTION +una I-EVOLUTION +ingesta I-EVOLUTION +copiosa I-EVOLUTION de I-EVOLUTION -volumen I-EVOLUTION -en I-EVOLUTION +alcohol, I-EVOLUTION +bebidas I-EVOLUTION +gaseosas I-EVOLUTION +y I-EVOLUTION +alimentos, I-EVOLUTION el I-EVOLUTION -dorso I-EVOLUTION -del I-EVOLUTION -pie I-EVOLUTION -izquierdo, I-EVOLUTION -además I-EVOLUTION -de I-EVOLUTION -pequeñas I-EVOLUTION -erosiones I-EVOLUTION -cutáneas I-EVOLUTION -debidas I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -fricción I-EVOLUTION +paciente I-EVOLUTION +desarrolló I-EVOLUTION +repentinamente I-EVOLUTION +un I-EVOLUTION +cuadro I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -prendas I-EVOLUTION +dolor I-EVOLUTION de I-EVOLUTION -presoterapia, I-EVOLUTION -que I-EVOLUTION -evolucionaron I-EVOLUTION -favorablemente I-EVOLUTION -con B-TREATMENT -curas I-TREATMENT -tópicas. I-TREATMENT - I-TREATMENT -A I-TREATMENT -los I-TREATMENT -7 I-TREATMENT -meses I-TREATMENT +espalda I-EVOLUTION +brusco I-EVOLUTION +e I-EVOLUTION +intenso, I-EVOLUTION +hipertermia, I-EVOLUTION +distensión I-EVOLUTION +abdominal I-EVOLUTION +e I-EVOLUTION +inestabilidad I-EVOLUTION +hemodinámica. I-EVOLUTION +En B-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +presentaba I-EXPLORATION +leucocitosis I-EXPLORATION +con I-EXPLORATION +desviación I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +izquierda I-EXPLORATION +con I-EXPLORATION +12% I-EXPLORATION +de I-EXPLORATION +cayados, I-EXPLORATION +acidosis I-EXPLORATION +metabólica I-EXPLORATION +(pH: I-EXPLORATION +7, I-EXPLORATION +27) I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +actividad I-EXPLORATION +de I-EXPLORATION +protrombina I-EXPLORATION +del I-EXPLORATION +52%. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +TAC I-EXPLORATION +abdominal I-EXPLORATION +que I-EXPLORATION +mostraba I-EXPLORATION +asas I-EXPLORATION +de I-EXPLORATION +intestino I-EXPLORATION +dilatadas, I-EXPLORATION +líquido I-EXPLORATION +libre I-EXPLORATION +intraabdominal, I-EXPLORATION +hígado I-EXPLORATION +de I-EXPLORATION +estasis I-EXPLORATION +y I-EXPLORATION +sospecha I-EXPLORATION +de I-EXPLORATION +trombosis I-EXPLORATION +venosa I-EXPLORATION +mesentérica I-EXPLORATION +y I-EXPLORATION +portal. I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT de I-TREATMENT -la I-TREATMENT -primera I-TREATMENT -cirugía I-TREATMENT -procedimos I-TREATMENT -a I-TREATMENT -intervenir I-TREATMENT +abdomen I-TREATMENT +agudo I-TREATMENT +se I-TREATMENT +intervino I-TREATMENT quirúrgicamente I-TREATMENT +hallándose I-TREATMENT +isquemia I-TREATMENT +intestinal I-TREATMENT +masiva I-TREATMENT de I-TREATMENT -nuevo I-TREATMENT -para I-TREATMENT -tratar I-TREATMENT +todo I-TREATMENT el I-TREATMENT -linfedema I-TREATMENT -residual I-TREATMENT -del I-TREATMENT -dorso I-TREATMENT -del I-TREATMENT -pie. I-TREATMENT -De I-TREATMENT -igual I-TREATMENT -modo, I-TREATMENT -llevaremos I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -según I-TREATMENT -la I-TREATMENT -técnica I-TREATMENT +intestino I-TREATMENT +delgado I-TREATMENT +y I-TREATMENT +parte I-TREATMENT de I-TREATMENT -Charles I-TREATMENT -escisión I-TREATMENT -completa I-TREATMENT +colon, I-TREATMENT +trombosis I-TREATMENT +portal, I-TREATMENT +hígado I-TREATMENT de I-TREATMENT -piel I-TREATMENT -y I-TREATMENT -tejido I-TREATMENT -subcutáneo I-TREATMENT -del I-TREATMENT -dorso I-TREATMENT -del I-TREATMENT -pie I-TREATMENT -izquierdo, I-TREATMENT -preservando I-TREATMENT -la I-TREATMENT -fascia I-TREATMENT -profunda, I-TREATMENT +estasis I-TREATMENT y I-TREATMENT -cobertura I-TREATMENT -del I-TREATMENT -área I-TREATMENT -cruenta I-TREATMENT -mediante I-TREATMENT -autoinjertos I-TREATMENT +una I-TREATMENT +arteria I-TREATMENT +mesentérica I-TREATMENT +superior I-TREATMENT +espástica I-TREATMENT de I-TREATMENT -espesor I-TREATMENT -parcial I-TREATMENT -mallados I-TREATMENT -1: I-TREATMENT -1.5 I-TREATMENT -obtenidos I-TREATMENT -del I-TREATMENT -muslo I-TREATMENT -derecho. I-TREATMENT -En B-EVOLUTION -6 I-EVOLUTION -días I-EVOLUTION -los I-EVOLUTION -injertos I-EVOLUTION -estaban I-EVOLUTION -prendidos I-EVOLUTION -y I-EVOLUTION -estables I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -recibió I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -hospitalaria. I-EVOLUTION - I-EVOLUTION -Pasados I-EVOLUTION -3 I-EVOLUTION -años I-EVOLUTION -con I-EVOLUTION -controles I-EVOLUTION -en I-EVOLUTION -consulta I-EVOLUTION -ambulatoria I-EVOLUTION -en I-EVOLUTION -intervalos I-EVOLUTION -de I-EVOLUTION -aproximadamente I-EVOLUTION -2 I-EVOLUTION -meses, I-EVOLUTION -persiste I-EVOLUTION -la I-EVOLUTION -aparición I-EVOLUTION -errática I-EVOLUTION -de I-EVOLUTION -áreas I-EVOLUTION -cruentas I-EVOLUTION -irritativas I-EVOLUTION -con I-EVOLUTION -exudado I-EVOLUTION -no I-EVOLUTION -purulento I-EVOLUTION -que B-TREATMENT +la I-TREATMENT +que I-TREATMENT +no I-TREATMENT se I-TREATMENT -van I-TREATMENT -controlando I-TREATMENT -con I-TREATMENT -curas I-TREATMENT -tópicas I-TREATMENT +extrajo I-TREATMENT +ningún I-TREATMENT +trombo I-TREATMENT en I-TREATMENT -las I-TREATMENT -que I-TREATMENT +la I-TREATMENT +exploración I-TREATMENT +mediante I-TREATMENT +sonda I-TREATMENT +de I-TREATMENT +Fogarty. I-TREATMENT +La B-EXPLORATION +ecografía I-EXPLORATION +Doppler I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION +trombosis I-EXPLORATION +completa I-EXPLORATION +y I-EXPLORATION +neumatosis I-EXPLORATION +del I-EXPLORATION +tronco I-EXPLORATION +principal I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +porta, I-EXPLORATION +y I-EXPLORATION +gas I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +intestinal. I-EXPLORATION +Las I-EXPLORATION +arterias I-EXPLORATION +hepática I-EXPLORATION +y I-EXPLORATION +mesentérica I-EXPLORATION +eran I-EXPLORATION +permeables. I-EXPLORATION +No B-TREATMENT se I-TREATMENT -alterna I-TREATMENT -sulfadiazina I-TREATMENT -argéntica, I-TREATMENT -nitrofurazona I-TREATMENT -y I-TREATMENT -solución I-TREATMENT -yodada. I-TREATMENT +consideró I-TREATMENT +indicada I-TREATMENT +la I-TREATMENT +realización I-TREATMENT +de I-TREATMENT +ningún I-TREATMENT +gesto I-TREATMENT +quirúrgico I-TREATMENT +añadido. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +hipercoagulabilidad I-EXPLORATION +fue I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +fue I-EXPLORATION +posible I-EXPLORATION +obtener I-EXPLORATION +una I-EXPLORATION +muestra I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION +fiable I-EXPLORATION +para I-EXPLORATION +detectar I-EXPLORATION +cocaína. I-EXPLORATION El B-EVOLUTION paciente I-EVOLUTION -presenta I-EVOLUTION -una I-EVOLUTION -extremidad I-EVOLUTION -funcional I-EVOLUTION -con I-EVOLUTION -dimensiones I-EVOLUTION -muy I-EVOLUTION -cercanas I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -contralateral I-EVOLUTION -sana I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -nuevos I-EVOLUTION -episodios I-EVOLUTION +evolucionó I-EVOLUTION +rápidamente I-EVOLUTION de I-EVOLUTION -linfangitis I-EVOLUTION -hasta I-EVOLUTION -la I-EVOLUTION -fecha. I-EVOLUTION -Sigue B-TREATMENT -realizando I-TREATMENT -presoterapia, I-TREATMENT -rehabilitación I-TREATMENT -y I-TREATMENT -medidas I-TREATMENT -higiénicas. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -4 I-EVOLUTION -años I-EVOLUTION +forma I-EVOLUTION +desfavorable, I-EVOLUTION +a I-EVOLUTION +pesar I-EVOLUTION +del I-EVOLUTION +inicio I-EVOLUTION de I-EVOLUTION -seguimiento, I-EVOLUTION -el I-EVOLUTION -aspecto I-EVOLUTION -es I-EVOLUTION -muy I-EVOLUTION -bueno, I-EVOLUTION -la I-EVOLUTION -pierna I-EVOLUTION -afectada I-EVOLUTION -mantiene I-EVOLUTION -un I-EVOLUTION -diámetro I-EVOLUTION -igual I-EVOLUTION -o I-EVOLUTION -incluso I-EVOLUTION -menor I-EVOLUTION -que I-EVOLUTION la I-EVOLUTION -extremidad I-EVOLUTION -sana; I-EVOLUTION +terapia I-EVOLUTION +anticoagulante I-EVOLUTION con I-EVOLUTION -una I-EVOLUTION -calidad I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -injertos I-EVOLUTION -aceptable, I-EVOLUTION +heparina, I-EVOLUTION con I-EVOLUTION -tejido I-EVOLUTION -fibrótico I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -pierna, I-EVOLUTION +inestabilidad I-EVOLUTION +hemodinámica I-EVOLUTION y I-EVOLUTION -con I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -linforrea I-EVOLUTION -ocasional I-EVOLUTION -que I-EVOLUTION -causa I-EVOLUTION -procesos I-EVOLUTION -de I-EVOLUTION -irritación I-EVOLUTION -cutánea I-EVOLUTION -que I-EVOLUTION -generan I-EVOLUTION -un I-EVOLUTION -proceso I-EVOLUTION -crónico I-EVOLUTION -de I-EVOLUTION -fibrosis. I-EVOLUTION -En I-EVOLUTION -el I-EVOLUTION -muslo I-EVOLUTION -no I-EVOLUTION -aparece I-EVOLUTION -linforrea, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -zona I-EVOLUTION -injertada I-EVOLUTION -del I-EVOLUTION -mismo I-EVOLUTION -presenta I-EVOLUTION -mejor I-EVOLUTION -aspecto I-EVOLUTION -que I-EVOLUTION -los I-EVOLUTION -injertos I-EVOLUTION +acidosis I-EVOLUTION +irreversible I-EVOLUTION +falleciendo I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +24 I-EVOLUTION +horas I-EVOLUTION de I-EVOLUTION la I-EVOLUTION -pierna. I-EVOLUTION - I-EVOLUTION +intervención I-EVOLUTION +quirúrgica. I-EVOLUTION +La B-EXPLORATION +necropsia I-EXPLORATION +confirmó I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +trombosis I-EXPLORATION +masiva I-EXPLORATION +de I-EXPLORATION +vena I-EXPLORATION +mesentérica I-EXPLORATION +inferior I-EXPLORATION +y I-EXPLORATION +vena I-EXPLORATION +porta I-EXPLORATION +con I-EXPLORATION +infarto I-EXPLORATION +hemorrágico I-EXPLORATION +de I-EXPLORATION +todo I-EXPLORATION +el I-EXPLORATION +intestino I-EXPLORATION +delgado I-EXPLORATION +y I-EXPLORATION +del I-EXPLORATION +colon I-EXPLORATION +derecho, I-EXPLORATION +con I-EXPLORATION +úlceras I-EXPLORATION +agudas I-EXPLORATION +mucosas I-EXPLORATION +y I-EXPLORATION +contenido I-EXPLORATION +hemático I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +luz I-EXPLORATION +intestinal. I-EXPLORATION +Infarto I-EXPLORATION +hemorrágico I-EXPLORATION +submasivo I-EXPLORATION +hepático, I-EXPLORATION +hipertrofia I-EXPLORATION +y I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +ventrículo I-EXPLORATION +izquierdo I-EXPLORATION +y I-EXPLORATION +microcalcificaciones I-EXPLORATION +focales I-EXPLORATION +en I-EXPLORATION +parénquima I-EXPLORATION +pulmonar I-EXPLORATION +(típico I-EXPLORATION +hallazgo I-EXPLORATION +en I-EXPLORATION +consumidores I-EXPLORATION +crónicos I-EXPLORATION +de I-EXPLORATION +cocaína I-EXPLORATION +inhalada). I-EXPLORATION +Se I-EXPLORATION +estableció I-EXPLORATION +como I-EXPLORATION +causa I-EXPLORATION +de I-EXPLORATION +muerte I-EXPLORATION +el I-EXPLORATION +shock I-EXPLORATION +hipovolémico I-EXPLORATION +y I-EXPLORATION +hemorrágico I-EXPLORATION +secundario I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +trombosis I-EXPLORATION +venosa I-EXPLORATION +mesentérica I-EXPLORATION +y I-EXPLORATION +portal. I-EXPLORATION + I-EXPLORATION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS @@ -102524,3080 +87969,3320 @@ loco-regional. I-TREATMENT Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY +27 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de B-PAST_MEDICAL_HISTORY +edad, I-PAST_MEDICAL_HISTORY +fumadora I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -junio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1995 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -distensión I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS +dos/tres I-PAST_MEDICAL_HISTORY +cigarrillos/día I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +veinte I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Menarquia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +7 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Primer I-PAST_MEDICAL_HISTORY +embarazo I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +16 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Cinco I-PAST_MEDICAL_HISTORY +gestaciones I-PAST_MEDICAL_HISTORY +(tres I-PAST_MEDICAL_HISTORY +cesáreas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +abortos). I-PAST_MEDICAL_HISTORY +Uso I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +anticonceptivos I-PAST_MEDICAL_HISTORY +orales I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +diciembre I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +2013 I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -A B-EXPLORATION +oncología I-PRESENT_ILLNESS +y B-EXPLORATION +a I-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION física I-EXPLORATION -se I-EXPLORATION -constata I-EXPLORATION +presenta I-EXPLORATION +edema I-EXPLORATION +cutáneo I-EXPLORATION +que I-EXPLORATION +engloba I-EXPLORATION +a I-EXPLORATION +toda I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -abdomen I-EXPLORATION -distendido, I-EXPLORATION +mama I-EXPLORATION +derecha I-EXPLORATION con I-EXPLORATION -semiología I-EXPLORATION -de I-EXPLORATION -ascitis, I-EXPLORATION -no I-EXPLORATION -a I-EXPLORATION -tensión. I-EXPLORATION -No I-EXPLORATION -hay I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -hepatopatía I-EXPLORATION -ni I-EXPLORATION -insuficiencia I-EXPLORATION -cardíaca. I-EXPLORATION -Las I-EXPLORATION -exploraciones I-EXPLORATION -complementarias I-EXPLORATION -muestran I-EXPLORATION -una I-EXPLORATION -bioqu��mica I-EXPLORATION -básica I-EXPLORATION +piel I-EXPLORATION +tensa, I-EXPLORATION +vesiculosa, I-EXPLORATION +areola I-EXPLORATION y I-EXPLORATION -hemograma I-EXPLORATION -sin I-EXPLORATION -alteraciones, I-EXPLORATION -unos I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -Ca I-EXPLORATION -125: I-EXPLORATION -35 I-EXPLORATION -Ul/ml, I-EXPLORATION -Ca I-EXPLORATION -19.9: I-EXPLORATION -37 I-EXPLORATION -Ul/ml I-EXPLORATION +pezón I-EXPLORATION +retraídos, I-EXPLORATION y I-EXPLORATION -CEA: I-EXPLORATION -8 I-EXPLORATION -Ul/ml. I-EXPLORATION -Se I-EXPLORATION -intenta I-EXPLORATION -realizar I-EXPLORATION -paracentesis I-EXPLORATION -diagnóstica, I-EXPLORATION -pero I-EXPLORATION -es I-EXPLORATION -infructuosa I-EXPLORATION +adenopatías I-EXPLORATION +axilares I-EXPLORATION +derecha I-EXPLORATION +e I-EXPLORATION +izquierda I-EXPLORATION +dolorosas I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación. I-EXPLORATION +Presenta I-EXPLORATION +molestia I-EXPLORATION en I-EXPLORATION -varios I-EXPLORATION -intentos. I-EXPLORATION -Las I-EXPLORATION +mama I-EXPLORATION +derecha, I-EXPLORATION +zona I-EXPLORATION +costal I-EXPLORATION +y I-EXPLORATION +submamaria. I-EXPLORATION +ECOG I-EXPLORATION +2 I-EXPLORATION +como I-EXPLORATION +estado I-EXPLORATION +general. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +realizaron I-EXPLORATION +las I-EXPLORATION pruebas I-EXPLORATION +necesarias I-EXPLORATION +para I-EXPLORATION +determinar I-EXPLORATION +el I-EXPLORATION +estadio I-EXPLORATION de I-EXPLORATION -imagen I-EXPLORATION -hablan I-EXPLORATION +la I-EXPLORATION +neoplasia. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +presentó I-EXPLORATION +Fe: I-EXPLORATION +26 I-EXPLORATION +μg/dL I-EXPLORATION +(RN: I-EXPLORATION +50-170 I-EXPLORATION +μg/dL), I-EXPLORATION +IST: I-EXPLORATION +9% I-EXPLORATION +(RN: I-EXPLORATION +25-50 I-EXPLORATION +%). I-EXPLORATION +Ca I-EXPLORATION +15 I-EXPLORATION +3: I-EXPLORATION +92, I-EXPLORATION +2 I-EXPLORATION +UI/mL I-EXPLORATION +(RN: I-EXPLORATION +< I-EXPLORATION +32, I-EXPLORATION +4 I-EXPLORATION +UI/mL) I-EXPLORATION +con I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION +hemograma I-EXPLORATION +normal. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -TAC I-EXPLORATION -abdomino-pélvica I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION +BAG I-EXPLORATION +(biopsia I-EXPLORATION +con I-EXPLORATION +aguja I-EXPLORATION +gruesa), I-EXPLORATION +Punch I-EXPLORATION +cutáneo I-EXPLORATION +y I-EXPLORATION +Hercep I-EXPLORATION +Test®: I-EXPLORATION +positivo I-EXPLORATION +(HER I-EXPLORATION +2 I-EXPLORATION ++). I-EXPLORATION +El I-EXPLORATION +PET-TAC I-EXPLORATION +describió I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -ascitis, I-EXPLORATION -con I-EXPLORATION +tejido I-EXPLORATION +tumoral I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +mama I-EXPLORATION +derecha, I-EXPLORATION +en I-EXPLORATION adenopatías I-EXPLORATION +axilares I-EXPLORATION +derechas I-EXPLORATION +e I-EXPLORATION +izquierda, I-EXPLORATION +adenopatía I-EXPLORATION +en I-EXPLORATION +cadena I-EXPLORATION +mamaria I-EXPLORATION +interna I-EXPLORATION +derecha, I-EXPLORATION +en I-EXPLORATION +vértebras I-EXPLORATION +óseas I-EXPLORATION y I-EXPLORATION -varios I-EXPLORATION -nódulos I-EXPLORATION -peritoneales; I-EXPLORATION -una I-EXPLORATION -colonoscopia I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -ginecológica I-EXPLORATION -normal. I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +segmento I-EXPLORATION +inferior I-EXPLORATION +(VI) I-EXPLORATION +del I-EXPLORATION +lóbulo I-EXPLORATION +derecho I-EXPLORATION +hepático. I-EXPLORATION I-EXPLORATION -Finalmente I-EXPLORATION +Por I-EXPLORATION +lo I-EXPLORATION +tanto I-EXPLORATION la I-EXPLORATION paciente I-EXPLORATION -se I-EXPLORATION -somete I-EXPLORATION -a I-EXPLORATION -laparotomía I-EXPLORATION -exploradora I-EXPLORATION -encontrándose I-EXPLORATION -una I-EXPLORATION -cantidad I-EXPLORATION -moderada I-EXPLORATION +fue I-EXPLORATION +diagnosticada I-EXPLORATION de I-EXPLORATION -ascitis I-EXPLORATION -con I-EXPLORATION -abundante I-EXPLORATION -moco, I-EXPLORATION -múltiples I-EXPLORATION -adherencias I-EXPLORATION -a I-EXPLORATION -intestino I-EXPLORATION -y I-EXPLORATION -anejos I-EXPLORATION -ginecológicos, I-EXPLORATION -numerosos I-EXPLORATION -implantes I-EXPLORATION -en I-EXPLORATION -omento, I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION +carcinoma I-EXPLORATION +ductal I-EXPLORATION +infiltrante I-EXPLORATION +G2 I-EXPLORATION +cT4d I-EXPLORATION +cN1 I-EXPLORATION +M1 I-EXPLORATION +(óseas, I-EXPLORATION +ganglionares I-EXPLORATION y I-EXPLORATION -peritoneo I-EXPLORATION -y, I-EXPLORATION -un I-EXPLORATION -apéndice I-EXPLORATION -abierto I-EXPLORATION +hepáticas) I-EXPLORATION +estadio I-EXPLORATION +IV, I-EXPLORATION +síndrome I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -mucoso. I-EXPLORATION -Se B-TREATMENT -practica I-TREATMENT -un I-TREATMENT -histerectomía I-TREATMENT +dolor I-EXPLORATION +mamario I-EXPLORATION +y I-EXPLORATION +ferropenia, I-EXPLORATION +secundarios I-EXPLORATION +a I-EXPLORATION +su I-EXPLORATION +enfermedad I-EXPLORATION +principal. I-EXPLORATION +Como B-TREATMENT +terapia I-TREATMENT +de I-TREATMENT +elección I-TREATMENT +se I-TREATMENT +propuso I-TREATMENT +pertuzumab I-TREATMENT +para I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +del I-TREATMENT +CM I-TREATMENT +HER2 I-TREATMENT ++ I-TREATMENT +metastásico I-TREATMENT +o I-TREATMENT +localmente I-TREATMENT +recurrente I-TREATMENT +no I-TREATMENT +resecable, I-TREATMENT +en I-TREATMENT +combinación I-TREATMENT con I-TREATMENT -doble I-TREATMENT -anexectomía, I-TREATMENT -linfadenectomía I-TREATMENT -pélvica, I-TREATMENT -apendicectomía I-TREATMENT +trastuzumab I-TREATMENT y I-TREATMENT -hemicolectomía I-TREATMENT -derecha. I-TREATMENT -La I-TREATMENT -cirugía I-TREATMENT -no I-TREATMENT -es I-TREATMENT -radical, I-TREATMENT -permaneciendo I-TREATMENT -enfermedad I-TREATMENT -residual I-TREATMENT -superior I-TREATMENT -a I-TREATMENT -2 I-TREATMENT -cms. I-TREATMENT -El B-EXPLORATION -análisis I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -piezas I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION +docetaxel4. I-TREATMENT +Se B-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -carcinomatosis I-EXPLORATION -peritoneal I-EXPLORATION -por I-EXPLORATION -adenocarcinoma I-EXPLORATION +ecocardiografía I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +monitorización I-EXPLORATION de I-EXPLORATION -apéndice; I-EXPLORATION -colon I-EXPLORATION +la I-EXPLORATION +función I-EXPLORATION +cardíaca I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +valor I-EXPLORATION +FEVI I-EXPLORATION +63, I-EXPLORATION +9% I-EXPLORATION +normal, I-EXPLORATION +ya I-EXPLORATION +que I-EXPLORATION +podía I-EXPLORATION +verse I-EXPLORATION +afectada I-EXPLORATION +por I-EXPLORATION +trastuzumab I-EXPLORATION y I-EXPLORATION -ovario I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -postcirugía I-EXPLORATION -muestra I-EXPLORATION -nódulos I-EXPLORATION -tumorales I-EXPLORATION -en I-EXPLORATION -epiplón I-EXPLORATION +pertuzumab, I-EXPLORATION y I-EXPLORATION -peritoneo. I-EXPLORATION -Los I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -habían I-EXPLORATION -descendido I-EXPLORATION +RMN I-EXPLORATION +(resonancia I-EXPLORATION +magnética I-EXPLORATION +nuclear) I-EXPLORATION +para I-EXPLORATION +descartar I-EXPLORATION +metástasis I-EXPLORATION +cerebrales I-EXPLORATION +ya I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +considera I-EXPLORATION +un I-EXPLORATION +criterio I-EXPLORATION +para I-EXPLORATION +excluir I-EXPLORATION a I-EXPLORATION -niveles I-EXPLORATION -normales I-EXPLORATION -(CEA: I-EXPLORATION -1, I-EXPLORATION -7 I-EXPLORATION -Ul/ml; I-EXPLORATION -Ca I-EXPLORATION -19.9: I-EXPLORATION -27 I-EXPLORATION -Ul/ I-EXPLORATION -ml). I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +del I-EXPLORATION +beneficio I-EXPLORATION +de I-EXPLORATION +pertuzumab. I-EXPLORATION I-EXPLORATION -Se B-TREATMENT -decide I-TREATMENT -administrar I-TREATMENT -quimioterapia I-TREATMENT -con I-TREATMENT +El B-TREATMENT esquema I-TREATMENT de I-TREATMENT +tratamiento I-TREATMENT +planteado I-TREATMENT +fue: I-TREATMENT +pertuzumab I-TREATMENT +840mg I-TREATMENT +(inicio) I-TREATMENT +/420 I-TREATMENT +mg I-TREATMENT +(mantenimiento), I-TREATMENT +trastuzumab I-TREATMENT +8mg/kg I-TREATMENT +(inicio) I-TREATMENT +/6mg/kg I-TREATMENT +(mantenimiento), I-TREATMENT +docetaxel I-TREATMENT +75mg/m2, I-TREATMENT +cada I-TREATMENT +21 I-TREATMENT +días5. I-TREATMENT +Las I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +antineoplásicos I-TREATMENT +fueron I-TREATMENT +calculadas I-TREATMENT +según I-TREATMENT +peso I-TREATMENT +(88kg) I-TREATMENT +y I-TREATMENT +superficie I-TREATMENT +corporal I-TREATMENT +(1, I-TREATMENT +95 I-TREATMENT +m2). I-TREATMENT +El I-TREATMENT +inicio I-TREATMENT +del I-TREATMENT +tratamiento I-TREATMENT +fue I-TREATMENT +interrumpido I-TREATMENT +por I-TREATMENT +una I-TREATMENT +reacción I-TREATMENT +inmediata I-TREATMENT +sistémica I-TREATMENT +a I-TREATMENT +la I-TREATMENT +infusión I-TREATMENT +de I-TREATMENT +docetaxel I-TREATMENT +con I-TREATMENT +presencia I-TREATMENT +de I-TREATMENT +disnea I-TREATMENT +y I-TREATMENT +mareos I-TREATMENT +que I-TREATMENT +precisó I-TREATMENT +paracetamol, I-TREATMENT +hidrocortisona, I-TREATMENT +lorazepam I-TREATMENT +y I-TREATMENT +posterior I-TREATMENT +valoración I-TREATMENT +por I-TREATMENT +parte I-TREATMENT +del I-TREATMENT +Servicio I-TREATMENT +de I-TREATMENT +Alergia I-TREATMENT +que I-TREATMENT +pautó I-TREATMENT +un I-TREATMENT +protocolo I-TREATMENT +de I-TREATMENT +desensibilización I-TREATMENT +para I-TREATMENT +administrar I-TREATMENT la I-TREATMENT -Clínica I-TREATMENT -Mayo I-TREATMENT -(5FU-FA). I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +docetaxel. I-TREATMENT La I-TREATMENT paciente I-TREATMENT -recibe I-TREATMENT +ingresó I-TREATMENT +en I-TREATMENT +UCI I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +programada I-TREATMENT +al I-TREATMENT +día I-TREATMENT +siguiente I-TREATMENT +para I-TREATMENT +su I-TREATMENT +administración I-TREATMENT +y I-TREATMENT +completar I-TREATMENT +así I-TREATMENT +el I-TREATMENT tratamiento I-TREATMENT -durante I-TREATMENT -un I-TREATMENT -año I-TREATMENT -con I-TREATMENT -un I-TREATMENT -total I-TREATMENT de I-TREATMENT -12 I-TREATMENT -ciclos, I-TREATMENT -desapareciendo I-TREATMENT -las I-TREATMENT -imágenes I-TREATMENT +QT. I-TREATMENT + I-TREATMENT +Para I-TREATMENT +la I-TREATMENT +pauta I-TREATMENT de I-TREATMENT -TAC I-TREATMENT +desensibilización I-TREATMENT +se I-TREATMENT +utilizaron I-TREATMENT +tres I-TREATMENT +soluciones I-TREATMENT +del I-TREATMENT +medicamento I-TREATMENT +(cada I-TREATMENT +una I-TREATMENT +de I-TREATMENT +250 I-TREATMENT +mL I-TREATMENT +ClNa I-TREATMENT +0, I-TREATMENT +9%): I-TREATMENT +A, I-TREATMENT +B I-TREATMENT y I-TREATMENT +C I-TREATMENT +que I-TREATMENT +se I-TREATMENT +administraron I-TREATMENT +en I-TREATMENT +doce I-TREATMENT +pasos I-TREATMENT +consecutivos I-TREATMENT con I-TREATMENT -normalización I-TREATMENT +aumento I-TREATMENT de I-TREATMENT -marcadores. I-TREATMENT -Desde I-TREATMENT -febrero I-TREATMENT +la I-TREATMENT +velocidad I-TREATMENT de I-TREATMENT -1997 I-TREATMENT -permanece I-TREATMENT -en I-TREATMENT -control I-TREATMENT -por I-TREATMENT -el I-TREATMENT -servicio I-TREATMENT +infusión. I-TREATMENT +La I-TREATMENT +solución I-TREATMENT +A I-TREATMENT +contenía I-TREATMENT +una I-TREATMENT +dilución I-TREATMENT +1/100 I-TREATMENT de I-TREATMENT -oncología I-TREATMENT -médica. I-TREATMENT -Durante B-EVOLUTION -el I-EVOLUTION -seguimiento, I-EVOLUTION -se I-EVOLUTION -aprecian I-EVOLUTION -nódulos I-EVOLUTION -peritoneales I-EVOLUTION -de I-EVOLUTION -lento I-EVOLUTION -crecimiento, I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -ascenso I-EVOLUTION -progresivo I-EVOLUTION -de I-EVOLUTION -marcadores I-EVOLUTION -tumorales. I-EVOLUTION -Se B-TREATMENT -opta I-TREATMENT -por I-TREATMENT la I-TREATMENT -abstención I-TREATMENT -terapéutica, I-TREATMENT -dado I-TREATMENT +concentración I-TREATMENT +objetivo I-TREATMENT +final I-TREATMENT +(pasos I-TREATMENT +1-4) I-TREATMENT +y I-TREATMENT +la I-TREATMENT +solución I-TREATMENT +B I-TREATMENT +una I-TREATMENT +dilución I-TREATMENT +1/10 I-TREATMENT +de I-TREATMENT +la I-TREATMENT +concentración I-TREATMENT +objetivo I-TREATMENT +final I-TREATMENT +(pasos I-TREATMENT +5-8). I-TREATMENT +De I-TREATMENT +la I-TREATMENT +solución I-TREATMENT +C I-TREATMENT +(150 I-TREATMENT +mg/250 I-TREATMENT +mL) I-TREATMENT +se I-TREATMENT +administró I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT +restante, I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +calculada I-TREATMENT +restando I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT +acumulada I-TREATMENT +a I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT +total I-TREATMENT que I-TREATMENT +había I-TREATMENT +que I-TREATMENT +administrar I-TREATMENT +a I-TREATMENT la I-TREATMENT -paciente I-TREATMENT -permanece I-TREATMENT -asintomática. I-TREATMENT -Cuando B-EXPLORATION -el I-EXPLORATION -crecimiento I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -nódulos I-EXPLORATION -se I-EXPLORATION -hizo I-EXPLORATION -manifiesto, I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -punción I-EXPLORATION -biopsia, I-EXPLORATION -en I-EXPLORATION -junio I-EXPLORATION -de I-EXPLORATION -2001, I-EXPLORATION -que I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -recaída I-EXPLORATION -peritoneal I-EXPLORATION -de I-EXPLORATION -adenocarcinoma I-EXPLORATION -apendicular. I-EXPLORATION -En B-TREATMENT -ese I-TREATMENT -momento I-TREATMENT +paciente. I-TREATMENT +Cada I-TREATMENT +uno I-TREATMENT +de I-TREATMENT +los I-TREATMENT +pasos I-TREATMENT +1 I-TREATMENT +a I-TREATMENT +11 I-TREATMENT se I-TREATMENT -decide I-TREATMENT -retratar I-TREATMENT -con I-TREATMENT -esquema I-TREATMENT -Clínica I-TREATMENT -Mayo I-TREATMENT -hasta I-TREATMENT +administró I-TREATMENT +en I-TREATMENT +15 I-TREATMENT +minutos I-TREATMENT +(la I-TREATMENT +dosis I-TREATMENT +se I-TREATMENT +incrementó I-TREATMENT +en I-TREATMENT un I-TREATMENT -total I-TREATMENT +2 I-TREATMENT +- I-TREATMENT +2, I-TREATMENT +5 I-TREATMENT +veces I-TREATMENT +con I-TREATMENT +cada I-TREATMENT +paso) I-TREATMENT +y I-TREATMENT +el I-TREATMENT +paso I-TREATMENT +12 I-TREATMENT +se I-TREATMENT +prolongó I-TREATMENT +para I-TREATMENT +completar I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT +objetivo I-TREATMENT de I-TREATMENT -8 I-TREATMENT -ciclos, I-TREATMENT -alcanzando I-TREATMENT -criterios I-TREATMENT +150 I-TREATMENT +mg. I-TREATMENT +El I-TREATMENT +tiempo I-TREATMENT +total I-TREATMENT de I-TREATMENT -enfermedad I-TREATMENT -estable. I-TREATMENT -Se I-TREATMENT -decide I-TREATMENT -continuar I-TREATMENT -con I-TREATMENT -quimioterapia I-TREATMENT +desensibilización I-TREATMENT +fue I-TREATMENT de I-TREATMENT -tercera I-TREATMENT -línea I-TREATMENT -con I-TREATMENT -Tomudex-Oxaliplatino I-TREATMENT -(6 I-TREATMENT -ciclos). I-TREATMENT +5, I-TREATMENT +8 I-TREATMENT +horas. I-TREATMENT + I-TREATMENT La B-EVOLUTION -respuesta, I-EVOLUTION -en I-EVOLUTION -agosto I-EVOLUTION -de I-EVOLUTION -2002, I-EVOLUTION -fue I-EVOLUTION -nuevamente I-EVOLUTION -de I-EVOLUTION -estabilización. I-EVOLUTION -Desde I-EVOLUTION -entonces I-EVOLUTION -la I-EVOLUTION paciente I-EVOLUTION -permanece I-EVOLUTION -oligoasintomática I-EVOLUTION -con I-EVOLUTION -vida I-EVOLUTION -activa, I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -múltiples I-EVOLUTION -nódulos I-EVOLUTION -peritoneales I-EVOLUTION -que I-EVOLUTION -forman I-EVOLUTION +presentó I-EVOLUTION una I-EVOLUTION -coraza I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -pared I-EVOLUTION -abdominal. I-EVOLUTION -En I-EVOLUTION -diciembre I-EVOLUTION +respuesta I-EVOLUTION +parcial I-EVOLUTION +tras I-EVOLUTION +el I-EVOLUTION +primer I-EVOLUTION +ciclo I-EVOLUTION +con I-EVOLUTION +evidente I-EVOLUTION +mejoría I-EVOLUTION de I-EVOLUTION -2003, I-EVOLUTION la I-EVOLUTION -enfermedad I-EVOLUTION -progresa I-EVOLUTION -produciéndose I-EVOLUTION -compresión I-EVOLUTION -de I-EVOLUTION -cola I-EVOLUTION -de I-EVOLUTION -caballo I-EVOLUTION -secundaria I-EVOLUTION -a I-EVOLUTION -masa I-EVOLUTION -presacra. I-EVOLUTION -Recibe B-TREATMENT -radioterapia I-TREATMENT -paliativa, I-TREATMENT -aliviándose I-TREATMENT -el I-TREATMENT -dolor I-TREATMENT -y I-TREATMENT -sin I-TREATMENT -producirse I-TREATMENT -déficit I-TREATMENT -neurológico. I-TREATMENT -La B-EVOLUTION -situación I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -a I-EVOLUTION -octubre I-EVOLUTION +mama I-EVOLUTION +afectada I-EVOLUTION +ya I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +observó I-EVOLUTION +disminución I-EVOLUTION de I-EVOLUTION -2004, I-EVOLUTION -es I-EVOLUTION +su I-EVOLUTION +volumen I-EVOLUTION +sin I-EVOLUTION la I-EVOLUTION -de I-EVOLUTION -lento I-EVOLUTION -deterioro I-EVOLUTION +presencia I-EVOLUTION del I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION -por I-EVOLUTION +aspecto I-EVOLUTION +necrótico I-EVOLUTION +previo. I-EVOLUTION +Tras B-EXPLORATION +el I-EXPLORATION +sexto I-EXPLORATION +ciclo I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +PET-TAC I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +actividad I-EXPLORATION +metabólica I-EXPLORATION +tanto I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +mama I-EXPLORATION +derecha I-EXPLORATION +y I-EXPLORATION +adenopatías I-EXPLORATION +axilares, I-EXPLORATION +como I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +óseo I-EXPLORATION +y I-EXPLORATION +hepático, I-EXPLORATION +con I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +muy I-EXPLORATION +buena I-EXPLORATION +respuesta I-EXPLORATION +metabólica I-EXPLORATION +y I-EXPLORATION +funcional I-EXPLORATION +al I-EXPLORATION +tratamiento. I-EXPLORATION +Actualmente B-EVOLUTION +tras I-EVOLUTION +el I-EVOLUTION +octavo I-EVOLUTION +ciclo I-EVOLUTION +no I-EVOLUTION +presenta I-EVOLUTION progresión I-EVOLUTION de I-EVOLUTION -enfermedad, I-EVOLUTION -con I-EVOLUTION -anemia I-EVOLUTION -y I-EVOLUTION -desnutrición I-EVOLUTION -por I-EVOLUTION -dificultad I-EVOLUTION -en I-EVOLUTION la I-EVOLUTION -ingesta I-EVOLUTION -debido I-EVOLUTION -a I-EVOLUTION -cuadros I-EVOLUTION -suboclusivos. I-EVOLUTION +enfermedad. I-EVOLUTION I-EVOLUTION Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -37 I-PRESENT_ILLNESS +18 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +atendido I-PRESENT_ILLNESS +luego I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +trauma I-PRESENT_ILLNESS +facial I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +violencia, I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +volumen I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +mentoniana. I-PRESENT_ILLNESS +La B-EXPLORATION +imagen I-EXPLORATION +radiográfica I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +fractura I-EXPLORATION +sinfisiaria I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +radio I-EXPLORATION +lúcida I-EXPLORATION +periapical. I-EXPLORATION + I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +enucleación I-TREATMENT +del I-TREATMENT +quiste I-TREATMENT +e I-TREATMENT +inmovilización I-TREATMENT +de I-TREATMENT +fragmentos I-TREATMENT +por I-TREATMENT +bloqueo I-TREATMENT +intermaxilar I-TREATMENT +y I-TREATMENT +terapia I-TREATMENT +endodóntica I-TREATMENT +posterior I-TREATMENT +a I-TREATMENT +la I-TREATMENT +intervención. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +histopatológico I-EXPLORATION +comprobó I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +quiste I-EXPLORATION +radicular. I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION +panorámica I-EXPLORATION +realizada I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +mes I-EXPLORATION +de I-EXPLORATION +post I-EXPLORATION +operatorio, I-EXPLORATION +evidenció I-EXPLORATION +la I-EXPLORATION +evolución I-EXPLORATION +favorable I-EXPLORATION +de I-EXPLORATION +ambas I-EXPLORATION +lesiones. I-EXPLORATION + I-EXPLORATION + +Se B-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +clínico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +niña I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +siete I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY +sin B-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +interés, I-FAMILY_HISTORY +salvo I-FAMILY_HISTORY +un I-FAMILY_HISTORY +caso I-FAMILY_HISTORY +de I-FAMILY_HISTORY +liquen I-FAMILY_HISTORY +plano I-FAMILY_HISTORY +cutáneo I-FAMILY_HISTORY +en I-FAMILY_HISTORY +el I-FAMILY_HISTORY +padre I-FAMILY_HISTORY +años I-FAMILY_HISTORY +antes. I-FAMILY_HISTORY +No B-PAST_MEDICAL_HISTORY +hay I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY personales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -años/paquete, I-PAST_MEDICAL_HISTORY -consumidor I-PAST_MEDICAL_HISTORY -habitual I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cocaína I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -drogas I-PAST_MEDICAL_HISTORY -sintéticas I-PAST_MEDICAL_HISTORY -(anfetaminas, I-PAST_MEDICAL_HISTORY -speed, I-PAST_MEDICAL_HISTORY -...) I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -25 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad, I-PAST_MEDICAL_HISTORY -enolismo I-PAST_MEDICAL_HISTORY -< I-PAST_MEDICAL_HISTORY -80 I-PAST_MEDICAL_HISTORY -gr. I-PAST_MEDICAL_HISTORY -etanol/día. I-PAST_MEDICAL_HISTORY -Homosexual I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -SIDA I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Noviembre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2001 I-PAST_MEDICAL_HISTORY -(estadio I-PAST_MEDICAL_HISTORY -C3), I-PAST_MEDICAL_HISTORY -según I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -criterios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -CDC I-PAST_MEDICAL_HISTORY -(neumonía I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -P. I-PAST_MEDICAL_HISTORY -carinni I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -recuento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -linfocitos I-PAST_MEDICAL_HISTORY -<200 I-PAST_MEDICAL_HISTORY -CD4/µL). I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -estudio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -subpoblaciones I-PAST_MEDICAL_HISTORY -linfoides I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -sangre I-PAST_MEDICAL_HISTORY -periférica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -aquella I-PAST_MEDICAL_HISTORY -fecha I-PAST_MEDICAL_HISTORY -mostró I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -siguientes I-PAST_MEDICAL_HISTORY -resultados I-PAST_MEDICAL_HISTORY -CD4: I-PAST_MEDICAL_HISTORY -4, I-PAST_MEDICAL_HISTORY -5% I-PAST_MEDICAL_HISTORY -(81), I-PAST_MEDICAL_HISTORY -CD8: I-PAST_MEDICAL_HISTORY -71, I-PAST_MEDICAL_HISTORY -7% I-PAST_MEDICAL_HISTORY -(1290) I-PAST_MEDICAL_HISTORY -CD4/CD8: I-PAST_MEDICAL_HISTORY -0, I-PAST_MEDICAL_HISTORY -06 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -carga I-PAST_MEDICAL_HISTORY -viral I-PAST_MEDICAL_HISTORY -HIV: I-PAST_MEDICAL_HISTORY -19.200 I-PAST_MEDICAL_HISTORY -copias I-PAST_MEDICAL_HISTORY -RNA/ml. I-PAST_MEDICAL_HISTORY -Con I-PAST_MEDICAL_HISTORY -estos I-PAST_MEDICAL_HISTORY -datos I-PAST_MEDICAL_HISTORY -inició I-PAST_MEDICAL_HISTORY -Tratamiento I-PAST_MEDICAL_HISTORY -Antiretroviral I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Alta I-PAST_MEDICAL_HISTORY -Eficacia I-PAST_MEDICAL_HISTORY -(HAART), I-PAST_MEDICAL_HISTORY -utilizando I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -inhibidores I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -transcriptasa I-PAST_MEDICAL_HISTORY -inversa, I-PAST_MEDICAL_HISTORY -zidovudina I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -lamivudina, I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -inhibidor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -proteasa, I-PAST_MEDICAL_HISTORY -abacavir, I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -cuales I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -ido I-PAST_MEDICAL_HISTORY -cambiando I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +salvo I-PAST_MEDICAL_HISTORY +estreñimiento I-PAST_MEDICAL_HISTORY +funcional I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -combinando I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -fármacos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -misma I-PAST_MEDICAL_HISTORY -familia I-PAST_MEDICAL_HISTORY -(efavirenz, I-PAST_MEDICAL_HISTORY -estavudina, I-PAST_MEDICAL_HISTORY -ritonavir). I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -Diciembre I-PRESENT_ILLNESS -2001 I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS +dermatitis I-PAST_MEDICAL_HISTORY +atópica I-PAST_MEDICAL_HISTORY +leve. I-PAST_MEDICAL_HISTORY +Consulta B-PRESENT_ILLNESS por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -disfonía I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +ungueales I-PRESENT_ILLNESS +(piqueteado, I-PRESENT_ILLNESS +líneas I-PRESENT_ILLNESS +transversales, I-PRESENT_ILLNESS +descamación I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +uñas I-PRESENT_ILLNESS +quebradizas) I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +algunas I-PRESENT_ILLNESS +uñas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS +manos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +pies, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -a B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -ORL I-EXPLORATION -destacaba I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -rinitis I-EXPLORATION -seca-costrosa I-EXPLORATION -anterior I-EXPLORATION -y I-EXPLORATION -bilateral I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -rinitis I-EXPLORATION +varios I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Sin I-PRESENT_ILLNESS +traumatismo I-PRESENT_ILLNESS +referido. I-PRESENT_ILLNESS +No B-PAST_MEDICAL_HISTORY +tiene I-PAST_MEDICAL_HISTORY +hábito I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +chupeteado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +dedos. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +hay I-PAST_MEDICAL_HISTORY +otras I-PAST_MEDICAL_HISTORY +lesiones I-PAST_MEDICAL_HISTORY +cutáneas I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +mucosas. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +presenta I-PAST_MEDICAL_HISTORY +otra I-PAST_MEDICAL_HISTORY +clínica I-PAST_MEDICAL_HISTORY +asociada. I-PAST_MEDICAL_HISTORY +Refiere I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +dieta I-PAST_MEDICAL_HISTORY +variada, I-PAST_MEDICAL_HISTORY +aunque I-PAST_MEDICAL_HISTORY +algo I-PAST_MEDICAL_HISTORY +deficitaria I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +frutas. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Exploración B-EXPLORATION +clínica I-EXPLORATION +normal, I-EXPLORATION +salvo I-EXPLORATION por I-EXPLORATION -inhalación I-EXPLORATION -de I-EXPLORATION -cocaína, I-EXPLORATION -candidiasis I-EXPLORATION -oral I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +ungueales I-EXPLORATION +descritas; I-EXPLORATION +peso I-EXPLORATION y I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -laringoscopia I-EXPLORATION -indirecta, I-EXPLORATION -lesión I-EXPLORATION -violácea I-EXPLORATION -localizada I-EXPLORATION +talla I-EXPLORATION en I-EXPLORATION -banda I-EXPLORATION -ventricular I-EXPLORATION -y I-EXPLORATION -repliegue I-EXPLORATION -aritenoepiglótico I-EXPLORATION -izdo., I-EXPLORATION -movilidad I-EXPLORATION +percentil I-EXPLORATION +50-75. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +un I-TREATMENT +polivitamínico I-TREATMENT +ante I-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +déficit I-TREATMENT +vitamínico, I-TREATMENT +pero I-TREATMENT +tras I-TREATMENT +dos I-TREATMENT +meses I-TREATMENT +seguían I-TREATMENT +las I-TREATMENT +lesiones I-TREATMENT +sin I-TREATMENT +cambios. I-TREATMENT + I-TREATMENT +El B-DERIVED_FROM/TO +piqueteado I-DERIVED_FROM/TO +ungueal I-DERIVED_FROM/TO +nos I-DERIVED_FROM/TO +hacía I-DERIVED_FROM/TO +sospechar I-DERIVED_FROM/TO +varias I-DERIVED_FROM/TO +enfermedades I-DERIVED_FROM/TO +como I-DERIVED_FROM/TO +diagnóstico I-DERIVED_FROM/TO +diferencial I-DERIVED_FROM/TO +(eccema, I-DERIVED_FROM/TO +psoriasis I-DERIVED_FROM/TO +ungueal, I-DERIVED_FROM/TO +liquen I-DERIVED_FROM/TO +plano I-DERIVED_FROM/TO +ungueal I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +alopecia I-DERIVED_FROM/TO +areata), I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +lo I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +Dermatología I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +valoración. I-DERIVED_FROM/TO +Fue B-EXPLORATION +diagnosticada I-EXPLORATION +inicialmente I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -cuerda I-EXPLORATION -vocal I-EXPLORATION -y I-EXPLORATION -aritenoides I-EXPLORATION -izdo. I-EXPLORATION -disminuida. I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION sospecha I-EXPLORATION -clínica I-EXPLORATION de I-EXPLORATION -sarcoma I-EXPLORATION +dermatitis I-EXPLORATION de I-EXPLORATION -Kaposi, I-EXPLORATION +contacto I-EXPLORATION +o I-EXPLORATION +lesiones I-EXPLORATION +secundarias I-EXPLORATION +a I-EXPLORATION +atopia. I-EXPLORATION +Se I-EXPLORATION +descartaron I-EXPLORATION +alergias, I-EXPLORATION +inclusive I-EXPLORATION +a I-EXPLORATION +metales I-EXPLORATION +pesados I-EXPLORATION y I-EXPLORATION -dada I-EXPLORATION -las I-EXPLORATION -posibles I-EXPLORATION -complicaciones I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION +níquel. I-EXPLORATION + I-EXPLORATION +Ante I-EXPLORATION la I-EXPLORATION -lesión, I-EXPLORATION -no I-EXPLORATION -obstante, I-EXPLORATION -se I-EXPLORATION -practicaron I-EXPLORATION -broncoscopia I-EXPLORATION -que I-EXPLORATION -informó I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION +contacto I-EXPLORATION +con I-EXPLORATION +materiales I-EXPLORATION +o I-EXPLORATION +productos I-EXPLORATION +que I-EXPLORATION +le I-EXPLORATION +pudiesen I-EXPLORATION +causar I-EXPLORATION +dermatitis I-EXPLORATION +localizada I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lecho I-EXPLORATION +ungueal, I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -laríngeo I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -placas I-EXPLORATION +lesiones I-EXPLORATION de I-EXPLORATION -color I-EXPLORATION -rojo I-EXPLORATION -intenso I-EXPLORATION -que I-EXPLORATION -también I-EXPLORATION -estaban I-EXPLORATION -localizadas I-EXPLORATION +atopia I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -porción I-EXPLORATION -más I-EXPLORATION -superior I-EXPLORATION +el I-EXPLORATION +momento I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -traquea I-EXPLORATION +consulta I-EXPLORATION y I-EXPLORATION -que I-EXPLORATION -igualmente I-EXPLORATION -eran I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -sarcoma I-EXPLORATION -de I-EXPLORATION -Kaposi I-EXPLORATION -a I-EXPLORATION -dicho I-EXPLORATION -nivel; I-EXPLORATION -gastroscopia I-EXPLORATION -que I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION la I-EXPLORATION -no I-EXPLORATION -existencia I-EXPLORATION +persistencia I-EXPLORATION de I-EXPLORATION -lesiones I-EXPLORATION +las I-EXPLORATION +lesiones, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +analítico I-EXPLORATION +para I-EXPLORATION +completar I-EXPLORATION +el I-EXPLORATION +estudio. I-EXPLORATION +Se I-EXPLORATION +analizó I-EXPLORATION +el I-EXPLORATION +metabolismo I-EXPLORATION +férrico, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +otros I-EXPLORATION +posibles I-EXPLORATION +déficits I-EXPLORATION +nutricionales I-EXPLORATION +(zinc, I-EXPLORATION +1-25 I-EXPLORATION +hidroxi-colecalciferol, I-EXPLORATION +vitaminas I-EXPLORATION +B12 I-EXPLORATION y I-EXPLORATION -colonoscopia I-EXPLORATION -que I-EXPLORATION -informó I-EXPLORATION +B6), I-EXPLORATION +tirotropina I-EXPLORATION +(TSH) I-EXPLORATION +y I-EXPLORATION +tiroxina I-EXPLORATION +(T4), I-EXPLORATION +resultando I-EXPLORATION +todos I-EXPLORATION +normales. I-EXPLORATION +Se I-EXPLORATION +solicitaron I-EXPLORATION +también I-EXPLORATION +parámetros I-EXPLORATION de I-EXPLORATION +autoinmunidad I-EXPLORATION +ante I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION +posibilidad I-EXPLORATION de I-EXPLORATION -hemorroides I-EXPLORATION -grado I-EXPLORATION -II/IV I-EXPLORATION -con I-EXPLORATION -discreta I-EXPLORATION -estenosis I-EXPLORATION -del I-EXPLORATION -canal I-EXPLORATION -anal. I-EXPLORATION +psoriasis I-EXPLORATION +ungueal, I-EXPLORATION +siendo I-EXPLORATION +negativos I-EXPLORATION +el I-EXPLORATION +factor I-EXPLORATION +reumatoide I-EXPLORATION +y I-EXPLORATION +los I-EXPLORATION +anticuerpos I-EXPLORATION +antinucleares. I-EXPLORATION I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -clínico I-TREATMENT +Ante B-TREATMENT +la I-TREATMENT +normalidad I-TREATMENT de I-TREATMENT -sarcoma I-TREATMENT -de I-TREATMENT -Kaposi I-TREATMENT -laringeo I-TREATMENT -el I-TREATMENT -paciente, I-TREATMENT +los I-TREATMENT +resultados I-TREATMENT +analíticos I-TREATMENT y I-TREATMENT -ante I-TREATMENT -el I-TREATMENT -riesgo I-TREATMENT -de I-TREATMENT -obstrucción I-TREATMENT -de I-TREATMENT la I-TREATMENT -vía I-TREATMENT -aérea, I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -radiaciones I-TREATMENT -ionizantes I-TREATMENT -sobre I-TREATMENT -PTV-región I-TREATMENT -laringea, I-TREATMENT -mediante I-TREATMENT -dos I-TREATMENT -campos I-TREATMENT -laterales I-TREATMENT -y I-TREATMENT -opuestos, I-TREATMENT -utilizando I-TREATMENT -mascara I-TREATMENT -termolábil I-TREATMENT -de I-TREATMENT -inmovilización I-TREATMENT -y I-TREATMENT -planificación I-TREATMENT -mediante I-TREATMENT -TAC I-TREATMENT -se I-TREATMENT -alcanzó I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT +persistencia I-TREATMENT de I-TREATMENT -15 I-TREATMENT -Gy I-TREATMENT -a I-TREATMENT +las I-TREATMENT +lesiones, I-TREATMENT +que I-TREATMENT +hacían I-TREATMENT +sospechar I-TREATMENT +como I-TREATMENT +posibilidades I-TREATMENT +diagnósticas I-TREATMENT la I-TREATMENT -isodosis I-TREATMENT -del I-TREATMENT -95% I-TREATMENT -a I-TREATMENT +psoriasis I-TREATMENT +ungueal, I-TREATMENT +sin I-TREATMENT +poder I-TREATMENT +descartar I-TREATMENT un I-TREATMENT -fraccionamiento I-TREATMENT -de I-TREATMENT -150 I-TREATMENT -cGy I-TREATMENT -/día I-TREATMENT -en I-TREATMENT -10 I-TREATMENT -fracciones I-TREATMENT -y I-TREATMENT -en I-TREATMENT -2 I-TREATMENT -semanas. I-TREATMENT -Una I-TREATMENT -semana I-TREATMENT -previa I-TREATMENT -al I-TREATMENT -inicio I-TREATMENT -del I-TREATMENT -tratamiento, I-TREATMENT -durante I-TREATMENT -y I-TREATMENT -una I-TREATMENT -semana I-TREATMENT -después I-TREATMENT +liquen I-TREATMENT +plano I-TREATMENT +ungueal, I-TREATMENT +o I-TREATMENT +lesiones I-TREATMENT de I-TREATMENT -haber I-TREATMENT -finalizado I-TREATMENT -la I-TREATMENT -radioterapia I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -medicado I-TREATMENT -con I-TREATMENT -fluconazol I-TREATMENT -50 I-TREATMENT -mg. I-TREATMENT -V.O./24h. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -dos I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -haber I-EVOLUTION -finalizado I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -había I-EVOLUTION -recuperado I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -disfonía I-EVOLUTION -sin I-EVOLUTION -haber I-EVOLUTION -presentado I-EVOLUTION -toxicidad I-EVOLUTION -mucosa I-EVOLUTION -aguda I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -tras I-EVOLUTION -un I-EVOLUTION -seguimiento I-EVOLUTION -de I-EVOLUTION -36 I-EVOLUTION -meses, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -haya I-EVOLUTION -en I-EVOLUTION -remisión I-EVOLUTION -completa I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -sarcoma I-EVOLUTION -de I-EVOLUTION -Kaposi I-EVOLUTION -laringeo, I-EVOLUTION -con I-EVOLUTION -controles I-EVOLUTION -periódicos. I-EVOLUTION -No I-EVOLUTION -obstante, I-EVOLUTION -en I-EVOLUTION -Febrero I-EVOLUTION -de I-EVOLUTION -2002 I-EVOLUTION -fue I-EVOLUTION -diagnosticado I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -Giardiasis I-EVOLUTION -intestinal, I-EVOLUTION -que B-TREATMENT +eccema I-TREATMENT +ungueal, I-TREATMENT se I-TREATMENT -resolvió I-TREATMENT -con I-TREATMENT +inició I-TREATMENT tratamiento I-TREATMENT -médico I-TREATMENT -y I-TREATMENT +con I-TREATMENT +tazaroteno I-TREATMENT +tópico I-TREATMENT +(un I-TREATMENT +derivado I-TREATMENT de I-TREATMENT -un I-TREATMENT -Ameboma I-TREATMENT -rectal I-TREATMENT -que I-TREATMENT -requirió I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -que B-EVOLUTION -ha I-EVOLUTION -dejado I-EVOLUTION -como I-EVOLUTION -secuelas I-EVOLUTION -una I-EVOLUTION -incontinencia I-EVOLUTION -anorrectal I-EVOLUTION -grado I-EVOLUTION -IV I-EVOLUTION -de I-EVOLUTION -caracter I-EVOLUTION -irreversible. I-EVOLUTION -También I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -diagnosticado I-EVOLUTION -en I-EVOLUTION -Abril I-EVOLUTION -2002 I-EVOLUTION -de I-EVOLUTION -Condilomas I-EVOLUTION -acuminados I-EVOLUTION -perianales, I-EVOLUTION -habiendo B-TREATMENT -sido I-TREATMENT -intervenido I-TREATMENT -en I-TREATMENT -dos I-TREATMENT -ocasiones, I-TREATMENT -en I-TREATMENT -Junio I-TREATMENT -2002 I-TREATMENT -y I-TREATMENT -Abril I-TREATMENT -2004. I-TREATMENT -Así B-EVOLUTION -mismo I-EVOLUTION -en I-EVOLUTION -Enero I-EVOLUTION -2003 I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -diagnosticado I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -Hepatopatía I-EVOLUTION -crónica I-EVOLUTION -por I-EVOLUTION -virus I-EVOLUTION -C I-EVOLUTION -(informe I-EVOLUTION -AP: I-EVOLUTION -hepatitis I-EVOLUTION -crónica I-EVOLUTION -C I-EVOLUTION -de I-EVOLUTION -actividad I-EVOLUTION -leve, I-EVOLUTION -estadio I-EVOLUTION -1 I-EVOLUTION -(fibrosis I-EVOLUTION -portal); I-EVOLUTION -siderosis I-EVOLUTION -focal I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -células I-EVOLUTION -de I-EVOLUTION -Kupffer); I-EVOLUTION -carga I-EVOLUTION -viral I-EVOLUTION -VHC I-EVOLUTION -(virus I-EVOLUTION -hepatitis I-EVOLUTION -C) I-EVOLUTION -2.443.750 I-EVOLUTION -UI/ml I-EVOLUTION -genotipo I-EVOLUTION -1, I-EVOLUTION -subtipo I-EVOLUTION -B. I-EVOLUTION -El B-EXPLORATION -último I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -subpoblaciones I-EXPLORATION -linfoides I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -periférica I-EXPLORATION -en I-EXPLORATION -Enero I-EXPLORATION -2005 I-EXPLORATION -muestra I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -resultados I-EXPLORATION -CD4: I-EXPLORATION -10, I-EXPLORATION -3% I-EXPLORATION -(504,7), I-EXPLORATION -CD8: I-EXPLORATION -60, I-EXPLORATION -7% I-EXPLORATION -(2.974,3), I-EXPLORATION -CD3: I-EXPLORATION -76, I-EXPLORATION -3, I-EXPLORATION -CD4/CD8: I-EXPLORATION -0, I-EXPLORATION -17 I-EXPLORATION -y I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -HIV: I-EXPLORATION -304 I-EXPLORATION -copias I-EXPLORATION -RNA/ml. I-EXPLORATION - I-EXPLORATION +vitamina I-TREATMENT +A) I-TREATMENT +sobre I-TREATMENT +la I-TREATMENT +lámina I-TREATMENT +ungueal I-TREATMENT +durante I-TREATMENT +tres I-TREATMENT +meses. I-TREATMENT +Evolucionó B-EVOLUTION +favorablemente, I-EVOLUTION +normalizándose I-EVOLUTION +las I-EVOLUTION +lesiones I-EVOLUTION +ungueales. I-EVOLUTION + I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS +34 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS +diagnosticado B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hemofilia I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +severa I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +Cuba I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +25 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +(su I-PAST_MEDICAL_HISTORY +país I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +origen I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +residente I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +España I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +últimos I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +años). I-PAST_MEDICAL_HISTORY +No B-FAMILY_HISTORY +refería I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +la I-FAMILY_HISTORY +enfermedad. I-FAMILY_HISTORY +Durante B-PAST_MEDICAL_HISTORY +estos I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +episodios I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hemartros I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +rodilla I-PAST_MEDICAL_HISTORY +derecha, I-PAST_MEDICAL_HISTORY +tratados I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +conservadora, I-PAST_MEDICAL_HISTORY +precisando I-PAST_MEDICAL_HISTORY +crioprecipitados. I-PAST_MEDICAL_HISTORY +Previo I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +episodio I-PAST_MEDICAL_HISTORY +actual I-PAST_MEDICAL_HISTORY +estaba I-PAST_MEDICAL_HISTORY +asintomático I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +médico I-PAST_MEDICAL_HISTORY +domiciliario. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +El B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +otro I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal, I-PRESENT_ILLNESS +localizado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hipogastrio, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -varios I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -no I-EXPLORATION -revela I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -analítico I-EXPLORATION -(hematológico I-EXPLORATION -y I-EXPLORATION -bioquímico) I-EXPLORATION -no I-EXPLORATION -presenta I-EXPLORATION -alteraciones. I-EXPLORATION -La I-EXPLORATION -radiología I-EXPLORATION -simple I-EXPLORATION +evolución I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +hematuria. I-PRESENT_ILLNESS +Tras B-EXPLORATION +la I-EXPLORATION +realización I-EXPLORATION de I-EXPLORATION -abdomen I-EXPLORATION -revela I-EXPLORATION -pequeñas I-EXPLORATION -imágenes I-EXPLORATION -radiopacas I-EXPLORATION +pruebas I-EXPLORATION +analíticas I-EXPLORATION +y I-EXPLORATION +radiológicas I-EXPLORATION +fue I-EXPLORATION +diagnosticado I-EXPLORATION de I-EXPLORATION -densidad I-EXPLORATION -cálcica I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -área I-EXPLORATION -hepática, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -corresponden I-EXPLORATION -en I-EXPLORATION +cólico I-EXPLORATION +nefrítico, I-EXPLORATION +siendo I-EXPLORATION +alta I-EXPLORATION +con I-EXPLORATION +tratamiento I-EXPLORATION +analgésico. I-EXPLORATION + I-EXPLORATION +Cinco B-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +tarde, I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +micción, I-PRESENT_ILLNESS +sufrió I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +síncope I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +conocimiento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +escasos I-PRESENT_ILLNESS +segundos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +duración, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +hospital. I-PRESENT_ILLNESS +A B-EXPLORATION la I-EXPLORATION -ecografía I-EXPLORATION +exploración I-EXPLORATION +física, I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +estaba I-EXPLORATION +consciente I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -TAC I-EXPLORATION +orientado, I-EXPLORATION con I-EXPLORATION -varias I-EXPLORATION -lesiones I-EXPLORATION -hipoecoicas I-EXPLORATION +regular I-EXPLORATION +estado I-EXPLORATION +general I-EXPLORATION e I-EXPLORATION -hipodensas I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -lóbulos I-EXPLORATION -hepáticos, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -tamaño I-EXPLORATION -comprendido I-EXPLORATION -entre I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -y I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION +intensa I-EXPLORATION +palidez I-EXPLORATION +mucocutánea. I-EXPLORATION +La I-EXPLORATION +tensión I-EXPLORATION +arterial I-EXPLORATION +sistólica I-EXPLORATION +era I-EXPLORATION de I-EXPLORATION -diámetro, I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -interpretadas I-EXPLORATION -como I-EXPLORATION -metástasis. I-EXPLORATION -Las I-EXPLORATION -exploraciones I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -primario I-EXPLORATION -mamario I-EXPLORATION +70 I-EXPLORATION +mmHg I-EXPLORATION y I-EXPLORATION -gastrointestinal I-EXPLORATION -fueron I-EXPLORATION -negativas. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -somete I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -laparotomia I-EXPLORATION -exploradora I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -visualizan I-EXPLORATION -varias I-EXPLORATION -lesiones I-EXPLORATION -blanquecinas I-EXPLORATION -que I-EXPLORATION -protuyen I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -superficie I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -lóbulos I-EXPLORATION -hepáticos, I-EXPLORATION +diastólica I-EXPLORATION de I-EXPLORATION -superficie I-EXPLORATION -lisa, I-EXPLORATION +37 I-EXPLORATION +mmHg, I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +frecuencia I-EXPLORATION +cardiaca I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -toman I-EXPLORATION -muestras I-EXPLORATION -para I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico. I-EXPLORATION - I-EXPLORATION -Estudio I-EXPLORATION -anatomopatológico I-EXPLORATION - I-EXPLORATION -Las I-EXPLORATION -muestras I-EXPLORATION -corresponden I-EXPLORATION +61 I-EXPLORATION +latidos/min. I-EXPLORATION +A I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +abdominal I-EXPLORATION +el I-EXPLORATION +abdomen I-EXPLORATION +estaba I-EXPLORATION +distendido, I-EXPLORATION +doloroso I-EXPLORATION a I-EXPLORATION -dos I-EXPLORATION -fragmentos I-EXPLORATION -cuneiformes I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION de I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION +forma I-EXPLORATION +difusa, I-EXPLORATION +con I-EXPLORATION +defensa I-EXPLORATION y I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -dimensiones I-EXPLORATION -máximas, I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -color I-EXPLORATION -blanquecino I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -central I-EXPLORATION -y I-EXPLORATION -marrón I-EXPLORATION -en I-EXPLORATION +irritación I-EXPLORATION +peritoneal I-EXPLORATION +generalizada. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -periferia. I-EXPLORATION -Al I-EXPLORATION -corte I-EXPLORATION -se I-EXPLORATION -aprecian I-EXPLORATION -dos I-EXPLORATION -lesiones I-EXPLORATION -blanquecinas, I-EXPLORATION +analítica I-EXPLORATION +realizada I-EXPLORATION +presentaba I-EXPLORATION +un I-EXPLORATION +hematocrito I-EXPLORATION +del I-EXPLORATION +20%, I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +hemoglobina I-EXPLORATION de I-EXPLORATION -límites I-EXPLORATION -definidos I-EXPLORATION +6, I-EXPLORATION +7 I-EXPLORATION +g/dl, I-EXPLORATION +leucocitos I-EXPLORATION +12.270/ul I-EXPLORATION +(84% I-EXPLORATION +neutrófilos) I-EXPLORATION y I-EXPLORATION -consistencia I-EXPLORATION -firme, I-EXPLORATION -rodeadas I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -marrón. I-EXPLORATION -Las I-EXPLORATION -muestras I-EXPLORATION +plaquetas I-EXPLORATION +358.000/ul. I-EXPLORATION +Actividad I-EXPLORATION de I-EXPLORATION -tejido I-EXPLORATION -seleccionadas I-EXPLORATION -para I-EXPLORATION -estudio I-EXPLORATION -microscópico I-EXPLORATION -fueron I-EXPLORATION -fijadas I-EXPLORATION -en I-EXPLORATION -formol I-EXPLORATION -acuoso I-EXPLORATION -al I-EXPLORATION -10% I-EXPLORATION -durante I-EXPLORATION -24 I-EXPLORATION -horas I-EXPLORATION -e I-EXPLORATION -incluidas I-EXPLORATION -en I-EXPLORATION -parafina. I-EXPLORATION +protrombina I-EXPLORATION +100%, I-EXPLORATION +TTPA I-EXPLORATION +46%. I-EXPLORATION Se I-EXPLORATION -obtuvieron I-EXPLORATION -cortes I-EXPLORATION -histológicos I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -micras I-EXPLORATION -de I-EXPLORATION -espesor I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -tiñeron I-EXPLORATION -con I-EXPLORATION -hematoxilina-eosina. I-EXPLORATION -Otros I-EXPLORATION -cortes I-EXPLORATION -se I-EXPLORATION -montaron I-EXPLORATION -sobre I-EXPLORATION -portas I-EXPLORATION -cargados I-EXPLORATION -eléctricamente I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -destinaron I-EXPLORATION -a I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION +le I-EXPLORATION realizó I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +que I-EXPLORATION +informaba I-EXPLORATION de I-EXPLORATION -forma I-EXPLORATION -automatizada I-EXPLORATION +abundante I-EXPLORATION +líquido I-EXPLORATION +libre I-EXPLORATION +subdiafragmático I-EXPLORATION +izquierdo, I-EXPLORATION +subhepático I-EXPLORATION +y I-EXPLORATION en I-EXPLORATION -un I-EXPLORATION -aparato I-EXPLORATION -tipo I-EXPLORATION -ventana. I-EXPLORATION - I-EXPLORATION -Microscópicamente I-EXPLORATION +ambas I-EXPLORATION +gotieras I-EXPLORATION +paracólicas. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +espacio I-EXPLORATION +vesicorrectal I-EXPLORATION se I-EXPLORATION -advierte I-EXPLORATION +visualizaba I-EXPLORATION una I-EXPLORATION -lesión I-EXPLORATION -neoplásica I-EXPLORATION +imagen I-EXPLORATION +ovalada, I-EXPLORATION con I-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -crecimiento I-EXPLORATION -sólido I-EXPLORATION -y I-EXPLORATION -márgenes I-EXPLORATION -infiltrativos I-EXPLORATION -que I-EXPLORATION -ocupa I-EXPLORATION -parcial I-EXPLORATION -o I-EXPLORATION -totalmente I-EXPLORATION -las I-EXPLORATION -luces I-EXPLORATION -venulares I-EXPLORATION -y I-EXPLORATION -sinusoidales, I-EXPLORATION -respetando I-EXPLORATION -los I-EXPLORATION -espacios I-EXPLORATION -porta I-EXPLORATION -y I-EXPLORATION +líquido I-EXPLORATION en I-EXPLORATION -cierta I-EXPLORATION -medida I-EXPLORATION -las I-EXPLORATION -trabéculas I-EXPLORATION -hepáticas I-EXPLORATION -y I-EXPLORATION -conductillos I-EXPLORATION -biliares. I-EXPLORATION -Alternan I-EXPLORATION -áreas I-EXPLORATION -celulares I-EXPLORATION -con I-EXPLORATION -otras I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -fibroso. I-EXPLORATION -Las I-EXPLORATION -células I-EXPLORATION -neoplásicas I-EXPLORATION -dominantes I-EXPLORATION -exhiben I-EXPLORATION -citoplasmas I-EXPLORATION -amplios I-EXPLORATION -y I-EXPLORATION -densos, I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -bien I-EXPLORATION -definidos, I-EXPLORATION -a I-EXPLORATION -veces I-EXPLORATION -con I-EXPLORATION -vacuolas I-EXPLORATION -únicas I-EXPLORATION -o I-EXPLORATION -múltiples, I-EXPLORATION -ocasionalmente I-EXPLORATION -ocupadas I-EXPLORATION -por I-EXPLORATION -hematíes I-EXPLORATION -y I-EXPLORATION -núcleos I-EXPLORATION -vesiculares I-EXPLORATION -con I-EXPLORATION -nucleolos I-EXPLORATION -evidentes I-EXPLORATION -y I-EXPLORATION -aisladas I-EXPLORATION -mitosis. I-EXPLORATION -La I-EXPLORATION -mayoría I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -tumorales I-EXPLORATION -expresan I-EXPLORATION -inmunopositividad I-EXPLORATION -fuerte I-EXPLORATION -frente I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -marcadores I-EXPLORATION -vasculares I-EXPLORATION -FVIII, I-EXPLORATION -CD I-EXPLORATION -31 I-EXPLORATION -y I-EXPLORATION -CD I-EXPLORATION -34 I-EXPLORATION -y I-EXPLORATION -ocasionalmente I-EXPLORATION -frente I-EXPLORATION -al I-EXPLORATION -anticuerpo I-EXPLORATION -citoqueratina. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -no I-TREATMENT -ha I-TREATMENT -recibido I-TREATMENT -tratamiento I-TREATMENT -y B-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -han I-EVOLUTION -permanecido I-EVOLUTION -estables I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -momento I-EVOLUTION -actual, I-EVOLUTION -año I-EVOLUTION -y I-EVOLUTION -medio I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -diagnóstico. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -transcurso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -exploración I-PRESENT_ILLNESS -ginecológica I-PRESENT_ILLNESS -rutinaria I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -descubre I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ecografía I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diámetro I-PRESENT_ILLNESS -máximo I-PRESENT_ILLNESS -sonodensa, I-PRESENT_ILLNESS -homogénea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -mal I-PRESENT_ILLNESS -definida I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -sus I-PRESENT_ILLNESS -contornos I-PRESENT_ILLNESS -posteriores I-PRESENT_ILLNESS -ya I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -existe I-PRESENT_ILLNESS -interfase I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -tejido I-PRESENT_ILLNESS -graso I-PRESENT_ILLNESS -circundante, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -localización I-PRESENT_ILLNESS -presacra, I-PRESENT_ILLNESS -detrás I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -imagen I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -recto-sigma. I-PRESENT_ILLNESS -Dicha B-EXPLORATION -masa I-EXPLORATION -fue I-EXPLORATION -confirmada I-EXPLORATION -por I-EXPLORATION +su I-EXPLORATION +interior. I-EXPLORATION +Se I-EXPLORATION +decidió I-EXPLORATION +realizar I-EXPLORATION +un I-EXPLORATION TAC I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION +donde I-EXPLORATION se I-EXPLORATION -apreció I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -redondeada, I-EXPLORATION -bien I-EXPLORATION -delimitada, I-EXPLORATION +observó I-EXPLORATION +la I-EXPLORATION +misma I-EXPLORATION +imagen I-EXPLORATION +quística I-EXPLORATION +retro I-EXPLORATION +y I-EXPLORATION +supravesical, I-EXPLORATION de I-EXPLORATION -unos I-EXPLORATION -6 I-EXPLORATION +5 I-EXPLORATION cm I-EXPLORATION de I-EXPLORATION diámetro, I-EXPLORATION que I-EXPLORATION -presentaba I-EXPLORATION -coeficientes I-EXPLORATION -de I-EXPLORATION -absorción I-EXPLORATION -predominantemente I-EXPLORATION -grasos I-EXPLORATION -con I-EXPLORATION -discreta I-EXPLORATION -heterogeneidad, I-EXPLORATION -todo I-EXPLORATION -ello I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -posible I-EXPLORATION -tumor I-EXPLORATION -dermoide I-EXPLORATION -presacro. I-EXPLORATION -Dicha I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -unas I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -hematocrito I-EXPLORATION +parece I-EXPLORATION +depender I-EXPLORATION de I-EXPLORATION -38% I-EXPLORATION +un I-EXPLORATION +vaso I-EXPLORATION +arterial I-EXPLORATION +pero I-EXPLORATION sin I-EXPLORATION -alteraciones I-EXPLORATION -hematológicas I-EXPLORATION -acompañantes. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -apreciaron I-EXPLORATION -visceromegalias. I-EXPLORATION +llegar I-EXPLORATION +a I-EXPLORATION +detectar I-EXPLORATION +el I-EXPLORATION +origen I-EXPLORATION +del I-EXPLORATION +mismo. I-EXPLORATION I-EXPLORATION -Macroscópicamente I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -irregular I-EXPLORATION -bien I-EXPLORATION -delimitada I-EXPLORATION -de I-EXPLORATION -7x5x3 I-EXPLORATION -cm I-EXPLORATION -que I-EXPLORATION -parecía I-EXPLORATION -estar I-EXPLORATION -constituida I-EXPLORATION -fundamentalmente I-EXPLORATION -por I-EXPLORATION -tejido I-EXPLORATION -adiposo, I-EXPLORATION -observándose I-EXPLORATION -un I-EXPLORATION -área I-EXPLORATION -central I-EXPLORATION -hemorrágica I-EXPLORATION +Ante B-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +sangrado I-TREATMENT +en I-TREATMENT +paciente I-TREATMENT +hemofílico I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +transfusión I-TREATMENT +inmediata I-TREATMENT +de I-TREATMENT +2 I-TREATMENT +concentrados I-TREATMENT +de I-TREATMENT +hematíes, I-TREATMENT +3 I-TREATMENT +viales I-TREATMENT +de I-TREATMENT +factor I-TREATMENT +VIII I-TREATMENT +además I-TREATMENT +de I-TREATMENT +otro I-TREATMENT +de I-TREATMENT +factor I-TREATMENT +VII I-TREATMENT +recombinante. I-TREATMENT +La B-EXPLORATION +administración I-EXPLORATION de I-EXPLORATION -2 I-EXPLORATION -cm, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION +factor I-EXPLORATION +VIII I-EXPLORATION +requirió I-EXPLORATION la I-EXPLORATION -periferia, I-EXPLORATION -una I-EXPLORATION -serie I-EXPLORATION -de I-EXPLORATION -áreas I-EXPLORATION -blanquecinas I-EXPLORATION +evaluación I-EXPLORATION +analítica I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -fibroso I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -otras I-EXPLORATION -edematosas. I-EXPLORATION - I-EXPLORATION -Histológicamente I-EXPLORATION -la I-EXPLORATION -neoplasia I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -relativamente I-EXPLORATION -bien I-EXPLORATION -circunscrita I-EXPLORATION -y I-EXPLORATION -estaba I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -tejido I-EXPLORATION -adiposo I-EXPLORATION -maduro, I-EXPLORATION -tejido I-EXPLORATION -conectivo I-EXPLORATION -laxo I-EXPLORATION -y I-EXPLORATION -celularidad I-EXPLORATION -hematopoyética I-EXPLORATION -mixta. I-EXPLORATION -Este I-EXPLORATION -último I-EXPLORATION -componente I-EXPLORATION -predominaba I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -áreas I-EXPLORATION -centrales I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION +Ac I-EXPLORATION +antifactor I-EXPLORATION +VIII I-EXPLORATION +que I-EXPLORATION +resultaron I-EXPLORATION +positivos, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +requirió, I-TREATMENT +previa I-TREATMENT +a I-TREATMENT +su I-TREATMENT +administración, I-TREATMENT +la I-TREATMENT +aplicación I-TREATMENT +de I-TREATMENT +inhibidores I-TREATMENT +de I-TREATMENT +Ac I-TREATMENT +antifactor I-TREATMENT +VIII I-TREATMENT +(4). I-TREATMENT +Tras B-EVOLUTION +la I-EVOLUTION +mejoría I-EVOLUTION +analítica I-EVOLUTION +y I-EVOLUTION +ante I-EVOLUTION +la I-EVOLUTION +persistencia I-EVOLUTION +del I-EVOLUTION +mal I-EVOLUTION +estado I-EVOLUTION +general I-EVOLUTION +del I-EVOLUTION +paciente, I-EVOLUTION +se B-TREATMENT +decidió I-TREATMENT +intervenir I-TREATMENT +mediante I-TREATMENT +laparotomía I-TREATMENT +media I-TREATMENT +suprainfraumbilical I-TREATMENT +hallando I-TREATMENT +hemoperitoneo I-TREATMENT +de I-TREATMENT +aproximadamente I-TREATMENT +3 I-TREATMENT +litros I-TREATMENT +de I-TREATMENT +coágulos I-TREATMENT +y I-TREATMENT +sangre I-TREATMENT +roja. I-TREATMENT +Se B-EXPLORATION +encontró I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION +quística I-EXPLORATION +de I-EXPLORATION +6 I-EXPLORATION +cm, I-EXPLORATION +retrovesical, I-EXPLORATION +de I-EXPLORATION +consistencia I-EXPLORATION +elástica I-EXPLORATION y I-EXPLORATION +superficie I-EXPLORATION +lisa, I-EXPLORATION +íntimamente I-EXPLORATION +adherida I-EXPLORATION +a I-EXPLORATION +cara I-EXPLORATION +posterior I-EXPLORATION +vesical. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +disección I-TREATMENT +roma I-TREATMENT +y I-TREATMENT +exéreis I-TREATMENT +de I-TREATMENT +la I-TREATMENT +tumoración. I-TREATMENT +Posteriormente B-EXPLORATION se I-EXPLORATION -hallaba I-EXPLORATION -representado I-EXPLORATION -por I-EXPLORATION -las I-EXPLORATION -tres I-EXPLORATION -series I-EXPLORATION -hematopoyéticas I-EXPLORATION -(megacariocítica, I-EXPLORATION -serie I-EXPLORATION -roja I-EXPLORATION -y I-EXPLORATION -serie I-EXPLORATION -blanca), I-EXPLORATION -con I-EXPLORATION -diferentes I-EXPLORATION -proporciones I-EXPLORATION -según I-EXPLORATION +revisó I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -zona I-EXPLORATION -estudiada I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION +cavidad I-EXPLORATION +abdominal I-EXPLORATION +sin I-EXPLORATION +objetivar I-EXPLORATION un I-EXPLORATION -índice I-EXPLORATION -eritromieloide I-EXPLORATION -que I-EXPLORATION -oscilaba I-EXPLORATION -entre I-EXPLORATION -1: I-EXPLORATION -1 I-EXPLORATION -y I-EXPLORATION -2: I-EXPLORATION -1. I-EXPLORATION -Los I-EXPLORATION -megacariocíticos I-EXPLORATION -se I-EXPLORATION -observaban I-EXPLORATION -con I-EXPLORATION -facilidad I-EXPLORATION -y I-EXPLORATION -aunque I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -ocasionales I-EXPLORATION -formas I-EXPLORATION -inmaduras I-EXPLORATION +punto I-EXPLORATION +sangrante I-EXPLORATION +activo. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +satisfactoriamente I-EVOLUTION +en I-EVOLUTION +planta, I-EVOLUTION +manteniéndose I-EVOLUTION +afebril, I-EVOLUTION +con I-EVOLUTION +hematocritos I-EVOLUTION +mantenidos I-EVOLUTION +y I-EVOLUTION +débitos I-EVOLUTION +decrecientes I-EVOLUTION +por I-EVOLUTION +el I-EVOLUTION +drenaje I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +fue I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +décimo I-EVOLUTION +día I-EVOLUTION +postoperatorio. I-EVOLUTION +El B-TREATMENT +paciente I-TREATMENT +precisó I-TREATMENT +controles I-TREATMENT +por I-TREATMENT +hematología I-TREATMENT +tras I-TREATMENT +la I-TREATMENT +administración I-TREATMENT +del I-TREATMENT +factor I-TREATMENT +VIII I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas I-TREATMENT +en I-TREATMENT +los I-TREATMENT +cuatro I-TREATMENT +primeros I-TREATMENT +días. I-TREATMENT + I-TREATMENT +La B-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +informó I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -mismos, I-EXPLORATION -no I-EXPLORATION -presentaban I-EXPLORATION -rasgos I-EXPLORATION -displásicos. I-EXPLORATION -El I-EXPLORATION -estroma I-EXPLORATION +formación I-EXPLORATION +cupuliforme I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -áreas I-EXPLORATION -hematopoyéticas I-EXPLORATION +6, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro. I-EXPLORATION +La I-EXPLORATION +superficie I-EXPLORATION +externa I-EXPLORATION era I-EXPLORATION -casi I-EXPLORATION -exclusivamente I-EXPLORATION +lisa I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +interna I-EXPLORATION +presentaba I-EXPLORATION +múltiples I-EXPLORATION +coágulos I-EXPLORATION +hemáticos I-EXPLORATION +adheridos. I-EXPLORATION +La I-EXPLORATION +cúpula I-EXPLORATION +fibrosa I-EXPLORATION +contenía I-EXPLORATION +moderada I-EXPLORATION +infiltración I-EXPLORATION +inflamatoria I-EXPLORATION de I-EXPLORATION -tipo I-EXPLORATION -adiposo. I-EXPLORATION +predominio I-EXPLORATION +crónico I-EXPLORATION +inespecífico I-EXPLORATION +con I-EXPLORATION +algunos I-EXPLORATION +hemosiderofagos. I-EXPLORATION En I-EXPLORATION la I-EXPLORATION -zona I-EXPLORATION -más I-EXPLORATION -periférica I-EXPLORATION +superficie I-EXPLORATION +interna I-EXPLORATION +presentaba, I-EXPLORATION +además I-EXPLORATION del I-EXPLORATION -tumor I-EXPLORATION -predominaba I-EXPLORATION -el I-EXPLORATION +material I-EXPLORATION +hemático I-EXPLORATION +adherido, I-EXPLORATION tejido I-EXPLORATION -adiposo I-EXPLORATION -maduro I-EXPLORATION +graso I-EXPLORATION +maduro, I-EXPLORATION +todo I-EXPLORATION +ello I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -fibrosis I-EXPLORATION -y I-EXPLORATION -abundantes I-EXPLORATION -hemosiderinófagos. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -lipoblastos I-EXPLORATION -ni I-EXPLORATION -células I-EXPLORATION -mesenquimales I-EXPLORATION -bizarras I-EXPLORATION -y I-EXPLORATION -existía I-EXPLORATION -cierto I-EXPLORATION -componente I-EXPLORATION -inflamatorio I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -linfocitario, I-EXPLORATION -ocasionalmente I-EXPLORATION -dispuesto I-EXPLORATION -en I-EXPLORATION -agregados I-EXPLORATION -de I-EXPLORATION -distribución I-EXPLORATION -aleatoria I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -zonas I-EXPLORATION -hematopoyéticas I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -adiposas. I-EXPLORATION +pseudotumor I-EXPLORATION +hemofílico. I-EXPLORATION I-EXPLORATION -Paciente B-PRESENT_ILLNESS +S. B-PRESENT_ILLNESS +Piris I-PRESENT_ILLNESS +Borregasa, I-PRESENT_ILLNESS +M.R. I-PRESENT_ILLNESS +Acuña I-PRESENT_ILLNESS +Allerb I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +aMIR-Pediatría. I-PRESENT_ILLNESS +Hospital I-PRESENT_ILLNESS +Universitario I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -74 I-PRESENT_ILLNESS +Octubre. I-PRESENT_ILLNESS +Madrid. I-PRESENT_ILLNESS +España. I-PRESENT_ILLNESS +bPediatra. I-PRESENT_ILLNESS +CS I-PRESENT_ILLNESS +Martín I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Vargas. I-PRESENT_ILLNESS +Madrid. I-PRESENT_ILLNESS +España. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +revisión I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +niña I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -en B-PAST_MEDICAL_HISTORY -1997, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -consulta I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -tumoración I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -mama I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -adenopatía I-PAST_MEDICAL_HISTORY -palpable. I-PAST_MEDICAL_HISTORY -Estudio I-PAST_MEDICAL_HISTORY -radiológico I-PAST_MEDICAL_HISTORY -compatible I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -carcinoma. I-PAST_MEDICAL_HISTORY -Es I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -mastectomía I-PAST_MEDICAL_HISTORY -radical I-PAST_MEDICAL_HISTORY -modificada I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -Madden I-PAST_MEDICAL_HISTORY -previa I-PAST_MEDICAL_HISTORY -biopsia I-PAST_MEDICAL_HISTORY -intraoperatoria I-PAST_MEDICAL_HISTORY -positiva I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -carcinoma. I-PAST_MEDICAL_HISTORY -Informe I-PAST_MEDICAL_HISTORY -anatomopatológico: I-PAST_MEDICAL_HISTORY -Carcinoma I-PAST_MEDICAL_HISTORY -ductal I-PAST_MEDICAL_HISTORY -infiltrante I-PAST_MEDICAL_HISTORY -mucinoso I-PAST_MEDICAL_HISTORY -(coloide) I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -3.2 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -eje I-PAST_MEDICAL_HISTORY -máximo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +pediatra I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cabecera I-PRESENT_ILLNESS +descubre I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +marcha I-PRESENT_ILLNESS +torpe: I-PRESENT_ILLNESS +sabe I-PRESENT_ILLNESS +ponerse I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pie I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +ayuda, I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +sabe I-PRESENT_ILLNESS +correr, I-PRESENT_ILLNESS +chuta I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +balón I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +ambos I-PRESENT_ILLNESS +pies I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +sube I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +baja I-PRESENT_ILLNESS +escaleras I-PRESENT_ILLNESS +agarrada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +manos. I-PRESENT_ILLNESS +No B-FAMILY_HISTORY +se I-FAMILY_HISTORY +describen I-FAMILY_HISTORY +alteraciones I-FAMILY_HISTORY +neurológicas I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +interés. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Antecedentes B-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Nacida I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY una I-PAST_MEDICAL_HISTORY -adenopatía I-PAST_MEDICAL_HISTORY -positiva I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -22 I-PAST_MEDICAL_HISTORY -ganglios I-PAST_MEDICAL_HISTORY -axilares I-PAST_MEDICAL_HISTORY -aislados. I-PAST_MEDICAL_HISTORY -Recibe I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -complementario I-PAST_MEDICAL_HISTORY -tamoxifeno I-PAST_MEDICAL_HISTORY +gestación I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -diarios. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -realizan I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -rastreo I-PAST_MEDICAL_HISTORY +término I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +cesárea I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +presentación I-PAST_MEDICAL_HISTORY +podálica. I-PAST_MEDICAL_HISTORY +Peso I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +nacer, I-PAST_MEDICAL_HISTORY +2780 I-PAST_MEDICAL_HISTORY +g; I-PAST_MEDICAL_HISTORY +test I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -tumor I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -resultan I-PAST_MEDICAL_HISTORY -negativos. I-PAST_MEDICAL_HISTORY -Así I-PAST_MEDICAL_HISTORY -mismo I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -realizan I-PAST_MEDICAL_HISTORY -ecografías I-PAST_MEDICAL_HISTORY -ginecológicas I-PAST_MEDICAL_HISTORY -anuales I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -son I-PAST_MEDICAL_HISTORY +Apgar, I-PAST_MEDICAL_HISTORY +8/9; I-PAST_MEDICAL_HISTORY +reanimación I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +II. I-PAST_MEDICAL_HISTORY +Pruebas I-PAST_MEDICAL_HISTORY +endocrinometabólicas I-PAST_MEDICAL_HISTORY normales. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -Mayo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2001 I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -metrorragia I-PRESENT_ILLNESS -postmenopáusica. I-PRESENT_ILLNESS -Se B-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -vaginal I-EXPLORATION -que I-EXPLORATION -resulta I-EXPLORATION -ser I-EXPLORATION -compatible I-EXPLORATION +Vacunación I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +día. I-PAST_MEDICAL_HISTORY +Desarrollo I-PAST_MEDICAL_HISTORY +psicomotor: I-PAST_MEDICAL_HISTORY +sonrisa I-PAST_MEDICAL_HISTORY +social I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +meses, I-PAST_MEDICAL_HISTORY +sostén I-PAST_MEDICAL_HISTORY +cefálico I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +meses, I-PAST_MEDICAL_HISTORY +sedestación I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +siete I-PAST_MEDICAL_HISTORY +meses, I-PAST_MEDICAL_HISTORY +gateo I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +ocho I-PAST_MEDICAL_HISTORY +meses, I-PAST_MEDICAL_HISTORY +marcha I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +apoyo I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +17 I-PAST_MEDICAL_HISTORY +meses, I-PAST_MEDICAL_HISTORY +motricidad I-PAST_MEDICAL_HISTORY +fina I-PAST_MEDICAL_HISTORY +normal. I-PAST_MEDICAL_HISTORY +Bisílabos I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +referenciales I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +ocho I-PAST_MEDICAL_HISTORY +meses, I-PAST_MEDICAL_HISTORY +bisílabos I-PAST_MEDICAL_HISTORY +referenciales I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +12 I-PAST_MEDICAL_HISTORY +meses. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Exploración B-EXPLORATION +física I-EXPLORATION + I-EXPLORATION +Talla, I-EXPLORATION +92 I-EXPLORATION +cm I-EXPLORATION +(percentil I-EXPLORATION +97 I-EXPLORATION +[P97]); I-EXPLORATION +peso, I-EXPLORATION +11, I-EXPLORATION +8 I-EXPLORATION +kg I-EXPLORATION +(P25-50); I-EXPLORATION +perímetro I-EXPLORATION +craneal. I-EXPLORATION +53, I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION +(P97). I-EXPLORATION +Buen I-EXPLORATION +estado I-EXPLORATION +general. I-EXPLORATION +Bien I-EXPLORATION +nutrida. I-EXPLORATION +Sin I-EXPLORATION +dismorfias I-EXPLORATION +ni I-EXPLORATION +discromías. I-EXPLORATION +Cráneo I-EXPLORATION +normoconfigurado. I-EXPLORATION +Auscultación I-EXPLORATION +cardiopulmonar I-EXPLORATION +normal. I-EXPLORATION +Abdomen I-EXPLORATION +depresible I-EXPLORATION +y I-EXPLORATION +sin I-EXPLORATION +organomegalias. I-EXPLORATION +Genitales I-EXPLORATION +externos I-EXPLORATION +femeninos I-EXPLORATION +y I-EXPLORATION +normales. I-EXPLORATION +Exploración I-EXPLORATION +neurológica: I-EXPLORATION +hábito I-EXPLORATION +longilíneo I-EXPLORATION con I-EXPLORATION -"pólipo I-EXPLORATION -endometrial" I-EXPLORATION -de I-EXPLORATION -19*16 I-EXPLORATION -mm. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -Histeroscopia I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -una I-EXPLORATION -formación I-EXPLORATION -excrecente I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cara I-EXPLORATION -anterior I-EXPLORATION -de I-EXPLORATION -vagina I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -biopsiada I-EXPLORATION +buena I-EXPLORATION +alineación I-EXPLORATION +del I-EXPLORATION +raquis I-EXPLORATION y I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -intrauterino I-EXPLORATION -una I-EXPLORATION -formación I-EXPLORATION -polipoidea I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +extremidades; I-EXPLORATION +pares I-EXPLORATION +craneales I-EXPLORATION +normales; I-EXPLORATION +tono I-EXPLORATION +activo I-EXPLORATION +normal; I-EXPLORATION +leve I-EXPLORATION +hipotonía I-EXPLORATION +pasiva I-EXPLORATION con I-EXPLORATION -vasos I-EXPLORATION -anómalos, I-EXPLORATION -altamente I-EXPLORATION -sospechosa I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -igualmente I-EXPLORATION -biopsiada. I-EXPLORATION -El I-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION +signo I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -zona I-EXPLORATION +bufanda I-EXPLORATION +que I-EXPLORATION +sobrepasa I-EXPLORATION +la I-EXPLORATION +línea I-EXPLORATION +media I-EXPLORATION +y I-EXPLORATION +dedo I-EXPLORATION +al I-EXPLORATION +antebrazo; I-EXPLORATION en I-EXPLORATION -vagina I-EXPLORATION -se I-EXPLORATION -informa I-EXPLORATION -como I-EXPLORATION -carcinoma I-EXPLORATION -pobremente I-EXPLORATION -diferenciado I-EXPLORATION +los I-EXPLORATION +miembros I-EXPLORATION +inferiores, I-EXPLORATION +el I-EXPLORATION +ángulo I-EXPLORATION +poplíteo I-EXPLORATION +supera I-EXPLORATION +los I-EXPLORATION +90o I-EXPLORATION +y I-EXPLORATION +hace I-EXPLORATION +abducción I-EXPLORATION +completa I-EXPLORATION +de I-EXPLORATION +caderas; I-EXPLORATION +reflejos I-EXPLORATION +osteotendinosos I-EXPLORATION +presentes I-EXPLORATION y I-EXPLORATION +simétricos; I-EXPLORATION +llama I-EXPLORATION la I-EXPLORATION -formación I-EXPLORATION -polipoidea I-EXPLORATION -como I-EXPLORATION -atipia I-EXPLORATION -celular I-EXPLORATION +atención I-EXPLORATION +la I-EXPLORATION +marcha I-EXPLORATION +ligeramente I-EXPLORATION +oscilante, I-EXPLORATION no I-EXPLORATION -filiada. I-EXPLORATION - B-TREATMENT -Se I-TREATMENT -realiza I-TREATMENT -una I-TREATMENT -histerectomía I-TREATMENT -total I-TREATMENT -con I-TREATMENT -doble I-TREATMENT -anexectomía, I-TREATMENT -manguito I-TREATMENT -vaginal I-TREATMENT -y I-TREATMENT -linfadenectomía. I-TREATMENT -Informe B-EXPLORATION -anatomopatológico: I-EXPLORATION -Lavado I-EXPLORATION -peritoneal I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -células I-EXPLORATION -malignas. I-EXPLORATION -Tumor I-EXPLORATION -intracavitario I-EXPLORATION +claudicante; I-EXPLORATION +no I-EXPLORATION +dismetría, I-EXPLORATION +signo I-EXPLORATION de I-EXPLORATION -6 I-EXPLORATION -cm, I-EXPLORATION -Tumor I-EXPLORATION -Mülleriano I-EXPLORATION -Mixto I-EXPLORATION -Maligno I-EXPLORATION -Heterólogo I-EXPLORATION +Romberg I-EXPLORATION +negativo; I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +disdiadococinesia; I-EXPLORATION +pinza I-EXPLORATION +digital I-EXPLORATION +normal; I-EXPLORATION +maniobra I-EXPLORATION +de I-EXPLORATION +Gowers I-EXPLORATION +negativa; I-EXPLORATION +sin I-EXPLORATION +hipertrofia I-EXPLORATION +gemelar. I-EXPLORATION + I-EXPLORATION +Evolución B-DERIVED_FROM/TO +posterior I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +El I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +consulta I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Neurología I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +control I-DERIVED_FROM/TO +clínico I-DERIVED_FROM/TO +cada I-DERIVED_FROM/TO +tres I-DERIVED_FROM/TO +meses. I-DERIVED_FROM/TO +Se B-EXPLORATION +solicitó I-EXPLORATION +un I-EXPLORATION +hemograma, I-EXPLORATION +una I-EXPLORATION +bioquímica I-EXPLORATION +general, I-EXPLORATION +pruebas I-EXPLORATION +tiroideas I-EXPLORATION +y I-EXPLORATION +creatinfosfocinasa, I-EXPLORATION con I-EXPLORATION -extensa I-EXPLORATION -permeación I-EXPLORATION -vascular I-EXPLORATION -linfática. I-EXPLORATION -Metástasis I-EXPLORATION -múltiples I-EXPLORATION +resultados I-EXPLORATION +normales. I-EXPLORATION +Durante B-EVOLUTION +los I-EVOLUTION +siguientes I-EVOLUTION +seis I-EVOLUTION +meses I-EVOLUTION +la I-EVOLUTION +niña I-EVOLUTION +desarrolló I-EVOLUTION +una I-EVOLUTION +macrocefalia I-EVOLUTION +de I-EVOLUTION ++3, I-EVOLUTION +6 I-EVOLUTION +desviaciones I-EVOLUTION +estándar I-EVOLUTION +(DS) I-EVOLUTION +y I-EVOLUTION +un I-EVOLUTION +discreto I-EVOLUTION +temblor I-EVOLUTION +intencional, I-EVOLUTION +sin I-EVOLUTION +mejoría I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +torpeza I-EVOLUTION +motora I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +deambulación, I-EVOLUTION +por B-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +un I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +cerebral, I-EXPLORATION en I-EXPLORATION -miometrio, I-EXPLORATION -trompa I-EXPLORATION -y I-EXPLORATION -ovarios I-EXPLORATION -y I-EXPLORATION -metástasis I-EXPLORATION -ganglionares. I-EXPLORATION -La I-EXPLORATION -formación I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +descubrió I-EXPLORATION +una I-EXPLORATION +llamativa I-EXPLORATION +dilatación I-EXPLORATION de I-EXPLORATION -vagina I-EXPLORATION -es I-EXPLORATION +los I-EXPLORATION +cuatro I-EXPLORATION +ventrículos I-EXPLORATION +cerebrales I-EXPLORATION +con I-EXPLORATION +quiste I-EXPLORATION +retrocerebeloso I-EXPLORATION +sin I-EXPLORATION +evidencia I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -carcinoma I-EXPLORATION -pobremente I-EXPLORATION -diferenciado I-EXPLORATION -probablemente I-EXPLORATION -metástasis I-EXPLORATION +otras I-EXPLORATION +malformaciones I-EXPLORATION +asociadas, I-EXPLORATION +sugerente I-EXPLORATION +todo I-EXPLORATION +ello I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +alteración I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +fosa I-EXPLORATION +posterior I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +contexto I-EXPLORATION del I-EXPLORATION -tumor I-EXPLORATION -Mülleriano I-EXPLORATION -mixto I-EXPLORATION -descrito I-EXPLORATION -(Estadio I-EXPLORATION -III). I-EXPLORATION -Realiza B-TREATMENT -tratamiento I-TREATMENT -complementario I-TREATMENT +complejo I-EXPLORATION +de I-EXPLORATION +Dandy-Walker. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +recomendó, I-TREATMENT +por I-TREATMENT +parte I-TREATMENT +de I-TREATMENT +Neurología, I-TREATMENT +fisioterapia I-TREATMENT +mediante I-TREATMENT +el I-TREATMENT +método I-TREATMENT +Bobath, I-TREATMENT con I-TREATMENT -Taxol, I-TREATMENT +la I-TREATMENT que I-TREATMENT -tolera I-TREATMENT -mal, I-TREATMENT -y I-TREATMENT -radioterapia, I-TREATMENT -falleciendo I-TREATMENT -al I-TREATMENT -año I-TREATMENT -de I-TREATMENT -este I-TREATMENT -proceso. I-TREATMENT +se I-TREATMENT +ha I-TREATMENT +detenido, I-TREATMENT +por I-TREATMENT +el I-TREATMENT +momento, I-TREATMENT +el I-TREATMENT +deterioro I-TREATMENT +neurológico. I-TREATMENT + I-TREATMENT +Dirección I-TREATMENT +para I-TREATMENT +correspondencia: I-TREATMENT +Salvador I-TREATMENT +Piris I-TREATMENT +Borregas I-TREATMENT +dockbps@hotmail.com I-TREATMENT I-TREATMENT -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -21 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-FAMILY_HISTORY -historia I-FAMILY_HISTORY -familiar I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés, I-FAMILY_HISTORY -y B-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -intervención I-PAST_MEDICAL_HISTORY +30 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -estrabismo I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ex-fumadora I-PAST_MEDICAL_HISTORY -(10 I-PAST_MEDICAL_HISTORY -cigarrillos/día). I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Inicia B-PRESENT_ILLNESS -estudio I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -otorrinolaringólogo I-PRESENT_ILLNESS -(ORL) I-PRESENT_ILLNESS +VIH, I-PAST_MEDICAL_HISTORY +estudiado B-PRESENT_ILLNESS por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -respiratoria I-PRESENT_ILLNESS -nasal I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -gusto, I-PRESENT_ILLNESS -anosmia, I-PRESENT_ILLNESS -epístaxis I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -epífora I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -ocasional, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -intensa I-PRESENT_ILLNESS -cefalea, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -iniciar I-PRESENT_ILLNESS -estudio. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -ORL I-EXPLORATION +proctitis I-PRESENT_ILLNESS +en B-EXPLORATION +cuya I-EXPLORATION +colonoscopia I-EXPLORATION se I-EXPLORATION -aprecia I-EXPLORATION +objetiva I-EXPLORATION una I-EXPLORATION -masa I-EXPLORATION -que I-EXPLORATION -ocupa I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -fosa I-EXPLORATION -nasal I-EXPLORATION -derecha I-EXPLORATION -e I-EXPLORATION -impide I-EXPLORATION -el I-EXPLORATION -paso I-EXPLORATION -del I-EXPLORATION -endoscopio I-EXPLORATION -con I-EXPLORATION -desplazamiento I-EXPLORATION -septal I-EXPLORATION -a I-EXPLORATION -fosa I-EXPLORATION -nasal I-EXPLORATION -izquierda, I-EXPLORATION +mucosa I-EXPLORATION +patológica I-EXPLORATION con I-EXPLORATION -biopsia I-EXPLORATION -sospechosa I-EXPLORATION -de I-EXPLORATION -tumor I-EXPLORATION -indiferenciado. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -detectan I-EXPLORATION -adenopatías I-EXPLORATION -palpables. I-EXPLORATION +exudado I-EXPLORATION +purulento I-EXPLORATION +en I-EXPLORATION +rectosigma. I-EXPLORATION Se I-EXPLORATION -realiza I-EXPLORATION -analítica I-EXPLORATION +descartó I-EXPLORATION +proceso I-EXPLORATION +maligno I-EXPLORATION y I-EXPLORATION -Radiografía I-EXPLORATION +el I-EXPLORATION +análisis I-EXPLORATION +microbiológico I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicitan I-EXPLORATION -Tomografía I-EXPLORATION -axial I-EXPLORATION -computerizada I-EXPLORATION -(TAC) I-EXPLORATION +las I-EXPLORATION +heces I-EXPLORATION +fue I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +virus I-EXPLORATION +herpes I-EXPLORATION +simple I-EXPLORATION +tipo I-EXPLORATION +2 I-EXPLORATION y I-EXPLORATION -Resonancia I-EXPLORATION -nuclear I-EXPLORATION -magnética I-EXPLORATION -(RNM) I-EXPLORATION -craneofacial I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION +Chalmydia I-EXPLORATION +trachomatis. I-EXPLORATION +Fue B-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +valganciclovir I-TREATMENT +y I-TREATMENT +azitromicina, I-TREATMENT +con I-TREATMENT +mejoría I-TREATMENT +de I-TREATMENT +la I-TREATMENT +clínica I-TREATMENT +infecciosa I-TREATMENT +pero I-TREATMENT +con I-TREATMENT +estreñimiento I-TREATMENT +progresivo. I-TREATMENT +Una B-EXPLORATION +nueva I-EXPLORATION +rectoscopia I-EXPLORATION objetiva I-EXPLORATION una I-EXPLORATION -tumoración I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -derecho I-EXPLORATION -que I-EXPLORATION -desplaza I-EXPLORATION -el I-EXPLORATION -septum I-EXPLORATION +zona I-EXPLORATION +fibrótica I-EXPLORATION y I-EXPLORATION -afecta I-EXPLORATION -celdillas I-EXPLORATION -etmoidales I-EXPLORATION +ulcerada I-EXPLORATION +en I-EXPLORATION +recto I-EXPLORATION +distal, I-EXPLORATION +con I-EXPLORATION +biopsias I-EXPLORATION y I-EXPLORATION -coanas I-EXPLORATION -del I-EXPLORATION -mismo I-EXPLORATION -lado. I-EXPLORATION - I-EXPLORATION -Es B-TREATMENT -intervenida I-TREATMENT -quirúrgicamente I-TREATMENT -mediante I-TREATMENT -resección I-TREATMENT -craneofacial I-TREATMENT -de I-TREATMENT -etmoides I-TREATMENT -y I-TREATMENT -translocación I-TREATMENT -facial I-TREATMENT -medial, I-TREATMENT -que I-TREATMENT -permite I-TREATMENT -apreciar I-TREATMENT -que I-TREATMENT +análisis I-EXPLORATION +microbiológico I-EXPLORATION +negativos. I-EXPLORATION +Ante B-TREATMENT la I-TREATMENT -tumoración I-TREATMENT -ocupaba I-TREATMENT -todo I-TREATMENT -el I-TREATMENT -seno I-TREATMENT -maxilar I-TREATMENT -derecho I-TREATMENT -y I-TREATMENT -celdas I-TREATMENT -etmoidales, I-TREATMENT -a I-TREATMENT -las I-TREATMENT -cuales I-TREATMENT -desplaza I-TREATMENT -por I-TREATMENT -compresión, I-TREATMENT -con I-TREATMENT -disrupción I-TREATMENT -de I-TREATMENT -partes I-TREATMENT +persistencia I-TREATMENT de I-TREATMENT la I-TREATMENT -pared I-TREATMENT -ósea I-TREATMENT -posterior I-TREATMENT -y I-TREATMENT -medial I-TREATMENT -del I-TREATMENT -seno I-TREATMENT -maxilar. I-TREATMENT -El I-TREATMENT -tumor I-TREATMENT -rellenaba I-TREATMENT -submucosamente I-TREATMENT -toda I-TREATMENT -la I-TREATMENT -fosa I-TREATMENT -nasal I-TREATMENT -derecha I-TREATMENT -y I-TREATMENT -parte I-TREATMENT -del I-TREATMENT -seno I-TREATMENT -esfenoidal. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -Anatomo-patológico I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -Neuroestesioblastoma, I-EXPLORATION -estadio I-EXPLORATION -B I-EXPLORATION -de I-EXPLORATION -Kádish. I-EXPLORATION -En B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -inmediato I-EVOLUTION -sufrió I-EVOLUTION -una I-EVOLUTION -meningitis I-EVOLUTION -bacteriana I-EVOLUTION -con I-EVOLUTION -evolución I-EVOLUTION -satisfactoria. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -RNM I-EXPLORATION -posquirúrgica I-EXPLORATION -solo I-EXPLORATION -se I-EXPLORATION -visualizan I-EXPLORATION -cambios I-EXPLORATION -postcirugía. I-EXPLORATION - I-EXPLORATION -Tras B-TREATMENT -valoración I-TREATMENT -en I-TREATMENT -Subcomité I-TREATMENT -de I-TREATMENT -tumores I-TREATMENT -de I-TREATMENT -cabeza I-TREATMENT -y I-TREATMENT -cuello I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -Radioterapia I-TREATMENT -postoperatoria, I-TREATMENT -recibiendo I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -total I-TREATMENT -sobre I-TREATMENT -lecho I-TREATMENT -tumoral I-TREATMENT -de I-TREATMENT -60 I-TREATMENT -Gy I-TREATMENT -con I-TREATMENT -técnica I-TREATMENT -de I-TREATMENT -simulación I-TREATMENT -virtual I-TREATMENT -y I-TREATMENT -planificación I-TREATMENT -tridimensional I-TREATMENT -(3D) I-TREATMENT -sobre I-TREATMENT -tomografía I-TREATMENT -computarizada I-TREATMENT -(TC) I-TREATMENT -helicoidal I-TREATMENT -individualizada I-TREATMENT -(cortes I-TREATMENT -cada I-TREATMENT -5 I-TREATMENT -mm), I-TREATMENT +clínica I-TREATMENT con I-TREATMENT -protección I-TREATMENT -plomada I-TREATMENT -personalizada I-TREATMENT -de I-TREATMENT -órganos I-TREATMENT -sanos, I-TREATMENT -fraccionamiento I-TREATMENT -de I-TREATMENT -2 I-TREATMENT -Gy/fracción, I-TREATMENT -5 I-TREATMENT -fracciones I-TREATMENT -semana I-TREATMENT -mediante I-TREATMENT -fotones I-TREATMENT -de I-TREATMENT -6 I-TREATMENT -Megavoltios I-TREATMENT -(MV) I-TREATMENT -procedentes I-TREATMENT -de I-TREATMENT -Acelerador I-TREATMENT -Lineal. I-TREATMENT -Se I-TREATMENT -emplea I-TREATMENT -sistema I-TREATMENT -de I-TREATMENT -homogeneización I-TREATMENT +tratamiento I-TREATMENT +conservador, I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +realizar I-TREATMENT +resección I-TREATMENT +anterior I-TREATMENT de I-TREATMENT -dosis I-TREATMENT +recto I-TREATMENT +ultrabaja I-TREATMENT con I-TREATMENT -cuñas I-TREATMENT -de I-TREATMENT -compensación I-TREATMENT -tisular, I-TREATMENT +reservorio I-TREATMENT +coloanal I-TREATMENT e I-TREATMENT -inmovilización I-TREATMENT -con I-TREATMENT -máscara I-TREATMENT -termoplástica I-TREATMENT -facial I-TREATMENT -para I-TREATMENT -una I-TREATMENT -adecuada I-TREATMENT -reproductibilidad I-TREATMENT -a I-TREATMENT -lo I-TREATMENT -largo I-TREATMENT -del I-TREATMENT -tratamiento. I-TREATMENT -La B-EVOLUTION -tolerancia I-EVOLUTION -es I-EVOLUTION -buena, I-EVOLUTION +ileostomía. I-TREATMENT +Tras B-EVOLUTION +posoperatorio I-EVOLUTION +complicado, I-EVOLUTION +se I-EVOLUTION +reconstruye I-EVOLUTION +el I-EVOLUTION +tránsito I-EVOLUTION +sin I-EVOLUTION +incidencias, I-EVOLUTION con I-EVOLUTION -toxicidad I-EVOLUTION -aguda I-EVOLUTION -dérmica I-EVOLUTION -grado I-EVOLUTION -1 I-EVOLUTION -(G1), I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -mucosa I-EVOLUTION -grado I-EVOLUTION -2 I-EVOLUTION -(G2). I-EVOLUTION -A B-TREATMENT -las I-TREATMENT -4 I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -finalizada I-TREATMENT -la I-TREATMENT -irradiación I-TREATMENT -es I-TREATMENT -reintervenida I-TREATMENT -por I-TREATMENT -fístula I-TREATMENT -oroantral I-TREATMENT -en I-TREATMENT -el I-TREATMENT -surco I-TREATMENT -gingival I-TREATMENT -derecho I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -del I-TREATMENT -primer I-TREATMENT -molar. I-TREATMENT -Siete I-TREATMENT -meses I-TREATMENT -después, I-TREATMENT -es I-TREATMENT -reintervenida I-TREATMENT -con I-TREATMENT -abordaje I-TREATMENT -craneofacial I-TREATMENT -por I-TREATMENT -granuloma I-TREATMENT -a I-TREATMENT -cuerpo I-TREATMENT -extraño I-TREATMENT -en I-TREATMENT -cavidad I-TREATMENT -frontal I-TREATMENT -izquierda I-TREATMENT -sin I-TREATMENT -datos I-TREATMENT -histológicos I-TREATMENT -de I-TREATMENT -recidiva. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -la I-EVOLUTION -actualidad, I-EVOLUTION -tras I-EVOLUTION -26 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -primera I-EVOLUTION -intervención, I-EVOLUTION -no I-EVOLUTION -existe I-EVOLUTION -evidencia I-EVOLUTION -de I-EVOLUTION -recidiva I-EVOLUTION -local, I-EVOLUTION -hallándose I-EVOLUTION -en I-EVOLUTION -remisión I-EVOLUTION -completa, I-EVOLUTION -realizando I-EVOLUTION -vida I-EVOLUTION -normal I-EVOLUTION -activa. I-EVOLUTION - I-EVOLUTION +seguimiento I-EVOLUTION +actual I-EVOLUTION +sin I-EVOLUTION +complicaciones. I-EVOLUTION +El B-EXPLORATION +estudio I-EXPLORATION +inmunohistoquímico I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -homosexual I-PRESENT_ILLNESS +Escolar B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -49 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -antecedentes B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tuberculosis I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY +8 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +residente B-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY +Santiago, I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -estreptomicina, I-PAST_MEDICAL_HISTORY -esfinterotomía I-PAST_MEDICAL_HISTORY -lateral I-PAST_MEDICAL_HISTORY -interna I-PAST_MEDICAL_HISTORY -reciente I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -fisura I-PAST_MEDICAL_HISTORY -anal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pólipos I-PAST_MEDICAL_HISTORY -centinela, I-PAST_MEDICAL_HISTORY -serología I-PAST_MEDICAL_HISTORY -VIH I-PAST_MEDICAL_HISTORY -positiva I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -enero I-PAST_MEDICAL_HISTORY -2003, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -estadio I-PAST_MEDICAL_HISTORY -C3 I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -neumonía I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -Pneumocystis I-PAST_MEDICAL_HISTORY -carinii. I-PAST_MEDICAL_HISTORY -Último I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -CD I-PAST_MEDICAL_HISTORY -30 I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +leucemia I-PAST_MEDICAL_HISTORY +mieloide I-PAST_MEDICAL_HISTORY +aguda I-PAST_MEDICAL_HISTORY +(LMA) I-PAST_MEDICAL_HISTORY +M4, I-PAST_MEDICAL_HISTORY +sometido I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +trasplante I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +precursores I-PAST_MEDICAL_HISTORY +hematopoyéticos I-PAST_MEDICAL_HISTORY +(TPH) I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -2.220.000 I-PAST_MEDICAL_HISTORY -copias I-PAST_MEDICAL_HISTORY -virales. I-PAST_MEDICAL_HISTORY -Inicia B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -lamivudina-zidovudina-ritonavir-lopinavir. I-TREATMENT -Consulta B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -epigástrico I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -postpandrial I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -pirosis. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -aprecian I-EXPLORATION -lesiones I-EXPLORATION -sobreelevadas I-EXPLORATION -rojovioláceas I-EXPLORATION -en I-EXPLORATION -zona I-EXPLORATION -laterocervical I-EXPLORATION -izquierda I-EXPLORATION -e I-EXPLORATION -inguinal I-EXPLORATION -derecha, I-EXPLORATION -la I-EXPLORATION -mayor I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -máximo. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -endoscopia I-EXPLORATION -oral, I-EXPLORATION -apreciándose I-EXPLORATION -lesiones I-EXPLORATION -eritematosas I-EXPLORATION -en I-EXPLORATION -estómago I-EXPLORATION -y I-EXPLORATION -primeras I-EXPLORATION -porciones I-EXPLORATION -duodenales, I-EXPLORATION -alguna I-EXPLORATION -de I-EXPLORATION -ellas I-EXPLORATION -ulceradas I-EXPLORATION -con I-EXPLORATION -biopsia I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -sarcoma I-EXPLORATION -de I-EXPLORATION -Kaposi. I-EXPLORATION -Estudio I-EXPLORATION -de I-EXPLORATION -extensión I-EXPLORATION -negativo, I-EXPLORATION -con I-EXPLORATION -TAC I-EXPLORATION -toracabdominal I-EXPLORATION -normal. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -sarcoma I-TREATMENT +rinitis I-PAST_MEDICAL_HISTORY +alérgica. I-PAST_MEDICAL_HISTORY +Evolucionó B-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +recaída I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +leucemia I-PRESENT_ILLNESS +tras B-TREATMENT +lo I-TREATMENT +cual I-TREATMENT +se I-TREATMENT +administró I-TREATMENT +un I-TREATMENT +ciclo I-TREATMENT de I-TREATMENT -kaposi I-TREATMENT -con I-TREATMENT -afectación I-TREATMENT -visceral I-TREATMENT -y I-TREATMENT -cutánea I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -adriamicina I-TREATMENT -liposomal I-TREATMENT -20 I-TREATMENT -mg/m2 I-TREATMENT -cada I-TREATMENT -3 I-TREATMENT -semanas. I-TREATMENT -Desde B-EVOLUTION -el I-EVOLUTION -primer I-EVOLUTION -de I-EVOLUTION -ciclo I-EVOLUTION -de I-EVOLUTION -tratamiento, I-EVOLUTION +quimioterapia I-TREATMENT +en I-TREATMENT +preparación I-TREATMENT +a I-TREATMENT +un I-TREATMENT +nuevo I-TREATMENT +TPH. I-TREATMENT +Ocho B-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION se I-EVOLUTION -produce I-EVOLUTION +hospitalizó I-EVOLUTION +por I-EVOLUTION +un I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +neutropenia I-EVOLUTION +febril, I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +vancomicina, I-TREATMENT +ceftazidima I-TREATMENT +y I-TREATMENT +amikacina. I-TREATMENT +Refirió B-EVOLUTION +dolor I-EVOLUTION +en I-EVOLUTION la I-EVOLUTION -desaparición I-EVOLUTION +fosa I-EVOLUTION +nasal I-EVOLUTION +derecha I-EVOLUTION +e I-EVOLUTION +incisivo I-EVOLUTION +superior, I-EVOLUTION +constatándose I-EVOLUTION +cuatro I-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION de I-EVOLUTION +su I-EVOLUTION +ingreso, I-EVOLUTION +una I-EVOLUTION +erosión I-EVOLUTION +leve I-EVOLUTION +en I-EVOLUTION la I-EVOLUTION -afectación I-EVOLUTION -cutánea I-EVOLUTION +fosa I-EVOLUTION +nasal I-EVOLUTION +derecha I-EVOLUTION +(FND) I-EVOLUTION +con I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +sangrado I-EVOLUTION +reciente I-EVOLUTION y I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -queda I-EVOLUTION -asintomático, I-EVOLUTION -al I-EVOLUTION -tercer I-EVOLUTION -ciclo I-EVOLUTION -se I-EVOLUTION -repite I-EVOLUTION -endoscopia I-EVOLUTION -oral, I-EVOLUTION -mostrando I-EVOLUTION una I-EVOLUTION -resolución I-EVOLUTION -completa I-EVOLUTION -de I-EVOLUTION +costra I-EVOLUTION +dolorosa I-EVOLUTION +en I-EVOLUTION la I-EVOLUTION -lesiones. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -52 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés I-FAMILY_HISTORY -oncológico I-FAMILY_HISTORY -y B-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -intervenida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -túnel I-PAST_MEDICAL_HISTORY -carpiano I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -mano I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -nódulos I-PAST_MEDICAL_HISTORY -mamarios I-PAST_MEDICAL_HISTORY -benignos. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -diagnostico I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -suplementos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -calcio I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -calcitonina I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -osteoporosis. I-PAST_MEDICAL_HISTORY -Desde B-PRESENT_ILLNESS -noviembre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1999 I-PRESENT_ILLNESS -notaba I-PRESENT_ILLNESS -perdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -visión I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -junto I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -ocular I-PRESENT_ILLNESS -ocasional I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -conjuntivitis I-PRESENT_ILLNESS -bilateral. I-PRESENT_ILLNESS -Vista B-EXPLORATION -por I-EXPLORATION -oftalmología I-EXPLORATION +porción I-EVOLUTION +antero-inferior I-EVOLUTION +del I-EVOLUTION +tabique I-EVOLUTION +nasal I-EVOLUTION +izquierdo I-EVOLUTION +(FNI). I-EVOLUTION +Esta B-EXPLORATION +última I-EXPLORATION se I-EXPLORATION -apreció I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -de I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -"edema I-EXPLORATION -de I-EXPLORATION -papila" I-EXPLORATION -unilateral I-EXPLORATION +removió I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +envió I-EXPLORATION a I-EXPLORATION -nivel I-EXPLORATION +cultivo I-EXPLORATION +bacteriano I-EXPLORATION +y I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION -izquierdo. I-EXPLORATION -No I-EXPLORATION +hongos. I-EXPLORATION +Bajo I-EXPLORATION +la I-EXPLORATION +costra I-EXPLORATION se I-EXPLORATION observó I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -movimientos I-EXPLORATION -oculares I-EXPLORATION -de I-EXPLORATION -ambas I-EXPLORATION -órbitas. I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +del I-EXPLORATION +cartílago I-EXPLORATION +septal I-EXPLORATION +más I-EXPLORATION +adherida I-EXPLORATION +y I-EXPLORATION +negruzca, I-EXPLORATION +cuya I-EXPLORATION +superficie I-EXPLORATION +se I-EXPLORATION +removió I-EXPLORATION +sin I-EXPLORATION +presentar I-EXPLORATION +sangrado. I-EXPLORATION Se I-EXPLORATION -realizaron I-EXPLORATION -las I-EXPLORATION -siguientes I-EXPLORATION -exploraciones I-EXPLORATION -complementarias. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -TC I-EXPLORATION +envió I-EXPLORATION +a I-EXPLORATION +tinción I-EXPLORATION de I-EXPLORATION -órbita: I-EXPLORATION -en I-EXPLORATION -vértice I-EXPLORATION +calcoflúor, I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +evidenció I-EXPLORATION +hifas I-EXPLORATION +septadas I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +voriconazol I-TREATMENT +iv I-TREATMENT +9 I-TREATMENT +mg/kg/dosis, I-TREATMENT +dos I-TREATMENT +veces I-TREATMENT +al I-TREATMENT +día. I-TREATMENT +La B-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION de I-EXPLORATION -órbita I-EXPLORATION -izquierda I-EXPLORATION +cavidades I-EXPLORATION +paranasales I-EXPLORATION +evidenció I-EXPLORATION +cambios I-EXPLORATION +inflamatorios I-EXPLORATION +pansinusales I-EXPLORATION +sin I-EXPLORATION +extensión I-EXPLORATION +extrasinusal. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +precozmente I-TREATMENT +una I-TREATMENT +cirugía I-TREATMENT +endoscópica I-TREATMENT +nasal, I-TREATMENT +consistente I-TREATMENT +en I-TREATMENT +una I-TREATMENT +esfenoidotomía I-TREATMENT +derecha, I-TREATMENT +con I-TREATMENT +resección I-TREATMENT +de I-TREATMENT +tabique I-TREATMENT +nasal I-TREATMENT +necr��tico I-TREATMENT +y I-TREATMENT +del I-TREATMENT +cartílago I-TREATMENT +septal I-TREATMENT +izquierdo. I-TREATMENT +Se B-EXPLORATION +enviaron I-EXPLORATION +muestras I-EXPLORATION +de I-EXPLORATION +cornete I-EXPLORATION +superior I-EXPLORATION y I-EXPLORATION -en I-EXPLORATION -íntimo I-EXPLORATION -contacto I-EXPLORATION -con I-EXPLORATION -nervio I-EXPLORATION -óptico, I-EXPLORATION +esfenoides I-EXPLORATION +derecho, I-EXPLORATION +mucosa I-EXPLORATION +de I-EXPLORATION +tabique I-EXPLORATION +nasal I-EXPLORATION +y I-EXPLORATION +cartílago I-EXPLORATION +septal I-EXPLORATION +izquierdo I-EXPLORATION +a I-EXPLORATION +biopsia. I-EXPLORATION +Las I-EXPLORATION +dos I-EXPLORATION +primeras I-EXPLORATION se I-EXPLORATION -visualiza I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION +enviaron I-EXPLORATION +además I-EXPLORATION +a I-EXPLORATION +tinción I-EXPLORATION de I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION +calcoflúor I-EXPLORATION +resultando I-EXPLORATION +negativas I-EXPLORATION +y I-EXPLORATION +a I-EXPLORATION +cultivo I-EXPLORATION +bacteriano. I-EXPLORATION +Las I-EXPLORATION +muestras I-EXPLORATION +fueron I-EXPLORATION +sembradas I-EXPLORATION +en I-EXPLORATION +agar I-EXPLORATION +Sabouraud I-EXPLORATION +dextrosa I-EXPLORATION +a I-EXPLORATION +temperatura I-EXPLORATION +ambiente I-EXPLORATION +y I-EXPLORATION +a I-EXPLORATION +35 I-EXPLORATION +°C. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +muestra I-EXPLORATION +quirúrgica I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION -mayor I-EXPLORATION +tabique I-EXPLORATION +nasal I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION de I-EXPLORATION -localización I-EXPLORATION -intraconal I-EXPLORATION -que I-EXPLORATION -captaba I-EXPLORATION -contraste I-EXPLORATION +cartílago I-EXPLORATION +septal I-EXPLORATION +mostraron I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +48 I-EXPLORATION +h I-EXPLORATION +desarrollo I-EXPLORATION de I-EXPLORATION -forma I-EXPLORATION -intensa I-EXPLORATION -y I-EXPLORATION -homogénea, I-EXPLORATION -observándose I-EXPLORATION -un I-EXPLORATION -engrosamiento I-EXPLORATION -difuso I-EXPLORATION +colonias I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -vaina I-EXPLORATION -del I-EXPLORATION -nervio I-EXPLORATION -óptico I-EXPLORATION -formando I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -en I-EXPLORATION -"railes I-EXPLORATION +4-6 I-EXPLORATION +mm, I-EXPLORATION +algodonosas, I-EXPLORATION +laxas I-EXPLORATION +con I-EXPLORATION +aspecto I-EXPLORATION de I-EXPLORATION -tranvía". I-EXPLORATION -No I-EXPLORATION -había I-EXPLORATION -evidencia I-EXPLORATION +polvo I-EXPLORATION de I-EXPLORATION -agrandamiento I-EXPLORATION +hollín, I-EXPLORATION +de I-EXPLORATION +color I-EXPLORATION +blanco I-EXPLORATION +grisáceo, I-EXPLORATION +y I-EXPLORATION +color I-EXPLORATION +oliváceo I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +reverso. I-EXPLORATION +La I-EXPLORATION +muestra I-EXPLORATION del I-EXPLORATION -agujero I-EXPLORATION -óptico I-EXPLORATION -ni I-EXPLORATION -invasión I-EXPLORATION -intracraneal; I-EXPLORATION -no I-EXPLORATION +esfenoides I-EXPLORATION +derecho I-EXPLORATION +fue I-EXPLORATION +negativa. I-EXPLORATION +A I-EXPLORATION +la I-EXPLORATION +microscopia I-EXPLORATION se I-EXPLORATION -aprecian I-EXPLORATION -erosiones I-EXPLORATION -óseas. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -RMN I-EXPLORATION -cerebral I-EXPLORATION +observaron I-EXPLORATION +hifas I-EXPLORATION +dematiáceas, I-EXPLORATION +con I-EXPLORATION +conidióforos I-EXPLORATION +color I-EXPLORATION +café I-EXPLORATION +claro, I-EXPLORATION +septados, I-EXPLORATION +solitarios I-EXPLORATION y I-EXPLORATION +geniculados, I-EXPLORATION +zigzageantes I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +apical, I-EXPLORATION +desde I-EXPLORATION +donde I-EXPLORATION +brotaban I-EXPLORATION +conidios I-EXPLORATION de I-EXPLORATION -órbita: I-EXPLORATION -masa I-EXPLORATION +forma I-EXPLORATION +simpodial. I-EXPLORATION +Éstos I-EXPLORATION +eran I-EXPLORATION +color I-EXPLORATION +marrón, I-EXPLORATION +cilíndricos, I-EXPLORATION de I-EXPLORATION -señal I-EXPLORATION -isointensa I-EXPLORATION +paredes I-EXPLORATION +pigmentadas I-EXPLORATION +gruesas, I-EXPLORATION con I-EXPLORATION -el I-EXPLORATION -parénquima I-EXPLORATION -cerebral I-EXPLORATION -en I-EXPLORATION -todas I-EXPLORATION -las I-EXPLORATION -secuencias I-EXPLORATION -que I-EXPLORATION -ocupa I-EXPLORATION -el I-EXPLORATION -agujero I-EXPLORATION -óptico I-EXPLORATION -izquierdo I-EXPLORATION +tres I-EXPLORATION +distoseptos I-EXPLORATION y I-EXPLORATION -que I-EXPLORATION -mostraba I-EXPLORATION -captación I-EXPLORATION -intensa I-EXPLORATION -y I-EXPLORATION -homogénea I-EXPLORATION +cuatro I-EXPLORATION +células, I-EXPLORATION +con I-EXPLORATION +cicatrices I-EXPLORATION de I-EXPLORATION -contraste. I-EXPLORATION -La I-EXPLORATION -lesión I-EXPLORATION -englobaba I-EXPLORATION +color I-EXPLORATION +marrón I-EXPLORATION +oscuro I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -nervio I-EXPLORATION -óptico I-EXPLORATION -izquierdo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -discretamente I-EXPLORATION -comprimido. I-EXPLORATION -El I-EXPLORATION -tamaño I-EXPLORATION -aproximado I-EXPLORATION +lugar I-EXPLORATION de I-EXPLORATION +unión I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -lesión I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -2x1x1 I-EXPLORATION -cm. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -radiológicos I-EXPLORATION -sugerían I-EXPLORATION +hifa I-EXPLORATION +conidiogénica. I-EXPLORATION +Basados I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -meningioma I-EXPLORATION -aunque I-EXPLORATION -no I-EXPLORATION +macroscopia I-EXPLORATION +y I-EXPLORATION +microscopia I-EXPLORATION se I-EXPLORATION -podían I-EXPLORATION -descartar I-EXPLORATION -otras I-EXPLORATION -posibilidades I-EXPLORATION +identificó I-EXPLORATION +el I-EXPLORATION +agente I-EXPLORATION como I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION +una I-EXPLORATION +Curvularia I-EXPLORATION +spicifera. I-EXPLORATION +Para I-EXPLORATION +confirmación I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -vaina I-EXPLORATION -nerviosa. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Estudio I-EXPLORATION -oftalmológico: I-EXPLORATION -mostró I-EXPLORATION +género, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +reacción I-EXPLORATION +de I-EXPLORATION +polimerasa I-EXPLORATION en I-EXPLORATION +cadena I-EXPLORATION +(RPC) I-EXPLORATION +universal I-EXPLORATION +y I-EXPLORATION +posterior I-EXPLORATION +secuenciación I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +segmentos I-EXPLORATION +génicos I-EXPLORATION +ITS1, I-EXPLORATION +ITS4 I-EXPLORATION +y I-EXPLORATION +5, I-EXPLORATION +6S I-EXPLORATION +ARNr, I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +colonias I-EXPLORATION +desarrolladas, I-EXPLORATION +identificándose I-EXPLORATION +Curvularia I-EXPLORATION +spp. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -una I-EXPLORATION -pérdida I-EXPLORATION +mucosa I-EXPLORATION +del I-EXPLORATION +tabique I-EXPLORATION +nasal I-EXPLORATION +y I-EXPLORATION +del I-EXPLORATION +cartílago I-EXPLORATION +septal I-EXPLORATION +izquierdo I-EXPLORATION +mostró I-EXPLORATION +extensas I-EXPLORATION +zonas I-EXPLORATION de I-EXPLORATION +destrucción, I-EXPLORATION +necrosis, I-EXPLORATION +ulceración I-EXPLORATION +y I-EXPLORATION +hemorragia I-EXPLORATION +asociadas I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -visión I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +abundantes I-EXPLORATION +elementos I-EXPLORATION +micóticos I-EXPLORATION +filamentosos I-EXPLORATION +histo I-EXPLORATION +y I-EXPLORATION +angioinvasores. I-EXPLORATION +Los I-EXPLORATION +elementos I-EXPLORATION +micóticos I-EXPLORATION +correspondían I-EXPLORATION a I-EXPLORATION -1/10 I-EXPLORATION +filamentos I-EXPLORATION +hialinos I-EXPLORATION +tabicados I-EXPLORATION +con I-EXPLORATION +algunas I-EXPLORATION +dilataciones I-EXPLORATION +globosas I-EXPLORATION +y I-EXPLORATION +crecimiento I-EXPLORATION +variable I-EXPLORATION +de I-EXPLORATION +45° I-EXPLORATION +a I-EXPLORATION +90°, I-EXPLORATION +con I-EXPLORATION +caracteres I-EXPLORATION +de I-EXPLORATION +hialohifomicetes. I-EXPLORATION +La I-EXPLORATION +muestra I-EXPLORATION +de I-EXPLORATION +pared I-EXPLORATION +ósteo-condro-mucosa I-EXPLORATION +de I-EXPLORATION +comete I-EXPLORATION y I-EXPLORATION +esfenoides I-EXPLORATION +derecho I-EXPLORATION +sólo I-EXPLORATION +mostró I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +inflamación I-EXPLORATION +crónica I-EXPLORATION +activa I-EXPLORATION +inespecífica. I-EXPLORATION + I-EXPLORATION +Para I-EXPLORATION el I-EXPLORATION estudio I-EXPLORATION -campimétrico I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -déficit I-EXPLORATION +de I-EXPLORATION +sensibilidad I-EXPLORATION +antifúngica I-EXPLORATION +las I-EXPLORATION +colonias I-EXPLORATION +obtenidas I-EXPLORATION en I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION -conservando I-EXPLORATION -parcialmente I-EXPLORATION -la I-EXPLORATION -visión I-EXPLORATION +agar I-EXPLORATION +Sabouraud I-EXPLORATION +fueron I-EXPLORATION +sembradas I-EXPLORATION en I-EXPLORATION -cuadrante I-EXPLORATION -superior I-EXPLORATION -interno. I-EXPLORATION +agar I-EXPLORATION +agua I-EXPLORATION +para I-EXPLORATION +aumentar I-EXPLORATION +la I-EXPLORATION +producción I-EXPLORATION +de I-EXPLORATION +conidias. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +micro I-EXPLORATION +dilución I-EXPLORATION +según I-EXPLORATION +la I-EXPLORATION +norma I-EXPLORATION +CLSI, I-EXPLORATION +documento I-EXPLORATION +M38-A2, I-EXPLORATION +resultando I-EXPLORATION +sensible I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +tres I-EXPLORATION +antifúngicos I-EXPLORATION +estudiados, I-EXPLORATION +con I-EXPLORATION +CIM I-EXPLORATION +a I-EXPLORATION +anfotericina I-EXPLORATION +B I-EXPLORATION +de I-EXPLORATION +1 I-EXPLORATION +μg/ml, I-EXPLORATION +posaconazol I-EXPLORATION +0, I-EXPLORATION +25 I-EXPLORATION +μg/ml I-EXPLORATION +y I-EXPLORATION +voriconazol I-EXPLORATION +0, I-EXPLORATION +25 I-EXPLORATION +μg/ml. I-EXPLORATION I-EXPLORATION -Valorado B-TREATMENT -por I-TREATMENT -el I-TREATMENT -Comité I-TREATMENT -de I-TREATMENT -Radiocirugía I-TREATMENT -(RC) I-TREATMENT +Tras B-TREATMENT +la I-TREATMENT +identificación I-TREATMENT +etiológica, I-TREATMENT se I-TREATMENT -aceptó I-TREATMENT +ajustó I-TREATMENT el I-TREATMENT -caso I-TREATMENT -para I-TREATMENT -RTEF, I-TREATMENT -siendo I-TREATMENT -irradiado I-TREATMENT -con I-TREATMENT +esquema I-TREATMENT +antifúngico I-TREATMENT +asociando I-TREATMENT +anfotericina I-TREATMENT +liposomal I-TREATMENT +5 I-TREATMENT +mg/kg/día I-TREATMENT +y I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT un I-TREATMENT -Acelerador I-TREATMENT -Lineal I-TREATMENT +nuevo I-TREATMENT +aseo I-TREATMENT +quirúrgico I-TREATMENT +dos I-TREATMENT +días I-TREATMENT +después, I-TREATMENT +observándose I-TREATMENT +la I-TREATMENT +mucosa I-TREATMENT +nasal I-TREATMENT +sin I-TREATMENT +necrosis, I-TREATMENT con I-TREATMENT -fotones I-TREATMENT +tinción I-TREATMENT de I-TREATMENT +calcoflúor I-TREATMENT +y I-TREATMENT +cultivo I-TREATMENT +negativos. I-TREATMENT +Las B-EVOLUTION +detecciones I-EVOLUTION +de I-EVOLUTION +galactomanano I-EVOLUTION +en I-EVOLUTION +sangre I-EVOLUTION +se I-EVOLUTION +mantuvieron I-EVOLUTION +negativas I-EVOLUTION +durante I-EVOLUTION +la I-EVOLUTION +evolución. I-EVOLUTION +Recibió B-TREATMENT +voriconazol I-TREATMENT +por I-TREATMENT +40 I-TREATMENT +días, I-TREATMENT +con I-TREATMENT +concentraciones I-TREATMENT +plasmáticas I-TREATMENT +variables I-TREATMENT +entre I-TREATMENT +0, I-TREATMENT +2-1, I-TREATMENT 6 I-TREATMENT -Mv, I-TREATMENT +mg/L I-TREATMENT +(rango I-TREATMENT +terapéutico I-TREATMENT +1-5 I-TREATMENT +mg/L) I-TREATMENT +y I-TREATMENT +anfotericina I-TREATMENT +liposomal I-TREATMENT +por I-TREATMENT +25 I-TREATMENT +días I-TREATMENT +(dosis I-TREATMENT +acumulada I-TREATMENT +125 I-TREATMENT +mg/kg). I-TREATMENT +Evolucionó B-EVOLUTION +en I-EVOLUTION +forma I-EVOLUTION +satisfactoria I-EVOLUTION +del I-EVOLUTION +punto I-EVOLUTION +de I-EVOLUTION +vista I-EVOLUTION +otorrinológico. I-EVOLUTION +Recibió B-TREATMENT +un I-TREATMENT +segundo I-TREATMENT +TPH, I-TREATMENT +sin B-EVOLUTION +presentar I-EVOLUTION +lesiones I-EVOLUTION +cutáneas I-EVOLUTION +ni I-EVOLUTION +síntomas I-EVOLUTION +nasales I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +siguientes I-EVOLUTION +meses. I-EVOLUTION +Sin I-EVOLUTION +embargo, I-EVOLUTION +no I-EVOLUTION +logró I-EVOLUTION +reconstitución I-EVOLUTION +inmune, I-EVOLUTION +falleciendo I-EVOLUTION +por I-EVOLUTION +otras I-EVOLUTION +complicaciones I-EVOLUTION +infecciosas. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +intermitente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +kg I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso. I-PRESENT_ILLNESS +La B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ileítis I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Crohn I-PAST_MEDICAL_HISTORY +desapareciendo I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +síntomas I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +esteroides. I-PAST_MEDICAL_HISTORY +Cinco B-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +después, I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +anemia I-PRESENT_ILLNESS +ferropénica I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +desnutrición I-PRESENT_ILLNESS +severa. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +TAC B-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +tránsito I-EXPLORATION +de I-EXPLORATION +intestino I-EXPLORATION +delgado I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +trayectos I-EXPLORATION +extraluminares I-EXPLORATION +desde I-EXPLORATION +ciego/íleon I-EXPLORATION +terminal I-EXPLORATION +a I-EXPLORATION +planos I-EXPLORATION +posteriores I-EXPLORATION +sugestivos I-EXPLORATION +de I-EXPLORATION +fístulas. I-EXPLORATION +Se B-TREATMENT +instauró I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -colimadores I-TREATMENT -cónicos I-TREATMENT +nutrición I-TREATMENT +enteral, I-TREATMENT +metronidazol I-TREATMENT +y I-TREATMENT +corticoides I-TREATMENT +a I-TREATMENT +bajas I-TREATMENT +dosis. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +buena I-EVOLUTION +evolución, I-EVOLUTION +pero I-EVOLUTION +diez I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +acude I-EVOLUTION +por I-EVOLUTION +supuración I-EVOLUTION +a I-EVOLUTION +nivel I-EVOLUTION +del I-EVOLUTION +glúteo I-EVOLUTION +y I-EVOLUTION +absceso I-EVOLUTION +retroperitoneal I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +con I-TREATMENT +resección I-TREATMENT +ileocecal I-TREATMENT +y I-TREATMENT +anastomosis I-TREATMENT +ileocólica I-TREATMENT +látero-lateral. I-TREATMENT + I-TREATMENT +En I-TREATMENT +la I-TREATMENT +EC I-TREATMENT +se I-TREATMENT +han I-TREATMENT +descrito I-TREATMENT +tres I-TREATMENT +enfoques I-TREATMENT +en I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT de I-TREATMENT -10 I-TREATMENT +los I-TREATMENT +abscesos: I-TREATMENT +tratamiento I-TREATMENT +médico I-TREATMENT +con I-TREATMENT +antibióticos I-TREATMENT y I-TREATMENT -25 I-TREATMENT -mm, I-TREATMENT +esteroides, I-TREATMENT +drenaje I-TREATMENT +percutáneo I-TREATMENT +y I-TREATMENT +cirugía I-TREATMENT con I-TREATMENT -2 I-TREATMENT -isocentros, I-TREATMENT -administrándose I-TREATMENT -8 I-TREATMENT -arcos I-TREATMENT -esterotáxicos I-TREATMENT +resección I-TREATMENT +de I-TREATMENT +los I-TREATMENT +segmentos I-TREATMENT +intestinales I-TREATMENT +afectados. I-TREATMENT + I-TREATMENT +El I-TREATMENT +tratamiento I-TREATMENT +médico I-TREATMENT +inicial I-TREATMENT +estaría I-TREATMENT +basado I-TREATMENT +en I-TREATMENT +la I-TREATMENT +utilización I-TREATMENT +de I-TREATMENT +5-ASA, I-TREATMENT +antibióticos I-TREATMENT y I-TREATMENT +corticosteroides, I-TREATMENT +azatioprina I-TREATMENT +o I-TREATMENT +6-mercaptopurina I-TREATMENT +en I-TREATMENT +caso I-TREATMENT +de I-TREATMENT +refractariedad I-TREATMENT +al I-TREATMENT +tratamiento I-TREATMENT +convencional I-TREATMENT +(2). I-TREATMENT +La I-TREATMENT +siguiente I-TREATMENT +línea I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +se I-TREATMENT +basa I-TREATMENT +en I-TREATMENT +la I-TREATMENT +utilización I-TREATMENT +de I-TREATMENT +infliximab I-TREATMENT +(anticuerpo I-TREATMENT +monoclonal I-TREATMENT +anti I-TREATMENT +TNF-a) I-TREATMENT +habiéndose I-TREATMENT +observado I-TREATMENT una I-TREATMENT -dosis I-TREATMENT -total I-TREATMENT +reducción I-TREATMENT +en I-TREATMENT +el I-TREATMENT +número I-TREATMENT de I-TREATMENT -52, I-TREATMENT -2 I-TREATMENT -Gy I-TREATMENT +intervenciones I-TREATMENT +quirúrgicas I-TREATMENT en I-TREATMENT -fracciones I-TREATMENT +este I-TREATMENT +grupo I-TREATMENT +de I-TREATMENT +pacientes. I-TREATMENT +Una I-TREATMENT +alternativa I-TREATMENT +terapéutica I-TREATMENT +para I-TREATMENT +los I-TREATMENT +pacientes I-TREATMENT +con I-TREATMENT +enfermedad I-TREATMENT +de I-TREATMENT +Crohn I-TREATMENT +fistulizante I-TREATMENT +refractaria I-TREATMENT +al I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +anti-TNF-a I-TREATMENT +sería I-TREATMENT +la I-TREATMENT +utilización I-TREATMENT +de I-TREATMENT +inmunosupresores I-TREATMENT +anticalcineurínicos I-TREATMENT +como I-TREATMENT +el I-TREATMENT +tacrolimus I-TREATMENT +con I-TREATMENT +remisiones I-TREATMENT +completas I-TREATMENT de I-TREATMENT -1, I-TREATMENT -8 I-TREATMENT -Gy, I-TREATMENT hasta I-TREATMENT un I-TREATMENT -total I-TREATMENT +40% I-TREATMENT +y I-TREATMENT +parciales I-TREATMENT +del I-TREATMENT +50% I-TREATMENT +(3). I-TREATMENT + I-TREATMENT +El I-TREATMENT +drenaje I-TREATMENT +percutáneo I-TREATMENT +guiado I-TREATMENT +radiológicamente I-TREATMENT +en I-TREATMENT +su I-TREATMENT +momento I-TREATMENT +se I-TREATMENT +convirtió I-TREATMENT +en I-TREATMENT +la I-TREATMENT +principal I-TREATMENT +alternativa I-TREATMENT +terapéutica I-TREATMENT +llegando I-TREATMENT +incluso I-TREATMENT +a I-TREATMENT +obviar I-TREATMENT +la I-TREATMENT +necesidad I-TREATMENT de I-TREATMENT -29 I-TREATMENT -fracciones. I-TREATMENT -Se I-TREATMENT -eligió I-TREATMENT -como I-TREATMENT -referencia I-TREATMENT +resección I-TREATMENT +intestinal. I-TREATMENT +Sin I-TREATMENT +embargo, I-TREATMENT +pueden I-TREATMENT +llegar I-TREATMENT +a I-TREATMENT +presentar I-TREATMENT +hasta I-TREATMENT +un I-TREATMENT +100% I-TREATMENT +de I-TREATMENT +recidivas I-TREATMENT +(4). I-TREATMENT +Hay I-TREATMENT +autores I-TREATMENT +que I-TREATMENT +defienden I-TREATMENT +que I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +definitivo I-TREATMENT +de I-TREATMENT +un I-TREATMENT +absceso I-TREATMENT +de I-TREATMENT +psoas I-TREATMENT +debe I-TREATMENT +incluir I-TREATMENT +además, I-TREATMENT la I-TREATMENT -Isodosis I-TREATMENT +resección I-TREATMENT de I-TREATMENT -Cubrimiento I-TREATMENT +la I-TREATMENT +porción I-TREATMENT +de I-TREATMENT +tubo I-TREATMENT +digestivo I-TREATMENT +afectada I-TREATMENT +(5). I-TREATMENT + I-TREATMENT +En I-TREATMENT +los I-TREATMENT +dos I-TREATMENT +casos I-TREATMENT +de I-TREATMENT +EC I-TREATMENT +fistulizante I-TREATMENT +con I-TREATMENT +abscesos I-TREATMENT +intraabdominales I-TREATMENT +presentados I-TREATMENT +hemos I-TREATMENT +podido I-TREATMENT +observar I-TREATMENT +dos I-TREATMENT +tipos I-TREATMENT +de I-TREATMENT +experiencias I-TREATMENT +en I-TREATMENT +cuanto I-TREATMENT +al I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +la I-TREATMENT +misma. I-TREATMENT +En I-TREATMENT +el I-TREATMENT +primer I-TREATMENT +caso I-TREATMENT +se I-TREATMENT +pudo I-TREATMENT +resolver I-TREATMENT +el I-TREATMENT +absceso I-TREATMENT +tras I-TREATMENT +drenaje I-TREATMENT +quirúrgico I-TREATMENT +y I-TREATMENT +tratamiento I-TREATMENT +conservador. I-TREATMENT +En I-TREATMENT +el I-TREATMENT +segundo I-TREATMENT +caso I-TREATMENT +no I-TREATMENT +tuvimos I-TREATMENT +la I-TREATMENT +oportunidad I-TREATMENT +de I-TREATMENT +tratar I-TREATMENT +a I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +con I-TREATMENT +anti-TNF I-TREATMENT +dado I-TREATMENT +que I-TREATMENT +el I-TREATMENT +cuadro I-TREATMENT +clínico I-TREATMENT +se I-TREATMENT +presentó I-TREATMENT +en I-TREATMENT +1999 I-TREATMENT +y I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +quirúrgico I-TREATMENT +fue I-TREATMENT +la I-TREATMENT +mejor I-TREATMENT +opción, I-TREATMENT +tras I-TREATMENT +el I-TREATMENT +fracaso I-TREATMENT del I-TREATMENT -80%. I-TREATMENT +tratamiento I-TREATMENT +conservador. I-TREATMENT + I-TREATMENT +En I-TREATMENT +conclusión, I-TREATMENT +los I-TREATMENT +pacientes I-TREATMENT +con I-TREATMENT +EC I-TREATMENT +fistulizante I-TREATMENT +con I-TREATMENT +presencia I-TREATMENT +de I-TREATMENT +abscesos I-TREATMENT +intraabdominales I-TREATMENT +pueden I-TREATMENT +ser I-TREATMENT +tratados I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +conservadora I-TREATMENT +inicialmente I-TREATMENT +llegando I-TREATMENT +a I-TREATMENT +resolverse I-TREATMENT +en I-TREATMENT +algunos I-TREATMENT +casos, I-TREATMENT +ya I-TREATMENT +sea I-TREATMENT +con I-TREATMENT +drenaje I-TREATMENT +radiológico, I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +anti-TNF I-TREATMENT +o I-TREATMENT +con I-TREATMENT +los I-TREATMENT +nuevos I-TREATMENT +inmunosupresores I-TREATMENT +(tacrolimus). I-TREATMENT +La I-TREATMENT +resección I-TREATMENT +quirúrgica I-TREATMENT +del I-TREATMENT +asa I-TREATMENT +intestinal I-TREATMENT +enferma I-TREATMENT +se I-TREATMENT +reservaría I-TREATMENT +para I-TREATMENT +los I-TREATMENT +casos I-TREATMENT +con I-TREATMENT +fracaso I-TREATMENT +del I-TREATMENT +tratamiento I-TREATMENT +médico I-TREATMENT +conservador I-TREATMENT +o I-TREATMENT +recurrencia I-TREATMENT +de I-TREATMENT +la I-TREATMENT +EC I-TREATMENT +fistulosa I-TREATMENT +(6). I-TREATMENT + I-TREATMENT +M. I-TREATMENT +Valdés I-TREATMENT +Mas, I-TREATMENT +J. I-TREATMENT +A. I-TREATMENT +Pons I-TREATMENT +Miñano I-TREATMENT +y I-TREATMENT +F. I-TREATMENT +Carballo I-TREATMENT +Álvarez I-TREATMENT + I-TREATMENT +Servicio I-TREATMENT +de I-TREATMENT +Aparato I-TREATMENT +Digestivo. I-TREATMENT +Hospital I-TREATMENT +Universitario I-TREATMENT +Virgen I-TREATMENT +de I-TREATMENT +la I-TREATMENT +Arrixaca. I-TREATMENT +Murcia I-TREATMENT I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -respondió I-EVOLUTION -clínicamente I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -desaparición I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sintomatología I-EVOLUTION -dolorosa I-EVOLUTION -orbitaria I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -exoftalmos I-EVOLUTION -ya I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -primer I-EVOLUTION -control I-EVOLUTION -semestral. I-EVOLUTION -Las I-EVOLUTION -exploraciones I-EVOLUTION -con I-EVOLUTION -RMN I-EVOLUTION -confirmaron I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -primer I-EVOLUTION -control I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -favorable, I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -disminución I-EVOLUTION -significativa I-EVOLUTION -del I-EVOLUTION -tamaño I-EVOLUTION -tumoral, I-EVOLUTION -quedando I-EVOLUTION -zonas I-EVOLUTION -de I-EVOLUTION -captación I-EVOLUTION -alrededor I-EVOLUTION -del I-EVOLUTION -agujero I-EVOLUTION -óptico, I-EVOLUTION -sugestivas I-EVOLUTION -de I-EVOLUTION -restos I-EVOLUTION -tumorales I-EVOLUTION -de I-EVOLUTION -meningioma I-EVOLUTION -que I-EVOLUTION -han I-EVOLUTION -permanecido I-EVOLUTION -estables I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -controles I-EVOLUTION -posteriores. I-EVOLUTION -Los I-EVOLUTION -estudios I-EVOLUTION -oftalmológicos I-EVOLUTION -demostraron I-EVOLUTION -mejora I-EVOLUTION -de I-EVOLUTION -cierto I-EVOLUTION -grado I-EVOLUTION -de I-EVOLUTION -visión, I-EVOLUTION -situación I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -mantenido I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -paso I-EVOLUTION -del I-EVOLUTION -tiempo. I-EVOLUTION -La I-EVOLUTION -paciente I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -etiquetada I-EVOLUTION -en I-EVOLUTION -remisión I-EVOLUTION -clínica I-EVOLUTION -parcial/completa. I-EVOLUTION -No I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -toxicidad I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -vía I-EVOLUTION -óptica I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -momento I-EVOLUTION -actual. I-EVOLUTION - I-EVOLUTION Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS @@ -106095,110738 +91780,12385 @@ del I-EXPLORATION 20%. I-EXPLORATION I-EXPLORATION -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +46 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +debilidad I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +mialgias I-PRESENT_ILLNESS +intensas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -65 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -fumador B-PAST_MEDICAL_HISTORY +una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +impedían I-PRESENT_ILLNESS +deambular. I-PRESENT_ILLNESS +Destacaba B-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +presencia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -40 I-PAST_MEDICAL_HISTORY -paquetes/año, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY +hipotiroidismo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -buen I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -farmacológico, I-PAST_MEDICAL_HISTORY -miopía I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -catarata I-PAST_MEDICAL_HISTORY -ojo I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY +T4 I-PAST_MEDICAL_HISTORY +50 I-PAST_MEDICAL_HISTORY +mcg/día I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +bypass I-PAST_MEDICAL_HISTORY +intestinal I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +obesidad I-PAST_MEDICAL_HISTORY +mórbida I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY años I-PAST_MEDICAL_HISTORY antes, I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +adelgazamiento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY más I-PAST_MEDICAL_HISTORY -destacables. I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -motivo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -oftalmología I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital, I-PRESENT_ILLNESS -consistió I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -escotoma I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -central I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -respiratorios, I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -constitucional. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -oftalmoscópica I-EXPLORATION +de I-PAST_MEDICAL_HISTORY +70 I-PAST_MEDICAL_HISTORY +Kg I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +ese I-PAST_MEDICAL_HISTORY +entonces. I-PAST_MEDICAL_HISTORY +Desde I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +cirugía I-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +deposiciones I-PAST_MEDICAL_HISTORY +pastosas I-PAST_MEDICAL_HISTORY +diarias. I-PAST_MEDICAL_HISTORY +Al B-EXPLORATION +ingreso I-EXPLORATION se I-EXPLORATION -identificaba I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -porción I-EXPLORATION -más I-EXPLORATION -superior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -papila, I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -despigmentación, I-EXPLORATION +encontraba I-EXPLORATION +vigil, I-EXPLORATION +eupneica I-EXPLORATION +y I-EXPLORATION +apirética. I-EXPLORATION +Presentaba I-EXPLORATION +adelgazamiento I-EXPLORATION con I-EXPLORATION -áreas I-EXPLORATION -pigmentadas I-EXPLORATION -anaranjadas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -centro, I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tamaño I-EXPLORATION +índice I-EXPLORATION de I-EXPLORATION -4-5 I-EXPLORATION -diámetros I-EXPLORATION -papilares I-EXPLORATION -y I-EXPLORATION -levantamiento I-EXPLORATION -exudativo I-EXPLORATION +masa I-EXPLORATION +corporal I-EXPLORATION +(IMC) I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -bordes. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -angiografía I-EXPLORATION -fluoresceínica I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -reconoce I-EXPLORATION +19. I-EXPLORATION +Tenía I-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION de I-EXPLORATION -nuevo I-EXPLORATION -esta I-EXPLORATION -misma I-EXPLORATION -lesión I-EXPLORATION -descrita I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -retinografía, I-EXPLORATION +hidratación I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -descartó I-EXPLORATION +sus I-EXPLORATION +cifras I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -hematoma I-EXPLORATION -o I-EXPLORATION -hemangioma. I-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION +(TA) I-EXPLORATION +eran I-EXPLORATION +120/70 I-EXPLORATION +mmHg. I-EXPLORATION La I-EXPLORATION -ecografía I-EXPLORATION -orbitaria I-EXPLORATION -mostraba I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION +evaluación I-EXPLORATION +neuromuscular I-EXPLORATION +mostró I-EXPLORATION +hipotonía I-EXPLORATION +generalizada, I-EXPLORATION +paresia I-EXPLORATION de I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -3 I-EXPLORATION -milímetros I-EXPLORATION -(mm) I-EXPLORATION +cuatro I-EXPLORATION +miembros I-EXPLORATION +sin I-EXPLORATION +fasciculaciones I-EXPLORATION +y I-EXPLORATION +reflejos I-EXPLORATION +osteotendinosos I-EXPLORATION +presentes. I-EXPLORATION +Presentaba I-EXPLORATION +un I-EXPLORATION +potasio I-EXPLORATION +plasmático I-EXPLORATION +(K+pl) I-EXPLORATION de I-EXPLORATION -diámetro, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION +1, I-EXPLORATION +1 I-EXPLORATION +mEq/L I-EXPLORATION +y I-EXPLORATION elevación I-EXPLORATION de I-EXPLORATION -3 I-EXPLORATION -mm. I-EXPLORATION +la I-EXPLORATION +CK. I-EXPLORATION +La I-EXPLORATION +dosificación I-EXPLORATION +de I-EXPLORATION +TSH I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +rango I-EXPLORATION +normal. I-EXPLORATION Se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION +inició I-EXPLORATION +reposición I-EXPLORATION +hidroelectrolítica I-EXPLORATION +con I-EXPLORATION +mejoría I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -órbita, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -un I-EXPLORATION -mínimo I-EXPLORATION -engrosamiento I-EXPLORATION -focal I-EXPLORATION -retiniano I-EXPLORATION -inmediatamente I-EXPLORATION -adyacente I-EXPLORATION +paresia I-EXPLORATION +muscular, I-EXPLORATION +disminución I-EXPLORATION +progresiva I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +mialgias I-EXPLORATION y I-EXPLORATION -lateral I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -papila, I-EXPLORATION -sin I-EXPLORATION -hiperseñal I-EXPLORATION -ni I-EXPLORATION -realce I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -administración I-EXPLORATION +normalización I-EXPLORATION de I-EXPLORATION -contraste. I-EXPLORATION -Un I-EXPLORATION -mes I-EXPLORATION -después I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -retinografía I-EXPLORATION +los I-EXPLORATION +valores I-EXPLORATION +de I-EXPLORATION +K+pl I-EXPLORATION y I-EXPLORATION -ecografía I-EXPLORATION -orbitaria, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION +CK. I-EXPLORATION +La I-EXPLORATION +hipopotasemia I-EXPLORATION se I-EXPLORATION -aprecia I-EXPLORATION -un I-EXPLORATION -claro I-EXPLORATION -aumento I-EXPLORATION +atribuyó I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +pérdidas I-EXPLORATION de I-EXPLORATION +origen I-EXPLORATION +digestivo, I-EXPLORATION +secundarias I-EXPLORATION +al I-EXPLORATION +procedimiento I-EXPLORATION +quirúrgico. I-EXPLORATION +Si I-EXPLORATION +bien I-EXPLORATION la I-EXPLORATION -lesión I-EXPLORATION -retiniana, I-EXPLORATION -llegando I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -dimensión I-EXPLORATION +severidad I-EXPLORATION de I-EXPLORATION -9, I-EXPLORATION -6 I-EXPLORATION -x I-EXPLORATION -3, I-EXPLORATION -9 I-EXPLORATION -mm. I-EXPLORATION -La I-EXPLORATION -aproximación I-EXPLORATION -diagnóstica I-EXPLORATION -fue I-EXPLORATION +la I-EXPLORATION +misma I-EXPLORATION +puede I-EXPLORATION +ser I-EXPLORATION +causa I-EXPLORATION de I-EXPLORATION -tumor I-EXPLORATION -retiniano, I-EXPLORATION -posiblemente I-EXPLORATION -metastásico. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION +las I-EXPLORATION +manifestaciones I-EXPLORATION +neuromusculares, I-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION -general I-EXPLORATION +hallazgo I-EXPLORATION de I-EXPLORATION -búsqueda I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -primario, I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION -toracoabdominopélvica I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -superior I-EXPLORATION -izquierdo I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION +niveles I-EXPLORATION +elevados I-EXPLORATION de I-EXPLORATION -2, I-EXPLORATION -2 I-EXPLORATION -cm, I-EXPLORATION -que I-EXPLORATION -engloba I-EXPLORATION +CK I-EXPLORATION +confirmó I-EXPLORATION la I-EXPLORATION -salida I-EXPLORATION -del I-EXPLORATION -bronquio I-EXPLORATION -del I-EXPLORATION -lóbulo I-EXPLORATION -superior, I-EXPLORATION -así I-EXPLORATION +sospecha I-EXPLORATION +de I-EXPLORATION +RM I-EXPLORATION +asociada. I-EXPLORATION + I-EXPLORATION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +54 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +obesa B-PAST_MEDICAL_HISTORY +mórbida I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hipertensa, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +agosto I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2007 I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +disnea I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +disfagia I-PRESENT_ILLNESS +intermitente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +posteriormente I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +asoció I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +volumen I-PRESENT_ILLNESS +cervical I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +rápido I-PRESENT_ILLNESS +crecimiento I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +ortopnea. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +La B-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +fue I-EXPLORATION +informada I-EXPLORATION como I-EXPLORATION -adenopatías I-EXPLORATION -mediastínicas I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +cervical I-EXPLORATION +mostró I-EXPLORATION +bocio I-EXPLORATION +con I-EXPLORATION +nodulo I-EXPLORATION +sólido I-EXPLORATION +izquierdo I-EXPLORATION de I-EXPLORATION +gran I-EXPLORATION tamaño I-EXPLORATION -superior I-EXPLORATION -a I-EXPLORATION -2 I-EXPLORATION -centímetros I-EXPLORATION -(cm) I-EXPLORATION -prevasculares, I-EXPLORATION -pretraqueales I-EXPLORATION -derechas, I-EXPLORATION -ventana I-EXPLORATION -aortopulmonar I-EXPLORATION +(4, I-EXPLORATION +3 I-EXPLORATION +x I-EXPLORATION +5, I-EXPLORATION +7 I-EXPLORATION +x I-EXPLORATION +4, I-EXPLORATION +5 I-EXPLORATION +cm), I-EXPLORATION +hipoecogénico, I-EXPLORATION +escasamente I-EXPLORATION +vascularizado I-EXPLORATION y I-EXPLORATION -subcarinales. I-EXPLORATION -A I-EXPLORATION -nivel I-EXPLORATION -abdominal I-EXPLORATION -destacan I-EXPLORATION -nódulos I-EXPLORATION -suprarrenales I-EXPLORATION +con I-EXPLORATION +adenopatías I-EXPLORATION +cervicales I-EXPLORATION bilaterales I-EXPLORATION de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION +aspecto I-EXPLORATION +reactivo. I-EXPLORATION +En I-EXPLORATION el I-EXPLORATION -izquierdo I-EXPLORATION +laboratorio I-EXPLORATION +destacó I-EXPLORATION +TSH I-EXPLORATION +elevada I-EXPLORATION y I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -derecho. I-EXPLORATION -La I-EXPLORATION -Tomografía I-EXPLORATION -por I-EXPLORATION -emisión I-EXPLORATION +T4 I-EXPLORATION +disminuida. I-EXPLORATION +Se B-TREATMENT +sospechó I-TREATMENT +cáncer I-TREATMENT +de I-TREATMENT +tiroides, I-TREATMENT +inició I-TREATMENT +levotiroxina I-TREATMENT +y I-TREATMENT +se I-TREATMENT +programó I-TREATMENT +resección I-TREATMENT +quirúrgica. I-TREATMENT + I-TREATMENT +En I-TREATMENT +la I-TREATMENT +cirugía, I-TREATMENT +se I-TREATMENT +seccionaron I-TREATMENT +los I-TREATMENT +músculos I-TREATMENT +pretiroideos I-TREATMENT +izquierdos I-TREATMENT +para I-TREATMENT +facilitar I-TREATMENT +la I-TREATMENT +exploración, I-TREATMENT +los I-TREATMENT +que I-TREATMENT +estaban I-TREATMENT +adheridos I-TREATMENT +a I-TREATMENT +la I-TREATMENT +lesión. I-TREATMENT +El I-TREATMENT +gran I-TREATMENT +nodulo I-TREATMENT +blanquecino I-TREATMENT +se I-TREATMENT +proyectaba I-TREATMENT +hacia I-TREATMENT +esófago I-TREATMENT +cervical. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +tiroidectomía I-TREATMENT +total. I-TREATMENT +La B-EXPLORATION +biopsia I-EXPLORATION +rápida I-EXPLORATION de I-EXPLORATION -positrones I-EXPLORATION -(PET) I-EXPLORATION -mostraba I-EXPLORATION -múltiples I-EXPLORATION -focos I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +quirúrgica I-EXPLORATION +informó I-EXPLORATION +proliferación I-EXPLORATION +linfoide I-EXPLORATION +atípica I-EXPLORATION +sugerente I-EXPLORATION de I-EXPLORATION -elevada I-EXPLORATION -actividad I-EXPLORATION -metabólica I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -paratraqueal I-EXPLORATION -derecho, I-EXPLORATION -mediastínico I-EXPLORATION -y I-EXPLORATION -región I-EXPLORATION -hiliar I-EXPLORATION +linfoma. I-EXPLORATION + I-EXPLORATION +Evolucionó B-EVOLUTION +con I-EVOLUTION +hipocalcemia I-EVOLUTION +sintomática I-EVOLUTION +de I-EVOLUTION +7, I-EVOLUTION +6 I-EVOLUTION +mg/dl I-EVOLUTION +que I-EVOLUTION +cedió I-EVOLUTION +con I-EVOLUTION +calcio I-EVOLUTION +oral. I-EVOLUTION +Fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +tercer I-EVOLUTION +día I-EVOLUTION +postoperatorio. I-EVOLUTION + I-EVOLUTION +La B-EXPLORATION +biopsia I-EXPLORATION +definitiva I-EXPLORATION +concluyó I-EXPLORATION +"infiltrado I-EXPLORATION +linfoide I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +grandes, I-EXPLORATION +con I-EXPLORATION +metaplasia I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +de I-EXPLORATION +Hürtle, I-EXPLORATION +que I-EXPLORATION +comprometió I-EXPLORATION +la I-EXPLORATION +cápsula I-EXPLORATION +tiroidea I-EXPLORATION y I-EXPLORATION -parahiliar I-EXPLORATION -izquierdo, I-EXPLORATION -región I-EXPLORATION -suprarrenal I-EXPLORATION -derecha, I-EXPLORATION -todo I-EXPLORATION -ello I-EXPLORATION -compatible I-EXPLORATION +focalmente I-EXPLORATION +el I-EXPLORATION +tejido I-EXPLORATION +muscular I-EXPLORATION +peritiroideo. I-EXPLORATION +Inmunohistoquímica: I-EXPLORATION +CD20 I-EXPLORATION +(+) I-EXPLORATION +difuso, I-EXPLORATION +CD3 I-EXPLORATION +(+) I-EXPLORATION +focal I-EXPLORATION +en I-EXPLORATION +linfocitos I-EXPLORATION +pequeños, I-EXPLORATION +CD10 I-EXPLORATION +(+) I-EXPLORATION +difuso, I-EXPLORATION +BCL2 I-EXPLORATION +(-) I-EXPLORATION +". I-EXPLORATION +Compatible I-EXPLORATION con I-EXPLORATION -afectación I-EXPLORATION -tumoral I-EXPLORATION -maligna. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -mediastinoscopia I-EXPLORATION -para I-EXPLORATION -toma I-EXPLORATION +LNH I-EXPLORATION +tiroideo I-EXPLORATION de I-EXPLORATION -biopsia I-EXPLORATION +células I-EXPLORATION +grandes I-EXPLORATION +estirpe I-EXPLORATION +B, I-EXPLORATION +tiroiditis I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -adenopatía I-EXPLORATION -paratraqueal I-EXPLORATION -derecha, I-EXPLORATION -cuyo I-EXPLORATION -resultado I-EXPLORATION -fue I-EXPLORATION -metástasis I-EXPLORATION +Hashimoto I-EXPLORATION +y I-EXPLORATION +metaplasia I-EXPLORATION +con I-EXPLORATION +células I-EXPLORATION de I-EXPLORATION -adenocarcinoma. I-EXPLORATION +Hürtle. I-EXPLORATION I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -metástasis I-TREATMENT -retiniana I-TREATMENT -derecha I-TREATMENT -y I-TREATMENT -suprarrenal I-TREATMENT -de I-TREATMENT -adenocarcinoma I-TREATMENT -de I-TREATMENT -pulmón, I-TREATMENT -comienza I-TREATMENT -tratamiento I-TREATMENT -quimioterápico I-TREATMENT -con I-TREATMENT -esquema I-TREATMENT -docetaxel I-TREATMENT -y I-TREATMENT -cisplatino, I-TREATMENT -mostrando I-TREATMENT -tras I-TREATMENT -dos I-TREATMENT -ciclos I-TREATMENT -una I-TREATMENT -respuesta I-TREATMENT -parcial I-TREATMENT -de I-TREATMENT +Se B-TREATMENT +indicó I-TREATMENT +quimioterapia I-TREATMENT +pero I-TREATMENT la I-TREATMENT -enfermedad I-TREATMENT -medible I-TREATMENT -y I-TREATMENT -una I-TREATMENT -aparente I-TREATMENT -mejoría I-TREATMENT -de I-TREATMENT +paciente I-TREATMENT la I-TREATMENT -formación I-TREATMENT -retiniana, I-TREATMENT -aunque I-TREATMENT -posteriormente, I-TREATMENT -se I-TREATMENT -complicó I-TREATMENT -con I-TREATMENT -un I-TREATMENT -desprendimiento I-TREATMENT -de I-TREATMENT -retina I-TREATMENT -leve I-TREATMENT -y I-TREATMENT -tuvo I-TREATMENT -que I-TREATMENT -ser I-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -radioterapia. I-TREATMENT +rechazó I-TREATMENT +por I-TREATMENT +motivos I-TREATMENT +religiosos. I-TREATMENT I-TREATMENT +Seis B-EVOLUTION +meses I-EVOLUTION +después, I-EVOLUTION +consultó I-EVOLUTION +en I-EVOLUTION +cirugía I-EVOLUTION +por I-EVOLUTION +recidiva I-EVOLUTION +local I-EVOLUTION +con I-EVOLUTION +sintomatología I-EVOLUTION +obstructiva I-EVOLUTION +de I-EVOLUTION +vía I-EVOLUTION +aérea. I-EVOLUTION +Fue B-DERIVED_FROM/TO +derivada I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +hematología I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +pierde I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +control. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO -Varón B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -57 I-PRESENT_ILLNESS +54 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -visto I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -vez I-PRESENT_ILLNESS -primera I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -nuestras I-PRESENT_ILLNESS -consultas I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +transcurso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +exploración I-PRESENT_ILLNESS +ginecológica I-PRESENT_ILLNESS +rutinaria I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +descubre I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +ecografía I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +tumoración I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +cm I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +diámetro I-PRESENT_ILLNESS +máximo I-PRESENT_ILLNESS +sonodensa, I-PRESENT_ILLNESS +homogénea I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +mal I-PRESENT_ILLNESS +definida I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -marzo I-PRESENT_ILLNESS +sus I-PRESENT_ILLNESS +contornos I-PRESENT_ILLNESS +posteriores I-PRESENT_ILLNESS +ya I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +existe I-PRESENT_ILLNESS +interfase I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +tejido I-PRESENT_ILLNESS +graso I-PRESENT_ILLNESS +circundante, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +localización I-PRESENT_ILLNESS +presacra, I-PRESENT_ILLNESS +detrás I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -2003. I-PRESENT_ILLNESS -Fue B-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Nefrología I-DERIVED_FROM/TO -tras I-DERIVED_FROM/TO -diagnosticarse I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -tumor I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -músculo I-DERIVED_FROM/TO -liso I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -potencial I-DERIVED_FROM/TO -maligno I-DERIVED_FROM/TO -incierto. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Entre B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -sólo I-PAST_MEDICAL_HISTORY -refería I-PAST_MEDICAL_HISTORY -cólico I-PAST_MEDICAL_HISTORY -nefrítico I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -estudiado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dicho I-PAST_MEDICAL_HISTORY -Servicio I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -haberse I-PAST_MEDICAL_HISTORY -detectado I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION +la I-PRESENT_ILLNESS +imagen I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +recto-sigma. I-PRESENT_ILLNESS +Dicha B-EXPLORATION +masa I-EXPLORATION +fue I-EXPLORATION +confirmada I-EXPLORATION +por I-EXPLORATION TAC I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -describió I-EXPLORATION +apreció I-EXPLORATION una I-EXPLORATION -masa I-EXPLORATION -abdominal I-EXPLORATION -polilobulada I-EXPLORATION +lesión I-EXPLORATION +redondeada, I-EXPLORATION +bien I-EXPLORATION +delimitada, I-EXPLORATION de I-EXPLORATION -8 I-EXPLORATION -x I-EXPLORATION +unos I-EXPLORATION 6 I-EXPLORATION cm I-EXPLORATION +de I-EXPLORATION +diámetro, I-EXPLORATION que I-EXPLORATION -realzaba I-EXPLORATION -en I-EXPLORATION -parte I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -y I-EXPLORATION presentaba I-EXPLORATION -zonas I-EXPLORATION +coeficientes I-EXPLORATION de I-EXPLORATION -necrosis I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extendía I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -espacio I-EXPLORATION -subfrénico I-EXPLORATION -hasta I-EXPLORATION -hilio I-EXPLORATION -esplénico I-EXPLORATION -y I-EXPLORATION -cola I-EXPLORATION -pancreática. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -13-2-03 I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -ecoendoscopia: I-EXPLORATION -gran I-EXPLORATION -tumoración I-EXPLORATION +absorción I-EXPLORATION +predominantemente I-EXPLORATION +grasos I-EXPLORATION con I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -necrosis I-EXPLORATION +discreta I-EXPLORATION +heterogeneidad, I-EXPLORATION +todo I-EXPLORATION +ello I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +posible I-EXPLORATION +tumor I-EXPLORATION +dermoide I-EXPLORATION +presacro. I-EXPLORATION +Dicha I-EXPLORATION +paciente I-EXPLORATION +presentaba I-EXPLORATION +unas I-EXPLORATION +cifras I-EXPLORATION de I-EXPLORATION -probable I-EXPLORATION -localización I-EXPLORATION -en I-EXPLORATION -retroperitoneo, I-EXPLORATION -independiente I-EXPLORATION -del I-EXPLORATION -riñón I-EXPLORATION -y I-EXPLORATION +hematocrito I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -cola I-EXPLORATION -del I-EXPLORATION -páncreas I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extendía I-EXPLORATION -hacia I-EXPLORATION -el I-EXPLORATION -polo I-EXPLORATION -superior I-EXPLORATION -del I-EXPLORATION -bazo I-EXPLORATION -del I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -podía I-EXPLORATION -independizar. I-EXPLORATION +38% I-EXPLORATION +sin I-EXPLORATION +alteraciones I-EXPLORATION +hematológicas I-EXPLORATION +acompañantes. I-EXPLORATION No I-EXPLORATION se I-EXPLORATION -observaron I-EXPLORATION -adenopatías. I-EXPLORATION -Se B-TREATMENT -intervino I-TREATMENT -el I-TREATMENT -6-3-03 I-TREATMENT -encontrándose I-TREATMENT -tumoración I-TREATMENT -multilobulada I-TREATMENT -entre I-TREATMENT -fornix I-TREATMENT -e I-TREATMENT -hilio I-TREATMENT -esplénico, I-TREATMENT -realizándose I-TREATMENT -extirpación I-TREATMENT -total I-TREATMENT -junto I-TREATMENT -a I-TREATMENT -bazo I-TREATMENT -y I-TREATMENT -pared I-TREATMENT -gástrica I-TREATMENT -a I-TREATMENT -la I-TREATMENT -que I-TREATMENT -se I-TREATMENT -adhiere. I-TREATMENT - I-TREATMENT -Anatomía B-EXPLORATION -Patológica I-EXPLORATION -: I-EXPLORATION +apreciaron I-EXPLORATION +visceromegalias. I-EXPLORATION + I-EXPLORATION Macroscópicamente I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -hilio I-EXPLORATION -esplénico I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION +trataba I-EXPLORATION +de I-EXPLORATION una I-EXPLORATION tumoración I-EXPLORATION -multinodular I-EXPLORATION +irregular I-EXPLORATION +bien I-EXPLORATION +delimitada I-EXPLORATION de I-EXPLORATION -11x9x6 I-EXPLORATION +7x5x3 I-EXPLORATION cm I-EXPLORATION +que I-EXPLORATION +parecía I-EXPLORATION +estar I-EXPLORATION +constituida I-EXPLORATION +fundamentalmente I-EXPLORATION +por I-EXPLORATION +tejido I-EXPLORATION +adiposo, I-EXPLORATION +observándose I-EXPLORATION +un I-EXPLORATION +área I-EXPLORATION +central I-EXPLORATION +hemorrágica I-EXPLORATION de I-EXPLORATION -consistencia I-EXPLORATION -firme I-EXPLORATION +2 I-EXPLORATION +cm, I-EXPLORATION y I-EXPLORATION -coloración I-EXPLORATION -pardusca I-EXPLORATION -que I-EXPLORATION -al I-EXPLORATION -corte I-EXPLORATION -presenta I-EXPLORATION -frecuentes I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +periferia, I-EXPLORATION +una I-EXPLORATION +serie I-EXPLORATION +de I-EXPLORATION áreas I-EXPLORATION -hemorrágicas. I-EXPLORATION -Microscópicamente, I-EXPLORATION -el I-EXPLORATION -bazo I-EXPLORATION -no I-EXPLORATION -muestra I-EXPLORATION -infiltración I-EXPLORATION -tumoral. I-EXPLORATION -Fragmento I-EXPLORATION +blanquecinas I-EXPLORATION de I-EXPLORATION -pared I-EXPLORATION -gástrica I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION -El I-EXPLORATION -tumor I-EXPLORATION -descrito I-EXPLORATION -previamente I-EXPLORATION -está I-EXPLORATION +aspecto I-EXPLORATION +fibroso I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +otras I-EXPLORATION +edematosas. I-EXPLORATION + I-EXPLORATION +Histológicamente I-EXPLORATION +la I-EXPLORATION +neoplasia I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +relativamente I-EXPLORATION bien I-EXPLORATION -delimitado I-EXPLORATION +circunscrita I-EXPLORATION +y I-EXPLORATION +estaba I-EXPLORATION +constituida I-EXPLORATION por I-EXPLORATION -una I-EXPLORATION -delgada I-EXPLORATION -cápsula I-EXPLORATION -fibrosa I-EXPLORATION +tejido I-EXPLORATION +adiposo I-EXPLORATION +maduro, I-EXPLORATION +tejido I-EXPLORATION +conectivo I-EXPLORATION +laxo I-EXPLORATION y I-EXPLORATION -está I-EXPLORATION -constituido I-EXPLORATION +celularidad I-EXPLORATION +hematopoyética I-EXPLORATION +mixta. I-EXPLORATION +Este I-EXPLORATION +último I-EXPLORATION +componente I-EXPLORATION +predominaba I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +áreas I-EXPLORATION +centrales I-EXPLORATION +del I-EXPLORATION +tumor I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +hallaba I-EXPLORATION +representado I-EXPLORATION por I-EXPLORATION -células I-EXPLORATION -fusiformes I-EXPLORATION -isomorfas, I-EXPLORATION -sin I-EXPLORATION -atipia I-EXPLORATION -ni I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -necrosis, I-EXPLORATION -presentado I-EXPLORATION +las I-EXPLORATION +tres I-EXPLORATION +series I-EXPLORATION +hematopoyéticas I-EXPLORATION +(megacariocítica, I-EXPLORATION +serie I-EXPLORATION +roja I-EXPLORATION +y I-EXPLORATION +serie I-EXPLORATION +blanca), I-EXPLORATION +con I-EXPLORATION +diferentes I-EXPLORATION +proporciones I-EXPLORATION +según I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +estudiada I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION un I-EXPLORATION índice I-EXPLORATION -mitótico I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -mitosis I-EXPLORATION -por I-EXPLORATION -10 I-EXPLORATION -campos I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -aumento. I-EXPLORATION -La I-EXPLORATION -inmunohistoquímica I-EXPLORATION -(IMH) I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -actina I-EXPLORATION -de I-EXPLORATION -músculo I-EXPLORATION -liso I-EXPLORATION +eritromieloide I-EXPLORATION +que I-EXPLORATION +oscilaba I-EXPLORATION +entre I-EXPLORATION +1: I-EXPLORATION +1 I-EXPLORATION y I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -desmina, I-EXPLORATION -S-100, I-EXPLORATION -CD I-EXPLORATION -57, I-EXPLORATION -EMA, I-EXPLORATION -CD68 I-EXPLORATION +2: I-EXPLORATION +1. I-EXPLORATION +Los I-EXPLORATION +megacariocíticos I-EXPLORATION +se I-EXPLORATION +observaban I-EXPLORATION +con I-EXPLORATION +facilidad I-EXPLORATION y I-EXPLORATION -neurofilamentos. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -fue I-EXPLORATION -"Tumor I-EXPLORATION +aunque I-EXPLORATION +se I-EXPLORATION +encontraron I-EXPLORATION +ocasionales I-EXPLORATION +formas I-EXPLORATION +inmaduras I-EXPLORATION de I-EXPLORATION -musculo I-EXPLORATION -liso I-EXPLORATION +los I-EXPLORATION +mismos, I-EXPLORATION +no I-EXPLORATION +presentaban I-EXPLORATION +rasgos I-EXPLORATION +displásicos. I-EXPLORATION +El I-EXPLORATION +estroma I-EXPLORATION de I-EXPLORATION -potencial I-EXPLORATION -maligno I-EXPLORATION -incierto" I-EXPLORATION -(11 I-EXPLORATION -cm). I-EXPLORATION - I-EXPLORATION -Tras I-EXPLORATION -estudio I-EXPLORATION +las I-EXPLORATION +áreas I-EXPLORATION +hematopoyéticas I-EXPLORATION +era I-EXPLORATION +casi I-EXPLORATION +exclusivamente I-EXPLORATION de I-EXPLORATION -extensión, I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -negativo, I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -revisión I-EXPLORATION +tipo I-EXPLORATION +adiposo. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +más I-EXPLORATION +periférica I-EXPLORATION del I-EXPLORATION -caso I-EXPLORATION -para I-EXPLORATION -catalogación I-EXPLORATION -definitiva I-EXPLORATION -mediante I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -IMH I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -esta I-EXPLORATION -ocasión I-EXPLORATION -incluyera I-EXPLORATION -CD I-EXPLORATION -117; I-EXPLORATION -ésta I-EXPLORATION -fue I-EXPLORATION -intensamente I-EXPLORATION -positiva. I-EXPLORATION - I-EXPLORATION -Resultados: I-EXPLORATION -Actina I-EXPLORATION -de I-EXPLORATION -músculo I-EXPLORATION -liso I-EXPLORATION -y I-EXPLORATION -Actina I-EXPLORATION -muscular I-EXPLORATION -específica: I-EXPLORATION -inmunotinción I-EXPLORATION -débil I-EXPLORATION -y I-EXPLORATION -focal; I-EXPLORATION -CD34 I-EXPLORATION -y I-EXPLORATION -c-kit I-EXPLORATION -(CD I-EXPLORATION -117): I-EXPLORATION -inmunotinción I-EXPLORATION -intensa I-EXPLORATION +tumor I-EXPLORATION +predominaba I-EXPLORATION +el I-EXPLORATION +tejido I-EXPLORATION +adiposo I-EXPLORATION +maduro I-EXPLORATION con I-EXPLORATION -control I-EXPLORATION -negativo I-EXPLORATION +focos I-EXPLORATION +de I-EXPLORATION +fibrosis I-EXPLORATION y I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -CD I-EXPLORATION -117; I-EXPLORATION -S-100 I-EXPLORATION +abundantes I-EXPLORATION +hemosiderinófagos. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +lipoblastos I-EXPLORATION +ni I-EXPLORATION +células I-EXPLORATION +mesenquimales I-EXPLORATION +bizarras I-EXPLORATION y I-EXPLORATION -desmina: I-EXPLORATION -ausencia I-EXPLORATION +existía I-EXPLORATION +cierto I-EXPLORATION +componente I-EXPLORATION +inflamatorio I-EXPLORATION de I-EXPLORATION -inmunotinción; I-EXPLORATION -Ki67: I-EXPLORATION -10%. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo I-EXPLORATION -fue I-EXPLORATION -tumor I-EXPLORATION -estromal I-EXPLORATION +predominio I-EXPLORATION +linfocitario, I-EXPLORATION +ocasionalmente I-EXPLORATION +dispuesto I-EXPLORATION +en I-EXPLORATION +agregados I-EXPLORATION de I-EXPLORATION -localización I-EXPLORATION +distribución I-EXPLORATION +aleatoria I-EXPLORATION +tanto I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +zonas I-EXPLORATION +hematopoyéticas I-EXPLORATION +como I-EXPLORATION en I-EXPLORATION -retroperitoneo I-EXPLORATION +las I-EXPLORATION +adiposas. I-EXPLORATION I-EXPLORATION -Paciente B-PRESENT_ILLNESS +Paciente, B-PRESENT_ILLNESS mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS +74 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -entre B-PAST_MEDICAL_HISTORY -cuyos I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -EPOC I-PAST_MEDICAL_HISTORY -estadio I-PAST_MEDICAL_HISTORY -I, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -únicamente I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -medidas I-PAST_MEDICAL_HISTORY -dietéticas, I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -beta-talasemia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -dermatitis I-PAST_MEDICAL_HISTORY -atópica. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -presenta I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -hábito I-PAST_MEDICAL_HISTORY -tabáquico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -30 I-PAST_MEDICAL_HISTORY -paquetes/año I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -comienza I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -ser I-PRESENT_ILLNESS -estudiada I-PRESENT_ILLNESS +atendida I-PRESENT_ILLNESS en I-PRESENT_ILLNESS el I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cirugía I-PRESENT_ILLNESS -vascular I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -mayo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2003 I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -raiz I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -úlceras I-PRESENT_ILLNESS -profundas, I-PRESENT_ILLNESS -dolorosas, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -inferiores, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mayor I-PRESENT_ILLNESS +Postgrado I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -ellas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -pierna I-PRESENT_ILLNESS -izquierda, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -mejoría I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -tratamientos I-PRESENT_ILLNESS -administrados I-PRESENT_ILLNESS +Rehabilitación I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -llegándose I-PRESENT_ILLNESS -finalmente I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS +Prótesis I-PRESENT_ILLNESS +Maxilofacial I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -pioderma I-PRESENT_ILLNESS -gangrenoso I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -realización I-PRESENT_ILLNESS +Universidad I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -biopsia I-PRESENT_ILLNESS +Barcelona, I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +sustituir I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +prótesis I-PRESENT_ILLNESS +óculo-palpebral I-PRESENT_ILLNESS de I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -lesión. I-PRESENT_ILLNESS -Ante B-DERIVED_FROM/TO -dicho I-DERIVED_FROM/TO -hallazgo, I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -medicina I-DERIVED_FROM/TO -interna I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -mayo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -2004 I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -sometida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -diversas I-DERIVED_FROM/TO -pruebas I-DERIVED_FROM/TO -diagnósticas, I-DERIVED_FROM/TO -destacando I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -normalidad I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -las I-DERIVED_FROM/TO -pruebas I-DERIVED_FROM/TO -realizadas, I-DERIVED_FROM/TO -tanto I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -pruebas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -imagen, I-DERIVED_FROM/TO -como I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -estudio I-DERIVED_FROM/TO -inmunológico. I-DERIVED_FROM/TO -Así I-DERIVED_FROM/TO -mismo I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -negaba I-DERIVED_FROM/TO -clínica I-DERIVED_FROM/TO -digestiva I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cualquier I-DERIVED_FROM/TO -índole. I-DERIVED_FROM/TO -Se B-TREATMENT -instaura I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -corticoides I-TREATMENT -y I-TREATMENT -ciclosporina I-TREATMENT -A I-TREATMENT -con I-TREATMENT -muy I-TREATMENT -buena I-TREATMENT -respuesta I-TREATMENT -clínica I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -sigue I-TREATMENT -este I-TREATMENT -tratamiento I-TREATMENT -hasta I-TREATMENT -noviembre I-TREATMENT -de I-TREATMENT -2004 I-TREATMENT -así I-TREATMENT -como I-TREATMENT -curas I-TREATMENT -locales I-TREATMENT -de I-TREATMENT -las I-TREATMENT -lesiones I-TREATMENT -ulcerosas, I-TREATMENT -aunque I-TREATMENT -con I-TREATMENT -persistencia I-TREATMENT -de I-TREATMENT -dichas I-TREATMENT -lesiones. I-TREATMENT - B-EVOLUTION -En I-EVOLUTION -noviembre I-EVOLUTION -de I-EVOLUTION -2004 I-EVOLUTION -comienza I-EVOLUTION -con I-EVOLUTION -clínica I-EVOLUTION -digestiva I-EVOLUTION -inespecífica I-EVOLUTION -consistente I-EVOLUTION -en I-EVOLUTION -molestias I-EVOLUTION -abdominales I-EVOLUTION -difusas I-EVOLUTION -y I-EVOLUTION -alteración I-EVOLUTION -del I-EVOLUTION -ritmo I-EVOLUTION -intestinal, I-EVOLUTION -por B-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -ante I-EXPLORATION -la I-EXPLORATION -clínica I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -anemia I-EXPLORATION +que I-PRESENT_ILLNESS +era I-PRESENT_ILLNESS +portadora. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Tras B-EXPLORATION +realizar I-EXPLORATION +un I-EXPLORATION +examen I-EXPLORATION +minucioso I-EXPLORATION +del I-EXPLORATION +defecto I-EXPLORATION +facial, I-EXPLORATION +se I-EXPLORATION +evaluaron I-EXPLORATION +las I-EXPLORATION +zonas I-EXPLORATION +de I-EXPLORATION +soporte I-EXPLORATION +para I-EXPLORATION +ver I-EXPLORATION +las I-EXPLORATION +posibilidades I-EXPLORATION +de I-EXPLORATION +obtención I-EXPLORATION de I-EXPLORATION +estabilidad, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION la I-EXPLORATION -paciente I-EXPLORATION -(en I-EXPLORATION -principio I-EXPLORATION -atribuida I-EXPLORATION -a I-EXPLORATION +forma I-EXPLORATION +de I-EXPLORATION +retención I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -beta-talasemia) I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -enema I-EXPLORATION -opaco I-EXPLORATION -y I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -baja, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION +prótesis4.. I-EXPLORATION +Éste I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +superficie I-EXPLORATION +cubierta I-EXPLORATION +totalmente I-EXPLORATION +de I-EXPLORATION +piel, I-EXPLORATION +firme, I-EXPLORATION +estable, I-EXPLORATION en I-EXPLORATION -recto I-EXPLORATION +forma I-EXPLORATION +de I-EXPLORATION una I-EXPLORATION -masa I-EXPLORATION -inmediatamente I-EXPLORATION -al I-EXPLORATION -pasar I-EXPLORATION -el I-EXPLORATION -esfinter, I-EXPLORATION +concavidad I-EXPLORATION +comunicada I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +fosa I-EXPLORATION +temporal I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION de I-EXPLORATION -tacto I-EXPLORATION -dura, I-EXPLORATION -mamelonada I-EXPLORATION -y I-EXPLORATION -muy I-EXPLORATION -friable, I-EXPLORATION -región I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -toman I-EXPLORATION -biopsias. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION +un I-EXPLORATION +agujero I-EXPLORATION +de I-EXPLORATION +aproximadamente I-EXPLORATION +5 I-EXPLORATION +mm I-EXPLORATION resultado I-EXPLORATION +del I-EXPLORATION +fracaso I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -mostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +osteointegración I-EXPLORATION de I-EXPLORATION -adenocarcinoma I-EXPLORATION -mucosecretor I-EXPLORATION -tipo I-EXPLORATION -coloide. I-EXPLORATION -Ante B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -referido I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT +un I-EXPLORATION +implante. I-EXPLORATION + I-EXPLORATION +Para B-TREATMENT la I-TREATMENT -intervención I-TREATMENT +elaboración I-TREATMENT de I-TREATMENT la I-TREATMENT -paciente I-TREATMENT -realizándose I-TREATMENT +prótesis I-TREATMENT +óculo-palpebral I-TREATMENT +flexible I-TREATMENT +se I-TREATMENT +debe I-TREATMENT +obtener I-TREATMENT una I-TREATMENT -amputación I-TREATMENT -abdomino-perineal I-TREATMENT -y I-TREATMENT +impresión I-TREATMENT +que I-TREATMENT +reproduzca I-TREATMENT +fielmente I-TREATMENT +los I-TREATMENT +tejidos I-TREATMENT +remanentes. I-TREATMENT +Para I-TREATMENT +ello I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT una I-TREATMENT -colostomía I-TREATMENT -terminal I-TREATMENT -izquierda I-TREATMENT -a I-TREATMENT -fecha I-TREATMENT +delimitación I-TREATMENT de I-TREATMENT -enero I-TREATMENT +la I-TREATMENT +extensión I-TREATMENT de I-TREATMENT -2005. I-TREATMENT -El B-EXPLORATION -resultado I-EXPLORATION -anatomopatológico I-EXPLORATION -definitivo I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -adenocarcinoma I-EXPLORATION -mucosecretor I-EXPLORATION -moderadamente I-EXPLORATION -diferenciado I-EXPLORATION -con I-EXPLORATION -extensas I-EXPLORATION -necrosis I-EXPLORATION -que I-EXPLORATION -infiltraba I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -espesor I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared. I-EXPLORATION -Afectación I-EXPLORATION -por I-EXPLORATION -adenocarcinoma I-EXPLORATION -en I-EXPLORATION -cinco I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -nueve I-EXPLORATION -ganglios I-EXPLORATION -aislados. I-EXPLORATION -Márgenes I-EXPLORATION -libres. I-EXPLORATION - I-EXPLORATION -Una I-EXPLORATION -vez I-EXPLORATION -realizada I-EXPLORATION -la I-EXPLORATION -cirugía, I-EXPLORATION -se I-EXPLORATION -somete I-EXPLORATION -a I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -extensión, I-EXPLORATION -que I-EXPLORATION -pone I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -metástasis I-EXPLORATION -pulmonares I-EXPLORATION -múltiples, I-EXPLORATION -y I-EXPLORATION -afectación I-EXPLORATION -adenopática I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -mesentérico, I-EXPLORATION -retroperitoneal, I-EXPLORATION -y I-EXPLORATION -pélvico. I-EXPLORATION -Con B-TREATMENT -diagnóstico I-TREATMENT +la I-TREATMENT +prótesis I-TREATMENT +debido I-TREATMENT +a I-TREATMENT +que I-TREATMENT +sus I-TREATMENT +márgenes I-TREATMENT +deben I-TREATMENT +estar I-TREATMENT +apoyados I-TREATMENT +en I-TREATMENT +superficies I-TREATMENT +estables. I-TREATMENT +La I-TREATMENT +finalidad I-TREATMENT +es I-TREATMENT +obtener I-TREATMENT +un I-TREATMENT +modelo I-TREATMENT de I-TREATMENT -adenocarcinoma I-TREATMENT +trabajo I-TREATMENT +y I-TREATMENT de I-TREATMENT -recto I-TREATMENT -estadio-IV I-TREATMENT -decidimos I-TREATMENT -iniciar I-TREATMENT -quimioterapia I-TREATMENT -paliativa I-TREATMENT +estudio I-TREATMENT en I-TREATMENT -régimen I-TREATMENT -FOLFOX-6, I-TREATMENT -tratamiento I-TREATMENT +yeso I-TREATMENT +piedra I-TREATMENT +o I-TREATMENT +yeso I-TREATMENT +extraduro. I-TREATMENT +Se I-TREATMENT +individualizaron I-TREATMENT +las I-TREATMENT +zonas I-TREATMENT +facial I-TREATMENT +y I-TREATMENT +temporal I-TREATMENT +a I-TREATMENT +impresionar I-TREATMENT +tapando I-TREATMENT +el I-TREATMENT +orificio I-TREATMENT +creado I-TREATMENT +por I-TREATMENT +la I-TREATMENT +perdida I-TREATMENT +del I-TREATMENT +implante I-TREATMENT +con I-TREATMENT +cera I-TREATMENT +«Utility», I-TREATMENT +para I-TREATMENT que I-TREATMENT +en I-TREATMENT +el I-TREATMENT +momento I-TREATMENT +de I-TREATMENT la I-TREATMENT -paciente I-TREATMENT -inició I-TREATMENT -a I-TREATMENT -finales I-TREATMENT +impresión I-TREATMENT +éste I-TREATMENT +no I-TREATMENT +bloquease I-TREATMENT +su I-TREATMENT +retirada. I-TREATMENT +Se I-TREATMENT +aplicó I-TREATMENT +vaselina I-TREATMENT +en I-TREATMENT +las I-TREATMENT +regiones I-TREATMENT +que I-TREATMENT +puedan I-TREATMENT +retener I-TREATMENT +el I-TREATMENT +material I-TREATMENT de I-TREATMENT -febrero I-TREATMENT +impresión I-TREATMENT +como I-TREATMENT +las I-TREATMENT +cejas I-TREATMENT +o I-TREATMENT +cabello, I-TREATMENT +además I-TREATMENT +también I-TREATMENT +se I-TREATMENT +puede I-TREATMENT +utilizar I-TREATMENT +como I-TREATMENT +material I-TREATMENT de I-TREATMENT -2005. I-TREATMENT -La B-EVOLUTION -respuesta I-EVOLUTION -al I-EVOLUTION -tratamiento I-EVOLUTION -quimioterápico I-EVOLUTION -fue I-EVOLUTION -favorable, I-EVOLUTION -con I-EVOLUTION -respuesta I-EVOLUTION -parcial I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -metástasis I-EVOLUTION -pulmonares I-EVOLUTION -y I-EVOLUTION -desaparición I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -afectación I-EVOLUTION -adenopática, I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -descenso I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -marcadores I-EVOLUTION -tumorales. I-EVOLUTION -En I-EVOLUTION -cuanto I-EVOLUTION -al I-EVOLUTION -pioderma I-EVOLUTION -gangrenoso I-EVOLUTION -y I-EVOLUTION -ya I-EVOLUTION -sin I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -que I-EVOLUTION -seguía I-EVOLUTION -previamente I-EVOLUTION -para I-EVOLUTION -éste, I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -hacia I-EVOLUTION -la I-EVOLUTION -desaparición I-EVOLUTION -completa I-EVOLUTION -en I-EVOLUTION -ambas I-EVOLUTION -piernas, I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -ningún I-EVOLUTION -tipo I-EVOLUTION -de I-EVOLUTION -sintomatología I-EVOLUTION -añadida. I-EVOLUTION - I-EVOLUTION -Sin I-EVOLUTION -embargo, I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -curso I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -(finalizado I-EVOLUTION -el I-EVOLUTION -4º I-EVOLUTION -ciclo) I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -acude I-EVOLUTION -al I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Urgencias I-EVOLUTION -por I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -febril I-EVOLUTION -de I-EVOLUTION -39º, I-EVOLUTION -náuseas, I-EVOLUTION -vómitos I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -en I-EVOLUTION -hipocondrio I-EVOLUTION -derecho, I-EVOLUTION -destacando I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -pruebas I-EVOLUTION -complementarias I-EVOLUTION -una I-EVOLUTION -neutropenia I-EVOLUTION -grado I-EVOLUTION -IV, I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -un I-EVOLUTION -patrón I-EVOLUTION -de I-EVOLUTION -citólisis I-EVOLUTION -hepática, I-EVOLUTION -colestasis I-EVOLUTION -e I-EVOLUTION -insuficiencia I-EVOLUTION -renal. I-EVOLUTION -Ante B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT +impresión I-TREATMENT +siliconas I-TREATMENT +fluidas, I-TREATMENT +agár, I-TREATMENT +materiales I-TREATMENT de I-TREATMENT -shock I-TREATMENT -séptico I-TREATMENT -secundario I-TREATMENT -a I-TREATMENT -una I-TREATMENT -colangitis, I-TREATMENT +poliéter I-TREATMENT +o I-TREATMENT +alginato2, I-TREATMENT +5*, I-TREATMENT +6, I-TREATMENT +8*. I-TREATMENT +En I-TREATMENT +este I-TREATMENT +caso I-TREATMENT se I-TREATMENT -procede I-TREATMENT +utilizó I-TREATMENT +alginato, I-TREATMENT +el I-TREATMENT +cual I-TREATMENT +debe I-TREATMENT +ser I-TREATMENT +muy I-TREATMENT +fluido I-TREATMENT +para I-TREATMENT +no I-TREATMENT +deformar I-TREATMENT +los I-TREATMENT +tegumentos I-TREATMENT +y I-TREATMENT +se I-TREATMENT +comienza I-TREATMENT a I-TREATMENT -su I-TREATMENT -ingreso I-TREATMENT +colocar I-TREATMENT en I-TREATMENT +las I-TREATMENT +zonas I-TREATMENT +más I-TREATMENT +profundas I-TREATMENT +del I-TREATMENT +defecto, I-TREATMENT +para I-TREATMENT +evitar I-TREATMENT la I-TREATMENT -Unidad I-TREATMENT +formación I-TREATMENT de I-TREATMENT -Cuidados I-TREATMENT -Intensivos, I-TREATMENT -donde I-TREATMENT +burbujas. I-TREATMENT + I-TREATMENT +Después I-TREATMENT se I-TREATMENT -instauraron I-TREATMENT +colocó I-TREATMENT +una I-TREATMENT +gasa I-TREATMENT +sobre I-TREATMENT +el I-TREATMENT +alginato I-TREATMENT +para I-TREATMENT +evitar I-TREATMENT +su I-TREATMENT +escurrimiento I-TREATMENT +y I-TREATMENT +que I-TREATMENT +además I-TREATMENT +sirvió I-TREATMENT +de I-TREATMENT +unión I-TREATMENT +a I-TREATMENT +la I-TREATMENT +capa I-TREATMENT +de I-TREATMENT +yeso I-TREATMENT +de I-TREATMENT +fraguado I-TREATMENT +rápido I-TREATMENT +que I-TREATMENT +se I-TREATMENT +coloca I-TREATMENT +sobre I-TREATMENT +el I-TREATMENT +material I-TREATMENT +de I-TREATMENT +impresión2, I-TREATMENT +6. I-TREATMENT + I-TREATMENT +Es I-TREATMENT +importante I-TREATMENT +mantener I-TREATMENT +libres I-TREATMENT las I-TREATMENT -medidas I-TREATMENT -antibióticas I-TREATMENT -necesarias, I-TREATMENT -así I-TREATMENT -como I-TREATMENT -drogas I-TREATMENT -vasoactivas, I-TREATMENT -sin B-EVOLUTION -conseguir I-EVOLUTION -la I-EVOLUTION -resolución I-EVOLUTION -del I-EVOLUTION -proceso I-EVOLUTION -y I-EVOLUTION -produciéndose I-EVOLUTION -el I-EVOLUTION -éxitus I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -que B-PAST_MEDICAL_HISTORY -trabaja I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -auxiliar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermería I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -38 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Entre I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -encontramos: I-PAST_MEDICAL_HISTORY -alérgica I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -Paracetamol, I-PAST_MEDICAL_HISTORY -hipotiroidismo, I-PAST_MEDICAL_HISTORY -microapneas. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -quirúrgicos I-PAST_MEDICAL_HISTORY -CIN3 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -varices I-PAST_MEDICAL_HISTORY -MMII. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Como I-PAST_MEDICAL_HISTORY -factores I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -riesgo I-PAST_MEDICAL_HISTORY -cardiovascular I-PAST_MEDICAL_HISTORY -destacan: I-PAST_MEDICAL_HISTORY -Hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento, I-PAST_MEDICAL_HISTORY -dislipemia, I-PAST_MEDICAL_HISTORY -fibrilación I-PAST_MEDICAL_HISTORY -auricular I-PAST_MEDICAL_HISTORY -paroxística I-PAST_MEDICAL_HISTORY -revertida I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2012. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Existe I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -conflicto I-PAST_MEDICAL_HISTORY -laboral I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -compañera, I-PAST_MEDICAL_HISTORY -conocido I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -valorado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -nuestro I-PAST_MEDICAL_HISTORY -Servicio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Prevención I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2005. I-PAST_MEDICAL_HISTORY -Entonces I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -recomendó I-PAST_MEDICAL_HISTORY -separar I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -partes I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -conflicto I-PAST_MEDICAL_HISTORY -si I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -podían I-PAST_MEDICAL_HISTORY -garantizar I-PAST_MEDICAL_HISTORY -unas I-PAST_MEDICAL_HISTORY -condiciones I-PAST_MEDICAL_HISTORY -óptimas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -trabajo. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -ofertó I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cambio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -puesto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -trabajo, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -rechazado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -trabajadora. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -servicio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Prevención I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Riesgos I-PAST_MEDICAL_HISTORY -Laborales I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -ofreció I-PAST_MEDICAL_HISTORY -entonces I-PAST_MEDICAL_HISTORY -comenzar I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -trabajar I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -técnicas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -afrontamiento I-PAST_MEDICAL_HISTORY -asertivo I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -manejo I-PAST_MEDICAL_HISTORY -adaptativo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -situación. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -julio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2012, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -produce I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -nueva I-PAST_MEDICAL_HISTORY -situación I-PAST_MEDICAL_HISTORY -estresante I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -compañera I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -mantenía I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -conflicto. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -precordial, I-PRESENT_ILLNESS -llanto I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -disnea, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -produce I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -relatar I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -sus I-PRESENT_ILLNESS -compañeras, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -situación I-PRESENT_ILLNESS -vital I-PRESENT_ILLNESS -estresante I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acababa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ocurrirle, I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -conflicto I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -compañera. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Exploración B-EXPLORATION -física I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -urgencia: I-EXPLORATION -TA: I-EXPLORATION -160/110 I-EXPLORATION -mmHg. I-EXPLORATION -Disneica. I-EXPLORATION -Crepitantes I-EXPLORATION -bibasales, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -gasometría, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -insuficiencia I-EXPLORATION -respiratoria I-EXPLORATION -aguda, I-EXPLORATION -con I-EXPLORATION -saturación I-EXPLORATION -del I-EXPLORATION -82%, I-EXPLORATION -PO2 I-EXPLORATION -de I-EXPLORATION -40 I-EXPLORATION -e I-EXPLORATION -hiperlactacidemia I-EXPLORATION -de I-EXPLORATION -3. I-EXPLORATION -Se B-TREATMENT -administran I-TREATMENT -dos I-TREATMENT -ampollas I-TREATMENT -de I-TREATMENT -Furosemida I-TREATMENT -intravenosa, I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -perfusión I-TREATMENT -de I-TREATMENT -nitroglicerina I-TREATMENT -intravenosa I-TREATMENT -y I-TREATMENT -ventilación I-TREATMENT -con I-TREATMENT -mascarilla I-TREATMENT -reservorio, I-TREATMENT -con B-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -y I-EVOLUTION -control I-EVOLUTION -de I-EVOLUTION -cifras I-EVOLUTION -tensionales. I-EVOLUTION - I-EVOLUTION -ECG B-EXPLORATION -realizado I-EXPLORATION -al I-EXPLORATION -ingreso: I-EXPLORATION -ritmo I-EXPLORATION -sinusal I-EXPLORATION -a I-EXPLORATION -92 I-EXPLORATION -lpm, I-EXPLORATION -eje I-EXPLORATION -desviado I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -izquierda, I-EXPLORATION -PR I-EXPLORATION -200 I-EXPLORATION -mseg, I-EXPLORATION -HBAI; I-EXPLORATION -pobre I-EXPLORATION -progresión I-EXPLORATION -de I-EXPLORATION -derivaciones I-EXPLORATION -en I-EXPLORATION -V1-V3 I-EXPLORATION -y I-EXPLORATION -dudosa I-EXPLORATION -supradesnivelación I-EXPLORATION -de I-EXPLORATION -ST I-EXPLORATION -en I-EXPLORATION -V1-V2, I-EXPLORATION -T I-EXPLORATION -picuda I-EXPLORATION -en I-EXPLORATION -V3-V6 I-EXPLORATION -y I-EXPLORATION -negativa I-EXPLORATION -en I-EXPLORATION -I I-EXPLORATION -y I-EXPLORATION -AVL I-EXPLORATION -(ECG, I-EXPLORATION -figuras I-EXPLORATION -1 I-EXPLORATION -y I-EXPLORATION -2, I-EXPLORATION -una I-EXPLORATION -vez I-EXPLORATION -desaparece I-EXPLORATION -el I-EXPLORATION -dolor). I-EXPLORATION - I-EXPLORATION -Rx I-EXPLORATION -de I-EXPLORATION -tórax: I-EXPLORATION -insuficiencia I-EXPLORATION -cardíaca. I-EXPLORATION - I-EXPLORATION -Ecocardiografía I-EXPLORATION -transtorácica: I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo I-EXPLORATION -esférico I-EXPLORATION -con I-EXPLORATION -acinesia I-EXPLORATION -septal, I-EXPLORATION -hipocinesia I-EXPLORATION -de I-EXPLORATION -segmento I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -cara I-EXPLORATION -inferior I-EXPLORATION -y I-EXPLORATION -FEVI I-EXPLORATION -estimada I-EXPLORATION -en I-EXPLORATION -torno I-EXPLORATION -al I-EXPLORATION -20-25% I-EXPLORATION -e I-EXPLORATION -IM I-EXPLORATION -leve. I-EXPLORATION -Con B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -Sd. I-TREATMENT -De I-TREATMENT -takotsubo, I-TREATMENT -discinesia I-TREATMENT -apical I-TREATMENT -transitoria I-TREATMENT -sin I-TREATMENT -aumento I-TREATMENT -del I-TREATMENT -valor I-TREATMENT -enzimático, I-TREATMENT -se I-TREATMENT -administran I-TREATMENT -300 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -AAS I-TREATMENT -y I-TREATMENT -600 I-TREATMENT -de I-TREATMENT -clopidogrel I-TREATMENT -y B-EXPLORATION -se I-EXPLORATION -traslada I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -sala I-EXPLORATION -de I-EXPLORATION -hemodinámica I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -coronariografía. I-EXPLORATION -Esta I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -vía I-EXPLORATION -femoral I-EXPLORATION -izquierda I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -evidencian I-EXPLORATION -lesiones I-EXPLORATION -angiográficamente I-EXPLORATION -significativas, I-EXPLORATION -aunque I-EXPLORATION -la I-EXPLORATION -DA I-EXPLORATION -muestra I-EXPLORATION -un I-EXPLORATION -flujo I-EXPLORATION -TIMI I-EXPLORATION -I. I-EXPLORATION -La I-EXPLORATION -ventriculografía I-EXPLORATION -muestra I-EXPLORATION -un I-EXPLORATION -VI I-EXPLORATION -ovoide I-EXPLORATION -con I-EXPLORATION -FEVI I-EXPLORATION -del I-EXPLORATION -25% I-EXPLORATION -y I-EXPLORATION -acinesia I-EXPLORATION -en I-EXPLORATION -banda I-EXPLORATION -de I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -segmento I-EXPLORATION -medial, I-EXPLORATION -hipocinesia I-EXPLORATION -leve I-EXPLORATION -de I-EXPLORATION -segmento I-EXPLORATION -basal I-EXPLORATION -y I-EXPLORATION -ápex. I-EXPLORATION - I-EXPLORATION -Permanece B-EVOLUTION -durante I-EVOLUTION -4 I-EVOLUTION -días I-EVOLUTION -ingresada, I-EVOLUTION -en I-EVOLUTION -UCOR I-EVOLUTION -(Unidad I-EVOLUTION -Coronaria), I-EVOLUTION -hemodinámicamente I-EVOLUTION -estable I-EVOLUTION -y I-EVOLUTION -asintomática. I-EVOLUTION -En B-EXPLORATION -el I-EXPLORATION -último I-EXPLORATION -ecocardiograma I-EXPLORATION -realizado I-EXPLORATION -durante I-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -obtiene I-EXPLORATION -un I-EXPLORATION -FEVI I-EXPLORATION -75%, I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -pruebas I-EXPLORATION -realizadas I-EXPLORATION -son I-EXPLORATION -normales, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -procede I-EXPLORATION -al I-EXPLORATION -alta I-EXPLORATION -hospitalaria. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Prevención I-EVOLUTION -confirma I-EVOLUTION -los I-EVOLUTION -desencadenantes I-EVOLUTION -emocionales I-EVOLUTION -de I-EVOLUTION -origen I-EVOLUTION -laboral I-EVOLUTION -y I-EVOLUTION -descarta I-EVOLUTION -otros I-EVOLUTION -factores I-EVOLUTION -extralaborales. I-EVOLUTION -Valorada I-EVOLUTION -la I-EVOLUTION -determinación I-EVOLUTION -de I-EVOLUTION -contingencia I-EVOLUTION -del I-EVOLUTION -proceso I-EVOLUTION -este I-EVOLUTION -se I-EVOLUTION -reconocería I-EVOLUTION -finalmente I-EVOLUTION -como I-EVOLUTION -accidente I-EVOLUTION -de I-EVOLUTION -trabajo. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -53 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -desplazado B-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -Haití I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -octubre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2013 I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -motivos I-PAST_MEDICAL_HISTORY -laborales. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Entre I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -baja I-PAST_MEDICAL_HISTORY -laboral I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -contingencia I-PAST_MEDICAL_HISTORY -común I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -febrero I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2014 I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dengue I-PAST_MEDICAL_HISTORY -confirmada, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -recuperación I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -reincorporación I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -puesto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -trabajo. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mayo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2014, I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -sufrir I-PAST_MEDICAL_HISTORY -abundantes I-PAST_MEDICAL_HISTORY -picaduras I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mosquito, I-PAST_MEDICAL_HISTORY -inició I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -brusca I-PAST_MEDICAL_HISTORY -fiebre I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -odinofagia I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -posterior I-PAST_MEDICAL_HISTORY -rash I-PAST_MEDICAL_HISTORY -cutáneo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -poliartralgias. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -descartó I-PAST_MEDICAL_HISTORY -infección I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -dengue. I-PAST_MEDICAL_HISTORY -Regresó B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -España, I-PRESENT_ILLNESS -causó I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -laboral I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -contingencia I-PRESENT_ILLNESS -común I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -estudiado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Enfermedades I-PRESENT_ILLNESS -Tropicales I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -Clínic I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Barcelona. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -hiperemia I-EXPLORATION -orofaringea I-EXPLORATION -y I-EXPLORATION -rash I-EXPLORATION -cutáneo I-EXPLORATION -que I-EXPLORATION -evolucionaron I-EXPLORATION -favorablemente I-EXPLORATION -al I-EXPLORATION -igual I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -fiebre; I-EXPLORATION -persistiendo I-EXPLORATION -las I-EXPLORATION -poliartralgias I-EXPLORATION -acompañadas I-EXPLORATION -de I-EXPLORATION -astenia I-EXPLORATION -intensa. I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION -destacar I-EXPLORATION -entre I-EXPLORATION -las I-EXPLORATION -exploraciones I-EXPLORATION -complementarias I-EXPLORATION -practicadas I-EXPLORATION -leve I-EXPLORATION -leucopenia, I-EXPLORATION -serología I-EXPLORATION -Chikungunya I-EXPLORATION -IgM I-EXPLORATION -e I-EXPLORATION -IgG I-EXPLORATION -y I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -ARN I-EXPLORATION -viral I-EXPLORATION -por I-EXPLORATION -RT-PCR I-EXPLORATION -positivas. I-EXPLORATION -PCR I-EXPLORATION -dengue I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -diagnosticó I-EXPLORATION -de I-EXPLORATION -Fiebre I-EXPLORATION -por I-EXPLORATION -virus I-EXPLORATION -Chikungunya I-EXPLORATION -no I-EXPLORATION -complicada I-EXPLORATION -adquirida I-EXPLORATION -en I-EXPLORATION -Haití I-EXPLORATION -y I-EXPLORATION -artralgias I-EXPLORATION -reactivas I-EXPLORATION -al I-EXPLORATION -proceso I-EXPLORATION -infeccioso, I-EXPLORATION -al I-EXPLORATION -cumplir I-EXPLORATION -criterios I-EXPLORATION -epidemiológicos, I-EXPLORATION -clínicos I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -laboratorio. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -siguió I-EVOLUTION -control I-EVOLUTION -médico I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -Servicio I-EVOLUTION -Público I-EVOLUTION -de I-EVOLUTION -Salud I-EVOLUTION -y I-EVOLUTION -desde I-EVOLUTION -julio I-EVOLUTION -de I-EVOLUTION -2014 I-EVOLUTION -con I-EVOLUTION -Mutua I-EVOLUTION -FREMAP, I-EVOLUTION -al I-EVOLUTION -tener I-EVOLUTION -la I-EVOLUTION -empresa I-EVOLUTION -concertada I-EVOLUTION -la I-EVOLUTION -cobertura I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -contingencia I-EVOLUTION -común I-EVOLUTION -con I-EVOLUTION -esta I-EVOLUTION -entidad10. I-EVOLUTION -El I-EVOLUTION -16 I-EVOLUTION -de I-EVOLUTION -octubre I-EVOLUTION -aportó I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -Servicios I-EVOLUTION -Médicos I-EVOLUTION -de I-EVOLUTION -FREMAP I-EVOLUTION -una I-EVOLUTION -solicitud I-EVOLUTION -de I-EVOLUTION -determinación I-EVOLUTION -de I-EVOLUTION -contingencia I-EVOLUTION -indicando I-EVOLUTION -le I-EVOLUTION -fuera I-EVOLUTION -reconocida I-EVOLUTION -dicha I-EVOLUTION -baja I-EVOLUTION -como I-EVOLUTION -laboral. I-EVOLUTION -Tras I-EVOLUTION -la I-EVOLUTION -valoración I-EVOLUTION -global I-EVOLUTION -del I-EVOLUTION -proceso I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -punto I-EVOLUTION -de I-EVOLUTION -vista I-EVOLUTION -epidemiológico, I-EVOLUTION -médico I-EVOLUTION -y I-EVOLUTION -laboral I-EVOLUTION -se I-EVOLUTION -aceptó I-EVOLUTION -el I-EVOLUTION -cambio I-EVOLUTION -de I-EVOLUTION -contingencia I-EVOLUTION -a I-EVOLUTION -Accidente I-EVOLUTION -de I-EVOLUTION -Trabajo. I-EVOLUTION - I-EVOLUTION -La I-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -fue I-EVOLUTION -lenta I-EVOLUTION -y I-EVOLUTION -fluctuante, I-EVOLUTION -con I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -astenia I-EVOLUTION -y I-EVOLUTION -poliartralgias I-EVOLUTION -limitantes, I-EVOLUTION -de I-EVOLUTION -predominio I-EVOLUTION -en I-EVOLUTION -carpo I-EVOLUTION -y I-EVOLUTION -manos. I-EVOLUTION -Descartada B-TREATMENT -artritis I-TREATMENT -siguió I-TREATMENT -tratamiento I-TREATMENT -sintomático. I-TREATMENT -En B-EVOLUTION -marzo I-EVOLUTION -de I-EVOLUTION -2015 I-EVOLUTION -manifestó I-EVOLUTION -una I-EVOLUTION -franca I-EVOLUTION -mejoría I-EVOLUTION -coincidiendo I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -cambio I-EVOLUTION -estacional. I-EVOLUTION -Se B-EXPLORATION -solicitó I-EXPLORATION -control I-EXPLORATION -analítico I-EXPLORATION -con I-EXPLORATION -hemograma I-EXPLORATION -y I-EXPLORATION -bioquímica I-EXPLORATION -incluyendo I-EXPLORATION -VSG, I-EXPLORATION -PCR I-EXPLORATION -e I-EXPLORATION -interleucina I-EXPLORATION -6, I-EXPLORATION -sin I-EXPLORATION -mostrar I-EXPLORATION -alteraciones I-EXPLORATION -significativas. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -14 I-EVOLUTION -de I-EVOLUTION -abril I-EVOLUTION -de I-EVOLUTION -2015 I-EVOLUTION -se I-EVOLUTION -extendió I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -laboral I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -julio I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -control I-EVOLUTION -ratificando I-EVOLUTION -la I-EVOLUTION -recuperación I-EVOLUTION -clínica. I-EVOLUTION -Hasta I-EVOLUTION -la I-EVOLUTION -fecha I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -solicitado I-EVOLUTION -nueva I-EVOLUTION -visita. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -16 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -residente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Chimbarongo, I-PAST_MEDICAL_HISTORY -VI I-PAST_MEDICAL_HISTORY -Región. I-PAST_MEDICAL_HISTORY -Tenía I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -padecer I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -epilepsia, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -fenobarbital. I-PAST_MEDICAL_HISTORY -Ingresó B-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -UCI I-EXPLORATION -del I-EXPLORATION -Hospital I-EXPLORATION -Barros I-EXPLORATION -Luco I-EXPLORATION -Trudeau I-EXPLORATION -(HBLT) I-EXPLORATION -el I-EXPLORATION -día I-EXPLORATION -cuarto I-EXPLORATION -de I-EXPLORATION -evolución I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -historia I-EXPLORATION -de I-EXPLORATION -tos, I-EXPLORATION -expectoración I-EXPLORATION -hemoptoica, I-EXPLORATION -apremio I-EXPLORATION -respiratorio I-EXPLORATION -y I-EXPLORATION -epistaxis I-EXPLORATION -anterior. I-EXPLORATION -La I-EXPLORATION -anamnesis I-EXPLORATION -describía I-EXPLORATION -los I-EXPLORATION -primeros I-EXPLORATION -días I-EXPLORATION -un I-EXPLORATION -cuadro I-EXPLORATION -caracterizado I-EXPLORATION -por I-EXPLORATION -fiebre, I-EXPLORATION -compromiso I-EXPLORATION -del I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -mialgia, I-EXPLORATION -cefalea, I-EXPLORATION -vómitos I-EXPLORATION -y I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -conciencia. I-EXPLORATION -Al I-EXPLORATION -segundo I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -se I-EXPLORATION -había I-EXPLORATION -agregado I-EXPLORATION -ictericia I-EXPLORATION -intensa, I-EXPLORATION -coluria I-EXPLORATION -y I-EXPLORATION -dolor I-EXPLORATION -abdominal. I-EXPLORATION -Consultó B-DERIVED_FROM/TO -inicialmente I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Emergencia I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Chimbarongo, I-DERIVED_FROM/TO -siendo I-DERIVED_FROM/TO -referido I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -hepatitis I-DERIVED_FROM/TO -aguda I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -San I-DERIVED_FROM/TO -Fernando, I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -estado I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -hipotensión I-DERIVED_FROM/TO -arterial, I-DERIVED_FROM/TO -taquicárdico, I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -epistaxis I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -dolor I-DERIVED_FROM/TO -abdominal I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -hipocondrio I-DERIVED_FROM/TO -derecho; I-DERIVED_FROM/TO -allí B-TREATMENT -fue I-TREATMENT -asistido I-TREATMENT -con I-TREATMENT -infusión I-TREATMENT -de I-TREATMENT -solución I-TREATMENT -salina I-TREATMENT -al I-TREATMENT -9‰ I-TREATMENT -y I-TREATMENT -dopamina I-TREATMENT -y B-DERIVED_FROM/TO -finalmente I-DERIVED_FROM/TO -enviado I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -HBLT I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -ingresó I-DERIVED_FROM/TO -vigil, I-DERIVED_FROM/TO -orientado I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -tiempo I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -espacio, I-DERIVED_FROM/TO -cooperando. I-DERIVED_FROM/TO -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaban I-EXPLORATION -intensa I-EXPLORATION -ictericia I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -escleras, I-EXPLORATION -taquicardia, I-EXPLORATION -taquipnea, I-EXPLORATION -normotensión I-EXPLORATION -y I-EXPLORATION -fiebre I-EXPLORATION -(38° I-EXPLORATION -C I-EXPLORATION -axilar), I-EXPLORATION -murmullo I-EXPLORATION -pulmonar I-EXPLORATION -disminuido I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hemicampo I-EXPLORATION -inferior I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -presente I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -derecho. I-EXPLORATION -Aproximadamente B-TREATMENT -50 I-TREATMENT -minutos I-TREATMENT -más I-TREATMENT -tarde I-TREATMENT -se I-TREATMENT -describió I-TREATMENT -en I-TREATMENT -estado I-TREATMENT -de I-TREATMENT -shock I-TREATMENT -séptico, I-TREATMENT -debiendo I-TREATMENT -ser I-TREATMENT -intubado, I-TREATMENT -maniobra I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -cual I-TREATMENT -eliminó I-TREATMENT -sangre I-TREATMENT -rutilante I-TREATMENT -por I-TREATMENT -la I-TREATMENT -vía I-TREATMENT -aérea, I-TREATMENT -y I-TREATMENT -fue I-TREATMENT -trasladado I-TREATMENT -a I-TREATMENT -UCI. I-TREATMENT -De I-TREATMENT -allí I-TREATMENT -en I-TREATMENT -adelante I-TREATMENT -evolucionó I-TREATMENT -con I-TREATMENT -escasa I-TREATMENT -respiración I-TREATMENT -espontánea I-TREATMENT -debió I-TREATMENT -ser I-TREATMENT -asistido I-TREATMENT -manualmente, I-TREATMENT -presentaba I-TREATMENT -sangramiento I-TREATMENT -por I-TREATMENT -el I-TREATMENT -tubo I-TREATMENT -orotraqueal, I-TREATMENT -ictericia I-TREATMENT -e I-TREATMENT -isocoria I-TREATMENT -reactiva. I-TREATMENT -Se I-TREATMENT -conectó I-TREATMENT -a I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -por I-TREATMENT -una I-TREATMENT -desaturación I-TREATMENT -de I-TREATMENT -65%, I-TREATMENT -mientras I-TREATMENT -estaba I-TREATMENT -taquicárdico I-TREATMENT -pero I-TREATMENT -con I-TREATMENT -normotensión. I-TREATMENT -Fue I-TREATMENT -ingresado I-TREATMENT -con I-TREATMENT -los I-TREATMENT -diagnósticos I-TREATMENT -de: I-TREATMENT -shock I-TREATMENT -séptico, I-TREATMENT -síndrome I-TREATMENT -de I-TREATMENT -distrés I-TREATMENT -respiratorio I-TREATMENT -del I-TREATMENT -adulto I-TREATMENT -y I-TREATMENT -la I-TREATMENT -hipótesis I-TREATMENT -de I-TREATMENT -una I-TREATMENT -leptospirosis. I-TREATMENT -Evolucionó B-EVOLUTION -con I-EVOLUTION -PA I-EVOLUTION -0/0 I-EVOLUTION -mm/Hg I-EVOLUTION -y I-EVOLUTION -falleció I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -hora I-EVOLUTION -de I-EVOLUTION -haber I-EVOLUTION -ingresado I-EVOLUTION -en I-EVOLUTION -UCI, I-EVOLUTION -pese I-EVOLUTION -a I-EVOLUTION -maniobras I-EVOLUTION -de I-EVOLUTION -reanimación I-EVOLUTION -avanzada. I-EVOLUTION - I-EVOLUTION -Anatomía B-EXPLORATION -patológica I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -morfológicos I-EXPLORATION -están I-EXPLORATION -relacionados I-EXPLORATION -con I-EXPLORATION -alteraciones I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -microcirculación, I-EXPLORATION -caracterizadas I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -panvasculitis I-EXPLORATION -venulocapilar I-EXPLORATION -en I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -órganos I-EXPLORATION -y I-EXPLORATION -sistemas9. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -pulmón I-EXPLORATION -se I-EXPLORATION -apreciaban I-EXPLORATION -macroscópicamente I-EXPLORATION -extensas I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -hemorragia I-EXPLORATION -parenquimatosa I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -microscopia I-EXPLORATION -necrosis I-EXPLORATION -alveolar. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -parénquima I-EXPLORATION -hepático I-EXPLORATION -se I-EXPLORATION -observaban I-EXPLORATION -extensas I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -necrosis I-EXPLORATION -hepatocelular I-EXPLORATION -e I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -linfoplasmocitario I-EXPLORATION -portal. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -miocardio I-EXPLORATION -exhibía I-EXPLORATION -degeneración I-EXPLORATION -miofibrilar I-EXPLORATION -focal I-EXPLORATION -y I-EXPLORATION -extenso I-EXPLORATION -infiltrado I-EXPLORATION -linfoplasmocitario I-EXPLORATION -intersticial. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -parénquima I-EXPLORATION -renal I-EXPLORATION -presentaba I-EXPLORATION -congestión I-EXPLORATION -vascular, I-EXPLORATION -vasculitis I-EXPLORATION -linfoplasmocitaria I-EXPLORATION -y I-EXPLORATION -extensa I-EXPLORATION -necrosis I-EXPLORATION -tubular I-EXPLORATION -aguda. I-EXPLORATION -Con I-EXPLORATION -la I-EXPLORATION -coloración I-EXPLORATION -argéntica I-EXPLORATION -de I-EXPLORATION -Warthin-Starry I-EXPLORATION -se I-EXPLORATION -identificaron I-EXPLORATION -formaciones I-EXPLORATION -espirilares I-EXPLORATION -adosadas I-EXPLORATION -al I-EXPLORATION -epitelio I-EXPLORATION -tubular I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -de I-EXPLORATION -coma, I-EXPLORATION -características I-EXPLORATION -de I-EXPLORATION -leptospira. I-EXPLORATION -Por I-EXPLORATION -métodos I-EXPLORATION -morfométricos I-EXPLORATION -se I-EXPLORATION -estableció I-EXPLORATION -una I-EXPLORATION -longitud I-EXPLORATION -promedio I-EXPLORATION -de I-EXPLORATION -13 I-EXPLORATION -mµ. I-EXPLORATION - I-EXPLORATION -Diagnósticos I-EXPLORATION -anátomo-patológicos: I-EXPLORATION - I-EXPLORATION -· I-EXPLORATION -Enfermedad I-EXPLORATION -de I-EXPLORATION -Weil I-EXPLORATION -(leptospirosis) I-EXPLORATION -con: I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Hemorragia I-EXPLORATION -pulmonar I-EXPLORATION -parenquimatosa- I-EXPLORATION -alveolitis I-EXPLORATION -necrosante. I-EXPLORATION -- I-EXPLORATION -Panvasculitis I-EXPLORATION -vénulo-capilar. I-EXPLORATION -- I-EXPLORATION -Necrosis I-EXPLORATION -tubular I-EXPLORATION -aguda-nefritis I-EXPLORATION -intersticial I-EXPLORATION -linfo-plasmocitaria. I-EXPLORATION -- I-EXPLORATION -Hepatitis I-EXPLORATION -aguda. I-EXPLORATION -- I-EXPLORATION -Miocarditis I-EXPLORATION -y I-EXPLORATION -pericarditis I-EXPLORATION -linfo-plasmocitaria. I-EXPLORATION -- I-EXPLORATION -Meningitis I-EXPLORATION -linfo-plasmocitaria. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -52 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -en B-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -prednisona I-PAST_MEDICAL_HISTORY -12, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -día, I-PAST_MEDICAL_HISTORY -metotrexato I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -semanales I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hidroxicloroquina I-PAST_MEDICAL_HISTORY -200 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -día, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lupus I-PAST_MEDICAL_HISTORY -eritematoso I-PAST_MEDICAL_HISTORY -sistémico I-PAST_MEDICAL_HISTORY -(LES) I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -manifestado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -poliartritis, I-PAST_MEDICAL_HISTORY -leucopenia, I-PAST_MEDICAL_HISTORY -linfopenia, I-PAST_MEDICAL_HISTORY -VHS I-PAST_MEDICAL_HISTORY -elevada I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -serología I-PAST_MEDICAL_HISTORY -compatible I-PAST_MEDICAL_HISTORY -(anti-DNA I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ANA I-PAST_MEDICAL_HISTORY -positivos, I-PAST_MEDICAL_HISTORY -C3 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -C4 I-PAST_MEDICAL_HISTORY -bajos). I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Con B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -insidioso, I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -escasamente I-PRESENT_ILLNESS -productiva, I-PRESENT_ILLNESS -expectoración I-PRESENT_ILLNESS -mucopurulenta, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hemitórax I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -tope I-PRESENT_ILLNESS -inspiratorio, I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -progresiva, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -~10%. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -este I-PRESENT_ILLNESS -período. I-PRESENT_ILLNESS -Inicialmente I-PRESENT_ILLNESS -recibió I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -claritromicina I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -días, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -buena I-PRESENT_ILLNESS -respuesta, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -hospitalizada I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -estudio. I-PRESENT_ILLNESS -Se B-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION -atelectasias I-EXPLORATION -bibasales I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -escasa I-EXPLORATION -efusión I-EXPLORATION -pleural I-EXPLORATION -derecha I-EXPLORATION -(no I-EXPLORATION -puncionable), I-EXPLORATION -sin I-EXPLORATION -consolidaciones I-EXPLORATION -ni I-EXPLORATION -imágenes I-EXPLORATION -de I-EXPLORATION -sustitución. I-EXPLORATION -Dada I-EXPLORATION -la I-EXPLORATION -asociación I-EXPLORATION -con I-EXPLORATION -poliartralgias I-EXPLORATION -y I-EXPLORATION -serología I-EXPLORATION -de I-EXPLORATION -LES I-EXPLORATION -positiva I-EXPLORATION -(anti I-EXPLORATION -ADN I-EXPLORATION -Farr I-EXPLORATION -975 I-EXPLORATION -U) I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -fueron I-EXPLORATION -interpretados I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -actividad I-EXPLORATION -lúpica I-EXPLORATION -y B-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -el I-TREATMENT -metotrexato I-TREATMENT -por I-TREATMENT -azatioprina I-TREATMENT -75 I-TREATMENT -mg/día. I-TREATMENT -Durante B-EVOLUTION -los I-EVOLUTION -siguientes I-EVOLUTION -meses I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -afebril, I-EVOLUTION -pero I-EVOLUTION -con I-EVOLUTION -tos I-EVOLUTION -persistente I-EVOLUTION -y I-EVOLUTION -ocasionalmente I-EVOLUTION -expectoración I-EVOLUTION -hemoptoica-purulenta, I-EVOLUTION -recibiendo B-TREATMENT -levofloxacina I-TREATMENT -500 I-TREATMENT -mg/día I-TREATMENT -durante I-TREATMENT -10 I-TREATMENT -días, I-TREATMENT -con B-EVOLUTION -lo I-EVOLUTION -cual I-EVOLUTION -disminuyó I-EVOLUTION -parcialmente I-EVOLUTION -la I-EVOLUTION -sintomatología. I-EVOLUTION -A B-EXPLORATION -pesar I-EXPLORATION -de I-EXPLORATION -carecer I-EXPLORATION -de I-EXPLORATION -factores I-EXPLORATION -de I-EXPLORATION -riesgo I-EXPLORATION -para I-EXPLORATION -adquirir I-EXPLORATION -infección I-EXPLORATION -por I-EXPLORATION -VIH I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -serológico I-EXPLORATION -de I-EXPLORATION -VIH-1 I-EXPLORATION -y I-EXPLORATION -VIH-2 I-EXPLORATION -(ELISA) I-EXPLORATION -con I-EXPLORATION -resultado I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -Al B-EVOLUTION -séptimo I-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -nuevamente I-EVOLUTION -hospitalizada I-EVOLUTION -por I-EVOLUTION -reagudización I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sintomatología, I-EVOLUTION -asociada I-EVOLUTION -a I-EVOLUTION -fiebre I-EVOLUTION -hasta I-EVOLUTION -38º I-EVOLUTION -C. I-EVOLUTION -La B-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -evidenció I-EXPLORATION -esta I-EXPLORATION -vez I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -consolidación I-EXPLORATION -bilaterales, I-EXPLORATION -nódulos I-EXPLORATION -excavados, I-EXPLORATION -y I-EXPLORATION -adenopatías I-EXPLORATION -mediastínicas. I-EXPLORATION -Laboratorio: I-EXPLORATION -PCR I-EXPLORATION -20, I-EXPLORATION -1 I-EXPLORATION -mg/dL I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -1, I-EXPLORATION -0 I-EXPLORATION -mg/dL) I-EXPLORATION -y I-EXPLORATION -VHS I-EXPLORATION -118 I-EXPLORATION -mm/h. I-EXPLORATION -En I-EXPLORATION -una I-EXPLORATION -fibrobroncoscopia I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -inflamación I-EXPLORATION -traqueo-bronquial I-EXPLORATION -proximal I-EXPLORATION -con I-EXPLORATION -deformación I-EXPLORATION -del I-EXPLORATION -bronquio I-EXPLORATION -segmentario I-EXPLORATION -apical I-EXPLORATION -derecho, I-EXPLORATION -lugar I-EXPLORATION -del I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -obtuvo I-EXPLORATION -biopsia. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -microbiológico I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -lavado I-EXPLORATION -bronco-alveolar I-EXPLORATION -(LBA) I-EXPLORATION -resultó I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -bacterias I-EXPLORATION -incluyendo I-EXPLORATION -micobacterias I-EXPLORATION -y I-EXPLORATION -hongos I-EXPLORATION -incluyendo I-EXPLORATION -Pneumocystis I-EXPLORATION -jiroveci. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -bronquial I-EXPLORATION -demostró I-EXPLORATION -exudado I-EXPLORATION -fibrinoleucocitario I-EXPLORATION -con I-EXPLORATION -tejido I-EXPLORATION -necrótico. I-EXPLORATION -Se B-TREATMENT -indicó I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -con I-TREATMENT -cefotaxima+clindamicina I-TREATMENT -que I-TREATMENT -recibió I-TREATMENT -durante I-TREATMENT -siete I-TREATMENT -días I-TREATMENT -bajo I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -neumonía I-TREATMENT -cavitada I-TREATMENT -de I-TREATMENT -etiología I-TREATMENT -no I-TREATMENT -precisada. I-TREATMENT -Dada B-EVOLUTION -la I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -dio I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -hospitalaria I-EVOLUTION -para B-TREATMENT -completar I-TREATMENT -tres I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -amoxicilina/ácido I-TREATMENT -clavulánico, I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -la I-TREATMENT -azatioprina I-TREATMENT -y I-TREATMENT -mantuvo I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -e I-TREATMENT -hidroxicloroquina. I-TREATMENT -Sin B-EVOLUTION -embargo, I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -semanas I-EVOLUTION -siguientes I-EVOLUTION -se I-EVOLUTION -reagudizó I-EVOLUTION -la I-EVOLUTION -sintomatología I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -internada I-EVOLUTION -nuevamente. I-EVOLUTION -La B-EXPLORATION -evaluación I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -demostró I-EXPLORATION -esta I-EXPLORATION -vez I-EXPLORATION -leucopenia I-EXPLORATION -con I-EXPLORATION -desviación I-EXPLORATION -a I-EXPLORATION -izquierda, I-EXPLORATION -VHS I-EXPLORATION -119 I-EXPLORATION -mm/h I-EXPLORATION -y I-EXPLORATION -PCR I-EXPLORATION -35 I-EXPLORATION -mg/dL. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -sospechosa I-EXPLORATION -de I-EXPLORATION -absceso I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -TAC I-EXPLORATION -se I-EXPLORATION -evidenciaron I-EXPLORATION -nódulos I-EXPLORATION -cavitados I-EXPLORATION -y I-EXPLORATION -consolidaciones I-EXPLORATION -masiformes. I-EXPLORATION -Se I-EXPLORATION -repitieron I-EXPLORATION -baciloscopias I-EXPLORATION -y I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Kinyoun I-EXPLORATION -en I-EXPLORATION -expectoración I-EXPLORATION -resultando I-EXPLORATION -negativas. I-EXPLORATION -En I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -fibrobroncoscopia I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -lesiones I-EXPLORATION -blanquecinas I-EXPLORATION -solevantadas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -traqueal, I-EXPLORATION -obteniéndose I-EXPLORATION -biopsia I-EXPLORATION -para I-EXPLORATION -estudios I-EXPLORATION -microbiológico I-EXPLORATION -e I-EXPLORATION -histológico. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -pulmonar I-EXPLORATION -percutánea I-EXPLORATION -bajo I-EXPLORATION -TAC, I-EXPLORATION -cuya I-EXPLORATION -histología I-EXPLORATION -evidenció I-EXPLORATION -gran I-EXPLORATION -proceso I-EXPLORATION -inflamatorio I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -bacilos I-EXPLORATION -grampositivos I-EXPLORATION -intra-macrófagos. I-EXPLORATION -Tanto I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -corriente I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -recuperado I-EXPLORATION -por I-EXPLORATION -biopsia I-EXPLORATION -bajo I-EXPLORATION -TAC I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -obtenido I-EXPLORATION -por I-EXPLORATION -fibrobroncoscopia I-EXPLORATION -hubo I-EXPLORATION -desarrollo I-EXPLORATION -de I-EXPLORATION -bacilos I-EXPLORATION -grampositivos, I-EXPLORATION -diagnosticados I-EXPLORATION -como I-EXPLORATION -Rhodococcus I-EXPLORATION -sp. I-EXPLORATION -La I-EXPLORATION -identificación I-EXPLORATION -de I-EXPLORATION -género I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Laboratorio I-EXPLORATION -de I-EXPLORATION -Microbiología I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Red I-EXPLORATION -de I-EXPLORATION -Salud I-EXPLORATION -UC I-EXPLORATION -mediante I-EXPLORATION -una I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Kinyoun I-EXPLORATION -positiva I-EXPLORATION -(ácido-alcohol I-EXPLORATION -resistencia I-EXPLORATION -parcial), I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -morfología I-EXPLORATION -bifásica I-EXPLORATION -característica I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -al I-EXPLORATION -incubar I-EXPLORATION -la I-EXPLORATION -colonia I-EXPLORATION -en I-EXPLORATION -agar I-EXPLORATION -BHI I-EXPLORATION -(infusión I-EXPLORATION -cerebro I-EXPLORATION -corazón): I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -6 I-EXPLORATION -horas I-EXPLORATION -de I-EXPLORATION -incubación I-EXPLORATION -aeróbica I-EXPLORATION -a I-EXPLORATION -35º I-EXPLORATION -C I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -elementos I-EXPLORATION -bacilares I-EXPLORATION -al I-EXPLORATION -Gram I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -continuar I-EXPLORATION -la I-EXPLORATION -incubación I-EXPLORATION -hasta I-EXPLORATION -las I-EXPLORATION -24 I-EXPLORATION -horas I-EXPLORATION -se I-EXPLORATION -observaban I-EXPLORATION -elementos I-EXPLORATION -cocoideos. I-EXPLORATION -El I-EXPLORATION -desarrollo I-EXPLORATION -en I-EXPLORATION -placas I-EXPLORATION -de I-EXPLORATION -agar I-EXPLORATION -sangre I-EXPLORATION -de I-EXPLORATION -cordero I-EXPLORATION -mostró I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -dos I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -incubación I-EXPLORATION -colonias I-EXPLORATION -mucoideas I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -coral. I-EXPLORATION -Con I-EXPLORATION -estas I-EXPLORATION -pruebas I-EXPLORATION -se I-EXPLORATION -envió I-EXPLORATION -al I-EXPLORATION -Instituto I-EXPLORATION -de I-EXPLORATION -Salud I-EXPLORATION -Pública I-EXPLORATION -de I-EXPLORATION -Chile I-EXPLORATION -(Laboratorio I-EXPLORATION -de I-EXPLORATION -Referencia) I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -presuntivo I-EXPLORATION -de I-EXPLORATION -Rhodococcus I-EXPLORATION -sp, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -morfología I-EXPLORATION -típica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -características I-EXPLORATION -macroscópicas I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -colonias. I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -bioquímicas I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -galería I-EXPLORATION -API I-EXPLORATION -Coryne® I-EXPLORATION -(Biomerieux) I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -resultados: I-EXPLORATION -reducción I-EXPLORATION -de I-EXPLORATION -nitratos I-EXPLORATION -negativa, I-EXPLORATION -pirazinamidasa I-EXPLORATION -negativa, I-EXPLORATION -pirrolidanil I-EXPLORATION -arilamidasa I-EXPLORATION -(PYR) I-EXPLORATION -negativa, I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -(PAL) I-EXPLORATION -positiva, I-EXPLORATION -b-glucuronidasa I-EXPLORATION -(bGUR) I-EXPLORATION -negativa, I-EXPLORATION -b-galactosidasa I-EXPLORATION -((bGAL) I-EXPLORATION -negativa, I-EXPLORATION -a-glucosidasa I-EXPLORATION -(aGLU) I-EXPLORATION -positiva, I-EXPLORATION -n-acetil-b-glucosaminidasa I-EXPLORATION -(bNAG) I-EXPLORATION -negativa, I-EXPLORATION -esculina I-EXPLORATION -positiva, I-EXPLORATION -ureasa I-EXPLORATION -negativa, I-EXPLORATION -hidrólisis I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -gelatina I-EXPLORATION -negativa, I-EXPLORATION -fermentación I-EXPLORATION -de I-EXPLORATION -ornitina, I-EXPLORATION -glucosa, I-EXPLORATION -ribosa, I-EXPLORATION -xilosa, I-EXPLORATION -manitol, I-EXPLORATION -maltosa, I-EXPLORATION -lactosa, I-EXPLORATION -sacarosa I-EXPLORATION -y I-EXPLORATION -glicógeno I-EXPLORATION -negativas I-EXPLORATION -y I-EXPLORATION -catalasa I-EXPLORATION -positiva. I-EXPLORATION -Por I-EXPLORATION -estas I-EXPLORATION -pruebas I-EXPLORATION -bioquímicas I-EXPLORATION -y I-EXPLORATION -por I-EXPLORATION -las I-EXPLORATION -características I-EXPLORATION -macroscópicas I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -Rhodococcus I-EXPLORATION -equi I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -vancomicina I-TREATMENT -2 I-TREATMENT -gr/día I-TREATMENT -y I-TREATMENT -rifampicina I-TREATMENT -600 I-TREATMENT -mg/día, I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -respuesta I-TREATMENT -inicial. I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -6 I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -terapia I-EVOLUTION -desarrolló I-EVOLUTION -un I-EVOLUTION -rash I-EVOLUTION -pruriginoso I-EVOLUTION -intenso I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -necesario I-EVOLUTION -cambiar I-EVOLUTION -el I-EVOLUTION -esquema. I-EVOLUTION -Para B-EXPLORATION -definir I-EXPLORATION -la I-EXPLORATION -siguiente I-EXPLORATION -terapia I-EXPLORATION -antimicrobiana I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -susceptibilidad I-EXPLORATION -in I-EXPLORATION -vitro I-EXPLORATION -mediante I-EXPLORATION -dilución I-EXPLORATION -en I-EXPLORATION -agar I-EXPLORATION -y I-EXPLORATION -epsilometría I-EXPLORATION -(E-test®). I-EXPLORATION -Si I-EXPLORATION -bien I-EXPLORATION -no I-EXPLORATION -están I-EXPLORATION -descritos I-EXPLORATION -los I-EXPLORATION -puntos I-EXPLORATION -de I-EXPLORATION -corte I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -antimicrobianos I-EXPLORATION -para I-EXPLORATION -este I-EXPLORATION -microorganismo2, I-EXPLORATION -se I-EXPLORATION -midieron I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -CIM I-EXPLORATION -> I-EXPLORATION -32 I-EXPLORATION -µg/mL I-EXPLORATION -a I-EXPLORATION -cefotaxima, I-EXPLORATION -> I-EXPLORATION -40 I-EXPLORATION -µg/mL I-EXPLORATION -a I-EXPLORATION -cotrimoxazol I-EXPLORATION -y I-EXPLORATION -< I-EXPLORATION -2µg/mL I-EXPLORATION -para I-EXPLORATION -ciprofloxacina, I-EXPLORATION -imipenem I-EXPLORATION -y I-EXPLORATION -gentamicina3. I-EXPLORATION -Con B-TREATMENT -esta I-TREATMENT -información I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT -fue I-TREATMENT -cambiado I-TREATMENT -a I-TREATMENT -ciprofloxacina+amikacina I-TREATMENT -y I-TREATMENT -luego I-TREATMENT -ciprofloxacina+ I-TREATMENT -claritromicina I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -24 I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -tratamiento. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -fue I-EVOLUTION -favorable I-EVOLUTION -con I-EVOLUTION -lenta I-EVOLUTION -y I-EVOLUTION -progresiva I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sintomatología I-EVOLUTION -hasta I-EVOLUTION -desaparecer, I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -inflamatorios I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -exámenes I-EVOLUTION -de I-EVOLUTION -laboratorio I-EVOLUTION -hasta I-EVOLUTION -su I-EVOLUTION -normalización, I-EVOLUTION -y I-EVOLUTION -regresión I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -imágenes I-EVOLUTION -de I-EVOLUTION -consolidación I-EVOLUTION -pulmonar I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -TAC I-EVOLUTION -de I-EVOLUTION -tórax. I-EVOLUTION - I-EVOLUTION - -Escolar B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -9 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia. I-PAST_MEDICAL_HISTORY -Presentaba B-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cefalea, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -periorbitario I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -hospitalizó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -otro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -realizó I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -TAC I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -senos I-PRESENT_ILLNESS -paranasales I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -órbita I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -demostró I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -pansinusitis I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sospecha I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -absceso I-PRESENT_ILLNESS -orbitario I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -iniciándose I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -antimicrobiano I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -ceftriaxona I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cloxacilina. I-PRESENT_ILLNESS -A B-EXPLORATION -las I-EXPLORATION -48 I-EXPLORATION -horas I-EXPLORATION -del I-EXPLORATION -ingreso, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -cursó I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -cuadro I-EXPLORATION -confusional I-EXPLORATION -agudo I-EXPLORATION -y I-EXPLORATION -crisis I-EXPLORATION -de I-EXPLORATION -agitación I-EXPLORATION -psicomotora I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -meníngea, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -obteniéndose I-EXPLORATION -LCR I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -meningitis I-EXPLORATION -(490 I-EXPLORATION -células/mm3 I-EXPLORATION -60% I-EXPLORATION -PMN, I-EXPLORATION -glucorraquia I-EXPLORATION -y I-EXPLORATION -proteínas I-EXPLORATION -normales), I-EXPLORATION -pero I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -del I-EXPLORATION -LCR I-EXPLORATION -y I-EXPLORATION -sangre I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Una I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -cerebro I-EXPLORATION -con I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -evidenció I-EXPLORATION -edema I-EXPLORATION -cerebral I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -subdural I-EXPLORATION -bilateral I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -trasladó I-EXPLORATION -a I-EXPLORATION -nuestro I-EXPLORATION -centro I-EXPLORATION -para I-EXPLORATION -evaluación I-EXPLORATION -neuro-quirúrgica I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -diagnósticos I-EXPLORATION -de I-EXPLORATION -pansinusitis, I-EXPLORATION -meningitis I-EXPLORATION -aguda I-EXPLORATION -secundaria I-EXPLORATION -y I-EXPLORATION -colección I-EXPLORATION -subdural. I-EXPLORATION - I-EXPLORATION -Al I-EXPLORATION -ingreso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -unidad I-EXPLORATION -de I-EXPLORATION -cuidados I-EXPLORATION -intensivos I-EXPLORATION -pediátricos I-EXPLORATION -destacaba I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico: I-EXPLORATION -T° I-EXPLORATION -axilar I-EXPLORATION -38, I-EXPLORATION -3 I-EXPLORATION -°C, I-EXPLORATION -frecuencia I-EXPLORATION -cardíaca I-EXPLORATION -de I-EXPLORATION -65 I-EXPLORATION -por I-EXPLORATION -min, I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -140/90 I-EXPLORATION -mm I-EXPLORATION -Hg, I-EXPLORATION -escala I-EXPLORATION -de I-EXPLORATION -Glasgow: I-EXPLORATION -6, I-EXPLORATION -hiperreflexia, I-EXPLORATION -anisocoria I-EXPLORATION -midriática I-EXPLORATION -a I-EXPLORATION -derecha, I-EXPLORATION -rigidez I-EXPLORATION -de I-EXPLORATION -nuca, I-EXPLORATION -edema I-EXPLORATION -bipalpebral I-EXPLORATION -y I-EXPLORATION -quemosis, I-EXPLORATION -clonus I-EXPLORATION -bilateral I-EXPLORATION -mayor I-EXPLORATION -a I-EXPLORATION -derecha. I-EXPLORATION -La I-EXPLORATION -PCR I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -215 I-EXPLORATION -mg/L, I-EXPLORATION -el I-EXPLORATION -recuento I-EXPLORATION -leucocitario I-EXPLORATION -de I-EXPLORATION -15.800/mm3, I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -plaquetas I-EXPLORATION -normal. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -manejo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -hipertensión I-TREATMENT -endocraneana I-TREATMENT -con I-TREATMENT -intubación I-TREATMENT -endotraqueal I-TREATMENT -y I-TREATMENT -conexión I-TREATMENT -a I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -asociada I-TREATMENT -a I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -manitol, I-TREATMENT -sedoanalgesia I-TREATMENT -con I-TREATMENT -midazolam-fentanilo I-TREATMENT -y I-TREATMENT -soporte I-TREATMENT -inotrópico I-TREATMENT -con I-TREATMENT -dopamina. I-TREATMENT -Se I-TREATMENT -instauró I-TREATMENT -terapia I-TREATMENT -anticonvulsivante I-TREATMENT -con I-TREATMENT -fenitoína I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -triasociado I-TREATMENT -con I-TREATMENT -ceftriaxona, I-TREATMENT -metronidazol I-TREATMENT -y I-TREATMENT -vancomicina. I-TREATMENT -Una B-EXPLORATION -nueva I-EXPLORATION -TAC I-EXPLORATION -cerebral I-EXPLORATION -con I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -contraste I-EXPLORATION -mostró I-EXPLORATION -edema I-EXPLORATION -cerebral I-EXPLORATION -y I-EXPLORATION -progresión I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -colección I-EXPLORATION -subdural I-EXPLORATION -planteándose I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -empiema I-EXPLORATION -subdural I-EXPLORATION -con I-EXPLORATION -efecto I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -inicial. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -fue I-EXPLORATION -evaluado I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -equipo I-EXPLORATION -de I-EXPLORATION -otorrinolaringología I-EXPLORATION -y I-EXPLORATION -neurocirugía I-EXPLORATION -realizándose I-EXPLORATION -exploración I-EXPLORATION -del I-EXPLORATION -meato I-EXPLORATION -medio I-EXPLORATION -y B-TREATMENT -drenaje I-TREATMENT -del I-TREATMENT -seno I-TREATMENT -maxilar I-TREATMENT -derecho I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -endoscópica I-TREATMENT -y I-TREATMENT -en I-TREATMENT -las I-TREATMENT -horas I-TREATMENT -siguientes I-TREATMENT -etmoidectomía I-TREATMENT -derecha, I-TREATMENT -drenaje I-TREATMENT -de I-TREATMENT -un I-TREATMENT -absceso I-TREATMENT -orbitario I-TREATMENT -derecho I-TREATMENT -y I-TREATMENT -drenaje I-TREATMENT -de I-TREATMENT -un I-TREATMENT -empiema I-TREATMENT -subdural I-TREATMENT -izquierdo I-TREATMENT -desde I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -retiró I-TREATMENT -abundante I-TREATMENT -material I-TREATMENT -purulento. I-TREATMENT -El B-EXPLORATION -cultivo I-EXPLORATION -microbiológico I-EXPLORATION -de I-EXPLORATION -estas I-EXPLORATION -zonas I-EXPLORATION -para I-EXPLORATION -aerobios I-EXPLORATION -y I-EXPLORATION -anaerobios I-EXPLORATION -estrictos, I-EXPLORATION -procesado I-EXPLORATION -en I-EXPLORATION -sistema I-EXPLORATION -BACTEC/ALERT® I-EXPLORATION -FN I-EXPLORATION -con I-EXPLORATION -bajo I-EXPLORATION -potencial I-EXPLORATION -de I-EXPLORATION -oxido I-EXPLORATION -reducción I-EXPLORATION -y I-EXPLORATION -carbón I-EXPLORATION -activado, I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -permaneció I-EVOLUTION -en I-EVOLUTION -ventilación I-EVOLUTION -asistida I-EVOLUTION -durante I-EVOLUTION -siete I-EVOLUTION -días I-EVOLUTION -y I-EVOLUTION -cursó I-EVOLUTION -con I-EVOLUTION -regresión I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -hipertensión I-EVOLUTION -endocraneana I-EVOLUTION -y I-EVOLUTION -recuperación I-EVOLUTION -progresiva I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -escala I-EVOLUTION -de I-EVOLUTION -Glasgow. I-EVOLUTION -Tras B-EXPLORATION -tres I-EXPLORATION -semanas I-EXPLORATION -de I-EXPLORATION -antibioterapia I-EXPLORATION -triasociada, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -nueva I-EXPLORATION -TAC I-EXPLORATION -cerebral I-EXPLORATION -con I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -dos I-EXPLORATION -colecciones I-EXPLORATION -encefálicas I-EXPLORATION -frontales I-EXPLORATION -derechas, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -debió I-TREATMENT -realizarse I-TREATMENT -una I-TREATMENT -nueva I-TREATMENT -intervención I-TREATMENT -quirúrgica: I-TREATMENT -cranectomía I-TREATMENT -con I-TREATMENT -vaciamiento I-TREATMENT -frontal I-TREATMENT -derecho, I-TREATMENT -drenaje I-TREATMENT -de I-TREATMENT -empiema I-TREATMENT -con I-TREATMENT -dos I-TREATMENT -agujeros I-TREATMENT -de I-TREATMENT -trépano I-TREATMENT -y I-TREATMENT -durotomía I-TREATMENT -que I-TREATMENT -dio I-TREATMENT -salida I-TREATMENT -a I-TREATMENT -pus I-TREATMENT -abundante. I-TREATMENT -Los B-EXPLORATION -cultivos I-EXPLORATION -nuevamente I-EXPLORATION -resultaron I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -evolución I-EXPLORATION -posterior I-EXPLORATION -fue I-EXPLORATION -favorable, I-EXPLORATION -completando I-EXPLORATION -5 I-EXPLORATION -semanas I-EXPLORATION -de I-EXPLORATION -antibioterapia I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -seguimiento I-EXPLORATION -con I-EXPLORATION -TAC I-EXPLORATION -cerebral I-EXPLORATION -con I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -no I-EXPLORATION -reveló I-EXPLORATION -la I-EXPLORATION -formación I-EXPLORATION -de I-EXPLORATION -nuevas I-EXPLORATION -colecciones. I-EXPLORATION -En B-EVOLUTION -los I-EVOLUTION -controles I-EVOLUTION -clínicos I-EVOLUTION -post I-EVOLUTION -egreso I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentaba I-EVOLUTION -una I-EVOLUTION -afasia I-EVOLUTION -de I-EVOLUTION -expresión, I-EVOLUTION -logrando I-EVOLUTION -comunicación I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -escrita I-EVOLUTION -y I-EVOLUTION -una I-EVOLUTION -hemiparesia I-EVOLUTION -derecha I-EVOLUTION -actualmente I-EVOLUTION -en I-EVOLUTION -regresión. I-EVOLUTION - I-EVOLUTION - -Recién B-PRESENT_ILLNESS -nacida I-PRESENT_ILLNESS -(RN) I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -término, I-PRESENT_ILLNESS -segunda B-PAST_MEDICAL_HISTORY -hija I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -19 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -sana I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -controlado. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Parto I-PAST_MEDICAL_HISTORY -vaginal I-PAST_MEDICAL_HISTORY -espontáneo, I-PAST_MEDICAL_HISTORY -Apgar I-PAST_MEDICAL_HISTORY -9 I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -minuto I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -minutos, I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -nacimiento: I-PAST_MEDICAL_HISTORY -3.370 I-PAST_MEDICAL_HISTORY -g. I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -38, I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -°C, I-PRESENT_ILLNESS -quejido I-PRESENT_ILLNESS -respiratorio I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -distensión I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -decidió I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Neonatología I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -Parroquial I-PRESENT_ILLNESS -San I-PRESENT_ILLNESS -Bernardo. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaban I-EXPLORATION -su I-EXPLORATION -hipoactividad, I-EXPLORATION -mala I-EXPLORATION -perfusión I-EXPLORATION -periférica, I-EXPLORATION -ictericia I-EXPLORATION -moderada I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -abdomen I-EXPLORATION -distendido I-EXPLORATION -con I-EXPLORATION -leve I-EXPLORATION -resistencia I-EXPLORATION -muscular. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -mostraban I-EXPLORATION -leucocitos I-EXPLORATION -de I-EXPLORATION -5.300/mm3 I-EXPLORATION -sin I-EXPLORATION -desviación I-EXPLORATION -a I-EXPLORATION -izquierda, I-EXPLORATION -PCR: I-EXPLORATION -204 I-EXPLORATION -mg/l I-EXPLORATION -y I-EXPLORATION -gases I-EXPLORATION -sanguíneos I-EXPLORATION -con I-EXPLORATION -acidosis I-EXPLORATION -metabólica. I-EXPLORATION -Orina I-EXPLORATION -completa I-EXPLORATION -y I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -dio I-EXPLORATION -un I-EXPLORATION -LCR I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -turbio. I-EXPLORATION -Citoquímico I-EXPLORATION -del I-EXPLORATION -LCR: I-EXPLORATION -glucosa I-EXPLORATION -49 I-EXPLORATION -mg/dl, I-EXPLORATION -proteínas I-EXPLORATION -266 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -leucocitos: I-EXPLORATION -950/mm3 I-EXPLORATION -con I-EXPLORATION -70% I-EXPLORATION -PMN, I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram: I-EXPLORATION -cocáceas I-EXPLORATION -grampositivas I-EXPLORATION -en I-EXPLORATION -pares I-EXPLORATION -(diplo). I-EXPLORATION -Los I-EXPLORATION -látex I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -y I-EXPLORATION -LCR I-EXPLORATION -para I-EXPLORATION -detección I-EXPLORATION -de I-EXPLORATION -antígeno I-EXPLORATION -de I-EXPLORATION -S. I-EXPLORATION -agalactiae I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ampicilina I-TREATMENT -y I-TREATMENT -cefotaxima. I-TREATMENT -Los B-EXPLORATION -hemocultivos I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -hicieron I-EXPLORATION -positivos I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -7, I-EXPLORATION -3 I-EXPLORATION -horas I-EXPLORATION -de I-EXPLORATION -incubación, I-EXPLORATION -informándose I-EXPLORATION -cocáceas I-EXPLORATION -grampositivas I-EXPLORATION -en I-EXPLORATION -cadena. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -RN I-EXPLORATION -persistió I-EXPLORATION -febril, I-EXPLORATION -hipoactiva I-EXPLORATION -y I-EXPLORATION -hemodinámicamente I-EXPLORATION -estable. I-EXPLORATION -Un I-EXPLORATION -nuevo I-EXPLORATION -LCR I-EXPLORATION -obtenido I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -72 I-EXPLORATION -horas I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -turbio I-EXPLORATION -y I-EXPLORATION -tenía I-EXPLORATION -5.050 I-EXPLORATION -leucocitos/mm3 I-EXPLORATION -con I-EXPLORATION -100% I-EXPLORATION -PMN. I-EXPLORATION -El I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -esta I-EXPLORATION -muestra I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION -Se I-EXPLORATION -recibió I-EXPLORATION -informe I-EXPLORATION -de I-EXPLORATION -hemocultivos I-EXPLORATION -(2), I-EXPLORATION -urocultivo I-EXPLORATION -y I-EXPLORATION -LCR I-EXPLORATION -tomados I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -con I-EXPLORATION -desarrollo I-EXPLORATION -de I-EXPLORATION -Streptococcus I-EXPLORATION -grupo I-EXPLORATION -viridans I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -penicilina I-EXPLORATION -y I-EXPLORATION -cefotaxima. I-EXPLORATION -El I-EXPLORATION -laboratorio I-EXPLORATION -de I-EXPLORATION -microbiología I-EXPLORATION -comunicó I-EXPLORATION -la I-EXPLORATION -identificación I-EXPLORATION -como I-EXPLORATION -preliminar I-EXPLORATION -y I-EXPLORATION -sujeta I-EXPLORATION -a I-EXPLORATION -confirmación. I-EXPLORATION - I-EXPLORATION -Al B-TREATMENT -cuarto I-TREATMENT -día I-TREATMENT -de I-TREATMENT -hospitalización I-TREATMENT -y I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -la I-TREATMENT -mala I-TREATMENT -evolución, I-TREATMENT -fue I-TREATMENT -evaluada I-TREATMENT -por I-TREATMENT -infectóloga, I-TREATMENT -suspendiéndose I-TREATMENT -ampicilina I-TREATMENT -y I-TREATMENT -agregando I-TREATMENT -en I-TREATMENT -su I-TREATMENT -reemplazo I-TREATMENT -penicilina I-TREATMENT -400.000 I-TREATMENT -UI/kg/día I-TREATMENT -y I-TREATMENT -gentamicina I-TREATMENT -4 I-TREATMENT -mg/kg/día I-TREATMENT -como I-TREATMENT -esquema I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -asociado I-TREATMENT -para I-TREATMENT -Streptococcus I-TREATMENT -grupo I-TREATMENT -viridans. I-TREATMENT -La I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -cefotaxima I-TREATMENT -se I-TREATMENT -aumentó I-TREATMENT -de I-TREATMENT -100 I-TREATMENT -a I-TREATMENT -150 I-TREATMENT -mg/kg/día I-TREATMENT -para I-TREATMENT -optimizar I-TREATMENT -su I-TREATMENT -concentración I-TREATMENT -en I-TREATMENT -el I-TREATMENT -SNC I-TREATMENT -y I-TREATMENT -por I-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -absceso I-TREATMENT -cerebral. I-TREATMENT - I-TREATMENT -Hemocultivos B-EXPLORATION -obtenidos I-EXPLORATION -intra-tratamiento I-EXPLORATION -resultaron I-EXPLORATION -negativos, I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -ecográfico I-EXPLORATION -de I-EXPLORATION -cerebro I-EXPLORATION -y I-EXPLORATION -abdomen I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -ecocardiografía I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -foramen I-EXPLORATION -oval I-EXPLORATION -permeable, I-EXPLORATION -descartándose I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -vegetaciones. I-EXPLORATION -La I-EXPLORATION -RN I-EXPLORATION -evolucionó I-EXPLORATION -afebril I-EXPLORATION -desde I-EXPLORATION -las I-EXPLORATION -48 I-EXPLORATION -horas I-EXPLORATION -de I-EXPLORATION -cambiado I-EXPLORATION -el I-EXPLORATION -esquema I-EXPLORATION -antimicrobiano. I-EXPLORATION -Al I-EXPLORATION -séptimo I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -vida I-EXPLORATION -se I-EXPLORATION -controló I-EXPLORATION -el I-EXPLORATION -LCR I-EXPLORATION -informándose: I-EXPLORATION -38 I-EXPLORATION -leucocitos/mm3, I-EXPLORATION -93% I-EXPLORATION -PMN, I-EXPLORATION -proteínas I-EXPLORATION -164 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -glucosa I-EXPLORATION -46 I-EXPLORATION -mg/dl, I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -sin I-EXPLORATION -bacterias I-EXPLORATION -y I-EXPLORATION -cultivo I-EXPLORATION -negativo. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -control I-EXPLORATION -ulterior I-EXPLORATION -del I-EXPLORATION -LCR. I-EXPLORATION - I-EXPLORATION -Una I-EXPLORATION -vez I-EXPLORATION -recibido, I-EXPLORATION -al I-EXPLORATION -octavo I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -tratamiento, I-EXPLORATION -el I-EXPLORATION -informe I-EXPLORATION -microbiológico I-EXPLORATION -definitivo I-EXPLORATION -de I-EXPLORATION -Streptococcus I-EXPLORATION -pneumoniae I-EXPLORATION -y I-EXPLORATION -susceptibilidad I-EXPLORATION -corregida I-EXPLORATION -según I-EXPLORATION -los I-EXPLORATION -puntos I-EXPLORATION -de I-EXPLORATION -corte I-EXPLORATION -para I-EXPLORATION -meningitis, I-EXPLORATION -se B-TREATMENT -completó I-TREATMENT -tratamiento I-TREATMENT -sólo I-TREATMENT -con I-TREATMENT -cefotaxima. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -hacia I-EVOLUTION -la I-EVOLUTION -mejoría I-EVOLUTION -recibiendo I-EVOLUTION -cefotaxima I-EVOLUTION -durante I-EVOLUTION -21 I-EVOLUTION -días, I-EVOLUTION -duración I-EVOLUTION -determinada I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -lenta I-EVOLUTION -recuperación I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -parámetros I-EVOLUTION -de I-EVOLUTION -laboratorio. I-EVOLUTION -Fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -22 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -vida, I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones, I-EVOLUTION -no I-EVOLUTION -siendo I-EVOLUTION -posible I-EVOLUTION -realizar I-EVOLUTION -seguimiento I-EVOLUTION -post I-EVOLUTION -alta. I-EVOLUTION - I-EVOLUTION -Informe B-EXPLORATION -microbiológico. I-EXPLORATION -Dos I-EXPLORATION -hemocultivos, I-EXPLORATION -un I-EXPLORATION -urocultivo I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -LCR I-EXPLORATION -obtenidos I-EXPLORATION -al I-EXPLORATION -ingresar I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -resultaron I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -cocáceas I-EXPLORATION -grampositivas I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -diplo. I-EXPLORATION -Los I-EXPLORATION -hemocultivos I-EXPLORATION -se I-EXPLORATION -hicieron I-EXPLORATION -positivos I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -7, I-EXPLORATION -3 I-EXPLORATION -horas I-EXPLORATION -de I-EXPLORATION -incubación I-EXPLORATION -(sistema I-EXPLORATION -BacT/Alert®, I-EXPLORATION -bioMérieux). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -subcultivo I-EXPLORATION -en I-EXPLORATION -agar I-EXPLORATION -sangre I-EXPLORATION -de I-EXPLORATION -cordero I-EXPLORATION -5% I-EXPLORATION -y I-EXPLORATION -agar I-EXPLORATION -chocolate I-EXPLORATION -(bioMérieux). I-EXPLORATION -Las I-EXPLORATION -placas I-EXPLORATION -se I-EXPLORATION -incubaron I-EXPLORATION -por I-EXPLORATION -24 I-EXPLORATION -horas I-EXPLORATION -a I-EXPLORATION -35°C I-EXPLORATION -en I-EXPLORATION -atmósfera I-EXPLORATION -con I-EXPLORATION -3 I-EXPLORATION -a I-EXPLORATION -5% I-EXPLORATION -de I-EXPLORATION -CO2 I-EXPLORATION -obteniéndose I-EXPLORATION -desarrollo I-EXPLORATION -de I-EXPLORATION -colonias I-EXPLORATION -a I-EXPLORATION -hemolíticas I-EXPLORATION -umbilicadas. I-EXPLORATION -Dado I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -obtuvo I-EXPLORATION -crecimiento I-EXPLORATION -de I-EXPLORATION -colonias I-EXPLORATION -fenotípicamente I-EXPLORATION -similares I-EXPLORATION -en I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -cultivos, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -la I-EXPLORATION -identificación I-EXPLORATION -a I-EXPLORATION -partir I-EXPLORATION -del I-EXPLORATION -crecimiento I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -hemocultivos. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -prueba I-EXPLORATION -de I-EXPLORATION -susceptibilidad I-EXPLORATION -a I-EXPLORATION -optoquina I-EXPLORATION -detectó I-EXPLORATION -resistencia I-EXPLORATION -a I-EXPLORATION -ella, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -emitió I-EXPLORATION -un I-EXPLORATION -informe I-EXPLORATION -preliminar I-EXPLORATION -de: I-EXPLORATION -Streptococcus I-EXPLORATION -grupo I-EXPLORATION -viridans. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -susceptibilidad I-EXPLORATION -para I-EXPLORATION -penicilina I-EXPLORATION -y I-EXPLORATION -cefotaxima I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -mediante I-EXPLORATION -E- I-EXPLORATION -test I-EXPLORATION -y I-EXPLORATION -fue I-EXPLORATION -interpretado I-EXPLORATION -utilizando I-EXPLORATION -los I-EXPLORATION -puntos I-EXPLORATION -de I-EXPLORATION -corte I-EXPLORATION -NCCLS/CLSI I-EXPLORATION -vigentes4 I-EXPLORATION -para I-EXPLORATION -Streptococcus I-EXPLORATION -no I-EXPLORATION -pneumoniae I-EXPLORATION -resultando I-EXPLORATION -sensible I-EXPLORATION -para I-EXPLORATION -penicilina I-EXPLORATION -y I-EXPLORATION -cefotaxima I-EXPLORATION -(penicilina I-EXPLORATION -0, I-EXPLORATION -015 I-EXPLORATION -µg/ml I-EXPLORATION -y I-EXPLORATION -cefotaxima I-EXPLORATION -0, I-EXPLORATION -032 I-EXPLORATION -µg/ml). I-EXPLORATION -Debido I-EXPLORATION -a I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -aspecto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -colonia I-EXPLORATION -era I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -S. I-EXPLORATION -pneumoniae, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -identificación I-EXPLORATION -mediante I-EXPLORATION -API I-EXPLORATION -20 I-EXPLORATION -Strep I-EXPLORATION -(bioMérieux) I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -no I-EXPLORATION -arrojó I-EXPLORATION -resultados I-EXPLORATION -concluyentes I-EXPLORATION -(S. I-EXPLORATION -mitis I-EXPLORATION -(33%), I-EXPLORATION -S. I-EXPLORATION -oralis I-EXPLORATION -(20%), I-EXPLORATION -S. I-EXPLORATION -sanguis I-EXPLORATION -(29%)). I-EXPLORATION -La I-EXPLORATION -cepa I-EXPLORATION -fue I-EXPLORATION -enviada I-EXPLORATION -al I-EXPLORATION -Programa I-EXPLORATION -de I-EXPLORATION -Microbiología, I-EXPLORATION -I.C.B.M., I-EXPLORATION -Universidad I-EXPLORATION -de I-EXPLORATION -Chile, I-EXPLORATION -donde I-EXPLORATION -uno I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -autores I-EXPLORATION -(MTUF) I-EXPLORATION -realizó I-EXPLORATION -prueba I-EXPLORATION -de I-EXPLORATION -solubilidad I-EXPLORATION -en I-EXPLORATION -bilis I-EXPLORATION -(soluble), I-EXPLORATION -detección I-EXPLORATION -de I-EXPLORATION -antígeno I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -celular I-EXPLORATION -de I-EXPLORATION -S. I-EXPLORATION -pneumoniae I-EXPLORATION -por I-EXPLORATION -inmunocromatografía I-EXPLORATION -(BinaxNow®)(positivo) I-EXPLORATION -y I-EXPLORATION -RPC I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -gen I-EXPLORATION -de I-EXPLORATION -neumolisina I-EXPLORATION -(positivo), I-EXPLORATION -identificándose I-EXPLORATION -el I-EXPLORATION -microorganismo I-EXPLORATION -definitivamente I-EXPLORATION -como I-EXPLORATION -Streptococcus I-EXPLORATION -pneumoniae. I-EXPLORATION -La I-EXPLORATION -cepa I-EXPLORATION -fue I-EXPLORATION -enviada I-EXPLORATION -al I-EXPLORATION -Instituto I-EXPLORATION -de I-EXPLORATION -Salud I-EXPLORATION -Pública I-EXPLORATION -cumpliendo I-EXPLORATION -la I-EXPLORATION -normativa I-EXPLORATION -vigente I-EXPLORATION -de I-EXPLORATION -envío I-EXPLORATION -de I-EXPLORATION -S. I-EXPLORATION -pneumoniae I-EXPLORATION -invasores I-EXPLORATION -al I-EXPLORATION -centro I-EXPLORATION -de I-EXPLORATION -referencia. I-EXPLORATION -Se I-EXPLORATION -recibió I-EXPLORATION -informe I-EXPLORATION -de I-EXPLORATION -identificación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cepa I-EXPLORATION -como I-EXPLORATION -Streptococcus I-EXPLORATION -pneumoniae I-EXPLORATION -serotipo I-EXPLORATION -5, I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -penicilina. I-EXPLORATION - I-EXPLORATION -Una I-EXPLORATION -vez I-EXPLORATION -hecho I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -microbiológico, I-EXPLORATION -se I-EXPLORATION -corrigió I-EXPLORATION -la I-EXPLORATION -interpretación I-EXPLORATION -de I-EXPLORATION -susceptibilidad I-EXPLORATION -para I-EXPLORATION -cefotaxima I-EXPLORATION -según I-EXPLORATION -los I-EXPLORATION -puntos I-EXPLORATION -de I-EXPLORATION -corte I-EXPLORATION -correspondientes I-EXPLORATION -a I-EXPLORATION -S. I-EXPLORATION -pneumoniae I-EXPLORATION -de I-EXPLORATION -localización I-EXPLORATION -meníngea, I-EXPLORATION -permaneciendo I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -categoría I-EXPLORATION -de I-EXPLORATION -susceptible I-EXPLORATION -tanto I-EXPLORATION -a I-EXPLORATION -penicilina I-EXPLORATION -como I-EXPLORATION -a I-EXPLORATION -cefotaxima. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -27 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -residente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Santiago, I-PAST_MEDICAL_HISTORY -soltero I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -heterosexual, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -infección I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -VIH I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -septiembre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2003 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -serología I-PAST_MEDICAL_HISTORY -confirmatoria I-PAST_MEDICAL_HISTORY -efectuada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -laboratorio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -referencia I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -Instituto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Salud I-PAST_MEDICAL_HISTORY -Pública I-PAST_MEDICAL_HISTORY -(ISP). I-PAST_MEDICAL_HISTORY -Fue I-PAST_MEDICAL_HISTORY -catalogado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -etapa I-PAST_MEDICAL_HISTORY -A, I-PAST_MEDICAL_HISTORY -nunca I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -realizó I-PAST_MEDICAL_HISTORY -determinación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -linfocitos I-PAST_MEDICAL_HISTORY -CD4 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tuvo I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -irregulares I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -otra I-PAST_MEDICAL_HISTORY -policlínica. I-PAST_MEDICAL_HISTORY -Desde I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -vivía I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -calle, I-PAST_MEDICAL_HISTORY -dedicado I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -comercio I-PAST_MEDICAL_HISTORY -ambulante I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -alojaba I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -residencia I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -individuos I-PAST_MEDICAL_HISTORY -indigentes. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Desde I-PAST_MEDICAL_HISTORY -abril I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2005 I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -aumento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -volumen I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -frontal, I-PAST_MEDICAL_HISTORY -asociándose, I-PAST_MEDICAL_HISTORY -además, I-PAST_MEDICAL_HISTORY -lesiones I-PAST_MEDICAL_HISTORY -papulares I-PAST_MEDICAL_HISTORY -eritematosas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -extremidades, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -consultó I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -policlínica I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Infectología-VIH, I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -Hospital I-PAST_MEDICAL_HISTORY -San I-PAST_MEDICAL_HISTORY -Juan I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Dios, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -agosto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2005. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -observaba I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -absceso I-PAST_MEDICAL_HISTORY -frontal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -lesiones I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -forúnculos I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ambas I-PAST_MEDICAL_HISTORY -extremidades, I-PAST_MEDICAL_HISTORY -siendo I-PAST_MEDICAL_HISTORY -enviado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -servicio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -urgencia I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -debridamiento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -absceso I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -obtención I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cultivos. I-PAST_MEDICAL_HISTORY -Acudió B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -control I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -semanas, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -progresión I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -absceso I-PRESENT_ILLNESS -frontal I-PRESENT_ILLNESS -(5 I-PRESENT_ILLNESS -x I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diámetro), I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -área I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -necrosis I-PRESENT_ILLNESS -central I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -borde I-PRESENT_ILLNESS -eritematoso I-PRESENT_ILLNESS -extenso, I-PRESENT_ILLNESS -coincidiendo I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuevas I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -papulares I-PRESENT_ILLNESS -eritematosas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -cm. I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diámetro I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cara, I-PRESENT_ILLNESS -principalmente, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -barba, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -extremidades I-PRESENT_ILLNESS -inferiores- I-PRESENT_ILLNESS -algunas I-PRESENT_ILLNESS -subcutáneas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -consistencia I-PRESENT_ILLNESS -blanda, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -dolorosas- I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -violáceas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -anterior I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tórax I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -extremidades I-PRESENT_ILLNESS -inferiores. I-PRESENT_ILLNESS -También I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -apreció I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -mucoso, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -exofiticas I-PRESENT_ILLNESS -costrosas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ángulo I-PRESENT_ILLNESS -interno I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ojo, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diámetro, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ambas I-PRESENT_ILLNESS -conjuntivas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -exofíticas I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -ulceración I-PRESENT_ILLNESS -central I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mucosa I-PRESENT_ILLNESS -oral, I-PRESENT_ILLNESS -localizadas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -vestibular I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -labio I-PRESENT_ILLNESS -inferior, I-PRESENT_ILLNESS -paladar I-PRESENT_ILLNESS -duro I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -blando. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -general I-EXPLORATION -se I-EXPLORATION -destacó I-EXPLORATION -un I-EXPLORATION -paciente I-EXPLORATION -en I-EXPLORATION -malas I-EXPLORATION -condiciones I-EXPLORATION -higiénicas, I-EXPLORATION -pálido, I-EXPLORATION -con I-EXPLORATION -candidiasis I-EXPLORATION -orofaríngea, I-EXPLORATION -T° I-EXPLORATION -axilar I-EXPLORATION -de I-EXPLORATION -37, I-EXPLORATION -5° I-EXPLORATION -C, I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -corporal I-EXPLORATION -de I-EXPLORATION -18, I-EXPLORATION -sin I-EXPLORATION -adenopatías I-EXPLORATION -regionales. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -cardiovascular I-EXPLORATION -no I-EXPLORATION -reveló I-EXPLORATION -alteraciones I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -visceromegalia I-EXPLORATION -abdominal. I-EXPLORATION -No I-EXPLORATION -presentaba I-EXPLORATION -compromiso I-EXPLORATION -neurológico I-EXPLORATION -clínico. I-EXPLORATION - I-EXPLORATION -Otros B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -relevantes I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -aparecieron I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -fueron I-PAST_MEDICAL_HISTORY -viajes I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -mochilero I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -Perú I-PAST_MEDICAL_HISTORY -(Tacna) I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2001 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -Bolivia I-PAST_MEDICAL_HISTORY -(Ororuro) I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -2003. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -mascotas; I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -embargo, I-PAST_MEDICAL_HISTORY -refirió I-PAST_MEDICAL_HISTORY -tener I-PAST_MEDICAL_HISTORY -contacto, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -frecuente, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -gatos I-PAST_MEDICAL_HISTORY -callejeros I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -todas I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -edades, I-PAST_MEDICAL_HISTORY -habiendo I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -rasguñado I-PAST_MEDICAL_HISTORY -ocasionalmente. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Se B-EVOLUTION -decidió, I-EVOLUTION -entonces, I-EVOLUTION -su I-EVOLUTION -hospitalización I-EVOLUTION -para I-EVOLUTION -realizar I-EVOLUTION -estudios. I-EVOLUTION -De B-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -generales I-EXPLORATION -destacó I-EXPLORATION -un I-EXPLORATION -hematocrito I-EXPLORATION -de I-EXPLORATION -31% I-EXPLORATION -con I-EXPLORATION -VCM I-EXPLORATION -80 I-EXPLORATION -fl I-EXPLORATION -y I-EXPLORATION -CHCM I-EXPLORATION -32%, I-EXPLORATION -leucocitos I-EXPLORATION -de I-EXPLORATION -5.700 I-EXPLORATION -céls/mm3, I-EXPLORATION -sin I-EXPLORATION -desviación I-EXPLORATION -a I-EXPLORATION -izquierda I-EXPLORATION -y I-EXPLORATION -plaquetas I-EXPLORATION -310.000 I-EXPLORATION -céls/mmm3, I-EXPLORATION -VHS I-EXPLORATION -81 I-EXPLORATION -mm/h, I-EXPLORATION -sin I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -hepática, I-EXPLORATION -con I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -de I-EXPLORATION -85 I-EXPLORATION -U/L I-EXPLORATION -y I-EXPLORATION -LDH I-EXPLORATION -185 I-EXPLORATION -U/L. I-EXPLORATION -Del I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -patología I-EXPLORATION -de I-EXPLORATION -base, I-EXPLORATION -tenía I-EXPLORATION -una I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION -(Nuclisens I-EXPLORATION -HIV-1 I-EXPLORATION -QT, I-EXPLORATION -Biomérieux) I-EXPLORATION -de I-EXPLORATION -130.000 I-EXPLORATION -copias I-EXPLORATION -ARN I-EXPLORATION -viral/ml I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -CD4 I-EXPLORATION -de I-EXPLORATION -83 I-EXPLORATION -céls/mm3. I-EXPLORATION -Los I-EXPLORATION -hemocultivos I-EXPLORATION -automatizados I-EXPLORATION -aeróbicos I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -siete I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -incubación, I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -secreción I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -lesión I-EXPLORATION -frontal I-EXPLORATION -también I-EXPLORATION -fue I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -bacterias, I-EXPLORATION -lo I-EXPLORATION -mismo I-EXPLORATION -la I-EXPLORATION -baciloscopia I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -micobacterias. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -imágenes I-EXPLORATION -realizado I-EXPLORATION -mostró: I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -normal, I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -patológicos I-EXPLORATION -y I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -cráneo I-EXPLORATION -sin I-EXPLORATION -lesiones I-EXPLORATION -osteolíticas. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -envió I-EXPLORATION -una I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -suero I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -anticuerpos I-EXPLORATION -IgG I-EXPLORATION -para I-EXPLORATION -B. I-EXPLORATION -henselae I-EXPLORATION -y I-EXPLORATION -B. I-EXPLORATION -quintana I-EXPLORATION -por I-EXPLORATION -inmunofluorescencia I-EXPLORATION -(Focus®) I-EXPLORATION -al I-EXPLORATION -Laboratorio I-EXPLORATION -de I-EXPLORATION -Infectología I-EXPLORATION -y I-EXPLORATION -Virología I-EXPLORATION -Molecular I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Pontificia I-EXPLORATION -Universidad I-EXPLORATION -Católica I-EXPLORATION -de I-EXPLORATION -Chile, I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -con I-EXPLORATION -títulos I-EXPLORATION -> I-EXPLORATION -1/256 I-EXPLORATION -para I-EXPLORATION -B. I-EXPLORATION -henselae I-EXPLORATION -y I-EXPLORATION -> I-EXPLORATION -1: I-EXPLORATION -64 I-EXPLORATION -para I-EXPLORATION -B. I-EXPLORATION -quintana. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -efectuó I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -cutánea I-EXPLORATION -frontal I-EXPLORATION -cuyo I-EXPLORATION -informe I-EXPLORATION -indicó: I-EXPLORATION -piel I-EXPLORATION -ulcerada I-EXPLORATION -por I-EXPLORATION -epitelio I-EXPLORATION -escamoso I-EXPLORATION -maduro, I-EXPLORATION -proliferación I-EXPLORATION -lobulillar I-EXPLORATION -de I-EXPLORATION -vasos I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -calibre, I-EXPLORATION -abundantes I-EXPLORATION -polimorfos I-EXPLORATION -nucleares I-EXPLORATION -intersticiales, I-EXPLORATION -algunos I-EXPLORATION -con I-EXPLORATION -cariorrexis. I-EXPLORATION -La I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Warthin I-EXPLORATION -Starry I-EXPLORATION -demostró I-EXPLORATION -estructuras I-EXPLORATION -cocobacilares I-EXPLORATION -en I-EXPLORATION -acúmulos I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -Bartonella I-EXPLORATION -sp. I-EXPLORATION - I-EXPLORATION -Dada B-TREATMENT -la I-TREATMENT -alta I-TREATMENT -sospecha I-TREATMENT -clínica, I-TREATMENT -después I-TREATMENT -de I-TREATMENT -tomar I-TREATMENT -cultivos I-TREATMENT -y I-TREATMENT -biopsia, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -azitromicina I-TREATMENT -500 I-TREATMENT -mg/d I-TREATMENT -v.o. I-TREATMENT -más I-TREATMENT -ciprofloxacina I-TREATMENT -500 I-TREATMENT -mg I-TREATMENT -c/12 I-TREATMENT -hs I-TREATMENT -v.o. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -cirugía I-TREATMENT -de I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -las I-TREATMENT -lesiones I-TREATMENT -exofiticas I-TREATMENT -conjuntivales I-TREATMENT -bilaterales, I-TREATMENT -las B-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -enviaron I-EXPLORATION -a I-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -que I-EXPLORATION -concluyó: I-EXPLORATION -tejido I-EXPLORATION -conectivo I-EXPLORATION -con I-EXPLORATION -epitelio I-EXPLORATION -escamoso I-EXPLORATION -y I-EXPLORATION -cilíndrico I-EXPLORATION -hiperplásico, I-EXPLORATION -proceso I-EXPLORATION -inflamatorio I-EXPLORATION -agudo I-EXPLORATION -y I-EXPLORATION -crónico, I-EXPLORATION -abundantes I-EXPLORATION -vasos I-EXPLORATION -de I-EXPLORATION -neoformación, I-EXPLORATION -material I-EXPLORATION -amorfo I-EXPLORATION -intersticial. I-EXPLORATION -La I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Warthin I-EXPLORATION -Starry I-EXPLORATION -demostró I-EXPLORATION -estructuras I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -Bartonella I-EXPLORATION -spp, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -angiomatosis I-EXPLORATION -bacilar. I-EXPLORATION - I-EXPLORATION -Para I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -molecular I-EXPLORATION -se I-EXPLORATION -efectuó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -violáceo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -abdominal I-EXPLORATION -anterior I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -envió I-EXPLORATION -al I-EXPLORATION -Laboratorio I-EXPLORATION -de I-EXPLORATION -Biología I-EXPLORATION -Molecular I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Pontificia I-EXPLORATION -Universidad I-EXPLORATION -Católica I-EXPLORATION -de I-EXPLORATION -Chile. I-EXPLORATION -La I-EXPLORATION -extracción I-EXPLORATION -del I-EXPLORATION -ADN I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -subcutáneo I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -utilizando I-EXPLORATION -un I-EXPLORATION -método I-EXPLORATION -comercial I-EXPLORATION -(QIAamp I-EXPLORATION -Tissue I-EXPLORATION -kit, I-EXPLORATION -Qiagen®), I-EXPLORATION -según I-EXPLORATION -las I-EXPLORATION -recomendaciones I-EXPLORATION -del I-EXPLORATION -fabricante. I-EXPLORATION -La I-EXPLORATION -amplificación I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -que I-EXPLORATION -codifica I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -16S I-EXPLORATION -ARNr I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -con I-EXPLORATION -partidores I-EXPLORATION -universales15. I-EXPLORATION -Posteriormente, I-EXPLORATION -se I-EXPLORATION -secuenció I-EXPLORATION -el I-EXPLORATION -producto I-EXPLORATION -amplificado I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -evaluó I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -analizador I-EXPLORATION -genético I-EXPLORATION -ABI I-EXPLORATION -310. I-EXPLORATION -Para I-EXPLORATION -la I-EXPLORATION -comparación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -secuencia I-EXPLORATION -nucleotídica I-EXPLORATION -obtenida I-EXPLORATION -con I-EXPLORATION -las I-EXPLORATION -secuencias I-EXPLORATION -depositadas I-EXPLORATION -en I-EXPLORATION -banco I-EXPLORATION -de I-EXPLORATION -genes I-EXPLORATION -Genebank, I-EXPLORATION -se I-EXPLORATION -utilizó I-EXPLORATION -al I-EXPLORATION -programa I-EXPLORATION -BLAST. I-EXPLORATION -Se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -homología I-EXPLORATION -de I-EXPLORATION -100% I-EXPLORATION -sobre I-EXPLORATION -418 I-EXPLORATION -pares I-EXPLORATION -de I-EXPLORATION -bases I-EXPLORATION -depositadas I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -especie I-EXPLORATION -B. I-EXPLORATION -quintana I-EXPLORATION -subespecie I-EXPLORATION -Toulouse, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -confirmó, I-EXPLORATION -posteriormente, I-EXPLORATION -por I-EXPLORATION -amplificación I-EXPLORATION -y I-EXPLORATION -secuenciación I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -segmentos I-EXPLORATION -ITS I-EXPLORATION -y I-EXPLORATION -336, I-EXPLORATION -que I-EXPLORATION -son I-EXPLORATION -específicos I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -género I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -especie, I-EXPLORATION -respectivamente. I-EXPLORATION - I-EXPLORATION -Previo B-TREATMENT -al I-TREATMENT -alta, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -terapia I-TREATMENT -antiretroviral I-TREATMENT -con I-TREATMENT -zidovudina, I-TREATMENT -lamivudina I-TREATMENT -y I-TREATMENT -efavirenz I-TREATMENT -con I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -infección I-TREATMENT -por I-TREATMENT -VIH I-TREATMENT -en I-TREATMENT -etapa I-TREATMENT -B-3 I-TREATMENT -y I-TREATMENT -angiomatosis I-TREATMENT -bacilar I-TREATMENT -por I-TREATMENT -B. I-TREATMENT -quintana. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -al I-EVOLUTION -inicio I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -antibioterapia I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -satisfactoria, I-EVOLUTION -con I-EVOLUTION -regresión I-EVOLUTION -del I-EVOLUTION -compromiso I-EVOLUTION -cutáneo I-EVOLUTION -y I-EVOLUTION -mucoso I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -cuatro I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -tratamiento. I-EVOLUTION - I-EVOLUTION - -Adolescente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -14 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad. I-PRESENT_ILLNESS -Durante I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -campamento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -verano I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -carpa I-PRESENT_ILLNESS -junto I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -familia, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -localidad I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Quisco, I-PRESENT_ILLNESS -Vª I-PRESENT_ILLNESS -Región, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -agachó I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -recoger I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -pelota I-PRESENT_ILLNESS -bajo I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -matorrales. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -ese I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -sintió I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -algo I-PRESENT_ILLNESS -apretaba I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -mano I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -Al I-PRESENT_ILLNESS -retirar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mano I-PRESENT_ILLNESS -vio I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -gran I-PRESENT_ILLNESS -culebra I-PRESENT_ILLNESS -prendada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -dorso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mano, I-PRESENT_ILLNESS -entre I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -dedos I-PRESENT_ILLNESS -pulgar I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -índice. I-PRESENT_ILLNESS -Ella I-PRESENT_ILLNESS -cogió I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cabeza I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -culebra I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -detrás, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mano I-PRESENT_ILLNESS -libre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -cabo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -algunos I-PRESENT_ILLNESS -segundos I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -reptil I-PRESENT_ILLNESS -soltó I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mano, I-PRESENT_ILLNESS -alcanzando I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -enrollarse I-PRESENT_ILLNESS -alrededor I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -brazo I-PRESENT_ILLNESS -izquierdo. I-PRESENT_ILLNESS -Para I-PRESENT_ILLNESS -evitar I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -culebra I-PRESENT_ILLNESS -escapara, I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -padres I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mataron I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -guardaron I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -recipiente. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -culebra I-PRESENT_ILLNESS -medía I-PRESENT_ILLNESS -137 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -longitud, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -cola I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -cm. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -dorsal I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -franja I-PRESENT_ILLNESS -oscura I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -flanqueada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -franjas I-PRESENT_ILLNESS -claras I-PRESENT_ILLNESS -laterales. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -logró I-PRESENT_ILLNESS -encontrar I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -dientes I-PRESENT_ILLNESS -inocu-ladores I-PRESENT_ILLNESS -posteriores. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -mordedura I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -provocó I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -accidente I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -logró I-PRESENT_ILLNESS -apreciar I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -sitio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -inoculación. I-PRESENT_ILLNESS -Aproximadamente I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -cabo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -minutos, I-PRESENT_ILLNESS -inició I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -sitio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mordedura. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Fue I-PRESENT_ILLNESS -llevada I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -Carlos I-PRESENT_ILLNESS -van I-PRESENT_ILLNESS -Buren, I-PRESENT_ILLNESS -Valparaíso, I-PRESENT_ILLNESS -Vª I-PRESENT_ILLNESS -Región. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION -inicial I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -un I-EXPLORATION -edema I-EXPLORATION -circunferencial I-EXPLORATION -que I-EXPLORATION -abarcaba I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -unión I-EXPLORATION -del I-EXPLORATION -tercio I-EXPLORATION -medio I-EXPLORATION -inferior I-EXPLORATION -del I-EXPLORATION -brazo, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -herida I-EXPLORATION -puntiforme I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mano I-EXPLORATION -izquierda I-EXPLORATION -y I-EXPLORATION -erosión I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -vecina, I-EXPLORATION -los I-EXPLORATION -dedos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -extremidad I-EXPLORATION -afectada I-EXPLORATION -se I-EXPLORATION -encontraban I-EXPLORATION -fríos, I-EXPLORATION -no I-EXPLORATION -refería I-EXPLORATION -mialgias. I-EXPLORATION - I-EXPLORATION -Fue B-TREATMENT -hospitalizada I-TREATMENT -con I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -mordedura I-TREATMENT -por I-TREATMENT -ofidio I-TREATMENT -y I-TREATMENT -observación I-TREATMENT -de I-TREATMENT -un I-TREATMENT -síndrome I-TREATMENT -com-partamental. I-TREATMENT -Se I-TREATMENT -indicó I-TREATMENT -como I-TREATMENT -tratamiento I-TREATMENT -corticoste-roides I-TREATMENT -y I-TREATMENT -anti-histamínicos I-TREATMENT -endovenosos, I-TREATMENT -analgésicos I-TREATMENT -tipo I-TREATMENT -AINE I-TREATMENT -y I-TREATMENT -ampicilina I-TREATMENT -parenteral. I-TREATMENT -Las I-TREATMENT -medidas I-TREATMENT -locales I-TREATMENT -indicadas I-TREATMENT -fueron I-TREATMENT -brazo I-TREATMENT -en I-TREATMENT -alto I-TREATMENT -y I-TREATMENT -aplicación I-TREATMENT -de I-TREATMENT -hielo. I-TREATMENT - I-TREATMENT -De B-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -solicitados I-EXPLORATION -destacaban: I-EXPLORATION -protrombinemia: I-EXPLORATION -57% I-EXPLORATION -(VN= I-EXPLORATION -70-100%), I-EXPLORATION -TTPK: I-EXPLORATION -41 I-EXPLORATION -seg I-EXPLORATION -(VN= I-EXPLORATION -26-36 I-EXPLORATION -seg), I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -plaquetas: I-EXPLORATION -300.000 I-EXPLORATION -(VN= I-EXPLORATION -150.000-400.000/mm3), I-EXPLORATION -hematocrito: I-EXPLORATION -44% I-EXPLORATION -(VN= I-EXPLORATION -34-44%); I-EXPLORATION -hemoglobinemia: I-EXPLORATION -14, I-EXPLORATION -6 I-EXPLORATION -gr/dL I-EXPLORATION -(VN= I-EXPLORATION -11, I-EXPLORATION -6-15 I-EXPLORATION -gr/ I-EXPLORATION -dL). I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -leucocitos. I-EXPLORATION - I-EXPLORATION -Evolucionó B-EVOLUTION -en I-EVOLUTION -regulares I-EVOLUTION -condiciones I-EVOLUTION -generales I-EVOLUTION -las I-EVOLUTION -primeras I-EVOLUTION -24 I-EVOLUTION -horas, I-EVOLUTION -sin I-EVOLUTION -fiebre, I-EVOLUTION -pero I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -intenso I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -extremidad I-EVOLUTION -superior I-EVOLUTION -izquierda. I-EVOLUTION -El I-EVOLUTION -edema I-EVOLUTION -se I-EVOLUTION -extendió I-EVOLUTION -hasta I-EVOLUTION -la I-EVOLUTION -región I-EVOLUTION -del I-EVOLUTION -hombro I-EVOLUTION -y I-EVOLUTION -zona I-EVOLUTION -pectoral I-EVOLUTION -y I-EVOLUTION -los I-EVOLUTION -dedos I-EVOLUTION -tomaron I-EVOLUTION -un I-EVOLUTION -aspecto I-EVOLUTION -equimótico. I-EVOLUTION -Destacó B-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -el I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -afectada I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -consistencia I-EXPLORATION -acartonada I-EXPLORATION -del I-EXPLORATION -edema. I-EXPLORATION -Presentó I-EXPLORATION -cefalea I-EXPLORATION -intensa, I-EXPLORATION -náuseas I-EXPLORATION -y I-EXPLORATION -febrículas, I-EXPLORATION -sin I-EXPLORATION -evidencias I-EXPLORATION -de I-EXPLORATION -sangramientos. I-EXPLORATION -La I-EXPLORATION -orina I-EXPLORATION -fue I-EXPLORATION -evaluada I-EXPLORATION -diariamente I-EXPLORATION -por I-EXPLORATION -colorometría I-EXPLORATION -a I-EXPLORATION -ojo I-EXPLORATION -desnudo, I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -detección I-EXPLORATION -de I-EXPLORATION -hemoglobinuria. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -mantuvo I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -analgésicos I-TREATMENT -y I-TREATMENT -corti-costeroides I-TREATMENT -endovenosos I-TREATMENT -y I-TREATMENT -el I-TREATMENT -edema I-TREATMENT -del I-TREATMENT -antebrazo I-TREATMENT -y I-TREATMENT -brazo I-TREATMENT -comenzó I-TREATMENT -a I-TREATMENT -disminuir. I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -aparecieron I-EVOLUTION -bulas I-EVOLUTION -serohemorrágicas I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -zona I-EVOLUTION -del I-EVOLUTION -pliegue I-EVOLUTION -del I-EVOLUTION -codo I-EVOLUTION -derecho, I-EVOLUTION -disminuyó I-EVOLUTION -la I-EVOLUTION -cefalea, I-EVOLUTION -desaparecieron I-EVOLUTION -las I-EVOLUTION -náuseas I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -fiebre, I-EVOLUTION -con I-EVOLUTION -persistencia I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -extremidad. I-EVOLUTION -La I-EVOLUTION -movilidad I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -dedos I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -muñeca I-EVOLUTION -estaban I-EVOLUTION -limitadas, I-EVOLUTION -pero I-EVOLUTION -con I-EVOLUTION -palpación I-EVOLUTION -de I-EVOLUTION -pulsos I-EVOLUTION -arteriales I-EVOLUTION -normales. I-EVOLUTION -Los I-EVOLUTION -cirujanos I-EVOLUTION -descartaron I-EVOLUTION -un I-EVOLUTION -síndrome I-EVOLUTION -compartamental. I-EVOLUTION - I-EVOLUTION -A I-EVOLUTION -las I-EVOLUTION -72 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -evolución, I-EVOLUTION -tanto I-EVOLUTION -el I-EVOLUTION -edema I-EVOLUTION -como I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -se I-EVOLUTION -encontraban I-EVOLUTION -en I-EVOLUTION -franca I-EVOLUTION -regresión I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -suspendieron I-EVOLUTION -los I-EVOLUTION -corticosteroides I-EVOLUTION -y I-EVOLUTION -anti-histamínicos. I-EVOLUTION -Al I-EVOLUTION -cuarto I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -se I-EVOLUTION -dio I-EVOLUTION -de I-EVOLUTION -alta, I-EVOLUTION -casi I-EVOLUTION -sin I-EVOLUTION -molestias, I-EVOLUTION -con B-TREATMENT -indicación I-TREATMENT -de I-TREATMENT -completar I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -predni-sona I-TREATMENT -durante I-TREATMENT -dos I-TREATMENT -días I-TREATMENT -y I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -por I-TREATMENT -seis I-TREATMENT -días. I-TREATMENT - I-TREATMENT - -Un B-PRESENT_ILLNESS -RN I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -21 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -de B-PAST_MEDICAL_HISTORY -raza I-PAST_MEDICAL_HISTORY -negra I-PAST_MEDICAL_HISTORY -y B-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -38, I-PRESENT_ILLNESS -5°C, I-PRESENT_ILLNESS -rechazo I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -pecho I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -manifestaciones I-PRESENT_ILLNESS -catarrales I-PRESENT_ILLNESS -respiratorias. I-PRESENT_ILLNESS -Los B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY --ocurrido I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -39 I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -gestación- I-PAST_MEDICAL_HISTORY -eran I-PAST_MEDICAL_HISTORY -normales; I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -puntaje I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Apgar I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -9-9 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pesó I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -nacer I-PAST_MEDICAL_HISTORY -2.880 I-PAST_MEDICAL_HISTORY -g. I-PAST_MEDICAL_HISTORY -Egresó I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -hospital I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -lactancia I-PAST_MEDICAL_HISTORY -materna I-PAST_MEDICAL_HISTORY -exclusiva. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -de I-EXPLORATION -reingreso I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -buena I-EXPLORATION -vitalidad I-EXPLORATION -y I-EXPLORATION -coloración, I-EXPLORATION -pesaba I-EXPLORATION -3.580 I-EXPLORATION -g, I-EXPLORATION -tenía I-EXPLORATION -escasa I-EXPLORATION -rinorrea I-EXPLORATION -serosa I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -otros I-EXPLORATION -hallazgos I-EXPLORATION -significativos. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION -para I-EXPLORATION -pesquisa I-EXPLORATION -de I-EXPLORATION -sepsis I-EXPLORATION -se I-EXPLORATION -estableció: I-EXPLORATION -leucocitos I-EXPLORATION -de I-EXPLORATION -8.500/mm3 I-EXPLORATION -(PMN I-EXPLORATION -68%), I-EXPLORATION -VHS I-EXPLORATION -26 I-EXPLORATION -mm/h, I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -normal, I-EXPLORATION -examen I-EXPLORATION -citoquímico I-EXPLORATION -del I-EXPLORATION -LCR I-EXPLORATION -con I-EXPLORATION -6 I-EXPLORATION -leucocitos/mm3, I-EXPLORATION -86 I-EXPLORATION -hematíes I-EXPLORATION -/mm3, I-EXPLORATION -proteína I-EXPLORATION -60 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -glucosa I-EXPLORATION -26 I-EXPLORATION -mg/dl; I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -pleuro-pulmonares. I-EXPLORATION -Por B-TREATMENT -sus I-TREATMENT -buenas I-TREATMENT -condiciones I-TREATMENT -clínicas I-TREATMENT -y I-TREATMENT -exámenes I-TREATMENT -de I-TREATMENT -laboratorio I-TREATMENT -dentro I-TREATMENT -de I-TREATMENT -rangos I-TREATMENT -normales, I-TREATMENT -se I-TREATMENT -ingresó I-TREATMENT -sin I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano. I-TREATMENT - I-TREATMENT -Al I-TREATMENT -segundo I-TREATMENT -día I-TREATMENT -reapareció I-TREATMENT -la I-TREATMENT -fiebre, I-TREATMENT -hasta I-TREATMENT -38, I-TREATMENT -0 I-TREATMENT -°C I-TREATMENT -y I-TREATMENT -se I-TREATMENT -informó I-TREATMENT -un I-TREATMENT -resultado I-TREATMENT -positivo I-TREATMENT -en I-TREATMENT -el I-TREATMENT -urocultivo, I-TREATMENT -(más I-TREATMENT -tarde, I-TREATMENT -se I-TREATMENT -identificó I-TREATMENT -una I-TREATMENT -Serratia I-TREATMENT -sp), I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -gentamicina I-TREATMENT -(7 I-TREATMENT -mg/kg/día) I-TREATMENT -ev. I-TREATMENT -El B-EXPLORATION -cultivo I-EXPLORATION -del I-EXPLORATION -LCR I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION -Entre B-EVOLUTION -el I-EVOLUTION -tercer I-EVOLUTION -y I-EVOLUTION -cuarto I-EVOLUTION -día I-EVOLUTION -apareció I-EVOLUTION -deterioro I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -condición I-EVOLUTION -clínica, I-EVOLUTION -con I-EVOLUTION -quejido, I-EVOLUTION -rechazo I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -lactancia I-EVOLUTION -materna, I-EVOLUTION -adinamia I-EVOLUTION -e I-EVOLUTION -hiporreflexia, I-EVOLUTION -somnolencia I-EVOLUTION -con I-EVOLUTION -irritabilidad, I-EVOLUTION -distensión I-EVOLUTION -abdominal I-EVOLUTION -y I-EVOLUTION -vómitos, I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -dificultad I-EVOLUTION -respiratoria, I-EVOLUTION -palidez, I-EVOLUTION -cianosis I-EVOLUTION -distal, I-EVOLUTION -taquicardia, I-EVOLUTION -oligoanuria I-EVOLUTION -y I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -hipoperfusión I-EVOLUTION -tisular, I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -aspecto I-EVOLUTION -tóxico-infeccioso, I-EVOLUTION -presentando I-EVOLUTION -convulsiones I-EVOLUTION -y I-EVOLUTION -bregma I-EVOLUTION -nor-motenso. I-EVOLUTION -Reevaluado B-EXPLORATION -con I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio, I-EXPLORATION -se I-EXPLORATION -encontró: I-EXPLORATION -leucocitos I-EXPLORATION -12.300/mm3 I-EXPLORATION -(PMN I-EXPLORATION -34% I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -granulaciones I-EXPLORATION -tóxicas), I-EXPLORATION -VHS I-EXPLORATION -16 I-EXPLORATION -mm/h, I-EXPLORATION -plaquetas I-EXPLORATION -de I-EXPLORATION -110.000/mm3, I-EXPLORATION -gasometría I-EXPLORATION -con I-EXPLORATION -acidosis I-EXPLORATION -metabólica; I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -normal, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -aparecieron I-EXPLORATION -imágenes I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -dificultad I-EXPLORATION -respiratoria I-EXPLORATION -del I-EXPLORATION -adulto. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -apoyado I-TREATMENT -con I-TREATMENT -cuidados I-TREATMENT -intensivos: I-TREATMENT -reposición I-TREATMENT -de I-TREATMENT -volumen, I-TREATMENT -inotrópicos, I-TREATMENT -ventilación I-TREATMENT -mecánica, I-TREATMENT -inmuno-moduladores I-TREATMENT -(inmunoglobulina I-TREATMENT -IV I-TREATMENT -y I-TREATMENT -corticosteroides) I-TREATMENT -y I-TREATMENT -recibió I-TREATMENT -fenobarbital. I-TREATMENT -Se I-TREATMENT -indicó I-TREATMENT -penicilina I-TREATMENT -G I-TREATMENT -sódica I-TREATMENT -(200.000 I-TREATMENT -U/kg/día) I-TREATMENT -ev I-TREATMENT -al I-TREATMENT -conocerse I-TREATMENT -resultado I-TREATMENT -del I-TREATMENT -hemocultivo I-TREATMENT -de I-TREATMENT -ingreso I-TREATMENT -positivo I-TREATMENT -a I-TREATMENT -S. I-TREATMENT -pyogenes. I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -iniciado I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -antimicrobiano I-EVOLUTION -se I-EVOLUTION -repitió I-EVOLUTION -la I-EVOLUTION -punción I-EVOLUTION -lumbar I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -informó I-EVOLUTION -el I-EVOLUTION -examen I-EVOLUTION -citoquímico I-EVOLUTION -del I-EVOLUTION -LCR I-EVOLUTION -con I-EVOLUTION -47 I-EVOLUTION -leucocitos/mm3, I-EVOLUTION -2.304 I-EVOLUTION -hematíes/mm3, I-EVOLUTION -proteína I-EVOLUTION -87 I-EVOLUTION -mg/dl I-EVOLUTION -y I-EVOLUTION -glucosa I-EVOLUTION -18 I-EVOLUTION -mg/dl. I-EVOLUTION -El I-EVOLUTION -cultivo I-EVOLUTION -del I-EVOLUTION -LCR I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -segunda I-EVOLUTION -punción I-EVOLUTION -lumbar I-EVOLUTION -resultó I-EVOLUTION -negativo. I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -posteriores, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -deterioro I-EVOLUTION -clínico I-EVOLUTION -progresivo I-EVOLUTION -con I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -convulsiones, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -incrementó I-EVOLUTION -la I-EVOLUTION -dosis I-EVOLUTION -de I-EVOLUTION -anticon-vulsivantes, I-EVOLUTION -cayó I-EVOLUTION -en I-EVOLUTION -coma I-EVOLUTION -profundo, I-EVOLUTION -con I-EVOLUTION -midriasis I-EVOLUTION -y I-EVOLUTION -respuesta I-EVOLUTION -pupilar I-EVOLUTION -débil, I-EVOLUTION -postura I-EVOLUTION -de I-EVOLUTION -descerebración I-EVOLUTION -y I-EVOLUTION -bregma I-EVOLUTION -tenso. I-EVOLUTION -En I-EVOLUTION -el I-EVOLUTION -ultrasonido I-EVOLUTION -cerebral I-EVOLUTION -se I-EVOLUTION -apreciaba I-EVOLUTION -una I-EVOLUTION -hemorragia I-EVOLUTION -periventricular I-EVOLUTION -e I-EVOLUTION -intraventricular. I-EVOLUTION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -para I-TREATMENT -la I-TREATMENT -hipertensión I-TREATMENT -intracraneal I-TREATMENT -y I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -los I-TREATMENT -antimicrobianos I-TREATMENT -iniciales I-TREATMENT -por I-TREATMENT -ceftriaxona I-TREATMENT -(130 I-TREATMENT -mg/kg/día) I-TREATMENT -ev. I-TREATMENT -Sin B-EVOLUTION -embargo, I-EVOLUTION -el I-EVOLUTION -RN I-EVOLUTION -falleció. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -necropsia I-EXPLORATION -se I-EXPLORATION -comprobaron I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -meningitis I-EXPLORATION -con I-EXPLORATION -hemorragias I-EXPLORATION -y I-EXPLORATION -daño I-EXPLORATION -cerebral I-EXPLORATION -grave, I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -shock I-EXPLORATION -séptico I-EXPLORATION -y I-EXPLORATION -pulmones I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -dificultad I-EXPLORATION -respiratoria I-EXPLORATION -del I-EXPLORATION -adulto. I-EXPLORATION - I-EXPLORATION - -Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -recién I-PRESENT_ILLNESS -nacida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pretérmino, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -gestacional I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nacimiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -685 I-PRESENT_ILLNESS -g. I-PRESENT_ILLNESS -Embarazo I-PRESENT_ILLNESS -gemelar I-PRESENT_ILLNESS -controlado, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fecundación I-PRESENT_ILLNESS -in I-PRESENT_ILLNESS -vitro. I-PRESENT_ILLNESS -Tras I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -parto I-PRESENT_ILLNESS -vaginal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -presentación I-PRESENT_ILLNESS -cefálica I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sufrimiento I-PRESENT_ILLNESS -fetal I-PRESENT_ILLNESS -(Apgar I-PRESENT_ILLNESS -4-6), I-PRESENT_ILLNESS -debió I-PRESENT_ILLNESS -ser I-PRESENT_ILLNESS -intubada I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -sala I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -parto. I-PRESENT_ILLNESS -Se B-TREATMENT -trasladó I-TREATMENT -a I-TREATMENT -la I-TREATMENT -unidad I-TREATMENT -de I-TREATMENT -cuidados I-TREATMENT -intensivos I-TREATMENT -siendo I-TREATMENT -conectada I-TREATMENT -a I-TREATMENT -ventilación I-TREATMENT -mecánica. I-TREATMENT -Permaneció I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -primer I-TREATMENT -día I-TREATMENT -con I-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -y I-TREATMENT -catéter I-TREATMENT -venoso I-TREATMENT -central I-TREATMENT -y I-TREATMENT -precisando I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -surfactante I-TREATMENT -pulmonar I-TREATMENT -exógeno I-TREATMENT -con I-TREATMENT -escasa I-TREATMENT -respuesta. I-TREATMENT -Se B-EXPLORATION -obtuvieron I-EXPLORATION -muestras I-EXPLORATION -para I-EXPLORATION -hemocultivo I-EXPLORATION -y I-EXPLORATION -urocultivo I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -e B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -empírico I-TREATMENT -de I-TREATMENT -sepsis I-TREATMENT -neonatal I-TREATMENT -precoz I-TREATMENT -(ampi-cilina I-TREATMENT -y I-TREATMENT -gentamicina). I-TREATMENT -Tras B-EVOLUTION -cinco I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -antimicrobiano I-EVOLUTION -presentó I-EVOLUTION -empeoramiento I-EVOLUTION -clínico I-EVOLUTION -y I-EVOLUTION -alteración I-EVOLUTION -de I-EVOLUTION -exámenes I-EVOLUTION -laboratorio I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -la I-TREATMENT -antibioterapia I-TREATMENT -para I-TREATMENT -cobertura I-TREATMENT -de I-TREATMENT -sepsis I-TREATMENT -nosocomial I-TREATMENT -(vancomicina I-TREATMENT -y I-TREATMENT -ceftazidima) I-TREATMENT -y B-EXPLORATION -se I-EXPLORATION -obtuvieron I-EXPLORATION -nuevas I-EXPLORATION -muestras I-EXPLORATION -para I-EXPLORATION -cultivo I-EXPLORATION -(sangre, I-EXPLORATION -orina I-EXPLORATION -y I-EXPLORATION -LCR). I-EXPLORATION - I-EXPLORATION -A B-TREATMENT -la I-TREATMENT -semana I-TREATMENT -de I-TREATMENT -vida I-TREATMENT -se I-TREATMENT -retiró I-TREATMENT -el I-TREATMENT -catéter I-TREATMENT -de I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -umbilical, I-TREATMENT -en B-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -aisló I-EXPLORATION -Staphylococcus I-EXPLORATION -epider-midis I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -vancomicina. I-EXPLORATION -Se B-TREATMENT -suspendió I-TREATMENT -la I-TREATMENT -ceftazidima I-TREATMENT -y I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -la I-TREATMENT -vancomicina I-TREATMENT -durante I-TREATMENT -10 I-TREATMENT -días I-TREATMENT -más. I-TREATMENT -Los B-EXPLORATION -cultivos I-EXPLORATION -realizados I-EXPLORATION -(sangre, I-EXPLORATION -orina I-EXPLORATION -y I-EXPLORATION -LCR) I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Persistieron B-EVOLUTION -las I-EVOLUTION -alteraciones I-EVOLUTION -hemodi-námicas, I-EVOLUTION -respiratorias I-EVOLUTION -y I-EVOLUTION -hematológicas, I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -empeoramiento I-EVOLUTION -progresivo I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -fallecimiento I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -20 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -vida. I-EVOLUTION -Tras B-EXPLORATION -su I-EXPLORATION -deceso I-EXPLORATION -se I-EXPLORATION -cultivaron I-EXPLORATION -los I-EXPLORATION -catéteres I-EXPLORATION -(venoso I-EXPLORATION -central I-EXPLORATION -y I-EXPLORATION -arterial) I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -tubo I-EXPLORATION -endotraqueal I-EXPLORATION -en I-EXPLORATION -caldo I-EXPLORATION -de I-EXPLORATION -enriquecimiento I-EXPLORATION -tioglicolato I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -agar I-EXPLORATION -chocolate. I-EXPLORATION -En I-EXPLORATION -todos I-EXPLORATION -ellos, I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -24 I-EXPLORATION -horas I-EXPLORATION -de I-EXPLORATION -incubación I-EXPLORATION -a I-EXPLORATION -37 I-EXPLORATION -°C I-EXPLORATION -se I-EXPLORATION -observó, I-EXPLORATION -en I-EXPLORATION -cultivo I-EXPLORATION -puro, I-EXPLORATION -colonias I-EXPLORATION -secas I-EXPLORATION -de I-EXPLORATION -coloración I-EXPLORATION -crema I-EXPLORATION -y I-EXPLORATION -superficie I-EXPLORATION -rugosa I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -resembradas I-EXPLORATION -en I-EXPLORATION -agar I-EXPLORATION -Albicans I-EXPLORATION -(Biomerieux®) I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -agar I-EXPLORATION -SGC2 I-EXPLORATION -(Biomerieux®) I-EXPLORATION -e I-EXPLORATION -incubadas I-EXPLORATION -a I-EXPLORATION -30 I-EXPLORATION -°C I-EXPLORATION -Posteriormente, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -su I-EXPLORATION -identificación I-EXPLORATION -mediante I-EXPLORATION -tarjeta I-EXPLORATION -ID I-EXPLORATION -Yeast I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -sistema I-EXPLORATION -automatizado I-EXPLORATION -Vitek I-EXPLORATION -(Biomerieux I-EXPLORATION -®), I-EXPLORATION -obteniéndose I-EXPLORATION -como I-EXPLORATION -resultado I-EXPLORATION -T. I-EXPLORATION -asahii. I-EXPLORATION -Paralelamente, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -visión I-EXPLORATION -directa I-EXPLORATION -al I-EXPLORATION -microscopio I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -hifas I-EXPLORATION -ramificadas I-EXPLORATION -con I-EXPLORATION -artroconidios I-EXPLORATION -intercalares I-EXPLORATION -y I-EXPLORATION -terminales I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -rectangular. I-EXPLORATION -Por I-EXPLORATION -último, I-EXPLORATION -se I-EXPLORATION -comprobó I-EXPLORATION -la I-EXPLORATION -positividad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -ureasa I-EXPLORATION -como I-EXPLORATION -diagnóstico I-EXPLORATION -diferencial I-EXPLORATION -con I-EXPLORATION -Geotrichum I-EXPLORATION -sp. I-EXPLORATION -Para I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -susceptibilidad I-EXPLORATION -se I-EXPLORATION -practicó I-EXPLORATION -un I-EXPLORATION -Sensititre I-EXPLORATION -YeastOne I-EXPLORATION -Y I-EXPLORATION -07 I-EXPLORATION -(Trek I-EXPLORATION -Diagnostic I-EXPLORATION -Systems®) I-EXPLORATION -que, I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -lectura I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -24 I-EXPLORATION -horas, I-EXPLORATION -arrojó I-EXPLORATION -una I-EXPLORATION -CIM I-EXPLORATION -de I-EXPLORATION -16 I-EXPLORATION -μg/ml I-EXPLORATION -para I-EXPLORATION -flucona-zol, I-EXPLORATION -0, I-EXPLORATION -25 I-EXPLORATION -μg/ml I-EXPLORATION -para I-EXPLORATION -itraconazol I-EXPLORATION -y I-EXPLORATION -1 I-EXPLORATION -μg/ml I-EXPLORATION -para I-EXPLORATION -keto-conazol, I-EXPLORATION -para I-EXPLORATION -5-fluocitosina I-EXPLORATION -una I-EXPLORATION -CIM I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -μg/ml I-EXPLORATION -y I-EXPLORATION -para I-EXPLORATION -anfotericina I-EXPLORATION -B I-EXPLORATION -una I-EXPLORATION -CIM, I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -48 I-EXPLORATION -horas, I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -μg/ml. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -cultivos I-EXPLORATION -del I-EXPLORATION -otro I-EXPLORATION -gemelo, I-EXPLORATION -que I-EXPLORATION -también I-EXPLORATION -ingresó I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -Unidad I-EXPLORATION -de I-EXPLORATION -Ciudados I-EXPLORATION -Intensivos I-EXPLORATION -Neonatales, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -aisló I-EXPLORATION -patógeno I-EXPLORATION -de I-EXPLORATION -interés I-EXPLORATION -alguno, I-EXPLORATION -teniendo B-EVOLUTION -una I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -en I-EVOLUTION -su I-EVOLUTION -estadía I-EVOLUTION -hospitalaria. I-EVOLUTION - I-EVOLUTION - -Preescolar B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -sano, B-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia, I-PAST_MEDICAL_HISTORY -con B-PRESENT_ILLNESS -controles I-PRESENT_ILLNESS -ocasionales I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -pediatra I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -año. I-PRESENT_ILLNESS -Estado B-EXPLORATION -nutricional I-EXPLORATION -eutrófico I-EXPLORATION -según I-EXPLORATION -P/E I-EXPLORATION -y I-EXPLORATION -P/T. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaba I-EXPLORATION -el I-EXPLORATION -desaseo I-EXPLORATION -personal. I-EXPLORATION - I-EXPLORATION -La B-PAST_MEDICAL_HISTORY -familia I-PAST_MEDICAL_HISTORY -procedía I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -rural I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Casablanca, I-PAST_MEDICAL_HISTORY -Región I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Valparaíso, I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -dedicaban I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -crianza I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vacunos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -aves. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -casa I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -piso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -madera, I-PAST_MEDICAL_HISTORY -disponía I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -agua I-PAST_MEDICAL_HISTORY -potable I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -alcantarillado, I-PAST_MEDICAL_HISTORY -patio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tierra. I-PAST_MEDICAL_HISTORY -Tenían I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -perros, I-PAST_MEDICAL_HISTORY -uno I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ellos I-PAST_MEDICAL_HISTORY -adulto I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -gato I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Las I-PAST_MEDICAL_HISTORY -mascotas I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -contaban I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -veterinario. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -niño I-PAST_MEDICAL_HISTORY -refería I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -abundantes I-PAST_MEDICAL_HISTORY -pulgas. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -niño I-PAST_MEDICAL_HISTORY -jugaba I-PAST_MEDICAL_HISTORY -frecuentemente I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -mascotas. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -El B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -derivado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Cátedra I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Parasitología I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -control I-DERIVED_FROM/TO -post I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -Hymenolepis I-DERIVED_FROM/TO -diminuta, I-DERIVED_FROM/TO -diagnosticada I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -otro I-DERIVED_FROM/TO -centro, I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -había I-DERIVED_FROM/TO -consultado I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -dolor I-DERIVED_FROM/TO -abdominal. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Al B-PAST_MEDICAL_HISTORY -interrogar I-PAST_MEDICAL_HISTORY -dirigidamente I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -destacaba I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -eliminación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -elementos I-PAST_MEDICAL_HISTORY -blanquecinos I-PAST_MEDICAL_HISTORY -móviles I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -deposiciones. I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -copro-parasitológico I-EXPLORATION -y I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -Graham, I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -elementos I-EXPLORATION -eliminados I-EXPLORATION -por I-EXPLORATION -las I-EXPLORATION -deposiciones I-EXPLORATION -del I-EXPLORATION -niño. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -observación I-EXPLORATION -macro I-EXPLORATION -y I-EXPLORATION -microscópica I-EXPLORATION -de I-EXPLORATION -estos I-EXPLORATION -elementos I-EXPLORATION -permitió I-EXPLORATION -la I-EXPLORATION -visualización I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -doble I-EXPLORATION -poro I-EXPLORATION -genital I-EXPLORATION -característico I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -huevos I-EXPLORATION -agrupados I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -membrana I-EXPLORATION -o I-EXPLORATION -cápsula I-EXPLORATION -ovígera, I-EXPLORATION -con I-EXPLORATION -liberación I-EXPLORATION -de I-EXPLORATION -huevos. I-EXPLORATION -De I-EXPLORATION -acuerdo I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -macro I-EXPLORATION -y I-EXPLORATION -microscópico I-EXPLORATION -se I-EXPLORATION -hizo I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -dipilidiosis. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -medidas I-TREATMENT -preventivas I-TREATMENT -para I-TREATMENT -dipilidiosis I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -praziquantel I-TREATMENT -por I-TREATMENT -una I-TREATMENT -vez. I-TREATMENT -Acudió B-EVOLUTION -a I-EVOLUTION -control I-EVOLUTION -con I-EVOLUTION -estudio I-EVOLUTION -copro-parasitológico I-EVOLUTION -de I-EVOLUTION -deposiciones I-EVOLUTION -post I-EVOLUTION -tratamiento, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -3 I-EVOLUTION -y I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -que I-EVOLUTION -fueron I-EVOLUTION -todos I-EVOLUTION -negativos. I-EVOLUTION -No I-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -eliminar I-EVOLUTION -proglótidas I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -actualmente I-EVOLUTION -asinto-mático. I-EVOLUTION -En I-EVOLUTION -el I-EVOLUTION -último I-EVOLUTION -control I-EVOLUTION -se I-EVOLUTION -informó I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -muerte I-EVOLUTION -del I-EVOLUTION -perro I-EVOLUTION -adulto. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -previamente B-PAST_MEDICAL_HISTORY -sano, I-PAST_MEDICAL_HISTORY -derivado B-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Urgencia I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Dermatología I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -Barros I-DERIVED_FROM/TO -Luco I-DERIVED_FROM/TO -Trudeau, I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -cuadro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -dos I-DERIVED_FROM/TO -semanas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución, I-DERIVED_FROM/TO -caracterizado I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -aparición I-DERIVED_FROM/TO -aguda I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -progresiva I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -lesiones I-DERIVED_FROM/TO -cutáneas I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -tronco. I-DERIVED_FROM/TO -En B-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -sólo I-PAST_MEDICAL_HISTORY -destacaba I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -erupción I-PAST_MEDICAL_HISTORY -recurrente I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -tronco I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad, I-PAST_MEDICAL_HISTORY -caracterizada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -pápulas I-PAST_MEDICAL_HISTORY -eritematosas I-PAST_MEDICAL_HISTORY -asintomáticas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -preesternal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -brazos. I-PAST_MEDICAL_HISTORY -Sin B-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -de I-FAMILY_HISTORY -infecciones I-FAMILY_HISTORY -herpéticas I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -piel I-FAMILY_HISTORY -o I-FAMILY_HISTORY -genitales, I-FAMILY_HISTORY -ni I-FAMILY_HISTORY -enfermedades I-FAMILY_HISTORY -cutáneas I-FAMILY_HISTORY -familiares. I-FAMILY_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -en I-EXPLORATION -regular I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -afebril I-EXPLORATION -y I-EXPLORATION -presentaba I-EXPLORATION -múltiples I-EXPLORATION -pápulas I-EXPLORATION -y I-EXPLORATION -pústulas I-EXPLORATION -umbilicadas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -tronco, I-EXPLORATION -confluentes, I-EXPLORATION -con I-EXPLORATION -algunas I-EXPLORATION -lesiones I-EXPLORATION -en I-EXPLORATION -etapa I-EXPLORATION -de I-EXPLORATION -costra. I-EXPLORATION -Sin I-EXPLORATION -lesiones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cara, I-EXPLORATION -genitales I-EXPLORATION -ni I-EXPLORATION -mucosas. I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -manos I-EXPLORATION -destacaba I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -pápulas I-EXPLORATION -aplanadas I-EXPLORATION -color I-EXPLORATION -piel I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -dorso, I-EXPLORATION -pits I-EXPLORATION -palmares I-EXPLORATION -y I-EXPLORATION -alternancia I-EXPLORATION -de I-EXPLORATION -líneas I-EXPLORATION -rojas I-EXPLORATION -y I-EXPLORATION -blancas I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -uñas, I-EXPLORATION -hallazgos I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Darier. I-EXPLORATION -Se I-EXPLORATION -hospitalizó I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -presuntivo I-EXPLORATION -de I-EXPLORATION -eccema I-EXPLORATION -herpético I-EXPLORATION -y I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Darier. I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -exámenes I-EXPLORATION -generales, I-EXPLORATION -cultivo I-EXPLORATION -corriente I-EXPLORATION -y I-EXPLORATION -reacción I-EXPLORATION -de I-EXPLORATION -polimerasa I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -(RPC) I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -herpes I-EXPLORATION -simplex I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -pústulas, I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Darier. I-EXPLORATION -Empíricamente B-TREATMENT -se I-TREATMENT -indicó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -aciclovir I-TREATMENT -oral I-TREATMENT -400 I-TREATMENT -mg I-TREATMENT -5 I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día I-TREATMENT -y I-TREATMENT -cloxacilina I-TREATMENT -ev I-TREATMENT -1 I-TREATMENT -gr I-TREATMENT -cada I-TREATMENT -6 I-TREATMENT -hrs, I-TREATMENT -el I-TREATMENT -que I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -durante I-TREATMENT -10 I-TREATMENT -días. I-TREATMENT -Entre B-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -generales I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -normal, I-EXPLORATION -VHS I-EXPLORATION -29 I-EXPLORATION -mm/h, I-EXPLORATION -PCR I-EXPLORATION -123 I-EXPLORATION -mg/L, I-EXPLORATION -GGT I-EXPLORATION -108 I-EXPLORATION -U/L. I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION -del I-EXPLORATION -VDRL I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -serologías I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION -y I-EXPLORATION -VHB I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -El I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -Staphylococcus I-EXPLORATION -aureus I-EXPLORATION -resistente I-EXPLORATION -sólo I-EXPLORATION -a I-EXPLORATION -clindamicina I-EXPLORATION -y I-EXPLORATION -eritromicina, I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -RPC I-EXPLORATION -en I-EXPLORATION -tiempo I-EXPLORATION -real, I-EXPLORATION -realizada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Laboratorio I-EXPLORATION -de I-EXPLORATION -Virología I-EXPLORATION -del I-EXPLORATION -Instituto I-EXPLORATION -de I-EXPLORATION -Ciencias I-EXPLORATION -Biomédicas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Facultad I-EXPLORATION -de I-EXPLORATION -Medicina I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Universidad I-EXPLORATION -de I-EXPLORATION -Chile, I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -VHS I-EXPLORATION -2. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -histopatológicos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -fueron I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Darier. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -respondió I-EVOLUTION -rápidamente I-EVOLUTION -al I-EVOLUTION -tratamiento, I-EVOLUTION -siendo I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -días. I-EVOLUTION - I-EVOLUTION - -Escolar B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -13 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -oriundo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Montevideo. I-PRESENT_ILLNESS -Buen I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -desarrollo. I-PRESENT_ILLNESS -Sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos. I-PAST_MEDICAL_HISTORY -Calendario B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -inmunizaciones I-PRESENT_ILLNESS -completo. I-PRESENT_ILLNESS -Ingresó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -febril I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -38 I-PRESENT_ILLNESS -°C I-PRESENT_ILLNESS -axilar. I-PRESENT_ILLNESS -Alas I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -iniciada I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -instaló I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -lumbalgia I-PRESENT_ILLNESS -permanente, I-PRESENT_ILLNESS -progresiva, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -irradiaciones, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -componente I-PRESENT_ILLNESS -nocturno, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -exacerbaba I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -movimientos. I-PRESENT_ILLNESS -Al I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -tenía I-PRESENT_ILLNESS -limitación I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -movilidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -columna I-PRESENT_ILLNESS -tóraco-lumbar I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -deambulación. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -esfinteriano. I-PRESENT_ILLNESS -Había B-TREATMENT -consultado I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -ambulatoria I-TREATMENT -donde I-TREATMENT -le I-TREATMENT -fuera I-TREATMENT -indicada I-TREATMENT -amoxicilina I-TREATMENT -por I-TREATMENT -7 I-TREATMENT -días I-TREATMENT -y I-TREATMENT -a I-TREATMENT -continuación I-TREATMENT -cotrimoxazol I-TREATMENT -durante I-TREATMENT -48 I-TREATMENT -horas. I-TREATMENT -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -evidenció I-EXPLORATION -un I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -con I-EXPLORATION -mialgias, I-EXPLORATION -febril I-EXPLORATION -38, I-EXPLORATION -5 I-EXPLORATION -°C I-EXPLORATION -axilar, I-EXPLORATION -sin I-EXPLORATION -lesiones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -ni I-EXPLORATION -mucosas I-EXPLORATION -o I-EXPLORATION -adenopatías. I-EXPLORATION -La I-EXPLORATION -columna I-EXPLORATION -presentaba I-EXPLORATION -rigidez I-EXPLORATION -y I-EXPLORATION -limitación I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -movilidad I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -flexión: I-EXPLORATION -actitud I-EXPLORATION -escoliótica I-EXPLORATION -del I-EXPLORATION -tronco, I-EXPLORATION -con I-EXPLORATION -desvío I-EXPLORATION -axial I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -a I-EXPLORATION -izquierda. I-EXPLORATION -Dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -masas I-EXPLORATION -musculares I-EXPLORATION -paravertebrales. I-EXPLORATION -Abdomen I-EXPLORATION -simétrico, I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -del I-EXPLORATION -hipogastrio, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal I-EXPLORATION -ni I-EXPLORATION -visceromegalias. I-EXPLORATION -Fosas I-EXPLORATION -lumbares I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio: I-EXPLORATION -leucocitos I-EXPLORATION -9.900/mm3 I-EXPLORATION -(neu-trófilos I-EXPLORATION -4.800/mm3, I-EXPLORATION -linfocitos I-EXPLORATION -3.700/mm3), I-EXPLORATION -hemoglobina I-EXPLORATION -11, I-EXPLORATION -1 I-EXPLORATION -g/dl, I-EXPLORATION -hematocnto I-EXPLORATION -38%, I-EXPLORATION -plaquetas I-EXPLORATION -407.000/mm3; I-EXPLORATION -PCR I-EXPLORATION -7, I-EXPLORATION -6 I-EXPLORATION -mg/1. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -hemocultivo I-EXPLORATION -se I-EXPLORATION -desarrolló I-EXPLORATION -Staphylococcus I-EXPLORATION -coagulasa I-EXPLORATION -negativa. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -del I-EXPLORATION -ingreso I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -escoliosis I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -estructurales, I-EXPLORATION -sin I-EXPLORATION -componente I-EXPLORATION -rotacional. I-EXPLORATION -El I-EXPLORATION -cintigrama I-EXPLORATION -óseo I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -hiperémica I-EXPLORATION -leve, I-EXPLORATION -en I-EXPLORATION -fase I-EXPLORATION -precoz, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -2a I-EXPLORATION -vértebra I-EXPLORATION -lumbar. I-EXPLORATION -La I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -proceso I-EXPLORATION -sustitutivo I-EXPLORATION -del I-EXPLORATION -cuerpo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -2a I-EXPLORATION -vértebra I-EXPLORATION -lumbar I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -del I-EXPLORATION -canal I-EXPLORATION -medular I-EXPLORATION -y I-EXPLORATION -foramen I-EXPLORATION -derecho, I-EXPLORATION -con I-EXPLORATION -indemnidad I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -discos I-EXPLORATION -intervertebrales. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -por I-EXPLORATION -punción I-EXPLORATION -del I-EXPLORATION -pedículo I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -dicha I-EXPLORATION -vértebra. I-EXPLORATION -La I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -informó I-EXPLORATION -proliferación I-EXPLORATION -polimorfa I-EXPLORATION -con I-EXPLORATION -linfocitos, I-EXPLORATION -polimorfonucleares I-EXPLORATION -y I-EXPLORATION -escasos I-EXPLORATION -eosinófilos; I-EXPLORATION -hallazgos I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -osteomielitis. I-EXPLORATION -El I-EXPLORATION -cultivo I-EXPLORATION -bacteriológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -biopsia I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -cefuroxima I-TREATMENT -ev I-TREATMENT -100 I-TREATMENT -mg/kg/día I-TREATMENT -el I-TREATMENT -que I-TREATMENT -mantuvo I-TREATMENT -durante I-TREATMENT -23 I-TREATMENT -días; I-TREATMENT -vancomicina I-TREATMENT -40 I-TREATMENT -mg/kg/ I-TREATMENT -día I-TREATMENT -por I-TREATMENT -3 I-TREATMENT -días, I-TREATMENT -ceftriaxona I-TREATMENT -100 I-TREATMENT -mg/kg/día I-TREATMENT -durante I-TREATMENT -8 I-TREATMENT -días I-TREATMENT -y I-TREATMENT -finalmente I-TREATMENT -rifampicina I-TREATMENT -10 I-TREATMENT -mg/kg/día I-TREATMENT -más I-TREATMENT -ciprofloxacina I-TREATMENT -20 I-TREATMENT -mg/kg/día I-TREATMENT -por I-TREATMENT -11 I-TREATMENT -días. I-TREATMENT -En I-TREATMENT -total I-TREATMENT -recibió I-TREATMENT -45 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano. I-TREATMENT - I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -imágenes I-EXPLORATION -hipodensas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hígado, I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -micro-abscesos. I-EXPLORATION -Frente I-EXPLORATION -a I-EXPLORATION -este I-EXPLORATION -hallazgo I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -efectuar I-EXPLORATION -una I-EXPLORATION -tinción I-EXPLORATION -argéntica I-EXPLORATION -con I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -Warthin-Starry I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -vertebral, I-EXPLORATION -lográndose I-EXPLORATION -detectar I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -bacilos I-EXPLORATION -gramnegativos I-EXPLORATION -con I-EXPLORATION -morfología I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -B. I-EXPLORATION -henselae. I-EXPLORATION -En B-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -persistió I-EVOLUTION -con I-EVOLUTION -dolor I-EVOLUTION -lumbar I-EVOLUTION -y I-EVOLUTION -fiebre I-EVOLUTION -durante I-EVOLUTION -30 I-EVOLUTION -días. I-EVOLUTION -Se I-EVOLUTION -otorgó I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -hospitalaria I-EVOLUTION -estando I-EVOLUTION -afebril I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -movilidad I-EVOLUTION -prácticamente I-EVOLUTION -normal I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -columna I-EVOLUTION -vertebral. I-EVOLUTION -La B-EXPLORATION -PCR I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -hemograma I-EXPLORATION -se I-EXPLORATION -normalizaron I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -evolución. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -47 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -mayores; I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -27 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -extirpado I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cuerpo I-PAST_MEDICAL_HISTORY -extraño I-PAST_MEDICAL_HISTORY -(cuesco I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cereza) I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -fosa I-PAST_MEDICAL_HISTORY -nasal I-PAST_MEDICAL_HISTORY -derecha. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -consistente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -descarga I-PRESENT_ILLNESS -posterior I-PRESENT_ILLNESS -recurrente, I-PRESENT_ILLNESS -muco-purulenta I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -restos I-PRESENT_ILLNESS -hemáticos, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -respuesta I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -terapia I-PRESENT_ILLNESS -antibacteriana. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaba I-EXPLORATION -la I-EXPLORATION -desviación I-EXPLORATION -del I-EXPLORATION -tabique I-EXPLORATION -nasal I-EXPLORATION -a I-EXPLORATION -derecha, I-EXPLORATION -sin I-EXPLORATION -otros I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -imagenológico I-EXPLORATION -con I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -cavidades I-EXPLORATION -paranasales I-EXPLORATION -mostró I-EXPLORATION -opacidad I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -cavidades I-EXPLORATION -paranasales I-EXPLORATION -fue I-EXPLORATION -informada I-EXPLORATION -como: I-EXPLORATION -"seno I-EXPLORATION -maxilar I-EXPLORATION -derecho I-EXPLORATION -ocupado I-EXPLORATION -por I-EXPLORATION -material I-EXPLORATION -con I-EXPLORATION -densidad I-EXPLORATION -de I-EXPLORATION -tejidos I-EXPLORATION -blandos, I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -burbujas I-EXPLORATION -de I-EXPLORATION -gas, I-EXPLORATION -con I-EXPLORATION -extensión I-EXPLORATION -hacia I-EXPLORATION -el I-EXPLORATION -canal I-EXPLORATION -osteo-infundibular I-EXPLORATION -y I-EXPLORATION -levemente I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -fosa I-EXPLORATION -nasal I-EXPLORATION -ipsilateral, I-EXPLORATION -ensanchamiento I-EXPLORATION -y I-EXPLORATION -remodelación I-EXPLORATION -ósea I-EXPLORATION -del I-EXPLORATION -canal I-EXPLORATION -infundibular, I-EXPLORATION -sin I-EXPLORATION -evidencias I-EXPLORATION -de I-EXPLORATION -erosiones". I-EXPLORATION -La I-EXPLORATION -naso-fibro-broncoscopia I-EXPLORATION -detectó I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -polipoidea I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -fosa I-EXPLORATION -nasal I-EXPLORATION -derecha I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -altura I-EXPLORATION -del I-EXPLORATION -meato I-EXPLORATION -medio, I-EXPLORATION -hacia I-EXPLORATION -posterior, I-EXPLORATION -sin I-EXPLORATION -alcanzar I-EXPLORATION -la I-EXPLORATION -coana, I-EXPLORATION -vascularizada. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -rinofaringe I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -tejido I-EXPLORATION -adenoideo I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -orofaringe I-EXPLORATION -e I-EXPLORATION -hipofaringe I-EXPLORATION -tenían I-EXPLORATION -aspecto I-EXPLORATION -normal. I-EXPLORATION -Exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -destacables: I-EXPLORATION -hemograma I-EXPLORATION -con I-EXPLORATION -hemoglobina I-EXPLORATION -12, I-EXPLORATION -5 I-EXPLORATION -g/dl, I-EXPLORATION -leucocitos I-EXPLORATION -4.500 I-EXPLORATION -céls/mm3 I-EXPLORATION -(eosinófilos I-EXPLORATION -2%, I-EXPLORATION -segmentados I-EXPLORATION -58%, I-EXPLORATION -linfocitos I-EXPLORATION -31%y I-EXPLORATION -monocitos I-EXPLORATION -8%), I-EXPLORATION -plaquetas I-EXPLORATION -312.000 I-EXPLORATION -céls/mm3, I-EXPLORATION -VHS I-EXPLORATION -44 I-EXPLORATION -mm/h. I-EXPLORATION - B-TREATMENT -Se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -cirugía I-TREATMENT -de I-TREATMENT -remoción I-TREATMENT -del I-TREATMENT -contenido I-TREATMENT -sinusal I-TREATMENT -mediante I-TREATMENT -técnica I-TREATMENT -de I-TREATMENT -Caldwell-Luc, I-TREATMENT -con I-TREATMENT -una I-TREATMENT -incisión I-TREATMENT -por I-TREATMENT -el I-TREATMENT -reborde I-TREATMENT -alveolar I-TREATMENT -superior I-TREATMENT -derecho I-TREATMENT -y I-TREATMENT -apertura I-TREATMENT -de I-TREATMENT -una I-TREATMENT -ventana I-TREATMENT -ósea I-TREATMENT -en I-TREATMENT -el I-TREATMENT -seno I-TREATMENT -maxilar, I-TREATMENT -dando I-TREATMENT -salida I-TREATMENT -a I-TREATMENT -secreción I-TREATMENT -negruzca I-TREATMENT -barrosa I-TREATMENT -de I-TREATMENT -gran I-TREATMENT -cantidad. I-TREATMENT -No I-TREATMENT -se I-TREATMENT -encontró I-TREATMENT -lesiones I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fosa I-TREATMENT -nasal I-TREATMENT -derecha I-TREATMENT -ni I-TREATMENT -tejido I-TREATMENT -adenoideo I-TREATMENT -anómalo I-TREATMENT -en I-TREATMENT -las I-TREATMENT -coanas I-TREATMENT -o I-TREATMENT -rinofaringe. I-TREATMENT -Evolucionó B-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -satisfactoria I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -post-operatorio. I-EVOLUTION -El B-EXPLORATION -material I-EXPLORATION -obtenido I-EXPLORATION -fue I-EXPLORATION -enviado I-EXPLORATION -a I-EXPLORATION -estudio I-EXPLORATION -microbiológico I-EXPLORATION -e I-EXPLORATION -histopatológico. I-EXPLORATION -El I-EXPLORATION -informe I-EXPLORATION -anátomo-patológico I-EXPLORATION -fue: I-EXPLORATION -"sinusitis I-EXPLORATION -crónica I-EXPLORATION -erosiva, I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -hongo I-EXPLORATION -filamentoso I-EXPLORATION -con I-EXPLORATION -hifas I-EXPLORATION -hialinas I-EXPLORATION -septadasy I-EXPLORATION -ramificadas, I-EXPLORATION -sugerente I-EXPLORATION -deAspergillus I-EXPLORATION -sp. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -invasión I-EXPLORATION -micótica I-EXPLORATION -ni I-EXPLORATION -atiplas".. I-EXPLORATION -Se I-EXPLORATION -aisló I-EXPLORATION -un I-EXPLORATION -hongo I-EXPLORATION -filamentoso I-EXPLORATION -de I-EXPLORATION -crecimiento I-EXPLORATION -rápido I-EXPLORATION -a I-EXPLORATION -25 I-EXPLORATION -°C, I-EXPLORATION -con I-EXPLORATION -colonias I-EXPLORATION -de I-EXPLORATION -textura I-EXPLORATION -aterciopelada I-EXPLORATION -a I-EXPLORATION -algodonosa, I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -crema I-EXPLORATION -a I-EXPLORATION -café I-EXPLORATION -canela, I-EXPLORATION -bordes I-EXPLORATION -irregulares I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -leve I-EXPLORATION -pigmento I-EXPLORATION -café. I-EXPLORATION -Microscópicamente I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -hifas I-EXPLORATION -hialinas I-EXPLORATION -septadas I-EXPLORATION -con I-EXPLORATION -conidióforos I-EXPLORATION -rectos, I-EXPLORATION -de I-EXPLORATION -largo I-EXPLORATION -variable I-EXPLORATION -con I-EXPLORATION -generación I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -porción I-EXPLORATION -distal I-EXPLORATION -de I-EXPLORATION -aneloconidio I-EXPLORATION -unicelular I-EXPLORATION -oval I-EXPLORATION -y I-EXPLORATION -base I-EXPLORATION -trunca, I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -identificado I-EXPLORATION -como I-EXPLORATION -S. I-EXPLORATION -apios-permum, I-EXPLORATION -forma I-EXPLORATION -anamorfa I-EXPLORATION -o I-EXPLORATION -asexuada I-EXPLORATION -de I-EXPLORATION -Pseudallescheria I-EXPLORATION -boydii. I-EXPLORATION -Se I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -identificación I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Laboratorio I-EXPLORATION -de I-EXPLORATION -Micología I-EXPLORATION -del I-EXPLORATION -Instituto I-EXPLORATION -de I-EXPLORATION -Ciencias I-EXPLORATION -Biomédicas I-EXPLORATION -(ICBM), I-EXPLORATION -Facultad I-EXPLORATION -de I-EXPLORATION -Medicina, I-EXPLORATION -Universidad I-EXPLORATION -de I-EXPLORATION -Chile. I-EXPLORATION - I-EXPLORATION -Dada B-TREATMENT -su I-TREATMENT -larga I-TREATMENT -evolución I-TREATMENT -sintomática I-TREATMENT -y I-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -una I-TREATMENT -lesión I-TREATMENT -polipoidea I-TREATMENT -de I-TREATMENT -tipo I-TREATMENT -invasora I-TREATMENT -se I-TREATMENT -dejó I-TREATMENT -inicialmente I-TREATMENT -tratamiento I-TREATMENT -antifúngico I-TREATMENT -con I-TREATMENT -200 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -itraconazol I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas, I-TREATMENT -siendo I-TREATMENT -bien I-TREATMENT -tolerado, I-TREATMENT -sin I-TREATMENT -alteración I-TREATMENT -de I-TREATMENT -las I-TREATMENT -pruebas I-TREATMENT -hepáticas, I-TREATMENT -el I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -suspendido I-TREATMENT -al I-TREATMENT -no I-TREATMENT -evidenciarse I-TREATMENT -compromiso I-TREATMENT -micótico I-TREATMENT -invasor I-TREATMENT -en I-TREATMENT -la I-TREATMENT -biopsia. I-TREATMENT - B-EVOLUTION -La I-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -a I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -plazo I-EVOLUTION -fue I-EVOLUTION -satisfactoria; I-EVOLUTION -una B-EXPLORATION -nueva I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -cavidades I-EXPLORATION -paranasales I-EXPLORATION -mostró I-EXPLORATION -su I-EXPLORATION -total I-EXPLORATION -neumatización I-EXPLORATION -y I-EXPLORATION -simetría, I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -maxilectomía I-EXPLORATION -medial I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -elementos I-EXPLORATION -inflamatorios I-EXPLORATION -marginales I-EXPLORATION -con I-EXPLORATION -pequeño I-EXPLORATION -nivel I-EXPLORATION -hidro-aéreo I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -74 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresó I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -HLC I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -junio I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -2007. I-PRESENT_ILLNESS -Tenía B-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -colecistectomizado I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -operado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hernia I-PAST_MEDICAL_HISTORY -inguinal. I-PAST_MEDICAL_HISTORY -Era I-PAST_MEDICAL_HISTORY -casado, I-PAST_MEDICAL_HISTORY -jubilado I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -trabajado, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -mayor I-PAST_MEDICAL_HISTORY -parte I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -vida, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -criaderos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -aves I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -zonas I-PAST_MEDICAL_HISTORY -rurales I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -Área I-PAST_MEDICAL_HISTORY -Metropolitana. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Su B-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -iniciado I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -moderado I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -vespertina I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ese I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -cuantificaba I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -diez I-PRESENT_ILLNESS -kilos. I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -ambulatoria I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -varias I-PRESENT_ILLNESS -oportunidades I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -realizaron I-PRESENT_ILLNESS -diversos I-PRESENT_ILLNESS -exámenes I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -llegar I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -diagnóstico. I-PRESENT_ILLNESS -Destacaban I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -ecograñay I-PRESENT_ILLNESS -tomograña I-PRESENT_ILLNESS -axial I-PRESENT_ILLNESS -computariza-da I-PRESENT_ILLNESS -(TAC) I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -abdomen I-PRESENT_ILLNESS -"sin I-PRESENT_ILLNESS -hallazgos I-PRESENT_ILLNESS -significativos" I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -ecocardiograma I-PRESENT_ILLNESS -trans-torácico I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -informaba I-PRESENT_ILLNESS -insuficiencia I-PRESENT_ILLNESS -aórtica I-PRESENT_ILLNESS -leve I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dilatación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cavidades I-PRESENT_ILLNESS -izquierdas. I-PRESENT_ILLNESS -Fue B-DERIVED_FROM/TO -derivado I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -HLC I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -completar I-DERIVED_FROM/TO -estudio. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Al B-EXPLORATION -ingreso I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -refería I-EXPLORATION -molestias I-EXPLORATION -específicas I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -no I-EXPLORATION -contribuía I-EXPLORATION -para I-EXPLORATION -orientar I-EXPLORATION -el I-EXPLORATION -diagnóstico. I-EXPLORATION -No I-EXPLORATION -tenía I-EXPLORATION -soplo I-EXPLORATION -cardíaco, I-EXPLORATION -visceromegalia, I-EXPLORATION -lesiones I-EXPLORATION -cutáneas I-EXPLORATION -ni I-EXPLORATION -mucosas, I-EXPLORATION -alteraciones I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -pulmonar I-EXPLORATION -ni I-EXPLORATION -de I-EXPLORATION -otros I-EXPLORATION -sistemas. I-EXPLORATION -Sólo I-EXPLORATION -se I-EXPLORATION -verificó I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -fiebre I-EXPLORATION -irregular, I-EXPLORATION -alrededor I-EXPLORATION -de I-EXPLORATION -38°C, I-EXPLORATION -y I-EXPLORATION -decaimiento. I-EXPLORATION -Se I-EXPLORATION -inició I-EXPLORATION -estudio I-EXPLORATION -del I-EXPLORATION -síndrome I-EXPLORATION -febril I-EXPLORATION -prolongado. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION -mostraba I-EXPLORATION -anemia I-EXPLORATION -moderada I-EXPLORATION -(hematocrito I-EXPLORATION -34, I-EXPLORATION -1%, I-EXPLORATION -hemoglobina I-EXPLORATION -11, I-EXPLORATION -3 I-EXPLORATION -gr%), I-EXPLORATION -leucocitos I-EXPLORATION -en I-EXPLORATION -rango I-EXPLORATION -normal, I-EXPLORATION -neutrofilia I-EXPLORATION -de I-EXPLORATION -76%) I-EXPLORATION -sin I-EXPLORATION -desviación I-EXPLORATION -a I-EXPLORATION -izquierda I-EXPLORATION -y I-EXPLORATION -VHS I-EXPLORATION -de I-EXPLORATION -36 I-EXPLORATION -mm/h. I-EXPLORATION -La I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION -y I-EXPLORATION -renal I-EXPLORATION -estaban I-EXPLORATION -normales, I-EXPLORATION -la I-EXPLORATION -albuminemia I-EXPLORATION -disminuida I-EXPLORATION -(3, I-EXPLORATION -3 I-EXPLORATION -gr%), I-EXPLORATION -la I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -moderadamente I-EXPLORATION -elevada I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -no I-EXPLORATION -evidenciaba I-EXPLORATION -alteraciones I-EXPLORATION -del I-EXPLORATION -parénquima I-EXPLORATION -pulmonar I-EXPLORATION -ni I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -silueta I-EXPLORATION -cardíaca. I-EXPLORATION -Tanto I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -ecograña I-EXPLORATION -abdominal I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -abdomen, I-EXPLORATION -realizadas I-EXPLORATION -durante I-EXPLORATION -su I-EXPLORATION -hospitalización, I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -nodulos I-EXPLORATION -espíemeos. I-EXPLORATION -Estaba I-EXPLORATION -solicitado I-EXPLORATION -un I-EXPLORATION -ecocardiograma I-EXPLORATION -trans-esofágico. I-EXPLORATION -Por I-EXPLORATION -no I-EXPLORATION -presentar I-EXPLORATION -expectoración, I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -hicieron I-EXPLORATION -baciloscopias I-EXPLORATION -de I-EXPLORATION -contenido I-EXPLORATION -gástrico I-EXPLORATION -que I-EXPLORATION -resultaron I-EXPLORATION -negativas. I-EXPLORATION -El I-EXPLORATION -urocultivo I-EXPLORATION -también I-EXPLORATION -fue I-EXPLORATION -negativo I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION -tomados I-EXPLORATION -al I-EXPLORATION -ingreso, I-EXPLORATION -no I-EXPLORATION -presentaron I-EXPLORATION -desarrollo. I-EXPLORATION -Como I-EXPLORATION -parte I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -síndrome I-EXPLORATION -febril I-EXPLORATION -prolongado I-EXPLORATION -se I-EXPLORATION -solicitaron I-EXPLORATION -también I-EXPLORATION -exámenes I-EXPLORATION -inmunológicos: I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares, I-EXPLORATION -factor I-EXPLORATION -reumatold I-EXPLORATION -eo, I-EXPLORATION -cuantificación I-EXPLORATION -de I-EXPLORATION -C3 I-EXPLORATION -y I-EXPLORATION -C4, I-EXPLORATION -anticuerpos I-EXPLORATION -anti-cardiolipina, I-EXPLORATION -todo I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -resultó I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -electroforesis I-EXPLORATION -de I-EXPLORATION -proteínas I-EXPLORATION -demostró I-EXPLORATION -una I-EXPLORATION -discreta I-EXPLORATION -hipoalbuminemia I-EXPLORATION -e I-EXPLORATION -hipergamaglobulinemia I-EXPLORATION -difusa I-EXPLORATION -moderada. I-EXPLORATION - I-EXPLORATION -Al I-EXPLORATION -11° I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -hospitalización, I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -la I-EXPLORATION -aparición I-EXPLORATION -de I-EXPLORATION -petequias I-EXPLORATION -subconjuntivales. I-EXPLORATION -Con B-TREATMENT -este I-TREATMENT -nuevo I-TREATMENT -hallazgo I-TREATMENT -al I-TREATMENT -examen I-TREATMENT -físico, I-TREATMENT -se I-TREATMENT -planteó I-TREATMENT -la I-TREATMENT -hipótesis I-TREATMENT -diagnóstica I-TREATMENT -de I-TREATMENT -endocarditis I-TREATMENT -infecciosa I-TREATMENT -y, I-TREATMENT -previa I-TREATMENT -toma I-TREATMENT -de I-TREATMENT -nueva I-TREATMENT -serie I-TREATMENT -de I-TREATMENT -hemocultivos, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -penicilina I-TREATMENT -y I-TREATMENT -gentamicina I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -endovenosa. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -estable I-EVOLUTION -en I-EVOLUTION -su I-EVOLUTION -condición, I-EVOLUTION -con I-EVOLUTION -fiebre I-EVOLUTION -irregular I-EVOLUTION -y, I-EVOLUTION -posteriormente, I-EVOLUTION -se I-EVOLUTION -pesquisó I-EVOLUTION -un I-EVOLUTION -soplo I-EVOLUTION -cardíaco. I-EVOLUTION - I-EVOLUTION -Al B-EXPLORATION -14° I-EXPLORATION -día I-EXPLORATION -se I-EXPLORATION -detectó I-EXPLORATION -crecimiento I-EXPLORATION -bacteriano I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION -tomados I-EXPLORATION -al I-EXPLORATION -paciente I-EXPLORATION -tres I-EXPLORATION -días I-EXPLORATION -antes. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -directamente I-EXPLORATION -del I-EXPLORATION -vial I-EXPLORATION -de I-EXPLORATION -cultivo, I-EXPLORATION -se I-EXPLORATION -visualizaron I-EXPLORATION -cocobacilos I-EXPLORATION -grampositivos. I-EXPLORATION -Posteriormente I-EXPLORATION -se I-EXPLORATION -aclaró I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -cocobacilos I-EXPLORATION -gramnegativos I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -17° I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -ingresado I-EXPLORATION -se I-EXPLORATION -emitió I-EXPLORATION -un I-EXPLORATION -pre-informe I-EXPLORATION -dando I-EXPLORATION -cuenta I-EXPLORATION -del I-EXPLORATION -desarrollo I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -bacilo I-EXPLORATION -gramnegativo, I-EXPLORATION -probablemente I-EXPLORATION -del I-EXPLORATION -grupo I-EXPLORATION -HACEK. I-EXPLORATION -Por I-EXPLORATION -la I-EXPLORATION -dificultad I-EXPLORATION -en I-EXPLORATION -llegar I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -diagnóstico I-EXPLORATION -microbiológico I-EXPLORATION -exacto, I-EXPLORATION -se I-EXPLORATION -envió I-EXPLORATION -la I-EXPLORATION -cepa I-EXPLORATION -al I-EXPLORATION -ISP I-EXPLORATION -para I-EXPLORATION -identificación. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -resultado I-TREATMENT -de I-TREATMENT -este I-TREATMENT -examen I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT -antimicrobiano I-TREATMENT -a I-TREATMENT -ampicilina, I-TREATMENT -gentamicina I-TREATMENT -y I-TREATMENT -ceftriaxona. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -22° I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -hospitalización I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -ecocardiograma I-EXPLORATION -trans-esofágico I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -servicio I-EXPLORATION -de I-EXPLORATION -cardiología I-EXPLORATION -del I-EXPLORATION -Hospital I-EXPLORATION -Barros I-EXPLORATION -Luco I-EXPLORATION -Trudeau. I-EXPLORATION -En I-EXPLORATION -dicho I-EXPLORATION -examen I-EXPLORATION -se I-EXPLORATION -visualizaron I-EXPLORATION -múltiples I-EXPLORATION -vegetaciones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -válvula I-EXPLORATION -aórtica I-EXPLORATION -con I-EXPLORATION -formación I-EXPLORATION -de I-EXPLORATION -absceso I-EXPLORATION -y I-EXPLORATION -dilatación I-EXPLORATION -aneurismática I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -coronario I-EXPLORATION -derecho, I-EXPLORATION -insuficiencia I-EXPLORATION -aórtica, I-EXPLORATION -dilatación I-EXPLORATION -auricular I-EXPLORATION -izquierda, I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo I-EXPLORATION -con I-EXPLORATION -hipertrofia I-EXPLORATION -excéntrica I-EXPLORATION -dilatada I-EXPLORATION -y I-EXPLORATION -disfunción I-EXPLORATION -sistólica I-EXPLORATION -leve. I-EXPLORATION - I-EXPLORATION -Ese B-DERIVED_FROM/TO -mismo I-DERIVED_FROM/TO -día I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -trasladado I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Instituto I-DERIVED_FROM/TO -Nacional I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Enfermedades I-DERIVED_FROM/TO -Respiratorias I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Tórax I-DERIVED_FROM/TO -(INERYCT) I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -quirúrgico. I-DERIVED_FROM/TO -Al B-EVOLUTION -ingreso I-EVOLUTION -a I-EVOLUTION -dicho I-EVOLUTION -centro I-EVOLUTION -asistencial I-EVOLUTION -se I-EVOLUTION -verificó I-EVOLUTION -un I-EVOLUTION -paciente I-EVOLUTION -tranquilo I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -refería I-EVOLUTION -molestias I-EVOLUTION -específicas, I-EVOLUTION -enflaquecido, I-EVOLUTION -he-modinámicamente I-EVOLUTION -estable, I-EVOLUTION -sin I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -insuficiencia I-EVOLUTION -cardíaca, I-EVOLUTION -con I-EVOLUTION -soplo I-EVOLUTION -cardíaco I-EVOLUTION -4/6 I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -foco I-EVOLUTION -aórtico. I-EVOLUTION -A I-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -horas, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -agravó I-EVOLUTION -bruscamente I-EVOLUTION -presentando I-EVOLUTION -dolor I-EVOLUTION -retro-esternal, I-EVOLUTION -disnea, I-EVOLUTION -ingurgitación I-EVOLUTION -yugular, I-EVOLUTION -hipotensión, I-EVOLUTION -shock I-EVOLUTION -y I-EVOLUTION -compromiso I-EVOLUTION -de I-EVOLUTION -conciencia. I-EVOLUTION -Fue B-TREATMENT -trasladado I-TREATMENT -a I-TREATMENT -la I-TREATMENT -unidad I-TREATMENT -de I-TREATMENT -cuidados I-TREATMENT -intensivos I-TREATMENT -y, I-TREATMENT -al I-TREATMENT -día I-TREATMENT -siguiente, I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -cirugía I-TREATMENT -de I-TREATMENT -urgencia. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -acto I-TREATMENT -quirúrgico I-TREATMENT -se I-TREATMENT -verificó I-TREATMENT -la I-TREATMENT -existencia I-TREATMENT -de I-TREATMENT -una I-TREATMENT -válvula I-TREATMENT -aórtica I-TREATMENT -bicúspide I-TREATMENT -con I-TREATMENT -gran I-TREATMENT -destrucción I-TREATMENT -de I-TREATMENT -los I-TREATMENT -velos I-TREATMENT -coronarios I-TREATMENT -y I-TREATMENT -del I-TREATMENT -anillo, I-TREATMENT -con I-TREATMENT -una I-TREATMENT -cavidad I-TREATMENT -de I-TREATMENT -2 I-TREATMENT -por I-TREATMENT -3 I-TREATMENT -cm I-TREATMENT -en I-TREATMENT -relación I-TREATMENT -al I-TREATMENT -seno I-TREATMENT -coronario I-TREATMENT -izquierdo I-TREATMENT -y I-TREATMENT -gran I-TREATMENT -cantidad I-TREATMENT -de I-TREATMENT -vegetaciones. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT -reemplazo I-TREATMENT -valvular, I-TREATMENT -con I-TREATMENT -prótesis I-TREATMENT -Edwards I-TREATMENT -Lifesciences I-TREATMENT -de I-TREATMENT -23 I-TREATMENT -mm, I-TREATMENT -y I-TREATMENT -reparación I-TREATMENT -del I-TREATMENT -anillo I-TREATMENT -con I-TREATMENT -parche I-TREATMENT -de I-TREATMENT -pericardio I-TREATMENT -bovino. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -post-operatorio I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -muy I-EVOLUTION -grave I-EVOLUTION -durante I-EVOLUTION -cuatro I-EVOLUTION -a I-EVOLUTION -cinco I-EVOLUTION -días, I-EVOLUTION -debió B-TREATMENT -ser I-TREATMENT -re-intervenido I-TREATMENT -por I-TREATMENT -sangrado I-TREATMENT -local, I-TREATMENT -presentó B-EVOLUTION -insuficiencia I-EVOLUTION -renal I-EVOLUTION -aguda, I-EVOLUTION -fibrilación I-EVOLUTION -auricular I-EVOLUTION -paroxística, I-EVOLUTION -estuvo B-TREATMENT -conectado I-TREATMENT -a I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -invasora I-TREATMENT -durante I-TREATMENT -cinco I-TREATMENT -días, I-TREATMENT -recibió I-TREATMENT -aminas I-TREATMENT -vasoactivas I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -con I-TREATMENT -ceftriaxona I-TREATMENT -y I-TREATMENT -cloxacilina I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -endovenosa. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -33° I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -internado I-EXPLORATION -se I-EXPLORATION -conoció I-EXPLORATION -la I-EXPLORATION -identificación I-EXPLORATION -del I-EXPLORATION -bacilo I-EXPLORATION -gramnegativo I-EXPLORATION -aislado I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -HLC; I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -Brucella I-EXPLORATION -abortus. I-EXPLORATION -En B-TREATMENT -ese I-TREATMENT -momento I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT -antimicrobiano I-TREATMENT -a I-TREATMENT -doxiciclina I-TREATMENT -más I-TREATMENT -rifampicina I-TREATMENT -y I-TREATMENT -gentamicina. I-TREATMENT -El B-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -operatoria I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -tórpida I-EVOLUTION -pero I-EVOLUTION -con I-EVOLUTION -tendencia I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -mejoría I-EVOLUTION -progresiva I-EVOLUTION -de I-EVOLUTION -modo I-EVOLUTION -que, I-EVOLUTION -cumplidos I-EVOLUTION -54 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -hospitalización, I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -en I-EVOLUTION -relativa I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -y B-TREATMENT -con I-TREATMENT -indicación I-TREATMENT -de I-TREATMENT -continuar I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -con I-TREATMENT -doxiciclina I-TREATMENT -y I-TREATMENT -rifampicina. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -día I-EVOLUTION -88° I-EVOLUTION -desde I-EVOLUTION -su I-EVOLUTION -ingreso I-EVOLUTION -fue I-EVOLUTION -controlado I-EVOLUTION -por I-EVOLUTION -cardio-cirujano I-EVOLUTION -encontrándose I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -generales. I-EVOLUTION -Se B-EXPLORATION -le I-EXPLORATION -solicitó I-EXPLORATION -ecocardiograma I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -y B-TREATMENT -se I-TREATMENT -le I-TREATMENT -suspendieron I-TREATMENT -los I-TREATMENT -antimicrobianos. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -cinco I-EVOLUTION -meses I-EVOLUTION -post I-EVOLUTION -alta I-EVOLUTION -fue I-EVOLUTION -evaluado I-EVOLUTION -en I-EVOLUTION -HLC. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -estaba I-EVOLUTION -asintomático, I-EVOLUTION -en I-EVOLUTION -muy I-EVOLUTION -buen I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -sin I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -insuficiencia I-EVOLUTION -cardíaca. I-EVOLUTION -Traía B-EXPLORATION -exámenes I-EXPLORATION -obtenidos I-EXPLORATION -un I-EXPLORATION -mes I-EXPLORATION -antes: I-EXPLORATION -creatininemia: I-EXPLORATION -1, I-EXPLORATION -01 I-EXPLORATION -mg/dL, I-EXPLORATION -albuminemia: I-EXPLORATION -4, I-EXPLORATION -62 I-EXPLORATION -g/%, I-EXPLORATION -VHS: I-EXPLORATION -15 I-EXPLORATION -mm/h, I-EXPLORATION -orina I-EXPLORATION -completa: I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -reciente I-EXPLORATION -indicaba I-EXPLORATION -un I-EXPLORATION -hematocrito I-EXPLORATION -de I-EXPLORATION -36, I-EXPLORATION -4%, I-EXPLORATION -hemoglobina I-EXPLORATION -12, I-EXPLORATION -5 I-EXPLORATION -g/% I-EXPLORATION -y I-EXPLORATION -leucocitos I-EXPLORATION -9.500/mm3. I-EXPLORATION -Se B-DERIVED_FROM/TO -le I-DERIVED_FROM/TO -derivó I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -seguimiento I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -cardiólogo. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -En B-EVOLUTION -controles I-EVOLUTION -posteriores I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -INERYCT I-EVOLUTION -se I-EVOLUTION -pesquisaron I-EVOLUTION -síntomas I-EVOLUTION -y I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -insuficiencia I-EVOLUTION -cardíaca I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -ecocardiograña I-EVOLUTION -evidenció I-EVOLUTION -reflujo I-EVOLUTION -a I-EVOLUTION -través I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -válvula I-EVOLUTION -protésica. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -27 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos. I-PAST_MEDICAL_HISTORY -Luego B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -estar I-PRESENT_ILLNESS -consumiendo I-PRESENT_ILLNESS -drogas I-PRESENT_ILLNESS -(clorhidrato I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pasta I-PRESENT_ILLNESS -base) I-PRESENT_ILLNESS -notó I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -AV I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ojos I-PRESENT_ILLNESS -rojos. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -acompañó I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -frontal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fotopsias I-PRESENT_ILLNESS -bilaterales. I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -después. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -oftalmológico I-EXPLORATION -destacaba: I-EXPLORATION -AVMC I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OD I-EXPLORATION -igual I-EXPLORATION -a I-EXPLORATION -0, I-EXPLORATION -05 I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Oí I-EXPLORATION -igual I-EXPLORATION -a I-EXPLORATION -0, I-EXPLORATION -1. I-EXPLORATION -Visión I-EXPLORATION -de I-EXPLORATION -colores I-EXPLORATION -alterada I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -ojos. I-EXPLORATION -Reflejos I-EXPLORATION -pupilares I-EXPLORATION -lentos I-EXPLORATION -bilaterales I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -DPAR. I-EXPLORATION -PIÓ I-EXPLORATION -igual I-EXPLORATION -a I-EXPLORATION -24 I-EXPLORATION -mm I-EXPLORATION -Hg I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OD I-EXPLORATION -y I-EXPLORATION -23 I-EXPLORATION -mm I-EXPLORATION -Hg I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Oí. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -al I-EXPLORATION -biomicroscopio I-EXPLORATION -destacaba I-EXPLORATION -Tyndall I-EXPLORATION -+++ I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -ojos. I-EXPLORATION -Presentaba I-EXPLORATION -al I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -vitreítis I-EXPLORATION -++ I-EXPLORATION -bilateral. I-EXPLORATION -Ambas I-EXPLORATION -papilas I-EXPLORATION -estaban I-EXPLORATION -levemente I-EXPLORATION -pálidas. I-EXPLORATION -El I-EXPLORATION -campo I-EXPLORATION -visual I-EXPLORATION -de I-EXPLORATION -Goldmann I-EXPLORATION -mostró I-EXPLORATION -escotomas I-EXPLORATION -centro I-EXPLORATION -centrales I-EXPLORATION -bilaterales. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -cerebro I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION -Se I-EXPLORATION -planteó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -neuritis I-EXPLORATION -óptica I-EXPLORATION -bilateral I-EXPLORATION -y I-EXPLORATION -panuveitis. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -etiológico I-EXPLORATION -mostró I-EXPLORATION -VDRL I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -(+), I-EXPLORATION -título: I-EXPLORATION -1/128, I-EXPLORATION -FTA-ABS I-EXPLORATION -(+) I-EXPLORATION -y I-EXPLORATION -VDRL I-EXPLORATION -en I-EXPLORATION -LCR I-EXPLORATION -(-). I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -citoquímico I-EXPLORATION -del I-EXPLORATION -LCR I-EXPLORATION -resultó I-EXPLORATION -normal. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -penicilina I-TREATMENT -según I-TREATMENT -pautas. I-TREATMENT -Diez B-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -iniciada I-EVOLUTION -la I-EVOLUTION -terapia I-EVOLUTION -los I-EVOLUTION -campos I-EVOLUTION -visuales I-EVOLUTION -mostraron I-EVOLUTION -una I-EVOLUTION -importante I-EVOLUTION -mejoría I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -agudeza I-EVOLUTION -visual I-EVOLUTION -mejoró I-EVOLUTION -a I-EVOLUTION -0, I-EVOLUTION -67 I-EVOLUTION -en I-EVOLUTION -ambos I-EVOLUTION -ojos. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -antecedente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -visión I-PRESENT_ILLNESS -borrosa I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -ya I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sífilis. I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -oftalmológico I-EXPLORATION -destacaba I-EXPLORATION -AVMC I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -025 I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OD I-EXPLORATION -y I-EXPLORATION -0, I-EXPLORATION -05 I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Oí. I-EXPLORATION -Pupilas I-EXPLORATION -isocóricas I-EXPLORATION -reactivas I-EXPLORATION -y I-EXPLORATION -simétricas. I-EXPLORATION -Disociación I-EXPLORATION -luz-cerca I-EXPLORATION -positiva, I-EXPLORATION -con I-EXPLORATION -DPAR I-EXPLORATION -(+) I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OD. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -al I-EXPLORATION -biomicroscopio I-EXPLORATION -mostraba I-EXPLORATION -una I-EXPLORATION -cornea I-EXPLORATION -clara, I-EXPLORATION -cámara I-EXPLORATION -anterior I-EXPLORATION -amplia I-EXPLORATION -y I-EXPLORATION -cristalino I-EXPLORATION -claro. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -se I-EXPLORATION -observaban I-EXPLORATION -papilas I-EXPLORATION -pálidas, I-EXPLORATION -excavación I-EXPLORATION -0, I-EXPLORATION -8 I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OD I-EXPLORATION -y I-EXPLORATION -0, I-EXPLORATION -4 I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Oí. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -revelaron I-EXPLORATION -concentraciones I-EXPLORATION -de I-EXPLORATION -vitamina I-EXPLORATION -B-12 I-EXPLORATION -normales, I-EXPLORATION -VDRL I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -(+), I-EXPLORATION -título I-EXPLORATION -1/32, I-EXPLORATION -FTA-ABS I-EXPLORATION -(+), I-EXPLORATION -VDRL I-EXPLORATION -en I-EXPLORATION -LCR I-EXPLORATION -(+), I-EXPLORATION -ELISA I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION -(-). I-EXPLORATION -RM I-EXPLORATION -cerebral I-EXPLORATION -normal. I-EXPLORATION -Campo I-EXPLORATION -visual I-EXPLORATION -de I-EXPLORATION -Goldmann I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -defecto I-EXPLORATION -altitudinal I-EXPLORATION -bilateral. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -diagnosticó I-EXPLORATION -una I-EXPLORATION -neuritis I-EXPLORATION -óptica I-EXPLORATION -bilateral I-EXPLORATION -luética. I-EXPLORATION -Se B-TREATMENT -hospitalizó I-TREATMENT -e I-TREATMENT -indicó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -penicilina I-TREATMENT -en I-TREATMENT -esquema I-TREATMENT -habitual. I-TREATMENT -Evolucionó B-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -AV I-EVOLUTION -(AVMC: I-EVOLUTION -0, I-EVOLUTION -2 I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -OD I-EVOLUTION -y I-EVOLUTION -0, I-EVOLUTION -3 I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -Oí) I-EVOLUTION -y I-EVOLUTION -del I-EVOLUTION -campo I-EVOLUTION -visual I-EVOLUTION -al I-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION -iniciado I-EVOLUTION -el I-EVOLUTION -tratamiento. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -portador I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -VIH, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -terapia I-PAST_MEDICAL_HISTORY -anti-retro I-PAST_MEDICAL_HISTORY -viral I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sífilis I-PAST_MEDICAL_HISTORY -genital. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -evolucionaba I-PRESENT_ILLNESS -hacían I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -semanas, I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -rojo I-PRESENT_ILLNESS -bilateral, I-PRESENT_ILLNESS -mayor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -OD. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -oftalmológico I-EXPLORATION -presentaba I-EXPLORATION -AVMC I-EXPLORATION -igual I-EXPLORATION -a I-EXPLORATION -0, I-EXPLORATION -05 I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OD I-EXPLORATION -y I-EXPLORATION -0, I-EXPLORATION -1 I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Oí. I-EXPLORATION -PIÓ I-EXPLORATION -de I-EXPLORATION -27 I-EXPLORATION -mm I-EXPLORATION -Hg I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OD I-EXPLORATION -y I-EXPLORATION -25 I-EXPLORATION -mm I-EXPLORATION -Hg I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Oí. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -al I-EXPLORATION -biomicroscopio I-EXPLORATION -presentaba I-EXPLORATION -hiperemia I-EXPLORATION -conjuntival I-EXPLORATION -bilateral, I-EXPLORATION -cornea I-EXPLORATION -con I-EXPLORATION -precipitados I-EXPLORATION -queráticos I-EXPLORATION -pequeños, I-EXPLORATION -mayor I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OD, I-EXPLORATION -sinequias I-EXPLORATION -posteriores I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Oí, I-EXPLORATION -Tyndall I-EXPLORATION -++ I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -OD I-EXPLORATION -y I-EXPLORATION -+ I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Oí. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -del I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -destacaba I-EXPLORATION -vitreítis I-EXPLORATION -bilateral, I-EXPLORATION -papila I-EXPLORATION -rosada, I-EXPLORATION -bordes I-EXPLORATION -netos, I-EXPLORATION -excavación I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -3 I-EXPLORATION -bilateral. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -mostraron I-EXPLORATION -VDRL I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -(+), I-EXPLORATION -título I-EXPLORATION -1/32, I-EXPLORATION -VDRL I-EXPLORATION -en I-EXPLORATION -LCR I-EXPLORATION -(+), I-EXPLORATION -estudio I-EXPLORATION -cito-químico I-EXPLORATION -de I-EXPLORATION -LCR I-EXPLORATION -normal, I-EXPLORATION -FTA-ABS I-EXPLORATION -(+). I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -cerebro I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION -Se B-TREATMENT -diagnosticó I-TREATMENT -una.panuveítis I-TREATMENT -bilateral I-TREATMENT -por I-TREATMENT -sífilis I-TREATMENT -y I-TREATMENT -se I-TREATMENT -le I-TREATMENT -practicó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -esquema I-TREATMENT -habitual I-TREATMENT -de I-TREATMENT -penicilina. I-TREATMENT -Evoluciono B-EVOLUTION -con I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -inflamación I-EVOLUTION -bilateral I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -dos I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -iniciado I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -y I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -AV. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -residencia I-PAST_MEDICAL_HISTORY -urbana I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -Región I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -Araucanía, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -Dr. I-PRESENT_ILLNESS -Hernán I-PRESENT_ILLNESS -Henríquez I-PRESENT_ILLNESS -Aravena I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Temuco I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -anorexia, I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -mialgias I-PRESENT_ILLNESS -generalizadas, I-PRESENT_ILLNESS -cefalea, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -esfuerzos I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -días, I-PRESENT_ILLNESS -refiriendo I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -habitado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -sector I-PRESENT_ILLNESS -rural I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -recientemente. I-PRESENT_ILLNESS -Los B-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -mostraban I-EXPLORATION -hematocrito I-EXPLORATION -de I-EXPLORATION -47%, I-EXPLORATION -leucocitos I-EXPLORATION -5.600/mm3 I-EXPLORATION -y I-EXPLORATION -plaquetas I-EXPLORATION -60.000/mm3 I-EXPLORATION -con I-EXPLORATION -infiltrados I-EXPLORATION -intersticiales I-EXPLORATION -difusos I-EXPLORATION -bilaterales I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax. I-EXPLORATION -Dado I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -clínico I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -antecedentes I-EXPLORATION -epidemiológicos I-EXPLORATION -se I-EXPLORATION -planteó I-EXPLORATION -un I-EXPLORATION -síndrome I-EXPLORATION -cardiopulmonar I-EXPLORATION -por I-EXPLORATION -hantavirus I-EXPLORATION -confirmándose I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -diagnóstica I-EXPLORATION -mediante I-EXPLORATION -test I-EXPLORATION -rápido I-EXPLORATION -específico I-EXPLORATION -(inmunocromatografía I-EXPLORATION -para I-EXPLORATION -IgM). I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -manejo I-TREATMENT -de I-TREATMENT -soporte I-TREATMENT -e I-TREATMENT -indicó I-TREATMENT -1 I-TREATMENT -g/día I-TREATMENT -de I-TREATMENT -metilprednisolona I-TREATMENT -iv I-TREATMENT -durante I-TREATMENT -5 I-TREATMENT -días. I-TREATMENT -Evolucionó B-EVOLUTION -con I-EVOLUTION -disfunción I-EVOLUTION -miocárdica, I-EVOLUTION -requiriendo B-TREATMENT -altas I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -fármacos I-TREATMENT -vasoactivos. I-TREATMENT -Desarrolló I-TREATMENT -durante I-TREATMENT -su I-TREATMENT -estadía I-TREATMENT -hospitalaria I-TREATMENT -una I-TREATMENT -neumonía I-TREATMENT -asociada I-TREATMENT -a I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -tratada I-TREATMENT -inicialmente I-TREATMENT -con I-TREATMENT -imipenem, I-TREATMENT -vancomicina I-TREATMENT -y I-TREATMENT -amikacina. I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -secreción I-EXPLORATION -bronquial I-EXPLORATION -se I-EXPLORATION -aisló I-EXPLORATION -Staphylococcus I-EXPLORATION -aureus I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -meticilina, I-EXPLORATION -cambiándose I-EXPLORATION -vancomicina I-EXPLORATION -por I-EXPLORATION -linezolid. I-EXPLORATION - I-EXPLORATION -Al B-EVOLUTION -sexto I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -inició I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -ictericia I-EVOLUTION -progresiva I-EVOLUTION -con I-EVOLUTION -hiperbilirrubinemia I-EVOLUTION -(13, I-EVOLUTION -9 I-EVOLUTION -mg/dL) I-EVOLUTION -de I-EVOLUTION -predominio I-EVOLUTION -directa I-EVOLUTION -(12, I-EVOLUTION -4 I-EVOLUTION -mg/dL), I-EVOLUTION -aumento I-EVOLUTION -de I-EVOLUTION -fosfatasas I-EVOLUTION -alcalinas I-EVOLUTION -(854 I-EVOLUTION -U/l) I-EVOLUTION -y B-EXPLORATION -una I-EXPLORATION -ecotomografía I-EXPLORATION -abdominal I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -colecistitis I-EXPLORATION -aguda I-EXPLORATION -alitiásica, I-EXPLORATION -la B-TREATMENT -que I-TREATMENT -fue I-TREATMENT -resuelta I-TREATMENT -quirúrgicamente I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -día. I-TREATMENT - I-TREATMENT -Durante B-EVOLUTION -la I-EVOLUTION -segunda I-EVOLUTION -y I-EVOLUTION -tercera I-EVOLUTION -semana, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -continuó I-EVOLUTION -febril I-EVOLUTION -con I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -lesiones I-EVOLUTION -costrosas I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -tronco I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -cara, I-EVOLUTION -una I-EVOLUTION -de I-EVOLUTION -ellas I-EVOLUTION -de I-EVOLUTION -localización I-EVOLUTION -nasal. I-EVOLUTION -Se B-EXPLORATION -obtuvieron I-EXPLORATION -cultivos I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -aspirado I-EXPLORATION -endotraqueal, I-EXPLORATION -los I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -informados I-EXPLORATION -como I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -Candida I-EXPLORATION -albicans I-EXPLORATION -y I-EXPLORATION -Pseudomonas I-EXPLORATION -aeruginosa I-EXPLORATION -respectivamente, I-EXPLORATION -agregándose I-EXPLORATION -al I-EXPLORATION -esquema I-EXPLORATION -antimicrobiano I-EXPLORATION -cobertura I-EXPLORATION -con I-EXPLORATION -anidulafungina I-EXPLORATION -para I-EXPLORATION -C. I-EXPLORATION -albicans I-EXPLORATION -y I-EXPLORATION -cefoperazona/sulbactam I-EXPLORATION -para I-EXPLORATION -Pseudomonas I-EXPLORATION -aeruginosa. I-EXPLORATION -Permaneció B-EVOLUTION -grave, I-EVOLUTION -aunque I-EVOLUTION -afebril I-EVOLUTION -y, I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -punto I-EVOLUTION -de I-EVOLUTION -vista I-EVOLUTION -cardiopulmonar, I-EVOLUTION -requiriendo I-EVOLUTION -menor I-EVOLUTION -apoyo I-EVOLUTION -ventilatorio, I-EVOLUTION -con I-EVOLUTION -modificación I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -de I-EVOLUTION -soporte I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -aminas I-EVOLUTION -vasoactivas. I-EVOLUTION -Durante I-EVOLUTION -la I-EVOLUTION -cuarta I-EVOLUTION -semana I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -se I-EVOLUTION -describió I-EVOLUTION -la I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -lesión I-EVOLUTION -ulcerada I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -dorso I-EVOLUTION -nasal, I-EVOLUTION -de I-EVOLUTION -fondo I-EVOLUTION -necrótico I-EVOLUTION -y I-EVOLUTION -bordes I-EVOLUTION -irregulares, I-EVOLUTION -además I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -escara I-EVOLUTION -sacra I-EVOLUTION -y I-EVOLUTION -otras I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -talones. I-EVOLUTION - I-EVOLUTION -Continuó I-EVOLUTION -afebril I-EVOLUTION -y B-TREATMENT -en I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -cefoperazona/ I-TREATMENT -sulbactam I-TREATMENT -y I-TREATMENT -anidulafungina. I-TREATMENT -Un B-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -nasal I-EXPLORATION -fue I-EXPLORATION -informado I-EXPLORATION -como I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -C. I-EXPLORATION -albicans. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -lesión I-EXPLORATION -se I-EXPLORATION -apreciaban I-EXPLORATION -abundantes I-EXPLORATION -elementos I-EXPLORATION -micóticos I-EXPLORATION -tipo I-EXPLORATION -hifas I-EXPLORATION -no I-EXPLORATION -septadas, I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -mucor, I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -fragmento I-EXPLORATION -del I-EXPLORATION -ala I-EXPLORATION -nasal. I-EXPLORATION -Con B-TREATMENT -estos I-TREATMENT -resultados I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -la I-TREATMENT -anidulafungina I-TREATMENT -e I-TREATMENT -inició I-TREATMENT -terapia I-TREATMENT -con I-TREATMENT -anfotericina I-TREATMENT -B I-TREATMENT -desoxicolato I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -ajustada I-TREATMENT -según I-TREATMENT -función I-TREATMENT -renal I-TREATMENT -(creatininemia: I-TREATMENT -3 I-TREATMENT -mg/dL). I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo, I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -(TAC) I-EXPLORATION -cerebral I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -cavidades I-EXPLORATION -paranasales I-EXPLORATION -no I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -concomitancia I-EXPLORATION -de I-EXPLORATION -lesiones I-EXPLORATION -profundas. I-EXPLORATION - I-EXPLORATION -Permaneció B-EVOLUTION -grave, I-EVOLUTION -con I-EVOLUTION -ictericia I-EVOLUTION -intensa I-EVOLUTION -(bilirrubinemia I-EVOLUTION -total: I-EVOLUTION -21 I-EVOLUTION -mg/dL, I-EVOLUTION -bilirrubinemia I-EVOLUTION -directa: I-EVOLUTION -19 I-EVOLUTION -mg/dL, I-EVOLUTION -fosfatasas I-EVOLUTION -alcalinas: I-EVOLUTION -854 I-EVOLUTION -U/l, I-EVOLUTION -GOT: I-EVOLUTION -83 I-EVOLUTION -U/L, I-EVOLUTION -GPT: I-EVOLUTION -8 I-EVOLUTION -U/L). I-EVOLUTION -La B-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -abdomen-pélvis I-EXPLORATION -demostró I-EXPLORATION -hepatomegalia I-EXPLORATION -difusa I-EXPLORATION -sin I-EXPLORATION -abscedación, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -de I-EXPLORATION -estructura I-EXPLORATION -conservada. I-EXPLORATION -Una I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -comprobó I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -extensa I-EXPLORATION -efusión I-EXPLORATION -pleural I-EXPLORATION -a I-EXPLORATION -izquierda I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -colapso I-EXPLORATION -pulmonar I-EXPLORATION -ipsilateral. I-EXPLORATION -La I-EXPLORATION -punción I-EXPLORATION -de I-EXPLORATION -esta I-EXPLORATION -efusión I-EXPLORATION -dio I-EXPLORATION -salida I-EXPLORATION -a I-EXPLORATION -líquido I-EXPLORATION -hemático I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -coagulaba I-EXPLORATION -y B-TREATMENT -se I-TREATMENT -instaló I-TREATMENT -un I-TREATMENT -tubo I-TREATMENT -de I-TREATMENT -drenaje I-TREATMENT -pleural. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -posteriores I-EVOLUTION -evolucionó I-EVOLUTION -febril, I-EVOLUTION -en I-EVOLUTION -anuria, I-EVOLUTION -con I-EVOLUTION -altos I-EVOLUTION -requerimientos I-EVOLUTION -de I-EVOLUTION -apoyo I-EVOLUTION -ventilatorio I-EVOLUTION -y I-EVOLUTION -hemodinámico. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -falleció, I-EVOLUTION -habiendo B-TREATMENT -completado I-TREATMENT -cinco I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -anfotericina I-TREATMENT -B I-TREATMENT -y I-TREATMENT -luego I-TREATMENT -de I-TREATMENT -efectuarse I-TREATMENT -dos I-TREATMENT -aseos I-TREATMENT -quirúrgicos I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -nasal. I-TREATMENT - I-TREATMENT - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -47 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -cinco I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -irregular I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -metabólico I-PAST_MEDICAL_HISTORY -(amaurosis I-PAST_MEDICAL_HISTORY -bilateral I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -hospitalizaciones I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cetoacidosis I-PAST_MEDICAL_HISTORY -diabética), I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -inicialmente I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -glibenclamida I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -luego I-PAST_MEDICAL_HISTORY -insulina I-PAST_MEDICAL_HISTORY -NPH. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -pierna I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -secundario I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -caída, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -somnolencia, I-PRESENT_ILLNESS -anorexia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -respiratoria, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -primario I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -salud I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -administró I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -millones I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -UI I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -penicilina I-PRESENT_ILLNESS -G I-PRESENT_ILLNESS -sódica. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -al I-EXPLORATION -servicio I-EXPLORATION -de I-EXPLORATION -urgencia I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -constató I-EXPLORATION -en I-EXPLORATION -sopor, I-EXPLORATION -afebril, I-EXPLORATION -hipotenso I-EXPLORATION -y I-EXPLORATION -deshidratado. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -necrótica I-EXPLORATION -y I-EXPLORATION -flictenas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -pretibial I-EXPLORATION -izquierda I-EXPLORATION -de I-EXPLORATION -30 I-EXPLORATION -x I-EXPLORATION -10 I-EXPLORATION -cm, I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -pulsos I-EXPLORATION -poplíteo I-EXPLORATION -y I-EXPLORATION -pedio I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -mostraron I-EXPLORATION -leucocitosis I-EXPLORATION -(20.400/mm3), I-EXPLORATION -hiperglicemia I-EXPLORATION -(539 I-EXPLORATION -mg/dL), I-EXPLORATION -acidosis I-EXPLORATION -metabólica I-EXPLORATION -(pH I-EXPLORATION -6, I-EXPLORATION -9), I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -elevada I-EXPLORATION -(189 I-EXPLORATION -mg/L) I-EXPLORATION -y I-EXPLORATION -disfunción I-EXPLORATION -renal I-EXPLORATION -(creatininemia: I-EXPLORATION -1, I-EXPLORATION -87 I-EXPLORATION -mg/dL, I-EXPLORATION -potasio: I-EXPLORATION -5, I-EXPLORATION -5 I-EXPLORATION -mmol/L). I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -le I-TREATMENT -efectuó I-TREATMENT -aseo I-TREATMENT -quirúrgico I-TREATMENT -encontrándose I-TREATMENT -una I-TREATMENT -necrosis I-TREATMENT -muscular I-TREATMENT -del I-TREATMENT -compartimiento I-TREATMENT -antero I-TREATMENT -lateral I-TREATMENT -de I-TREATMENT -la I-TREATMENT -pierna I-TREATMENT -izquierda; I-TREATMENT -se B-EXPLORATION -envió I-EXPLORATION -muestras I-EXPLORATION -para I-EXPLORATION -cultivo I-EXPLORATION -y I-EXPLORATION -biopsia. I-EXPLORATION -Ingresó B-TREATMENT -a I-TREATMENT -la I-TREATMENT -UCI I-TREATMENT -con I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -fascitis I-TREATMENT -necrosante I-TREATMENT -y I-TREATMENT -sepsis I-TREATMENT -grave, I-TREATMENT -iniciando I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -con I-TREATMENT -ceftriaxona I-TREATMENT -y I-TREATMENT -clindamicina, I-TREATMENT -analgesia I-TREATMENT -con I-TREATMENT -fentanilo I-TREATMENT -y I-TREATMENT -corrección I-TREATMENT -metabólica I-TREATMENT -con I-TREATMENT -bicarbonato I-TREATMENT -de I-TREATMENT -sodio, I-TREATMENT -gluconato I-TREATMENT -de I-TREATMENT -calcio, I-TREATMENT -aporte I-TREATMENT -de I-TREATMENT -volumen I-TREATMENT -e I-TREATMENT -insulina. I-TREATMENT - I-TREATMENT -Evolucionó B-EVOLUTION -hacia I-EVOLUTION -la I-EVOLUTION -estabilidad, I-EVOLUTION -afebril, I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -sus I-EVOLUTION -parámetros I-EVOLUTION -metabólicos I-EVOLUTION -pero I-EVOLUTION -con I-EVOLUTION -persistencia I-EVOLUTION -y I-EVOLUTION -progresión I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -lesión I-EVOLUTION -necrótica I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -pierna I-EVOLUTION -izquierda. I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -informó I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tejido I-EXPLORATION -fibroconectivo I-EXPLORATION -denso I-EXPLORATION -y I-EXPLORATION -muscular I-EXPLORATION -esquelético I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -proceso I-EXPLORATION -inflamatorio I-EXPLORATION -agudo I-EXPLORATION -necrosante I-EXPLORATION -y I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -elementos I-EXPLORATION -micóticos I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -hifas I-EXPLORATION -no I-EXPLORATION -septadas, I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -mucor, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -indicó I-EXPLORATION -anfotericina I-EXPLORATION -B I-EXPLORATION -desoxicolato. I-EXPLORATION -El I-EXPLORATION -cultivo I-EXPLORATION -resultó I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -elementos I-EXPLORATION -micóticos. I-EXPLORATION - I-EXPLORATION -Luego I-EXPLORATION -de I-EXPLORATION -20 I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -tratamiento I-EXPLORATION -antifúngico I-EXPLORATION -y I-EXPLORATION -tres I-EXPLORATION -aseos I-EXPLORATION -quirúrgicos, I-EXPLORATION -la I-EXPLORATION -RM I-EXPLORATION -evidenciaba I-EXPLORATION -un I-EXPLORATION -compromiso I-EXPLORATION -infeccioso I-EXPLORATION -necrosante I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -tuberosidad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tibia I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -realizar I-EXPLORATION -amputación I-EXPLORATION -suprapatelar I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pierna I-EXPLORATION -izquierda. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -biopsia I-EXPLORATION -intra-operatoria I-EXPLORATION -del I-EXPLORATION -margen I-EXPLORATION -de I-EXPLORATION -sección I-EXPLORATION -proximal I-EXPLORATION -no I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -elementos I-EXPLORATION -micóticos I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -mucor. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -punto I-EVOLUTION -de I-EVOLUTION -vista I-EVOLUTION -quirúrgico I-EVOLUTION -e I-EVOLUTION -infeccioso I-EVOLUTION -completando I-EVOLUTION -30 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -anfotericina I-EVOLUTION -B. I-EVOLUTION -Fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -encontrándose, I-EVOLUTION -al I-EVOLUTION -momento I-EVOLUTION -de I-EVOLUTION -preparar I-EVOLUTION -este I-EVOLUTION -reporte, I-EVOLUTION -bajo I-EVOLUTION -controles I-EVOLUTION -con I-EVOLUTION -fisiatra I-EVOLUTION -y I-EVOLUTION -terapia I-EVOLUTION -ocupacional. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -42 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -soltero B-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -hijo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -comerciante, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -marzo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2009 I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -Dr. I-PRESENT_ILLNESS -Sótero I-PRESENT_ILLNESS -Del I-PRESENT_ILLNESS -Río I-PRESENT_ILLNESS -(HSDR) I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -cervical I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS -Refería I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -cervical I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -progresivo, I-PRESENT_ILLNESS -indoloro, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -lógica I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -acompañado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -nocturna I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -febril I-PRESENT_ILLNESS -intermitente I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -temperatura I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -cuantificada. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -revisión I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -sistemas I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -destacaban I-PRESENT_ILLNESS -otros I-PRESENT_ILLNESS -síntomas. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -relevantes I-PAST_MEDICAL_HISTORY -destacaban I-PAST_MEDICAL_HISTORY -relaciones I-PAST_MEDICAL_HISTORY -sexuales I-PAST_MEDICAL_HISTORY -previas I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hombres I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -uso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -preservativo. I-PAST_MEDICAL_HISTORY -Negaba I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -drogas. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -un I-EXPLORATION -paciente I-EXPLORATION -en I-EXPLORATION -buenas I-EXPLORATION -condiciones I-EXPLORATION -generales, I-EXPLORATION -afebril, I-EXPLORATION -piel I-EXPLORATION -con I-EXPLORATION -descamación I-EXPLORATION -fina I-EXPLORATION -difusa, I-EXPLORATION -algorra I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -paladar I-EXPLORATION -y I-EXPLORATION -leucoplaquia I-EXPLORATION -vellosa I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -lengua. I-EXPLORATION -Destacaba I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -cervical I-EXPLORATION -lateral I-EXPLORATION -derecha I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -cms, I-EXPLORATION -indolora, I-EXPLORATION -pétrea, I-EXPLORATION -adherida I-EXPLORATION -a I-EXPLORATION -planos I-EXPLORATION -profundos, I-EXPLORATION -de I-EXPLORATION -textura I-EXPLORATION -nodular I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -inflamatorios. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -decidió I-EXPLORATION -hospitalizar I-EXPLORATION -para I-EXPLORATION -estudio I-EXPLORATION -por I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -neoplasia I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -inmunosupresión. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -principales I-EXPLORATION -hallazgos I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -fueron I-EXPLORATION -anemia I-EXPLORATION -normocítica I-EXPLORATION -- I-EXPLORATION -normocrómica I-EXPLORATION -con I-EXPLORATION -hematocrito I-EXPLORATION -de I-EXPLORATION -31, I-EXPLORATION -1%, I-EXPLORATION -leucocitos I-EXPLORATION -de I-EXPLORATION -5.900 I-EXPLORATION -céls/mm3 I-EXPLORATION -con I-EXPLORATION -65, I-EXPLORATION -6% I-EXPLORATION -de I-EXPLORATION -granulocitos I-EXPLORATION -y I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -plaquetas I-EXPLORATION -de I-EXPLORATION -161.000 I-EXPLORATION -céls/mm3, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -(PCR) I-EXPLORATION -56 I-EXPLORATION -mg/L I-EXPLORATION -(N I-EXPLORATION -< I-EXPLORATION -5 I-EXPLORATION -mg/L). I-EXPLORATION -Creatininemia, I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -coagulación, I-EXPLORATION -electrolitos I-EXPLORATION -plasmáticos, I-EXPLORATION -perfil I-EXPLORATION -bioquímico I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -sedimento I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Baciloscopias I-EXPLORATION -de I-EXPLORATION -expectoración I-EXPLORATION -y I-EXPLORATION -urocultivo I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -no I-EXPLORATION -demostró I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -ELISA I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -positivo I-EXPLORATION -y I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -VHB I-EXPLORATION -y I-EXPLORATION -VHC, I-EXPLORATION -ambas I-EXPLORATION -negativas. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -solicitó I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -cerebro, I-EXPLORATION -cuello, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -cervical I-EXPLORATION -derecho I-EXPLORATION -que I-EXPLORATION -parecía I-EXPLORATION -depender I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -glándula I-EXPLORATION -submandibular I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -8, I-EXPLORATION -4 I-EXPLORATION -x I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -6 I-EXPLORATION -cm, I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -neoplásico I-EXPLORATION -infiltrativo, I-EXPLORATION -en I-EXPLORATION -cuyo I-EXPLORATION -diagnóstico I-EXPLORATION -diferencial I-EXPLORATION -se I-EXPLORATION -sugería I-EXPLORATION -considerar I-EXPLORATION -carcinoma I-EXPLORATION -adenoide I-EXPLORATION -quístico I-EXPLORATION -con I-EXPLORATION -baja I-EXPLORATION -probabilidad I-EXPLORATION -de I-EXPLORATION -linfoma. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -recibieron I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION -del I-EXPLORATION -hemocultivo I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -Salmonella I-EXPLORATION -grupo I-EXPLORATION -B I-EXPLORATION -multisensible I-EXPLORATION -(sensible I-EXPLORATION -a I-EXPLORATION -cefo-taxima, I-EXPLORATION -ciprofloxacina, I-EXPLORATION -ácido I-EXPLORATION -nalidíxico, I-EXPLORATION -cloranfenicol I-EXPLORATION -y I-EXPLORATION -cotrimoxazol) I-EXPLORATION -posterior I-EXPLORATION -a I-EXPLORATION -3, I-EXPLORATION -8 I-EXPLORATION -horas I-EXPLORATION -de I-EXPLORATION -incubación I-EXPLORATION -(automatizados). I-EXPLORATION - I-EXPLORATION -Además, I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -incisional I-EXPLORATION -quirúrgica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -cervical I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -tejido I-EXPLORATION -tumoral I-EXPLORATION -cerebroideo I-EXPLORATION -con I-EXPLORATION -sangrado I-EXPLORATION -profuso I-EXPLORATION -y I-EXPLORATION -gran I-EXPLORATION -compromiso I-EXPLORATION -inflamatorio I-EXPLORATION -circundante. I-EXPLORATION -Se I-EXPLORATION -enviaron I-EXPLORATION -muestras I-EXPLORATION -a I-EXPLORATION -cultivos I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -corriente I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -Koch, I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -directa I-EXPLORATION -y I-EXPLORATION -baciloscopia. I-EXPLORATION -Los I-EXPLORATION -cultivos I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -fueron I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -Salmonella I-EXPLORATION -grupo I-EXPLORATION -B I-EXPLORATION -multisensible, I-EXPLORATION -al I-EXPLORATION -tercer I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -incubación. I-EXPLORATION -Ambos I-EXPLORATION -cultivos I-EXPLORATION -fueron I-EXPLORATION -enviados I-EXPLORATION -al I-EXPLORATION -Instituto I-EXPLORATION -de I-EXPLORATION -Salud I-EXPLORATION -Pública I-EXPLORATION -(ISP) I-EXPLORATION -para I-EXPLORATION -su I-EXPLORATION -confirmación I-EXPLORATION -y I-EXPLORATION -tipificación, I-EXPLORATION -correspondiendo I-EXPLORATION -a I-EXPLORATION -Salmonella I-EXPLORATION -Typhimurium. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ceftriaxona I-TREATMENT -ev I-TREATMENT -2 I-TREATMENT -g/día I-TREATMENT -por I-TREATMENT -14 I-TREATMENT -días I-TREATMENT -seguido I-TREATMENT -por I-TREATMENT -ciprofloxacina I-TREATMENT -oral I-TREATMENT -500 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas I-TREATMENT -por I-TREATMENT -30 I-TREATMENT -días. I-TREATMENT -El B-EXPLORATION -examen I-EXPLORATION -histológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -cervical I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -proceso I-EXPLORATION -inflamatorio I-EXPLORATION -crónico I-EXPLORATION -granulomatoso I-EXPLORATION -no I-EXPLORATION -necrosante I-EXPLORATION -con I-EXPLORATION -focos I-EXPLORATION -supurativos. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -elementos I-EXPLORATION -celulares I-EXPLORATION -malignos I-EXPLORATION -ni I-EXPLORATION -microorganismos I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -microscópico. I-EXPLORATION -El I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -Koch I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -con I-EVOLUTION -disminución I-EVOLUTION -progresiva I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -masa I-EVOLUTION -cervical I-EVOLUTION -y I-EVOLUTION -resolución I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -febril, I-EVOLUTION -no I-EVOLUTION -requiriendo I-EVOLUTION -nuevas I-EVOLUTION -intervenciones I-EVOLUTION -quirúrgicas. I-EVOLUTION -Fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -luego I-EVOLUTION -de I-EVOLUTION -44 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -con I-EVOLUTION -indicación I-EVOLUTION -de I-EVOLUTION -mantener I-EVOLUTION -ciprofloxacina I-EVOLUTION -oral I-EVOLUTION -hasta I-EVOLUTION -completar I-EVOLUTION -30 I-EVOLUTION -días. I-EVOLUTION -Se I-EVOLUTION -controló I-EVOLUTION -posteriormente I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -policlínica I-EVOLUTION -de I-EVOLUTION -Infectología I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -HSDR I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -constató I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones, I-EVOLUTION -con I-EVOLUTION -aumento I-EVOLUTION -de I-EVOLUTION -peso I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -síntomas I-EVOLUTION -sistémicos; I-EVOLUTION -PCR I-EVOLUTION -3 I-EVOLUTION -mg/L. I-EVOLUTION -Con B-TREATMENT -confirmación I-TREATMENT -del I-TREATMENT -Instituto I-TREATMENT -de I-TREATMENT -Salud I-TREATMENT -Pública I-TREATMENT -de I-TREATMENT -la I-TREATMENT -serología I-TREATMENT -positiva I-TREATMENT -para I-TREATMENT -VIH I-TREATMENT -y I-TREATMENT -confirmación I-TREATMENT -de I-TREATMENT -identidad I-TREATMENT -informada I-TREATMENT -luego I-TREATMENT -del I-TREATMENT -alta, I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -ingreso I-TREATMENT -al I-TREATMENT -Programa I-TREATMENT -de I-TREATMENT -VIH/SIDA I-TREATMENT -para I-TREATMENT -iniciar I-TREATMENT -terapia I-TREATMENT -anti-retroviral I-TREATMENT -(TARV) I-TREATMENT -con I-TREATMENT -tenofovir, I-TREATMENT -lamivudina I-TREATMENT -y I-TREATMENT -atazanavir/ritonavir I-TREATMENT -con I-TREATMENT -un I-TREATMENT -recuento I-TREATMENT -de I-TREATMENT -linfocitos I-TREATMENT -CD4 I-TREATMENT -de I-TREATMENT -12 I-TREATMENT -céls/mL I-TREATMENT -y I-TREATMENT -carga I-TREATMENT -viral I-TREATMENT -de I-TREATMENT -1.800 I-TREATMENT -copias I-TREATMENT -ARN/ml. I-TREATMENT -La I-TREATMENT -decisión I-TREATMENT -de I-TREATMENT -utilizar I-TREATMENT -este I-TREATMENT -esquema, I-TREATMENT -el I-TREATMENT -cual I-TREATMENT -no I-TREATMENT -es I-TREATMENT -el I-TREATMENT -de I-TREATMENT -uso I-TREATMENT -habitual I-TREATMENT -como I-TREATMENT -primera I-TREATMENT -línea, I-TREATMENT -fue I-TREATMENT -decisión I-TREATMENT -del I-TREATMENT -equipo I-TREATMENT -de I-TREATMENT -Infectología I-TREATMENT -para I-TREATMENT -mejorar I-TREATMENT -la I-TREATMENT -adherencia I-TREATMENT -del I-TREATMENT -paciente I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -es I-TREATMENT -mejor I-TREATMENT -tolerado I-TREATMENT -en I-TREATMENT -pacientes I-TREATMENT -operados I-TREATMENT -y I-TREATMENT -con I-TREATMENT -un I-TREATMENT -nivel I-TREATMENT -avanzado I-TREATMENT -de I-TREATMENT -inmunosupresión. I-TREATMENT -Una B-EXPLORATION -nuevo I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -cabeza I-EXPLORATION -y I-EXPLORATION -cuello I-EXPLORATION -posterior I-EXPLORATION -a I-EXPLORATION -18 I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -tratamiento I-EXPLORATION -antimicrobiano, I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -adenopatías I-EXPLORATION -susceptibles I-EXPLORATION -de I-EXPLORATION -ser I-EXPLORATION -biopsiadas I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -dado I-EXPLORATION -de I-EXPLORATION -alta I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -equipo I-EXPLORATION -de I-EXPLORATION -Cirugía I-EXPLORATION -de I-EXPLORATION -Cabeza I-EXPLORATION -y I-EXPLORATION -Cuello. I-EXPLORATION - I-EXPLORATION -Un B-EVOLUTION -año I-EVOLUTION -después I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones, I-EVOLUTION -con I-EVOLUTION -resolución I-EVOLUTION -definitiva I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -masa I-EVOLUTION -cervical I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -mismo I-EVOLUTION -esquema I-EVOLUTION -de I-EVOLUTION -TARV I-EVOLUTION -A I-EVOLUTION -15 I-EVOLUTION -meses I-EVOLUTION -plazo I-EVOLUTION -presentaba I-EVOLUTION -carga I-EVOLUTION -viral I-EVOLUTION -indetectable, I-EVOLUTION -con I-EVOLUTION -recuento I-EVOLUTION -de I-EVOLUTION -linfocitos I-EVOLUTION -CD4 I-EVOLUTION -de I-EVOLUTION -181 I-EVOLUTION -céls/mL I-EVOLUTION -y I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -nuevas I-EVOLUTION -infecciones I-EVOLUTION -bacterianas I-EVOLUTION -graves. I-EVOLUTION - I-EVOLUTION - -Prescolar B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -asfixia I-PAST_MEDICAL_HISTORY -neonatal I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -circular I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -cuello, I-PAST_MEDICAL_HISTORY -bronconeumonía I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -virus I-PAST_MEDICAL_HISTORY -respiratorio I-PAST_MEDICAL_HISTORY -sincicial I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -calendario I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vacunación I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -programa I-PAST_MEDICAL_HISTORY -nacional I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -inmunizaciones I-PAST_MEDICAL_HISTORY -completo I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -edad. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -inició I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -diagnóstico, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -gastrointestinales I-PRESENT_ILLNESS -caracterizados I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -constipación, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -difuso, I-PRESENT_ILLNESS -intermitente, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -intensificó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -siguientes. I-PRESENT_ILLNESS -Consultó B-TREATMENT -reiteradamente I-TREATMENT -a I-TREATMENT -pediatra I-TREATMENT -y I-TREATMENT -gastroenterólogo I-TREATMENT -infantil, I-TREATMENT -indicándose I-TREATMENT -dieta I-TREATMENT -y I-TREATMENT -lactulosa; I-TREATMENT -además B-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -eco-grafía I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -normal. I-EXPLORATION -A B-EVOLUTION -las I-EVOLUTION -tres I-EVOLUTION -semanas I-EVOLUTION -se I-EVOLUTION -agregó I-EVOLUTION -decaimiento, I-EVOLUTION -irritabilidad I-EVOLUTION -nocturna, I-EVOLUTION -dolor I-EVOLUTION -lumbar I-EVOLUTION -y I-EVOLUTION -posteriormente I-EVOLUTION -postración I-EVOLUTION -relativa I-EVOLUTION -(no I-EVOLUTION -caminaba, I-EVOLUTION -no I-EVOLUTION -jugaba) I-EVOLUTION -y I-EVOLUTION -dificultad I-EVOLUTION -para I-EVOLUTION -mantenerse I-EVOLUTION -sentado. I-EVOLUTION -Se B-EXPLORATION -le I-EXPLORATION -solicitó I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -lumbar I-EXPLORATION -con I-EXPLORATION -resultado I-EXPLORATION -normal. I-EXPLORATION -Por B-TREATMENT -persistencia I-TREATMENT -de I-TREATMENT -sintomatología, I-TREATMENT -fue I-TREATMENT -hospitalizada I-TREATMENT -con I-TREATMENT -la I-TREATMENT -hipótesis I-TREATMENT -de I-TREATMENT -síndrome I-TREATMENT -de I-TREATMENT -Guillain I-TREATMENT -Barré. I-TREATMENT -Una B-EXPLORATION -segunda I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -lumbar I-EXPLORATION -y I-EXPLORATION -evaluación I-EXPLORATION -neurológica I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Hemograma I-EXPLORATION -con I-EXPLORATION -hematocrito I-EXPLORATION -de I-EXPLORATION -37, I-EXPLORATION -7%, I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -leucocitos I-EXPLORATION -9.300/mm3, I-EXPLORATION -sin I-EXPLORATION -desviación I-EXPLORATION -a I-EXPLORATION -izquierda, I-EXPLORATION -plaquetas I-EXPLORATION -en I-EXPLORATION -rango I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -VHS I-EXPLORATION -de I-EXPLORATION -48 I-EXPLORATION -mm/hora, I-EXPLORATION -con I-EXPLORATION -PCR I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -5 I-EXPLORATION -mg/dL I-EXPLORATION -(normal: I-EXPLORATION -0-1). I-EXPLORATION -Un I-EXPLORATION -cintigrama I-EXPLORATION -óseo I-EXPLORATION -mostró I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -captación I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -L2-L3. I-EXPLORATION -En I-EXPLORATION -virtud I-EXPLORATION -de I-EXPLORATION -este I-EXPLORATION -hallazgo, I-EXPLORATION -se I-EXPLORATION -reevaluó I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -obtenida I-EXPLORATION -con I-EXPLORATION -anterioridad, I-EXPLORATION -evidenciándose I-EXPLORATION -disminución I-EXPLORATION -del I-EXPLORATION -espacio I-EXPLORATION -intervertebral I-EXPLORATION -L2-L3. I-EXPLORATION -Una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -fue I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -espondilodiscitis. I-EXPLORATION -La I-EXPLORATION -punción I-EXPLORATION -del I-EXPLORATION -disco I-EXPLORATION -vertebral I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -L2- I-EXPLORATION -L3 I-EXPLORATION -bajo I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -(TC), I-EXPLORATION -mostró I-EXPLORATION -líquido I-EXPLORATION -con I-EXPLORATION -abundantes I-EXPLORATION -polimorfonucleares. I-EXPLORATION -Se I-EXPLORATION -envió I-EXPLORATION -a I-EXPLORATION -cultivo I-EXPLORATION -corriente, I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -Koch I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -reacción I-EXPLORATION -de I-EXPLORATION -polimerasa I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -(RPC) I-EXPLORATION -para I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -ARN I-EXPLORATION -16S I-EXPLORATION -universal. I-EXPLORATION -Se B-TREATMENT -tomaron I-TREATMENT -hemocultivos I-TREATMENT -que I-TREATMENT -resultaron I-TREATMENT -negativos I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -empírico I-TREATMENT -iv I-TREATMENT -con I-TREATMENT -cloxacilina I-TREATMENT -y I-TREATMENT -cefotaxima, I-TREATMENT -además I-TREATMENT -de I-TREATMENT -analgesia I-TREATMENT -con I-TREATMENT -ketoprofeno. I-TREATMENT -Evolucionó B-EVOLUTION -favorablemente, I-EVOLUTION -afebril I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -disminución I-EVOLUTION -del I-EVOLUTION -dolor. I-EVOLUTION -Los B-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -mostraron I-EXPLORATION -lenta I-EXPLORATION -regresión I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -parámetros I-EXPLORATION -infecciosos I-EXPLORATION -inflamatorios, I-EXPLORATION -con I-EXPLORATION -8.900 I-EXPLORATION -leucocitos/mm3 I-EXPLORATION -sin I-EXPLORATION -desviación I-EXPLORATION -a I-EXPLORATION -izquierda, I-EXPLORATION -VHS I-EXPLORATION -de I-EXPLORATION -35 I-EXPLORATION -mm/hora I-EXPLORATION -y I-EXPLORATION -PCR I-EXPLORATION -de I-EXPLORATION -4, I-EXPLORATION -4 I-EXPLORATION -mg/dL. I-EXPLORATION -El I-EXPLORATION -cultivo I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -articular I-EXPLORATION -resultó I-EXPLORATION -negativo I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -RPC I-EXPLORATION -universal I-EXPLORATION -demostró I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -K. I-EXPLORATION -kingae. I-EXPLORATION - I-EXPLORATION -Una B-TREATMENT -vez I-TREATMENT -completado I-TREATMENT -los I-TREATMENT -10 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -iv, I-TREATMENT -y I-TREATMENT -dada I-TREATMENT -la I-TREATMENT -buena I-TREATMENT -evolución I-TREATMENT -tanto I-TREATMENT -clínica I-TREATMENT -como I-TREATMENT -de I-TREATMENT -laboratorio, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -dar I-TREATMENT -el I-TREATMENT -alta, I-TREATMENT -con I-TREATMENT -inmovilización I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -un I-TREATMENT -corset I-TREATMENT -y I-TREATMENT -con I-TREATMENT -indicación I-TREATMENT -de I-TREATMENT -completar I-TREATMENT -cuatro I-TREATMENT -semanas I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -con I-TREATMENT -amoxicilina. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sana, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia, I-PAST_MEDICAL_HISTORY -en B-PRESENT_ILLNESS -proceso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -amamantamiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -hijo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -meses. I-PRESENT_ILLNESS -Procedente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -suburbana I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Villa I-PAST_MEDICAL_HISTORY -Alemana, I-PAST_MEDICAL_HISTORY -Región I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Valparaíso. I-PAST_MEDICAL_HISTORY -Vive I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -casa I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -dispone I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -agua I-PAST_MEDICAL_HISTORY -potable I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -alcantarillado; I-PAST_MEDICAL_HISTORY -posee I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -perro, I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -gatos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -conejo I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -mascotas. I-PAST_MEDICAL_HISTORY -Como I-PAST_MEDICAL_HISTORY -dueña I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -casa, I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -ella I-PAST_MEDICAL_HISTORY -quien I-PAST_MEDICAL_HISTORY -prepara I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -alimentos. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -mes, I-PAST_MEDICAL_HISTORY -separado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -quince I-PAST_MEDICAL_HISTORY -dias, I-PAST_MEDICAL_HISTORY -habia I-PAST_MEDICAL_HISTORY -efectuado I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -viajes I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -ciudad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Talcahuano, I-PAST_MEDICAL_HISTORY -Concepción, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -consecuencias I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -desastre I-PAST_MEDICAL_HISTORY -ocurrido I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -casa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -familiar I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -terremoto I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tsunami I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -febrero I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2010. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Consultorio I-PRESENT_ILLNESS -Periférico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Villa I-PRESENT_ILLNESS -Alemana I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -ejemplares I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -gusanos I-PRESENT_ILLNESS -eliminados I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -boca I-PRESENT_ILLNESS -hacia I-PRESENT_ILLNESS -siete I-PRESENT_ILLNESS -dias. I-PRESENT_ILLNESS -Relató I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encontraba I-PRESENT_ILLNESS -durmiendo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -despertó I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -sentir I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -muy I-PRESENT_ILLNESS -extraña I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -garganta I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -luego I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -boca; I-PRESENT_ILLNESS -frente I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -movimiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuerpo I-PRESENT_ILLNESS -extraño I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -boca, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -lengua I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -aprisionó I-PRESENT_ILLNESS -contra I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paladar I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -retirarlo I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -sus I-PRESENT_ILLNESS -dedos. I-PRESENT_ILLNESS -Lo I-PRESENT_ILLNESS -dejó I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -velador I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -observó I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -enroscaba. I-PRESENT_ILLNESS -Posteriormente I-PRESENT_ILLNESS -eliminó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -segundo I-PRESENT_ILLNESS -ejemplar; I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -casos I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -tos, I-PRESENT_ILLNESS -expectoración I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -vómito. I-PRESENT_ILLNESS -Durante I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -dia I-PRESENT_ILLNESS -habia I-PRESENT_ILLNESS -presentado I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS -náuseas, I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -acuosa, I-PRESENT_ILLNESS -hiporexia, I-PRESENT_ILLNESS -dispepsia, I-PRESENT_ILLNESS -meteorismo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -Relató I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -consumido I-PRESENT_ILLNESS -merluza I-PRESENT_ILLNESS -cruda I-PRESENT_ILLNESS -(cebiche) I-PRESENT_ILLNESS -once I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -atrás I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -negó I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -consumo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -verduras I-PRESENT_ILLNESS -crudas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -familia. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -familia I-PRESENT_ILLNESS -integrada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -componentes: I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -esposo, I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -hermana I-PRESENT_ILLNESS -(18 I-PRESENT_ILLNESS -años), I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -hijos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nueve I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -menor I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -presentaron I-PRESENT_ILLNESS -signos I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -síntomas. I-PRESENT_ILLNESS -El B-TREATMENT -médico I-TREATMENT -tratante I-TREATMENT -le I-TREATMENT -indicó I-TREATMENT -terapia I-TREATMENT -con I-TREATMENT -mebendazol I-TREATMENT -100 I-TREATMENT -mg, I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -por I-TREATMENT -tres I-TREATMENT -días. I-TREATMENT - I-TREATMENT -En I-TREATMENT -el I-TREATMENT -laboratorio I-TREATMENT -del I-TREATMENT -consultorio, I-TREATMENT -por I-TREATMENT -las I-TREATMENT -características I-TREATMENT -morfométricas I-TREATMENT -se I-TREATMENT -sospechó I-TREATMENT -que I-TREATMENT -los I-TREATMENT -ejemplares I-TREATMENT -correspondían I-TREATMENT -a I-TREATMENT -A. I-TREATMENT -lumbricoides I-TREATMENT -en I-TREATMENT -estado I-TREATMENT -juvenil. I-TREATMENT -Por B-EXPLORATION -igual I-EXPLORATION -motivo I-EXPLORATION -se I-EXPLORATION -efectuó I-EXPLORATION -examen I-EXPLORATION -copro-parasitario I-EXPLORATION -seriado, I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -Uno I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -ejemplares I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -gusanos I-EXPLORATION -eliminados I-EXPLORATION -fue I-EXPLORATION -derivado I-EXPLORATION -al I-EXPLORATION -laboratorio I-EXPLORATION -de I-EXPLORATION -Parasitología I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Escuela I-EXPLORATION -de I-EXPLORATION -Medicina I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Universidad I-EXPLORATION -de I-EXPLORATION -Valparaíso I-EXPLORATION -para I-EXPLORATION -comprobar I-EXPLORATION -el I-EXPLORATION -diagnóstico. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -morfométrico, I-EXPLORATION -destacando I-EXPLORATION -su I-EXPLORATION -color I-EXPLORATION -amarillento, I-EXPLORATION -una I-EXPLORATION -forma I-EXPLORATION -cilíndrica I-EXPLORATION -de I-EXPLORATION -extremos I-EXPLORATION -aguzados I-EXPLORATION -rojizos, I-EXPLORATION -de I-EXPLORATION -3, I-EXPLORATION -9 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -longitud I-EXPLORATION -y I-EXPLORATION -1, I-EXPLORATION -0 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -ancho. I-EXPLORATION -Microscópicamente, I-EXPLORATION -se I-EXPLORATION -comprobó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -tres I-EXPLORATION -labios I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -extremo I-EXPLORATION -anterior; I-EXPLORATION -uno I-EXPLORATION -dorsal I-EXPLORATION -con I-EXPLORATION -dos I-EXPLORATION -papilas I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -sólo I-EXPLORATION -una I-EXPLORATION -cada I-EXPLORATION -uno I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -dos I-EXPLORATION -labios I-EXPLORATION -ventrolaterales3 I-EXPLORATION -rodeando I-EXPLORATION -la I-EXPLORATION -cavidad I-EXPLORATION -oral. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -el I-EXPLORATION -objeto I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -mejor I-EXPLORATION -observación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -características I-EXPLORATION -del I-EXPLORATION -gusano, I-EXPLORATION -el I-EXPLORATION -ejemplar I-EXPLORATION -fue I-EXPLORATION -sometido I-EXPLORATION -a I-EXPLORATION -diafanización I-EXPLORATION -en I-EXPLORATION -lactofenol I-EXPLORATION -de I-EXPLORATION -Amann. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -fue I-EXPLORATION -corroborado I-EXPLORATION -al I-EXPLORATION -visualizar I-EXPLORATION -microscópicamente I-EXPLORATION -los I-EXPLORATION -tres I-EXPLORATION -labios I-EXPLORATION -que I-EXPLORATION -rodean I-EXPLORATION -la I-EXPLORATION -cavidad I-EXPLORATION -oral I-EXPLORATION -triangular I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -extremo I-EXPLORATION -anterior, I-EXPLORATION -y I-EXPLORATION -por I-EXPLORATION -las I-EXPLORATION -características I-EXPLORATION -del I-EXPLORATION -tubo I-EXPLORATION -digestivo I-EXPLORATION -por I-EXPLORATION -transparencia I-EXPLORATION -(esófago I-EXPLORATION -corto, I-EXPLORATION -intestino I-EXPLORATION -aplanado I-EXPLORATION -recorriendo I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -longitud I-EXPLORATION -del I-EXPLORATION -cuerpo, I-EXPLORATION -terminado I-EXPLORATION -en I-EXPLORATION -recto). I-EXPLORATION - I-EXPLORATION -Obtenido I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -certeza, I-EXPLORATION -se I-EXPLORATION -sostuvo I-EXPLORATION -entrevista I-EXPLORATION -telefónica I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -paciente: I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -indicó I-EXPLORATION -las I-EXPLORATION -medidas I-EXPLORATION -profilácticas I-EXPLORATION -para I-EXPLORATION -evitar I-EXPLORATION -la I-EXPLORATION -reinfección I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -sugirió I-EXPLORATION -control I-EXPLORATION -mediante I-EXPLORATION -examen I-EXPLORATION -copro-parasitario I-EXPLORATION -seriado, I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION -formas I-EXPLORATION -vacuoladas I-EXPLORATION -de I-EXPLORATION -Blastocystis I-EXPLORATION -hominis. I-EXPLORATION -Como I-EXPLORATION -investigación I-EXPLORATION -complementaria I-EXPLORATION -se I-EXPLORATION -efectuó I-EXPLORATION -examen I-EXPLORATION -copro-parasitario I-EXPLORATION -seriado I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -integrantes I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -grupo I-EXPLORATION -familiar, I-EXPLORATION -evidenciándose I-EXPLORATION -formas I-EXPLORATION -vacuoladas I-EXPLORATION -de I-EXPLORATION -B. I-EXPLORATION -hominis I-EXPLORATION -y I-EXPLORATION -quistes I-EXPLORATION -de I-EXPLORATION -Entamoeba I-EXPLORATION -coli I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -hermana; I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -integrantes I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION - -Un B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -27 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -diabético, B-PAST_MEDICAL_HISTORY -fue B-PRESENT_ILLNESS -internado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -rigidez I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuca I-PRESENT_ILLNESS -aparecidos I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cursar I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -infección I-PRESENT_ILLNESS -respiratoria I-PRESENT_ILLNESS -aguda. I-PRESENT_ILLNESS -Se B-EXPLORATION -le I-EXPLORATION -diagnosticó I-EXPLORATION -una I-EXPLORATION -meningoencefalitis I-EXPLORATION -aséptica I-EXPLORATION -(LCR I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -claro, I-EXPLORATION -con I-EXPLORATION -presión I-EXPLORATION -de I-EXPLORATION -12 I-EXPLORATION -cm I-EXPLORATION -H2O; I-EXPLORATION -leucocitos: I-EXPLORATION -200/mm3; I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -directa I-EXPLORATION -y I-EXPLORATION -cultivo I-EXPLORATION -bacteriano: I-EXPLORATION -negativos) I-EXPLORATION -y B-TREATMENT -recibió I-TREATMENT -ceftriaxona I-TREATMENT -más I-TREATMENT -vancomicina I-TREATMENT -y I-TREATMENT -corticoterapia I-TREATMENT -(dexametasona, I-TREATMENT -10 I-TREATMENT -mg I-TREATMENT -iv I-TREATMENT -cada I-TREATMENT -6-horas I-TREATMENT -durante I-TREATMENT -4 I-TREATMENT -días). I-TREATMENT -Inicialmente B-EVOLUTION -ingresó I-EVOLUTION -en I-EVOLUTION -una I-EVOLUTION -UCI I-EVOLUTION -y I-EVOLUTION -estuvo I-EVOLUTION -en I-EVOLUTION -ventilación I-EVOLUTION -mecánica, I-EVOLUTION -siendo I-EVOLUTION -desconectado I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -4 I-EVOLUTION -días. I-EVOLUTION - I-EVOLUTION -Desarrolló I-EVOLUTION -fiebre I-EVOLUTION -y I-EVOLUTION -tos I-EVOLUTION -productiva I-EVOLUTION -tras I-EVOLUTION -una I-EVOLUTION -semana I-EVOLUTION -de I-EVOLUTION -evolución. I-EVOLUTION -Una B-EXPLORATION -Rx I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -detectó I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -pulmonar I-EXPLORATION -bilateral. I-EXPLORATION -Tres I-EXPLORATION -días I-EXPLORATION -más I-EXPLORATION -tarde, I-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -Rx I-EXPLORATION -reveló I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -múltiples I-EXPLORATION -abscesos I-EXPLORATION -pulmonares I-EXPLORATION -con I-EXPLORATION -niveles I-EXPLORATION -hidro-aéreos. I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -comprobó I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -lesiones I-EXPLORATION -cavitarias I-EXPLORATION -con I-EXPLORATION -formación I-EXPLORATION -de I-EXPLORATION -gas. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -toracoscopia I-EXPLORATION -video-asistida I-EXPLORATION -e B-TREATMENT -inserción I-TREATMENT -de I-TREATMENT -drenaje. I-TREATMENT -Se I-TREATMENT -inició I-TREATMENT -entonces I-TREATMENT -terapia I-TREATMENT -asociada I-TREATMENT -con I-TREATMENT -linezolid I-TREATMENT -(600 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -12h I-TREATMENT -iv) I-TREATMENT -y I-TREATMENT -meropenem I-TREATMENT -(1, I-TREATMENT -0 I-TREATMENT -gm I-TREATMENT -cada I-TREATMENT -8h I-TREATMENT -iv), I-TREATMENT -la I-TREATMENT -que I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -por I-TREATMENT -dos I-TREATMENT -semanas. I-TREATMENT -La B-EXPLORATION -efusión I-EXPLORATION -pleural I-EXPLORATION -(de I-EXPLORATION -aspecto I-EXPLORATION -purulento, I-EXPLORATION -glucosa: I-EXPLORATION -40 I-EXPLORATION -mg/dL, I-EXPLORATION -pH I-EXPLORATION -7, I-EXPLORATION -18) I-EXPLORATION -dio I-EXPLORATION -un I-EXPLORATION -cultivo I-EXPLORATION -para I-EXPLORATION -P I-EXPLORATION -aeruginosa I-EXPLORATION -(susceptible I-EXPLORATION -a I-EXPLORATION -amikacina, I-EXPLORATION -gentamicina, I-EXPLORATION -ciprofloxacina, I-EXPLORATION -cefepime, I-EXPLORATION -ceftazidima I-EXPLORATION -e I-EXPLORATION -imipenem). I-EXPLORATION -Hubo B-EVOLUTION -recuperación I-EVOLUTION -ad I-EVOLUTION -integrum I-EVOLUTION -luego I-EVOLUTION -de I-EVOLUTION -completarse I-EVOLUTION -el I-EVOLUTION -drenaje I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -antibioterapia. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -nacido B-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Buenos I-PAST_MEDICAL_HISTORY -Aires, I-PAST_MEDICAL_HISTORY -vendedor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -comercio I-PAST_MEDICAL_HISTORY -céntrico, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -efectuado I-PAST_MEDICAL_HISTORY -viajes I-PAST_MEDICAL_HISTORY -fuera I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -ciudad I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -poseía I-PAST_MEDICAL_HISTORY -mascotas, I-PAST_MEDICAL_HISTORY -realizaba I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -alimentación I-PAST_MEDICAL_HISTORY -balanceada, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -comidas I-PAST_MEDICAL_HISTORY -diarias. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -significación. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Sanatorio I-PRESENT_ILLNESS -IPENSA I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -Plata I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -omalgia I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -realizar I-PRESENT_ILLNESS -abducción, I-PRESENT_ILLNESS -aducción I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -rotación I-PRESENT_ILLNESS -interna, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -data I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana. I-PRESENT_ILLNESS -Posteriormente B-EXPLORATION -presentó I-EXPLORATION -una I-EXPLORATION -placa I-EXPLORATION -eritematosa I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -torácica I-EXPLORATION -anterior I-EXPLORATION -de I-EXPLORATION -cuatro I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -no I-EXPLORATION -indurada, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -inflamatorios I-EXPLORATION -superficiales. I-EXPLORATION -No I-EXPLORATION -presentaba I-EXPLORATION -fiebre, I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -peso, I-EXPLORATION -hemoptisis, I-EXPLORATION -ni I-EXPLORATION -historia I-EXPLORATION -previa I-EXPLORATION -de I-EXPLORATION -traumatismo. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -de I-EXPLORATION -tejidos I-EXPLORATION -blandos I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -visualizó I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -hemitórax I-EXPLORATION -derecho I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -heterogénea I-EXPLORATION -de I-EXPLORATION -3, I-EXPLORATION -89 I-EXPLORATION -cm, I-EXPLORATION -ubicada I-EXPLORATION -a I-EXPLORATION -2, I-EXPLORATION -46 I-EXPLORATION -cm I-EXPLORATION -bajo I-EXPLORATION -la I-EXPLORATION -piel, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -celulitis. I-EXPLORATION -No I-EXPLORATION -presentaba I-EXPLORATION -lesiones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -miembro I-EXPLORATION -superior I-EXPLORATION -ipsilateral, I-EXPLORATION -adenopatías, I-EXPLORATION -soplo I-EXPLORATION -cardíaco I-EXPLORATION -ni I-EXPLORATION -dolores I-EXPLORATION -óseos. I-EXPLORATION - I-EXPLORATION -Comenzó B-TREATMENT -con I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -(cefalexina I-TREATMENT -1 I-TREATMENT -gramo I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -hs); I-TREATMENT -a B-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -registro I-EVOLUTION -febril I-EVOLUTION -de I-EVOLUTION -38, I-EVOLUTION -6°C I-EVOLUTION -y I-EVOLUTION -una I-EVOLUTION -tumoración I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -región I-EVOLUTION -pectoral I-EVOLUTION -derecha. I-EVOLUTION - I-EVOLUTION -El B-EXPLORATION -laboratorio I-EXPLORATION -mostró I-EXPLORATION -leucocitos I-EXPLORATION -16.600/mm3 I-EXPLORATION -(81% I-EXPLORATION -neutró I-EXPLORATION -filos I-EXPLORATION -segmentados), I-EXPLORATION -hematocrito I-EXPLORATION -40%, I-EXPLORATION -hemoglobina I-EXPLORATION -12, I-EXPLORATION -3 I-EXPLORATION -g%, I-EXPLORATION -(VCM I-EXPLORATION -89, I-EXPLORATION -7 I-EXPLORATION -fl), I-EXPLORATION -250.000 I-EXPLORATION -plaquetas/mm3, I-EXPLORATION -glicemia I-EXPLORATION -85 I-EXPLORATION -mg/dL, I-EXPLORATION -VHS I-EXPLORATION -110 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -primer I-EXPLORATION -hora, I-EXPLORATION -TGO I-EXPLORATION -40 I-EXPLORATION -U/L I-EXPLORATION -y I-EXPLORATION -TGP I-EXPLORATION -70 I-EXPLORATION -U/L. I-EXPLORATION -La I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -creatin-fosfoquinasa I-EXPLORATION -(CPK) I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -ensanchamiento I-EXPLORATION -mediastinal, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -cuello I-EXPLORATION -con I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -ev I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -hemitórax I-EXPLORATION -derecho I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -con I-EXPLORATION -densidad I-EXPLORATION -de I-EXPLORATION -tejidos I-EXPLORATION -blandos, I-EXPLORATION -que I-EXPLORATION -provocaba I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -espesor I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -músculos I-EXPLORATION -pectorales. I-EXPLORATION -Dicha I-EXPLORATION -lesión I-EXPLORATION -se I-EXPLORATION -extendía I-EXPLORATION -hacia I-EXPLORATION -el I-EXPLORATION -mediastino I-EXPLORATION -anterior I-EXPLORATION -y I-EXPLORATION -superior, I-EXPLORATION -en I-EXPLORATION -proximidad I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -grandes I-EXPLORATION -vasos I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -asociaba I-EXPLORATION -a I-EXPLORATION -cambios I-EXPLORATION -densitométricos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -grasa I-EXPLORATION -mediastinal. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -punción-aspirativa I-TREATMENT -guiada I-TREATMENT -por I-TREATMENT -TAC, I-TREATMENT -obteniéndose I-TREATMENT -25 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -material I-TREATMENT -purulento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -colección I-TREATMENT -parietal I-TREATMENT -y I-TREATMENT -7 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -la I-TREATMENT -mediastinal I-TREATMENT -Se I-TREATMENT -remitieron I-TREATMENT -a I-TREATMENT -estudio I-TREATMENT -microbiológico I-TREATMENT -y I-TREATMENT -se I-TREATMENT -ajustó I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT -anti-infeccioso I-TREATMENT -a I-TREATMENT -vancomicina I-TREATMENT -1 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas I-TREATMENT -(dosis I-TREATMENT -máxima), I-TREATMENT -clindamicina I-TREATMENT -600 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -6 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -ceftazidima I-TREATMENT -2 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas I-TREATMENT -ev. I-TREATMENT - I-TREATMENT -Posteriormente I-TREATMENT -se I-TREATMENT -drenó I-TREATMENT -quirúrgicamente I-TREATMENT -el I-TREATMENT -absceso I-TREATMENT -pectoral. I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -cocáceas I-EXPLORATION -grampositivas I-EXPLORATION -agrupadas I-EXPLORATION -en I-EXPLORATION -racimos I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -tercer I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -tratamiento I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -S. I-EXPLORATION -aureus I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -oxacilina, I-EXPLORATION -cefalotina, I-EXPLORATION -eritromicina, I-EXPLORATION -clindamicina, I-EXPLORATION -cotri-moxazol, I-EXPLORATION -vancomicina I-EXPLORATION -y I-EXPLORATION -ciprofloxacina. I-EXPLORATION -Las I-EXPLORATION -tinciones I-EXPLORATION -de I-EXPLORATION -Ziehl-Neelsen, I-EXPLORATION -Giemsa I-EXPLORATION -y I-EXPLORATION -Gomori-Grocott I-EXPLORATION -resultaron I-EXPLORATION -negativas. I-EXPLORATION -Se B-TREATMENT -modificó I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -indicado I-TREATMENT -a I-TREATMENT -cefazolina I-TREATMENT -2 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas I-TREATMENT -ev. I-TREATMENT -Las B-EXPLORATION -serologías I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana I-EXPLORATION -(VIH) I-EXPLORATION -y I-EXPLORATION -VDRL I-EXPLORATION -fueron I-EXPLORATION -no I-EXPLORATION -reactivas. I-EXPLORATION -El I-EXPLORATION -urocultivo, I-EXPLORATION -hemocultivos, I-EXPLORATION -cultivos I-EXPLORATION -para I-EXPLORATION -hongos I-EXPLORATION -y I-EXPLORATION -micobacterias I-EXPLORATION -del I-EXPLORATION -material I-EXPLORATION -purulento I-EXPLORATION -resultaron I-EXPLORATION -negativos. I-EXPLORATION -Un I-EXPLORATION -ecocardiograma I-EXPLORATION -bidimensional I-EXPLORATION -transtorácico I-EXPLORATION -no I-EXPLORATION -evidenció I-EXPLORATION -vegetaciones I-EXPLORATION -valvulares. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -no I-EXPLORATION -presentó I-EXPLORATION -alteraciones. I-EXPLORATION -Al B-EVOLUTION -cabo I-EVOLUTION -de I-EVOLUTION -72 I-EVOLUTION -hs I-EVOLUTION -se I-EVOLUTION -encontraba I-EVOLUTION -afebril, I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -evidente. I-EVOLUTION -Dada B-TREATMENT -la I-TREATMENT -buena I-TREATMENT -respuesta I-TREATMENT -postquirúrgica I-TREATMENT -y I-TREATMENT -habiendo I-TREATMENT -aislado I-TREATMENT -en I-TREATMENT -todas I-TREATMENT -las I-TREATMENT -muestras I-TREATMENT -S. I-TREATMENT -aureus I-TREATMENT -sensible I-TREATMENT -a I-TREATMENT -meticilina I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -tratamiento I-TREATMENT -a I-TREATMENT -cefalexina I-TREATMENT -1 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -evolucionando B-EVOLUTION -favorablemente. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -38 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -de B-PAST_MEDICAL_HISTORY -nacionalidad I-PAST_MEDICAL_HISTORY -chilena, I-PAST_MEDICAL_HISTORY -residente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Italia I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -aproximadamente. I-PAST_MEDICAL_HISTORY -Presentó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -mayo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2011 I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -coxalgia I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -realizándose B-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -tejido I-EXPLORATION -de I-EXPLORATION -neo-formación I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ala I-EXPLORATION -ilíaca I-EXPLORATION -derecha, I-EXPLORATION -con I-EXPLORATION -infiltración I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -muscular I-EXPLORATION -adyacente. I-EXPLORATION -Una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -fue I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -linfoma I-EXPLORATION -no-Hodgkin, I-EXPLORATION -isotipo I-EXPLORATION -linfo-plasmocitario. I-EXPLORATION -Asociado I-EXPLORATION -a I-EXPLORATION -esto, I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -falla I-EXPLORATION -renal I-EXPLORATION -aguda I-EXPLORATION -con I-EXPLORATION -hipercalcemia I-EXPLORATION -y I-EXPLORATION -proteinuria, I-EXPLORATION -principalmente I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -Bence I-EXPLORATION -Jones, I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -componente I-EXPLORATION -monoclonal I-EXPLORATION -tipo I-EXPLORATION -IgD-lambda. I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -junio I-EVOLUTION -del I-EVOLUTION -año I-EVOLUTION -2011 I-EVOLUTION -ingresó I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -Unidad I-EVOLUTION -de I-EVOLUTION -Hemato-Oncología I-EVOLUTION -del I-EVOLUTION -Hospital I-EVOLUTION -de I-EVOLUTION -Lucca, I-EVOLUTION -Italia, I-EVOLUTION -iniciándose B-TREATMENT -esquema I-TREATMENT -de I-TREATMENT -quimioterapia I-TREATMENT -con I-TREATMENT -bortezomib I-TREATMENT -más I-TREATMENT -dexame-tasona, I-TREATMENT -asociado I-TREATMENT -a I-TREATMENT -ácido I-TREATMENT -zolendrónico. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -julio I-EXPLORATION -de I-EXPLORATION -2011 I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -renal I-EXPLORATION -debido I-EXPLORATION -al I-EXPLORATION -deterioro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -función I-EXPLORATION -renal, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -nefropatía I-EXPLORATION -tubulo-intersticial, I-EXPLORATION -comenzando I-EXPLORATION -con I-EXPLORATION -terapia I-EXPLORATION -de I-EXPLORATION -sustitución I-EXPLORATION -renal I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -mismo I-EXPLORATION -centro. I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -agosto I-EVOLUTION -de I-EVOLUTION -2011 I-EVOLUTION -se I-EVOLUTION -reevaluó I-EVOLUTION -al I-EVOLUTION -paciente, I-EVOLUTION -el I-EVOLUTION -que I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -aumento I-EVOLUTION -del I-EVOLUTION -tamaño I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -lesión, I-EVOLUTION -siendo I-EVOLUTION -internado I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -unidad I-EVOLUTION -de I-EVOLUTION -Hematología I-EVOLUTION -del I-EVOLUTION -Hospital I-EVOLUTION -Universitario I-EVOLUTION -de I-EVOLUTION -Pisa. I-EVOLUTION -Se B-TREATMENT -le I-TREATMENT -indicó I-TREATMENT -un I-TREATMENT -esquema I-TREATMENT -de I-TREATMENT -quimioterapia I-TREATMENT -VDT-PACE I-TREATMENT -(bortezomib, I-TREATMENT -talidomida, I-TREATMENT -dexametasona, I-TREATMENT -cisplatino, I-TREATMENT -doxorrubicina, I-TREATMENT -ciclofosfamida I-TREATMENT -y I-TREATMENT -etopósido). I-TREATMENT -Previo B-EVOLUTION -a I-EVOLUTION -esto, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -habría I-EVOLUTION -sufrido I-EVOLUTION -una I-EVOLUTION -gastrectomía I-EVOLUTION -parcial I-EVOLUTION -debido I-EVOLUTION -a I-EVOLUTION -una I-EVOLUTION -úlcera I-EVOLUTION -péptica I-EVOLUTION -perforada. I-EVOLUTION - I-EVOLUTION -Se B-TREATMENT -decidió I-TREATMENT -luego I-TREATMENT -continuar I-TREATMENT -con I-TREATMENT -un I-TREATMENT -esquema I-TREATMENT -CHOP I-TREATMENT -(ciclofosfamida, I-TREATMENT -doxirrubicinada, I-TREATMENT -vincristina, I-TREATMENT -prednisona), I-TREATMENT -recibiendo I-TREATMENT -el I-TREATMENT -primer I-TREATMENT -ciclo I-TREATMENT -en I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -centro. I-TREATMENT -En B-EXPLORATION -evaluaciones I-EXPLORATION -sucesivas I-EXPLORATION -durante I-EXPLORATION -su I-EXPLORATION -hospitalización, I-EXPLORATION -la I-EXPLORATION -ecotomografía I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -mostró I-EXPLORATION -compromiso I-EXPLORATION -infiltrativo I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -ala I-EXPLORATION -ilíaca I-EXPLORATION -derecha I-EXPLORATION -hasta I-EXPLORATION -las I-EXPLORATION -asas I-EXPLORATION -intestinales, I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -tamizaje I-EXPLORATION -con I-EXPLORATION -hisopado I-EXPLORATION -rectal I-EXPLORATION -mostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -Klebsiella I-EXPLORATION -pneumoniae I-EXPLORATION -multi-resistente. I-EXPLORATION - I-EXPLORATION -Estando B-EVOLUTION -en I-EVOLUTION -su I-EVOLUTION -domicilio I-EVOLUTION -en I-EVOLUTION -Italia, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -varias I-EVOLUTION -crisis I-EVOLUTION -convulsivas I-EVOLUTION -que I-EVOLUTION -fueron I-EVOLUTION -atribuidas I-EVOLUTION -a I-EVOLUTION -trastornos I-EVOLUTION -metabólicos. I-EVOLUTION -Se I-EVOLUTION -descartó I-EVOLUTION -la I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -lesiones I-EVOLUTION -intracerebrales. I-EVOLUTION -Fue B-DERIVED_FROM/TO -referido I-DERIVED_FROM/TO -entonces I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Versilia, I-DERIVED_FROM/TO -Italia; I-DERIVED_FROM/TO -recibió B-TREATMENT -allí I-TREATMENT -un I-TREATMENT -segundo I-TREATMENT -y I-TREATMENT -tercer I-TREATMENT -ciclo I-TREATMENT -de I-TREATMENT -quimioterapia I-TREATMENT -con I-TREATMENT -esquema I-TREATMENT -CHOP, I-TREATMENT -el I-TREATMENT -22.12.2011 I-TREATMENT -y I-TREATMENT -el I-TREATMENT -19.01.2012, I-TREATMENT -respectivamente, I-TREATMENT -presentando I-TREATMENT -aplasia I-TREATMENT -medular I-TREATMENT -secundaria I-TREATMENT -que I-TREATMENT -requirió I-TREATMENT -apoyo I-TREATMENT -con I-TREATMENT -estimulador I-TREATMENT -de I-TREATMENT -colonia I-TREATMENT -de I-TREATMENT -granulocitos I-TREATMENT -y I-TREATMENT -eritropoyetina. I-TREATMENT - I-TREATMENT -Viajó I-TREATMENT -desde I-TREATMENT -Italia I-TREATMENT -a I-TREATMENT -Chile, I-TREATMENT -ingresando I-TREATMENT -directamente I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -aeropuerto I-TREATMENT -de I-TREATMENT -Santiago I-TREATMENT -el I-TREATMENT -día I-TREATMENT -28.02.2012 I-TREATMENT -al I-TREATMENT -Servicio I-TREATMENT -de I-TREATMENT -Medicina I-TREATMENT -del I-TREATMENT -Hospital I-TREATMENT -Clínico I-TREATMENT -San I-TREATMENT -Borja I-TREATMENT -Arriarán, I-TREATMENT -para I-TREATMENT -coordinar I-TREATMENT -la I-TREATMENT -hemodiálisis I-TREATMENT -y I-TREATMENT -evaluación I-TREATMENT -por I-TREATMENT -el I-TREATMENT -equipo I-TREATMENT -de I-TREATMENT -hemato-oncología I-TREATMENT -para I-TREATMENT -eventual I-TREATMENT -quimioterapia I-TREATMENT -paliativa. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -el I-TREATMENT -primer I-TREATMENT -procedimiento I-TREATMENT -de I-TREATMENT -hemodiálisis I-TREATMENT -el I-TREATMENT -día I-TREATMENT -01.03.2012 I-TREATMENT -presentando B-EVOLUTION -fiebre I-EVOLUTION -por B-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -obtuvo I-EXPLORATION -hemocultivos I-EXPLORATION -con I-EXPLORATION -tiempo I-EXPLORATION -diferencial I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -una I-EXPLORATION -infección I-EXPLORATION -del I-EXPLORATION -tracto I-EXPLORATION -sanguíneo I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -catéter I-EXPLORATION -venoso I-EXPLORATION -central, I-EXPLORATION -y I-EXPLORATION -urocultivo. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -6 I-EXPLORATION -de I-EXPLORATION -marzo I-EXPLORATION -de I-EXPLORATION -2012 I-EXPLORATION -se I-EXPLORATION -aisló I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -urocultivo I-EXPLORATION -una I-EXPLORATION -cepa I-EXPLORATION -de I-EXPLORATION -K. I-EXPLORATION -pneumoniae I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -ami-noglucósidos, I-EXPLORATION -quinolonas, I-EXPLORATION -β-lactámicos, I-EXPLORATION -cefalosporinas I-EXPLORATION -y I-EXPLORATION -carbapenémicos I-EXPLORATION -con I-EXPLORATION -halo I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -mm I-EXPLORATION -(de I-EXPLORATION -contacto) I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -retuvo I-EXPLORATION -el I-EXPLORATION -resultado I-EXPLORATION -dado I-EXPLORATION -el I-EXPLORATION -perfil I-EXPLORATION -de I-EXPLORATION -susceptibilidad I-EXPLORATION -no I-EXPLORATION -descrito I-EXPLORATION -antes I-EXPLORATION -en I-EXPLORATION -nuestro I-EXPLORATION -país. I-EXPLORATION -Además I-EXPLORATION -de I-EXPLORATION -lo I-EXPLORATION -anterior, I-EXPLORATION -se I-EXPLORATION -aisló I-EXPLORATION -a I-EXPLORATION -partir I-EXPLORATION -de I-EXPLORATION -dos I-EXPLORATION -series I-EXPLORATION -de I-EXPLORATION -hemocultivos I-EXPLORATION -de I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -positividad I-EXPLORATION -diferencial I-EXPLORATION -un I-EXPLORATION -bacilo I-EXPLORATION -gramnegativo I-EXPLORATION -no I-EXPLORATION -fermen-tador I-EXPLORATION -que I-EXPLORATION -posteriormente I-EXPLORATION -el I-EXPLORATION -Laboratorio I-EXPLORATION -de I-EXPLORATION -Microbiología I-EXPLORATION -del I-EXPLORATION -Hospital I-EXPLORATION -Clínico I-EXPLORATION -Universidad I-EXPLORATION -de I-EXPLORATION -Chile I-EXPLORATION -identificó I-EXPLORATION -como I-EXPLORATION -Achromobacter I-EXPLORATION -denitrificans I-EXPLORATION -realizándose I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -clínico I-EXPLORATION -de I-EXPLORATION -ITS/CVC I-EXPLORATION -e I-EXPLORATION -interpretándose I-EXPLORATION -el I-EXPLORATION -urocultivo I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -bacteriuria I-EXPLORATION -asintomática. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -8 I-EXPLORATION -de I-EXPLORATION -marzo I-EXPLORATION -de I-EXPLORATION -2012, I-EXPLORATION -el I-EXPLORATION -Laboratorio I-EXPLORATION -de I-EXPLORATION -Microbiología I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -equipo I-EXPLORATION -de I-EXPLORATION -Control I-EXPLORATION -de I-EXPLORATION -Infecciones I-EXPLORATION -obtuvieron I-EXPLORATION -el I-EXPLORATION -antecedente I-EXPLORATION -epidemiológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -procedencia I-EXPLORATION -del I-EXPLORATION -paciente I-EXPLORATION -(hospital I-EXPLORATION -en I-EXPLORATION -Italia). I-EXPLORATION -Frente I-EXPLORATION -a I-EXPLORATION -dicho I-EXPLORATION -antecedente I-EXPLORATION -se I-EXPLORATION -sospechó I-EXPLORATION -la I-EXPLORATION -posible I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -carbapenemasa I-EXPLORATION -KPC I-EXPLORATION -importada, I-EXPLORATION -indicándose I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -microbiológico I-EXPLORATION -de I-EXPLORATION -portación I-EXPLORATION -de I-EXPLORATION -KPC I-EXPLORATION -mediante I-EXPLORATION -hisopado I-EXPLORATION -rectal. I-EXPLORATION -Se I-EXPLORATION -repitió I-EXPLORATION -el I-EXPLORATION -urocultivo, I-EXPLORATION -se I-EXPLORATION -iniciaron I-EXPLORATION -las I-EXPLORATION -medidas I-EXPLORATION -de I-EXPLORATION -contención I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -transmisión I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -comunicación I-EXPLORATION -vía I-EXPLORATION -correo I-EXPLORATION -electrónico I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -médico I-EXPLORATION -tratante I-EXPLORATION -italiano I-EXPLORATION -para I-EXPLORATION -consultarle I-EXPLORATION -si I-EXPLORATION -la I-EXPLORATION -K. I-EXPLORATION -pneumoniae I-EXPLORATION -multi-resistente I-EXPLORATION -indicada I-EXPLORATION -en I-EXPLORATION -resumen I-EXPLORATION -de I-EXPLORATION -traslado I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -poseedora I-EXPLORATION -de I-EXPLORATION -BLEE I-EXPLORATION -o I-EXPLORATION -KPC. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -equipo I-EXPLORATION -de I-EXPLORATION -hemato-oncología I-EXPLORATION -solicitó I-EXPLORATION -un I-EXPLORATION -nuevo I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -etapificación I-EXPLORATION -con I-EXPLORATION -imágenes I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -compromiso I-EXPLORATION -óseo I-EXPLORATION -difuso I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -extensa I-EXPLORATION -lesión I-EXPLORATION -lítica I-EXPLORATION -del I-EXPLORATION -ilíaco I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -tumoración I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -tejidos I-EXPLORATION -blandos. I-EXPLORATION -Desde B-TREATMENT -el I-TREATMENT -punto I-TREATMENT -de I-TREATMENT -vista I-TREATMENT -hemato-oncológico, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -sería I-TREATMENT -candidato I-TREATMENT -a I-TREATMENT -tratamiento I-TREATMENT -paliativo I-TREATMENT -dado I-TREATMENT -el I-TREATMENT -estadio I-TREATMENT -actual I-TREATMENT -de I-TREATMENT -la I-TREATMENT -enfermedad I-TREATMENT -de I-TREATMENT -base I-TREATMENT -y I-TREATMENT -sus I-TREATMENT -magras I-TREATMENT -condiciones I-TREATMENT -generales. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -11 I-EXPLORATION -de I-EXPLORATION -marzo I-EXPLORATION -se I-EXPLORATION -recibió I-EXPLORATION -confirmación I-EXPLORATION -desde I-EXPLORATION -Italia I-EXPLORATION -del I-EXPLORATION -antecedente I-EXPLORATION -de I-EXPLORATION -KPC. I-EXPLORATION -Se I-EXPLORATION -logró I-EXPLORATION -identificar I-EXPLORATION -nuevamente I-EXPLORATION -una I-EXPLORATION -K. I-EXPLORATION -pneumoniae I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -antimicrobianos I-EXPLORATION -excepto I-EXPLORATION -colistin I-EXPLORATION -y I-EXPLORATION -tigeciclina I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -urocultivo I-EXPLORATION -e I-EXPLORATION -hisopado I-EXPLORATION -rectal, I-EXPLORATION -los I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -estudiados I-EXPLORATION -con I-EXPLORATION -batería I-EXPLORATION -bioquímica I-EXPLORATION -convencional I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -identificación I-EXPLORATION -de I-EXPLORATION -especie I-EXPLORATION -y I-EXPLORATION -antibio-grama I-EXPLORATION -por I-EXPLORATION -difusión I-EXPLORATION -con I-EXPLORATION -discos I-EXPLORATION -de I-EXPLORATION -acuerdo I-EXPLORATION -a I-EXPLORATION -estándares I-EXPLORATION -CLSI6. I-EXPLORATION -Siguiendo I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -protocolo I-EXPLORATION -de I-EXPLORATION -vigilancia I-EXPLORATION -acordado I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -Grupo I-EXPLORATION -Colaborativo I-EXPLORATION -de I-EXPLORATION -Resistencia I-EXPLORATION -de I-EXPLORATION -Chile I-EXPLORATION -(datos I-EXPLORATION -no I-EXPLORATION -publicados I-EXPLORATION -Reunión-Curso I-EXPLORATION -de I-EXPLORATION -Resistencia I-EXPLORATION -Santa I-EXPLORATION -Cruz I-EXPLORATION -2009), I-EXPLORATION -la I-EXPLORATION -cepa I-EXPLORATION -fue I-EXPLORATION -derivada I-EXPLORATION -al I-EXPLORATION -Laboratorio I-EXPLORATION -de I-EXPLORATION -Microbiología I-EXPLORATION -Molecular I-EXPLORATION -del I-EXPLORATION -Departamento I-EXPLORATION -de I-EXPLORATION -Laboratorios I-EXPLORATION -Clínicos I-EXPLORATION -Pontificia I-EXPLORATION -Universidad I-EXPLORATION -de I-EXPLORATION -Chile I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -molecular I-EXPLORATION -de I-EXPLORATION -genes I-EXPLORATION -de I-EXPLORATION -resistencia I-EXPLORATION -antimicrobiana. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -día I-EXPLORATION -12 I-EXPLORATION -de I-EXPLORATION -marzo I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -la I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -susceptibilidad I-EXPLORATION -in I-EXPLORATION -vitro I-EXPLORATION -por I-EXPLORATION -CIM I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -cepa I-EXPLORATION -de I-EXPLORATION -K. I-EXPLORATION -pneumoniae I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -test I-EXPLORATION -fenotípicos6 I-EXPLORATION -de I-EXPLORATION -Hodge I-EXPLORATION -y I-EXPLORATION -ácido I-EXPLORATION -borónico, I-EXPLORATION -de I-EXPLORATION -acuerdo I-EXPLORATION -a I-EXPLORATION -estándares I-EXPLORATION -CLSI. I-EXPLORATION -Se I-EXPLORATION -obtuvo I-EXPLORATION -el I-EXPLORATION -resultado I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -ambos I-EXPLORATION -test I-EXPLORATION -fenotípicos I-EXPLORATION -confirmándose I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -blaKPC I-EXPLORATION -(grupo I-EXPLORATION -KPC-2/ I-EXPLORATION -KPC-3), I-EXPLORATION -blaTEM I-EXPLORATION -y I-EXPLORATION -bla I-EXPLORATION -Se I-EXPLORATION -descartaron I-EXPLORATION -β-lactamasas I-EXPLORATION -tipo I-EXPLORATION -CTX-M, I-EXPLORATION -β-lactamasas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -familia I-EXPLORATION -AmpC, I-EXPLORATION -metalo-β-lactamasas I-EXPLORATION -(blaIMI I-EXPLORATION -blaVIM I-EXPLORATION -blaNDM-1), I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -car I-EXPLORATION -bapenemasas I-EXPLORATION -del I-EXPLORATION -grupo I-EXPLORATION -A I-EXPLORATION -(blaGES I-EXPLORATION -blaIMI I-EXPLORATION -blaSME). I-EXPLORATION - I-EXPLORATION -Finalmente, I-EXPLORATION -el I-EXPLORATION -Instituto I-EXPLORATION -de I-EXPLORATION -Salud I-EXPLORATION -Pública, I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -hallazgo I-EXPLORATION -de I-EXPLORATION -KPC I-EXPLORATION -(KPC-2/KPC-3) I-EXPLORATION -el I-EXPLORATION -día I-EXPLORATION -13 I-EXPLORATION -de I-EXPLORATION -marzo. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -corporal, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -parálisis I-PAST_MEDICAL_HISTORY -cerebral I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -asfixia I-PAST_MEDICAL_HISTORY -neonatal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -epilepsia, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -prolongado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -ácido I-PAST_MEDICAL_HISTORY -valproico I-PAST_MEDICAL_HISTORY -oral, I-PAST_MEDICAL_HISTORY -32 I-PAST_MEDICAL_HISTORY -mg/kg/día I-PAST_MEDICAL_HISTORY -administrados I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -sonda I-PAST_MEDICAL_HISTORY -nasogástrica I-PAST_MEDICAL_HISTORY -(SNG). I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -UPC I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -neumonía I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -adenovirus, I-PRESENT_ILLNESS -asociada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -insuficiencia I-PRESENT_ILLNESS -respiratoria I-PRESENT_ILLNESS -grave I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -shock I-PRESENT_ILLNESS -séptico-hipovolémico I-PRESENT_ILLNESS -refractario I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -catecolaminas, I-PRESENT_ILLNESS -recibiendo B-TREATMENT -hidrocortisona I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -estrés I-TREATMENT -y I-TREATMENT -asociándose I-TREATMENT -terapia I-TREATMENT -antimicrobiana I-TREATMENT -con I-TREATMENT -cefotaxima, I-TREATMENT -clindamicina I-TREATMENT -y I-TREATMENT -amikacina I-TREATMENT -iv. I-TREATMENT -El B-EVOLUTION -octavo I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -se I-EVOLUTION -tomó I-EVOLUTION -un I-EVOLUTION -nivel I-EVOLUTION -plasmático I-EVOLUTION -de I-EVOLUTION -ácido I-EVOLUTION -valproico, I-EVOLUTION -el I-EVOLUTION -que I-EVOLUTION -resultó I-EVOLUTION -en I-EVOLUTION -90, I-EVOLUTION -1 I-EVOLUTION -μg/ml. I-EVOLUTION -El I-EVOLUTION -décimo I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -deterioro I-EVOLUTION -hemodinámico I-EVOLUTION -y I-EVOLUTION -respiratorio, I-EVOLUTION -con I-EVOLUTION -cultivo I-EVOLUTION -de I-EVOLUTION -aspirado I-EVOLUTION -traqueal I-EVOLUTION -para I-EVOLUTION -Pseudomonas I-EVOLUTION -aeruginosa, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -esquema I-TREATMENT -antimicrobiano I-TREATMENT -a I-TREATMENT -vancomicina I-TREATMENT -y I-TREATMENT -meropenem I-TREATMENT -(120 I-TREATMENT -mg/kg/día), I-TREATMENT -manteniendo I-TREATMENT -amikacina. I-TREATMENT -Tras B-EXPLORATION -cinco I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -tratamiento I-EXPLORATION -con I-EXPLORATION -meropenem I-EXPLORATION -se I-EXPLORATION -monitorizó I-EXPLORATION -el I-EXPLORATION -ácido I-EXPLORATION -valproico, I-EXPLORATION -encontrándose I-EXPLORATION -un I-EXPLORATION -valor I-EXPLORATION -plasmático I-EXPLORATION -< I-EXPLORATION -3 I-EXPLORATION -μg/ I-EXPLORATION -ml. I-EXPLORATION -Por B-TREATMENT -estrategia I-TREATMENT -de I-TREATMENT -de-escalamiento I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -el I-TREATMENT -carbapenémico. I-TREATMENT -El B-EVOLUTION -ácido I-EVOLUTION -valproico I-EVOLUTION -se I-EVOLUTION -aumentó I-EVOLUTION -a I-EVOLUTION -45 I-EVOLUTION -mg/kg/día, I-EVOLUTION -controlándose I-EVOLUTION -un I-EVOLUTION -nuevo I-EVOLUTION -nivel I-EVOLUTION -plasmático I-EVOLUTION -siete I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -suspensión I-EVOLUTION -de I-EVOLUTION -meropenem, I-EVOLUTION -cuyo I-EVOLUTION -resultado I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -55 I-EVOLUTION -μg/ml. I-EVOLUTION -Catorce I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -suspensión I-EVOLUTION -de I-EVOLUTION -mero-penem I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -nuevo I-EVOLUTION -deterioro I-EVOLUTION -hemodinámico I-EVOLUTION -debido I-EVOLUTION -a I-EVOLUTION -una I-EVOLUTION -sepsis I-EVOLUTION -por I-EVOLUTION -Enterobacter I-EVOLUTION -cloacae I-EVOLUTION -identificada I-EVOLUTION -en I-EVOLUTION -hemocultivos I-EVOLUTION -y I-EVOLUTION -secreción I-EVOLUTION -traqueal, I-EVOLUTION -reiniciándose B-TREATMENT -nuevamente I-TREATMENT -el I-TREATMENT -carbapenémico I-TREATMENT -a I-TREATMENT -igual I-TREATMENT -dosis I-TREATMENT -que I-TREATMENT -la I-TREATMENT -vez I-TREATMENT -anterior, I-TREATMENT -provocando B-EVOLUTION -una I-EVOLUTION -nueva I-EVOLUTION -caída I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -niveles I-EVOLUTION -plasmáticos I-EVOLUTION -de I-EVOLUTION -ácido I-EVOLUTION -valproico I-EVOLUTION -a I-EVOLUTION -< I-EVOLUTION -3 I-EVOLUTION -μg/ml, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -reiniciado. I-EVOLUTION -Se B-TREATMENT -mantuvo I-TREATMENT -con I-TREATMENT -igual I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -valproato. I-TREATMENT -Transcurridos B-EVOLUTION -20 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -terapia I-EVOLUTION -carbapenémica I-EVOLUTION -falleció I-EVOLUTION -por I-EVOLUTION -falla I-EVOLUTION -hipoxémica I-EVOLUTION -refractaria. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -63 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -crónico, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hemitórax I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -cuanti-ficada I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -sensible I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -músculo I-PRESENT_ILLNESS -pectoral I-PRESENT_ILLNESS -izquierdo. I-PRESENT_ILLNESS -La B-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -opacidad I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -mal I-EXPLORATION -definidos I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -perihiliar I-EXPLORATION -izquierda. I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -3 I-EXPLORATION -por I-EXPLORATION -5, I-EXPLORATION -8 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -pulmonar I-EXPLORATION -superior I-EXPLORATION -izquierdo I-EXPLORATION -(flecha I-EXPLORATION -larga I-EXPLORATION -Figura I-EXPLORATION -1B) I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -extenso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -torácica I-EXPLORATION -anterior, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -invasión I-EXPLORATION -ni I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -estructuras I-EXPLORATION -bronquio-vasculares I-EXPLORATION -centrales, I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -neoplásica I-EXPLORATION -broncogénica I-EXPLORATION -periférica I-EXPLORATION -del I-EXPLORATION -lóbulo I-EXPLORATION -superior I-EXPLORATION -izquierdo I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -adenopatías I-EXPLORATION -hiliares I-EXPLORATION -y I-EXPLORATION -mediastínicas I-EXPLORATION -ipsilaterales I-EXPLORATION -(flecha I-EXPLORATION -corta I-EXPLORATION -Figura I-EXPLORATION -1B). I-EXPLORATION -Con I-EXPLORATION -estos I-EXPLORATION -hallazgos, I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -fibrobroncoscopia I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -leve I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -carina, I-EXPLORATION -língula I-EXPLORATION -y I-EXPLORATION -lóbulo I-EXPLORATION -superior I-EXPLORATION -izquierdo, I-EXPLORATION -sin I-EXPLORATION -lesiones I-EXPLORATION -intraluminales. I-EXPLORATION -Se I-EXPLORATION -tomaron I-EXPLORATION -tres I-EXPLORATION -muestras I-EXPLORATION -transbronquiales I-EXPLORATION -cuya I-EXPLORATION -biopsia I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -bronquitis I-EXPLORATION -crónica I-EXPLORATION -inespecífica I-EXPLORATION -con I-EXPLORATION -metaplasia I-EXPLORATION -escamosa I-EXPLORATION -incompleta. I-EXPLORATION -Fue B-EVOLUTION -internado I-EVOLUTION -para I-EVOLUTION -completar I-EVOLUTION -su I-EVOLUTION -estudio I-EVOLUTION -evolucionando I-EVOLUTION -con I-EVOLUTION -dolor I-EVOLUTION -persistente I-EVOLUTION -en I-EVOLUTION -relación I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -masa I-EVOLUTION -tumoral, I-EVOLUTION -sin I-EVOLUTION -fiebre I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -hemodinamia I-EVOLUTION -estable. I-EVOLUTION -Dentro B-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -anemia I-EXPLORATION -(hemoglobina I-EXPLORATION -9, I-EXPLORATION -5 I-EXPLORATION -g/dl), I-EXPLORATION -trombocitosis I-EXPLORATION -(776.000 I-EXPLORATION -/mm3) I-EXPLORATION -y I-EXPLORATION -leucocitosis I-EXPLORATION -con I-EXPLORATION -desviación I-EXPLORATION -izquierda I-EXPLORATION -(42.600/ I-EXPLORATION -mm3 I-EXPLORATION -con I-EXPLORATION -37% I-EXPLORATION -de I-EXPLORATION -baciliformes). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -mielograma I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -hiperplasia I-EXPLORATION -mieloide I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -médula I-EXPLORATION -reactiva I-EXPLORATION -sin I-EXPLORATION -constituir I-EXPLORATION -una I-EXPLORATION -neoplasia I-EXPLORATION -hematológica. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -punción I-EXPLORATION -percutánea I-EXPLORATION -por I-EXPLORATION -radiología I-EXPLORATION -intervencional I-EXPLORATION -que I-EXPLORATION -dio I-EXPLORATION -salida I-EXPLORATION -a I-EXPLORATION -contenido I-EXPLORATION -purulento, I-EXPLORATION -cuyo I-EXPLORATION -cultivo I-EXPLORATION -bacteriano I-EXPLORATION -aeróbico I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION -Por B-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -tumor I-TREATMENT -de I-TREATMENT -la I-TREATMENT -pared I-TREATMENT -costal I-TREATMENT -abscedado, I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT -drenaje I-TREATMENT -quirúrgico I-TREATMENT -del I-TREATMENT -absceso, I-TREATMENT -aseo I-TREATMENT -y I-TREATMENT -desbridamiento I-TREATMENT -del I-TREATMENT -tejido I-TREATMENT -desvitalizado. I-TREATMENT -Se I-TREATMENT -tomó I-TREATMENT -una I-TREATMENT -muestra I-TREATMENT -de I-TREATMENT -la I-TREATMENT -pared I-TREATMENT -torácica I-TREATMENT -para I-TREATMENT -biopsia I-TREATMENT -y I-TREATMENT -se I-TREATMENT -instaló I-TREATMENT -un I-TREATMENT -sistema I-TREATMENT -aspirativo I-TREATMENT -para I-TREATMENT -cierre I-TREATMENT -de I-TREATMENT -la I-TREATMENT -herida. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -biopsia I-EXPLORATION -fue I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -actinomicosis I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -torácica, I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -piel, I-EXPLORATION -tejido I-EXPLORATION -subcutáneo, I-EXPLORATION -músculo I-EXPLORATION -pectoral I-EXPLORATION -y I-EXPLORATION -porción I-EXPLORATION -perióstica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -costilla, I-EXPLORATION -sin I-EXPLORATION -elementos I-EXPLORATION -histológicos I-EXPLORATION -malignos. I-EXPLORATION -Fue B-TREATMENT -evaluado I-TREATMENT -por I-TREATMENT -el I-TREATMENT -equipo I-TREATMENT -de I-TREATMENT -infectología I-TREATMENT -decidiéndose I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -con I-TREATMENT -penicilina I-TREATMENT -G I-TREATMENT -sódica I-TREATMENT -i.v. I-TREATMENT -durante I-TREATMENT -2 I-TREATMENT -semanas. I-TREATMENT -Evolucionó B-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -generales, I-EVOLUTION -con I-EVOLUTION -regresión I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -inflamatorios I-EVOLUTION -y I-EVOLUTION -disminución I-EVOLUTION -del I-EVOLUTION -débito I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -drenajes. I-EVOLUTION -A B-TREATMENT -las I-TREATMENT -tres I-TREATMENT -semanas I-TREATMENT -postoperatorias I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -el I-TREATMENT -último I-TREATMENT -aseo I-TREATMENT -quirúrgico I-TREATMENT -y I-TREATMENT -cierre I-TREATMENT -definitivo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -herida. I-TREATMENT - I-TREATMENT -Se B-EVOLUTION -dio I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -amoxicilina I-EVOLUTION -hasta I-EVOLUTION -completar I-EVOLUTION -tres I-EVOLUTION -meses. I-EVOLUTION -Se I-EVOLUTION -mantuvo I-EVOLUTION -en I-EVOLUTION -controles I-EVOLUTION -ambulatorios, I-EVOLUTION -sin I-EVOLUTION -evidencias I-EVOLUTION -de I-EVOLUTION -complicaciones I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -control I-EVOLUTION -radiológico I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -siete I-EVOLUTION -meses I-EVOLUTION -postoperatorios I-EVOLUTION -que I-EVOLUTION -mostró I-EVOLUTION -regresión I-EVOLUTION -completa I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -lesión. I-EVOLUTION - I-EVOLUTION - -RNT B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -gestación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -38 I-PRESENT_ILLNESS -semanas, I-PRESENT_ILLNESS -AEG, I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nacimiento I-PRESENT_ILLNESS -3.510 I-PRESENT_ILLNESS -gr I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -talla I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -cm. I-PRESENT_ILLNESS -Apgar B-PAST_MEDICAL_HISTORY -9-10, I-PAST_MEDICAL_HISTORY -segunda I-PAST_MEDICAL_HISTORY -hija I-PAST_MEDICAL_HISTORY -de B-FAMILY_HISTORY -padres I-FAMILY_HISTORY -sanos. I-FAMILY_HISTORY -Nació B-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cesárea I-PAST_MEDICAL_HISTORY -electiva I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -cesárea I-PAST_MEDICAL_HISTORY -anterior. I-PAST_MEDICAL_HISTORY -La B-FAMILY_HISTORY -madre I-FAMILY_HISTORY -tenía I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -de I-FAMILY_HISTORY -un I-FAMILY_HISTORY -embarazo I-FAMILY_HISTORY -fisiológico, I-FAMILY_HISTORY -una I-FAMILY_HISTORY -infección I-FAMILY_HISTORY -urinaria I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -primer I-FAMILY_HISTORY -trimestre I-FAMILY_HISTORY -de I-FAMILY_HISTORY -gestación I-FAMILY_HISTORY -y I-FAMILY_HISTORY -detección I-FAMILY_HISTORY -de I-FAMILY_HISTORY -portación I-FAMILY_HISTORY -recto-vaginal I-FAMILY_HISTORY -de I-FAMILY_HISTORY -Streptococcus I-FAMILY_HISTORY -agalactiae I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -tercer I-FAMILY_HISTORY -trimestre I-FAMILY_HISTORY -del I-FAMILY_HISTORY -embarazo. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Inició B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -25 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida, I-PRESENT_ILLNESS -movimientos I-PRESENT_ILLNESS -mioclónicos I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -hemicuerpo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -estando I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -vigilia; I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -madre I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -notó I-PRESENT_ILLNESS -somnolienta I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -demanda I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -alimentos. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Fue I-PRESENT_ILLNESS -llevada I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -(SU) I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -evaluación. I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso I-EXPLORATION -estaba I-EXPLORATION -febril, I-EXPLORATION -en I-EXPLORATION -relativas I-EXPLORATION -buenas I-EXPLORATION -condiciones I-EXPLORATION -generales, I-EXPLORATION -sin I-EXPLORATION -movimientos I-EXPLORATION -anormales, I-EXPLORATION -fontanela I-EXPLORATION -con I-EXPLORATION -tensión I-EXPLORATION -normal, I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -lesiones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -mucosas I-EXPLORATION -y I-EXPLORATION -su I-EXPLORATION -examen I-EXPLORATION -segmentario I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -Signos I-EXPLORATION -vitales: I-EXPLORATION -FC I-EXPLORATION -177 I-EXPLORATION -por I-EXPLORATION -min, I-EXPLORATION -FR I-EXPLORATION -52 I-EXPLORATION -por I-EXPLORATION -min, I-EXPLORATION -T° I-EXPLORATION -38, I-EXPLORATION -3° I-EXPLORATION -C I-EXPLORATION -axilar, I-EXPLORATION -P. I-EXPLORATION -arterial I-EXPLORATION -91/55 I-EXPLORATION -mm/Hg, I-EXPLORATION -P. I-EXPLORATION -arterial I-EXPLORATION -media I-EXPLORATION -62 I-EXPLORATION -mm/Hg, I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -O2 I-EXPLORATION -97%. I-EXPLORATION -Exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -iniciales: I-EXPLORATION -leucocitos I-EXPLORATION -6.800/mm3 I-EXPLORATION -(52% I-EXPLORATION -linfocitos), I-EXPLORATION -hematocrito I-EXPLORATION -40, I-EXPLORATION -7%, I-EXPLORATION -PCR: I-EXPLORATION -0 I-EXPLORATION -mg/L, I-EXPLORATION -perfil I-EXPLORATION -bioquímico I-EXPLORATION -con I-EXPLORATION -leve I-EXPLORATION -hiperbilirrubinemia I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -indirecto. I-EXPLORATION -Examen I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -y I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -normales. I-EXPLORATION -Durante B-EVOLUTION -la I-EVOLUTION -observación I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -SU I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -respiración I-EVOLUTION -irregular, I-EVOLUTION -piel I-EVOLUTION -reticulada I-EVOLUTION -y I-EVOLUTION -movimientos I-EVOLUTION -mioclónicos I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -hemicuerpo I-EVOLUTION -derecho I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -cedían I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -contención. I-EVOLUTION -Por B-TREATMENT -su I-TREATMENT -condición I-TREATMENT -clínica I-TREATMENT -se I-TREATMENT -le I-TREATMENT -indicó I-TREATMENT -apoyo I-TREATMENT -con I-TREATMENT -oxígeno, I-TREATMENT -solución I-TREATMENT -salina I-TREATMENT -isotónica I-TREATMENT -(NaCl I-TREATMENT -9%) I-TREATMENT -20 I-TREATMENT -ml/kg I-TREATMENT -en I-TREATMENT -bolo, I-TREATMENT -lorazepam I-TREATMENT -0. I-TREATMENT -1 I-TREATMENT -mg/kg I-TREATMENT -i.v., I-TREATMENT -iniciándose I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -empírico I-TREATMENT -con I-TREATMENT -ampicilina I-TREATMENT -+ I-TREATMENT -cefotaxima I-TREATMENT -i.v. I-TREATMENT -luego I-TREATMENT -de I-TREATMENT -obtener I-TREATMENT -hemocultivos I-TREATMENT -y I-TREATMENT -las I-TREATMENT -muestras I-TREATMENT -de I-TREATMENT -LCR. I-TREATMENT -El B-EXPLORATION -análisis I-EXPLORATION -citoquímico I-EXPLORATION -del I-EXPLORATION -LCR I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -directa I-EXPLORATION -no I-EXPLORATION -evidenció I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -bacterias I-EXPLORATION -(muestra I-EXPLORATION -1, I-EXPLORATION -Tabla I-EXPLORATION -1). I-EXPLORATION -Un I-EXPLORATION -ml I-EXPLORATION -adicional I-EXPLORATION -de I-EXPLORATION -LCR I-EXPLORATION -se I-EXPLORATION -guardó I-EXPLORATION -a I-EXPLORATION -4°C I-EXPLORATION -para I-EXPLORATION -estudios I-EXPLORATION -posteriores I-EXPLORATION -de I-EXPLORATION -biología I-EXPLORATION -molecular. I-EXPLORATION - I-EXPLORATION -Se B-DERIVED_FROM/TO -trasladó I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cuidados I-DERIVED_FROM/TO -Intensivos I-DERIVED_FROM/TO -Neonatales I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -monitorización. I-DERIVED_FROM/TO -A B-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -h I-EVOLUTION -de I-EVOLUTION -internación, I-EVOLUTION -nuevamente I-EVOLUTION -presentó I-EVOLUTION -fiebre, I-EVOLUTION -hiporreactividad, I-EVOLUTION -y I-EVOLUTION -un I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -fijación I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mirada I-EVOLUTION -con I-EVOLUTION -repetición I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -crisis I-EVOLUTION -convulsiva I-EVOLUTION -focal. I-EVOLUTION -Se B-EXPLORATION -plantearon I-EXPLORATION -como I-EXPLORATION -posibles I-EXPLORATION -diagnósticos I-EXPLORATION -una I-EXPLORATION -meningitis I-EXPLORATION -bacteriana I-EXPLORATION -aguda I-EXPLORATION -inicial I-EXPLORATION -o I-EXPLORATION -una I-EXPLORATION -encefalitis I-EXPLORATION -herpética I-EXPLORATION -por I-EXPLORATION -los I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -repetir I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -del I-EXPLORATION -LCR I-EXPLORATION -y B-TREATMENT -adicionar I-TREATMENT -a I-TREATMENT -la I-TREATMENT -terapia I-TREATMENT -antimicrobiana, I-TREATMENT -aciclovir I-TREATMENT -i.v. I-TREATMENT -60 I-TREATMENT -mg/kg/día I-TREATMENT -fraccionado I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -h. I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -citoquímico I-EXPLORATION -del I-EXPLORATION -segundo I-EXPLORATION -LCR I-EXPLORATION -destacó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -190 I-EXPLORATION -leucocitos/mm3 I-EXPLORATION -con I-EXPLORATION -predominio I-EXPLORATION -mononuclear I-EXPLORATION -(79%), I-EXPLORATION -170 I-EXPLORATION -eritrocitos/mm3, I-EXPLORATION -glucorraquia I-EXPLORATION -y I-EXPLORATION -proteínorraquia I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -directa I-EXPLORATION -no I-EXPLORATION -evidenció I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -bacterias I-EXPLORATION -(muestra I-EXPLORATION -2, I-EXPLORATION -Tabla I-EXPLORATION -1). I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -RPC I-EXPLORATION -de I-EXPLORATION -LCR I-EXPLORATION -cualitativa I-EXPLORATION -para I-EXPLORATION -VHS I-EXPLORATION -tipos I-EXPLORATION -1 I-EXPLORATION -y I-EXPLORATION -2 I-EXPLORATION -(herpes I-EXPLORATION -simplex I-EXPLORATION -virus I-EXPLORATION -1/2 I-EXPLORATION -Real I-EXPLORATION -Time I-EXPLORATION -PCR I-EXPLORATION -kit, I-EXPLORATION -InsideGen® I-EXPLORATION -Bioscan, I-EXPLORATION -Chile) I-EXPLORATION -sin I-EXPLORATION -lograrse I-EXPLORATION -la I-EXPLORATION -detección I-EXPLORATION -de I-EXPLORATION -ADN I-EXPLORATION -viral. I-EXPLORATION -Pese B-TREATMENT -al I-TREATMENT -resultado I-TREATMENT -negativo I-TREATMENT -de I-TREATMENT -RPC-TR I-TREATMENT -a I-TREATMENT -las I-TREATMENT -24 I-TREATMENT -h I-TREATMENT -de I-TREATMENT -iniciado I-TREATMENT -el I-TREATMENT -cuadro I-TREATMENT -clínico, I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -aciclovir I-TREATMENT -1. I-TREATMENT -v. I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -permanecía I-TREATMENT -con I-TREATMENT -compromiso I-TREATMENT -de I-TREATMENT -conciencia I-TREATMENT -y I-TREATMENT -crisis I-TREATMENT -focales. I-TREATMENT - I-TREATMENT -Una B-EXPLORATION -TAC I-EXPLORATION -cerebral, I-EXPLORATION -al I-EXPLORATION -segundo I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -hospitalización, I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -electroencefalograma I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -lentitud I-EXPLORATION -hipovoltada I-EXPLORATION -difusa I-EXPLORATION -y I-EXPLORATION -ocasionales I-EXPLORATION -paroxismos I-EXPLORATION -agudos I-EXPLORATION -multifocales. I-EXPLORATION -Se B-TREATMENT -le I-TREATMENT -administró I-TREATMENT -fenobarbital I-TREATMENT -15 I-TREATMENT -mg/ I-TREATMENT -kg I-TREATMENT -i.v. I-TREATMENT -y I-TREATMENT -luego I-TREATMENT -5 I-TREATMENT -mg/kg/día I-TREATMENT -v.o. I-TREATMENT -como I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -mantención. I-TREATMENT -Los B-EXPLORATION -cultivos I-EXPLORATION -bacteriológicos I-EXPLORATION -del I-EXPLORATION -primer I-EXPLORATION -y I-EXPLORATION -segundo I-EXPLORATION -LCR I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -Evolucionó B-EVOLUTION -con I-EVOLUTION -persistencia I-EVOLUTION -del I-EVOLUTION -compromiso I-EVOLUTION -de I-EVOLUTION -conciencia, I-EVOLUTION -posturas I-EVOLUTION -anormales I-EVOLUTION -en I-EVOLUTION -reposo, I-EVOLUTION -crisis I-EVOLUTION -clónicas I-EVOLUTION -multifocales I-EVOLUTION -múltiples I-EVOLUTION -y B-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -alta I-EXPLORATION -sospecha I-EXPLORATION -clínica I-EXPLORATION -de I-EXPLORATION -encefalitis I-EXPLORATION -herpética, I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -tercera I-EXPLORATION -RPC-TR I-EXPLORATION -en I-EXPLORATION -LCR I-EXPLORATION -para I-EXPLORATION -VHS I-EXPLORATION -1 I-EXPLORATION -y I-EXPLORATION -2 I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -48 I-EXPLORATION -h I-EXPLORATION -de I-EXPLORATION -iniciado I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -clínico I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -24 I-EXPLORATION -h I-EXPLORATION -de I-EXPLORATION -comenzar I-EXPLORATION -el I-EXPLORATION -tratamiento I-EXPLORATION -con I-EXPLORATION -aciclovir, I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -VHS I-EXPLORATION -1 I-EXPLORATION -(muestra I-EXPLORATION -3, I-EXPLORATION -Tabla I-EXPLORATION -1). I-EXPLORATION - I-EXPLORATION -Las I-EXPLORATION -funciones I-EXPLORATION -hepática I-EXPLORATION -y I-EXPLORATION -renal I-EXPLORATION -fueron I-EXPLORATION -normales, I-EXPLORATION -al I-EXPLORATION -igual I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION -oftalmológica. I-EXPLORATION -Las B-EVOLUTION -manifestaciones I-EVOLUTION -convulsivas I-EVOLUTION -persistieron I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización. I-EVOLUTION -De I-EVOLUTION -allí I-EVOLUTION -en I-EVOLUTION -adelante, I-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -apreció I-EVOLUTION -alerta, I-EVOLUTION -con I-EVOLUTION -succión I-EVOLUTION -vigorosa, I-EVOLUTION -sin I-EVOLUTION -nuevas I-EVOLUTION -crisis, I-EVOLUTION -destacando I-EVOLUTION -sólo I-EVOLUTION -un I-EVOLUTION -síndrome I-EVOLUTION -tembloroso I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -extremidad I-EVOLUTION -superior I-EVOLUTION -izquierda. I-EVOLUTION - I-EVOLUTION -Una B-EXPLORATION -RM I-EXPLORATION -de I-EXPLORATION -cerebro I-EXPLORATION -efectuada I-EXPLORATION -al I-EXPLORATION -día I-EXPLORATION -10 I-EXPLORATION -de I-EXPLORATION -internación I-EXPLORATION -evidenció I-EXPLORATION -lesiones I-EXPLORATION -hiperintensas I-EXPLORATION -subcorticales I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -peri-rolándica I-EXPLORATION -bilateral, I-EXPLORATION -frontomedial I-EXPLORATION -e I-EXPLORATION -insular I-EXPLORATION -derecha, I-EXPLORATION -con I-EXPLORATION -impregnación I-EXPLORATION -leptomeníngea I-EXPLORATION -focal, I-EXPLORATION -hallazgos I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -meningo-encefalitis. I-EXPLORATION - I-EXPLORATION -Al I-EXPLORATION -obtener I-EXPLORATION -el I-EXPLORATION -resultado I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -RPC-TR I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -VHS I-EXPLORATION -1, I-EXPLORATION -se I-EXPLORATION -reinterrogó I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -madre I-EXPLORATION -dirigidamente I-EXPLORATION -quien I-EXPLORATION -relató I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -padre I-EXPLORATION -habría I-EXPLORATION -presentado I-EXPLORATION -una I-EXPLORATION -erupción I-EXPLORATION -labial I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -herpes I-EXPLORATION -labial I-EXPLORATION -dos I-EXPLORATION -semanas I-EXPLORATION -antes I-EXPLORATION -de I-EXPLORATION -enfermar I-EXPLORATION -la I-EXPLORATION -niña I-EXPLORATION -y I-EXPLORATION -tenía I-EXPLORATION -recurrencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma. I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -20 I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -tratamiento I-EXPLORATION -antiviral I-EXPLORATION -se I-EXPLORATION -controló I-EXPLORATION -el I-EXPLORATION -LCR I-EXPLORATION -certificándose I-EXPLORATION -la I-EXPLORATION -negatividad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -RPC-TR I-EXPLORATION -para I-EXPLORATION -VHS I-EXPLORATION -1 I-EXPLORATION -y I-EXPLORATION -2 I-EXPLORATION -en I-EXPLORATION -LCR. I-EXPLORATION -Completó B-TREATMENT -21 I-TREATMENT -días I-TREATMENT -con I-TREATMENT -aciclovir, I-TREATMENT -sin I-TREATMENT -complicaciones. I-TREATMENT - I-TREATMENT -Desde B-EVOLUTION -su I-EVOLUTION -alta, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -controló I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -sistemática I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -Policlínicas I-EVOLUTION -de I-EVOLUTION -Infectología I-EVOLUTION -y I-EVOLUTION -Neurología I-EVOLUTION -infantil. I-EVOLUTION -En I-EVOLUTION -nuestra I-EVOLUTION -última I-EVOLUTION -evaluación, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -vida, I-EVOLUTION -se I-EVOLUTION -constató I-EVOLUTION -una I-EVOLUTION -lactante I-EVOLUTION -eutrófica I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -significativo I-EVOLUTION -retraso I-EVOLUTION -del I-EVOLUTION -desarrollo I-EVOLUTION -psicomotor. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -previamente B-PAST_MEDICAL_HISTORY -sano, I-PAST_MEDICAL_HISTORY -originario I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Concepción I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -radicado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -AAntofagasta I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -año. I-PAST_MEDICAL_HISTORY -Fue B-PRESENT_ILLNESS -internado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -privado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -salud I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -alta, I-PRESENT_ILLNESS -mialgias, I-PRESENT_ILLNESS -cefalea, I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -seca I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -alimentarios. I-PRESENT_ILLNESS -Tenía B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -viajado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -Región I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -Bío-Bío I-PAST_MEDICAL_HISTORY -(zona I-PAST_MEDICAL_HISTORY -urbana I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Concepción) I-PAST_MEDICAL_HISTORY -36 I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -tenido I-PAST_MEDICAL_HISTORY -contacto I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -amigo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -cursando I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -diarreico. I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -del I-EXPLORATION -ingreso I-EXPLORATION -presentaba I-EXPLORATION -escasas I-EXPLORATION -crepitaciones I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -auscultación I-EXPLORATION -pulmonar I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -no I-EXPLORATION -había I-EXPLORATION -imágenes I-EXPLORATION -de I-EXPLORATION -consolidación. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -con I-EXPLORATION -28.400 I-EXPLORATION -leucocitos/mm3 I-EXPLORATION -y I-EXPLORATION -desviación I-EXPLORATION -a I-EXPLORATION -izquierda I-EXPLORATION -(63% I-EXPLORATION -segmentados I-EXPLORATION -y I-EXPLORATION -17% I-EXPLORATION -baciliformes), I-EXPLORATION -35.000 I-EXPLORATION -plaquetas/mm3, I-EXPLORATION -PCR I-EXPLORATION -7, I-EXPLORATION -5 I-EXPLORATION -mg/dl I-EXPLORATION -(N I-EXPLORATION -= I-EXPLORATION -0-1), I-EXPLORATION -LDH I-EXPLORATION -y I-EXPLORATION -transaminasas I-EXPLORATION -elevadas. I-EXPLORATION -Al B-EVOLUTION -segundo I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -presentó I-EVOLUTION -disnea, I-EVOLUTION -polipnea I-EVOLUTION -e I-EVOLUTION -hipoxemia. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -opacidades I-EXPLORATION -pulmonares I-EXPLORATION -bilaterales. I-EXPLORATION -Se B-DERIVED_FROM/TO -trasladó I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cuidados I-DERIVED_FROM/TO -Intensivos I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -conectó I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -ventilación I-DERIVED_FROM/TO -mecánica. I-DERIVED_FROM/TO -Evolucionó B-EVOLUTION -rápidamente I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -SDRA I-EVOLUTION -y I-EVOLUTION -al I-EVOLUTION -tercer I-EVOLUTION -día, I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -disfunción I-EVOLUTION -multiorgánica. I-EVOLUTION -Se B-TREATMENT -manejó I-TREATMENT -con I-TREATMENT -corticoesteroides I-TREATMENT -i.v., I-TREATMENT -aminas I-TREATMENT -vasoactivas, I-TREATMENT -antimicrobianos I-TREATMENT -de I-TREATMENT -amplio I-TREATMENT -espectro I-TREATMENT -y I-TREATMENT -oseltamivir I-TREATMENT -empíricos. I-TREATMENT -La B-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION -y I-EXPLORATION -RPC I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -influenza I-EXPLORATION -A I-EXPLORATION -H1N1, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION -resultaron I-EXPLORATION -negativos. I-EXPLORATION -Además I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -hantavirus I-EXPLORATION -al I-EXPLORATION -Instituto I-EXPLORATION -de I-EXPLORATION -Salud I-EXPLORATION -Pública. I-EXPLORATION -Al B-EVOLUTION -sexto I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -falleció I-EVOLUTION -por I-EVOLUTION -hipotensión I-EVOLUTION -arterial I-EVOLUTION -refractaria, I-EVOLUTION -oligoanuria, I-EVOLUTION -hipoxemia I-EVOLUTION -y I-EVOLUTION -acidosis I-EVOLUTION -metabólica I-EVOLUTION -grave. I-EVOLUTION -Postmortem B-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -una I-EXPLORATION -serología I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -hantavirus I-EXPLORATION -(IgM I-EXPLORATION -e I-EXPLORATION -IgG) I-EXPLORATION -10. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -infección I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -VIH I-PAST_MEDICAL_HISTORY -adquirida I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -transmisión I-PAST_MEDICAL_HISTORY -vertical, I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -cutáneas I-PRESENT_ILLNESS -maculares I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -necrótico. I-PRESENT_ILLNESS -Posteriormente, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -agregó I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cefaleas I-PRESENT_ILLNESS -intensas I-PRESENT_ILLNESS -asociadas I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -Fue I-PRESENT_ILLNESS -internado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS -probable I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -meningitis. I-PRESENT_ILLNESS -Dentro B-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -céfalo-raquídeo I-EXPLORATION -(LCR) I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -tinción I-EXPLORATION -con I-EXPLORATION -tinta I-EXPLORATION -china I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -positiva I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -hubo I-EXPLORATION -aislamiento I-EXPLORATION -de I-EXPLORATION -Cryptococcus I-EXPLORATION -neoformans. I-EXPLORATION -En I-EXPLORATION -ese I-EXPLORATION -momento, I-EXPLORATION -tenía I-EXPLORATION -linfocitos I-EXPLORATION -CD4 I-EXPLORATION -de I-EXPLORATION -158 I-EXPLORATION -céls/mm3 I-EXPLORATION -(9%). I-EXPLORATION -Recibió B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -anfotericina I-TREATMENT -B I-TREATMENT -deoxicolato I-TREATMENT -i.v I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -fluconazol I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -evolución. I-TREATMENT -Se I-TREATMENT -mantuvo I-TREATMENT -hospitalizado I-TREATMENT -con I-TREATMENT -tratamiento I-TREATMENT -antifúngico I-TREATMENT -durante I-TREATMENT -42 I-TREATMENT -días. I-TREATMENT -Tres I-TREATMENT -meses I-TREATMENT -después I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -monoterapia I-TREATMENT -con I-TREATMENT -zidovudina I-TREATMENT -(AZT), I-TREATMENT -que I-TREATMENT -luego I-TREATMENT -de I-TREATMENT -8 I-TREATMENT -meses I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -a I-TREATMENT -didanosina I-TREATMENT -(ddI). I-TREATMENT -Posteriormente, I-TREATMENT -recibió I-TREATMENT -biterapia I-TREATMENT -con I-TREATMENT -ddI I-TREATMENT -y I-TREATMENT -ritonavir. I-TREATMENT -Falleció B-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -8 I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -edad. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -infección I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -VIH I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -transmisión I-PRESENT_ILLNESS -vertical, I-PRESENT_ILLNESS -diagnosticada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad. I-PRESENT_ILLNESS -Tenía B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mala I-PAST_MEDICAL_HISTORY -adherencia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -varios I-PAST_MEDICAL_HISTORY -regímenes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -propuestos, I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -también I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -rechazado I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -TAR. I-PAST_MEDICAL_HISTORY -Había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -internado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -enfermedades I-PAST_MEDICAL_HISTORY -intercurrentes I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -microorganismos I-PAST_MEDICAL_HISTORY -habituales I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -oportunistas. I-PAST_MEDICAL_HISTORY -Fue B-PRESENT_ILLNESS -internado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -acompañados I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -38, I-PRESENT_ILLNESS -5° I-PRESENT_ILLNESS -C I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -exantema I-PRESENT_ILLNESS -máculo-papular I-PRESENT_ILLNESS -generalizado. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION -del I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -además I-EXPLORATION -del I-EXPLORATION -exantema, I-EXPLORATION -una I-EXPLORATION -desnutrición I-EXPLORATION -secundaria, I-EXPLORATION -mal I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -adenopatías I-EXPLORATION -cervicales, I-EXPLORATION -estertores I-EXPLORATION -húmedos I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -campos I-EXPLORATION -pulmonares, I-EXPLORATION -caries I-EXPLORATION -dentales I-EXPLORATION -y I-EXPLORATION -otorrea I-EXPLORATION -purulenta I-EXPLORATION -a I-EXPLORATION -izquierda. I-EXPLORATION -En I-EXPLORATION -ese I-EXPLORATION -momento I-EXPLORATION -tenía I-EXPLORATION -una I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -(CV) I-EXPLORATION -de I-EXPLORATION -95.000 I-EXPLORATION -copias/ml I-EXPLORATION -y I-EXPLORATION -linfocitos I-EXPLORATION -CD4 I-EXPLORATION -de I-EXPLORATION -26 I-EXPLORATION -céls/mm3. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -antibioterapia, I-TREATMENT -sin B-EVOLUTION -embargo, I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -h I-EVOLUTION -persistía I-EVOLUTION -con I-EVOLUTION -fiebre I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -agregó I-EVOLUTION -cefalea I-EVOLUTION -intensa, I-EVOLUTION -vómitos, I-EVOLUTION -fotofobia I-EVOLUTION -y I-EVOLUTION -acusofobia. I-EVOLUTION - I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -cráneo I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -normal; I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -citoquímico I-EXPLORATION -de I-EXPLORATION -LCR: I-EXPLORATION -glucosa I-EXPLORATION -0, I-EXPLORATION -43 I-EXPLORATION -g/l, I-EXPLORATION -proteínas I-EXPLORATION -1, I-EXPLORATION -15 I-EXPLORATION -gr/l, I-EXPLORATION -celularidad: I-EXPLORATION -5 I-EXPLORATION -leucocitos/mm3; I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -microbio-lógico I-EXPLORATION -directo I-EXPLORATION -(tinta I-EXPLORATION -china) I-EXPLORATION -y I-EXPLORATION -cultivo I-EXPLORATION -fueron I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -C. I-EXPLORATION -neoformans. I-EXPLORATION -Se B-TREATMENT -trató I-TREATMENT -con I-TREATMENT -anfotericina I-TREATMENT -B I-TREATMENT -deoxicolato I-TREATMENT -i.v. I-TREATMENT -durante I-TREATMENT -21 I-TREATMENT -días I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -fluconazol I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -en I-TREATMENT -plan I-TREATMENT -de I-TREATMENT -mantención. I-TREATMENT -Hubo B-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -y B-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -LCR I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -21 I-EXPLORATION -días I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -con I-EXPLORATION -cultivo I-EXPLORATION -negativo. I-EXPLORATION -Fue B-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -33 I-EVOLUTION -días I-EVOLUTION -y I-EVOLUTION -al I-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -ya I-EVOLUTION -evidenciaba I-EVOLUTION -aumento I-EVOLUTION -de I-EVOLUTION -peso I-EVOLUTION -y I-EVOLUTION -buen I-EVOLUTION -estado I-EVOLUTION -general. I-EVOLUTION -El B-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -genotipificación I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -mutaciones I-EXPLORATION -asociadas I-EXPLORATION -a I-EXPLORATION -resistencia I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -AZT, I-TREATMENT -lamivudina I-TREATMENT -(3TC) I-TREATMENT -y I-TREATMENT -lopinavir/ritonavir. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -25 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -cuantificada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -comenzó I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -odinofagia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -confirmándose I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -candidiasis I-PRESENT_ILLNESS -orofaríngea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -esofágica I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -endoscopia. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -recibió I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -específico I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -procedió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -investigar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -posible I-PRESENT_ILLNESS -infección I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -VIH, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -posteriormente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -confirmó. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -enflaquecimiento I-EXPLORATION -marcado I-EXPLORATION -y I-EXPLORATION -lesiones I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -candidiasis I-EXPLORATION -orofaríngea. I-EXPLORATION -Se I-EXPLORATION -encontraba I-EXPLORATION -afebril, I-EXPLORATION -eupneico, I-EXPLORATION -con I-EXPLORATION -examen I-EXPLORATION -pulmonar I-EXPLORATION -y I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Inició B-TREATMENT -profilaxis I-TREATMENT -con I-TREATMENT -cotrimoxazol I-TREATMENT -960 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -ácido I-TREATMENT -folínico I-TREATMENT -15 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -fluconazol I-TREATMENT -150 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día I-TREATMENT -y I-TREATMENT -terapia I-TREATMENT -anti-retroviral I-TREATMENT -(TAR) I-TREATMENT -con I-TREATMENT -abacavir/lamivudina I-TREATMENT -y I-TREATMENT -efavirenz, I-TREATMENT -con I-TREATMENT -muy I-TREATMENT -buena I-TREATMENT -tolerancia I-TREATMENT -y I-TREATMENT -adherencia. I-TREATMENT -Dos B-EVOLUTION -semanas I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -consultó I-EVOLUTION -por I-EVOLUTION -tres I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -fiebre I-EVOLUTION -hasta I-EVOLUTION -39°C, I-EVOLUTION -cefalea I-EVOLUTION -y I-EVOLUTION -tos I-EVOLUTION -seca. I-EVOLUTION -Se I-EVOLUTION -decidió I-EVOLUTION -su I-EVOLUTION -internación I-EVOLUTION -por I-EVOLUTION -fiebre I-EVOLUTION -de I-EVOLUTION -39°C, I-EVOLUTION -taquicardia I-EVOLUTION -y I-EVOLUTION -saturación I-EVOLUTION -de I-EVOLUTION -oxígeno I-EVOLUTION -de I-EVOLUTION -93% I-EVOLUTION -con I-EVOLUTION -aire I-EVOLUTION -ambiental. I-EVOLUTION -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -no I-EXPLORATION -había I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -candidiasis I-EXPLORATION -oral I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -pulmonar I-EXPLORATION -en I-EXPLORATION -esos I-EXPLORATION -momentos I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -algodonoso I-EXPLORATION -difuso I-EXPLORATION -bilateral. I-EXPLORATION -Los I-EXPLORATION -cultivos I-EXPLORATION -de I-EXPLORATION -expectoración, I-EXPLORATION -urocultivo, I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -baciloscopias I-EXPLORATION -resultaron I-EXPLORATION -negativos. I-EXPLORATION -La I-EXPLORATION -RPC I-EXPLORATION -para I-EXPLORATION -Pneumocystis I-EXPLORATION -jiroveci I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -expectoración I-EXPLORATION -inducida I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION -Se B-TREATMENT -ajustó I-TREATMENT -el I-TREATMENT -cotrimoxazol I-TREATMENT -de I-TREATMENT -dosis I-TREATMENT -profiláctica I-TREATMENT -a I-TREATMENT -terapéutica I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -iv, I-TREATMENT -se I-TREATMENT -agregó I-TREATMENT -prednisona I-TREATMENT -y I-TREATMENT -ceftriaxona I-TREATMENT -iv, I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -el I-TREATMENT -ácido I-TREATMENT -folínico I-TREATMENT -y I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -la I-TREATMENT -TAR I-TREATMENT -iniciada I-TREATMENT -recientemente. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -h, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -afebril, I-EVOLUTION -con I-EVOLUTION -saturación I-EVOLUTION -de I-EVOLUTION -oxígeno I-EVOLUTION -adecuada I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -inflamatorios. I-EVOLUTION -Se B-TREATMENT -dio I-TREATMENT -el I-TREATMENT -alta I-TREATMENT -hospitalaria I-TREATMENT -al I-TREATMENT -quinto I-TREATMENT -día I-TREATMENT -con I-TREATMENT -cotrimoxazol I-TREATMENT -oral I-TREATMENT -y I-TREATMENT -prednisona I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -21 I-TREATMENT -días. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -control I-EVOLUTION -ambulatorio I-EVOLUTION -estaba I-EVOLUTION -completamente I-EVOLUTION -asintomático I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -radiografía I-EVOLUTION -mostró I-EVOLUTION -la I-EVOLUTION -desaparición I-EVOLUTION -del I-EVOLUTION -infiltrado I-EVOLUTION -pulmonar. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos. I-PAST_MEDICAL_HISTORY -Acudió B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -hospitalario I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -traumatismo I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -atropello I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -pie I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tejido. I-PRESENT_ILLNESS -Previo B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -ingreso I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -atendido I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -otro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -salud I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -realizó I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -curación I-DERIVED_FROM/TO -amplia I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -herida I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -hemostasia, I-DERIVED_FROM/TO -tras I-DERIVED_FROM/TO -lo I-DERIVED_FROM/TO -cual I-DERIVED_FROM/TO -nos I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -resolución I-DERIVED_FROM/TO -quirúrgica. I-DERIVED_FROM/TO -Ingresó B-EXPLORATION -consciente I-EXPLORATION -(Glasgow I-EXPLORATION -15), I-EXPLORATION -afebril, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -PA I-EXPLORATION -de I-EXPLORATION -80/60 I-EXPLORATION -mm I-EXPLORATION -Hg, I-EXPLORATION -FC: I-EXPLORATION -115 I-EXPLORATION -por I-EXPLORATION -min, I-EXPLORATION -FR: I-EXPLORATION -21 I-EXPLORATION -por I-EXPLORATION -min, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -vía I-EXPLORATION -aérea I-EXPLORATION -permeable, I-EXPLORATION -inmovilización I-EXPLORATION -cervical I-EXPLORATION -y I-EXPLORATION -ventilación I-EXPLORATION -espontánea. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -extremidad I-EXPLORATION -inferior I-EXPLORATION -izquierda I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -hemorragia I-EXPLORATION -activa I-EXPLORATION -del I-EXPLORATION -pie I-EXPLORATION -izquierdo, I-EXPLORATION -con I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -piel, I-EXPLORATION -tejido I-EXPLORATION -celular I-EXPLORATION -subcutáneo I-EXPLORATION -y I-EXPLORATION -músculo I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -inframaleolar I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -punta I-EXPLORATION -del I-EXPLORATION -pie, I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -falanges I-EXPLORATION -distales I-EXPLORATION -del I-EXPLORATION -primer, I-EXPLORATION -segundo, I-EXPLORATION -tercer I-EXPLORATION -y I-EXPLORATION -cuarto I-EXPLORATION -ortejos, I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -clasificado I-EXPLORATION -como I-EXPLORATION -traumatismo I-EXPLORATION -grave I-EXPLORATION -Gustilo I-EXPLORATION -3 I-EXPLORATION -c. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -estabilización I-TREATMENT -hemodinámica I-TREATMENT -con I-TREATMENT -aporte I-TREATMENT -de I-TREATMENT -cristaloides I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -respuesta. I-TREATMENT -Dentro B-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -con I-EXPLORATION -leucocitos I-EXPLORATION -de I-EXPLORATION -20.310/mm3, I-EXPLORATION -neutrófilos I-EXPLORATION -86%, I-EXPLORATION -baciliformes I-EXPLORATION -2%. I-EXPLORATION -En I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -extremidad I-EXPLORATION -se I-EXPLORATION -constató, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -blando, I-EXPLORATION -una I-EXPLORATION -fractura I-EXPLORATION -del I-EXPLORATION -maléolo I-EXPLORATION -tibial I-EXPLORATION -interno I-EXPLORATION -discretamente I-EXPLORATION -diastasado. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -angiotomografía I-EXPLORATION -de I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -del I-EXPLORATION -calibre I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -vasos I-EXPLORATION -tibiales I-EXPLORATION -anteriores, I-EXPLORATION -con I-EXPLORATION -vasoespasmo I-EXPLORATION -y I-EXPLORATION -compresión I-EXPLORATION -por I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -edema I-EXPLORATION -de I-EXPLORATION -tejidos I-EXPLORATION -blandos I-EXPLORATION -adyacentes I-EXPLORATION -sin I-EXPLORATION -extravasación I-EXPLORATION -del I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -contraste. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -primera I-TREATMENT -exploración I-TREATMENT -quirúrgica I-TREATMENT -con I-TREATMENT -deforramiento I-TREATMENT -total I-TREATMENT -del I-TREATMENT -pie I-TREATMENT -izquierdo I-TREATMENT -más I-TREATMENT -un I-TREATMENT -colgajo I-TREATMENT -en I-TREATMENT -la I-TREATMENT -región I-TREATMENT -plantar I-TREATMENT -con I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -un I-TREATMENT -dispositivo I-TREATMENT -para I-TREATMENT -el I-TREATMENT -cierre I-TREATMENT -asistido I-TREATMENT -de I-TREATMENT -las I-TREATMENT -heridas I-TREATMENT -por I-TREATMENT -presión I-TREATMENT -negativa. I-TREATMENT -Se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -empírico I-TREATMENT -con I-TREATMENT -ampicilina/sulbactam I-TREATMENT -iv. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -satisfactoria I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -primeras I-EVOLUTION -48 I-EVOLUTION -h, I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -registro I-EVOLUTION -único I-EVOLUTION -de I-EVOLUTION -temperatura I-EVOLUTION -bucal I-EVOLUTION -de I-EVOLUTION -37, I-EVOLUTION -5°C I-EVOLUTION -post-quirúrgico, I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -atribuido I-EVOLUTION -al I-EVOLUTION -proceso I-EVOLUTION -inflamatorio. I-EVOLUTION -Al B-TREATMENT -tercer I-TREATMENT -día I-TREATMENT -de I-TREATMENT -hospitalización I-TREATMENT -se I-TREATMENT -planificó I-TREATMENT -realizar I-TREATMENT -un I-TREATMENT -autoinjerto, I-TREATMENT -procedimiento I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -sustituido I-TREATMENT -por I-TREATMENT -un I-TREATMENT -aseo I-TREATMENT -quirúrgico I-TREATMENT -más I-TREATMENT -un I-TREATMENT -desbridamiento, I-TREATMENT -al I-TREATMENT -encontrarse I-TREATMENT -en I-TREATMENT -la I-TREATMENT -cirugía I-TREATMENT -escaso I-TREATMENT -tejido I-TREATMENT -de I-TREATMENT -granulación I-TREATMENT -con I-TREATMENT -secreción I-TREATMENT -en I-TREATMENT -moderada I-TREATMENT -cantidad, I-TREATMENT -de I-TREATMENT -mal I-TREATMENT -olor. I-TREATMENT -Luego B-EXPLORATION -del I-EXPLORATION -procedimiento I-EXPLORATION -se I-EXPLORATION -obtuvo I-EXPLORATION -un I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -secreción. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -células I-EXPLORATION -escasas, I-EXPLORATION -con I-EXPLORATION -moderada I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -polimorfonucleares I-EXPLORATION -(PMN) I-EXPLORATION -y I-EXPLORATION -bacilos I-EXPLORATION -gramnegativos. I-EXPLORATION -A I-EXPLORATION -las I-EXPLORATION -24 I-EXPLORATION -h, I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -evidenció I-EXPLORATION -el I-EXPLORATION -desarrollo I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -bacilo I-EXPLORATION -gramnegativo, I-EXPLORATION -lactosa I-EXPLORATION -negativa. I-EXPLORATION -Desde B-EVOLUTION -el I-EVOLUTION -quinto I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -internación, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -fiebre I-EVOLUTION -hasta I-EVOLUTION -3 I-EVOLUTION -8°C I-EVOLUTION -bucal, I-EVOLUTION -con I-EVOLUTION -mala I-EVOLUTION -condición I-EVOLUTION -del I-EVOLUTION -tejido I-EVOLUTION -en I-EVOLUTION -cicatrización, I-EVOLUTION -incremento I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -secreción I-EVOLUTION -y I-EVOLUTION -mal I-EVOLUTION -olor. I-EVOLUTION -Los B-EXPLORATION -parámetros I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -mostraron I-EXPLORATION -una I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -12.800/mm3 I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -PCR I-EXPLORATION -de I-EXPLORATION -308 I-EXPLORATION -mg/L. I-EXPLORATION -Los I-EXPLORATION -hemocultivos I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -realizar, I-TREATMENT -por I-TREATMENT -deterioro I-TREATMENT -de I-TREATMENT -su I-TREATMENT -estado I-TREATMENT -clínico I-TREATMENT -y I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -infección I-TREATMENT -en I-TREATMENT -el I-TREATMENT -sitio I-TREATMENT -de I-TREATMENT -arrollamiento, I-TREATMENT -una I-TREATMENT -amputación I-TREATMENT -corta I-TREATMENT -bajo I-TREATMENT -la I-TREATMENT -articulación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -rodilla I-TREATMENT -del I-TREATMENT -miembro I-TREATMENT -inferior I-TREATMENT -izquierdo I-TREATMENT -con I-TREATMENT -técnica I-TREATMENT -de I-TREATMENT -Lisfranc. I-TREATMENT -Finalmente, B-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -secreción, I-EXPLORATION -al I-EXPLORATION -quinto I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -hospitalización, I-EXPLORATION -analizado I-EXPLORATION -por I-EXPLORATION -métodos I-EXPLORATION -automatizados I-EXPLORATION -Bact/Alert® I-EXPLORATION -3d I-EXPLORATION -60 I-EXPLORATION -(Biomérieux, I-EXPLORATION -France) I-EXPLORATION -fue I-EXPLORATION -informado I-EXPLORATION -con I-EXPLORATION -crecimiento I-EXPLORATION -de I-EXPLORATION -Cedecea I-EXPLORATION -lapagei I-EXPLORATION -susceptible I-EXPLORATION -a I-EXPLORATION -cefuroxima, I-EXPLORATION -amikacina, I-EXPLORATION -cotrimoxazol, I-EXPLORATION -ciprofloxacina, I-EXPLORATION -cefotaxima, I-EXPLORATION -carbapenémicos I-EXPLORATION -y I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -ampicilina I-EXPLORATION -y I-EXPLORATION -ampicilina/sulbactam. I-EXPLORATION -El I-EXPLORATION -aislado I-EXPLORATION -fue I-EXPLORATION -confirmado I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -Centro I-EXPLORATION -de I-EXPLORATION -Referencia I-EXPLORATION -(Centro I-EXPLORATION -de I-EXPLORATION -Microbiología, I-EXPLORATION -Hospital I-EXPLORATION -Vozandes, I-EXPLORATION -Quito). I-EXPLORATION -Tres B-EVOLUTION -días I-EVOLUTION -posteriores I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -quirúrgica I-EVOLUTION -y I-EVOLUTION -al I-EVOLUTION -tratamiento I-EVOLUTION -intravenoso I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta; I-EVOLUTION -sin I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -infección I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -descenso I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -inflamatorios. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -de B-PAST_MEDICAL_HISTORY -oficio I-PAST_MEDICAL_HISTORY -clasificador I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -residuos. I-PAST_MEDICAL_HISTORY -Su I-PAST_MEDICAL_HISTORY -pareja I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ese I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -infección I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -VIH I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -utilizaba I-PAST_MEDICAL_HISTORY -métodos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -barrera. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -emergencia I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -líquidas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -día, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -sangre, I-PRESENT_ILLNESS -mucus I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -pus; I-PRESENT_ILLNESS -acompañadas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -Presentaba I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -meses. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -estaba I-EXPLORATION -vigil, I-EXPLORATION -afebril, I-EXPLORATION -normotenso I-EXPLORATION -(120/70), I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -FC I-EXPLORATION -de I-EXPLORATION -82 I-EXPLORATION -por I-EXPLORATION -min, I-EXPLORATION -pálido I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -mal I-EXPLORATION -estado I-EXPLORATION -general. I-EXPLORATION -A B-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -h I-EVOLUTION -presentó I-EVOLUTION -fiebre I-EVOLUTION -de I-EVOLUTION -hasta I-EVOLUTION -38, I-EVOLUTION -5° I-EVOLUTION -C I-EVOLUTION -axilar I-EVOLUTION -y I-EVOLUTION -heces I-EVOLUTION -líquidas I-EVOLUTION -con I-EVOLUTION -sangre I-EVOLUTION -y I-EVOLUTION -mucus I-EVOLUTION -en I-EVOLUTION -varias I-EVOLUTION -oportunidades. I-EVOLUTION -Fue I-EVOLUTION -internado I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -misma I-EVOLUTION -sala I-EVOLUTION -que I-EVOLUTION -el I-EVOLUTION -primer I-EVOLUTION -paciente, I-EVOLUTION -con I-EVOLUTION -diagnóstico I-EVOLUTION -clínico I-EVOLUTION -de I-EVOLUTION -diarrea I-EVOLUTION -en I-EVOLUTION -paciente I-EVOLUTION -con I-EVOLUTION -probable I-EVOLUTION -infección I-EVOLUTION -por I-EVOLUTION -VIH. I-EVOLUTION - I-EVOLUTION -De B-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -destacaban: I-EXPLORATION -hemoglobina I-EXPLORATION -9, I-EXPLORATION -8 I-EXPLORATION -g/dl; I-EXPLORATION -hematocrito: I-EXPLORATION -28, I-EXPLORATION -3%; I-EXPLORATION -VCM I-EXPLORATION -77, I-EXPLORATION -2 I-EXPLORATION -fl I-EXPLORATION -y I-EXPLORATION -HCM I-EXPLORATION -24, I-EXPLORATION -9 I-EXPLORATION -pg; I-EXPLORATION -leucocitos: I-EXPLORATION -5.500/mm3; I-EXPLORATION -linfocitos: I-EXPLORATION -750/ I-EXPLORATION -mm3 I-EXPLORATION -(17,1%); I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -CD4 I-EXPLORATION -150 I-EXPLORATION -céls/ I-EXPLORATION -mm3; I-EXPLORATION -VHS: I-EXPLORATION -69 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -1° I-EXPLORATION -hora. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -directo I-EXPLORATION -de I-EXPLORATION -deposiciones I-EXPLORATION -mostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -abundantes I-EXPLORATION -PMN I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -coprocultivo I-EXPLORATION -se I-EXPLORATION -desarrolló I-EXPLORATION -Shigella I-EXPLORATION -sp. I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -dos I-EXPLORATION -hemocultivos. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION -fue I-EXPLORATION -reactiva I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -por I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -Western I-EXPLORATION -blot I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Laboratorio I-EXPLORATION -de I-EXPLORATION -Referencia I-EXPLORATION -Nacional. I-EXPLORATION - I-EXPLORATION -Estudios I-EXPLORATION -bacteriológicos I-EXPLORATION - I-EXPLORATION -Las I-EXPLORATION -cepas I-EXPLORATION -se I-EXPLORATION -enviaron I-EXPLORATION -al I-EXPLORATION -Departamento I-EXPLORATION -de I-EXPLORATION -Bacteriología I-EXPLORATION -y I-EXPLORATION -Virología, I-EXPLORATION -Instituto I-EXPLORATION -de I-EXPLORATION -Higiene, I-EXPLORATION -para I-EXPLORATION -completar I-EXPLORATION -su I-EXPLORATION -estudio. I-EXPLORATION -La I-EXPLORATION -identificación I-EXPLORATION -de I-EXPLORATION -género I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -por I-EXPLORATION -métodos I-EXPLORATION -fenotípicos I-EXPLORATION -convencionales I-EXPLORATION -utilizando I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -medios I-EXPLORATION -de I-EXPLORATION -identificación: I-EXPLORATION -triple I-EXPLORATION -azúcar I-EXPLORATION -hierro I-EXPLORATION -(TSI), I-EXPLORATION -movilidad-indol-ornitina I-EXPLORATION -decarboxilasa I-EXPLORATION -(MIO), I-EXPLORATION -citrato I-EXPLORATION -de I-EXPLORATION -Simmons, I-EXPLORATION -fenilalanina I-EXPLORATION -deaminasa, I-EXPLORATION -agar I-EXPLORATION -hierro-lisina I-EXPLORATION -(LIA), I-EXPLORATION -arginina I-EXPLORATION -dehidrolasa, I-EXPLORATION -utilización I-EXPLORATION -de I-EXPLORATION -mucato, I-EXPLORATION -malonato I-EXPLORATION -y I-EXPLORATION -fermentación I-EXPLORATION -de I-EXPLORATION -carbohidratos I-EXPLORATION -en I-EXPLORATION -caldo I-EXPLORATION -con I-EXPLORATION -rojo-fenol10. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -serogrupo I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -cepas I-EXPLORATION -de I-EXPLORATION -Shigella I-EXPLORATION -se I-EXPLORATION -determinó I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -aglutinación I-EXPLORATION -en I-EXPLORATION -lámina I-EXPLORATION -utilizando I-EXPLORATION -antisueros I-EXPLORATION -policlonales I-EXPLORATION -comerciales I-EXPLORATION -(BD, I-EXPLORATION -Difco I-EXPLORATION -TM) I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -serotipo I-EXPLORATION -con I-EXPLORATION -antisueros I-EXPLORATION -absorbidos I-EXPLORATION -serotipo-específicos. I-EXPLORATION - I-EXPLORATION -Para I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -susceptibilidad I-EXPLORATION -antimicrobiana I-EXPLORATION -se I-EXPLORATION -utilizó I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -difusión I-EXPLORATION -en I-EXPLORATION -disco I-EXPLORATION -en I-EXPLORATION -agar11. I-EXPLORATION -Los I-EXPLORATION -antibacterianos I-EXPLORATION -ensayados I-EXPLORATION -fueron: I-EXPLORATION -ampicilina, I-EXPLORATION -ampicilina/sulbactam, I-EXPLORATION -cefradina, I-EXPLORATION -cefoxitina, I-EXPLORATION -ceftriaxona, I-EXPLORATION -ácido I-EXPLORATION -nalidíxico, I-EXPLORATION -ciprofloxacina, I-EXPLORATION -tetraciclina I-EXPLORATION -y I-EXPLORATION -cotrimoxazol I-EXPLORATION -(Oxoid I-EXPLORATION -Ltd., I-EXPLORATION -Basingstoke, I-EXPLORATION -Hampshire, I-EXPLORATION -Inglaterra). I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -evaluación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -sensibilidad I-EXPLORATION -a I-EXPLORATION -azitromicina I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -existen I-EXPLORATION -puntos I-EXPLORATION -de I-EXPLORATION -corte I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -interpretación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -susceptibilidad I-EXPLORATION -por I-EXPLORATION -esta I-EXPLORATION -técnica I-EXPLORATION -para I-EXPLORATION -azitromicina I-EXPLORATION -en I-EXPLORATION -EUCAST I-EXPLORATION -ni I-EXPLORATION -en I-EXPLORATION -CLSI11. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -electroforesis I-EXPLORATION -en I-EXPLORATION -gel I-EXPLORATION -en I-EXPLORATION -campo I-EXPLORATION -pulsado I-EXPLORATION -(PFGE) I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -cuatro I-EXPLORATION -aislados I-EXPLORATION -de I-EXPLORATION -Shigella I-EXPLORATION -spp. I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -de I-EXPLORATION -acuerdo I-EXPLORATION -al I-EXPLORATION -procedimiento I-EXPLORATION -estándar I-EXPLORATION -del I-EXPLORATION -CDC12. I-EXPLORATION -La I-EXPLORATION -interpretación I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -patrones I-EXPLORATION -de I-EXPLORATION -bandas I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -visualmente I-EXPLORATION -siguiendo I-EXPLORATION -los I-EXPLORATION -criterios I-EXPLORATION -de I-EXPLORATION -Tenover I-EXPLORATION -y I-EXPLORATION -cols13. I-EXPLORATION - I-EXPLORATION -Las I-EXPLORATION -cuatro I-EXPLORATION -cepas I-EXPLORATION -correspondieron I-EXPLORATION -a I-EXPLORATION -Shigella I-EXPLORATION -flexneri I-EXPLORATION -del I-EXPLORATION -serotipo I-EXPLORATION -6 I-EXPLORATION -y I-EXPLORATION -presentaron I-EXPLORATION -resistencia I-EXPLORATION -sólo I-EXPLORATION -a I-EXPLORATION -cotrimoxa-zol. I-EXPLORATION -Las I-EXPLORATION -dos I-EXPLORATION -cepas I-EXPLORATION -recuperadas I-EXPLORATION -del I-EXPLORATION -mismo I-EXPLORATION -paciente I-EXPLORATION -(heces I-EXPLORATION -y I-EXPLORATION -sangre) I-EXPLORATION -mostraron I-EXPLORATION -un I-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -bandas I-EXPLORATION -idéntico I-EXPLORATION -entre I-EXPLORATION -sí I-EXPLORATION -y I-EXPLORATION -muy I-EXPLORATION -similar I-EXPLORATION -al I-EXPLORATION -patrón I-EXPLORATION -obtenido I-EXPLORATION -con I-EXPLORATION -las I-EXPLORATION -cepas I-EXPLORATION -del I-EXPLORATION -otro I-EXPLORATION -paciente. I-EXPLORATION -Las I-EXPLORATION -cepas I-EXPLORATION -se I-EXPLORATION -definieron I-EXPLORATION -como I-EXPLORATION -muy I-EXPLORATION -relacionadas I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -punto I-EXPLORATION -de I-EXPLORATION -vista I-EXPLORATION -genético. I-EXPLORATION - I-EXPLORATION -Tratamiento B-TREATMENT -antimicrobiano I-TREATMENT -y I-TREATMENT -evolución I-TREATMENT - I-TREATMENT -El I-TREATMENT -primer I-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -cotrimoxazol, I-TREATMENT -800/160 I-TREATMENT -mg, I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -h, I-TREATMENT -por I-TREATMENT -48 I-TREATMENT -h. I-TREATMENT -Luego I-TREATMENT -de I-TREATMENT -conocer I-TREATMENT -el I-TREATMENT -resultado I-TREATMENT -bacteriológico I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -a I-TREATMENT -ampicilina I-TREATMENT -1 I-TREATMENT -gr I-TREATMENT -iv, I-TREATMENT -4 I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -durante I-TREATMENT -6 I-TREATMENT -días, I-TREATMENT -y I-TREATMENT -luego I-TREATMENT -ciprofloxacina I-TREATMENT -500 I-TREATMENT -mg I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -h, I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -14 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento. I-TREATMENT - I-TREATMENT -El I-TREATMENT -segundo I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -sin I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -hasta I-TREATMENT -el I-TREATMENT -resultado I-TREATMENT -bacteriológico. I-TREATMENT -Recibió I-TREATMENT -ciprofloxacina I-TREATMENT -400 I-TREATMENT -mg I-TREATMENT -iv, I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -por I-TREATMENT -7 I-TREATMENT -días I-TREATMENT -y I-TREATMENT -luego I-TREATMENT -500 I-TREATMENT -mg I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -14 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -ambos I-EVOLUTION -casos I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -favorable I-EVOLUTION -con I-EVOLUTION -remisión I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sintomatología I-EVOLUTION -digestiva I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -otras I-EVOLUTION -complicaciones, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -fueron I-EVOLUTION -dados I-EVOLUTION -de I-EVOLUTION -alta. I-EVOLUTION - I-EVOLUTION - -Escolar B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -portador B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -reflujo I-PAST_MEDICAL_HISTORY -vesicoureteral I-PAST_MEDICAL_HISTORY -grado I-PAST_MEDICAL_HISTORY -5, I-PAST_MEDICAL_HISTORY -bilateral, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hidronefrosis I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -desnutrición I-PAST_MEDICAL_HISTORY -grave. I-PAST_MEDICAL_HISTORY -Recibía I-PAST_MEDICAL_HISTORY -profilaxis I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -ITU I-PAST_MEDICAL_HISTORY -recurrentes I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -cotrimoxazol I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -exposición I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -varios I-PAST_MEDICAL_HISTORY -antibacterianos I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -(cefuroximo, I-PAST_MEDICAL_HISTORY -ceftriaxona I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ciprofloxacina). I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -UCI I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -pielonefritis I-PRESENT_ILLNESS -aguda I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -insuficiencia I-PRESENT_ILLNESS -renal I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS -reagudizada. I-PRESENT_ILLNESS -El B-EXPLORATION -urocultivo I-EXPLORATION -realizado I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -a I-EXPLORATION -E.coli I-EXPLORATION -(cepa I-EXPLORATION -ITU1) I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -ampicilina, I-EXPLORATION -cefalotina, I-EXPLORATION -cefuroximo, I-EXPLORATION -ceftriaxona I-EXPLORATION -y I-EXPLORATION -gentamicina; I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -ciprofloxacina I-EXPLORATION -y I-EXPLORATION -cotrimoxazol. I-EXPLORATION -Recibió B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -cefuroximo I-TREATMENT -iv I-TREATMENT -150 I-TREATMENT -mg/kg/día. I-TREATMENT -Al B-EVOLUTION -sexto I-EVOLUTION -día I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -sepsis I-EVOLUTION -de I-EVOLUTION -foco I-EVOLUTION -urinario. I-EVOLUTION -Se B-TREATMENT -cambió I-TREATMENT -tratamiento I-TREATMENT -a I-TREATMENT -ceftriaxona I-TREATMENT -iv I-TREATMENT -a I-TREATMENT -100 I-TREATMENT -mg/ I-TREATMENT -kg/día I-TREATMENT -previa I-TREATMENT -toma I-TREATMENT -de I-TREATMENT -urocultivo. I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -h I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -persistía I-EVOLUTION -febril. I-EVOLUTION -El B-EXPLORATION -urocultivo I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -con I-EXPLORATION -> I-EXPLORATION -105 I-EXPLORATION -UFC/ml I-EXPLORATION -de I-EXPLORATION -E. I-EXPLORATION -coli I-EXPLORATION -(cepa I-EXPLORATION -ITU2) I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -imipenem, I-EXPLORATION -meropenem, I-EXPLORATION -amikacina I-EXPLORATION -y I-EXPLORATION -gentamicina; I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -ampicilina, I-EXPLORATION -cefalotina, I-EXPLORATION -cefuroximo, I-EXPLORATION -ceftriaxona, I-EXPLORATION -ciprofloxacina I-EXPLORATION -y I-EXPLORATION -cotrimoxazol. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -meropenem I-TREATMENT -iv I-TREATMENT -60 I-TREATMENT -mg/kg/día, I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -evolución I-TREATMENT -clínica I-TREATMENT -y I-TREATMENT -urocultivo I-TREATMENT -de I-TREATMENT -control, I-TREATMENT -intra-tratamiento, I-TREATMENT -sin I-TREATMENT -desarrollo I-TREATMENT -bacteriano. I-TREATMENT - I-TREATMENT -Tipificación B-EXPLORATION -molecular I-EXPLORATION -y I-EXPLORATION -mecanismo I-EXPLORATION -de I-EXPLORATION -resistencia: I-EXPLORATION -Mediante I-EXPLORATION -EFCP I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -que I-EXPLORATION -ambas I-EXPLORATION -cepas I-EXPLORATION -eran I-EXPLORATION -genéticamente I-EXPLORATION -indistinguibles. I-EXPLORATION -La I-EXPLORATION -cepa I-EXPLORATION -ITU2 I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -BLEE I-EXPLORATION -SHV-5 I-EXPLORATION -codificada I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -plásmido I-EXPLORATION -conjugativo I-EXPLORATION -del I-EXPLORATION -grupo I-EXPLORATION -IncFIB, I-EXPLORATION -ausente I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cepa I-EXPLORATION -ITU1. I-EXPLORATION - I-EXPLORATION - -Recién B-PRESENT_ILLNESS -nacido I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -17 I-PRESENT_ILLNESS -días, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -perinatales I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -destacar. I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -internación I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -UCI I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -bronquiolitis I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -VRS I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -flebitis I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -brazo I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -vía I-PRESENT_ILLNESS -venosa I-PRESENT_ILLNESS -periférica I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -tumefacción I-PRESENT_ILLNESS -dolorosa, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -rubor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -calor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -segunda I-PRESENT_ILLNESS -articulación I-PRESENT_ILLNESS -condrocostal I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS -Con B-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -osteoartritis I-TREATMENT -condrocostal I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antibacteriano I-TREATMENT -empírico I-TREATMENT -con I-TREATMENT -meropenem I-TREATMENT -60 I-TREATMENT -mg/kg/día I-TREATMENT -y I-TREATMENT -vancomicina I-TREATMENT -40 I-TREATMENT -mg/kg/día I-TREATMENT -durante I-TREATMENT -72 I-TREATMENT -h. I-TREATMENT -Los B-EXPLORATION -hemocultivos I-EXPLORATION -fueron I-EXPLORATION -positivos I-EXPLORATION -a I-EXPLORATION -Klebsiella I-EXPLORATION -pneumoniae I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -oxiiminocefaslosporinas, I-EXPLORATION -amikacina, I-EXPLORATION -gentamicina, I-EXPLORATION -meropenem I-EXPLORATION -e I-EXPLORATION -imipenem. I-EXPLORATION -Se B-TREATMENT -suspendió I-TREATMENT -vancomicina I-TREATMENT -y I-TREATMENT -continuó I-TREATMENT -con I-TREATMENT -meropenem I-TREATMENT -durante I-TREATMENT -14 I-TREATMENT -días I-TREATMENT -con B-EXPLORATION -negativización I-EXPLORATION -del I-EXPLORATION -hemocultivo I-EXPLORATION -al I-EXPLORATION -7° I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -terapia. I-EXPLORATION -Mejoraron B-EVOLUTION -los I-EVOLUTION -signos I-EVOLUTION -locales I-EVOLUTION -pero I-EVOLUTION -continuó I-EVOLUTION -febril I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -agregó I-EVOLUTION -limitación I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -rotación I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cadera I-EVOLUTION -derecha. I-EVOLUTION -Con B-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -probable I-TREATMENT -osteoartritis I-TREATMENT -coxofemoral I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -punción I-TREATMENT -articular I-TREATMENT -y I-TREATMENT -drenaje I-TREATMENT -quirúrgico I-TREATMENT -que I-TREATMENT -dio I-TREATMENT -salida I-TREATMENT -a I-TREATMENT -material I-TREATMENT -purulento. I-TREATMENT -En I-TREATMENT -ese I-TREATMENT -momento I-TREATMENT -se I-TREATMENT -agregó I-TREATMENT -amikacina I-TREATMENT -15 I-TREATMENT -mg/kg/día I-TREATMENT -por I-TREATMENT -el I-TREATMENT -antecedente I-TREATMENT -de I-TREATMENT -K. I-TREATMENT -pneumoniae I-TREATMENT -aislada I-TREATMENT -del I-TREATMENT -hemocultivo. I-TREATMENT -Del B-EXPLORATION -cultivo I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -articular I-EXPLORATION -se I-EXPLORATION -obtuvo I-EXPLORATION -K. I-EXPLORATION -pneumoniae I-EXPLORATION -(cepa I-EXPLORATION -OA1) I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -mismo I-EXPLORATION -perfil I-EXPLORATION -de I-EXPLORATION -susceptibilidad I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -cepa I-EXPLORATION -aislada I-EXPLORATION -en I-EXPLORATION -sangre. I-EXPLORATION -Dado B-TREATMENT -que I-TREATMENT -persistió I-TREATMENT -febril, I-TREATMENT -se I-TREATMENT -realizaron I-TREATMENT -aseos I-TREATMENT -quirúrgicos I-TREATMENT -sucesivos I-TREATMENT -aislándose, B-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -17 I-EXPLORATION -días I-EXPLORATION -del I-EXPLORATION -primer I-EXPLORATION -aislado I-EXPLORATION -(OA1), I-EXPLORATION -K. I-EXPLORATION -pneumoniae I-EXPLORATION -(cepa I-EXPLORATION -OA2) I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -oxiiminocefalosporinas, I-EXPLORATION -amikacina I-EXPLORATION -y I-EXPLORATION -gentamicina. I-EXPLORATION -Los I-EXPLORATION -hemocultivos I-EXPLORATION -realizados I-EXPLORATION -durante I-EXPLORATION -la I-EXPLORATION -evolución I-EXPLORATION -fueron I-EXPLORATION -negativos, I-EXPLORATION -manteniéndose I-EXPLORATION -el I-EXPLORATION -mismo I-EXPLORATION -esquema I-EXPLORATION -antibacteriano. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -evaluación I-EXPLORATION -inmunológica I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -normal. I-EXPLORATION -Luego B-TREATMENT -de I-TREATMENT -múltiples I-TREATMENT -aseos I-TREATMENT -quirúrgicos, I-TREATMENT -35 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -fiebre I-TREATMENT -y I-TREATMENT -45 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -antibacteriano I-TREATMENT -se B-EVOLUTION -dio I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -posterior. I-EVOLUTION - I-EVOLUTION -Tipificación B-EXPLORATION -molecular I-EXPLORATION -y I-EXPLORATION -mecanismo I-EXPLORATION -de I-EXPLORATION -resistencia: I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -por I-EXPLORATION -EFCP I-EXPLORATION -mostró I-EXPLORATION -que I-EXPLORATION -las I-EXPLORATION -cepas I-EXPLORATION -OA1 I-EXPLORATION -y I-EXPLORATION -OA2 I-EXPLORATION -no I-EXPLORATION -estaban I-EXPLORATION -genéticamente I-EXPLORATION -relacionadas. I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION -diferencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cepa I-EXPLORATION -OA1, I-EXPLORATION -OA2 I-EXPLORATION -presentó I-EXPLORATION -el I-EXPLORATION -gen I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -BLEE I-EXPLORATION -CTX-M-9 I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -plásmido I-EXPLORATION -IncHI1-HI2 I-EXPLORATION -no I-EXPLORATION -conjugativo. I-EXPLORATION -Adicionalmente I-EXPLORATION -OA2 I-EXPLORATION -presentaba I-EXPLORATION -el I-EXPLORATION -gen I-EXPLORATION -aac I-EXPLORATION -(6') I-EXPLORATION -1b, I-EXPLORATION -que I-EXPLORATION -confiere I-EXPLORATION -resistencia I-EXPLORATION -a I-EXPLORATION -amikacina I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -integrón I-EXPLORATION -de I-EXPLORATION -clase I-EXPLORATION -1 I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -genes I-EXPLORATION -aadB-aadA2 I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -variable, I-EXPLORATION -responsables I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -resistencia I-EXPLORATION -a I-EXPLORATION -gentamicina. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -77 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -jubilado, B-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresó I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -febril I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -estudio. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Tenía B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -coartación I-PAST_MEDICAL_HISTORY -aórtica I-PAST_MEDICAL_HISTORY -operada, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -recambio I-PAST_MEDICAL_HISTORY -valvular I-PAST_MEDICAL_HISTORY -aórtico I-PAST_MEDICAL_HISTORY -hacían I-PAST_MEDICAL_HISTORY -ya I-PAST_MEDICAL_HISTORY -40 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -reemplazo I-PAST_MEDICAL_HISTORY -compuesto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -válvula I-PAST_MEDICAL_HISTORY -aórtica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -aorta I-PAST_MEDICAL_HISTORY -ascendente I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -reemplazo I-PAST_MEDICAL_HISTORY -valvular I-PAST_MEDICAL_HISTORY -mitral, I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -atrás, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontraba I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -anticoagulante I-PAST_MEDICAL_HISTORY -oral. I-PAST_MEDICAL_HISTORY -Además I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -cardíaca I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -control. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -intermitente I-PRESENT_ILLNESS -cuantificada I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -38 I-PRESENT_ILLNESS -°C I-PRESENT_ILLNESS -axilar, I-PRESENT_ILLNESS -asociada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -moderado I-PRESENT_ILLNESS -difuso, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -carácter I-PRESENT_ILLNESS -inespecífico, I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -nocturna I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -mes. I-PRESENT_ILLNESS -Sin I-PRESENT_ILLNESS -diarrea, I-PRESENT_ILLNESS -vómitos, I-PRESENT_ILLNESS -tos, I-PRESENT_ILLNESS -disuria, I-PRESENT_ILLNESS -artralgias I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -cutáneas. I-PRESENT_ILLNESS -Dentro B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -epidemiológicos, I-PAST_MEDICAL_HISTORY -residía I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Santiago I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -viajes I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -extranjero. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -momento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -consciente, I-EXPLORATION -vigil, I-EXPLORATION -cooperador, I-EXPLORATION -con I-EXPLORATION -hemodinamia I-EXPLORATION -estable, I-EXPLORATION -yugulares I-EXPLORATION -planas I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -adenopatías I-EXPLORATION -palpables. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -pulmonar I-EXPLORATION -era I-EXPLORATION -normal, I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -cardíaco I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -soplo I-EXPLORATION -sistólico I-EXPLORATION -en I-EXPLORATION -foco I-EXPLORATION -aórtico I-EXPLORATION -3/6, I-EXPLORATION -el I-EXPLORATION -abdomen I-EXPLORATION -era I-EXPLORATION -blando, I-EXPLORATION -depresible, I-EXPLORATION -sensible I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -difusa I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal I-EXPLORATION -ni I-EXPLORATION -visceromegalia. I-EXPLORATION -Las I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -no I-EXPLORATION -presentaban I-EXPLORATION -edema I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -lechos I-EXPLORATION -ungueales I-EXPLORATION -no I-EXPLORATION -tenían I-EXPLORATION -lesiones. I-EXPLORATION -El I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio, I-EXPLORATION -destacando I-EXPLORATION -un I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -completa I-EXPLORATION -y I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION -normales, I-EXPLORATION -hemograma I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -anemia I-EXPLORATION -normocítica I-EXPLORATION -normocrómica I-EXPLORATION -(hemoglobina I-EXPLORATION -de I-EXPLORATION -11 I-EXPLORATION -gr/dL I-EXPLORATION -y I-EXPLORATION -hematocrito I-EXPLORATION -de I-EXPLORATION -31, I-EXPLORATION -7%), I-EXPLORATION -con I-EXPLORATION -las I-EXPLORATION -otras I-EXPLORATION -series I-EXPLORATION -normales; I-EXPLORATION -VHS I-EXPLORATION -82 I-EXPLORATION -mm I-EXPLORATION -1° I-EXPLORATION -hora; I-EXPLORATION -PCR I-EXPLORATION -5, I-EXPLORATION -3 I-EXPLORATION -mg/dL I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -1 I-EXPLORATION -mg/dL) I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -INR I-EXPLORATION -2, I-EXPLORATION -5. I-EXPLORATION -Por I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -de I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -solicitaron I-EXPLORATION -pruebas I-EXPLORATION -hepáticas: I-EXPLORATION -GOT I-EXPLORATION -45 I-EXPLORATION -UI/L, I-EXPLORATION -GGT I-EXPLORATION -81 I-EXPLORATION -UI/L, I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -0, I-EXPLORATION -69 I-EXPLORATION -mg/dL, I-EXPLORATION -LDH I-EXPLORATION -360 I-EXPLORATION -U/L, I-EXPLORATION -GPT I-EXPLORATION -y I-EXPLORATION -fosfatasas I-EXPLORATION -alcalinas I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -serologías I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -hepatitis I-EXPLORATION -A, I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C I-EXPLORATION -y I-EXPLORATION -VIH I-EXPLORATION -que I-EXPLORATION -resultaron I-EXPLORATION -negativas, I-EXPLORATION -reacción I-EXPLORATION -de I-EXPLORATION -Widal I-EXPLORATION -negativa, I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION -Entre I-EXPLORATION -otros I-EXPLORATION -exámenes I-EXPLORATION -destacaba I-EXPLORATION -TSH I-EXPLORATION -0, I-EXPLORATION -84 I-EXPLORATION -U/ml I-EXPLORATION -(VN I-EXPLORATION -0, I-EXPLORATION -3-4, I-EXPLORATION -2 I-EXPLORATION -U/ml) I-EXPLORATION -y I-EXPLORATION -factor I-EXPLORATION -reumatoide I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -Por I-EXPLORATION -persistencia I-EXPLORATION -del I-EXPLORATION -cuadro, I-EXPLORATION -fue I-EXPLORATION -internado I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -continuó I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -AP I-EXPLORATION -y I-EXPLORATION -lateral I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -Por I-EXPLORATION -el I-EXPLORATION -antecedente I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -válvula I-EXPLORATION -protésica I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -ecocardiograma I-EXPLORATION -transesofágico I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -filamentosa I-EXPLORATION -de I-EXPLORATION -20 I-EXPLORATION -x I-EXPLORATION -8 I-EXPLORATION -x I-EXPLORATION -5 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -válvula I-EXPLORATION -aórtica. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -empírico I-TREATMENT -para I-TREATMENT -una I-TREATMENT -EI I-TREATMENT -asociada I-TREATMENT -a I-TREATMENT -válvula I-TREATMENT -protésica I-TREATMENT -con I-TREATMENT -vancomicina I-TREATMENT -iv I-TREATMENT -1 I-TREATMENT -g, I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -gentamicina I-TREATMENT -iv I-TREATMENT -80 I-TREATMENT -mg, I-TREATMENT -tres I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día I-TREATMENT -y I-TREATMENT -rifampicina I-TREATMENT -600 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día. I-TREATMENT -Los B-EXPLORATION -dos I-EXPLORATION -hemocultivos I-EXPLORATION -tomados I-EXPLORATION -previo I-EXPLORATION -al I-EXPLORATION -inicio I-EXPLORATION -de I-EXPLORATION -tratamiento I-EXPLORATION -antibacteriano, I-EXPLORATION -fueron I-EXPLORATION -positivos I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -23 I-EXPLORATION -hrs. I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -bacilo I-EXPLORATION -grampositivo, I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -identificado I-EXPLORATION -como I-EXPLORATION -L. I-EXPLORATION -monocytogenes. I-EXPLORATION -Se B-TREATMENT -ajustó I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -a I-TREATMENT -ampicilina I-TREATMENT -2 I-TREATMENT -g I-TREATMENT -iv, I-TREATMENT -seis I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día I-TREATMENT -y I-TREATMENT -gentamicina I-TREATMENT -80 I-TREATMENT -mg, I-TREATMENT -tres I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día. I-TREATMENT - I-TREATMENT -Por B-EVOLUTION -presentar I-EVOLUTION -una I-EVOLUTION -buena I-EVOLUTION -respuesta I-EVOLUTION -clínica I-EVOLUTION -se I-EVOLUTION -decidió I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -y B-TREATMENT -continuó I-TREATMENT -con I-TREATMENT -tratamiento I-TREATMENT -antibacteriano I-TREATMENT -intravenoso I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -ambulatoria. I-TREATMENT -Se B-EVOLUTION -controló I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -mensual I-EVOLUTION -durante I-EVOLUTION -los I-EVOLUTION -tres I-EVOLUTION -primeros I-EVOLUTION -meses, I-EVOLUTION -luego I-EVOLUTION -cada I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -hasta I-EVOLUTION -completar I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -y I-EVOLUTION -posteriormente I-EVOLUTION -cada I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -durante I-EVOLUTION -el I-EVOLUTION -segundo I-EVOLUTION -año. I-EVOLUTION -Durante I-EVOLUTION -su I-EVOLUTION -seguimiento I-EVOLUTION -se I-EVOLUTION -constató I-EVOLUTION -un I-EVOLUTION -descenso I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -inflamatorios I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -ajustaron I-EVOLUTION -las I-EVOLUTION -dosis I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -antibacterianos I-EVOLUTION -según I-EVOLUTION -su I-EVOLUTION -función I-EVOLUTION -renal. I-EVOLUTION -Completó B-TREATMENT -tres I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -gentamicina I-TREATMENT -80 I-TREATMENT -mg, I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -suspendiéndose I-TREATMENT -por I-TREATMENT -deterioro I-TREATMENT -de I-TREATMENT -la I-TREATMENT -función I-TREATMENT -renal; I-TREATMENT -ampicilina I-TREATMENT -2 I-TREATMENT -g, I-TREATMENT -cuatro I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -por I-TREATMENT -doce I-TREATMENT -semanas I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -mantención I-TREATMENT -con I-TREATMENT -amoxicilina I-TREATMENT -1 I-TREATMENT -g, I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día I-TREATMENT -y I-TREATMENT -y I-TREATMENT -luego I-TREATMENT -terapia I-TREATMENT -supresora I-TREATMENT -con I-TREATMENT -500 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -dos I-TREATMENT -años, I-TREATMENT -para I-TREATMENT -garantizar I-TREATMENT -la I-TREATMENT -esterilidad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -residual. I-TREATMENT -El B-EXPLORATION -último I-EXPLORATION -ecocardiograma I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -variaciones I-EXPLORATION -significativas I-EXPLORATION -con I-EXPLORATION -respecto I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -inicial. I-EXPLORATION -Actualmente, B-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -mantenido I-EVOLUTION -asintomático. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -22 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -residente B-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -procedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -ciudad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Iquitos, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos. I-PAST_MEDICAL_HISTORY -Inició B-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -enfermedad I-PRESENT_ILLNESS -(día I-PRESENT_ILLNESS -1) I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -mialgias, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -óseo, I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -retro-ocular. I-PRESENT_ILLNESS -Ante I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -persistencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -estos I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -3, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -salud I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -diagnosticó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -dengue I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -signos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -alarma, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -rash, I-PRESENT_ILLNESS -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -le I-TREATMENT -indicó I-TREATMENT -paracetamol I-TREATMENT -(500 I-TREATMENT -mg I-TREATMENT -tres I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día) I-TREATMENT -e I-TREATMENT -hidratación I-TREATMENT -oral. I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -contexto I-EXPLORATION -del I-EXPLORATION -proyecto I-EXPLORATION -de I-EXPLORATION -investigación I-EXPLORATION -"Vigilancia I-EXPLORATION -y I-EXPLORATION -etiología I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -enfermedad I-EXPLORATION -febril I-EXPLORATION -aguda I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Perú", I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -venosa I-EXPLORATION -para I-EXPLORATION -ser I-EXPLORATION -enviada I-EXPLORATION -al I-EXPLORATION -laboratorio I-EXPLORATION -del I-EXPLORATION -Naval I-EXPLORATION -Medical I-EXPLORATION -Research I-EXPLORATION -Unit I-EXPLORATION -Six I-EXPLORATION -(NAMRU-6) I-EXPLORATION -para I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -reacción I-EXPLORATION -de I-EXPLORATION -polimerasa I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -(RPC) I-EXPLORATION -para I-EXPLORATION -dengue I-EXPLORATION -y I-EXPLORATION -leptospirosis, I-EXPLORATION -IgM I-EXPLORATION -por I-EXPLORATION -método I-EXPLORATION -de I-EXPLORATION -ELISA I-EXPLORATION -y I-EXPLORATION -cultivo I-EXPLORATION -viral I-EXPLORATION -para I-EXPLORATION -otras I-EXPLORATION -arbovirosis. I-EXPLORATION -Al B-EVOLUTION -quinto I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -se I-EVOLUTION -agregó I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -moderado I-EVOLUTION -a I-EVOLUTION -intenso, I-EVOLUTION -tipo I-EVOLUTION -cólico, I-EVOLUTION -localizado I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -epigastrio I-EVOLUTION -e I-EVOLUTION -hipocondrio I-EVOLUTION -derecho, I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -náuseas I-EVOLUTION -y I-EVOLUTION -vómitos. I-EVOLUTION -En I-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -6 I-EVOLUTION -y I-EVOLUTION -7 I-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -aumentaron I-EVOLUTION -en I-EVOLUTION -intensidad I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -consultó I-EVOLUTION -nuevamente. I-EVOLUTION -Recibió B-TREATMENT -hidratación I-TREATMENT -y I-TREATMENT -analgesia I-TREATMENT -intravenosa; I-TREATMENT -sin I-TREATMENT -embargo, I-TREATMENT -al I-TREATMENT -no I-TREATMENT -presentar I-TREATMENT -mejoría I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -su I-TREATMENT -internación. I-TREATMENT -Ingresó B-EVOLUTION -en I-EVOLUTION -mal I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -quejumbrosa, I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -temperatura I-EVOLUTION -de I-EVOLUTION -37, I-EVOLUTION -6°C I-EVOLUTION -axilar, I-EVOLUTION -presión I-EVOLUTION -arterial I-EVOLUTION -90/60 I-EVOLUTION -mmHg, I-EVOLUTION -frecuencia I-EVOLUTION -respiratoria I-EVOLUTION -26 I-EVOLUTION -por I-EVOLUTION -min, I-EVOLUTION -y I-EVOLUTION -frecuencia I-EVOLUTION -cardíaca I-EVOLUTION -98 I-EVOLUTION -latidos/ I-EVOLUTION -min. I-EVOLUTION -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -presentaba I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -deshidratación I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -rash I-EXPLORATION -eritematoso I-EXPLORATION -generalizado, I-EXPLORATION -sin I-EXPLORATION -linfadenopatías. I-EXPLORATION -Presentaba I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -abdominal I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hipocondrio I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -signo I-EXPLORATION -de I-EXPLORATION -Murphy I-EXPLORATION -positivo. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -cardiopulmonar I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -neurológico I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -prueba I-EXPLORATION -del I-EXPLORATION -lazo I-EXPLORATION -o I-EXPLORATION -torniquete I-EXPLORATION -resultó I-EXPLORATION -negativa. I-EXPLORATION -Entre I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -ALT I-EXPLORATION -(alanino I-EXPLORATION -aminotransferasa) I-EXPLORATION -180 I-EXPLORATION -U/L, I-EXPLORATION -AST I-EXPLORATION -(aspartato I-EXPLORATION -aminotransferasa) I-EXPLORATION -365 I-EXPLORATION -U/L, I-EXPLORATION -albúmina I-EXPLORATION -sérica I-EXPLORATION -2, I-EXPLORATION -39 I-EXPLORATION -g/dl, I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -0, I-EXPLORATION -18 I-EXPLORATION -mg/dl, I-EXPLORATION -bilirrubina I-EXPLORATION -indirecta I-EXPLORATION -0, I-EXPLORATION -09 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -hematocrito I-EXPLORATION -43%, I-EXPLORATION -recuento I-EXPLORATION -plaquetario I-EXPLORATION -100.000/mm3. I-EXPLORATION -La I-EXPLORATION -glicemia, I-EXPLORATION -urea I-EXPLORATION -y I-EXPLORATION -creatinina I-EXPLORATION -sérica I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -amilasa I-EXPLORATION -sérica I-EXPLORATION -inicial I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -41 I-EXPLORATION -U/L. I-EXPLORATION -Se B-TREATMENT -continuó I-TREATMENT -con I-TREATMENT -hidratación I-TREATMENT -y I-TREATMENT -medicación I-TREATMENT -sintomática I-TREATMENT -intravenosa I-TREATMENT -(hioscina, I-TREATMENT -metamizol I-TREATMENT -y I-TREATMENT -dimenhidrinato). I-TREATMENT -El B-EVOLUTION -día I-EVOLUTION -8 I-EVOLUTION -ya I-EVOLUTION -no I-EVOLUTION -presentaba I-EVOLUTION -fiebre, I-EVOLUTION -pero I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -y I-EVOLUTION -los I-EVOLUTION -vómitos I-EVOLUTION -se I-EVOLUTION -hicieron I-EVOLUTION -aún I-EVOLUTION -más I-EVOLUTION -intensos. I-EVOLUTION -Se B-EXPLORATION -controló I-EXPLORATION -la I-EXPLORATION -amilasa I-EXPLORATION -sérica I-EXPLORATION -213 I-EXPLORATION -U/L I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -fosfatasas I-EXPLORATION -alcalinas I-EXPLORATION -75, I-EXPLORATION -5 I-EXPLORATION -U/L I-EXPLORATION -(VN I-EXPLORATION -hasta I-EXPLORATION -270 I-EXPLORATION -U/L). I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ultrasonografía I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -escasa I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -ascítico, I-EXPLORATION -efusión I-EXPLORATION -pleural, I-EXPLORATION -edema I-EXPLORATION -peri-vesicular I-EXPLORATION -y I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -vesicular I-EXPLORATION -(8, I-EXPLORATION -5 I-EXPLORATION -mm), I-EXPLORATION -sin I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -litiasis I-EXPLORATION -o I-EXPLORATION -visceromegalia. I-EXPLORATION -El I-EXPLORATION -día I-EXPLORATION -10 I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -abdominal I-EXPLORATION -cuya I-EXPLORATION -mala I-EXPLORATION -calidad I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -mayores I-EXPLORATION -detalles I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vesícula I-EXPLORATION -biliar I-EXPLORATION -pero I-EXPLORATION -permitió I-EXPLORATION -descartar I-EXPLORATION -el I-EXPLORATION -compromiso I-EXPLORATION -pancreático. I-EXPLORATION -La I-EXPLORATION -prueba I-EXPLORATION -del I-EXPLORATION -lazo, I-EXPLORATION -realizada I-EXPLORATION -ese I-EXPLORATION -mismo I-EXPLORATION -día, I-EXPLORATION -resultó I-EXPLORATION -positiva. I-EXPLORATION -Se B-TREATMENT -continuó I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -soporte I-TREATMENT -hasta I-TREATMENT -el I-TREATMENT -día I-TREATMENT -12, I-TREATMENT -cuando B-EVOLUTION -se I-EVOLUTION -decidió I-EVOLUTION -su I-EVOLUTION -alta I-EVOLUTION -médica I-EVOLUTION -por I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -parcial I-EVOLUTION -(disminución I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -y I-EVOLUTION -ausencia I-EVOLUTION -de I-EVOLUTION -náuseas I-EVOLUTION -y I-EVOLUTION -vómitos) I-EVOLUTION -con I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -dengue I-EVOLUTION -y I-EVOLUTION -colecistitis I-EVOLUTION -alitiásica. I-EVOLUTION -La I-EVOLUTION -sintomatología I-EVOLUTION -disminuyó I-EVOLUTION -progresivamente I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -día I-EVOLUTION -25 I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -un I-EVOLUTION -control I-EVOLUTION -de I-EVOLUTION -transaminasas I-EVOLUTION -ALT I-EVOLUTION -y I-EVOLUTION -AST I-EVOLUTION -que I-EVOLUTION -fueron I-EVOLUTION -de I-EVOLUTION -18 I-EVOLUTION -y I-EVOLUTION -25 I-EVOLUTION -U/L, I-EVOLUTION -respectivamente. I-EVOLUTION - I-EVOLUTION -El B-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -muestras I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -otras I-EXPLORATION -infecciones I-EXPLORATION -resultaron I-EXPLORATION -negativas: I-EXPLORATION -leptospirosis I-EXPLORATION -(RPC), I-EXPLORATION -rickettsiosis I-EXPLORATION -(IgG), I-EXPLORATION -hepatitis I-EXPLORATION -B I-EXPLORATION -(HBsAg) I-EXPLORATION -y I-EXPLORATION -otras I-EXPLORATION -arbovirosis I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -encefalitis I-EXPLORATION -equina I-EXPLORATION -venezolana, I-EXPLORATION -mayaro, I-EXPLORATION -oropuche, I-EXPLORATION -fiebre I-EXPLORATION -amarilla I-EXPLORATION -y I-EXPLORATION -virus I-EXPLORATION -del I-EXPLORATION -grupo I-EXPLORATION -C I-EXPLORATION -(serología I-EXPLORATION -IgM I-EXPLORATION -y I-EXPLORATION -aislamiento I-EXPLORATION -viral). I-EXPLORATION -La I-EXPLORATION -gota I-EXPLORATION -gruesa I-EXPLORATION -para I-EXPLORATION -malaria I-EXPLORATION -también I-EXPLORATION -resultó I-EXPLORATION -negativa. I-EXPLORATION -La I-EXPLORATION -RPC I-EXPLORATION -para I-EXPLORATION -dengue I-EXPLORATION -resultó I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -virus I-EXPLORATION -dengue I-EXPLORATION -serotipo I-EXPLORATION -4. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -52 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -TEC I-PAST_MEDICAL_HISTORY -simple I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -secuelas I-PAST_MEDICAL_HISTORY -y B-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -rinorrea I-PRESENT_ILLNESS -acuosa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -cefalea. I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -otorrinolaringología I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -diagnosticó I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -probable I-PRESENT_ILLNESS -rinitis I-PRESENT_ILLNESS -vasomotora. I-PRESENT_ILLNESS -Se B-TREATMENT -prescribió I-TREATMENT -corticoides I-TREATMENT -intranasales I-TREATMENT -y I-TREATMENT -sistémicos I-TREATMENT -(prednisona I-TREATMENT -10 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día) I-TREATMENT -y I-TREATMENT -azitromicina I-TREATMENT -por I-TREATMENT -siete I-TREATMENT -días. I-TREATMENT - I-TREATMENT -Luego B-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -transitoria I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -cefalea I-EVOLUTION -holocránea I-EVOLUTION -de I-EVOLUTION -inicio I-EVOLUTION -súbito, I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -dolor I-EVOLUTION -cervical, I-EVOLUTION -compromiso I-EVOLUTION -de I-EVOLUTION -conciencia I-EVOLUTION -sin I-EVOLUTION -focalidad I-EVOLUTION -neurológica I-EVOLUTION -evidente I-EVOLUTION -y I-EVOLUTION -calofríos, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -consultó I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Urgencia I-EVOLUTION -de I-EVOLUTION -nuestro I-EVOLUTION -hospital. I-EVOLUTION -Al B-EXPLORATION -ingreso I-EXPLORATION -destacaban I-EXPLORATION -cifras I-EXPLORATION -tensionales I-EXPLORATION -límites I-EXPLORATION -(presión I-EXPLORATION -arterial I-EXPLORATION -108/70 I-EXPLORATION -mm I-EXPLORATION -Hg) I-EXPLORATION -que I-EXPLORATION -respondieron I-EXPLORATION -a I-EXPLORATION -volumen, I-EXPLORATION -fiebre I-EXPLORATION -(T° I-EXPLORATION -38, I-EXPLORATION -5°C), I-EXPLORATION -desorientación I-EXPLORATION -temporo-espacial, I-EXPLORATION -agitación I-EXPLORATION -psicomotora I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION -meníngeos. I-EXPLORATION -Se I-EXPLORATION -tomaron I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -efectuó I-EXPLORATION -una I-EXPLORATION -punción I-EXPLORATION -lumbar I-EXPLORATION -que I-EXPLORATION -dio I-EXPLORATION -salida I-EXPLORATION -a I-EXPLORATION -LCR I-EXPLORATION -turbio, I-EXPLORATION -citoquímico: I-EXPLORATION -8.480 I-EXPLORATION -céls/mm3, I-EXPLORATION -100% I-EXPLORATION -polimorfonucleares, I-EXPLORATION -proteínas I-EXPLORATION -370 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -glucosa I-EXPLORATION -2 I-EXPLORATION -mg/dl. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -una I-TREATMENT -MBA I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -empírico I-TREATMENT -con I-TREATMENT -ceftriaxona I-TREATMENT -2 I-TREATMENT -g, I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día I-TREATMENT -y I-TREATMENT -dexametasona I-TREATMENT -i.v. I-TREATMENT -10 I-TREATMENT -mg, I-TREATMENT -4 I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -esta I-TREATMENT -última I-TREATMENT -por I-TREATMENT -4 I-TREATMENT -días. I-TREATMENT -La B-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -(TAC) I-EXPLORATION -de I-EXPLORATION -cerebro I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -alteraciones I-EXPLORATION -significativas. I-EXPLORATION -Fue B-EVOLUTION -admitida I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -Unidad I-EVOLUTION -de I-EVOLUTION -Pacientes I-EVOLUTION -Críticos, I-EVOLUTION -donde I-EVOLUTION -evolucionó I-EVOLUTION -sin I-EVOLUTION -requerimiento I-EVOLUTION -de I-EVOLUTION -fármacos I-EVOLUTION -vasoactivos, I-EVOLUTION -con I-EVOLUTION -caída I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -curva I-EVOLUTION -febril I-EVOLUTION -y I-EVOLUTION -recuperación I-EVOLUTION -en I-EVOLUTION -su I-EVOLUTION -condición I-EVOLUTION -neurológica I-EVOLUTION -en I-EVOLUTION -menos I-EVOLUTION -de I-EVOLUTION -24 I-EVOLUTION -h. I-EVOLUTION - I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -del I-EXPLORATION -LCR I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -bacterias I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -naranja I-EXPLORATION -de I-EXPLORATION -acridina I-EXPLORATION -mostró I-EXPLORATION -formas I-EXPLORATION -cocoides. I-EXPLORATION -Tanto I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -LCR I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION -hubo I-EXPLORATION -identificación I-EXPLORATION -de I-EXPLORATION -S. I-EXPLORATION -agalactiae I-EXPLORATION -susceptible I-EXPLORATION -a I-EXPLORATION -penicilina, I-EXPLORATION -eritromicina I-EXPLORATION -y I-EXPLORATION -clindamicina. I-EXPLORATION -El I-EXPLORATION -laboratorio I-EXPLORATION -de I-EXPLORATION -referencia I-EXPLORATION -(Instituto I-EXPLORATION -de I-EXPLORATION -Salud I-EXPLORATION -Pública I-EXPLORATION -de I-EXPLORATION -Chile) I-EXPLORATION -confirmó I-EXPLORATION -posteriormente I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -cultivos, I-EXPLORATION -informando I-EXPLORATION -además I-EXPLORATION -que I-EXPLORATION -correspondía I-EXPLORATION -al I-EXPLORATION -serotipo I-EXPLORATION -Ib. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -fue I-EXPLORATION -evaluada I-EXPLORATION -por I-EXPLORATION -ginecología I-EXPLORATION -encontrándose I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -vulvovaginitis I-EXPLORATION -y I-EXPLORATION -miomas I-EXPLORATION -uterinos, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -microbiológico. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -otorrino-laringológico I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -rinorrea I-EXPLORATION -acuosa I-EXPLORATION -abundante I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -fosa I-EXPLORATION -nasal I-EXPLORATION -izquierda I-EXPLORATION -evidenciada I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -maniobra I-EXPLORATION -de I-EXPLORATION -Valsalva. I-EXPLORATION -Por I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -fístula I-EXPLORATION -de I-EXPLORATION -LCR I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -cavidades I-EXPLORATION -paranasales I-EXPLORATION -de I-EXPLORATION -alta I-EXPLORATION -resolución I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -continuidad I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lámina I-EXPLORATION -cribosa I-EXPLORATION -del I-EXPLORATION -etmoides I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -adelgazamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -postero-lateral I-EXPLORATION -del I-EXPLORATION -hemiseno I-EXPLORATION -esfenoidal I-EXPLORATION -izquierdo I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -aspecto I-EXPLORATION -más I-EXPLORATION -craneal I-EXPLORATION -con I-EXPLORATION -engrasamiento I-EXPLORATION -mucoso. I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -β2-transferrina I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -nasal, I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -positivo. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -además I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -reveló I-EXPLORATION -hallazgos I-EXPLORATION -de I-EXPLORATION -importancia. I-EXPLORATION - I-EXPLORATION -Su B-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -fue I-EVOLUTION -favorable, I-EVOLUTION -con I-EVOLUTION -disminución I-EVOLUTION -progresiva I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -inflamatorios, I-EVOLUTION -completando I-EVOLUTION -14 I-EVOLUTION -días I-EVOLUTION -con I-EVOLUTION -ceftriaxona. I-EVOLUTION -Se I-EVOLUTION -decidió I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -programación I-EVOLUTION -diferida I-EVOLUTION -de I-EVOLUTION -resolución I-EVOLUTION -quirúrgica I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -fístula I-EVOLUTION -de I-EVOLUTION -LCR. I-EVOLUTION -Se B-TREATMENT -recomendó I-TREATMENT -la I-TREATMENT -vacunación I-TREATMENT -antineumocócica I-TREATMENT -polisacárida I-TREATMENT -y I-TREATMENT -antimeningocócica I-TREATMENT -cuadrivalente I-TREATMENT -conjugada. I-TREATMENT - I-TREATMENT -En B-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -dirigida I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -refirió I-PAST_MEDICAL_HISTORY -golpes I-PAST_MEDICAL_HISTORY -menores I-PAST_MEDICAL_HISTORY -recurrentes I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cabeza I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -previas I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -muro I-PAST_MEDICAL_HISTORY -debajo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -escalera I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -permitía I-PAST_MEDICAL_HISTORY -acceder I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -patio I-PAST_MEDICAL_HISTORY -común I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -tender I-PAST_MEDICAL_HISTORY -ropa. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -reconoció I-PAST_MEDICAL_HISTORY -además I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -ocupado I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -mismo I-PAST_MEDICAL_HISTORY -papel I-PAST_MEDICAL_HISTORY -higiénico I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -limpiarse I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -genital I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -nasal I-PAST_MEDICAL_HISTORY -unos I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -escasez I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -éste I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -baño, I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -visita I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -unos I-PAST_MEDICAL_HISTORY -familiares I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -atendiendo I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -intensa I-PAST_MEDICAL_HISTORY -rinorrea. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Tras B-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -presentar I-EVOLUTION -salida I-EVOLUTION -de I-EVOLUTION -LCR I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -nariz. I-EVOLUTION -A B-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -esto, I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -que I-TREATMENT -presentaba I-TREATMENT -una I-TREATMENT -fístula I-TREATMENT -de I-TREATMENT -probable I-TREATMENT -origen I-TREATMENT -espontáneo I-TREATMENT -y I-TREATMENT -que I-TREATMENT -ya I-TREATMENT -había I-TREATMENT -tenido I-TREATMENT -un I-TREATMENT -episodio I-TREATMENT -de I-TREATMENT -MBA, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -aconsejó I-TREATMENT -someterse I-TREATMENT -a I-TREATMENT -una I-TREATMENT -cirugía I-TREATMENT -endoscópica I-TREATMENT -nasal I-TREATMENT -para I-TREATMENT -reparar I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -dehiscente I-TREATMENT -en I-TREATMENT -la I-TREATMENT -base I-TREATMENT -del I-TREATMENT -cráneo I-TREATMENT -anterior. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -cutánea I-PRESENT_ILLNESS -dolorosa I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -pápula, I-PRESENT_ILLNESS -pardo-negruzca, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -bordes I-PRESENT_ILLNESS -eritematosos, I-PRESENT_ILLNESS -ubicada I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -pulpejo I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -segundo I-PRESENT_ILLNESS -ortejo I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -pie I-PRESENT_ILLNESS -izquierdo. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -múltiples I-EXPLORATION -huevecillos I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -blanco, I-EXPLORATION -de I-EXPLORATION -menos I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro. I-EXPLORATION -La B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -regresado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -viaje I-PAST_MEDICAL_HISTORY -turístico I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -Paraguay I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -antes. I-PAST_MEDICAL_HISTORY -Se B-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -extracción I-TREATMENT -quirúrgica I-TREATMENT -de I-TREATMENT -los I-TREATMENT -parásitos. I-TREATMENT -Además I-TREATMENT -se I-TREATMENT -indicaron I-TREATMENT -antibacterianos I-TREATMENT -tópicos I-TREATMENT -y I-TREATMENT -profilaxis I-TREATMENT -antitetánica, I-TREATMENT -con B-EVOLUTION -resolución I-EVOLUTION -total I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -46 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -torácico I-PRESENT_ILLNESS -punzante, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -productiva. I-PRESENT_ILLNESS -Además I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -lógica, I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -(siete I-PRESENT_ILLNESS -kg) I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -nocturna. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Se B-EXPLORATION -tomó I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -hemoglobina I-EXPLORATION -6, I-EXPLORATION -2 I-EXPLORATION -g/dl, I-EXPLORATION -leucocitos I-EXPLORATION -9.830/mm3, I-EXPLORATION -plaquetas I-EXPLORATION -77.200/mm3, I-EXPLORATION -PCR I-EXPLORATION -216 I-EXPLORATION -mg/l I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -demostró I-EXPLORATION -una I-EXPLORATION -consolidación I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -superior I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION -Se B-EVOLUTION -hospitalizó I-EVOLUTION -para I-EVOLUTION -estudio I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -bicitopenia, I-EVOLUTION -disfagia I-EVOLUTION -y I-EVOLUTION -síndrome I-EVOLUTION -consuntivo. I-EVOLUTION -Se I-EVOLUTION -diagnosticó B-TREATMENT -una I-TREATMENT -neumonía I-TREATMENT -bacteriana I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -recibió I-TREATMENT -ceftriaxona I-TREATMENT -por I-TREATMENT -10 I-TREATMENT -días, I-TREATMENT -con B-EVOLUTION -buena I-EVOLUTION -respuesta I-EVOLUTION -clínica. I-EVOLUTION - I-EVOLUTION -Dentro B-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -disfagia I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -endoscopía I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -(EDA) I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -tres I-EXPLORATION -úlceras I-EXPLORATION -esofágicas I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -etiología I-EXPLORATION -viral I-EXPLORATION -(citomegalovirus) I-EXPLORATION -(CMV). I-EXPLORATION -Se I-EXPLORATION -tomaron I-EXPLORATION -biopsias I-EXPLORATION -y B-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ganciclovir I-TREATMENT -por I-TREATMENT -10 I-TREATMENT -días, I-TREATMENT -con B-EVOLUTION -escasa I-EVOLUTION -respuesta I-EVOLUTION -clínica. I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -erosión I-EXPLORATION -mucosa I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -citopáticos I-EXPLORATION -de I-EXPLORATION -CMV. I-EXPLORATION -La I-EXPLORATION -RPC I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -para I-EXPLORATION -CMV I-EXPLORATION -también I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -bicitopenia I-EXPLORATION -fue I-EXPLORATION -confirmada I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -con I-EXPLORATION -neutropenia I-EXPLORATION -de I-EXPLORATION -200 I-EXPLORATION -neutrófilos/mm3; I-EXPLORATION -88% I-EXPLORATION -de I-EXPLORATION -blastos I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -mielograma I-EXPLORATION -que I-EXPLORATION -informó I-EXPLORATION -una I-EXPLORATION -leucemia I-EXPLORATION -mieloide I-EXPLORATION -aguda I-EXPLORATION -(LMA). I-EXPLORATION -Una B-TREATMENT -vez I-TREATMENT -finalizados I-TREATMENT -los I-TREATMENT -tratamientos I-TREATMENT -antimicrobianos I-TREATMENT -inició I-TREATMENT -quimioterapia. I-TREATMENT - I-TREATMENT -Tres B-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -quimioterapia I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -neutropenia I-EVOLUTION -febril I-EVOLUTION -(NF) I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -RAN I-EVOLUTION -de I-EVOLUTION -20 I-EVOLUTION -neutrófilos/mm3. I-EVOLUTION -Una B-EXPLORATION -nueva I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -cambios I-EXPLORATION -con I-EXPLORATION -respecto I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -anterior. I-EXPLORATION -Inició B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -imipenem I-TREATMENT -y I-TREATMENT -vancomicina I-TREATMENT -i.v. I-TREATMENT -Por B-EXPLORATION -persistencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -fiebre I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -neutropenia, I-EXPLORATION -al I-EXPLORATION -cuarto I-EXPLORATION -día I-EXPLORATION -se I-EXPLORATION -repitieron I-EXPLORATION -los I-EXPLORATION -cultivos I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -pulmonar, I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -pelvis. I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -pulmonar I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -superior I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -"signo I-EXPLORATION -del I-EXPLORATION -halo". I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -voriconazol I-TREATMENT -sospechando I-TREATMENT -una I-TREATMENT -aspergilosis I-TREATMENT -pulmonar. I-TREATMENT -Los B-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -galactomananos I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -resultaron I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -Por I-EXPLORATION -persistencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -disfagia, I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -EDA I-EXPLORATION -mostró I-EXPLORATION -persistencia I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -úlceras I-EXPLORATION -esofágicas. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -evidenció I-EXPLORATION -hifas I-EXPLORATION -septadas, I-EXPLORATION -ramificadas I-EXPLORATION -en I-EXPLORATION -45°, I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -Aspergillus I-EXPLORATION -spp. I-EXPLORATION - I-EXPLORATION -Luego B-EVOLUTION -de I-EVOLUTION -dos I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -antifúngico I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encontraba I-EVOLUTION -sin I-EVOLUTION -fiebre I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -disfagia. I-EVOLUTION -Se B-TREATMENT -completaron I-TREATMENT -18 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -antibacteriano I-TREATMENT -y I-TREATMENT -21 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -voriconazol. I-TREATMENT - I-TREATMENT - -Un B-PRESENT_ILLNESS -adulto I-PRESENT_ILLNESS -mayor I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -61 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -ingresado I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -Departamento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Neurología I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Ataque I-PAST_MEDICAL_HISTORY -Isquémico I-PAST_MEDICAL_HISTORY -Transitorio I-PAST_MEDICAL_HISTORY -(AIT). I-PAST_MEDICAL_HISTORY -Sin B-PRESENT_ILLNESS -embargo, I-PRESENT_ILLNESS -ya I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -casa, I-PRESENT_ILLNESS -comenzó I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y, I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -egreso I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -nuevamente I-PRESENT_ILLNESS -hospitalizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -segundo I-PRESENT_ILLNESS -AIT. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -esta I-PRESENT_ILLNESS -ocasión I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dado I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -curso I-PRESENT_ILLNESS -febril, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -evaluado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Departamento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Infectología. I-PRESENT_ILLNESS -No B-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -factores I-PAST_MEDICAL_HISTORY -comunes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -riesgo I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -desarrollar I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -EI, I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -aproximadamente I-PAST_MEDICAL_HISTORY -1, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -sometido I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -AC I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -raíz I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -torácico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -causa I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -precisada. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Hallazgos B-EXPLORATION -destacables I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -eran: I-EXPLORATION -fiebre I-EXPLORATION -de I-EXPLORATION -39, I-EXPLORATION -7°C I-EXPLORATION -acompañada I-EXPLORATION -de I-EXPLORATION -calofríos I-EXPLORATION -solemnes, I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -motricidad I-EXPLORATION -en I-EXPLORATION -grado I-EXPLORATION -3/5 I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -superior I-EXPLORATION -e I-EXPLORATION -inferior I-EXPLORATION -derechas, I-EXPLORATION -borde I-EXPLORATION -hepático I-EXPLORATION -palpable I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -bajo I-EXPLORATION -el I-EXPLORATION -reborde I-EXPLORATION -costal I-EXPLORATION -derecho, I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -soplo I-EXPLORATION -sistólico I-EXPLORATION -de I-EXPLORATION -eyección, I-EXPLORATION -3/6, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -borde I-EXPLORATION -esternal I-EXPLORATION -izquierdo. I-EXPLORATION -No I-EXPLORATION -había I-EXPLORATION -estigmas I-EXPLORATION -periféricos I-EXPLORATION -de I-EXPLORATION -EI. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -mostraban: I-EXPLORATION -recuento I-EXPLORATION -leucocitario I-EXPLORATION -de I-EXPLORATION -19.870/mm3, I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -10, I-EXPLORATION -9 I-EXPLORATION -g/dL, I-EXPLORATION -PCR I-EXPLORATION -de I-EXPLORATION -31 I-EXPLORATION -mg/dL, I-EXPLORATION -creatininemia I-EXPLORATION -1, I-EXPLORATION -3 I-EXPLORATION -mg/dL. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -químicos I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION -Habiendo B-TREATMENT -obtenido I-TREATMENT -hemocultivos, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -una I-TREATMENT -antibioterapia I-TREATMENT -combinada I-TREATMENT -de I-TREATMENT -cefepime I-TREATMENT -y I-TREATMENT -amikacina, I-TREATMENT -considerando I-TREATMENT -el I-TREATMENT -antecedente I-TREATMENT -de I-TREATMENT -la I-TREATMENT -hospitalización I-TREATMENT -en I-TREATMENT -el I-TREATMENT -mes I-TREATMENT -previo. I-TREATMENT -Una B-EXPLORATION -ETT I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -vegetación I-EXPLORATION -libremente I-EXPLORATION -móvil I-EXPLORATION -de I-EXPLORATION -12 I-EXPLORATION -x I-EXPLORATION -6 I-EXPLORATION -mm I-EXPLORATION -adherida I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -válvula I-EXPLORATION -mitral, I-EXPLORATION -junto I-EXPLORATION -a I-EXPLORATION -cierto I-EXPLORATION -grado I-EXPLORATION -de I-EXPLORATION -insuficiencia I-EXPLORATION -mitral. I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -tres I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -incubación, I-EXPLORATION -se I-EXPLORATION -aisló I-EXPLORATION -P. I-EXPLORATION -aeruginosa I-EXPLORATION -en I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -hemocultivos. I-EXPLORATION -Se I-EXPLORATION -constató I-EXPLORATION -que I-EXPLORATION -esta I-EXPLORATION -cepa I-EXPLORATION -tenía I-EXPLORATION -el I-EXPLORATION -mismo I-EXPLORATION -antibiograma I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -1. I-EXPLORATION -La B-TREATMENT -antibioterapia I-TREATMENT -en I-TREATMENT -curso I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -y, B-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -control I-EXPLORATION -ecocadiográfico, I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -una I-EXPLORATION -reducción I-EXPLORATION -del I-EXPLORATION -tamaño I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vegetación. I-EXPLORATION -No B-EVOLUTION -obstante, I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -día I-EVOLUTION -24 I-EVOLUTION -de I-EVOLUTION -antibioterapia, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -falla I-EVOLUTION -cardiaca I-EVOLUTION -aguda. I-EVOLUTION -Fue B-DERIVED_FROM/TO -trasladado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cuidados I-DERIVED_FROM/TO -intensivos I-DERIVED_FROM/TO -(UCI) I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -apoyado I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -ventilación I-DERIVED_FROM/TO -mecánica. I-DERIVED_FROM/TO -Se B-TREATMENT -le I-TREATMENT -sometió I-TREATMENT -a I-TREATMENT -cirugía I-TREATMENT -cardiaca I-TREATMENT -con I-TREATMENT -reemplazo I-TREATMENT -mitral I-TREATMENT -por I-TREATMENT -una I-TREATMENT -válvula I-TREATMENT -protésica. I-TREATMENT -Diez B-EVOLUTION -días I-EVOLUTION -tras I-EVOLUTION -ser I-EVOLUTION -operado, I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -tamponamiento I-EVOLUTION -cardiaco, I-EVOLUTION -drenándose B-TREATMENT -quirúrgicamente I-TREATMENT -abundante I-TREATMENT -fluido. I-TREATMENT -La B-EVOLUTION -condición I-EVOLUTION -clínica I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -mejoró, I-EVOLUTION -pero I-EVOLUTION -16 I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -esta I-EVOLUTION -cirugía, I-EVOLUTION -reapareció I-EVOLUTION -la I-EVOLUTION -fiebre, I-EVOLUTION -acompañada I-EVOLUTION -de I-EVOLUTION -leucocitosis, I-EVOLUTION -secreción I-EVOLUTION -respiratoria I-EVOLUTION -purulenta, I-EVOLUTION -y I-EVOLUTION -una I-EVOLUTION -efusión I-EVOLUTION -pleural I-EVOLUTION -masiva. I-EVOLUTION -Se B-TREATMENT -cambió I-TREATMENT -la I-TREATMENT -terapia I-TREATMENT -a I-TREATMENT -meropenem I-TREATMENT -y I-TREATMENT -se I-TREATMENT -le I-TREATMENT -efectuó I-TREATMENT -una I-TREATMENT -toracostomia I-TREATMENT -a I-TREATMENT -izquierda. I-TREATMENT -Se B-EVOLUTION -comprobó I-EVOLUTION -la I-EVOLUTION -existencia I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -neumonía I-EVOLUTION -asociada I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -ventilación I-EVOLUTION -mecánica, I-EVOLUTION -por I-EVOLUTION -Acinetobacter I-EVOLUTION -baumannii.: I-EVOLUTION -La I-EVOLUTION -condición I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -hemodinámica I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -empeoró I-EVOLUTION -y I-EVOLUTION -finalmente I-EVOLUTION -falleció. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -27 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -peruana, B-PAST_MEDICAL_HISTORY -procedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Lima, I-PAST_MEDICAL_HISTORY -consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -múltiples I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -piel I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -pie I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -pruriginosas, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Posteriormente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -asoció I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -extremidad I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -previos I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -evaluación. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -antecedente, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -visitado I-PAST_MEDICAL_HISTORY -Tulum I-PAST_MEDICAL_HISTORY -(Riviera I-PAST_MEDICAL_HISTORY -Maya, I-PAST_MEDICAL_HISTORY -México) I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -días, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -caminó I-PAST_MEDICAL_HISTORY -descalza I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -arena I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -practicó I-PAST_MEDICAL_HISTORY -buceo, I-PAST_MEDICAL_HISTORY -además I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -sufrido I-PAST_MEDICAL_HISTORY -múltiples I-PAST_MEDICAL_HISTORY -picaduras I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -mosquitos I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -extremidades I-PAST_MEDICAL_HISTORY -inferiores. I-PAST_MEDICAL_HISTORY -Había I-PAST_MEDICAL_HISTORY -retornado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -Lima I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -consultar. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -físico, I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -serpiginosas, I-EXPLORATION -solevantadas, I-EXPLORATION -eritematosas, I-EXPLORATION -confluentes, I-EXPLORATION -de I-EXPLORATION -uno I-EXPLORATION -a I-EXPLORATION -tres I-EXPLORATION -centímetros I-EXPLORATION -de I-EXPLORATION -longitud I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -uno I-EXPLORATION -a I-EXPLORATION -dos I-EXPLORATION -milímetros I-EXPLORATION -de I-EXPLORATION -espesor, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -dorso I-EXPLORATION -y I-EXPLORATION -2°, I-EXPLORATION -3° I-EXPLORATION -y I-EXPLORATION -4° I-EXPLORATION -ortejos I-EXPLORATION -del I-EXPLORATION -pie I-EXPLORATION -derecho. I-EXPLORATION -Además, I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -dedos I-EXPLORATION -se I-EXPLORATION -observaban I-EXPLORATION -pequeñas I-EXPLORATION -vesículas I-EXPLORATION -pruriginosas. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -clínico I-TREATMENT -de I-TREATMENT -larva I-TREATMENT -migrans I-TREATMENT -cutánea I-TREATMENT -y I-TREATMENT -se I-TREATMENT -indicó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ivermectina I-TREATMENT -6 I-TREATMENT -mg/ml, I-TREATMENT -solución I-TREATMENT -oral I-TREATMENT -en I-TREATMENT -gotas, I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -200 I-TREATMENT -μg/kg I-TREATMENT -de I-TREATMENT -peso, I-TREATMENT -durante I-TREATMENT -dos I-TREATMENT -días I-TREATMENT -y I-TREATMENT -reposo. I-TREATMENT -Presentó B-EVOLUTION -un I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -fiebre, I-EVOLUTION -de I-EVOLUTION -38°C I-EVOLUTION -axilar. I-EVOLUTION -Las I-EVOLUTION -lesiones I-EVOLUTION -empezaron I-EVOLUTION -a I-EVOLUTION -remitir I-EVOLUTION -a I-EVOLUTION -partir I-EVOLUTION -del I-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -tratamiento. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -62 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -poliquística I-PAST_MEDICAL_HISTORY -hepatorenal, I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Crohn I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -fenotipo I-PAST_MEDICAL_HISTORY -inflamatorio I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -compromiso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -yeyuno I-PAST_MEDICAL_HISTORY -(demostrado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -tomografía I-PAST_MEDICAL_HISTORY -computada I-PAST_MEDICAL_HISTORY -[TC] I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -abdomen I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pelvis I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cápsula I-PAST_MEDICAL_HISTORY -endoscópica) I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -íleon I-PAST_MEDICAL_HISTORY -terminal I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -infliximab I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -azatioprina. I-PAST_MEDICAL_HISTORY -Había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -sometido I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -resección I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -íleon I-PAST_MEDICAL_HISTORY -terminal I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -ileoascendo I-PAST_MEDICAL_HISTORY -anastomosis, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hemorragia I-PAST_MEDICAL_HISTORY -digestiva I-PAST_MEDICAL_HISTORY -baja I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -base I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -presentado I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diverticulitis I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -motivaron I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -suspensión I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -terapia I-PAST_MEDICAL_HISTORY -biológica. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -desarrolló I-PAST_MEDICAL_HISTORY -seis I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -bacteriemia I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -Escherichia I-PAST_MEDICAL_HISTORY -coli, I-PAST_MEDICAL_HISTORY -siendo I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -quinolonas I-PAST_MEDICAL_HISTORY -(ciprofloxacina) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cefalosporinas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -3era I-PAST_MEDICAL_HISTORY -generación I-PAST_MEDICAL_HISTORY -(ceftriaxona). I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -extenso I-EXPLORATION -estudio I-EXPLORATION -que I-EXPLORATION -descartó I-EXPLORATION -otro I-EXPLORATION -foco I-EXPLORATION -primario, I-EXPLORATION -incluyendo I-EXPLORATION -ecocardiograma I-EXPLORATION -y I-EXPLORATION -tomografía I-EXPLORATION -por I-EXPLORATION -emisión I-EXPLORATION -de I-EXPLORATION -positrones I-EXPLORATION -con I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -(TEP-TC), I-EXPLORATION -entre I-EXPLORATION -otros. I-EXPLORATION -Un B-EVOLUTION -mes I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -segundo I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -bacteriemia I-EVOLUTION -por I-EVOLUTION -E. I-EVOLUTION -coli I-EVOLUTION -se I-EVOLUTION -hospitalizó I-EVOLUTION -por I-EVOLUTION -un I-EVOLUTION -síndrome I-EVOLUTION -febril I-EVOLUTION -y I-EVOLUTION -diarrea I-EVOLUTION -por I-EVOLUTION -CD I-EVOLUTION -(toxina I-EVOLUTION -A I-EVOLUTION -positiva) I-EVOLUTION -y I-EVOLUTION -colonoscopia I-EVOLUTION -completa I-EVOLUTION -con I-EVOLUTION -ileoscopia I-EVOLUTION -compatible I-EVOLUTION -con I-EVOLUTION -colitis I-EVOLUTION -pseudomebranosa I-EVOLUTION -siendo B-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -vancomicina I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -por I-TREATMENT -14 I-TREATMENT -días I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -respuesta. I-TREATMENT -Aproximadamente B-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -después, I-EVOLUTION -presentó I-EVOLUTION -nuevo I-EVOLUTION -episodio I-EVOLUTION -febril. I-EVOLUTION -La B-EXPLORATION -TC I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -pequeña I-EXPLORATION -perforación I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -yeyuno I-EXPLORATION -atribuido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Crohn I-EXPLORATION -activa. I-EXPLORATION -Por B-TREATMENT -hemocultivos I-TREATMENT -positivos I-TREATMENT -a I-TREATMENT -E. I-TREATMENT -coli I-TREATMENT -fue I-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -ceftriaxona I-TREATMENT -y I-TREATMENT -metronidazol. I-TREATMENT -Posteriormente B-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -diarrea I-EVOLUTION -por I-EVOLUTION -CD, I-EVOLUTION -con I-EVOLUTION -toxina I-EVOLUTION -A I-EVOLUTION -y I-EVOLUTION -B I-EVOLUTION -positiva, I-EVOLUTION -siendo B-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -vancomicina, I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -por I-TREATMENT -14 I-TREATMENT -días I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -respuesta. I-TREATMENT - I-TREATMENT -Un B-EVOLUTION -mes I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -cuarto I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -bacteriemia I-EVOLUTION -por I-EVOLUTION -E. I-EVOLUTION -coli, I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -nuevo I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -diarrea I-EVOLUTION -por I-EVOLUTION -CD, I-EVOLUTION -con I-EVOLUTION -toxina I-EVOLUTION -A I-EVOLUTION -y I-EVOLUTION -B I-EVOLUTION -positiva, I-EVOLUTION -siendo B-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -vancomicina, I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -por I-TREATMENT -14 I-TREATMENT -días I-TREATMENT -con B-EVOLUTION -buena I-EVOLUTION -respuesta, I-EVOLUTION -sin I-EVOLUTION -embargo, I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -recaída I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -tres I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -haber I-EVOLUTION -completado I-EVOLUTION -el I-EVOLUTION -tratamiento, I-EVOLUTION -motivo B-TREATMENT -por I-TREATMENT -el I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -trató I-TREATMENT -nuevamente I-TREATMENT -con I-TREATMENT -vancomicina I-TREATMENT -en I-TREATMENT -disminución I-TREATMENT -progresiva I-TREATMENT -y I-TREATMENT -probióticos I-TREATMENT -(Sacharomyces I-TREATMENT -boulardi), I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -respuesta. I-TREATMENT - I-TREATMENT -Un B-EVOLUTION -año I-EVOLUTION -después, I-EVOLUTION -estando I-EVOLUTION -con I-EVOLUTION -profilaxis I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -diverticulitis I-EVOLUTION -con I-EVOLUTION -rifaximina I-EVOLUTION -y I-EVOLUTION -mesalazina, I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -nueva I-EVOLUTION -diarrea I-EVOLUTION -por I-EVOLUTION -CD, I-EVOLUTION -con I-EVOLUTION -RPC I-EVOLUTION -positiva I-EVOLUTION -en I-EVOLUTION -deposiciones. I-EVOLUTION -Fue B-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -vancomicina, I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -por I-TREATMENT -14 I-TREATMENT -días I-TREATMENT -con B-EVOLUTION -buena I-EVOLUTION -respuesta I-EVOLUTION -pero I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -nueva I-EVOLUTION -recaída I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -cuatro I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -haber I-EVOLUTION -terminado I-EVOLUTION -el I-EVOLUTION -tratamiento. I-EVOLUTION -Fue B-TREATMENT -tratado I-TREATMENT -nuevamente I-TREATMENT -con I-TREATMENT -vancomicina I-TREATMENT -en I-TREATMENT -disminución I-TREATMENT -progresiva I-TREATMENT -y I-TREATMENT -probióticos. I-TREATMENT -Evolucionó B-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -tórpida I-EVOLUTION -con I-EVOLUTION -fiebre, I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -y I-EVOLUTION -diarrea, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -internado I-TREATMENT -y I-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -vancomicina I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -asociado I-TREATMENT -a I-TREATMENT -metronidazol I-TREATMENT -intravenoso I-TREATMENT -(IV). I-TREATMENT -Al I-TREATMENT -no I-TREATMENT -presentar I-TREATMENT -mejoría I-TREATMENT -al I-TREATMENT -3° I-TREATMENT -día I-TREATMENT -recibió I-TREATMENT -inmunoglobulina I-TREATMENT -IV I-TREATMENT -400 I-TREATMENT -mg/kg I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -en I-TREATMENT -cinco I-TREATMENT -dosis, I-TREATMENT -con I-TREATMENT -una I-TREATMENT -respuesta I-TREATMENT -clínica I-TREATMENT -parcial. I-TREATMENT - I-TREATMENT -Dada I-TREATMENT -la I-TREATMENT -mala I-TREATMENT -evolución I-TREATMENT -a I-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -todas I-TREATMENT -las I-TREATMENT -terapias I-TREATMENT -probadas I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -un I-TREATMENT -TMF I-TREATMENT -vía I-TREATMENT -colonoscopia I-TREATMENT -con I-TREATMENT -deposiciones I-TREATMENT -de I-TREATMENT -un I-TREATMENT -donante I-TREATMENT -familiar I-TREATMENT -directo I-TREATMENT -sin I-TREATMENT -antecedentes I-TREATMENT -de I-TREATMENT -patologías I-TREATMENT -y I-TREATMENT -con I-TREATMENT -estudio I-TREATMENT -pre-trasplante I-TREATMENT -en I-TREATMENT -sangre I-TREATMENT -y I-TREATMENT -deposiciones I-TREATMENT -(3) I-TREATMENT -negativo. I-TREATMENT -Se I-TREATMENT -suspendió I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -azatioprina I-TREATMENT -y I-TREATMENT -antimicrobianos, I-TREATMENT -cinco I-TREATMENT -días I-TREATMENT -y I-TREATMENT -24 I-TREATMENT -h I-TREATMENT -antes I-TREATMENT -del I-TREATMENT -TMF, I-TREATMENT -respectivamente. I-TREATMENT - I-TREATMENT -Descripción I-TREATMENT -del I-TREATMENT -procedimiento: I-TREATMENT -se I-TREATMENT -utilizaron I-TREATMENT -69 I-TREATMENT -g I-TREATMENT -de I-TREATMENT -deposiciones I-TREATMENT -sólidas I-TREATMENT -diluidas I-TREATMENT -en I-TREATMENT -300 I-TREATMENT -cc I-TREATMENT -de I-TREATMENT -suero I-TREATMENT -fisiológico I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -filtradas. I-TREATMENT -La I-TREATMENT -solución I-TREATMENT -fue I-TREATMENT -instilada I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -íleon I-TREATMENT -terminal I-TREATMENT -hasta I-TREATMENT -el I-TREATMENT -sigmoides I-TREATMENT -incluyendo I-TREATMENT -el I-TREATMENT -área I-TREATMENT -con I-TREATMENT -divertículos. I-TREATMENT - I-TREATMENT -A I-TREATMENT -las I-TREATMENT -24 I-TREATMENT -h I-TREATMENT -del I-TREATMENT -TMF I-TREATMENT -presentó I-TREATMENT -un I-TREATMENT -cuadro I-TREATMENT -febril I-TREATMENT -(T° I-TREATMENT -axilar I-TREATMENT -39°C) I-TREATMENT -con I-TREATMENT -hemocultivos I-TREATMENT -positivos I-TREATMENT -a I-TREATMENT -E. I-TREATMENT -coli. I-TREATMENT -Fue I-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -aztreonam I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -respuesta I-TREATMENT -clínica I-TREATMENT -y I-TREATMENT -de I-TREATMENT -laboratorio. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -haber I-EVOLUTION -realizado I-EVOLUTION -el I-EVOLUTION -TMF, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -nuevo I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -bacteriemia I-EVOLUTION -por I-EVOLUTION -E. I-EVOLUTION -coli I-EVOLUTION -siendo B-TREATMENT -nuevamente I-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -aztreonam. I-TREATMENT -A I-TREATMENT -las I-TREATMENT -dos I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -completar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antibacteriano I-TREATMENT -evolucionó I-TREATMENT -con I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -cuadro I-TREATMENT -de I-TREATMENT -diarrea I-TREATMENT -por I-TREATMENT -CD I-TREATMENT -con I-TREATMENT -RPC I-TREATMENT -positiva I-TREATMENT -para I-TREATMENT -CD. I-TREATMENT -Fue I-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -vancomicina, I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -por I-TREATMENT -14 I-TREATMENT -días I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -respuesta. I-TREATMENT -Un B-EVOLUTION -año I-EVOLUTION -y I-EVOLUTION -cuatro I-EVOLUTION -meses I-EVOLUTION -posterior I-EVOLUTION -al I-EVOLUTION -TMF I-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -presentar I-EVOLUTION -un I-EVOLUTION -nuevo I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -diarrea I-EVOLUTION -por I-EVOLUTION -CD I-EVOLUTION -(con I-EVOLUTION -RPC I-EVOLUTION -positiva) I-EVOLUTION -que B-TREATMENT -fue I-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -vancomicina, I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -en I-TREATMENT -disminución I-TREATMENT -progresiva, I-TREATMENT -probióticos I-TREATMENT -e I-TREATMENT -inmunoglobulina I-TREATMENT -IV I-TREATMENT -400 I-TREATMENT -mg/kg I-TREATMENT -día I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -respuesta. I-TREATMENT -Actualmente B-EVOLUTION -se I-EVOLUTION -mantiene I-EVOLUTION -en I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -azatioprina I-EVOLUTION -por I-EVOLUTION -su I-EVOLUTION -enfermedad I-EVOLUTION -de I-EVOLUTION -Crohn. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -42 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -infección I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -VIH I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -ocho I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -atrás, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -inmunológicos I-PAST_MEDICAL_HISTORY -periódicos, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -criterios I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -inicio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -antirretroviral. I-PAST_MEDICAL_HISTORY -Tenía I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -leishmaniasis I-PAST_MEDICAL_HISTORY -cutánea I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antebrazo I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -atrás, I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -residía I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Madre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Dios I-PAST_MEDICAL_HISTORY -(Amazonía I-PAST_MEDICAL_HISTORY -oriental I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -Perú). I-PAST_MEDICAL_HISTORY -Refirió I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -recibido I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -incompleto, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -pudo I-PAST_MEDICAL_HISTORY -especificar. I-PAST_MEDICAL_HISTORY -Además I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -operado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -colesteatoma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -oído I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -atrás, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -parálisis I-PAST_MEDICAL_HISTORY -facial I-PAST_MEDICAL_HISTORY -periférica I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -secuela. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -otras I-PAST_MEDICAL_HISTORY -enfermedades. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Tenía I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -clínicos I-PAST_MEDICAL_HISTORY -anuales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -carga I-PAST_MEDICAL_HISTORY -viral I-PAST_MEDICAL_HISTORY -(CV) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -niveles I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -linfocitos I-PAST_MEDICAL_HISTORY -T I-PAST_MEDICAL_HISTORY -CD4, I-PAST_MEDICAL_HISTORY -manteniéndose I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -valores I-PAST_MEDICAL_HISTORY -estables I-PAST_MEDICAL_HISTORY -(CV I-PAST_MEDICAL_HISTORY -< I-PAST_MEDICAL_HISTORY -20.000 I-PAST_MEDICAL_HISTORY -copias/ml I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -CD4 I-PAST_MEDICAL_HISTORY -> I-PAST_MEDICAL_HISTORY -700 I-PAST_MEDICAL_HISTORY -cél/mm3), I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -evidenció I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -leve I-PAST_MEDICAL_HISTORY -disminución I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -CD4 I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -643 I-PAST_MEDICAL_HISTORY -(28%) I-PAST_MEDICAL_HISTORY -cél/mm3 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -aumento I-PAST_MEDICAL_HISTORY -importante I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -CV I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -47.466 I-PAST_MEDICAL_HISTORY -copias/ml. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -ese I-PAST_MEDICAL_HISTORY -período I-PAST_MEDICAL_HISTORY -tuvo I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -intercurrentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diarrea I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -coriza I-PAST_MEDICAL_HISTORY -autolimitados. I-PAST_MEDICAL_HISTORY -Tenía I-PAST_MEDICAL_HISTORY -además I-PAST_MEDICAL_HISTORY -marcadores I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -B I-PAST_MEDICAL_HISTORY -positivos: I-PAST_MEDICAL_HISTORY -HBsAg I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -anticore I-PAST_MEDICAL_HISTORY -total, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -alteración I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -pruebas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -función I-PAST_MEDICAL_HISTORY -hepática. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acudió B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -control I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Infectología I-PRESENT_ILLNESS -refiriendo I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -parietal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -congestión I-PRESENT_ILLNESS -nasal I-PRESENT_ILLNESS -persistente, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -examen I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nasofaringe. I-PRESENT_ILLNESS -Un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -epistaxis, I-PRESENT_ILLNESS -secreción I-PRESENT_ILLNESS -nasal I-PRESENT_ILLNESS -mucopurulenta I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -observó I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -fosa I-PRESENT_ILLNESS -nasal I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -(ala I-PRESENT_ILLNESS -nasal). I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -se I-EXPLORATION -evidenciaron I-EXPLORATION -lesiones I-EXPLORATION -pápulo-ulcerativas I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -vestibular I-EXPLORATION -y I-EXPLORATION -mucosa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -fosa I-EXPLORATION -nasal I-EXPLORATION -derecha, I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -secreción I-EXPLORATION -mucopurulenta I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -exofítica. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tumoración I-EXPLORATION -nasal I-EXPLORATION -para I-EXPLORATION -estudio. I-EXPLORATION - I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -presentaba I-EXPLORATION -además I-EXPLORATION -una I-EXPLORATION -cicatriz I-EXPLORATION -deprimida, I-EXPLORATION -delgada, I-EXPLORATION -lisa, I-EXPLORATION -hipopigmentada, I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -irregulares I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -antebrazo I-EXPLORATION -derecho, I-EXPLORATION -correspondiente I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -antigua I-EXPLORATION -de I-EXPLORATION -leishmaniasis I-EXPLORATION -cutánea. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antirretroviral I-TREATMENT -de I-TREATMENT -gran I-TREATMENT -actividad I-TREATMENT -(TARGA) I-TREATMENT -con I-TREATMENT -zidovudina, I-TREATMENT -lamivudina, I-TREATMENT -lopinavir I-TREATMENT -y I-TREATMENT -ritonavir, I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -aparición I-TREATMENT -de I-TREATMENT -síntomas I-TREATMENT -y I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -neoplasia I-TREATMENT -relacionada I-TREATMENT -al I-TREATMENT -VIH. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -mostró I-EXPLORATION -estructuras I-EXPLORATION -ovaladas, I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -a I-EXPLORATION -4 I-EXPLORATION -μm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -uniforme, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -cinetoplasto I-EXPLORATION -periférico, I-EXPLORATION -localizadas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -citoplasma I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -histiocitos, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -amastigotes I-EXPLORATION -de I-EXPLORATION -Leishmania I-EXPLORATION -spp. I-EXPLORATION -La I-EXPLORATION -inmunofluorescencia I-EXPLORATION -indirecta I-EXPLORATION -(IFI) I-EXPLORATION -(con I-EXPLORATION -antígeno I-EXPLORATION -total I-EXPLORATION -para I-EXPLORATION -L. I-EXPLORATION -boliviana I-EXPLORATION -y I-EXPLORATION -L. I-EXPLORATION -brasiliensis) I-EXPLORATION -detectó I-EXPLORATION -anticuerpos I-EXPLORATION -anti-Leishmania I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -dilución I-EXPLORATION -de I-EXPLORATION -1/80, I-EXPLORATION -confirmándose I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -leishmaniasis. I-EXPLORATION -Al B-TREATMENT -mes I-TREATMENT -siguiente I-TREATMENT -de I-TREATMENT -iniciado I-TREATMENT -el I-TREATMENT -TARGA I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -estibogluconato I-TREATMENT -sódico, I-TREATMENT -20 I-TREATMENT -mg/kg/día I-TREATMENT -por I-TREATMENT -30 I-TREATMENT -días. I-TREATMENT - I-TREATMENT -Luego B-EVOLUTION -de I-EVOLUTION -completar I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -estibogluconato I-EVOLUTION -sódico, I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -favorable I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -lesión I-EVOLUTION -mejoró I-EVOLUTION -entre I-EVOLUTION -las I-EVOLUTION -dos I-EVOLUTION -y I-EVOLUTION -cuatro I-EVOLUTION -semanas, I-EVOLUTION -hasta I-EVOLUTION -su I-EVOLUTION -cicatrización I-EVOLUTION -completa. I-EVOLUTION -Tres I-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -los I-EVOLUTION -valores I-EVOLUTION -de I-EVOLUTION -CD4 I-EVOLUTION -se I-EVOLUTION -elevaron I-EVOLUTION -hasta I-EVOLUTION -843 I-EVOLUTION -cél/ml I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -carga I-EVOLUTION -viral I-EVOLUTION -disminuyó I-EVOLUTION -a I-EVOLUTION -< I-EVOLUTION -40 I-EVOLUTION -copias/ml. I-EVOLUTION -Actualmente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomático, I-EVOLUTION -con I-EVOLUTION -TARGA, I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -recaída I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -lesión I-EVOLUTION -ni I-EVOLUTION -lesiones I-EVOLUTION -similares. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -y B-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Down, I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -congénita I-PAST_MEDICAL_HISTORY -operada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -primer I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -(canal I-PAST_MEDICAL_HISTORY -aurículo-ventricular I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ductus I-PAST_MEDICAL_HISTORY -arterioso I-PAST_MEDICAL_HISTORY -persistente). I-PAST_MEDICAL_HISTORY -Tenía B-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -vacunas I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Programa I-PRESENT_ILLNESS -Nacional I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Inmunizaciones I-PRESENT_ILLNESS -(PNI) I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -día, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -vacunas I-PRESENT_ILLNESS -extra-PNI. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -veces I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencia I-PRESENT_ILLNESS -Infantil I-PRESENT_ILLNESS -(SUI) I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -eritrodermia. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -eritema I-PRESENT_ILLNESS -comenzó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -hemi-cara I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -luego I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -extendió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -lado I-PRESENT_ILLNESS -contra-lateral. I-PRESENT_ILLNESS -Al I-PRESENT_ILLNESS -segundo I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -40° I-PRESENT_ILLNESS -C, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -eritema I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -progresión I-PRESENT_ILLNESS -descendente, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -comprometió I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cuello, I-PRESENT_ILLNESS -tronco I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ambas I-PRESENT_ILLNESS -extremidades I-PRESENT_ILLNESS -superiores. I-PRESENT_ILLNESS -Además I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -acompañó I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -flictenas I-PRESENT_ILLNESS -eritematosas, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -pruriginosas, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -mentoniana I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -preauricular I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -desaparecieron I-PRESENT_ILLNESS -espontáneamente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -transcurso I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -día. I-PRESENT_ILLNESS -Se B-EXPLORATION -evaluó I-EXPLORATION -con I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio, I-EXPLORATION -destacando I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -con I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -leucocitos I-EXPLORATION -normales I-EXPLORATION -(10.470/mm3) I-EXPLORATION -con I-EXPLORATION -predominio I-EXPLORATION -polimorfonuclear I-EXPLORATION -(92,3%), I-EXPLORATION -sin I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -serie I-EXPLORATION -roja I-EXPLORATION -y I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -(PCR) I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -5 I-EXPLORATION -mg/dl I-EXPLORATION -(VN I-EXPLORATION -< I-EXPLORATION -1 I-EXPLORATION -mg/dl). I-EXPLORATION -Se B-TREATMENT -le I-TREATMENT -hizo I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -una I-TREATMENT -dermatitis I-TREATMENT -alérgica I-TREATMENT -y I-TREATMENT -se I-TREATMENT -indicó I-TREATMENT -clorfenamina I-TREATMENT -y I-TREATMENT -glucocorticoides I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -durante I-TREATMENT -tres I-TREATMENT -días. I-TREATMENT - I-TREATMENT -Por B-DERIVED_FROM/TO -persistencia I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -sintomatología, I-DERIVED_FROM/TO -consultó I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -pediatra I-DERIVED_FROM/TO -tratante I-DERIVED_FROM/TO -quien I-DERIVED_FROM/TO -lo I-DERIVED_FROM/TO -derivó I-DERIVED_FROM/TO -nuevamente I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -SUI. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -En B-EVOLUTION -ese I-EVOLUTION -momento, I-EVOLUTION -en I-EVOLUTION -su I-EVOLUTION -8° I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -y I-EVOLUTION -7° I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -fiebre, I-EVOLUTION -se I-EVOLUTION -apreciaba I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -generales. I-EVOLUTION -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -describía I-EXPLORATION -una I-EXPLORATION -"lesión I-EXPLORATION -eritro-descamativa I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cara I-EXPLORATION -que I-EXPLORATION -respetaba I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -peribucal I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -placa I-EXPLORATION -eritematosa I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -superiores I-EXPLORATION -que I-EXPLORATION -respetaba I-EXPLORATION -las I-EXPLORATION -muñecas, I-EXPLORATION -manos I-EXPLORATION -y I-EXPLORATION -cara I-EXPLORATION -anterior I-EXPLORATION -de I-EXPLORATION -codo. I-EXPLORATION -También I-EXPLORATION -afectaba I-EXPLORATION -el I-EXPLORATION -cuero I-EXPLORATION -cabelludo, I-EXPLORATION -cuello I-EXPLORATION -y I-EXPLORATION -mitad I-EXPLORATION -superior I-EXPLORATION -de I-EXPLORATION -tronco, I-EXPLORATION -con I-EXPLORATION -bordes I-EXPLORATION -bien I-EXPLORATION -delimitados, I-EXPLORATION -sin I-EXPLORATION -adenopatías I-EXPLORATION -palpables. I-EXPLORATION -Presentaba I-EXPLORATION -una I-EXPLORATION -inyección I-EXPLORATION -conjuntival I-EXPLORATION -sin I-EXPLORATION -secreción I-EXPLORATION -y I-EXPLORATION -lengua I-EXPLORATION -aframbuesada. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -cardíaco I-EXPLORATION -era I-EXPLORATION -normal, I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -descamación I-EXPLORATION -periungueal". I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicitaron I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio, I-EXPLORATION -destacando I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -con I-EXPLORATION -leucopenia I-EXPLORATION -de I-EXPLORATION -4.880/mm3, I-EXPLORATION -con I-EXPLORATION -predominio I-EXPLORATION -polimorfonuclear I-EXPLORATION -(90%), I-EXPLORATION -plaquetas I-EXPLORATION -198.000/mm3, I-EXPLORATION -PCR I-EXPLORATION -de I-EXPLORATION -20, I-EXPLORATION -2 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -anticuerpos I-EXPLORATION -anti-estreptolisina I-EXPLORATION -O I-EXPLORATION -759 I-EXPLORATION -U/ I-EXPLORATION -ml I-EXPLORATION -(VN: I-EXPLORATION -< I-EXPLORATION -200). I-EXPLORATION -Además I-EXPLORATION -se I-EXPLORATION -tomaron I-EXPLORATION -un I-EXPLORATION -cultivo I-EXPLORATION -faríngeo I-EXPLORATION -y I-EXPLORATION -dos I-EXPLORATION -hemocultivos I-EXPLORATION -periféricos. I-EXPLORATION - I-EXPLORATION -Ingresó B-EVOLUTION -al I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Pediatría I-EVOLUTION -al I-EVOLUTION -8° I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -evolución, I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -generales, I-EVOLUTION -con I-EVOLUTION -estabilidad I-EVOLUTION -hemodinámica I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -compromiso I-EVOLUTION -de I-EVOLUTION -conciencia. I-EVOLUTION -Se B-TREATMENT -planteó I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -escarlatina I-TREATMENT -e I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -con I-TREATMENT -amoxicilina, I-TREATMENT -vía I-TREATMENT -oral. I-TREATMENT -Además B-EXPLORATION -se I-EXPLORATION -planteó I-EXPLORATION -la I-EXPLORATION -necesidad I-EXPLORATION -de I-EXPLORATION -realizar I-EXPLORATION -un I-EXPLORATION -ecocardiograma I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -una I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Kawasaki I-EXPLORATION -atípica I-EXPLORATION -o I-EXPLORATION -una I-EXPLORATION -endocarditis I-EXPLORATION -infecciosa. I-EXPLORATION -Se B-EVOLUTION -controlaron I-EVOLUTION -exámenes I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -h I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -ingreso. I-EVOLUTION -Tenía I-EVOLUTION -una I-EVOLUTION -PCR I-EVOLUTION -de I-EVOLUTION -23, I-EVOLUTION -9 I-EVOLUTION -mg/dl I-EVOLUTION -y I-EVOLUTION -un I-EVOLUTION -perfil I-EVOLUTION -bioquímico I-EVOLUTION -normal. I-EVOLUTION -Evaluada B-TREATMENT -por I-TREATMENT -infectología, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -cambiar I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -a I-TREATMENT -penicilina I-TREATMENT -sódica I-TREATMENT -i.v. I-TREATMENT - I-TREATMENT -Evolucionó B-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -antimicrobiano, I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -generales. I-EVOLUTION -A I-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -h I-EVOLUTION -de I-EVOLUTION -incubación I-EVOLUTION -se I-EVOLUTION -informaron I-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -hemocultivos I-EVOLUTION -positivos I-EVOLUTION -para I-EVOLUTION -Streptococcus I-EVOLUTION -ß- I-EVOLUTION -hemolítico I-EVOLUTION -del I-EVOLUTION -grupo I-EVOLUTION -G, I-EVOLUTION -con I-EVOLUTION -susceptibilidad I-EVOLUTION -in I-EVOLUTION -vitro I-EVOLUTION -a I-EVOLUTION -penicilina, I-EVOLUTION -clindamicina, I-EVOLUTION -cloxacilina, I-EVOLUTION -eritromicina I-EVOLUTION -y I-EVOLUTION -levofloxacino, I-EVOLUTION -y I-EVOLUTION -resistencia I-EVOLUTION -a I-EVOLUTION -cotrimoxazol. I-EVOLUTION -El I-EVOLUTION -ecocardiograma I-EVOLUTION -realizado I-EVOLUTION -fue I-EVOLUTION -normal I-EVOLUTION -y I-EVOLUTION -no I-EVOLUTION -hubo I-EVOLUTION -detección I-EVOLUTION -de I-EVOLUTION -otros I-EVOLUTION -focos I-EVOLUTION -clínicos I-EVOLUTION -secundarios. I-EVOLUTION - I-EVOLUTION -Evolucionó I-EVOLUTION -afebril, I-EVOLUTION -con I-EVOLUTION -franca I-EVOLUTION -disminución I-EVOLUTION -del I-EVOLUTION -eritema I-EVOLUTION -facial I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -tronco. I-EVOLUTION -Al I-EVOLUTION -5° I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -antimicrobiano, I-EVOLUTION -se I-EVOLUTION -informó I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -especie I-EVOLUTION -identificada, I-EVOLUTION -por I-EVOLUTION -método I-EVOLUTION -de I-EVOLUTION -Vitek®, I-EVOLUTION -correspondía I-EVOLUTION -a I-EVOLUTION -Streptococcus I-EVOLUTION -dysgalactiae I-EVOLUTION -subespecie I-EVOLUTION -equisimilis. I-EVOLUTION - I-EVOLUTION -La B-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -10 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -i.v. I-TREATMENT -más I-TREATMENT -cuatro I-TREATMENT -días I-TREATMENT -de I-TREATMENT -amoxicilina/ácido I-TREATMENT -clavulánico, I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -completando I-TREATMENT -en I-TREATMENT -la I-TREATMENT -fase I-TREATMENT -ambulatoria I-TREATMENT -14 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento. I-TREATMENT -El B-EVOLUTION -control I-EVOLUTION -posterior I-EVOLUTION -demostró I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -satisfactoria. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -básico I-EXPLORATION -de I-EXPLORATION -inmunodeficiencia I-EXPLORATION -descartándose I-EXPLORATION -una I-EXPLORATION -hipogamaglobulinemia, I-EXPLORATION -hipocomplementemia I-EXPLORATION -o I-EXPLORATION -leucopenia I-EXPLORATION -secundaria I-EXPLORATION -al I-EXPLORATION -Síndrome I-EXPLORATION -de I-EXPLORATION -Down. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -cepa I-EXPLORATION -se I-EXPLORATION -envió I-EXPLORATION -al I-EXPLORATION -Laboratorio I-EXPLORATION -de I-EXPLORATION -Biología I-EXPLORATION -Molecular I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Universidad I-EXPLORATION -Católica I-EXPLORATION -para I-EXPLORATION -genotipificación. I-EXPLORATION -Por I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -RPC I-EXPLORATION -universal I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -Streptococcus I-EXPLORATION -dysgalactiae I-EXPLORATION -subespecie I-EXPLORATION -equisimilis, I-EXPLORATION -genotipo I-EXPLORATION -stg653.0. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -84 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -nacionalidad B-PAST_MEDICAL_HISTORY -chilena, I-PAST_MEDICAL_HISTORY -dueña I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -casa. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -policlínico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Dermatología I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nódulos I-PRESENT_ILLNESS -cutáneos I-PRESENT_ILLNESS -eritematosos I-PRESENT_ILLNESS -ulcerados, I-PRESENT_ILLNESS -asintomáticos, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -palmar I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -dedo I-PRESENT_ILLNESS -meñique I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -ventral I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -antebrazo I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -siguiendo I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -patrón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -disposición I-PRESENT_ILLNESS -lineal I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -largo I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -trayecto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vasos I-PRESENT_ILLNESS -linfáticos I-PRESENT_ILLNESS -; I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -otros I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -acompañantes. I-PRESENT_ILLNESS -La B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -esencial, I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -cardíaca I-PAST_MEDICAL_HISTORY -congestiva, I-PAST_MEDICAL_HISTORY -hipotiroidis-mo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -anemia I-PAST_MEDICAL_HISTORY -hemolítica I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -crioaglutininas. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -previa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tuberculosis, I-PAST_MEDICAL_HISTORY -uso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -corticoides, I-PAST_MEDICAL_HISTORY -inmunosupresión I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -trauma I-PAST_MEDICAL_HISTORY -reciente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -zonas I-PAST_MEDICAL_HISTORY -afectadas. I-PAST_MEDICAL_HISTORY -No B-FAMILY_HISTORY -existían I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -relevancia I-FAMILY_HISTORY -ni I-FAMILY_HISTORY -viajes I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -último I-FAMILY_HISTORY -tiempo. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Se B-EXPLORATION -planteó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -diferencial I-EXPLORATION -de I-EXPLORATION -micosis I-EXPLORATION -subcutánea, I-EXPLORATION -micobacteriosis I-EXPLORATION -tuberculosa I-EXPLORATION -y I-EXPLORATION -micobacteriosis I-EXPLORATION -atípica, I-EXPLORATION -realizándose I-EXPLORATION -biopsia I-EXPLORATION -y I-EXPLORATION -estudio I-EXPLORATION -microbiológico I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -cutáneas. I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -histopatológico I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -paniculitis I-EXPLORATION -granulomatosa I-EXPLORATION -supurativa I-EXPLORATION -sin I-EXPLORATION -caseificación. I-EXPLORATION -Las I-EXPLORATION -tinciones I-EXPLORATION -de I-EXPLORATION -PAS, I-EXPLORATION -Grocott, I-EXPLORATION -Ziehl-Neelsen I-EXPLORATION -y I-EXPLORATION -Gram I-EXPLORATION -no I-EXPLORATION -revelaron I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -microorganismos I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -muestra. I-EXPLORATION -Sin I-EXPLORATION -embargo, I-EXPLORATION -la I-EXPLORATION -reacción I-EXPLORATION -de I-EXPLORATION -polimerasa I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -(RPC) I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -fueron I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -M. I-EXPLORATION -tuberculosis. I-EXPLORATION -Dentro I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -se I-EXPLORATION -realizaron I-EXPLORATION -hemograma, I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -sedimentación, I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -VIH, I-EXPLORATION -perfil I-EXPLORATION -bioquímico, I-EXPLORATION -función I-EXPLORATION -renal, I-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -orina, I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION -y I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -los I-EXPLORATION -que I-EXPLORATION -resultaron I-EXPLORATION -todos I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -Quantiferon I-EXPLORATION -TB I-EXPLORATION -gold® I-EXPLORATION -resultó I-EXPLORATION -positivo. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -PPD. I-EXPLORATION - I-EXPLORATION -Basado I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -resultados, I-EXPLORATION -se I-EXPLORATION -estableció I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -tuberculosis I-EXPLORATION -cutánea I-EXPLORATION -y B-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -esquema I-TREATMENT -primario I-TREATMENT -de I-TREATMENT -cuatro I-TREATMENT -fármacos: I-TREATMENT -isoniacida, I-TREATMENT -pirazinamida, I-TREATMENT -rifampicina I-TREATMENT -y I-TREATMENT -etambutol. I-TREATMENT -Durante I-TREATMENT -dos I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -seguimiento I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -continuó I-TREATMENT -con I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT -de I-TREATMENT -terapia I-TREATMENT -antituberculosa I-TREATMENT -de I-TREATMENT -acuerdo I-TREATMENT -a I-TREATMENT -los I-TREATMENT -protocolos I-TREATMENT -establecidos, I-TREATMENT -demostrando B-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -clínicamente I-EVOLUTION -significativa I-EVOLUTION -con I-EVOLUTION -regresión I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -ulcerativas I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -efectos I-EVOLUTION -secundarios I-EVOLUTION -reportados. I-EVOLUTION - I-EVOLUTION - -Comunicamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -22 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -procedente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Iquitos, I-PAST_MEDICAL_HISTORY -selva I-PAST_MEDICAL_HISTORY -peruana, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia. I-PAST_MEDICAL_HISTORY -Tenía B-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -febril, I-PRESENT_ILLNESS -calofríos, I-PRESENT_ILLNESS -cefalea, I-PRESENT_ILLNESS -epigastralgia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -gingivorragia. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -temperatura I-EXPLORATION -de I-EXPLORATION -37, I-EXPLORATION -5°C, I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -de I-EXPLORATION -110/80 I-EXPLORATION -mm I-EXPLORATION -Hg I-EXPLORATION -y I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION -de I-EXPLORATION -22 I-EXPLORATION -respiraciones I-EXPLORATION -por I-EXPLORATION -min. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -no I-EXPLORATION -tenía I-EXPLORATION -alteraciones. I-EXPLORATION -Al B-EVOLUTION -día I-EVOLUTION -siguiente, I-EVOLUTION -se I-EVOLUTION -agregó I-EVOLUTION -distensión I-EVOLUTION -abdominal, I-EVOLUTION -disnea I-EVOLUTION -a I-EVOLUTION -mediano I-EVOLUTION -esfuerzo I-EVOLUTION -y I-EVOLUTION -deposiciones I-EVOLUTION -con I-EVOLUTION -contenido I-EVOLUTION -rojizo I-EVOLUTION -oscuro, I-EVOLUTION -cuyo I-EVOLUTION -cultivo I-EVOLUTION -fue I-EVOLUTION -negativo; I-EVOLUTION -al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -pulmonar I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -murmullo I-EXPLORATION -vesicular I-EXPLORATION -disminuido I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -tercio I-EXPLORATION -inferior, I-EXPLORATION -sin I-EXPLORATION -ruidos I-EXPLORATION -agregados. I-EXPLORATION -Dentro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -parámetros I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -un I-EXPLORATION -hematocrito I-EXPLORATION -de I-EXPLORATION -48% I-EXPLORATION -y I-EXPLORATION -plaquetas I-EXPLORATION -en I-EXPLORATION -51.000/mm3. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -dengue I-EXPLORATION -y I-EXPLORATION -leptospira, I-EXPLORATION -resultando I-EXPLORATION -la I-EXPLORATION -IgM I-EXPLORATION -para I-EXPLORATION -dengue I-EXPLORATION -positiva. I-EXPLORATION -Se I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -dengue I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -IgM. I-EXPLORATION -Por I-EXPLORATION -la I-EXPLORATION -aparición I-EXPLORATION -de I-EXPLORATION -disnea I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecocardiografía I-EXPLORATION -y I-EXPLORATION -troponina I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -positiva I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -configuró I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -miocarditis. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -cardiomegalia I-EXPLORATION -con I-EXPLORATION -derrame I-EXPLORATION -pleural. I-EXPLORATION -Se B-EVOLUTION -ingresó I-EVOLUTION -a I-EVOLUTION -Unidad I-EVOLUTION -de I-EVOLUTION -Cuidados I-EVOLUTION -Intensivos I-EVOLUTION -por I-EVOLUTION -mala I-EVOLUTION -evolución I-EVOLUTION -y I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -fiebre. I-EVOLUTION -Por B-TREATMENT -insuficiencia I-TREATMENT -respiratoria I-TREATMENT -y I-TREATMENT -compromiso I-TREATMENT -de I-TREATMENT -conciencia I-TREATMENT -(Glasgow I-TREATMENT -10) I-TREATMENT -se I-TREATMENT -conectó I-TREATMENT -a I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -invasora. I-TREATMENT -Dentro B-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -auxiliares I-EXPLORATION -destacaban I-EXPLORATION -gases I-EXPLORATION -arteriales: I-EXPLORATION -pH I-EXPLORATION -7, I-EXPLORATION -52; I-EXPLORATION -pCO2 I-EXPLORATION -58 I-EXPLORATION -mmHg I-EXPLORATION -y I-EXPLORATION -PO2 I-EXPLORATION -(A-a) I-EXPLORATION -368 I-EXPLORATION -mmHg, I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -plaquetas I-EXPLORATION -157.000/mm3, I-EXPLORATION -hematocrito I-EXPLORATION -43%, I-EXPLORATION -glucosa I-EXPLORATION -167 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -creatinina I-EXPLORATION -1, I-EXPLORATION -08 I-EXPLORATION -mg/dl. I-EXPLORATION -Se B-EVOLUTION -diagnosticó I-EVOLUTION -dengue I-EVOLUTION -grave I-EVOLUTION -con I-EVOLUTION -injuria I-EVOLUTION -renal I-EVOLUTION -aguda, I-EVOLUTION -insuficiencia I-EVOLUTION -cardíaca, I-EVOLUTION -respiratoria I-EVOLUTION -y I-EVOLUTION -sepsis I-EVOLUTION -grave. I-EVOLUTION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ciprofloxacina, I-TREATMENT -ceftazidima I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -empírica, I-TREATMENT -vitamina I-TREATMENT -K I-TREATMENT -y I-TREATMENT -furosemida I-TREATMENT -i.v. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -días, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -hacia I-EVOLUTION -la I-EVOLUTION -mejoría, I-EVOLUTION -con I-EVOLUTION -ventilación I-EVOLUTION -espontánea I-EVOLUTION -y I-EVOLUTION -disminución I-EVOLUTION -del I-EVOLUTION -edema. I-EVOLUTION -Dentro B-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -el I-EXPLORATION -control I-EXPLORATION -de I-EXPLORATION -troponina I-EXPLORATION -fue I-EXPLORATION -negativo I-EXPLORATION -y I-EXPLORATION -creatinina I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -rangos I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecocardiografia I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -semana I-EXPLORATION -de I-EXPLORATION -evolución I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -dedicado B-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -construcción, I-PAST_MEDICAL_HISTORY -originario I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Guanajuato, I-PAST_MEDICAL_HISTORY -Gto., I-PAST_MEDICAL_HISTORY -sin B-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -o B-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -importantes. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -verrugosa I-PRESENT_ILLNESS -nodular I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -nariz I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -gradual I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses. I-PRESENT_ILLNESS -Un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -presentado I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -abscesos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -brazo I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -cuales I-PRESENT_ILLNESS -fueron I-PRESENT_ILLNESS -drenados, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -notó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -tercer I-PRESENT_ILLNESS -absceso I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -brazo. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -periorbitaria I-EXPLORATION -y I-EXPLORATION -antecubital I-EXPLORATION -derecho I-EXPLORATION -placas I-EXPLORATION -nodulares I-EXPLORATION -verrugosas, I-EXPLORATION -edematosas I-EXPLORATION -y I-EXPLORATION -cubiertas I-EXPLORATION -por I-EXPLORATION -costras I-EXPLORATION -hemáticas. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -directo I-EXPLORATION -y I-EXPLORATION -cultivo I-EXPLORATION -fueron I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -Coccidioides I-EXPLORATION -spp. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -coccidioidomicosis I-TREATMENT -cutánea I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -itraconazol I-TREATMENT -oral I-TREATMENT -400 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -chofer, B-PAST_MEDICAL_HISTORY -originario I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Jiquilpan, I-PAST_MEDICAL_HISTORY -Mich I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -residente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Tijuana, I-PAST_MEDICAL_HISTORY -B.C. I-PAST_MEDICAL_HISTORY -Con I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -nueve I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hipoglicemiantes I-PAST_MEDICAL_HISTORY -orales I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -osteoartrosis I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -meloxicam I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -corticoesteroides I-PAST_MEDICAL_HISTORY -intralesionales I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -ocasiones. I-PAST_MEDICAL_HISTORY -Además I-PAST_MEDICAL_HISTORY -mencionó I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -neumonía I-PAST_MEDICAL_HISTORY -aparentemente I-PAST_MEDICAL_HISTORY -bacteriana I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antibacterianos. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -localizadas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -glabelar, I-PRESENT_ILLNESS -nariz I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -paranasal I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -Las B-EXPLORATION -lesiones I-EXPLORATION -eran I-EXPLORATION -placas I-EXPLORATION -nodulares I-EXPLORATION -poco I-EXPLORATION -elevadas, I-EXPLORATION -ulceradas, I-EXPLORATION -con I-EXPLORATION -fondo I-EXPLORATION -granulomatoso I-EXPLORATION -y I-EXPLORATION -costras I-EXPLORATION -sanguíneas, I-EXPLORATION -de I-EXPLORATION -1-2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -con I-EXPLORATION -examen I-EXPLORATION -directo I-EXPLORATION -y I-EXPLORATION -cultivo I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -Coccidioides I-EXPLORATION -spp. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -intradermorreacción I-EXPLORATION -positiva. I-EXPLORATION - I-EXPLORATION -Recibió B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -itraconazol I-TREATMENT -oral I-TREATMENT -400 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día I-TREATMENT -por I-TREATMENT -cuatro I-TREATMENT -meses I-TREATMENT -y I-TREATMENT -por I-TREATMENT -intolerancia I-TREATMENT -gástrica I-TREATMENT -tuvo I-TREATMENT -que I-TREATMENT -ser I-TREATMENT -sustituido I-TREATMENT -por I-TREATMENT -terbinafina I-TREATMENT -oral I-TREATMENT -500 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -durante I-TREATMENT -cinco I-TREATMENT -meses. I-TREATMENT -Al B-EVOLUTION -suspender I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -acudió I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -flogosis I-EVOLUTION -de I-EVOLUTION -ambas I-EVOLUTION -rodillas I-EVOLUTION -y I-EVOLUTION -salida I-EVOLUTION -de I-EVOLUTION -material I-EVOLUTION -purulento I-EVOLUTION -a I-EVOLUTION -través I-EVOLUTION -de I-EVOLUTION -fístulas. I-EVOLUTION -Se B-TREATMENT -aisló I-TREATMENT -C. I-TREATMENT -posadasii I-TREATMENT -y I-TREATMENT -se I-TREATMENT -internó I-TREATMENT -para I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -anfotericina I-TREATMENT -B. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -originario B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Puebla I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -residente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Tijuana, I-PAST_MEDICAL_HISTORY -B.C., I-PAST_MEDICAL_HISTORY -agricultor, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -enalapril I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -amlodipino. I-PAST_MEDICAL_HISTORY -Acudió B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ala I-PRESENT_ILLNESS -nasal I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -caracterizada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen, I-PRESENT_ILLNESS -eritema, I-PRESENT_ILLNESS -exulceraciones I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -exudado I-PRESENT_ILLNESS -seroso, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diámetro I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -El B-EXPLORATION -diagnóstico I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -esférulas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -directo I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -cultivo I-EXPLORATION -positivo I-EXPLORATION -a I-EXPLORATION -Coccidioides I-EXPLORATION -spp. I-EXPLORATION -Recibió B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -itraconazol I-TREATMENT -400 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día. I-TREATMENT - I-TREATMENT - -Escolar B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -género I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hospitalizaciones I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -patología I-PAST_MEDICAL_HISTORY -crónica, I-PAST_MEDICAL_HISTORY -Un B-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -previo I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -hospitalización I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -recibido I-PRESENT_ILLNESS -flucloxacilina I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -impétigo. I-PRESENT_ILLNESS -Su B-FAMILY_HISTORY -madre I-FAMILY_HISTORY -era I-FAMILY_HISTORY -portadora I-FAMILY_HISTORY -de I-FAMILY_HISTORY -un I-FAMILY_HISTORY -lupus I-FAMILY_HISTORY -eritematoso I-FAMILY_HISTORY -sistémico, I-FAMILY_HISTORY -dueña I-FAMILY_HISTORY -de I-FAMILY_HISTORY -casa I-FAMILY_HISTORY -y I-FAMILY_HISTORY -su I-FAMILY_HISTORY -padre, I-FAMILY_HISTORY -trabajador I-FAMILY_HISTORY -en I-FAMILY_HISTORY -servicios I-FAMILY_HISTORY -de I-FAMILY_HISTORY -correo I-FAMILY_HISTORY -internacional. I-FAMILY_HISTORY -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -sufrió I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -caída I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Unidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Emergencia I-PRESENT_ILLNESS -(UE) I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -rodilla I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS -Se I-PRESENT_ILLNESS -diagnosticó I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -contusión I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -manejó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -ambulatoria I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -inmovilización I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -analgesia. I-PRESENT_ILLNESS -Dada I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -persistencia I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -vuelve I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consultar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -después. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -presentaba I-EXPLORATION -dolor I-EXPLORATION -espontáneo I-EXPLORATION -intenso I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -rodilla I-EXPLORATION -derecha, I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -metáfisis I-EXPLORATION -proximal I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tibia I-EXPLORATION -derecha I-EXPLORATION -con I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -y I-EXPLORATION -temperatura I-EXPLORATION -local, I-EXPLORATION -sin I-EXPLORATION -fiebre, I-EXPLORATION -sin I-EXPLORATION -compromiso I-EXPLORATION -hemodinámico, I-EXPLORATION -ni I-EXPLORATION -del I-EXPLORATION -estado I-EXPLORATION -general. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -con I-EXPLORATION -leucocitosis I-EXPLORATION -y I-EXPLORATION -desviación I-EXPLORATION -a I-EXPLORATION -izquierda I-EXPLORATION -(24% I-EXPLORATION -baciliformes), I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -(PCR) I-EXPLORATION -270 I-EXPLORATION -mg/L I-EXPLORATION -y I-EXPLORATION -VHS I-EXPLORATION -101 I-EXPLORATION -mm/h. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -discreto I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -tejidos I-EXPLORATION -blandos I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -rodilla I-EXPLORATION -derecha, I-EXPLORATION -sin I-EXPLORATION -lesión I-EXPLORATION -ósea I-EXPLORATION -asociada. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -aseo I-EXPLORATION -quirúrgico I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -inició I-EXPLORATION -tratamiento I-EXPLORATION -antimicrobiano I-EXPLORATION -con I-EXPLORATION -cloxacilina I-EXPLORATION -iv I-EXPLORATION -(185 I-EXPLORATION -mg/kg/día) I-EXPLORATION -cada I-EXPLORATION -6 I-EXPLORATION -h. I-EXPLORATION -Al I-EXPLORATION -tercer I-EXPLORATION -día I-EXPLORATION -post-operatorio, I-EXPLORATION -persistió I-EXPLORATION -con I-EXPLORATION -dolor I-EXPLORATION -intenso I-EXPLORATION -y I-EXPLORATION -comenzó I-EXPLORATION -con I-EXPLORATION -fiebre I-EXPLORATION -y I-EXPLORATION -compromiso I-EXPLORATION -del I-EXPLORATION -estado I-EXPLORATION -general. I-EXPLORATION -Los I-EXPLORATION -dos I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -óseo I-EXPLORATION -fueron I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -SARM, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -vancomicina, I-TREATMENT -aislamiento I-TREATMENT -de I-TREATMENT -contacto I-TREATMENT -según I-TREATMENT -la I-TREATMENT -norma I-TREATMENT -institucional I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -aseo I-TREATMENT -quirúrgico. I-TREATMENT -Dada B-EXPLORATION -la I-EXPLORATION -persistencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -fiebre I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -cintigrama I-EXPLORATION -óseo I-EXPLORATION -trifásico, I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -demostró I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -actividad I-EXPLORATION -osteoblástica I-EXPLORATION -localizado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -metáfisis I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tibia I-EXPLORATION -proximal I-EXPLORATION -derecha. I-EXPLORATION -La B-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -tórpida, I-EVOLUTION -con I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -fiebre I-EVOLUTION -hasta I-EVOLUTION -15 I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -haber I-EVOLUTION -iniciado I-EVOLUTION -vancomicina, I-EVOLUTION -requiriendo I-EVOLUTION -múltiples I-EVOLUTION -aseos I-EVOLUTION -quirúrgicos I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -encontraron I-EVOLUTION -colecciones I-EVOLUTION -y I-EVOLUTION -daño I-EVOLUTION -articular. I-EVOLUTION -Los I-EVOLUTION -cultivos I-EVOLUTION -intraoperatorios I-EVOLUTION -persistieron I-EVOLUTION -positivos I-EVOLUTION -hasta I-EVOLUTION -12 I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -haber I-EVOLUTION -iniciado I-EVOLUTION -vancomicina. I-EVOLUTION -Por I-EVOLUTION -la I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -fiebre I-EVOLUTION -se I-EVOLUTION -descartaron I-EVOLUTION -focos I-EVOLUTION -secundarios I-EVOLUTION -u I-EVOLUTION -otra I-EVOLUTION -infección. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -inmunológico I-EXPLORATION -básico I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -normal. I-EXPLORATION -El B-TREATMENT -día I-TREATMENT -18 I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -vancomicina I-TREATMENT -presentó I-TREATMENT -un I-TREATMENT -exantema I-TREATMENT -máculo-papular I-TREATMENT -morbiliforme, I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -considerada I-TREATMENT -como I-TREATMENT -una I-TREATMENT -reacción I-TREATMENT -adversa I-TREATMENT -a I-TREATMENT -fármacos, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -la I-TREATMENT -terapia I-TREATMENT -a I-TREATMENT -clindamicina I-TREATMENT -iv. I-TREATMENT -Evolucionó B-EVOLUTION -afebril I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -dolor I-EVOLUTION -local, I-EVOLUTION -completando I-EVOLUTION -en I-EVOLUTION -total I-EVOLUTION -56 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -antibacteriano: I-EVOLUTION -17 B-TREATMENT -días I-TREATMENT -de I-TREATMENT -vancomicina I-TREATMENT -y I-TREATMENT -39 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -clindamicina. I-TREATMENT -Fue B-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -parámetros I-EVOLUTION -inflamatorios I-EVOLUTION -en I-EVOLUTION -descenso I-EVOLUTION -(VHS I-EVOLUTION -28 I-EVOLUTION -mm/h I-EVOLUTION -y I-EVOLUTION -PCR I-EVOLUTION -19, I-EVOLUTION -2 I-EVOLUTION -mg/L), I-EVOLUTION -y I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -linezolid I-EVOLUTION -vía I-EVOLUTION -oral I-EVOLUTION -(300 I-EVOLUTION -mg, I-EVOLUTION -dos I-EVOLUTION -veces I-EVOLUTION -al I-EVOLUTION -día), I-EVOLUTION -por I-EVOLUTION -20 I-EVOLUTION -días. I-EVOLUTION -El B-EXPLORATION -ISP I-EXPLORATION -confirmó I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -cepa I-EXPLORATION -fue I-EXPLORATION -SARM, I-EXPLORATION -PVL I-EXPLORATION -negativa. I-EXPLORATION -Además, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -portación I-EXPLORATION -nasal I-EXPLORATION -familiar I-EXPLORATION -en I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -madre I-EXPLORATION -resultó I-EXPLORATION -ser I-EXPLORATION -positiva I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -decolonización I-EXPLORATION -con I-EXPLORATION -mupirocina I-EXPLORATION -tópica. I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -genético I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -caracterización I-EXPLORATION -molecular I-EXPLORATION -de I-EXPLORATION -ambas I-EXPLORATION -cepas I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION -del I-EXPLORATION -marcador I-EXPLORATION -PV-L I-EXPLORATION -y I-EXPLORATION -determinaron I-EXPLORATION -un I-EXPLORATION -mismo I-EXPLORATION -subtipo I-EXPLORATION -genético I-EXPLORATION -por I-EXPLORATION -PFGE I-EXPLORATION -(CL-SAU-COM-SMA-017) I-EXPLORATION -y I-EXPLORATION -por I-EXPLORATION -MLST I-EXPLORATION -al I-EXPLORATION -tipo I-EXPLORATION -de I-EXPLORATION -secuencia I-EXPLORATION -ST8. I-EXPLORATION - I-EXPLORATION - -Escolar B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -género I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -familiares I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -patologías I-PAST_MEDICAL_HISTORY -crónicas, I-PAST_MEDICAL_HISTORY -hospitalizaciones, I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -uso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -antibacterianos I-PAST_MEDICAL_HISTORY -recientes. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -adinamia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -lumbalgia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -posterior I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -trauma I-PRESENT_ILLNESS -dorso-lumbar I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -39° I-PRESENT_ILLNESS -C. I-PRESENT_ILLNESS -Se B-EVOLUTION -internó I-EVOLUTION -para I-EVOLUTION -estudio I-EVOLUTION -evolucionando I-EVOLUTION -con I-EVOLUTION -fiebre I-EVOLUTION -y I-EVOLUTION -PCR I-EVOLUTION -hasta I-EVOLUTION -150 I-EVOLUTION -mg/L. I-EVOLUTION -A B-EXPLORATION -las I-EXPLORATION -48 I-EXPLORATION -h, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -renal I-EXPLORATION -izquierda, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -inició I-TREATMENT -cefotaxima I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -empírica. I-TREATMENT -Al I-TREATMENT -día I-TREATMENT -siguiente I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -a I-TREATMENT -cloxacilina I-TREATMENT -(170 I-TREATMENT -mg/kg/día) I-TREATMENT -cada I-TREATMENT -6 I-TREATMENT -h. I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -angio-TAC I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -un I-EXPLORATION -absceso I-EXPLORATION -renal I-EXPLORATION -izquierdo I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro. I-EXPLORATION -Al B-TREATMENT -cuarto I-TREATMENT -día I-TREATMENT -de I-TREATMENT -tratamiento, I-TREATMENT -dada I-TREATMENT -persistencia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fiebre I-TREATMENT -e I-TREATMENT -incremento I-TREATMENT -de I-TREATMENT -PCR I-TREATMENT -hasta I-TREATMENT -270 I-TREATMENT -mg/L, I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -esquema I-TREATMENT -a I-TREATMENT -vancomicina I-TREATMENT -(40 I-TREATMENT -mg/kg/día) I-TREATMENT -y I-TREATMENT -meropenem I-TREATMENT -(60 I-TREATMENT -mg/kg/ I-TREATMENT -día). I-TREATMENT -Luego B-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -seis I-DERIVED_FROM/TO -días I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -vancomicina I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -clínica I-DERIVED_FROM/TO -desfavorable, I-DERIVED_FROM/TO -aumento I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -parámetros I-DERIVED_FROM/TO -inflamatorios I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -tamaño I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -lesión I-DERIVED_FROM/TO -renal I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -trasladó I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -otra I-DERIVED_FROM/TO -institución I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -instalación I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -catéter I-DERIVED_FROM/TO -ureteral I-DERIVED_FROM/TO -(pig-tail) I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -drenaje I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -colección I-DERIVED_FROM/TO -renal, I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -tomó I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -muestra I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -cultivo. I-DERIVED_FROM/TO -Al B-EVOLUTION -5o I-EVOLUTION -día I-EVOLUTION -post-operatorio I-EVOLUTION -bajó I-EVOLUTION -la I-EVOLUTION -fiebre, I-EVOLUTION -con I-EVOLUTION -descenso I-EVOLUTION -de I-EVOLUTION -parámetros I-EVOLUTION -inflamatorios. I-EVOLUTION -El B-EXPLORATION -resultado I-EXPLORATION -del I-EXPLORATION -cultivo I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -SARM. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -informe I-TREATMENT -microbiológico I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -meropenem I-TREATMENT -y I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -vancomicina I-TREATMENT -con B-EVOLUTION -buena I-EVOLUTION -respuesta I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -definitivamente I-EVOLUTION -afebril I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -12 I-EVOLUTION -días I-EVOLUTION -del I-EVOLUTION -drenaje I-EVOLUTION -quirúrgico, I-EVOLUTION -normalización I-EVOLUTION -de I-EVOLUTION -PCR, I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -siempre I-EVOLUTION -conservada I-EVOLUTION -e I-EVOLUTION -imagen I-EVOLUTION -ecográfica I-EVOLUTION -con I-EVOLUTION -absceso I-EVOLUTION -en I-EVOLUTION -regresión. I-EVOLUTION -Completó B-TREATMENT -un I-TREATMENT -total I-TREATMENT -de I-TREATMENT -36 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -vancomicina. I-TREATMENT -Se B-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -cepa I-EXPLORATION -como I-EXPLORATION -SARM, I-EXPLORATION -PV-L I-EXPLORATION -positivo. I-EXPLORATION -La I-EXPLORATION -caracterización I-EXPLORATION -molecular I-EXPLORATION -correspondió I-EXPLORATION -al I-EXPLORATION -subtipo I-EXPLORATION -CL-SAU-COM-SMA-002 I-EXPLORATION -(PFGE) I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -ST731 I-EXPLORATION -perteneciente I-EXPLORATION -al I-EXPLORATION -CC I-EXPLORATION -30 I-EXPLORATION -por I-EXPLORATION -MLST. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -portación I-EXPLORATION -nasal I-EXPLORATION -a I-EXPLORATION -ambos I-EXPLORATION -padres, I-EXPLORATION -hermanos I-EXPLORATION -y I-EXPLORATION -abuelos, I-EXPLORATION -todos I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION - -Preescolar B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -vacunas I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -PNI I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -día I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -asistencia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -jardín I-PAST_MEDICAL_HISTORY -infantil. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -menos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -40°C I-PRESENT_ILLNESS -axilar, I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -alimentarios, I-PRESENT_ILLNESS -coriza I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -frontal. I-PRESENT_ILLNESS -Presentó I-PRESENT_ILLNESS -alucinaciones I-PRESENT_ILLNESS -visuales I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -Servicio I-EXPLORATION -de I-EXPLORATION -Urgencia I-EXPLORATION -(SU) I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -febril, I-EXPLORATION -decaída, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -examen I-EXPLORATION -segmentario I-EXPLORATION -y I-EXPLORATION -neurológico I-EXPLORATION -normal. I-EXPLORATION -Dentro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -destacaban I-EXPLORATION -una I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -36.100 I-EXPLORATION -céls/mm3 I-EXPLORATION -(25% I-EXPLORATION -segmentados), I-EXPLORATION -PCR I-EXPLORATION -205 I-EXPLORATION -mg/L I-EXPLORATION -(valor I-EXPLORATION -normal I-EXPLORATION -< I-EXPLORATION -10), I-EXPLORATION -orina I-EXPLORATION -completa I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -con I-EXPLORATION -escaso I-EXPLORATION -infiltrado I-EXPLORATION -intersticial. I-EXPLORATION -Se I-EXPLORATION -hospitalizó I-EXPLORATION -con I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -síndrome I-EXPLORATION -febril I-EXPLORATION -sin I-EXPLORATION -foco. I-EXPLORATION -Evolucionó I-EXPLORATION -con I-EXPLORATION -fiebre I-EXPLORATION -persistente, I-EXPLORATION -regular I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -sin I-EXPLORATION -foco I-EXPLORATION -evidente I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -parámetros I-EXPLORATION -inflamatorios I-EXPLORATION -elevados. I-EXPLORATION -Se I-EXPLORATION -planteó I-EXPLORATION -una I-EXPLORATION -probable I-EXPLORATION -neumonía I-EXPLORATION -neumocóccica; I-EXPLORATION -sin I-EXPLORATION -embargo, I-EXPLORATION -tenía I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -evidenciaba I-EXPLORATION -consolidación I-EXPLORATION -pulmonar. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -con I-TREATMENT -ampicilina I-TREATMENT -i.v. I-TREATMENT -100 I-TREATMENT -mg/kg/día I-TREATMENT -fraccionado I-TREATMENT -cada I-TREATMENT -6 I-TREATMENT -h, I-TREATMENT -previa I-TREATMENT -toma I-TREATMENT -de I-TREATMENT -hemocultivos. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -se I-EXPLORATION -complementó I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -panel I-EXPLORATION -viral I-EXPLORATION -(por I-EXPLORATION -inmunofluorescencia) I-EXPLORATION -de I-EXPLORATION -aspirado I-EXPLORATION -nasofaríngeo, I-EXPLORATION -urocultivo, I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -LCR I-EXPLORATION -y I-EXPLORATION -hemocultivos I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Por I-EXPLORATION -persistir I-EXPLORATION -febril, I-EXPLORATION -luego I-EXPLORATION -de I-EXPLORATION -48 I-EXPLORATION -h I-EXPLORATION -de I-EXPLORATION -terapia I-EXPLORATION -antimicrobiana, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION -una I-EXPLORATION -asimetría I-EXPLORATION -renal, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -riñón I-EXPLORATION -izquierdo I-EXPLORATION -más I-EXPLORATION -grande, I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -más I-EXPLORATION -globuloso I-EXPLORATION -y I-EXPLORATION -mayor I-EXPLORATION -ecogenicidad. I-EXPLORATION -Se B-TREATMENT -ajustó I-TREATMENT -terapia I-TREATMENT -antimicrobiana I-TREATMENT -a I-TREATMENT -ceftriaxona I-TREATMENT -50 I-TREATMENT -mg/kg/día I-TREATMENT -una I-TREATMENT -vez I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -por I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -un I-TREATMENT -foco I-TREATMENT -urinario I-TREATMENT -y I-TREATMENT -se I-TREATMENT -solicitó I-TREATMENT -un I-TREATMENT -cintigrama I-TREATMENT -renal I-TREATMENT -con I-TREATMENT -DMSA I-TREATMENT -(dimercaptosuccinic I-TREATMENT -acid), I-TREATMENT -que I-TREATMENT -se I-TREATMENT -informó I-TREATMENT -como I-TREATMENT -sugerente I-TREATMENT -de I-TREATMENT -un I-TREATMENT -proceso I-TREATMENT -inflamatorio I-TREATMENT -agudo I-TREATMENT -renal I-TREATMENT -izquierdo. I-TREATMENT -La B-EVOLUTION -fiebre I-EVOLUTION -cedió I-EVOLUTION -al I-EVOLUTION -cuarto I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -ceftriaxona, I-EVOLUTION -junto I-EVOLUTION -con I-EVOLUTION -descenso I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -inflamatorios. I-EVOLUTION -Se I-EVOLUTION -dio I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -séptimo I-EVOLUTION -día, I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -clínicas, I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -nefronia I-EVOLUTION -izquierda. I-EVOLUTION -Recibió B-TREATMENT -cefadroxilo I-TREATMENT -30 I-TREATMENT -mg/kg/día I-TREATMENT -por I-TREATMENT -siete I-TREATMENT -días, I-TREATMENT -completando I-TREATMENT -14 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -en I-TREATMENT -total. I-TREATMENT -Se I-TREATMENT -mantuvo B-EVOLUTION -en I-EVOLUTION -seguimiento I-EVOLUTION -en I-EVOLUTION -policlínico I-EVOLUTION -de I-EVOLUTION -infectología I-EVOLUTION -y I-EVOLUTION -nefrología, I-EVOLUTION -con I-EVOLUTION -evolución I-EVOLUTION -favorable. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -21 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -oriundo B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -provincia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Buenos I-PAST_MEDICAL_HISTORY -Aires, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -infección I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -VIH I-PAST_MEDICAL_HISTORY -adquirida I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -transmisión I-PAST_MEDICAL_HISTORY -vertical, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -abandono I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -varios I-PAST_MEDICAL_HISTORY -tratamientos I-PAST_MEDICAL_HISTORY -antirretrovirales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -gran I-PAST_MEDICAL_HISTORY -actividad I-PAST_MEDICAL_HISTORY -(TARGA). I-PAST_MEDICAL_HISTORY -Se B-PRESENT_ILLNESS -internó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -febril I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -kg. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -febril, I-EXPLORATION -en I-EXPLORATION -regular I-EXPLORATION -estado I-EXPLORATION -general I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -palidez I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -mucosas. I-EXPLORATION -Se I-EXPLORATION -palpaba I-EXPLORATION -una I-EXPLORATION -hepato-esplenomegalia I-EXPLORATION -indolora I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -auscultación I-EXPLORATION -pulmonar I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -generalizada I-EXPLORATION -del I-EXPLORATION -murmullo I-EXPLORATION -pulmonar I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -campos I-EXPLORATION -pulmonares. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -opacidad I-EXPLORATION -parahiliar I-EXPLORATION -y I-EXPLORATION -basal I-EXPLORATION -derecha I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -neumónico. I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -al I-EXPLORATION -ingreso I-EXPLORATION -fueron: I-EXPLORATION -entro-sedimentación I-EXPLORATION -> I-EXPLORATION -140 I-EXPLORATION -mm I-EXPLORATION -1° I-EXPLORATION -hora, I-EXPLORATION -hematocrito I-EXPLORATION -21%, I-EXPLORATION -hemoglobina I-EXPLORATION -6, I-EXPLORATION -6 I-EXPLORATION -g/L, I-EXPLORATION -leucocitos I-EXPLORATION -4.400 I-EXPLORATION -cél/mm3, I-EXPLORATION -plaquetas I-EXPLORATION -40.000 I-EXPLORATION -cél/mm3, I-EXPLORATION -concentración I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -68%, I-EXPLORATION -urea I-EXPLORATION -16 I-EXPLORATION -mg/dL, I-EXPLORATION -creatinina I-EXPLORATION -0, I-EXPLORATION -9 I-EXPLORATION -mg/dL, I-EXPLORATION -transaminasas I-EXPLORATION -GOT I-EXPLORATION -61 I-EXPLORATION -UI/L, I-EXPLORATION -GPT I-EXPLORATION -20 I-EXPLORATION -UI/L, I-EXPLORATION -fosfatasas I-EXPLORATION -alcalinas: I-EXPLORATION -185 I-EXPLORATION -U/L I-EXPLORATION -y I-EXPLORATION -láctico I-EXPLORATION -deshidrogenasa: I-EXPLORATION -400 I-EXPLORATION -U/l. I-EXPLORATION -El I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -T I-EXPLORATION -CD4 I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -21 I-EXPLORATION -cél/mm3 I-EXPLORATION -(8%). I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -tomaron I-EXPLORATION -muestras I-EXPLORATION -de I-EXPLORATION -expectoración I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -identificación I-EXPLORATION -de I-EXPLORATION -bacterias I-EXPLORATION -de I-EXPLORATION -crecimiento I-EXPLORATION -corriente, I-EXPLORATION -micobacterias I-EXPLORATION -y I-EXPLORATION -hongos. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -directo I-EXPLORATION -mediante I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -Zielh-Neelsen, I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -10 I-EXPLORATION -bacilos I-EXPLORATION -ácido-alcohol I-EXPLORATION -resistentes I-EXPLORATION -(BAAR) I-EXPLORATION -por I-EXPLORATION -cada I-EXPLORATION -10 I-EXPLORATION -campos. I-EXPLORATION -La I-EXPLORATION -ecotomografía I-EXPLORATION -abdominal I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -hepato-esplenomegalia I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -múltiples I-EXPLORATION -adenopatías I-EXPLORATION -hipoecogénicas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -retroperitoneo, I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -cava I-EXPLORATION -inferior I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -ligamento I-EXPLORATION -hepato-duodenal. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -imágenes I-EXPLORATION -hipoecogénicas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -bazo, I-EXPLORATION -mesenterio I-EXPLORATION -y I-EXPLORATION -retroperitoneo. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -una I-TREATMENT -probable I-TREATMENT -tuberculosis I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -isoniacida, I-TREATMENT -rifampicina, I-TREATMENT -pirazinamida I-TREATMENT -y I-TREATMENT -etambutol I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -diaria I-TREATMENT -y I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -habituales. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -la I-EVOLUTION -semana I-EVOLUTION -de I-EVOLUTION -iniciada I-EVOLUTION -la I-EVOLUTION -terapia I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -comenzó I-EVOLUTION -a I-EVOLUTION -referir I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -articulación I-EVOLUTION -coxo-femoral I-EVOLUTION -izquierda I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -irradiaba I-EVOLUTION -hacia I-EVOLUTION -el I-EVOLUTION -muslo, I-EVOLUTION -produciendo I-EVOLUTION -impotencia I-EVOLUTION -funcional I-EVOLUTION -y I-EVOLUTION -posición I-EVOLUTION -antiálgica I-EVOLUTION -en I-EVOLUTION -semiflexión. I-EVOLUTION -Presentaba I-EVOLUTION -dolor I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -palpación I-EVOLUTION -de I-EVOLUTION -dicha I-EVOLUTION -articulación I-EVOLUTION -coxo-femoral I-EVOLUTION -con I-EVOLUTION -imposibilidad I-EVOLUTION -de I-EVOLUTION -extensión I-EVOLUTION -activa I-EVOLUTION -y I-EVOLUTION -pasiva I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -extremidad I-EVOLUTION -inferior I-EVOLUTION -izquierda. I-EVOLUTION -La I-EVOLUTION -ecotomografía I-EVOLUTION -mostró I-EVOLUTION -una I-EVOLUTION -moderada I-EVOLUTION -cantidad I-EVOLUTION -de I-EVOLUTION -líquido I-EVOLUTION -articular I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -tomografía I-EVOLUTION -axial I-EVOLUTION -computarizada I-EVOLUTION -(TAC) I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -una I-EVOLUTION -imagen I-EVOLUTION -radiolúcida, I-EVOLUTION -redondeada, I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -unión I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cabeza I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -cuello I-EVOLUTION -femoral, I-EVOLUTION -con I-EVOLUTION -solución I-EVOLUTION -de I-EVOLUTION -continuidad I-EVOLUTION -hacia I-EVOLUTION -la I-EVOLUTION -cortical I-EVOLUTION -ósea. I-EVOLUTION -La I-EVOLUTION -cavidad I-EVOLUTION -acetabular I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -cabeza I-EVOLUTION -femoral I-EVOLUTION -estaban I-EVOLUTION -respetadas I-EVOLUTION -igual I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -sínfisis I-EVOLUTION -pubiana I-EVOLUTION -y I-EVOLUTION -las I-EVOLUTION -ramas I-EVOLUTION -isquio I-EVOLUTION -e I-EVOLUTION -ilio-pubianas. I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -cavidad I-EVOLUTION -articular I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -un I-EVOLUTION -moderado I-EVOLUTION -volumen I-EVOLUTION -de I-EVOLUTION -líquido. I-EVOLUTION - I-EVOLUTION -Se I-EVOLUTION -realizó I-EVOLUTION -una I-EVOLUTION -artrocentesis I-EVOLUTION -obteniéndose I-EVOLUTION -un I-EVOLUTION -material I-EVOLUTION -sero-hemático. I-EVOLUTION -Se I-EVOLUTION -enviaron I-EVOLUTION -muestras I-EVOLUTION -para I-EVOLUTION -la I-EVOLUTION -identificación I-EVOLUTION -de I-EVOLUTION -bacterias I-EVOLUTION -de I-EVOLUTION -crecimiento I-EVOLUTION -común, I-EVOLUTION -micobacterias I-EVOLUTION -y I-EVOLUTION -hongos. I-EVOLUTION -El I-EVOLUTION -examen I-EVOLUTION -directo I-EVOLUTION -mediante I-EVOLUTION -la I-EVOLUTION -técnica I-EVOLUTION -de I-EVOLUTION -Zielh-Neelsen, I-EVOLUTION -mostró I-EVOLUTION -cinco I-EVOLUTION -a I-EVOLUTION -nueve I-EVOLUTION -BAAR I-EVOLUTION -por I-EVOLUTION -cada I-EVOLUTION -100 I-EVOLUTION -campos I-EVOLUTION -de I-EVOLUTION -observación. I-EVOLUTION - I-EVOLUTION -Además B-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -antituberculoso I-TREATMENT -se I-TREATMENT -agregaron I-TREATMENT -analgésicos I-TREATMENT -y I-TREATMENT -corticoesteroides. I-TREATMENT -Siete B-EVOLUTION -días I-EVOLUTION -después, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -favorable, I-EVOLUTION -con I-EVOLUTION -paulatina I-EVOLUTION -recuperación I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -movilidad I-EVOLUTION -del I-EVOLUTION -miembro I-EVOLUTION -inferior I-EVOLUTION -izquierdo, I-EVOLUTION -apoyada I-EVOLUTION -con I-EVOLUTION -soporte I-EVOLUTION -kinésico. I-EVOLUTION - I-EVOLUTION -Los B-EXPLORATION -cultivos I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -muestras I-EXPLORATION -tanto I-EXPLORATION -de I-EXPLORATION -esputo I-EXPLORATION -como I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -articular, I-EXPLORATION -permitieron I-EXPLORATION -identificar I-EXPLORATION -Mycobacterium I-EXPLORATION -tuberculosis I-EXPLORATION -con I-EXPLORATION -susceptibilidad I-EXPLORATION -conservada I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -fármacos I-EXPLORATION -proscriptos. I-EXPLORATION - I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -30 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -se I-EVOLUTION -comprobó I-EVOLUTION -una I-EVOLUTION -marcada I-EVOLUTION -mejoría I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -pulmonares I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -examen I-EVOLUTION -directo I-EVOLUTION -de I-EVOLUTION -expectoración I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -fue I-EVOLUTION -negativo I-EVOLUTION -para I-EVOLUTION -BAAR. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -67 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -natural B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Huaral I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -procedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Lima I-PAST_MEDICAL_HISTORY -Metropolitana, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ocupación I-PAST_MEDICAL_HISTORY -dueña I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -casa, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pesadez I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -distensión I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -post-prandial I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -todo I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -comida. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -estos I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -asociaron I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -epigastralgia I-PRESENT_ILLNESS -urente I-PRESENT_ILLNESS -leve. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaba I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -profunda I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -epigastrio, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -peritoneales. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -demostraron I-EXPLORATION -una I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -11.700/mm3 I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -eosinofilia I-EXPLORATION -de I-EXPLORATION -6.300/mm3, I-EXPLORATION -las I-EXPLORATION -fosfatasas I-EXPLORATION -alcalinas, I-EXPLORATION -GGT, I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -y I-EXPLORATION -alfa-fetoproteínas I-EXPLORATION -se I-EXPLORATION -encontraban I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -hepatitis I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal, I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -dos I-EXPLORATION -imágenes I-EXPLORATION -quísticas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hígado, I-EXPLORATION -una I-EXPLORATION -de I-EXPLORATION -11 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -segmento I-EXPLORATION -VII I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -otra I-EXPLORATION -de I-EXPLORATION -45 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -segmento I-EXPLORATION -II. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -hipodensa I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -irregulares, I-EXPLORATION -de I-EXPLORATION -35 I-EXPLORATION -por I-EXPLORATION -15 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -segmento I-EXPLORATION -hepático I-EXPLORATION -II. I-EXPLORATION -Se I-EXPLORATION -internó I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -hepático I-EXPLORATION -para I-EXPLORATION -realizarse I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -percutánea I-EXPLORATION -guiada I-EXPLORATION -por I-EXPLORATION -ecografía. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -histopatológicos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -hepática I-EXPLORATION -fueron: I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -compuesto I-EXPLORATION -por I-EXPLORATION -linfocitos, I-EXPLORATION -células I-EXPLORATION -plasmáticas I-EXPLORATION -y I-EXPLORATION -eosinófilos, I-EXPLORATION -estos I-EXPLORATION -últimos I-EXPLORATION -en I-EXPLORATION -gran I-EXPLORATION -cantidad. I-EXPLORATION -Se I-EXPLORATION -observaron I-EXPLORATION -además I-EXPLORATION -hepatocitos I-EXPLORATION -reactivos, I-EXPLORATION -regenerativos I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -parén-quima I-EXPLORATION -hepático. I-EXPLORATION -Por I-EXPLORATION -este I-EXPLORATION -motivo, I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -Fas2-Elisa I-EXPLORATION -para I-EXPLORATION -F. I-EXPLORATION -hepatica, I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -tuvo I-EXPLORATION -un I-EXPLORATION -valor I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -37 I-EXPLORATION -(valor I-EXPLORATION -normal: I-EXPLORATION -< I-EXPLORATION -0, I-EXPLORATION -2), I-EXPLORATION -muy I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -infección. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -triclabendazol I-TREATMENT -10 I-TREATMENT -mg/kg, I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -única. I-TREATMENT -Evolucionó B-EVOLUTION -favorablemente; I-EVOLUTION -luego I-EVOLUTION -de I-EVOLUTION -dos I-EVOLUTION -meses I-EVOLUTION -desapareció I-EVOLUTION -la I-EVOLUTION -sintomatología I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -eosinofilia. I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -TAC I-EVOLUTION -abdominal I-EVOLUTION -realizada I-EVOLUTION -al I-EVOLUTION -sexto I-EVOLUTION -mes I-EVOLUTION -post-tratamiento, I-EVOLUTION -se I-EVOLUTION -evidenció I-EVOLUTION -regresión I-EVOLUTION -completa I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -lesión I-EVOLUTION -hepática. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -49 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -medicamentos I-PAST_MEDICAL_HISTORY -recientes. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -seca I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -asociada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -odinofagia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -pruriginosas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -muslos. I-PRESENT_ILLNESS -Se B-TREATMENT -diagnosticó I-TREATMENT -una I-TREATMENT -faringoamigdalitis I-TREATMENT -aguda I-TREATMENT -con I-TREATMENT -una I-TREATMENT -escarlatina I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -lincomicina I-TREATMENT -oral, I-TREATMENT -sin I-TREATMENT -mejoría I-TREATMENT -de I-TREATMENT -la I-TREATMENT -sintomatología I-TREATMENT -ni I-TREATMENT -remisión I-TREATMENT -de I-TREATMENT -las I-TREATMENT -lesiones I-TREATMENT -cutáneas. I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -h, I-EVOLUTION -se I-EVOLUTION -agregó I-EVOLUTION -fiebre I-EVOLUTION -hasta I-EVOLUTION -38, I-EVOLUTION -5°C I-EVOLUTION -y I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -se I-EVOLUTION -diseminaron I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -centrípeta, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -consultó I-EVOLUTION -nuevamente. I-EVOLUTION -La B-EXPLORATION -paciente I-EXPLORATION -estaba I-EXPLORATION -en I-EXPLORATION -regulares I-EXPLORATION -condiciones I-EXPLORATION -generales, I-EXPLORATION -hemodinámicamente I-EXPLORATION -estable. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -físico, I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -leve I-EXPLORATION -eritema I-EXPLORATION -faríngeo I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -examen I-EXPLORATION -pulmonar I-EXPLORATION -normal. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -pesquisaron I-EXPLORATION -adenopatías. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -cutáneo, I-EXPLORATION -destacaban I-EXPLORATION -máculas I-EXPLORATION -y I-EXPLORATION -pápulas I-EXPLORATION -eritematosas I-EXPLORATION -palmoplantares I-EXPLORATION -y I-EXPLORATION -pústulas I-EXPLORATION -no I-EXPLORATION -foliculares, I-EXPLORATION -de I-EXPLORATION -base I-EXPLORATION -eritematosa, I-EXPLORATION -confluentes I-EXPLORATION -en I-EXPLORATION -placas, I-EXPLORATION -localizadas I-EXPLORATION -en I-EXPLORATION -cuello, I-EXPLORATION -dorso, I-EXPLORATION -región I-EXPLORATION -lumbar I-EXPLORATION -y I-EXPLORATION -muslos. I-EXPLORATION -El I-EXPLORATION -signo I-EXPLORATION -de I-EXPLORATION -Nikolsky I-EXPLORATION -era I-EXPLORATION -negativo. I-EXPLORATION -No I-EXPLORATION -tenía I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -oral, I-EXPLORATION -ocular I-EXPLORATION -ni I-EXPLORATION -genital. I-EXPLORATION -Sin B-TREATMENT -embargo, I-TREATMENT -dado I-TREATMENT -el I-TREATMENT -compromiso I-TREATMENT -cutáneo I-TREATMENT -extenso, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -su I-TREATMENT -internación. I-TREATMENT - I-TREATMENT -Los B-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -mostraron I-EXPLORATION -una I-EXPLORATION -leucocitosis I-EXPLORATION -(15.500 I-EXPLORATION -neutrófilos/mm3, I-EXPLORATION -sin I-EXPLORATION -eosinofilia), I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -de I-EXPLORATION -14, I-EXPLORATION -7 I-EXPLORATION -mg/dL I-EXPLORATION -(valor I-EXPLORATION -normal I-EXPLORATION -< I-EXPLORATION -1 I-EXPLORATION -mg/dL) I-EXPLORATION -y I-EXPLORATION -pruebas I-EXPLORATION -hepáticas I-EXPLORATION -levemente I-EXPLORATION -alteradas: I-EXPLORATION -GOT: I-EXPLORATION -23 I-EXPLORATION -UI/L I-EXPLORATION -(VN I-EXPLORATION -9-25), I-EXPLORATION -GPT: I-EXPLORATION -48 I-EXPLORATION -UI/L I-EXPLORATION -(VN I-EXPLORATION -7-30), I-EXPLORATION -fosfatasas I-EXPLORATION -alcalinas: I-EXPLORATION -199 I-EXPLORATION -UI/L I-EXPLORATION -(VN I-EXPLORATION -30-100), I-EXPLORATION -GGT: I-EXPLORATION -110 I-EXPLORATION -UI/L I-EXPLORATION -(VN I-EXPLORATION -4-50). I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -mostró I-EXPLORATION -escaso I-EXPLORATION -infiltrado I-EXPLORATION -intersticial, I-EXPLORATION -sin I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -consolidación. I-EXPLORATION -El I-EXPLORATION -panel I-EXPLORATION -viral I-EXPLORATION -respiratorio I-EXPLORATION -molecular, I-EXPLORATION -por I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -reacción I-EXPLORATION -de I-EXPLORATION -polimerasa I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -(RPC), I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION -La I-EXPLORATION -IgM I-EXPLORATION -para I-EXPLORATION -M. I-EXPLORATION -pneumoniae I-EXPLORATION -(técnica I-EXPLORATION -cualitativa I-EXPLORATION -por I-EXPLORATION -ELISA) I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -al I-EXPLORATION -segundo I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -hospitalización I-EXPLORATION -(correspondiente I-EXPLORATION -al I-EXPLORATION -noveno I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -evolución). I-EXPLORATION -Las I-EXPLORATION -serologías I-EXPLORATION -para I-EXPLORATION -VIH, I-EXPLORATION -virus I-EXPLORATION -hepatitis I-EXPLORATION -B, I-EXPLORATION -C, I-EXPLORATION -y I-EXPLORATION -sífilis I-EXPLORATION -fueron I-EXPLORATION -negativas. I-EXPLORATION -La I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -corriente I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -pústulas I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -en I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -mostró I-EXPLORATION -acantosis, I-EXPLORATION -espongiosis, I-EXPLORATION -exocitosis I-EXPLORATION -de I-EXPLORATION -neutrófilos I-EXPLORATION -y I-EXPLORATION -pústulas I-EXPLORATION -intracórneas, I-EXPLORATION -intraepidérmicas I-EXPLORATION -e I-EXPLORATION -intrafoliculares. I-EXPLORATION -La I-EXPLORATION -dermis I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -perivascular I-EXPLORATION -difuso I-EXPLORATION -con I-EXPLORATION -linfocitos I-EXPLORATION -y I-EXPLORATION -neutrófilos. I-EXPLORATION -La I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -PAS I-EXPLORATION -fue I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -microorganismos. I-EXPLORATION -Dado I-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION -clínicos I-EXPLORATION -e I-EXPLORATION -histopatológicos, I-EXPLORATION -se I-EXPLORATION -diagnosticó I-EXPLORATION -una I-EXPLORATION -PEGA, I-EXPLORATION -probablemente I-EXPLORATION -causada I-EXPLORATION -por I-EXPLORATION -M. I-EXPLORATION -pneumoniae. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -hidrocortisona I-TREATMENT -i.v., I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -50 I-TREATMENT -mg I-TREATMENT -fraccionada I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -h, I-TREATMENT -y I-TREATMENT -levofloxacina I-TREATMENT -oral I-TREATMENT -400 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -con B-EVOLUTION -excelente I-EVOLUTION -evolución I-EVOLUTION -marcada I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -desaparición I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -fiebre I-EVOLUTION -y I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -cutáneas, I-EVOLUTION -dándose I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -h I-EVOLUTION -con B-TREATMENT -prednisona I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -decrecientes I-TREATMENT -y I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -antimicrobiano, I-TREATMENT -ambos I-TREATMENT -por I-TREATMENT -7 I-TREATMENT -días I-TREATMENT -más. I-TREATMENT -Al B-EVOLUTION -control I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -dos I-EVOLUTION -semanas, I-EVOLUTION -ya I-EVOLUTION -no I-EVOLUTION -presentaba I-EVOLUTION -lesiones I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -piel. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -66 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -insulino-requiriente, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -dislipide-mia, I-PAST_MEDICAL_HISTORY -gota, I-PAST_MEDICAL_HISTORY -glaucoma I-PAST_MEDICAL_HISTORY -bilateral I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -meningo-encefalitis I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -otro I-PAST_MEDICAL_HISTORY -hospital. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -brusco I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pocas I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -febril I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -calofríos, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS -conductuales I-PRESENT_ILLNESS -(agresividad I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -familiares) I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -posteriormente I-PRESENT_ILLNESS -rápido I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conciencia. I-PRESENT_ILLNESS -Una B-EXPLORATION -medición I-EXPLORATION -de I-EXPLORATION -glicemia I-EXPLORATION -capilar I-EXPLORATION -en I-EXPLORATION -domicilio I-EXPLORATION -descartó I-EXPLORATION -una I-EXPLORATION -hipoglicemia. I-EXPLORATION -Ingresó I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -centro I-EXPLORATION -asistencial I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -puntaje I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -escala I-EXPLORATION -Glasgow I-EXPLORATION -de I-EXPLORATION -coma I-EXPLORATION -(GCS) I-EXPLORATION -de I-EXPLORATION -14 I-EXPLORATION -puntos, I-EXPLORATION -confuso, I-EXPLORATION -desorientado I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -agitación I-EXPLORATION -psicomotora I-EXPLORATION -(que I-EXPLORATION -se I-EXPLORATION -contuvo I-EXPLORATION -farmacológicamente I-EXPLORATION -con I-EXPLORATION -propofol, I-EXPLORATION -ketamina I-EXPLORATION -y I-EXPLORATION -lorazepam) I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION -meníngeos I-EXPLORATION -negativos. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -imágenes I-EXPLORATION -con I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -y I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -de I-EXPLORATION -encéfalo I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -informadas I-EXPLORATION -como I-EXPLORATION -normales. I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -del I-EXPLORATION -LCR I-EXPLORATION -reveló I-EXPLORATION -un I-EXPLORATION -líquido I-EXPLORATION -incoloro, I-EXPLORATION -glucorraquia I-EXPLORATION -de I-EXPLORATION -132 I-EXPLORATION -mg/dL I-EXPLORATION -(glicemia I-EXPLORATION -de I-EXPLORATION -199 I-EXPLORATION -mg/dL), I-EXPLORATION -proteínas I-EXPLORATION -249 I-EXPLORATION -mg/dL, I-EXPLORATION -pleocitosis I-EXPLORATION -de I-EXPLORATION -940 I-EXPLORATION -céls/mm3 I-EXPLORATION -con I-EXPLORATION -36% I-EXPLORATION -polimorfonucleares I-EXPLORATION -y I-EXPLORATION -64% I-EXPLORATION -mononucleares, I-EXPLORATION -hematíes I-EXPLORATION -100 I-EXPLORATION -céls/mm3, I-EXPLORATION -100% I-EXPLORATION -frescos I-EXPLORATION -y I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -sin I-EXPLORATION -bacterias I-EXPLORATION -visibles. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -microbiológico I-EXPLORATION -del I-EXPLORATION -LCR I-EXPLORATION -con I-EXPLORATION -cultivo I-EXPLORATION -y I-EXPLORATION -reacción I-EXPLORATION -de I-EXPLORATION -polimerasa I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -(RPC) I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -varicela I-EXPLORATION -zoster, I-EXPLORATION -virus I-EXPLORATION -herpes I-EXPLORATION -simplex I-EXPLORATION -1, I-EXPLORATION -2 I-EXPLORATION -y I-EXPLORATION -6, I-EXPLORATION -citomegalovirus, I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -látex I-EXPLORATION -para I-EXPLORATION -N. I-EXPLORATION -meningitidis, I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -urocultivo, I-EXPLORATION -fueron I-EXPLORATION -todos I-EXPLORATION -negativos. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -generales I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -14.850 I-EXPLORATION -céls/mm3, I-EXPLORATION -neutrofilia I-EXPLORATION -(82%), I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -eritrosedimentación I-EXPLORATION -(VHS) I-EXPLORATION -discretamente I-EXPLORATION -elevada I-EXPLORATION -(21 I-EXPLORATION -mm/h), I-EXPLORATION -pruebas I-EXPLORATION -bioquímicas I-EXPLORATION -y I-EXPLORATION -hepáticas I-EXPLORATION -normales, I-EXPLORATION -salvo I-EXPLORATION -una I-EXPLORATION -hiperglicemia I-EXPLORATION -y I-EXPLORATION -alza I-EXPLORATION -leve I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -creatinina I-EXPLORATION -plasmática I-EXPLORATION -(1, I-EXPLORATION -3 I-EXPLORATION -mg/dL). I-EXPLORATION -Los I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -(5, I-EXPLORATION -5 I-EXPLORATION -mg/L) I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -procalcitonina I-EXPLORATION -bajos I-EXPLORATION -(< I-EXPLORATION -0, I-EXPLORATION -05 I-EXPLORATION -ng/mL). I-EXPLORATION -Evolucionó B-TREATMENT -con I-TREATMENT -una I-TREATMENT -hipotensión I-TREATMENT -arterial I-TREATMENT -(96/56 I-TREATMENT -mm I-TREATMENT -Hg) I-TREATMENT -que I-TREATMENT -respondió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -volumen, I-TREATMENT -además I-TREATMENT -de I-TREATMENT -compromiso I-TREATMENT -de I-TREATMENT -conciencia I-TREATMENT -fluctuante I-TREATMENT -(Glasgow I-TREATMENT -bajó I-TREATMENT -a I-TREATMENT -11). I-TREATMENT -Se I-TREATMENT -inició I-TREATMENT -terapia I-TREATMENT -antimicrobiana I-TREATMENT -empírica I-TREATMENT -con I-TREATMENT -ceftriaxona, I-TREATMENT -ampicilina I-TREATMENT -y I-TREATMENT -aciclovir I-TREATMENT -i.v. I-TREATMENT -y I-TREATMENT -glucocorticoides I-TREATMENT -(dexametasona I-TREATMENT -8 I-TREATMENT -mg). I-TREATMENT -Se B-DERIVED_FROM/TO -trasladó I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -ingresó I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -Glasgow I-DERIVED_FROM/TO -fluctuante I-DERIVED_FROM/TO -(entre I-DERIVED_FROM/TO -10 I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -13 I-DERIVED_FROM/TO -puntos), I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -hemodinamia I-DERIVED_FROM/TO -estable, I-DERIVED_FROM/TO -febril I-DERIVED_FROM/TO -(38, I-DERIVED_FROM/TO -5 I-DERIVED_FROM/TO -oC), I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -reflejos I-DERIVED_FROM/TO -osteotendíneos I-DERIVED_FROM/TO -exacerbados, I-DERIVED_FROM/TO -sin I-DERIVED_FROM/TO -focalidad I-DERIVED_FROM/TO -neurológica, I-DERIVED_FROM/TO -signos I-DERIVED_FROM/TO -meníngeos I-DERIVED_FROM/TO -o I-DERIVED_FROM/TO -lesiones I-DERIVED_FROM/TO -embólicas I-DERIVED_FROM/TO -sistémicas I-DERIVED_FROM/TO -o I-DERIVED_FROM/TO -cutáneas. I-DERIVED_FROM/TO -Se B-EXPLORATION -repitió I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -LCR, I-EXPLORATION -en I-EXPLORATION -cuyo I-EXPLORATION -citoquímico I-EXPLORATION -las I-EXPLORATION -proteínas I-EXPLORATION -disminuyeron I-EXPLORATION -a I-EXPLORATION -81 I-EXPLORATION -mg/dL I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -pleocitosis I-EXPLORATION -a I-EXPLORATION -40 I-EXPLORATION -céls/mm3. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -en I-EXPLORATION -LCR I-EXPLORATION -para I-EXPLORATION -tuberculosis I-EXPLORATION -(adenosina I-EXPLORATION -deaminasa, I-EXPLORATION -baciloscopia I-EXPLORATION -y I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -Koch), I-EXPLORATION -enterovirus I-EXPLORATION -(RPC) I-EXPLORATION -y I-EXPLORATION -hongos I-EXPLORATION -(tinta I-EXPLORATION -china I-EXPLORATION -y I-EXPLORATION -cultivo) I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION -y/o I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -descartó I-EXPLORATION -también I-EXPLORATION -una I-EXPLORATION -neumonía I-EXPLORATION -por I-EXPLORATION -imágenes I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente, I-EVOLUTION -se B-TREATMENT -logró I-TREATMENT -desconectar I-TREATMENT -del I-TREATMENT -ventilador I-TREATMENT -mecánico I-TREATMENT -a I-TREATMENT -las I-TREATMENT -24 I-TREATMENT -h I-TREATMENT -de I-TREATMENT -su I-TREATMENT -ingreso, I-TREATMENT -sin B-EVOLUTION -demostrar I-EVOLUTION -focalización I-EVOLUTION -neurológica I-EVOLUTION -alguna I-EVOLUTION -y I-EVOLUTION -recuperando I-EVOLUTION -totalmente I-EVOLUTION -sus I-EVOLUTION -funciones I-EVOLUTION -cerebrales I-EVOLUTION -superiores. I-EVOLUTION -Los B-TREATMENT -antimicrobianos I-TREATMENT -fueron I-TREATMENT -suspendidos I-TREATMENT -a I-TREATMENT -las I-TREATMENT -72 I-TREATMENT -h. I-TREATMENT -Al B-EXPLORATION -interrogatorio I-EXPLORATION -dirigido, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -refirió I-EXPLORATION -ningún I-EXPLORATION -síntoma I-EXPLORATION -respiratorio I-EXPLORATION -alto I-EXPLORATION -o I-EXPLORATION -bajo I-EXPLORATION -(rinorrea, I-EXPLORATION -tos, I-EXPLORATION -odinofagia I-EXPLORATION -o I-EXPLORATION -disfonía) I-EXPLORATION -que I-EXPLORATION -justificara I-EXPLORATION -la I-EXPLORATION -búsqueda I-EXPLORATION -de I-EXPLORATION -virus I-EXPLORATION -respiratorios. I-EXPLORATION -Fue B-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -cuarto I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -ingreso. I-EVOLUTION - I-EVOLUTION -Se B-PAST_MEDICAL_HISTORY -obtuvieron I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -meningoencefalitis I-PAST_MEDICAL_HISTORY -ocurrida I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -atrás, I-PAST_MEDICAL_HISTORY -según I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -epicrisis. I-PAST_MEDICAL_HISTORY -Había I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY -internado I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -días, I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ellos I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ventilación I-PAST_MEDICAL_HISTORY -mecánica. I-PAST_MEDICAL_HISTORY -El B-EXPLORATION -estudio I-EXPLORATION -del I-EXPLORATION -LCR I-EXPLORATION -indicó I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -bacterias I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram, I-EXPLORATION -pleocitosis I-EXPLORATION -de I-EXPLORATION -70 I-EXPLORATION -céls/mm3 I-EXPLORATION -(60% I-EXPLORATION -mononuclear), I-EXPLORATION -proteínas I-EXPLORATION -de I-EXPLORATION -68 I-EXPLORATION -mg/dL I-EXPLORATION -y I-EXPLORATION -glucosa I-EXPLORATION -de I-EXPLORATION -135 I-EXPLORATION -mg/dL. I-EXPLORATION -El B-TREATMENT -cuadro I-TREATMENT -se I-TREATMENT -interpretó I-TREATMENT -como I-TREATMENT -viral, I-TREATMENT -tratándose I-TREATMENT -con I-TREATMENT -aciclovir I-TREATMENT -i.v. I-TREATMENT -por I-TREATMENT -10 I-TREATMENT -días, I-TREATMENT -sin I-TREATMENT -realizarse I-TREATMENT -estudio I-TREATMENT -viral I-TREATMENT -del I-TREATMENT -LCR. I-TREATMENT - I-TREATMENT -En B-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -dirigida I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -rescató I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vacunación I-PAST_MEDICAL_HISTORY -anual I-PAST_MEDICAL_HISTORY -contra I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -influenza I-PAST_MEDICAL_HISTORY -(vacuna I-PAST_MEDICAL_HISTORY -trivalente) I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -consecutivos I-PAST_MEDICAL_HISTORY -(2011 I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -2015). I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2014, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -vacuna I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -administrada I-PAST_MEDICAL_HISTORY -16 I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -meningoencefalitis I-PAST_MEDICAL_HISTORY -(Vaxigrip®, I-PAST_MEDICAL_HISTORY -Sanofi, I-PAST_MEDICAL_HISTORY -lote I-PAST_MEDICAL_HISTORY -K7375-2) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -episodio, I-PAST_MEDICAL_HISTORY -producido I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2015, I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -(Influval®, I-PAST_MEDICAL_HISTORY -Abbott, I-PAST_MEDICAL_HISTORY -lote I-PAST_MEDICAL_HISTORY -HY01N). I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -análisis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -causalidad, I-PAST_MEDICAL_HISTORY -según I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -puntuación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Naranjo I-PAST_MEDICAL_HISTORY -dio I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -puntos18. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -clínicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -39, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -°C I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -14 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -asociada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -escalofríos, I-PRESENT_ILLNESS -palidez I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -piel, I-PRESENT_ILLNESS -adenopatías I-PRESENT_ILLNESS -cervicales I-PRESENT_ILLNESS -bilaterales, I-PRESENT_ILLNESS -decaimiento I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -inapetencia. I-PRESENT_ILLNESS -Había I-PRESENT_ILLNESS -sido I-PRESENT_ILLNESS -tratado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -azitromicina I-PRESENT_ILLNESS -500 I-PRESENT_ILLNESS -mg I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -día, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS -días. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física, I-EXPLORATION -destacaba I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -soplo I-EXPLORATION -sistólico I-EXPLORATION -grado I-EXPLORATION -II/III I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -foco I-EXPLORATION -auscultatorio I-EXPLORATION -correspondiente I-EXPLORATION -al I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo. I-EXPLORATION -El I-EXPLORATION -electroencefalograma I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -no I-EXPLORATION -evidenciaron I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -mostraron I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -marcadores I-EXPLORATION -inflamatorios: I-EXPLORATION -leucocitos I-EXPLORATION -de I-EXPLORATION -10.500 I-EXPLORATION -céls/ml, I-EXPLORATION -una I-EXPLORATION -neutrofilia I-EXPLORATION -de I-EXPLORATION -70% I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -PCR I-EXPLORATION -elevada I-EXPLORATION -(119 I-EXPLORATION -mg/L). I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -cefotaxima I-TREATMENT -i.v. I-TREATMENT -200 I-TREATMENT -mg/kg/día I-TREATMENT -previa I-TREATMENT -toma I-TREATMENT -de I-TREATMENT -hemocultivos I-TREATMENT -seriados I-TREATMENT -en I-TREATMENT -dos I-TREATMENT -días I-TREATMENT -consecutivos. I-TREATMENT -A B-EXPLORATION -las I-EXPLORATION -24 I-EXPLORATION -h I-EXPLORATION -de I-EXPLORATION -incubación, I-EXPLORATION -ambos I-EXPLORATION -hemocultivos I-EXPLORATION -fueron I-EXPLORATION -positivos. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -bacilos I-EXPLORATION -grampositivos I-EXPLORATION -pleomórficos I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -de I-EXPLORATION -"V". I-EXPLORATION -La I-EXPLORATION -identificación I-EXPLORATION -directa I-EXPLORATION -del I-EXPLORATION -microorganismo I-EXPLORATION -a I-EXPLORATION -partir I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION -positivos I-EXPLORATION -mediante I-EXPLORATION -espectrometría I-EXPLORATION -de I-EXPLORATION -masas I-EXPLORATION -MALDI-TOF I-EXPLORATION -fue I-EXPLORATION -C. I-EXPLORATION -pseudodiphtheriticum. I-EXPLORATION -En I-EXPLORATION -este I-EXPLORATION -contexto, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecocardiografía I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -formación I-EXPLORATION -vegetativa I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -mm I-EXPLORATION -del I-EXPLORATION -lado I-EXPLORATION -ventricular I-EXPLORATION -izquierdo, I-EXPLORATION -provocando I-EXPLORATION -insuficiencia I-EXPLORATION -moderada, I-EXPLORATION -sin I-EXPLORATION -repercusión I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -hemodinamia I-EXPLORATION -y I-EXPLORATION -función I-EXPLORATION -cardíaca. I-EXPLORATION -Asimismo, I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -valvulopatía I-EXPLORATION -aórtica I-EXPLORATION -bicúspide. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -una I-TREATMENT -endocarditis I-TREATMENT -infecciosa I-TREATMENT -se I-TREATMENT -agregó I-TREATMENT -gentamicina I-TREATMENT -(6 I-TREATMENT -mg/kg/día) I-TREATMENT -a I-TREATMENT -la I-TREATMENT -terapia I-TREATMENT -a I-TREATMENT -la I-TREATMENT -espera I-TREATMENT -de I-TREATMENT -la I-TREATMENT -identificación I-TREATMENT -definitiva I-TREATMENT -del I-TREATMENT -microorganismo I-TREATMENT -y I-TREATMENT -su I-TREATMENT -perfil I-TREATMENT -de I-TREATMENT -susceptibilidad I-TREATMENT -antimicrobiana. I-TREATMENT -A B-EXPLORATION -las I-EXPLORATION -24 I-EXPLORATION -h I-EXPLORATION -de I-EXPLORATION -incubación I-EXPLORATION -en I-EXPLORATION -medios I-EXPLORATION -de I-EXPLORATION -cultivo I-EXPLORATION -sólidos I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -el I-EXPLORATION -crecimiento I-EXPLORATION -de I-EXPLORATION -colonias I-EXPLORATION -grises I-EXPLORATION -en I-EXPLORATION -placas I-EXPLORATION -de I-EXPLORATION -agar I-EXPLORATION -sangre, I-EXPLORATION -catalasa I-EXPLORATION -positivas. I-EXPLORATION -La I-EXPLORATION -identificación I-EXPLORATION -mediante I-EXPLORATION -secuenciación I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -ARN I-EXPLORATION -16S I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -aislamiento I-EXPLORATION -de I-EXPLORATION -C. I-EXPLORATION -pseudodiphtheriticum. I-EXPLORATION -El I-EXPLORATION -antibiograma I-EXPLORATION -con I-EXPLORATION -epsilometría I-EXPLORATION -(E-test) I-EXPLORATION -mostró I-EXPLORATION -resistencia I-EXPLORATION -a I-EXPLORATION -azitromicina I-EXPLORATION -(CIM I-EXPLORATION -> I-EXPLORATION -256 I-EXPLORATION -μg/ml) I-EXPLORATION -y I-EXPLORATION -sensibilidad I-EXPLORATION -(CIM) I-EXPLORATION -a I-EXPLORATION -amoxicilina/ác. I-EXPLORATION -clavulánico I-EXPLORATION -(0, I-EXPLORATION -016 I-EXPLORATION -μg/ml), I-EXPLORATION -cefotaxima I-EXPLORATION -(0, I-EXPLORATION -38 I-EXPLORATION -μg/ml), I-EXPLORATION -ciprofloxacina I-EXPLORATION -(0, I-EXPLORATION -5 I-EXPLORATION -μg/ I-EXPLORATION -ml), I-EXPLORATION -linezolid I-EXPLORATION -(0, I-EXPLORATION -016 I-EXPLORATION -μg/ml), I-EXPLORATION -penicilina I-EXPLORATION -G I-EXPLORATION -(0, I-EXPLORATION -25 I-EXPLORATION -μg/ml) I-EXPLORATION -y I-EXPLORATION -vancomicina I-EXPLORATION -(0, I-EXPLORATION -38 I-EXPLORATION -μg/ml). I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -favorable, I-EVOLUTION -remitiendo I-EVOLUTION -su I-EVOLUTION -cuadro I-EVOLUTION -febril I-EVOLUTION -antes I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -h I-EVOLUTION -de I-EVOLUTION -iniciada I-EVOLUTION -la I-EVOLUTION -terapia I-EVOLUTION -antimicrobiana I-EVOLUTION -combinada. I-EVOLUTION -Dada B-TREATMENT -su I-TREATMENT -buena I-TREATMENT -evolución, I-TREATMENT -habiendo I-TREATMENT -negativizado I-TREATMENT -los I-TREATMENT -hemocultivos I-TREATMENT -y I-TREATMENT -sin I-TREATMENT -cambios I-TREATMENT -imagenológicos I-TREATMENT -no I-TREATMENT -se I-TREATMENT -planteó I-TREATMENT -una I-TREATMENT -cirugía I-TREATMENT -cardíaca I-TREATMENT -en I-TREATMENT -ese I-TREATMENT -momento, I-TREATMENT -salvo I-TREATMENT -que I-TREATMENT -hubiera I-TREATMENT -algún I-TREATMENT -deterioro I-TREATMENT -clínico. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -16 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -internación, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -nuevamente I-EVOLUTION -fiebre I-EVOLUTION -asociada I-EVOLUTION -a I-EVOLUTION -cefalea I-EVOLUTION -frontal, I-EVOLUTION -desorientación I-EVOLUTION -y I-EVOLUTION -escaso I-EVOLUTION -tono I-EVOLUTION -motor I-EVOLUTION -que I-EVOLUTION -evolucionó I-EVOLUTION -a I-EVOLUTION -una I-EVOLUTION -paresia I-EVOLUTION -braquial I-EVOLUTION -derecha, I-EVOLUTION -hemicara I-EVOLUTION -derecha I-EVOLUTION -y I-EVOLUTION -afasia. I-EVOLUTION -El I-EVOLUTION -cuadro I-EVOLUTION -se I-EVOLUTION -interpretó I-EVOLUTION -como I-EVOLUTION -una I-EVOLUTION -embolia I-EVOLUTION -séptica I-EVOLUTION -cerebral. I-EVOLUTION -Se B-TREATMENT -agregó I-TREATMENT -linezolid I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -antimicrobiano I-TREATMENT -por I-TREATMENT -una I-TREATMENT -eventual I-TREATMENT -sobreinfección I-TREATMENT -por I-TREATMENT -microorganismos I-TREATMENT -resistentes I-TREATMENT -en I-TREATMENT -algún I-TREATMENT -otro I-TREATMENT -foco. I-TREATMENT -Ante I-TREATMENT -el I-TREATMENT -riesgo I-TREATMENT -de I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -embolismo, I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -cirugía I-TREATMENT -cardíaca I-TREATMENT -sobre I-TREATMENT -el I-TREATMENT -territorio I-TREATMENT -valvular I-TREATMENT -aórtico I-TREATMENT -(procedimiento I-TREATMENT -Ross) I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -superada I-TREATMENT -con I-TREATMENT -éxito. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -post-operatorio I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -hipertensión I-EVOLUTION -intracraneal. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -cerebral I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -infarto I-EXPLORATION -isquémico I-EXPLORATION -por I-EXPLORATION -oclusión I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -origen I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -cerebral I-EXPLORATION -media I-EXPLORATION -izquierda. I-EXPLORATION -Debido B-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -gravedad, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -falleció I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -posteriores. I-EVOLUTION -Los B-EXPLORATION -resultados I-EXPLORATION -microbiológicos I-EXPLORATION -finales I-EXPLORATION -confirmaron I-EXPLORATION -nuevamente I-EXPLORATION -el I-EXPLORATION -aislamiento I-EXPLORATION -de I-EXPLORATION -C. I-EXPLORATION -pseudodiphtheriticum I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -hemocultivos. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -71 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -(DM-2) I-PAST_MEDICAL_HISTORY -mal I-PAST_MEDICAL_HISTORY -controlada, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -(ERC) I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -etapa I-PAST_MEDICAL_HISTORY -V I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -hemodiálisis I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -fístula I-PAST_MEDICAL_HISTORY -arterio-venosa I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pie I-PAST_MEDICAL_HISTORY -diabético I-PAST_MEDICAL_HISTORY -izquierdo, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -amputación I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -primer I-PAST_MEDICAL_HISTORY -ortejo, I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -mes I-PAST_MEDICAL_HISTORY -previo I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -consulta. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencia I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -erupciones I-PRESENT_ILLNESS -cutáneas I-PRESENT_ILLNESS -inicialmente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cuero I-PRESENT_ILLNESS -cabelludo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -luego I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -extendieron I-PRESENT_ILLNESS -hacia I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cara I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -extremidades I-PRESENT_ILLNESS -superiores. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -confusa, I-EXPLORATION -somnolienta, I-EXPLORATION -con I-EXPLORATION -mala I-EXPLORATION -perfusión I-EXPLORATION -distal I-EXPLORATION -y I-EXPLORATION -taquicárdica. I-EXPLORATION -Los I-EXPLORATION -signos I-EXPLORATION -vitales I-EXPLORATION -eran: I-EXPLORATION -frecuencia I-EXPLORATION -cardíaca I-EXPLORATION -118 I-EXPLORATION -latidos/ I-EXPLORATION -min, I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -112/72 I-EXPLORATION -mmHg I-EXPLORATION -y I-EXPLORATION -temperatura I-EXPLORATION -axilar I-EXPLORATION -37, I-EXPLORATION -5 I-EXPLORATION -°C. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaba I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -adenopatías I-EXPLORATION -cervicales I-EXPLORATION -múltiples I-EXPLORATION -dolorosas I-EXPLORATION -y I-EXPLORATION -seis I-EXPLORATION -pústulas I-EXPLORATION -con I-EXPLORATION -base I-EXPLORATION -eritematosa I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mejilla I-EXPLORATION -izquierda. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -témporo-occipital I-EXPLORATION -del I-EXPLORATION -cuero I-EXPLORATION -cabelludo I-EXPLORATION -tenía I-EXPLORATION -una I-EXPLORATION -placa I-EXPLORATION -costrosa I-EXPLORATION -con I-EXPLORATION -secreción I-EXPLORATION -purulenta I-EXPLORATION -de I-EXPLORATION -mal I-EXPLORATION -olor, I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -brazo I-EXPLORATION -derecho I-EXPLORATION -presentaba I-EXPLORATION -dos I-EXPLORATION -bulas I-EXPLORATION -tensas, I-EXPLORATION -que I-EXPLORATION -posteriormente I-EXPLORATION -se I-EXPLORATION -ulceraron, I-EXPLORATION -evolucionando I-EXPLORATION -con I-EXPLORATION -necrosis. I-EXPLORATION -No I-EXPLORATION -tenía I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -mucosas I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -mostraron: I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -7, I-EXPLORATION -3 I-EXPLORATION -mg/dL, I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -leucocitos I-EXPLORATION -27.500/mm3, I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -plaquetas I-EXPLORATION -513.000/mm3, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -(PCR): I-EXPLORATION -78 I-EXPLORATION -mg/dL I-EXPLORATION -(valor I-EXPLORATION -normal I-EXPLORATION -< I-EXPLORATION -5 I-EXPLORATION -mg/dL), I-EXPLORATION -nitrógeno I-EXPLORATION -ureico I-EXPLORATION -98 I-EXPLORATION -mg/ I-EXPLORATION -dL, I-EXPLORATION -pH I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -7, I-EXPLORATION -1 I-EXPLORATION -y I-EXPLORATION -bicarbonato I-EXPLORATION -sérico I-EXPLORATION -13, I-EXPLORATION -8 I-EXPLORATION -mEq/L. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -el I-TREATMENT -escenario I-TREATMENT -clínico I-TREATMENT -de I-TREATMENT -una I-TREATMENT -sepsis I-TREATMENT -con I-TREATMENT -foco I-TREATMENT -de I-TREATMENT -entrada I-TREATMENT -cutánea, I-TREATMENT -recibió I-TREATMENT -volumen I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -terapia I-TREATMENT -antimicrobiana I-TREATMENT -empírica I-TREATMENT -con I-TREATMENT -ceftriaxona I-TREATMENT -y I-TREATMENT -clindamicina I-TREATMENT -i.v., I-TREATMENT -previa I-TREATMENT -toma I-TREATMENT -de I-TREATMENT -cultivos. I-TREATMENT -Evaluada I-TREATMENT -por I-TREATMENT -infectología I-TREATMENT -y I-TREATMENT -dermatología, I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -antibioterapia I-TREATMENT -a I-TREATMENT -piperacilina/ I-TREATMENT -tazobactam, I-TREATMENT -debido I-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -clínica I-TREATMENT -de I-TREATMENT -EG. I-TREATMENT -Los B-EXPLORATION -he-mocultivos I-EXPLORATION -resultaron I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -efectuó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -cutánea I-EXPLORATION -realizándose I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram, I-EXPLORATION -cultivo I-EXPLORATION -y I-EXPLORATION -estudio I-EXPLORATION -histopatológico. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -cocáceas I-EXPLORATION -grampositivas I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -Staphylococcus I-EXPLORATION -aureus I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -meticilina I-EXPLORATION -(SARM). I-EXPLORATION -El I-EXPLORATION -antibiograma I-EXPLORATION -mostró I-EXPLORATION -sensibilidad I-EXPLORATION -a I-EXPLORATION -vancomicina I-EXPLORATION -(concentración I-EXPLORATION -inhibitoria I-EXPLORATION -mínima I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -75 I-EXPLORATION -ug/mL), I-EXPLORATION -rifampicina I-EXPLORATION -y I-EXPLORATION -cotrimoxazol, I-EXPLORATION -y I-EXPLORATION -resistencia I-EXPLORATION -a I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -β I-EXPLORATION -lactámicos, I-EXPLORATION -clindamicina, I-EXPLORATION -ciprofloxacina I-EXPLORATION -y I-EXPLORATION -eritromicina. I-EXPLORATION -Se B-TREATMENT -ajustó I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antibacteriano I-TREATMENT -adicionándose I-TREATMENT -vancomicina I-TREATMENT -i.v. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -EG, I-EXPLORATION -evidenciándose I-EXPLORATION -una I-EXPLORATION -inflamación I-EXPLORATION -dérmica I-EXPLORATION -supurativa I-EXPLORATION -y I-EXPLORATION -necrosante I-EXPLORATION -con I-EXPLORATION -vasculitis I-EXPLORATION -neutrofílica. I-EXPLORATION - I-EXPLORATION -Evolucionó B-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -favorable, I-EVOLUTION -con I-EVOLUTION -lesiones I-EVOLUTION -costrosas I-EVOLUTION -no I-EVOLUTION -exudativas, I-EVOLUTION -afebril I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -descenso I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -inflamatorios. I-EVOLUTION -Sin I-EVOLUTION -embargo, I-EVOLUTION -durante I-EVOLUTION -su I-EVOLUTION -estadía I-EVOLUTION -hospitalaria I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -necrosis I-EVOLUTION -del I-EVOLUTION -segundo I-EVOLUTION -ortejo I-EVOLUTION -del I-EVOLUTION -pie I-EVOLUTION -izquierdo I-EVOLUTION -realizándose B-TREATMENT -una I-TREATMENT -amputación I-TREATMENT -transmetatarsiana I-TREATMENT -que I-TREATMENT -obligó I-TREATMENT -a I-TREATMENT -prolongar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antibacteriano I-TREATMENT -con I-TREATMENT -vancomicina I-TREATMENT -y I-TREATMENT -piperacilina/tazobactam I-TREATMENT -por I-TREATMENT -30 I-TREATMENT -días. I-TREATMENT -Tras I-TREATMENT -una I-TREATMENT -semana I-TREATMENT -de I-TREATMENT -cotrimoxazol I-TREATMENT -oral, I-TREATMENT -la B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -en I-EVOLUTION -buenas I-EVOLUTION -condiciones I-EVOLUTION -generales, I-EVOLUTION -afebril I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -resolución I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -cutáneas. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -radiculo-patía I-PAST_MEDICAL_HISTORY -lumbar I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -trastorno I-PAST_MEDICAL_HISTORY -depresivo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -carbamazepina I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -clomipramina I-PAST_MEDICAL_HISTORY -iniciado I-PAST_MEDICAL_HISTORY -seis I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -ingreso. I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -siete I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -°C I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -calofríos, I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -intensa, I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -principalmente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS -A B-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -estaba I-EXPLORATION -lúcido, I-EXPLORATION -febril, I-EXPLORATION -taquicárdico I-EXPLORATION -e I-EXPLORATION -hipertenso. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -facial, I-EXPLORATION -sin I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -oral, I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -púrpura I-EXPLORATION -no I-EXPLORATION -palpable I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -parte I-EXPLORATION -superior I-EXPLORATION -del I-EXPLORATION -tórax, I-EXPLORATION -con I-EXPLORATION -sensibilidad I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hipocondrio I-EXPLORATION -derecho, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -ade-nopatías I-EXPLORATION -cervicales, I-EXPLORATION -axilares I-EXPLORATION -o I-EXPLORATION -inguinales I-EXPLORATION -palpables. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -con I-EXPLORATION -discreto I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -eosinófilos I-EXPLORATION -(6% I-EXPLORATION -de I-EXPLORATION -3.300 I-EXPLORATION -leucocitos) I-EXPLORATION -y I-EXPLORATION -escasos I-EXPLORATION -linfocitos I-EXPLORATION -atípicos I-EXPLORATION -(menos I-EXPLORATION -de I-EXPLORATION -1%), I-EXPLORATION -creatinina I-EXPLORATION -1 I-EXPLORATION -mg/dL, I-EXPLORATION -LDH I-EXPLORATION -172 I-EXPLORATION -U/L, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -pruebas I-EXPLORATION -hepáticas I-EXPLORATION -con I-EXPLORATION -patrón I-EXPLORATION -mixto I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -colestásico I-EXPLORATION -(GPT: I-EXPLORATION -215 I-EXPLORATION -U/L, I-EXPLORATION -GOT: I-EXPLORATION -64 I-EXPLORATION -U/L, I-EXPLORATION -GGT: I-EXPLORATION -598 I-EXPLORATION -U/L, I-EXPLORATION -FA: I-EXPLORATION -257 I-EXPLORATION -U/L, I-EXPLORATION -bilirrubina I-EXPLORATION -total: I-EXPLORATION -0, I-EXPLORATION -72 I-EXPLORATION -mg/dL, I-EXPLORATION -INR: I-EXPLORATION -1, I-EXPLORATION -5) I-EXPLORATION -y I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva: I-EXPLORATION -22, I-EXPLORATION -2 I-EXPLORATION -mg/dL I-EXPLORATION -(Valor I-EXPLORATION -normal I-EXPLORATION -< I-EXPLORATION -0, I-EXPLORATION -5). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -hepato-esplenomegalia I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -hiperecogenicidad I-EXPLORATION -de I-EXPLORATION -espacios I-EXPLORATION -portales. I-EXPLORATION -Una I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computada I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis I-EXPLORATION -corroboró I-EXPLORATION -la I-EXPLORATION -hepato-esplenomegalia I-EXPLORATION -y I-EXPLORATION -evidenció I-EXPLORATION -adenopatías I-EXPLORATION -peri-portales. I-EXPLORATION -Se I-EXPLORATION -ingresó I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -hepatitis I-EXPLORATION -en I-EXPLORATION -estudio; I-EXPLORATION -probablemente I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -medicamentos I-EXPLORATION -o I-EXPLORATION -de I-EXPLORATION -etiología I-EXPLORATION -infecciosa. I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -un I-EXPLORATION -extenso I-EXPLORATION -estudio I-EXPLORATION -etiológico. I-EXPLORATION -Los I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -urocultivo I-EXPLORATION -resultaron I-EXPLORATION -negativos. I-EXPLORATION -Las I-EXPLORATION -serologías I-EXPLORATION -IgM I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -hepatitis I-EXPLORATION -A, I-EXPLORATION -antígeno I-EXPLORATION -de I-EXPLORATION -superficie I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -hepatitis I-EXPLORATION -B, I-EXPLORATION -anticuerpos I-EXPLORATION -de I-EXPLORATION -virus I-EXPLORATION -hepatitis I-EXPLORATION -C, I-EXPLORATION -IgM I-EXPLORATION -VCA I-EXPLORATION -de I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -Epstein I-EXPLORATION -Barr I-EXPLORATION -(VEB), I-EXPLORATION -citomegalovirus I-EXPLORATION -y I-EXPLORATION -VIH, I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Se I-EXPLORATION -complementó I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -RPR, I-EXPLORATION -IgM I-EXPLORATION -Toxoplasma I-EXPLORATION -gondii, I-EXPLORATION -IgM I-EXPLORATION -e I-EXPLORATION -IgG I-EXPLORATION -Leptospira I-EXPLORATION -spp., I-EXPLORATION -IgM I-EXPLORATION -sarampión, I-EXPLORATION -reacción I-EXPLORATION -de I-EXPLORATION -aglutinación I-EXPLORATION -para I-EXPLORATION -Brucella I-EXPLORATION -abortus/melitensis, I-EXPLORATION -IgG I-EXPLORATION -Brucella I-EXPLORATION -canis, I-EXPLORATION -IgG I-EXPLORATION -Bartonella I-EXPLORATION -hensenlae, I-EXPLORATION -IgG I-EXPLORATION -e I-EXPLORATION -IgM I-EXPLORATION -Borrelia I-EXPLORATION -burgorferi, I-EXPLORATION -IgM I-EXPLORATION -Myco-plasma I-EXPLORATION -pneumoniae I-EXPLORATION -fueron I-EXPLORATION -todas I-EXPLORATION -negativas. I-EXPLORATION -Además I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -panel I-EXPLORATION -molecular I-EXPLORATION -de I-EXPLORATION -virus I-EXPLORATION -respiratorios I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -negativo. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -reumatológico I-EXPLORATION -con I-EXPLORATION -anticuerpos I-EXPLORATION -anti-nucleares, I-EXPLORATION -anti-citoplasmáticos, I-EXPLORATION -anti-músculo I-EXPLORATION -liso, I-EXPLORATION -anti-mitocondriales, I-EXPLORATION -anti-endomisio, I-EXPLORATION -factor I-EXPLORATION -reumatoideo, I-EXPLORATION -y I-EXPLORATION -antitransglutaminasa I-EXPLORATION -tisular I-EXPLORATION -resultó I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -estabilidad I-EVOLUTION -clínica, I-EVOLUTION -sin I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -insuficiencia I-EVOLUTION -hepática, I-EVOLUTION -pero I-EVOLUTION -con I-EVOLUTION -fiebre I-EVOLUTION -persistente I-EVOLUTION -y I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -cefalea I-EVOLUTION -y I-EVOLUTION -un I-EVOLUTION -exantema I-EVOLUTION -máculo-papular I-EVOLUTION -morbiliforme I-EVOLUTION -de I-EVOLUTION -predominio I-EVOLUTION -perifolicular, I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -cara I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -cuello, I-EVOLUTION -con I-EVOLUTION -posterior I-EVOLUTION -extensión I-EVOLUTION -hacia I-EVOLUTION -el I-EVOLUTION -tórax, I-EVOLUTION -dorso, I-EVOLUTION -abdomen I-EVOLUTION -y I-EVOLUTION -extremidades, I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -púrpura I-EVOLUTION -no I-EVOLUTION -palpable I-EVOLUTION -en I-EVOLUTION -extremidades I-EVOLUTION -inferiores. I-EVOLUTION -Dado B-EXPLORATION -que I-EXPLORATION -durante I-EXPLORATION -su I-EXPLORATION -evolución I-EXPLORATION -la I-EXPLORATION -cefalea I-EXPLORATION -se I-EXPLORATION -fue I-EXPLORATION -intensificando, I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -punción I-EXPLORATION -lumbar, I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -dio I-EXPLORATION -salida I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -líquido I-EXPLORATION -cefalo-raquídeo I-EXPLORATION -(LCR) I-EXPLORATION -incoloro, I-EXPLORATION -transparente, I-EXPLORATION -en I-EXPLORATION -cuyo I-EXPLORATION -análisis I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -30 I-EXPLORATION -células/mm3, I-EXPLORATION -100% I-EXPLORATION -mononucleares, I-EXPLORATION -con I-EXPLORATION -glucosa I-EXPLORATION -y I-EXPLORATION -proteínas I-EXPLORATION -normales, I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -sin I-EXPLORATION -bacterias I-EXPLORATION -y I-EXPLORATION -látex I-EXPLORATION -bacteriano I-EXPLORATION -negativo. I-EXPLORATION -El I-EXPLORATION -cultivo I-EXPLORATION -corriente I-EXPLORATION -también I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -reacción I-EXPLORATION -de I-EXPLORATION -polimerasa I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -(RPC) I-EXPLORATION -en I-EXPLORATION -LCR I-EXPLORATION -para I-EXPLORATION -enterovirus, I-EXPLORATION -virus I-EXPLORATION -herpes I-EXPLORATION -simplex I-EXPLORATION -1-2 I-EXPLORATION -y I-EXPLORATION -virus I-EXPLORATION -varicela I-EXPLORATION -zoster I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Con I-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -realizar I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -RPC I-EXPLORATION -cualitativa I-EXPLORATION -para I-EXPLORATION -VHH-6 I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -LCR, I-EXPLORATION -que I-EXPLORATION -resultaron I-EXPLORATION -ambas I-EXPLORATION -positivas I-EXPLORATION -para I-EXPLORATION -VHH-6. I-EXPLORATION -Para I-EXPLORATION -completar I-EXPLORATION -el I-EXPLORATION -estudio, I-EXPLORATION -se I-EXPLORATION -tomaron I-EXPLORATION -biopsias I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -cutáneas. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -demostró I-EXPLORATION -una I-EXPLORATION -dermatitis I-EXPLORATION -perivascular I-EXPLORATION -superficial I-EXPLORATION -y I-EXPLORATION -perifolicular I-EXPLORATION -liquenoide I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -eosinófilos, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -reacción I-EXPLORATION -adversa I-EXPLORATION -a I-EXPLORATION -medicamentos. I-EXPLORATION -Dada I-EXPLORATION -la I-EXPLORATION -presentación I-EXPLORATION -clínica, I-EXPLORATION -hallazgos I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -antecedente I-EXPLORATION -de I-EXPLORATION -uso I-EXPLORATION -reciente I-EXPLORATION -de I-EXPLORATION -carbamazepina, I-EXPLORATION -fármaco I-EXPLORATION -frecuentemente I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -cuadros I-EXPLORATION -de I-EXPLORATION -hipersensibilidad, I-EXPLORATION -se I-EXPLORATION -estableció I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -síndrome I-EXPLORATION -DRESS I-EXPLORATION -en I-EXPLORATION -concomitancia I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -meningoencefalitis I-EXPLORATION -aguda I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -infección I-EXPLORATION -por I-EXPLORATION -VHH-6. I-EXPLORATION -En I-EXPLORATION -este I-EXPLORATION -caso I-EXPLORATION -se I-EXPLORATION -estableció I-EXPLORATION -un I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo I-EXPLORATION -de I-EXPLORATION -DRESS I-EXPLORATION -de I-EXPLORATION -acuerdo I-EXPLORATION -a I-EXPLORATION -criterios I-EXPLORATION -RegiSCAR I-EXPLORATION -y I-EXPLORATION -DRESS I-EXPLORATION -atípico I-EXPLORATION -según I-EXPLORATION -criterios I-EXPLORATION -JSCAR. I-EXPLORATION -Tras B-EVOLUTION -la I-EVOLUTION -suspensión I-EVOLUTION -del I-EVOLUTION -fármaco I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -espontáneamente I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -desaparición I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cefalea. I-EVOLUTION -El B-TREATMENT -compromiso I-TREATMENT -cutáneo I-TREATMENT -disminuyó I-TREATMENT -con I-TREATMENT -el I-TREATMENT -uso I-TREATMENT -de I-TREATMENT -hidrocortisona I-TREATMENT -tópica, I-TREATMENT -sin I-TREATMENT -requerir I-TREATMENT -corticoesteroides I-TREATMENT -sistémicos. I-TREATMENT -Los B-EVOLUTION -exámenes I-EVOLUTION -de I-EVOLUTION -laboratorio I-EVOLUTION -fueron I-EVOLUTION -mejorando I-EVOLUTION -gradualmente, I-EVOLUTION -llegando I-EVOLUTION -a I-EVOLUTION -tener I-EVOLUTION -pruebas I-EVOLUTION -hepáticas I-EVOLUTION -normales I-EVOLUTION -al I-EVOLUTION -mes I-EVOLUTION -y I-EVOLUTION -medio I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -cuadro. I-EVOLUTION -No I-EVOLUTION -se I-EVOLUTION -encontró I-EVOLUTION -eosinofilia I-EVOLUTION -ni I-EVOLUTION -linfoci-tosis I-EVOLUTION -atípica I-EVOLUTION -> I-EVOLUTION -5%. I-EVOLUTION -Debido B-TREATMENT -a I-TREATMENT -su I-TREATMENT -buena I-TREATMENT -evolución I-TREATMENT -y I-TREATMENT -siendo I-TREATMENT -inmunocompetente I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -no I-TREATMENT -dar I-TREATMENT -tratamiento I-TREATMENT -antiviral, I-TREATMENT -siendo B-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -tras I-EVOLUTION -nueve I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -para I-EVOLUTION -ser I-EVOLUTION -observado I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -ambulatoria. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -alta, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -ha I-EVOLUTION -permanecido I-EVOLUTION -estable, I-EVOLUTION -sin I-EVOLUTION -recurrencia I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -síntomas. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -25 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -residente I-PRESENT_ILLNESS -en B-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -provincia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Buenos I-PAST_MEDICAL_HISTORY -Aires, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -paludismo I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -viaje I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -amazónica I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Bolivia, I-PAST_MEDICAL_HISTORY -Perú, I-PAST_MEDICAL_HISTORY -Ecuador I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -Brasil, I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -mefloquina I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -otra I-PAST_MEDICAL_HISTORY -institución. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -regresó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -área I-PAST_MEDICAL_HISTORY -endémica. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Tres B-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -completado I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -un I-EXPLORATION -peso I-EXPLORATION -corporal I-EXPLORATION -de I-EXPLORATION -72 I-EXPLORATION -kg, I-EXPLORATION -palidez I-EXPLORATION -generalizada I-EXPLORATION -y I-EXPLORATION -esplenomegalia I-EXPLORATION -leve. I-EXPLORATION -Entre I-EXPLORATION -los I-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -14.300/mm3 I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -fórmula I-EXPLORATION -leucocitaria I-EXPLORATION -conservada, I-EXPLORATION -plaquetas I-EXPLORATION -84.000/mm3. I-EXPLORATION -La I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION -y I-EXPLORATION -hepática I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -frotis I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -periférica I-EXPLORATION -(FSP) I-EXPLORATION -observándose I-EXPLORATION -trofozoítos I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -P. I-EXPLORATION -vivax, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -parasitemia I-EXPLORATION -< I-EXPLORATION -2%. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -fue I-EXPLORATION -realizado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Laboratorio I-EXPLORATION -de I-EXPLORATION -Referencia I-EXPLORATION -en I-EXPLORATION -Parasitología I-EXPLORATION -del I-EXPLORATION -Hospital I-EXPLORATION -de I-EXPLORATION -Enfermedades I-EXPLORATION -Infecciosas I-EXPLORATION -"Francisco I-EXPLORATION -J. I-EXPLORATION -Muñiz". I-EXPLORATION -Recibió B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -cloroquina I-TREATMENT -(CQ) I-TREATMENT -1.500 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -dosis I-TREATMENT -total, I-TREATMENT -constatándose B-EVOLUTION -una I-EVOLUTION -remisión I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -parasitemia I-EVOLUTION -negativa I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -h. I-EVOLUTION -El B-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -glucosa-6-fosfato I-EXPLORATION -deshidrogenasa I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -266 I-EXPLORATION -mg/dl I-EXPLORATION -(rango I-EXPLORATION -normal), I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -recibió I-EXPLORATION -PQ I-EXPLORATION -15 I-EXPLORATION -mg I-EXPLORATION -al I-EXPLORATION -día I-EXPLORATION -durante I-EXPLORATION -15 I-EXPLORATION -días, I-EXPLORATION -con I-EXPLORATION -buena I-EXPLORATION -adherencia. I-EXPLORATION -Se B-EVOLUTION -realizaron I-EVOLUTION -parasitemias I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -primera I-EVOLUTION -y I-EVOLUTION -cuarta I-EVOLUTION -semana I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -resultando I-EVOLUTION -negativas. I-EVOLUTION - I-EVOLUTION -Posteriormente I-EVOLUTION -presentó I-EVOLUTION -dos I-EVOLUTION -nuevos I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -recaída I-EVOLUTION -por I-EVOLUTION -P. I-EVOLUTION -vivax. I-EVOLUTION -Siete I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -consultó I-EVOLUTION -por I-EVOLUTION -fiebre I-EVOLUTION -de I-EVOLUTION -cuatro I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -asociada I-EVOLUTION -a I-EVOLUTION -calofríos, I-EVOLUTION -cefalea I-EVOLUTION -holocraneana, I-EVOLUTION -artralgias I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -abdominal. I-EVOLUTION -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -palidez I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -mucosas, I-EXPLORATION -ictericia I-EXPLORATION -en I-EXPLORATION -conjuntivas I-EXPLORATION -y I-EXPLORATION -petequias I-EXPLORATION -en I-EXPLORATION -miembros I-EXPLORATION -inferiores. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -y I-EXPLORATION -recuento I-EXPLORATION -plaquetario I-EXPLORATION -normales, I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -bilirrubina I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -5 I-EXPLORATION -mg/dl I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -indirecto. I-EXPLORATION -El I-EXPLORATION -FSP I-EXPLORATION -informó I-EXPLORATION -una I-EXPLORATION -parasitemia I-EXPLORATION -< I-EXPLORATION -2%. I-EXPLORATION -Completó B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -CQ I-TREATMENT -1.500 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -dosis I-TREATMENT -total I-TREATMENT -y I-TREATMENT -PQ I-TREATMENT -30 I-TREATMENT -mg I-TREATMENT -al I-TREATMENT -día I-TREATMENT -durante I-TREATMENT -15 I-TREATMENT -días, I-TREATMENT -con B-EVOLUTION -una I-EVOLUTION -buena I-EVOLUTION -adherencia I-EVOLUTION -y I-EVOLUTION -parasitemia I-EVOLUTION -negativa I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -cuatro I-EVOLUTION -semanas. I-EVOLUTION - I-EVOLUTION -Cinco I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -consultó I-EVOLUTION -por I-EVOLUTION -presentar I-EVOLUTION -fiebre I-EVOLUTION -intermitente I-EVOLUTION -de I-EVOLUTION -dos I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -asociada I-EVOLUTION -a I-EVOLUTION -cefalea I-EVOLUTION -y I-EVOLUTION -astenia. I-EVOLUTION -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -laboratorio I-EXPLORATION -no I-EXPLORATION -presentaron I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION -Se I-EXPLORATION -constató I-EXPLORATION -una I-EXPLORATION -parasitemia I-EXPLORATION -< I-EXPLORATION -2%. I-EXPLORATION -Reinició B-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -esquema I-TREATMENT -con B-EVOLUTION -buena I-EVOLUTION -adherencia I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -parasitemia I-EVOLUTION -negativa I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -cuatro I-EVOLUTION -semanas. I-EVOLUTION -No I-EVOLUTION -presentó I-EVOLUTION -nuevas I-EVOLUTION -recaídas I-EVOLUTION -durante I-EVOLUTION -los I-EVOLUTION -15 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -83 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -procedente B-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -departamento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -San I-PAST_MEDICAL_HISTORY -Martín I-PAST_MEDICAL_HISTORY -(Amazonía I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -Perú), I-PAST_MEDICAL_HISTORY -agricultor. I-PAST_MEDICAL_HISTORY -Tenía I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -anemia I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -malaria, I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -relevancia. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -inició I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -previos I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -ingreso, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -cólico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -mesogastrio, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -falta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -apetito, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -Finalmente I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -intensificación I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -extendía I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -todo I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -abdomen, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -incoercibles, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -ausencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -eliminación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -gases I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -deposiciones. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -quejumbroso, I-EXPLORATION -taquicárdico I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -ictericia I-EXPLORATION -de I-EXPLORATION -escleras. I-EXPLORATION -La I-EXPLORATION -auscultación I-EXPLORATION -reveló I-EXPLORATION -ruidos I-EXPLORATION -cardíacos I-EXPLORATION -arrítmicos, I-EXPLORATION -de I-EXPLORATION -intensidad I-EXPLORATION -normal. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -abdominal I-EXPLORATION -los I-EXPLORATION -ruidos I-EXPLORATION -hidroaéreos I-EXPLORATION -estaban I-EXPLORATION -disminuidos, I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -blanda, I-EXPLORATION -depresible I-EXPLORATION -y I-EXPLORATION -dolorosa I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -difusa. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -visceromegalia. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -fue I-EXPLORATION -considerado I-EXPLORATION -no I-EXPLORATION -contributorio. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -posible I-EXPLORATION -obstrucción I-EXPLORATION -intestinal, I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -pie I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -asas I-EXPLORATION -intestinales I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -múltiples I-EXPLORATION -niveles I-EXPLORATION -hidroaéreos. I-EXPLORATION - I-EXPLORATION -Entre I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -con I-EXPLORATION -hemoglobina I-EXPLORATION -15, I-EXPLORATION -3 I-EXPLORATION -g/dL, I-EXPLORATION -hematocrito I-EXPLORATION -44%, I-EXPLORATION -11.570 I-EXPLORATION -leucocitos/mm3, I-EXPLORATION -segmentados I-EXPLORATION -81%, I-EXPLORATION -sin I-EXPLORATION -baciliformes I-EXPLORATION -ni I-EXPLORATION -eosinófilos, I-EXPLORATION -PCR I-EXPLORATION -de I-EXPLORATION -386 I-EXPLORATION -mg/L, I-EXPLORATION -hiperbilirrubinemia I-EXPLORATION -directa I-EXPLORATION -(bilirrubina I-EXPLORATION -total I-EXPLORATION -3, I-EXPLORATION -3 I-EXPLORATION -mg/dL I-EXPLORATION -y I-EXPLORATION -bilirrubina I-EXPLORATION -directa I-EXPLORATION -2, I-EXPLORATION -7 I-EXPLORATION -mg/dL), I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -GGT I-EXPLORATION -181 I-EXPLORATION -U/L I-EXPLORATION -(GOT I-EXPLORATION -y I-EXPLORATION -GPT I-EXPLORATION -normales), I-EXPLORATION -hipoalbuminemia I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -4 I-EXPLORATION -g/dL, I-EXPLORATION -y I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -urea: I-EXPLORATION -61 I-EXPLORATION -mg/dL I-EXPLORATION -y I-EXPLORATION -creatinina: I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -mg/dL. I-EXPLORATION -Las I-EXPLORATION -serologías I-EXPLORATION -para I-EXPLORATION -VIH, I-EXPLORATION -HTLV I-EXPLORATION -1-2 I-EXPLORATION -y I-EXPLORATION -VHC I-EXPLORATION -fueron I-EXPLORATION -negativas. I-EXPLORATION -El I-EXPLORATION -HBsAg I-EXPLORATION -y I-EXPLORATION -RPR I-EXPLORATION -también I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -laparotomía I-EXPLORATION -exploratoria I-EXPLORATION -de I-EXPLORATION -urgencia I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -probable I-EXPLORATION -obstrucción I-EXPLORATION -intestinal I-EXPLORATION -mecánica. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -intraoperatorios I-EXPLORATION -mostraron I-EXPLORATION -una I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -asas I-EXPLORATION -del I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -que I-EXPLORATION -demarcaban I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -superficie I-EXPLORATION -formas I-EXPLORATION -lineares I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -ejemplares I-EXPLORATION -de I-EXPLORATION -A. I-EXPLORATION -lumbricoides. I-EXPLORATION -En B-TREATMENT -ese I-TREATMENT -momento I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -el I-TREATMENT -manejo I-TREATMENT -médico, I-TREATMENT -procediendo I-TREATMENT -al I-TREATMENT -cierre I-TREATMENT -de I-TREATMENT -la I-TREATMENT -pared I-TREATMENT -abdominal. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -posquirúrgica I-EVOLUTION -fue I-EVOLUTION -desfavorable. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -hacia I-EVOLUTION -un I-EVOLUTION -shock I-EVOLUTION -hipovolémico, I-EVOLUTION -observándose I-EVOLUTION -la I-EVOLUTION -salida I-EVOLUTION -espontánea I-EVOLUTION -y I-EVOLUTION -masiva I-EVOLUTION -de I-EVOLUTION -gusanos I-EVOLUTION -adultos I-EVOLUTION -a I-EVOLUTION -través I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cavidad I-EVOLUTION -oral I-EVOLUTION -y I-EVOLUTION -fosas I-EVOLUTION -nasales. I-EVOLUTION -Se B-TREATMENT -decidió I-TREATMENT -una I-TREATMENT -re-intervención I-TREATMENT -quirúrgica I-TREATMENT -de I-TREATMENT -urgencia, I-TREATMENT -en I-TREATMENT -que I-TREATMENT -se I-TREATMENT -evidenció I-TREATMENT -una I-TREATMENT -gran I-TREATMENT -dilatación I-TREATMENT -de I-TREATMENT -asas I-TREATMENT -intestinales, I-TREATMENT -con I-TREATMENT -abundante I-TREATMENT -cantidad I-TREATMENT -de I-TREATMENT -ejemplares I-TREATMENT -adultos, I-TREATMENT -con I-TREATMENT -múltiples I-TREATMENT -zonas I-TREATMENT -de I-TREATMENT -aglomeración I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -de I-TREATMENT -ovillos, I-TREATMENT -que I-TREATMENT -obstruían I-TREATMENT -la I-TREATMENT -totalidad I-TREATMENT -del I-TREATMENT -lumen I-TREATMENT -intestinal. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -enterotomía I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -del I-TREATMENT -íleon, I-TREATMENT -a I-TREATMENT -40 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -la I-TREATMENT -válvula I-TREATMENT -ileocecal, I-TREATMENT -con I-TREATMENT -extracción I-TREATMENT -de I-TREATMENT -20 I-TREATMENT -gusanos. I-TREATMENT -Se I-TREATMENT -ordeñaron I-TREATMENT -las I-TREATMENT -asas I-TREATMENT -intestinales, I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -ángulo I-TREATMENT -de I-TREATMENT -Treitz I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -enterotomía, I-TREATMENT -eliminando I-TREATMENT -abundante I-TREATMENT -cantidad I-TREATMENT -de I-TREATMENT -deposiciones I-TREATMENT -con I-TREATMENT -parásitos. I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -cavidad I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -líquido I-EXPLORATION -seroso I-EXPLORATION -claro. I-EXPLORATION -El I-EXPLORATION -apéndice I-EXPLORATION -cecal I-EXPLORATION -y I-EXPLORATION -vesícula I-EXPLORATION -biliar I-EXPLORATION -eran I-EXPLORATION -de I-EXPLORATION -características I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Luego B-TREATMENT -de I-TREATMENT -la I-TREATMENT -primera I-TREATMENT -cirugía, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antiparasitario I-TREATMENT -con I-TREATMENT -albendazol. I-TREATMENT -Sin B-EVOLUTION -embargo, I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -fue I-EVOLUTION -insatisfactoria, I-EVOLUTION -requiriendo I-EVOLUTION -luego I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -segunda I-EVOLUTION -intervención I-EVOLUTION -quirúrgica, I-EVOLUTION -soporte I-EVOLUTION -ventilatorio I-EVOLUTION -y I-EVOLUTION -manejo I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -Unidad I-EVOLUTION -de I-EVOLUTION -Cuidados I-EVOLUTION -Intensivos I-EVOLUTION -(UCI). I-EVOLUTION -Durante B-EXPLORATION -su I-EXPLORATION -estadía I-EXPLORATION -en I-EXPLORATION -UCI, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -cursó I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -neumonía I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -ventilador I-EXPLORATION -mecánico I-EXPLORATION -por I-EXPLORATION -Pseudomonas I-EXPLORATION -aeru-ginosa I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -bacteriemia I-EXPLORATION -por I-EXPLORATION -Acinetobacter I-EXPLORATION -baumannii I-EXPLORATION -multiresistentes. I-EXPLORATION -La B-EVOLUTION -eliminación I-EVOLUTION -de I-EVOLUTION -gusanos I-EVOLUTION -adultos I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -cavidad I-EVOLUTION -oral I-EVOLUTION -continuó I-EVOLUTION -hasta I-EVOLUTION -varios I-EVOLUTION -días I-EVOLUTION -posteriores I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -última I-EVOLUTION -cirugía. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -residente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -área I-PRESENT_ILLNESS -urbana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Santiago I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Cali I-PRESENT_ILLNESS -(Valle I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Cauca, I-PRESENT_ILLNESS -Colombia), I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -estrato I-PRESENT_ILLNESS -socioeconómico I-PRESENT_ILLNESS -bajo, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -ocupación I-PRESENT_ILLNESS -"vendedora I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dulces" I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -calle. I-PRESENT_ILLNESS -Tenía B-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -gastritis I-PAST_MEDICAL_HISTORY -crónica, I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -desnutrición I-PAST_MEDICAL_HISTORY -grave, I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -embarazos I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -hijos I-PAST_MEDICAL_HISTORY -vivos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ligadura I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -trompas I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -16 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -tabaquismo. I-PAST_MEDICAL_HISTORY -Presentaba I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -hábito I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ingerir I-PAST_MEDICAL_HISTORY -agua I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -potable. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -inició I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -hospitalario, I-PRESENT_ILLNESS -consistente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -mesogastrio, I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -adinamia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -extremidades I-PRESENT_ILLNESS -inferiores, I-PRESENT_ILLNESS -evolucionando I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -fétida, I-PRESENT_ILLNESS -emesis, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -apetito I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -hemoptoica. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -salud I-PRESENT_ILLNESS -periférico I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -evidenciaron I-PRESENT_ILLNESS -larvas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -S. I-PRESENT_ILLNESS -stercolaris I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -examen I-PRESENT_ILLNESS -directo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -solución I-PRESENT_ILLNESS -salina I-PRESENT_ILLNESS -fisiológica I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -0, I-PRESENT_ILLNESS -9% I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -lugol. I-PRESENT_ILLNESS -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -médico I-TREATMENT -con I-TREATMENT -ivermectina I-TREATMENT -durante I-TREATMENT -dos I-TREATMENT -días I-TREATMENT -(200 I-TREATMENT -μg/kg/día) I-TREATMENT -y I-TREATMENT -albendazol I-TREATMENT -(400 I-TREATMENT -mg/día). I-TREATMENT -Entre B-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -albúmina I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -g/dL, I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION -negativa I-EXPLORATION -y I-EXPLORATION -para I-EXPLORATION -HTLV I-EXPLORATION -I-II I-EXPLORATION -positiva. I-EXPLORATION -La I-EXPLORATION -TSH I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -normal. I-EXPLORATION -Siete I-EXPLORATION -días I-EXPLORATION -después I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -remitió I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -Unidad I-EXPLORATION -de I-EXPLORATION -Cuidados I-EXPLORATION -Intensivos I-EXPLORATION -(UCI) I-EXPLORATION -extrainstitucional I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -cuadro I-EXPLORATION -de I-EXPLORATION -dificultad I-EXPLORATION -respiratoria. I-EXPLORATION -Los I-EXPLORATION -diagnósticos I-EXPLORATION -presuntivos I-EXPLORATION -fueron I-EXPLORATION -un I-EXPLORATION -trombo-embolismo I-EXPLORATION -pulmonar I-EXPLORATION -(TEP), I-EXPLORATION -un I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -Lóeffler I-EXPLORATION -o I-EXPLORATION -una I-EXPLORATION -neumonía I-EXPLORATION -bacteriana. I-EXPLORATION - I-EXPLORATION -Ingresó B-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -UCI I-EVOLUTION -consciente, I-EVOLUTION -con I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -dificultad I-EVOLUTION -respiratoria, I-EVOLUTION -taquicárdica, I-EVOLUTION -afebril, I-EVOLUTION -con I-EVOLUTION -saturación I-EVOLUTION -arterial I-EVOLUTION -de I-EVOLUTION -oxígeno I-EVOLUTION -(SaO2) I-EVOLUTION -por I-EVOLUTION -oximetría I-EVOLUTION -de I-EVOLUTION -pulso I-EVOLUTION -de I-EVOLUTION -87%, I-EVOLUTION -con I-EVOLUTION -soporte I-EVOLUTION -de I-EVOLUTION -oxígeno I-EVOLUTION -(FiO2 I-EVOLUTION -50%). I-EVOLUTION -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -destacaba I-EXPLORATION -estertores I-EXPLORATION -finos I-EXPLORATION -pulmonares I-EXPLORATION -bibasales, I-EXPLORATION -abdomen I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal, I-EXPLORATION -edema I-EXPLORATION -grado I-EXPLORATION -III I-EXPLORATION -en I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -y, I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -lesiones I-EXPLORATION -eritematosas, I-EXPLORATION -pruriginosas, I-EXPLORATION -no I-EXPLORATION -descamativas I-EXPLORATION -en I-EXPLORATION -piel, I-EXPLORATION -predominantemente I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -muslos. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -evidenciaban I-EXPLORATION -leucocitos I-EXPLORATION -de I-EXPLORATION -26.200/mm3, I-EXPLORATION -hemoglobina I-EXPLORATION -9, I-EXPLORATION -1 I-EXPLORATION -g/dL, I-EXPLORATION -neutrófilos I-EXPLORATION -86%, I-EXPLORATION -eosinófilos I-EXPLORATION -2%, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -(PCR) I-EXPLORATION -18 I-EXPLORATION -mg/dL, I-EXPLORATION -electrolitos I-EXPLORATION -y I-EXPLORATION -creatinina I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -rangos I-EXPLORATION -normales, I-EXPLORATION -hipoxemia I-EXPLORATION -grave I-EXPLORATION -sin I-EXPLORATION -trastorno I-EXPLORATION -ácido-base. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -mostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -infiltrados I-EXPLORATION -mixtos I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -alveolar I-EXPLORATION -de I-EXPLORATION -distribución I-EXPLORATION -difusa. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -dificultad I-EVOLUTION -respiratoria I-EVOLUTION -progresiva, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -requirió I-TREATMENT -finalmente I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -invasora, I-TREATMENT -sin I-TREATMENT -necesidad I-TREATMENT -de I-TREATMENT -parámetros I-TREATMENT -ventilatorios I-TREATMENT -altos. I-TREATMENT -Además I-TREATMENT -requirió I-TREATMENT -soporte I-TREATMENT -vasoactivo I-TREATMENT -con I-TREATMENT -norepinefrina I-TREATMENT -por I-TREATMENT -una I-TREATMENT -hipotensión I-TREATMENT -arterial I-TREATMENT -persistente. I-TREATMENT -En B-EVOLUTION -su I-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -presentó I-EVOLUTION -secreciones I-EVOLUTION -respiratorias I-EVOLUTION -hemáticas I-EVOLUTION -constantes I-EVOLUTION -con I-EVOLUTION -descenso I-EVOLUTION -significativo I-EVOLUTION - I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -hemoglobina, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -requirió I-TREATMENT -transfusión I-TREATMENT -de I-TREATMENT -glóbulos I-TREATMENT -rojos. I-TREATMENT -Ante I-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -una I-TREATMENT -neumonía I-TREATMENT -bacteriana I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -cobertura I-TREATMENT -antibacteriana I-TREATMENT -de I-TREATMENT -amplio I-TREATMENT -espectro I-TREATMENT -con I-TREATMENT -piperacilina/tazobactam. I-TREATMENT -Posteriormente B-EXPLORATION -se I-EXPLORATION -informaron I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -urocultivo I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -Escherichia I-EXPLORATION -coli I-EXPLORATION -productora I-EXPLORATION -de I-EXPLORATION -betalactamasas I-EXPLORATION -de I-EXPLORATION -espectro I-EXPLORATION -extendido I-EXPLORATION -(BLEE), I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -tratamiento I-TREATMENT -a I-TREATMENT -meropenem. I-TREATMENT -Ante B-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -estrongiloidosis I-EXPLORATION -pulmonar I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -microscopía I-EXPLORATION -en I-EXPLORATION -fresco I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -secreción I-EXPLORATION -orotraqueal, I-EXPLORATION -observándose I-EXPLORATION -larvas I-EXPLORATION -de I-EXPLORATION -S. I-EXPLORATION -stercoralis, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -administró I-TREATMENT -una I-TREATMENT -nueva I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -ivermectina I-TREATMENT -(200 I-TREATMENT -μg/kg) I-TREATMENT -y I-TREATMENT -se I-TREATMENT -continuó I-TREATMENT -con I-TREATMENT -albendazol I-TREATMENT -oral I-TREATMENT -(400 I-TREATMENT -mg, I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día). I-TREATMENT -También B-EXPLORATION -se I-EXPLORATION -descartó I-EXPLORATION -una I-EXPLORATION -tuberculosis I-EXPLORATION -pulmonar I-EXPLORATION -con I-EXPLORATION -baciloscopias I-EXPLORATION -seriadas I-EXPLORATION -negativas. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -colonoscopia, I-EXPLORATION -cuyo I-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION -fue I-EXPLORATION -una I-EXPLORATION -colitis I-EXPLORATION -crónica I-EXPLORATION -leve I-EXPLORATION -inespecífica. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -realizaron I-EXPLORATION -pruebas I-EXPLORATION -inmunológicas I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -estrongiloidosis. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -el I-TREATMENT -proceso I-TREATMENT -de I-TREATMENT -desvinculación I-TREATMENT -progresiva I-TREATMENT -del I-TREATMENT -soporte I-TREATMENT -ventilatorio, I-TREATMENT -logrando I-TREATMENT -la I-TREATMENT -extubación I-TREATMENT -al I-TREATMENT -quinto I-TREATMENT -día I-TREATMENT -de I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -invasora. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -completó I-EVOLUTION -una I-EVOLUTION -estancia I-EVOLUTION -hospitalaria I-EVOLUTION -de I-EVOLUTION -12 I-EVOLUTION -días, I-EVOLUTION -período I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -cual I-EVOLUTION -presentó I-EVOLUTION -episodios I-EVOLUTION -repetitivos I-EVOLUTION -de I-EVOLUTION -tos I-EVOLUTION -seca. I-EVOLUTION -En I-EVOLUTION -el I-EVOLUTION -seguimiento I-EVOLUTION -clínico I-EVOLUTION -el I-EVOLUTION -estudio I-EVOLUTION -coproscópico I-EVOLUTION -no I-EVOLUTION -evidenció I-EVOLUTION -parásitos I-EVOLUTION -intestinales, I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -radiografía I-EVOLUTION -de I-EVOLUTION -tórax I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -15 I-EVOLUTION -días I-EVOLUTION -evidenció I-EVOLUTION -una I-EVOLUTION -resolución I-EVOLUTION -significativa I-EVOLUTION -del I-EVOLUTION -infiltrado I-EVOLUTION -pulmonar. I-EVOLUTION -Completó B-TREATMENT -10 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -antihelmíntico I-TREATMENT -con I-TREATMENT -albendazol. I-TREATMENT -La B-EVOLUTION -hemoglobina I-EVOLUTION -de I-EVOLUTION -egreso I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -9, I-EVOLUTION -9 I-EVOLUTION -g/dL. I-EVOLUTION - I-EVOLUTION -Durante B-TREATMENT -la I-TREATMENT -permanencia I-TREATMENT -en I-TREATMENT -la I-TREATMENT -institución I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -manejo I-TREATMENT -de I-TREATMENT -fisioterapia, I-TREATMENT -donde B-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -favorable I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -condición I-EVOLUTION -cardiorrespiratoria I-EVOLUTION -y I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -funcionalidad. I-EVOLUTION - I-EVOLUTION - -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -13 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -fractura I-PAST_MEDICAL_HISTORY -triplanar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tobillo I-PAST_MEDICAL_HISTORY -derecho, I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -quirúrgicamente I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -material I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -osteosíntesis I-PAST_MEDICAL_HISTORY -(MOS) I-PAST_MEDICAL_HISTORY -retirado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -meses, I-PAST_MEDICAL_HISTORY -cuya I-PAST_MEDICAL_HISTORY -herida I-PAST_MEDICAL_HISTORY -quirúrgica I-PAST_MEDICAL_HISTORY -nunca I-PAST_MEDICAL_HISTORY -cicatrizó. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -retiro I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -MOS I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cambios I-PRESENT_ILLNESS -inflamatorios I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -tobillo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -salida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -material I-PRESENT_ILLNESS -purulento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -mal I-PRESENT_ILLNESS -olor. I-PRESENT_ILLNESS -No B-EXPLORATION -presentaba I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -respuesta I-EXPLORATION -inflamatoria I-EXPLORATION -sistémica I-EXPLORATION -y I-EXPLORATION -había I-EXPLORATION -permanecido I-EXPLORATION -afebril. I-EXPLORATION -Recibió B-TREATMENT -un I-TREATMENT -curso I-TREATMENT -de I-TREATMENT -dicloxacilina I-TREATMENT -empírica I-TREATMENT -sin I-TREATMENT -mejoría. I-TREATMENT -Por I-TREATMENT -este I-TREATMENT -motivo I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT -aseo I-TREATMENT -y I-TREATMENT -desbridamiento I-TREATMENT -quirúrgico I-TREATMENT -en I-TREATMENT -el I-TREATMENT -que I-TREATMENT -se I-TREATMENT -encontró I-TREATMENT -un I-TREATMENT -defecto I-TREATMENT -de I-TREATMENT -continuidad I-TREATMENT -de I-TREATMENT -aproximadamente I-TREATMENT -2, I-TREATMENT -5 I-TREATMENT -cm I-TREATMENT -x I-TREATMENT -1, I-TREATMENT -5 I-TREATMENT -cm I-TREATMENT -en I-TREATMENT -la I-TREATMENT -región I-TREATMENT -maleolar I-TREATMENT -medial, I-TREATMENT -con I-TREATMENT -drenaje I-TREATMENT -de I-TREATMENT -un I-TREATMENT -material I-TREATMENT -óseo I-TREATMENT -friable I-TREATMENT -y I-TREATMENT -necrótico. I-TREATMENT -Se B-EXPLORATION -tomaron I-EXPLORATION -muestras I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -para I-EXPLORATION -cultivo I-EXPLORATION -y B-TREATMENT -se I-TREATMENT -inició I-TREATMENT -cefazolina I-TREATMENT -intravenosa I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -empírica. I-TREATMENT -La B-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -mostró I-EXPLORATION -bacilos I-EXPLORATION -grampositivos I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -demostró I-EXPLORATION -crecimiento I-EXPLORATION -de I-EXPLORATION -Bacillus I-EXPLORATION -spp., I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -considerado I-EXPLORATION -como I-EXPLORATION -contaminación I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -continuó I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -tratamiento I-EXPLORATION -prescrito. I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -persistió I-TREATMENT -con I-TREATMENT -drenaje I-TREATMENT -de I-TREATMENT -secreción I-TREATMENT -sero-hemática I-TREATMENT -por I-TREATMENT -la I-TREATMENT -herida I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -nuevo I-TREATMENT -desbridamiento I-TREATMENT -quirúrgico I-TREATMENT -y I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -la I-TREATMENT -terapia I-TREATMENT -a I-TREATMENT -clindamicina I-TREATMENT -intravenosa. I-TREATMENT -En B-EXPLORATION -las I-EXPLORATION -muestras I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -y I-EXPLORATION -hueso I-EXPLORATION -se I-EXPLORATION -obtuvo I-EXPLORATION -crecimiento I-EXPLORATION -de I-EXPLORATION -bacilos I-EXPLORATION -grampositivos I-EXPLORATION -identificados I-EXPLORATION -como I-EXPLORATION -Bacillus I-EXPLORATION -spp. I-EXPLORATION -sin I-EXPLORATION -posibilidad I-EXPLORATION -de I-EXPLORATION -identificación I-EXPLORATION -de I-EXPLORATION -especie I-EXPLORATION -ni I-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -susceptibilidad I-EXPLORATION -antimicrobiana I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -método I-EXPLORATION -disponible I-EXPLORATION -(sistema I-EXPLORATION -VITEK I-EXPLORATION -2). I-EXPLORATION -El I-EXPLORATION -antibiograma I-EXPLORATION -realizado I-EXPLORATION -por I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -Kirby I-EXPLORATION -Bauer I-EXPLORATION -mostró I-EXPLORATION -resistencia I-EXPLORATION -a I-EXPLORATION -clindamicina, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -iniciar I-EXPLORATION -vancomicina I-EXPLORATION -intravenosa. I-EXPLORATION -La I-EXPLORATION -cepa I-EXPLORATION -finalmente I-EXPLORATION -fue I-EXPLORATION -identificada I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -metodología I-EXPLORATION -MALDI-TOF I-EXPLORATION -MS I-EXPLORATION -(matrix-assisted I-EXPLORATION -laser I-EXPLORATION -desorption/ionization I-EXPLORATION -time-of-flight I-EXPLORATION -mass I-EXPLORATION -spectrometry) I-EXPLORATION -como I-EXPLORATION -Corynebacterium I-EXPLORATION -striatum. I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -siete I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -vancomicina I-EVOLUTION -la I-EVOLUTION -herida I-EVOLUTION -persistía I-EVOLUTION -con I-EVOLUTION -secreción. I-EVOLUTION -La B-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -del I-EXPLORATION -tobillo I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -de I-EXPLORATION -tejidos I-EXPLORATION -blandos, I-EXPLORATION -edema I-EXPLORATION -perióseo, I-EXPLORATION -irregularidad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cortical I-EXPLORATION -del I-EXPLORATION -hueso I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -trayecto I-EXPLORATION -fistuloso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -piel. I-EXPLORATION -En B-TREATMENT -la I-TREATMENT -tercera I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -se I-TREATMENT -corrigió I-TREATMENT -la I-TREATMENT -fístula I-TREATMENT -fibrótica I-TREATMENT -y B-EXPLORATION -se I-EXPLORATION -tomaron I-EXPLORATION -nuevas I-EXPLORATION -muestras I-EXPLORATION -para I-EXPLORATION -cultivos, I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -cuales I-EXPLORATION -se I-EXPLORATION -obtuvo I-EXPLORATION -crecimiento I-EXPLORATION -del I-EXPLORATION -mismo I-EXPLORATION -microorganismo, I-EXPLORATION -identificado I-EXPLORATION -igualmente I-EXPLORATION -por I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -MALDI-TOF I-EXPLORATION -como I-EXPLORATION -Corynebacterium I-EXPLORATION -striatum. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -antibiograma I-EXPLORATION -manual I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION -susceptibilidad I-EXPLORATION -a I-EXPLORATION -vancomicina, I-EXPLORATION -linezolid, I-EXPLORATION -daptomicina I-EXPLORATION -e I-EXPLORATION -imipenem, I-EXPLORATION -y I-EXPLORATION -resistencia I-EXPLORATION -a I-EXPLORATION -clindamicina, I-EXPLORATION -cefalosporinas, I-EXPLORATION -rifampicina, I-EXPLORATION -levofloxacina I-EXPLORATION -y I-EXPLORATION -cotrimoxazol. I-EXPLORATION -Las B-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -vancomicina I-TREATMENT -se I-TREATMENT -aumentaron I-TREATMENT -hasta I-TREATMENT -alcanzar I-TREATMENT -niveles I-TREATMENT -valle I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -ug/ml. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -última I-EVOLUTION -cirugía I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -ajuste I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -dosis I-EVOLUTION -fue I-EVOLUTION -satisfactoria, I-EVOLUTION -con I-EVOLUTION -término I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -secreción I-EVOLUTION -y I-EVOLUTION -cicatrización I-EVOLUTION -completa I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -herida. I-EVOLUTION -Se B-TREATMENT -continuó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -vancomicina I-TREATMENT -por I-TREATMENT -28 I-TREATMENT -días I-TREATMENT -y I-TREATMENT -se I-TREATMENT -completó I-TREATMENT -tratamiento I-TREATMENT -ambulatorio I-TREATMENT -dos I-TREATMENT -semanas I-TREATMENT -más I-TREATMENT -con I-TREATMENT -linezolid I-TREATMENT -oral. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -evaluada I-EVOLUTION -un I-EVOLUTION -mes I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -egreso I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -herida I-EVOLUTION -quirúrgica I-EVOLUTION -se I-EVOLUTION -encontró I-EVOLUTION -completamente I-EVOLUTION -sana, I-EVOLUTION -sin I-EVOLUTION -signos I-EVOLUTION -inflamatorios I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -reactantes I-EVOLUTION -de I-EVOLUTION -fase I-EVOLUTION -aguda I-EVOLUTION -normales. I-EVOLUTION - I-EVOLUTION - -Preescolar B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -previamente B-PAST_MEDICAL_HISTORY -sana, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -calendario I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vacunación I-PAST_MEDICAL_HISTORY -PNI I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -día, I-PAST_MEDICAL_HISTORY -incluyendo I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vacuna I-PAST_MEDICAL_HISTORY -conjugada I-PAST_MEDICAL_HISTORY -ACWY-CRM197 I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -Plan I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Acción I-PAST_MEDICAL_HISTORY -W135. I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -caracterizó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -coriza I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -38, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -°C, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -mialgias I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -epistaxis. I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -oportunidades I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -SAPU, I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -indicó I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -sintomático I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -antiinflamatorio I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -esteroidal. I-PRESENT_ILLNESS -Al I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -siguiente I-PRESENT_ILLNESS -aparecieron I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -violáceas I-PRESENT_ILLNESS -puntiformes I-PRESENT_ILLNESS -generalizadas, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -llevado I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencia. I-PRESENT_ILLNESS -Ingresó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -paro I-PRESENT_ILLNESS -cardio-respiratorio, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -exantema I-PRESENT_ILLNESS -purpúrico I-PRESENT_ILLNESS -generalizado. I-PRESENT_ILLNESS -Se B-TREATMENT -inició I-TREATMENT -reanimación I-TREATMENT -con I-TREATMENT -masaje I-TREATMENT -cardíaco, I-TREATMENT -adrenalina I-TREATMENT -e I-TREATMENT -intubación I-TREATMENT -orotraqueal, I-TREATMENT -además I-TREATMENT -de I-TREATMENT -ceftriaxona I-TREATMENT -100 I-TREATMENT -mg/kg I-TREATMENT -y I-TREATMENT -vancomicina I-TREATMENT -15 I-TREATMENT -mg/kg/dosis I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -vía I-TREATMENT -intraósea. I-TREATMENT -Falleció B-EVOLUTION -a I-EVOLUTION -consecuencia I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -fibrilación I-EVOLUTION -ventricular, I-EVOLUTION -sin I-EVOLUTION -respuesta I-EVOLUTION -a I-EVOLUTION -cardioversión I-EVOLUTION -eléctrica I-EVOLUTION -y I-EVOLUTION -dosis I-EVOLUTION -sucesivas I-EVOLUTION -de I-EVOLUTION -adrenalina. I-EVOLUTION -La B-EXPLORATION -sospecha I-EXPLORATION -diagnóstica I-EXPLORATION -fue I-EXPLORATION -una I-EXPLORATION -meningococcemia I-EXPLORATION -fulminante. I-EXPLORATION -Debido I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -gravedad I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -pudo I-EXPLORATION -realizar I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -LCR. I-EXPLORATION -Los I-EXPLORATION -hemocultivos I-EXPLORATION -tomados I-EXPLORATION -durante I-EXPLORATION -la I-EXPLORATION -reanimación I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Dada I-EXPLORATION -la I-EXPLORATION -alta I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -etiología I-EXPLORATION -meningocócica, I-EXPLORATION -se I-EXPLORATION -envió I-EXPLORATION -una I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -remanente I-EXPLORATION -para I-EXPLORATION -realizar I-EXPLORATION -RPC, I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -confirmó I-EXPLORATION -N. I-EXPLORATION -meningitidis I-EXPLORATION -serogrupo I-EXPLORATION -B. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -60 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -residido I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -transitoria I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Ovalle, I-PAST_MEDICAL_HISTORY -Región I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Coquimbo, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -motivos I-PAST_MEDICAL_HISTORY -laborales I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -aproximadamente I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -además I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -parálisis I-PAST_MEDICAL_HISTORY -facial I-PAST_MEDICAL_HISTORY -periférica I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -antes. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -repetidos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -posterior I-PRESENT_ILLNESS -trastorno I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -equilibrio I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vértigo. I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso, I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -enflaquecido, I-EXPLORATION -consciente I-EXPLORATION -y I-EXPLORATION -orientado, I-EXPLORATION -sin I-EXPLORATION -otros I-EXPLORATION -hallazgos I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -general. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -neurológico I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -sin I-EXPLORATION -afasia, I-EXPLORATION -con I-EXPLORATION -prueba I-EXPLORATION -positiva I-EXPLORATION -de I-EXPLORATION -mínima I-EXPLORATION -paresia, I-EXPLORATION -dismetría I-EXPLORATION -y I-EXPLORATION -disdiadococinesia I-EXPLORATION -izquierdas. I-EXPLORATION -Entre I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -tenía I-EXPLORATION -un I-EXPLORATION -hemograma, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva, I-EXPLORATION -función I-EXPLORATION -renal, I-EXPLORATION -perfil I-EXPLORATION -hepático, I-EXPLORATION -coagulación I-EXPLORATION -y I-EXPLORATION -orina I-EXPLORATION -completa I-EXPLORATION -normales, I-EXPLORATION -salvo I-EXPLORATION -una I-EXPLORATION -albuminemia I-EXPLORATION -de I-EXPLORATION -3, I-EXPLORATION -4 I-EXPLORATION -g/dl. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -cerebral I-EXPLORATION -reveló I-EXPLORATION -un I-EXPLORATION -edema I-EXPLORATION -vasogénico I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -tipo I-EXPLORATION -masa I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -frontal I-EXPLORATION -derecho; I-EXPLORATION -y I-EXPLORATION -otra I-EXPLORATION -imagen I-EXPLORATION -parietal I-EXPLORATION -con I-EXPLORATION -impregnación I-EXPLORATION -de I-EXPLORATION -contomos I-EXPLORATION -irregulares I-EXPLORATION -al I-EXPLORATION -contraste. I-EXPLORATION -La I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -cerebral I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -al I-EXPLORATION -menos I-EXPLORATION -tres I-EXPLORATION -lesiones I-EXPLORATION -hipointensas I-EXPLORATION -con I-EXPLORATION -impregnación I-EXPLORATION -marginal I-EXPLORATION -con I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -y I-EXPLORATION -significativo I-EXPLORATION -edema I-EXPLORATION -perilesional I-EXPLORATION -de I-EXPLORATION -ubicación I-EXPLORATION -frontal, I-EXPLORATION -con I-EXPLORATION -características I-EXPLORATION -de I-EXPLORATION -granulomas, I-EXPLORATION -y I-EXPLORATION -otras I-EXPLORATION -similares I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -frontoparietal I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -fosa I-EXPLORATION -posterior I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -cerebelar I-EXPLORATION -izquierdo, I-EXPLORATION -menores I-EXPLORATION -a I-EXPLORATION -2, I-EXPLORATION -6 I-EXPLORATION -cm, I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -probable I-EXPLORATION -toxoplasmosis I-EXPLORATION -cerebral. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -segmentario I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -candidiasis I-EXPLORATION -orofaríngea I-EXPLORATION -y I-EXPLORATION -leucoplaquia I-EXPLORATION -vellosa I-EXPLORATION -y B-TREATMENT -por I-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -una I-TREATMENT -toxoplasmosis I-TREATMENT -cerebral I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -terapia I-TREATMENT -con I-TREATMENT -cotrimoxazol I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -8-10 I-TREATMENT -mg/kg/día I-TREATMENT -(en I-TREATMENT -base I-TREATMENT -a I-TREATMENT -trimetoprim), I-TREATMENT -corticoesteroides I-TREATMENT -sistémicos I-TREATMENT -(dexametasona I-TREATMENT -12-16 I-TREATMENT -mg/día) I-TREATMENT -y I-TREATMENT -fluconazol I-TREATMENT -oral I-TREATMENT -(150 I-TREATMENT -mg/día I-TREATMENT -v.o. I-TREATMENT -por I-TREATMENT -10 I-TREATMENT -días). I-TREATMENT -Las B-EXPLORATION -serologías I-EXPLORATION -por I-EXPLORATION -quimioluminiscencia I-EXPLORATION -de I-EXPLORATION -VIH I-EXPLORATION -y I-EXPLORATION -ELISA I-EXPLORATION -de I-EXPLORATION -T. I-EXPLORATION -cruzi I-EXPLORATION -resultaron I-EXPLORATION -reactivas, I-EXPLORATION -siendo I-EXPLORATION -ambas I-EXPLORATION -confirmadas I-EXPLORATION -posteriormente I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -laboratorio I-EXPLORATION -de I-EXPLORATION -referencia I-EXPLORATION -nacional I-EXPLORATION -(ELISA I-EXPLORATION -e I-EXPLORATION -IFI I-EXPLORATION -positivas I-EXPLORATION -para I-EXPLORATION -Chagas) I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -además I-EXPLORATION -serología I-EXPLORATION -positiva I-EXPLORATION -IgG I-EXPLORATION -para I-EXPLORATION -Toxoplasma I-EXPLORATION -gondii. I-EXPLORATION -Las I-EXPLORATION -serologías I-EXPLORATION -para I-EXPLORATION -sífilis, I-EXPLORATION -hepatitis I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C I-EXPLORATION -fueron I-EXPLORATION -negativas, I-EXPLORATION -sin I-EXPLORATION -detectar I-EXPLORATION -anomalías I-EXPLORATION -al I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo. I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -LCR I-EXPLORATION -no I-EXPLORATION -demostró I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -sus I-EXPLORATION -valores I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -para I-EXPLORATION -sífilis, I-EXPLORATION -bacterias, I-EXPLORATION -hongos I-EXPLORATION -y I-EXPLORATION -tuberculosis I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -hizo I-EXPLORATION -estudio I-EXPLORATION -molecular I-EXPLORATION -en I-EXPLORATION -esta I-EXPLORATION -primera I-EXPLORATION -punción I-EXPLORATION -lumbar. I-EXPLORATION -Posteriormente, I-EXPLORATION -se I-EXPLORATION -obtuvo I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -CD4 I-EXPLORATION -de I-EXPLORATION -73 I-EXPLORATION -cél/mm3 I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -VIH I-EXPLORATION -de I-EXPLORATION -54.438 I-EXPLORATION -copias/ml I-EXPLORATION -(log I-EXPLORATION -4, I-EXPLORATION -74). I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -por I-EXPLORATION -TC I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -adenopatías, I-EXPLORATION -visceromegalias I-EXPLORATION -ni I-EXPLORATION -lesiones I-EXPLORATION -residuales I-EXPLORATION -de I-EXPLORATION -tuberculosis. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -rechazo I-EVOLUTION -alimentario, I-EVOLUTION -ánimo I-EVOLUTION -bajo I-EVOLUTION -y I-EVOLUTION -labilidad I-EVOLUTION -emocional. I-EVOLUTION -Se I-EVOLUTION -diagnosticó I-EVOLUTION -un I-EVOLUTION -trastorno I-EVOLUTION -depresivo/adaptativo I-EVOLUTION -grave, I-EVOLUTION -que B-TREATMENT -se I-TREATMENT -trató I-TREATMENT -con I-TREATMENT -mirtazapina I-TREATMENT -y I-TREATMENT -olanzapina. I-TREATMENT -A I-TREATMENT -los I-TREATMENT -10 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -cotrimoxazol I-TREATMENT -y I-TREATMENT -26 I-TREATMENT -de I-TREATMENT -hospitalización I-TREATMENT -se I-TREATMENT -inicio I-TREATMENT -terapia I-TREATMENT -antiretroviral I-TREATMENT -(TARV) I-TREATMENT -con I-TREATMENT -abacavir, I-TREATMENT -lamivudina I-TREATMENT -y I-TREATMENT -raltegravir, I-TREATMENT -que I-TREATMENT -toleró I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -adecuada I-TREATMENT -y I-TREATMENT -con I-TREATMENT -estudio I-TREATMENT -previo I-TREATMENT -genotípico I-TREATMENT -para I-TREATMENT -HLA*B5701 I-TREATMENT -negativo. I-TREATMENT -Se I-TREATMENT -desestimó I-TREATMENT -el I-TREATMENT -uso I-TREATMENT -de I-TREATMENT -inhibidores I-TREATMENT -de I-TREATMENT -proteasa I-TREATMENT -por I-TREATMENT -eventuales I-TREATMENT -interacciones I-TREATMENT -con I-TREATMENT -psicofármacos I-TREATMENT -y I-TREATMENT -de I-TREATMENT -efavirenz I-TREATMENT -por I-TREATMENT -la I-TREATMENT -depresión I-TREATMENT -concurrente. I-TREATMENT -Durante B-EVOLUTION -los I-EVOLUTION -primeros I-EVOLUTION -días I-EVOLUTION -del I-EVOLUTION -inicio I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -TARV I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -diplopía, I-EVOLUTION -nistagmus I-EVOLUTION -y I-EVOLUTION -estrabismo I-EVOLUTION -convergente I-EVOLUTION -del I-EVOLUTION -ojo I-EVOLUTION -derecho, I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -una I-EVOLUTION -marcada I-EVOLUTION -agresividad. I-EVOLUTION -Se B-EXPLORATION -controló I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -RM I-EXPLORATION -cerebral I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -15 I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -terapia I-EXPLORATION -con I-EXPLORATION -cotrimoxazol I-EXPLORATION -(+31 I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -hospitalización), I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -significativa I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -frontales I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -edema I-EXPLORATION -pero I-EXPLORATION -con I-EXPLORATION -lesiones I-EXPLORATION -cerebelares I-EXPLORATION -estacionarias I-EXPLORATION -con I-EXPLORATION -mayor I-EXPLORATION -edema I-EXPLORATION -perilesional. I-EXPLORATION -Se I-EXPLORATION -planteó I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones, I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -un I-EXPLORATION -linfoma I-EXPLORATION -primario I-EXPLORATION -de I-EXPLORATION -SNC I-EXPLORATION -y I-EXPLORATION -otros I-EXPLORATION -diagnósticos I-EXPLORATION -diferenciales. I-EXPLORATION -No I-EXPLORATION -obstante, I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -que I-EXPLORATION -dichas I-EXPLORATION -lesiones I-EXPLORATION -radiológicamente I-EXPLORATION -no I-EXPLORATION -empeoraron, I-EXPLORATION -el I-EXPLORATION -equipo I-EXPLORATION -de I-EXPLORATION -Neurocirugía I-EXPLORATION -desestimó I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -abierta. I-EXPLORATION - I-EXPLORATION -Durante B-EVOLUTION -la I-EVOLUTION -cuarta I-EVOLUTION -semana I-EVOLUTION -de I-EVOLUTION -terapia I-EVOLUTION -con I-EVOLUTION -cotrimoxazol I-EVOLUTION -y I-EVOLUTION -tercera I-EVOLUTION -de I-EVOLUTION -TARV, I-EVOLUTION -inició I-EVOLUTION -fiebre I-EVOLUTION -hasta I-EVOLUTION -38°C, I-EVOLUTION -somnolencia I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -sopor I-EVOLUTION -profundo, I-EVOLUTION -paresia I-EVOLUTION -de I-EVOLUTION -hemicuerpo I-EVOLUTION -izquierdo, I-EVOLUTION -del I-EVOLUTION -velo I-EVOLUTION -palatino I-EVOLUTION -izquierdo I-EVOLUTION -y I-EVOLUTION -disartria I-EVOLUTION -intensa, I-EVOLUTION -objetivándose I-EVOLUTION -una I-EVOLUTION -infección I-EVOLUTION -del I-EVOLUTION -tracto I-EVOLUTION -urinario I-EVOLUTION -por I-EVOLUTION -Klebsiella I-EVOLUTION -pneumoniae I-EVOLUTION -multiresistente. I-EVOLUTION -Un B-EXPLORATION -nuevo I-EXPLORATION -control I-EXPLORATION -de I-EXPLORATION -RM I-EXPLORATION -cerebral, I-EXPLORATION -al I-EXPLORATION -mes I-EXPLORATION -de I-EXPLORATION -tratamiento I-EXPLORATION -con I-EXPLORATION -cotrimoxazol, I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -progresión I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -cerebrales, I-EXPLORATION -especialmente I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -fosa I-EXPLORATION -posterior I-EXPLORATION -izquierda I-EXPLORATION -con I-EXPLORATION -mayor I-EXPLORATION -edema I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -frontal I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -aparición I-EXPLORATION -de I-EXPLORATION -nuevas I-EXPLORATION -lesiones I-EXPLORATION -supra I-EXPLORATION -e I-EXPLORATION -infratentoriales, I-EXPLORATION -efecto I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -y I-EXPLORATION -herniación I-EXPLORATION -subfalcina I-EXPLORATION -a I-EXPLORATION -izquierda. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -planteó I-TREATMENT -un I-TREATMENT -probable I-TREATMENT -compromiso I-TREATMENT -de I-TREATMENT -SNC I-TREATMENT -por I-TREATMENT -enfermedad I-TREATMENT -de I-TREATMENT -Chagas I-TREATMENT -o I-TREATMENT -un I-TREATMENT -síndrome I-TREATMENT -inflamatorio I-TREATMENT -de I-TREATMENT -reconstitución I-TREATMENT -inmune I-TREATMENT -(SIRI), I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -trasladar I-TREATMENT -a I-TREATMENT -UCI I-TREATMENT -ese I-TREATMENT -mismo I-TREATMENT -día I-TREATMENT -para I-TREATMENT -protección I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vía I-TREATMENT -aérea I-TREATMENT -(escala I-TREATMENT -Glasgow I-TREATMENT -de I-TREATMENT -coma I-TREATMENT -5-6 I-TREATMENT -puntos) I-TREATMENT -con I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -invasora I-TREATMENT -y I-TREATMENT -monitorización, I-TREATMENT -manteniéndose I-TREATMENT -la I-TREATMENT -TARV, I-TREATMENT -cotrimoxazol I-TREATMENT -y I-TREATMENT -corticoesteroides. I-TREATMENT -Se I-TREATMENT -inició I-TREATMENT -empíricamente I-TREATMENT -nifurtimox I-TREATMENT -8 I-TREATMENT -mg/kg/día I-TREATMENT -(120 I-TREATMENT -mg I-TREATMENT -fraccionado I-TREATMENT -cada I-TREATMENT -6 I-TREATMENT -horas I-TREATMENT -por I-TREATMENT -SNG), I-TREATMENT -asociado I-TREATMENT -a I-TREATMENT -meropenem I-TREATMENT -i.v. I-TREATMENT -para I-TREATMENT -el I-TREATMENT -manejo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -infección I-TREATMENT -urinaria. I-TREATMENT -Se B-EXPLORATION -amplió I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -etiológico I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -para I-EXPLORATION -citomegalovirus I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -indetectable I-EXPLORATION -y I-EXPLORATION -hemocultivos I-EXPLORATION -para I-EXPLORATION -micobacterias I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -negativo. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -punción I-EXPLORATION -lumbar, I-EXPLORATION -con I-EXPLORATION -cultivo I-EXPLORATION -corriente, I-EXPLORATION -de I-EXPLORATION -hongos I-EXPLORATION -y I-EXPLORATION -tinta I-EXPLORATION -china I-EXPLORATION -en I-EXPLORATION -LCR I-EXPLORATION -nuevamente I-EXPLORATION -negativos, I-EXPLORATION -pero I-EXPLORATION -apareció I-EXPLORATION -una I-EXPLORATION -proteinorraquia I-EXPLORATION -de I-EXPLORATION -55 I-EXPLORATION -mg/dL. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -complementario I-EXPLORATION -del I-EXPLORATION -LCR I-EXPLORATION -con I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -tripomastigotes, I-EXPLORATION -RPC I-EXPLORATION -con I-EXPLORATION -Xpert I-EXPLORATION -MTB/RIF I-EXPLORATION -para I-EXPLORATION -Mycobacterium I-EXPLORATION -tuberculosis I-EXPLORATION -y I-EXPLORATION -RPC I-EXPLORATION -de I-EXPLORATION -virus I-EXPLORATION -herpes I-EXPLORATION -simplex-1 I-EXPLORATION -y I-EXPLORATION -2, I-EXPLORATION -varicela I-EXPLORATION -zoster, I-EXPLORATION -Epstein-Barr I-EXPLORATION -y I-EXPLORATION -JC I-EXPLORATION -también I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Además, I-EXPLORATION -la I-EXPLORATION -RPC I-EXPLORATION -para I-EXPLORATION -T. I-EXPLORATION -gondii I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -periférica I-EXPLORATION -y I-EXPLORATION -LCR I-EXPLORATION -también I-EXPLORATION -fue I-EXPLORATION -negativa I-EXPLORATION -teniendo I-EXPLORATION -como I-EXPLORATION -target I-EXPLORATION -el I-EXPLORATION -gen I-EXPLORATION -multicopia I-EXPLORATION -B1 I-EXPLORATION -9. I-EXPLORATION -Sin I-EXPLORATION -embargo, I-EXPLORATION -la I-EXPLORATION -RPC I-EXPLORATION -para I-EXPLORATION -T. I-EXPLORATION -cruzi I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -reveló I-EXPLORATION -1.400 I-EXPLORATION -copias/mL, I-EXPLORATION -y I-EXPLORATION -35.000 I-EXPLORATION -copias/mL I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -LCR, I-EXPLORATION -confirmándose I-EXPLORATION -una I-EXPLORATION -encefalitis I-EXPLORATION -chagásica. I-EXPLORATION -Los I-EXPLORATION -targets I-EXPLORATION -utilizados I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -detección I-EXPLORATION -de I-EXPLORATION -T. I-EXPLORATION -cruzi I-EXPLORATION -fueron I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -minicírculo I-EXPLORATION -contenido I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ADN I-EXPLORATION -de I-EXPLORATION -kinetoplasto I-EXPLORATION -(ADNk) I-EXPLORATION -10 I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -repetitiva I-EXPLORATION -de I-EXPLORATION -195 I-EXPLORATION -pb I-EXPLORATION -contenida I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -núcleo, I-EXPLORATION -denominado I-EXPLORATION -ADN I-EXPLORATION -satélite I-EXPLORATION -(ADNsat). I-EXPLORATION -11 I-EXPLORATION -En B-EVOLUTION -su I-EVOLUTION -quinta I-EVOLUTION -semana I-EVOLUTION -de I-EVOLUTION -TARV I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -control I-EVOLUTION -de I-EVOLUTION -carga I-EVOLUTION -viral I-EVOLUTION -de I-EVOLUTION -VIH I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -indetectable I-EVOLUTION -(con I-EVOLUTION -reducción I-EVOLUTION -> I-EVOLUTION -1 I-EVOLUTION -log I-EVOLUTION -respecto I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -basal), I-EVOLUTION -sin I-EVOLUTION -aumento I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -recuento I-EVOLUTION -CD4 I-EVOLUTION -(30 I-EVOLUTION -céls/μL), I-EVOLUTION -aunque I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -estaba I-EVOLUTION -recibiendo I-EVOLUTION -altas I-EVOLUTION -dosis I-EVOLUTION -de I-EVOLUTION -corticoesteroides. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -con I-EVOLUTION -extrema I-EVOLUTION -gravedad, I-EVOLUTION -necesidad I-EVOLUTION -continua I-EVOLUTION -de I-EVOLUTION -VM I-EVOLUTION -y I-EVOLUTION -aminas I-EVOLUTION -vasoactivas, I-EVOLUTION -sin I-EVOLUTION -mayor I-EVOLUTION -respuesta I-EVOLUTION -neurológica I-EVOLUTION -a I-EVOLUTION -terapias I-EVOLUTION -instauradas. I-EVOLUTION -Luego I-EVOLUTION -de I-EVOLUTION -dos I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -falleció I-EVOLUTION -por I-EVOLUTION -un I-EVOLUTION -síndrome I-EVOLUTION -de I-EVOLUTION -hipertensión I-EVOLUTION -intracraneal I-EVOLUTION -y I-EVOLUTION -falla I-EVOLUTION -multiorgánica. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -infección I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -VIH, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -tuberculosis I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -diagnóstico. I-PAST_MEDICAL_HISTORY -Recibió I-PAST_MEDICAL_HISTORY -terapia I-PAST_MEDICAL_HISTORY -anti-retroviral I-PAST_MEDICAL_HISTORY -(TARV) I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -adherencia I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -ocho I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -respuesta I-PAST_MEDICAL_HISTORY -inmunológica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -virológica I-PAST_MEDICAL_HISTORY -favorable, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -abandonó, I-PAST_MEDICAL_HISTORY -según I-PAST_MEDICAL_HISTORY -refirió, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -mejoría I-PAST_MEDICAL_HISTORY -clínica. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -abandono, I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -nuevamente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tuberculosis, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -compromiso I-PAST_MEDICAL_HISTORY -ganglionar I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -multirresistencia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -fármacos I-PAST_MEDICAL_HISTORY -antituberculosos. I-PAST_MEDICAL_HISTORY -Había I-PAST_MEDICAL_HISTORY -recibido I-PAST_MEDICAL_HISTORY -terapia I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -régimen I-PAST_MEDICAL_HISTORY -individualizado I-PAST_MEDICAL_HISTORY -(amikacina, I-PAST_MEDICAL_HISTORY -pirazinamida, I-PAST_MEDICAL_HISTORY -cicloserina, I-PAST_MEDICAL_HISTORY -etionamida I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -levofloxacina) I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -siete I-PAST_MEDICAL_HISTORY -meses, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -reinicio I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -TARV I-PAST_MEDICAL_HISTORY -previa I-PAST_MEDICAL_HISTORY -(tenofovir, I-PAST_MEDICAL_HISTORY -lamivudina, I-PAST_MEDICAL_HISTORY -efavirenz). I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -embargo, I-PAST_MEDICAL_HISTORY -finalmente I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -abandonado I-PAST_MEDICAL_HISTORY -ambos I-PAST_MEDICAL_HISTORY -esquemas I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -intolerancia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -medicación. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Además, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -empírica I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -encefalitis I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -Toxoplasma I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -cotrimoxazol I-PAST_MEDICAL_HISTORY -(5 I-PAST_MEDICAL_HISTORY -mg/kg/día I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -trimetoprim, I-PAST_MEDICAL_HISTORY -fraccionado I-PAST_MEDICAL_HISTORY -cada I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -h) I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -seis I-PAST_MEDICAL_HISTORY -semanas, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -respuesta I-PAST_MEDICAL_HISTORY -favorable I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -imágenes I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -resonancia I-PAST_MEDICAL_HISTORY -magnética I-PAST_MEDICAL_HISTORY -(RM). I-PAST_MEDICAL_HISTORY -Al I-PAST_MEDICAL_HISTORY -alta, I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -reiniciado I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -antituberculoso, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -continuado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -cotrimoxazol, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mantención I-PAST_MEDICAL_HISTORY -(160/800 I-PAST_MEDICAL_HISTORY -mg, I-PAST_MEDICAL_HISTORY -cada I-PAST_MEDICAL_HISTORY -24 I-PAST_MEDICAL_HISTORY -h); I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -adherencia I-PAST_MEDICAL_HISTORY -regular. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Tres B-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -reingresó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Emergencias I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -neurológico, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -paraparesia I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -inferiores, I-PRESENT_ILLNESS -retención I-PRESENT_ILLNESS -urinaria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -sensitivo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -T8. I-PRESENT_ILLNESS -Se B-EXPLORATION -realizó I-EXPLORATION -RM I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -y I-EXPLORATION -médula I-EXPLORATION -espinal I-EXPLORATION -revelando I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -intramedular I-EXPLORATION -captadora I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -en I-EXPLORATION -anillo I-EXPLORATION -(0, I-EXPLORATION -9 I-EXPLORATION -cm I-EXPLORATION -x I-EXPLORATION -2, I-EXPLORATION -6 I-EXPLORATION -cm) I-EXPLORATION -con I-EXPLORATION -edema I-EXPLORATION -perilesional, I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -T8. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -cefalorraquídeo I-EXPLORATION -(LCR) I-EXPLORATION -mostró I-EXPLORATION -20 I-EXPLORATION -células I-EXPLORATION -a I-EXPLORATION -predominio I-EXPLORATION -linfomononuclear I-EXPLORATION -(90%), I-EXPLORATION -hiperproteinorraquia I-EXPLORATION -(247 I-EXPLORATION -mg/dL), I-EXPLORATION -glucorraquia I-EXPLORATION -y I-EXPLORATION -prueba I-EXPLORATION -de I-EXPLORATION -ADA I-EXPLORATION -(adenosina I-EXPLORATION -deaminasa) I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -microbiológicos I-EXPLORATION -en I-EXPLORATION -LCR I-EXPLORATION -para I-EXPLORATION -bacterias I-EXPLORATION -(tinción I-EXPLORATION -Gram I-EXPLORATION -y I-EXPLORATION -cultivo), I-EXPLORATION -hongos I-EXPLORATION -(tinta I-EXPLORATION -china I-EXPLORATION -y I-EXPLORATION -antígeno I-EXPLORATION -para I-EXPLORATION -Cryptococcus) I-EXPLORATION -y I-EXPLORATION -micobacterias I-EXPLORATION -(baciloscopias I-EXPLORATION -y I-EXPLORATION -GeneXpert I-EXPLORATION -MTB/RIF) I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -RPC I-EXPLORATION -para I-EXPLORATION -Toxoplasma I-EXPLORATION -en I-EXPLORATION -LCR, I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -cargas I-EXPLORATION -virales I-EXPLORATION -para I-EXPLORATION -CMV I-EXPLORATION -y I-EXPLORATION -VEB I-EXPLORATION -séricas I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -LCR I-EXPLORATION -fueron I-EXPLORATION -indetectables. I-EXPLORATION -El I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -T I-EXPLORATION -CD4+ I-EXPLORATION -fue I-EXPLORATION -11 I-EXPLORATION -céls/mm3, I-EXPLORATION -con I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -VIH I-EXPLORATION -de I-EXPLORATION -548.800 I-EXPLORATION -copias I-EXPLORATION -ARN/ml; I-EXPLORATION -los I-EXPLORATION -títulos I-EXPLORATION -séricos I-EXPLORATION -de I-EXPLORATION -IgG I-EXPLORATION -para I-EXPLORATION -Toxoplasma I-EXPLORATION -fueron I-EXPLORATION -positivos I-EXPLORATION -en I-EXPLORATION -4, I-EXPLORATION -37 I-EXPLORATION -(< I-EXPLORATION -0, I-EXPLORATION -8 I-EXPLORATION -= I-EXPLORATION -negativo) I-EXPLORATION -obtenidos I-EXPLORATION -mediante I-EXPLORATION -inmunoanálisis I-EXPLORATION -quimioluminiscente I-EXPLORATION -de I-EXPLORATION -partículas I-EXPLORATION -(CMIA). I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -reinició I-TREATMENT -terapia I-TREATMENT -empírica, I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -que I-TREATMENT -no I-TREATMENT -se I-TREATMENT -pudo I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -biopsia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -intramedular, I-TREATMENT -con I-TREATMENT -cotrimoxazol I-TREATMENT -i.v. I-TREATMENT -(5 I-TREATMENT -mg/kg I-TREATMENT -de I-TREATMENT -trimetoprim, I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día), I-TREATMENT -durante I-TREATMENT -cuatro I-TREATMENT -semanas I-TREATMENT -asociado I-TREATMENT -a I-TREATMENT -dexametasona I-TREATMENT -i.v. I-TREATMENT -8 I-TREATMENT -mg, I-TREATMENT -fraccionado I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -h, I-TREATMENT -por I-TREATMENT -siete I-TREATMENT -días. I-TREATMENT -Posteriormente I-TREATMENT -continuó I-TREATMENT -dos I-TREATMENT -semanas I-TREATMENT -con I-TREATMENT -cotrimoxazol I-TREATMENT -a I-TREATMENT -la I-TREATMENT -misma I-TREATMENT -dosis I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -y I-TREATMENT -reducción I-TREATMENT -semanal I-TREATMENT -progresiva I-TREATMENT -de I-TREATMENT -corticoesteroides I-TREATMENT -con I-TREATMENT -prednisona, I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -seis I-TREATMENT -semanas. I-TREATMENT -Tuvo B-EVOLUTION -control I-EVOLUTION -imagenológico I-EVOLUTION -cuatro I-EVOLUTION -semanas I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -tratamiento, I-EVOLUTION -evidenciándose I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -lesión I-EVOLUTION -intramedular, I-EVOLUTION -con I-EVOLUTION -evidente I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -tamaño I-EVOLUTION -y I-EVOLUTION -menor I-EVOLUTION -realce I-EVOLUTION -al I-EVOLUTION -contraste. I-EVOLUTION -Clínicamente I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -semana I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -empírico, I-EVOLUTION -comenzó I-EVOLUTION -a I-EVOLUTION -evidenciarse I-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sensibilidad I-EVOLUTION -discriminatoria I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -fuerza I-EVOLUTION -muscular; I-EVOLUTION -sin I-EVOLUTION -embargo, I-EVOLUTION -persistió I-EVOLUTION -con I-EVOLUTION -compromiso I-EVOLUTION -del I-EVOLUTION -esfínter I-EVOLUTION -urinario I-EVOLUTION -(retención I-EVOLUTION -urinaria). I-EVOLUTION -Ante B-TREATMENT -la I-TREATMENT -mejoría I-TREATMENT -inicial, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -continuar I-TREATMENT -con I-TREATMENT -tratamiento I-TREATMENT -para I-TREATMENT -toxoplasmosis I-TREATMENT -(durante I-TREATMENT -seis I-TREATMENT -semanas), I-TREATMENT -y I-TREATMENT -terapia I-TREATMENT -de I-TREATMENT -rehabilitación I-TREATMENT -física. I-TREATMENT -Previo I-TREATMENT -al I-TREATMENT -alta I-TREATMENT -se I-TREATMENT -reinició I-TREATMENT -la I-TREATMENT -TARV I-TREATMENT -con I-TREATMENT -mismo I-TREATMENT -esquema I-TREATMENT -recibido I-TREATMENT -previamente. I-TREATMENT -Finalmente, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -continuó I-TREATMENT -la I-TREATMENT -terapia I-TREATMENT -antituberculosa I-TREATMENT -de I-TREATMENT -manera I-TREATMENT -regular I-TREATMENT -y I-TREATMENT -con I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -mantención I-TREATMENT -con I-TREATMENT -cotrimoxazol I-TREATMENT -160/800 I-TREATMENT -mg, I-TREATMENT -fraccionado I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -h. I-TREATMENT - I-TREATMENT - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -chofer B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ambulancia, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -activo I-PAST_MEDICAL_HISTORY -(5 I-PAST_MEDICAL_HISTORY -cigarrillos/día) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -(IMC I-PAST_MEDICAL_HISTORY -31 I-PAST_MEDICAL_HISTORY -kg/m2) I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mialgias, I-PAST_MEDICAL_HISTORY -tos, I-PAST_MEDICAL_HISTORY -odinofagia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -rinorrea. I-PAST_MEDICAL_HISTORY -Un B-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -agregó I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -cuantitativo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conciencia. I-PRESENT_ILLNESS -Ingresó B-EXPLORATION -al I-EXPLORATION -Servicio I-EXPLORATION -de I-EXPLORATION -Urgencia I-EXPLORATION -comprometido I-EXPLORATION -de I-EXPLORATION -conciencia, I-EXPLORATION -mal I-EXPLORATION -perfundido, I-EXPLORATION -hipotenso I-EXPLORATION -(106/46 I-EXPLORATION -mmHg), I-EXPLORATION -taquicárdico I-EXPLORATION -(106/min), I-EXPLORATION -con I-EXPLORATION -uso I-EXPLORATION -de I-EXPLORATION -musculatura I-EXPLORATION -accesoria, I-EXPLORATION -saturando I-EXPLORATION -60-67% I-EXPLORATION -por I-EXPLORATION -oximetría I-EXPLORATION -de I-EXPLORATION -pulso I-EXPLORATION -a I-EXPLORATION -Fi02 I-EXPLORATION -ambiental I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -roncus I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -campos I-EXPLORATION -pulmonares. I-EXPLORATION -Se I-EXPLORATION -administró I-EXPLORATION -oxigenoterapia I-EXPLORATION -con I-EXPLORATION -mascarilla I-EXPLORATION -de I-EXPLORATION -alto I-EXPLORATION -flujo I-EXPLORATION -sin I-EXPLORATION -respuesta, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -intubó I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -trasladó I-EXPLORATION -a I-EXPLORATION -UCI. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -mostraron I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION -con I-EXPLORATION -creatinina I-EXPLORATION -plasmática I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -45 I-EXPLORATION -mg/dL I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -ingreso I-EXPLORATION -y I-EXPLORATION -NU I-EXPLORATION -de I-EXPLORATION -47 I-EXPLORATION -mg/dL. I-EXPLORATION -Tenía I-EXPLORATION -una I-EXPLORATION -PCR I-EXPLORATION -elevada I-EXPLORATION -(200 I-EXPLORATION -mg/L), I-EXPLORATION -con I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -leucocitos, I-EXPLORATION -eritrocitos I-EXPLORATION -y I-EXPLORATION -plaquetas I-EXPLORATION -normales. I-EXPLORATION -Además, I-EXPLORATION -presentó I-EXPLORATION -una I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -LDH I-EXPLORATION -plasmática I-EXPLORATION -(1.500 I-EXPLORATION -U/L) I-EXPLORATION -y I-EXPLORATION -lactato I-EXPLORATION -arterial I-EXPLORATION -45 I-EXPLORATION -mg/dL I-EXPLORATION -(4,5-14,4). I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -confirmó I-EXPLORATION -una I-EXPLORATION -neumonía I-EXPLORATION -multilobar I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -inició I-EXPLORATION -tratamiento I-EXPLORATION -empírico I-EXPLORATION -con I-EXPLORATION -ceftriaxona, I-EXPLORATION -moxifloxacino I-EXPLORATION -y I-EXPLORATION -oseltamivir. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -evolucionó I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -shock I-EXPLORATION -(con I-EXPLORATION -requerimientos I-EXPLORATION -de I-EXPLORATION -noradrenalina I-EXPLORATION -hasta I-EXPLORATION -0, I-EXPLORATION -15 I-EXPLORATION -μg/kg/min) I-EXPLORATION -e I-EXPLORATION -insuficiencia I-EXPLORATION -respiratoria I-EXPLORATION -catastrófica I-EXPLORATION -en I-EXPLORATION -VM, I-EXPLORATION -decidiéndose I-EXPLORATION -ventilar I-EXPLORATION -en I-EXPLORATION -posición I-EXPLORATION -prono. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -microbiológico I-EXPLORATION -no I-EXPLORATION -demostró I-EXPLORATION -agentes I-EXPLORATION -por I-EXPLORATION -hemocultivos, I-EXPLORATION -urocultivo, I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -aspirado I-EXPLORATION -endotraqueal I-EXPLORATION -o I-EXPLORATION -panel I-EXPLORATION -viral I-EXPLORATION -por I-EXPLORATION -inmunofluorescencia. I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -VIH I-EXPLORATION -fue I-EXPLORATION -negativa I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -una I-EXPLORATION -influenza I-EXPLORATION -A I-EXPLORATION -H1N1 I-EXPLORATION -pdm09 I-EXPLORATION -por I-EXPLORATION -RPC. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -complementario I-EXPLORATION -por I-EXPLORATION -RPC I-EXPLORATION -reveló I-EXPLORATION -además I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -ADV I-EXPLORATION -y I-EXPLORATION -VRS I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -aérea. I-EXPLORATION - I-EXPLORATION -Desde I-EXPLORATION -las I-EXPLORATION -48 I-EXPLORATION -h I-EXPLORATION -del I-EXPLORATION -ingreso I-EXPLORATION -disminuyeron I-EXPLORATION -los I-EXPLORATION -requerimientos I-EXPLORATION -de I-EXPLORATION -noradrenalina I-EXPLORATION -(0, I-EXPLORATION -03 I-EXPLORATION -μg/kg/min), I-EXPLORATION -estabilizándose I-EXPLORATION -su I-EXPLORATION -insuficiencia I-EXPLORATION -respiratoria I-EXPLORATION -(PaFi I-EXPLORATION -> I-EXPLORATION -250), I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -volvió I-EXPLORATION -a I-EXPLORATION -posición I-EXPLORATION -supina. I-EXPLORATION -No I-EXPLORATION -obstante, I-EXPLORATION -presentó I-EXPLORATION -una I-EXPLORATION -progresión I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -IRA, I-EXPLORATION -desde I-EXPLORATION -oliguria I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -anuria, I-EXPLORATION -con I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -creatinina I-EXPLORATION -hasta I-EXPLORATION -5, I-EXPLORATION -7 I-EXPLORATION -mg/dL, I-EXPLORATION -NU I-EXPLORATION -hasta I-EXPLORATION -98 I-EXPLORATION -mg/dL I-EXPLORATION -e I-EXPLORATION -hiperkalemia I-EXPLORATION -grave. I-EXPLORATION -Se I-EXPLORATION -inició I-EXPLORATION -soporte I-EXPLORATION -dialítico I-EXPLORATION -con I-EXPLORATION -HD I-EXPLORATION -intermitente I-EXPLORATION -diaria. I-EXPLORATION -La I-EXPLORATION -evolución I-EXPLORATION -de I-EXPLORATION -oliguria I-EXPLORATION -a I-EXPLORATION -anuria I-EXPLORATION -no I-EXPLORATION -permitió I-EXPLORATION -realizar I-EXPLORATION -FENa; I-EXPLORATION -sin I-EXPLORATION -embargo, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -había I-EXPLORATION -sido I-EXPLORATION -reanimado I-EXPLORATION -y I-EXPLORATION -estabilizado I-EXPLORATION -hemodinámicamente I-EXPLORATION -(con I-EXPLORATION -mínimo I-EXPLORATION -requerimiento I-EXPLORATION -de I-EXPLORATION -vasoactivos), I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -era I-EXPLORATION -planteable I-EXPLORATION -un I-EXPLORATION -componente I-EXPLORATION -pre-renal I-EXPLORATION -en I-EXPLORATION -ese I-EXPLORATION -contexto. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -pudieron I-EXPLORATION -efectuar I-EXPLORATION -imágenes I-EXPLORATION -abdominales I-EXPLORATION -para I-EXPLORATION -evaluar I-EXPLORATION -la I-EXPLORATION -anatomía I-EXPLORATION -renal, I-EXPLORATION -ya I-EXPLORATION -que I-EXPLORATION -su I-EXPLORATION -condición I-EXPLORATION -inestable I-EXPLORATION -impidió I-EXPLORATION -su I-EXPLORATION -realización. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -presentó I-EXPLORATION -un I-EXPLORATION -nuevo I-EXPLORATION -deterioro I-EXPLORATION -gasométrico I-EXPLORATION -con I-EXPLORATION -PaFi I-EXPLORATION -menor I-EXPLORATION -a I-EXPLORATION -150, I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -hizo I-EXPLORATION -necesario I-EXPLORATION -volver I-EXPLORATION -a I-EXPLORATION -VM I-EXPLORATION -en I-EXPLORATION -posición I-EXPLORATION -prono. I-EXPLORATION -Se I-EXPLORATION -descartó I-EXPLORATION -una I-EXPLORATION -falla I-EXPLORATION -ventricular I-EXPLORATION -por I-EXPLORATION -ecocardiografía I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -administraron I-EXPLORATION -bolos I-EXPLORATION -de I-EXPLORATION -metilprednisolona I-EXPLORATION -62, I-EXPLORATION -5 I-EXPLORATION -mg I-EXPLORATION -por I-EXPLORATION -5 I-EXPLORATION -días I-EXPLORATION -en I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -SDRA I-EXPLORATION -grave. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -de I-EXPLORATION -orina, I-EXPLORATION -al I-EXPLORATION -recuperar I-EXPLORATION -la I-EXPLORATION -diuresis, I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -perfil I-EXPLORATION -inflamatorio I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -proteinuria I-EXPLORATION -de I-EXPLORATION -300 I-EXPLORATION -mg/dL, I-EXPLORATION -hematuria I-EXPLORATION -con I-EXPLORATION -eritrocitos I-EXPLORATION -incontables I-EXPLORATION -e I-EXPLORATION -índice I-EXPLORATION -proteinuria/creatininuria I-EXPLORATION -de I-EXPLORATION -7.384 I-EXPLORATION -mg/g. I-EXPLORATION -Por I-EXPLORATION -su I-EXPLORATION -parte, I-EXPLORATION -los I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -CK, I-EXPLORATION -C3 I-EXPLORATION -y I-EXPLORATION -C4 I-EXPLORATION -resultaron I-EXPLORATION -normales I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -autoinmune I-EXPLORATION -con I-EXPLORATION -ANCA-c, I-EXPLORATION -ANCA-p I-EXPLORATION -y I-EXPLORATION -ANA I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -marcadores I-EXPLORATION -virales I-EXPLORATION -de I-EXPLORATION -hepatitis I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -mejoró I-EXPLORATION -progresivamente I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -cuadro I-EXPLORATION -respiratorio I-EXPLORATION -extubándose I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -21 I-EXPLORATION -días. I-EXPLORATION -En B-TREATMENT -total, I-TREATMENT -se I-TREATMENT -completaron I-TREATMENT -15 I-TREATMENT -sesiones I-TREATMENT -de I-TREATMENT -HD I-TREATMENT -recuperando I-TREATMENT -la I-TREATMENT -función I-TREATMENT -renal, I-TREATMENT -con I-TREATMENT -mejoría I-TREATMENT -de I-TREATMENT -sedimento I-TREATMENT -urinario I-TREATMENT -inflamatorio I-TREATMENT -(proteinuria I-TREATMENT -de I-TREATMENT -30 I-TREATMENT -mg/dL I-TREATMENT -y I-TREATMENT -eritrocitos I-TREATMENT -2-4 I-TREATMENT -por I-TREATMENT -campo) I-TREATMENT -y I-TREATMENT -normalización I-TREATMENT -de I-TREATMENT -la I-TREATMENT -diuresis. I-TREATMENT -Se B-EVOLUTION -dio I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -mes I-EVOLUTION -y I-EVOLUTION -medio I-EVOLUTION -de I-EVOLUTION -internación. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -tenía I-EVOLUTION -indicación I-EVOLUTION -de I-EVOLUTION -vacuna I-EVOLUTION -influenza I-EVOLUTION -por I-EVOLUTION -su I-EVOLUTION -obesidad I-EVOLUTION -y I-EVOLUTION -ser I-EVOLUTION -personal I-EVOLUTION -de I-EVOLUTION -salud, I-EVOLUTION -pero I-EVOLUTION -no I-EVOLUTION -la I-EVOLUTION -había I-EVOLUTION -recibido. I-EVOLUTION -Se I-EVOLUTION -efectuó I-EVOLUTION -un I-EVOLUTION -control I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -después, I-EVOLUTION -que I-EVOLUTION -mostró I-EVOLUTION -normalización I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -y I-EVOLUTION -un I-EVOLUTION -sedimento I-EVOLUTION -de I-EVOLUTION -orina I-EVOLUTION -normal. I-EVOLUTION - I-EVOLUTION -Estudios I-EVOLUTION -moleculares I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -el I-EVOLUTION -Instituto I-EVOLUTION -de I-EVOLUTION -Salud I-EVOLUTION -Pública I-EVOLUTION -de I-EVOLUTION -Chile I-EVOLUTION -las I-EVOLUTION -muestras I-EVOLUTION -respiratorias I-EVOLUTION -se I-EVOLUTION -sometieron I-EVOLUTION -a I-EVOLUTION -extracción I-EVOLUTION -de I-EVOLUTION -ácidos I-EVOLUTION -nucleicos I-EVOLUTION -totales I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -equipo I-EVOLUTION -automatizado I-EVOLUTION -EASYMAG I-EVOLUTION -de I-EVOLUTION -Nuclisens. I-EVOLUTION -Se I-EVOLUTION -realizó I-EVOLUTION -RT-RPC I-EVOLUTION -usando I-EVOLUTION -el I-EVOLUTION -protocolo I-EVOLUTION -estándar I-EVOLUTION -del I-EVOLUTION -CDC I-EVOLUTION -para I-EVOLUTION -la I-EVOLUTION -detección I-EVOLUTION -y I-EVOLUTION -subtipificación I-EVOLUTION -de I-EVOLUTION -virus I-EVOLUTION -influenza I-EVOLUTION -(CDC I-EVOLUTION -real I-EVOLUTION -time I-EVOLUTION -RT-PCR I-EVOLUTION -protocol I-EVOLUTION -for I-EVOLUTION -detection I-EVOLUTION -and I-EVOLUTION -characterization I-EVOLUTION -of I-EVOLUTION -influenza, I-EVOLUTION -2012), I-EVOLUTION -y I-EVOLUTION -para I-EVOLUTION -otros I-EVOLUTION -virus I-EVOLUTION -respiratorios I-EVOLUTION -(Real-time I-EVOLUTION -RT-PCR I-EVOLUTION -assay I-EVOLUTION -for I-EVOLUTION -non-influenza I-EVOLUTION -respiratory I-EVOLUTION -viruses) I-EVOLUTION -en I-EVOLUTION -termociclador I-EVOLUTION -7500 I-EVOLUTION -Fast I-EVOLUTION -de I-EVOLUTION -Applied I-EVOLUTION -Biosystems. I-EVOLUTION -Se I-EVOLUTION -amplificó I-EVOLUTION -un I-EVOLUTION -panel I-EVOLUTION -de I-EVOLUTION -virus I-EVOLUTION -respiratorios I-EVOLUTION -que I-EVOLUTION -incluyen I-EVOLUTION -influenza, I-EVOLUTION -virus I-EVOLUTION -respiratorio I-EVOLUTION -sincicial, I-EVOLUTION -metapneumovirus, I-EVOLUTION -parainfluenza I-EVOLUTION -1, I-EVOLUTION -2 I-EVOLUTION -y I-EVOLUTION -3, I-EVOLUTION -adenovirus I-EVOLUTION -y I-EVOLUTION -rinovirus, I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -el I-EVOLUTION -que I-EVOLUTION -permitió I-EVOLUTION -detectar I-EVOLUTION -las I-EVOLUTION -co-infecciones I-EVOLUTION -ya I-EVOLUTION -descritas. I-EVOLUTION - I-EVOLUTION -Además, I-EVOLUTION -para I-EVOLUTION -explorar I-EVOLUTION -la I-EVOLUTION -existencia I-EVOLUTION -de I-EVOLUTION -mutaciones I-EVOLUTION -que I-EVOLUTION -pudieran I-EVOLUTION -estar I-EVOLUTION -potencialmente I-EVOLUTION -asociadas I-EVOLUTION -a I-EVOLUTION -una I-EVOLUTION -mayor I-EVOLUTION -gravedad I-EVOLUTION -clínica, I-EVOLUTION -se I-EVOLUTION -hizo I-EVOLUTION -un I-EVOLUTION -estudio I-EVOLUTION -de I-EVOLUTION -secuenciación I-EVOLUTION -del I-EVOLUTION -segmento I-EVOLUTION -HA1 I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -hemaglutinina I-EVOLUTION -viral, I-EVOLUTION -mediante I-EVOLUTION -secuenciación I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -método I-EVOLUTION -de I-EVOLUTION -Sanger I-EVOLUTION -en I-EVOLUTION -un I-EVOLUTION -equipo I-EVOLUTION -Applied I-EVOLUTION -Biosystems/Genetic I-EVOLUTION -analyzer I-EVOLUTION -3500. I-EVOLUTION -Ambas I-EVOLUTION -muestras I-EVOLUTION -fueron I-EVOLUTION -comparadas I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -grupo I-EVOLUTION -de I-EVOLUTION -76 I-EVOLUTION -muestras I-EVOLUTION -de I-EVOLUTION -distintas I-EVOLUTION -regiones I-EVOLUTION -del I-EVOLUTION -país, I-EVOLUTION -tanto I-EVOLUTION -de I-EVOLUTION -pacientes I-EVOLUTION -ambulatorios I-EVOLUTION -como I-EVOLUTION -hospitalizados, I-EVOLUTION -incluyendo I-EVOLUTION -11 I-EVOLUTION -muestras I-EVOLUTION -de I-EVOLUTION -pacientes I-EVOLUTION -fallecidos. I-EVOLUTION -El I-EVOLUTION -análisis I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -secuenciación I-EVOLUTION -del I-EVOLUTION -segmento I-EVOLUTION -HA1 I-EVOLUTION -de I-EVOLUTION -virus I-EVOLUTION -influenza I-EVOLUTION -H1N1pdm09, I-EVOLUTION -comparado I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -cepa I-EVOLUTION -estándar I-EVOLUTION -A/California/07/2009 I-EVOLUTION -demostró I-EVOLUTION -que I-EVOLUTION -ambos I-EVOLUTION -casos I-EVOLUTION -presentaron I-EVOLUTION -las I-EVOLUTION -mismas I-EVOLUTION -ocho I-EVOLUTION -mutaciones I-EVOLUTION -comunes I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -otras I-EVOLUTION -76 I-EVOLUTION -muestras I-EVOLUTION -analizadas I-EVOLUTION -del I-EVOLUTION -año I-EVOLUTION -2015, I-EVOLUTION -indicando I-EVOLUTION -que I-EVOLUTION -fueron I-EVOLUTION -las I-EVOLUTION -mismas I-EVOLUTION -cepas I-EVOLUTION -circulantes I-EVOLUTION -(datos I-EVOLUTION -no I-EVOLUTION -mostrados). I-EVOLUTION -Sin I-EVOLUTION -embargo, I-EVOLUTION -la I-EVOLUTION -muestra I-EVOLUTION -del I-EVOLUTION -caso I-EVOLUTION -1 I-EVOLUTION -evidenció I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -única I-EVOLUTION -la I-EVOLUTION -mutación I-EVOLUTION -D222N I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -detectó I-EVOLUTION -en I-EVOLUTION -ninguna I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -otras I-EVOLUTION -muestras I-EVOLUTION -analizadas. I-EVOLUTION -En I-EVOLUTION -las I-EVOLUTION -dos I-EVOLUTION -muestras I-EVOLUTION -analizadas I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -resto I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -muestras I-EVOLUTION -de I-EVOLUTION -esa I-EVOLUTION -temporada, I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -detectaron I-EVOLUTION -otras I-EVOLUTION -mutaciones I-EVOLUTION -previamente I-EVOLUTION -reportadas I-EVOLUTION -como I-EVOLUTION -A90S I-EVOLUTION -ni I-EVOLUTION -K180Q. I-EVOLUTION - I-EVOLUTION - -Preescolar B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -previamente B-PAST_MEDICAL_HISTORY -sano I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -esquema I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -inmunizaciones I-PAST_MEDICAL_HISTORY -completas I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -edad. I-PAST_MEDICAL_HISTORY -Tres B-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -respiratorio I-PRESENT_ILLNESS -alto I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -diagnosticó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Guillain I-PRESENT_ILLNESS -Barré, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresó I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -unidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -terapia I-PRESENT_ILLNESS -intensiva I-PRESENT_ILLNESS -pediátrica. I-PRESENT_ILLNESS -Recibió B-TREATMENT -tratamientos I-TREATMENT -antibacterianos I-TREATMENT -de I-TREATMENT -amplio I-TREATMENT -espectro I-TREATMENT -(piperacilina/tazobactam I-TREATMENT -por I-TREATMENT -ocho I-TREATMENT -días I-TREATMENT -por I-TREATMENT -una I-TREATMENT -neumonía I-TREATMENT -asociada I-TREATMENT -a I-TREATMENT -ventilación I-TREATMENT -mecánica, I-TREATMENT -sin I-TREATMENT -aislamiento I-TREATMENT -microbiológico, I-TREATMENT -y I-TREATMENT -luego I-TREATMENT -meropenem I-TREATMENT -durante I-TREATMENT -10 I-TREATMENT -días I-TREATMENT -por I-TREATMENT -una I-TREATMENT -bacteriemia I-TREATMENT -asociada I-TREATMENT -a I-TREATMENT -un I-TREATMENT -catéter I-TREATMENT -venoso I-TREATMENT -central I-TREATMENT -(CVC) I-TREATMENT -por I-TREATMENT -Klebsiella I-TREATMENT -pneumoniae. I-TREATMENT -Durante I-TREATMENT -su I-TREATMENT -estancia I-TREATMENT -en I-TREATMENT -terapia I-TREATMENT -intensiva I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -una I-TREATMENT -cateterización I-TREATMENT -urinaria I-TREATMENT -permanente I-TREATMENT -y I-TREATMENT -a I-TREATMENT -una I-TREATMENT -traqueostomía. I-TREATMENT - I-TREATMENT -Al B-EVOLUTION -quinto I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -meropenem, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -persistió I-EVOLUTION -febril, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -sospechó I-EVOLUTION -una I-EVOLUTION -infección I-EVOLUTION -fúngica. I-EVOLUTION -En B-EXPLORATION -orina I-EXPLORATION -y I-EXPLORATION -sangre I-EXPLORATION -hubo I-EXPLORATION -aislamiento I-EXPLORATION -de I-EXPLORATION -C. I-EXPLORATION -tropicalis. I-EXPLORATION -La I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -orina I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -levaduras I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -urocultivo I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -con I-EXPLORATION -30.000 I-EXPLORATION -ufc I-EXPLORATION -de I-EXPLORATION -C. I-EXPLORATION -tropicalis I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -CIM I-EXPLORATION -≤ I-EXPLORATION -0, I-EXPLORATION -25 I-EXPLORATION -μg/mL I-EXPLORATION -para I-EXPLORATION -anfotericina I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -caspofungina, I-EXPLORATION -y I-EXPLORATION -≤ I-EXPLORATION -1 I-EXPLORATION -μg/mL I-EXPLORATION -para I-EXPLORATION -fluconazol. I-EXPLORATION -La I-EXPLORATION -cepa I-EXPLORATION -se I-EXPLORATION -identificó I-EXPLORATION -por I-EXPLORATION -CHROMagar; I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -asimilación I-EXPLORATION -de I-EXPLORATION -azúcares. I-EXPLORATION -Se I-EXPLORATION -confirmó I-EXPLORATION -C. I-EXPLORATION -tropicalis I-EXPLORATION -por I-EXPLORATION -Vitek I-EXPLORATION -2 I-EXPLORATION -® I-EXPLORATION -2 I-EXPLORATION -compact I-EXPLORATION -60 I-EXPLORATION -(Biomérieux) I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -puntos I-EXPLORATION -de I-EXPLORATION -corte I-EXPLORATION -para I-EXPLORATION -CIM I-EXPLORATION -se I-EXPLORATION -obtuvieron I-EXPLORATION -por I-EXPLORATION -microdilución I-EXPLORATION -en I-EXPLORATION -caldo I-EXPLORATION -según I-EXPLORATION -CLSI. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -anfotericina I-TREATMENT -B I-TREATMENT -deoxicolato I-TREATMENT -1 I-TREATMENT -mg/kg/día. I-TREATMENT -La B-EVOLUTION -fiebre I-EVOLUTION -bajó I-EVOLUTION -al I-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -y B-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION -se I-EXPLORATION -negativizaron I-EXPLORATION -al I-EXPLORATION -cuarto I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -terapia. I-EXPLORATION -Anfotericina B-EVOLUTION -B I-EVOLUTION -deoxicolato I-EVOLUTION -fue I-EVOLUTION -bien I-EVOLUTION -tolerada, I-EVOLUTION -manteniéndose I-EVOLUTION -una I-EVOLUTION -función I-EVOLUTION -renal I-EVOLUTION -normal. I-EVOLUTION - I-EVOLUTION -Al B-EXPLORATION -séptimo I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -tratamiento I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecotomografía I-EXPLORATION -renal I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -vías I-EXPLORATION -urinarias, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -ambos I-EXPLORATION -riñones I-EXPLORATION -con I-EXPLORATION -cambios I-EXPLORATION -inflamatorios I-EXPLORATION -agudos: I-EXPLORATION -el I-EXPLORATION -riñón I-EXPLORATION -derecho I-EXPLORATION -medía I-EXPLORATION -9 I-EXPLORATION -x I-EXPLORATION -3, I-EXPLORATION -6 I-EXPLORATION -x I-EXPLORATION -3, I-EXPLORATION -1 I-EXPLORATION -cm, I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -riñón I-EXPLORATION -izquierdo, I-EXPLORATION -8, I-EXPLORATION -8 I-EXPLORATION -x I-EXPLORATION -3, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -4, I-EXPLORATION -6 I-EXPLORATION -cm. I-EXPLORATION -La I-EXPLORATION -vejiga I-EXPLORATION -urinaria I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -engrosada I-EXPLORATION -(4 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -espesor) I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior I-EXPLORATION -se I-EXPLORATION -identificó I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -única I-EXPLORATION -hiperecogénica I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -proyectaba I-EXPLORATION -sombra I-EXPLORATION -sónica I-EXPLORATION -posterior, I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -discreta I-EXPLORATION -vascularidad I-EXPLORATION -central I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -fungoma, I-EXPLORATION -imagen I-EXPLORATION -que I-EXPLORATION -persistía I-EXPLORATION -al I-EXPLORATION -día I-EXPLORATION -14 I-EXPLORATION -de I-EXPLORATION -tratamiento. I-EXPLORATION -Habiendo B-TREATMENT -completado I-TREATMENT -40 I-TREATMENT -mg/kg I-TREATMENT -de I-TREATMENT -anfotericina I-TREATMENT -B I-TREATMENT -deoxicolato, I-TREATMENT -y I-TREATMENT -por I-TREATMENT -persistencia I-TREATMENT -del I-TREATMENT -fungoma I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -éste I-TREATMENT -por I-TREATMENT -cistoscopia. I-TREATMENT -Macroscópicamente B-EXPLORATION -el I-EXPLORATION -tejido I-EXPLORATION -tenía I-EXPLORATION -un I-EXPLORATION -color I-EXPLORATION -blanquecino I-EXPLORATION -y I-EXPLORATION -consistencia I-EXPLORATION -blanda. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histopatológico, I-EXPLORATION -con I-EXPLORATION -tinción I-EXPLORATION -con I-EXPLORATION -hematoxilina-eosina, I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -como I-EXPLORATION -mucosa I-EXPLORATION -vesical I-EXPLORATION -con I-EXPLORATION -edema I-EXPLORATION -estromal, I-EXPLORATION -erosiones I-EXPLORATION -del I-EXPLORATION -epitelio I-EXPLORATION -transicional I-EXPLORATION -y I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -y I-EXPLORATION -macrófagos I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -cistitis I-EXPLORATION -crónica. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -realizaron I-EXPLORATION -tinciones I-EXPLORATION -especiales I-EXPLORATION -para I-EXPLORATION -hongos. I-EXPLORATION -El I-EXPLORATION -urocultivo I-EXPLORATION -se I-EXPLORATION -negativizó I-EXPLORATION -posterior I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -resección I-EXPLORATION -del I-EXPLORATION -fungoma, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -suspendió I-EXPLORATION -el I-EXPLORATION -antifúngico I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -48 I-EXPLORATION -h I-EXPLORATION -después I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cirugía, I-EXPLORATION -con I-EXPLORATION -ecografía I-EXPLORATION -post-quirúrgica I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -fungoma. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -permaneció I-EVOLUTION -en I-EVOLUTION -terapia I-EVOLUTION -intensiva I-EVOLUTION -durante I-EVOLUTION -16 I-EVOLUTION -días I-EVOLUTION -y B-DERIVED_FROM/TO -después I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -trasladado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -neurología I-DERIVED_FROM/TO -pediátrica I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -permaneció I-DERIVED_FROM/TO -tres I-DERIVED_FROM/TO -meses I-DERIVED_FROM/TO -internado. I-DERIVED_FROM/TO -Egresó B-EVOLUTION -sin I-EVOLUTION -traqueostomía I-EVOLUTION -y I-EVOLUTION -sigue I-EVOLUTION -sus I-EVOLUTION -controles I-EVOLUTION -ambulatorios. I-EVOLUTION - I-EVOLUTION - -Escolar B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -siete I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -procedente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -área I-PAST_MEDICAL_HISTORY -urbana I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Santiago I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -Estero. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -epidemiológicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hemiparesia I-PRESENT_ILLNESS -facio-braquio-crural I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -asociada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -quística I-PRESENT_ILLNESS -infratemporal I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -TC I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cerebro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diámetro. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -tuvo I-PRESENT_ILLNESS -compromiso I-PRESENT_ILLNESS -hepático I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -pulmonar. I-PRESENT_ILLNESS -La B-EXPLORATION -prueba I-EXPLORATION -de I-EXPLORATION -HAI I-EXPLORATION -fue I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -hidatidosis I-EXPLORATION -antes I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cirugía. I-EXPLORATION -No I-EXPLORATION -tuvo I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hemograma I-EXPLORATION -ni I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION -al I-EXPLORATION -momento I-EXPLORATION -del I-EXPLORATION -diagnóstico. I-EXPLORATION -Inició B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -albendazol I-TREATMENT -30 I-TREATMENT -días I-TREATMENT -previos I-TREATMENT -a I-TREATMENT -la I-TREATMENT -cirugía, I-TREATMENT -la I-TREATMENT -que I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -sin I-TREATMENT -complicaciones. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -quística I-EXPLORATION -con I-EXPLORATION -escólices I-EXPLORATION -de I-EXPLORATION -E. I-EXPLORATION -granulosus I-EXPLORATION -en I-EXPLORATION -estadio I-EXPLORATION -de I-EXPLORATION -degeneración. I-EXPLORATION -Presentó B-EVOLUTION -como I-EVOLUTION -complicación I-EVOLUTION -una I-EVOLUTION -hidrocefalia I-EVOLUTION -transitoria I-EVOLUTION -que B-TREATMENT -no I-TREATMENT -requirió I-TREATMENT -tratamiento. I-TREATMENT -Completó I-TREATMENT -seis I-TREATMENT -semanas I-TREATMENT -post-quirúrgicas I-TREATMENT -de I-TREATMENT -albendazol I-TREATMENT -con B-EVOLUTION -resolución I-EVOLUTION -ad I-EVOLUTION -integrum I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -secuelas. I-EVOLUTION - I-EVOLUTION - -Escolar B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -siete I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -procedente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Río I-PAST_MEDICAL_HISTORY -Negro. I-PAST_MEDICAL_HISTORY -Vivía I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -crianza I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ganado I-PAST_MEDICAL_HISTORY -bovino, I-PAST_MEDICAL_HISTORY -ovino I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -vacuno I-PAST_MEDICAL_HISTORY -cercano I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -domicilio. I-PAST_MEDICAL_HISTORY -Consultó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -convulsiones I-PRESENT_ILLNESS -tónico-clónicas I-PRESENT_ILLNESS -generalizadas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -hemiparesia I-PRESENT_ILLNESS -braquio-crural I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aparición. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -RM I-EXPLORATION -de I-EXPLORATION -cerebro I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -supratentorial I-EXPLORATION -expansivo I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -de I-EXPLORATION -localización I-EXPLORATION -subcortical I-EXPLORATION -temporo-parietal I-EXPLORATION -izquierdo I-EXPLORATION -que I-EXPLORATION -colapsaba I-EXPLORATION -ventrículos I-EXPLORATION -y I-EXPLORATION -desplazaba I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -media. I-EXPLORATION -Imágenes I-EXPLORATION -complementarias I-EXPLORATION -descartaron I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -otros I-EXPLORATION -órganos. I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -hidatidosis I-EXPLORATION -por I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -HAI I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION -No I-EXPLORATION -tuvo I-EXPLORATION -eosinofilia I-EXPLORATION -ni I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -laboratorio I-EXPLORATION -general. I-EXPLORATION -Inició B-TREATMENT -tratamiento I-TREATMENT -previo I-TREATMENT -a I-TREATMENT -la I-TREATMENT -cirugía I-TREATMENT -con I-TREATMENT -albendazol I-TREATMENT -por I-TREATMENT -sospecha I-TREATMENT -clínica I-TREATMENT -e I-TREATMENT -imagenológica I-TREATMENT -de I-TREATMENT -hidatidosis. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -exéresis I-TREATMENT -total I-TREATMENT -del I-TREATMENT -quiste. I-TREATMENT -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -quística I-EXPLORATION -con I-EXPLORATION -pared I-EXPLORATION -membranosa I-EXPLORATION -acelular, I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -ácido I-EXPLORATION -peryódico I-EXPLORATION -de I-EXPLORATION -Schiff I-EXPLORATION -(PAS) I-EXPLORATION -positiva, I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -de I-EXPLORATION -sus I-EXPLORATION -caras, I-EXPLORATION -con I-EXPLORATION -calcoforitos I-EXPLORATION -y I-EXPLORATION -restos I-EXPLORATION -celulares. I-EXPLORATION -Además, I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -escólices I-EXPLORATION -con I-EXPLORATION -variables I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -necrosis I-EXPLORATION -y I-EXPLORATION -degeneración. I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -como I-EVOLUTION -secuela I-EVOLUTION -una I-EVOLUTION -hemiparesia I-EVOLUTION -facio-braquio-crural I-EVOLUTION -derecha I-EVOLUTION -que I-EVOLUTION -le I-EVOLUTION -dificultaba I-EVOLUTION -la I-EVOLUTION -deambulación. I-EVOLUTION - I-EVOLUTION - -Escolar B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -nueve I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -proveniente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -provincia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Buenos I-PAST_MEDICAL_HISTORY -Aires, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cría I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -animales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -granja I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -faenamiento. I-PAST_MEDICAL_HISTORY -Fue B-DERIVED_FROM/TO -derivado I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -sospecha I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -tumor I-DERIVED_FROM/TO -quístico I-DERIVED_FROM/TO -supratentorial. I-DERIVED_FROM/TO -Tenía B-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vómitos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cefalea I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución. I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -realizó I-EXPLORATION -RM I-EXPLORATION -de I-EXPLORATION -cerebro I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -quística I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -supratentorial I-EXPLORATION -periventricular I-EXPLORATION -derecha I-EXPLORATION -que I-EXPLORATION -desplazaba I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -media. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -por I-EXPLORATION -HAI I-EXPLORATION -para I-EXPLORATION -hidatidosis I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION -no I-EXPLORATION -mostraba I-EXPLORATION -alteración I-EXPLORATION -significativa. I-EXPLORATION -Recibió B-TREATMENT -tratamiento I-TREATMENT -pre I-TREATMENT -y I-TREATMENT -postquirúrgico I-TREATMENT -con I-TREATMENT -albendazol. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -del I-TREATMENT -quiste I-TREATMENT -sin I-TREATMENT -complicaciones. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -describió I-EXPLORATION -una I-EXPLORATION -estructura I-EXPLORATION -quística I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -pared I-EXPLORATION -con I-EXPLORATION -capa I-EXPLORATION -celular I-EXPLORATION -eosinófila I-EXPLORATION -(cutícula), I-EXPLORATION -germinativa I-EXPLORATION -y I-EXPLORATION -abundantes I-EXPLORATION -escólices. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -dueña B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -casa, I-PAST_MEDICAL_HISTORY -profesional, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -trastorno I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ánimo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -contexto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -separación I-PAST_MEDICAL_HISTORY -conyugal. I-PAST_MEDICAL_HISTORY -Además, I-PAST_MEDICAL_HISTORY -señalaba I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -gustaba I-PAST_MEDICAL_HISTORY -realizar I-PAST_MEDICAL_HISTORY -actividades I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -jardinería I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -domicilio. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refirió I-PRESENT_ILLNESS -expulsar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -"lombriz" I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -sus I-PRESENT_ILLNESS -deposiciones. I-PRESENT_ILLNESS -Fue B-TREATMENT -evaluada I-TREATMENT -por I-TREATMENT -un I-TREATMENT -médico I-TREATMENT -internista I-TREATMENT -quien I-TREATMENT -la I-TREATMENT -trató I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -empírica I-TREATMENT -con I-TREATMENT -albendazol I-TREATMENT -400 I-TREATMENT -mg I-TREATMENT -por I-TREATMENT -día, I-TREATMENT -durante I-TREATMENT -15 I-TREATMENT -días. I-TREATMENT - I-TREATMENT -El I-TREATMENT -EPSD I-TREATMENT -y I-TREATMENT -test I-TREATMENT -de I-TREATMENT -Graham I-TREATMENT -fueron I-TREATMENT -negativos. I-TREATMENT -El B-EXPLORATION -examen I-EXPLORATION -macroscópico I-EXPLORATION -del I-EXPLORATION -verme I-EXPLORATION -llevado I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -consulta I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -correspondió I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -lombriz I-EXPLORATION -de I-EXPLORATION -tierra I-EXPLORATION -o I-EXPLORATION -Lombricus I-EXPLORATION -terrarius. I-EXPLORATION -Un B-EVOLUTION -mes I-EVOLUTION -después, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -consultar I-EVOLUTION -por I-EVOLUTION -haber I-EVOLUTION -eliminado I-EVOLUTION -por I-EVOLUTION -las I-EVOLUTION -deposiciones I-EVOLUTION -una I-EVOLUTION -nueva I-EVOLUTION -"lombriz". I-EVOLUTION -Fue B-TREATMENT -tratada I-TREATMENT -con I-TREATMENT -albendazol I-TREATMENT -por I-TREATMENT -15 I-TREATMENT -días, I-TREATMENT -con I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -estudio I-TREATMENT -parasitológico I-TREATMENT -sin I-TREATMENT -hallazgos. I-TREATMENT -El B-EXPLORATION -verme I-EXPLORATION -fue I-EXPLORATION -analizado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Instituto I-EXPLORATION -de I-EXPLORATION -Salud I-EXPLORATION -Pública I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -inicial. I-EXPLORATION - I-EXPLORATION -Dos B-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -refirió I-EVOLUTION -que I-EVOLUTION -al I-EVOLUTION -ducharse I-EVOLUTION -notó I-EVOLUTION -la I-EVOLUTION -expulsión I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -lombriz I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -ano, I-EVOLUTION -que I-EVOLUTION -resultó I-EVOLUTION -ser I-EVOLUTION -similar I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -anteriores. I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -laboratorio I-EXPLORATION -de I-EXPLORATION -parasitología I-EXPLORATION -del I-EXPLORATION -espécimen I-EXPLORATION -informó I-EXPLORATION -nuevamente I-EXPLORATION -una I-EXPLORATION -lombriz I-EXPLORATION -de I-EXPLORATION -tierra. I-EXPLORATION -La B-EVOLUTION -paciente, I-EVOLUTION -muy I-EVOLUTION -molesta, I-EVOLUTION -reclamó I-EVOLUTION -que I-EVOLUTION -nadie I-EVOLUTION -encontraba I-EVOLUTION -una I-EVOLUTION -solución I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -mal I-EVOLUTION -en I-EVOLUTION -Chile, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -consultaría I-EVOLUTION -en I-EVOLUTION -otro I-EVOLUTION -país. I-EVOLUTION -Se I-EVOLUTION -le I-EVOLUTION -recomendó I-EVOLUTION -la I-EVOLUTION -evaluación I-EVOLUTION -por I-EVOLUTION -psiquiatría, I-EVOLUTION -sin I-EVOLUTION -embargo, I-EVOLUTION -se I-EVOLUTION -negó I-EVOLUTION -a I-EVOLUTION -considerar I-EVOLUTION -esta I-EVOLUTION -alternativa. I-EVOLUTION - I-EVOLUTION - -Escolar B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -residente B-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Santiago, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -leucemia I-PAST_MEDICAL_HISTORY -mieloide I-PAST_MEDICAL_HISTORY -aguda I-PAST_MEDICAL_HISTORY -(LMA) I-PAST_MEDICAL_HISTORY -M4, I-PAST_MEDICAL_HISTORY -sometido I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -trasplante I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -precursores I-PAST_MEDICAL_HISTORY -hematopoyéticos I-PAST_MEDICAL_HISTORY -(TPH) I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -rinitis I-PAST_MEDICAL_HISTORY -alérgica. I-PAST_MEDICAL_HISTORY -Evolucionó B-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -recaída I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -leucemia I-PRESENT_ILLNESS -tras B-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -administró I-TREATMENT -un I-TREATMENT -ciclo I-TREATMENT -de I-TREATMENT -quimioterapia I-TREATMENT -en I-TREATMENT -preparación I-TREATMENT -a I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -TPH. I-TREATMENT -Ocho B-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -se I-EVOLUTION -hospitalizó I-EVOLUTION -por I-EVOLUTION -un I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -neutropenia I-EVOLUTION -febril, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -vancomicina, I-TREATMENT -ceftazidima I-TREATMENT -y I-TREATMENT -amikacina. I-TREATMENT -Refirió B-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -fosa I-EVOLUTION -nasal I-EVOLUTION -derecha I-EVOLUTION -e I-EVOLUTION -incisivo I-EVOLUTION -superior, I-EVOLUTION -constatándose I-EVOLUTION -cuatro I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -ingreso, I-EVOLUTION -una I-EVOLUTION -erosión I-EVOLUTION -leve I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -fosa I-EVOLUTION -nasal I-EVOLUTION -derecha I-EVOLUTION -(FND) I-EVOLUTION -con I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -sangrado I-EVOLUTION -reciente I-EVOLUTION -y I-EVOLUTION -una I-EVOLUTION -costra I-EVOLUTION -dolorosa I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -porción I-EVOLUTION -antero-inferior I-EVOLUTION -del I-EVOLUTION -tabique I-EVOLUTION -nasal I-EVOLUTION -izquierdo I-EVOLUTION -(FNI). I-EVOLUTION -Esta B-EXPLORATION -última I-EXPLORATION -se I-EXPLORATION -removió I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -envió I-EXPLORATION -a I-EXPLORATION -cultivo I-EXPLORATION -bacteriano I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -hongos. I-EXPLORATION -Bajo I-EXPLORATION -la I-EXPLORATION -costra I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -del I-EXPLORATION -cartílago I-EXPLORATION -septal I-EXPLORATION -más I-EXPLORATION -adherida I-EXPLORATION -y I-EXPLORATION -negruzca, I-EXPLORATION -cuya I-EXPLORATION -superficie I-EXPLORATION -se I-EXPLORATION -removió I-EXPLORATION -sin I-EXPLORATION -presentar I-EXPLORATION -sangrado. I-EXPLORATION -Se I-EXPLORATION -envió I-EXPLORATION -a I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -calcoflúor, I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -evidenció I-EXPLORATION -hifas I-EXPLORATION -septadas I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -voriconazol I-TREATMENT -iv I-TREATMENT -9 I-TREATMENT -mg/kg/dosis, I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -día. I-TREATMENT -La B-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -de I-EXPLORATION -cavidades I-EXPLORATION -paranasales I-EXPLORATION -evidenció I-EXPLORATION -cambios I-EXPLORATION -inflamatorios I-EXPLORATION -pansinusales I-EXPLORATION -sin I-EXPLORATION -extensión I-EXPLORATION -extrasinusal. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -precozmente I-TREATMENT -una I-TREATMENT -cirugía I-TREATMENT -endoscópica I-TREATMENT -nasal, I-TREATMENT -consistente I-TREATMENT -en I-TREATMENT -una I-TREATMENT -esfenoidotomía I-TREATMENT -derecha, I-TREATMENT -con I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -tabique I-TREATMENT -nasal I-TREATMENT -necrótico I-TREATMENT -y I-TREATMENT -del I-TREATMENT -cartílago I-TREATMENT -septal I-TREATMENT -izquierdo. I-TREATMENT -Se B-EXPLORATION -enviaron I-EXPLORATION -muestras I-EXPLORATION -de I-EXPLORATION -cornete I-EXPLORATION -superior I-EXPLORATION -y I-EXPLORATION -esfenoides I-EXPLORATION -derecho, I-EXPLORATION -mucosa I-EXPLORATION -de I-EXPLORATION -tabique I-EXPLORATION -nasal I-EXPLORATION -y I-EXPLORATION -cartílago I-EXPLORATION -septal I-EXPLORATION -izquierdo I-EXPLORATION -a I-EXPLORATION -biopsia. I-EXPLORATION -Las I-EXPLORATION -dos I-EXPLORATION -primeras I-EXPLORATION -se I-EXPLORATION -enviaron I-EXPLORATION -además I-EXPLORATION -a I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -calcoflúor I-EXPLORATION -resultando I-EXPLORATION -negativas I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -cultivo I-EXPLORATION -bacteriano. I-EXPLORATION -Las I-EXPLORATION -muestras I-EXPLORATION -fueron I-EXPLORATION -sembradas I-EXPLORATION -en I-EXPLORATION -agar I-EXPLORATION -Sabouraud I-EXPLORATION -dextrosa I-EXPLORATION -a I-EXPLORATION -temperatura I-EXPLORATION -ambiente I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -35 I-EXPLORATION -°C. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -muestra I-EXPLORATION -quirúrgica I-EXPLORATION -de I-EXPLORATION -tabique I-EXPLORATION -nasal I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -de I-EXPLORATION -cartílago I-EXPLORATION -septal I-EXPLORATION -mostraron I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -48 I-EXPLORATION -h I-EXPLORATION -desarrollo I-EXPLORATION -de I-EXPLORATION -colonias I-EXPLORATION -de I-EXPLORATION -4-6 I-EXPLORATION -mm, I-EXPLORATION -algodonosas, I-EXPLORATION -laxas I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -de I-EXPLORATION -polvo I-EXPLORATION -de I-EXPLORATION -hollín, I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -blanco I-EXPLORATION -grisáceo, I-EXPLORATION -y I-EXPLORATION -color I-EXPLORATION -oliváceo I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -reverso. I-EXPLORATION -La I-EXPLORATION -muestra I-EXPLORATION -del I-EXPLORATION -esfenoides I-EXPLORATION -derecho I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -microscopia I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -hifas I-EXPLORATION -dematiáceas, I-EXPLORATION -con I-EXPLORATION -conidióforos I-EXPLORATION -color I-EXPLORATION -café I-EXPLORATION -claro, I-EXPLORATION -septados, I-EXPLORATION -solitarios I-EXPLORATION -y I-EXPLORATION -geniculados, I-EXPLORATION -zigzageantes I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -apical, I-EXPLORATION -desde I-EXPLORATION -donde I-EXPLORATION -brotaban I-EXPLORATION -conidios I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -simpodial. I-EXPLORATION -Éstos I-EXPLORATION -eran I-EXPLORATION -color I-EXPLORATION -marrón, I-EXPLORATION -cilíndricos, I-EXPLORATION -de I-EXPLORATION -paredes I-EXPLORATION -pigmentadas I-EXPLORATION -gruesas, I-EXPLORATION -con I-EXPLORATION -tres I-EXPLORATION -distoseptos I-EXPLORATION -y I-EXPLORATION -cuatro I-EXPLORATION -células, I-EXPLORATION -con I-EXPLORATION -cicatrices I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -marrón I-EXPLORATION -oscuro I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lugar I-EXPLORATION -de I-EXPLORATION -unión I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -hifa I-EXPLORATION -conidiogénica. I-EXPLORATION -Basados I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -macroscopia I-EXPLORATION -y I-EXPLORATION -microscopia I-EXPLORATION -se I-EXPLORATION -identificó I-EXPLORATION -el I-EXPLORATION -agente I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -Curvularia I-EXPLORATION -spicifera. I-EXPLORATION -Para I-EXPLORATION -confirmación I-EXPLORATION -de I-EXPLORATION -género, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -reacción I-EXPLORATION -de I-EXPLORATION -polimerasa I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -(RPC) I-EXPLORATION -universal I-EXPLORATION -y I-EXPLORATION -posterior I-EXPLORATION -secuenciación I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -segmentos I-EXPLORATION -génicos I-EXPLORATION -ITS1, I-EXPLORATION -ITS4 I-EXPLORATION -y I-EXPLORATION -5, I-EXPLORATION -6S I-EXPLORATION -ARNr, I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -colonias I-EXPLORATION -desarrolladas, I-EXPLORATION -identificándose I-EXPLORATION -Curvularia I-EXPLORATION -spp. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -del I-EXPLORATION -tabique I-EXPLORATION -nasal I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -cartílago I-EXPLORATION -septal I-EXPLORATION -izquierdo I-EXPLORATION -mostró I-EXPLORATION -extensas I-EXPLORATION -zonas I-EXPLORATION -de I-EXPLORATION -destrucción, I-EXPLORATION -necrosis, I-EXPLORATION -ulceración I-EXPLORATION -y I-EXPLORATION -hemorragia I-EXPLORATION -asociadas I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -abundantes I-EXPLORATION -elementos I-EXPLORATION -micóticos I-EXPLORATION -filamentosos I-EXPLORATION -histo I-EXPLORATION -y I-EXPLORATION -angioinvasores. I-EXPLORATION -Los I-EXPLORATION -elementos I-EXPLORATION -micóticos I-EXPLORATION -correspondían I-EXPLORATION -a I-EXPLORATION -filamentos I-EXPLORATION -hialinos I-EXPLORATION -tabicados I-EXPLORATION -con I-EXPLORATION -algunas I-EXPLORATION -dilataciones I-EXPLORATION -globosas I-EXPLORATION -y I-EXPLORATION -crecimiento I-EXPLORATION -variable I-EXPLORATION -de I-EXPLORATION -45° I-EXPLORATION -a I-EXPLORATION -90°, I-EXPLORATION -con I-EXPLORATION -caracteres I-EXPLORATION -de I-EXPLORATION -hialohifomicetes. I-EXPLORATION -La I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -ósteo-condro-mucosa I-EXPLORATION -de I-EXPLORATION -comete I-EXPLORATION -y I-EXPLORATION -esfenoides I-EXPLORATION -derecho I-EXPLORATION -sólo I-EXPLORATION -mostró I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -inflamación I-EXPLORATION -crónica I-EXPLORATION -activa I-EXPLORATION -inespecífica. I-EXPLORATION - I-EXPLORATION -Para I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -sensibilidad I-EXPLORATION -antifúngica I-EXPLORATION -las I-EXPLORATION -colonias I-EXPLORATION -obtenidas I-EXPLORATION -en I-EXPLORATION -agar I-EXPLORATION -Sabouraud I-EXPLORATION -fueron I-EXPLORATION -sembradas I-EXPLORATION -en I-EXPLORATION -agar I-EXPLORATION -agua I-EXPLORATION -para I-EXPLORATION -aumentar I-EXPLORATION -la I-EXPLORATION -producción I-EXPLORATION -de I-EXPLORATION -conidias. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -micro I-EXPLORATION -dilución I-EXPLORATION -según I-EXPLORATION -la I-EXPLORATION -norma I-EXPLORATION -CLSI, I-EXPLORATION -documento I-EXPLORATION -M38-A2, I-EXPLORATION -resultando I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -tres I-EXPLORATION -antifúngicos I-EXPLORATION -estudiados, I-EXPLORATION -con I-EXPLORATION -CIM I-EXPLORATION -a I-EXPLORATION -anfotericina I-EXPLORATION -B I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -μg/ml, I-EXPLORATION -posaconazol I-EXPLORATION -0, I-EXPLORATION -25 I-EXPLORATION -μg/ml I-EXPLORATION -y I-EXPLORATION -voriconazol I-EXPLORATION -0, I-EXPLORATION -25 I-EXPLORATION -μg/ml. I-EXPLORATION - I-EXPLORATION -Tras B-TREATMENT -la I-TREATMENT -identificación I-TREATMENT -etiológica, I-TREATMENT -se I-TREATMENT -ajustó I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT -antifúngico I-TREATMENT -asociando I-TREATMENT -anfotericina I-TREATMENT -liposomal I-TREATMENT -5 I-TREATMENT -mg/kg/día I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -aseo I-TREATMENT -quirúrgico I-TREATMENT -dos I-TREATMENT -días I-TREATMENT -después, I-TREATMENT -observándose I-TREATMENT -la I-TREATMENT -mucosa I-TREATMENT -nasal I-TREATMENT -sin I-TREATMENT -necrosis, I-TREATMENT -con I-TREATMENT -tinción I-TREATMENT -de I-TREATMENT -calcoflúor I-TREATMENT -y I-TREATMENT -cultivo I-TREATMENT -negativos. I-TREATMENT -Las B-EVOLUTION -detecciones I-EVOLUTION -de I-EVOLUTION -galactomanano I-EVOLUTION -en I-EVOLUTION -sangre I-EVOLUTION -se I-EVOLUTION -mantuvieron I-EVOLUTION -negativas I-EVOLUTION -durante I-EVOLUTION -la I-EVOLUTION -evolución. I-EVOLUTION -Recibió B-TREATMENT -voriconazol I-TREATMENT -por I-TREATMENT -40 I-TREATMENT -días, I-TREATMENT -con I-TREATMENT -concentraciones I-TREATMENT -plasmáticas I-TREATMENT -variables I-TREATMENT -entre I-TREATMENT -0, I-TREATMENT -2-1, I-TREATMENT -6 I-TREATMENT -mg/L I-TREATMENT -(rango I-TREATMENT -terapéutico I-TREATMENT -1-5 I-TREATMENT -mg/L) I-TREATMENT -y I-TREATMENT -anfotericina I-TREATMENT -liposomal I-TREATMENT -por I-TREATMENT -25 I-TREATMENT -días I-TREATMENT -(dosis I-TREATMENT -acumulada I-TREATMENT -125 I-TREATMENT -mg/kg). I-TREATMENT -Evolucionó B-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -satisfactoria I-EVOLUTION -del I-EVOLUTION -punto I-EVOLUTION -de I-EVOLUTION -vista I-EVOLUTION -otorrinológico. I-EVOLUTION -Recibió B-TREATMENT -un I-TREATMENT -segundo I-TREATMENT -TPH, I-TREATMENT -sin B-EVOLUTION -presentar I-EVOLUTION -lesiones I-EVOLUTION -cutáneas I-EVOLUTION -ni I-EVOLUTION -síntomas I-EVOLUTION -nasales I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -siguientes I-EVOLUTION -meses. I-EVOLUTION -Sin I-EVOLUTION -embargo, I-EVOLUTION -no I-EVOLUTION -logró I-EVOLUTION -reconstitución I-EVOLUTION -inmune, I-EVOLUTION -falleciendo I-EVOLUTION -por I-EVOLUTION -otras I-EVOLUTION -complicaciones I-EVOLUTION -infecciosas. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -25 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -remitido B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -tumoración I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -hipocondrio I-DERIVED_FROM/TO -izquierdo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -seis I-DERIVED_FROM/TO -meses I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -crecimiento I-DERIVED_FROM/TO -progresivo. I-DERIVED_FROM/TO -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -palpaba I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION -en I-EXPLORATION -hipocondrio I-EXPLORATION -izquierdo I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -pétrea, I-EXPLORATION -discretamente I-EXPLORATION -dolorosa. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -no I-EXPLORATION -aportaba I-EXPLORATION -datos I-EXPLORATION -de I-EXPLORATION -interés. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -retroperitoneal I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -20 I-EXPLORATION -cm I-EXPLORATION -que I-EXPLORATION -desplazaba I-EXPLORATION -hacia I-EXPLORATION -delante I-EXPLORATION -la I-EXPLORATION -cola I-EXPLORATION -del I-EXPLORATION -páncreas. I-EXPLORATION -Radiológicamente I-EXPLORATION -su I-EXPLORATION -estructura I-EXPLORATION -era I-EXPLORATION -compleja, I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -necrosis I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -calcificación, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -tumor I-EXPLORATION -de I-EXPLORATION -baja I-EXPLORATION -malignidad. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -esplenopancreatectomía I-TREATMENT -distal I-TREATMENT -con I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tumoración, I-TREATMENT -que I-TREATMENT -presentaba I-TREATMENT -un I-TREATMENT -diámetro I-TREATMENT -máximo I-TREATMENT -de I-TREATMENT -24 I-TREATMENT -cm, I-TREATMENT -y I-TREATMENT -estaba I-TREATMENT -adherida I-TREATMENT -al I-TREATMENT -hilio I-TREATMENT -esplénico, I-TREATMENT -bazo, I-TREATMENT -epiplon I-TREATMENT -mayor I-TREATMENT -y I-TREATMENT -gastrocólico, I-TREATMENT -sin I-TREATMENT -aparente I-TREATMENT -fijación I-TREATMENT -al I-TREATMENT -páncreas. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -se I-EXPLORATION -describió I-EXPLORATION -como I-EXPLORATION -neoplasia I-EXPLORATION -epitelial I-EXPLORATION -papilar I-EXPLORATION -sólida-quística I-EXPLORATION -del I-EXPLORATION -páncreas. I-EXPLORATION -Inmunohistoquímica: I-EXPLORATION -vimentina I-EXPLORATION -positivo; I-EXPLORATION -cromogranina I-EXPLORATION -y I-EXPLORATION -marcadores I-EXPLORATION -epiteliales I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -evolución I-EVOLUTION -postoperatoria I-EVOLUTION -fue I-EVOLUTION -normal I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -controles I-EVOLUTION -normales I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -cuatro I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -intervención. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -reflujo I-PRESENT_ILLNESS -gastroesofágico I-PRESENT_ILLNESS -severo I-PRESENT_ILLNESS -resistente I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -altas I-PRESENT_ILLNESS -dosis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -omeprazol I-PRESENT_ILLNESS -(60 I-PRESENT_ILLNESS -mg/día) I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -habitual I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cocaína I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -grandes I-PAST_MEDICAL_HISTORY -cantidades I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcohol I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -fines I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -semana. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -endoscopia I-EXPLORATION -de I-EXPLORATION -tracto I-EXPLORATION -digestivo I-EXPLORATION -superior I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -esofagitis I-EXPLORATION -grave I-EXPLORATION -e I-EXPLORATION -imágenes I-EXPLORATION -sugestivas I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -esófago I-EXPLORATION -de I-EXPLORATION -Barret. I-EXPLORATION -La I-EXPLORATION -pHmetría I-EXPLORATION -esofágica I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -un I-EXPLORATION -intenso I-EXPLORATION -RGE I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -puntuación I-EXPLORATION -de I-EXPLORATION -DeMeester I-EXPLORATION -de I-EXPLORATION -193 I-EXPLORATION -(rango I-EXPLORATION -normal I-EXPLORATION -< I-EXPLORATION -14, I-EXPLORATION -72) I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -manometría I-EXPLORATION -demostró I-EXPLORATION -un I-EXPLORATION -esfínter I-EXPLORATION -esofágico I-EXPLORATION -inferior I-EXPLORATION -hipotónico I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -presión I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -mmHg I-EXPLORATION -(rango I-EXPLORATION -normal I-EXPLORATION -8-25 I-EXPLORATION -mmHg). I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -estas I-TREATMENT -pruebas I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -propuesto I-TREATMENT -para I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -una I-TREATMENT -funduplicatura I-TREATMENT -de I-TREATMENT -Nissen I-TREATMENT -laparoscópica. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -profilaxis I-TREATMENT -del I-TREATMENT -tromboembolismo I-TREATMENT -con I-TREATMENT -2.500 I-TREATMENT -U.I. I-TREATMENT -de I-TREATMENT -heparina I-TREATMENT -de I-TREATMENT -bajo I-TREATMENT -peso I-TREATMENT -molecular I-TREATMENT -(Clexane®, I-TREATMENT -Aventis I-TREATMENT -Pharma, I-TREATMENT -España) I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -2 I-TREATMENT -horas I-TREATMENT -antes I-TREATMENT -de I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -y I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -diaria I-TREATMENT -en I-TREATMENT -los I-TREATMENT -tres I-TREATMENT -primeros I-TREATMENT -días I-TREATMENT -postoperatorios. I-TREATMENT -El I-TREATMENT -neumoperitoneo I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -con I-TREATMENT -CO2 I-TREATMENT -a I-TREATMENT -una I-TREATMENT -presión I-TREATMENT -máxima I-TREATMENT -controlada I-TREATMENT -de I-TREATMENT -14 I-TREATMENT -mmHg. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -funduplicatura I-TREATMENT -de I-TREATMENT -Nissen I-TREATMENT -con I-TREATMENT -material I-TREATMENT -irreabsorbible, I-TREATMENT -suturándose I-TREATMENT -los I-TREATMENT -pilares I-TREATMENT -diafragmáticos. I-TREATMENT -No I-TREATMENT -hubo I-TREATMENT -incidencias I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -que I-TREATMENT -duró I-TREATMENT -105 I-TREATMENT -minutos. I-TREATMENT -El B-EVOLUTION -postoperatorio I-EVOLUTION -transcurrió I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION -durante I-EVOLUTION -las I-EVOLUTION -primeras I-EVOLUTION -72 I-EVOLUTION -horas, I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -asintomático. I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -el I-EVOLUTION -séptimo I-EVOLUTION -día I-EVOLUTION -postoperatorio, I-EVOLUTION -tras I-EVOLUTION -una I-EVOLUTION -ingesta I-EVOLUTION -copiosa I-EVOLUTION -de I-EVOLUTION -alcohol, I-EVOLUTION -bebidas I-EVOLUTION -gaseosas I-EVOLUTION -y I-EVOLUTION -alimentos, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -desarrolló I-EVOLUTION -repentinamente I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -de I-EVOLUTION -espalda I-EVOLUTION -brusco I-EVOLUTION -e I-EVOLUTION -intenso, I-EVOLUTION -hipertermia, I-EVOLUTION -distensión I-EVOLUTION -abdominal I-EVOLUTION -e I-EVOLUTION -inestabilidad I-EVOLUTION -hemodinámica. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -presentaba I-EXPLORATION -leucocitosis I-EXPLORATION -con I-EXPLORATION -desviación I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -izquierda I-EXPLORATION -con I-EXPLORATION -12% I-EXPLORATION -de I-EXPLORATION -cayados, I-EXPLORATION -acidosis I-EXPLORATION -metabólica I-EXPLORATION -(pH: I-EXPLORATION -7, I-EXPLORATION -27) I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -actividad I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -del I-EXPLORATION -52%. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -mostraba I-EXPLORATION -asas I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -dilatadas, I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -intraabdominal, I-EXPLORATION -hígado I-EXPLORATION -de I-EXPLORATION -estasis I-EXPLORATION -y I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -trombosis I-EXPLORATION -venosa I-EXPLORATION -mesentérica I-EXPLORATION -y I-EXPLORATION -portal. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -abdomen I-TREATMENT -agudo I-TREATMENT -se I-TREATMENT -intervino I-TREATMENT -quirúrgicamente I-TREATMENT -hallándose I-TREATMENT -isquemia I-TREATMENT -intestinal I-TREATMENT -masiva I-TREATMENT -de I-TREATMENT -todo I-TREATMENT -el I-TREATMENT -intestino I-TREATMENT -delgado I-TREATMENT -y I-TREATMENT -parte I-TREATMENT -de I-TREATMENT -colon, I-TREATMENT -trombosis I-TREATMENT -portal, I-TREATMENT -hígado I-TREATMENT -de I-TREATMENT -estasis I-TREATMENT -y I-TREATMENT -una I-TREATMENT -arteria I-TREATMENT -mesentérica I-TREATMENT -superior I-TREATMENT -espástica I-TREATMENT -de I-TREATMENT -la I-TREATMENT -que I-TREATMENT -no I-TREATMENT -se I-TREATMENT -extrajo I-TREATMENT -ningún I-TREATMENT -trombo I-TREATMENT -en I-TREATMENT -la I-TREATMENT -exploración I-TREATMENT -mediante I-TREATMENT -sonda I-TREATMENT -de I-TREATMENT -Fogarty. I-TREATMENT -La B-EXPLORATION -ecografía I-EXPLORATION -Doppler I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -trombosis I-EXPLORATION -completa I-EXPLORATION -y I-EXPLORATION -neumatosis I-EXPLORATION -del I-EXPLORATION -tronco I-EXPLORATION -principal I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -porta, I-EXPLORATION -y I-EXPLORATION -gas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -intestinal. I-EXPLORATION -Las I-EXPLORATION -arterias I-EXPLORATION -hepática I-EXPLORATION -y I-EXPLORATION -mesentérica I-EXPLORATION -eran I-EXPLORATION -permeables. I-EXPLORATION -No B-TREATMENT -se I-TREATMENT -consideró I-TREATMENT -indicada I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -ningún I-TREATMENT -gesto I-TREATMENT -quirúrgico I-TREATMENT -añadido. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -hipercoagulabilidad I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -fue I-EXPLORATION -posible I-EXPLORATION -obtener I-EXPLORATION -una I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -fiable I-EXPLORATION -para I-EXPLORATION -detectar I-EXPLORATION -cocaína. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -rápidamente I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -desfavorable, I-EVOLUTION -a I-EVOLUTION -pesar I-EVOLUTION -del I-EVOLUTION -inicio I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -terapia I-EVOLUTION -anticoagulante I-EVOLUTION -con I-EVOLUTION -heparina, I-EVOLUTION -con I-EVOLUTION -inestabilidad I-EVOLUTION -hemodinámica I-EVOLUTION -y I-EVOLUTION -acidosis I-EVOLUTION -irreversible I-EVOLUTION -falleciendo I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -quirúrgica. I-EVOLUTION -La B-EXPLORATION -necropsia I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -trombosis I-EXPLORATION -masiva I-EXPLORATION -de I-EXPLORATION -vena I-EXPLORATION -mesentérica I-EXPLORATION -inferior I-EXPLORATION -y I-EXPLORATION -vena I-EXPLORATION -porta I-EXPLORATION -con I-EXPLORATION -infarto I-EXPLORATION -hemorrágico I-EXPLORATION -de I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -colon I-EXPLORATION -derecho, I-EXPLORATION -con I-EXPLORATION -úlceras I-EXPLORATION -agudas I-EXPLORATION -mucosas I-EXPLORATION -y I-EXPLORATION -contenido I-EXPLORATION -hemático I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -intestinal. I-EXPLORATION -Infarto I-EXPLORATION -hemorrágico I-EXPLORATION -submasivo I-EXPLORATION -hepático, I-EXPLORATION -hipertrofia I-EXPLORATION -y I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -microcalcificaciones I-EXPLORATION -focales I-EXPLORATION -en I-EXPLORATION -parénquima I-EXPLORATION -pulmonar I-EXPLORATION -(típico I-EXPLORATION -hallazgo I-EXPLORATION -en I-EXPLORATION -consumidores I-EXPLORATION -crónicos I-EXPLORATION -de I-EXPLORATION -cocaína I-EXPLORATION -inhalada). I-EXPLORATION -Se I-EXPLORATION -estableció I-EXPLORATION -como I-EXPLORATION -causa I-EXPLORATION -de I-EXPLORATION -muerte I-EXPLORATION -el I-EXPLORATION -shock I-EXPLORATION -hipovolémico I-EXPLORATION -y I-EXPLORATION -hemorrágico I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -trombosis I-EXPLORATION -venosa I-EXPLORATION -mesentérica I-EXPLORATION -y I-EXPLORATION -portal. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -16 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -(sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés), I-PAST_MEDICAL_HISTORY -derivada B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -prurito I-DERIVED_FROM/TO -generalizado, I-DERIVED_FROM/TO -tinte I-DERIVED_FROM/TO -ictérico, I-DERIVED_FROM/TO -coluria I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -heces I-DERIVED_FROM/TO -acólicas. I-DERIVED_FROM/TO -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -mostraba I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -ictericia I-EXPLORATION -cutaneomucosa, I-EXPLORATION -y I-EXPLORATION -hepatomegalia I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -traveses. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -anamnesis I-EXPLORATION -por I-EXPLORATION -aparatos I-EXPLORATION -resultó I-EXPLORATION -normal. I-EXPLORATION -Bioquímica: I-EXPLORATION -bilirrubina I-EXPLORATION -directa I-EXPLORATION -22, I-EXPLORATION -13 I-EXPLORATION -mg/dl, I-EXPLORATION -GOT I-EXPLORATION -66 I-EXPLORATION -UI/l, I-EXPLORATION -GPT I-EXPLORATION -91 I-EXPLORATION -UI/l, I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -1838 I-EXPLORATION -UI/l, I-EXPLORATION -GGT I-EXPLORATION -37 I-EXPLORATION -UI/l. I-EXPLORATION -Antígeno I-EXPLORATION -CA I-EXPLORATION -19-9 I-EXPLORATION -86 I-EXPLORATION -UI/l I-EXPLORATION -(0-37), I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -parámetros I-EXPLORATION -bioquímicos I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -coagulación I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -intra-extrahepática I-EXPLORATION -sin I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -litiasis. I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -y I-EXPLORATION -colangio I-EXPLORATION -RMN I-EXPLORATION -mostraron I-EXPLORATION -hepatomegalia, I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -intra-extrahepática, I-EXPLORATION -dilatación I-EXPLORATION -del I-EXPLORATION -conducto I-EXPLORATION -de I-EXPLORATION -Wirsung, I-EXPLORATION -desestructuración I-EXPLORATION -y I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -tamaño I-EXPLORATION -del I-EXPLORATION -proceso I-EXPLORATION -uncinado I-EXPLORATION -y I-EXPLORATION -cabeza I-EXPLORATION -de I-EXPLORATION -páncreas, I-EXPLORATION -sugestivas I-EXPLORATION -de I-EXPLORATION -neoplasia. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -colocar I-TREATMENT -percutáneamente I-TREATMENT -un I-TREATMENT -drenaje I-TREATMENT -biliar I-TREATMENT -externo-interno I-TREATMENT -para I-TREATMENT -resolver I-TREATMENT -la I-TREATMENT -ictericia I-TREATMENT -obstructiva. I-TREATMENT -Bajo I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -neoplasia I-TREATMENT -pancreática, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -intervino I-TREATMENT -quirúrgicamente; I-TREATMENT -la I-TREATMENT -exploración I-TREATMENT -intraoperatoria I-TREATMENT -mostraba I-TREATMENT -induración I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cabeza I-TREATMENT -del I-TREATMENT -páncreas I-TREATMENT -y I-TREATMENT -adenopatías I-TREATMENT -hiliares; I-TREATMENT -de B-EXPLORATION -ambas, I-EXPLORATION -se I-EXPLORATION -tomaron I-EXPLORATION -biopsias I-EXPLORATION -intraoperatorias I-EXPLORATION -que I-EXPLORATION -informaron I-EXPLORATION -de I-EXPLORATION -fibrosis I-EXPLORATION -intersticial I-EXPLORATION -y I-EXPLORATION -negativas I-EXPLORATION -para I-EXPLORATION -neoplasia I-EXPLORATION -respectivamente. I-EXPLORATION -Fue B-TREATMENT -practicada I-TREATMENT -duodenopancreatectomía I-TREATMENT -cefálica I-TREATMENT -con I-TREATMENT -preservación I-TREATMENT -pilórica. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -pancreatitis I-EXPLORATION -crónica I-EXPLORATION -obstructiva I-EXPLORATION -fibrosante I-EXPLORATION -e I-EXPLORATION -hiperplasia I-EXPLORATION -ductal I-EXPLORATION -inflamatoria I-EXPLORATION -de I-EXPLORATION -conducto I-EXPLORATION -pancreático. I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -duodécimo I-EVOLUTION -día I-EVOLUTION -postoperatorio I-EVOLUTION -sin I-EVOLUTION -complicaciones. I-EVOLUTION -Fue B-EXPLORATION -realizado, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -6º I-EXPLORATION -mes I-EXPLORATION -postoperatorio, I-EXPLORATION -estudio I-EXPLORATION -genético I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mutación I-EXPLORATION -N34S I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -gen I-EXPLORATION -SPINK1, I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -negativa. I-EXPLORATION -Dos B-EVOLUTION -años I-EVOLUTION -después I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION -La B-EXPLORATION -IFP I-EXPLORATION -es I-EXPLORATION -una I-EXPLORATION -rara I-EXPLORATION -causa I-EXPLORATION -de I-EXPLORATION -pancreatitis I-EXPLORATION -crónica I-EXPLORATION -en I-EXPLORATION -niños. I-EXPLORATION -El I-EXPLORATION -rango I-EXPLORATION -de I-EXPLORATION -edad I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -meses I-EXPLORATION -a I-EXPLORATION -20 I-EXPLORATION -años I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -edad I-EXPLORATION -media I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -años I-EXPLORATION -(1). I-EXPLORATION -Hasta I-EXPLORATION -la I-EXPLORATION -fecha I-EXPLORATION -sólo I-EXPLORATION -44 I-EXPLORATION -casos I-EXPLORATION -han I-EXPLORATION -sido I-EXPLORATION -publicados I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -literatura. I-EXPLORATION -La I-EXPLORATION -etiología I-EXPLORATION -es I-EXPLORATION -desconocida, I-EXPLORATION -aunque I-EXPLORATION -se I-EXPLORATION -ha I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -determinadas I-EXPLORATION -alteraciones I-EXPLORATION -genéticas I-EXPLORATION -(CFTR, I-EXPLORATION -PRSS1), I-EXPLORATION -destacando I-EXPLORATION -por I-EXPLORATION -su I-EXPLORATION -frecuencia I-EXPLORATION -la I-EXPLORATION -mutación I-EXPLORATION -N34S I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -SPINK1, I-EXPLORATION -que I-EXPLORATION -también I-EXPLORATION -se I-EXPLORATION -ha I-EXPLORATION -relacionado I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -pancreatitis I-EXPLORATION -juvenil I-EXPLORATION -tropical I-EXPLORATION -(1,3,4). I-EXPLORATION -A I-EXPLORATION -diferencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pancreatitis I-EXPLORATION -hereditaria I-EXPLORATION -autonómica I-EXPLORATION -dominante, I-EXPLORATION -los I-EXPLORATION -pacientes I-EXPLORATION -con I-EXPLORATION -IFP I-EXPLORATION -no I-EXPLORATION -presentan I-EXPLORATION -antecedentes I-EXPLORATION -familiares. I-EXPLORATION -La I-EXPLORATION -forma I-EXPLORATION -de I-EXPLORATION -presentación I-EXPLORATION -más I-EXPLORATION -frecuente I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -IFP I-EXPLORATION -es I-EXPLORATION -la I-EXPLORATION -ictericia I-EXPLORATION -obstructiva I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -crisis I-EXPLORATION -de I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -recidivante I-EXPLORATION -(1,2,5,6,). I-EXPLORATION -Analíticamente, I-EXPLORATION -los I-EXPLORATION -pacientes I-EXPLORATION -con I-EXPLORATION -IFP, I-EXPLORATION -presentan I-EXPLORATION -un I-EXPLORATION -patrón I-EXPLORATION -colestásico, I-EXPLORATION -citolítico I-EXPLORATION -y, I-EXPLORATION -ocasionalmente, I-EXPLORATION -una I-EXPLORATION -leve I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -amilasa I-EXPLORATION -sérica I-EXPLORATION -y I-EXPLORATION -urinaria. I-EXPLORATION -Respecto I-EXPLORATION -al I-EXPLORATION -diagnóstico, I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION -son I-EXPLORATION -útiles I-EXPLORATION -para I-EXPLORATION -objetivar I-EXPLORATION -el I-EXPLORATION -origen I-EXPLORATION -pancreático I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -obstrucción I-EXPLORATION -de I-EXPLORATION -vía I-EXPLORATION -biliar. I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -y I-EXPLORATION -colangioRMN I-EXPLORATION -permiten, I-EXPLORATION -como I-EXPLORATION -sucedió I-EXPLORATION -en I-EXPLORATION -nuestro I-EXPLORATION -caso, I-EXPLORATION -visualizar I-EXPLORATION -con I-EXPLORATION -mayor I-EXPLORATION -nitidez I-EXPLORATION -el I-EXPLORATION -páncreas, I-EXPLORATION -cuya I-EXPLORATION -cabeza I-EXPLORATION -usualmente I-EXPLORATION -estará I-EXPLORATION -aumentada I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -y I-EXPLORATION -desestructurada. I-EXPLORATION -El I-EXPLORATION -Wirsung I-EXPLORATION -puede I-EXPLORATION -presentar I-EXPLORATION -dilatación I-EXPLORATION -preestenótica. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo I-EXPLORATION -se I-EXPLORATION -consigue I-EXPLORATION -por I-EXPLORATION -exclusión I-EXPLORATION -de I-EXPLORATION -otras I-EXPLORATION -patologías I-EXPLORATION -más I-EXPLORATION -frecuentes I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -(biopsia I-EXPLORATION -o I-EXPLORATION -cirugía). I-EXPLORATION -Histológicamente I-EXPLORATION -el I-EXPLORATION -páncreas I-EXPLORATION -muestra I-EXPLORATION -bandas I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -colagenizado I-EXPLORATION -envolviendo I-EXPLORATION -acinos I-EXPLORATION -de I-EXPLORATION -apariencia I-EXPLORATION -normal. I-EXPLORATION -El I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -acompañante I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -proliferación I-EXPLORATION -fibrosante I-EXPLORATION -no I-EXPLORATION -suele I-EXPLORATION -ser I-EXPLORATION -prominente I-EXPLORATION -(1,6,). I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -debe I-TREATMENT -comenzar I-TREATMENT -por, I-TREATMENT -en I-TREATMENT -caso I-TREATMENT -de I-TREATMENT -existir, I-TREATMENT -resolver I-TREATMENT -la I-TREATMENT -ictericia I-TREATMENT -obstructiva, I-TREATMENT -en I-TREATMENT -espera I-TREATMENT -del I-TREATMENT -procedimiento I-TREATMENT -quirúrgico I-TREATMENT -definitivo. I-TREATMENT -El I-TREATMENT -drenaje I-TREATMENT -percutáneo I-TREATMENT -de I-TREATMENT -vía I-TREATMENT -biliar I-TREATMENT -o I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -stent I-TREATMENT -por I-TREATMENT -CPRE I-TREATMENT -son I-TREATMENT -las I-TREATMENT -técnicas I-TREATMENT -de I-TREATMENT -elección I-TREATMENT -(1,6,). I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -es I-TREATMENT -controvertido I-TREATMENT -y I-TREATMENT -podemos I-TREATMENT -clasificarlos I-TREATMENT -en I-TREATMENT -derivativos I-TREATMENT -y I-TREATMENT -resectivos. I-TREATMENT -Los I-TREATMENT -primeros I-TREATMENT -(coledocoduodenostomía I-TREATMENT -y I-TREATMENT -coledocoyeyunostomía I-TREATMENT -en I-TREATMENT -Y I-TREATMENT -de I-TREATMENT -Roux) I-TREATMENT -se I-TREATMENT -encuentran I-TREATMENT -en I-TREATMENT -desuso I-TREATMENT -porque I-TREATMENT -no I-TREATMENT -resuelven I-TREATMENT -la I-TREATMENT -obstrucción I-TREATMENT -del I-TREATMENT -Wirsung, I-TREATMENT -persistiendo I-TREATMENT -el I-TREATMENT -dolor I-TREATMENT -abdominal I-TREATMENT -o I-TREATMENT -la I-TREATMENT -evolución I-TREATMENT -a I-TREATMENT -insuficiencia I-TREATMENT -pancreática I-TREATMENT -exo-endocrina I-TREATMENT -(1). I-TREATMENT -Entre I-TREATMENT -los I-TREATMENT -procedimientos I-TREATMENT -resectivos I-TREATMENT -destaca I-TREATMENT -la I-TREATMENT -DPC I-TREATMENT -con I-TREATMENT -preservación I-TREATMENT -pilórica. I-TREATMENT -Algunos I-TREATMENT -autores I-TREATMENT -la I-TREATMENT -desanconsejan I-TREATMENT -por I-TREATMENT -la I-TREATMENT -alta I-TREATMENT -frecuencia I-TREATMENT -de I-TREATMENT -diabetes I-TREATMENT -y I-TREATMENT -mala I-TREATMENT -digestión I-TREATMENT -posoperatoria, I-TREATMENT -así I-TREATMENT -como I-TREATMENT -el I-TREATMENT -escaso I-TREATMENT -alivio I-TREATMENT -del I-TREATMENT -dolor I-TREATMENT -a I-TREATMENT -largo I-TREATMENT -plazo. I-TREATMENT -Fue I-TREATMENT -la I-TREATMENT -técnica I-TREATMENT -utilizada I-TREATMENT -en I-TREATMENT -nuestro I-TREATMENT -caso I-TREATMENT -y B-EVOLUTION -24 I-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -permanece I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -podemos I-EVOLUTION -apoyar I-EVOLUTION -dicha I-EVOLUTION -afirmación. I-EVOLUTION -La B-TREATMENT -pancreatectomía I-TREATMENT -cefálica I-TREATMENT -con I-TREATMENT -preservación I-TREATMENT -duodenal I-TREATMENT -(DPPHR) I-TREATMENT -elimina I-TREATMENT -las I-TREATMENT -complicaciones I-TREATMENT -de I-TREATMENT -las I-TREATMENT -pancreatitis I-TREATMENT -crónicas I-TREATMENT -y I-TREATMENT -proporciona I-TREATMENT -alivio I-TREATMENT -del I-TREATMENT -dolor I-TREATMENT -a I-TREATMENT -largo I-TREATMENT -plazo I-TREATMENT -en I-TREATMENT -más I-TREATMENT -del I-TREATMENT -80% I-TREATMENT -de I-TREATMENT -los I-TREATMENT -pacientes I-TREATMENT -(1). I-TREATMENT - I-TREATMENT -G. I-TREATMENT -Suárez I-TREATMENT -Artacho, I-TREATMENT -J. I-TREATMENT -Rodríguez I-TREATMENT -Muñoz, I-TREATMENT -M. I-TREATMENT -A. I-TREATMENT -Gómez I-TREATMENT -Bravo, I-TREATMENT -F. I-TREATMENT -Docobo I-TREATMENT -Durántez, I-TREATMENT -R. I-TREATMENT -García I-TREATMENT -Lozano I-TREATMENT -y I-TREATMENT -S. I-TREATMENT -P. I-TREATMENT -Alconchel I-TREATMENT -Gonzaga I-TREATMENT - I-TREATMENT -Servicio I-TREATMENT -de I-TREATMENT -Cirugía I-TREATMENT -General I-TREATMENT -y I-TREATMENT -Aparato I-TREATMENT -Digestivo. I-TREATMENT -Hospital I-TREATMENT -Universitario I-TREATMENT -Virgen I-TREATMENT -del I-TREATMENT -Rocío. I-TREATMENT -Sevilla. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -66 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -ex-fumadora B-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -bebedora I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -aproximadamente I-PAST_MEDICAL_HISTORY -70 I-PAST_MEDICAL_HISTORY -g I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcohol I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -día. I-PAST_MEDICAL_HISTORY -Menopausia I-PAST_MEDICAL_HISTORY -precoz I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -estrógenos I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Ingresa B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -otro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hidrotórax I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS -Fue I-PRESENT_ILLNESS -diagnosticada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hidrotórax I-PRESENT_ILLNESS -hepático I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -biopsia I-PRESENT_ILLNESS -hepática I-PRESENT_ILLNESS -diagnóstica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cirrosis I-PRESENT_ILLNESS -macro-micronodular I-PRESENT_ILLNESS -poco I-PRESENT_ILLNESS -evolucionada, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -moderada I-PRESENT_ILLNESS -actividad I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -esteatosis I-PRESENT_ILLNESS -focal. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -estudio I-PRESENT_ILLNESS -viral, I-PRESENT_ILLNESS -metabólico I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -autoinmune I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hepatopatía I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -negativo. I-PRESENT_ILLNESS -Se I-PRESENT_ILLNESS -descartó I-PRESENT_ILLNESS -patología I-PRESENT_ILLNESS -cardiopulmonar I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -causante I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -derrame I-PRESENT_ILLNESS -pleural, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -patología I-PRESENT_ILLNESS -infecciosa I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -tuberculosa I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -neoplásica I-PRESENT_ILLNESS -pleuropulmonar. I-PRESENT_ILLNESS -Ante I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -falta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -respuesta I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -restricción I-PRESENT_ILLNESS -hidrosalina I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -diurético, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -sometida I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -toracocentesis I-PRESENT_ILLNESS -evacuadoras I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -colocación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tubo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tórax I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -alivio I-PRESENT_ILLNESS -sintomático. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Ingresa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -tarde I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hidrotórax I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -recidivante. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destacaba I-EXPLORATION -hipoventilación I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -2/3 I-EXPLORATION -inferiores I-EXPLORATION -del I-EXPLORATION -campo I-EXPLORATION -pulmonar I-EXPLORATION -derecho. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -hemograma I-EXPLORATION -se I-EXPLORATION -detectó I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -20.500/µL I-EXPLORATION -con I-EXPLORATION -77% I-EXPLORATION -de I-EXPLORATION -PMN, I-EXPLORATION -sin I-EXPLORATION -anemia I-EXPLORATION -ni I-EXPLORATION -trombopenia. I-EXPLORATION -La I-EXPLORATION -bioquímica I-EXPLORATION -mostraba I-EXPLORATION -una I-EXPLORATION -creatinina I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -9 I-EXPLORATION -mg/dl, I-EXPLORATION -con I-EXPLORATION -sodio I-EXPLORATION -129 I-EXPLORATION -mEq/litro; I-EXPLORATION -potasio I-EXPLORATION -5, I-EXPLORATION -4 I-EXPLORATION -mEq/litro; I-EXPLORATION -proteínas I-EXPLORATION -totales: I-EXPLORATION -5, I-EXPLORATION -68 I-EXPLORATION -g/dl; I-EXPLORATION -albúmina: I-EXPLORATION -2, I-EXPLORATION -44 I-EXPLORATION -g/dl; I-EXPLORATION -GOT: I-EXPLORATION -107 I-EXPLORATION -UI/L; I-EXPLORATION -GPT: I-EXPLORATION -52 I-EXPLORATION -UI/L; I-EXPLORATION -LDH: I-EXPLORATION -157UI/L; I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -1, I-EXPLORATION -81 I-EXPLORATION -mg/dl; I-EXPLORATION -GGT I-EXPLORATION -370 I-EXPLORATION -UI/L, I-EXPLORATION -F.A. I-EXPLORATION -278 I-EXPLORATION -UI/L; I-EXPLORATION -actividad I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -69%; I-EXPLORATION -TTPA I-EXPLORATION -30'', I-EXPLORATION -fibrinógeno I-EXPLORATION -283 I-EXPLORATION -mg/dl. I-EXPLORATION -AFP I-EXPLORATION -6 I-EXPLORATION -ng/ml, I-EXPLORATION -serologías I-EXPLORATION -de I-EXPLORATION -VHB, I-EXPLORATION -VHC, I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -Epstein-Barr I-EXPLORATION -y I-EXPLORATION -sífilis I-EXPLORATION -negativas; I-EXPLORATION -la I-EXPLORATION -bioquímica I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -pleural I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -era I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -exudado I-EXPLORATION -(proteínas I-EXPLORATION -totales I-EXPLORATION -de I-EXPLORATION -3, I-EXPLORATION -34 I-EXPLORATION -g/dl; I-EXPLORATION -LDH I-EXPLORATION -427 I-EXPLORATION -UI/L; I-EXPLORATION -pH I-EXPLORATION -7, I-EXPLORATION -073, I-EXPLORATION -glucosa I-EXPLORATION -62 I-EXPLORATION -mg/dl; I-EXPLORATION -albúmina I-EXPLORATION -1, I-EXPLORATION -82 I-EXPLORATION -mg/Dl, I-EXPLORATION -leucocitos I-EXPLORATION -648 I-EXPLORATION -cel/mm3 I-EXPLORATION -con I-EXPLORATION -50% I-EXPLORATION -PMN) I-EXPLORATION -con I-EXPLORATION -cultivo I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -Staphylococcus I-EXPLORATION -aureus I-EXPLORATION -coagulasa I-EXPLORATION -positivo I-EXPLORATION -oxacilin I-EXPLORATION -sensible. I-EXPLORATION -Se I-EXPLORATION -descartó I-EXPLORATION -tuberculosis I-EXPLORATION -mediante I-EXPLORATION -la I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -bacilos I-EXPLORATION -ácido-alcohol I-EXPLORATION -resistentes I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -gamma-interferón I-EXPLORATION -en I-EXPLORATION -líquido I-EXPLORATION -pleural I-EXPLORATION -y I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -negatividad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -reacción I-EXPLORATION -de I-EXPLORATION -Mantoux. I-EXPLORATION -Asímismo I-EXPLORATION -se I-EXPLORATION -descartó I-EXPLORATION -malignidad I-EXPLORATION -mediante I-EXPLORATION -citologías I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -pleural I-EXPLORATION -y I-EXPLORATION -biopsias I-EXPLORATION -pleurales. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -doppler I-EXPLORATION -abdominal I-EXPLORATION -mostraba I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -hepatopatía I-EXPLORATION -crónica I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -morfológicos I-EXPLORATION -ni I-EXPLORATION -hemodinámicos I-EXPLORATION -de I-EXPLORATION -hipertensión I-EXPLORATION -portal, I-EXPLORATION -con I-EXPLORATION -ascitis I-EXPLORATION -mínima I-EXPLORATION -y I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -derecho. I-EXPLORATION -Tras B-TREATMENT -comprobar I-TREATMENT -que I-TREATMENT -no I-TREATMENT -había I-TREATMENT -respuesta I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -restricción I-TREATMENT -hidrosalina I-TREATMENT -y I-TREATMENT -diuréticos, I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -un I-TREATMENT -tubo I-TREATMENT -torácico I-TREATMENT -como I-TREATMENT -tratamiento I-TREATMENT -sintomático I-TREATMENT -del I-TREATMENT -hidrotórax I-TREATMENT -drenando I-TREATMENT -2000-2500 I-TREATMENT -cc I-TREATMENT -de I-TREATMENT -líquido I-TREATMENT -al I-TREATMENT -día. I-TREATMENT -Como B-EVOLUTION -complicaciones I-EVOLUTION -del I-EVOLUTION -derrame I-EVOLUTION -pleural I-EVOLUTION -presentó I-EVOLUTION -insuficiencia I-EVOLUTION -renal I-EVOLUTION -prerrenal I-EVOLUTION -por I-EVOLUTION -alto I-EVOLUTION -débito I-EVOLUTION -e I-EVOLUTION -hipoproteinemia I-EVOLUTION -con I-EVOLUTION -hipoalbuminemia. I-EVOLUTION -En B-TREATMENT -un I-TREATMENT -intento I-TREATMENT -de I-TREATMENT -controlar I-TREATMENT -la I-TREATMENT -producción I-TREATMENT -de I-TREATMENT -líquido I-TREATMENT -pleural I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -minitoracotomía I-TREATMENT -con I-TREATMENT -pleurodesis I-TREATMENT -con I-TREATMENT -talco I-TREATMENT -que I-TREATMENT -no I-TREATMENT -fue I-TREATMENT -efectiva. I-TREATMENT -Ante I-TREATMENT -el I-TREATMENT -fracaso I-TREATMENT -de I-TREATMENT -la I-TREATMENT -pleurodesis I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -colocar I-TREATMENT -una I-TREATMENT -DPPI, I-TREATMENT -tras I-TREATMENT -hallar I-TREATMENT -en I-TREATMENT -las I-TREATMENT -medidas I-TREATMENT -de I-TREATMENT -presión I-TREATMENT -datos I-TREATMENT -de I-TREATMENT -hipertensión I-TREATMENT -portal I-TREATMENT -leve I-TREATMENT -(gradiente I-TREATMENT -de I-TREATMENT -presión I-TREATMENT -enclavamiento-libre: I-TREATMENT -13 I-TREATMENT -mmHg) I-TREATMENT -sugestivo I-TREATMENT -de I-TREATMENT -hidrotórax I-TREATMENT -de I-TREATMENT -origen I-TREATMENT -hepático. I-TREATMENT -Con I-TREATMENT -ello I-TREATMENT -se I-TREATMENT -consiguió I-TREATMENT -un I-TREATMENT -descenso I-TREATMENT -transitorio I-TREATMENT -(2-3 I-TREATMENT -días) I-TREATMENT -del I-TREATMENT -débito I-TREATMENT -torácico. I-TREATMENT -Se B-EXPLORATION -descartó I-EXPLORATION -disfunción I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -DPPI I-EXPLORATION -mediante I-EXPLORATION -eco-doppler. I-EXPLORATION -Se B-TREATMENT -desestimó I-TREATMENT -el I-TREATMENT -trasplante I-TREATMENT -hepático I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -la I-TREATMENT -ingesta I-TREATMENT -reciente I-TREATMENT -de I-TREATMENT -alcohol. I-TREATMENT -Ante I-TREATMENT -la I-TREATMENT -gravedad I-TREATMENT -del I-TREATMENT -cuadro I-TREATMENT -y I-TREATMENT -la I-TREATMENT -ausencia I-TREATMENT -de I-TREATMENT -otras I-TREATMENT -opciones I-TREATMENT -terapéuticas, I-TREATMENT -quince I-TREATMENT -días I-TREATMENT -más I-TREATMENT -tarde I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -iniciar I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -octreótido I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -25 I-TREATMENT -µg/h I-TREATMENT -i.v. I-TREATMENT -el I-TREATMENT -primer I-TREATMENT -día, I-TREATMENT -50 I-TREATMENT -el I-TREATMENT -segundo I-TREATMENT -y I-TREATMENT -100 I-TREATMENT -durante I-TREATMENT -otros I-TREATMENT -5 I-TREATMENT -días. I-TREATMENT -La I-TREATMENT -paciente I-TREATMENT -presentó I-TREATMENT -muy I-TREATMENT -buena I-TREATMENT -respuesta I-TREATMENT -a I-TREATMENT -dicho I-TREATMENT -tratamiento, I-TREATMENT -con I-TREATMENT -disminución I-TREATMENT -progresiva I-TREATMENT -del I-TREATMENT -débito I-TREATMENT -por I-TREATMENT -el I-TREATMENT -tubo I-TREATMENT -de I-TREATMENT -tórax, I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -permitió I-TREATMENT -la I-TREATMENT -retirada I-TREATMENT -del I-TREATMENT -mismo I-TREATMENT -sin I-TREATMENT -posterior I-TREATMENT -recidiva I-TREATMENT -del I-TREATMENT -derrame I-TREATMENT -pleural. I-TREATMENT -Se I-TREATMENT -pautó I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -10 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -octreótido I-TREATMENT -subcutáneo I-TREATMENT -antes I-TREATMENT -del I-TREATMENT -alta. I-TREATMENT -En B-EVOLUTION -los I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -siguientes, I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -derrame I-EVOLUTION -pleural I-EVOLUTION -ni I-EVOLUTION -ascitis I-EVOLUTION -bajo I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -dosis I-EVOLUTION -de I-EVOLUTION -25 I-EVOLUTION -mg I-EVOLUTION -de I-EVOLUTION -aldactone I-EVOLUTION -al I-EVOLUTION -día. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -institución I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -cólico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -irradia I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -dorso, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos, I-PRESENT_ILLNESS -sub-ictericia, I-PRESENT_ILLNESS -coluria, I-PRESENT_ILLNESS -hipocolia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -escalofríos. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -presenta: I-EXPLORATION -dolor I-EXPLORATION -y I-EXPLORATION -defensa I-EXPLORATION -leve I-EXPLORATION -en I-EXPLORATION -hipocondrio I-EXPLORATION -derecho, I-EXPLORATION -distensión I-EXPLORATION -abdominal I-EXPLORATION -e I-EXPLORATION -ictericia. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -dificultad I-EXPLORATION -para I-EXPLORATION -evaluar I-EXPLORATION -la I-EXPLORATION -fosa I-EXPLORATION -vesicular I-EXPLORATION -que I-EXPLORATION -atribuye I-EXPLORATION -al I-EXPLORATION -meteorismo I-EXPLORATION -existente I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -vesícula I-EXPLORATION -biliar I-EXPLORATION -con I-EXPLORATION -paredes I-EXPLORATION -engrosadas I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -sombras I-EXPLORATION -acústicas I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -litiasis. I-EXPLORATION -No I-EXPLORATION -puede I-EXPLORATION -evaluar I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -ni I-EXPLORATION -páncreas. I-EXPLORATION -El I-EXPLORATION -laboratorio I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -franca I-EXPLORATION -leucocitosis, I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -bilirrubina I-EXPLORATION -a I-EXPLORATION -expensas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -directa, I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -cinco I-EXPLORATION -veces I-EXPLORATION -lo I-EXPLORATION -normal I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -e I-EXPLORATION -importante I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -transaminasas. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -síndrome I-EXPLORATION -coledociano, I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -es I-EXPLORATION -sometida I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -laparotomía I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que, I-EXPLORATION -a I-EXPLORATION -pesar I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -minuciosa I-EXPLORATION -exploración, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -puede I-EXPLORATION -hallar I-EXPLORATION -la I-EXPLORATION -vesícula I-EXPLORATION -biliar. I-EXPLORATION -Se I-EXPLORATION -libera I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -extra-hepática I-EXPLORATION -en I-EXPLORATION -todo I-EXPLORATION -su I-EXPLORATION -recorrido I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -colangiografía I-EXPLORATION -por I-EXPLORATION -punción I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -excepto I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -importante I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -panlitiasis I-EXPLORATION -coledociana I-EXPLORATION -no I-EXPLORATION -puede I-EXPLORATION -objetivarse I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vesícula I-EXPLORATION -biliar. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -efectúa I-TREATMENT -coledocotomía, I-TREATMENT -extracción I-TREATMENT -de I-TREATMENT -8 I-TREATMENT -litos I-TREATMENT -de I-TREATMENT -diferentes I-TREATMENT -tamaños I-TREATMENT -y I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -coledocoduodenostomía. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -y I-EVOLUTION -alta. I-EVOLUTION -Asintomática I-EVOLUTION -a I-EVOLUTION -dos I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -operada. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -89 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -HTA, I-PAST_MEDICAL_HISTORY -DM I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -varios I-PAST_MEDICAL_HISTORY -accidentes I-PAST_MEDICAL_HISTORY -cerebrovasculares I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -repetición I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -consecuencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -cuales I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -hemiplejía I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -alteraciones I-PAST_MEDICAL_HISTORY -deglutorias I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -habían I-PAST_MEDICAL_HISTORY -requerido I-PAST_MEDICAL_HISTORY -nutrición I-PAST_MEDICAL_HISTORY -enteral I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -través I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sonda I-PAST_MEDICAL_HISTORY -nasogástrica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -De B-PRESENT_ILLNESS -acuerdo I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -familia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -geriatra I-PRESENT_ILLNESS -habitual I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -indicó I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -colocación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sonda I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -gastrostomía I-PRESENT_ILLNESS -percutánea I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -control I-PRESENT_ILLNESS -endoscópico. I-PRESENT_ILLNESS -El B-TREATMENT -procedimiento I-TREATMENT -fue I-TREATMENT -realizado I-TREATMENT -bajo I-TREATMENT -sedación I-TREATMENT -profunda I-TREATMENT -por I-TREATMENT -un I-TREATMENT -anestesiólogo I-TREATMENT -y I-TREATMENT -siguiendo I-TREATMENT -las I-TREATMENT -pautas I-TREATMENT -de I-TREATMENT -profilaxis I-TREATMENT -antibiótica I-TREATMENT -recomendadas I-TREATMENT -actualmente. I-TREATMENT -La I-TREATMENT -técnica I-TREATMENT -de I-TREATMENT -colocación I-TREATMENT -por I-TREATMENT -tracción I-TREATMENT -se I-TREATMENT -llevó I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -con I-TREATMENT -set I-TREATMENT -comercializado I-TREATMENT -por I-TREATMENT -dos I-TREATMENT -endoscopistas I-TREATMENT -expertos. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -estricta I-TREATMENT -desinfección I-TREATMENT -de I-TREATMENT -la I-TREATMENT -zona, I-TREATMENT -colocando I-TREATMENT -la I-TREATMENT -presilla I-TREATMENT -externa I-TREATMENT -de I-TREATMENT -la I-TREATMENT -sonda I-TREATMENT -a I-TREATMENT -una I-TREATMENT -distancia I-TREATMENT -entre I-TREATMENT -2-3 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -la I-TREATMENT -superficie I-TREATMENT -de I-TREATMENT -la I-TREATMENT -piel I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -una I-TREATMENT -incisión I-TREATMENT -de I-TREATMENT -aproximadamente I-TREATMENT -1 I-TREATMENT -cm. I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -12 I-EVOLUTION -horas I-EVOLUTION -del I-EVOLUTION -proceso I-EVOLUTION -se I-EVOLUTION -inició I-EVOLUTION -alimentación I-EVOLUTION -a I-EVOLUTION -través I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -PEG I-EVOLUTION -y I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION -aconsejándose I-EVOLUTION -los I-EVOLUTION -cuidados I-EVOLUTION -domiciliarios I-EVOLUTION -habituales. I-EVOLUTION -Transcurridas I-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -ingresa I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Urgencias I-EVOLUTION -de I-EVOLUTION -nuestro I-EVOLUTION -hospital I-EVOLUTION -por I-EVOLUTION -deterioro I-EVOLUTION -del I-EVOLUTION -estado I-EVOLUTION -general; I-EVOLUTION -eritema, I-EVOLUTION -edema I-EVOLUTION -e I-EVOLUTION -induración I-EVOLUTION -en I-EVOLUTION -pared I-EVOLUTION -abdominal I-EVOLUTION -con I-EVOLUTION -supuración I-EVOLUTION -de I-EVOLUTION -líquido I-EVOLUTION -purulento I-EVOLUTION -a I-EVOLUTION -través I-EVOLUTION -y I-EVOLUTION -alrededor I-EVOLUTION -del I-EVOLUTION -orificio I-EVOLUTION -de I-EVOLUTION -gastrostomía. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destacaban I-EXPLORATION -un I-EXPLORATION -claro I-EXPLORATION -empeoramiento I-EXPLORATION -del I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -tiraje I-EXPLORATION -intercostal I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -hipoperfusión I-EXPLORATION -periférica. I-EXPLORATION -La I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -presentaba I-EXPLORATION -extensa I-EXPLORATION -crepitación, I-EXPLORATION -edema I-EXPLORATION -y I-EXPLORATION -eritema I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -perigastrostomía I-EXPLORATION -con I-EXPLORATION -supuración I-EXPLORATION -espontánea I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -presión I-EXPLORATION -de I-EXPLORATION -material I-EXPLORATION -purulento I-EXPLORATION -por I-EXPLORATION -orificio I-EXPLORATION -de I-EXPLORATION -gastrostomía. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -mostraba I-EXPLORATION -intensa I-EXPLORATION -leucocitosis I-EXPLORATION -con I-EXPLORATION -desviación I-EXPLORATION -izquierda, I-EXPLORATION -plaquetopenia I-EXPLORATION -y I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -tiempos I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -y I-EXPLORATION -cefalina. I-EXPLORATION -Se I-EXPLORATION -decidió I-EXPLORATION -realizar I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -urgente I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -extenso I-EXPLORATION -enfisema I-EXPLORATION -subcutáneo I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -: I-EXPLORATION -imagen I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -abscesificación I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -subyacente I-EXPLORATION -a I-EXPLORATION -gastrostomía; I-EXPLORATION -importante I-EXPLORATION -íleo I-EXPLORATION -paralítico I-EXPLORATION -y I-EXPLORATION -pneumoperitoneo. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -antibióticos I-TREATMENT -de I-TREATMENT -amplio I-TREATMENT -espectro, I-TREATMENT -desbridamiento I-TREATMENT -quirúrgico I-TREATMENT -del I-TREATMENT -absceso I-TREATMENT -abdominal I-TREATMENT -y I-TREATMENT -estrictos I-TREATMENT -cuidados I-TREATMENT -locales I-TREATMENT -de I-TREATMENT -la I-TREATMENT -herida. I-TREATMENT -Pese B-EVOLUTION -a I-EVOLUTION -todo I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -falleció I-EVOLUTION -una I-EVOLUTION -semana I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -tratamiento. I-EVOLUTION -El B-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -muestras I-EXPLORATION -tomada I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -resultó I-EXPLORATION -positivo I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -diez I-EXPLORATION -días I-EXPLORATION -del I-EXPLORATION -ingreso I-EXPLORATION -para I-EXPLORATION -Pseudomonas I-EXPLORATION -putrida I-EXPLORATION -y I-EXPLORATION -Acinetobacter. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -gastrectomía I-PRESENT_ILLNESS -total I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -reconstrucción I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Y I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Roux I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -adenocarcinoma I-PRESENT_ILLNESS -gástrico I-PRESENT_ILLNESS -pobremente I-PRESENT_ILLNESS -diferenciado I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -antes. I-PRESENT_ILLNESS -Se B-TREATMENT -asoció I-TREATMENT -quimioterapia I-TREATMENT -con I-TREATMENT -la I-TREATMENT -pauta I-TREATMENT -cisplatino I-TREATMENT -e I-TREATMENT -iridotecán, I-TREATMENT -y I-TREATMENT -se I-TREATMENT -administraron I-TREATMENT -12 I-TREATMENT -ciclos. I-TREATMENT -Requirió I-TREATMENT -cirugía I-TREATMENT -de I-TREATMENT -rescate I-TREATMENT -18 I-TREATMENT -meses I-TREATMENT -después I-TREATMENT -de I-TREATMENT -la I-TREATMENT -1ª I-TREATMENT -cirugía I-TREATMENT -por I-TREATMENT -recidiva I-TREATMENT -tumoral I-TREATMENT -extraluminal I-TREATMENT -local: I-TREATMENT -anastomosis I-TREATMENT -terminolateral I-TREATMENT -con I-TREATMENT -nueva I-TREATMENT -reconstrucción I-TREATMENT -en I-TREATMENT -Y I-TREATMENT -de I-TREATMENT -Roux I-TREATMENT -y I-TREATMENT -colectomía I-TREATMENT -subtotal I-TREATMENT -con I-TREATMENT -anastomosis I-TREATMENT -ileocólica I-TREATMENT -terminolateral I-TREATMENT -con I-TREATMENT -ileostomía I-TREATMENT -asociada. I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -se I-EXPLORATION -pudo I-EXPLORATION -comprobar I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -peritoneo, I-EXPLORATION -colon, I-EXPLORATION -asa I-EXPLORATION -intestinal I-EXPLORATION -ascendida I-EXPLORATION -previamente I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -rodete I-EXPLORATION -esofágico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -resección. I-EXPLORATION - I-EXPLORATION -Es B-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Aparato I-DERIVED_FROM/TO -Digestivo I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -disfagia I-DERIVED_FROM/TO -progresiva I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -2 I-DERIVED_FROM/TO -meses I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -cirugía, I-DERIVED_FROM/TO -acompañada I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -pérdida I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -peso. I-DERIVED_FROM/TO -Se B-EXPLORATION -realizó I-EXPLORATION -esofagograma I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -estenosis I-EXPLORATION -esofágica I-EXPLORATION -distal I-EXPLORATION -y I-EXPLORATION -posteriormente, I-EXPLORATION -se I-EXPLORATION -hizo I-EXPLORATION -una I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta: I-EXPLORATION -estenosis I-EXPLORATION -esofágica I-EXPLORATION -distal I-EXPLORATION -con I-EXPLORATION -mucosa I-EXPLORATION -normal, I-EXPLORATION -con I-EXPLORATION -biopsias I-EXPLORATION -negativas I-EXPLORATION -para I-EXPLORATION -malignidad; I-EXPLORATION -además I-EXPLORATION -había I-EXPLORATION -puntos I-EXPLORATION -de I-EXPLORATION -sutura I-EXPLORATION -y I-EXPLORATION -grapas I-EXPLORATION -quirúrgicas. I-EXPLORATION -Se B-TREATMENT -optó I-TREATMENT -por I-TREATMENT -retirar I-TREATMENT -los I-TREATMENT -puntos I-TREATMENT -de I-TREATMENT -sutura I-TREATMENT -y I-TREATMENT -se I-TREATMENT -hicieron I-TREATMENT -6 I-TREATMENT -sesiones I-TREATMENT -de I-TREATMENT -dilatación I-TREATMENT -neumática, I-TREATMENT -siendo I-TREATMENT -ineficaces. I-TREATMENT -Ante I-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -infiltración I-TREATMENT -neoplásica I-TREATMENT -transmural I-TREATMENT -y I-TREATMENT -el I-TREATMENT -mantenimiento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -disfagia, I-TREATMENT -se I-TREATMENT -colocó I-TREATMENT -una I-TREATMENT -prótesis I-TREATMENT -esofágica I-TREATMENT -no I-TREATMENT -recubierta I-TREATMENT -de I-TREATMENT -7 I-TREATMENT -cm. I-TREATMENT -Al B-EXPLORATION -expandirse I-EXPLORATION -la I-EXPLORATION -prótesis, I-EXPLORATION -permitió I-EXPLORATION -ver I-EXPLORATION -la I-EXPLORATION -infiltración I-EXPLORATION -neoplásica. I-EXPLORATION -A B-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION -pudo I-EVOLUTION -tomar I-EVOLUTION -dieta I-EVOLUTION -blanda, I-EVOLUTION -y I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -franca I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -disfagia. I-EVOLUTION -La B-TREATMENT -paciente I-TREATMENT -ha I-TREATMENT -recibido I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -quimioterapia I-TREATMENT -paliativos I-TREATMENT -asociados. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -8 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -colocación I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -prótesis, I-EVOLUTION -aparece I-EVOLUTION -de I-EVOLUTION -nuevo I-EVOLUTION -disfagia I-EVOLUTION -y I-EVOLUTION -pérdida I-EVOLUTION -de I-EVOLUTION -peso. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -endoscopia I-EXPLORATION -realizada I-EXPLORATION -se I-EXPLORATION -vio I-EXPLORATION -crecimiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -neoplasia I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -prótesis I-EXPLORATION -; I-EXPLORATION -se B-TREATMENT -decidió I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -una I-TREATMENT -prótesis I-TREATMENT -esofágica I-TREATMENT -recubierta I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -longitud. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -vuelve I-EVOLUTION -a I-EVOLUTION -reiniciar I-EVOLUTION -la I-EVOLUTION -alimentación I-EVOLUTION -oral, I-EVOLUTION -mejorando I-EVOLUTION -su I-EVOLUTION -disfagia. I-EVOLUTION -Falleció I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -por I-EVOLUTION -invasión I-EVOLUTION -tumoral I-EVOLUTION -sistémica. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -69 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -gastrectomía I-PRESENT_ILLNESS -total I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -Y I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Roux I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -adenocarcinoma I-PRESENT_ILLNESS -gástrico I-PRESENT_ILLNESS -pobremente I-PRESENT_ILLNESS -diferenciado I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -meses. I-PRESENT_ILLNESS -Como B-TREATMENT -tratamiento I-TREATMENT -adyuvante I-TREATMENT -recibió I-TREATMENT -radioterapia I-TREATMENT -y I-TREATMENT -quimioterapia, I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -que I-TREATMENT -presentaba I-TREATMENT -implantes I-TREATMENT -peritoneales I-TREATMENT -en I-TREATMENT -el I-TREATMENT -estudio I-TREATMENT -histológico I-TREATMENT -de I-TREATMENT -la I-TREATMENT -pieza I-TREATMENT -quirúrgica. I-TREATMENT -Se B-EXPLORATION -realiza I-EXPLORATION -endoscopia I-EXPLORATION -alta I-EXPLORATION -por I-EXPLORATION -disfagia I-EXPLORATION -progresiva I-EXPLORATION -y I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -peso, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -evidencia I-EXPLORATION -anillo I-EXPLORATION -fibroso I-EXPLORATION -en I-EXPLORATION -anastomosis I-EXPLORATION -esofagoenteral, I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -estenosis I-EXPLORATION -yeyunal I-EXPLORATION -próxima I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -anastomosis. I-EXPLORATION -Se I-EXPLORATION -tomaron I-EXPLORATION -biopsias I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -negativas I-EXPLORATION -para I-EXPLORATION -malignidad. I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -recidiva I-TREATMENT -local I-TREATMENT -por I-TREATMENT -carcinomatosis I-TREATMENT -peritoneal, I-TREATMENT -se I-TREATMENT -coloca I-TREATMENT -prótesis I-TREATMENT -esofágica I-TREATMENT -expandible I-TREATMENT -no I-TREATMENT -recubierta I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -longitud. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -fallece I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -4 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -por I-EVOLUTION -invasión I-EVOLUTION -tumoral I-EVOLUTION -sistémica. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -fumador B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -40 I-PAST_MEDICAL_HISTORY -cigarrillos/día I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -bebedor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -> I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -g I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcohol/día, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -hepatopatía I-PAST_MEDICAL_HISTORY -conocida, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -melenas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -"posos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -café". I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destacaba I-EXPLORATION -el I-EXPLORATION -mal I-EXPLORATION -estado I-EXPLORATION -nutricional, I-EXPLORATION -los I-EXPLORATION -estigmas I-EXPLORATION -de I-EXPLORATION -hepatopatía I-EXPLORATION -crónica, I-EXPLORATION -una I-EXPLORATION -hepatomegalia I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm, I-EXPLORATION -edemas I-EXPLORATION -bimaleolares I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -ascitis I-EXPLORATION -grado I-EXPLORATION -2-3. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -mostraba I-EXPLORATION -una I-EXPLORATION -anemia I-EXPLORATION -normocítica-normocrómica I-EXPLORATION -(Hb: I-EXPLORATION -9 I-EXPLORATION -g/dl; I-EXPLORATION -Hct: I-EXPLORATION -26, I-EXPLORATION -6%; I-EXPLORATION -VCM: I-EXPLORATION -92 I-EXPLORATION -fl) I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -transaminasas I-EXPLORATION -(AST: I-EXPLORATION -145 I-EXPLORATION -U/l; I-EXPLORATION -ALT: I-EXPLORATION -75 I-EXPLORATION -U/l; I-EXPLORATION -GGT: I-EXPLORATION -166 I-EXPLORATION -U/l) I-EXPLORATION -con I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -bilirrubina, I-EXPLORATION -albúmina I-EXPLORATION -y I-EXPLORATION -actividad I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION -Las I-EXPLORATION -serologías I-EXPLORATION -virales I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -estudio I-EXPLORATION -etiológico I-EXPLORATION -de I-EXPLORATION -hepatopatía I-EXPLORATION -resultaron I-EXPLORATION -negativos. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -datos I-EXPLORATION -de I-EXPLORATION -cirrosis I-EXPLORATION -e I-EXPLORATION -hipertensión I-EXPLORATION -portal, I-EXPLORATION -con I-EXPLORATION -ascitis I-EXPLORATION -moderada. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -gastroscopia I-EXPLORATION -urgente I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -hallazgos: I-EXPLORATION -varices I-EXPLORATION -esofágicas I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -moderado I-EXPLORATION -ocupando I-EXPLORATION -menos I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tercio I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -esofágica, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -alarma I-EXPLORATION -y I-EXPLORATION -gastropatía I-EXPLORATION -hipertensiva. I-EXPLORATION -Dos I-EXPLORATION -días I-EXPLORATION -después I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -presentó I-EXPLORATION -febrícula I-EXPLORATION -y I-EXPLORATION -malestar I-EXPLORATION -abdominal, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -paracentesis I-EXPLORATION -diagnóstica, I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -siguiente I-EXPLORATION -resultado: I-EXPLORATION -leucocitos: I-EXPLORATION -3.500/mm3 I-EXPLORATION -(2.975 I-EXPLORATION -PMN); I-EXPLORATION -proteínas I-EXPLORATION -totales: I-EXPLORATION -0, I-EXPLORATION -8 I-EXPLORATION -g/dl; I-EXPLORATION -albúmina: I-EXPLORATION -0, I-EXPLORATION -4 I-EXPLORATION -g/dl; I-EXPLORATION -glucosa: I-EXPLORATION -95 I-EXPLORATION -mg/dl; I-EXPLORATION -LDH: I-EXPLORATION -150 I-EXPLORATION -U/l; I-EXPLORATION -cultivo: I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -Streptococcus I-EXPLORATION -pneumoniae. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -hemocultivos I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -81 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -pluripatológico, B-PAST_MEDICAL_HISTORY -acude B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -últimas I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -persistentes. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -mostraba I-EXPLORATION -ictericia I-EXPLORATION -escleral I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -abdomen I-EXPLORATION -con I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -hipocondrio I-EXPLORATION -derecho I-EXPLORATION -sin I-EXPLORATION -peritonismo. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -y I-EXPLORATION -TAC I-EXPLORATION -Abdominal I-EXPLORATION -evidenciaban I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -intrahepática I-EXPLORATION -con I-EXPLORATION -aerobilia, I-EXPLORATION -vesícula I-EXPLORATION -mal I-EXPLORATION -delimitada I-EXPLORATION -con I-EXPLORATION -litiasis; I-EXPLORATION -gran I-EXPLORATION -cálculo I-EXPLORATION -biliar I-EXPLORATION -en I-EXPLORATION -bulbo I-EXPLORATION -duodenal I-EXPLORATION -que I-EXPLORATION -condiciona I-EXPLORATION -obstrucción I-EXPLORATION -y I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cámara I-EXPLORATION -gástrica. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -observando I-EXPLORATION -contenido I-EXPLORATION -líquido I-EXPLORATION -en I-EXPLORATION -cavidad I-EXPLORATION -gástrica I-EXPLORATION -y, I-EXPLORATION -en I-EXPLORATION -bulbo I-EXPLORATION -duodenal I-EXPLORATION -un I-EXPLORATION -gran I-EXPLORATION -cálculo I-EXPLORATION -que I-EXPLORATION -ocupaba I-EXPLORATION -la I-EXPLORATION -práctica I-EXPLORATION -totalidad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -luz. I-EXPLORATION -Con B-TREATMENT -ayuda I-TREATMENT -del I-TREATMENT -endoscopio I-TREATMENT -lateral I-TREATMENT -y I-TREATMENT -litotriptor I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -fragmentación I-TREATMENT -parcial I-TREATMENT -del I-TREATMENT -cálculo, I-TREATMENT -con I-TREATMENT -extracción I-TREATMENT -de I-TREATMENT -los I-TREATMENT -mismos, I-TREATMENT -quedando I-TREATMENT -en I-TREATMENT -duodeno I-TREATMENT -un I-TREATMENT -fragmento I-TREATMENT -de I-TREATMENT -aproximadamente I-TREATMENT -2 I-TREATMENT -cm. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -notable I-EVOLUTION -con I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -ictericia I-EVOLUTION -y I-EVOLUTION -ausencia I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -abdominal. I-EVOLUTION -A I-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -endoscopia I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -observando I-EVOLUTION -imagen I-EVOLUTION -sugestiva I-EVOLUTION -de I-EVOLUTION -fístula I-EVOLUTION -bilio-duodenal I-EVOLUTION -y I-EVOLUTION -ausencia I-EVOLUTION -del I-EVOLUTION -cálculo I-EVOLUTION -descrito. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -quinto I-EVOLUTION -día I-EVOLUTION -en I-EVOLUTION -buen I-EVOLUTION -estado I-EVOLUTION -clínico I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -notable I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -de I-EVOLUTION -colestasis. I-EVOLUTION -Dado I-EVOLUTION -el I-EVOLUTION -alto I-EVOLUTION -riesgo I-EVOLUTION -quirúrgico I-EVOLUTION -se I-EVOLUTION -decidió I-EVOLUTION -actitud I-EVOLUTION -expectante, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -está I-EVOLUTION -sintomático I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -12 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -rectal I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -nota I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -tacto I-PRESENT_ILLNESS -rectal I-PRESENT_ILLNESS -debido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -estreñimiento I-PRESENT_ILLNESS -crónico I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -requería I-PRESENT_ILLNESS -alguna I-PRESENT_ILLNESS -digitalización. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -clínica I-EXPLORATION -y I-EXPLORATION -anuscopia-rectoscopia, I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -nodular I-EXPLORATION -submucosa I-EXPLORATION -única I-EXPLORATION -a I-EXPLORATION -3-4 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -margen I-EXPLORATION -anal I-EXPLORATION -de I-EXPLORATION -alrededor I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -móvil, I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -amarillento I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cara I-EXPLORATION -anterior I-EXPLORATION -rectal. I-EXPLORATION -Se B-TREATMENT -realiza I-TREATMENT -una I-TREATMENT -exéresis I-TREATMENT -local I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión, I-TREATMENT -respetando I-TREATMENT -la I-TREATMENT -muscular I-TREATMENT -al I-TREATMENT -no I-TREATMENT -estar I-TREATMENT -adherido I-TREATMENT -a I-TREATMENT -ella. I-TREATMENT -El B-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -tumor I-EXPLORATION -carcinoide I-EXPLORATION -rectal I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -bien I-EXPLORATION -diferenciado, I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -atipias, I-EXPLORATION -desarrollado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -submucosa. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -invasión I-EXPLORATION -vascular, I-EXPLORATION -linfática I-EXPLORATION -o I-EXPLORATION -perineural. I-EXPLORATION -En I-EXPLORATION -superficie I-EXPLORATION -aparece I-EXPLORATION -cubierta I-EXPLORATION -por I-EXPLORATION -mucosa I-EXPLORATION -rectal I-EXPLORATION -bien I-EXPLORATION -diferenciada. I-EXPLORATION -En I-EXPLORATION -su I-EXPLORATION -base I-EXPLORATION -muestra I-EXPLORATION -escaso I-EXPLORATION -margen I-EXPLORATION -de I-EXPLORATION -seguridad I-EXPLORATION -afectando I-EXPLORATION -uno I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -bordes, I-EXPLORATION -si I-EXPLORATION -bien I-EXPLORATION -no I-EXPLORATION -muestra I-EXPLORATION -invasión I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -muscular I-EXPLORATION -propia. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -este I-TREATMENT -hallazgo I-TREATMENT -se I-TREATMENT -propone I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -un I-TREATMENT -seguimiento I-TREATMENT -clínico I-TREATMENT -y I-TREATMENT -una I-TREATMENT -biopsia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cicatriz I-TREATMENT -mucosa I-TREATMENT -en I-TREATMENT -tres I-TREATMENT -meses. I-TREATMENT -La B-EXPLORATION -exéresis I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -pericicatricial I-EXPLORATION -no I-EXPLORATION -evidencia I-EXPLORATION -restos I-EXPLORATION -tumorales. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -se I-EXPLORATION -completó I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -colonoscopia I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -evidenció I-EXPLORATION -otros I-EXPLORATION -tumores. I-EXPLORATION -Tras B-EVOLUTION -21 I-EVOLUTION -meses I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -está I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -27 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -previamente I-PRESENT_ILLNESS -sana, I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -diarrea, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -difuso I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -estaba I-PRESENT_ILLNESS -tomando I-PRESENT_ILLNESS -anovulatorios I-PRESENT_ILLNESS -orales I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ingreso. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -presenta I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal I-EXPLORATION -en I-EXPLORATION -fosa I-EXPLORATION -iliaca I-EXPLORATION -derecha. I-EXPLORATION -Presentaba I-EXPLORATION -leucocitosis I-EXPLORATION -con I-EXPLORATION -importante I-EXPLORATION -desviación I-EXPLORATION -izquierda. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -estudios I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -y I-EXPLORATION -radiológicos I-EXPLORATION -resultaron I-EXPLORATION -normales. I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -apendicitis I-TREATMENT -aguda I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -laparotomía I-TREATMENT -de I-TREATMENT -urgencia I-TREATMENT -encontrándose I-TREATMENT -una I-TREATMENT -apendicitis I-TREATMENT -aguda I-TREATMENT -gangrenosa I-TREATMENT -(anat. I-TREATMENT -patológica: I-TREATMENT -apendicitis I-TREATMENT -aguda), I-TREATMENT -realizándose I-TREATMENT -apendicectomía. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -le I-TREATMENT -administró I-TREATMENT -empíricamente I-TREATMENT -1 I-TREATMENT -g/8 I-TREATMENT -h I-TREATMENT -endovenoso I-TREATMENT -de I-TREATMENT -amoxicilina-clavulánico, I-TREATMENT -en I-TREATMENT -el I-TREATMENT -en I-TREATMENT -el I-TREATMENT -5º I-TREATMENT -día I-TREATMENT -postoperatorio I-TREATMENT -empezó I-TREATMENT -con I-TREATMENT -fiebre I-TREATMENT -"en I-TREATMENT -picos" I-TREATMENT -de I-TREATMENT -hasta I-TREATMENT -40 I-TREATMENT -ºC. I-TREATMENT -Se B-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -siendo I-EXPLORATION -informado I-EXPLORATION -como I-EXPLORATION -trombosis I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -mesentérica I-EXPLORATION -superior I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -ramas I-EXPLORATION -ileocólicas, I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -la I-TREATMENT -instauró I-TREATMENT -sueroterapia, I-TREATMENT -reposo I-TREATMENT -intestinal I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -enoxiparina I-TREATMENT -subcutánea I-TREATMENT -60 I-TREATMENT -mg/12 I-TREATMENT -h I-TREATMENT -y I-TREATMENT -meropenem I-TREATMENT -endovenoso I-TREATMENT -1 I-TREATMENT -g/8 I-TREATMENT -h. I-TREATMENT -Se B-EVOLUTION -completan I-EVOLUTION -14 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -antibiótico I-EVOLUTION -y I-EVOLUTION -ante I-EVOLUTION -ausencia I-EVOLUTION -de I-EVOLUTION -fiebre I-EVOLUTION -y I-EVOLUTION -problemas I-EVOLUTION -digestivos I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -causa I-EVOLUTION -alta I-EVOLUTION -el I-EVOLUTION -24º I-EVOLUTION -día I-EVOLUTION -del I-EVOLUTION -postoperatorio I-EVOLUTION -con I-EVOLUTION -acenocumarol I-EVOLUTION -oral. I-EVOLUTION - I-EVOLUTION -En B-EXPLORATION -los I-EXPLORATION -cultivos I-EXPLORATION -intraoperatorios I-EXPLORATION -crecieron I-EXPLORATION -Proteus I-EXPLORATION -mirabilis I-EXPLORATION -y I-EXPLORATION -Escherichia I-EXPLORATION -coli I-EXPLORATION -sensibles I-EXPLORATION -a I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -antibióticos I-EXPLORATION -testados. I-EXPLORATION -El I-EXPLORATION -cultivo I-EXPLORATION -intraoperatorio I-EXPLORATION -para I-EXPLORATION -gérmenes I-EXPLORATION -anaerobios I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION -Dos I-EXPLORATION -hemocultivos I-EXPLORATION -resultaron I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -Bacteroides I-EXPLORATION -fragilis I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -clindamicina I-EXPLORATION -y I-EXPLORATION -penicilina, I-EXPLORATION -siendo I-EXPLORATION -sensible I-EXPLORATION -al I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -antibióticos I-EXPLORATION -testados. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -para I-EXPLORATION -anticuerpos I-EXPLORATION -antifosfolípido I-EXPLORATION -resultó I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -Al B-EVOLUTION -mes I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -66 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -ingresada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -tromboembolismo I-PRESENT_ILLNESS -pulmonar I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS -bajo I-PRESENT_ILLNESS -terapia I-PRESENT_ILLNESS -anticoagulante I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -enoxaparina, I-PRESENT_ILLNESS -iniciándose B-TREATMENT -a I-TREATMENT -las I-TREATMENT -72 I-TREATMENT -horas I-TREATMENT -paso I-TREATMENT -a I-TREATMENT -anticoagulación I-TREATMENT -oral I-TREATMENT -con I-TREATMENT -acenocumarol. I-TREATMENT -Al B-EVOLUTION -octavo I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -ingreso, I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -INR I-EVOLUTION -de I-EVOLUTION -2, I-EVOLUTION -1, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -desarrolla, I-EVOLUTION -tras I-EVOLUTION -un I-EVOLUTION -episodio I-EVOLUTION -emético I-EVOLUTION -autolimitado, I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -malestar I-EVOLUTION -general, I-EVOLUTION -sudación, I-EVOLUTION -tendencia I-EVOLUTION -a I-EVOLUTION -hipotensión I-EVOLUTION -arterial I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -hipogástrico I-EVOLUTION -sin I-EVOLUTION -peritonismo, I-EVOLUTION -por B-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -practica I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -que I-EXPLORATION -objetiva I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -líquida I-EXPLORATION -intraabdominal I-EXPLORATION -hipogástrica I-EXPLORATION -de I-EXPLORATION -15 I-EXPLORATION -x I-EXPLORATION -11 I-EXPLORATION -cm. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -hipogástrica I-EXPLORATION -subperitoneal I-EXPLORATION -de I-EXPLORATION -15 I-EXPLORATION -x I-EXPLORATION -15 I-EXPLORATION -x I-EXPLORATION -11 I-EXPLORATION -cm, I-EXPLORATION -dependiente I-EXPLORATION -del I-EXPLORATION -recto I-EXPLORATION -abdominal I-EXPLORATION -anterior I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -ocupa I-EXPLORATION -gran I-EXPLORATION -parte I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cavidad I-EXPLORATION -pélvica. I-EXPLORATION -Se I-EXPLORATION -objetiva I-EXPLORATION -importante I-EXPLORATION -anemización I-EXPLORATION -(descenso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -4, I-EXPLORATION -2 I-EXPLORATION -g/dl I-EXPLORATION -en I-EXPLORATION -72 I-EXPLORATION -horas), I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -ante I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -shock I-EXPLORATION -hemorrágico I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -gran I-EXPLORATION -hematoma I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -se B-TREATMENT -instaura I-TREATMENT -tratamiento I-TREATMENT -enérgico I-TREATMENT -con I-TREATMENT -reposición I-TREATMENT -de I-TREATMENT -volemia, I-TREATMENT -se I-TREATMENT -revierte I-TREATMENT -la I-TREATMENT -anticoagulación I-TREATMENT -y I-TREATMENT -se I-TREATMENT -solicita I-TREATMENT -valoración I-TREATMENT -quirúrgica I-TREATMENT -urgente. I-TREATMENT -Ante B-EVOLUTION -la I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -inestabilidad I-EVOLUTION -hemodinámica I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -manejo I-EVOLUTION -conservador I-EVOLUTION -inicial I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -semiología I-EVOLUTION -de I-EVOLUTION -abdomen I-EVOLUTION -agudo, I-EVOLUTION -se B-TREATMENT -decide I-TREATMENT -practicar I-TREATMENT -laparotomía I-TREATMENT -urgente I-TREATMENT -que I-TREATMENT -muestra I-TREATMENT -"estallido" I-TREATMENT -del I-TREATMENT -peritoneo I-TREATMENT -parietal I-TREATMENT -y I-TREATMENT -del I-TREATMENT -músculo I-TREATMENT -recto I-TREATMENT -anterior I-TREATMENT -derecho I-TREATMENT -con I-TREATMENT -gran I-TREATMENT -hemoperitoneo I-TREATMENT -secundario I-TREATMENT -que I-TREATMENT -diseca I-TREATMENT -todo I-TREATMENT -el I-TREATMENT -espacio I-TREATMENT -prevesical, I-TREATMENT -objetivándose I-TREATMENT -sangrado I-TREATMENT -arterial I-TREATMENT -por I-TREATMENT -laceración I-TREATMENT -de I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -epigástrica I-TREATMENT -derecha I-TREATMENT -que I-TREATMENT -se I-TREATMENT -liga I-TREATMENT -y I-TREATMENT -sutura, I-TREATMENT -procediéndose I-TREATMENT -a I-TREATMENT -evacuar I-TREATMENT -aproximadamente I-TREATMENT -2 I-TREATMENT -litros I-TREATMENT -de I-TREATMENT -hemoperitoneo I-TREATMENT -con I-TREATMENT -grandes I-TREATMENT -coágulos I-TREATMENT -prevesicales, I-TREATMENT -y I-TREATMENT -cierre I-TREATMENT -con I-TREATMENT -malla I-TREATMENT -de I-TREATMENT -polipropileno I-TREATMENT -por I-TREATMENT -defecto I-TREATMENT -de I-TREATMENT -músculo I-TREATMENT -suprafascial. I-TREATMENT -Tras I-TREATMENT -soporte I-TREATMENT -en I-TREATMENT -Unidad I-TREATMENT -de I-TREATMENT -Cuidados I-TREATMENT -Intensivos I-TREATMENT -e I-TREATMENT -implantación I-TREATMENT -de I-TREATMENT -filtro I-TREATMENT -temporal I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -cava I-TREATMENT -inferior, I-TREATMENT -la B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta, I-EVOLUTION -reinstaurándose B-TREATMENT -terapia I-TREATMENT -anticoagulante I-TREATMENT -con I-TREATMENT -acenocumarol. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -hematoma I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -es I-EXPLORATION -una I-EXPLORATION -entidad I-EXPLORATION -infrecuente I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -difícil I-EXPLORATION -diagnóstico I-EXPLORATION -que I-EXPLORATION -generalmente I-EXPLORATION -está I-EXPLORATION -relacionada I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -anticoagulación I-EXPLORATION -sistémica. I-EXPLORATION -En I-EXPLORATION -su I-EXPLORATION -patogenia I-EXPLORATION -se I-EXPLORATION -involucra I-EXPLORATION -la I-EXPLORATION -anticoagulación I-EXPLORATION -como I-EXPLORATION -factor I-EXPLORATION -predisponerte I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -contracción I-EXPLORATION -vigorosa I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -músculos I-EXPLORATION -rectos I-EXPLORATION -del I-EXPLORATION -abdomen I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -seno I-EXPLORATION -de I-EXPLORATION -movimientos I-EXPLORATION -de I-EXPLORATION -Valsalva I-EXPLORATION -enérgicos I-EXPLORATION -y I-EXPLORATION -bruscos I-EXPLORATION -(tos, I-EXPLORATION -vómitos, I-EXPLORATION -estreñimiento) I-EXPLORATION -como I-EXPLORATION -factor I-EXPLORATION -desencadenante. I-EXPLORATION -En I-EXPLORATION -varios I-EXPLORATION -trabajos I-EXPLORATION -previos I-EXPLORATION -se I-EXPLORATION -ha I-EXPLORATION -documentado I-EXPLORATION -la I-EXPLORATION -laceración I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -arterias I-EXPLORATION -epigástricas I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -causa I-EXPLORATION -del I-EXPLORATION -hematoma I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -(1-6). I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -se I-EXPLORATION -basa I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -contexto I-EXPLORATION -clínico I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION -abdominal. I-EXPLORATION -La I-EXPLORATION -presentación I-EXPLORATION -clínica I-EXPLORATION -habitual I-EXPLORATION -consiste I-EXPLORATION -en I-EXPLORATION -dolor I-EXPLORATION -abdominal, I-EXPLORATION -pudiendo I-EXPLORATION -objetivarse I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -abdominal I-EXPLORATION -con I-EXPLORATION -o I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal I-EXPLORATION -y/o I-EXPLORATION -un I-EXPLORATION -hematoma I-EXPLORATION -superficial. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -suele I-EXPLORATION -documentar I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -TAC I-EXPLORATION -es I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -elección I-EXPLORATION -ya I-EXPLORATION -que I-EXPLORATION -permite I-EXPLORATION -definir I-EXPLORATION -y I-EXPLORATION -precisar I-EXPLORATION -la I-EXPLORATION -extensión I-EXPLORATION -del I-EXPLORATION -proceso I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -afectación I-EXPLORATION -de I-EXPLORATION -órganos I-EXPLORATION -vecinos. I-EXPLORATION - I-EXPLORATION -Su I-EXPLORATION -manejo I-EXPLORATION -es, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -general, I-EXPLORATION -conservador, I-EXPLORATION -incluso I-EXPLORATION -ante I-EXPLORATION -hallazgos I-EXPLORATION -clínicos I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -agudo I-EXPLORATION -(1,3), I-EXPLORATION -ya I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -propio I-EXPLORATION -hematoma I-EXPLORATION -ejerce I-EXPLORATION -efecto I-EXPLORATION -de I-EXPLORATION -auto-taponamiento, I-EXPLORATION -siendo I-EXPLORATION -suficientes I-EXPLORATION -el I-EXPLORATION -tratamiento I-EXPLORATION -sintomático I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -transfusión I-EXPLORATION -sanguínea I-EXPLORATION -en I-EXPLORATION -casos I-EXPLORATION -necesarios. I-EXPLORATION -No B-TREATMENT -obstante, I-TREATMENT -existen I-TREATMENT -situaciones I-TREATMENT -en I-TREATMENT -las I-TREATMENT -que I-TREATMENT -la I-TREATMENT -hemorragia I-TREATMENT -puede I-TREATMENT -ser I-TREATMENT -muy I-TREATMENT -severa I-TREATMENT -y I-TREATMENT -llega I-TREATMENT -a I-TREATMENT -comprometer I-TREATMENT -la I-TREATMENT -vida, I-TREATMENT -precisándose I-TREATMENT -un I-TREATMENT -abordaje I-TREATMENT -quirúrgico I-TREATMENT -para I-TREATMENT -localizar I-TREATMENT -el I-TREATMENT -punto I-TREATMENT -sangrante I-TREATMENT -y I-TREATMENT -drenar I-TREATMENT -el I-TREATMENT -hematoma. I-TREATMENT -También I-TREATMENT -se I-TREATMENT -ha I-TREATMENT -descrito I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -exitoso I-TREATMENT -mediante I-TREATMENT -embolización I-TREATMENT -endovascular I-TREATMENT -de I-TREATMENT -los I-TREATMENT -vasos I-TREATMENT -sangrantes I-TREATMENT -(1). I-TREATMENT -La I-TREATMENT -inestabilidad I-TREATMENT -hemodinámica I-TREATMENT -a I-TREATMENT -pesar I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -médico I-TREATMENT -intensivo I-TREATMENT -y/o I-TREATMENT -la I-TREATMENT -aparición I-TREATMENT -de I-TREATMENT -complicaciones I-TREATMENT -(hemoperitoneo, I-TREATMENT -sobre-infección, I-TREATMENT -etc.) I-TREATMENT -son I-TREATMENT -las I-TREATMENT -principales I-TREATMENT -indicaciones I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -quirúrgico, I-TREATMENT -como I-TREATMENT -ocurrió I-TREATMENT -en I-TREATMENT -el I-TREATMENT -caso I-TREATMENT -que I-TREATMENT -presentamos. I-TREATMENT - I-TREATMENT -Nuestra B-EXPLORATION -experiencia I-EXPLORATION -confirma I-EXPLORATION -la I-EXPLORATION -importancia I-EXPLORATION -del I-EXPLORATION -diagnóstico I-EXPLORATION -precoz I-EXPLORATION -del I-EXPLORATION -hematoma I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -necesidad I-EXPLORATION -de I-EXPLORATION -llevar I-EXPLORATION -a I-EXPLORATION -cabo I-EXPLORATION -un I-EXPLORATION -manejo I-EXPLORATION -individualizado I-EXPLORATION -del I-EXPLORATION -mismo, I-EXPLORATION -ya I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -trata I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -entidad I-EXPLORATION -que, I-EXPLORATION -aunque I-EXPLORATION -generalmente I-EXPLORATION -es I-EXPLORATION -leve I-EXPLORATION -y I-EXPLORATION -autolimitada, I-EXPLORATION -puede I-EXPLORATION -presentar I-EXPLORATION -complicaciones I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -magnitud I-EXPLORATION -(shock I-EXPLORATION -hemorrágico I-EXPLORATION -refractario I-EXPLORATION -a I-EXPLORATION -soporte I-EXPLORATION -médico, I-EXPLORATION -hemoperitoneo, I-EXPLORATION -compromiso I-EXPLORATION -de I-EXPLORATION -vísceras I-EXPLORATION -abdomino-pélvicas, I-EXPLORATION -etc.) I-EXPLORATION -que B-TREATMENT -llegan I-TREATMENT -a I-TREATMENT -poner I-TREATMENT -en I-TREATMENT -peligro I-TREATMENT -la I-TREATMENT -vida I-TREATMENT -del I-TREATMENT -paciente I-TREATMENT -y I-TREATMENT -requieren I-TREATMENT -un I-TREATMENT -abordaje I-TREATMENT -quirúrgico. I-TREATMENT - I-TREATMENT -J. B-EXPLORATION -F. I-EXPLORATION -Varona, I-EXPLORATION -R. I-EXPLORATION -Díaz-Conradi1, I-EXPLORATION -M. I-EXPLORATION -Valle, I-EXPLORATION -F. I-EXPLORATION -Muñoz2 I-EXPLORATION -y I-EXPLORATION -M. I-EXPLORATION -A. I-EXPLORATION -Bufalá I-EXPLORATION -Departamentos I-EXPLORATION -de I-EXPLORATION -Medicina I-EXPLORATION -Interna, I-EXPLORATION -1Cirugía I-EXPLORATION -General I-EXPLORATION -y I-EXPLORATION -2Radiodiagnóstico. I-EXPLORATION -Hospital I-EXPLORATION -El I-EXPLORATION -Escorial. I-EXPLORATION -San I-EXPLORATION -Lorenzo I-EXPLORATION -del I-EXPLORATION -Escorial, I-EXPLORATION -Madrid I-EXPLORATION - I-EXPLORATION - -MRB. B-PRESENT_ILLNESS -Varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -67 I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS -Hermano. B-FAMILY_HISTORY -Casado I-FAMILY_HISTORY -y I-FAMILY_HISTORY -con I-FAMILY_HISTORY -2 I-FAMILY_HISTORY -hijos, I-FAMILY_HISTORY -uno I-FAMILY_HISTORY -afecto I-FAMILY_HISTORY -de I-FAMILY_HISTORY -esclerosis I-FAMILY_HISTORY -múltiple. I-FAMILY_HISTORY -Rinitis B-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -faringitis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -repetición I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia. I-PAST_MEDICAL_HISTORY -Lesiones I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -psoriasis I-PAST_MEDICAL_HISTORY -generalizada, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -codos, I-PAST_MEDICAL_HISTORY -rodillas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cuero I-PAST_MEDICAL_HISTORY -cabelludo I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -25 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -el I-EXPLORATION -hemograma I-EXPLORATION -destaca I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -leucopenia I-EXPLORATION -mantenida I-EXPLORATION -(3.700), I-EXPLORATION -acompañada I-EXPLORATION -de I-EXPLORATION -ligero I-EXPLORATION -descenso I-EXPLORATION -de I-EXPLORATION -ferritina I-EXPLORATION -(21 I-EXPLORATION -ng/ml) I-EXPLORATION -sin I-EXPLORATION -anemia I-EXPLORATION -asociada I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -descenso I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -séricos I-EXPLORATION -de I-EXPLORATION -vitamina I-EXPLORATION -B12 I-EXPLORATION -(177 I-EXPLORATION -pg/ml). I-EXPLORATION -La I-EXPLORATION -TTG I-EXPLORATION -estaba I-EXPLORATION -discretamente I-EXPLORATION -elevada I-EXPLORATION -(1, I-EXPLORATION -74 I-EXPLORATION -U/ml) I-EXPLORATION -(N I-EXPLORATION -≤ I-EXPLORATION -1). I-EXPLORATION -Es I-EXPLORATION -DQ2 I-EXPLORATION -(+) I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -duodenal I-EXPLORATION -fue I-EXPLORATION -interpretada I-EXPLORATION -como I-EXPLORATION -normal I-EXPLORATION -(estadio I-EXPLORATION -0 I-EXPLORATION -de I-EXPLORATION -Marsh). I-EXPLORATION -Se B-TREATMENT -le I-TREATMENT -diagnosticó I-TREATMENT -de I-TREATMENT -EC I-TREATMENT -hace I-TREATMENT -6 I-TREATMENT -meses I-TREATMENT -y I-TREATMENT -se I-TREATMENT -puso I-TREATMENT -a I-TREATMENT -DSG I-TREATMENT -con B-EVOLUTION -buena I-EVOLUTION -respuesta I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -analítica I-EVOLUTION -al I-EVOLUTION -cabo I-EVOLUTION -de I-EVOLUTION -ellos. I-EVOLUTION - I-EVOLUTION - -FGR. B-PRESENT_ILLNESS -Mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS -Sobrina. B-PAST_MEDICAL_HISTORY -Hija I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -JoRB I-PAST_MEDICAL_HISTORY -(caso I-PAST_MEDICAL_HISTORY -4). I-PAST_MEDICAL_HISTORY -Soltera. I-PAST_MEDICAL_HISTORY -Nacida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -meses, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -vuelta I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cordón I-PAST_MEDICAL_HISTORY -umbilical I-PAST_MEDICAL_HISTORY -alrededor I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -cuello I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -distócico. I-PAST_MEDICAL_HISTORY -Como I-PAST_MEDICAL_HISTORY -consecuencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ello, I-PAST_MEDICAL_HISTORY -padece I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -parálisis I-PAST_MEDICAL_HISTORY -cerebral I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -importante I-PAST_MEDICAL_HISTORY -retraso I-PAST_MEDICAL_HISTORY -mental I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -psicomotriz, I-PAST_MEDICAL_HISTORY -camina I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -dificultad I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -muletas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -utiliza I-PAST_MEDICAL_HISTORY -parcialmente I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -silla I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ruedas. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -encuentra I-PAST_MEDICAL_HISTORY -muy I-PAST_MEDICAL_HISTORY -hinchada I-PAST_MEDICAL_HISTORY -habitualmente I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -sientan I-PAST_MEDICAL_HISTORY -muy I-PAST_MEDICAL_HISTORY -mal I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -comidas. I-PAST_MEDICAL_HISTORY -Ardores I-PAST_MEDICAL_HISTORY -epigástricos I-PAST_MEDICAL_HISTORY -frecuentes, I-PAST_MEDICAL_HISTORY -acompañados I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -reflujo. I-PAST_MEDICAL_HISTORY -Hábito I-PAST_MEDICAL_HISTORY -intestinal I-PAST_MEDICAL_HISTORY -muy I-PAST_MEDICAL_HISTORY -estreñido, I-PAST_MEDICAL_HISTORY -precisando I-PAST_MEDICAL_HISTORY -empleo I-PAST_MEDICAL_HISTORY -habitual I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -laxantes. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -existe I-EXPLORATION -un I-EXPLORATION -descenso I-EXPLORATION -persistente I-EXPLORATION -de I-EXPLORATION -ferritina I-EXPLORATION -(6 I-EXPLORATION -ng/ml) I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -IST I-EXPLORATION -(13,4%) I-EXPLORATION -sin I-EXPLORATION -anemia I-EXPLORATION -acompañante. I-EXPLORATION -Presenta I-EXPLORATION -anticuerpos I-EXPLORATION -anti-tiroideos I-EXPLORATION -ligeramente I-EXPLORATION -positivos I-EXPLORATION -(163 I-EXPLORATION -U/ml), I-EXPLORATION -con I-EXPLORATION -normofunción I-EXPLORATION -tiroidea. I-EXPLORATION -La I-EXPLORATION -TTG I-EXPLORATION -es I-EXPLORATION -ligeramente I-EXPLORATION -positiva I-EXPLORATION -(1,9), I-EXPLORATION -el I-EXPLORATION -DQ2 I-EXPLORATION -es I-EXPLORATION -negativo, I-EXPLORATION -siendo I-EXPLORATION -DQ8 I-EXPLORATION -(+) I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -biopsias I-EXPLORATION -duodenales I-EXPLORATION -mostraron I-EXPLORATION -un I-EXPLORATION -claro I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -linfocitos I-EXPLORATION -intraepiteliales I-EXPLORATION -(estadio I-EXPLORATION -1 I-EXPLORATION -de I-EXPLORATION -Marsh). I-EXPLORATION - I-EXPLORATION - -JRA. B-PRESENT_ILLNESS -Varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -16 I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS -Sobrino. I-PRESENT_ILLNESS -Sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Asintomático. B-EXPLORATION -Erupciones I-EXPLORATION -cutáneas I-EXPLORATION -generalizadas, I-EXPLORATION -especialmente I-EXPLORATION -en I-EXPLORATION -cara, I-EXPLORATION -brazos I-EXPLORATION -y I-EXPLORATION -piernas, I-EXPLORATION -muy I-EXPLORATION -pruriginosas I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -infancia, I-EXPLORATION -diagnosticado I-EXPLORATION -de I-EXPLORATION -dermatitis I-EXPLORATION -herpetiforme I-EXPLORATION -(DH). I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -destaca I-EXPLORATION -una I-EXPLORATION -ligera I-EXPLORATION -leucopenia I-EXPLORATION -(4.800), I-EXPLORATION -con I-EXPLORATION -descenso I-EXPLORATION -del I-EXPLORATION -colesterol I-EXPLORATION -total I-EXPLORATION -(116 I-EXPLORATION -mg/dl). I-EXPLORATION -La I-EXPLORATION -TTG I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -(0, I-EXPLORATION -88 I-EXPLORATION -U/ml). I-EXPLORATION -Es I-EXPLORATION -DQ2 I-EXPLORATION -(-) I-EXPLORATION -y I-EXPLORATION -DQ8 I-EXPLORATION -(+). I-EXPLORATION -Las I-EXPLORATION -biopsias I-EXPLORATION -duodenales I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -(estadio I-EXPLORATION -0 I-EXPLORATION -de I-EXPLORATION -Marsh). I-EXPLORATION -Se B-TREATMENT -le I-TREATMENT -puso I-TREATMENT -a I-TREATMENT -DSG I-TREATMENT -hace I-TREATMENT -10 I-TREATMENT -meses, I-TREATMENT -con B-EVOLUTION -buena I-EVOLUTION -respuesta I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -analítica, I-EVOLUTION -con I-EVOLUTION -desaparición I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -cutáneas. I-EVOLUTION - I-EVOLUTION - -Un B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -61 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -emesis I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -algunos I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -arcadas. I-PRESENT_ILLNESS -Tenía B-PAST_MEDICAL_HISTORY -cirrosis I-PAST_MEDICAL_HISTORY -hepática I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -hemorragias I-PAST_MEDICAL_HISTORY -previas. I-PAST_MEDICAL_HISTORY -Una B-EXPLORATION -endoscopia I-EXPLORATION -alta I-EXPLORATION -reveló I-EXPLORATION -un I-EXPLORATION -desgarro I-EXPLORATION -amplio I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -cm I-EXPLORATION -que I-EXPLORATION -afectaba I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -submucosa I-EXPLORATION -del I-EXPLORATION -esófago I-EXPLORATION -distal, I-EXPLORATION -respetando I-EXPLORATION -un I-EXPLORATION -segmento I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -largo I-EXPLORATION -proximal I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -Z. I-EXPLORATION -La B-TREATMENT -laceración I-TREATMENT -presentaba I-TREATMENT -una I-TREATMENT -hemorragia I-TREATMENT -rezumante I-TREATMENT -lenta I-TREATMENT -que I-TREATMENT -se I-TREATMENT -detuvo I-TREATMENT -con I-TREATMENT -la I-TREATMENT -inyección I-TREATMENT -de I-TREATMENT -6 I-TREATMENT -cc I-TREATMENT -de I-TREATMENT -adrenalina I-TREATMENT -al I-TREATMENT -1: I-TREATMENT -10000 I-TREATMENT -y I-TREATMENT -la I-TREATMENT -aplicación I-TREATMENT -de I-TREATMENT -17 I-TREATMENT -endoclips I-TREATMENT -para I-TREATMENT -cerrar I-TREATMENT -la I-TREATMENT -laceración. I-TREATMENT -La I-TREATMENT -recurrencia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -hemorragia I-TREATMENT -8 I-TREATMENT -días I-TREATMENT -después I-TREATMENT -se I-TREATMENT -controló I-TREATMENT -con I-TREATMENT -la I-TREATMENT -aplicación I-TREATMENT -de I-TREATMENT -otros I-TREATMENT -4 I-TREATMENT -endoclips. I-TREATMENT -No B-EVOLUTION -hubo I-EVOLUTION -ninguna I-EVOLUTION -otra I-EVOLUTION -recurrencia I-EVOLUTION -hemorrágica I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -repitió I-EVOLUTION -la I-EVOLUTION -endoscopia I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -semana I-EVOLUTION -6 I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -semana I-EVOLUTION -24, I-EVOLUTION -no I-EVOLUTION -observándose I-EVOLUTION -lesión I-EVOLUTION -alguna. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -hipogástrico, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -presenta I-EXPLORATION -una I-EXPLORATION -temperatura I-EXPLORATION -de I-EXPLORATION -37, I-EXPLORATION -3 I-EXPLORATION -ºC, I-EXPLORATION -115 I-EXPLORATION -lat./min, I-EXPLORATION -tensión I-EXPLORATION -arterial I-EXPLORATION -130/80 I-EXPLORATION -mmHg, I-EXPLORATION -dolor I-EXPLORATION -hipogástrico I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal. I-EXPLORATION -Analítica: I-EXPLORATION -leucocitos I-EXPLORATION -18.000µ/l I-EXPLORATION -y I-EXPLORATION -fibrinógeno I-EXPLORATION -939, I-EXPLORATION -9 I-EXPLORATION -mg/dl. I-EXPLORATION - I-EXPLORATION -TAC I-EXPLORATION -abdominal: I-EXPLORATION -el I-EXPLORATION -duodeno I-EXPLORATION -presenta I-EXPLORATION -malrotación, I-EXPLORATION -haciendo I-EXPLORATION -un I-EXPLORATION -tirabuzón I-EXPLORATION -alrededor I-EXPLORATION -del I-EXPLORATION -eje I-EXPLORATION -venoso I-EXPLORATION -mesentérico. I-EXPLORATION -Se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -con I-EXPLORATION -burbujas I-EXPLORATION -de I-EXPLORATION -gas I-EXPLORATION -y I-EXPLORATION -líquido I-EXPLORATION -que I-EXPLORATION -engloba I-EXPLORATION -asas I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -proximidad I-EXPLORATION -al I-EXPLORATION -fundus I-EXPLORATION -uterino I-EXPLORATION -y I-EXPLORATION -receso I-EXPLORATION -vesicouterino, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -apéndice I-EXPLORATION -inflamado I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -afectación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -grasa I-EXPLORATION -periapendicular I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cuadrante I-EXPLORATION -inferior I-EXPLORATION -izquierdo. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -intervenida I-TREATMENT -quirúrgicamente, I-TREATMENT -encontrándose I-TREATMENT -la I-TREATMENT -malrotación I-TREATMENT -intestinal I-TREATMENT -descrita I-TREATMENT -con I-TREATMENT -el I-TREATMENT -duodeno I-TREATMENT -en I-TREATMENT -el I-TREATMENT -lado I-TREATMENT -derecho I-TREATMENT -y I-TREATMENT -el I-TREATMENT -ciego I-TREATMENT -descansando I-TREATMENT -en I-TREATMENT -el I-TREATMENT -cuadrante I-TREATMENT -superior I-TREATMENT -izquierdo I-TREATMENT -del I-TREATMENT -abdomen. I-TREATMENT -El I-TREATMENT -apéndice I-TREATMENT -se I-TREATMENT -encuentra I-TREATMENT -inflamado I-TREATMENT -con I-TREATMENT -un I-TREATMENT -importante I-TREATMENT -absceso I-TREATMENT -pélvico I-TREATMENT -asociado. I-TREATMENT -Realizamos I-TREATMENT -apendicectomía, I-TREATMENT -drenaje I-TREATMENT -de I-TREATMENT -absceso I-TREATMENT -pélvico I-TREATMENT -y I-TREATMENT -liberación I-TREATMENT -de I-TREATMENT -asas I-TREATMENT -de I-TREATMENT -intestino I-TREATMENT -delgado I-TREATMENT -previa I-TREATMENT -sección I-TREATMENT -de I-TREATMENT -las I-TREATMENT -bandas I-TREATMENT -de I-TREATMENT -Ladd. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -recupera I-EVOLUTION -satisfactoriamente I-EVOLUTION -tras I-EVOLUTION -una I-EVOLUTION -semana I-EVOLUTION -de I-EVOLUTION -ingreso I-EVOLUTION -con B-TREATMENT -tratamiento I-TREATMENT -antibiótico. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -60 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -ingresado I-PRESENT_ILLNESS -presentando I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ictericia. I-PRESENT_ILLNESS -La B-EXPLORATION -RMN I-EXPLORATION -y I-EXPLORATION -colangio-RMN I-EXPLORATION -establecieron I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -colangiocarcinoma. I-EXPLORATION -En B-TREATMENT -el I-TREATMENT -curso I-TREATMENT -de I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -se I-TREATMENT -consiguó I-TREATMENT -la I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -una I-TREATMENT -masa I-TREATMENT -en I-TREATMENT -el I-TREATMENT -área I-TREATMENT -de I-TREATMENT -la I-TREATMENT -bifurcación I-TREATMENT -biliar I-TREATMENT -y I-TREATMENT -reconstrucción I-TREATMENT -de I-TREATMENT -la I-TREATMENT -continuidad I-TREATMENT -biliar I-TREATMENT -mediante I-TREATMENT -anastomosis I-TREATMENT -segmentarias I-TREATMENT -a I-TREATMENT -un I-TREATMENT -asa I-TREATMENT -desfuncionalizada I-TREATMENT -yeyunal I-TREATMENT -en I-TREATMENT -Y I-TREATMENT -de I-TREATMENT -Roux. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -reveló I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -carcinoide. I-EXPLORATION - I-EXPLORATION - -Presentamos B-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -83 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de B-PAST_MEDICAL_HISTORY -edad, I-PAST_MEDICAL_HISTORY -hipertensa, I-PAST_MEDICAL_HISTORY -dislipémica, I-PAST_MEDICAL_HISTORY -apendicectomizada, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -practicó I-PAST_MEDICAL_HISTORY -antrectomía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -reconstrucción I-PAST_MEDICAL_HISTORY -Billroth-II I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -ulcerosa I-PAST_MEDICAL_HISTORY -péptica. I-PAST_MEDICAL_HISTORY -Acudió B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Durante B-EXPLORATION -su I-EXPLORATION -exploración I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -ni I-EXPLORATION -ictericia I-EXPLORATION -ni I-EXPLORATION -fiebre. I-EXPLORATION -Las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -mostraron I-EXPLORATION -cambios I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION -(GGT I-EXPLORATION -386 I-EXPLORATION -IU/L, I-EXPLORATION -AP I-EXPLORATION -337 I-EXPLORATION -IU/L, I-EXPLORATION -AST I-EXPLORATION -245 I-EXPLORATION -U/L, I-EXPLORATION -ALT I-EXPLORATION -342 I-EXPLORATION -U/L, I-EXPLORATION -y I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -0, I-EXPLORATION -03 I-EXPLORATION -g/l). I-EXPLORATION -Se I-EXPLORATION -detectaron I-EXPLORATION -también I-EXPLORATION -hiperamilasemia I-EXPLORATION -y I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva; I-EXPLORATION -además, I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -mostró I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -colecistitis, I-EXPLORATION -colelitiasis, I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vesícula I-EXPLORATION -biliar I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -extrahepática. I-EXPLORATION -Basándose I-EXPLORATION -en I-EXPLORATION -todos I-EXPLORATION -estos, I-EXPLORATION -se I-EXPLORATION -sospechó I-EXPLORATION -colecistopancreatitis I-EXPLORATION -aguda I-EXPLORATION -litiásica. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -por I-EXPLORATION -contraste I-EXPLORATION -oral I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -drenaje I-EXPLORATION -biliar I-EXPLORATION -al I-EXPLORATION -asa I-EXPLORATION -eferente. I-EXPLORATION -Por I-EXPLORATION -otra I-EXPLORATION -parte, I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -endoscópicos I-EXPLORATION -no I-EXPLORATION -aportaron I-EXPLORATION -nuevos I-EXPLORATION -datos. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(CT) I-EXPLORATION -reveló I-EXPLORATION -marcada I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -extrahepática, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vesícula I-EXPLORATION -biliar I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -asa I-EXPLORATION -yeyunal; I-EXPLORATION -también I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -incremento I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -colecistitis I-EXPLORATION -mostrados I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -inicial, I-EXPLORATION -pero I-EXPLORATION -no I-EXPLORATION -reveló I-EXPLORATION -la I-EXPLORATION -causa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -ictericia I-EXPLORATION -obstructiva. I-EXPLORATION - I-EXPLORATION -Por I-EXPLORATION -otro I-EXPLORATION -lado, I-EXPLORATION -se I-EXPLORATION -fueron I-EXPLORATION -incrementando I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -hiperbilirrubinemia I-EXPLORATION -(0, I-EXPLORATION -097 I-EXPLORATION -g/l) I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -hepáticas I-EXPLORATION -(AST I-EXPLORATION -600 I-EXPLORATION -U/L) I-EXPLORATION -tras I-EXPLORATION -quince I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -hospitalización. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -indicó I-TREATMENT -laparotomía I-TREATMENT -en I-TREATMENT -base I-TREATMENT -al I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -colecistitis I-TREATMENT -aguda I-TREATMENT -litiásica I-TREATMENT -e I-TREATMENT -ictericia I-TREATMENT -obstructiva I-TREATMENT -progresiva I-TREATMENT -que I-TREATMENT -involucraba I-TREATMENT -al I-TREATMENT -asa I-TREATMENT -aferente I-TREATMENT -de I-TREATMENT -la I-TREATMENT -reconstrucción I-TREATMENT -Billroth-II. I-TREATMENT -Se B-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -vesícula I-EXPLORATION -biliar I-EXPLORATION -dilatada I-EXPLORATION -y I-EXPLORATION -necrótica, I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -estenosis I-EXPLORATION -del I-EXPLORATION -asa I-EXPLORATION -aferente I-EXPLORATION -volvulada I-EXPLORATION -sobre I-EXPLORATION -el I-EXPLORATION -asa I-EXPLORATION -eferente I-EXPLORATION -provocando I-EXPLORATION -la I-EXPLORATION -ictericia I-EXPLORATION -obstructiva. I-EXPLORATION -Se B-TREATMENT -resecó I-TREATMENT -el I-TREATMENT -asa I-TREATMENT -aferente I-TREATMENT -estenótica, I-TREATMENT -se I-TREATMENT -drenó I-TREATMENT -el I-TREATMENT -éstasis I-TREATMENT -biliar I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -reconstrucción I-TREATMENT -mediante I-TREATMENT -Y-Roux I-TREATMENT -yeyuno-yeyunal. I-TREATMENT -Así I-TREATMENT -mismo I-TREATMENT -se I-TREATMENT -practicó I-TREATMENT -colecistectomía, I-TREATMENT -y I-TREATMENT -colangiografía I-TREATMENT -intraoperatoria, I-TREATMENT -obtenida I-TREATMENT -a I-TREATMENT -la I-TREATMENT -finalización I-TREATMENT -del I-TREATMENT -procedimiento, I-TREATMENT -mostrando I-TREATMENT -un I-TREATMENT -drenaje I-TREATMENT -satisfactorio I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -la I-TREATMENT -papila I-TREATMENT -de I-TREATMENT -Vater I-TREATMENT -hacia I-TREATMENT -el I-TREATMENT -duodeno I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -transanastomótico I-TREATMENT -y I-TREATMENT -a I-TREATMENT -lo I-TREATMENT -largo I-TREATMENT -del I-TREATMENT -yeyuno. I-TREATMENT - I-TREATMENT -Al B-EVOLUTION -sexto I-EVOLUTION -día I-EVOLUTION -postoperatorio I-EVOLUTION -los I-EVOLUTION -niveles I-EVOLUTION -de I-EVOLUTION -amilasemia I-EVOLUTION -y I-EVOLUTION -bilirrubina I-EVOLUTION -se I-EVOLUTION -normalizaron I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -normalización I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -exploración I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sintomatología. I-EVOLUTION -La I-EVOLUTION -ictericia I-EVOLUTION -desapareció I-EVOLUTION -completamente I-EVOLUTION -antes I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -hospitalaria. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -estudio I-EVOLUTION -histopatológico I-EVOLUTION -del I-EVOLUTION -espécimen I-EVOLUTION -reveló I-EVOLUTION -colecistitis I-EVOLUTION -crónica, I-EVOLUTION -colelitiasis, I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -asa I-EVOLUTION -intestinal I-EVOLUTION -presentó I-EVOLUTION -signos I-EVOLUTION -inespecíficos I-EVOLUTION -inflamatorios I-EVOLUTION -y I-EVOLUTION -atrofia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mucosa. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -70 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -aquejado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -ponderal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -kg, I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS -intensa, I-PRESENT_ILLNESS -anorexia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -estreñimiento I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -transcurso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -última I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -además, I-PRESENT_ILLNESS -importante I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -cólico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hemiabdomen I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -escasa I-PRESENT_ILLNESS -mejoría I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -analgésicos I-PRESENT_ILLNESS -habituales. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destaca I-EXPLORATION -aceptable I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -palidez I-EXPLORATION -mucocutánea, I-EXPLORATION -auscultación I-EXPLORATION -cardiorrespiratoria I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -y I-EXPLORATION -abdomen I-EXPLORATION -blando I-EXPLORATION -y I-EXPLORATION -depresible I-EXPLORATION -con I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -profunda, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -palpación I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -5-6 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -en I-EXPLORATION -cuadrante I-EXPLORATION -inferior I-EXPLORATION -izdo. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -de I-EXPLORATION -ingreso, I-EXPLORATION -destaca: I-EXPLORATION -Hb: I-EXPLORATION -10.8 I-EXPLORATION -g, I-EXPLORATION -Hcto: I-EXPLORATION -38%, I-EXPLORATION -VCM: I-EXPLORATION -78, I-EXPLORATION -leucocitos: I-EXPLORATION -13.600/μl, I-EXPLORATION -con I-EXPLORATION -neutrofilia, I-EXPLORATION -Fe: I-EXPLORATION -8, I-EXPLORATION -úrico: I-EXPLORATION -9, I-EXPLORATION -6, I-EXPLORATION -LDH: I-EXPLORATION -876 I-EXPLORATION -y I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -parámetros I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -Rx I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -abdomen I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -aprecian I-EXPLORATION -alteraciones I-EXPLORATION -significativas. I-EXPLORATION - I-EXPLORATION -A B-EVOLUTION -las I-EVOLUTION -8 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -ingreso, I-EVOLUTION -se I-EVOLUTION -agudiza I-EVOLUTION -de I-EVOLUTION -manera I-EVOLUTION -importante I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -fosa I-EVOLUTION -ilíaca I-EVOLUTION -izquierda, I-EVOLUTION -irradiándose I-EVOLUTION -este I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -zona I-EVOLUTION -centroabdominal. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -presenta, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -referida I-EXPLORATION -sensación I-EXPLORATION -de I-EXPLORATION -masa, I-EXPLORATION -una I-EXPLORATION -crepitación I-EXPLORATION -difusa I-EXPLORATION -en I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -peritonismo. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -un I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -urgente, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -: I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -asas I-EXPLORATION -intestinales I-EXPLORATION -producida I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -sólida I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -10 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -máximo, I-EXPLORATION -situada I-EXPLORATION -en I-EXPLORATION -pelvis I-EXPLORATION -izquierda, I-EXPLORATION -que I-EXPLORATION -condiciona I-EXPLORATION -estenosis I-EXPLORATION -y I-EXPLORATION -obstrucción I-EXPLORATION -intestinal I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -sigma. I-EXPLORATION -La I-EXPLORATION -masa, I-EXPLORATION -de I-EXPLORATION -contornos I-EXPLORATION -mamelonados I-EXPLORATION -infiltra I-EXPLORATION -el I-EXPLORATION -músculo I-EXPLORATION -ilíaco I-EXPLORATION -izquierdo, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -porción I-EXPLORATION -superior I-EXPLORATION -parece I-EXPLORATION -ulcerada I-EXPLORATION -y I-EXPLORATION -fistulizada I-EXPLORATION -a I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -anterior, I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -está I-EXPLORATION -marcadamente I-EXPLORATION -engrosada, I-EXPLORATION -con I-EXPLORATION -aire I-EXPLORATION -y I-EXPLORATION -colección I-EXPLORATION -líquida, I-EXPLORATION -más I-EXPLORATION -evidente I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lado I-EXPLORATION -izquierdo. I-EXPLORATION - I-EXPLORATION -Diagnóstico: I-EXPLORATION -neoplasia I-EXPLORATION -de I-EXPLORATION -sigma I-EXPLORATION -fistulizada I-EXPLORATION -a I-EXPLORATION -pared I-EXPLORATION -abdominal, I-EXPLORATION -con I-EXPLORATION -abscesificación. I-EXPLORATION -Enfisema I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -abdominal. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -evoluciona I-EVOLUTION -desfavorablemente, I-EVOLUTION -presentando I-EVOLUTION -un I-EVOLUTION -shock I-EVOLUTION -séptico I-EVOLUTION -refractario I-EVOLUTION -al I-EVOLUTION -tratamiento I-EVOLUTION -durante I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -quirúrgica, I-EVOLUTION -falleciendo I-EVOLUTION -horas I-EVOLUTION -después. I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -necropsia I-EVOLUTION -se I-EVOLUTION -corroboran I-EVOLUTION -los I-EVOLUTION -diagnósticos I-EVOLUTION -realizados I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -prueba I-EVOLUTION -de I-EVOLUTION -imagen, I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -la I-EVOLUTION -neoplasia I-EVOLUTION -de I-EVOLUTION -colon I-EVOLUTION -que I-EVOLUTION -resultó I-EVOLUTION -ser I-EVOLUTION -un I-EVOLUTION -adenocarcinoma. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -intermitente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -La B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ileítis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Crohn I-PAST_MEDICAL_HISTORY -desapareciendo I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -síntomas I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -esteroides. I-PAST_MEDICAL_HISTORY -Cinco B-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -después, I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -anemia I-PRESENT_ILLNESS -ferropénica I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -desnutrición I-PRESENT_ILLNESS -severa. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -TAC B-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -tránsito I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -trayectos I-EXPLORATION -extraluminares I-EXPLORATION -desde I-EXPLORATION -ciego/íleon I-EXPLORATION -terminal I-EXPLORATION -a I-EXPLORATION -planos I-EXPLORATION -posteriores I-EXPLORATION -sugestivos I-EXPLORATION -de I-EXPLORATION -fístulas. I-EXPLORATION -Se B-TREATMENT -instauró I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -nutrición I-TREATMENT -enteral, I-TREATMENT -metronidazol I-TREATMENT -y I-TREATMENT -corticoides I-TREATMENT -a I-TREATMENT -bajas I-TREATMENT -dosis. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -buena I-EVOLUTION -evolución, I-EVOLUTION -pero I-EVOLUTION -diez I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -acude I-EVOLUTION -por I-EVOLUTION -supuración I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -del I-EVOLUTION -glúteo I-EVOLUTION -y I-EVOLUTION -absceso I-EVOLUTION -retroperitoneal I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -con I-TREATMENT -resección I-TREATMENT -ileocecal I-TREATMENT -y I-TREATMENT -anastomosis I-TREATMENT -ileocólica I-TREATMENT -látero-lateral. I-TREATMENT - I-TREATMENT -En I-TREATMENT -la I-TREATMENT -EC I-TREATMENT -se I-TREATMENT -han I-TREATMENT -descrito I-TREATMENT -tres I-TREATMENT -enfoques I-TREATMENT -en I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -los I-TREATMENT -abscesos: I-TREATMENT -tratamiento I-TREATMENT -médico I-TREATMENT -con I-TREATMENT -antibióticos I-TREATMENT -y I-TREATMENT -esteroides, I-TREATMENT -drenaje I-TREATMENT -percutáneo I-TREATMENT -y I-TREATMENT -cirugía I-TREATMENT -con I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -los I-TREATMENT -segmentos I-TREATMENT -intestinales I-TREATMENT -afectados. I-TREATMENT - I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -médico I-TREATMENT -inicial I-TREATMENT -estaría I-TREATMENT -basado I-TREATMENT -en I-TREATMENT -la I-TREATMENT -utilización I-TREATMENT -de I-TREATMENT -5-ASA, I-TREATMENT -antibióticos I-TREATMENT -y I-TREATMENT -corticosteroides, I-TREATMENT -azatioprina I-TREATMENT -o I-TREATMENT -6-mercaptopurina I-TREATMENT -en I-TREATMENT -caso I-TREATMENT -de I-TREATMENT -refractariedad I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -convencional I-TREATMENT -(2). I-TREATMENT -La I-TREATMENT -siguiente I-TREATMENT -línea I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -basa I-TREATMENT -en I-TREATMENT -la I-TREATMENT -utilización I-TREATMENT -de I-TREATMENT -infliximab I-TREATMENT -(anticuerpo I-TREATMENT -monoclonal I-TREATMENT -anti I-TREATMENT -TNF-a) I-TREATMENT -habiéndose I-TREATMENT -observado I-TREATMENT -una I-TREATMENT -reducción I-TREATMENT -en I-TREATMENT -el I-TREATMENT -número I-TREATMENT -de I-TREATMENT -intervenciones I-TREATMENT -quirúrgicas I-TREATMENT -en I-TREATMENT -este I-TREATMENT -grupo I-TREATMENT -de I-TREATMENT -pacientes. I-TREATMENT -Una I-TREATMENT -alternativa I-TREATMENT -terapéutica I-TREATMENT -para I-TREATMENT -los I-TREATMENT -pacientes I-TREATMENT -con I-TREATMENT -enfermedad I-TREATMENT -de I-TREATMENT -Crohn I-TREATMENT -fistulizante I-TREATMENT -refractaria I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -anti-TNF-a I-TREATMENT -sería I-TREATMENT -la I-TREATMENT -utilización I-TREATMENT -de I-TREATMENT -inmunosupresores I-TREATMENT -anticalcineurínicos I-TREATMENT -como I-TREATMENT -el I-TREATMENT -tacrolimus I-TREATMENT -con I-TREATMENT -remisiones I-TREATMENT -completas I-TREATMENT -de I-TREATMENT -hasta I-TREATMENT -un I-TREATMENT -40% I-TREATMENT -y I-TREATMENT -parciales I-TREATMENT -del I-TREATMENT -50% I-TREATMENT -(3). I-TREATMENT - I-TREATMENT -El I-TREATMENT -drenaje I-TREATMENT -percutáneo I-TREATMENT -guiado I-TREATMENT -radiológicamente I-TREATMENT -en I-TREATMENT -su I-TREATMENT -momento I-TREATMENT -se I-TREATMENT -convirtió I-TREATMENT -en I-TREATMENT -la I-TREATMENT -principal I-TREATMENT -alternativa I-TREATMENT -terapéutica I-TREATMENT -llegando I-TREATMENT -incluso I-TREATMENT -a I-TREATMENT -obviar I-TREATMENT -la I-TREATMENT -necesidad I-TREATMENT -de I-TREATMENT -resección I-TREATMENT -intestinal. I-TREATMENT -Sin I-TREATMENT -embargo, I-TREATMENT -pueden I-TREATMENT -llegar I-TREATMENT -a I-TREATMENT -presentar I-TREATMENT -hasta I-TREATMENT -un I-TREATMENT -100% I-TREATMENT -de I-TREATMENT -recidivas I-TREATMENT -(4). I-TREATMENT -Hay I-TREATMENT -autores I-TREATMENT -que I-TREATMENT -defienden I-TREATMENT -que I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -definitivo I-TREATMENT -de I-TREATMENT -un I-TREATMENT -absceso I-TREATMENT -de I-TREATMENT -psoas I-TREATMENT -debe I-TREATMENT -incluir I-TREATMENT -además, I-TREATMENT -la I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -la I-TREATMENT -porción I-TREATMENT -de I-TREATMENT -tubo I-TREATMENT -digestivo I-TREATMENT -afectada I-TREATMENT -(5). I-TREATMENT - I-TREATMENT -En I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -casos I-TREATMENT -de I-TREATMENT -EC I-TREATMENT -fistulizante I-TREATMENT -con I-TREATMENT -abscesos I-TREATMENT -intraabdominales I-TREATMENT -presentados I-TREATMENT -hemos I-TREATMENT -podido I-TREATMENT -observar I-TREATMENT -dos I-TREATMENT -tipos I-TREATMENT -de I-TREATMENT -experiencias I-TREATMENT -en I-TREATMENT -cuanto I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -misma. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -primer I-TREATMENT -caso I-TREATMENT -se I-TREATMENT -pudo I-TREATMENT -resolver I-TREATMENT -el I-TREATMENT -absceso I-TREATMENT -tras I-TREATMENT -drenaje I-TREATMENT -quirúrgico I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -conservador. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -segundo I-TREATMENT -caso I-TREATMENT -no I-TREATMENT -tuvimos I-TREATMENT -la I-TREATMENT -oportunidad I-TREATMENT -de I-TREATMENT -tratar I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -con I-TREATMENT -anti-TNF I-TREATMENT -dado I-TREATMENT -que I-TREATMENT -el I-TREATMENT -cuadro I-TREATMENT -clínico I-TREATMENT -se I-TREATMENT -presentó I-TREATMENT -en I-TREATMENT -1999 I-TREATMENT -y I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -fue I-TREATMENT -la I-TREATMENT -mejor I-TREATMENT -opción, I-TREATMENT -tras I-TREATMENT -el I-TREATMENT -fracaso I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -conservador. I-TREATMENT - I-TREATMENT -En I-TREATMENT -conclusión, I-TREATMENT -los I-TREATMENT -pacientes I-TREATMENT -con I-TREATMENT -EC I-TREATMENT -fistulizante I-TREATMENT -con I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -abscesos I-TREATMENT -intraabdominales I-TREATMENT -pueden I-TREATMENT -ser I-TREATMENT -tratados I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -conservadora I-TREATMENT -inicialmente I-TREATMENT -llegando I-TREATMENT -a I-TREATMENT -resolverse I-TREATMENT -en I-TREATMENT -algunos I-TREATMENT -casos, I-TREATMENT -ya I-TREATMENT -sea I-TREATMENT -con I-TREATMENT -drenaje I-TREATMENT -radiológico, I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -anti-TNF I-TREATMENT -o I-TREATMENT -con I-TREATMENT -los I-TREATMENT -nuevos I-TREATMENT -inmunosupresores I-TREATMENT -(tacrolimus). I-TREATMENT -La I-TREATMENT -resección I-TREATMENT -quirúrgica I-TREATMENT -del I-TREATMENT -asa I-TREATMENT -intestinal I-TREATMENT -enferma I-TREATMENT -se I-TREATMENT -reservaría I-TREATMENT -para I-TREATMENT -los I-TREATMENT -casos I-TREATMENT -con I-TREATMENT -fracaso I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -médico I-TREATMENT -conservador I-TREATMENT -o I-TREATMENT -recurrencia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -EC I-TREATMENT -fistulosa I-TREATMENT -(6). I-TREATMENT - I-TREATMENT -M. I-TREATMENT -Valdés I-TREATMENT -Mas, I-TREATMENT -J. I-TREATMENT -A. I-TREATMENT -Pons I-TREATMENT -Miñano I-TREATMENT -y I-TREATMENT -F. I-TREATMENT -Carballo I-TREATMENT -Álvarez I-TREATMENT - I-TREATMENT -Servicio I-TREATMENT -de I-TREATMENT -Aparato I-TREATMENT -Digestivo. I-TREATMENT -Hospital I-TREATMENT -Universitario I-TREATMENT -Virgen I-TREATMENT -de I-TREATMENT -la I-TREATMENT -Arrixaca. I-TREATMENT -Murcia I-TREATMENT - I-TREATMENT - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -22 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -primípara I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -Presentaba B-EXPLORATION -un I-EXPLORATION -hematocrito I-EXPLORATION -del I-EXPLORATION -29%, I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -12, I-EXPLORATION -6 I-EXPLORATION -x I-EXPLORATION -109/L I-EXPLORATION -con I-EXPLORATION -89, I-EXPLORATION -7% I-EXPLORATION -de I-EXPLORATION -neutrófilos, I-EXPLORATION -amilasemia I-EXPLORATION -de I-EXPLORATION -1.684 I-EXPLORATION -UI/L, I-EXPLORATION -AST I-EXPLORATION -de I-EXPLORATION -41 I-EXPLORATION -UI/L, I-EXPLORATION -ALT I-EXPLORATION -de I-EXPLORATION -75 I-EXPLORATION -UI/L, I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -de I-EXPLORATION -81 I-EXPLORATION -UI/L I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -bGT I-EXPLORATION -de I-EXPLORATION -28 I-EXPLORATION -UI/L. I-EXPLORATION -Una I-EXPLORATION -ecografía I-EXPLORATION -mostró I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -colecistitis I-EXPLORATION -litiásica, I-EXPLORATION -una I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -intrahepática I-EXPLORATION -y I-EXPLORATION -extrahepática I-EXPLORATION -y I-EXPLORATION -páncreas I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION -Una I-EXPLORATION -ecografía I-EXPLORATION -fetal I-EXPLORATION -comprobó I-EXPLORATION -una I-EXPLORATION -gestación I-EXPLORATION -de I-EXPLORATION -18 I-EXPLORATION -semanas I-EXPLORATION -sin I-EXPLORATION -complicaciones. I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -ingresó I-TREATMENT -bajo I-TREATMENT -tratamiento I-TREATMENT -médico I-TREATMENT -antibiótico I-TREATMENT -pero I-TREATMENT -con I-TREATMENT -persistencia I-TREATMENT -de I-TREATMENT -los I-TREATMENT -síntomas I-TREATMENT -a I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -horas. I-TREATMENT -Se I-TREATMENT -decidió I-TREATMENT -CL I-TREATMENT -electiva. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -CL I-TREATMENT -hallando I-TREATMENT -una I-TREATMENT -colelitiasis I-TREATMENT -simple I-TREATMENT -con I-TREATMENT -mínimos I-TREATMENT -signos I-TREATMENT -de I-TREATMENT -colecistitis, I-TREATMENT -con I-TREATMENT -una I-TREATMENT -presión I-TREATMENT -intraabdominal I-TREATMENT -inferior I-TREATMENT -a I-TREATMENT -12 I-TREATMENT -mmHg I-TREATMENT -y I-TREATMENT -en I-TREATMENT -un I-TREATMENT -tiempo I-TREATMENT -de I-TREATMENT -40 I-TREATMENT -minutos. I-TREATMENT -El B-EVOLUTION -postoperatorio I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -embarazo I-EVOLUTION -transcurrieron I-EVOLUTION -sin I-EVOLUTION -incidencias. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -gestante B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cinco I-PAST_MEDICAL_HISTORY -semanas, I-PAST_MEDICAL_HISTORY -que B-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -cuadro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cinco I-DERIVED_FROM/TO -días I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -náuseas, I-DERIVED_FROM/TO -vómitos I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -dolor I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -hemiabdomen I-DERIVED_FROM/TO -superior. I-DERIVED_FROM/TO -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -murphy I-EXPLORATION -positivo. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -15 I-EXPLORATION -x I-EXPLORATION -109/L, I-EXPLORATION -amilasemia I-EXPLORATION -de I-EXPLORATION -1.300 I-EXPLORATION -UI/L, I-EXPLORATION -AST I-EXPLORATION -de I-EXPLORATION -78 I-EXPLORATION -UI/L, I-EXPLORATION -ALT I-EXPLORATION -de I-EXPLORATION -272 I-EXPLORATION -UI/L, I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -de I-EXPLORATION -288 I-EXPLORATION -UI/L I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -bGT I-EXPLORATION -de I-EXPLORATION -108 I-EXPLORATION -UI/L. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -halla I-EXPLORATION -una I-EXPLORATION -vesícula I-EXPLORATION -biliar I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -litiasis I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -tamaño, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -no I-EXPLORATION -dilatada. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -visualizaron I-EXPLORATION -claros I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -colecistitis I-EXPLORATION -aguda I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -área I-EXPLORATION -pancreática I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -El B-EVOLUTION -estado I-EVOLUTION -clínico I-EVOLUTION -se I-EVOLUTION -deterioró I-EVOLUTION -y I-EVOLUTION -a I-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -estar I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -primer I-EVOLUTION -trimestre, I-EVOLUTION -se B-TREATMENT -decidió I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -realizándose I-TREATMENT -CL I-TREATMENT -con I-TREATMENT -una I-TREATMENT -presión I-TREATMENT -intraabdominal I-TREATMENT -inferior I-TREATMENT -a I-TREATMENT -12 I-TREATMENT -mmHg I-TREATMENT -en I-TREATMENT -un I-TREATMENT -tiempo I-TREATMENT -de I-TREATMENT -55 I-TREATMENT -minutos. I-TREATMENT -Una B-EXPLORATION -colangiografía I-EXPLORATION -intraoperatoria I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -El B-EVOLUTION -postoperatorio I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -5 I-EVOLUTION -días I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -gestación I-EVOLUTION -transcurrió I-EVOLUTION -sin I-EVOLUTION -incidencias. I-EVOLUTION - I-EVOLUTION -Durante I-EVOLUTION -la I-EVOLUTION -gestación, I-EVOLUTION -al I-EVOLUTION -igual I-EVOLUTION -que I-EVOLUTION -las I-EVOLUTION -pacientes I-EVOLUTION -que I-EVOLUTION -toman I-EVOLUTION -anticonceptivos I-EVOLUTION -orales I-EVOLUTION -o I-EVOLUTION -estrógenos I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -periodo I-EVOLUTION -menopáusico, I-EVOLUTION -la I-EVOLUTION -incidencia I-EVOLUTION -de I-EVOLUTION -colelitiasis I-EVOLUTION -está I-EVOLUTION -aumentada I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -estímulo I-EVOLUTION -estrogénico I-EVOLUTION -hormonal I-EVOLUTION -(2). I-EVOLUTION -Las I-EVOLUTION -gestantes I-EVOLUTION -no I-EVOLUTION -escapan I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -posibilidad I-EVOLUTION -de I-EVOLUTION -sufrir I-EVOLUTION -un I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -colecistitis I-EVOLUTION -o I-EVOLUTION -colelitiasis I-EVOLUTION -y I-EVOLUTION -su I-EVOLUTION -manejo I-EVOLUTION -es I-EVOLUTION -similar I-EVOLUTION -al I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -gestante, I-EVOLUTION -incluyendo I-EVOLUTION -una I-EVOLUTION -monitorización I-EVOLUTION -fetal. I-EVOLUTION -La I-EVOLUTION -CL I-EVOLUTION -durante I-EVOLUTION -la I-EVOLUTION -gestación I-EVOLUTION -no I-EVOLUTION -está I-EVOLUTION -exenta I-EVOLUTION -de I-EVOLUTION -riesgos I-EVOLUTION -para I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -feto I-EVOLUTION -pese I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -gran I-EVOLUTION -aceptación. I-EVOLUTION -Así, I-EVOLUTION -el I-EVOLUTION -uso I-EVOLUTION -de I-EVOLUTION -dióxido I-EVOLUTION -de I-EVOLUTION -carbono I-EVOLUTION -para I-EVOLUTION -realizar I-EVOLUTION -el I-EVOLUTION -pneumoperitoneo I-EVOLUTION -puede I-EVOLUTION -producir I-EVOLUTION -una I-EVOLUTION -acidosis I-EVOLUTION -respiratoria I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -madre I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -feto, I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -propuesto I-EVOLUTION -el I-EVOLUTION -uso I-EVOLUTION -de I-EVOLUTION -óxido I-EVOLUTION -nitroso I-EVOLUTION -(3). I-EVOLUTION -Aun I-EVOLUTION -así, I-EVOLUTION -los I-EVOLUTION -efectos I-EVOLUTION -a I-EVOLUTION -corto I-EVOLUTION -plazo I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -acidosis I-EVOLUTION -fetal I-EVOLUTION -severa I-EVOLUTION -en I-EVOLUTION -animales I-EVOLUTION -no I-EVOLUTION -han I-EVOLUTION -demostrado I-EVOLUTION -efectos I-EVOLUTION -adversos I-EVOLUTION -(4). I-EVOLUTION -Además, I-EVOLUTION -un I-EVOLUTION -aumento I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -presión I-EVOLUTION -intraabdominal I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -presión I-EVOLUTION -del I-EVOLUTION -útero I-EVOLUTION -sobre I-EVOLUTION -la I-EVOLUTION -vena I-EVOLUTION -cava I-EVOLUTION -inferior I-EVOLUTION -pueden I-EVOLUTION -disminuir I-EVOLUTION -el I-EVOLUTION -flujo I-EVOLUTION -del I-EVOLUTION -retorno I-EVOLUTION -venoso I-EVOLUTION -y I-EVOLUTION -disminuir I-EVOLUTION -de I-EVOLUTION -manera I-EVOLUTION -consiguiente I-EVOLUTION -el I-EVOLUTION -gasto I-EVOLUTION -cardiaco, I-EVOLUTION -el I-EVOLUTION -riego I-EVOLUTION -uterino I-EVOLUTION -y I-EVOLUTION -aparecer I-EVOLUTION -hipoxia I-EVOLUTION -fetal. I-EVOLUTION -Algunos I-EVOLUTION -autores I-EVOLUTION -usan I-EVOLUTION -presiones I-EVOLUTION -intraabdominales I-EVOLUTION -mínimas I-EVOLUTION -y I-EVOLUTION -una I-EVOLUTION -posición I-EVOLUTION -de I-EVOLUTION -decúbito I-EVOLUTION -lateral I-EVOLUTION -izquierdo I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -mínima I-EVOLUTION -posición I-EVOLUTION -de I-EVOLUTION -anti-Trendelenberg I-EVOLUTION -(4). I-EVOLUTION -Algún I-EVOLUTION -estudio I-EVOLUTION -demuestra I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -puede I-EVOLUTION -trabajar I-EVOLUTION -con I-EVOLUTION -presiones I-EVOLUTION -de I-EVOLUTION -aire I-EVOLUTION -mínimas, I-EVOLUTION -pero I-EVOLUTION -el I-EVOLUTION -riesgo I-EVOLUTION -de I-EVOLUTION -reconversión I-EVOLUTION -es I-EVOLUTION -mayor I-EVOLUTION -(5). I-EVOLUTION -Se I-EVOLUTION -recomienda I-EVOLUTION -colocar I-EVOLUTION -primero I-EVOLUTION -un I-EVOLUTION -trocar I-EVOLUTION -epigástrico I-EVOLUTION -(6). I-EVOLUTION -La I-EVOLUTION -colangiografía I-EVOLUTION -intraoperatoria I-EVOLUTION -no I-EVOLUTION -está I-EVOLUTION -recomendada I-EVOLUTION -de I-EVOLUTION -rutina I-EVOLUTION -y I-EVOLUTION -solo I-EVOLUTION -en I-EVOLUTION -pacientes I-EVOLUTION -con I-EVOLUTION -factores I-EVOLUTION -de I-EVOLUTION -riesgo I-EVOLUTION -para I-EVOLUTION -desarrollar I-EVOLUTION -coledocolitiasis I-EVOLUTION -(historia I-EVOLUTION -de I-EVOLUTION -pancreatitis, I-EVOLUTION -de I-EVOLUTION -ictericia I-EVOLUTION -o I-EVOLUTION -de I-EVOLUTION -dilatación I-EVOLUTION -coledocal) I-EVOLUTION -(7). I-EVOLUTION -Hay I-EVOLUTION -un I-EVOLUTION -mayor I-EVOLUTION -riesgo I-EVOLUTION -de I-EVOLUTION -complicaciones I-EVOLUTION -obstétricas I-EVOLUTION -como I-EVOLUTION -el I-EVOLUTION -aborto I-EVOLUTION -espontáneo I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -primer I-EVOLUTION -trimestre I-EVOLUTION -(7). I-EVOLUTION -La I-EVOLUTION -CL I-EVOLUTION -en I-EVOLUTION -gestantes I-EVOLUTION -debería I-EVOLUTION -de I-EVOLUTION -ser I-EVOLUTION -pospuesta I-EVOLUTION -al I-EVOLUTION -segundo I-EVOLUTION -trimestre I-EVOLUTION -(4). I-EVOLUTION - I-EVOLUTION -Existe I-EVOLUTION -una I-EVOLUTION -amplia I-EVOLUTION -experiencia I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -CL I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -demostrado I-EVOLUTION -una I-EVOLUTION -menor I-EVOLUTION -tasa I-EVOLUTION -de I-EVOLUTION -complicaciones I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -madre I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -feto I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -grupo I-EVOLUTION -de I-EVOLUTION -pacientes I-EVOLUTION -intervenidos I-EVOLUTION -respecto I-EVOLUTION -al I-EVOLUTION -grupo I-EVOLUTION -de I-EVOLUTION -gestantes I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -manejo I-EVOLUTION -conservador I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -patología I-EVOLUTION -biliar I-EVOLUTION -(8). I-EVOLUTION -La I-EVOLUTION -CL I-EVOLUTION -ofrece I-EVOLUTION -ventajas I-EVOLUTION -respecto I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -colecistectomía I-EVOLUTION -abierta I-EVOLUTION -y I-EVOLUTION -debe I-EVOLUTION -de I-EVOLUTION -plantearse I-EVOLUTION -como I-EVOLUTION -primera I-EVOLUTION -opción I-EVOLUTION -durante I-EVOLUTION -la I-EVOLUTION -gestación I-EVOLUTION -(9). I-EVOLUTION -Requiere I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -experiencia I-EVOLUTION -quirúrgica I-EVOLUTION -para I-EVOLUTION -conseguir I-EVOLUTION -un I-EVOLUTION -tiempo I-EVOLUTION -quirúrgico I-EVOLUTION -menor I-EVOLUTION -y I-EVOLUTION -debe I-EVOLUTION -de I-EVOLUTION -acompañarse I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -serie I-EVOLUTION -de I-EVOLUTION -medidas I-EVOLUTION -encaminadas I-EVOLUTION -a I-EVOLUTION -disminuir I-EVOLUTION -las I-EVOLUTION -posibles I-EVOLUTION -complicaciones I-EVOLUTION -maternofetales I-EVOLUTION -(10). I-EVOLUTION - I-EVOLUTION -R. I-EVOLUTION -Vilallonga, I-EVOLUTION -J. I-EVOLUTION -J. I-EVOLUTION -Olsina, I-EVOLUTION -C. I-EVOLUTION -Margarit† I-EVOLUTION -y I-EVOLUTION -J. I-EVOLUTION -Balsells I-EVOLUTION - I-EVOLUTION -Unidad I-EVOLUTION -de I-EVOLUTION -Cirugía I-EVOLUTION -Hepatobiliopancreática I-EVOLUTION -y I-EVOLUTION -Trasplante I-EVOLUTION -Hepático. I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Cirugía I-EVOLUTION -General I-EVOLUTION -y I-EVOLUTION -del I-EVOLUTION -Aparato I-EVOLUTION -Digestivo. I-EVOLUTION -Hospital I-EVOLUTION -Vall I-EVOLUTION -d´Hebron. I-EVOLUTION -Universidad I-EVOLUTION -Autónoma I-EVOLUTION -de I-EVOLUTION -Barcelona I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -parálisis I-PAST_MEDICAL_HISTORY -facial I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -once I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -fumadora I-PAST_MEDICAL_HISTORY -habitual, I-PAST_MEDICAL_HISTORY -dispepsia I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -ulcerosa, I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -ansioso-depresivo, I-PAST_MEDICAL_HISTORY -menstruaciones I-PAST_MEDICAL_HISTORY -irregulares, I-PAST_MEDICAL_HISTORY -multípara I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -relaciones I-PAST_MEDICAL_HISTORY -sexuales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -riesgo. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acude I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -veces I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -Urgencias I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -doloroso I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -hipocondrio I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -lumbar I-PAST_MEDICAL_HISTORY -irradiado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -genitales I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -miccional, I-PAST_MEDICAL_HISTORY -siendo I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -veces I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cólico I-PAST_MEDICAL_HISTORY -nefrítico. I-PAST_MEDICAL_HISTORY -Desde B-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -diámetro I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -dispareunia, I-PRESENT_ILLNESS -leucorrea, I-PRESENT_ILLNESS -disuria, I-PRESENT_ILLNESS -orinas I-PRESENT_ILLNESS -oscuras I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -mugüet I-PRESENT_ILLNESS -oral. I-PRESENT_ILLNESS -Presentando I-PRESENT_ILLNESS -además I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -anorexia, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -transtornos I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -hábito I-PRESENT_ILLNESS -intestinal. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -presenta I-EXPLORATION -abdomen I-EXPLORATION -doloroso I-EXPLORATION -con I-EXPLORATION -puño-percusión I-EXPLORATION -renal I-EXPLORATION -positiva I-EXPLORATION -y I-EXPLORATION -oleada I-EXPLORATION -ascítica. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -anamnesis I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -clínica I-EXPLORATION -se I-EXPLORATION -pensó I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -serie I-EXPLORATION -de I-EXPLORATION -diagnósticos I-EXPLORATION -diferenciales I-EXPLORATION -tales I-EXPLORATION -como: I-EXPLORATION -carcimomatosis I-EXPLORATION -peritoneal, I-EXPLORATION -hepatopatía, I-EXPLORATION -neoplasia I-EXPLORATION -ovárica, I-EXPLORATION -celiaquía, I-EXPLORATION -tuberculosis I-EXPLORATION -intestinal I-EXPLORATION -y I-EXPLORATION -EPI I-EXPLORATION -con I-EXPLORATION -infección I-EXPLORATION -perihepática I-EXPLORATION -(síndrome I-EXPLORATION -de I-EXPLORATION -Fitz-Hugh-Curtis) I-EXPLORATION -por I-EXPLORATION -gonococos I-EXPLORATION -o I-EXPLORATION -chlamidias, I-EXPLORATION -entre I-EXPLORATION -otras I-EXPLORATION -entidades I-EXPLORATION -patológicas. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -presentó I-EXPLORATION -neutrofilia I-EXPLORATION -sin I-EXPLORATION -leucocitosis, I-EXPLORATION -linfopenia, I-EXPLORATION -anemia I-EXPLORATION -microcítica I-EXPLORATION -hipocrómica, I-EXPLORATION -plaquetas I-EXPLORATION -disminuidas, I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -VSG I-EXPLORATION -(111 I-EXPLORATION -mm/h, I-EXPLORATION -n I-EXPLORATION -< I-EXPLORATION -10) I-EXPLORATION -y I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -PCR I-EXPLORATION -(182 I-EXPLORATION -mg/l, I-EXPLORATION -n I-EXPLORATION -< I-EXPLORATION -5). I-EXPLORATION -Además I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -hipoalbuminemia I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -g/l, I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -globulinas, I-EXPLORATION -aumento I-EXPLORATION -discreto I-EXPLORATION -de I-EXPLORATION -bilirrubina. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -sometió I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -ginecológico, I-EXPLORATION -resultando I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -prueba I-EXPLORATION -de I-EXPLORATION -Mantoux I-EXPLORATION -fue I-EXPLORATION -negativa, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -también I-EXPLORATION -fue I-EXPLORATION -negativa I-EXPLORATION -la I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -Brucella, I-EXPLORATION -Retrovirus, I-EXPLORATION -VHC I-EXPLORATION -y I-EXPLORATION -VHB. I-EXPLORATION -Se I-EXPLORATION -encontró I-EXPLORATION -elevado I-EXPLORATION -el I-EXPLORATION -ADA I-EXPLORATION -(25, I-EXPLORATION -8 I-EXPLORATION -U/l, I-EXPLORATION -n I-EXPLORATION -< I-EXPLORATION -18, I-EXPLORATION -2) I-EXPLORATION -y I-EXPLORATION -muy I-EXPLORATION -elevado I-EXPLORATION -el I-EXPLORATION -antígeno I-EXPLORATION -neoplásico I-EXPLORATION -Ca-125 I-EXPLORATION -(714 I-EXPLORATION -U/ml, I-EXPLORATION -n I-EXPLORATION -< I-EXPLORATION -35). I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -un I-EXPLORATION -exudado I-EXPLORATION -faríngeo I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -S. I-EXPLORATION -aureus. I-EXPLORATION -Los I-EXPLORATION -anticuerpos I-EXPLORATION -antigliadina I-EXPLORATION -y I-EXPLORATION -antiendomisio I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION -su I-EXPLORATION -vez I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -orina I-EXPLORATION -reveló I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -bilirrubina I-EXPLORATION -moderado, I-EXPLORATION -indicio I-EXPLORATION -de I-EXPLORATION -cuerpos I-EXPLORATION -cetónicos, I-EXPLORATION -siendo I-EXPLORATION -el I-EXPLORATION -urocultivo I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -heces I-EXPLORATION -fue I-EXPLORATION -negativo I-EXPLORATION -con I-EXPLORATION -respecto I-EXPLORATION -al I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -Ziehl-Neelsen I-EXPLORATION -para I-EXPLORATION -BAAR I-EXPLORATION -en I-EXPLORATION -dos I-EXPLORATION -ocasiones, I-EXPLORATION -y I-EXPLORATION -negativo I-EXPLORATION -también I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -Lowenstein. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -paracentesis I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -ascítico I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -obtuvo I-EXPLORATION -un I-EXPLORATION -líquido I-EXPLORATION -claro I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -1.476 I-EXPLORATION -células/ml, I-EXPLORATION -siendo I-EXPLORATION -un I-EXPLORATION -80% I-EXPLORATION -polimorfos I-EXPLORATION -nucleares I-EXPLORATION -(n I-EXPLORATION -< I-EXPLORATION -20%), I-EXPLORATION -LDH I-EXPLORATION -muy I-EXPLORATION -elevada, I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -proteínas I-EXPLORATION -y I-EXPLORATION -cultivo I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -S. I-EXPLORATION -haemoliticus, I-EXPLORATION -resultando I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Ziehl-Neelsen I-EXPLORATION -negativa. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiología I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -podemos I-EXPLORATION -comprobar I-EXPLORATION -una I-EXPLORATION -distribución I-EXPLORATION -de I-EXPLORATION -gas I-EXPLORATION -normal I-EXPLORATION -aunque I-EXPLORATION -con I-EXPLORATION -cierta I-EXPLORATION -tendencia I-EXPLORATION -a I-EXPLORATION -situarse I-EXPLORATION -hacia I-EXPLORATION -el I-EXPLORATION -centro, I-EXPLORATION -no I-EXPLORATION -pudiendo I-EXPLORATION -valorarse I-EXPLORATION -adecuadamente I-EXPLORATION -al I-EXPLORATION -no I-EXPLORATION -poder I-EXPLORATION -visualizarse I-EXPLORATION -los I-EXPLORATION -flancos. I-EXPLORATION -En I-EXPLORATION -pelvis I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -signos I-EXPLORATION -que I-EXPLORATION -indican I-EXPLORATION -la I-EXPLORATION -presentación I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -libre. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -nos I-EXPLORATION -muestra I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -peritoneal, I-EXPLORATION -no I-EXPLORATION -existiendo I-EXPLORATION -hallazgos I-EXPLORATION -significativos I-EXPLORATION -en I-EXPLORATION -vísceras I-EXPLORATION -abdominales. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -baritado I-EXPLORATION -gastroduodenal I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -comprobó I-EXPLORATION -alteración I-EXPLORATION -del I-EXPLORATION -tránsito I-EXPLORATION -intestinal. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -abominal I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -abundante I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -y I-EXPLORATION -engrosamiento I-EXPLORATION -peritoneal I-EXPLORATION -como I-EXPLORATION -signos I-EXPLORATION -más I-EXPLORATION -llamativos. I-EXPLORATION - I-EXPLORATION -Sin I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -clara I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -patología I-EXPLORATION -principal I-EXPLORATION -que I-EXPLORATION -originó I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -y I-EXPLORATION -teniendo I-EXPLORATION -en I-EXPLORATION -mente I-EXPLORATION -la I-EXPLORATION -carcinomatosis I-EXPLORATION -peritoneal, I-EXPLORATION -una I-EXPLORATION -infección I-EXPLORATION -difusa I-EXPLORATION -intraperitoneal I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -propia I-EXPLORATION -tuberculosis I-EXPLORATION -peritoneal, I-EXPLORATION -se I-EXPLORATION -ingresó I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -para I-EXPLORATION -ser I-EXPLORATION -sometida I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -laparoscopia I-EXPLORATION -diagnóstica I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -reglada. I-EXPLORATION - I-EXPLORATION -Al I-EXPLORATION -entrar I-EXPLORATION -en I-EXPLORATION -cavidad I-EXPLORATION -nos I-EXPLORATION -encontramos I-EXPLORATION -multitud I-EXPLORATION -de I-EXPLORATION -adherencias I-EXPLORATION -y I-EXPLORATION -septos I-EXPLORATION -intraperitoneales I-EXPLORATION -y I-EXPLORATION -entre I-EXPLORATION -los I-EXPLORATION -distintos I-EXPLORATION -órganos I-EXPLORATION -abdominales, I-EXPLORATION -destacando I-EXPLORATION -las I-EXPLORATION -adherencias I-EXPLORATION -hepáticas. I-EXPLORATION -Además I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -siembra I-EXPLORATION -peritoneal I-EXPLORATION -muy I-EXPLORATION -extensa I-EXPLORATION -de I-EXPLORATION -tuberculomas. I-EXPLORATION -Se I-EXPLORATION -tomó I-EXPLORATION -biopsia I-EXPLORATION -peritoneal I-EXPLORATION -de I-EXPLORATION -tuberculomas I-EXPLORATION -y I-EXPLORATION -hepática, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -liberaron I-EXPLORATION -las I-EXPLORATION -adherencias I-EXPLORATION -más I-EXPLORATION -llamativas. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION -de I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -dieron I-EXPLORATION -a I-EXPLORATION -conocer I-EXPLORATION -una I-EXPLORATION -granulomatosis I-EXPLORATION -peritoneal I-EXPLORATION -de I-EXPLORATION -etiología I-EXPLORATION -sugestivamente I-EXPLORATION -tuberculosa I-EXPLORATION -con I-EXPLORATION -hígado I-EXPLORATION -con I-EXPLORATION -granulomatosis I-EXPLORATION -capsular I-EXPLORATION -de I-EXPLORATION -etiología I-EXPLORATION -sugestivamente I-EXPLORATION -tuberculosa I-EXPLORATION -de I-EXPLORATION -alteraciones I-EXPLORATION -inflamatorias I-EXPLORATION -parenquimatosas I-EXPLORATION -de I-EXPLORATION -carácter I-EXPLORATION -reactivo. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -28 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -duración I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -epigástrico I-PRESENT_ILLNESS -postprandrial, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -diarrea. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -estaba I-EXPLORATION -pálida I-EXPLORATION -y I-EXPLORATION -presentaba I-EXPLORATION -dolor I-EXPLORATION -epigástrico I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -abdominal. I-EXPLORATION -Analítica: I-EXPLORATION -Hb I-EXPLORATION -8, I-EXPLORATION -6 I-EXPLORATION -g/dl, I-EXPLORATION -Htco I-EXPLORATION -28%, I-EXPLORATION -VCM I-EXPLORATION -64, I-EXPLORATION -Fe I-EXPLORATION -6 I-EXPLORATION -mcg/dl, I-EXPLORATION -ferritina I-EXPLORATION -1 I-EXPLORATION -ng/ml, I-EXPLORATION -saturación I-EXPLORATION -transferrina I-EXPLORATION -1, I-EXPLORATION -5%, I-EXPLORATION -vitamina I-EXPLORATION -B12 I-EXPLORATION -y I-EXPLORATION -ácido I-EXPLORATION -fólico I-EXPLORATION -normales. I-EXPLORATION -Anticuerpos I-EXPLORATION -antigliadina I-EXPLORATION -24, I-EXPLORATION -5 I-EXPLORATION -(0-20 I-EXPLORATION -UI/ml) I-EXPLORATION -y I-EXPLORATION -antiendomisio I-EXPLORATION -> I-EXPLORATION -20. I-EXPLORATION -Resto I-EXPLORATION -de I-EXPLORATION -parámetros I-EXPLORATION -biológicos I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION -Ca19.9, I-EXPLORATION -CEA, I-EXPLORATION -alfafetoproteína I-EXPLORATION -normales. I-EXPLORATION -Hemólisis I-EXPLORATION -negativo. I-EXPLORATION -Rx I-EXPLORATION -gastroduodenal-tránsito I-EXPLORATION -intestinal: I-EXPLORATION -varias I-EXPLORATION -estenosis I-EXPLORATION -duodenales, I-EXPLORATION -con I-EXPLORATION -ulceración I-EXPLORATION -e I-EXPLORATION -imágenes I-EXPLORATION -diverticulares I-EXPLORATION -en I-EXPLORATION -duodeno I-EXPLORATION -distal-yeyuno. I-EXPLORATION -Esofagogastroscopia: I-EXPLORATION -mucosa I-EXPLORATION -duodenal I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -atrófico I-EXPLORATION -y I-EXPLORATION -ulceraciones I-EXPLORATION -lineales I-EXPLORATION -postbulbares. I-EXPLORATION -Anatomía I-EXPLORATION -patológica: I-EXPLORATION -atrofia I-EXPLORATION -vellositaria I-EXPLORATION -severa I-EXPLORATION -e I-EXPLORATION -infiltración I-EXPLORATION -extensa I-EXPLORATION -inflamatoria. I-EXPLORATION -No I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -granulomas, I-EXPLORATION -tejido I-EXPLORATION -linfoide I-EXPLORATION -ni I-EXPLORATION -carcinoma. I-EXPLORATION -Biopsia I-EXPLORATION -con I-EXPLORATION -cápsula I-EXPLORATION -de I-EXPLORATION -Crosby I-EXPLORATION -dirigida I-EXPLORATION -a I-EXPLORATION -zona I-EXPLORATION -estenótica: I-EXPLORATION -hallazgos I-EXPLORATION -histológicos I-EXPLORATION -similares. I-EXPLORATION -TAC I-EXPLORATION -abdominal: I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -significativos. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -dieta I-TREATMENT -sin I-TREATMENT -gluten I-TREATMENT -con B-EVOLUTION -mejoría I-EVOLUTION -analítica I-EVOLUTION -y I-EVOLUTION -clínica I-EVOLUTION -progresiva I-EVOLUTION -y I-EVOLUTION -posterior I-EVOLUTION -normalización I-EVOLUTION -de I-EVOLUTION -todos I-EVOLUTION -los I-EVOLUTION -parámetros. I-EVOLUTION -Ocho I-EVOLUTION -años I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -continúa I-EVOLUTION -asintomática I-EVOLUTION -con I-EVOLUTION -controles I-EVOLUTION -anuales. I-EVOLUTION -La B-EXPLORATION -endoscopia I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -histología I-EXPLORATION -objetivaron I-EXPLORATION -una I-EXPLORATION -mucosa I-EXPLORATION -intestinal I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -analítica, I-EXPLORATION -incluidos I-EXPLORATION -anticuerpos I-EXPLORATION -de I-EXPLORATION -celiaquia, I-EXPLORATION -no I-EXPLORATION -presenta I-EXPLORATION -hallazgos I-EXPLORATION -significativos. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -estenosis I-EXPLORATION -del I-EXPLORATION -duodeno I-EXPLORATION -es I-EXPLORATION -una I-EXPLORATION -forma I-EXPLORATION -inusual I-EXPLORATION -del I-EXPLORATION -presentación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -enfermedad I-EXPLORATION -celiaca I-EXPLORATION -(3). I-EXPLORATION -La I-EXPLORATION -ulceración I-EXPLORATION -intestinal I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -estenosis I-EXPLORATION -se I-EXPLORATION -cree I-EXPLORATION -que I-EXPLORATION -aparecen I-EXPLORATION -en I-EXPLORATION -zonas I-EXPLORATION -con I-EXPLORATION -mucosa I-EXPLORATION -inflamatoria. I-EXPLORATION -Estas I-EXPLORATION -lesiones I-EXPLORATION -típicamente I-EXPLORATION -se I-EXPLORATION -localizan I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -proximal I-EXPLORATION -y I-EXPLORATION -generalmente I-EXPLORATION -se I-EXPLORATION -describen I-EXPLORATION -en I-EXPLORATION -fases I-EXPLORATION -avanzadas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -enfermedad I-EXPLORATION -celiaca I-EXPLORATION -(1,2). I-EXPLORATION -Más I-EXPLORATION -recientemente, I-EXPLORATION -Schweger I-EXPLORATION -y I-EXPLORATION -Murray I-EXPLORATION -(3) I-EXPLORATION -han I-EXPLORATION -descrito I-EXPLORATION -5 I-EXPLORATION -casos I-EXPLORATION -más I-EXPLORATION -indicando I-EXPLORATION -que I-EXPLORATION -estas I-EXPLORATION -complicaciones, I-EXPLORATION -si I-EXPLORATION -bien I-EXPLORATION -raras, I-EXPLORATION -pueden I-EXPLORATION -presentarse I-EXPLORATION -más I-EXPLORATION -frecuentemente I-EXPLORATION -que I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -pensaba I-EXPLORATION -y I-EXPLORATION -parece I-EXPLORATION -que I-EXPLORATION -podrían I-EXPLORATION -aparecer I-EXPLORATION -más I-EXPLORATION -temprano I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -curso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -enfermedad. I-EXPLORATION -Las I-EXPLORATION -erosiones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -segunda I-EXPLORATION -porción I-EXPLORATION -duodenal I-EXPLORATION -en I-EXPLORATION -pacientes I-EXPLORATION -celiacos I-EXPLORATION -han I-EXPLORATION -sido I-EXPLORATION -descritas I-EXPLORATION -recientemente I-EXPLORATION -endoscópicamente I-EXPLORATION -(4). I-EXPLORATION -Nuestra I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -tenía I-EXPLORATION -clínica I-EXPLORATION -típica I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -celiaca, I-EXPLORATION -presentando I-EXPLORATION -estreñimiento I-EXPLORATION -y I-EXPLORATION -dolor I-EXPLORATION -epigástrico. I-EXPLORATION -La I-EXPLORATION -radiología I-EXPLORATION -objetivó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -estenosis I-EXPLORATION -duodenal I-EXPLORATION -y I-EXPLORATION -ulceración, I-EXPLORATION -y I-EXPLORATION -tuvimos I-EXPLORATION -que I-EXPLORATION -realizar I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -diferencial I-EXPLORATION -entre I-EXPLORATION -enfermedad I-EXPLORATION -celiaca I-EXPLORATION -y I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Crohn, I-EXPLORATION -linfoma, I-EXPLORATION -carcinoma I-EXPLORATION -intestinal, I-EXPLORATION -y I-EXPLORATION -yeyunitis I-EXPLORATION -ulcerativa. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -analíticos, I-EXPLORATION -endoscópicos I-EXPLORATION -e I-EXPLORATION -histológicos, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -evolución I-EXPLORATION -posterior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -con I-EXPLORATION -dieta I-EXPLORATION -sin I-EXPLORATION -gluten, I-EXPLORATION -confirmaron I-EXPLORATION -la I-EXPLORATION -enfermedad. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -enfermedad I-EXPLORATION -celiaca I-EXPLORATION -debe I-EXPLORATION -ser I-EXPLORATION -tenido I-EXPLORATION -en I-EXPLORATION -cuenta I-EXPLORATION -el I-EXPLORATION -desarrollo I-EXPLORATION -temprano I-EXPLORATION -de I-EXPLORATION -estenosis I-EXPLORATION -duodenal I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -ulceraciones, I-EXPLORATION -y I-EXPLORATION -más I-EXPLORATION -en I-EXPLORATION -aquellos I-EXPLORATION -pacientes I-EXPLORATION -con I-EXPLORATION -síntomas I-EXPLORATION -no I-EXPLORATION -típicos I-EXPLORATION -o I-EXPLORATION -con I-EXPLORATION -hallazgos I-EXPLORATION -radiológicos I-EXPLORATION -inespecíficos, I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -que I-EXPLORATION -los I-EXPLORATION -cambios I-EXPLORATION -radiológicos I-EXPLORATION -antes I-EXPLORATION -mencionados I-EXPLORATION -pueden I-EXPLORATION -preceder I-EXPLORATION -al I-EXPLORATION -diagnóstico I-EXPLORATION -clínico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -enfermedad. I-EXPLORATION - I-EXPLORATION -A. I-EXPLORATION -Castiella, I-EXPLORATION -I. I-EXPLORATION -Aramberri1, I-EXPLORATION -J. I-EXPLORATION -Fernández, I-EXPLORATION -C. I-EXPLORATION -Carrera1, I-EXPLORATION -L. I-EXPLORATION -Legasa2, I-EXPLORATION -I. I-EXPLORATION -Ruiz3 I-EXPLORATION -y I-EXPLORATION -E. I-EXPLORATION -Zapata I-EXPLORATION - I-EXPLORATION -Unidad I-EXPLORATION -de I-EXPLORATION -Gastroenterología, I-EXPLORATION -1Medicina I-EXPLORATION -de I-EXPLORATION -Familia, I-EXPLORATION -2Servicios I-EXPLORATION -de I-EXPLORATION -Radiología I-EXPLORATION -y I-EXPLORATION -3Anatomía I-EXPLORATION -Patológica. I-EXPLORATION -Hospital I-EXPLORATION -Mendaro. I-EXPLORATION -Gipuzkoa I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -46 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -diagnosticada B-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -14 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -PQH I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -poliquistosis I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sometida I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -drenaje I-PAST_MEDICAL_HISTORY -percutáneo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -quistes I-PAST_MEDICAL_HISTORY -hepáticos. I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -incluida I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -lista I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -espera I-PRESENT_ILLNESS -(LE) I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -trasplante I-PRESENT_ILLNESS -hepático I-PRESENT_ILLNESS -(TH) I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -PQH I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -criterios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hepatomegalia I-PRESENT_ILLNESS -gigantesca, I-PRESENT_ILLNESS -caquexia, I-PRESENT_ILLNESS -hipertensión I-PRESENT_ILLNESS -portal, I-PRESENT_ILLNESS -ascitis, I-PRESENT_ILLNESS -minusvalía I-PRESENT_ILLNESS -física I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -social I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -insuficiencia I-PRESENT_ILLNESS -renal I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS -grado I-PRESENT_ILLNESS -II I-PRESENT_ILLNESS -(creatinemia I-PRESENT_ILLNESS -2, I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -mg/dl). I-PRESENT_ILLNESS -La B-EXPLORATION -puntuación I-EXPLORATION -MELD I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -23. I-EXPLORATION -El B-TREATMENT -TH I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -con I-TREATMENT -la I-TREATMENT -técnica I-TREATMENT -de I-TREATMENT -la I-TREATMENT -preservación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -cava I-TREATMENT -inferior I-TREATMENT -(técnica I-TREATMENT -de I-TREATMENT -piggy-back), I-TREATMENT -sin I-TREATMENT -by-pass I-TREATMENT -veno-venoso I-TREATMENT -y I-TREATMENT -reconstrucción I-TREATMENT -biliar I-TREATMENT -mediante I-TREATMENT -colédoco-yeyunostomía I-TREATMENT -sobre I-TREATMENT -asa I-TREATMENT -desfuncionalizada I-TREATMENT -en I-TREATMENT -Y I-TREATMENT -de I-TREATMENT -Roux. I-TREATMENT -El I-TREATMENT -injerto I-TREATMENT -se I-TREATMENT -perfundió I-TREATMENT -y I-TREATMENT -almacenó I-TREATMENT -con I-TREATMENT -la I-TREATMENT -solución I-TREATMENT -de I-TREATMENT -preservación I-TREATMENT -de I-TREATMENT -Celsior. I-TREATMENT -Tiempo I-TREATMENT -de I-TREATMENT -isquemia I-TREATMENT -fría: I-TREATMENT -5 I-TREATMENT -h I-TREATMENT -50 I-TREATMENT -min. I-TREATMENT -Peso I-TREATMENT -de I-TREATMENT -la I-TREATMENT -pieza I-TREATMENT -de I-TREATMENT -hepatectomía: I-TREATMENT -14 I-TREATMENT -kg. I-TREATMENT -No I-TREATMENT -se I-TREATMENT -presentó I-TREATMENT -síndrome I-TREATMENT -de I-TREATMENT -reperfusión. I-TREATMENT -Duración I-TREATMENT -de I-TREATMENT -la I-TREATMENT -intervención: I-TREATMENT -6 I-TREATMENT -h I-TREATMENT -25 I-TREATMENT -min. I-TREATMENT -Transfusión: I-TREATMENT -2.620 I-TREATMENT -cc I-TREATMENT -de I-TREATMENT -concentrados I-TREATMENT -de I-TREATMENT -hematíes I-TREATMENT -y I-TREATMENT -2.370 I-TREATMENT -cc I-TREATMENT -de I-TREATMENT -plasma. I-TREATMENT -Debido I-TREATMENT -a I-TREATMENT -la I-TREATMENT -insuficiencia I-TREATMENT -renal, I-TREATMENT -la I-TREATMENT -inducción I-TREATMENT -de I-TREATMENT -la I-TREATMENT -inmunosupresión I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -con I-TREATMENT -basiliximab I-TREATMENT -y I-TREATMENT -corticoides; I-TREATMENT -al I-TREATMENT -4º I-TREATMENT -día I-TREATMENT -del I-TREATMENT -trasplante, I-TREATMENT -siendo I-TREATMENT -normal I-TREATMENT -la I-TREATMENT -creatinina I-TREATMENT -(1 I-TREATMENT -mg/dl), I-TREATMENT -se I-TREATMENT -introdujo I-TREATMENT -tacrolimus. I-TREATMENT -La B-EVOLUTION -estancia I-EVOLUTION -en I-EVOLUTION -UCI I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -4 I-EVOLUTION -días. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -14 I-EVOLUTION -días I-EVOLUTION -del I-EVOLUTION -TH I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -hospitalaria. I-EVOLUTION -Actualmente I-EVOLUTION -han I-EVOLUTION -transcurrido I-EVOLUTION -5 I-EVOLUTION -años I-EVOLUTION -y I-EVOLUTION -medio I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -TH, I-EVOLUTION -la I-EVOLUTION -enferma I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -bien, I-EVOLUTION -hace I-EVOLUTION -vida I-EVOLUTION -normal I-EVOLUTION -y I-EVOLUTION -las I-EVOLUTION -pruebas I-EVOLUTION -de I-EVOLUTION -función I-EVOLUTION -hepática I-EVOLUTION -son I-EVOLUTION -normales. I-EVOLUTION - I-EVOLUTION - -Una B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -66 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -es B-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -ante I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -hallazgo I-DERIVED_FROM/TO -ambulatorio I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -TAC I-DERIVED_FROM/TO -abdominal I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -lesión I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -7 I-DERIVED_FROM/TO -cm I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -lóbulo I-DERIVED_FROM/TO -hepático I-DERIVED_FROM/TO -izquierdo. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Se B-PAST_MEDICAL_HISTORY -trata I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -sana I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -acudido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cabecera I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -realizarse I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -chequeo I-PRESENT_ILLNESS -rutinario I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -este I-PRESENT_ILLNESS -detectó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -analítica I-PRESENT_ILLNESS -convencional I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -discreta I-PRESENT_ILLNESS -elevación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -transaminasas, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -decidió I-PRESENT_ILLNESS -completar I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -estudio I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -prueba I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -imagen. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -ninguna I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -reseñable I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -aparatos. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general I-EXPLORATION -llamando I-EXPLORATION -únicamente I-EXPLORATION -la I-EXPLORATION -atención I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -discreta I-EXPLORATION -molestia I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -hipocondrio I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -en I-EXPLORATION -nuestra I-EXPLORATION -unidad I-EXPLORATION -se I-EXPLORATION -realizaron I-EXPLORATION -las I-EXPLORATION -siguientes I-EXPLORATION -pruebas I-EXPLORATION -complementarias: I-EXPLORATION - I-EXPLORATION -Hemograma I-EXPLORATION -y I-EXPLORATION -coagulación: I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION - I-EXPLORATION -Bioquímica: I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -1, I-EXPLORATION -12, I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -690 I-EXPLORATION -(n I-EXPLORATION -< I-EXPLORATION -258), I-EXPLORATION -LDH I-EXPLORATION -359, I-EXPLORATION -GOT I-EXPLORATION -(AST) I-EXPLORATION -185 I-EXPLORATION -(n I-EXPLORATION -< I-EXPLORATION -40), I-EXPLORATION -GPT I-EXPLORATION -(ALT) I-EXPLORATION -211 I-EXPLORATION -(n I-EXPLORATION -< I-EXPLORATION -40), I-EXPLORATION -GGT I-EXPLORATION -673 I-EXPLORATION -(n I-EXPLORATION -< I-EXPLORATION -36), I-EXPLORATION -resto I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Marcadores I-EXPLORATION -tumorales: I-EXPLORATION -CA I-EXPLORATION -19.9, I-EXPLORATION -10.9, I-EXPLORATION -alfafetoproteína I-EXPLORATION -386, I-EXPLORATION -9 I-EXPLORATION -(n I-EXPLORATION -< I-EXPLORATION -10), I-EXPLORATION -CEA I-EXPLORATION -1.12. I-EXPLORATION - I-EXPLORATION -EKG: I-EXPLORATION -ritmo I-EXPLORATION -sinusal I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -significativas. I-EXPLORATION - I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -tórax: I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION - I-EXPLORATION -TAC I-EXPLORATION -abdominal: I-EXPLORATION -tumoración I-EXPLORATION -de I-EXPLORATION -7 I-EXPLORATION -cm, I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -bien I-EXPLORATION -delimitados, I-EXPLORATION -centrada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -segmento I-EXPLORATION -medial I-EXPLORATION -del I-EXPLORATION -lóbulo I-EXPLORATION -hepático I-EXPLORATION -izquierdo, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -al I-EXPLORATION -lóbulo I-EXPLORATION -hepático I-EXPLORATION -derecho. I-EXPLORATION -La I-EXPLORATION -masa I-EXPLORATION -produce I-EXPLORATION -compresión I-EXPLORATION -del I-EXPLORATION -tronco I-EXPLORATION -principal I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -porta I-EXPLORATION -y, I-EXPLORATION -sobre I-EXPLORATION -todo, I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -rama I-EXPLORATION -izquierda I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -discreta I-EXPLORATION -dilatación I-EXPLORATION -del I-EXPLORATION -árbol I-EXPLORATION -biliar I-EXPLORATION -izquierdo. I-EXPLORATION -La I-EXPLORATION -lesión I-EXPLORATION -está I-EXPLORATION -poco I-EXPLORATION -vascularizada I-EXPLORATION -y I-EXPLORATION -muestra I-EXPLORATION -importantes I-EXPLORATION -áreas I-EXPLORATION -necróticas. I-EXPLORATION - I-EXPLORATION -Biopsia I-EXPLORATION -hepática: I-EXPLORATION -cambios I-EXPLORATION -de I-EXPLORATION -hiperplasia I-EXPLORATION -nodular I-EXPLORATION -con I-EXPLORATION -marcada I-EXPLORATION -esteatosis, I-EXPLORATION -no I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -malignidad I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -material I-EXPLORATION -remitido. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -discordancia I-EXPLORATION -entre I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION -y I-EXPLORATION -analíticas, I-EXPLORATION -que I-EXPLORATION -orientaban I-EXPLORATION -hacia I-EXPLORATION -un I-EXPLORATION -proceso I-EXPLORATION -neoplásico, I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -(no I-EXPLORATION -concluyente I-EXPLORATION -de I-EXPLORATION -malignidad) I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -explicar I-EXPLORATION -la I-EXPLORATION -situación I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -ofreciéndole I-EXPLORATION -la I-EXPLORATION -posibilidad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cirugía. I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -acepta I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -practicándosele I-TREATMENT -una I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -los I-TREATMENT -segmentos I-TREATMENT -IV I-TREATMENT -y I-TREATMENT -V I-TREATMENT -hepáticos. I-TREATMENT - I-TREATMENT -Durante B-EXPLORATION -la I-EXPLORATION -operación I-EXPLORATION -se I-EXPLORATION -envía I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -intraoperatoria I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -informada I-EXPLORATION -nuevamente I-EXPLORATION -como I-EXPLORATION -biopsia I-EXPLORATION -no I-EXPLORATION -concluyente I-EXPLORATION -de I-EXPLORATION -malignidad I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -material I-EXPLORATION -remitido, I-EXPLORATION -pero I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -de I-EXPLORATION -resección I-EXPLORATION -macroscópicamente I-EXPLORATION -se I-EXPLORATION -diferencia I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -mayor I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -x I-EXPLORATION -6 I-EXPLORATION -cm, I-EXPLORATION -bien I-EXPLORATION -delimitado I-EXPLORATION -y I-EXPLORATION -encapsulado, I-EXPLORATION -que I-EXPLORATION -presenta I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -central I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -tamaño, I-EXPLORATION -necrosado I-EXPLORATION -y I-EXPLORATION -multilobulado. I-EXPLORATION -Microscópicamente I-EXPLORATION -se I-EXPLORATION -diferencian I-EXPLORATION -áreas I-EXPLORATION -extensas I-EXPLORATION -sin I-EXPLORATION -atipias, I-EXPLORATION -con I-EXPLORATION -abundantes I-EXPLORATION -vacuolas I-EXPLORATION -lipídicas I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -proliferación I-EXPLORATION -muy I-EXPLORATION -bajo I-EXPLORATION -y I-EXPLORATION -otras I-EXPLORATION -áreas I-EXPLORATION -con I-EXPLORATION -alta I-EXPLORATION -celuraridad, I-EXPLORATION -núcleos I-EXPLORATION -atípicos, I-EXPLORATION -mitosis I-EXPLORATION -e I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -proliferación I-EXPLORATION -en I-EXPLORATION -torno I-EXPLORATION -al I-EXPLORATION -15%. I-EXPLORATION -Finalmente I-EXPLORATION -el I-EXPLORATION -tumor I-EXPLORATION -es I-EXPLORATION -catalogado I-EXPLORATION -como I-EXPLORATION -hepatocarcinoma I-EXPLORATION -bien I-EXPLORATION -diferenciado I-EXPLORATION -(grado I-EXPLORATION -II) I-EXPLORATION -rico I-EXPLORATION -en I-EXPLORATION -lípidos. I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presentó I-EVOLUTION -ninguna I-EVOLUTION -complicación I-EVOLUTION -reseñable I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -posterior I-EVOLUTION -seguimiento I-EVOLUTION -en I-EVOLUTION -consultas I-EVOLUTION -externas. I-EVOLUTION -Actualmente B-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -asintomática I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -analítica I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -se I-EXPLORATION -ha I-EXPLORATION -comprobado I-EXPLORATION -la I-EXPLORATION -normalización I-EXPLORATION -tanto I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -transaminasas I-EXPLORATION -como I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -alfafetoproteína. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -47 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -diabético B-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -II. I-PAST_MEDICAL_HISTORY -Bebedor I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pancreatitis I-PAST_MEDICAL_HISTORY -crónica. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -epigástrico, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -el I-EXPLORATION -abdomen I-EXPLORATION -es I-EXPLORATION -blando I-EXPLORATION -y I-EXPLORATION -depresible, I-EXPLORATION -no I-EXPLORATION -presenta I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal I-EXPLORATION -ni I-EXPLORATION -alteraciones I-EXPLORATION -analíticas. I-EXPLORATION - I-EXPLORATION -Ingresa I-EXPLORATION -en I-EXPLORATION -observación I-EXPLORATION -practicándose I-EXPLORATION -una I-EXPLORATION -TC I-EXPLORATION -que I-EXPLORATION -mostraba I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -pancreatitis I-EXPLORATION -crónica I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -calcificaciones. I-EXPLORATION -Existen I-EXPLORATION -dos I-EXPLORATION -formaciones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -páncreas: I-EXPLORATION -una I-EXPLORATION -de I-EXPLORATION -11 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cola I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -pseudoquiste I-EXPLORATION -y I-EXPLORATION -otra I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -sólido I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cabeza I-EXPLORATION -que I-EXPLORATION -corresponde I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -pseudoaneurisma I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -gastroduodenal. I-EXPLORATION -Evoluciona B-EVOLUTION -favorablemente I-EVOLUTION -mejorando I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -y I-EVOLUTION -presentando I-EVOLUTION -una I-EVOLUTION -ligera I-EVOLUTION -anemización. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -días I-EVOLUTION -presenta I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -muy I-EVOLUTION -intenso I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -hematemesis I-EVOLUTION -y I-EVOLUTION -rectorragia I-EVOLUTION -masiva. I-EVOLUTION -Se I-EVOLUTION -produce I-EVOLUTION -un I-EVOLUTION -shock I-EVOLUTION -hemodinámico I-EVOLUTION -mejorando I-EVOLUTION -posteriormente I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -y I-EVOLUTION -persistiendo I-EVOLUTION -el I-EVOLUTION -sangrado. I-EVOLUTION -Una B-EXPLORATION -nueva I-EXPLORATION -TC I-EXPLORATION -muestra I-EXPLORATION -la I-EXPLORATION -desaparición I-EXPLORATION -del I-EXPLORATION -pseudoquiste I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cola I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -cabeza I-EXPLORATION -pancreática I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -sangrado I-EXPLORATION -arterial I-EXPLORATION -activo I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior. I-EXPLORATION -El I-EXPLORATION -cuadro I-EXPLORATION -es I-EXPLORATION -interpretado I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -drenaje I-EXPLORATION -espontáneo I-EXPLORATION -del I-EXPLORATION -pseudoquiste I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -cavidad I-EXPLORATION -gástrica I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -sangrado I-EXPLORATION -digestivo I-EXPLORATION -ocasionado I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -pseudoaneurisma I-EXPLORATION -en I-EXPLORATION -comunicación I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -del I-EXPLORATION -pseudoquiste I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -tubo I-EXPLORATION -digestivo. I-EXPLORATION -Ante B-TREATMENT -tal I-TREATMENT -situación I-TREATMENT -se I-TREATMENT -desaconseja I-TREATMENT -el I-TREATMENT -traslado I-TREATMENT -y I-TREATMENT -se I-TREATMENT -interveniene I-TREATMENT -quirúrgicamente. I-TREATMENT - I-TREATMENT -En I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -se I-TREATMENT -aprecia I-TREATMENT -una I-TREATMENT -masa I-TREATMENT -del I-TREATMENT -tamaño I-TREATMENT -de I-TREATMENT -un I-TREATMENT -puño I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cabeza I-TREATMENT -pancreática. I-TREATMENT -Se I-TREATMENT -aborda I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -gastroduodenal I-TREATMENT -que I-TREATMENT -se I-TREATMENT -liga I-TREATMENT -en I-TREATMENT -el I-TREATMENT -origen I-TREATMENT -para I-TREATMENT -detener I-TREATMENT -la I-TREATMENT -principal I-TREATMENT -fuente I-TREATMENT -de I-TREATMENT -sangre I-TREATMENT -que I-TREATMENT -alimenta I-TREATMENT -el I-TREATMENT -aneurisma. I-TREATMENT -Se I-TREATMENT -realiza I-TREATMENT -una I-TREATMENT -gastrotomía I-TREATMENT -comprobando I-TREATMENT -la I-TREATMENT -comunicación I-TREATMENT -del I-TREATMENT -pseudoquiste I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cola I-TREATMENT -con I-TREATMENT -la I-TREATMENT -pared I-TREATMENT -gástrica I-TREATMENT -posterior I-TREATMENT -y I-TREATMENT -comprobando I-TREATMENT -que I-TREATMENT -no I-TREATMENT -existe I-TREATMENT -sangrado. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -es I-EVOLUTION -favorable. I-EVOLUTION -A B-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -pocos I-DERIVED_FROM/TO -días I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -intervención, I-DERIVED_FROM/TO -tras I-DERIVED_FROM/TO -haber I-DERIVED_FROM/TO -repuesto I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -las I-DERIVED_FROM/TO -primeras I-DERIVED_FROM/TO -horas I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -hematocrito, I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -aprecia I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -disminución I-DERIVED_FROM/TO -progresiva I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -valores I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -hemoglobina, I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -lo I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -remite I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -enfermo I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -radiología I-DERIVED_FROM/TO -intervencionista. I-DERIVED_FROM/TO -Se B-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -arteriografía I-EXPLORATION -selectiva I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -puede I-EXPLORATION -acceder I-EXPLORATION -al I-EXPLORATION -pseudoaneurisma I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -principal I-EXPLORATION -que I-EXPLORATION -lo I-EXPLORATION -nutre, I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -la I-EXPLORATION -gastroduodenal, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -accede I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -ramas I-EXPLORATION -arteriales I-EXPLORATION -secundarias I-EXPLORATION -que I-EXPLORATION -proceden I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pancreático-yeyunal. I-EXPLORATION -Se B-TREATMENT -consigue I-TREATMENT -excluir I-TREATMENT -por I-TREATMENT -completo I-TREATMENT -el I-TREATMENT -pseudoaneurisma. I-TREATMENT -En B-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -siguientes I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -permanece I-EVOLUTION -estable I-EVOLUTION -y I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -evidencian I-EVOLUTION -nuevos I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -sangrado. I-EVOLUTION -Tras I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomático. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -83 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -histerectomía, I-PAST_MEDICAL_HISTORY -cólicos I-PAST_MEDICAL_HISTORY -renales, I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -B, I-PAST_MEDICAL_HISTORY -anemia I-PAST_MEDICAL_HISTORY -megaloblástica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cólicos I-PAST_MEDICAL_HISTORY -biliares I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -repetición, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -difuso, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -varios I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -superficial I-EXPLORATION -y I-EXPLORATION -profunda I-EXPLORATION -en I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -hemiabdomen I-EXPLORATION -superior, I-EXPLORATION -especialmente I-EXPLORATION -en I-EXPLORATION -hipocondrio I-EXPLORATION -derecho. I-EXPLORATION -Analítica I-EXPLORATION -al I-EXPLORATION -ingreso: I-EXPLORATION -17 I-EXPLORATION -x I-EXPLORATION -109/l I-EXPLORATION -leucocitos I-EXPLORATION -con I-EXPLORATION -86% I-EXPLORATION -de I-EXPLORATION -neutrofilia; I-EXPLORATION -amilasemia I-EXPLORATION -5.203 I-EXPLORATION -U/l; I-EXPLORATION -amilasuria I-EXPLORATION -43.703 I-EXPLORATION -U/l; I-EXPLORATION -LDH I-EXPLORATION -675 I-EXPLORATION -U/l; I-EXPLORATION -bilirubina I-EXPLORATION -total I-EXPLORATION -1, I-EXPLORATION -55 I-EXPLORATION -mg/dl; I-EXPLORATION -GOT I-EXPLORATION -111 I-EXPLORATION -U/L; I-EXPLORATION -GPT I-EXPLORATION -152 I-EXPLORATION -U/l; I-EXPLORATION -GGT I-EXPLORATION -203 I-EXPLORATION -U/l; I-EXPLORATION -PH I-EXPLORATION -7.222, I-EXPLORATION -PCO2 I-EXPLORATION -28, I-EXPLORATION -8 I-EXPLORATION -mmHg; I-EXPLORATION -PO2 I-EXPLORATION -80 I-EXPLORATION -mmHg; I-EXPLORATION -bicarbonato I-EXPLORATION -13, I-EXPLORATION -7 I-EXPLORATION -mmol/l; I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -y I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -coagulación I-EXPLORATION -normales. I-EXPLORATION -A I-EXPLORATION -las I-EXPLORATION -48 I-EXPLORATION -horas I-EXPLORATION -del I-EXPLORATION -ingreso I-EXPLORATION -mantiene I-EXPLORATION -cifras I-EXPLORATION -similares I-EXPLORATION -de I-EXPLORATION -amilasemia I-EXPLORATION -y I-EXPLORATION -amilasuria I-EXPLORATION -con I-EXPLORATION -alteraciones I-EXPLORATION -graves I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -coagulación: I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -50%; I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -cefalina I-EXPLORATION -48, I-EXPLORATION -2 I-EXPLORATION -s. I-EXPLORATION -Por I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computerizada I-EXPLORATION -del I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -aprecia: I-EXPLORATION -colecistitis I-EXPLORATION -aguda I-EXPLORATION -litiásica, I-EXPLORATION -coledocolitiasis, I-EXPLORATION -aumento I-EXPLORATION -difuso I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -del I-EXPLORATION -páncreas I-EXPLORATION -y I-EXPLORATION -ascitis, I-EXPLORATION -apreciándose I-EXPLORATION -en I-EXPLORATION -bazo I-EXPLORATION -múltiples I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -infarto. I-EXPLORATION -A B-TREATMENT -los I-TREATMENT -tres I-TREATMENT -días I-TREATMENT -del I-TREATMENT -ingreso I-TREATMENT -se I-TREATMENT -practica I-TREATMENT -esfinterotomía I-TREATMENT -endoscópica. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -evoluciona I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -tórpida, I-EVOLUTION -falleciendo I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -17 I-EVOLUTION -días I-EVOLUTION -por I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -shock I-EVOLUTION -hemorrágico I-EVOLUTION -de I-EVOLUTION -origen I-EVOLUTION -digestivo. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica, I-PAST_MEDICAL_HISTORY -quistes I-PAST_MEDICAL_HISTORY -renales I-PAST_MEDICAL_HISTORY -bilaterales, I-PAST_MEDICAL_HISTORY -hemorragia I-PAST_MEDICAL_HISTORY -digestiva I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -úlcera I-PAST_MEDICAL_HISTORY -duodenal, I-PAST_MEDICAL_HISTORY -dislipemia, I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -I I-PAST_MEDICAL_HISTORY -(índice I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -masa I-PAST_MEDICAL_HISTORY -corporal I-PAST_MEDICAL_HISTORY -33, I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -kg/m2) I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -prolactinoma. I-PAST_MEDICAL_HISTORY -Presenta B-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -suprarrenal I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -funcionante I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -gran I-PRESENT_ILLNESS -tamaño, I-PRESENT_ILLNESS -diagnosticada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -TC I-PRESENT_ILLNESS -abdominal. I-PRESENT_ILLNESS -Se B-TREATMENT -efectuó I-TREATMENT -un I-TREATMENT -abordaje I-TREATMENT -laparoscópico, I-TREATMENT -con I-TREATMENT -liberación I-TREATMENT -del I-TREATMENT -ángulo I-TREATMENT -esplénico I-TREATMENT -del I-TREATMENT -colon I-TREATMENT -y I-TREATMENT -movilización I-TREATMENT -medial I-TREATMENT -espleno-pancreática; I-TREATMENT -sección I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -principal I-TREATMENT -adrenal I-TREATMENT -izquierda I-TREATMENT -y I-TREATMENT -de I-TREATMENT -los I-TREATMENT -vasos I-TREATMENT -accesorios I-TREATMENT -venosos I-TREATMENT -y I-TREATMENT -arteriales; I-TREATMENT -exéresis I-TREATMENT -completa I-TREATMENT -de I-TREATMENT -la I-TREATMENT -glándula I-TREATMENT -adrenal I-TREATMENT -tumoral, I-TREATMENT -revisión I-TREATMENT -de I-TREATMENT -la I-TREATMENT -hemostasia I-TREATMENT -y I-TREATMENT -extracción I-TREATMENT -de I-TREATMENT -la I-TREATMENT -pieza I-TREATMENT -en I-TREATMENT -una I-TREATMENT -bolsa I-TREATMENT -preformada I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -una I-TREATMENT -minilaparotomía I-TREATMENT -transversa. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -de I-EXPLORATION -carácter I-EXPLORATION -heterogéneo, I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -hemorrágicas, I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -coloración I-EXPLORATION -parduzcas, I-EXPLORATION -áreas I-EXPLORATION -amarillentas I-EXPLORATION -y I-EXPLORATION -extensas I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -necrosis I-EXPLORATION -hemorrágicas; I-EXPLORATION -también I-EXPLORATION -se I-EXPLORATION -identificaron I-EXPLORATION -septos I-EXPLORATION -con I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -calcificación. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -adenoma I-EXPLORATION -cortical I-EXPLORATION -suprarrenal I-EXPLORATION -(14 I-EXPLORATION -x I-EXPLORATION -12 I-EXPLORATION -x I-EXPLORATION -11, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro). I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -sin I-EVOLUTION -complicaciones. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -32 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -hospitalizada I-PRESENT_ILLNESS -doce I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -unidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuidado I-PRESENT_ILLNESS -intensivo, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -epigastralgia I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -irradiada, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -cede I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -administración I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ranitidina, I-PRESENT_ILLNESS -valorada I-PRESENT_ILLNESS -inicialmente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias, I-PRESENT_ILLNESS -donde B-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -hiperamilasemia I-EXPLORATION -e I-EXPLORATION -hipertrigliceridemia I-EXPLORATION -(5.080 I-EXPLORATION -mg/dl) I-EXPLORATION -con I-EXPLORATION -ecografía I-EXPLORATION -de I-EXPLORATION -hígado I-EXPLORATION -y I-EXPLORATION -vías I-EXPLORATION -biliares I-EXPLORATION -más I-EXPLORATION -colangiorresonancia I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION -Por I-EXPLORATION -estado I-EXPLORATION -de I-EXPLORATION -deshidratación I-EXPLORATION -grado I-EXPLORATION -III, I-EXPLORATION -SIRS I-EXPLORATION -y I-EXPLORATION -dolor I-EXPLORATION -severo, I-EXPLORATION -se I-EXPLORATION -manejó I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -unidad I-EXPLORATION -de I-EXPLORATION -cuidado I-EXPLORATION -intensivo. I-EXPLORATION -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dislipidemia I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -manejo I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -lovastatina I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -mg/día I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -gemfibrozilo I-PAST_MEDICAL_HISTORY -irregularmente, I-PAST_MEDICAL_HISTORY -adicionalmente I-PAST_MEDICAL_HISTORY -uso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -productos I-PAST_MEDICAL_HISTORY -homeopáticos I-PAST_MEDICAL_HISTORY -(espirulina I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -vinagre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -manzana), I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -G2P1C1 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -planifica I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -anticonceptivos I-PAST_MEDICAL_HISTORY -orales. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -de I-EXPLORATION -ingreso, I-EXPLORATION -como I-EXPLORATION -hallazgos I-EXPLORATION -relevantes I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -paciente I-EXPLORATION -somnolienta, I-EXPLORATION -taquicárdica, I-EXPLORATION -taquipneica, I-EXPLORATION -deshidratada; I-EXPLORATION -signos I-EXPLORATION -vitales: I-EXPLORATION -TA I-EXPLORATION -114/70; I-EXPLORATION -FC: I-EXPLORATION -105 I-EXPLORATION -por I-EXPLORATION -minuto; I-EXPLORATION -FR: I-EXPLORATION -28 I-EXPLORATION -por I-EXPLORATION -min: I-EXPLORATION -SaO2: I-EXPLORATION -90% I-EXPLORATION -con I-EXPLORATION -FIO2 I-EXPLORATION -28%; I-EXPLORATION -IMC I-EXPLORATION -32, I-EXPLORATION -5, I-EXPLORATION -abdomen I-EXPLORATION -blando I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -epigastrio I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal, I-EXPLORATION -sin I-EXPLORATION -otro I-EXPLORATION -hallazgo I-EXPLORATION -anormal I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico. I-EXPLORATION -Se I-EXPLORATION -hace I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -pancreatitis I-EXPLORATION -aguda I-EXPLORATION -severa I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -hipertrigliceridemia, I-EXPLORATION -con I-EXPLORATION -puntuación I-EXPLORATION -de I-EXPLORATION -11 I-EXPLORATION -en I-EXPLORATION -APACHE I-EXPLORATION -inicial I-EXPLORATION -y I-EXPLORATION -5 I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -24 I-EXPLORATION -horas, I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -TAC I-EXPLORATION -contrastada I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -Baltazar I-EXPLORATION -E I-EXPLORATION -con I-EXPLORATION -necrosis I-EXPLORATION -de I-EXPLORATION -menos I-EXPLORATION -del I-EXPLORATION -30%. I-EXPLORATION -Se B-TREATMENT -manejó I-TREATMENT -multidisciplinariamente I-TREATMENT -con I-TREATMENT -los I-TREATMENT -servicios I-TREATMENT -de I-TREATMENT -gastroenterología I-TREATMENT -y I-TREATMENT -soporte I-TREATMENT -nutricional, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -infusión I-TREATMENT -de I-TREATMENT -insulina I-TREATMENT -con I-TREATMENT -descenso I-TREATMENT -significativo I-TREATMENT -de I-TREATMENT -triglicéridos I-TREATMENT -a I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -horas I-TREATMENT -(valor I-TREATMENT -inicial I-TREATMENT -5.080, I-TREATMENT -control I-TREATMENT -a I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -h: I-TREATMENT -369), I-TREATMENT -al I-TREATMENT -séptimo I-TREATMENT -día I-TREATMENT -se I-TREATMENT -observó I-TREATMENT -aumento I-TREATMENT -de I-TREATMENT -leucocitos, I-TREATMENT -persistencia I-TREATMENT -de I-TREATMENT -taquicardia I-TREATMENT -y I-TREATMENT -PCR I-TREATMENT -mayor I-TREATMENT -a I-TREATMENT -16 I-TREATMENT -mg/dl, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -iniciar I-TREATMENT -cubrimiento I-TREATMENT -antibiótico I-TREATMENT -con I-TREATMENT -meropenem. I-TREATMENT -Al B-EVOLUTION -noveno I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -hospitalización, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -mostraba I-EVOLUTION -una I-EVOLUTION -apariencia I-EVOLUTION -clínica I-EVOLUTION -normal I-EVOLUTION -sin I-EVOLUTION -dolor, I-EVOLUTION -con I-EVOLUTION -descenso I-EVOLUTION -de I-EVOLUTION -leucocitosis I-EVOLUTION -y I-EVOLUTION -bandemia; I-EVOLUTION -dada I-EVOLUTION -su I-EVOLUTION -evolución, I-EVOLUTION -se I-EVOLUTION -decide I-EVOLUTION -traslado I-EVOLUTION -a I-EVOLUTION -planta. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -constitucional I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tenesmo I-PRESENT_ILLNESS -rectal. I-PRESENT_ILLNESS -Presentaba B-EXPLORATION -molestias I-EXPLORATION -abdominales I-EXPLORATION -difusas I-EXPLORATION -y, I-EXPLORATION -al I-EXPLORATION -tacto, I-EXPLORATION -un I-EXPLORATION -recto I-EXPLORATION -rígido I-EXPLORATION -a I-EXPLORATION -punta I-EXPLORATION -de I-EXPLORATION -dedo. I-EXPLORATION -Se I-EXPLORATION -descartaron I-EXPLORATION -metástasis I-EXPLORATION -pulmonares I-EXPLORATION -y I-EXPLORATION -hepáticas. I-EXPLORATION -La I-EXPLORATION -rectocolonoscopia I-EXPLORATION -mostró I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -pliegues I-EXPLORATION -mucosos I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -pseudopolipoide I-EXPLORATION -y I-EXPLORATION -duro I-EXPLORATION -del I-EXPLORATION -7º I-EXPLORATION -al I-EXPLORATION -15º I-EXPLORATION -cm I-EXPLORATION -del I-EXPLORATION -margen I-EXPLORATION -anal I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -intacta. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -infiltración I-EXPLORATION -carcinomatosa I-EXPLORATION -rectal I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -metástasis I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -mamario I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -lobulillar, I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -siguiente I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico: I-EXPLORATION -citoqueratina I-EXPLORATION -7 I-EXPLORATION -+, I-EXPLORATION -citoqueratina I-EXPLORATION -20 I-EXPLORATION --, I-EXPLORATION -e-cadherina I-EXPLORATION -- I-EXPLORATION -y I-EXPLORATION -receptores I-EXPLORATION -estrogénicos I-EXPLORATION -+. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -mamográfico I-EXPLORATION -dirigido I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -espiculación I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mama I-EXPLORATION -izquierda, I-EXPLORATION -cuya I-EXPLORATION -biopsia I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -gruesa I-EXPLORATION -(BAG) I-EXPLORATION -remedó I-EXPLORATION -la I-EXPLORATION -rectal. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computerizada I-EXPLORATION -(TAC) I-EXPLORATION -abdominopélvica I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -rectal I-EXPLORATION -que I-EXPLORATION -ocupaba I-EXPLORATION -el I-EXPLORATION -saco I-EXPLORATION -de I-EXPLORATION -Douglas I-EXPLORATION -y I-EXPLORATION -destruía I-EXPLORATION -los I-EXPLORATION -planos I-EXPLORATION -"de I-EXPLORATION -clivaje" I-EXPLORATION -rectouterinos. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -al I-EXPLORATION -alta I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -lobulillar I-EXPLORATION -mamario I-EXPLORATION -izquierdo I-EXPLORATION -en I-EXPLORATION -estadio I-EXPLORATION -IV, I-EXPLORATION -con I-EXPLORATION -metástasis I-EXPLORATION -rectales. I-EXPLORATION -En B-TREATMENT -la I-TREATMENT -actualidad I-TREATMENT -sigue I-TREATMENT -régimen I-TREATMENT -quimioterápico I-TREATMENT -ambulatorio I-TREATMENT -con I-TREATMENT -pobre I-TREATMENT -respuesta I-TREATMENT -clínica I-TREATMENT -y I-TREATMENT -mal I-TREATMENT -tolerado. I-TREATMENT -En B-EVOLUTION -5 I-EVOLUTION -meses I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -sufrido I-EVOLUTION -complicación I-EVOLUTION -alguna I-EVOLUTION -que I-EVOLUTION -haya I-EVOLUTION -requerido I-EVOLUTION -cirugía I-EVOLUTION -paliativa. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -22 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -alergia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -penicilina I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -abdominal I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -año, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -características I-PAST_MEDICAL_HISTORY -similares I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -actual. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -comenzó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -periumbilical I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -irradió I-PRESENT_ILLNESS -posteriormente I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -FID, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -carácter I-PRESENT_ILLNESS -continuo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -intensidad I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -deambulación. I-PRESENT_ILLNESS -Presentó I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -previos. I-PRESENT_ILLNESS -Ausencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -mareo. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -hábito I-PRESENT_ILLNESS -intestinal I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -miccional. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -estaba I-EXPLORATION -afebril, I-EXPLORATION -normotenso I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -afectación I-EXPLORATION -del I-EXPLORATION -estado I-EXPLORATION -general. I-EXPLORATION -Presentaba I-EXPLORATION -abdomen I-EXPLORATION -blando I-EXPLORATION -y I-EXPLORATION -depresible, I-EXPLORATION -sin I-EXPLORATION -masas I-EXPLORATION -ni I-EXPLORATION -megalias, I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -FID I-EXPLORATION -e I-EXPLORATION -hipogastrio, I-EXPLORATION -con I-EXPLORATION -defensa I-EXPLORATION -y I-EXPLORATION -peritonismo. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -destacaba I-EXPLORATION -leucocitosis I-EXPLORATION -(13.390 I-EXPLORATION -x I-EXPLORATION -103/mcl) I-EXPLORATION -con I-EXPLORATION -neutrofilia I-EXPLORATION -(66,7%). I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -apendicitis I-TREATMENT -aguda I-TREATMENT -se I-TREATMENT -intervino I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -urgente I-TREATMENT -encontrando I-TREATMENT -divertículo I-TREATMENT -en I-TREATMENT -cara I-TREATMENT -anterior I-TREATMENT -de I-TREATMENT -ciego I-TREATMENT -inflamado I-TREATMENT -y I-TREATMENT -necrótico I-TREATMENT -por I-TREATMENT -fecalito I-TREATMENT -impactado I-TREATMENT -en I-TREATMENT -su I-TREATMENT -interior I-TREATMENT -y I-TREATMENT -apéndice I-TREATMENT -ileocecal I-TREATMENT -hiperémico. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -apendicectomía I-TREATMENT -reglada I-TREATMENT -y I-TREATMENT -diverticulectomía I-TREATMENT -con I-TREATMENT -sutura I-TREATMENT -manual I-TREATMENT -transversal I-TREATMENT -con I-TREATMENT -Byosin® I-TREATMENT -2-0, I-TREATMENT -dejando I-TREATMENT -drenaje I-TREATMENT -de I-TREATMENT -Penrose. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -12º I-EVOLUTION -día I-EVOLUTION -postoperatorio I-EVOLUTION -completamente I-EVOLUTION -asintomático. I-EVOLUTION - I-EVOLUTION -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -reveló I-EXPLORATION -apéndice I-EXPLORATION -ileocecal, I-EXPLORATION -periapendicitis, I-EXPLORATION -fecalito I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -segmento I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -grueso I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -con I-EXPLORATION -severa I-EXPLORATION -inflamación I-EXPLORATION -aguda. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -32 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -naturales B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Perú, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acuden I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -doce I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -localizado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -epigástrico, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -irradiado, I-PRESENT_ILLNESS -continuo, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -asociada. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -único I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -referían I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -noche I-PAST_MEDICAL_HISTORY -previa I-PAST_MEDICAL_HISTORY -ingesta I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -comida I-PAST_MEDICAL_HISTORY -típica I-PAST_MEDICAL_HISTORY -peruana, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pescado I-PAST_MEDICAL_HISTORY -crudo. I-PAST_MEDICAL_HISTORY -El B-EXPLORATION -abdomen I-EXPLORATION -era I-EXPLORATION -blando, I-EXPLORATION -depresible I-EXPLORATION -pero I-EXPLORATION -doloroso I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -epigastrio. I-EXPLORATION -No I-EXPLORATION -había I-EXPLORATION -masas, I-EXPLORATION -organomegalias I-EXPLORATION -abdominales I-EXPLORATION -ni I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal. I-EXPLORATION -Se I-EXPLORATION -observó I-EXPLORATION -leucocitosis I-EXPLORATION -importante I-EXPLORATION -con I-EXPLORATION -neutrofilia I-EXPLORATION -(16.000 I-EXPLORATION -L), I-EXPLORATION -sin I-EXPLORATION -eosinofilia. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -endoscópico I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -pacientes I-EXPLORATION -mostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -incontables I-EXPLORATION -AS I-EXPLORATION -adheridos I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -gástrica I-EXPLORATION -y I-EXPLORATION -duodenal, I-EXPLORATION -la I-EXPLORATION -mayoría I-EXPLORATION -de I-EXPLORATION -ellos I-EXPLORATION -agrupados I-EXPLORATION -en I-EXPLORATION -nidos I-EXPLORATION -con I-EXPLORATION -más I-EXPLORATION -de I-EXPLORATION -diez I-EXPLORATION -parásitos. I-EXPLORATION -También I-EXPLORATION -los I-EXPLORATION -había I-EXPLORATION -aislados I-EXPLORATION -entre I-EXPLORATION -los I-EXPLORATION -pliegues I-EXPLORATION -mucosos, I-EXPLORATION -donde I-EXPLORATION -producían I-EXPLORATION -intenso I-EXPLORATION -edema I-EXPLORATION -y I-EXPLORATION -múltiples I-EXPLORATION -erosiones I-EXPLORATION -por I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -cavidad I-EXPLORATION -gástrica I-EXPLORATION -y I-EXPLORATION -duodenal. I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -extracción I-TREATMENT -de I-TREATMENT -los I-TREATMENT -mismos I-TREATMENT -mediante I-TREATMENT -pinza I-TREATMENT -de I-TREATMENT -biopsia. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -60 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -diagnosticada B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -hernia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hiato I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -intolerancia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -lactosa. I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -porque I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -diarreico, I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -veces I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -rectorragia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal. I-PRESENT_ILLNESS -Se B-EXPLORATION -le I-EXPLORATION -realiza I-EXPLORATION -estudio I-EXPLORATION -bioquímico I-EXPLORATION -y I-EXPLORATION -hematológico I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -normal, I-EXPLORATION -incluyendo I-EXPLORATION -hormonas I-EXPLORATION -tiroideas I-EXPLORATION -y I-EXPLORATION -perfil I-EXPLORATION -hepático. I-EXPLORATION -Los I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -CEA, I-EXPLORATION -CA. I-EXPLORATION -125 I-EXPLORATION -y I-EXPLORATION -CA I-EXPLORATION -19.9 I-EXPLORATION -fueron I-EXPLORATION -también I-EXPLORATION -normales. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -fosa I-EXPLORATION -iliaca I-EXPLORATION -izquierda, I-EXPLORATION -existe I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -redondeada, I-EXPLORATION -ligeramente I-EXPLORATION -hiperecogénica, I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -45 I-EXPLORATION -mm, I-EXPLORATION -que I-EXPLORATION -pudiera I-EXPLORATION -corresponder I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -intraluminal I-EXPLORATION -o I-EXPLORATION -un I-EXPLORATION -artefacto I-EXPLORATION -por I-EXPLORATION -heces. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -fibrocolonoscopia I-EXPLORATION -para I-EXPLORATION -observar I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -tercio I-EXPLORATION -medio I-EXPLORATION -del I-EXPLORATION -sigma, I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION -polipoide, I-EXPLORATION -lisa I-EXPLORATION -y I-EXPLORATION -nacarada I-EXPLORATION -en I-EXPLORATION -superficie I-EXPLORATION -y I-EXPLORATION -azulada I-EXPLORATION -en I-EXPLORATION -profundidad, I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -7 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -dura, I-EXPLORATION -desplazable, I-EXPLORATION -no I-EXPLORATION -apreciándose I-EXPLORATION -pedículo I-EXPLORATION -tras I-EXPLORATION -inyectar I-EXPLORATION -contraste. I-EXPLORATION -Dada B-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -naturaleza I-DERIVED_FROM/TO -inespecífica I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -lesión I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -no I-DERIVED_FROM/TO -obstrucción I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -luz I-DERIVED_FROM/TO -colónica I-DERIVED_FROM/TO -no I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -procede I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -colocación I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -stent I-DERIVED_FROM/TO -colónico I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -decide I-DERIVED_FROM/TO -remitir I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -cirugía I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -valorar I-DERIVED_FROM/TO -intervención I-DERIVED_FROM/TO -quirúrgica I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -lesión. I-DERIVED_FROM/TO -Previo B-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -intervención I-EXPLORATION -quirúrgica I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -hace I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -tumoración I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -unión I-EXPLORATION -del I-EXPLORATION -colon I-EXPLORATION -descendente I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -sigma I-EXPLORATION -con I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -y I-EXPLORATION -reducción I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -intestinal. I-EXPLORATION -A B-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -finalmente I-TREATMENT -se I-TREATMENT -le I-TREATMENT -practicó I-TREATMENT -una I-TREATMENT -hemicolectomía I-TREATMENT -izquierda. I-TREATMENT -A I-TREATMENT -la I-TREATMENT -apertura I-TREATMENT -se I-TREATMENT -identifica I-TREATMENT -una I-TREATMENT -neoformación I-TREATMENT -excrecente, I-TREATMENT -polipoidea; I-TREATMENT -externamente I-TREATMENT -es I-TREATMENT -de I-TREATMENT -superficie I-TREATMENT -lisa, I-TREATMENT -con I-TREATMENT -un I-TREATMENT -pedículo I-TREATMENT -de I-TREATMENT -2 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -diámetro I-TREATMENT -máximo I-TREATMENT -y I-TREATMENT -ocupa I-TREATMENT -la I-TREATMENT -luz I-TREATMENT -intestinal I-TREATMENT -casi I-TREATMENT -por I-TREATMENT -completo. I-TREATMENT -A I-TREATMENT -los I-TREATMENT -cortes, I-TREATMENT -dicha I-TREATMENT -neoformación I-TREATMENT -es I-TREATMENT -blanquecina, I-TREATMENT -amarillenta I-TREATMENT -de I-TREATMENT -consistencia I-TREATMENT -elástica, I-TREATMENT -aspecto I-TREATMENT -homogéneo I-TREATMENT -y I-TREATMENT -parece I-TREATMENT -estar I-TREATMENT -rodeado I-TREATMENT -por I-TREATMENT -una I-TREATMENT -pared I-TREATMENT -que I-TREATMENT -lo I-TREATMENT -delimita I-TREATMENT -en I-TREATMENT -su I-TREATMENT -mayor I-TREATMENT -parte. I-TREATMENT -Fue I-TREATMENT -informada I-TREATMENT -como I-TREATMENT -un I-TREATMENT -lipoma I-TREATMENT -submucoso I-TREATMENT -infartado I-TREATMENT -con I-TREATMENT -ulceración I-TREATMENT -epitelial I-TREATMENT -y I-TREATMENT -necrosis I-TREATMENT -grasa. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -47 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -alcoholismo I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -agudo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pseudoquiste I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -cabeza I-PRESENT_ILLNESS -pancreática I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS -pancreatitis I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS -alcohólica. I-PRESENT_ILLNESS -Amilasemia B-EXPLORATION -normal. I-EXPLORATION -Tras B-TREATMENT -tratamiento I-TREATMENT -sintomático, I-TREATMENT -el B-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -disnea I-EVOLUTION -progresiva I-EVOLUTION -y I-EVOLUTION -derrame I-EVOLUTION -pleural I-EVOLUTION -derecho I-EVOLUTION -que B-TREATMENT -mejora I-TREATMENT -tras I-TREATMENT -drenaje I-TREATMENT -pleural. I-TREATMENT -Una B-EXPLORATION -colangio-RM I-EXPLORATION -verifica I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -y I-EXPLORATION -revela I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -volumen I-EXPLORATION -del I-EXPLORATION -pseudoquiste I-EXPLORATION -con I-EXPLORATION -probable I-EXPLORATION -punto I-EXPLORATION -de I-EXPLORATION -comunicación I-EXPLORATION -entre I-EXPLORATION -ducto I-EXPLORATION -pancreático I-EXPLORATION -y I-EXPLORATION -pseudoquiste. I-EXPLORATION -Posteriormente, B-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -aumento I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -y I-EVOLUTION -empeoramiento I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -disnea, I-EVOLUTION -consecuencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -rotura I-EVOLUTION -del I-EVOLUTION -pseudoquiste I-EVOLUTION -y I-EVOLUTION -difusión I-EVOLUTION -a I-EVOLUTION -cavidad I-EVOLUTION -pleural I-EVOLUTION -izquierda I-EVOLUTION -a I-EVOLUTION -través I-EVOLUTION -de I-EVOLUTION -hiato I-EVOLUTION -esofágico. I-EVOLUTION -Se B-TREATMENT -realizó I-TREATMENT -drenaje I-TREATMENT -pleural, I-TREATMENT -evidenciándose I-TREATMENT -líquido I-TREATMENT -pleural I-TREATMENT -de I-TREATMENT -características I-TREATMENT -hemorrágicas, I-TREATMENT -compatible I-TREATMENT -con I-TREATMENT -comunicación I-TREATMENT -pancreático-pleural. I-TREATMENT -Tras B-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -inicial, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -una I-EVOLUTION -progresión I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -disnea I-EVOLUTION -y I-EVOLUTION -recurrencia I-EVOLUTION -del I-EVOLUTION -derrame, I-EVOLUTION -realizándose B-TREATMENT -un I-TREATMENT -tercer I-TREATMENT -drenaje I-TREATMENT -pleural I-TREATMENT -y I-TREATMENT -pleurodesis. I-TREATMENT -Tras B-EVOLUTION -la I-EVOLUTION -mejoría I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -se B-TREATMENT -decide I-TREATMENT -tratamiento I-TREATMENT -quirúgico I-TREATMENT -definitivo I-TREATMENT -del I-TREATMENT -pseudoquiste. I-TREATMENT - I-TREATMENT -A I-TREATMENT -los I-TREATMENT -25 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -su I-TREATMENT -ingreso I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -intervenido, I-TREATMENT -realizándosele I-TREATMENT -una I-TREATMENT -cistogastrostomía I-TREATMENT -a I-TREATMENT -cara I-TREATMENT -posterior I-TREATMENT -gástrica I-TREATMENT -con B-EVOLUTION -mejoría I-EVOLUTION -definitiva I-EVOLUTION -y I-EVOLUTION -reducción I-EVOLUTION -del I-EVOLUTION -pseudoquiste. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -con B-EXPLORATION -una I-EXPLORATION -analítica I-EXPLORATION -que I-EXPLORATION -evidenciaba I-EXPLORATION -anemia, I-EXPLORATION -trombopenia I-EXPLORATION -y I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -bilirrubina I-EXPLORATION -y I-EXPLORATION -enzimas I-EXPLORATION -de I-EXPLORATION -colestasis. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -13 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -segmentos I-EXPLORATION -IV, I-EXPLORATION -V I-EXPLORATION -y I-EXPLORATION -VIII. I-EXPLORATION -Al B-EVOLUTION -mes I-EVOLUTION -del I-EVOLUTION -ingreso I-EVOLUTION -falleció I-EVOLUTION -por I-EVOLUTION -shock I-EVOLUTION -hipovolémico I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -autopsia I-EVOLUTION -compatible I-EVOLUTION -con I-EVOLUTION -ASH. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cirrosis I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -C, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ictericia, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -constitucional I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -presentaba I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -bilirrubina I-EXPLORATION -y I-EXPLORATION -enzimas I-EXPLORATION -de I-EXPLORATION -colestasis. I-EXPLORATION -La I-EXPLORATION -TC I-EXPLORATION -mostró I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -lóbulos I-EXPLORATION -hepáticos I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -metástasis I-EXPLORATION -versus I-EXPLORATION -hepatocarcinoma I-EXPLORATION -multicéntrico I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -nodular I-EXPLORATION -en I-EXPLORATION -bazo. I-EXPLORATION -A B-EVOLUTION -las I-EVOLUTION -dos I-EVOLUTION -semanas I-EVOLUTION -del I-EVOLUTION -ingreso I-EVOLUTION -falleció I-EVOLUTION -por I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -insuficiencia I-EVOLUTION -hepática I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -autopsia I-EVOLUTION -compatible I-EVOLUTION -con I-EVOLUTION -ASH I-EVOLUTION -con I-EVOLUTION -metástasis I-EVOLUTION -esplénicas. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -52 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diez I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -analítica I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -evidenciaba I-PRESENT_ILLNESS -trombopenia, I-PRESENT_ILLNESS -elevación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -bilirrubina I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -enzimas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -colestasis. I-PRESENT_ILLNESS -La B-EXPLORATION -TC I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -16 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -hepático I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -nódulos I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -bazo. I-EXPLORATION -Al B-EVOLUTION -cuarto I-EVOLUTION -día I-EVOLUTION -del I-EVOLUTION -ingreso I-EVOLUTION -falleció I-EVOLUTION -por I-EVOLUTION -un I-EVOLUTION -shock I-EVOLUTION -hipovolémico I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -autopsia I-EVOLUTION -compatible I-EVOLUTION -con I-EVOLUTION -ASH I-EVOLUTION -con I-EVOLUTION -metástasis I-EVOLUTION -esplénicas. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -61 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -con B-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -inespecífica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -incremento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -perímetro I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -constitucional. I-PRESENT_ILLNESS -Intervenido B-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -urgencia I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -otro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -sospecha I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -apendicitis, I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -le I-DERIVED_FROM/TO -diagnosticó I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -pseudomixoma, I-DERIVED_FROM/TO -practicándole I-DERIVED_FROM/TO -exclusivamente I-DERIVED_FROM/TO -toma I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -biopsias, I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -remitiéndolo I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestra I-DERIVED_FROM/TO -atención. I-DERIVED_FROM/TO -A B-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -que I-TREATMENT -la I-TREATMENT -enfermedad I-TREATMENT -comprometía I-TREATMENT -todas I-TREATMENT -las I-TREATMENT -regiones I-TREATMENT -abdominales I-TREATMENT -y I-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -presentaba I-TREATMENT -un I-TREATMENT -índice I-TREATMENT -de I-TREATMENT -carcinomatosis I-TREATMENT -peritoneal I-TREATMENT -de I-TREATMENT -32, I-TREATMENT -acorde I-TREATMENT -con I-TREATMENT -la I-TREATMENT -clasificación I-TREATMENT -de I-TREATMENT -Sugarbaker I-TREATMENT -(4), I-TREATMENT -se I-TREATMENT -consiguió I-TREATMENT -realizar I-TREATMENT -un I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -intención I-TREATMENT -curativa I-TREATMENT -mediante I-TREATMENT -citorreducción I-TREATMENT -completa I-TREATMENT -de I-TREATMENT -la I-TREATMENT -enfermedad I-TREATMENT -macroscópica I-TREATMENT -tipo I-TREATMENT -CC0, I-TREATMENT -precisando I-TREATMENT -las I-TREATMENT -6 I-TREATMENT -peritonectomías I-TREATMENT -parietales I-TREATMENT -con I-TREATMENT -omentectomía I-TREATMENT -mayor I-TREATMENT -y I-TREATMENT -menor, I-TREATMENT -colecistectomía I-TREATMENT -y I-TREATMENT -resección I-TREATMENT -del I-TREATMENT -tumor I-TREATMENT -primario I-TREATMENT -mediante I-TREATMENT -apendicectomía I-TREATMENT -con I-TREATMENT -cequectomía. I-TREATMENT -Se I-TREATMENT -completó I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -posible I-TREATMENT -enfermedad I-TREATMENT -microscópica I-TREATMENT -residual I-TREATMENT -con I-TREATMENT -QIIH I-TREATMENT -con I-TREATMENT -mitomicina I-TREATMENT -C I-TREATMENT -a I-TREATMENT -12 I-TREATMENT -mg/m2 I-TREATMENT -disueltos I-TREATMENT -en I-TREATMENT -1, I-TREATMENT -5 I-TREATMENT -l I-TREATMENT -de I-TREATMENT -solución I-TREATMENT -de I-TREATMENT -diálisis I-TREATMENT -peritoneal I-TREATMENT -de I-TREATMENT -dianeal I-TREATMENT -al I-TREATMENT -0, I-TREATMENT -33% I-TREATMENT -a I-TREATMENT -42 I-TREATMENT -ºC I-TREATMENT -durante I-TREATMENT -60 I-TREATMENT -min, I-TREATMENT -con I-TREATMENT -un I-TREATMENT -flujo I-TREATMENT -de I-TREATMENT -perfusión I-TREATMENT -continua I-TREATMENT -de I-TREATMENT -1, I-TREATMENT -5 I-TREATMENT -l/min, I-TREATMENT -mediante I-TREATMENT -la I-TREATMENT -técnica I-TREATMENT -abierta I-TREATMENT -o I-TREATMENT -"técnica I-TREATMENT -de I-TREATMENT -coliseo". I-TREATMENT -Durante I-TREATMENT -su I-TREATMENT -estancia I-TREATMENT -en I-TREATMENT -la I-TREATMENT -unidad I-TREATMENT -de I-TREATMENT -cuidados I-TREATMENT -intensivos, I-TREATMENT -recibió I-TREATMENT -QIPP I-TREATMENT -los I-TREATMENT -días I-TREATMENT -1º I-TREATMENT -a I-TREATMENT -5º I-TREATMENT -del I-TREATMENT -postoperatorio I-TREATMENT -inmediato I-TREATMENT -con I-TREATMENT -5-fluorouracilo I-TREATMENT -750 I-TREATMENT -mg/m2 I-TREATMENT -en I-TREATMENT -1, I-TREATMENT -5 I-TREATMENT -l I-TREATMENT -de I-TREATMENT -glucosado I-TREATMENT -al I-TREATMENT -5% I-TREATMENT -durante I-TREATMENT -23 I-TREATMENT -horas. I-TREATMENT -Su B-EVOLUTION -evolución I-EVOLUTION -postoperatoria I-EVOLUTION -fue I-EVOLUTION -satisfactoria I-EVOLUTION -con I-EVOLUTION -estancia I-EVOLUTION -de I-EVOLUTION -19 I-EVOLUTION -días I-EVOLUTION -sin I-EVOLUTION -complicaciones. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -permanece I-EVOLUTION -vivo I-EVOLUTION -y I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -más I-EVOLUTION -de I-EVOLUTION -10 I-EVOLUTION -años I-EVOLUTION -después, I-EVOLUTION -habiendo I-EVOLUTION -sufrido I-EVOLUTION -un I-EVOLUTION -AVC I-EVOLUTION -por I-EVOLUTION -HTA, I-EVOLUTION -con I-EVOLUTION -hemiplejía I-EVOLUTION -residual. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -entre B-PAST_MEDICAL_HISTORY -cuyos I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -únicamente I-PAST_MEDICAL_HISTORY -destacaba I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -amigdalectomizado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -varios I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -atrás I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -neumonía I-PAST_MEDICAL_HISTORY -adquirida I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -comunidad. I-PAST_MEDICAL_HISTORY -Es I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -cigarrillos I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -día, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -seguía I-PAST_MEDICAL_HISTORY -ningún I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -crónico. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Presentaba I-PAST_MEDICAL_HISTORY -dolores I-PAST_MEDICAL_HISTORY -abdominales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -repetición, I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -supuesto I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -ingresos I-PAST_MEDICAL_HISTORY -hospitalarios I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -cifras I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -amilasa I-PAST_MEDICAL_HISTORY -elevadas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pancreatitis I-PAST_MEDICAL_HISTORY -aguda, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -pudiera I-PAST_MEDICAL_HISTORY -alcanzar I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -etiológico. I-PAST_MEDICAL_HISTORY -Por I-PAST_MEDICAL_HISTORY -ello I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -realizando I-PAST_MEDICAL_HISTORY -estudio I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -consultas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -gastroenterología. I-PAST_MEDICAL_HISTORY -Durante I-PAST_MEDICAL_HISTORY -este I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -realizaron I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -analíticas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -cifras I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -calcio I-PAST_MEDICAL_HISTORY -plasmático I-PAST_MEDICAL_HISTORY -rondaban I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -límites I-PAST_MEDICAL_HISTORY -superiores I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -normalidad I-PAST_MEDICAL_HISTORY -(considerando I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -rangos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -normalidad I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -calcio I-PAST_MEDICAL_HISTORY -sérico I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -8, I-PAST_MEDICAL_HISTORY -4-10, I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -mg/dl), I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -llegar I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -francamente I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ningún I-PAST_MEDICAL_HISTORY -caso. I-PAST_MEDICAL_HISTORY -Es I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -destacar I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -ingresos I-PAST_MEDICAL_HISTORY -previos I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -pancreatitis I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -cifras I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -calcio I-PAST_MEDICAL_HISTORY -fueron I-PAST_MEDICAL_HISTORY -siempre I-PAST_MEDICAL_HISTORY -normales. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Ingresa B-PRESENT_ILLNESS -nuevamente I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -localizado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -epigastrio I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -irradiación I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -hipocondrios. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -era I-PRESENT_ILLNESS -continuo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -limitaba I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -ingesta. I-PRESENT_ILLNESS -Analíticamente B-EXPLORATION -destacaba I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -recepción: I-EXPLORATION - I-EXPLORATION --Hb: I-EXPLORATION -13, I-EXPLORATION -8 I-EXPLORATION -g/dl; I-EXPLORATION -Hcto: I-EXPLORATION -40%; I-EXPLORATION -leucocitos: I-EXPLORATION -13400 I-EXPLORATION -(81% I-EXPLORATION -neutrófilos). I-EXPLORATION - I-EXPLORATION --Glucosa: I-EXPLORATION -99 I-EXPLORATION -mg/dl; I-EXPLORATION -urea: I-EXPLORATION -33 I-EXPLORATION -mg/dl; I-EXPLORATION -creatinina: I-EXPLORATION -1, I-EXPLORATION -03 I-EXPLORATION -mg/dl. I-EXPLORATION - I-EXPLORATION --Amilasa I-EXPLORATION -plasmática: I-EXPLORATION -1980 I-EXPLORATION -U/l; I-EXPLORATION -lipasa: I-EXPLORATION -630 I-EXPLORATION -U/l. I-EXPLORATION - I-EXPLORATION --Colesterol: I-EXPLORATION -210 I-EXPLORATION -mg/dl; I-EXPLORATION -triglicéridos: I-EXPLORATION -98 I-EXPLORATION -mg/dl. I-EXPLORATION - I-EXPLORATION --Proteínas: I-EXPLORATION -7, I-EXPLORATION -1 I-EXPLORATION -g/dl; I-EXPLORATION -albúmina: I-EXPLORATION -4, I-EXPLORATION -5 I-EXPLORATION -g/dl. I-EXPLORATION - I-EXPLORATION --Calcio: I-EXPLORATION -11, I-EXPLORATION -7 I-EXPLORATION -mg I-EXPLORATION -mg/dl; I-EXPLORATION -ácido I-EXPLORATION -úrico: I-EXPLORATION -6, I-EXPLORATION -9 I-EXPLORATION -mg/dl. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -pancreatitis I-EXPLORATION -aguda I-EXPLORATION -se I-EXPLORATION -realizan I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -primero, I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -ecoendoscopia I-EXPLORATION -posteriormente, I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -evidencia I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -litiasis, I-EXPLORATION -microlitiasis I-EXPLORATION -ni I-EXPLORATION -barro I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar. I-EXPLORATION -El I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -un I-EXPLORATION -páncreas I-EXPLORATION -edematoso I-EXPLORATION -y I-EXPLORATION -desestructurado, I-EXPLORATION -sin I-EXPLORATION -más I-EXPLORATION -hallazgos. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -negatividad I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -exploraciones I-EXPLORATION -en I-EXPLORATION -cuanto I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -etiología I-EXPLORATION -del I-EXPLORATION -cuadro I-EXPLORATION -de I-EXPLORATION -pancreatitis, I-EXPLORATION -se I-EXPLORATION -postuló I-EXPLORATION -una I-EXPLORATION -posible I-EXPLORATION -relación I-EXPLORATION -del I-EXPLORATION -mismo I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -hipercalcemia I-EXPLORATION -objetivada I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -rutinaria I-EXPLORATION -del I-EXPLORATION -paciente I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -ingreso. I-EXPLORATION -Así, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -calcio I-EXPLORATION -plasmático I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -paratohormona I-EXPLORATION -intacta I-EXPLORATION -(PTHi), I-EXPLORATION -cuyos I-EXPLORATION -valores I-EXPLORATION -fueron I-EXPLORATION -respectivamente I-EXPLORATION -de I-EXPLORATION -11, I-EXPLORATION -9 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -451 I-EXPLORATION -pg/ml I-EXPLORATION -(valores I-EXPLORATION -normales I-EXPLORATION -por I-EXPLORATION -debajo I-EXPLORATION -de I-EXPLORATION -9 I-EXPLORATION -pg/ml), I-EXPLORATION -confirmándose I-EXPLORATION -la I-EXPLORATION -hipercalcemia I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -hiperparatiroidismo. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -pancreatitis I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -ulteriores, I-EVOLUTION -con I-EVOLUTION -normalización I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -cifras I-EVOLUTION -de I-EVOLUTION -amilasa I-EVOLUTION -y I-EVOLUTION -lipasa, I-EVOLUTION -obtención I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -correcta I-EVOLUTION -tolerancia I-EVOLUTION -oral I-EVOLUTION -y I-EVOLUTION -desaparición I-EVOLUTION -del I-EVOLUTION -dolor. I-EVOLUTION -Cuando B-EXPLORATION -se I-EXPLORATION -hubo I-EXPLORATION -resuelto I-EXPLORATION -por I-EXPLORATION -completo I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -gammagrafía I-EXPLORATION -con I-EXPLORATION -Tc99-Sestamibi, I-EXPLORATION -que I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -una I-EXPLORATION -captación I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -adenoma I-EXPLORATION -paratiroideo I-EXPLORATION -inferior I-EXPLORATION -derecho. I-EXPLORATION -Días B-TREATMENT -más I-TREATMENT -tarde I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -intervino I-TREATMENT -quirúrgicamente, I-TREATMENT -hallándose I-TREATMENT -dicha I-TREATMENT -lesión I-TREATMENT -y I-TREATMENT -procediéndose I-TREATMENT -a I-TREATMENT -su I-TREATMENT -extirpación. I-TREATMENT -Se B-EXPLORATION -comprobó I-EXPLORATION -intraoperatoriamente I-EXPLORATION -el I-EXPLORATION -descenso I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -PTHi. I-EXPLORATION -La I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -confirmó I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -adenoma I-EXPLORATION -paratiroideo. I-EXPLORATION - I-EXPLORATION -Tras B-EVOLUTION -este I-EVOLUTION -episodio I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -referir I-EVOLUTION -más I-EVOLUTION -cuadros I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -revisiones I-EVOLUTION -posteriores. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -73 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -diabético B-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipertenso I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -sigue I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -farmacológico. I-PAST_MEDICAL_HISTORY -Dos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -ingresado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -tóxica I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -amoxicilina-clavulánico. I-PAST_MEDICAL_HISTORY -Desde I-PAST_MEDICAL_HISTORY -entonces I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -especialista I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Aparato I-PAST_MEDICAL_HISTORY -Digestivo. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -varios I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -presentado I-PAST_MEDICAL_HISTORY -cifras I-PAST_MEDICAL_HISTORY -discretamente I-PAST_MEDICAL_HISTORY -elevadas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -calcio I-PAST_MEDICAL_HISTORY -plasmático, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -hubiera I-PAST_MEDICAL_HISTORY -llegado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -filiar I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dicha I-PAST_MEDICAL_HISTORY -alteración I-PAST_MEDICAL_HISTORY -analítica. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -seguía I-PAST_MEDICAL_HISTORY -tratamientos I-PAST_MEDICAL_HISTORY -crónicos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -refería I-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Ingresa B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pancreatitis I-PRESENT_ILLNESS -aguda, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -epigástrico, I-PRESENT_ILLNESS -intolerancia I-PRESENT_ILLNESS -oral, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -elevación I-PRESENT_ILLNESS -significativa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -cifras I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -amilasa I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -lipasa, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -resto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -datos I-PRESENT_ILLNESS -analíticos I-PRESENT_ILLNESS -anodinos. I-PRESENT_ILLNESS -La B-EVOLUTION -evolución I-EVOLUTION -es I-EVOLUTION -favorable I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -primeros I-EVOLUTION -días, I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -y I-EVOLUTION -reinstauración I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -dieta I-EVOLUTION -oral. I-EVOLUTION -No I-EVOLUTION -obstante, I-EVOLUTION -sufre I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -súbita I-EVOLUTION -un I-EVOLUTION -empeoramiento I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -situación I-EVOLUTION -clínica, I-EVOLUTION -con I-EVOLUTION -aparición I-EVOLUTION -nuevamente I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -y I-EVOLUTION -deterioro I-EVOLUTION -progresivo I-EVOLUTION -del I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -conciencia, I-EVOLUTION -con I-EVOLUTION -episodios I-EVOLUTION -fluctuantes I-EVOLUTION -de I-EVOLUTION -desconexión I-EVOLUTION -del I-EVOLUTION -medio, I-EVOLUTION -objetivándose I-EVOLUTION -además, I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -controles I-EVOLUTION -analíticos I-EVOLUTION -llevados I-EVOLUTION -a I-EVOLUTION -cabo I-EVOLUTION -esos I-EVOLUTION -días, I-EVOLUTION -elevación I-EVOLUTION -progresiva I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -cifras I-EVOLUTION -de I-EVOLUTION -calcio I-EVOLUTION -total, I-EVOLUTION -alcanzándose I-EVOLUTION -niveles I-EVOLUTION -de I-EVOLUTION -15, I-EVOLUTION -5 I-EVOLUTION -mg/dl I-EVOLUTION -(rangos I-EVOLUTION -de I-EVOLUTION -normalidad I-EVOLUTION -del I-EVOLUTION -calcio I-EVOLUTION -sérico I-EVOLUTION -entre I-EVOLUTION -8, I-EVOLUTION -4-10, I-EVOLUTION -4 I-EVOLUTION -mg/dl). I-EVOLUTION -Se B-EXPLORATION -determinaron I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -paratohormona I-EXPLORATION -intacta I-EXPLORATION -(PTHi): I-EXPLORATION -311, I-EXPLORATION -2 I-EXPLORATION -pg/ml I-EXPLORATION -(valores I-EXPLORATION -de I-EXPLORATION -normalidad I-EXPLORATION -< I-EXPLORATION -9 I-EXPLORATION -pg/ml) I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -cervical I-EXPLORATION -que I-EXPLORATION -informaba I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -quístico I-EXPLORATION -junto I-EXPLORATION -a I-EXPLORATION -lóbulo I-EXPLORATION -tiroideo I-EXPLORATION -izquierdo. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -requirió I-EVOLUTION -ingreso I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -Unidad I-EVOLUTION -de I-EVOLUTION -Cuidados I-EVOLUTION -Intensivos, I-EVOLUTION -con I-EVOLUTION -mala I-EVOLUTION -evolución I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -posteriores. I-EVOLUTION -No I-EVOLUTION -se I-EVOLUTION -pudo I-EVOLUTION -corregir I-EVOLUTION -la I-EVOLUTION -hipercalcemia I-EVOLUTION -a I-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -médico I-EVOLUTION -intensivo I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -PTHi I-EVOLUTION -alcanzó I-EVOLUTION -cifras I-EVOLUTION -de I-EVOLUTION -1.900 I-EVOLUTION -pg/ml. I-EVOLUTION -Se B-TREATMENT -intervino I-TREATMENT -quirúrgicamente, I-TREATMENT -extirpándose I-TREATMENT -un I-TREATMENT -nódulo I-TREATMENT -paratiroideo I-TREATMENT -dependiente I-TREATMENT -de I-TREATMENT -la I-TREATMENT -glándula I-TREATMENT -superior I-TREATMENT -izquierda, I-TREATMENT -tras I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -la I-TREATMENT -PTHi I-TREATMENT -descendió I-TREATMENT -a I-TREATMENT -324, I-TREATMENT -7 I-TREATMENT -pg/ml, I-TREATMENT -llegando I-TREATMENT -a I-TREATMENT -normalizarse I-TREATMENT -en I-TREATMENT -las I-TREATMENT -horas I-TREATMENT -siguientes. I-TREATMENT -El B-EVOLUTION -calcio I-EVOLUTION -plasmático I-EVOLUTION -ionizado I-EVOLUTION -disminuyó I-EVOLUTION -igualmente, I-EVOLUTION -consiguiéndose I-EVOLUTION -valores I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -límite I-EVOLUTION -alto I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -normalidad. I-EVOLUTION -No I-EVOLUTION -obstante, I-EVOLUTION -y I-EVOLUTION -a I-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -medidas I-EVOLUTION -de I-EVOLUTION -soporte, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -pudo I-EVOLUTION -superar I-EVOLUTION -un I-EVOLUTION -shock I-EVOLUTION -refractario I-EVOLUTION -con I-EVOLUTION -intensa I-EVOLUTION -acidosis I-EVOLUTION -metabólica I-EVOLUTION -láctica, I-EVOLUTION -falleciendo I-EVOLUTION -por I-EVOLUTION -asistolia I-EVOLUTION -sin I-EVOLUTION -respuesta I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -maniobras I-EVOLUTION -de I-EVOLUTION -reanimación. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -38 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -fallo I-PRESENT_ILLNESS -intestinal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -nutrición I-PRESENT_ILLNESS -parenteral I-PRESENT_ILLNESS -domiciliaria I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Presentaba B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -mórbida, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -quirúrgicamente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2002. I-PAST_MEDICAL_HISTORY -Tras B-TREATMENT -cuatro I-TREATMENT -años I-TREATMENT -de I-TREATMENT -buen I-TREATMENT -estado I-TREATMENT -general I-TREATMENT -y I-TREATMENT -una I-TREATMENT -reducción I-TREATMENT -importante I-TREATMENT -de I-TREATMENT -peso I-TREATMENT -presentó I-TREATMENT -un I-TREATMENT -vólvulo I-TREATMENT -intestinal, I-TREATMENT -que I-TREATMENT -obligó I-TREATMENT -a I-TREATMENT -la I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -la I-TREATMENT -totalidad I-TREATMENT -del I-TREATMENT -intestino I-TREATMENT -delgado I-TREATMENT -y I-TREATMENT -colon I-TREATMENT -derecho. I-TREATMENT -El B-EVOLUTION -tracto I-EVOLUTION -digestivo I-EVOLUTION -quedó I-EVOLUTION -cerrado I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cuarta I-EVOLUTION -porción I-EVOLUTION -duodenal I-EVOLUTION -sin I-EVOLUTION -continuidad I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -colon I-EVOLUTION -transverso, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -era I-EVOLUTION -portador I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -gastrostomía I-EVOLUTION -de I-EVOLUTION -descarga. I-EVOLUTION -Debido I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -pérdida I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -totalidad I-EVOLUTION -del I-EVOLUTION -intestino I-EVOLUTION -delgado, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -permaneció I-EVOLUTION -con I-EVOLUTION -nutrición I-EVOLUTION -parenteral I-EVOLUTION -domiciliaria, I-EVOLUTION -sin I-EVOLUTION -la I-EVOLUTION -posibilidad I-EVOLUTION -de I-EVOLUTION -ningún I-EVOLUTION -tipo I-EVOLUTION -de I-EVOLUTION -rehabilitación I-EVOLUTION -intestinal. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -remitido I-EVOLUTION -a I-EVOLUTION -nuestro I-EVOLUTION -centro I-EVOLUTION -para I-EVOLUTION -valorar I-EVOLUTION -la I-EVOLUTION -posibilidad I-EVOLUTION -de I-EVOLUTION -trasplante I-EVOLUTION -intestinal. I-EVOLUTION -Dadas I-EVOLUTION -las I-EVOLUTION -circunstancias I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -y I-EVOLUTION -teniendo I-EVOLUTION -en I-EVOLUTION -cuenta I-EVOLUTION -que I-EVOLUTION -había I-EVOLUTION -presentado I-EVOLUTION -repetidos I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -sepsis I-EVOLUTION -por I-EVOLUTION -catéter I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -último I-EVOLUTION -año, I-EVOLUTION -se I-EVOLUTION -indicó I-EVOLUTION -el I-EVOLUTION -trasplante I-EVOLUTION -intestinal I-EVOLUTION -aislado. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -incluido I-EVOLUTION -en I-EVOLUTION -lista I-EVOLUTION -de I-EVOLUTION -espera I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -peso I-EVOLUTION -de I-EVOLUTION -60 I-EVOLUTION -kg, I-EVOLUTION -180 I-EVOLUTION -cm I-EVOLUTION -de I-EVOLUTION -altura I-EVOLUTION -y I-EVOLUTION -18, I-EVOLUTION -3 I-EVOLUTION -de I-EVOLUTION -índice I-EVOLUTION -de I-EVOLUTION -masa I-EVOLUTION -corporal. I-EVOLUTION - I-EVOLUTION -A B-TREATMENT -los I-TREATMENT -2 I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -su I-TREATMENT -inclusión I-TREATMENT -en I-TREATMENT -lista I-TREATMENT -de I-TREATMENT -espera I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -el I-TREATMENT -trasplante I-TREATMENT -intestinal I-TREATMENT -con I-TREATMENT -un I-TREATMENT -donante I-TREATMENT -isogrupo. I-TREATMENT -Al I-TREATMENT -donante I-TREATMENT -se I-TREATMENT -le I-TREATMENT -administró I-TREATMENT -timoglobulina I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -2 I-TREATMENT -mg/kg I-TREATMENT -con I-TREATMENT -el I-TREATMENT -objetivo I-TREATMENT -de I-TREATMENT -deplecionar I-TREATMENT -al I-TREATMENT -máximo I-TREATMENT -el I-TREATMENT -número I-TREATMENT -de I-TREATMENT -linfocitos I-TREATMENT -y I-TREATMENT -así I-TREATMENT -disminuir I-TREATMENT -la I-TREATMENT -probabilidad I-TREATMENT -de I-TREATMENT -rechazo I-TREATMENT -y I-TREATMENT -de I-TREATMENT -enfermedad I-TREATMENT -de I-TREATMENT -injerto I-TREATMENT -contra I-TREATMENT -huésped. I-TREATMENT -El I-TREATMENT -receptor I-TREATMENT -presentaba I-TREATMENT -una I-TREATMENT -trasposición I-TREATMENT -de I-TREATMENT -los I-TREATMENT -grandes I-TREATMENT -vasos I-TREATMENT -con I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -cava I-TREATMENT -situada I-TREATMENT -a I-TREATMENT -la I-TREATMENT -izquierda I-TREATMENT -de I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -aorta. I-TREATMENT -Este I-TREATMENT -problema I-TREATMENT -se I-TREATMENT -solucionó I-TREATMENT -con I-TREATMENT -una I-TREATMENT -rotación I-TREATMENT -del I-TREATMENT -injerto I-TREATMENT -de I-TREATMENT -180º I-TREATMENT -sobre I-TREATMENT -su I-TREATMENT -eje I-TREATMENT -mesentérico, I-TREATMENT -con I-TREATMENT -el I-TREATMENT -objetivo I-TREATMENT -de I-TREATMENT -que I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -y I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -mesentérica I-TREATMENT -superior I-TREATMENT -del I-TREATMENT -injerto I-TREATMENT -coincidieran I-TREATMENT -con I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -cava I-TREATMENT -y I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -aorta I-TREATMENT -del I-TREATMENT -receptor. I-TREATMENT -La I-TREATMENT -primera I-TREATMENT -asa I-TREATMENT -yeyunal I-TREATMENT -del I-TREATMENT -injerto I-TREATMENT -se I-TREATMENT -anastomosó I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -latero-lateral I-TREATMENT -a I-TREATMENT -la I-TREATMENT -cuarta I-TREATMENT -porción I-TREATMENT -duodenal I-TREATMENT -y I-TREATMENT -el I-TREATMENT -íleon I-TREATMENT -terminal I-TREATMENT -del I-TREATMENT -injerto I-TREATMENT -al I-TREATMENT -colon I-TREATMENT -transverso I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -latero-terminal I-TREATMENT -dejando I-TREATMENT -una I-TREATMENT -ileostomía I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -de I-TREATMENT -"chimenea" I-TREATMENT -para I-TREATMENT -poder I-TREATMENT -acceder I-TREATMENT -con I-TREATMENT -facilidad I-TREATMENT -a I-TREATMENT -la I-TREATMENT -mucosa I-TREATMENT -intestinal I-TREATMENT -y I-TREATMENT -realizar I-TREATMENT -las I-TREATMENT -biopsias I-TREATMENT -de I-TREATMENT -protocolo. I-TREATMENT -Al I-TREATMENT -girar I-TREATMENT -el I-TREATMENT -injerto I-TREATMENT -180º, I-TREATMENT -la I-TREATMENT -ileostomía I-TREATMENT -quedó I-TREATMENT -fijada I-TREATMENT -en I-TREATMENT -el I-TREATMENT -flanco I-TREATMENT -derecho I-TREATMENT -del I-TREATMENT -abdomen I-TREATMENT -en I-TREATMENT -lugar I-TREATMENT -del I-TREATMENT -izquierdo. I-TREATMENT -Además, I-TREATMENT -se I-TREATMENT -dejó I-TREATMENT -una I-TREATMENT -yeyunostomía I-TREATMENT -de I-TREATMENT -alimentación I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -colecistectomía I-TREATMENT -por I-TREATMENT -barro I-TREATMENT -biliar, I-TREATMENT -muy I-TREATMENT -frecuente I-TREATMENT -en I-TREATMENT -este I-TREATMENT -tipo I-TREATMENT -de I-TREATMENT -pacientes. I-TREATMENT - I-TREATMENT -El I-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -inducción I-TREATMENT -con I-TREATMENT -timoglobulina I-TREATMENT -1, I-TREATMENT -5 I-TREATMENT -mg/kg I-TREATMENT -y I-TREATMENT -profilaxis I-TREATMENT -antibiótica I-TREATMENT -con I-TREATMENT -vancomicina, I-TREATMENT -aztreonam I-TREATMENT -y I-TREATMENT -anfotericina I-TREATMENT -B I-TREATMENT -lioposomal. I-TREATMENT -Durante I-TREATMENT -el I-TREATMENT -postoperatorio I-TREATMENT -inmediato I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -siguió I-TREATMENT -tratamiento I-TREATMENT -inmunosupresor I-TREATMENT -con I-TREATMENT -triple I-TREATMENT -terapia: I-TREATMENT -timoglobulina I-TREATMENT -1, I-TREATMENT -5 I-TREATMENT -mg/kg/día I-TREATMENT -(durante I-TREATMENT -5 I-TREATMENT -días), I-TREATMENT -tacrolimus I-TREATMENT -0, I-TREATMENT -15 I-TREATMENT -mg/kg/día I-TREATMENT -(administrado I-TREATMENT -en I-TREATMENT -dos I-TREATMENT -dosis) I-TREATMENT -por I-TREATMENT -sonda I-TREATMENT -nasogástrica, I-TREATMENT -modificando I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -hasta I-TREATMENT -alcanzar I-TREATMENT -niveles I-TREATMENT -sanguíneos I-TREATMENT -entre I-TREATMENT -15-20 I-TREATMENT -ng/dl, I-TREATMENT -y I-TREATMENT -prednisolona I-TREATMENT -200 I-TREATMENT -mg/día I-TREATMENT -en I-TREATMENT -pauta I-TREATMENT -descendente I-TREATMENT -hasta I-TREATMENT -llegar I-TREATMENT -a I-TREATMENT -20 I-TREATMENT -mg I-TREATMENT -el I-TREATMENT -6º I-TREATMENT -día. I-TREATMENT -Al I-TREATMENT -no I-TREATMENT -alcanzar I-TREATMENT -niveles I-TREATMENT -sanguíneos I-TREATMENT -de I-TREATMENT -tacrolimus I-TREATMENT -adecuados I-TREATMENT -al I-TREATMENT -3er I-TREATMENT -día I-TREATMENT -postoperatorio, I-TREATMENT -se I-TREATMENT -pasó I-TREATMENT -a I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -intravenosa I-TREATMENT -durante I-TREATMENT -4 I-TREATMENT -días I-TREATMENT -hasta I-TREATMENT -que I-TREATMENT -los I-TREATMENT -niveles I-TREATMENT -fueron I-TREATMENT -correctos, I-TREATMENT -volviendo I-TREATMENT -de I-TREATMENT -nuevo I-TREATMENT -a I-TREATMENT -la I-TREATMENT -vía I-TREATMENT -enteral. I-TREATMENT -Además I-TREATMENT -se I-TREATMENT -administró I-TREATMENT -PGE1 I-TREATMENT -(Alprostadil®) I-TREATMENT -en I-TREATMENT -el I-TREATMENT -postoperatorio I-TREATMENT -inmediato I-TREATMENT -con I-TREATMENT -el I-TREATMENT -fin I-TREATMENT -de I-TREATMENT -mejorar I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -de I-TREATMENT -reperfusión I-TREATMENT -(4). I-TREATMENT - I-TREATMENT -A I-TREATMENT -las I-TREATMENT -72 I-TREATMENT -horas I-TREATMENT -del I-TREATMENT -trasplante I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -presentó I-TREATMENT -una I-TREATMENT -hemorragia I-TREATMENT -digestiva I-TREATMENT -secundaria I-TREATMENT -a I-TREATMENT -una I-TREATMENT -úlcera I-TREATMENT -cardial I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT -mediante I-TREATMENT -"clip" I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -endoscópica. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -días I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -UCI I-EVOLUTION -y I-EVOLUTION -trasladado I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -planta I-EVOLUTION -de I-EVOLUTION -hospitalización. I-EVOLUTION -Dentro I-EVOLUTION -del I-EVOLUTION -protocolo I-EVOLUTION -para I-EVOLUTION -el I-EVOLUTION -control I-EVOLUTION -del I-EVOLUTION -rechazo, I-EVOLUTION -se I-EVOLUTION -realizaron I-EVOLUTION -biopsias I-EVOLUTION -2 I-EVOLUTION -veces I-EVOLUTION -por I-EVOLUTION -semana I-EVOLUTION -a I-EVOLUTION -través I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -ileostomía I-EVOLUTION -durante I-EVOLUTION -el I-EVOLUTION -primer I-EVOLUTION -mes, I-EVOLUTION -y I-EVOLUTION -1 I-EVOLUTION -vez I-EVOLUTION -por I-EVOLUTION -semana I-EVOLUTION -durante I-EVOLUTION -el I-EVOLUTION -segundo I-EVOLUTION -mes. I-EVOLUTION -Durante I-EVOLUTION -las I-EVOLUTION -seis I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -ingreso I-EVOLUTION -sólo I-EVOLUTION -una I-EVOLUTION -biopsia I-EVOLUTION -mostró I-EVOLUTION -rechazo I-EVOLUTION -indeterminado I-EVOLUTION -y I-EVOLUTION -otra I-EVOLUTION -rechazo I-EVOLUTION -leve, I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -trató I-EVOLUTION -con I-EVOLUTION -3 I-EVOLUTION -bolus I-EVOLUTION -de I-EVOLUTION -500 I-EVOLUTION -mg I-EVOLUTION -de I-EVOLUTION -metil-prednisolona. I-EVOLUTION - I-EVOLUTION -Desde I-EVOLUTION -el I-EVOLUTION -punto I-EVOLUTION -de I-EVOLUTION -vista I-EVOLUTION -nutricional, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -7 I-EVOLUTION -días I-EVOLUTION -post-trasplante I-EVOLUTION -se I-EVOLUTION -inició I-EVOLUTION -la I-EVOLUTION -administración I-EVOLUTION -de I-EVOLUTION -agua I-EVOLUTION -y I-EVOLUTION -posteriormente I-EVOLUTION -de I-EVOLUTION -nutrición I-EVOLUTION -enteral I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -sonda I-EVOLUTION -de I-EVOLUTION -yeyunostomía. I-EVOLUTION -A I-EVOLUTION -las I-EVOLUTION -tres I-EVOLUTION -semanas I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -inició I-EVOLUTION -la I-EVOLUTION -ingesta I-EVOLUTION -oral I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -progresiva I-EVOLUTION -hasta I-EVOLUTION -ingerir I-EVOLUTION -2.100 I-EVOLUTION -kcal I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -permitió I-EVOLUTION -suspender I-EVOLUTION -la I-EVOLUTION -nutrición I-EVOLUTION -parenteral. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -aumentó I-EVOLUTION -10 I-EVOLUTION -kg I-EVOLUTION -de I-EVOLUTION -peso I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -6 I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -ingreso I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -hospitalaria I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -séptima I-EVOLUTION -semana I-EVOLUTION -del I-EVOLUTION -trasplante, I-EVOLUTION -sin I-EVOLUTION -requerir I-EVOLUTION -nutrición I-EVOLUTION -parenteral. I-EVOLUTION -La I-EVOLUTION -evolución I-EVOLUTION -hasta I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -excelente I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -aumento I-EVOLUTION -ponderal, I-EVOLUTION -que I-EVOLUTION -indica I-EVOLUTION -la I-EVOLUTION -viabilidad I-EVOLUTION -y I-EVOLUTION -buena I-EVOLUTION -función I-EVOLUTION -del I-EVOLUTION -injerto I-EVOLUTION -intestinal. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -67 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -insulindependiente, I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -apnea I-PAST_MEDICAL_HISTORY -obstructiva I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -sueño I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -gastritis I-PAST_MEDICAL_HISTORY -atrófica I-PAST_MEDICAL_HISTORY -autoinmune I-PAST_MEDICAL_HISTORY -(con I-PAST_MEDICAL_HISTORY -anticuerpos I-PAST_MEDICAL_HISTORY -anticélulas I-PAST_MEDICAL_HISTORY -parietales I-PAST_MEDICAL_HISTORY -positivos I-PAST_MEDICAL_HISTORY -1/160, I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -agosto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2007), I-PAST_MEDICAL_HISTORY -así I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -colecistectomía I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -colelitiasis I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -septiembre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2007. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -enero I-EXPLORATION -de I-EXPLORATION -2008 I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -por I-EXPLORATION -presentar I-EXPLORATION -molestias I-EXPLORATION -epigástricas I-EXPLORATION -irradiadas I-EXPLORATION -en I-EXPLORATION -cinturón I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -9 I-EXPLORATION -kg I-EXPLORATION -de I-EXPLORATION -peso, I-EXPLORATION -objetivándose I-EXPLORATION -un I-EXPLORATION -engrosamiento I-EXPLORATION -concéntrico I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -paredes I-EXPLORATION -gástricas, I-EXPLORATION -motivo I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -completa I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -gastroscopia, I-EXPLORATION -ecoendoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta, I-EXPLORATION -analítica I-EXPLORATION -y I-EXPLORATION -marcadores I-EXPLORATION -tumorales. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -tan I-EXPLORATION -sólo I-EXPLORATION -mostraba I-EXPLORATION -un I-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -colestasis I-EXPLORATION -disociada I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -parámetros I-EXPLORATION -y I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -gastroscopia I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -un I-EXPLORATION -pólipo I-EXPLORATION -sesil I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -fundus, I-EXPLORATION -sobre I-EXPLORATION -una I-EXPLORATION -mucosa I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -atrófico, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extirpó I-EXPLORATION -y I-EXPLORATION -cuyo I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -resultó I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION -gástrico I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -difuso. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -ecoendoscopia I-EXPLORATION -alta I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -objetivaron I-EXPLORATION -adenopatías I-EXPLORATION -locorregionales. I-EXPLORATION -Dados B-TREATMENT -los I-TREATMENT -hallazgos I-TREATMENT -de I-TREATMENT -la I-TREATMENT -anatomía I-TREATMENT -patológica, I-TREATMENT -se I-TREATMENT -programó I-TREATMENT -para I-TREATMENT -gastrectomía I-TREATMENT -total, I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -cual I-TREATMENT -macroscópicamente I-TREATMENT -no I-TREATMENT -se I-TREATMENT -evidenció I-TREATMENT -aparentemente I-TREATMENT -tumoración I-TREATMENT -gástrica I-TREATMENT -macroscópica, I-TREATMENT -ni I-TREATMENT -afectación I-TREATMENT -ganglionar I-TREATMENT -ni I-TREATMENT -peritoneal. I-TREATMENT -La B-EXPLORATION -histopatología I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -mostró I-EXPLORATION -múltiples I-EXPLORATION -tumores I-EXPLORATION -neuroendocrinos I-EXPLORATION -bien I-EXPLORATION -diferenciados I-EXPLORATION -tipo I-EXPLORATION -I I-EXPLORATION -(tumores I-EXPLORATION -carcinoides) I-EXPLORATION -en I-EXPLORATION -cuerpo I-EXPLORATION -y I-EXPLORATION -fundus, I-EXPLORATION -de I-EXPLORATION -1-5 I-EXPLORATION -mm, I-EXPLORATION -asociados I-EXPLORATION -a I-EXPLORATION -hiperplasia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -neuroendocrinas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -oxíntica I-EXPLORATION -y I-EXPLORATION -gastritis I-EXPLORATION -crónica I-EXPLORATION -atrófica I-EXPLORATION -de I-EXPLORATION -cuerpo I-EXPLORATION -y I-EXPLORATION -fundus I-EXPLORATION -con I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -displasia I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -grado I-EXPLORATION -y I-EXPLORATION -márgenes I-EXPLORATION -quirúrgicos I-EXPLORATION -no I-EXPLORATION -afectados. I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -53 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -apendicectomía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -neurinoma I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -cervical I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1986. I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -prurito I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -reciente I-PRESENT_ILLNESS -comienzo, I-PRESENT_ILLNESS -sin B-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -ni I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -destacaba I-EXPLORATION -FA I-EXPLORATION -1499 I-EXPLORATION -UI/l, I-EXPLORATION -GGT I-EXPLORATION -1163 I-EXPLORATION -UI/l, I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -1, I-EXPLORATION -62 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -CA-19.9 I-EXPLORATION -533 I-EXPLORATION -UI/ml I-EXPLORATION -(normal I-EXPLORATION -< I-EXPLORATION -37 I-EXPLORATION -UI/ml). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -ecografía-doppler I-EXPLORATION -y I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -mostraban I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -situada I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cabeza I-EXPLORATION -del I-EXPLORATION -páncreas, I-EXPLORATION -con I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -intra- I-EXPLORATION -y I-EXPLORATION -extrahepática. I-EXPLORATION -La I-EXPLORATION -lesión I-EXPLORATION -presentaba I-EXPLORATION -zonas I-EXPLORATION -quísticas, I-EXPLORATION -con I-EXPLORATION -septos I-EXPLORATION -y I-EXPLORATION -mamelones I-EXPLORATION -sólidos I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior, I-EXPLORATION -alguno I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -cuales I-EXPLORATION -captaba I-EXPLORATION -contraste I-EXPLORATION -intensamente I-EXPLORATION -; I-EXPLORATION -sin I-EXPLORATION -datos I-EXPLORATION -de I-EXPLORATION -invasión I-EXPLORATION -vascular I-EXPLORATION -ni I-EXPLORATION -adenopatías. I-EXPLORATION -Con B-TREATMENT -la I-TREATMENT -impresión I-TREATMENT -diagnóstica I-TREATMENT -de I-TREATMENT -neoplasia I-TREATMENT -quística I-TREATMENT -del I-TREATMENT -páncreas I-TREATMENT -sin I-TREATMENT -contraindicación I-TREATMENT -quirúrgica I-TREATMENT -y I-TREATMENT -resecable, I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -duodeno-pancreatectomía I-TREATMENT -cefálica. I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -sólida I-EXPLORATION -de I-EXPLORATION -coloración I-EXPLORATION -blanquecina I-EXPLORATION -y I-EXPLORATION -consistencia I-EXPLORATION -elástica, I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cabeza I-EXPLORATION -del I-EXPLORATION -páncreas, I-EXPLORATION -no I-EXPLORATION -encapsulada I-EXPLORATION -pero I-EXPLORATION -de I-EXPLORATION -contornos I-EXPLORATION -bien I-EXPLORATION -delimitados, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -separaba I-EXPLORATION -con I-EXPLORATION -facilidad I-EXPLORATION -del I-EXPLORATION -páncreas I-EXPLORATION -adyacente. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -inmunohistoquímica I-EXPLORATION -mostró I-EXPLORATION -positividad I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -marcador I-EXPLORATION -vimentina, I-EXPLORATION -y I-EXPLORATION -negatividad I-EXPLORATION -para I-EXPLORATION -citoqueratinas I-EXPLORATION -(AE1-AE3), I-EXPLORATION -S-100, I-EXPLORATION -cromogranina, I-EXPLORATION -CD I-EXPLORATION -34, I-EXPLORATION -C-KIT I-EXPLORATION -y I-EXPLORATION -actina, I-EXPLORATION -presentando I-EXPLORATION -además I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -proliferación I-EXPLORATION -celular I-EXPLORATION -(MIB-I) I-EXPLORATION -muy I-EXPLORATION -bajo I-EXPLORATION -; I-EXPLORATION -siendo I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -sugestivos I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -sarcoma I-EXPLORATION -fusocelular I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -grado I-EXPLORATION -de I-EXPLORATION -malignidad. I-EXPLORATION -Tras B-EVOLUTION -dos I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -permanece I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -recidiva I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -epigástrico I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -Analítica: B-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -17.500/mm3, I-EXPLORATION -PMN I-EXPLORATION -75%, I-EXPLORATION -amilasa I-EXPLORATION -1.956 I-EXPLORATION -U/L, I-EXPLORATION -AST: I-EXPLORATION -89U/L, I-EXPLORATION -ALT I-EXPLORATION -120U/L. I-EXPLORATION -Ecografía I-EXPLORATION -abdominal: I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -extrahepática I-EXPLORATION -con I-EXPLORATION -defectos I-EXPLORATION -de I-EXPLORATION -repleción. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -CPRE: I-EXPLORATION -colédoco I-EXPLORATION -dilatado I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -defecto I-EXPLORATION -de I-EXPLORATION -repleción I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -filiforme, I-EXPLORATION -plegada I-EXPLORATION -sobre I-EXPLORATION -sí I-EXPLORATION -misma I-EXPLORATION -que I-EXPLORATION -ocupaba I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -extrahepática. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -limpieza I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vía I-TREATMENT -biliar I-TREATMENT -con I-TREATMENT -balón I-TREATMENT -Fogarty, I-TREATMENT -extrayéndose I-TREATMENT -un I-TREATMENT -gusano I-TREATMENT -cilíndrico I-TREATMENT -de I-TREATMENT -23 I-TREATMENT -cm, I-TREATMENT -barro I-TREATMENT -biliar I-TREATMENT -y I-TREATMENT -dos I-TREATMENT -cálculos I-TREATMENT -menores I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -mm. I-TREATMENT -Se I-TREATMENT -lavó I-TREATMENT -la I-TREATMENT -vía I-TREATMENT -biliar I-TREATMENT -con I-TREATMENT -suero I-TREATMENT -fisiológico I-TREATMENT -y I-TREATMENT -se I-TREATMENT -pautó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -400 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -albendazol I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -durante I-TREATMENT -4 I-TREATMENT -días. I-TREATMENT -Fue B-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta, I-EVOLUTION -asintomática, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -7 I-EVOLUTION -días I-EVOLUTION -del I-EVOLUTION -ingreso. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -65 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -deterioro I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -perímetro I-PRESENT_ILLNESS -abdominal. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -trabaja I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -auxiliar I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -despacho I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -notario I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -tiene I-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos. I-PAST_MEDICAL_HISTORY -Durante I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -previos I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -seguido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -intermitente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -consultas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Digestivo I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alteración I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -perfil I-PAST_MEDICAL_HISTORY -hepático I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -predominio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -colestasis I-PAST_MEDICAL_HISTORY -leve. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -resto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -y B-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -carecían I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Durante B-PAST_MEDICAL_HISTORY -esos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -realizaron I-PAST_MEDICAL_HISTORY -múltiples I-PAST_MEDICAL_HISTORY -analíticas, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -cuales I-PAST_MEDICAL_HISTORY -únicamente I-PAST_MEDICAL_HISTORY -destacaba I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -consabido I-PAST_MEDICAL_HISTORY -patrón I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -colestasis I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -trombocitopenia I-PAST_MEDICAL_HISTORY -leve I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -algunos I-PAST_MEDICAL_HISTORY -controles. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -largo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -este I-PAST_MEDICAL_HISTORY -periodo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tiempo I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -cifras I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -GOT I-PAST_MEDICAL_HISTORY -oscilaron I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -31-56 I-PAST_MEDICAL_HISTORY -UI/l; I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -GPT, I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -27-75 I-PAST_MEDICAL_HISTORY -UI/l; I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -GGT, I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -150-185 I-PAST_MEDICAL_HISTORY -UI/l; I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -FA, I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -213-456 I-PAST_MEDICAL_HISTORY -UI/l. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -bilirrubina I-PAST_MEDICAL_HISTORY -total I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -movió I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -1, I-PAST_MEDICAL_HISTORY -2-2, I-PAST_MEDICAL_HISTORY -56 I-PAST_MEDICAL_HISTORY -mg/dl. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -realizó I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -estudio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -autoinmunidad, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -negativo. I-PAST_MEDICAL_HISTORY -Igual I-PAST_MEDICAL_HISTORY -resultado I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -obtuvo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -serologías I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -virus I-PAST_MEDICAL_HISTORY -hepatotropos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -VIH, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -marcadores I-PAST_MEDICAL_HISTORY -tumorales I-PAST_MEDICAL_HISTORY -(CEA, I-PAST_MEDICAL_HISTORY -Ca I-PAST_MEDICAL_HISTORY -19.9 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -α-fetoproteína). I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -resto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -datos I-PAST_MEDICAL_HISTORY -analíticos, I-PAST_MEDICAL_HISTORY -incluyendo I-PAST_MEDICAL_HISTORY -hemograma, I-PAST_MEDICAL_HISTORY -bioquímica I-PAST_MEDICAL_HISTORY -completa, I-PAST_MEDICAL_HISTORY -coagulación, I-PAST_MEDICAL_HISTORY -estudio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ferrocinética, I-PAST_MEDICAL_HISTORY -proteinograma, I-PAST_MEDICAL_HISTORY -hormonas I-PAST_MEDICAL_HISTORY -tiroideas, I-PAST_MEDICAL_HISTORY -... I-PAST_MEDICAL_HISTORY -fueron I-PAST_MEDICAL_HISTORY -siempre I-PAST_MEDICAL_HISTORY -normales. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -También I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -sometió I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -diversas I-PAST_MEDICAL_HISTORY -pruebas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -imagen. I-PAST_MEDICAL_HISTORY -Durante I-PAST_MEDICAL_HISTORY -esos I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -llevaron I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -cabo I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -ecografías I-PAST_MEDICAL_HISTORY -abdominales, I-PAST_MEDICAL_HISTORY -todas I-PAST_MEDICAL_HISTORY -ellas I-PAST_MEDICAL_HISTORY -normales I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -excepción I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -realizada I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -ingreso, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -informaba I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -discreta I-PAST_MEDICAL_HISTORY -esplenomegalia. I-PAST_MEDICAL_HISTORY -Dos I-PAST_MEDICAL_HISTORY -estudios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -TAC, I-PAST_MEDICAL_HISTORY -uno I-PAST_MEDICAL_HISTORY -abdominal, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -otro I-PAST_MEDICAL_HISTORY -abdómino-pélvico I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -siete I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -nuestro I-PAST_MEDICAL_HISTORY -centro, I-PAST_MEDICAL_HISTORY -habían I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -igualmente I-PAST_MEDICAL_HISTORY -informados I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -normales. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A B-EXPLORATION -su I-EXPLORATION -recepción I-EXPLORATION -en I-EXPLORATION -nuestra I-EXPLORATION -planta I-EXPLORATION -de I-EXPLORATION -hospitalización I-EXPLORATION -se I-EXPLORATION -pone I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -una I-EXPLORATION -ictericia I-EXPLORATION -mucocutánea I-EXPLORATION -franca I-EXPLORATION -y I-EXPLORATION -ascitis I-EXPLORATION -no I-EXPLORATION -a I-EXPLORATION -tensión, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -leve I-EXPLORATION -deterioro I-EXPLORATION -del I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -conciencia I-EXPLORATION -del I-EXPLORATION -paciente. I-EXPLORATION -Analíticamente I-EXPLORATION -destaca: I-EXPLORATION -Hb: I-EXPLORATION -9, I-EXPLORATION -6 I-EXPLORATION -g/dl; I-EXPLORATION -Hcto: I-EXPLORATION -26, I-EXPLORATION -9%; I-EXPLORATION -plaquetas: I-EXPLORATION -37000; I-EXPLORATION -leucocitos: I-EXPLORATION -3800; I-EXPLORATION -bilirrubina I-EXPLORATION -total: I-EXPLORATION -27, I-EXPLORATION -5 I-EXPLORATION -mg/dl; I-EXPLORATION -GOT: I-EXPLORATION -88; I-EXPLORATION -GPT: I-EXPLORATION -73; I-EXPLORATION -GGT: I-EXPLORATION -243; I-EXPLORATION -FA: I-EXPLORATION -305; I-EXPLORATION -actividad I-EXPLORATION -de I-EXPLORATION -protrombina: I-EXPLORATION -33%; I-EXPLORATION -INR: I-EXPLORATION -2, I-EXPLORATION -1; I-EXPLORATION -creatinina: I-EXPLORATION -2, I-EXPLORATION -09 I-EXPLORATION -mg/dl; I-EXPLORATION -urea: I-EXPLORATION -172 I-EXPLORATION -mg/dl; I-EXPLORATION -α-fetoproteína: I-EXPLORATION -1 I-EXPLORATION -ng/ml; I-EXPLORATION -Las I-EXPLORATION -serologías I-EXPLORATION -de I-EXPLORATION -VHB, I-EXPLORATION -VHC, I-EXPLORATION -VIH, I-EXPLORATION -CMV I-EXPLORATION -y I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -Epstein I-EXPLORATION -Barr I-EXPLORATION -son I-EXPLORATION -nuevamente I-EXPLORATION -negativas. I-EXPLORATION -Se I-EXPLORATION -lleva I-EXPLORATION -a I-EXPLORATION -cabo I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal, I-EXPLORATION -que I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -hígado I-EXPLORATION -con I-EXPLORATION -estigmas I-EXPLORATION -de I-EXPLORATION -hepatopatía I-EXPLORATION -crónica, I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -nódulos I-EXPLORATION -de I-EXPLORATION -regeneración I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior; I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear, I-EXPLORATION -con I-EXPLORATION -imágenes I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -cirrosis I-EXPLORATION -hepática I-EXPLORATION -macronodular I-EXPLORATION -y I-EXPLORATION -ascitis I-EXPLORATION -perihepática I-EXPLORATION -y I-EXPLORATION -periesplénica I-EXPLORATION -en I-EXPLORATION -escasa I-EXPLORATION -cantidad. I-EXPLORATION -Con I-EXPLORATION -todo I-EXPLORATION -ello I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -hepática I-EXPLORATION -transyugular. I-EXPLORATION - I-EXPLORATION -No B-EVOLUTION -obstante, I-EVOLUTION -y I-EVOLUTION -mientras I-EVOLUTION -se I-EVOLUTION -espera I-EVOLUTION -el I-EVOLUTION -resultado I-EVOLUTION -histológico I-EVOLUTION -de I-EVOLUTION -dicha I-EVOLUTION -biopsia, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -sufre I-EVOLUTION -un I-EVOLUTION -empeoramiento I-EVOLUTION -brusco I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -situación I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -función I-EVOLUTION -respiratoria, I-EVOLUTION -requiriendo B-TREATMENT -ventilación I-TREATMENT -mecánica, I-TREATMENT -intubación I-TREATMENT -orotraqueal I-TREATMENT -e I-TREATMENT -ingreso I-TREATMENT -en I-TREATMENT -UCI I-TREATMENT -por I-TREATMENT -cuadro I-TREATMENT -de I-TREATMENT -distrés I-TREATMENT -respiratorio. I-TREATMENT -Fallece B-EVOLUTION -36 I-EVOLUTION -horas I-EVOLUTION -después. I-EVOLUTION - I-EVOLUTION -La B-EXPLORATION -biopsia I-EXPLORATION -hepática, I-EXPLORATION -cuyo I-EXPLORATION -resultado I-EXPLORATION -se I-EXPLORATION -recibió I-EXPLORATION -tras I-EXPLORATION -el I-EXPLORATION -fallecimiento I-EXPLORATION -del I-EXPLORATION -enfermo, I-EXPLORATION -es I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -dilatación I-EXPLORATION -irregular I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -sinusoides I-EXPLORATION -(peliosis) I-EXPLORATION -y I-EXPLORATION -proliferación I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -endoteliales, I-EXPLORATION -sin I-EXPLORATION -que I-EXPLORATION -estas I-EXPLORATION -presenten I-EXPLORATION -mitosis. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -necropsia, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -macroscópicamente I-EXPLORATION -hígado I-EXPLORATION -con I-EXPLORATION -superficie I-EXPLORATION -externa I-EXPLORATION -macronodular, I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -al I-EXPLORATION -corte I-EXPLORATION -áreas I-EXPLORATION -peliótico-esponjosas, I-EXPLORATION -entre I-EXPLORATION -las I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -sitúan I-EXPLORATION -zonas I-EXPLORATION -con I-EXPLORATION -parénquima I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -sano I-EXPLORATION -pero I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -macroscópicos I-EXPLORATION -de I-EXPLORATION -colestasis. I-EXPLORATION -Al I-EXPLORATION -microscopio I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -proliferación I-EXPLORATION -neoplásica I-EXPLORATION -con I-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -crecimiento I-EXPLORATION -sinusoidal, I-EXPLORATION -configurando I-EXPLORATION -espacios I-EXPLORATION -cavernosos I-EXPLORATION -tapizados I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -atípicas. I-EXPLORATION -La I-EXPLORATION -afectación I-EXPLORATION -hepática I-EXPLORATION -es I-EXPLORATION -difusa I-EXPLORATION -y I-EXPLORATION -parcheada, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -algunas I-EXPLORATION -zonas I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -crecimiento I-EXPLORATION -intravascular I-EXPLORATION -neoplásico, I-EXPLORATION -a I-EXPLORATION -veces I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -mitosis, I-EXPLORATION -algunas I-EXPLORATION -de I-EXPLORATION -ellas I-EXPLORATION -atípicas. I-EXPLORATION -Las I-EXPLORATION -células I-EXPLORATION -se I-EXPLORATION -muestran I-EXPLORATION -intensamente I-EXPLORATION -positivas I-EXPLORATION -para I-EXPLORATION -marcadores I-EXPLORATION -endoteliales I-EXPLORATION -CD-31 I-EXPLORATION -y I-EXPLORATION -CD-34. I-EXPLORATION -Todo I-EXPLORATION -ello I-EXPLORATION -es I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -angiosarcoma I-EXPLORATION -hepático I-EXPLORATION -primario. I-EXPLORATION - I-EXPLORATION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -73 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -entre B-PAST_MEDICAL_HISTORY -cuyos I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -únicamente I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -tuberculosis I-PAST_MEDICAL_HISTORY -pasada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -juventud, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -dejó I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -secuela I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -importante I-PAST_MEDICAL_HISTORY -fibrosis I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -lóbulo I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -superior I-PAST_MEDICAL_HISTORY -izquierdo. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Sufre B-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -caída I-PRESENT_ILLNESS -accidental, I-PRESENT_ILLNESS -produciéndose I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -herida I-PRESENT_ILLNESS -incisocontusa I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -pierna I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -sangra I-PRESENT_ILLNESS -profusamente, I-PRESENT_ILLNESS -llamando I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -atención I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -personal I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -atiende I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -dificultoso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -hemostasia. I-PRESENT_ILLNESS -Por B-EXPLORATION -ello I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -analítica, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -pone I-EXPLORATION -de I-EXPLORATION -manifiesto: I-EXPLORATION -Hb: I-EXPLORATION -10, I-EXPLORATION -6 I-EXPLORATION -g/dl; I-EXPLORATION -plaquetas: I-EXPLORATION -115.000; I-EXPLORATION -leucocitos: I-EXPLORATION -3.450; I-EXPLORATION -bilirrubina I-EXPLORATION -total: I-EXPLORATION -7, I-EXPLORATION -1 I-EXPLORATION -mg/dl; I-EXPLORATION -GOT: I-EXPLORATION -45; I-EXPLORATION -GPT: I-EXPLORATION -53; I-EXPLORATION -GGT: I-EXPLORATION -293; I-EXPLORATION -FA: I-EXPLORATION -286; I-EXPLORATION -actividad I-EXPLORATION -de I-EXPLORATION -protrombina: I-EXPLORATION -61%. I-EXPLORATION -Tras I-EXPLORATION -esto I-EXPLORATION -se I-EXPLORATION -inicia I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -hepatopatía, I-EXPLORATION -realizándose I-EXPLORATION -serologías I-EXPLORATION -virales, I-EXPLORATION -proteinograma, I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -autoinmunidad I-EXPLORATION -y I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -marcadores I-EXPLORATION -tumorales, I-EXPLORATION -que I-EXPLORATION -son I-EXPLORATION -todos I-EXPLORATION -negativos. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -hacen I-EXPLORATION -varias I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen, I-EXPLORATION -que I-EXPLORATION -arrojan I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -datos: I-EXPLORATION -TAC I-EXPLORATION -abdominal: I-EXPLORATION -hígado I-EXPLORATION -aumentado I-EXPLORATION -de I-EXPLORATION -tamaño, I-EXPLORATION -con I-EXPLORATION -imágenes I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -metástasis I-EXPLORATION -hepáticas, I-EXPLORATION -algunas I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -tamaño, I-EXPLORATION -y I-EXPLORATION -repartidas I-EXPLORATION -por I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -segmentos I-EXPLORATION -del I-EXPLORATION -hígado. I-EXPLORATION -Escasa I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -ascitis I-EXPLORATION -de I-EXPLORATION -distribución I-EXPLORATION -atípica I-EXPLORATION -; I-EXPLORATION -colangio-RMN: I-EXPLORATION -cirrosis I-EXPLORATION -hepática I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -imágenes I-EXPLORATION -sugestivas I-EXPLORATION -de I-EXPLORATION -nódulos I-EXPLORATION -de I-EXPLORATION -regeneración I-EXPLORATION -sin I-EXPLORATION -poder I-EXPLORATION -descartarse I-EXPLORATION -otra I-EXPLORATION -etiología I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -metastásica. I-EXPLORATION -Ascitis; I-EXPLORATION -PET-TAC: I-EXPLORATION -captación I-EXPLORATION -patológica I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -lóbulos I-EXPLORATION -hepáticos I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -más I-EXPLORATION -captación I-EXPLORATION -patológica I-EXPLORATION -extrahepática; I-EXPLORATION -ecografía I-EXPLORATION -abdominal: I-EXPLORATION -varias I-EXPLORATION -lesiones I-EXPLORATION -ocupantes I-EXPLORATION -de I-EXPLORATION -espacio I-EXPLORATION -(LOE) I-EXPLORATION -hepáticas I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -metastático. I-EXPLORATION -Ante I-EXPLORATION -estos I-EXPLORATION -hallazgos, I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -patología I-EXPLORATION -neoplásica, I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -PAAF I-EXPLORATION -guiada I-EXPLORATION -por I-EXPLORATION -ecografía I-EXPLORATION -de I-EXPLORATION -estas I-EXPLORATION -lesiones, I-EXPLORATION -cuyo I-EXPLORATION -informe I-EXPLORATION -reza: I-EXPLORATION -tumor I-EXPLORATION -de I-EXPLORATION -estirpe I-EXPLORATION -mesenquimal, I-EXPLORATION -con I-EXPLORATION -células I-EXPLORATION -con I-EXPLORATION -núcleos I-EXPLORATION -hipercromáticos, I-EXPLORATION -positivas I-EXPLORATION -para I-EXPLORATION -diferentes I-EXPLORATION -marcadores I-EXPLORATION -endoteliales, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -angiosarcoma I-EXPLORATION -hepático. I-EXPLORATION - I-EXPLORATION -Cuarenta B-EVOLUTION -y I-EVOLUTION -ocho I-EVOLUTION -horas I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -punción I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -precisa I-EVOLUTION -ingreso I-EVOLUTION -hospitalario I-EVOLUTION -por I-EVOLUTION -presentar I-EVOLUTION -hemoperitoneo I-EVOLUTION -secundario, I-EVOLUTION -con I-EVOLUTION -distensión I-EVOLUTION -abdominal I-EVOLUTION -y I-EVOLUTION -clínica I-EVOLUTION -de I-EVOLUTION -peritonismo. I-EVOLUTION -El I-EVOLUTION -sangrado I-EVOLUTION -cede I-EVOLUTION -espontáneamente I-EVOLUTION -y I-EVOLUTION -no I-EVOLUTION -requiere I-EVOLUTION -intervencionismo, I-EVOLUTION -siendo I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -domicilio I-EVOLUTION -varios I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -sin I-EVOLUTION -más I-EVOLUTION -complicaciones. I-EVOLUTION -Sin I-EVOLUTION -embargo, I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -semanas I-EVOLUTION -siguientes I-EVOLUTION -sufre I-EVOLUTION -un I-EVOLUTION -deterioro I-EVOLUTION -progresivo I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -estado, I-EVOLUTION -llegando I-EVOLUTION -a I-EVOLUTION -presentar I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -mixto I-EVOLUTION -de I-EVOLUTION -insuficiencia I-EVOLUTION -hepática, I-EVOLUTION -encefalopatía, I-EVOLUTION -e I-EVOLUTION -insuficiencia I-EVOLUTION -respiratoria, I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -responde I-EVOLUTION -al I-EVOLUTION -tratamiento I-EVOLUTION -médico, I-EVOLUTION -falleciendo I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -por I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -final I-EVOLUTION -de I-EVOLUTION -fracaso I-EVOLUTION -multiorgánico. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -adicto I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -drogas I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -vía I-PRESENT_ILLNESS -parenteral, I-PRESENT_ILLNESS -diagnosticado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -infección I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -VIH I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -dejado I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -antirretroviral I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -meses. I-PRESENT_ILLNESS -Ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -odinofagia I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dudosa I-PRESENT_ILLNESS -disfagia, I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -importante I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -deposiciones/día I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -heces I-PRESENT_ILLNESS -líquidas. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -importante I-EXPLORATION -desnutrición I-EXPLORATION -con I-EXPLORATION -muguet I-EXPLORATION -orofaríngeo. I-EXPLORATION -Hepatomegalia I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -a I-EXPLORATION -expensas I-EXPLORATION -lóbulo I-EXPLORATION -hepático I-EXPLORATION -derecho I-EXPLORATION -sin I-EXPLORATION -esplenomegalia. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -presentaba I-EXPLORATION -6.830 I-EXPLORATION -leucocitos I-EXPLORATION -con I-EXPLORATION -7, I-EXPLORATION -2% I-EXPLORATION -linfocitos I-EXPLORATION -y I-EXPLORATION -86, I-EXPLORATION -7% I-EXPLORATION -neutrófilos. I-EXPLORATION -CD4 I-EXPLORATION -10 I-EXPLORATION -cel/µl. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -esofagogastrocopia I-EXPLORATION -que I-EXPLORATION -demostró I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -segunda I-EXPLORATION -porción I-EXPLORATION -de I-EXPLORATION -duodeno I-EXPLORATION -una I-EXPLORATION -mucosa I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -velloso, I-EXPLORATION -blanquecino, I-EXPLORATION -irregular I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -tomaron I-EXPLORATION -biopsias. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -endoscopia I-EXPLORATION -oral I-EXPLORATION -no I-EXPLORATION -presentó I-EXPLORATION -alteraciones. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -Leishmania I-EXPLORATION -amastigotes I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -interior I-EXPLORATION -de I-EXPLORATION -histiocitos. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -amfotericina I-TREATMENT -B I-TREATMENT -mejorando B-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -acudió I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -sucesivas I-EVOLUTION -revisiones. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -trasplantado B-PAST_MEDICAL_HISTORY -hepático I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cirrosis I-PAST_MEDICAL_HISTORY -VHC I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -inmunosupresor I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -esteroides, I-PAST_MEDICAL_HISTORY -tacrolimus I-PAST_MEDICAL_HISTORY -(FK) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -mofetil-micofenolato I-PAST_MEDICAL_HISTORY -(MMF). I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -primeros I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -postrasplante I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -produjo I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -deterioro I-PAST_MEDICAL_HISTORY -progresivo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -función I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -aparición I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -relacionada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -tacrolimus, I-PAST_MEDICAL_HISTORY -planteándose I-PAST_MEDICAL_HISTORY -sustituir I-PAST_MEDICAL_HISTORY -FK I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -MMF I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -rapamicina I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -mg/día. I-PAST_MEDICAL_HISTORY -Transcurridos B-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -seca I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -febrícula. I-PRESENT_ILLNESS -En B-EXPLORATION -ese I-EXPLORATION -momento I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -plasmáticos I-EXPLORATION -de I-EXPLORATION -rapamicina I-EXPLORATION -eran I-EXPLORATION -25 I-EXPLORATION -ng/ml I-EXPLORATION -(normal: I-EXPLORATION -9-19). I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -mostró I-EXPLORATION -varios I-EXPLORATION -infiltrados I-EXPLORATION -alveolares I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -medio I-EXPLORATION -y I-EXPLORATION -segmento I-EXPLORATION -posterior I-EXPLORATION -de I-EXPLORATION -lóbulo I-EXPLORATION -superior I-EXPLORATION -del I-EXPLORATION -pulmón I-EXPLORATION -derecho I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -ipsilateral. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -empíricamente I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -levofloxacino I-TREATMENT -por I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -bronconeumonía I-TREATMENT -y I-TREATMENT -se I-TREATMENT -redujo I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -1 I-TREATMENT -mg/día, I-TREATMENT -presentando B-EVOLUTION -evolución I-EVOLUTION -desfavorable I-EVOLUTION -con I-EVOLUTION -dolor I-EVOLUTION -costal I-EVOLUTION -mecánico, I-EVOLUTION -tos I-EVOLUTION -irritativa, I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -febrícula I-EVOLUTION -y I-EVOLUTION -apareciendo I-EVOLUTION -disnea. I-EVOLUTION -Se B-TREATMENT -decidió I-TREATMENT -cambiar I-TREATMENT -a I-TREATMENT -piperacilina-tazobactam, I-TREATMENT -persistiendo I-TREATMENT -la I-TREATMENT -fiebre. I-TREATMENT -La B-EXPLORATION -gasometría I-EXPLORATION -arterial I-EXPLORATION -basal I-EXPLORATION -mostró I-EXPLORATION -hipoxia I-EXPLORATION -leve. I-EXPLORATION -La I-EXPLORATION -TC I-EXPLORATION -torácica I-EXPLORATION -reveló I-EXPLORATION -opacidades I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -basal I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -hemotórax, I-EXPLORATION -cavitación I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -segmentos I-EXPLORATION -anteriores I-EXPLORATION -de I-EXPLORATION -lóbulos I-EXPLORATION -inferiores I-EXPLORATION -y I-EXPLORATION -áreas I-EXPLORATION -nodulares I-EXPLORATION -múltiples, I-EXPLORATION -realizándose I-EXPLORATION -una I-EXPLORATION -punción I-EXPLORATION -aspiración I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina I-EXPLORATION -(PAAF) I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -condensaciones. I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -PAAF I-EXPLORATION -mostraron I-EXPLORATION -Ziehl I-EXPLORATION -negativo, I-EXPLORATION -anticuerpos I-EXPLORATION -monoclonales I-EXPLORATION -para I-EXPLORATION -Pneumocystis I-EXPLORATION -carinii I-EXPLORATION -negativos I-EXPLORATION -y I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -aerobios I-EXPLORATION -estéril. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -fibrobroncoscopia I-EXPLORATION -con I-EXPLORATION -lavado I-EXPLORATION -bronquioloalveolar I-EXPLORATION -(LAB) I-EXPLORATION -cuya I-EXPLORATION -baciloscopia I-EXPLORATION -y I-EXPLORATION -cultivo I-EXPLORATION -fueron I-EXPLORATION -estériles I-EXPLORATION -para I-EXPLORATION -bacterias, I-EXPLORATION -virus, I-EXPLORATION -hongos, I-EXPLORATION -micobacterias I-EXPLORATION -o I-EXPLORATION -parásitos, I-EXPLORATION -incluyendo I-EXPLORATION -nocardia. I-EXPLORATION -Los I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -cultivos I-EXPLORATION -de I-EXPLORATION -micobacterias I-EXPLORATION -en I-EXPLORATION -esputo I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Las I-EXPLORATION -serologías I-EXPLORATION -para I-EXPLORATION -micoplasma, I-EXPLORATION -fiebre I-EXPLORATION -Q, I-EXPLORATION -clamidia I-EXPLORATION -y I-EXPLORATION -legionela I-EXPLORATION -fueron I-EXPLORATION -negativas, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -el I-EXPLORATION -galactomanano, I-EXPLORATION -la I-EXPLORATION -antigenemia I-EXPLORATION -y I-EXPLORATION -PCR I-EXPLORATION -de I-EXPLORATION -citomegalovirus. I-EXPLORATION -Debido B-TREATMENT -a I-TREATMENT -la I-TREATMENT -inapropiada I-TREATMENT -respuesta I-TREATMENT -antibiótica, I-TREATMENT -y I-TREATMENT -sin I-TREATMENT -aislarse I-TREATMENT -ningún I-TREATMENT -microorganismo, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -suspender I-TREATMENT -la I-TREATMENT -rapamicina. I-TREATMENT -El B-EVOLUTION -cuadro I-EVOLUTION -clínico I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente, I-EVOLUTION -encontrándose I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -asintomático I-EVOLUTION -en I-EVOLUTION -posteriores I-EVOLUTION -revisiones, I-EVOLUTION -aunque I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -radiológicas I-EVOLUTION -persistieron I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -TC I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -12 I-EVOLUTION -semanas, I-EVOLUTION -normalizándose I-EVOLUTION -transcurridos I-EVOLUTION -6 I-EVOLUTION -meses. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -46 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -ingresada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -anémico I-PRESENT_ILLNESS -(Hb I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -g/dl, I-PRESENT_ILLNESS -Hto I-PRESENT_ILLNESS -30%) I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -constitucional. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -presentaba I-EXPLORATION -manchas I-EXPLORATION -"café I-EXPLORATION -con I-EXPLORATION -leche" I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -espalda I-EXPLORATION -y I-EXPLORATION -cuello, I-EXPLORATION -y I-EXPLORATION -múltiples I-EXPLORATION -neurofibromas. I-EXPLORATION -El I-EXPLORATION -abdomen I-EXPLORATION -era I-EXPLORATION -blando, I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -hipogastrio I-EXPLORATION -y I-EXPLORATION -zona I-EXPLORATION -periumbilical, I-EXPLORATION -sin I-EXPLORATION -masas I-EXPLORATION -palpables I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -peristalsis I-EXPLORATION -conservada. I-EXPLORATION -El I-EXPLORATION -tacto I-EXPLORATION -rectal I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -refería I-EXPLORATION -presentar I-EXPLORATION -un I-EXPLORATION -fenotipo I-EXPLORATION -similar I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -padre. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -ecografía I-EXPLORATION -abdominal, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -asa I-EXPLORATION -intestinal I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -trayecto I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm, I-EXPLORATION -y I-EXPLORATION -TAC I-EXPLORATION -abdominal, I-EXPLORATION -objetivándose I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -intraluminal I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -colon I-EXPLORATION -ascendente. I-EXPLORATION -Se B-TREATMENT -intervino I-TREATMENT -quirúrgicamente, I-TREATMENT -hallándose I-TREATMENT -3 I-TREATMENT -tumoraciones, I-TREATMENT -la I-TREATMENT -mayor I-TREATMENT -de I-TREATMENT -12 I-TREATMENT -cm, I-TREATMENT -que I-TREATMENT -englobaba I-TREATMENT -íleon I-TREATMENT -terminal I-TREATMENT -y I-TREATMENT -ciego, I-TREATMENT -y I-TREATMENT -otras I-TREATMENT -dos I-TREATMENT -de I-TREATMENT -3, I-TREATMENT -5 I-TREATMENT -y I-TREATMENT -1, I-TREATMENT -2 I-TREATMENT -cm, I-TREATMENT -proximales I-TREATMENT -a I-TREATMENT -la I-TREATMENT -primera. I-TREATMENT -El B-EXPLORATION -informe I-EXPLORATION -anatomopatológico, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -GIST, I-EXPLORATION -describía I-EXPLORATION -formación I-EXPLORATION -nodular I-EXPLORATION -fusiforme, I-EXPLORATION -con I-EXPLORATION -marcada I-EXPLORATION -positividad I-EXPLORATION -para I-EXPLORATION -CD I-EXPLORATION -117, I-EXPLORATION -CD I-EXPLORATION -34, I-EXPLORATION -y I-EXPLORATION -negatividad I-EXPLORATION -para I-EXPLORATION -S-100. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -meningitis I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia, I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -gestacional I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -colestasis I-PAST_MEDICAL_HISTORY -gravídica. I-PAST_MEDICAL_HISTORY -Diagnosticada B-PRESENT_ILLNESS -previamente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -pancreatitis I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS -idiopática, I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -localización I-PRESENT_ILLNESS -epigástrico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -obstructiva. I-PRESENT_ILLNESS -Se B-EXPLORATION -realizada I-EXPLORATION -un I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -helicoidal I-EXPLORATION -con I-EXPLORATION -contraste, I-EXPLORATION -identificándose I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -múltiples I-EXPLORATION -calcificaciones I-EXPLORATION -pancreáticas, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cabeza I-EXPLORATION -del I-EXPLORATION -páncreas I-EXPLORATION -(alcanza I-EXPLORATION -los I-EXPLORATION -6 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -mayor), I-EXPLORATION -con I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -planos I-EXPLORATION -grasos I-EXPLORATION -con I-EXPLORATION -duodeno. I-EXPLORATION -Existe I-EXPLORATION -una I-EXPLORATION -discreta I-EXPLORATION -dilatación I-EXPLORATION -del I-EXPLORATION -conducto I-EXPLORATION -pancreático I-EXPLORATION -principal, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -gran I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -adenopatías I-EXPLORATION -periaorticocavas I-EXPLORATION -y I-EXPLORATION -mesentéricas. I-EXPLORATION -Se I-EXPLORATION -establece I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -inflamatoria I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -pancreatitis I-EXPLORATION -crónica, I-EXPLORATION -sin I-EXPLORATION -poder I-EXPLORATION -descartar I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION -de I-EXPLORATION -páncreas. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -USE, I-EXPLORATION -confirmándose I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -en I-EXPLORATION -cabeza I-EXPLORATION -pancreática, I-EXPLORATION -heteroecogénica, I-EXPLORATION -irregular, I-EXPLORATION -mal I-EXPLORATION -delimitada, I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -calcificaciones I-EXPLORATION -dispersas, I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -parénquima I-EXPLORATION -pancreático, I-EXPLORATION -que I-EXPLORATION -presenta I-EXPLORATION -un I-EXPLORATION -patrón I-EXPLORATION -lobular, I-EXPLORATION -con I-EXPLORATION -puntos I-EXPLORATION -y I-EXPLORATION -bandas I-EXPLORATION -hiperecogénicas I-EXPLORATION -(característico I-EXPLORATION -de I-EXPLORATION -pancreatitis I-EXPLORATION -crónica). I-EXPLORATION -El I-EXPLORATION -conducto I-EXPLORATION -pancreático I-EXPLORATION -principal I-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -dilatado, I-EXPLORATION -con I-EXPLORATION -pared I-EXPLORATION -hiperecogénica, I-EXPLORATION -patrón I-EXPLORATION -irregular I-EXPLORATION -y I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -colaterales. I-EXPLORATION -La I-EXPLORATION -lesión I-EXPLORATION -pancreática I-EXPLORATION -afecta I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -principal, I-EXPLORATION -con I-EXPLORATION -dilatación I-EXPLORATION -secundaria I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma. I-EXPLORATION -Durante I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -USE I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -elastográfico. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -basal I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -un I-EXPLORATION -patrón I-EXPLORATION -heterogéneo I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -verde, I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -elastográfico I-EXPLORATION -de I-EXPLORATION -segunda I-EXPLORATION -generación I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -un I-EXPLORATION -coeficiente I-EXPLORATION -de I-EXPLORATION -elasticidad I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -35 I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -valor I-EXPLORATION -de I-EXPLORATION -A I-EXPLORATION -(lesión I-EXPLORATION -a I-EXPLORATION -estudio) I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -12%. I-EXPLORATION -Finalmente I-EXPLORATION -se I-EXPLORATION -rea-liza I-EXPLORATION -una I-EXPLORATION -punción I-EXPLORATION -aspiración I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina I-EXPLORATION -de I-EXPLORATION -22G, I-EXPLORATION -apreciándose I-EXPLORATION -hallazgos I-EXPLORATION -característicos I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -inflamatoria I-EXPLORATION -en I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -pancreatitis I-EXPLORATION -crónica I-EXPLORATION -(18). I-EXPLORATION -Finalmente B-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -una I-TREATMENT -colangiopancreatografía I-TREATMENT -retrógrada I-TREATMENT -endoscópica I-TREATMENT -con I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -una I-TREATMENT -prótesis I-TREATMENT -de I-TREATMENT -polietileno. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -satisfactoria, I-EVOLUTION -encontrándose I-EVOLUTION -tras I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento, I-EVOLUTION -estable I-EVOLUTION -y I-EVOLUTION -asintomática. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pancreatitis I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -alcohólica, I-PAST_MEDICAL_HISTORY -ingresado B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -insuficiencia I-PRESENT_ILLNESS -respiratoria. I-PRESENT_ILLNESS -Tras B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -y I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -se I-EXPLORATION -diagnosticó I-EXPLORATION -un I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -derecho. I-EXPLORATION -Tras B-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -toracocentesis I-TREATMENT -diagnóstica I-TREATMENT -y I-TREATMENT -evacuadora, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -experimentó I-TREATMENT -disnea I-TREATMENT -y I-TREATMENT -síndrome I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -cava I-TREATMENT -superior. I-TREATMENT -En B-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -ensanchamiento I-EXPLORATION -mediastínico. I-EXPLORATION -En I-EXPLORATION -un I-EXPLORATION -TAC I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -colección I-EXPLORATION -líquida I-EXPLORATION -torácica I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -patológicos I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -abdomen, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -drenó I-EXPLORATION -mediante I-EXPLORATION -un I-EXPLORATION -tubo I-EXPLORATION -torácico. I-EXPLORATION -Este I-EXPLORATION -líquido I-EXPLORATION -contenía I-EXPLORATION -una I-EXPLORATION -elevada I-EXPLORATION -concentración I-EXPLORATION -de I-EXPLORATION -amilasa I-EXPLORATION -(104.000 I-EXPLORATION -U/ml). I-EXPLORATION -Además B-EVOLUTION -apareció I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -región I-EVOLUTION -cervical I-EVOLUTION -lateral I-EVOLUTION -derecha I-EVOLUTION -un I-EVOLUTION -área I-EVOLUTION -de I-EVOLUTION -abultamiento I-EVOLUTION -con I-EVOLUTION -signos I-EVOLUTION -inflamatorios, I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -drenó, I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cual I-EVOLUTION -se I-EVOLUTION -obtuvo I-EVOLUTION -también I-EVOLUTION -una I-EVOLUTION -elevada I-EVOLUTION -concentración I-EVOLUTION -de I-EVOLUTION -amilasa I-EVOLUTION -(90.000 I-EVOLUTION -U/ml). I-EVOLUTION -Tras I-EVOLUTION -el I-EVOLUTION -drenaje I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -colecciones I-EVOLUTION -cervical I-EVOLUTION -y I-EVOLUTION -torácica, I-EVOLUTION -mejoró I-EVOLUTION -la I-EVOLUTION -disnea I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -estabilizó. I-EVOLUTION -A B-EXPLORATION -fin I-EXPLORATION -de I-EXPLORATION -investigar I-EXPLORATION -el I-EXPLORATION -sospechado I-EXPLORATION -origen I-EXPLORATION -pancreático I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -colecciones, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -CPRE I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -conducto I-EXPLORATION -de I-EXPLORATION -Wirsung I-EXPLORATION -era I-EXPLORATION -irregular I-EXPLORATION -pero I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -dilataciones I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -comunicaba I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -pleura. I-EXPLORATION -Se B-TREATMENT -colocó I-TREATMENT -una I-TREATMENT -prótesis I-TREATMENT -plástica, I-TREATMENT -con I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -la I-TREATMENT -fístula I-TREATMENT -se I-TREATMENT -cerró. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -mejoró I-EVOLUTION -sin I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -cirugía. I-EVOLUTION -La I-EVOLUTION -prótesis I-EVOLUTION -se I-EVOLUTION -retiró I-EVOLUTION -endoscópicamente I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -3 I-EVOLUTION -meses. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encontraba I-EVOLUTION -bien, I-EVOLUTION -sin I-EVOLUTION -recidiva I-EVOLUTION -del I-EVOLUTION -pseudoquiste I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -2 I-EVOLUTION -años. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -57 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -intermitentes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -advirtió I-PRESENT_ILLNESS -rectorragia. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -no I-EXPLORATION -demostró I-EXPLORATION -alteraciones I-EXPLORATION -significativas. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -analítico I-EXPLORATION -no I-EXPLORATION -presentó I-EXPLORATION -alteraciones. I-EXPLORATION -La I-EXPLORATION -colonoscopia I-EXPLORATION -evidenció I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -colon I-EXPLORATION -transverso I-EXPLORATION -una I-EXPLORATION -formación I-EXPLORATION -polipoide I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -tamaño I-EXPLORATION -que I-EXPLORATION -ocupaba I-EXPLORATION -casi I-EXPLORATION -por I-EXPLORATION -completo I-EXPLORATION -la I-EXPLORATION -luz, I-EXPLORATION -y I-EXPLORATION -mostraba I-EXPLORATION -ulceraciones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cabeza. I-EXPLORATION -El I-EXPLORATION -lugar I-EXPLORATION -se I-EXPLORATION -marcó I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -clip I-EXPLORATION -para I-EXPLORATION -valorar I-EXPLORATION -mejor I-EXPLORATION -la I-EXPLORATION -localización I-EXPLORATION -del I-EXPLORATION -pólipo I-EXPLORATION -mediante I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION -simple. I-EXPLORATION -Se I-EXPLORATION -tomaron I-EXPLORATION -biopsias I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -informadas I-EXPLORATION -como: I-EXPLORATION -mucosa I-EXPLORATION -colónica I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -ulceración I-EXPLORATION -y I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -de I-EXPLORATION -granulación I-EXPLORATION -y I-EXPLORATION -tejido I-EXPLORATION -conectivo I-EXPLORATION -fibroso, I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -malignidad. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -TC I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -que I-EXPLORATION -confirmó I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -endoscópicos. I-EXPLORATION -Tres B-TREATMENT -semanas I-TREATMENT -más I-TREATMENT -tarde I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -tuvo I-TREATMENT -que I-TREATMENT -ser I-TREATMENT -operada I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -urgente I-TREATMENT -al I-TREATMENT -presentar I-TREATMENT -un I-TREATMENT -cuadro I-TREATMENT -suboclusivo. I-TREATMENT -En I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -se I-TREATMENT -objetivó I-TREATMENT -una I-TREATMENT -invaginación I-TREATMENT -colónica I-TREATMENT -asociada I-TREATMENT -a I-TREATMENT -un I-TREATMENT -lipoma I-TREATMENT -de I-TREATMENT -5, I-TREATMENT -5 I-TREATMENT -cm, I-TREATMENT -con I-TREATMENT -origen I-TREATMENT -en I-TREATMENT -la I-TREATMENT -submucosa. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -hemicolectomía I-TREATMENT -derecha. I-TREATMENT -Se I-TREATMENT -aislaron I-TREATMENT -varios I-TREATMENT -ganglios I-TREATMENT -reactivos. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -69 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -exfumador, B-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -aneurisma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -aorta I-PAST_MEDICAL_HISTORY -abdominal I-PAST_MEDICAL_HISTORY -infrarrenal I-PAST_MEDICAL_HISTORY -7, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -anticoagulación I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -tromboembolismo I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -previo, I-PAST_MEDICAL_HISTORY -recibió B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pulmón I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -microcítico I-PRESENT_ILLNESS -CPNM I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -epidermoide I-PRESENT_ILLNESS -T3aN2M0 I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -lóbulo I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -izquierdo. I-PRESENT_ILLNESS -Considerado B-TREATMENT -irresecable, I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -4 I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -cisplatino-vinorelbina I-TREATMENT -junto I-TREATMENT -con I-TREATMENT -radioterapia I-TREATMENT -torácica; I-TREATMENT -con I-TREATMENT -moderada I-TREATMENT -respuesta. I-TREATMENT -Seis B-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -diagnóstico, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -ingresó I-EVOLUTION -por I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -difuso I-EVOLUTION -de I-EVOLUTION -seis I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -y I-EVOLUTION -vómitos I-EVOLUTION -esporádicos. I-EVOLUTION -Presentaba B-EXPLORATION -hipoalbuminemia I-EXPLORATION -leve I-EXPLORATION -y I-EXPLORATION -anemia I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -5 I-EXPLORATION -g/dl I-EXPLORATION --precisando I-EXPLORATION -concentrados I-EXPLORATION -de I-EXPLORATION -hematíes-. I-EXPLORATION -La I-EXPLORATION -TC I-EXPLORATION -abdómino-pélvica I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -procedente I-EXPLORATION -de I-EXPLORATION -mesenterio I-EXPLORATION -que I-EXPLORATION -englobaba I-EXPLORATION -varias I-EXPLORATION -asas I-EXPLORATION -de I-EXPLORATION -intestino. I-EXPLORATION -La I-EXPLORATION -ultrasonografía I-EXPLORATION -evidenció I-EXPLORATION -un I-EXPLORATION -trayecto I-EXPLORATION -fistuloso I-EXPLORATION -entre I-EXPLORATION -asas I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -área I-EXPLORATION -flemonosa I-EXPLORATION -con I-EXPLORATION -pequeñas I-EXPLORATION -burbujas I-EXPLORATION -de I-EXPLORATION -gas I-EXPLORATION -extraluminal, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -instauró I-EXPLORATION -tratamiento I-EXPLORATION -antibiótico. I-EXPLORATION -Al B-EVOLUTION -5o I-EVOLUTION -día I-EVOLUTION -desarrolló I-EVOLUTION -un I-EVOLUTION -franco I-EVOLUTION -cuadro I-EVOLUTION -obstructivo; I-EVOLUTION -siendo B-TREATMENT -entonces I-TREATMENT -intervenido I-TREATMENT -con I-TREATMENT -carácter I-TREATMENT -urgente. I-TREATMENT -Se B-EXPLORATION -halló I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -abdominal I-EXPLORATION -de I-EXPLORATION -15 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -mesenterio I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -promontorio I-EXPLORATION -y I-EXPLORATION -cercana I-EXPLORATION -al I-EXPLORATION -aneurisma. I-EXPLORATION -Esta I-EXPLORATION -englobaba I-EXPLORATION -al I-EXPLORATION -intestino I-EXPLORATION -delgado, I-EXPLORATION -dos I-EXPLORATION -asas I-EXPLORATION -de I-EXPLORATION -yeyuno, I-EXPLORATION -una I-EXPLORATION -de I-EXPLORATION -íleon I-EXPLORATION --a I-EXPLORATION -30 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -válvula I-EXPLORATION -cecal- I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -colon I-EXPLORATION -sigmoideo I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -longitud I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -cm. I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -resección I-TREATMENT -segmentaria I-TREATMENT -de I-TREATMENT -sigma I-TREATMENT -y I-TREATMENT -asas I-TREATMENT -englobadas I-TREATMENT -en I-TREATMENT -el I-TREATMENT -tumor I-TREATMENT -mesentérico, I-TREATMENT -reconstruyendo I-TREATMENT -mediante I-TREATMENT -tres I-TREATMENT -anastomosis I-TREATMENT -de I-TREATMENT -intestino I-TREATMENT -delgado I-TREATMENT -con I-TREATMENT -autosutura I-TREATMENT -mecánica I-TREATMENT -latero-lateral, I-TREATMENT -y I-TREATMENT -una I-TREATMENT -de I-TREATMENT -sigma I-TREATMENT -término-terminal. I-TREATMENT -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -grasa I-EXPLORATION -mesentérica I-EXPLORATION -y I-EXPLORATION -su I-EXPLORATION -extensión I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -asas I-EXPLORATION -intestinales I-EXPLORATION --alcanzando I-EXPLORATION -la I-EXPLORATION -mucosa-, I-EXPLORATION -englobándolas, I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -abscesificación I-EXPLORATION -y I-EXPLORATION -fistulización. I-EXPLORATION -El B-EVOLUTION -postoperatorio I-EVOLUTION -transcurrió I-EVOLUTION -sin I-EVOLUTION -incidencias I-EVOLUTION --recuperó I-EVOLUTION -la I-EVOLUTION -ingesta I-EVOLUTION -oral I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -tránsito I-EVOLUTION -intestinal- I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -8o I-EVOLUTION -día, I-EVOLUTION -cuando I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -pico I-EVOLUTION -febril. I-EVOLUTION -La B-EXPLORATION -TC I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -de I-EXPLORATION -8 I-EXPLORATION -cm I-EXPLORATION --por I-EXPLORATION -mínima I-EXPLORATION -dehiscencia I-EXPLORATION -de I-EXPLORATION -sigma- I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -drenó I-EXPLORATION -y I-EXPLORATION -resolvió I-EXPLORATION -radiológicamente. I-EXPLORATION -Con B-EVOLUTION -función I-EVOLUTION -intestinal I-EVOLUTION -normal, I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta. I-EVOLUTION -En I-EVOLUTION -las I-EVOLUTION -semanas I-EVOLUTION -posteriores, I-EVOLUTION -experimentó I-EVOLUTION -rápido I-EVOLUTION -deterioro I-EVOLUTION -del I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION -y I-EVOLUTION -progresión I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad I-EVOLUTION -tumoral I-EVOLUTION -(linfangitis I-EVOLUTION -carcinomatosa I-EVOLUTION -pulmonar, I-EVOLUTION -crecimiento I-EVOLUTION -de I-EVOLUTION -metástasis I-EVOLUTION -subcutánea I-EVOLUTION -en I-EVOLUTION -pared I-EVOLUTION -torácica, I-EVOLUTION -hipercalcemia I-EVOLUTION -tumoral). I-EVOLUTION -No I-EVOLUTION -estando I-EVOLUTION -en I-EVOLUTION -condiciones I-EVOLUTION -de I-EVOLUTION -iniciar I-EVOLUTION -una I-EVOLUTION -segunda I-EVOLUTION -línea I-EVOLUTION -de I-EVOLUTION -quimioterapia, I-EVOLUTION -falleció I-EVOLUTION -al I-EVOLUTION -mes I-EVOLUTION -y I-EVOLUTION -medio I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -exéresis I-EVOLUTION -quirúrgica I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -metástasis I-EVOLUTION -abdominal. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -44 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -diagnosticado B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -colitis I-PRESENT_ILLNESS -ulcerosa I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -intervenido, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -colectomía I-PRESENT_ILLNESS -total I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -ileostomía I-PRESENT_ILLNESS -terminal, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -megacolon I-PRESENT_ILLNESS -tóxico. I-PRESENT_ILLNESS -Acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -difuso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -cólico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -varias I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -líquidas I-PRESENT_ILLNESS -inicialmente, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cierre I-PRESENT_ILLNESS -intestinal I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -últimas I-PRESENT_ILLNESS -horas. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración, I-EXPLORATION -abdomen I-EXPLORATION -distendido I-EXPLORATION -y I-EXPLORATION -doloroso, I-EXPLORATION -con I-EXPLORATION -ruidos I-EXPLORATION -hidroaéreos I-EXPLORATION -ausentes. I-EXPLORATION -Ileostomía I-EXPLORATION -terminal I-EXPLORATION -iliaca I-EXPLORATION -derecha I-EXPLORATION -con I-EXPLORATION -escaso I-EXPLORATION -débito I-EXPLORATION -y I-EXPLORATION -hernia I-EXPLORATION -paraileostómica I-EXPLORATION -no I-EXPLORATION -reductible. I-EXPLORATION -Analíticamente, I-EXPLORATION -presentaba I-EXPLORATION -hemograma I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -bioquímica I-EXPLORATION -con I-EXPLORATION -glucosa I-EXPLORATION -388 I-EXPLORATION -mg/dl, I-EXPLORATION -urea I-EXPLORATION -98 I-EXPLORATION -mg/dl, I-EXPLORATION -GOT I-EXPLORATION -50 I-EXPLORATION -U/l, I-EXPLORATION -GPT I-EXPLORATION -52 I-EXPLORATION -U/l, I-EXPLORATION -LDH I-EXPLORATION -556 I-EXPLORATION -U/l, I-EXPLORATION -GGT I-EXPLORATION -159 I-EXPLORATION -U/l, I-EXPLORATION -CK I-EXPLORATION -41 I-EXPLORATION -U/l, I-EXPLORATION -TG I-EXPLORATION -358 I-EXPLORATION -mg/dl, I-EXPLORATION -PT I-EXPLORATION -5, I-EXPLORATION -2 I-EXPLORATION -g/l I-EXPLORATION -y I-EXPLORATION -PCR I-EXPLORATION -63 I-EXPLORATION -mg/l. I-EXPLORATION -La I-EXPLORATION -gasometría I-EXPLORATION -venosa, I-EXPLORATION -ionograma I-EXPLORATION -y I-EXPLORATION -coagulación I-EXPLORATION -eran I-EXPLORATION -normales I-EXPLORATION -con I-EXPLORATION -fibrinógeno I-EXPLORATION -de I-EXPLORATION -891 I-EXPLORATION -mg/dl. I-EXPLORATION -La I-EXPLORATION -radiología I-EXPLORATION -simple I-EXPLORATION -y I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -eran I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -oclusión I-EXPLORATION -intestinal. I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -falta I-TREATMENT -de I-TREATMENT -respuesta I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -médico, I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -de I-TREATMENT -la I-TREATMENT -hernia I-TREATMENT -paraileostómica I-TREATMENT -presentando B-EVOLUTION -posteriormente I-EVOLUTION -empeoramiento I-EVOLUTION -del I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -sepsis I-EVOLUTION -y I-EVOLUTION -celulitis I-EVOLUTION -de I-EVOLUTION -piel I-EVOLUTION -y I-EVOLUTION -tejido I-EVOLUTION -celular I-EVOLUTION -subcutáneo I-EVOLUTION -abdominal I-EVOLUTION -circundante I-EVOLUTION -al I-EVOLUTION -ostoma, I-EVOLUTION -reinterviniéndose B-TREATMENT -en I-TREATMENT -otras I-TREATMENT -2 I-TREATMENT -ocasiones, I-TREATMENT -con I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -50 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -intestino I-TREATMENT -delgado I-TREATMENT -cada I-TREATMENT -una, I-TREATMENT -presentando I-TREATMENT -ulceraciones I-TREATMENT -profundas, I-TREATMENT -perforaciones I-TREATMENT -y I-TREATMENT -pequeños I-TREATMENT -abscesos I-TREATMENT -adyacentes I-TREATMENT -al I-TREATMENT -ostoma. I-TREATMENT -Durante B-EVOLUTION -el I-EVOLUTION -postoperatorio, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -comienza I-EVOLUTION -con I-EVOLUTION -sangrado I-EVOLUTION -difuso I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -orificio I-EVOLUTION -de I-EVOLUTION -ileostomía I-EVOLUTION -y I-EVOLUTION -necrosis I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -últimos I-EVOLUTION -centímetros I-EVOLUTION -de I-EVOLUTION -esta. I-EVOLUTION -La B-EXPLORATION -endoscopia I-EXPLORATION -alta, I-EXPLORATION -hasta I-EXPLORATION -segunda I-EXPLORATION -porción I-EXPLORATION -duodenal I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -Ante I-EXPLORATION -estos I-EXPLORATION -hallazgos, I-EXPLORATION -se I-EXPLORATION -procede I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -reapertura I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -herida I-EXPLORATION -quirúrgica, I-EXPLORATION -apreciándose I-EXPLORATION -necrosis I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -últimos I-EXPLORATION -centímetros I-EXPLORATION -del I-EXPLORATION -asa I-EXPLORATION -de I-EXPLORATION -ileostomía, I-EXPLORATION -sangrado I-EXPLORATION -activo I-EXPLORATION -de I-EXPLORATION -ulceraciones I-EXPLORATION -profundas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -y I-EXPLORATION -perforaciones I-EXPLORATION -cubiertas I-EXPLORATION -con I-EXPLORATION -coágulos I-EXPLORATION -intraluminales, I-EXPLORATION -resecándose I-EXPLORATION -nuevamente I-EXPLORATION -50 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -afectado. I-EXPLORATION -La I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -resulta I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Crohn. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -continuó I-EVOLUTION -con I-EVOLUTION -hemorragia I-EVOLUTION -digestiva I-EVOLUTION -persistente I-EVOLUTION -y I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -inestabilidad I-EVOLUTION -hemodinámica, I-EVOLUTION -requiriendo B-TREATMENT -transfusión I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -concentrados I-TREATMENT -de I-TREATMENT -hematíes I-TREATMENT -y I-TREATMENT -2 I-TREATMENT -de I-TREATMENT -fibrinógeno, I-TREATMENT -sin I-TREATMENT -respuesta I-TREATMENT -a I-TREATMENT -corticoterapia I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -plenas, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -infliximab I-TREATMENT -previa I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -placa I-TREATMENT -de I-TREATMENT -tórax, I-TREATMENT -mantoux I-TREATMENT -negativo I-TREATMENT -y I-TREATMENT -TAC I-TREATMENT -toracoabdominal I-TREATMENT -que I-TREATMENT -descartó I-TREATMENT -procesos I-TREATMENT -infecciosos. I-TREATMENT -Cinco B-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -primera I-EVOLUTION -dosis I-EVOLUTION -de I-EVOLUTION -infliximab, I-EVOLUTION -el I-EVOLUTION -sangrado I-EVOLUTION -remite I-EVOLUTION -y I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomático, I-EVOLUTION -con I-EVOLUTION -terapia I-EVOLUTION -de I-EVOLUTION -mantenimiento I-EVOLUTION -con I-EVOLUTION -infliximab I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -enteroscopia I-EVOLUTION -de I-EVOLUTION -control, I-EVOLUTION -se I-EVOLUTION -observa I-EVOLUTION -mucosa I-EVOLUTION -intestinal I-EVOLUTION -sin I-EVOLUTION -ulceraciones. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -colecistectomía I-PAST_MEDICAL_HISTORY -abierta I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -cólico I-PRESENT_ILLNESS -intermitente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -epigastrio I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -biliosos, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -consultado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -diversas I-PRESENT_ILLNESS -ocasiones I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -atención I-PRESENT_ILLNESS -primaria I-PRESENT_ILLNESS -realizándose I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -sintomático I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -omeprazol. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física, I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -afebril, I-EXPLORATION -hemodinámicamente I-EXPLORATION -estable I-EXPLORATION -con I-EXPLORATION -leve I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -profunda I-EXPLORATION -en I-EXPLORATION -hipocondrio I-EXPLORATION -derecho, I-EXPLORATION -sin I-EXPLORATION -datos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -no I-EXPLORATION -mostraba I-EXPLORATION -alteraciones. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -y, I-EXPLORATION -posteriormente, I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -revelaba I-EXPLORATION -una I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -hepática I-EXPLORATION -propia I-EXPLORATION -próxima I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -bifurcación I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -pseudoaneurisma, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -luz I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -componente I-EXPLORATION -mural I-EXPLORATION -trombosado I-EXPLORATION -de I-EXPLORATION -4, I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION -que I-EXPLORATION -condicionaba I-EXPLORATION -una I-EXPLORATION -compresión I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -con I-EXPLORATION -dilatación I-EXPLORATION -secundaria. I-EXPLORATION -Al I-EXPLORATION -día I-EXPLORATION -siguiente I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -por I-EXPLORATION -vía I-EXPLORATION -femoral I-EXPLORATION -derecha I-EXPLORATION -una I-EXPLORATION -arteriografía I-EXPLORATION -selectiva I-EXPLORATION -del I-EXPLORATION -tronco I-EXPLORATION -celiaco, I-EXPLORATION -arteria I-EXPLORATION -hepática I-EXPLORATION -común I-EXPLORATION -y I-EXPLORATION -mesentérica I-EXPLORATION -superior I-EXPLORATION -objetivando I-EXPLORATION -un I-EXPLORATION -aneurisma I-EXPLORATION -sacular I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -bifurcación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -hepática I-EXPLORATION -propia, I-EXPLORATION -con I-EXPLORATION -vascularización I-EXPLORATION -distal I-EXPLORATION -intrahepática I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -relleno I-EXPLORATION -retrógrado I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arcada I-EXPLORATION -pancreatoduodenal. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -una I-TREATMENT -prótesis I-TREATMENT -metálica I-TREATMENT -autoexpandible I-TREATMENT -y I-TREATMENT -embolización I-TREATMENT -del I-TREATMENT -pseudoaneurisma I-TREATMENT -mediante I-TREATMENT -coils I-TREATMENT -con I-TREATMENT -una I-TREATMENT -oclusión I-TREATMENT -efectiva I-TREATMENT -y I-TREATMENT -sin I-TREATMENT -complicaciones I-TREATMENT -en I-TREATMENT -el I-TREATMENT -control. I-TREATMENT -Al B-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -estancia I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Reanimación, I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -e I-EVOLUTION -hipotensión I-EVOLUTION -brusca I-EVOLUTION -secundaria I-EVOLUTION -a I-EVOLUTION -rotura I-EVOLUTION -del I-EVOLUTION -aneurisma I-EVOLUTION -hacia I-EVOLUTION -la I-EVOLUTION -cavidad I-EVOLUTION -peritoneal I-EVOLUTION -falleciendo I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -durante I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -quirúrgica. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -62 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -constitucional. I-PRESENT_ILLNESS -Antecedentes B-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hiperuricemia I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -metformina I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -alopurinol. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -apetito I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hipercalcemia. I-PRESENT_ILLNESS -En B-EXPLORATION -analítica I-EXPLORATION -destaca: I-EXPLORATION -Hb I-EXPLORATION -9, I-EXPLORATION -9 I-EXPLORATION -mg/dl, I-EXPLORATION -eosinófilos I-EXPLORATION -7, I-EXPLORATION -5%, I-EXPLORATION -GGT I-EXPLORATION -225 I-EXPLORATION -U/l, I-EXPLORATION -calcio I-EXPLORATION -11, I-EXPLORATION -8 I-EXPLORATION -mg/dl, I-EXPLORATION -proteínas I-EXPLORATION -totales I-EXPLORATION -7, I-EXPLORATION -2 I-EXPLORATION -g/dl, I-EXPLORATION -creatinina I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -mg/dl. I-EXPLORATION -ECA I-EXPLORATION -134.8. I-EXPLORATION -Resto I-EXPLORATION -normal. I-EXPLORATION -Anticuerpos I-EXPLORATION -antinucleares I-EXPLORATION -negativos. I-EXPLORATION -Serología I-EXPLORATION -hepatitis, I-EXPLORATION -CMV, I-EXPLORATION -VEB, I-EXPLORATION -toxoplasma, I-EXPLORATION -Aspergillus I-EXPLORATION -fumigatus, I-EXPLORATION -Brucella, I-EXPLORATION -Candida I-EXPLORATION -negativos; I-EXPLORATION -VEB I-EXPLORATION -Ig I-EXPLORATION -G I-EXPLORATION -positivo, I-EXPLORATION -Coxiella I-EXPLORATION -Ig I-EXPLORATION -G I-EXPLORATION -positivo I-EXPLORATION -1/80, I-EXPLORATION -Ig I-EXPLORATION -M I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -Endoscopia I-EXPLORATION -alta, I-EXPLORATION -colonoscopia, I-EXPLORATION -broncoscopia, I-EXPLORATION -gammagrafía, I-EXPLORATION -proteinograma I-EXPLORATION -y I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -médula I-EXPLORATION -ósea I-EXPLORATION -normales. I-EXPLORATION -En I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -toraco-abdominal I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -hepatopatía I-EXPLORATION -difusa I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -hipertensión I-EXPLORATION -portal. I-EXPLORATION -Tras B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -furosemida I-TREATMENT -y I-TREATMENT -sueroterapia I-TREATMENT -presenta I-TREATMENT -inicialmente I-TREATMENT -empeoramiento I-TREATMENT -de I-TREATMENT -las I-TREATMENT -cifras I-TREATMENT -de I-TREATMENT -calcemia I-TREATMENT -hasta I-TREATMENT -14, I-TREATMENT -7 I-TREATMENT -mg/dl. I-TREATMENT -Se B-EXPLORATION -realiza I-EXPLORATION -biopsia I-EXPLORATION -hepática I-EXPLORATION -objetivándose I-EXPLORATION -granulomas I-EXPLORATION -no I-EXPLORATION -necrotizantes I-EXPLORATION -con I-EXPLORATION -células I-EXPLORATION -epiteliodes I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -acompaña I-EXPLORATION -de I-EXPLORATION -fibrosis. I-EXPLORATION -Está I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -epiteliodes, I-EXPLORATION -gigantes I-EXPLORATION -multinucleadas I-EXPLORATION -(algunas I-EXPLORATION -microvacuoladas) I-EXPLORATION -con I-EXPLORATION -componente I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -plasmáticas, I-EXPLORATION -mononucleares I-EXPLORATION -y I-EXPLORATION -polimorfonucleares. I-EXPLORATION -La I-EXPLORATION -inflamación I-EXPLORATION -sobrepasa I-EXPLORATION -la I-EXPLORATION -limitante I-EXPLORATION -portal, I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -esteatosis I-EXPLORATION -macrovesicular, I-EXPLORATION -neutrófilos I-EXPLORATION -y I-EXPLORATION -eosinófilos. I-EXPLORATION -Tinciones I-EXPLORATION -para I-EXPLORATION -hongos I-EXPLORATION -y I-EXPLORATION -Ziehl I-EXPLORATION -negativa. I-EXPLORATION -Dado B-TREATMENT -que I-TREATMENT -el I-TREATMENT -cuadro I-TREATMENT -clínico I-TREATMENT -era I-TREATMENT -compatible I-TREATMENT -con I-TREATMENT -granulomas I-TREATMENT -secundarios I-TREATMENT -a I-TREATMENT -fármacos, I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -retirada I-TREATMENT -del I-TREATMENT -alopurinol I-TREATMENT -y I-TREATMENT -de I-TREATMENT -la I-TREATMENT -furosemida. I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -3 I-EVOLUTION -semanas I-EVOLUTION -persistía I-EVOLUTION -hipercalcemia I-EVOLUTION -leve I-EVOLUTION -(10, I-EVOLUTION -7 I-EVOLUTION -mg/dl) I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -pauta I-TREATMENT -corta I-TREATMENT -de I-TREATMENT -corticoides, I-TREATMENT -normalizándose I-TREATMENT -la I-TREATMENT -calcemia I-TREATMENT -y I-TREATMENT -las I-TREATMENT -enzimas I-TREATMENT -hepáticas I-TREATMENT -a I-TREATMENT -los I-TREATMENT -2 I-TREATMENT -meses. I-TREATMENT -La B-EVOLUTION -ecografía I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -4 I-EVOLUTION -meses I-EVOLUTION -fue I-EVOLUTION -normal. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -80 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Antecedentes B-FAMILY_HISTORY -familiares: I-FAMILY_HISTORY -padres I-FAMILY_HISTORY -y I-FAMILY_HISTORY -ocho I-FAMILY_HISTORY -hermanos I-FAMILY_HISTORY -fallecidos I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -patología I-FAMILY_HISTORY -digestiva I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés. I-FAMILY_HISTORY -Antecedentes B-PAST_MEDICAL_HISTORY -personales: I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -alergias, I-PAST_MEDICAL_HISTORY -hábito I-PAST_MEDICAL_HISTORY -tabáquico I-PAST_MEDICAL_HISTORY -(60 I-PAST_MEDICAL_HISTORY -cigarrillos/día) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -etílico I-PAST_MEDICAL_HISTORY -(80 I-PAST_MEDICAL_HISTORY -g/día) I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -25 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -apendicectomizado, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -obstructiva I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -enfisematosa, I-PAST_MEDICAL_HISTORY -hipertrofia I-PAST_MEDICAL_HISTORY -benigna I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -próstata I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -artrosis I-PAST_MEDICAL_HISTORY -generalizada. I-PAST_MEDICAL_HISTORY -Diagnosticado I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -diverticular I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -colon I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -enema I-PAST_MEDICAL_HISTORY -opaco, I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -referir I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -hipogástrico. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -practicó I-PAST_MEDICAL_HISTORY -colonoscopia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -analítica I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -detectaron I-PAST_MEDICAL_HISTORY -alteraciones I-PAST_MEDICAL_HISTORY -significativas, I-PAST_MEDICAL_HISTORY -siendo I-PAST_MEDICAL_HISTORY -entonces I-PAST_MEDICAL_HISTORY -normal I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cifra I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -proteínas I-PAST_MEDICAL_HISTORY -totales. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -habitual I-PAST_MEDICAL_HISTORY -con: I-PAST_MEDICAL_HISTORY -tamsulosina, I-PAST_MEDICAL_HISTORY -tartrato I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -zolpidem, I-PAST_MEDICAL_HISTORY -biotina, I-PAST_MEDICAL_HISTORY -candesartán, I-PAST_MEDICAL_HISTORY -fumarato I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -formoterol, I-PAST_MEDICAL_HISTORY -bromuro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ipratropio I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -budesonida I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -inhalatoria. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -ingesta I-PAST_MEDICAL_HISTORY -habitual I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -antiinflamatorios I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -esteroideos I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -antibióticos. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -mes, I-PAST_MEDICAL_HISTORY -dada I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diarrea, I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -loperamida I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ciprofloxacino, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -observarse I-PAST_MEDICAL_HISTORY -mejoría. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -- I-PAST_MEDICAL_HISTORY -Enfermedad B-PRESENT_ILLNESS -actual: I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -progresiva: I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -anorexia, I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -(10 I-PRESENT_ILLNESS -kg), I-PRESENT_ILLNESS -numerosas I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -precedidas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -hipogástrico, I-PRESENT_ILLNESS -diurnas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -nocturnas, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -consistencia I-PRESENT_ILLNESS -blanda I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -líquida, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -contenido I-PRESENT_ILLNESS -hemático I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -abundante I-PRESENT_ILLNESS -mucosidad. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -vómitos, I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -otros I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -interés. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -- B-EXPLORATION -Exploración I-EXPLORATION -física: I-EXPLORATION -deterioro I-EXPLORATION -físico I-EXPLORATION -atribuible I-EXPLORATION -a I-EXPLORATION -edad I-EXPLORATION -avanzada I-EXPLORATION -y I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -muscular. I-EXPLORATION -Talla I-EXPLORATION -164 I-EXPLORATION -cm. I-EXPLORATION -Peso I-EXPLORATION -67 I-EXPLORATION -kg. I-EXPLORATION -Necesitaba I-EXPLORATION -ayuda I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -deambulación. I-EXPLORATION -Ausencia I-EXPLORATION -de I-EXPLORATION -ictericia I-EXPLORATION -o I-EXPLORATION -de I-EXPLORATION -palidez I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -mucosas. I-EXPLORATION -Presencia I-EXPLORATION -de I-EXPLORATION -máculas I-EXPLORATION -hiperpigmentadas I-EXPLORATION -en I-EXPLORATION -miembros I-EXPLORATION -superiores. I-EXPLORATION -Escaso I-EXPLORATION -vello I-EXPLORATION -corporal. I-EXPLORATION -No I-EXPLORATION -adenopatías I-EXPLORATION -periféricas. I-EXPLORATION -Auscultación I-EXPLORATION -cardiaca I-EXPLORATION -normal. I-EXPLORATION -Frecuencia I-EXPLORATION -cardiaca: I-EXPLORATION -80 I-EXPLORATION -sístoles/minuto. I-EXPLORATION -Tensión I-EXPLORATION -arterial: I-EXPLORATION -150/90 I-EXPLORATION -mmHg. I-EXPLORATION -Auscultación I-EXPLORATION -respiratoria: I-EXPLORATION -disminución I-EXPLORATION -difusa I-EXPLORATION -del I-EXPLORATION -murmullo I-EXPLORATION -vesicular I-EXPLORATION -con I-EXPLORATION -escasos I-EXPLORATION -roncus I-EXPLORATION -y I-EXPLORATION -sibilantes. I-EXPLORATION -Abdomen I-EXPLORATION -con I-EXPLORATION -auscultación I-EXPLORATION -normal, I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -hipogastrio I-EXPLORATION -y I-EXPLORATION -ambas I-EXPLORATION -fosas I-EXPLORATION -iliacas, I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -masas I-EXPLORATION -o I-EXPLORATION -visceromegalias. I-EXPLORATION -Atrofia I-EXPLORATION -muscular I-EXPLORATION -en I-EXPLORATION -extremidades, I-EXPLORATION -pulsos I-EXPLORATION -normales I-EXPLORATION -y I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -edemas. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Analítica: I-EXPLORATION -las I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -hematocrito, I-EXPLORATION -hemoglobina, I-EXPLORATION -volumen I-EXPLORATION -corpuscular I-EXPLORATION -medio, I-EXPLORATION -plaquetas, I-EXPLORATION -glucosa, I-EXPLORATION -urea, I-EXPLORATION -sodio, I-EXPLORATION -creatinina, I-EXPLORATION -bilirrubina, I-EXPLORATION -transaminasas, I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina, I-EXPLORATION -colesterol, I-EXPLORATION -triglicéridos, I-EXPLORATION -ácido I-EXPLORATION -fólico, I-EXPLORATION -ferritina I-EXPLORATION -y I-EXPLORATION -vitamina I-EXPLORATION -B12 I-EXPLORATION -se I-EXPLORATION -mantuvieron I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -rango I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION -Elevación I-EXPLORATION -progresiva I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -leucocitos I-EXPLORATION -(13.900- I-EXPLORATION -30.900, I-EXPLORATION -normal I-EXPLORATION -4.600-10.200/mm3), I-EXPLORATION -con I-EXPLORATION -neutrofilia I-EXPLORATION -(70-90%), I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -(16, I-EXPLORATION -9-93, I-EXPLORATION -4, I-EXPLORATION -normal I-EXPLORATION -0-5 I-EXPLORATION -mg/l); I-EXPLORATION -descenso I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -proteínas I-EXPLORATION -totales I-EXPLORATION -(4, I-EXPLORATION -4-5, I-EXPLORATION -3, I-EXPLORATION -normal I-EXPLORATION -6, I-EXPLORATION -6-8, I-EXPLORATION -7 I-EXPLORATION -g/dl), I-EXPLORATION -calcio I-EXPLORATION -(4, I-EXPLORATION -7-7, I-EXPLORATION -0, I-EXPLORATION -normal I-EXPLORATION -8, I-EXPLORATION -5-10, I-EXPLORATION -5 I-EXPLORATION -mg/dl) I-EXPLORATION -y I-EXPLORATION -colinesterasa I-EXPLORATION -(1.557-2.591, I-EXPLORATION -normal I-EXPLORATION -5.300-12.900 I-EXPLORATION -U/l). I-EXPLORATION -Estudio I-EXPLORATION -de I-EXPLORATION -coagulación I-EXPLORATION -normal. I-EXPLORATION -Proteinograma: I-EXPLORATION -hipoalbuminemia I-EXPLORATION -(2, I-EXPLORATION -49, I-EXPLORATION -normal I-EXPLORATION -4, I-EXPLORATION -0-4, I-EXPLORATION -7 I-EXPLORATION -g/dl) I-EXPLORATION -e I-EXPLORATION -hipogammaglobulinemia I-EXPLORATION -(0, I-EXPLORATION -39, I-EXPLORATION -normal I-EXPLORATION -0, I-EXPLORATION -80-1, I-EXPLORATION -35 I-EXPLORATION -g/dl), I-EXPLORATION -con I-EXPLORATION -proteínas I-EXPLORATION -totales I-EXPLORATION -4, I-EXPLORATION -7 I-EXPLORATION -g/dl. I-EXPLORATION -Las I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -potasio, I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -anodinas I-EXPLORATION -durante I-EXPLORATION -las I-EXPLORATION -primeras I-EXPLORATION -semanas I-EXPLORATION -del I-EXPLORATION -ingreso, I-EXPLORATION -alcanzaron I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -3-1, I-EXPLORATION -9, I-EXPLORATION -normal I-EXPLORATION -3, I-EXPLORATION -5-5 I-EXPLORATION -mEq/l). I-EXPLORATION -Elevación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -gastrina I-EXPLORATION -(263, I-EXPLORATION -normal I-EXPLORATION -13-115 I-EXPLORATION -pg/ml) I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -tirotropina I-EXPLORATION -(TSH) I-EXPLORATION -(33, I-EXPLORATION -9-17, I-EXPLORATION -3, I-EXPLORATION -normal I-EXPLORATION -0, I-EXPLORATION -12-5 I-EXPLORATION -uU/ml), I-EXPLORATION -descenso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tiroxina I-EXPLORATION -(T4) I-EXPLORATION -(0, I-EXPLORATION -56-0, I-EXPLORATION -27, I-EXPLORATION -normal I-EXPLORATION -0, I-EXPLORATION -8-1, I-EXPLORATION -8 I-EXPLORATION -ng/dl) I-EXPLORATION -y I-EXPLORATION -normalidad I-EXPLORATION -de I-EXPLORATION -cortisol I-EXPLORATION -sérico. I-EXPLORATION -Las I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -TSH I-EXPLORATION -y I-EXPLORATION -T4 I-EXPLORATION -eran I-EXPLORATION -normales I-EXPLORATION -al I-EXPLORATION -ingreso. I-EXPLORATION -Anticuerpos I-EXPLORATION -anti-peroxidasa I-EXPLORATION -tiroidea, I-EXPLORATION -anti-tiroglobulina, I-EXPLORATION -antinucleares I-EXPLORATION -y I-EXPLORATION -anti-transglutaminasa I-EXPLORATION -negativos. I-EXPLORATION -Sedimento I-EXPLORATION -urinario I-EXPLORATION -normal. I-EXPLORATION -Elevación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -antígeno I-EXPLORATION -carcinoembrionario I-EXPLORATION -(28, I-EXPLORATION -5-88, I-EXPLORATION -1, I-EXPLORATION -normal I-EXPLORATION -0-5 I-EXPLORATION -ng/ml) I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -antígeno I-EXPLORATION -CA I-EXPLORATION -19., I-EXPLORATION -9 I-EXPLORATION -(57, I-EXPLORATION -8, I-EXPLORATION -normal I-EXPLORATION -0-37 I-EXPLORATION -U/ml); I-EXPLORATION -las I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -antígeno I-EXPLORATION -específico I-EXPLORATION -prostático, I-EXPLORATION -alfa-fetoproteína I-EXPLORATION -y I-EXPLORATION -antígeno I-EXPLORATION -CA I-EXPLORATION -125 I-EXPLORATION -resultaron I-EXPLORATION -normales. I-EXPLORATION -Cuantificación I-EXPLORATION -de I-EXPLORATION -grasas I-EXPLORATION -en I-EXPLORATION -heces I-EXPLORATION -no I-EXPLORATION -valorable. I-EXPLORATION -Microbiología: I-EXPLORATION -negatividad I-EXPLORATION -de I-EXPLORATION -coprocultivos, I-EXPLORATION -urocultivos, I-EXPLORATION -parásitos I-EXPLORATION -en I-EXPLORATION -heces, I-EXPLORATION -toxina I-EXPLORATION -de I-EXPLORATION -Clostridium I-EXPLORATION -difficile, I-EXPLORATION -Mantoux I-EXPLORATION -y I-EXPLORATION -serología I-EXPLORATION -a I-EXPLORATION -Helicobacter I-EXPLORATION -pylori, I-EXPLORATION -VIH, I-EXPLORATION -citomegalovirus, I-EXPLORATION -Salmonella I-EXPLORATION -y I-EXPLORATION -Yersinia I-EXPLORATION -enterocolítica. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Exploraciones I-EXPLORATION -complementarias: I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Colonoscopia I-EXPLORATION -(practicada I-EXPLORATION -en I-EXPLORATION -dos I-EXPLORATION -ocasiones): I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -difusa, I-EXPLORATION -principalmente I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -unión I-EXPLORATION -rectosigmoidea I-EXPLORATION -y I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -válvula I-EXPLORATION -ileocecal, I-EXPLORATION -numerosas I-EXPLORATION -lesiones I-EXPLORATION -nodulares I-EXPLORATION -o I-EXPLORATION -polipoides I-EXPLORATION -sésiles, I-EXPLORATION -de I-EXPLORATION -variable I-EXPLORATION -tamaño, I-EXPLORATION -llegando I-EXPLORATION -en I-EXPLORATION -algunos I-EXPLORATION -tramos I-EXPLORATION -a I-EXPLORATION -ocupar I-EXPLORATION -casi I-EXPLORATION -la I-EXPLORATION -totalidad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -del I-EXPLORATION -colon, I-EXPLORATION -dificultando I-EXPLORATION -el I-EXPLORATION -paso I-EXPLORATION -del I-EXPLORATION -endoscopio. I-EXPLORATION -Las I-EXPLORATION -lesiones I-EXPLORATION -muestran I-EXPLORATION -una I-EXPLORATION -superficie I-EXPLORATION -enrojecida I-EXPLORATION -con I-EXPLORATION -lesiones I-EXPLORATION -petequiales I-EXPLORATION -y I-EXPLORATION -equimóticas. I-EXPLORATION -Se I-EXPLORATION -obtuvieron I-EXPLORATION -biopsias I-EXPLORATION -a I-EXPLORATION -distintos I-EXPLORATION -niveles I-EXPLORATION -y, I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -exploración, I-EXPLORATION -una I-EXPLORATION -macrobiopsia I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -rectal I-EXPLORATION -con I-EXPLORATION -asa I-EXPLORATION -de I-EXPLORATION -polipectomía. I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Gastroscopia: I-EXPLORATION -esófago, I-EXPLORATION -fundus I-EXPLORATION -y I-EXPLORATION -cuerpo I-EXPLORATION -gástrico I-EXPLORATION -normales. I-EXPLORATION -La I-EXPLORATION -mucosa I-EXPLORATION -de I-EXPLORATION -antro I-EXPLORATION -gástrico, I-EXPLORATION -sobre I-EXPLORATION -todo I-EXPLORATION -prepilórico, I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -duodenal I-EXPLORATION -mostraban, I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -difusa, I-EXPLORATION -nódulos I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -tamaño. I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Radiología I-EXPLORATION -del I-EXPLORATION -tórax: I-EXPLORATION -bullas I-EXPLORATION -enfisematosas I-EXPLORATION -en I-EXPLORATION -base I-EXPLORATION -pulmonar I-EXPLORATION -derecha. I-EXPLORATION -No I-EXPLORATION -derrame I-EXPLORATION -pleural. I-EXPLORATION -Sospecha I-EXPLORATION -de I-EXPLORATION -leve I-EXPLORATION -derrame I-EXPLORATION -pericárdico. I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Radiología I-EXPLORATION -baritada I-EXPLORATION -de I-EXPLORATION -esófago, I-EXPLORATION -estómago I-EXPLORATION -e I-EXPLORATION -intestino I-EXPLORATION -delgado: I-EXPLORATION -pliegues I-EXPLORATION -gástricos I-EXPLORATION -antrales I-EXPLORATION -engrosados, I-EXPLORATION -irregulares I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -defectos I-EXPLORATION -de I-EXPLORATION -repleción. I-EXPLORATION -Engrosamiento I-EXPLORATION -de I-EXPLORATION -pliegues I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado, I-EXPLORATION -con I-EXPLORATION -patrón I-EXPLORATION -nodular, I-EXPLORATION -sobre I-EXPLORATION -todo I-EXPLORATION -en I-EXPLORATION -yeyuno, I-EXPLORATION -y I-EXPLORATION -dilución I-EXPLORATION -del I-EXPLORATION -contraste. I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Enema I-EXPLORATION -opaco: I-EXPLORATION -divertículos I-EXPLORATION -en I-EXPLORATION -colon I-EXPLORATION -sigmoideo I-EXPLORATION -y I-EXPLORATION -descendente. I-EXPLORATION -Múltiples I-EXPLORATION -defectos I-EXPLORATION -de I-EXPLORATION -repleción I-EXPLORATION -en I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -extensión I-EXPLORATION -del I-EXPLORATION -colon. I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Tomografía I-EXPLORATION -computarizada I-EXPLORATION -abdominal: I-EXPLORATION -quistes I-EXPLORATION -en I-EXPLORATION -riñón I-EXPLORATION -izquierdo. I-EXPLORATION -Probable I-EXPLORATION -adenoma I-EXPLORATION -suprarrenal I-EXPLORATION -derecho. I-EXPLORATION -Divertículos I-EXPLORATION -en I-EXPLORATION -colon I-EXPLORATION -descendente I-EXPLORATION -y I-EXPLORATION -sigmoides. I-EXPLORATION -Engrosamiento I-EXPLORATION -difuso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -del I-EXPLORATION -colon. I-EXPLORATION -Hipertrofia I-EXPLORATION -prostática. I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Ecografía I-EXPLORATION -tiroidea: I-EXPLORATION -tiroides I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -normal. I-EXPLORATION -Pequeños I-EXPLORATION -quistes I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -derecho. I-EXPLORATION -Lóbulo I-EXPLORATION -izquierdo I-EXPLORATION -con I-EXPLORATION -ecogenicidad I-EXPLORATION -homogénea I-EXPLORATION -y I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Ecocardiograma I-EXPLORATION -transtorácico: I-EXPLORATION -no I-EXPLORATION -derrame I-EXPLORATION -pericárdico, I-EXPLORATION -función I-EXPLORATION -sistólica I-EXPLORATION -conservada, I-EXPLORATION -insuficiencia I-EXPLORATION -valvular I-EXPLORATION -mitral I-EXPLORATION -y I-EXPLORATION -aórtica. I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Histología I-EXPLORATION -de I-EXPLORATION -biopsias I-EXPLORATION -de I-EXPLORATION -colon I-EXPLORATION -y I-EXPLORATION -macrobiopsia I-EXPLORATION -rectal: I-EXPLORATION -mucosa I-EXPLORATION -con I-EXPLORATION -distorsión I-EXPLORATION -intensa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arquitectura I-EXPLORATION -glandular, I-EXPLORATION -dilataciones I-EXPLORATION -glandulares I-EXPLORATION -microquísticas I-EXPLORATION -y I-EXPLORATION -colecciones I-EXPLORATION -de I-EXPLORATION -mucina, I-EXPLORATION -lámina I-EXPLORATION -propia I-EXPLORATION -edematosa I-EXPLORATION -con I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -moderado I-EXPLORATION -a I-EXPLORATION -severo I-EXPLORATION -con I-EXPLORATION -abundantes I-EXPLORATION -células I-EXPLORATION -plasmáticas, I-EXPLORATION -neutrófilos I-EXPLORATION -y I-EXPLORATION -eosinófilos. I-EXPLORATION -Las I-EXPLORATION -alteraciones I-EXPLORATION -detectadas I-EXPLORATION -son I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -hamartomas I-EXPLORATION -de I-EXPLORATION -colon I-EXPLORATION -y I-EXPLORATION -recto. I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Histología I-EXPLORATION -de I-EXPLORATION -biopsias I-EXPLORATION -gástricas I-EXPLORATION -y I-EXPLORATION -duodenales: I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -dilataciones I-EXPLORATION -glandulares I-EXPLORATION -e I-EXPLORATION -intenso I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -mixto, I-EXPLORATION -siendo I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -hamartomas I-EXPLORATION -de I-EXPLORATION -estómago I-EXPLORATION -y I-EXPLORATION -duodeno. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Evolución B-EVOLUTION -clínica: I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -es I-EVOLUTION -diagnosticado I-EVOLUTION -de I-EVOLUTION -síndrome I-EVOLUTION -de I-EVOLUTION -Cronkhite-Canadá, I-EVOLUTION -falleciendo I-EVOLUTION -tras I-EVOLUTION -dos I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -ingreso I-EVOLUTION -hospitalario I-EVOLUTION -sin I-EVOLUTION -detectarse I-EVOLUTION -en I-EVOLUTION -ningún I-EVOLUTION -momento I-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -evidente I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -clínico I-EVOLUTION -inicial. I-EVOLUTION -Mantuvo I-EVOLUTION -el I-EVOLUTION -estado I-EVOLUTION -de I-EVOLUTION -astenia I-EVOLUTION -y I-EVOLUTION -anorexia, I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -número I-EVOLUTION -variable I-EVOLUTION -de I-EVOLUTION -deposiciones I-EVOLUTION -con I-EVOLUTION -abundante I-EVOLUTION -contenido I-EVOLUTION -mucoso, I-EVOLUTION -mayor I-EVOLUTION -pérdida I-EVOLUTION -de I-EVOLUTION -peso I-EVOLUTION -y I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -hipoproteinemia I-EVOLUTION -con I-EVOLUTION -edemas I-EVOLUTION -en I-EVOLUTION -miembros I-EVOLUTION -inferiores. I-EVOLUTION -Presencia I-EVOLUTION -de I-EVOLUTION -fiebre I-EVOLUTION -(38 I-EVOLUTION -oC) I-EVOLUTION -en I-EVOLUTION -días I-EVOLUTION -aislados I-EVOLUTION -con I-EVOLUTION -hemocultivos I-EVOLUTION -positivos I-EVOLUTION -a I-EVOLUTION -E. I-EVOLUTION -coli I-EVOLUTION -atribuible I-EVOLUTION -a I-EVOLUTION -flebitis I-EVOLUTION -e I-EVOLUTION -infecciones I-EVOLUTION -urinarias, I-EVOLUTION -un I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -tetania I-EVOLUTION -hipocalcémica, I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -miembros I-EVOLUTION -inferiores I-EVOLUTION -de I-EVOLUTION -probable I-EVOLUTION -origen I-EVOLUTION -neuropático I-EVOLUTION -y I-EVOLUTION -lesiones I-EVOLUTION -ungueales I-EVOLUTION -con I-EVOLUTION -onicólisis I-EVOLUTION -muy I-EVOLUTION -evidente. I-EVOLUTION -Es I-EVOLUTION -destacable I-EVOLUTION -el I-EVOLUTION -desarrollo I-EVOLUTION -de I-EVOLUTION -hipotiroidismo I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -elevación I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -cifras I-EVOLUTION -de I-EVOLUTION -antígeno I-EVOLUTION -carcinoembrionario. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -fallece I-EVOLUTION -tras I-EVOLUTION -presentar, I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -últimas I-EVOLUTION -24 I-EVOLUTION -horas, I-EVOLUTION -fiebre, I-EVOLUTION -tos I-EVOLUTION -con I-EVOLUTION -expectoración I-EVOLUTION -hemoptoica, I-EVOLUTION -disnea, I-EVOLUTION -datos I-EVOLUTION -de I-EVOLUTION -insuficiencia I-EVOLUTION -respiratoria I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -gasometría I-EVOLUTION -arterial I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -neumonía I-EVOLUTION -de I-EVOLUTION -base I-EVOLUTION -izquierda I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -radiología I-EVOLUTION -de I-EVOLUTION -tórax. I-EVOLUTION -Se B-EXPLORATION -practicó I-EXPLORATION -necropsia. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Tratamientos: B-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -durante I-TREATMENT -su I-TREATMENT -prolongada I-TREATMENT -estancia I-TREATMENT -hospitalaria I-TREATMENT -recibió I-TREATMENT -tratamiento, I-TREATMENT -no I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -simultánea, I-TREATMENT -con: I-TREATMENT -nutrición I-TREATMENT -enteral I-TREATMENT -oral I-TREATMENT -y I-TREATMENT -por I-TREATMENT -sonda, I-TREATMENT -sueroterapia I-TREATMENT -con I-TREATMENT -aporte I-TREATMENT -de I-TREATMENT -cloruro I-TREATMENT -potásico, I-TREATMENT -calcio I-TREATMENT -oral I-TREATMENT -y I-TREATMENT -sistémico, I-TREATMENT -albúmina I-TREATMENT -intravenosa, I-TREATMENT -omeprazol I-TREATMENT -20 I-TREATMENT -mg/día, I-TREATMENT -mesalazina, I-TREATMENT -complejos I-TREATMENT -vitamínicos, I-TREATMENT -loratadina I-TREATMENT -10 I-TREATMENT -mg/día, I-TREATMENT -corticoides I-TREATMENT -orales I-TREATMENT -y I-TREATMENT -sistémicos, I-TREATMENT -loperamida, I-TREATMENT -octeótrida I-TREATMENT -subcutánea I-TREATMENT -50 I-TREATMENT -mcg/8 I-TREATMENT -h, I-TREATMENT -gabapentina I-TREATMENT -300 I-TREATMENT -mg/8 I-TREATMENT -h, I-TREATMENT -antibióticos I-TREATMENT -(piperacilina-tazobactam, I-TREATMENT -amoxicilina-clavulámico, I-TREATMENT -metronidazol I-TREATMENT -y I-TREATMENT -ciprofloxacino), I-TREATMENT -levotiroxina I-TREATMENT -y I-TREATMENT -medicación I-TREATMENT -para I-TREATMENT -su I-TREATMENT -patología I-TREATMENT -previas: I-TREATMENT -hipertensión I-TREATMENT -arterial, I-TREATMENT -broncopatía I-TREATMENT -crónica I-TREATMENT -e I-TREATMENT -hipertrofia I-TREATMENT -prostática. I-TREATMENT - I-TREATMENT -- B-EXPLORATION -Informe I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -necropsia: I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -autópsicos I-EXPLORATION -resultan I-EXPLORATION -concordantes I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -Cronkhite-Canadá. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Examen I-EXPLORATION -externo: I-EXPLORATION -disminución I-EXPLORATION -del I-EXPLORATION -vello I-EXPLORATION -corporal I-EXPLORATION -y I-EXPLORATION -máculas I-EXPLORATION -de I-EXPLORATION -coloración I-EXPLORATION -pardo-oscuras I-EXPLORATION -en I-EXPLORATION -miembros I-EXPLORATION -superiores, I-EXPLORATION -especialmente I-EXPLORATION -en I-EXPLORATION -cara I-EXPLORATION -dorsal I-EXPLORATION -de I-EXPLORATION -mano I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -anterior I-EXPLORATION -de I-EXPLORATION -antebrazo I-EXPLORATION -izquierdo. I-EXPLORATION -Los I-EXPLORATION -dedos I-EXPLORATION -de I-EXPLORATION -ambas I-EXPLORATION -manos I-EXPLORATION -presentan I-EXPLORATION -onicólisis I-EXPLORATION -con I-EXPLORATION -coloración I-EXPLORATION -ungueal I-EXPLORATION -blanquecino-amarillenta. I-EXPLORATION -Hidrocele I-EXPLORATION -bilateral. I-EXPLORATION -Edemas I-EXPLORATION -en I-EXPLORATION -miembros I-EXPLORATION -inferiores. I-EXPLORATION - I-EXPLORATION --Examen I-EXPLORATION -interno: I-EXPLORATION -derrame I-EXPLORATION -pericárdico, I-EXPLORATION -pleural I-EXPLORATION -y I-EXPLORATION -peritoneal. I-EXPLORATION -Hipotrofia I-EXPLORATION -tiroides. I-EXPLORATION -Enfisema I-EXPLORATION -pulmonar I-EXPLORATION -y I-EXPLORATION -neumonía I-EXPLORATION -pulmón I-EXPLORATION -izquierdo. I-EXPLORATION -Hiperplasia I-EXPLORATION -nodular I-EXPLORATION -suprarrenal I-EXPLORATION -bilateral. I-EXPLORATION -Arterioesclerosis I-EXPLORATION -moderada. I-EXPLORATION -Adenocarcinoma I-EXPLORATION -de I-EXPLORATION -próstata I-EXPLORATION -localizado I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -lóbulos I-EXPLORATION -sin I-EXPLORATION -afectación I-EXPLORATION -extracapsular I-EXPLORATION -ni I-EXPLORATION -metástasica. I-EXPLORATION -Atrofia I-EXPLORATION -testicular. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -detectan I-EXPLORATION -alteraciones I-EXPLORATION -destacables I-EXPLORATION -en I-EXPLORATION -hígado, I-EXPLORATION -vías I-EXPLORATION -biliares I-EXPLORATION -o I-EXPLORATION -páncreas. I-EXPLORATION -Estudio I-EXPLORATION -del I-EXPLORATION -tubo I-EXPLORATION -digestivo: I-EXPLORATION -esófago I-EXPLORATION -sin I-EXPLORATION -datos I-EXPLORATION -de I-EXPLORATION -interés. I-EXPLORATION -El I-EXPLORATION -cuerpo I-EXPLORATION -gástrico I-EXPLORATION -muestra I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -pliegues. I-EXPLORATION -El I-EXPLORATION -antro I-EXPLORATION -gástrico I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -superficie I-EXPLORATION -rugosa, I-EXPLORATION -"en I-EXPLORATION -empedrado", I-EXPLORATION -con I-EXPLORATION -engrosamienro I-EXPLORATION -nodular I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -pliegues I-EXPLORATION -y I-EXPLORATION -equimosis I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -superficie, I-EXPLORATION -persistiendo I-EXPLORATION -estas I-EXPLORATION -alteraciones I-EXPLORATION -hasta I-EXPLORATION -segunda I-EXPLORATION -porción I-EXPLORATION -duodenal, I-EXPLORATION -donde I-EXPLORATION -es I-EXPLORATION -más I-EXPLORATION -evidente I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -pólipos I-EXPLORATION -sésiles. I-EXPLORATION -En I-EXPLORATION -yeyuno I-EXPLORATION -e I-EXPLORATION -íleon I-EXPLORATION -no I-EXPLORATION -aparecen I-EXPLORATION -alteraciones I-EXPLORATION -significativas. I-EXPLORATION -La I-EXPLORATION -mucosa I-EXPLORATION -del I-EXPLORATION -colon I-EXPLORATION -muestra, I-EXPLORATION -en I-EXPLORATION -toda I-EXPLORATION -su I-EXPLORATION -extensión, I-EXPLORATION -una I-EXPLORATION -morfología I-EXPLORATION -polipoidea, I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -prominencias I-EXPLORATION -sésiles, I-EXPLORATION -de I-EXPLORATION -superficie I-EXPLORATION -equimótica I-EXPLORATION -y I-EXPLORATION -aspecto I-EXPLORATION -friable. I-EXPLORATION -Las I-EXPLORATION -alteraciones I-EXPLORATION -son I-EXPLORATION -menos I-EXPLORATION -evidentes I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -colon I-EXPLORATION -derecho. I-EXPLORATION -Divertículos I-EXPLORATION -en I-EXPLORATION -colon I-EXPLORATION -izquierdo. I-EXPLORATION - I-EXPLORATION -Microscópicamente I-EXPLORATION -lo I-EXPLORATION -más I-EXPLORATION -llamativo I-EXPLORATION -era I-EXPLORATION -la I-EXPLORATION -afectación I-EXPLORATION -del I-EXPLORATION -antro, I-EXPLORATION -duodeno, I-EXPLORATION -colon I-EXPLORATION -y I-EXPLORATION -recto I-EXPLORATION -(en I-EXPLORATION -su I-EXPLORATION -totalidad), I-EXPLORATION -que I-EXPLORATION -mostraban I-EXPLORATION -una I-EXPLORATION -histopatología I-EXPLORATION -similar, I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -múltiples I-EXPLORATION -formaciones I-EXPLORATION -polipoides, I-EXPLORATION -algunos I-EXPLORATION -de I-EXPLORATION -ellos I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -hamartomatoso, I-EXPLORATION -con I-EXPLORATION -criptas I-EXPLORATION -dilatadas I-EXPLORATION -y I-EXPLORATION -quísticas I-EXPLORATION -que I-EXPLORATION -disminuyen I-EXPLORATION -en I-EXPLORATION -número I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -presentan I-EXPLORATION -hipersecreción I-EXPLORATION -de I-EXPLORATION -moco. I-EXPLORATION -En I-EXPLORATION -lámina I-EXPLORATION -propia I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -edema I-EXPLORATION -con I-EXPLORATION -hiperplasia I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -fibras I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -muscularis I-EXPLORATION -mucosa, I-EXPLORATION -e I-EXPLORATION -inflamación I-EXPLORATION -crónica I-EXPLORATION -leve-moderada. I-EXPLORATION -Existe I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -vellosidades I-EXPLORATION -intestinales I-EXPLORATION -tanto I-EXPLORATION -de I-EXPLORATION -duodeno I-EXPLORATION -como I-EXPLORATION -de I-EXPLORATION -colon, I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -pliegues I-EXPLORATION -gástricos I-EXPLORATION -de I-EXPLORATION -fondo I-EXPLORATION -y I-EXPLORATION -cuerpo. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -reconocen I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -displasia I-EXPLORATION -en I-EXPLORATION -ninguno I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -cortes I-EXPLORATION -examinados. I-EXPLORATION - I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -detectó I-EXPLORATION -justificación I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -antígeno I-EXPLORATION -carcinoembrionario. I-EXPLORATION - I-EXPLORATION -Causa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -muerte: I-EXPLORATION -malnutrición I-EXPLORATION -grave I-EXPLORATION -secundaria I-EXPLORATION -al I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -Cronkhite I-EXPLORATION -Canada. I-EXPLORATION -Neumonía I-EXPLORATION -en I-EXPLORATION -pulmón I-EXPLORATION -izquierdo. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -71 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -perímetro I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -molestias I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -ese I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Presentaba I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cantidad I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -consistencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sus I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -pero I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -frecuencia. I-PRESENT_ILLNESS -En B-FAMILY_HISTORY -sus I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -personales I-FAMILY_HISTORY -destacan: I-FAMILY_HISTORY -alergia I-FAMILY_HISTORY -a I-FAMILY_HISTORY -la I-FAMILY_HISTORY -penicilina, I-FAMILY_HISTORY -hipertensa, I-FAMILY_HISTORY -dislipémica I-FAMILY_HISTORY -y I-FAMILY_HISTORY -asma I-FAMILY_HISTORY -intrínseco. I-FAMILY_HISTORY - I-FAMILY_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destacaba I-EXPLORATION -gran I-EXPLORATION -tumoración I-EXPLORATION -abdominal I-EXPLORATION -palpable, I-EXPLORATION -dura I-EXPLORATION -y I-EXPLORATION -dolorosa. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION -abdómino-pélvica I-EXPLORATION -mostraban I-EXPLORATION -anejos I-EXPLORATION -normales, I-EXPLORATION -endometrio I-EXPLORATION -lineal I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -sólida I-EXPLORATION -de I-EXPLORATION -17, I-EXPLORATION -6 I-EXPLORATION -x I-EXPLORATION -17, I-EXPLORATION -6 I-EXPLORATION -x I-EXPLORATION -11 I-EXPLORATION -cm I-EXPLORATION -sin I-EXPLORATION -poder I-EXPLORATION -precisar I-EXPLORATION -origen. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -intervino I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -programada, I-TREATMENT -Servicio I-TREATMENT -de I-TREATMENT -Ginecología, I-TREATMENT -realizando I-TREATMENT -laparotomía I-TREATMENT -media I-TREATMENT -infraumbilical, I-TREATMENT -evidenciando I-TREATMENT -una I-TREATMENT -tumoración I-TREATMENT -de I-TREATMENT -aproximadamente I-TREATMENT -20 I-TREATMENT -cm I-TREATMENT -dependiente I-TREATMENT -de I-TREATMENT -mesenterio I-TREATMENT -adherida I-TREATMENT -a I-TREATMENT -un I-TREATMENT -asa I-TREATMENT -de I-TREATMENT -intestino I-TREATMENT -delgado I-TREATMENT -y I-TREATMENT -a I-TREATMENT -colon I-TREATMENT -sigmoide. I-TREATMENT -Se I-TREATMENT -avisó I-TREATMENT -al I-TREATMENT -cirujano I-TREATMENT -de I-TREATMENT -guardia I-TREATMENT -que I-TREATMENT -realizó I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tumoración I-TREATMENT -con I-TREATMENT -resección I-TREATMENT -intestinal I-TREATMENT -de I-TREATMENT -50 I-TREATMENT -cm I-TREATMENT -y I-TREATMENT -sutura I-TREATMENT -de I-TREATMENT -área I-TREATMENT -deserosada I-TREATMENT -de I-TREATMENT -colon I-TREATMENT -sigmoide. I-TREATMENT -Al I-TREATMENT -7o I-TREATMENT -día I-TREATMENT -postoperatorio I-TREATMENT -se I-TREATMENT -reintervino I-TREATMENT -de I-TREATMENT -urgencia I-TREATMENT -por I-TREATMENT -presentar I-TREATMENT -abdomen I-TREATMENT -agudo I-TREATMENT -realizando I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -colon I-TREATMENT -sigmoide I-TREATMENT -perforado I-TREATMENT -y I-TREATMENT -anastomosis I-TREATMENT -T-T. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -posteriormente I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -favorable I-EVOLUTION -siendo I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -17 I-EVOLUTION -día I-EVOLUTION -postoperatorio I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -segunda I-EVOLUTION -intervención. I-EVOLUTION - I-EVOLUTION -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -mostró I-EXPLORATION -proliferación I-EXPLORATION -fusocelular I-EXPLORATION -sin I-EXPLORATION -atipias I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -alguna I-EXPLORATION -mitosis I-EXPLORATION -ocasional. I-EXPLORATION -Las I-EXPLORATION -células I-EXPLORATION -tumorales I-EXPLORATION -son I-EXPLORATION -positivas I-EXPLORATION -con I-EXPLORATION -vimentina I-EXPLORATION -y I-EXPLORATION -CD117 I-EXPLORATION -(C-Kit). I-EXPLORATION -Actualmente, B-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -y I-EVOLUTION -medio I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención, I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática I-EVOLUTION -y B-TREATMENT -en I-TREATMENT -tratamiento I-TREATMENT -adyuvante I-TREATMENT -con I-TREATMENT -mesilato I-TREATMENT -de I-TREATMENT -imatinib. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -diagnosticado B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hemofilia I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -severa I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Cuba I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -25 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -(su I-PAST_MEDICAL_HISTORY -país I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -residente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -España I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -años). I-PAST_MEDICAL_HISTORY -No B-FAMILY_HISTORY -refería I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -enfermedad. I-FAMILY_HISTORY -Durante B-PAST_MEDICAL_HISTORY -estos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hemartros I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -rodilla I-PAST_MEDICAL_HISTORY -derecha, I-PAST_MEDICAL_HISTORY -tratados I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -conservadora, I-PAST_MEDICAL_HISTORY -precisando I-PAST_MEDICAL_HISTORY -crioprecipitados. I-PAST_MEDICAL_HISTORY -Previo I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -actual I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -asintomático I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -médico I-PAST_MEDICAL_HISTORY -domiciliario. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -otro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -localizado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipogastrio, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -hematuria. I-PRESENT_ILLNESS -Tras B-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -pruebas I-EXPLORATION -analíticas I-EXPLORATION -y I-EXPLORATION -radiológicas I-EXPLORATION -fue I-EXPLORATION -diagnosticado I-EXPLORATION -de I-EXPLORATION -cólico I-EXPLORATION -nefrítico, I-EXPLORATION -siendo I-EXPLORATION -alta I-EXPLORATION -con I-EXPLORATION -tratamiento I-EXPLORATION -analgésico. I-EXPLORATION - I-EXPLORATION -Cinco B-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -tarde, I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -micción, I-PRESENT_ILLNESS -sufrió I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síncope I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conocimiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -escasos I-PRESENT_ILLNESS -segundos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -duración, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -estaba I-EXPLORATION -consciente I-EXPLORATION -y I-EXPLORATION -orientado, I-EXPLORATION -con I-EXPLORATION -regular I-EXPLORATION -estado I-EXPLORATION -general I-EXPLORATION -e I-EXPLORATION -intensa I-EXPLORATION -palidez I-EXPLORATION -mucocutánea. I-EXPLORATION -La I-EXPLORATION -tensión I-EXPLORATION -arterial I-EXPLORATION -sistólica I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -70 I-EXPLORATION -mmHg I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -diastólica I-EXPLORATION -de I-EXPLORATION -37 I-EXPLORATION -mmHg, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION -de I-EXPLORATION -61 I-EXPLORATION -latidos/min. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -abdominal I-EXPLORATION -el I-EXPLORATION -abdomen I-EXPLORATION -estaba I-EXPLORATION -distendido, I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -difusa, I-EXPLORATION -con I-EXPLORATION -defensa I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal I-EXPLORATION -generalizada. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -realizada I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -hematocrito I-EXPLORATION -del I-EXPLORATION -20%, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -7 I-EXPLORATION -g/dl, I-EXPLORATION -leucocitos I-EXPLORATION -12.270/ul I-EXPLORATION -(84% I-EXPLORATION -neutrófilos) I-EXPLORATION -y I-EXPLORATION -plaquetas I-EXPLORATION -358.000/ul. I-EXPLORATION -Actividad I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -100%, I-EXPLORATION -TTPA I-EXPLORATION -46%. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -que I-EXPLORATION -informaba I-EXPLORATION -de I-EXPLORATION -abundante I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -subdiafragmático I-EXPLORATION -izquierdo, I-EXPLORATION -subhepático I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -ambas I-EXPLORATION -gotieras I-EXPLORATION -paracólicas. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -espacio I-EXPLORATION -vesicorrectal I-EXPLORATION -se I-EXPLORATION -visualizaba I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -ovalada, I-EXPLORATION -con I-EXPLORATION -líquido I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior. I-EXPLORATION -Se I-EXPLORATION -decidió I-EXPLORATION -realizar I-EXPLORATION -un I-EXPLORATION -TAC I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -imagen I-EXPLORATION -quística I-EXPLORATION -retro I-EXPLORATION -y I-EXPLORATION -supravesical, I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -que I-EXPLORATION -parece I-EXPLORATION -depender I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -vaso I-EXPLORATION -arterial I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -llegar I-EXPLORATION -a I-EXPLORATION -detectar I-EXPLORATION -el I-EXPLORATION -origen I-EXPLORATION -del I-EXPLORATION -mismo. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -sangrado I-TREATMENT -en I-TREATMENT -paciente I-TREATMENT -hemofílico I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -transfusión I-TREATMENT -inmediata I-TREATMENT -de I-TREATMENT -2 I-TREATMENT -concentrados I-TREATMENT -de I-TREATMENT -hematíes, I-TREATMENT -3 I-TREATMENT -viales I-TREATMENT -de I-TREATMENT -factor I-TREATMENT -VIII I-TREATMENT -además I-TREATMENT -de I-TREATMENT -otro I-TREATMENT -de I-TREATMENT -factor I-TREATMENT -VII I-TREATMENT -recombinante. I-TREATMENT -La B-EXPLORATION -administración I-EXPLORATION -de I-EXPLORATION -factor I-EXPLORATION -VIII I-EXPLORATION -requirió I-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION -analítica I-EXPLORATION -de I-EXPLORATION -Ac I-EXPLORATION -antifactor I-EXPLORATION -VIII I-EXPLORATION -que I-EXPLORATION -resultaron I-EXPLORATION -positivos, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -requirió, I-TREATMENT -previa I-TREATMENT -a I-TREATMENT -su I-TREATMENT -administración, I-TREATMENT -la I-TREATMENT -aplicación I-TREATMENT -de I-TREATMENT -inhibidores I-TREATMENT -de I-TREATMENT -Ac I-TREATMENT -antifactor I-TREATMENT -VIII I-TREATMENT -(4). I-TREATMENT -Tras B-EVOLUTION -la I-EVOLUTION -mejoría I-EVOLUTION -analítica I-EVOLUTION -y I-EVOLUTION -ante I-EVOLUTION -la I-EVOLUTION -persistencia I-EVOLUTION -del I-EVOLUTION -mal I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION -del I-EVOLUTION -paciente, I-EVOLUTION -se B-TREATMENT -decidió I-TREATMENT -intervenir I-TREATMENT -mediante I-TREATMENT -laparotomía I-TREATMENT -media I-TREATMENT -suprainfraumbilical I-TREATMENT -hallando I-TREATMENT -hemoperitoneo I-TREATMENT -de I-TREATMENT -aproximadamente I-TREATMENT -3 I-TREATMENT -litros I-TREATMENT -de I-TREATMENT -coágulos I-TREATMENT -y I-TREATMENT -sangre I-TREATMENT -roja. I-TREATMENT -Se B-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -quística I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -cm, I-EXPLORATION -retrovesical, I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -elástica I-EXPLORATION -y I-EXPLORATION -superficie I-EXPLORATION -lisa, I-EXPLORATION -íntimamente I-EXPLORATION -adherida I-EXPLORATION -a I-EXPLORATION -cara I-EXPLORATION -posterior I-EXPLORATION -vesical. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -disección I-TREATMENT -roma I-TREATMENT -y I-TREATMENT -exéreis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tumoración. I-TREATMENT -Posteriormente B-EXPLORATION -se I-EXPLORATION -revisó I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cavidad I-EXPLORATION -abdominal I-EXPLORATION -sin I-EXPLORATION -objetivar I-EXPLORATION -un I-EXPLORATION -punto I-EXPLORATION -sangrante I-EXPLORATION -activo. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -satisfactoriamente I-EVOLUTION -en I-EVOLUTION -planta, I-EVOLUTION -manteniéndose I-EVOLUTION -afebril, I-EVOLUTION -con I-EVOLUTION -hematocritos I-EVOLUTION -mantenidos I-EVOLUTION -y I-EVOLUTION -débitos I-EVOLUTION -decrecientes I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -drenaje I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -décimo I-EVOLUTION -día I-EVOLUTION -postoperatorio. I-EVOLUTION -El B-TREATMENT -paciente I-TREATMENT -precisó I-TREATMENT -controles I-TREATMENT -por I-TREATMENT -hematología I-TREATMENT -tras I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -del I-TREATMENT -factor I-TREATMENT -VIII I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas I-TREATMENT -en I-TREATMENT -los I-TREATMENT -cuatro I-TREATMENT -primeros I-TREATMENT -días. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -formación I-EXPLORATION -cupuliforme I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro. I-EXPLORATION -La I-EXPLORATION -superficie I-EXPLORATION -externa I-EXPLORATION -era I-EXPLORATION -lisa I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -interna I-EXPLORATION -presentaba I-EXPLORATION -múltiples I-EXPLORATION -coágulos I-EXPLORATION -hemáticos I-EXPLORATION -adheridos. I-EXPLORATION -La I-EXPLORATION -cúpula I-EXPLORATION -fibrosa I-EXPLORATION -contenía I-EXPLORATION -moderada I-EXPLORATION -infiltración I-EXPLORATION -inflamatoria I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -crónico I-EXPLORATION -inespecífico I-EXPLORATION -con I-EXPLORATION -algunos I-EXPLORATION -hemosiderofagos. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION -interna I-EXPLORATION -presentaba, I-EXPLORATION -además I-EXPLORATION -del I-EXPLORATION -material I-EXPLORATION -hemático I-EXPLORATION -adherido, I-EXPLORATION -tejido I-EXPLORATION -graso I-EXPLORATION -maduro, I-EXPLORATION -todo I-EXPLORATION -ello I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -pseudotumor I-EXPLORATION -hemofílico. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -64 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -difuso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -intensidad I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -acompañado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS -mareo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -profusa. I-PRESENT_ILLNESS -Unas I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -trabajando I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -campo I-PRESENT_ILLNESS -fumigando I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -insecticida I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -contenía I-PRESENT_ILLNESS -polvo I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -espolvoreo. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -mostraba I-EXPLORATION -importante I-EXPLORATION -diaforesis I-EXPLORATION -con I-EXPLORATION -leve I-EXPLORATION -bradipsiquia I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -datos I-EXPLORATION -de I-EXPLORATION -focalidad I-EXPLORATION -neurológica. I-EXPLORATION -Tras B-TREATMENT -estabilización I-TREATMENT -hemodinámica, I-TREATMENT -se B-EXPLORATION -realizó I-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -parénquima I-EXPLORATION -hepático I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -distinta I-EXPLORATION -intensidad I-EXPLORATION -con I-EXPLORATION -gran I-EXPLORATION -colección I-EXPLORATION -subcapsular I-EXPLORATION -de I-EXPLORATION -11 I-EXPLORATION -x I-EXPLORATION -6 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -probable I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -hemoperitoneo. I-EXPLORATION -La I-EXPLORATION -vesícula I-EXPLORATION -adyacente I-EXPLORATION -mostraba I-EXPLORATION -un I-EXPLORATION -nivel I-EXPLORATION -líquido-líquido I-EXPLORATION -sin I-EXPLORATION -poder I-EXPLORATION -descartar I-EXPLORATION -contenido I-EXPLORATION -hemático. I-EXPLORATION -Así I-EXPLORATION -mismo I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -engrosamiento I-EXPLORATION -y I-EXPLORATION -realce I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -de I-EXPLORATION -antro I-EXPLORATION -gástrico I-EXPLORATION -y I-EXPLORATION -duodeno I-EXPLORATION -con I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -periesplénico I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -ambas I-EXPLORATION -gotieras, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -gastroscopia I-EXPLORATION -confirmando I-EXPLORATION -gastroduodenitis I-EXPLORATION -sin I-EXPLORATION -otras I-EXPLORATION -alteraciones. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -los I-TREATMENT -resultados, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -urgente I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -evidenció I-TREATMENT -gran I-TREATMENT -hemoperitoneo I-TREATMENT -con I-TREATMENT -coágulos I-TREATMENT -suprahepáticos I-TREATMENT -y I-TREATMENT -brecha I-TREATMENT -en I-TREATMENT -lóbulo I-TREATMENT -hepático I-TREATMENT -derecho I-TREATMENT -de I-TREATMENT -unos I-TREATMENT -10 I-TREATMENT -cm, I-TREATMENT -de I-TREATMENT -aspecto I-TREATMENT -necrótico I-TREATMENT -con I-TREATMENT -sangrado I-TREATMENT -activo I-TREATMENT -en I-TREATMENT -sábana. I-TREATMENT -Se I-TREATMENT -drenó I-TREATMENT -un I-TREATMENT -total I-TREATMENT -de I-TREATMENT -200 I-TREATMENT -cc I-TREATMENT -de I-TREATMENT -contenido I-TREATMENT -hemático I-TREATMENT -y I-TREATMENT -se I-TREATMENT -controló I-TREATMENT -el I-TREATMENT -sangrado I-TREATMENT -mediante I-TREATMENT -medidas I-TREATMENT -hemostáticas. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -tras I-EVOLUTION -el I-EVOLUTION -postoperatorio. I-EVOLUTION -La B-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -mostró I-EXPLORATION -persistencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -colección I-EXPLORATION -aunque I-EXPLORATION -de I-EXPLORATION -menor I-EXPLORATION -tamaño I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -resolvió I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -práctica I-EXPLORATION -totalidad I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -drenaje I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ulcus I-PAST_MEDICAL_HISTORY -duodenal I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -EPOC I-PAST_MEDICAL_HISTORY -(no I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -previamente I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -paquetes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cigarrillos/día). I-PAST_MEDICAL_HISTORY -Intervenido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -papila I-PAST_MEDICAL_HISTORY -anal I-PAST_MEDICAL_HISTORY -hipertrófica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2007 I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -fístula I-PAST_MEDICAL_HISTORY -perianal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -recidiva I-PAST_MEDICAL_HISTORY -precoz. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Ingresa B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8-10 I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -diarias, I-PRESENT_ILLNESS -blandas-líquidas, I-PRESENT_ILLNESS -algunas I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -sangre, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -carácter I-PRESENT_ILLNESS -diurno I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -nocturno I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -cedieron I-PRESENT_ILLNESS -parcialmente I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -ciprofloxacino I-PRESENT_ILLNESS -vía I-PRESENT_ILLNESS -oral. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -previos I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -aparece I-PRESENT_ILLNESS -empeoramiento I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -mucorrea I-PRESENT_ILLNESS -sanguinolenta I-PRESENT_ILLNESS -(6-8 I-PRESENT_ILLNESS -deposiciones/día), I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -hipogástrico I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -proctalgia I-PRESENT_ILLNESS -intensa. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -aqueja I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS -creciente I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -picos I-PRESENT_ILLNESS -febriles I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -38, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -oC I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -predominio I-PRESENT_ILLNESS -vespertino I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -última I-PRESENT_ILLNESS -semana. I-PRESENT_ILLNESS -No B-EXPLORATION -presentaba I-EXPLORATION -fístulas I-EXPLORATION -perianales I-EXPLORATION -activas I-EXPLORATION -ni I-EXPLORATION -supuración. I-EXPLORATION - I-EXPLORATION -Desde I-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -evidencia I-EXPLORATION -la I-EXPLORATION -aparición I-EXPLORATION -brusca I-EXPLORATION -de I-EXPLORATION -lesiones I-EXPLORATION -inflamatorias I-EXPLORATION -eritematosas I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -pustuloso I-EXPLORATION -sobre I-EXPLORATION -placas, I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -brazos I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -dorso I-EXPLORATION -de I-EXPLORATION -ambas I-EXPLORATION -manos, I-EXPLORATION -con I-EXPLORATION -centro I-EXPLORATION -umbilicado, I-EXPLORATION -dolorosas, I-EXPLORATION -de I-EXPLORATION -distribución I-EXPLORATION -asimétrica. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -inspección I-EXPLORATION -rectal I-EXPLORATION -destaca I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -perianal I-EXPLORATION -complicada I-EXPLORATION -con I-EXPLORATION -dos I-EXPLORATION -orificios I-EXPLORATION -fistulosos I-EXPLORATION -inactivos, I-EXPLORATION -mariscas I-EXPLORATION -hemorroidales I-EXPLORATION -y I-EXPLORATION -fisura I-EXPLORATION -aguda I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -media I-EXPLORATION -posterior. I-EXPLORATION - I-EXPLORATION -Analíticamente I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -anemia I-EXPLORATION -microcítica I-EXPLORATION -hipocroma I-EXPLORATION -ferropénica I-EXPLORATION -sin I-EXPLORATION -leucocitosis I-EXPLORATION -y I-EXPLORATION -coagulación I-EXPLORATION -normal, I-EXPLORATION -destacando I-EXPLORATION -GGT I-EXPLORATION -de I-EXPLORATION -203 I-EXPLORATION -mU/ml, I-EXPLORATION -PCR: I-EXPLORATION -248 I-EXPLORATION -mg/l I-EXPLORATION -y I-EXPLORATION -VSG: I-EXPLORATION -120 I-EXPLORATION -mm/h. I-EXPLORATION -Hemocultivos I-EXPLORATION -y I-EXPLORATION -coprocultivos I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -describe I-EXPLORATION -un I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -paredes I-EXPLORATION -del I-EXPLORATION -rectosigma, I-EXPLORATION -confirmada I-EXPLORATION -por I-EXPLORATION -TC I-EXPLORATION -abdominal, I-EXPLORATION -que I-EXPLORATION -también I-EXPLORATION -revela I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -colon I-EXPLORATION -transverso I-EXPLORATION -y I-EXPLORATION -ciego, I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -adenopatías I-EXPLORATION -en I-EXPLORATION -territorio I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -vasos I-EXPLORATION -iliacos, I-EXPLORATION -sin I-EXPLORATION -líquido I-EXPLORATION -libre. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -colonoscopia I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -rectal I-EXPLORATION -aparece I-EXPLORATION -edematosa I-EXPLORATION -y I-EXPLORATION -eritematosa I-EXPLORATION -con I-EXPLORATION -formaciones I-EXPLORATION -pseudopolipoideas I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extienden I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -mayor I-EXPLORATION -parte I-EXPLORATION -del I-EXPLORATION -colon, I-EXPLORATION -intercalando I-EXPLORATION -áreas I-EXPLORATION -con I-EXPLORATION -mucosa I-EXPLORATION -conservada. I-EXPLORATION -El I-EXPLORATION -íleon I-EXPLORATION -es I-EXPLORATION -macroscópicamente I-EXPLORATION -normal. I-EXPLORATION -Las I-EXPLORATION -biopsias I-EXPLORATION -colónicas I-EXPLORATION -confirman I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -ulceración I-EXPLORATION -e I-EXPLORATION -inflamación I-EXPLORATION -crónica, I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -granulomas. I-EXPLORATION - I-EXPLORATION -El B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -valorado I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -Dermatología. I-DERIVED_FROM/TO -Una B-EXPLORATION -biopsia I-EXPLORATION -cutánea I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -eminencia I-EXPLORATION -hipotecar I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mano I-EXPLORATION -demuestra I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -infiltrado I-EXPLORATION -neutrofílico I-EXPLORATION -con I-EXPLORATION -edema I-EXPLORATION -dérmico I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -vasculitis, I-EXPLORATION -confirmándose I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -dermatosis I-EXPLORATION -neutrofílica I-EXPLORATION -(DN). I-EXPLORATION - I-EXPLORATION -Por I-EXPLORATION -tanto I-EXPLORATION -se I-EXPLORATION -diagnostica I-EXPLORATION -al I-EXPLORATION -paciente I-EXPLORATION -de: I-EXPLORATION -a) I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Crohn I-EXPLORATION -colónica I-EXPLORATION -con I-EXPLORATION -brote I-EXPLORATION -de I-EXPLORATION -actividad I-EXPLORATION -moderada I-EXPLORATION -con I-EXPLORATION -CDAI: I-EXPLORATION -345 I-EXPLORATION -(debut I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -enfermedad) I-EXPLORATION -y I-EXPLORATION -enfermedad I-EXPLORATION -perianal I-EXPLORATION -(EPA), I-EXPLORATION -clasificación I-EXPLORATION -de I-EXPLORATION -Montreal: I-EXPLORATION -A3 I-EXPLORATION -L2 I-EXPLORATION -B1p; I-EXPLORATION -y I-EXPLORATION -b) I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -Sweet, I-EXPLORATION -cumpliendo I-EXPLORATION -los I-EXPLORATION -criterios I-EXPLORATION -aceptados. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -fluidoterapia, I-TREATMENT -metilprednisolona I-TREATMENT -(60 I-TREATMENT -mg/i.v./24 I-TREATMENT -h), I-TREATMENT -antibioterapia I-TREATMENT -(ciprofloxacino I-TREATMENT -400 I-TREATMENT -mg/i.v./12 I-TREATMENT -h I-TREATMENT -y I-TREATMENT -metronidazol I-TREATMENT -1.500 I-TREATMENT -mg/i.v./24 I-TREATMENT -h), I-TREATMENT -nutrición I-TREATMENT -enteral I-TREATMENT -y I-TREATMENT -mesalazina I-TREATMENT -(3 I-TREATMENT -g/v.o./24 I-TREATMENT -h), I-TREATMENT -con I-TREATMENT -muy I-TREATMENT -buena I-TREATMENT -respuesta I-TREATMENT -clínica. I-TREATMENT -La B-EVOLUTION -fiebre I-EVOLUTION -desapareció I-EVOLUTION -en I-EVOLUTION -48 I-EVOLUTION -h, I-EVOLUTION -mejorando I-EVOLUTION -en I-EVOLUTION -pocos I-EVOLUTION -días I-EVOLUTION -las I-EVOLUTION -molestias I-EVOLUTION -abdominales I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -diarrea. I-EVOLUTION - I-EVOLUTION -Como B-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -las I-TREATMENT -lesiones I-TREATMENT -cutáneas I-TREATMENT -se I-TREATMENT -asoció I-TREATMENT -beclometasona I-TREATMENT -tópica. I-TREATMENT -Estas B-EVOLUTION -fueron I-EVOLUTION -reduciéndose I-EVOLUTION -de I-EVOLUTION -tamaño, I-EVOLUTION -disminuyendo I-EVOLUTION -las I-EVOLUTION -molestias I-EVOLUTION -locales I-EVOLUTION -tras I-EVOLUTION -3 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -tratamiento. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con B-TREATMENT -dosis I-TREATMENT -descendentes I-TREATMENT -de I-TREATMENT -prednisona I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -comprobándose B-EVOLUTION -la I-EVOLUTION -desaparición I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -pápulas I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -6 I-EVOLUTION -semanas, I-EVOLUTION -sin I-EVOLUTION -dejar I-EVOLUTION -cicatriz I-EVOLUTION -ni I-EVOLUTION -secuelas I-EVOLUTION -cutáneas. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -61 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -transplantado I-PRESENT_ILLNESS -cardiaco I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -décimo I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -postoperatorio I-PRESENT_ILLNESS -desarrolló I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -vólvulo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ciego. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -miocardiopatía I-PAST_MEDICAL_HISTORY -dilatada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -fracción I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -eyección I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -23% I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -isquémica I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -doble I-PAST_MEDICAL_HISTORY -bypass I-PAST_MEDICAL_HISTORY -aortocoronario. I-PAST_MEDICAL_HISTORY -Como I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -destacar I-PAST_MEDICAL_HISTORY -apendicectomía, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Fue I-PAST_MEDICAL_HISTORY -sometido I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -trasplante I-PAST_MEDICAL_HISTORY -cardiaco I-PAST_MEDICAL_HISTORY -ortotópico I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -anastomosis I-PAST_MEDICAL_HISTORY -bicava. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -tiempo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -isquemia I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -280 I-PAST_MEDICAL_HISTORY -min I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -duración I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -circulación I-PAST_MEDICAL_HISTORY -extracorpórea I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -200 I-PAST_MEDICAL_HISTORY -min. I-PAST_MEDICAL_HISTORY -Presentó I-PAST_MEDICAL_HISTORY -tendencia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -hipotensión I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -requerimiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -drogas I-PAST_MEDICAL_HISTORY -vasoactivas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -hemoderivados. I-PAST_MEDICAL_HISTORY -Recibió I-PAST_MEDICAL_HISTORY -profilaxis I-PAST_MEDICAL_HISTORY -antibiótica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -inducción I-PAST_MEDICAL_HISTORY -inmunosupresor I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -micofenolato I-PAST_MEDICAL_HISTORY -mofetil, I-PAST_MEDICAL_HISTORY -solu-moderin I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -daclizumab. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -postoperatorio I-PAST_MEDICAL_HISTORY -inmediato I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -diarreas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fiebre, I-PAST_MEDICAL_HISTORY -descartándose I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Clostridium I-PAST_MEDICAL_HISTORY -difficile I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -determinación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -toxina I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -B I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -heces I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -enzimoinmunoanálisis. I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -décimo I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -postoperatorio I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -intenso, I-PRESENT_ILLNESS -distensión I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -palpación I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -fosa I-PRESENT_ILLNESS -iliaca I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -leucocitosis I-PRESENT_ILLNESS -(35.000 I-PRESENT_ILLNESS -l/mm3). I-PRESENT_ILLNESS -Se B-EXPLORATION -realizó I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -urgente, I-EXPLORATION -objetivándose I-EXPLORATION -distensión I-EXPLORATION -de I-EXPLORATION -ciego I-EXPLORATION -de I-EXPLORATION -hasta I-EXPLORATION -12 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -vólvulo I-EXPLORATION -tipo I-EXPLORATION -"báscula I-EXPLORATION -cecal". I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -laparotomía I-EXPLORATION -urgente I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -vólvulo I-EXPLORATION -cecal I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -necrosis I-EXPLORATION -intestinal, I-EXPLORATION -sin I-EXPLORATION -perforación. I-EXPLORATION -Se B-TREATMENT -practicó I-TREATMENT -hemicolectomía I-TREATMENT -derecha I-TREATMENT -con I-TREATMENT -anastomosis I-TREATMENT -íleo-cólica I-TREATMENT -manual. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -enfermo I-EVOLUTION -desarrolló I-EVOLUTION -un I-EVOLUTION -postoperatorio I-EVOLUTION -sin I-EVOLUTION -incidencias. I-EVOLUTION -El B-EXPLORATION -informe I-EXPLORATION -anatomopatológico: I-EXPLORATION -infarto I-EXPLORATION -hemorrágico I-EXPLORATION -intestinal I-EXPLORATION -con I-EXPLORATION -necrosis I-EXPLORATION -transmural. I-EXPLORATION -Fue B-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -45 I-EVOLUTION -días I-EVOLUTION -post-trasplante I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -complicaciones I-EVOLUTION -postquirúrgicas I-EVOLUTION -abdominales. I-EVOLUTION -La I-EVOLUTION -función I-EVOLUTION -del I-EVOLUTION -injerto I-EVOLUTION -fue I-EVOLUTION -normal, I-EVOLUTION -con I-EVOLUTION -fracción I-EVOLUTION -de I-EVOLUTION -eyección I-EVOLUTION -del I-EVOLUTION -77% I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -trasplante. I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -nuestra I-EVOLUTION -experiencia I-EVOLUTION -las I-EVOLUTION -complicaciones I-EVOLUTION -colónicas I-EVOLUTION -agudas I-EVOLUTION -afectan I-EVOLUTION -al I-EVOLUTION -2% I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -trasplantados, I-EVOLUTION -siendo I-EVOLUTION -más I-EVOLUTION -frecuentes I-EVOLUTION -en I-EVOLUTION -varones I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -edad I-EVOLUTION -media I-EVOLUTION -superior I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -55 I-EVOLUTION -años I-EVOLUTION -(2,3). I-EVOLUTION - I-EVOLUTION -La I-EVOLUTION -patogenia I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -relacionado I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -inmunosupresor, I-EVOLUTION -especialmente I-EVOLUTION -los I-EVOLUTION -esteroides, I-EVOLUTION -bien I-EVOLUTION -por I-EVOLUTION -presentar I-EVOLUTION -un I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -rechazo I-EVOLUTION -agudo I-EVOLUTION -o I-EVOLUTION -por I-EVOLUTION -acontecer I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -primeros I-EVOLUTION -días I-EVOLUTION -post-trasplante. I-EVOLUTION -La I-EVOLUTION -otra I-EVOLUTION -causa I-EVOLUTION -posible I-EVOLUTION -son I-EVOLUTION -las I-EVOLUTION -derivadas I-EVOLUTION -del I-EVOLUTION -compromiso I-EVOLUTION -vascular I-EVOLUTION -gastrointestinal I-EVOLUTION -bien I-EVOLUTION -por I-EVOLUTION -patología I-EVOLUTION -vascular I-EVOLUTION -previa I-EVOLUTION -abdominal I-EVOLUTION -o I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -bajo I-EVOLUTION -gasto I-EVOLUTION -cardiaco I-EVOLUTION -tras I-EVOLUTION -el I-EVOLUTION -trasplante I-EVOLUTION -(isquemia I-EVOLUTION -intestinal I-EVOLUTION -no I-EVOLUTION -oclusiva) I-EVOLUTION -(1-3). I-EVOLUTION -Deben I-EVOLUTION -descartarse I-EVOLUTION -las I-EVOLUTION -infecciones, I-EVOLUTION -especialmente I-EVOLUTION -cuando I-EVOLUTION -el I-EVOLUTION -enfermo I-EVOLUTION -había I-EVOLUTION -desarrollado I-EVOLUTION -fiebre, I-EVOLUTION -leucocitosis I-EVOLUTION -y I-EVOLUTION -diarrea. I-EVOLUTION -En I-EVOLUTION -los I-EVOLUTION -primeros I-EVOLUTION -días I-EVOLUTION -post-trasplante I-EVOLUTION -la I-EVOLUTION -infección I-EVOLUTION -por I-EVOLUTION -Clostridium I-EVOLUTION -difficile I-EVOLUTION -cursa I-EVOLUTION -con I-EVOLUTION -diarreas, I-EVOLUTION -fiebre I-EVOLUTION -y I-EVOLUTION -leucocitosis, I-EVOLUTION -descartándose I-EVOLUTION -en I-EVOLUTION -nuestro I-EVOLUTION -caso I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -determinación I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -toxina I-EVOLUTION -A I-EVOLUTION -y I-EVOLUTION -B I-EVOLUTION -(6). I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -descrito I-EVOLUTION -presentaba I-EVOLUTION -varios I-EVOLUTION -factores I-EVOLUTION -de I-EVOLUTION -riesgo I-EVOLUTION -como I-EVOLUTION -el I-EVOLUTION -tratarse I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -reintervención, I-EVOLUTION -duración I-EVOLUTION -prolongada I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención, I-EVOLUTION -transfusión I-EVOLUTION -de I-EVOLUTION -hemoderivados I-EVOLUTION -y I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -drogas I-EVOLUTION -vasoactivas I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -inmediato I-EVOLUTION -(dobutamina, I-EVOLUTION -noradrenalina). I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -81 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -medicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -hospitalario I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hematoquecia I-PRESENT_ILLNESS -grave I-PRESENT_ILLNESS -(Hb I-PRESENT_ILLNESS -7, I-PRESENT_ILLNESS -9 I-PRESENT_ILLNESS -g/dl). I-PRESENT_ILLNESS -No B-EXPLORATION -se I-EXPLORATION -evidenciaron I-EXPLORATION -lesiones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta. I-EXPLORATION -Sin I-EXPLORATION -embargo, I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -estabilización I-EXPLORATION -hemodinámica I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -colonoscopia I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -ulcerada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -colon I-EXPLORATION -descendente, I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -submucoso, I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -12 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -interior I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -formación I-EXPLORATION -diverticular I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -tamaño. I-EXPLORATION -El I-EXPLORATION -enema I-EXPLORATION -opaco I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -duplicación I-EXPLORATION -colónica I-EXPLORATION -a I-EXPLORATION -dicho I-EXPLORATION -nivel, I-EXPLORATION -simulando I-EXPLORATION -un I-EXPLORATION -gran I-EXPLORATION -divertículo, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -fija I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -borde I-EXPLORATION -superior. I-EXPLORATION -La I-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -no I-EXPLORATION -demostró I-EXPLORATION -otras I-EXPLORATION -lesiones. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -histológico I-EXPLORATION -obtenido I-EXPLORATION -por I-EXPLORATION -biopsias I-EXPLORATION -endoscópicas I-EXPLORATION -fue I-EXPLORATION -el I-EXPLORATION -de I-EXPLORATION -GIST I-EXPLORATION -de I-EXPLORATION -colon. I-EXPLORATION - I-EXPLORATION -Tras B-TREATMENT -la I-TREATMENT -evaluación I-TREATMENT -quirúrgica I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -resección I-TREATMENT -colónica I-TREATMENT -segmentaria I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -laparoscópica. I-TREATMENT -La B-EXPLORATION -pieza I-EXPLORATION -obtenida I-EXPLORATION -contenía I-EXPLORATION -una I-EXPLORATION -duplicación I-EXPLORATION -colónica I-EXPLORATION -de I-EXPLORATION -32 I-EXPLORATION -x I-EXPLORATION -30 I-EXPLORATION -mm, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -grisáceo I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior, I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -dura, I-EXPLORATION -de I-EXPLORATION -12 I-EXPLORATION -x I-EXPLORATION -7 I-EXPLORATION -mm. I-EXPLORATION -Histológicamente I-EXPLORATION -este I-EXPLORATION -nódulo I-EXPLORATION -era I-EXPLORATION -un I-EXPLORATION -GIST I-EXPLORATION -de I-EXPLORATION -colon I-EXPLORATION -calcificado I-EXPLORATION -(c-kit I-EXPLORATION -+, I-EXPLORATION -CD34 I-EXPLORATION -+), I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -fusocelular, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION -mitótico I-EXPLORATION -< I-EXPLORATION -5/50 I-EXPLORATION -campos I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -aumento. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -permanece I-EXPLORATION -asintomática I-EXPLORATION -7 I-EXPLORATION -meses I-EXPLORATION -después I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -intervención. I-EXPLORATION - I-EXPLORATION - -Una B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -artritis I-PAST_MEDICAL_HISTORY -reumatoide I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -larga I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -metotrexate, I-PAST_MEDICAL_HISTORY -es B-PRESENT_ILLNESS -evaluada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -mucorrea, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -rectorragia, I-PRESENT_ILLNESS -acompañada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -marcada I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -ponderal I-PRESENT_ILLNESS -(10 I-PRESENT_ILLNESS -kg). I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -detectó I-EXPLORATION -leve I-EXPLORATION -anemia I-EXPLORATION -ferropénica I-EXPLORATION -(hemoglobina I-EXPLORATION -9, I-EXPLORATION -2 I-EXPLORATION -g/dl, I-EXPLORATION -ferritina I-EXPLORATION -2 I-EXPLORATION -ng/ml) I-EXPLORATION -con I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -en I-EXPLORATION -rango I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -ileocolonoscopia I-EXPLORATION -con I-EXPLORATION -biopsias I-EXPLORATION -normales I-EXPLORATION -a I-EXPLORATION -ambos I-EXPLORATION -niveles. I-EXPLORATION -La I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -mucosa I-EXPLORATION -nodular I-EXPLORATION -con I-EXPLORATION -erosiones I-EXPLORATION -milimétricas I-EXPLORATION -parcheadas I-EXPLORATION -en I-EXPLORATION -bulbo I-EXPLORATION -duodenal, I-EXPLORATION -mientras I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -2a I-EXPLORATION -y I-EXPLORATION -3a I-EXPLORATION -porción I-EXPLORATION -duodenales I-EXPLORATION -había I-EXPLORATION -erosiones I-EXPLORATION -superficiales I-EXPLORATION -longitudinales I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -mínimo I-EXPLORATION -acortamiento I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -pliegues. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -interrogatorio I-EXPLORATION -dirigido, I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -negó I-EXPLORATION -la I-EXPLORATION -ingesta I-EXPLORATION -de I-EXPLORATION -aspirina I-EXPLORATION -o I-EXPLORATION -antiinflamatorios I-EXPLORATION -no I-EXPLORATION -esteroideos I-EXPLORATION -(AINE). I-EXPLORATION -La I-EXPLORATION -infección I-EXPLORATION -por I-EXPLORATION -Helicobacter I-EXPLORATION -pylori I-EXPLORATION -se I-EXPLORATION -descartó I-EXPLORATION -mediante I-EXPLORATION -biopsias I-EXPLORATION -gástricas I-EXPLORATION -parcheadas. I-EXPLORATION -Los I-EXPLORATION -coprocultivos I-EXPLORATION -para I-EXPLORATION -parásitos, I-EXPLORATION -bacterias I-EXPLORATION -y I-EXPLORATION -virus I-EXPLORATION -fueron I-EXPLORATION -negativos, I-EXPLORATION -mientras I-EXPLORATION -que I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -gastrina I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -multicorte I-EXPLORATION -descartaron I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -Zollinger-Ellison. I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -histológico I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -biopsias I-EXPLORATION -duodenales I-EXPLORATION -mostró I-EXPLORATION -atrofia I-EXPLORATION -vellositaria I-EXPLORATION -severa I-EXPLORATION -e I-EXPLORATION -infiltración I-EXPLORATION -masiva I-EXPLORATION -por I-EXPLORATION -linfocitos I-EXPLORATION -intraepiteliales, I-EXPLORATION -sugestivo I-EXPLORATION -de I-EXPLORATION -EC I-EXPLORATION -estadio I-EXPLORATION -3b I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -clasificación I-EXPLORATION -de I-EXPLORATION -Marsh-Oberhuber. I-EXPLORATION -La I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -anticuerpos I-EXPLORATION -fue I-EXPLORATION -igualmente I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -EC I-EXPLORATION -(Ig I-EXPLORATION -A I-EXPLORATION -anti-transglutaminasa I-EXPLORATION -tisular I-EXPLORATION -112 I-EXPLORATION -UI, I-EXPLORATION -rango I-EXPLORATION -normal I-EXPLORATION -< I-EXPLORATION -7). I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -alcanzó I-EVOLUTION -la I-EVOLUTION -remisión I-EVOLUTION -clínica, I-EVOLUTION -endoscópica I-EVOLUTION -e I-EVOLUTION -histológica I-EVOLUTION -tras I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -dieta I-EVOLUTION -sin I-EVOLUTION -gluten. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -66 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -diabética B-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -II I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -insulina I-PAST_MEDICAL_HISTORY -bifásica I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -16 I-PAST_MEDICAL_HISTORY -UI I-PAST_MEDICAL_HISTORY -- I-PAST_MEDICAL_HISTORY -0 I-PAST_MEDICAL_HISTORY -- I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -UI, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -acompañante, I-PRESENT_ILLNESS -salvo I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -necesidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aumentar I-PRESENT_ILLNESS -progresivamente I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -dosis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -insulina I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -UI I-PRESENT_ILLNESS -- I-PRESENT_ILLNESS -0 I-PRESENT_ILLNESS -- I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -UI I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -optimizar I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -control I-PRESENT_ILLNESS -glucémico. I-PRESENT_ILLNESS -Su B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -era I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -analíticamente I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -plaquetas I-EXPLORATION -(601.000/l) I-EXPLORATION -y I-EXPLORATION -VSG I-EXPLORATION -(107 I-EXPLORATION -mm/1a I-EXPLORATION -hora), I-EXPLORATION -siendo I-EXPLORATION -normal I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -resultados I-EXPLORATION -que I-EXPLORATION -incluían I-EXPLORATION -transaminasas, I-EXPLORATION -autoinmunidad, I-EXPLORATION -hormonas I-EXPLORATION -tiroi-deas, I-EXPLORATION -inmunoglobulinas I-EXPLORATION -e I-EXPLORATION -IgG4, I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -y I-EXPLORATION -serolo-gías I-EXPLORATION -virales I-EXPLORATION -(hepatitis, I-EXPLORATION -CMV, I-EXPLORATION -VIH, I-EXPLORATION -Epstein-Barr, I-EXPLORATION -amebiasis I-EXPLORATION -e I-EXPLORATION -hidatidosis). I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -dos I-EXPLORATION -lesiones I-EXPLORATION -ocupantes I-EXPLORATION -de I-EXPLORATION -espacio I-EXPLORATION -localizadas I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -hepático I-EXPLORATION -derecho, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -tamaño I-EXPLORATION -de I-EXPLORATION -4, I-EXPLORATION -3 I-EXPLORATION -x I-EXPLORATION -3, I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -3, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -2, I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION -respectivamente, I-EXPLORATION -y I-EXPLORATION -otra I-EXPLORATION -lesión I-EXPLORATION -de I-EXPLORATION -4, I-EXPLORATION -6 I-EXPLORATION -x I-EXPLORATION -2, I-EXPLORATION -6 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -hepático I-EXPLORATION -izquierdo, I-EXPLORATION -y I-EXPLORATION -posteriormente I-EXPLORATION -un I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -también I-EXPLORATION -manifiesta I-EXPLORATION -dos I-EXPLORATION -masas I-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -y I-EXPLORATION -3, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -cada I-EXPLORATION -una I-EXPLORATION -asentadas I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -hepático I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -otra I-EXPLORATION -lesión I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -izquierdo, I-EXPLORATION -todas I-EXPLORATION -ellas I-EXPLORATION -de I-EXPLORATION -características I-EXPLORATION -densitométricas I-EXPLORATION -inespecíficas. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -hepática I-EXPLORATION -percutánea I-EXPLORATION -bajo I-EXPLORATION -control I-EXPLORATION -ecográfico I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -malignidad, I-EXPLORATION -y I-EXPLORATION -su I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -revela I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -extenso I-EXPLORATION -formado I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -plasmáticas I-EXPLORATION -y, I-EXPLORATION -en I-EXPLORATION -menor I-EXPLORATION -medida, I-EXPLORATION -linfocitos I-EXPLORATION -y I-EXPLORATION -fibroblastos, I-EXPLORATION -con I-EXPLORATION -alguna I-EXPLORATION -célula I-EXPLORATION -gigante I-EXPLORATION -multinucleada, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -pseudotumor I-EXPLORATION -inflamatorio. I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -inmunohistoquímico I-EXPLORATION -mostró I-EXPLORATION -células I-EXPLORATION -plasmáticas I-EXPLORATION -con I-EXPLORATION -cadenas I-EXPLORATION -kappa- I-EXPLORATION -y I-EXPLORATION -lambda- I-EXPLORATION -en I-EXPLORATION -igual I-EXPLORATION -proporción, I-EXPLORATION -con I-EXPLORATION -predominio I-EXPLORATION -de I-EXPLORATION -cadenas I-EXPLORATION -IgG I-EXPLORATION -pero I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -plasmáticas I-EXPLORATION -IgG4 I-EXPLORATION -positivas. I-EXPLORATION -Dado B-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -encontraba I-TREATMENT -asintomática I-TREATMENT -y I-TREATMENT -con I-TREATMENT -mejor I-TREATMENT -control I-TREATMENT -glucémico I-TREATMENT -no I-TREATMENT -se I-TREATMENT -adoptó I-TREATMENT -ninguna I-TREATMENT -medida I-TREATMENT -especial I-TREATMENT -y B-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -reevaluar I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -un I-EXPLORATION -mes I-EXPLORATION -más I-EXPLORATION -tarde I-EXPLORATION -mediante I-EXPLORATION -nuevo I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -ultrasonidos, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -la I-EXPLORATION -resolución I-EXPLORATION -espontánea I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -hepáticas. I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -durante I-EVOLUTION -este I-EVOLUTION -tiempo I-EVOLUTION -permaneció I-EVOLUTION -asintomática I-EVOLUTION -y B-TREATMENT -con I-TREATMENT -descenso I-TREATMENT -progresivo I-TREATMENT -en I-TREATMENT -las I-TREATMENT -necesidades I-TREATMENT -de I-TREATMENT -insulina I-TREATMENT -hasta I-TREATMENT -estabilizarse I-TREATMENT -en I-TREATMENT -su I-TREATMENT -dosis I-TREATMENT -basal I-TREATMENT -habitual. I-TREATMENT - I-TREATMENT - -Varón, B-PRESENT_ILLNESS -75 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -gastrectomía B-PAST_MEDICAL_HISTORY -parcial I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -Billroth I-PAST_MEDICAL_HISTORY -II I-PAST_MEDICAL_HISTORY -(gastroyeyunostomía) I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -21 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -ulcus I-PAST_MEDICAL_HISTORY -gástrico. I-PAST_MEDICAL_HISTORY -Lumbalgia I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -sintomático I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -paracetamol I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -metamizol. I-PAST_MEDICAL_HISTORY -Ingresó I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -pancreatitis I-PAST_MEDICAL_HISTORY -aguda I-PAST_MEDICAL_HISTORY -biliar. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -ecoendoscopia I-EXPLORATION -oral: I-EXPLORATION -mucosa I-EXPLORATION -metaplásica I-EXPLORATION -en I-EXPLORATION -anastomosis I-EXPLORATION -de I-EXPLORATION -gastrectomía. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -colecistectomía I-TREATMENT -programada. I-TREATMENT -Desde B-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -varias I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -dorsolumbar I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -flanco I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derechos, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hiporexia, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -palidez I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -coloración I-PRESENT_ILLNESS -amarillenta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -piel, I-PRESENT_ILLNESS -orinas I-PRESENT_ILLNESS -oscuras I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pico I-PRESENT_ILLNESS -febril I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -antes. I-PRESENT_ILLNESS -En B-EXPLORATION -exploración I-EXPLORATION -física, I-EXPLORATION -febrícula I-EXPLORATION -(37, I-EXPLORATION -2 I-EXPLORATION -oC), I-EXPLORATION -palidez I-EXPLORATION -cutánea I-EXPLORATION -e I-EXPLORATION -ictericia. I-EXPLORATION -Dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -epigastrio I-EXPLORATION -e I-EXPLORATION -hipocondrio I-EXPLORATION -derecho, I-EXPLORATION -con I-EXPLORATION -hepatomegalia I-EXPLORATION -de I-EXPLORATION -7 I-EXPLORATION -cm I-EXPLORATION -al I-EXPLORATION -borde I-EXPLORATION -costal. I-EXPLORATION -En I-EXPLORATION -analítica, I-EXPLORATION -destacaba: I-EXPLORATION -hiperbilirrubinemia I-EXPLORATION -(bilirrubina I-EXPLORATION -total I-EXPLORATION -3 I-EXPLORATION -mg/dl) I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -indirecta I-EXPLORATION -(bilirrubina I-EXPLORATION -directa I-EXPLORATION -0, I-EXPLORATION -02 I-EXPLORATION -mg/dl), I-EXPLORATION -LDH I-EXPLORATION -muy I-EXPLORATION -elevada I-EXPLORATION -(2.960 I-EXPLORATION -mU/ml), I-EXPLORATION -hipertransaminasemia I-EXPLORATION -ligera I-EXPLORATION -(GOT I-EXPLORATION -303 I-EXPLORATION -mU/ml, I-EXPLORATION -GPT I-EXPLORATION -129 I-EXPLORATION -mU/ml, I-EXPLORATION -GGT I-EXPLORATION -383 I-EXPLORATION -mU/ml) I-EXPLORATION -y I-EXPLORATION -ligera I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -(371 I-EXPLORATION -mU/ml). I-EXPLORATION -Además, I-EXPLORATION -insuficiencia I-EXPLORATION -renal I-EXPLORATION -leve I-EXPLORATION -(urea I-EXPLORATION -58 I-EXPLORATION -mg/dl I-EXPLORATION -creatinina I-EXPLORATION -1, I-EXPLORATION -3 I-EXPLORATION -mg/dl). I-EXPLORATION -En I-EXPLORATION -hemograma: I-EXPLORATION -anemia I-EXPLORATION -moderada I-EXPLORATION -(Hb I-EXPLORATION -8, I-EXPLORATION -1 I-EXPLORATION -g/dl; I-EXPLORATION -Hto I-EXPLORATION -24, I-EXPLORATION -3%) I-EXPLORATION -macrocítica I-EXPLORATION -(VCM I-EXPLORATION -102 I-EXPLORATION -fl) I-EXPLORATION -con I-EXPLORATION -series I-EXPLORATION -blanca I-EXPLORATION -y I-EXPLORATION -plaquetaria I-EXPLORATION -normales. I-EXPLORATION -Frotis I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -periférica I-EXPLORATION -con I-EXPLORATION -frecuentes I-EXPLORATION -esquistozitos I-EXPLORATION -y I-EXPLORATION -algunos I-EXPLORATION -esferocitos. I-EXPLORATION -Test I-EXPLORATION -de I-EXPLORATION -Coombs I-EXPLORATION -directo I-EXPLORATION -negativo. I-EXPLORATION -Haptoglobina I-EXPLORATION -baja I-EXPLORATION -(3 I-EXPLORATION -mg/dl), I-EXPLORATION -reticulocitos I-EXPLORATION -elevados I-EXPLORATION -(7,3%). I-EXPLORATION -Vitamina I-EXPLORATION -B12 I-EXPLORATION -sérica I-EXPLORATION -y I-EXPLORATION -ácido I-EXPLORATION -fólico I-EXPLORATION -sérico I-EXPLORATION -e I-EXPLORATION -intraeritrocitario I-EXPLORATION -normales. I-EXPLORATION -Coagulación: I-EXPLORATION -hipoprotrombinemia I-EXPLORATION -(73%), I-EXPLORATION -fibrinógeno I-EXPLORATION -normal. I-EXPLORATION -Orina: I-EXPLORATION -urobilinógeno I-EXPLORATION -y I-EXPLORATION -bilirrubinuria I-EXPLORATION -positivas. I-EXPLORATION -Serologías I-EXPLORATION -VHB, I-EXPLORATION -VHC I-EXPLORATION -VIH I-EXPLORATION -negativas. I-EXPLORATION -Marcadores I-EXPLORATION -tumorales: I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -CEA I-EXPLORATION -(66 I-EXPLORATION -ng/ml, I-EXPLORATION -VN I-EXPLORATION -< I-EXPLORATION -5 I-EXPLORATION -ng/ml) I-EXPLORATION -y I-EXPLORATION -CA I-EXPLORATION -19-9 I-EXPLORATION -(82 I-EXPLORATION -U/ml, I-EXPLORATION -VN I-EXPLORATION -< I-EXPLORATION -37 I-EXPLORATION -U/ml). I-EXPLORATION -En I-EXPLORATION -gastroscopia: I-EXPLORATION -en I-EXPLORATION -muñón I-EXPLORATION -gástrico, I-EXPLORATION -5-6 I-EXPLORATION -cm I-EXPLORATION -proximal I-EXPLORATION -a I-EXPLORATION -anastomosis, I-EXPLORATION -lesión I-EXPLORATION -sobreelevada I-EXPLORATION -de I-EXPLORATION -25-30 I-EXPLORATION -mm, I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -ulceración I-EXPLORATION -y I-EXPLORATION -necrosis, I-EXPLORATION -friable, I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -pétrea I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -toma I-EXPLORATION -de I-EXPLORATION -biopsia, I-EXPLORATION -con I-EXPLORATION -histopatología I-EXPLORATION -de I-EXPLORATION -adenocarcinoma I-EXPLORATION -moderadamente I-EXPLORATION -bien I-EXPLORATION -diferenciado, I-EXPLORATION -tipo I-EXPLORATION -intestinal. I-EXPLORATION -En I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TAC) I-EXPLORATION -toracoabdominal: I-EXPLORATION -hepatomegalia I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -hipodensas I-EXPLORATION -de I-EXPLORATION -diferentes I-EXPLORATION -tamaños, I-EXPLORATION -diseminadas I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -lóbulos, I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -metástasis I-EXPLORATION -hepáticas. I-EXPLORATION -Se B-TREATMENT -consultó I-TREATMENT -con I-TREATMENT -Oncología, I-TREATMENT -que I-TREATMENT -desestimó I-TREATMENT -quimioterapia, I-TREATMENT -pautándose I-TREATMENT -tratamiento I-TREATMENT -sintomático I-TREATMENT -paliativo. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -falleció I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -20 I-EVOLUTION -días I-EVOLUTION -del I-EVOLUTION -diagnóstico. I-EVOLUTION - I-EVOLUTION - -Un B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -cólico, I-PRESENT_ILLNESS -náuseas, I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Su I-PRESENT_ILLNESS -hijo I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -semejante I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -habían I-PRESENT_ILLNESS -ingerido I-PRESENT_ILLNESS -codornices I-PRESENT_ILLNESS -cocidas I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -antes. I-PRESENT_ILLNESS -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -diagnósticos I-PAST_MEDICAL_HISTORY -previos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertrofia I-PAST_MEDICAL_HISTORY -benigna I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -próstata I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipertension I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antagonistas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -receptores I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -angiotensina-II I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -torasemida, I-PAST_MEDICAL_HISTORY -así I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -abdominal I-PAST_MEDICAL_HISTORY -secundario I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -duodenitis I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -toma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ibuprofeno I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -resuelto I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -omeprazol. I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -ingreso I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -afebril I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -área I-EXPLORATION -abdominal, I-EXPLORATION -auscultación I-EXPLORATION -cardiaca I-EXPLORATION -ni I-EXPLORATION -respiratoria. I-EXPLORATION -Las I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -mostraron I-EXPLORATION -un I-EXPLORATION -hemograma, I-EXPLORATION -función I-EXPLORATION -renal, I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -amilasa, I-EXPLORATION -lipasa I-EXPLORATION -y I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION -en I-EXPLORATION -rangos I-EXPLORATION -de I-EXPLORATION -normalidad, I-EXPLORATION -salvo I-EXPLORATION -el I-EXPLORATION -valor I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -bilirrubina I-EXPLORATION -sérica I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -80 I-EXPLORATION -mg/dl I-EXPLORATION -(límite I-EXPLORATION -superior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad I-EXPLORATION -1, I-EXPLORATION -2 I-EXPLORATION -mg/dl) I-EXPLORATION -y I-EXPLORATION -LDH I-EXPLORATION -(lactato I-EXPLORATION -deshidrogenasa) I-EXPLORATION -de I-EXPLORATION -547 I-EXPLORATION -U/l I-EXPLORATION -(límite I-EXPLORATION -superior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad I-EXPLORATION -460 I-EXPLORATION -U/l). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -pequeños I-EXPLORATION -focos I-EXPLORATION -hiperecoicos I-EXPLORATION -móviles I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -rama I-EXPLORATION -principal I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -porta, I-EXPLORATION -junto I-EXPLORATION -a I-EXPLORATION -múltiples I-EXPLORATION -zonas I-EXPLORATION -hipoecogénicas I-EXPLORATION -distribuidas I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -lóbulos I-EXPLORATION -hepáticos I-EXPLORATION -sugestivos I-EXPLORATION -de I-EXPLORATION -gas. I-EXPLORATION -La I-EXPLORATION -vesícula I-EXPLORATION -biliar, I-EXPLORATION -la I-EXPLORATION -cabeza I-EXPLORATION -del I-EXPLORATION -páncreas I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -asas I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -visualizadas I-EXPLORATION -no I-EXPLORATION -presentaban I-EXPLORATION -alteraciones I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -existía I-EXPLORATION -líquido I-EXPLORATION -libre. I-EXPLORATION -La I-EXPLORATION -única I-EXPLORATION -causa I-EXPLORATION -posible I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -neumatosis I-EXPLORATION -podía I-EXPLORATION -ser I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -del I-EXPLORATION -estómago, I-EXPLORATION -en I-EXPLORATION -posible I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -gastroduodenitis I-EXPLORATION -enfisematosa. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -abdominopélvica, I-EXPLORATION -que I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -gas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -tronco I-EXPLORATION -y I-EXPLORATION -ramas I-EXPLORATION -distales I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -porta I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -lóbulos I-EXPLORATION -hepáticos. I-EXPLORATION -Se I-EXPLORATION -descartó I-EXPLORATION -isquemia I-EXPLORATION -mesentérica, I-EXPLORATION -inflamación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vesícula I-EXPLORATION -biliar I-EXPLORATION -y I-EXPLORATION -alteraciones I-EXPLORATION -pélvicas. I-EXPLORATION -Al I-EXPLORATION -contrario I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -previa, I-EXPLORATION -las I-EXPLORATION -paredes I-EXPLORATION -del I-EXPLORATION -estómago I-EXPLORATION -parecían I-EXPLORATION -normales, I-EXPLORATION -aunque I-EXPLORATION -existía I-EXPLORATION -una I-EXPLORATION -mínima I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -gas I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -vasos I-EXPLORATION -cortos I-EXPLORATION -del I-EXPLORATION -estómago. I-EXPLORATION - I-EXPLORATION -Aunque I-EXPLORATION -la I-EXPLORATION -presentación I-EXPLORATION -del I-EXPLORATION -caso I-EXPLORATION -semejaba I-EXPLORATION -una I-EXPLORATION -gastroenteritis I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -contaminación I-EXPLORATION -alimentaria, I-EXPLORATION -la I-EXPLORATION -neumatosis I-EXPLORATION -portal I-EXPLORATION -motivó I-EXPLORATION -el I-EXPLORATION -ingreso I-EXPLORATION -del I-EXPLORATION -paciente. I-EXPLORATION -Recibió B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -amoxicilina-clavulámico I-TREATMENT -y I-TREATMENT -descoagulación I-TREATMENT -con I-TREATMENT -heparina I-TREATMENT -de I-TREATMENT -bajo I-TREATMENT -peso I-TREATMENT -molecular I-TREATMENT -subcutánea I-TREATMENT -por I-TREATMENT -el I-TREATMENT -riesgo I-TREATMENT -de I-TREATMENT -trombosis I-TREATMENT -portal I-TREATMENT -secundaria I-TREATMENT -a I-TREATMENT -pileflebitis. I-TREATMENT -Los B-EXPLORATION -coprocultivos I-EXPLORATION -fueron I-EXPLORATION -negativos I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -descartó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -Entamoeba I-EXPLORATION -histolytica, I-EXPLORATION -huevos I-EXPLORATION -y I-EXPLORATION -parásitos. I-EXPLORATION -En I-EXPLORATION -un I-EXPLORATION -hemocultivo I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -dos I-EXPLORATION -extraídos I-EXPLORATION -creció I-EXPLORATION -Streptococus I-EXPLORATION -viridans. I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -4 I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -tratamiento I-EXPLORATION -se I-EXPLORATION -repitió I-EXPLORATION -la I-EXPLORATION -TAC I-EXPLORATION -abdominopélvica I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -la I-EXPLORATION -desaparición I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -neumatosis I-EXPLORATION -portal. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -y I-EVOLUTION -visto I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -en I-EVOLUTION -consultas I-EVOLUTION -externas, I-EVOLUTION -encontrándose I-EVOLUTION -asintomático I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -ecografía I-EVOLUTION -abdominal I-EVOLUTION -dentro I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -límites I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -normalidad. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -46 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -reiterada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -Era B-PAST_MEDICAL_HISTORY -natural I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Ecuador I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -llevaba I-PAST_MEDICAL_HISTORY -9 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -viviendo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -España, I-PAST_MEDICAL_HISTORY -actualmente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Murcia. I-PAST_MEDICAL_HISTORY -Como I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -destacaba I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -resección I-PAST_MEDICAL_HISTORY -intestinal I-PAST_MEDICAL_HISTORY -realizada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -país I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -colelitiasis I-PAST_MEDICAL_HISTORY -pendiente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -intervención. I-PAST_MEDICAL_HISTORY -Refería B-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -epigástrico I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -periumbilical I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -ingesta, I-PRESENT_ILLNESS -además I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -verdosas I-PRESENT_ILLNESS -abundantes, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -productos I-PRESENT_ILLNESS -patológicos, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -respetaban I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -descanso I-PRESENT_ILLNESS -nocturno, I-PRESENT_ILLNESS -junto I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -importante, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -cuantificada. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -destacaba I-EXPLORATION -palidez I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -mucosas, I-EXPLORATION -caquexia, I-EXPLORATION -distensión I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -dolor I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -difusa I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -anemia I-EXPLORATION -microcítica I-EXPLORATION -(hemoglobina I-EXPLORATION -7 I-EXPLORATION -g/dl, I-EXPLORATION -VCM I-EXPLORATION -67 I-EXPLORATION -nm), I-EXPLORATION -leucocitos I-EXPLORATION -totales I-EXPLORATION -normales I-EXPLORATION -pero I-EXPLORATION -con I-EXPLORATION -discreta I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -eosinófilos I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -reactantes I-EXPLORATION -de I-EXPLORATION -fase I-EXPLORATION -aguda. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -abdominal I-EXPLORATION -era I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -suboclusión I-EXPLORATION -intestinal I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -abundantes I-EXPLORATION -niveles I-EXPLORATION -hidroaéreos. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -bulboduodenitis, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -tomaron I-EXPLORATION -biopsias I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -informaron I-EXPLORATION -como I-EXPLORATION -inflamación I-EXPLORATION -inespecífica I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -atrofia I-EXPLORATION -vellositaria, I-EXPLORATION -y I-EXPLORATION -gastritis I-EXPLORATION -erosiva. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -tránsito I-EXPLORATION -del I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -se I-EXPLORATION -vio I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -válvulas I-EXPLORATION -conniventes I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -duodeno I-EXPLORATION -y I-EXPLORATION -yeyuno I-EXPLORATION -y I-EXPLORATION -otros I-EXPLORATION -signos I-EXPLORATION -radiológicos I-EXPLORATION -sugestivos I-EXPLORATION -de I-EXPLORATION -malabsorción, I-EXPLORATION -siendo I-EXPLORATION -las I-EXPLORATION -determinaciones I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -D-xilosa I-EXPLORATION -negativas I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -orina. I-EXPLORATION -En I-EXPLORATION -una I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -muestras I-EXPLORATION -de I-EXPLORATION -heces I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -envió I-EXPLORATION -a I-EXPLORATION -microbiología, I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -larvas I-EXPLORATION -de I-EXPLORATION -primera I-EXPLORATION -fase I-EXPLORATION -o I-EXPLORATION -rabditiformes I-EXPLORATION -de I-EXPLORATION -Strongyloides I-EXPLORATION -stercolaris. I-EXPLORATION -Se B-TREATMENT -trató I-TREATMENT -la I-TREATMENT -infección I-TREATMENT -con I-TREATMENT -ivermectina I-TREATMENT -6 I-TREATMENT -g I-TREATMENT -al I-TREATMENT -día I-TREATMENT -durante I-TREATMENT -dos I-TREATMENT -días I-TREATMENT -consecutivos, I-TREATMENT -quedando B-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -asintomática I-EVOLUTION -y I-EVOLUTION -no I-EVOLUTION -visualizándose I-EVOLUTION -el I-EVOLUTION -parásito I-EVOLUTION -en I-EVOLUTION -muestras I-EVOLUTION -de I-EVOLUTION -heces I-EVOLUTION -sucesivas I-EVOLUTION -tras I-EVOLUTION -el I-EVOLUTION -final I-EVOLUTION -del I-EVOLUTION -tratamiento. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -70 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -cirrosis I-PAST_MEDICAL_HISTORY -hepática I-PAST_MEDICAL_HISTORY -virus I-PAST_MEDICAL_HISTORY -C I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -portal, I-PAST_MEDICAL_HISTORY -estadio I-PAST_MEDICAL_HISTORY -B I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Child-Pugh, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -previos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hemorragia I-PAST_MEDICAL_HISTORY -digestiva I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -varices I-PAST_MEDICAL_HISTORY -esofágicas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -descompensación I-PAST_MEDICAL_HISTORY -edemoascítica. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Estando B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -lista I-PRESENT_ILLNESS -activa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -trasplante I-PRESENT_ILLNESS -hepático, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -control I-PRESENT_ILLNESS -ecográfico I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -cribado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -hepatocelular, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -detectan I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -LOES I-PRESENT_ILLNESS -hepáticas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -1, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -cm, I-PRESENT_ILLNESS -compatibles I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -hepatocarcinoma I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -técnicas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -imagen I-PRESENT_ILLNESS -(ecografía I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -contraste I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -TAC I-PRESENT_ILLNESS -abdominal). I-PRESENT_ILLNESS -Iniciamos B-TREATMENT -tratamiento I-TREATMENT -percutáneo I-TREATMENT -mediante I-TREATMENT -etanolización I-TREATMENT -de I-TREATMENT -la I-TREATMENT -LOE I-TREATMENT -de I-TREATMENT -mayor I-TREATMENT -tamaño, I-TREATMENT -realizando I-TREATMENT -tres I-TREATMENT -sesiones. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -de I-EXPLORATION -control, I-EXPLORATION -tras I-EXPLORATION -tres I-EXPLORATION -días I-EXPLORATION -desde I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -última I-EXPLORATION -etanolización, I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -trombosis I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -tronco I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -porta I-EXPLORATION -y I-EXPLORATION -ramas I-EXPLORATION -principales, I-EXPLORATION -que I-EXPLORATION -exploramos I-EXPLORATION -con I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -(SonoVue®), I-EXPLORATION -sin I-EXPLORATION -apreciar I-EXPLORATION -captación I-EXPLORATION -en I-EXPLORATION -fase I-EXPLORATION -arterial I-EXPLORATION -ni I-EXPLORATION -posteriores, I-EXPLORATION -característica I-EXPLORATION -sugestiva I-EXPLORATION -de I-EXPLORATION -benignidad. I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -PAAF I-EXPLORATION -realizadas I-EXPLORATION -posteriormente, I-EXPLORATION -confirman I-EXPLORATION -el I-EXPLORATION -origen I-EXPLORATION -benigno I-EXPLORATION -del I-EXPLORATION -trombo. I-EXPLORATION -Dado I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -trata I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -hallazgo I-EXPLORATION -no I-EXPLORATION -presente I-EXPLORATION -en I-EXPLORATION -ecografías I-EXPLORATION -ni I-EXPLORATION -TAC I-EXPLORATION -abdominales I-EXPLORATION -previas, I-EXPLORATION -detectado I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -posterior I-EXPLORATION -al I-EXPLORATION -tratamiento I-EXPLORATION -percutáneo I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -SonoVue®, I-EXPLORATION -TAC I-EXPLORATION -y I-EXPLORATION -PAAF I-EXPLORATION -confirman I-EXPLORATION -el I-EXPLORATION -origen I-EXPLORATION -benigno I-EXPLORATION -del I-EXPLORATION -trombo I-EXPLORATION -portal, I-EXPLORATION -se I-EXPLORATION -considera I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -complicación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -etanolización. I-EXPLORATION -Iniciamos B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -heparina I-TREATMENT -de I-TREATMENT -bajo I-TREATMENT -peso I-TREATMENT -molecular I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -1 I-TREATMENT -mg/kg/día I-TREATMENT -subcutánea, I-TREATMENT -comprobando I-TREATMENT -en I-TREATMENT -controles I-TREATMENT -ecográficos I-TREATMENT -posteriores I-TREATMENT -que I-TREATMENT -la I-TREATMENT -trombosis I-TREATMENT -ha I-TREATMENT -mejorado, I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -tras I-TREATMENT -22 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -tan I-TREATMENT -sólo I-TREATMENT -está I-TREATMENT -presente I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -parcial I-TREATMENT -en I-TREATMENT -la I-TREATMENT -rama I-TREATMENT -portal I-TREATMENT -izquierda. I-TREATMENT - I-TREATMENT -Finalmente B-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -es I-EVOLUTION -trasplantado, I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION -hasta I-EVOLUTION -la I-EVOLUTION -actualidad. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -nuevo I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evisceración I-PRESENT_ILLNESS -vaginal I-PRESENT_ILLNESS -espontánea I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -posmenopáusica. I-PRESENT_ILLNESS -Se I-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -77 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -histerectomía I-PAST_MEDICAL_HISTORY -vaginal I-PAST_MEDICAL_HISTORY -13 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, B-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -salida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -asas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -intestino I-PRESENT_ILLNESS -delgado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -través I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vagina I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -hora I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -ataque I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -risa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -domicilio. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -evisceración I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -1 I-EXPLORATION -metro I-EXPLORATION -de I-EXPLORATION -asas I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -congestivo I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -vagina, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -indica I-EXPLORATION -intervención I-EXPLORATION -quirúrgica I-EXPLORATION -urgente. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -urgente I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -conjunta I-TREATMENT -con I-TREATMENT -el I-TREATMENT -servicio I-TREATMENT -de I-TREATMENT -ginecología I-TREATMENT -con I-TREATMENT -un I-TREATMENT -abordaje I-TREATMENT -combinado I-TREATMENT -abdominal I-TREATMENT -y I-TREATMENT -vaginal. I-TREATMENT -Mediante I-TREATMENT -laparotomía I-TREATMENT -media I-TREATMENT -infraumbilical I-TREATMENT -se I-TREATMENT -evidencia I-TREATMENT -la I-TREATMENT -cúpula I-TREATMENT -vaginal I-TREATMENT -abierta I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -la I-TREATMENT -que I-TREATMENT -se I-TREATMENT -introduce I-TREATMENT -el I-TREATMENT -intestino I-TREATMENT -delgado I-TREATMENT -eviscerado I-TREATMENT -que I-TREATMENT -correspondía I-TREATMENT -a I-TREATMENT -íleon. I-TREATMENT -Se I-TREATMENT -reduce I-TREATMENT -el I-TREATMENT -intestino I-TREATMENT -delgado I-TREATMENT -a I-TREATMENT -la I-TREATMENT -cavidad I-TREATMENT -abdominal I-TREATMENT -comprobando I-TREATMENT -su I-TREATMENT -viabilidad I-TREATMENT -y I-TREATMENT -se I-TREATMENT -cierra I-TREATMENT -el I-TREATMENT -defecto I-TREATMENT -vaginal I-TREATMENT -con I-TREATMENT -material I-TREATMENT -irreabsorbible. I-TREATMENT -Se I-TREATMENT -utiliza I-TREATMENT -una I-TREATMENT -malla I-TREATMENT -Dual I-TREATMENT -Mesh I-TREATMENT -para I-TREATMENT -reforzar I-TREATMENT -la I-TREATMENT -sutura I-TREATMENT -vaginal I-TREATMENT -y I-TREATMENT -se I-TREATMENT -cierra I-TREATMENT -el I-TREATMENT -peritoneo I-TREATMENT -del I-TREATMENT -fondo I-TREATMENT -de I-TREATMENT -saco I-TREATMENT -de I-TREATMENT -Douglas. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -postoperatorio I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -satisfactorio I-EVOLUTION -siendo I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía. I-EVOLUTION -Tras I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -permanece I-EVOLUTION -asintomática. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -consulta I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2001 I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -diarrea I-PAST_MEDICAL_HISTORY -líquida I-PAST_MEDICAL_HISTORY -(7-10 I-PAST_MEDICAL_HISTORY -deposiciones I-PAST_MEDICAL_HISTORY -diarias), I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -difuso I-PAST_MEDICAL_HISTORY -abdominal, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -cólico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pérdida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -(18 I-PAST_MEDICAL_HISTORY -kg I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -inicio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -síntomas) I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -últimas I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -artralgias I-PRESENT_ILLNESS -recurrentes I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -autolimitadas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -grandes I-PRESENT_ILLNESS -articulaciones. I-PRESENT_ILLNESS -Acude B-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -especialista I-EXPLORATION -de I-EXPLORATION -digestivo, I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -ambulatoria, I-EXPLORATION -quien I-EXPLORATION -solicita I-EXPLORATION -analítica I-EXPLORATION -elemental, I-EXPLORATION -coprocultivo, I-EXPLORATION -parásitos I-EXPLORATION -y I-EXPLORATION -enema I-EXPLORATION -opaco I-EXPLORATION -que I-EXPLORATION -son I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -hizo, I-EXPLORATION -posteriormente, I-EXPLORATION -colonoscopia I-EXPLORATION -que I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -un I-EXPLORATION -colon I-EXPLORATION -normal. I-EXPLORATION -En I-EXPLORATION -íleon I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -mucosa I-EXPLORATION -hiperémica, I-EXPLORATION -edematosa I-EXPLORATION -y I-EXPLORATION -friable I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -punteado I-EXPLORATION -blanquecino, I-EXPLORATION -granuloso I-EXPLORATION -y I-EXPLORATION -aislado I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -hace I-EXPLORATION -confluente I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -de I-EXPLORATION -"grano I-EXPLORATION -de I-EXPLORATION -arroz" I-EXPLORATION -a I-EXPLORATION -medida I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -progresa I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -endoscopio. I-EXPLORATION - I-EXPLORATION -Mientras B-EVOLUTION -espera I-EVOLUTION -el I-EVOLUTION -resultado I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -biopsias, I-EVOLUTION -empeora I-EVOLUTION -su I-EVOLUTION -situación I-EVOLUTION -clínica I-EVOLUTION -con I-EVOLUTION -aumento I-EVOLUTION -del I-EVOLUTION -número I-EVOLUTION -de I-EVOLUTION -deposiciones I-EVOLUTION -e I-EVOLUTION -hipertermia I-EVOLUTION -de I-EVOLUTION -39o I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -ingresa I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -hospital. I-EVOLUTION -Se B-EXPLORATION -aprecia I-EXPLORATION -afectación I-EXPLORATION -del I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -fiebre I-EXPLORATION -de I-EXPLORATION -38, I-EXPLORATION -5o I-EXPLORATION -y I-EXPLORATION -dolor I-EXPLORATION -difuso I-EXPLORATION -abdominal. I-EXPLORATION -No I-EXPLORATION -hay I-EXPLORATION -lesiones I-EXPLORATION -cutáneas, I-EXPLORATION -ni I-EXPLORATION -se I-EXPLORATION -palpan I-EXPLORATION -adenopatías. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -resaltan I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -datos: I-EXPLORATION -hematocrito I-EXPLORATION -29, I-EXPLORATION -8% I-EXPLORATION -(40-50), I-EXPLORATION -plaquetas I-EXPLORATION -409.000 I-EXPLORATION -mm3 I-EXPLORATION -(140-400.000), I-EXPLORATION -proteínas I-EXPLORATION -totales I-EXPLORATION -4, I-EXPLORATION -9 I-EXPLORATION -g/dl, I-EXPLORATION -albúmina I-EXPLORATION -2 I-EXPLORATION -g/dl, I-EXPLORATION -hierro I-EXPLORATION -10 I-EXPLORATION -ng/dl I-EXPLORATION -(60-160), I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -transferrina I-EXPLORATION -3% I-EXPLORATION -(15-50) I-EXPLORATION -y I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -D-xilosa I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -malabsorción. I-EXPLORATION -Las I-EXPLORATION -determinaciones I-EXPLORATION -de I-EXPLORATION -bilirrubina, I-EXPLORATION -glucosa, I-EXPLORATION -urea, I-EXPLORATION -creatinina, I-EXPLORATION -vitamina I-EXPLORATION -B12, I-EXPLORATION -ácido I-EXPLORATION -fólico, I-EXPLORATION -hormonas I-EXPLORATION -tiroideas, I-EXPLORATION -triglicéridos, I-EXPLORATION -fósforo, I-EXPLORATION -magnesio, I-EXPLORATION -pruebas I-EXPLORATION -hepáticas, I-EXPLORATION -inmunoglobulinas, I-EXPLORATION -transferrina, I-EXPLORATION -ferritina I-EXPLORATION -y I-EXPLORATION -anticuerpos I-EXPLORATION -antiendomisio I-EXPLORATION -y I-EXPLORATION -antigliadina I-EXPLORATION -son I-EXPLORATION -normales. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -microbiológico I-EXPLORATION -de I-EXPLORATION -heces, I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -orina, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -y I-EXPLORATION -bacterias I-EXPLORATION -(virus I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana, I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -hepatitis I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C, I-EXPLORATION -Salmonella, I-EXPLORATION -Clostridium I-EXPLORATION -difficile I-EXPLORATION -y I-EXPLORATION -micobacterias), I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -o I-EXPLORATION -negativas. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -tránsito I-EXPLORATION -intestinal, I-EXPLORATION -ecografía I-EXPLORATION -y I-EXPLORATION -TAC I-EXPLORATION -abdominopélvica I-EXPLORATION -sin I-EXPLORATION -apreciarse I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION -La I-EXPLORATION -fibrogastroscopia I-EXPLORATION -detectó I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -segunda I-EXPLORATION -y I-EXPLORATION -tercera I-EXPLORATION -porción I-EXPLORATION -duodenal I-EXPLORATION -un I-EXPLORATION -engrosamiento I-EXPLORATION -marcado I-EXPLORATION -de I-EXPLORATION -pliegues I-EXPLORATION -con I-EXPLORATION -edema I-EXPLORATION -y I-EXPLORATION -aspecto I-EXPLORATION -granular I-EXPLORATION -con I-EXPLORATION -infiltrados I-EXPLORATION -blanquecinos. I-EXPLORATION -La I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -duodenal I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -gránulos I-EXPLORATION -PAS I-EXPLORATION -positivos, I-EXPLORATION -diastasa I-EXPLORATION -resistentes, I-EXPLORATION -hallazgos I-EXPLORATION -también I-EXPLORATION -presentes I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -previa I-EXPLORATION -ileal. I-EXPLORATION -Se I-EXPLORATION -determinó I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -duodeno I-EXPLORATION -la I-EXPLORATION -secuencia I-EXPLORATION -de I-EXPLORATION -ARN I-EXPLORATION -ribosomal I-EXPLORATION -16 I-EXPLORATION -S I-EXPLORATION -de I-EXPLORATION -T. I-EXPLORATION -whippleii I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -positiva. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -penicilina I-TREATMENT -(1, I-TREATMENT -2 I-TREATMENT -x I-TREATMENT -106 I-TREATMENT -unidades I-TREATMENT -al I-TREATMENT -día) I-TREATMENT -más I-TREATMENT -estreptomicina I-TREATMENT -(1 I-TREATMENT -g/día) I-TREATMENT -durante I-TREATMENT -14 I-TREATMENT -días, I-TREATMENT -seguido I-TREATMENT -de I-TREATMENT -cotrimoxazol I-TREATMENT -(800/160 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas) I-TREATMENT -durante I-TREATMENT -un I-TREATMENT -año. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -favorable I-EVOLUTION -desapareciendo I-EVOLUTION -la I-EVOLUTION -fiebre I-EVOLUTION -y I-EVOLUTION -ganando I-EVOLUTION -peso I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -primeras I-EVOLUTION -dos I-EVOLUTION -semanas. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -meses, I-EVOLUTION -la I-EVOLUTION -duodenoscopia I-EVOLUTION -era I-EVOLUTION -normal I-EVOLUTION -pero I-EVOLUTION -persistían I-EVOLUTION -focos I-EVOLUTION -aislados I-EVOLUTION -de I-EVOLUTION -macrófagos I-EVOLUTION -PAS I-EVOLUTION -positivos I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -lámina I-EVOLUTION -propia. I-EVOLUTION -La B-EXPLORATION -PCR I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -duodenal I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -8 I-EXPLORATION -años I-EXPLORATION -de I-EXPLORATION -evolución, I-EXPLORATION -las I-EXPLORATION -biopsias I-EXPLORATION -duodenal I-EXPLORATION -e I-EXPLORATION -ileal I-EXPLORATION -no I-EXPLORATION -mostraban I-EXPLORATION -hallazgos I-EXPLORATION -histológicos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -enfermedad I-EXPLORATION -al I-EXPLORATION -microscopio I-EXPLORATION -óptico. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -fumador, B-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -26 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -EC I-PAST_MEDICAL_HISTORY -íleo-cólica. I-PAST_MEDICAL_HISTORY -Durante I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -fístula I-PAST_MEDICAL_HISTORY -perianal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -suboclusión I-PAST_MEDICAL_HISTORY --intestinal I-PAST_MEDICAL_HISTORY -secundario I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -brote I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -EC, I-PAST_MEDICAL_HISTORY -objetivando I-PAST_MEDICAL_HISTORY -fístula I-PAST_MEDICAL_HISTORY -entero-vesical, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -requirió I-PAST_MEDICAL_HISTORY -intervención I-PAST_MEDICAL_HISTORY -quirúrgica I-PAST_MEDICAL_HISTORY -(resección I-PAST_MEDICAL_HISTORY -íleo-cólica). I-PAST_MEDICAL_HISTORY -Coincidiendo I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -suboclusión I-PAST_MEDICAL_HISTORY -comenzó I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -edemas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -miembros I-PAST_MEDICAL_HISTORY -inferiores, I-PAST_MEDICAL_HISTORY -deterioro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -función I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -proteinuria I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -rango I-PAST_MEDICAL_HISTORY -nefrótico, I-PAST_MEDICAL_HISTORY -realizándosele I-PAST_MEDICAL_HISTORY -biopsia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -confirmó I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -sospecha I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -AA I-PAST_MEDICAL_HISTORY -renal. I-PAST_MEDICAL_HISTORY -Recibió B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -colchicina I-TREATMENT -con I-TREATMENT -mejoría I-TREATMENT -clínica I-TREATMENT -y I-TREATMENT -de I-TREATMENT -la I-TREATMENT -función I-TREATMENT -renal. I-TREATMENT -La I-TREATMENT -EC I-TREATMENT -recidivó I-TREATMENT -en I-TREATMENT -la I-TREATMENT -anastomosis I-TREATMENT -siendo I-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -azatioprina, I-TREATMENT -con B-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -ha I-EVOLUTION -controlado I-EVOLUTION -la I-EVOLUTION -enfermedad I-EVOLUTION -intestinal, I-EVOLUTION -aunque I-EVOLUTION -persiste I-EVOLUTION -la I-EVOLUTION -fístula I-EVOLUTION -perianal I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -oligosintomática. I-EVOLUTION -En B-TREATMENT -la I-TREATMENT -actualidad I-TREATMENT -mantiene I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -azatioprina I-TREATMENT -más I-TREATMENT -mesalacina, I-TREATMENT -presentando I-TREATMENT -función I-TREATMENT -renal I-TREATMENT -normal, I-TREATMENT -con I-TREATMENT -persistencia I-TREATMENT -de I-TREATMENT -proteinuria I-TREATMENT -en I-TREATMENT -rango I-TREATMENT -no I-TREATMENT -nefrótico. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -fumador, B-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -quince I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -acalasia, I-PAST_MEDICAL_HISTORY -realizándose I-PAST_MEDICAL_HISTORY -dilatación I-PAST_MEDICAL_HISTORY -endoscópica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ese I-PAST_MEDICAL_HISTORY -momento, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -posterior I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -decisión I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -paciente. I-PAST_MEDICAL_HISTORY -Ingresa B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -sólidos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -líquidos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -Se B-EXPLORATION -realiza I-EXPLORATION -endoscopia I-EXPLORATION -oral I-EXPLORATION -objetivando I-EXPLORATION -esófago I-EXPLORATION -con I-EXPLORATION -abundantes I-EXPLORATION -restos I-EXPLORATION -líquidos, I-EXPLORATION -con I-EXPLORATION -paredes I-EXPLORATION -dilatadas, I-EXPLORATION -morfología I-EXPLORATION -sigmoide I-EXPLORATION -y I-EXPLORATION -mucosa I-EXPLORATION -distal I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -agrietado, I-EXPLORATION -friable I-EXPLORATION -y I-EXPLORATION -cardias I-EXPLORATION -puntiforme, I-EXPLORATION -con I-EXPLORATION -resistencia I-EXPLORATION -al I-EXPLORATION -paso I-EXPLORATION -del I-EXPLORATION -endoscopio, I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -acalasia I-EXPLORATION -evolucionada, I-EXPLORATION -sin I-EXPLORATION -lesiones I-EXPLORATION -subcardiales I-EXPLORATION -que I-EXPLORATION -justifiquen I-EXPLORATION -pseudoacalasia. I-EXPLORATION -A I-EXPLORATION -22 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -arcada I-EXPLORATION -dentaria I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -lesión I-EXPLORATION -mucosa I-EXPLORATION -excavada, I-EXPLORATION -profunda, I-EXPLORATION -cubierta I-EXPLORATION -de I-EXPLORATION -fibrina I-EXPLORATION -y I-EXPLORATION -punteado I-EXPLORATION -hemático, I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -tamaño, I-EXPLORATION -que I-EXPLORATION -abarca I-EXPLORATION -la I-EXPLORATION -mitad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -circunferencia, I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -maligno I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -biopsia, I-EXPLORATION -con I-EXPLORATION -histología I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -epidermoide I-EXPLORATION -moderadamente I-EXPLORATION -diferenciado. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -TC I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -esófago I-EXPLORATION -marcadamente I-EXPLORATION -dilatado I-EXPLORATION -y I-EXPLORATION -engrosamiento I-EXPLORATION -parietal I-EXPLORATION -del I-EXPLORATION -tercio I-EXPLORATION -proximal I-EXPLORATION -esofágico I-EXPLORATION -con I-EXPLORATION -probable I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -posterior I-EXPLORATION -traqueal, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -confirma I-EXPLORATION -al I-EXPLORATION -realizar I-EXPLORATION -broncoscopia. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -carcinoma I-TREATMENT -epidermoide I-TREATMENT -de I-TREATMENT -esófago I-TREATMENT -moderadamente I-TREATMENT -diferenciado I-TREATMENT -estadio I-TREATMENT -III I-TREATMENT -con I-TREATMENT -infiltración I-TREATMENT -traqueal I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -quimioterapia I-TREATMENT -sistémica I-TREATMENT -según I-TREATMENT -esquema I-TREATMENT -cisplatino/5-fluouracilo. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -sufre I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -compatible I-EVOLUTION -con I-EVOLUTION -broncoaspiración, I-EVOLUTION -presentando I-EVOLUTION -deterioro I-EVOLUTION -clínico I-EVOLUTION -progresivo I-EVOLUTION -produciéndose I-EVOLUTION -finalmente I-EVOLUTION -el I-EVOLUTION -fallecimiento I-EVOLUTION -siete I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -tratamiento, I-EVOLUTION -poniéndose I-EVOLUTION -en I-EVOLUTION -relación I-EVOLUTION -con I-EVOLUTION -perforación I-EVOLUTION -traqueoesofágica, I-EVOLUTION -bronconeumonía I-EVOLUTION -y I-EVOLUTION -mediastinitis I-EVOLUTION -asociada. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés, I-FAMILY_HISTORY -diagnosticado B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -subclínico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -esclerodermia I-PAST_MEDICAL_HISTORY -precoz I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -consultas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Reumatología I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -Dermatología. I-PAST_MEDICAL_HISTORY -Un I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -presentado I-PAST_MEDICAL_HISTORY -necrosis I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -pulpejos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -dedos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -manos I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -inició I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -estudio. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -capilaroscopia I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -compatible I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -ANA I-PAST_MEDICAL_HISTORY -positivos I-PAST_MEDICAL_HISTORY -(1/640), I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -anticuerpos I-PAST_MEDICAL_HISTORY -anticentrómero, I-PAST_MEDICAL_HISTORY -RNP I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -scl-70 I-PAST_MEDICAL_HISTORY -negativos. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -inició I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -entonces I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -bosentán I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ácido I-PAST_MEDICAL_HISTORY -acetilsalicílico. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acudió B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -melenas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -epistaxis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso I-EXPLORATION -presentó I-EXPLORATION -un I-EXPLORATION -valor I-EXPLORATION -de I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -8, I-EXPLORATION -5 I-EXPLORATION -mg/dl I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -cifra I-EXPLORATION -de I-EXPLORATION -plaquetas I-EXPLORATION -normales, I-EXPLORATION -una I-EXPLORATION -coagulación I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -VSG I-EXPLORATION -de I-EXPLORATION -48 I-EXPLORATION -mm/h. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -destacaban I-EXPLORATION -múltiples I-EXPLORATION -telangiectasias I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -pulpejos I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -dedos, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -mucosa I-EXPLORATION -oral I-EXPLORATION -y I-EXPLORATION -región I-EXPLORATION -peribucal. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -gastroscopia I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -varias I-EXPLORATION -lesiones I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -tamaño I-EXPLORATION -(menor I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -mm) I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -vascular I-EXPLORATION -en I-EXPLORATION -mucosa I-EXPLORATION -esofágica, I-EXPLORATION -gástrica I-EXPLORATION -y I-EXPLORATION -duodenal, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -sangrado I-EXPLORATION -reciente I-EXPLORATION -ni I-EXPLORATION -restos I-EXPLORATION -hemáticos. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -colonoscopia I-EXPLORATION -se I-EXPLORATION -visualizaron I-EXPLORATION -múltiples I-EXPLORATION -telangiectasias I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -ano I-EXPLORATION -hasta I-EXPLORATION -ciego. I-EXPLORATION -No B-EVOLUTION -presentó I-EVOLUTION -melenas I-EVOLUTION -durante I-EVOLUTION -el I-EVOLUTION -ingreso I-EVOLUTION -ni I-EVOLUTION -hubo I-EVOLUTION -un I-EVOLUTION -descenso I-EVOLUTION -del I-EVOLUTION -hematocrito I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con B-TREATMENT -suplementos I-TREATMENT -de I-TREATMENT -hierro I-TREATMENT -y I-TREATMENT -ácido I-TREATMENT -fólico I-TREATMENT -orales. I-TREATMENT - I-TREATMENT - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -diagnosticada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -urotelial I-PRESENT_ILLNESS -sólido I-PRESENT_ILLNESS -infiltrante I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -alto I-PRESENT_ILLNESS -grado, I-PRESENT_ILLNESS -pobremente I-PRESENT_ILLNESS -diferenciado, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -infiltración I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -lámina I-PRESENT_ILLNESS -propia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -muscular. I-PRESENT_ILLNESS -Se B-TREATMENT -realiza I-TREATMENT -cistectomía I-TREATMENT -radical I-TREATMENT -y I-TREATMENT -ureterosigmoidostomia I-TREATMENT -destubulizada I-TREATMENT -(Mainz I-TREATMENT -II) I-TREATMENT -implantándose I-TREATMENT -ambos I-TREATMENT -uréteres I-TREATMENT -en I-TREATMENT -cara I-TREATMENT -lateral I-TREATMENT -izquierda I-TREATMENT -de I-TREATMENT -la I-TREATMENT -bolsa I-TREATMENT -con I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -catéteres I-TREATMENT -que I-TREATMENT -salen I-TREATMENT -por I-TREATMENT -contraincisión I-TREATMENT -a I-TREATMENT -bolsa I-TREATMENT -de I-TREATMENT -urostomía. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -comienza I-EVOLUTION -con I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -en I-EVOLUTION -flanco I-EVOLUTION -derecho I-EVOLUTION -con I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -irritación I-EVOLUTION -peritoneal I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -leucocitosis. I-EVOLUTION -Se I-EVOLUTION -objetiva I-EVOLUTION -migración I-EVOLUTION -subcutánea I-EVOLUTION -de I-EVOLUTION -catéter I-EVOLUTION -izquierdo. I-EVOLUTION -Se B-EXPLORATION -realiza I-EXPLORATION -TC I-EXPLORATION -urgente I-EXPLORATION -identificándose I-EXPLORATION -el I-EXPLORATION -catéter I-EXPLORATION -tipo I-EXPLORATION -pig-tail I-EXPLORATION -con I-EXPLORATION -rizo I-EXPLORATION -en I-EXPLORATION -pelvis I-EXPLORATION -renal I-EXPLORATION -izquierda I-EXPLORATION -que I-EXPLORATION -lleva I-EXPLORATION -un I-EXPLORATION -trayecto I-EXPLORATION -normal I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -parte I-EXPLORATION -anterior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -neovejiga, I-EXPLORATION -saliendo I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -parte I-EXPLORATION -posterior I-EXPLORATION -y I-EXPLORATION -presentando I-EXPLORATION -desde I-EXPLORATION -entonces I-EXPLORATION -una I-EXPLORATION -trayectoria I-EXPLORATION -ascendente I-EXPLORATION -anterior I-EXPLORATION -al I-EXPLORATION -ciego I-EXPLORATION -para I-EXPLORATION -posteriormente I-EXPLORATION -dirigirse I-EXPLORATION -a I-EXPLORATION -línea I-EXPLORATION -media, I-EXPLORATION -siempre I-EXPLORATION -superficial I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -asas I-EXPLORATION -girando I-EXPLORATION -en I-EXPLORATION -última I-EXPLORATION -instancia I-EXPLORATION -hacia I-EXPLORATION -flanco I-EXPLORATION -derecho. I-EXPLORATION -La I-EXPLORATION -punta I-EXPLORATION -se I-EXPLORATION -localiza I-EXPLORATION -inmediatamente I-EXPLORATION -posterior I-EXPLORATION -al I-EXPLORATION -músculo I-EXPLORATION -recto I-EXPLORATION -abdominal I-EXPLORATION -anterior I-EXPLORATION -derecho. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -ven I-EXPLORATION -burbujas I-EXPLORATION -aéreas I-EXPLORATION -extraluminares I-EXPLORATION -que I-EXPLORATION -sugieran I-EXPLORATION -perforación. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -colonoscopia I-EXPLORATION -urgente, I-EXPLORATION -introduciendo I-EXPLORATION -el I-EXPLORATION -endoscopio I-EXPLORATION -hasta I-EXPLORATION -20 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -margen I-EXPLORATION -anal. I-EXPLORATION -A I-EXPLORATION -ese I-EXPLORATION -nivel I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -neovejiga I-EXPLORATION -con I-EXPLORATION -catéter I-EXPLORATION -en I-EXPLORATION -unión I-EXPLORATION -uretero-vesical I-EXPLORATION -con I-EXPLORATION -salida I-EXPLORATION -por I-EXPLORATION -pared I-EXPLORATION -posterior, I-EXPLORATION -sin I-EXPLORATION -identificarse I-EXPLORATION -extremo I-EXPLORATION -distal. I-EXPLORATION -Se B-TREATMENT -extrae I-TREATMENT -catéter I-TREATMENT -con I-TREATMENT -pinza I-TREATMENT -sin I-TREATMENT -incidencias, I-TREATMENT -presentando B-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -posteriormente I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -clínica, I-EVOLUTION -con I-EVOLUTION -desaparición I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -abdominal, I-EVOLUTION -siendo I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION -del I-EVOLUTION -procedimiento. I-EVOLUTION - I-EVOLUTION - -Un B-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -fue B-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestra I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -ya I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -hacía I-DERIVED_FROM/TO -dos I-DERIVED_FROM/TO -años I-DERIVED_FROM/TO -tenía I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -concentración I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -ferritina I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -suero I-DERIVED_FROM/TO -superior I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -1.000 I-DERIVED_FROM/TO -µg/l I-DERIVED_FROM/TO -(rango I-DERIVED_FROM/TO -normal, I-DERIVED_FROM/TO -26-370). I-DERIVED_FROM/TO -El B-EXPLORATION -paciente I-EXPLORATION -tenía I-EXPLORATION -la I-EXPLORATION -ferritina I-EXPLORATION -sérica I-EXPLORATION -(1.277 I-EXPLORATION -µg/l) I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -γGT I-EXPLORATION -(116 I-EXPLORATION -U/L; I-EXPLORATION -rango I-EXPLORATION -normal, I-EXPLORATION -10-60) I-EXPLORATION -aumentadas, I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -del I-EXPLORATION -hígado I-EXPLORATION -nos I-EXPLORATION -llevó I-EXPLORATION -a I-EXPLORATION -sospechar I-EXPLORATION -posible I-EXPLORATION -hígado I-EXPLORATION -graso. I-EXPLORATION -Las I-EXPLORATION -pruebas I-EXPLORATION -analíticas I-EXPLORATION -y I-EXPLORATION -serológicas I-EXPLORATION -complementarias I-EXPLORATION -no I-EXPLORATION -revelaron I-EXPLORATION -ninguna I-EXPLORATION -anomalía. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -estaba I-EXPLORATION -asintomático. I-EXPLORATION -No B-PAST_MEDICAL_HISTORY -bebía I-PAST_MEDICAL_HISTORY -alcohol I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -consumía I-PAST_MEDICAL_HISTORY -tabaco. I-PAST_MEDICAL_HISTORY -Su B-FAMILY_HISTORY -historia I-FAMILY_HISTORY -clínica I-FAMILY_HISTORY -personal I-FAMILY_HISTORY -y I-FAMILY_HISTORY -familiar, I-FAMILY_HISTORY -y I-FAMILY_HISTORY -el I-FAMILY_HISTORY -examen I-FAMILY_HISTORY -físico I-FAMILY_HISTORY -no I-FAMILY_HISTORY -reflejaban I-FAMILY_HISTORY -nada I-FAMILY_HISTORY -destacable. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Analizamos B-EXPLORATION -los I-EXPLORATION -marcadores I-EXPLORATION -del I-EXPLORATION -metabolismo I-EXPLORATION -del I-EXPLORATION -hierro I-EXPLORATION -(niveles I-EXPLORATION -de I-EXPLORATION -hierro I-EXPLORATION -en I-EXPLORATION -suero, I-EXPLORATION -ferritina, I-EXPLORATION -receptor I-EXPLORATION -soluble I-EXPLORATION -de I-EXPLORATION -transferrina I-EXPLORATION -e I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -transferrina), I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -concentración I-EXPLORATION -de I-EXPLORATION -hierro I-EXPLORATION -hepático I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -arquitectura I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -hepático I-EXPLORATION -mediante I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -del I-EXPLORATION -hígado. I-EXPLORATION -Las I-EXPLORATION -secciones I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -hepático I-EXPLORATION -de I-EXPLORATION -cinco I-EXPLORATION -micrómetros I-EXPLORATION -se I-EXPLORATION -tiñeron I-EXPLORATION -con I-EXPLORATION -hematoxilina-eosina, I-EXPLORATION -y I-EXPLORATION -azul I-EXPLORATION -Prusia I-EXPLORATION -de I-EXPLORATION -Perls I-EXPLORATION -para I-EXPLORATION -detectar I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -hierro. I-EXPLORATION -Se I-EXPLORATION -estudió I-EXPLORATION -la I-EXPLORATION -imagen I-EXPLORATION -obtenida I-EXPLORATION -mediante I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -del I-EXPLORATION -hígado I-EXPLORATION -(MRI). I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -buscaron I-EXPLORATION -las I-EXPLORATION -variaciones I-EXPLORATION -alélicas I-EXPLORATION -c.845G>A I-EXPLORATION -(p.C282Y) I-EXPLORATION -y I-EXPLORATION -c.187C>G I-EXPLORATION -(p.H63D) I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -gen I-EXPLORATION -HFE. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -ADN I-EXPLORATION -genómico I-EXPLORATION -se I-EXPLORATION -extrajo I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -periférica, I-EXPLORATION -la I-EXPLORATION -reacción I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -de I-EXPLORATION -polimerasa I-EXPLORATION -(PCR) I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -mediante I-EXPLORATION -oligonucleótidos I-EXPLORATION -específicos I-EXPLORATION -para I-EXPLORATION -amplificar I-EXPLORATION -las I-EXPLORATION -regiones I-EXPLORATION -codificantes, I-EXPLORATION -las I-EXPLORATION -regiones I-EXPLORATION -intrónicas I-EXPLORATION -adyacentes, I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -regiones I-EXPLORATION -sin I-EXPLORATION -traducir I-EXPLORATION -5 I-EXPLORATION -' I-EXPLORATION -y I-EXPLORATION -3 I-EXPLORATION -' I-EXPLORATION -(UTR) I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -genes: I-EXPLORATION -HFE, I-EXPLORATION -hemojuvelina I-EXPLORATION -(HJV), I-EXPLORATION -hepcidina I-EXPLORATION -(HAMP), I-EXPLORATION -receptor I-EXPLORATION -2 I-EXPLORATION -de I-EXPLORATION -transferrina I-EXPLORATION -(TFR2) I-EXPLORATION -y I-EXPLORATION -ferroportina I-EXPLORATION -(SLC40A1). I-EXPLORATION -Los I-EXPLORATION -productos I-EXPLORATION -de I-EXPLORATION -PCR I-EXPLORATION -se I-EXPLORATION -secuenciaron I-EXPLORATION -bidireccionalmente I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -secuenciador I-EXPLORATION -de I-EXPLORATION -ADN I-EXPLORATION -ABI I-EXPLORATION -Prism I-EXPLORATION -3130x1, I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -secuencias I-EXPLORATION -se I-EXPLORATION -compararon I-EXPLORATION -con I-EXPLORATION -las I-EXPLORATION -de I-EXPLORATION -referencia I-EXPLORATION -(números I-EXPLORATION -de I-EXPLORATION -accesión I-EXPLORATION -del I-EXPLORATION -GenBank: I-EXPLORATION -NG_008720.1, I-EXPLORATION -NG_011568.1, I-EXPLORATION -NG_011563.1, I-EXPLORATION -NM_003227.3 I-EXPLORATION -y I-EXPLORATION -NG_009027.1, I-EXPLORATION -respectivamente, I-EXPLORATION -para I-EXPLORATION -los I-EXPLORATION -genes I-EXPLORATION -mencionados). I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -obtuvo I-EXPLORATION -el I-EXPLORATION -consentimiento I-EXPLORATION -informado I-EXPLORATION -del I-EXPLORATION -paciente I-EXPLORATION -según I-EXPLORATION -las I-EXPLORATION -recomendaciones I-EXPLORATION -locales I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -genético I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -del I-EXPLORATION -hígado. I-EXPLORATION -El I-EXPLORATION -protocolo I-EXPLORATION -de I-EXPLORATION -estudio I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -de I-EXPLORATION -acuerdo I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -principios I-EXPLORATION -éticos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -declaración I-EXPLORATION -de I-EXPLORATION -Helsinki I-EXPLORATION -(2008). I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -parámetros I-EXPLORATION -de I-EXPLORATION -hierro I-EXPLORATION -del I-EXPLORATION -paciente I-EXPLORATION -fueron: I-EXPLORATION -ferritina I-EXPLORATION -en I-EXPLORATION -suero, I-EXPLORATION -1.070 I-EXPLORATION -µg/l I-EXPLORATION -(rango I-EXPLORATION -normal, I-EXPLORATION -26-370 I-EXPLORATION -µg/l); I-EXPLORATION -hierro I-EXPLORATION -en I-EXPLORATION -suero, I-EXPLORATION -160 I-EXPLORATION -µg/dl I-EXPLORATION -(rango I-EXPLORATION -normal, I-EXPLORATION -59-158 I-EXPLORATION -µg/dl); I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -transferrina, I-EXPLORATION -48% I-EXPLORATION -(rango I-EXPLORATION -normal, I-EXPLORATION -20-45%); I-EXPLORATION -y I-EXPLORATION -receptor I-EXPLORATION -soluble I-EXPLORATION -de I-EXPLORATION -transferrina, I-EXPLORATION -0, I-EXPLORATION -90 I-EXPLORATION -mg/l I-EXPLORATION -(rango I-EXPLORATION -normal, I-EXPLORATION -1, I-EXPLORATION -76 I-EXPLORATION -± I-EXPLORATION -0, I-EXPLORATION -83 I-EXPLORATION -mg/l). I-EXPLORATION -La I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -hepática I-EXPLORATION -mostró I-EXPLORATION -anomalías I-EXPLORATION -difusas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -intensidad I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -parénquima, I-EXPLORATION -asociadas I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -hierro; I-EXPLORATION -el I-EXPLORATION -contenido I-EXPLORATION -de I-EXPLORATION -hierro I-EXPLORATION -hepático I-EXPLORATION -fue I-EXPLORATION -estimado I-EXPLORATION -en I-EXPLORATION -160 I-EXPLORATION -µmol/g I-EXPLORATION -(valores I-EXPLORATION -normales, I-EXPLORATION -< I-EXPLORATION -36 I-EXPLORATION -µmol/g). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -hepática I-EXPLORATION -percutánea I-EXPLORATION -guiada I-EXPLORATION -por I-EXPLORATION -ecografía. I-EXPLORATION -La I-EXPLORATION -evaluación I-EXPLORATION -histopatológica I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -arquitectura I-EXPLORATION -lobular I-EXPLORATION -normal, I-EXPLORATION -estrechos I-EXPLORATION -espacios I-EXPLORATION -portales I-EXPLORATION -sin I-EXPLORATION -inflamación I-EXPLORATION -o I-EXPLORATION -fibrosis I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -lesiones I-EXPLORATION -vasculares I-EXPLORATION -o I-EXPLORATION -ductales. I-EXPLORATION -El I-EXPLORATION -lóbulo I-EXPLORATION -estaba I-EXPLORATION -compuesto I-EXPLORATION -por I-EXPLORATION -hepatocitos I-EXPLORATION -con I-EXPLORATION -morfología I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -depósitos I-EXPLORATION -de I-EXPLORATION -baja I-EXPLORATION -intensidad I-EXPLORATION -de I-EXPLORATION -hemosiderina, I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -patrón I-EXPLORATION -típico I-EXPLORATION -de I-EXPLORATION -hemocromatosis, I-EXPLORATION -es I-EXPLORATION -decir, I-EXPLORATION -depósitos I-EXPLORATION -de I-EXPLORATION -hierro I-EXPLORATION -localizados I-EXPLORATION -casi I-EXPLORATION -exclusivamente I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -parenquimatosas I-EXPLORATION -en I-EXPLORATION -áreas I-EXPLORATION -periportales, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -patrón I-EXPLORATION -granular I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -distribución I-EXPLORATION -pericanalicular. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -flebotomías I-TREATMENT -y, I-TREATMENT -después I-TREATMENT -de I-TREATMENT -20 I-TREATMENT -flebotomías I-TREATMENT -quincenales, I-TREATMENT -se I-TREATMENT -eliminaron I-TREATMENT -más I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -g I-TREATMENT -de I-TREATMENT -hierro, I-TREATMENT -y I-TREATMENT -las I-TREATMENT -concentraciones I-TREATMENT -de I-TREATMENT -γGT I-TREATMENT -y I-TREATMENT -ferritina I-TREATMENT -volvieron I-TREATMENT -a I-TREATMENT -valores I-TREATMENT -normales. I-TREATMENT -Actualmente I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -somete I-TREATMENT -a I-TREATMENT -flebotomías I-TREATMENT -de I-TREATMENT -mantenimiento I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -año. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -molecular I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -genes I-EXPLORATION -implicados I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -metabolismo I-EXPLORATION -del I-EXPLORATION -hierro I-EXPLORATION -mostró I-EXPLORATION -las I-EXPLORATION -siguientes I-EXPLORATION -variantes I-EXPLORATION -alélicas I-EXPLORATION -en I-EXPLORATION -estado I-EXPLORATION -heterocigoto: I-EXPLORATION -c.187C>G I-EXPLORATION -(p.H63D) I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -gen I-EXPLORATION -HFE I-EXPLORATION -y I-EXPLORATION -c.840C>G I-EXPLORATION -(p.F280L) I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -gen I-EXPLORATION -TFR2. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -81 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus, I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -arteriopatía I-PAST_MEDICAL_HISTORY -periférica. I-PAST_MEDICAL_HISTORY -Presenta B-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -tóxico I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dispepsia I-PRESENT_ILLNESS -gástrica. I-PRESENT_ILLNESS -Estudio B-EXPLORATION -endoscópico I-EXPLORATION -que I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -neoformación I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -antral I-EXPLORATION -yuxtapilórica I-EXPLORATION -que I-EXPLORATION -dificulta I-EXPLORATION -el I-EXPLORATION -paso I-EXPLORATION -del I-EXPLORATION -endoscopio I-EXPLORATION -y I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -adenocarcinoma. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -destaca I-EXPLORATION -una I-EXPLORATION -anemia I-EXPLORATION -hipocrómica, I-EXPLORATION -y I-EXPLORATION -unos I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad I-EXPLORATION -(CEA: I-EXPLORATION -3, I-EXPLORATION -17 I-EXPLORATION -µg/l, I-EXPLORATION -CA I-EXPLORATION -19.9: I-EXPLORATION -17, I-EXPLORATION -31 I-EXPLORATION -KU/l). I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -evidencia I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -gástrica I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -por I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -curvatura I-EXPLORATION -menor I-EXPLORATION -hasta I-EXPLORATION -bulbo I-EXPLORATION -y I-EXPLORATION -primera I-EXPLORATION -porción I-EXPLORATION -duodenal I-EXPLORATION -con I-EXPLORATION -adenopatías I-EXPLORATION -adyacentes I-EXPLORATION -al I-EXPLORATION -margen I-EXPLORATION -inferior. I-EXPLORATION -Colelitiasis. I-EXPLORATION -No I-EXPLORATION -presenta I-EXPLORATION -adenopatías I-EXPLORATION -retroperitoneales I-EXPLORATION -ni I-EXPLORATION -metástasis I-EXPLORATION -a I-EXPLORATION -distancia. I-EXPLORATION -Se B-TREATMENT -practica I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -que I-TREATMENT -evidencia I-TREATMENT -neoplasia I-TREATMENT -antral I-TREATMENT -extendida I-TREATMENT -a I-TREATMENT -cuerpo I-TREATMENT -gástrico I-TREATMENT -y I-TREATMENT -se I-TREATMENT -practica I-TREATMENT -colecistectomía, I-TREATMENT -gastrectomía I-TREATMENT -total I-TREATMENT -y I-TREATMENT -esófago-yeyunostomía I-TREATMENT -en I-TREATMENT -Y I-TREATMENT -de I-TREATMENT -Roux. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -informa I-EXPLORATION -de I-EXPLORATION -dos I-EXPLORATION -masas I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -neoplásico, I-EXPLORATION -con I-EXPLORATION -centro I-EXPLORATION -úlcero-necrótico I-EXPLORATION -y I-EXPLORATION -márgenes I-EXPLORATION -mamelonados, I-EXPLORATION -separadas I-EXPLORATION -por I-EXPLORATION -pared I-EXPLORATION -gástrica I-EXPLORATION -de I-EXPLORATION -apariencia I-EXPLORATION -normal I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -longitud I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm. I-EXPLORATION -La I-EXPLORATION -tumoración I-EXPLORATION -más I-EXPLORATION -proximal I-EXPLORATION -mide I-EXPLORATION -65 I-EXPLORATION -x I-EXPLORATION -55 I-EXPLORATION -mm I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -proliferación I-EXPLORATION -neoplásica, I-EXPLORATION -de I-EXPLORATION -patrón I-EXPLORATION -difuso, I-EXPLORATION -que I-EXPLORATION -infiltra I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -gástrica I-EXPLORATION -alcanzando I-EXPLORATION -el I-EXPLORATION -tejido I-EXPLORATION -adiposo I-EXPLORATION -circundante, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -trata I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -linfoma I-EXPLORATION -no I-EXPLORATION -Hodgkin I-EXPLORATION -de I-EXPLORATION -alto I-EXPLORATION -grado, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -linfoma I-EXPLORATION -difuso I-EXPLORATION -de I-EXPLORATION -célula I-EXPLORATION -grande I-EXPLORATION -de I-EXPLORATION -inmunofenotipo I-EXPLORATION -B. I-EXPLORATION -La I-EXPLORATION -tumoración I-EXPLORATION -más I-EXPLORATION -distal I-EXPLORATION -mide I-EXPLORATION -55 I-EXPLORATION -x I-EXPLORATION -55 I-EXPLORATION -mm, I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -proliferación I-EXPLORATION -neoplásicas, I-EXPLORATION -de I-EXPLORATION -patrón I-EXPLORATION -difuso I-EXPLORATION -y I-EXPLORATION -glandular, I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -poligonales, I-EXPLORATION -con I-EXPLORATION -núcleo I-EXPLORATION -irregular, I-EXPLORATION -redondo, I-EXPLORATION -con I-EXPLORATION -nucléolo I-EXPLORATION -prominente I-EXPLORATION -y I-EXPLORATION -citoplasma I-EXPLORATION -amplio, I-EXPLORATION -eosinófilo. I-EXPLORATION -Dicha I-EXPLORATION -proliferación I-EXPLORATION -neoplásica I-EXPLORATION -infiltra I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -gástrica I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -capa I-EXPLORATION -muscular I-EXPLORATION -propia, I-EXPLORATION -sin I-EXPLORATION -alcanzar I-EXPLORATION -la I-EXPLORATION -serosa I-EXPLORATION -ni I-EXPLORATION -el I-EXPLORATION -tejido I-EXPLORATION -adiposo. I-EXPLORATION -Se I-EXPLORATION -trata I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION -de I-EXPLORATION -patrón I-EXPLORATION -intestinal I-EXPLORATION -y I-EXPLORATION -difuso. I-EXPLORATION -Márgenes I-EXPLORATION -quirúrgicos I-EXPLORATION -de I-EXPLORATION -resección I-EXPLORATION -no I-EXPLORATION -afectados. I-EXPLORATION -Se I-EXPLORATION -halla I-EXPLORATION -infiltración I-EXPLORATION -neoplásica I-EXPLORATION -por I-EXPLORATION -adenocarcinoma I-EXPLORATION -en I-EXPLORATION -uno I-EXPLORATION -de I-EXPLORATION -32 I-EXPLORATION -ganglios I-EXPLORATION -resecados, I-EXPLORATION -sin I-EXPLORATION -extensión I-EXPLORATION -extracapsular. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -sigue I-EVOLUTION -curso I-EVOLUTION -postoperatorio I-EVOLUTION -sin I-EVOLUTION -complicaciones. I-EVOLUTION -Valorado B-TREATMENT -por I-TREATMENT -el I-TREATMENT -comité I-TREATMENT -oncológico I-TREATMENT -se I-TREATMENT -desestima I-TREATMENT -tratamiento I-TREATMENT -adyuvante I-TREATMENT -por I-TREATMENT -las I-TREATMENT -comorbilidades I-TREATMENT -del I-TREATMENT -paciente. I-TREATMENT -Controlado B-EVOLUTION -en I-EVOLUTION -consultas I-EVOLUTION -externas I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -sigue I-EVOLUTION -buena I-EVOLUTION -evolución. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -75 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -cirugías I-PAST_MEDICAL_HISTORY -abdominales I-PAST_MEDICAL_HISTORY -(colecistectomía, I-PAST_MEDICAL_HISTORY -histerectomía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -eventroplastia) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pólipos I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -colon, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -remitida I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cambios I-PRESENT_ILLNESS -recientes I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hábito I-PRESENT_ILLNESS -intestinal. I-PRESENT_ILLNESS -La B-EXPLORATION -colonoscopia I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -segmento I-EXPLORATION -de I-EXPLORATION -colon I-EXPLORATION -sigmoideo I-EXPLORATION -muy I-EXPLORATION -angulado I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -divertículos I-EXPLORATION -que I-EXPLORATION -impedía I-EXPLORATION -el I-EXPLORATION -paso I-EXPLORATION -del I-EXPLORATION -endoscopio I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -través. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -otras I-EXPLORATION -anomalías. I-EXPLORATION -Dada I-EXPLORATION -la I-EXPLORATION -situación, I-EXPLORATION -decidimos I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -colonoscopia I-EXPLORATION -con I-EXPLORATION -cápsula I-EXPLORATION -para I-EXPLORATION -evaluar I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -colon, I-EXPLORATION -observándose I-EXPLORATION -un I-EXPLORATION -segmento I-EXPLORATION -de I-EXPLORATION -colon I-EXPLORATION -izquierdo I-EXPLORATION -estenótico, I-EXPLORATION -escasamente I-EXPLORATION -distensible I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -divertículos. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -otras I-EXPLORATION -lesiones. I-EXPLORATION -A I-EXPLORATION -pesar I-EXPLORATION -de I-EXPLORATION -todo, I-EXPLORATION -la I-EXPLORATION -colonoscopia I-EXPLORATION -con I-EXPLORATION -cápsula I-EXPLORATION -fue I-EXPLORATION -completa I-EXPLORATION -siendo I-EXPLORATION -esta I-EXPLORATION -excretada I-EXPLORATION -antes I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -finalización I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -baterías I-EXPLORATION -(< I-EXPLORATION -10 I-EXPLORATION -horas). I-EXPLORATION - I-EXPLORATION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -femenina I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -nulípara, B-PAST_MEDICAL_HISTORY -sexualmente I-PAST_MEDICAL_HISTORY -activa, I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -cuyos I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destacaba I-PAST_MEDICAL_HISTORY -anticoncepción I-PAST_MEDICAL_HISTORY -hormonal I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -anillo I-PAST_MEDICAL_HISTORY -vaginal, I-PAST_MEDICAL_HISTORY -aproximadamente I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -flujo I-PAST_MEDICAL_HISTORY -vaginal I-PAST_MEDICAL_HISTORY -anormal I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -año, I-PAST_MEDICAL_HISTORY -algunas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -cuales I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -tópico I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antimicóticos, I-PAST_MEDICAL_HISTORY -drenaje I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -absceso I-PAST_MEDICAL_HISTORY -adyacente I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -clítoris I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -dispareunia I-PAST_MEDICAL_HISTORY -profunda I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -leucorrea I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -tratadas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -mes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución. I-PAST_MEDICAL_HISTORY -Fumadora I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -15 I-PAST_MEDICAL_HISTORY -cigarrillos I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -día, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -seguía I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -habitual. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Ingresa B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -rápidamente I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS -exacerbado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -inspiración I-PRESENT_ILLNESS -profunda, I-PRESENT_ILLNESS -movimientos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -maniobras I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Valsalva, I-PRESENT_ILLNESS -inicialmente I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -flanco I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fosa I-PRESENT_ILLNESS -iliaca I-PRESENT_ILLNESS -derechas, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -exacerbación I-PRESENT_ILLNESS -postprandial, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ocasiones I-PRESENT_ILLNESS -acompañado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -Coincidiendo I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -última I-PRESENT_ILLNESS -menstruación, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -acompañaba I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -leve I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -moderado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipogastrio. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -presentado I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -hábito I-PRESENT_ILLNESS -deposicional I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -otros I-PRESENT_ILLNESS -síntomas. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -en I-EXPLORATION -urgencias I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -hemodinámicamente I-EXPLORATION -estable, I-EXPLORATION -afebril. I-EXPLORATION -Auscultación I-EXPLORATION -pulmonar I-EXPLORATION -y I-EXPLORATION -cardiacas I-EXPLORATION -normales. I-EXPLORATION -Abdomen I-EXPLORATION -no I-EXPLORATION -distendido, I-EXPLORATION -peristaltismo I-EXPLORATION -conservado, I-EXPLORATION -blando I-EXPLORATION -depresible I-EXPLORATION -muy I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -superficial I-EXPLORATION -y I-EXPLORATION -defensa I-EXPLORATION -en I-EXPLORATION -hipocondrio I-EXPLORATION -derecho, I-EXPLORATION -doloroso I-EXPLORATION -leve I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -hipogastrio. I-EXPLORATION -Blumberg I-EXPLORATION -positivo I-EXPLORATION -reflejado I-EXPLORATION -en I-EXPLORATION -dicha I-EXPLORATION -localización. I-EXPLORATION -Puñopercusión I-EXPLORATION -lumbar I-EXPLORATION -derecha I-EXPLORATION -positiva I-EXPLORATION -reflejada I-EXPLORATION -a I-EXPLORATION -hipocondrio I-EXPLORATION -derecho. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -genital I-EXPLORATION -se I-EXPLORATION -evidencia I-EXPLORATION -eritema I-EXPLORATION -vulvar I-EXPLORATION -y I-EXPLORATION -perianal, I-EXPLORATION -vagina I-EXPLORATION -con I-EXPLORATION -anillo I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior I-EXPLORATION -y I-EXPLORATION -leucorrea. I-EXPLORATION -Cérvix I-EXPLORATION -posterior I-EXPLORATION -formado I-EXPLORATION -y I-EXPLORATION -cerrado. I-EXPLORATION - I-EXPLORATION -Analíticamente I-EXPLORATION -destacaba: I-EXPLORATION -Hb: I-EXPLORATION -12, I-EXPLORATION -1 I-EXPLORATION -g/dl; I-EXPLORATION -leucocitos: I-EXPLORATION -12.800; I-EXPLORATION -neutrófilos: I-EXPLORATION -77%; I-EXPLORATION -plaquetas: I-EXPLORATION -281.000, I-EXPLORATION -quick: I-EXPLORATION -103%, I-EXPLORATION -fibrinógeno I-EXPLORATION -3, I-EXPLORATION -1 I-EXPLORATION -mg/dl; I-EXPLORATION -creatinina I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -mg/dl; I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -0, I-EXPLORATION -2 I-EXPLORATION -mg/dl; I-EXPLORATION -sodio I-EXPLORATION -138; I-EXPLORATION -potasio I-EXPLORATION -3, I-EXPLORATION -5; I-EXPLORATION -AST I-EXPLORATION -14; I-EXPLORATION -ALT I-EXPLORATION -12; I-EXPLORATION -amilasa I-EXPLORATION -41; I-EXPLORATION -LDH I-EXPLORATION -271; I-EXPLORATION -PCR: I-EXPLORATION -6, I-EXPLORATION -77 I-EXPLORATION -mg/dl; I-EXPLORATION -VSG I-EXPLORATION -28. I-EXPLORATION -El I-EXPLORATION -sedimento I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -estaba I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad, I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -evidenciaba I-EXPLORATION -únicamente I-EXPLORATION -neumatización I-EXPLORATION -del I-EXPLORATION -colon. I-EXPLORATION -No I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -asas I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -y I-EXPLORATION -gas I-EXPLORATION -en I-EXPLORATION -ampolla I-EXPLORATION -rectal. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -patología I-EXPLORATION -hepatobiliar, I-EXPLORATION -por I-EXPLORATION -tratarse I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -causa I-EXPLORATION -más I-EXPLORATION -frecuente I-EXPLORATION -de I-EXPLORATION -dolor I-EXPLORATION -en I-EXPLORATION -cuadrante I-EXPLORATION -superior I-EXPLORATION -derecho, I-EXPLORATION -a I-EXPLORATION -pesar I-EXPLORATION -de I-EXPLORATION -no I-EXPLORATION -encontrar I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -al I-EXPLORATION -respecto, I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -realizar I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -reporta I-EXPLORATION -vesícula I-EXPLORATION -biliar I-EXPLORATION -distendida, I-EXPLORATION -de I-EXPLORATION -paredes I-EXPLORATION -finas I-EXPLORATION -y I-EXPLORATION -alitiásica I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -mínima I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -perivesicular. I-EXPLORATION - I-EXPLORATION -Al I-EXPLORATION -descartar I-EXPLORATION -patología I-EXPLORATION -hepática, I-EXPLORATION -biliar I-EXPLORATION -litiásica I-EXPLORATION -y I-EXPLORATION -vesicular I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -que I-EXPLORATION -objetiva I-EXPLORATION -hepatomegalia I-EXPLORATION -homogénea I-EXPLORATION -sin I-EXPLORATION -lesiones I-EXPLORATION -focales, I-EXPLORATION -edema I-EXPLORATION -periportal I-EXPLORATION -difuso I-EXPLORATION -; I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -no I-EXPLORATION -dilatada, I-EXPLORATION -líquido I-EXPLORATION -perivesicular, I-EXPLORATION -riñones I-EXPLORATION -normales, I-EXPLORATION -no I-EXPLORATION -había I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -asas I-EXPLORATION -intestinales. I-EXPLORATION -Ciego I-EXPLORATION -y I-EXPLORATION -apéndice I-EXPLORATION -normales I-EXPLORATION -de I-EXPLORATION -localización I-EXPLORATION -pélvica. I-EXPLORATION -Páncreas I-EXPLORATION -normal. I-EXPLORATION -Mínimo I-EXPLORATION -líquido I-EXPLORATION -pélvico I-EXPLORATION -de I-EXPLORATION -localización I-EXPLORATION -perianexial I-EXPLORATION -izquierdo. I-EXPLORATION -Resto I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Siendo I-EXPLORATION -descartadas I-EXPLORATION -otras I-EXPLORATION -patologías I-EXPLORATION -causantes I-EXPLORATION -de I-EXPLORATION -dolor I-EXPLORATION -en I-EXPLORATION -cuadrante I-EXPLORATION -superior I-EXPLORATION -izquierdo, I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -hepatobiliar, I-EXPLORATION -neumonía, I-EXPLORATION -patología I-EXPLORATION -renal, I-EXPLORATION -etc., I-EXPLORATION -tanto I-EXPLORATION -por I-EXPLORATION -analítica I-EXPLORATION -como I-EXPLORATION -por I-EXPLORATION -estudios I-EXPLORATION -de I-EXPLORATION -imagen, I-EXPLORATION -y I-EXPLORATION -tomando I-EXPLORATION -en I-EXPLORATION -cuenta I-EXPLORATION -las I-EXPLORATION -características I-EXPLORATION -del I-EXPLORATION -dolor, I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -en I-EXPLORATION -eco I-EXPLORATION -y I-EXPLORATION -TAC I-EXPLORATION -sugestivos I-EXPLORATION -de I-EXPLORATION -afectación I-EXPLORATION -inflamatoria I-EXPLORATION -perihepática, I-EXPLORATION -líquido I-EXPLORATION -perianexial I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -marcadores I-EXPLORATION -inflamatorios, I-EXPLORATION -en I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -probable I-EXPLORATION -infección I-EXPLORATION -ginecológica I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -pélvico, I-EXPLORATION -se I-EXPLORATION -orienta I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -como I-EXPLORATION -perihepatitis I-EXPLORATION -de I-EXPLORATION -origen I-EXPLORATION -infeccioso, I-EXPLORATION -motivo I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -ecografía I-EXPLORATION -transvaginal I-EXPLORATION -que I-EXPLORATION -reporta I-EXPLORATION -útero I-EXPLORATION -y I-EXPLORATION -ovarios I-EXPLORATION -normales, I-EXPLORATION -endometrio I-EXPLORATION -de I-EXPLORATION -8 I-EXPLORATION -mm I-EXPLORATION -homogéneo, I-EXPLORATION -sin I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -en I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -saco I-EXPLORATION -de I-EXPLORATION -Douglas. I-EXPLORATION -Se I-EXPLORATION -obtienen I-EXPLORATION -muestras I-EXPLORATION -de I-EXPLORATION -flujo I-EXPLORATION -vaginal I-EXPLORATION -para I-EXPLORATION -cultivos I-EXPLORATION -que I-EXPLORATION -resultan I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -Candida I-EXPLORATION -albicans, I-EXPLORATION -Gardnerella I-EXPLORATION -vaginalis I-EXPLORATION -y I-EXPLORATION -Ureraplasma I-EXPLORATION -urealiticum. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -amplificación I-EXPLORATION -genética I-EXPLORATION -de I-EXPLORATION -PCR I-EXPLORATION -(reacción I-EXPLORATION -de I-EXPLORATION -cadena I-EXPLORATION -de I-EXPLORATION -polimerasa) I-EXPLORATION -para I-EXPLORATION -Chlamydia I-EXPLORATION -trachomatis I-EXPLORATION -fue I-EXPLORATION -positivo. I-EXPLORATION - I-EXPLORATION -Una B-TREATMENT -vez I-TREATMENT -confirmado I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -como I-TREATMENT -una I-TREATMENT -perihepatitis I-TREATMENT -por I-TREATMENT -C. I-TREATMENT -trachomatis I-TREATMENT -de I-TREATMENT -punto I-TREATMENT -de I-TREATMENT -partida I-TREATMENT -de I-TREATMENT -una I-TREATMENT -EIP, I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -azitromicina I-TREATMENT -2 I-TREATMENT -g I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -única, I-TREATMENT -presentando B-EVOLUTION -franca I-EVOLUTION -mejoría I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -inflamatorios I-EVOLUTION -al I-EVOLUTION -cabo I-EVOLUTION -de I-EVOLUTION -24-48 I-EVOLUTION -horas. I-EVOLUTION -Así B-TREATMENT -mismo I-TREATMENT -iniciamos I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -óvulos I-TREATMENT -de I-TREATMENT -clotrimazol I-TREATMENT -con I-TREATMENT -mejoría I-TREATMENT -del I-TREATMENT -prurito I-TREATMENT -y I-TREATMENT -de I-TREATMENT -la I-TREATMENT -leucorrea. I-TREATMENT -Debido B-EXPLORATION -a I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -Chlamydia I-EXPLORATION -trachomatis I-EXPLORATION -es I-EXPLORATION -un I-EXPLORATION -germen I-EXPLORATION -de I-EXPLORATION -transmisión I-EXPLORATION -sexual, I-EXPLORATION -se I-EXPLORATION -practicaron I-EXPLORATION -pruebas I-EXPLORATION -serológicas I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -otros I-EXPLORATION -agentes I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -categoría I-EXPLORATION -como I-EXPLORATION -VIH I-EXPLORATION -y I-EXPLORATION -VDRL I-EXPLORATION -siendo I-EXPLORATION -ambas I-EXPLORATION -negativas. I-EXPLORATION -Después I-EXPLORATION -de I-EXPLORATION -haber I-EXPLORATION -culminado I-EXPLORATION -tratamiento I-EXPLORATION -antibiótico, I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -tomografía I-EXPLORATION -abdominal I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -que I-EXPLORATION -destaca I-EXPLORATION -una I-EXPLORATION -fina I-EXPLORATION -línea I-EXPLORATION -de I-EXPLORATION -colección I-EXPLORATION -líquida I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -saco I-EXPLORATION -de I-EXPLORATION -Douglas. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -estudio I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Al B-EVOLUTION -cabo I-EVOLUTION -de I-EVOLUTION -1 I-EVOLUTION -mes I-EVOLUTION -se I-EVOLUTION -cita I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -para I-EVOLUTION -valorar I-EVOLUTION -estado I-EVOLUTION -clínico I-EVOLUTION -y I-EVOLUTION -nuevo I-EVOLUTION -control I-EVOLUTION -analítico, I-EVOLUTION -quien I-EVOLUTION -se I-EVOLUTION -encontraba I-EVOLUTION -con I-EVOLUTION -buen I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -sin I-EVOLUTION -leucorrea, I-EVOLUTION -dispareunia, I-EVOLUTION -ni I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -palpación I-EVOLUTION -superficial I-EVOLUTION -y I-EVOLUTION -profunda. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -únicos I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -acude B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -mucocutánea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -coluria, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -epigástrico I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -características I-PRESENT_ILLNESS -cólicas, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -mostraba I-EXPLORATION -dolor I-EXPLORATION -en I-EXPLORATION -hipocondrio I-EXPLORATION -derecho I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -peritonismo. I-EXPLORATION -En I-EXPLORATION -una I-EXPLORATION -analítica I-EXPLORATION -sanguínea I-EXPLORATION -destacaba I-EXPLORATION -bilirrubina I-EXPLORATION -5, I-EXPLORATION -6 I-EXPLORATION -mg/dl, I-EXPLORATION -GOT I-EXPLORATION -608 I-EXPLORATION -UI/l I-EXPLORATION -y I-EXPLORATION -GPT I-EXPLORATION -720 I-EXPLORATION -UI/l. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -coledocolitiasis I-EXPLORATION -con I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -colédoco I-EXPLORATION -(22, I-EXPLORATION -4 I-EXPLORATION -mm) I-EXPLORATION -y I-EXPLORATION -colelitiasis. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -CPRE, I-EXPLORATION -confirmándose I-EXPLORATION -la I-EXPLORATION -coledocolitiasis; I-EXPLORATION -se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -realizar I-TREATMENT -esfinterotomía I-TREATMENT -endoscópica I-TREATMENT -y I-TREATMENT -extracción I-TREATMENT -del I-TREATMENT -cálculo I-TREATMENT -en I-TREATMENT -colédoco. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -2 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -finalizar I-EVOLUTION -la I-EVOLUTION -prueba, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -comienza I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -dolor I-EVOLUTION -súbito I-EVOLUTION -en I-EVOLUTION -hipocondrio I-EVOLUTION -derecho. I-EVOLUTION -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -dolor I-EXPLORATION -en I-EXPLORATION -hipocondrio I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal, I-EXPLORATION -taquicardia, I-EXPLORATION -taquipnea I-EXPLORATION -e I-EXPLORATION -hipotensión I-EXPLORATION -arterial I-EXPLORATION -de I-EXPLORATION -95/60. I-EXPLORATION -Analíticamente I-EXPLORATION -destacaba I-EXPLORATION -bilirrubina I-EXPLORATION -3, I-EXPLORATION -4 I-EXPLORATION -mg/dl, I-EXPLORATION -GOT I-EXPLORATION -315, I-EXPLORATION -amilasa I-EXPLORATION -64 I-EXPLORATION -U/l, I-EXPLORATION -GPT I-EXPLORATION -450, I-EXPLORATION -leucocitos I-EXPLORATION -15.400/mm3, I-EXPLORATION -hemoglobina I-EXPLORATION -5, I-EXPLORATION -5 I-EXPLORATION -g/dl I-EXPLORATION -y I-EXPLORATION -creatinina I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -4 I-EXPLORATION -mg/dl. I-EXPLORATION -Se B-TREATMENT -administró I-TREATMENT -fluidoterapia I-TREATMENT -con I-TREATMENT -parcial I-TREATMENT -respuesta I-TREATMENT -hemodinámica. I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -evidenciándose I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -intraperitoneal I-EXPLORATION -en I-EXPLORATION -ambas I-EXPLORATION -gotieras I-EXPLORATION -y I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -saco I-EXPLORATION -de I-EXPLORATION -Douglas, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -hipodensa I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -mal I-EXPLORATION -definidos I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -hepático I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -aerobilia I-EXPLORATION -en I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -extrahepática, I-EXPLORATION -sin I-EXPLORATION -neumoperitoneo. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -estos I-TREATMENT -hallazgos I-TREATMENT -y I-TREATMENT -la I-TREATMENT -persistencia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -inestabilidad I-TREATMENT -hemodinámica I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -intervenir I-TREATMENT -quirúrgicamente I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente. I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -cirugía I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -hemoperitoneo I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -hematoma I-EXPLORATION -subcapsular I-EXPLORATION -hepático I-EXPLORATION -de I-EXPLORATION -8 I-EXPLORATION -cm I-EXPLORATION -parcialmente I-EXPLORATION -roto I-EXPLORATION -localizado I-EXPLORATION -en I-EXPLORATION -segmentos I-EXPLORATION -V-VI I-EXPLORATION -hepáticos. I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -evacuación I-TREATMENT -del I-TREATMENT -mismo I-TREATMENT -y I-TREATMENT -hemostasia I-TREATMENT -local I-TREATMENT -con I-TREATMENT -electrocoagulación I-TREATMENT -y I-TREATMENT -Surgicel®, I-TREATMENT -dejando I-TREATMENT -un I-TREATMENT -drenaje I-TREATMENT -tipo I-TREATMENT -Jackson-Pratt I-TREATMENT -en I-TREATMENT -espacio I-TREATMENT -subfrénico I-TREATMENT -derecho. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -estuvo I-EVOLUTION -ingresada I-EVOLUTION -en I-EVOLUTION -UCI I-EVOLUTION -durante I-EVOLUTION -48 I-EVOLUTION -horas. I-EVOLUTION -La I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presentó I-EVOLUTION -nuevos I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -sangrado I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -TC I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -objetivó I-EVOLUTION -ninguna I-EVOLUTION -colección, I-EVOLUTION -siendo I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -4 I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -rectorragia I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -coágulos, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Otros I-PRESENT_ILLNESS -síntomas: I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -anorrectal I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -defecar, I-PRESENT_ILLNESS -urgencia I-PRESENT_ILLNESS -defecatoria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -estreñimiento I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año. I-PRESENT_ILLNESS -La B-EVOLUTION -rectorragia I-EVOLUTION -cedió I-EVOLUTION -espontáneamente I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -del I-EVOLUTION -ingreso. I-EVOLUTION - I-EVOLUTION -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -autoadministraba I-PAST_MEDICAL_HISTORY -supositorios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -paracetamol-codeína I-PAST_MEDICAL_HISTORY -(500/300 I-PAST_MEDICAL_HISTORY -mg) I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cefalea I-PAST_MEDICAL_HISTORY -crónica. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Exploración B-EXPLORATION -física: I-EXPLORATION -normal, I-EXPLORATION -pero I-EXPLORATION -tacto I-EXPLORATION -rectal I-EXPLORATION -muy I-EXPLORATION -doloroso, I-EXPLORATION -palpando I-EXPLORATION -zonas I-EXPLORATION -induradas I-EXPLORATION -e I-EXPLORATION -irregulares I-EXPLORATION -en I-EXPLORATION -mucosa I-EXPLORATION -rectal, I-EXPLORATION -apareciendo I-EXPLORATION -sangre I-EXPLORATION -fresca I-EXPLORATION -en I-EXPLORATION -guante. I-EXPLORATION - I-EXPLORATION -Analítica, I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -abdomen: I-EXPLORATION -normales. I-EXPLORATION -Colonoscopia I-EXPLORATION -total: I-EXPLORATION -pérdida I-EXPLORATION -del I-EXPLORATION -patrón I-EXPLORATION -vascular I-EXPLORATION -normal I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -rectal, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -gran I-EXPLORATION -ulceración I-EXPLORATION -difusa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -con I-EXPLORATION -pseudopólipos I-EXPLORATION -aislados, I-EXPLORATION -extendiéndose I-EXPLORATION -unos I-EXPLORATION -10 I-EXPLORATION -cm I-EXPLORATION -desde I-EXPLORATION -margen I-EXPLORATION -anal. I-EXPLORATION -Anatomía-patológica: I-EXPLORATION -ulceración I-EXPLORATION -inespecífica. I-EXPLORATION -Tomografía I-EXPLORATION -computerizada: I-EXPLORATION -estenosis I-EXPLORATION -rectal I-EXPLORATION -concéntrica I-EXPLORATION -y I-EXPLORATION -adenopatías I-EXPLORATION -perirectales. I-EXPLORATION -Serologías I-EXPLORATION -y I-EXPLORATION -tuberculina: I-EXPLORATION -negativas. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -este I-EXPLORATION -momento, I-EXPLORATION -se I-EXPLORATION -interrogó I-EXPLORATION -de I-EXPLORATION -nuevo I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -paciente, I-EXPLORATION -que I-EXPLORATION -finalmente I-EXPLORATION -admitió I-EXPLORATION -la I-EXPLORATION -administración I-EXPLORATION -de I-EXPLORATION -16 I-EXPLORATION -supositorios I-EXPLORATION -al I-EXPLORATION -día I-EXPLORATION -de I-EXPLORATION -paracetamol-codeína I-EXPLORATION -durante I-EXPLORATION -el I-EXPLORATION -último I-EXPLORATION -año. I-EXPLORATION -Entonces I-EXPLORATION -se I-EXPLORATION -diagnosticó I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -como I-EXPLORATION -rectitis/úlcera I-EXPLORATION -rectal I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -supositorios I-EXPLORATION -de I-EXPLORATION -paracetamol-codeína, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -adicción I-EXPLORATION -a I-EXPLORATION -opiáceos I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -confirmado I-EXPLORATION -y I-EXPLORATION -seguido I-EXPLORATION -por I-EXPLORATION -Psiquiatría. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -suspendieron I-TREATMENT -los I-TREATMENT -supositorios I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -enemas I-TREATMENT -de I-TREATMENT -hidrocortisona, I-TREATMENT -junto I-TREATMENT -con I-TREATMENT -benzodiazepinas I-TREATMENT -por I-TREATMENT -la I-TREATMENT -adicción I-TREATMENT -a I-TREATMENT -opiáceos. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -mejoró I-EVOLUTION -significativamente I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta. I-EVOLUTION - I-EVOLUTION -Las B-EXPLORATION -colonoscopias I-EXPLORATION -realizadas I-EXPLORATION -al I-EXPLORATION -segundo I-EXPLORATION -y I-EXPLORATION -sexto I-EXPLORATION -mes I-EXPLORATION -después I-EXPLORATION -del I-EXPLORATION -alta I-EXPLORATION -demostraron I-EXPLORATION -progresiva I-EXPLORATION -mejoría I-EXPLORATION -y I-EXPLORATION -curación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -rectales. I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -a I-TREATMENT -los I-TREATMENT -8 I-TREATMENT -meses. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -meses I-EVOLUTION -estaba I-EVOLUTION -completamente I-EVOLUTION -asintomática. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -de B-PAST_MEDICAL_HISTORY -nacionalidad I-PAST_MEDICAL_HISTORY -argentina, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -estreñimiento. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración, I-EXPLORATION -presenta I-EXPLORATION -discomfort I-EXPLORATION -abdominal I-EXPLORATION -en I-EXPLORATION -hemiabdomen I-EXPLORATION -inferior I-EXPLORATION -con I-EXPLORATION -sensación I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -en I-EXPLORATION -hipogastrio. I-EXPLORATION -Tacto I-EXPLORATION -rectal I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -descarta I-EXPLORATION -patología I-EXPLORATION -ginecológica I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -Rx I-EXPLORATION -abdomen I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -abundante I-EXPLORATION -material I-EXPLORATION -fecal. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -con I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -es I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -objetiva I-EXPLORATION -un I-EXPLORATION -fecaloma I-EXPLORATION -recto-sigmoidal I-EXPLORATION -y I-EXPLORATION -dilatación I-EXPLORATION -del I-EXPLORATION -colon. I-EXPLORATION -Los I-EXPLORATION -enemas I-EXPLORATION -de I-EXPLORATION -limpieza I-EXPLORATION -son I-EXPLORATION -efectivos I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -practica I-EXPLORATION -fibrocolonoscopia I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -normal. I-EXPLORATION -Durante B-FAMILY_HISTORY -el I-FAMILY_HISTORY -ingreso I-FAMILY_HISTORY -se I-FAMILY_HISTORY -reinterroga I-FAMILY_HISTORY -a I-FAMILY_HISTORY -la I-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -destacando I-FAMILY_HISTORY -como I-FAMILY_HISTORY -antecedente I-FAMILY_HISTORY -familiar I-FAMILY_HISTORY -la I-FAMILY_HISTORY -muerte I-FAMILY_HISTORY -de I-FAMILY_HISTORY -su I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -por I-FAMILY_HISTORY -afectación I-FAMILY_HISTORY -cardíaca I-FAMILY_HISTORY -por I-FAMILY_HISTORY -ECH I-FAMILY_HISTORY -a I-FAMILY_HISTORY -los I-FAMILY_HISTORY -45 I-FAMILY_HISTORY -años. I-FAMILY_HISTORY -Se B-EXPLORATION -realiza I-EXPLORATION -serología I-EXPLORATION -de I-EXPLORATION -ECH I-EXPLORATION -siendo I-EXPLORATION -esta I-EXPLORATION -positiva. I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -es I-EVOLUTION -sometida I-EVOLUTION -a I-EVOLUTION -tratamiento I-EVOLUTION -conservador, I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -y I-EVOLUTION -siendo I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -sin I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -intervención I-EVOLUTION -quirúrgica. I-EVOLUTION - I-EVOLUTION - -Una B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -fue B-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -carcinoma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -células I-PAST_MEDICAL_HISTORY -renales I-PAST_MEDICAL_HISTORY -estadio I-PAST_MEDICAL_HISTORY -1. I-PAST_MEDICAL_HISTORY -Fue I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -nefrectomía I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -quimioterapia I-PAST_MEDICAL_HISTORY -adyuvante. I-PAST_MEDICAL_HISTORY -Tres I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -tarde I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -metástasis I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cerebral. I-PAST_MEDICAL_HISTORY -Hace B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año, I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hemorragia I-PRESENT_ILLNESS -digestiva I-PRESENT_ILLNESS -alta. I-PRESENT_ILLNESS -Presentaba B-EXPLORATION -aceptable I-EXPLORATION -estado I-EXPLORATION -general I-EXPLORATION -y I-EXPLORATION -nutricional, I-EXPLORATION -TA I-EXPLORATION -120/70 I-EXPLORATION -y I-EXPLORATION -exploración I-EXPLORATION -cardiorrespiratoria I-EXPLORATION -normal. I-EXPLORATION -Abdomen I-EXPLORATION -blando, I-EXPLORATION -depresible I-EXPLORATION -sin I-EXPLORATION -masas I-EXPLORATION -palpables. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -analítico I-EXPLORATION -reveló I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -3 I-EXPLORATION -g/dl. I-EXPLORATION -Un I-EXPLORATION -TAC I-EXPLORATION -toraco-abdominal I-EXPLORATION -demostró I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION -en I-EXPLORATION -cuerpo I-EXPLORATION -y I-EXPLORATION -antro I-EXPLORATION -gástrico I-EXPLORATION -de I-EXPLORATION -11 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -mayor I-EXPLORATION -sin I-EXPLORATION -invasión I-EXPLORATION -de I-EXPLORATION -estructuras I-EXPLORATION -adyacentes. I-EXPLORATION -Una I-EXPLORATION -endoscopia I-EXPLORATION -alta I-EXPLORATION -demostró I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION -en I-EXPLORATION -cuerpo I-EXPLORATION -y I-EXPLORATION -antro I-EXPLORATION -gástrico. I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT -con I-TREATMENT -gastrectomía I-TREATMENT -subtotal I-TREATMENT -sin I-TREATMENT -complicaciones. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -demostró I-EXPLORATION -metástasis I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -renal. I-EXPLORATION - I-EXPLORATION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -65 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -diagnosticado B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Crohn I-PAST_MEDICAL_HISTORY -cólica I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -11 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -actualmente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -mesalazina, I-PAST_MEDICAL_HISTORY -y B-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -flanco I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -hipogastrio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -esporádicos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -apetito. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -este I-PRESENT_ILLNESS -contexto I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -palpa I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -dura I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -vacío I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fosa I-PRESENT_ILLNESS -iliaca I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -palpó I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -pétrea, I-EXPLORATION -no I-EXPLORATION -dolorosa, I-EXPLORATION -desplazable I-EXPLORATION -ligeramente I-EXPLORATION -aunque I-EXPLORATION -adherida I-EXPLORATION -a I-EXPLORATION -planos I-EXPLORATION -profundos. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -detectó I-EXPLORATION -leucocitosis I-EXPLORATION -(16,79x10e9/l) I-EXPLORATION -con I-EXPLORATION -neutrofilia I-EXPLORATION -y I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -122.0 I-EXPLORATION -g/l. I-EXPLORATION -Tanto I-EXPLORATION -la I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -sedimentación I-EXPLORATION -globular I-EXPLORATION -(89, I-EXPLORATION -0 I-EXPLORATION -mm/h) I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -(38, I-EXPLORATION -6 I-EXPLORATION -mg/l) I-EXPLORATION -se I-EXPLORATION -encontraban I-EXPLORATION -elevadas. I-EXPLORATION -Los I-EXPLORATION -marcadores I-EXPLORATION -tumorales I-EXPLORATION -(antígeno I-EXPLORATION -carcinoembrionario, I-EXPLORATION -beta-2-microglobulina, I-EXPLORATION -antígeno I-EXPLORATION -C.A. I-EXPLORATION -15.3, I-EXPLORATION -19.9 I-EXPLORATION -y I-EXPLORATION -125) I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -tomografía I-EXPLORATION -computadorizada I-EXPLORATION -abdominal I-EXPLORATION -apreciándose I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -sólida I-EXPLORATION -que I-EXPLORATION -englobaba I-EXPLORATION -al I-EXPLORATION -colon I-EXPLORATION -sigmoideo I-EXPLORATION -(flecha I-EXPLORATION -hueca), I-EXPLORATION -íleon I-EXPLORATION -distal I-EXPLORATION -(flecha I-EXPLORATION -blanca) I-EXPLORATION -y I-EXPLORATION -ciego I-EXPLORATION -(flecha I-EXPLORATION -negra) I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -múltiples I-EXPLORATION -adenopatías I-EXPLORATION -en I-EXPLORATION -algunos I-EXPLORATION -casos I-EXPLORATION -formando I-EXPLORATION -conglomerados I-EXPLORATION -(asteriscos). I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -colon I-EXPLORATION -sigmoideo I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -linfoma I-EXPLORATION -B I-EXPLORATION -difuso I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -grandes, I-EXPLORATION -con I-EXPLORATION -inmunofenotipo I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -centrogerminal. I-EXPLORATION -Ingresa B-TREATMENT -para I-TREATMENT -tratamiento I-TREATMENT -quimioterápico I-TREATMENT -según I-TREATMENT -protocolo I-TREATMENT -GELTAMO, I-TREATMENT -falleciendo B-EVOLUTION -4 I-EVOLUTION -días I-EVOLUTION -después. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -62 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -sólidos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -padecía I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -cirrosis I-PAST_MEDICAL_HISTORY -hepática I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -etílico I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -estadio I-PAST_MEDICAL_HISTORY -B8 I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Child-Pugh. I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -realizó I-EXPLORATION -gastroscopia I-EXPLORATION -encontrando I-EXPLORATION -dilatación I-EXPLORATION -y I-EXPLORATION -atonía I-EXPLORATION -del I-EXPLORATION -cuerpo I-EXPLORATION -esofágico, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -tres I-EXPLORATION -cordones I-EXPLORATION -varicosos I-EXPLORATION -de I-EXPLORATION -mediano I-EXPLORATION -tamaño I-EXPLORATION -en I-EXPLORATION -tercio I-EXPLORATION -inferior. I-EXPLORATION -Un I-EXPLORATION -tránsito I-EXPLORATION -baritado I-EXPLORATION -mostró I-EXPLORATION -dilatación I-EXPLORATION -esofágica I-EXPLORATION -con I-EXPLORATION -afilamiento I-EXPLORATION -distal. I-EXPLORATION -La I-EXPLORATION -manometría I-EXPLORATION -constató I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -peristaltismo I-EXPLORATION -en I-EXPLORATION -cuerpo I-EXPLORATION -esofágico. I-EXPLORATION -Un I-EXPLORATION -TC I-EXPLORATION -toraco-abdominal I-EXPLORATION -descartó I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -neoplasia I-EXPLORATION -regional. I-EXPLORATION -Se I-EXPLORATION -obtuvo I-EXPLORATION -6 I-EXPLORATION -sobre I-EXPLORATION -un I-EXPLORATION -score I-EXPLORATION -de I-EXPLORATION -disfagia I-EXPLORATION -de I-EXPLORATION -9 I-EXPLORATION -puntos I-EXPLORATION -(2). I-EXPLORATION -Con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -acalasia I-EXPLORATION -y B-TREATMENT -tras I-TREATMENT -valorar I-TREATMENT -las I-TREATMENT -diferentes I-TREATMENT -opciones I-TREATMENT -terapéuticas I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -ITB I-TREATMENT -guiada I-TREATMENT -por I-TREATMENT -ecoendoscopia. I-TREATMENT -Mediante I-TREATMENT -ecoendoscopio I-TREATMENT -Pentax I-TREATMENT -EG-3830UT I-TREATMENT -se I-TREATMENT -localizó I-TREATMENT -el I-TREATMENT -EEI I-TREATMENT -como I-TREATMENT -área I-TREATMENT -hipoecoica I-TREATMENT -engrosada I-TREATMENT -(7 I-TREATMENT -mm) I-TREATMENT -en I-TREATMENT -continuidad I-TREATMENT -con I-TREATMENT -la I-TREATMENT -capa I-TREATMENT -muscular I-TREATMENT -propia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -pared I-TREATMENT -esofágica. I-TREATMENT -En I-TREATMENT -dicha I-TREATMENT -zona I-TREATMENT -se I-TREATMENT -inyectó I-TREATMENT -mediante I-TREATMENT -aguja I-TREATMENT -de I-TREATMENT -ecoendoscopio I-TREATMENT -de I-TREATMENT -22 I-TREATMENT -G I-TREATMENT -EchoTip I-TREATMENT -Ultra I-TREATMENT -(COOK I-TREATMENT -Medical), I-TREATMENT -un I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -toxina I-TREATMENT -botulínica I-TREATMENT -(20 I-TREATMENT -UI) I-TREATMENT -(BoTox; I-TREATMENT -Inc., I-TREATMENT -Irvine, I-TREATMENT -Calif.) I-TREATMENT -diluida I-TREATMENT -a I-TREATMENT -1/5 I-TREATMENT -por I-TREATMENT -cuadrante I-TREATMENT -evitando I-TREATMENT -la I-TREATMENT -inyección I-TREATMENT -intravariz. I-TREATMENT -No B-EVOLUTION -hubo I-EVOLUTION -complicaciones I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -toleró I-EVOLUTION -dieta I-EVOLUTION -sólida I-EVOLUTION -en I-EVOLUTION -72 I-EVOLUTION -horas. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -9 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -solo I-EVOLUTION -refiere I-EVOLUTION -disfagia I-EVOLUTION -ocasional, I-EVOLUTION -puntuando I-EVOLUTION -1 I-EVOLUTION -sobre I-EVOLUTION -9 I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -score I-EVOLUTION -de I-EVOLUTION -disfagia. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -94 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -cardiaca I-PAST_MEDICAL_HISTORY -clase I-PAST_MEDICAL_HISTORY -funcional I-PAST_MEDICAL_HISTORY -III, I-PAST_MEDICAL_HISTORY -fibrilación I-PAST_MEDICAL_HISTORY -auricular I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -litiasis I-PAST_MEDICAL_HISTORY -vesicular I-PAST_MEDICAL_HISTORY -conocida I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -requirió I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -esfinterotomía I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -endoscopia I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -coledocolitiasis I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -88 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -desestimó I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -colecistectomía I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -comorbilidad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente. I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -intensificado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -días. I-PRESENT_ILLNESS -Refería I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -cuadrante I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -horas. I-PRESENT_ILLNESS -Negó I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Una B-EXPLORATION -punción I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -masa, I-EXPLORATION -de I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -11, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -objetivó I-EXPLORATION -la I-EXPLORATION -salida I-EXPLORATION -de I-EXPLORATION -material I-EXPLORATION -purulento. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica, I-EXPLORATION -presentaba I-EXPLORATION -únicamente I-EXPLORATION -leucocitosis I-EXPLORATION -(17,6.103/μl) I-EXPLORATION -con I-EXPLORATION -neutrofilia I-EXPLORATION -del I-EXPLORATION -88, I-EXPLORATION -9%. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -litiasis I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -vesícula, I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -contactaba I-EXPLORATION -directamente I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -adyacente, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -10 I-EXPLORATION -x I-EXPLORATION -6 I-EXPLORATION -x I-EXPLORATION -8, I-EXPLORATION -6 I-EXPLORATION -cm I-EXPLORATION -con I-EXPLORATION -aire I-EXPLORATION -y I-EXPLORATION -calcificaciones I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -mismas I-EXPLORATION -características I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -del I-EXPLORATION -interior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vesícula I-EXPLORATION -correspondiendo I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -Empiema I-EXPLORATION -necessitatis I-EXPLORATION -por I-EXPLORATION -colecistitis. I-EXPLORATION - I-EXPLORATION -Dada B-TREATMENT -la I-TREATMENT -comorbilidad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -únicamente I-TREATMENT -desbridamiento I-TREATMENT -y I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -un I-TREATMENT -drenaje I-TREATMENT -en I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -del I-TREATMENT -empiema I-TREATMENT -bajo I-TREATMENT -sedación. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -correcta. I-EVOLUTION -Fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -noveno I-EVOLUTION -día I-EVOLUTION -postoperatorio. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -53 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -cólico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hemiabdomen I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -acompañado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -oC, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -asociada. I-PRESENT_ILLNESS -El B-EXPLORATION -paciente I-EXPLORATION -presenta I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -hemiabdomen I-EXPLORATION -inferior, I-EXPLORATION -más I-EXPLORATION -intenso I-EXPLORATION -en I-EXPLORATION -fosa I-EXPLORATION -iliaca I-EXPLORATION -derecha, I-EXPLORATION -con I-EXPLORATION -defensa I-EXPLORATION -y I-EXPLORATION -signo I-EXPLORATION -de I-EXPLORATION -Blumberg I-EXPLORATION -positivo. I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -analítica I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -leucocitosis I-EXPLORATION -ni I-EXPLORATION -neutrofilia I-EXPLORATION -(leucocitos I-EXPLORATION -8, I-EXPLORATION -8 I-EXPLORATION -x I-EXPLORATION -109/L, I-EXPLORATION -neutrófilos I-EXPLORATION -70%) I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION -abdominal I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -únicamente I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -asas I-EXPLORATION -intestinales. I-EXPLORATION -Se I-EXPLORATION -solicita I-EXPLORATION -una I-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -evidencia I-EXPLORATION -un I-EXPLORATION -apéndice I-EXPLORATION -cecal I-EXPLORATION -en I-EXPLORATION -disposición I-EXPLORATION -pélvica, I-EXPLORATION -discretamente I-EXPLORATION -engrosado, I-EXPLORATION -con I-EXPLORATION -mínimos I-EXPLORATION -cambios I-EXPLORATION -inflamatorios I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -grasa I-EXPLORATION -adyacente I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -pequeña I-EXPLORATION -colección I-EXPLORATION -líquida I-EXPLORATION -de I-EXPLORATION -12 I-EXPLORATION -x I-EXPLORATION -9 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -punta, I-EXPLORATION -sin I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -intraabdominal, I-EXPLORATION -pneumoperitoneo I-EXPLORATION -ni I-EXPLORATION -adenopatías I-EXPLORATION -retroperitoneales I-EXPLORATION -o I-EXPLORATION -pélvicas I-EXPLORATION -significativas. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -presunción I-TREATMENT -de I-TREATMENT -apendicitis I-TREATMENT -aguda I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -una I-TREATMENT -apendicectomía I-TREATMENT -laparotómica, I-TREATMENT -hallando I-TREATMENT -un I-TREATMENT -apéndice I-TREATMENT -gangrenoso I-TREATMENT -perforado I-TREATMENT -con I-TREATMENT -líquido I-TREATMENT -libre I-TREATMENT -intraabdominal. I-TREATMENT -El B-EVOLUTION -curso I-EVOLUTION -postoperatorio I-EVOLUTION -transcurre I-EVOLUTION -sin I-EVOLUTION -incidencias. I-EVOLUTION -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -identifica I-EXPLORATION -una I-EXPLORATION -neoplasia I-EXPLORATION -mucinosa I-EXPLORATION -apendicular I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -grado I-EXPLORATION -de I-EXPLORATION -malignidad I-EXPLORATION -con I-EXPLORATION -extravasación I-EXPLORATION -de I-EXPLORATION -mucina I-EXPLORATION -y I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -epitelio I-EXPLORATION -extraapendicular, I-EXPLORATION -con I-EXPLORATION -margen I-EXPLORATION -de I-EXPLORATION -resección I-EXPLORATION -libre I-EXPLORATION -y I-EXPLORATION -cambios I-EXPLORATION -típicos I-EXPLORATION -de I-EXPLORATION -apendicitis I-EXPLORATION -aguda I-EXPLORATION -sobreañadidos. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -19 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -sido I-PRESENT_ILLNESS -seguido I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Departamento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Pediatría I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -anemia I-PRESENT_ILLNESS -ferropénica. I-PRESENT_ILLNESS -Se B-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -gastroscopia, I-PAST_MEDICAL_HISTORY -colonoscopia, I-PAST_MEDICAL_HISTORY -tránsito I-PAST_MEDICAL_HISTORY -gastrointestinal, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -gammagrafía I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -descartar I-PAST_MEDICAL_HISTORY -divertículo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Meckel, I-PAST_MEDICAL_HISTORY -siendo I-PAST_MEDICAL_HISTORY -todas I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -pruebas I-PAST_MEDICAL_HISTORY -negativas. I-PAST_MEDICAL_HISTORY -Había I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY -todos I-PAST_MEDICAL_HISTORY -estos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -asintomático I-PAST_MEDICAL_HISTORY -recibiendo I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hierro I-PAST_MEDICAL_HISTORY -oral. I-PAST_MEDICAL_HISTORY -El B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -seguimiento I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -estudio. I-DERIVED_FROM/TO -Se B-EXPLORATION -le I-EXPLORATION -repitieron I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -diagnósticas I-EXPLORATION -iniciales I-EXPLORATION -(gastroscopia, I-EXPLORATION -colonoscopia I-EXPLORATION -y I-EXPLORATION -tránsito I-EXPLORATION -gastrointestinal), I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -conseguir I-EXPLORATION -llegar I-EXPLORATION -al I-EXPLORATION -diagnóstico. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -objetivo I-EXPLORATION -un I-EXPLORATION -engrosamiento I-EXPLORATION -mural I-EXPLORATION -concéntrico I-EXPLORATION -ileal I-EXPLORATION -con I-EXPLORATION -realce I-EXPLORATION -homogéneo I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -pared I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -8 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -longitud. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -sugerían I-EXPLORATION -como I-EXPLORATION -primera I-EXPLORATION -posibilidad I-EXPLORATION -una I-EXPLORATION -enfermedad I-EXPLORATION -inflamatoria I-EXPLORATION -intestinal I-EXPLORATION -crónica I-EXPLORATION -tipo I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Crohn, I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -poder I-EXPLORATION -descartarse I-EXPLORATION -linfoma I-EXPLORATION -intestinal. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -rechazó I-TREATMENT -el I-TREATMENT -estudio I-TREATMENT -con I-TREATMENT -cápsula I-TREATMENT -endoscópica, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -empírico I-TREATMENT -con I-TREATMENT -5-ASA I-TREATMENT -y I-TREATMENT -hierro I-TREATMENT -intravenoso. I-TREATMENT - I-TREATMENT -Fue B-EVOLUTION -ingresado I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -hospital I-EVOLUTION -dos I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -por I-EVOLUTION -anemia I-EVOLUTION -severa I-EVOLUTION -(hemoglobina: I-EVOLUTION -4, I-EVOLUTION -8 I-EVOLUTION -g/dl), I-EVOLUTION -secundaria I-EVOLUTION -a I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -melenas, I-EVOLUTION -aceptando B-TREATMENT -esta I-TREATMENT -vez I-TREATMENT -realizarse I-TREATMENT -cápsula I-TREATMENT -endoscópica. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -lesión I-EXPLORATION -polipoidea I-EXPLORATION -submucosa I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -violáceo I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -zona I-EXPLORATION -que I-EXPLORATION -parecía I-EXPLORATION -corresponder I-EXPLORATION -a I-EXPLORATION -íleon I-EXPLORATION -proximal, I-EXPLORATION -que I-EXPLORATION -ocluía I-EXPLORATION -la I-EXPLORATION -mitad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -circunferencia I-EXPLORATION -ileal I-EXPLORATION -y I-EXPLORATION -pareciendo I-EXPLORATION -rezumar I-EXPLORATION -sangre I-EXPLORATION -de I-EXPLORATION -dicha I-EXPLORATION -zona. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -laparotomía I-TREATMENT -encontrando I-TREATMENT -una I-TREATMENT -tumoración I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -longitud I-TREATMENT -de I-TREATMENT -color I-TREATMENT -púrpura, I-TREATMENT -vascularizada, I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -resecada, I-TREATMENT -siendo I-TREATMENT -diagnosticado I-TREATMENT -histológicamente I-TREATMENT -como I-TREATMENT -hemangioma I-TREATMENT -cavernoso I-TREATMENT -gigante I-TREATMENT -de I-TREATMENT -intestino I-TREATMENT -delgado. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -cinco I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía, I-EVOLUTION -permanecido I-EVOLUTION -posteriormente I-EVOLUTION -asintomático, I-EVOLUTION -con I-EVOLUTION -análisis I-EVOLUTION -de I-EVOLUTION -sangre I-EVOLUTION -normales I-EVOLUTION -desde I-EVOLUTION -entonces. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -60 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -epigástrico I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -espalda I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -consuntivo. I-PRESENT_ILLNESS -En B-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -halló I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cabeza I-EXPLORATION -de I-EXPLORATION -páncreas I-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -x I-EXPLORATION -6 I-EXPLORATION -cm, I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -mal I-EXPLORATION -definidos, I-EXPLORATION -heterogénea I-EXPLORATION -e I-EXPLORATION -hipoecogénica, I-EXPLORATION -sin I-EXPLORATION -invasión I-EXPLORATION -vascular I-EXPLORATION -ni I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -y I-EXPLORATION -dos I-EXPLORATION -nódulos I-EXPLORATION -hepáticos I-EXPLORATION -de I-EXPLORATION -naturaleza I-EXPLORATION -incierta. I-EXPLORATION -Se I-EXPLORATION -completó I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -inyección I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -bolo I-EXPLORATION -convencional I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -4 I-EXPLORATION -ml I-EXPLORATION -del I-EXPLORATION -contraste I-EXPLORATION -ecográfico I-EXPLORATION -hexafluoruro I-EXPLORATION -de I-EXPLORATION -azufre I-EXPLORATION -(Sonovue®, I-EXPLORATION -Bracco, I-EXPLORATION -Milán). I-EXPLORATION -La I-EXPLORATION -fase I-EXPLORATION -arterial I-EXPLORATION -(10-30 I-EXPLORATION -segundos) I-EXPLORATION -definió I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -pancreática I-EXPLORATION -hipocaptante I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -al I-EXPLORATION -parénquima I-EXPLORATION -vecino I-EXPLORATION -que I-EXPLORATION -estenosaba I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -hepática I-EXPLORATION -y I-EXPLORATION -esplénica. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -fase I-EXPLORATION -venosa I-EXPLORATION -(30-120 I-EXPLORATION -segundos) I-EXPLORATION -se I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -permeabilidad I-EXPLORATION -del I-EXPLORATION -eje I-EXPLORATION -venoso I-EXPLORATION -esplenoportomesentérico I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -barrido I-EXPLORATION -hepático I-EXPLORATION -en I-EXPLORATION -fase I-EXPLORATION -tardía I-EXPLORATION -(> I-EXPLORATION -120 I-EXPLORATION -segundos) I-EXPLORATION -detectó I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -hipocaptantes. I-EXPLORATION -En I-EXPLORATION -resumen, I-EXPLORATION -las I-EXPLORATION -imágenes I-EXPLORATION -ecográficas I-EXPLORATION -fueron I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -masa I-EXPLORATION -pancreática I-EXPLORATION -de I-EXPLORATION -naturaleza I-EXPLORATION -maligna I-EXPLORATION -con I-EXPLORATION -invasión I-EXPLORATION -vascular I-EXPLORATION -arterial I-EXPLORATION -y I-EXPLORATION -metastásica I-EXPLORATION -hepática. I-EXPLORATION -Estos I-EXPLORATION -datos I-EXPLORATION -fueron I-EXPLORATION -corroborados I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -helicoidal. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -figura I-EXPLORATION -1 I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -cómo I-EXPLORATION -las I-EXPLORATION -imágenes I-EXPLORATION -angiográficas I-EXPLORATION -con I-EXPLORATION -ecografía I-EXPLORATION -contrastada I-EXPLORATION -y I-EXPLORATION -angioTAC I-EXPLORATION -fueron I-EXPLORATION -equiparables. I-EXPLORATION -La I-EXPLORATION -PAAF I-EXPLORATION -guiada I-EXPLORATION -por I-EXPLORATION -ecografía I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -hepático I-EXPLORATION -fue I-EXPLORATION -diagnóstica I-EXPLORATION -de I-EXPLORATION -adenocarcinoma I-EXPLORATION -pancreático. I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -sometida I-TREATMENT -a I-TREATMENT -quimioterapia I-TREATMENT -paliativa. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -83 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes, I-PAST_MEDICAL_HISTORY -estudiada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -hemorragia I-PAST_MEDICAL_HISTORY -digestiva I-PAST_MEDICAL_HISTORY -oculta I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -realizó I-PAST_MEDICAL_HISTORY -CE. I-PAST_MEDICAL_HISTORY -Su B-PRESENT_ILLNESS -lectura I-PRESENT_ILLNESS -objetivó I-PRESENT_ILLNESS -detención I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -estenosis. I-PRESENT_ILLNESS -A I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingesta, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -compatible I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -cierre I-PRESENT_ILLNESS -intestinal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Analítica: B-EXPLORATION -9.400 I-EXPLORATION -leucocitos/µl, I-EXPLORATION -hemoglobina: I-EXPLORATION -11, I-EXPLORATION -2 I-EXPLORATION -g/dl, I-EXPLORATION -plaquetas I-EXPLORATION -y I-EXPLORATION -coagulación I-EXPLORATION -normales. I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -abdomen: I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -asas I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -y I-EXPLORATION -artefacto I-EXPLORATION -correspondiente I-EXPLORATION -a I-EXPLORATION -CE. I-EXPLORATION -Tomografía I-EXPLORATION -computerizada I-EXPLORATION -: I-EXPLORATION -obstrucción I-EXPLORATION -intestinal I-EXPLORATION -mecánica I-EXPLORATION -completa I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -CE. I-EXPLORATION -Se B-TREATMENT -indicó I-TREATMENT -cirugía I-TREATMENT -abdominal I-TREATMENT -urgente, I-TREATMENT -encontrando I-TREATMENT -una I-TREATMENT -distensión I-TREATMENT -del I-TREATMENT -intestino I-TREATMENT -proximal I-TREATMENT -a I-TREATMENT -4 I-TREATMENT -estenosis I-TREATMENT -de I-TREATMENT -íleon I-TREATMENT -de I-TREATMENT -aspecto I-TREATMENT -inflamatorio, I-TREATMENT -causando I-TREATMENT -una I-TREATMENT -de I-TREATMENT -ellas I-TREATMENT -una I-TREATMENT -obstrucción I-TREATMENT -completa, I-TREATMENT -en I-TREATMENT -cuyo I-TREATMENT -interior I-TREATMENT -se I-TREATMENT -palpaba I-TREATMENT -la I-TREATMENT -CE. I-TREATMENT -Se I-TREATMENT -resecaron I-TREATMENT -30 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -íleon I-TREATMENT -que I-TREATMENT -incluían I-TREATMENT -3 I-TREATMENT -de I-TREATMENT -las I-TREATMENT -4 I-TREATMENT -estenosis, I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -anastomosis I-TREATMENT -latero-lateral I-TREATMENT -mecánica I-TREATMENT -y I-TREATMENT -estricturoplastia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -estenosis I-TREATMENT -restante. I-TREATMENT -El B-EVOLUTION -postoperatorio I-EVOLUTION -transcurrió I-EVOLUTION -favorablemente, I-EVOLUTION -siendo I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -7.o I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION -El B-EXPLORATION -resultado I-EXPLORATION -histológico I-EXPLORATION -del I-EXPLORATION -espécimen I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Crohn. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -estudiada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -epigastralgia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -ó I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -ingesta I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -mejoran I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -emesis. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -relevancia I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -anticonceptivos I-PAST_MEDICAL_HISTORY -orales I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -tan I-EXPLORATION -sólo, I-EXPLORATION -leucocitos I-EXPLORATION -en I-EXPLORATION -3.570 I-EXPLORATION -x I-EXPLORATION -109/l, I-EXPLORATION -Hb I-EXPLORATION -115 I-EXPLORATION -g/l I-EXPLORATION -con I-EXPLORATION -VCM I-EXPLORATION -de I-EXPLORATION -78 I-EXPLORATION -fl. I-EXPLORATION -Resto I-EXPLORATION -en I-EXPLORATION -límites I-EXPLORATION -normales. I-EXPLORATION -Entre I-EXPLORATION -episodios I-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -asintomática I-EXPLORATION -con I-EXPLORATION -hábito I-EXPLORATION -intestinal I-EXPLORATION -normal I-EXPLORATION -sin I-EXPLORATION -productos I-EXPLORATION -patológicos. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -objetivan I-EXPLORATION -imágenes I-EXPLORATION -heterogéneas I-EXPLORATION -de I-EXPLORATION -densidad I-EXPLORATION -calcio I-EXPLORATION -de I-EXPLORATION -4-5 I-EXPLORATION -cm I-EXPLORATION -proyectadas I-EXPLORATION -sobre I-EXPLORATION -flexura I-EXPLORATION -hepática I-EXPLORATION -del I-EXPLORATION -colon. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -objetiva I-EXPLORATION -barro I-EXPLORATION -biliar I-EXPLORATION -y I-EXPLORATION -adyacente I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -vesícula I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -45 I-EXPLORATION -mm, I-EXPLORATION -heterogénea I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -hiperecogénicas I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -quiste I-EXPLORATION -hidatídico. I-EXPLORATION -A I-EXPLORATION -pesar I-EXPLORATION -de I-EXPLORATION -referir I-EXPLORATION -convivencia I-EXPLORATION -continuada I-EXPLORATION -con I-EXPLORATION -perros I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -área I-EXPLORATION -endémica I-EXPLORATION -de I-EXPLORATION -hidatidosis I-EXPLORATION -como I-EXPLORATION -es I-EXPLORATION -España I-EXPLORATION -(1,2), I-EXPLORATION -y I-EXPLORATION -orientar I-EXPLORATION -inicialmente I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -hacia I-EXPLORATION -esta I-EXPLORATION -patología, I-EXPLORATION -la I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -hidatidosis I-EXPLORATION -resulta I-EXPLORATION -negativa. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -hepatomegalia I-EXPLORATION -con I-EXPLORATION -LOE I-EXPLORATION -parcialmente I-EXPLORATION -calcificada I-EXPLORATION -en I-EXPLORATION -segmento I-EXPLORATION -V I-EXPLORATION -de I-EXPLORATION -50 I-EXPLORATION -mm I-EXPLORATION -y I-EXPLORATION -morfología I-EXPLORATION -redondeada I-EXPLORATION -con I-EXPLORATION -bordes I-EXPLORATION -lobulados I-EXPLORATION -e I-EXPLORATION -imágenes I-EXPLORATION -redondeadas I-EXPLORATION -de I-EXPLORATION -menor I-EXPLORATION -tamaño I-EXPLORATION -en I-EXPLORATION -periferia. I-EXPLORATION -La I-EXPLORATION -imagen I-EXPLORATION -es I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -quiste I-EXPLORATION -hidatídico I-EXPLORATION -sin I-EXPLORATION -descartar I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -diagnóstico I-EXPLORATION -diferencial I-EXPLORATION -la I-EXPLORATION -posibilidad I-EXPLORATION -de I-EXPLORATION -hemangioma I-EXPLORATION -parcialmente I-EXPLORATION -calcificado. I-EXPLORATION -La I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vesícula I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -numerosas I-EXPLORATION -microlitiasis I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -inflamatorios. I-EXPLORATION -Se I-EXPLORATION -objetiva I-EXPLORATION -del I-EXPLORATION -mismo I-EXPLORATION -modo I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -TAC I-EXPLORATION -un I-EXPLORATION -hemangioma I-EXPLORATION -de I-EXPLORATION -31 I-EXPLORATION -mm I-EXPLORATION -en I-EXPLORATION -segmento I-EXPLORATION -IV I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -quistes I-EXPLORATION -corticales I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -riñones. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -programa I-TREATMENT -colecistectomía I-TREATMENT -más I-TREATMENT -quistoperiquistectomía I-TREATMENT -con I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -presunción I-TREATMENT -de I-TREATMENT -quiste I-TREATMENT -hidatídico I-TREATMENT -más I-TREATMENT -colelitiasis. I-TREATMENT -Se I-TREATMENT -realiza I-TREATMENT -abordaje I-TREATMENT -mediante I-TREATMENT -laparotomía I-TREATMENT -subcostal I-TREATMENT -derecha. I-TREATMENT -Se I-TREATMENT -objetiva I-TREATMENT -vesícula I-TREATMENT -biliar I-TREATMENT -con I-TREATMENT -tumoración I-TREATMENT -intravesicular I-TREATMENT -de I-TREATMENT -consistencia I-TREATMENT -pétrea I-TREATMENT -que I-TREATMENT -no I-TREATMENT -infiltra I-TREATMENT -parénquima I-TREATMENT -hepático, I-TREATMENT -sin I-TREATMENT -LOE I-TREATMENT -en I-TREATMENT -segmento I-TREATMENT -V. I-TREATMENT -Mediante B-EXPLORATION -biopsia I-EXPLORATION -intraoperatoria I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -se I-EXPLORATION -diagnostica I-EXPLORATION -como I-EXPLORATION -angiomioma I-EXPLORATION -vesicular I-EXPLORATION -benigno, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -realizar I-TREATMENT -colecistectomía I-TREATMENT -simple, I-TREATMENT -que I-TREATMENT -incluye I-TREATMENT -la I-TREATMENT -totalidad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -masa I-TREATMENT -tumoral. I-TREATMENT -El B-EVOLUTION -postoperatorio I-EVOLUTION -fue I-EVOLUTION -favorable, I-EVOLUTION -transcurriendo I-EVOLUTION -sin I-EVOLUTION -incidencias. I-EVOLUTION - I-EVOLUTION -El B-EXPLORATION -posterior I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -describe I-EXPLORATION -masa I-EXPLORATION -sólida, I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -elástica I-EXPLORATION -y I-EXPLORATION -crecimiento I-EXPLORATION -expansivo I-EXPLORATION -que I-EXPLORATION -respeta I-EXPLORATION -mucosa I-EXPLORATION -y I-EXPLORATION -serosa I-EXPLORATION -císticas. I-EXPLORATION -La I-EXPLORATION -histología I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -concluyeron I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -leiomioma I-EXPLORATION -intramural I-EXPLORATION -y I-EXPLORATION -endocavitario I-EXPLORATION -con I-EXPLORATION -calcificaciones I-EXPLORATION -y I-EXPLORATION -osificación I-EXPLORATION -distrófica, I-EXPLORATION -de I-EXPLORATION -carácter I-EXPLORATION -benigno I-EXPLORATION -sin I-EXPLORATION -infiltrar I-EXPLORATION -parénquima I-EXPLORATION -hepático. I-EXPLORATION -La I-EXPLORATION -muestra I-EXPLORATION -fue I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -VEB I-EXPLORATION -y I-EXPLORATION -C-Kit I-EXPLORATION -/ I-EXPLORATION -CD-117. I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -la I-EVOLUTION -actualidad, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática, I-EVOLUTION -tras I-EVOLUTION -realización I-EVOLUTION -de I-EVOLUTION -ecografía I-EVOLUTION -abdominal I-EVOLUTION -no I-EVOLUTION -muestra I-EVOLUTION -recidiva I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad I-EVOLUTION -ni I-EVOLUTION -otras I-EVOLUTION -alteraciones I-EVOLUTION -15 I-EVOLUTION -meses I-EVOLUTION -después. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -rectorragia I-PRESENT_ILLNESS -masiva I-PRESENT_ILLNESS -indolora, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -síncope. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destacan: I-PAST_MEDICAL_HISTORY -carcinoma I-PAST_MEDICAL_HISTORY -epidermoide I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cérvix I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -2004 I-PAST_MEDICAL_HISTORY -(histerectomía, I-PAST_MEDICAL_HISTORY -doble I-PAST_MEDICAL_HISTORY -anexectomía, I-PAST_MEDICAL_HISTORY -radioterapia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -braquiterapia), I-PAST_MEDICAL_HISTORY -carcinoma I-PAST_MEDICAL_HISTORY -epidermoide I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -lengua I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2005 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -resección I-PAST_MEDICAL_HISTORY -posterior I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -atípica I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -metástasis. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -estable, I-EXPLORATION -destacando I-EXPLORATION -una I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -7, I-EXPLORATION -8 I-EXPLORATION -g/dl I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -hematocrito I-EXPLORATION -del I-EXPLORATION -24%. I-EXPLORATION -La I-EXPLORATION -radiología I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -eran I-EXPLORATION -inespecíficas. I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -endoscópicos I-EXPLORATION -evidenciaban I-EXPLORATION -abundantes I-EXPLORATION -restos I-EXPLORATION -hemáticos I-EXPLORATION -en I-EXPLORATION -colon, I-EXPLORATION -sin I-EXPLORATION -identificar I-EXPLORATION -causa. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -visualizó I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -con I-EXPLORATION -gas I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -psoas I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -estos I-TREATMENT -hallazgos I-TREATMENT -y I-TREATMENT -la I-TREATMENT -persistencia I-TREATMENT -de I-TREATMENT -rectorragia, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -intervenida I-TREATMENT -al I-TREATMENT -cuarto I-TREATMENT -día I-TREATMENT -del I-TREATMENT -ingreso, I-TREATMENT -realizándose I-TREATMENT -una I-TREATMENT -laparotomía I-TREATMENT -de I-TREATMENT -urgencia I-TREATMENT -en I-TREATMENT -la I-TREATMENT -que I-TREATMENT -se I-TREATMENT -encontró I-TREATMENT -un I-TREATMENT -proceso I-TREATMENT -inflamatorio I-TREATMENT -retrocecal I-TREATMENT -afectando I-TREATMENT -a I-TREATMENT -ciego, I-TREATMENT -apéndice I-TREATMENT -y I-TREATMENT -englobando I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -iliaca I-TREATMENT -derecha, I-TREATMENT -comprobándose I-TREATMENT -la I-TREATMENT -existencia I-TREATMENT -de I-TREATMENT -fistulización I-TREATMENT -iliaco-apendicular. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -hemicolectomía I-TREATMENT -derecha I-TREATMENT -ampliada I-TREATMENT -y I-TREATMENT -by-pass I-TREATMENT -fémoro-femoral I-TREATMENT -con I-TREATMENT -vena I-TREATMENT -safena. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente, I-EVOLUTION -siendo I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -14 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION - I-EVOLUTION -La B-EXPLORATION -anatomía-patológica I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -pieza I-EXPLORATION -de I-EXPLORATION -hemicolectomía I-EXPLORATION -derecha I-EXPLORATION -con I-EXPLORATION -necrosis I-EXPLORATION -mucosa I-EXPLORATION -y I-EXPLORATION -abundante I-EXPLORATION -material I-EXPLORATION -sanguíneo I-EXPLORATION -parcialmente I-EXPLORATION -organizado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lecho I-EXPLORATION -apendicular. I-EXPLORATION -Focos I-EXPLORATION -metastáticos I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -escamosas I-EXPLORATION -afectando I-EXPLORATION -a I-EXPLORATION -serosa, I-EXPLORATION -tejido I-EXPLORATION -graso I-EXPLORATION -y I-EXPLORATION -áreas I-EXPLORATION -perineurales I-EXPLORATION -y I-EXPLORATION -perivasculares I-EXPLORATION -(grandes I-EXPLORATION -vasos). I-EXPLORATION -Ganglios I-EXPLORATION -linfáticos I-EXPLORATION -aislados I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -malignidad. I-EXPLORATION -Material I-EXPLORATION -endoarterial I-EXPLORATION -con I-EXPLORATION -grupos I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -tumorales I-EXPLORATION -de I-EXPLORATION -hábito I-EXPLORATION -escamoso. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -natural B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Filipinas, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -regresado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -país I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -antes, I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -pancreatitis I-PRESENT_ILLNESS -aguda. I-PRESENT_ILLNESS -Presenta B-EXPLORATION -leucocitosis I-EXPLORATION -con I-EXPLORATION -eosinofilia, I-EXPLORATION -hipertransaminasemia I-EXPLORATION -leve I-EXPLORATION -(< I-EXPLORATION -90 I-EXPLORATION -mg/dl) I-EXPLORATION -y I-EXPLORATION -bilirrubina I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -vesícula I-EXPLORATION -distendida I-EXPLORATION -con I-EXPLORATION -paredes I-EXPLORATION -engrosadas I-EXPLORATION -y, I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior, I-EXPLORATION -una I-EXPLORATION -estructura I-EXPLORATION -alargada I-EXPLORATION -hiperecogénica I-EXPLORATION -con I-EXPLORATION -movimientos I-EXPLORATION -ondulatorios I-EXPLORATION -espontáneos. I-EXPLORATION -Se I-EXPLORATION -extendía I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -conducto I-EXPLORATION -biliar I-EXPLORATION -principal I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -vesícula I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -papila. I-EXPLORATION -Ante B-TREATMENT -este I-TREATMENT -hallazgo, I-TREATMENT -se I-TREATMENT -administra I-TREATMENT -albendazol I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -una I-TREATMENT -colangiopancreatografía I-TREATMENT -retrógrada I-TREATMENT -endoscópica I-TREATMENT -(CPRE) I-TREATMENT -24 I-TREATMENT -horas I-TREATMENT -después I-TREATMENT -para I-TREATMENT -extraer I-TREATMENT -el I-TREATMENT -parásito. I-TREATMENT -Sin B-EXPLORATION -embargo, I-EXPLORATION -la I-EXPLORATION -papila I-EXPLORATION -estaba I-EXPLORATION -rasgada I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -el I-EXPLORATION -mismo. I-EXPLORATION -Una I-EXPLORATION -nueva I-EXPLORATION -ecografía I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -colangiorresonancia I-EXPLORATION -magnética I-EXPLORATION -confirmaron I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -parásito I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar. I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta. I-EVOLUTION - I-EVOLUTION - -Niño B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -localizado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -fosa I-PRESENT_ILLNESS -iliaca I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS -Febrícula I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -vómito I-PRESENT_ILLNESS -alimentario. I-PRESENT_ILLNESS -Deposiciones I-PRESENT_ILLNESS -normales. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -presentaba I-EXPLORATION -afectación I-EXPLORATION -del I-EXPLORATION -estado I-EXPLORATION -general. I-EXPLORATION -La I-EXPLORATION -palpación I-EXPLORATION -abdominal I-EXPLORATION -objetivó I-EXPLORATION -defensa I-EXPLORATION -voluntaria I-EXPLORATION -en I-EXPLORATION -FID, I-EXPLORATION -Blumberg I-EXPLORATION -y I-EXPLORATION -psoas I-EXPLORATION -positivo. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -mostraba I-EXPLORATION -leucocitosis I-EXPLORATION -con I-EXPLORATION -neutrofilia I-EXPLORATION -y I-EXPLORATION -eosinofilia. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -visualizó I-EXPLORATION -apéndice I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -mm I-EXPLORATION -retrocecal. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -apendicectomía I-TREATMENT -laparotómica I-TREATMENT -urgente, I-TREATMENT -apreciando I-TREATMENT -inflamación I-TREATMENT -macroscópica I-TREATMENT -del I-TREATMENT -apéndice, I-TREATMENT -sin I-TREATMENT -líquido. I-TREATMENT -Exploración B-EXPLORATION -ileal I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histopatológico, I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -AA, I-EXPLORATION -visualizándose I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -inflamación I-EXPLORATION -aguda I-EXPLORATION -invadiendo I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -apendicular I-EXPLORATION -y I-EXPLORATION -oxiuros I-EXPLORATION -ocluyendo I-EXPLORATION -la I-EXPLORATION -luz. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -estos I-TREATMENT -hallazgos, I-TREATMENT -se I-TREATMENT -contactó I-TREATMENT -con I-TREATMENT -la I-TREATMENT -familia I-TREATMENT -para I-TREATMENT -iniciar I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -mebendazol. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -61 I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS -Asmática, B-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -sustitutivo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -portadora I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -marcapasos I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -bloqueo I-PAST_MEDICAL_HISTORY -aurículo-ventricular I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2o I-PAST_MEDICAL_HISTORY -grado. I-PAST_MEDICAL_HISTORY -Apendicectomizada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -agudo I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -distensión, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -saciedad I-PRESENT_ILLNESS -precoz, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -postprandiales I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2-3 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Durante I-PRESENT_ILLNESS -este I-PRESENT_ILLNESS -tiempo I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -perdido I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -destaca I-EXPLORATION -abdomen I-EXPLORATION -distendido, I-EXPLORATION -timpanizado, I-EXPLORATION -doloroso I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -difusa I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación. I-EXPLORATION -Ruidos I-EXPLORATION -metálicos. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -urgencias I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -Rx I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -marcada I-EXPLORATION -dilatación I-EXPLORATION -gástrica I-EXPLORATION -y I-EXPLORATION -duodenal I-EXPLORATION -(signo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -doble I-EXPLORATION -burbuja). I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -gastroscopia I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -estómago I-EXPLORATION -con I-EXPLORATION -motilidad I-EXPLORATION -prácticamente I-EXPLORATION -ausente I-EXPLORATION -y I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -restos I-EXPLORATION -alimentarios. I-EXPLORATION -El I-EXPLORATION -duodeno I-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -edematoso I-EXPLORATION -con I-EXPLORATION -imposibilidad I-EXPLORATION -de I-EXPLORATION -pasar I-EXPLORATION -a I-EXPLORATION -segunda I-EXPLORATION -porción, I-EXPLORATION -se I-EXPLORATION -toman I-EXPLORATION -biopsias I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -informadas I-EXPLORATION -posteriormente I-EXPLORATION -como I-EXPLORATION -duodenitis I-EXPLORATION -inespecífica I-EXPLORATION -con I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -malignas. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -TC I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -visualiza I-EXPLORATION -dilatación I-EXPLORATION -gástrica I-EXPLORATION -y I-EXPLORATION -duodenal I-EXPLORATION -con I-EXPLORATION -estenosis I-EXPLORATION -en I-EXPLORATION -3a I-EXPLORATION -porción I-EXPLORATION -duodenal. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -estos I-EXPLORATION -resultados I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -EGD I-EXPLORATION -baritado I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -3 I-EXPLORATION -estenosis I-EXPLORATION -lisas I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -regulares, I-EXPLORATION -en I-EXPLORATION -segunda-tercera I-EXPLORATION -porción I-EXPLORATION -duodenal, I-EXPLORATION -con I-EXPLORATION -paso I-EXPLORATION -dificultoso I-EXPLORATION -de I-EXPLORATION -contraste, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -diafragmas. I-EXPLORATION - I-EXPLORATION -Dado B-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -hallazgos, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -rehistorió I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -comentó I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -siempre I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -tenido I-PAST_MEDICAL_HISTORY -saciedad I-PAST_MEDICAL_HISTORY -precoz I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -digestiones I-PAST_MEDICAL_HISTORY -lentas, I-PAST_MEDICAL_HISTORY -siendo I-PAST_MEDICAL_HISTORY -siempre I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -persona I-PAST_MEDICAL_HISTORY -muy I-PAST_MEDICAL_HISTORY -delgada I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -talla I-PAST_MEDICAL_HISTORY -corta. I-PAST_MEDICAL_HISTORY -Se B-TREATMENT -realizó I-TREATMENT -gastroenteroanastomosis I-TREATMENT -en I-TREATMENT -Y I-TREATMENT -Roux. I-TREATMENT - I-TREATMENT - -Presentamos B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -77 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -fumador B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -paquetes/año, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -EPOC I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fibrilación I-PAST_MEDICAL_HISTORY -auricular. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -sólidos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -líquidos I-PRESENT_ILLNESS -junto I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -anorexia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La B-EXPLORATION -endoscopia I-EXPLORATION -detecta I-EXPLORATION -una I-EXPLORATION -neoformación I-EXPLORATION -exofítica I-EXPLORATION -en I-EXPLORATION -tercio I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -esófago I-EXPLORATION -de I-EXPLORATION -seis I-EXPLORATION -centímetros I-EXPLORATION -que I-EXPLORATION -provoca I-EXPLORATION -estenosis I-EXPLORATION -parcial I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -luz. I-EXPLORATION -El I-EXPLORATION -escáner I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -esofágica I-EXPLORATION -sin I-EXPLORATION -extensión I-EXPLORATION -local I-EXPLORATION -ni I-EXPLORATION -a I-EXPLORATION -distancia. I-EXPLORATION -La I-EXPLORATION -broncoscopia I-EXPLORATION -fue I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -malignidad I-EXPLORATION -descartando I-EXPLORATION -así I-EXPLORATION -invasión I-EXPLORATION -del I-EXPLORATION -árbol I-EXPLORATION -respiratorio. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -microscópico I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -proliferación I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -fusiformes I-EXPLORATION -mesenquimales I-EXPLORATION -dispuestas I-EXPLORATION -en I-EXPLORATION -haces, I-EXPLORATION -con I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vascularización I-EXPLORATION -y I-EXPLORATION -elevado I-EXPLORATION -índice I-EXPLORATION -mitótico I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -abundante I-EXPLORATION -necrosis. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -inmunohistoquímico I-EXPLORATION -es I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -desmina, I-EXPLORATION -proteína I-EXPLORATION -S-100, I-EXPLORATION -c-kit I-EXPLORATION -y I-EXPLORATION -citoqueratina I-EXPLORATION -C117 I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -para I-EXPLORATION -las I-EXPLORATION -citoqueratinas I-EXPLORATION -AE1/AE3, I-EXPLORATION -CAM5, I-EXPLORATION -2 I-EXPLORATION -y I-EXPLORATION -5/6. I-EXPLORATION - I-EXPLORATION -Por I-EXPLORATION -lo I-EXPLORATION -tanto, I-EXPLORATION -concluíamos I-EXPLORATION -que I-EXPLORATION -nuestro I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -mesenquimal I-EXPLORATION -maligno I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -sarcoma I-EXPLORATION -pobremente I-EXPLORATION -diferenciado. I-EXPLORATION -Fue B-TREATMENT -valorado I-TREATMENT -para I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -y I-TREATMENT -oncológico, I-TREATMENT -desestimando I-TREATMENT -los I-TREATMENT -mismos I-TREATMENT -por I-TREATMENT -deterioro I-TREATMENT -de I-TREATMENT -su I-TREATMENT -estado I-TREATMENT -general, I-TREATMENT -con I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -una I-TREATMENT -endoprótesis. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -79 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -artritis I-PRESENT_ILLNESS -metacarpofalángica, I-PRESENT_ILLNESS -recibe I-PRESENT_ILLNESS -amoxilicina-clavulánico I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -posteriormente I-PRESENT_ILLNESS -ciprofloxacino I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Dos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -finalización I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -antibiótico, I-PRESENT_ILLNESS -comienza I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -diarreicas I-PRESENT_ILLNESS -acuosas I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -productos I-PRESENT_ILLNESS -patológicos I-PRESENT_ILLNESS -(tanto I-PRESENT_ILLNESS -diurnas I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -nocturnas), I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -oC, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -decaimiento I-PRESENT_ILLNESS -progresivo. I-PRESENT_ILLNESS -Acude B-EVOLUTION -en I-EVOLUTION -varias I-EVOLUTION -ocasiones I-EVOLUTION -al I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Urgencias, I-EVOLUTION -realizándose I-EVOLUTION -coprocultivos I-EVOLUTION -y I-EVOLUTION -determinación I-EVOLUTION -de I-EVOLUTION -toxina I-EVOLUTION -de I-EVOLUTION -Clostridium I-EVOLUTION -difficile I-EVOLUTION -que I-EVOLUTION -resultan I-EVOLUTION -negativos I-EVOLUTION -con I-EVOLUTION -posterior I-EVOLUTION -alta I-EVOLUTION -por I-EVOLUTION -mejoría I-EVOLUTION -tras I-EVOLUTION -medidas I-EVOLUTION -astringentes I-EVOLUTION -(aunque I-EVOLUTION -sin I-EVOLUTION -resolución I-EVOLUTION -del I-EVOLUTION -cuadro). I-EVOLUTION -Una I-EVOLUTION -semana I-EVOLUTION -después I-EVOLUTION -reingresa I-EVOLUTION -por I-EVOLUTION -continuar I-EVOLUTION -con I-EVOLUTION -abundantes I-EVOLUTION -diarreas I-EVOLUTION -acuosas, I-EVOLUTION -dolor I-EVOLUTION -abdominal, I-EVOLUTION -febrícula I-EVOLUTION -y I-EVOLUTION -decaimiento. I-EVOLUTION -Analíticamente B-EXPLORATION -solo I-EXPLORATION -destaca I-EXPLORATION -una I-EXPLORATION -ligera I-EXPLORATION -anemia I-EXPLORATION -normocítica I-EXPLORATION -normocrómica. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -colonoscopia I-EXPLORATION -realizada I-EXPLORATION -se I-EXPLORATION -aprecian I-EXPLORATION -úlceras I-EXPLORATION -de I-EXPLORATION -diferentes I-EXPLORATION -tamaños I-EXPLORATION -y I-EXPLORATION -profundidad, I-EXPLORATION -con I-EXPLORATION -fondo I-EXPLORATION -blanquecino I-EXPLORATION -y I-EXPLORATION -halo I-EXPLORATION -enrojecido, I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -difusa I-EXPLORATION -hasta I-EXPLORATION -colon I-EXPLORATION -ascendente. I-EXPLORATION -Las I-EXPLORATION -biopsias I-EXPLORATION -confirmaron I-EXPLORATION -el I-EXPLORATION -diagnóstico. I-EXPLORATION -Se I-EXPLORATION -extrajeron I-EXPLORATION -hemocultivos I-EXPLORATION -por I-EXPLORATION -fiebre I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -Clostridium I-EXPLORATION -ramosum. I-EXPLORATION -Tras B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -endoscópica, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -metronidazol, I-TREATMENT -el I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -durante I-TREATMENT -15 I-TREATMENT -días I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -evolución I-TREATMENT -posterior. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -67 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -periumbilical, I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ausencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -expulsión I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -heces I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Presentaba B-EXPLORATION -deshidratación I-EXPLORATION -cutáneo-mucosa I-EXPLORATION -importante I-EXPLORATION -y I-EXPLORATION -leucocitos I-EXPLORATION -de I-EXPLORATION -12.100/mm3. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -asas I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -con I-EXPLORATION -niveles I-EXPLORATION -hidroaéreos I-EXPLORATION -y I-EXPLORATION -neumoperitoneo. I-EXPLORATION -Un I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -confirmó I-EXPLORATION -los I-EXPLORATION -hallazgos, I-EXPLORATION -y I-EXPLORATION -mostró I-EXPLORATION -aerobilia, I-EXPLORATION -un I-EXPLORATION -cálculo I-EXPLORATION -impactado I-EXPLORATION -en I-EXPLORATION -yeyuno I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -fístula I-EXPLORATION -colecisto-duodenal. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -laparotomía I-EXPLORATION -urgente I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION -un I-EXPLORATION -cálculo I-EXPLORATION -intraluminal I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -localizado I-EXPLORATION -a I-EXPLORATION -100 I-EXPLORATION -cm I-EXPLORATION -del I-EXPLORATION -ángulo I-EXPLORATION -de I-EXPLORATION -Treitz I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -perforación I-EXPLORATION -puntiforme I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -borde I-EXPLORATION -mesentérico I-EXPLORATION -a I-EXPLORATION -40 I-EXPLORATION -cm I-EXPLORATION -del I-EXPLORATION -ángulo I-EXPLORATION -de I-EXPLORATION -Treitz. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -enterotomía, I-TREATMENT -extracción I-TREATMENT -del I-TREATMENT -cálculo I-TREATMENT -y I-TREATMENT -resección I-TREATMENT -del I-TREATMENT -intestino I-TREATMENT -perforado. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -recuperó I-EVOLUTION -sin I-EVOLUTION -complicaciones. I-EVOLUTION - I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -presentó I-EXPLORATION -una I-EXPLORATION -perforación I-EXPLORATION -intestinal, I-EXPLORATION -con I-EXPLORATION -material I-EXPLORATION -necrótico I-EXPLORATION -y I-EXPLORATION -restos I-EXPLORATION -alimenticios I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -dos I-EXPLORATION -divertículos I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -proximidades I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -perforación. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -47 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -rectorragia I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -finalizar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -deposición; I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -niega I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -acompañante, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -hábito I-PRESENT_ILLNESS -intestinal, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -es I-EXPLORATION -normal I-EXPLORATION -salvo I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -hemorroides I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -rectal. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -tanto I-EXPLORATION -la I-EXPLORATION -hematimetría I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -bioquímica I-EXPLORATION -son I-EXPLORATION -estrictamente I-EXPLORATION -normales. I-EXPLORATION -Se B-TREATMENT -le I-TREATMENT -solicita I-TREATMENT -una I-TREATMENT -colonoscopia I-TREATMENT -en I-TREATMENT -la I-TREATMENT -que I-TREATMENT -se I-TREATMENT -observa I-TREATMENT -pólipo I-TREATMENT -submucoso I-TREATMENT -que I-TREATMENT -se I-TREATMENT -extirpa I-TREATMENT -y I-TREATMENT -hemorroides I-TREATMENT -internas. I-TREATMENT -La B-EXPLORATION -histopatología I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -extirpada I-EXPLORATION -dio I-EXPLORATION -como I-EXPLORATION -resultado I-EXPLORATION -granuloma I-EXPLORATION -eosinofílico I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION -parásito I-EXPLORATION -Anisakis. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -47 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -junio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2010 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hepatitis I-PRESENT_ILLNESS -aguda I-PRESENT_ILLNESS -colestásica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -probable I-PRESENT_ILLNESS -origen I-PRESENT_ILLNESS -etílico. I-PRESENT_ILLNESS -Tenía B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -esquizofrenia I-PAST_MEDICAL_HISTORY -paranoide I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -olanzapina I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -mg/24 I-PAST_MEDICAL_HISTORY -h I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -11 I-PAST_MEDICAL_HISTORY -meses. I-PAST_MEDICAL_HISTORY -Aunque B-EXPLORATION -la I-EXPLORATION -evolución I-EXPLORATION -inicial I-EXPLORATION -del I-EXPLORATION -cuadro I-EXPLORATION -clínico I-EXPLORATION -era I-EXPLORATION -favorable, I-EXPLORATION -con I-EXPLORATION -normalización I-EXPLORATION -paulatina I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -parámetros I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION -(bilirrubina I-EXPLORATION -y I-EXPLORATION -coagulación), I-EXPLORATION -cada I-EXPLORATION -vez I-EXPLORATION -estaba I-EXPLORATION -más I-EXPLORATION -acentuada I-EXPLORATION -la I-EXPLORATION -citolisis. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -etiológico I-EXPLORATION -completo I-EXPLORATION -(virus, I-EXPLORATION -autoanticuerpos, I-EXPLORATION -fármacos, I-EXPLORATION -etc.) I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION -Al B-TREATMENT -haber I-TREATMENT -casos I-TREATMENT -descritos I-TREATMENT -en I-TREATMENT -la I-TREATMENT -literatura I-TREATMENT -de I-TREATMENT -hepatotoxicidad I-TREATMENT -a I-TREATMENT -olanzapina, I-TREATMENT -se I-TREATMENT -suspende I-TREATMENT -el I-TREATMENT -fármaco I-TREATMENT -y I-TREATMENT -se I-TREATMENT -sustituye I-TREATMENT -por I-TREATMENT -haloperidol, I-TREATMENT -existiendo I-TREATMENT -mejoría I-TREATMENT -evidente I-TREATMENT -de I-TREATMENT -la I-TREATMENT -citolisis I-TREATMENT -hasta B-EVOLUTION -su I-EVOLUTION -total I-EVOLUTION -normalización. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -67 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -cirrosis I-PAST_MEDICAL_HISTORY -hepática I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -enólico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -cardiopulmonares I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -encefalopatía I-PRESENT_ILLNESS -hepática I-PRESENT_ILLNESS -secundario I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -estreñimiento. I-PRESENT_ILLNESS -En B-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -radiopaca, I-EXPLORATION -redondeada I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -bordes I-EXPLORATION -regulares I-EXPLORATION -en I-EXPLORATION -hemitórax I-EXPLORATION -izquierdo I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -existía I-EXPLORATION -en I-EXPLORATION -controles I-EXPLORATION -previos I-EXPLORATION -iniciándose I-EXPLORATION -tratamiento I-EXPLORATION -antibiótico I-EXPLORATION -empírico I-EXPLORATION -ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -neumonía. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -TC I-EXPLORATION -torácica I-EXPLORATION -la I-EXPLORATION -colección I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -lisos I-EXPLORATION -y I-EXPLORATION -regulares I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -contenido I-EXPLORATION -de I-EXPLORATION -densidad I-EXPLORATION -"agua" I-EXPLORATION -planteándose I-EXPLORATION -la I-EXPLORATION -posibilidad I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -ascitis I-EXPLORATION -intratorácica I-EXPLORATION -loculada. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -mejoró I-EVOLUTION -rápidamente I-EVOLUTION -de I-EVOLUTION -sus I-EVOLUTION -síntomas, I-EVOLUTION -pero I-EVOLUTION -al I-EVOLUTION -alta I-EVOLUTION -persistía I-EVOLUTION -la I-EVOLUTION -lesión I-EVOLUTION -anteriormente I-EVOLUTION -descrita, I-EVOLUTION -la I-EVOLUTION -cual I-EVOLUTION -desapareció I-EVOLUTION -al I-EVOLUTION -cabo I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -mes I-EVOLUTION -con B-TREATMENT -terapia I-TREATMENT -diurética. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos. I-PAST_MEDICAL_HISTORY -Presenta B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -difuso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -brusca, I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -biliosos I-PRESENT_ILLNESS -incoercibles I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -profusa. I-PRESENT_ILLNESS -A I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -rectorragia I-PRESENT_ILLNESS -abundante I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sangre I-PRESENT_ILLNESS -fresca I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -coágulos, I-PRESENT_ILLNESS -emisión I-PRESENT_ILLNESS -independiente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -alivio I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -dolor. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -asociada. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encontraba I-PRESENT_ILLNESS -destacado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -extranjero I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -misión I-PRESENT_ILLNESS -militar I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -realizado I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -centrales I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -alta I-PRESENT_ILLNESS -temperatura I-PRESENT_ILLNESS -ambiente, I-PRESENT_ILLNESS -sesiones I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -entrenamiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -minutos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -musculación I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -carrera I-PRESENT_ILLNESS -continua. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -clínica, I-PRESENT_ILLNESS -además, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -entrenamiento I-PRESENT_ILLNESS -comenzó I-PRESENT_ILLNESS -inmediatamente I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -ingesta I-PRESENT_ILLNESS -copiosa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -alimento. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -trasladado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -local I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -mal I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -febrícula, I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -objetivó I-PRESENT_ILLNESS -"leucocitosis I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -elevación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -creatinina" I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -realizó I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -colonoscopia I-PRESENT_ILLNESS -cuyo I-PRESENT_ILLNESS -informe I-PRESENT_ILLNESS -refleja I-PRESENT_ILLNESS -gran I-PRESENT_ILLNESS -cantidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sangre I-PRESENT_ILLNESS -intraluminal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mucosa I-PRESENT_ILLNESS -intensamente I-PRESENT_ILLNESS -edematosa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -sigma I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -impide I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paso I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -endoscopio. I-PRESENT_ILLNESS -Fue I-PRESENT_ILLNESS -mantenido I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -observación I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dieta I-PRESENT_ILLNESS -absoluta, I-PRESENT_ILLNESS -sueroterapia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ciprofloxacino I-PRESENT_ILLNESS -intravenoso. I-PRESENT_ILLNESS -Ante B-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -persistencia I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -clínica I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -aparición I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -somnolencia I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -palidez I-DERIVED_FROM/TO -cérea, I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -médicos I-DERIVED_FROM/TO -militares I-DERIVED_FROM/TO -españoles I-DERIVED_FROM/TO -encargados I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -solicitaron I-DERIVED_FROM/TO -evacuación I-DERIVED_FROM/TO -aérea I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -A B-EXPLORATION -su I-EXPLORATION -llegada, I-EXPLORATION -48 I-EXPLORATION -horas I-EXPLORATION -después I-EXPLORATION -del I-EXPLORATION -inicio I-EXPLORATION -del I-EXPLORATION -cuadro, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -estaba I-EXPLORATION -hipertenso, I-EXPLORATION -taquicárdico, I-EXPLORATION -con I-EXPLORATION -buena I-EXPLORATION -saturación I-EXPLORATION -basal I-EXPLORATION -de I-EXPLORATION -oxígeno I-EXPLORATION -y I-EXPLORATION -febrícula. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -abdomen I-EXPLORATION -blando, I-EXPLORATION -discretamente I-EXPLORATION -distendido I-EXPLORATION -y I-EXPLORATION -timpánico, I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -(superficial I-EXPLORATION -y I-EXPLORATION -profunda) I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -difusa, I-EXPLORATION -con I-EXPLORATION -contractura I-EXPLORATION -voluntaria I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -musculatura, I-EXPLORATION -sin I-EXPLORATION -claros I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal I-EXPLORATION -y I-EXPLORATION -ruidos I-EXPLORATION -hidroaéreos I-EXPLORATION -presentes. I-EXPLORATION -Al I-EXPLORATION -tacto I-EXPLORATION -rectal I-EXPLORATION -el I-EXPLORATION -dedil I-EXPLORATION -mostraba I-EXPLORATION -restos I-EXPLORATION -hemáticos I-EXPLORATION -frescos. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -analítica I-EXPLORATION -completa I-EXPLORATION -con I-EXPLORATION -leucocitosis I-EXPLORATION -de I-EXPLORATION -26.010 I-EXPLORATION -células I-EXPLORATION -(85% I-EXPLORATION -neutrófilos) I-EXPLORATION -y I-EXPLORATION -glucosa I-EXPLORATION -146 I-EXPLORATION -mg/dl I-EXPLORATION -como I-EXPLORATION -únicos I-EXPLORATION -hallazgos. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -TC I-EXPLORATION -abdominopélvica I-EXPLORATION -(sin I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -intravenoso) I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -halló I-EXPLORATION -una I-EXPLORATION -marcada I-EXPLORATION -dilatación I-EXPLORATION -del I-EXPLORATION -colon I-EXPLORATION -con I-EXPLORATION -engrosamiento I-EXPLORATION -difuso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared, I-EXPLORATION -afectación I-EXPLORATION -de I-EXPLORATION -grasa I-EXPLORATION -pericólica, I-EXPLORATION -gran I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -intraabdominal I-EXPLORATION -y I-EXPLORATION -múltiples I-EXPLORATION -ganglios I-EXPLORATION -mesentéricos I-EXPLORATION -menores I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -cm. I-EXPLORATION -Se I-EXPLORATION -descartaron I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -perforación I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -defectos I-EXPLORATION -de I-EXPLORATION -repleción I-EXPLORATION -vasculares. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -completó I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -colonoscopia I-EXPLORATION -urgente I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -solo I-EXPLORATION -pudieron I-EXPLORATION -introducirse I-EXPLORATION -100 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -endoscopio I-EXPLORATION -debido I-EXPLORATION -al I-EXPLORATION -alto I-EXPLORATION -riesgo I-EXPLORATION -de I-EXPLORATION -perforación, I-EXPLORATION -se I-EXPLORATION -objetivaron I-EXPLORATION -ulceraciones I-EXPLORATION -geográficas I-EXPLORATION -profundas I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -unión I-EXPLORATION -rectosigma I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -mucosa I-EXPLORATION -edematosa I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -hematoma I-EXPLORATION -submucoso, I-EXPLORATION -más I-EXPLORATION -intensas I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -regiones I-EXPLORATION -proximales I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -pseudotumoral I-EXPLORATION -(que I-EXPLORATION -se I-EXPLORATION -biopsiaron). I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -endoscópico I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -colitis I-EXPLORATION -isquémica, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -posteriormente I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION -anatomopatológicos. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -enfermo I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -con B-TREATMENT -tratamiento I-TREATMENT -conservador I-TREATMENT -con I-TREATMENT -dieta I-TREATMENT -absoluta, I-TREATMENT -nutrición I-TREATMENT -parenteral, I-TREATMENT --antibioterapia I-TREATMENT -intravenosa, I-TREATMENT -analgesia I-TREATMENT -y I-TREATMENT -corticoterapia I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -bajas. I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -colonoscopia I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -12 I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -persistían I-EXPLORATION -las I-EXPLORATION -alteraciones I-EXPLORATION -anteriormente I-EXPLORATION -descritas. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -evidenciaron I-EXPLORATION -alteraciones I-EXPLORATION -vasculares I-EXPLORATION -en I-EXPLORATION -angio-TC. I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -inmunológicos I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -hipercoagulabilidad I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -objetivaron I-EXPLORATION -focos I-EXPLORATION -trombóticos. I-EXPLORATION -Los I-EXPLORATION -coprocultivos I-EXPLORATION -fueron I-EXPLORATION -reiteradamente I-EXPLORATION -negativos. I-EXPLORATION -Se I-EXPLORATION -descartó I-EXPLORATION -asimismo I-EXPLORATION -una I-EXPLORATION -enfermedad I-EXPLORATION -inflamatoria I-EXPLORATION -intestinal I-EXPLORATION -por I-EXPLORATION -histología I-EXPLORATION -no I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -dicha I-EXPLORATION -patología. I-EXPLORATION -El B-EVOLUTION -enfermo I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -asintomático I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -29 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -ingreso. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -colonoscopia I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -6 I-EXPLORATION -semanas I-EXPLORATION -del I-EXPLORATION -alta, I-EXPLORATION -que I-EXPLORATION -constató I-EXPLORATION -restitución I-EXPLORATION -ad I-EXPLORATION -integrum I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mucosa. I-EXPLORATION - I-EXPLORATION -Tras I-EXPLORATION -descartar I-EXPLORATION -otra I-EXPLORATION -etiología, I-EXPLORATION -se I-EXPLORATION -estableció I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -origen I-EXPLORATION -del I-EXPLORATION -cuadro I-EXPLORATION -fue I-EXPLORATION -un I-EXPLORATION -secuestro I-EXPLORATION -vascular I-EXPLORATION -producido I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -demandas I-EXPLORATION -sanguíneas I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -ejercicio I-EXPLORATION -intenso I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -día I-EXPLORATION -caluroso, I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -paciente I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -gran I-EXPLORATION -parte I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -gasto I-EXPLORATION -cardiaco I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -territorio I-EXPLORATION -mesentérico. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -hiporexia, I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -cutánea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -conjuntival, I-PRESENT_ILLNESS -orinas I-PRESENT_ILLNESS -colúricas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -heces I-PRESENT_ILLNESS -hipocólicas. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -urgente I-EXPLORATION -destaca I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -citolisis I-EXPLORATION -(GOT I-EXPLORATION -1720 I-EXPLORATION -UI/dl, I-EXPLORATION -GPT I-EXPLORATION -2660 I-EXPLORATION -UI/dl), I-EXPLORATION -hiperbilirrubinemia I-EXPLORATION -(bilirrubina I-EXPLORATION -total I-EXPLORATION -20, I-EXPLORATION -94 I-EXPLORATION -mg/dl) I-EXPLORATION -y I-EXPLORATION -coagulopatía I-EXPLORATION -(actividad I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -45%, I-EXPLORATION -INR I-EXPLORATION -1, I-EXPLORATION -79). I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -serologías I-EXPLORATION -virales I-EXPLORATION -destaca I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -HBsAg I-EXPLORATION -positivo I-EXPLORATION -con I-EXPLORATION -antiHBc I-EXPLORATION -IgM I-EXPLORATION -positivo I-EXPLORATION -y I-EXPLORATION -AgHBe I-EXPLORATION -positivo. I-EXPLORATION -Las I-EXPLORATION -serologías I-EXPLORATION -del I-EXPLORATION -VHC, I-EXPLORATION -VHD I-EXPLORATION -y I-EXPLORATION -VIH I-EXPLORATION -resultaron I-EXPLORATION -negativas. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -insuficiencia I-TREATMENT -hepática I-TREATMENT -aguda I-TREATMENT -grave, I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -instaurar I-TREATMENT -tratamiento I-TREATMENT -específico I-TREATMENT -para I-TREATMENT -la I-TREATMENT -hepatitis I-TREATMENT -aguda I-TREATMENT -por I-TREATMENT -VHB I-TREATMENT -con I-TREATMENT -tenofovir I-TREATMENT -245 I-TREATMENT -mg/24 I-TREATMENT -horas I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -día I-TREATMENT -1 I-TREATMENT -de I-TREATMENT -ingreso I-TREATMENT -hospitalario. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -permaneció I-EVOLUTION -ingresado I-EVOLUTION -durante I-EVOLUTION -14 I-EVOLUTION -días, I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -encefalopatía I-EVOLUTION -hepática I-EVOLUTION -ni I-EVOLUTION -signos I-EVOLUTION -externos I-EVOLUTION -de I-EVOLUTION -sangrado I-EVOLUTION -en I-EVOLUTION -ningún I-EVOLUTION -momento, I-EVOLUTION -mejorando I-EVOLUTION -las I-EVOLUTION -cifras I-EVOLUTION -analíticas I-EVOLUTION -a I-EVOLUTION -partir I-EVOLUTION -del I-EVOLUTION -día I-EVOLUTION -+7 I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -antiviral. I-EVOLUTION -Posteriormente, B-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -continuó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -tenofovir I-TREATMENT -de I-TREATMENT -manera I-TREATMENT -ambulatoria, I-TREATMENT -produciéndose I-TREATMENT -la I-TREATMENT -seroconversión I-TREATMENT -antiHBe I-TREATMENT -al I-TREATMENT -mes I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -y I-TREATMENT -negativizando I-TREATMENT -el I-TREATMENT -AgHBs I-TREATMENT -a I-TREATMENT -las I-TREATMENT -8 I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -tratamiento. I-TREATMENT -Tras I-TREATMENT -2 I-TREATMENT -serologías I-TREATMENT -consecutivas I-TREATMENT -AgHBs I-TREATMENT -negativo I-TREATMENT -y I-TREATMENT -antiHBs I-TREATMENT -positivo I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antiviral. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -28 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -seguía I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -hormonal I-PAST_MEDICAL_HISTORY -anticonceptivo I-PAST_MEDICAL_HISTORY -(etonogestrel I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -etinilestradiol) I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -anillo I-PAST_MEDICAL_HISTORY -intravaginal I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -debido I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -trastornos I-PAST_MEDICAL_HISTORY -menstruales. I-PAST_MEDICAL_HISTORY - B-PRESENT_ILLNESS -Durante I-PRESENT_ILLNESS -este I-PRESENT_ILLNESS -tiempo I-PRESENT_ILLNESS -desarrolló I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -estreñimiento I-PRESENT_ILLNESS -crónico I-PRESENT_ILLNESS -por B-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -colonoscopia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -colon I-EXPLORATION -descendente I-EXPLORATION -una I-EXPLORATION -mucosa I-EXPLORATION -edematosa I-EXPLORATION -y I-EXPLORATION -friable I-EXPLORATION -con I-EXPLORATION -ulceraciones I-EXPLORATION -superficiales I-EXPLORATION -cubiertas I-EXPLORATION -por I-EXPLORATION -fibrina. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -biopsias I-EXPLORATION -mostró I-EXPLORATION -cambios I-EXPLORATION -atróficos I-EXPLORATION -y I-EXPLORATION -regenerativos I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -epitelio I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -microtrombos. I-EXPLORATION -El I-EXPLORATION -infiltrado I-EXPLORATION -neutrofílico I-EXPLORATION -era I-EXPLORATION -mínimo, I-EXPLORATION -pero I-EXPLORATION -con I-EXPLORATION -importante I-EXPLORATION -edema I-EXPLORATION -submucoso. I-EXPLORATION -Los I-EXPLORATION -cambios I-EXPLORATION -eran I-EXPLORATION -atribuibles I-EXPLORATION -a I-EXPLORATION -isquemia, I-EXPLORATION -aunque I-EXPLORATION -las I-EXPLORATION -causas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -isquemia I-EXPLORATION -estaban I-EXPLORATION -aún I-EXPLORATION -por I-EXPLORATION -determinar. I-EXPLORATION - I-EXPLORATION -Tras I-EXPLORATION -la I-EXPLORATION -colonoscopia, I-EXPLORATION -se I-EXPLORATION -retiró I-EXPLORATION -el I-EXPLORATION -anillo I-EXPLORATION -vaginal I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -repitió I-EXPLORATION -la I-EXPLORATION -colonoscopia I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -4 I-EXPLORATION -meses I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -comprobó I-EXPLORATION -la I-EXPLORATION -resolución I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones. I-EXPLORATION -El B-TREATMENT -estreñimiento I-TREATMENT -se I-TREATMENT -corrigió I-TREATMENT -con I-TREATMENT -medidas I-TREATMENT -convencionales. I-TREATMENT -Con B-EXPLORATION -la I-EXPLORATION -finalidad I-EXPLORATION -de I-EXPLORATION -excluir I-EXPLORATION -otras I-EXPLORATION -posibles I-EXPLORATION -causas I-EXPLORATION -de I-EXPLORATION -colitis I-EXPLORATION -isquémica, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -analítico, I-EXPLORATION -electrocardiograma, I-EXPLORATION -ecocardiograma I-EXPLORATION -y I-EXPLORATION -angio-TC I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -hipercoagulabilidad I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -déficit I-EXPLORATION -de I-EXPLORATION -proteína I-EXPLORATION -S I-EXPLORATION -antigénica I-EXPLORATION -y I-EXPLORATION -anticoagulante. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -detectaron I-EXPLORATION -el I-EXPLORATION -factor I-EXPLORATION -V I-EXPLORATION -de I-EXPLORATION -Leyden I-EXPLORATION -ni I-EXPLORATION -la I-EXPLORATION -mutación I-EXPLORATION -FII I-EXPLORATION -G20210A I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -protrombina. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -familiar I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -padre I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -paciente. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -66 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -intermitentes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -melenas. I-PRESENT_ILLNESS -Estudio I-PRESENT_ILLNESS -inicial I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -EDA I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -colonoscopia I-PRESENT_ILLNESS -normal. I-PRESENT_ILLNESS -Ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -nuevo I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -melenas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -anemización. I-PRESENT_ILLNESS -Se B-EXPLORATION -realiza I-EXPLORATION -de I-EXPLORATION -nuevo I-EXPLORATION -EDA I-EXPLORATION -y I-EXPLORATION -colonoscopia, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -tránsito I-EXPLORATION -intestinal I-EXPLORATION -seguido I-EXPLORATION -de I-EXPLORATION -cápsula I-EXPLORATION -endoscópica I-EXPLORATION -(CE) I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -reseñables. I-EXPLORATION -Ante I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -clínico I-EXPLORATION -de I-EXPLORATION -HDOO I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -angioTAC: I-EXPLORATION -"lesión I-EXPLORATION -sólida I-EXPLORATION -hipercaptante I-EXPLORATION -de I-EXPLORATION -3, I-EXPLORATION -3 I-EXPLORATION -x I-EXPLORATION -4, I-EXPLORATION -4 I-EXPLORATION -x I-EXPLORATION -4, I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -con I-EXPLORATION -crecimiento I-EXPLORATION -exofítico I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -asa I-EXPLORATION -yeyunal, I-EXPLORATION -con I-EXPLORATION -hipertrofia I-EXPLORATION -vascular I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -vasos I-EXPLORATION -nutricios I-EXPLORATION -que I-EXPLORATION -drenan I-EXPLORATION -directamente I-EXPLORATION -a I-EXPLORATION -ramas I-EXPLORATION -arteriales I-EXPLORATION -mesentéricas, I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -GIST, I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -adenopatías". I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -es I-TREATMENT -intervenida: I-TREATMENT -resección I-TREATMENT -segmentaria I-TREATMENT -de I-TREATMENT -yeyuno I-TREATMENT -medio. I-TREATMENT -Estudio B-EXPLORATION -histológico I-EXPLORATION -e I-EXPLORATION -inmunohistoquímico: I-EXPLORATION -GIST I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -grado I-EXPLORATION -de I-EXPLORATION -malignidad: I-EXPLORATION -tamaño I-EXPLORATION -< I-EXPLORATION -5 I-EXPLORATION -cm, I-EXPLORATION -< I-EXPLORATION -1 I-EXPLORATION -mitosis/10 I-EXPLORATION -campos I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -aumento, I-EXPLORATION -diferenciación I-EXPLORATION -muscular I-EXPLORATION -e I-EXPLORATION -índice I-EXPLORATION -proliferativo I-EXPLORATION -< I-EXPLORATION -1 I-EXPLORATION -%, I-EXPLORATION -medido I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -anticuerpo I-EXPLORATION -monoclonal I-EXPLORATION -KI67. I-EXPLORATION -La B-TREATMENT -resección I-TREATMENT -completa I-TREATMENT -del I-TREATMENT -tumor I-TREATMENT -sin I-TREATMENT -afectación I-TREATMENT -metastásica I-TREATMENT -determina I-TREATMENT -la I-TREATMENT -ausencia I-TREATMENT -de I-TREATMENT -necesidad I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -farmacológico I-TREATMENT -posterior I-TREATMENT -con I-TREATMENT -inhibidores I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tirosin I-TREATMENT -quinasa I-TREATMENT -(imatinib). I-TREATMENT -Tres B-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -diagnosticado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -EC I-PRESENT_ILLNESS -ileal I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -1978, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -enfermedad I-PRESENT_ILLNESS -perianal I-PRESENT_ILLNESS -(EPA) I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -larga I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -difícil I-PRESENT_ILLNESS -control. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Debido B-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -severidad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -EPA, I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -observándose I-EXPLORATION -una I-EXPLORATION -abscesificación I-EXPLORATION -del I-EXPLORATION -paquete I-EXPLORATION -adenopático I-EXPLORATION -intraabdominal. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -laparotomía I-TREATMENT -exploradora I-TREATMENT -con I-TREATMENT -biopsia I-TREATMENT -intraoperatoria I-TREATMENT -con I-TREATMENT -histología I-TREATMENT -de I-TREATMENT -adenocarcinoma I-TREATMENT -mucinoso I-TREATMENT -de I-TREATMENT -bajo I-TREATMENT -grado, I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -una I-TREATMENT -amputación I-TREATMENT -abdominoperineal I-TREATMENT -amplia I-TREATMENT -con I-TREATMENT -cistoprostatectomía I-TREATMENT -radical I-TREATMENT -por I-TREATMENT -infiltración I-TREATMENT -vesical, I-TREATMENT -no I-TREATMENT -pudiendo I-TREATMENT -resecar I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -obturatriz I-TREATMENT -también I-TREATMENT -infiltrada I-TREATMENT -por I-TREATMENT -el I-TREATMENT -tumor. I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -histológica I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION -moderadamente I-EXPLORATION -diferenciado I-EXPLORATION -de I-EXPLORATION -recto I-EXPLORATION -y I-EXPLORATION -periné, I-EXPLORATION -implantado I-EXPLORATION -sobre I-EXPLORATION -fístula I-EXPLORATION -perineal I-EXPLORATION -profunda. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -descartó I-TREATMENT -la I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -radioterapia, I-TREATMENT -estando I-TREATMENT -actualmente I-TREATMENT -con I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -quimioterapia. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hematoquecia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -sintomatología. I-PRESENT_ILLNESS -Destaca B-EXPLORATION -hemiabdomen I-EXPLORATION -derecho I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación, I-EXPLORATION -sin I-EXPLORATION -masas, I-EXPLORATION -anemia I-EXPLORATION -ferropénica I-EXPLORATION -(hemoglobina I-EXPLORATION -6, I-EXPLORATION -6 I-EXPLORATION -g/dl I-EXPLORATION -e I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -transferrina I-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -%) I-EXPLORATION -y I-EXPLORATION -antígeno I-EXPLORATION -carcinoembrionario I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -gastroscopia I-EXPLORATION -y I-EXPLORATION -colonoscopia I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -encuentran I-EXPLORATION -lesiones I-EXPLORATION -potencialmente I-EXPLORATION -sangrantes. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -tránsito I-EXPLORATION -gastrointestinal, I-EXPLORATION -un I-EXPLORATION -dudoso I-EXPLORATION -defecto I-EXPLORATION -de I-EXPLORATION -repleción I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -último I-EXPLORATION -asa I-EXPLORATION -ileal. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -cápsula I-EXPLORATION -endoscópica I-EXPLORATION -que I-EXPLORATION -detecta I-EXPLORATION -10 I-EXPLORATION -minutos I-EXPLORATION -antes I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -imagen I-EXPLORATION -del I-EXPLORATION -ciego I-EXPLORATION -una I-EXPLORATION -formación I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -submucoso I-EXPLORATION -erosionada I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -cm, I-EXPLORATION -con I-EXPLORATION -sangrado I-EXPLORATION -en I-EXPLORATION -sábana. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -este I-EXPLORATION -hallazgo I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -una I-EXPLORATION -exploración I-EXPLORATION -quirúrgica. I-EXPLORATION -Se I-EXPLORATION -identifica I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION -del I-EXPLORATION -intestino I-EXPLORATION -a I-EXPLORATION -70 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -válvula I-EXPLORATION -ileocecal I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -< I-EXPLORATION -1 I-EXPLORATION -cm, I-EXPLORATION -rosada I-EXPLORATION -sobre I-EXPLORATION -mucosa I-EXPLORATION -pálida; I-EXPLORATION -sin I-EXPLORATION -otras I-EXPLORATION -lesiones I-EXPLORATION -ni I-EXPLORATION -adenopatías I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -asas, I-EXPLORATION -mesenterio I-EXPLORATION -y I-EXPLORATION -cavidad I-EXPLORATION -abdominal. I-EXPLORATION -Se B-TREATMENT -realiza I-TREATMENT -una I-TREATMENT -enterectomía I-TREATMENT -de I-TREATMENT -7 I-TREATMENT -cm I-TREATMENT -con I-TREATMENT -márgenes I-TREATMENT -de I-TREATMENT -seguridad I-TREATMENT -de I-TREATMENT -3 I-TREATMENT -cm I-TREATMENT -y I-TREATMENT -anastomosis I-TREATMENT -término-terminal. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -describe I-EXPLORATION -una I-EXPLORATION -proliferación I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -eosinófilas I-EXPLORATION -epitelioides I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -irregular I-EXPLORATION -y I-EXPLORATION -nucléolos I-EXPLORATION -prominentes, I-EXPLORATION -formando I-EXPLORATION -lóbulos I-EXPLORATION -y I-EXPLORATION -pequeñas I-EXPLORATION -luces I-EXPLORATION -vasculares I-EXPLORATION -que I-EXPLORATION -contienen I-EXPLORATION -hematíes. I-EXPLORATION -La I-EXPLORATION -inmunohistoquímica I-EXPLORATION -CD34+ I-EXPLORATION -con I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -proliferación I-EXPLORATION -Ki67 I-EXPLORATION -del I-EXPLORATION -20 I-EXPLORATION -% I-EXPLORATION -traduce I-EXPLORATION -malignidad I-EXPLORATION -intermedia, I-EXPLORATION -siendo I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -hemangioendotelioma. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -extensión I-EXPLORATION -mediante I-EXPLORATION -PET-TAC I-EXPLORATION -no I-EXPLORATION -detectó I-EXPLORATION -captación I-EXPLORATION -patológica. I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -en I-EVOLUTION -remisión I-EVOLUTION -tras I-EVOLUTION -tres I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -76 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -ingresada I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Cirugía I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -anemia, I-PRESENT_ILLNESS -ascitis, I-PRESENT_ILLNESS -debilidad I-PRESENT_ILLNESS -generalizada, I-PRESENT_ILLNESS -neurológicamente I-PRESENT_ILLNESS -estuporosa I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -rectal I-PRESENT_ILLNESS -prolapsada I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -irreductible. I-PRESENT_ILLNESS -La B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -venido I-PAST_MEDICAL_HISTORY -presentado I-PAST_MEDICAL_HISTORY -diarrea I-PAST_MEDICAL_HISTORY -mucosa, I-PAST_MEDICAL_HISTORY -sangrado I-PAST_MEDICAL_HISTORY -rectal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -prolapso I-PAST_MEDICAL_HISTORY -rectal I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -rectal I-EXPLORATION -prolapsada I-EXPLORATION -e I-EXPLORATION -incarcerada I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -centímetros I-EXPLORATION -de I-EXPLORATION -longitud I-EXPLORATION -que I-EXPLORATION -secretaba I-EXPLORATION -abundante I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -moco. I-EXPLORATION -Analíticamente I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -estaba I-EXPLORATION -anémica I-EXPLORATION -con I-EXPLORATION -hemoglobina I-EXPLORATION -6 I-EXPLORATION -g/dl, I-EXPLORATION -hematocrito I-EXPLORATION -18 I-EXPLORATION -%, I-EXPLORATION -y I-EXPLORATION -datos I-EXPLORATION -de I-EXPLORATION -insuficiencia I-EXPLORATION -renal I-EXPLORATION -aguda I-EXPLORATION -(urea I-EXPLORATION -158 I-EXPLORATION -mg/dl, I-EXPLORATION -creatinina I-EXPLORATION -1, I-EXPLORATION -94 I-EXPLORATION -mg/dl), I-EXPLORATION -hiponatrémica I-EXPLORATION -e I-EXPLORATION -hipopotasémica I-EXPLORATION -(sodio, I-EXPLORATION -126 I-EXPLORATION -mEq/ I-EXPLORATION -l; I-EXPLORATION -potasio, I-EXPLORATION -2, I-EXPLORATION -6 I-EXPLORATION -mEq/l). I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION -abdominal I-EXPLORATION -urgente I-EXPLORATION -que I-EXPLORATION -informa I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION -rectal I-EXPLORATION -prolapsada, I-EXPLORATION -ascitis I-EXPLORATION -y I-EXPLORATION -metástasis I-EXPLORATION -hepáticas I-EXPLORATION -múltiples I-EXPLORATION -algunas I-EXPLORATION -de I-EXPLORATION -ellas I-EXPLORATION -necrosadas. I-EXPLORATION -Debido B-TREATMENT -al I-TREATMENT -intenso I-TREATMENT -dolor I-TREATMENT -que I-TREATMENT -le I-TREATMENT -causaba I-TREATMENT -la I-TREATMENT -tumoración I-TREATMENT -prolapsada I-TREATMENT -y I-TREATMENT -a I-TREATMENT -la I-TREATMENT -profusa I-TREATMENT -mucorrea I-TREATMENT -y I-TREATMENT -rectorragia, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -intervenida I-TREATMENT -quirúrgicamente, I-TREATMENT -una I-TREATMENT -vez I-TREATMENT -corregida I-TREATMENT -la I-TREATMENT -insuficiencia I-TREATMENT -renal, I-TREATMENT -realizándose I-TREATMENT -una I-TREATMENT -resección I-TREATMENT -transanal I-TREATMENT -con I-TREATMENT -carácter I-TREATMENT -paliativo. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -falleció I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -debido I-EVOLUTION -a I-EVOLUTION -complicaciones I-EVOLUTION -cardiorrespiratorias. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -63 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -exfumador, B-PAST_MEDICAL_HISTORY -asintomático, I-PAST_MEDICAL_HISTORY -remitido B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -julio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -2001 I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -hepatomegalia I-DERIVED_FROM/TO -(de I-DERIVED_FROM/TO -4 I-DERIVED_FROM/TO -cm I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -expensas I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -lóbulo I-DERIVED_FROM/TO -hepático I-DERIVED_FROM/TO -derecho) I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -colestasis I-DERIVED_FROM/TO -disociada I-DERIVED_FROM/TO --fosfatasa I-DERIVED_FROM/TO -alcalina I-DERIVED_FROM/TO -(FA) I-DERIVED_FROM/TO -873 I-DERIVED_FROM/TO -IU/L I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -gamma-glutaryl I-DERIVED_FROM/TO -transpeptidasa I-DERIVED_FROM/TO -(GGT) I-DERIVED_FROM/TO -637 I-DERIVED_FROM/TO -IU/L- I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -analítica I-DERIVED_FROM/TO -rutinaria. I-DERIVED_FROM/TO -El B-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -parámetros, I-EXPLORATION -incluyendo I-EXPLORATION -ANA I-EXPLORATION -(anticuerpos I-EXPLORATION -antinucleares), I-EXPLORATION -AMA I-EXPLORATION -(anticuerpos I-EXPLORATION -antimitocondriales), I-EXPLORATION -ASMA I-EXPLORATION -(anticuerpos I-EXPLORATION -anti-músculo I-EXPLORATION -liso) I-EXPLORATION -y I-EXPLORATION -LKM I-EXPLORATION -(anticuerpos I-EXPLORATION -anti I-EXPLORATION -anti-antígenos I-EXPLORATION -microsomales I-EXPLORATION -de I-EXPLORATION -hígado I-EXPLORATION -y I-EXPLORATION -riñón), I-EXPLORATION -porfirias, I-EXPLORATION -ceruloplasmina, I-EXPLORATION -alfa-fetoproteína, I-EXPLORATION -beta2-microglobulina, I-EXPLORATION -antígeno I-EXPLORATION -carcinoembrionario, I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -hepatitis I-EXPLORATION -B I-EXPLORATION -(VHB), I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -hepatitis I-EXPLORATION -C I-EXPLORATION -(VHC) I-EXPLORATION -y I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana I-EXPLORATION -(VIH) I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -inmunoglobulinas I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -IgG I-EXPLORATION -1.900 I-EXPLORATION -mg/dl I-EXPLORATION -(690-1400), I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -gammapatía I-EXPLORATION -monoclonal I-EXPLORATION -sin I-EXPLORATION -datos I-EXPLORATION -de I-EXPLORATION -mieloma I-EXPLORATION -tras I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -médula I-EXPLORATION -ósea. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -diátesis I-EXPLORATION -protrombótica I-EXPLORATION -también I-EXPLORATION -resultó I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -ecográfico I-EXPLORATION -no I-EXPLORATION -aportó I-EXPLORATION -datos I-EXPLORATION -relevantes. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -abdominal I-EXPLORATION -insinuó I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -subdiafragmática, I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -segmentos I-EXPLORATION -VIII I-EXPLORATION -y I-EXPLORATION -IV, I-EXPLORATION -de I-EXPLORATION -contorno I-EXPLORATION -mal I-EXPLORATION -definido, I-EXPLORATION -hipodensa, I-EXPLORATION -a I-EXPLORATION -ambos I-EXPLORATION -lados I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -suprahepática I-EXPLORATION -media. I-EXPLORATION -La I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -hepática I-EXPLORATION -objetivó I-EXPLORATION -dos I-EXPLORATION -lesiones I-EXPLORATION -hepáticas I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -× I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -3 I-EXPLORATION -× I-EXPLORATION -2 I-EXPLORATION -cm, I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -segmentos I-EXPLORATION -IV-VIII I-EXPLORATION -y I-EXPLORATION -II-III I-EXPLORATION -respectivamente, I-EXPLORATION -que I-EXPLORATION -encajaban I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -suprahepática I-EXPLORATION -media I-EXPLORATION -y I-EXPLORATION -desplazaban I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -suprahepática I-EXPLORATION -derecha, I-EXPLORATION -sin I-EXPLORATION -apreciarse I-EXPLORATION -trombosis I-EXPLORATION -intravascular, I-EXPLORATION -ni I-EXPLORATION -otras I-EXPLORATION -lesiones I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -extrahepática, I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -esplenomegalia I-EXPLORATION -e I-EXPLORATION -hipoplasia I-EXPLORATION -del I-EXPLORATION -lóbulo I-EXPLORATION -hepático I-EXPLORATION -izquierdo. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -colangiocarcinoma I-EXPLORATION -y I-EXPLORATION -menos I-EXPLORATION -probablemente I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -hepatocarcinoma I-EXPLORATION -sobre I-EXPLORATION -un I-EXPLORATION -hígado I-EXPLORATION -no I-EXPLORATION -cirrótico, I-EXPLORATION -se I-EXPLORATION -desestimó I-EXPLORATION -la I-EXPLORATION -PAAF I-EXPLORATION -(punción-aspiración I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina) I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -laparotomía I-EXPLORATION -diagnóstico-terapéutica, I-EXPLORATION -observándose I-EXPLORATION -un I-EXPLORATION -hígado I-EXPLORATION -de I-EXPLORATION -superficie I-EXPLORATION -lisa I-EXPLORATION -y I-EXPLORATION -brillante, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -quístico, I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -obtuvieron I-EXPLORATION -biopsias I-EXPLORATION -en I-EXPLORATION -cuña. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -informe I-EXPLORATION -histopatológico I-EXPLORATION -intraoperatorio I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -proceso I-EXPLORATION -fibro-inflamatorio I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -agregados I-EXPLORATION -linfoides, I-EXPLORATION -hialinización I-EXPLORATION -vascular, I-EXPLORATION -en I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -microorganismos I-EXPLORATION -y I-EXPLORATION -atipia, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -pseudotumor I-EXPLORATION -inflamatorio I-EXPLORATION -hepático. I-EXPLORATION -Dado B-TREATMENT -que I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -no I-TREATMENT -cumplía I-TREATMENT -criterios I-TREATMENT -de I-TREATMENT -malignidad I-TREATMENT -y I-TREATMENT -dada I-TREATMENT -la I-TREATMENT -alta I-TREATMENT -morbimortalidad I-TREATMENT -asociada, I-TREATMENT -se I-TREATMENT -desestimó I-TREATMENT -su I-TREATMENT -resección I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -y I-TREATMENT -esteroideo, I-TREATMENT -sin I-TREATMENT -respuesta. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -enero I-EVOLUTION -de I-EVOLUTION -2006 I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -hemorragia I-EVOLUTION -digestiva I-EVOLUTION -alta I-EVOLUTION -autolimitada, I-EVOLUTION -seguido I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -fiebre, I-EVOLUTION -astenia, I-EVOLUTION -hiporexia I-EVOLUTION -y I-EVOLUTION -alteración I-EVOLUTION -del I-EVOLUTION -comportamiento. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -subictericia I-EXPLORATION -cutáneo-mucosa, I-EXPLORATION -bradipsiquia, I-EXPLORATION -flapping I-EXPLORATION -tardío, I-EXPLORATION -hepatomegalia I-EXPLORATION -y I-EXPLORATION -ascitis. I-EXPLORATION -Analíticamente I-EXPLORATION -destacaba I-EXPLORATION -anemia I-EXPLORATION -de I-EXPLORATION -procesos I-EXPLORATION -crónicos I-EXPLORATION -(hemoglobina I-EXPLORATION -9, I-EXPLORATION -1 I-EXPLORATION -g/dl, I-EXPLORATION -hematocrito I-EXPLORATION -26, I-EXPLORATION -3%, I-EXPLORATION -VCM I-EXPLORATION -95), I-EXPLORATION -ligera I-EXPLORATION -trombopenia I-EXPLORATION -(116.000), I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -4, I-EXPLORATION -3 I-EXPLORATION -mg/dl I-EXPLORATION -(bilirrubina I-EXPLORATION -conjugada: I-EXPLORATION -3, I-EXPLORATION -8 I-EXPLORATION -mg/dl) I-EXPLORATION -GOT I-EXPLORATION -56 I-EXPLORATION -UI/l, I-EXPLORATION -GPT I-EXPLORATION -106 I-EXPLORATION -UI/l, I-EXPLORATION -GGT I-EXPLORATION -335 I-EXPLORATION -UI/l, I-EXPLORATION -FA I-EXPLORATION -700 I-EXPLORATION -UI/l. I-EXPLORATION -Gamma I-EXPLORATION -30, I-EXPLORATION -7% I-EXPLORATION -(10,5-19,5), I-EXPLORATION -leucocitos I-EXPLORATION -7.700 I-EXPLORATION -y I-EXPLORATION -800 I-EXPLORATION -linfocitos. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -del I-EXPLORATION -líquido I-EXPLORATION -ascítico I-EXPLORATION -reveló I-EXPLORATION -900 I-EXPLORATION -células I-EXPLORATION -(> I-EXPLORATION -250 I-EXPLORATION -polimorfonucleares/mm3), I-EXPLORATION -albúmina I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -g/dl, I-EXPLORATION -proteínas I-EXPLORATION -totales I-EXPLORATION -0, I-EXPLORATION -6 I-EXPLORATION -g/dl, I-EXPLORATION -GASA I-EXPLORATION -> I-EXPLORATION -1, I-EXPLORATION -1. I-EXPLORATION -y I-EXPLORATION -cultivo I-EXPLORATION -negativo. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -peritonitis I-TREATMENT -bacteriana I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -(cefalosporina I-TREATMENT -de I-TREATMENT -tercera I-TREATMENT -generación) I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -respuesta I-TREATMENT -clínico-analítica. I-TREATMENT -En I-TREATMENT -la I-TREATMENT -gastroscopia I-TREATMENT -se I-TREATMENT -observaron I-TREATMENT -varices I-TREATMENT -esofágicas I-TREATMENT -grado I-TREATMENT -II/III, I-TREATMENT -iniciándose I-TREATMENT -tratamiento I-TREATMENT -beta-bloqueante. I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -RM, I-EXPLORATION -que I-EXPLORATION -describía I-EXPLORATION -un I-EXPLORATION -hígado I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -hepatopatía I-EXPLORATION -crónica I-EXPLORATION -y I-EXPLORATION -cómo I-EXPLORATION -el I-EXPLORATION -PTI I-EXPLORATION -comprimía I-EXPLORATION -y I-EXPLORATION -colapsaba I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -cava I-EXPLORATION -inferior I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -trayecto I-EXPLORATION -intrahepático. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -síndrome I-TREATMENT -de I-TREATMENT -Budd-Chiari I-TREATMENT -subagudo I-TREATMENT -secundario I-TREATMENT -al I-TREATMENT -PTI I-TREATMENT -hepático, I-TREATMENT -se I-TREATMENT -colocó I-TREATMENT -un I-TREATMENT -TIPS I-TREATMENT -(anastomosis I-TREATMENT -porto-sistémica I-TREATMENT -transyugular I-TREATMENT -tipo I-TREATMENT -Wallstent I-TREATMENT -autoexpandible I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -mm I-TREATMENT -de I-TREATMENT -calibre) I-TREATMENT -con I-TREATMENT -buenos I-TREATMENT -resultados I-TREATMENT -durante I-TREATMENT -los I-TREATMENT -cinco I-TREATMENT -años I-TREATMENT -de I-TREATMENT -seguimiento. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -urente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -epigastrio, I-PRESENT_ILLNESS -náuseas, I-PRESENT_ILLNESS -saciedad I-PRESENT_ILLNESS -temprana, I-PRESENT_ILLNESS -vómitos, I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -blandas, I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -kg, I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -adinamia. I-PRESENT_ILLNESS -Dos I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -hospitalario I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -inferiores I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hematemesis. I-PRESENT_ILLNESS -Tenía B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sífilis I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -ingreso I-EXPLORATION -hospitalario I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -en I-EXPLORATION -anasarca I-EXPLORATION -y I-EXPLORATION -palidez I-EXPLORATION -mucocutánea. I-EXPLORATION -Se I-EXPLORATION -objetivó I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -de I-EXPLORATION -epigastrio, I-EXPLORATION -sin I-EXPLORATION -masas I-EXPLORATION -ni I-EXPLORATION -visceromegalias, I-EXPLORATION -con I-EXPLORATION -onda I-EXPLORATION -ascítica. I-EXPLORATION -Se I-EXPLORATION -observaron I-EXPLORATION -máculas I-EXPLORATION -violáceas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -paladar I-EXPLORATION -duro, I-EXPLORATION -el I-EXPLORATION -piso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lengua I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -glande I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -vascular, I-EXPLORATION -no I-EXPLORATION -sangrantes, I-EXPLORATION -con I-EXPLORATION -laceración I-EXPLORATION -del I-EXPLORATION -surco I-EXPLORATION -balano-prepucial I-EXPLORATION -y I-EXPLORATION -edema I-EXPLORATION -grado I-EXPLORATION -II I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -miembros I-EXPLORATION -inferiores. I-EXPLORATION -Se I-EXPLORATION -documentó I-EXPLORATION -VIH I-EXPLORATION -positivo I-EXPLORATION -por I-EXPLORATION -ELISA, I-EXPLORATION -confirmado I-EXPLORATION -por I-EXPLORATION -Western I-EXPLORATION -Blot, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -hipoproteinemia I-EXPLORATION -sin I-EXPLORATION -etiología I-EXPLORATION -clara; I-EXPLORATION -se I-EXPLORATION -descartaron I-EXPLORATION -causas I-EXPLORATION -cardiacas, I-EXPLORATION -hepáticas, I-EXPLORATION -renales I-EXPLORATION -o I-EXPLORATION -nutricionales. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -abdominal I-EXPLORATION -contrastada I-EXPLORATION -reportó I-EXPLORATION -engrosamiento I-EXPLORATION -polipoide I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -paredes I-EXPLORATION -gástricas I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -extensa I-EXPLORATION -lesión I-EXPLORATION -gástrica I-EXPLORATION -difusa I-EXPLORATION -multinodular I-EXPLORATION -y I-EXPLORATION -exofítica, I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cuerpo I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -fondo. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -gástrica I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -marcada I-EXPLORATION -proliferación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -foveolares, I-EXPLORATION -formando I-EXPLORATION -invaginaciones I-EXPLORATION -profundas I-EXPLORATION -y I-EXPLORATION -reemplazando I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -oxíntica I-EXPLORATION -original. I-EXPLORATION -A I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lámina I-EXPLORATION -propia I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -SK I-EXPLORATION -confirmado I-EXPLORATION -con I-EXPLORATION -inmunomarcación I-EXPLORATION -para I-EXPLORATION -herpes I-EXPLORATION -virus I-EXPLORATION -humano I-EXPLORATION -tipo I-EXPLORATION -8 I-EXPLORATION -(HHV8). I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -terapia I-TREATMENT -antirretroviral I-TREATMENT -y I-TREATMENT -se I-TREATMENT -programó I-TREATMENT -para I-TREATMENT -ulterior I-TREATMENT -inicio I-TREATMENT -de I-TREATMENT -quimioterapia I-TREATMENT -con I-TREATMENT -antraciclinas. I-TREATMENT - I-TREATMENT - -Los B-PRESENT_ILLNESS -autores I-PRESENT_ILLNESS -presentan I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -insuficiente B-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónico I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -programa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hemodiálisis, I-PAST_MEDICAL_HISTORY -referenciado B-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -realización I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cápsula I-DERIVED_FROM/TO -endoscópica I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -hemorragia I-DERIVED_FROM/TO -gastrointestinal I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -causa I-DERIVED_FROM/TO -oscura, I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -necesidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -transfusión I-DERIVED_FROM/TO -sanguínea, I-DERIVED_FROM/TO -no I-DERIVED_FROM/TO -esclarecida I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -gastroscopia I-DERIVED_FROM/TO -o I-DERIVED_FROM/TO -colonoscopia. I-DERIVED_FROM/TO -Se B-EXPLORATION -usó I-EXPLORATION -una I-EXPLORATION -cápsula I-EXPLORATION -PillCam I-EXPLORATION -SB I-EXPLORATION -(Given I-EXPLORATION -Imaging, I-EXPLORATION -Israel). I-EXPLORATION -La I-EXPLORATION -ingesta I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cápsula I-EXPLORATION -fue I-EXPLORATION -presenciada I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -médico. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -tuvo I-EVOLUTION -dificultad I-EVOLUTION -en I-EVOLUTION -iniciar I-EVOLUTION -la I-EVOLUTION -deglución, I-EVOLUTION -con I-EVOLUTION -varias I-EVOLUTION -tentativas I-EVOLUTION -sin I-EVOLUTION -éxito. I-EVOLUTION -Súbitamente I-EVOLUTION -desarrolló I-EVOLUTION -una I-EVOLUTION -crisis I-EVOLUTION -de I-EVOLUTION -tos I-EVOLUTION -vigorosa I-EVOLUTION -que I-EVOLUTION -revertió I-EVOLUTION -espontáneamente I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -algunos I-EVOLUTION -minutos, I-EVOLUTION -sin I-EVOLUTION -recurrencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sintomatología I-EVOLUTION -respiratoria. I-EVOLUTION -El B-EXPLORATION -grabador I-EXPLORATION -de I-EXPLORATION -datos I-EXPLORATION -fue I-EXPLORATION -recuperado I-EXPLORATION -agotada I-EXPLORATION -la I-EXPLORATION -duración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -batería I-EXPLORATION -(9 I-EXPLORATION -h) I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -fue I-EXPLORATION -interpretado I-EXPLORATION -al I-EXPLORATION -día I-EXPLORATION -siguiente. I-EXPLORATION -Se I-EXPLORATION -constató I-EXPLORATION -que, I-EXPLORATION -después I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -periodo I-EXPLORATION -de I-EXPLORATION -permanencia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cavidad I-EXPLORATION -oral I-EXPLORATION -de I-EXPLORATION -75 I-EXPLORATION -segundos, I-EXPLORATION -la I-EXPLORATION -cápsula I-EXPLORATION -transitó I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -aérea, I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -típica I-EXPLORATION -estructura I-EXPLORATION -anular I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tráquea I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -bifurcación I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -bronquios I-EXPLORATION -principales. I-EXPLORATION -Después I-EXPLORATION -de I-EXPLORATION -cerca I-EXPLORATION -de I-EXPLORATION -dos I-EXPLORATION -minutos I-EXPLORATION -de I-EXPLORATION -inactividad, I-EXPLORATION -la I-EXPLORATION -cápsula I-EXPLORATION -transmite I-EXPLORATION -imágenes I-EXPLORATION -del I-EXPLORATION -esófago. I-EXPLORATION -Una I-EXPLORATION -vez I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -tubo I-EXPLORATION -digestivo, I-EXPLORATION -la I-EXPLORATION -cápsula I-EXPLORATION -sigue I-EXPLORATION -el I-EXPLORATION -trayecto I-EXPLORATION -habitual, I-EXPLORATION -alcanzando I-EXPLORATION -el I-EXPLORATION -ciego I-EXPLORATION -transcurridas I-EXPLORATION -7 I-EXPLORATION -h I-EXPLORATION -28 I-EXPLORATION -m. I-EXPLORATION -Se I-EXPLORATION -identificaron I-EXPLORATION -abundantes I-EXPLORATION -angiodisplasias I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -intestino I-EXPLORATION -delgado, I-EXPLORATION -probable I-EXPLORATION -causa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -hemorragia I-EXPLORATION -gastrointestinal I-EXPLORATION -en I-EXPLORATION -este I-EXPLORATION -paciente. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -80 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -valvulopatía I-PAST_MEDICAL_HISTORY -mitral, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fibrilación I-PAST_MEDICAL_HISTORY -auricular, I-PAST_MEDICAL_HISTORY -estudiada B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -anemia I-PRESENT_ILLNESS -ferropénica. I-PRESENT_ILLNESS -La B-EXPLORATION -colonoscopia I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -vegetante I-EXPLORATION -polilobulada, I-EXPLORATION -que I-EXPLORATION -ocupaba I-EXPLORATION -el I-EXPLORATION -60-70 I-EXPLORATION -% I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -cecal, I-EXPLORATION -con I-EXPLORATION -resultado I-EXPLORATION -histopatológico I-EXPLORATION -de I-EXPLORATION -adenocarcinoma I-EXPLORATION -moderadamente I-EXPLORATION -diferenciado. I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -evidenció I-EXPLORATION -un I-EXPLORATION -marcado I-EXPLORATION -estrechamiento I-EXPLORATION -cecal I-EXPLORATION -de I-EXPLORATION -5, I-EXPLORATION -8 I-EXPLORATION -x I-EXPLORATION -4, I-EXPLORATION -9 I-EXPLORATION -x I-EXPLORATION -3, I-EXPLORATION -7 I-EXPLORATION -cm, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -obstrucción. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -paravertebral I-EXPLORATION -derecha, I-EXPLORATION -entre I-EXPLORATION -D1-D2, I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -en I-EXPLORATION -reloj I-EXPLORATION -de I-EXPLORATION -arena I-EXPLORATION -de I-EXPLORATION -22 I-EXPLORATION -x I-EXPLORATION -29 I-EXPLORATION -x I-EXPLORATION -21mm, I-EXPLORATION -que I-EXPLORATION -crecía I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -del I-EXPLORATION -canal I-EXPLORATION -espinal, I-EXPLORATION -ensanchando I-EXPLORATION -el I-EXPLORATION -orificio I-EXPLORATION -intervertebral. I-EXPLORATION -Mediante I-EXPLORATION -PAAF-USE, I-EXPLORATION -se I-EXPLORATION -accedió I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -cara I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -esófago, I-EXPLORATION -observando I-EXPLORATION -en I-EXPLORATION -disposición I-EXPLORATION -para-espinal I-EXPLORATION -derecha I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -redondeada I-EXPLORATION -de I-EXPLORATION -30 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -hiperecogénica I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -ecogenicidad I-EXPLORATION -grasa, I-EXPLORATION -sobre I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizaron I-EXPLORATION -3 I-EXPLORATION -pases I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -de I-EXPLORATION -25-gauge I-EXPLORATION -(ECHO-25-HD I-EXPLORATION -Cook©). I-EXPLORATION -La I-EXPLORATION -punción I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -sin I-EXPLORATION -jeringa I-EXPLORATION -de I-EXPLORATION -aspiración, I-EXPLORATION -mediante I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -retirada I-EXPLORATION -lenta I-EXPLORATION -del I-EXPLORATION -estilete I-EXPLORATION -y I-EXPLORATION -movimientos I-EXPLORATION -de I-EXPLORATION -entrada-salida, I-EXPLORATION -con I-EXPLORATION -patólogo I-EXPLORATION -in I-EXPLORATION -situ, I-EXPLORATION -obteniéndose I-EXPLORATION -material I-EXPLORATION -suficiente I-EXPLORATION -para I-EXPLORATION -establecer I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -meningioma I-EXPLORATION -(inmunorreactividad I-EXPLORATION -intensa I-EXPLORATION -para I-EXPLORATION -receptores I-EXPLORATION -progesterona; I-EXPLORATION -TTF-1 I-EXPLORATION -y I-EXPLORATION -CK I-EXPLORATION -AE3-AE1 I-EXPLORATION -negativas) I-EXPLORATION -(parte I-EXPLORATION -inferior I-EXPLORATION -Fig. I-EXPLORATION -1), I-EXPLORATION -apreciándose I-EXPLORATION -células I-EXPLORATION -redondas I-EXPLORATION -de I-EXPLORATION -mediano I-EXPLORATION -tamaño, I-EXPLORATION -sin I-EXPLORATION -atipia I-EXPLORATION -pero I-EXPLORATION -con I-EXPLORATION -modificaciones I-EXPLORATION -nucleares I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -de I-EXPLORATION -pseudoinclusiones I-EXPLORATION -y I-EXPLORATION -cuerpos I-EXPLORATION -de I-EXPLORATION -psammoma, I-EXPLORATION -que I-EXPLORATION -formaban I-EXPLORATION -estructuras I-EXPLORATION -lobuladas I-EXPLORATION -rodeadas I-EXPLORATION -por I-EXPLORATION -tabiques I-EXPLORATION -de I-EXPLORATION -colágeno. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -hemicolectomía I-TREATMENT -derecha I-TREATMENT -con I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -adenocarcinoma I-TREATMENT -de I-TREATMENT -ciego, I-TREATMENT -sin I-TREATMENT -afectación I-TREATMENT -en I-TREATMENT -los I-TREATMENT -11 I-TREATMENT -ganglios I-TREATMENT -resecados, I-TREATMENT -ni I-TREATMENT -factores I-TREATMENT -de I-TREATMENT -riesgo I-TREATMENT -(pT2 I-TREATMENT -pN0 I-TREATMENT -Mx). I-TREATMENT -Se B-EVOLUTION -recomendó I-EVOLUTION -inicio I-EVOLUTION -de I-EVOLUTION -revisiones, I-EVOLUTION -no I-EVOLUTION -hallándose, I-EVOLUTION -cumplidos I-EVOLUTION -los I-EVOLUTION -3 I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -hasta I-EVOLUTION -la I-EVOLUTION -actualidad, I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -recaída I-EVOLUTION -local I-EVOLUTION -o I-EVOLUTION -a I-EVOLUTION -distancia. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -procedente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Marruecos I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -colecistectomía, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos, I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -factores I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -riesgo I-PAST_MEDICAL_HISTORY -sexual. I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -mayo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2011 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -picos I-PRESENT_ILLNESS -febriles I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -38, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -oC, I-PRESENT_ILLNESS -junto I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -cólico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -epigastrio, I-PRESENT_ILLNESS -prurito I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -disfagia. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -presentaba I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -abdominal, I-EXPLORATION -focalizado I-EXPLORATION -en I-EXPLORATION -hipocondrio I-EXPLORATION -derecho I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal, I-EXPLORATION -tinte I-EXPLORATION -ictérico, I-EXPLORATION -y I-EXPLORATION -muguet I-EXPLORATION -oral. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -anamnesis I-EXPLORATION -y I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -destacaban I-EXPLORATION -hemoglobina I-EXPLORATION -10, I-EXPLORATION -9 I-EXPLORATION -g/dl, I-EXPLORATION -VCM I-EXPLORATION -82 I-EXPLORATION -fl, I-EXPLORATION -leucocitos I-EXPLORATION -2.300 I-EXPLORATION -cél/μl, I-EXPLORATION -58, I-EXPLORATION -3% I-EXPLORATION -de I-EXPLORATION -neutrófilos, I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -0, I-EXPLORATION -1 I-EXPLORATION -mg/dl, I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -1, I-EXPLORATION -44 I-EXPLORATION -mg/dl, I-EXPLORATION -FA I-EXPLORATION -663 I-EXPLORATION -U/l, I-EXPLORATION -GGT I-EXPLORATION -185 I-EXPLORATION -U/l, I-EXPLORATION -GOT I-EXPLORATION -231U/l, I-EXPLORATION -GPT I-EXPLORATION -156 I-EXPLORATION -U/l; I-EXPLORATION -gammaglobulinas I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -04 I-EXPLORATION -g/dl, I-EXPLORATION -Ig I-EXPLORATION -A I-EXPLORATION -553 I-EXPLORATION -mg/dl, I-EXPLORATION -Ig I-EXPLORATION -G I-EXPLORATION -2400 I-EXPLORATION -mg/dl I-EXPLORATION -e I-EXPLORATION -IgM I-EXPLORATION -62 I-EXPLORATION -mg/dl; I-EXPLORATION -autoanticuerpos I-EXPLORATION -anticitoplasma I-EXPLORATION -de I-EXPLORATION -neutrófilo I-EXPLORATION -perinucleares I-EXPLORATION -(p-ANCA) I-EXPLORATION -positivos I-EXPLORATION -1: I-EXPLORATION -320 I-EXPLORATION -U/l I-EXPLORATION -patrón I-EXPLORATION -atípico, I-EXPLORATION -y I-EXPLORATION -antimúsculo I-EXPLORATION -liso I-EXPLORATION -(SMA) I-EXPLORATION -positivos I-EXPLORATION -1: I-EXPLORATION -320 I-EXPLORATION -U/l. I-EXPLORATION -Autoanticuerpos I-EXPLORATION -anticitoplasma I-EXPLORATION -de I-EXPLORATION -neutrófilo I-EXPLORATION -citoplasmáticos I-EXPLORATION -(c-ANCA), I-EXPLORATION -antinucleares I-EXPLORATION -(ANA), I-EXPLORATION -antimitocondriales I-EXPLORATION -(AMA), I-EXPLORATION -antimicrosomales I-EXPLORATION -(LKM-1) I-EXPLORATION -y I-EXPLORATION -antisacaromices I-EXPLORATION -(ASCA) I-EXPLORATION -negativos. I-EXPLORATION -Serología I-EXPLORATION -VIH I-EXPLORATION -positiva I-EXPLORATION -con I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -mayor I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -millones I-EXPLORATION -de I-EXPLORATION -copias/ml, I-EXPLORATION -CMV I-EXPLORATION -IgG I-EXPLORATION -positiva I-EXPLORATION -con I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -2 I-EXPLORATION -a I-EXPLORATION -5 I-EXPLORATION -millones I-EXPLORATION -de I-EXPLORATION -copias/ml, I-EXPLORATION -rubéola I-EXPLORATION -IgG I-EXPLORATION -positiva I-EXPLORATION -y I-EXPLORATION -Toxoplasma I-EXPLORATION -gondii I-EXPLORATION -IgG I-EXPLORATION -mayor I-EXPLORATION -a I-EXPLORATION -250 I-EXPLORATION -UI/ml. I-EXPLORATION -Serología I-EXPLORATION -VHB, I-EXPLORATION -VHC, I-EXPLORATION -VHA, I-EXPLORATION -LUES, I-EXPLORATION -Brucella, I-EXPLORATION -Cryptococcus, I-EXPLORATION -Leishmania, I-EXPLORATION -CMV I-EXPLORATION -IgM I-EXPLORATION -negativa; I-EXPLORATION -VEB I-EXPLORATION -IgM I-EXPLORATION -resultado I-EXPLORATION -indeterminado. I-EXPLORATION -Antígeno I-EXPLORATION -de I-EXPLORATION -Giardia I-EXPLORATION -lamblia I-EXPLORATION -y I-EXPLORATION -Cryptosporidium I-EXPLORATION -en I-EXPLORATION -heces, I-EXPLORATION -antígeno I-EXPLORATION -de I-EXPLORATION -Legionella I-EXPLORATION -y I-EXPLORATION -neumococo I-EXPLORATION -en I-EXPLORATION -orina, I-EXPLORATION -baciloscopias I-EXPLORATION -en I-EXPLORATION -esputo I-EXPLORATION -y I-EXPLORATION -orina I-EXPLORATION -por I-EXPLORATION -tres, I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -urocultivos I-EXPLORATION -negativos. I-EXPLORATION -Desarrollo I-EXPLORATION -de I-EXPLORATION -Candida I-EXPLORATION -albicans I-EXPLORATION -en I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -esputo. I-EXPLORATION -Mantoux I-EXPLORATION -negativo. I-EXPLORATION -Las I-EXPLORATION -poblaciones I-EXPLORATION -linfocitarias I-EXPLORATION -eran I-EXPLORATION -de I-EXPLORATION -177 I-EXPLORATION -CD4/μl, I-EXPLORATION -534 I-EXPLORATION -CD3/μl, I-EXPLORATION -346 I-EXPLORATION -CD8/μl I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -cociente I-EXPLORATION -CD4/CD8 I-EXPLORATION -de I-EXPLORATION -0, I-EXPLORATION -51. I-EXPLORATION -Fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -colédoco I-EXPLORATION -dilatado I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -fusiforme, I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -placas I-EXPLORATION -blanquecinas I-EXPLORATION -por I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -esófago I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -candidiasis I-EXPLORATION -esofágica. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -colangiorresonancia I-EXPLORATION -que I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -ectasia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -intrahepática I-EXPLORATION -con I-EXPLORATION -algún I-EXPLORATION -segmento I-EXPLORATION -estenótico I-EXPLORATION -y I-EXPLORATION -ligera I-EXPLORATION -dilatación I-EXPLORATION -del I-EXPLORATION -hepatocolédoco I-EXPLORATION -sin I-EXPLORATION -estenosis I-EXPLORATION -ni I-EXPLORATION -litiasis. I-EXPLORATION -Durante B-TREATMENT -el I-TREATMENT -ingreso I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -médico I-TREATMENT -con I-TREATMENT -ganciclovir I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -500 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas I-TREATMENT -intravenoso I-TREATMENT -durante I-TREATMENT -dos I-TREATMENT -semanas, I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -valganciclovir I-TREATMENT -900 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -24 I-TREATMENT -horas. I-TREATMENT -A I-TREATMENT -partir I-TREATMENT -de I-TREATMENT -la I-TREATMENT -segunda I-TREATMENT -semana I-TREATMENT -se I-TREATMENT -instauró I-TREATMENT -tratamiento I-TREATMENT -antirretroviral I-TREATMENT -(emtricitabina/tenofovir, I-TREATMENT -darunavir I-TREATMENT -y I-TREATMENT -ritonavir) I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -tolerancia. I-TREATMENT -Junto I-TREATMENT -a I-TREATMENT -esto, I-TREATMENT -se I-TREATMENT -pautó I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -fluconazol I-TREATMENT -100 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -24 I-TREATMENT -horas I-TREATMENT -durante I-TREATMENT -7 I-TREATMENT -días, I-TREATMENT -ácido I-TREATMENT -ursodesoxicólico I-TREATMENT -300 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas, I-TREATMENT -colestiramina I-TREATMENT -4 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas, I-TREATMENT -dexclorfeniramina I-TREATMENT -6 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -cotrimoxazol I-TREATMENT -800/160 I-TREATMENT -mg I-TREATMENT -lunes, I-TREATMENT -miércoles I-TREATMENT -y I-TREATMENT -viernes. I-TREATMENT -A B-EXPLORATION -pesar I-EXPLORATION -del I-EXPLORATION -tratamiento I-EXPLORATION -médico I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -continuaba I-EXPLORATION -con I-EXPLORATION -colestasis I-EXPLORATION -y I-EXPLORATION -citolisis I-EXPLORATION -(bilirrubina I-EXPLORATION -total I-EXPLORATION -10, I-EXPLORATION -26 I-EXPLORATION -mg/dl, I-EXPLORATION -FA I-EXPLORATION -544 I-EXPLORATION -U/l, I-EXPLORATION -GGT I-EXPLORATION -175 I-EXPLORATION -U/l, I-EXPLORATION -GOT I-EXPLORATION -448 I-EXPLORATION -U/l, I-EXPLORATION -GPT I-EXPLORATION -170 I-EXPLORATION -U/l) I-EXPLORATION -motivo I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -CPRE I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -25 I-EXPLORATION -días I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -instauración I-EXPLORATION -de I-EXPLORATION -tratamiento I-EXPLORATION -con I-EXPLORATION -ganciclovir. I-EXPLORATION -La B-TREATMENT -CPRE I-TREATMENT -confirmó I-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -dilatación I-TREATMENT -fusiforme I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vía I-TREATMENT -biliar I-TREATMENT -extrahepática, I-TREATMENT -con I-TREATMENT -normalidad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -intrahepática, I-TREATMENT -y I-TREATMENT -permitió I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -esfinterotomía, I-TREATMENT -colocándosele I-TREATMENT -una I-TREATMENT -endoprótesis I-TREATMENT -plástica I-TREATMENT -en I-TREATMENT -la I-TREATMENT -porción I-TREATMENT -extrahepática. I-TREATMENT -Cuatro B-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -CPRE I-EVOLUTION -mejoró I-EVOLUTION -tanto I-EVOLUTION -clínica I-EVOLUTION -como I-EVOLUTION -analíticamente I-EVOLUTION -(FA I-EVOLUTION -310 I-EVOLUTION -U/l, I-EVOLUTION -GGT I-EVOLUTION -94 I-EVOLUTION -U/l, I-EVOLUTION -GOT I-EVOLUTION -212 I-EVOLUTION -U/l, I-EVOLUTION -GPT I-EVOLUTION -84 I-EVOLUTION -U/l, I-EVOLUTION -carga I-EVOLUTION -viral I-EVOLUTION -de I-EVOLUTION -CMV I-EVOLUTION -negativa I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -VIH I-EVOLUTION -1.602 I-EVOLUTION -copias/ml). I-EVOLUTION -En I-EVOLUTION -las I-EVOLUTION -revisiones I-EVOLUTION -posteriores I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -mantenido I-EVOLUTION -estable I-EVOLUTION -con I-EVOLUTION -elevación I-EVOLUTION -persistente I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -fosfatasa I-EVOLUTION -alcalina I-EVOLUTION -en I-EVOLUTION -rangos I-EVOLUTION -de I-EVOLUTION -400-600 I-EVOLUTION -U/l, I-EVOLUTION -carga I-EVOLUTION -viral I-EVOLUTION -de I-EVOLUTION -VIH I-EVOLUTION -y I-EVOLUTION -CMV I-EVOLUTION -negativas. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -71 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-EXPLORATION -presencia I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -excrecente, I-EXPLORATION -ulcerada I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -dura I-EXPLORATION -en I-EXPLORATION -flanco I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -acompañada I-EXPLORATION -de I-EXPLORATION -otra I-EXPLORATION -similar I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -zona I-EXPLORATION -infraclavicular I-EXPLORATION -izquierda. I-EXPLORATION -Presenta I-EXPLORATION -disfagia I-EXPLORATION -a I-EXPLORATION -sólidos I-EXPLORATION -y I-EXPLORATION -líquidos I-EXPLORATION -semanas I-EXPLORATION -después I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -aparición I-EXPLORATION -de I-EXPLORATION -dichas I-EXPLORATION -lesiones, I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -20 I-EXPLORATION -kg I-EXPLORATION -de I-EXPLORATION -peso. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -endoscópico I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -una I-EXPLORATION -neoplasia I-EXPLORATION -excrecente I-EXPLORATION -y I-EXPLORATION -ulcerada, I-EXPLORATION -a I-EXPLORATION -22 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arcada I-EXPLORATION -dental, I-EXPLORATION -que I-EXPLORATION -ocluye I-EXPLORATION -casi I-EXPLORATION -completamente I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -del I-EXPLORATION -esófago I-EXPLORATION -con I-EXPLORATION -resultado I-EXPLORATION -histológico I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -epidermoide I-EXPLORATION -infiltrante. I-EXPLORATION -La I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -dérmicas I-EXPLORATION -revela I-EXPLORATION -infiltración I-EXPLORATION -cutánea I-EXPLORATION -metastásica I-EXPLORATION -por I-EXPLORATION -carcinoma I-EXPLORATION -epidermoide, I-EXPLORATION -inmunohistoquimica I-EXPLORATION -más I-EXPLORATION -paracitoqueratina I-EXPLORATION -alto I-EXPLORATION -peso I-EXPLORATION -molecular I-EXPLORATION -y I-EXPLORATION -vimentina. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -indicaron I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -metastásica I-EXPLORATION -ósea I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -costal I-EXPLORATION -izquierdo, I-EXPLORATION -cuerpo I-EXPLORATION -vertebral I-EXPLORATION -D9 I-EXPLORATION -y I-EXPLORATION -hueso I-EXPLORATION -iliaco I-EXPLORATION -derecho. I-EXPLORATION -Finalmente B-TREATMENT -se I-TREATMENT -optó I-TREATMENT -por I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -prótesis I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -quimioterápico. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hidatidosis I-PAST_MEDICAL_HISTORY -hepática I-PAST_MEDICAL_HISTORY -intervenida I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2009 I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -portal I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -cavernomatosis I-PAST_MEDICAL_HISTORY -portal I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -complicación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cirugía, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -cirrosis I-PAST_MEDICAL_HISTORY -hepática I-PAST_MEDICAL_HISTORY -asociada. I-PAST_MEDICAL_HISTORY -Presentó I-PAST_MEDICAL_HISTORY -varices I-PAST_MEDICAL_HISTORY -esofágicas I-PAST_MEDICAL_HISTORY -grado I-PAST_MEDICAL_HISTORY -III-IV I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -ingresos I-PAST_MEDICAL_HISTORY -previos I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -sangrado I-PAST_MEDICAL_HISTORY -digestivo. I-PAST_MEDICAL_HISTORY -Acudió B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -agudo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hematemesis I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -melénicas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Se B-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -gastroscopia I-EXPLORATION -urgente I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -4 I-EXPLORATION -cordones I-EXPLORATION -varicosos I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -tamaño I-EXPLORATION -desde I-EXPLORATION -tercio I-EXPLORATION -medio I-EXPLORATION -esofágico I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -prolongan I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -subcardial, I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -rojos I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -pared I-EXPLORATION -aunque I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -sangrado I-EXPLORATION -activo. I-EXPLORATION -Se B-TREATMENT -colocaron I-TREATMENT -9 I-TREATMENT -bandas I-TREATMENT -de I-TREATMENT -ligadura I-TREATMENT -sin I-TREATMENT -complicaciones I-TREATMENT -inmediatas. I-TREATMENT -En B-EXPLORATION -estómago I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -evidenciaron I-EXPLORATION -lesiones I-EXPLORATION -potencialmente I-EXPLORATION -sangrantes I-EXPLORATION -ni I-EXPLORATION -restos I-EXPLORATION -hemáticos, I-EXPLORATION -ni I-EXPLORATION -tampoco I-EXPLORATION -en I-EXPLORATION -duodeno. I-EXPLORATION -Posteriormente B-EVOLUTION -presentó I-EVOLUTION -múltiples I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -melenas, I-EVOLUTION -con I-EVOLUTION -anemización I-EVOLUTION -secundaria I-EVOLUTION -y I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -transfusión I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -total I-EVOLUTION -de I-EVOLUTION -22 I-EVOLUTION -UCH. I-EVOLUTION -Se B-TREATMENT -realizaron I-TREATMENT -dos I-TREATMENT -intentos I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -endoscópica I-TREATMENT -de I-TREATMENT -controlar I-TREATMENT -el I-TREATMENT -sangrado I-TREATMENT -sin I-TREATMENT -objetivar I-TREATMENT -sangrado I-TREATMENT -de I-TREATMENT -las I-TREATMENT -escaras I-TREATMENT -de I-TREATMENT -las I-TREATMENT -bandas I-TREATMENT -previas I-TREATMENT -ni I-TREATMENT -a I-TREATMENT -otro I-TREATMENT -nivel I-TREATMENT -gastrointestinal. I-TREATMENT -En B-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION -realizada, I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -varices I-EXPLORATION -esofágicas I-EXPLORATION -secundarias I-EXPLORATION -a I-EXPLORATION -trombosis I-EXPLORATION -crónica I-EXPLORATION -del I-EXPLORATION -eje I-EXPLORATION -espleno-portal, I-EXPLORATION -esplenomegalia I-EXPLORATION -y I-EXPLORATION -ascitis I-EXPLORATION -sin I-EXPLORATION -identificar I-EXPLORATION -sangrado I-EXPLORATION -activo. I-EXPLORATION -Una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -mostró I-EXPLORATION -hidatidosis I-EXPLORATION -hepática I-EXPLORATION -ya I-EXPLORATION -descrita I-EXPLORATION -en I-EXPLORATION -estudios I-EXPLORATION -anteriores, I-EXPLORATION -cavernomatosis I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -trombosis I-EXPLORATION -portal I-EXPLORATION -y I-EXPLORATION -esplenomegalia. I-EXPLORATION -Ante I-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION -decidimos I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -arteriografía I-EXPLORATION -abdominal I-EXPLORATION -selectiva I-EXPLORATION -del I-EXPLORATION -tronco I-EXPLORATION -celiaco I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -mesentérica I-EXPLORATION -superior I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -identificó I-EXPLORATION -puntos I-EXPLORATION -sangrantes I-EXPLORATION -activos I-EXPLORATION -ni I-EXPLORATION -malformaciones I-EXPLORATION -vasculares. I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -hallazgos, I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -realizar I-EXPLORATION -enteroscopia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -rodilla I-EXPLORATION -duodenal I-EXPLORATION -un I-EXPLORATION -conglomerado I-EXPLORATION -de I-EXPLORATION -varices I-EXPLORATION -submucosas I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -comprueban I-EXPLORATION -con I-EXPLORATION -ecoendoscopio I-EXPLORATION -radial. I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -inyectar I-TREATMENT -3 I-TREATMENT -cc I-TREATMENT -de I-TREATMENT -pegamento I-TREATMENT -(cianoacrilato) I-TREATMENT -en I-TREATMENT -varices I-TREATMENT -duodenales I-TREATMENT -sin I-TREATMENT -complicaciones I-TREATMENT -inmediatas. I-TREATMENT -Tras B-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION -sin I-EVOLUTION -recidiva I-EVOLUTION -del I-EVOLUTION -sangrado I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -hematemesis I-EVOLUTION -de I-EVOLUTION -alto I-EVOLUTION -volumen I-EVOLUTION -que I-EVOLUTION -le I-EVOLUTION -ocasionó I-EVOLUTION -una I-EVOLUTION -broncoaspiración I-EVOLUTION -y I-EVOLUTION -secundariamente I-EVOLUTION -parada I-EVOLUTION -cardiorrespiratoria I-EVOLUTION -a I-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -maniobras I-EVOLUTION -de I-EVOLUTION -resucitación I-EVOLUTION -realizadas. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -hipertenso, B-PAST_MEDICAL_HISTORY -diabético I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -II I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -cirrosis I-PAST_MEDICAL_HISTORY -hepática I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -alcohólico, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -estadio I-PAST_MEDICAL_HISTORY -C I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Child, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -portal. I-PAST_MEDICAL_HISTORY -Presentaba I-PAST_MEDICAL_HISTORY -varices I-PAST_MEDICAL_HISTORY -esofágicas I-PAST_MEDICAL_HISTORY -grado I-PAST_MEDICAL_HISTORY -II I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -requerido I-PAST_MEDICAL_HISTORY -ingresos I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -sangrado I-PAST_MEDICAL_HISTORY -digestivo. I-PAST_MEDICAL_HISTORY -Acudió B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hematemesis I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -rectorragia. I-PRESENT_ILLNESS -Se B-EXPLORATION -realizó I-EXPLORATION -gastroscopia I-EXPLORATION -urgente I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -tres I-EXPLORATION -cordones I-EXPLORATION -varicosos I-EXPLORATION -de I-EXPLORATION -mediano-pequeño I-EXPLORATION -tamaño, I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -rojos I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -pared I-EXPLORATION -que I-EXPLORATION -afectaban I-EXPLORATION -a I-EXPLORATION -tercio I-EXPLORATION -inferior I-EXPLORATION -del I-EXPLORATION -esófago, I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -sangrado I-EXPLORATION -activo I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION -de I-EXPLORATION -realizar I-EXPLORATION -la I-EXPLORATION -exploración. I-EXPLORATION -Se B-TREATMENT -colocaron I-TREATMENT -dos I-TREATMENT -bandas I-TREATMENT -de I-TREATMENT -ligadura. I-TREATMENT -Una B-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -reveló I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -hepatopatía I-EXPLORATION -crónica I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -hipertensión I-EXPLORATION -portal, I-EXPLORATION -flujo I-EXPLORATION -portal I-EXPLORATION -hepatófugo I-EXPLORATION -y I-EXPLORATION -ascitis. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -sangrado I-EXPLORATION -activo I-EXPLORATION -ni I-EXPLORATION -lesiones I-EXPLORATION -potencialmente I-EXPLORATION -sangrantes I-EXPLORATION -en I-EXPLORATION -estómago I-EXPLORATION -ni I-EXPLORATION -en I-EXPLORATION -duodeno. I-EXPLORATION -Posteriormente B-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -nuevo I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -deposiciones I-EVOLUTION -melénicas, I-EVOLUTION -realizándose B-EXPLORATION -endoscopia I-EXPLORATION -que I-EXPLORATION -observó I-EXPLORATION -tres I-EXPLORATION -cordones I-EXPLORATION -varicosos I-EXPLORATION -pequeños I-EXPLORATION -con I-EXPLORATION -2 I-EXPLORATION -escaras I-EXPLORATION -en I-EXPLORATION -tercio I-EXPLORATION -distal I-EXPLORATION -y I-EXPLORATION -cierto I-EXPLORATION -edema. I-EXPLORATION -En I-EXPLORATION -estómago I-EXPLORATION -sangre I-EXPLORATION -roja I-EXPLORATION -en I-EXPLORATION -curvatura I-EXPLORATION -mayor. I-EXPLORATION -En I-EXPLORATION -duodeno I-EXPLORATION -presentaba I-EXPLORATION -variz I-EXPLORATION -duodenal I-EXPLORATION -en I-EXPLORATION -segunda I-EXPLORATION -porción I-EXPLORATION -con I-EXPLORATION -pezón I-EXPLORATION -de I-EXPLORATION -fibrina. I-EXPLORATION -Se B-TREATMENT -inyectó I-TREATMENT -1 I-TREATMENT -cc I-TREATMENT -de I-TREATMENT -cianoacrilato I-TREATMENT -y I-TREATMENT -4 I-TREATMENT -cc I-TREATMENT -de I-TREATMENT -etoxiesclerol. I-TREATMENT -Tras B-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -endoscópico I-EVOLUTION -no I-EVOLUTION -presentó I-EVOLUTION -nuevos I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -exteriorización I-EVOLUTION -de I-EVOLUTION -sangrado I-EVOLUTION -ni I-EVOLUTION -anemización I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -es I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta. I-EVOLUTION -Tras I-EVOLUTION -trece I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -momento I-EVOLUTION -nuevos I-EVOLUTION -ingresos I-EVOLUTION -por I-EVOLUTION -hemorragia I-EVOLUTION -digestiva I-EVOLUTION -alta I-EVOLUTION -secundaria I-EVOLUTION -a I-EVOLUTION -sangrado I-EVOLUTION -por I-EVOLUTION -variz I-EVOLUTION -duodenal. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -46 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -hipotiroidismo I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Graves-Basedow, I-PAST_MEDICAL_HISTORY -artritis I-PAST_MEDICAL_HISTORY -reumatoide I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -CU I-PAST_MEDICAL_HISTORY -corticodependiente I-PAST_MEDICAL_HISTORY -refractaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -inmunosupresores I-PAST_MEDICAL_HISTORY -tiopurínicos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -antiTNF, I-PAST_MEDICAL_HISTORY -otras I-PAST_MEDICAL_HISTORY -complicaciones I-PAST_MEDICAL_HISTORY -asociadas I-PAST_MEDICAL_HISTORY -son I-PAST_MEDICAL_HISTORY -eritema I-PAST_MEDICAL_HISTORY -nodoso I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -perianal I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -precisó I-PAST_MEDICAL_HISTORY -drenaje I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -abscesos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -colocación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -seton I-PAST_MEDICAL_HISTORY -laxo I-PAST_MEDICAL_HISTORY -sobre I-PAST_MEDICAL_HISTORY -fístula I-PAST_MEDICAL_HISTORY -anal I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -antes. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Controlada B-TREATMENT -por I-TREATMENT -la I-TREATMENT -Unidad I-TREATMENT -de I-TREATMENT -Enfermedad I-TREATMENT -Inflamatoria I-TREATMENT -Intestinal I-TREATMENT -(EII), I-TREATMENT -es I-TREATMENT -refractaria I-TREATMENT -al I-TREATMENT -tratamiento, I-TREATMENT -manteniéndose I-TREATMENT -lesiones I-TREATMENT -evidentes I-TREATMENT -endoscópicas I-TREATMENT -e I-TREATMENT -histológicas, I-TREATMENT -unido I-TREATMENT -a I-TREATMENT -importante I-TREATMENT -afectación I-TREATMENT -de I-TREATMENT -su I-TREATMENT -estado I-TREATMENT -general I-TREATMENT -y I-TREATMENT -calidad I-TREATMENT -de I-TREATMENT -vida, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -recomienda I-TREATMENT -tratamiento I-TREATMENT -quirúrgico. I-TREATMENT -Dada I-TREATMENT -la I-TREATMENT -enfermedad I-TREATMENT -perianal I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -pancoloproctectomía I-TREATMENT -e I-TREATMENT -ileostomía I-TREATMENT -terminal I-TREATMENT -en I-TREATMENT -fosa I-TREATMENT -ilíaca I-TREATMENT -derecha. I-TREATMENT -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -CU. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -evolución I-EVOLUTION -postoperatoria I-EVOLUTION -es I-EVOLUTION -lenta, I-EVOLUTION -con I-EVOLUTION -infección I-EVOLUTION -del I-EVOLUTION -tracto I-EVOLUTION -urinario I-EVOLUTION -e I-EVOLUTION -íleo I-EVOLUTION -paralítico I-EVOLUTION -que B-TREATMENT -requiere I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -sonda I-TREATMENT -naso-gástrica. I-TREATMENT - I-TREATMENT -Previo I-TREATMENT -a I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -se I-TREATMENT -había I-TREATMENT -retirado I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -tiopurinas I-TREATMENT -y I-TREATMENT -antiTNF I-TREATMENT -y I-TREATMENT -durante I-TREATMENT -el I-TREATMENT -ingreso I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -pauta I-TREATMENT -de I-TREATMENT -retirada I-TREATMENT -de I-TREATMENT -corticoides I-TREATMENT -orales I-TREATMENT -hasta I-TREATMENT -su I-TREATMENT -suspensión I-TREATMENT -completa. I-TREATMENT -Es B-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta, I-EVOLUTION -asintomática, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -35 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION - I-EVOLUTION -Siete I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -acude I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -consulta I-EVOLUTION -de I-EVOLUTION -estomaterapia I-EVOLUTION -por I-EVOLUTION -presentar I-EVOLUTION -una I-EVOLUTION -ulceración I-EVOLUTION -de I-EVOLUTION -bordes I-EVOLUTION -anfractuosos I-EVOLUTION -y I-EVOLUTION -un I-EVOLUTION -absceso I-EVOLUTION -subcutáneo I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -proximidad I-EVOLUTION -del I-EVOLUTION -estoma, I-EVOLUTION -que I-EVOLUTION -le I-EVOLUTION -origina I-EVOLUTION -intenso I-EVOLUTION -dolor I-EVOLUTION -y I-EVOLUTION -dificultad I-EVOLUTION -para I-EVOLUTION -la I-EVOLUTION -aplicación I-EVOLUTION -del I-EVOLUTION -dispositivo I-EVOLUTION -colector. I-EVOLUTION - I-EVOLUTION -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -una I-EXPLORATION -ulceración I-EXPLORATION -profunda, I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -irregulares I-EXPLORATION -e I-EXPLORATION -indurados, I-EXPLORATION -sumamente I-EXPLORATION -dolorosa, I-EXPLORATION -que I-EXPLORATION -afecta I-EXPLORATION -a I-EXPLORATION -gran I-EXPLORATION -parte I-EXPLORATION -del I-EXPLORATION -margen I-EXPLORATION -izquierdo I-EXPLORATION -e I-EXPLORATION -inferior I-EXPLORATION -del I-EXPLORATION -estoma; I-EXPLORATION -en I-EXPLORATION -proximidad, I-EXPLORATION -pequeña I-EXPLORATION -colección I-EXPLORATION -purulenta I-EXPLORATION -que, I-EXPLORATION -al I-EXPLORATION -drenarla, I-EXPLORATION -pone I-EXPLORATION -en I-EXPLORATION -evidencia I-EXPLORATION -otra I-EXPLORATION -ulceración, I-EXPLORATION -con I-EXPLORATION -márgenes I-EXPLORATION -necróticos I-EXPLORATION -y I-EXPLORATION -eritematosos, I-EXPLORATION -tunelizada I-EXPLORATION -mediante I-EXPLORATION -un I-EXPLORATION -pequeño I-EXPLORATION -puente I-EXPLORATION -dérmico I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -anterior. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -PGP I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -ingreso I-TREATMENT -para I-TREATMENT -tratamiento I-TREATMENT -y I-TREATMENT -vigilar I-TREATMENT -evolución. I-TREATMENT - I-TREATMENT -Se B-EXPLORATION -tomaron I-EXPLORATION -muestras I-EXPLORATION -para I-EXPLORATION -cultivo I-EXPLORATION -y I-EXPLORATION -estudio I-EXPLORATION -histológico; I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -ningún I-EXPLORATION -germen I-EXPLORATION -anormal I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -fue I-EXPLORATION -informado I-EXPLORATION -de I-EXPLORATION -inflamación I-EXPLORATION -inespecífica. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -instauró I-TREATMENT -tratamiento I-TREATMENT -mediante I-TREATMENT -tacrolimus I-TREATMENT -vía I-TREATMENT -tópica, I-TREATMENT -en I-TREATMENT -solución I-TREATMENT -al I-TREATMENT -0, I-TREATMENT -3 I-TREATMENT -%, I-TREATMENT -una I-TREATMENT -aplicación I-TREATMENT -diaria; I-TREATMENT -adalimumab: I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -inducción I-TREATMENT -de I-TREATMENT -80 I-TREATMENT -mg I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -40 I-TREATMENT -mg I-TREATMENT -subcutáneos I-TREATMENT -cada I-TREATMENT -dos I-TREATMENT -semanas, I-TREATMENT -de I-TREATMENT -mantenimiento; I-TREATMENT -metilprednisolona: I-TREATMENT -32 I-TREATMENT -mg I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -con I-TREATMENT -pauta I-TREATMENT -descendente I-TREATMENT -de I-TREATMENT -8 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -14 I-TREATMENT -días; I-TREATMENT -y I-TREATMENT -metronidazol I-TREATMENT -y I-TREATMENT -ciprofloxacino I-TREATMENT -a I-TREATMENT -las I-TREATMENT -dosis I-TREATMENT -habituales I-TREATMENT -durante I-TREATMENT -dos I-TREATMENT -semanas. I-TREATMENT - I-TREATMENT -Sobreañadido I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -general, I-TREATMENT -se I-TREATMENT -realizaron I-TREATMENT -curas I-TREATMENT -locales I-TREATMENT -por I-TREATMENT -parte I-TREATMENT -de I-TREATMENT -la I-TREATMENT -Unidad I-TREATMENT -de I-TREATMENT -Estomaterapia, I-TREATMENT -aplicándose I-TREATMENT -apósito I-TREATMENT -absorbente I-TREATMENT -hidrocoloide I-TREATMENT -transparente I-TREATMENT -(carboximetilcelulosa I-TREATMENT -y I-TREATMENT -film I-TREATMENT -de I-TREATMENT -poliuretano), I-TREATMENT -sobre I-TREATMENT -el I-TREATMENT -que I-TREATMENT -se I-TREATMENT -adapta I-TREATMENT -dispositivo I-TREATMENT -de I-TREATMENT -ileostomía I-TREATMENT -de I-TREATMENT -doble I-TREATMENT -sistema I-TREATMENT -y I-TREATMENT -cinturón, I-TREATMENT -realizando I-TREATMENT -cambios I-TREATMENT -diarios I-TREATMENT -para I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -tacrolimus I-TREATMENT -tópico. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -fue I-EVOLUTION -muy I-EVOLUTION -satisfactoria I-EVOLUTION -con I-EVOLUTION -resolución I-EVOLUTION -completa I-EVOLUTION -del I-EVOLUTION -pioderma I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -ocho I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -tratamiento. I-EVOLUTION -Continúa I-EVOLUTION -seguimiento I-EVOLUTION -en I-EVOLUTION -consultas I-EVOLUTION -externas I-EVOLUTION -y I-EVOLUTION -diez I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -han I-EVOLUTION -desaparecido I-EVOLUTION -y B-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -no I-TREATMENT -precisa I-TREATMENT -tratamiento I-TREATMENT -médico I-TREATMENT -de I-TREATMENT -mantenimiento. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus, I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -isquémica, I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -cardiaca, I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -vascular I-PAST_MEDICAL_HISTORY -periférica, I-PAST_MEDICAL_HISTORY -anemia I-PAST_MEDICAL_HISTORY -ferropénica I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica. I-PAST_MEDICAL_HISTORY -Seguía I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -furosemida, I-PAST_MEDICAL_HISTORY -hidralacina, I-PAST_MEDICAL_HISTORY -sulfato I-PAST_MEDICAL_HISTORY -ferroso, I-PAST_MEDICAL_HISTORY -ácido I-PAST_MEDICAL_HISTORY -acetilsalicílico, I-PAST_MEDICAL_HISTORY -lisinopril, I-PAST_MEDICAL_HISTORY -carvedilol, I-PAST_MEDICAL_HISTORY -doxazosina I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -insulina. I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -EDA I-EXPLORATION -por I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -anemia, I-EXPLORATION -visualizándose I-EXPLORATION -bandas I-EXPLORATION -longitudinales I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -negruzco I-EXPLORATION -en I-EXPLORATION -antro I-EXPLORATION -gástrico I-EXPLORATION -y I-EXPLORATION -múltiples I-EXPLORATION -manchas I-EXPLORATION -puntiformes I-EXPLORATION -oscuras I-EXPLORATION -en I-EXPLORATION -bulbo I-EXPLORATION -y I-EXPLORATION -segunda I-EXPLORATION -porción I-EXPLORATION -duodenal. I-EXPLORATION -La I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -confirmó, I-EXPLORATION -mediante I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -Perls, I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -depósitos I-EXPLORATION -de I-EXPLORATION -material I-EXPLORATION -férrico. I-EXPLORATION - I-EXPLORATION - -Varón, B-PRESENT_ILLNESS -71 I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS -Antecedentes B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cirrosis I-PAST_MEDICAL_HISTORY -hepática I-PAST_MEDICAL_HISTORY -enólica, I-PAST_MEDICAL_HISTORY -hemorragia I-PAST_MEDICAL_HISTORY -digestiva I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -varices I-PAST_MEDICAL_HISTORY -esofágicas, I-PAST_MEDICAL_HISTORY -trombosis I-PAST_MEDICAL_HISTORY -portal I-PAST_MEDICAL_HISTORY -recanalizada, I-PAST_MEDICAL_HISTORY -derivación I-PAST_MEDICAL_HISTORY -percutánea I-PAST_MEDICAL_HISTORY -portosistémica I-PAST_MEDICAL_HISTORY -intrahepática I-PAST_MEDICAL_HISTORY -(DPPI) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cavernomatosis I-PAST_MEDICAL_HISTORY -portal. I-PAST_MEDICAL_HISTORY -Ingresa B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -compatible I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -colangitis I-PRESENT_ILLNESS -aguda. I-PRESENT_ILLNESS -Se B-EXPLORATION -solicita I-EXPLORATION -colangiopancreatografía I-EXPLORATION -retrógrada I-EXPLORATION -endoscópica, I-EXPLORATION -objetivándose I-EXPLORATION -una I-EXPLORATION -VB I-EXPLORATION -extrahepática I-EXPLORATION -irregular, I-EXPLORATION -con I-EXPLORATION -estenosis I-EXPLORATION -y I-EXPLORATION -dilataciones; I-EXPLORATION -se I-EXPLORATION -extraen I-EXPLORATION -varios I-EXPLORATION -coágulos I-EXPLORATION -con I-EXPLORATION -balón, I-EXPLORATION -persistiendo I-EXPLORATION -algunos I-EXPLORATION -defectos I-EXPLORATION -de I-EXPLORATION -repleción, I-EXPLORATION -planteando I-EXPLORATION -diagnóstico I-EXPLORATION -diferencial I-EXPLORATION -entre I-EXPLORATION -colangiocarcinoma I-EXPLORATION -y I-EXPLORATION -colangitis I-EXPLORATION -esclerosante. I-EXPLORATION -Se I-EXPLORATION -completa I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -DPPI I-EXPLORATION -no I-EXPLORATION -permeable I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -hipertensión I-EXPLORATION -portal. I-EXPLORATION -Al I-EXPLORATION -alta I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -ecoendoscopia I-EXPLORATION -objetivándose I-EXPLORATION -varices I-EXPLORATION -esofagogástricas, I-EXPLORATION -circulación I-EXPLORATION -colateral I-EXPLORATION -periesplénica I-EXPLORATION -y I-EXPLORATION -periportal, I-EXPLORATION -cavernomatosis I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -mesentérica I-EXPLORATION -superior I-EXPLORATION -y I-EXPLORATION -circulación I-EXPLORATION -colateral I-EXPLORATION -en I-EXPLORATION -torno I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -VB, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -prominente I-EXPLORATION -ovillo I-EXPLORATION -vascular I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -VB I-EXPLORATION -extrahepática I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -cístico, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -varices I-EXPLORATION -coledocianas. I-EXPLORATION - I-EXPLORATION - -Presentamos B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -47 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -remitido B-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -dolor I-DERIVED_FROM/TO -abdominal I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -anemia I-DERIVED_FROM/TO -(Hb I-DERIVED_FROM/TO -11, I-DERIVED_FROM/TO -4 I-DERIVED_FROM/TO -mg/dl I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -hierro I-DERIVED_FROM/TO -sérico I-DERIVED_FROM/TO -15 I-DERIVED_FROM/TO -µg/dl) I-DERIVED_FROM/TO -asociada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -hiperferritinemia I-DERIVED_FROM/TO -(707 I-DERIVED_FROM/TO -ng/ml). I-DERIVED_FROM/TO -La B-EXPLORATION -gastroscopia, I-EXPLORATION -colonoscopia, I-EXPLORATION -ecografía I-EXPLORATION -y I-EXPLORATION -tránsito I-EXPLORATION -gastrointestinal I-EXPLORATION -descartaron I-EXPLORATION -afectación I-EXPLORATION -inflamatoria. I-EXPLORATION -A I-EXPLORATION -pesar I-EXPLORATION -de I-EXPLORATION -presentar I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -transferrina I-EXPLORATION -bajo I-EXPLORATION -(3, I-EXPLORATION -7 I-EXPLORATION -%) I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -genético I-EXPLORATION -de I-EXPLORATION -hemocromatosis I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION -Dada I-EXPLORATION -la I-EXPLORATION -normalidad I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -la I-EXPLORATION -ceruloplasmina I-EXPLORATION -y I-EXPLORATION -estudio I-EXPLORATION -del I-EXPLORATION -metabolismo I-EXPLORATION -del I-EXPLORATION -cobre, I-EXPLORATION -que I-EXPLORATION -confirmaron I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -aceruloplasminemia: I-EXPLORATION -ceruloplasmina I-EXPLORATION -inferior I-EXPLORATION -a I-EXPLORATION -7 I-EXPLORATION -mg/dl I-EXPLORATION -(rango I-EXPLORATION -normal, I-EXPLORATION -22-61 I-EXPLORATION -mg/dl), I-EXPLORATION -cobre I-EXPLORATION -sérico I-EXPLORATION -13 I-EXPLORATION -µg/dl I-EXPLORATION -(rango I-EXPLORATION -normal, I-EXPLORATION -70-150 I-EXPLORATION -µg/dl) I-EXPLORATION -y I-EXPLORATION -cobre I-EXPLORATION -en I-EXPLORATION -orina I-EXPLORATION -de I-EXPLORATION -24 I-EXPLORATION -horas I-EXPLORATION -normal. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -test I-EXPLORATION -genético I-EXPLORATION -por I-EXPLORATION -no I-EXPLORATION -encontrarse I-EXPLORATION -disponible I-EXPLORATION -en I-EXPLORATION -nuestro I-EXPLORATION -centro. I-EXPLORATION -La I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -abdominal I-EXPLORATION -identificó I-EXPLORATION -baja I-EXPLORATION -intensidad I-EXPLORATION -de I-EXPLORATION -señal I-EXPLORATION -en I-EXPLORATION -T1 I-EXPLORATION -y I-EXPLORATION -T2 I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -depósito I-EXPLORATION -hepático I-EXPLORATION -de I-EXPLORATION -hierro I-EXPLORATION -sin I-EXPLORATION -observar I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -RM I-EXPLORATION -cerebral I-EXPLORATION -ni I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -oftalmológico. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -lista I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -espera I-PRESENT_ILLNESS -quirúrgica I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -colecistectomía I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -litiasis I-PRESENT_ILLNESS -biliar I-PRESENT_ILLNESS -sintomática I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -resección I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -adenoma I-PRESENT_ILLNESS -hepático I-PRESENT_ILLNESS -(de I-PRESENT_ILLNESS -6, I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS -x I-PRESENT_ILLNESS -5, I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS -x I-PRESENT_ILLNESS -6, I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -cm, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -segmento I-PRESENT_ILLNESS -II-III). I-PRESENT_ILLNESS -Consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -agudo I-PRESENT_ILLNESS -epigástrico I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -hipocondrios, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -sanguínea I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -amilasa I-EXPLORATION -de I-EXPLORATION -3315 I-EXPLORATION -UI/L I-EXPLORATION -(rango I-EXPLORATION -de I-EXPLORATION -normalidad: I-EXPLORATION -25-115 I-EXPLORATION -UI/L), I-EXPLORATION -sin I-EXPLORATION -otros I-EXPLORATION -hallazgos; I-EXPLORATION -ingresándose I-EXPLORATION -con I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -pancreatitis I-EXPLORATION -aguda I-EXPLORATION -biliar, I-EXPLORATION -sin I-EXPLORATION -criterios I-EXPLORATION -de I-EXPLORATION -Ranson. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -vesícula I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -litiasis, I-EXPLORATION -con I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -intra I-EXPLORATION -y I-EXPLORATION -extrahepática, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -páncreas I-EXPLORATION -aumentado I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -difusa. I-EXPLORATION - I-EXPLORATION -Requirió B-EVOLUTION -estancia I-EVOLUTION -en I-EVOLUTION -Unidad I-EVOLUTION -de I-EVOLUTION -Medicina I-EVOLUTION -Intensiva I-EVOLUTION -por I-EVOLUTION -mala I-EVOLUTION -evolución I-EVOLUTION -con I-EVOLUTION -oligoanuria I-EVOLUTION -los I-EVOLUTION -primeros I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -ingreso; I-EVOLUTION -realizándose B-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -de I-EXPLORATION -abdomen, I-EXPLORATION -que I-EXPLORATION -mostraba I-EXPLORATION -una I-EXPLORATION -pancreatitis I-EXPLORATION -grado I-EXPLORATION -E I-EXPLORATION -de I-EXPLORATION -Balthazar. I-EXPLORATION -Durante B-EVOLUTION -su I-EVOLUTION -estancia I-EVOLUTION -prolongada I-EVOLUTION -en I-EVOLUTION -planta I-EVOLUTION -presentó I-EVOLUTION -numerosas I-EVOLUTION -complicaciones: I-EVOLUTION -condensación I-EVOLUTION -pulmonar I-EVOLUTION -con I-EVOLUTION -derrame I-EVOLUTION -pleural I-EVOLUTION -asociado I-EVOLUTION -(Klebsiella I-EVOLUTION -pneumoniae I-EVOLUTION -en I-EVOLUTION -esputo), I-EVOLUTION -infección I-EVOLUTION -del I-EVOLUTION -tracto I-EVOLUTION -urinario I-EVOLUTION -(Candida I-EVOLUTION -albicans), I-EVOLUTION -sepsis I-EVOLUTION -por I-EVOLUTION -catéter I-EVOLUTION -(Stafilococo I-EVOLUTION -haemolyticus), I-EVOLUTION -trombosis I-EVOLUTION -venosa I-EVOLUTION -profunda I-EVOLUTION -de I-EVOLUTION -yugular I-EVOLUTION -interna I-EVOLUTION -y I-EVOLUTION -subclavia I-EVOLUTION -derecha I-EVOLUTION -por I-EVOLUTION -catéter I-EVOLUTION -central, I-EVOLUTION -desnutrición I-EVOLUTION -proteica I-EVOLUTION -severa, I-EVOLUTION -e I-EVOLUTION -imposibilidad I-EVOLUTION -de I-EVOLUTION -reintroducir I-EVOLUTION -alimentación I-EVOLUTION -por I-EVOLUTION -vía I-EVOLUTION -enteral I-EVOLUTION -por I-EVOLUTION -cuadros I-EVOLUTION -suboclusivos I-EVOLUTION -con I-EVOLUTION -vómitos I-EVOLUTION -y I-EVOLUTION -distensión I-EVOLUTION -abdominal. I-EVOLUTION -En B-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -de I-EXPLORATION -control, I-EXPLORATION -se I-EXPLORATION -visualizó I-EXPLORATION -estenosis I-EXPLORATION -severa I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -ángulo I-EXPLORATION -hepático I-EXPLORATION -del I-EXPLORATION -colon I-EXPLORATION -con I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -pliegues I-EXPLORATION -y I-EXPLORATION -varios I-EXPLORATION -trayectos I-EXPLORATION -fistulosos, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -confirmaron I-EXPLORATION -con I-EXPLORATION -enema I-EXPLORATION -opaco I-EXPLORATION -; I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -colecciones I-EXPLORATION -multiloculadas I-EXPLORATION -en I-EXPLORATION -psoas-iliaco I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -falta I-TREATMENT -de I-TREATMENT -respuesta I-TREATMENT -a I-TREATMENT -tratamiento I-TREATMENT -conservador I-TREATMENT -se I-TREATMENT -programó I-TREATMENT -para I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -realizándose I-TREATMENT -bypass I-TREATMENT -íleo-cólico, I-TREATMENT -colecistectomía I-TREATMENT -y I-TREATMENT -resección I-TREATMENT -del I-TREATMENT -adenoma I-TREATMENT -hepático. I-TREATMENT - I-TREATMENT -Actualmente B-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática, I-EVOLUTION -con I-EVOLUTION -TAC I-EVOLUTION -abdomen I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -normal. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -67 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -espasmo I-PAST_MEDICAL_HISTORY -hemifacial I-PAST_MEDICAL_HISTORY -izquierdo, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -epigastrio I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -coluria I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física, I-EXPLORATION -dolor I-EXPLORATION -en I-EXPLORATION -hipocondrio I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -Murphy I-EXPLORATION -negativo I-EXPLORATION -con I-EXPLORATION -leve I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -transaminasas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -analítica. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -objetiva I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -quística I-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -hilio I-EXPLORATION -hepático. I-EXPLORATION -El I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -manifiesta I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -con I-EXPLORATION -lesión I-EXPLORATION -hipodensa I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hilio I-EXPLORATION -hepático. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -RMN I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -hilio I-EXPLORATION -hepático I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -quística I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -polilobulada I-EXPLORATION -con I-EXPLORATION -compresión I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -intrahepática I-EXPLORATION -sin I-EXPLORATION -realce I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -captación I-EXPLORATION -de I-EXPLORATION -contraste. I-EXPLORATION - I-EXPLORATION -Dados I-EXPLORATION -los I-EXPLORATION -episodios I-EXPLORATION -de I-EXPLORATION -colangitis I-EXPLORATION -se I-EXPLORATION -diagnostica I-EXPLORATION -como I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Caroli I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -laparotomía I-EXPLORATION -exploradora, I-EXPLORATION -apreciándose I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -quística I-EXPLORATION -intrahepática I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -segmentos I-EXPLORATION -IV-III I-EXPLORATION -que, I-EXPLORATION -tras I-EXPLORATION -una I-EXPLORATION -colangiografía I-EXPLORATION -intraoperatoria, I-EXPLORATION -presenta I-EXPLORATION -comunicación I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -principal. I-EXPLORATION -Se B-TREATMENT -realiza I-TREATMENT -una I-TREATMENT -colecistectomía I-TREATMENT -y I-TREATMENT -hepatectomía I-TREATMENT -izquierda I-TREATMENT -reglada, I-TREATMENT -siendo B-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -postoperatoria I-EVOLUTION -favorable. I-EVOLUTION - I-EVOLUTION -La B-EXPLORATION -histología I-EXPLORATION -describe I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -múltiples I-EXPLORATION -quistes I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -fibrosa, I-EXPLORATION -revestidas I-EXPLORATION -por I-EXPLORATION -epitelio I-EXPLORATION -mucosecretor I-EXPLORATION -con I-EXPLORATION -zonas I-EXPLORATION -planas, I-EXPLORATION -proyecciones I-EXPLORATION -papilares, I-EXPLORATION -atipia I-EXPLORATION -citológica I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -sólido I-EXPLORATION -con I-EXPLORATION -infiltración I-EXPLORATION -focal I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -del I-EXPLORATION -quiste, I-EXPLORATION -sin I-EXPLORATION -alcanzar I-EXPLORATION -el I-EXPLORATION -parénquima I-EXPLORATION -hepático I-EXPLORATION -ni I-EXPLORATION -bordes I-EXPLORATION -quirúrgicos. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -evidencia I-EXPLORATION -estroma I-EXPLORATION -ovárico. I-EXPLORATION -Todo I-EXPLORATION -ello I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnostico I-EXPLORATION -de I-EXPLORATION -cistoadenocarcinoma I-EXPLORATION -hepático. I-EXPLORATION - I-EXPLORATION -Cinco B-EVOLUTION -años I-EVOLUTION -después, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -está I-EVOLUTION -asintomático I-EVOLUTION -sin I-EVOLUTION -signos I-EVOLUTION -radiológicos I-EVOLUTION -de I-EVOLUTION -recidiva. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -63 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -progresiva, I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -hábito I-PAST_MEDICAL_HISTORY -tabáquico, I-PAST_MEDICAL_HISTORY -alcoholismo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pancreatitis I-PAST_MEDICAL_HISTORY -crónica. I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -realizó I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -en I-EXPLORATION -urgencias I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION -un I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -izquierdo I-EXPLORATION -masivo. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -toracocentesis I-EXPLORATION -siendo I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -negativo, I-EXPLORATION -con I-EXPLORATION -criterios I-EXPLORATION -de I-EXPLORATION -exudado I-EXPLORATION -con I-EXPLORATION -60 I-EXPLORATION -% I-EXPLORATION -de I-EXPLORATION -polimorfonucleares, I-EXPLORATION -destacando I-EXPLORATION -12.400 I-EXPLORATION -UI/L I-EXPLORATION -de I-EXPLORATION -amilasa I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -líquido I-EXPLORATION -pleural. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -TAC I-EXPLORATION -torácico, I-EXPLORATION -que I-EXPLORATION -mostraba I-EXPLORATION -infiltrado I-EXPLORATION -en I-EXPLORATION -LII I-EXPLORATION -y I-EXPLORATION -pequeñas I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -vidrio I-EXPLORATION -deslustrado. I-EXPLORATION -Con B-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -derrame I-TREATMENT -paraneumónico I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -médico. I-TREATMENT -Sin B-EXPLORATION -embargo, I-EXPLORATION -el I-EXPLORATION -derrame I-EXPLORATION -empeoró, I-EXPLORATION -realizándose I-EXPLORATION -nueva I-EXPLORATION -toracocentesis I-EXPLORATION -diagnóstica I-EXPLORATION -y I-EXPLORATION -evacuadora, I-EXPLORATION -con I-EXPLORATION -citología I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -células I-EXPLORATION -malignas, I-EXPLORATION -cultivo I-EXPLORATION -negativo I-EXPLORATION -y I-EXPLORATION -biopsia I-EXPLORATION -pleural I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -tumor, I-EXPLORATION -destacando I-EXPLORATION -nuevamente I-EXPLORATION -amilasa I-EXPLORATION -elevada, I-EXPLORATION -con I-EXPLORATION -10.156 I-EXPLORATION -UL/L. I-EXPLORATION -Ante I-EXPLORATION -el I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -recidivante I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -TAC I-EXPLORATION -toraco-abdominal, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -evidenciaba I-EXPLORATION -un I-EXPLORATION -pseudoquiste I-EXPLORATION -pancreático I-EXPLORATION -de I-EXPLORATION -28 I-EXPLORATION -mm I-EXPLORATION -comunicado I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -líquida I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -x I-EXPLORATION -5, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -7 I-EXPLORATION -cm I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extendía I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -páncreas I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -espacio I-EXPLORATION -subfrénico, I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -izquierdo I-EXPLORATION -masivo, I-EXPLORATION -siendo I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -fístula I-EXPLORATION -pleuropancreática. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -médico I-TREATMENT -con I-TREATMENT -dieta I-TREATMENT -absoluta, I-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -total, I-TREATMENT -drenaje I-TREATMENT -torácico I-TREATMENT -con I-TREATMENT -tubo I-TREATMENT -y I-TREATMENT -octeótrido I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -100 I-TREATMENT -µg I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas I-TREATMENT -subcutáneo, I-TREATMENT -duplicando I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -ante I-TREATMENT -el I-TREATMENT -alto I-TREATMENT -débito. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -CPRE I-TREATMENT -con I-TREATMENT -intento I-TREATMENT -de I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -stent I-TREATMENT -en I-TREATMENT -el I-TREATMENT -conducto I-TREATMENT -pancreático I-TREATMENT -principal, I-TREATMENT -que I-TREATMENT -no I-TREATMENT -fue I-TREATMENT -posible I-TREATMENT -técnicamente I-TREATMENT -al I-TREATMENT -encontrarse I-TREATMENT -el I-TREATMENT -origen I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fístula I-TREATMENT -en I-TREATMENT -pseudoquiste I-TREATMENT -pancreático I-TREATMENT -situado I-TREATMENT -en I-TREATMENT -la I-TREATMENT -cola I-TREATMENT -del I-TREATMENT -páncreas. I-TREATMENT -Pese I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -médico I-TREATMENT -inicial, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -no I-TREATMENT -presentó I-TREATMENT -mejoría, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -finalmente I-TREATMENT -fue I-TREATMENT -intervenido I-TREATMENT -tras I-TREATMENT -dos I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -iniciado I-TREATMENT -el I-TREATMENT -tratamiento, I-TREATMENT -evidenciando I-TREATMENT -un I-TREATMENT -orifico I-TREATMENT -en I-TREATMENT -el I-TREATMENT -diafragma I-TREATMENT -de I-TREATMENT -2 I-TREATMENT -cm I-TREATMENT -que I-TREATMENT -comunicaba I-TREATMENT -el I-TREATMENT -pseudoquiste I-TREATMENT -con I-TREATMENT -la I-TREATMENT -cavidad I-TREATMENT -pleural I-TREATMENT -y I-TREATMENT -que I-TREATMENT -determinaba I-TREATMENT -la I-TREATMENT -fístula I-TREATMENT -pleuropancreática. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -pancreatectomía I-TREATMENT -distal, I-TREATMENT -no I-TREATMENT -pudiendo I-TREATMENT -respetar I-TREATMENT -el I-TREATMENT -bazo I-TREATMENT -por I-TREATMENT -la I-TREATMENT -gran I-TREATMENT -inflamación I-TREATMENT -presente, I-TREATMENT -así I-TREATMENT -como I-TREATMENT -cierre I-TREATMENT -del I-TREATMENT -orificio I-TREATMENT -diafragmático I-TREATMENT -y I-TREATMENT -drenaje I-TREATMENT -pleural I-TREATMENT -izquierdo, I-TREATMENT -con I-TREATMENT -derivación I-TREATMENT -de I-TREATMENT -conducto I-TREATMENT -de I-TREATMENT -Wirsung I-TREATMENT -distal I-TREATMENT -término-lateral I-TREATMENT -en I-TREATMENT -Y I-TREATMENT -de I-TREATMENT -Roux I-TREATMENT -retrocólica-transmesocólica I-TREATMENT -tras I-TREATMENT -extracción I-TREATMENT -de I-TREATMENT -cálculos. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -satisfactoria, I-EVOLUTION -siendo I-EVOLUTION -retirado I-EVOLUTION -el I-EVOLUTION -drenaje I-EVOLUTION -pleural I-EVOLUTION -al I-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -sin I-EVOLUTION -recidiva I-EVOLUTION -del I-EVOLUTION -derrame I-EVOLUTION -y I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -sexto I-EVOLUTION -día I-EVOLUTION -post-operatorio. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -continúa I-EVOLUTION -asintomático I-EVOLUTION -dos I-EVOLUTION -años I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -embarazada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -semanas, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -cavernomatosis I-PRESENT_ILLNESS -portal I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -7años. I-PRESENT_ILLNESS -Durante B-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -adolescencia I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hemorragia I-PAST_MEDICAL_HISTORY -digestiva I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -secundarios I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -varices I-PAST_MEDICAL_HISTORY -esofágicas I-PAST_MEDICAL_HISTORY -(VE). I-PAST_MEDICAL_HISTORY -Anticoagulada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -trombosis I-PAST_MEDICAL_HISTORY -venosa I-PAST_MEDICAL_HISTORY -mesentérica I-PAST_MEDICAL_HISTORY -aguda. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -primer I-PAST_MEDICAL_HISTORY -trimestre I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -retiraron I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -beta-bloqueantes I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -anticoagulantes I-PAST_MEDICAL_HISTORY -orales, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -pasó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -heparina I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -bajo I-PAST_MEDICAL_HISTORY -peso. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -gastroscopia I-EXPLORATION -realizada I-EXPLORATION -para I-EXPLORATION -control I-EXPLORATION -de I-EXPLORATION -varices I-EXPLORATION -esofágicas I-EXPLORATION -6 I-EXPLORATION -días I-EXPLORATION -antes I-EXPLORATION -del I-EXPLORATION -evento, I-EXPLORATION -se I-EXPLORATION -objetivaron I-EXPLORATION -VE I-EXPLORATION -grado I-EXPLORATION -I I-EXPLORATION -y I-EXPLORATION -II I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -rojos. I-EXPLORATION - I-EXPLORATION -Acudió I-EXPLORATION -a I-EXPLORATION -urgencias I-EXPLORATION -por I-EXPLORATION -melenas I-EXPLORATION -e I-EXPLORATION -hipotensión I-EXPLORATION -arterial. I-EXPLORATION -En I-EXPLORATION -analítica I-EXPLORATION -destacaba I-EXPLORATION -hemoglobina I-EXPLORATION -7, I-EXPLORATION -1 I-EXPLORATION -g/dl. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -gastroscopia I-TREATMENT -urgente I-TREATMENT -en I-TREATMENT -la I-TREATMENT -que I-TREATMENT -se I-TREATMENT -observaron I-TREATMENT -VE I-TREATMENT -grado I-TREATMENT -II I-TREATMENT -con I-TREATMENT -puntos I-TREATMENT -rojos I-TREATMENT -y I-TREATMENT -sangrado I-TREATMENT -activo, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -ligadura I-TREATMENT -con I-TREATMENT -bandas I-TREATMENT -elásticas. I-TREATMENT -Se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -cesárea I-TREATMENT -urgente I-TREATMENT -para I-TREATMENT -extracción I-TREATMENT -fetal I-TREATMENT -por I-TREATMENT -shock I-TREATMENT -hipovolémico I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -y I-TREATMENT -a I-TREATMENT -continuación I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -somatostatina I-TREATMENT -y I-TREATMENT -se I-TREATMENT -revisó I-TREATMENT -endoscópicamente, I-TREATMENT -objetivando I-TREATMENT -el I-TREATMENT -cese I-TREATMENT -del I-TREATMENT -sangrado. I-TREATMENT -La B-EVOLUTION -recién I-EVOLUTION -nacida I-EVOLUTION -requirió I-EVOLUTION -cuidados I-EVOLUTION -en I-EVOLUTION -incubadora I-EVOLUTION -y I-EVOLUTION -tras I-EVOLUTION -unos I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -ingreso I-EVOLUTION -ambas I-EVOLUTION -fueron I-EVOLUTION -dadas I-EVOLUTION -de I-EVOLUTION -alta. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -fallecida I-FAMILY_HISTORY -por I-FAMILY_HISTORY -hepatopatía I-FAMILY_HISTORY -crónica I-FAMILY_HISTORY -inespecífica I-FAMILY_HISTORY -evolucionada I-FAMILY_HISTORY -hacia I-FAMILY_HISTORY -cirrosis I-FAMILY_HISTORY -hepática I-FAMILY_HISTORY -y I-FAMILY_HISTORY -hermana I-FAMILY_HISTORY -con I-FAMILY_HISTORY -hepatopatía I-FAMILY_HISTORY -no I-FAMILY_HISTORY -filiada. I-FAMILY_HISTORY -En B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -C I-PAST_MEDICAL_HISTORY -(VHC) I-PAST_MEDICAL_HISTORY -genotipo I-PAST_MEDICAL_HISTORY -1b I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -nula I-PAST_MEDICAL_HISTORY -respuesta I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -peginterferón I-PAST_MEDICAL_HISTORY -α-2a I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ribavirina I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -ocasiones. I-PAST_MEDICAL_HISTORY -Además, I-PAST_MEDICAL_HISTORY -cólicos I-PAST_MEDICAL_HISTORY -nefríticos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -repetición. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -febrero I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2011 I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -intensa, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -prurito I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -epigastralgia I-PRESENT_ILLNESS -asociada. I-PRESENT_ILLNESS -Los B-EXPLORATION -valores I-EXPLORATION -analíticos I-EXPLORATION -más I-EXPLORATION -destacables I-EXPLORATION -fueron: I-EXPLORATION -AST I-EXPLORATION -145 I-EXPLORATION -U/L I-EXPLORATION -(0-37 I-EXPLORATION -U/L), I-EXPLORATION -ALT I-EXPLORATION -121 I-EXPLORATION -U/L I-EXPLORATION -(0-37 I-EXPLORATION -U/L), I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -116 I-EXPLORATION -U/L I-EXPLORATION -(50-190 I-EXPLORATION -U/L), I-EXPLORATION -GGT I-EXPLORATION -167 I-EXPLORATION -U/L I-EXPLORATION -(6-50 I-EXPLORATION -U/L), I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -14, I-EXPLORATION -6 I-EXPLORATION -mg/dl I-EXPLORATION -(0-1, I-EXPLORATION -8 I-EXPLORATION -mg/dl), I-EXPLORATION -y I-EXPLORATION -alfa-feto I-EXPLORATION -proteína I-EXPLORATION -19, I-EXPLORATION -14 I-EXPLORATION -ng/ml I-EXPLORATION -(0-5 I-EXPLORATION -ng/ml), I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -VHC I-EXPLORATION -de I-EXPLORATION -14.600.000 I-EXPLORATION -UI I-EXPLORATION -ml. I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -las I-EXPLORATION -siguientes I-EXPLORATION -pruebas I-EXPLORATION -diagnósticas: I-EXPLORATION -ecografía I-EXPLORATION -digestiva, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -apreciaban I-EXPLORATION -lesiones I-EXPLORATION -ocupantes I-EXPLORATION -del I-EXPLORATION -espacio I-EXPLORATION -ni I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -vías I-EXPLORATION -biliares I-EXPLORATION -y I-EXPLORATION -mostraba I-EXPLORATION -una I-EXPLORATION -bilis I-EXPLORATION -espesa I-EXPLORATION -sin I-EXPLORATION -datos I-EXPLORATION -concluyentes I-EXPLORATION -de I-EXPLORATION -colelitiasis; I-EXPLORATION -colangio-RM I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -descartó I-EXPLORATION -coledocolitiasis I-EXPLORATION -y I-EXPLORATION -litiasis I-EXPLORATION -intrahepática; I-EXPLORATION -endoscopia I-EXPLORATION -oral I-EXPLORATION -normal; I-EXPLORATION -angio-TAC I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -hepatomegalia I-EXPLORATION -homogénea I-EXPLORATION -y I-EXPLORATION -ecoendoscopia I-EXPLORATION -que I-EXPLORATION -descartó I-EXPLORATION -lesiones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -páncreas I-EXPLORATION -o I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -hepática I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -fibrosis I-EXPLORATION -grado I-EXPLORATION -3 I-EXPLORATION -según I-EXPLORATION -METAVIR I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -hepatitis I-EXPLORATION -C, I-EXPLORATION -sin I-EXPLORATION -otras I-EXPLORATION -alteraciones I-EXPLORATION -valorables. I-EXPLORATION - I-EXPLORATION -Un B-EVOLUTION -año I-EVOLUTION -después I-EVOLUTION -(febrero I-EVOLUTION -2012) I-EVOLUTION -vuelve I-EVOLUTION -a I-EVOLUTION -consulta I-EVOLUTION -presentando I-EVOLUTION -un I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -similares I-EVOLUTION -características I-EVOLUTION -(ictericia, I-EVOLUTION -prurito I-EVOLUTION -y I-EVOLUTION -epigastralgia); I-EVOLUTION -ante B-TREATMENT -la I-TREATMENT -recurrencia I-TREATMENT -del I-TREATMENT -cuadro I-TREATMENT -se I-TREATMENT -prescribió I-TREATMENT -AUDC, I-TREATMENT -con B-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -rápida I-EVOLUTION -del I-EVOLUTION -cuadro. I-EVOLUTION - I-EVOLUTION -Ante B-EXPLORATION -la I-EXPLORATION -clínica I-EXPLORATION -recidivante I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -causa I-EXPLORATION -etiológica, I-EXPLORATION -se I-EXPLORATION -sospechó I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -síndrome I-EXPLORATION -LPAC. I-EXPLORATION -Se I-EXPLORATION -envió I-EXPLORATION -una I-EXPLORATION -muestra I-EXPLORATION -al I-EXPLORATION -Hospital I-EXPLORATION -Universitario I-EXPLORATION -La I-EXPLORATION -Paz I-EXPLORATION -(Madrid) I-EXPLORATION -para I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -hepática, I-EXPLORATION -apreciándose I-EXPLORATION -una I-EXPLORATION -expresión I-EXPLORATION -canicular I-EXPLORATION -normal I-EXPLORATION -de I-EXPLORATION -MRD3. I-EXPLORATION -Posteriormente I-EXPLORATION -se I-EXPLORATION -estudió I-EXPLORATION -la I-EXPLORATION -secuencia I-EXPLORATION -codificante I-EXPLORATION -del I-EXPLORATION -gen I-EXPLORATION -ABCB4 I-EXPLORATION -(muestra I-EXPLORATION -de I-EXPLORATION -ADN I-EXPLORATION -de I-EXPLORATION -linfocitos I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -periférica) I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Hospital I-EXPLORATION -Universitario I-EXPLORATION -Saint-Antoine I-EXPLORATION -(París) I-EXPLORATION -mediante I-EXPLORATION -la I-EXPLORATION -tecnología I-EXPLORATION -Roche I-EXPLORATION -454 I-EXPLORATION -GS I-EXPLORATION -Junior I-EXPLORATION -sequencing, I-EXPLORATION -siendo I-EXPLORATION -esta I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -generación I-EXPLORATION -de I-EXPLORATION -secuenciación I-EXPLORATION -del I-EXPLORATION -ADN I-EXPLORATION -por I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -secuenciación I-EXPLORATION -ultraprofunda I-EXPLORATION -de I-EXPLORATION -productos I-EXPLORATION -PCR, I-EXPLORATION -no I-EXPLORATION -encontrándose I-EXPLORATION -tampoco I-EXPLORATION -ninguna I-EXPLORATION -mutación. I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -persistencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -clínica, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Hospital I-EXPLORATION -Universitario I-EXPLORATION -La I-EXPLORATION -Paz I-EXPLORATION -se I-EXPLORATION -analizó I-EXPLORATION -nuevamente I-EXPLORATION -el I-EXPLORATION -gen I-EXPLORATION -ABCB4 I-EXPLORATION -esta I-EXPLORATION -vez I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION -MLPA® I-EXPLORATION -(Multiplex I-EXPLORATION -Ligation-dependent I-EXPLORATION -Probe I-EXPLORATION -Amplification) I-EXPLORATION -(9), I-EXPLORATION -tratándose I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -técnica I-EXPLORATION -complementaria I-EXPLORATION -que I-EXPLORATION -detecta I-EXPLORATION -cambios I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -número I-EXPLORATION -de I-EXPLORATION -copias I-EXPLORATION -genómicas, I-EXPLORATION -inserciones I-EXPLORATION -o I-EXPLORATION -deleciones I-EXPLORATION -no I-EXPLORATION -detectados I-EXPLORATION -por I-EXPLORATION -los I-EXPLORATION -métodos I-EXPLORATION -convencionales I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -secuenciación. I-EXPLORATION -Se I-EXPLORATION -comparó I-EXPLORATION -la I-EXPLORATION -muestra I-EXPLORATION -del I-EXPLORATION -paciente I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -hermana I-EXPLORATION -(control I-EXPLORATION -1) I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -individuo I-EXPLORATION -sano I-EXPLORATION -(control I-EXPLORATION -2). I-EXPLORATION -Se I-EXPLORATION -identificó I-EXPLORATION -una I-EXPLORATION -mutación I-EXPLORATION -en I-EXPLORATION -heterocigosis I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -deleción I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -fragmento I-EXPLORATION -de I-EXPLORATION -gen I-EXPLORATION -que I-EXPLORATION -contiene I-EXPLORATION -el I-EXPLORATION -exón I-EXPLORATION -4 I-EXPLORATION -completo, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -deficiencia I-EXPLORATION -parcial I-EXPLORATION -de I-EXPLORATION -MDR3 I-EXPLORATION -(10), I-EXPLORATION -confirmándose I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -LPAC. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -19 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -intermitente, I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -distensión I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -progresiva. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -evidencian I-EXPLORATION -hepatomegalia I-EXPLORATION -y I-EXPLORATION -onda I-EXPLORATION -ascítica I-EXPLORATION -positiva. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -destaca: I-EXPLORATION -Mantoux I-EXPLORATION -+, I-EXPLORATION -CA I-EXPLORATION -125 I-EXPLORATION -797.7, I-EXPLORATION -leucocitos I-EXPLORATION -4.000, I-EXPLORATION -Hb I-EXPLORATION -9.7. I-EXPLORATION -TC I-EXPLORATION -toracoabdominal: I-EXPLORATION -ascitis, I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -serosa I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -nodulares I-EXPLORATION -sugestivas I-EXPLORATION -de I-EXPLORATION -implantes I-EXPLORATION -peritoneales, I-EXPLORATION -principalmente I-EXPLORATION -en I-EXPLORATION -epiplón. I-EXPLORATION -Leve I-EXPLORATION -esplenomegalia. I-EXPLORATION -Múltiples I-EXPLORATION -adenopatías I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -patológico, I-EXPLORATION -mesentéricas, I-EXPLORATION -en I-EXPLORATION -eje I-EXPLORATION -aortoilíaco, I-EXPLORATION -retrocurales I-EXPLORATION -y I-EXPLORATION -periceliacas. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -biopsia I-EXPLORATION -peritoneal I-EXPLORATION -ecoguiada I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -de I-EXPLORATION -mayor I-EXPLORATION -engrosamiento I-EXPLORATION -peritoneal I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -toman I-EXPLORATION -muestras I-EXPLORATION -para I-EXPLORATION -cultivo, I-EXPLORATION -con I-EXPLORATION -crecimiento I-EXPLORATION -de I-EXPLORATION -Mycobacterium I-EXPLORATION -tuberculosis. I-EXPLORATION -Se B-TREATMENT -realiza I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -tuberculostáticos I-TREATMENT -con B-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -clínica, I-EVOLUTION -desaparición I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -ascitis I-EVOLUTION -y I-EVOLUTION -del I-EVOLUTION -engrosamiento I-EVOLUTION -peritoneal. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -31 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -remitida I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -octubre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2012 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -prurito I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -ingresada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -clínico-analítico I-PRESENT_ILLNESS -compatible I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -hepatitis I-PRESENT_ILLNESS -aguda I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -grave. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -anamnesis I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -tatuaje I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -toma I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Inneov I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -capilar® I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -resumen I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tabla I-EXPLORATION -I. I-EXPLORATION -La I-EXPLORATION -inmunología I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -serología I-EXPLORATION -viral I-EXPLORATION -fueron I-EXPLORATION -negativas. I-EXPLORATION -Al B-EVOLUTION -quinto I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -suspender I-EVOLUTION -Inneov I-EVOLUTION -masa I-EVOLUTION -capilar® I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -mejoría I-EVOLUTION -clínica, I-EVOLUTION -con I-EVOLUTION -desaparición I-EVOLUTION -del I-EVOLUTION -prurito, I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -analítica, I-EVOLUTION -con I-EVOLUTION -normalización I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -pruebas I-EVOLUTION -de I-EVOLUTION -función I-EVOLUTION -hepática I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -más I-EVOLUTION -tarde. I-EVOLUTION - I-EVOLUTION -La I-EVOLUTION -causalidad I-EVOLUTION -utilizando I-EVOLUTION -la I-EVOLUTION -escala I-EVOLUTION -de I-EVOLUTION -CIOMS/RUCAM I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -caso I-EVOLUTION -2 I-EVOLUTION -y I-EVOLUTION -3 I-EVOLUTION -fue I-EVOLUTION -altamente I-EVOLUTION -probable. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -niño I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -citopatía I-PAST_MEDICAL_HISTORY -mitocondrial I-PAST_MEDICAL_HISTORY -(déficit I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -complejos I-PAST_MEDICAL_HISTORY -I-III-IV I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cadena I-PAST_MEDICAL_HISTORY -respiratoria) I-PAST_MEDICAL_HISTORY -en B-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -vitaminas I-PRESENT_ILLNESS -B1 I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -B6, I-PRESENT_ILLNESS -carnitina, I-PRESENT_ILLNESS -coenzima I-PRESENT_ILLNESS -Q, I-PRESENT_ILLNESS -clobazam I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fenobarbital. I-PRESENT_ILLNESS -El B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Gastroenterología I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -Nutrición I-DERIVED_FROM/TO -Infantil I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -valoración I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -episodios I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -atragantamiento I-DERIVED_FROM/TO -durante I-DERIVED_FROM/TO -las I-DERIVED_FROM/TO -comidas I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -varios I-DERIVED_FROM/TO -ingresos I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -neumonía. I-DERIVED_FROM/TO -En B-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -anamnesis I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -padres I-PRESENT_ILLNESS -referían I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -era I-PRESENT_ILLNESS -alimentado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -purés, I-PRESENT_ILLNESS -pero I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -accesos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -carraspeo I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -tragar. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -tenía I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -deshidratación I-EXPLORATION -ni I-EXPLORATION -de I-EXPLORATION -desnutrición, I-EXPLORATION -con I-EXPLORATION -datos I-EXPLORATION -antropométricos I-EXPLORATION -en I-EXPLORATION -percentiles I-EXPLORATION -adecuados I-EXPLORATION -para I-EXPLORATION -su I-EXPLORATION -edad I-EXPLORATION -y I-EXPLORATION -sexo. I-EXPLORATION -Como I-EXPLORATION -hallazgos I-EXPLORATION -patológicos I-EXPLORATION -presentaba I-EXPLORATION -hipotonía I-EXPLORATION -generalizada, I-EXPLORATION -apraxia I-EXPLORATION -fonoarticulatoria I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -deglución, I-EXPLORATION -e I-EXPLORATION -hipotonía I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -musculatura I-EXPLORATION -oral I-EXPLORATION -con I-EXPLORATION -babeo I-EXPLORATION -constante. I-EXPLORATION -Resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -datos I-EXPLORATION -previos I-EXPLORATION -se I-EXPLORATION -estableció I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -disfagia I-EXPLORATION -orofaríngea, I-EXPLORATION -y I-EXPLORATION -ante I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -videofluoroscopia I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -en I-EXPLORATION -nuestro I-EXPLORATION -centro, I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -fibroendoscopia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -deglución I-EXPLORATION -(FEES) I-EXPLORATION -durante I-EXPLORATION -el I-EXPLORATION -test I-EXPLORATION -de I-EXPLORATION -deglución I-EXPLORATION -con I-EXPLORATION -diferentes I-EXPLORATION -volúmenes/texturas. I-EXPLORATION -En I-EXPLORATION -reposo I-EXPLORATION -se I-EXPLORATION -apreciaban I-EXPLORATION -secreciones I-EXPLORATION -en I-EXPLORATION -vallécula, I-EXPLORATION -faringe I-EXPLORATION -y I-EXPLORATION -senos I-EXPLORATION -piriformes; I-EXPLORATION -tras I-EXPLORATION -administrar I-EXPLORATION -distintas I-EXPLORATION -consistencias I-EXPLORATION -y I-EXPLORATION -volúmenes I-EXPLORATION -teñidos I-EXPLORATION -con I-EXPLORATION -azul I-EXPLORATION -de I-EXPLORATION -metileno I-EXPLORATION -se I-EXPLORATION -concluyó I-EXPLORATION -que I-EXPLORATION -con I-EXPLORATION -5 I-EXPLORATION -cc I-EXPLORATION -de I-EXPLORATION -textura I-EXPLORATION -néctar I-EXPLORATION -había I-EXPLORATION -reflejo I-EXPLORATION -deglutorio I-EXPLORATION -enlentecido I-EXPLORATION -y I-EXPLORATION -muy I-EXPLORATION -fraccionado I-EXPLORATION -sin I-EXPLORATION -reflejo I-EXPLORATION -tusígeno; I-EXPLORATION -el I-EXPLORATION -alimento I-EXPLORATION -se I-EXPLORATION -quedaba I-EXPLORATION -inicialmente I-EXPLORATION -en I-EXPLORATION -vallécula, I-EXPLORATION -faringe I-EXPLORATION -y I-EXPLORATION -senos I-EXPLORATION -piriformes I-EXPLORATION -(pasando I-EXPLORATION -posteriormente I-EXPLORATION -a I-EXPLORATION -esófago I-EXPLORATION -por I-EXPLORATION -gravedad). I-EXPLORATION -Con I-EXPLORATION -5 I-EXPLORATION -cc I-EXPLORATION -de I-EXPLORATION -pudding I-EXPLORATION -(más I-EXPLORATION -espeso) I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -penetración I-EXPLORATION -sin I-EXPLORATION -reflejo I-EXPLORATION -tusígeno; I-EXPLORATION -deglución I-EXPLORATION -fraccionada I-EXPLORATION -con I-EXPLORATION -acumulación I-EXPLORATION -en I-EXPLORATION -vallécula, I-EXPLORATION -faringe I-EXPLORATION -y I-EXPLORATION -senos I-EXPLORATION -piriformes; I-EXPLORATION -enlentecimiento I-EXPLORATION -del I-EXPLORATION -paso I-EXPLORATION -a I-EXPLORATION -esófago I-EXPLORATION -y I-EXPLORATION -déficit I-EXPLORATION -de I-EXPLORATION -apertura I-EXPLORATION -del I-EXPLORATION -esfínter I-EXPLORATION -esofágico I-EXPLORATION -superior. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -este I-EXPLORATION -paciente, I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -patología I-EXPLORATION -neurológica I-EXPLORATION -de I-EXPLORATION -base, I-EXPLORATION -también I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -manometría I-EXPLORATION -de I-EXPLORATION -alta I-EXPLORATION -resolución I-EXPLORATION -para I-EXPLORATION -valorar I-EXPLORATION -la I-EXPLORATION -motilidad I-EXPLORATION -esofágica. I-EXPLORATION -Con I-EXPLORATION -dicha I-EXPLORATION -prueba I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -hallazgos I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -esfínter I-EXPLORATION -esofágico I-EXPLORATION -superior I-EXPLORATION -hipertenso I-EXPLORATION -con I-EXPLORATION -pobre I-EXPLORATION -bomba I-EXPLORATION -faríngea I-EXPLORATION -y I-EXPLORATION -ondas I-EXPLORATION -peristálticas I-EXPLORATION -normales I-EXPLORATION -alternando I-EXPLORATION -con I-EXPLORATION -contracciones I-EXPLORATION -de I-EXPLORATION -muy I-EXPLORATION -baja I-EXPLORATION -amplitud. I-EXPLORATION -La I-EXPLORATION -presión I-EXPLORATION -de I-EXPLORATION -reposo I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cuerpo I-EXPLORATION -esofágico I-EXPLORATION -era I-EXPLORATION -normal I-EXPLORATION -mientras I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -del I-EXPLORATION -esfínter I-EXPLORATION -esofágico I-EXPLORATION -inferior I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -límite I-EXPLORATION -bajo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -estableció I-EXPLORATION -el I-EXPLORATION -diagnostico I-EXPLORATION -de I-EXPLORATION -disfagia I-EXPLORATION -orofaríngea I-EXPLORATION -de I-EXPLORATION -etiología I-EXPLORATION -neurógena I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -procedió I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -abordaje I-EXPLORATION -multidisciplinar. I-EXPLORATION -Se B-TREATMENT -prescribió I-TREATMENT -espesante I-TREATMENT -para I-TREATMENT -líquidos I-TREATMENT -y I-TREATMENT -dieta I-TREATMENT -hipercalórica I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -de I-TREATMENT -textura I-TREATMENT -néctar, I-TREATMENT -administrándolos I-TREATMENT -en I-TREATMENT -pequeños I-TREATMENT -volúmenes, I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -mostró I-TREATMENT -menor I-TREATMENT -riesgo I-TREATMENT -de I-TREATMENT -aspiración I-TREATMENT -en I-TREATMENT -las I-TREATMENT -pruebas I-TREATMENT -de I-TREATMENT -deglución I-TREATMENT -realizadas. I-TREATMENT -Se I-TREATMENT -recomendaron I-TREATMENT -medidas I-TREATMENT -generales I-TREATMENT -como I-TREATMENT -evitar I-TREATMENT -dobles I-TREATMENT -texturas I-TREATMENT -y I-TREATMENT -posturar I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -durante I-TREATMENT -las I-TREATMENT -comidas I-TREATMENT -(tronco I-TREATMENT -erguido, I-TREATMENT -hombros I-TREATMENT -simétricos, I-TREATMENT -cabeza I-TREATMENT -ligeramente I-TREATMENT -flexionada), I-TREATMENT -y I-TREATMENT -también I-TREATMENT -se I-TREATMENT -solicitó I-TREATMENT -interconsulta I-TREATMENT -a I-TREATMENT -Logopedia I-TREATMENT -para I-TREATMENT -ejercicios I-TREATMENT -de I-TREATMENT -rehabilitación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -deglución. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -en I-EVOLUTION -años I-EVOLUTION -posteriores I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -favorable; I-EVOLUTION -presenta I-EVOLUTION -atragantamientos I-EVOLUTION -leves I-EVOLUTION -pero I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -vuelto I-EVOLUTION -a I-EVOLUTION -ingresar I-EVOLUTION -por I-EVOLUTION -neumonía I-EVOLUTION -aspirativa I-EVOLUTION -ni I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -otras I-EVOLUTION -complicaciones I-EVOLUTION -como I-EVOLUTION -deshidratación I-EVOLUTION -o I-EVOLUTION -desnutrición, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -considerado I-EVOLUTION -la I-EVOLUTION -realización I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -gastrostomía. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -endometriosis, I-PAST_MEDICAL_HISTORY -mioma I-PAST_MEDICAL_HISTORY -uterino I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -embolización I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -miomectomía, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tabaquismo I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -alcoholismo. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -hijos; I-PAST_MEDICAL_HISTORY -padres I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -hermanos I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -varios I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -perímetro I-PRESENT_ILLNESS -abdominal, I-PRESENT_ILLNESS -molestias I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -epigastrio I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -pirosis, I-PRESENT_ILLNESS -pesadez I-PRESENT_ILLNESS -posprandial I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -difuso I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -continuo, I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -un I-EXPLORATION -abdomen I-EXPLORATION -distendido, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -palpa I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -abdominal I-EXPLORATION -en I-EXPLORATION -hipocondrio I-EXPLORATION -derecho, I-EXPLORATION -epigastrio I-EXPLORATION -y I-EXPLORATION -mesogastrio, I-EXPLORATION -indurada I-EXPLORATION -y I-EXPLORATION -dolorosa. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -palpa I-EXPLORATION -esplenomegalia I-EXPLORATION -ni I-EXPLORATION -existe I-EXPLORATION -semiología I-EXPLORATION -de I-EXPLORATION -ascitis. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -presenta I-EXPLORATION -una I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -GGT, I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -(hemograma, I-EXPLORATION -sistemático I-EXPLORATION -de I-EXPLORATION -orina, I-EXPLORATION -bioquímica I-EXPLORATION -general, I-EXPLORATION -proteinograma, I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -coagulación, I-EXPLORATION -marcadores I-EXPLORATION -de I-EXPLORATION -virus I-EXPLORATION -hepatotropos I-EXPLORATION -y I-EXPLORATION -tumorales), I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -significativos. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -abdominal I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -hepatomegalia I-EXPLORATION -con I-EXPLORATION -incontables I-EXPLORATION -lesiones I-EXPLORATION -quísticas; I-EXPLORATION -destaca I-EXPLORATION -en I-EXPLORATION -lóbulo I-EXPLORATION -hepático I-EXPLORATION -derecho I-EXPLORATION -(LHD) I-EXPLORATION -un I-EXPLORATION -quiste I-EXPLORATION -de I-EXPLORATION -18 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -tamaño, I-EXPLORATION -vía I-EXPLORATION -biliar, I-EXPLORATION -páncreas I-EXPLORATION -y I-EXPLORATION -bazo I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION -Riñón I-EXPLORATION -derecho I-EXPLORATION -pélvico I-EXPLORATION -por I-EXPLORATION -desplazamiento I-EXPLORATION -hepático. I-EXPLORATION -Sendos I-EXPLORATION -quistes I-EXPLORATION -renales I-EXPLORATION -bilaterales I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -tamaño. I-EXPLORATION -Miomas I-EXPLORATION -uterinos I-EXPLORATION -calcificados. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -enfermedad I-EXPLORATION -hepática I-EXPLORATION -poliquística, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -quiste I-EXPLORATION -gigante I-EXPLORATION -en I-EXPLORATION -LHD. I-EXPLORATION -La I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -quistes I-EXPLORATION -renales I-EXPLORATION -significativos I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -criterios I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -poliquística I-EXPLORATION -renal I-EXPLORATION -permite I-EXPLORATION -establecer I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -EHPA. I-EXPLORATION -Posteriormente B-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -ingresa I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -programada I-TREATMENT -a I-TREATMENT -la I-TREATMENT -planta I-TREATMENT -del I-TREATMENT -Servicio I-TREATMENT -de I-TREATMENT -Digestivo, I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -un I-TREATMENT -drenaje I-TREATMENT -percutáneo I-TREATMENT -con I-TREATMENT -catéter I-TREATMENT -8F I-TREATMENT -pig-tail, I-TREATMENT -con I-TREATMENT -control I-TREATMENT -ecográfico I-TREATMENT -del I-TREATMENT -quiste I-TREATMENT -hepático I-TREATMENT -gigante, I-TREATMENT -evacuándose I-TREATMENT -un I-TREATMENT -líquido I-TREATMENT -transparente, I-TREATMENT -sin I-TREATMENT -complicaciones I-TREATMENT -inmediatas. I-TREATMENT -En I-TREATMENT -un I-TREATMENT -segundo I-TREATMENT -tiempo, I-TREATMENT -durante I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -día, I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -en I-TREATMENT -el I-TREATMENT -Servicio I-TREATMENT -de I-TREATMENT -Radiología I-TREATMENT -una I-TREATMENT -quistografía I-TREATMENT -transcatéter, I-TREATMENT -en I-TREATMENT -la I-TREATMENT -que I-TREATMENT -no I-TREATMENT -se I-TREATMENT -advierten I-TREATMENT -signos I-TREATMENT -de I-TREATMENT -fugas I-TREATMENT -de I-TREATMENT -contraste I-TREATMENT -y I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -la I-TREATMENT -instilación I-TREATMENT -de I-TREATMENT -270 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -alcohol I-TREATMENT -puro I-TREATMENT -durante I-TREATMENT -treinta I-TREATMENT -minutos, I-TREATMENT -y I-TREATMENT -que I-TREATMENT -se I-TREATMENT -aspira I-TREATMENT -posteriormente. I-TREATMENT -Más B-EVOLUTION -tarde I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -analítica, I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION -inmediatas. I-EVOLUTION -Continúa I-EVOLUTION -en I-EVOLUTION -seguimiento I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -consultas, I-EVOLUTION -permaneciendo I-EVOLUTION -asintomática, I-EVOLUTION -sin I-EVOLUTION -requerir I-EVOLUTION -más I-EVOLUTION -sesiones I-EVOLUTION -de I-EVOLUTION -escleroterapia. I-EVOLUTION -Tras I-EVOLUTION -4 I-EVOLUTION -años I-EVOLUTION -del I-EVOLUTION -procedimiento, I-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -realizó I-EVOLUTION -un I-EVOLUTION -TAC I-EVOLUTION -abdominal, I-EVOLUTION -observándose I-EVOLUTION -una I-EVOLUTION -disminución I-EVOLUTION -del I-EVOLUTION -tamaño I-EVOLUTION -del I-EVOLUTION -quiste I-EVOLUTION -hepático I-EVOLUTION -tratado I-EVOLUTION -(8, I-EVOLUTION -4 I-EVOLUTION -cm). I-EVOLUTION - I-EVOLUTION - -En B-PRESENT_ILLNESS -este I-PRESENT_ILLNESS -trabajo I-PRESENT_ILLNESS -presentamos I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -catorce I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -esteatohepatitis I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -alcohólica I-PAST_MEDICAL_HISTORY --confirmada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -biopsia, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -indicar I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -grado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -misma-, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -ese I-PAST_MEDICAL_HISTORY -periodo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -recomendaciones I-PAST_MEDICAL_HISTORY -generales I-PAST_MEDICAL_HISTORY -dietéticas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -práctica I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ejercicio I-PAST_MEDICAL_HISTORY -físico I-PAST_MEDICAL_HISTORY -recreativo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -aeróbico. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -sujeto I-PRESENT_ILLNESS -participó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -programa I-PRESENT_ILLNESS -individualizado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -prescripción I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ejercicio I-PRESENT_ILLNESS -bajo I-PRESENT_ILLNESS -nuestra I-PRESENT_ILLNESS -supervisión, I-PRESENT_ILLNESS -además I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -seguir I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -control I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS -habitual. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -incorporación I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -programa, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -sujeto I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -características I-PRESENT_ILLNESS -antropométricas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fisiológicas I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -resumen I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -tabla I-PRESENT_ILLNESS -I. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -sujeto I-PRESENT_ILLNESS -declaró: I-PRESENT_ILLNESS -a) I-PRESENT_ILLNESS -ser I-PRESENT_ILLNESS -físicamente I-PRESENT_ILLNESS -activo I-PRESENT_ILLNESS --realizando I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -sesiones I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -semana, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -duración, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pádel, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -rutas I-PRESENT_ILLNESS -cicloturistas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -larga I-PRESENT_ILLNESS -duración I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -fines I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -semana, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -controlar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -intensidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ninguna I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ellas-; I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -b) I-PRESENT_ILLNESS -seguir I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -dieta I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -lípidos, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -ingesta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -alcohol I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -fármacos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -manera I-PRESENT_ILLNESS -habitual. I-PRESENT_ILLNESS -A B-EXPLORATION -su I-EXPLORATION -incorporación I-EXPLORATION -al I-EXPLORATION -programa I-EXPLORATION -se I-EXPLORATION -estudió I-EXPLORATION -su I-EXPLORATION -condición I-EXPLORATION -física I-EXPLORATION -cardiorrespiratoria I-EXPLORATION --mediante I-EXPLORATION -una I-EXPLORATION -ergometría I-EXPLORATION -submáxima I-EXPLORATION -(conforme I-EXPLORATION -al I-EXPLORATION -protocolo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -YMCA) I-EXPLORATION -(8) I-EXPLORATION -- I-EXPLORATION -y I-EXPLORATION -su I-EXPLORATION -fuerza I-EXPLORATION -muscular I-EXPLORATION -(conforme I-EXPLORATION -al I-EXPLORATION -protocolo I-EXPLORATION -de I-EXPLORATION -Brzycki) I-EXPLORATION -(9), I-EXPLORATION -estimándose I-EXPLORATION -con I-EXPLORATION -ello I-EXPLORATION -la I-EXPLORATION -intensidad I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -prescribir I-EXPLORATION -el I-EXPLORATION -entrenamiento, I-EXPLORATION -tanto I-EXPLORATION -de I-EXPLORATION -resistencia I-EXPLORATION -aeróbica I-EXPLORATION -como I-EXPLORATION -de I-EXPLORATION -fuerza, I-EXPLORATION -respectivamente. I-EXPLORATION -Se B-TREATMENT -animó I-TREATMENT -al I-TREATMENT -sujeto I-TREATMENT -a I-TREATMENT -seguir I-TREATMENT -manteniendo I-TREATMENT -su I-TREATMENT -práctica I-TREATMENT -autónoma I-TREATMENT -de I-TREATMENT -ejercicio I-TREATMENT -y I-TREATMENT -se I-TREATMENT -le I-TREATMENT -instruyó I-TREATMENT -para I-TREATMENT -el I-TREATMENT -uso I-TREATMENT -de I-TREATMENT -un I-TREATMENT -pulsómetro I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -misma, I-TREATMENT -así I-TREATMENT -como I-TREATMENT -para I-TREATMENT -recoger I-TREATMENT -los I-TREATMENT -datos I-TREATMENT -de I-TREATMENT -cada I-TREATMENT -sesión I-TREATMENT -en I-TREATMENT -un I-TREATMENT -"diario I-TREATMENT -de I-TREATMENT -entrenamiento" I-TREATMENT -digital. I-TREATMENT -Se I-TREATMENT -diseñó I-TREATMENT -un I-TREATMENT -programa I-TREATMENT -de I-TREATMENT -entrenamiento I-TREATMENT --complementario I-TREATMENT -al I-TREATMENT -ejercicio I-TREATMENT -auto-reportado I-TREATMENT -por I-TREATMENT -el I-TREATMENT -paciente-, I-TREATMENT -consistente I-TREATMENT -en I-TREATMENT -dos I-TREATMENT -sesiones I-TREATMENT -de I-TREATMENT -una I-TREATMENT -hora I-TREATMENT -al I-TREATMENT -día, I-TREATMENT -en I-TREATMENT -dos I-TREATMENT -días I-TREATMENT -no I-TREATMENT -consecutivos, I-TREATMENT -a I-TREATMENT -realizar I-TREATMENT -en I-TREATMENT -gimnasio I-TREATMENT -bajo I-TREATMENT -supervisión I-TREATMENT -de I-TREATMENT -un I-TREATMENT -instructor. I-TREATMENT -Se I-TREATMENT -intentó I-TREATMENT -con I-TREATMENT -estas I-TREATMENT -sesiones I-TREATMENT -complementarias I-TREATMENT -ajustar I-TREATMENT -la I-TREATMENT -carga I-TREATMENT -de I-TREATMENT -entrenamiento I-TREATMENT -del I-TREATMENT -sujeto I-TREATMENT -para I-TREATMENT -que, I-TREATMENT -sumada I-TREATMENT -a I-TREATMENT -la I-TREATMENT -realizada I-TREATMENT -espontáneamente I-TREATMENT -por I-TREATMENT -él, I-TREATMENT -se I-TREATMENT -cumplieran I-TREATMENT -las I-TREATMENT -recomendaciones I-TREATMENT -del I-TREATMENT -American I-TREATMENT -College I-TREATMENT -of I-TREATMENT -Sports I-TREATMENT -Medicine I-TREATMENT -(10). I-TREATMENT -Periódicamente I-TREATMENT -se I-TREATMENT -reevaluaba I-TREATMENT -la I-TREATMENT -condición I-TREATMENT -física I-TREATMENT -del I-TREATMENT -paciente, I-TREATMENT -con I-TREATMENT -el I-TREATMENT -fin I-TREATMENT -de I-TREATMENT -reajustar I-TREATMENT -las I-TREATMENT -intensidades I-TREATMENT -de I-TREATMENT -entrenamiento I-TREATMENT -a I-TREATMENT -las I-TREATMENT -mejoras I-TREATMENT -funcionales I-TREATMENT -que I-TREATMENT -se I-TREATMENT -iban I-TREATMENT -consiguiendo I-TREATMENT -progresivamente I-TREATMENT -con I-TREATMENT -el I-TREATMENT -mismo. I-TREATMENT -En B-EXPLORATION -un I-EXPLORATION -análisis I-EXPLORATION -post I-EXPLORATION -hoc I-EXPLORATION -se I-EXPLORATION -identificaron I-EXPLORATION -cuatro I-EXPLORATION -grandes I-EXPLORATION -periodos I-EXPLORATION -según I-EXPLORATION -el I-EXPLORATION -porcentaje I-EXPLORATION -promedio I-EXPLORATION -de I-EXPLORATION -carga I-EXPLORATION -de I-EXPLORATION -trabajo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -sesión I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -dedicaba I-EXPLORATION -a I-EXPLORATION -mejorar I-EXPLORATION -la I-EXPLORATION -resistencia I-EXPLORATION -cardiorrespiratoria I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -fuerza I-EXPLORATION -muscular. I-EXPLORATION -Durante B-TREATMENT -el I-TREATMENT -periodo I-TREATMENT -de I-TREATMENT -intervención I-TREATMENT -no I-TREATMENT -se I-TREATMENT -realizaron I-TREATMENT -ajustes I-TREATMENT -de I-TREATMENT -la I-TREATMENT -dieta, I-TREATMENT -sino I-TREATMENT -que I-TREATMENT -el I-TREATMENT -sujeto I-TREATMENT -siguió I-TREATMENT -manteniendo I-TREATMENT -las I-TREATMENT -pautas I-TREATMENT -nutricionales I-TREATMENT -que I-TREATMENT -le I-TREATMENT -eran I-TREATMENT -indicadas I-TREATMENT -en I-TREATMENT -sus I-TREATMENT -controles I-TREATMENT -médicos I-TREATMENT -periódicos. I-TREATMENT - I-TREATMENT -Tras B-EVOLUTION -dos I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -este I-EVOLUTION -entrenamiento I-EVOLUTION -complementario I-EVOLUTION -se I-EVOLUTION -pudo I-EVOLUTION -objetivar I-EVOLUTION -un I-EVOLUTION -incremento I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -cardiorrespiratoria I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -fuerza I-EVOLUTION -muscular I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -indica I-EVOLUTION -que I-EVOLUTION -tanto I-EVOLUTION -la I-EVOLUTION -intensidad, I-EVOLUTION -como I-EVOLUTION -la I-EVOLUTION -periodización I-EVOLUTION -y I-EVOLUTION -planificación I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -sesiones I-EVOLUTION -complementarias I-EVOLUTION -de I-EVOLUTION -ejercicio I-EVOLUTION -fueron I-EVOLUTION -los I-EVOLUTION -correctos I-EVOLUTION -como I-EVOLUTION -para I-EVOLUTION -desencadenar I-EVOLUTION -y I-EVOLUTION -mantener I-EVOLUTION -las I-EVOLUTION -adaptaciones I-EVOLUTION -fisiológicas I-EVOLUTION -buscadas. I-EVOLUTION -Los I-EVOLUTION -parámetros I-EVOLUTION -analíticos I-EVOLUTION -registrados I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -revisiones I-EVOLUTION -periódicas I-EVOLUTION -realizadas I-EVOLUTION -mostraron I-EVOLUTION -un I-EVOLUTION -importante I-EVOLUTION -cambio I-EVOLUTION -de I-EVOLUTION -tendencia I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -valores I-EVOLUTION -de I-EVOLUTION -colesterolemia I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -trigliceridemia I-EVOLUTION --datos I-EVOLUTION -no I-EVOLUTION -mostrados- I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -periodo I-EVOLUTION -de I-EVOLUTION -intervención. I-EVOLUTION -Del I-EVOLUTION -mismo I-EVOLUTION -modo, I-EVOLUTION -los I-EVOLUTION -valores I-EVOLUTION -plasmáticos I-EVOLUTION -de I-EVOLUTION -transaminasas, I-EVOLUTION -aunque I-EVOLUTION -siguieron I-EVOLUTION -elevados, I-EVOLUTION -mostraron I-EVOLUTION -una I-EVOLUTION -tendencia I-EVOLUTION -a I-EVOLUTION -ser I-EVOLUTION -inferiores I-EVOLUTION -al I-EVOLUTION -periodo I-EVOLUTION -anterior I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -entrada I-EVOLUTION -del I-EVOLUTION -sujeto I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -programa, I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -a I-EVOLUTION -mostrar I-EVOLUTION -menor I-EVOLUTION -dispersión. I-EVOLUTION -No I-EVOLUTION -se I-EVOLUTION -observó, I-EVOLUTION -sin I-EVOLUTION -embargo, I-EVOLUTION -ninguna I-EVOLUTION -reducción I-EVOLUTION -del I-EVOLUTION -peso I-EVOLUTION -corporal I-EVOLUTION -o I-EVOLUTION -del I-EVOLUTION -porcentaje I-EVOLUTION -de I-EVOLUTION -masa I-EVOLUTION -grasa I-EVOLUTION -que, I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -contrario, I-EVOLUTION -tendieron I-EVOLUTION -a I-EVOLUTION -elevarse. I-EVOLUTION -De I-EVOLUTION -todo I-EVOLUTION -ello I-EVOLUTION -se I-EVOLUTION -puede I-EVOLUTION -concluir I-EVOLUTION -que I-EVOLUTION -con I-EVOLUTION -las I-EVOLUTION -adaptaciones I-EVOLUTION -fisiológicas I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -logran I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -ejercicio I-EVOLUTION -adecuadamente I-EVOLUTION -"dosificado", I-EVOLUTION -puede I-EVOLUTION -alterarse I-EVOLUTION -el I-EVOLUTION -curso I-EVOLUTION -natural I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad. I-EVOLUTION -Por I-EVOLUTION -el I-EVOLUTION -contrario, I-EVOLUTION -la I-EVOLUTION -realización I-EVOLUTION -autónoma I-EVOLUTION -y I-EVOLUTION -recreativa I-EVOLUTION -de I-EVOLUTION -ejercicio I-EVOLUTION -no I-EVOLUTION -lograría I-EVOLUTION -dichas I-EVOLUTION -adaptaciones, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -resultaría I-EVOLUTION -ineficaz I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -53 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -anal, I-PRESENT_ILLNESS -sangrado I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cambio I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -heces, I-PRESENT_ILLNESS -estudiado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -otro I-PRESENT_ILLNESS -centro, I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -han I-PRESENT_ILLNESS -realizado I-PRESENT_ILLNESS -colonoscopia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -resonancia I-PRESENT_ILLNESS -magnética I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -ano-rectal, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -posterior I-PRESENT_ILLNESS -ecoendoscopia I-PRESENT_ILLNESS -diagnosticándose I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -anillo I-PRESENT_ILLNESS -estenótico I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -importantes I-PRESENT_ILLNESS -cambios I-PRESENT_ILLNESS -inflamatorios I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -desestructuran I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -pared, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -poder I-PRESENT_ILLNESS -definir I-PRESENT_ILLNESS -infiltración, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -biospias I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -inflamación I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -displasia I-PRESENT_ILLNESS -compatible I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -úlcera I-PRESENT_ILLNESS -rectal I-PRESENT_ILLNESS -solitaria. I-PRESENT_ILLNESS -Se B-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -han I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dicho I-PAST_MEDICAL_HISTORY -centro I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -anorrectoplastias, I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -colgajo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Z I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -posteriormente I-PAST_MEDICAL_HISTORY -dilataciones, I-PAST_MEDICAL_HISTORY -persistiendo I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -crónico. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -nuestro I-EXPLORATION -centro I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -presenta I-EXPLORATION -importante I-EXPLORATION -dolor I-EXPLORATION -mal I-EXPLORATION -controlado I-EXPLORATION -a I-EXPLORATION -pesar I-EXPLORATION -de I-EXPLORATION -altas I-EXPLORATION -dosis I-EXPLORATION -de I-EXPLORATION -mórficos, I-EXPLORATION -incontinencia I-EXPLORATION -rectal I-EXPLORATION -severa I-EXPLORATION -y I-EXPLORATION -exploración I-EXPLORATION -rectal I-EXPLORATION -con I-EXPLORATION -estenosis I-EXPLORATION -a I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -línea I-EXPLORATION -pectínea I-EXPLORATION -que I-EXPLORATION -permite I-EXPLORATION -malamente I-EXPLORATION -el I-EXPLORATION -paso I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -dedo. I-EXPLORATION -Ante B-TREATMENT -este I-TREATMENT -cuadro, I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -realizar I-TREATMENT -resección I-TREATMENT -anterior I-TREATMENT -laparoscópica I-TREATMENT -ultrabaja. I-TREATMENT -Intraoperatoriamente I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -realizar I-TREATMENT -pulltrough I-TREATMENT -endoanal, I-TREATMENT -a I-TREATMENT -expensas I-TREATMENT -de I-TREATMENT -la I-TREATMENT -anatomía I-TREATMENT -patológica I-TREATMENT -definitiva, I-TREATMENT -siendo I-TREATMENT -el I-TREATMENT -resultado I-TREATMENT -de I-TREATMENT -la I-TREATMENT -misma I-TREATMENT -adenocarcinoma I-TREATMENT -de I-TREATMENT -glándulas I-TREATMENT -anales I-TREATMENT -sin I-TREATMENT -áreas I-TREATMENT -mucinosas, I-TREATMENT -CD7 I-TREATMENT -(+) I-TREATMENT -/CD20 I-TREATMENT -(-) I-TREATMENT -/PSA I-TREATMENT -(-), I-TREATMENT -T3 I-TREATMENT -N0, I-TREATMENT -con I-TREATMENT -márgenes I-TREATMENT -radial I-TREATMENT -y I-TREATMENT -distal I-TREATMENT -afectos, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -completar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -mediante I-TREATMENT -amputación I-TREATMENT -abdómino-perineal I-TREATMENT -cilíndrica I-TREATMENT -laparoscópica. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -supervivencia I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -a I-EVOLUTION -12 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -diagnosticada B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -EW I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -cirrosis I-PAST_MEDICAL_HISTORY -hepática I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -portal, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -afectación I-PAST_MEDICAL_HISTORY -neuropsiquiátrica. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -D-penicilamina I-PAST_MEDICAL_HISTORY -(350 I-PAST_MEDICAL_HISTORY -mg/8 I-PAST_MEDICAL_HISTORY -horas I-PAST_MEDICAL_HISTORY -v.o.) I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -diagnóstico. I-PAST_MEDICAL_HISTORY -Consulta B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -flexibilidad I-PRESENT_ILLNESS -cutánea, I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pápulas I-PRESENT_ILLNESS -blanquecinas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -piel I-PRESENT_ILLNESS -redundante I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -cervical I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -axilar. I-PRESENT_ILLNESS -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -pseudo-pseudoxantoma I-EXPLORATION -elástico I-EXPLORATION -(PPXE) I-EXPLORATION -secundario I-EXPLORATION -al I-EXPLORATION -tratamiento I-EXPLORATION -con I-EXPLORATION -D-penicilamina. I-EXPLORATION -Ante B-TREATMENT -este I-TREATMENT -hallazgo I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -D-penicilamina I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -acetato I-TREATMENT -de I-TREATMENT -zinc I-TREATMENT -(50 I-TREATMENT -mg/8 I-TREATMENT -horas I-TREATMENT -v.o.). I-TREATMENT -Así B-EXPLORATION -mismo, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -examen I-EXPLORATION -oftalmológico I-EXPLORATION -y I-EXPLORATION -ecocardiográfico I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -afectación I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -elástico I-EXPLORATION -a I-EXPLORATION -otro I-EXPLORATION -nivel, I-EXPLORATION -siendo I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hepatopatía I-PAST_MEDICAL_HISTORY -previa, I-PAST_MEDICAL_HISTORY -consumidora B-PRESENT_ILLNESS -habitual I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -productos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Herbalife I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -zumo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Noni. I-PRESENT_ILLNESS -Acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -inespecífico, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -mucocutánea. I-PRESENT_ILLNESS -No B-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -deterioro I-EXPLORATION -neurológico. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -sanguínea I-EXPLORATION -destacaba: I-EXPLORATION -ALT I-EXPLORATION -940 I-EXPLORATION -U/l, I-EXPLORATION -AST I-EXPLORATION -1300 I-EXPLORATION -U/l, I-EXPLORATION -GGT I-EXPLORATION -173U/l, I-EXPLORATION -FA I-EXPLORATION -187 I-EXPLORATION -U/l, I-EXPLORATION -LDH I-EXPLORATION -431 I-EXPLORATION -U/l, I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -21, I-EXPLORATION -45 I-EXPLORATION -mg/dl, I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -actividad I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -del I-EXPLORATION -41% I-EXPLORATION -(INR I-EXPLORATION -2.03). I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -etiología I-EXPLORATION -incluyó I-EXPLORATION -serologías I-EXPLORATION -de I-EXPLORATION -virus I-EXPLORATION -hepatotropos: I-EXPLORATION -VHA, I-EXPLORATION -VHB, I-EXPLORATION -VHC, I-EXPLORATION -VHE, I-EXPLORATION -CMV, I-EXPLORATION -EB, I-EXPLORATION -VVZ, I-EXPLORATION -HHV I-EXPLORATION -6-8 I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -IgG I-EXPLORATION -e I-EXPLORATION -IgM I-EXPLORATION -negativas. I-EXPLORATION -Serología I-EXPLORATION -VIH I-EXPLORATION -negativa. I-EXPLORATION -ARN-VHC I-EXPLORATION -y I-EXPLORATION -ADN-VHB I-EXPLORATION -negativos. I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -de I-EXPLORATION -Coxiella, I-EXPLORATION -T. I-EXPLORATION -Cruzi, I-EXPLORATION -Treponema I-EXPLORATION -y I-EXPLORATION -Brucella, I-EXPLORATION -fueron I-EXPLORATION -negativas I-EXPLORATION -para I-EXPLORATION -IgG I-EXPLORATION -e I-EXPLORATION -IgM. I-EXPLORATION -Se I-EXPLORATION -descartó I-EXPLORATION -además I-EXPLORATION -enfermedad I-EXPLORATION -de I-EXPLORATION -Wilson, I-EXPLORATION -deficiencia I-EXPLORATION -de I-EXPLORATION -alfa I-EXPLORATION -1 I-EXPLORATION -antitripsina I-EXPLORATION -y I-EXPLORATION -hepatitis I-EXPLORATION -autoinmune. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -colangio-hepato I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -descartaron I-EXPLORATION -patología I-EXPLORATION -biliopancreática. I-EXPLORATION -La I-EXPLORATION -evolución I-EXPLORATION -analítica I-EXPLORATION -fue I-EXPLORATION -tórpida I-EXPLORATION -como I-EXPLORATION -se I-EXPLORATION -muestra I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tabla I-EXPLORATION -I. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -hepática I-EXPLORATION -transyugular I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -hepatitis I-EXPLORATION -lobulillar I-EXPLORATION -con I-EXPLORATION -necrosis I-EXPLORATION -confluente I-EXPLORATION -que I-EXPLORATION -iniciaba I-EXPLORATION -transformación I-EXPLORATION -nodular. I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -la I-EVOLUTION -tercera I-EVOLUTION -semana I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -desarrolló I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -encefalopatía I-EVOLUTION -hepática I-EVOLUTION -grado I-EVOLUTION -II I-EVOLUTION -y I-EVOLUTION -un I-EVOLUTION -empeoramiento I-EVOLUTION -clínico I-EVOLUTION -con I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -ascitis. I-EVOLUTION -El B-TREATMENT -cuadro I-TREATMENT -clínico I-TREATMENT -progresó I-TREATMENT -hacia I-TREATMENT -fallo I-TREATMENT -hepático I-TREATMENT -que I-TREATMENT -precisó I-TREATMENT -trasplante I-TREATMENT -hepático I-TREATMENT -urgente, I-TREATMENT -con I-TREATMENT -buena I-TREATMENT -evolución I-TREATMENT -posterior. I-TREATMENT - I-TREATMENT - -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -abdominalgia I-PRESENT_ILLNESS -generalizada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -predominio I-PRESENT_ILLNESS -horario I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -ingesta I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -incluso I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -despierta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -noche. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -asocia I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -cambios I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hábito I-PRESENT_ILLNESS -deposicional. I-PRESENT_ILLNESS -Antecedentes B-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -realiza I-EXPLORATION -hemograma I-EXPLORATION -con I-EXPLORATION -hemoglobina I-EXPLORATION -12, I-EXPLORATION -6 I-EXPLORATION -g/dl, I-EXPLORATION -volumen I-EXPLORATION -corpuscular I-EXPLORATION -medio I-EXPLORATION -79, I-EXPLORATION -6 I-EXPLORATION -fl. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -hemograma I-EXPLORATION -es I-EXPLORATION -normal. I-EXPLORATION -Además, I-EXPLORATION -presenta I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION -con I-EXPLORATION -AST, I-EXPLORATION -ALT I-EXPLORATION -y I-EXPLORATION -GGT I-EXPLORATION -normales I-EXPLORATION -y I-EXPLORATION -función I-EXPLORATION -renal I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION -Destaca I-EXPLORATION -ferropenia I-EXPLORATION -con I-EXPLORATION -ferritina I-EXPLORATION -de I-EXPLORATION -9 I-EXPLORATION -ng/ml I-EXPLORATION -(20-200 I-EXPLORATION -ng/ml) I-EXPLORATION -sin I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -reactantes I-EXPLORATION -de I-EXPLORATION -fase I-EXPLORATION -aguda I-EXPLORATION -(proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -y I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -sedimentación I-EXPLORATION -globular). I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -despistaje I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -celiaca I-EXPLORATION -con I-EXPLORATION -IgA I-EXPLORATION -total, I-EXPLORATION -anticuerpos I-EXPLORATION -antitransglutaminasa I-EXPLORATION -(IgA-AAT), I-EXPLORATION -anticuerpos I-EXPLORATION -antipéptido I-EXPLORATION -deaminado I-EXPLORATION -de I-EXPLORATION -gliadina I-EXPLORATION -que I-EXPLORATION -son I-EXPLORATION -negativos I-EXPLORATION -y I-EXPLORATION -HLA I-EXPLORATION -DQ2-DQ8 I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -enfermedad I-EXPLORATION -celiaca. I-EXPLORATION -Además I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -sensibilización I-EXPLORATION -alimentaria I-EXPLORATION -con I-EXPLORATION -IgE I-EXPLORATION -total I-EXPLORATION -y I-EXPLORATION -específica I-EXPLORATION -a I-EXPLORATION -proteínas I-EXPLORATION -de I-EXPLORATION -leche I-EXPLORATION -de I-EXPLORATION -vaca I-EXPLORATION -(PLV) I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -huevo I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Tras I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION -normales, I-EXPLORATION -se I-EXPLORATION -había I-EXPLORATION -realizado I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -en I-EXPLORATION -otro I-EXPLORATION -centro I-EXPLORATION -hospitalario I-EXPLORATION -con I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -gastritis, I-EXPLORATION -con I-EXPLORATION -test I-EXPLORATION -rápido I-EXPLORATION -de I-EXPLORATION -ureasa I-EXPLORATION -en I-EXPLORATION -biopsia I-EXPLORATION -antral I-EXPLORATION -negativa I-EXPLORATION -para I-EXPLORATION -infección I-EXPLORATION -por I-EXPLORATION -Helicobacter I-EXPLORATION -pylori. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -tomaron I-EXPLORATION -otras I-EXPLORATION -muestras I-EXPLORATION -gástricas I-EXPLORATION -para I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico. I-EXPLORATION -Se B-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -IBP I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -altas I-TREATMENT -(2 I-TREATMENT -mg/ I-TREATMENT -kg/día) I-TREATMENT -con I-TREATMENT -mejoría I-TREATMENT -inicial I-TREATMENT -presentando I-TREATMENT -recaída I-TREATMENT -al I-TREATMENT -suspender I-TREATMENT -IBP I-TREATMENT -a I-TREATMENT -los I-TREATMENT -2 I-TREATMENT -meses. I-TREATMENT - I-TREATMENT -Reconsulta B-EVOLUTION -en I-EVOLUTION -nuestro I-EVOLUTION -centro I-EVOLUTION -por I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -sintomatología, I-EVOLUTION -dolor I-EVOLUTION -más I-EVOLUTION -localizado I-EVOLUTION -e I-EVOLUTION -intensificado I-EVOLUTION -en I-EVOLUTION -epigastrio I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -último I-EVOLUTION -mes. I-EVOLUTION -Se B-EXPLORATION -decide I-EXPLORATION -nueva I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -alta I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -únicamente I-EXPLORATION -imagen I-EXPLORATION -nodular I-EXPLORATION -en I-EXPLORATION -antro I-EXPLORATION -gástrico. I-EXPLORATION -Se I-EXPLORATION -toman I-EXPLORATION -muestras I-EXPLORATION -de I-EXPLORATION -antro I-EXPLORATION -gástrico I-EXPLORATION -para I-EXPLORATION -test I-EXPLORATION -rápido I-EXPLORATION -de I-EXPLORATION -ureasa I-EXPLORATION -para I-EXPLORATION -Helicobacter I-EXPLORATION -pylori I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -negativo I-EXPLORATION -y I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -descripción I-EXPLORATION -histológica I-EXPLORATION -destaca I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -mucosa I-EXPLORATION -gástrica I-EXPLORATION -con I-EXPLORATION -moderado I-EXPLORATION -componente I-EXPLORATION -inflamatorio I-EXPLORATION -linfoplasmocitario I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -fibrosis I-EXPLORATION -colágena I-EXPLORATION -subepitelial I-EXPLORATION -de I-EXPLORATION -distribución I-EXPLORATION -parcheada I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -que I-EXPLORATION -superan I-EXPLORATION -las I-EXPLORATION -10 I-EXPLORATION -micras I-EXPLORATION -de I-EXPLORATION -espesor I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -también I-EXPLORATION -se I-EXPLORATION -distribuyen I-EXPLORATION -alrededor I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -glándulas. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -linfocitosis I-EXPLORATION -intraepitelial I-EXPLORATION -significativa, I-EXPLORATION -ni I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -Helicobacter I-EXPLORATION -pylori. I-EXPLORATION -Las I-EXPLORATION -muestras I-EXPLORATION -de I-EXPLORATION -esófago I-EXPLORATION -y I-EXPLORATION -duodeno I-EXPLORATION -no I-EXPLORATION -presentan I-EXPLORATION -alteraciones I-EXPLORATION -histológicas. I-EXPLORATION - I-EXPLORATION -Orientada I-EXPLORATION -como I-EXPLORATION -GC I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -colonoscopia I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -colitis I-EXPLORATION -colágena I-EXPLORATION -asociada I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -normal I-EXPLORATION -tanto I-EXPLORATION -la I-EXPLORATION -imagen I-EXPLORATION -como I-EXPLORATION -histológicamente. I-EXPLORATION -Se B-TREATMENT -reinicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -esomeprazol I-TREATMENT -oral I-TREATMENT -40 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -24 I-TREATMENT -horas, I-TREATMENT -desapareciendo I-TREATMENT -la I-TREATMENT -sintomatología I-TREATMENT -a I-TREATMENT -los I-TREATMENT -pocos I-TREATMENT -días I-TREATMENT -junto I-TREATMENT -suplemento I-TREATMENT -de I-TREATMENT -hierro I-TREATMENT -oral. I-TREATMENT -A I-TREATMENT -los I-TREATMENT -3 I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -inicio I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -puede I-TREATMENT -disminuir I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -IBP I-TREATMENT -a I-TREATMENT -la I-TREATMENT -mitad I-TREATMENT -permaneciendo B-EVOLUTION -asintomática I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -diagnóstico. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -relevantes, I-PAST_MEDICAL_HISTORY -con B-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -esofágica I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Dos B-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -presentado I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -impactación I-PAST_MEDICAL_HISTORY -alimentaria. I-PAST_MEDICAL_HISTORY -El B-EXPLORATION -estudio I-EXPLORATION -radiológico I-EXPLORATION -gastroduodenal I-EXPLORATION -baritado I-EXPLORATION -(EGD) I-EXPLORATION -detectó I-EXPLORATION -en I-EXPLORATION -tercio I-EXPLORATION -esofágico I-EXPLORATION -inferior I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -sacular I-EXPLORATION -con I-EXPLORATION -nivel I-EXPLORATION -hidroaéreo, I-EXPLORATION -bien I-EXPLORATION -delimitada I-EXPLORATION -de I-EXPLORATION -9 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -tóraco-abdominal I-EXPLORATION -corroboró I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -descritos I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -EGD. I-EXPLORATION -La I-EXPLORATION -gastroscopia I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -doble I-EXPLORATION -luz I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -tamaño I-EXPLORATION -con I-EXPLORATION -contenido I-EXPLORATION -alimentario I-EXPLORATION -semisólido I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -reseñables, I-PAST_MEDICAL_HISTORY -remitido B-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -otorrinolaringología I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -sensación I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cuerpo I-DERIVED_FROM/TO -extraño I-DERIVED_FROM/TO -faringo-laríngeo I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -descartar I-DERIVED_FROM/TO -reflujo I-DERIVED_FROM/TO -gastroesofágico. I-DERIVED_FROM/TO -El B-EXPLORATION -EGD I-EXPLORATION -reveló I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -sacular I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -epifrénica, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -endoscópicamente. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -77 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -virus I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -C I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -hernia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hiato, I-PAST_MEDICAL_HISTORY -con B-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -esofágica I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -asociada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -pirosis I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -ocasionales I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -regurgitación I-PRESENT_ILLNESS -alimentaria. I-PRESENT_ILLNESS -El B-EXPLORATION -EGD I-EXPLORATION -identificó I-EXPLORATION -una I-EXPLORATION -formación I-EXPLORATION -sacular I-EXPLORATION -anterior I-EXPLORATION -de I-EXPLORATION -boca I-EXPLORATION -ancha I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -situado I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -10 I-EXPLORATION -cm I-EXPLORATION -distales I-EXPLORATION -del I-EXPLORATION -esófago I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -hernia I-EXPLORATION -hiatal I-EXPLORATION -por I-EXPLORATION -deslizamiento. I-EXPLORATION -La I-EXPLORATION -endoscopia I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -divertículo, I-EXPLORATION -con I-EXPLORATION -contenido I-EXPLORATION -alimentario I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior, I-EXPLORATION -a I-EXPLORATION -30 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arcada I-EXPLORATION -dentaria. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica, I-PAST_MEDICAL_HISTORY -con B-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -sólidos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -líquidos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -broncoaspiración. I-PRESENT_ILLNESS -El B-EXPLORATION -EGD I-EXPLORATION -sugería I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -contracciones I-EXPLORATION -terciarias I-EXPLORATION -en I-EXPLORATION -tercio I-EXPLORATION -medio I-EXPLORATION -inferior, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -divertículo I-EXPLORATION -en I-EXPLORATION -cara I-EXPLORATION -posterior I-EXPLORATION -derecha I-EXPLORATION -inferior I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -9x2, I-EXPLORATION -8 I-EXPLORATION -cm I-EXPLORATION -diámetro I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -endoscópico. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -86 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tiroidectomía I-PAST_MEDICAL_HISTORY -total I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -bocio I-PAST_MEDICAL_HISTORY -multinodular I-PAST_MEDICAL_HISTORY -endotorácico, I-PAST_MEDICAL_HISTORY -esofagitis I-PAST_MEDICAL_HISTORY -denudativa I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2011 I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -amoxicilina, I-PAST_MEDICAL_HISTORY -divertículo I-PAST_MEDICAL_HISTORY -esofágico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pequeña I-PAST_MEDICAL_HISTORY -hernia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hiato. I-PAST_MEDICAL_HISTORY -Presentaba B-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -predominio I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -líquidos I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -motivó I-PRESENT_ILLNESS -ingresos I-PRESENT_ILLNESS -hospitalarios I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -broncoaspiración I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -ocasiones. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -último I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -divertículo I-EXPLORATION -ya I-EXPLORATION -conocido I-EXPLORATION -situado I-EXPLORATION -a I-EXPLORATION -unos I-EXPLORATION -28 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -arcada I-EXPLORATION -dentaria I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -endoscopia. I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -seis I-EXPLORATION -pacientes I-EXPLORATION -descritos I-EXPLORATION -se I-EXPLORATION -les I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -manometría I-EXPLORATION -de I-EXPLORATION -alta I-EXPLORATION -resolución I-EXPLORATION -(MAR), I-EXPLORATION -identificándose I-EXPLORATION -en I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -casos I-EXPLORATION -un I-EXPLORATION -trastorno I-EXPLORATION -motor I-EXPLORATION -esofágico I-EXPLORATION -(TME) I-EXPLORATION -concomitante. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -obtenidos I-EXPLORATION -con I-EXPLORATION -MAR I-EXPLORATION -en I-EXPLORATION -cada I-EXPLORATION -uno I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -pacientes I-EXPLORATION -se I-EXPLORATION -muestran I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tabla I-EXPLORATION -I. I-EXPLORATION -Se I-EXPLORATION -utilizaron I-EXPLORATION -como I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -referencia I-EXPLORATION -los I-EXPLORATION -parámetros I-EXPLORATION -descritos I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -clasificación I-EXPLORATION -de I-EXPLORATION -Chicago I-EXPLORATION -vigente I-EXPLORATION -(7). I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -del I-EXPLORATION -primer I-EXPLORATION -caso I-EXPLORATION -presentaba I-EXPLORATION -ondas I-EXPLORATION -hipercontráctiles I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -segmentos I-EXPLORATION -S2 I-EXPLORATION -y I-EXPLORATION -S3, I-EXPLORATION -siendo I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -manométrico I-EXPLORATION -de I-EXPLORATION -TME I-EXPLORATION -hipercontráctil I-EXPLORATION -("jackhammer"). I-EXPLORATION -La I-EXPLORATION -MAR I-EXPLORATION -del I-EXPLORATION -segundo I-EXPLORATION -paciente I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -un I-EXPLORATION -TME I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -espasmo I-EXPLORATION -esofágico I-EXPLORATION -distal, I-EXPLORATION -con I-EXPLORATION -afectación I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -segmento I-EXPLORATION -S3. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -tercer I-EXPLORATION -caso, I-EXPLORATION -la I-EXPLORATION -MAR I-EXPLORATION -reveló I-EXPLORATION -un I-EXPLORATION -TME I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -peristalsis I-EXPLORATION -débil I-EXPLORATION -por I-EXPLORATION -defecto I-EXPLORATION -peristáltico I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -tamaño I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -contorno I-EXPLORATION -isobárico I-EXPLORATION -de I-EXPLORATION -20 I-EXPLORATION -mmHg I-EXPLORATION -(en I-EXPLORATION -el I-EXPLORATION -50% I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -degluciones), I-EXPLORATION -con I-EXPLORATION -ondas I-EXPLORATION -de I-EXPLORATION -duración I-EXPLORATION -prolongada I-EXPLORATION -y I-EXPLORATION -morfología I-EXPLORATION -de I-EXPLORATION -doble I-EXPLORATION -y I-EXPLORATION -triple I-EXPLORATION -pico I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -56% I-EXPLORATION -y I-EXPLORATION -11% I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -degluciones I-EXPLORATION -respectivamente I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -segmento I-EXPLORATION -S3. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -del I-EXPLORATION -caso I-EXPLORATION -4 I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -obstrucción I-EXPLORATION -al I-EXPLORATION -tracto I-EXPLORATION -de I-EXPLORATION -salida I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -unión I-EXPLORATION -gastroesofágica I-EXPLORATION -(UGE) I-EXPLORATION -y I-EXPLORATION -simultáneamente I-EXPLORATION -un I-EXPLORATION -TME I-EXPLORATION -con I-EXPLORATION -rasgos I-EXPLORATION -de I-EXPLORATION -acalasia I-EXPLORATION -tipo I-EXPLORATION -III I-EXPLORATION -(espástica) I-EXPLORATION -de I-EXPLORATION -probable I-EXPLORATION -origen I-EXPLORATION -secundario, I-EXPLORATION -observándose I-EXPLORATION -gran I-EXPLORATION -duración I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -ondas I-EXPLORATION -peristálticas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -segmento I-EXPLORATION -S2 I-EXPLORATION -(a I-EXPLORATION -unos I-EXPLORATION -30 I-EXPLORATION -cm I-EXPLORATION -del I-EXPLORATION -orificio I-EXPLORATION -nasal). I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -5 I-EXPLORATION -presentó I-EXPLORATION -también I-EXPLORATION -un I-EXPLORATION -TME I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -hipercontráctil I-EXPLORATION -("jackhammer") I-EXPLORATION -con I-EXPLORATION -ondas I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -tamaño I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -segmentos I-EXPLORATION -S2 I-EXPLORATION -y I-EXPLORATION -sobre I-EXPLORATION -todo I-EXPLORATION -en I-EXPLORATION -S3. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -del I-EXPLORATION -caso I-EXPLORATION -6 I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -TME I-EXPLORATION -consistente I-EXPLORATION -en I-EXPLORATION -obstrucción I-EXPLORATION -al I-EXPLORATION -flujo I-EXPLORATION -de I-EXPLORATION -salida I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -UGE, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -secuencia I-EXPLORATION -contráctil I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -del I-EXPLORATION -divertículo I-EXPLORATION -esofágico I-EXPLORATION -consistente I-EXPLORATION -en I-EXPLORATION -ensanchamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -onda I-EXPLORATION -de I-EXPLORATION -contracción I-EXPLORATION -(entre I-EXPLORATION -segmentos I-EXPLORATION -S2-S3). I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -casos I-EXPLORATION -el I-EXPLORATION -segmento I-EXPLORATION -predominantemente I-EXPLORATION -afectado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -MAR, I-EXPLORATION -coincidió I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -localización I-EXPLORATION -del I-EXPLORATION -DE I-EXPLORATION -objetivada I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION -radiológicos I-EXPLORATION -y I-EXPLORATION -endoscópicos. I-EXPLORATION - I-EXPLORATION -Cinco B-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -pacientes I-DERIVED_FROM/TO -fueron I-DERIVED_FROM/TO -remitidos I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -valoración I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -quirúrgico. I-DERIVED_FROM/TO -El B-TREATMENT -paciente I-TREATMENT -del I-TREATMENT -primer I-TREATMENT -caso I-TREATMENT -fue I-TREATMENT -tratado I-TREATMENT -mediante I-TREATMENT -diverticulectomía I-TREATMENT -que I-TREATMENT -se I-TREATMENT -complicó I-TREATMENT -con I-TREATMENT -fístula I-TREATMENT -esófago-pleural I-TREATMENT -y I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT -mediante I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -una I-TREATMENT -prótesis I-TREATMENT -esofágica I-TREATMENT -metálica I-TREATMENT -cubierta I-TREATMENT -(Wallflex®). I-TREATMENT -Los I-TREATMENT -pacientes I-TREATMENT -del I-TREATMENT -segundo I-TREATMENT -y I-TREATMENT -tercer I-TREATMENT -caso I-TREATMENT -decidieron I-TREATMENT -continuar I-TREATMENT -un I-TREATMENT -manejo I-TREATMENT -conservador, I-TREATMENT -tras I-TREATMENT -desestimar I-TREATMENT -la I-TREATMENT -opción I-TREATMENT -de I-TREATMENT -cirugía I-TREATMENT -debido I-TREATMENT -al I-TREATMENT -riesgo I-TREATMENT -de I-TREATMENT -morbi-mortalidad I-TREATMENT -asociado I-TREATMENT -al I-TREATMENT -mismo. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -del I-EVOLUTION -cuarto I-EVOLUTION -caso I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -hemorragia I-EVOLUTION -digestiva I-EVOLUTION -alta, I-EVOLUTION -identificándose B-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -endoscópico I-EXPLORATION -urgente I-EXPLORATION -un I-EXPLORATION -gran I-EXPLORATION -coágulo I-EXPLORATION -adherido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -del I-EXPLORATION -divertículo. I-EXPLORATION -Ello B-EVOLUTION -aceleró I-EVOLUTION -la I-EVOLUTION -decisión I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -quirúrgico I-EVOLUTION -del I-EVOLUTION -DE, I-EVOLUTION -una I-EVOLUTION -vez I-EVOLUTION -superado I-EVOLUTION -el I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -sangrado I-EVOLUTION -digestivo. I-EVOLUTION -No I-EVOLUTION -obstante, I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -posteriores I-EVOLUTION -al I-EVOLUTION -evento I-EVOLUTION -hemorrágico, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -desarrolló I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -séptico I-EVOLUTION -secundario I-EVOLUTION -a I-EVOLUTION -neumonía I-EVOLUTION -de I-EVOLUTION -origen I-EVOLUTION -espirativo, I-EVOLUTION -falleciendo I-EVOLUTION -finalmente. I-EVOLUTION -La B-TREATMENT -paciente I-TREATMENT -del I-TREATMENT -quinto I-TREATMENT -caso I-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT -quirúrgicamente I-TREATMENT -realizándose I-TREATMENT -diverticulectomía I-TREATMENT -y I-TREATMENT -miotomía I-TREATMENT -mediante I-TREATMENT -toracoscopia. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -tórpida I-EVOLUTION -al I-EVOLUTION -presentar I-EVOLUTION -mediastinitis I-EVOLUTION -secundaria I-EVOLUTION -a I-EVOLUTION -fístula I-EVOLUTION -esófago-pleural. I-EVOLUTION -Se B-TREATMENT -trató I-TREATMENT -la I-TREATMENT -misma I-TREATMENT -mediante I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -prótesis I-TREATMENT -esofágica I-TREATMENT -metálica I-TREATMENT -cubierta I-TREATMENT -(Wallflex®). I-TREATMENT -La I-TREATMENT -paciente I-TREATMENT -número I-TREATMENT -seis I-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT -mediante I-TREATMENT -inyección I-TREATMENT -de I-TREATMENT -toxina I-TREATMENT -botulínica I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -la I-TREATMENT -UGE I-TREATMENT -para I-TREATMENT -resolver I-TREATMENT -el I-TREATMENT -cuadro I-TREATMENT -de I-TREATMENT -obstrucción I-TREATMENT -funcional. I-TREATMENT -Se I-TREATMENT -consideró I-TREATMENT -el I-TREATMENT -mejor I-TREATMENT -tratamiento I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -la I-TREATMENT -edad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente, I-TREATMENT -mejorando I-TREATMENT -la I-TREATMENT -sintomatología. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -español, B-PAST_MEDICAL_HISTORY -ingeniero I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -caminos I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -residido I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Costa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Marfil I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -motivos I-PAST_MEDICAL_HISTORY -laborales. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -actualidad I-PRESENT_ILLNESS -regresa I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -España I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -prurito I-PRESENT_ILLNESS -perianal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -difuso I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -cólico. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -asocia I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -última I-PRESENT_ILLNESS -deposición I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -diarreica, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -deja I-PRESENT_ILLNESS -entrever I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -gusano I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -gran I-PRESENT_ILLNESS -tamaño. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -destaca I-EXPLORATION -dolor I-EXPLORATION -leve I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -profunda I-EXPLORATION -en I-EXPLORATION -fosa I-EXPLORATION -iliaca I-EXPLORATION -derecha. I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -resalta I-EXPLORATION -discreta I-EXPLORATION -eosinofilia I-EXPLORATION -(750 I-EXPLORATION -eosinófilos I-EXPLORATION -por I-EXPLORATION -microlitro). I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -visualización I-EXPLORATION -macroscópica I-EXPLORATION -del I-EXPLORATION -parásito I-EXPLORATION -impresiona I-EXPLORATION -de I-EXPLORATION -Taenia. I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -diferido I-EXPLORATION -microbiológico I-EXPLORATION -lo I-EXPLORATION -describe I-EXPLORATION -como I-EXPLORATION -Taenia I-EXPLORATION -saginata I-EXPLORATION -(T. I-EXPLORATION -saginata). I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -85 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -hipertensiva, I-PAST_MEDICAL_HISTORY -fibrilación I-PAST_MEDICAL_HISTORY -auricular I-PAST_MEDICAL_HISTORY -crónica, I-PAST_MEDICAL_HISTORY -accidente I-PAST_MEDICAL_HISTORY -isquémico I-PAST_MEDICAL_HISTORY -transitorio I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -secuelas I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -infecciones I-PAST_MEDICAL_HISTORY -respiratorias I-PAST_MEDICAL_HISTORY -recurrentes I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -broncoaspiración. I-PAST_MEDICAL_HISTORY -Intervenido B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -fractura I-PRESENT_ILLNESS -subcapital I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fémur I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -corrección I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -coagulación I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -horas. I-PRESENT_ILLNESS -A B-EXPLORATION -las I-EXPLORATION -24 I-EXPLORATION -horas I-EXPLORATION -presenta I-EXPLORATION -dificultad I-EXPLORATION -respiratoria I-EXPLORATION -y I-EXPLORATION -disminución I-EXPLORATION -del I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -consciencia I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -pulmonar, I-EXPLORATION -con I-EXPLORATION -mejoría I-EXPLORATION -tras I-EXPLORATION -antibioterapia. I-EXPLORATION -A I-EXPLORATION -las I-EXPLORATION -96 I-EXPLORATION -horas I-EXPLORATION -postoperatorias I-EXPLORATION -presenta I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -brusco, I-EXPLORATION -vómitos I-EXPLORATION -y I-EXPLORATION -distensión. I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -abdomen: I-EXPLORATION -aire I-EXPLORATION -en I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -curvatura I-EXPLORATION -mayor I-EXPLORATION -gástrica. I-EXPLORATION -Tomografía I-EXPLORATION -computarizada I-EXPLORATION -abdominal I-EXPLORATION -urgente: I-EXPLORATION -gas I-EXPLORATION -intramural I-EXPLORATION -circunferencial I-EXPLORATION -gástrico I-EXPLORATION -de I-EXPLORATION -extensión I-EXPLORATION -difusa I-EXPLORATION -y I-EXPLORATION -hacia I-EXPLORATION -tercio I-EXPLORATION -inferior I-EXPLORATION -esofágico, I-EXPLORATION -con I-EXPLORATION -pequeña I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -neumoperitoneo I-EXPLORATION -adyacente I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -curvatura I-EXPLORATION -menor, I-EXPLORATION -gas I-EXPLORATION -venoso I-EXPLORATION -portal I-EXPLORATION -y I-EXPLORATION -neumomediastino I-EXPLORATION -adyacente I-EXPLORATION -a I-EXPLORATION -esófago; I-EXPLORATION -hallazgos I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -gastritis I-EXPLORATION -enfisematosa. I-EXPLORATION -Tratamiento B-TREATMENT -con I-TREATMENT -antibioterapia I-TREATMENT -intravenosa I-TREATMENT -de I-TREATMENT -amplio I-TREATMENT -espectro, I-TREATMENT -nutrición I-TREATMENT -parenteral, I-TREATMENT -inhibidores I-TREATMENT -de I-TREATMENT -la I-TREATMENT -bomba I-TREATMENT -de I-TREATMENT -protones I-TREATMENT -y I-TREATMENT -sonda I-TREATMENT -nasogástrica. I-TREATMENT -Se B-EXPLORATION -descarta I-EXPLORATION -etiología I-EXPLORATION -isquémica I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -angiotomografía I-EXPLORATION -computarizada: I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -defectos I-EXPLORATION -de I-EXPLORATION -repleción I-EXPLORATION -arterial. I-EXPLORATION -Tomografía I-EXPLORATION -computarizada I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -11 I-EXPLORATION -días: I-EXPLORATION -desaparición I-EXPLORATION -de I-EXPLORATION -neumatosis I-EXPLORATION -gastroesofágica I-EXPLORATION -; I-EXPLORATION -colapso I-EXPLORATION -completo I-EXPLORATION -del I-EXPLORATION -pulmón I-EXPLORATION -izquierdo. I-EXPLORATION -Broncoscopia I-EXPLORATION -urgente I-EXPLORATION -resolutiva: I-EXPLORATION -aspiración I-EXPLORATION -de I-EXPLORATION -tapones I-EXPLORATION -de I-EXPLORATION -moco. I-EXPLORATION -Se B-TREATMENT -suspende I-TREATMENT -la I-TREATMENT -antibioterapia I-TREATMENT -tras I-TREATMENT -14 I-TREATMENT -días I-TREATMENT -iniciando I-TREATMENT -tolerancia I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -satisfactoriamente. I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -96 I-EVOLUTION -horas, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -una I-EVOLUTION -broncoaspiración, I-EVOLUTION -empeoramiento I-EVOLUTION -clínico I-EVOLUTION -y I-EVOLUTION -respiratorio, I-EVOLUTION -falleciendo I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -horas. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cólicos I-PAST_MEDICAL_HISTORY -biliares I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -colelitiasis I-PAST_MEDICAL_HISTORY -conocida, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -localizado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -clínica I-EXPLORATION -destacaban I-EXPLORATION -dolor I-EXPLORATION -y I-EXPLORATION -defensa I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -hipocondrio I-EXPLORATION -derecho, I-EXPLORATION -con I-EXPLORATION -signo I-EXPLORATION -de I-EXPLORATION -Murphy I-EXPLORATION -positivo. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -solicitada, I-EXPLORATION -el I-EXPLORATION -rango I-EXPLORATION -de I-EXPLORATION -leucocitos I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -6, I-EXPLORATION -7x103/µL I-EXPLORATION -(referencia: I-EXPLORATION -4-10, I-EXPLORATION -5 I-EXPLORATION -103/µL), I-EXPLORATION -con I-EXPLORATION -neutrofilia I-EXPLORATION -asociada. I-EXPLORATION -Bilirrubina I-EXPLORATION -total I-EXPLORATION -0, I-EXPLORATION -6 I-EXPLORATION -mg/dl I-EXPLORATION -(referencia: I-EXPLORATION -0, I-EXPLORATION -2-1, I-EXPLORATION -10 I-EXPLORATION -mg/dl), I-EXPLORATION -AST I-EXPLORATION -66 I-EXPLORATION -mg/dl I-EXPLORATION -(referencia I-EXPLORATION -8-40 I-EXPLORATION -mg/dl), I-EXPLORATION -amilasa I-EXPLORATION -43 I-EXPLORATION -mg/dl I-EXPLORATION -(referencia: I-EXPLORATION -25-115 I-EXPLORATION -mg/dl), I-EXPLORATION -PCR I-EXPLORATION -15, I-EXPLORATION -84 I-EXPLORATION -mg/dl I-EXPLORATION -(referencia I-EXPLORATION -inferior I-EXPLORATION -a I-EXPLORATION -5 I-EXPLORATION -mg/dl). I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -ecografía I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -urgente I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -de I-EXPLORATION -vesícula I-EXPLORATION -biliar I-EXPLORATION -distendida, I-EXPLORATION -con I-EXPLORATION -edema I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -pared I-EXPLORATION -y I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -colelitiasis. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -colecistitis I-TREATMENT -aguda, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -una I-TREATMENT -colecistectomía I-TREATMENT -laparoscópica I-TREATMENT -urgente I-TREATMENT -tras B-EVOLUTION -la I-EVOLUTION -cual I-EVOLUTION -tuvo I-EVOLUTION -una I-EVOLUTION -recuperación I-EVOLUTION -postoperatoria I-EVOLUTION -favorable I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -complicaciones. I-EVOLUTION -El B-EXPLORATION -resultado I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -reveló I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -colecistitis I-EXPLORATION -crónica I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -pancreático I-EXPLORATION -ectópico I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vesícula I-EXPLORATION -biliar. I-EXPLORATION - I-EXPLORATION - -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -estenosis I-PRESENT_ILLNESS -esofágica I-PRESENT_ILLNESS -secundaria I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -ingesta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -caústicos I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -respondió I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -dilataciones I-PRESENT_ILLNESS -consecutivas I-PRESENT_ILLNESS -realizadas I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -balón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dilatación I-PRESENT_ILLNESS -esofágico. I-PRESENT_ILLNESS -La B-EXPLORATION -estenosis I-EXPLORATION -tenía I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -longitud I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -calibre I-EXPLORATION -inicial I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -mm. I-EXPLORATION -Se B-TREATMENT -realizaron I-TREATMENT -2 I-TREATMENT -sesiones I-TREATMENT -de I-TREATMENT -inyección I-TREATMENT -intralesional I-TREATMENT -de I-TREATMENT -mitomicina I-TREATMENT -C I-TREATMENT -(1, I-TREATMENT -6 I-TREATMENT -ml I-TREATMENT -en I-TREATMENT -cada I-TREATMENT -ocasión) I-TREATMENT -y I-TREATMENT -dilatación I-TREATMENT -con I-TREATMENT -balones I-TREATMENT -de I-TREATMENT -10-11-12 I-TREATMENT -mm I-TREATMENT -con I-TREATMENT -40 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -separación I-TREATMENT -entre I-TREATMENT -sesiones, I-TREATMENT -obteniendo B-EVOLUTION -la I-EVOLUTION -resolución I-EVOLUTION -completa I-EVOLUTION -del I-EVOLUTION -cuadro. I-EVOLUTION -Han I-EVOLUTION -transcurrido I-EVOLUTION -2 I-EVOLUTION -años I-EVOLUTION -y I-EVOLUTION -5 I-EVOLUTION -meses I-EVOLUTION -desde I-EVOLUTION -la I-EVOLUTION -ingesta I-EVOLUTION -y I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -precisado I-EVOLUTION -nuevas I-EVOLUTION -dilataciones I-EVOLUTION -esofágicas I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -últimos I-EVOLUTION -19 I-EVOLUTION -meses. I-EVOLUTION - I-EVOLUTION - -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -intervenida I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -atresia I-PRESENT_ILLNESS -esofágica I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -long-gap, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -realización I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -gastrostomía I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -mismo I-PRESENT_ILLNESS -acto I-PRESENT_ILLNESS -quirúrgico. I-PRESENT_ILLNESS -A B-TREATMENT -los I-TREATMENT -2 I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -(4 I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -vida) I-TREATMENT -requiere I-TREATMENT -dilatación I-TREATMENT -esofágica I-TREATMENT -con I-TREATMENT -balón I-TREATMENT -hidroneumático I-TREATMENT -por I-TREATMENT -estenosis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -anastomótica. I-TREATMENT -Tras I-TREATMENT -una I-TREATMENT -buena I-TREATMENT -respuesta I-TREATMENT -inicial I-TREATMENT -se I-TREATMENT -produjo I-TREATMENT -una I-TREATMENT -reestenosis I-TREATMENT -a I-TREATMENT -las I-TREATMENT -4 I-TREATMENT -semanas I-TREATMENT -motivo I-TREATMENT -por I-TREATMENT -el I-TREATMENT -que I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -una I-TREATMENT -segunda I-TREATMENT -dilatación. I-TREATMENT -Desde I-TREATMENT -ese I-TREATMENT -momento I-TREATMENT -se I-TREATMENT -hicieron I-TREATMENT -dilataciones I-TREATMENT -sucesivas I-TREATMENT -con I-TREATMENT -una I-TREATMENT -periodicidad I-TREATMENT -que I-TREATMENT -oscila I-TREATMENT -entre I-TREATMENT -4 I-TREATMENT -y I-TREATMENT -8 I-TREATMENT -semanas I-TREATMENT -(excepto I-TREATMENT -en I-TREATMENT -una I-TREATMENT -ocasión I-TREATMENT -que I-TREATMENT -precisó I-TREATMENT -dilatación I-TREATMENT -a I-TREATMENT -las I-TREATMENT -2 I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -la I-TREATMENT -previa I-TREATMENT -y I-TREATMENT -otra I-TREATMENT -ocasión I-TREATMENT -en I-TREATMENT -que I-TREATMENT -no I-TREATMENT -precisó I-TREATMENT -dilataciones I-TREATMENT -por I-TREATMENT -ausencia I-TREATMENT -de I-TREATMENT -reestenosis I-TREATMENT -en I-TREATMENT -un I-TREATMENT -periodo I-TREATMENT -de I-TREATMENT -7 I-TREATMENT -meses). I-TREATMENT -Además B-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -nacimiento I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -marcada I-PAST_MEDICAL_HISTORY -traqueomalacia I-PAST_MEDICAL_HISTORY -asociada, I-PAST_MEDICAL_HISTORY -lo B-TREATMENT -que I-TREATMENT -condicionaba I-TREATMENT -una I-TREATMENT -intubación I-TREATMENT -nasotraqueal I-TREATMENT -compleja I-TREATMENT -y I-TREATMENT -ciertos I-TREATMENT -problemas I-TREATMENT -en I-TREATMENT -la I-TREATMENT -extubación I-TREATMENT -tras I-TREATMENT -cada I-TREATMENT -proceso I-TREATMENT -de I-TREATMENT -dilatación I-TREATMENT -esofágica. I-TREATMENT - I-TREATMENT -Tras I-TREATMENT -un I-TREATMENT -total I-TREATMENT -de I-TREATMENT -14 I-TREATMENT -dilataciones I-TREATMENT -hidroneumáticas I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -sesión I-TREATMENT -de I-TREATMENT -MC I-TREATMENT -(con I-TREATMENT -2 I-TREATMENT -años I-TREATMENT -y I-TREATMENT -6 I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -vida). I-TREATMENT -Se B-EVOLUTION -produjo I-EVOLUTION -una I-EVOLUTION -respuesta I-EVOLUTION -muy I-EVOLUTION -favorable I-EVOLUTION -pues I-EVOLUTION -tras I-EVOLUTION -una I-EVOLUTION -sesión, I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -precisado I-EVOLUTION -nuevas I-EVOLUTION -dilataciones I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -últimos I-EVOLUTION -19 I-EVOLUTION -meses I-EVOLUTION -ni I-EVOLUTION -ha I-EVOLUTION -mostrado I-EVOLUTION -ningún I-EVOLUTION -tipo I-EVOLUTION -de I-EVOLUTION -clínica I-EVOLUTION -digestiva I-EVOLUTION -ni I-EVOLUTION -respiratoria I-EVOLUTION -en I-EVOLUTION -este I-EVOLUTION -periodo. I-EVOLUTION - I-EVOLUTION -Análisis B-TREATMENT -de I-TREATMENT -la I-TREATMENT -serie I-TREATMENT - I-TREATMENT -En I-TREATMENT -total I-TREATMENT -se I-TREATMENT -han I-TREATMENT -puesto I-TREATMENT -5 I-TREATMENT -prótesis I-TREATMENT -en I-TREATMENT -4 I-TREATMENT -pacientes I-TREATMENT -(en I-TREATMENT -1 I-TREATMENT -caso I-TREATMENT -se I-TREATMENT -han I-TREATMENT -usado I-TREATMENT -2 I-TREATMENT -prótesis). I-TREATMENT -Se B-EVOLUTION -ha I-EVOLUTION -conseguido I-EVOLUTION -el I-EVOLUTION -objetivo I-EVOLUTION -de I-EVOLUTION -solucionar I-EVOLUTION -la I-EVOLUTION -estenosis I-EVOLUTION -en I-EVOLUTION -2 I-EVOLUTION -casos, I-EVOLUTION -ha I-EVOLUTION -habido I-EVOLUTION -respuesta I-EVOLUTION -parcial I-EVOLUTION -temporal I-EVOLUTION -en I-EVOLUTION -3 I-EVOLUTION -casos I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -un I-EVOLUTION -paciente I-EVOLUTION -un I-EVOLUTION -empeoramiento I-EVOLUTION -clínico I-EVOLUTION -(por I-EVOLUTION -presentar I-EVOLUTION -una I-EVOLUTION -úlcera I-EVOLUTION -esofágica). I-EVOLUTION -Tres I-EVOLUTION -han I-EVOLUTION -sido I-EVOLUTION -customizadas I-EVOLUTION -y I-EVOLUTION -2 I-EVOLUTION -comercializadas I-EVOLUTION -(todas I-EVOLUTION -del I-EVOLUTION -menor I-EVOLUTION -calibre I-EVOLUTION -23/18/23). I-EVOLUTION -Tres I-EVOLUTION -han I-EVOLUTION -sido I-EVOLUTION -no I-EVOLUTION -recubiertas, I-EVOLUTION -una I-EVOLUTION -parcialmente I-EVOLUTION -cubierta I-EVOLUTION -y I-EVOLUTION -otra I-EVOLUTION -completamente I-EVOLUTION -cubierta. I-EVOLUTION -De I-EVOLUTION -las I-EVOLUTION -dos I-EVOLUTION -fístulas I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -efectiva I-EVOLUTION -la I-EVOLUTION -de I-EVOLUTION -prótesis I-EVOLUTION -cubierta I-EVOLUTION -y I-EVOLUTION -falló I-EVOLUTION -la I-EVOLUTION -parcialmente I-EVOLUTION -cubierta. I-EVOLUTION - I-EVOLUTION -Al I-EVOLUTION -analizar I-EVOLUTION -las I-EVOLUTION -complicaciones I-EVOLUTION -observadas I-EVOLUTION -con I-EVOLUTION -las I-EVOLUTION -PD I-EVOLUTION -hemos I-EVOLUTION -visto I-EVOLUTION -como I-EVOLUTION -la I-EVOLUTION -más I-EVOLUTION -frecuente I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -significativo I-EVOLUTION -(necesidad I-EVOLUTION -de I-EVOLUTION -analgesia I-EVOLUTION -mantenida I-EVOLUTION -más I-EVOLUTION -de I-EVOLUTION -5 I-EVOLUTION -días) I-EVOLUTION -en I-EVOLUTION -2 I-EVOLUTION -casos I-EVOLUTION -(2/5, I-EVOLUTION -40%), I-EVOLUTION -hiperplasia I-EVOLUTION -grave I-EVOLUTION -(que I-EVOLUTION -ha I-EVOLUTION -requerido I-EVOLUTION -dilatación I-EVOLUTION -específica I-EVOLUTION -en I-EVOLUTION -2 I-EVOLUTION -casos I-EVOLUTION -(2/5, I-EVOLUTION -40%), I-EVOLUTION -hiperplasia I-EVOLUTION -leve I-EVOLUTION -(no I-EVOLUTION -precisa I-EVOLUTION -dilatación) I-EVOLUTION -en I-EVOLUTION -2 I-EVOLUTION -casos I-EVOLUTION -(2/5, I-EVOLUTION -40%), I-EVOLUTION -migración I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -prótesis I-EVOLUTION -en I-EVOLUTION -1 I-EVOLUTION -caso I-EVOLUTION -(1/5, I-EVOLUTION -20%), I-EVOLUTION -aunque I-EVOLUTION -se I-EVOLUTION -pudo I-EVOLUTION -recolocar I-EVOLUTION -y I-EVOLUTION -una I-EVOLUTION -úlcera I-EVOLUTION -penetrante I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -borde I-EVOLUTION -superior I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -prótesis I-EVOLUTION -en I-EVOLUTION -un I-EVOLUTION -paciente I-EVOLUTION -(1/5, I-EVOLUTION -20%). I-EVOLUTION -Todas I-EVOLUTION -han I-EVOLUTION -podido I-EVOLUTION -ser I-EVOLUTION -resueltas I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -conservadora. I-EVOLUTION - I-EVOLUTION -Con I-EVOLUTION -respecto I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -MC I-EVOLUTION -se I-EVOLUTION -han I-EVOLUTION -hecho I-EVOLUTION -5 I-EVOLUTION -terapias I-EVOLUTION -en I-EVOLUTION -6 I-EVOLUTION -enfermos, I-EVOLUTION -con I-EVOLUTION -2 I-EVOLUTION -en I-EVOLUTION -4 I-EVOLUTION -enfermos I-EVOLUTION -y I-EVOLUTION -1 I-EVOLUTION -sesión I-EVOLUTION -en I-EVOLUTION -uno. I-EVOLUTION -Se I-EVOLUTION -ha I-EVOLUTION -solucionado I-EVOLUTION -la I-EVOLUTION -estenosis I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -definitiva I-EVOLUTION -en I-EVOLUTION -3 I-EVOLUTION -casos I-EVOLUTION -(60%) I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -otros I-EVOLUTION -dos I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -efectiva I-EVOLUTION -(40%). I-EVOLUTION - I-EVOLUTION -No I-EVOLUTION -hemos I-EVOLUTION -detectado I-EVOLUTION -efectos I-EVOLUTION -secundarios I-EVOLUTION -al I-EVOLUTION -uso I-EVOLUTION -de I-EVOLUTION -MC. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -tiempo I-EVOLUTION -medio I-EVOLUTION -dedicado I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -técnica I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -MC I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -de I-EVOLUTION -28, I-EVOLUTION -7 I-EVOLUTION -minutos I-EVOLUTION -(16-75). I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -cuanto I-EVOLUTION -al I-EVOLUTION -cómputo I-EVOLUTION -total I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -serie I-EVOLUTION -manejando I-EVOLUTION -ambas I-EVOLUTION -técnicas, I-EVOLUTION -podemos I-EVOLUTION -decir I-EVOLUTION -que I-EVOLUTION -hemos I-EVOLUTION -solucionado I-EVOLUTION -las I-EVOLUTION -estenosis I-EVOLUTION -en I-EVOLUTION -5 I-EVOLUTION -de I-EVOLUTION -6 I-EVOLUTION -casos I-EVOLUTION -de I-EVOLUTION -EER I-EVOLUTION -(83,3%) I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -1 I-EVOLUTION -de I-EVOLUTION -2 I-EVOLUTION -fístulas I-EVOLUTION -(50%); I-EVOLUTION -la I-EVOLUTION -fístula I-EVOLUTION -que I-EVOLUTION -fracasó I-EVOLUTION -tuvo I-EVOLUTION -que I-EVOLUTION -reintervenirse. I-EVOLUTION -De I-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -fracasos I-EVOLUTION -uno I-EVOLUTION -presenta I-EVOLUTION -un I-EVOLUTION -cierre I-EVOLUTION -completo I-EVOLUTION -esofágico I-EVOLUTION -que I-EVOLUTION -ha I-EVOLUTION -obligado I-EVOLUTION -a I-EVOLUTION -replantear I-EVOLUTION -cirugía I-EVOLUTION -reparadora I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -otro I-EVOLUTION -persiste I-EVOLUTION -con I-EVOLUTION -dieta I-EVOLUTION -oral I-EVOLUTION -mediante I-EVOLUTION -dilataciones I-EVOLUTION -quincenales. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -seguimiento I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -casos I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -prótesis I-EVOLUTION -o I-EVOLUTION -mitomicina I-EVOLUTION -final I-EVOLUTION -(último I-EVOLUTION -caso I-EVOLUTION -incluido) I-EVOLUTION -osciló I-EVOLUTION -entre I-EVOLUTION -los I-EVOLUTION -8 I-EVOLUTION -meses I-EVOLUTION -y I-EVOLUTION -2 I-EVOLUTION -años. I-EVOLUTION - I-EVOLUTION - -Lactante B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hipotonía I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -respiratoria, I-PRESENT_ILLNESS -motivo I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -origen. I-PRESENT_ILLNESS -Durante B-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -fiebre, I-EXPLORATION -deposiciones I-EXPLORATION -líquidas, I-EXPLORATION -hipoglucemia I-EXPLORATION -sintomática I-EXPLORATION -con I-EXPLORATION -clonias I-EXPLORATION -de I-EXPLORATION -extremidades I-EXPLORATION -de I-EXPLORATION -menos I-EXPLORATION -de I-EXPLORATION -30 I-EXPLORATION -segundos I-EXPLORATION -de I-EXPLORATION -duración I-EXPLORATION -y I-EXPLORATION -nistagmo, I-EXPLORATION -acidosis I-EXPLORATION -metabólica, I-EXPLORATION -hiperlactacidemia I-EXPLORATION -y I-EXPLORATION -coagulopatía I-EXPLORATION -moderada I-EXPLORATION -con I-EXPLORATION -sangrado I-EXPLORATION -digestivo. I-EXPLORATION -Sufrió B-EVOLUTION -deterioro I-EVOLUTION -hemodinámico I-EVOLUTION -progresivo I-EVOLUTION -hasta I-EVOLUTION -situación I-EVOLUTION -de I-EVOLUTION -shock, I-EVOLUTION -precisando I-EVOLUTION -expansión I-EVOLUTION -volumétrica I-EVOLUTION -y I-EVOLUTION -administración I-EVOLUTION -de I-EVOLUTION -dopamina, I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -cefotaxima I-EVOLUTION -y I-EVOLUTION -clindamicina I-EVOLUTION -tras I-EVOLUTION -objetivar I-EVOLUTION -aumento I-EVOLUTION -de I-EVOLUTION -procalcitonina I-EVOLUTION -(59, I-EVOLUTION -1 I-EVOLUTION -ng/ml). I-EVOLUTION -Ante B-DERIVED_FROM/TO -sospecha I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -shock I-DERIVED_FROM/TO -séptico I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -origen I-DERIVED_FROM/TO -entérico, I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -trasladado I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -las I-DERIVED_FROM/TO -primeras I-DERIVED_FROM/TO -24 I-DERIVED_FROM/TO -horas I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro, I-DERIVED_FROM/TO -ingresando I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cuidados I-DERIVED_FROM/TO -Críticos I-DERIVED_FROM/TO -Pediátricos. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destacaba I-PAST_MEDICAL_HISTORY -prematuridad I-PAST_MEDICAL_HISTORY -tardía I-PAST_MEDICAL_HISTORY -(34 I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -gestacional), I-PAST_MEDICAL_HISTORY -alimentación I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -fórmula I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -inicio I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -ganancia I-PAST_MEDICAL_HISTORY -ponderoestatural, I-PAST_MEDICAL_HISTORY -refiriendo I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -frecuentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -llanto, I-PAST_MEDICAL_HISTORY -considerados I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -crisis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cólico. I-PAST_MEDICAL_HISTORY -Recibía I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -producto I-PAST_MEDICAL_HISTORY -homeopático I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -contenía I-PAST_MEDICAL_HISTORY -Argentum I-PAST_MEDICAL_HISTORY -nitricum I-PAST_MEDICAL_HISTORY -D5, I-PAST_MEDICAL_HISTORY -Chamomilla I-PAST_MEDICAL_HISTORY -D1, I-PAST_MEDICAL_HISTORY -China I-PAST_MEDICAL_HISTORY -D3 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -Cuprum I-PAST_MEDICAL_HISTORY -aceticum I-PAST_MEDICAL_HISTORY -D4, I-PAST_MEDICAL_HISTORY -infusiones I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -manzanilla I-PAST_MEDICAL_HISTORY -adquiridas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -farmacia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -paracetamol I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -puntual, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -adecuada. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -palidez I-EXPLORATION -cutánea, I-EXPLORATION -sangrado I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -puntos I-EXPLORATION -de I-EXPLORATION -punción I-EXPLORATION -y I-EXPLORATION -capilaritis, I-EXPLORATION -distensión I-EXPLORATION -abdominal, I-EXPLORATION -hepatomegalia I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm, I-EXPLORATION -irritabilidad, I-EXPLORATION -hiperexcitabilidad I-EXPLORATION -y I-EXPLORATION -discreto I-EXPLORATION -nistagmo I-EXPLORATION -horizontal. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -constató I-EXPLORATION -fallo I-EXPLORATION -hepático I-EXPLORATION -agudo I-EXPLORATION -con I-EXPLORATION -hipertransaminasemia I-EXPLORATION -(aspartato I-EXPLORATION -aminotransferasa I-EXPLORATION -[AST] I-EXPLORATION -812 I-EXPLORATION -U/l, I-EXPLORATION -alanino I-EXPLORATION -aminotransferasa I-EXPLORATION -[ALT] I-EXPLORATION -1002 I-EXPLORATION -U/l), I-EXPLORATION -coagulopatía I-EXPLORATION -grave I-EXPLORATION -(actividad I-EXPLORATION -de I-EXPLORATION -protrombina I-EXPLORATION -22%, I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -tromboplastina I-EXPLORATION -parcial I-EXPLORATION -activada I-EXPLORATION -[TTPa] I-EXPLORATION -59 I-EXPLORATION -segundos, I-EXPLORATION -factor I-EXPLORATION -V I-EXPLORATION -Leiden I-EXPLORATION -34%, I-EXPLORATION -plaquetas I-EXPLORATION -86.000/μl), I-EXPLORATION -administrándose I-EXPLORATION -vitamina I-EXPLORATION -K I-EXPLORATION -y I-EXPLORATION -plasma. I-EXPLORATION -Presentó I-EXPLORATION -hipoglucemia I-EXPLORATION -(27 I-EXPLORATION -mg/dl) I-EXPLORATION -con I-EXPLORATION -cetonemia I-EXPLORATION -negativa, I-EXPLORATION -acidosis I-EXPLORATION -metabólica I-EXPLORATION -moderada I-EXPLORATION -(pH I-EXPLORATION -7, I-EXPLORATION -25, I-EXPLORATION -bicarbonato I-EXPLORATION -13 I-EXPLORATION -mmol/l, I-EXPLORATION -exceso I-EXPLORATION -de I-EXPLORATION -bases I-EXPLORATION --12, I-EXPLORATION -7 I-EXPLORATION -mmol/l), I-EXPLORATION -precisando I-EXPLORATION -elevado I-EXPLORATION -aporte I-EXPLORATION -endovenoso I-EXPLORATION -de I-EXPLORATION -glucosa I-EXPLORATION -(14 I-EXPLORATION -mg/kg/min) I-EXPLORATION -y I-EXPLORATION -bicarbonato. I-EXPLORATION -Los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -y I-EXPLORATION -directa, I-EXPLORATION -amonio I-EXPLORATION -y I-EXPLORATION -albúmina I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Presentó B-TREATMENT -febrícula I-TREATMENT -las I-TREATMENT -primeras I-TREATMENT -72 I-TREATMENT -horas, I-TREATMENT -aumento I-TREATMENT -de I-TREATMENT -proteína I-TREATMENT -C I-TREATMENT -reactiva I-TREATMENT -(56 I-TREATMENT -mg/l) I-TREATMENT -y I-TREATMENT -procalcitonina I-TREATMENT -(88 I-TREATMENT -ng/ml), I-TREATMENT -sustituyéndose I-TREATMENT -la I-TREATMENT -antibioterapia I-TREATMENT -por I-TREATMENT -piperacilina-tazobactam I-TREATMENT -ante I-TREATMENT -probable I-TREATMENT -clínica I-TREATMENT -infecciosa I-TREATMENT -entérica, I-TREATMENT -ampliándose I-TREATMENT -el I-TREATMENT -estudio I-TREATMENT -etiológico I-TREATMENT -infeccioso. I-TREATMENT -La B-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -mostró I-EXPLORATION -ascitis I-EXPLORATION -y I-EXPLORATION -peristaltismo I-EXPLORATION -aumentado I-EXPLORATION -de I-EXPLORATION -asas I-EXPLORATION -intestinales, I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -hepáticas. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -insuficiencia I-TREATMENT -hepática I-TREATMENT -aguda I-TREATMENT -grave I-TREATMENT -con I-TREATMENT -sospecha I-TREATMENT -inicial I-TREATMENT -de I-TREATMENT -enfermedad I-TREATMENT -metabólica I-TREATMENT -descompensada, I-TREATMENT -se I-TREATMENT -efectuó I-TREATMENT -despistaje I-TREATMENT -metabólico I-TREATMENT -y I-TREATMENT -se I-TREATMENT -instauró I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -N-acetilcisteina, I-TREATMENT -y I-TREATMENT -NTBC I-TREATMENT -(2-[2-nitro-4-trifluorometibenzoil]-1-3-ciclohexanediona) I-TREATMENT -así I-TREATMENT -como I-TREATMENT -dieta I-TREATMENT -exenta I-TREATMENT -de I-TREATMENT -tirosina I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -presunción I-TREATMENT -diagnóstica I-TREATMENT -de I-TREATMENT -tirosinemia. I-TREATMENT - I-TREATMENT -Se B-EVOLUTION -objetivó I-EVOLUTION -mejoría I-EVOLUTION -neurológica, I-EVOLUTION -hemodinámica, I-EVOLUTION -infecciosa I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -función I-EVOLUTION -hepática I-EVOLUTION -progresivas, I-EVOLUTION -presentando I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -60 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -ingreso I-EVOLUTION -actividad I-EVOLUTION -de I-EVOLUTION -protrombina I-EVOLUTION -del I-EVOLUTION -82%, I-EVOLUTION -AST I-EVOLUTION -148 I-EVOLUTION -U/l I-EVOLUTION -y I-EVOLUTION -ALT I-EVOLUTION -684 I-EVOLUTION -U/l. I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -infeccioso I-EXPLORATION -ampliado I-EXPLORATION -resultó I-EXPLORATION -negativo, I-EXPLORATION -incluidos I-EXPLORATION -virus I-EXPLORATION -hepatotropos I-EXPLORATION -(VHA, I-EXPLORATION -VHB I-EXPLORATION -y I-EXPLORATION -VHC), I-EXPLORATION -influenzae I-EXPLORATION -(A, I-EXPLORATION -B), I-EXPLORATION -perfil I-EXPLORATION -TORCH, I-EXPLORATION -citoquímica I-EXPLORATION -y I-EXPLORATION -PCR I-EXPLORATION -virales I-EXPLORATION -en I-EXPLORATION -líquido I-EXPLORATION -cefalorraquídeo I-EXPLORATION -(LCR), I-EXPLORATION -y I-EXPLORATION -cultivos I-EXPLORATION -(sangre, I-EXPLORATION -LCR, I-EXPLORATION -orina, I-EXPLORATION -heces). I-EXPLORATION -También I-EXPLORATION -fue I-EXPLORATION -negativo I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -hepático I-EXPLORATION -autoinmune. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -metabólico I-EXPLORATION -se I-EXPLORATION -detectó I-EXPLORATION -excreción I-EXPLORATION -elevada I-EXPLORATION -de I-EXPLORATION -ácido I-EXPLORATION -homovanílico, I-EXPLORATION -ligeramente I-EXPLORATION -elevada I-EXPLORATION -de I-EXPLORATION -vanilmandélico I-EXPLORATION -y I-EXPLORATION -4-hidroxifenilpirúvico I-EXPLORATION -y I-EXPLORATION -leve I-EXPLORATION -hipoaminoacidemia. I-EXPLORATION -La I-EXPLORATION -espectometría I-EXPLORATION -de I-EXPLORATION -masas I-EXPLORATION -en I-EXPLORATION -tándem, I-EXPLORATION -alfafetoproteína I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -succinilacetona I-EXPLORATION -en I-EXPLORATION -orina I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -reevaluó I-EXPLORATION -la I-EXPLORATION -anamnesis, I-EXPLORATION -registrándose I-EXPLORATION -la I-EXPLORATION -ingesta I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -mantenida I-EXPLORATION -durante I-EXPLORATION -los I-EXPLORATION -últimos I-EXPLORATION -dos I-EXPLORATION -meses I-EXPLORATION -de I-EXPLORATION -infusión I-EXPLORATION -elaborada I-EXPLORATION -con I-EXPLORATION -dos I-EXPLORATION -cucharadas I-EXPLORATION -de I-EXPLORATION -manzanilla, I-EXPLORATION -una I-EXPLORATION -estrella I-EXPLORATION -de I-EXPLORATION -anís I-EXPLORATION -estrellado I-EXPLORATION -(Illicium I-EXPLORATION -verum) I-EXPLORATION -y I-EXPLORATION -dos I-EXPLORATION -granos I-EXPLORATION -de I-EXPLORATION -matalahúva I-EXPLORATION -(anís I-EXPLORATION -verde I-EXPLORATION -o I-EXPLORATION -Pimpinella I-EXPLORATION -anisum) I-EXPLORATION -en I-EXPLORATION -500 I-EXPLORATION -ml I-EXPLORATION -de I-EXPLORATION -agua, I-EXPLORATION -con I-EXPLORATION -ingesta I-EXPLORATION -diaria I-EXPLORATION -de I-EXPLORATION -250 I-EXPLORATION -ml. I-EXPLORATION -Se B-EVOLUTION -contactó I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Información I-EVOLUTION -Toxicológica, I-EVOLUTION -que I-EVOLUTION -recomendó I-EVOLUTION -determinar I-EVOLUTION -la I-EVOLUTION -posible I-EVOLUTION -existencia I-EVOLUTION -de I-EVOLUTION -contaminación I-EVOLUTION -con I-EVOLUTION -Illicium I-EVOLUTION -anisatum, I-EVOLUTION -de I-EVOLUTION -conocido I-EVOLUTION -efecto I-EVOLUTION -tóxico, I-EVOLUTION -que I-EVOLUTION -justificara I-EVOLUTION -el I-EVOLUTION -cuadro I-EVOLUTION -clínico I-EVOLUTION -mediante I-EVOLUTION -un I-EVOLUTION -sencillo I-EVOLUTION -procedimiento I-EVOLUTION -que I-EVOLUTION -sugiere I-EVOLUTION -su I-EVOLUTION -presencia: I-EVOLUTION -a B-EXPLORATION -un I-EXPLORATION -fragmento I-EXPLORATION -de I-EXPLORATION -estrella I-EXPLORATION -de I-EXPLORATION -anís I-EXPLORATION -estrellado I-EXPLORATION -se I-EXPLORATION -añadieron I-EXPLORATION -3 I-EXPLORATION -ml I-EXPLORATION -de I-EXPLORATION -alcohol I-EXPLORATION -96o I-EXPLORATION -y, I-EXPLORATION -tras I-EXPLORATION -hervir I-EXPLORATION -y I-EXPLORATION -filtrar, I-EXPLORATION -se I-EXPLORATION -añadieron I-EXPLORATION -al I-EXPLORATION -líquido I-EXPLORATION -obtenido I-EXPLORATION -cinco I-EXPLORATION -gotas I-EXPLORATION -de I-EXPLORATION -agua. I-EXPLORATION -La I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -turbidez I-EXPLORATION -sugirió I-EXPLORATION -la I-EXPLORATION -contaminación I-EXPLORATION -con I-EXPLORATION -Illicium I-EXPLORATION -anisatum. I-EXPLORATION -La B-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -fue I-EVOLUTION -satisfactoria I-EVOLUTION -con I-EVOLUTION -recuperación I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -analítica I-EVOLUTION -completa I-EVOLUTION -del I-EVOLUTION -paciente. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -boliviana B-PAST_MEDICAL_HISTORY -de B-PRESENT_ILLNESS -32 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -y B-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Fue B-PRESENT_ILLNESS -diagnosticada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -enfermedad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Chagas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Madrid, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -serología I-PRESENT_ILLNESS -positiva I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -IgG I-PRESENT_ILLNESS -Trypanosoma I-PRESENT_ILLNESS -cruzi, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -posterior I-PRESENT_ILLNESS -seguimiento I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Málaga. I-PRESENT_ILLNESS -Durante I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -distensión I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -molestias I-PRESENT_ILLNESS -abdominales I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -estreñimiento, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -empeora I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -progresiva, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -refractario I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -uso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -laxantes I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -enemas, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -recurriendo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ocasiones I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -desimpactaciones I-PRESENT_ILLNESS -manuales. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Consulta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -prolapso I-PRESENT_ILLNESS -rectal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS -secundario I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -maniobra I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Valsalva I-PRESENT_ILLNESS -intensa, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -reducido I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -cirujanos I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -complicaciones I-PRESENT_ILLNESS -inmediatas. I-PRESENT_ILLNESS -Tras I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -agudo, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -realizó I-PRESENT_ILLNESS -enema I-PRESENT_ILLNESS -opaco I-PRESENT_ILLNESS -objetivándose I-PRESENT_ILLNESS -dilatación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -colon I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -recto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -cm. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Dos I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -después, I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuevo I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -agudo I-PRESENT_ILLNESS -difuso, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -asociados. I-PRESENT_ILLNESS -Se B-EXPLORATION -objetiva I-EXPLORATION -mediante I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -un I-EXPLORATION -vólvulo I-EXPLORATION -colónico, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -resolvió I-EXPLORATION -sin I-EXPLORATION -incidencias I-EXPLORATION -con I-EXPLORATION -endoscopia I-EXPLORATION -descompresiva. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -quien I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -ambulatoria I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -epigastralgia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La B-EXPLORATION -esofagogastroduodenoscopia I-EXPLORATION -evidenció I-EXPLORATION -gastritis I-EXPLORATION -nodular I-EXPLORATION -antral. I-EXPLORATION -Las I-EXPLORATION -biopsias I-EXPLORATION -de I-EXPLORATION -antro I-EXPLORATION -reportaron I-EXPLORATION -gastritis I-EXPLORATION -crónica I-EXPLORATION -difusa I-EXPLORATION -no I-EXPLORATION -atrófica, I-EXPLORATION -activa I-EXPLORATION -grave, I-EXPLORATION -con I-EXPLORATION -plasmocitos I-EXPLORATION -y I-EXPLORATION -cuerpos I-EXPLORATION -de I-EXPLORATION -Russell I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior, I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -bacilos I-EXPLORATION -Helicobacter I-EXPLORATION -pylori I-EXPLORATION -(HP) I-EXPLORATION -+++/+++. I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -de I-EXPLORATION -inmunohistoquímica I-EXPLORATION -con I-EXPLORATION -CD138 I-EXPLORATION -demostraron I-EXPLORATION -reactividad I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -citoplasmáticas I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -cadenas I-EXPLORATION -livianas I-EXPLORATION -de I-EXPLORATION -inmunoglobulinas I-EXPLORATION -Kappa I-EXPLORATION -y I-EXPLORATION -Lambda, I-EXPLORATION -confirmando I-EXPLORATION -el I-EXPLORATION -diagnostico I-EXPLORATION -de I-EXPLORATION -GCR. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -suministró I-TREATMENT -tratamiento I-TREATMENT -para I-TREATMENT -HP, I-TREATMENT -con I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -presentó I-TREATMENT -resolución I-TREATMENT -de I-TREATMENT -su I-TREATMENT -sintomatología. I-TREATMENT - I-TREATMENT -Se B-EVOLUTION -realizó I-EVOLUTION -control I-EVOLUTION -endoscópico I-EVOLUTION -e I-EVOLUTION -histopatológico I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -nueve I-EVOLUTION -meses I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -cual I-EVOLUTION -se I-EVOLUTION -evidenció I-EVOLUTION -marcada I-EVOLUTION -mejoría I-EVOLUTION -con I-EVOLUTION -respecto I-EVOLUTION -a I-EVOLUTION -estudio I-EVOLUTION -previo. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -2007 I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -presentación I-PRESENT_ILLNESS -episódica. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -único I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -crónico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cannabis I-PAST_MEDICAL_HISTORY -inhalado I-PAST_MEDICAL_HISTORY -(10-15 I-PAST_MEDICAL_HISTORY -porros I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -día). I-PAST_MEDICAL_HISTORY -Mediante B-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -abdominal I-EXPLORATION -es I-EXPLORATION -diagnosticado I-EXPLORATION -de I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -pinza I-EXPLORATION -aortomesentérica I-EXPLORATION -tanto I-EXPLORATION -sobre I-EXPLORATION -la I-EXPLORATION -tercera I-EXPLORATION -porción I-EXPLORATION -duodenal I-EXPLORATION -como I-EXPLORATION -sobre I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -renal I-EXPLORATION -izquierda I-EXPLORATION -que B-TREATMENT -no I-TREATMENT -mejora I-TREATMENT -con I-TREATMENT -la I-TREATMENT -ganancia I-TREATMENT -ponderal, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -(duodeno-yeyunostomía I-TREATMENT -en I-TREATMENT -septiembre I-TREATMENT -de I-TREATMENT -2009). I-TREATMENT -Posteriormente B-EVOLUTION -los I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -continúan I-EVOLUTION -sin I-EVOLUTION -cambios I-EVOLUTION -pese I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -resolución I-EVOLUTION -radiológica I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -alteraciones I-EVOLUTION -anatómicas. I-EVOLUTION -En B-EXPLORATION -el I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -crisis I-EXPLORATION -de I-EXPLORATION -dolor I-EXPLORATION -con I-EXPLORATION -asistencia I-EXPLORATION -a I-EXPLORATION -Urgencias I-EXPLORATION -se I-EXPLORATION -objetivan I-EXPLORATION -ecográficamente I-EXPLORATION -varias I-EXPLORATION -invaginaciones I-EXPLORATION -intestinales I-EXPLORATION -en I-EXPLORATION -diferentes I-EXPLORATION -localizaciones I-EXPLORATION -del I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -resuelven I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -conservadora. I-EXPLORATION -En I-EXPLORATION -otras I-EXPLORATION -múltiples I-EXPLORATION -exploraciones I-EXPLORATION -realizadas I-EXPLORATION -en I-EXPLORATION -periodos I-EXPLORATION -asintomáticos I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -patología I-EXPLORATION -intestinal I-EXPLORATION -que I-EXPLORATION -justifique I-EXPLORATION -el I-EXPLORATION -cuadro. I-EXPLORATION -Durante B-EVOLUTION -el I-EVOLUTION -seguimiento I-EVOLUTION -en I-EVOLUTION -consultas, I-EVOLUTION -y I-EVOLUTION -coincidiendo I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -abandono I-EVOLUTION -del I-EVOLUTION -consumo I-EVOLUTION -de I-EVOLUTION -cannabis, I-EVOLUTION -los I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -y I-EVOLUTION -vómitos I-EVOLUTION -desaparecen I-EVOLUTION -por I-EVOLUTION -completo, I-EVOLUTION -pudiendo I-EVOLUTION -ser I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -tras I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -completamente I-EVOLUTION -asintomático. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -47 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -diagnosticado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -adenocarcinoma I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vejiga, I-PRESENT_ILLNESS -tratado I-PRESENT_ILLNESS -mediante I-PRESENT_ILLNESS -derivación I-PRESENT_ILLNESS -intestinal I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -Mainz I-PRESENT_ILLNESS -II. I-PRESENT_ILLNESS -Durante B-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -una I-TREATMENT -colonoscopia I-TREATMENT -posterior, I-TREATMENT -se I-TREATMENT -extirparon I-TREATMENT -dos I-TREATMENT -lesiones I-TREATMENT -polipoides I-TREATMENT -sesiles, I-TREATMENT -que I-TREATMENT -resultaron I-TREATMENT -ser I-TREATMENT -granulomas I-TREATMENT -de I-TREATMENT -la I-TREATMENT -ureterosigmoidostomía. I-TREATMENT -En B-EVOLUTION -los I-EVOLUTION -controles I-EVOLUTION -posteriores I-EVOLUTION -apareció I-EVOLUTION -una I-EVOLUTION -dilatación I-EVOLUTION -ureteral I-EVOLUTION -y I-EVOLUTION -estenosis I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -anastomosis I-EVOLUTION -del I-EVOLUTION -uréter I-EVOLUTION -izquierdo I-EVOLUTION -a I-EVOLUTION -consecuencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cicatrización I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -"polipectomía". I-EVOLUTION -Se B-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -un I-TREATMENT -tratamiento I-TREATMENT -combinado I-TREATMENT -uro-endoscópico I-TREATMENT -en I-TREATMENT -quirófano I-TREATMENT -y I-TREATMENT -radioguiado: I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -una I-TREATMENT -nefrostomía I-TREATMENT -izquierda, I-TREATMENT -se I-TREATMENT -pasó I-TREATMENT -una I-TREATMENT -guía I-TREATMENT -radio-opaca I-TREATMENT -que I-TREATMENT -atravesó I-TREATMENT -el I-TREATMENT -estoma I-TREATMENT -estenosado I-TREATMENT -y I-TREATMENT -apareció I-TREATMENT -en I-TREATMENT -sigma. I-TREATMENT -Por I-TREATMENT -endoscopia, I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -guía, I-TREATMENT -se I-TREATMENT -aplicó I-TREATMENT -un I-TREATMENT -balón I-TREATMENT -de I-TREATMENT -dilatación I-TREATMENT -de I-TREATMENT -6 I-TREATMENT -mm I-TREATMENT -Ø, I-TREATMENT -sin I-TREATMENT -conseguir I-TREATMENT -un I-TREATMENT -aumento I-TREATMENT -significativo I-TREATMENT -del I-TREATMENT -calibre I-TREATMENT -de I-TREATMENT -la I-TREATMENT -misma. I-TREATMENT -Finalmente, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -ampliar I-TREATMENT -la I-TREATMENT -estenosis I-TREATMENT -utilizando I-TREATMENT -un I-TREATMENT -esfinterótomo I-TREATMENT -convencional, I-TREATMENT -con I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -consiguió I-TREATMENT -una I-TREATMENT -apertura I-TREATMENT -significativa I-TREATMENT -de I-TREATMENT -la I-TREATMENT -anastomosis I-TREATMENT -comprobando I-TREATMENT -débito I-TREATMENT -de I-TREATMENT -suero I-TREATMENT -salino. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -muy I-EVOLUTION -satisfactoria. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -diaforesis I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -ingesta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -g I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hachís I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -transporte I-PRESENT_ILLNESS -ilegal, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -custodiado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Policía I-PRESENT_ILLNESS -Nacional I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -toda I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -estancia I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hospital. I-PRESENT_ILLNESS -En B-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -dos I-EXPLORATION -cuerpos I-EXPLORATION -extraños I-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -íleon, I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -obstrucción I-EXPLORATION -mecánica I-EXPLORATION -sin I-EXPLORATION -perforación, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -expulsaron I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -espontánea I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -24 I-EXPLORATION -horas, I-EXPLORATION -confirmándose I-EXPLORATION -su I-EXPLORATION -naturaleza I-EXPLORATION -tras I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -específico. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -TC I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -48 I-EXPLORATION -horas I-EXPLORATION -se I-EXPLORATION -describía I-EXPLORATION -otro I-EXPLORATION -cuerpo I-EXPLORATION -extraño I-EXPLORATION -en I-EXPLORATION -antro I-EXPLORATION -gástrico, I-EXPLORATION -no I-EXPLORATION -objetivado I-EXPLORATION -previamente, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -endoscopia I-TREATMENT -oral I-TREATMENT -con I-TREATMENT -extracción I-TREATMENT -mediante I-TREATMENT -cesta I-TREATMENT -de I-TREATMENT -Dormia I-TREATMENT -de I-TREATMENT -un I-TREATMENT -tercer I-TREATMENT -paquete I-TREATMENT -de I-TREATMENT -4 I-TREATMENT -cm, I-TREATMENT -morfología I-TREATMENT -redondeada I-TREATMENT -y I-TREATMENT -consistencia I-TREATMENT -semidura. I-TREATMENT -El B-EVOLUTION -procedimiento I-EVOLUTION -se I-EVOLUTION -llevó I-EVOLUTION -a I-EVOLUTION -cabo I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION -bajo I-EVOLUTION -sedación I-EVOLUTION -profunda I-EVOLUTION -por I-EVOLUTION -anestesista. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -trasplantado B-PAST_MEDICAL_HISTORY -hepático, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -inmunosupresor I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -esteroides I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tacrolimus, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -trasplante I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -intervenido I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -neoplasia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -colon I-PRESENT_ILLNESS -obstructiva I-PRESENT_ILLNESS -realizándose B-TREATMENT -resección. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -adenocarcinoma I-EXPLORATION -bien I-EXPLORATION -diferenciado I-EXPLORATION -con I-EXPLORATION -infiltración I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -perirrectal, I-EXPLORATION -sin I-EXPLORATION -afectación I-EXPLORATION -de I-EXPLORATION -márgenes I-EXPLORATION -quirúrgicos I-EXPLORATION -o I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -ganglios I-EXPLORATION -linfáticos. I-EXPLORATION -Tras B-TREATMENT -la I-TREATMENT -cirugía I-TREATMENT -se I-TREATMENT -modificó I-TREATMENT -la I-TREATMENT -inmunosupresión I-TREATMENT -introduciendo I-TREATMENT -everolimus. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -se I-EVOLUTION -detectaron I-EVOLUTION -metástasis I-EVOLUTION -hepáticas I-EVOLUTION -en I-EVOLUTION -segmentos I-EVOLUTION -IV I-EVOLUTION -y I-EVOLUTION -VII. I-EVOLUTION -Se B-TREATMENT -intervino I-TREATMENT -de I-TREATMENT -nuevo I-TREATMENT -realizando I-TREATMENT -una I-TREATMENT -hepatectomía I-TREATMENT -izquierda I-TREATMENT -y I-TREATMENT -una I-TREATMENT -ablación I-TREATMENT -por I-TREATMENT -microondas I-TREATMENT -de I-TREATMENT -la I-TREATMENT -metástasis I-TREATMENT -del I-TREATMENT -segmento I-TREATMENT -VII. I-TREATMENT -Tras B-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento, I-EVOLUTION -la I-EVOLUTION -enfermedad I-EVOLUTION -está I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -controlada. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -57 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -intervenida B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -adenocarcinoma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -colon, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -recidiva I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -carcinomatosis I-PAST_MEDICAL_HISTORY -peritoneal, I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -quimioterapia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cirugía, I-PAST_MEDICAL_HISTORY -utilizando I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -cierre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -pared I-PAST_MEDICAL_HISTORY -abdominal I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -malla I-PAST_MEDICAL_HISTORY -biológica I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Permacol™. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -2015, I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -nueva I-PRESENT_ILLNESS -recidiva I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -fondo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -saco I-PRESENT_ILLNESS -recto-vesical I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -infiltración I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -recto, I-PRESENT_ILLNESS -vejiga I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cúpula I-PRESENT_ILLNESS -vaginal, I-PRESENT_ILLNESS -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -exenteración I-TREATMENT -pélvica I-TREATMENT -con I-TREATMENT -reconstrucción I-TREATMENT -vaginal I-TREATMENT -y I-TREATMENT -derivación I-TREATMENT -urinaria I-TREATMENT -tipo I-TREATMENT -Bricker I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -la I-TREATMENT -malla. I-TREATMENT -Durante B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -se I-EVOLUTION -objetivó I-EVOLUTION -fístula I-EVOLUTION -urinaria I-EVOLUTION -del I-EVOLUTION -asa I-EVOLUTION -ileal, I-EVOLUTION -secundaria I-EVOLUTION -al I-EVOLUTION -decúbito I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -malla. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -endoscopia I-EXPLORATION -del I-EXPLORATION -asa I-EXPLORATION -del I-EXPLORATION -Bricker, I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -orificio I-EXPLORATION -fistuloso I-EXPLORATION -con I-EXPLORATION -fondo I-EXPLORATION -blanquecino I-EXPLORATION -a I-EXPLORATION -7 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -ileostomía I-EXPLORATION -correspondiente I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -malla, I-EXPLORATION -que I-EXPLORATION -ocupaba I-EXPLORATION -el I-EXPLORATION -50% I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -circunferencia. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -colocación I-TREATMENT -endoscópica I-TREATMENT -de I-TREATMENT -una I-TREATMENT -prótesis I-TREATMENT -metálica I-TREATMENT -cubierta I-TREATMENT -(Hanarostent® I-TREATMENT -Colon/Rectum) I-TREATMENT -de I-TREATMENT -100 I-TREATMENT -mm I-TREATMENT -x I-TREATMENT -20 I-TREATMENT -mm, I-TREATMENT -que I-TREATMENT -se I-TREATMENT -retiró I-TREATMENT -sin I-TREATMENT -incidencias I-TREATMENT -tras I-TREATMENT -12 I-TREATMENT -semanas, I-TREATMENT -objetivándose I-TREATMENT -resolución I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fístula. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -permanencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -prótesis I-EVOLUTION -fue I-EVOLUTION -más I-EVOLUTION -prolongada I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -recomendada, I-EVOLUTION -dada I-EVOLUTION -nuestra I-EVOLUTION -experiencia I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -tamaño I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -fístula. I-EVOLUTION -A I-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -posibilidad I-EVOLUTION -de I-EVOLUTION -recidiva I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -malla, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -mantiene I-EVOLUTION -sin I-EVOLUTION -recurrencia, I-EVOLUTION -probablemente I-EVOLUTION -por I-EVOLUTION -formación I-EVOLUTION -de I-EVOLUTION -tejido I-EVOLUTION -fibroso I-EVOLUTION -perifístula. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -dislipemia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -suprarrenalectomía I-PAST_MEDICAL_HISTORY -bilateral I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -hipertrofia I-PAST_MEDICAL_HISTORY -macronodular I-PAST_MEDICAL_HISTORY -bilateral I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -glándulas I-PAST_MEDICAL_HISTORY -suprarrenales. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -losartán I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hidroclorotiazida, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -sustitutivo I-PAST_MEDICAL_HISTORY -hormonal, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hidrocortisona I-PAST_MEDICAL_HISTORY -30 I-PAST_MEDICAL_HISTORY -mg/24 I-PAST_MEDICAL_HISTORY -horas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fludrocortisona I-PAST_MEDICAL_HISTORY -0, I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -mg/24 I-PAST_MEDICAL_HISTORY -horas. I-PAST_MEDICAL_HISTORY -Presenta B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nueve I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pancreatitis I-PRESENT_ILLNESS -aguda I-PRESENT_ILLNESS -recidivante, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -manifiesta I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -agudos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -intensidad I-PRESENT_ILLNESS -leve I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -autolimitan I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -4-5 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dieta I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -analgésico. I-PRESENT_ILLNESS -Durante B-EXPLORATION -su I-EXPLORATION -primer I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -analítica I-EXPLORATION -con I-EXPLORATION -perfil I-EXPLORATION -hepático I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -perfil I-EXPLORATION -lipídico I-EXPLORATION -con I-EXPLORATION -leve I-EXPLORATION -elevación I-EXPLORATION -del I-EXPLORATION -colesterol I-EXPLORATION -(225 I-EXPLORATION -mg/dL) I-EXPLORATION -y I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -TG I-EXPLORATION -normales, I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -colangio-RMN, I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -objetivan I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar, I-EXPLORATION -colelitiasis I-EXPLORATION -ni I-EXPLORATION -lesiones I-EXPLORATION -pancreáticas I-EXPLORATION -o I-EXPLORATION -biliares, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -cataloga I-EXPLORATION -de I-EXPLORATION -pancreatitis I-EXPLORATION -aguda I-EXPLORATION -idiopática. I-EXPLORATION -Posteriormente I-EXPLORATION -presenta I-EXPLORATION -nuevos I-EXPLORATION -episodios I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -periodicidad I-EXPLORATION -de I-EXPLORATION -entre I-EXPLORATION -siete I-EXPLORATION -meses I-EXPLORATION -y I-EXPLORATION -tres I-EXPLORATION -años, I-EXPLORATION -realizándose I-EXPLORATION -en I-EXPLORATION -este I-EXPLORATION -tiempo I-EXPLORATION -estudios I-EXPLORATION -analíticos I-EXPLORATION -que I-EXPLORATION -son I-EXPLORATION -normales I-EXPLORATION -y I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION -que I-EXPLORATION -incluyen I-EXPLORATION -ecografía I-EXPLORATION -abdominal, I-EXPLORATION -colangio-RMN, I-EXPLORATION -TC I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -ecoendoscopia I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -identifica I-EXPLORATION -la I-EXPLORATION -causa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pancreatitis. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -últimos I-EXPLORATION -dos I-EXPLORATION -años I-EXPLORATION -la I-EXPLORATION -periodicidad I-EXPLORATION -se I-EXPLORATION -reduce, I-EXPLORATION -con I-EXPLORATION -episodios I-EXPLORATION -cada I-EXPLORATION -6-7 I-EXPLORATION -meses, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -repite I-EXPLORATION -nuevamente I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -estudio, I-EXPLORATION -objetivándose I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -colangio-RMN I-EXPLORATION -realizada I-EXPLORATION -un I-EXPLORATION -remanente I-EXPLORATION -de I-EXPLORATION -glándula I-EXPLORATION -suprarrenal I-EXPLORATION -que I-EXPLORATION -plantea I-EXPLORATION -el I-EXPLORATION -posible I-EXPLORATION -origen I-EXPLORATION -tóxico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pancreatitis, I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION -corticoterapia I-EXPLORATION -crónica I-EXPLORATION -e I-EXPLORATION -hiperproducción I-EXPLORATION -endógena I-EXPLORATION -de I-EXPLORATION -corticoides. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -analítica I-EXPLORATION -con I-EXPLORATION -estudio I-EXPLORATION -hormonal I-EXPLORATION -con I-EXPLORATION -cifras I-EXPLORATION -de I-EXPLORATION -cortisol I-EXPLORATION -de I-EXPLORATION -25, I-EXPLORATION -7 I-EXPLORATION -mcg/dL, I-EXPLORATION -ACTH I-EXPLORATION -y I-EXPLORATION -cortisol I-EXPLORATION -en I-EXPLORATION -orina I-EXPLORATION -de I-EXPLORATION -24 I-EXPLORATION -horas I-EXPLORATION -normales, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -reduce I-EXPLORATION -la I-EXPLORATION -dosis I-EXPLORATION -de I-EXPLORATION -corticoterapia I-EXPLORATION -sustitutiva I-EXPLORATION -a I-EXPLORATION -hidrocortisona I-EXPLORATION -10 I-EXPLORATION -mg I-EXPLORATION -al I-EXPLORATION -día, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -van I-EXPLORATION -reduciendo I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -progresiva I-EXPLORATION -hasta I-EXPLORATION -su I-EXPLORATION -suspensión. I-EXPLORATION -Además, B-TREATMENT -ante I-TREATMENT -la I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -origen I-TREATMENT -farmacológico I-TREATMENT -se I-TREATMENT -cambia I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antihipertensivo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -asociación I-TREATMENT -de I-TREATMENT -losartán I-TREATMENT -e I-TREATMENT -hidroclorotiazida I-TREATMENT -a I-TREATMENT -ramipril I-TREATMENT -en I-TREATMENT -monoterapia. I-TREATMENT -Se B-EXPLORATION -completa I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -etiológico I-EXPLORATION -con I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -IG4 I-EXPLORATION -y I-EXPLORATION -ANA I-EXPLORATION -que I-EXPLORATION -son I-EXPLORATION -normales, I-EXPLORATION -test I-EXPLORATION -del I-EXPLORATION -sudor I-EXPLORATION -y I-EXPLORATION -test I-EXPLORATION -genético I-EXPLORATION -para I-EXPLORATION -fibrosis I-EXPLORATION -quística I-EXPLORATION -que I-EXPLORATION -son I-EXPLORATION -negativos. I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -modificación I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -vuelve I-EVOLUTION -a I-EVOLUTION -ingresar I-EVOLUTION -por I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -pancreatitis I-EVOLUTION -aguda I-EVOLUTION -leve. I-EVOLUTION -Se I-EVOLUTION -interroga I-EVOLUTION -nuevamente I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -paciente, I-EVOLUTION -quien I-EVOLUTION -finalmente I-EVOLUTION -refiere I-EVOLUTION -consumir I-EVOLUTION -infusiones I-EVOLUTION -de I-EVOLUTION -cola I-EVOLUTION -de I-EVOLUTION -caballo I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -habitual. I-EVOLUTION -Ante I-EVOLUTION -la I-EVOLUTION -posibilidad I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -pancreatitis I-EVOLUTION -recidivante I-EVOLUTION -secundaria I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -toma I-EVOLUTION -de I-EVOLUTION -esta I-EVOLUTION -infusión, I-EVOLUTION -se I-EVOLUTION -suspende I-EVOLUTION -por I-EVOLUTION -completo I-EVOLUTION -la I-EVOLUTION -misma. I-EVOLUTION -Desde I-EVOLUTION -entonces, I-EVOLUTION -14 I-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -mantenido I-EVOLUTION -asintomática I-EVOLUTION -con I-EVOLUTION -controles I-EVOLUTION -ecográficos I-EVOLUTION -normales. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -casos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pseudodiverticulosis I-PRESENT_ILLNESS -yeyunal I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -debutaron I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -abdomen I-PRESENT_ILLNESS -agudo. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -primero I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ellos, I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -75 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -obstrucción I-PRESENT_ILLNESS -intestinal. I-PRESENT_ILLNESS -El B-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -sugiere I-EXPLORATION -brida I-EXPLORATION -o I-EXPLORATION -hernia I-EXPLORATION -interna, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -cirugía. I-EXPLORATION -En B-PRESENT_ILLNESS -segundo I-PRESENT_ILLNESS -lugar, I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -90 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -El B-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -no I-EXPLORATION -objetiva I-EXPLORATION -causa I-EXPLORATION -obstructiva. I-EXPLORATION -Tras B-TREATMENT -24 I-TREATMENT -horas I-TREATMENT -de I-TREATMENT -manejo I-TREATMENT -conservador I-TREATMENT -sufre I-TREATMENT -empeoramiento. I-TREATMENT -Se I-TREATMENT -objetiva I-TREATMENT -neumoperitoneo I-TREATMENT -en I-TREATMENT -TC I-TREATMENT -abdominal, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -cirugía. I-TREATMENT -Por B-PRESENT_ILLNESS -último, I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -75 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal. I-PRESENT_ILLNESS -El B-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -informa I-EXPLORATION -perforación I-EXPLORATION -de I-EXPLORATION -divertículo I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -es I-TREATMENT -llevado I-TREATMENT -a I-TREATMENT -quirófano. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -los I-EXPLORATION -dos I-EXPLORATION -primeros I-EXPLORATION -casos I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -una I-EXPLORATION -causa I-EXPLORATION -obstructiva I-EXPLORATION -en I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -pseudodivertículos I-EXPLORATION -yeyunales I-EXPLORATION -proximalmente; I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -segundo I-EXPLORATION -y I-EXPLORATION -tercer I-EXPLORATION -caso, I-EXPLORATION -con I-EXPLORATION -perforación I-EXPLORATION -de I-EXPLORATION -uno I-EXPLORATION -de I-EXPLORATION -estos. I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -resección I-TREATMENT -intestinal I-TREATMENT -del I-TREATMENT -segmento I-TREATMENT -afecto I-TREATMENT -y I-TREATMENT -anastomosis I-TREATMENT -primaria. I-TREATMENT -El B-EVOLUTION -postoperatorio I-EVOLUTION -cursó I-EVOLUTION -sin I-EVOLUTION -incidencias. I-EVOLUTION -El B-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION -confirma I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -falsos I-EXPLORATION -divertículos I-EXPLORATION -en I-EXPLORATION -yeyuno, I-EXPLORATION -en I-EXPLORATION -dos I-EXPLORATION -casos I-EXPLORATION -perforados, I-EXPLORATION -sin I-EXPLORATION -datos I-EXPLORATION -de I-EXPLORATION -malignidad. I-EXPLORATION - I-EXPLORATION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -diagnosticado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cirrosis I-PRESENT_ILLNESS -hepática I-PRESENT_ILLNESS -secundaria I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -infección I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -VHC I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -seguimiento I-PRESENT_ILLNESS -estrecho I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -consultas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Hepatología I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -2000. I-PRESENT_ILLNESS -Estaba B-PAST_MEDICAL_HISTORY -infectado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -genotipo I-PAST_MEDICAL_HISTORY -1b I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -recibido I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -antiviral I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -pasado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -rechazo I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -parte I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -recibir I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -interferón. I-PAST_MEDICAL_HISTORY -Entre I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -relevantes I-PAST_MEDICAL_HISTORY -destacaba I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -intervención I-PAST_MEDICAL_HISTORY -quirúrgica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -ductus I-PAST_MEDICAL_HISTORY -arterioso I-PAST_MEDICAL_HISTORY -persistente, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -fibrilación I-PAST_MEDICAL_HISTORY -auricular I-PAST_MEDICAL_HISTORY -paroxística, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -colocación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -stents I-PAST_MEDICAL_HISTORY -coronarios I-PAST_MEDICAL_HISTORY -convencionales I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2004 I-PAST_MEDICAL_HISTORY -indicados I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -isquémica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -recambio I-PAST_MEDICAL_HISTORY -valvular I-PAST_MEDICAL_HISTORY -aórtico I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2013 I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -prótesis I-PAST_MEDICAL_HISTORY -metálica, I-PAST_MEDICAL_HISTORY -requiriendo I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -entonces I-PAST_MEDICAL_HISTORY -anticoagulación I-PAST_MEDICAL_HISTORY -oral I-PAST_MEDICAL_HISTORY -(Eliquis®). I-PAST_MEDICAL_HISTORY -Además, I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -presentado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2007 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -2013 I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -accidentes I-PAST_MEDICAL_HISTORY -cerebrovasculares I-PAST_MEDICAL_HISTORY -agudos I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -secuelas I-PAST_MEDICAL_HISTORY -posteriores I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -obstructiva I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -afectación I-PAST_MEDICAL_HISTORY -moderada. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -mayo I-EXPLORATION -de I-EXPLORATION -2014, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -contexto I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -prueba I-EXPLORATION -de I-EXPLORATION -cribado I-EXPLORATION -de I-EXPLORATION -hepatocarcinoma, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -hepática I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -de I-EXPLORATION -25 I-EXPLORATION -x I-EXPLORATION -17 I-EXPLORATION -milímetros I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -segmento I-EXPLORATION -VI I-EXPLORATION -hepático I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -hepatocelular. I-EXPLORATION -Se B-TREATMENT -optó I-TREATMENT -por I-TREATMENT -realizar I-TREATMENT -ablación I-TREATMENT -mediante I-TREATMENT -radiofrecuencia I-TREATMENT -como I-TREATMENT -tratamiento, I-TREATMENT -lográndose I-TREATMENT -respuesta I-TREATMENT -completa I-TREATMENT -radiológica I-TREATMENT -en I-TREATMENT -la I-TREATMENT -resonancia I-TREATMENT -magnética I-TREATMENT -realizada I-TREATMENT -cuatro I-TREATMENT -semanas I-TREATMENT -tras I-TREATMENT -el I-TREATMENT -tratamiento. I-TREATMENT -Se B-EVOLUTION -sometió I-EVOLUTION -al I-EVOLUTION -paciente I-EVOLUTION -a I-EVOLUTION -continuación I-EVOLUTION -a I-EVOLUTION -seguimiento I-EVOLUTION -clínico I-EVOLUTION -y I-EVOLUTION -radiológico I-EVOLUTION -realizando I-EVOLUTION -pruebas I-EVOLUTION -de I-EVOLUTION -imagen I-EVOLUTION -cada I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -sin I-EVOLUTION -objetivarse I-EVOLUTION -recidiva I-EVOLUTION -tumoral. I-EVOLUTION -En B-TREATMENT -mayo I-TREATMENT -de I-TREATMENT -2015, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -comenzó I-TREATMENT -tratamiento I-TREATMENT -antiviral I-TREATMENT -con I-TREATMENT -ledipasvir/sofosbuvir I-TREATMENT -90/400 I-TREATMENT -mg I-TREATMENT -(Harvoni®) I-TREATMENT -una I-TREATMENT -vez I-TREATMENT -al I-TREATMENT -día I-TREATMENT -durante I-TREATMENT -12 I-TREATMENT -semanas, I-TREATMENT -tras I-TREATMENT -documentarse I-TREATMENT -la I-TREATMENT -ausencia I-TREATMENT -de I-TREATMENT -enfermedad I-TREATMENT -tumoral I-TREATMENT -mediante I-TREATMENT -una I-TREATMENT -resonancia I-TREATMENT -magnética I-TREATMENT -hepática I-TREATMENT -dos I-TREATMENT -días I-TREATMENT -antes I-TREATMENT -de I-TREATMENT -empezar I-TREATMENT -el I-TREATMENT -tratamiento. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -finalizó I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -eventos I-EVOLUTION -adversos I-EVOLUTION -ni I-EVOLUTION -complicaciones I-EVOLUTION -y I-EVOLUTION -logrando I-EVOLUTION -alcanzar I-EVOLUTION -respuesta I-EVOLUTION -virológica I-EVOLUTION -sostenida I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -12 I-EVOLUTION -y I-EVOLUTION -24 I-EVOLUTION -semanas I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -finalizar I-EVOLUTION -el I-EVOLUTION -tratamiento. I-EVOLUTION - I-EVOLUTION -En B-EXPLORATION -octubre I-EXPLORATION -de I-EXPLORATION -2015 I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -hepática I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -el I-EXPLORATION -área I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -hepático I-EXPLORATION -tratado I-EXPLORATION -con I-EXPLORATION -radiofrecuencia I-EXPLORATION -sin I-EXPLORATION -captación I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -otros I-EXPLORATION -datos I-EXPLORATION -que I-EXPLORATION -orientaran I-EXPLORATION -a I-EXPLORATION -recidiva I-EXPLORATION -tumoral. I-EXPLORATION -No I-EXPLORATION -obstante, I-EXPLORATION -tres I-EXPLORATION -meses I-EXPLORATION -después I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -resonancia I-EXPLORATION -magnética, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -aparecieron I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -hipointensas I-EXPLORATION -en I-EXPLORATION -T1 I-EXPLORATION -y I-EXPLORATION -ligeramente I-EXPLORATION -hiperintensas I-EXPLORATION -en I-EXPLORATION -T2 I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -tamaño I-EXPLORATION -a I-EXPLORATION -lo I-EXPLORATION -largo I-EXPLORATION -de I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -parénquima I-EXPLORATION -hepático, I-EXPLORATION -algunas I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -cuales I-EXPLORATION -presentaban I-EXPLORATION -realce I-EXPLORATION -periférico I-EXPLORATION -en I-EXPLORATION -anillo, I-EXPLORATION -siendo I-EXPLORATION -sugerentes I-EXPLORATION -como I-EXPLORATION -primera I-EXPLORATION -posibilidad I-EXPLORATION -de I-EXPLORATION -metástasis I-EXPLORATION -hepáticas. I-EXPLORATION -La I-EXPLORATION -zona I-EXPLORATION -del I-EXPLORATION -segmento I-EXPLORATION -VI I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -había I-EXPLORATION -aplicado I-EXPLORATION -radiofrecuencia I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -pasado I-EXPLORATION -se I-EXPLORATION -mantenía I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -radiológicos I-EXPLORATION -de I-EXPLORATION -recidiva I-EXPLORATION -tumoral. I-EXPLORATION -En I-EXPLORATION -ese I-EXPLORATION -momento, I-EXPLORATION -la I-EXPLORATION -hipótesis I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -posible I-EXPLORATION -recidiva I-EXPLORATION -tumoral I-EXPLORATION -de I-EXPLORATION -comportamiento I-EXPLORATION -agresivo I-EXPLORATION -del I-EXPLORATION -hepatocarcinoma I-EXPLORATION -previo I-EXPLORATION -era I-EXPLORATION -uno I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -diagnósticos I-EXPLORATION -más I-EXPLORATION -probables, I-EXPLORATION -aunque I-EXPLORATION -el I-EXPLORATION -comportamiento I-EXPLORATION -radiológico I-EXPLORATION -también I-EXPLORATION -hacía I-EXPLORATION -sospechar I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -tratara I-EXPLORATION -de I-EXPLORATION -metástasis I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -primario I-EXPLORATION -no I-EXPLORATION -conocido I-EXPLORATION -y I-EXPLORATION -originado I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -extrahepático. I-EXPLORATION -Por I-EXPLORATION -ello, I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -punción-aspiración I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -hepáticas I-EXPLORATION -para I-EXPLORATION -análisis I-EXPLORATION -citológico, I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -mostró I-EXPLORATION -células I-EXPLORATION -metastásicas I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -carcinoma I-EXPLORATION -neuroendocrino I-EXPLORATION -de I-EXPLORATION -célula I-EXPLORATION -pequeña I-EXPLORATION -(CD56+; I-EXPLORATION -sinaptofisina+ I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico). I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -a I-EXPLORATION -continuación I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -cérvico-tóraco-abdominal I-EXPLORATION -para I-EXPLORATION -completar I-EXPLORATION -el I-EXPLORATION -estudio, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -visualizaron I-EXPLORATION -lesiones I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -cuerpos I-EXPLORATION -vertebrales I-EXPLORATION -dorsales I-EXPLORATION -y I-EXPLORATION -lumbosacros, I-EXPLORATION -siendo I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -metastásica. I-EXPLORATION -La I-EXPLORATION -gammagrafía I-EXPLORATION -ósea I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -realizadas I-EXPLORATION -posteriormente I-EXPLORATION -confirmaron I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tomografía. I-EXPLORATION - I-EXPLORATION -Hasta I-EXPLORATION -la I-EXPLORATION -fecha, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -ha I-EXPLORATION -logrado I-EXPLORATION -encontrar I-EXPLORATION -la I-EXPLORATION -localización I-EXPLORATION -primaria I-EXPLORATION -del I-EXPLORATION -tumor, I-EXPLORATION -si I-EXPLORATION -bien I-EXPLORATION -la I-EXPLORATION -hipótesis I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -carcinoma I-EXPLORATION -microcítico I-EXPLORATION -de I-EXPLORATION -pulmón I-EXPLORATION -con I-EXPLORATION -afectación I-EXPLORATION -metastásica I-EXPLORATION -es I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -más I-EXPLORATION -probable. I-EXPLORATION -En B-TREATMENT -el I-TREATMENT -momento I-TREATMENT -actual I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -está I-TREATMENT -recibiendo I-TREATMENT -quimioterapia I-TREATMENT -basada I-TREATMENT -en I-TREATMENT -un I-TREATMENT -régimen I-TREATMENT -consistente I-TREATMENT -en I-TREATMENT -carboplatino I-TREATMENT -y I-TREATMENT -etopósido I-TREATMENT -y I-TREATMENT -ha I-TREATMENT -recibido I-TREATMENT -radioterapia I-TREATMENT -paliativa I-TREATMENT -para I-TREATMENT -control I-TREATMENT -del I-TREATMENT -dolor I-TREATMENT -secundario I-TREATMENT -a I-TREATMENT -las I-TREATMENT -metástasis I-TREATMENT -óseas I-TREATMENT -de I-TREATMENT -columna, I-TREATMENT -presentando I-TREATMENT -buena I-TREATMENT -respuesta I-TREATMENT -clínica. I-TREATMENT -En B-EXPLORATION -la I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -tóraco-abdominal I-EXPLORATION -realizada I-EXPLORATION -seis I-EXPLORATION -meses I-EXPLORATION -después I-EXPLORATION -de I-EXPLORATION -comenzar I-EXPLORATION -el I-EXPLORATION -tratamiento I-EXPLORATION -quimioterápico I-EXPLORATION -han I-EXPLORATION -desaparecido I-EXPLORATION -la I-EXPLORATION -mayoría I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -hepáticas I-EXPLORATION -y I-EXPLORATION -óseas I-EXPLORATION -metastásicas, I-EXPLORATION -persistiendo I-EXPLORATION -solo I-EXPLORATION -algunos I-EXPLORATION -nódulos I-EXPLORATION -milimétricos I-EXPLORATION -hepáticos. I-EXPLORATION -Dada B-EVOLUTION -la I-EVOLUTION -buena I-EVOLUTION -respuesta, I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -reiniciado I-EVOLUTION -un I-EVOLUTION -nuevo I-EVOLUTION -ciclo I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -oncológico I-EVOLUTION -cuyos I-EVOLUTION -resultados I-EVOLUTION -serán I-EVOLUTION -evaluados I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -futuro I-EVOLUTION -próximo. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -85 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -colelitiasis I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -espalda, I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -hematoquecia. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -leucocitosis I-EXPLORATION -(14.300, I-EXPLORATION -neutrófilos I-EXPLORATION -84, I-EXPLORATION -5%), I-EXPLORATION -hemoglobina I-EXPLORATION -7 I-EXPLORATION -g/dl, I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -179 I-EXPLORATION -mg/l, I-EXPLORATION -amilasa I-EXPLORATION -648 I-EXPLORATION -U/l, I-EXPLORATION -lipasa I-EXPLORATION -1.417 I-EXPLORATION -U/l I-EXPLORATION -y I-EXPLORATION -patrón I-EXPLORATION -colestático. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -vesicular, I-EXPLORATION -con I-EXPLORATION -colelitiasis I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -proceso I-EXPLORATION -inflamatorio I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cola I-EXPLORATION -pancreática. I-EXPLORATION -Dado I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -HDA I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -anemia I-EXPLORATION -continuaron, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -angio-TC I-EXPLORATION -abdominal, I-EXPLORATION -visualizándose I-EXPLORATION -una I-EXPLORATION -estructura I-EXPLORATION -de I-EXPLORATION -contornos I-EXPLORATION -lobulados I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vesícula, I-EXPLORATION -hiperdensa I-EXPLORATION -en I-EXPLORATION -fase I-EXPLORATION -arterial, I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -cambiaba I-EXPLORATION -su I-EXPLORATION -morfología I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -venoso, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -pseudoaneurisma I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -cística. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -final I-EXPLORATION -fue I-EXPLORATION -el I-EXPLORATION -de I-EXPLORATION -pancreatitis I-EXPLORATION -aguda I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -hemobilia I-EXPLORATION -por I-EXPLORATION -sangrado I-EXPLORATION -de I-EXPLORATION -pseudoaneurisma I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -cística. I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -embolización I-TREATMENT -con B-EVOLUTION -recuperación I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente. I-EVOLUTION - I-EVOLUTION - -En B-PRESENT_ILLNESS -primer I-PRESENT_ILLNESS -lugar, I-PRESENT_ILLNESS -presentamos I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -17 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -retroesternal, I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -oC. I-PRESENT_ILLNESS -La B-EXPLORATION -endoscopia I-EXPLORATION -oral I-EXPLORATION -mostraba I-EXPLORATION -erosiones I-EXPLORATION -longitudinales I-EXPLORATION -profundas, I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -irregulares I-EXPLORATION -y I-EXPLORATION -sobreelevados, I-EXPLORATION -desde I-EXPLORATION -esófago I-EXPLORATION -medio I-EXPLORATION -hasta I-EXPLORATION -distal. I-EXPLORATION -Se B-TREATMENT -pautó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -aciclovir I-TREATMENT -por I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -EH I-TREATMENT -que I-TREATMENT -se I-TREATMENT -confirmó I-TREATMENT -histológicamente. I-TREATMENT -Además, B-EXPLORATION -el I-EXPLORATION -recuento I-EXPLORATION -de I-EXPLORATION -eosinófilos I-EXPLORATION -en I-EXPLORATION -esófago I-EXPLORATION -proximal I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -> I-EXPLORATION -15 I-EXPLORATION -por I-EXPLORATION -campo, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -EEo. I-EXPLORATION -La I-EXPLORATION -endoscopia I-EXPLORATION -de I-EXPLORATION -revisión I-EXPLORATION -al I-EXPLORATION -mes I-EXPLORATION -de I-EXPLORATION -finalizar I-EXPLORATION -el I-EXPLORATION -tratamiento I-EXPLORATION -mantenía I-EXPLORATION -signos I-EXPLORATION -endoscópicos I-EXPLORATION -e I-EXPLORATION -histológicos I-EXPLORATION -sugestivos I-EXPLORATION -de I-EXPLORATION -EEo I-EXPLORATION -sin I-EXPLORATION -aislarse I-EXPLORATION -VHS-I. I-EXPLORATION - I-EXPLORATION -Asimismo, B-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -asma, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -broncodilatador, I-PAST_MEDICAL_HISTORY -corticoideo I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -antibiótico, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -aguda I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -endoscopia I-EXPLORATION -oral I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -ulcerada I-EXPLORATION -longitudinal I-EXPLORATION -subcentimétrica I-EXPLORATION -en I-EXPLORATION -cardias, I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -presentaba I-EXPLORATION -inclusiones I-EXPLORATION -de I-EXPLORATION -Cowdry I-EXPLORATION -tipo I-EXPLORATION -A I-EXPLORATION -sugestivas I-EXPLORATION -de I-EXPLORATION -EH. I-EXPLORATION -Histológicamente, I-EXPLORATION -coexistían I-EXPLORATION -una I-EXPLORATION -candidiasis I-EXPLORATION -esofágica I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -EEo. I-EXPLORATION -A B-TREATMENT -las I-TREATMENT -ocho I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -finalizar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -fluconazol, I-TREATMENT -aciclovir I-TREATMENT -y I-TREATMENT -pantoprazol I-TREATMENT -habían B-EVOLUTION -desaparecido I-EVOLUTION -las I-EVOLUTION -alteraciones I-EVOLUTION -sugestivas I-EVOLUTION -de I-EVOLUTION -esofagitis I-EVOLUTION -infecciosa, I-EVOLUTION -persistiendo I-EVOLUTION -las I-EVOLUTION -compatibles I-EVOLUTION -con I-EVOLUTION -EEo. I-EVOLUTION - I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -inmunológico I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -pacientes. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -60 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresó I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -sugerente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -colangitis. I-PRESENT_ILLNESS -Durante B-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -colangio-RMN I-EXPLORATION -que I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -litiasis I-EXPLORATION -de I-EXPLORATION -7, I-EXPLORATION -7 I-EXPLORATION -mm I-EXPLORATION -enclavada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -colédoco, I-EXPLORATION -a I-EXPLORATION -unos I-EXPLORATION -4, I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -papila, I-EXPLORATION -con I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -intra I-EXPLORATION -y I-EXPLORATION -extrahepática. I-EXPLORATION -Ante I-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -realizar I-EXPLORATION -una I-EXPLORATION -CPRE I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -consiguió I-EXPLORATION -canular I-EXPLORATION -la I-EXPLORATION -papila I-EXPLORATION -de I-EXPLORATION -Vater. I-EXPLORATION -Dos I-EXPLORATION -días I-EXPLORATION -después, I-EXPLORATION -ante I-EXPLORATION -la I-EXPLORATION -persistencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -ictericia, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -CPRE I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -coágulo I-EXPLORATION -fresco I-EXPLORATION -cubriendo I-EXPLORATION -la I-EXPLORATION -papila. I-EXPLORATION -Tras I-EXPLORATION -retirarlo, I-EXPLORATION -se I-EXPLORATION -accedió I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar, I-EXPLORATION -observando I-EXPLORATION -el I-EXPLORATION -cálculo I-EXPLORATION -descrito I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -colangiorresonancia, I-EXPLORATION -que B-TREATMENT -fue I-TREATMENT -extraído I-TREATMENT -tras I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -esfinterotomía I-TREATMENT -biliar. I-TREATMENT -Finalmente, I-TREATMENT -se I-TREATMENT -inyectó I-TREATMENT -adrenalina I-TREATMENT -diluida I-TREATMENT -en I-TREATMENT -la I-TREATMENT -papila, I-TREATMENT -la I-TREATMENT -cual I-TREATMENT -continuaba I-TREATMENT -con I-TREATMENT -signos I-TREATMENT -de I-TREATMENT -hemorragia I-TREATMENT -reciente. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -siete I-EVOLUTION -días I-EVOLUTION -tras I-EVOLUTION -el I-EVOLUTION -alta, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -acudió I-EVOLUTION -de I-EVOLUTION -nuevo I-EVOLUTION -al I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Urgencias I-EVOLUTION -por I-EVOLUTION -fiebre, I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -y I-EVOLUTION -astenia I-EVOLUTION -intensa. I-EVOLUTION -Analíticamente, B-EXPLORATION -destacaba I-EXPLORATION -Hb I-EXPLORATION -8, I-EXPLORATION -6 I-EXPLORATION -g/dl, I-EXPLORATION -hematocrito I-EXPLORATION -(Hto) I-EXPLORATION -27, I-EXPLORATION -2%, I-EXPLORATION -leucocitos I-EXPLORATION -10.000 I-EXPLORATION -U/ml I-EXPLORATION -con I-EXPLORATION -68% I-EXPLORATION -de I-EXPLORATION -polimorfonucleares, I-EXPLORATION -plaquetas I-EXPLORATION -627.000 I-EXPLORATION -U/ml, I-EXPLORATION -y I-EXPLORATION -proteína I-EXPLORATION -C-reactiva I-EXPLORATION -(PCR) I-EXPLORATION -187, I-EXPLORATION -4 I-EXPLORATION -mg/l. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -ocupante I-EXPLORATION -del I-EXPLORATION -espacio I-EXPLORATION -(LOE) I-EXPLORATION -hepática I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -10 I-EXPLORATION -x I-EXPLORATION -6 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -segmento I-EXPLORATION -III, I-EXPLORATION -con I-EXPLORATION -características I-EXPLORATION -ecográficas I-EXPLORATION -de I-EXPLORATION -absceso. I-EXPLORATION -Se I-EXPLORATION -intentó I-EXPLORATION -el I-EXPLORATION -drenaje I-EXPLORATION -percutáneo, I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -fue I-EXPLORATION -posible I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -densidad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -del I-EXPLORATION -material I-EXPLORATION -obtenido I-EXPLORATION -se I-EXPLORATION -aisló I-EXPLORATION -Enterobacter I-EXPLORATION -cloacae. I-EXPLORATION - I-EXPLORATION -Una I-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -tras I-EXPLORATION -el I-EXPLORATION -tratamiento I-EXPLORATION -antibiótico I-EXPLORATION -mostró I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -descrita I-EXPLORATION -previamente, I-EXPLORATION -que I-EXPLORATION -correspondía I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -posible I-EXPLORATION -hematoma I-EXPLORATION -hepático. I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -persistencia I-TREATMENT -de I-TREATMENT -fiebre I-TREATMENT -elevada I-TREATMENT -se I-TREATMENT -colocó I-TREATMENT -un I-TREATMENT -catéter I-TREATMENT -de I-TREATMENT -drenaje I-TREATMENT -de I-TREATMENT -8 I-TREATMENT -Fr. I-TREATMENT - I-TREATMENT -Tras B-EVOLUTION -el I-EVOLUTION -drenaje, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -permaneció I-EVOLUTION -asintomática, I-EVOLUTION -apirética I-EVOLUTION -y I-EVOLUTION -hemodinámicamente I-EVOLUTION -estable. I-EVOLUTION -Se B-EXPLORATION -realizaron I-EXPLORATION -ecografías I-EXPLORATION -abdominales I-EXPLORATION -semanales I-EXPLORATION -para I-EXPLORATION -control I-EXPLORATION -evolutivo I-EXPLORATION -del I-EXPLORATION -hematoma I-EXPLORATION -que I-EXPLORATION -mostraron I-EXPLORATION -la I-EXPLORATION -disminución I-EXPLORATION -progresiva I-EXPLORATION -del I-EXPLORATION -mismo. I-EXPLORATION -Tras B-EVOLUTION -seis I-EVOLUTION -semanas, I-EVOLUTION -se I-EVOLUTION -retiró I-EVOLUTION -el I-EVOLUTION -drenaje I-EVOLUTION -sin I-EVOLUTION -observar I-EVOLUTION -complicaciones. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pancreatitis I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -calcificante I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -reagudizaciones I-PAST_MEDICAL_HISTORY -frecuentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -enólico. I-PAST_MEDICAL_HISTORY -Tras B-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -ingesta I-PRESENT_ILLNESS -abundante I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -alcohol I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -epigástrico I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -cinturón I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -aumenta I-PRESENT_ILLNESS -progresivamente. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -pálido, I-EXPLORATION -sudoroso I-EXPLORATION -y I-EXPLORATION -taquicárdico. I-EXPLORATION -Palpación I-EXPLORATION -abdominal I-EXPLORATION -dolorosa I-EXPLORATION -en I-EXPLORATION -epigastrio I-EXPLORATION -e I-EXPLORATION -hipocondrios. I-EXPLORATION -En I-EXPLORATION -estudio I-EXPLORATION -analítico I-EXPLORATION -destacan I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -7, I-EXPLORATION -8 I-EXPLORATION -g/dl, I-EXPLORATION -hematocrito I-EXPLORATION -del I-EXPLORATION -23, I-EXPLORATION -5% I-EXPLORATION -y I-EXPLORATION -amilasa I-EXPLORATION -aumentada I-EXPLORATION -(338 I-EXPLORATION -U/l). I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -ecografía I-EXPLORATION -y I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -abdominal I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -intravenoso I-EXPLORATION -en I-EXPLORATION -fases I-EXPLORATION -arterial I-EXPLORATION -tardía I-EXPLORATION -y I-EXPLORATION -portal I-EXPLORATION -que I-EXPLORATION -mostraron I-EXPLORATION -páncreas I-EXPLORATION -atrófico I-EXPLORATION -con I-EXPLORATION -calcificaciones I-EXPLORATION -dispersas, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -pseudoquiste I-EXPLORATION -en I-EXPLORATION -hilio I-EXPLORATION -esplénico, I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -cara I-EXPLORATION -visceral I-EXPLORATION -hacia I-EXPLORATION -el I-EXPLORATION -parénquima I-EXPLORATION -del I-EXPLORATION -bazo. I-EXPLORATION -Produce I-EXPLORATION -una I-EXPLORATION -sección I-EXPLORATION -del I-EXPLORATION -mismo I-EXPLORATION -que I-EXPLORATION -comunica I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -gran I-EXPLORATION -hematoma I-EXPLORATION -subcapsular. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -punción-drenaje I-TREATMENT -guiado I-TREATMENT -por I-TREATMENT -TC I-TREATMENT -del I-TREATMENT -hematoma I-TREATMENT -periesplénico, I-TREATMENT -evolucionando B-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -favorable. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -polivalvulopatía I-PAST_MEDICAL_HISTORY -reumática I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -epigastrio I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -hacia I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -espalda I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -cinturón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -ictericia, I-PRESENT_ILLNESS -coluria, I-PRESENT_ILLNESS -acolia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -(38, I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -oC). I-PRESENT_ILLNESS -En B-EXPLORATION -analítica I-EXPLORATION -muestra I-EXPLORATION -amilasa I-EXPLORATION -2.126 I-EXPLORATION -U/l, I-EXPLORATION -ALT I-EXPLORATION -124 I-EXPLORATION -U/l, I-EXPLORATION -AST I-EXPLORATION -169 I-EXPLORATION -U/l, I-EXPLORATION -GGT I-EXPLORATION -3.548 I-EXPLORATION -U/l, I-EXPLORATION -FA I-EXPLORATION -1.516 I-EXPLORATION -U/l, I-EXPLORATION -BrT I-EXPLORATION -12, I-EXPLORATION -2 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -BrD I-EXPLORATION -9, I-EXPLORATION -1 I-EXPLORATION -mg/dl. I-EXPLORATION -En I-EXPLORATION -ecografía I-EXPLORATION -y I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -evidencia I-EXPLORATION -colelitiasis I-EXPLORATION -con I-EXPLORATION -leve I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -(DVB) I-EXPLORATION -extrahepática I-EXPLORATION -y I-EXPLORATION -cambios I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -PAL. I-EXPLORATION -Ingresa B-TREATMENT -con I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -colangitis I-TREATMENT -aguda I-TREATMENT -y I-TREATMENT -PAL, I-TREATMENT -iniciándose I-TREATMENT -tratamiento I-TREATMENT -empírico I-TREATMENT -con I-TREATMENT -piperazilina-tazobactam. I-TREATMENT -Al B-EVOLUTION -segundo I-EVOLUTION -día I-EVOLUTION -aparecen I-EVOLUTION -en I-EVOLUTION -ambas I-EVOLUTION -piernas I-EVOLUTION -nódulos I-EVOLUTION -subcutáneos I-EVOLUTION -dolorosos I-EVOLUTION -y I-EVOLUTION -eritematosos, I-EVOLUTION -compatibles I-EVOLUTION -histológicamente I-EVOLUTION -con I-EVOLUTION -PP. I-EVOLUTION -Los B-EXPLORATION -hemocultivos I-EXPLORATION -fueron I-EXPLORATION -positivos I-EXPLORATION -para I-EXPLORATION -R. I-EXPLORATION -planticola I-EXPLORATION -sensible I-EXPLORATION -al I-EXPLORATION -tratamiento I-EXPLORATION -instaurado. I-EXPLORATION -En I-EXPLORATION -colangio-resonancia I-EXPLORATION -magnética I-EXPLORATION -(RNM) I-EXPLORATION -se I-EXPLORATION -descartan I-EXPLORATION -DVB I-EXPLORATION -y I-EXPLORATION -coledocolitiasis. I-EXPLORATION -Ante B-EVOLUTION -la I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -de I-EVOLUTION -colestasis I-EVOLUTION -y I-EVOLUTION -ausencia I-EVOLUTION -de I-EVOLUTION -patología I-EVOLUTION -obstructiva, I-EVOLUTION -y I-EVOLUTION -asumiendo I-EVOLUTION -la I-EVOLUTION -salida I-EVOLUTION -espontánea I-EVOLUTION -de I-EVOLUTION -coledocoliatiasis, I-EVOLUTION -se I-EVOLUTION -decide I-EVOLUTION -no I-EVOLUTION -realizar I-EVOLUTION -CPRE. I-EVOLUTION -Al I-EVOLUTION -decimoprimer I-EVOLUTION -día I-EVOLUTION -se I-EVOLUTION -da I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -por I-EVOLUTION -buena I-EVOLUTION -evolución. I-EVOLUTION - I-EVOLUTION - -En B-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -previamente B-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Crohn I-PAST_MEDICAL_HISTORY -colónica I-PAST_MEDICAL_HISTORY -se B-PRESENT_ILLNESS -sospechó I-PRESENT_ILLNESS -afectación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ID I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -indicó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -estudio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -CE. I-PRESENT_ILLNESS -Presentaba B-EXPLORATION -síntomas I-EXPLORATION -que I-EXPLORATION -hicieron I-EXPLORATION -sospechar I-EXPLORATION -una I-EXPLORATION -estenosis, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -comprobar I-EXPLORATION -antes I-EXPLORATION -la I-EXPLORATION -permeabilidad I-EXPLORATION -intestinal I-EXPLORATION -mediante I-EXPLORATION -una I-EXPLORATION -cápsula I-EXPLORATION -Agile®. I-EXPLORATION -Aproximadamente B-EVOLUTION -30 I-EVOLUTION -horas I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -administración I-EVOLUTION -comenzó I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -intenso I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -abdominal, I-EVOLUTION -distensión I-EVOLUTION -y I-EVOLUTION -vómitos. I-EVOLUTION -Se B-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -(TAC), I-EXPLORATION -diagnosticándose I-EXPLORATION -una I-EXPLORATION -obstrucción I-EXPLORATION -intestinal I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -impactación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Agile® I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -estenosis I-EXPLORATION -ileal, I-EXPLORATION -con I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -asas I-EXPLORATION -proximales I-EXPLORATION -y I-EXPLORATION -edema I-EXPLORATION -de I-EXPLORATION -sus I-EXPLORATION -paredes. I-EXPLORATION -A B-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -mejoró I-TREATMENT -con I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -analgesia I-TREATMENT -y I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -una I-TREATMENT -sonda I-TREATMENT -nasogástrica, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -intervenirla, I-TREATMENT -objetivándose I-TREATMENT -la I-TREATMENT -estenosis I-TREATMENT -ileal I-TREATMENT -con I-TREATMENT -un I-TREATMENT -discreto I-TREATMENT -edema I-TREATMENT -de I-TREATMENT -asas I-TREATMENT -proximales, I-TREATMENT -ya I-TREATMENT -sin I-TREATMENT -dilatación I-TREATMENT -de I-TREATMENT -las I-TREATMENT -mismas. I-TREATMENT -Se I-TREATMENT -resecó I-TREATMENT -el I-TREATMENT -segmento I-TREATMENT -afecto I-TREATMENT -y I-TREATMENT -no I-TREATMENT -se I-TREATMENT -encontró I-TREATMENT -la I-TREATMENT -cápsula I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -intervención. I-TREATMENT - I-TREATMENT - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -diarreicas, I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -cólico I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -kg. I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -analítica I-EXPLORATION -con I-EXPLORATION -23.660 I-EXPLORATION -leucocitos I-EXPLORATION -y I-EXPLORATION -colonoscopia I-EXPLORATION -con I-EXPLORATION -pancolitis I-EXPLORATION -moderada I-EXPLORATION -por I-EXPLORATION -CU. I-EXPLORATION -Precozmente I-EXPLORATION -presentó I-EXPLORATION -una I-EXPLORATION -hemorragia I-EXPLORATION -digestiva I-EXPLORATION -alta, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -gastroscopia I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -afectación I-EXPLORATION -continua I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -gástrica, I-EXPLORATION -pérdida I-EXPLORATION -del I-EXPLORATION -patrón I-EXPLORATION -vascular I-EXPLORATION -y I-EXPLORATION -pliegues, I-EXPLORATION -exudado I-EXPLORATION -mucoso, I-EXPLORATION -friabilidad I-EXPLORATION -y I-EXPLORATION -erosiones I-EXPLORATION -en I-EXPLORATION -duodeno. I-EXPLORATION -Lesiones I-EXPLORATION -que I-EXPLORATION -impresionaban I-EXPLORATION -de I-EXPLORATION -CU. I-EXPLORATION -La I-EXPLORATION -anatomía-patológica I-EXPLORATION -demostró I-EXPLORATION -criptitis I-EXPLORATION -aguda, I-EXPLORATION -abscesos I-EXPLORATION -crípticos I-EXPLORATION -e I-EXPLORATION -hiperplasia I-EXPLORATION -foveolar, I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -CU. I-EXPLORATION -Se I-EXPLORATION -descartó I-EXPLORATION -infección I-EXPLORATION -por I-EXPLORATION -Helicobacter I-EXPLORATION -pylori I-EXPLORATION -y I-EXPLORATION -negatividad I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -técnicas I-EXPLORATION -inmunohistoquímicas I-EXPLORATION -(ácido I-EXPLORATION -peryódico I-EXPLORATION -de I-EXPLORATION -Schiff I-EXPLORATION -[PAS], I-EXPLORATION -Gram I-EXPLORATION -y I-EXPLORATION -CMV). I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -afectación I-TREATMENT -proximal I-TREATMENT -de I-TREATMENT -la I-TREATMENT -CU I-TREATMENT -se I-TREATMENT -continuó I-TREATMENT -con I-TREATMENT -corticoides I-TREATMENT -intravenosos I-TREATMENT -con B-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -y I-EVOLUTION -resolución I-EVOLUTION -sintomática I-EVOLUTION -en I-EVOLUTION -una I-EVOLUTION -semana. I-EVOLUTION -La I-EVOLUTION -gastroscopia I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -fue I-EVOLUTION -normal. I-EVOLUTION -Actualmente, B-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -encuentra I-TREATMENT -asintomático, I-TREATMENT -con I-TREATMENT -azatioprina I-TREATMENT -150 I-TREATMENT -mg/24 I-TREATMENT -h I-TREATMENT -y I-TREATMENT -mesalazina I-TREATMENT -4 I-TREATMENT -g/24 I-TREATMENT -h. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -64 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -estudiado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -unas I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -acompañante. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -solo I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -GGT I-EXPLORATION -discretamente I-EXPLORATION -elevada I-EXPLORATION -(70 I-EXPLORATION -U/l) I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -CA I-EXPLORATION -19.9 I-EXPLORATION -de I-EXPLORATION -170 I-EXPLORATION -U/ml. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -parámetros I-EXPLORATION -analíticos I-EXPLORATION -eran I-EXPLORATION -normales. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -ya I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -izquierda, I-EXPLORATION -mientras I-EXPLORATION -que I-EXPLORATION -las I-EXPLORATION -vías I-EXPLORATION -biliares I-EXPLORATION -principal I-EXPLORATION -y I-EXPLORATION -derechas I-EXPLORATION -presentaban I-EXPLORATION -características I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -practica I-EXPLORATION -una I-EXPLORATION -colangio-RMN I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -puede I-EXPLORATION -apreciar I-EXPLORATION -una I-EXPLORATION -dilatación I-EXPLORATION -del I-EXPLORATION -árbol I-EXPLORATION -biliar I-EXPLORATION -izquierdo I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -polipoidea I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -origen I-EXPLORATION -del I-EXPLORATION -conducto I-EXPLORATION -hepático I-EXPLORATION -izquierdo, I-EXPLORATION -sin I-EXPLORATION -otros I-EXPLORATION -hallazgos. I-EXPLORATION -Previo I-EXPLORATION -a I-EXPLORATION -plantear I-EXPLORATION -un I-EXPLORATION -tratamiento I-EXPLORATION -se I-EXPLORATION -practica I-EXPLORATION -CPRE, I-EXPLORATION -que I-EXPLORATION -demuestra I-EXPLORATION -la I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -izquierda I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -polipoidea I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -origen I-EXPLORATION -del I-EXPLORATION -conducto I-EXPLORATION -hepático I-EXPLORATION -izquierdo, I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -biopsiado. I-EXPLORATION -Además, B-TREATMENT -se I-TREATMENT -coloca I-TREATMENT -una I-TREATMENT -prótesis I-TREATMENT -plástica. I-TREATMENT -La B-EXPLORATION -biopsia I-EXPLORATION -confirma I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -neoplasia I-EXPLORATION -papilar I-EXPLORATION -con I-EXPLORATION -displasia I-EXPLORATION -de I-EXPLORATION -alto I-EXPLORATION -grado. I-EXPLORATION -Se B-TREATMENT -plantea I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -y I-TREATMENT -se I-TREATMENT -practican I-TREATMENT -colecistectomía, I-TREATMENT -hepatectomía I-TREATMENT -izquierda I-TREATMENT -anatómica I-TREATMENT -con I-TREATMENT -resección I-TREATMENT -del I-TREATMENT -segmento I-TREATMENT -I I-TREATMENT -y I-TREATMENT -exéresis I-TREATMENT -del I-TREATMENT -árbol I-TREATMENT -biliar I-TREATMENT -izquierdo I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -confluencia I-TREATMENT -con I-TREATMENT -el I-TREATMENT -derecho. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -intraoperatorio I-EXPLORATION -del I-EXPLORATION -borde I-EXPLORATION -de I-EXPLORATION -sección I-EXPLORATION -biliar I-EXPLORATION -no I-EXPLORATION -demuestra I-EXPLORATION -afectación. I-EXPLORATION -El B-EVOLUTION -postoperatorio I-EVOLUTION -transcurre I-EVOLUTION -sin I-EVOLUTION -incidencias I-EVOLUTION -reseñables. I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -confirma I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -neoplasia I-EXPLORATION -papilar I-EXPLORATION -biliar I-EXPLORATION -intraductal I-EXPLORATION -con I-EXPLORATION -foco I-EXPLORATION -de I-EXPLORATION -colangiocarcinoma I-EXPLORATION -papilar I-EXPLORATION -e I-EXPLORATION -invasivo, I-EXPLORATION -sin I-EXPLORATION -afectación I-EXPLORATION -linfática. I-EXPLORATION -Los I-EXPLORATION -bordes I-EXPLORATION -de I-EXPLORATION -resección I-EXPLORATION -estaban I-EXPLORATION -libres. I-EXPLORATION -No B-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -tratamiento I-TREATMENT -complementario I-TREATMENT -y B-EVOLUTION -tras I-EVOLUTION -cinco I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -está I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -ingresado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -acompañado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -subictericia I-PRESENT_ILLNESS -cutánea-mucosa. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -destaca I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -GGT I-EXPLORATION -y I-EXPLORATION -discreta I-EXPLORATION -de I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -CA I-EXPLORATION -19.9 I-EXPLORATION -de I-EXPLORATION -1.973 I-EXPLORATION -U/ml. I-EXPLORATION -Al I-EXPLORATION -igual I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -primer I-EXPLORATION -caso, I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -demuestra I-EXPLORATION -una I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -izquierda. I-EXPLORATION -En I-EXPLORATION -este I-EXPLORATION -caso, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -colangio-RMN I-EXPLORATION -se I-EXPLORATION -puede I-EXPLORATION -ver I-EXPLORATION -gran I-EXPLORATION -dilatación I-EXPLORATION -del I-EXPLORATION -árbol I-EXPLORATION -biliar I-EXPLORATION -izquierdo I-EXPLORATION -con I-EXPLORATION -ocupación I-EXPLORATION -por I-EXPLORATION -material I-EXPLORATION -velloso I-EXPLORATION -y I-EXPLORATION -mucina. I-EXPLORATION -La I-EXPLORATION -CPRE I-EXPLORATION -demuestra I-EXPLORATION -la I-EXPLORATION -salida I-EXPLORATION -de I-EXPLORATION -mucina I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -ocupación I-EXPLORATION -vellosa I-EXPLORATION -del I-EXPLORATION -árbol I-EXPLORATION -biliar I-EXPLORATION -izquierdo, I-EXPLORATION -del I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -toma I-EXPLORATION -una I-EXPLORATION -biopsia, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -coloca I-EXPLORATION -una I-EXPLORATION -prótesis I-EXPLORATION -plástica. I-EXPLORATION -La I-EXPLORATION -histología I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -neoplasia I-EXPLORATION -papilar I-EXPLORATION -intraductal I-EXPLORATION -con I-EXPLORATION -displasia I-EXPLORATION -de I-EXPLORATION -alto I-EXPLORATION -grado. I-EXPLORATION -También B-TREATMENT -se I-TREATMENT -le I-TREATMENT -plantea I-TREATMENT -tratamiento I-TREATMENT -quirúrgico, I-TREATMENT -practicando I-TREATMENT -hepatectomía I-TREATMENT -izquierda I-TREATMENT -con I-TREATMENT -resección I-TREATMENT -del I-TREATMENT -segmento I-TREATMENT -I I-TREATMENT -y I-TREATMENT -del I-TREATMENT -árbol I-TREATMENT -biliar I-TREATMENT -izquierdo, I-TREATMENT -colecistectomía I-TREATMENT -y I-TREATMENT -linfadenectomía I-TREATMENT -del I-TREATMENT -hilio I-TREATMENT -hepático. I-TREATMENT -La B-EXPLORATION -biopsia I-EXPLORATION -intraoperatoria I-EXPLORATION -demuestra I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -afectación I-EXPLORATION -del I-EXPLORATION -borde I-EXPLORATION -de I-EXPLORATION -resección I-EXPLORATION -biliar. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -definitivo I-EXPLORATION -confirma I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -colangiocarcinoma I-EXPLORATION -con I-EXPLORATION -componente I-EXPLORATION -microinfiltrante I-EXPLORATION -aislado I-EXPLORATION -y I-EXPLORATION -focal I-EXPLORATION -en I-EXPLORATION -rama I-EXPLORATION -distal I-EXPLORATION -del I-EXPLORATION -segmento I-EXPLORATION -III I-EXPLORATION -hepático I-EXPLORATION -con I-EXPLORATION -producción I-EXPLORATION -de I-EXPLORATION -moco. I-EXPLORATION -Tampoco B-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -tratamiento I-TREATMENT -adyuvante I-TREATMENT -y B-EVOLUTION -el I-EVOLUTION -paciente, I-EVOLUTION -tras I-EVOLUTION -cuatro I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento, I-EVOLUTION -no I-EVOLUTION -presenta I-EVOLUTION -recidiva I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -familiares I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -CEP I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2010. I-PAST_MEDICAL_HISTORY -Tras B-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -se I-EXPLORATION -estudió I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -asociación I-EXPLORATION -con I-EXPLORATION -CU I-EXPLORATION -mediante I-EXPLORATION -endoscopia I-EXPLORATION -digestiva I-EXPLORATION -baja I-EXPLORATION -completa I-EXPLORATION -sin I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -objetivaran I-EXPLORATION -alteraciones I-EXPLORATION -macroscópicas I-EXPLORATION -ni I-EXPLORATION -histológicas. I-EXPLORATION -En B-TREATMENT -2013 I-TREATMENT -fue I-TREATMENT -sometida I-TREATMENT -a I-TREATMENT -trasplante I-TREATMENT -hepático I-TREATMENT -cadavérico I-TREATMENT -por I-TREATMENT -insuficiencia I-TREATMENT -hepatocelular I-TREATMENT -y I-TREATMENT -colangitis I-TREATMENT -de I-TREATMENT -repetición. I-TREATMENT -No B-EVOLUTION -presentó I-EVOLUTION -complicaciones I-EVOLUTION -inmediatas I-EVOLUTION -postrasplante, I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -función I-EVOLUTION -del I-EVOLUTION -injerto I-EVOLUTION -y I-EVOLUTION -régimen I-EVOLUTION -de I-EVOLUTION -inmunosupresión I-EVOLUTION -basado I-EVOLUTION -en I-EVOLUTION -tacrolimus I-EVOLUTION -de I-EVOLUTION -liberación I-EVOLUTION -prolongada. I-EVOLUTION -Nueve I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -trasplante, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -debutó I-EVOLUTION -con I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -diarrea I-EVOLUTION -sanguinolenta, I-EVOLUTION -con I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -CU I-EVOLUTION -de I-EVOLUTION -localización I-EVOLUTION -extensa I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -actividad I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -endoscópica I-EVOLUTION -moderada. I-EVOLUTION -Desde I-EVOLUTION -los I-EVOLUTION -primeros I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -CU, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -cumplió I-EVOLUTION -criterios I-EVOLUTION -de I-EVOLUTION -corticodependencia. I-EVOLUTION -Ante B-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -discreta I-TREATMENT -leucopenia, I-TREATMENT -no I-TREATMENT -se I-TREATMENT -optó I-TREATMENT -por I-TREATMENT -azatioprina I-TREATMENT -y I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -tratamiento I-TREATMENT -biológico I-TREATMENT -anti-TNFα I-TREATMENT -con I-TREATMENT -golimumab I-TREATMENT -subcutáneo I-TREATMENT -(dosis I-TREATMENT -de I-TREATMENT -inducción I-TREATMENT -habitual I-TREATMENT -200 I-TREATMENT -mg I-TREATMENT -sc I-TREATMENT -inicialmente, I-TREATMENT -100 I-TREATMENT -mg I-TREATMENT -a I-TREATMENT -las I-TREATMENT -dos I-TREATMENT -semanas) I-TREATMENT -y I-TREATMENT -50 I-TREATMENT -mg I-TREATMENT -mensualmente I-TREATMENT -de I-TREATMENT -mantenimiento I-TREATMENT -(peso I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -61 I-TREATMENT -kg). I-TREATMENT -La I-TREATMENT -respuesta I-TREATMENT -a I-TREATMENT -golimumab I-TREATMENT -fue I-TREATMENT -solo I-TREATMENT -parcial, I-TREATMENT -precisando I-TREATMENT -de I-TREATMENT -intensificación I-TREATMENT -a I-TREATMENT -100 I-TREATMENT -mg I-TREATMENT -mensuales I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -segundo I-TREATMENT -mes I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -y I-TREATMENT -no I-TREATMENT -consiguiendo I-TREATMENT -suspender I-TREATMENT -los I-TREATMENT -esteroides I-TREATMENT -orales, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -a I-TREATMENT -los I-TREATMENT -cuatro I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -golimumab I-TREATMENT -se I-TREATMENT -cambia I-TREATMENT -a I-TREATMENT -un I-TREATMENT -agente I-TREATMENT -anti-TNF I-TREATMENT -intravenoso: I-TREATMENT -infliximab I-TREATMENT -(IFX). I-TREATMENT -Tras B-EVOLUTION -iniciar I-EVOLUTION -IFX I-EVOLUTION -a I-EVOLUTION -dosis I-EVOLUTION -de I-EVOLUTION -inducción I-EVOLUTION -convencionales I-EVOLUTION -(5 I-EVOLUTION -mg/kg I-EVOLUTION -intravenoso I-EVOLUTION -[iv], I-EVOLUTION -semanas I-EVOLUTION -0, I-EVOLUTION -2 I-EVOLUTION -y I-EVOLUTION -6), I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -alcanzó I-EVOLUTION -respuesta I-EVOLUTION -clínica I-EVOLUTION -ni I-EVOLUTION -suspensión I-EVOLUTION -de I-EVOLUTION -esteroides I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -tratamiento, I-EVOLUTION -pese I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -intensificación I-EVOLUTION -precoz I-EVOLUTION -(5 I-EVOLUTION -mg/kg I-EVOLUTION -iv I-EVOLUTION -cada I-EVOLUTION -cuatro I-EVOLUTION -semanas) I-EVOLUTION -a I-EVOLUTION -partir I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -quinta I-EVOLUTION -infusión. I-EVOLUTION -La B-EXPLORATION -monitorización I-EXPLORATION -de I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -IFX I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -demostró I-EXPLORATION -que I-EXPLORATION -estaban I-EXPLORATION -en I-EXPLORATION -rango I-EXPLORATION -terapéutico. I-EXPLORATION -Ello, I-EXPLORATION -junto I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -anticuerpos I-EXPLORATION -anti-infliximab I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -infección I-EXPLORATION -entérica I-EXPLORATION -concomitante I-EXPLORATION -o I-EXPLORATION -sobreinfección I-EXPLORATION -por I-EXPLORATION -citomegalovirus I-EXPLORATION -(CMV), I-EXPLORATION -hizo I-EXPLORATION -cambiar I-EXPLORATION -de I-EXPLORATION -diana I-EXPLORATION -terapéutica. I-EXPLORATION -En B-TREATMENT -diciembre I-TREATMENT -de I-TREATMENT -2016 I-TREATMENT -(35 I-TREATMENT -meses I-TREATMENT -después I-TREATMENT -del I-TREATMENT -trasplante), I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -iniciar I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -vedolizumab I-TREATMENT -(VDZ), I-TREATMENT -según I-TREATMENT -pauta I-TREATMENT -de I-TREATMENT -inducción I-TREATMENT -habitual I-TREATMENT -(300 I-TREATMENT -mg I-TREATMENT -iv I-TREATMENT -en I-TREATMENT -semanas I-TREATMENT -0, I-TREATMENT -2 I-TREATMENT -y I-TREATMENT -6), I-TREATMENT -y I-TREATMENT -mantenimiento I-TREATMENT -con I-TREATMENT -300 I-TREATMENT -mg I-TREATMENT -VDZ I-TREATMENT -iv I-TREATMENT -cada I-TREATMENT -ocho I-TREATMENT -semanas. I-TREATMENT -Justo I-TREATMENT -antes I-TREATMENT -del I-TREATMENT -inicio I-TREATMENT -de I-TREATMENT -VDZ, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -presentaba I-TREATMENT -un I-TREATMENT -índice I-TREATMENT -de I-TREATMENT -Mayo I-TREATMENT -total I-TREATMENT -de I-TREATMENT -7. I-TREATMENT -Tras B-EVOLUTION -la I-EVOLUTION -segunda I-EVOLUTION -infusión I-EVOLUTION -se I-EVOLUTION -asistió I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -respuesta I-EVOLUTION -clínica I-EVOLUTION -con I-EVOLUTION -normalización I-EVOLUTION -del I-EVOLUTION -hábito I-EVOLUTION -deposicional I-EVOLUTION -pero I-EVOLUTION -manteniendo I-EVOLUTION -parámetros I-EVOLUTION -de I-EVOLUTION -actividad I-EVOLUTION -biológica I-EVOLUTION -elevados I-EVOLUTION -(calprotectina I-EVOLUTION -fecal I-EVOLUTION -805 I-EVOLUTION -mcg/g I-EVOLUTION -y I-EVOLUTION -proteína I-EVOLUTION -C I-EVOLUTION -reactiva I-EVOLUTION -[PCR] I-EVOLUTION -8 I-EVOLUTION -mg/l). I-EVOLUTION -A B-TREATMENT -los I-TREATMENT -tres I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -logró I-TREATMENT -suspender I-TREATMENT -los I-TREATMENT -esteroides, I-TREATMENT -y I-TREATMENT -un I-TREATMENT -mes I-TREATMENT -después I-TREATMENT -de I-TREATMENT -su I-TREATMENT -retirada I-TREATMENT -fue I-TREATMENT -precisa I-TREATMENT -una I-TREATMENT -intensificación I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -VDZ, I-TREATMENT -acortando I-TREATMENT -el I-TREATMENT -intervalo I-TREATMENT -de I-TREATMENT -infusiones I-TREATMENT -a I-TREATMENT -cuatro I-TREATMENT -semanas. I-TREATMENT -Al B-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -su I-EVOLUTION -puntuaci��n I-EVOLUTION -de I-EVOLUTION -Mayo I-EVOLUTION -total I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -4 I-EVOLUTION -(subpuntuación I-EVOLUTION -endoscópica I-EVOLUTION -1), I-EVOLUTION -la I-EVOLUTION -calprotectina I-EVOLUTION -descendió I-EVOLUTION -a I-EVOLUTION -270 I-EVOLUTION -mcg/g I-EVOLUTION -y I-EVOLUTION -los I-EVOLUTION -niveles I-EVOLUTION -de I-EVOLUTION -PCR I-EVOLUTION -se I-EVOLUTION -normalizaron. I-EVOLUTION -Los I-EVOLUTION -niveles I-EVOLUTION -de I-EVOLUTION -tacrolimus I-EVOLUTION -permanecieron I-EVOLUTION -estables, I-EVOLUTION -dentro I-EVOLUTION -del I-EVOLUTION -rango I-EVOLUTION -pretendido I-EVOLUTION -(5-10 I-EVOLUTION -ng/ml) I-EVOLUTION -y B-TREATMENT -sin I-TREATMENT -requerir I-TREATMENT -ajustes I-TREATMENT -de I-TREATMENT -dosis. I-TREATMENT -La B-EVOLUTION -bioquímica I-EVOLUTION -hepática I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -mantenido I-EVOLUTION -estable I-EVOLUTION -durante I-EVOLUTION -todo I-EVOLUTION -este I-EVOLUTION -periodo. I-EVOLUTION -No I-EVOLUTION -se I-EVOLUTION -han I-EVOLUTION -registrado I-EVOLUTION -hasta I-EVOLUTION -la I-EVOLUTION -fecha I-EVOLUTION -efectos I-EVOLUTION -adversos I-EVOLUTION -infecciosos I-EVOLUTION -ni I-EVOLUTION -interacciones I-EVOLUTION -farmacológicas. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -VIH, I-PAST_MEDICAL_HISTORY -estudiado B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -proctitis I-PRESENT_ILLNESS -en B-EXPLORATION -cuya I-EXPLORATION -colonoscopia I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -una I-EXPLORATION -mucosa I-EXPLORATION -patológica I-EXPLORATION -con I-EXPLORATION -exudado I-EXPLORATION -purulento I-EXPLORATION -en I-EXPLORATION -rectosigma. I-EXPLORATION -Se I-EXPLORATION -descartó I-EXPLORATION -proceso I-EXPLORATION -maligno I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -microbiológico I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -heces I-EXPLORATION -fue I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION -herpes I-EXPLORATION -simple I-EXPLORATION -tipo I-EXPLORATION -2 I-EXPLORATION -y I-EXPLORATION -Chalmydia I-EXPLORATION -trachomatis. I-EXPLORATION -Fue B-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -valganciclovir I-TREATMENT -y I-TREATMENT -azitromicina, I-TREATMENT -con I-TREATMENT -mejoría I-TREATMENT -de I-TREATMENT -la I-TREATMENT -clínica I-TREATMENT -infecciosa I-TREATMENT -pero I-TREATMENT -con I-TREATMENT -estreñimiento I-TREATMENT -progresivo. I-TREATMENT -Una B-EXPLORATION -nueva I-EXPLORATION -rectoscopia I-EXPLORATION -objetiva I-EXPLORATION -una I-EXPLORATION -zona I-EXPLORATION -fibrótica I-EXPLORATION -y I-EXPLORATION -ulcerada I-EXPLORATION -en I-EXPLORATION -recto I-EXPLORATION -distal, I-EXPLORATION -con I-EXPLORATION -biopsias I-EXPLORATION -y I-EXPLORATION -análisis I-EXPLORATION -microbiológico I-EXPLORATION -negativos. I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -persistencia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -clínica I-TREATMENT -con I-TREATMENT -tratamiento I-TREATMENT -conservador, I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -realizar I-TREATMENT -resección I-TREATMENT -anterior I-TREATMENT -de I-TREATMENT -recto I-TREATMENT -ultrabaja I-TREATMENT -con I-TREATMENT -reservorio I-TREATMENT -coloanal I-TREATMENT -e I-TREATMENT -ileostomía. I-TREATMENT -Tras B-EVOLUTION -posoperatorio I-EVOLUTION -complicado, I-EVOLUTION -se I-EVOLUTION -reconstruye I-EVOLUTION -el I-EVOLUTION -tránsito I-EVOLUTION -sin I-EVOLUTION -incidencias, I-EVOLUTION -con I-EVOLUTION -seguimiento I-EVOLUTION -actual I-EVOLUTION -sin I-EVOLUTION -complicaciones. I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION - -Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -cardiaca I-PAST_MEDICAL_HISTORY -grave, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica. I-PAST_MEDICAL_HISTORY -Debutó B-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -eritematosa, I-PRESENT_ILLNESS -dura I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -dolorosa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -subcutáneo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -esternal I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -extirpó. I-PRESENT_ILLNESS -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -metástasis I-EXPLORATION -subcutánea I-EXPLORATION -de I-EXPLORATION -cistoadenocarcinoma I-EXPLORATION -mucinoso I-EXPLORATION -de I-EXPLORATION -origen I-EXPLORATION -biliar. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -abdominal I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -hepática I-EXPLORATION -central I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -colangiocarcinoma I-EXPLORATION -hiliar I-EXPLORATION -o I-EXPLORATION -tumor I-EXPLORATION -de I-EXPLORATION -Klatskin. I-EXPLORATION -Dada B-TREATMENT -la I-TREATMENT -situación I-TREATMENT -basal I-TREATMENT -se I-TREATMENT -instauró I-TREATMENT -tratamiento I-TREATMENT -paliativo. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -estenosis I-PRESENT_ILLNESS -esofágica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -secundaria I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -ingesta I-PRESENT_ILLNESS -accidental I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cáustico. I-PRESENT_ILLNESS -El B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -derivado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestra I-DERIVED_FROM/TO -institución I-DERIVED_FROM/TO -siendo I-DERIVED_FROM/TO -portador I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -gastrostomía I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -sutura I-DERIVED_FROM/TO -nasogástrica I-DERIVED_FROM/TO -(stringing) I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -permitía I-DERIVED_FROM/TO -dilataciones I-DERIVED_FROM/TO -retrógradas. I-DERIVED_FROM/TO -El B-EXPLORATION -esofagograma I-EXPLORATION -de I-EXPLORATION -bario I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -estenosis I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -longitud I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -nivel I-EXPLORATION -cricotraqueal I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -tercio I-EXPLORATION -inferior I-EXPLORATION -del I-EXPLORATION -esófago. I-EXPLORATION -Se B-TREATMENT -llevó I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -un I-TREATMENT -programa I-TREATMENT -de I-TREATMENT -dilataciones I-TREATMENT -esofágicas I-TREATMENT -retrógradas I-TREATMENT -cada I-TREATMENT -dos I-TREATMENT -semanas I-TREATMENT -sin I-TREATMENT -ninguna I-TREATMENT -mejora, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que, I-TREATMENT -a I-TREATMENT -los I-TREATMENT -cinco I-TREATMENT -meses I-TREATMENT -postingesta I-TREATMENT -del I-TREATMENT -agente I-TREATMENT -corrosivo, I-TREATMENT -se I-TREATMENT -colocaron I-TREATMENT -del I-TREATMENT -mismo I-TREATMENT -modo I-TREATMENT -tres I-TREATMENT -stents I-TREATMENT -autoexpandibles I-TREATMENT -de I-TREATMENT -nitinol I-TREATMENT -cubiertos I-TREATMENT -de I-TREATMENT -silicona I-TREATMENT -internamente I-TREATMENT -(Stents I-TREATMENT -MI I-TREATMENT -Tech, I-TREATMENT -Izasa); I-TREATMENT -dos I-TREATMENT -de I-TREATMENT -16 I-TREATMENT -x I-TREATMENT -60 I-TREATMENT -mm I-TREATMENT -y I-TREATMENT -uno I-TREATMENT -de I-TREATMENT -16 I-TREATMENT -x I-TREATMENT -40 I-TREATMENT -mm. I-TREATMENT -El I-TREATMENT -más I-TREATMENT -craneal I-TREATMENT -se I-TREATMENT -colocó I-TREATMENT -primero, I-TREATMENT -introduciendo I-TREATMENT -los I-TREATMENT -otros I-TREATMENT -en I-TREATMENT -dirección I-TREATMENT -caudal I-TREATMENT -y I-TREATMENT -manteniendo I-TREATMENT -una I-TREATMENT -distancia I-TREATMENT -de I-TREATMENT -superposición I-TREATMENT -de I-TREATMENT -1-2 I-TREATMENT -cm I-TREATMENT -para I-TREATMENT -evitar I-TREATMENT -el I-TREATMENT -desplazamiento I-TREATMENT -de I-TREATMENT -los I-TREATMENT -mismos. I-TREATMENT -Este B-EVOLUTION -procedimiento I-EVOLUTION -logró I-EVOLUTION -una I-EVOLUTION -dilatación I-EVOLUTION -completa I-EVOLUTION -durante I-EVOLUTION -un I-EVOLUTION -mes. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -niño I-EVOLUTION -refirió I-EVOLUTION -dolor I-EVOLUTION -como I-EVOLUTION -único I-EVOLUTION -síntoma I-EVOLUTION -postoperatorio I-EVOLUTION -que I-EVOLUTION -remitió I-EVOLUTION -espontáneamente I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -cuatro I-EVOLUTION -días. I-EVOLUTION -No B-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -ni I-EXPLORATION -migración I-EXPLORATION -ni I-EXPLORATION -otras I-EXPLORATION -complicaciones I-EXPLORATION -a I-EXPLORATION -corto I-EXPLORATION -plazo. I-EXPLORATION -Tolerando B-TREATMENT -su I-TREATMENT -alimentación I-TREATMENT -habitual I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -de I-TREATMENT -manera I-TREATMENT -adecuada, I-TREATMENT -fue I-TREATMENT -dado I-TREATMENT -de I-TREATMENT -alta I-TREATMENT -con I-TREATMENT -omeprazol I-TREATMENT -pautado I-TREATMENT -(15 I-TREATMENT -mg/24 I-TREATMENT -horas I-TREATMENT -vía I-TREATMENT -oral) I-TREATMENT -y I-TREATMENT -seguimiento I-TREATMENT -en I-TREATMENT -consultas I-TREATMENT -externas. I-TREATMENT - I-TREATMENT -Los I-TREATMENT -stents I-TREATMENT -se I-TREATMENT -retiraron I-TREATMENT -a I-TREATMENT -las I-TREATMENT -cuatro I-TREATMENT -semanas I-TREATMENT -y I-TREATMENT -en I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -procedimiento I-TREATMENT -se I-TREATMENT -pulverizó I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -mitomicina I-TREATMENT -(0, I-TREATMENT -4 I-TREATMENT -ml/kg) I-TREATMENT -sobre I-TREATMENT -el I-TREATMENT -área I-TREATMENT -dilatada I-TREATMENT -a I-TREATMENT -través I-TREATMENT -del I-TREATMENT -irrigador I-TREATMENT -del I-TREATMENT -endoscopio. I-TREATMENT -Se B-EXPLORATION -identificaron I-EXPLORATION -dos I-EXPLORATION -estenosis I-EXPLORATION -residuales I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -largo I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -esfínter I-EXPLORATION -cricofaríngeo I-EXPLORATION -y I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -por I-EXPLORATION -encima I-EXPLORATION -del I-EXPLORATION -cardias I-EXPLORATION -respectivamente. I-EXPLORATION -La I-EXPLORATION -primera I-EXPLORATION -ya I-EXPLORATION -había I-EXPLORATION -sido I-EXPLORATION -visualizada I-EXPLORATION -durante I-EXPLORATION -la I-EXPLORATION -intervención I-EXPLORATION -endoscópica I-EXPLORATION -previa, I-EXPLORATION -cuando I-EXPLORATION -fue I-EXPLORATION -imposible I-EXPLORATION -la I-EXPLORATION -colocación I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -stent I-EXPLORATION -en I-EXPLORATION -dicha I-EXPLORATION -región I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -compresión I-EXPLORATION -traqueal. I-EXPLORATION -La B-TREATMENT -estenosis I-TREATMENT -esofágica I-TREATMENT -distal I-TREATMENT -requirió I-TREATMENT -otro I-TREATMENT -stent I-TREATMENT -(16 I-TREATMENT -x I-TREATMENT -40 I-TREATMENT -mm), I-TREATMENT -obteniendo I-TREATMENT -la I-TREATMENT -dilatación I-TREATMENT -completa I-TREATMENT -de I-TREATMENT -la I-TREATMENT -misma I-TREATMENT -después I-TREATMENT -de I-TREATMENT -un I-TREATMENT -mes I-TREATMENT -desde I-TREATMENT -su I-TREATMENT -colocación. I-TREATMENT -Las I-TREATMENT -dilataciones I-TREATMENT -con I-TREATMENT -balón I-TREATMENT -posteriores I-TREATMENT -se I-TREATMENT -realizaron I-TREATMENT -a I-TREATMENT -intervalos I-TREATMENT -de I-TREATMENT -cuatro I-TREATMENT -semanas, I-TREATMENT -consiguiéndose I-TREATMENT -un I-TREATMENT -esófago I-TREATMENT -elástico I-TREATMENT -con I-TREATMENT -aspecto I-TREATMENT -normal I-TREATMENT -de I-TREATMENT -su I-TREATMENT -mucosa. I-TREATMENT -Sin I-TREATMENT -embargo, I-TREATMENT -la I-TREATMENT -estenosis I-TREATMENT -del I-TREATMENT -esófago I-TREATMENT -proximal I-TREATMENT -mencionada I-TREATMENT -con I-TREATMENT -anterioridad I-TREATMENT -tuvo I-TREATMENT -una I-TREATMENT -respuesta I-TREATMENT -pobre, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -optó I-TREATMENT -por I-TREATMENT -resección I-TREATMENT -quirúrgica I-TREATMENT -y I-TREATMENT -anastomosis I-TREATMENT -mediante I-TREATMENT -un I-TREATMENT -abordaje I-TREATMENT -laterocervical I-TREATMENT -inferior I-TREATMENT -izquierdo I-TREATMENT -seguida I-TREATMENT -de I-TREATMENT -dilataciones I-TREATMENT -neumáticas I-TREATMENT -dos I-TREATMENT -veces I-TREATMENT -al I-TREATMENT -mes I-TREATMENT -con I-TREATMENT -intervalos I-TREATMENT -progresivamente I-TREATMENT -más I-TREATMENT -largos I-TREATMENT -durante I-TREATMENT -cinco I-TREATMENT -meses. I-TREATMENT - I-TREATMENT -Después B-EVOLUTION -de I-EVOLUTION -dos I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -totalmente I-EVOLUTION -asintomático I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -excelente I-EVOLUTION -aspecto I-EVOLUTION -macroscópico I-EVOLUTION -del I-EVOLUTION -esófago I-EVOLUTION -valorado I-EVOLUTION -endoscópicamente I-EVOLUTION -y I-EVOLUTION -mediante I-EVOLUTION -un I-EVOLUTION -esofagograma I-EVOLUTION -baritado I-EVOLUTION -de I-EVOLUTION -control. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -19 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -previamente I-PRESENT_ILLNESS -sano, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -precisó I-PRESENT_ILLNESS -hospitalización I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ictericia, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -otras I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -exploración. I-PRESENT_ILLNESS -Confesó B-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -usado I-PAST_MEDICAL_HISTORY -estanozolol I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -mg/48 I-PAST_MEDICAL_HISTORY -h I-PAST_MEDICAL_HISTORY -(Winstrol®), I-PAST_MEDICAL_HISTORY -enantato I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -metenolona I-PAST_MEDICAL_HISTORY -(Primobolan®) I-PAST_MEDICAL_HISTORY -100 I-PAST_MEDICAL_HISTORY -mg/96 I-PAST_MEDICAL_HISTORY -h I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -propionato I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -drostanolona I-PAST_MEDICAL_HISTORY -(Masteron®) I-PAST_MEDICAL_HISTORY -200 I-PAST_MEDICAL_HISTORY -mg/96 I-PAST_MEDICAL_HISTORY -h, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -intramuscular, I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -56 I-PAST_MEDICAL_HISTORY -días, I-PAST_MEDICAL_HISTORY -interrumpiendo I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -diez I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ingreso. I-PAST_MEDICAL_HISTORY -Destacaba B-EXPLORATION -una I-EXPLORATION -bilirrubina I-EXPLORATION -de I-EXPLORATION -41, I-EXPLORATION -9 I-EXPLORATION -mg/dl I-EXPLORATION -con I-EXPLORATION -GPT I-EXPLORATION -114 I-EXPLORATION -UI/l I-EXPLORATION -y I-EXPLORATION -GGT I-EXPLORATION -normal; I-EXPLORATION -la I-EXPLORATION -creatinina I-EXPLORATION -máxima I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -2 I-EXPLORATION -mg/dl I-EXPLORATION -(día I-EXPLORATION -+39). I-EXPLORATION -Se I-EXPLORATION -excluyeron I-EXPLORATION -otras I-EXPLORATION -causas I-EXPLORATION -de I-EXPLORATION -hepatopatía, I-EXPLORATION -patología I-EXPLORATION -biliar I-EXPLORATION -y I-EXPLORATION -trastornos I-EXPLORATION -vasculares. I-EXPLORATION -Una I-EXPLORATION -biopsia I-EXPLORATION -hepática I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -marcada I-EXPLORATION -colestasis I-EXPLORATION -parenquimatosa I-EXPLORATION -y I-EXPLORATION -canalicular I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -centrolobulillar. I-EXPLORATION -La B-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -lentamente I-EVOLUTION -favorable, I-EVOLUTION -con I-EVOLUTION -resolución I-EVOLUTION -espontánea I-EVOLUTION -ad I-EVOLUTION -integrum I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -tres I-EVOLUTION -meses. I-EVOLUTION - I-EVOLUTION - -Recientemente, B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -colecistectomizada I-PRESENT_ILLNESS -se B-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -CPRE I-EXPLORATION -por I-EXPLORATION -coledocolitiasis. I-EXPLORATION -Horas B-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -misma, I-EVOLUTION -comenzó I-EVOLUTION -con I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -en I-EVOLUTION -hipocondrio I-EVOLUTION -derecho I-EVOLUTION -y I-EVOLUTION -anemización. I-EVOLUTION -Se B-EXPLORATION -solicitó I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -hematoma I-EXPLORATION -subcapsular I-EXPLORATION -hepático I-EXPLORATION -de I-EXPLORATION -16 I-EXPLORATION -x I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -16 I-EXPLORATION -cm, I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -comprimía I-EXPLORATION -y I-EXPLORATION -desplazaba I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -media I-EXPLORATION -el I-EXPLORATION -parénquima I-EXPLORATION -hepático. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -a I-EXPLORATION -continuación I-EXPLORATION -angio-TC, I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -extravasación I-EXPLORATION -del I-EXPLORATION -contraste. I-EXPLORATION - I-EXPLORATION -Dada B-TREATMENT -la I-TREATMENT -estabilidad I-TREATMENT -clínica I-TREATMENT -y I-TREATMENT -ausencia I-TREATMENT -de I-TREATMENT -sangrado I-TREATMENT -activo, I-TREATMENT -se I-TREATMENT -optó I-TREATMENT -por I-TREATMENT -un I-TREATMENT -manejo I-TREATMENT -conservador I-TREATMENT -con I-TREATMENT -vigilancia I-TREATMENT -en I-TREATMENT -la I-TREATMENT -Unidad I-TREATMENT -de I-TREATMENT -Cuidados I-TREATMENT -Intensivos I-TREATMENT -(UCI), I-TREATMENT -donde I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -hemodinámicamente I-TREATMENT -estable. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -diez I-EVOLUTION -días, I-EVOLUTION -un I-EVOLUTION -TC I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -mostró I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -colección, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -efectuó I-TREATMENT -drenaje I-TREATMENT -percutáneo I-TREATMENT -en I-TREATMENT -el I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -extrajeron I-TREATMENT -1.000 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -contenido I-TREATMENT -hemático. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -favorable, I-EVOLUTION -con I-EVOLUTION -alta I-EVOLUTION -12 I-EVOLUTION -días I-EVOLUTION -después. I-EVOLUTION -No B-TREATMENT -obstante, I-TREATMENT -fue I-TREATMENT -necesario I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -drenaje I-TREATMENT -de I-TREATMENT -unos I-TREATMENT -1.100 I-TREATMENT -ml I-TREATMENT -días I-TREATMENT -más I-TREATMENT -tarde, I-TREATMENT -tras B-EVOLUTION -el I-EVOLUTION -cual I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -permaneció I-EVOLUTION -asintomática. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -niña I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -9 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -procedente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -país I-PAST_MEDICAL_HISTORY -africano I-PAST_MEDICAL_HISTORY -que B-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -través I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -ONG. I-DERIVED_FROM/TO -Presentaba B-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -limitación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -apertura I-PRESENT_ILLNESS -oral I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -mm I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consecuencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -caída I-PRESENT_ILLNESS -casual I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -fractura I-PRESENT_ILLNESS -bicondílea. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -una I-EXPLORATION -hipoplasia I-EXPLORATION -mandibular I-EXPLORATION -sin I-EXPLORATION -asimetría, I-EXPLORATION -oclusión I-EXPLORATION -en I-EXPLORATION -clase I-EXPLORATION -II I-EXPLORATION -con I-EXPLORATION -compensación I-EXPLORATION -de I-EXPLORATION -incisivos I-EXPLORATION -superiores I-EXPLORATION -e I-EXPLORATION -inferiores I-EXPLORATION -y I-EXPLORATION -deficiente I-EXPLORATION -higiene I-EXPLORATION -bucal I-EXPLORATION -con I-EXPLORATION -caries. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ortopantomografía I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -telerradiografía I-EXPLORATION -lateral I-EXPLORATION -de I-EXPLORATION -cráneo I-EXPLORATION -que I-EXPLORATION -mostraron I-EXPLORATION -una I-EXPLORATION -anquilosis I-EXPLORATION -temporomandibular I-EXPLORATION -bilateral. I-EXPLORATION -Se I-EXPLORATION -completó I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -TC I-EXPLORATION -con I-EXPLORATION -reconstrucción I-EXPLORATION -3D, I-EXPLORATION -toma I-EXPLORATION -de I-EXPLORATION -fotografías I-EXPLORATION -y I-EXPLORATION -valoración I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -Servicio I-EXPLORATION -de I-EXPLORATION -Anestesiología. I-EXPLORATION -Las B-TREATMENT -características I-TREATMENT -sociales I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -impidieron I-TREATMENT -indicar I-TREATMENT -un I-TREATMENT -tratamiento I-TREATMENT -ortodóncico. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -planificó I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -contando I-TREATMENT -con I-TREATMENT -el I-TREATMENT -consentimiento I-TREATMENT -de I-TREATMENT -su I-TREATMENT -familia I-TREATMENT -de I-TREATMENT -acogida. I-TREATMENT -La I-TREATMENT -intubación I-TREATMENT -nasotraqueal I-TREATMENT -se I-TREATMENT -efectuó I-TREATMENT -con I-TREATMENT -fibroscopio. I-TREATMENT -Realizamos I-TREATMENT -un I-TREATMENT -abordaje I-TREATMENT -preauricular I-TREATMENT -con I-TREATMENT -exposición I-TREATMENT -del I-TREATMENT -bloque I-TREATMENT -anquilótico, I-TREATMENT -el I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -resecó I-TREATMENT -ampliamente I-TREATMENT -creando I-TREATMENT -una I-TREATMENT -nueva I-TREATMENT -cavidad I-TREATMENT -glenoidea, I-TREATMENT -sin I-TREATMENT -interponer I-TREATMENT -ningún I-TREATMENT -material I-TREATMENT -en I-TREATMENT -el I-TREATMENT -espacio I-TREATMENT -creado. I-TREATMENT -Se I-TREATMENT -completó I-TREATMENT -con I-TREATMENT -una I-TREATMENT -coronoidectomía I-TREATMENT -con I-TREATMENT -desinserción I-TREATMENT -del I-TREATMENT -músculo I-TREATMENT -temporal I-TREATMENT -bilateral. I-TREATMENT -Seguidamente, I-TREATMENT -tras I-TREATMENT -comprobar I-TREATMENT -una I-TREATMENT -apertura I-TREATMENT -oral I-TREATMENT -de I-TREATMENT -30 I-TREATMENT -mm, I-TREATMENT -colocamos I-TREATMENT -un I-TREATMENT -distractor I-TREATMENT -extraoral I-TREATMENT -de I-TREATMENT -Molina I-TREATMENT -fijado I-TREATMENT -en I-TREATMENT -el I-TREATMENT -arco I-TREATMENT -cigomático I-TREATMENT -y I-TREATMENT -en I-TREATMENT -la I-TREATMENT -rama I-TREATMENT -mandibular I-TREATMENT -ascendente, I-TREATMENT -con I-TREATMENT -la I-TREATMENT -finalidad I-TREATMENT -de I-TREATMENT -elongar I-TREATMENT -el I-TREATMENT -tejido I-TREATMENT -blando I-TREATMENT -y I-TREATMENT -prevenir I-TREATMENT -la I-TREATMENT -reanquilosis, I-TREATMENT -manteniendo I-TREATMENT -separadas I-TREATMENT -las I-TREATMENT -superficies I-TREATMENT -cruentas I-TREATMENT -de I-TREATMENT -la I-TREATMENT -resección. I-TREATMENT -La I-TREATMENT -misma I-TREATMENT -intervención I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -en I-TREATMENT -la I-TREATMENT -articulación I-TREATMENT -contralateral. I-TREATMENT - I-TREATMENT -Tras I-TREATMENT -un I-TREATMENT -período I-TREATMENT -de I-TREATMENT -latencia I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -días, I-TREATMENT -iniciamos I-TREATMENT -la I-TREATMENT -distracción I-TREATMENT -a I-TREATMENT -1 I-TREATMENT -mm I-TREATMENT -diario I-TREATMENT -y I-TREATMENT -la I-TREATMENT -fisioterapia, I-TREATMENT -la I-TREATMENT -cual I-TREATMENT -implicaba I-TREATMENT -desactivar I-TREATMENT -el I-TREATMENT -distractor I-TREATMENT -mientras I-TREATMENT -se I-TREATMENT -realizaban I-TREATMENT -los I-TREATMENT -ejercicios. I-TREATMENT -La I-TREATMENT -distracción I-TREATMENT -se I-TREATMENT -completó I-TREATMENT -al I-TREATMENT -conseguir I-TREATMENT -una I-TREATMENT -clase I-TREATMENT -I. I-TREATMENT -Durante I-TREATMENT -el I-TREATMENT -período I-TREATMENT -de I-TREATMENT -«consolidación» I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -sufrió I-TREATMENT -un I-TREATMENT -accidente I-TREATMENT -de I-TREATMENT -tráfico I-TREATMENT -que I-TREATMENT -supuso I-TREATMENT -el I-TREATMENT -desanclaje I-TREATMENT -del I-TREATMENT -distractor I-TREATMENT -derecho I-TREATMENT -que I-TREATMENT -se I-TREATMENT -recolocó I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general I-TREATMENT -y I-TREATMENT -mascarilla I-TREATMENT -laríngea. I-TREATMENT -La I-TREATMENT -retirada I-TREATMENT -definitiva I-TREATMENT -de I-TREATMENT -los I-TREATMENT -distratores I-TREATMENT -se I-TREATMENT -llevó I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -local I-TREATMENT -11 I-TREATMENT -semanas I-TREATMENT -después I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cirugía. I-TREATMENT -El B-EVOLUTION -seguimiento I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -mensual I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -retirada I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -distractores, I-EVOLUTION -hasta I-EVOLUTION -que I-EVOLUTION -tuvo I-EVOLUTION -que I-EVOLUTION -regresar I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -país I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -12 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención, I-EVOLUTION -manteniendo I-EVOLUTION -la I-EVOLUTION -apertura I-EVOLUTION -oral I-EVOLUTION -de I-EVOLUTION -30 I-EVOLUTION -mm.. I-EVOLUTION -No I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -posible I-EVOLUTION -realizar I-EVOLUTION -un I-EVOLUTION -seguimiento I-EVOLUTION -a I-EVOLUTION -largo I-EVOLUTION -plazo. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -46 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que B-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -Oral I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -Maxilofacial I-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Oftalmología I-DERIVED_FROM/TO -para B-PRESENT_ILLNESS -valoración I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -exoftalmos I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -mórbida I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -alergia I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -yodo. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -1980 I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertiroidismo I-PAST_MEDICAL_HISTORY -originado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -Enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Graves-Basedow, I-PAST_MEDICAL_HISTORY -siendo I-PAST_MEDICAL_HISTORY -operada I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -después, I-PAST_MEDICAL_HISTORY -realizándose I-PAST_MEDICAL_HISTORY -tiroidectomía I-PAST_MEDICAL_HISTORY -subtotal, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -pauta I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -Levotiroxina I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -mg/día. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -1999 I-PAST_MEDICAL_HISTORY -acude I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -Servicio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Oftalmología I-PAST_MEDICAL_HISTORY -refiriendo I-PAST_MEDICAL_HISTORY -lento I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -progresivo I-PAST_MEDICAL_HISTORY -empeoramiento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -exoftalmos, I-PAST_MEDICAL_HISTORY -así I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -signos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -síntomas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -queratitis. I-PAST_MEDICAL_HISTORY -Tras I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -megadosis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -esteroides I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -desestimar I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -radioterapia, I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -intervenida I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -dicho I-PAST_MEDICAL_HISTORY -Servicio I-PAST_MEDICAL_HISTORY -realizándose I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -descompresión I-PAST_MEDICAL_HISTORY -quirúrgica I-PAST_MEDICAL_HISTORY -(pared I-PAST_MEDICAL_HISTORY -medial I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -suelo) I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ojo I-PAST_MEDICAL_HISTORY -izquierdo I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -abordaje I-PAST_MEDICAL_HISTORY -subciliar. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -Marzo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2002 I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -realiza I-PAST_MEDICAL_HISTORY -tiroidectomía I-PAST_MEDICAL_HISTORY -total. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -Junio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2003 I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestra I-PRESENT_ILLNESS -Consulta, I-PRESENT_ILLNESS -presentando I-PRESENT_ILLNESS -retracción I-PRESENT_ILLNESS -palpebral I-PRESENT_ILLNESS -severa, I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -acentuada I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -tercio I-PRESENT_ILLNESS -externo I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -temporal I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -párpado I-PRESENT_ILLNESS -superior; I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -limbo I-PRESENT_ILLNESS -corneal I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -queda I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -descubierto, I-PRESENT_ILLNESS -dejando I-PRESENT_ILLNESS -porción I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -esclera I-PRESENT_ILLNESS -expuesta. I-PRESENT_ILLNESS -Se B-EXPLORATION -objetiva I-EXPLORATION -hipertrofia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -grasa I-EXPLORATION -suborbicular I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -subciliar I-EXPLORATION -del I-EXPLORATION -párpado I-EXPLORATION -inferior. I-EXPLORATION - I-EXPLORATION -Es I-EXPLORATION -evidente I-EXPLORATION -el I-EXPLORATION -exoftalmos, I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -bilateral. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -queja I-EXPLORATION -de I-EXPLORATION -incapacidad I-EXPLORATION -para I-EXPLORATION -mantener I-EXPLORATION -la I-EXPLORATION -lectura I-EXPLORATION -durante I-EXPLORATION -un I-EXPLORATION -tiempo I-EXPLORATION -prolongado, I-EXPLORATION -con I-EXPLORATION -fatiga I-EXPLORATION -y I-EXPLORATION -disconfort, I-EXPLORATION -síntomas I-EXPLORATION -de I-EXPLORATION -restricción I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -motilidad I-EXPLORATION -ocular. I-EXPLORATION -La I-EXPLORATION -enfermedad I-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -en I-EXPLORATION -fase I-EXPLORATION -no I-EXPLORATION -inflamatoria, I-EXPLORATION -no I-EXPLORATION -presentando I-EXPLORATION -queratitis I-EXPLORATION -severa, I-EXPLORATION -hiperemia, I-EXPLORATION -quemosis I-EXPLORATION -conjuntival, I-EXPLORATION -ni I-EXPLORATION -diplopia. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -TAC I-EXPLORATION -orbitario I-EXPLORATION -muestra I-EXPLORATION -exoftalmos, I-EXPLORATION -engrosamiento I-EXPLORATION -muscular, I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -volumen I-EXPLORATION -graso I-EXPLORATION -orbitario I-EXPLORATION -y I-EXPLORATION -rectificación I-EXPLORATION -del I-EXPLORATION -nervio I-EXPLORATION -óptico. I-EXPLORATION -Tiene I-EXPLORATION -la I-EXPLORATION -ventaja I-EXPLORATION -respecto I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -RM I-EXPLORATION -de I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -el I-EXPLORATION -detalle I-EXPLORATION -óseo, I-EXPLORATION -que I-EXPLORATION -tiene I-EXPLORATION -un I-EXPLORATION -gran I-EXPLORATION -valor I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -planificación I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -procedimientos I-EXPLORATION -quirúrgicos I-EXPLORATION -de I-EXPLORATION -descompresión. I-EXPLORATION -La I-EXPLORATION -RM I-EXPLORATION -muestra I-EXPLORATION -exoftalmos, I-EXPLORATION -con I-EXPLORATION -engrosamiento I-EXPLORATION -muscular I-EXPLORATION -severo I-EXPLORATION -con I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -porción I-EXPLORATION -ventral I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -graso. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -los I-TREATMENT -antecedentes I-TREATMENT -descritos, I-TREATMENT -la I-TREATMENT -clínica I-TREATMENT -y I-TREATMENT -las I-TREATMENT -pruebas I-TREATMENT -de I-TREATMENT -imagen I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -mediante I-TREATMENT -la I-TREATMENT -remoción I-TREATMENT -parcial I-TREATMENT -de I-TREATMENT -la I-TREATMENT -pared I-TREATMENT -lateral I-TREATMENT -y I-TREATMENT -del I-TREATMENT -suelo I-TREATMENT -orbitario, I-TREATMENT -junto I-TREATMENT -a I-TREATMENT -lipectomía I-TREATMENT -y I-TREATMENT -osteotomía I-TREATMENT -con I-TREATMENT -avance I-TREATMENT -del I-TREATMENT -marco I-TREATMENT -orbitario I-TREATMENT -superior, I-TREATMENT -lateral I-TREATMENT -e I-TREATMENT -inferior. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -abordaje I-TREATMENT -bicoronal, I-TREATMENT -con I-TREATMENT -un I-TREATMENT -colgajo I-TREATMENT -subgaleal I-TREATMENT -hasta I-TREATMENT -aproximadamente I-TREATMENT -2 I-TREATMENT -cm. I-TREATMENT -del I-TREATMENT -reborde I-TREATMENT -supraorbitario, I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -una I-TREATMENT -incisión I-TREATMENT -del I-TREATMENT -periostio I-TREATMENT -y I-TREATMENT -se I-TREATMENT -continúa I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -órbita I-TREATMENT -por I-TREATMENT -el I-TREATMENT -plano I-TREATMENT -subperióstico. I-TREATMENT -La I-TREATMENT -porción I-TREATMENT -anterior I-TREATMENT -del I-TREATMENT -músculo I-TREATMENT -temporal I-TREATMENT -fue I-TREATMENT -liberada I-TREATMENT -de I-TREATMENT -su I-TREATMENT -inserción I-TREATMENT -para I-TREATMENT -permitir I-TREATMENT -un I-TREATMENT -mejor I-TREATMENT -acceso I-TREATMENT -a I-TREATMENT -la I-TREATMENT -pared I-TREATMENT -lateral I-TREATMENT -orbitaria. I-TREATMENT -El I-TREATMENT -abordaje I-TREATMENT -se I-TREATMENT -completó I-TREATMENT -con I-TREATMENT -una I-TREATMENT -incisión I-TREATMENT -subciliar I-TREATMENT -bilateral I-TREATMENT -que I-TREATMENT -permitió I-TREATMENT -el I-TREATMENT -acceso I-TREATMENT -al I-TREATMENT -reborde I-TREATMENT -infraorbitario I-TREATMENT -y I-TREATMENT -a I-TREATMENT -la I-TREATMENT -región I-TREATMENT -medial I-TREATMENT -del I-TREATMENT -suelo I-TREATMENT -orbitario. I-TREATMENT - I-TREATMENT -Realizamos I-TREATMENT -una I-TREATMENT -osteotomía I-TREATMENT -bilateral I-TREATMENT --orbitotomía- I-TREATMENT -del I-TREATMENT -marco I-TREATMENT -orbitario I-TREATMENT -superior, I-TREATMENT -lateral I-TREATMENT -e I-TREATMENT -inferior; I-TREATMENT -que I-TREATMENT -se I-TREATMENT -avanza I-TREATMENT -8 I-TREATMENT -mm I-TREATMENT -respecto I-TREATMENT -a I-TREATMENT -su I-TREATMENT -posición I-TREATMENT -de I-TREATMENT -origen. I-TREATMENT -Se I-TREATMENT -realiza I-TREATMENT -la I-TREATMENT -osteosíntesis I-TREATMENT -con I-TREATMENT -miniplacas I-TREATMENT -2, I-TREATMENT -0. I-TREATMENT -Se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -la I-TREATMENT -eliminación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -pared I-TREATMENT -lateral I-TREATMENT -orbitaria I-TREATMENT -y I-TREATMENT -del I-TREATMENT -suelo I-TREATMENT -en I-TREATMENT -su I-TREATMENT -porción I-TREATMENT -medial I-TREATMENT -y I-TREATMENT -lateral, I-TREATMENT -respetando I-TREATMENT -el I-TREATMENT -trayecto I-TREATMENT -del I-TREATMENT -nervio I-TREATMENT -infraorbitario. I-TREATMENT -Se I-TREATMENT -realizan I-TREATMENT -incisiones I-TREATMENT -en I-TREATMENT -la I-TREATMENT -periórbita I-TREATMENT -y I-TREATMENT -lipectomía I-TREATMENT -tras I-TREATMENT -la I-TREATMENT -liberación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -grasa I-TREATMENT -periorbitaria. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -colocó I-TREATMENT -un I-TREATMENT -drenaje I-TREATMENT -aspirativo I-TREATMENT -subgaleal I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -retirado I-TREATMENT -a I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -horas. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -mantuvo I-TREATMENT -una I-TREATMENT -tarsorrafia I-TREATMENT -temporal I-TREATMENT -(punto I-TREATMENT -de I-TREATMENT -Frost) I-TREATMENT -las I-TREATMENT -primeras I-TREATMENT -48 I-TREATMENT -horas. I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -72 I-EVOLUTION -horas I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -dolor I-EVOLUTION -intenso I-EVOLUTION -en I-EVOLUTION -región I-EVOLUTION -posterior I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -pierna I-EVOLUTION -izquierda, I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -diagnosticado I-EVOLUTION -como I-EVOLUTION -trombosis I-EVOLUTION -del I-EVOLUTION -lago I-EVOLUTION -gemelar I-EVOLUTION -y I-EVOLUTION -tratada I-EVOLUTION -con I-EVOLUTION -heparina. I-EVOLUTION -La I-EVOLUTION -sutura I-EVOLUTION -subciliar I-EVOLUTION -se I-EVOLUTION -retiró I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -días I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -coronal I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -días. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -44 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -remitida B-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -médico I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cabecera I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -Oral I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -Maxilofacial I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -presentar I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -tumoración I-DERIVED_FROM/TO -parotídea, I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -palpación I-DERIVED_FROM/TO -parecía I-DERIVED_FROM/TO -constar I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -único I-DERIVED_FROM/TO -nódulo. I-DERIVED_FROM/TO -Con B-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -tumoración I-EXPLORATION -benigna I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -punción I-EXPLORATION -aspiración I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina I-EXPLORATION -de I-EXPLORATION -23-G I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -Servicio I-EXPLORATION -de I-EXPLORATION -Anatomía I-EXPLORATION -Patológica, I-EXPLORATION -fijando I-EXPLORATION -el I-EXPLORATION -material I-EXPLORATION -obtenido, I-EXPLORATION -de I-EXPLORATION -manera I-EXPLORATION -inmediata, I-EXPLORATION -en I-EXPLORATION -alcohol I-EXPLORATION -de I-EXPLORATION -95% I-EXPLORATION -y I-EXPLORATION -reservando I-EXPLORATION -uno I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -aspirados I-EXPLORATION -para I-EXPLORATION -secado I-EXPLORATION -al I-EXPLORATION -aire. I-EXPLORATION -Las I-EXPLORATION -muestras I-EXPLORATION -fijadas I-EXPLORATION -en I-EXPLORATION -alcohol I-EXPLORATION -se I-EXPLORATION -tiñeron I-EXPLORATION -siguiendo I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -Papanicolaou, I-EXPLORATION -mientras I-EXPLORATION -que I-EXPLORATION -los I-EXPLORATION -secados I-EXPLORATION -al I-EXPLORATION -aire I-EXPLORATION -se I-EXPLORATION -colorean I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -Diff- I-EXPLORATION -Quick. I-EXPLORATION - I-EXPLORATION -Citológicamente I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -compuesta I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -epiteliales I-EXPLORATION -y I-EXPLORATION -ductales I-EXPLORATION -sobre I-EXPLORATION -un I-EXPLORATION -fondo I-EXPLORATION -basofílico I-EXPLORATION -fibrilar I-EXPLORATION -y I-EXPLORATION -mixomatoso, I-EXPLORATION -además I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -un I-EXPLORATION -material I-EXPLORATION -condroide I-EXPLORATION -y I-EXPLORATION -fragmentos I-EXPLORATION -de I-EXPLORATION -estroma I-EXPLORATION -eosinófilo I-EXPLORATION -fibrilar. I-EXPLORATION -El B-TREATMENT -diagnóstico I-TREATMENT -citológico I-TREATMENT -fue I-TREATMENT -de I-TREATMENT -adenoma I-TREATMENT -pleomorfo I-TREATMENT -(AP) I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -parotidectomía I-TREATMENT -total I-TREATMENT -con I-TREATMENT -preservación I-TREATMENT -del I-TREATMENT -nervio I-TREATMENT -facial. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -se I-EXPLORATION -incluyó I-EXPLORATION -en I-EXPLORATION -formaldehído I-EXPLORATION -al I-EXPLORATION -10% I-EXPLORATION -observando I-EXPLORATION -macroscópicamente I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -de I-EXPLORATION -2x2 I-EXPLORATION -cm, I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -blando-elástica I-EXPLORATION -y I-EXPLORATION -coloración I-EXPLORATION -blanquecina, I-EXPLORATION -parcialmente I-EXPLORATION -encapsulado, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -nodular I-EXPLORATION -polilobulada I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -apariencia I-EXPLORATION -linfoide, I-EXPLORATION -separada I-EXPLORATION -del I-EXPLORATION -tumor I-EXPLORATION -principal I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -fino I-EXPLORATION -cordón I-EXPLORATION -estromal. I-EXPLORATION -Tras I-EXPLORATION -la I-EXPLORATION -fijación I-EXPLORATION -se I-EXPLORATION -secciona I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -totalidad I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -procesa I-EXPLORATION -de I-EXPLORATION -manera I-EXPLORATION -rutinaria I-EXPLORATION -para I-EXPLORATION -obtener I-EXPLORATION -los I-EXPLORATION -bloques I-EXPLORATION -de I-EXPLORATION -parafina. I-EXPLORATION -La I-EXPLORATION -tinción I-EXPLORATION -empleada I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -observación I-EXPLORATION -microscópica I-EXPLORATION -es I-EXPLORATION -hematoxilina-eosina I-EXPLORATION -clásica. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -microscópico I-EXPLORATION -muestra I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -principal I-EXPLORATION -bien I-EXPLORATION -circunscrito, I-EXPLORATION -rodeado I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -pseudocápsula I-EXPLORATION -conectiva, I-EXPLORATION -compuesto I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -población I-EXPLORATION -celular I-EXPLORATION -bifásica I-EXPLORATION -de I-EXPLORATION -epitelio I-EXPLORATION -glandular I-EXPLORATION -y I-EXPLORATION -células I-EXPLORATION -mioepiteliales I-EXPLORATION -rodeadas I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -material I-EXPLORATION -fibrilar I-EXPLORATION -mixoide, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -confirma I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -adenoma I-EXPLORATION -pleomorfo. I-EXPLORATION -Los I-EXPLORATION -otros I-EXPLORATION -nódulos I-EXPLORATION -eran I-EXPLORATION -ganglios I-EXPLORATION -linfáticos, I-EXPLORATION -pero I-EXPLORATION -apareció I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -lesión, I-EXPLORATION -de I-EXPLORATION -pequeña I-EXPLORATION -talla, I-EXPLORATION -muy I-EXPLORATION -cercana I-EXPLORATION -al I-EXPLORATION -tumor I-EXPLORATION -mixto, I-EXPLORATION -de I-EXPLORATION -apariencia I-EXPLORATION -quística I-EXPLORATION -y I-EXPLORATION -papilar, I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -doble I-EXPLORATION -hilera I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -oncocíticas I-EXPLORATION -rodeando I-EXPLORATION -los I-EXPLORATION -espacios I-EXPLORATION -quísticos I-EXPLORATION -con I-EXPLORATION -estroma I-EXPLORATION -linfoide I-EXPLORATION -adyacente. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -histopatológico I-EXPLORATION -definitivo I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -adenoma I-EXPLORATION -pleomorfo I-EXPLORATION -y I-EXPLORATION -tumor I-EXPLORATION -de I-EXPLORATION -Warthin I-EXPLORATION -sincrónicos I-EXPLORATION -de I-EXPLORATION -parótida I-EXPLORATION -derecha. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -84 I-PRESENT_ILLNESS -enviada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -recidiva I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -carcinoma I-PRESENT_ILLNESS -epidermoide I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -preauricular I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -tratada I-PRESENT_ILLNESS -previamente I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -cirugía I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -RT. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -TC I-EXPLORATION -facial I-EXPLORATION -aparece I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -preauricular I-EXPLORATION -derecha I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -hacia I-EXPLORATION -las I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -malar, I-EXPLORATION -contactando I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -músculo I-EXPLORATION -masetero I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -glándula I-EXPLORATION -parótida. I-EXPLORATION -El I-EXPLORATION -tratamiento I-EXPLORATION -quirúrgico I-EXPLORATION -consistió I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -extirpación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -incluyendo I-EXPLORATION -el I-EXPLORATION -pabellón I-EXPLORATION -auricular I-EXPLORATION -derecho, I-EXPLORATION -CAE I-EXPLORATION -y I-EXPLORATION -parotidectomía I-EXPLORATION -total I-EXPLORATION -radical. I-EXPLORATION -La I-EXPLORATION -reconstrucción I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -con I-EXPLORATION -colgajo I-EXPLORATION -de I-EXPLORATION -músculo I-EXPLORATION -temporal I-EXPLORATION -que I-EXPLORATION -desinsertado I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cresta I-EXPLORATION -temporal I-EXPLORATION -y I-EXPLORATION -pediculado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -coronoides, I-EXPLORATION -fue I-EXPLORATION -rotado I-EXPLORATION -en I-EXPLORATION -dirección I-EXPLORATION -caudal I-EXPLORATION -para I-EXPLORATION -cubrir I-EXPLORATION -el I-EXPLORATION -defecto. I-EXPLORATION -La I-EXPLORATION -porción I-EXPLORATION -inferior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -fascia I-EXPLORATION -temporal I-EXPLORATION -profunda I-EXPLORATION -fue I-EXPLORATION -disecada I-EXPLORATION -y I-EXPLORATION -dividida I-EXPLORATION -en I-EXPLORATION -dos I-EXPLORATION -láminas I-EXPLORATION -cuyos I-EXPLORATION -extremos I-EXPLORATION -libres I-EXPLORATION -fueron I-EXPLORATION -suturados I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -comisura I-EXPLORATION -y I-EXPLORATION -musculatura I-EXPLORATION -del I-EXPLORATION -labio I-EXPLORATION -superior. I-EXPLORATION -El I-EXPLORATION -músculo I-EXPLORATION -temporal I-EXPLORATION -traspuesto I-EXPLORATION -se I-EXPLORATION -cubrió I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -injerto I-EXPLORATION -parcial I-EXPLORATION -de I-EXPLORATION -piel. I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -meses I-EVOLUTION -postoperatorio I-EVOLUTION -se I-EVOLUTION -observa I-EVOLUTION -cómo I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -consigue I-EVOLUTION -elevar I-EVOLUTION -la I-EVOLUTION -comisura I-EVOLUTION -bucal I-EVOLUTION -y I-EVOLUTION -una I-EVOLUTION -estética I-EVOLUTION -aceptable I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -zona I-EVOLUTION -reconstruida. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-DERIVED_FROM/TO -acude I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -consultas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -Oral I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -Maxilofacial I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -Infanta I-DERIVED_FROM/TO -Cristina I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Badajoz, I-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -Médico I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Familia. I-DERIVED_FROM/TO -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tensión I-PRESENT_ILLNESS -hemifacial I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -palpación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dicha I-PRESENT_ILLNESS -región. I-PRESENT_ILLNESS -Refiere I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolorinflamación I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -cedieron I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -antibióticos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -antiinflamatorios. I-PRESENT_ILLNESS -Describe I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -discreta I-PRESENT_ILLNESS -asimetría I-PRESENT_ILLNESS -facial I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -ido I-PRESENT_ILLNESS -evolucionando I-PRESENT_ILLNESS -progresivamente I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -hacerse I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -patente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -meses. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -abombamiento I-EXPLORATION -de I-EXPLORATION -vestíbulo I-EXPLORATION -superior I-EXPLORATION -derecho, I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -ortopantomografía I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -TAC I-EXPLORATION -facial I-EXPLORATION -apreciándose I-EXPLORATION -en I-EXPLORATION -ambas I-EXPLORATION -un I-EXPLORATION -tercer I-EXPLORATION -molar I-EXPLORATION -(18) I-EXPLORATION -incluido I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -techo I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -derecho I-EXPLORATION -- I-EXPLORATION -región I-EXPLORATION -infraorbitaria I-EXPLORATION -derecha. I-EXPLORATION - I-EXPLORATION -Dada B-TREATMENT -la I-TREATMENT -sintomatología I-TREATMENT -clínica I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -optó I-TREATMENT -por I-TREATMENT -realizar I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -mediante I-TREATMENT -abordaje I-TREATMENT -de I-TREATMENT -Caldwell- I-TREATMENT -Luc.13-21 I-TREATMENT -Bajo I-TREATMENT -anestesia I-TREATMENT -general I-TREATMENT -e I-TREATMENT -intubación I-TREATMENT -oro-traqueal I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -incisión I-TREATMENT -de I-TREATMENT -Neumann I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -vestíbulo I-TREATMENT -superior I-TREATMENT -derecho. I-TREATMENT -Tras I-TREATMENT -elevación I-TREATMENT -de I-TREATMENT -colgajo I-TREATMENT -mucoperióstico I-TREATMENT -se I-TREATMENT -visualizó I-TREATMENT -la I-TREATMENT -cápsula I-TREATMENT -quística I-TREATMENT -y I-TREATMENT -la I-TREATMENT -cortical I-TREATMENT -maxilar I-TREATMENT -de I-TREATMENT -aspecto I-TREATMENT -papiráceo I-TREATMENT -con I-TREATMENT -adherencias I-TREATMENT -y I-TREATMENT -fibrosis. I-TREATMENT -Posteriormente I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cavidad I-TREATMENT -quística I-TREATMENT -y I-TREATMENT -exodoncia I-TREATMENT -del I-TREATMENT -cordal I-TREATMENT -mediante I-TREATMENT -el I-TREATMENT -uso I-TREATMENT -de I-TREATMENT -fórceps. I-TREATMENT -Finalmente I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -legrado I-TREATMENT -intenso I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cavidad I-TREATMENT -y I-TREATMENT -sutura I-TREATMENT -del I-TREATMENT -colgajo I-TREATMENT -mediante I-TREATMENT -material I-TREATMENT -reabsorbible. I-TREATMENT - B-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -fue I-EXPLORATION -informado I-EXPLORATION -como I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -quiste I-EXPLORATION -radicular. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -género I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -desdentada I-PRESENT_ILLNESS -parcial I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -clase I-PRESENT_ILLNESS -I I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Kennedy I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -remanencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -piezas I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -boca, I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -rehabilitar I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -sector I-PRESENT_ILLNESS -posterior. I-PRESENT_ILLNESS -De B-EXPLORATION -acuerdo I-EXPLORATION -al I-EXPLORATION -estudio I-EXPLORATION -radiográfico I-EXPLORATION -presenta I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -reabsorción I-EXPLORATION -bilateral I-EXPLORATION -por I-EXPLORATION -neumatización I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -planifica I-EXPLORATION -una I-EXPLORATION -reconstrucción I-EXPLORATION -con I-EXPLORATION -injerto I-EXPLORATION -de I-EXPLORATION -calota I-EXPLORATION -e I-EXPLORATION -implantes I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -segundo I-EXPLORATION -tiempo, I-EXPLORATION -tratamiento I-EXPLORATION -que I-EXPLORATION -rechaza I-EXPLORATION -por I-EXPLORATION -su I-EXPLORATION -alta I-EXPLORATION -morbilidad. I-EXPLORATION -Por B-TREATMENT -esta I-TREATMENT -razón I-TREATMENT -se I-TREATMENT -planifica I-TREATMENT -la I-TREATMENT -rehabilitación I-TREATMENT -en I-TREATMENT -base I-TREATMENT -a I-TREATMENT -implantes I-TREATMENT -cigomáticos, I-TREATMENT -para I-TREATMENT -reemplazar I-TREATMENT -hasta I-TREATMENT -el I-TREATMENT -primer I-TREATMENT -molar. I-TREATMENT -Para I-TREATMENT -esto I-TREATMENT -se I-TREATMENT -instalan I-TREATMENT -dos I-TREATMENT -implantes I-TREATMENT -cigomáticos I-TREATMENT -a I-TREATMENT -cada I-TREATMENT -lado, I-TREATMENT -3 I-TREATMENT -de I-TREATMENT -45 I-TREATMENT -mm I-TREATMENT -y I-TREATMENT -uno I-TREATMENT -de I-TREATMENT -40 I-TREATMENT -mm. I-TREATMENT - I-TREATMENT -Para I-TREATMENT -rehabilitar I-TREATMENT -en I-TREATMENT -base I-TREATMENT -a I-TREATMENT -prótesis I-TREATMENT -fija I-TREATMENT -se I-TREATMENT -requería I-TREATMENT -la I-TREATMENT -emergencia I-TREATMENT -de I-TREATMENT -los I-TREATMENT -implantes I-TREATMENT -sobre I-TREATMENT -el I-TREATMENT -reborde I-TREATMENT -alveolar, I-TREATMENT -para I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -modificó I-TREATMENT -la I-TREATMENT -técnica I-TREATMENT -original. I-TREATMENT -Los I-TREATMENT -implantes I-TREATMENT -del I-TREATMENT -lado I-TREATMENT -derecho I-TREATMENT -se I-TREATMENT -instalaron I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -las I-TREATMENT -piezas I-TREATMENT -dentarias I-TREATMENT -3 I-TREATMENT -y I-TREATMENT -4. I-TREATMENT -El I-TREATMENT -implante I-TREATMENT -posterior I-TREATMENT -se I-TREATMENT -ubicó I-TREATMENT -por I-TREATMENT -fuera I-TREATMENT -del I-TREATMENT -seno I-TREATMENT -maxilar I-TREATMENT -y I-TREATMENT -el I-TREATMENT -anterior I-TREATMENT -por I-TREATMENT -dentro I-TREATMENT -pero I-TREATMENT -con I-TREATMENT -una I-TREATMENT -angulación I-TREATMENT -mayor I-TREATMENT -con I-TREATMENT -respecto I-TREATMENT -al I-TREATMENT -plano I-TREATMENT -oclusal. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -lado I-TREATMENT -izquierdo, I-TREATMENT -en I-TREATMENT -posición I-TREATMENT -de I-TREATMENT -las I-TREATMENT -piezas I-TREATMENT -dentarias I-TREATMENT -13 I-TREATMENT -y I-TREATMENT -14, I-TREATMENT -el I-TREATMENT -implante I-TREATMENT -anterior I-TREATMENT -se I-TREATMENT -posicionó I-TREATMENT -por I-TREATMENT -fuera I-TREATMENT -del I-TREATMENT -seno I-TREATMENT -maxilar I-TREATMENT -y I-TREATMENT -el I-TREATMENT -implante I-TREATMENT -posterior I-TREATMENT -por I-TREATMENT -dentro I-TREATMENT -con I-TREATMENT -mayor I-TREATMENT -angulación. I-TREATMENT -Con I-TREATMENT -esto I-TREATMENT -se I-TREATMENT -logró I-TREATMENT -que I-TREATMENT -los I-TREATMENT -cuatro I-TREATMENT -implantes I-TREATMENT -emergieran I-TREATMENT -en I-TREATMENT -el I-TREATMENT -reborde I-TREATMENT -alveolar I-TREATMENT -con I-TREATMENT -una I-TREATMENT -angulación I-TREATMENT -dentro I-TREATMENT -de I-TREATMENT -límites I-TREATMENT -aceptables. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -RGP, I-PRESENT_ILLNESS -HC: I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS -14 I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -tiene I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -motivo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -labio I-PRESENT_ILLNESS -inferior. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -remonta I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -15 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -mordisco I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -labio I-PAST_MEDICAL_HISTORY -inferior I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -intensa I-PAST_MEDICAL_HISTORY -hemorragia. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -partir I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -traumatismo I-PAST_MEDICAL_HISTORY -apareció I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -central I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -labio I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -aumento I-PAST_MEDICAL_HISTORY -progresivo, I-PAST_MEDICAL_HISTORY -indoloro, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -color I-PAST_MEDICAL_HISTORY -azul I-PAST_MEDICAL_HISTORY -violáceo, I-PAST_MEDICAL_HISTORY -pulsátil, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diámetro. I-PAST_MEDICAL_HISTORY -Clasificada I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -lesión I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -hemangioma I-PAST_MEDICAL_HISTORY -traumático, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -comenzó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -tratar I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -inyecciones I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -betametasona. I-PAST_MEDICAL_HISTORY -Luego I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -betametasona, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -realizó I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -exéresis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -tumoración I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -bucal. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -histopatológico I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -compatible I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hemangioma I-PAST_MEDICAL_HISTORY -traumático. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -este I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -nos I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -nuevamente, I-PRESENT_ILLNESS -ya I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -labial I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -voluminoso, I-PRESENT_ILLNESS -pulsátil, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -soplo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -frenito. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -intrabucal I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -los I-EXPLORATION -relieves I-EXPLORATION -vasculares I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -del I-EXPLORATION -labio I-EXPLORATION -inferior I-EXPLORATION -Indicamos I-EXPLORATION -ecografía I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -y B-TREATMENT -ejecutamos I-TREATMENT -una I-TREATMENT -disección I-TREATMENT -de I-TREATMENT -la I-TREATMENT -carótida I-TREATMENT -derecha I-TREATMENT -para I-TREATMENT -arteriografía I-TREATMENT -la I-TREATMENT -cual I-TREATMENT -informa I-TREATMENT -de I-TREATMENT -un I-TREATMENT -saco I-TREATMENT -aneurismático I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -las I-TREATMENT -regiones I-TREATMENT -labial I-TREATMENT -inferior I-TREATMENT -y I-TREATMENT -mentoniana. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -ligó I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -carótida I-TREATMENT -externa I-TREATMENT -entre I-TREATMENT -la I-TREATMENT -tiroidea I-TREATMENT -superior I-TREATMENT -y I-TREATMENT -la I-TREATMENT -lingual, I-TREATMENT -por I-TREATMENT -incisión I-TREATMENT -submentoniana I-TREATMENT -se I-TREATMENT -ligaron I-TREATMENT -los I-TREATMENT -vasos I-TREATMENT -venosos I-TREATMENT -del I-TREATMENT -aneurisma, I-TREATMENT -para I-TREATMENT -aislar I-TREATMENT -esta I-TREATMENT -cavidad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -circulación. I-TREATMENT - I-TREATMENT -Al I-TREATMENT -final I-TREATMENT -de I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -se I-TREATMENT -inyectaron I-TREATMENT -4cc I-TREATMENT -de I-TREATMENT -betametasona I-TREATMENT -en I-TREATMENT -la I-TREATMENT -tumoración I-TREATMENT -y I-TREATMENT -se I-TREATMENT -aplicó I-TREATMENT -un I-TREATMENT -esparadrapo I-TREATMENT -elástico. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -aplicaron I-TREATMENT -4 I-TREATMENT -inyecciones I-TREATMENT -adicionales I-TREATMENT -con I-TREATMENT -triancinolona I-TREATMENT -a I-TREATMENT -intervalos I-TREATMENT -de I-TREATMENT -3 I-TREATMENT -semanas, I-TREATMENT -notándose I-TREATMENT -una I-TREATMENT -progresiva I-TREATMENT -reducción I-TREATMENT -y I-TREATMENT -fibrosis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tumoración I-TREATMENT -no I-TREATMENT -constatándose I-TREATMENT -soplo. I-TREATMENT - I-TREATMENT -A I-TREATMENT -los I-TREATMENT -tres I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -la I-TREATMENT -ligadura I-TREATMENT -de I-TREATMENT -los I-TREATMENT -vasos I-TREATMENT -se I-TREATMENT -practicó I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fibrosis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tumoración I-TREATMENT -labial. I-TREATMENT -El B-EVOLUTION -resultado I-EVOLUTION -estético I-EVOLUTION -final I-EVOLUTION -fue I-EVOLUTION -aceptable. I-EVOLUTION -En I-EVOLUTION -estos I-EVOLUTION -momentos I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -lleva I-EVOLUTION -5 I-EVOLUTION -años I-EVOLUTION -desde I-EVOLUTION -la I-EVOLUTION -ultima I-EVOLUTION -intervención, I-EVOLUTION -no I-EVOLUTION -apareciendo I-EVOLUTION -recidiva I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -lesión. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -63 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -remitida B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestra I-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -odontólogo, I-DERIVED_FROM/TO -quejándose I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -masa I-DERIVED_FROM/TO -dolorosa I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -región I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -canino I-DERIVED_FROM/TO -inferior I-DERIVED_FROM/TO -derecho, I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -había I-DERIVED_FROM/TO -descubierto I-DERIVED_FROM/TO -cuatro I-DERIVED_FROM/TO -semanas I-DERIVED_FROM/TO -antes. I-DERIVED_FROM/TO -Negaba B-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -alteración I-PRESENT_ILLNESS -neurosensorial, I-PRESENT_ILLNESS -disfagia, I-PRESENT_ILLNESS -odinofagia, I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -demostraba I-EXPLORATION -una I-EXPLORATION -mínima I-EXPLORATION -tumefacción I-EXPLORATION -facial I-EXPLORATION -y I-EXPLORATION -asimetría. I-EXPLORATION -Intraoralmente, I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -un I-EXPLORATION -abombamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tabla I-EXPLORATION -lingual I-EXPLORATION -derecha I-EXPLORATION -mandibular I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -canino, I-EXPLORATION -con I-EXPLORATION -vestibulización I-EXPLORATION -del I-EXPLORATION -mismo. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -palpaban I-EXPLORATION -adenopatías I-EXPLORATION -cervicales. I-EXPLORATION -La I-EXPLORATION -ortopantomografía I-EXPLORATION -demostró I-EXPLORATION -un I-EXPLORATION -area I-EXPLORATION -radiolúcida, I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -regulares, I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -canino, I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -máximo. I-EXPLORATION -Se I-EXPLORATION -diagnosticó I-EXPLORATION -como I-EXPLORATION -patología I-EXPLORATION -quística I-EXPLORATION -benigna. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -incisional I-EXPLORATION -bajo I-EXPLORATION -anestesia I-EXPLORATION -local. I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -microscópicos I-EXPLORATION -concluyeron I-EXPLORATION -que I-EXPLORATION -era I-EXPLORATION -una I-EXPLORATION -neoplasia I-EXPLORATION -maligna I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -fusiformes. I-EXPLORATION - I-EXPLORATION -Como I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -extensión I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -TC I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -pelvis, I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -absolutamente I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -intervenida I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general I-TREATMENT -tres I-TREATMENT -semanas I-TREATMENT -después I-TREATMENT -de I-TREATMENT -su I-TREATMENT -primera I-TREATMENT -visita. I-TREATMENT -En B-EXPLORATION -ese I-EXPLORATION -momento, I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -que I-EXPLORATION -había I-EXPLORATION -emergido I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -cara I-EXPLORATION -vestibular, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -biopsia. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -disección I-TREATMENT -cervical I-TREATMENT -supraomohioidea I-TREATMENT -derecha, I-TREATMENT -con I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -glándula I-TREATMENT -submaxilar I-TREATMENT -y I-TREATMENT -los I-TREATMENT -ganglios I-TREATMENT -linfáticos I-TREATMENT -regionales. I-TREATMENT -La I-TREATMENT -mandíbula I-TREATMENT -fue I-TREATMENT -resecada I-TREATMENT -desde I-TREATMENT -la I-TREATMENT -sínfisis I-TREATMENT -hasta I-TREATMENT -el I-TREATMENT -primer I-TREATMENT -molar I-TREATMENT -inferior I-TREATMENT -derecho. I-TREATMENT -La B-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -vaciamiento I-EXPLORATION -cervical I-EXPLORATION -estaban, I-EXPLORATION -macroscópicamente, I-EXPLORATION -libres I-EXPLORATION -de I-EXPLORATION -tumor. I-EXPLORATION -Para B-TREATMENT -la I-TREATMENT -reconstrucción I-TREATMENT -primaria I-TREATMENT -del I-TREATMENT -defecto I-TREATMENT -se I-TREATMENT -utilizó I-TREATMENT -una I-TREATMENT -placa I-TREATMENT -de I-TREATMENT -reconstrucción. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -inmediato, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -desarrolló I-EVOLUTION -una I-EVOLUTION -infección I-EVOLUTION -cervical, I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -comunicación I-EVOLUTION -orocervical, I-EVOLUTION -a I-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sonda I-EVOLUTION -nasogástrica I-EVOLUTION -colocada I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -momento I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía. I-EVOLUTION -A B-TREATMENT -pesar I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -intravenoso, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -no I-TREATMENT -mejoró, I-TREATMENT -con I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -retiró I-TREATMENT -la I-TREATMENT -placa I-TREATMENT -de I-TREATMENT -reconstrucción I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general. I-TREATMENT -Posteriormente, B-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente, I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -20 I-EVOLUTION -día I-EVOLUTION -postoperatorio. I-EVOLUTION - I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -mostraban I-EXPLORATION -que I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -tumorales I-EXPLORATION -eran I-EXPLORATION -reactivas I-EXPLORATION -para I-EXPLORATION -vimentina I-EXPLORATION -y I-EXPLORATION -actina I-EXPLORATION -músculo-específica. I-EXPLORATION -Asimismo, I-EXPLORATION -también I-EXPLORATION -eran I-EXPLORATION -reactivas I-EXPLORATION -para I-EXPLORATION -desmina. I-EXPLORATION -Finalmente, I-EXPLORATION -se I-EXPLORATION -diagnosticó I-EXPLORATION -de I-EXPLORATION -leiomiosarcoma I-EXPLORATION -grado I-EXPLORATION -II. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -seguimientos I-EVOLUTION -periódicos I-EVOLUTION -en I-EVOLUTION -nuestra I-EVOLUTION -consulta, I-EVOLUTION -hace I-EVOLUTION -ya I-EVOLUTION -15 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -diagnóstico, I-EVOLUTION -y I-EVOLUTION -está I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -recidivas I-EVOLUTION -o I-EVOLUTION -metástasis. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestra I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -cutánea I-PRESENT_ILLNESS -nodular, I-PRESENT_ILLNESS -eritematosa, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -superficie I-PRESENT_ILLNESS -brillante, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -rápido, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -mejilla I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -mejorado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -tópico I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -corticoides I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -potencia I-PRESENT_ILLNESS -pautado I-PRESENT_ILLNESS -progresivamente I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cabecera. I-PRESENT_ILLNESS -Se B-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -que I-EXPLORATION -arrojó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -Tumor I-EXPLORATION -de I-EXPLORATION -Merkel. I-EXPLORATION - I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -palpaban I-EXPLORATION -adenopatías I-EXPLORATION -cervicales. I-EXPLORATION -Analítica I-EXPLORATION -preoperatoria, I-EXPLORATION -incluyendo I-EXPLORATION -marcadores I-EXPLORATION -tumorales, I-EXPLORATION -normal I-EXPLORATION -salvo I-EXPLORATION -el I-EXPLORATION -valor I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -glucemia I-EXPLORATION -de I-EXPLORATION -177. I-EXPLORATION -TC I-EXPLORATION -cervical I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -de I-EXPLORATION -afectación I-EXPLORATION -ganglionar I-EXPLORATION -cervical I-EXPLORATION -donde I-EXPLORATION -únicamente I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -cuánea I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -malar I-EXPLORATION -derecha I-EXPLORATION -que I-EXPLORATION -coincide I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -localización I-EXPLORATION -externa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -afectación I-EXPLORATION -ósea. I-EXPLORATION -Rastreo I-EXPLORATION -corporal I-EXPLORATION -con I-EXPLORATION -TC I-EXPLORATION -toraco-abdominal I-EXPLORATION -igualmente I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -susceptibles I-EXPLORATION -de I-EXPLORATION -invasión I-EXPLORATION -sistémica. I-EXPLORATION - I-EXPLORATION -Bajo B-TREATMENT -Anestesia I-TREATMENT -General I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -extirpación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -con I-TREATMENT -márgenes I-TREATMENT -oncológicos I-TREATMENT -y I-TREATMENT -reconstrucción I-TREATMENT -con I-TREATMENT -colgajo I-TREATMENT -cutáneo I-TREATMENT -de I-TREATMENT -rotación-deslizamiento I-TREATMENT -cérvicofacial. I-TREATMENT -Posteriormente I-TREATMENT -se I-TREATMENT -administró I-TREATMENT -Radioterapia I-TREATMENT -externa I-TREATMENT -con I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -total I-TREATMENT -acumulada I-TREATMENT -de I-TREATMENT -60 I-TREATMENT -Gy. I-TREATMENT -12 B-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -quirúrgica I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -en I-EVOLUTION -una I-EVOLUTION -revisión I-EVOLUTION -programada, I-EVOLUTION -una I-EVOLUTION -tumoración I-EVOLUTION -submandibular I-EVOLUTION -cuya I-EVOLUTION -PAAF I-EVOLUTION -fue I-EVOLUTION -informada I-EVOLUTION -como I-EVOLUTION -metástasis I-EVOLUTION -cervical I-EVOLUTION -de I-EVOLUTION -Carcinoma I-EVOLUTION -cutáneo I-EVOLUTION -de I-EVOLUTION -células I-EVOLUTION -de I-EVOLUTION -Merkel. I-EVOLUTION -Se B-TREATMENT -realizó I-TREATMENT -Disección I-TREATMENT -cervical I-TREATMENT -Radical, I-TREATMENT -cuyo I-TREATMENT -resultado I-TREATMENT -fue I-TREATMENT -de I-TREATMENT -2 I-TREATMENT -ganglios I-TREATMENT -afectos, I-TREATMENT -ninguno I-TREATMENT -de I-TREATMENT -ellos I-TREATMENT -presentando I-TREATMENT -afectación I-TREATMENT -extracapsular. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -57 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -Hepatitis I-PAST_MEDICAL_HISTORY -C. I-PAST_MEDICAL_HISTORY -Diagnosticado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -plasmocitoma I-PAST_MEDICAL_HISTORY -óseo I-PAST_MEDICAL_HISTORY -solitario I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -undécima I-PAST_MEDICAL_HISTORY -costilla, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -evolucionó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -Mieloma I-PAST_MEDICAL_HISTORY -Múltiple I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -Bence I-PAST_MEDICAL_HISTORY -Jones I-PAST_MEDICAL_HISTORY -Lambda. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -diálisis I-PAST_MEDICAL_HISTORY -peritoneal I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nefropatía I-PAST_MEDICAL_HISTORY -asociada I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -Mieloma I-PAST_MEDICAL_HISTORY -Múltiple. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Consulta B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -varias I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -lengua I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -labio I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -producían I-PRESENT_ILLNESS -importante I-PRESENT_ILLNESS -escozor. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -cinco I-EXPLORATION -lesiones I-EXPLORATION -nodulares I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -punta I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lengua, I-EXPLORATION -cara I-EXPLORATION -lateral I-EXPLORATION -de I-EXPLORATION -esta I-EXPLORATION -y I-EXPLORATION -labio I-EXPLORATION -izquierdo. I-EXPLORATION -Tres I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -nódulos, I-EXPLORATION -presentaban I-EXPLORATION -un I-EXPLORATION -color I-EXPLORATION -violáceo I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -centro I-EXPLORATION -ligeramente I-EXPLORATION -blanquecino I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -otros I-EXPLORATION -dos, I-EXPLORATION -más I-EXPLORATION -claros, I-EXPLORATION -sin I-EXPLORATION -tonalidad I-EXPLORATION -violácea. I-EXPLORATION -La I-EXPLORATION -consistencia I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -era I-EXPLORATION -algo I-EXPLORATION -indurada. I-EXPLORATION -El I-EXPLORATION -nódulo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cara I-EXPLORATION -lateral I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lengua I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -diámetro I-EXPLORATION -mayor I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -cm, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -labio, I-EXPLORATION -el I-EXPLORATION -mayor I-EXPLORATION -de I-EXPLORATION -ellos, I-EXPLORATION -tenía I-EXPLORATION -1, I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -tamaño I-EXPLORATION -del I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -nódulos I-EXPLORATION -era I-EXPLORATION -inferior I-EXPLORATION -a I-EXPLORATION -estas I-EXPLORATION -medidas. I-EXPLORATION -Al B-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -exploración I-EVOLUTION -oral, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -acude I-EVOLUTION -de I-EVOLUTION -nuevo, I-EVOLUTION -presentando I-EVOLUTION -lesiones I-EVOLUTION -de I-EVOLUTION -color I-EVOLUTION -púrpura I-EVOLUTION -perioculares I-EVOLUTION -bilaterales. I-EVOLUTION - I-EVOLUTION -Se B-EXPLORATION -procede I-EXPLORATION -a I-EXPLORATION -realizar I-EXPLORATION -un I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -biopsias, I-EXPLORATION -una I-EXPLORATION -del I-EXPLORATION -labio I-EXPLORATION -y I-EXPLORATION -dos I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -linguales. I-EXPLORATION -Dichas I-EXPLORATION -biopsias I-EXPLORATION -se I-EXPLORATION -describien I-EXPLORATION -como I-EXPLORATION -depósitos I-EXPLORATION -densos I-EXPLORATION -de I-EXPLORATION -material I-EXPLORATION -hialino, I-EXPLORATION -acelular, I-EXPLORATION -homogéneo I-EXPLORATION -que I-EXPLORATION -ocupa I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -submucosa I-EXPLORATION -separando I-EXPLORATION -haces I-EXPLORATION -musculares I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -afectación I-EXPLORATION -de I-EXPLORATION -paredes I-EXPLORATION -vasculares. I-EXPLORATION -Estos I-EXPLORATION -depósitos I-EXPLORATION -se I-EXPLORATION -tiñen I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Rojo I-EXPLORATION -Congo I-EXPLORATION -presentado I-EXPLORATION -una I-EXPLORATION -birrefringencia I-EXPLORATION -verde I-EXPLORATION -manzana. I-EXPLORATION -Además I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -tioflavina I-EXPLORATION -T I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -fluorescencia I-EXPLORATION -verde-amarillenta. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -ligera I-EXPLORATION -acantosis I-EXPLORATION -con I-EXPLORATION -paraqueratosis I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -leve I-EXPLORATION -infiltrado I-EXPLORATION -linfoplasmocitario. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -observados, I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -Puncion I-EXPLORATION -aspiración I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina I-EXPLORATION -(PAAF) I-EXPLORATION -de I-EXPLORATION -grasa I-EXPLORATION -abdominal, I-EXPLORATION -que I-EXPLORATION -resulto I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -material I-EXPLORATION -amiloide I-EXPLORATION -con I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Rojo I-EXPLORATION -Congo. I-EXPLORATION -Se I-EXPLORATION -confirma I-EXPLORATION -con I-EXPLORATION -esto I-EXPLORATION -el I-EXPLORATION -diagnostico I-EXPLORATION -de I-EXPLORATION -Amiloidosis I-EXPLORATION -Sistémica, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realizan I-EXPLORATION -diferentes I-EXPLORATION -pruebas I-EXPLORATION -que I-EXPLORATION -objetivan I-EXPLORATION -una I-EXPLORATION -alteración I-EXPLORATION -multiorgánica, I-EXPLORATION -con I-EXPLORATION -afectación I-EXPLORATION -de I-EXPLORATION -piel, I-EXPLORATION -tejido I-EXPLORATION -nervioso, I-EXPLORATION -aparato I-EXPLORATION -gastrointestinal, I-EXPLORATION -corazón I-EXPLORATION -y I-EXPLORATION -riñón. I-EXPLORATION - I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -15 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -diagnostico I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -Amiloidosis, I-EVOLUTION -fallece I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -como I-EVOLUTION -consecuencia I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -megacolon I-EVOLUTION -y I-EVOLUTION -por I-EVOLUTION -fallo I-EVOLUTION -multiorgánico. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -54 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestra I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -disfagia, I-PRESENT_ILLNESS -dislalia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuerpo I-PRESENT_ILLNESS -extraño I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -cavidad I-PRESENT_ILLNESS -oral I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -habitual. I-PAST_MEDICAL_HISTORY -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -intraoral I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -masa I-EXPLORATION -exofítica I-EXPLORATION -de I-EXPLORATION -7 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -máximo, I-EXPLORATION -carnosa, I-EXPLORATION -que I-EXPLORATION -parecía I-EXPLORATION -pediculada I-EXPLORATION -a I-EXPLORATION -paladar I-EXPLORATION -blando I-EXPLORATION -y I-EXPLORATION -ocupaba I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -orofaringe. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -palpaban I-EXPLORATION -adenopatías I-EXPLORATION -cervicales. I-EXPLORATION -La I-EXPLORATION -TC I-EXPLORATION -cervicofacial I-EXPLORATION -objetivaba I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -tamaño I-EXPLORATION -y I-EXPLORATION -bordes I-EXPLORATION -bien I-EXPLORATION -definidos I-EXPLORATION -que I-EXPLORATION -parecía I-EXPLORATION -originarse I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -paladar I-EXPLORATION -blando, I-EXPLORATION -creciendo I-EXPLORATION -exofíticamente I-EXPLORATION -y I-EXPLORATION -ocupando I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -orofaringe. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -objetivaron I-EXPLORATION -adenopatías I-EXPLORATION -de I-EXPLORATION -características I-EXPLORATION -patológicas. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -TC I-EXPLORATION -toracoabdominal I-EXPLORATION -no I-EXPLORATION -objetivaron I-EXPLORATION -otras I-EXPLORATION -lesiones I-EXPLORATION -a I-EXPLORATION -distancia. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -incisional I-EXPLORATION -que I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -neoplasia I-EXPLORATION -fusocelular I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -población I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -hábito I-EXPLORATION -fibrohistiocitario I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -crecimiento I-EXPLORATION -tipo I-EXPLORATION -estoriforme, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -fibrohistiocitoma I-EXPLORATION -maligno. I-EXPLORATION -Dada B-TREATMENT -la I-TREATMENT -obstrucción I-TREATMENT -rápidamente I-TREATMENT -progresiva I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vía I-TREATMENT -aérea I-TREATMENT -superior, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -requirió I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -una I-TREATMENT -traqueostomía I-TREATMENT -previamente I-TREATMENT -a I-TREATMENT -la I-TREATMENT -cirugía I-TREATMENT -definitiva. I-TREATMENT -El I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -cirugía I-TREATMENT -realizándose I-TREATMENT -un I-TREATMENT -abordaje I-TREATMENT -mediante I-TREATMENT -labiomandibulotomía I-TREATMENT -media, I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -con I-TREATMENT -márgenes I-TREATMENT -de I-TREATMENT -seguridad I-TREATMENT --lo I-TREATMENT -que I-TREATMENT -supuso I-TREATMENT -la I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -la I-TREATMENT -totalidad I-TREATMENT -del I-TREATMENT -paladar I-TREATMENT -blando, I-TREATMENT -pilares I-TREATMENT -amigdalinos I-TREATMENT -y I-TREATMENT -la I-TREATMENT -pared I-TREATMENT -de I-TREATMENT -orofaringe I-TREATMENT -izquierda- I-TREATMENT -y I-TREATMENT -la I-TREATMENT -reconstrucción I-TREATMENT -inmediata I-TREATMENT -con I-TREATMENT -un I-TREATMENT -colgajo I-TREATMENT -fasciocutáneo I-TREATMENT -radial I-TREATMENT -del I-TREATMENT -lado I-TREATMENT -izquierdo. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -neoplasia I-EXPLORATION -fusocelular I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -población I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -hábito I-EXPLORATION -fibrohistiocitario, I-EXPLORATION -de I-EXPLORATION -núcleos I-EXPLORATION -ovalados, I-EXPLORATION -pleomórficos I-EXPLORATION -y I-EXPLORATION -citoplasmas I-EXPLORATION -fusiformes, I-EXPLORATION -que I-EXPLORATION -alternaba I-EXPLORATION -con I-EXPLORATION -otras I-EXPLORATION -de I-EXPLORATION -hábito I-EXPLORATION -epitelioide, I-EXPLORATION -dispuestas I-EXPLORATION -formando I-EXPLORATION -haces I-EXPLORATION -entrecruzados I-EXPLORATION -y I-EXPLORATION -adoptando I-EXPLORATION -en I-EXPLORATION -zonas I-EXPLORATION -un I-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -crecimiento I-EXPLORATION -tipo I-EXPLORATION -estoriforme, I-EXPLORATION -confirmando I-EXPLORATION -así I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -inicial. I-EXPLORATION -Se I-EXPLORATION -identificaron I-EXPLORATION -frecuentes I-EXPLORATION -figuras I-EXPLORATION -de I-EXPLORATION -mitosis, I-EXPLORATION -algunas I-EXPLORATION -de I-EXPLORATION -ellas I-EXPLORATION -atípicas. I-EXPLORATION -Las I-EXPLORATION -tinciones I-EXPLORATION -para I-EXPLORATION -vimentina I-EXPLORATION -y I-EXPLORATION -proteina I-EXPLORATION -CD68 I-EXPLORATION -fueron I-EXPLORATION -positivas. I-EXPLORATION -La I-EXPLORATION -neoplasia I-EXPLORATION -respetaba I-EXPLORATION -ampliamente I-EXPLORATION -los I-EXPLORATION -márgenes I-EXPLORATION -de I-EXPLORATION -resección I-EXPLORATION -quirúrgicos. I-EXPLORATION -Dado B-TREATMENT -el I-TREATMENT -gran I-TREATMENT -tamaño I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión, I-TREATMENT -fue I-TREATMENT -administrado I-TREATMENT -tratamiento I-TREATMENT -radioterápico I-TREATMENT -complementario. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -ha I-EVOLUTION -permanecido I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -recidiva I-EVOLUTION -local I-EVOLUTION -o I-EVOLUTION -a I-EVOLUTION -distancia I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -momento I-EVOLUTION -actual I-EVOLUTION -y I-EVOLUTION -presenta I-EVOLUTION -un I-EVOLUTION -excelente I-EVOLUTION -resultado I-EVOLUTION -estético I-EVOLUTION -y I-EVOLUTION -funcional, I-EVOLUTION -con I-EVOLUTION -deglución I-EVOLUTION -y I-EVOLUTION -fonación I-EVOLUTION -normales. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -traumatismo I-PRESENT_ILLNESS -centrofacial I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -accidente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tráfico. I-PRESENT_ILLNESS -Presentaba B-EXPLORATION -fractura I-EXPLORATION -tipo I-EXPLORATION -Le I-EXPLORATION -Fort I-EXPLORATION -II I-EXPLORATION -y I-EXPLORATION -nasoetmoidal I-EXPLORATION -derecha I-EXPLORATION -tipo I-EXPLORATION -II I-EXPLORATION -e I-EXPLORATION -izquierda I-EXPLORATION -tipo I-EXPLORATION -I I-EXPLORATION -que I-EXPLORATION -le I-EXPLORATION -produce I-EXPLORATION -una I-EXPLORATION -mordida I-EXPLORATION -abierta I-EXPLORATION -anterior, I-EXPLORATION -hipertelorismo I-EXPLORATION -y I-EXPLORATION -equimosis I-EXPLORATION -orbitaria I-EXPLORATION -bilateral. I-EXPLORATION -Tras B-TREATMENT -proceder I-TREATMENT -a I-TREATMENT -la I-TREATMENT -ferulización I-TREATMENT -de I-TREATMENT -ambas I-TREATMENT -arcadas I-TREATMENT -se I-TREATMENT -reduce I-TREATMENT -el I-TREATMENT -maxilar I-TREATMENT -y I-TREATMENT -se I-TREATMENT -lleva I-TREATMENT -a I-TREATMENT -bloqueo I-TREATMENT -rígido. I-TREATMENT -Se I-TREATMENT -exponen I-TREATMENT -las I-TREATMENT -fracturas I-TREATMENT -desde I-TREATMENT -abordajes I-TREATMENT -inferiores I-TREATMENT -bilateralmente. I-TREATMENT -Se I-TREATMENT -consigue I-TREATMENT -una I-TREATMENT -buena I-TREATMENT -estabilización I-TREATMENT -del I-TREATMENT -maxilar I-TREATMENT -y I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fractura I-TREATMENT -nasoetmoidal I-TREATMENT -en I-TREATMENT -el I-TREATMENT -lado I-TREATMENT -izquierdo. I-TREATMENT -Se I-TREATMENT -realiza I-TREATMENT -una I-TREATMENT -incisión I-TREATMENT -transconjuntival I-TREATMENT -en I-TREATMENT -el I-TREATMENT -derecho I-TREATMENT -que I-TREATMENT -se I-TREATMENT -amplia I-TREATMENT -con I-TREATMENT -una I-TREATMENT -transcaruncular. I-TREATMENT -Ambos I-TREATMENT -abordajes I-TREATMENT -se I-TREATMENT -unen I-TREATMENT -tras I-TREATMENT -la I-TREATMENT -desinserción I-TREATMENT -del I-TREATMENT -oblícuo I-TREATMENT -inferior. I-TREATMENT -Se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -la I-TREATMENT -reducción I-TREATMENT -de I-TREATMENT -los I-TREATMENT -fragmentos I-TREATMENT -comprobando I-TREATMENT -el I-TREATMENT -plano I-TREATMENT -de I-TREATMENT -reducción I-TREATMENT -en I-TREATMENT -la I-TREATMENT -pared I-TREATMENT -medial. I-TREATMENT -Osteosíntesis I-TREATMENT -con I-TREATMENT -microplacas I-TREATMENT -en I-TREATMENT -reborde I-TREATMENT -infraorbitario. I-TREATMENT -Colocamos I-TREATMENT -injertos I-TREATMENT -de I-TREATMENT -PDS I-TREATMENT -de I-TREATMENT -20 I-TREATMENT -mm I-TREATMENT -por I-TREATMENT -25 I-TREATMENT -mm I-TREATMENT -en I-TREATMENT -pared I-TREATMENT -medial I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -adecuada I-TREATMENT -restitución I-TREATMENT -volumétrica. I-TREATMENT -Con I-TREATMENT -Vicryl I-TREATMENT -5/0 I-TREATMENT -de I-TREATMENT -aguja I-TREATMENT -de I-TREATMENT -13 I-TREATMENT -mm I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -la I-TREATMENT -sutura I-TREATMENT -del I-TREATMENT -periostio I-TREATMENT -y I-TREATMENT -se I-TREATMENT -reinserta I-TREATMENT -el I-TREATMENT -oblícuo I-TREATMENT -inferior. I-TREATMENT -No I-TREATMENT -se I-TREATMENT -cierra I-TREATMENT -abordaje I-TREATMENT -transconjuntival. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -refiere I-EVOLUTION -diplopia I-EVOLUTION -ni I-EVOLUTION -se I-EVOLUTION -observa I-EVOLUTION -déficit I-EVOLUTION -o I-EVOLUTION -sobreacción I-EVOLUTION -del I-EVOLUTION -oblícuo I-EVOLUTION -inferior I-EVOLUTION -ni I-EVOLUTION -del I-EVOLUTION -resto I-EVOLUTION -de I-EVOLUTION -musculatura I-EVOLUTION -extrínseca, I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -controles I-EVOLUTION -oftalmológicos I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -semana I-EVOLUTION -y I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION - I-EVOLUTION - -Niño B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -siete I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nacido I-PRESENT_ILLNESS -placa I-PRESENT_ILLNESS -violácea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ocupaba I-PRESENT_ILLNESS -gran I-PRESENT_ILLNESS -parte I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -punta I-PRESENT_ILLNESS -nasal; I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -valorada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -pediatra I-PRESENT_ILLNESS -quien I-PRESENT_ILLNESS -mantiene I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -expectante I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -observar I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -continuaba I-PRESENT_ILLNESS -progresando, I-PRESENT_ILLNESS -ocasionándole I-PRESENT_ILLNESS -deformidad I-PRESENT_ILLNESS -facial, I-PRESENT_ILLNESS -decide I-PRESENT_ILLNESS -remitirla I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -servicio. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -ser I-EXPLORATION -valorada, I-EXPLORATION -detectamos I-EXPLORATION -deformidad I-EXPLORATION -del I-EXPLORATION -cartílago I-EXPLORATION -y I-EXPLORATION -discreta I-EXPLORATION -dificultad I-EXPLORATION -respiratoria. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -esclerosante I-TREATMENT -con I-TREATMENT -Betametazona I-TREATMENT -4 I-TREATMENT -mg I-TREATMENT -intralesional, I-TREATMENT -cuando I-TREATMENT -se I-TREATMENT -logró I-TREATMENT -la I-TREATMENT -fibrosis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -su I-TREATMENT -exéresis I-TREATMENT -quirúrgica I-TREATMENT -de I-TREATMENT -la I-TREATMENT -misma I-TREATMENT -por I-TREATMENT -una I-TREATMENT -incisión I-TREATMENT -en I-TREATMENT -ala I-TREATMENT -de I-TREATMENT -gaviota I-TREATMENT -invertida. I-TREATMENT - I-TREATMENT -Paciente B-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -quirúrgica. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -atendido I-PRESENT_ILLNESS -luego I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -trauma I-PRESENT_ILLNESS -facial I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -violencia, I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -mentoniana. I-PRESENT_ILLNESS -La B-EXPLORATION -imagen I-EXPLORATION -radiográfica I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -fractura I-EXPLORATION -sinfisiaria I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -radio I-EXPLORATION -lúcida I-EXPLORATION -periapical. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -enucleación I-TREATMENT -del I-TREATMENT -quiste I-TREATMENT -e I-TREATMENT -inmovilización I-TREATMENT -de I-TREATMENT -fragmentos I-TREATMENT -por I-TREATMENT -bloqueo I-TREATMENT -intermaxilar I-TREATMENT -y I-TREATMENT -terapia I-TREATMENT -endodóntica I-TREATMENT -posterior I-TREATMENT -a I-TREATMENT -la I-TREATMENT -intervención. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -comprobó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -quiste I-EXPLORATION -radicular. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -panorámica I-EXPLORATION -realizada I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -mes I-EXPLORATION -de I-EXPLORATION -post I-EXPLORATION -operatorio, I-EXPLORATION -evidenció I-EXPLORATION -la I-EXPLORATION -evolución I-EXPLORATION -favorable I-EXPLORATION -de I-EXPLORATION -ambas I-EXPLORATION -lesiones. I-EXPLORATION - I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -ingresado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -fractura I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ángulo I-PRESENT_ILLNESS -mandibular I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cuerpo I-PRESENT_ILLNESS -mandibular I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -asociada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -larga I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -radiolúcida. I-PRESENT_ILLNESS -Esta B-TREATMENT -fue I-TREATMENT -enucleada I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -intraoral I-TREATMENT -al I-TREATMENT -igual I-TREATMENT -que I-TREATMENT -las I-TREATMENT -raíces I-TREATMENT -dentarias I-TREATMENT -asociadas, I-TREATMENT -seguido I-TREATMENT -de I-TREATMENT -estabilización I-TREATMENT -de I-TREATMENT -fragmentos I-TREATMENT -mediante I-TREATMENT -bloqueo I-TREATMENT -intermaxilar I-TREATMENT -utilizando I-TREATMENT -ligaduras I-TREATMENT -Ivy. I-TREATMENT -La B-EXPLORATION -histología I-EXPLORATION -confirmó I-EXPLORATION -su I-EXPLORATION -naturaleza I-EXPLORATION -de I-EXPLORATION -quiste I-EXPLORATION -radicular. I-EXPLORATION - I-EXPLORATION - -Presentamos B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -tercer I-PRESENT_ILLNESS -molar I-PRESENT_ILLNESS -fusionado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuarto I-PRESENT_ILLNESS -molar I-PRESENT_ILLNESS -supernumerario I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Departamento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Medicina I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -Cirugía I-PRESENT_ILLNESS -Bucofacial I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor, I-PRESENT_ILLNESS -inflamación I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -trismo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -repetición I-PRESENT_ILLNESS -causados I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -tercer I-PRESENT_ILLNESS -molar I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -semierupcionado. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -un I-EXPLORATION -tercer I-EXPLORATION -molar I-EXPLORATION -de I-EXPLORATION -grandes I-EXPLORATION -dimensiones I-EXPLORATION -en I-EXPLORATION -posición I-EXPLORATION -mesioangular I-EXPLORATION -semierupcionado, I-EXPLORATION -responsable I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -episodios I-EXPLORATION -de I-EXPLORATION -pericoronaritis. I-EXPLORATION -Realizamos I-EXPLORATION -una I-EXPLORATION -ortopantomografía I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -el I-EXPLORATION -tercer I-EXPLORATION -molar I-EXPLORATION -unido I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -supernumerario I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -corona I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -raíz. I-EXPLORATION -Se I-EXPLORATION -da I-EXPLORATION -la I-EXPLORATION -circunstancia I-EXPLORATION -de I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -presenta I-EXPLORATION -otro I-EXPLORATION -molar I-EXPLORATION -supernumerario I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -maxilar I-EXPLORATION -superior I-EXPLORATION -lado I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION -Tras B-PAST_MEDICAL_HISTORY -realizar I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -(sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés), I-PAST_MEDICAL_HISTORY -se B-TREATMENT -explica I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -el I-TREATMENT -propósito I-TREATMENT -y I-TREATMENT -los I-TREATMENT -riesgos I-TREATMENT -de I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -y I-TREATMENT -firma I-TREATMENT -el I-TREATMENT -consentimiento I-TREATMENT -informado. I-TREATMENT -El B-EXPLORATION -paciente I-EXPLORATION -rechaza I-EXPLORATION -la I-EXPLORATION -posibilidad I-EXPLORATION -de I-EXPLORATION -realizar I-EXPLORATION -un I-EXPLORATION -escáner I-EXPLORATION -para I-EXPLORATION -conocer I-EXPLORATION -la I-EXPLORATION -relación I-EXPLORATION -del I-EXPLORATION -molar I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -conducto I-EXPLORATION -del I-EXPLORATION -nervio I-EXPLORATION -dentario I-EXPLORATION -inferior. I-EXPLORATION -Se B-TREATMENT -procede I-TREATMENT -a I-TREATMENT -la I-TREATMENT -extracción I-TREATMENT -quirúrgica I-TREATMENT -del I-TREATMENT -tercer I-TREATMENT -y I-TREATMENT -cuarto I-TREATMENT -molar, I-TREATMENT -con I-TREATMENT -anestesia I-TREATMENT -local, I-TREATMENT -siendo I-TREATMENT -necesario I-TREATMENT -hacer I-TREATMENT -odontosección I-TREATMENT -por I-TREATMENT -el I-TREATMENT -gran I-TREATMENT -tamaño I-TREATMENT -del I-TREATMENT -molar I-TREATMENT -fusionado. I-TREATMENT - I-TREATMENT -No B-EVOLUTION -hubo I-EVOLUTION -complicaciones I-EVOLUTION -ni I-EVOLUTION -intra I-EVOLUTION -ni I-EVOLUTION -postoperatorias. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -acude I-EVOLUTION -a I-EVOLUTION -revisión I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -tres I-EVOLUTION -meses, I-EVOLUTION -descartándose I-EVOLUTION -problemas I-EVOLUTION -periodontales I-EVOLUTION -y I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -caries I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -segundo I-EVOLUTION -molar. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -enoftalmos, I-PRESENT_ILLNESS -diplopia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -distopia I-PRESENT_ILLNESS -derechas I-PRESENT_ILLNESS -posteriores I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -accidente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tránsito I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -fractura I-PRESENT_ILLNESS -blow-out I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS -Se B-TREATMENT -realiza I-TREATMENT -la I-TREATMENT -corrección I-TREATMENT -de I-TREATMENT -dichas I-TREATMENT -secuelas I-TREATMENT -realizando I-TREATMENT -injerto I-TREATMENT -escalonado I-TREATMENT -de I-TREATMENT -calota I-TREATMENT -en I-TREATMENT -piso I-TREATMENT -de I-TREATMENT -orbita I-TREATMENT -derecho I-TREATMENT -y I-TREATMENT -adición I-TREATMENT -de I-TREATMENT -gel I-TREATMENT -de I-TREATMENT -plasma I-TREATMENT -rico I-TREATMENT -en I-TREATMENT -plaquetas, I-TREATMENT -11 I-TREATMENT -meses I-TREATMENT -posterior I-TREATMENT -al I-TREATMENT -accidente, I-TREATMENT -mediante I-TREATMENT -abordaje I-TREATMENT -infraorbitario I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -cicatriz I-TREATMENT -previa. I-TREATMENT -Tanto B-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -postoperatorio, I-EVOLUTION -como I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -16 I-EVOLUTION -semanas, I-EVOLUTION -se I-EVOLUTION -observan I-EVOLUTION -ejes I-EVOLUTION -pupilares I-EVOLUTION -más I-EVOLUTION -simétricos I-EVOLUTION -y I-EVOLUTION -mejoría I-EVOLUTION -importante I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -proyección I-EVOLUTION -del I-EVOLUTION -globo I-EVOLUTION -ocular I-EVOLUTION -derecho I-EVOLUTION -y I-EVOLUTION -especialmente I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -diplopia I-EVOLUTION -postraumática. I-EVOLUTION - I-EVOLUTION - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -27 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -secuelas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -trauma I-PRESENT_ILLNESS -contundente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hemicara I-PRESENT_ILLNESS -izquierda, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -fractura I-PRESENT_ILLNESS -blow-out I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -tratada. I-PRESENT_ILLNESS -Como B-EXPLORATION -consecuencia I-EXPLORATION -presentó I-EXPLORATION -enoftalmos, I-EXPLORATION -distopia I-EXPLORATION -y I-EXPLORATION -diplopia I-EXPLORATION -izquierdas I-EXPLORATION -; I-EXPLORATION -18 B-TREATMENT -meses I-TREATMENT -posterior I-TREATMENT -al I-TREATMENT -trauma I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -la I-TREATMENT -corrección I-TREATMENT -de I-TREATMENT -dichas I-TREATMENT -secuelas I-TREATMENT -mediante I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -injerto I-TREATMENT -escalonado I-TREATMENT -de I-TREATMENT -calota I-TREATMENT -en I-TREATMENT -suelo I-TREATMENT -de I-TREATMENT -órbita, I-TREATMENT -previo I-TREATMENT -abordaje I-TREATMENT -transconjuntival I-TREATMENT -izquierdo. I-TREATMENT -Observándose B-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -evaluación I-EVOLUTION -postoperatoria I-EVOLUTION -mejoría I-EVOLUTION -estética I-EVOLUTION -y I-EVOLUTION -funcional I-EVOLUTION -importante I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -condiciones I-EVOLUTION -ya I-EVOLUTION -descritas. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -remitido I-PRESENT_ILLNESS -a B-DERIVED_FROM/TO -nuestras I-DERIVED_FROM/TO -consultas I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -oftalmología I-DERIVED_FROM/TO -por B-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -exoftalmos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -globo I-PRESENT_ILLNESS -ocular I-PRESENT_ILLNESS -secundario I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -seno I-PRESENT_ILLNESS -maxilar I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -refería I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -fractura I-PAST_MEDICAL_HISTORY -máxilo-malar I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -28 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -realizó I-PAST_MEDICAL_HISTORY -reducción I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fijación I-PAST_MEDICAL_HISTORY -alámbrica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -reborde I-PAST_MEDICAL_HISTORY -infraorbitario I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -arbotante I-PAST_MEDICAL_HISTORY -frontomalar. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -encontramos I-EXPLORATION -exoftalmos, I-EXPLORATION -distopia I-EXPLORATION -vertical I-EXPLORATION -del I-EXPLORATION -globo I-EXPLORATION -ocular I-EXPLORATION -y I-EXPLORATION -oftalmoplejia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mirada I-EXPLORATION -vertical. I-EXPLORATION -Se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -falta I-EXPLORATION -de I-EXPLORATION -proyección I-EXPLORATION -del I-EXPLORATION -reborde I-EXPLORATION -infraorbitario I-EXPLORATION -que I-EXPLORATION -permitía I-EXPLORATION -palpar I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -blanda I-EXPLORATION -a I-EXPLORATION -dicho I-EXPLORATION -nivel. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -ortopantomografía I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -vió I-EXPLORATION -relación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -con I-EXPLORATION -dientes. I-EXPLORATION -La I-EXPLORATION -TC I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -de I-EXPLORATION -3, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -derecho, I-EXPLORATION -bien I-EXPLORATION -delimitada, I-EXPLORATION -con I-EXPLORATION -remodelación I-EXPLORATION -ósea I-EXPLORATION -y I-EXPLORATION -destrucción I-EXPLORATION -del I-EXPLORATION -suelo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -órbita I-EXPLORATION -y I-EXPLORATION -desplazamiento I-EXPLORATION -del I-EXPLORATION -músculo I-EXPLORATION -recto I-EXPLORATION -inferior, I-EXPLORATION -provocando I-EXPLORATION -un I-EXPLORATION -exoftalmos I-EXPLORATION -secundario. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -asociada I-TREATMENT -a I-TREATMENT -la I-TREATMENT -extracción I-TREATMENT -de I-TREATMENT -las I-TREATMENT -fijaciones I-TREATMENT -alámbricas I-TREATMENT -vía I-TREATMENT -subciliar I-TREATMENT -figura I-TREATMENT -3), I-TREATMENT -y I-TREATMENT -reconstrucción I-TREATMENT -con I-TREATMENT -prótesis I-TREATMENT -de I-TREATMENT -Medpor I-TREATMENT -del I-TREATMENT -complejo I-TREATMENT -máxilomalar I-TREATMENT -destruido I-TREATMENT -(reborde I-TREATMENT -infraorbitario, I-TREATMENT -suelo I-TREATMENT -de I-TREATMENT -órbita, I-TREATMENT -arbotante I-TREATMENT -frontomalar). I-TREATMENT - I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -mucocele I-EXPLORATION -maxilar. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -evolución I-EVOLUTION -del I-EVOLUTION -enfermo I-EVOLUTION -fue I-EVOLUTION -satisfactoria, I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -motilidad I-EVOLUTION -ocular, I-EVOLUTION -sin I-EVOLUTION -diplopia I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -correcto I-EVOLUTION -resultado I-EVOLUTION -estético. I-EVOLUTION -El I-EVOLUTION -seguimiento I-EVOLUTION -actual I-EVOLUTION -tras I-EVOLUTION -tres I-EVOLUTION -años I-EVOLUTION -continúa I-EVOLUTION -siendo I-EVOLUTION -satisfactorio I-EVOLUTION -sin I-EVOLUTION -recidiva I-EVOLUTION -ni I-EVOLUTION -complicaciones. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -ingresada I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -quirúrgico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -deformidad I-PRESENT_ILLNESS -dentofacial. I-PRESENT_ILLNESS -Entre B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -anemia I-PAST_MEDICAL_HISTORY -ferropénica, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -presentar I-PAST_MEDICAL_HISTORY -ninguna I-PAST_MEDICAL_HISTORY -alergia I-PAST_MEDICAL_HISTORY -medicamentosa I-PAST_MEDICAL_HISTORY -conocida. I-PAST_MEDICAL_HISTORY -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -un I-EXPLORATION -prognatismo I-EXPLORATION -marcado I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -clase I-EXPLORATION -III I-EXPLORATION -molar I-EXPLORATION -y I-EXPLORATION -pseudohipoplasia I-EXPLORATION -de I-EXPLORATION -maxilar I-EXPLORATION -superior. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ortopantomografía I-EXPLORATION -y I-EXPLORATION -telerradiografía I-EXPLORATION -lateral I-EXPLORATION -de I-EXPLORATION -cráneo, I-EXPLORATION -iniciando I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -cefalométrico I-EXPLORATION -correspondiente. I-EXPLORATION - I-EXPLORATION -Tras B-TREATMENT -tratamiento I-TREATMENT -ortodóncico I-TREATMENT -y I-TREATMENT -extracción I-TREATMENT -de I-TREATMENT -los I-TREATMENT -4 I-TREATMENT -cordales I-TREATMENT -se I-TREATMENT -somete I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -a I-TREATMENT -intervención I-TREATMENT -de I-TREATMENT -cirugía I-TREATMENT -ortognática I-TREATMENT -convencional I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general I-TREATMENT -e I-TREATMENT -intubación I-TREATMENT -nasotraqueal I-TREATMENT -en I-TREATMENT -la I-TREATMENT -que I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -osteotomía I-TREATMENT -tipo I-TREATMENT -LeFort I-TREATMENT -I I-TREATMENT -fijada I-TREATMENT -con I-TREATMENT -dos I-TREATMENT -placas I-TREATMENT -preformadas I-TREATMENT -de I-TREATMENT -titanio I-TREATMENT -en I-TREATMENT -ambos I-TREATMENT -arbotantes I-TREATMENT -naso I-TREATMENT -maxilares I-TREATMENT -con I-TREATMENT -avance I-TREATMENT -de I-TREATMENT -7 I-TREATMENT -mm, I-TREATMENT -impactación I-TREATMENT -anterior I-TREATMENT -de I-TREATMENT -3 I-TREATMENT -mm I-TREATMENT -y I-TREATMENT -posterior I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -mm, I-TREATMENT -rotación I-TREATMENT -izquierda I-TREATMENT -de I-TREATMENT -1mm, I-TREATMENT -resección I-TREATMENT -parcial I-TREATMENT -inferior I-TREATMENT -de I-TREATMENT -septum I-TREATMENT -nasal, I-TREATMENT -cincha I-TREATMENT -de I-TREATMENT -alares I-TREATMENT -y I-TREATMENT -cierre I-TREATMENT -labial I-TREATMENT -en I-TREATMENT -V-Y. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -y I-EVOLUTION -seguida I-EVOLUTION -en I-EVOLUTION -revisiones I-EVOLUTION -en I-EVOLUTION -consultas I-EVOLUTION -externas I-EVOLUTION -evidenciándose I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -celulitis I-EVOLUTION -genianas I-EVOLUTION -bilaterales I-EVOLUTION -de I-EVOLUTION -repetición. I-EVOLUTION -Su I-EVOLUTION -inicio I-EVOLUTION -se I-EVOLUTION -produjo I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -6-9 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -inicial. I-EVOLUTION -Se B-TREATMENT -decide I-TREATMENT -reintervenir I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -1 I-TREATMENT -año I-TREATMENT -después I-TREATMENT -de I-TREATMENT -la I-TREATMENT -primera I-TREATMENT -intervención I-TREATMENT -y I-TREATMENT -retirar I-TREATMENT -el I-TREATMENT -material I-TREATMENT -de I-TREATMENT -osteosíntesis I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -la I-TREATMENT -osteotomía I-TREATMENT -LeFort I-TREATMENT -I I-TREATMENT -tras I-TREATMENT -reapertura I-TREATMENT -del I-TREATMENT -abordaje I-TREATMENT -sublabial I-TREATMENT -superior I-TREATMENT -bilateral I-TREATMENT -previo. I-TREATMENT -Intraoperatoriamente I-TREATMENT -no I-TREATMENT -se I-TREATMENT -objetiva I-TREATMENT -movilidad I-TREATMENT -del I-TREATMENT -tercio I-TREATMENT -medio I-TREATMENT -facial I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -la I-TREATMENT -osteotomía I-TREATMENT -tipo I-TREATMENT -LeFort I-TREATMENT -I I-TREATMENT -y I-TREATMENT -se I-TREATMENT -cataloga I-TREATMENT -dicho I-TREATMENT -episodio I-TREATMENT -quirúrgico I-TREATMENT -como I-TREATMENT -una I-TREATMENT -intolerancia I-TREATMENT -al I-TREATMENT -material I-TREATMENT -de I-TREATMENT -osteosíntesis. I-TREATMENT - I-TREATMENT -Tras B-EVOLUTION -seguir I-EVOLUTION -revisiones I-EVOLUTION -periódicas I-EVOLUTION -dentro I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -normalidad I-EVOLUTION -tanto I-EVOLUTION -en I-EVOLUTION -nuestras I-EVOLUTION -consultas I-EVOLUTION -externas I-EVOLUTION -como I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -ortodoncista, I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -última I-EVOLUTION -intervención I-EVOLUTION -quirúrgica I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -refiere I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -fuerza I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -masticación, I-EVOLUTION -impidiendo I-EVOLUTION -la I-EVOLUTION -práctica I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -dieta I-EVOLUTION -con I-EVOLUTION -alimentos I-EVOLUTION -sólidos. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -clínica I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -leve I-EXPLORATION -movilidad I-EXPLORATION -del I-EXPLORATION -maxilar I-EXPLORATION -superior I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -LeFort I-EXPLORATION -I, I-EXPLORATION -manteniendo I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -una I-EXPLORATION -oclusión I-EXPLORATION -correcta I-EXPLORATION -en I-EXPLORATION -clase I-EXPLORATION -I. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -TC I-EXPLORATION -de I-EXPLORATION -tercio I-EXPLORATION -medio I-EXPLORATION -facial I-EXPLORATION -solicitado I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -consolidación I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -maxilar I-EXPLORATION -superior I-EXPLORATION -con I-EXPLORATION -solución I-EXPLORATION -de I-EXPLORATION -continuidad I-EXPLORATION -ósea I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -osteotomía I-EXPLORATION -LeFort I-EXPLORATION -I. I-EXPLORATION -Dado B-EVOLUTION -el I-EVOLUTION -tiempo I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -desde I-EVOLUTION -la I-EVOLUTION -primera I-EVOLUTION -intervención I-EVOLUTION -se I-EVOLUTION -establece I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -presunción I-EVOLUTION -de I-EVOLUTION -pseudoartrosis I-EVOLUTION -de I-EVOLUTION -maxilar I-EVOLUTION -superior I-EVOLUTION -en I-EVOLUTION -dicha I-EVOLUTION -osteotomía. I-EVOLUTION - I-EVOLUTION -Se B-TREATMENT -decide I-TREATMENT -reintervenir I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -para I-TREATMENT -el I-TREATMENT -manejo I-TREATMENT -definitivo I-TREATMENT -de I-TREATMENT -dicha I-TREATMENT -complicación. I-TREATMENT -Tras I-TREATMENT -realizar I-TREATMENT -un I-TREATMENT -bloqueo I-TREATMENT -intermaxilar I-TREATMENT -elástico I-TREATMENT -en I-TREATMENT -clase I-TREATMENT -I I-TREATMENT -y I-TREATMENT -reabrir I-TREATMENT -de I-TREATMENT -nuevo I-TREATMENT -el I-TREATMENT -abordaje I-TREATMENT -sublabial I-TREATMENT -superior I-TREATMENT -previo, I-TREATMENT -se I-TREATMENT -retira I-TREATMENT -el I-TREATMENT -tejido I-TREATMENT -fibroso I-TREATMENT -interpuesto I-TREATMENT -en I-TREATMENT -los I-TREATMENT -márgenes I-TREATMENT -óseos I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -la I-TREATMENT -osteotomía I-TREATMENT -maxilar I-TREATMENT -superior. I-TREATMENT -Se I-TREATMENT -fija I-TREATMENT -la I-TREATMENT -osteotomía I-TREATMENT -maxilar I-TREATMENT -superior I-TREATMENT -mediante I-TREATMENT -dos I-TREATMENT -placas I-TREATMENT -preformadas I-TREATMENT -de I-TREATMENT -titanio I-TREATMENT -con I-TREATMENT -el I-TREATMENT -avance I-TREATMENT -inicialmente I-TREATMENT -establecido. I-TREATMENT -Se I-TREATMENT -obtienen I-TREATMENT -injertos I-TREATMENT -óseos I-TREATMENT -esponjosos I-TREATMENT -de I-TREATMENT -tibia I-TREATMENT -derecha I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -un I-TREATMENT -abordaje I-TREATMENT -medial I-TREATMENT -y I-TREATMENT -se I-TREATMENT -colocan I-TREATMENT -los I-TREATMENT -mismos I-TREATMENT -en I-TREATMENT -el I-TREATMENT -gap I-TREATMENT -óseo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -osteotomía I-TREATMENT -Le-Fort I-TREATMENT -I I-TREATMENT -sellando I-TREATMENT -dicho I-TREATMENT -defecto. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -del I-EXPLORATION -tejido I-EXPLORATION -localizado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -foco I-EXPLORATION -interfracturario I-EXPLORATION -revela I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -cartilaginosas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -interior I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tejido I-EXPLORATION -con I-EXPLORATION -predominante I-EXPLORATION -proliferación I-EXPLORATION -fibroblástica. I-EXPLORATION - I-EXPLORATION -Tras B-EVOLUTION -dicha I-EVOLUTION -intervención I-EVOLUTION -es I-EVOLUTION -seguida I-EVOLUTION -en I-EVOLUTION -nuestras I-EVOLUTION -consultas I-EVOLUTION -apreciándose I-EVOLUTION -la I-EVOLUTION -consolidación I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -osteotomía, I-EVOLUTION -sin I-EVOLUTION -movilidad I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -misma, I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -oclusión I-EVOLUTION -estable I-EVOLUTION -y I-EVOLUTION -aspecto I-EVOLUTION -estético I-EVOLUTION -favorable. I-EVOLUTION -Asimismo I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -apreciaron I-EVOLUTION -complicaciones I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -toma I-EVOLUTION -del I-EVOLUTION -injerto I-EVOLUTION -tibial, I-EVOLUTION -siendo I-EVOLUTION -favorable I-EVOLUTION -su I-EVOLUTION -Rx I-EVOLUTION -de I-EVOLUTION -control. I-EVOLUTION - I-EVOLUTION - -El B-PRESENT_ILLNESS -segundo I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -presentando I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -cerrar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -boca. I-PRESENT_ILLNESS -El B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -valorado I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -pediatría I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -diagnosticado I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -luxación I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -ATM, I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -lo I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -referido I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -cirujano I-DERIVED_FROM/TO -maxilofacial I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -guardia. I-DERIVED_FROM/TO -En B-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -valoración I-EXPLORATION -el I-EXPLORATION -niño I-EXPLORATION -estaba I-EXPLORATION -inquieto I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -boca I-EXPLORATION -semiabierta, I-EXPLORATION -sin I-EXPLORATION -embargo I-EXPLORATION -al I-EXPLORATION -forzar I-EXPLORATION -el I-EXPLORATION -cierre I-EXPLORATION -la I-EXPLORATION -oclusión I-EXPLORATION -dentaria I-EXPLORATION -era I-EXPLORATION -buena I-EXPLORATION -aunque I-EXPLORATION -muy I-EXPLORATION -dolorosa. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -tenía I-EXPLORATION -fiebre I-EXPLORATION -ni I-EXPLORATION -supuración I-EXPLORATION -de I-EXPLORATION -oídos. I-EXPLORATION -En B-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -refería I-PAST_MEDICAL_HISTORY -ningún I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -duración I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -síntomas I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -unas I-PAST_MEDICAL_HISTORY -horas, I-PAST_MEDICAL_HISTORY -pues I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -acompañaba I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -maestra I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -guardería. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -interrogó I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -maestra I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -busca I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -infecciosos I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -traumáticos, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -nos I-PAST_MEDICAL_HISTORY -informó I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -habían I-PAST_MEDICAL_HISTORY -faltado I-PAST_MEDICAL_HISTORY -varios I-PAST_MEDICAL_HISTORY -niños I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -porque I-PAST_MEDICAL_HISTORY -estaban I-PAST_MEDICAL_HISTORY -enfermos. I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ortopantomografía, I-EXPLORATION -sin I-EXPLORATION -evidenciarse I-EXPLORATION -patología I-EXPLORATION -articular. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -otoscopia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -apreciaron I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -otitis I-EXPLORATION -externa I-EXPLORATION -aguda. I-EXPLORATION -Tras B-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -adecuado I-TREATMENT -se B-EVOLUTION -produjo I-EVOLUTION -la I-EVOLUTION -resolución I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -situación I-EVOLUTION -clínica. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -32 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -japonesa, B-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médico-quirúrgicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -fumadora I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -bebedora, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -maxilar I-PRESENT_ILLNESS -indolora I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -varios I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -que I-EXPLORATION -hace I-EXPLORATION -prominencia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -vestibular I-EXPLORATION -premolar I-EXPLORATION -izquierda I-EXPLORATION -del I-EXPLORATION -maxilar I-EXPLORATION -superior, I-EXPLORATION -manteniéndose I-EXPLORATION -la I-EXPLORATION -integridad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mucosa. I-EXPLORATION -No I-EXPLORATION -presenta I-EXPLORATION -alteraciones I-EXPLORATION -sensitivas I-EXPLORATION -asociadas I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -cervical I-EXPLORATION -es I-EXPLORATION -negativa. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -panorámica I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -mixta I-EXPLORATION -radioopaca-radiolúcida I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -de I-EXPLORATION -"panal I-EXPLORATION -de I-EXPLORATION -abejas" I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -expande I-EXPLORATION -entre I-EXPLORATION -el I-EXPLORATION -canino I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -primer I-EXPLORATION -bicúspide I-EXPLORATION -superior I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -origina I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -separación I-EXPLORATION -entre I-EXPLORATION -las I-EXPLORATION -raíces I-EXPLORATION -de I-EXPLORATION -esas I-EXPLORATION -piezas I-EXPLORATION -dentarias, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -ligero I-EXPLORATION -desplazamiento I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -límites I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -y I-EXPLORATION -escotadura I-EXPLORATION -piriforme. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -delimita I-EXPLORATION -con I-EXPLORATION -mayor I-EXPLORATION -precisión I-EXPLORATION -los I-EXPLORATION -bordes I-EXPLORATION -de I-EXPLORATION -esta I-EXPLORATION -tumoración, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -palatina I-EXPLORATION -sin I-EXPLORATION -llegar I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -media; I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -zona I-EXPLORATION -central I-EXPLORATION -presenta I-EXPLORATION -una I-EXPLORATION -clara I-EXPLORATION -imagen I-EXPLORATION -radiolúcida I-EXPLORATION -rodeada I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -punteado I-EXPLORATION -de I-EXPLORATION -imágenes I-EXPLORATION -alternantes I-EXPLORATION -radiolúcidas I-EXPLORATION -y I-EXPLORATION -radioopacas I-EXPLORATION -que I-EXPLORATION -configuran I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -tumoral. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -diagnósticos I-EXPLORATION -diferenciales I-EXPLORATION -barajados, I-EXPLORATION -en I-EXPLORATION -espera I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -confirmación I-EXPLORATION -histológica, I-EXPLORATION -fueron: I-EXPLORATION -lesión I-EXPLORATION -fibroósea I-EXPLORATION -benigna, I-EXPLORATION -sarcoma I-EXPLORATION -osteogénico, I-EXPLORATION -tumor I-EXPLORATION -epitelial I-EXPLORATION -calcificante, I-EXPLORATION -etc. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -primera I-EXPLORATION -biopsia I-EXPLORATION -realizada I-EXPLORATION -fue I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -ameloblastoma, I-EXPLORATION -pero I-EXPLORATION -la I-EXPLORATION -falta I-EXPLORATION -de I-EXPLORATION -concordancia I-EXPLORATION -clínico-radiológica I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -ameloblastoma I-EXPLORATION -común I-EXPLORATION -apoyó I-EXPLORATION -la I-EXPLORATION -indicación I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -biopsia. I-EXPLORATION -En I-EXPLORATION -esta I-EXPLORATION -se I-EXPLORATION -podían I-EXPLORATION -observar I-EXPLORATION -con I-EXPLORATION -mayor I-EXPLORATION -claridad I-EXPLORATION -escasos I-EXPLORATION -nidos I-EXPLORATION -y I-EXPLORATION -cordones I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -basaloides, I-EXPLORATION -sin I-EXPLORATION -atipia, I-EXPLORATION -dispuestas I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -estroma I-EXPLORATION -fibroso I-EXPLORATION -densamente I-EXPLORATION -colagenizado, I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -consideró I-EXPLORATION -característico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -variante I-EXPLORATION -desmoplásica I-EXPLORATION -del I-EXPLORATION -ameloblastoma. I-EXPLORATION - I-EXPLORATION -Bajo B-TREATMENT -anestesia I-TREATMENT -general I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -la I-TREATMENT -disección I-TREATMENT -de I-TREATMENT -un I-TREATMENT -colgajo I-TREATMENT -mucoso I-TREATMENT -palatino I-TREATMENT -y I-TREATMENT -vestibular I-TREATMENT -en I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -peritumoral, I-TREATMENT -así I-TREATMENT -como I-TREATMENT -la I-TREATMENT -separación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -mucosa I-TREATMENT -nasal I-TREATMENT -y I-TREATMENT -del I-TREATMENT -seno I-TREATMENT -maxilar, I-TREATMENT -que I-TREATMENT -en I-TREATMENT -ningún I-TREATMENT -momento I-TREATMENT -se I-TREATMENT -encontraban I-TREATMENT -adheridas I-TREATMENT -al I-TREATMENT -tumor. I-TREATMENT -Expuesta I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -a I-TREATMENT -resecar, I-TREATMENT -y I-TREATMENT -siguiendo I-TREATMENT -los I-TREATMENT -límites I-TREATMENT -macroscópicos I-TREATMENT -del I-TREATMENT -tumor, I-TREATMENT -se I-TREATMENT -practica I-TREATMENT -una I-TREATMENT -maxilectomía I-TREATMENT -en I-TREATMENT -bloque I-TREATMENT -que I-TREATMENT -abarca I-TREATMENT -desde I-TREATMENT -distal I-TREATMENT -del I-TREATMENT -incisivo I-TREATMENT -lateral, I-TREATMENT -hasta I-TREATMENT -mesial I-TREATMENT -del I-TREATMENT -segundo I-TREATMENT -molar, I-TREATMENT -incluyendo I-TREATMENT -en I-TREATMENT -la I-TREATMENT -pieza I-TREATMENT -la I-TREATMENT -pared I-TREATMENT -lateral I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fosa I-TREATMENT -nasal I-TREATMENT -izquierda, I-TREATMENT -el I-TREATMENT -suelo I-TREATMENT -del I-TREATMENT -seno I-TREATMENT -maxilar I-TREATMENT -izquierdo I-TREATMENT -y I-TREATMENT -la I-TREATMENT -porción I-TREATMENT -palatina I-TREATMENT -afectada. I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -retirado I-TREATMENT -el I-TREATMENT -bloque I-TREATMENT -tumoral I-TREATMENT -se I-TREATMENT -amplían I-TREATMENT -los I-TREATMENT -límites I-TREATMENT -de I-TREATMENT -seguridad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -resección I-TREATMENT -sobre I-TREATMENT -hueso I-TREATMENT -clínicamente I-TREATMENT -sano. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -acto I-TREATMENT -operatorio I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -la I-TREATMENT -reconstrucción I-TREATMENT -del I-TREATMENT -defecto I-TREATMENT -resultante I-TREATMENT -mediante I-TREATMENT -interposición I-TREATMENT -de I-TREATMENT -un I-TREATMENT -bloque I-TREATMENT -de I-TREATMENT -autoinjerto I-TREATMENT -córtico-esponjoso I-TREATMENT -libre I-TREATMENT -de I-TREATMENT -cadera, I-TREATMENT -fijándolo I-TREATMENT -con I-TREATMENT -miniplacas I-TREATMENT -de I-TREATMENT -osteosíntesis I-TREATMENT -al I-TREATMENT -hueso I-TREATMENT -maxilar. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -macroscópico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -de I-EXPLORATION -resección I-EXPLORATION -mostraba I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -que I-EXPLORATION -medía I-EXPLORATION -3 I-EXPLORATION -x I-EXPLORATION -3 I-EXPLORATION -y I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -2, I-EXPLORATION -5 I-EXPLORATION -cm, I-EXPLORATION -relativamente I-EXPLORATION -bien I-EXPLORATION -delimitada I-EXPLORATION -aunque I-EXPLORATION -infiltrante I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hueso I-EXPLORATION -maxilar, I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -extendía I-EXPLORATION -al I-EXPLORATION -hueso I-EXPLORATION -limítrofe. I-EXPLORATION -Histológicamente I-EXPLORATION -la I-EXPLORATION -tumoración I-EXPLORATION -estaba I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -nidos I-EXPLORATION -irregulares I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -basaloide, I-EXPLORATION -con I-EXPLORATION -escaso I-EXPLORATION -citoplasma I-EXPLORATION -y I-EXPLORATION -núcleos I-EXPLORATION -monomorfos I-EXPLORATION -carentes I-EXPLORATION -de I-EXPLORATION -atipia. I-EXPLORATION -Los I-EXPLORATION -nidos I-EXPLORATION -celulares I-EXPLORATION -estaban I-EXPLORATION -dispuestos I-EXPLORATION -de I-EXPLORATION -manera I-EXPLORATION -salpicada I-EXPLORATION -sobre I-EXPLORATION -un I-EXPLORATION -abundante I-EXPLORATION -estroma I-EXPLORATION -muy I-EXPLORATION -colagenizado. I-EXPLORATION -Se I-EXPLORATION -emitió I-EXPLORATION -un I-EXPLORATION -informe I-EXPLORATION -de I-EXPLORATION -ameloblastoma I-EXPLORATION -variante I-EXPLORATION -desmoplásica I-EXPLORATION -que I-EXPLORATION -respetaba I-EXPLORATION -los I-EXPLORATION -bordes I-EXPLORATION -óseos. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -postoperatorio I-EVOLUTION -inmediato I-EVOLUTION -cursa I-EVOLUTION -sin I-EVOLUTION -complicaciones; I-EVOLUTION -se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -una I-TREATMENT -prótesis I-TREATMENT -dentaria I-TREATMENT -provisional I-TREATMENT -removible I-TREATMENT -al I-TREATMENT -cabo I-TREATMENT -de I-TREATMENT -unas I-TREATMENT -semanas. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -último I-EVOLUTION -control I-EVOLUTION -clínico-radiológico I-EVOLUTION -realizado I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -4 I-EVOLUTION -años I-EVOLUTION -no I-EVOLUTION -existen I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -recidiva; I-EVOLUTION -un B-EXPLORATION -año I-EXPLORATION -y I-EXPLORATION -medio I-EXPLORATION -después I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -intervención I-EXPLORATION -se I-EXPLORATION -realizó, I-EXPLORATION -para I-EXPLORATION -mayor I-EXPLORATION -seguridad, I-EXPLORATION -un I-EXPLORATION -examen I-EXPLORATION -histológico I-EXPLORATION -del I-EXPLORATION -hueso I-EXPLORATION -remanente I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -distal I-EXPLORATION -del I-EXPLORATION -incisivo I-EXPLORATION -lateral I-EXPLORATION -por I-EXPLORATION -hallarse I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -de I-EXPLORATION -resección I-EXPLORATION -muy I-EXPLORATION -próxima I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -resultado I-EXPLORATION -fue I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -tumor I-EXPLORATION -residual. I-EXPLORATION -Se B-EVOLUTION -mantienen I-EVOLUTION -revisiones I-EVOLUTION -periódicas. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -ni B-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés, I-FAMILY_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestra I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -valorar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -latero-cervical I-PRESENT_ILLNESS -izquierda, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -varios I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -produce I-PRESENT_ILLNESS -disfonía, I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -seca I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -disnea. I-PRESENT_ILLNESS -Niega I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -anorexia, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cuenta I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -profusa I-PRESENT_ILLNESS -nocturna, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -holocraneal I-PRESENT_ILLNESS -frecuente. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -palpa I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -dura, I-EXPLORATION -adherida I-EXPLORATION -a I-EXPLORATION -planos I-EXPLORATION -profundos I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -tercio I-EXPLORATION -inferior I-EXPLORATION -cervical I-EXPLORATION -izquierdo, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -media, I-EXPLORATION -sin I-EXPLORATION -palparse I-EXPLORATION -adenopatías I-EXPLORATION -locorregionales. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -revela I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -de I-EXPLORATION -7 I-EXPLORATION -x I-EXPLORATION -2 I-EXPLORATION -cm, I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -tiroideo I-EXPLORATION -izquierdo I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -cayado I-EXPLORATION -aórtico, I-EXPLORATION -que I-EXPLORATION -produce I-EXPLORATION -cierta I-EXPLORATION -estenosis I-EXPLORATION -traqueal I-EXPLORATION -y I-EXPLORATION -desplazamiento I-EXPLORATION -del I-EXPLORATION -esófago. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -cortes I-EXPLORATION -histológicos I-EXPLORATION -muestran I-EXPLORATION -un I-EXPLORATION -tejido I-EXPLORATION -conjuntivo I-EXPLORATION -infiltrado I-EXPLORATION -en I-EXPLORATION -ciertas I-EXPLORATION -zonas I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -neoplasia I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -dispone I-EXPLORATION -formando I-EXPLORATION -grandes I-EXPLORATION -nidos I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -pequeño I-EXPLORATION -o I-EXPLORATION -intermedio. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -tumorales I-EXPLORATION -son I-EXPLORATION -reactivas I-EXPLORATION -exclusivamente I-EXPLORATION -para I-EXPLORATION -CD99, I-EXPLORATION -enolasa I-EXPLORATION -neuroespecífica I-EXPLORATION -y, I-EXPLORATION -débilmente, I-EXPLORATION -para I-EXPLORATION -sinaptofisina. I-EXPLORATION -La I-EXPLORATION -positividad I-EXPLORATION -nuclear I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -anticuerpo I-EXPLORATION -de I-EXPLORATION -proliferación I-EXPLORATION -Ki-67 I-EXPLORATION -oscila I-EXPLORATION -entre I-EXPLORATION -el I-EXPLORATION -25 I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -50% I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -núcleos I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -tumorales. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -obtenido I-TREATMENT -mediante I-TREATMENT -la I-TREATMENT -biopsia, I-TREATMENT -se I-TREATMENT -programa I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -para I-TREATMENT -recibir I-TREATMENT -tratamiento I-TREATMENT -quimiorradioterápico. I-TREATMENT -Recibió I-TREATMENT -4 I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -quimioterapia, I-TREATMENT -seguidos I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -radioterápico I-TREATMENT -con I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -total I-TREATMENT -administrada I-TREATMENT -de I-TREATMENT -55, I-TREATMENT -8 I-TREATMENT -Gy, I-TREATMENT -tras I-TREATMENT -el I-TREATMENT -cual I-TREATMENT -presentó I-TREATMENT -esofagitis I-TREATMENT -y I-TREATMENT -epitelitis I-TREATMENT -de I-TREATMENT -grado I-TREATMENT -2. I-TREATMENT -Tras I-TREATMENT -la I-TREATMENT -radioterapia, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -recibió I-TREATMENT -6 I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -poliquimioterapia. I-TREATMENT - I-TREATMENT -Los B-EVOLUTION -días I-EVOLUTION -siguientes I-EVOLUTION -al I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -progresiva I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -estridor I-EVOLUTION -respiratorio, I-EVOLUTION -que I-EVOLUTION -desapareció I-EVOLUTION -por I-EVOLUTION -completo, I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -una I-EVOLUTION -disminución I-EVOLUTION -del I-EVOLUTION -tamaño I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -tumoración I-EVOLUTION -latero-cervical I-EVOLUTION -mayor I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -50%. I-EVOLUTION -Tras I-EVOLUTION -finalizar I-EVOLUTION -todos I-EVOLUTION -los I-EVOLUTION -ciclos I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -se I-EVOLUTION -objetivó I-EVOLUTION -remisión I-EVOLUTION -completa I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -permaneció I-EVOLUTION -asintomático I-EVOLUTION -durante I-EVOLUTION -7 I-EVOLUTION -años I-EVOLUTION -hasta I-EVOLUTION -que I-EVOLUTION -acude I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -consulta I-EVOLUTION -refiriendo I-EVOLUTION -disnea I-EVOLUTION -y I-EVOLUTION -tos I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -y B-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -TAC I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -recidiva I-EXPLORATION -mediastínica I-EXPLORATION -con I-EXPLORATION -extensión I-EXPLORATION -pulmonar. I-EXPLORATION -Se B-TREATMENT -realiza I-TREATMENT -traqueostomía I-TREATMENT -por I-TREATMENT -compresión I-TREATMENT -traqueal I-TREATMENT -del I-TREATMENT -tumor I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -citotóxico I-TREATMENT -con I-TREATMENT -4 I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -poliquimioterapia. I-TREATMENT -Presentó B-EVOLUTION -una I-EVOLUTION -supervivencia I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -hasta I-EVOLUTION -su I-EVOLUTION -fallecimiento I-EVOLUTION -por I-EVOLUTION -causa I-EVOLUTION -tumoral. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -familiares I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -nota I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -chasquido I-PRESENT_ILLNESS -mandibular I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -apertura I-PRESENT_ILLNESS -mandibular I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -palpable I-PRESENT_ILLNESS -preauricular I-PRESENT_ILLNESS -dolorosa I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -mejoró I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -antiinflamatorios I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -esteroideos, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Cirugía I-PRESENT_ILLNESS -Maxilofacial. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -presenta I-EXPLORATION -asimetría I-EXPLORATION -facial, I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -preauricular I-EXPLORATION -izquierda, I-EXPLORATION -arco I-EXPLORATION -cigomático I-EXPLORATION -y I-EXPLORATION -ángulo I-EXPLORATION -mandibular I-EXPLORATION -izquierdo. I-EXPLORATION -Este I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -se I-EXPLORATION -halla I-EXPLORATION -mal I-EXPLORATION -delimitado, I-EXPLORATION -sin I-EXPLORATION -poderse I-EXPLORATION -definir I-EXPLORATION -clara I-EXPLORATION -tumoración. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -cavidad I-EXPLORATION -oral I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -induración I-EXPLORATION -irregular I-EXPLORATION -del I-EXPLORATION -espacio I-EXPLORATION -masticador I-EXPLORATION -izquierdo, I-EXPLORATION -sospechosa I-EXPLORATION -de I-EXPLORATION -afectación I-EXPLORATION -tumoral. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -apertura I-EXPLORATION -oral I-EXPLORATION -de I-EXPLORATION -40 I-EXPLORATION -mm. I-EXPLORATION -No I-EXPLORATION -presentaba I-EXPLORATION -adenopatías I-EXPLORATION -cervicales I-EXPLORATION -ni I-EXPLORATION -supraclaviculares I-EXPLORATION -palpables. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION -aparece I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -de I-EXPLORATION -carácter I-EXPLORATION -sólido I-EXPLORATION -en I-EXPLORATION -hemimandíbula I-EXPLORATION -izquierda, I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -2 I-EXPLORATION -x I-EXPLORATION -1, I-EXPLORATION -8 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -del I-EXPLORATION -cóndilo I-EXPLORATION -mandibular, I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -bien I-EXPLORATION -delimitados, I-EXPLORATION -que I-EXPLORATION -sugiere I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -agresiva, I-EXPLORATION -de I-EXPLORATION -probable I-EXPLORATION -origen I-EXPLORATION -óseo, I-EXPLORATION -objetivándose I-EXPLORATION -destrucción I-EXPLORATION -de I-EXPLORATION -rama I-EXPLORATION -mandibular I-EXPLORATION -izquierda I-EXPLORATION -de I-EXPLORATION -carácter I-EXPLORATION -lítico. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -punción-aspiración I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina I-EXPLORATION -con I-EXPLORATION -diagnóstico I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -tumor I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -redondas, I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -citoqueratinas, I-EXPLORATION -antígeno I-EXPLORATION -leucocitario I-EXPLORATION -común, I-EXPLORATION -sinaptofisina I-EXPLORATION -y I-EXPLORATION -CD99. I-EXPLORATION - I-EXPLORATION -Finalmente I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -PNET I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -tumoral I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -mandaron I-EXPLORATION -5 I-EXPLORATION -fragmentos I-EXPLORATION -irregulares I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -rojizo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -diagnosticaron I-EXPLORATION -como I-EXPLORATION -"tumoración I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -redondas I-EXPLORATION -y I-EXPLORATION -pequeñas I-EXPLORATION -infiltrando I-EXPLORATION -hueso". I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -sobre I-EXPLORATION -el I-EXPLORATION -material I-EXPLORATION -fijado I-EXPLORATION -en I-EXPLORATION -formol I-EXPLORATION -incluido I-EXPLORATION -en I-EXPLORATION -parafina I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -tan I-EXPLORATION -solo I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -positividad I-EXPLORATION -con I-EXPLORATION -vimentina I-EXPLORATION -y I-EXPLORATION -CD99. I-EXPLORATION -El I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -proliferación I-EXPLORATION -medido I-EXPLORATION -como I-EXPLORATION -positividad I-EXPLORATION -nuclear I-EXPLORATION -con I-EXPLORATION -MIB-1 I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -el I-EXPLORATION -15% I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -celularidad I-EXPLORATION -tumoral. I-EXPLORATION -Dado I-EXPLORATION -el I-EXPLORATION -escaso I-EXPLORATION -material I-EXPLORATION -examinado, I-EXPLORATION -no I-EXPLORATION -fue I-EXPLORATION -posible I-EXPLORATION -determinar I-EXPLORATION -si I-EXPLORATION -la I-EXPLORATION -tumoración I-EXPLORATION -correspondía I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -de I-EXPLORATION -Ewing I-EXPLORATION -o I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -neuroepitelioma I-EXPLORATION -periférico. I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -citogenético I-EXPLORATION -no I-EXPLORATION -fue I-EXPLORATION -realizado. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -gammagrafía I-EXPLORATION -ósea I-EXPLORATION -no I-EXPLORATION -mostraron I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -metastásica. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -comenzar I-TREATMENT -tratamiento I-TREATMENT -quimioterápico I-TREATMENT -y I-TREATMENT -valorar I-TREATMENT -tratamiento I-TREATMENT -quirúrgico/radioterápico I-TREATMENT -según I-TREATMENT -la I-TREATMENT -respuesta. I-TREATMENT -Se I-TREATMENT -dieron I-TREATMENT -5 I-TREATMENT -ciclos I-TREATMENT -durante I-TREATMENT -4 I-TREATMENT -meses. I-TREATMENT -Tras B-EVOLUTION -el I-EVOLUTION -tercer I-EVOLUTION -ciclo I-EVOLUTION -precisó I-EVOLUTION -ingreso I-EVOLUTION -por I-EVOLUTION -neutropenia I-EVOLUTION -febril. I-EVOLUTION - I-EVOLUTION -La B-TREATMENT -resonancia I-TREATMENT -magnética I-TREATMENT -nuclear I-TREATMENT -(RMN) I-TREATMENT -tras I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -quimioterápico I-TREATMENT -sugería I-TREATMENT -la I-TREATMENT -posible I-TREATMENT -progresión I-TREATMENT -del I-TREATMENT -tumor, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -dar I-TREATMENT -tratamiento I-TREATMENT -radioterápico I-TREATMENT -planificado I-TREATMENT -con I-TREATMENT -intención I-TREATMENT -radical, I-TREATMENT -durante I-TREATMENT -un I-TREATMENT -mes I-TREATMENT -y I-TREATMENT -medio. I-TREATMENT -La I-TREATMENT -irradiación I-TREATMENT -se I-TREATMENT -hizo I-TREATMENT -en I-TREATMENT -dos I-TREATMENT -fases, I-TREATMENT -con I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -total I-TREATMENT -sobre I-TREATMENT -tumor I-TREATMENT -y I-TREATMENT -margen I-TREATMENT -reducido I-TREATMENT -de I-TREATMENT -60 I-TREATMENT -Gy. I-TREATMENT -Después B-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -radioterápico I-EVOLUTION -presentó I-EVOLUTION -mucositis I-EVOLUTION -grado I-EVOLUTION -2, I-EVOLUTION -otitis I-EVOLUTION -externa I-EVOLUTION -y I-EVOLUTION -epitelitis I-EVOLUTION -grado I-EVOLUTION -2 I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -campo I-EVOLUTION -de I-EVOLUTION -tratamiento. I-EVOLUTION - I-EVOLUTION -En B-TREATMENT -la I-TREATMENT -TAC I-TREATMENT -de I-TREATMENT -control I-TREATMENT -se I-TREATMENT -objetivaron I-TREATMENT -hallazgos I-TREATMENT -compatibles I-TREATMENT -con I-TREATMENT -restos/recidiva I-TREATMENT -del I-TREATMENT -PNET I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -tratar I-TREATMENT -con I-TREATMENT -otros I-TREATMENT -5 I-TREATMENT -ciclos I-TREATMENT -más I-TREATMENT -de I-TREATMENT -quimioterapia, I-TREATMENT -siguiendo I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -esquema I-TREATMENT -anterior, I-TREATMENT -durante I-TREATMENT -otros I-TREATMENT -4 I-TREATMENT -meses. I-TREATMENT - I-TREATMENT -Actualmente B-EVOLUTION -han I-EVOLUTION -pasado I-EVOLUTION -6 I-EVOLUTION -años I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -continúa I-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad, I-EVOLUTION -en I-EVOLUTION -tratamiento I-EVOLUTION -de I-EVOLUTION -rehabilitación I-EVOLUTION -dental. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -19 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -leve I-PRESENT_ILLNESS -recurrente I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -hemimandíbula I-PRESENT_ILLNESS -izquierda, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -parestesia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -mencionada, I-PRESENT_ILLNESS -especialmente I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -labio I-PRESENT_ILLNESS -inferior. I-PRESENT_ILLNESS -Además, I-PRESENT_ILLNESS -describe I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -leve I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -masticar I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -molares I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -premolares I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -lado I-PRESENT_ILLNESS -afectado. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -leve I-EXPLORATION -asimetría I-EXPLORATION -facial I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -ubicado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -más I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -cuerpo I-EXPLORATION -mandibular I-EXPLORATION -y I-EXPLORATION -rama I-EXPLORATION -ascendente I-EXPLORATION -izquierda. I-EXPLORATION -El I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -es I-EXPLORATION -indoloro. I-EXPLORATION -Intrabucalmente I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -tabla I-EXPLORATION -ósea I-EXPLORATION -externa I-EXPLORATION -abombada I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -del I-EXPLORATION -segundo I-EXPLORATION -molar. I-EXPLORATION -Situación I-EXPLORATION -similar, I-EXPLORATION -pero I-EXPLORATION -con I-EXPLORATION -expansión I-EXPLORATION -de I-EXPLORATION -ambas I-EXPLORATION -tablas, I-EXPLORATION -se I-EXPLORATION -pesquisa I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -rama I-EXPLORATION -ascendente I-EXPLORATION -mandibular. I-EXPLORATION -Tercer I-EXPLORATION -molar I-EXPLORATION -ausente I-EXPLORATION -clínicamente. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -la I-EXPLORATION -hipótesis I-EXPLORATION -diagnóstica I-EXPLORATION -de I-EXPLORATION -quiste I-EXPLORATION -mandibular I-EXPLORATION -odontogénico I-EXPLORATION -o I-EXPLORATION -tumor I-EXPLORATION -odontogénico, I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -estudio I-EXPLORATION -imagenológico I-EXPLORATION -previo I-EXPLORATION -a I-EXPLORATION -biopsia. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -panorámica I-EXPLORATION -revela I-EXPLORATION -una I-EXPLORATION -extensa I-EXPLORATION -lesión I-EXPLORATION -radiolúcida I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -netos, I-EXPLORATION -uniloculada I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -afecta I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -totalidad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -rama I-EXPLORATION -ascendente I-EXPLORATION -mandibular. I-EXPLORATION -Asociada I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -lesión, I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -el I-EXPLORATION -tercer I-EXPLORATION -molar I-EXPLORATION -incluido I-EXPLORATION -en I-EXPLORATION -posición I-EXPLORATION -baja I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -distoversión. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -programa I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -incisional, I-EXPLORATION -durante B-TREATMENT -la I-TREATMENT -cual, I-TREATMENT -y I-TREATMENT -de I-TREATMENT -acuerdo I-TREATMENT -a I-TREATMENT -las I-TREATMENT -características I-TREATMENT -clínicas I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión, I-TREATMENT -se I-TREATMENT -instala I-TREATMENT -una I-TREATMENT -cánula I-TREATMENT -de I-TREATMENT -descompresión. I-TREATMENT -El B-EXPLORATION -informe I-EXPLORATION -histopatológico I-EXPLORATION -informa I-EXPLORATION -ameloblastoma I-EXPLORATION -uniquístico I-EXPLORATION -de I-EXPLORATION -crecimiento I-EXPLORATION -intramural I-EXPLORATION -tipo I-EXPLORATION -IIIa I-EXPLORATION -de I-EXPLORATION -Ackerman9. I-EXPLORATION - I-EXPLORATION -Después B-TREATMENT -de I-TREATMENT -10 I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -seguimiento I-TREATMENT -clínico-radiográfico, I-TREATMENT -con I-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -una I-TREATMENT -cánula I-TREATMENT -de I-TREATMENT -descompresión I-TREATMENT -cuya I-TREATMENT -longitud I-TREATMENT -se I-TREATMENT -reduce I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -gradual, I-TREATMENT -se I-TREATMENT -constata I-TREATMENT -reducción I-TREATMENT -casi I-TREATMENT -total I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -quística I-TREATMENT -ameloblástica, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -efectúa I-TREATMENT -cirugía I-TREATMENT -de I-TREATMENT -enucleación I-TREATMENT -y I-TREATMENT -curetaje I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cavidad I-TREATMENT -residual, I-TREATMENT -además I-TREATMENT -de I-TREATMENT -exodoncia I-TREATMENT -del I-TREATMENT -tercer I-TREATMENT -molar I-TREATMENT -involucrado. I-TREATMENT - I-TREATMENT - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -derivado B-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cirugía I-DERIVED_FROM/TO -máxilofacial I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -Luis I-DERIVED_FROM/TO -Calvo I-DERIVED_FROM/TO -Mackenna, I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -presentar I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -lesión I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -zona I-DERIVED_FROM/TO -malar I-DERIVED_FROM/TO -derecha. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos, I-PAST_MEDICAL_HISTORY -relata I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -aumento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -volumen I-PAST_MEDICAL_HISTORY -secundario I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -traumatismo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -malar I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -persiste I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -fecha.. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen, I-EXPLORATION -asintomático, I-EXPLORATION -circunscrito, I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -firme, I-EXPLORATION -con I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -evolución I-EXPLORATION -indeterminado. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -intraoral I-EXPLORATION -el I-EXPLORATION -vestíbulo I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -desocupado I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -del I-EXPLORATION -reborde I-EXPLORATION -óseo I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -más I-EXPLORATION -alta. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -que I-EXPLORATION -compromete I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -malar I-EXPLORATION -derecha, I-EXPLORATION -destruyendo I-EXPLORATION -el I-EXPLORATION -hueso I-EXPLORATION -cigomático, I-EXPLORATION -parte I-EXPLORATION -del I-EXPLORATION -piso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -órbita I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -arco I-EXPLORATION -cigomático. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -incisional I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión. I-EXPLORATION - I-EXPLORATION -De I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -se I-EXPLORATION -obtuvo I-EXPLORATION -como I-EXPLORATION -resultado I-EXPLORATION -HCL, I-EXPLORATION -con I-EXPLORATION -marcadores I-EXPLORATION -inmunohistoquímicos I-EXPLORATION -CD1a I-EXPLORATION -y I-EXPLORATION -S100 I-EXPLORATION -intensamente I-EXPLORATION -positivos. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -completo I-EXPLORATION -estudio I-EXPLORATION -del I-EXPLORATION -paciente, I-EXPLORATION -sin I-EXPLORATION -evidenciar I-EXPLORATION -compromiso I-EXPLORATION -en I-EXPLORATION -otras I-EXPLORATION -áreas I-EXPLORATION -del I-EXPLORATION -cuerpo. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -lesión I-TREATMENT -fue I-TREATMENT -clasificada I-TREATMENT -como I-TREATMENT -lesión I-TREATMENT -ósea I-TREATMENT -única I-TREATMENT -de I-TREATMENT -sitio I-TREATMENT -especial I-TREATMENT -y I-TREATMENT -tratada I-TREATMENT -con I-TREATMENT -el I-TREATMENT -protocolo I-TREATMENT -correspondiente, I-TREATMENT -recibiendo I-TREATMENT -4 I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -prednisona I-TREATMENT -y I-TREATMENT -6 I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -vinblastina. I-TREATMENT - I-TREATMENT -Posteriormente I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -como I-TREATMENT -tratamiento I-TREATMENT -local, I-TREATMENT -infiltración I-TREATMENT -con I-TREATMENT -triamcinolona I-TREATMENT -y I-TREATMENT -curetaje I-TREATMENT -después I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tercera I-TREATMENT -infiltración. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -18 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -realizado I-EVOLUTION -el I-EVOLUTION -tratamiento, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomático, I-EVOLUTION -sin I-EVOLUTION -aumento I-EVOLUTION -de I-EVOLUTION -volumen I-EVOLUTION -facial I-EVOLUTION -ni I-EVOLUTION -del I-EVOLUTION -reborde I-EVOLUTION -óseo. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -la I-EXPLORATION -regeneración I-EXPLORATION -ósea I-EXPLORATION -del I-EXPLORATION -hueso I-EXPLORATION -malar, I-EXPLORATION -el I-EXPLORATION -arco I-EXPLORATION -cigomático I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -piso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -órbita. I-EXPLORATION - I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -70 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -trasladado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -bajo I-PRESENT_ILLNESS -intubación I-PRESENT_ILLNESS -orotraqueal I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -traumatismo I-PRESENT_ILLNESS -facial I-PRESENT_ILLNESS -severo I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -intento I-PRESENT_ILLNESS -autolítico I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -arma I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fuego. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -traumática I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -tercios I-EXPLORATION -medio I-EXPLORATION -e I-EXPLORATION -inferior I-EXPLORATION -faciales, I-EXPLORATION -con I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -tejidos I-EXPLORATION -óseos I-EXPLORATION -y I-EXPLORATION -blandos I-EXPLORATION -(pérdida I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -espesor I-EXPLORATION -completo I-EXPLORATION -del I-EXPLORATION -labio I-EXPLORATION -inferior, I-EXPLORATION -región I-EXPLORATION -perioral, I-EXPLORATION -mentoniana I-EXPLORATION -y I-EXPLORATION -pérdida I-EXPLORATION -parcial I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -labio I-EXPLORATION -superior). I-EXPLORATION -Se I-EXPLORATION -procedió I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION -craneofacial, I-EXPLORATION -que I-EXPLORATION -descartó I-EXPLORATION -daño I-EXPLORATION -cerebral I-EXPLORATION -y I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -pérdida I-EXPLORATION -extensa I-EXPLORATION -de I-EXPLORATION -sustancia I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -mandibular, I-EXPLORATION -con I-EXPLORATION -fracturas I-EXPLORATION -múltiples I-EXPLORATION -maxilares, I-EXPLORATION -fractura I-EXPLORATION -de I-EXPLORATION -suelos I-EXPLORATION -orbitarios, I-EXPLORATION -fractura I-EXPLORATION -de I-EXPLORATION -huesos I-EXPLORATION -propios I-EXPLORATION -y I-EXPLORATION -tabique I-EXPLORATION -nasal I-EXPLORATION -óseo. I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -trasladado I-TREATMENT -a I-TREATMENT -quirófano, I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -traqueostomía I-TREATMENT -reglada, I-TREATMENT -limpieza I-TREATMENT -y I-TREATMENT -hemostasia I-TREATMENT -de I-TREATMENT -heridas I-TREATMENT -faciales I-TREATMENT -y I-TREATMENT -retirada I-TREATMENT -de I-TREATMENT -fragmentos I-TREATMENT -óseos I-TREATMENT -conminutos I-TREATMENT -y I-TREATMENT -cuerpos I-TREATMENT -extraños. I-TREATMENT -Seguidamente I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -puenteo I-TREATMENT -del I-TREATMENT -defecto I-TREATMENT -óseo I-TREATMENT -mediante I-TREATMENT -una I-TREATMENT -placa I-TREATMENT -de I-TREATMENT -reconstrucción I-TREATMENT -mandibular I-TREATMENT -de I-TREATMENT -2, I-TREATMENT -5mm I-TREATMENT -y I-TREATMENT -cierre I-TREATMENT -primario I-TREATMENT -de I-TREATMENT -tejidos I-TREATMENT -blados. I-TREATMENT -Se I-TREATMENT -comprobó I-TREATMENT -la I-TREATMENT -estabilidad I-TREATMENT -de I-TREATMENT -fracturas I-TREATMENT -en I-TREATMENT -tercio I-TREATMENT -medio, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -adoptó I-TREATMENT -una I-TREATMENT -actitud I-TREATMENT -expectante. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -reducción I-TREATMENT -nasal I-TREATMENT -cerrada. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -permaneció I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -Unidad I-EVOLUTION -de I-EVOLUTION -Cuidados I-EVOLUTION -Intensivos I-EVOLUTION -durante I-EVOLUTION -cuatro I-EVOLUTION -días. I-EVOLUTION - I-EVOLUTION -Diez B-TREATMENT -días I-TREATMENT -más I-TREATMENT -tarde I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -reconstrucción I-TREATMENT -secundaria, I-TREATMENT -con I-TREATMENT -retirada I-TREATMENT -de I-TREATMENT -la I-TREATMENT -placa I-TREATMENT -de I-TREATMENT -reconstrucción I-TREATMENT -mandibular, I-TREATMENT -tallado I-TREATMENT -de I-TREATMENT -colgajo I-TREATMENT -osteofasciocutáneo I-TREATMENT -microvascularizado I-TREATMENT -de I-TREATMENT -peroné I-TREATMENT -izquierdo I-TREATMENT -y I-TREATMENT -preformado I-TREATMENT -in I-TREATMENT -situ I-TREATMENT -por I-TREATMENT -medio I-TREATMENT -de I-TREATMENT -adaptación I-TREATMENT -a I-TREATMENT -la I-TREATMENT -placa I-TREATMENT -de I-TREATMENT -reconstrucción I-TREATMENT -mandibular I-TREATMENT -previamente I-TREATMENT -retirada, I-TREATMENT -y I-TREATMENT -fijación I-TREATMENT -a I-TREATMENT -remanentes I-TREATMENT -mandibulares I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -ambos I-TREATMENT -ángulos I-TREATMENT -goniacos I-TREATMENT -y I-TREATMENT -ramas I-TREATMENT -mandibulares. I-TREATMENT -La I-TREATMENT -cobertura I-TREATMENT -externa I-TREATMENT -del I-TREATMENT -peroné I-TREATMENT -fue I-TREATMENT -realizada I-TREATMENT -mediante I-TREATMENT -su I-TREATMENT -paleta I-TREATMENT -cutánea, I-TREATMENT -dispuesta I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -mentoniano I-TREATMENT -y I-TREATMENT -submental, I-TREATMENT -y I-TREATMENT -la I-TREATMENT -cobertura I-TREATMENT -interna I-TREATMENT -mediante I-TREATMENT -despegamiento I-TREATMENT -y I-TREATMENT -avance I-TREATMENT -de I-TREATMENT -mucosa I-TREATMENT -del I-TREATMENT -suelo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -boca I-TREATMENT -anterior. I-TREATMENT -Finalmente, I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -microanastomosis I-TREATMENT -de I-TREATMENT -vasos I-TREATMENT -peroneos I-TREATMENT -a I-TREATMENT -vasos I-TREATMENT -faciales. I-TREATMENT -Se I-TREATMENT -levantaron I-TREATMENT -colgajos I-TREATMENT -de I-TREATMENT -espesor I-TREATMENT -completo I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -del I-TREATMENT -remanente I-TREATMENT -de I-TREATMENT -mentón I-TREATMENT -pediculados I-TREATMENT -de I-TREATMENT -base I-TREATMENT -superior I-TREATMENT -a I-TREATMENT -modo I-TREATMENT -de I-TREATMENT -colgajos I-TREATMENT -de I-TREATMENT -Karapandzic I-TREATMENT -modificado, I-TREATMENT -con I-TREATMENT -preservación I-TREATMENT -del I-TREATMENT -pedículo I-TREATMENT -facial, I-TREATMENT -y I-TREATMENT -tallado I-TREATMENT -de I-TREATMENT -colgajos I-TREATMENT -de I-TREATMENT -avance I-TREATMENT -de I-TREATMENT -mucosa I-TREATMENT -para I-TREATMENT -creación I-TREATMENT -de I-TREATMENT -neo-bermellón. I-TREATMENT -Ambos I-TREATMENT -colgajos I-TREATMENT -mucocutáneos I-TREATMENT -fueron I-TREATMENT -rotados I-TREATMENT -medialmente I-TREATMENT -para I-TREATMENT -su I-TREATMENT -unión I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -central, I-TREATMENT -neoformando I-TREATMENT -el I-TREATMENT -labio I-TREATMENT -inferior I-TREATMENT -de I-TREATMENT -espesor I-TREATMENT -completo I-TREATMENT -y I-TREATMENT -creando I-TREATMENT -el I-TREATMENT -vestíbulo I-TREATMENT -labial I-TREATMENT -inferior. I-TREATMENT -Seguidamente I-TREATMENT -se I-TREATMENT -empleó I-TREATMENT -un I-TREATMENT -colgajo I-TREATMENT -de I-TREATMENT -Webster I-TREATMENT -izquierdo I-TREATMENT -para I-TREATMENT -la I-TREATMENT -reconstrucción I-TREATMENT -del I-TREATMENT -defecto I-TREATMENT -labial I-TREATMENT -superior. I-TREATMENT -Además I-TREATMENT -de I-TREATMENT -la I-TREATMENT -reconstrucción I-TREATMENT -de I-TREATMENT -tejidos I-TREATMENT -blandos I-TREATMENT -y I-TREATMENT -óseos, I-TREATMENT -en I-TREATMENT -nuestro I-TREATMENT -caso I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -presentaba I-TREATMENT -una I-TREATMENT -macroglosia I-TREATMENT -constitucional, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -realizamos I-TREATMENT -una I-TREATMENT -glosectomía I-TREATMENT -media I-TREATMENT -(resecando I-TREATMENT -el I-TREATMENT -tercio I-TREATMENT -medio I-TREATMENT -de I-TREATMENT -lengua I-TREATMENT -libre) I-TREATMENT -como I-TREATMENT -procedimiento I-TREATMENT -complementario I-TREATMENT -con I-TREATMENT -el I-TREATMENT -objetivo I-TREATMENT -de I-TREATMENT -facilitar I-TREATMENT -la I-TREATMENT -competencia I-TREATMENT -labial, I-TREATMENT -deglución I-TREATMENT -y I-TREATMENT -fonación. I-TREATMENT - I-TREATMENT -Durante B-EXPLORATION -el I-EXPLORATION -postoperatorio, I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION -fueron I-EXPLORATION -evaluados I-EXPLORATION -en I-EXPLORATION -términos I-EXPLORATION -de I-EXPLORATION -competencia I-EXPLORATION -labial, I-EXPLORATION -habla, I-EXPLORATION -alimentación I-EXPLORATION -y I-EXPLORATION -estética. I-EXPLORATION -La I-EXPLORATION -competencia I-EXPLORATION -labial I-EXPLORATION -fue I-EXPLORATION -óptima, I-EXPLORATION -sin I-EXPLORATION -conseguir I-EXPLORATION -el I-EXPLORATION -cierre I-EXPLORATION -hermético I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -labios, I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -líquidos I-EXPLORATION -al I-EXPLORATION -beber. I-EXPLORATION -El I-EXPLORATION -habla I-EXPLORATION -fue I-EXPLORATION -evaluada I-EXPLORATION -en I-EXPLORATION -función I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -inteligibilidad I-EXPLORATION -del I-EXPLORATION -paciente I-EXPLORATION -por I-EXPLORATION -teléfono, I-EXPLORATION -que I-EXPLORATION -resultó I-EXPLORATION -positiva. I-EXPLORATION -En I-EXPLORATION -cuanto I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -capacidad I-EXPLORATION -de I-EXPLORATION -alimentarse, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -tiene I-EXPLORATION -una I-EXPLORATION -dieta I-EXPLORATION -normal I-EXPLORATION -(triturada I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -falta I-EXPLORATION -de I-EXPLORATION -dentición). I-EXPLORATION -El I-EXPLORATION -resultado I-EXPLORATION -estético I-EXPLORATION -fue I-EXPLORATION -aceptable. I-EXPLORATION -Durante B-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -posterior I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -producido I-EVOLUTION -ninguna I-EVOLUTION -complicación I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -en I-EVOLUTION -seguimiento I-EVOLUTION -y I-EVOLUTION -tratamiento I-EVOLUTION -por I-EVOLUTION -parte I-EVOLUTION -de I-EVOLUTION -psiquiatría. I-EVOLUTION -En I-EVOLUTION -un I-EVOLUTION -futuro I-EVOLUTION -próximo I-EVOLUTION -se I-EVOLUTION -prevee I-EVOLUTION -la I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -realizar I-EVOLUTION -alguna I-EVOLUTION -intervención I-EVOLUTION -adicional I-EVOLUTION -(refinamiento I-EVOLUTION -estético I-EVOLUTION -labial, I-EVOLUTION -rehabilitación I-EVOLUTION -protésica I-EVOLUTION -dental, I-EVOLUTION -etc.). I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -vista I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Carabineros I-PRESENT_ILLNESS -Santiago, I-PRESENT_ILLNESS -Chile, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -parto I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -madre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -28 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cesárea. I-PRESENT_ILLNESS -Con B-EXPLORATION -un I-EXPLORATION -peso I-EXPLORATION -de I-EXPLORATION -3.163 I-EXPLORATION -gramos, I-EXPLORATION -talla I-EXPLORATION -49cm I-EXPLORATION -y I-EXPLORATION -perímetro I-EXPLORATION -craneal I-EXPLORATION -cercano I-EXPLORATION -a I-EXPLORATION -35cm. I-EXPLORATION -Al I-EXPLORATION -momento I-EXPLORATION -del I-EXPLORATION -nacimiento I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -lesiones I-EXPLORATION -vesiculosas I-EXPLORATION -en I-EXPLORATION -extremidades I-EXPLORATION -inferiores, I-EXPLORATION -zona I-EXPLORATION -glútea I-EXPLORATION -y I-EXPLORATION -axilas I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -rompen I-EXPLORATION -al I-EXPLORATION -retirar I-EXPLORATION -el I-EXPLORATION -unto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -piel I-EXPLORATION -quedando I-EXPLORATION -lesiones I-EXPLORATION -eritematosas I-EXPLORATION -y I-EXPLORATION -descamativas. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -diagnosticó I-EXPLORATION -en I-EXPLORATION -primera I-EXPLORATION -instancia I-EXPLORATION -epidermolisis I-EXPLORATION -bulosa, I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -posteriormente I-EXPLORATION -fue I-EXPLORATION -descartada. I-EXPLORATION -Destacaba I-EXPLORATION -además I-EXPLORATION -zona I-EXPLORATION -de I-EXPLORATION -alopecia I-EXPLORATION -en I-EXPLORATION -vértex I-EXPLORATION -y I-EXPLORATION -paladar I-EXPLORATION -fisurado. I-EXPLORATION - I-EXPLORATION -Se B-DERIVED_FROM/TO -da I-DERIVED_FROM/TO -refiere I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -oftalmología I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -realiza I-DERIVED_FROM/TO -examen I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -fondo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -ojo I-DERIVED_FROM/TO -observándose I-DERIVED_FROM/TO -epitelio I-DERIVED_FROM/TO -pigmentario I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -poco I-DERIVED_FROM/TO -pigmento I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -forma I-DERIVED_FROM/TO -generalizada, I-DERIVED_FROM/TO -resto I-DERIVED_FROM/TO -normal. I-DERIVED_FROM/TO -Evaluación B-EXPLORATION -por I-EXPLORATION -neurólogo I-EXPLORATION -normal. I-EXPLORATION -Dermatólogo I-EXPLORATION -plantea I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -IP I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -encontrándose I-EXPLORATION -la I-EXPLORATION -muestra I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -limites I-EXPLORATION -histológicos I-EXPLORATION -normales, I-EXPLORATION -pero I-EXPLORATION -se I-EXPLORATION -recomienda I-EXPLORATION -otra I-EXPLORATION -nueva I-EXPLORATION -muestra. I-EXPLORATION -Visto I-EXPLORATION -por I-EXPLORATION -genetista I-EXPLORATION -clínicamente I-EXPLORATION -se I-EXPLORATION -confirma I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -de I-EXPLORATION -herencia I-EXPLORATION -ligada I-EXPLORATION -a I-EXPLORATION -X I-EXPLORATION -dominante, I-EXPLORATION -ya B-FAMILY_HISTORY -que I-FAMILY_HISTORY -la I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -presentó I-FAMILY_HISTORY -las I-FAMILY_HISTORY -mismas I-FAMILY_HISTORY -lesiones I-FAMILY_HISTORY -al I-FAMILY_HISTORY -nacimiento. I-FAMILY_HISTORY -Se B-DERIVED_FROM/TO -derivó I-DERIVED_FROM/TO -también I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -maxilofacial I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -CP. I-DERIVED_FROM/TO -A B-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -edad I-EVOLUTION -fue I-EVOLUTION -operada I-EVOLUTION -de I-EVOLUTION -paladar I-EVOLUTION -fisurado, I-EVOLUTION -reconstituyendo I-EVOLUTION -funcionalmente I-EVOLUTION -los I-EVOLUTION -anillos I-EVOLUTION -musculares I-EVOLUTION -del I-EVOLUTION -velo I-EVOLUTION -palatino I-EVOLUTION -y I-EVOLUTION -evolucionó I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -complicaciones I-EVOLUTION -postoperatorias. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -niña I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médico-quirúrgicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -remitida B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -consultas I-DERIVED_FROM/TO -externas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -Maxilofacial I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -Universitario I-DERIVED_FROM/TO -Marqués I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Valdecilla I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -noviembre I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -2004 I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -masa I-DERIVED_FROM/TO -indolora I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -región I-DERIVED_FROM/TO -anterior I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -suelo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -boca I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -meses I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evolución. I-DERIVED_FROM/TO -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -dentición I-EXPLORATION -mixta I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -sínfisis I-EXPLORATION -mandibular, I-EXPLORATION -con I-EXPLORATION -mucosa I-EXPLORATION -oral I-EXPLORATION -respetada I-EXPLORATION -y I-EXPLORATION -abombamiento I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -corticales I-EXPLORATION -lingual I-EXPLORATION -y I-EXPLORATION -vestibular, I-EXPLORATION -y I-EXPLORATION -dientes I-EXPLORATION -deciduos I-EXPLORATION -estables I-EXPLORATION -a I-EXPLORATION -ese I-EXPLORATION -nivel. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -presenta I-EXPLORATION -alteraciones I-EXPLORATION -neurológicas I-EXPLORATION -significativas. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -ortopantomografía I-EXPLORATION -(OPG) I-EXPLORATION -revela I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -radiolúcida I-EXPLORATION -de I-EXPLORATION -márgenes I-EXPLORATION -mal I-EXPLORATION -definidos I-EXPLORATION -en I-EXPLORATION -sínfisis I-EXPLORATION -mandibular I-EXPLORATION --de I-EXPLORATION -73 I-EXPLORATION -a I-EXPLORATION -83-, I-EXPLORATION -con I-EXPLORATION -basilar I-EXPLORATION -desestructurada I-EXPLORATION -a I-EXPLORATION -ese I-EXPLORATION -nivel. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -3 I-EXPLORATION -dientes I-EXPLORATION -definitivos I-EXPLORATION -incluidos I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -y I-EXPLORATION -cierto I-EXPLORATION -grado I-EXPLORATION -de I-EXPLORATION -rizólisis I-EXPLORATION -y I-EXPLORATION -desplazamientos I-EXPLORATION -dentales. I-EXPLORATION -Se I-EXPLORATION -solicita I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC), I-EXPLORATION -que I-EXPLORATION -confirma I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -osteolítica, I-EXPLORATION -insuflante I-EXPLORATION -y I-EXPLORATION -multilocular I-EXPLORATION -de I-EXPLORATION -3×1, I-EXPLORATION -8cm, I-EXPLORATION -con I-EXPLORATION -corticales I-EXPLORATION -expandidas I-EXPLORATION -y I-EXPLORATION -adelgazadas, I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -afectación I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas; I-EXPLORATION -asimismo, I-EXPLORATION -se I-EXPLORATION -describe I-EXPLORATION -el I-EXPLORATION -interior I-EXPLORATION -de I-EXPLORATION -densidad I-EXPLORATION -sólida, I-EXPLORATION -todo I-EXPLORATION -ello I-EXPLORATION -sugestivo I-EXPLORATION -de I-EXPLORATION -quiste I-EXPLORATION -óseo I-EXPLORATION -aneurismático I-EXPLORATION -sólido. I-EXPLORATION -La I-EXPLORATION -punción-aspiración I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina I-EXPLORATION -(PAAF) I-EXPLORATION -no I-EXPLORATION -es I-EXPLORATION -concluyente. I-EXPLORATION - I-EXPLORATION -Bajo I-EXPLORATION -anestesia I-EXPLORATION -general I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -abordaje I-EXPLORATION -vestibular, I-EXPLORATION -que I-EXPLORATION -permite I-EXPLORATION -visualizar I-EXPLORATION -la I-EXPLORATION -cortical I-EXPLORATION -expandida I-EXPLORATION -y I-EXPLORATION -adelgazada I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -continuidad, I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -típico I-EXPLORATION -aspecto I-EXPLORATION -en I-EXPLORATION -«cáscara I-EXPLORATION -de I-EXPLORATION -huevo». I-EXPLORATION -Una I-EXPLORATION -vez I-EXPLORATION -expuesta I-EXPLORATION -la I-EXPLORATION -lesión, I-EXPLORATION -se I-EXPLORATION -toma I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -intraoperatoria I-EXPLORATION -que I-EXPLORATION -descarta I-EXPLORATION -patología I-EXPLORATION -ósea I-EXPLORATION -maligna. I-EXPLORATION -Con B-TREATMENT -la I-TREATMENT -firme I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -QOA I-TREATMENT -sólido, I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -curetaje I-TREATMENT -y I-TREATMENT -exodoncia I-TREATMENT -de I-TREATMENT -los I-TREATMENT -tres I-TREATMENT -dientes I-TREATMENT -definitivos I-TREATMENT -incluidos I-TREATMENT -en I-TREATMENT -la I-TREATMENT -lesión. I-TREATMENT -El I-TREATMENT -defecto I-TREATMENT -óseo I-TREATMENT -no I-TREATMENT -precisa I-TREATMENT -reconstrucción, I-TREATMENT -pero I-TREATMENT -a I-TREATMENT -fin I-TREATMENT -de I-TREATMENT -favorecer I-TREATMENT -la I-TREATMENT -remodelación I-TREATMENT -ósea I-TREATMENT -guiada I-TREATMENT -del I-TREATMENT -lecho I-TREATMENT -quirúrgico I-TREATMENT -se I-TREATMENT -emplea I-TREATMENT -una I-TREATMENT -lámina I-TREATMENT -de I-TREATMENT -hueso I-TREATMENT -desmineralizado I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cortical I-TREATMENT -externa I-TREATMENT -mandibular. I-TREATMENT - I-TREATMENT -Al B-DERIVED_FROM/TO -alta I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -ortodoncista I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -ferulización I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -arcada I-DERIVED_FROM/TO -inferior, I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -objetivo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -asegurar I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -estabilidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -misma, I-DERIVED_FROM/TO -dada I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -importante I-DERIVED_FROM/TO -pérdida I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -soporte I-DERIVED_FROM/TO -óseo I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nivel I-DERIVED_FROM/TO -crestal I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -sínfisis I-DERIVED_FROM/TO -mandibular. I-DERIVED_FROM/TO -Dicha B-EVOLUTION -fijación I-EVOLUTION -es I-EVOLUTION -mantenida I-EVOLUTION -durante I-EVOLUTION -6 I-EVOLUTION -meses. I-EVOLUTION - I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -histológico I-EXPLORATION -definitivo I-EXPLORATION -confirma I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -quiste I-EXPLORATION -óseo I-EXPLORATION -aneurismático I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -sólido. I-EXPLORATION -A I-EXPLORATION -nivel I-EXPLORATION -macroscópico I-EXPLORATION -se I-EXPLORATION -identifican I-EXPLORATION -varios I-EXPLORATION -fragmentos I-EXPLORATION -irregulares I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -pardo-negruzco I-EXPLORATION -y I-EXPLORATION -consistencia I-EXPLORATION -elástica I-EXPLORATION -y I-EXPLORATION -firme; I-EXPLORATION -mientras I-EXPLORATION -que I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -microscópico, I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -pequeños I-EXPLORATION -espacios I-EXPLORATION -vasculares I-EXPLORATION -revestidos I-EXPLORATION -por I-EXPLORATION -tejido I-EXPLORATION -celular I-EXPLORATION -fibroso, I-EXPLORATION -células I-EXPLORATION -gigantes I-EXPLORATION -y I-EXPLORATION -macrófagos, I-EXPLORATION -con I-EXPLORATION -mitosis I-EXPLORATION -ocasionales, I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -atipias I-EXPLORATION -y I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -hemosiderina. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -una I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -postoperatoria, I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -correcta I-EVOLUTION -apariencia I-EVOLUTION -estética I-EVOLUTION -y I-EVOLUTION -funcional. I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -y I-EVOLUTION -tras I-EVOLUTION -6 I-EVOLUTION -años I-EVOLUTION -en I-EVOLUTION -seguimiento, I-EVOLUTION -no I-EVOLUTION -presenta I-EVOLUTION -signos I-EVOLUTION -clínicos I-EVOLUTION -ni I-EVOLUTION -radiológicos I-EVOLUTION -de I-EVOLUTION -recidiva I-EVOLUTION -local I-EVOLUTION -y B-TREATMENT -ha I-TREATMENT -iniciado I-TREATMENT -tratamiento I-TREATMENT -ortodóncico I-TREATMENT -para I-TREATMENT -corrección I-TREATMENT -de I-TREATMENT -la I-TREATMENT -malposición I-TREATMENT -dentaria. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -género I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -32 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Estomatología I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Facultad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Odontología I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Bauru I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Universidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -São I-PRESENT_ILLNESS -Paulo, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -queja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -"diente I-PRESENT_ILLNESS -dentro I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -hueso" I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -realizarse I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -examen I-PRESENT_ILLNESS -radiográfico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -rutina. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Clínicamente, B-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -diente I-EXPLORATION -83 I-EXPLORATION -estaba I-EXPLORATION -presente I-EXPLORATION -dentro I-EXPLORATION -del I-EXPLORATION -arco I-EXPLORATION -dentario I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -elemento I-EXPLORATION -dentario I-EXPLORATION -43 I-EXPLORATION -estaba I-EXPLORATION -ausente. I-EXPLORATION -Se I-EXPLORATION -confirmó I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -óseo I-EXPLORATION -asintomático, I-EXPLORATION -con I-EXPLORATION -evolución I-EXPLORATION -aproximada I-EXPLORATION -de I-EXPLORATION -cinco I-EXPLORATION -años, I-EXPLORATION -extendiéndose I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -del I-EXPLORATION -diente I-EXPLORATION -32 I-EXPLORATION -al I-EXPLORATION -diente I-EXPLORATION -44. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -visualización I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -radiográfico I-EXPLORATION -panorámico I-EXPLORATION -fue I-EXPLORATION -detectada I-EXPLORATION -una I-EXPLORATION -alteración I-EXPLORATION -radiolúcida I-EXPLORATION -de I-EXPLORATION -límites I-EXPLORATION -bien I-EXPLORATION -definidos I-EXPLORATION -con I-EXPLORATION -material I-EXPLORATION -amorfo I-EXPLORATION -radiopaco I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -centro, I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -lobular, I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -reabsorción I-EXPLORATION -radicular I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -dientes I-EXPLORATION -adyacentes I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -del I-EXPLORATION -elemento I-EXPLORATION -dentario I-EXPLORATION -43 I-EXPLORATION -no I-EXPLORATION -erupcionado. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -presuntivo I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -odontoma I-EXPLORATION -complejo. I-EXPLORATION - I-EXPLORATION -Bajo B-TREATMENT -anestesia I-TREATMENT -local, I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -el I-TREATMENT -acceso I-TREATMENT -por I-TREATMENT -medio I-TREATMENT -de I-TREATMENT -una I-TREATMENT -incisión I-TREATMENT -intra-sulcular I-TREATMENT -extendiéndose I-TREATMENT -de I-TREATMENT -la I-TREATMENT -región I-TREATMENT -de I-TREATMENT -los I-TREATMENT -dientes I-TREATMENT -34 I-TREATMENT -al I-TREATMENT -45 I-TREATMENT -con I-TREATMENT -consecuente I-TREATMENT -exposición I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -la I-TREATMENT -ventana I-TREATMENT -ósea I-TREATMENT -creada I-TREATMENT -con I-TREATMENT -fresa I-TREATMENT -quirúrgica I-TREATMENT -bajo I-TREATMENT -irrigación I-TREATMENT -constante. I-TREATMENT -La I-TREATMENT -lesión I-TREATMENT -fue I-TREATMENT -removida I-TREATMENT -por I-TREATMENT -enucleación I-TREATMENT -con I-TREATMENT -un I-TREATMENT -curetaje I-TREATMENT -agresivo I-TREATMENT -juntamente I-TREATMENT -con I-TREATMENT -el I-TREATMENT -diente I-TREATMENT -43 I-TREATMENT -no I-TREATMENT -erupcionado. I-TREATMENT -Los B-EXPLORATION -cortes I-EXPLORATION -microscópicos I-EXPLORATION -revelaron I-EXPLORATION -la I-EXPLORATION -proliferación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -epiteliales I-EXPLORATION -odontogénicas I-EXPLORATION -en I-EXPLORATION -��ntimo I-EXPLORATION -contacto I-EXPLORATION -con I-EXPLORATION -inúmeros I-EXPLORATION -focos I-EXPLORATION -redondeados I-EXPLORATION -concéntricos I-EXPLORATION -de I-EXPLORATION -mineralización I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -anillos I-EXPLORATION -de I-EXPLORATION -Liesegang, I-EXPLORATION -a I-EXPLORATION -veces I-EXPLORATION -resultando I-EXPLORATION -en I-EXPLORATION -densas I-EXPLORATION -masas I-EXPLORATION -sean I-EXPLORATION -eosinofílicas I-EXPLORATION -o I-EXPLORATION -basofílicas. I-EXPLORATION -Las I-EXPLORATION -células I-EXPLORATION -presentaban I-EXPLORATION -puentes I-EXPLORATION -intercelulares I-EXPLORATION -bien I-EXPLORATION -evidentes, I-EXPLORATION -además I-EXPLORATION -del I-EXPLORATION -pleomorfismo, I-EXPLORATION -hipercromatismo I-EXPLORATION -y I-EXPLORATION -variación I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -al I-EXPLORATION -tamaño I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -núcleos. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -tejido I-EXPLORATION -conjuntivo I-EXPLORATION -fibroso, I-EXPLORATION -se I-EXPLORATION -observaban I-EXPLORATION -cordones I-EXPLORATION -o I-EXPLORATION -islas I-EXPLORATION -de I-EXPLORATION -epitelio I-EXPLORATION -odontogénico. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -histopatológico I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -TEOC. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -examen I-EXPLORATION -radiográfico I-EXPLORATION -de I-EXPLORATION -proservación I-EXPLORATION -de I-EXPLORATION -cinco I-EXPLORATION -años I-EXPLORATION -muestra I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -señales I-EXPLORATION -de I-EXPLORATION -recurrencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión. I-EXPLORATION - I-EXPLORATION - -Paciente, B-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -derivado B-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -año I-DERIVED_FROM/TO -2004 I-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -endocrinología I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cirugía I-DERIVED_FROM/TO -maxilofacial I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -tumor I-DERIVED_FROM/TO -maxilar I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -estudio. I-DERIVED_FROM/TO -Sus B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -mórbidos I-PAST_MEDICAL_HISTORY -incluyen I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -18 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -hemodiálisis I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -veces I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -semana. I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -27 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -detecta, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -ecotomografía I-PAST_MEDICAL_HISTORY -doppler, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -nódulos I-PAST_MEDICAL_HISTORY -bilaterales I-PAST_MEDICAL_HISTORY -compatibles I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -adenoma I-PAST_MEDICAL_HISTORY -paratiroideo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -niveles I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -PTH I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2.448 I-PAST_MEDICAL_HISTORY -pg/ml I-PAST_MEDICAL_HISTORY -(150-500 I-PAST_MEDICAL_HISTORY -pg/ml). I-PAST_MEDICAL_HISTORY -Con I-PAST_MEDICAL_HISTORY -estos I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -diagnosticó I-PAST_MEDICAL_HISTORY -hiperparatiroidismo I-PAST_MEDICAL_HISTORY -secundario. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -realiza I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paratiroidectomía I-PAST_MEDICAL_HISTORY -parcial I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -indica I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -farmacológico I-PAST_MEDICAL_HISTORY -protocolario, I-PAST_MEDICAL_HISTORY -obteniéndose I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -normalización I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -niveles I-PAST_MEDICAL_HISTORY -séricos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -calcio, I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -manteniéndose I-PAST_MEDICAL_HISTORY -altos I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -niveles I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -paratohormona. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -nota I-PAST_MEDICAL_HISTORY -aumento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -volumen I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -maxilar I-PAST_MEDICAL_HISTORY -izquierda, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -crecimiento I-PAST_MEDICAL_HISTORY -lento I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -progresivo I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución, I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2002. I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -momento I-EXPLORATION -de I-EXPLORATION -consultar I-EXPLORATION -en I-EXPLORATION -nuestro I-EXPLORATION -servicio, I-EXPLORATION -clínicamente I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -que I-EXPLORATION -compromete I-EXPLORATION -el I-EXPLORATION -maxilar I-EXPLORATION -superior I-EXPLORATION -izquierdo I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -cara I-EXPLORATION -anterior, I-EXPLORATION -posterior I-EXPLORATION -y I-EXPLORATION -paladar I-EXPLORATION -duro, I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -firme, I-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -indoloro, I-EXPLORATION -cubierto I-EXPLORATION -por I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -mucosa I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -normal, I-EXPLORATION -sin I-EXPLORATION -alteración I-EXPLORATION -sensitiva, I-EXPLORATION -que I-EXPLORATION -produce I-EXPLORATION -asimetría I-EXPLORATION -y I-EXPLORATION -deformación I-EXPLORATION -facial I-EXPLORATION -evidente. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -exámenes I-EXPLORATION -radiográficos I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -múltiples I-EXPLORATION -imágenes I-EXPLORATION -osteolíticas I-EXPLORATION -que I-EXPLORATION -afectan I-EXPLORATION -el I-EXPLORATION -cráneo, I-EXPLORATION -la I-EXPLORATION -mandíbula I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -maxilar I-EXPLORATION -izquierdo. I-EXPLORATION -El I-EXPLORATION -TAC I-EXPLORATION -muestra I-EXPLORATION -tumoración I-EXPLORATION -exofítica I-EXPLORATION -que I-EXPLORATION -compromete I-EXPLORATION -maxilar I-EXPLORATION -izquierdo, I-EXPLORATION -seno I-EXPLORATION -maxilar, I-EXPLORATION -fosas I-EXPLORATION -nasales I-EXPLORATION -y I-EXPLORATION -piso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -órbita I-EXPLORATION -izquierda. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -biopsia I-EXPLORATION -incisional I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -describe I-EXPLORATION -múltiples I-EXPLORATION -trabéculas I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -óseo I-EXPLORATION -inmaduro I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -matriz I-EXPLORATION -fibrosa I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -células I-EXPLORATION -gigantes I-EXPLORATION -multinucleadas. I-EXPLORATION -Los I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -muestran I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -calcio I-EXPLORATION -sérico I-EXPLORATION -de I-EXPLORATION -12, I-EXPLORATION -6 I-EXPLORATION -mg/dl I-EXPLORATION -(8,1-10,3), I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina: I-EXPLORATION -218 I-EXPLORATION -UI/L I-EXPLORATION -(73-189 I-EXPLORATION -UI/L), I-EXPLORATION -fósforo I-EXPLORATION -inorgánico: I-EXPLORATION -56, I-EXPLORATION -7 I-EXPLORATION -mg/dl I-EXPLORATION -(2, I-EXPLORATION -5-5 I-EXPLORATION -mg/dl) I-EXPLORATION -y I-EXPLORATION -PTH I-EXPLORATION -intacta: I-EXPLORATION -2, I-EXPLORATION -448 I-EXPLORATION -pg/ml I-EXPLORATION -(150-500 I-EXPLORATION -pg/ml). I-EXPLORATION -Con I-EXPLORATION -todos I-EXPLORATION -estos I-EXPLORATION -antecedentes I-EXPLORATION -se I-EXPLORATION -diagnosticó I-EXPLORATION -tumor I-EXPLORATION -pardo I-EXPLORATION -del I-EXPLORATION -maxilar I-EXPLORATION -superior I-EXPLORATION -izquierdo. I-EXPLORATION -Se B-TREATMENT -decide I-TREATMENT -realizar I-TREATMENT -la I-TREATMENT -paratiroidectomía I-TREATMENT -total I-TREATMENT -y I-TREATMENT -mantener I-TREATMENT -conducta I-TREATMENT -expectante I-TREATMENT -respecto I-TREATMENT -al I-TREATMENT -tumor I-TREATMENT -pardo, I-TREATMENT -esperando I-TREATMENT -una I-TREATMENT -eventual I-TREATMENT -remisión I-TREATMENT -espontánea I-TREATMENT -con I-TREATMENT -la I-TREATMENT -normalización I-TREATMENT -de I-TREATMENT -los I-TREATMENT -valores I-TREATMENT -de I-TREATMENT -PTH, I-TREATMENT -calcio, I-TREATMENT -fósforo I-TREATMENT -y I-TREATMENT -fosfatasa I-TREATMENT -alcalina. I-TREATMENT -El I-TREATMENT -plan I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -incluye I-TREATMENT -también I-TREATMENT -controles I-TREATMENT -periódicos I-TREATMENT -clínicos, I-TREATMENT -radiográficos I-TREATMENT -y I-TREATMENT -de I-TREATMENT -laboratorio I-TREATMENT -para I-TREATMENT -evaluar I-TREATMENT -el I-TREATMENT -comportamiento I-TREATMENT -de I-TREATMENT -las I-TREATMENT -lesiones I-TREATMENT -craneomaxilofaciales. I-TREATMENT - I-TREATMENT -Tras B-EVOLUTION -2 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -efectuada I-EVOLUTION -la I-EVOLUTION -paratiroidectomía I-EVOLUTION -total I-EVOLUTION -y I-EVOLUTION -alcanzados I-EVOLUTION -los I-EVOLUTION -valores I-EVOLUTION -normales I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -de I-EVOLUTION -PTH, I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -evidencia I-EVOLUTION -remisión I-EVOLUTION -tumoral I-EVOLUTION -maxilar. I-EVOLUTION -Considerando B-TREATMENT -el I-TREATMENT -compromiso I-TREATMENT -de I-TREATMENT -las I-TREATMENT -estructuras I-TREATMENT -anatómicas I-TREATMENT -vecinas I-TREATMENT -y I-TREATMENT -las I-TREATMENT -posibles I-TREATMENT -complicaciones I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión. I-TREATMENT - I-TREATMENT -Bajo I-TREATMENT -anestesia I-TREATMENT -general I-TREATMENT -e I-TREATMENT -intubación I-TREATMENT -nasotraqueal I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -incisión I-TREATMENT -en I-TREATMENT -la I-TREATMENT -cara I-TREATMENT -interna I-TREATMENT -del I-TREATMENT -labio I-TREATMENT -superior I-TREATMENT -desde I-TREATMENT -la I-TREATMENT -línea I-TREATMENT -media I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -tuberosidad. I-TREATMENT -Se I-TREATMENT -levanta I-TREATMENT -colgajo I-TREATMENT -mucoperióstico I-TREATMENT -hasta I-TREATMENT -el I-TREATMENT -penacho I-TREATMENT -suborbitario, I-TREATMENT -exponiéndose I-TREATMENT -ampliamente I-TREATMENT -el I-TREATMENT -tumor. I-TREATMENT -Se I-TREATMENT -realiza I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -gran I-TREATMENT -parte I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -osteotomía I-TREATMENT -con I-TREATMENT -sierra I-TREATMENT -reciprocante I-TREATMENT -en I-TREATMENT -zona I-TREATMENT -pediculada I-TREATMENT -que I-TREATMENT -se I-TREATMENT -encuentra I-TREATMENT -adosa I-TREATMENT -a I-TREATMENT -la I-TREATMENT -pared I-TREATMENT -anterior I-TREATMENT -y I-TREATMENT -lateral I-TREATMENT -del I-TREATMENT -seno I-TREATMENT -maxilar, I-TREATMENT -a I-TREATMENT -continuación I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -la I-TREATMENT -remodelación I-TREATMENT -ósea I-TREATMENT -con I-TREATMENT -fresas I-TREATMENT -tipo I-TREATMENT -pimpollo, I-TREATMENT -conservando I-TREATMENT -la I-TREATMENT -pared I-TREATMENT -de I-TREATMENT -seno I-TREATMENT -maxilar I-TREATMENT -y I-TREATMENT -penacho I-TREATMENT -suborbitario, I-TREATMENT -sin I-TREATMENT -necesidad I-TREATMENT -de I-TREATMENT -injerto I-TREATMENT -óseo. I-TREATMENT -Se I-TREATMENT -logra I-TREATMENT -cierre I-TREATMENT -por I-TREATMENT -primera I-TREATMENT -intención. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -postoperatoria I-EVOLUTION -es I-EVOLUTION -satisfactoria, I-EVOLUTION -siendo I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -72 I-EVOLUTION -h. I-EVOLUTION - I-EVOLUTION -Se I-EVOLUTION -realizan I-EVOLUTION -controles I-EVOLUTION -postoperatorios I-EVOLUTION -clínicos I-EVOLUTION -y I-EVOLUTION -radiográficos, I-EVOLUTION -se I-EVOLUTION -evidencia I-EVOLUTION -clínicamente I-EVOLUTION -simetría I-EVOLUTION -facial, I-EVOLUTION -sin I-EVOLUTION -compromiso I-EVOLUTION -de I-EVOLUTION -sensibilidad I-EVOLUTION -y I-EVOLUTION -ausencia I-EVOLUTION -de I-EVOLUTION -recurrencia I-EVOLUTION -durante I-EVOLUTION -los I-EVOLUTION -7 I-EVOLUTION -años I-EVOLUTION -desde I-EVOLUTION -la I-EVOLUTION -resección I-EVOLUTION -del I-EVOLUTION -tumor. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -73 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -sistémica I-PAST_MEDICAL_HISTORY -actualmente I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -médico, I-PAST_MEDICAL_HISTORY -quien B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -valoración I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cara I-PRESENT_ILLNESS -ventral I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -borde I-PRESENT_ILLNESS -lateral I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -lengua, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -exofítico, B-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -granulomatoso, I-EXPLORATION -fácilmente I-EXPLORATION -sangrante, I-EXPLORATION -que I-EXPLORATION -dificulta I-EXPLORATION -considerablemente I-EXPLORATION -la I-EXPLORATION -deglución I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -habla, I-EXPLORATION -de I-EXPLORATION -crecimiento I-EXPLORATION -aparentemente I-EXPLORATION -rápido, I-EXPLORATION -con I-EXPLORATION -medidas I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -× I-EXPLORATION -3 I-EXPLORATION -cm, I-EXPLORATION -de I-EXPLORATION -coloración I-EXPLORATION -violácea, I-EXPLORATION -con I-EXPLORATION -zonas I-EXPLORATION -eritematosas, I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -rojo I-EXPLORATION -intenso I-EXPLORATION -brillante, I-EXPLORATION -adherido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION -lingual I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -pedículo I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -cm, I-EXPLORATION -refiriendo I-EXPLORATION -sangrados I-EXPLORATION -espontáneos I-EXPLORATION -y I-EXPLORATION -controlables I-EXPLORATION -con I-EXPLORATION -presión I-EXPLORATION -simple, I-EXPLORATION -sin I-EXPLORATION -linfadenopatía I-EXPLORATION -regional I-EXPLORATION -palpable I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -edentulismo I-EXPLORATION -total I-EXPLORATION -adquirido. I-EXPLORATION -Se I-EXPLORATION -obtienen I-EXPLORATION -exámenes I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -de I-EXPLORATION -rutina, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -abdomen I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -descartan I-EXPLORATION -lesiones I-EXPLORATION -y I-EXPLORATION -metástasis I-EXPLORATION -a I-EXPLORATION -distancia. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -biopsia I-EXPLORATION -incisional I-EXPLORATION -bajo I-EXPLORATION -anestesia I-EXPLORATION -local I-EXPLORATION -cuyo I-EXPLORATION -estudio I-EXPLORATION -reporta I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -leiomiosarcoma. I-EXPLORATION -En B-TREATMENT -un I-TREATMENT -segundo I-TREATMENT -tiempo I-TREATMENT -quirúrgico, I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -resección I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -con I-TREATMENT -márgenes I-TREATMENT -de I-TREATMENT -seguridad I-TREATMENT -amplios I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -plastia I-TREATMENT -lingual I-TREATMENT -y I-TREATMENT -cierre I-TREATMENT -primario I-TREATMENT -del I-TREATMENT -defecto. I-TREATMENT -La B-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -es I-EXPLORATION -enviada I-EXPLORATION -para I-EXPLORATION -valoración I-EXPLORATION -histológica I-EXPLORATION -e I-EXPLORATION -inmunohistoquímica I-EXPLORATION -siendo I-EXPLORATION -confirmado I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -leiomiosarcoma I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -grado I-EXPLORATION -con I-EXPLORATION -márgenes I-EXPLORATION -libres I-EXPLORATION -de I-EXPLORATION -neoplasia. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -alta I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -espinosas I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -músculo I-EXPLORATION -liso, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -inmunorreactividad I-EXPLORATION -para I-EXPLORATION -vicentina I-EXPLORATION -y I-EXPLORATION -actina I-EXPLORATION -alfa I-EXPLORATION -músculo I-EXPLORATION -liso, I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -panqueratina, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -para I-EXPLORATION -desmina I-EXPLORATION -y I-EXPLORATION -CD34. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -cursó I-EVOLUTION -un I-EVOLUTION -postoperatorio I-EVOLUTION -inmediato I-EVOLUTION -favorable I-EVOLUTION -siendo I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -hospitalaria I-EVOLUTION -al I-EVOLUTION -5.° I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -internamiento I-EVOLUTION -para I-EVOLUTION -continuar I-EVOLUTION -con I-EVOLUTION -manejo I-EVOLUTION -ambulatorio. I-EVOLUTION -A I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -postoperada I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -continúa I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -adecuada I-EVOLUTION -evolución, I-EVOLUTION -alimentándose I-EVOLUTION -de I-EVOLUTION -manera I-EVOLUTION -adecuada, I-EVOLUTION -sin I-EVOLUTION -problemas I-EVOLUTION -de I-EVOLUTION -fonación I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -intensiva I-EVOLUTION -terapia I-EVOLUTION -de I-EVOLUTION -lenguaje; I-EVOLUTION -no I-EVOLUTION -hay I-EVOLUTION -datos I-EVOLUTION -de I-EVOLUTION -metástasis I-EVOLUTION -corroborados I-EVOLUTION -con I-EVOLUTION -TAC I-EVOLUTION -de I-EVOLUTION -control. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -femenina I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -13 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Cirugía I-PRESENT_ILLNESS -Oral I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -odontológica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Corporación I-PRESENT_ILLNESS -Universitaria I-PRESENT_ILLNESS -Rafael I-PRESENT_ILLNESS -Núñez I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -agrandamiento I-PRESENT_ILLNESS -gingival I-PRESENT_ILLNESS -generalizado. I-PRESENT_ILLNESS -Como B-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares, I-FAMILY_HISTORY -la I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -y I-FAMILY_HISTORY -un I-FAMILY_HISTORY -hermano I-FAMILY_HISTORY -describieron I-FAMILY_HISTORY -presentar I-FAMILY_HISTORY -aumento I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -volumen I-FAMILY_HISTORY -del I-FAMILY_HISTORY -tejido I-FAMILY_HISTORY -gingival I-FAMILY_HISTORY -de I-FAMILY_HISTORY -forma I-FAMILY_HISTORY -generalizada. I-FAMILY_HISTORY -En B-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -manifestó I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -practicó I-PAST_MEDICAL_HISTORY -gingivectomía I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -aumento I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -tamaño I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -encía I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -resultados I-PAST_MEDICAL_HISTORY -satisfactorios, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -epilépticos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -farmacológico I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -anticonvulsivante I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -fenitoína, I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -periodo I-PAST_MEDICAL_HISTORY -aproximado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -25 I-PAST_MEDICAL_HISTORY -días; I-PAST_MEDICAL_HISTORY -en B-EXPLORATION -la I-EXPLORATION -revisión I-EXPLORATION -de I-EXPLORATION -órganos I-EXPLORATION -y I-EXPLORATION -sistemas I-EXPLORATION -no I-EXPLORATION -presentó I-EXPLORATION -alteraciones. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -clínico I-EXPLORATION -intraoral I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -agrandamiento I-EXPLORATION -gingival I-EXPLORATION -generalizado I-EXPLORATION -comprometiendo I-EXPLORATION -maxilar I-EXPLORATION -y I-EXPLORATION -mandíbula, I-EXPLORATION -cubriendo I-EXPLORATION -más I-EXPLORATION -del I-EXPLORATION -85% I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -corona I-EXPLORATION -dentaria I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -dientes I-EXPLORATION -posteriores I-EXPLORATION -y I-EXPLORATION -90% I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -anteriores, I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -un I-EXPLORATION -año I-EXPLORATION -de I-EXPLORATION -evolución, I-EXPLORATION -consistencia I-EXPLORATION -firme, I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -sangrado, I-EXPLORATION -sin I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -placa I-EXPLORATION -bacteriana, I-EXPLORATION -asintomático, I-EXPLORATION -originando I-EXPLORATION -discapacidad I-EXPLORATION -funcional, I-EXPLORATION -estética I-EXPLORATION -y I-EXPLORATION -problemas I-EXPLORATION -psicosociales. I-EXPLORATION -Examen I-EXPLORATION -radiográfico: I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -ortopantomografía I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -dientes I-EXPLORATION -en I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -del I-EXPLORATION -diente I-EXPLORATION -número I-EXPLORATION -73. I-EXPLORATION - I-EXPLORATION -Por I-EXPLORATION -ser I-EXPLORATION -un I-EXPLORATION -crecimiento I-EXPLORATION -gingival I-EXPLORATION -fibroso, I-EXPLORATION -espontáneo, I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -tamaño, I-EXPLORATION -sin I-EXPLORATION -asociación I-EXPLORATION -a I-EXPLORATION -síndromes I-EXPLORATION -y I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -historia I-EXPLORATION -familiar I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -la I-EXPLORATION -madre I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -hermano I-EXPLORATION -presentaron I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -patología, I-EXPLORATION -se I-EXPLORATION -estableció I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -fibromatosis I-EXPLORATION -gingival I-EXPLORATION -hereditaria. I-EXPLORATION - I-EXPLORATION -Procedimiento B-TREATMENT - I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -una I-TREATMENT -gingivectomía I-TREATMENT -y I-TREATMENT -gingivoplastía I-TREATMENT -en I-TREATMENT -2 I-TREATMENT -fases I-TREATMENT -quirúrgicas I-TREATMENT -inicialmente I-TREATMENT -en I-TREATMENT -la I-TREATMENT -mandíbula I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -en I-TREATMENT -el I-TREATMENT -maxilar I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -local. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -incisión I-TREATMENT -primaria I-TREATMENT -a I-TREATMENT -bisel I-TREATMENT -interno I-TREATMENT -a I-TREATMENT -un I-TREATMENT -ángulo I-TREATMENT -de I-TREATMENT -45o I-TREATMENT -hacia I-TREATMENT -el I-TREATMENT -ápice I-TREATMENT -de I-TREATMENT -los I-TREATMENT -dientes, I-TREATMENT -previa I-TREATMENT -localización I-TREATMENT -de I-TREATMENT -los I-TREATMENT -mismos I-TREATMENT -con I-TREATMENT -la I-TREATMENT -sonda I-TREATMENT -periodontal I-TREATMENT -de I-TREATMENT -Williams, I-TREATMENT -aproximadamente I-TREATMENT -a I-TREATMENT -5 I-TREATMENT -mm I-TREATMENT -del I-TREATMENT -surco I-TREATMENT -gingival, I-TREATMENT -con I-TREATMENT -hoja I-TREATMENT -de I-TREATMENT -bisturí I-TREATMENT -del I-TREATMENT -número I-TREATMENT -11 I-TREATMENT -y I-TREATMENT -12 I-TREATMENT -y I-TREATMENT -mango I-TREATMENT -bard I-TREATMENT -parker I-TREATMENT -número I-TREATMENT -3; I-TREATMENT -luego I-TREATMENT -se I-TREATMENT -efectuó I-TREATMENT -incisión I-TREATMENT -intrasurcular I-TREATMENT -creando I-TREATMENT -un I-TREATMENT -collar I-TREATMENT -de I-TREATMENT -tejido I-TREATMENT -gingival, I-TREATMENT -el I-TREATMENT -cual I-TREATMENT -fue I-TREATMENT -removido I-TREATMENT -posteriormente I-TREATMENT -por I-TREATMENT -curetas I-TREATMENT -gracey I-TREATMENT -específicas I-TREATMENT -de I-TREATMENT -cada I-TREATMENT -diente, I-TREATMENT -después I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT -reafinado I-TREATMENT -del I-TREATMENT -bisel I-TREATMENT -con I-TREATMENT -el I-TREATMENT -bisturí I-TREATMENT -de I-TREATMENT -Kirklan I-TREATMENT -y I-TREATMENT -Orban I-TREATMENT -para I-TREATMENT -las I-TREATMENT -áreas I-TREATMENT -interproximales I-TREATMENT -y I-TREATMENT -exodoncia I-TREATMENT -del I-TREATMENT -diente I-TREATMENT -73; I-TREATMENT -finalmente I-TREATMENT -se I-TREATMENT -llevó I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -hemostasia I-TREATMENT -y I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -un I-TREATMENT -tutor I-TREATMENT -en I-TREATMENT -acetato I-TREATMENT -diseñado I-TREATMENT -prequirúrgicamente I-TREATMENT -en I-TREATMENT -modelos I-TREATMENT -de I-TREATMENT -estudios I-TREATMENT -con I-TREATMENT -cemento I-TREATMENT -quirúrgico I-TREATMENT -periodontal, I-TREATMENT -para I-TREATMENT -proteger I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -física I-TREATMENT -la I-TREATMENT -superficie I-TREATMENT -de I-TREATMENT -la I-TREATMENT -herida I-TREATMENT -del I-TREATMENT -trauma I-TREATMENT -mecánico I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -cicatrización, I-TREATMENT -evitar I-TREATMENT -la I-TREATMENT -formación I-TREATMENT -de I-TREATMENT -tejido I-TREATMENT -excesivo I-TREATMENT -de I-TREATMENT -granulación I-TREATMENT -y I-TREATMENT -empaquetamiento I-TREATMENT -de I-TREATMENT -alimentos, I-TREATMENT -se I-TREATMENT -ordenó I-TREATMENT -farmacoterapia I-TREATMENT -con I-TREATMENT -antibiótico, I-TREATMENT -analgésico I-TREATMENT -y I-TREATMENT -antiinflamatorio, I-TREATMENT -las I-TREATMENT -indicaciones I-TREATMENT -postoperatorias I-TREATMENT -incluyeron I-TREATMENT -adecuada I-TREATMENT -higiene I-TREATMENT -oral I-TREATMENT -con I-TREATMENT -uso I-TREATMENT -del I-TREATMENT -cepillo, I-TREATMENT -seda I-TREATMENT -dental I-TREATMENT -y I-TREATMENT -enjuagues I-TREATMENT -con I-TREATMENT -colutorios I-TREATMENT -sin I-TREATMENT -alcohol. I-TREATMENT -El I-TREATMENT -mismo I-TREATMENT -procedimiento I-TREATMENT -fue I-TREATMENT -realizado I-TREATMENT -en I-TREATMENT -el I-TREATMENT -maxilar I-TREATMENT -20 I-TREATMENT -días I-TREATMENT -después. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -examen I-EXPLORATION -histopatológico I-EXPLORATION -describe I-EXPLORATION -microscópicamente I-EXPLORATION -fragmentos I-EXPLORATION -de I-EXPLORATION -mucosa I-EXPLORATION -oral I-EXPLORATION -revestidos I-EXPLORATION -por I-EXPLORATION -epitelio I-EXPLORATION -paraqueratósico, I-EXPLORATION -hiperplásico, I-EXPLORATION -sobre I-EXPLORATION -estroma I-EXPLORATION -con I-EXPLORATION -abundante I-EXPLORATION -haces I-EXPLORATION -gruesos I-EXPLORATION -de I-EXPLORATION -colágeno I-EXPLORATION -dispuestos I-EXPLORATION -al I-EXPLORATION -azar, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -fibromatosis I-EXPLORATION -gingival. I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -el I-EVOLUTION -control I-EVOLUTION -posquirúrgico I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -20 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -cada I-EVOLUTION -procedimiento I-EVOLUTION -(maxilar I-EVOLUTION -y I-EVOLUTION -mandíbula), I-EVOLUTION -se I-EVOLUTION -evidenció I-EVOLUTION -disminución I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -volumen I-EVOLUTION -del I-EVOLUTION -tejido I-EVOLUTION -gingival, I-EVOLUTION -buen I-EVOLUTION -proceso I-EVOLUTION -de I-EVOLUTION -cicatrización, I-EVOLUTION -las I-EVOLUTION -coronas I-EVOLUTION -dentarias I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -encontraron I-EVOLUTION -cubiertas I-EVOLUTION -por I-EVOLUTION -tejido, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -manifestó I-EVOLUTION -mejoras I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -proceso I-EVOLUTION -de I-EVOLUTION -masticación, I-EVOLUTION -que I-EVOLUTION -sonríe I-EVOLUTION -frecuentemente I-EVOLUTION -y I-EVOLUTION -tiene I-EVOLUTION -mayor I-EVOLUTION -relación I-EVOLUTION -social I-EVOLUTION -con I-EVOLUTION -los I-EVOLUTION -compañeros I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -escuela. I-EVOLUTION -También I-EVOLUTION -presentó I-EVOLUTION -alteraciones I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -oclusión I-EVOLUTION -dental, I-EVOLUTION -como I-EVOLUTION -diastemas, I-EVOLUTION -mordida I-EVOLUTION -profunda, I-EVOLUTION -mala I-EVOLUTION -posición I-EVOLUTION -dentaria, I-EVOLUTION -entre I-EVOLUTION -otros, I-EVOLUTION -razón I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -cual I-EVOLUTION -se I-EVOLUTION -remitió I-EVOLUTION -al I-EVOLUTION -servicio I-EVOLUTION -de I-EVOLUTION -ortodoncia I-EVOLUTION -para I-EVOLUTION -su I-EVOLUTION -terapéutica. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -57 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -22 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -meningioma I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -frontal. I-PAST_MEDICAL_HISTORY -En B-DERIVED_FROM/TO -seguimiento I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Neurocirugía I-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -entonces I-DERIVED_FROM/TO -sin I-DERIVED_FROM/TO -signos I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -recidiva I-DERIVED_FROM/TO -locorregional, I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -remite I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -Maxilofacial I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -valoración I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -reconstrucción I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -partes I-DERIVED_FROM/TO -blandas I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nivel I-DERIVED_FROM/TO -frontal I-DERIVED_FROM/TO -como I-DERIVED_FROM/TO -secuela I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -craniotomía I-DERIVED_FROM/TO -complicada I-DERIVED_FROM/TO -hace I-DERIVED_FROM/TO -años. I-DERIVED_FROM/TO -Ha B-EVOLUTION -presentado I-EVOLUTION -numerosas I-EVOLUTION -infecciones I-EVOLUTION -de I-EVOLUTION -repetición I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -local I-EVOLUTION -con I-EVOLUTION -rechazo I-EVOLUTION -de I-EVOLUTION -plastia I-EVOLUTION -craneal I-EVOLUTION -en I-EVOLUTION -3 I-EVOLUTION -ocasiones I-EVOLUTION -e I-EVOLUTION -intentos I-EVOLUTION -fallidos I-EVOLUTION -de I-EVOLUTION -reconstrucción I-EVOLUTION -con I-EVOLUTION -injertos I-EVOLUTION -cutáneos I-EVOLUTION -y I-EVOLUTION -colgajos I-EVOLUTION -locales. I-EVOLUTION -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -reveló I-EXPLORATION -un I-EXPLORATION -defecto I-EXPLORATION -estético I-EXPLORATION -importante I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -frontal I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -lesiones I-EXPLORATION -ulceradas I-EXPLORATION -y I-EXPLORATION -supuración. I-EXPLORATION -La I-EXPLORATION -visión I-EXPLORATION -tanto I-EXPLORATION -de I-EXPLORATION -frente I-EXPLORATION -como I-EXPLORATION -de I-EXPLORATION -perfil I-EXPLORATION -revelan I-EXPLORATION -una I-EXPLORATION -pérdida I-EXPLORATION -severa I-EXPLORATION -de I-EXPLORATION -altura I-EXPLORATION -facial I-EXPLORATION -a I-EXPLORATION -expensas I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -tercio I-EXPLORATION -superior, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION -considerable I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -curvatura I-EXPLORATION -y I-EXPLORATION -proyección I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -bóveda I-EXPLORATION -craneal. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -radiológico I-EXPLORATION -mediante I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION -(RMN) I-EXPLORATION -y I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION -informaba I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -deformidad I-EXPLORATION -anatómica I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -frontal I-EXPLORATION -y I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas, I-EXPLORATION -con I-EXPLORATION -captación I-EXPLORATION -heterogénea I-EXPLORATION -y I-EXPLORATION -áreas I-EXPLORATION -hiperintensas I-EXPLORATION -en I-EXPLORATION -secuencias I-EXPLORATION -potenciadas I-EXPLORATION -en I-EXPLORATION -T2, I-EXPLORATION -con I-EXPLORATION -zonas I-EXPLORATION -de I-EXPLORATION -nivel I-EXPLORATION -hidroaéreo I-EXPLORATION -realzadas I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -administración I-EXPLORATION -de I-EXPLORATION -gadolinio, I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -posible I-EXPLORATION -proceso I-EXPLORATION -infeccioso. I-EXPLORATION -Asimismo, I-EXPLORATION -se I-EXPLORATION -indicaba I-EXPLORATION -un I-EXPLORATION -realce I-EXPLORATION -meníngeo I-EXPLORATION -en I-EXPLORATION -localización I-EXPLORATION -supero-anterior I-EXPLORATION -sin I-EXPLORATION -objetivarse I-EXPLORATION -colecciones I-EXPLORATION -extradurales, I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -cerebritis I-EXPLORATION -o I-EXPLORATION -abscesos I-EXPLORATION -intraparenquimatosos I-EXPLORATION -en I-EXPLORATION -probable I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -cambios I-EXPLORATION -posquirúrgicos I-EXPLORATION -secundarios I-EXPLORATION -a I-EXPLORATION -plastia. I-EXPLORATION - I-EXPLORATION -Tras B-TREATMENT -estos I-TREATMENT -datos I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -reconstruir I-TREATMENT -el I-TREATMENT -defecto I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -frontal I-TREATMENT -mediante I-TREATMENT -el I-TREATMENT -empleo I-TREATMENT -de I-TREATMENT -un I-TREATMENT -colgajo I-TREATMENT -libre I-TREATMENT -microvascularizado I-TREATMENT -anterolateral I-TREATMENT -de I-TREATMENT -muslo I-TREATMENT -(ALT) I-TREATMENT -derecho I-TREATMENT -en I-TREATMENT -un I-TREATMENT -intento I-TREATMENT -de I-TREATMENT -resolver I-TREATMENT -ambos I-TREATMENT -problemas, I-TREATMENT -estético I-TREATMENT -e I-TREATMENT -infeccioso. I-TREATMENT -Para I-TREATMENT -ello I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -exposición I-TREATMENT -del I-TREATMENT -defecto I-TREATMENT -frontal I-TREATMENT -mediante I-TREATMENT -un I-TREATMENT -abordaje I-TREATMENT -coronal I-TREATMENT -empleando I-TREATMENT -una I-TREATMENT -cicatriz I-TREATMENT -previa. I-TREATMENT -Tras I-TREATMENT -acceso I-TREATMENT -al I-TREATMENT -seno I-TREATMENT -frontal I-TREATMENT -remanente, I-TREATMENT -resultado I-TREATMENT -de I-TREATMENT -cirugías I-TREATMENT -previas, I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -limpieza I-TREATMENT -del I-TREATMENT -mismo I-TREATMENT -y I-TREATMENT -a I-TREATMENT -la I-TREATMENT -reparación I-TREATMENT -de I-TREATMENT -una I-TREATMENT -fístula I-TREATMENT -de I-TREATMENT -pequeño I-TREATMENT -tamaño I-TREATMENT -de I-TREATMENT -duramadre I-TREATMENT -con I-TREATMENT -un I-TREATMENT -injerto I-TREATMENT -de I-TREATMENT -fascia I-TREATMENT -de I-TREATMENT -músculo I-TREATMENT -temporal. I-TREATMENT -Posteriormente I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -disección I-TREATMENT -del I-TREATMENT -colgajo I-TREATMENT -fasciocutáneo I-TREATMENT -ALT I-TREATMENT -con I-TREATMENT -un I-TREATMENT -tamaño I-TREATMENT -de I-TREATMENT -10 I-TREATMENT -x I-TREATMENT -15 I-TREATMENT -cm, I-TREATMENT -siendo I-TREATMENT -desepitelizada I-TREATMENT -un I-TREATMENT -área I-TREATMENT -de I-TREATMENT -7 I-TREATMENT -x I-TREATMENT -5 I-TREATMENT -cm. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -área I-TREATMENT -desepitelizada I-TREATMENT -se I-TREATMENT -conservó I-TREATMENT -tejido I-TREATMENT -celular I-TREATMENT -subcutáneo I-TREATMENT -para I-TREATMENT -recubrimiento I-TREATMENT -y I-TREATMENT -sellado I-TREATMENT -de I-TREATMENT -la I-TREATMENT -duramadre I-TREATMENT -y I-TREATMENT -seno I-TREATMENT -frontal. I-TREATMENT -La I-TREATMENT -anastomosis I-TREATMENT -vascular I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -tras I-TREATMENT -un I-TREATMENT -abordaje I-TREATMENT -preauricular I-TREATMENT -empleando I-TREATMENT -los I-TREATMENT -vasos I-TREATMENT -temporales I-TREATMENT -superficiales. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -post-intervención I-EVOLUTION -el I-EVOLUTION -colgajo I-EVOLUTION -presentaba I-EVOLUTION -un I-EVOLUTION -aspecto I-EVOLUTION -óptimo, I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -excelente I-EVOLUTION -resultado I-EVOLUTION -estético I-EVOLUTION -y I-EVOLUTION -funcional. I-EVOLUTION -No I-EVOLUTION -se I-EVOLUTION -apreciaron I-EVOLUTION -signos I-EVOLUTION -infección, I-EVOLUTION -reabsorción I-EVOLUTION -ni I-EVOLUTION -pérdida I-EVOLUTION -de I-EVOLUTION -volumen I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -frontal, I-EVOLUTION -habiéndose I-EVOLUTION -preservado I-EVOLUTION -su I-EVOLUTION -tamaño I-EVOLUTION -y I-EVOLUTION -forma I-EVOLUTION -desde I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION -Actualmente, I-EVOLUTION -el I-EVOLUTION -paciente, I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -recuperación I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -identidad I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -solución I-EVOLUTION -efectiva I-EVOLUTION -del I-EVOLUTION -problema I-EVOLUTION -fistuloso, I-EVOLUTION -ha I-EVOLUTION -rehusado I-EVOLUTION -una I-EVOLUTION -nueva I-EVOLUTION -intervención I-EVOLUTION -para I-EVOLUTION -la I-EVOLUTION -realización I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -cranioplastia I-EVOLUTION -por I-EVOLUTION -parte I-EVOLUTION -del I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Neurocirugía. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -84 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -que B-DERIVED_FROM/TO -nos I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cirugía I-DERIVED_FROM/TO -oral I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -maxilofacial I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -dentista I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -presentar I-DERIVED_FROM/TO -exposición I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -hueso I-DERIVED_FROM/TO -crestal I-DERIVED_FROM/TO -mandibular I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -supuración I-DERIVED_FROM/TO -periimplantar I-DERIVED_FROM/TO -3 I-DERIVED_FROM/TO -semanas I-DERIVED_FROM/TO -después I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -colocación I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -6 I-DERIVED_FROM/TO -implantes I-DERIVED_FROM/TO -dentales I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -carga I-DERIVED_FROM/TO -inmediata. I-DERIVED_FROM/TO -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -solo I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -osteoporosis. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -tomó I-PAST_MEDICAL_HISTORY -ningún I-PAST_MEDICAL_HISTORY -medicamento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -regularidad I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -nunca I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -bifosfonatos. I-PAST_MEDICAL_HISTORY -Cinco I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -colocación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -implantes, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -comenzó I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -antirresortivo I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -denosumab I-PAST_MEDICAL_HISTORY -60 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -subcutánea I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -tratar I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -osteoporosis. I-PAST_MEDICAL_HISTORY -Solo I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -administró I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -sola I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -60 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -denosumab. I-PAST_MEDICAL_HISTORY -El B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -mostró I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -del I-EXPLORATION -reborde I-EXPLORATION -alveolar I-EXPLORATION -mandibular I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -zonas I-EXPLORATION -de I-EXPLORATION -exposición I-EXPLORATION -ósea I-EXPLORATION -que I-EXPLORATION -correspondían I-EXPLORATION -con I-EXPLORATION -las I-EXPLORATION -extracciones I-EXPLORATION -dentales I-EXPLORATION -previas I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -cirugía I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -dientes I-EXPLORATION -48 I-EXPLORATION -y I-EXPLORATION -47. I-EXPLORATION -Una I-EXPLORATION -ortopantomografía I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -varias I-EXPLORATION -zonas I-EXPLORATION -osteolíticas I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -cuerpo I-EXPLORATION -mandibular I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION -alrededor I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -implantes. I-EXPLORATION -En I-EXPLORATION -una I-EXPLORATION -TC I-EXPLORATION -mandibular I-EXPLORATION -para I-EXPLORATION -determinar I-EXPLORATION -la I-EXPLORATION -extensión I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -destrucción I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -7 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -longitud I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cortical I-EXPLORATION -vestibular I-EXPLORATION -del I-EXPLORATION -cuerpo I-EXPLORATION -mandibular I-EXPLORATION -derecho, I-EXPLORATION -espacios I-EXPLORATION -trabeculares I-EXPLORATION -dilatados I-EXPLORATION -e I-EXPLORATION -irregulares I-EXPLORATION -con I-EXPLORATION -áreas I-EXPLORATION -hipodensas I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -osteonecrosis I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -implantes I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -alveolos I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -dientes I-EXPLORATION -extraídos. I-EXPLORATION -Una I-EXPLORATION -gammagrafía I-EXPLORATION -ósea I-EXPLORATION -objetivó I-EXPLORATION -una I-EXPLORATION -infección I-EXPLORATION -severa I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -mandibular. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -conservador I-TREATMENT -con I-TREATMENT -antibióticos I-TREATMENT -según I-TREATMENT -protocolo I-TREATMENT -de I-TREATMENT -nuestro I-TREATMENT -servicio I-TREATMENT -(amoxicilina-clavulánico I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -875/125 I-TREATMENT -mg, I-TREATMENT -3 I-TREATMENT -veces/día I-TREATMENT -durante I-TREATMENT -15 I-TREATMENT -días I-TREATMENT -asociados I-TREATMENT -con I-TREATMENT -enjuagues I-TREATMENT -de I-TREATMENT -clorhexidina I-TREATMENT -al I-TREATMENT -0, I-TREATMENT -12%, I-TREATMENT -2-3 I-TREATMENT -veces/día) I-TREATMENT -y I-TREATMENT -se I-TREATMENT -interrumpió I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -denosumab. I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -2 I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -iniciar I-EVOLUTION -el I-EVOLUTION -tratamiento, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -mejoría I-EVOLUTION -del I-EVOLUTION -dolor, I-EVOLUTION -con I-EVOLUTION -desaparición I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -supuración I-EVOLUTION -y I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -periimplantitis. I-EVOLUTION -Se B-TREATMENT -inició I-TREATMENT -entonces I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -bajas I-TREATMENT -con I-TREATMENT -teriparatida I-TREATMENT -20 I-TREATMENT -μg I-TREATMENT -subcutánea I-TREATMENT -en I-TREATMENT -inyección I-TREATMENT -diaria I-TREATMENT -durante I-TREATMENT -6 I-TREATMENT -meses. I-TREATMENT -Pasado I-TREATMENT -este I-TREATMENT -tiempo, I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -en I-TREATMENT -ese I-TREATMENT -momento I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -teriparatida, I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -los I-TREATMENT -focos I-TREATMENT -de I-TREATMENT -exposición I-TREATMENT -ósea I-TREATMENT -fueron I-TREATMENT -cubiertos I-TREATMENT -por I-TREATMENT -mucosa I-TREATMENT -oral I-TREATMENT -sana, I-TREATMENT -observándose B-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -TC I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -una I-EXPLORATION -recuperación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -densidad I-EXPLORATION -ósea I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -zonas I-EXPLORATION -osteolíticas I-EXPLORATION -con I-EXPLORATION -cierto I-EXPLORATION -grado I-EXPLORATION -de I-EXPLORATION -esclerosis. I-EXPLORATION -En B-EVOLUTION -la I-EVOLUTION -actualidad, I-EVOLUTION -8 I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -finalización I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -teriparida, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática, I-EVOLUTION -habiéndose I-EVOLUTION -realizado I-EVOLUTION -la I-EVOLUTION -rehabilitación I-EVOLUTION -protésica I-EVOLUTION -sobre I-EVOLUTION -los I-EVOLUTION -implantes I-EVOLUTION -viables I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -remisión I-EVOLUTION -completa I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -parotídea I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -asintomática, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -rápido I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -meses. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -único I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -personal I-PAST_MEDICAL_HISTORY -relevante, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -intervenida I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -dermatofibrosarcoma I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -escapular. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -la I-EXPLORATION -tumoración I-EXPLORATION -mide I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -está I-EXPLORATION -mal I-EXPLORATION -delimitada I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -localiza I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -espesor I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cola I-EXPLORATION -parotídea I-EXPLORATION -derecha. I-EXPLORATION -No I-EXPLORATION -presenta I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -motilidad I-EXPLORATION -facial I-EXPLORATION -ni I-EXPLORATION -adenopatías I-EXPLORATION -palpables I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -cervical. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -realizada I-EXPLORATION -mediante I-EXPLORATION -punción I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina I-EXPLORATION -(PAAF), I-EXPLORATION -obtiene I-EXPLORATION -material I-EXPLORATION -sugestivo I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -quística I-EXPLORATION -benigna, I-EXPLORATION -con I-EXPLORATION -ligera I-EXPLORATION -linfocitosis I-EXPLORATION -sin I-EXPLORATION -componente I-EXPLORATION -epitelial. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -cervicofacial I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -de I-EXPLORATION -contornos I-EXPLORATION -irregulares, I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -superficial I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -glándula I-EXPLORATION -parótida I-EXPLORATION -derecha, I-EXPLORATION -con I-EXPLORATION -extensión I-EXPLORATION -focal I-EXPLORATION -al I-EXPLORATION -lóbulo I-EXPLORATION -profundo. I-EXPLORATION -Se I-EXPLORATION -trata I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -hipodensa I-EXPLORATION -de I-EXPLORATION -18 I-EXPLORATION -× I-EXPLORATION -24 I-EXPLORATION -× I-EXPLORATION -34 I-EXPLORATION -mm, I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -fina I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -realza I-EXPLORATION -mínimamente I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -administración I-EXPLORATION -de I-EXPLORATION -contraste. I-EXPLORATION -Así, I-EXPLORATION -el I-EXPLORATION -primer I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -sospecha I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -tumoración I-EXPLORATION -parotídea I-EXPLORATION -quística I-EXPLORATION -benigna, I-EXPLORATION -sin I-EXPLORATION -poder I-EXPLORATION -descartar I-EXPLORATION -otras I-EXPLORATION -posibilidades. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -interviene I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general, I-TREATMENT -mediante I-TREATMENT -incisión I-TREATMENT -de I-TREATMENT -ritidectomía I-TREATMENT -y I-TREATMENT -colgajo I-TREATMENT -de I-TREATMENT -SMAS. I-TREATMENT -Se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -la I-TREATMENT -identificación I-TREATMENT -rutinaria I-TREATMENT -del I-TREATMENT -tronco I-TREATMENT -del I-TREATMENT -nervio I-TREATMENT -facial, I-TREATMENT -con I-TREATMENT -gran I-TREATMENT -dificultad I-TREATMENT -para I-TREATMENT -su I-TREATMENT -localización, I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -pone I-TREATMENT -de I-TREATMENT -manifiesto I-TREATMENT -su I-TREATMENT -íntima I-TREATMENT -relación I-TREATMENT -con I-TREATMENT -el I-TREATMENT -tumor. I-TREATMENT -Tras I-TREATMENT -la I-TREATMENT -disección I-TREATMENT -retrógrada I-TREATMENT -de I-TREATMENT -las I-TREATMENT -principales I-TREATMENT -ramas I-TREATMENT -del I-TREATMENT -VII I-TREATMENT -par I-TREATMENT -(marginal, I-TREATMENT -bucal, I-TREATMENT -palpebral I-TREATMENT -y I-TREATMENT -frontal) I-TREATMENT -utilizando I-TREATMENT -microscopio I-TREATMENT -óptico, I-TREATMENT -no I-TREATMENT -es I-TREATMENT -posible I-TREATMENT -separar I-TREATMENT -el I-TREATMENT -tumor I-TREATMENT -del I-TREATMENT -tronco I-TREATMENT -nervioso I-TREATMENT -y I-TREATMENT -del I-TREATMENT -resto I-TREATMENT -de I-TREATMENT -ramas. I-TREATMENT -La I-TREATMENT -lesión I-TREATMENT -está I-TREATMENT -integrada I-TREATMENT -por I-TREATMENT -fascículos I-TREATMENT -fusiformes I-TREATMENT -imbricados I-TREATMENT -entre I-TREATMENT -ramos I-TREATMENT -nerviosos I-TREATMENT -y I-TREATMENT -áreas I-TREATMENT -quísticas, I-TREATMENT -conformando I-TREATMENT -una I-TREATMENT -lesión I-TREATMENT -lobulada I-TREATMENT -bien I-TREATMENT -delimitada I-TREATMENT -respeto I-TREATMENT -al I-TREATMENT -tejido I-TREATMENT -parotídeo. I-TREATMENT -Se I-TREATMENT -realiza I-TREATMENT -drenaje I-TREATMENT -del I-TREATMENT -contenido I-TREATMENT -quístico, I-TREATMENT -con I-TREATMENT -gran I-TREATMENT -reducción I-TREATMENT -del I-TREATMENT -tamaño I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tumoración I-TREATMENT -y I-TREATMENT -se I-TREATMENT -mandan I-TREATMENT -2 I-TREATMENT -biopsias I-TREATMENT -intraoperatorias. I-TREATMENT -La B-EXPLORATION -primera I-EXPLORATION -fue I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -tejido I-EXPLORATION -conectivo I-EXPLORATION -inflamatorio I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -segunda, I-EXPLORATION -como I-EXPLORATION -tumor I-EXPLORATION -fusiforme I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -grado I-EXPLORATION -sugestivo I-EXPLORATION -de I-EXPLORATION -schwannoma. I-EXPLORATION - I-EXPLORATION -Tras B-TREATMENT -explicar I-TREATMENT -a I-TREATMENT -la I-TREATMENT -familia I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -las I-TREATMENT -diferentes I-TREATMENT -opciones I-TREATMENT -terapéuticas, I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -no I-TREATMENT -extirpar I-TREATMENT -la I-TREATMENT -tumoración I-TREATMENT -en I-TREATMENT -su I-TREATMENT -totalidad I-TREATMENT -y I-TREATMENT -esperar I-TREATMENT -el I-TREATMENT -resultado I-TREATMENT -histopatológico I-TREATMENT -definitivo. I-TREATMENT -Se I-TREATMENT -dispone I-TREATMENT -un I-TREATMENT -tubo I-TREATMENT -de I-TREATMENT -silicona I-TREATMENT -en I-TREATMENT -torno I-TREATMENT -a I-TREATMENT -3 I-TREATMENT -de I-TREATMENT -las I-TREATMENT -ramas I-TREATMENT -distales I-TREATMENT -del I-TREATMENT -nervio I-TREATMENT -facial I-TREATMENT -disecadas, I-TREATMENT -para I-TREATMENT -facilitar I-TREATMENT -su I-TREATMENT -ulterior I-TREATMENT -identificación I-TREATMENT -si I-TREATMENT -fuera I-TREATMENT -necesaria I-TREATMENT -una I-TREATMENT -segunda I-TREATMENT -intervención. I-TREATMENT -Se I-TREATMENT -procede I-TREATMENT -al I-TREATMENT -tensado I-TREATMENT -de I-TREATMENT -SMAS I-TREATMENT -y I-TREATMENT -cierre I-TREATMENT -por I-TREATMENT -planos, I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -drenaje I-TREATMENT -con I-TREATMENT -vacío I-TREATMENT -y I-TREATMENT -vendaje, I-TREATMENT -según I-TREATMENT -el I-TREATMENT -protocolo I-TREATMENT -habitual. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -inmediato, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -parálisis I-EVOLUTION -facial I-EVOLUTION -completa I-EVOLUTION -(grado I-EVOLUTION -VI I-EVOLUTION -en I-EVOLUTION -escala I-EVOLUTION -House-Brackman) I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -recuperación I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -15 I-EVOLUTION -meses I-EVOLUTION -(grado I-EVOLUTION -I, I-EVOLUTION -House-Brackman). I-EVOLUTION -La I-EVOLUTION -paciente I-EVOLUTION -también I-EVOLUTION -manifiesta I-EVOLUTION -síntomas I-EVOLUTION -de I-EVOLUTION -síndrome I-EVOLUTION -de I-EVOLUTION -Frey, I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía, I-EVOLUTION -tratándose B-TREATMENT -con I-TREATMENT -toxina I-TREATMENT -botulínica I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -exitosa. I-TREATMENT - I-TREATMENT -El I-TREATMENT -diagnóstico I-TREATMENT -anatomopatológico I-TREATMENT -definitivo I-TREATMENT -fue I-TREATMENT -de I-TREATMENT -schwannoma I-TREATMENT -de I-TREATMENT -nervio I-TREATMENT -periférico. I-TREATMENT -Se I-TREATMENT -discute I-TREATMENT -con I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -la I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -extirpación I-TREATMENT -completa I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tumoración, I-TREATMENT -con I-TREATMENT -sacrificio I-TREATMENT -del I-TREATMENT -nervio I-TREATMENT -facial I-TREATMENT -y I-TREATMENT -reconstrucción I-TREATMENT -inmediata I-TREATMENT -con I-TREATMENT -injerto I-TREATMENT -nervioso, I-TREATMENT -pero I-TREATMENT -hasta I-TREATMENT -el I-TREATMENT -momento I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -rechaza I-TREATMENT -esta I-TREATMENT -opción. I-TREATMENT - I-TREATMENT -El B-EXPLORATION -primer I-EXPLORATION -control I-EXPLORATION -posquirúrgico I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -con I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -5 I-EXPLORATION -meses I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cirugía, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -aparece I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -nodular I-EXPLORATION -hipercaptante I-EXPLORATION -en I-EXPLORATION -celda I-EXPLORATION -parotídea, I-EXPLORATION -englobada I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -área I-EXPLORATION -de I-EXPLORATION -fibrosis. I-EXPLORATION -La I-EXPLORATION -imagen I-EXPLORATION -es I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -fibrosis I-EXPLORATION -inmadura I-EXPLORATION -sin I-EXPLORATION -descartar I-EXPLORATION -restos I-EXPLORATION -de I-EXPLORATION -schwannoma. I-EXPLORATION -Clínicamente, B-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presenta I-EVOLUTION -tumoración I-EVOLUTION -palpable I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -región I-EVOLUTION -intervenida I-EVOLUTION -ni I-EVOLUTION -empeoramiento I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -motilidad I-EVOLUTION -facial I-EVOLUTION -tras I-EVOLUTION -un I-EVOLUTION -seguimiento I-EVOLUTION -de I-EVOLUTION -3 I-EVOLUTION -años. I-EVOLUTION -Los I-EVOLUTION -controles I-EVOLUTION -mediante I-EVOLUTION -RM I-EVOLUTION -anuales I-EVOLUTION -no I-EVOLUTION -muestran I-EVOLUTION -cambios I-EVOLUTION -respecto I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -controles I-EVOLUTION -previos. I-EVOLUTION - I-EVOLUTION - -Una B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -femenina I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -27 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -quien I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -queja I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -mostrar I-PRESENT_ILLNESS -excesivamente I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -gingival I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -sonreír, I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -objetivo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -mejorar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -estética I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -sonrisa I-PRESENT_ILLNESS -gingival. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -informa I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -encuentra I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -sonrisa I-PRESENT_ILLNESS -armoniosa, I-PRESENT_ILLNESS -pero I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -está I-PRESENT_ILLNESS -dispuesta I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -realizar I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -procedimiento I-PRESENT_ILLNESS -invasivo I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -corregir I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -situación I-PRESENT_ILLNESS -bucal. I-PRESENT_ILLNESS -Al B-EXPLORATION -momento I-EXPLORATION -de I-EXPLORATION -ser I-EXPLORATION -realizada I-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION -clínica, I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -que I-EXPLORATION -presentaba I-EXPLORATION -4 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -exposición I-EXPLORATION -gingival. I-EXPLORATION - I-EXPLORATION -Fue I-EXPLORATION -evaluada I-EXPLORATION -la I-EXPLORATION -etiología I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -sonrisa I-EXPLORATION -gingival, I-EXPLORATION -llegando I-EXPLORATION -al I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -que I-EXPLORATION -su I-EXPLORATION -sonrisa I-EXPLORATION -gingival I-EXPLORATION -era I-EXPLORATION -debida I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -hiperactividad I-EXPLORATION -del I-EXPLORATION -músculo I-EXPLORATION -elevador I-EXPLORATION -del I-EXPLORATION -labio I-EXPLORATION -superior. I-EXPLORATION -Entre B-TREATMENT -las I-TREATMENT -opciones I-TREATMENT -para I-TREATMENT -resolver I-TREATMENT -el I-TREATMENT -caso I-TREATMENT -que I-TREATMENT -fueron I-TREATMENT -presentadas I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -(incluyendo I-TREATMENT -ventajas I-TREATMENT -y I-TREATMENT -limitaciones I-TREATMENT -de I-TREATMENT -cada I-TREATMENT -una), I-TREATMENT -fue I-TREATMENT -escogido I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -BTX-A, I-TREATMENT -con I-TREATMENT -el I-TREATMENT -fin I-TREATMENT -de I-TREATMENT -reducir I-TREATMENT -la I-TREATMENT -fuerza I-TREATMENT -de I-TREATMENT -contracción I-TREATMENT -del I-TREATMENT -labio I-TREATMENT -superior. I-TREATMENT - I-TREATMENT -Para I-TREATMENT -la I-TREATMENT -ubicación I-TREATMENT -del I-TREATMENT -punto I-TREATMENT -de I-TREATMENT -aplicación, I-TREATMENT -fue I-TREATMENT -utilizada I-TREATMENT -la I-TREATMENT -técnica I-TREATMENT -"Yonsei I-TREATMENT -Point"2, I-TREATMENT -descrita I-TREATMENT -en I-TREATMENT -la I-TREATMENT -figura I-TREATMENT -2. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -utilizó I-TREATMENT -la I-TREATMENT -BTX-A I-TREATMENT -(botox I-TREATMENT -de I-TREATMENT -la I-TREATMENT -casa I-TREATMENT -comercial I-TREATMENT -Allergan) I-TREATMENT -de I-TREATMENT -100 I-TREATMENT -unidades I-TREATMENT -(U) I-TREATMENT -como I-TREATMENT -medicación I-TREATMENT -de I-TREATMENT -elección. I-TREATMENT -La I-TREATMENT -dilución I-TREATMENT -del I-TREATMENT -medicamento I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -como I-TREATMENT -se I-TREATMENT -describe I-TREATMENT -en I-TREATMENT -las I-TREATMENT -instrucciones I-TREATMENT -de I-TREATMENT -uso I-TREATMENT -del I-TREATMENT -mismo. I-TREATMENT -La I-TREATMENT -BTX-A I-TREATMENT -se I-TREATMENT -diluyó I-TREATMENT -con I-TREATMENT -2 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -solución I-TREATMENT -salina I-TREATMENT -0, I-TREATMENT -9% I-TREATMENT -sin I-TREATMENT -conservantes I-TREATMENT -y I-TREATMENT -estéril I-TREATMENT -para I-TREATMENT -producir I-TREATMENT -5 I-TREATMENT -U I-TREATMENT -por I-TREATMENT -0, I-TREATMENT -1 I-TREATMENT -ml. I-TREATMENT -Se I-TREATMENT -inyectaron I-TREATMENT -2, I-TREATMENT -5 I-TREATMENT -U I-TREATMENT -en I-TREATMENT -el I-TREATMENT -músculo I-TREATMENT -elevador I-TREATMENT -del I-TREATMENT -labio I-TREATMENT -superior, I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -bilateral. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -evaluó I-EVOLUTION -2 I-EVOLUTION -semanas I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -aplicación. I-EVOLUTION - I-EVOLUTION -La I-EVOLUTION -exposición I-EVOLUTION -gingival I-EVOLUTION -se I-EVOLUTION -redujo I-EVOLUTION -notablemente I-EVOLUTION -desde I-EVOLUTION -la I-EVOLUTION -primera I-EVOLUTION -evaluación I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -refirió I-EVOLUTION -estar I-EVOLUTION -satisfecha I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -tratamiento, I-EVOLUTION -resultado I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -sin I-EVOLUTION -la I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -nuevas I-EVOLUTION -aplicaciones I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -medicación I-EVOLUTION -por I-EVOLUTION -6 I-EVOLUTION -meses. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -67 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -linfedema I-PRESENT_ILLNESS -facial I-PRESENT_ILLNESS -inexorable. I-PRESENT_ILLNESS -Dos B-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -carcinoma I-PAST_MEDICAL_HISTORY -epidermoide I-PAST_MEDICAL_HISTORY -supraglótico. I-PAST_MEDICAL_HISTORY -Se B-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -laringectomía I-TREATMENT -supraglótica I-TREATMENT -con I-TREATMENT -vaciamiento I-TREATMENT -cervical I-TREATMENT -bilateral I-TREATMENT -y I-TREATMENT -RT. I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -farmacológico I-TREATMENT -empleado I-TREATMENT -fue I-TREATMENT -amlodipino, I-TREATMENT -manitol, I-TREATMENT -acetazolamida, I-TREATMENT -furosemida I-TREATMENT -y I-TREATMENT -dexametasona. I-TREATMENT -Le B-EVOLUTION -provocó I-EVOLUTION -tensiones I-EVOLUTION -arteriales I-EVOLUTION -inestables I-EVOLUTION -y I-EVOLUTION -fluctuantes, I-EVOLUTION -hiperglucemia I-EVOLUTION -e I-EVOLUTION -hiponatremia I-EVOLUTION -afectando I-EVOLUTION -al I-EVOLUTION -estado I-EVOLUTION -hemodinámico I-EVOLUTION -del I-EVOLUTION -paciente. I-EVOLUTION -Se B-TREATMENT -utilizó I-TREATMENT -también I-TREATMENT -tratamiento I-TREATMENT -rehabilitador, I-TREATMENT -punciones I-TREATMENT -transcutáneas I-TREATMENT -y I-TREATMENT -cámara I-TREATMENT -hiperbárica, I-TREATMENT -pero I-TREATMENT -sin I-TREATMENT -éxito. I-TREATMENT - I-TREATMENT -En B-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -momento I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -nos I-DERIVED_FROM/TO -remiten I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -presenta I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -edema I-DERIVED_FROM/TO -facial I-DERIVED_FROM/TO -masivo, I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -gran I-DERIVED_FROM/TO -fibrosis I-DERIVED_FROM/TO -cervical, I-DERIVED_FROM/TO -traqueotomía, I-DERIVED_FROM/TO -gastrostomía, I-DERIVED_FROM/TO -disnea I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -saturaciones I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -oxígeno I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -85%, I-DERIVED_FROM/TO -edema I-DERIVED_FROM/TO -bipalpebral I-DERIVED_FROM/TO -bilateral I-DERIVED_FROM/TO -sin I-DERIVED_FROM/TO -apertura I-DERIVED_FROM/TO -voluntaria I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -párpados, I-DERIVED_FROM/TO -hipoacusia I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -transmisión, I-DERIVED_FROM/TO -incompetencia I-DERIVED_FROM/TO -labial I-DERIVED_FROM/TO -e I-DERIVED_FROM/TO -imposibilidad I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -deglución. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Se B-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -un I-TREATMENT -colgajo I-TREATMENT -miocutáneo I-TREATMENT -deltopectoral I-TREATMENT -diferido I-TREATMENT -con I-TREATMENT -el I-TREATMENT -objetivo I-TREATMENT -de I-TREATMENT -introducir I-TREATMENT -nuevos I-TREATMENT -vasos I-TREATMENT -linfáticos I-TREATMENT -en I-TREATMENT -la I-TREATMENT -mejilla I-TREATMENT -y I-TREATMENT -mejorar I-TREATMENT -su I-TREATMENT -situación. I-TREATMENT - I-TREATMENT -Un I-TREATMENT -colgajo I-TREATMENT -deltopectoral I-TREATMENT -derecho I-TREATMENT -fue I-TREATMENT -tallado, I-TREATMENT -un I-TREATMENT -área I-TREATMENT -distal I-TREATMENT -de I-TREATMENT -6 I-TREATMENT -× I-TREATMENT -5 I-TREATMENT -cm I-TREATMENT -se I-TREATMENT -desepiteliza I-TREATMENT -y I-TREATMENT -se I-TREATMENT -introduce I-TREATMENT -en I-TREATMENT -un I-TREATMENT -bolsillo I-TREATMENT -subdérmico I-TREATMENT -en I-TREATMENT -la I-TREATMENT -mejilla. I-TREATMENT -Se I-TREATMENT -realiza I-TREATMENT -cierre I-TREATMENT -directo I-TREATMENT -del I-TREATMENT -defecto I-TREATMENT -salvo I-TREATMENT -el I-TREATMENT -extremo I-TREATMENT -distal I-TREATMENT -que I-TREATMENT -se I-TREATMENT -cubre I-TREATMENT -con I-TREATMENT -el I-TREATMENT -tejido I-TREATMENT -desepitelizado I-TREATMENT -como I-TREATMENT -injerto I-TREATMENT -cutáneo I-TREATMENT -libre. I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -72 I-EVOLUTION -h I-EVOLUTION -comenzó I-EVOLUTION -a I-EVOLUTION -oír, I-EVOLUTION -a I-EVOLUTION -ver, I-EVOLUTION -mejoró I-EVOLUTION -la I-EVOLUTION -competencia I-EVOLUTION -labial I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -volumen I-EVOLUTION -facial I-EVOLUTION -había I-EVOLUTION -disminuido. I-EVOLUTION -Una I-EVOLUTION -semana I-EVOLUTION -después I-EVOLUTION -presenta I-EVOLUTION -dificultad I-EVOLUTION -respiratoria I-EVOLUTION -provocada I-EVOLUTION -por I-EVOLUTION -una I-EVOLUTION -atelectasia I-EVOLUTION -basal I-EVOLUTION -derecha I-EVOLUTION -que I-EVOLUTION -empeora I-EVOLUTION -progresivamente. I-EVOLUTION -Se I-EVOLUTION -acompaña I-EVOLUTION -de I-EVOLUTION -fibrilación I-EVOLUTION -auricular, I-EVOLUTION -hiponatremia I-EVOLUTION -e I-EVOLUTION -hiperglucemia. I-EVOLUTION -Finalmente, I-EVOLUTION -fallece I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -31 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION -por I-EVOLUTION -fallo I-EVOLUTION -multiorgánico. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -67 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de B-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -indoeuropeo I-PAST_MEDICAL_HISTORY -que B-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -odontólogo I-DERIVED_FROM/TO -tras I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -hallazgo I-DERIVED_FROM/TO -incidental, I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -realizar I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -ortopantomografía, I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -imágenes I-DERIVED_FROM/TO -intrasinusales I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -radioopacidad I-DERIVED_FROM/TO -metálica. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -solo I-PAST_MEDICAL_HISTORY -destacaba I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -herida I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -arma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -fuego I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -consulta, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -temporal I-PAST_MEDICAL_HISTORY -izquierda. I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ocupación I-PRESENT_ILLNESS -pansinusal I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -marcada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -seno I-PRESENT_ILLNESS -maxilar I-PRESENT_ILLNESS -izquierdo, I-PRESENT_ILLNESS -acompañada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -rinorrea I-PRESENT_ILLNESS -ocasional I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -fosa I-PRESENT_ILLNESS -nasal I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -volvió I-EXPLORATION -a I-EXPLORATION -resultar I-EXPLORATION -anodina, I-EXPLORATION -sin I-EXPLORATION -abombamiento I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -vestibular I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -segundo I-EXPLORATION -cuadrante, I-EXPLORATION -ni I-EXPLORATION -hallazgo I-EXPLORATION -de I-EXPLORATION -fístulas I-EXPLORATION -orosinusales I-EXPLORATION -visibles. I-EXPLORATION - I-EXPLORATION -Las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION -realizadas I-EXPLORATION -(ortopantomografía, I-EXPLORATION -DentaScan I-EXPLORATION -y I-EXPLORATION -TC I-EXPLORATION -facial) I-EXPLORATION -mostraron I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -material I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -intrasinusal I-EXPLORATION -de I-EXPLORATION -radiopacidad I-EXPLORATION -metálica I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -único I-EXPLORATION -nódulo I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -circular I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -superolateral I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -izquierdo, I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -reacción I-EXPLORATION -inflamatoria I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -sinusal. I-EXPLORATION - I-EXPLORATION -Dados B-TREATMENT -los I-TREATMENT -antecedentes I-TREATMENT -de I-TREATMENT -herida I-TREATMENT -por I-TREATMENT -arma I-TREATMENT -de I-TREATMENT -fuego I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -pensó I-TREATMENT -que I-TREATMENT -pudiera I-TREATMENT -tratarse I-TREATMENT -de I-TREATMENT -cuerpos I-TREATMENT -extraños I-TREATMENT -intrasinusales I-TREATMENT -derivados I-TREATMENT -del I-TREATMENT -mismo, I-TREATMENT -así I-TREATMENT -que I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT -Cadwell-Luc I-TREATMENT -y I-TREATMENT -antrostomía I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -intraoral I-TREATMENT -para I-TREATMENT -la I-TREATMENT -extirpación I-TREATMENT -del I-TREATMENT -cuerpo I-TREATMENT -extraño I-TREATMENT -y I-TREATMENT -de I-TREATMENT -la I-TREATMENT -mucosa I-TREATMENT -sinusal I-TREATMENT -afecta, I-TREATMENT -sin I-TREATMENT -identificarse I-TREATMENT -fragmentos I-TREATMENT -metálicos I-TREATMENT -o I-TREATMENT -restos I-TREATMENT -óseos. I-TREATMENT -Se B-EXPLORATION -obtuvo I-EXPLORATION -un I-EXPLORATION -material I-EXPLORATION -blanquecino I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -fibroelástica I-EXPLORATION -similar I-EXPLORATION -al I-EXPLORATION -obtenido I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -caso I-EXPLORATION -presentado I-EXPLORATION -anterior. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -se I-EXPLORATION -informó I-EXPLORATION -como I-EXPLORATION -mucosa I-EXPLORATION -sinusal I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -inflamación I-EXPLORATION -crónica, I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -material I-EXPLORATION -blanquecino I-EXPLORATION -formado I-EXPLORATION -por I-EXPLORATION -hifas I-EXPLORATION -ramificadas I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -bola I-EXPLORATION -fúngica I-EXPLORATION -intrasinusal I-EXPLORATION -causada I-EXPLORATION -por I-EXPLORATION -Aspergillus. I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -microbiológicos I-EXPLORATION -volvieron I-EXPLORATION -a I-EXPLORATION -resultar I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -este I-EVOLUTION -caso I-EVOLUTION -la I-EVOLUTION -mucosa I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -hallaba I-EVOLUTION -infiltrada I-EVOLUTION -a I-EVOLUTION -ningún I-EVOLUTION -nivel, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -h I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION -ni I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -antifúngico I-EVOLUTION -intravenoso. I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -las I-EVOLUTION -revisiones I-EVOLUTION -posteriores I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -refiere I-EVOLUTION -desaparición I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -ausencia I-EVOLUTION -de I-EVOLUTION -complicaciones I-EVOLUTION -en I-EVOLUTION -un I-EVOLUTION -periodo I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -de I-EVOLUTION -8 I-EVOLUTION -años. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -femenina I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -volumen I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -mandibular I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -lado I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -rápido, I-PRESENT_ILLNESS -ligero I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -lesión. I-PRESENT_ILLNESS -Intraoralmente B-EXPLORATION -expansión I-EXPLORATION -de I-EXPLORATION -corticales I-EXPLORATION -óseas I-EXPLORATION -mandibulares I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -molares. I-EXPLORATION -Una I-EXPLORATION -tomografía I-EXPLORATION -tridimensional I-EXPLORATION -confirma I-EXPLORATION -extensa I-EXPLORATION -destrucción I-EXPLORATION -ósea. I-EXPLORATION -Resultado I-EXPLORATION -histopatológico, I-EXPLORATION -osteoblastoma I-EXPLORATION -benigno I-EXPLORATION -mandibular. I-EXPLORATION -Dada B-TREATMENT -la I-TREATMENT -amplia I-TREATMENT -destrucción, I-TREATMENT -y I-TREATMENT -el I-TREATMENT -comportamiento I-TREATMENT -local I-TREATMENT -agresivo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -hemimandibulectomía I-TREATMENT -derecha, I-TREATMENT -y I-TREATMENT -se I-TREATMENT -coloca I-TREATMENT -prótesis I-TREATMENT -de I-TREATMENT -reconstrucción I-TREATMENT -mandibular I-TREATMENT -con I-TREATMENT -cóndilo I-TREATMENT -en I-TREATMENT -el I-TREATMENT -lecho I-TREATMENT -quirúrgico. I-TREATMENT -Control B-EVOLUTION -postoperatorio I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -apertura I-EVOLUTION -bucal, I-EVOLUTION -sin I-EVOLUTION -daño I-EVOLUTION -a I-EVOLUTION -estructuras I-EVOLUTION -nerviosas I-EVOLUTION -de I-EVOLUTION -importancia, I-EVOLUTION -conservando I-EVOLUTION -continuidad I-EVOLUTION -de I-EVOLUTION -nervios I-EVOLUTION -sensitivos I-EVOLUTION -(dentario I-EVOLUTION -inferior), I-EVOLUTION -y I-EVOLUTION -motores. I-EVOLUTION -A B-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT -a I-TREATMENT -los I-TREATMENT -6 I-TREATMENT -meses I-TREATMENT -posteriores I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cirugía I-TREATMENT -inicial, I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -matriz I-TREATMENT -ósea I-TREATMENT -mezclada I-TREATMENT -con I-TREATMENT -aspirado I-TREATMENT -medular I-TREATMENT -en I-TREATMENT -el I-TREATMENT -lecho I-TREATMENT -quirúrgico, I-TREATMENT -observando B-EVOLUTION -al I-EVOLUTION -año I-EVOLUTION -y I-EVOLUTION -medio I-EVOLUTION -posterior I-EVOLUTION -ligera I-EVOLUTION -formación I-EVOLUTION -ósea I-EVOLUTION -conservando I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -fecha I-EVOLUTION -excelente I-EVOLUTION -oclusión I-EVOLUTION -dental I-EVOLUTION -y I-EVOLUTION -apertura I-EVOLUTION -bucal I-EVOLUTION -adecuadas I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -estética I-EVOLUTION -facial I-EVOLUTION -satisfactorias, I-EVOLUTION -adecuada I-EVOLUTION -sensibilidad I-EVOLUTION -y I-EVOLUTION -motricidad, I-EVOLUTION -5 I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -sin I-EVOLUTION -complicaciones. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -trece I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cefalea I-PAST_MEDICAL_HISTORY -progresiva I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -intensidad I-PAST_MEDICAL_HISTORY -y, I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nuestra I-PAST_MEDICAL_HISTORY -institución, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -obstrucción I-PAST_MEDICAL_HISTORY -nasal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -anosmia I-PAST_MEDICAL_HISTORY -derechas. I-PAST_MEDICAL_HISTORY -Durante B-PRESENT_ILLNESS -todo I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -padecimiento I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -proptosis I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -junto I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -diplopia I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mirada I-PRESENT_ILLNESS -extrema. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -reveló I-EXPLORATION -proptosis I-EXPLORATION -derecha, I-EXPLORATION -con I-EXPLORATION -leve I-EXPLORATION -asimetría I-EXPLORATION -facial I-EXPLORATION -por I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -volumen I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -mejilla I-EXPLORATION -ipsilateral. I-EXPLORATION -La I-EXPLORATION -rinoscopía I-EXPLORATION -mostró I-EXPLORATION -abombamiento I-EXPLORATION -septal I-EXPLORATION -con I-EXPLORATION -convexidad I-EXPLORATION -izquierda I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -tumoral I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -área I-EXPLORATION -coanal I-EXPLORATION -derecha. I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION -neurológica I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computada I-EXPLORATION -(TC) I-EXPLORATION -demostró I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -hipodensa, I-EXPLORATION -ovoidea, I-EXPLORATION -ocupando I-EXPLORATION -la I-EXPLORATION -fosa I-EXPLORATION -infratemporal, I-EXPLORATION -seno I-EXPLORATION -esfenoidal, I-EXPLORATION -espacio I-EXPLORATION -parafaríngeo I-EXPLORATION -y I-EXPLORATION -fosa I-EXPLORATION -nasal I-EXPLORATION -derechos, I-EXPLORATION -provocando I-EXPLORATION -compresión I-EXPLORATION -y I-EXPLORATION -desplazamientos I-EXPLORATION -rostral I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -caudal I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -maxilar, I-EXPLORATION -caudal I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -apófisis I-EXPLORATION -pterigoides I-EXPLORATION -y I-EXPLORATION -dorsal I-EXPLORATION -del I-EXPLORATION -piso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -órbita, I-EXPLORATION -contactando I-EXPLORATION -incluso I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -clivus; I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -administración I-EXPLORATION -de I-EXPLORATION -material I-EXPLORATION -de I-EXPLORATION -contraste I-EXPLORATION -mostró I-EXPLORATION -escasa I-EXPLORATION -captación. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(IRM) I-EXPLORATION -se I-EXPLORATION -mostró I-EXPLORATION -hipointensa I-EXPLORATION -en I-EXPLORATION -T1 I-EXPLORATION -e I-EXPLORATION -hiperintensa I-EXPLORATION -en I-EXPLORATION -T2, I-EXPLORATION -realzándose I-EXPLORATION -intensamente I-EXPLORATION -con I-EXPLORATION -gadolinio. I-EXPLORATION -Sus I-EXPLORATION -bordes I-EXPLORATION -aparecían I-EXPLORATION -bien I-EXPLORATION -definidos I-EXPLORATION -y, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -desplazamientos I-EXPLORATION -ya I-EXPLORATION -escritos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -TC, I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -moldeamiento I-EXPLORATION -del I-EXPLORATION -paladar I-EXPLORATION -blando I-EXPLORATION -y I-EXPLORATION -duro I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -septum I-EXPLORATION -nasal. I-EXPLORATION -También I-EXPLORATION -observamos I-EXPLORATION -adelgazamiento I-EXPLORATION -y I-EXPLORATION -deformidad I-EXPLORATION -del I-EXPLORATION -piso I-EXPLORATION -medio, I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -hacía I-EXPLORATION -difícil I-EXPLORATION -determinar I-EXPLORATION -si I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -se I-EXPLORATION -originaba I-EXPLORATION -en I-EXPLORATION -dicha I-EXPLORATION -área, I-EXPLORATION -o I-EXPLORATION -era I-EXPLORATION -una I-EXPLORATION -extensión I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -fosa I-EXPLORATION -infratemporal. I-EXPLORATION -Por I-EXPLORATION -lo I-EXPLORATION -tanto, I-EXPLORATION -los I-EXPLORATION -diagnósticos I-EXPLORATION -probables I-EXPLORATION -fueron I-EXPLORATION -de I-EXPLORATION -neurinoma I-EXPLORATION -y I-EXPLORATION -papiloma I-EXPLORATION -invertido I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -esfenoidal. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -sometida I-TREATMENT -a I-TREATMENT -cirugía I-TREATMENT -mediante I-TREATMENT -incisión I-TREATMENT -sublabial I-TREATMENT -con I-TREATMENT -abordaje I-TREATMENT -intercartilaginoso I-TREATMENT -centrofacial I-TREATMENT -transmaxilar, I-TREATMENT -replegamiento I-TREATMENT -del I-TREATMENT -colgajo I-TREATMENT -miocutáneo I-TREATMENT -y I-TREATMENT -abordaje I-TREATMENT -transmaxilar. I-TREATMENT -Se I-TREATMENT -halló I-TREATMENT -una I-TREATMENT -tumoración I-TREATMENT -de I-TREATMENT -bastante I-TREATMENT -consistencia I-TREATMENT -encapsulada I-TREATMENT -(como I-TREATMENT -tela I-TREATMENT -de I-TREATMENT -hule) I-TREATMENT -de I-TREATMENT -coloración I-TREATMENT -grisácea, I-TREATMENT -escasamente I-TREATMENT -vascularizada I-TREATMENT -que I-TREATMENT -desplazaba I-TREATMENT -estructuras I-TREATMENT -vecinas. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -intracapsular I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión, I-TREATMENT -sin I-TREATMENT -incidentes. I-TREATMENT -El B-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -reveló I-EXPLORATION -schwannoma. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -postoperatorio I-EVOLUTION -cursó I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION -y I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -notable I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -proptosis. I-EVOLUTION -La B-EXPLORATION -TC I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -mostró I-EXPLORATION -exéresis I-EXPLORATION -completa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión. I-EXPLORATION - I-EXPLORATION - -Recien B-PRESENT_ILLNESS -nacido I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -gestación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -parto I-PRESENT_ILLNESS -asistido I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -forceps. I-PRESENT_ILLNESS -Es B-DERIVED_FROM/TO -trasladado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -cefalohematoma I-DERIVED_FROM/TO -parietal I-DERIVED_FROM/TO -izquierdo I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -fractura I-DERIVED_FROM/TO -deprimida I-DERIVED_FROM/TO -parietal I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -hematoma I-DERIVED_FROM/TO -epidural I-DERIVED_FROM/TO -subyacente. I-DERIVED_FROM/TO -La B-EXPLORATION -exploración I-EXPLORATION -neurológica I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -Fue B-TREATMENT -intervenido I-TREATMENT -evacuándose I-TREATMENT -el I-TREATMENT -hematoma I-TREATMENT -y I-TREATMENT -elevándose I-TREATMENT -la I-TREATMENT -fractura I-TREATMENT -deprimida, I-TREATMENT -dejando I-TREATMENT -un I-TREATMENT -drenaje I-TREATMENT -epidural I-TREATMENT -24 I-TREATMENT -horas. I-TREATMENT -Fue B-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -4 I-EVOLUTION -días I-EVOLUTION -y I-EVOLUTION -tras I-EVOLUTION -2 I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -está I-EVOLUTION -asintomático. I-EVOLUTION - I-EVOLUTION - -Niña B-PRESENT_ILLNESS -recién I-PRESENT_ILLNESS -nacida I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -forceps I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -gran I-PRESENT_ILLNESS -fractura I-PRESENT_ILLNESS -deprimida I-PRESENT_ILLNESS -frontal I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -mostrada I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -TAC. I-PRESENT_ILLNESS -Fue B-TREATMENT -intervenida I-TREATMENT -de I-TREATMENT -urgencia I-TREATMENT -elevando I-TREATMENT -la I-TREATMENT -depresión. I-TREATMENT -Se B-EVOLUTION -remitió I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -domicilio I-EVOLUTION -tras I-EVOLUTION -5 I-EVOLUTION -días I-EVOLUTION -postoperatorio; I-EVOLUTION -tras I-EVOLUTION -dos I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -es I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -definitivamente I-EVOLUTION -con I-EVOLUTION -TAC I-EVOLUTION -normal. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -politraumatismo I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -accidente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -competición I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -bicicleta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -montaña. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -evento I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -portador I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -casco I-PRESENT_ILLNESS -integral I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -armilla I-PRESENT_ILLNESS -protectora I-PRESENT_ILLNESS -presentando I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -impacto I-PRESENT_ILLNESS -traumatismo I-PRESENT_ILLNESS -cráneo-encefálico I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conocimiento I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -hiperextensión I-PRESENT_ILLNESS -cervical. I-PRESENT_ILLNESS -A I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -llegada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encuentra I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -GCS I-PRESENT_ILLNESS -13 I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paresia I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -VI I-PRESENT_ILLNESS -par I-PRESENT_ILLNESS -craneal I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS -Se B-EXPLORATION -realiza I-EXPLORATION -TC I-EXPLORATION -craneal I-EXPLORATION -y I-EXPLORATION -cervical I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -lesión I-EXPLORATION -hemorrágica I-EXPLORATION -subdural I-EXPLORATION -retroclival I-EXPLORATION -y I-EXPLORATION -espinal. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -fracturas I-EXPLORATION -de I-EXPLORATION -base I-EXPLORATION -de I-EXPLORATION -cráneo I-EXPLORATION -ni I-EXPLORATION -cervicales. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -TC I-EXPLORATION -toraco-abdominal I-EXPLORATION -que I-EXPLORATION -descarta I-EXPLORATION -otras I-EXPLORATION -lesiones I-EXPLORATION -y I-EXPLORATION -analítica I-EXPLORATION -sanguínea I-EXPLORATION -con I-EXPLORATION -parámetros I-EXPLORATION -de I-EXPLORATION -coagulación I-EXPLORATION -normales. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -mantiene I-EVOLUTION -estable I-EVOLUTION -neurológicamente I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -realizar I-TREATMENT -manejo I-TREATMENT -conservador I-TREATMENT -con I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -collarín I-TREATMENT -rígido. I-TREATMENT -Se B-EXPLORATION -completa I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -con I-EXPLORATION -resonancia I-EXPLORATION -cráneo-cervical I-EXPLORATION -que I-EXPLORATION -descarta I-EXPLORATION -lesiones I-EXPLORATION -de I-EXPLORATION -estructuras I-EXPLORATION -ligamentosas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -unión I-EXPLORATION -cráneo-cervical. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -con I-EVOLUTION -15 I-EVOLUTION -puntos I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -escala I-EVOLUTION -de I-EVOLUTION -Glasgow I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -y I-EVOLUTION -resolución I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paresia I-EVOLUTION -del I-EVOLUTION -VI I-EVOLUTION -par I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -días. I-EVOLUTION -Tras I-EVOLUTION -una I-EVOLUTION -semana I-EVOLUTION -de I-EVOLUTION -evolución I-EVOLUTION -se I-EVOLUTION -comprueba I-EVOLUTION -mediante I-EVOLUTION -TC I-EVOLUTION -cráneo-cervical I-EVOLUTION -reducción I-EVOLUTION -del I-EVOLUTION -hematoma I-EVOLUTION -subdural I-EVOLUTION -y I-EVOLUTION -mediante I-EVOLUTION -radiografías I-EVOLUTION -funcionales I-EVOLUTION -cervicales I-EVOLUTION -la I-EVOLUTION -estabilidad I-EVOLUTION -atlo-axoidea. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presenta I-EVOLUTION -resolución I-EVOLUTION -completa I-EVOLUTION -del I-EVOLUTION -hematoma I-EVOLUTION -subdural I-EVOLUTION -con I-EVOLUTION -íntegra I-EVOLUTION -recuperación I-EVOLUTION -neurológica. I-EVOLUTION - I-EVOLUTION - -A B-PRESENT_ILLNESS -continuación I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad. I-PRESENT_ILLNESS -Vive B-PAST_MEDICAL_HISTORY -solo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Barcelona I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -tiene I-PAST_MEDICAL_HISTORY -pareja. I-PAST_MEDICAL_HISTORY -Trabaja I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -ámbito I-PAST_MEDICAL_HISTORY -militar, I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -implica I-PAST_MEDICAL_HISTORY -disponibilidad I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -viajar I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -países I-PAST_MEDICAL_HISTORY -frecuentemente. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -acudir I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -plantea I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cambio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ubicación I-PAST_MEDICAL_HISTORY -estable I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -puesto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -trabajo. I-PAST_MEDICAL_HISTORY -Su I-PAST_MEDICAL_HISTORY -familia I-PAST_MEDICAL_HISTORY -reside I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -otra I-PAST_MEDICAL_HISTORY -ciudad I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -está I-PAST_MEDICAL_HISTORY -estrechamente I-PAST_MEDICAL_HISTORY -relacionada I-PAST_MEDICAL_HISTORY -también I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -ámbito I-PAST_MEDICAL_HISTORY -militar. I-PAST_MEDICAL_HISTORY -Su I-PAST_MEDICAL_HISTORY -entorno I-PAST_MEDICAL_HISTORY -social I-PAST_MEDICAL_HISTORY -está I-PAST_MEDICAL_HISTORY -muy I-PAST_MEDICAL_HISTORY -vinculado I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcohol I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tiempo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ocio, I-PAST_MEDICAL_HISTORY -así I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -entorno I-PAST_MEDICAL_HISTORY -laboral. I-PAST_MEDICAL_HISTORY -Presenta I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -bajo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -satisfacción I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -personal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -laboral. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -demanda I-PRESENT_ILLNESS -principal I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -centra I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -problema I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -alcoholismo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -bulimia, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -conductas I-PRESENT_ILLNESS -englobadas I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -desorden I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -general. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcohol, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -cliente I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -puede I-PAST_MEDICAL_HISTORY -estar I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -seguidos I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -beber I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -establece I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -línea I-PAST_MEDICAL_HISTORY -base I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -consumiciones I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -bebidas I-PAST_MEDICAL_HISTORY -alcohólicas I-PAST_MEDICAL_HISTORY -diarias, I-PAST_MEDICAL_HISTORY -reflejado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -embriaguez I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -acude I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -primeras I-PAST_MEDICAL_HISTORY -sesiones I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evaluación. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -aumentó I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -coincidiendo I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -período I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -disminución I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -conductas I-PAST_MEDICAL_HISTORY -bulímicas. I-PAST_MEDICAL_HISTORY -Cuando I-PAST_MEDICAL_HISTORY -acude I-PAST_MEDICAL_HISTORY -solo I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -bar I-PAST_MEDICAL_HISTORY -procura I-PAST_MEDICAL_HISTORY -ir I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -lugares I-PAST_MEDICAL_HISTORY -diferentes I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -vean I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -amigos. I-PAST_MEDICAL_HISTORY -Si I-PAST_MEDICAL_HISTORY -bebe I-PAST_MEDICAL_HISTORY -acompañado, I-PAST_MEDICAL_HISTORY -normalmente I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -compañeros I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -trabajo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -amiga I-PAST_MEDICAL_HISTORY -suya, I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -también I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -otras I-PAST_MEDICAL_HISTORY -situaciones I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ocio. I-PAST_MEDICAL_HISTORY -El B-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -consumo I-EXPLORATION -encajaría I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -trastorno I-EXPLORATION -por I-EXPLORATION -consumo I-EXPLORATION -de I-EXPLORATION -alcohol I-EXPLORATION -definido I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -DSM-5 I-EXPLORATION -(APA, I-EXPLORATION -2014) I-EXPLORATION -como I-EXPLORATION -“un I-EXPLORATION -patrón I-EXPLORATION -problemático I-EXPLORATION -de I-EXPLORATION -consumo I-EXPLORATION -de I-EXPLORATION -alcohol I-EXPLORATION -que I-EXPLORATION -provoca I-EXPLORATION -un I-EXPLORATION -deterioro I-EXPLORATION -o I-EXPLORATION -malestar I-EXPLORATION -clínicamente I-EXPLORATION -significativo”. I-EXPLORATION -Incluye I-EXPLORATION -una I-EXPLORATION -serie I-EXPLORATION -de I-EXPLORATION -criterios I-EXPLORATION -para I-EXPLORATION -diagnosticar, I-EXPLORATION -teniendo I-EXPLORATION -que I-EXPLORATION -cumplirse I-EXPLORATION -al I-EXPLORATION -menos I-EXPLORATION -dos I-EXPLORATION -de I-EXPLORATION -ellos I-EXPLORATION -durante I-EXPLORATION -un I-EXPLORATION -mínimo I-EXPLORATION -de I-EXPLORATION -12 I-EXPLORATION -meses. I-EXPLORATION -El I-EXPLORATION -cliente I-EXPLORATION -cumple I-EXPLORATION -la I-EXPLORATION -mayoría I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -criterios, I-EXPLORATION -incluido I-EXPLORATION -el I-EXPLORATION -criterio I-EXPLORATION -temporal. I-EXPLORATION - I-EXPLORATION -Por B-PAST_MEDICAL_HISTORY -otro I-PAST_MEDICAL_HISTORY -lado, I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -conductas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -bulimia I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -inician I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -tiene I-PAST_MEDICAL_HISTORY -19 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -reducen I-PAST_MEDICAL_HISTORY -considerablemente I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -período I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -vuelto I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -purgarse I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -darse I-PAST_MEDICAL_HISTORY -atracones I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -frecuencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -veces I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -semana, I-PAST_MEDICAL_HISTORY -todo I-PAST_MEDICAL_HISTORY -ello I-PAST_MEDICAL_HISTORY -elicitado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -verbalizaciones I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -fracaso I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -“me I-PAST_MEDICAL_HISTORY -he I-PAST_MEDICAL_HISTORY -pasado”, I-PAST_MEDICAL_HISTORY -“me I-PAST_MEDICAL_HISTORY -he I-PAST_MEDICAL_HISTORY -descontrolado”. I-PAST_MEDICAL_HISTORY -El B-EXPLORATION -trastorno I-EXPLORATION -de I-EXPLORATION -bulimia I-EXPLORATION -nerviosa I-EXPLORATION -se I-EXPLORATION -caracteriza I-EXPLORATION -por I-EXPLORATION -episodios I-EXPLORATION -recurrentes I-EXPLORATION -de I-EXPLORATION -atracones I-EXPLORATION -acompañado I-EXPLORATION -de I-EXPLORATION -conductas I-EXPLORATION -compensatorias I-EXPLORATION -inadecuadas, I-EXPLORATION -como I-EXPLORATION -vómito I-EXPLORATION -autoprovocado I-EXPLORATION -o I-EXPLORATION -uso I-EXPLORATION -de I-EXPLORATION -laxantes I-EXPLORATION -(DSM-5; I-EXPLORATION -APA, I-EXPLORATION -2014). I-EXPLORATION -La I-EXPLORATION -gravedad I-EXPLORATION -del I-EXPLORATION -trastorno I-EXPLORATION -se I-EXPLORATION -diagnostica I-EXPLORATION -con I-EXPLORATION -base I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -frecuencia I-EXPLORATION -de I-EXPLORATION -esas I-EXPLORATION -conductas I-EXPLORATION -compensatorias, I-EXPLORATION -pudiendo I-EXPLORATION -ser I-EXPLORATION -de I-EXPLORATION -grado I-EXPLORATION -leve, I-EXPLORATION -medio I-EXPLORATION -o I-EXPLORATION -grave. I-EXPLORATION -En I-EXPLORATION -este I-EXPLORATION -caso, I-EXPLORATION -el I-EXPLORATION -cliente I-EXPLORATION -cumpliría I-EXPLORATION -criterios I-EXPLORATION -para I-EXPLORATION -ser I-EXPLORATION -diagnosticado I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -grado I-EXPLORATION -leve I-EXPLORATION -de I-EXPLORATION -bulimia I-EXPLORATION -nerviosa. I-EXPLORATION - I-EXPLORATION -Evaluación I-EXPLORATION - I-EXPLORATION -Para I-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION -se I-EXPLORATION -ha I-EXPLORATION -empleado I-EXPLORATION -la I-EXPLORATION -entrevista I-EXPLORATION -no I-EXPLORATION -estructurada, I-EXPLORATION -complementada I-EXPLORATION -con I-EXPLORATION -autorregistros. I-EXPLORATION -Esta I-EXPLORATION -fase I-EXPLORATION -se I-EXPLORATION -extiende, I-EXPLORATION -de I-EXPLORATION -manera I-EXPLORATION -formal, I-EXPLORATION -durante I-EXPLORATION -las I-EXPLORATION -tres I-EXPLORATION -primeras I-EXPLORATION -sesiones. I-EXPLORATION -Una I-EXPLORATION -vez I-EXPLORATION -realizada I-EXPLORATION -la I-EXPLORATION -evaluación, I-EXPLORATION -se I-EXPLORATION -establece I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -de I-EXPLORATION -trabajo I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -objetivo I-EXPLORATION -central, I-EXPLORATION -que I-EXPLORATION -será I-EXPLORATION -fundamental I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -cumplimiento I-EXPLORATION -de I-EXPLORATION -otros I-EXPLORATION -objetivos: I-EXPLORATION -incrementar I-EXPLORATION -autocontrol. I-EXPLORATION -La B-TREATMENT -periodicidad I-TREATMENT -de I-TREATMENT -las I-TREATMENT -sesiones I-TREATMENT -comienza I-TREATMENT -siendo I-TREATMENT -semanal, I-TREATMENT -pero I-TREATMENT -según I-TREATMENT -avanza I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -espacia I-TREATMENT -a I-TREATMENT -quincenal I-TREATMENT -hasta I-TREATMENT -finalizar I-TREATMENT -con I-TREATMENT -un I-TREATMENT -seguimiento I-TREATMENT -mensual I-TREATMENT -a I-TREATMENT -partir I-TREATMENT -de I-TREATMENT -la I-TREATMENT -octava I-TREATMENT -sesión. I-TREATMENT -Este I-TREATMENT -espaciamiento I-TREATMENT -es I-TREATMENT -importante I-TREATMENT -de I-TREATMENT -cara I-TREATMENT -al I-TREATMENT -análisis I-TREATMENT -de I-TREATMENT -los I-TREATMENT -resultados I-TREATMENT -conseguidos I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -intervención. I-TREATMENT - I-TREATMENT -Como I-TREATMENT -el I-TREATMENT -cliente I-TREATMENT -no I-TREATMENT -presenta I-TREATMENT -problemas I-TREATMENT -de I-TREATMENT -salud, I-TREATMENT -el I-TREATMENT -objetivo I-TREATMENT -en I-TREATMENT -relación I-TREATMENT -al I-TREATMENT -patrón I-TREATMENT -de I-TREATMENT -bebida I-TREATMENT -es I-TREATMENT -modificar I-TREATMENT -las I-TREATMENT -situaciones I-TREATMENT -de I-TREATMENT -consumo I-TREATMENT -en I-TREATMENT -lugar I-TREATMENT -de I-TREATMENT -plantear I-TREATMENT -una I-TREATMENT -reducción I-TREATMENT -del I-TREATMENT -mismo, I-TREATMENT -aunque I-TREATMENT -sí I-TREATMENT -se I-TREATMENT -consigue I-TREATMENT -esa I-TREATMENT -reducción I-TREATMENT -como I-TREATMENT -consecuencia I-TREATMENT -del I-TREATMENT -trabajo I-TREATMENT -realizado. I-TREATMENT -Dado I-TREATMENT -que I-TREATMENT -es I-TREATMENT -una I-TREATMENT -conducta I-TREATMENT -reforzada I-TREATMENT -en I-TREATMENT -su I-TREATMENT -ambiente, I-TREATMENT -sería I-TREATMENT -inadecuado I-TREATMENT -dirigir I-TREATMENT -el I-TREATMENT -objetivo I-TREATMENT -a I-TREATMENT -la I-TREATMENT -abstinencia, I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -pretende I-TREATMENT -es I-TREATMENT -eliminar I-TREATMENT -el I-TREATMENT -patrón I-TREATMENT -de I-TREATMENT -consumo I-TREATMENT -problemático, I-TREATMENT -sustituyéndolo I-TREATMENT -por I-TREATMENT -uno I-TREATMENT -más I-TREATMENT -controlado I-TREATMENT -que I-TREATMENT -no I-TREATMENT -genere I-TREATMENT -malestar. I-TREATMENT -De I-TREATMENT -este I-TREATMENT -modo I-TREATMENT -el I-TREATMENT -cliente I-TREATMENT -puede I-TREATMENT -conseguir I-TREATMENT -un I-TREATMENT -consumo I-TREATMENT -fuera I-TREATMENT -de I-TREATMENT -los I-TREATMENT -parámetros I-TREATMENT -problemáticos I-TREATMENT -así I-TREATMENT -como I-TREATMENT -mantener I-TREATMENT -el I-TREATMENT -acceso I-TREATMENT -a I-TREATMENT -sus I-TREATMENT -reforzadores I-TREATMENT -sociales I-TREATMENT -relacionados I-TREATMENT -con I-TREATMENT -el I-TREATMENT -consumo I-TREATMENT -de I-TREATMENT -alcohol. I-TREATMENT -Es I-TREATMENT -por I-TREATMENT -ello I-TREATMENT -que I-TREATMENT -la I-TREATMENT -terapia I-TREATMENT -se I-TREATMENT -orienta I-TREATMENT -a I-TREATMENT -facilitar I-TREATMENT -la I-TREATMENT -discriminación I-TREATMENT -de I-TREATMENT -cuándo I-TREATMENT -es I-TREATMENT -adecuado I-TREATMENT -beber I-TREATMENT -y I-TREATMENT -cuándo I-TREATMENT -no. I-TREATMENT - I-TREATMENT -Análisis B-PAST_MEDICAL_HISTORY -funcional I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -continuación I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -expone I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -análisis I-PAST_MEDICAL_HISTORY -funcional I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -caso I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -base I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -modelo I-PAST_MEDICAL_HISTORY -propuesto I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -Segura, I-PAST_MEDICAL_HISTORY -Sánchez I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -Barbado I-PAST_MEDICAL_HISTORY -(1991). I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Variables I-PAST_MEDICAL_HISTORY -disposicionales I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Dentro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -aprendizaje I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -elevado I-PAST_MEDICAL_HISTORY -cumplimiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -normas, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -muy I-PAST_MEDICAL_HISTORY -reforzado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -ámbito I-PAST_MEDICAL_HISTORY -familiar I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -laboral, I-PAST_MEDICAL_HISTORY -dadas I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -exigencias I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -demandan I-PAST_MEDICAL_HISTORY -ambos I-PAST_MEDICAL_HISTORY -contextos I-PAST_MEDICAL_HISTORY -relacionados I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -militar. I-PAST_MEDICAL_HISTORY -Esto I-PAST_MEDICAL_HISTORY -significa I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -conducta, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -mayor I-PAST_MEDICAL_HISTORY -medida, I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY -gobernada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -discriminativos I-PAST_MEDICAL_HISTORY -externos. I-PAST_MEDICAL_HISTORY -Todo I-PAST_MEDICAL_HISTORY -ello, I-PAST_MEDICAL_HISTORY -sumado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -ausencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -discriminativos I-PAST_MEDICAL_HISTORY -internos, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -prácticamente I-PAST_MEDICAL_HISTORY -inexistente I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -elementos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -(como I-PAST_MEDICAL_HISTORY -vivir I-PAST_MEDICAL_HISTORY -solo, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -tener I-PAST_MEDICAL_HISTORY -pareja, I-PAST_MEDICAL_HISTORY -viajar I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -frecuencia) I-PAST_MEDICAL_HISTORY -fuera I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ámbito I-PAST_MEDICAL_HISTORY -laboral, I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -precipitado I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -ausencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -aprendizaje I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -conductas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -autocontrol. I-PAST_MEDICAL_HISTORY -Cierto I-PAST_MEDICAL_HISTORY -condicionamiento I-PAST_MEDICAL_HISTORY -aversivo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -falta I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fracaso I-PAST_MEDICAL_HISTORY -precipita I-PAST_MEDICAL_HISTORY -también I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -ingesta I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcohol I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -atracones. I-PAST_MEDICAL_HISTORY -Por I-PAST_MEDICAL_HISTORY -otra I-PAST_MEDICAL_HISTORY -parte, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -ausencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -consecuencias I-PAST_MEDICAL_HISTORY -aversivas I-PAST_MEDICAL_HISTORY -ante I-PAST_MEDICAL_HISTORY -conductas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -descontrol I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -ámbito I-PAST_MEDICAL_HISTORY -personal I-PAST_MEDICAL_HISTORY -también I-PAST_MEDICAL_HISTORY -contribuye I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -continua I-PAST_MEDICAL_HISTORY -emisión I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ese I-PAST_MEDICAL_HISTORY -patrón I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -respuesta. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -baja I-PAST_MEDICAL_HISTORY -tasa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -reforzadores I-PAST_MEDICAL_HISTORY -precipita I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -cliente I-PAST_MEDICAL_HISTORY -presente I-PAST_MEDICAL_HISTORY -bajo I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ánimo I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -incrementa I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -valor I-PAST_MEDICAL_HISTORY -reforzante I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -conducta I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -beber, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -alcohol I-PAST_MEDICAL_HISTORY -uno I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -pocos I-PAST_MEDICAL_HISTORY -reforzadores I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -tiene I-PAST_MEDICAL_HISTORY -fácil I-PAST_MEDICAL_HISTORY -acceso, I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -afecta I-PAST_MEDICAL_HISTORY -directamente I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -mantenimiento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -problema. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Un I-PAST_MEDICAL_HISTORY -entorno I-PAST_MEDICAL_HISTORY -laboral I-PAST_MEDICAL_HISTORY -percibido I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -poco I-PAST_MEDICAL_HISTORY -demandante I-PAST_MEDICAL_HISTORY -facilita I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcohol, I-PAST_MEDICAL_HISTORY -dado I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -existen I-PAST_MEDICAL_HISTORY -consecuencias I-PAST_MEDICAL_HISTORY -aversivas I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -entorpezcan I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -labor I-PAST_MEDICAL_HISTORY -profesional. I-PAST_MEDICAL_HISTORY -Otro I-PAST_MEDICAL_HISTORY -factor I-PAST_MEDICAL_HISTORY -añadido I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -relaciones I-PAST_MEDICAL_HISTORY -sociales I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -producen I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -trabajo I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -desarrollan I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -mayoría I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -torno I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -bebida I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -comida. I-PAST_MEDICAL_HISTORY -Todo I-PAST_MEDICAL_HISTORY -ello I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -facilitado I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -asocie I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -ocio I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tiempo I-PAST_MEDICAL_HISTORY -libre I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcohol, I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -precipita I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -beba I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -solitario I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -tiene I-PAST_MEDICAL_HISTORY -tiempo I-PAST_MEDICAL_HISTORY -libre. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Variables B-EXPLORATION -funcionales: I-EXPLORATION -atracones I-EXPLORATION -y I-EXPLORATION -vómitos I-EXPLORATION - I-EXPLORATION -Hipótesis I-EXPLORATION -de I-EXPLORATION -adquisición: I-EXPLORATION -se I-EXPLORATION -parte I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -asociación I-EXPLORATION -pavloviana I-EXPLORATION -previa I-EXPLORATION -entre I-EXPLORATION -ingesta I-EXPLORATION -de I-EXPLORATION -comida I-EXPLORATION -calórica I-EXPLORATION -y I-EXPLORATION -respuestas I-EXPLORATION -de I-EXPLORATION -malestar. I-EXPLORATION -El I-EXPLORATION -ingerir I-EXPLORATION -comida I-EXPLORATION -calórica, I-EXPLORATION -por I-EXPLORATION -poca I-EXPLORATION -que I-EXPLORATION -sea, I-EXPLORATION -elicita I-EXPLORATION -verbalizaciones I-EXPLORATION -de I-EXPLORATION -fracaso I-EXPLORATION -y I-EXPLORATION -culpa I-EXPLORATION -(“me I-EXPLORATION -he I-EXPLORATION -pasado”). I-EXPLORATION -Se I-EXPLORATION -hipotetiza I-EXPLORATION -que I-EXPLORATION -esta I-EXPLORATION -asociación I-EXPLORATION -aversiva I-EXPLORATION -lleva I-EXPLORATION -a I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -cliente I-EXPLORATION -se I-EXPLORATION -mantenga I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -estado I-EXPLORATION -de I-EXPLORATION -privación I-EXPLORATION -respecto I-EXPLORATION -a I-EXPLORATION -esos I-EXPLORATION -alimentos: I-EXPLORATION -evita I-EXPLORATION -ingerirlos. I-EXPLORATION -Esa I-EXPLORATION -asociación I-EXPLORATION -también I-EXPLORATION -lleva I-EXPLORATION -a I-EXPLORATION -sentimientos I-EXPLORATION -de I-EXPLORATION -culpa I-EXPLORATION -cuando I-EXPLORATION -ingiere I-EXPLORATION -esos I-EXPLORATION -alimentos, I-EXPLORATION -discriminada I-EXPLORATION -tal I-EXPLORATION -conducta I-EXPLORATION -por I-EXPLORATION -aburrimiento. I-EXPLORATION - I-EXPLORATION -Hipótesis I-EXPLORATION -de I-EXPLORATION -mantenimiento: I-EXPLORATION -el I-EXPLORATION -estado I-EXPLORATION -de I-EXPLORATION -privación I-EXPLORATION -del I-EXPLORATION -cliente I-EXPLORATION -aumenta I-EXPLORATION -el I-EXPLORATION -valor I-EXPLORATION -reforzante I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -comida I-EXPLORATION -calórica. I-EXPLORATION -Una I-EXPLORATION -vez I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -ha I-EXPLORATION -producido I-EXPLORATION -la I-EXPLORATION -ingesta, I-EXPLORATION -la I-EXPLORATION -culpa I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -malestar I-EXPLORATION -finalmente I-EXPLORATION -elicitan I-EXPLORATION -verbalizaciones I-EXPLORATION -de I-EXPLORATION -permiso I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -anticipación I-EXPLORATION -del I-EXPLORATION -vómito, I-EXPLORATION -que I-EXPLORATION -discriminan I-EXPLORATION -la I-EXPLORATION -conducta I-EXPLORATION -de I-EXPLORATION -atracón, I-EXPLORATION -manteniéndose I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -valor I-EXPLORATION -reforzante I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -comida, I-EXPLORATION -aumentado I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -efecto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -privación. I-EXPLORATION -Esto I-EXPLORATION -lleva I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -serie I-EXPLORATION -de I-EXPLORATION -sensaciones I-EXPLORATION -desagradables, I-EXPLORATION -condicionadas I-EXPLORATION -e I-EXPLORATION -incondicionadas, I-EXPLORATION -que I-EXPLORATION -discriminan I-EXPLORATION -el I-EXPLORATION -vómito I-EXPLORATION -para I-EXPLORATION -reducir I-EXPLORATION -el I-EXPLORATION -malestar I-EXPLORATION -generado I-EXPLORATION -por I-EXPLORATION -las I-EXPLORATION -mismas. I-EXPLORATION - I-EXPLORATION -Variables I-EXPLORATION -funcionales: I-EXPLORATION -ingesta I-EXPLORATION -de I-EXPLORATION -alcohol I-EXPLORATION - I-EXPLORATION -Hipótesis I-EXPLORATION -de I-EXPLORATION -adquisición: I-EXPLORATION -el I-EXPLORATION -cliente I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -consumo I-EXPLORATION -de I-EXPLORATION -alcohol I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -parámetros I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad, I-EXPLORATION -relacionado I-EXPLORATION -con I-EXPLORATION -situaciones I-EXPLORATION -sociales I-EXPLORATION -de I-EXPLORATION -ocio. I-EXPLORATION -El I-EXPLORATION -mantenimiento I-EXPLORATION -de I-EXPLORATION -este I-EXPLORATION -tipo I-EXPLORATION -de I-EXPLORATION -ocio I-EXPLORATION -puede I-EXPLORATION -llevar I-EXPLORATION -a I-EXPLORATION -percibir I-EXPLORATION -el I-EXPLORATION -alcohol I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -vía I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -obtención I-EXPLORATION -de I-EXPLORATION -refuerzo I-EXPLORATION -social, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -reforzadores I-EXPLORATION -propios I-EXPLORATION -del I-EXPLORATION -alcohol I-EXPLORATION -(sabor, I-EXPLORATION -efectos). I-EXPLORATION -El I-EXPLORATION -consumo I-EXPLORATION -empezó I-EXPLORATION -a I-EXPLORATION -aumentar I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -etapa I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -desaparecieron I-EXPLORATION -los I-EXPLORATION -atracones. I-EXPLORATION -El I-EXPLORATION -beber I-EXPLORATION -se I-EXPLORATION -convirtió I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -sustituto I-EXPLORATION -del I-EXPLORATION -comer, I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -consecuentes I-EXPLORATION -refuerzos I-EXPLORATION -negativos I-EXPLORATION -de I-EXPLORATION -sentirse I-EXPLORATION -lleno I-EXPLORATION -sin I-EXPLORATION -comer. I-EXPLORATION -El I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -consumo I-EXPLORATION -comenzó I-EXPLORATION -primero I-EXPLORATION -en I-EXPLORATION -casa, I-EXPLORATION -pasando I-EXPLORATION -posteriormente I-EXPLORATION -a I-EXPLORATION -beber I-EXPLORATION -en I-EXPLORATION -solitario I-EXPLORATION -en I-EXPLORATION -bares I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -obtención I-EXPLORATION -del I-EXPLORATION -refuerzo I-EXPLORATION -social I-EXPLORATION -y I-EXPLORATION -por I-EXPLORATION -pasar I-EXPLORATION -menos I-EXPLORATION -tiempo I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -vivienda. I-EXPLORATION -Cabe I-EXPLORATION -mencionar I-EXPLORATION -la I-EXPLORATION -influencia I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -consumo I-EXPLORATION -de I-EXPLORATION -algunas I-EXPLORATION -variables I-EXPLORATION -disposicionales. I-EXPLORATION -Por I-EXPLORATION -ejemplo, I-EXPLORATION -cierto I-EXPLORATION -déficit I-EXPLORATION -de I-EXPLORATION -reforzadores I-EXPLORATION -podría I-EXPLORATION -precipitar I-EXPLORATION -un I-EXPLORATION -mayor I-EXPLORATION -consumo I-EXPLORATION -de I-EXPLORATION -alcohol I-EXPLORATION -porque I-EXPLORATION -llevaría I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -obtención I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -mismos I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -menor I-EXPLORATION -coste. I-EXPLORATION - I-EXPLORATION -Hipótesis I-EXPLORATION -de I-EXPLORATION -mantenimiento: I-EXPLORATION -las I-EXPLORATION -variables I-EXPLORATION -disposicionales I-EXPLORATION -anteriormente I-EXPLORATION -citadas I-EXPLORATION -también I-EXPLORATION -estarían I-EXPLORATION -ejerciendo I-EXPLORATION -cierta I-EXPLORATION -influencia I-EXPLORATION -sobre I-EXPLORATION -el I-EXPLORATION -mantenimiento I-EXPLORATION -del I-EXPLORATION -problema. I-EXPLORATION -Cuando I-EXPLORATION -bebe I-EXPLORATION -acompañado I-EXPLORATION -suele I-EXPLORATION -ser I-EXPLORATION -en I-EXPLORATION -situaciones I-EXPLORATION -de I-EXPLORATION -ocio I-EXPLORATION -y I-EXPLORATION -tiempo I-EXPLORATION -libre I-EXPLORATION -asociadas I-EXPLORATION -al I-EXPLORATION -consumo. I-EXPLORATION -En I-EXPLORATION -cambio, I-EXPLORATION -cuando I-EXPLORATION -bebe I-EXPLORATION -en I-EXPLORATION -solitario I-EXPLORATION -lo I-EXPLORATION -hace I-EXPLORATION -por I-EXPLORATION -escapar I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -situación I-EXPLORATION -de I-EXPLORATION -aburrimiento. I-EXPLORATION -El I-EXPLORATION -consumo I-EXPLORATION -también I-EXPLORATION -está I-EXPLORATION -discriminado I-EXPLORATION -por I-EXPLORATION -determinadas I-EXPLORATION -situaciones I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -han I-EXPLORATION -establecido I-EXPLORATION -como I-EXPLORATION -rutinarias. I-EXPLORATION -Hay I-EXPLORATION -una I-EXPLORATION -serie I-EXPLORATION -de I-EXPLORATION -estímulos I-EXPLORATION -que I-EXPLORATION -discriminan I-EXPLORATION -conductas I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -del I-EXPLORATION -consumo I-EXPLORATION -de I-EXPLORATION -alcohol: I-EXPLORATION -comer I-EXPLORATION -sano I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -trabajo, I-EXPLORATION -ir I-EXPLORATION -al I-EXPLORATION -gimnasio, I-EXPLORATION -tener I-EXPLORATION -pareja, I-EXPLORATION -realizar I-EXPLORATION -tareas I-EXPLORATION -del I-EXPLORATION -hogar I-EXPLORATION -nada I-EXPLORATION -más I-EXPLORATION -llegar. I-EXPLORATION -Serán I-EXPLORATION -muy I-EXPLORATION -importantes I-EXPLORATION -de I-EXPLORATION -cara I-EXPLORATION -al I-EXPLORATION -inicio I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -intervención. I-EXPLORATION - I-EXPLORATION -Tratamiento B-TREATMENT - I-TREATMENT -Con I-TREATMENT -base I-TREATMENT -en I-TREATMENT -el I-TREATMENT -análisis I-TREATMENT -funcional I-TREATMENT -plasmado I-TREATMENT -anteriormente, I-TREATMENT -se I-TREATMENT -plantean I-TREATMENT -una I-TREATMENT -serie I-TREATMENT -de I-TREATMENT -objetivos I-TREATMENT -de I-TREATMENT -tratamiento: I-TREATMENT - I-TREATMENT -Fomentar I-TREATMENT -un I-TREATMENT -estilo I-TREATMENT -de I-TREATMENT -vida I-TREATMENT -más I-TREATMENT -organizado. I-TREATMENT -Se I-TREATMENT -centra I-TREATMENT -en I-TREATMENT -lograr I-TREATMENT -que I-TREATMENT -el I-TREATMENT -cliente I-TREATMENT -sea I-TREATMENT -capaz I-TREATMENT -de I-TREATMENT -seguir I-TREATMENT -unos I-TREATMENT -horarios I-TREATMENT -estables I-TREATMENT -entre I-TREATMENT -semana, I-TREATMENT -llegando I-TREATMENT -puntual I-TREATMENT -al I-TREATMENT -trabajo I-TREATMENT -y I-TREATMENT -acudiendo I-TREATMENT -al I-TREATMENT -gimnasio, I-TREATMENT -entre I-TREATMENT -otras I-TREATMENT -actividades I-TREATMENT -o I-TREATMENT -tareas. I-TREATMENT -También I-TREATMENT -se I-TREATMENT -busca I-TREATMENT -que I-TREATMENT -el I-TREATMENT -cliente I-TREATMENT -tenga I-TREATMENT -un I-TREATMENT -patrón I-TREATMENT -de I-TREATMENT -comidas I-TREATMENT -más I-TREATMENT -ordenado I-TREATMENT -y I-TREATMENT -planificado, I-TREATMENT -así I-TREATMENT -como I-TREATMENT -más I-TREATMENT -saludable. I-TREATMENT -Este I-TREATMENT -objetivo I-TREATMENT -tiene I-TREATMENT -gran I-TREATMENT -relevancia I-TREATMENT -en I-TREATMENT -el I-TREATMENT -caso, I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -se I-TREATMENT -parte I-TREATMENT -de I-TREATMENT -que I-TREATMENT -el I-TREATMENT -descontrol I-TREATMENT -y I-TREATMENT -la I-TREATMENT -desorganización I-TREATMENT -general I-TREATMENT -han I-TREATMENT -precipitado I-TREATMENT -otras I-TREATMENT -conductas I-TREATMENT -problemáticas. I-TREATMENT - I-TREATMENT -Disminuir I-TREATMENT -el I-TREATMENT -consumo I-TREATMENT -de I-TREATMENT -alcohol I-TREATMENT -y I-TREATMENT -aumentar I-TREATMENT -la I-TREATMENT -capacidad I-TREATMENT -de I-TREATMENT -control I-TREATMENT -sobre I-TREATMENT -el I-TREATMENT -mismo. I-TREATMENT -La I-TREATMENT -disminución I-TREATMENT -del I-TREATMENT -consumo I-TREATMENT -se I-TREATMENT -orienta I-TREATMENT -a I-TREATMENT -la I-TREATMENT -frecuencia I-TREATMENT -y I-TREATMENT -las I-TREATMENT -situaciones I-TREATMENT -en I-TREATMENT -las I-TREATMENT -que I-TREATMENT -se I-TREATMENT -produce. I-TREATMENT -De I-TREATMENT -esta I-TREATMENT -manera, I-TREATMENT -se I-TREATMENT -cambia I-TREATMENT -de I-TREATMENT -un I-TREATMENT -patrón I-TREATMENT -de I-TREATMENT -consumo I-TREATMENT -desajustado I-TREATMENT -a I-TREATMENT -uno I-TREATMENT -más I-TREATMENT -normalizado, I-TREATMENT -pudiendo I-TREATMENT -beber I-TREATMENT -en I-TREATMENT -situaciones I-TREATMENT -sociales I-TREATMENT -o I-TREATMENT -de I-TREATMENT -ocio I-TREATMENT -en I-TREATMENT -las I-TREATMENT -que I-TREATMENT -sea I-TREATMENT -oportuno. I-TREATMENT -La I-TREATMENT -parte I-TREATMENT -más I-TREATMENT -importante I-TREATMENT -es I-TREATMENT -el I-TREATMENT -control I-TREATMENT -sobre I-TREATMENT -el I-TREATMENT -consumo, I-TREATMENT -entendiendo I-TREATMENT -como I-TREATMENT -tal I-TREATMENT -que I-TREATMENT -el I-TREATMENT -cliente I-TREATMENT -pueda I-TREATMENT -decidir I-TREATMENT -beber I-TREATMENT -o I-TREATMENT -no I-TREATMENT -y I-TREATMENT -ser I-TREATMENT -congruente I-TREATMENT -con I-TREATMENT -esa I-TREATMENT -decisión. I-TREATMENT - I-TREATMENT -Eliminar I-TREATMENT -atracones I-TREATMENT -y I-TREATMENT -vómitos. I-TREATMENT -Se I-TREATMENT -centra I-TREATMENT -en I-TREATMENT -la I-TREATMENT -eliminación I-TREATMENT -de I-TREATMENT -las I-TREATMENT -conductas I-TREATMENT -de I-TREATMENT -atracones I-TREATMENT -así I-TREATMENT -como I-TREATMENT -de I-TREATMENT -las I-TREATMENT -purgas I-TREATMENT -subsiguientes. I-TREATMENT -También I-TREATMENT -incluye I-TREATMENT -la I-TREATMENT -introducción I-TREATMENT -de I-TREATMENT -una I-TREATMENT -mayor I-TREATMENT -variedad I-TREATMENT -de I-TREATMENT -alimentos I-TREATMENT -en I-TREATMENT -la I-TREATMENT -dieta. I-TREATMENT - I-TREATMENT -Aumentar I-TREATMENT -las I-TREATMENT -fuentes I-TREATMENT -de I-TREATMENT -reforzadores. I-TREATMENT -Este I-TREATMENT -objetivo I-TREATMENT -resulta I-TREATMENT -central I-TREATMENT -en I-TREATMENT -el I-TREATMENT -caso, I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -el I-TREATMENT -déficit I-TREATMENT -en I-TREATMENT -esta I-TREATMENT -área I-TREATMENT -ha I-TREATMENT -podido I-TREATMENT -influir I-TREATMENT -en I-TREATMENT -el I-TREATMENT -aumento I-TREATMENT -del I-TREATMENT -consumo. I-TREATMENT -Se I-TREATMENT -divide I-TREATMENT -en I-TREATMENT -tres I-TREATMENT -subobjetivos: I-TREATMENT -llevar I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -actividades I-TREATMENT -gratificantes I-TREATMENT -en I-TREATMENT -solitario, I-TREATMENT -realizar I-TREATMENT -actividades I-TREATMENT -sociales I-TREATMENT -y I-TREATMENT -de I-TREATMENT -ocio I-TREATMENT -no I-TREATMENT -relacionadas I-TREATMENT -con I-TREATMENT -el I-TREATMENT -alcohol I-TREATMENT -y, I-TREATMENT -por I-TREATMENT -último, I-TREATMENT -buscar I-TREATMENT -pareja. I-TREATMENT - I-TREATMENT -Para I-TREATMENT -lograr I-TREATMENT -estos I-TREATMENT -objetivos, I-TREATMENT -se I-TREATMENT -desarrollan I-TREATMENT -y I-TREATMENT -se I-TREATMENT -ponen I-TREATMENT -en I-TREATMENT -marcha I-TREATMENT -una I-TREATMENT -serie I-TREATMENT -de I-TREATMENT -técnicas I-TREATMENT -de I-TREATMENT -intervención, I-TREATMENT -tanto I-TREATMENT -dentro I-TREATMENT -de I-TREATMENT -sesión I-TREATMENT -como I-TREATMENT -fuera, I-TREATMENT -en I-TREATMENT -este I-TREATMENT -último I-TREATMENT -caso I-TREATMENT -pautándolas I-TREATMENT -como I-TREATMENT -tareas I-TREATMENT -para I-TREATMENT -la I-TREATMENT -semana: I-TREATMENT - I-TREATMENT -El I-TREATMENT -objetivo I-TREATMENT -1 I-TREATMENT -se I-TREATMENT -trabaja I-TREATMENT -mediante I-TREATMENT -el I-TREATMENT -establecimiento I-TREATMENT -de I-TREATMENT -un I-TREATMENT -calendario I-TREATMENT -de I-TREATMENT -organización I-TREATMENT -conductual I-TREATMENT -o I-TREATMENT -planning. I-TREATMENT -A I-TREATMENT -través I-TREATMENT -del I-TREATMENT -cumplimiento I-TREATMENT -de I-TREATMENT -este I-TREATMENT -calendario, I-TREATMENT -y I-TREATMENT -por I-TREATMENT -tanto I-TREATMENT -de I-TREATMENT -la I-TREATMENT -consecución I-TREATMENT -del I-TREATMENT -primer I-TREATMENT -objetivo, I-TREATMENT -se I-TREATMENT -facilita I-TREATMENT -el I-TREATMENT -cambio I-TREATMENT -en I-TREATMENT -las I-TREATMENT -demás I-TREATMENT -áreas I-TREATMENT -problemáticas. I-TREATMENT - I-TREATMENT -El I-TREATMENT -objetivo I-TREATMENT -2 I-TREATMENT -se I-TREATMENT -consigue I-TREATMENT -con I-TREATMENT -la I-TREATMENT -implementación I-TREATMENT -de I-TREATMENT -diferentes I-TREATMENT -estrategias. I-TREATMENT -En I-TREATMENT -primer I-TREATMENT -lugar, I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -un I-TREATMENT -moldeamiento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -conducta I-TREATMENT -de I-TREATMENT -beber I-TREATMENT -con I-TREATMENT -control. I-TREATMENT -En I-TREATMENT -segundo I-TREATMENT -lugar, I-TREATMENT -se I-TREATMENT -desarrolla I-TREATMENT -dentro I-TREATMENT -y I-TREATMENT -fuera I-TREATMENT -de I-TREATMENT -sesión I-TREATMENT -un I-TREATMENT -entrenamiento I-TREATMENT -en I-TREATMENT -detección I-TREATMENT -de I-TREATMENT -los I-TREATMENT -estímulos I-TREATMENT -discriminativos I-TREATMENT -de I-TREATMENT -la I-TREATMENT -conducta I-TREATMENT -de I-TREATMENT -beber, I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -la I-TREATMENT -interacción I-TREATMENT -terapéutica I-TREATMENT -y I-TREATMENT -de I-TREATMENT -autorregistros. I-TREATMENT -En I-TREATMENT -tercer I-TREATMENT -lugar, I-TREATMENT -se I-TREATMENT -entrena I-TREATMENT -al I-TREATMENT -cliente I-TREATMENT -en I-TREATMENT -autocontrol, I-TREATMENT -buscando I-TREATMENT -que I-TREATMENT -sus I-TREATMENT -propias I-TREATMENT -verbalizaciones I-TREATMENT -adquieran I-TREATMENT -valor I-TREATMENT -discriminativo I-TREATMENT -para I-TREATMENT -guiar I-TREATMENT -su I-TREATMENT -conducta. I-TREATMENT - I-TREATMENT -El I-TREATMENT -objetivo I-TREATMENT -3 I-TREATMENT -se I-TREATMENT -lleva I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -mediante I-TREATMENT -la I-TREATMENT -técnica I-TREATMENT -de I-TREATMENT -exposición I-TREATMENT -con I-TREATMENT -prevención I-TREATMENT -de I-TREATMENT -respuesta, I-TREATMENT -centrada I-TREATMENT -en I-TREATMENT -el I-TREATMENT -aumento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cantidad I-TREATMENT -y I-TREATMENT -frecuencia I-TREATMENT -de I-TREATMENT -ingestas I-TREATMENT -calóricas I-TREATMENT -con I-TREATMENT -ausencia I-TREATMENT -de I-TREATMENT -conductas I-TREATMENT -compensatorias. I-TREATMENT - I-TREATMENT -Los I-TREATMENT -subobjetivos I-TREATMENT -incluidos I-TREATMENT -en I-TREATMENT -el I-TREATMENT -objetivo I-TREATMENT -4 I-TREATMENT -se I-TREATMENT -consiguen I-TREATMENT -con I-TREATMENT -pautas I-TREATMENT -concretas I-TREATMENT -relacionadas I-TREATMENT -con I-TREATMENT -cada I-TREATMENT -uno I-TREATMENT -de I-TREATMENT -ellos: I-TREATMENT -meter I-TREATMENT -en I-TREATMENT -el I-TREATMENT -calendario I-TREATMENT -momentos I-TREATMENT -determinados I-TREATMENT -para I-TREATMENT -llevar I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -actividades I-TREATMENT -en I-TREATMENT -solitario, I-TREATMENT -pautar I-TREATMENT -actividades I-TREATMENT -en I-TREATMENT -grupo, I-TREATMENT -utilizar I-TREATMENT -páginas I-TREATMENT -de I-TREATMENT -contacto I-TREATMENT -social I-TREATMENT -y I-TREATMENT -páginas I-TREATMENT -para I-TREATMENT -buscar I-TREATMENT -pareja. I-TREATMENT -Durante B-EVOLUTION -la I-EVOLUTION -consecución I-EVOLUTION -de I-EVOLUTION -este I-EVOLUTION -objetivo, I-EVOLUTION -surgen I-EVOLUTION -nuevas I-EVOLUTION -conductas I-EVOLUTION -problemáticas I-EVOLUTION -en I-EVOLUTION -relación I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -búsqueda I-EVOLUTION -y I-EVOLUTION -mantenimiento I-EVOLUTION -de I-EVOLUTION -relaciones I-EVOLUTION -de I-EVOLUTION -pareja. I-EVOLUTION -Por I-EVOLUTION -este I-EVOLUTION -motivo, I-EVOLUTION -a I-EVOLUTION -partir I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -novena I-EVOLUTION -sesión I-EVOLUTION -se I-EVOLUTION -evalúan I-EVOLUTION -y I-EVOLUTION -tratan I-EVOLUTION -estas I-EVOLUTION -conductas I-EVOLUTION -como I-EVOLUTION -nueva I-EVOLUTION -demanda, I-EVOLUTION -siendo I-EVOLUTION -de I-EVOLUTION -gran I-EVOLUTION -relevancia I-EVOLUTION -para I-EVOLUTION -el I-EVOLUTION -mantenimiento I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -demás I-EVOLUTION -objetivos. I-EVOLUTION - I-EVOLUTION -Un B-TREATMENT -objetivo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -trabaja I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -paralela I-TREATMENT -a I-TREATMENT -los I-TREATMENT -anteriores, I-TREATMENT -y I-TREATMENT -transversalmente I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -terapia, I-TREATMENT -teniendo I-TREATMENT -más I-TREATMENT -peso I-TREATMENT -en I-TREATMENT -las I-TREATMENT -últimas I-TREATMENT -sesiones, I-TREATMENT -es I-TREATMENT -la I-TREATMENT -detección I-TREATMENT -y I-TREATMENT -afrontamiento I-TREATMENT -de I-TREATMENT -situaciones I-TREATMENT -de I-TREATMENT -riesgo, I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -conoce I-TREATMENT -en I-TREATMENT -la I-TREATMENT -literatura I-TREATMENT -como I-TREATMENT -prevención I-TREATMENT -de I-TREATMENT -recaídas I-TREATMENT -(Larimer, I-TREATMENT -Palmer I-TREATMENT -y I-TREATMENT -Marlatt, I-TREATMENT -1999). I-TREATMENT -Siguiendo B-EXPLORATION -el I-EXPLORATION -modelo I-EXPLORATION -de I-EXPLORATION -recaídas I-EXPLORATION -presentado I-EXPLORATION -por I-EXPLORATION -Marlatt I-EXPLORATION -y I-EXPLORATION -George I-EXPLORATION -(1984, I-EXPLORATION -citado I-EXPLORATION -en I-EXPLORATION -Echeburúa-Odriozola, I-EXPLORATION -1994), I-EXPLORATION -una I-EXPLORATION -vez I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -persona I-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -situación I-EXPLORATION -de I-EXPLORATION -riesgo I-EXPLORATION -puede I-EXPLORATION -llevar I-EXPLORATION -a I-EXPLORATION -cabo I-EXPLORATION -o I-EXPLORATION -no I-EXPLORATION -respuestas I-EXPLORATION -de I-EXPLORATION -afrontamiento. I-EXPLORATION -Si I-EXPLORATION -lo I-EXPLORATION -hace, I-EXPLORATION -su I-EXPLORATION -percepción I-EXPLORATION -de I-EXPLORATION -autoeficacia I-EXPLORATION -aumentará I-EXPLORATION -y I-EXPLORATION -disminuirá I-EXPLORATION -la I-EXPLORATION -probabilidad I-EXPLORATION -de I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -produzca I-EXPLORATION -una I-EXPLORATION -recaída. I-EXPLORATION -En I-EXPLORATION -cambio, I-EXPLORATION -si I-EXPLORATION -no I-EXPLORATION -aparecen I-EXPLORATION -las I-EXPLORATION -respuestas I-EXPLORATION -adecuadas I-EXPLORATION -se I-EXPLORATION -producirá I-EXPLORATION -el I-EXPLORATION -efecto I-EXPLORATION -contrario. I-EXPLORATION -Se I-EXPLORATION -parte I-EXPLORATION -del I-EXPLORATION -planteamiento I-EXPLORATION -de I-EXPLORATION -Bandura I-EXPLORATION -(2005) I-EXPLORATION -de I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -eficacia I-EXPLORATION -percibida I-EXPLORATION -o I-EXPLORATION -autoeficacia I-EXPLORATION -no I-EXPLORATION -es I-EXPLORATION -un I-EXPLORATION -rasgo I-EXPLORATION -global I-EXPLORATION -o I-EXPLORATION -estable I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -persona, I-EXPLORATION -sino I-EXPLORATION -un I-EXPLORATION -conjunto I-EXPLORATION -de I-EXPLORATION -autocreencias I-EXPLORATION -ligadas I-EXPLORATION -a I-EXPLORATION -ámbitos I-EXPLORATION -de I-EXPLORATION -funcionamiento I-EXPLORATION -diferenciado I-EXPLORATION -dependientes I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -situación. I-EXPLORATION -Se B-TREATMENT -trabaja I-TREATMENT -en I-TREATMENT -esta I-TREATMENT -línea I-TREATMENT -a I-TREATMENT -partir I-TREATMENT -de I-TREATMENT -la I-TREATMENT -octava I-TREATMENT -sesión, I-TREATMENT -en I-TREATMENT -la I-TREATMENT -que I-TREATMENT -se I-TREATMENT -explica I-TREATMENT -la I-TREATMENT -diferencia I-TREATMENT -entre I-TREATMENT -una I-TREATMENT -recaída I-TREATMENT -y I-TREATMENT -una I-TREATMENT -caída, I-TREATMENT -reestructurando I-TREATMENT -verbalizaciones I-TREATMENT -de I-TREATMENT -fracaso I-TREATMENT -o I-TREATMENT -retroceso, I-TREATMENT -quitando I-TREATMENT -valor I-TREATMENT -negativo I-TREATMENT -a I-TREATMENT -las I-TREATMENT -mismas I-TREATMENT -y I-TREATMENT -destacando I-TREATMENT -el I-TREATMENT -manejo I-TREATMENT -adecuado I-TREATMENT -durante I-TREATMENT -la I-TREATMENT -semana. I-TREATMENT -De I-TREATMENT -esta I-TREATMENT -manera I-TREATMENT -mejoraría I-TREATMENT -la I-TREATMENT -autoeficacia I-TREATMENT -y I-TREATMENT -sensación I-TREATMENT -de I-TREATMENT -control I-TREATMENT -percibidas I-TREATMENT -por I-TREATMENT -el I-TREATMENT -cliente. I-TREATMENT -En I-TREATMENT -sesiones I-TREATMENT -anteriores, I-TREATMENT -también I-TREATMENT -se I-TREATMENT -trabaja I-TREATMENT -prevención I-TREATMENT -de I-TREATMENT -recaídas, I-TREATMENT -pautando I-TREATMENT -tareas I-TREATMENT -y I-TREATMENT -emitiendo I-TREATMENT -discriminativos I-TREATMENT -en I-TREATMENT -sesión, I-TREATMENT -encaminadas I-TREATMENT -ambas I-TREATMENT -estrategias I-TREATMENT -a I-TREATMENT -que I-TREATMENT -el I-TREATMENT -cliente I-TREATMENT -detecte I-TREATMENT -situaciones I-TREATMENT -de I-TREATMENT -riesgo I-TREATMENT -y I-TREATMENT -emita I-TREATMENT -respuestas I-TREATMENT -de I-TREATMENT -control I-TREATMENT -y I-TREATMENT -afrontamiento I-TREATMENT -en I-TREATMENT -las I-TREATMENT -mismas. I-TREATMENT -Esta I-TREATMENT -parte I-TREATMENT -de I-TREATMENT -la I-TREATMENT -terapia I-TREATMENT -es I-TREATMENT -especialmente I-TREATMENT -importante I-TREATMENT -en I-TREATMENT -este I-TREATMENT -tipo I-TREATMENT -de I-TREATMENT -problemática, I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -si I-TREATMENT -ante I-TREATMENT -una I-TREATMENT -situación I-TREATMENT -de I-TREATMENT -riesgo I-TREATMENT -el I-TREATMENT -sujeto I-TREATMENT -logra I-TREATMENT -emitir I-TREATMENT -una I-TREATMENT -respuesta I-TREATMENT -adecuada I-TREATMENT -con I-TREATMENT -la I-TREATMENT -que I-TREATMENT -evita I-TREATMENT -el I-TREATMENT -consumo, I-TREATMENT -la I-TREATMENT -sensación I-TREATMENT -de I-TREATMENT -autocontrol I-TREATMENT -y I-TREATMENT -autoeficacia I-TREATMENT -incrementa I-TREATMENT -y I-TREATMENT -la I-TREATMENT -probabilidad I-TREATMENT -de I-TREATMENT -recaída I-TREATMENT -disminuirá I-TREATMENT -significativamente I-TREATMENT -(Becoña-Iglesias I-TREATMENT -y I-TREATMENT -Cortés-Tomás, I-TREATMENT -2008). I-TREATMENT - I-TREATMENT -Resultados B-EVOLUTION - I-EVOLUTION -Para I-EVOLUTION -el I-EVOLUTION -análisis I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -resultados I-EVOLUTION -nos I-EVOLUTION -centramos I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -tres I-EVOLUTION -primeros I-EVOLUTION -objetivos: I-EVOLUTION -conseguir I-EVOLUTION -un I-EVOLUTION -estilo I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -más I-EVOLUTION -organizado, I-EVOLUTION -disminuir I-EVOLUTION -el I-EVOLUTION -consumo I-EVOLUTION -de I-EVOLUTION -alcohol I-EVOLUTION -aprendiendo I-EVOLUTION -a I-EVOLUTION -controlarlo I-EVOLUTION -y I-EVOLUTION -eliminar I-EVOLUTION -vómitos I-EVOLUTION -y I-EVOLUTION -atracones. I-EVOLUTION -El I-EVOLUTION -cuarto I-EVOLUTION -objetivo, I-EVOLUTION -aumento I-EVOLUTION -de I-EVOLUTION -fuentes I-EVOLUTION -de I-EVOLUTION -refuerzo, I-EVOLUTION -quedaría I-EVOLUTION -reflejado I-EVOLUTION -dentro I-EVOLUTION -del I-EVOLUTION -establecimiento I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -estilo I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -más I-EVOLUTION -organizado, I-EVOLUTION -trabajado I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -calendario I-EVOLUTION -de I-EVOLUTION -organización I-EVOLUTION -conductual. I-EVOLUTION - I-EVOLUTION -A I-EVOLUTION -lo I-EVOLUTION -largo I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -se I-EVOLUTION -observa I-EVOLUTION -cómo I-EVOLUTION -han I-EVOLUTION -evolucionado I-EVOLUTION -las I-EVOLUTION -conductas I-EVOLUTION -problemáticas, I-EVOLUTION -reduciéndose I-EVOLUTION -su I-EVOLUTION -emisión I-EVOLUTION -a I-EVOLUTION -medida I-EVOLUTION -que I-EVOLUTION -el I-EVOLUTION -terapeuta I-EVOLUTION -pauta I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -de I-EVOLUTION -consumo I-EVOLUTION -para I-EVOLUTION -las I-EVOLUTION -semanas. I-EVOLUTION -Se I-EVOLUTION -produce I-EVOLUTION -una I-EVOLUTION -disminución I-EVOLUTION -y I-EVOLUTION -retirada I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -ingesta I-EVOLUTION -de I-EVOLUTION -bebidas I-EVOLUTION -alcohólicas, I-EVOLUTION -obteniendo I-EVOLUTION -unos I-EVOLUTION -parámetros I-EVOLUTION -de I-EVOLUTION -consumo I-EVOLUTION -más I-EVOLUTION -normalizados. I-EVOLUTION -La I-EVOLUTION -ingesta I-EVOLUTION -de I-EVOLUTION -alcohol I-EVOLUTION -estando I-EVOLUTION -solo I-EVOLUTION -en I-EVOLUTION -casa I-EVOLUTION -se I-EVOLUTION -elimina I-EVOLUTION -a I-EVOLUTION -partir I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sesión I-EVOLUTION -7 I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -comienza I-EVOLUTION -a I-EVOLUTION -controlar I-EVOLUTION -la I-EVOLUTION -ingesta I-EVOLUTION -de I-EVOLUTION -alcohol I-EVOLUTION -estando I-EVOLUTION -fuera I-EVOLUTION -de I-EVOLUTION -casa I-EVOLUTION -en I-EVOLUTION -solitario I-EVOLUTION -entre I-EVOLUTION -la I-EVOLUTION -sesión I-EVOLUTION -7 I-EVOLUTION -y I-EVOLUTION -8, I-EVOLUTION -habiendo I-EVOLUTION -reducido I-EVOLUTION -anteriormente I-EVOLUTION -la I-EVOLUTION -frecuencia. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -segundo I-EVOLUTION -objetivo, I-EVOLUTION -disminuir I-EVOLUTION -y I-EVOLUTION -controlar I-EVOLUTION -el I-EVOLUTION -consumo I-EVOLUTION -de I-EVOLUTION -alcohol, I-EVOLUTION -se I-EVOLUTION -refleja I-EVOLUTION -y I-EVOLUTION -analiza I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -figura I-EVOLUTION -4. I-EVOLUTION -Esta I-EVOLUTION -ingesta I-EVOLUTION -de I-EVOLUTION -bebidas I-EVOLUTION -alcohólicas I-EVOLUTION -disminuye I-EVOLUTION -a I-EVOLUTION -medida I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -pautan I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -de I-EVOLUTION -consumo. I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -figura I-EVOLUTION -4 I-EVOLUTION -se I-EVOLUTION -observa I-EVOLUTION -que I-EVOLUTION -durante I-EVOLUTION -las I-EVOLUTION -primeras I-EVOLUTION -sesiones I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -(de I-EVOLUTION -la I-EVOLUTION -semana I-EVOLUTION -1 I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -semana I-EVOLUTION -3, I-EVOLUTION -coincidiendo I-EVOLUTION -con I-EVOLUTION -las I-EVOLUTION -sesiones I-EVOLUTION -4, I-EVOLUTION -5 I-EVOLUTION -y I-EVOLUTION -6) I-EVOLUTION -se I-EVOLUTION -presentan I-EVOLUTION -mayores I-EVOLUTION -unidades I-EVOLUTION -de I-EVOLUTION -alcohol I-EVOLUTION -ingerido I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -menor I-EVOLUTION -variedad, I-EVOLUTION -siendo I-EVOLUTION -el I-EVOLUTION -vino I-EVOLUTION -la I-EVOLUTION -bebida I-EVOLUTION -que I-EVOLUTION -predomina, I-EVOLUTION -cuya I-EVOLUTION -frecuencia I-EVOLUTION -y I-EVOLUTION -cantidad I-EVOLUTION -de I-EVOLUTION -ingesta I-EVOLUTION -es I-EVOLUTION -mayor I-EVOLUTION -en I-EVOLUTION -comparación I-EVOLUTION -con I-EVOLUTION -las I-EVOLUTION -últimas I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -tratamiento. I-EVOLUTION -Los I-EVOLUTION -datos I-EVOLUTION -correspondientes I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -sesiones I-EVOLUTION -7 I-EVOLUTION -y I-EVOLUTION -8 I-EVOLUTION -(semanas I-EVOLUTION -5, I-EVOLUTION -6, I-EVOLUTION -7 I-EVOLUTION -y I-EVOLUTION -8) I-EVOLUTION -reflejan I-EVOLUTION -una I-EVOLUTION -reducción I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -frecuencia I-EVOLUTION -de I-EVOLUTION -consumo I-EVOLUTION -por I-EVOLUTION -días, I-EVOLUTION -disminuyendo I-EVOLUTION -considerablemente I-EVOLUTION -durante I-EVOLUTION -la I-EVOLUTION -semana I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -fin I-EVOLUTION -de I-EVOLUTION -semana. I-EVOLUTION -Por I-EVOLUTION -último, I-EVOLUTION -los I-EVOLUTION -datos I-EVOLUTION -correspondientes I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -sesión I-EVOLUTION -9 I-EVOLUTION -(de I-EVOLUTION -la I-EVOLUTION -semana I-EVOLUTION -9 I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -semana I-EVOLUTION -15 I-EVOLUTION -del I-EVOLUTION -tratamiento) I-EVOLUTION -indican I-EVOLUTION -que I-EVOLUTION -el I-EVOLUTION -cliente I-EVOLUTION -no I-EVOLUTION -solo I-EVOLUTION -reduce I-EVOLUTION -el I-EVOLUTION -consumo I-EVOLUTION -de I-EVOLUTION -bebidas I-EVOLUTION -alcohólicas, I-EVOLUTION -sino I-EVOLUTION -que I-EVOLUTION -también I-EVOLUTION -incorpora I-EVOLUTION -mayor I-EVOLUTION -variedad I-EVOLUTION -en I-EVOLUTION -su I-EVOLUTION -consumo I-EVOLUTION -de I-EVOLUTION -bebidas I-EVOLUTION -no I-EVOLUTION -alcohólicas I-EVOLUTION -y I-EVOLUTION -alcohólicas I-EVOLUTION -con I-EVOLUTION -menor I-EVOLUTION -graduación I-EVOLUTION -en I-EVOLUTION -situaciones I-EVOLUTION -de I-EVOLUTION -ocio, I-EVOLUTION -como I-EVOLUTION -agua I-EVOLUTION -con I-EVOLUTION -gas I-EVOLUTION -o I-EVOLUTION -claras I-EVOLUTION -de I-EVOLUTION -cerveza. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -exceso I-EVOLUTION -percibido I-EVOLUTION -de I-EVOLUTION -consumo I-EVOLUTION -queda I-EVOLUTION -reflejado I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -figura I-EVOLUTION -5, I-EVOLUTION -que I-EVOLUTION -representa I-EVOLUTION -las I-EVOLUTION -verbalizaciones I-EVOLUTION -que I-EVOLUTION -el I-EVOLUTION -cliente I-EVOLUTION -emite I-EVOLUTION -en I-EVOLUTION -sesión I-EVOLUTION -en I-EVOLUTION -relación I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -percepción I-EVOLUTION -de I-EVOLUTION -haberse I-EVOLUTION -excedido I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -consumo I-EVOLUTION -de I-EVOLUTION -alcohol I-EVOLUTION -y I-EVOLUTION -los I-EVOLUTION -registros I-EVOLUTION -relacionados I-EVOLUTION -con I-EVOLUTION -tareas I-EVOLUTION -concretas I-EVOLUTION -que I-EVOLUTION -indicaba I-EVOLUTION -el I-EVOLUTION -terapeuta. I-EVOLUTION -Se I-EVOLUTION -puede I-EVOLUTION -observar I-EVOLUTION -que I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -marcas I-EVOLUTION -correspondientes I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -sesión I-EVOLUTION -8 I-EVOLUTION -y I-EVOLUTION -9 I-EVOLUTION -(del I-EVOLUTION -día I-EVOLUTION -40 I-EVOLUTION -al I-EVOLUTION -80) I-EVOLUTION -continúa I-EVOLUTION -apareciendo I-EVOLUTION -esa I-EVOLUTION -percepción I-EVOLUTION -de I-EVOLUTION -exceso, I-EVOLUTION -pero I-EVOLUTION -esta I-EVOLUTION -vez I-EVOLUTION -asociada I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -consumo I-EVOLUTION -menor I-EVOLUTION -y I-EVOLUTION -más I-EVOLUTION -controlado. I-EVOLUTION -Esto I-EVOLUTION -supone I-EVOLUTION -un I-EVOLUTION -cambio I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -percepción I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -ingesta I-EVOLUTION -de I-EVOLUTION -bebidas I-EVOLUTION -alcohólicas I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -relación I-EVOLUTION -a I-EVOLUTION -cuándo I-EVOLUTION -dejar I-EVOLUTION -de I-EVOLUTION -beber. I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -figura I-EVOLUTION -3 I-EVOLUTION -podemos I-EVOLUTION -observar I-EVOLUTION -el I-EVOLUTION -cumplimiento I-EVOLUTION -de I-EVOLUTION -actividades I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -calendario I-EVOLUTION -de I-EVOLUTION -organización I-EVOLUTION -conductual, I-EVOLUTION -relacionado I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -objetivo I-EVOLUTION -de I-EVOLUTION -fomentar I-EVOLUTION -un I-EVOLUTION -estilo I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -más I-EVOLUTION -saludable, I-EVOLUTION -incluyendo I-EVOLUTION -reforzadores. I-EVOLUTION -El I-EVOLUTION -número I-EVOLUTION -máximo I-EVOLUTION -de I-EVOLUTION -actividades I-EVOLUTION -diarias I-EVOLUTION -viene I-EVOLUTION -indicado I-EVOLUTION -por I-EVOLUTION -una I-EVOLUTION -puntuación I-EVOLUTION -máxima I-EVOLUTION -de I-EVOLUTION -10 I-EVOLUTION -coincidiendo I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -número I-EVOLUTION -de I-EVOLUTION -ítems I-EVOLUTION -que I-EVOLUTION -debía I-EVOLUTION -cumplir. I-EVOLUTION -Lo I-EVOLUTION -relevante I-EVOLUTION -en I-EVOLUTION -este I-EVOLUTION -caso I-EVOLUTION -es I-EVOLUTION -la I-EVOLUTION -reducción I-EVOLUTION -de I-EVOLUTION -días I-EVOLUTION -que I-EVOLUTION -pueden I-EVOLUTION -indicar I-EVOLUTION -descontrol I-EVOLUTION -no I-EVOLUTION -cumpliendo I-EVOLUTION -ningún I-EVOLUTION -ítem. I-EVOLUTION -En I-EVOLUTION -las I-EVOLUTION -medidas I-EVOLUTION -del I-EVOLUTION -1 I-EVOLUTION -al I-EVOLUTION -20, I-EVOLUTION -correspondientes I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -comprendidos I-EVOLUTION -entre I-EVOLUTION -las I-EVOLUTION -sesiones I-EVOLUTION -4, I-EVOLUTION -5 I-EVOLUTION -y I-EVOLUTION -6, I-EVOLUTION -se I-EVOLUTION -observan I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -no I-EVOLUTION -cumplimiento I-EVOLUTION -de I-EVOLUTION -tareas I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -frecuencia I-EVOLUTION -semanal I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -consecutiva. I-EVOLUTION -En I-EVOLUTION -las I-EVOLUTION -medidas I-EVOLUTION -correspondientes I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -sesiones I-EVOLUTION -7 I-EVOLUTION -y I-EVOLUTION -8 I-EVOLUTION -(del I-EVOLUTION -día I-EVOLUTION -20 I-EVOLUTION -al I-EVOLUTION -50) I-EVOLUTION -se I-EVOLUTION -produce I-EVOLUTION -una I-EVOLUTION -reducción I-EVOLUTION -considerable I-EVOLUTION -de I-EVOLUTION -días I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -cumple I-EVOLUTION -ningún I-EVOLUTION -ítem, I-EVOLUTION -coincidiendo I-EVOLUTION -estos I-EVOLUTION -días I-EVOLUTION -con I-EVOLUTION -eventos I-EVOLUTION -familiares I-EVOLUTION -y I-EVOLUTION -laborales I-EVOLUTION -que I-EVOLUTION -dificultan I-EVOLUTION -el I-EVOLUTION -cumplimiento, I-EVOLUTION -siendo I-EVOLUTION -más I-EVOLUTION -elevadas I-EVOLUTION -las I-EVOLUTION -puntuaciones, I-EVOLUTION -lo I-EVOLUTION -cual I-EVOLUTION -significa I-EVOLUTION -que I-EVOLUTION -el I-EVOLUTION -cliente I-EVOLUTION -cumple I-EVOLUTION -la I-EVOLUTION -mayor I-EVOLUTION -parte I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -ítems I-EVOLUTION -diarios I-EVOLUTION -en I-EVOLUTION -estas I-EVOLUTION -semanas. I-EVOLUTION -Por I-EVOLUTION -último, I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -período I-EVOLUTION -comprendido I-EVOLUTION -entre I-EVOLUTION -el I-EVOLUTION -día I-EVOLUTION -50 I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -día I-EVOLUTION -80, I-EVOLUTION -correspondiente I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -sesión I-EVOLUTION -9, I-EVOLUTION -se I-EVOLUTION -puede I-EVOLUTION -observar I-EVOLUTION -un I-EVOLUTION -cumplimiento I-EVOLUTION -más I-EVOLUTION -estable, I-EVOLUTION -aunque I-EVOLUTION -con I-EVOLUTION -excepciones I-EVOLUTION -de I-EVOLUTION -no I-EVOLUTION -cumplimiento I-EVOLUTION -que I-EVOLUTION -coinciden I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -eventos I-EVOLUTION -sociales I-EVOLUTION -o I-EVOLUTION -viajes I-EVOLUTION -de I-EVOLUTION -trabajo I-EVOLUTION -que I-EVOLUTION -dificultan I-EVOLUTION -la I-EVOLUTION -realización I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -tareas. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -cambio I-EVOLUTION -de I-EVOLUTION -patrón I-EVOLUTION -en I-EVOLUTION -relación I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -atracones I-EVOLUTION -y I-EVOLUTION -vómitos I-EVOLUTION -es I-EVOLUTION -también I-EVOLUTION -evidente I-EVOLUTION -y I-EVOLUTION -muy I-EVOLUTION -temprano I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -tiempo. I-EVOLUTION -Sólo I-EVOLUTION -se I-EVOLUTION -dan I-EVOLUTION -en I-EVOLUTION -dos I-EVOLUTION -ocasiones, I-EVOLUTION -coincidiendo I-EVOLUTION -con I-EVOLUTION -las I-EVOLUTION -semanas I-EVOLUTION -5 I-EVOLUTION -y I-EVOLUTION -6. I-EVOLUTION -La I-EVOLUTION -eliminación I-EVOLUTION -de I-EVOLUTION -atracones I-EVOLUTION -se I-EVOLUTION -trabaja I-EVOLUTION -a I-EVOLUTION -partir I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sexta I-EVOLUTION -sesión, I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -logro I-EVOLUTION -total I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -inicio I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -aplicación I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -técnica I-EVOLUTION -de I-EVOLUTION -exposición I-EVOLUTION -con I-EVOLUTION -prevención I-EVOLUTION -de I-EVOLUTION -respuesta, I-EVOLUTION -introduciendo I-EVOLUTION -cada I-EVOLUTION -vez I-EVOLUTION -más I-EVOLUTION -alimentos I-EVOLUTION -calóricos I-EVOLUTION -hasta I-EVOLUTION -llegar I-EVOLUTION -a I-EVOLUTION -una I-EVOLUTION -percepción I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -total I-EVOLUTION -sobre I-EVOLUTION -esta I-EVOLUTION -conducta I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -sesión I-EVOLUTION -9 I-EVOLUTION -y I-EVOLUTION -10. I-EVOLUTION -Los I-EVOLUTION -vómitos I-EVOLUTION -se I-EVOLUTION -eliminan I-EVOLUTION -a I-EVOLUTION -partir I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sesión I-EVOLUTION -3. I-EVOLUTION - I-EVOLUTION -Estos I-EVOLUTION -resultados I-EVOLUTION -indican, I-EVOLUTION -de I-EVOLUTION -manera I-EVOLUTION -tentativa, I-EVOLUTION -la I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -elevado I-EVOLUTION -cumplimiento I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -pautas, I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -un I-EVOLUTION -elevado I-EVOLUTION -compromiso I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -terapia. I-EVOLUTION -Los I-EVOLUTION -resultados I-EVOLUTION -indican I-EVOLUTION -una I-EVOLUTION -notable I-EVOLUTION -mejoría I-EVOLUTION -en I-EVOLUTION -relación I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -adquisición I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -estilo I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -más I-EVOLUTION -organizado I-EVOLUTION -y I-EVOLUTION -mayor I-EVOLUTION -autocontrol I-EVOLUTION -en I-EVOLUTION -relación I-EVOLUTION -al I-EVOLUTION -consumo I-EVOLUTION -de I-EVOLUTION -alcohol I-EVOLUTION -y I-EVOLUTION -cumplimiento I-EVOLUTION -de I-EVOLUTION -actividades. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -71 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -diagnosticado B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -carcinoma I-PAST_MEDICAL_HISTORY -epidermoide I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pulmón I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -microcítico I-PAST_MEDICAL_HISTORY -estadio I-PAST_MEDICAL_HISTORY -IIIb. I-PAST_MEDICAL_HISTORY -Inició I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -quimioterápico I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -cisplatino I-PAST_MEDICAL_HISTORY -75 I-PAST_MEDICAL_HISTORY -mg/m2 I-PAST_MEDICAL_HISTORY -día I-PAST_MEDICAL_HISTORY -1, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -vinorelbina I-PAST_MEDICAL_HISTORY -oral I-PAST_MEDICAL_HISTORY -60 I-PAST_MEDICAL_HISTORY -mg/m2 I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -8, I-PAST_MEDICAL_HISTORY -cada I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -semanas, I-PAST_MEDICAL_HISTORY -combinado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -radioterapia. I-PAST_MEDICAL_HISTORY -Coincidiendo B-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -infusión I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -segundo I-PRESENT_ILLNESS -ciclo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cisplatino, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -brusca I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -caída I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -saturación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -oxígeno I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -70%, I-PRESENT_ILLNESS -que B-TREATMENT -recuperó I-TREATMENT -parcialmente I-TREATMENT -con I-TREATMENT -corticoterapia I-TREATMENT -y I-TREATMENT -oxígeno I-TREATMENT -a I-TREATMENT -alto I-TREATMENT -flujo. I-TREATMENT -La B-EXPLORATION -gravedad I-EXPLORATION -de I-EXPLORATION -dicha I-EXPLORATION -reacción I-EXPLORATION -fue I-EXPLORATION -clasificada I-EXPLORATION -según I-EXPLORATION -la I-EXPLORATION -Common I-EXPLORATION -Toxicity I-EXPLORATION -Criteria I-EXPLORATION -(versión I-EXPLORATION -4.0) I-EXPLORATION -9 I-EXPLORATION -en I-EXPLORATION -RHS I-EXPLORATION -grado I-EXPLORATION -3, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -recomienda I-EXPLORATION -cambiar I-EXPLORATION -el I-EXPLORATION -tratamiento, I-EXPLORATION -opción I-EXPLORATION -a I-EXPLORATION -veces I-EXPLORATION -limitada I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -quimiosensibilidad I-EXPLORATION -del I-EXPLORATION -tumor, I-EXPLORATION -o I-EXPLORATION -bien I-EXPLORATION -aplicar I-EXPLORATION -protocolos I-EXPLORATION -de I-EXPLORATION -desensibilización I-EXPLORATION -en I-EXPLORATION -aquellos I-EXPLORATION -pacientes I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -desee I-EXPLORATION -discontinuar I-EXPLORATION -la I-EXPLORATION -terapia. I-EXPLORATION -Se I-EXPLORATION -decidió I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -pruebas I-EXPLORATION -cutáneas I-EXPLORATION -con I-EXPLORATION -cisplatino, I-EXPLORATION -para I-EXPLORATION -confirmar I-EXPLORATION -la I-EXPLORATION -posible I-EXPLORATION -asociación I-EXPLORATION -entre I-EXPLORATION -la I-EXPLORATION -reacción I-EXPLORATION -anafiláctica I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -administración I-EXPLORATION -de I-EXPLORATION -dicho I-EXPLORATION -citostático. I-EXPLORATION -Además, I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -importante I-EXPLORATION -reactividad I-EXPLORATION -cruzada I-EXPLORATION -entre I-EXPLORATION -las I-EXPLORATION -sales I-EXPLORATION -de I-EXPLORATION -platino I-EXPLORATION -cuya I-EXPLORATION -incidencia I-EXPLORATION -aún I-EXPLORATION -no I-EXPLORATION -ha I-EXPLORATION -sido I-EXPLORATION -establecida8, I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -realizar I-EXPLORATION -dichas I-EXPLORATION -pruebas I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -tres I-EXPLORATION -análogos I-EXPLORATION -de I-EXPLORATION -platino. I-EXPLORATION -Las I-EXPLORATION -soluciones I-EXPLORATION -madre I-EXPLORATION -utilizadas I-EXPLORATION -fueron: I-EXPLORATION -cisplatino I-EXPLORATION -1 I-EXPLORATION -mg/ml, I-EXPLORATION -carboplatino I-EXPLORATION -10 I-EXPLORATION -mg/ml I-EXPLORATION -y I-EXPLORATION -oxaliplatino I-EXPLORATION -5 I-EXPLORATION -mg/ml. I-EXPLORATION -A I-EXPLORATION -partir I-EXPLORATION -de I-EXPLORATION -éstas, I-EXPLORATION -se I-EXPLORATION -realizaron I-EXPLORATION -diluciones I-EXPLORATION -1/10000, I-EXPLORATION -1/1000, I-EXPLORATION -1/100 I-EXPLORATION -y I-EXPLORATION -1/10 I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -tres I-EXPLORATION -platinos I-EXPLORATION -para I-EXPLORATION -administración I-EXPLORATION -intradérmica. I-EXPLORATION - I-EXPLORATION -Las I-EXPLORATION -pruebas I-EXPLORATION -cutáneas I-EXPLORATION -realizadas I-EXPLORATION -con I-EXPLORATION -cisplatino I-EXPLORATION -fueron I-EXPLORATION -positivas I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -solución I-EXPLORATION -madre I-EXPLORATION -y I-EXPLORATION -negativas I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -diluciones. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -demás I-EXPLORATION -análogos I-EXPLORATION -de I-EXPLORATION -platino, I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -resultaron I-EXPLORATION -todas I-EXPLORATION -negativas, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -protocolizar I-TREATMENT -una I-TREATMENT -pauta I-TREATMENT -de I-TREATMENT -desensibilización I-TREATMENT -para I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -del I-TREATMENT -siguiente I-TREATMENT -ciclo I-TREATMENT -de I-TREATMENT -cisplatino. I-TREATMENT - I-TREATMENT -El I-TREATMENT -PD I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -12 I-TREATMENT -etapas I-TREATMENT -para I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -total I-TREATMENT -del I-TREATMENT -fármaco I-TREATMENT -(140 I-TREATMENT -mg). I-TREATMENT -El I-TREATMENT -protocolo I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -ir I-TREATMENT -aumentando I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -progresiva I-TREATMENT -la I-TREATMENT -velocidad I-TREATMENT -de I-TREATMENT -infusión I-TREATMENT -y I-TREATMENT -la I-TREATMENT -concentración I-TREATMENT -del I-TREATMENT -fármaco. I-TREATMENT -Se I-TREATMENT -prepararon I-TREATMENT -tres I-TREATMENT -soluciones I-TREATMENT -de I-TREATMENT -las I-TREATMENT -siguientes I-TREATMENT -diluciones: I-TREATMENT -1/100; I-TREATMENT -1/10 I-TREATMENT -y I-TREATMENT -1/1, I-TREATMENT -con I-TREATMENT -un I-TREATMENT -volumen I-TREATMENT -total I-TREATMENT -de I-TREATMENT -250 I-TREATMENT -ml. I-TREATMENT -La I-TREATMENT -primera I-TREATMENT -solución I-TREATMENT -se I-TREATMENT -utilizó I-TREATMENT -en I-TREATMENT -los I-TREATMENT -cuatro I-TREATMENT -primeros I-TREATMENT -pasos, I-TREATMENT -la I-TREATMENT -segunda I-TREATMENT -en I-TREATMENT -los I-TREATMENT -cuatro I-TREATMENT -siguientes, I-TREATMENT -y I-TREATMENT -la I-TREATMENT -tercera I-TREATMENT -solución I-TREATMENT -en I-TREATMENT -los I-TREATMENT -últimos I-TREATMENT -cuatro I-TREATMENT -pasos. I-TREATMENT -La I-TREATMENT -velocidad I-TREATMENT -de I-TREATMENT -infusión I-TREATMENT -se I-TREATMENT -incrementó I-TREATMENT -cada I-TREATMENT -quince I-TREATMENT -minutos, I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -que I-TREATMENT -con I-TREATMENT -cada I-TREATMENT -paso I-TREATMENT -se I-TREATMENT -administraba I-TREATMENT -el I-TREATMENT -doble I-TREATMENT -que I-TREATMENT -en I-TREATMENT -el I-TREATMENT -paso I-TREATMENT -anterior. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -último I-TREATMENT -paso I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -la I-TREATMENT -velocidad I-TREATMENT -constante I-TREATMENT -hasta I-TREATMENT -acabar I-TREATMENT -de I-TREATMENT -administrar I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -total. I-TREATMENT -En I-TREATMENT -la I-TREATMENT -tabla I-TREATMENT -1 I-TREATMENT -se I-TREATMENT -resumen I-TREATMENT -las I-TREATMENT -soluciones I-TREATMENT -y I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT -de I-TREATMENT -administración I-TREATMENT -del I-TREATMENT -protocolo I-TREATMENT -de I-TREATMENT -desensibilización. I-TREATMENT - I-TREATMENT -La I-TREATMENT -administración I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -en I-TREATMENT -hospital I-TREATMENT -de I-TREATMENT -día I-TREATMENT -bajo I-TREATMENT -estrecha I-TREATMENT -monitorización I-TREATMENT -y I-TREATMENT -supervisión I-TREATMENT -médica, I-TREATMENT -con I-TREATMENT -una I-TREATMENT -duración I-TREATMENT -total I-TREATMENT -de I-TREATMENT -5 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -37 I-TREATMENT -minutos. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -presentó I-EVOLUTION -ninguna I-EVOLUTION -RHS I-EVOLUTION -durante I-EVOLUTION -la I-EVOLUTION -infusión I-EVOLUTION -del I-EVOLUTION -citostático I-EVOLUTION -mediante I-EVOLUTION -el I-EVOLUTION -PD I-EVOLUTION -ni I-EVOLUTION -posteriormente. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -83 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -DM I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -II, I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -carcinoma I-PAST_MEDICAL_HISTORY -urotelial I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vejiga I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -RTU, I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -cual I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -adyuvante I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -mitomicina I-PAST_MEDICAL_HISTORY -intravesical I-PAST_MEDICAL_HISTORY -semanal, I-PAST_MEDICAL_HISTORY -seguido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mantenimiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -instilaciones I-PAST_MEDICAL_HISTORY -vesicales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mitomicina I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -40 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -mensuales. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Tras B-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -quinta I-PRESENT_ILLNESS -instilación I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -mantenimiento, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -dilatación I-PRESENT_ILLNESS -uretral, I-PRESENT_ILLNESS -asociada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -intensa I-PRESENT_ILLNESS -reacción I-PRESENT_ILLNESS -cutánea I-PRESENT_ILLNESS -genital I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -toxicodermia I-PRESENT_ILLNESS -sistémica, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -diagnosticado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -posible I-PRESENT_ILLNESS -reacción I-PRESENT_ILLNESS -alérgica I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -mitomicina. I-PRESENT_ILLNESS -Se B-TREATMENT -le I-TREATMENT -pautó I-TREATMENT -tratamiento I-TREATMENT -sintomático I-TREATMENT -con I-TREATMENT -corticoides, I-TREATMENT -siendo B-DERIVED_FROM/TO -referido I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -dermatología I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -hospital, I-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -realizó I-DERIVED_FROM/TO -seguimiento I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -evolución. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Dos B-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -tras I-EVOLUTION -un I-EVOLUTION -periodo I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -cual I-EVOLUTION -la I-EVOLUTION -erupción I-EVOLUTION -había I-EVOLUTION -mostrado I-EVOLUTION -un I-EVOLUTION -progreso I-EVOLUTION -favorable, I-EVOLUTION -aunque I-EVOLUTION -sin I-EVOLUTION -llegar I-EVOLUTION -a I-EVOLUTION -resolverse I-EVOLUTION -por I-EVOLUTION -completo, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -acudió I-EVOLUTION -al I-EVOLUTION -servicio I-EVOLUTION -de I-EVOLUTION -urgencias I-EVOLUTION -por I-EVOLUTION -un I-EVOLUTION -empeoramiento I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones, I-EVOLUTION -siendo I-EVOLUTION -diagnosticado I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -sobreinfección I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -mismas. I-EVOLUTION -Se B-TREATMENT -comenzó I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -sistémico I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -empírica I-TREATMENT -(ciprofloxacino I-TREATMENT -500mg I-TREATMENT -v.o. I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas), I-TREATMENT -asociado I-TREATMENT -a I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -corticoides I-TREATMENT -tópicos. I-TREATMENT -Pese B-EVOLUTION -al I-EVOLUTION -tratamiento, I-EVOLUTION -tres I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -acudir I-EVOLUTION -a I-EVOLUTION -urgencias I-EVOLUTION -por I-EVOLUTION -un I-EVOLUTION -aumento I-EVOLUTION -del I-EVOLUTION -eritema I-EVOLUTION -con I-EVOLUTION -enrojecimiento I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -zona I-EVOLUTION -genital, I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -incremento I-EVOLUTION -del I-EVOLUTION -perímetro I-EVOLUTION -de I-EVOLUTION -ambos I-EVOLUTION -miembros I-EVOLUTION -inferiores. I-EVOLUTION -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -detectó I-EXPLORATION -una I-EXPLORATION -úlcera I-EXPLORATION -extensa I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cara I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -pene I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cara I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -escroto, I-EXPLORATION -con I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -temperatura I-EXPLORATION -local I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -bordes I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -necrótica I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -pene; I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -edema I-EXPLORATION -(con I-EXPLORATION -fóvea) I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -miembros I-EXPLORATION -inferiores I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -altura I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -rodilla. I-EXPLORATION - I-EXPLORATION -Tras B-TREATMENT -valoración I-TREATMENT -del I-TREATMENT -servicio I-TREATMENT -de I-TREATMENT -Cirugía I-TREATMENT -Plástica, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -para I-TREATMENT -desbridar I-TREATMENT -el I-TREATMENT -tejido I-TREATMENT -necrotizado. I-TREATMENT -Durante B-EVOLUTION -el I-EVOLUTION -ingreso I-EVOLUTION -se I-EVOLUTION -registraron I-EVOLUTION -varios I-EVOLUTION -picos I-EVOLUTION -febriles, I-EVOLUTION -siendo B-TREATMENT -reintervenido I-TREATMENT -en I-TREATMENT -varias I-TREATMENT -ocasiones I-TREATMENT -para I-TREATMENT -desbridar I-TREATMENT -más I-TREATMENT -tejido I-TREATMENT -fibrótico-granulomatoso, I-TREATMENT -hasta I-TREATMENT -albugínea I-TREATMENT -testicular I-TREATMENT -y I-TREATMENT -cuerpos I-TREATMENT -cavernosos, I-TREATMENT -recibiendo I-TREATMENT -curas I-TREATMENT -periódicas I-TREATMENT -de I-TREATMENT -las I-TREATMENT -lesiones I-TREATMENT -durante I-TREATMENT -un I-TREATMENT -mes. I-TREATMENT -El B-EXPLORATION -cultivo I-EXPLORATION -microbiológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -herida I-EXPLORATION -reveló I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -sobreinfección I-EXPLORATION -se I-EXPLORATION -debía I-EXPLORATION -a I-EXPLORATION -Enterococcus I-EXPLORATION -tecalis, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -fosfomicina I-TREATMENT -oral I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -1.000 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -6 I-TREATMENT -horas I-TREATMENT -durante I-TREATMENT -24 I-TREATMENT -días. I-TREATMENT - I-TREATMENT -Tras I-TREATMENT -la I-TREATMENT -resolución I-TREATMENT -de I-TREATMENT -la I-TREATMENT -sobreinfección, I-TREATMENT -se I-TREATMENT -programó I-TREATMENT -una I-TREATMENT -cirugía I-TREATMENT -plástica I-TREATMENT -de I-TREATMENT -reconstrucción, I-TREATMENT -utilizando I-TREATMENT -piel I-TREATMENT -sana I-TREATMENT -del I-TREATMENT -escroto I-TREATMENT -para I-TREATMENT -cubrir I-TREATMENT -las I-TREATMENT -zonas I-TREATMENT -desprovistas I-TREATMENT -en I-TREATMENT -pene I-TREATMENT -y I-TREATMENT -testículos; I-TREATMENT -así I-TREATMENT -mismo, I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -uretroplastia I-TREATMENT -para I-TREATMENT -reconstruir I-TREATMENT -la I-TREATMENT -parte I-TREATMENT -de I-TREATMENT -la I-TREATMENT -uretra I-TREATMENT -que I-TREATMENT -había I-TREATMENT -sido I-TREATMENT -dañada. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -HIV+, B-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -(único I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -recibió I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -antirretroviral), I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -acude B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -insuficiencia I-PRESENT_ILLNESS -respiratoria I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -inicial I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -tos I-EXPLORATION -seca, I-EXPLORATION -crepitantes I-EXPLORATION -en I-EXPLORATION -ambas I-EXPLORATION -bases I-EXPLORATION -y I-EXPLORATION -febrícula. I-EXPLORATION -La B-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -no I-FAMILY_HISTORY -presentó I-FAMILY_HISTORY -otros I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés, I-FAMILY_HISTORY -enfermedades I-FAMILY_HISTORY -respiratorias I-FAMILY_HISTORY -en I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -cercanos, I-FAMILY_HISTORY -ni I-FAMILY_HISTORY -viajes I-FAMILY_HISTORY -recientes. I-FAMILY_HISTORY -No B-EXPLORATION -se I-EXPLORATION -evidenciaron I-EXPLORATION -adenomegalias, I-EXPLORATION -insuficiencia I-EXPLORATION -cardiaca I-EXPLORATION -o I-EXPLORATION -troboembolismo I-EXPLORATION -venoso I-EXPLORATION -profundo. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -último I-EXPLORATION -control, I-EXPLORATION -6 I-EXPLORATION -meses I-EXPLORATION -previos I-EXPLORATION -al I-EXPLORATION -ingreso, I-EXPLORATION -presentó I-EXPLORATION -49 I-EXPLORATION -5 I-EXPLORATION -x I-EXPLORATION -106/L I-EXPLORATION -CD4 I-EXPLORATION -(33%) I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -carga I-EXPLORATION -viral I-EXPLORATION -de I-EXPLORATION -51.000 I-EXPLORATION -copias. I-EXPLORATION -Al I-EXPLORATION -ingreso, I-EXPLORATION -estas I-EXPLORATION -cifras I-EXPLORATION -fueron I-EXPLORATION -de I-EXPLORATION -129 I-EXPLORATION -x I-EXPLORATION -106/L I-EXPLORATION -CD4 I-EXPLORATION -(16%) I-EXPLORATION -y I-EXPLORATION -330.000 I-EXPLORATION -copias. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -evolución I-EVOLUTION -inicial I-EVOLUTION -fue I-EVOLUTION -tórpida, I-EVOLUTION -con I-EVOLUTION -dificultad I-EVOLUTION -respiratoria I-EVOLUTION -progresiva. I-EVOLUTION -La B-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -patrón I-EXPLORATION -reticular-intersticial, I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -gammagrafía I-EXPLORATION -pulmonar I-EXPLORATION -descartó I-EXPLORATION -un I-EXPLORATION -tromboembolismo I-EXPLORATION -pulmonar. I-EXPLORATION -Se I-EXPLORATION -recogieron I-EXPLORATION -muestras I-EXPLORATION -de I-EXPLORATION -esputo I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -fibrobroncoscopia I-EXPLORATION -con I-EXPLORATION -lavado I-EXPLORATION -broncoalveolar I-EXPLORATION -(BAL). I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -cotrimoxazol I-TREATMENT -+ I-TREATMENT -levofloxacino I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -intravenosa, I-TREATMENT -pero I-TREATMENT -ante I-TREATMENT -el I-TREATMENT -hallazgo I-TREATMENT -posterior I-TREATMENT -de I-TREATMENT -P. I-TREATMENT -jirovecii I-TREATMENT -en I-TREATMENT -el I-TREATMENT -BAL, I-TREATMENT -se I-TREATMENT -retiró I-TREATMENT -la I-TREATMENT -quinolona. I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -h I-EVOLUTION -del I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -antibiótico I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -mejoró I-EVOLUTION -notablemente, I-EVOLUTION -disminuyó I-EVOLUTION -la I-EVOLUTION -demanda I-EVOLUTION -de I-EVOLUTION -O2 I-EVOLUTION -y B-TREATMENT -en I-TREATMENT -el I-TREATMENT -sexto I-TREATMENT -día I-TREATMENT -se I-TREATMENT -pasó I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -a I-TREATMENT -vía I-TREATMENT -oral. I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -11 I-EVOLUTION -días, I-EVOLUTION -apareció I-EVOLUTION -una I-EVOLUTION -erupción I-EVOLUTION -cutánea I-EVOLUTION -eritematosa I-EVOLUTION -en I-EVOLUTION -espalda I-EVOLUTION -y I-EVOLUTION -cuello, I-EVOLUTION -no I-EVOLUTION -pruriginosa, I-EVOLUTION -junto I-EVOLUTION -con I-EVOLUTION -fiebre I-EVOLUTION -de I-EVOLUTION -39o I-EVOLUTION -C. I-EVOLUTION -Ante B-TREATMENT -el I-TREATMENT -cuadro I-TREATMENT -sugestivo I-TREATMENT -de I-TREATMENT -reacción I-TREATMENT -alérgica I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -cotrimoxazol I-TREATMENT -y I-TREATMENT -se I-TREATMENT -pasó I-TREATMENT -a I-TREATMENT -pentamidina I-TREATMENT -IV. I-TREATMENT -Sin I-TREATMENT -embargo, I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -buena I-TREATMENT -evolución I-TREATMENT -de I-TREATMENT -la I-TREATMENT -neumonía I-TREATMENT -y I-TREATMENT -la I-TREATMENT -desaparición I-TREATMENT -del I-TREATMENT -rash I-TREATMENT -y I-TREATMENT +vías I-TREATMENT +respiratorias I-TREATMENT +de I-TREATMENT la I-TREATMENT -fiebre I-TREATMENT -a I-TREATMENT -las I-TREATMENT -48 I-TREATMENT -h, I-TREATMENT -se I-TREATMENT -valoró I-TREATMENT +paciente, I-TREATMENT +diciéndole I-TREATMENT +que I-TREATMENT +respire I-TREATMENT +por I-TREATMENT la I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -administrar I-TREATMENT -trimetroprim I-TREATMENT +boca I-TREATMENT y I-TREATMENT -dapsona I-TREATMENT -oral, I-TREATMENT -como I-TREATMENT -alternativa I-TREATMENT -a I-TREATMENT -cotrimoxazol, I-TREATMENT +conversando I-TREATMENT con I-TREATMENT +ella I-TREATMENT +durante I-TREATMENT el I-TREATMENT -objetivo I-TREATMENT +procedimiento, I-TREATMENT +para I-TREATMENT +tranquilizarla I-TREATMENT +e I-TREATMENT +informarla2. I-TREATMENT + I-TREATMENT +La I-TREATMENT +confección I-TREATMENT de I-TREATMENT -plantear I-TREATMENT la I-TREATMENT -continuación I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -ambulatoria. I-TREATMENT -Sin B-EVOLUTION -embargo, I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -h I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -administración I-EVOLUTION -de I-EVOLUTION -dapsona, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -volvió I-EVOLUTION -a I-EVOLUTION -presentar I-EVOLUTION -el I-EVOLUTION -rash I-EVOLUTION -morbiliforme I-EVOLUTION -y B-TREATMENT -fiebre, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT +prótesis I-TREATMENT +ocular I-TREATMENT se I-TREATMENT -retiró I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -oral I-TREATMENT -y I-TREATMENT -finalizó I-TREATMENT +realizó I-TREATMENT +a I-TREATMENT +continuación, I-TREATMENT +imitando I-TREATMENT el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -pentamidina I-TREATMENT -IV I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -21 I-TREATMENT -días. I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -83 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -ingresado B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -raíz I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -hipoglucemia I-PRESENT_ILLNESS -severa I-PRESENT_ILLNESS -secundaria I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -antidiabéticos I-PRESENT_ILLNESS -orales. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Al B-EXPLORATION -ingreso I-EXPLORATION -presentaba I-EXPLORATION -traumatismo I-EXPLORATION -con I-EXPLORATION -herida I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -dorso I-EXPLORATION -del I-EXPLORATION -pie I-EXPLORATION -izquierdo I-EXPLORATION -que I-EXPLORATION -tuvo I-EXPLORATION -como I-EXPLORATION -consecuencia I-EXPLORATION -una I-EXPLORATION -úlcera I-EXPLORATION -por I-EXPLORATION -presión I-EXPLORATION -talar I-EXPLORATION -izquierda I-EXPLORATION -diagnosticada I-EXPLORATION -como I-EXPLORATION -pie I-EXPLORATION -diabético. I-EXPLORATION -Mediante I-EXPLORATION -cultivo I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -que I-EXPLORATION -era I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -PAMR I-EXPLORATION -y I-EXPLORATION -SARM. I-EXPLORATION - I-EXPLORATION -Posteriormente I-EXPLORATION -mediante I-EXPLORATION -antibiograma I-EXPLORATION -se I-EXPLORATION -valoró I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -PAMR I-EXPLORATION -era I-EXPLORATION -sensible I-EXPLORATION -únicamente I-EXPLORATION -a I-EXPLORATION -colistina I-EXPLORATION -(CMI I-EXPLORATION -< I-EXPLORATION -2) I-EXPLORATION -e I-EXPLORATION -intermedio I-EXPLORATION -a I-EXPLORATION -amikacina I-EXPLORATION -(CMI I-EXPLORATION -= I-EXPLORATION -16) I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -SARM I-EXPLORATION -era I-EXPLORATION -sensible I-EXPLORATION -entre I-EXPLORATION -otros I-EXPLORATION -a I-EXPLORATION -cotrimoxazol I-EXPLORATION -(CMI I-EXPLORATION -≤ I-EXPLORATION -1/19). I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -crema I-TREATMENT +ojo I-TREATMENT +remanente. I-TREATMENT +Por I-TREATMENT +las I-TREATMENT +características I-TREATMENT +individuales I-TREATMENT de I-TREATMENT -colistina I-TREATMENT -0, I-TREATMENT -1% I-TREATMENT -con I-TREATMENT -una I-TREATMENT -aplicación I-TREATMENT -diaria I-TREATMENT -en I-TREATMENT la I-TREATMENT -cura I-TREATMENT -y I-TREATMENT -además I-TREATMENT -se I-TREATMENT -administró I-TREATMENT -cotrimoxazol I-TREATMENT -800/160mg I-TREATMENT -oral I-TREATMENT -cada I-TREATMENT -doce I-TREATMENT -horas I-TREATMENT -para I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -del I-TREATMENT -SARM. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -úlcera I-EVOLUTION -fue I-EVOLUTION -favorable. I-EVOLUTION -Según B-TREATMENT -criterio I-TREATMENT -médico, I-TREATMENT -se I-TREATMENT -finalizó I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -tópico I-TREATMENT -con I-TREATMENT -colistina I-TREATMENT -tras I-TREATMENT -23 I-TREATMENT -días, I-TREATMENT -realizando B-EXPLORATION -un I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -úlcera I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -4 I-EXPLORATION -días I-EXPLORATION -cuyo I-EXPLORATION -resultado I-EXPLORATION -fue I-EXPLORATION -negativo I-EXPLORATION -a I-EXPLORATION -PAMR, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -el I-TREATMENT -tratamiento. I-TREATMENT -La B-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -úlcera I-EVOLUTION -al I-EVOLUTION -finalizar I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -tópico I-EVOLUTION -con I-EVOLUTION -colistina I-EVOLUTION -fue I-EVOLUTION -notable. I-EVOLUTION -Se B-TREATMENT -continuó I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -cotrimoxazol I-TREATMENT +misma I-TREATMENT +algunos I-TREATMENT +autores I-TREATMENT +la I-TREATMENT +denominan I-TREATMENT +«almendra»3*. I-TREATMENT +Su I-TREATMENT +tamaño I-TREATMENT +corresponderá I-TREATMENT al I-TREATMENT -persistir I-TREATMENT +ancho I-TREATMENT +entre I-TREATMENT el I-TREATMENT -SARM. I-TREATMENT - I-TREATMENT -No I-TREATMENT +canto I-TREATMENT +interno I-TREATMENT +y I-TREATMENT +externo I-TREATMENT +del I-TREATMENT +ojo I-TREATMENT +sano. I-TREATMENT +La I-TREATMENT +cara I-TREATMENT +externa I-TREATMENT +es I-TREATMENT +totalmente I-TREATMENT +convexa I-TREATMENT +y I-TREATMENT +recubierta I-TREATMENT +de I-TREATMENT +acrílico I-TREATMENT +transparente I-TREATMENT +para I-TREATMENT +obtener I-TREATMENT +mejor I-TREATMENT +resultado I-TREATMENT +estético. I-TREATMENT +Su I-TREATMENT +cara I-TREATMENT +interna I-TREATMENT +será I-TREATMENT +plana I-TREATMENT +y I-TREATMENT se I-TREATMENT -administró I-TREATMENT +apoyará I-TREATMENT en I-TREATMENT -ninguno I-TREATMENT +la I-TREATMENT +pared I-TREATMENT +posterior I-TREATMENT de I-TREATMENT -los I-TREATMENT -casos I-TREATMENT -tratamiento I-TREATMENT -sistémico I-TREATMENT -con I-TREATMENT -colistina I-TREATMENT -intravenosa. I-TREATMENT +la I-TREATMENT +prótesis I-TREATMENT +óculo-palpebral3*. I-TREATMENT I-TREATMENT -En I-TREATMENT -conclusión, I-TREATMENT -los I-TREATMENT -resultados I-TREATMENT -sugieren I-TREATMENT +Para I-TREATMENT +esta I-TREATMENT +paciente I-TREATMENT +se I-TREATMENT +utilizó I-TREATMENT +un I-TREATMENT +molde I-TREATMENT +de I-TREATMENT +silicona, I-TREATMENT que I-TREATMENT -el I-TREATMENT -preparado I-TREATMENT +había I-TREATMENT +sido I-TREATMENT +confeccionado I-TREATMENT de I-TREATMENT -colistina I-TREATMENT -0, I-TREATMENT -1% I-TREATMENT -elaborado I-TREATMENT -por I-TREATMENT -el I-TREATMENT -servicio I-TREATMENT +unas I-TREATMENT +impresiones I-TREATMENT de I-TREATMENT -farmacia I-TREATMENT -podría I-TREATMENT +otra I-TREATMENT +paciente. I-TREATMENT +Se I-TREATMENT +pueden I-TREATMENT +utilizar I-TREATMENT +numerosas I-TREATMENT +ceras, I-TREATMENT +que I-TREATMENT +sean I-TREATMENT +duras I-TREATMENT +y I-TREATMENT +que I-TREATMENT +pesen I-TREATMENT +poco. I-TREATMENT +Aquí I-TREATMENT +que I-TREATMENT +se I-TREATMENT +utilizó I-TREATMENT +cera I-TREATMENT +color I-TREATMENT +marfil I-TREATMENT +de I-TREATMENT +una I-TREATMENT +consistencia I-TREATMENT +dura. I-TREATMENT + I-TREATMENT +El I-TREATMENT +iris I-TREATMENT +debe I-TREATMENT ser I-TREATMENT -útil I-TREATMENT +caracterizado I-TREATMENT +previamente, I-TREATMENT para I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT +esto I-TREATMENT +se I-TREATMENT +han I-TREATMENT +descrito I-TREATMENT +muchas I-TREATMENT +técnicas4. I-TREATMENT +En I-TREATMENT +este I-TREATMENT +caso I-TREATMENT +se I-TREATMENT +utilizaron I-TREATMENT +discos I-TREATMENT de I-TREATMENT -úlceras I-TREATMENT -infectadas I-TREATMENT +grafito I-TREATMENT por I-TREATMENT -PAMR I-TREATMENT -negativizando I-TREATMENT -el I-TREATMENT -cultivo I-TREATMENT -del I-TREATMENT -exudado I-TREATMENT -en I-TREATMENT -uno I-TREATMENT -de I-TREATMENT +ser I-TREATMENT +muy I-TREATMENT +resistentes, I-TREATMENT +retienen I-TREATMENT +mejor I-TREATMENT +la I-TREATMENT +pintura I-TREATMENT +y I-TREATMENT los I-TREATMENT -casos. I-TREATMENT - I-TREATMENT -No B-EVOLUTION -se I-EVOLUTION -pudo I-EVOLUTION -disponer I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -cultivo I-EVOLUTION -posterior I-EVOLUTION -al I-EVOLUTION -tratamiento I-EVOLUTION -en I-EVOLUTION -uno I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -pacientes, I-EVOLUTION -aunque I-EVOLUTION -a I-EVOLUTION -criterio I-EVOLUTION -médico I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -crecimiento I-EVOLUTION -de I-EVOLUTION -bordes I-EVOLUTION -y I-EVOLUTION -tejido I-EVOLUTION -de I-EVOLUTION -granulación, I-EVOLUTION -indicativos I-EVOLUTION -de I-EVOLUTION -mejoría I-EVOLUTION -clínica. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -aumento I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -casos I-EVOLUTION -de I-EVOLUTION -esta I-EVOLUTION -infección I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -falta I-EVOLUTION -de I-EVOLUTION -información I-EVOLUTION -en I-EVOLUTION -cuanto I-EVOLUTION -a I-EVOLUTION -eficacia I-EVOLUTION -y I-EVOLUTION -resultados I-EVOLUTION -plantea I-EVOLUTION -la I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -seguir I-EVOLUTION -investigando I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -campo I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -colistina I-EVOLUTION -tópica I-EVOLUTION -para I-EVOLUTION -llegar I-EVOLUTION -a I-EVOLUTION -conclusiones I-EVOLUTION -más I-EVOLUTION -sólidas I-EVOLUTION -sobre I-EVOLUTION -las I-EVOLUTION -posibilidades I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -utilización I-EVOLUTION -de I-EVOLUTION -este I-EVOLUTION -tratamiento. I-EVOLUTION - I-EVOLUTION -P. I-EVOLUTION -March I-EVOLUTION -López1, I-EVOLUTION -S. I-EVOLUTION -Redondo I-EVOLUTION -Capafons2, I-EVOLUTION -D. I-EVOLUTION -Cruz I-EVOLUTION -Guerrero3 I-EVOLUTION -y I-EVOLUTION -R. I-EVOLUTION -Garriga I-EVOLUTION -Biosca2 I-EVOLUTION -1Farmacéutico I-EVOLUTION -Residente. I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Farmacia. I-EVOLUTION -Hospital I-EVOLUTION -Universitari I-EVOLUTION -Mútua I-EVOLUTION -Terrassa I-EVOLUTION -(Barcelona). I-EVOLUTION -España. I-EVOLUTION -2Farmacéutica I-EVOLUTION -Adjunta. I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Farmacia. I-EVOLUTION -Hospital I-EVOLUTION -Universitari I-EVOLUTION -Mútua I-EVOLUTION -Terrassa I-EVOLUTION -(Barcelona). I-EVOLUTION -España. I-EVOLUTION -3Médico I-EVOLUTION -Adjunto. I-EVOLUTION -Centre I-EVOLUTION -Soci-Sanitari I-EVOLUTION -Residencia I-EVOLUTION -L´Ametlla I-EVOLUTION -del I-EVOLUTION -Vallés. I-EVOLUTION -Fundació I-EVOLUTION -Vallparadis. I-EVOLUTION -Grup I-EVOLUTION -Mútua I-EVOLUTION -Terrassa. I-EVOLUTION -Terrassa I-EVOLUTION -(Barcelona). I-EVOLUTION -España. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -52 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -segunda I-PRESENT_ILLNESS -instilación I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -gemcitabina I-PRESENT_ILLNESS -intravesical I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -local I-PRESENT_ILLNESS -intenso, I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -quemazón I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tenesmo I-PRESENT_ILLNESS -vesical I-PRESENT_ILLNESS -(grado I-PRESENT_ILLNESS -2) I-PRESENT_ILLNESS -5, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -obligó I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -interrupción I-PRESENT_ILLNESS -inmediata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -administración, I-PRESENT_ILLNESS -persistiendo I-PRESENT_ILLNESS -disuria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -suprapúbico I-PRESENT_ILLNESS -que B-TREATMENT -mejoró I-TREATMENT -durante I-TREATMENT -las I-TREATMENT -24 I-TREATMENT -horas I-TREATMENT -siguientes I-TREATMENT -con I-TREATMENT -tratamiento I-TREATMENT -antiinflamatorio I-TREATMENT -vía I-TREATMENT -oral. I-TREATMENT +hay I-TREATMENT +de I-TREATMENT +varios I-TREATMENT +tamaños. I-TREATMENT El I-TREATMENT -tratamiento I-TREATMENT +disco I-TREATMENT +de I-TREATMENT +grafito I-TREATMENT se I-TREATMENT -suspendió I-TREATMENT -a I-TREATMENT -petición I-TREATMENT +selecciona I-TREATMENT +según I-TREATMENT +el I-TREATMENT +tamaño I-TREATMENT +del I-TREATMENT +iris I-TREATMENT del I-TREATMENT paciente. I-TREATMENT -Dos I-TREATMENT -semanas I-TREATMENT -después I-TREATMENT +El I-TREATMENT +diámetro I-TREATMENT +del I-TREATMENT +iris I-TREATMENT +varía I-TREATMENT +entre I-TREATMENT +11, I-TREATMENT +5-12 I-TREATMENT +mm, I-TREATMENT +y I-TREATMENT el I-TREATMENT -paciente I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -intravesical I-TREATMENT -con I-TREATMENT -MMC, I-TREATMENT +diámetro I-TREATMENT +de I-TREATMENT +la I-TREATMENT +pupila I-TREATMENT +varia I-TREATMENT +entre I-TREATMENT +2, I-TREATMENT +5-3 I-TREATMENT +mm5. I-TREATMENT +Dicha I-TREATMENT +caracterización I-TREATMENT +precisa I-TREATMENT +de I-TREATMENT +una I-TREATMENT +mezcla I-TREATMENT +de I-TREATMENT +monómero I-TREATMENT +(líquido) I-TREATMENT con I-TREATMENT -buena I-TREATMENT -tolerancia I-TREATMENT -tras I-TREATMENT -cuatro I-TREATMENT -instilaciones. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -46 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Neurocirugía I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -hematoma I-PRESENT_ILLNESS -cerebral I-PRESENT_ILLNESS -secundario I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -rotura I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aneurisma I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -arteria I-PRESENT_ILLNESS -cerebral I-PRESENT_ILLNESS -media I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -Se B-TREATMENT -realiza I-TREATMENT -un I-TREATMENT -clipaje I-TREATMENT +polímero I-TREATMENT +(polvo I-TREATMENT de I-TREATMENT -aneurisma I-TREATMENT +acrílico) I-TREATMENT +y I-TREATMENT +óleo, I-TREATMENT +haciéndola I-TREATMENT +lo I-TREATMENT +más I-TREATMENT +suave I-TREATMENT +posible5*. I-TREATMENT +Se I-TREATMENT +colocaron I-TREATMENT +los I-TREATMENT +colores I-TREATMENT +base I-TREATMENT +en I-TREATMENT +una I-TREATMENT +paleta7. I-TREATMENT +La I-TREATMENT +fijación I-TREATMENT +del I-TREATMENT +disco I-TREATMENT +a I-TREATMENT +un I-TREATMENT +puntero I-TREATMENT +facilita I-TREATMENT +su I-TREATMENT +pintura I-TREATMENT de I-TREATMENT -urgencia I-TREATMENT +una I-TREATMENT +forma I-TREATMENT +radial4, I-TREATMENT +5*. I-TREATMENT +Existen I-TREATMENT +varias I-TREATMENT +técnicas I-TREATMENT para I-TREATMENT la I-TREATMENT -evacuación I-TREATMENT -del I-TREATMENT -hematoma I-TREATMENT +mejor I-TREATMENT +disposición I-TREATMENT +de I-TREATMENT +colores. I-TREATMENT +La I-TREATMENT +que I-TREATMENT +se I-TREATMENT +utilizó I-TREATMENT +fue I-TREATMENT +la I-TREATMENT +que I-TREATMENT +empieza I-TREATMENT +con I-TREATMENT +colores I-TREATMENT +más I-TREATMENT +claros I-TREATMENT y I-TREATMENT +sigue I-TREATMENT +subiendo I-TREATMENT +las I-TREATMENT +tonalidades, I-TREATMENT +pintando I-TREATMENT +desde I-TREATMENT +el I-TREATMENT +centro I-TREATMENT +hacia I-TREATMENT +la I-TREATMENT +periferia. I-TREATMENT +Se I-TREATMENT +consigue I-TREATMENT +así I-TREATMENT una I-TREATMENT -craniectomía I-TREATMENT -frontotemporal I-TREATMENT -izquierda I-TREATMENT -descompresiva, I-TREATMENT -dejándose I-TREATMENT +mejor I-TREATMENT +perspectiva I-TREATMENT +de I-TREATMENT +profundidad. I-TREATMENT +Este I-TREATMENT +paso I-TREATMENT +depende I-TREATMENT un I-TREATMENT -drenaje I-TREATMENT -ventricular I-TREATMENT -externo. I-TREATMENT -Desde B-EVOLUTION -el I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -presenta I-EVOLUTION -fiebre I-EVOLUTION -persistente, I-EVOLUTION -siendo I-EVOLUTION -diagnosticada I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -posible I-EVOLUTION -Síndrome I-EVOLUTION -de I-EVOLUTION -Respuesta I-EVOLUTION -Inflamatoria I-EVOLUTION -Sistémica I-EVOLUTION -con I-EVOLUTION -sospecha I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -foco I-EVOLUTION -pulmonar, I-EVOLUTION -posiblemente I-EVOLUTION -por I-EVOLUTION -neumonía I-EVOLUTION -aspirativa. I-EVOLUTION -Recibe B-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -con I-TREATMENT -vancomicina I-TREATMENT -1.000 I-TREATMENT -mg/12 I-TREATMENT -h I-TREATMENT -durante I-TREATMENT -7 I-TREATMENT -días I-TREATMENT +50% I-TREATMENT +de I-TREATMENT +la I-TREATMENT +técnica I-TREATMENT y I-TREATMENT -meropenem I-TREATMENT -1.000 I-TREATMENT -mg/8 I-TREATMENT -h I-TREATMENT -durante I-TREATMENT -14 I-TREATMENT -días. I-TREATMENT +otro I-TREATMENT +50% I-TREATMENT +del I-TREATMENT +arte3*, I-TREATMENT +5*, I-TREATMENT +8. I-TREATMENT I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -dos I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención, I-EVOLUTION -es I-EVOLUTION -diagnosticada I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -infección I-EVOLUTION -por I-EVOLUTION -Enterococcus I-EVOLUTION -faecalis I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -herida I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -craniectomía I-EVOLUTION -y B-EXPLORATION -7 I-EXPLORATION -días I-EXPLORATION -después I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -practica I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear I-EXPLORATION -cerebral I-EXPLORATION -cuyo I-EXPLORATION -resultado I-EXPLORATION -es I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -meningoencefalitis, I-EXPLORATION -pese I-EXPLORATION -a I-EXPLORATION -que I-EXPLORATION -los I-EXPLORATION -cultivos I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -cefalorraquídeo I-EXPLORATION -(LCR) I-EXPLORATION -son I-EXPLORATION -negativos. I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT +El I-TREATMENT +color I-TREATMENT +de I-TREATMENT +un I-TREATMENT +objeto, I-TREATMENT +no I-TREATMENT es I-TREATMENT -tratada I-TREATMENT -con I-TREATMENT -vancomicina I-TREATMENT -1.000 I-TREATMENT -mg/8 I-TREATMENT -h I-TREATMENT -y I-TREATMENT -cefepima I-TREATMENT -2.000 I-TREATMENT -mg/8 I-TREATMENT -h I-TREATMENT -durante I-TREATMENT -23 I-TREATMENT -días. I-TREATMENT -A B-EXPLORATION -los I-EXPLORATION -45 I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -intervención I-EXPLORATION -se I-EXPLORATION -diagnostica, I-EXPLORATION -tras I-EXPLORATION -extraer I-EXPLORATION -nuevos I-EXPLORATION -cultivos I-EXPLORATION -de I-EXPLORATION -LCR, I-EXPLORATION -una I-EXPLORATION -ventriculitis I-EXPLORATION -por I-EXPLORATION -E. I-EXPLORATION -faecalis I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -derivación I-EXPLORATION -externa I-EXPLORATION -y I-EXPLORATION -es I-EXPLORATION -tratada I-EXPLORATION -con I-EXPLORATION -meropenem I-EXPLORATION -1.000 I-EXPLORATION -mg/8 I-EXPLORATION -h I-EXPLORATION -durante I-EXPLORATION -13 I-EXPLORATION -días I-EXPLORATION -y I-EXPLORATION -ampicilina I-EXPLORATION -2.000 I-EXPLORATION -mg/24 I-EXPLORATION -h I-EXPLORATION -durante I-EXPLORATION -24 I-EXPLORATION -días. I-EXPLORATION -Tras I-EXPLORATION -59 I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -ingreso I-EXPLORATION -se I-EXPLORATION -aísla I-EXPLORATION -Candida I-EXPLORATION -albicans I-EXPLORATION -en I-EXPLORATION -LCR I-EXPLORATION -con I-EXPLORATION -candidemia I-EXPLORATION -asociada I-EXPLORATION -y B-TREATMENT -se I-TREATMENT -añade I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -fluconazol I-TREATMENT -400 I-TREATMENT -mg/12 I-TREATMENT -h I-TREATMENT -durante I-TREATMENT -17 I-TREATMENT -días. I-TREATMENT - I-TREATMENT -Los B-EXPLORATION -cultivos I-EXPLORATION -posteriores I-EXPLORATION -de I-EXPLORATION -LCR I-EXPLORATION -y I-EXPLORATION -sangre I-EXPLORATION -para I-EXPLORATION -los I-EXPLORATION -patógenos I-EXPLORATION -mencionados I-EXPLORATION -resultan I-EXPLORATION -negativos, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -infiere I-EXPLORATION -la I-EXPLORATION -resolución I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -infecciones I-EXPLORATION -previas; I-EXPLORATION -sin B-EVOLUTION -embargo I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -vuelve I-EVOLUTION -a I-EVOLUTION -presentar I-EVOLUTION -fiebre I-EVOLUTION -elevada I-EVOLUTION -y B-EXPLORATION -el I-EXPLORATION -día I-EXPLORATION -+70 I-EXPLORATION -se I-EXPLORATION -aísla, I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -secreciones I-EXPLORATION -respiratorias, I-EXPLORATION -P. I-EXPLORATION -aeruginosa I-EXPLORATION -multirresistente, I-EXPLORATION -sensible I-EXPLORATION -únicamente I-EXPLORATION -a I-EXPLORATION -ceftazidima I-EXPLORATION -(CMI I-EXPLORATION -≤ I-EXPLORATION -4 I-EXPLORATION -mg/L) I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -colistina I-EXPLORATION -(CMI I-EXPLORATION -≤ I-EXPLORATION -2 I-EXPLORATION -mg/L) I-EXPLORATION -(EUCAST-2012, I-EXPLORATION -www.eucast.org). I-EXPLORATION -Asimismo, I-EXPLORATION -el I-EXPLORATION -día I-EXPLORATION -+73 I-EXPLORATION -se I-EXPLORATION -aísla I-EXPLORATION -en I-EXPLORATION -LCR I-EXPLORATION -Stenotrophomonas I-EXPLORATION -maltophilia, I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -betalactámicos, I-EXPLORATION -aminoglucósidos I-EXPLORATION -y I-EXPLORATION -fluoroquinolonas, I-EXPLORATION -sensible I-EXPLORATION -solo I-EXPLORATION -a I-EXPLORATION -cotrimoxazol I-EXPLORATION -(CMI I-EXPLORATION -≤ I-EXPLORATION -2/38 I-EXPLORATION -mg/L) I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -CMI I-EXPLORATION -de I-EXPLORATION -colistina I-EXPLORATION -≤ I-EXPLORATION -2 I-EXPLORATION -mg/L. I-EXPLORATION -Debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -falta I-EXPLORATION -de I-EXPLORATION -punto I-EXPLORATION -de I-EXPLORATION -corte I-EXPLORATION -para I-EXPLORATION -este I-EXPLORATION -último I-EXPLORATION -antimicrobiano I-EXPLORATION -frente I-EXPLORATION -a I-EXPLORATION -S. I-EXPLORATION -maltophilia I-EXPLORATION -se I-EXPLORATION -utilizó I-EXPLORATION -el I-EXPLORATION -definido I-EXPLORATION -por I-EXPLORATION -EUCAST I-EXPLORATION -para I-EXPLORATION -Acinetobacter I-EXPLORATION -spp I-EXPLORATION -(sensibilidad, I-EXPLORATION -≤ I-EXPLORATION -2 I-EXPLORATION -mg/L). I-EXPLORATION -Tras B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -cotrimoxazol I-TREATMENT -iv I-TREATMENT -800/160 I-TREATMENT -mg/12 I-TREATMENT -h I-TREATMENT +otra I-TREATMENT +cosa I-TREATMENT +que I-TREATMENT +la I-TREATMENT +propiedad I-TREATMENT +que I-TREATMENT +él I-TREATMENT +mismo I-TREATMENT +tiene I-TREATMENT +de I-TREATMENT +absorber I-TREATMENT +una I-TREATMENT +determinada I-TREATMENT +cantidad I-TREATMENT +de I-TREATMENT +radiación I-TREATMENT +de I-TREATMENT +luz I-TREATMENT y I-TREATMENT -con I-TREATMENT -ceftazidima I-TREATMENT -iv I-TREATMENT -2.000 I-TREATMENT -mg/8 I-TREATMENT -h, I-TREATMENT +emitir I-TREATMENT +otras. I-TREATMENT +Por I-TREATMENT +eso I-TREATMENT +es I-TREATMENT +importante I-TREATMENT +utilizar I-TREATMENT +el I-TREATMENT +mismo I-TREATMENT +tipo I-TREATMENT +de I-TREATMENT +luz I-TREATMENT +a I-TREATMENT +la I-TREATMENT +hora I-TREATMENT +de I-TREATMENT +examinar I-TREATMENT +el I-TREATMENT +color I-TREATMENT +del I-TREATMENT +iris. I-TREATMENT +Es I-TREATMENT +aconsejable I-TREATMENT +la I-TREATMENT +presencia I-TREATMENT +del I-TREATMENT +paciente I-TREATMENT +para I-TREATMENT +una I-TREATMENT +mejor I-TREATMENT +reproducción I-TREATMENT +de I-TREATMENT +los I-TREATMENT +colores I-TREATMENT +del I-TREATMENT +ojo I-TREATMENT +sano3*, I-TREATMENT +5*, I-TREATMENT +8. I-TREATMENT + I-TREATMENT +Existen I-TREATMENT +varias I-TREATMENT +maneras I-TREATMENT +de I-TREATMENT +hacer I-TREATMENT +la I-TREATMENT +pupila. I-TREATMENT +También I-TREATMENT +se I-TREATMENT +pueden I-TREATMENT +adquirir I-TREATMENT +conformadores I-TREATMENT +de I-TREATMENT +córnea I-TREATMENT +preformados I-TREATMENT +que I-TREATMENT +la I-TREATMENT +incorporan, I-TREATMENT +para I-TREATMENT +ser I-TREATMENT +adheridos I-TREATMENT +al I-TREATMENT +disco I-TREATMENT +donde I-TREATMENT +está I-TREATMENT +pintado I-TREATMENT el I-TREATMENT -día I-TREATMENT -+75 I-TREATMENT +iris4. I-TREATMENT +Estos I-TREATMENT +conformadores I-TREATMENT +permiten I-TREATMENT +comprobar I-TREATMENT +en I-TREATMENT +cera I-TREATMENT +el I-TREATMENT +centrado I-TREATMENT +del I-TREATMENT +ojo I-TREATMENT +sobre I-TREATMENT +el I-TREATMENT +paciente. I-TREATMENT + I-TREATMENT +Tras I-TREATMENT +adaptar I-TREATMENT +el I-TREATMENT +conjunto I-TREATMENT +iris-pupila I-TREATMENT +al I-TREATMENT +modelo I-TREATMENT +en I-TREATMENT +cera, I-TREATMENT +se I-TREATMENT +construyó I-TREATMENT +una I-TREATMENT +mufla I-TREATMENT +para I-TREATMENT +obtener I-TREATMENT +el I-TREATMENT +ojo I-TREATMENT +protésico I-TREATMENT +en I-TREATMENT +acrílico. I-TREATMENT +Se I-TREATMENT +cargó I-TREATMENT la I-TREATMENT -paciente I-TREATMENT -continúa I-TREATMENT +mufla I-TREATMENT con I-TREATMENT -fiebre, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT +resina I-TREATMENT +blanca, I-TREATMENT +incluyendo I-TREATMENT +pigmentos I-TREATMENT que I-TREATMENT se I-TREATMENT -plantea I-TREATMENT -un I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -rescate I-TREATMENT -con I-TREATMENT -colistina I-TREATMENT -iv I-TREATMENT -2 I-TREATMENT -MUI/8 I-TREATMENT -h, I-TREATMENT -colistina I-TREATMENT -intraventricular I-TREATMENT -60.000 I-TREATMENT -UI/12 I-TREATMENT -h I-TREATMENT +asemejen I-TREATMENT +lo I-TREATMENT +más I-TREATMENT +posible I-TREATMENT +a I-TREATMENT +la I-TREATMENT +esclerótica I-TREATMENT y I-TREATMENT -cotrimoxazol I-TREATMENT -iv I-TREATMENT -1.600/320 I-TREATMENT -mg/12 I-TREATMENT -h. I-TREATMENT -Transcurridos B-EXPLORATION -7 I-EXPLORATION -días I-EXPLORATION -con I-EXPLORATION -dicho I-EXPLORATION -tratamiento, I-EXPLORATION -el I-EXPLORATION -día I-EXPLORATION -+82 I-EXPLORATION -crece, I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -LCR, I-EXPLORATION -S. I-EXPLORATION -maltophilia I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -minociclina I-EXPLORATION -(CMI I-EXPLORATION -≤ I-EXPLORATION -4 I-EXPLORATION -mg/L, I-EXPLORATION -CLSI-2012) I-EXPLORATION -y I-EXPLORATION -resistente I-EXPLORATION -a I-EXPLORATION -colistina I-EXPLORATION -(CMI I-EXPLORATION -> I-EXPLORATION -4 I-EXPLORATION -mg/L) I-EXPLORATION -2. I-EXPLORATION -Tras I-EXPLORATION -la I-EXPLORATION -confirmación I-EXPLORATION -de I-EXPLORATION -este I-EXPLORATION -valor I-EXPLORATION -mediante I-EXPLORATION -una I-EXPLORATION -tira I-EXPLORATION -de I-EXPLORATION -gradiente I-EXPLORATION -preformado I-EXPLORATION -de I-EXPLORATION -CMI, I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -debe I-EXPLORATION -al I-EXPLORATION -crecimiento I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -subpoblación I-EXPLORATION -diferente I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mayoritaria. I-EXPLORATION -Ante B-TREATMENT -esta I-TREATMENT -situación I-TREATMENT se I-TREATMENT -suspende I-TREATMENT -colistina I-TREATMENT -y I-TREATMENT +polimerizó I-TREATMENT +en I-TREATMENT +agua I-TREATMENT +hirviendo I-TREATMENT +durante I-TREATMENT +30 I-TREATMENT +minutos. I-TREATMENT +Tras I-TREATMENT +el I-TREATMENT +enfriamiento I-TREATMENT se I-TREATMENT -administra I-TREATMENT -minociclina I-TREATMENT -200 I-TREATMENT -mg/12 I-TREATMENT -h I-TREATMENT -por I-TREATMENT -sonda I-TREATMENT -nasogástrica, I-TREATMENT -además I-TREATMENT +desgastó I-TREATMENT +el I-TREATMENT +exceso I-TREATMENT de I-TREATMENT -cotrimoxazol I-TREATMENT -iv I-TREATMENT -1.600/320 I-TREATMENT -mg/12 I-TREATMENT -h. I-TREATMENT -Posteriormente, I-TREATMENT -ante I-TREATMENT +resina I-TREATMENT +existente I-TREATMENT +en I-TREATMENT la I-TREATMENT -necesidad I-TREATMENT -de I-TREATMENT -dieta I-TREATMENT -absoluta I-TREATMENT -como I-TREATMENT -consecuencia I-TREATMENT -de I-TREATMENT +superficie I-TREATMENT +del I-TREATMENT +iris, I-TREATMENT +dejándola I-TREATMENT +inclusive I-TREATMENT +cóncava, I-TREATMENT +para I-TREATMENT +dar I-TREATMENT una I-TREATMENT -hemorragia I-TREATMENT -digestiva, I-TREATMENT +mayor I-TREATMENT +apariencia I-TREATMENT +de I-TREATMENT +profundidad; I-TREATMENT +lo I-TREATMENT +mismo I-TREATMENT +se I-TREATMENT +hizo I-TREATMENT +con I-TREATMENT el I-TREATMENT -día I-TREATMENT -+94 I-TREATMENT +espacio I-TREATMENT +correspondiente I-TREATMENT +a I-TREATMENT +la I-TREATMENT +esclerótica. I-TREATMENT + I-TREATMENT +La I-TREATMENT +caracterización I-TREATMENT +de I-TREATMENT +la I-TREATMENT +esclerótica I-TREATMENT se I-TREATMENT -suspende I-TREATMENT -minociclina I-TREATMENT +realizó I-TREATMENT +imitando I-TREATMENT +los I-TREATMENT +vasos I-TREATMENT +sanguíneos I-TREATMENT +con I-TREATMENT +hilos I-TREATMENT +de I-TREATMENT +lana I-TREATMENT +o I-TREATMENT +seda I-TREATMENT +cortados I-TREATMENT y I-TREATMENT -se I-TREATMENT -pauta I-TREATMENT -tigeciclina I-TREATMENT -iv I-TREATMENT -50 I-TREATMENT -mg/12 I-TREATMENT -h. I-TREATMENT -Finalmente B-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -fallece I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -95 I-EVOLUTION -días I-EVOLUTION -del I-EVOLUTION -ingreso I-EVOLUTION -por I-EVOLUTION -infecciones I-EVOLUTION -intercurrentes. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -27 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de B-PAST_MEDICAL_HISTORY -edad, I-PAST_MEDICAL_HISTORY -fumadora I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dos/tres I-PAST_MEDICAL_HISTORY -cigarrillos/día I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -veinte I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Menarquia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Primer I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -16 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Cinco I-PAST_MEDICAL_HISTORY -gestaciones I-PAST_MEDICAL_HISTORY -(tres I-PAST_MEDICAL_HISTORY -cesáreas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -abortos). I-PAST_MEDICAL_HISTORY -Uso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -anticonceptivos I-PAST_MEDICAL_HISTORY -orales I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -diciembre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2013 I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -oncología I-PRESENT_ILLNESS -y B-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -presenta I-EXPLORATION -edema I-EXPLORATION -cutáneo I-EXPLORATION -que I-EXPLORATION -engloba I-EXPLORATION -a I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -mama I-EXPLORATION -derecha I-EXPLORATION -con I-EXPLORATION -piel I-EXPLORATION -tensa, I-EXPLORATION -vesiculosa, I-EXPLORATION -areola I-EXPLORATION -y I-EXPLORATION -pezón I-EXPLORATION -retraídos, I-EXPLORATION -y I-EXPLORATION -adenopatías I-EXPLORATION -axilares I-EXPLORATION -derecha I-EXPLORATION -e I-EXPLORATION -izquierda I-EXPLORATION -dolorosas I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación. I-EXPLORATION -Presenta I-EXPLORATION -molestia I-EXPLORATION -en I-EXPLORATION -mama I-EXPLORATION -derecha, I-EXPLORATION -zona I-EXPLORATION -costal I-EXPLORATION -y I-EXPLORATION -submamaria. I-EXPLORATION -ECOG I-EXPLORATION -2 I-EXPLORATION -como I-EXPLORATION -estado I-EXPLORATION -general. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizaron I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -necesarias I-EXPLORATION -para I-EXPLORATION -determinar I-EXPLORATION -el I-EXPLORATION -estadio I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -neoplasia. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -presentó I-EXPLORATION -Fe: I-EXPLORATION -26 I-EXPLORATION -μg/dL I-EXPLORATION -(RN: I-EXPLORATION -50-170 I-EXPLORATION -μg/dL), I-EXPLORATION -IST: I-EXPLORATION -9% I-EXPLORATION -(RN: I-EXPLORATION -25-50 I-EXPLORATION -%). I-EXPLORATION -Ca I-EXPLORATION -15 I-EXPLORATION -3: I-EXPLORATION -92, I-EXPLORATION -2 I-EXPLORATION -UI/mL I-EXPLORATION -(RN: I-EXPLORATION -< I-EXPLORATION -32, I-EXPLORATION -4 I-EXPLORATION -UI/mL) I-EXPLORATION -con I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -hemograma I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -BAG I-EXPLORATION -(biopsia I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -gruesa), I-EXPLORATION -Punch I-EXPLORATION -cutáneo I-EXPLORATION -y I-EXPLORATION -Hercep I-EXPLORATION -Test®: I-EXPLORATION -positivo I-EXPLORATION -(HER I-EXPLORATION -2 I-EXPLORATION -+). I-EXPLORATION -El I-EXPLORATION -PET-TAC I-EXPLORATION -describió I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -tumoral I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mama I-EXPLORATION -derecha, I-EXPLORATION -en I-EXPLORATION -adenopatías I-EXPLORATION -axilares I-EXPLORATION -derechas I-EXPLORATION -e I-EXPLORATION -izquierda, I-EXPLORATION -adenopatía I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION -mamaria I-EXPLORATION -interna I-EXPLORATION -derecha, I-EXPLORATION -en I-EXPLORATION -vértebras I-EXPLORATION -óseas I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -segmento I-EXPLORATION -inferior I-EXPLORATION -(VI) I-EXPLORATION -del I-EXPLORATION -lóbulo I-EXPLORATION -derecho I-EXPLORATION -hepático. I-EXPLORATION - I-EXPLORATION -Por I-EXPLORATION -lo I-EXPLORATION -tanto I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -fue I-EXPLORATION -diagnosticada I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -ductal I-EXPLORATION -infiltrante I-EXPLORATION -G2 I-EXPLORATION -cT4d I-EXPLORATION -cN1 I-EXPLORATION -M1 I-EXPLORATION -(óseas, I-EXPLORATION -ganglionares I-EXPLORATION -y I-EXPLORATION -hepáticas) I-EXPLORATION -estadio I-EXPLORATION -IV, I-EXPLORATION -síndrome I-EXPLORATION -de I-EXPLORATION -dolor I-EXPLORATION -mamario I-EXPLORATION -y I-EXPLORATION -ferropenia, I-EXPLORATION -secundarios I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -enfermedad I-EXPLORATION -principal. I-EXPLORATION -Como B-TREATMENT -terapia I-TREATMENT +pegados I-TREATMENT +en I-TREATMENT +la I-TREATMENT +esclerótica I-TREATMENT +en I-TREATMENT +sentido I-TREATMENT +longitudinal, I-TREATMENT +partiendo I-TREATMENT de I-TREATMENT -elección I-TREATMENT +los I-TREATMENT +ángulos I-TREATMENT +donde I-TREATMENT +hay I-TREATMENT +mas I-TREATMENT +concentración I-TREATMENT +y I-TREATMENT +disminuyendo I-TREATMENT +de I-TREATMENT +intensidad I-TREATMENT +cuando I-TREATMENT se I-TREATMENT -propuso I-TREATMENT -pertuzumab I-TREATMENT +aproximan I-TREATMENT +al I-TREATMENT +iris3*, I-TREATMENT +5*, I-TREATMENT +8*, I-TREATMENT +9. I-TREATMENT +Se I-TREATMENT +utilizan I-TREATMENT +las I-TREATMENT +mismas I-TREATMENT +pinturas I-TREATMENT +usadas I-TREATMENT para I-TREATMENT el I-TREATMENT -tratamiento I-TREATMENT -del I-TREATMENT -CM I-TREATMENT -HER2 I-TREATMENT -+ I-TREATMENT -metastásico I-TREATMENT -o I-TREATMENT -localmente I-TREATMENT -recurrente I-TREATMENT -no I-TREATMENT -resecable, I-TREATMENT +iris. I-TREATMENT + I-TREATMENT +Terminada I-TREATMENT +la I-TREATMENT +pigmentación I-TREATMENT +externa I-TREATMENT +de I-TREATMENT +la I-TREATMENT +prótesis I-TREATMENT +esta I-TREATMENT +se I-TREATMENT +reubicó I-TREATMENT en I-TREATMENT -combinación I-TREATMENT +la I-TREATMENT +mufla I-TREATMENT +y I-TREATMENT +se I-TREATMENT +carga I-TREATMENT con I-TREATMENT -trastuzumab I-TREATMENT +una I-TREATMENT +capa I-TREATMENT +de I-TREATMENT +acrílico I-TREATMENT +transparente I-TREATMENT +que I-TREATMENT +tiene I-TREATMENT +la I-TREATMENT +función I-TREATMENT +de I-TREATMENT +proteger I-TREATMENT y I-TREATMENT -docetaxel4. I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecocardiografía I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -monitorización I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -función I-EXPLORATION -cardíaca I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -valor I-EXPLORATION -FEVI I-EXPLORATION -63, I-EXPLORATION -9% I-EXPLORATION -normal, I-EXPLORATION -ya I-EXPLORATION -que I-EXPLORATION -podía I-EXPLORATION -verse I-EXPLORATION -afectada I-EXPLORATION -por I-EXPLORATION -trastuzumab I-EXPLORATION -y I-EXPLORATION -pertuzumab, I-EXPLORATION -y I-EXPLORATION -RMN I-EXPLORATION -(resonancia I-EXPLORATION -magnética I-EXPLORATION -nuclear) I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -metástasis I-EXPLORATION -cerebrales I-EXPLORATION -ya I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -considera I-EXPLORATION -un I-EXPLORATION -criterio I-EXPLORATION -para I-EXPLORATION -excluir I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -del I-EXPLORATION -beneficio I-EXPLORATION -de I-EXPLORATION -pertuzumab. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -esquema I-TREATMENT +dar I-TREATMENT +translucidez I-TREATMENT +a I-TREATMENT +la I-TREATMENT +prótesis4, I-TREATMENT +5. I-TREATMENT + I-TREATMENT +Tras I-TREATMENT +el I-TREATMENT +pulido I-TREATMENT +las I-TREATMENT +dos I-TREATMENT +resinas I-TREATMENT +tienen I-TREATMENT +que I-TREATMENT +quedar I-TREATMENT +perfectamente I-TREATMENT +unidas, I-TREATMENT +sin I-TREATMENT +irregularidades. I-TREATMENT +Para I-TREATMENT +eso, I-TREATMENT +se I-TREATMENT +puede I-TREATMENT +utilizar I-TREATMENT +fresas I-TREATMENT de I-TREATMENT -tratamiento I-TREATMENT -planteado I-TREATMENT -fue: I-TREATMENT -pertuzumab I-TREATMENT -840mg I-TREATMENT -(inicio) I-TREATMENT -/420 I-TREATMENT -mg I-TREATMENT -(mantenimiento), I-TREATMENT -trastuzumab I-TREATMENT -8mg/kg I-TREATMENT -(inicio) I-TREATMENT -/6mg/kg I-TREATMENT -(mantenimiento), I-TREATMENT -docetaxel I-TREATMENT -75mg/m2, I-TREATMENT -cada I-TREATMENT -21 I-TREATMENT -días5. I-TREATMENT -Las I-TREATMENT -dosis I-TREATMENT +diamante, I-TREATMENT +conos I-TREATMENT de I-TREATMENT -antineoplásicos I-TREATMENT -fueron I-TREATMENT -calculadas I-TREATMENT -según I-TREATMENT -peso I-TREATMENT -(88kg) I-TREATMENT +silicona, I-TREATMENT +papel I-TREATMENT +de I-TREATMENT +lija, I-TREATMENT y I-TREATMENT -superficie I-TREATMENT -corporal I-TREATMENT -(1, I-TREATMENT -95 I-TREATMENT -m2). I-TREATMENT +siempre I-TREATMENT +a I-TREATMENT +baja I-TREATMENT +velocidad. I-TREATMENT El I-TREATMENT -inicio I-TREATMENT +pulido I-TREATMENT +se I-TREATMENT +hizo I-TREATMENT +con I-TREATMENT +agua, I-TREATMENT +polvo I-TREATMENT +de I-TREATMENT +piedra-pómez I-TREATMENT +y I-TREATMENT +algodón5, I-TREATMENT +10. I-TREATMENT + I-TREATMENT +El I-TREATMENT +encerado I-TREATMENT del I-TREATMENT -tratamiento I-TREATMENT -fue I-TREATMENT -interrumpido I-TREATMENT +globo I-TREATMENT +ocular I-TREATMENT +empieza I-TREATMENT +a I-TREATMENT +partir I-TREATMENT +de I-TREATMENT +una I-TREATMENT +hoja I-TREATMENT +de I-TREATMENT +cera I-TREATMENT +rosa I-TREATMENT +bien I-TREATMENT +adaptada I-TREATMENT +al I-TREATMENT +modelo I-TREATMENT +de I-TREATMENT +trabajo, I-TREATMENT +rellenando I-TREATMENT +los I-TREATMENT +espacios I-TREATMENT +y I-TREATMENT +esculpiendo I-TREATMENT +los I-TREATMENT +límites I-TREATMENT +y I-TREATMENT +los I-TREATMENT +salientes I-TREATMENT +de I-TREATMENT +la I-TREATMENT +prótesis, I-TREATMENT +los I-TREATMENT +cuales I-TREATMENT +tienen I-TREATMENT +que I-TREATMENT +estar I-TREATMENT +perfectamente I-TREATMENT +definidos I-TREATMENT +y I-TREATMENT +adaptados2, I-TREATMENT +6, I-TREATMENT +10, I-TREATMENT +11. I-TREATMENT + I-TREATMENT +La I-TREATMENT +ubicación I-TREATMENT +del I-TREATMENT +ojo I-TREATMENT +protésico I-TREATMENT +constituye I-TREATMENT +un I-TREATMENT +paso I-TREATMENT +extremadamente I-TREATMENT +crítico I-TREATMENT por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +recomienda I-TREATMENT +la I-TREATMENT +presencia I-TREATMENT +del I-TREATMENT +paciente8*, I-TREATMENT +11. I-TREATMENT +Se I-TREATMENT +debe I-TREATMENT +conseguir I-TREATMENT +que I-TREATMENT +la I-TREATMENT +«almendra» I-TREATMENT +ocupe I-TREATMENT +la I-TREATMENT +posición I-TREATMENT +correcta I-TREATMENT +en I-TREATMENT +los I-TREATMENT +tres I-TREATMENT +planos I-TREATMENT +del I-TREATMENT +espacio12. I-TREATMENT +Se I-TREATMENT +usan I-TREATMENT +diferentes I-TREATMENT +técnicas I-TREATMENT +de I-TREATMENT +alineación; I-TREATMENT +todas I-TREATMENT +ellas I-TREATMENT +tienen I-TREATMENT +la I-TREATMENT +finalidad I-TREATMENT +de I-TREATMENT +lograr I-TREATMENT +la I-TREATMENT +posición I-TREATMENT +correcta I-TREATMENT +en I-TREATMENT +la I-TREATMENT +lámina I-TREATMENT +de I-TREATMENT +cera. I-TREATMENT +Aparatos I-TREATMENT +como I-TREATMENT +la I-TREATMENT +regla I-TREATMENT +de I-TREATMENT +Vernier I-TREATMENT +y I-TREATMENT +pupilómetros, I-TREATMENT +se I-TREATMENT +usan I-TREATMENT +para I-TREATMENT +ayudar I-TREATMENT +a I-TREATMENT +conseguir I-TREATMENT +la I-TREATMENT +ubicación I-TREATMENT +de I-TREATMENT +la I-TREATMENT +prótesis I-TREATMENT +ocular I-TREATMENT +dentro I-TREATMENT +de I-TREATMENT +la I-TREATMENT +órbita. I-TREATMENT +La I-TREATMENT +regla I-TREATMENT +de I-TREATMENT +Vernier I-TREATMENT +mide I-TREATMENT +la I-TREATMENT +distancia I-TREATMENT +interpupilar I-TREATMENT +que I-TREATMENT +normalmente I-TREATMENT +es I-TREATMENT +de I-TREATMENT +60 I-TREATMENT +mm, I-TREATMENT +aproximadamente2, I-TREATMENT +3*, I-TREATMENT +10. I-TREATMENT +Una I-TREATMENT +vez I-TREATMENT +ubicada I-TREATMENT +la I-TREATMENT +«almendra» I-TREATMENT +se I-TREATMENT +comienza I-TREATMENT +la I-TREATMENT +escultura., I-TREATMENT +confeccionando I-TREATMENT +un I-TREATMENT +ojo I-TREATMENT +con I-TREATMENT +un I-TREATMENT +tamaño I-TREATMENT +mayor I-TREATMENT +que I-TREATMENT +permite I-TREATMENT una I-TREATMENT -reacción I-TREATMENT -inmediata I-TREATMENT -sistémica I-TREATMENT +mayor I-TREATMENT +adaptación I-TREATMENT a I-TREATMENT la I-TREATMENT -infusión I-TREATMENT +cavidad. I-TREATMENT + I-TREATMENT +La I-TREATMENT +escultura I-TREATMENT +intenta I-TREATMENT +copiar I-TREATMENT +todas I-TREATMENT +las I-TREATMENT +líneas I-TREATMENT de I-TREATMENT -docetaxel I-TREATMENT +expresión I-TREATMENT +e I-TREATMENT +irregularidades I-TREATMENT +de I-TREATMENT +la I-TREATMENT +piel I-TREATMENT +en I-TREATMENT +la I-TREATMENT +cera. I-TREATMENT +Se I-TREATMENT +crean I-TREATMENT +los I-TREATMENT +párpados I-TREATMENT +y I-TREATMENT +la I-TREATMENT +abertura I-TREATMENT +palpebral, I-TREATMENT +siempre I-TREATMENT +comparándolos I-TREATMENT con I-TREATMENT -presencia I-TREATMENT +el I-TREATMENT +ojo I-TREATMENT +sano I-TREATMENT +del I-TREATMENT +paciente. I-TREATMENT +Las I-TREATMENT +marcas I-TREATMENT +en I-TREATMENT +el I-TREATMENT +yeso I-TREATMENT +que I-TREATMENT +se I-TREATMENT +aprecian I-TREATMENT +en I-TREATMENT +la I-TREATMENT +foto, I-TREATMENT +corresponden I-TREATMENT +a I-TREATMENT +la I-TREATMENT +línea I-TREATMENT +media I-TREATMENT de I-TREATMENT -disnea I-TREATMENT +la I-TREATMENT +cara I-TREATMENT y I-TREATMENT -mareos I-TREATMENT +a I-TREATMENT +la I-TREATMENT +línea I-TREATMENT +bipupilar. I-TREATMENT +Los I-TREATMENT +límites I-TREATMENT +de I-TREATMENT +la I-TREATMENT +prótesis I-TREATMENT +deben I-TREATMENT +quedar I-TREATMENT +disimulados I-TREATMENT +con I-TREATMENT +las I-TREATMENT +arrugas I-TREATMENT +y I-TREATMENT +salientes I-TREATMENT +naturales I-TREATMENT +de I-TREATMENT +la I-TREATMENT +piel, I-TREATMENT +con I-TREATMENT +la I-TREATMENT +intención I-TREATMENT +de I-TREATMENT +conseguir I-TREATMENT +la I-TREATMENT +correcta I-TREATMENT +expresión I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cara I-TREATMENT +del I-TREATMENT +paciente8. I-TREATMENT +La I-TREATMENT +prueba I-TREATMENT +de I-TREATMENT +la I-TREATMENT +épitesis I-TREATMENT +sobre I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +permite I-TREATMENT +verificar I-TREATMENT +la I-TREATMENT +alineación I-TREATMENT +de I-TREATMENT +los I-TREATMENT +dos I-TREATMENT +ojos. I-TREATMENT +Se I-TREATMENT +pide I-TREATMENT +al I-TREATMENT +paciente I-TREATMENT +que I-TREATMENT +imite I-TREATMENT +la I-TREATMENT +acción I-TREATMENT +de I-TREATMENT +leer I-TREATMENT +un I-TREATMENT +periódico. I-TREATMENT + I-TREATMENT +Cuando I-TREATMENT +todo I-TREATMENT +es I-TREATMENT +correcto I-TREATMENT +se I-TREATMENT +incluye I-TREATMENT +el I-TREATMENT +encerado I-TREATMENT +de I-TREATMENT +la I-TREATMENT +épitesis I-TREATMENT +en I-TREATMENT +la I-TREATMENT +mufla, I-TREATMENT +donde I-TREATMENT +la I-TREATMENT +cara I-TREATMENT +interna I-TREATMENT +de I-TREATMENT +la I-TREATMENT +escultura I-TREATMENT +corresponde I-TREATMENT +a I-TREATMENT +la I-TREATMENT +cavidad I-TREATMENT +del I-TREATMENT +defecto. I-TREATMENT +Este I-TREATMENT +tipo I-TREATMENT +de I-TREATMENT +prótesis I-TREATMENT +es I-TREATMENT +la I-TREATMENT +única I-TREATMENT +que I-TREATMENT +permite I-TREATMENT +reproducir I-TREATMENT +las I-TREATMENT +zonas I-TREATMENT +retentivas I-TREATMENT +del I-TREATMENT +fondo I-TREATMENT +cavitario. I-TREATMENT +Las I-TREATMENT +muflas I-TREATMENT +deben I-TREATMENT +tener I-TREATMENT +guías I-TREATMENT que I-TREATMENT -precisó I-TREATMENT -paracetamol, I-TREATMENT -hidrocortisona, I-TREATMENT -lorazepam I-TREATMENT +nos I-TREATMENT +aseguren I-TREATMENT +la I-TREATMENT +correcta I-TREATMENT +colocación I-TREATMENT y I-TREATMENT -posterior I-TREATMENT -valoración I-TREATMENT por I-TREATMENT -parte I-TREATMENT -del I-TREATMENT -Servicio I-TREATMENT +ello I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +una I-TREATMENT +retención I-TREATMENT +en I-TREATMENT +el I-TREATMENT +ojo I-TREATMENT +que I-TREATMENT +permite I-TREATMENT +su I-TREATMENT +ubicación I-TREATMENT +en I-TREATMENT +la I-TREATMENT +mufla. I-TREATMENT +Es I-TREATMENT +muy I-TREATMENT +importante I-TREATMENT +que I-TREATMENT +los I-TREATMENT +márgenes I-TREATMENT de I-TREATMENT -Alergia I-TREATMENT +la I-TREATMENT +cera I-TREATMENT +estén I-TREATMENT +en I-TREATMENT +una I-TREATMENT +base I-TREATMENT +pulida I-TREATMENT +de I-TREATMENT +yeso I-TREATMENT +para I-TREATMENT que I-TREATMENT -pautó I-TREATMENT -un I-TREATMENT -protocolo I-TREATMENT +queden I-TREATMENT +bien I-TREATMENT +definidos. I-TREATMENT +La I-TREATMENT +silicona I-TREATMENT +fue I-TREATMENT +el I-TREATMENT +material I-TREATMENT de I-TREATMENT -desensibilización I-TREATMENT +elección I-TREATMENT para I-TREATMENT -administrar I-TREATMENT +confeccionar I-TREATMENT la I-TREATMENT -dosis I-TREATMENT +épitesis. I-TREATMENT +Viene I-TREATMENT +con I-TREATMENT +una I-TREATMENT +presentación I-TREATMENT de I-TREATMENT -docetaxel. I-TREATMENT -La I-TREATMENT -paciente I-TREATMENT -ingresó I-TREATMENT -en I-TREATMENT -UCI I-TREATMENT +un I-TREATMENT +endurecedor I-TREATMENT +o I-TREATMENT +«crosslinker», I-TREATMENT +un I-TREATMENT +catalizador I-TREATMENT +y I-TREATMENT +una I-TREATMENT +base I-TREATMENT de I-TREATMENT -forma I-TREATMENT -programada I-TREATMENT -al I-TREATMENT -día I-TREATMENT -siguiente I-TREATMENT +coloración I-TREATMENT +de I-TREATMENT +la I-TREATMENT +piel I-TREATMENT +en I-TREATMENT +diferentes I-TREATMENT +tonalidades, I-TREATMENT para I-TREATMENT -su I-TREATMENT -administración I-TREATMENT +facilitar I-TREATMENT +la I-TREATMENT +mezcla I-TREATMENT y I-TREATMENT -completar I-TREATMENT -así I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT +poder I-TREATMENT +encontrar I-TREATMENT +los I-TREATMENT +colores I-TREATMENT +adecuados I-TREATMENT +en I-TREATMENT +cada I-TREATMENT +caso. I-TREATMENT +En I-TREATMENT +éste I-TREATMENT +se I-TREATMENT +utilizó I-TREATMENT +una I-TREATMENT +silicona I-TREATMENT +catalizada I-TREATMENT +con I-TREATMENT +platina I-TREATMENT +(Episyl, I-TREATMENT de I-TREATMENT -QT. I-TREATMENT - I-TREATMENT -Para I-TREATMENT la I-TREATMENT -pauta I-TREATMENT +casa I-TREATMENT +Dreve), I-TREATMENT +que I-TREATMENT +ya I-TREATMENT +viene I-TREATMENT +pre-coloreada. I-TREATMENT +Algunos I-TREATMENT +profesionales I-TREATMENT +prefieren I-TREATMENT +siliconas I-TREATMENT +transparentes I-TREATMENT de I-TREATMENT -desensibilización I-TREATMENT +otras I-TREATMENT +casas I-TREATMENT +comerciales. I-TREATMENT +Si I-TREATMENT se I-TREATMENT -utilizaron I-TREATMENT -tres I-TREATMENT -soluciones I-TREATMENT -del I-TREATMENT -medicamento I-TREATMENT -(cada I-TREATMENT +utiliza I-TREATMENT una I-TREATMENT -de I-TREATMENT -250 I-TREATMENT -mL I-TREATMENT -ClNa I-TREATMENT -0, I-TREATMENT -9%): I-TREATMENT -A, I-TREATMENT -B I-TREATMENT -y I-TREATMENT -C I-TREATMENT +u I-TREATMENT +otra I-TREATMENT +silicona, I-TREATMENT +es I-TREATMENT +necesario I-TREATMENT +añadir I-TREATMENT +pigmentos, I-TREATMENT que I-TREATMENT +pueden I-TREATMENT +ser I-TREATMENT +minerales I-TREATMENT +u I-TREATMENT +orgánicos13. I-TREATMENT +Aquí I-TREATMENT se I-TREATMENT -administraron I-TREATMENT -en I-TREATMENT -doce I-TREATMENT -pasos I-TREATMENT -consecutivos I-TREATMENT +utilizaron I-TREATMENT +pigmentos I-TREATMENT +orgánicos, I-TREATMENT +que I-TREATMENT +ya I-TREATMENT +vienen I-TREATMENT +mezclados I-TREATMENT con I-TREATMENT -aumento I-TREATMENT +aceite I-TREATMENT +de I-TREATMENT +silicona. I-TREATMENT + I-TREATMENT +Por I-TREATMENT +otro I-TREATMENT +lado I-TREATMENT +la I-TREATMENT +iluminación I-TREATMENT +del I-TREATMENT +local I-TREATMENT +debe I-TREATMENT +ser I-TREATMENT +natural, I-TREATMENT +para I-TREATMENT +evitar I-TREATMENT +errores. I-TREATMENT +El I-TREATMENT +paciente I-TREATMENT +debe I-TREATMENT +estar I-TREATMENT +presente I-TREATMENT +en I-TREATMENT +el I-TREATMENT +momento I-TREATMENT de I-TREATMENT la I-TREATMENT -velocidad I-TREATMENT +caracterización I-TREATMENT de I-TREATMENT -infusión. I-TREATMENT -La I-TREATMENT -solución I-TREATMENT -A I-TREATMENT -contenía I-TREATMENT -una I-TREATMENT -dilución I-TREATMENT -1/100 I-TREATMENT +la I-TREATMENT +silicona. I-TREATMENT +Primero I-TREATMENT +se I-TREATMENT +determina I-TREATMENT +el I-TREATMENT +color I-TREATMENT +base I-TREATMENT de I-TREATMENT la I-TREATMENT -concentración I-TREATMENT -objetivo I-TREATMENT -final I-TREATMENT -(pasos I-TREATMENT -1-4) I-TREATMENT +piel I-TREATMENT +mezclando I-TREATMENT +las I-TREATMENT +siliconas I-TREATMENT +de I-TREATMENT +vulcanización I-TREATMENT +a I-TREATMENT +frío I-TREATMENT y I-TREATMENT +haciendo I-TREATMENT +presión. I-TREATMENT +Después I-TREATMENT +de I-TREATMENT +presionar I-TREATMENT +con I-TREATMENT +el I-TREATMENT +dedo I-TREATMENT +durante I-TREATMENT +unos I-TREATMENT +segundos I-TREATMENT la I-TREATMENT -solución I-TREATMENT -B I-TREATMENT -una I-TREATMENT -dilución I-TREATMENT -1/10 I-TREATMENT +piel I-TREATMENT +del I-TREATMENT +paciente, I-TREATMENT +ésta I-TREATMENT +presenta I-TREATMENT +un I-TREATMENT +color I-TREATMENT +sin I-TREATMENT +afluencia I-TREATMENT +sanguínea. I-TREATMENT +Es I-TREATMENT +este I-TREATMENT +el I-TREATMENT +momento I-TREATMENT +en I-TREATMENT +que I-TREATMENT +se I-TREATMENT +debe I-TREATMENT +comparar I-TREATMENT +el I-TREATMENT +color. I-TREATMENT +En I-TREATMENT +seguida I-TREATMENT +se I-TREATMENT +intenta I-TREATMENT +llegar I-TREATMENT +al I-TREATMENT +color I-TREATMENT +exterior I-TREATMENT de I-TREATMENT la I-TREATMENT -concentración I-TREATMENT -objetivo I-TREATMENT -final I-TREATMENT -(pasos I-TREATMENT -5-8). I-TREATMENT -De I-TREATMENT +piel. I-TREATMENT +Se I-TREATMENT +separa I-TREATMENT +los I-TREATMENT +diferentes I-TREATMENT +colores I-TREATMENT +y I-TREATMENT +se I-TREATMENT +van I-TREATMENT +mezclando I-TREATMENT +los I-TREATMENT +pigmentos I-TREATMENT +hasta I-TREATMENT +conseguir I-TREATMENT +imitar I-TREATMENT +las I-TREATMENT +regiones I-TREATMENT +de I-TREATMENT +los I-TREATMENT +párpados I-TREATMENT +superior I-TREATMENT +e I-TREATMENT +inferior I-TREATMENT +y I-TREATMENT +de I-TREATMENT +las I-TREATMENT +zonas I-TREATMENT +aledañas5. I-TREATMENT +Se I-TREATMENT +pueden I-TREATMENT +ir I-TREATMENT +agregando I-TREATMENT +con I-TREATMENT +un I-TREATMENT +pincel I-TREATMENT +diferentes I-TREATMENT +colores I-TREATMENT +directamente I-TREATMENT +en I-TREATMENT +las I-TREATMENT +distintas I-TREATMENT +áreas I-TREATMENT +de I-TREATMENT la I-TREATMENT -solución I-TREATMENT -C I-TREATMENT -(150 I-TREATMENT -mg/250 I-TREATMENT -mL) I-TREATMENT +mufla. I-TREATMENT +Una I-TREATMENT +vez I-TREATMENT +colocado I-TREATMENT +el I-TREATMENT +ojo I-TREATMENT +en I-TREATMENT +la I-TREATMENT +mufla, I-TREATMENT se I-TREATMENT -administró I-TREATMENT +cargó I-TREATMENT +con I-TREATMENT la I-TREATMENT -dosis I-TREATMENT -restante, I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -calculada I-TREATMENT -restando I-TREATMENT +silicona I-TREATMENT +correspondiente I-TREATMENT +al I-TREATMENT +color I-TREATMENT +base I-TREATMENT +de I-TREATMENT la I-TREATMENT -dosis I-TREATMENT -acumulada I-TREATMENT +piel. I-TREATMENT +Cargada I-TREATMENT +la I-TREATMENT +mufla, I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT a I-TREATMENT +su I-TREATMENT +prensado, I-TREATMENT +hasta I-TREATMENT +que I-TREATMENT +los I-TREATMENT +bordes I-TREATMENT +metálicos I-TREATMENT +de I-TREATMENT la I-TREATMENT -dosis I-TREATMENT -total I-TREATMENT +mufla I-TREATMENT +contactaron. I-TREATMENT +Hecho I-TREATMENT +esto, I-TREATMENT +se I-TREATMENT +coloca I-TREATMENT +en I-TREATMENT +agua I-TREATMENT +y I-TREATMENT +se I-TREATMENT +hace I-TREATMENT +hervir I-TREATMENT +durante I-TREATMENT +dos I-TREATMENT +horas I-TREATMENT +hasta I-TREATMENT que I-TREATMENT -había I-TREATMENT +el I-TREATMENT +material I-TREATMENT +polimerice I-TREATMENT +o I-TREATMENT +se I-TREATMENT +sigue I-TREATMENT +las I-TREATMENT +instrucciones I-TREATMENT +del I-TREATMENT +fabricante. I-TREATMENT +Luego I-TREATMENT que I-TREATMENT -administrar I-TREATMENT -a I-TREATMENT +se I-TREATMENT +comprueba I-TREATMENT la I-TREATMENT -paciente. I-TREATMENT -Cada I-TREATMENT -uno I-TREATMENT +vulcanización I-TREATMENT de I-TREATMENT -los I-TREATMENT -pasos I-TREATMENT -1 I-TREATMENT -a I-TREATMENT -11 I-TREATMENT +la I-TREATMENT +silicona, I-TREATMENT se I-TREATMENT -administró I-TREATMENT +abre I-TREATMENT +la I-TREATMENT +mufla I-TREATMENT +con I-TREATMENT +cuidado I-TREATMENT +ya I-TREATMENT +que I-TREATMENT +la I-TREATMENT +silicona I-TREATMENT +puede I-TREATMENT +rasgarse I-TREATMENT en I-TREATMENT -15 I-TREATMENT -minutos I-TREATMENT -(la I-TREATMENT -dosis I-TREATMENT -se I-TREATMENT -incrementó I-TREATMENT +los I-TREATMENT +bordes I-TREATMENT +y I-TREATMENT +estropear I-TREATMENT +el I-TREATMENT +trabajo. I-TREATMENT + I-TREATMENT +Con I-TREATMENT +la I-TREATMENT +epítesis I-TREATMENT en I-TREATMENT +mano, I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +recortar I-TREATMENT +los I-TREATMENT +márgenes. I-TREATMENT +Se I-TREATMENT +limpian I-TREATMENT +los I-TREATMENT +restos I-TREATMENT +de I-TREATMENT +yeso I-TREATMENT +que I-TREATMENT +pueden I-TREATMENT +haber I-TREATMENT +quedado. I-TREATMENT +También I-TREATMENT +se I-TREATMENT +retira I-TREATMENT +el I-TREATMENT +ojo I-TREATMENT +para I-TREATMENT un I-TREATMENT -2 I-TREATMENT -- I-TREATMENT -2, I-TREATMENT -5 I-TREATMENT -veces I-TREATMENT -con I-TREATMENT -cada I-TREATMENT -paso) I-TREATMENT +nuevo I-TREATMENT +pulido I-TREATMENT y I-TREATMENT -el I-TREATMENT -paso I-TREATMENT -12 I-TREATMENT se I-TREATMENT -prolongó I-TREATMENT +rellena I-TREATMENT +el I-TREATMENT +agujero I-TREATMENT +efectuado, I-TREATMENT para I-TREATMENT -completar I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -objetivo I-TREATMENT -de I-TREATMENT -150 I-TREATMENT -mg. I-TREATMENT -El I-TREATMENT -tiempo I-TREATMENT -total I-TREATMENT -de I-TREATMENT -desensibilización I-TREATMENT -fue I-TREATMENT -de I-TREATMENT -5, I-TREATMENT -8 I-TREATMENT -horas. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -respuesta I-EVOLUTION -parcial I-EVOLUTION -tras I-EVOLUTION -el I-EVOLUTION -primer I-EVOLUTION -ciclo I-EVOLUTION -con I-EVOLUTION -evidente I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -mama I-EVOLUTION -afectada I-EVOLUTION -ya I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -volumen I-EVOLUTION -sin I-EVOLUTION -la I-EVOLUTION -presencia I-EVOLUTION -del I-EVOLUTION -aspecto I-EVOLUTION -necrótico I-EVOLUTION -previo. I-EVOLUTION -Tras B-EXPLORATION -el I-EXPLORATION -sexto I-EXPLORATION -ciclo I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -PET-TAC I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -actividad I-EXPLORATION -metabólica I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mama I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -adenopatías I-EXPLORATION -axilares, I-EXPLORATION -como I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -óseo I-EXPLORATION -y I-EXPLORATION -hepático, I-EXPLORATION -con I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -muy I-EXPLORATION -buena I-EXPLORATION -respuesta I-EXPLORATION -metabólica I-EXPLORATION -y I-EXPLORATION -funcional I-EXPLORATION -al I-EXPLORATION -tratamiento. I-EXPLORATION -Actualmente B-EVOLUTION -tras I-EVOLUTION -el I-EVOLUTION -octavo I-EVOLUTION -ciclo I-EVOLUTION -no I-EVOLUTION -presenta I-EVOLUTION -progresión I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -80 I-PRESENT_ILLNESS -Kg I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -ADPV, I-PRESENT_ILLNESS -diagnosticado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hepatopatía I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -VHC I-PRESENT_ILLNESS -(genotipo I-PRESENT_ILLNESS -1a, I-PRESENT_ILLNESS -polimorfismo I-PRESENT_ILLNESS -IL-B28 I-PRESENT_ILLNESS -CC), I-PRESENT_ILLNESS -fibrosis I-PRESENT_ILLNESS -grado I-PRESENT_ILLNESS -F4 I-PRESENT_ILLNESS -(Fibroscan I-PRESENT_ILLNESS -36, I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -KPa), I-PRESENT_ILLNESS -carga I-PRESENT_ILLNESS -viral I-PRESENT_ILLNESS -(CV) I-PRESENT_ILLNESS -14.440 I-PRESENT_ILLNESS -UI I-PRESENT_ILLNESS -RNA/ml, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -datos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hipertensión I-PRESENT_ILLNESS -portal, I-PRESENT_ILLNESS -probable I-PRESENT_ILLNESS -esteatohepatitis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -origen I-PRESENT_ILLNESS -mixto, I-PRESENT_ILLNESS -Child I-PRESENT_ILLNESS -A5 I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -elevación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -alfafetoproteína. I-PRESENT_ILLNESS -Entre B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -destacan I-PAST_MEDICAL_HISTORY -hemocromatosis I-PAST_MEDICAL_HISTORY -(mutación I-PAST_MEDICAL_HISTORY -H63D I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -heterocigosis) I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -sobrecarga I-PAST_MEDICAL_HISTORY -férrica I-PAST_MEDICAL_HISTORY -controlada I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -realización I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sangrías, I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -II I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -insulina I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -metformina, I-PAST_MEDICAL_HISTORY -esofagitis I-PAST_MEDICAL_HISTORY -grado I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pequeño I-PAST_MEDICAL_HISTORY -cordón I-PAST_MEDICAL_HISTORY -varicoso I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ansiedad. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -los I-EXPLORATION -datos I-EXPLORATION -analíticos I-EXPLORATION -se I-EXPLORATION -objetivan I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -valores: I-EXPLORATION -Hemoglobina I-EXPLORATION -13, I-EXPLORATION -2 I-EXPLORATION -g/dl, I-EXPLORATION -Hematocrito I-EXPLORATION -39, I-EXPLORATION -3%, I-EXPLORATION -Leucocitos I-EXPLORATION -6070, I-EXPLORATION -Plaquetas I-EXPLORATION -90000, I-EXPLORATION -INR I-EXPLORATION -1, I-EXPLORATION -04, I-EXPLORATION -Creatinina I-EXPLORATION -0, I-EXPLORATION -9 I-EXPLORATION -mg/dl, I-EXPLORATION -Bilirrubina I-EXPLORATION -total I-EXPLORATION -1, I-EXPLORATION -4 I-EXPLORATION -mg/dl, I-EXPLORATION -Albúmina I-EXPLORATION -3, I-EXPLORATION -1 I-EXPLORATION -g/dl, I-EXPLORATION -ASAT I-EXPLORATION -106 I-EXPLORATION -UI/L, I-EXPLORATION -ALAT I-EXPLORATION -108 I-EXPLORATION -UI/L, I-EXPLORATION -Fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -144 I-EXPLORATION -UI/L, I-EXPLORATION -Gamma-GT I-EXPLORATION -553 I-EXPLORATION -UI/L I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION -MELD I-EXPLORATION -(Model I-EXPLORATION -for I-EXPLORATION -End I-EXPLORATION -Stage I-EXPLORATION -Liver I-EXPLORATION -Disease) I-EXPLORATION -de I-EXPLORATION -8. I-EXPLORATION - I-EXPLORATION -Respondedor B-TREATMENT -nulo I-TREATMENT -a I-TREATMENT -IFN I-TREATMENT -en I-TREATMENT -monoterapia I-TREATMENT +colocar I-TREATMENT +el I-TREATMENT +ojo. I-TREATMENT +Con I-TREATMENT +una I-TREATMENT +aguja I-TREATMENT +hipodérmica, I-TREATMENT +se I-TREATMENT +cose I-TREATMENT +con I-TREATMENT +cabello I-TREATMENT +las I-TREATMENT +cejas I-TREATMENT y I-TREATMENT -posteriormente I-TREATMENT -a I-TREATMENT -P-INF I-TREATMENT -asociado I-TREATMENT +las I-TREATMENT +pestañas. I-TREATMENT +El I-TREATMENT +color I-TREATMENT +debe I-TREATMENT +ser I-TREATMENT +lo I-TREATMENT +más I-TREATMENT +parecido I-TREATMENT +posible I-TREATMENT a I-TREATMENT -RBV I-TREATMENT +las I-TREATMENT +del I-TREATMENT +paciente, I-TREATMENT por I-TREATMENT lo I-TREATMENT que I-TREATMENT es I-TREATMENT -candidato I-TREATMENT +ideal I-TREATMENT +utilizar I-TREATMENT +los I-TREATMENT +propios I-TREATMENT +cabellos I-TREATMENT +del I-TREATMENT +paciente3*. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +coloca I-TREATMENT +la I-TREATMENT +prótesis I-TREATMENT +y I-TREATMENT +se I-TREATMENT +verifican I-TREATMENT +los I-TREATMENT +márgenes. I-TREATMENT +La I-TREATMENT +utilización I-TREATMENT +de I-TREATMENT +gafas I-TREATMENT +es I-TREATMENT +recomendable I-TREATMENT +porque I-TREATMENT +ayuda I-TREATMENT a I-TREATMENT -triple I-TREATMENT -terapia I-TREATMENT -con I-TREATMENT -boceprevir. I-TREATMENT -Inicia I-TREATMENT -lead I-TREATMENT -in I-TREATMENT -con I-TREATMENT -RBV I-TREATMENT -oral I-TREATMENT -1000 I-TREATMENT -mg/día I-TREATMENT +la I-TREATMENT +protección I-TREATMENT +del I-TREATMENT +ojo I-TREATMENT +natural I-TREATMENT y I-TREATMENT -P-INF I-TREATMENT -α2b I-TREATMENT -subcutáneo I-TREATMENT -120 I-TREATMENT -mcg/semana. I-TREATMENT -No I-TREATMENT -superó I-TREATMENT +disimula I-TREATMENT la I-TREATMENT -fase I-TREATMENT +prótesis14. I-TREATMENT + I-TREATMENT +Es I-TREATMENT +imprescindible I-TREATMENT +explicar I-TREATMENT +a I-TREATMENT +cada I-TREATMENT +paciente I-TREATMENT +la I-TREATMENT +adecuada I-TREATMENT +manipulación I-TREATMENT de I-TREATMENT -lead I-TREATMENT -in I-TREATMENT -(CV=33.680 I-TREATMENT -UI I-TREATMENT -RNA/ml), I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT +su I-TREATMENT +epítesis I-TREATMENT +óculo-palpebral, I-TREATMENT +su I-TREATMENT +colocación, I-TREATMENT +limpieza I-TREATMENT +y I-TREATMENT +adhesivo I-TREATMENT +médico I-TREATMENT +más I-TREATMENT +adecuado8*. I-TREATMENT +Los I-TREATMENT +adhesivos I-TREATMENT +utilizados I-TREATMENT +son I-TREATMENT +a I-TREATMENT +base I-TREATMENT +de I-TREATMENT +silicona I-TREATMENT +médica I-TREATMENT +(siliconas I-TREATMENT +externas I-TREATMENT +sin I-TREATMENT +plomo). I-TREATMENT +Normalmente I-TREATMENT +el I-TREATMENT +tiempo I-TREATMENT +de I-TREATMENT +efectividad I-TREATMENT +de I-TREATMENT +los I-TREATMENT +adhesivos I-TREATMENT +cutáneos I-TREATMENT +es I-TREATMENT +de I-TREATMENT +48 I-TREATMENT +horas, I-TREATMENT +pero I-TREATMENT +depende I-TREATMENT +del I-TREATMENT +clima. I-TREATMENT +Pasado I-TREATMENT +ese I-TREATMENT +tiempo, I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +deberá I-TREATMENT +retirar I-TREATMENT +la I-TREATMENT +prótesis, I-TREATMENT +limpiarla I-TREATMENT +correctamente, I-TREATMENT +limpiando I-TREATMENT +también I-TREATMENT +la I-TREATMENT +zona I-TREATMENT +donde I-TREATMENT +ésta I-TREATMENT se I-TREATMENT -suspendió I-TREATMENT +asienta. I-TREATMENT +Esta I-TREATMENT +tarea I-TREATMENT +casi I-TREATMENT +diaria I-TREATMENT +debe I-TREATMENT +ser I-TREATMENT +muy I-TREATMENT +cuidadosa I-TREATMENT +ya I-TREATMENT +que I-TREATMENT +los I-TREATMENT +bordes I-TREATMENT +finos I-TREATMENT +de I-TREATMENT +la I-TREATMENT +prótesis I-TREATMENT +no I-TREATMENT +deben I-TREATMENT +recibir I-TREATMENT el I-TREATMENT -tratamiento I-TREATMENT -a I-TREATMENT +adhesivo, I-TREATMENT +evitando I-TREATMENT +así I-TREATMENT +el I-TREATMENT +deterioro I-TREATMENT +de I-TREATMENT +los I-TREATMENT +mismos3*. I-TREATMENT +También I-TREATMENT +se I-TREATMENT +debe I-TREATMENT +advertir I-TREATMENT +al I-TREATMENT +paciente I-TREATMENT +para I-TREATMENT +proteger I-TREATMENT +su I-TREATMENT +prótesis I-TREATMENT +de I-TREATMENT +los I-TREATMENT +limpiadores I-TREATMENT +abrasivos, I-TREATMENT +solventes I-TREATMENT +o I-TREATMENT +volátiles, I-TREATMENT +perfumes, I-TREATMENT +colonias I-TREATMENT +y I-TREATMENT +sprays. I-TREATMENT +Solamente I-TREATMENT +se I-TREATMENT +deberá I-TREATMENT +usar I-TREATMENT +agua I-TREATMENT +tibia, I-TREATMENT +jabón I-TREATMENT +suave I-TREATMENT +o I-TREATMENT +detergente I-TREATMENT +para I-TREATMENT +limpiar I-TREATMENT la I-TREATMENT -5a I-TREATMENT -semana, I-TREATMENT -sin I-TREATMENT -haber I-TREATMENT -iniciado I-TREATMENT -boceprevir. I-TREATMENT +prótesis. I-TREATMENT I-TREATMENT -Tras B-EVOLUTION -la I-EVOLUTION -última I-EVOLUTION -inyección I-EVOLUTION -de I-EVOLUTION -P-INF I-EVOLUTION -α2b I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -acudió I-EVOLUTION -a I-EVOLUTION -urgencias I-EVOLUTION -objetivando I-EVOLUTION -hematoma I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -local I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -cara I-EVOLUTION -anterior I-EVOLUTION -del I-EVOLUTION -muslo I-EVOLUTION -derecho I-EVOLUTION -con I-EVOLUTION -aumento I-EVOLUTION -de I-EVOLUTION -volumen I-EVOLUTION -y I-EVOLUTION -temperatura I-EVOLUTION -local, I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -al I-EVOLUTION -mover I-EVOLUTION -la I-EVOLUTION -cadera I-EVOLUTION -derecha, I-EVOLUTION -administrándose I-EVOLUTION -analgésicos I-EVOLUTION -y I-EVOLUTION -antibióticos I-EVOLUTION -(amoxicilina-clavulánico I-EVOLUTION -1g/62, I-EVOLUTION -5mg/8 I-EVOLUTION -horas I-EVOLUTION -oral). I-EVOLUTION -Dos I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -regresó I-EVOLUTION -a I-EVOLUTION -urgencias I-EVOLUTION -presentando I-EVOLUTION -impotencia I-EVOLUTION -funcional I-EVOLUTION -y I-EVOLUTION -sensación I-EVOLUTION -distérmica. I-EVOLUTION -Mediante B-EXPLORATION -ecografía I-EXPLORATION -se I-EXPLORATION -visualizó I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -hipoecogénica I-EXPLORATION -ovoidea I-EXPLORATION -de I-EXPLORATION -21x19x9 I-EXPLORATION -mm. I-EXPLORATION -Posteriormente I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -imagen I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -infección I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -absceso I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -espesor I-EXPLORATION -del I-EXPLORATION -musculo I-EXPLORATION -abductor I-EXPLORATION -largo I-EXPLORATION -del I-EXPLORATION -muslo I-EXPLORATION -derecho I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extendía I-EXPLORATION -inferiormente I-EXPLORATION -entre I-EXPLORATION -el I-EXPLORATION -compartimento I-EXPLORATION -anterior I-EXPLORATION -y I-EXPLORATION -medio I-EXPLORATION -del I-EXPLORATION -mismo. I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +fractura I-PRESENT_ILLNESS +abierta I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tibia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +peroné I-PRESENT_ILLNESS +tratada I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +placa I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +fijador I-PRESENT_ILLNESS +externo, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sustancia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +exposición I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +material I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +osteosíntesis. I-PRESENT_ILLNESS Se B-TREATMENT -trató I-TREATMENT -con I-TREATMENT -antibióticos I-TREATMENT -(piperacilina/tazobactam I-TREATMENT -4g/0, I-TREATMENT -5g/8 I-TREATMENT -horas I-TREATMENT +practica I-TREATMENT +desbridamiento I-TREATMENT y I-TREATMENT -daptomicina I-TREATMENT -500mg/24 I-TREATMENT -horas I-TREATMENT -intravenosos, I-TREATMENT -durante I-TREATMENT -3 I-TREATMENT -días) I-TREATMENT +limpieza I-TREATMENT y I-TREATMENT se I-TREATMENT -realizó I-TREATMENT -desbridamiento I-TREATMENT -quirúrgico. I-TREATMENT +coloca I-TREATMENT +sistema I-TREATMENT +Renasys® I-TREATMENT +a-125 I-TREATMENT +mm I-TREATMENT +Hg. I-TREATMENT Tras B-EVOLUTION -una I-EVOLUTION -cirugía I-EVOLUTION -con I-EVOLUTION -complicaciones, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -ingresó I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -unidad I-EVOLUTION +12 I-EVOLUTION +días I-EVOLUTION de I-EVOLUTION -cuidados I-EVOLUTION -intensivos I-EVOLUTION -(UCI). I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -UCI I-EVOLUTION -presentó I-EVOLUTION -shock I-EVOLUTION -séptico I-EVOLUTION -complicado I-EVOLUTION +su I-EVOLUTION +aplicación, I-EVOLUTION +se I-EVOLUTION +consigue I-EVOLUTION +un I-EVOLUTION +lecho I-EVOLUTION +limpio I-EVOLUTION con I-EVOLUTION -síndrome I-EVOLUTION +tejido I-EVOLUTION de I-EVOLUTION -disfunción I-EVOLUTION -multiorgánica. I-EVOLUTION -En B-EXPLORATION -los I-EXPLORATION -cultivos I-EXPLORATION -del I-EXPLORATION -absceso I-EXPLORATION -muscular I-EXPLORATION -se I-EXPLORATION -aisló I-EXPLORATION -Staphylococcus I-EXPLORATION -aureus I-EXPLORATION -meticilin-sensible, I-EXPLORATION -que B-TREATMENT +granulación I-EVOLUTION +sano. I-EVOLUTION +Finalmente B-TREATMENT se I-TREATMENT -trató I-TREATMENT -con I-TREATMENT -linezolid I-TREATMENT -(600mg/12 I-TREATMENT -horas I-TREATMENT -intravenoso) I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -con I-TREATMENT -cloxacilina I-TREATMENT -(1g/6 I-TREATMENT -horas I-TREATMENT -intravenoso) I-TREATMENT -durante I-TREATMENT -15 I-TREATMENT -días. I-TREATMENT - I-TREATMENT -Posteriormente B-EVOLUTION -desarrolló I-EVOLUTION -síndrome I-EVOLUTION -de I-EVOLUTION -distress I-EVOLUTION -respiratorio I-EVOLUTION -agudo I-EVOLUTION -que B-TREATMENT -precisó I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -invasiva; I-TREATMENT -neumonía B-EVOLUTION -por I-EVOLUTION -Escherichia I-EVOLUTION -Coli I-EVOLUTION -asociada I-EVOLUTION -a I-EVOLUTION -ventilación I-EVOLUTION -mecánica I-EVOLUTION -que I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente I-EVOLUTION -con B-TREATMENT -meropenem I-TREATMENT -(1000mg/8 I-TREATMENT -horas I-TREATMENT -intravenoso) I-TREATMENT -y I-TREATMENT -levofloxacino I-TREATMENT -(500 I-TREATMENT -mg/24 I-TREATMENT -horas I-TREATMENT -intravenoso) I-TREATMENT -durante I-TREATMENT -10 I-TREATMENT -días; I-TREATMENT -insuficiencia B-EVOLUTION -renal I-EVOLUTION -(IR) I-EVOLUTION -con I-EVOLUTION -oliguria I-EVOLUTION -que B-TREATMENT -requirió I-TREATMENT -hemofiltración I-TREATMENT -venosa I-TREATMENT -continua; I-TREATMENT -anemia B-EVOLUTION -y I-EVOLUTION -trombopenia I-EVOLUTION -graves I-EVOLUTION -que B-TREATMENT -requirieron I-TREATMENT -transfusiones I-TREATMENT -de I-TREATMENT -concentrados I-TREATMENT -de I-TREATMENT -hematíes I-TREATMENT -y I-TREATMENT -plaquetas; I-TREATMENT -hiperfosfatemia; B-EVOLUTION -hiperglucemia I-EVOLUTION -que B-TREATMENT -requirió I-TREATMENT -perfusión I-TREATMENT -de I-TREATMENT -insulina; I-TREATMENT -colonización B-EVOLUTION -por I-EVOLUTION -Candida I-EVOLUTION -Albicans I-EVOLUTION -en I-EVOLUTION -orina, I-EVOLUTION -secreciones I-EVOLUTION -y I-EVOLUTION -heces; I-EVOLUTION -hemorragia I-EVOLUTION -digestiva I-EVOLUTION -alta I-EVOLUTION -(HDA) I-EVOLUTION -y I-EVOLUTION -melenas; I-EVOLUTION -varices I-EVOLUTION -esofágicas I-EVOLUTION -grado I-EVOLUTION -III I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -mostraban I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -sangrado I-EVOLUTION -activo I-EVOLUTION -pero B-TREATMENT -que I-TREATMENT -requirieron I-TREATMENT -ligadura I-TREATMENT +realiza I-TREATMENT +cobertura I-TREATMENT con I-TREATMENT -bandas I-TREATMENT -elásticas I-TREATMENT -y I-TREATMENT -aumento I-TREATMENT -transitorio I-TREATMENT +colgajo I-TREATMENT +anterolateral I-TREATMENT de I-TREATMENT -enzimas I-TREATMENT -hepáticas I-TREATMENT -y I-TREATMENT -bilirrubina I-TREATMENT -(17, I-TREATMENT -2 I-TREATMENT -mg/dL). I-TREATMENT +muslo. I-TREATMENT I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -continuó I-EVOLUTION -con I-EVOLUTION -deterioro I-EVOLUTION -gasométrico I-EVOLUTION -y I-EVOLUTION -radiológico, I-EVOLUTION -con I-EVOLUTION -infiltrados I-EVOLUTION -alveolo-intersticiales I-EVOLUTION -basales I-EVOLUTION -y I-EVOLUTION -bilaterales I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -aisló I-EVOLUTION -Klebsiella I-EVOLUTION -Pneumoniae I-EVOLUTION -productora I-EVOLUTION -de I-EVOLUTION -betalactamasas I-EVOLUTION -de I-EVOLUTION -amplio I-EVOLUTION -espectro I-EVOLUTION -sensible I-EVOLUTION -a I-EVOLUTION -colistina. I-EVOLUTION -A I-EVOLUTION -pesar I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -dirigido I-EVOLUTION -(colistina I-EVOLUTION -intravenosa I-EVOLUTION -e I-EVOLUTION -inhalada I-EVOLUTION -ajustada I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -renal) I-EVOLUTION -durante I-EVOLUTION -4 I-EVOLUTION -días I-EVOLUTION -más, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -insuficiencia I-EVOLUTION -respiratoria I-EVOLUTION -aguda I-EVOLUTION -grave, I-EVOLUTION -disfunción I-EVOLUTION -multiorgánica I-EVOLUTION -con I-EVOLUTION -acidosis I-EVOLUTION -láctica I-EVOLUTION -grave I-EVOLUTION -y I-EVOLUTION -shock I-EVOLUTION -séptico I-EVOLUTION -refractario I-EVOLUTION -siendo I-EVOLUTION -finalmente I-EVOLUTION -exitus. I-EVOLUTION - I-EVOLUTION Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -51 I-PRESENT_ILLNESS +68 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -fumadora, B-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -medicamentosas I-PAST_MEDICAL_HISTORY -conocidas, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY +sin B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -colon I-PAST_MEDICAL_HISTORY -irritable, I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -depresivo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -migrañas, I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -carcinoma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cuello I-PAST_MEDICAL_HISTORY -uterino I-PAST_MEDICAL_HISTORY -aparentemente I-PAST_MEDICAL_HISTORY -localizado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -julio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2012. I-PAST_MEDICAL_HISTORY -Se B-TREATMENT -realizó I-TREATMENT -histerectomía, I-TREATMENT -doble I-TREATMENT -annexectomía I-TREATMENT -y I-TREATMENT -estadificación I-TREATMENT -ganglionar I-TREATMENT -quirúrgica I-TREATMENT -retroperitoneal. I-TREATMENT -La B-EXPLORATION -estadificación I-EXPLORATION -final I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -pT3N1 I-EXPLORATION -(ganglios I-EXPLORATION -pélvicos). I-EXPLORATION -A B-TREATMENT -continuación I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -cisplatino I-TREATMENT -(40 I-TREATMENT -mg/m2 I-TREATMENT -semanales) I-TREATMENT -concomitante I-TREATMENT -a I-TREATMENT -radioterapia. I-TREATMENT -Por I-TREATMENT -alta I-TREATMENT -probabilidad I-TREATMENT -de I-TREATMENT -recaída I-TREATMENT -recibió I-TREATMENT -posteriormente I-TREATMENT -quimioterapia I-TREATMENT -con I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT -carboplatino I-TREATMENT -(5 I-TREATMENT -mg/AUC) I-TREATMENT -y I-TREATMENT -paclitaxel I-TREATMENT -(175 I-TREATMENT -mg/m2), I-TREATMENT -recibiendo I-TREATMENT -cinco I-TREATMENT -ciclos I-TREATMENT -en I-TREATMENT -total I-TREATMENT -con I-TREATMENT -varias I-TREATMENT -reducciones I-TREATMENT -de I-TREATMENT -dosis I-TREATMENT -por I-TREATMENT -diferentes I-TREATMENT -toxicidades I-TREATMENT -(plaquetopenia I-TREATMENT -grado I-TREATMENT -IV, I-TREATMENT -oclusión I-TREATMENT -intestinal I-TREATMENT -y I-TREATMENT -neurotoxicidad I-TREATMENT -grado I-TREATMENT -II). I-TREATMENT -Permaneció B-EVOLUTION -libre I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -hasta I-EVOLUTION -octubre I-EVOLUTION -de I-EVOLUTION -2014, I-EVOLUTION -fecha I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -detecta I-EVOLUTION -progresión I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad I-EVOLUTION -en I-EVOLUTION -forma I-EVOLUTION -de I-EVOLUTION -implantes I-EVOLUTION -peritoneales I-EVOLUTION -e I-EVOLUTION -implantes I-EVOLUTION -metastásicos I-EVOLUTION -esplénicos. I-EVOLUTION -Inicia B-TREATMENT -tratamiento I-TREATMENT -quimioterápico I-TREATMENT -con I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT -bevacizumab I-TREATMENT -(15 I-TREATMENT -mg/kg), I-TREATMENT -cisplatino I-TREATMENT -(50 I-TREATMENT -mg/m2) I-TREATMENT -y I-TREATMENT -paclitaxel I-TREATMENT -(175 I-TREATMENT -mg/m2), I-TREATMENT -cada I-TREATMENT -21 I-TREATMENT -días. I-TREATMENT -El B-EVOLUTION -día I-EVOLUTION -posterior I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -primera I-EVOLUTION -administración I-EVOLUTION -acude I-EVOLUTION -a I-EVOLUTION -urgencias I-EVOLUTION -con I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -agudo I-EVOLUTION -y I-EVOLUTION -náuseas I-EVOLUTION -sin I-EVOLUTION -vómitos, I-EVOLUTION -no I-EVOLUTION -presentado I-EVOLUTION -fiebre. I-EVOLUTION -En B-EXPLORATION +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +prostático I-PRESENT_ILLNESS +leve I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +IPSS I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +PSA: I-PRESENT_ILLNESS +0, I-PRESENT_ILLNESS +91. I-PRESENT_ILLNESS +A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION física I-EXPLORATION -se I-EXPLORATION -detecta I-EXPLORATION -abdomen I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación, I-EXPLORATION -diseminado I-EXPLORATION -tanto I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -superficial I-EXPLORATION -como I-EXPLORATION -profundo, I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -peritonismo. I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -perforación I-EXPLORATION +destaca I-EXPLORATION +un I-EXPLORATION +tacto I-EXPLORATION +rectal I-EXPLORATION +encontrando I-EXPLORATION +un I-EXPLORATION +adenoma I-EXPLORATION +grado I-EXPLORATION +1, I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +en I-EXPLORATION +hemiescroto I-EXPLORATION +derecho I-EXPLORATION de I-EXPLORATION -implante I-EXPLORATION -peritoneal I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION +lisa, I-EXPLORATION +dura, I-EXPLORATION +no I-EXPLORATION +adherida I-EXPLORATION a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -sigma, I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -burbujas I-EXPLORATION -aéreas I-EXPLORATION -en I-EXPLORATION -hemiabdomen I-EXPLORATION -superior I-EXPLORATION +planos I-EXPLORATION +profundos, I-EXPLORATION +blanquecina I-EXPLORATION e I-EXPLORATION -inferior, I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -peritonitis I-EXPLORATION -fecaloidea. I-EXPLORATION -Se B-TREATMENT -procede I-TREATMENT -a I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -urgente I-TREATMENT -(sigmoidectomía I-TREATMENT -y I-TREATMENT -colostomía I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -ciego). I-TREATMENT - I-TREATMENT - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -diagnosticado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -LLC I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -B I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -evidencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -progresión I-PRESENT_ILLNESS +indolora I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +exploración. I-EXPLORATION +El B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -enfermedad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -progresión I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -adenopatías I-PRESENT_ILLNESS -inguinales, I-PRESENT_ILLNESS -axiales I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -cervicales. I-PRESENT_ILLNESS -Recibe B-TREATMENT -6 I-TREATMENT -ciclos I-TREATMENT -con I-TREATMENT -el I-TREATMENT -esquema I-TREATMENT -rituximab I-TREATMENT -(375 I-TREATMENT -mg/m2 I-TREATMENT -IV I-TREATMENT -de I-TREATMENT -inicio, I-TREATMENT -500 I-TREATMENT -mg/m2 I-TREATMENT -IV I-TREATMENT -dosis I-TREATMENT -sucesivas), I-TREATMENT -fludarabina I-TREATMENT -(25 I-TREATMENT -mg/m2 I-TREATMENT -IV) I-TREATMENT -y I-TREATMENT -ciclofosfamida I-TREATMENT -(250 I-TREATMENT -mg/m2 I-TREATMENT -i.v.), I-TREATMENT -alcanzando I-TREATMENT -remisión I-TREATMENT -parcial I-TREATMENT -con I-TREATMENT -persistencia I-TREATMENT +demanda I-PRESENT_ILLNESS +cirugía I-PRESENT_ILLNESS +aduciendo I-PRESENT_ILLNESS +problemas I-PRESENT_ILLNESS +estéticos. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Se B-TREATMENT +realiza I-TREATMENT +exéresis I-TREATMENT de I-TREATMENT la I-TREATMENT -enfermedad, I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -cariotipo I-TREATMENT -complejo I-TREATMENT -y I-TREATMENT -aparición I-TREATMENT -de I-TREATMENT -deleción I-TREATMENT -del I-TREATMENT -gen I-TREATMENT -p53. I-TREATMENT -Por I-TREATMENT -estas I-TREATMENT -características I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -idelalisib I-TREATMENT -(150 I-TREATMENT -mg/12 I-TREATMENT -horas I-TREATMENT -v.o.) I-TREATMENT -combinado I-TREATMENT -con I-TREATMENT -rituximab I-TREATMENT -(dosis I-TREATMENT -inicial I-TREATMENT -de I-TREATMENT -375 I-TREATMENT -mg/m2 I-TREATMENT -IV, I-TREATMENT -dosis I-TREATMENT -posteriores I-TREATMENT -de I-TREATMENT -500 I-TREATMENT -mg/m2 I-TREATMENT -IV). I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -ingresa I-EVOLUTION -por I-EVOLUTION -diarrea I-EVOLUTION -líquida I-EVOLUTION -de I-EVOLUTION -4 I-EVOLUTION -días I-EVOLUTION -evolución, I-EVOLUTION -con I-EVOLUTION -7-8 I-EVOLUTION -deposiciones I-EVOLUTION -al I-EVOLUTION -día, I-EVOLUTION -sin I-EVOLUTION -productos I-EVOLUTION -patológicos, I-EVOLUTION -acompañada I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -mesogástrico I-EVOLUTION -continuo I-EVOLUTION -que I-EVOLUTION -cede I-EVOLUTION -parcialmente I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -deposición, I-EVOLUTION -con I-EVOLUTION -febrícula I-EVOLUTION -pero I-EVOLUTION -sin I-EVOLUTION -náuseas I-EVOLUTION -ni I-EVOLUTION -vómitos. I-EVOLUTION -Los B-EXPLORATION -resultados I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -coprocultivos I-EXPLORATION +masa I-TREATMENT +bajo I-TREATMENT +anestesia I-TREATMENT +local I-TREATMENT +sin I-TREATMENT +incidencias. I-TREATMENT +Macroscópicamente B-EXPLORATION +la I-EXPLORATION +masa I-EXPLORATION +presenta I-EXPLORATION +coloración I-EXPLORATION +blanquecina I-EXPLORATION y I-EXPLORATION -hemocultivos I-EXPLORATION -realizados I-EXPLORATION -son I-EXPLORATION -negativos. I-EXPLORATION -En I-EXPLORATION +consistencia I-EXPLORATION +firme I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +tamaño I-EXPLORATION +de I-EXPLORATION +1, I-EXPLORATION +7 I-EXPLORATION +cm, I-EXPLORATION la I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -asas I-EXPLORATION +superficie I-EXPLORATION de I-EXPLORATION -colon I-EXPLORATION -ascendente I-EXPLORATION +corte I-EXPLORATION +muestra I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +sólida, I-EXPLORATION +amarillenta I-EXPLORATION de I-EXPLORATION -calibre I-EXPLORATION -aumentado, I-EXPLORATION -engrosamiento I-EXPLORATION -mural I-EXPLORATION -y I-EXPLORATION -realce I-EXPLORATION +aspecto I-EXPLORATION +arremolinado. I-EXPLORATION + I-EXPLORATION +Microscópicamente I-EXPLORATION +se I-EXPLORATION +describe I-EXPLORATION +una I-EXPLORATION +neoformación I-EXPLORATION +mesenquimal I-EXPLORATION +relativamente I-EXPLORATION +bien I-EXPLORATION +delimitada, I-EXPLORATION +no I-EXPLORATION +encapsulada, I-EXPLORATION +constituida I-EXPLORATION +por I-EXPLORATION +haces I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +células I-EXPLORATION de I-EXPLORATION -colitis I-EXPLORATION -inflamatoria. I-EXPLORATION -Se I-EXPLORATION -suspende I-EXPLORATION -el I-EXPLORATION -tratamiento I-EXPLORATION +estirpe I-EXPLORATION +muscular I-EXPLORATION +lisa I-EXPLORATION +que I-EXPLORATION +muestra I-EXPLORATION +marcada I-EXPLORATION +positividad I-EXPLORATION +citoplasmática I-EXPLORATION con I-EXPLORATION -idelalisib I-EXPLORATION +actina, I-EXPLORATION +desmina I-EXPLORATION y I-EXPLORATION +focal I-EXPLORATION +con I-EXPLORATION +CD I-EXPLORATION +68. I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -inicia I-EXPLORATION -sueroterapia I-EXPLORATION -y I-EXPLORATION -analgesia. I-EXPLORATION -Evoluciona B-TREATMENT -con I-TREATMENT -pico I-TREATMENT -febril I-TREATMENT -y I-TREATMENT -deterioro I-TREATMENT -general, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -añade I-TREATMENT -ciprofloxacino I-TREATMENT -(400 I-TREATMENT -mg/12 I-TREATMENT -h I-TREATMENT -IV), I-TREATMENT -sustituyéndose I-TREATMENT -posteriormente I-TREATMENT -por I-TREATMENT -piperacilina/tazobactam I-TREATMENT -(4 I-TREATMENT -g/6 I-TREATMENT -h I-TREATMENT -IV). I-TREATMENT - I-TREATMENT -Como B-EVOLUTION -complicaciones I-EVOLUTION -derivadas I-EVOLUTION -del I-EVOLUTION -ingreso, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -desarrolla I-EVOLUTION -un I-EVOLUTION -neumotórax I-EVOLUTION -durante I-EVOLUTION -la I-EVOLUTION -canalización I-EVOLUTION +observa I-EXPLORATION +atipia I-EXPLORATION +citológica. I-EXPLORATION +La I-EXPLORATION +actividad I-EXPLORATION +mitótica I-EXPLORATION +es I-EXPLORATION +muy I-EXPLORATION +baja I-EXPLORATION +(0, I-EXPLORATION +5 I-EXPLORATION +mitosis I-EXPLORATION +por I-EXPLORATION +50 I-EXPLORATION +HPF), I-EXPLORATION +no I-EXPLORATION +observándose I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +hemorragia I-EXPLORATION +ni I-EXPLORATION +necrosis. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +diagnóstico I-EVOLUTION +fue I-EVOLUTION de I-EVOLUTION -una I-EVOLUTION -vía I-EVOLUTION -central I-EVOLUTION -y, I-EVOLUTION -durante I-EVOLUTION +leiomioma I-EVOLUTION +escrotal. I-EVOLUTION +Tras I-EVOLUTION dos I-EVOLUTION -días I-EVOLUTION -en I-EVOLUTION -UCI, I-EVOLUTION -presenta I-EVOLUTION -diarrea I-EVOLUTION -cuantiosa I-EVOLUTION -con I-EVOLUTION -alteraciones I-EVOLUTION -hidroelectrolíticas I-EVOLUTION -que I-EVOLUTION -requieren I-EVOLUTION -reposición I-EVOLUTION -volémica I-EVOLUTION -y I-EVOLUTION -electrolítica I-EVOLUTION -y I-EVOLUTION -aporte I-EVOLUTION +años I-EVOLUTION de I-EVOLUTION -nutrición I-EVOLUTION -parenteral. I-EVOLUTION +evolución I-EVOLUTION +no I-EVOLUTION +hay I-EVOLUTION +evidencia I-EVOLUTION +de I-EVOLUTION +recidiva I-EVOLUTION +local. I-EVOLUTION I-EVOLUTION -A B-TREATMENT -la I-TREATMENT -semana I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -se I-TREATMENT -origina I-TREATMENT -alteración I-TREATMENT -de I-TREATMENT -la I-TREATMENT -función I-TREATMENT -renal I-TREATMENT -y, I-TREATMENT -debido I-TREATMENT -al I-TREATMENT -deterioro I-TREATMENT -clínico I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -digestivo, I-TREATMENT -recibe I-TREATMENT -corticoides I-TREATMENT -(budesónida I-TREATMENT -9 I-TREATMENT -mg/24 I-TREATMENT -h I-TREATMENT -VO I-TREATMENT -que I-TREATMENT -es I-TREATMENT -sustituida I-TREATMENT -por I-TREATMENT -metilprednisolona I-TREATMENT -60 I-TREATMENT -mg/24 I-TREATMENT -h I-TREATMENT -IV I-TREATMENT -por I-TREATMENT -persistencia I-TREATMENT + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS +años. I-PRESENT_ILLNESS +Con B-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +mesenquimopatía I-PAST_MEDICAL_HISTORY +indiferenciada I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +nariz I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +silla I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +montar, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +condritis. I-PAST_MEDICAL_HISTORY +Anticuerpos I-PAST_MEDICAL_HISTORY +antinucleares I-PAST_MEDICAL_HISTORY +(ANA) I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +anticuerpos I-PAST_MEDICAL_HISTORY +anti-Ro I-PAST_MEDICAL_HISTORY ++. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +alopecia, I-PRESENT_ILLNESS +artritis, I-PRESENT_ILLNESS +úlceras I-PRESENT_ILLNESS +orales I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +nasales. I-PRESENT_ILLNESS +Presentaba B-EXPLORATION +soplo I-EXPLORATION +aórtico I-EXPLORATION +sistólico I-EXPLORATION +V/VI I-EXPLORATION +irradiado I-EXPLORATION +al I-EXPLORATION +cuello. I-EXPLORATION +Tenía I-EXPLORATION +velocidad I-EXPLORATION +de I-EXPLORATION +eritrosedimentación I-EXPLORATION +(VHS) I-EXPLORATION +64 I-EXPLORATION +mm/h, I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +(PCR) I-EXPLORATION +5 I-EXPLORATION +(VN I-EXPLORATION +< I-EXPLORATION +10 I-EXPLORATION +mg/L), I-EXPLORATION +creatininemia I-EXPLORATION +0, I-EXPLORATION +5 I-EXPLORATION +mg/dl, I-EXPLORATION +ANA I-EXPLORATION +1/160 I-EXPLORATION +moteado, I-EXPLORATION +anti-Ro I-EXPLORATION +22, I-EXPLORATION +5 I-EXPLORATION +U I-EXPLORATION +(VN I-EXPLORATION +< I-EXPLORATION +15), I-EXPLORATION +anti-B2 I-EXPLORATION +glicoproteína I-EXPLORATION +1 I-EXPLORATION +IgM I-EXPLORATION +31, I-EXPLORATION +2 I-EXPLORATION +MPL I-EXPLORATION +(VN I-EXPLORATION +< I-EXPLORATION +8) I-EXPLORATION +e I-EXPLORATION +IgG I-EXPLORATION +17 I-EXPLORATION +GPL I-EXPLORATION +(VN I-EXPLORATION +< I-EXPLORATION +8), I-EXPLORATION +examen I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION +normal. I-EXPLORATION +Ecocardiograma: I-EXPLORATION +aceleración I-EXPLORATION +del I-EXPLORATION +flujo I-EXPLORATION +de I-EXPLORATION +aorta I-EXPLORATION +torácica I-EXPLORATION +y I-EXPLORATION +vasos I-EXPLORATION +del I-EXPLORATION +cuello. I-EXPLORATION +aTAC I-EXPLORATION +de I-EXPLORATION +tórax, I-EXPLORATION +cuello I-EXPLORATION +y I-EXPLORATION +cerebral: I-EXPLORATION +engrosamiento I-EXPLORATION +segmentario I-EXPLORATION +y I-EXPLORATION +realce I-EXPLORATION +con I-EXPLORATION +contraste I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +aórtica I-EXPLORATION +y I-EXPLORATION +sus I-EXPLORATION +ramas I-EXPLORATION +principales, I-EXPLORATION +con I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +estenosis I-EXPLORATION +y I-EXPLORATION +dilatación I-EXPLORATION +alternadas. I-EXPLORATION +Estenosis I-EXPLORATION +moderada I-EXPLORATION +de I-EXPLORATION +carótida I-EXPLORATION +derecha, I-EXPLORATION +origen I-EXPLORATION +del I-EXPLORATION +tronco I-EXPLORATION +celíaco I-EXPLORATION +y I-EXPLORATION +arteria I-EXPLORATION +mesentérica I-EXPLORATION +superior. I-EXPLORATION +Vasos I-EXPLORATION +cerebrales I-EXPLORATION +normales. I-EXPLORATION +Se B-TREATMENT +trató I-TREATMENT +con I-TREATMENT +corticoides, I-TREATMENT +hidroxicloroquina I-TREATMENT +y I-TREATMENT +6 I-TREATMENT +pulsos I-TREATMENT de I-TREATMENT -la I-TREATMENT -diarrea) I-TREATMENT +ciclofosfamida, I-TREATMENT +luego I-TREATMENT +azatioprina I-TREATMENT y I-TREATMENT -rifaximina I-TREATMENT -(200 I-TREATMENT -mg/6 I-TREATMENT -h I-TREATMENT -VO). I-TREATMENT -Tras B-EVOLUTION -siete I-EVOLUTION -días I-EVOLUTION -con I-EVOLUTION -corticoides I-EVOLUTION -sistémicos I-EVOLUTION -se I-EVOLUTION -observa I-EVOLUTION -una I-EVOLUTION -mejoría I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -(llegando I-EVOLUTION +prednisona. I-TREATMENT +El B-EVOLUTION +control I-EVOLUTION a I-EVOLUTION -desaparecer), I-EVOLUTION -con I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +demostró I-EVOLUTION disminución I-EVOLUTION -del I-EVOLUTION -número I-EVOLUTION -y I-EVOLUTION +de I-EVOLUTION la I-EVOLUTION -cantidad I-EVOLUTION +inflamación I-EVOLUTION de I-EVOLUTION -deposiciones I-EVOLUTION +aorta I-EVOLUTION +abdominal, I-EVOLUTION +tronco I-EVOLUTION +celíaco I-EVOLUTION y I-EVOLUTION -recuperación I-EVOLUTION +arteria I-EVOLUTION +mesentérica I-EVOLUTION +superior, I-EVOLUTION +estenosis I-EVOLUTION +de I-EVOLUTION +50% I-EVOLUTION del I-EVOLUTION -estado I-EVOLUTION -general. I-EVOLUTION -En B-TREATMENT -el I-TREATMENT -momento I-TREATMENT -del I-TREATMENT -alta I-TREATMENT -hospitalaria I-TREATMENT -se I-TREATMENT -mantiene I-TREATMENT -prednisona I-TREATMENT -(50 I-TREATMENT -mg/24 I-TREATMENT -h I-TREATMENT -VO) I-TREATMENT -hasta I-TREATMENT -resolución I-TREATMENT -completa I-TREATMENT -de I-TREATMENT -los I-TREATMENT -síntomas. I-TREATMENT - I-TREATMENT -A I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -meses I-TREATMENT -del I-TREATMENT -alta I-TREATMENT -hospitalaria I-TREATMENT -reanuda I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -idelalisib I-TREATMENT -(100 I-TREATMENT -mg/12 I-TREATMENT -h I-TREATMENT -VO) I-TREATMENT -y I-TREATMENT -dos I-TREATMENT -meses I-TREATMENT -después I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -reingresa I-TREATMENT -por I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -episodio I-TREATMENT -de I-TREATMENT -colitis, I-TREATMENT -aunque I-TREATMENT -más I-TREATMENT -leve I-TREATMENT -que I-TREATMENT -el I-TREATMENT -primero. I-TREATMENT -Se I-TREATMENT -suspende I-TREATMENT -idelalisib I-TREATMENT -definitivamente I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -sueroterapia I-TREATMENT -de I-TREATMENT -soporte. I-TREATMENT -A I-TREATMENT -las I-TREATMENT -24 I-TREATMENT -h I-TREATMENT -continúa I-TREATMENT -con I-TREATMENT -diarrea I-TREATMENT -profusa I-TREATMENT -(10 I-TREATMENT -deposiciones I-TREATMENT -líquidas I-TREATMENT -diarias) I-TREATMENT -y I-TREATMENT -pico I-TREATMENT -febril, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -antibioterapia I-TREATMENT -con I-TREATMENT -levofloxacino I-TREATMENT -(500 I-TREATMENT -mg/24 I-TREATMENT -h I-TREATMENT -IV), I-TREATMENT -que I-TREATMENT -es I-TREATMENT -sustituido I-TREATMENT -por I-TREATMENT -meropenem I-TREATMENT -(1 I-TREATMENT -g/8h I-TREATMENT -IV). I-TREATMENT -Los B-EXPLORATION -coprocultivos I-EXPLORATION -y I-EXPLORATION -hemocultivos I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Después B-TREATMENT -de I-TREATMENT -una I-TREATMENT -semana I-TREATMENT -con I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -terapia I-TREATMENT -con I-TREATMENT -corticoides I-TREATMENT -sistémicos I-TREATMENT -a I-TREATMENT -1 I-TREATMENT -mg/kg/día, I-TREATMENT -presentando I-TREATMENT -mejoría I-TREATMENT -del I-TREATMENT -estado I-TREATMENT -general, I-TREATMENT -con I-TREATMENT -disminución I-TREATMENT -del I-TREATMENT -número I-TREATMENT -de I-TREATMENT -deposiciones I-TREATMENT -al I-TREATMENT -cabo I-TREATMENT -de I-TREATMENT -una I-TREATMENT -semana I-TREATMENT -de I-TREATMENT -tratamiento, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -es I-TREATMENT -dado I-TREATMENT -de I-TREATMENT -alta I-TREATMENT -hospitalaria I-TREATMENT -con I-TREATMENT -prednisona I-TREATMENT -oral I-TREATMENT -hasta I-TREATMENT -resolución I-TREATMENT -completa I-TREATMENT -de I-TREATMENT -los I-TREATMENT -síntomas. I-TREATMENT - I-TREATMENT +origen I-EVOLUTION +del I-EVOLUTION +tronco I-EVOLUTION +celíaco I-EVOLUTION +con I-EVOLUTION +dilatación I-EVOLUTION +post I-EVOLUTION +estenótica I-EVOLUTION +y I-EVOLUTION +normalización I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +parámetros I-EVOLUTION +inflamatorios. I-EVOLUTION +A I-EVOLUTION +2 I-EVOLUTION +años I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +asintomática I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +exámenes I-EVOLUTION +normales. I-EVOLUTION + I-EVOLUTION -Varón B-PRESENT_ILLNESS +Niño B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -67 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -bebedor B-PAST_MEDICAL_HISTORY -moderado, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY +12 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Puertas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +volumen I-PRESENT_ILLNESS +escrotal I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hemiescroto I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +y B-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +traumático I-PAST_MEDICAL_HISTORY +conocido. I-PAST_MEDICAL_HISTORY +No B-PRESENT_ILLNESS +fiebre. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +miccional. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Sin B-PAST_MEDICAL_HISTORY +alergias I-PAST_MEDICAL_HISTORY +medicamentosas, I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +tiene I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -cardiopatía I-PAST_MEDICAL_HISTORY -hipertensiva, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -moderada, I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -cardiaca I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -fallo I-PAST_MEDICAL_HISTORY -sistólico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ventrículo I-PAST_MEDICAL_HISTORY -izquierdo I-PAST_MEDICAL_HISTORY -transitorio I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fibrilación I-PAST_MEDICAL_HISTORY -auricular I-PAST_MEDICAL_HISTORY -paroxística I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -amiodarona I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -2013. I-PAST_MEDICAL_HISTORY -Su I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -habitual I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -torasemida I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -QD, I-PAST_MEDICAL_HISTORY -acenocumarol I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -QD, I-PAST_MEDICAL_HISTORY -enalapril I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -QD, I-PAST_MEDICAL_HISTORY -bisoprolol I-PAST_MEDICAL_HISTORY -2, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -QD I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -omeprazol I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -QD. I-PAST_MEDICAL_HISTORY +interés. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -abril I-EXPLORATION +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física, I-EXPLORATION +se I-EXPLORATION +detecta I-EXPLORATION +edema I-EXPLORATION +y I-EXPLORATION +enrojecimiento I-EXPLORATION de I-EXPLORATION -2015 I-EXPLORATION -presentó I-EXPLORATION +la I-EXPLORATION +piel I-EXPLORATION +escrotal, I-EXPLORATION +más I-EXPLORATION +acusado I-EXPLORATION en I-EXPLORATION -una I-EXPLORATION -analítica I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -hipertiroidismo I-EXPLORATION -primario: I-EXPLORATION -T4 I-EXPLORATION -libre I-EXPLORATION -25, I-EXPLORATION -5 I-EXPLORATION -pg/ml I-EXPLORATION +el I-EXPLORATION +hemiescroto I-EXPLORATION +izquierdo I-EXPLORATION +ligeramente I-EXPLORATION +doloroso I-EXPLORATION +a I-EXPLORATION +palpación. I-EXPLORATION +Cordón I-EXPLORATION y I-EXPLORATION -hormona I-EXPLORATION -estimulante I-EXPLORATION +testículos I-EXPLORATION de I-EXPLORATION -tiroides I-EXPLORATION -(TSH) I-EXPLORATION -0, I-EXPLORATION -002 I-EXPLORATION -Ul/ml. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -gammagrafía I-EXPLORATION -tiroidea I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -bocio I-EXPLORATION -difuso I-EXPLORATION -hipercaptador. I-EXPLORATION -Respecto I-EXPLORATION +tamaño I-EXPLORATION +y I-EXPLORATION +consistencia I-EXPLORATION +normales I-EXPLORATION +no I-EXPLORATION +dolorosos. I-EXPLORATION + I-EXPLORATION +No I-EXPLORATION +aparece I-EXPLORATION +hidrocele I-EXPLORATION a I-EXPLORATION la I-EXPLORATION -autoinmunidad I-EXPLORATION -tiroidea I-EXPLORATION -presentó I-EXPLORATION -anticuerpos I-EXPLORATION -antitiroglobulina, I-EXPLORATION -anticuerpos I-EXPLORATION -antiperoxidasa I-EXPLORATION +transluminación I-EXPLORATION y I-EXPLORATION -anticuerpos I-EXPLORATION -receptor I-EXPLORATION -TSH I-EXPLORATION -en I-EXPLORATION -rangos I-EXPLORATION -normales. I-EXPLORATION -Se B-TREATMENT -orientó I-TREATMENT -como I-TREATMENT -un I-TREATMENT -hipertiroidismo I-TREATMENT -inducido I-TREATMENT -por I-TREATMENT -amiodarona I-TREATMENT -tipo I-TREATMENT -l5, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -este I-TREATMENT -tratamiento I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tiamazol, I-TREATMENT -5 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas. I-TREATMENT -Se I-TREATMENT -incrementó I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -bisoprolol I-TREATMENT -de I-TREATMENT -2, I-TREATMENT -5 I-TREATMENT -mg I-TREATMENT -a I-TREATMENT -5 I-TREATMENT -mg I-TREATMENT -QD I-TREATMENT -para I-TREATMENT -el I-TREATMENT -control I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fibrilación I-TREATMENT -auricular. I-TREATMENT - I-TREATMENT -Tras I-TREATMENT -dos I-TREATMENT -meses I-TREATMENT -en I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -tiamazol, I-TREATMENT -en B-EXPLORATION -consultas I-EXPLORATION -de I-EXPLORATION -Endocrinología, I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -analítica I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -elevación I-EXPLORATION +maniobra I-EXPLORATION de I-EXPLORATION -enzimas I-EXPLORATION -hepáticas: I-EXPLORATION -glutamato-oxalacetato I-EXPLORATION -transaminasa I-EXPLORATION -(GOT) I-EXPLORATION -100 I-EXPLORATION -Ul/L, I-EXPLORATION -glutamato-piruvato I-EXPLORATION -transaminasa I-EXPLORATION -(GPT) I-EXPLORATION -109 I-EXPLORATION -Ul/L, I-EXPLORATION -GGT I-EXPLORATION -1177 I-EXPLORATION -Ul/L, I-EXPLORATION -lactato I-EXPLORATION -deshidrogenasa I-EXPLORATION -(LDH) I-EXPLORATION -742 I-EXPLORATION -Ul/L, I-EXPLORATION -FA I-EXPLORATION -247 I-EXPLORATION -Ul/L; I-EXPLORATION -mientras I-EXPLORATION +Prehn I-EXPLORATION +es I-EXPLORATION +negativa. I-EXPLORATION +Reflejos I-EXPLORATION +cremastéricos I-EXPLORATION +conservados. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +estudio I-EXPLORATION +ultrasonográfico I-EXPLORATION que I-EXPLORATION -permanecieron I-EXPLORATION +informó I-EXPLORATION +de: I-EXPLORATION +testículo I-EXPLORATION +y I-EXPLORATION +epidídimos I-EXPLORATION +bilaterales I-EXPLORATION +de I-EXPLORATION +tamaño I-EXPLORATION normales I-EXPLORATION -los I-EXPLORATION -valores I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -bilirrubina I-EXPLORATION -directa, I-EXPLORATION -0, I-EXPLORATION -3 I-EXPLORATION -mg/dL, I-EXPLORATION +inflamación I-EXPLORATION y I-EXPLORATION -bilirrubina I-EXPLORATION -total, I-EXPLORATION -0, I-EXPLORATION -7 I-EXPLORATION -mg/dL. I-EXPLORATION -Se B-DERIVED_FROM/TO -ingresó I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -Medicina I-DERIVED_FROM/TO -Interna I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -estudiar I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -posible I-DERIVED_FROM/TO -colestasis I-DERIVED_FROM/TO -disociada I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -citolisis. I-DERIVED_FROM/TO -Se B-EXPLORATION -descartaron I-EXPLORATION -causas I-EXPLORATION -autoinmunes I-EXPLORATION -e I-EXPLORATION -infecciosas. I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION +sin I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -virus I-EXPLORATION -hepatotropos I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION -Ante B-TREATMENT -estos I-TREATMENT -resultados I-TREATMENT -se I-TREATMENT -asoció I-TREATMENT -la I-TREATMENT -colestasis I-TREATMENT -disociada I-TREATMENT -al I-TREATMENT -uso I-TREATMENT +el I-EXPLORATION +flujo I-EXPLORATION +al I-EXPLORATION +Eco-Doppler. I-EXPLORATION +Cubiertas I-EXPLORATION +testiculares I-EXPLORATION +y I-EXPLORATION +tejido I-EXPLORATION +celular I-EXPLORATION +subcutáneo I-EXPLORATION +de I-EXPLORATION +hemiescroto I-EXPLORATION +izquierdo I-EXPLORATION +engrosados I-EXPLORATION +con I-EXPLORATION +aumento I-EXPLORATION +del I-EXPLORATION +flujo I-EXPLORATION +Doppler. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +le I-TREATMENT +diagnosticó I-TREATMENT de I-TREATMENT -tiamazol, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -retiró I-TREATMENT -y I-TREATMENT -se I-TREATMENT -observó I-TREATMENT -una I-TREATMENT -mejoría I-TREATMENT -progresiva I-TREATMENT +edema I-TREATMENT de I-TREATMENT -los I-TREATMENT -niveles I-TREATMENT -enzimáticos I-TREATMENT -hasta I-TREATMENT -su I-TREATMENT -completa I-TREATMENT -normalización I-TREATMENT -dos I-TREATMENT -meses I-TREATMENT -después. I-TREATMENT - I-TREATMENT -Los B-EVOLUTION -valores I-EVOLUTION -de I-EVOLUTION -hormonas I-EVOLUTION -tiroideas I-EVOLUTION +escroto I-TREATMENT +agudo I-TREATMENT +idiopático, I-TREATMENT +se I-TREATMENT +le I-TREATMENT +recetaron I-TREATMENT +AINES I-TREATMENT +y B-EVOLUTION se I-EVOLUTION -normalizaron, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION +le I-EVOLUTION +cito I-EVOLUTION +para I-EVOLUTION +revisión I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +5 I-EVOLUTION +días, I-EVOLUTION +donde I-EVOLUTION se I-EVOLUTION -recomendó I-EVOLUTION -control I-EVOLUTION -cada I-EVOLUTION -6-12 I-EVOLUTION -meses I-EVOLUTION -sin I-EVOLUTION +pudo I-EVOLUTION +observar I-EVOLUTION que I-EVOLUTION -precisase I-EVOLUTION -tratamiento. I-EVOLUTION +el I-EVOLUTION +edema, I-EVOLUTION +el I-EVOLUTION +eritema I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +dolor I-EVOLUTION +habían I-EVOLUTION +desaparecido I-EVOLUTION +casi I-EVOLUTION +por I-EVOLUTION +completo. I-EVOLUTION I-EVOLUTION -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS +En B-PRESENT_ILLNESS +Mayo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -niño I-PRESENT_ILLNESS +1997, I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -ocho I-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -del B-PAST_MEDICAL_HISTORY -ámbito I-PAST_MEDICAL_HISTORY -rural, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +intervenida, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +otro I-PRESENT_ILLNESS +centro, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -acompañado I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +carcinoma I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -distensión I-PRESENT_ILLNESS -abdominal. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION -inicial I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -fue I-EXPLORATION -negativa, I-EXPLORATION -a I-EXPLORATION -excepción I-EXPLORATION -de I-EXPLORATION -múltiples I-EXPLORATION -erosiones I-EXPLORATION -en I-EXPLORATION -antebrazo, I-EXPLORATION -brazo I-EXPLORATION -izquierdo I-EXPLORATION +la I-PRESENT_ILLNESS +glándula I-PRESENT_ILLNESS +suprarrenal I-PRESENT_ILLNESS +izquierda I-PRESENT_ILLNESS +clínicamente I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +funcionante I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +manifestó I-PRESENT_ILLNESS +clínicamente I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +molestias I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +flanco I-PRESENT_ILLNESS +izquierdo, I-PRESENT_ILLNESS +poco I-PRESENT_ILLNESS +específicas, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +postparto I-PRESENT_ILLNESS +inmediato; I-PRESENT_ILLNESS +la B-EXPLORATION +ecografía I-EXPLORATION y I-EXPLORATION -piernas, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -pústula I-EXPLORATION -de I-EXPLORATION -aproximadamente I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -cara I-EXPLORATION -externa I-EXPLORATION +la I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computerizada I-EXPLORATION +abdominales I-EXPLORATION +mostraron I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +suprarrenal I-EXPLORATION +izquierda I-EXPLORATION de I-EXPLORATION -brazo I-EXPLORATION -izquierdo I-EXPLORATION +10 I-EXPLORATION +cmts., I-EXPLORATION +sólida I-EXPLORATION y I-EXPLORATION -adenopatía I-EXPLORATION -axilar I-EXPLORATION -izquierda. I-EXPLORATION -Los I-EXPLORATION -datos I-EXPLORATION -de I-EXPLORATION -laboratorio I-EXPLORATION -iniciales I-EXPLORATION -incluyeron, I-EXPLORATION -leucocitosis I-EXPLORATION -12.400 I-EXPLORATION con I-EXPLORATION -69% I-EXPLORATION -de I-EXPLORATION -granulocitos, I-EXPLORATION -8% I-EXPLORATION -de I-EXPLORATION -monocitos, I-EXPLORATION -23% I-EXPLORATION -de I-EXPLORATION -linfocitos, I-EXPLORATION -VSG I-EXPLORATION -63 I-EXPLORATION -mm/h, I-EXPLORATION -cultivo I-EXPLORATION +áreas I-EXPLORATION de I-EXPLORATION -sangre I-EXPLORATION +calcificación I-EXPLORATION y I-EXPLORATION -heces I-EXPLORATION -negativos, I-EXPLORATION -tuberculina I-EXPLORATION -2UI I-EXPLORATION -PPD I-EXPLORATION -negativa, I-EXPLORATION -orina I-EXPLORATION -normal, I-EXPLORATION +necrosis I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +interior, I-EXPLORATION +siendo I-EXPLORATION +la I-EXPLORATION radiografía I-EXPLORATION de I-EXPLORATION tórax I-EXPLORATION y I-EXPLORATION -senos I-EXPLORATION -normal, I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION +la I-EXPLORATION +gammagrafía I-EXPLORATION +ósea I-EXPLORATION normales. I-EXPLORATION -Mantienen I-EXPLORATION +En I-EXPLORATION los I-EXPLORATION -picos I-EXPLORATION -febriles I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -frecuencia I-EXPLORATION -diaria. I-EXPLORATION -Ante B-TREATMENT +análisis, I-EXPLORATION +presentaba I-EXPLORATION +ligero I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +cortisoluria I-EXPLORATION +(284.5 I-EXPLORATION +mcgr./24h.) I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +17-OH-esteroides I-EXPLORATION +en I-EXPLORATION +orina I-EXPLORATION +(12.7 I-EXPLORATION +mcg./24h.), I-EXPLORATION +sin I-EXPLORATION +síntomas I-EXPLORATION +de I-EXPLORATION +hipercortisolismo I-EXPLORATION +sistémico. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +resección I-TREATMENT +completa I-TREATMENT +de I-TREATMENT la I-TREATMENT -sospecha I-TREATMENT +tumoración, I-TREATMENT +con I-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +histológico I-TREATMENT de I-TREATMENT -fiebre I-TREATMENT -botonosa, I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT +carcinoma I-TREATMENT +suprarrenal I-TREATMENT +de I-TREATMENT +10 I-TREATMENT +x I-TREATMENT +7 I-TREATMENT +x I-TREATMENT +5 I-TREATMENT +cmts. I-TREATMENT +(215 I-TREATMENT +grs.) I-TREATMENT +bien I-TREATMENT +encapsulado, I-TREATMENT +aunque I-TREATMENT con I-TREATMENT -doxiciclina I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -habitual, I-TREATMENT -que I-TREATMENT +invasión I-TREATMENT +vascular, I-TREATMENT +amplias I-TREATMENT +zonas I-TREATMENT +de I-TREATMENT +necrosis I-TREATMENT +y I-TREATMENT +un I-TREATMENT +índice I-TREATMENT +mitótico I-TREATMENT +de I-TREATMENT +5.8/50; I-TREATMENT +el I-TREATMENT +estudio I-TREATMENT +histoquímico I-TREATMENT +fue I-TREATMENT +(+) I-TREATMENT +para I-TREATMENT +Vimentina I-TREATMENT +y I-TREATMENT +(-) I-TREATMENT +para I-TREATMENT +Citoqueratina, I-TREATMENT +EMA, I-TREATMENT +Cromogranina I-TREATMENT +y I-TREATMENT +Sm- I-TREATMENT +100. I-TREATMENT +Se I-TREATMENT +etiquetó I-TREATMENT +como I-TREATMENT +Estadio I-TREATMENT +II I-TREATMENT +y I-TREATMENT +Grado I-TREATMENT +II. I-TREATMENT +Treinta B-EVOLUTION +meses I-EVOLUTION +después, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +estudios I-EVOLUTION +radiológicos I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +una I-EVOLUTION +masa I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +lecho I-EVOLUTION +de I-EVOLUTION +resección I-EVOLUTION +previo I-EVOLUTION +de I-EVOLUTION +7 I-EVOLUTION +cmts., I-EVOLUTION +en I-EVOLUTION +contacto I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +hilio I-EVOLUTION +renal I-EVOLUTION +izquierdo I-EVOLUTION +y I-EVOLUTION +técnicamente I-EVOLUTION +resecable; I-EVOLUTION +se B-TREATMENT +reintervino I-TREATMENT +y I-TREATMENT se I-TREATMENT -suspende I-TREATMENT +llevó I-TREATMENT a I-TREATMENT -los I-TREATMENT -seis I-TREATMENT -días I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -negatividad I-TREATMENT +cabo I-TREATMENT +una I-TREATMENT +resección I-TREATMENT de I-TREATMENT la I-TREATMENT -serología I-TREATMENT +recidiva I-TREATMENT +asociada I-TREATMENT +a I-TREATMENT +nefrectomía I-TREATMENT +izquierda, I-TREATMENT +esplenectomía I-TREATMENT +y I-TREATMENT +pancreatectomía I-TREATMENT +distal I-TREATMENT +(radical I-TREATMENT +completa I-TREATMENT +y I-TREATMENT +con I-TREATMENT +márgenes I-TREATMENT +libres). I-TREATMENT +Posteriormente, I-TREATMENT +recibió I-TREATMENT +tratamiento I-TREATMENT +quimioterápico I-TREATMENT +sistémico I-TREATMENT +adyuvante I-TREATMENT +con I-TREATMENT +6 I-TREATMENT +ciclos I-TREATMENT +completos I-TREATMENT de I-TREATMENT -Rickettsia I-TREATMENT -conorii. I-TREATMENT +cisplatino I-TREATMENT +(CDDP) I-TREATMENT +y I-TREATMENT +etopósido I-TREATMENT +(VP-16) I-TREATMENT +en I-TREATMENT +régimen I-TREATMENT +adyuvante. I-TREATMENT I-TREATMENT -El B-EXPLORATION -paciente I-EXPLORATION -continúa I-EXPLORATION -presentando I-EXPLORATION -picos I-EXPLORATION -febriles, I-EXPLORATION -programándose I-EXPLORATION -nuevos I-EXPLORATION -estudios I-EXPLORATION -complementarios, I-EXPLORATION -que I-EXPLORATION -revelaron I-EXPLORATION -un I-EXPLORATION -recuento I-EXPLORATION +Cuatro B-EVOLUTION +años I-EVOLUTION +y I-EVOLUTION +once I-EVOLUTION +meses I-EVOLUTION +tras I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +inicial, I-EVOLUTION +se I-EVOLUTION +detecta I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +seguimiento I-EVOLUTION +radiológico I-EVOLUTION +la I-EVOLUTION +presencia I-EVOLUTION +de I-EVOLUTION +varios I-EVOLUTION +nódulos I-EVOLUTION +hepáticos I-EVOLUTION +sugerentes I-EVOLUTION +de I-EVOLUTION +metástasis. I-EVOLUTION +Se B-TREATMENT +sometió I-TREATMENT +de I-TREATMENT +nuevo I-TREATMENT +a I-TREATMENT +cirugía I-TREATMENT +abdominal I-TREATMENT +realizándose, I-TREATMENT +previo I-TREATMENT +control I-TREATMENT +con I-TREATMENT +ecografía I-TREATMENT +hepática I-TREATMENT +intraoperatoria, I-TREATMENT +una I-TREATMENT +bisegmentectomía I-TREATMENT +IV-B I-TREATMENT +y I-TREATMENT +V I-TREATMENT +y I-TREATMENT +una I-TREATMENT +resección I-TREATMENT +limitada I-TREATMENT +del I-TREATMENT +segmento I-TREATMENT +VIII; I-TREATMENT +el B-EXPLORATION +análisis I-EXPLORATION de I-EXPLORATION -leucocitos I-EXPLORATION -normal, I-EXPLORATION -VSG I-EXPLORATION -92 I-EXPLORATION -mm/h, I-EXPLORATION -citomorfología I-EXPLORATION -normal, I-EXPLORATION -PCR I-EXPLORATION -3 I-EXPLORATION -mg/dl, I-EXPLORATION -pruebas I-EXPLORATION -hepáticas I-EXPLORATION -normales, I-EXPLORATION -aglutinaciones I-EXPLORATION -a I-EXPLORATION -Salmonella I-EXPLORATION -y I-EXPLORATION -Brucella I-EXPLORATION -negativas, I-EXPLORATION -serología I-EXPLORATION +anatomía-patológica I-EXPLORATION +informó I-EXPLORATION de I-EXPLORATION -Epstein I-EXPLORATION -Barr, I-EXPLORATION -Citomegalovirus, I-EXPLORATION -Hepatitis, I-EXPLORATION -HIV, I-EXPLORATION -Borrelia I-EXPLORATION -burgdorferi I-EXPLORATION -negativas. I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -abdominal, I-EXPLORATION -revela I-EXPLORATION la I-EXPLORATION presencia I-EXPLORATION de I-EXPLORATION -múltiples I-EXPLORATION -imágenes I-EXPLORATION -hipoecoicas, I-EXPLORATION -la I-EXPLORATION -mayor I-EXPLORATION -de I-EXPLORATION -ellas I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -mm, I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -bazo I-EXPLORATION +7 I-EXPLORATION +nódulos I-EXPLORATION +(de I-EXPLORATION +tamaño I-EXPLORATION +variable I-EXPLORATION +entre I-EXPLORATION +0.5 I-EXPLORATION y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hígado I-EXPLORATION -imagen I-EXPLORATION -similar I-EXPLORATION -única I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro. I-EXPLORATION -La I-EXPLORATION -TAC I-EXPLORATION -abdominal I-EXPLORATION +1.5 I-EXPLORATION +cmts.) I-EXPLORATION +compatibles I-EXPLORATION con I-EXPLORATION -contraste I-EXPLORATION -corrobora I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -ecográficos I-EXPLORATION -y I-EXPLORATION -sugiere I-EXPLORATION -la I-EXPLORATION -posibilidad I-EXPLORATION -diagnóstica I-EXPLORATION -de I-EXPLORATION -microabscesos I-EXPLORATION -o I-EXPLORATION -Enfermedad I-EXPLORATION -por I-EXPLORATION -Arañazo I-EXPLORATION +metástasis I-EXPLORATION de I-EXPLORATION -Gato; I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -serología I-EXPLORATION -a I-EXPLORATION -Bartonella I-EXPLORATION -Henselae, I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -positiva, I-EXPLORATION -iniciándose B-TREATMENT +carcinoma I-EXPLORATION +suprarrenal. I-EXPLORATION + I-EXPLORATION +Diez B-EVOLUTION +meses I-EVOLUTION +después, I-EVOLUTION +se I-EVOLUTION +detecta I-EVOLUTION +una I-EVOLUTION +nueva I-EVOLUTION +recidiva I-EVOLUTION +tumoral I-EVOLUTION +a I-EVOLUTION +nivel I-EVOLUTION +subdiafragmático I-EVOLUTION +izquierdo I-EVOLUTION +(de I-EVOLUTION +6 I-EVOLUTION +x I-EVOLUTION +4 I-EVOLUTION +cmts. I-EVOLUTION +según I-EVOLUTION +la I-EVOLUTION +TAC) I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +raiz I-EVOLUTION +del I-EVOLUTION +mesenterio, I-EVOLUTION +esta I-EVOLUTION +última I-EVOLUTION +de I-EVOLUTION +4 I-EVOLUTION +x I-EVOLUTION +3 I-EVOLUTION +cmts. I-EVOLUTION +y I-EVOLUTION +localizada I-EVOLUTION +a I-EVOLUTION +nivel I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +salida I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +arteria I-EVOLUTION +mesentérica I-EVOLUTION +superior I-EVOLUTION +(AMS). I-EVOLUTION +Dada B-TREATMENT +la I-TREATMENT +difícil I-TREATMENT +resecabilidad I-TREATMENT +de I-TREATMENT +la I-TREATMENT +nueva I-TREATMENT +recidiva I-TREATMENT +se I-TREATMENT +decide I-TREATMENT tratamiento I-TREATMENT +quimioterápico I-TREATMENT con I-TREATMENT -eritromicina. I-TREATMENT - I-TREATMENT -Ante I-TREATMENT +intención I-TREATMENT +neoadyuvante I-TREATMENT +( I-TREATMENT +5 I-TREATMENT +ciclos I-TREATMENT +completos I-TREATMENT +de I-TREATMENT +CDDP I-TREATMENT +y I-TREATMENT +VP-16), I-TREATMENT +decidiéndose I-TREATMENT +por I-TREATMENT +regresión I-TREATMENT +parcial I-TREATMENT +de I-TREATMENT +las I-TREATMENT +lesiones I-TREATMENT +una I-TREATMENT +nueva I-TREATMENT +exploración I-TREATMENT +quirúrgica. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT la I-TREATMENT -persistencia I-TREATMENT +resección I-TREATMENT de I-TREATMENT -picos I-TREATMENT -febriles I-TREATMENT +las I-TREATMENT +dos I-TREATMENT +masas I-TREATMENT +tumorales, I-TREATMENT +la I-TREATMENT +primera I-TREATMENT +incluyendo I-TREATMENT +el I-TREATMENT +pilar I-TREATMENT +izquierdo I-TREATMENT +del I-TREATMENT +diafragma I-TREATMENT +y I-TREATMENT +una I-TREATMENT +pastilla I-TREATMENT +de I-TREATMENT +5 I-TREATMENT +cmts. I-TREATMENT +de I-TREATMENT +dicho I-TREATMENT +músculo, I-TREATMENT y I-TREATMENT -dolor I-TREATMENT -abdominal, I-TREATMENT -se I-TREATMENT -sustituye I-TREATMENT la I-TREATMENT -eritromicina I-TREATMENT -por I-TREATMENT -rifampicina I-TREATMENT -más I-TREATMENT -gentamicina, I-TREATMENT -constatándose B-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -tres I-EVOLUTION -días I-EVOLUTION +segunda I-TREATMENT +disecando I-TREATMENT +en I-TREATMENT +su I-TREATMENT +origen I-TREATMENT +el I-TREATMENT +tronco I-TREATMENT +celíaco I-TREATMENT +y I-TREATMENT +la I-TREATMENT +AMS I-TREATMENT +y I-TREATMENT +resecando I-TREATMENT +todo I-TREATMENT +el I-TREATMENT +tejido I-TREATMENT +tumoral I-TREATMENT +entre I-TREATMENT +ambos I-TREATMENT +vasos. I-TREATMENT +La B-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION +recidiva, I-EXPLORATION +estando I-EXPLORATION +los I-EXPLORATION +bordes I-EXPLORATION +de I-EXPLORATION +resección I-EXPLORATION +no I-EXPLORATION +afectos. I-EXPLORATION +La B-EVOLUTION +evolución I-EVOLUTION +postoperatoria I-EVOLUTION +fue I-EVOLUTION +satisfactoria. I-EVOLUTION + I-EVOLUTION +La I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encuentra, I-EVOLUTION +tras I-EVOLUTION +7 I-EVOLUTION +años I-EVOLUTION +y I-EVOLUTION +3 I-EVOLUTION +meses I-EVOLUTION +del I-EVOLUTION +diagnóstico I-EVOLUTION +del I-EVOLUTION +tumor I-EVOLUTION +primario, I-EVOLUTION +libre I-EVOLUTION de I-EVOLUTION -iniciado I-EVOLUTION -dicho I-EVOLUTION -tratamiento I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION +enfermedad I-EVOLUTION y I-EVOLUTION -desaparición I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +calidad I-EVOLUTION de I-EVOLUTION +vida I-EVOLUTION +aceptable, I-EVOLUTION +mínimamente I-EVOLUTION +limitada I-EVOLUTION +por I-EVOLUTION +las I-EVOLUTION +deposiciones I-EVOLUTION +diarreicas I-EVOLUTION +secundarias I-EVOLUTION +a I-EVOLUTION la I-EVOLUTION -fiebre, I-EVOLUTION -cuya I-EVOLUTION -duración I-EVOLUTION -total I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -28 I-EVOLUTION -días. I-EVOLUTION +denervación I-EVOLUTION +simpática I-EVOLUTION +celíaca. I-EVOLUTION I-EVOLUTION -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS +67 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS +de B-PAST_MEDICAL_HISTORY +origen I-PAST_MEDICAL_HISTORY +indoeuropeo I-PAST_MEDICAL_HISTORY +que B-DERIVED_FROM/TO +consulta I-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +odontólogo I-DERIVED_FROM/TO +tras I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +hallazgo I-DERIVED_FROM/TO +incidental, I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +realizar I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +ortopantomografía, I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +imágenes I-DERIVED_FROM/TO +intrasinusales I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +radioopacidad I-DERIVED_FROM/TO +metálica. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Como B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +solo I-PAST_MEDICAL_HISTORY +destacaba I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +herida I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +arma I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +fuego I-PAST_MEDICAL_HISTORY +12 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +consulta, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +región I-PAST_MEDICAL_HISTORY +temporal I-PAST_MEDICAL_HISTORY +izquierda. I-PAST_MEDICAL_HISTORY +La B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -38º I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +sensación I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS +ocupación I-PRESENT_ILLNESS +pansinusal I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +marcada I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +seno I-PRESENT_ILLNESS +maxilar I-PRESENT_ILLNESS +izquierdo, I-PRESENT_ILLNESS +acompañada I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -escasa I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -expectoración I-PRESENT_ILLNESS -blanquecina. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION +rinorrea I-PRESENT_ILLNESS +ocasional I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +fosa I-PRESENT_ILLNESS +nasal I-PRESENT_ILLNESS +izquierda. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +La B-EXPLORATION exploración I-EXPLORATION -sólo I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -hipertrofia I-EXPLORATION -en I-EXPLORATION -amígdala I-EXPLORATION -izquierda I-EXPLORATION -con I-EXPLORATION -adenopatías I-EXPLORATION +física I-EXPLORATION +volvió I-EXPLORATION +a I-EXPLORATION +resultar I-EXPLORATION +anodina, I-EXPLORATION +sin I-EXPLORATION +abombamiento I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +vestibular I-EXPLORATION en I-EXPLORATION -cadena I-EXPLORATION -yugular I-EXPLORATION -izquierda I-EXPLORATION -de I-EXPLORATION -gran I-EXPLORATION -tamaño I-EXPLORATION -(3x3 I-EXPLORATION -cm). I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -faringoamigdalitis I-TREATMENT -bacteriana I-TREATMENT -se I-TREATMENT -pautó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -amoxicilina I-TREATMENT -e I-TREATMENT -ibuprofeno. I-TREATMENT -No B-EXPLORATION -obstante, I-EXPLORATION -ante I-EXPLORATION el I-EXPLORATION -tamaño I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -adenopatías I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -solicitar I-EXPLORATION -test I-EXPLORATION +segundo I-EXPLORATION +cuadrante, I-EXPLORATION +ni I-EXPLORATION +hallazgo I-EXPLORATION de I-EXPLORATION -mononucleosis I-EXPLORATION -infecciosa I-EXPLORATION -(MI) I-EXPLORATION -y I-EXPLORATION -analítica I-EXPLORATION -general. I-EXPLORATION +fístulas I-EXPLORATION +orosinusales I-EXPLORATION +visibles. I-EXPLORATION I-EXPLORATION -Acude B-EVOLUTION -de I-EVOLUTION -nuevo I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -14 I-EVOLUTION -días I-EVOLUTION -por I-EVOLUTION -fiebre I-EVOLUTION -alta, I-EVOLUTION -malestar I-EVOLUTION -general, I-EVOLUTION -cansancio I-EVOLUTION -intenso I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -región I-EVOLUTION -laterocervical I-EVOLUTION -izquierda. I-EVOLUTION -En B-EXPLORATION -este I-EXPLORATION -momento I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -gran I-EXPLORATION -adenopatía I-EXPLORATION -submaxilar I-EXPLORATION -izquierda I-EXPLORATION +Las I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -3 I-EXPLORATION -x I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -dolorosa I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION -y I-EXPLORATION -otra I-EXPLORATION -supraclavicular I-EXPLORATION -izquierda. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -adenopatías I-EXPLORATION -en I-EXPLORATION -otros I-EXPLORATION -grupos I-EXPLORATION -ganglionares, I-EXPLORATION -hepatoesplenomegalia, I-EXPLORATION -lesiones I-EXPLORATION -cutáneas I-EXPLORATION -o I-EXPLORATION -afectación I-EXPLORATION -articular. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -aprecian I-EXPLORATION -lesiones I-EXPLORATION -locales, I-EXPLORATION -la I-EXPLORATION -otoscopia I-EXPLORATION -es I-EXPLORATION -normal, I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -faríngea I-EXPLORATION +imagen I-EXPLORATION +realizadas I-EXPLORATION +(ortopantomografía, I-EXPLORATION +DentaScan I-EXPLORATION y I-EXPLORATION -tiroidea I-EXPLORATION -son I-EXPLORATION -normales. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -destaca: I-EXPLORATION -LDH I-EXPLORATION -1400 I-EXPLORATION -UI/l, I-EXPLORATION -Got I-EXPLORATION -56, I-EXPLORATION -gpt I-EXPLORATION -47 I-EXPLORATION -UI/l, I-EXPLORATION -no I-EXPLORATION -existe I-EXPLORATION -leucocitosis, I-EXPLORATION -sólo I-EXPLORATION -una I-EXPLORATION -leve I-EXPLORATION -linfocitosis. I-EXPLORATION -Test I-EXPLORATION -de I-EXPLORATION -MI: I-EXPLORATION -negativo. I-EXPLORATION -Se I-EXPLORATION -solicita I-EXPLORATION -test I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION +TC I-EXPLORATION +facial) I-EXPLORATION +mostraron I-EXPLORATION la I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana I-EXPLORATION -(VIH), I-EXPLORATION -análisis I-EXPLORATION -anatomopatológico I-EXPLORATION -mediante I-EXPLORATION -punción I-EXPLORATION -aspiración I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina I-EXPLORATION -(PAAF) I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -nuevo I-EXPLORATION -test I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -MI. I-EXPLORATION -Para I-EXPLORATION -evitar I-EXPLORATION -demoras I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -acude I-EXPLORATION +material I-EXPLORATION a I-EXPLORATION -un I-EXPLORATION -centro I-EXPLORATION -privado I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION +nivel I-EXPLORATION +intrasinusal I-EXPLORATION de I-EXPLORATION -PAAF I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -cirujanos I-EXPLORATION -encargados I-EXPLORATION +radiopacidad I-EXPLORATION +metálica I-EXPLORATION +en I-EXPLORATION +forma I-EXPLORATION de I-EXPLORATION -realizarla, I-EXPLORATION -ante I-EXPLORATION -el I-EXPLORATION -tamaño I-EXPLORATION +un I-EXPLORATION +único I-EXPLORATION +nódulo I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -adenopatías, I-EXPLORATION -deciden I-EXPLORATION +forma I-EXPLORATION +circular I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -biopsia. I-EXPLORATION -El I-EXPLORATION -resultado I-EXPLORATION +región I-EXPLORATION +superolateral I-EXPLORATION del I-EXPLORATION -test I-EXPLORATION +seno I-EXPLORATION +maxilar I-EXPLORATION +izquierdo, I-EXPLORATION +asociado I-EXPLORATION +a I-EXPLORATION +reacción I-EXPLORATION +inflamatoria I-EXPLORATION de I-EXPLORATION -MI I-EXPLORATION -es I-EXPLORATION -nuevamente I-EXPLORATION -negativo. I-EXPLORATION +la I-EXPLORATION +mucosa I-EXPLORATION +sinusal. I-EXPLORATION I-EXPLORATION -La B-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -favorable, I-EVOLUTION -persistiendo I-EVOLUTION -febrícula I-EVOLUTION -durante I-EVOLUTION -20 I-EVOLUTION -días I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -disminución I-EVOLUTION -lenta I-EVOLUTION -y I-EVOLUTION -paulatina I-EVOLUTION -del I-EVOLUTION -tamaño I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -adenopatías. I-EVOLUTION -El B-EXPLORATION -resultado I-EXPLORATION +Dados B-TREATMENT +los I-TREATMENT +antecedentes I-TREATMENT +de I-TREATMENT +herida I-TREATMENT +por I-TREATMENT +arma I-TREATMENT +de I-TREATMENT +fuego I-TREATMENT +de I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +se I-TREATMENT +pensó I-TREATMENT +que I-TREATMENT +pudiera I-TREATMENT +tratarse I-TREATMENT +de I-TREATMENT +cuerpos I-TREATMENT +extraños I-TREATMENT +intrasinusales I-TREATMENT +derivados I-TREATMENT +del I-TREATMENT +mismo, I-TREATMENT +así I-TREATMENT +que I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +un I-TREATMENT +Cadwell-Luc I-TREATMENT +y I-TREATMENT +antrostomía I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +intraoral I-TREATMENT +para I-TREATMENT +la I-TREATMENT +extirpación I-TREATMENT +del I-TREATMENT +cuerpo I-TREATMENT +extraño I-TREATMENT +y I-TREATMENT +de I-TREATMENT +la I-TREATMENT +mucosa I-TREATMENT +sinusal I-TREATMENT +afecta, I-TREATMENT +sin I-TREATMENT +identificarse I-TREATMENT +fragmentos I-TREATMENT +metálicos I-TREATMENT +o I-TREATMENT +restos I-TREATMENT +óseos. I-TREATMENT +Se B-EXPLORATION +obtuvo I-EXPLORATION +un I-EXPLORATION +material I-EXPLORATION +blanquecino I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION +consistencia I-EXPLORATION +fibroelástica I-EXPLORATION +similar I-EXPLORATION +al I-EXPLORATION +obtenido I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +caso I-EXPLORATION +presentado I-EXPLORATION +anterior. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION se I-EXPLORATION -informa I-EXPLORATION -como: I-EXPLORATION -linfadenitis I-EXPLORATION -histiocitaria I-EXPLORATION -necrotizante I-EXPLORATION -o I-EXPLORATION -enfermedad I-EXPLORATION +informó I-EXPLORATION +como I-EXPLORATION +mucosa I-EXPLORATION +sinusal I-EXPLORATION +con I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -Kikuchi. I-EXPLORATION -Ante I-EXPLORATION -este I-EXPLORATION -resultado I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -analítica I-EXPLORATION -y I-EXPLORATION -otras I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -posibles I-EXPLORATION -procesos I-EXPLORATION -asociados I-EXPLORATION +inflamación I-EXPLORATION +crónica, I-EXPLORATION +asociada I-EXPLORATION a I-EXPLORATION -esta I-EXPLORATION -enfermedad. I-EXPLORATION +material I-EXPLORATION +blanquecino I-EXPLORATION +formado I-EXPLORATION +por I-EXPLORATION +hifas I-EXPLORATION +ramificadas I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +bola I-EXPLORATION +fúngica I-EXPLORATION +intrasinusal I-EXPLORATION +causada I-EXPLORATION +por I-EXPLORATION +Aspergillus. I-EXPLORATION Los I-EXPLORATION -resultados I-EXPLORATION -son I-EXPLORATION -los I-EXPLORATION -siguientes: I-EXPLORATION -factor I-EXPLORATION -reumatoide I-EXPLORATION -negativo, I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares I-EXPLORATION -(ANAs) I-EXPLORATION -negativos, I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -normal. I-EXPLORATION +estudios I-EXPLORATION +microbiológicos I-EXPLORATION +volvieron I-EXPLORATION +a I-EXPLORATION +resultar I-EXPLORATION +negativos. I-EXPLORATION I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -hipercolesterolemia, I-PAST_MEDICAL_HISTORY -hiperuricemia, I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -40 I-PAST_MEDICAL_HISTORY -cigarrillos I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -día I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -33 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -bebedor I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -25-30 I-PAST_MEDICAL_HISTORY -unidades I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcohol I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -semana; I-PAST_MEDICAL_HISTORY -fibrilación I-PAST_MEDICAL_HISTORY -auricular I-PAST_MEDICAL_HISTORY -paroxística I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -última I-PAST_MEDICAL_HISTORY -revisión I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -problema I-PAST_MEDICAL_HISTORY -cardiológico, I-PAST_MEDICAL_HISTORY -cinco I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes, I-PAST_MEDICAL_HISTORY -mostró I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -todas I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -pruebas I-PAST_MEDICAL_HISTORY -complementarias I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontraban I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -rangos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -normalidad I-PAST_MEDICAL_HISTORY -(incluidas I-PAST_MEDICAL_HISTORY -hormonas I-PAST_MEDICAL_HISTORY -tiroideas). I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -consulta I-PAST_MEDICAL_HISTORY -seguía I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -enalapril I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -mg/día, I-PAST_MEDICAL_HISTORY -clortalidona I-PAST_MEDICAL_HISTORY -25 I-PAST_MEDICAL_HISTORY -mg/día, I-PAST_MEDICAL_HISTORY -atorvastatina I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -mg/día, I-PAST_MEDICAL_HISTORY -ácido I-PAST_MEDICAL_HISTORY -acetilsalicílico I-PAST_MEDICAL_HISTORY -200 I-PAST_MEDICAL_HISTORY -mg/día I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -amiodarona I-PAST_MEDICAL_HISTORY -400 I-PAST_MEDICAL_HISTORY -mg/día I-PAST_MEDICAL_HISTORY -excepto I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -sábados I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -domingos. I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -comenzó I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -constitucional I-PRESENT_ILLNESS -dominado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -importante I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -apetito I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -adelgazamiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -kilogramos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -(que I-PRESENT_ILLNESS -suponen I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -10% I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -corporal). I-PRESENT_ILLNESS -Además I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -debilidad I-PRESENT_ILLNESS -importante I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS +En B-EVOLUTION +este I-EVOLUTION +caso I-EVOLUTION +la I-EVOLUTION +mucosa I-EVOLUTION +no I-EVOLUTION +se I-EVOLUTION +hallaba I-EVOLUTION +infiltrada I-EVOLUTION +a I-EVOLUTION +ningún I-EVOLUTION +nivel, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +h I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +cirugía I-EVOLUTION +sin I-EVOLUTION +complicaciones I-EVOLUTION +ni I-EVOLUTION +necesidad I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION +antifúngico I-EVOLUTION +intravenoso. I-EVOLUTION + I-EVOLUTION +En I-EVOLUTION +las I-EVOLUTION +revisiones I-EVOLUTION +posteriores I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +refiere I-EVOLUTION +desaparición I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +clínica I-EVOLUTION +y I-EVOLUTION +ausencia I-EVOLUTION +de I-EVOLUTION +complicaciones I-EVOLUTION +en I-EVOLUTION +un I-EVOLUTION +periodo I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +de I-EVOLUTION +8 I-EVOLUTION +años. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -cinturas I-PRESENT_ILLNESS -escapular I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pélvica, I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -llamativa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -primera. I-PRESENT_ILLNESS -Otro I-PRESENT_ILLNESS -dato I-PRESENT_ILLNESS -destacable I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS +58 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +chilena, I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -aquejaba I-PRESENT_ILLNESS -insomnio I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -nerviosismo. I-PRESENT_ILLNESS -Una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS consulta I-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -autolimitado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +evolución I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Sjögren, I-PAST_MEDICAL_HISTORY +tratado I-PAST_MEDICAL_HISTORY +únicamente I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +lágrimas I-PAST_MEDICAL_HISTORY +artificiales. I-PAST_MEDICAL_HISTORY +Tiene I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +hijo I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +vitíligo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +hermana I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Sjögren. I-PAST_MEDICAL_HISTORY +Sin I-PAST_MEDICAL_HISTORY +consumo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +medicamentos I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +tabaquismo. I-PAST_MEDICAL_HISTORY +Sin B-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +cáncer I-FAMILY_HISTORY +digestivo. I-FAMILY_HISTORY +Niega B-PRESENT_ILLNESS +síntomas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -consistente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -líquidas I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -productos I-PRESENT_ILLNESS -patológicos I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS +hemorragia I-PRESENT_ILLNESS +digestiva, I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS -abdominal. I-PRESENT_ILLNESS -En B-EXPLORATION +abdominal, I-PRESENT_ILLNESS +diarrea, I-PRESENT_ILLNESS +fatiga I-PRESENT_ILLNESS +o I-PRESENT_ILLNESS +baja I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso. I-PRESENT_ILLNESS +Fue B-DERIVED_FROM/TO +derivada I-DERIVED_FROM/TO +desde I-DERIVED_FROM/TO +Reumatología I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Dermatología I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +Hospital I-DERIVED_FROM/TO +Padre I-DERIVED_FROM/TO +Hurtado I-DERIVED_FROM/TO +debido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +aparición I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +bandas I-DERIVED_FROM/TO +hiperpigmentadas I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +uñas I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +pies I-DERIVED_FROM/TO +desde I-DERIVED_FROM/TO +hacía I-DERIVED_FROM/TO +5 I-DERIVED_FROM/TO +años, I-DERIVED_FROM/TO +seguidas I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +las I-DERIVED_FROM/TO +uñas I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +las I-DERIVED_FROM/TO +manos. I-DERIVED_FROM/TO +Hacía B-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +habían I-PRESENT_ILLNESS +aparecido I-PRESENT_ILLNESS +máculas I-PRESENT_ILLNESS +color I-PRESENT_ILLNESS +café I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +mucosa I-PRESENT_ILLNESS +oral, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +hiperpigmentación I-PRESENT_ILLNESS +periungueal I-PRESENT_ILLNESS +progresiva. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +físico, I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -nos I-EXPLORATION -encontramos I-EXPLORATION -ante I-EXPLORATION -un I-EXPLORATION -paciente I-EXPLORATION -con I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general I-EXPLORATION -y I-EXPLORATION -buenas I-EXPLORATION -constantes I-EXPLORATION -(TA I-EXPLORATION -120/70 I-EXPLORATION -mm I-EXPLORATION -Hg, I-EXPLORATION -Tª I-EXPLORATION -36, I-EXPLORATION -5 I-EXPLORATION -ºC I-EXPLORATION -y I-EXPLORATION -78 I-EXPLORATION -lpm, I-EXPLORATION -peso I-EXPLORATION -74 I-EXPLORATION -kg), I-EXPLORATION -eupneico, I-EXPLORATION -bien I-EXPLORATION -nutrido I-EXPLORATION +mucosa I-EXPLORATION +oral I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +mácula I-EXPLORATION +café I-EXPLORATION +en I-EXPLORATION +labio I-EXPLORATION +inferior I-EXPLORATION +hacia I-EXPLORATION +comisura I-EXPLORATION +labial I-EXPLORATION +izquierda. I-EXPLORATION +En I-EXPLORATION +uñas I-EXPLORATION +de I-EXPLORATION +manos I-EXPLORATION y I-EXPLORATION -coloreado, I-EXPLORATION -no I-EXPLORATION +pies I-EXPLORATION se I-EXPLORATION -palpaban I-EXPLORATION -adenopatías I-EXPLORATION -ni I-EXPLORATION -bocio. I-EXPLORATION +observaban I-EXPLORATION +máculas I-EXPLORATION +café I-EXPLORATION +periungueales I-EXPLORATION +y I-EXPLORATION +melanoniquia. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +histopatología I-EXPLORATION +de I-EXPLORATION +mucosa I-EXPLORATION +oral I-EXPLORATION +mostró I-EXPLORATION +acantosis I-EXPLORATION +leve I-EXPLORATION +e I-EXPLORATION +hipermelanosis. I-EXPLORATION En I-EXPLORATION la I-EXPLORATION -auscultación I-EXPLORATION -cardiopulmonar I-EXPLORATION -no I-EXPLORATION -había I-EXPLORATION -alteraciones. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -abdomen I-EXPLORATION +unión I-EXPLORATION +dermoepidérmica I-EXPLORATION se I-EXPLORATION -palpaba I-EXPLORATION -el I-EXPLORATION -hígado I-EXPLORATION -a I-EXPLORATION +observaron I-EXPLORATION +numerosos I-EXPLORATION +melanófagos, I-EXPLORATION +con I-EXPLORATION +capilares I-EXPLORATION +prominentes I-EXPLORATION +en I-EXPLORATION +dermis. I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +mostraron: I-EXPLORATION +Leucopenia I-EXPLORATION +leve I-EXPLORATION +(3, I-EXPLORATION +700/uL I-EXPLORATION +con I-EXPLORATION 1, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION +370/uL I-EXPLORATION +linfocitos). I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION del I-EXPLORATION -reborde I-EXPLORATION -costal, I-EXPLORATION +hemograma, I-EXPLORATION +velocidad I-EXPLORATION de I-EXPLORATION -consistencia I-EXPLORATION -blanda I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -otros I-EXPLORATION -hallazgos. I-EXPLORATION -Presentaba I-EXPLORATION -un I-EXPLORATION -discreto I-EXPLORATION -edema I-EXPLORATION -pretibial I-EXPLORATION -bilateral I-EXPLORATION -que I-EXPLORATION -dejaba I-EXPLORATION -fovea I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -presión I-EXPLORATION -con I-EXPLORATION -pulsos I-EXPLORATION -periféricos I-EXPLORATION -conservados I-EXPLORATION +eritrosedimentasión, I-EXPLORATION +hormonas I-EXPLORATION +tiroideas, I-EXPLORATION +cortisol I-EXPLORATION +plasmático I-EXPLORATION y I-EXPLORATION -simétricos. I-EXPLORATION -Ante I-EXPLORATION -esta I-EXPLORATION -situación I-EXPLORATION +ACTH I-EXPLORATION se I-EXPLORATION -solicitaron I-EXPLORATION -algunas I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -cuyos I-EXPLORATION -resultados I-EXPLORATION +encontraban I-EXPLORATION +dentro I-EXPLORATION +del I-EXPLORATION +rango I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +anticuerpos I-EXPLORATION +anti-Ro I-EXPLORATION +(43, I-EXPLORATION +7 I-EXPLORATION +U/mL) I-EXPLORATION +y I-EXPLORATION +anti-La I-EXPLORATION +(> I-EXPLORATION +48 I-EXPLORATION +U/mL) I-EXPLORATION fueron I-EXPLORATION +positivos, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +también I-EXPLORATION los I-EXPLORATION -siguientes: I-EXPLORATION -Hemograma: I-EXPLORATION -4.640 I-EXPLORATION -leucocitos/ I-EXPLORATION -mm3 I-EXPLORATION +anticuerpos I-EXPLORATION +antinucleares I-EXPLORATION +(1/2560) I-EXPLORATION con I-EXPLORATION -fórmula I-EXPLORATION -normal, I-EXPLORATION -4, I-EXPLORATION -17 I-EXPLORATION -millones I-EXPLORATION -de I-EXPLORATION -hematíes/ I-EXPLORATION -mm3, I-EXPLORATION -Hb I-EXPLORATION -12, I-EXPLORATION -7g/dl, I-EXPLORATION -Hto I-EXPLORATION -36, I-EXPLORATION -3%, I-EXPLORATION -VCM I-EXPLORATION -87, I-EXPLORATION -1, I-EXPLORATION -HCM I-EXPLORATION -30, I-EXPLORATION -5, I-EXPLORATION -231.000 I-EXPLORATION -plaquetas/mm3. I-EXPLORATION -VSG I-EXPLORATION -23 I-EXPLORATION -mm/h. I-EXPLORATION -Bioquímica: I-EXPLORATION -glucosa I-EXPLORATION -83 I-EXPLORATION -mg/dl, I-EXPLORATION -creatinina I-EXPLORATION -0, I-EXPLORATION -7 I-EXPLORATION -mg/dl, I-EXPLORATION -urea I-EXPLORATION -54 I-EXPLORATION -mg/dl, I-EXPLORATION -ácido I-EXPLORATION -úrico I-EXPLORATION -7, I-EXPLORATION -10 I-EXPLORATION -mg/dl, I-EXPLORATION -GGT I-EXPLORATION -91 I-EXPLORATION -mg/dl, I-EXPLORATION -GPT I-EXPLORATION -143 I-EXPLORATION -mg/dl, I-EXPLORATION -GOT I-EXPLORATION -95 I-EXPLORATION -mg/dl, I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -59 I-EXPLORATION -mg/dl, I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION -0, I-EXPLORATION -50 I-EXPLORATION -mg/dl, I-EXPLORATION -colesterol I-EXPLORATION -140 I-EXPLORATION -mg/dl, I-EXPLORATION -triglicéridos I-EXPLORATION -221 I-EXPLORATION -mg/dl, I-EXPLORATION -HDL I-EXPLORATION -colesterol I-EXPLORATION -24 I-EXPLORATION -mg/dl, I-EXPLORATION -colesterol I-EXPLORATION -VLDL I-EXPLORATION -44 I-EXPLORATION -mg/dl, I-EXPLORATION -colesterol I-EXPLORATION -LDL I-EXPLORATION -72 I-EXPLORATION -mg/dl. I-EXPLORATION -Ferritina I-EXPLORATION -1.172 I-EXPLORATION -mg/ml, I-EXPLORATION -hierro I-EXPLORATION -47 I-EXPLORATION -µg/dl, I-EXPLORATION -Transferrina I-EXPLORATION -148 I-EXPLORATION -mg/dl I-EXPLORATION -e I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -saturación I-EXPLORATION -25%. I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -tórax: I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -significativas. I-EXPLORATION -Serología I-EXPLORATION -de I-EXPLORATION -hepatitis: I-EXPLORATION -Ac I-EXPLORATION -HVC I-EXPLORATION -(-), I-EXPLORATION -Ac I-EXPLORATION -HB I-EXPLORATION -core I-EXPLORATION -(-), I-EXPLORATION -AcHBs I-EXPLORATION -(- I-EXPLORATION -) I-EXPLORATION -y I-EXPLORATION -HAV I-EXPLORATION -Ig I-EXPLORATION -M I-EXPLORATION -(-) I-EXPLORATION -Serología I-EXPLORATION -de I-EXPLORATION -CMV I-EXPLORATION -: I-EXPLORATION -Ig I-EXPLORATION -M I-EXPLORATION -(-) I-EXPLORATION -e I-EXPLORATION -Ig I-EXPLORATION -G I-EXPLORATION -(+). I-EXPLORATION -Marcadores I-EXPLORATION -tumorales: I-EXPLORATION -alfa-fetoproteína, I-EXPLORATION -antígeno I-EXPLORATION -carcinoembrionario I-EXPLORATION +patrón I-EXPLORATION +moteado. I-EXPLORATION +Los I-EXPLORATION +anticuerpos I-EXPLORATION +anti-dsDNA, I-EXPLORATION +anti-Sm I-EXPLORATION y I-EXPLORATION -antígeno I-EXPLORATION -prostático I-EXPLORATION -específico I-EXPLORATION -total I-EXPLORATION +anticardiolipinas I-EXPLORATION +fueron I-EXPLORATION negativos. I-EXPLORATION -Ecografía I-EXPLORATION -abdominal: I-EXPLORATION -alteración I-EXPLORATION -difusa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -ecogenicidad I-EXPLORATION -hepática I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -esteatosis I-EXPLORATION -sin I-EXPLORATION -lesiones I-EXPLORATION -ocupantes I-EXPLORATION -de I-EXPLORATION -espacio I-EXPLORATION -ni I-EXPLORATION -otros I-EXPLORATION -hallazgos. I-EXPLORATION -Colonoscopia I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -polo I-EXPLORATION -cecal I-EXPLORATION -sin I-EXPLORATION -alteraciones. I-EXPLORATION -Hormonas I-EXPLORATION -tiroideas: I-EXPLORATION -TSH I-EXPLORATION -0, I-EXPLORATION -01 I-EXPLORATION -mUI/l I-EXPLORATION -(0,20-5,00), I-EXPLORATION -T4 I-EXPLORATION -libre I-EXPLORATION -9, I-EXPLORATION -86 I-EXPLORATION -ng/dl I-EXPLORATION -(0,85-2,1). I-EXPLORATION - I-EXPLORATION -DISCUSIÓN I-EXPLORATION -Nos I-EXPLORATION -encontramos I-EXPLORATION -ante I-EXPLORATION -un I-EXPLORATION -paciente I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -síndrome I-EXPLORATION -constitucional I-EXPLORATION -y I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -hepática. I-EXPLORATION -Debemos I-EXPLORATION -tener I-EXPLORATION -en I-EXPLORATION -cuenta I-EXPLORATION -que I-EXPLORATION -un I-EXPLORATION -incremento I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -transaminasas I-EXPLORATION -es I-EXPLORATION -un I-EXPLORATION -fenómeno I-EXPLORATION -inespecífico1 I-EXPLORATION -que I-EXPLORATION -puede I-EXPLORATION -ocurrir I-EXPLORATION -en I-EXPLORATION -gran I-EXPLORATION -número I-EXPLORATION -de I-EXPLORATION -situaciones I-EXPLORATION -patológicas I-EXPLORATION +El I-EXPLORATION +factor I-EXPLORATION +reumatoideo, I-EXPLORATION +anticoagulante I-EXPLORATION +lúpico I-EXPLORATION y I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -siempre I-EXPLORATION -traduce I-EXPLORATION -una I-EXPLORATION -enfermedad I-EXPLORATION -hepática. I-EXPLORATION -La I-EXPLORATION -valoración I-EXPLORATION -e I-EXPLORATION -interpretación I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -hipertransaminasemia I-EXPLORATION -han I-EXPLORATION +la I-EXPLORATION +cuantificación I-EXPLORATION de I-EXPLORATION -hacerse I-EXPLORATION -siempre I-EXPLORATION +inmunoglobulinas I-EXPLORATION +resultaron I-EXPLORATION dentro I-EXPLORATION -del I-EXPLORATION -contexto I-EXPLORATION -clínico I-EXPLORATION -del I-EXPLORATION -paciente I-EXPLORATION -y I-EXPLORATION -han I-EXPLORATION -de I-EXPLORATION -tenerse I-EXPLORATION -siempre I-EXPLORATION -presentes I-EXPLORATION -tanto I-EXPLORATION -la I-EXPLORATION -importancia I-EXPLORATION -cuantitativa I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -elevación I-EXPLORATION -como I-EXPLORATION -el I-EXPLORATION -tiempo I-EXPLORATION -durante I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -persiste I-EXPLORATION -la I-EXPLORATION -anomalía. I-EXPLORATION -La I-EXPLORATION +rangos I-EXPLORATION +normales. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +endoscopía I-EXPLORATION +digestiva I-EXPLORATION alta I-EXPLORATION -prevalencia I-EXPLORATION -de I-EXPLORATION -enolismo I-EXPLORATION y I-EXPLORATION -hepatitis I-EXPLORATION -víricas I-EXPLORATION -en I-EXPLORATION -nuestro I-EXPLORATION -entorno I-EXPLORATION -hacen I-EXPLORATION -que I-EXPLORATION -estas I-EXPLORATION -etiologías I-EXPLORATION -deban I-EXPLORATION -descartarse I-EXPLORATION -de I-EXPLORATION -entrada2. I-EXPLORATION -Iniciamos I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -confirmación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -alteraciones I-EXPLORATION -bioquímicas I-EXPLORATION -ya I-EXPLORATION +colonoscopía, I-EXPLORATION que I-EXPLORATION -el I-EXPLORATION -primer I-EXPLORATION -paso I-EXPLORATION -siempre I-EXPLORATION -debe I-EXPLORATION -ser I-EXPLORATION -repetir I-EXPLORATION -la I-EXPLORATION -pruebas I-EXPLORATION +no I-EXPLORATION +muestran I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -laboratorio3 I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -cualquier I-EXPLORATION -error. I-EXPLORATION -A B-PAST_MEDICAL_HISTORY -continuación I-PAST_MEDICAL_HISTORY -realizamos I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -anamnesis I-PAST_MEDICAL_HISTORY -exhaustiva I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -encontramos I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alcohol I-PAST_MEDICAL_HISTORY -moderado I-PAST_MEDICAL_HISTORY -(insuficiente I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -justificar I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -hepatopatía I-PAST_MEDICAL_HISTORY -alcohólica), I-PAST_MEDICAL_HISTORY -uso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -atorvastatina I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -puede I-PAST_MEDICAL_HISTORY -aumentar I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -transaminasas I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -alteración I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY -general, I-PAST_MEDICAL_HISTORY -así B-FAMILY_HISTORY -como I-FAMILY_HISTORY +pólipos, I-EXPLORATION +hiperpigmentación I-EXPLORATION +u I-EXPLORATION +otros I-EXPLORATION +hallazgos I-EXPLORATION +significativos. I-EXPLORATION + I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +continúa I-EVOLUTION +en I-EVOLUTION +seguimiento I-EVOLUTION +clínico, I-EVOLUTION +sin I-EVOLUTION +aparición I-EVOLUTION +de I-EVOLUTION +nuevas I-EVOLUTION +lesiones. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +27 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +queja I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +aspecto I-PRESENT_ILLNESS +inestético I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +labio I-PRESENT_ILLNESS +superior I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +comenzó I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +notar I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +18 I-PRESENT_ILLNESS +años. I-PRESENT_ILLNESS +Refiere I-PRESENT_ILLNESS +gran I-PRESENT_ILLNESS +dificultad I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +relación I-PRESENT_ILLNESS +social, I-PRESENT_ILLNESS +así I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +relación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pareja. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +La B-FAMILY_HISTORY +historia I-FAMILY_HISTORY +clínica I-FAMILY_HISTORY +familiar I-FAMILY_HISTORY +no I-FAMILY_HISTORY +reveló I-FAMILY_HISTORY la I-FAMILY_HISTORY -ausencia I-FAMILY_HISTORY -de I-FAMILY_HISTORY -datos I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY +existencia I-FAMILY_HISTORY de I-FAMILY_HISTORY -interés, I-FAMILY_HISTORY -prácticas B-PAST_MEDICAL_HISTORY +casos I-FAMILY_HISTORY +semejantes. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Presentaba B-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +pronunciado I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +labio I-PRESENT_ILLNESS +superior, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +hacía I-PRESENT_ILLNESS +mucho I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +evidente I-PRESENT_ILLNESS +cuando I-PRESENT_ILLNESS +sonreía, I-PRESENT_ILLNESS +junto I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +presencia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +retracción I-PRESENT_ILLNESS +central. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +El B-TREATMENT +tratamiento I-TREATMENT +quirúrgico I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +bajo I-TREATMENT +bloqueo I-TREATMENT +anestésico I-TREATMENT +de I-TREATMENT +ambos I-TREATMENT +nervios I-TREATMENT +infraorbitarios. I-TREATMENT +Marcamos I-TREATMENT +la I-TREATMENT +zona I-TREATMENT +quirúrgica I-TREATMENT +con I-TREATMENT +azul I-TREATMENT +de I-TREATMENT +metileno I-TREATMENT +en I-TREATMENT +forma I-TREATMENT +de I-TREATMENT +dos I-TREATMENT +elipses I-TREATMENT +tranversas I-TREATMENT +con I-TREATMENT +una I-TREATMENT +"z" I-TREATMENT +central. I-TREATMENT +Resecamos I-TREATMENT +el I-TREATMENT +exceso I-TREATMENT +de I-TREATMENT +tejido I-TREATMENT +mucoso I-TREATMENT +y I-TREATMENT +submucoso I-TREATMENT +labial I-TREATMENT +con I-TREATMENT +excisiones I-TREATMENT +elípticas I-TREATMENT +y I-TREATMENT +la I-TREATMENT +brida I-TREATMENT +central I-TREATMENT +se I-TREATMENT +corrigió I-TREATMENT +con I-TREATMENT +una I-TREATMENT +z-plastia I-TREATMENT +de I-TREATMENT +acuerdo I-TREATMENT +con I-TREATMENT +el I-TREATMENT +marcaje I-TREATMENT +realizado. I-TREATMENT +La I-TREATMENT +cirugía I-TREATMENT +finalizó I-TREATMENT +con I-TREATMENT +el I-TREATMENT +cierre I-TREATMENT +mediante I-TREATMENT +suturas I-TREATMENT +simples I-TREATMENT +con I-TREATMENT +hilo I-TREATMENT +sintético I-TREATMENT +reabsorbible I-TREATMENT +de I-TREATMENT +poliglactin I-TREATMENT +6-0. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +herida I-EVOLUTION +quirúrgica I-EVOLUTION +evolucionó I-EVOLUTION +con I-EVOLUTION +edema I-EVOLUTION +local I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +resolvió I-EVOLUTION +al I-EVOLUTION +final I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +segunda I-EVOLUTION +semana I-EVOLUTION +de I-EVOLUTION +postoperatorio. I-EVOLUTION +Dos I-EVOLUTION +meses I-EVOLUTION +después, I-EVOLUTION +en I-EVOLUTION +revisión I-EVOLUTION +en I-EVOLUTION +consulta I-EVOLUTION +ambulatoria, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +estaba I-EVOLUTION +plenamente I-EVOLUTION +satisfecha I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +resultado I-EVOLUTION +obtenido, I-EVOLUTION +contando I-EVOLUTION +incluso I-EVOLUTION +que I-EVOLUTION +había I-EVOLUTION +vuelto I-EVOLUTION +a I-EVOLUTION +frecuentar I-EVOLUTION +relaciones I-EVOLUTION +sociales I-EVOLUTION +en I-EVOLUTION +compañía I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +pareja. I-EVOLUTION +Tras I-EVOLUTION +18 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +seguimiento, I-EVOLUTION +no I-EVOLUTION +hay I-EVOLUTION +señales I-EVOLUTION +de I-EVOLUTION +recidiva I-EVOLUTION +o I-EVOLUTION +complicaciones I-EVOLUTION +tardías. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +70 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +blanco, B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -riesgo, I-PAST_MEDICAL_HISTORY -transfusiones I-PAST_MEDICAL_HISTORY -sanguíneas, I-PAST_MEDICAL_HISTORY -etc. I-PAST_MEDICAL_HISTORY -A B-EXPLORATION -continuación I-EXPLORATION +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +llevando I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +enalapril I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +mg/día, I-PAST_MEDICAL_HISTORY +así I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +cuadro I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +prostatismo I-PAST_MEDICAL_HISTORY +caracterizado I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +polaquiuria I-PAST_MEDICAL_HISTORY +nocturna I-PAST_MEDICAL_HISTORY +(3-4 I-PAST_MEDICAL_HISTORY +veces I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +noche), I-PAST_MEDICAL_HISTORY +disuria, I-PAST_MEDICAL_HISTORY +chorro I-PAST_MEDICAL_HISTORY +débil, I-PAST_MEDICAL_HISTORY +micción I-PAST_MEDICAL_HISTORY +demorada, I-PAST_MEDICAL_HISTORY +micciones I-PAST_MEDICAL_HISTORY +imperiosas, I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +aproximadamente I-PAST_MEDICAL_HISTORY +1 I-PAST_MEDICAL_HISTORY +año, I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +mejorando I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +impuesto I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +médico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cabecera I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +llegando I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +RAO. I-PAST_MEDICAL_HISTORY +Acude B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urología I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +sonda I-PRESENT_ILLNESS +vesical I-PRESENT_ILLNESS +permanente I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hace I-PRESENT_ILLNESS +aproximadamente I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +debido I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +RAO, I-PRESENT_ILLNESS +fracasando I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +intentos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +retirar I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +misma, I-PRESENT_ILLNESS +al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION se I-EXPLORATION -le I-EXPLORATION -hizo I-EXPLORATION +constata I-EXPLORATION +mucosas: I-EXPLORATION +húmedas I-EXPLORATION +y I-EXPLORATION +normocoloreadas, I-EXPLORATION +tejido I-EXPLORATION +celular I-EXPLORATION +subcutáneo I-EXPLORATION +no I-EXPLORATION +infiltrado, I-EXPLORATION +auscultación I-EXPLORATION +cardiorespiratoria I-EXPLORATION +normal, I-EXPLORATION +abdomen I-EXPLORATION +negativo, I-EXPLORATION +fosas I-EXPLORATION +lumbares I-EXPLORATION +libres, I-EXPLORATION +puntos I-EXPLORATION +pielorreno-ureterales I-EXPLORATION +no I-EXPLORATION +dolorosos, I-EXPLORATION +genitales I-EXPLORATION +externos I-EXPLORATION +y I-EXPLORATION +regiones I-EXPLORATION +inguinales I-EXPLORATION +normales, I-EXPLORATION +al I-EXPLORATION +tacto I-EXPLORATION +rectal I-EXPLORATION +se I-EXPLORATION +palpa I-EXPLORATION una I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -completa I-EXPLORATION -sin I-EXPLORATION -obtener I-EXPLORATION -datos I-EXPLORATION -reseñables I-EXPLORATION -salvo I-EXPLORATION +próstata I-EXPLORATION +aumentada I-EXPLORATION +de I-EXPLORATION +volumen, I-EXPLORATION +superficie I-EXPLORATION +regular, I-EXPLORATION +bien I-EXPLORATION +delimitada, I-EXPLORATION +consistencia I-EXPLORATION +fibroadenomatosa, I-EXPLORATION +grado I-EXPLORATION +III, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION una I-EXPLORATION -discreta I-EXPLORATION -hepatomegalia. I-EXPLORATION -Con I-EXPLORATION -las I-EXPLORATION -serologías I-EXPLORATION -(primero I-EXPLORATION +hiperplasia I-EXPLORATION +benigna I-EXPLORATION de I-EXPLORATION -virus I-EXPLORATION +próstata I-EXPLORATION +(HBP). I-EXPLORATION +Analítica I-EXPLORATION +sanguínea I-EXPLORATION +cifras I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -hepatitis I-EXPLORATION +hemoglobina, I-EXPLORATION +hematocrito, I-EXPLORATION +leucocitos I-EXPLORATION +totales, I-EXPLORATION +urea I-EXPLORATION +creatinina, I-EXPLORATION +PSA I-EXPLORATION y I-EXPLORATION -posteriormente I-EXPLORATION -de I-EXPLORATION -otros I-EXPLORATION -virus I-EXPLORATION -hepatotropos I-EXPLORATION -como I-EXPLORATION -son I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina, I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +Ecográfícamente I-EXPLORATION +llamó I-EXPLORATION +la I-EXPLORATION +atención I-EXPLORATION el I-EXPLORATION -citomegalovirus I-EXPLORATION -y I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +volumen I-EXPLORATION +prostático I-EXPLORATION +con I-EXPLORATION +ecogenicidad I-EXPLORATION +heterogénea. I-EXPLORATION + I-EXPLORATION +Dado B-TREATMENT +el I-TREATMENT +cuadro I-TREATMENT +clínico I-TREATMENT +y I-TREATMENT +los I-TREATMENT +antecedentes, I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +tratamiento I-TREATMENT +quirúrgico, I-TREATMENT +realizándosele I-TREATMENT +una I-TREATMENT +prostatectomía I-TREATMENT +retropúbica. I-TREATMENT +En B-EXPLORATION el I-EXPLORATION -virus I-EXPLORATION +informe I-EXPLORATION +anatomopatológico I-EXPLORATION de I-EXPLORATION -Epstein-Barr) I-EXPLORATION -descartamos I-EXPLORATION la I-EXPLORATION -posibilidad I-EXPLORATION +pieza I-EXPLORATION +quirúrgica I-EXPLORATION +se I-EXPLORATION +describe I-EXPLORATION +un I-EXPLORATION +fragmento I-EXPLORATION de I-EXPLORATION -hepatitis I-EXPLORATION -vírica I-EXPLORATION -y I-EXPLORATION -otros I-EXPLORATION -cuadros I-EXPLORATION -infecciosos I-EXPLORATION -parecían I-EXPLORATION -poco I-EXPLORATION -probables I-EXPLORATION +próstata I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -contexto I-EXPLORATION -del I-EXPLORATION -paciente. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -aprecia I-EXPLORATION -una I-EXPLORATION -alteración I-EXPLORATION -ecogénica I-EXPLORATION -del I-EXPLORATION -hígado I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -esteatosis I-EXPLORATION -hepática I-EXPLORATION -(no I-EXPLORATION -debemos I-EXPLORATION -olvidar I-EXPLORATION +observa I-EXPLORATION +un I-EXPLORATION +infiltrado I-EXPLORATION +linfocitario I-EXPLORATION +monomorfo, I-EXPLORATION que I-EXPLORATION -nuestro I-EXPLORATION -paciente I-EXPLORATION -presenta I-EXPLORATION -una I-EXPLORATION -hipercolesterolemia I-EXPLORATION -y I-EXPLORATION -consume I-EXPLORATION -alcohol) I-EXPLORATION -que, I-EXPLORATION -si I-EXPLORATION +se I-EXPLORATION +corresponde I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +linfoma I-EXPLORATION +linfocítico I-EXPLORATION bien I-EXPLORATION -podría I-EXPLORATION -justificar I-EXPLORATION -las I-EXPLORATION -alteraciones I-EXPLORATION -hepáticas, I-EXPLORATION -no I-EXPLORATION -parece I-EXPLORATION -justificar I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION +diferenciado. I-EXPLORATION +Posteriormente B-TREATMENT +es I-TREATMENT +remitido I-TREATMENT +al I-TREATMENT +servicio I-TREATMENT +de I-TREATMENT +Oncología I-TREATMENT +donde I-TREATMENT +la I-TREATMENT +aplican I-TREATMENT +tratamiento I-TREATMENT +radioterapia. I-TREATMENT +Actualmente B-EVOLUTION +continúa I-EVOLUTION +seguimiento I-EVOLUTION +en I-EVOLUTION +consulta I-EVOLUTION +de I-EVOLUTION +Urología. I-EVOLUTION + I-EVOLUTION + +Historia B-PRESENT_ILLNESS +actual: I-PRESENT_ILLNESS +mujer, I-PRESENT_ILLNESS +84 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +mantenía I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +buenas I-PRESENT_ILLNESS +condiciones I-PRESENT_ILLNESS +generales, I-PRESENT_ILLNESS +autovalente I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +sus I-PRESENT_ILLNESS +actividades I-PRESENT_ILLNESS +habituales. I-PRESENT_ILLNESS +Ingresó I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +31/12/04 I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +través I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencia I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +decaimiento I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +malestar I-PRESENT_ILLNESS +general I-PRESENT_ILLNESS +inespecífico. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +anterior I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +semilíquidas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +cólico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +intensidad I-PRESENT_ILLNESS +leve. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +observada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +hijo I-PRESENT_ILLNESS +médico I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +domicilio I-PRESENT_ILLNESS +quien I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +encontró I-PRESENT_ILLNESS +comprometida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +conciencia, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +falta I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +reactividad I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +órdenes I-PRESENT_ILLNESS +verbales, I-PRESENT_ILLNESS +mirada I-PRESENT_ILLNESS +fija, I-PRESENT_ILLNESS +midriasis I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +hipoventilación I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +evoluciona I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +apnea, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +sometida I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +reanimación I-PRESENT_ILLNESS +básica, I-PRESENT_ILLNESS +recuperando I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +conciencia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +ventilación I-PRESENT_ILLNESS +espontánea. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Antecedentes B-PAST_MEDICAL_HISTORY +mórbidos: I-PAST_MEDICAL_HISTORY +angina I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +pecho I-PAST_MEDICAL_HISTORY +estable I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +varios I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +evolución, I-PAST_MEDICAL_HISTORY +accidente I-PAST_MEDICAL_HISTORY +cerebrovascular I-PAST_MEDICAL_HISTORY +cerebeloso I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +secuelas, I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes. I-PAST_MEDICAL_HISTORY +Linfoma I-PAST_MEDICAL_HISTORY +tratado I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +recidiva I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +(HTA) I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +difícil I-PAST_MEDICAL_HISTORY +manejo I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +mitral I-PAST_MEDICAL_HISTORY +severa, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +disnea I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +medianos I-PAST_MEDICAL_HISTORY +esfuerzos. I-PAST_MEDICAL_HISTORY +Terapia I-PAST_MEDICAL_HISTORY +habitual: I-PAST_MEDICAL_HISTORY +carvedilol I-PAST_MEDICAL_HISTORY +6, I-PAST_MEDICAL_HISTORY +25 I-PAST_MEDICAL_HISTORY +mg/día, I-PAST_MEDICAL_HISTORY +losartan I-PAST_MEDICAL_HISTORY +50 I-PAST_MEDICAL_HISTORY +mg/día, I-PAST_MEDICAL_HISTORY +espironolactona I-PAST_MEDICAL_HISTORY +25 I-PAST_MEDICAL_HISTORY +mg/día, I-PAST_MEDICAL_HISTORY +hidroclorotiazida I-PAST_MEDICAL_HISTORY +12, I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +mg/día, I-PAST_MEDICAL_HISTORY +amlodipino I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +mg/día. I-PAST_MEDICAL_HISTORY +Mantenía I-PAST_MEDICAL_HISTORY +controles I-PAST_MEDICAL_HISTORY +médicos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +laboratorio I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +periódica. I-PAST_MEDICAL_HISTORY +De I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +exámenes I-PAST_MEDICAL_HISTORY +previos, I-PAST_MEDICAL_HISTORY +destacaba I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +creatinina I-PAST_MEDICAL_HISTORY +basal I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +1, I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +mg/dl, I-PAST_MEDICAL_HISTORY +clearence I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +creatinina I-PAST_MEDICAL_HISTORY +35-40 I-PAST_MEDICAL_HISTORY +ml/min I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +electrocardiograma I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +ritmo I-PAST_MEDICAL_HISTORY +sinusal. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Examen B-EXPLORATION +físico: I-EXPLORATION +soporosa, I-EXPLORATION +sin I-EXPLORATION +déficit I-EXPLORATION +neurológico I-EXPLORATION +focal, I-EXPLORATION +presión I-EXPLORATION +arterial: I-EXPLORATION +146/76 I-EXPLORATION +mmHg, I-EXPLORATION +pulso I-EXPLORATION +30 I-EXPLORATION +a I-EXPLORATION +40 I-EXPLORATION +por I-EXPLORATION +min, I-EXPLORATION +Sa02 I-EXPLORATION +>95%. I-EXPLORATION +Pulso I-EXPLORATION +venoso I-EXPLORATION +yugular I-EXPLORATION +normal. I-EXPLORATION +Examen I-EXPLORATION +cardíaco: I-EXPLORATION +ruidos I-EXPLORATION +regulares, I-EXPLORATION +soplo I-EXPLORATION +holosistólico I-EXPLORATION +intensidad I-EXPLORATION +III/VI I-EXPLORATION +en I-EXPLORATION +foco I-EXPLORATION +mitral. I-EXPLORATION +Sin I-EXPLORATION +signos I-EXPLORATION +congestivos I-EXPLORATION +pulmonares, I-EXPLORATION +sin I-EXPLORATION +edema I-EXPLORATION de I-EXPLORATION -deterioro I-EXPLORATION -general I-EXPLORATION -y I-EXPLORATION -diarrea. I-EXPLORATION +extremidades. I-EXPLORATION +Abdomen I-EXPLORATION +depresible I-EXPLORATION +e I-EXPLORATION +indoloro. I-EXPLORATION I-EXPLORATION -Dada I-EXPLORATION -la I-EXPLORATION -edad I-EXPLORATION -del I-EXPLORATION -paciente, I-EXPLORATION -la I-EXPLORATION -alteración I-EXPLORATION -del I-EXPLORATION -hábito I-EXPLORATION -intestinal I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -elevación I-EXPLORATION +Laboratorio I-EXPLORATION +al I-EXPLORATION +ingreso: I-EXPLORATION +electrocardiograma: I-EXPLORATION +ritmo I-EXPLORATION +idioventricular I-EXPLORATION +50/min, I-EXPLORATION +trastorno I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -ferritina, I-EXPLORATION -otra I-EXPLORATION -opción I-EXPLORATION -diagnóstica I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -nos I-EXPLORATION -plantea I-EXPLORATION -es I-EXPLORATION -la I-EXPLORATION -etiología I-EXPLORATION -tumoral, I-EXPLORATION -aunque I-EXPLORATION +conducción I-EXPLORATION +intraventricular I-EXPLORATION +mal I-EXPLORATION +definido I-EXPLORATION con I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -habíamos I-EXPLORATION -descartado I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -lesiones I-EXPLORATION -ocupantes I-EXPLORATION -de I-EXPLORATION -espacio, I-EXPLORATION +QRS I-EXPLORATION +0, I-EXPLORATION +12 I-EXPLORATION +s I-EXPLORATION y I-EXPLORATION -por I-EXPLORATION -ello I-EXPLORATION -decidimos I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -colonoscopia I-EXPLORATION -que I-EXPLORATION -descarta I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION +ondas I-EXPLORATION +T I-EXPLORATION +aumentadas I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -neoformación. I-EXPLORATION -Otra I-EXPLORATION -posibilidad I-EXPLORATION -sería I-EXPLORATION -la I-EXPLORATION -hemocromatosis I-EXPLORATION -pero I-EXPLORATION -no I-EXPLORATION -hay I-EXPLORATION -otros I-EXPLORATION -datos I-EXPLORATION -sugestivos I-EXPLORATION -(articulares, I-EXPLORATION -miocárdicos, I-EXPLORATION -gonadales, I-EXPLORATION -cutáneos, I-EXPLORATION -etc.) I-EXPLORATION -ni I-EXPLORATION -antecedentes I-EXPLORATION -familiares I-EXPLORATION -sugestivos I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -saturación I-EXPLORATION +voltaje. I-EXPLORATION +Electrólitos I-EXPLORATION +plasmáticos: I-EXPLORATION +K: I-EXPLORATION +8, I-EXPLORATION +4 I-EXPLORATION +mEq/l, I-EXPLORATION +Cl: I-EXPLORATION +109 I-EXPLORATION +mEq/l, I-EXPLORATION +Na: I-EXPLORATION +132 I-EXPLORATION +mEq/, I-EXPLORATION +pH I-EXPLORATION +7, I-EXPLORATION +24, I-EXPLORATION +PCO2: I-EXPLORATION +27, I-EXPLORATION +HCO3 I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -transferrina I-EXPLORATION -tampoco I-EXPLORATION -apoya I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -puesto I-EXPLORATION -que I-EXPLORATION -debería I-EXPLORATION -estar I-EXPLORATION -elevada. I-EXPLORATION -Antes I-EXPLORATION +12 I-EXPLORATION +mEq/, I-EXPLORATION +anion I-EXPLORATION +gap I-EXPLORATION +10. I-EXPLORATION +BE: I-EXPLORATION +-14, I-EXPLORATION +4. I-EXPLORATION +Nitrógeno I-EXPLORATION +ureico I-EXPLORATION +61 I-EXPLORATION +mg/dl, I-EXPLORATION +creatinina I-EXPLORATION +2, I-EXPLORATION +63 I-EXPLORATION +mg/dl, I-EXPLORATION +hematocrito I-EXPLORATION +33%, I-EXPLORATION +hemoglobina I-EXPLORATION +0, I-EXPLORATION +7 I-EXPLORATION +mg/dl, I-EXPLORATION +glóbulos I-EXPLORATION +blancos I-EXPLORATION +8.660, I-EXPLORATION +glicemia I-EXPLORATION +137 I-EXPLORATION +mg/dl, I-EXPLORATION +troponinas I-EXPLORATION +T I-EXPLORATION +<0, I-EXPLORATION +01, I-EXPLORATION +orina I-EXPLORATION +completa I-EXPLORATION +normal. I-EXPLORATION +Radiografía I-EXPLORATION de I-EXPLORATION -recurrir I-EXPLORATION -a I-EXPLORATION -otros I-EXPLORATION -estudios I-EXPLORATION -más I-EXPLORATION -complejos I-EXPLORATION +tórax I-EXPLORATION +sin I-EXPLORATION +congestión I-EXPLORATION +pulmonar. I-EXPLORATION +Ecocardiograma: I-EXPLORATION +mixomatosis I-EXPLORATION +mitral I-EXPLORATION y I-EXPLORATION -costosos, I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -repetir I-EXPLORATION -la I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -hormonas I-EXPLORATION -tiroideas, I-EXPLORATION -a I-EXPLORATION -pesar I-EXPLORATION -de I-EXPLORATION -tener I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -rigurosamente I-EXPLORATION -normal I-EXPLORATION -cinco I-EXPLORATION -meses I-EXPLORATION -antes, I-EXPLORATION -porque I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -continuaba I-EXPLORATION -en I-EXPLORATION -tratamiento I-EXPLORATION -con I-EXPLORATION -amiodarona. I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION -fueron I-EXPLORATION -compatibles I-EXPLORATION +tricuspídea, I-EXPLORATION con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -hipertiroidismo I-EXPLORATION -en I-EXPLORATION -paciente I-EXPLORATION -tratado I-EXPLORATION +prolapso I-EXPLORATION +mitral I-EXPLORATION +e I-EXPLORATION +insuficiencia I-EXPLORATION +mitral I-EXPLORATION +y I-EXPLORATION +tricuspídea I-EXPLORATION +severas, I-EXPLORATION +hipertrofia I-EXPLORATION +ventricular I-EXPLORATION +izquierda I-EXPLORATION +concéntrica I-EXPLORATION +leve I-EXPLORATION con I-EXPLORATION -amiodarona. I-EXPLORATION -La B-TREATMENT -actitud I-TREATMENT -que I-TREATMENT -seguimos I-TREATMENT -fue I-TREATMENT -retirar I-TREATMENT -el I-TREATMENT -fármaco I-TREATMENT -e I-TREATMENT -iniciar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -metimazol I-TREATMENT -y I-TREATMENT -betabloqueantes I-TREATMENT +función I-EXPLORATION +sistólica I-EXPLORATION +normal, I-EXPLORATION +dilatación I-EXPLORATION +biauricular I-EXPLORATION +moderada. I-EXPLORATION + I-EXPLORATION +Evolución: B-EVOLUTION +no I-EVOLUTION +presentó I-EVOLUTION +diarrea I-EVOLUTION +durante I-EVOLUTION +la I-EVOLUTION +hospitalización. I-EVOLUTION +No B-TREATMENT +hubo I-TREATMENT +respuesta I-TREATMENT +a I-TREATMENT +las I-TREATMENT +medidas I-TREATMENT +médicas I-TREATMENT +habituales I-TREATMENT para I-TREATMENT controlar I-TREATMENT -su I-TREATMENT -arritmia. I-TREATMENT - I-TREATMENT -La I-TREATMENT -amiodarona I-TREATMENT -es I-TREATMENT -un I-TREATMENT -antiarrítmico I-TREATMENT -de I-TREATMENT -clase I-TREATMENT -III I-TREATMENT -cuya I-TREATMENT -estructura I-TREATMENT -molecular I-TREATMENT -es I-TREATMENT -muy I-TREATMENT -similar I-TREATMENT -a I-TREATMENT la I-TREATMENT -triiodotironina. I-TREATMENT -Contiene I-TREATMENT -dos I-TREATMENT -átomos I-TREATMENT -de I-TREATMENT -yodo, I-TREATMENT +hiperkalemia, I-TREATMENT +por I-TREATMENT lo I-TREATMENT que I-TREATMENT -le I-TREATMENT -confiere I-TREATMENT -un I-TREATMENT -37, I-TREATMENT -2% I-TREATMENT -del I-TREATMENT -peso I-TREATMENT -en I-TREATMENT -yodo. I-TREATMENT -Esto I-TREATMENT -supone I-TREATMENT -que I-TREATMENT -con I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -mantenimiento I-TREATMENT -de I-TREATMENT -200 I-TREATMENT -a I-TREATMENT -600 I-TREATMENT -mg I-TREATMENT se I-TREATMENT -aporten I-TREATMENT -75 I-TREATMENT -a I-TREATMENT -225 I-TREATMENT -mg/día I-TREATMENT -de I-TREATMENT -yodo4. I-TREATMENT -Este I-TREATMENT -exceso I-TREATMENT +efectuó I-TREATMENT +hemodiálisis I-TREATMENT de I-TREATMENT -yodo I-TREATMENT -puede I-TREATMENT -tener I-TREATMENT -consecuencias I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -fisiología I-TREATMENT -tiroidea. I-TREATMENT -Por I-TREATMENT -otra I-TREATMENT -parte I-TREATMENT -debemos I-TREATMENT -tener I-TREATMENT -en I-TREATMENT -cuenta I-TREATMENT -que I-TREATMENT -es I-TREATMENT -una I-TREATMENT -molécula I-TREATMENT -muy I-TREATMENT -lipofílica, I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -le I-TREATMENT -confiere I-TREATMENT -una I-TREATMENT -vida I-TREATMENT -media I-TREATMENT -muy I-TREATMENT -prolongada I-TREATMENT -(22-55 I-TREATMENT -días), I-TREATMENT -pudiendo I-TREATMENT -detectarse I-TREATMENT -en I-TREATMENT -plasma I-TREATMENT -hasta I-TREATMENT -9 I-TREATMENT -meses I-TREATMENT +emergencia I-TREATMENT después I-TREATMENT de I-TREATMENT -retirado I-TREATMENT +su I-TREATMENT +ingreso. I-TREATMENT +Durante I-TREATMENT el I-TREATMENT -fármaco. I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -amiodarona I-TREATMENT -provoca I-TREATMENT -una I-TREATMENT -serie I-TREATMENT -de I-TREATMENT -cambios I-TREATMENT -en I-TREATMENT -las I-TREATMENT -hormonas I-TREATMENT -tiroideas I-TREATMENT -que I-TREATMENT -consisten I-TREATMENT -en I-TREATMENT -un I-TREATMENT -aumento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -T4 I-TREATMENT -total I-TREATMENT -y I-TREATMENT -libre I-TREATMENT -y I-TREATMENT -de I-TREATMENT -rT3, I-TREATMENT -una I-TREATMENT -disminución I-TREATMENT -de I-TREATMENT -la I-TREATMENT -T3 I-TREATMENT -total, I-TREATMENT -junto I-TREATMENT -con I-TREATMENT -un I-TREATMENT -aumento I-TREATMENT -inicial I-TREATMENT -y I-TREATMENT -precoz I-TREATMENT -de I-TREATMENT -TSH I-TREATMENT -que I-TREATMENT -tiende I-TREATMENT -a I-TREATMENT -normalizarse, I-TREATMENT -aunque I-TREATMENT -en I-TREATMENT -ocasiones I-TREATMENT -persiste I-TREATMENT -aumentado I-TREATMENT -tras I-TREATMENT -tratamientos I-TREATMENT -crónicos. I-TREATMENT -Estos I-TREATMENT -cambios I-TREATMENT -se I-TREATMENT -producen I-TREATMENT -en I-TREATMENT -más I-TREATMENT -del I-TREATMENT -50% I-TREATMENT -de I-TREATMENT -los I-TREATMENT -pacientes I-TREATMENT -en I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -amiodarona, I-TREATMENT -sin I-TREATMENT -ninguna I-TREATMENT -relevancia I-TREATMENT -clínica I-TREATMENT -(estado I-TREATMENT -eutiroideo). I-TREATMENT -La I-TREATMENT -incidencia I-TREATMENT -de I-TREATMENT -disfunción I-TREATMENT -tiroidea I-TREATMENT -oscila I-TREATMENT -entre I-TREATMENT -un I-TREATMENT -2 I-TREATMENT -y I-TREATMENT -un I-TREATMENT -24%5. I-TREATMENT -En I-TREATMENT -nuestro I-TREATMENT -medio I-TREATMENT -la I-TREATMENT -incidencia I-TREATMENT -de I-TREATMENT -tirotoxicosis I-TREATMENT +procedimiento I-TREATMENT +recuperó I-TREATMENT +ritmo I-TREATMENT +sinusal I-TREATMENT +102 I-TREATMENT por I-TREATMENT -amiodarona I-TREATMENT -se I-TREATMENT -encuentra I-TREATMENT -en I-TREATMENT -torno I-TREATMENT -al I-TREATMENT -1, I-TREATMENT -5% I-TREATMENT +min, I-TREATMENT +inicialmente I-TREATMENT +hipertensa I-TREATMENT +sistólica I-TREATMENT +hasta I-TREATMENT +208/63 I-TREATMENT +mmHg I-TREATMENT y I-TREATMENT -es I-TREATMENT -más I-TREATMENT -frecuente I-TREATMENT -en I-TREATMENT -zonas I-TREATMENT +luego I-TREATMENT con I-TREATMENT -déficit I-TREATMENT +uso I-TREATMENT de I-TREATMENT -yodo. I-TREATMENT -Se B-EXPLORATION -han I-EXPLORATION -descrito I-EXPLORATION -dos I-EXPLORATION -mecanismos I-EXPLORATION -fisiopatológicos I-EXPLORATION -diferentes6: I-EXPLORATION -Tipo I-EXPLORATION -I: I-EXPLORATION -se I-EXPLORATION -produce I-EXPLORATION -sobre I-EXPLORATION -tiroides I-EXPLORATION -con I-EXPLORATION -patología I-EXPLORATION -subyacente I-EXPLORATION +propanolol I-TREATMENT +mantuvo I-TREATMENT +presiones I-TREATMENT +normales, I-TREATMENT +en B-EXPLORATION +estas I-EXPLORATION +circunstancias I-EXPLORATION +presentó I-EXPLORATION +angina I-EXPLORATION +de I-EXPLORATION +pecho I-EXPLORATION con I-EXPLORATION -una I-EXPLORATION -alteración I-EXPLORATION +infradesnivel I-EXPLORATION +del I-EXPLORATION +segmento I-EXPLORATION +ST I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -mecanismo I-EXPLORATION -autorregulador I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -captación I-EXPLORATION -de I-EXPLORATION -yodo I-EXPLORATION -que I-EXPLORATION -llevaría I-EXPLORATION +ECG I-EXPLORATION +y I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION +marcadores I-EXPLORATION +de I-EXPLORATION +daño I-EXPLORATION +miocárdico: I-EXPLORATION +CPK I-EXPLORATION +fracción I-EXPLORATION +MB I-EXPLORATION +hasta I-EXPLORATION +8, I-EXPLORATION +3 I-EXPLORATION +mg/dl, I-EXPLORATION +TT I-EXPLORATION +hasta I-EXPLORATION +0, I-EXPLORATION +072 I-EXPLORATION +y I-EXPLORATION +mioglobina I-EXPLORATION +hasta I-EXPLORATION +384 I-EXPLORATION +mg/dl, I-EXPLORATION +el I-EXPLORATION +K I-EXPLORATION +había I-EXPLORATION +descendido I-EXPLORATION a I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION +4, I-EXPLORATION +7 I-EXPLORATION +mEq/L. I-EXPLORATION +Fracción I-EXPLORATION +excretada I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -consiguiente I-EXPLORATION -aumento I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -síntesis I-EXPLORATION +Na I-EXPLORATION +13%, I-EXPLORATION +fracción I-EXPLORATION +excretada I-EXPLORATION de I-EXPLORATION -hormona I-EXPLORATION -tiroidea. I-EXPLORATION -Tipo I-EXPLORATION -II: I-EXPLORATION -se I-EXPLORATION -produce I-EXPLORATION -sobre I-EXPLORATION -glándulas I-EXPLORATION -aparentemente I-EXPLORATION +nitrógeno I-EXPLORATION +ureico: I-EXPLORATION +16%. I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +normalizó I-EVOLUTION +antes I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +24 I-EVOLUTION +h I-EVOLUTION +su I-EVOLUTION +potasio I-EVOLUTION +y B-EXPLORATION +diuresis, I-EXPLORATION +mantuvo I-EXPLORATION +cifras I-EXPLORATION +tensionales I-EXPLORATION normales, I-EXPLORATION -sin I-EXPLORATION -bocio I-EXPLORATION -y I-EXPLORATION con I-EXPLORATION -anticuerpos I-EXPLORATION -antiroideos I-EXPLORATION -y I-EXPLORATION -antirreceptor I-EXPLORATION +niveles I-EXPLORATION de I-EXPLORATION -TSH I-EXPLORATION -negativos. I-EXPLORATION +creatinina I-EXPLORATION +de I-EXPLORATION +1, I-EXPLORATION +3 I-EXPLORATION +m/dl, I-EXPLORATION +nitrógeno I-EXPLORATION +ureico I-EXPLORATION +24 I-EXPLORATION +mg/dl I-EXPLORATION +y B-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +quinto I-EVOLUTION +día I-EVOLUTION +en I-EVOLUTION +buenas I-EVOLUTION +condiciones. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +57 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +intermitentes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +diarrea I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +advirtió I-PRESENT_ILLNESS +rectorragia. I-PRESENT_ILLNESS +La B-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +no I-EXPLORATION +demostró I-EXPLORATION +alteraciones I-EXPLORATION +significativas. I-EXPLORATION El I-EXPLORATION -mecanismo I-EXPLORATION -sería I-EXPLORATION +estudio I-EXPLORATION +analítico I-EXPLORATION +no I-EXPLORATION +presentó I-EXPLORATION +alteraciones. I-EXPLORATION +La I-EXPLORATION +colonoscopia I-EXPLORATION +evidenció I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +colon I-EXPLORATION +transverso I-EXPLORATION una I-EXPLORATION -citotoxicidad I-EXPLORATION -inducida I-EXPLORATION +formación I-EXPLORATION +polipoide I-EXPLORATION +de I-EXPLORATION +gran I-EXPLORATION +tamaño I-EXPLORATION +que I-EXPLORATION +ocupaba I-EXPLORATION +casi I-EXPLORATION por I-EXPLORATION +completo I-EXPLORATION la I-EXPLORATION -amiodarona I-EXPLORATION -o I-EXPLORATION -el I-EXPLORATION -yodo. I-EXPLORATION -La I-EXPLORATION -manifestación I-EXPLORATION -clínica I-EXPLORATION -más I-EXPLORATION -frecuente I-EXPLORATION +luz, I-EXPLORATION +y I-EXPLORATION +mostraba I-EXPLORATION +ulceraciones I-EXPLORATION en I-EXPLORATION -estos I-EXPLORATION -casos I-EXPLORATION -suele I-EXPLORATION -ser I-EXPLORATION +la I-EXPLORATION +cabeza. I-EXPLORATION +El I-EXPLORATION +lugar I-EXPLORATION +se I-EXPLORATION +marcó I-EXPLORATION +con I-EXPLORATION un I-EXPLORATION -empeoramiento I-EXPLORATION -de I-EXPLORATION +clip I-EXPLORATION +para I-EXPLORATION +valorar I-EXPLORATION +mejor I-EXPLORATION la I-EXPLORATION -enfermedad I-EXPLORATION -cardiaca I-EXPLORATION -subyacente, I-EXPLORATION -aunque I-EXPLORATION -pueden I-EXPLORATION -existir I-EXPLORATION -los I-EXPLORATION -síntomas I-EXPLORATION -clásicos I-EXPLORATION +localización I-EXPLORATION +del I-EXPLORATION +pólipo I-EXPLORATION +mediante I-EXPLORATION +una I-EXPLORATION +radiografía I-EXPLORATION +simple. I-EXPLORATION +Se I-EXPLORATION +tomaron I-EXPLORATION +biopsias I-EXPLORATION +que I-EXPLORATION +fueron I-EXPLORATION +informadas I-EXPLORATION +como: I-EXPLORATION +mucosa I-EXPLORATION +colónica I-EXPLORATION +con I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -hipertiroidismo. I-EXPLORATION -En I-EXPLORATION -ocasiones I-EXPLORATION -el I-EXPLORATION -curso I-EXPLORATION +ulceración I-EXPLORATION +y I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -enfermedad I-EXPLORATION -es I-EXPLORATION -autolimitado, I-EXPLORATION -resolviéndose I-EXPLORATION -la I-EXPLORATION -situación I-EXPLORATION -tras I-EXPLORATION -la I-EXPLORATION -retirada I-EXPLORATION +tejido I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -amiodarona I-EXPLORATION +granulación I-EXPLORATION y I-EXPLORATION +tejido I-EXPLORATION +conectivo I-EXPLORATION +fibroso, I-EXPLORATION sin I-EXPLORATION -tratamiento I-EXPLORATION -adicional, I-EXPLORATION -aunque I-EXPLORATION -generalmente I-EXPLORATION -tras I-EXPLORATION -largos I-EXPLORATION -periodos I-EXPLORATION +evidencia I-EXPLORATION de I-EXPLORATION -tiempo. I-EXPLORATION -La I-EXPLORATION -resolución I-EXPLORATION -del I-EXPLORATION -cuadro I-EXPLORATION -es I-EXPLORATION -más I-EXPLORATION -precoz I-EXPLORATION -cuando I-EXPLORATION -no I-EXPLORATION -existe I-EXPLORATION -patología I-EXPLORATION -subyacente. I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -incluye I-TREATMENT -tionamidas I-TREATMENT +malignidad. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +TC I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +que I-EXPLORATION +confirmó I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +endoscópicos. I-EXPLORATION +Tres B-TREATMENT +semanas I-TREATMENT +más I-TREATMENT +tarde I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +tuvo I-TREATMENT que I-TREATMENT -pueden I-TREATMENT -asociarse I-TREATMENT -con I-TREATMENT -perclorato I-TREATMENT -potásico I-TREATMENT -para I-TREATMENT -conseguir I-TREATMENT -una I-TREATMENT -rápida I-TREATMENT -descarga I-TREATMENT -del I-TREATMENT -yodo I-TREATMENT -intratiroideo I-TREATMENT -aumentando I-TREATMENT -su I-TREATMENT -eficacia, I-TREATMENT -corticoides, I-TREATMENT -plasmaféresis I-TREATMENT -en I-TREATMENT -casos I-TREATMENT +ser I-TREATMENT +operada I-TREATMENT de I-TREATMENT -crisis I-TREATMENT -tireotóxicas I-TREATMENT -que I-TREATMENT -ponen I-TREATMENT -en I-TREATMENT -peligro I-TREATMENT -la I-TREATMENT -vida I-TREATMENT -del I-TREATMENT -paciente, I-TREATMENT -litio I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -quirúrgico. I-TREATMENT -Bartalena I-TREATMENT -ha I-TREATMENT -propuesto I-TREATMENT +forma I-TREATMENT +urgente I-TREATMENT +al I-TREATMENT +presentar I-TREATMENT un I-TREATMENT -tratamiento I-TREATMENT -específico I-TREATMENT -según I-TREATMENT -el I-TREATMENT -tipo. I-TREATMENT +cuadro I-TREATMENT +suboclusivo. I-TREATMENT En I-TREATMENT -el I-TREATMENT -tipo I-TREATMENT -I, I-TREATMENT -en I-TREATMENT -el I-TREATMENT -que I-TREATMENT -existe I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +se I-TREATMENT +objetivó I-TREATMENT una I-TREATMENT -síntesis I-TREATMENT -de I-TREATMENT -hormona I-TREATMENT -tiroidea I-TREATMENT -aumentada, I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -elección I-TREATMENT -serían I-TREATMENT -los I-TREATMENT -antitiroideos I-TREATMENT -junto I-TREATMENT +invaginación I-TREATMENT +colónica I-TREATMENT +asociada I-TREATMENT a I-TREATMENT -perclorato I-TREATMENT -potásico, I-TREATMENT -mientras I-TREATMENT -que I-TREATMENT -los I-TREATMENT -corticoides I-TREATMENT -tendrían I-TREATMENT un I-TREATMENT -papel I-TREATMENT -limitado. I-TREATMENT -Sin I-TREATMENT -embargo, I-TREATMENT -en I-TREATMENT -el I-TREATMENT -tipo I-TREATMENT -II, I-TREATMENT -en I-TREATMENT -el I-TREATMENT -que I-TREATMENT -el I-TREATMENT -mecanismo I-TREATMENT -fundamental I-TREATMENT -es I-TREATMENT -una I-TREATMENT -destrucción I-TREATMENT -tisular, I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -elección I-TREATMENT -serían I-TREATMENT -los I-TREATMENT -corticoides I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -altas, I-TREATMENT -por I-TREATMENT -su I-TREATMENT -efecto I-TREATMENT -antiinflamatorio I-TREATMENT -y I-TREATMENT -estabilizador I-TREATMENT +lipoma I-TREATMENT de I-TREATMENT -membranas. I-TREATMENT -La I-TREATMENT -cirugía I-TREATMENT -está I-TREATMENT -indicada I-TREATMENT -en I-TREATMENT -casos I-TREATMENT -graves I-TREATMENT +5, I-TREATMENT +5 I-TREATMENT +cm, I-TREATMENT con I-TREATMENT -arritmias I-TREATMENT -potencialmente I-TREATMENT -letales I-TREATMENT -para I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT +origen I-TREATMENT en I-TREATMENT -los I-TREATMENT -que I-TREATMENT -se I-TREATMENT -requiera I-TREATMENT -una I-TREATMENT -solución I-TREATMENT -rápida, I-TREATMENT -cuando I-TREATMENT -no I-TREATMENT -se I-TREATMENT -pueda I-TREATMENT -retirar I-TREATMENT la I-TREATMENT -amiodarona I-TREATMENT -y I-TREATMENT -cuando I-TREATMENT -se I-TREATMENT -haya I-TREATMENT -demostrado I-TREATMENT -una I-TREATMENT -resistencia I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -médico. I-TREATMENT -Debe I-TREATMENT -practicarse I-TREATMENT +submucosa. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT una I-TREATMENT -tiroidectomía I-TREATMENT -total I-TREATMENT -o I-TREATMENT -casi I-TREATMENT -total I-TREATMENT -sobre I-TREATMENT -todo I-TREATMENT -en I-TREATMENT -aquellos I-TREATMENT -pacientes I-TREATMENT -que I-TREATMENT -vayan I-TREATMENT -a I-TREATMENT -seguir I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -amiodarona. I-TREATMENT - I-TREATMENT -CORRESPONDENCIA: I-TREATMENT -Carmen I-TREATMENT -G. I-TREATMENT -Suárez I-TREATMENT -Álvarez I-TREATMENT -Unidad I-TREATMENT -Hospitalización I-TREATMENT -a I-TREATMENT -Domicilio I-TREATMENT -Fundación I-TREATMENT -Jiménez I-TREATMENT -Díaz I-TREATMENT -Avda. I-TREATMENT -Reyes I-TREATMENT -Católicos, I-TREATMENT -2 I-TREATMENT -28040 I-TREATMENT -Madrid I-TREATMENT +hemicolectomía I-TREATMENT +derecha. I-TREATMENT +Se I-TREATMENT +aislaron I-TREATMENT +varios I-TREATMENT +ganglios I-TREATMENT +reactivos. I-TREATMENT I-TREATMENT -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS de I-PRESENT_ILLNESS +46 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +mórbidos. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS una I-PRESENT_ILLNESS -persona I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -49 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -nacido B-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -aldea I-PAST_MEDICAL_HISTORY -asturiana I-PAST_MEDICAL_HISTORY -cuya I-PAST_MEDICAL_HISTORY -familia I-PAST_MEDICAL_HISTORY -vive I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -campo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -ganadería. I-PAST_MEDICAL_HISTORY -Sus B-FAMILY_HISTORY -padres, I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -estudios, I-FAMILY_HISTORY -fallecen I-FAMILY_HISTORY -él I-FAMILY_HISTORY -por I-FAMILY_HISTORY -patología I-FAMILY_HISTORY -tumoral, I-FAMILY_HISTORY -y I-FAMILY_HISTORY -ella I-FAMILY_HISTORY -por I-FAMILY_HISTORY -cardiopatía I-FAMILY_HISTORY -y I-FAMILY_HISTORY -diabetes. I-FAMILY_HISTORY -Es B-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cinco I-PAST_MEDICAL_HISTORY -hermanos. I-PAST_MEDICAL_HISTORY -Escolarizado I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -15 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -comienza I-PAST_MEDICAL_HISTORY -luego I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -trabajar I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -peón I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -posteriormente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -minería. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -reconoce I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -persona I-PAST_MEDICAL_HISTORY -alegre, I-PAST_MEDICAL_HISTORY -amigo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -fiestas, I-PAST_MEDICAL_HISTORY -trabajador, I-PAST_MEDICAL_HISTORY -activo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -colaborador. I-PAST_MEDICAL_HISTORY -Dos B-FAMILY_HISTORY -de I-FAMILY_HISTORY -sus I-FAMILY_HISTORY -hermanas I-FAMILY_HISTORY -emigran I-FAMILY_HISTORY -a I-FAMILY_HISTORY -Europa I-FAMILY_HISTORY -por I-FAMILY_HISTORY -motivos I-FAMILY_HISTORY -laborales. I-FAMILY_HISTORY -Una I-FAMILY_HISTORY -de I-FAMILY_HISTORY -ellas, I-FAMILY_HISTORY -la I-FAMILY_HISTORY -mayor, I-FAMILY_HISTORY -se I-FAMILY_HISTORY -suicida I-FAMILY_HISTORY -a I-FAMILY_HISTORY -los I-FAMILY_HISTORY -48 I-FAMILY_HISTORY -años. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Poco B-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -esquizofrenia I-PAST_MEDICAL_HISTORY -paranoide I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1982, I-PAST_MEDICAL_HISTORY -contrajo I-PAST_MEDICAL_HISTORY -matrimonio I-PAST_MEDICAL_HISTORY -aunque I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -mujer I-PAST_MEDICAL_HISTORY -pidió I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -separación I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -pocos I-PAST_MEDICAL_HISTORY -meses. I-PAST_MEDICAL_HISTORY -Recibe I-PAST_MEDICAL_HISTORY -atención I-PAST_MEDICAL_HISTORY -ambulatoria I-PAST_MEDICAL_HISTORY -haciendo I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cumplimiento I-PAST_MEDICAL_HISTORY -irregular I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -farmacológico I-PAST_MEDICAL_HISTORY -evitando I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -tomas I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -engaño, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1984 I-PAST_MEDICAL_HISTORY -abandona I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -tratamiento. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Cuatro I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -tarde I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -detenido I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -acusado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -doble I-PAST_MEDICAL_HISTORY -intento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -homicidio I-PAST_MEDICAL_HISTORY -contra I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -matrimonio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vecinos, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -siempre I-PAST_MEDICAL_HISTORY -mantuvo I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -excelente I-PAST_MEDICAL_HISTORY -relación. I-PAST_MEDICAL_HISTORY -Según I-PAST_MEDICAL_HISTORY -él, I-PAST_MEDICAL_HISTORY -esas I-PAST_MEDICAL_HISTORY -personas I-PAST_MEDICAL_HISTORY -"ponían I-PAST_MEDICAL_HISTORY -cirios" I-PAST_MEDICAL_HISTORY -(hacían I-PAST_MEDICAL_HISTORY -ofrendas) I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -cosas I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -fueran I-PAST_MEDICAL_HISTORY -mal. I-PAST_MEDICAL_HISTORY -Es I-PAST_MEDICAL_HISTORY -encarcelado, I-PAST_MEDICAL_HISTORY -ingresado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -UHP I-PAST_MEDICAL_HISTORY -(unidad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hospitalización I-PAST_MEDICAL_HISTORY -psiquiátrica) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -posteriormente I-PAST_MEDICAL_HISTORY -trasladado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -hospital I-PAST_MEDICAL_HISTORY -psiquiátrico I-PAST_MEDICAL_HISTORY -penitenciario. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -1996 I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -retornado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -Asturias, I-PAST_MEDICAL_HISTORY -permaneciendo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -diferentes I-PAST_MEDICAL_HISTORY -unidades I-PAST_MEDICAL_HISTORY -cerradas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -Servicios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Salud I-PAST_MEDICAL_HISTORY -Mental I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -mayo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2000 I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -ingresa I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -Casita. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -caracteriza I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -tener I-PAST_MEDICAL_HISTORY -conciencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -psiquiátrica I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -somática, I-PAST_MEDICAL_HISTORY -ya I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -padece I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -insulino-dependiente, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -manifiesta I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -claro I-PAST_MEDICAL_HISTORY -rechazo I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -aunque I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -toma I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -condición I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -permanecer I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -hogar I-PAST_MEDICAL_HISTORY -tutelado. I-PAST_MEDICAL_HISTORY -Posee I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -alto I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -conservación I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -actividades I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -diaria I-PAST_MEDICAL_HISTORY -(AVDs) I-PAST_MEDICAL_HISTORY +dolor I-PRESENT_ILLNESS +torácico I-PRESENT_ILLNESS +punzante, I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +productiva. I-PRESENT_ILLNESS +Además I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +disfagia I-PRESENT_ILLNESS +lógica, I-PRESENT_ILLNESS +baja I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +(siete I-PRESENT_ILLNESS +kg) I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +sudoración I-PRESENT_ILLNESS +nocturna. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Se B-EXPLORATION +tomó I-EXPLORATION +un I-EXPLORATION +hemograma I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +hemoglobina I-EXPLORATION +6, I-EXPLORATION +2 I-EXPLORATION +g/dl, I-EXPLORATION +leucocitos I-EXPLORATION +9.830/mm3, I-EXPLORATION +plaquetas I-EXPLORATION +77.200/mm3, I-EXPLORATION +PCR I-EXPLORATION +216 I-EXPLORATION +mg/l I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +demostró I-EXPLORATION +una I-EXPLORATION +consolidación I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lóbulo I-EXPLORATION +superior I-EXPLORATION +derecho. I-EXPLORATION + I-EXPLORATION +Se B-EVOLUTION +hospitalizó I-EVOLUTION +para I-EVOLUTION +estudio I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +bicitopenia, I-EVOLUTION +disfagia I-EVOLUTION +y I-EVOLUTION +síndrome I-EVOLUTION +consuntivo. I-EVOLUTION +Se I-EVOLUTION +diagnosticó B-TREATMENT +una I-TREATMENT +neumonía I-TREATMENT +bacteriana I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +recibió I-TREATMENT +ceftriaxona I-TREATMENT +por I-TREATMENT +10 I-TREATMENT +días, I-TREATMENT +con B-EVOLUTION +buena I-EVOLUTION +respuesta I-EVOLUTION +clínica. I-EVOLUTION + I-EVOLUTION +Dentro B-EXPLORATION +del I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +disfagia I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +endoscopía I-EXPLORATION +digestiva I-EXPLORATION +alta I-EXPLORATION +(EDA) I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +tres I-EXPLORATION +úlceras I-EXPLORATION +esofágicas I-EXPLORATION +sugerentes I-EXPLORATION +de I-EXPLORATION +etiología I-EXPLORATION +viral I-EXPLORATION +(citomegalovirus) I-EXPLORATION +(CMV). I-EXPLORATION +Se I-EXPLORATION +tomaron I-EXPLORATION +biopsias I-EXPLORATION +y B-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +ganciclovir I-TREATMENT +por I-TREATMENT +10 I-TREATMENT +días, I-TREATMENT +con B-EVOLUTION +escasa I-EVOLUTION +respuesta I-EVOLUTION +clínica. I-EVOLUTION +El B-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +se I-EXPLORATION +informó I-EXPLORATION +como I-EXPLORATION +una I-EXPLORATION +erosión I-EXPLORATION +mucosa I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +citopáticos I-EXPLORATION +de I-EXPLORATION +CMV. I-EXPLORATION +La I-EXPLORATION +RPC I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +para I-EXPLORATION +CMV I-EXPLORATION +también I-EXPLORATION +fue I-EXPLORATION +negativa. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +bicitopenia I-EXPLORATION +fue I-EXPLORATION +confirmada I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +hemograma I-EXPLORATION +con I-EXPLORATION +neutropenia I-EXPLORATION +de I-EXPLORATION +200 I-EXPLORATION +neutrófilos/mm3; I-EXPLORATION +88% I-EXPLORATION +de I-EXPLORATION +blastos I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +mielograma I-EXPLORATION +que I-EXPLORATION +informó I-EXPLORATION +una I-EXPLORATION +leucemia I-EXPLORATION +mieloide I-EXPLORATION +aguda I-EXPLORATION +(LMA). I-EXPLORATION +Una B-TREATMENT +vez I-TREATMENT +finalizados I-TREATMENT +los I-TREATMENT +tratamientos I-TREATMENT +antimicrobianos I-TREATMENT +inició I-TREATMENT +quimioterapia. I-TREATMENT + I-TREATMENT +Tres B-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +quimioterapia I-EVOLUTION +presentó I-EVOLUTION +un I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +neutropenia I-EVOLUTION +febril I-EVOLUTION +(NF) I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +RAN I-EVOLUTION +de I-EVOLUTION +20 I-EVOLUTION +neutrófilos/mm3. I-EVOLUTION +Una B-EXPLORATION +nueva I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION +cambios I-EXPLORATION +con I-EXPLORATION +respecto I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +anterior. I-EXPLORATION +Inició B-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +imipenem I-TREATMENT +y I-TREATMENT +vancomicina I-TREATMENT +i.v. I-TREATMENT +Por B-EXPLORATION +persistencia I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +fiebre I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +neutropenia, I-EXPLORATION +al I-EXPLORATION +cuarto I-EXPLORATION +día I-EXPLORATION +se I-EXPLORATION +repitieron I-EXPLORATION +los I-EXPLORATION +cultivos I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +TAC I-EXPLORATION +pulmonar, I-EXPLORATION +abdominal I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +pelvis. I-EXPLORATION +La I-EXPLORATION +TAC I-EXPLORATION +pulmonar I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +infiltrado I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lóbulo I-EXPLORATION +superior I-EXPLORATION +derecho I-EXPLORATION +con I-EXPLORATION +"signo I-EXPLORATION +del I-EXPLORATION +halo". I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +voriconazol I-TREATMENT +sospechando I-TREATMENT +una I-TREATMENT +aspergilosis I-TREATMENT +pulmonar. I-TREATMENT +Los B-EXPLORATION +hemocultivos I-EXPLORATION +y I-EXPLORATION +los I-EXPLORATION +galactomananos I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +resultaron I-EXPLORATION +negativos. I-EXPLORATION + I-EXPLORATION +Por I-EXPLORATION +persistencia I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +disfagia, I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +EDA I-EXPLORATION +mostró I-EXPLORATION +persistencia I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +úlceras I-EXPLORATION +esofágicas. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +evidenció I-EXPLORATION +hifas I-EXPLORATION +septadas, I-EXPLORATION +ramificadas I-EXPLORATION +en I-EXPLORATION +45°, I-EXPLORATION +sugerentes I-EXPLORATION +de I-EXPLORATION +Aspergillus I-EXPLORATION +spp. I-EXPLORATION + I-EXPLORATION +Luego B-EVOLUTION +de I-EVOLUTION +dos I-EVOLUTION +semanas I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION +antifúngico I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encontraba I-EVOLUTION +sin I-EVOLUTION +fiebre I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +disfagia. I-EVOLUTION +Se B-TREATMENT +completaron I-TREATMENT +18 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +antibacteriano I-TREATMENT +y I-TREATMENT +21 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +voriconazol. I-TREATMENT + I-TREATMENT + +Niño B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +eritematosas, I-PRESENT_ILLNESS +redondeadas, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +bordes I-PRESENT_ILLNESS +definidos, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +pálido I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +rostro, I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +miembros I-PRESENT_ILLNESS +superiores, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +aspecto I-PRESENT_ILLNESS +reticulado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +miembros I-PRESENT_ILLNESS +inferiores I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dorso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Hepatoesplenomegalia. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Madre B-FAMILY_HISTORY +y I-FAMILY_HISTORY +abuela I-FAMILY_HISTORY +materna I-FAMILY_HISTORY +con I-FAMILY_HISTORY +diagnóstico I-FAMILY_HISTORY +de I-FAMILY_HISTORY +Lupus I-FAMILY_HISTORY +Eritematoso I-FAMILY_HISTORY +sistémico I-FAMILY_HISTORY +(LES) I-FAMILY_HISTORY + I-FAMILY_HISTORY +Exámenes B-EXPLORATION +complementarios: I-EXPLORATION +Hb I-EXPLORATION +10g/dl, I-EXPLORATION +Hto I-EXPLORATION +30%, I-EXPLORATION +GPT I-EXPLORATION +78 I-EXPLORATION +UI/L, I-EXPLORATION +C3 I-EXPLORATION +53 I-EXPLORATION +mg/dl I-EXPLORATION +y I-EXPLORATION +C4 I-EXPLORATION +3mg/dl, I-EXPLORATION +FAN+ I-EXPLORATION +1/100, I-EXPLORATION +acs. I-EXPLORATION +anti I-EXPLORATION +Ro, I-EXPLORATION +anti I-EXPLORATION +La, I-EXPLORATION +anti I-EXPLORATION +Sm I-EXPLORATION +y I-EXPLORATION +anti I-EXPLORATION +U1RNP I-EXPLORATION +negativos. I-EXPLORATION + I-EXPLORATION +Estudio I-EXPLORATION +histopatológico: I-EXPLORATION +hiperqueratosis, I-EXPLORATION +atrofia I-EXPLORATION +epidérmica, I-EXPLORATION +vacuolización I-EXPLORATION +de I-EXPLORATION +queratinocitos I-EXPLORATION +basales I-EXPLORATION +e I-EXPLORATION +infiltrado I-EXPLORATION +difuso I-EXPLORATION +mononuclear I-EXPLORATION +en I-EXPLORATION +dermis I-EXPLORATION +superficial. I-EXPLORATION +Inmunofluorescencia I-EXPLORATION +directa I-EXPLORATION +(IFD): I-EXPLORATION +banda I-EXPLORATION +segmentaria I-EXPLORATION +dermoepidérmica I-EXPLORATION +de I-EXPLORATION +disposición I-EXPLORATION +granular I-EXPLORATION +fina I-EXPLORATION +IgG+ I-EXPLORATION +y I-EXPLORATION +C3+. I-EXPLORATION + I-EXPLORATION +Valoración I-EXPLORATION +cardiológica I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Tratamiento: B-TREATMENT +hidrocortisona I-TREATMENT +1% I-TREATMENT +crema. I-TREATMENT + I-TREATMENT +Resolución B-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +lesiones I-EVOLUTION +cutáneas, I-EVOLUTION +negativización I-EVOLUTION +del I-EVOLUTION +FAN I-EVOLUTION +y I-EVOLUTION +normalización I-EVOLUTION +del I-EVOLUTION +hepatograma I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +vida. I-EVOLUTION + I-EVOLUTION + +Niño B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +seis I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +previamente B-PAST_MEDICAL_HISTORY +sano I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -goza I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -capacidad I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -comunicación I-PAST_MEDICAL_HISTORY -verbal. I-PAST_MEDICAL_HISTORY -Ha I-PAST_MEDICAL_HISTORY -perdido I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -contacto I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -entorno I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -consecuencia I-PAST_MEDICAL_HISTORY +correctamente I-PAST_MEDICAL_HISTORY +vacunado, I-PAST_MEDICAL_HISTORY +excepto I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -casi I-PAST_MEDICAL_HISTORY -15 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -lleva I-PAST_MEDICAL_HISTORY -institucionalizado I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -aunque I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -tiene I-PAST_MEDICAL_HISTORY -problemas I-PAST_MEDICAL_HISTORY -económicos, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -soporte I-PAST_MEDICAL_HISTORY -familiar I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -suficiente I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -permanecer I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -casa. I-PAST_MEDICAL_HISTORY +varicela. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -A B-EXPLORATION -su I-EXPLORATION -ingreso, I-EXPLORATION -se I-EXPLORATION -hace I-EXPLORATION +Tuvo B-PRESENT_ILLNESS +escarlatina I-PRESENT_ILLNESS +seis I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +aparición I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +exantema. I-PRESENT_ILLNESS +Al I-PRESENT_ILLNESS +quinto I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +persiste I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +alta I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +edema I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +pie I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +tobillo I-PRESENT_ILLNESS +izquierdos. I-PRESENT_ILLNESS +Es I-PRESENT_ILLNESS +diagnosticado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +celulitis I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tobillo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +tratado I-PRESENT_ILLNESS +ambulatoriamente I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +amoxicilina-clavulánico I-PRESENT_ILLNESS +oral I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +dosis I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +80 I-PRESENT_ILLNESS +mg/kg/día I-PRESENT_ILLNESS +(de I-PRESENT_ILLNESS +amoxicilina). I-PRESENT_ILLNESS +A I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +aumenta I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +tumefacción, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +decide I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ingreso. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION -valoración I-EXPLORATION +exploración I-EXPLORATION +presenta I-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +con I-EXPLORATION +múltiples I-EXPLORATION +lesiones I-EXPLORATION de I-EXPLORATION -enfermería I-EXPLORATION -usando I-EXPLORATION +varicela I-EXPLORATION +de I-EXPLORATION +predominio I-EXPLORATION +pustuloso, I-EXPLORATION +dolor, I-EXPLORATION +tumefacción, I-EXPLORATION +edema I-EXPLORATION +importante I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -protocolo I-EXPLORATION +pie I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +tobillo I-EXPLORATION +izquierdos I-EXPLORATION +y I-EXPLORATION +placa I-EXPLORATION +eritematosa I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +planta I-EXPLORATION +del I-EXPLORATION +pie. I-EXPLORATION +No I-EXPLORATION +realiza I-EXPLORATION +deambulación I-EXPLORATION +autónoma. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -salud I-EXPLORATION -mental4, I-EXPLORATION -procediendo I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -detección I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +está I-EXPLORATION +dentro I-EXPLORATION de I-EXPLORATION -patrones I-EXPLORATION -alterados I-EXPLORATION -según I-EXPLORATION -Gordon5, I-EXPLORATION +la I-EXPLORATION +normalidad. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +control I-EXPLORATION +analítico I-EXPLORATION +muestra I-EXPLORATION +13 I-EXPLORATION +600 I-EXPLORATION +leucocitos/mm3 I-EXPLORATION +(68, I-EXPLORATION +3% I-EXPLORATION +neutrófilos); I-EXPLORATION +hemoglobina, I-EXPLORATION +10, I-EXPLORATION +7 I-EXPLORATION +g/dl; I-EXPLORATION +hematocrito, I-EXPLORATION +31, I-EXPLORATION +1%; I-EXPLORATION +plaquetas, I-EXPLORATION +374 I-EXPLORATION +000/mm3, I-EXPLORATION y I-EXPLORATION -utilizando I-EXPLORATION -diagnósticos I-EXPLORATION -NANDA I-EXPLORATION -2001-20026. I-EXPLORATION -Se I-EXPLORATION -aplican I-EXPLORATION -también I-EXPLORATION -dos I-EXPLORATION -escalas I-EXPLORATION +velocidad I-EXPLORATION +de I-EXPLORATION +sedimentación I-EXPLORATION +globular I-EXPLORATION +(VSG), I-EXPLORATION +116. I-EXPLORATION +Hemocultivo I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +trata I-TREATMENT +con I-TREATMENT +amoxicilina/clavulánico I-TREATMENT +intravenoso I-TREATMENT +(IV), I-TREATMENT +pero I-TREATMENT +al I-TREATMENT +cuarto I-TREATMENT +día I-TREATMENT +presenta I-TREATMENT +un I-TREATMENT +empeoramiento I-TREATMENT +de I-TREATMENT +la I-TREATMENT +tumefacción. I-TREATMENT +Se B-EXPLORATION +le I-EXPLORATION +realiza I-EXPLORATION +una I-EXPLORATION +radiografía I-EXPLORATION +del I-EXPLORATION +miembro I-EXPLORATION +inferior I-EXPLORATION +que I-EXPLORATION +muestra I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +partes I-EXPLORATION +blandas, I-EXPLORATION y I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +que I-EXPLORATION +muestra I-EXPLORATION un I-EXPLORATION -cuestionario I-EXPLORATION -cuyos I-EXPLORATION -resultados I-EXPLORATION -están I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tabla I-EXPLORATION -1 I-EXPLORATION +músculo I-EXPLORATION +gemelo I-EXPLORATION +interno I-EXPLORATION +con I-EXPLORATION +hipoecogenicidad I-EXPLORATION y I-EXPLORATION -posteriormente I-EXPLORATION -se I-EXPLORATION -evalúa I-EXPLORATION -por I-EXPLORATION -objetivos. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -cuanto I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -patrones I-EXPLORATION +tumefacción I-EXPLORATION +con I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -salud, I-EXPLORATION +patrón I-EXPLORATION +fibroadiposo, I-EXPLORATION +que I-EXPLORATION +refleja I-EXPLORATION +edema I-EXPLORATION +e I-EXPLORATION +infiltración I-EXPLORATION +de I-EXPLORATION +tejido I-EXPLORATION +graso I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +piomiositis. I-EXPLORATION +No I-EXPLORATION hay I-EXPLORATION -cuatro I-EXPLORATION -claramente I-EXPLORATION -disfuncionales. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -tabla I-EXPLORATION -2 I-EXPLORATION -se I-EXPLORATION -comentan I-EXPLORATION -dichos I-EXPLORATION -patrones I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -muestran I-EXPLORATION -los I-EXPLORATION -diagnósticos I-EXPLORATION -seleccionados I-EXPLORATION -para I-EXPLORATION -cada I-EXPLORATION -uno I-EXPLORATION +constancia I-EXPLORATION de I-EXPLORATION -ellos. I-EXPLORATION -Una B-TREATMENT -vez I-TREATMENT -examinados I-TREATMENT -los I-TREATMENT -patrones I-TREATMENT +absceso I-EXPLORATION +susceptible I-EXPLORATION +de I-EXPLORATION +drenaje. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +instaura I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +con I-TREATMENT +cefotaxima I-TREATMENT y I-TREATMENT -seleccionados I-TREATMENT -los I-TREATMENT -diagnósticos, I-TREATMENT +cloxacilina, I-TREATMENT +pero I-TREATMENT +al I-TREATMENT +ser I-TREATMENT +la I-TREATMENT +evolución I-TREATMENT +clínica, I-TREATMENT +analítica I-TREATMENT +y I-TREATMENT +ecográfica I-TREATMENT +desfavorable, I-TREATMENT se I-TREATMENT -establecen I-TREATMENT -diferentes I-TREATMENT -grupos I-TREATMENT +decide I-TREATMENT +un I-TREATMENT +cambio I-TREATMENT de I-TREATMENT -objetivos I-TREATMENT -a I-TREATMENT -partir I-TREATMENT +pauta I-TREATMENT +por I-TREATMENT +clindamicina I-TREATMENT +y I-TREATMENT +vancomicina I-TREATMENT +IV I-TREATMENT +con I-TREATMENT +posterior I-TREATMENT +disminución I-TREATMENT de I-TREATMENT -los I-TREATMENT -cuales I-TREATMENT -se I-TREATMENT -diseñaran I-TREATMENT -actividades I-TREATMENT -para I-TREATMENT la I-TREATMENT -consecución I-TREATMENT +VSG I-TREATMENT +y I-TREATMENT +ecografía I-TREATMENT +sin I-TREATMENT +alteraciones I-TREATMENT +significativas. I-TREATMENT +Al B-EVOLUTION +alta I-EVOLUTION +realizaba I-EVOLUTION +deambulación I-EVOLUTION +autónoma I-EVOLUTION +y I-EVOLUTION +no I-EVOLUTION +presentaba I-EVOLUTION +secuelas I-EVOLUTION +funcionales. I-EVOLUTION + I-EVOLUTION + +Hombre B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +23 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +mórbidos I-PAST_MEDICAL_HISTORY +conocidos, I-PAST_MEDICAL_HISTORY +consulta B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +Unidad I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Emergencia I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +15 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +astenia I-PRESENT_ILLNESS +progresiva, I-PRESENT_ILLNESS +palidez, I-PRESENT_ILLNESS +mialgias, I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +escalofríos. I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +destacan I-EXPLORATION +en I-EXPLORATION +paladar I-EXPLORATION +numerosas I-EXPLORATION +lesiones I-EXPLORATION +herpetiformes, I-EXPLORATION +hemograma I-EXPLORATION +evidencia I-EXPLORATION +pancitopenia, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +decide I-EXPLORATION +hospitalizar. I-EXPLORATION +Se I-EXPLORATION +efectúa I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +mielograma, I-EXPLORATION +inmunofenotipo I-EXPLORATION +y I-EXPLORATION +cariograma, I-EXPLORATION +diagnosticándose I-EXPLORATION +LMA I-EXPLORATION +indiferenciada I-EXPLORATION +con I-EXPLORATION +expresión I-EXPLORATION +aberrante I-EXPLORATION +CD7. I-EXPLORATION +Se B-TREATMENT +inicia I-TREATMENT +quimioterapia I-TREATMENT de I-TREATMENT -los I-TREATMENT -mismos. I-TREATMENT - I-TREATMENT -Manejo I-TREATMENT -inefectivo I-TREATMENT -del I-TREATMENT -régimen I-TREATMENT -terapéutico. I-TREATMENT -Respecto I-TREATMENT +inducción I-TREATMENT +con I-TREATMENT +esquema I-TREATMENT +3+7 I-TREATMENT +(daunorrubicina I-TREATMENT ++ I-TREATMENT +citarabina) I-TREATMENT +presentando I-TREATMENT al I-TREATMENT +cuarto I-TREATMENT +día I-TREATMENT +del I-TREATMENT primer I-TREATMENT -diagnóstico, I-TREATMENT -se I-TREATMENT -establecen I-TREATMENT -tres I-TREATMENT -grupos I-TREATMENT -de I-TREATMENT -objetivos: I-TREATMENT -objetivos I-TREATMENT -iniciales; I-TREATMENT -objetivos I-TREATMENT -a I-TREATMENT -los I-TREATMENT -seis I-TREATMENT -meses I-TREATMENT +ciclo I-TREATMENT +diarrea I-TREATMENT y I-TREATMENT -a I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -años. I-TREATMENT -Los I-TREATMENT -objetivos I-TREATMENT -iniciales I-TREATMENT -son I-TREATMENT -aquellos I-TREATMENT +fiebre, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT que I-TREATMENT se I-TREATMENT -deben I-TREATMENT -cumplir I-TREATMENT -desde I-TREATMENT -un I-TREATMENT -primer I-TREATMENT -momento. I-TREATMENT -Tienen I-TREATMENT -que I-TREATMENT -ver I-TREATMENT +toman I-TREATMENT +hemocultivos I-TREATMENT +y I-TREATMENT +se I-TREATMENT +inicia I-TREATMENT +terapia I-TREATMENT +antibiótica I-TREATMENT +empírica I-TREATMENT +de I-TREATMENT +amplio I-TREATMENT +espectro. I-TREATMENT +Los B-EXPLORATION +hemocultivos I-EXPLORATION +resultaron I-EXPLORATION +positivos I-EXPLORATION +para I-EXPLORATION +Klebsiella I-EXPLORATION +pneumoniae I-EXPLORATION +resistente I-EXPLORATION +a I-EXPLORATION +cefalosporinas I-EXPLORATION +de I-EXPLORATION +tercera I-EXPLORATION +generación, I-EXPLORATION +manteniéndose I-EXPLORATION +el I-EXPLORATION +tratamiento I-EXPLORATION +antibiótico I-EXPLORATION +inicial. I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +persiste I-EVOLUTION +febril I-EVOLUTION +sin I-EVOLUTION +clínica I-EVOLUTION +que I-EVOLUTION +sugiera I-EVOLUTION +el I-EVOLUTION +foco I-EVOLUTION +infeccioso; I-EVOLUTION +cursa I-EVOLUTION +con I-EVOLUTION +neutropenia I-EVOLUTION +grave I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +prolonga I-EVOLUTION +por I-EVOLUTION +20 I-EVOLUTION +días, I-EVOLUTION +con I-EVOLUTION +parámetros I-EVOLUTION +inflamatorios I-EVOLUTION +en I-EVOLUTION +ascenso I-EVOLUTION +y I-EVOLUTION +alteración I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +pruebas I-EVOLUTION +hepáticas I-EVOLUTION +con I-EVOLUTION +patrón I-EVOLUTION +colestásico. I-EVOLUTION +Se B-TREATMENT +decide I-TREATMENT +agregar I-TREATMENT +tratamiento I-TREATMENT +antifúngico I-TREATMENT +empírico I-TREATMENT con I-TREATMENT -cuestiones I-TREATMENT -básicas I-TREATMENT -del I-TREATMENT -funcionamiento I-TREATMENT -del I-TREATMENT -dispositivo I-TREATMENT -que I-TREATMENT -el I-TREATMENT -sujeto I-TREATMENT -debe I-TREATMENT -asumir I-TREATMENT -para I-TREATMENT -poder I-TREATMENT -permanecer I-TREATMENT -en I-TREATMENT -el I-TREATMENT -hogar I-TREATMENT -tutelado. I-TREATMENT -Son I-TREATMENT -los I-TREATMENT -siguientes: I-TREATMENT -1) I-TREATMENT -que I-TREATMENT -tome I-TREATMENT -su I-TREATMENT -medicación I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -primer I-TREATMENT -día; I-TREATMENT -2) I-TREATMENT -que I-TREATMENT -acuda I-TREATMENT -acompañado I-TREATMENT -a I-TREATMENT -las I-TREATMENT -citas I-TREATMENT -en I-TREATMENT -el I-TREATMENT -centro I-TREATMENT +anidulafungina I-TREATMENT +y B-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +tomografia I-EXPLORATION +computada I-EXPLORATION +(TC) I-EXPLORATION +de I-EXPLORATION +tórax, I-EXPLORATION +abdomen I-EXPLORATION +y I-EXPLORATION +pelvis I-EXPLORATION +en I-EXPLORATION +que I-EXPLORATION +destaca I-EXPLORATION +hepatoesplenomegalia I-EXPLORATION +con I-EXPLORATION +lesiones I-EXPLORATION +focales I-EXPLORATION +esplénicas I-EXPLORATION +sugerentes I-EXPLORATION +de I-EXPLORATION +compromiso I-EXPLORATION +inflamatorio-infeccioso. I-EXPLORATION +Además I-EXPLORATION +presenta I-EXPLORATION +coriorretinitis I-EXPLORATION +izquierda I-EXPLORATION +con I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo I-EXPLORATION +sugerente I-EXPLORATION +de I-EXPLORATION +micosis. I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +hemocultivo I-EXPLORATION +de I-EXPLORATION +hongos I-EXPLORATION +(medio I-EXPLORATION +Sabourand) I-EXPLORATION +que I-EXPLORATION +resulta I-EXPLORATION +negativos, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +MALDI I-EXPLORATION +TOF I-EXPLORATION +MS I-EXPLORATION +(Matrix-Assisted I-EXPLORATION +Laser I-EXPLORATION +Desorption/Ionization I-EXPLORATION +time I-EXPLORATION +of I-EXPLORATION +flight I-EXPLORATION +mass I-EXPLORATION +espectrometry) I-EXPLORATION +el I-EXPLORATION +cual I-EXPLORATION +resulta I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +S. I-EXPLORATION +capitata, I-EXPLORATION +agregándose I-EXPLORATION +tratamiento I-EXPLORATION +con I-EXPLORATION +voriconazol I-EXPLORATION +(200 I-EXPLORATION +mg/12 I-EXPLORATION +h). I-EXPLORATION +Por B-TREATMENT +falta I-TREATMENT de I-TREATMENT -atención I-TREATMENT -primaria I-TREATMENT -(CAP); I-TREATMENT -3) I-TREATMENT -someterse I-TREATMENT +respuesta I-TREATMENT a I-TREATMENT -los I-TREATMENT -controles I-TREATMENT -analíticos I-TREATMENT -pertinentes, I-TREATMENT -y I-TREATMENT -4) I-TREATMENT -aceptar I-TREATMENT la I-TREATMENT -dieta I-TREATMENT -antiglucemiante. I-TREATMENT - I-TREATMENT -El I-TREATMENT -segundo I-TREATMENT -grupo I-TREATMENT -de I-TREATMENT -objetivos, I-TREATMENT -es I-TREATMENT -decir, I-TREATMENT -los I-TREATMENT -que I-TREATMENT +terapia I-TREATMENT se I-TREATMENT -deben I-TREATMENT -alcanzar I-TREATMENT -a I-TREATMENT -los I-TREATMENT -seis I-TREATMENT -meses, I-TREATMENT -son: I-TREATMENT -1) I-TREATMENT +reemplaza I-TREATMENT +la I-TREATMENT +anidulafungina I-TREATMENT +por I-TREATMENT +anfotericina I-TREATMENT +B I-TREATMENT +liposomal I-TREATMENT +(50 I-TREATMENT +mg/día), I-TREATMENT +se I-TREATMENT +practica I-TREATMENT +ecocardiografía I-TREATMENT que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -tenga I-TREATMENT -una I-TREATMENT -noción I-TREATMENT -básica I-TREATMENT +descarta I-TREATMENT +endocarditis. I-TREATMENT +Nuevo B-EXPLORATION +TC I-EXPLORATION +muestra I-EXPLORATION +múltiples I-EXPLORATION +áreas I-EXPLORATION +en I-EXPLORATION +vidrio I-EXPLORATION +esmerilado I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +lóbulos I-EXPLORATION +pulmonares I-EXPLORATION +superiores I-EXPLORATION +y I-EXPLORATION +lóbulo I-EXPLORATION +medio, I-EXPLORATION +atelectasias I-EXPLORATION +bibasales I-EXPLORATION +y I-EXPLORATION +derrame I-EXPLORATION +pleural I-EXPLORATION +moderado I-EXPLORATION +izquierdo, I-EXPLORATION +adenopatías I-EXPLORATION +mediastínicas I-EXPLORATION +e I-EXPLORATION +hiliares I-EXPLORATION +bilaterales, I-EXPLORATION +hepatoesplenomagalia I-EXPLORATION +y I-EXPLORATION +múltiples I-EXPLORATION +lesiones I-EXPLORATION +focales I-EXPLORATION +hipovasculares, I-EXPLORATION +en I-EXPLORATION +hígado, I-EXPLORATION +bazo I-EXPLORATION +y I-EXPLORATION +riñón. I-EXPLORATION +Los I-EXPLORATION +cultivos I-EXPLORATION +realizados I-EXPLORATION +de I-EXPLORATION +catéteres I-EXPLORATION +resultados I-EXPLORATION +todos I-EXPLORATION +negativos. I-EXPLORATION +Se B-TREATMENT +realiza I-TREATMENT +toracocentesis I-TREATMENT +evacuadora I-TREATMENT +con I-TREATMENT +estudio I-TREATMENT de I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -son I-TREATMENT -los I-TREATMENT -fármacos, I-TREATMENT -pudiendo I-TREATMENT -enumerar I-TREATMENT -tres I-TREATMENT -beneficios I-TREATMENT -y I-TREATMENT -tres I-TREATMENT -efectos I-TREATMENT -secundarios; I-TREATMENT -2) I-TREATMENT +líquido I-TREATMENT +pleural I-TREATMENT que I-TREATMENT -pueda I-TREATMENT -autoadministrase I-TREATMENT +muestra I-TREATMENT +exudado I-TREATMENT +de I-TREATMENT +predominio I-TREATMENT +mononuclear. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +evoluciona I-EVOLUTION +con I-EVOLUTION +dolor I-EVOLUTION +invalidante I-EVOLUTION +en I-EVOLUTION +hipocondrio I-EVOLUTION +y I-EVOLUTION +flanco I-EVOLUTION +izquierdos, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +realiza I-EVOLUTION +control I-EVOLUTION +radiológico I-EVOLUTION +que I-EVOLUTION +evidencia I-EVOLUTION +regresión I-EVOLUTION +de I-EVOLUTION +lesiones I-EVOLUTION +hepáticas I-EVOLUTION +y I-EVOLUTION +renales, I-EVOLUTION +pero I-EVOLUTION +aumento I-EVOLUTION +del I-EVOLUTION +derrame I-EVOLUTION +pleural I-EVOLUTION +izquierdo I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +lesiones I-EVOLUTION +esplénicas I-EVOLUTION +que I-EVOLUTION +ahora I-EVOLUTION +son I-EVOLUTION +de I-EVOLUTION +aspecto I-EVOLUTION +hemorrágico. I-EVOLUTION +Analizado B-TREATMENT el I-TREATMENT -tratamiento I-TREATMENT -bajo I-TREATMENT -supervisión; I-TREATMENT -3) I-TREATMENT -será I-TREATMENT -capaz I-TREATMENT +caso I-TREATMENT +en I-TREATMENT +forma I-TREATMENT +multidisciplinaria I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +esplenectomía I-TREATMENT de I-TREATMENT -acudir I-TREATMENT -a I-TREATMENT -la I-TREATMENT -farmacia I-TREATMENT -sin I-TREATMENT -acompañamiento; I-TREATMENT -4) I-TREATMENT -podrá I-TREATMENT -reconocer I-TREATMENT +desfocamiento I-TREATMENT y I-TREATMENT -nombrar I-TREATMENT -al I-TREATMENT -menos I-TREATMENT -doce I-TREATMENT -alimentos I-TREATMENT -habituales I-TREATMENT -contraindicados I-TREATMENT +VTC, I-TREATMENT +para I-TREATMENT +evacuación I-TREATMENT y I-TREATMENT -5) I-TREATMENT -conocerá I-TREATMENT -los I-TREATMENT -riesgos I-TREATMENT -de I-TREATMENT -ser I-TREATMENT -gran I-TREATMENT -fumador I-TREATMENT -describiendo I-TREATMENT -tres I-TREATMENT -enfermedades I-TREATMENT -graves I-TREATMENT +aseo I-TREATMENT +pleural I-TREATMENT +y, I-TREATMENT +definir I-TREATMENT +diagnóstico I-TREATMENT +diferencial I-TREATMENT +(neoplásico, I-TREATMENT +tuberculoso I-TREATMENT y I-TREATMENT -tres I-TREATMENT -beneficios I-TREATMENT +micosis I-TREATMENT +invasora). I-TREATMENT +Se I-TREATMENT +efectúa I-TREATMENT +VTC I-TREATMENT +con I-TREATMENT +evacuación I-TREATMENT de I-TREATMENT -no I-TREATMENT -fumar. I-TREATMENT - I-TREATMENT -Los I-TREATMENT -objetivos I-TREATMENT -a I-TREATMENT -conseguir I-TREATMENT -a I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -años, I-TREATMENT -son I-TREATMENT -el I-TREATMENT -tercer I-TREATMENT -grupo I-TREATMENT +2.000 I-TREATMENT +ml I-TREATMENT de I-TREATMENT -los I-TREATMENT -que I-TREATMENT -corresponden I-TREATMENT -al I-TREATMENT -primer I-TREATMENT -diagnóstico I-TREATMENT +derrame I-TREATMENT +pleural, I-TREATMENT +aseo I-TREATMENT +con I-TREATMENT +solución I-TREATMENT +salina, I-TREATMENT +biopsia I-TREATMENT +pleural I-TREATMENT y I-TREATMENT -contemplan: I-TREATMENT -1) I-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT +drenaje, I-TREATMENT +observándose B-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +múltiples I-EXPLORATION +lesiones I-EXPLORATION +de I-EXPLORATION +aproximadamente I-EXPLORATION +4 I-EXPLORATION +mm I-EXPLORATION +distribuidas I-EXPLORATION +difusamente I-EXPLORATION +en I-EXPLORATION +pleura I-EXPLORATION +parietal, I-EXPLORATION +visceral I-EXPLORATION +y I-EXPLORATION +diafragmática. I-EXPLORATION +Se I-EXPLORATION +efectúa I-EXPLORATION +laparotomía I-EXPLORATION +observándose I-EXPLORATION +esplenomegalia I-EXPLORATION +hemorrágica I-EXPLORATION +más I-EXPLORATION +abscesos I-EXPLORATION +esplénicos, I-EXPLORATION +se B-TREATMENT +practica I-TREATMENT +esplenectomía I-TREATMENT +para I-TREATMENT +limpieza I-TREATMENT +del I-TREATMENT +foco. I-TREATMENT +En B-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +muestras I-EXPLORATION +tomadas I-EXPLORATION +durante I-EXPLORATION +la I-EXPLORATION +VTC I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +laparotomía I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +hifas I-EXPLORATION +septadas. I-EXPLORATION +Los I-EXPLORATION +cultivos I-EXPLORATION +intraoperatorios I-EXPLORATION +resultaron I-EXPLORATION +positivos I-EXPLORATION +para I-EXPLORATION +S. I-EXPLORATION +capitata I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +72 I-EXPLORATION +h. I-EXPLORATION +Posterior B-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +cirugía I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +evoluciona I-EVOLUTION +favorablemente I-EVOLUTION +y B-TREATMENT se I-TREATMENT -autoadministre I-TREATMENT -su I-TREATMENT -medicación I-TREATMENT -preparándola I-TREATMENT -él I-TREATMENT -mismo I-TREATMENT -y I-TREATMENT +completan I-TREATMENT +58 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +anfotericina I-TREATMENT +B I-TREATMENT +liposomal I-TREATMENT +(alcanzando I-TREATMENT +una I-TREATMENT +dosis I-TREATMENT +acumulada I-TREATMENT +de I-TREATMENT +2, I-TREATMENT +9 I-TREATMENT +g I-TREATMENT sin I-TREATMENT -triturar, I-TREATMENT -incluso I-TREATMENT -estando I-TREATMENT -fuera; I-TREATMENT -2) I-TREATMENT -irá I-TREATMENT -solo I-TREATMENT -al I-TREATMENT -CAP I-TREATMENT +manifestar I-TREATMENT +efectos I-TREATMENT +adversos) I-TREATMENT y I-TREATMENT -usará I-TREATMENT -su I-TREATMENT -tarjeta I-TREATMENT +80 I-TREATMENT +días I-TREATMENT +con I-TREATMENT +voriconazol I-TREATMENT +(dosis I-TREATMENT +acumulada I-TREATMENT de I-TREATMENT -crónicos I-TREATMENT -para I-TREATMENT -obtener I-TREATMENT -las I-TREATMENT -recetas; I-TREATMENT -3) I-TREATMENT -sellará I-TREATMENT -sus I-TREATMENT -recetas I-TREATMENT -en I-TREATMENT -la I-TREATMENT -inspección I-TREATMENT -médica I-TREATMENT -sin I-TREATMENT -acompañamiento; I-TREATMENT -4) I-TREATMENT -si I-TREATMENT -come I-TREATMENT -fuera I-TREATMENT -podrá I-TREATMENT -elegir I-TREATMENT -platos I-TREATMENT -adecuados I-TREATMENT +32 I-TREATMENT +g I-TREATMENT sin I-TREATMENT -apoyo; I-TREATMENT -5) I-TREATMENT -habrá I-TREATMENT -reducido I-TREATMENT -la I-TREATMENT -dosis/día I-TREATMENT +efectos I-TREATMENT +adversos). I-TREATMENT +Se B-EVOLUTION +da I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +en I-EVOLUTION +buenas I-EVOLUTION +condiciones, I-EVOLUTION +finalizando I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +oncológico I-EVOLUTION +manteniéndose I-EVOLUTION +durante I-EVOLUTION +los I-EVOLUTION +ciclos I-EVOLUTION +de I-EVOLUTION +quimioterapia I-EVOLUTION +con I-EVOLUTION +profilaxis I-EVOLUTION +con I-EVOLUTION +voriconazol. I-EVOLUTION +A I-EVOLUTION +más I-EVOLUTION +de I-EVOLUTION +2 I-EVOLUTION +años I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +presenta I-EVOLUTION +evidencia I-EVOLUTION +de I-EVOLUTION +enfermedad. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +38 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +NF1 I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +manifestó I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +infancia I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +abundantes I-PAST_MEDICAL_HISTORY +efélides I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +todo I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +cuerpo, I-PAST_MEDICAL_HISTORY +región I-PAST_MEDICAL_HISTORY +axilar I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +inguinal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +neurofibro-mas I-PAST_MEDICAL_HISTORY +discretos. I-PAST_MEDICAL_HISTORY +La B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +Unidad I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Emergencia I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +Hospital I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +Serena I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +clínico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +7 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +intenso I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal, I-PRESENT_ILLNESS +inicialmente I-PRESENT_ILLNESS +epigástrico I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +posteriormente I-PRESENT_ILLNESS +difuso. I-PRESENT_ILLNESS +Ingresó B-EXPLORATION +en I-EXPLORATION +shock I-EXPLORATION +séptico I-EXPLORATION +y I-EXPLORATION +mala I-EXPLORATION +condición I-EXPLORATION +general. I-EXPLORATION +Después B-TREATMENT de I-TREATMENT -cigarrillos I-TREATMENT -a I-TREATMENT -10 I-TREATMENT -como I-TREATMENT -máximo. I-TREATMENT - I-TREATMENT -Después I-TREATMENT +estabilización I-TREATMENT +hemodi-námica I-TREATMENT se I-TREATMENT -da I-TREATMENT -paso I-TREATMENT -a I-TREATMENT -la I-TREATMENT -programación I-TREATMENT -de I-TREATMENT -actividades I-TREATMENT -dirigidas I-TREATMENT -al I-TREATMENT -logro I-TREATMENT -de I-TREATMENT -cada I-TREATMENT -uno I-TREATMENT +decidió I-TREATMENT +su I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +con I-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT de I-TREATMENT -los I-TREATMENT -tres I-TREATMENT -grupos I-TREATMENT +abdomen I-TREATMENT +agudo I-TREATMENT de I-TREATMENT -objetivos. I-TREATMENT -Para I-TREATMENT -los I-TREATMENT -objetivos I-TREATMENT -iniciales, I-TREATMENT +origen I-TREATMENT +no I-TREATMENT +precisado I-TREATMENT +y I-TREATMENT +peritonitis I-TREATMENT +secundaria. I-TREATMENT +No B-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +ningún I-EXPLORATION +estudio I-EXPLORATION +radiológico I-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION +que I-EXPLORATION +nuestro I-EXPLORATION +hospital I-EXPLORATION +no I-EXPLORATION +cuenta I-EXPLORATION +con I-EXPLORATION +radiólogo I-EXPLORATION +de I-EXPLORATION +turno I-EXPLORATION +y I-EXPLORATION +tampoco I-EXPLORATION +ecografía I-EXPLORATION +o I-EXPLORATION +tomografía I-EXPLORATION +de I-EXPLORATION +urgencia. I-EXPLORATION +El B-TREATMENT +abordaje I-TREATMENT +del I-TREATMENT +abdomen I-TREATMENT se I-TREATMENT -trabajó I-TREATMENT +realizó I-TREATMENT a I-TREATMENT -nivel I-TREATMENT +través I-TREATMENT de I-TREATMENT -entrevista I-TREATMENT -paciente-tutor I-TREATMENT -en I-TREATMENT -el I-TREATMENT -momento I-TREATMENT -del I-TREATMENT -ingreso. I-TREATMENT +una I-TREATMENT +laparotomía I-TREATMENT +mediana. I-TREATMENT Se I-TREATMENT -informa I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -de I-TREATMENT -las I-TREATMENT -normas I-TREATMENT -a I-TREATMENT -seguir, I-TREATMENT -de I-TREATMENT -la I-TREATMENT -importancia I-TREATMENT +aspiraron I-TREATMENT +3 I-TREATMENT +litros I-TREATMENT de I-TREATMENT -la I-TREATMENT -medicación I-TREATMENT -y I-TREATMENT -controles I-TREATMENT -que I-TREATMENT -debe I-TREATMENT -asumir, I-TREATMENT -mostrándole I-TREATMENT -las I-TREATMENT -ventajas I-TREATMENT +exudado I-TREATMENT +purulento I-TREATMENT y I-TREATMENT -los I-TREATMENT -lugares I-TREATMENT en I-TREATMENT +la I-TREATMENT +exploración I-TREATMENT +se I-TREATMENT +evidenció I-TREATMENT +un I-TREATMENT +tumor I-TREATMENT +quístico I-TREATMENT +de I-TREATMENT +15 I-TREATMENT +cm I-TREATMENT +de I-TREATMENT +diámetro I-TREATMENT que I-TREATMENT se I-TREATMENT -va I-TREATMENT -a I-TREATMENT -realizar. I-TREATMENT -Se I-TREATMENT -le I-TREATMENT -acompaña I-TREATMENT +originaba I-TREATMENT +en I-TREATMENT +la I-TREATMENT +A- I-TREATMENT +porción I-TREATMENT +del I-TREATMENT +duodeno, I-TREATMENT +perforado, I-TREATMENT +adherido I-TREATMENT al I-TREATMENT -CAP I-TREATMENT +colon I-TREATMENT +sigmoides I-TREATMENT y I-TREATMENT -se I-TREATMENT -le I-TREATMENT -presenta I-TREATMENT -a I-TREATMENT -los I-TREATMENT -profesionales I-TREATMENT -que I-TREATMENT -le I-TREATMENT -van I-TREATMENT -a I-TREATMENT -atender. I-TREATMENT -Se I-TREATMENT -le I-TREATMENT -pide I-TREATMENT +cubierto I-TREATMENT +de I-TREATMENT +epiplón I-TREATMENT +mayor. I-TREATMENT +El I-TREATMENT +tumor I-TREATMENT +fue I-TREATMENT +resecado I-TREATMENT +en I-TREATMENT +bloque I-TREATMENT +con I-TREATMENT el I-TREATMENT -consentimiento I-TREATMENT -expreso I-TREATMENT +epiplón I-TREATMENT y I-TREATMENT la I-TREATMENT -aceptación I-TREATMENT -voluntaria I-TREATMENT -de I-TREATMENT -la I-TREATMENT -normativa I-TREATMENT -de I-TREATMENT -funcionamiento I-TREATMENT -de I-TREATMENT -La I-TREATMENT -Casita. I-TREATMENT - I-TREATMENT -De I-TREATMENT -entre I-TREATMENT -las I-TREATMENT -actividades I-TREATMENT -que I-TREATMENT +A- I-TREATMENT +porción I-TREATMENT +del I-TREATMENT +duodeno. I-TREATMENT +El I-TREATMENT +tránsito I-TREATMENT +intestinal I-TREATMENT se I-TREATMENT -realizaron I-TREATMENT -para I-TREATMENT +reconstituyó I-TREATMENT +mediante I-TREATMENT +anastomosis I-TREATMENT +término-terminal I-TREATMENT +entre I-TREATMENT la I-TREATMENT -consecución I-TREATMENT -de I-TREATMENT -los I-TREATMENT -objetivos I-TREATMENT -a I-TREATMENT -los I-TREATMENT -seis I-TREATMENT -meses I-TREATMENT +3a I-TREATMENT +porción I-TREATMENT +del I-TREATMENT +duodeno I-TREATMENT y I-TREATMENT -a I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -años, I-TREATMENT -se I-TREATMENT -destaca I-TREATMENT +el I-TREATMENT +yeyuno. I-TREATMENT +La B-EVOLUTION +evolución I-EVOLUTION +postoperatoria I-EVOLUTION +fue I-EVOLUTION +tórpida, I-EVOLUTION +con I-EVOLUTION +complicaciones: I-EVOLUTION +infección I-EVOLUTION +del I-EVOLUTION +sitio I-EVOLUTION +quirúrgico I-EVOLUTION +superficial, I-EVOLUTION +íleo I-EVOLUTION +intestinal I-EVOLUTION +prolongado I-EVOLUTION +y I-EVOLUTION +neumonía I-EVOLUTION +nosocomial. I-EVOLUTION +Después I-EVOLUTION +de I-EVOLUTION +37 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +hospitalización I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +en I-EVOLUTION +buenas I-EVOLUTION +condiciones. I-EVOLUTION +El B-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +demostró I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +sólido-quísti-co, I-EXPLORATION +parcialmente I-EXPLORATION +necrótico I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +bajo I-EXPLORATION +índice I-EXPLORATION +mitótico I-EXPLORATION +(1 I-EXPLORATION +a I-EXPLORATION +2 I-EXPLORATION +mitosis I-EXPLORATION +por I-EXPLORATION +50 I-EXPLORATION +campos I-EXPLORATION +de I-EXPLORATION +aumento I-EXPLORATION +mayor). I-EXPLORATION +Se I-EXPLORATION +observaron I-EXPLORATION +células I-EXPLORATION +epiteloides I-EXPLORATION +y I-EXPLORATION +fusiformes, I-EXPLORATION +positivas I-EXPLORATION +para I-EXPLORATION +CD117, I-EXPLORATION +CD34 I-EXPLORATION +y I-EXPLORATION +desmina. I-EXPLORATION +La I-EXPLORATION +reacción I-EXPLORATION +inmunohistoquímica I-EXPLORATION +fue I-EXPLORATION +negativa I-EXPLORATION +para I-EXPLORATION +S100, I-EXPLORATION +vimentina I-EXPLORATION +y I-EXPLORATION +acüna-a I-EXPLORATION +de I-EXPLORATION +músculo I-EXPLORATION +liso. I-EXPLORATION +El I-EXPLORATION +tamaño I-EXPLORATION +del I-EXPLORATION +tumor I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +cuadro I-EXPLORATION +clínico I-EXPLORATION +de I-EXPLORATION +presentación I-EXPLORATION +(necrosis I-EXPLORATION +y I-EXPLORATION +perforación), I-EXPLORATION +constituyen I-EXPLORATION +indicaciones I-EXPLORATION +para I-EXPLORATION +terapia I-EXPLORATION +con I-EXPLORATION +imatinib I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +derivada I-EXPLORATION +al I-EXPLORATION +Comité I-EXPLORATION +Oncológico I-EXPLORATION +Regional I-EXPLORATION +para I-EXPLORATION +iniciar I-EXPLORATION +tratamiento I-EXPLORATION +pertinente. I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +asintomática I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +seguimiento I-EVOLUTION +hace I-EVOLUTION +11 I-EVOLUTION +meses. I-EVOLUTION +Figura I-EVOLUTION +2 I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +56 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +dislipemia I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +suprarrenalectomía I-PAST_MEDICAL_HISTORY +bilateral I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +hipertrofia I-PAST_MEDICAL_HISTORY +macronodular I-PAST_MEDICAL_HISTORY +bilateral I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +glándulas I-PAST_MEDICAL_HISTORY +suprarrenales. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +losartán I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hidroclorotiazida, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +sustitutivo I-PAST_MEDICAL_HISTORY +hormonal, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +hidrocortisona I-PAST_MEDICAL_HISTORY +30 I-PAST_MEDICAL_HISTORY +mg/24 I-PAST_MEDICAL_HISTORY +horas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +fludrocortisona I-PAST_MEDICAL_HISTORY +0, I-PAST_MEDICAL_HISTORY +1 I-PAST_MEDICAL_HISTORY +mg/24 I-PAST_MEDICAL_HISTORY +horas. I-PAST_MEDICAL_HISTORY +Presenta B-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nueve I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pancreatitis I-PRESENT_ILLNESS +aguda I-PRESENT_ILLNESS +recidivante, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +manifiesta I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +agudos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +intensidad I-PRESENT_ILLNESS +leve I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +autolimitan I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +unos I-PRESENT_ILLNESS +4-5 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dieta I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +analgésico. I-PRESENT_ILLNESS +Durante B-EXPLORATION +su I-EXPLORATION +primer I-EXPLORATION +ingreso I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +una I-EXPLORATION +analítica I-EXPLORATION +con I-EXPLORATION +perfil I-EXPLORATION +hepático I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +perfil I-EXPLORATION +lipídico I-EXPLORATION +con I-EXPLORATION +leve I-EXPLORATION +elevación I-EXPLORATION +del I-EXPLORATION +colesterol I-EXPLORATION +(225 I-EXPLORATION +mg/dL) I-EXPLORATION +y I-EXPLORATION +cifras I-EXPLORATION +de I-EXPLORATION +TG I-EXPLORATION +normales, I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +y I-EXPLORATION +colangio-RMN, I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +objetivan I-EXPLORATION +alteraciones I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar, I-EXPLORATION +colelitiasis I-EXPLORATION +ni I-EXPLORATION +lesiones I-EXPLORATION +pancreáticas I-EXPLORATION +o I-EXPLORATION +biliares, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +cataloga I-EXPLORATION +de I-EXPLORATION +pancreatitis I-EXPLORATION +aguda I-EXPLORATION +idiopática. I-EXPLORATION +Posteriormente I-EXPLORATION +presenta I-EXPLORATION +nuevos I-EXPLORATION +episodios I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +periodicidad I-EXPLORATION +de I-EXPLORATION +entre I-EXPLORATION +siete I-EXPLORATION +meses I-EXPLORATION +y I-EXPLORATION +tres I-EXPLORATION +años, I-EXPLORATION +realizándose I-EXPLORATION +en I-EXPLORATION +este I-EXPLORATION +tiempo I-EXPLORATION +estudios I-EXPLORATION +analíticos I-EXPLORATION +que I-EXPLORATION +son I-EXPLORATION +normales I-EXPLORATION +y I-EXPLORATION +pruebas I-EXPLORATION +de I-EXPLORATION +imagen I-EXPLORATION +que I-EXPLORATION +incluyen I-EXPLORATION +ecografía I-EXPLORATION +abdominal, I-EXPLORATION +colangio-RMN, I-EXPLORATION +TC I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +y I-EXPLORATION +ecoendoscopia I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +identifica I-EXPLORATION +la I-EXPLORATION +causa I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pancreatitis. I-EXPLORATION +En I-EXPLORATION +los I-EXPLORATION +últimos I-EXPLORATION +dos I-EXPLORATION +años I-EXPLORATION +la I-EXPLORATION +periodicidad I-EXPLORATION +se I-EXPLORATION +reduce, I-EXPLORATION +con I-EXPLORATION +episodios I-EXPLORATION +cada I-EXPLORATION +6-7 I-EXPLORATION +meses, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +repite I-EXPLORATION +nuevamente I-EXPLORATION +todo I-EXPLORATION +el I-EXPLORATION +estudio, I-EXPLORATION +objetivándose I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +colangio-RMN I-EXPLORATION +realizada I-EXPLORATION +un I-EXPLORATION +remanente I-EXPLORATION +de I-EXPLORATION +glándula I-EXPLORATION +suprarrenal I-EXPLORATION +que I-EXPLORATION +plantea I-EXPLORATION +el I-EXPLORATION +posible I-EXPLORATION +origen I-EXPLORATION +tóxico I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pancreatitis, I-EXPLORATION +secundario I-EXPLORATION +a I-EXPLORATION +corticoterapia I-EXPLORATION +crónica I-EXPLORATION +e I-EXPLORATION +hiperproducción I-EXPLORATION +endógena I-EXPLORATION +de I-EXPLORATION +corticoides. I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +una I-EXPLORATION +analítica I-EXPLORATION +con I-EXPLORATION +estudio I-EXPLORATION +hormonal I-EXPLORATION +con I-EXPLORATION +cifras I-EXPLORATION +de I-EXPLORATION +cortisol I-EXPLORATION +de I-EXPLORATION +25, I-EXPLORATION +7 I-EXPLORATION +mcg/dL, I-EXPLORATION +ACTH I-EXPLORATION +y I-EXPLORATION +cortisol I-EXPLORATION +en I-EXPLORATION +orina I-EXPLORATION +de I-EXPLORATION +24 I-EXPLORATION +horas I-EXPLORATION +normales, I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +reduce I-EXPLORATION +la I-EXPLORATION +dosis I-EXPLORATION +de I-EXPLORATION +corticoterapia I-EXPLORATION +sustitutiva I-EXPLORATION +a I-EXPLORATION +hidrocortisona I-EXPLORATION +10 I-EXPLORATION +mg I-EXPLORATION +al I-EXPLORATION +día, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +van I-EXPLORATION +reduciendo I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +progresiva I-EXPLORATION +hasta I-EXPLORATION +su I-EXPLORATION +suspensión. I-EXPLORATION +Además, B-TREATMENT +ante I-TREATMENT la I-TREATMENT -inclusión I-TREATMENT -del I-TREATMENT -paciente I-TREATMENT -en I-TREATMENT -un I-TREATMENT -programa I-TREATMENT +posibilidad I-TREATMENT de I-TREATMENT -automedicación I-TREATMENT -que I-TREATMENT +origen I-TREATMENT +farmacológico I-TREATMENT se I-TREATMENT -desarrolla I-TREATMENT -con I-TREATMENT -formato I-TREATMENT -de I-TREATMENT -taller I-TREATMENT -y I-TREATMENT -que I-TREATMENT -integra I-TREATMENT -también I-TREATMENT -actividades I-TREATMENT -individuales I-TREATMENT -como I-TREATMENT -elaboración I-TREATMENT -de I-TREATMENT -fichas I-TREATMENT -de I-TREATMENT -los I-TREATMENT -fármacos I-TREATMENT -que I-TREATMENT -está I-TREATMENT -tomando, I-TREATMENT -posters I-TREATMENT -y I-TREATMENT -puestas I-TREATMENT -en I-TREATMENT -común I-TREATMENT -sobre I-TREATMENT +cambia I-TREATMENT el I-TREATMENT -tema. I-TREATMENT -Se I-TREATMENT -refuerza I-TREATMENT -continuamente I-TREATMENT -su I-TREATMENT -colaboración I-TREATMENT -y I-TREATMENT -aceptación I-TREATMENT -del I-TREATMENT tratamiento I-TREATMENT -y I-TREATMENT -se I-TREATMENT -le I-TREATMENT -anima I-TREATMENT -a I-TREATMENT -que I-TREATMENT -vaya I-TREATMENT -preparando I-TREATMENT -la I-TREATMENT -medicación. I-TREATMENT -En I-TREATMENT -la I-TREATMENT -entrevista I-TREATMENT -semanal I-TREATMENT -con I-TREATMENT -el I-TREATMENT -tutor I-TREATMENT -se I-TREATMENT -tratan I-TREATMENT -los I-TREATMENT -problemas I-TREATMENT -surgidos I-TREATMENT -al I-TREATMENT -respecto. I-TREATMENT -Se I-TREATMENT -acompaña I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -a I-TREATMENT -la I-TREATMENT -farmacia, I-TREATMENT -a I-TREATMENT -la I-TREATMENT -inspección I-TREATMENT -y I-TREATMENT -al I-TREATMENT -CAP I-TREATMENT -para I-TREATMENT -que I-TREATMENT -aprenda I-TREATMENT -el I-TREATMENT -proceso. I-TREATMENT -Se I-TREATMENT -refuerza I-TREATMENT -la I-TREATMENT -abstinencia I-TREATMENT -del I-TREATMENT -tabaco, I-TREATMENT -se I-TREATMENT -restringe I-TREATMENT -su I-TREATMENT -uso I-TREATMENT -a I-TREATMENT -determinados I-TREATMENT -espacios I-TREATMENT +antihipertensivo I-TREATMENT de I-TREATMENT la I-TREATMENT -casa I-TREATMENT -y I-TREATMENT -se I-TREATMENT -colocan I-TREATMENT -señales I-TREATMENT +asociación I-TREATMENT de I-TREATMENT -advertencia. I-TREATMENT -Se I-TREATMENT -hacen I-TREATMENT -además I-TREATMENT -sesiones I-TREATMENT -para I-TREATMENT -debatir I-TREATMENT -sobre I-TREATMENT -el I-TREATMENT -hábito I-TREATMENT -tabáquico. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -la I-EVOLUTION -evaluación, I-EVOLUTION -decir I-EVOLUTION -que I-EVOLUTION -tanto I-EVOLUTION -los I-EVOLUTION -objetivos I-EVOLUTION -inmediatos I-EVOLUTION -como I-EVOLUTION -los I-EVOLUTION -que I-EVOLUTION -van I-EVOLUTION -a I-EVOLUTION +losartán I-TREATMENT +e I-TREATMENT +hidroclorotiazida I-TREATMENT +a I-TREATMENT +ramipril I-TREATMENT +en I-TREATMENT +monoterapia. I-TREATMENT +Se B-EXPLORATION +completa I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +etiológico I-EXPLORATION +con I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +IG4 I-EXPLORATION +y I-EXPLORATION +ANA I-EXPLORATION +que I-EXPLORATION +son I-EXPLORATION +normales, I-EXPLORATION +test I-EXPLORATION +del I-EXPLORATION +sudor I-EXPLORATION +y I-EXPLORATION +test I-EXPLORATION +genético I-EXPLORATION +para I-EXPLORATION +fibrosis I-EXPLORATION +quística I-EXPLORATION +que I-EXPLORATION +son I-EXPLORATION +negativos. I-EXPLORATION +A B-EVOLUTION los I-EVOLUTION seis I-EVOLUTION meses I-EVOLUTION -se I-EVOLUTION -han I-EVOLUTION -conseguido. I-EVOLUTION -No I-EVOLUTION -ocurre I-EVOLUTION -los I-EVOLUTION -mismo I-EVOLUTION -con I-EVOLUTION -los I-EVOLUTION -programados I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +modificación I-EVOLUTION +del I-EVOLUTION +tratamiento I-EVOLUTION +vuelve I-EVOLUTION a I-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -años, I-EVOLUTION -ya I-EVOLUTION -que I-EVOLUTION -los I-EVOLUTION -objetivos I-EVOLUTION -1, I-EVOLUTION -4 I-EVOLUTION -y I-EVOLUTION -5 I-EVOLUTION -referentes I-EVOLUTION +ingresar I-EVOLUTION +por I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +pancreatitis I-EVOLUTION +aguda I-EVOLUTION +leve. I-EVOLUTION +Se I-EVOLUTION +interroga I-EVOLUTION +nuevamente I-EVOLUTION a I-EVOLUTION la I-EVOLUTION -autoadministración I-EVOLUTION -farmacológica, I-EVOLUTION +paciente, I-EVOLUTION +quien I-EVOLUTION +finalmente I-EVOLUTION +refiere I-EVOLUTION +consumir I-EVOLUTION +infusiones I-EVOLUTION +de I-EVOLUTION +cola I-EVOLUTION +de I-EVOLUTION +caballo I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +habitual. I-EVOLUTION +Ante I-EVOLUTION +la I-EVOLUTION +posibilidad I-EVOLUTION +de I-EVOLUTION +una I-EVOLUTION +pancreatitis I-EVOLUTION +recidivante I-EVOLUTION +secundaria I-EVOLUTION +a I-EVOLUTION la I-EVOLUTION -dieta I-EVOLUTION -antiglucemiante I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -tabaco I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -lograron. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -sigue I-EVOLUTION -fumando I-EVOLUTION ->40 I-EVOLUTION -cigarrillos/día, I-EVOLUTION -y I-EVOLUTION -si I-EVOLUTION -no I-EVOLUTION -está I-EVOLUTION -bajo I-EVOLUTION -supervisión I-EVOLUTION -no I-EVOLUTION toma I-EVOLUTION -su I-EVOLUTION -medicación I-EVOLUTION -ni I-EVOLUTION -tampoco I-EVOLUTION -respeta I-EVOLUTION +de I-EVOLUTION +esta I-EVOLUTION +infusión, I-EVOLUTION +se I-EVOLUTION +suspende I-EVOLUTION +por I-EVOLUTION +completo I-EVOLUTION la I-EVOLUTION -dieta. I-EVOLUTION +misma. I-EVOLUTION +Desde I-EVOLUTION +entonces, I-EVOLUTION +14 I-EVOLUTION +meses I-EVOLUTION +después, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +ha I-EVOLUTION +mantenido I-EVOLUTION +asintomática I-EVOLUTION +con I-EVOLUTION +controles I-EVOLUTION +ecográficos I-EVOLUTION +normales. I-EVOLUTION I-EVOLUTION -Trastornos B-TREATMENT -de I-TREATMENT -los I-TREATMENT -procesos I-TREATMENT -del I-TREATMENT -pensamiento I-TREATMENT -y I-TREATMENT -Trastorno I-TREATMENT + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +60 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +ingresado I-PRESENT_ILLNESS +presentando I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +ictericia. I-PRESENT_ILLNESS +La B-EXPLORATION +RMN I-EXPLORATION +y I-EXPLORATION +colangio-RMN I-EXPLORATION +establecieron I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +sospecha I-EXPLORATION +de I-EXPLORATION +colangiocarcinoma. I-EXPLORATION +En B-TREATMENT +el I-TREATMENT +curso I-TREATMENT de I-TREATMENT la I-TREATMENT -percepción I-TREATMENT -sensorial I-TREATMENT -auditiva. I-TREATMENT -Continuando I-TREATMENT -con I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -siguientes I-TREATMENT -diagnósticos, I-TREATMENT +intervención I-TREATMENT se I-TREATMENT -presentaron I-TREATMENT -dos I-TREATMENT -grupos I-TREATMENT -de I-TREATMENT -objetivos: I-TREATMENT -unos I-TREATMENT -permanentes I-TREATMENT -y I-TREATMENT -otros I-TREATMENT -a I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -años. I-TREATMENT - I-TREATMENT -Los I-TREATMENT -permanentes I-TREATMENT -fueron: I-TREATMENT -1) I-TREATMENT -conocer I-TREATMENT -los I-TREATMENT -síntomas I-TREATMENT -psicopatológicos I-TREATMENT -que I-TREATMENT -presenta I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -en I-TREATMENT -cuanto I-TREATMENT -a I-TREATMENT -alteraciones I-TREATMENT -del I-TREATMENT -pensamiento I-TREATMENT -y I-TREATMENT -en I-TREATMENT -lo I-TREATMENT -cognitivo-perceptivo, I-TREATMENT -y I-TREATMENT -2) I-TREATMENT -evitar I-TREATMENT -episodios I-TREATMENT -de I-TREATMENT -héteroagresividad I-TREATMENT -y I-TREATMENT -aparición I-TREATMENT -de I-TREATMENT -crisis. I-TREATMENT -El I-TREATMENT -objetivo I-TREATMENT -a I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -años, I-TREATMENT -indica I-TREATMENT -que I-TREATMENT -el I-TREATMENT -sujeto I-TREATMENT -habrá I-TREATMENT -eliminado I-TREATMENT -las I-TREATMENT -expresiones I-TREATMENT -verbales I-TREATMENT -agresivas I-TREATMENT -y I-TREATMENT -con I-TREATMENT -contenido I-TREATMENT +consiguó I-TREATMENT +la I-TREATMENT +resección I-TREATMENT de I-TREATMENT -muerte I-TREATMENT -hacia I-TREATMENT -otras I-TREATMENT -personas. I-TREATMENT - I-TREATMENT -Siguiendo I-TREATMENT -con I-TREATMENT -el I-TREATMENT -proceso, I-TREATMENT -se I-TREATMENT -realizan I-TREATMENT -las I-TREATMENT -actividades I-TREATMENT -acordadas I-TREATMENT -que I-TREATMENT -incluyen I-TREATMENT +una I-TREATMENT +masa I-TREATMENT en I-TREATMENT -primer I-TREATMENT -lugar I-TREATMENT el I-TREATMENT -registro I-TREATMENT +área I-TREATMENT de I-TREATMENT -los I-TREATMENT -datos I-TREATMENT -recogidos I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -ideación I-TREATMENT -delirante I-TREATMENT -y I-TREATMENT -conducta I-TREATMENT -del I-TREATMENT -paciente. I-TREATMENT -Se I-TREATMENT -procura I-TREATMENT -generar I-TREATMENT -y I-TREATMENT -mantener I-TREATMENT -un I-TREATMENT -espacio I-TREATMENT -común I-TREATMENT -para I-TREATMENT la I-TREATMENT -convivencia I-TREATMENT +bifurcación I-TREATMENT +biliar I-TREATMENT y I-TREATMENT +reconstrucción I-TREATMENT +de I-TREATMENT la I-TREATMENT -tolerancia, I-TREATMENT -fomentando I-TREATMENT -el I-TREATMENT -respeto I-TREATMENT -a I-TREATMENT -las I-TREATMENT -personas. I-TREATMENT -En I-TREATMENT -las I-TREATMENT -entrevistas I-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -mantiene I-TREATMENT -con I-TREATMENT -el I-TREATMENT -tutor, I-TREATMENT -se I-TREATMENT -analizan I-TREATMENT -las I-TREATMENT -conductas I-TREATMENT -inapropiadas, I-TREATMENT -presentando I-TREATMENT -alternativas I-TREATMENT -que I-TREATMENT -cuando I-TREATMENT -se I-TREATMENT -reproducen I-TREATMENT -son I-TREATMENT -reforzadas I-TREATMENT +continuidad I-TREATMENT +biliar I-TREATMENT mediante I-TREATMENT -elogios. I-TREATMENT -También I-TREATMENT -se I-TREATMENT -solicita I-TREATMENT -presencia I-TREATMENT -del I-TREATMENT -clínico, I-TREATMENT +anastomosis I-TREATMENT +segmentarias I-TREATMENT a I-TREATMENT -parte I-TREATMENT -de I-TREATMENT -las I-TREATMENT -consultas, I-TREATMENT -para I-TREATMENT -las I-TREATMENT -entrevistas I-TREATMENT -cuando I-TREATMENT -el I-TREATMENT -tutor I-TREATMENT -lo I-TREATMENT -valora. I-TREATMENT - I-TREATMENT -Los B-EVOLUTION -tres I-EVOLUTION -objetivos I-EVOLUTION -que I-EVOLUTION -acabamos I-EVOLUTION -de I-EVOLUTION -exponer, I-EVOLUTION -dos I-EVOLUTION -permanentes I-EVOLUTION -y I-EVOLUTION -uno I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -años, I-EVOLUTION -fueron I-EVOLUTION -conseguidos I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -plazos I-EVOLUTION -previstos. I-EVOLUTION - I-EVOLUTION -Deterioro B-TREATMENT +un I-TREATMENT +asa I-TREATMENT +desfuncionalizada I-TREATMENT +yeyunal I-TREATMENT +en I-TREATMENT +Y I-TREATMENT de I-TREATMENT -la I-TREATMENT -interacción I-TREATMENT -social. I-TREATMENT -Para I-TREATMENT -trabajar I-TREATMENT -la I-TREATMENT -problemática I-TREATMENT -que I-TREATMENT -presenta I-TREATMENT +Roux. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +histopatológico I-EXPLORATION +reveló I-EXPLORATION +se I-EXPLORATION +trataba I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +carcinoide. I-EXPLORATION + I-EXPLORATION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +45 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +remitida B-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +Medicina I-DERIVED_FROM/TO +Interna I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +estudio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +fondo I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +ojo I-DERIVED_FROM/TO +por B-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +midriasis I-PRESENT_ILLNESS +media I-PRESENT_ILLNESS +bilateral I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +cefalea, I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +visión, I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION +una I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +de I-EXPLORATION +0, I-EXPLORATION +8 I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +ojos I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +midriasis I-EXPLORATION +bilateral I-EXPLORATION +arreactiva; I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +exploración, I-EXPLORATION +incluídas I-EXPLORATION +las I-EXPLORATION +papilas, I-EXPLORATION +es I-EXPLORATION +normal, I-EXPLORATION +salvo I-EXPLORATION +que I-EXPLORATION +presenta I-EXPLORATION +cámaras I-EXPLORATION +anteriores I-EXPLORATION +estrechas I-EXPLORATION +y I-EXPLORATION +unas I-EXPLORATION +presiones I-EXPLORATION +intraoculares I-EXPLORATION +de I-EXPLORATION +65 I-EXPLORATION +y I-EXPLORATION +58 I-EXPLORATION +mm I-EXPLORATION +Hg I-EXPLORATION +en I-EXPLORATION +cada I-EXPLORATION +ojo. I-EXPLORATION +Ante I-EXPLORATION +este I-EXPLORATION +cuadro I-EXPLORATION +se I-EXPLORATION +procede I-EXPLORATION +a I-EXPLORATION +tomar I-EXPLORATION +imágenes I-EXPLORATION +del I-EXPLORATION +polo I-EXPLORATION +anterior I-EXPLORATION +con I-EXPLORATION +OCT I-EXPLORATION +y I-EXPLORATION +BMU, I-EXPLORATION +mostrando I-EXPLORATION +un I-EXPLORATION +cierre I-EXPLORATION +angular I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +360º I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +bilateral. I-EXPLORATION +Con B-TREATMENT +estos I-TREATMENT +datos, I-TREATMENT +se I-TREATMENT +establece I-TREATMENT el I-TREATMENT -cuarto I-TREATMENT diagnóstico I-TREATMENT -se I-TREATMENT -establecen I-TREATMENT -cuatro I-TREATMENT -objetivos I-TREATMENT -a I-TREATMENT -los I-TREATMENT -seis I-TREATMENT -meses I-TREATMENT -y I-TREATMENT -dos I-TREATMENT -a I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -años. I-TREATMENT -Los I-TREATMENT -cuatro I-TREATMENT -primeros I-TREATMENT -son: I-TREATMENT -1) I-TREATMENT -visitar I-TREATMENT -e I-TREATMENT -informar I-TREATMENT -a I-TREATMENT -los I-TREATMENT -vecinos I-TREATMENT de I-TREATMENT -su I-TREATMENT -pueblo; I-TREATMENT -2) I-TREATMENT -entrevistarse I-TREATMENT -con I-TREATMENT -las I-TREATMENT -personas I-TREATMENT -agredidas; I-TREATMENT -3) I-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -haga I-TREATMENT -visitas I-TREATMENT -programadas I-TREATMENT -a I-TREATMENT -su I-TREATMENT -casa I-TREATMENT -siendo I-TREATMENT -acompañado I-TREATMENT -por I-TREATMENT -personal I-TREATMENT -enfermero I-TREATMENT +ataque I-TREATMENT +agudo I-TREATMENT +de I-TREATMENT +glaucoma I-TREATMENT +bilateral, I-TREATMENT +se I-TREATMENT +prescribe I-TREATMENT +tratamiento I-TREATMENT +médico I-TREATMENT +para I-TREATMENT +dicho I-TREATMENT +cuadro I-TREATMENT y I-TREATMENT -4) I-TREATMENT se I-TREATMENT -informará I-TREATMENT -a I-TREATMENT +realizan I-TREATMENT +iridotomías I-TREATMENT +bilaterales I-TREATMENT +que I-TREATMENT +resultan I-TREATMENT +permeables I-TREATMENT +como I-TREATMENT +muestran I-TREATMENT las I-TREATMENT -fuerzas I-TREATMENT +imágenes I-TREATMENT del I-TREATMENT -orden I-TREATMENT -público I-TREATMENT -de I-TREATMENT -dicha I-TREATMENT -actividad. I-TREATMENT - I-TREATMENT -Los I-TREATMENT -dos I-TREATMENT -objetivos I-TREATMENT -siguientes, I-TREATMENT -a I-TREATMENT -conseguir I-TREATMENT -a I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -años, I-TREATMENT -son: I-TREATMENT -1) I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -desarrollará I-TREATMENT -una I-TREATMENT -actividad I-TREATMENT -normal I-TREATMENT -durante I-TREATMENT -las I-TREATMENT -visitas, I-TREATMENT -relacionándose I-TREATMENT -con I-TREATMENT -parientes I-TREATMENT -y I-TREATMENT -vecinos I-TREATMENT -en I-TREATMENT +OCT, I-TREATMENT +ampliándose I-TREATMENT la I-TREATMENT -mediada I-TREATMENT -de I-TREATMENT -lo I-TREATMENT -posible I-TREATMENT -y I-TREATMENT -2) I-TREATMENT -su I-TREATMENT -presencia I-TREATMENT +profundidad I-TREATMENT +camerular I-TREATMENT en I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -no I-TREATMENT -será I-TREATMENT -causa I-TREATMENT -de I-TREATMENT -temor I-TREATMENT -o I-TREATMENT -alarma I-TREATMENT -social. I-TREATMENT +ambos I-TREATMENT +ojos. I-TREATMENT I-TREATMENT -Para I-TREATMENT -lograr I-TREATMENT -estos I-TREATMENT -objetivos I-TREATMENT -se I-TREATMENT -fueron I-TREATMENT -realizando I-TREATMENT -a I-TREATMENT -lo I-TREATMENT -largo I-TREATMENT -de I-TREATMENT -los I-TREATMENT -meses I-TREATMENT -numerosas I-TREATMENT -entrevistas I-TREATMENT -con I-TREATMENT -vecinos I-TREATMENT -del I-TREATMENT -pueblo I-TREATMENT -y I-TREATMENT -familiares, I-TREATMENT -con I-TREATMENT -la I-TREATMENT -persona I-TREATMENT -agredida I-TREATMENT -(la I-TREATMENT -otra I-TREATMENT -falleció) I-TREATMENT -y I-TREATMENT + +Niño B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +seis I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +octubre I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +39, I-PRESENT_ILLNESS +7 I-PRESENT_ILLNESS +oC, I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +ocular I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +leve I-EXPLORATION +eritema I-EXPLORATION +palpebral, I-EXPLORATION +sin I-EXPLORATION +oftalmoplejia I-EXPLORATION +ni I-EXPLORATION +proptosis, I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +normal. I-EXPLORATION +Se B-TREATMENT +pauta I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -el I-TREATMENT -cura I-TREATMENT -amenazado I-TREATMENT +amoxicilina/clavulánico I-TREATMENT +en I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +80 I-TREATMENT +mg/kg/día I-TREATMENT por I-TREATMENT -nuestro I-TREATMENT -paciente. I-TREATMENT -En I-TREATMENT -estos I-TREATMENT -encuentros I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT +y I-TREATMENT se I-TREATMENT -informó I-TREATMENT -de I-TREATMENT +informa I-TREATMENT +sobre I-TREATMENT las I-TREATMENT -características I-TREATMENT -del I-TREATMENT -programa I-TREATMENT -de I-TREATMENT -visitas I-TREATMENT +posibles I-TREATMENT +complicaciones. I-TREATMENT +A B-EVOLUTION +las I-EVOLUTION +24 I-EVOLUTION +horas I-EVOLUTION +de I-EVOLUTION +iniciar I-EVOLUTION +el I-EVOLUTION +tratamiento, I-EVOLUTION +acude I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +urgencia I-EVOLUTION +hospitalaria I-EVOLUTION +por I-EVOLUTION +no I-EVOLUTION +tolerar I-EVOLUTION +el I-EVOLUTION +antibiótico I-EVOLUTION +oral I-EVOLUTION +y I-EVOLUTION +persistir I-EVOLUTION +el I-EVOLUTION +dolor I-EVOLUTION +ocular I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +fiebre. I-EVOLUTION +En B-EXPLORATION +el I-EXPLORATION +hospital, I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +ocular I-EXPLORATION +detectó I-EXPLORATION +ptosis I-EXPLORATION +palpebral I-EXPLORATION +derecha I-EXPLORATION +con I-EXPLORATION +dolor I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +movilidad I-EXPLORATION +ocular, I-EXPLORATION +discreto I-EXPLORATION +eritema I-EXPLORATION +palpebral, I-EXPLORATION +pupilas I-EXPLORATION +isocóricas I-EXPLORATION +y I-EXPLORATION +normorreactivas, I-EXPLORATION +motilidad I-EXPLORATION +ocular I-EXPLORATION +conservada I-EXPLORATION +y I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo I-EXPLORATION +normal. I-EXPLORATION +Entre I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +complementarias, I-EXPLORATION +destaca: I-EXPLORATION +hemograma I-EXPLORATION +con I-EXPLORATION +leucocitos, I-EXPLORATION +14 I-EXPLORATION +720/μl I-EXPLORATION +(N: I-EXPLORATION +76, I-EXPLORATION +7%; I-EXPLORATION +L: I-EXPLORATION +15, I-EXPLORATION +5%; I-EXPLORATION +M: I-EXPLORATION +7, I-EXPLORATION +7%); I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +(PCR), I-EXPLORATION +227, I-EXPLORATION +1 I-EXPLORATION +mg/l; I-EXPLORATION +hemocultivo, I-EXPLORATION +negativo; I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax, I-EXPLORATION +normal; I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION +orbital, I-EXPLORATION +informada I-EXPLORATION +con I-EXPLORATION +cambios I-EXPLORATION +inflamatorios I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +grasa I-EXPLORATION +intraorbitaria I-EXPLORATION +extraconal I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +órbita I-EXPLORATION +derecha I-EXPLORATION +y I-EXPLORATION +cambios I-EXPLORATION +inflamatorios I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +senos I-EXPLORATION +paranasales. I-EXPLORATION +Es B-TREATMENT +ingresado I-TREATMENT y I-TREATMENT se I-TREATMENT -procuró I-TREATMENT -reforzar I-TREATMENT -la I-TREATMENT -idea I-TREATMENT -de I-TREATMENT +pauta I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +amoxicilina/clavulánico I-TREATMENT +intravenoso, I-TREATMENT que I-TREATMENT -dichas I-TREATMENT -visitas I-TREATMENT -no I-TREATMENT -alterarían I-TREATMENT -en I-TREATMENT -absoluto I-TREATMENT -el I-TREATMENT -orden I-TREATMENT -público I-TREATMENT -ni I-TREATMENT -supondrían I-TREATMENT -riesgo I-TREATMENT -para I-TREATMENT -nadie. I-TREATMENT -Además I-TREATMENT se I-TREATMENT -dejó I-TREATMENT -perfectamente I-TREATMENT -claro I-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -siempre I-TREATMENT -estaría I-TREATMENT -acompañado I-TREATMENT -de I-TREATMENT -personal I-TREATMENT -sanitario. I-TREATMENT -La I-TREATMENT -Guardia I-TREATMENT -Civil I-TREATMENT -también I-TREATMENT -fue I-TREATMENT -puntualmente I-TREATMENT -informada. I-TREATMENT - I-TREATMENT -Dichas B-EVOLUTION -actividades I-EVOLUTION -condujeron I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -consecución I-EVOLUTION -satisfactoria I-EVOLUTION -en I-EVOLUTION -tiempo I-EVOLUTION -y I-EVOLUTION -forma I-EVOLUTION -de I-EVOLUTION -todos I-EVOLUTION -los I-EVOLUTION -objetivos I-EVOLUTION -propuestos. I-EVOLUTION - I-EVOLUTION -Afrontamiento B-TREATMENT -familiar I-TREATMENT -comprometido. I-TREATMENT -El I-TREATMENT -quinto I-TREATMENT -y I-TREATMENT -último I-TREATMENT -de I-TREATMENT -los I-TREATMENT -diagnósticos I-TREATMENT -exige I-TREATMENT -de I-TREATMENT -nuevo I-TREATMENT -el I-TREATMENT -planteamiento I-TREATMENT -de I-TREATMENT -tres I-TREATMENT -grupos I-TREATMENT -de I-TREATMENT -objetivos. I-TREATMENT -Un I-TREATMENT -primer I-TREATMENT -objetivo I-TREATMENT -permanente, I-TREATMENT -el I-TREATMENT -segundo I-TREATMENT -grupo I-TREATMENT -compuesto I-TREATMENT -por I-TREATMENT -tres I-TREATMENT -objetivos I-TREATMENT -a I-TREATMENT -cumplir I-TREATMENT -a I-TREATMENT -los I-TREATMENT +mantiene I-TREATMENT +durante I-TREATMENT seis I-TREATMENT -meses I-TREATMENT +días, I-TREATMENT y I-TREATMENT -dos I-TREATMENT -más I-TREATMENT -que I-TREATMENT -deberían I-TREATMENT -lograrse I-TREATMENT -a I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -años. I-TREATMENT - I-TREATMENT -El I-TREATMENT -objetivo I-TREATMENT -permanente, I-TREATMENT es I-TREATMENT -que I-TREATMENT -su I-TREATMENT -familia I-TREATMENT -reciba I-TREATMENT -información I-TREATMENT -del I-TREATMENT -proyecto I-TREATMENT -rehabilitador I-TREATMENT -y I-TREATMENT -evolución I-TREATMENT -del I-TREATMENT -paciente I-TREATMENT +dado I-TREATMENT de I-TREATMENT -forma I-TREATMENT -sostenida, I-TREATMENT -a I-TREATMENT -través I-TREATMENT -del I-TREATMENT -contacto I-TREATMENT -y I-TREATMENT -entrevistas I-TREATMENT +alta I-TREATMENT con I-TREATMENT el I-TREATMENT -tutor. I-TREATMENT -En I-TREATMENT -los I-TREATMENT -objetivos I-TREATMENT -a I-TREATMENT -los I-TREATMENT -seis I-TREATMENT -meses, I-TREATMENT -se I-TREATMENT -incluyen: I-TREATMENT -1) I-TREATMENT -un I-TREATMENT -mayor I-TREATMENT -protagonismo I-TREATMENT -de I-TREATMENT -esta I-TREATMENT -familia I-TREATMENT -en I-TREATMENT -el I-TREATMENT -proceso I-TREATMENT -terapéutico; I-TREATMENT -2) I-TREATMENT -visitas I-TREATMENT -programadas I-TREATMENT -semanales I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT +mismo I-TREATMENT +antibiótico I-TREATMENT +oral I-TREATMENT +hasta I-TREATMENT +completar I-TREATMENT +15 I-TREATMENT +días. I-TREATMENT +Su B-EVOLUTION +evolución I-EVOLUTION +fue I-EVOLUTION +favorable I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +complicaciones. I-EVOLUTION + I-EVOLUTION + +Una B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +femenina I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +27 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +quien I-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +queja I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +mostrar I-PRESENT_ILLNESS +excesivamente I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +gingival I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +sonreír, I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +objetivo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +mejorar I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +estética I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +sonrisa I-PRESENT_ILLNESS +gingival. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +informa I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +encuentra I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +sonrisa I-PRESENT_ILLNESS +armoniosa, I-PRESENT_ILLNESS +pero I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +está I-PRESENT_ILLNESS +dispuesta I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +realizar I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +procedimiento I-PRESENT_ILLNESS +invasivo I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +corregir I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +situación I-PRESENT_ILLNESS +bucal. I-PRESENT_ILLNESS +Al B-EXPLORATION +momento I-EXPLORATION +de I-EXPLORATION +ser I-EXPLORATION +realizada I-EXPLORATION +la I-EXPLORATION +evaluación I-EXPLORATION +clínica, I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +que I-EXPLORATION +presentaba I-EXPLORATION +4 I-EXPLORATION +mm I-EXPLORATION +de I-EXPLORATION +exposición I-EXPLORATION +gingival. I-EXPLORATION + I-EXPLORATION +Fue I-EXPLORATION +evaluada I-EXPLORATION +la I-EXPLORATION +etiología I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +sonrisa I-EXPLORATION +gingival, I-EXPLORATION +llegando I-EXPLORATION +al I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +que I-EXPLORATION +su I-EXPLORATION +sonrisa I-EXPLORATION +gingival I-EXPLORATION +era I-EXPLORATION +debida I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +hiperactividad I-EXPLORATION +del I-EXPLORATION +músculo I-EXPLORATION +elevador I-EXPLORATION +del I-EXPLORATION +labio I-EXPLORATION +superior. I-EXPLORATION +Entre B-TREATMENT +las I-TREATMENT +opciones I-TREATMENT para I-TREATMENT -llevarlo I-TREATMENT -a I-TREATMENT -comer I-TREATMENT -fuera, I-TREATMENT -y I-TREATMENT -3) I-TREATMENT -hacerse I-TREATMENT -cargo I-TREATMENT -del I-TREATMENT -lavado I-TREATMENT -de I-TREATMENT -su I-TREATMENT -ropa I-TREATMENT -a I-TREATMENT -cambio I-TREATMENT -de I-TREATMENT -una I-TREATMENT -contraprestación I-TREATMENT -económica I-TREATMENT -pactada. I-TREATMENT -A I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -años I-TREATMENT -se I-TREATMENT -establecen I-TREATMENT -como I-TREATMENT -objetivos, I-TREATMENT -por I-TREATMENT -una I-TREATMENT -parte: I-TREATMENT -1) I-TREATMENT -que I-TREATMENT -su I-TREATMENT -hermano I-TREATMENT -sea I-TREATMENT -capaz I-TREATMENT -de I-TREATMENT -verbalizar I-TREATMENT -elogios I-TREATMENT -hacia I-TREATMENT +resolver I-TREATMENT el I-TREATMENT -paciente I-TREATMENT -por I-TREATMENT -su I-TREATMENT -progresos I-TREATMENT -y I-TREATMENT -en I-TREATMENT -su I-TREATMENT -presencia I-TREATMENT -y I-TREATMENT -por I-TREATMENT -otro I-TREATMENT -lado: I-TREATMENT -2) I-TREATMENT +caso I-TREATMENT que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -respete I-TREATMENT +fueron I-TREATMENT +presentadas I-TREATMENT +a I-TREATMENT la I-TREATMENT -opinión I-TREATMENT -de I-TREATMENT -sus I-TREATMENT -familiares I-TREATMENT -omitiendo I-TREATMENT -expresiones I-TREATMENT -desautorizantes I-TREATMENT -o I-TREATMENT -insultantes. I-TREATMENT - I-TREATMENT -El I-TREATMENT -diseño I-TREATMENT -de I-TREATMENT -actividades I-TREATMENT -para I-TREATMENT -estos I-TREATMENT -objetivos I-TREATMENT -incluyó I-TREATMENT -en I-TREATMENT -un I-TREATMENT -primer I-TREATMENT -momento I-TREATMENT -una I-TREATMENT -serie I-TREATMENT -de I-TREATMENT -entrevistas I-TREATMENT -programadas I-TREATMENT -entre I-TREATMENT -familiares, I-TREATMENT paciente I-TREATMENT +(incluyendo I-TREATMENT +ventajas I-TREATMENT y I-TREATMENT -tutor I-TREATMENT -a I-TREATMENT +limitaciones I-TREATMENT +de I-TREATMENT +cada I-TREATMENT +una), I-TREATMENT +fue I-TREATMENT +escogido I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +BTX-A, I-TREATMENT +con I-TREATMENT +el I-TREATMENT fin I-TREATMENT de I-TREATMENT -aclarar I-TREATMENT -todos I-TREATMENT -los I-TREATMENT -aspectos I-TREATMENT -concernientes I-TREATMENT -al I-TREATMENT -proyecto I-TREATMENT -terapéutico I-TREATMENT -del I-TREATMENT -paciente, I-TREATMENT -normas I-TREATMENT +reducir I-TREATMENT +la I-TREATMENT +fuerza I-TREATMENT de I-TREATMENT -funcionamiento, I-TREATMENT -actividades I-TREATMENT -dentro I-TREATMENT -y I-TREATMENT -fuera I-TREATMENT +contracción I-TREATMENT del I-TREATMENT -dispositivo I-TREATMENT -y I-TREATMENT -colaboración I-TREATMENT -necesaria I-TREATMENT -de I-TREATMENT +labio I-TREATMENT +superior. I-TREATMENT + I-TREATMENT +Para I-TREATMENT la I-TREATMENT -familia. I-TREATMENT -A I-TREATMENT -lo I-TREATMENT -largo I-TREATMENT +ubicación I-TREATMENT del I-TREATMENT -tiempo I-TREATMENT -se I-TREATMENT -les I-TREATMENT -fue I-TREATMENT -informando I-TREATMENT +punto I-TREATMENT de I-TREATMENT +aplicación, I-TREATMENT +fue I-TREATMENT +utilizada I-TREATMENT la I-TREATMENT -evolución I-TREATMENT -del I-TREATMENT -paciente, I-TREATMENT +técnica I-TREATMENT +"Yonsei I-TREATMENT +Point"2, I-TREATMENT +descrita I-TREATMENT +en I-TREATMENT +la I-TREATMENT +figura I-TREATMENT +2. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +utilizó I-TREATMENT +la I-TREATMENT +BTX-A I-TREATMENT +(botox I-TREATMENT de I-TREATMENT la I-TREATMENT -autonomía I-TREATMENT -que I-TREATMENT -conseguía I-TREATMENT -y I-TREATMENT +casa I-TREATMENT +comercial I-TREATMENT +Allergan) I-TREATMENT de I-TREATMENT -todos I-TREATMENT -los I-TREATMENT -avances I-TREATMENT -y I-TREATMENT -obstáculos. I-TREATMENT -Se I-TREATMENT -anima I-TREATMENT -en I-TREATMENT -las I-TREATMENT -entrevistas I-TREATMENT -a I-TREATMENT -verbalizar I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -piensan I-TREATMENT -unos I-TREATMENT +100 I-TREATMENT +unidades I-TREATMENT +(U) I-TREATMENT +como I-TREATMENT +medicación I-TREATMENT de I-TREATMENT -otros I-TREATMENT -con I-TREATMENT -corrección I-TREATMENT -y I-TREATMENT -respeto, I-TREATMENT +elección. I-TREATMENT +La I-TREATMENT +dilución I-TREATMENT +del I-TREATMENT +medicamento I-TREATMENT se I-TREATMENT -enseña I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -a I-TREATMENT -que I-TREATMENT -respete I-TREATMENT +realizó I-TREATMENT +como I-TREATMENT +se I-TREATMENT +describe I-TREATMENT +en I-TREATMENT las I-TREATMENT -opiniones I-TREATMENT -y I-TREATMENT -los I-TREATMENT -turnos I-TREATMENT +instrucciones I-TREATMENT de I-TREATMENT -intervención I-TREATMENT +uso I-TREATMENT +del I-TREATMENT +mismo. I-TREATMENT +La I-TREATMENT +BTX-A I-TREATMENT +se I-TREATMENT +diluyó I-TREATMENT +con I-TREATMENT +2 I-TREATMENT +ml I-TREATMENT de I-TREATMENT -los I-TREATMENT -demás I-TREATMENT +solución I-TREATMENT +salina I-TREATMENT +0, I-TREATMENT +9% I-TREATMENT +sin I-TREATMENT +conservantes I-TREATMENT y I-TREATMENT -se I-TREATMENT -consensuan I-TREATMENT -acuerdos I-TREATMENT +estéril I-TREATMENT para I-TREATMENT +producir I-TREATMENT +5 I-TREATMENT +U I-TREATMENT +por I-TREATMENT +0, I-TREATMENT +1 I-TREATMENT +ml. I-TREATMENT +Se I-TREATMENT +inyectaron I-TREATMENT +2, I-TREATMENT +5 I-TREATMENT +U I-TREATMENT +en I-TREATMENT el I-TREATMENT -funcionamiento I-TREATMENT -diario, I-TREATMENT -visitas I-TREATMENT -de I-TREATMENT -la I-TREATMENT -familia, I-TREATMENT -salidas I-TREATMENT -a I-TREATMENT -comer I-TREATMENT -fuera, I-TREATMENT -día I-TREATMENT -de I-TREATMENT -recogida I-TREATMENT +músculo I-TREATMENT +elevador I-TREATMENT +del I-TREATMENT +labio I-TREATMENT +superior, I-TREATMENT de I-TREATMENT -la I-TREATMENT -ropa I-TREATMENT -sucia, I-TREATMENT -etc. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -evaluación I-EVOLUTION -evidencia I-EVOLUTION -que I-EVOLUTION -tanto I-EVOLUTION -el I-EVOLUTION -objetivo I-EVOLUTION -permanente I-EVOLUTION -como I-EVOLUTION -los I-EVOLUTION -referidos I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -se I-EVOLUTION -consiguieron I-EVOLUTION -correctamente, I-EVOLUTION -no I-EVOLUTION -así I-EVOLUTION -los I-EVOLUTION -objetivos I-EVOLUTION -propuestos I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -dos I-EVOLUTION -años. I-EVOLUTION -El I-EVOLUTION -hermano I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -a I-EVOLUTION -penas I-EVOLUTION -si I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -capaz I-EVOLUTION -de I-EVOLUTION -elogiar I-EVOLUTION -los I-EVOLUTION -evidentes I-EVOLUTION -avances I-EVOLUTION -del I-EVOLUTION -paciente, I-EVOLUTION -ni I-EVOLUTION -éste I-EVOLUTION -último I-EVOLUTION -ha I-EVOLUTION -podido I-EVOLUTION -eliminar I-EVOLUTION -determinadas I-EVOLUTION -expresiones I-EVOLUTION -inapropiadas I-EVOLUTION -hacia I-EVOLUTION -su I-EVOLUTION -familia, I-EVOLUTION -en I-EVOLUTION -especial I-EVOLUTION -hacia I-EVOLUTION -su I-EVOLUTION -hermano, I-EVOLUTION -aunque I-EVOLUTION -si I-EVOLUTION -disminuyeron I-EVOLUTION -en I-EVOLUTION -tono I-EVOLUTION -y I-EVOLUTION -frecuencia. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -52 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipercolesterolemia, I-PAST_MEDICAL_HISTORY -obesidad, I-PAST_MEDICAL_HISTORY -rigidez I-PAST_MEDICAL_HISTORY -articular, I-PAST_MEDICAL_HISTORY -microadenoma I-PAST_MEDICAL_HISTORY -hipofisiario I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -migrañoso, I-PAST_MEDICAL_HISTORY -quien I-PAST_MEDICAL_HISTORY -ejerce I-PAST_MEDICAL_HISTORY -funciones I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pinche I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -Hospital I-PAST_MEDICAL_HISTORY -Universitario I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Ceuta I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -diez I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Inicia B-PRESENT_ILLNESS -enfermedad I-PRESENT_ILLNESS -presentando I-PRESENT_ILLNESS -contracturas I-PRESENT_ILLNESS -musculares I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -lumbalgias I-PRESENT_ILLNESS -severas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -mayoría I-PRESENT_ILLNESS -ocasionadas I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -rol I-PRESENT_ILLNESS -dentro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cocina, I-PRESENT_ILLNESS -solicitando I-PRESENT_ILLNESS -constantes I-PRESENT_ILLNESS -bajas I-PRESENT_ILLNESS -laborales, I-PRESENT_ILLNESS -evoluciona I-PRESENT_ILLNESS -presentando I-PRESENT_ILLNESS -parestesias I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -miembros I-PRESENT_ILLNESS -inferiores I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -incontinencia I-PRESENT_ILLNESS -urinaria, I-PRESENT_ILLNESS -es B-DERIVED_FROM/TO -referida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -especializado I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -decide I-DERIVED_FROM/TO -realizar I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -artrodesis I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -columna I-DERIVED_FROM/TO -lumbo-sacra I-DERIVED_FROM/TO -L4-L5-S1 I-DERIVED_FROM/TO -precisando I-DERIVED_FROM/TO -incapacidad I-DERIVED_FROM/TO -temporal I-DERIVED_FROM/TO -durante I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -año, I-DERIVED_FROM/TO -posteriormente B-EVOLUTION -presenta I-EVOLUTION -síntomas I-EVOLUTION -sugestivos I-EVOLUTION -de I-EVOLUTION -compresión I-EVOLUTION -radicular I-EVOLUTION -y I-EVOLUTION -estenosis I-EVOLUTION -de I-EVOLUTION -canal I-EVOLUTION -medular, I-EVOLUTION -por B-DERIVED_FROM/TO -lo I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -nuevamente I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -referida I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -quirúrgico, I-DERIVED_FROM/TO -realizándose I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -resección I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -hernias I-DERIVED_FROM/TO -discales I-DERIVED_FROM/TO -C5-C6 I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -C6-C7, I-DERIVED_FROM/TO -necesitando I-DERIVED_FROM/TO -nuevamente I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -incapacidad I-DERIVED_FROM/TO -temporal I-DERIVED_FROM/TO -otro I-DERIVED_FROM/TO -año I-DERIVED_FROM/TO -más. I-DERIVED_FROM/TO -Al B-EVOLUTION -reincorporarse I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -puesto I-EVOLUTION -de I-EVOLUTION -trabajo, I-EVOLUTION -se I-EVOLUTION -realiza I-EVOLUTION -una I-EVOLUTION -valoración I-EVOLUTION -médica I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Prevención I-EVOLUTION -de I-EVOLUTION -Riesgos I-EVOLUTION -Laborales I-EVOLUTION -del I-EVOLUTION -Hospital, I-EVOLUTION -donde I-EVOLUTION -posterior I-EVOLUTION -al I-EVOLUTION -estudio I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -protocolos I-EVOLUTION -de I-EVOLUTION -manipulación I-EVOLUTION -manual I-EVOLUTION -de I-EVOLUTION -cargas I-EVOLUTION -y I-EVOLUTION -movimientos I-EVOLUTION -repetitivos, I-EVOLUTION -se I-EVOLUTION -valora I-EVOLUTION -como I-EVOLUTION -No I-EVOLUTION -Apta I-EVOLUTION -para I-EVOLUTION -realizar I-EVOLUTION -las I-EVOLUTION -funciones I-EVOLUTION -de I-EVOLUTION -pinche I-EVOLUTION -dentro I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cocina. I-EVOLUTION -Se I-EVOLUTION -propone I-EVOLUTION -una I-EVOLUTION -adaptación I-EVOLUTION -del I-EVOLUTION -puesto I-EVOLUTION -de I-EVOLUTION -trabajo, I-EVOLUTION -de I-EVOLUTION -imposible I-EVOLUTION -cumplimiento I-EVOLUTION -por I-EVOLUTION -su I-EVOLUTION -mando I-EVOLUTION -intermedio. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -caso I-EVOLUTION -es I-EVOLUTION -estudiado I-EVOLUTION -por I-EVOLUTION -Gerencia I-EVOLUTION -para I-EVOLUTION -solicitar I-EVOLUTION -su I-EVOLUTION -reubicación I-EVOLUTION -en I-EVOLUTION -un I-EVOLUTION -puesto I-EVOLUTION -acorde I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -patologías I-EVOLUTION -que I-EVOLUTION -presenta, I-EVOLUTION -donde I-EVOLUTION -pudiera I-EVOLUTION -desempeñar I-EVOLUTION -funciones I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -perjudicaran I-EVOLUTION -su I-EVOLUTION -salud; I-EVOLUTION -en I-EVOLUTION -vista I-EVOLUTION -de I-EVOLUTION -no I-EVOLUTION -tener I-EVOLUTION -un I-EVOLUTION -puesto I-EVOLUTION -con I-EVOLUTION -esas I-EVOLUTION -características I-EVOLUTION -dentro I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -empresa, I-EVOLUTION -la I-EVOLUTION -trabajadora I-EVOLUTION -denuncia I-EVOLUTION -ante I-EVOLUTION -la I-EVOLUTION -inspectoría I-EVOLUTION -del I-EVOLUTION -trabajo I-EVOLUTION -su I-EVOLUTION -situación I-EVOLUTION -y I-EVOLUTION -solicita I-EVOLUTION -una I-EVOLUTION -minusvalía I-EVOLUTION -al I-EVOLUTION -Instituto I-EVOLUTION -de I-EVOLUTION -Mayores I-EVOLUTION -y I-EVOLUTION -Servicios I-EVOLUTION -Sociales, I-EVOLUTION -donde I-EVOLUTION -el I-EVOLUTION -equipo I-EVOLUTION -de I-EVOLUTION -valoración I-EVOLUTION -y I-EVOLUTION -orientación I-EVOLUTION -otorga I-EVOLUTION -un I-EVOLUTION -grado I-EVOLUTION -de I-EVOLUTION -discapacidad I-EVOLUTION -del I-EVOLUTION -65% I-EVOLUTION -según I-EVOLUTION -los I-EVOLUTION -baremos I-EVOLUTION -vigentes I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -fecha I-EVOLUTION -y I-EVOLUTION -además I-EVOLUTION -la I-EVOLUTION -resolución I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -Inspección I-EVOLUTION -de I-EVOLUTION -Trabajo I-EVOLUTION -requiere I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -empresa I-EVOLUTION -realizar I-EVOLUTION -una I-EVOLUTION -adaptación I-EVOLUTION -del I-EVOLUTION -puesto I-EVOLUTION -de I-EVOLUTION -trabajo I-EVOLUTION -ya I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -debe I-EVOLUTION -garantizar I-EVOLUTION -la I-EVOLUTION -reinserción I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -trabajadores I-EVOLUTION -con I-EVOLUTION -minusvalías I-EVOLUTION -por I-EVOLUTION -condiciones I-EVOLUTION -médicas. I-EVOLUTION -Se I-EVOLUTION -replantea I-EVOLUTION -la I-EVOLUTION -adaptación I-EVOLUTION -del I-EVOLUTION -puesto I-EVOLUTION -de I-EVOLUTION -trabajo I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -nueva I-EVOLUTION -valoración I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -riesgos I-EVOLUTION -por I-EVOLUTION -parte I-EVOLUTION -del I-EVOLUTION -Técnico I-EVOLUTION -de I-EVOLUTION -Prevención I-EVOLUTION -en I-EVOLUTION -conjunto I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -Gobernanta, I-EVOLUTION -haciéndolo I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -minuciosa I-EVOLUTION -y I-EVOLUTION -específica, I-EVOLUTION -se I-EVOLUTION -logra I-EVOLUTION -un I-EVOLUTION -acuerdo I-EVOLUTION -para I-EVOLUTION -su I-EVOLUTION -reintegro I-EVOLUTION -a I-EVOLUTION -dicha I-EVOLUTION -área. I-EVOLUTION -Sin I-EVOLUTION -embargo I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -reincorporación, I-EVOLUTION -la I-EVOLUTION -trabajadora I-EVOLUTION -sufre I-EVOLUTION -múltiples I-EVOLUTION -episodios I-EVOLUTION -conflictivospor I-EVOLUTION -parte I-EVOLUTION -de I-EVOLUTION -compañeros, I-EVOLUTION -quienes I-EVOLUTION +forma I-TREATMENT +bilateral. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION se I-EVOLUTION -niegan I-EVOLUTION -a I-EVOLUTION -asumir I-EVOLUTION -gran I-EVOLUTION -parte I-EVOLUTION +evaluó I-EVOLUTION +2 I-EVOLUTION +semanas I-EVOLUTION +después I-EVOLUTION de I-EVOLUTION -sus I-EVOLUTION -actividades I-EVOLUTION -diarias I-EVOLUTION -por I-EVOLUTION la I-EVOLUTION -adaptación I-EVOLUTION -que I-EVOLUTION +aplicación. I-EVOLUTION + I-EVOLUTION +La I-EVOLUTION +exposición I-EVOLUTION +gingival I-EVOLUTION se I-EVOLUTION -ha I-EVOLUTION -realizado. I-EVOLUTION -Pasado I-EVOLUTION -un I-EVOLUTION -tiempo, I-EVOLUTION -su I-EVOLUTION -jefe I-EVOLUTION -inmediato I-EVOLUTION -ha I-EVOLUTION -logrado I-EVOLUTION -establecer I-EVOLUTION -un I-EVOLUTION -plan I-EVOLUTION -de I-EVOLUTION -trabajo I-EVOLUTION -adecuado I-EVOLUTION -para I-EVOLUTION -distribuir I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -homogénea I-EVOLUTION -las I-EVOLUTION -actividades I-EVOLUTION -diarias I-EVOLUTION -de I-EVOLUTION -cocina I-EVOLUTION +redujo I-EVOLUTION +notablemente I-EVOLUTION +desde I-EVOLUTION +la I-EVOLUTION +primera I-EVOLUTION +evaluación I-EVOLUTION y I-EVOLUTION -mejorar I-EVOLUTION -las I-EVOLUTION -relaciones I-EVOLUTION -interpersonales. I-EVOLUTION -Actualmente I-EVOLUTION -desempeña I-EVOLUTION -las I-EVOLUTION -funciones I-EVOLUTION -de I-EVOLUTION -pinche I-EVOLUTION -de I-EVOLUTION -cocina, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +refirió I-EVOLUTION +estar I-EVOLUTION +satisfecha I-EVOLUTION con I-EVOLUTION -las I-EVOLUTION -restricciones I-EVOLUTION -impuestas I-EVOLUTION -por I-EVOLUTION el I-EVOLUTION -Servicio I-EVOLUTION +tratamiento, I-EVOLUTION +resultado I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +mantuvo I-EVOLUTION +sin I-EVOLUTION +la I-EVOLUTION +necesidad I-EVOLUTION de I-EVOLUTION -Prevención I-EVOLUTION +nuevas I-EVOLUTION +aplicaciones I-EVOLUTION de I-EVOLUTION -Riesgos I-EVOLUTION -Laborales, I-EVOLUTION -además I-EVOLUTION -acude I-EVOLUTION -a I-EVOLUTION -reconocimientos I-EVOLUTION -médicos I-EVOLUTION -anuales I-EVOLUTION -valorando I-EVOLUTION la I-EVOLUTION -evolución I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -patología. I-EVOLUTION +medicación I-EVOLUTION +por I-EVOLUTION +6 I-EVOLUTION +meses. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Paciente B-PAST_MEDICAL_HISTORY +chileno, I-PAST_MEDICAL_HISTORY +masculino, B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -53 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +59 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -reconocimiento I-PRESENT_ILLNESS -medico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +viaje I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -abril I-PRESENT_ILLNESS -2015. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -- B-PAST_MEDICAL_HISTORY -Antecedentes I-PAST_MEDICAL_HISTORY -personales: I-PAST_MEDICAL_HISTORY -bocio I-PAST_MEDICAL_HISTORY -coloide I-PAST_MEDICAL_HISTORY -(tiroidectomía I-PAST_MEDICAL_HISTORY -total I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2010), I-PAST_MEDICAL_HISTORY -intervención I-PAST_MEDICAL_HISTORY -quirúrgica I-PAST_MEDICAL_HISTORY -debida I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -hernia I-PAST_MEDICAL_HISTORY -cervical I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -accidente I-PAST_MEDICAL_HISTORY +el I-PRESENT_ILLNESS +Cuzco, I-PRESENT_ILLNESS +Perú, I-PRESENT_ILLNESS +inicia I-PRESENT_ILLNESS +súbitamente I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +disnea I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +reposo I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +agrega I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +epigástrico I-PRESENT_ILLNESS +intenso, I-PRESENT_ILLNESS +sensación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +distensión I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +compromiso I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +estado I-PRESENT_ILLNESS +general. I-PRESENT_ILLNESS +Se B-TREATMENT +diagnostica I-TREATMENT +mal I-TREATMENT +de I-TREATMENT +altura I-TREATMENT +agudo, I-TREATMENT +recibiendo I-TREATMENT +furosemida, I-TREATMENT +acetazolamida, I-TREATMENT +dexametasona, I-TREATMENT +ranitidina I-TREATMENT +y I-TREATMENT +ceftriaxona. I-TREATMENT + B-EVOLUTION +En I-EVOLUTION +Chile, I-EVOLUTION +6 I-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +consultó I-EVOLUTION +por I-EVOLUTION +persistir I-EVOLUTION +con I-EVOLUTION +idéntica I-EVOLUTION +sintomatología I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +derivado I-EVOLUTION +al I-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Urgencia I-EVOLUTION +del I-EVOLUTION +Hospital I-EVOLUTION +Clínico I-EVOLUTION +Universidad I-EVOLUTION +de I-EVOLUTION +Chile I-EVOLUTION +por I-EVOLUTION +sospecha I-EVOLUTION +de I-EVOLUTION +tromboembolismo I-EVOLUTION +pulmonar. I-EVOLUTION +Ingresó B-EXPLORATION +afebril, I-EXPLORATION +disneico, I-EXPLORATION +con I-EXPLORATION +tope I-EXPLORATION +inspiratorio I-EXPLORATION +y I-EXPLORATION +distensión I-EXPLORATION +abdominal. I-EXPLORATION +Tenía B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -tráfico I-PAST_MEDICAL_HISTORY -(1995). I-PAST_MEDICAL_HISTORY -Menopausia I-PAST_MEDICAL_HISTORY -precoz, I-PAST_MEDICAL_HISTORY -anemia I-PAST_MEDICAL_HISTORY -hipocrómica, I-PAST_MEDICAL_HISTORY -accidente I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -tráfico I-PAST_MEDICAL_HISTORY -(2009), I-PAST_MEDICAL_HISTORY +apnea-hipopnea I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +sueño, I-PAST_MEDICAL_HISTORY +trastorno I-PAST_MEDICAL_HISTORY +bipolar I-PAST_MEDICAL_HISTORY +manejado I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +ácido I-PAST_MEDICAL_HISTORY +valproico, I-PAST_MEDICAL_HISTORY rinitis I-PAST_MEDICAL_HISTORY -vasomotora I-PAST_MEDICAL_HISTORY -alergia I-PAST_MEDICAL_HISTORY -extrínseca I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -polen I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -asma, I-PAST_MEDICAL_HISTORY -gonalgia, I-PAST_MEDICAL_HISTORY -hipocalcemia, I-PAST_MEDICAL_HISTORY -adenoma I-PAST_MEDICAL_HISTORY -tubular I-PAST_MEDICAL_HISTORY +alérgica, I-PAST_MEDICAL_HISTORY +várices I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +miembros I-PAST_MEDICAL_HISTORY +inferiores, I-PAST_MEDICAL_HISTORY +apendicectomizado, I-PAST_MEDICAL_HISTORY +tabáquico I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -colon I-PAST_MEDICAL_HISTORY -(2014), I-PAST_MEDICAL_HISTORY -obesidad. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Hace I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +paquetes-año, I-PAST_MEDICAL_HISTORY +bebedor I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -aparecen I-PAST_MEDICAL_HISTORY -lesiones I-PAST_MEDICAL_HISTORY -pigmentada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -dorsal I-PAST_MEDICAL_HISTORY -siendo I-PAST_MEDICAL_HISTORY -diagnosticadas I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +copas I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -notalgia I-PAST_MEDICAL_HISTORY -parestésica. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -relaciona I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -aparición I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -ninguna I-PAST_MEDICAL_HISTORY -situación I-PAST_MEDICAL_HISTORY -especial, I-PAST_MEDICAL_HISTORY -no B-FAMILY_HISTORY -refiere I-FAMILY_HISTORY -otros I-FAMILY_HISTORY -casos I-FAMILY_HISTORY -en I-FAMILY_HISTORY -familiares. I-FAMILY_HISTORY - I-FAMILY_HISTORY -- B-EXPLORATION -Exploración I-EXPLORATION -física: I-EXPLORATION -mácula I-EXPLORATION -hiperpigmentada I-EXPLORATION +vino I-PAST_MEDICAL_HISTORY +diarias I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +30 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Signos B-EXPLORATION +vitales: I-EXPLORATION +Pulso I-EXPLORATION +81, I-EXPLORATION +ventilación I-EXPLORATION +18 I-EXPLORATION +por I-EXPLORATION +minuto, I-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION +102-67 I-EXPLORATION +mmHg, I-EXPLORATION +temperatura I-EXPLORATION +axilar I-EXPLORATION +36°C. I-EXPLORATION +Al I-EXPLORATION +examen: I-EXPLORATION en I-EXPLORATION -zona I-EXPLORATION -supraescapular; I-EXPLORATION -contracturas I-EXPLORATION -musculares I-EXPLORATION +decúbito I-EXPLORATION +dorsal, I-EXPLORATION +consciente, I-EXPLORATION +hidratado, I-EXPLORATION +bien I-EXPLORATION +perfundido, I-EXPLORATION +piel I-EXPLORATION +blanca, I-EXPLORATION +pálida. I-EXPLORATION +Destacaba I-EXPLORATION +abdomen I-EXPLORATION +doloroso I-EXPLORATION en I-EXPLORATION -zona I-EXPLORATION +hipocondrio I-EXPLORATION +izquierdo, I-EXPLORATION +con I-EXPLORATION +bazo I-EXPLORATION +aumentado I-EXPLORATION +de I-EXPLORATION +tamaño, I-EXPLORATION +várices I-EXPLORATION +en I-EXPLORATION +extremidades I-EXPLORATION +inferiores. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +del I-EXPLORATION +examen I-EXPLORATION +era I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio: I-EXPLORATION +hemograma I-EXPLORATION +con I-EXPLORATION +hematocrito I-EXPLORATION +27, I-EXPLORATION +1%, I-EXPLORATION +hemoglobina I-EXPLORATION +8, I-EXPLORATION +7 I-EXPLORATION +g/dl, I-EXPLORATION +VCM I-EXPLORATION +y I-EXPLORATION +CHCM I-EXPLORATION +normales, I-EXPLORATION +leucocitos I-EXPLORATION +10.100/uL, I-EXPLORATION +VHS I-EXPLORATION +28 I-EXPLORATION +mm/hr, I-EXPLORATION +tiempo I-EXPLORATION +de I-EXPLORATION +protrombina I-EXPLORATION +y I-EXPLORATION +TTPK I-EXPLORATION +normales. I-EXPLORATION +Dímero I-EXPLORATION +D I-EXPLORATION +4.683 I-EXPLORATION +ng/ml I-EXPLORATION +(normal I-EXPLORATION +< I-EXPLORATION +500), I-EXPLORATION +LDH I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +1.247 I-EXPLORATION +(rango: I-EXPLORATION +313-618), I-EXPLORATION +proBNP, I-EXPLORATION +CK, I-EXPLORATION +CK-MB I-EXPLORATION +y I-EXPLORATION +troponinas I-EXPLORATION +normales. I-EXPLORATION +Angio-TAC I-EXPLORATION +pulmonar I-EXPLORATION +descartó I-EXPLORATION +tromboembolismo I-EXPLORATION +y I-EXPLORATION +demostró I-EXPLORATION +un I-EXPLORATION +hematoma I-EXPLORATION +periesplénico, I-EXPLORATION +subcapsular I-EXPLORATION +de I-EXPLORATION +17 I-EXPLORATION +cm, I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +ingresado I-EVOLUTION +a I-EVOLUTION +cuidados I-EVOLUTION +intermedios I-EVOLUTION +con I-EVOLUTION +diagnóstico I-EVOLUTION +probable I-EVOLUTION +de I-EVOLUTION +infarto I-EVOLUTION +esplénico I-EVOLUTION +con I-EVOLUTION +transformación I-EVOLUTION +hemorrágica. I-EVOLUTION + I-EVOLUTION +Hemogramas B-EXPLORATION +seriados I-EXPLORATION +no I-EXPLORATION +mostraron I-EXPLORATION +cambios, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +ecocardiografía I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +que I-EXPLORATION +reveló I-EXPLORATION +crecimiento I-EXPLORATION +del I-EXPLORATION +hematoma I-EXPLORATION +esplénico I-EXPLORATION +a I-EXPLORATION +19 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro. I-EXPLORATION +Ante B-EVOLUTION +estabilidad I-EVOLUTION +clínica I-EVOLUTION +fue I-EVOLUTION +trasladado I-EVOLUTION +a I-EVOLUTION +sala I-EVOLUTION +en I-EVOLUTION +cirugía. I-EVOLUTION + I-EVOLUTION +La B-EXPLORATION +clínica I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +laboratorio I-EXPLORATION +no I-EXPLORATION +sugerían I-EXPLORATION +etiologías I-EXPLORATION +infecciosas I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +hematoma I-EXPLORATION +esplénico, I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +había I-EXPLORATION +elementos I-EXPLORATION +sospechosos I-EXPLORATION +de I-EXPLORATION +síndromes I-EXPLORATION +mieloproliferativos, I-EXPLORATION +linfoproliferativos I-EXPLORATION +u I-EXPLORATION +otra I-EXPLORATION +neoplasia I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +estudios I-EXPLORATION +de I-EXPLORATION +tomografía I-EXPLORATION +y I-EXPLORATION +bioquímicos. I-EXPLORATION +Hemogramas I-EXPLORATION +previos I-EXPLORATION +a I-EXPLORATION +este I-EXPLORATION +evento I-EXPLORATION +eran I-EXPLORATION +normales. I-EXPLORATION +Ante I-EXPLORATION +el I-EXPLORATION +cuadro I-EXPLORATION +de I-EXPLORATION +síndrome I-EXPLORATION +esplénico, I-EXPLORATION +pese I-EXPLORATION +a I-EXPLORATION +ser I-EXPLORATION +una I-EXPLORATION +causa I-EXPLORATION +rara, I-EXPLORATION +fue I-EXPLORATION +estudiado I-EXPLORATION +para I-EXPLORATION +un I-EXPLORATION +posible I-EXPLORATION +rasgo I-EXPLORATION +falciforme I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +prueba I-EXPLORATION +de I-EXPLORATION +inducción I-EXPLORATION +de I-EXPLORATION +drepanocitos I-EXPLORATION +con I-EXPLORATION +metabisulfito I-EXPLORATION +de I-EXPLORATION +sodio I-EXPLORATION +al I-EXPLORATION +2%, I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +positiva. I-EXPLORATION +Dada B-TREATMENT +la I-TREATMENT +evolución I-TREATMENT +intrahospitalaria I-TREATMENT +favorable, I-TREATMENT +acompañado I-TREATMENT +de I-TREATMENT +laboratorio I-TREATMENT +general I-TREATMENT +y I-TREATMENT +estudios I-TREATMENT +radiológicos I-TREATMENT +sin I-TREATMENT +progresión, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +no I-TREATMENT +intervenir I-TREATMENT +quirúrgicamente I-TREATMENT +y B-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta. I-EVOLUTION + I-EVOLUTION +En B-EXPLORATION +control I-EXPLORATION +ambulatorio I-EXPLORATION +por I-EXPLORATION +hematología I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +electroforesis I-EXPLORATION +de I-EXPLORATION +hemoglobina I-EXPLORATION +en I-EXPLORATION +medio I-EXPLORATION +alcalino I-EXPLORATION +que I-EXPLORATION +reveló I-EXPLORATION +hemoglobina I-EXPLORATION +normal I-EXPLORATION +A I-EXPLORATION +54, I-EXPLORATION +8% I-EXPLORATION +y I-EXPLORATION +41, I-EXPLORATION +8% I-EXPLORATION +de I-EXPLORATION +fracción I-EXPLORATION +3, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +hemoglobina I-EXPLORATION +S I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +diagnosticó I-EXPLORATION +rasgo I-EXPLORATION +falciforme. I-EXPLORATION + I-EXPLORATION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +75 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +curso I-PRESENT_ILLNESS +lentamente I-PRESENT_ILLNESS +progresivo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +describe I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +«pinchazos» I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +puntas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +dedos, I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +«acorchamiento», I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +inicialmente I-PRESENT_ILLNESS +notaba I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +ambas I-PRESENT_ILLNESS +manos I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +sensación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +tacto, I-PRESENT_ILLNESS +pero I-PRESENT_ILLNESS +que, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +último I-PRESENT_ILLNESS +mes, I-PRESENT_ILLNESS +también I-PRESENT_ILLNESS +afecta I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +ambos I-PRESENT_ILLNESS +pies. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +neurológica, I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +hipoestesia I-EXPLORATION +táctil I-EXPLORATION +con I-EXPLORATION +distribución I-EXPLORATION +en I-EXPLORATION +«guante» I-EXPLORATION +y I-EXPLORATION +«calcetín», I-EXPLORATION +apalestesia I-EXPLORATION +maleolar I-EXPLORATION +e I-EXPLORATION +hipopalestesia I-EXPLORATION +en I-EXPLORATION +crestas I-EXPLORATION +tibiales I-EXPLORATION +y I-EXPLORATION +codos. I-EXPLORATION +Los I-EXPLORATION +reflejos I-EXPLORATION +estaban I-EXPLORATION +presentes I-EXPLORATION +y I-EXPLORATION +eran I-EXPLORATION +simétricos. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +neurológica I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +parestesias, I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +alteración I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +sensibilidad I-EXPLORATION +vibratoria I-EXPLORATION +y I-EXPLORATION +preservación I-EXPLORATION +de I-EXPLORATION +reflejos I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +exploración I-EXPLORATION +neurológica, I-EXPLORATION +obliga I-EXPLORATION +a I-EXPLORATION +considerar I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +sufra I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +medular I-EXPLORATION +cervical I-EXPLORATION +con I-EXPLORATION +afectación I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +cordones I-EXPLORATION +posteriores. I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +analítica I-EXPLORATION +(incluyendo I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +vitamina I-EXPLORATION +B12), I-EXPLORATION +una I-EXPLORATION +RM I-EXPLORATION +cervical I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION +neurofisiológico. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +RM I-EXPLORATION +cervical I-EXPLORATION +(Magnetom-Trio, I-EXPLORATION +Siemens, I-EXPLORATION +Erlangen, I-EXPLORATION +Germany) I-EXPLORATION +mostró I-EXPLORATION +en I-EXPLORATION +secuencias I-EXPLORATION +potenciadas I-EXPLORATION +en I-EXPLORATION +T2 I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +plano I-EXPLORATION +sagital I-EXPLORATION +una I-EXPLORATION +hiperintensidad I-EXPLORATION +de I-EXPLORATION +señal I-EXPLORATION +sin I-EXPLORATION +efecto I-EXPLORATION +de I-EXPLORATION +masa I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +cordonal I-EXPLORATION +posterior I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +extendía I-EXPLORATION +desde I-EXPLORATION +C1-C2 I-EXPLORATION +a I-EXPLORATION +C6-C7. I-EXPLORATION +En I-EXPLORATION +los I-EXPLORATION +cortes I-EXPLORATION +axiales I-EXPLORATION +y I-EXPLORATION +coronales I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +afectación I-EXPLORATION +era I-EXPLORATION +bilateral I-EXPLORATION +y I-EXPLORATION +simétrica. I-EXPLORATION +Estos I-EXPLORATION +hallazgos I-EXPLORATION +son I-EXPLORATION +característicos I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +DCS. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +polineuropatía I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +velocidades I-EXPLORATION +de I-EXPLORATION +conducción, I-EXPLORATION +mientras I-EXPLORATION +que I-EXPLORATION +los I-EXPLORATION +potenciales I-EXPLORATION +evocados I-EXPLORATION +somatosensoriales I-EXPLORATION +estaban I-EXPLORATION +desestructurados I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +latencias I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +cuatro I-EXPLORATION +miembros, I-EXPLORATION +indicando I-EXPLORATION +una I-EXPLORATION +afectación I-EXPLORATION +cordonal I-EXPLORATION +posterior. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +hemograma I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +discreta I-EXPLORATION +anemia I-EXPLORATION +megaloblástica, I-EXPLORATION +con I-EXPLORATION +4, I-EXPLORATION +44 I-EXPLORATION +10E12/L I-EXPLORATION +de I-EXPLORATION +hematíes I-EXPLORATION +(4, I-EXPLORATION +7-5, I-EXPLORATION +1 I-EXPLORATION +10E12/L), I-EXPLORATION +VCM: I-EXPLORATION +108 I-EXPLORATION +fL I-EXPLORATION +(80-95 I-EXPLORATION +fL) I-EXPLORATION +y I-EXPLORATION +HCM: I-EXPLORATION +34, I-EXPLORATION +9 I-EXPLORATION +pg I-EXPLORATION +(27-31 I-EXPLORATION +pg), I-EXPLORATION +siendo I-EXPLORATION +la I-EXPLORATION +hemoglobina I-EXPLORATION +(15, I-EXPLORATION +5 I-EXPLORATION +g/dl) I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +hematocrito I-EXPLORATION +(47,9%) I-EXPLORATION +normales. I-EXPLORATION +Los I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +vitamina I-EXPLORATION +B12 I-EXPLORATION +en I-EXPLORATION +suero I-EXPLORATION +fueron I-EXPLORATION +de I-EXPLORATION +78 I-EXPLORATION +pg/mL I-EXPLORATION +(210-930 I-EXPLORATION +pg/mL) I-EXPLORATION +y I-EXPLORATION +los I-EXPLORATION +de I-EXPLORATION +ácido I-EXPLORATION +fólico I-EXPLORATION +de I-EXPLORATION +26, I-EXPLORATION +5 I-EXPLORATION +ng/mL I-EXPLORATION +(2, I-EXPLORATION +2-16, I-EXPLORATION +9 I-EXPLORATION +ng/mL), I-EXPLORATION +siendo I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +determinaciones I-EXPLORATION +bioquímicas I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +normales. I-EXPLORATION +Los I-EXPLORATION +anticuerpos I-EXPLORATION +frente I-EXPLORATION +a I-EXPLORATION +células I-EXPLORATION +parietales I-EXPLORATION +gástricas I-EXPLORATION +fueron I-EXPLORATION +positivos I-EXPLORATION +(1/40), I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +los I-EXPLORATION +anticuerpos I-EXPLORATION +anti-FI I-EXPLORATION +(factor I-EXPLORATION +intrínseco) I-EXPLORATION +(>97, I-EXPLORATION +9; I-EXPLORATION +normal: I-EXPLORATION +0-25). I-EXPLORATION +La I-EXPLORATION +biopsia I-EXPLORATION +gástrica I-EXPLORATION +mostró I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +gastritis I-EXPLORATION +crónica I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +atrófico, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION +del I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio. I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +DSC I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +cianocobalamina I-TREATMENT +(1.000 I-TREATMENT +µ/día I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +intramuscular, I-TREATMENT +durante I-TREATMENT +dos I-TREATMENT +semanas I-TREATMENT +y I-TREATMENT +después I-TREATMENT +mensualmente). I-TREATMENT +En B-EVOLUTION +los I-EVOLUTION +meses I-EVOLUTION +siguientes I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +progresiva I-EVOLUTION +mejoría I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +alteraciones I-EVOLUTION +sensitivas. I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +10 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +evolución, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +refería I-EVOLUTION +una I-EVOLUTION +leve I-EVOLUTION +e I-EVOLUTION +inconstante I-EVOLUTION +sensación I-EVOLUTION +de I-EVOLUTION +«hormigueos» I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +pies I-EVOLUTION +y B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +neurológica I-EXPLORATION +solo I-EXPLORATION +mostraba I-EXPLORATION +una I-EXPLORATION +discreta I-EXPLORATION +hipopalestesia I-EXPLORATION +maleolar. I-EXPLORATION +La I-EXPLORATION +analítica I-EXPLORATION de I-EXPLORATION -ambos I-EXPLORATION -trapecios I-EXPLORATION +control I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +resolución I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +anemia I-EXPLORATION +megaloblásica I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +vitamina I-EXPLORATION +B12 I-EXPLORATION +(438 I-EXPLORATION +pg/mL). I-EXPLORATION +Una I-EXPLORATION +RM I-EXPLORATION +medular I-EXPLORATION +de I-EXPLORATION +control, I-EXPLORATION +utilizando I-EXPLORATION +el I-EXPLORATION +mismo I-EXPLORATION +equipo, I-EXPLORATION +puso I-EXPLORATION +de I-EXPLORATION +manifiesto I-EXPLORATION +la I-EXPLORATION +completa I-EXPLORATION +desaparición I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION y I-EXPLORATION -zona I-EXPLORATION -supraescapular I-EXPLORATION -izquierda. I-EXPLORATION +la I-EXPLORATION +normalidad I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +intensidad I-EXPLORATION +de I-EXPLORATION +señal I-EXPLORATION +del I-EXPLORATION +cordón I-EXPLORATION +medular. I-EXPLORATION I-EXPLORATION -- I-EXPLORATION -Síntomas: I-EXPLORATION -refiere I-EXPLORATION -mucho I-EXPLORATION -prurito I-EXPLORATION -y I-EXPLORATION -"pinchazos", I-EXPLORATION -mejora I-EXPLORATION -cuando I-EXPLORATION -está I-EXPLORATION -más I-EXPLORATION -relajada I-EXPLORATION + +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +85 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +colelitiasis I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +irradiado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +espalda, I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +hematoquecia. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +leucocitosis I-EXPLORATION +(14.300, I-EXPLORATION +neutrófilos I-EXPLORATION +84, I-EXPLORATION +5%), I-EXPLORATION +hemoglobina I-EXPLORATION +7 I-EXPLORATION +g/dl, I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +179 I-EXPLORATION +mg/l, I-EXPLORATION +amilasa I-EXPLORATION +648 I-EXPLORATION +U/l, I-EXPLORATION +lipasa I-EXPLORATION +1.417 I-EXPLORATION +U/l I-EXPLORATION y I-EXPLORATION -tras I-EXPLORATION -tratamiento I-EXPLORATION -rehabilitador I-EXPLORATION +patrón I-EXPLORATION +colestático. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION +abdominal I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +engrosamiento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +vesicular, I-EXPLORATION con I-EXPLORATION -fisioterapia I-EXPLORATION +colelitiasis I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +proceso I-EXPLORATION +inflamatorio I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cola I-EXPLORATION +pancreática. I-EXPLORATION +Dado I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +HDA I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +anemia I-EXPLORATION +continuaron, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +angio-TC I-EXPLORATION +abdominal, I-EXPLORATION +visualizándose I-EXPLORATION +una I-EXPLORATION +estructura I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -contracturas I-EXPLORATION -musculares. I-EXPLORATION -Los I-EXPLORATION -síntomas I-EXPLORATION -empeoran I-EXPLORATION +contornos I-EXPLORATION +lobulados I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vesícula, I-EXPLORATION +hiperdensa I-EXPLORATION +en I-EXPLORATION +fase I-EXPLORATION +arterial, I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +cambiaba I-EXPLORATION +su I-EXPLORATION +morfología I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +venoso, I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION +un I-EXPLORATION +pseudoaneurisma I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +cística. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +final I-EXPLORATION +fue I-EXPLORATION el I-EXPLORATION -rascado. I-EXPLORATION - I-EXPLORATION -- B-TREATMENT -Tratamiento: I-TREATMENT -no I-TREATMENT -ha I-TREATMENT -requerido I-TREATMENT -tratamiento I-TREATMENT -específico I-TREATMENT -salvo I-TREATMENT -hidratación I-TREATMENT -y I-TREATMENT -evitar I-TREATMENT -irritación I-TREATMENT +de I-EXPLORATION +pancreatitis I-EXPLORATION +aguda I-EXPLORATION +secundaria I-EXPLORATION +a I-EXPLORATION +hemobilia I-EXPLORATION +por I-EXPLORATION +sangrado I-EXPLORATION +de I-EXPLORATION +pseudoaneurisma I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +cística. I-EXPLORATION +Se B-TREATMENT +procedió I-TREATMENT +a I-TREATMENT la I-TREATMENT -zona. I-TREATMENT - I-TREATMENT +embolización I-TREATMENT +con B-EVOLUTION +recuperación I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +paciente. I-EVOLUTION + I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS +26 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -reconocimiento I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -abril I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2015. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -- B-PAST_MEDICAL_HISTORY -Antecedentes I-PAST_MEDICAL_HISTORY -personales: I-PAST_MEDICAL_HISTORY -alergia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -gramíneas, I-PAST_MEDICAL_HISTORY -condromalacia I-PAST_MEDICAL_HISTORY -bilateral, I-PAST_MEDICAL_HISTORY -lumbalgia I-PAST_MEDICAL_HISTORY -(RMN I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2015: I-PAST_MEDICAL_HISTORY -prolapso I-PAST_MEDICAL_HISTORY -discal), I-PAST_MEDICAL_HISTORY -contracturas I-PAST_MEDICAL_HISTORY -cervicodorsales, I-PAST_MEDICAL_HISTORY -urticaria I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2011que I-PAST_MEDICAL_HISTORY -duró I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -causa I-PAST_MEDICAL_HISTORY -probada I-PAST_MEDICAL_HISTORY -(tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -Xazal I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -remisión). I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Hace I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -apareció I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -lesión I-PAST_MEDICAL_HISTORY -pigmentada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -dorsal, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -eccema I-PAST_MEDICAL_HISTORY -inespecífico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -corticoides I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -unos I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -(por I-PAST_MEDICAL_HISTORY -dermatólogo) I-PAST_MEDICAL_HISTORY +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -notalgia I-PAST_MEDICAL_HISTORY -parestestica. I-PAST_MEDICAL_HISTORY -Habitualmente B-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -contracturas I-PRESENT_ILLNESS -cervicodorsales I-PRESENT_ILLNESS -tensionales I-PRESENT_ILLNESS +interés I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +hábitos I-PAST_MEDICAL_HISTORY +tóxicos. I-PAST_MEDICAL_HISTORY +Presenta B-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +difuso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +aparición I-PRESENT_ILLNESS +brusca, I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +biliosos I-PRESENT_ILLNESS +incoercibles I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -estrés. I-PRESENT_ILLNESS -Refiere I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS +sudoración I-PRESENT_ILLNESS +profusa. I-PRESENT_ILLNESS +A I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +cinco I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +inicio I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +rectorragia I-PRESENT_ILLNESS +abundante I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -piel I-PRESENT_ILLNESS -mejoró I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS +sangre I-PRESENT_ILLNESS +fresca I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -relajantes I-PRESENT_ILLNESS -muscularespor I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS +coágulos, I-PRESENT_ILLNESS +emisión I-PRESENT_ILLNESS +independiente I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -lumbalgia I-PRESENT_ILLNESS -aguda. I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +alivio I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +dolor. I-PRESENT_ILLNESS No I-PRESENT_ILLNESS -relaciona I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -ninguna I-PRESENT_ILLNESS -situación I-PRESENT_ILLNESS -especial, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -otros I-PRESENT_ILLNESS -casos I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +otra I-PRESENT_ILLNESS +sintomatología I-PRESENT_ILLNESS +asociada. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +encontraba I-PRESENT_ILLNESS +destacado I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -familiares. I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +extranjero I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +misión I-PRESENT_ILLNESS +militar I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +haber I-PRESENT_ILLNESS +realizado I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +centrales I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +alta I-PRESENT_ILLNESS +temperatura I-PRESENT_ILLNESS +ambiente, I-PRESENT_ILLNESS +sesiones I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +entrenamiento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +20 I-PRESENT_ILLNESS +minutos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +musculación I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +carrera I-PRESENT_ILLNESS +continua. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +inicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +clínica, I-PRESENT_ILLNESS +además, I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +entrenamiento I-PRESENT_ILLNESS +comenzó I-PRESENT_ILLNESS +inmediatamente I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +ingesta I-PRESENT_ILLNESS +copiosa I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +alimento. I-PRESENT_ILLNESS I-PRESENT_ILLNESS -- I-PRESENT_ILLNESS -Exploración B-EXPLORATION -física: I-EXPLORATION -mácula I-EXPLORATION -hiperpigmentada I-EXPLORATION -en I-EXPLORATION -zona I-EXPLORATION -dorsal I-EXPLORATION -media I-EXPLORATION +El I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +trasladado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +local I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +mal I-PRESENT_ILLNESS +estado I-PRESENT_ILLNESS +general I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +febrícula, I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +objetivó I-PRESENT_ILLNESS +"leucocitosis I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +elevación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +creatinina" I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +realizó I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +colonoscopia I-PRESENT_ILLNESS +cuyo I-PRESENT_ILLNESS +informe I-PRESENT_ILLNESS +refleja I-PRESENT_ILLNESS +gran I-PRESENT_ILLNESS +cantidad I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sangre I-PRESENT_ILLNESS +intraluminal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mucosa I-PRESENT_ILLNESS +intensamente I-PRESENT_ILLNESS +edematosa I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +sigma I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +impide I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +paso I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +endoscopio. I-PRESENT_ILLNESS +Fue I-PRESENT_ILLNESS +mantenido I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +observación I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dieta I-PRESENT_ILLNESS +absoluta, I-PRESENT_ILLNESS +sueroterapia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +ciprofloxacino I-PRESENT_ILLNESS +intravenoso. I-PRESENT_ILLNESS +Ante B-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +persistencia I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +clínica I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +aparición I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +somnolencia I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +palidez I-DERIVED_FROM/TO +cérea, I-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +médicos I-DERIVED_FROM/TO +militares I-DERIVED_FROM/TO +españoles I-DERIVED_FROM/TO +encargados I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +solicitaron I-DERIVED_FROM/TO +evacuación I-DERIVED_FROM/TO +aérea I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +centro. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +A B-EXPLORATION +su I-EXPLORATION +llegada, I-EXPLORATION +48 I-EXPLORATION +horas I-EXPLORATION +después I-EXPLORATION +del I-EXPLORATION +inicio I-EXPLORATION +del I-EXPLORATION +cuadro, I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +estaba I-EXPLORATION +hipertenso, I-EXPLORATION +taquicárdico, I-EXPLORATION +con I-EXPLORATION +buena I-EXPLORATION +saturación I-EXPLORATION +basal I-EXPLORATION +de I-EXPLORATION +oxígeno I-EXPLORATION y I-EXPLORATION -lateral I-EXPLORATION -derecha, I-EXPLORATION -contracturas I-EXPLORATION -musculares I-EXPLORATION +febrícula. I-EXPLORATION +A I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +destacaba I-EXPLORATION +un I-EXPLORATION +abdomen I-EXPLORATION +blando, I-EXPLORATION +discretamente I-EXPLORATION +distendido I-EXPLORATION +y I-EXPLORATION +timpánico, I-EXPLORATION +doloroso I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +(superficial I-EXPLORATION +y I-EXPLORATION +profunda) I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +difusa, I-EXPLORATION +con I-EXPLORATION +contractura I-EXPLORATION +voluntaria I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +musculatura, I-EXPLORATION +sin I-EXPLORATION +claros I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +irritación I-EXPLORATION +peritoneal I-EXPLORATION +y I-EXPLORATION +ruidos I-EXPLORATION +hidroaéreos I-EXPLORATION +presentes. I-EXPLORATION +Al I-EXPLORATION +tacto I-EXPLORATION +rectal I-EXPLORATION +el I-EXPLORATION +dedil I-EXPLORATION +mostraba I-EXPLORATION +restos I-EXPLORATION +hemáticos I-EXPLORATION +frescos. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +analítica I-EXPLORATION +completa I-EXPLORATION +con I-EXPLORATION +leucocitosis I-EXPLORATION +de I-EXPLORATION +26.010 I-EXPLORATION +células I-EXPLORATION +(85% I-EXPLORATION +neutrófilos) I-EXPLORATION +y I-EXPLORATION +glucosa I-EXPLORATION +146 I-EXPLORATION +mg/dl I-EXPLORATION +como I-EXPLORATION +únicos I-EXPLORATION +hallazgos. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +TC I-EXPLORATION +abdominopélvica I-EXPLORATION +(sin I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +contraste I-EXPLORATION +intravenoso) I-EXPLORATION en I-EXPLORATION -zona I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +halló I-EXPLORATION +una I-EXPLORATION +marcada I-EXPLORATION +dilatación I-EXPLORATION +del I-EXPLORATION +colon I-EXPLORATION +con I-EXPLORATION +engrosamiento I-EXPLORATION +difuso I-EXPLORATION de I-EXPLORATION -ambos I-EXPLORATION -trapecios I-EXPLORATION +la I-EXPLORATION +pared, I-EXPLORATION +afectación I-EXPLORATION +de I-EXPLORATION +grasa I-EXPLORATION +pericólica, I-EXPLORATION +gran I-EXPLORATION +cantidad I-EXPLORATION +de I-EXPLORATION +líquido I-EXPLORATION +libre I-EXPLORATION +intraabdominal I-EXPLORATION y I-EXPLORATION -músculos I-EXPLORATION -paravertebrales I-EXPLORATION +múltiples I-EXPLORATION +ganglios I-EXPLORATION +mesentéricos I-EXPLORATION +menores I-EXPLORATION de I-EXPLORATION +1 I-EXPLORATION +cm. I-EXPLORATION +Se I-EXPLORATION +descartaron I-EXPLORATION la I-EXPLORATION -zona I-EXPLORATION -cervicodorsal. I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +perforación I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +defectos I-EXPLORATION +de I-EXPLORATION +repleción I-EXPLORATION +vasculares. I-EXPLORATION I-EXPLORATION -- I-EXPLORATION -Síntomas: I-EXPLORATION -prurito. I-EXPLORATION +Se I-EXPLORATION +completó I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +colonoscopia I-EXPLORATION +urgente I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +solo I-EXPLORATION +pudieron I-EXPLORATION +introducirse I-EXPLORATION +100 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +endoscopio I-EXPLORATION +debido I-EXPLORATION +al I-EXPLORATION +alto I-EXPLORATION +riesgo I-EXPLORATION +de I-EXPLORATION +perforación, I-EXPLORATION +se I-EXPLORATION +objetivaron I-EXPLORATION +ulceraciones I-EXPLORATION +geográficas I-EXPLORATION +profundas I-EXPLORATION +desde I-EXPLORATION +la I-EXPLORATION +unión I-EXPLORATION +rectosigma I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +mucosa I-EXPLORATION +edematosa I-EXPLORATION +con I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +hematoma I-EXPLORATION +submucoso, I-EXPLORATION +más I-EXPLORATION +intensas I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +regiones I-EXPLORATION +proximales I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +aspecto I-EXPLORATION +pseudotumoral I-EXPLORATION +(que I-EXPLORATION +se I-EXPLORATION +biopsiaron). I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +endoscópico I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +colitis I-EXPLORATION +isquémica, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +posteriormente I-EXPLORATION +con I-EXPLORATION +los I-EXPLORATION +resultados I-EXPLORATION +anatomopatológicos. I-EXPLORATION I-EXPLORATION -- I-EXPLORATION -Tratamiento: B-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -refiere I-TREATMENT -que I-TREATMENT -los I-TREATMENT -dermatólogos I-TREATMENT -que I-TREATMENT -lo I-TREATMENT -habían I-TREATMENT -visto I-TREATMENT -inicialmente I-TREATMENT -lo I-TREATMENT -diagnosticaban I-TREATMENT -más I-TREATMENT -como I-TREATMENT -un I-TREATMENT -eczema I-TREATMENT -inespecífico I-TREATMENT -y I-TREATMENT -lo I-TREATMENT -trataron I-TREATMENT -con I-TREATMENT -corticoides I-TREATMENT -tópicos, I-TREATMENT -que I-TREATMENT -remitían I-TREATMENT -parcialmente I-TREATMENT -la I-TREATMENT -sintomatología, I-TREATMENT -con I-TREATMENT -recaídas I-TREATMENT -continuadas I-TREATMENT -tras I-TREATMENT -cese I-TREATMENT -de I-TREATMENT -tratamiento. I-TREATMENT -Los I-TREATMENT -síntomas I-TREATMENT -mejoran I-TREATMENT -con I-TREATMENT -crema I-TREATMENT -hidratante I-TREATMENT -tipo I-TREATMENT -urea; I-TREATMENT -el I-TREATMENT -rascado I-TREATMENT -empeora I-TREATMENT -los I-TREATMENT -síntomas I-TREATMENT -y I-TREATMENT -provoca I-TREATMENT -aumento I-TREATMENT -de I-TREATMENT -tamaño I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión. I-TREATMENT - I-TREATMENT - -Hombre B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -57 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -remitido B-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Urgencias I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -dolor I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -pelvis. I-DERIVED_FROM/TO -Refería B-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales: I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -suprarrenal I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -sospecha I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipoaldosteronismo, I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -pulmonar I-PAST_MEDICAL_HISTORY -obstructiva I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -(EPOC) I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -broncodilatadores. I-PAST_MEDICAL_HISTORY -Tras B-TREATMENT -múltiples I-TREATMENT -resecciones I-TREATMENT -transuretrales I-TREATMENT -por I-TREATMENT -adenocarcinoma I-TREATMENT -vesical, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -practicó I-TREATMENT -una I-TREATMENT -prostatocistectomía I-TREATMENT -más I-TREATMENT -nefrectomía I-TREATMENT -izquierda I-TREATMENT +El B-EVOLUTION +enfermo I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente I-EVOLUTION +con B-TREATMENT +tratamiento I-TREATMENT +conservador I-TREATMENT con I-TREATMENT -derivación I-TREATMENT -tipo I-TREATMENT -Bricker I-TREATMENT -por I-TREATMENT -adenocarcinoma I-TREATMENT -de I-TREATMENT -próstata, I-TREATMENT -carcinoma I-TREATMENT -vesical I-TREATMENT -infiltrante I-TREATMENT +dieta I-TREATMENT +absoluta, I-TREATMENT +nutrición I-TREATMENT +parenteral, I-TREATMENT +-antibioterapia I-TREATMENT +intravenosa, I-TREATMENT +analgesia I-TREATMENT y I-TREATMENT -anulación I-TREATMENT -pielonefrótica I-TREATMENT -izquierda. I-TREATMENT -Posteriormente B-EVOLUTION -al I-EVOLUTION -cabo I-EVOLUTION -de I-EVOLUTION -6 I-EVOLUTION -semanas I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -drenaje I-EVOLUTION -mediante I-EVOLUTION -punción I-EVOLUTION -percutánea I-EVOLUTION -de I-EVOLUTION -absceso I-EVOLUTION -pelviano I-EVOLUTION -post-quirúrgico. I-EVOLUTION - I-EVOLUTION -Aproximadamente I-EVOLUTION -al I-EVOLUTION -año I-EVOLUTION +corticoterapia I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT +bajas. I-TREATMENT +Se B-EXPLORATION +realizó I-EXPLORATION +colonoscopia I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +12 I-EXPLORATION +días I-EXPLORATION +de I-EXPLORATION +ingreso I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +persistían I-EXPLORATION +las I-EXPLORATION +alteraciones I-EXPLORATION +anteriormente I-EXPLORATION +descritas. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +evidenciaron I-EXPLORATION +alteraciones I-EXPLORATION +vasculares I-EXPLORATION +en I-EXPLORATION +angio-TC. I-EXPLORATION +Los I-EXPLORATION +estudios I-EXPLORATION +inmunológicos I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +hipercoagulabilidad I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +objetivaron I-EXPLORATION +focos I-EXPLORATION +trombóticos. I-EXPLORATION +Los I-EXPLORATION +coprocultivos I-EXPLORATION +fueron I-EXPLORATION +reiteradamente I-EXPLORATION +negativos. I-EXPLORATION +Se I-EXPLORATION +descartó I-EXPLORATION +asimismo I-EXPLORATION +una I-EXPLORATION +enfermedad I-EXPLORATION +inflamatoria I-EXPLORATION +intestinal I-EXPLORATION +por I-EXPLORATION +histología I-EXPLORATION +no I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +dicha I-EXPLORATION +patología. I-EXPLORATION +El B-EVOLUTION +enfermo I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -intervención I-EVOLUTION -quirúrgica, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -comenzó I-EVOLUTION -con I-EVOLUTION -elevaciones I-EVOLUTION -importantes I-EVOLUTION -del I-EVOLUTION -PSA I-EVOLUTION +alta I-EVOLUTION +asintomático I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +29 I-EVOLUTION +días I-EVOLUTION de I-EVOLUTION -858, I-EVOLUTION -59 I-EVOLUTION -ng.ml-1, I-EVOLUTION -se I-EVOLUTION -instauró I-EVOLUTION -bloqueo I-EVOLUTION -hormonal I-EVOLUTION -con I-EVOLUTION -antiandrógenos, I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -fueron I-EVOLUTION -efectivos. I-EVOLUTION -Clínicamente B-EXPLORATION -presentaba I-EXPLORATION -astenia, I-EXPLORATION -anorexia, I-EXPLORATION -objetivándose I-EXPLORATION +ingreso. I-EVOLUTION +Se B-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION +nueva I-EXPLORATION +colonoscopia I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +6 I-EXPLORATION +semanas I-EXPLORATION +del I-EXPLORATION +alta, I-EXPLORATION +que I-EXPLORATION +constató I-EXPLORATION +restitución I-EXPLORATION +ad I-EXPLORATION +integrum I-EXPLORATION de I-EXPLORATION -1.404 I-EXPLORATION -U. I-EXPLORATION -L-1, I-EXPLORATION -descenso I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hematocrito I-EXPLORATION -(28,1%) I-EXPLORATION -y I-EXPLORATION -hemoglobina I-EXPLORATION -(9, I-EXPLORATION -3 I-EXPLORATION -g.dl-1), I-EXPLORATION -se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -eritropoyetina I-TREATMENT -más I-TREATMENT -hierro. I-TREATMENT -En B-EXPLORATION la I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computerizada I-EXPLORATION -(TAC) I-EXPLORATION -abdomino-pélvica, I-EXPLORATION +mucosa. I-EXPLORATION + I-EXPLORATION +Tras I-EXPLORATION +descartar I-EXPLORATION +otra I-EXPLORATION +etiología, I-EXPLORATION se I-EXPLORATION -observaba I-EXPLORATION -afectación I-EXPLORATION -linfoadenopática I-EXPLORATION -retroperitoneal I-EXPLORATION -de I-EXPLORATION -carácter I-EXPLORATION -metastásico, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -metástasis I-EXPLORATION -óseas I-EXPLORATION -osteoblásticas I-EXPLORATION +estableció I-EXPLORATION que I-EXPLORATION -afectaban I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -columna I-EXPLORATION -lumbosacra I-EXPLORATION -y I-EXPLORATION -estructuras I-EXPLORATION -pélvicas. I-EXPLORATION -Se I-EXPLORATION -efectuó I-EXPLORATION -nuevo I-EXPLORATION -control I-EXPLORATION -al I-EXPLORATION -cabo I-EXPLORATION +el I-EXPLORATION +origen I-EXPLORATION +del I-EXPLORATION +cuadro I-EXPLORATION +fue I-EXPLORATION +un I-EXPLORATION +secuestro I-EXPLORATION +vascular I-EXPLORATION +producido I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -tres I-EXPLORATION -meses I-EXPLORATION -con I-EXPLORATION -hallazgos I-EXPLORATION -similares, I-EXPLORATION -llamaba I-EXPLORATION -la I-EXPLORATION -atención I-EXPLORATION -la I-EXPLORATION -importante I-EXPLORATION -esclerosis I-EXPLORATION -existente I-EXPLORATION +las I-EXPLORATION +demandas I-EXPLORATION +sanguíneas I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +ejercicio I-EXPLORATION +intenso I-EXPLORATION en I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -cuerpos I-EXPLORATION -vertebrales I-EXPLORATION -dorsales I-EXPLORATION -y I-EXPLORATION -primeros I-EXPLORATION -lumbares I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION +un I-EXPLORATION +día I-EXPLORATION +caluroso, I-EXPLORATION en I-EXPLORATION -todas I-EXPLORATION -las I-EXPLORATION -costillas, I-EXPLORATION -compatible I-EXPLORATION +un I-EXPLORATION +paciente I-EXPLORATION con I-EXPLORATION -metástasis I-EXPLORATION -blásticas. I-EXPLORATION +la I-EXPLORATION +gran I-EXPLORATION +parte I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +gasto I-EXPLORATION +cardiaco I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +territorio I-EXPLORATION +mesentérico. I-EXPLORATION I-EXPLORATION -El B-PRESENT_ILLNESS -motivo I-PRESENT_ILLNESS + +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestra I-PRESENT_ILLNESS -Unidad I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Dolor I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -existencia I-PRESENT_ILLNESS +21 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +oriundo B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +provincia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Buenos I-PAST_MEDICAL_HISTORY +Aires, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +infección I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +VIH I-PAST_MEDICAL_HISTORY +adquirida I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +transmisión I-PAST_MEDICAL_HISTORY +vertical, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +abandono I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +varios I-PAST_MEDICAL_HISTORY +tratamientos I-PAST_MEDICAL_HISTORY +antirretrovirales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +gran I-PAST_MEDICAL_HISTORY +actividad I-PAST_MEDICAL_HISTORY +(TARGA). I-PAST_MEDICAL_HISTORY +Se B-PRESENT_ILLNESS +internó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +febril I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -pelvis, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -lumbar, I-PRESENT_ILLNESS -ambas I-PRESENT_ILLNESS -caderas, I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -inguinal I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -extremidad I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS pérdida I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -fuerza. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -era I-PRESENT_ILLNESS -continuo, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -intensidad I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -EVA I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -8/10, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -conciliar I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -sueño, I-PRESENT_ILLNESS -aumentaba I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -movilización I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -asociaba I-PRESENT_ILLNESS -parestesias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ambas I-PRESENT_ILLNESS -extremidades. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION +aproximadamente I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +kg. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -ligera I-EXPLORATION -paresia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -extremidad I-EXPLORATION -inferior I-EXPLORATION -derecha I-EXPLORATION -de I-EXPLORATION -grado I-EXPLORATION -leve I-EXPLORATION -(4/5) I-EXPLORATION +encontraba I-EXPLORATION +febril, I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -escala I-EXPLORATION +regular I-EXPLORATION +estado I-EXPLORATION +general I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +palidez I-EXPLORATION de I-EXPLORATION -balance I-EXPLORATION -muscular. I-EXPLORATION +piel I-EXPLORATION +y I-EXPLORATION +mucosas. I-EXPLORATION Se I-EXPLORATION -solicitó I-EXPLORATION -un I-EXPLORATION -gammagrafía I-EXPLORATION -ósea I-EXPLORATION -hallándose I-EXPLORATION +palpaba I-EXPLORATION una I-EXPLORATION -importante I-EXPLORATION -diseminación I-EXPLORATION -metastásica I-EXPLORATION +hepato-esplenomegalia I-EXPLORATION +indolora I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +auscultación I-EXPLORATION +pulmonar I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +disminución I-EXPLORATION +generalizada I-EXPLORATION +del I-EXPLORATION +murmullo I-EXPLORATION +pulmonar I-EXPLORATION en I-EXPLORATION -calota, I-EXPLORATION -escápula I-EXPLORATION -derecha, I-EXPLORATION -ambos I-EXPLORATION -hombros, I-EXPLORATION -húmero, I-EXPLORATION -parrilla I-EXPLORATION -costal, I-EXPLORATION -pelvis, I-EXPLORATION ambos I-EXPLORATION -fémures I-EXPLORATION +campos I-EXPLORATION +pulmonares. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +opacidad I-EXPLORATION +parahiliar I-EXPLORATION y I-EXPLORATION -tibias. I-EXPLORATION - B-TREATMENT -Se I-TREATMENT -inició I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -amitriptilina I-TREATMENT -25 I-TREATMENT -mg.24 I-TREATMENT -h-1, I-TREATMENT -sulfato I-TREATMENT -de I-TREATMENT -morfina I-TREATMENT -de I-TREATMENT -liberación I-TREATMENT -controlada I-TREATMENT -15 I-TREATMENT -mg.12 I-TREATMENT -h-1, I-TREATMENT -acetil I-TREATMENT -salicilato I-TREATMENT -de I-TREATMENT -lisisna I-TREATMENT -1800 I-TREATMENT -mg.8 I-TREATMENT -h-1, I-TREATMENT -omeprazol I-TREATMENT -20 I-TREATMENT -mg.24 I-TREATMENT -h-1, I-TREATMENT -lactulosa I-TREATMENT -10 I-TREATMENT -g.8 I-TREATMENT -h-1 I-TREATMENT -y I-TREATMENT -metamizol I-TREATMENT -de I-TREATMENT -analgésico I-TREATMENT -de I-TREATMENT -rescate. I-TREATMENT -En I-TREATMENT -la I-TREATMENT -visita I-TREATMENT -sucesiva I-TREATMENT -se I-TREATMENT -apreció I-TREATMENT -un I-TREATMENT -mal I-TREATMENT -control I-TREATMENT -del I-TREATMENT -dolor I-TREATMENT -a I-TREATMENT -pesar I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -analgésico. I-TREATMENT -Se I-TREATMENT -aumentó I-TREATMENT -el I-TREATMENT -sulfato I-TREATMENT -de I-TREATMENT -morfina I-TREATMENT -30 I-TREATMENT -mg.8 I-TREATMENT -h-1, I-TREATMENT -iniciándose I-TREATMENT -pauta I-TREATMENT -con I-TREATMENT -dexametasona I-TREATMENT -y I-TREATMENT -se I-TREATMENT -remitió I-TREATMENT -al I-TREATMENT -Servicio I-TREATMENT -de I-TREATMENT -Medicina I-TREATMENT -Nuclear I-TREATMENT -para I-TREATMENT -valorar I-TREATMENT -tratamiento I-TREATMENT -paliativo I-TREATMENT -con I-TREATMENT -Sm-153 I-TREATMENT -Lexidronam I-TREATMENT -(Quadramet®). I-TREATMENT -El B-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -anemia I-EXPLORATION +basal I-EXPLORATION +derecha I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +neumónico. I-EXPLORATION +Los I-EXPLORATION +resultados I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +al I-EXPLORATION +ingreso I-EXPLORATION +fueron: I-EXPLORATION +entro-sedimentación I-EXPLORATION +> I-EXPLORATION +140 I-EXPLORATION +mm I-EXPLORATION +1° I-EXPLORATION +hora, I-EXPLORATION +hematocrito I-EXPLORATION +21%, I-EXPLORATION +hemoglobina I-EXPLORATION +6, I-EXPLORATION +6 I-EXPLORATION +g/L, I-EXPLORATION +leucocitos I-EXPLORATION +4.400 I-EXPLORATION +cél/mm3, I-EXPLORATION +plaquetas I-EXPLORATION +40.000 I-EXPLORATION +cél/mm3, I-EXPLORATION +concentración I-EXPLORATION +de I-EXPLORATION +protrombina I-EXPLORATION +68%, I-EXPLORATION +urea I-EXPLORATION +16 I-EXPLORATION +mg/dL, I-EXPLORATION +creatinina I-EXPLORATION +0, I-EXPLORATION +9 I-EXPLORATION +mg/dL, I-EXPLORATION +transaminasas I-EXPLORATION +GOT I-EXPLORATION +61 I-EXPLORATION +UI/L, I-EXPLORATION +GPT I-EXPLORATION +20 I-EXPLORATION +UI/L, I-EXPLORATION +fosfatasas I-EXPLORATION +alcalinas: I-EXPLORATION +185 I-EXPLORATION +U/L I-EXPLORATION +y I-EXPLORATION +láctico I-EXPLORATION +deshidrogenasa: I-EXPLORATION +400 I-EXPLORATION +U/l. I-EXPLORATION +El I-EXPLORATION +recuento I-EXPLORATION +de I-EXPLORATION +linfocitos I-EXPLORATION +T I-EXPLORATION +CD4 I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +21 I-EXPLORATION +cél/mm3 I-EXPLORATION +(8%). I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +tomaron I-EXPLORATION +muestras I-EXPLORATION +de I-EXPLORATION +expectoración I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +identificación I-EXPLORATION +de I-EXPLORATION +bacterias I-EXPLORATION +de I-EXPLORATION +crecimiento I-EXPLORATION +corriente, I-EXPLORATION +micobacterias I-EXPLORATION +y I-EXPLORATION +hongos. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +directo I-EXPLORATION +mediante I-EXPLORATION +la I-EXPLORATION +técnica I-EXPLORATION +de I-EXPLORATION +Zielh-Neelsen, I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +10 I-EXPLORATION +bacilos I-EXPLORATION +ácido-alcohol I-EXPLORATION +resistentes I-EXPLORATION +(BAAR) I-EXPLORATION +por I-EXPLORATION +cada I-EXPLORATION +10 I-EXPLORATION +campos. I-EXPLORATION +La I-EXPLORATION +ecotomografía I-EXPLORATION +abdominal I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +hepato-esplenomegalia I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +múltiples I-EXPLORATION +adenopatías I-EXPLORATION +hipoecogénicas I-EXPLORATION en I-EXPLORATION +el I-EXPLORATION +retroperitoneo, I-EXPLORATION +en I-EXPLORATION +relación I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -analítica I-EXPLORATION -previa I-EXPLORATION +vena I-EXPLORATION +cava I-EXPLORATION +inferior I-EXPLORATION +y I-EXPLORATION al I-EXPLORATION -tratamiento. I-EXPLORATION -Se B-TREATMENT -administró I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -paliativa I-TREATMENT -de I-TREATMENT -80 I-TREATMENT -mCi I-TREATMENT -de I-TREATMENT -Sm-153. I-TREATMENT - I-TREATMENT -Al B-EVOLUTION -cabo I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -semana, I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -región I-EVOLUTION -lumbar I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -pelvis I-EVOLUTION -habían I-EVOLUTION -desaparecido I-EVOLUTION -en I-EVOLUTION -48 I-EVOLUTION -horas, I-EVOLUTION -persistiendo I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -fémur I-EVOLUTION -derecho. I-EVOLUTION -El I-EVOLUTION -EVA I-EVOLUTION -era I-EVOLUTION -de I-EVOLUTION -5/10 I-EVOLUTION -y I-EVOLUTION -había I-EVOLUTION -mejorado I-EVOLUTION -la I-EVOLUTION -deambulación. I-EVOLUTION -Se B-TREATMENT -decidió I-TREATMENT -mantener I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -tratamiento I-TREATMENT -analgésico I-TREATMENT -excepto I-TREATMENT -la I-TREATMENT -dexametasona I-TREATMENT -que I-TREATMENT -se I-TREATMENT -retiró. I-TREATMENT -Transcurridas B-EVOLUTION -4 I-EVOLUTION -semanas I-EVOLUTION -del I-EVOLUTION -Sm-153, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -encontraba I-EVOLUTION -asintomático I-EVOLUTION -con I-EVOLUTION -EVA I-EVOLUTION -de I-EVOLUTION -1/10, I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -analítica I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -se I-EVOLUTION -apreciaba I-EVOLUTION -leucopenia I-EVOLUTION -(3.000/mm3) I-EVOLUTION -y I-EVOLUTION -plaquetopenia I-EVOLUTION -(121.000/mm3), I-EVOLUTION -sin I-EVOLUTION -repercusiones I-EVOLUTION -clínicas. I-EVOLUTION -Los I-EVOLUTION -opiáceos I-EVOLUTION -y I-EVOLUTION -los I-EVOLUTION -AINE I-EVOLUTION -fueron I-EVOLUTION -retirados I-EVOLUTION -progresivamente, I-EVOLUTION -permaneciendo I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -con I-EVOLUTION -amitriptilina I-EVOLUTION -25 I-EVOLUTION -mg.24 I-EVOLUTION -h-1 I-EVOLUTION -y I-EVOLUTION -metamizol I-EVOLUTION -a I-EVOLUTION -demanda. I-EVOLUTION -La I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -al I-EVOLUTION -cabo I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -8 I-EVOLUTION -semanas I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -analítica I-EVOLUTION -se I-EVOLUTION -normalizó. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -75 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -colecistectomía, I-PAST_MEDICAL_HISTORY -hallux I-PAST_MEDICAL_HISTORY -valgus, I-PAST_MEDICAL_HISTORY -úlcera I-PAST_MEDICAL_HISTORY -gástrica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -neuralgia I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -quinto I-PAST_MEDICAL_HISTORY -par I-PAST_MEDICAL_HISTORY -izquierdo. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Presentaba B-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -territorio I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -trigémino I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -lado I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -comenzó I-PRESENT_ILLNESS -hacía I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -mantenido I-PRESENT_ILLNESS -controlado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -gabapentina. I-PRESENT_ILLNESS -Desde I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -era I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -intensidad I-PRESENT_ILLNESS -severa, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -respuesta I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -farmacológico. I-PRESENT_ILLNESS -La B-DERIVED_FROM/TO -falta I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -control I-DERIVED_FROM/TO -motivó I-DERIVED_FROM/TO -ingreso I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -carácter I-DERIVED_FROM/TO -urgente I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Neurología, I-DERIVED_FROM/TO -desde I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -solicitaron I-DERIVED_FROM/TO -colaboración I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Dolor. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -En B-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -anamnesis I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -fronto-parietal I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -paladar, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -descargas I-PRESENT_ILLNESS -eléctricas I-PRESENT_ILLNESS -muy I-PRESENT_ILLNESS -frecuentes I-PRESENT_ILLNESS -(en I-PRESENT_ILLNESS -torno I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -diarias), I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -intensidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -EVA I-PRESENT_ILLNESS -9-10. I-PRESENT_ILLNESS -En B-TREATMENT -ese I-TREATMENT -momento I-TREATMENT -estaba I-TREATMENT -en I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -metamizol I-TREATMENT -(8 I-TREATMENT -gr/24 I-TREATMENT -horas) I-TREATMENT -y I-TREATMENT -tramadol I-TREATMENT -(300 I-TREATMENT -mgr/24 I-TREATMENT -horas) I-TREATMENT -intravenoso I-TREATMENT -en I-TREATMENT -perfusión I-TREATMENT -continua, I-TREATMENT -gabapentina I-TREATMENT -(1.200 I-TREATMENT -mgr/8 I-TREATMENT -horas) I-TREATMENT -y I-TREATMENT -topiramato I-TREATMENT -(25 I-TREATMENT -mgr/12 I-TREATMENT -horas I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral), I-TREATMENT -buprenorfina I-TREATMENT -transdérmica I-TREATMENT -(35 I-TREATMENT -µgr/hora) I-TREATMENT -y I-TREATMENT -petidina I-TREATMENT -intravenosa I-TREATMENT -de I-TREATMENT -rescate I-TREATMENT -(100 I-TREATMENT -mgr/8 I-TREATMENT -horas). I-TREATMENT - I-TREATMENT -Se I-TREATMENT -llevó I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -bloqueo I-TREATMENT -nervioso I-TREATMENT -de I-TREATMENT -1ª I-TREATMENT -y I-TREATMENT -2ª I-TREATMENT -ramas I-TREATMENT -izquierdas I-TREATMENT -del I-TREATMENT -quinto I-TREATMENT -par I-TREATMENT -con I-TREATMENT -bupivacaína I-TREATMENT -0, I-TREATMENT -5%, I-TREATMENT -con B-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -logró I-EVOLUTION -una I-EVOLUTION -buena I-EVOLUTION -analgesia I-EVOLUTION -superficial I-EVOLUTION -(EVA I-EVOLUTION -4), I-EVOLUTION -aunque I-EVOLUTION -persistía I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -paladar. I-EVOLUTION -Se B-TREATMENT -ajustó I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -farmacológico I-TREATMENT -asociando I-TREATMENT -oxcarbacepina I-TREATMENT -300 I-TREATMENT -mgr/12 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -topiramato I-TREATMENT -y I-TREATMENT -de I-TREATMENT -manera I-TREATMENT -progresiva I-TREATMENT -la I-TREATMENT -buprenorfina. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -días, I-EVOLUTION -dada I-EVOLUTION -la I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente, I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta, I-EVOLUTION -presentando I-EVOLUTION -entonces I-EVOLUTION -EVA I-EVOLUTION -0 I-EVOLUTION -(incluso I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -paladar). I-EVOLUTION -La I-EVOLUTION -cifra I-EVOLUTION -de I-EVOLUTION -sodio I-EVOLUTION -al I-EVOLUTION -abandonar I-EVOLUTION -el I-EVOLUTION -hospital I-EVOLUTION -estaba I-EVOLUTION -dentro I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -límites I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -normalidad, I-EVOLUTION -según I-EVOLUTION -una I-EVOLUTION -analítica I-EVOLUTION -realizada I-EVOLUTION -durante I-EVOLUTION -su I-EVOLUTION -ingreso. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -dolor I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -controlado I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -una I-EVOLUTION -revisión I-EVOLUTION -efectuada I-EVOLUTION -4 I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -ingreso I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -refirió I-EVOLUTION -ausencia I-EVOLUTION -de I-EVOLUTION -crisis I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -ese I-EVOLUTION -tiempo. I-EVOLUTION -En B-EXPLORATION -esa I-EXPLORATION -misma I-EXPLORATION -visita I-EXPLORATION +ligamento I-EXPLORATION +hepato-duodenal. I-EXPLORATION +También I-EXPLORATION se I-EXPLORATION -comprueba I-EXPLORATION -que I-EXPLORATION +observaron I-EXPLORATION +imágenes I-EXPLORATION +hipoecogénicas I-EXPLORATION en I-EXPLORATION -un I-EXPLORATION -análisis I-EXPLORATION -realizado I-EXPLORATION -unos I-EXPLORATION -días I-EXPLORATION -antes I-EXPLORATION -aparece I-EXPLORATION -una I-EXPLORATION -cifra I-EXPLORATION -de I-EXPLORATION -sodio I-EXPLORATION -de I-EXPLORATION -125 I-EXPLORATION -mgr/dl. I-EXPLORATION -Hacía B-TREATMENT -más I-TREATMENT +el I-EXPLORATION +bazo, I-EXPLORATION +mesenterio I-EXPLORATION +y I-EXPLORATION +retroperitoneo. I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT de I-TREATMENT -un I-TREATMENT -mes I-TREATMENT -había I-TREATMENT -comenzado I-TREATMENT +una I-TREATMENT +probable I-TREATMENT +tuberculosis I-TREATMENT +se I-TREATMENT +inició I-TREATMENT tratamiento I-TREATMENT con I-TREATMENT -un I-TREATMENT -antihipertensivo I-TREATMENT -que I-TREATMENT -combina I-TREATMENT -un I-TREATMENT -inhibidor I-TREATMENT -de I-TREATMENT -los I-TREATMENT -receptores I-TREATMENT -de I-TREATMENT -angiotensina I-TREATMENT -II I-TREATMENT +isoniacida, I-TREATMENT +rifampicina, I-TREATMENT +pirazinamida I-TREATMENT y I-TREATMENT -un I-TREATMENT -diurético I-TREATMENT -tiazídico I-TREATMENT -(hidroclorotiazida). I-TREATMENT -La I-TREATMENT -paciente I-TREATMENT -no I-TREATMENT -presentaba I-TREATMENT -síntomas I-TREATMENT -atribuibles I-TREATMENT -a I-TREATMENT -dicha I-TREATMENT -hiponatremia. I-TREATMENT - I-TREATMENT -Debido I-TREATMENT -a I-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -la I-TREATMENT -contribución I-TREATMENT -tanto I-TREATMENT -de I-TREATMENT -hidroclorotiazida I-TREATMENT -como I-TREATMENT -oxcarbacepina I-TREATMENT +etambutol I-TREATMENT en I-TREATMENT -la I-TREATMENT -hiponatremia, I-TREATMENT -se I-TREATMENT -retiró, I-TREATMENT -de I-TREATMENT -acuerdo I-TREATMENT -con I-TREATMENT -su I-TREATMENT -médico I-TREATMENT -de I-TREATMENT -cabecera, I-TREATMENT -la I-TREATMENT -hidroclorotiazida. I-TREATMENT -En B-EXPLORATION -un I-EXPLORATION -ionograma I-EXPLORATION -solicitado I-EXPLORATION -15 I-EXPLORATION -días I-EXPLORATION -después, I-EXPLORATION -el I-EXPLORATION -valor I-EXPLORATION -del I-EXPLORATION -sodio I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -143 I-EXPLORATION -mgr/dl, I-EXPLORATION -con I-EXPLORATION -normalidad I-EXPLORATION -del I-EXPLORATION -potasio I-EXPLORATION -y I-EXPLORATION -cloro. I-EXPLORATION - I-EXPLORATION -Dos B-EVOLUTION -meses I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION +forma I-TREATMENT +diaria I-TREATMENT +y I-TREATMENT +en I-TREATMENT +dosis I-TREATMENT +habituales. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +la I-EVOLUTION +semana I-EVOLUTION +de I-EVOLUTION +iniciada I-EVOLUTION la I-EVOLUTION +terapia I-EVOLUTION +el I-EVOLUTION paciente I-EVOLUTION -fue I-EVOLUTION -ingresada I-EVOLUTION +comenzó I-EVOLUTION +a I-EVOLUTION +referir I-EVOLUTION +dolor I-EVOLUTION en I-EVOLUTION +la I-EVOLUTION +articulación I-EVOLUTION +coxo-femoral I-EVOLUTION +izquierda I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +irradiaba I-EVOLUTION +hacia I-EVOLUTION el I-EVOLUTION -Servicio I-EVOLUTION +muslo, I-EVOLUTION +produciendo I-EVOLUTION +impotencia I-EVOLUTION +funcional I-EVOLUTION +y I-EVOLUTION +posición I-EVOLUTION +antiálgica I-EVOLUTION +en I-EVOLUTION +semiflexión. I-EVOLUTION +Presentaba I-EVOLUTION +dolor I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +palpación I-EVOLUTION de I-EVOLUTION -Urgencias I-EVOLUTION +dicha I-EVOLUTION +articulación I-EVOLUTION +coxo-femoral I-EVOLUTION con I-EVOLUTION -clínica I-EVOLUTION +imposibilidad I-EVOLUTION de I-EVOLUTION -intensa I-EVOLUTION -astenia I-EVOLUTION +extensión I-EVOLUTION +activa I-EVOLUTION y I-EVOLUTION -debilidad I-EVOLUTION -muscular I-EVOLUTION +pasiva I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +extremidad I-EVOLUTION +inferior I-EVOLUTION +izquierda. I-EVOLUTION +La I-EVOLUTION +ecotomografía I-EVOLUTION +mostró I-EVOLUTION +una I-EVOLUTION +moderada I-EVOLUTION +cantidad I-EVOLUTION +de I-EVOLUTION +líquido I-EVOLUTION +articular I-EVOLUTION y I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +tomografía I-EVOLUTION +axial I-EVOLUTION +computarizada I-EVOLUTION +(TAC) I-EVOLUTION +se I-EVOLUTION +observó I-EVOLUTION una I-EVOLUTION -cifra I-EVOLUTION +imagen I-EVOLUTION +radiolúcida, I-EVOLUTION +redondeada, I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +unión I-EVOLUTION de I-EVOLUTION -sodio I-EVOLUTION +la I-EVOLUTION +cabeza I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +cuello I-EVOLUTION +femoral, I-EVOLUTION +con I-EVOLUTION +solución I-EVOLUTION de I-EVOLUTION -120 I-EVOLUTION -mgr/dl. I-EVOLUTION -Nuevamente B-TREATMENT -había I-TREATMENT -comenzado, I-TREATMENT -hacía I-TREATMENT -un I-TREATMENT -mes, I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -hidroclorotiazida I-TREATMENT -debido I-TREATMENT -al I-TREATMENT -mal I-TREATMENT -control I-TREATMENT -de I-TREATMENT -su I-TREATMENT -presión I-TREATMENT -arterial. I-TREATMENT - I-TREATMENT -Ante B-EVOLUTION +continuidad I-EVOLUTION +hacia I-EVOLUTION la I-EVOLUTION -buena I-EVOLUTION -evolución, I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -últimos I-EVOLUTION -meses, I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -doloroso I-EVOLUTION -se B-TREATMENT -decidió I-TREATMENT -retirar I-TREATMENT -la I-TREATMENT -oxcarbacepina I-TREATMENT -y I-TREATMENT -dejar I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -únicamente I-TREATMENT -con I-TREATMENT -gabapentina I-TREATMENT -para I-TREATMENT -control I-TREATMENT -de I-TREATMENT -su I-TREATMENT -dolor I-TREATMENT -neuropático. I-TREATMENT -En B-EVOLUTION -esta I-EVOLUTION -ocasión I-EVOLUTION +cortical I-EVOLUTION +ósea. I-EVOLUTION +La I-EVOLUTION +cavidad I-EVOLUTION +acetabular I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +cabeza I-EVOLUTION +femoral I-EVOLUTION +estaban I-EVOLUTION +respetadas I-EVOLUTION +igual I-EVOLUTION +que I-EVOLUTION +la I-EVOLUTION +sínfisis I-EVOLUTION +pubiana I-EVOLUTION +y I-EVOLUTION +las I-EVOLUTION +ramas I-EVOLUTION +isquio I-EVOLUTION +e I-EVOLUTION +ilio-pubianas. I-EVOLUTION +En I-EVOLUTION +la I-EVOLUTION +cavidad I-EVOLUTION +articular I-EVOLUTION se I-EVOLUTION -mantuvo I-EVOLUTION +observó I-EVOLUTION +un I-EVOLUTION +moderado I-EVOLUTION +volumen I-EVOLUTION +de I-EVOLUTION +líquido. I-EVOLUTION + I-EVOLUTION +Se I-EVOLUTION +realizó I-EVOLUTION +una I-EVOLUTION +artrocentesis I-EVOLUTION +obteniéndose I-EVOLUTION +un I-EVOLUTION +material I-EVOLUTION +sero-hemático. I-EVOLUTION +Se I-EVOLUTION +enviaron I-EVOLUTION +muestras I-EVOLUTION +para I-EVOLUTION la I-EVOLUTION -dosis I-EVOLUTION +identificación I-EVOLUTION de I-EVOLUTION -hidroclorotiazida. I-EVOLUTION -Los I-EVOLUTION -síntomas I-EVOLUTION -atribuibles I-EVOLUTION -a I-EVOLUTION +bacterias I-EVOLUTION +de I-EVOLUTION +crecimiento I-EVOLUTION +común, I-EVOLUTION +micobacterias I-EVOLUTION +y I-EVOLUTION +hongos. I-EVOLUTION +El I-EVOLUTION +examen I-EVOLUTION +directo I-EVOLUTION +mediante I-EVOLUTION la I-EVOLUTION -hiponatremia I-EVOLUTION -mejoraron I-EVOLUTION +técnica I-EVOLUTION de I-EVOLUTION -forma I-EVOLUTION -inmediata I-EVOLUTION -al I-EVOLUTION -retirar I-EVOLUTION -oxcarbacepina. I-EVOLUTION -En B-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -analítica I-EXPLORATION -solicitada I-EXPLORATION -8 I-EXPLORATION -días I-EXPLORATION -después I-EXPLORATION -del I-EXPLORATION -ingreso I-EXPLORATION -el I-EXPLORATION -nivel I-EXPLORATION +Zielh-Neelsen, I-EVOLUTION +mostró I-EVOLUTION +cinco I-EVOLUTION +a I-EVOLUTION +nueve I-EVOLUTION +BAAR I-EVOLUTION +por I-EVOLUTION +cada I-EVOLUTION +100 I-EVOLUTION +campos I-EVOLUTION +de I-EVOLUTION +observación. I-EVOLUTION + I-EVOLUTION +Además B-TREATMENT +del I-TREATMENT +tratamiento I-TREATMENT +antituberculoso I-TREATMENT +se I-TREATMENT +agregaron I-TREATMENT +analgésicos I-TREATMENT +y I-TREATMENT +corticoesteroides. I-TREATMENT +Siete B-EVOLUTION +días I-EVOLUTION +después, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +evolución I-EVOLUTION +favorable, I-EVOLUTION +con I-EVOLUTION +paulatina I-EVOLUTION +recuperación I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +movilidad I-EVOLUTION +del I-EVOLUTION +miembro I-EVOLUTION +inferior I-EVOLUTION +izquierdo, I-EVOLUTION +apoyada I-EVOLUTION +con I-EVOLUTION +soporte I-EVOLUTION +kinésico. I-EVOLUTION + I-EVOLUTION +Los B-EXPLORATION +cultivos I-EXPLORATION de I-EXPLORATION -sodio I-EXPLORATION -fue I-EXPLORATION -140 I-EXPLORATION -mg/dl. I-EXPLORATION +las I-EXPLORATION +muestras I-EXPLORATION +tanto I-EXPLORATION +de I-EXPLORATION +esputo I-EXPLORATION +como I-EXPLORATION +del I-EXPLORATION +líquido I-EXPLORATION +articular, I-EXPLORATION +permitieron I-EXPLORATION +identificar I-EXPLORATION +Mycobacterium I-EXPLORATION +tuberculosis I-EXPLORATION +con I-EXPLORATION +susceptibilidad I-EXPLORATION +conservada I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +fármacos I-EXPLORATION +proscriptos. I-EXPLORATION I-EXPLORATION +A B-EVOLUTION +los I-EVOLUTION +30 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION +se I-EVOLUTION +comprobó I-EVOLUTION +una I-EVOLUTION +marcada I-EVOLUTION +mejoría I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +lesiones I-EVOLUTION +pulmonares I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +examen I-EVOLUTION +directo I-EVOLUTION +de I-EVOLUTION +expectoración I-EVOLUTION +de I-EVOLUTION +control I-EVOLUTION +fue I-EVOLUTION +negativo I-EVOLUTION +para I-EVOLUTION +BAAR. I-EVOLUTION + I-EVOLUTION -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -medicamentosas I-PAST_MEDICAL_HISTORY -conocidas, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -fumadora I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -cigarrillos I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -día, I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -embarazos I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -complicaciones I-PAST_MEDICAL_HISTORY +72 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +ex B-PAST_MEDICAL_HISTORY +fumador I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -cirugía I-PAST_MEDICAL_HISTORY +bebedor I-PAST_MEDICAL_HISTORY +moderado I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +otros I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -estapedectomía I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -oído I-PAST_MEDICAL_HISTORY -izquierdo I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -otoesclerosis. I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Traumatología I-PRESENT_ILLNESS -derivada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -Centro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Salud I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Mayo I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -2002 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -omalgia I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -atraumática I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Previamente I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -sido I-PRESENT_ILLNESS -valorada I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tratada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -servicios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Neurología, I-PRESENT_ILLNESS -Reumatología I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -Rehabilitación I-PRESENT_ILLNESS +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +hallado I-PRESENT_ILLNESS sin I-PRESENT_ILLNESS -mejoría. I-PRESENT_ILLNESS -A B-EXPLORATION +vida I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +vía I-PRESENT_ILLNESS +pública. I-PRESENT_ILLNESS +La B-EXPLORATION +autopsia I-EXPLORATION +se I-EXPLORATION +practica I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +19 I-EXPLORATION +horas I-EXPLORATION +del I-EXPLORATION +fallecimiento I-EXPLORATION +según I-EXPLORATION +las I-EXPLORATION +recomendaciones I-EXPLORATION +para I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -dolor I-EXPLORATION -inespecífico I-EXPLORATION -en I-EXPLORATION -tercio I-EXPLORATION -medio I-EXPLORATION +armonización I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +autopsias I-EXPLORATION +médico-legales I-EXPLORATION del I-EXPLORATION -brazo I-EXPLORATION -izquierdo, I-EXPLORATION +Comité I-EXPLORATION +de I-EXPLORATION +Ministros I-EXPLORATION +del I-EXPLORATION +Consejo I-EXPLORATION +de I-EXPLORATION +Europa I-EXPLORATION +[3]. I-EXPLORATION +Concretamente I-EXPLORATION +se I-EXPLORATION +siguió I-EXPLORATION +el I-EXPLORATION +protocolo I-EXPLORATION +aprobado I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +Red I-EXPLORATION +de I-EXPLORATION +Muerte I-EXPLORATION +Súbita I-EXPLORATION que I-EXPLORATION +incluye I-EXPLORATION +peso, I-EXPLORATION +talla I-EXPLORATION +y I-EXPLORATION +perímetro I-EXPLORATION +abdominal I-EXPLORATION +del I-EXPLORATION +cadáver; I-EXPLORATION +peso I-EXPLORATION +y I-EXPLORATION +examen I-EXPLORATION +macroscópico-microscópico I-EXPLORATION +de I-EXPLORATION +todos I-EXPLORATION +los I-EXPLORATION +órganos I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +investigación I-EXPLORATION +químico-toxicológica I-EXPLORATION +general I-EXPLORATION en I-EXPLORATION -ocasiones I-EXPLORATION +sangre. I-EXPLORATION +Los I-EXPLORATION +estudios I-EXPLORATION +complementarios I-EXPLORATION se I-EXPLORATION -exacerbaba I-EXPLORATION -sin I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -esfuerzos I-EXPLORATION -ni I-EXPLORATION -cambios I-EXPLORATION -posturales. I-EXPLORATION -No I-EXPLORATION -habia I-EXPLORATION -signos I-EXPLORATION +realizaron I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +Delegación I-EXPLORATION de I-EXPLORATION -atrapamiento I-EXPLORATION -subacromial I-EXPLORATION -ni I-EXPLORATION -atrofias I-EXPLORATION -musculares I-EXPLORATION -clínicamente I-EXPLORATION -evidentes. I-EXPLORATION -La I-EXPLORATION -movilidad I-EXPLORATION -era I-EXPLORATION -completa. I-EXPLORATION -Los I-EXPLORATION -reflejos I-EXPLORATION -eran I-EXPLORATION -normales I-EXPLORATION +Tenerife I-EXPLORATION +(estudio I-EXPLORATION +histopatológico) I-EXPLORATION y I-EXPLORATION -simétricos. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -RM I-EXPLORATION -cervical I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +Departamento I-EXPLORATION +de I-EXPLORATION +Sevilla I-EXPLORATION +(análisis I-EXPLORATION +químico-toxicológico) I-EXPLORATION +del I-EXPLORATION +Instituto I-EXPLORATION +Nacional I-EXPLORATION +de I-EXPLORATION +Toxicología I-EXPLORATION +y I-EXPLORATION +Ciencias I-EXPLORATION +Forenses. I-EXPLORATION + I-EXPLORATION +a) I-EXPLORATION +Examen I-EXPLORATION +de I-EXPLORATION +autopsia: I-EXPLORATION + I-EXPLORATION +Talla I-EXPLORATION +162 I-EXPLORATION +cm, I-EXPLORATION +peso I-EXPLORATION +84 I-EXPLORATION +kg, I-EXPLORATION +perímetro I-EXPLORATION +abdominal I-EXPLORATION +de I-EXPLORATION +104 I-EXPLORATION +cm. I-EXPLORATION +El I-EXPLORATION +índice I-EXPLORATION +de I-EXPLORATION +masa I-EXPLORATION +corporal I-EXPLORATION +(IMC) I-EXPLORATION += I-EXPLORATION +peso I-EXPLORATION +(kg) I-EXPLORATION +/ I-EXPLORATION +[talla I-EXPLORATION +(m) I-EXPLORATION +] I-EXPLORATION +² I-EXPLORATION +era I-EXPLORATION +de I-EXPLORATION +32 I-EXPLORATION +lo I-EXPLORATION que I-EXPLORATION -aportaba I-EXPLORATION -(Abril I-EXPLORATION -2002) I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -hallazgos I-EXPLORATION -patológicos I-EXPLORATION -evidentes. I-EXPLORATION +significa I-EXPLORATION +una I-EXPLORATION +obesidad I-EXPLORATION +de I-EXPLORATION +grado I-EXPLORATION +I I-EXPLORATION +con I-EXPLORATION +obesidad I-EXPLORATION +visceral I-EXPLORATION +[4, I-EXPLORATION +5]. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +externo I-EXPLORATION +sólo I-EXPLORATION +destacaba I-EXPLORATION una I-EXPLORATION -RM I-EXPLORATION +intensa I-EXPLORATION +congestión I-EXPLORATION +cefálica. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +interno I-EXPLORATION +los I-EXPLORATION +pulmones I-EXPLORATION +estaban I-EXPLORATION +aumentados I-EXPLORATION de I-EXPLORATION -hombro I-EXPLORATION -(Mayo I-EXPLORATION -2002) I-EXPLORATION +peso I-EXPLORATION +(D: I-EXPLORATION +675 I-EXPLORATION +g, I-EXPLORATION +I: I-EXPLORATION +490 I-EXPLORATION +g), I-EXPLORATION +con I-EXPLORATION +patrón I-EXPLORATION +de I-EXPLORATION +congestión I-EXPLORATION +y I-EXPLORATION +edema I-EXPLORATION +de I-EXPLORATION +grado I-EXPLORATION +importante. I-EXPLORATION +Cardiomegalia I-EXPLORATION +de I-EXPLORATION +485 I-EXPLORATION +g, I-EXPLORATION +siendo I-EXPLORATION +el I-EXPLORATION +valor I-EXPLORATION +medio I-EXPLORATION +esperado I-EXPLORATION +según I-EXPLORATION +peso I-EXPLORATION +corporal I-EXPLORATION +de I-EXPLORATION +358 I-EXPLORATION +g I-EXPLORATION +(rango I-EXPLORATION +271-473 I-EXPLORATION +g) I-EXPLORATION +[6]. I-EXPLORATION +La I-EXPLORATION +pared I-EXPLORATION +libre I-EXPLORATION +del I-EXPLORATION +ventrículo I-EXPLORATION +derecho I-EXPLORATION +tenía I-EXPLORATION +un I-EXPLORATION +espesor I-EXPLORATION +de I-EXPLORATION +7 I-EXPLORATION +mm I-EXPLORATION +(rango I-EXPLORATION +2-7 I-EXPLORATION +mm) I-EXPLORATION +mientras I-EXPLORATION que I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -rotura I-EXPLORATION -parcial I-EXPLORATION +el I-EXPLORATION +espesor I-EXPLORATION del I-EXPLORATION -tendón I-EXPLORATION -supraespinoso I-EXPLORATION +ventrículo I-EXPLORATION +izquierdo I-EXPLORATION +era I-EXPLORATION +de I-EXPLORATION +15 I-EXPLORATION +mm I-EXPLORATION +tanto I-EXPLORATION +en I-EXPLORATION +septum I-EXPLORATION +como I-EXPLORATION +en I-EXPLORATION +pared I-EXPLORATION +libre I-EXPLORATION +(rango I-EXPLORATION +10-15 I-EXPLORATION +mm). I-EXPLORATION +Abundante I-EXPLORATION +infiltrado I-EXPLORATION +graso I-EXPLORATION +en I-EXPLORATION +miocardio I-EXPLORATION +de I-EXPLORATION +ventrículo I-EXPLORATION +derecho I-EXPLORATION y I-EXPLORATION -bursitis I-EXPLORATION -subacromial I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT -mediante I-TREATMENT -infiltraciones I-TREATMENT -locales I-TREATMENT -con I-TREATMENT -corticoides I-TREATMENT -y I-TREATMENT -rehabilitación I-TREATMENT -sin I-TREATMENT -mejoría. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -seguía I-EVOLUTION -presentando I-EVOLUTION -la I-EVOLUTION -misma I-EVOLUTION -sintomatología I-EVOLUTION -por B-EXPLORATION -lo I-EXPLORATION +en I-EXPLORATION +pared I-EXPLORATION +posterior I-EXPLORATION +de I-EXPLORATION +ventrículo I-EXPLORATION +izquierdo I-EXPLORATION +formando I-EXPLORATION +una I-EXPLORATION +banda I-EXPLORATION +subepicárdica I-EXPLORATION +de I-EXPLORATION +2.5 I-EXPLORATION +x I-EXPLORATION +0.5 I-EXPLORATION +cm I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -neurofisiológico I-EXPLORATION -(Junio I-EXPLORATION -2003) I-EXPLORATION +extendía I-EXPLORATION +desde I-EXPLORATION +mesocardio I-EXPLORATION +hasta I-EXPLORATION +ápex. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +anterior I-EXPLORATION +del I-EXPLORATION +ventrículo I-EXPLORATION +izquierdo I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +otra I-EXPLORATION +zona I-EXPLORATION +más I-EXPLORATION +pequeña I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -músculos I-EXPLORATION -dependientes I-EXPLORATION +infiltración I-EXPLORATION +grasa I-EXPLORATION de I-EXPLORATION -C5-C6 I-EXPLORATION -izquierdos, I-EXPLORATION +0.5 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro. I-EXPLORATION +Las I-EXPLORATION +arterias I-EXPLORATION +coronarias I-EXPLORATION +estaban I-EXPLORATION +permeables I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +escasas I-EXPLORATION +placas I-EXPLORATION +de I-EXPLORATION +ateroma I-EXPLORATION que I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION +determinaban I-EXPLORATION una I-EXPLORATION -nueva I-EXPLORATION -RM I-EXPLORATION +estenosis I-EXPLORATION +luminal I-EXPLORATION +inferior I-EXPLORATION +al I-EXPLORATION +25%. I-EXPLORATION + I-EXPLORATION +b) I-EXPLORATION +Estudio I-EXPLORATION +microscópico: I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +histopatológico, I-EXPLORATION +utilizando I-EXPLORATION +Tricrómico I-EXPLORATION de I-EXPLORATION -hombro I-EXPLORATION -(Agosto I-EXPLORATION -2003) I-EXPLORATION +Masson, I-EXPLORATION +puso I-EXPLORATION +de I-EXPLORATION +manifiesto I-EXPLORATION +abundante I-EXPLORATION +infiltrado I-EXPLORATION +graso I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +miocardio I-EXPLORATION +constituido I-EXPLORATION +por I-EXPLORATION +adipocitos I-EXPLORATION +maduros I-EXPLORATION +entre I-EXPLORATION +los I-EXPLORATION que I-EXPLORATION -evidencia I-EXPLORATION -nuevamente I-EXPLORATION -una I-EXPLORATION -rotura I-EXPLORATION -parcial I-EXPLORATION -del I-EXPLORATION -tendón I-EXPLORATION -supraespinoso. I-EXPLORATION -Ante I-EXPLORATION -esta I-EXPLORATION -situación I-EXPLORATION -y I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +islotes I-EXPLORATION de I-EXPLORATION -acuerdo I-EXPLORATION +miocardiocitos I-EXPLORATION con I-EXPLORATION +estructura I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +mínima I-EXPLORATION +fibrosis I-EXPLORATION +intersticial. I-EXPLORATION +Las I-EXPLORATION +arterias I-EXPLORATION +coronarias I-EXPLORATION +presentan I-EXPLORATION +placas I-EXPLORATION +fibrolipídicas I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -paciente I-EXPLORATION +íntima I-EXPLORATION +determinando I-EXPLORATION +una I-EXPLORATION +estenosis I-EXPLORATION +luminal I-EXPLORATION +no I-EXPLORATION +superior I-EXPLORATION +al I-EXPLORATION +25% I-EXPLORATION +(aterosclerosis I-EXPLORATION +leve). I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -decide I-EXPLORATION -exploración I-EXPLORATION -artroscópica I-EXPLORATION -(Diciembre I-EXPLORATION -2003) I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION +observa I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION +ni I-EXPLORATION signos I-EXPLORATION de I-EXPLORATION -bursitis I-EXPLORATION -subacromial I-EXPLORATION -con I-EXPLORATION -manguito I-EXPLORATION -íntegro, I-EXPLORATION -realizándose B-TREATMENT -una I-TREATMENT -acromioplastia I-TREATMENT -artroscópica. I-TREATMENT -Tras B-EXPLORATION -dicha I-EXPLORATION -intervención I-EXPLORATION -y I-EXPLORATION -nueva I-EXPLORATION -rehabilitación I-EXPLORATION +necrosis I-EXPLORATION +miocárdica I-EXPLORATION +reciente I-EXPLORATION +y/o I-EXPLORATION +fibrosis I-EXPLORATION +de I-EXPLORATION +reparación. I-EXPLORATION + I-EXPLORATION +c) I-EXPLORATION +Análisis I-EXPLORATION +químico-toxicológico: I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +investigación I-EXPLORATION +toxicológica I-EXPLORATION +general I-EXPLORATION +detectó I-EXPLORATION la I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -muestra I-EXPLORATION -mejoría I-EXPLORATION -clínica. I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +alcohol I-EXPLORATION +etílico I-EXPLORATION +en I-EXPLORATION +concentración I-EXPLORATION +de I-EXPLORATION +2.59 I-EXPLORATION +g/L. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -decide I-EXPLORATION -realizar I-EXPLORATION + +Niña B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +diez I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que, B-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +recordar I-PRESENT_ILLNESS +traumatismo I-PRESENT_ILLNESS +previo, I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +refiriendo I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +tumoración I-PRESENT_ILLNESS +dolorosa I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +muslo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +advertida I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +antes. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +fiebre, I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +otra I-PRESENT_ILLNESS +sintomatología. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +se I-EXPLORATION +palpa I-EXPLORATION una I-EXPLORATION -serie I-EXPLORATION -de I-EXPLORATION -pruebas I-EXPLORATION +tumoración I-EXPLORATION +dolorosa I-EXPLORATION de I-EXPLORATION -imagen I-EXPLORATION -que I-EXPLORATION -consistieron I-EXPLORATION +7 I-EXPLORATION +× I-EXPLORATION +11 I-EXPLORATION +cm I-EXPLORATION en I-EXPLORATION -un I-EXPLORATION -TAC I-EXPLORATION -torácico I-EXPLORATION -(Diciembre I-EXPLORATION -2004), I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION +el I-EXPLORATION +tercio I-EXPLORATION +medio-distal I-EXPLORATION +del I-EXPLORATION +muslo I-EXPLORATION +izquierdo. I-EXPLORATION +La I-EXPLORATION +extremidad I-EXPLORATION +está I-EXPLORATION +mínimamente I-EXPLORATION +aumentada I-EXPLORATION +de I-EXPLORATION +tamaño I-EXPLORATION +respecto I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +contralateral. I-EXPLORATION +La I-EXPLORATION +piel I-EXPLORATION +presenta I-EXPLORATION +coloración I-EXPLORATION +y I-EXPLORATION +temperatura I-EXPLORATION +normales. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -hombro I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +es I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Ante I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +clínicos I-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +radiografía I-EXPLORATION +simple I-EXPLORATION +del I-EXPLORATION +fémur I-EXPLORATION izquierdo I-EXPLORATION -y I-EXPLORATION +que I-EXPLORATION +evidencia I-EXPLORATION una I-EXPLORATION -RM I-EXPLORATION +masa I-EXPLORATION +calcificada. I-EXPLORATION +Posteriormente I-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +ecografía I-EXPLORATION del I-EXPLORATION -plexo I-EXPLORATION -braquial I-EXPLORATION -(Enero I-EXPLORATION -2005) I-EXPLORATION +muslo, I-EXPLORATION que I-EXPLORATION -mostraron I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION +pone I-EXPLORATION de I-EXPLORATION +manifiesto I-EXPLORATION una I-EXPLORATION -lesión I-EXPLORATION -compatible I-EXPLORATION +imagen I-EXPLORATION +oval I-EXPLORATION con I-EXPLORATION -schwannoma I-EXPLORATION -del I-EXPLORATION -plexo I-EXPLORATION -braquial. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -RM I-EXPLORATION -del I-EXPLORATION -plexo I-EXPLORATION -braquial I-EXPLORATION -(Junio I-EXPLORATION -2005) I-EXPLORATION -mostrando I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -lesión I-EXPLORATION -y I-EXPLORATION -nuevo I-EXPLORATION -estudio I-EXPLORATION -neurofisiológico I-EXPLORATION -(Julio I-EXPLORATION -2005) I-EXPLORATION +múltiples I-EXPLORATION +imágenes I-EXPLORATION +hiperecogénicas I-EXPLORATION en I-EXPLORATION +su I-EXPLORATION +interior I-EXPLORATION +que I-EXPLORATION +provocan I-EXPLORATION +sombras I-EXPLORATION +acústicas I-EXPLORATION +posteriores, I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +sugiere I-EXPLORATION +un I-EXPLORATION +diagnóstico I-EXPLORATION +definitivo. I-EXPLORATION +Para I-EXPLORATION +concretar I-EXPLORATION el I-EXPLORATION +diagnóstico I-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC), I-EXPLORATION +que I-EXPLORATION +pone I-EXPLORATION +de I-EXPLORATION +manifiesto I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +calcificada I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +engloba I-EXPLORATION +estructuras I-EXPLORATION +neuromusculares, I-EXPLORATION +de I-EXPLORATION +características I-EXPLORATION +aparentemente I-EXPLORATION +benignas, I-EXPLORATION +pero I-EXPLORATION que I-EXPLORATION no I-EXPLORATION +permite I-EXPLORATION +descartar I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -evidenciaba I-EXPLORATION -signos I-EXPLORATION +trate I-EXPLORATION de I-EXPLORATION -afectación I-EXPLORATION -del I-EXPLORATION -plexo I-EXPLORATION -braquial. I-EXPLORATION -En B-TREATMENT -este I-TREATMENT -momento I-TREATMENT +un I-EXPLORATION +condroma I-EXPLORATION +de I-EXPLORATION +partes I-EXPLORATION +blandas. I-EXPLORATION + I-EXPLORATION +Ante I-EXPLORATION +la I-EXPLORATION +posibilidad I-EXPLORATION +de I-EXPLORATION +patología I-EXPLORATION +maligna, I-EXPLORATION +se I-EXPLORATION +deriva I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +hospital I-EXPLORATION +de I-EXPLORATION +tercer I-EXPLORATION +nivel I-EXPLORATION +para I-EXPLORATION +su I-EXPLORATION +valoración, I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +reevalúa I-EXPLORATION +el I-EXPLORATION +caso. I-EXPLORATION +Un I-EXPLORATION +familiar I-EXPLORATION +recuerda I-EXPLORATION +un I-EXPLORATION +traumatismo I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +manillar I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +bicicleta I-EXPLORATION +unos I-EXPLORATION +cuatro I-EXPLORATION +meses I-EXPLORATION +antes I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +consulta I-EXPLORATION +inicial, I-EXPLORATION +seguido I-EXPLORATION +de I-EXPLORATION +dolor I-EXPLORATION +e I-EXPLORATION +inflamación I-EXPLORATION +los I-EXPLORATION +siete I-EXPLORATION +días I-EXPLORATION +posteriores. I-EXPLORATION +El B-TREATMENT +caso I-TREATMENT se I-TREATMENT -plantea I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -la I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -una I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -para I-TREATMENT -su I-TREATMENT -resección. I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -en I-TREATMENT -ese I-TREATMENT -momento I-TREATMENT -incluía I-TREATMENT -pregabalina I-TREATMENT -(300 I-TREATMENT -mg/12 I-TREATMENT -horas), I-TREATMENT -fentanilo I-TREATMENT -transdermico I-TREATMENT -(50 I-TREATMENT -μg/72 I-TREATMENT -horas) I-TREATMENT +orienta I-TREATMENT +inicialmente I-TREATMENT +como I-TREATMENT +un I-TREATMENT +hematoma I-TREATMENT +calcificado I-TREATMENT y I-TREATMENT -ketorolaco I-TREATMENT -(10 I-TREATMENT -mg/8 I-TREATMENT -horas). I-TREATMENT - I-TREATMENT -La I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT se I-TREATMENT -lleva I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -en I-TREATMENT -Agosto I-TREATMENT -2005 I-TREATMENT -procediéndose I-TREATMENT -a I-TREATMENT -la I-TREATMENT -extirpación I-TREATMENT -del I-TREATMENT -tumor I-TREATMENT -mediante I-TREATMENT -osteotomía I-TREATMENT +sugiere I-TREATMENT +un I-TREATMENT +tratamiento I-TREATMENT +conservador I-TREATMENT +y I-TREATMENT +una I-TREATMENT +visita I-TREATMENT de I-TREATMENT -clavícula I-TREATMENT -con I-TREATMENT -posterior I-TREATMENT -reconstrucción I-TREATMENT -con I-TREATMENT -placa. I-TREATMENT -La B-EVOLUTION -anestesia I-EVOLUTION -y I-EVOLUTION -cirugía I-EVOLUTION -transcurren I-EVOLUTION -sin I-EVOLUTION -incidencias. I-EVOLUTION -La B-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -lo I-EXPLORATION -describe I-EXPLORATION -como I-EXPLORATION -schwannoma I-EXPLORATION -(neurilenoma) I-EXPLORATION -antiguo. I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -posteriores I-EVOLUTION -consultas I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -de I-EVOLUTION -miembro I-EVOLUTION -superior I-EVOLUTION -izquierdo I-EVOLUTION -se I-EVOLUTION -había I-EVOLUTION -resuelto. I-EVOLUTION -Sólo I-EVOLUTION -quedó I-EVOLUTION +seguimiento I-TREATMENT +tres I-TREATMENT +meses I-TREATMENT +después. I-TREATMENT +Pasado B-EVOLUTION +ese I-EVOLUTION +tiempo, I-EVOLUTION +solicitan I-EVOLUTION una I-EVOLUTION -ligera I-EVOLUTION -hipoestesia I-EVOLUTION +radiografía I-EVOLUTION +simple I-EVOLUTION +de I-EVOLUTION +control I-EVOLUTION +que I-EVOLUTION +no I-EVOLUTION +muestra I-EVOLUTION +cambios I-EVOLUTION +respecto I-EVOLUTION a I-EVOLUTION -nivel I-EVOLUTION -del I-EVOLUTION -territorio I-EVOLUTION -del I-EVOLUTION -nervio I-EVOLUTION -circunflejo, I-EVOLUTION -sin I-EVOLUTION -evidenciarse I-EVOLUTION -alteraciones I-EVOLUTION -en I-EVOLUTION la I-EVOLUTION -fuerza I-EVOLUTION -o I-EVOLUTION -los I-EVOLUTION -reflejos, I-EVOLUTION -que I-EVOLUTION -en I-EVOLUTION +previa. I-EVOLUTION +Ante I-EVOLUTION la I-EVOLUTION -última I-EVOLUTION -revisión I-EVOLUTION -de I-EVOLUTION +evolución I-EVOLUTION +clínica, I-EVOLUTION +revaloran I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION +TC I-EVOLUTION +inicial I-EVOLUTION +y I-EVOLUTION +reorientan I-EVOLUTION +el I-EVOLUTION +diagnóstico I-EVOLUTION +como I-EVOLUTION +miositis I-EVOLUTION +osificante I-EVOLUTION +traumática I-EVOLUTION +(MOT). I-EVOLUTION +Cuatro I-EVOLUTION +años I-EVOLUTION +después I-EVOLUTION +la I-EVOLUTION +lesión I-EVOLUTION +apenas I-EVOLUTION +ha I-EVOLUTION +disminuido I-EVOLUTION +su I-EVOLUTION +tamaño, I-EVOLUTION +pero I-EVOLUTION +la I-EVOLUTION +cirugía I-EVOLUTION +no I-EVOLUTION se I-EVOLUTION -había I-EVOLUTION -normalizado. I-EVOLUTION +plantea I-EVOLUTION +ya I-EVOLUTION +que I-EVOLUTION +clínicamente I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +está I-EVOLUTION +asintomática. I-EVOLUTION I-EVOLUTION Mujer B-PRESENT_ILLNESS -caucásica I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS +55 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -sufrió I-PRESENT_ILLNESS -traumatismo I-PRESENT_ILLNESS -torácico I-PRESENT_ILLNESS -(contusión I-PRESENT_ILLNESS -pulmonar I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fractura I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -clavícula I-PRESENT_ILLNESS -izquierda) I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pélvico I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -consecuencia I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +ingresó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +constitucional I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -accidente I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tráfico. I-PRESENT_ILLNESS -Debido B-TREATMENT -a I-TREATMENT -que I-TREATMENT -desarrolló I-TREATMENT -insuficiencia I-TREATMENT -respiratoria I-TREATMENT -hipoxémica I-TREATMENT -fue I-TREATMENT -ingresada I-TREATMENT -en I-TREATMENT -Unidad I-TREATMENT -de I-TREATMENT -Reanimación I-TREATMENT -para I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT -invasiva. I-TREATMENT -A B-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -complicó I-EVOLUTION -con I-EVOLUTION -síndrome I-EVOLUTION -del I-EVOLUTION -distrés I-EVOLUTION -respiratorio I-EVOLUTION -del I-EVOLUTION -adulto, I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION -final I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -respiratorio I-EVOLUTION -fue I-EVOLUTION -favorable I-EVOLUTION -y B-TREATMENT -fue I-TREATMENT -posible I-TREATMENT -extubar I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -a I-TREATMENT -las I-TREATMENT -72 I-TREATMENT -h. I-TREATMENT -La I-TREATMENT -sedoanalgesia I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -midazolam I-TREATMENT -y I-TREATMENT -fentanilo I-TREATMENT -en I-TREATMENT -perfusión I-TREATMENT -continua I-TREATMENT -endovenosa. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -la I-EVOLUTION -extubación I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -refería I-EVOLUTION -dolor I-EVOLUTION -intenso I-EVOLUTION -y I-EVOLUTION -lancinante I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -del I-EVOLUTION -hombro I-EVOLUTION -izquierdo I-EVOLUTION -con I-EVOLUTION -impotencia I-EVOLUTION -funcional. I-EVOLUTION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -analgésico I-TREATMENT -con I-TREATMENT -paracetamol I-TREATMENT -1g/6 I-TREATMENT -h I-TREATMENT -e I-TREATMENT -infusión I-TREATMENT -continua I-TREATMENT -endovenosa I-TREATMENT -de I-TREATMENT -remifentanilo, I-TREATMENT -y B-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION +evolución I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +tenesmo I-PRESENT_ILLNESS +rectal. I-PRESENT_ILLNESS +Presentaba B-EXPLORATION +molestias I-EXPLORATION +abdominales I-EXPLORATION +difusas I-EXPLORATION +y, I-EXPLORATION +al I-EXPLORATION +tacto, I-EXPLORATION +un I-EXPLORATION +recto I-EXPLORATION +rígido I-EXPLORATION +a I-EXPLORATION +punta I-EXPLORATION +de I-EXPLORATION +dedo. I-EXPLORATION +Se I-EXPLORATION +descartaron I-EXPLORATION +metástasis I-EXPLORATION +pulmonares I-EXPLORATION +y I-EXPLORATION +hepáticas. I-EXPLORATION +La I-EXPLORATION +rectocolonoscopia I-EXPLORATION +mostró I-EXPLORATION +engrosamiento I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +pliegues I-EXPLORATION +mucosos I-EXPLORATION +con I-EXPLORATION +aspecto I-EXPLORATION +pseudopolipoide I-EXPLORATION +y I-EXPLORATION +duro I-EXPLORATION +del I-EXPLORATION +7º I-EXPLORATION +al I-EXPLORATION +15º I-EXPLORATION +cm I-EXPLORATION +del I-EXPLORATION +margen I-EXPLORATION +anal I-EXPLORATION +con I-EXPLORATION la I-EXPLORATION -realización I-EXPLORATION +mucosa I-EXPLORATION +intacta. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +informó I-EXPLORATION +de I-EXPLORATION +infiltración I-EXPLORATION +carcinomatosa I-EXPLORATION +rectal I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +metástasis I-EXPLORATION +de I-EXPLORATION +carcinoma I-EXPLORATION +mamario I-EXPLORATION de I-EXPLORATION +tipo I-EXPLORATION +lobulillar, I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +siguiente I-EXPLORATION +estudio I-EXPLORATION +inmunohistoquímico: I-EXPLORATION +citoqueratina I-EXPLORATION +7 I-EXPLORATION ++, I-EXPLORATION +citoqueratina I-EXPLORATION +20 I-EXPLORATION +-, I-EXPLORATION +e-cadherina I-EXPLORATION +- I-EXPLORATION +y I-EXPLORATION +receptores I-EXPLORATION +estrogénicos I-EXPLORATION ++. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +mamográfico I-EXPLORATION +dirigido I-EXPLORATION +mostró I-EXPLORATION una I-EXPLORATION -resonancia I-EXPLORATION -magnética, I-EXPLORATION -hallándose I-EXPLORATION -lesión I-EXPLORATION +espiculación I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +mama I-EXPLORATION +izquierda, I-EXPLORATION +cuya I-EXPLORATION +biopsia I-EXPLORATION +con I-EXPLORATION +aguja I-EXPLORATION +gruesa I-EXPLORATION +(BAG) I-EXPLORATION +remedó I-EXPLORATION +la I-EXPLORATION +rectal. I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computerizada I-EXPLORATION +(TAC) I-EXPLORATION +abdominopélvica I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +rectal I-EXPLORATION +que I-EXPLORATION +ocupaba I-EXPLORATION +el I-EXPLORATION +saco I-EXPLORATION de I-EXPLORATION -plexo I-EXPLORATION -braquial I-EXPLORATION +Douglas I-EXPLORATION +y I-EXPLORATION +destruía I-EXPLORATION +los I-EXPLORATION +planos I-EXPLORATION +"de I-EXPLORATION +clivaje" I-EXPLORATION +rectouterinos. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +al I-EXPLORATION +alta I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +carcinoma I-EXPLORATION +lobulillar I-EXPLORATION +mamario I-EXPLORATION izquierdo I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -supra I-EXPLORATION -e I-EXPLORATION -infraclavicular. I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -prescrito I-TREATMENT -fue I-TREATMENT -ineficaz I-TREATMENT -y I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -remifentanilo I-TREATMENT -fue I-TREATMENT -elevándose I-TREATMENT -hasta I-TREATMENT -llegar I-TREATMENT -a I-TREATMENT -un I-TREATMENT -máximo I-TREATMENT -de I-TREATMENT -0, I-TREATMENT -5 I-TREATMENT -mcg/kg/min; I-TREATMENT -en I-TREATMENT -esta I-TREATMENT -situación I-TREATMENT -este I-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -mostró I-TREATMENT -ineficaz I-TREATMENT -porque I-TREATMENT -la I-TREATMENT -intensidad I-TREATMENT -del I-TREATMENT -dolor I-TREATMENT -no I-TREATMENT -mejoró I-TREATMENT -(VAS I-TREATMENT -8) I-TREATMENT -y I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -presentaba I-TREATMENT -excesiva I-TREATMENT -sedación I-TREATMENT -que I-TREATMENT -se I-TREATMENT -manifestaba I-TREATMENT -con I-TREATMENT -desaturaciones I-TREATMENT -frecuentes I-TREATMENT -en I-TREATMENT -la I-TREATMENT -monitorización I-TREATMENT -con I-TREATMENT -pulsioximetría I-TREATMENT -continua. I-TREATMENT - I-TREATMENT -En I-TREATMENT -vista I-TREATMENT -de I-TREATMENT -las I-TREATMENT -imágenes I-TREATMENT -radiológicas, I-TREATMENT -la I-TREATMENT -alternativa I-TREATMENT -analgésica I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -un I-TREATMENT -catéter I-TREATMENT -epidural I-TREATMENT -cervical I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -C5-C6 I-TREATMENT -para I-TREATMENT -analgesia I-TREATMENT -controlada I-TREATMENT -por I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -(PCA) I-TREATMENT -con I-TREATMENT -una I-TREATMENT -perfusión I-TREATMENT -de I-TREATMENT -0, I-TREATMENT -375 I-TREATMENT -% I-TREATMENT -ropivacaína I-TREATMENT -a I-TREATMENT -2 I-TREATMENT -mL/h I-TREATMENT -con I-TREATMENT -bolos I-TREATMENT -de I-TREATMENT -2 I-TREATMENT -mL I-TREATMENT -(tiempo I-TREATMENT -de I-TREATMENT -cierre I-TREATMENT -60 I-TREATMENT -min), I-TREATMENT -tras I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -dosis I-TREATMENT -test I-TREATMENT -y I-TREATMENT -de I-TREATMENT -carga I-TREATMENT -con I-TREATMENT -5 I-TREATMENT -mL I-TREATMENT -de I-TREATMENT -ropivacaína I-TREATMENT -0, I-TREATMENT -375 I-TREATMENT -% I-TREATMENT -se B-EVOLUTION -logró I-EVOLUTION -en I-EVOLUTION -diez I-EVOLUTION -minutos I-EVOLUTION -un I-EVOLUTION -adecuado I-EVOLUTION -control I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -(VAS I-EVOLUTION -2) I-EVOLUTION -sin I-EVOLUTION -complicaciones I-EVOLUTION -respiratorias I-EVOLUTION -ni I-EVOLUTION -hemodinámicas I-EVOLUTION -asociadas. I-EVOLUTION -A B-TREATMENT -la I-TREATMENT -vez I-TREATMENT -se I-TREATMENT -comenzó I-TREATMENT -tratamiento I-TREATMENT -específico I-TREATMENT -para I-TREATMENT -el I-TREATMENT -dolor I-TREATMENT -neuropático. I-TREATMENT - I-TREATMENT -La B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -trasladada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -referencia I-DERIVED_FROM/TO -12 I-DERIVED_FROM/TO -días I-DERIVED_FROM/TO -después I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -ingreso I-DERIVED_FROM/TO -hospitalario, I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -adecuado I-DERIVED_FROM/TO -control I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -dolor I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -gabapentina I-DERIVED_FROM/TO -600 I-DERIVED_FROM/TO -mg/8 I-DERIVED_FROM/TO -h I-DERIVED_FROM/TO -vo, I-DERIVED_FROM/TO -amitriptilina I-DERIVED_FROM/TO -25 I-DERIVED_FROM/TO -mg/d I-DERIVED_FROM/TO -vo, I-DERIVED_FROM/TO -clonacepam I-DERIVED_FROM/TO -2 I-DERIVED_FROM/TO -mg/d, I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -tramadol I-DERIVED_FROM/TO -75 I-DERIVED_FROM/TO -mg/12 I-DERIVED_FROM/TO -h I-DERIVED_FROM/TO -vo. I-DERIVED_FROM/TO -El B-TREATMENT -catéter I-TREATMENT -fue I-TREATMENT -entonces I-TREATMENT -retirado I-TREATMENT -sin I-TREATMENT -incidencias. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -67 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -diestra, I-PRESENT_ILLNESS -viuda, I-PRESENT_ILLNESS -ocupación: I-PRESENT_ILLNESS -hogar. I-PRESENT_ILLNESS -Padecimiento I-PRESENT_ILLNESS -actual I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -toque I-PRESENT_ILLNESS -eléctrico I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -descargas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -frontal, I-PRESENT_ILLNESS -temporal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -periorbitaria I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -lado I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -varios I-PRESENT_ILLNESS -segundos I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -minuto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -duración, I-PRESENT_ILLNESS -muy I-PRESENT_ILLNESS -intenso, I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -ocasiones I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -día, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -períodos I-PRESENT_ILLNESS -libres I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -entre I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -descargas I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS -sensitivas, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -producía I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -hablar I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -comer. I-PRESENT_ILLNESS -Cuatro B-TREATMENT -años I-TREATMENT -previos I-TREATMENT -a I-TREATMENT -su I-TREATMENT -llegada I-TREATMENT -a I-TREATMENT -nuestra I-TREATMENT -clínica I-TREATMENT -del I-TREATMENT -dolor I-TREATMENT -se I-TREATMENT -le I-TREATMENT -había I-TREATMENT -realizado I-TREATMENT -una I-TREATMENT -compresión I-TREATMENT -con I-TREATMENT -balón I-TREATMENT -en I-TREATMENT -ganglio I-TREATMENT -de I-TREATMENT -Gasser I-TREATMENT -izquierdo I-TREATMENT -y I-TREATMENT -había I-TREATMENT -sido I-TREATMENT -tratada I-TREATMENT -con I-TREATMENT -carbamacepina I-TREATMENT -por I-TREATMENT -otros I-TREATMENT -médicos, I-TREATMENT -con I-TREATMENT -éxito I-TREATMENT -durante I-TREATMENT -un I-TREATMENT -año, I-TREATMENT -posterior I-TREATMENT -al I-TREATMENT -cual I-TREATMENT -reinicio I-TREATMENT -cuadro I-TREATMENT -de I-TREATMENT -mismas I-TREATMENT -característica. I-TREATMENT -La B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -contaba I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -trauma I-PAST_MEDICAL_HISTORY -craneal, I-PAST_MEDICAL_HISTORY -cambios I-PAST_MEDICAL_HISTORY -visuales, I-PAST_MEDICAL_HISTORY -tinnitus, I-PAST_MEDICAL_HISTORY -vértigo I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -pérdida I-PAST_MEDICAL_HISTORY -auditiva. I-PAST_MEDICAL_HISTORY -Había I-PAST_MEDICAL_HISTORY -perdido I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -kg I-PAST_MEDICAL_HISTORY -debido I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -disminución I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ingesta I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alimentos I-PAST_MEDICAL_HISTORY -secundario I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -dolor. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermedades I-PAST_MEDICAL_HISTORY -crónico-degenerativas. I-PAST_MEDICAL_HISTORY -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -inicial I-EXPLORATION -era I-EXPLORATION -esencialmente I-EXPLORATION -normal. I-EXPLORATION -Contaba I-EXPLORATION +en I-EXPLORATION +estadio I-EXPLORATION +IV, I-EXPLORATION con I-EXPLORATION -exámenes I-EXPLORATION -generales I-EXPLORATION -normales, I-EXPLORATION -TAC I-EXPLORATION -de I-EXPLORATION -cráneo I-EXPLORATION -normal. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -bloqueo I-TREATMENT -de I-TREATMENT -ganglio I-TREATMENT -de I-TREATMENT -Gasser I-TREATMENT -con I-TREATMENT -fenol I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inicio I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -carbamacepina I-TREATMENT -200 I-TREATMENT -mg I-TREATMENT -c-12 I-TREATMENT -hrs I-TREATMENT -y I-TREATMENT -gabapentina I-TREATMENT -300 I-TREATMENT -mg I-TREATMENT -c-12 I-TREATMENT -hrs, I-TREATMENT -presentó I-TREATMENT -mejoría I-TREATMENT -24 I-TREATMENT -hrs I-TREATMENT -y I-TREATMENT -reinició I-TREATMENT -sintomatología. I-TREATMENT -Evolucionó B-EVOLUTION -sin I-EVOLUTION -control I-EVOLUTION -y I-EVOLUTION -al I-EVOLUTION -reexplorar I-EVOLUTION -se I-EVOLUTION -encontró I-EVOLUTION -punto I-EVOLUTION -doloroso I-EVOLUTION -bajo I-EVOLUTION -mastoides I-EVOLUTION -del I-EVOLUTION -lado I-EVOLUTION -izquierdo I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -exacerbado I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -flexión I-EVOLUTION -de I-EVOLUTION -cuello. I-EVOLUTION -Se B-TREATMENT -realizó I-TREATMENT -bloqueo I-TREATMENT -de I-TREATMENT -plexo I-TREATMENT -cervical I-TREATMENT -superficial I-TREATMENT -con I-TREATMENT -lidocaína I-TREATMENT -al I-TREATMENT -2% I-TREATMENT -simple I-TREATMENT -y I-TREATMENT -C2 I-TREATMENT -izquierdo I-TREATMENT +metástasis I-EXPLORATION +rectales. I-EXPLORATION +En B-TREATMENT +la I-TREATMENT +actualidad I-TREATMENT +sigue I-TREATMENT +régimen I-TREATMENT +quimioterápico I-TREATMENT +ambulatorio I-TREATMENT con I-TREATMENT -lidocaína I-TREATMENT -al I-TREATMENT -1% I-TREATMENT -simple I-TREATMENT +pobre I-TREATMENT +respuesta I-TREATMENT +clínica I-TREATMENT y I-TREATMENT -alcohol I-TREATMENT -puro I-TREATMENT -con I-TREATMENT -mejoría I-TREATMENT -inmediata, I-TREATMENT -desapareciendo I-TREATMENT -el I-TREATMENT -dolor. I-TREATMENT -La B-EXPLORATION -RMN I-EXPLORATION -mostró I-EXPLORATION -estenosis I-EXPLORATION -del I-EXPLORATION -conducto I-EXPLORATION -cervical. I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -permanece I-EVOLUTION -asintomática I-EVOLUTION -7 I-EVOLUTION +mal I-TREATMENT +tolerado. I-TREATMENT +En B-EVOLUTION +5 I-EVOLUTION meses I-EVOLUTION -después I-EVOLUTION -al I-EVOLUTION -procedimiento, I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -momento I-EVOLUTION -de I-EVOLUTION -éste I-EVOLUTION -reporte I-EVOLUTION -sin I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -realizar I-EVOLUTION -nuevo I-EVOLUTION -bloqueo. I-EVOLUTION -La B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -enviada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -columna I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -completar I-DERIVED_FROM/TO -tratamiento. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO +no I-EVOLUTION +ha I-EVOLUTION +sufrido I-EVOLUTION +complicación I-EVOLUTION +alguna I-EVOLUTION +que I-EVOLUTION +haya I-EVOLUTION +requerido I-EVOLUTION +cirugía I-EVOLUTION +paliativa. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -31 I-PRESENT_ILLNESS +59 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -diestra, B-PAST_MEDICAL_HISTORY -soltera, I-PAST_MEDICAL_HISTORY -médico I-PAST_MEDICAL_HISTORY -ortopedista. I-PAST_MEDICAL_HISTORY -Padecimiento B-PRESENT_ILLNESS -actual I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +diagnóstico I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +carcinoma I-PRESENT_ILLNESS +basocelular I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +ceja I-PRESENT_ILLNESS +izquierda I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +defecto I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +7x5 I-PRESENT_ILLNESS +cm. I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +resección I-PRESENT_ILLNESS +tumoral. I-PRESENT_ILLNESS +Realizamos B-TREATMENT +un I-TREATMENT +colgajo I-TREATMENT +en I-TREATMENT +isla I-TREATMENT +de I-TREATMENT +arteria I-TREATMENT +temporal I-TREATMENT +para I-TREATMENT +reconstrucción I-TREATMENT +completa I-TREATMENT +de I-TREATMENT +la I-TREATMENT +ceja I-TREATMENT +con I-TREATMENT +piel I-TREATMENT +con I-TREATMENT +pelo. I-TREATMENT +Posteriormente I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +depilación I-TREATMENT +con I-TREATMENT +láser I-TREATMENT +para I-TREATMENT +lograr I-TREATMENT +simetría I-TREATMENT +con I-TREATMENT +la I-TREATMENT +ceja I-TREATMENT +contralateral. I-TREATMENT + I-TREATMENT + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +39 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -caracterizado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS +urente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +epigastrio, I-PRESENT_ILLNESS +náuseas, I-PRESENT_ILLNESS +saciedad I-PRESENT_ILLNESS +temprana, I-PRESENT_ILLNESS +vómitos, I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +blandas, I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -punzante I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS +7 I-PRESENT_ILLNESS +kg, I-PRESENT_ILLNESS +astenia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +adinamia. I-PRESENT_ILLNESS +Dos I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +hospitalario I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +edema I-PRESENT_ILLNESS +progresivo I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -frontal I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -lado I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -temporal I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -mismo I-PRESENT_ILLNESS -lado I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +miembros I-PRESENT_ILLNESS +inferiores I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -periorbitario I-PRESENT_ILLNESS -intenso, I-PRESENT_ILLNESS -intermitente, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS -sensitivas. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -limitaba I-PRESENT_ILLNESS -sueño I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -bajado I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -causa I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -mismo. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION +hematemesis. I-PRESENT_ILLNESS +Tenía B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +sífilis I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +18 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Al B-EXPLORATION +ingreso I-EXPLORATION +hospitalario I-EXPLORATION se I-EXPLORATION encontró I-EXPLORATION +en I-EXPLORATION +anasarca I-EXPLORATION +y I-EXPLORATION +palidez I-EXPLORATION +mucocutánea. I-EXPLORATION +Se I-EXPLORATION +objetivó I-EXPLORATION dolor I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +de I-EXPLORATION +epigastrio, I-EXPLORATION +sin I-EXPLORATION +masas I-EXPLORATION +ni I-EXPLORATION +visceromegalias, I-EXPLORATION +con I-EXPLORATION +onda I-EXPLORATION +ascítica. I-EXPLORATION +Se I-EXPLORATION +observaron I-EXPLORATION +máculas I-EXPLORATION +violáceas I-EXPLORATION en I-EXPLORATION -apófisis I-EXPLORATION -espinosas I-EXPLORATION +el I-EXPLORATION +paladar I-EXPLORATION +duro, I-EXPLORATION +el I-EXPLORATION +piso I-EXPLORATION de I-EXPLORATION -C2, I-EXPLORATION -C3 I-EXPLORATION +la I-EXPLORATION +lengua I-EXPLORATION y I-EXPLORATION -punto I-EXPLORATION -doloroso I-EXPLORATION -occipital I-EXPLORATION -izquierdo. I-EXPLORATION -Las I-EXPLORATION -radiografías I-EXPLORATION -mostraban I-EXPLORATION -pérdida I-EXPLORATION +el I-EXPLORATION +glande I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +vascular, I-EXPLORATION +no I-EXPLORATION +sangrantes, I-EXPLORATION +con I-EXPLORATION +laceración I-EXPLORATION +del I-EXPLORATION +surco I-EXPLORATION +balano-prepucial I-EXPLORATION +y I-EXPLORATION +edema I-EXPLORATION +grado I-EXPLORATION +II I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +miembros I-EXPLORATION +inferiores. I-EXPLORATION +Se I-EXPLORATION +documentó I-EXPLORATION +VIH I-EXPLORATION +positivo I-EXPLORATION +por I-EXPLORATION +ELISA, I-EXPLORATION +confirmado I-EXPLORATION +por I-EXPLORATION +Western I-EXPLORATION +Blot, I-EXPLORATION +además I-EXPLORATION +de I-EXPLORATION +hipoproteinemia I-EXPLORATION +sin I-EXPLORATION +etiología I-EXPLORATION +clara; I-EXPLORATION +se I-EXPLORATION +descartaron I-EXPLORATION +causas I-EXPLORATION +cardiacas, I-EXPLORATION +hepáticas, I-EXPLORATION +renales I-EXPLORATION +o I-EXPLORATION +nutricionales. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +abdominal I-EXPLORATION +contrastada I-EXPLORATION +reportó I-EXPLORATION +engrosamiento I-EXPLORATION +polipoide I-EXPLORATION de I-EXPLORATION +las I-EXPLORATION +paredes I-EXPLORATION +gástricas I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -lordosis I-EXPLORATION -cervical. I-EXPLORATION +endoscopia I-EXPLORATION +digestiva I-EXPLORATION +alta I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +extensa I-EXPLORATION +lesión I-EXPLORATION +gástrica I-EXPLORATION +difusa I-EXPLORATION +multinodular I-EXPLORATION +y I-EXPLORATION +exofítica, I-EXPLORATION +de I-EXPLORATION +predominio I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +cuerpo I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +fondo. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +histopatológico I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +gástrica I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +marcada I-EXPLORATION +proliferación I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +foveolares, I-EXPLORATION +formando I-EXPLORATION +invaginaciones I-EXPLORATION +profundas I-EXPLORATION +y I-EXPLORATION +reemplazando I-EXPLORATION +la I-EXPLORATION +mucosa I-EXPLORATION +oxíntica I-EXPLORATION +original. I-EXPLORATION +A I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lámina I-EXPLORATION +propia I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +SK I-EXPLORATION +confirmado I-EXPLORATION +con I-EXPLORATION +inmunomarcación I-EXPLORATION +para I-EXPLORATION +herpes I-EXPLORATION +virus I-EXPLORATION +humano I-EXPLORATION +tipo I-EXPLORATION +8 I-EXPLORATION +(HHV8). I-EXPLORATION Se B-TREATMENT -realizó I-TREATMENT -bloqueo I-TREATMENT -desinflamatorio I-TREATMENT -de I-TREATMENT -C2 I-TREATMENT +inició I-TREATMENT +terapia I-TREATMENT +antirretroviral I-TREATMENT y I-TREATMENT -C3 I-TREATMENT -izquierdos I-TREATMENT -con I-TREATMENT -lidocaína I-TREATMENT -al I-TREATMENT -1% I-TREATMENT -simple I-TREATMENT -con I-TREATMENT -mejoría I-TREATMENT -del I-TREATMENT -80% I-TREATMENT -en I-TREATMENT -sintomatología, I-TREATMENT se I-TREATMENT -inicia I-TREATMENT -gabapentina I-TREATMENT -300 I-TREATMENT -mg I-TREATMENT -c-12 I-TREATMENT -hrs. I-TREATMENT -Se I-TREATMENT -dio I-TREATMENT -manejo I-TREATMENT +programó I-TREATMENT para I-TREATMENT -patología I-TREATMENT -cervical I-TREATMENT -por I-TREATMENT -parte I-TREATMENT -del I-TREATMENT -servicio I-TREATMENT +ulterior I-TREATMENT +inicio I-TREATMENT de I-TREATMENT -columna, I-TREATMENT -no I-TREATMENT -hubo I-TREATMENT -necesidad I-TREATMENT +quimioterapia I-TREATMENT +con I-TREATMENT +antraciclinas. I-TREATMENT + I-TREATMENT + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +raza I-PRESENT_ILLNESS +blanca, I-PRESENT_ILLNESS +80 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nuestra I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +disfagia I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +induración I-EXPLORATION +eritematosa, I-EXPLORATION +parcialmente I-EXPLORATION +ulcerada, I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +dorso I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lengua I-EXPLORATION +dolorosa I-EXPLORATION +al I-EXPLORATION +tacto. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +objetivó, I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación, I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +adenomegalias, I-EXPLORATION +ni I-EXPLORATION +de I-EXPLORATION +otras I-EXPLORATION +masas I-EXPLORATION +cervicales. I-EXPLORATION +Se I-EXPLORATION +efectuó I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +incisional I-EXPLORATION +cuyo I-EXPLORATION +estudio I-EXPLORATION +histopatológico I-EXPLORATION +evidenció I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +proliferación I-EXPLORATION +uniforme I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +linfoides I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +linfoma. I-EXPLORATION +La I-EXPLORATION +analítica I-EXPLORATION +preoperatoria I-EXPLORATION +(hemograma, I-EXPLORATION +bioquímica) I-EXPLORATION +y I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax, I-EXPLORATION +no I-EXPLORATION +mostraron I-EXPLORATION +alteraciones I-EXPLORATION +significativas. I-EXPLORATION +Bajo B-TREATMENT +anestesia I-TREATMENT +local I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +la I-TREATMENT +exéresis I-TREATMENT de I-TREATMENT -aplicar I-TREATMENT -nuevos I-TREATMENT -bloqueos I-TREATMENT -cervicales. I-TREATMENT +la I-TREATMENT +tumoración I-TREATMENT +con I-TREATMENT +amplios I-TREATMENT +márgenes I-TREATMENT +de I-TREATMENT +seguridad. I-TREATMENT + I-TREATMENT +Microscópicamente, B-EXPLORATION +el I-EXPLORATION +infiltrado I-EXPLORATION +linfoide I-EXPLORATION +ulceraba I-EXPLORATION +la I-EXPLORATION +superficie I-EXPLORATION +epitelial I-EXPLORATION +infiltrando, I-EXPLORATION +en I-EXPLORATION +profundidad, I-EXPLORATION +la I-EXPLORATION +musculatura I-EXPLORATION +lingual. I-EXPLORATION +Alrededor I-EXPLORATION +de I-EXPLORATION +este I-EXPLORATION +infiltrado I-EXPLORATION +se I-EXPLORATION +podían I-EXPLORATION +reconocer I-EXPLORATION +múltiples I-EXPLORATION +folículos I-EXPLORATION +linfoides; I-EXPLORATION +algunos I-EXPLORATION +mostraban I-EXPLORATION +centros I-EXPLORATION +germinales I-EXPLORATION +reactivos I-EXPLORATION +con I-EXPLORATION +histiocitos I-EXPLORATION +tipo I-EXPLORATION +cielo I-EXPLORATION +estrellado I-EXPLORATION +(starry-sky); I-EXPLORATION +otros I-EXPLORATION +mostraron I-EXPLORATION +cambios I-EXPLORATION +regresivos I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +centros I-EXPLORATION +germinales I-EXPLORATION +con I-EXPLORATION +depósitos I-EXPLORATION +de I-EXPLORATION +sustancia I-EXPLORATION +eosinófila I-EXPLORATION +homogénea. I-EXPLORATION +Todos I-EXPLORATION +estaban I-EXPLORATION +rodeados I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +importante I-EXPLORATION +infiltrado I-EXPLORATION +perifolicular I-EXPLORATION +compuesto I-EXPLORATION +por I-EXPLORATION +pequeñas I-EXPLORATION +células I-EXPLORATION +linfoides I-EXPLORATION +con I-EXPLORATION +núcleos I-EXPLORATION +ligeramente I-EXPLORATION +irregulares I-EXPLORATION +y I-EXPLORATION +acúmulos I-EXPLORATION +de I-EXPLORATION +cromatina I-EXPLORATION +moderadamente I-EXPLORATION +densos I-EXPLORATION +similares I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +centrocitos I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +marginal. I-EXPLORATION +También I-EXPLORATION +se I-EXPLORATION +pudo I-EXPLORATION +reconocer I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +numerosos I-EXPLORATION +histiocitos I-EXPLORATION +y I-EXPLORATION +eosinófilos. I-EXPLORATION +Ocasionalmente I-EXPLORATION +algunas I-EXPLORATION +células I-EXPLORATION +de I-EXPLORATION +gran I-EXPLORATION +tamaño, I-EXPLORATION +con I-EXPLORATION +varios I-EXPLORATION +nucleolos I-EXPLORATION +prominentes, I-EXPLORATION +se I-EXPLORATION +entremezclaban I-EXPLORATION +con I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +pequeñas I-EXPLORATION +formando I-EXPLORATION +columnas I-EXPLORATION +de I-EXPLORATION +centroblastos I-EXPLORATION +e I-EXPLORATION +inmunoblastos. I-EXPLORATION +También I-EXPLORATION +podía I-EXPLORATION +reconocerse I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +importante I-EXPLORATION +diferenciación I-EXPLORATION +plasmocitoide, I-EXPLORATION +predominante I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +paraseptal I-EXPLORATION +y I-EXPLORATION +subepitelial. I-EXPLORATION +En I-EXPLORATION +los I-EXPLORATION +bordes I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +tumoración, I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +lóbulos, I-EXPLORATION +parcialmente I-EXPLORATION +conservados, I-EXPLORATION +de I-EXPLORATION +glándulas I-EXPLORATION +salivales I-EXPLORATION +menores I-EXPLORATION +de I-EXPLORATION +tipo I-EXPLORATION +mucoso, I-EXPLORATION +mostrando I-EXPLORATION +una I-EXPLORATION +destacada I-EXPLORATION +infiltración I-EXPLORATION +linfoidea. I-EXPLORATION +Los I-EXPLORATION +conductos I-EXPLORATION +salivales I-EXPLORATION +estaban I-EXPLORATION +dilatados I-EXPLORATION +e I-EXPLORATION +infiltrados I-EXPLORATION +por I-EXPLORATION +células I-EXPLORATION +B I-EXPLORATION +con I-EXPLORATION +formación I-EXPLORATION +ocasional I-EXPLORATION +de I-EXPLORATION +islas I-EXPLORATION +epimioepiteliales. I-EXPLORATION +También I-EXPLORATION +se I-EXPLORATION +podían I-EXPLORATION +reconocer, I-EXPLORATION +abundantes I-EXPLORATION +células I-EXPLORATION +plasmáticas I-EXPLORATION +alrededor I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +conductos I-EXPLORATION +glandulares. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +inmunohistoquímico I-EXPLORATION +se I-EXPLORATION +efectuó I-EXPLORATION +sobre I-EXPLORATION +secciones I-EXPLORATION +congeladas I-EXPLORATION +y I-EXPLORATION +fijadas I-EXPLORATION +en I-EXPLORATION +formalina I-EXPLORATION +y I-EXPLORATION +parafina, I-EXPLORATION +utilizando I-EXPLORATION +el I-EXPLORATION +método I-EXPLORATION +estreptavidina-biotina. I-EXPLORATION +Se I-EXPLORATION +emplearon I-EXPLORATION +los I-EXPLORATION +siguientes I-EXPLORATION +anticuerpos: I-EXPLORATION +CD20, I-EXPLORATION +CD3, I-EXPLORATION +CD5, I-EXPLORATION +CD10, I-EXPLORATION +CD23, I-EXPLORATION +CD43, I-EXPLORATION +DBA44, I-EXPLORATION +CD68, I-EXPLORATION +inmunoglobulinas I-EXPLORATION +α, I-EXPLORATION +γ, I-EXPLORATION +µ I-EXPLORATION +de I-EXPLORATION +cadena I-EXPLORATION +pesada I-EXPLORATION +y I-EXPLORATION +κ, I-EXPLORATION +λ I-EXPLORATION +de I-EXPLORATION +cadena I-EXPLORATION +ligera. I-EXPLORATION +Las I-EXPLORATION +células I-EXPLORATION +centrocíticas, I-EXPLORATION +mostraron I-EXPLORATION +un I-EXPLORATION +fenotipo I-EXPLORATION +B, I-EXPLORATION +con I-EXPLORATION +positividad I-EXPLORATION +para I-EXPLORATION +CD20, I-EXPLORATION +CD5 I-EXPLORATION +y I-EXPLORATION +CD43. I-EXPLORATION +CD10, I-EXPLORATION +CD23 I-EXPLORATION +y I-EXPLORATION +DBA44 I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +También I-EXPLORATION +se I-EXPLORATION +evidenció I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +pequeña I-EXPLORATION +proporción I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +T, I-EXPLORATION +con I-EXPLORATION +positividad I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +CD3. I-EXPLORATION +Las I-EXPLORATION +células I-EXPLORATION +plasmáticas I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +bandas I-EXPLORATION +paraseptales I-EXPLORATION +y I-EXPLORATION +subepiteliales I-EXPLORATION +y I-EXPLORATION +también I-EXPLORATION +las I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +conductos I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +glándulas I-EXPLORATION +mucosas, I-EXPLORATION +mostraron I-EXPLORATION +producción I-EXPLORATION +de I-EXPLORATION +inmunoglobulina I-EXPLORATION +IgG/κ. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +definitivo I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +linfoma I-EXPLORATION +MALT. I-EXPLORATION +Las I-EXPLORATION +alteraciones I-EXPLORATION +morfológicas I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +glándulas I-EXPLORATION +salivales I-EXPLORATION +menores I-EXPLORATION +próximas I-EXPLORATION +al I-EXPLORATION +tumor, I-EXPLORATION +se I-EXPLORATION +interpretaron I-EXPLORATION +como I-EXPLORATION +sialoadenitis I-EXPLORATION +mioepitelial. I-EXPLORATION + I-EXPLORATION La B-EVOLUTION paciente I-EVOLUTION -permanece I-EVOLUTION -asintomática I-EVOLUTION -3 I-EVOLUTION -años I-EVOLUTION -después. I-EVOLUTION - I-EVOLUTION +no I-EVOLUTION +sufrió I-EVOLUTION +otras I-EVOLUTION +manifestaciones I-EVOLUTION +de I-EVOLUTION +enfermedad I-EVOLUTION +como I-EVOLUTION +síndrome I-EVOLUTION +de I-EVOLUTION +Sjögren, I-EVOLUTION +artritis I-EVOLUTION +reumatoide I-EVOLUTION +diseminada, I-EVOLUTION +lupus I-EVOLUTION +eritematoso, I-EVOLUTION +o I-EVOLUTION +tiroiditis I-EVOLUTION +de I-EVOLUTION +Hashimoto. I-EVOLUTION +El I-EVOLUTION +linfoma I-EVOLUTION +se I-EVOLUTION +consideró I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +tanto I-EVOLUTION +en I-EVOLUTION +un I-EVOLUTION +estadio I-EVOLUTION +IE. I-EVOLUTION +La B-TREATMENT +paciente I-TREATMENT +no I-TREATMENT +ha I-TREATMENT +recibido I-TREATMENT +ningún I-TREATMENT +tratamiento I-TREATMENT +salvo I-TREATMENT +el I-TREATMENT +quirúrgico, I-TREATMENT +sin I-TREATMENT +presentar I-TREATMENT +signos I-TREATMENT +de I-TREATMENT +enfermedad I-TREATMENT +al I-TREATMENT +año I-TREATMENT +del I-TREATMENT +diagnóstico. I-TREATMENT + I-TREATMENT -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +Lactante B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +11 I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -diagnosticado I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alergia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +proteína I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +leche I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vaca, I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +clínica I-PAST_MEDICAL_HISTORY +compatible I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +contrapruebas I-PAST_MEDICAL_HISTORY +positivas, I-PAST_MEDICAL_HISTORY +alimentada I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +lactancia I-PAST_MEDICAL_HISTORY +materna I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +dieta I-PAST_MEDICAL_HISTORY +hipoalergénica. I-PAST_MEDICAL_HISTORY +Tuvo I-PAST_MEDICAL_HISTORY +adecuado I-PAST_MEDICAL_HISTORY +incremento I-PAST_MEDICAL_HISTORY +pondoestatural I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +9 I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +(P/T I-PAST_MEDICAL_HISTORY +–0, I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +DS I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +T/E I-PAST_MEDICAL_HISTORY +–0, I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +DS), I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +evolucionó I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +peso I-PAST_MEDICAL_HISTORY +estacionario I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +caída I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +curva I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +peso I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +talla I-PAST_MEDICAL_HISTORY +(P/T I-PAST_MEDICAL_HISTORY +–0, I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +DS I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +T/E I-PAST_MEDICAL_HISTORY +–0, I-PAST_MEDICAL_HISTORY +8). I-PAST_MEDICAL_HISTORY +Por B-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -hernia I-PRESENT_ILLNESS -discal, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -Durogesic® I-PRESENT_ILLNESS -150 I-PRESENT_ILLNESS -μg/h I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -buena I-PRESENT_ILLNESS -eficacia I-PRESENT_ILLNESS +modo I-PRESENT_ILLNESS +intercurrente I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +alta I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +solicitaron I-PRESENT_ILLNESS +exámenes I-PRESENT_ILLNESS +generales I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -seguridad. I-PRESENT_ILLNESS -Se B-TREATMENT -cambia I-TREATMENT -por I-TREATMENT -un I-TREATMENT -genérico, I-TREATMENT -notándose B-EVOLUTION -un I-EVOLUTION -empeoramiento I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -doloroso I-EVOLUTION -y I-EVOLUTION -síntomas I-EVOLUTION -neurológicos I-EVOLUTION +de I-PRESENT_ILLNESS +orina, I-PRESENT_ILLNESS +compatibles I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +infección I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +tracto I-PRESENT_ILLNESS +urinario. I-PRESENT_ILLNESS +Los B-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +sangre I-EXPLORATION +mostraron I-EXPLORATION +leucocitosis I-EXPLORATION +con I-EXPLORATION +desviación I-EXPLORATION +a I-EXPLORATION +izquierda I-EXPLORATION +y I-EXPLORATION +elevación I-EXPLORATION +severa I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +FA I-EXPLORATION +(4.552 I-EXPLORATION +UI/l), I-EXPLORATION +calcio, I-EXPLORATION +fósforo I-EXPLORATION +y I-EXPLORATION +enzimas I-EXPLORATION +hepáticas I-EXPLORATION +en I-EXPLORATION +rango I-EXPLORATION +normal. I-EXPLORATION +Se I-EXPLORATION +solicitaron I-EXPLORATION +isoenzimas I-EXPLORATION +que I-EXPLORATION +revelaron I-EXPLORATION +predominio I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +fracción I-EXPLORATION +ósea I-EXPLORATION +sobre I-EXPLORATION +la I-EXPLORATION +hepática I-EXPLORATION +de I-EXPLORATION +96, I-EXPLORATION +3% I-EXPLORATION +a I-EXPLORATION +3, I-EXPLORATION +7% I-EXPLORATION +respectivamente. I-EXPLORATION +Evolucionó B-EVOLUTION +con I-EVOLUTION +normalización I-EVOLUTION de I-EVOLUTION -inestabilidad. I-EVOLUTION -Se B-TREATMENT -vuelve I-TREATMENT -a I-TREATMENT -cambiar I-TREATMENT -a I-TREATMENT -Durogesic®, I-TREATMENT -y B-EVOLUTION +los I-EVOLUTION +niveles I-EVOLUTION de I-EVOLUTION -nuevo I-EVOLUTION -se I-EVOLUTION -estabiliza I-EVOLUTION -la I-EVOLUTION -analgesia I-EVOLUTION +FA I-EVOLUTION +a I-EVOLUTION +269 I-EVOLUTION +UI/l I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +3 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION y I-EVOLUTION -desaparece I-EVOLUTION -la I-EVOLUTION -sintomatología I-EVOLUTION -neurológica. I-EVOLUTION +recuperación I-EVOLUTION +de I-EVOLUTION +curva I-EVOLUTION +pondoestatural. I-EVOLUTION I-EVOLUTION Paciente B-PRESENT_ILLNESS @@ -216884,16807 +104216,19430 @@ analgesia. I-TREATMENT I-TREATMENT Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -62 B-TREATMENT -kg, I-TREATMENT -en I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -Durogesic® I-TREATMENT -100 I-TREATMENT -μg/h. I-TREATMENT -Se I-TREATMENT -cambia I-TREATMENT -la I-TREATMENT -prescripción I-TREATMENT -a I-TREATMENT -fentanilo I-TREATMENT -genérico I-TREATMENT -100 I-TREATMENT -μg. I-TREATMENT -Pérdida B-EVOLUTION -de I-EVOLUTION -eficacia I-EVOLUTION -analgésica. I-EVOLUTION -Se B-TREATMENT -restaura I-TREATMENT -Durogesic® I-TREATMENT -100 I-TREATMENT -μg/h. I-TREATMENT -Mejoría B-EVOLUTION -clínica. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -diagnosticada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -estenosis I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -canal I-PRESENT_ILLNESS -medular I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -hernia I-PRESENT_ILLNESS -discal, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -Durogesic® I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -μg/h I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -buena I-PRESENT_ILLNESS -eficacia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -seguridad. I-PRESENT_ILLNESS -Se B-TREATMENT -cambia I-TREATMENT -por I-TREATMENT -fentanilo I-TREATMENT -genérico, I-TREATMENT -notándose I-TREATMENT -un I-TREATMENT -empeoramiento I-TREATMENT -del I-TREATMENT -cuadro I-TREATMENT -doloroso. I-TREATMENT -Se I-TREATMENT -vuelve I-TREATMENT -a I-TREATMENT -cambiar I-TREATMENT -a I-TREATMENT -Durogesic®, I-TREATMENT -y I-TREATMENT -de I-TREATMENT -nuevo I-TREATMENT -se I-TREATMENT -estabiliza I-TREATMENT -la I-TREATMENT -analgesia. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS +38 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -diagnosticado B-PAST_MEDICAL_HISTORY +multípara B-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -osteoartrosis I-PAST_MEDICAL_HISTORY -primaria, I-PAST_MEDICAL_HISTORY -muy I-PAST_MEDICAL_HISTORY -invalidante, I-PAST_MEDICAL_HISTORY +5, I-PAST_MEDICAL_HISTORY +IMC I-PAST_MEDICAL_HISTORY +25, I-PAST_MEDICAL_HISTORY +7 I-PAST_MEDICAL_HISTORY +kg/m2, I-PAST_MEDICAL_HISTORY +puérpera I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +7 I-PAST_MEDICAL_HISTORY +días I-PAST_MEDICAL_HISTORY +(parto I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +cesárea I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +otra I-PAST_MEDICAL_HISTORY +institución), I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -prótesis I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -cadera I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY +hipotiroidismo I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY tratamiento I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -Durogesic® I-PAST_MEDICAL_HISTORY -25 I-PAST_MEDICAL_HISTORY -μg/h. I-PAST_MEDICAL_HISTORY -Durante I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -mismo I-PAST_MEDICAL_HISTORY -modo. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -actualidad I-PAST_MEDICAL_HISTORY -continúa I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -Durogesic® I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -μg/h. I-PAST_MEDICAL_HISTORY -Hace I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -brote I-PAST_MEDICAL_HISTORY -psicótico, I-PAST_MEDICAL_HISTORY -motivo I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -tuvo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -ingresado I-PAST_MEDICAL_HISTORY -psiquiátricamente. I-PAST_MEDICAL_HISTORY -Al B-TREATMENT -alta I-TREATMENT -del I-TREATMENT -hospital I-TREATMENT -se I-TREATMENT -le I-TREATMENT -prescribió I-TREATMENT -fentanilo I-TREATMENT -50 I-TREATMENT -μg/h I-TREATMENT -(genérico). I-TREATMENT -A B-EVOLUTION -raíz I-EVOLUTION -de I-EVOLUTION -dicho I-EVOLUTION -cambio I-EVOLUTION -se I-EVOLUTION -volvieran I-EVOLUTION -a I-EVOLUTION -agravar I-EVOLUTION -sus I-EVOLUTION -algias I-EVOLUTION -y I-EVOLUTION -un I-EVOLUTION -síndrome I-EVOLUTION -de I-EVOLUTION -abstinencia I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -caracterizaba I-EVOLUTION -por I-EVOLUTION -inquietud, I-EVOLUTION -irritabilidad I-EVOLUTION -y B-TREATMENT -un I-TREATMENT -cuadro I-TREATMENT -confusional I-TREATMENT -que I-TREATMENT -desapareció I-TREATMENT -al I-TREATMENT -volver I-TREATMENT -a I-TREATMENT -prescribirse I-TREATMENT -nuevamente I-TREATMENT -Durogesic® I-TREATMENT -50 I-TREATMENT -μg/h. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -diagnosticado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cáncer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vejiga I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -metástasis, I-PRESENT_ILLNESS +levotiroxina I-PAST_MEDICAL_HISTORY +75 I-PAST_MEDICAL_HISTORY +mcg/día. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Consulta B-PRESENT_ILLNESS en I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -Durogesic® I-PRESENT_ILLNESS -75 I-PRESENT_ILLNESS -μg/h I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -buena I-PRESENT_ILLNESS -eficacia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -seguridad. I-PRESENT_ILLNESS -En B-TREATMENT -oncología I-TREATMENT -se I-TREATMENT -cambia I-TREATMENT -por I-TREATMENT -fentanilo I-TREATMENT -genérico, I-TREATMENT -notándose I-TREATMENT -un I-TREATMENT -empeoramiento I-TREATMENT -del I-TREATMENT -cuadro I-TREATMENT -doloroso. I-TREATMENT -Se B-EVOLUTION -vuelve I-EVOLUTION -a I-EVOLUTION -cambiar I-EVOLUTION -a I-EVOLUTION -Durogesic®, I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -nuevo I-EVOLUTION -se I-EVOLUTION -estabiliza I-EVOLUTION -la I-EVOLUTION -analgesia. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +general I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS +Santiago I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +h I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS +retroesternal I-PRESENT_ILLNESS +opresivo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -miembro I-PRESENT_ILLNESS -fantasma I-PRESENT_ILLNESS +inicio I-PRESENT_ILLNESS +súbito I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -muñón I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -extremidad I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -(EID) I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1/3 I-PRESENT_ILLNESS -medio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -muslo I-PRESENT_ILLNESS -refractario I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -analgésico I-PRESENT_ILLNESS -vía I-PRESENT_ILLNESS -oral, I-PRESENT_ILLNESS -remitido B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Dolor I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -decide I-DERIVED_FROM/TO -colocación I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -bomba I-DERIVED_FROM/TO -intratecal I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -ziconotide. I-DERIVED_FROM/TO -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -presenta: I-PAST_MEDICAL_HISTORY -obesidad, I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -ansioso-depresivo, I-PAST_MEDICAL_HISTORY -neumonía I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY -atípica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -abril I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2007 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -alergia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -ciprofloxacino, I-PAST_MEDICAL_HISTORY -castaña, I-PAST_MEDICAL_HISTORY -kiwi I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -látex. I-PAST_MEDICAL_HISTORY -Respecto I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -traumatológica, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -sufre I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -fractura I-PAST_MEDICAL_HISTORY -espiroidea I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tercio I-PAST_MEDICAL_HISTORY -distal I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tibia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -maleolo I-PAST_MEDICAL_HISTORY -peroneo I-PAST_MEDICAL_HISTORY -derechos I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -mayo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2000 I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -accidente I-PAST_MEDICAL_HISTORY -laboral, I-PAST_MEDICAL_HISTORY -siendo I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -osteosíntesis I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -tornillos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -placa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -neutralización. I-PAST_MEDICAL_HISTORY -Tras I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -curso I-PAST_MEDICAL_HISTORY -postoperatorio I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -complicaciones I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -dada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alta. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -comienza I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -presentar I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -espontáneo, I-PAST_MEDICAL_HISTORY -punzante I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tobillo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cara I-PAST_MEDICAL_HISTORY -anterior I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -pierna I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -aumenta I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -palpación I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -cargar I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -miembro I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -intenta I-PAST_MEDICAL_HISTORY -caminar, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -cual I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -añade I-PAST_MEDICAL_HISTORY -edema I-PAST_MEDICAL_HISTORY -severo I-PAST_MEDICAL_HISTORY -infracondíleo, I-PAST_MEDICAL_HISTORY -palidez, I-PAST_MEDICAL_HISTORY -frialdad I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hiperhidrosis I-PAST_MEDICAL_HISTORY -diagnosticándose I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Distrofia I-PAST_MEDICAL_HISTORY -Simpático I-PAST_MEDICAL_HISTORY -Refleja I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -EID. I-PAST_MEDICAL_HISTORY -Es I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -técnicas I-PAST_MEDICAL_HISTORY -regionales I-PAST_MEDICAL_HISTORY -asociadas I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -médico I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -fracasaron, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -finalmente, I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -sufrir I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -intervenciones I-PAST_MEDICAL_HISTORY -(simpatectomía I-PAST_MEDICAL_HISTORY -lumbar, I-PAST_MEDICAL_HISTORY -absceso, I-PAST_MEDICAL_HISTORY -celulitis) I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -decide I-PAST_MEDICAL_HISTORY -amputación I-PAST_MEDICAL_HISTORY -infracondílea I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -EID. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -posteriori, I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -desfavorable, I-PAST_MEDICAL_HISTORY -realizándose I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -nueva I-PAST_MEDICAL_HISTORY -amputación I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -1/3 I-PAST_MEDICAL_HISTORY -medio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -muslo I-PAST_MEDICAL_HISTORY -EID I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -marzo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2004. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Seguidamente I-PAST_MEDICAL_HISTORY -continúa I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -intenso I-PAST_MEDICAL_HISTORY -continuo I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tobillo, I-PAST_MEDICAL_HISTORY -pie I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -rodilla I-PAST_MEDICAL_HISTORY -amputados I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -decide I-PAST_MEDICAL_HISTORY -implantación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -catéter I-PAST_MEDICAL_HISTORY -epidural I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -ambulatorio I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -analgesia I-PAST_MEDICAL_HISTORY -epidural I-PAST_MEDICAL_HISTORY -controlada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -(PCEA) I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -13 I-PAST_MEDICAL_HISTORY -abril I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2004, I-PAST_MEDICAL_HISTORY -asociado I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -bajada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dosis I-PAST_MEDICAL_HISTORY -importante I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -farmacológico I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -venía I-PAST_MEDICAL_HISTORY -tomando I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -anterioridad I-PAST_MEDICAL_HISTORY -(antidepresivos I-PAST_MEDICAL_HISTORY -tricíclicos, I-PAST_MEDICAL_HISTORY -benzodiacepinas, I-PAST_MEDICAL_HISTORY -mórficos, I-PAST_MEDICAL_HISTORY -AINEs, I-PAST_MEDICAL_HISTORY -etc.). I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -favorable I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2005 I-PAST_MEDICAL_HISTORY -sufre I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -accidente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tráfico I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -arrancamiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -catéter I-PAST_MEDICAL_HISTORY -epidural, I-PAST_MEDICAL_HISTORY -contractura I-PAST_MEDICAL_HISTORY -cervical I-PAST_MEDICAL_HISTORY -muscular I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -vertiginoso I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -empeoramiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -depresivo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -doloroso. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -intentó I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -adaptación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -prótesis I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -poder I-PAST_MEDICAL_HISTORY -caminar I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -sesiones I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -rehabilitación, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -éxito I-PAST_MEDICAL_HISTORY -debido I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -secuela I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -crónico I-PAST_MEDICAL_HISTORY -consistente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -flexo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cadera I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -EID I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -impidió I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -adaptación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -prótesis I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -consecuencia, I-PAST_MEDICAL_HISTORY -caminar I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -normalidad. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-TREATMENT -enero I-TREATMENT +máxima I-PRESENT_ILLNESS +intensidad. I-PRESENT_ILLNESS +Ingresa B-EXPLORATION +sin I-EXPLORATION +compromiso I-EXPLORATION +hemodinámico, I-EXPLORATION +afebril, I-EXPLORATION +con I-EXPLORATION +examen I-EXPLORATION +cardiopulmonar I-EXPLORATION +normal. I-EXPLORATION +Electrocardiograma I-EXPLORATION +(ECG) I-EXPLORATION +muestra I-EXPLORATION +infradesnivel I-EXPLORATION +del I-EXPLORATION +ST I-EXPLORATION +difuso. I-EXPLORATION +Se B-TREATMENT +inicia I-TREATMENT +manejo I-TREATMENT +médico I-TREATMENT +con I-TREATMENT +aspirina, I-TREATMENT +morfina I-TREATMENT +y I-TREATMENT +nitroglicerina I-TREATMENT +sublingual; I-TREATMENT +y B-EXPLORATION +se I-EXPLORATION +solicitan I-EXPLORATION +enzimas I-EXPLORATION +cardíacas I-EXPLORATION +y I-EXPLORATION +dímero I-EXPLORATION +D. I-EXPLORATION +Exámenes I-EXPLORATION +de I-EXPLORATION +ingreso I-EXPLORATION +evidencian: I-EXPLORATION +hemoglobina I-EXPLORATION +14, I-EXPLORATION +9 I-EXPLORATION +g/dL, I-EXPLORATION +hematocrito I-EXPLORATION +43, I-EXPLORATION +7%, I-EXPLORATION +recuento I-EXPLORATION +de I-EXPLORATION +plaquetas I-EXPLORATION +288.000/uL, I-EXPLORATION +eosinóflos I-EXPLORATION +2, I-EXPLORATION +9%, I-EXPLORATION +VHS I-EXPLORATION +17 I-EXPLORATION +mm/h, I-EXPLORATION +creatinina I-EXPLORATION +0, I-EXPLORATION +43 I-EXPLORATION +mg/dL, I-EXPLORATION +troponina I-EXPLORATION +0, I-EXPLORATION +45 I-EXPLORATION +ng/ml, I-EXPLORATION +creatincinasa I-EXPLORATION +(CK) I-EXPLORATION +72 I-EXPLORATION +U/L, I-EXPLORATION +Ck-mb I-EXPLORATION +2, I-EXPLORATION +8 I-EXPLORATION +U/L; I-EXPLORATION +dímero I-EXPLORATION +D I-EXPLORATION +554 I-EXPLORATION +ng/ml. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +solicita I-EXPLORATION +AngioTAC I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +dímero I-EXPLORATION +D I-EXPLORATION +elevado, I-EXPLORATION +que I-EXPLORATION +descarta I-EXPLORATION +tromboembolismo I-EXPLORATION +pulmonar. I-EXPLORATION + I-EXPLORATION +Persiste I-EXPLORATION +con I-EXPLORATION +dolor I-EXPLORATION +y I-EXPLORATION +ECG I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +evidencia I-EXPLORATION +QS I-EXPLORATION +en I-EXPLORATION +AVL, I-EXPLORATION +qR I-EXPLORATION +en I-EXPLORATION +DI I-EXPLORATION +y I-EXPLORATION +cambios I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +amplitud I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +onda I-EXPLORATION +R I-EXPLORATION +en I-EXPLORATION +V4-V6. I-EXPLORATION +Enzimas I-EXPLORATION +cardiacas I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +con I-EXPLORATION +troponina I-EXPLORATION +> I-EXPLORATION +50 I-EXPLORATION +ng/ml, I-EXPLORATION +CK I-EXPLORATION +3.800 I-EXPLORATION +U/L I-EXPLORATION +y I-EXPLORATION +Ck-mb I-EXPLORATION +> I-EXPLORATION +300 I-EXPLORATION +U/L. I-EXPLORATION +Coronariografía I-EXPLORATION +muestra I-EXPLORATION +disección I-EXPLORATION +de I-EXPLORATION +tronco I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +coronaria I-EXPLORATION +izquierda, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +extiende I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +circunfleja I-EXPLORATION +(Cx) I-EXPLORATION +proximal I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +rama I-EXPLORATION +marginal I-EXPLORATION +pequeña. I-EXPLORATION +Arteria I-EXPLORATION +descendente I-EXPLORATION +anterior I-EXPLORATION +(ADA) I-EXPLORATION +y I-EXPLORATION +coronaria I-EXPLORATION +derecha I-EXPLORATION +sin I-EXPLORATION +lesiones. I-EXPLORATION +Se B-TREATMENT +instala I-TREATMENT +balón I-TREATMENT de I-TREATMENT -2008 I-TREATMENT -acude I-TREATMENT +contrapulsación I-TREATMENT +aórtica I-TREATMENT +y I-TREATMENT +se I-TREATMENT +traslada I-TREATMENT a I-TREATMENT -nuestra I-TREATMENT -Unidad I-TREATMENT -del I-TREATMENT -Dolor I-TREATMENT +cirugía, I-TREATMENT donde I-TREATMENT se I-TREATMENT -le I-TREATMENT -propone I-TREATMENT -la I-TREATMENT -implantación I-TREATMENT -de I-TREATMENT -bomba I-TREATMENT +realiza I-TREATMENT +bypass I-TREATMENT +con I-TREATMENT +arteria I-TREATMENT +mamaria I-TREATMENT +interna I-TREATMENT +(LIMA) I-TREATMENT +a I-TREATMENT +ADA I-TREATMENT +y I-TREATMENT +puente I-TREATMENT +safeno I-TREATMENT +a I-TREATMENT +lateral I-TREATMENT +Cx, I-TREATMENT +sin I-TREATMENT +incidentes. I-TREATMENT + I-TREATMENT +Evoluciona B-EVOLUTION +favorablemente I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +post I-EVOLUTION +operatorio, I-EVOLUTION +con B-TREATMENT +retiro I-TREATMENT de I-TREATMENT -infusión I-TREATMENT -continua I-TREATMENT +drogas I-TREATMENT +vasoactivas I-TREATMENT +y I-TREATMENT +balón I-TREATMENT de I-TREATMENT -Ziconotide I-TREATMENT +contrapulsación I-TREATMENT a I-TREATMENT -nivel I-TREATMENT -intratecal, I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -acepta I-TREATMENT -tras I-TREATMENT -ser I-TREATMENT -informada I-TREATMENT -del I-TREATMENT -procedimiento, I-TREATMENT -posibles I-TREATMENT -resultados, I-TREATMENT -complicaciones I-TREATMENT +las I-TREATMENT +48 I-TREATMENT +h. I-TREATMENT + I-TREATMENT +Ecocardiograma B-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +con I-EXPLORATION +acinesia I-EXPLORATION +no I-EXPLORATION +adelgazada I-EXPLORATION +anterolateral I-EXPLORATION +con I-EXPLORATION +fracción I-EXPLORATION +de I-EXPLORATION +eyección I-EXPLORATION +de I-EXPLORATION +42%. I-EXPLORATION +Se B-TREATMENT +optimiza I-TREATMENT +control I-TREATMENT +farmacológico I-TREATMENT +de I-TREATMENT +insuficiencia I-TREATMENT +cardíaca I-TREATMENT +con I-TREATMENT +bisoprolol I-TREATMENT +1, I-TREATMENT +25 I-TREATMENT +mg I-TREATMENT +al I-TREATMENT +día, I-TREATMENT +espironolactona I-TREATMENT +25 I-TREATMENT +mg I-TREATMENT +al I-TREATMENT +día, I-TREATMENT +enalapril I-TREATMENT +5 I-TREATMENT +mg I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +h I-TREATMENT y I-TREATMENT -efectos I-TREATMENT -adversos. I-TREATMENT -Se I-TREATMENT -entrega I-TREATMENT -consentimiento I-TREATMENT -informado I-TREATMENT +atorvastatina I-TREATMENT +40 I-TREATMENT +mg I-TREATMENT +al I-TREATMENT +día. I-TREATMENT +Se B-DERIVED_FROM/TO +traslada I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +quinto I-DERIVED_FROM/TO +día I-DERIVED_FROM/TO +post I-DERIVED_FROM/TO +cirugía I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +otro I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +motivos I-DERIVED_FROM/TO +previsionales. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Se B-EVOLUTION +controla I-EVOLUTION +en I-EVOLUTION +policlínico I-EVOLUTION +15 I-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +alta, I-EVOLUTION +encontrándose I-EVOLUTION +en I-EVOLUTION +buenas I-EVOLUTION +condiciones I-EVOLUTION +generales, I-EVOLUTION +asintomática, I-EVOLUTION +sin I-EVOLUTION +angina, I-EVOLUTION +en I-EVOLUTION +capacidad I-EVOLUTION +funcional I-EVOLUTION +I, I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +ya I-EVOLUTION +descrito, I-EVOLUTION +sin I-EVOLUTION +lactancia I-EVOLUTION +materna. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +50 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +ni B-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +interés, I-FAMILY_HISTORY +remitido B-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +consulta I-DERIVED_FROM/TO +externa I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +urología I-DERIVED_FROM/TO +ante I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +hallazgo I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +ecografía I-DERIVED_FROM/TO +abdominal, I-DERIVED_FROM/TO +realizada I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +síntomas I-DERIVED_FROM/TO +digestivos I-DERIVED_FROM/TO +inespecíficos, I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +tumoración I-DERIVED_FROM/TO +suprarrenal I-DERIVED_FROM/TO +derecha I-DERIVED_FROM/TO +sólida I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +6 I-DERIVED_FROM/TO +cm I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +diámetro. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +La B-EXPLORATION +anamnesis I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +no I-EXPLORATION +revelaron I-EXPLORATION +síntomas I-EXPLORATION +ni I-EXPLORATION +signos I-EXPLORATION +que I-EXPLORATION +orientaran I-EXPLORATION +hacia I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +endocrinopatía, I-EXPLORATION +ni I-EXPLORATION +hacia I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +primario. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +procedió, I-EXPLORATION +mediante I-EXPLORATION +estudio I-EXPLORATION +endocrinológico, I-EXPLORATION +a I-EXPLORATION +establecer I-EXPLORATION +el I-EXPLORATION +carácter I-EXPLORATION +funcionante I-EXPLORATION +o I-EXPLORATION +no I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +tumoración I-EXPLORATION +suprarrenal. I-EXPLORATION +Se I-EXPLORATION +determinaron: I-EXPLORATION +cortisol I-EXPLORATION +libre I-EXPLORATION +en I-EXPLORATION +orina; I-EXPLORATION +cortisol I-EXPLORATION +en I-EXPLORATION +orina I-EXPLORATION +de I-EXPLORATION +24 I-EXPLORATION +horas; I-EXPLORATION +supresión I-EXPLORATION +con I-EXPLORATION +1 I-EXPLORATION +mgr I-EXPLORATION +de I-EXPLORATION +dexametasona; I-EXPLORATION +cortisol I-EXPLORATION +basal I-EXPLORATION +en I-EXPLORATION +sangre; I-EXPLORATION +ACTH; I-EXPLORATION +aldosterona I-EXPLORATION +en I-EXPLORATION +sangre; I-EXPLORATION +DHEA-sulfato; I-EXPLORATION +catecolaminas I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +(noradrenalina, I-EXPLORATION +adrenalina) I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +orina, I-EXPLORATION +y I-EXPLORATION +sus I-EXPLORATION +metabolitos I-EXPLORATION +(vanilmandélico, I-EXPLORATION +metanefrinas). I-EXPLORATION +Los I-EXPLORATION +resultados I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +parámetros I-EXPLORATION +analíticos I-EXPLORATION +practicados I-EXPLORATION +fueron I-EXPLORATION +todos I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +TAC I-EXPLORATION +abdominal I-EXPLORATION +demuestra I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +suprarrenal I-EXPLORATION +derecha I-EXPLORATION +sólida, I-EXPLORATION +de I-EXPLORATION +contornos I-EXPLORATION +bien I-EXPLORATION +definidos I-EXPLORATION +y I-EXPLORATION +densidad I-EXPLORATION +heterogénea, I-EXPLORATION +con I-EXPLORATION +áreas I-EXPLORATION +hipodensas I-EXPLORATION +e I-EXPLORATION +imágenes I-EXPLORATION +de I-EXPLORATION +densidad I-EXPLORATION +calcio I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +interior, I-EXPLORATION +que I-EXPLORATION +mide I-EXPLORATION +6, I-EXPLORATION +5 I-EXPLORATION +x I-EXPLORATION +3 I-EXPLORATION +cm. I-EXPLORATION +La I-EXPLORATION +Resonancia I-EXPLORATION +Magnética I-EXPLORATION +muestra I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +ovalada I-EXPLORATION +y I-EXPLORATION +bien I-EXPLORATION +definida, I-EXPLORATION +de I-EXPLORATION +6, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +mayor, I-EXPLORATION +isointensa I-EXPLORATION +respecto I-EXPLORATION +al I-EXPLORATION +bazo I-EXPLORATION +en I-EXPLORATION +T1 I-EXPLORATION +y I-EXPLORATION +T2, I-EXPLORATION +con I-EXPLORATION +áreas I-EXPLORATION +irregulares I-EXPLORATION +hiperintensas I-EXPLORATION +en I-EXPLORATION +T2. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +concluyó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +suprarrenal I-EXPLORATION +derecha I-EXPLORATION +sólida, I-EXPLORATION +de I-EXPLORATION +6, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +funcionante. I-EXPLORATION +Con B-TREATMENT +este I-TREATMENT +diagnóstico, I-TREATMENT y I-TREATMENT -se I-TREATMENT -cita I-TREATMENT -para I-TREATMENT +apoyados I-TREATMENT +fundamentalmente I-TREATMENT +en I-TREATMENT el I-TREATMENT -20/2/2008 I-TREATMENT -para I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -bomba. I-TREATMENT - I-TREATMENT -Colocación I-TREATMENT -de I-TREATMENT -bomba I-TREATMENT -intratecal I-TREATMENT +tamaño I-TREATMENT de I-TREATMENT -ziconotide I-TREATMENT -y I-TREATMENT -evolución I-TREATMENT -posterior I-TREATMENT - I-TREATMENT -Con I-TREATMENT la I-TREATMENT -paciente I-TREATMENT +tumoración, I-TREATMENT +así I-TREATMENT +como I-TREATMENT en I-TREATMENT -decúbito I-TREATMENT -lateral I-TREATMENT -se I-TREATMENT -hace I-TREATMENT -incisión I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -abdomen I-TREATMENT -para I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT la I-TREATMENT -bomba I-TREATMENT +presencia I-TREATMENT de I-TREATMENT -infusión I-TREATMENT -subcutánea. I-TREATMENT -Posteriormente I-TREATMENT -se I-TREATMENT -localiza I-TREATMENT -espacio I-TREATMENT -intradural I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -L4-L5 I-TREATMENT -donde I-TREATMENT +calcificaciones I-TREATMENT +irregulares I-TREATMENT +en I-TREATMENT +su I-TREATMENT +interior, I-TREATMENT se I-TREATMENT -introduce I-TREATMENT -catéter I-TREATMENT +decidió I-TREATMENT +la I-TREATMENT +exéresis I-TREATMENT +quirúrgica I-TREATMENT de I-TREATMENT -infusión I-TREATMENT -continua. I-TREATMENT -Dicho I-TREATMENT -catéter I-TREATMENT -se I-TREATMENT -tuneliza I-TREATMENT -vía I-TREATMENT -subcutánea I-TREATMENT -hasta I-TREATMENT la I-TREATMENT -unión I-TREATMENT -con I-TREATMENT +misma I-TREATMENT +ante I-TREATMENT la I-TREATMENT -bomba I-TREATMENT +posibilidad I-TREATMENT de I-TREATMENT -infusión. I-TREATMENT -Cierre I-TREATMENT +que I-TREATMENT +se I-TREATMENT +tratara I-TREATMENT de I-TREATMENT -incisiones I-TREATMENT -con I-TREATMENT -sutura. I-TREATMENT -Programación I-TREATMENT +un I-TREATMENT +carcinoma I-TREATMENT +suprarrenal. I-TREATMENT +Se I-TREATMENT +practicó I-TREATMENT +suprarrenalectomía I-TREATMENT +derecha I-TREATMENT +a I-TREATMENT +través I-TREATMENT de I-TREATMENT +lumbotomía. I-TREATMENT + I-TREATMENT +Macroscópicamente, I-TREATMENT la I-TREATMENT -bomba I-TREATMENT -de I-TREATMENT -ziconotide. I-TREATMENT -La I-TREATMENT -dosis I-TREATMENT -inicial I-TREATMENT -fue I-TREATMENT -de I-TREATMENT -1, I-TREATMENT -2 I-TREATMENT -microg/día I-TREATMENT -de I-TREATMENT -ziconotide I-TREATMENT -que I-TREATMENT -a I-TREATMENT -lo I-TREATMENT -largo I-TREATMENT +pieza I-TREATMENT de I-TREATMENT -13 I-TREATMENT -meses I-TREATMENT -se I-TREATMENT -aumentó I-TREATMENT -a I-TREATMENT -7, I-TREATMENT +suprarrenalectomía I-TREATMENT +midió I-TREATMENT 8 I-TREATMENT -microg/día. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -estado I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -cuando I-EVOLUTION -acudió I-EVOLUTION -por I-EVOLUTION -primera I-EVOLUTION -vez I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -Unidad I-EVOLUTION -era I-EVOLUTION -muy I-EVOLUTION -desfavorable: I-EVOLUTION -EVA I-EVOLUTION -8/10, I-EVOLUTION -imposibilidad I-EVOLUTION -de I-EVOLUTION -sueño I-EVOLUTION -reparador I-EVOLUTION -por I-EVOLUTION -despertares I-EVOLUTION -frecuentes I-EVOLUTION -por I-EVOLUTION -dolor, I-EVOLUTION -estreñimiento I-EVOLUTION -moderado I-EVOLUTION -debido I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -opiodes, I-EVOLUTION -falta I-EVOLUTION -de I-EVOLUTION -apetito, I-EVOLUTION -incapacidad I-EVOLUTION -de I-EVOLUTION -realizar I-EVOLUTION -actividad I-EVOLUTION -normal I-EVOLUTION -por I-EVOLUTION -dolor I-EVOLUTION -y I-EVOLUTION -estado I-EVOLUTION -depresivo I-EVOLUTION -grave. I-EVOLUTION -Los I-EVOLUTION -requerimientos I-EVOLUTION -analgésicos I-EVOLUTION -eran I-EVOLUTION -altos I-EVOLUTION -con I-EVOLUTION -dosis I-EVOLUTION -muy I-EVOLUTION -elevada I-EVOLUTION -de I-EVOLUTION -opioides I-EVOLUTION -y I-EVOLUTION -necesidad I-EVOLUTION -de I-EVOLUTION -rescates I-EVOLUTION -frecuentes I-EVOLUTION -(cada I-EVOLUTION +x I-TREATMENT +6, I-TREATMENT +5 I-TREATMENT +x I-TREATMENT +3 I-TREATMENT +cm. I-TREATMENT +La B-EXPLORATION +tumoración I-EXPLORATION +muestra I-EXPLORATION +una I-EXPLORATION +superficie I-EXPLORATION +multinodular, I-EXPLORATION +constituida I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +tejido I-EXPLORATION +homogéneo, I-EXPLORATION +blanquecino-grisáceo I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +fasciculado. I-EXPLORATION +Microscópicamente, I-EXPLORATION +el I-EXPLORATION +tumor I-EXPLORATION +está I-EXPLORATION +constituido I-EXPLORATION +por I-EXPLORATION +células I-EXPLORATION +de I-EXPLORATION +Schwann I-EXPLORATION +dispuestas I-EXPLORATION +en I-EXPLORATION +pequeños I-EXPLORATION +fascículos I-EXPLORATION +entrelazados I-EXPLORATION +con I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +focos I-EXPLORATION +de I-EXPLORATION +estroma I-EXPLORATION +mixoide I-EXPLORATION +y I-EXPLORATION +grupos I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +ganglionares I-EXPLORATION +maduras. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +inmunohistoquímico I-EXPLORATION +para I-EXPLORATION +determinación I-EXPLORATION +de I-EXPLORATION +proteína I-EXPLORATION +S-100, I-EXPLORATION +observándose I-EXPLORATION +intensa I-EXPLORATION +y I-EXPLORATION +generalizada I-EXPLORATION +inmunoreacción I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +neoplásicas. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +definitivo I-EXPLORATION +es I-EXPLORATION +de I-EXPLORATION +ganglioneuroma I-EXPLORATION +suprarrenal. I-EXPLORATION + I-EXPLORATION +Tras B-EVOLUTION 2 I-EVOLUTION -horas). I-EVOLUTION -Durante I-EVOLUTION -la I-EVOLUTION -subida I-EVOLUTION -progresiva I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -bomba I-EVOLUTION +años I-EVOLUTION de I-EVOLUTION -ziconotide I-EVOLUTION +seguimiento I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION se I-EVOLUTION -consiguió I-EVOLUTION -disminuir I-EVOLUTION -su I-EVOLUTION -tratamiento I-EVOLUTION -antiálgico I-EVOLUTION +encuentra I-EVOLUTION +asintomático I-EVOLUTION y I-EVOLUTION -mejorar I-EVOLUTION -notablemente I-EVOLUTION -su I-EVOLUTION -dolor I-EVOLUTION -pasando I-EVOLUTION -de I-EVOLUTION -8/10 I-EVOLUTION -a I-EVOLUTION -4/10 I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -escala I-EVOLUTION -EVA, I-EVOLUTION -además I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -mayor I-EVOLUTION -descanso I-EVOLUTION -nocturno I-EVOLUTION -(durmiendo I-EVOLUTION -más I-EVOLUTION -de I-EVOLUTION -6 I-EVOLUTION -horas I-EVOLUTION sin I-EVOLUTION -despertar I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -dolor), I-EVOLUTION -recuperar I-EVOLUTION -apetito, I-EVOLUTION -eliminar I-EVOLUTION -estreñimiento, I-EVOLUTION -volver I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -vida I-EVOLUTION -cotidiana I-EVOLUTION -y I-EVOLUTION -elevar I-EVOLUTION -su I-EVOLUTION -estado I-EVOLUTION -de I-EVOLUTION -ánimo. I-EVOLUTION -En I-EVOLUTION -este I-EVOLUTION -tiempo I-EVOLUTION -de I-EVOLUTION -adaptación I-EVOLUTION -dosis/efecto, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -tuvo I-EVOLUTION -periodos I-EVOLUTION -limitados I-EVOLUTION +evidencias I-EVOLUTION de I-EVOLUTION -mareo, I-EVOLUTION -sensación I-EVOLUTION +recidiva I-EVOLUTION de I-EVOLUTION -embotamiento I-EVOLUTION -en I-EVOLUTION la I-EVOLUTION -cabeza, I-EVOLUTION -acúfenos I-EVOLUTION -y I-EVOLUTION -cefalea I-EVOLUTION -que I-EVOLUTION -remitieron I-EVOLUTION -con I-EVOLUTION -tratamiento I-EVOLUTION -sintomático I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -paso I-EVOLUTION -del I-EVOLUTION -tiempo. I-EVOLUTION - I-EVOLUTION -Actualmente, I-EVOLUTION -continúa I-EVOLUTION -en I-EVOLUTION -seguimiento I-EVOLUTION -en I-EVOLUTION -nuestra I-EVOLUTION -unidad I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -recaída I-EVOLUTION -del I-EVOLUTION -dolor. I-EVOLUTION +lesión. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Una B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS +56 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -16 I-PRESENT_ILLNESS -kg I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY +fue B-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -rabdomiosarcoma I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -muslo I-PAST_MEDICAL_HISTORY -izquierdo I-PAST_MEDICAL_HISTORY +carcinoma I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +células I-PAST_MEDICAL_HISTORY +renales I-PAST_MEDICAL_HISTORY +estadio I-PAST_MEDICAL_HISTORY +1. I-PAST_MEDICAL_HISTORY +Fue I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +nefrectomía I-PAST_MEDICAL_HISTORY +derecha I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -metástasis I-PAST_MEDICAL_HISTORY -ganglionar I-PAST_MEDICAL_HISTORY -inguinal I-PAST_MEDICAL_HISTORY -ipsilateral, I-PAST_MEDICAL_HISTORY -fue B-PRESENT_ILLNESS -programada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -electiva I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -resección I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -recidiva I-PRESENT_ILLNESS -tumoral I-PRESENT_ILLNESS -local I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -tejidos I-PRESENT_ILLNESS -blandos, I-PRESENT_ILLNESS -vaciamiento I-PRESENT_ILLNESS -ganglionar I-PRESENT_ILLNESS -inguinal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -colocación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -catéteres I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -braquiterapia. I-PRESENT_ILLNESS -La B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -recibido I-PAST_MEDICAL_HISTORY quimioterapia I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -previos, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alergia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -medicamentos I-PAST_MEDICAL_HISTORY +adyuvante. I-PAST_MEDICAL_HISTORY +Tres I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +tarde I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -intervención I-PAST_MEDICAL_HISTORY -previa I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -tumor I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -tuvo I-PAST_MEDICAL_HISTORY -complicaciones I-PAST_MEDICAL_HISTORY -anestésicas. I-PAST_MEDICAL_HISTORY -Sus B-EXPLORATION -exámenes I-EXPLORATION -prequirúrgicos I-EXPLORATION -mostraban I-EXPLORATION +metástasis I-PAST_MEDICAL_HISTORY +pulmonar I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +cerebral. I-PAST_MEDICAL_HISTORY +Hace B-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +año, I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +hemorragia I-PRESENT_ILLNESS +digestiva I-PRESENT_ILLNESS +alta. I-PRESENT_ILLNESS +Presentaba B-EXPLORATION +aceptable I-EXPLORATION +estado I-EXPLORATION +general I-EXPLORATION +y I-EXPLORATION +nutricional, I-EXPLORATION +TA I-EXPLORATION +120/70 I-EXPLORATION +y I-EXPLORATION +exploración I-EXPLORATION +cardiorrespiratoria I-EXPLORATION +normal. I-EXPLORATION +Abdomen I-EXPLORATION +blando, I-EXPLORATION +depresible I-EXPLORATION +sin I-EXPLORATION +masas I-EXPLORATION +palpables. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +analítico I-EXPLORATION +reveló I-EXPLORATION hemoglobina I-EXPLORATION -10, I-EXPLORATION -9 I-EXPLORATION -g/dl, I-EXPLORATION -hematocrito I-EXPLORATION -31, I-EXPLORATION -7%, I-EXPLORATION -conteo I-EXPLORATION -plaquetario I-EXPLORATION -213.000/µl, I-EXPLORATION -TPT I-EXPLORATION -24, I-EXPLORATION -5 I-EXPLORATION -segundos, I-EXPLORATION -TP I-EXPLORATION -11, I-EXPLORATION +de I-EXPLORATION +6, I-EXPLORATION 3 I-EXPLORATION -segundos I-EXPLORATION -e I-EXPLORATION -INR I-EXPLORATION -1, I-EXPLORATION -06. I-EXPLORATION -Se I-EXPLORATION -reservó I-EXPLORATION -1 I-EXPLORATION -unidad I-EXPLORATION +g/dl. I-EXPLORATION +Un I-EXPLORATION +TAC I-EXPLORATION +toraco-abdominal I-EXPLORATION +demostró I-EXPLORATION +una I-EXPLORATION +gran I-EXPLORATION +masa I-EXPLORATION +en I-EXPLORATION +cuerpo I-EXPLORATION +y I-EXPLORATION +antro I-EXPLORATION +gástrico I-EXPLORATION de I-EXPLORATION -glóbulos I-EXPLORATION -rojos I-EXPLORATION -empaquetados I-EXPLORATION +11 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +mayor I-EXPLORATION +sin I-EXPLORATION +invasión I-EXPLORATION +de I-EXPLORATION +estructuras I-EXPLORATION +adyacentes. I-EXPLORATION +Una I-EXPLORATION +endoscopia I-EXPLORATION +alta I-EXPLORATION +demostró I-EXPLORATION +una I-EXPLORATION +gran I-EXPLORATION +masa I-EXPLORATION en I-EXPLORATION -su I-EXPLORATION -evaluación I-EXPLORATION -preanestésica. I-EXPLORATION -Se B-TREATMENT -discutió I-TREATMENT -con I-TREATMENT -su I-TREATMENT -madre I-TREATMENT -en I-TREATMENT -la I-TREATMENT -evaluación I-TREATMENT -preanestésica I-TREATMENT -la I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -ofrecer I-TREATMENT -una I-TREATMENT -técnica I-TREATMENT -regional I-TREATMENT -continua I-TREATMENT -para I-TREATMENT -el I-TREATMENT -manejo I-TREATMENT -del I-TREATMENT -perioperatorio, I-TREATMENT -destacando I-TREATMENT -su I-TREATMENT -papel I-TREATMENT -en I-TREATMENT -el I-TREATMENT -control I-TREATMENT -analgésico I-TREATMENT -post-quirúrgico. I-TREATMENT -El I-TREATMENT -consentimiento I-TREATMENT -informado I-TREATMENT -fue I-TREATMENT -diligenciado. I-TREATMENT -La I-TREATMENT +cuerpo I-EXPLORATION +y I-EXPLORATION +antro I-EXPLORATION +gástrico. I-EXPLORATION +La B-TREATMENT paciente I-TREATMENT -tenía I-TREATMENT -una I-TREATMENT -vena I-TREATMENT -periférica I-TREATMENT -canalizada I-TREATMENT -a I-TREATMENT -su I-TREATMENT -ingreso I-TREATMENT -al I-TREATMENT -quirófano I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -inducción I-TREATMENT -anestésica I-TREATMENT -convencional I-TREATMENT -con I-TREATMENT -fentanil I-TREATMENT -2 I-TREATMENT -µg/kg, I-TREATMENT -lidocaína I-TREATMENT -1 I-TREATMENT -mg/kg, I-TREATMENT -propofol I-TREATMENT -2 I-TREATMENT -mg/kg, I-TREATMENT -dexametasona I-TREATMENT -0, I-TREATMENT -15 I-TREATMENT -mg/kg I-TREATMENT -y I-TREATMENT -cisatracurio I-TREATMENT -2 I-TREATMENT -mg/kg, I-TREATMENT -intubación I-TREATMENT -orotraqueal I-TREATMENT +fue I-TREATMENT +tratada I-TREATMENT con I-TREATMENT -tubo I-TREATMENT -5.0 I-TREATMENT +gastrectomía I-TREATMENT +subtotal I-TREATMENT sin I-TREATMENT -balón, I-TREATMENT -mantenimiento I-TREATMENT -anestésico I-TREATMENT -balanceado I-TREATMENT -con I-TREATMENT -remifentanilo I-TREATMENT -en I-TREATMENT -infusión I-TREATMENT -titulada I-TREATMENT -y I-TREATMENT -sevoflurano I-TREATMENT -a I-TREATMENT -0, I-TREATMENT -8 I-TREATMENT -MAC, I-TREATMENT -ventilación I-TREATMENT -mecánica I-TREATMENT +complicaciones. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION +demostró I-EXPLORATION +metástasis I-EXPLORATION +de I-EXPLORATION +carcinoma I-EXPLORATION +renal. I-EXPLORATION + I-EXPLORATION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +36 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +traumatismo I-PRESENT_ILLNESS +craneoencefálico I-PRESENT_ILLNESS +presenta, I-PRESENT_ILLNESS +8 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +después, I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +medular I-PRESENT_ILLNESS +incompleto I-PRESENT_ILLNESS +sensitivo I-PRESENT_ILLNESS +motor I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +par I-PRESENT_ILLNESS +VI I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +(OI) I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +produce I-PRESENT_ILLNESS +diplopía I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +todas I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +posiciones I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +mirada. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +motora I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +limitación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +abducción I-EXPLORATION +de I-EXPLORATION +-3, I-EXPLORATION +tortícolis I-EXPLORATION +cara I-EXPLORATION +izquierda I-EXPLORATION +de I-EXPLORATION +10o, I-EXPLORATION +endotropía I-EXPLORATION +de I-EXPLORATION +45 I-EXPLORATION +r I-EXPLORATION +en I-EXPLORATION +posición I-EXPLORATION +primaria I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +mirada I-EXPLORATION +con I-EXPLORATION +ojo I-EXPLORATION +derecho I-EXPLORATION +(OD) I-EXPLORATION +fijador. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +sensorial, I-EXPLORATION +la I-EXPLORATION +prueba I-EXPLORATION +de I-EXPLORATION +Worth I-EXPLORATION +muestra I-EXPLORATION +supresión I-EXPLORATION +intermitente I-EXPLORATION +de I-EXPLORATION +OI. I-EXPLORATION +La I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +(AV) I-EXPLORATION +es I-EXPLORATION +de I-EXPLORATION +OD I-EXPLORATION +1 I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +OI I-EXPLORATION +1. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +oftalmológica I-EXPLORATION +es I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -volumen I-TREATMENT -corriente I-TREATMENT +dos I-TREATMENT +inyecciones I-TREATMENT de I-TREATMENT -7 I-TREATMENT -ml/kg, I-TREATMENT -frecuencia I-TREATMENT -respiratoria I-TREATMENT -22 I-TREATMENT -por I-TREATMENT -minuto, I-TREATMENT -PEEP I-TREATMENT +toxina I-TREATMENT +botulínica I-TREATMENT 5 I-TREATMENT -cmH2O I-TREATMENT -y I-TREATMENT -FiO2 I-TREATMENT -70%. I-TREATMENT -Después I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -posicionó I-TREATMENT +UI I-TREATMENT en I-TREATMENT -decúbito I-TREATMENT -lateral I-TREATMENT -izquierdo I-TREATMENT -y I-TREATMENT -flexión I-TREATMENT -de I-TREATMENT -las I-TREATMENT -caderas. I-TREATMENT -En I-TREATMENT -esta I-TREATMENT -posición I-TREATMENT -realizamos I-TREATMENT -un I-TREATMENT -escaneo I-TREATMENT -previo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -caudal I-TREATMENT -utilizando I-TREATMENT -un I-TREATMENT -equipo I-TREATMENT -SonoSite I-TREATMENT -M-Turbo® I-TREATMENT +recto I-TREATMENT +medio I-TREATMENT +del I-TREATMENT +OI, I-TREATMENT con I-TREATMENT -transductor I-TREATMENT -lineal I-TREATMENT -L25x I-TREATMENT -de I-TREATMENT -13-6 I-TREATMENT -MHz, I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -identificaron I-TREATMENT -los I-TREATMENT -distintas I-TREATMENT -estructuras I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +disminuyó I-TREATMENT +la I-TREATMENT +endotropía I-TREATMENT a I-TREATMENT -ese I-TREATMENT -nivel I-TREATMENT -incluida I-TREATMENT +30 I-TREATMENT +r I-TREATMENT +sin I-TREATMENT +mejorar I-TREATMENT la I-TREATMENT -membrana I-TREATMENT -sacro-coxígea I-TREATMENT -y I-TREATMENT +abducción. I-TREATMENT + I-TREATMENT +A I-TREATMENT los I-TREATMENT -cuernos I-TREATMENT -sacros. I-TREATMENT -Posteriormente I-TREATMENT +6 I-TREATMENT +meses I-TREATMENT se I-TREATMENT -realizó I-TREATMENT -antisepsia I-TREATMENT +realiza I-TREATMENT +TRV I-TREATMENT con I-TREATMENT -clorhexidina I-TREATMENT -al I-TREATMENT -4% I-TREATMENT +fijación I-TREATMENT +escleral I-TREATMENT en I-TREATMENT -zona I-TREATMENT -lumbosacra I-TREATMENT -y I-TREATMENT -perineal I-TREATMENT -y I-TREATMENT -se I-TREATMENT -cubrió I-TREATMENT -con I-TREATMENT -campos I-TREATMENT -estériles. I-TREATMENT -Con I-TREATMENT -técnica I-TREATMENT -aséptica I-TREATMENT -nuevamente I-TREATMENT -se I-TREATMENT -escanearon I-TREATMENT -las I-TREATMENT -estructuras I-TREATMENT -y I-TREATMENT +OI I-TREATMENT con I-TREATMENT -el I-TREATMENT -transductor I-TREATMENT -en I-TREATMENT -el I-TREATMENT -eje I-TREATMENT -longitudinal I-TREATMENT -al I-TREATMENT -sacro I-TREATMENT -y I-TREATMENT +anestesia I-TREATMENT +general. I-TREATMENT +En B-EVOLUTION +el I-EVOLUTION +postoperatorio I-EVOLUTION +inmediato I-EVOLUTION +se I-EVOLUTION +observó I-EVOLUTION +exotropía I-EVOLUTION +consecutiva I-EVOLUTION +de I-EVOLUTION +45 I-EVOLUTION +r, I-EVOLUTION +inversión I-EVOLUTION +del I-EVOLUTION +tortícolis, I-EVOLUTION +limitación I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +aducción I-EVOLUTION +de I-EVOLUTION +-1 I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +abducción I-EVOLUTION +de I-EVOLUTION +-1 I-EVOLUTION +del I-EVOLUTION +ojo I-EVOLUTION +afectado I-EVOLUTION +y I-EVOLUTION +diplopía. I-EVOLUTION + I-EVOLUTION +A B-TREATMENT +los I-TREATMENT +15 I-TREATMENT +días I-TREATMENT se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -abordar I-TREATMENT -el I-TREATMENT -espacio I-TREATMENT -caudal I-TREATMENT -en I-TREATMENT -plano I-TREATMENT -con I-TREATMENT -una I-TREATMENT -aguja I-TREATMENT -20G I-TREATMENT -de I-TREATMENT +inyectan I-TREATMENT 5 I-TREATMENT -cm I-TREATMENT -para I-TREATMENT -técnica I-TREATMENT -continua I-TREATMENT -(Set I-TREATMENT -StimuLong I-TREATMENT -Sono I-TREATMENT -catheter I-TREATMENT -PAJUNK®). I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -allí I-TREATMENT -y I-TREATMENT -bajo I-TREATMENT -visión I-TREATMENT -ultrasonográfica I-TREATMENT -directa I-TREATMENT -se I-TREATMENT -pasó I-TREATMENT -el I-TREATMENT -catéter I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -la I-TREATMENT -aguja, I-TREATMENT -avanzándolo I-TREATMENT -hasta I-TREATMENT -una I-TREATMENT -distancia I-TREATMENT +U I-TREATMENT de I-TREATMENT -8 I-TREATMENT -cm, I-TREATMENT -quedando I-TREATMENT -3 I-TREATMENT -cm I-TREATMENT -en I-TREATMENT -el I-TREATMENT -espacio I-TREATMENT -caudal, I-TREATMENT -se I-TREATMENT -retiró I-TREATMENT -la I-TREATMENT -aguja I-TREATMENT -y I-TREATMENT -se I-TREATMENT -instaló I-TREATMENT -el I-TREATMENT -filtro I-TREATMENT -del I-TREATMENT -equipo. I-TREATMENT -Visualizando I-TREATMENT -la I-TREATMENT -punta I-TREATMENT -del I-TREATMENT -catéter I-TREATMENT -en I-TREATMENT -el I-TREATMENT -espacio I-TREATMENT -caudal I-TREATMENT -y I-TREATMENT -con I-TREATMENT -el I-TREATMENT -modo I-TREATMENT -Doppler I-TREATMENT -color I-TREATMENT -activado I-TREATMENT +toxina I-TREATMENT +botulínica I-TREATMENT en I-TREATMENT -el I-TREATMENT -quipo I-TREATMENT -se I-TREATMENT -inyectó I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -bolo I-TREATMENT -de I-TREATMENT -16 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -mezcla I-TREATMENT -anestésica I-TREATMENT -(bupivacaína I-TREATMENT -0, I-TREATMENT -5% I-TREATMENT -con I-TREATMENT -epinefrina I-TREATMENT -1: I-TREATMENT -200.000, I-TREATMENT -8 I-TREATMENT -ml I-TREATMENT -+ I-TREATMENT -solución I-TREATMENT -salina I-TREATMENT -0, I-TREATMENT -9% I-TREATMENT -estéril I-TREATMENT -8 I-TREATMENT -ml) I-TREATMENT -visualizando I-TREATMENT -la I-TREATMENT -estela I-TREATMENT -de I-TREATMENT -color I-TREATMENT -(efecto I-TREATMENT -Doppler) I-TREATMENT -confirmando I-TREATMENT -flujo I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -del I-TREATMENT -espacio I-TREATMENT -epidural. I-TREATMENT -Finalmente I-TREATMENT -la I-TREATMENT -porción I-TREATMENT -externa I-TREATMENT -del I-TREATMENT -catéter I-TREATMENT -fue I-TREATMENT -dirigida I-TREATMENT -hacia I-TREATMENT -cefálico I-TREATMENT -y I-TREATMENT -se I-TREATMENT -cubrió I-TREATMENT -con I-TREATMENT -apósitos I-TREATMENT -estériles I-TREATMENT -3M™ I-TREATMENT -Tegaderm™. I-TREATMENT - I-TREATMENT -Después I-TREATMENT -de I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT +recto I-TREATMENT +lateral I-TREATMENT del I-TREATMENT -catéter, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -reposicionó I-TREATMENT -en I-TREATMENT -decúbito I-TREATMENT -supino I-TREATMENT -y I-TREATMENT -fue I-TREATMENT -llevada I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -la I-TREATMENT -cirugía I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -encuentra I-TREATMENT -conglomerado I-TREATMENT -tumoral I-TREATMENT -sobre I-TREATMENT -vasos I-TREATMENT -inguinales I-TREATMENT -los I-TREATMENT -cuales I-TREATMENT -se I-TREATMENT -liberaron, I-TREATMENT +OI I-TREATMENT +sin I-TREATMENT +que I-TREATMENT se I-TREATMENT -envió I-TREATMENT -un I-TREATMENT -espécimen I-TREATMENT -inicial I-TREATMENT -reseccionado I-TREATMENT -para I-TREATMENT -biopsia I-TREATMENT +modificase I-TREATMENT +el I-TREATMENT +resultado, I-TREATMENT por I-TREATMENT -congelación, I-TREATMENT +lo I-TREATMENT que I-TREATMENT -resultó I-TREATMENT -positiva I-TREATMENT -en I-TREATMENT +a I-TREATMENT los I-TREATMENT -márgenes I-TREATMENT -y I-TREATMENT +2 I-TREATMENT +meses I-TREATMENT se I-TREATMENT -decidió I-TREATMENT -ampliar I-TREATMENT -dicha I-TREATMENT -resección I-TREATMENT -con I-TREATMENT -nuevo I-TREATMENT -resultado I-TREATMENT -negativo. I-TREATMENT -Se I-TREATMENT -resecó I-TREATMENT -vasto I-TREATMENT -medial I-TREATMENT -y I-TREATMENT -crural I-TREATMENT -completamente I-TREATMENT -en I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -afectada. I-TREATMENT -Se I-TREATMENT -dejaron I-TREATMENT -8 I-TREATMENT -catéteres I-TREATMENT -para I-TREATMENT -braquiterapia. I-TREATMENT -La I-TREATMENT -pérdida I-TREATMENT -sanguínea I-TREATMENT -fue I-TREATMENT -aproximadamente I-TREATMENT -de I-TREATMENT -50 I-TREATMENT -ml I-TREATMENT -y I-TREATMENT -no I-TREATMENT -fue I-TREATMENT -transfundida. I-TREATMENT -La I-TREATMENT -duración I-TREATMENT -de I-TREATMENT +decide I-TREATMENT +retirar I-TREATMENT la I-TREATMENT -cirugía I-TREATMENT +fijación I-TREATMENT +escleral, I-TREATMENT +lo I-TREATMENT +que I-TREATMENT fue I-TREATMENT +técnicamente I-TREATMENT +imposible I-TREATMENT +por I-TREATMENT +las I-TREATMENT +adherencias I-TREATMENT +encontradas. I-TREATMENT +Se I-TREATMENT +reinterviene I-TREATMENT +al I-TREATMENT +paciente I-TREATMENT +realizando I-TREATMENT +una I-TREATMENT +resección I-TREATMENT +del I-TREATMENT +recto I-TREATMENT +medio I-TREATMENT de I-TREATMENT -4 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -15 I-TREATMENT -minutos I-TREATMENT -y I-TREATMENT -los I-TREATMENT -requerimientos I-TREATMENT -anestésicos I-TREATMENT -durante I-TREATMENT -su I-TREATMENT -realización I-TREATMENT -fueron I-TREATMENT -mínimos. I-TREATMENT -Al I-TREATMENT -finalizar I-TREATMENT -la I-TREATMENT -cirugía I-TREATMENT -se I-TREATMENT -aplicaron I-TREATMENT -2 I-TREATMENT -mg I-TREATMENT +OI I-TREATMENT de I-TREATMENT -morfina I-TREATMENT -intravenosos, I-TREATMENT -se I-TREATMENT -extubó I-TREATMENT -sin I-TREATMENT -complicaciones I-TREATMENT +7 I-TREATMENT +mm I-TREATMENT y I-TREATMENT -fue I-TREATMENT -llevada I-TREATMENT -a I-TREATMENT -recuperación I-TREATMENT -para I-TREATMENT -vigilancia I-TREATMENT -donde I-TREATMENT se I-TREATMENT -inició I-TREATMENT -la I-TREATMENT -infusión I-TREATMENT -por I-TREATMENT -el I-TREATMENT -catéter I-TREATMENT -caudal I-TREATMENT -a I-TREATMENT -3 I-TREATMENT -ml/h I-TREATMENT -de I-TREATMENT -una I-TREATMENT -mezcla I-TREATMENT +inyectan I-TREATMENT +5 I-TREATMENT +U I-TREATMENT de I-TREATMENT -fentanilo I-TREATMENT -3 I-TREATMENT -µg/ml I-TREATMENT -y I-TREATMENT -bupivacaína I-TREATMENT -al I-TREATMENT -0, I-TREATMENT -1% I-TREATMENT -sin I-TREATMENT -epinefrina. I-TREATMENT -La B-EVOLUTION +toxina I-TREATMENT +botulínica I-TREATMENT +en I-TREATMENT +recto I-TREATMENT +lateral I-TREATMENT +del I-TREATMENT +OI I-TREATMENT +intraoperatoriamente. I-TREATMENT +El B-EVOLUTION paciente I-EVOLUTION -permaneció I-EVOLUTION -estable I-EVOLUTION +quedó I-EVOLUTION +con I-EVOLUTION +tortícolis I-EVOLUTION en I-EVOLUTION -recuperación I-EVOLUTION -durante I-EVOLUTION -3 I-EVOLUTION -horas I-EVOLUTION -más I-EVOLUTION +la I-EVOLUTION +cara I-EVOLUTION +derecha I-EVOLUTION +de I-EVOLUTION +10o, I-EVOLUTION +limitación I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +abducción I-EVOLUTION +de I-EVOLUTION +-1, I-EVOLUTION +exotropía I-EVOLUTION +de I-EVOLUTION +10-15 I-EVOLUTION +r I-EVOLUTION +en I-EVOLUTION +posición I-EVOLUTION +primaria I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +mirada I-EVOLUTION +(PPM) I-EVOLUTION sin I-EVOLUTION -requerir I-EVOLUTION -suplementos I-EVOLUTION -analgésicos I-EVOLUTION -y I-EVOLUTION -luego I-EVOLUTION -fue I-EVOLUTION -trasladada I-EVOLUTION +diplopía. I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +2 I-EVOLUTION +años I-EVOLUTION +vuelve I-EVOLUTION a I-EVOLUTION +presentar I-EVOLUTION +diplopía, I-EVOLUTION +exotropÍa I-EVOLUTION +de I-EVOLUTION +20-30 I-EVOLUTION +r I-EVOLUTION +en I-EVOLUTION +PPM, I-EVOLUTION +limitación I-EVOLUTION +de I-EVOLUTION la I-EVOLUTION -habitación I-EVOLUTION +abducción I-EVOLUTION de I-EVOLUTION -hospitalización I-EVOLUTION -general I-EVOLUTION -pediátrica. I-EVOLUTION -Los B-TREATMENT -medicamentos I-TREATMENT -analgésicos I-TREATMENT -que I-TREATMENT -recibió I-TREATMENT -adicionalmente I-TREATMENT -durante I-TREATMENT -su I-TREATMENT -hospitalización I-TREATMENT -fueron I-TREATMENT -acetaminofeno I-TREATMENT -240 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -6 I-TREATMENT -horas I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -y I-TREATMENT -diclofenaco I-TREATMENT -15 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas I-TREATMENT -vía I-TREATMENT -intravenosa I-TREATMENT -por I-TREATMENT -horario, I-TREATMENT -con I-TREATMENT -rescates I-TREATMENT -de I-TREATMENT -hidromorfona I-TREATMENT -a I-TREATMENT -necesidad. I-TREATMENT -El B-EVOLUTION -seguimiento I-EVOLUTION -analgésico I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -se I-EVOLUTION -detalla I-EVOLUTION +-1, I-EVOLUTION +limitación I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +aducción I-EVOLUTION +de I-EVOLUTION +-1 I-EVOLUTION +y I-EVOLUTION +tortícolis I-EVOLUTION en I-EVOLUTION la I-EVOLUTION -tabla I-EVOLUTION -I. I-EVOLUTION -No B-TREATMENT -fueron I-TREATMENT -requeridos I-TREATMENT -rescates I-TREATMENT -con I-TREATMENT -opioides. I-TREATMENT -El I-TREATMENT -catéter I-TREATMENT -fue I-TREATMENT -retirado I-TREATMENT -al I-TREATMENT -tercer I-TREATMENT -día I-TREATMENT -postoperatorio I-TREATMENT -después I-TREATMENT -de I-TREATMENT -70 I-TREATMENT -horas I-TREATMENT +cara I-EVOLUTION +derecha I-EVOLUTION +de I-EVOLUTION +20o. I-EVOLUTION + I-EVOLUTION +Se B-TREATMENT +decide I-TREATMENT +realizar I-TREATMENT +una I-TREATMENT +nueva I-TREATMENT +resección I-TREATMENT +del I-TREATMENT +recto I-TREATMENT +medio I-TREATMENT +del I-TREATMENT +OI I-TREATMENT de I-TREATMENT -colocado I-TREATMENT -sin I-TREATMENT -complicaciones. I-TREATMENT -El B-EVOLUTION -mismo I-EVOLUTION -día I-EVOLUTION -se I-EVOLUTION -dio I-EVOLUTION +6 I-TREATMENT +mm. I-TREATMENT + I-TREATMENT +Un B-EVOLUTION +año I-EVOLUTION +después I-EVOLUTION de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION la I-EVOLUTION +última I-EVOLUTION +cirugía I-EVOLUTION +presenta: I-EVOLUTION +limitación I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +abducción I-EVOLUTION +de I-EVOLUTION +-1, I-EVOLUTION +tortícolis I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +cara I-EVOLUTION +derecha I-EVOLUTION +de I-EVOLUTION +5o, I-EVOLUTION +exotropía I-EVOLUTION +de I-EVOLUTION +10-15 I-EVOLUTION +r I-EVOLUTION +en I-EVOLUTION +PPM I-EVOLUTION +sin I-EVOLUTION +diplopía. I-EVOLUTION +El I-EVOLUTION paciente I-EVOLUTION +está I-EVOLUTION +satisfecho I-EVOLUTION con I-EVOLUTION -adecuado I-EVOLUTION -control I-EVOLUTION -del I-EVOLUTION -dolor, I-EVOLUTION -medicación I-EVOLUTION -oral I-EVOLUTION -e I-EVOLUTION -instrucciones. I-EVOLUTION +el I-EVOLUTION +resultado. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -60 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -48 I-PAST_MEDICAL_HISTORY -kg, I-PAST_MEDICAL_HISTORY -talla I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -156 I-PAST_MEDICAL_HISTORY -cm I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ASA I-PAST_MEDICAL_HISTORY -III. I-PAST_MEDICAL_HISTORY -Exfumadora I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -cigarrillos I-PAST_MEDICAL_HISTORY -diarios, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY +25 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ceguera I-PAST_MEDICAL_HISTORY -total I-PAST_MEDICAL_HISTORY -postraumática I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dificultad I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -marcha I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -apoyo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -estudiada. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Ingresó B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cirugía I-PRESENT_ILLNESS -vascular I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS +mórbidos. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -isquemia I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +baja I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -miembro I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -grado I-PRESENT_ILLNESS -IV, I-PRESENT_ILLNESS -pendiente I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +cuantificada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +comenzó I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +odinofagia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +disfagia I-PRESENT_ILLNESS +confirmándose I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +candidiasis I-PRESENT_ILLNESS +orofaríngea I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +esofágica I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +endoscopia. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +recibió I-PRESENT_ILLNESS tratamiento I-PRESENT_ILLNESS -quirúrgico I-PRESENT_ILLNESS -mediante I-PRESENT_ILLNESS +específico I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +procedió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +investigar I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +posible I-PRESENT_ILLNESS +infección I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +VIH, I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -amputación I-PRESENT_ILLNESS -supracondílea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dicho I-PRESENT_ILLNESS -miembro. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El B-EXPLORATION -estudio I-EXPLORATION -preoperatorio I-EXPLORATION -mostró: I-EXPLORATION -anemia I-EXPLORATION -microcítica I-EXPLORATION -- I-EXPLORATION -hipocrómica, I-EXPLORATION -coagulación I-EXPLORATION +que I-PRESENT_ILLNESS +posteriormente I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +confirmó. I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +destacaba I-EXPLORATION +un I-EXPLORATION +enflaquecimiento I-EXPLORATION +marcado I-EXPLORATION y I-EXPLORATION -bioquímica I-EXPLORATION -normales I-EXPLORATION +lesiones I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +candidiasis I-EXPLORATION +orofaríngea. I-EXPLORATION +Se I-EXPLORATION +encontraba I-EXPLORATION +afebril, I-EXPLORATION +eupneico, I-EXPLORATION +con I-EXPLORATION +examen I-EXPLORATION +pulmonar I-EXPLORATION y I-EXPLORATION -un I-EXPLORATION -trastorno I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -repolarización I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -electrocardiograma. I-EXPLORATION +tórax I-EXPLORATION +normal. I-EXPLORATION I-EXPLORATION -Durante I-EXPLORATION -su I-EXPLORATION -estancia I-EXPLORATION -en I-EXPLORATION -dicho I-EXPLORATION -servicio I-EXPLORATION -mantuvo I-EXPLORATION -dolor I-EXPLORATION -del I-EXPLORATION -miembro I-EXPLORATION -inferior I-EXPLORATION -derecho, I-EXPLORATION -continuo I-EXPLORATION -y I-EXPLORATION -progresivamente I-EXPLORATION -intolerable, I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -precisó I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -un I-TREATMENT -catéter I-TREATMENT -epidural I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -de I-TREATMENT -L3-L4 I-TREATMENT -para I-TREATMENT -la I-TREATMENT -conexión I-TREATMENT -de I-TREATMENT -una I-TREATMENT -bomba I-TREATMENT -de I-TREATMENT -infusión I-TREATMENT -PCA I-TREATMENT -(Analgesia I-TREATMENT -Controlada I-TREATMENT -por I-TREATMENT -el I-TREATMENT -Paciente) I-TREATMENT -y I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -una I-TREATMENT -solución I-TREATMENT -compuesta I-TREATMENT -por I-TREATMENT -ropivacaína I-TREATMENT -0, I-TREATMENT -2 I-TREATMENT -% I-TREATMENT -más I-TREATMENT -cloruro I-TREATMENT -mórfico I-TREATMENT -0, I-TREATMENT -004 I-TREATMENT -% I-TREATMENT -a I-TREATMENT -una I-TREATMENT -velocidad I-TREATMENT -de I-TREATMENT -4 I-TREATMENT -ml/h I-TREATMENT -y I-TREATMENT -bolos I-TREATMENT -de I-TREATMENT -rescate I-TREATMENT -de I-TREATMENT -4 I-TREATMENT -ml. I-TREATMENT -La I-TREATMENT -punción I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT +Inició B-TREATMENT +profilaxis I-TREATMENT con I-TREATMENT -una I-TREATMENT -aguja I-TREATMENT -Tuohy I-TREATMENT -18 I-TREATMENT -G. I-TREATMENT -La I-TREATMENT -colocación I-TREATMENT -del I-TREATMENT -catéter I-TREATMENT -fue I-TREATMENT -técnicamente I-TREATMENT -sencilla I-TREATMENT +cotrimoxazol I-TREATMENT +960 I-TREATMENT +mg I-TREATMENT +al I-TREATMENT +día, I-TREATMENT +ácido I-TREATMENT +folínico I-TREATMENT +15 I-TREATMENT +mg I-TREATMENT +al I-TREATMENT +día, I-TREATMENT +fluconazol I-TREATMENT +150 I-TREATMENT +mg I-TREATMENT +al I-TREATMENT +día I-TREATMENT y I-TREATMENT -sin I-TREATMENT -incidencias. I-TREATMENT -No I-TREATMENT -hubo I-TREATMENT -aspiración I-TREATMENT -de I-TREATMENT -sangre I-TREATMENT -o I-TREATMENT -de I-TREATMENT -líquido I-TREATMENT -cefalorraquídeo I-TREATMENT +terapia I-TREATMENT +anti-retroviral I-TREATMENT +(TAR) I-TREATMENT +con I-TREATMENT +abacavir/lamivudina I-TREATMENT y I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT -test I-TREATMENT -(4 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -bupivacaína I-TREATMENT -0, I-TREATMENT -25 I-TREATMENT -% I-TREATMENT +efavirenz, I-TREATMENT con I-TREATMENT -vasoconstrictor) I-TREATMENT -fue I-TREATMENT -negativa. I-TREATMENT -La I-TREATMENT -paciente I-TREATMENT -no I-TREATMENT -había I-TREATMENT -recibido I-TREATMENT -tratamiento I-TREATMENT -anticoagulante I-TREATMENT -durante I-TREATMENT -las I-TREATMENT -12 I-TREATMENT -horas I-TREATMENT -previas I-TREATMENT +muy I-TREATMENT +buena I-TREATMENT +tolerancia I-TREATMENT +y I-TREATMENT +adherencia. I-TREATMENT +Dos B-EVOLUTION +semanas I-EVOLUTION +más I-EVOLUTION +tarde I-EVOLUTION +consultó I-EVOLUTION +por I-EVOLUTION +tres I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +fiebre I-EVOLUTION +hasta I-EVOLUTION +39°C, I-EVOLUTION +cefalea I-EVOLUTION +y I-EVOLUTION +tos I-EVOLUTION +seca. I-EVOLUTION +Se I-EVOLUTION +decidió I-EVOLUTION +su I-EVOLUTION +internación I-EVOLUTION +por I-EVOLUTION +fiebre I-EVOLUTION +de I-EVOLUTION +39°C, I-EVOLUTION +taquicardia I-EVOLUTION +y I-EVOLUTION +saturación I-EVOLUTION +de I-EVOLUTION +oxígeno I-EVOLUTION +de I-EVOLUTION +93% I-EVOLUTION +con I-EVOLUTION +aire I-EVOLUTION +ambiental. I-EVOLUTION +En B-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +no I-EXPLORATION +había I-EXPLORATION +evidencia I-EXPLORATION +de I-EXPLORATION +candidiasis I-EXPLORATION +oral I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +pulmonar I-EXPLORATION +en I-EXPLORATION +esos I-EXPLORATION +momentos I-EXPLORATION +era I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +infiltrado I-EXPLORATION +algodonoso I-EXPLORATION +difuso I-EXPLORATION +bilateral. I-EXPLORATION +Los I-EXPLORATION +cultivos I-EXPLORATION +de I-EXPLORATION +expectoración, I-EXPLORATION +urocultivo, I-EXPLORATION +hemocultivos I-EXPLORATION +y I-EXPLORATION +baciloscopias I-EXPLORATION +resultaron I-EXPLORATION +negativos. I-EXPLORATION +La I-EXPLORATION +RPC I-EXPLORATION +para I-EXPLORATION +Pneumocystis I-EXPLORATION +jiroveci I-EXPLORATION +en I-EXPLORATION +una I-EXPLORATION +muestra I-EXPLORATION +de I-EXPLORATION +expectoración I-EXPLORATION +inducida I-EXPLORATION +fue I-EXPLORATION +negativa. I-EXPLORATION +Se B-TREATMENT +ajustó I-TREATMENT +el I-TREATMENT +cotrimoxazol I-TREATMENT +de I-TREATMENT +dosis I-TREATMENT +profiláctica I-TREATMENT a I-TREATMENT +terapéutica I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +iv, I-TREATMENT +se I-TREATMENT +agregó I-TREATMENT +prednisona I-TREATMENT +y I-TREATMENT +ceftriaxona I-TREATMENT +iv, I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT +el I-TREATMENT +ácido I-TREATMENT +folínico I-TREATMENT +y I-TREATMENT +se I-TREATMENT +mantuvo I-TREATMENT la I-TREATMENT -colocación I-TREATMENT -del I-TREATMENT -catéter. I-TREATMENT -Tras B-EVOLUTION +TAR I-TREATMENT +iniciada I-TREATMENT +recientemente. I-TREATMENT + I-TREATMENT +A B-EVOLUTION las I-EVOLUTION -primeras I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -colocación I-EVOLUTION -del I-EVOLUTION -catéter I-EVOLUTION -epidural I-EVOLUTION -la I-EVOLUTION +48 I-EVOLUTION +h, I-EVOLUTION +el I-EVOLUTION paciente I-EVOLUTION -presentó I-EVOLUTION -un I-EVOLUTION -empeoramiento I-EVOLUTION +evolucionó I-EVOLUTION +afebril, I-EVOLUTION +con I-EVOLUTION +saturación I-EVOLUTION de I-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -preexistentes: I-EVOLUTION -mayor I-EVOLUTION -severidad I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -del I-EVOLUTION -miembro I-EVOLUTION -inferior I-EVOLUTION -derecho, I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -bloqueo I-EVOLUTION -motor I-EVOLUTION -completo I-EVOLUTION +oxígeno I-EVOLUTION +adecuada I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +mejoría I-EVOLUTION de I-EVOLUTION -ambos I-EVOLUTION -miembros I-EVOLUTION -inferiores. I-EVOLUTION +los I-EVOLUTION +parámetros I-EVOLUTION +inflamatorios. I-EVOLUTION Se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -suspender I-TREATMENT -la I-TREATMENT -perfusión I-TREATMENT -a I-TREATMENT -través I-TREATMENT -del I-TREATMENT -catéter I-TREATMENT -epidural I-TREATMENT -y I-TREATMENT -se I-TREATMENT -reevaluó I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -pasadas I-TREATMENT -2, I-TREATMENT -4 I-TREATMENT +dio I-TREATMENT +el I-TREATMENT +alta I-TREATMENT +hospitalaria I-TREATMENT +al I-TREATMENT +quinto I-TREATMENT +día I-TREATMENT +con I-TREATMENT +cotrimoxazol I-TREATMENT +oral I-TREATMENT y I-TREATMENT -8 I-TREATMENT -horas. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -exploración I-EXPLORATION -a I-EXPLORATION +prednisona I-TREATMENT +hasta I-TREATMENT +completar I-TREATMENT +21 I-TREATMENT +días. I-TREATMENT +En B-EVOLUTION +el I-EVOLUTION +control I-EVOLUTION +ambulatorio I-EVOLUTION +estaba I-EVOLUTION +completamente I-EVOLUTION +asintomático I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +radiografía I-EVOLUTION +mostró I-EVOLUTION +la I-EVOLUTION +desaparición I-EVOLUTION +del I-EVOLUTION +infiltrado I-EVOLUTION +pulmonar. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +85 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +cardiopatía I-PAST_MEDICAL_HISTORY +hipertensiva, I-PAST_MEDICAL_HISTORY +fibrilación I-PAST_MEDICAL_HISTORY +auricular I-PAST_MEDICAL_HISTORY +crónica, I-PAST_MEDICAL_HISTORY +accidente I-PAST_MEDICAL_HISTORY +isquémico I-PAST_MEDICAL_HISTORY +transitorio I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +secuelas I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +infecciones I-PAST_MEDICAL_HISTORY +respiratorias I-PAST_MEDICAL_HISTORY +recurrentes I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +broncoaspiración. I-PAST_MEDICAL_HISTORY +Intervenido B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +fractura I-PRESENT_ILLNESS +subcapital I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +fémur I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +corrección I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +coagulación I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +72 I-PRESENT_ILLNESS +horas. I-PRESENT_ILLNESS +A B-EXPLORATION las I-EXPLORATION -8 I-EXPLORATION +24 I-EXPLORATION horas I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -monoplejía I-EXPLORATION -del I-EXPLORATION -miembro I-EXPLORATION -inferior I-EXPLORATION -derecho I-EXPLORATION +presenta I-EXPLORATION +dificultad I-EXPLORATION +respiratoria I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -monoparesia I-EXPLORATION -del I-EXPLORATION -miembro I-EXPLORATION -inferior I-EXPLORATION -izquierdo, I-EXPLORATION -sin I-EXPLORATION -incontinencia I-EXPLORATION +disminución I-EXPLORATION del I-EXPLORATION -esfínter I-EXPLORATION -anal I-EXPLORATION -(la I-EXPLORATION -paciente I-EXPLORATION -era I-EXPLORATION -portadora I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -sonda I-EXPLORATION -vesical). I-EXPLORATION -En I-EXPLORATION -todo I-EXPLORATION -momento, I-EXPLORATION -nuestra I-EXPLORATION -paciente I-EXPLORATION -negó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -dolor I-EXPLORATION -lumbar. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -retirada I-TREATMENT -del I-TREATMENT -catéter I-TREATMENT -epidural I-TREATMENT -solicitándose B-EXPLORATION +consciencia I-EXPLORATION +secundario I-EXPLORATION +a I-EXPLORATION un I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION +infiltrado I-EXPLORATION +pulmonar, I-EXPLORATION con I-EXPLORATION -RM I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -lumbar I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -evidenciaron I-EXPLORATION -fracturas I-EXPLORATION -vertebrales I-EXPLORATION -L1, I-EXPLORATION -L2 I-EXPLORATION -y I-EXPLORATION -L4 I-EXPLORATION +mejoría I-EXPLORATION +tras I-EXPLORATION +antibioterapia. I-EXPLORATION +A I-EXPLORATION +las I-EXPLORATION +96 I-EXPLORATION +horas I-EXPLORATION +postoperatorias I-EXPLORATION +presenta I-EXPLORATION +dolor I-EXPLORATION +abdominal I-EXPLORATION +brusco, I-EXPLORATION +vómitos I-EXPLORATION y I-EXPLORATION -protrusión I-EXPLORATION -discal I-EXPLORATION -L3-L4 I-EXPLORATION -que I-EXPLORATION -condicionaba I-EXPLORATION -compromiso I-EXPLORATION -radicular I-EXPLORATION -(más I-EXPLORATION -marcado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lado I-EXPLORATION -derecho) I-EXPLORATION -e I-EXPLORATION -importante I-EXPLORATION -estenosis I-EXPLORATION -del I-EXPLORATION -canal I-EXPLORATION -lumbar, I-EXPLORATION -agravada I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -hematoma I-EXPLORATION -epidural I-EXPLORATION +distensión. I-EXPLORATION +Radiografía I-EXPLORATION de I-EXPLORATION -pequeño I-EXPLORATION -tamaño I-EXPLORATION -a I-EXPLORATION -dicho I-EXPLORATION -nivel. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -dexametasona I-TREATMENT -4 I-TREATMENT -mg/6 I-TREATMENT -h, I-TREATMENT -y I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -su I-TREATMENT -traslado I-TREATMENT -al I-TREATMENT -servicio I-TREATMENT -de I-TREATMENT -neurocirugía I-TREATMENT -para I-TREATMENT -su I-TREATMENT -valoración. I-TREATMENT - I-TREATMENT -Durante B-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION +abdomen: I-EXPLORATION +aire I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -servicio I-EXPLORATION +toda I-EXPLORATION +la I-EXPLORATION +curvatura I-EXPLORATION +mayor I-EXPLORATION +gástrica. I-EXPLORATION +Tomografía I-EXPLORATION +computarizada I-EXPLORATION +abdominal I-EXPLORATION +urgente: I-EXPLORATION +gas I-EXPLORATION +intramural I-EXPLORATION +circunferencial I-EXPLORATION +gástrico I-EXPLORATION de I-EXPLORATION -neurocirugía I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -electromiografía, I-EXPLORATION -objetivándose I-EXPLORATION -una I-EXPLORATION -afectación I-EXPLORATION -del I-EXPLORATION -sistema I-EXPLORATION -nervioso I-EXPLORATION -periférico I-EXPLORATION -que I-EXPLORATION -podría I-EXPLORATION -corresponderse I-EXPLORATION +extensión I-EXPLORATION +difusa I-EXPLORATION +y I-EXPLORATION +hacia I-EXPLORATION +tercio I-EXPLORATION +inferior I-EXPLORATION +esofágico, I-EXPLORATION con I-EXPLORATION -una I-EXPLORATION -polineuropatía I-EXPLORATION -mixta. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -todos I-EXPLORATION -estos I-EXPLORATION -datos, I-EXPLORATION -se I-EXPLORATION -consideró I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -clínica I-EXPLORATION +pequeña I-EXPLORATION +cantidad I-EXPLORATION de I-EXPLORATION +neumoperitoneo I-EXPLORATION +adyacente I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -paciente I-EXPLORATION -era I-EXPLORATION -el I-EXPLORATION -resultado I-EXPLORATION -de I-EXPLORATION +curvatura I-EXPLORATION +menor, I-EXPLORATION +gas I-EXPLORATION +venoso I-EXPLORATION +portal I-EXPLORATION +y I-EXPLORATION +neumomediastino I-EXPLORATION +adyacente I-EXPLORATION +a I-EXPLORATION +esófago; I-EXPLORATION +hallazgos I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION una I-EXPLORATION -conjunción I-EXPLORATION -de I-EXPLORATION -múltiples I-EXPLORATION -patologías, I-EXPLORATION -desestimándose I-EXPLORATION -la I-EXPLORATION -intervención I-EXPLORATION -quirúrgica I-EXPLORATION -dado I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -beneficiaría I-EXPLORATION -de I-EXPLORATION -dicho I-EXPLORATION -tratamiento. I-EXPLORATION - I-EXPLORATION -Finalmente, B-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -trasladada I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cirugía I-DERIVED_FROM/TO -vascular I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -completar I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -quirúrgico. I-DERIVED_FROM/TO -La B-TREATMENT -amputación I-TREATMENT -supracondílea I-TREATMENT -del I-TREATMENT -miembro I-TREATMENT -inferior I-TREATMENT -derecho I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general I-TREATMENT +gastritis I-EXPLORATION +enfisematosa. I-EXPLORATION +Tratamiento B-TREATMENT con I-TREATMENT -mascarilla I-TREATMENT -laríngea I-TREATMENT -i-gel™ I-TREATMENT -(Intersurgical I-TREATMENT -Ltd., I-TREATMENT -Wokingham, I-TREATMENT -England) I-TREATMENT -número I-TREATMENT -4. I-TREATMENT -La I-TREATMENT -inducción I-TREATMENT -de I-TREATMENT -la I-TREATMENT -anestesia I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -mediante I-TREATMENT -la I-TREATMENT -administración I-TREATMENT +antibioterapia I-TREATMENT intravenosa I-TREATMENT de I-TREATMENT -fentanilo I-TREATMENT -2 I-TREATMENT -µg/kg I-TREATMENT -y I-TREATMENT -propofol I-TREATMENT -2 I-TREATMENT -mg/kg. I-TREATMENT -El I-TREATMENT -mantenimiento I-TREATMENT +amplio I-TREATMENT +espectro, I-TREATMENT +nutrición I-TREATMENT +parenteral, I-TREATMENT +inhibidores I-TREATMENT de I-TREATMENT la I-TREATMENT -misma I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -con I-TREATMENT -sevofluorano I-TREATMENT -2 I-TREATMENT -% I-TREATMENT -en I-TREATMENT -una I-TREATMENT -mezcla I-TREATMENT -de I-TREATMENT -oxígeno I-TREATMENT -- I-TREATMENT -aire I-TREATMENT -con I-TREATMENT -un I-TREATMENT -flujo I-TREATMENT -de I-TREATMENT -gas I-TREATMENT -fresco I-TREATMENT -de I-TREATMENT -2 I-TREATMENT -l/min. I-TREATMENT -La I-TREATMENT -administración I-TREATMENT -adicional I-TREATMENT -de I-TREATMENT -fentanilo I-TREATMENT -durante I-TREATMENT -el I-TREATMENT -procedimiento I-TREATMENT -quirúrgico I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -según I-TREATMENT -parámetros I-TREATMENT -clínicos, I-TREATMENT -cifras I-TREATMENT +bomba I-TREATMENT de I-TREATMENT -tensión I-TREATMENT -arterial I-TREATMENT +protones I-TREATMENT y I-TREATMENT -frecuencia I-TREATMENT -cardiaca. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -monitorización I-TREATMENT -estándar I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -constatándose I-TREATMENT -estabilidad I-TREATMENT -hemodinámica I-TREATMENT -durante I-TREATMENT -toda I-TREATMENT +sonda I-TREATMENT +nasogástrica. I-TREATMENT +Se B-EXPLORATION +descarta I-EXPLORATION +etiología I-EXPLORATION +isquémica I-EXPLORATION +en I-EXPLORATION +una I-EXPLORATION +angiotomografía I-EXPLORATION +computarizada: I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +defectos I-EXPLORATION +de I-EXPLORATION +repleción I-EXPLORATION +arterial. I-EXPLORATION +Tomografía I-EXPLORATION +computarizada I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +11 I-EXPLORATION +días: I-EXPLORATION +desaparición I-EXPLORATION +de I-EXPLORATION +neumatosis I-EXPLORATION +gastroesofágica I-EXPLORATION +; I-EXPLORATION +colapso I-EXPLORATION +completo I-EXPLORATION +del I-EXPLORATION +pulmón I-EXPLORATION +izquierdo. I-EXPLORATION +Broncoscopia I-EXPLORATION +urgente I-EXPLORATION +resolutiva: I-EXPLORATION +aspiración I-EXPLORATION +de I-EXPLORATION +tapones I-EXPLORATION +de I-EXPLORATION +moco. I-EXPLORATION +Se B-TREATMENT +suspende I-TREATMENT la I-TREATMENT -cirugía. I-TREATMENT -Al B-EVOLUTION -finalizar I-EVOLUTION +antibioterapia I-TREATMENT +tras I-TREATMENT +14 I-TREATMENT +días I-TREATMENT +iniciando I-TREATMENT +tolerancia I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT +satisfactoriamente. I-TREATMENT +A B-EVOLUTION +las I-EVOLUTION +96 I-EVOLUTION +horas, I-EVOLUTION el I-EVOLUTION -procedimiento I-EVOLUTION -quirúrgico I-EVOLUTION -se I-EVOLUTION -retiró I-EVOLUTION -la I-EVOLUTION -mascarilla I-EVOLUTION -laríngea I-EVOLUTION -cuando I-EVOLUTION -la I-EVOLUTION paciente I-EVOLUTION -estuvo I-EVOLUTION -completamente I-EVOLUTION -despierta. I-EVOLUTION -Fue I-EVOLUTION -trasladada I-EVOLUTION +presenta I-EVOLUTION +una I-EVOLUTION +broncoaspiración, I-EVOLUTION +empeoramiento I-EVOLUTION +clínico I-EVOLUTION +y I-EVOLUTION +respiratorio, I-EVOLUTION +falleciendo I-EVOLUTION a I-EVOLUTION -la I-EVOLUTION -Unidad I-EVOLUTION -de I-EVOLUTION -Recuperación I-EVOLUTION -Postanestésica I-EVOLUTION -donde I-EVOLUTION -permaneció I-EVOLUTION -durante I-EVOLUTION -2 I-EVOLUTION +las I-EVOLUTION +24 I-EVOLUTION horas. I-EVOLUTION -Su I-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -favorable. I-EVOLUTION I-EVOLUTION -Niña B-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +39 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -SDRC I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -extremidad I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -secundario I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -esguince I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +maseterina I-PRESENT_ILLNESS +bilateral I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tobillo I-PRESENT_ILLNESS -ocurrido I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS +varios I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -llegada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +siendo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +mayor I-PRESENT_ILLNESS +tamaño I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +músculo I-PRESENT_ILLNESS +masetero I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +lado I-PRESENT_ILLNESS +izquierdo, I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +motivó I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -Unidad. I-PRESENT_ILLNESS -Colocación B-TREATMENT -en I-TREATMENT -quirófano, I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general I-TREATMENT -de I-TREATMENT -un I-TREATMENT -electrodo I-TREATMENT -octopolar I-TREATMENT -(Octrode) I-TREATMENT +consulta. I-PRESENT_ILLNESS +En B-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +clínica I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +refiere I-PAST_MEDICAL_HISTORY +estar I-PAST_MEDICAL_HISTORY +asintomático, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +patologías I-PAST_MEDICAL_HISTORY +agregadas, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +malos I-PAST_MEDICAL_HISTORY +hábitos I-PAST_MEDICAL_HISTORY +dietéticos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +bruxismo I-PAST_MEDICAL_HISTORY +diurno I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +nocturno. I-PAST_MEDICAL_HISTORY +Se B-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +en I-EXPLORATION +marzo I-EXPLORATION +del I-EXPLORATION +2008 I-EXPLORATION +mediante I-EXPLORATION +Tomografía I-EXPLORATION +Axial I-EXPLORATION +Computerizada I-EXPLORATION +(TAC) I-EXPLORATION +simple I-EXPLORATION +y I-EXPLORATION +contrastada I-EXPLORATION +para I-EXPLORATION +descartar I-EXPLORATION +patología I-EXPLORATION +de I-EXPLORATION +tejidos I-EXPLORATION +blandos I-EXPLORATION +y I-EXPLORATION +duros I-EXPLORATION +tipo I-EXPLORATION +neoplasia, I-EXPLORATION +proceso I-EXPLORATION +infeccioso I-EXPLORATION +crónico I-EXPLORATION +o I-EXPLORATION +crecimiento I-EXPLORATION +óseo. I-EXPLORATION +Se I-EXPLORATION +diagnosticó I-EXPLORATION +finalmente I-EXPLORATION +como I-EXPLORATION +hipertrofia I-EXPLORATION +del I-EXPLORATION +músculo I-EXPLORATION +masetero I-EXPLORATION +bilateral, I-EXPLORATION +mayor I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lado I-EXPLORATION +izquierdo. I-EXPLORATION + I-EXPLORATION +Tomamos I-EXPLORATION +medidas I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +músculos I-EXPLORATION +maseteros I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +cortes I-EXPLORATION +tomográficos, I-EXPLORATION +de I-EXPLORATION +anterior I-EXPLORATION +a I-EXPLORATION +posterior I-EXPLORATION +de I-EXPLORATION +ambos I-EXPLORATION +músculos I-EXPLORATION +maseteros I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +diámetro I-EXPLORATION +transverso I-EXPLORATION +con I-EXPLORATION +los I-EXPLORATION +siguientes I-EXPLORATION +resultados: I-EXPLORATION +1.40 I-EXPLORATION +cm, I-EXPLORATION +1.60 I-EXPLORATION +cm I-EXPLORATION +y I-EXPLORATION +0.95 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION +masetero I-EXPLORATION +derecho; I-EXPLORATION +1.83 I-EXPLORATION +cm, I-EXPLORATION +1.53 I-EXPLORATION +y I-EXPLORATION +1.13 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION +músculo I-EXPLORATION +masetero I-EXPLORATION +izquierdo, I-EXPLORATION +ambos I-EXPLORATION +mayores I-EXPLORATION +de I-EXPLORATION +lo I-EXPLORATION +normal. I-EXPLORATION +Iniciamos B-TREATMENT +tratamiento I-TREATMENT +a I-TREATMENT +base I-TREATMENT de I-TREATMENT -la I-TREATMENT -firma I-TREATMENT -ANS I-TREATMENT -(Advances I-TREATMENT -Neurological I-TREATMENT -Systems I-TREATMENT -Inc, I-TREATMENT -Plano. I-TREATMENT -USA) I-TREATMENT -entre I-TREATMENT -T8-T12 I-TREATMENT +guarda I-TREATMENT +oclusal I-TREATMENT +nocturna I-TREATMENT y I-TREATMENT -conexión I-TREATMENT -a I-TREATMENT -un I-TREATMENT -generador I-TREATMENT +aplicación I-TREATMENT de I-TREATMENT -impulsos I-TREATMENT -eléctricos I-TREATMENT -externo. I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -despierta I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -llevó I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -la I-TREATMENT -programación I-TREATMENT +toxina I-TREATMENT +botulínica I-TREATMENT +en I-TREATMENT +noviembre I-TREATMENT del I-TREATMENT -sistema I-TREATMENT -hasta I-TREATMENT +2009, I-TREATMENT +de I-TREATMENT +acuerdo I-TREATMENT +al I-TREATMENT +protocolo I-TREATMENT +seleccionado. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +propuso I-TREATMENT la I-TREATMENT -localización I-TREATMENT +aplicación I-TREATMENT +de I-TREATMENT +toxina I-TREATMENT +botulínica. I-TREATMENT +La I-TREATMENT +Primera I-TREATMENT +aplicación I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +50 I-TREATMENT +U, I-TREATMENT +25 I-TREATMENT de I-TREATMENT las I-TREATMENT -parestesias I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -afectada. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -se I-EVOLUTION -revisó I-EVOLUTION -dos I-EVOLUTION -semanas I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -observándose I-EVOLUTION -una I-EVOLUTION -buena I-EVOLUTION -respuesta, I-EVOLUTION -tanto I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -como I-EVOLUTION -del I-EVOLUTION -resto I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sintomatología I-EVOLUTION -acompañante, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT +cuales I-TREATMENT se I-TREATMENT -decidió I-TREATMENT -la I-TREATMENT -colocación, I-TREATMENT +aplicaron I-TREATMENT en I-TREATMENT -quirófano I-TREATMENT -y I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general, I-TREATMENT -de I-TREATMENT -un I-TREATMENT -generador I-TREATMENT +la I-TREATMENT +zona I-TREATMENT de I-TREATMENT -impulsos I-TREATMENT -eléctricos I-TREATMENT -implantable I-TREATMENT -y I-TREATMENT -programable, I-TREATMENT -marca I-TREATMENT -Génesis. I-TREATMENT - I-TREATMENT -Se B-EVOLUTION -revisó I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -semana, I-EVOLUTION -15 I-EVOLUTION -y I-EVOLUTION -30 I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -implantación I-EVOLUTION -del I-EVOLUTION -generador, I-EVOLUTION -observando I-EVOLUTION -que I-EVOLUTION -había I-EVOLUTION -iniciado I-EVOLUTION -los I-EVOLUTION -ejercicios I-EVOLUTION -de I-EVOLUTION -rehabilitación I-EVOLUTION -que I-EVOLUTION -antes I-EVOLUTION -no I-EVOLUTION -podía I-EVOLUTION -hacer I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -intenso I-EVOLUTION -dolor I-EVOLUTION -y I-EVOLUTION -alodinia I-EVOLUTION -del I-EVOLUTION -tobillo I-EVOLUTION -y I-EVOLUTION -pie, I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -también I-EVOLUTION -había I-EVOLUTION -vuelto I-EVOLUTION -al I-EVOLUTION -colegio I-EVOLUTION -primero I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -ayuda I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -muleta I-EVOLUTION -y I-EVOLUTION -después I-EVOLUTION -sin I-EVOLUTION -protección I-EVOLUTION -alguna I-EVOLUTION -haciendo I-EVOLUTION -una I-EVOLUTION -vida I-EVOLUTION -completamente I-EVOLUTION -normal I-EVOLUTION -para I-EVOLUTION -su I-EVOLUTION -edad. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -implantación I-EVOLUTION -del I-EVOLUTION -generador, I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -revisión I-EVOLUTION -realizada I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -Unidad I-EVOLUTION -encontramos I-EVOLUTION -que, I-EVOLUTION -tanto I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -como I-EVOLUTION -el I-EVOLUTION -edema I-EVOLUTION -articular I-EVOLUTION -estaban I-EVOLUTION -haciendo I-EVOLUTION -su I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -nuevo I-EVOLUTION -desde I-EVOLUTION -hacía I-EVOLUTION -una I-EVOLUTION -semana. I-EVOLUTION -Se B-EXPLORATION -comprobó I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -batería I-EXPLORATION -del I-EXPLORATION -generador I-EXPLORATION -implantable I-EXPLORATION -se I-EXPLORATION -estaba I-EXPLORATION -agotando, I-EXPLORATION -debido I-EXPLORATION -al I-EXPLORATION -funcionamiento I-EXPLORATION -continuo I-EXPLORATION -que I-EXPLORATION -había I-EXPLORATION -sido I-EXPLORATION -necesario I-EXPLORATION -hacer I-EXPLORATION -para I-EXPLORATION -mantener I-EXPLORATION -controlados I-EXPLORATION -los I-EXPLORATION -síntomas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -paciente, I-EXPLORATION -ante B-TREATMENT +mayor I-TREATMENT +hipertrofia I-TREATMENT +(zona I-TREATMENT +IV I-TREATMENT +descrita I-TREATMENT +por I-TREATMENT +Da-Hye I-TREATMENT +Kim), I-TREATMENT +15 I-TREATMENT +U I-TREATMENT +en I-TREATMENT +dirección I-TREATMENT +al I-TREATMENT +borde I-TREATMENT +inferior I-TREATMENT +mandibular I-TREATMENT +y I-TREATMENT +10 I-TREATMENT +U I-TREATMENT +por I-TREATMENT +encima I-TREATMENT +de I-TREATMENT +la I-TREATMENT +aplicación I-TREATMENT +previa I-TREATMENT +(correspondiente I-TREATMENT +a I-TREATMENT +zona I-TREATMENT +V I-TREATMENT +de I-TREATMENT +Da-Hye I-TREATMENT +Kim). I-TREATMENT +Con I-TREATMENT esta I-TREATMENT -situación I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -implantar I-TREATMENT -un I-TREATMENT -generador I-TREATMENT -recargable, I-TREATMENT -marca I-TREATMENT -EON I-TREATMENT -Mini, I-TREATMENT +distribución I-TREATMENT +de I-TREATMENT +aplicación I-TREATMENT +en I-TREATMENT +los I-TREATMENT +puntos I-TREATMENT +propuestos I-TREATMENT +por I-TREATMENT +Nam-Ho I-TREATMENT +Kim I-TREATMENT que I-TREATMENT -le I-TREATMENT -permita I-TREATMENT +mejoran I-TREATMENT +el I-TREATMENT +contorno I-TREATMENT +mandibular, I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +marcaje I-TREATMENT +sobre I-TREATMENT +la I-TREATMENT +piel I-TREATMENT a I-TREATMENT +nivel I-TREATMENT +de I-TREATMENT +ambos I-TREATMENT +músculos I-TREATMENT +maseteros I-TREATMENT +(5). I-TREATMENT +Para I-TREATMENT la I-TREATMENT -paciente I-TREATMENT +preparación I-TREATMENT +del I-TREATMENT +producto I-TREATMENT +se I-TREATMENT +utilizó I-TREATMENT una I-TREATMENT -prolongación I-TREATMENT -en I-TREATMENT +aguja I-TREATMENT +gruesa I-TREATMENT +(18G) I-TREATMENT +con I-TREATMENT el I-TREATMENT -tiempo I-TREATMENT +fin I-TREATMENT de I-TREATMENT -recambio I-TREATMENT +evitar I-TREATMENT +la I-TREATMENT +formación I-TREATMENT +de I-TREATMENT +turbulencias. I-TREATMENT +El I-TREATMENT +alcohol, I-TREATMENT +usado I-TREATMENT +ya I-TREATMENT +sea I-TREATMENT +en I-TREATMENT +el I-TREATMENT +tapón I-TREATMENT del I-TREATMENT -generador. I-TREATMENT -Este I-TREATMENT -nuevo I-TREATMENT -generador I-TREATMENT -también I-TREATMENT -se I-TREATMENT -implantó I-TREATMENT +vial I-TREATMENT +o I-TREATMENT +bien I-TREATMENT en I-TREATMENT -quirófano I-TREATMENT -y I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general. I-TREATMENT -La B-EVOLUTION -niña I-EVOLUTION -ha I-EVOLUTION -vuelto I-EVOLUTION -al I-EVOLUTION -colegio I-EVOLUTION -con I-EVOLUTION -control I-EVOLUTION -tanto I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -como I-EVOLUTION -del I-EVOLUTION -resto I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -síntomas, I-EVOLUTION -permaneciendo, I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -actualidad, I-EVOLUTION -totalmente I-EVOLUTION -asintomática. I-EVOLUTION - I-EVOLUTION - -Niña B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -13 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -diagnosticó I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -SDRC I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -extremidad I-PAST_MEDICAL_HISTORY -inferior I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -secundario I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -fractura I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tobillo. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Fue B-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Dolor I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Traumatología I-DERIVED_FROM/TO -Pediátrica. I-DERIVED_FROM/TO -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -farmacológico I-TREATMENT -sin I-TREATMENT -resultado I-TREATMENT -analgésico I-TREATMENT -adecuado I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -(previa I-TREATMENT -información I-TREATMENT -y I-TREATMENT -obtención I-TREATMENT +la I-TREATMENT +piel I-TREATMENT del I-TREATMENT -consentimiento I-TREATMENT -por I-TREATMENT -parte I-TREATMENT +paciente, I-TREATMENT +debe I-TREATMENT +evaporarse I-TREATMENT +completamente I-TREATMENT +antes I-TREATMENT de I-TREATMENT -los I-TREATMENT -padres) I-TREATMENT +aplicar I-TREATMENT +la I-TREATMENT +toxina I-TREATMENT +dado I-TREATMENT +que I-TREATMENT +también I-TREATMENT +puede I-TREATMENT +inactivarla. I-TREATMENT +A I-TREATMENT +pesar I-TREATMENT +de I-TREATMENT +que I-TREATMENT +el I-TREATMENT +vial I-TREATMENT +puede I-TREATMENT +reconstituirse I-TREATMENT +a I-TREATMENT +una I-TREATMENT +dilución I-TREATMENT +de I-TREATMENT +8 I-TREATMENT +cc/100 I-TREATMENT +U, I-TREATMENT +preferimos I-TREATMENT la I-TREATMENT -implantación, I-TREATMENT +dilución I-TREATMENT en I-TREATMENT -quirófano I-TREATMENT -y I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general, I-TREATMENT +4 I-TREATMENT +cc. I-TREATMENT +a I-TREATMENT +fin I-TREATMENT de I-TREATMENT +conseguir I-TREATMENT +una I-TREATMENT +dosificación I-TREATMENT +de I-TREATMENT +2.5 I-TREATMENT +U/0.1 I-TREATMENT +cc. I-TREATMENT +El I-TREATMENT +obtener I-TREATMENT +de I-TREATMENT +esta I-TREATMENT +forma I-TREATMENT un I-TREATMENT -catéter I-TREATMENT -epidural I-TREATMENT -lumbar I-TREATMENT -conectado I-TREATMENT -a I-TREATMENT +volumen I-TREATMENT +menor, I-TREATMENT +limitará I-TREATMENT +la I-TREATMENT +posibilidad I-TREATMENT +de I-TREATMENT +que I-TREATMENT +la I-TREATMENT +toxina I-TREATMENT +difunda I-TREATMENT +hacia I-TREATMENT +las I-TREATMENT +zonas I-TREATMENT +adyacentes. I-TREATMENT +Es I-TREATMENT +importante I-TREATMENT +recordar I-TREATMENT +que I-TREATMENT una I-TREATMENT -bomba I-TREATMENT -externa I-TREATMENT +vez I-TREATMENT +realizada I-TREATMENT +la I-TREATMENT +reconstitución, I-TREATMENT +el I-TREATMENT +producto I-TREATMENT +deberá I-TREATMENT +utilizarse I-TREATMENT +en I-TREATMENT +el I-TREATMENT +plazo I-TREATMENT +de I-TREATMENT +las I-TREATMENT +4 I-TREATMENT +horas I-TREATMENT +siguientes I-TREATMENT para I-TREATMENT -administrar I-TREATMENT -una I-TREATMENT -infusión I-TREATMENT -continua I-TREATMENT +evitar I-TREATMENT +pérdida I-TREATMENT de I-TREATMENT -bupivacaína I-TREATMENT -durante I-TREATMENT -dos I-TREATMENT -semanas. I-TREATMENT -Se B-EVOLUTION -obtuvo I-EVOLUTION -un I-EVOLUTION -alivio I-EVOLUTION -completo I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -del I-EVOLUTION -resto I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -síntomas, I-EVOLUTION -pero I-EVOLUTION -este I-EVOLUTION -desapareció I-EVOLUTION -una I-EVOLUTION -vez I-EVOLUTION -retirada I-EVOLUTION -la I-EVOLUTION -infusión I-EVOLUTION -de I-EVOLUTION -bupivacaína I-EVOLUTION -volviendo I-EVOLUTION -a I-EVOLUTION -aparecer I-EVOLUTION -tanto I-EVOLUTION -el I-EVOLUTION -dolor I-EVOLUTION -como I-EVOLUTION -el I-EVOLUTION -resto I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -acompañantes. I-EVOLUTION - I-EVOLUTION -Previa B-TREATMENT -información I-TREATMENT -y I-TREATMENT -consentimiento I-TREATMENT -paterno I-TREATMENT +eficacia, I-TREATMENT +aunque I-TREATMENT +algunos I-TREATMENT +autores I-TREATMENT +señalan I-TREATMENT +que I-TREATMENT se I-TREATMENT -implantó I-TREATMENT -en I-TREATMENT -quirófano, I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general, I-TREATMENT -un I-TREATMENT -electrodo I-TREATMENT -octopolar I-TREATMENT +puede I-TREATMENT +utilizar I-TREATMENT +sin I-TREATMENT +disminuir I-TREATMENT +su I-TREATMENT +eficacia I-TREATMENT +dentro I-TREATMENT +de I-TREATMENT +los I-TREATMENT +3 I-TREATMENT +a I-TREATMENT +7 I-TREATMENT +días I-TREATMENT +posteriores. I-TREATMENT + I-TREATMENT +Para I-TREATMENT +disminuir I-TREATMENT +las I-TREATMENT +molestias I-TREATMENT +y I-TREATMENT +que I-TREATMENT +la I-TREATMENT +aplicación I-TREATMENT +sea I-TREATMENT +segura I-TREATMENT +utilizamos I-TREATMENT +una I-TREATMENT +aguja I-TREATMENT +fina I-TREATMENT +(30G). I-TREATMENT +Es I-TREATMENT +importante I-TREATMENT +insistir I-TREATMENT en I-TREATMENT -cordones I-TREATMENT -medulares I-TREATMENT -posteriores I-TREATMENT +que I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +no I-TREATMENT +debe I-TREATMENT +tomar I-TREATMENT +medicamentos I-TREATMENT +que I-TREATMENT +interfieran I-TREATMENT +con I-TREATMENT +la I-TREATMENT +coagulación I-TREATMENT +de I-TREATMENT +10 I-TREATMENT a I-TREATMENT -nivel I-TREATMENT +14 I-TREATMENT +días I-TREATMENT +antes I-TREATMENT de I-TREATMENT -T12-T9 I-TREATMENT -y I-TREATMENT -se I-TREATMENT -conectó I-TREATMENT +la I-TREATMENT +inyección I-TREATMENT +para I-TREATMENT +evitar I-TREATMENT +equímosis. I-TREATMENT +También I-TREATMENT +solicitamos I-TREATMENT +al I-TREATMENT +paciente I-TREATMENT +la I-TREATMENT +correspondiente I-TREATMENT +autorización I-TREATMENT +para I-TREATMENT +llevar I-TREATMENT a I-TREATMENT +cabo I-TREATMENT +el I-TREATMENT +procedimiento I-TREATMENT +mediante I-TREATMENT +un I-TREATMENT +consentimiento I-TREATMENT +informado I-TREATMENT +específico, I-TREATMENT +tal I-TREATMENT +y I-TREATMENT +como I-TREATMENT +habitualmente I-TREATMENT +hacemos I-TREATMENT +con I-TREATMENT +cualquier I-TREATMENT +procedimiento I-TREATMENT +invasivo. I-TREATMENT + I-TREATMENT +Para I-TREATMENT +las I-TREATMENT +aplicaciones I-TREATMENT +posteriores I-TREATMENT +citamos I-TREATMENT +al I-TREATMENT +paciente I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +semanas I-TREATMENT +(3 I-TREATMENT +meses), I-TREATMENT +utilizando I-TREATMENT +la I-TREATMENT +misma I-TREATMENT +técnica I-TREATMENT +y I-TREATMENT +completando I-TREATMENT +hasta I-TREATMENT un I-TREATMENT -generador I-TREATMENT +total I-TREATMENT de I-TREATMENT -impulsos I-TREATMENT -eléctricos I-TREATMENT -externo. I-TREATMENT -Se B-EVOLUTION -programó I-EVOLUTION -una I-EVOLUTION -vez I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -estaba I-EVOLUTION -despierta I-EVOLUTION -consiguiéndose I-EVOLUTION -un I-EVOLUTION -buen I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -parestesias I-EVOLUTION -con I-EVOLUTION -alivio I-EVOLUTION -completo I-EVOLUTION -del I-EVOLUTION -dolor. I-EVOLUTION -Ello I-EVOLUTION -permitió I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -iniciara I-EVOLUTION -la I-EVOLUTION -rehabilitación I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -extremidad I-EVOLUTION -afectada. I-EVOLUTION -A I-EVOLUTION -las I-EVOLUTION -dos I-EVOLUTION -semanas I-EVOLUTION -se I-EVOLUTION -revisó I-EVOLUTION -observándose I-EVOLUTION -que I-EVOLUTION -continuaba I-EVOLUTION -el I-EVOLUTION -alivio I-EVOLUTION -sin I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -utilizase I-EVOLUTION -el I-EVOLUTION -generador I-EVOLUTION -de I-EVOLUTION -impulsos I-EVOLUTION -externo. I-EVOLUTION -Ante B-TREATMENT -esta I-TREATMENT -situación I-TREATMENT +4 I-TREATMENT +aplicaciones. I-TREATMENT +Se I-TREATMENT +sabe I-TREATMENT +que I-TREATMENT +al I-TREATMENT +utilizar I-TREATMENT +toxina I-TREATMENT +botulínica I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +repetitiva I-TREATMENT se I-TREATMENT -desconectó I-TREATMENT +causa I-TREATMENT +atrofia I-TREATMENT +en I-TREATMENT +los I-TREATMENT +grupos I-TREATMENT +musculares I-TREATMENT +infiltrados, I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +hace I-TREATMENT +que I-TREATMENT el I-TREATMENT -generador I-TREATMENT -externo I-TREATMENT -y I-TREATMENT +paciente I-TREATMENT +presente I-TREATMENT +mejoría I-TREATMENT +clínica. I-TREATMENT +También I-TREATMENT se I-TREATMENT -continuó I-TREATMENT +indicó I-TREATMENT +continuar I-TREATMENT con I-TREATMENT el I-TREATMENT -tratamiento I-TREATMENT -rehabilitador I-TREATMENT -citando I-TREATMENT -a I-TREATMENT +uso I-TREATMENT +de I-TREATMENT la I-TREATMENT -paciente I-TREATMENT -cuatro I-TREATMENT -semanas I-TREATMENT -más I-TREATMENT -tarde. I-TREATMENT -Ante B-EVOLUTION +guarda I-TREATMENT +oclusal I-TREATMENT +nocturna I-TREATMENT +para I-TREATMENT +controlar I-TREATMENT +el I-TREATMENT +bruxismo. I-TREATMENT + I-TREATMENT + +Niña B-PRESENT_ILLNESS +previamente I-PRESENT_ILLNESS +sana, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés; I-PAST_MEDICAL_HISTORY +está I-PAST_MEDICAL_HISTORY +correctamente I-PAST_MEDICAL_HISTORY +vacunada. I-PAST_MEDICAL_HISTORY +A B-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +23 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +tiene I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +primer I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +inflamación I-PRESENT_ILLNESS +parotídea. I-PRESENT_ILLNESS +Cuadro I-PRESENT_ILLNESS +clínico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +inflamación I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +parotídea I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +borraba I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +ángulo I-PRESENT_ILLNESS +mandibular, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +signos I-PRESENT_ILLNESS +inflamatorios I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +supuración I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +conducto I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Stenon. I-PRESENT_ILLNESS +Se B-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +analítica I-EXPLORATION +sanguínea I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +leucocitosis I-EXPLORATION +(19 I-EXPLORATION +700/mm3) I-EXPLORATION +con I-EXPLORATION +neutrofilia I-EXPLORATION +(65%), I-EXPLORATION +PCR I-EXPLORATION +de I-EXPLORATION +5, I-EXPLORATION +45 I-EXPLORATION +mg/dl I-EXPLORATION +y I-EXPLORATION +amilasa I-EXPLORATION +de I-EXPLORATION +881 I-EXPLORATION +U/l. I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +que I-EXPLORATION +muestra I-EXPLORATION +una I-EXPLORATION +inflamación I-EXPLORATION +bilateral I-EXPLORATION +de I-EXPLORATION +ambas I-EXPLORATION +parótidas, I-EXPLORATION +sin I-EXPLORATION +colecciones. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +ingreso I-TREATMENT +para I-TREATMENT +antibioterapia I-TREATMENT +intravenosa I-TREATMENT +con I-TREATMENT +amoxicilina-clavulánico, I-TREATMENT +analgesia I-TREATMENT +y I-TREATMENT +antiinflamatorios. I-TREATMENT +Dada B-EVOLUTION la I-EVOLUTION -persistencia I-EVOLUTION +buena I-EVOLUTION +evolución, I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -ausencia I-EVOLUTION +alta I-EVOLUTION +tres I-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +para I-EVOLUTION +continuar I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION de I-EVOLUTION -dolor I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -mejoría I-EVOLUTION +forma I-EVOLUTION +ambulatoria. I-EVOLUTION + I-EVOLUTION +Posteriormente I-EVOLUTION +ha I-EVOLUTION +presentado I-EVOLUTION +sucesivos I-EVOLUTION +episodios I-EVOLUTION +(cuatro I-EVOLUTION +más) I-EVOLUTION de I-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -acompañantes, I-EVOLUTION -se I-EVOLUTION -decidió I-EVOLUTION -(de I-EVOLUTION -acuerdo I-EVOLUTION +características I-EVOLUTION +clínicas I-EVOLUTION +y I-EVOLUTION +analíticas I-EVOLUTION +similares, I-EVOLUTION +que I-EVOLUTION +han I-EVOLUTION +sido I-EVOLUTION +tratados I-EVOLUTION con I-EVOLUTION -los I-EVOLUTION -padres) I-EVOLUTION -explantar I-EVOLUTION -el I-EVOLUTION -electrodo I-EVOLUTION -medular. I-EVOLUTION -La I-EVOLUTION -paciente I-EVOLUTION -continúa I-EVOLUTION +antibioterapia I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +ambulatoria I-EVOLUTION con I-EVOLUTION +buena I-EVOLUTION +evolución. I-EVOLUTION +Son I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION una I-EVOLUTION -remisión I-EVOLUTION -completa I-EVOLUTION +semana I-EVOLUTION de I-EVOLUTION -los I-EVOLUTION -síntomas. I-EVOLUTION +duración I-EVOLUTION +aproximadamente, I-EVOLUTION +bilaterales, I-EVOLUTION +pero I-EVOLUTION +con I-EVOLUTION +predominio I-EVOLUTION +de I-EVOLUTION +afectación I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +lado I-EVOLUTION +izquierdo. I-EVOLUTION I-EVOLUTION - -Niño B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -13 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -cuando I-PRESENT_ILLNESS -sufrió I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -esguince I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tobillo I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS -Fue I-PRESENT_ILLNESS -diagnosticado I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tratado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Traumatología I-PRESENT_ILLNESS -Pediátrica I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -remitido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -unidad I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -cuadro. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Se B-TREATMENT -inició I-TREATMENT -un I-TREATMENT -tratamiento I-TREATMENT -farmacológico I-TREATMENT -(gabapentina I-TREATMENT -más I-TREATMENT -tramadol) I-TREATMENT -con I-TREATMENT -remisión I-TREATMENT -completa I-TREATMENT -del I-TREATMENT -cuadro I-TREATMENT -de I-TREATMENT -dolor I-TREATMENT -que I-TREATMENT -permitió I-TREATMENT -el I-TREATMENT -inicio I-TREATMENT -de I-TREATMENT -la I-TREATMENT -rehabilitación I-TREATMENT -del I-TREATMENT -pie. I-TREATMENT -Continúa B-EVOLUTION +Es I-EVOLUTION +seguida I-EVOLUTION en I-EVOLUTION -igual I-EVOLUTION -situación. I-EVOLUTION +consulta I-EVOLUTION +de I-EVOLUTION +Infectología I-EVOLUTION +Pediátrica I-EVOLUTION +donde I-EVOLUTION +se I-EVOLUTION +ha I-EVOLUTION +completado I-EVOLUTION +el I-EVOLUTION +estudio. I-EVOLUTION +Todas B-EXPLORATION +las I-EXPLORATION +serologías I-EXPLORATION +y I-EXPLORATION +pruebas I-EXPLORATION +reumatoideas I-EXPLORATION +son I-EXPLORATION +negativas. I-EXPLORATION +Se I-EXPLORATION +repiten I-EXPLORATION +ecografías I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +el I-EXPLORATION +aumento I-EXPLORATION +glandular, I-EXPLORATION +con I-EXPLORATION +fotos I-EXPLORATION +heterogéneos I-EXPLORATION +hipoecogénicos. I-EXPLORATION +En B-EVOLUTION +la I-EVOLUTION +actualidad I-EVOLUTION +sin I-EVOLUTION +nuevos I-EVOLUTION +episodios. I-EVOLUTION I-EVOLUTION Niña B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad I-PRESENT_ILLNESS -cuando I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -inicia I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cuadro. I-PRESENT_ILLNESS -Presenta I-PRESENT_ILLNESS -esguince I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tobillo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -desarrollo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS +estenosis I-PRESENT_ILLNESS +esofágica I-PRESENT_ILLNESS +secundaria I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +ingesta I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -SDRC I-PRESENT_ILLNESS +caústicos I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +respondió I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +7 I-PRESENT_ILLNESS +dilataciones I-PRESENT_ILLNESS +consecutivas I-PRESENT_ILLNESS +realizadas I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +balón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tobillo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pie I-PRESENT_ILLNESS -izquierdo. I-PRESENT_ILLNESS -Es B-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Dolor I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Reumatología I-DERIVED_FROM/TO -Pediátrica I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -cuatro I-DERIVED_FROM/TO -años I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -diagnóstico. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO +dilatación I-PRESENT_ILLNESS +esofágico. I-PRESENT_ILLNESS +La B-EXPLORATION +estenosis I-EXPLORATION +tenía I-EXPLORATION +1 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +longitud I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +calibre I-EXPLORATION +inicial I-EXPLORATION +de I-EXPLORATION +2 I-EXPLORATION +mm. I-EXPLORATION Se B-TREATMENT -le I-TREATMENT -administra I-TREATMENT -tratamiento I-TREATMENT -farmacológico I-TREATMENT -más I-TREATMENT -aplicación I-TREATMENT +realizaron I-TREATMENT +2 I-TREATMENT +sesiones I-TREATMENT de I-TREATMENT -parche I-TREATMENT +inyección I-TREATMENT +intralesional I-TREATMENT de I-TREATMENT -capsaicina I-TREATMENT -al I-TREATMENT -8 I-TREATMENT -% I-TREATMENT -sin I-TREATMENT -remisión I-TREATMENT -del I-TREATMENT -cuadro. I-TREATMENT -Colocación I-TREATMENT +mitomicina I-TREATMENT +C I-TREATMENT +(1, I-TREATMENT +6 I-TREATMENT +ml I-TREATMENT en I-TREATMENT -quirófano, I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general I-TREATMENT -y I-TREATMENT -previo I-TREATMENT -consentimiento I-TREATMENT -paterno, I-TREATMENT -de I-TREATMENT -un I-TREATMENT -catéter I-TREATMENT -epidural I-TREATMENT -lumbar I-TREATMENT +cada I-TREATMENT +ocasión) I-TREATMENT y I-TREATMENT -conexión I-TREATMENT -a I-TREATMENT -una I-TREATMENT -bomba I-TREATMENT -externa I-TREATMENT -para I-TREATMENT -administración I-TREATMENT -de I-TREATMENT -una I-TREATMENT -infusión I-TREATMENT -continúa I-TREATMENT +dilatación I-TREATMENT +con I-TREATMENT +balones I-TREATMENT de I-TREATMENT -bupivacaína I-TREATMENT -durante I-TREATMENT -dos I-TREATMENT -semanas. I-TREATMENT -Retirada I-TREATMENT -del I-TREATMENT -catéter I-TREATMENT -pasado I-TREATMENT -ese I-TREATMENT -tiempo. I-TREATMENT -Remisión B-EVOLUTION -completa I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -síntomas. I-EVOLUTION - I-EVOLUTION - -Niño B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -cuando I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -realizó I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -diagnóstico. I-PRESENT_ILLNESS -Presentó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -traumatismo I-PRESENT_ILLNESS -previo I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -esguince I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tobillo I-PRESENT_ILLNESS -izquierdo. I-PRESENT_ILLNESS -Fue B-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -4 I-DERIVED_FROM/TO -meses I-DERIVED_FROM/TO -después I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -diagnóstico. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Se B-TREATMENT -le I-TREATMENT -administra I-TREATMENT -tratamiento I-TREATMENT -farmacológico I-TREATMENT -más I-TREATMENT -aplicación I-TREATMENT -del I-TREATMENT -parche I-TREATMENT +10-11-12 I-TREATMENT +mm I-TREATMENT +con I-TREATMENT +40 I-TREATMENT +días I-TREATMENT de I-TREATMENT -capsaicina I-TREATMENT -al I-TREATMENT -8 I-TREATMENT -%. I-TREATMENT -Remisión B-EVOLUTION +separación I-TREATMENT +entre I-TREATMENT +sesiones, I-TREATMENT +obteniendo B-EVOLUTION +la I-EVOLUTION +resolución I-EVOLUTION completa I-EVOLUTION -de I-EVOLUTION +del I-EVOLUTION +cuadro. I-EVOLUTION +Han I-EVOLUTION +transcurrido I-EVOLUTION +2 I-EVOLUTION +años I-EVOLUTION +y I-EVOLUTION +5 I-EVOLUTION +meses I-EVOLUTION +desde I-EVOLUTION +la I-EVOLUTION +ingesta I-EVOLUTION +y I-EVOLUTION +no I-EVOLUTION +ha I-EVOLUTION +precisado I-EVOLUTION +nuevas I-EVOLUTION +dilataciones I-EVOLUTION +esofágicas I-EVOLUTION +en I-EVOLUTION los I-EVOLUTION -síntomas. I-EVOLUTION +últimos I-EVOLUTION +19 I-EVOLUTION +meses. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -43 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -medicamentosas I-PAST_MEDICAL_HISTORY -conocidas I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -8 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -historia I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS +51 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +trasplantado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +1986 I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +glomerulonefritis I-PRESENT_ILLNESS +mesangiocapilar I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +II, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +disfunción I-PRESENT_ILLNESS +crónica I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +injerto I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +recidiva I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -sacro I-PRESENT_ILLNESS -incapacitante, I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +enfermedad I-PRESENT_ILLNESS +renal I-PRESENT_ILLNESS +sobre I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +mismo, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +obliga I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +reanudar I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +hemodiálisis I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +1996. I-PRESENT_ILLNESS +Se I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +realizado I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +descenso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -manera I-PRESENT_ILLNESS -continua I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +inmunosupresión I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -cierta I-PRESENT_ILLNESS -irradiación I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS +CsA I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -porción I-PRESENT_ILLNESS -posterior I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -muslo I-PRESENT_ILLNESS -izquierdo. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -apreciaba I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS -sensitivas I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -control I-PRESENT_ILLNESS +adición I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -esfínteres. I-PRESENT_ILLNESS +Azathioprina, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +resultados. I-PRESENT_ILLNESS +Presenta I-PRESENT_ILLNESS +15 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +iniciar I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +hemodiálisis I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +agudo I-PRESENT_ILLNESS +sobre I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +injerto I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +inestabilidad I-PRESENT_ILLNESS +hemodinámica I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +refractaria I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +médico. I-PRESENT_ILLNESS I-PRESENT_ILLNESS -Por I-PRESENT_ILLNESS -dicho I-PRESENT_ILLNESS -motivo I-PRESENT_ILLNESS -realizó I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -múltiples I-PRESENT_ILLNESS -hospitales. I-PRESENT_ILLNESS -Se B-EXPLORATION -le I-EXPLORATION -practicaron I-EXPLORATION -una I-EXPLORATION -TC I-EXPLORATION -lumbar I-EXPLORATION -que I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -relieve I-EXPLORATION -un I-EXPLORATION -hemangioma I-EXPLORATION -en I-EXPLORATION -L5, I-EXPLORATION -una I-EXPLORATION -RMN I-EXPLORATION -de I-EXPLORATION -pelvis I-EXPLORATION -en I-EXPLORATION +En B-EXPLORATION la I-EXPLORATION +ecografía I-EXPLORATION +urgente I-EXPLORATION +se I-EXPLORATION +detecta I-EXPLORATION +hematoma I-EXPLORATION +subcapsular I-EXPLORATION +e I-EXPLORATION +intraparenquimatoso I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +injerto, I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -evidenció I-EXPLORATION -rotura I-EXPLORATION -muscular I-EXPLORATION -grado I-EXPLORATION -I I-EXPLORATION +confirma I-EXPLORATION +mediante I-EXPLORATION +TC, I-EXPLORATION +realizándose B-TREATMENT +trasplantectomía I-TREATMENT +pocas I-TREATMENT +horas I-TREATMENT +después. I-TREATMENT +Durante B-EXPLORATION +la I-EXPLORATION +intervención I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +lesión I-EXPLORATION +sólida I-EXPLORATION +en I-EXPLORATION +polo I-EXPLORATION +superior I-EXPLORATION del I-EXPLORATION -glúteo I-EXPLORATION -mayor I-EXPLORATION -izquierdo I-EXPLORATION +injerto, I-EXPLORATION +de I-EXPLORATION +unos I-EXPLORATION +4 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro, I-EXPLORATION +con I-EXPLORATION +evidentes I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +ruptura I-EXPLORATION +espontánea I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -estructura I-EXPLORATION -que I-EXPLORATION +sangrado. I-EXPLORATION +También I-EXPLORATION se I-EXPLORATION -interpretó I-EXPLORATION -como I-EXPLORATION -quiste I-EXPLORATION +advierten I-EXPLORATION +otras I-EXPLORATION +múltiples I-EXPLORATION +lesiones I-EXPLORATION +sólidas I-EXPLORATION +y I-EXPLORATION +quísticas I-EXPLORATION de I-EXPLORATION -Tarlov I-EXPLORATION -sacro. I-EXPLORATION -Recibió B-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -paracetamol, I-TREATMENT -nolotil, I-TREATMENT -tramadol I-TREATMENT -y I-TREATMENT -gabapentina I-TREATMENT -sin I-TREATMENT -mejoría. I-TREATMENT -Se I-TREATMENT -le I-TREATMENT -realizaron I-TREATMENT -dos I-TREATMENT -bloqueos I-TREATMENT -facetarios I-TREATMENT -e I-TREATMENT -incluso I-TREATMENT -un I-TREATMENT -bloqueo I-TREATMENT -del I-TREATMENT -músculo I-TREATMENT -piriforme I-TREATMENT -izquierdo, I-TREATMENT -todo I-TREATMENT -ello I-TREATMENT -sin I-TREATMENT -resultados. I-TREATMENT -En B-EVOLUTION -este I-EVOLUTION -último I-EVOLUTION -la I-EVOLUTION +pequeño I-EXPLORATION +tamaño I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +superficie I-EXPLORATION +del I-EXPLORATION +injerto. I-EXPLORATION +El I-EXPLORATION +análisis I-EXPLORATION +anatomopatológico I-EXPLORATION +reveló I-EXPLORATION +un I-EXPLORATION +CCR I-EXPLORATION +multicéntrico, I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +seno I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +enfermedad I-EXPLORATION +quística I-EXPLORATION +renal I-EXPLORATION +adquirida I-EXPLORATION +del I-EXPLORATION +injerto. I-EXPLORATION +El B-EVOLUTION paciente I-EVOLUTION -quedó I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -hipoestesia I-EVOLUTION -de I-EVOLUTION +reanudó I-EVOLUTION la I-EVOLUTION -extremidad I-EVOLUTION -inferior I-EVOLUTION -izquierda I-EVOLUTION -residual. I-EVOLUTION -Fue B-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -valoración I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -dolor I-DERIVED_FROM/TO -ante I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -sospecha I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -este I-DERIVED_FROM/TO -pudiera I-DERIVED_FROM/TO -ser I-DERIVED_FROM/TO -causado I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -hemangioma I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -L5. I-DERIVED_FROM/TO +hemodiálisis I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +libre I-EVOLUTION +de I-EVOLUTION +enfermedad I-EVOLUTION +y I-EVOLUTION +asintomático I-EVOLUTION +tras I-EVOLUTION +12 I-EVOLUTION +años I-EVOLUTION +de I-EVOLUTION +seguimiento. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +36 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +reseñables, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +macrohematuria I-PRESENT_ILLNESS +asintomática I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS La B-EXPLORATION -paciente I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION +exploración I-EXPLORATION +física, I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION +laboratorio, I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -estaba I-EXPLORATION -consciente I-EXPLORATION +citología I-EXPLORATION +urinaria I-EXPLORATION y I-EXPLORATION -orientada. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -apreciaron I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lenguaje. I-EXPLORATION -La I-EXPLORATION -función I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -pares I-EXPLORATION -craneales I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION -Presentaba I-EXPLORATION -un I-EXPLORATION -dolor I-EXPLORATION -muy I-EXPLORATION -importante I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -palpación I-EXPLORATION -sacra I-EXPLORATION -8/10 I-EXPLORATION -según I-EXPLORATION +cistoscopia I-EXPLORATION +eran I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -escala I-EXPLORATION -EVA, I-EXPLORATION -aproximadamente I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -S2 I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -discreta I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -fuerza I-EXPLORATION +urografía I-EXPLORATION +intravenosa I-EXPLORATION +se I-EXPLORATION +evidenciaba I-EXPLORATION +un I-EXPLORATION +efecto I-EXPLORATION +masa I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -extremidad I-EXPLORATION +polo I-EXPLORATION inferior I-EXPLORATION -izquierda I-EXPLORATION de I-EXPLORATION -4/5, I-EXPLORATION +riñón I-EXPLORATION +derecho, I-EXPLORATION con I-EXPLORATION -déficit I-EXPLORATION -de I-EXPLORATION -flexo-extensión I-EXPLORATION -distal. I-EXPLORATION +desplazamiento I-EXPLORATION +craneal I-EXPLORATION +del I-EXPLORATION +sistema I-EXPLORATION +colector. I-EXPLORATION + I-EXPLORATION El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -extremidades I-EXPLORATION -la I-EXPLORATION -fuerza I-EXPLORATION -era I-EXPLORATION -5/5. I-EXPLORATION -Se I-EXPLORATION -advirtió I-EXPLORATION +TAC I-EXPLORATION +abdominal I-EXPLORATION +mostraba I-EXPLORATION una I-EXPLORATION -hipoestesia I-EXPLORATION +masa I-EXPLORATION +renal I-EXPLORATION +derecha I-EXPLORATION +heterogénea I-EXPLORATION +de I-EXPLORATION +10 I-EXPLORATION +cm, I-EXPLORATION en I-EXPLORATION -territorio I-EXPLORATION +polo I-EXPLORATION +inferior, I-EXPLORATION +con I-EXPLORATION +realce I-EXPLORATION +periférico, I-EXPLORATION +áreas I-EXPLORATION +hipodensas I-EXPLORATION +centrales I-EXPLORATION +y I-EXPLORATION +calcificaciones. I-EXPLORATION +Se I-EXPLORATION +observaban I-EXPLORATION +asimismo I-EXPLORATION +adenopatías I-EXPLORATION +látero-cava, I-EXPLORATION +retrocava I-EXPLORATION +e I-EXPLORATION +interaorto-cava, I-EXPLORATION +siendo I-EXPLORATION +la I-EXPLORATION +mayor I-EXPLORATION de I-EXPLORATION -L5. I-EXPLORATION -No I-EXPLORATION +4 I-EXPLORATION +cm. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +practicó I-TREATMENT +nefrectomía I-TREATMENT +radical I-TREATMENT +derecha I-TREATMENT +y I-TREATMENT +linfadenectomía I-TREATMENT +retroperitoneal, I-TREATMENT +mediante I-TREATMENT +abordaje I-TREATMENT +abdominal I-TREATMENT +anterior. I-TREATMENT +El I-TREATMENT +estudio I-TREATMENT +anatomopatológico I-TREATMENT +reveló I-TREATMENT +la I-TREATMENT +existencia I-TREATMENT +de I-TREATMENT +un I-TREATMENT +adenocarcinoma I-TREATMENT +renal I-TREATMENT +de I-TREATMENT +células I-TREATMENT +claras I-TREATMENT +de I-TREATMENT +10, I-TREATMENT +5 I-TREATMENT +x I-TREATMENT +9 I-TREATMENT +cm I-TREATMENT +y I-TREATMENT +afectación I-TREATMENT +metastásica I-TREATMENT +de I-TREATMENT +9 I-TREATMENT +de I-TREATMENT +los I-TREATMENT +12 I-TREATMENT +ganglios I-TREATMENT +linfáticos I-TREATMENT +aislados, I-TREATMENT +cuyo I-TREATMENT +tamaño I-TREATMENT +oscilaba I-TREATMENT +entre I-TREATMENT +0, I-TREATMENT +3 I-TREATMENT +y I-TREATMENT +6 I-TREATMENT +cm. I-TREATMENT + I-TREATMENT +El B-EVOLUTION +postoperatorio I-EVOLUTION +transcurrió I-EVOLUTION +con I-EVOLUTION +normalidad I-EVOLUTION +hasta I-EVOLUTION +el I-EVOLUTION +4º I-EVOLUTION +día, I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +observó I-EVOLUTION +la I-EVOLUTION +salida I-EVOLUTION +de I-EVOLUTION +un I-EVOLUTION +líquido I-EVOLUTION +lechoso I-EVOLUTION +y I-EVOLUTION +denso I-EVOLUTION +por I-EVOLUTION +el I-EVOLUTION +catéter I-EVOLUTION +de I-EVOLUTION +drenaje. I-EVOLUTION +El B-EXPLORATION +cultivo I-EXPLORATION +del I-EXPLORATION +líquido I-EXPLORATION +era I-EXPLORATION +estéril I-EXPLORATION +y I-EXPLORATION +su I-EXPLORATION +análisis I-EXPLORATION +bioquímico I-EXPLORATION +y I-EXPLORATION +citológico I-EXPLORATION +era I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +quilo: I-EXPLORATION +pH: I-EXPLORATION +7, I-EXPLORATION +581, I-EXPLORATION +7600 I-EXPLORATION +células I-EXPLORATION +nucleadas/mm3 I-EXPLORATION +(82% I-EXPLORATION +mononucleares, I-EXPLORATION +18% I-EXPLORATION +polinucleares), I-EXPLORATION +colesterol: I-EXPLORATION +352 I-EXPLORATION +mg/dl, I-EXPLORATION +triglicéridos: I-EXPLORATION +3920 I-EXPLORATION +mg/dl. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +tinción I-EXPLORATION +con I-EXPLORATION +Sudan I-EXPLORATION +III I-EXPLORATION se I-EXPLORATION -evidenció I-EXPLORATION -signo I-EXPLORATION +visualizaban I-EXPLORATION +abundantes I-EXPLORATION +gotas I-EXPLORATION de I-EXPLORATION -Babinsky. I-EXPLORATION -La I-EXPLORATION -deambulación I-EXPLORATION -era I-EXPLORATION -dificultosa. I-EXPLORATION +grasa I-EXPLORATION +neutra. I-EXPLORATION + I-EXPLORATION Se I-EXPLORATION -le I-EXPLORATION realizó I-EXPLORATION +TAC I-EXPLORATION +abdominal, I-EXPLORATION +observando I-EXPLORATION una I-EXPLORATION -analítica I-EXPLORATION -general I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -alteraciones I-EXPLORATION -destacables. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -RM I-EXPLORATION -(Philips I-EXPLORATION -Medical I-EXPLORATION -Systems) I-EXPLORATION -lumbosacra I-EXPLORATION -en I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -visualizaban I-EXPLORATION -hemangiomas I-EXPLORATION -vertebrales I-EXPLORATION -en I-EXPLORATION -L2 I-EXPLORATION -y I-EXPLORATION -L5, I-EXPLORATION -advirtiéndose I-EXPLORATION -claramente I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -quística I-EXPLORATION +colección I-EXPLORATION +líquida I-EXPLORATION de I-EXPLORATION -localización I-EXPLORATION -central I-EXPLORATION -y I-EXPLORATION -lateral I-EXPLORATION -derecha I-EXPLORATION +10 I-EXPLORATION +cm I-EXPLORATION en I-EXPLORATION -canal I-EXPLORATION -espinal I-EXPLORATION -sacro I-EXPLORATION +porción I-EXPLORATION +izquierda I-EXPLORATION +del I-EXPLORATION +mesenterio, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +linfocele. I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +ascitis I-TREATMENT +quilosa I-TREATMENT +se I-TREATMENT +instauró I-TREATMENT +tratamiento I-TREATMENT +consistente I-TREATMENT +en I-TREATMENT +suspensión I-TREATMENT +de I-TREATMENT +dieta I-TREATMENT +oral I-TREATMENT +y I-TREATMENT +nutrición I-TREATMENT +parenteral I-TREATMENT +total. I-TREATMENT +Ante I-TREATMENT +el I-TREATMENT +incremento I-TREATMENT +del I-TREATMENT +débito I-TREATMENT +de I-TREATMENT +la I-TREATMENT +fístula I-TREATMENT +quilosa I-TREATMENT +en I-TREATMENT +las I-TREATMENT +48 I-TREATMENT +horas I-TREATMENT +siguientes I-TREATMENT +al I-TREATMENT +inicio I-TREATMENT +del I-TREATMENT +tratamiento, I-TREATMENT +se I-TREATMENT +añadió I-TREATMENT +octreótide I-TREATMENT +(0, I-TREATMENT +1 I-TREATMENT +mg/8h, I-TREATMENT +subcutáneo), I-TREATMENT +observándose I-TREATMENT +un I-TREATMENT +descenso I-TREATMENT +manifiesto I-TREATMENT +del I-TREATMENT +drenaje I-TREATMENT +quiloso. I-TREATMENT + I-TREATMENT +Se B-EXPLORATION +realizó I-EXPLORATION +linfografía I-EXPLORATION +isotópica I-EXPLORATION +(99mTc) I-EXPLORATION a I-EXPLORATION -la I-EXPLORATION -altura I-EXPLORATION +los I-EXPLORATION +12 I-EXPLORATION +y I-EXPLORATION +24 I-EXPLORATION +días I-EXPLORATION +del I-EXPLORATION +inicio I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -transición I-EXPLORATION -S2-S3. I-EXPLORATION -Esta I-EXPLORATION -estructura I-EXPLORATION -ocupaba I-EXPLORATION -la I-EXPLORATION -práctica I-EXPLORATION -totalidad I-EXPLORATION -del I-EXPLORATION -canal I-EXPLORATION -y I-EXPLORATION -remodelaba I-EXPLORATION -parcialmente I-EXPLORATION -el I-EXPLORATION -contorno I-EXPLORATION -posterior I-EXPLORATION +fístula, I-EXPLORATION +observando I-EXPLORATION +un I-EXPLORATION +acúmulo I-EXPLORATION de I-EXPLORATION -dichos I-EXPLORATION -cuerpos I-EXPLORATION -vertebrales I-EXPLORATION -y I-EXPLORATION -elementos I-EXPLORATION -posteriores. I-EXPLORATION -Esta I-EXPLORATION -formación I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -en I-EXPLORATION -íntimo I-EXPLORATION -contacto I-EXPLORATION +trazador I-EXPLORATION +medial I-EXPLORATION +a I-EXPLORATION +cadena I-EXPLORATION +ilíaca I-EXPLORATION +derecha, I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -ambas I-EXPLORATION -raíces I-EXPLORATION -S3 I-EXPLORATION -y I-EXPLORATION -S4 I-EXPLORATION +linfonodo, I-EXPLORATION sin I-EXPLORATION -englobarlas. I-EXPLORATION -Su I-EXPLORATION -morfología I-EXPLORATION -era I-EXPLORATION -ovalada I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -contornos I-EXPLORATION -nítidos I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -tamaño I-EXPLORATION -máximo I-EXPLORATION -aproximado I-EXPLORATION +objetivarse I-EXPLORATION +fuga I-EXPLORATION +linfática I-EXPLORATION +alguna. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +TAC I-EXPLORATION de I-EXPLORATION -22 I-EXPLORATION -X I-EXPLORATION -19 I-EXPLORATION -X I-EXPLORATION -14 I-EXPLORATION -mm. I-EXPLORATION -Según I-EXPLORATION +control, I-EXPLORATION +tras I-EXPLORATION +9 I-EXPLORATION +días I-EXPLORATION +sin I-EXPLORATION +débito I-EXPLORATION +fistuloso, I-EXPLORATION +se I-EXPLORATION +comprobó I-EXPLORATION la I-EXPLORATION -clasificación I-EXPLORATION -de I-EXPLORATION -Nabors I-EXPLORATION -correspondía I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -meningocele I-EXPLORATION -intrasacro I-EXPLORATION -oculto. I-EXPLORATION +persistencia I-EXPLORATION +del I-EXPLORATION +quilocele I-EXPLORATION +retroperitoneal, I-EXPLORATION +procediendo B-TREATMENT +a I-TREATMENT +realizar I-TREATMENT +drenaje I-TREATMENT +TAC-dirigido I-TREATMENT +del I-TREATMENT +mismo. I-TREATMENT +El I-TREATMENT +drenaje I-TREATMENT +de I-TREATMENT +la I-TREATMENT +colección I-TREATMENT +se I-TREATMENT +mantuvo I-TREATMENT +hasta I-TREATMENT +los I-TREATMENT +7 I-TREATMENT +días, I-TREATMENT +tras I-TREATMENT +4 I-TREATMENT +días I-TREATMENT +sin I-TREATMENT +débito. I-TREATMENT + I-TREATMENT +El I-TREATMENT +paciente I-TREATMENT +permaneció I-TREATMENT +en I-TREATMENT +dieta I-TREATMENT +absoluta I-TREATMENT +y I-TREATMENT +con I-TREATMENT +nutrición I-TREATMENT +parenteral I-TREATMENT +total I-TREATMENT +durante I-TREATMENT +15 I-TREATMENT +días. I-TREATMENT +El I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +octreótide I-TREATMENT +se I-TREATMENT +mantuvo I-TREATMENT +22 I-TREATMENT +días. I-TREATMENT + I-TREATMENT +Cinco B-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +intervención I-EVOLUTION +quirúrgica I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +permanece I-EVOLUTION +clínica I-EVOLUTION +y I-EVOLUTION +radiológicamente I-EVOLUTION +libre I-EVOLUTION +de I-EVOLUTION +enfermedad I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +evidencia I-EVOLUTION +de I-EVOLUTION +fuga I-EVOLUTION +quilosa. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +22 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +(178 I-PRESENT_ILLNESS +cm, I-PRESENT_ILLNESS +70 I-PRESENT_ILLNESS +Kg), I-PRESENT_ILLNESS +varón, B-PAST_MEDICAL_HISTORY +militar I-PAST_MEDICAL_HISTORY +afgano, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS +quemadura I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +segundo I-PRESENT_ILLNESS +grado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +cara I-PRESENT_ILLNESS +interna I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +antebrazo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +brazo I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +(7% I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +superficie I-PRESENT_ILLNESS +corporal I-PRESENT_ILLNESS +quemada) I-PRESENT_ILLNESS +secundaria I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +explosión I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hace I-PRESENT_ILLNESS +72 I-PRESENT_ILLNESS +horas. I-PRESENT_ILLNESS Se B-TREATMENT -realizó I-TREATMENT -punción I-TREATMENT -(Needle I-TREATMENT -Ostycut I-TREATMENT -150 I-TREATMENT -mm I-TREATMENT -13G I-TREATMENT -Angiomed) I-TREATMENT +aplicó I-TREATMENT +tratamiento I-TREATMENT +tópico I-TREATMENT +que I-TREATMENT +resultó I-TREATMENT +ineficaz. I-TREATMENT +Debido I-TREATMENT +a I-TREATMENT +la I-TREATMENT +evolución I-TREATMENT +tórpida I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +desbridamiento I-TREATMENT +mecánico I-TREATMENT +local I-TREATMENT +y I-TREATMENT +aplicación I-TREATMENT +de I-TREATMENT +sulfadiacina I-TREATMENT +argéntica I-TREATMENT +y I-TREATMENT +apósito I-TREATMENT +Tulgrasum® I-TREATMENT +cicatrizante I-TREATMENT +impregnado I-TREATMENT +de I-TREATMENT +antibiótico I-TREATMENT +(bacitracina-zinc, I-TREATMENT +neomicina, I-TREATMENT +sulfato I-TREATMENT +de I-TREATMENT +polimixina I-TREATMENT +B). I-TREATMENT +Para I-TREATMENT +permitir I-TREATMENT +el I-TREATMENT +procedimiento I-TREATMENT +se I-TREATMENT +administró I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +previa I-TREATMENT +midazolam I-TREATMENT +(3 I-TREATMENT +mg I-TREATMENT +i.m) I-TREATMENT +y I-TREATMENT +a I-TREATMENT +los I-TREATMENT +5 I-TREATMENT +minutos I-TREATMENT +ketamina I-TREATMENT +(200 I-TREATMENT +mg I-TREATMENT +i.m). I-TREATMENT +Se I-TREATMENT +consiguió I-TREATMENT +analgesia I-TREATMENT +(grado I-TREATMENT +1 I-TREATMENT +según I-TREATMENT +la I-TREATMENT +escala I-TREATMENT +verbal I-TREATMENT +del I-TREATMENT +dolor) I-TREATMENT +y I-TREATMENT +sedación I-TREATMENT +a I-TREATMENT +los I-TREATMENT +12 I-TREATMENT +minutos I-TREATMENT +(puntuación I-TREATMENT +3 I-TREATMENT +en I-TREATMENT +escala I-TREATMENT +Ramsay), I-TREATMENT +permitiendo I-TREATMENT +realizar I-TREATMENT +la I-TREATMENT +cura I-TREATMENT +sin I-TREATMENT +incidencias I-TREATMENT +durante I-TREATMENT +16 I-TREATMENT +minutos. I-TREATMENT +El I-TREATMENT +paciente I-TREATMENT +recuperó I-TREATMENT +sensibilidad I-TREATMENT y I-TREATMENT -evacuación I-TREATMENT +vigilia I-TREATMENT +a I-TREATMENT +los I-TREATMENT +55 I-TREATMENT +minutos I-TREATMENT +de I-TREATMENT +la I-TREATMENT +administración I-TREATMENT del I-TREATMENT -quiste I-TREATMENT -sacro I-TREATMENT -guiado I-TREATMENT +tratamiento. I-TREATMENT +El I-TREATMENT +grado I-TREATMENT +de I-TREATMENT +amnesia I-TREATMENT +del I-TREATMENT +procedimiento I-TREATMENT +quirúrgico I-TREATMENT +valorado I-TREATMENT por I-TREATMENT -TC I-TREATMENT -(GE I-TREATMENT -Medical I-TREATMENT -Systems I-TREATMENT -BrightSpeed) I-TREATMENT -obteniéndose I-TREATMENT -unos I-TREATMENT -2 I-TREATMENT -cc I-TREATMENT +la I-TREATMENT +escala I-TREATMENT +de I-TREATMENT +Korttila I-TREATMENT +y I-TREATMENT +Linnolia I-TREATMENT +fue I-TREATMENT +total. I-TREATMENT + I-TREATMENT +Ambos I-TREATMENT +casos I-TREATMENT +presentaron I-TREATMENT +una I-TREATMENT +evolución I-TREATMENT +favorable I-TREATMENT +sin I-TREATMENT +efectos I-TREATMENT +adversos I-TREATMENT +durante I-TREATMENT +curas I-TREATMENT +posteriores. I-TREATMENT + I-TREATMENT +En I-TREATMENT +zona I-TREATMENT +de I-TREATMENT +combate, I-TREATMENT +es I-TREATMENT +frecuente I-TREATMENT +encontrar I-TREATMENT +heridos I-TREATMENT +que I-TREATMENT +presentan I-TREATMENT +quemaduras I-TREATMENT +de I-TREATMENT +distinto I-TREATMENT +grado I-TREATMENT +y I-TREATMENT +extensión I-TREATMENT +debido I-TREATMENT +principalmente I-TREATMENT +al I-TREATMENT +empleo I-TREATMENT +de I-TREATMENT +artefactos I-TREATMENT +explosivos I-TREATMENT +por I-TREATMENT +parte I-TREATMENT de I-TREATMENT +los I-TREATMENT +contendientes. I-TREATMENT +En I-TREATMENT un I-TREATMENT -líquido I-TREATMENT -hemático. I-TREATMENT -El B-EXPLORATION -examen I-EXPLORATION -citológico I-EXPLORATION -describió I-EXPLORATION -una I-EXPLORATION -celularidad I-EXPLORATION -benigna. I-EXPLORATION -La B-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -fue I-EVOLUTION -de I-EVOLUTION -mejoría I-EVOLUTION -notable I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -sacro I-EVOLUTION -que I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -escala I-EVOLUTION -de I-EVOLUTION -EVA I-EVOLUTION -era I-EVOLUTION -de I-EVOLUTION -3/10 I-EVOLUTION -reiniciando I-EVOLUTION -la I-EVOLUTION -deambulación I-EVOLUTION -sin I-EVOLUTION -dificultad, I-EVOLUTION -no I-EVOLUTION -presentando I-EVOLUTION -debilidad I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -pierna I-EVOLUTION -izquierda I-EVOLUTION -ni I-EVOLUTION -hipoestesia. I-EVOLUTION - I-EVOLUTION +estudio I-TREATMENT +realizado I-TREATMENT +sobre I-TREATMENT +256 I-TREATMENT +heridos I-TREATMENT +por I-TREATMENT +arma I-TREATMENT +de I-TREATMENT +fuego I-TREATMENT +o I-TREATMENT +por I-TREATMENT +artefacto I-TREATMENT +explosivo I-TREATMENT +improvisado I-TREATMENT +atendidos I-TREATMENT +en I-TREATMENT +el I-TREATMENT +hospital I-TREATMENT +militar I-TREATMENT +español I-TREATMENT +de I-TREATMENT +Herat I-TREATMENT +(Afganistán) I-TREATMENT +entre I-TREATMENT +2005 I-TREATMENT +y I-TREATMENT +2008, I-TREATMENT +se I-TREATMENT +describe I-TREATMENT +que I-TREATMENT +23 I-TREATMENT +(9%) I-TREATMENT +sufrieron I-TREATMENT +quemaduras5. I-TREATMENT + I-TREATMENT +A I-TREATMENT +dosis I-TREATMENT +adecuadas I-TREATMENT +el I-TREATMENT +empleo I-TREATMENT +de I-TREATMENT +ketamina I-TREATMENT +y I-TREATMENT +midazolam I-TREATMENT +consigue I-TREATMENT +un I-TREATMENT +adecuado I-TREATMENT +estado I-TREATMENT +analgésico, I-TREATMENT +hipnótico I-TREATMENT +y I-TREATMENT +ansiolítico I-TREATMENT +con I-TREATMENT +una I-TREATMENT +estabilidad I-TREATMENT +hemodinámica I-TREATMENT +notable I-TREATMENT +y I-TREATMENT +un I-TREATMENT +mantenimiento I-TREATMENT +espontáneo I-TREATMENT +de I-TREATMENT +la I-TREATMENT +función I-TREATMENT +respiratoria. I-TREATMENT +Además, I-TREATMENT +la I-TREATMENT +posibilidad I-TREATMENT +de I-TREATMENT +emplear I-TREATMENT +ambos I-TREATMENT +fármacos I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +intramuscular I-TREATMENT +minimiza I-TREATMENT +ostensiblemente I-TREATMENT +los I-TREATMENT +requerimientos I-TREATMENT +logísticos I-TREATMENT +necesarios I-TREATMENT +en I-TREATMENT +cada I-TREATMENT +paciente. I-TREATMENT +La I-TREATMENT +sedación I-TREATMENT +con I-TREATMENT +midazolam I-TREATMENT +debe I-TREATMENT +ser I-TREATMENT +previa I-TREATMENT +a I-TREATMENT +la I-TREATMENT +administración I-TREATMENT +de I-TREATMENT +la I-TREATMENT +ketamina, I-TREATMENT +ya I-TREATMENT +que I-TREATMENT +en I-TREATMENT +caso I-TREATMENT +contrario I-TREATMENT +podría I-TREATMENT +producirse I-TREATMENT +una I-TREATMENT +marcada I-TREATMENT +estimulación I-TREATMENT +cardiovascular I-TREATMENT +y I-TREATMENT +presentarse I-TREATMENT +desagradables I-TREATMENT +reacciones I-TREATMENT +psicomiméticas I-TREATMENT +al I-TREATMENT +despertar. I-TREATMENT +Así I-TREATMENT +mismo I-TREATMENT +se I-TREATMENT +podría I-TREATMENT +añadir I-TREATMENT +atropina I-TREATMENT +para I-TREATMENT +minimizar I-TREATMENT +la I-TREATMENT +posible I-TREATMENT +aparición I-TREATMENT +de I-TREATMENT +sialorrea, I-TREATMENT +aunque I-TREATMENT +en I-TREATMENT +ninguno I-TREATMENT +de I-TREATMENT +los I-TREATMENT +dos I-TREATMENT +casos I-TREATMENT +fue I-TREATMENT +administrada I-TREATMENT +ni I-TREATMENT +apareció I-TREATMENT +un I-TREATMENT +aumento I-TREATMENT +de I-TREATMENT +secreciones I-TREATMENT +en I-TREATMENT +estos I-TREATMENT +pacientes. I-TREATMENT +Dichas I-TREATMENT +características I-TREATMENT +hacen I-TREATMENT +estos I-TREATMENT +fármacos I-TREATMENT +de I-TREATMENT +elección I-TREATMENT +para I-TREATMENT +la I-TREATMENT +anestesia I-TREATMENT +en I-TREATMENT +ambientes I-TREATMENT +austeros, I-TREATMENT +como I-TREATMENT +es I-TREATMENT +el I-TREATMENT +de I-TREATMENT +la I-TREATMENT +guerra I-TREATMENT +de I-TREATMENT +Afganistán. I-TREATMENT + I-TREATMENT +Ricardo I-TREATMENT +Navarro I-TREATMENT +Suay1, I-TREATMENT +Sergio I-TREATMENT +Castillejo I-TREATMENT +Pérez2, I-TREATMENT +Javier I-TREATMENT +de I-TREATMENT +las I-TREATMENT +Heras I-TREATMENT +Díez3 I-TREATMENT +y I-TREATMENT +Rafael I-TREATMENT +Tamburri I-TREATMENT +Bariain4 I-TREATMENT +1Cte. I-TREATMENT +Médico. I-TREATMENT +2Cap. I-TREATMENT +Médico. I-TREATMENT +3Cap. I-TREATMENT +Médico. I-TREATMENT +Servicio I-TREATMENT +de I-TREATMENT +Anestesiología I-TREATMENT +y I-TREATMENT +Reanimación I-TREATMENT +4Cte. I-TREATMENT +Médico. I-TREATMENT +Servicio I-TREATMENT +de I-TREATMENT +Traumatología. I-TREATMENT +Hospital I-TREATMENT +Central I-TREATMENT +de I-TREATMENT +la I-TREATMENT +Defensa I-TREATMENT +«Gómez I-TREATMENT +Ulla». I-TREATMENT +Madrid I-TREATMENT + I-TREATMENT -Hombre B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS +35 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -que, B-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -unos I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -presenta I-PAST_MEDICAL_HISTORY -molestias I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -parestesias I-PAST_MEDICAL_HISTORY -(no I-PAST_MEDICAL_HISTORY -dolor) I-PAST_MEDICAL_HISTORY +que I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urología I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +nódulo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2, I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +cm. I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +paratesticular I-PRESENT_ILLNESS +izquierda. I-PRESENT_ILLNESS +Tres B-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes, I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +ingresado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +nuestro I-PAST_MEDICAL_HISTORY +hospital I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +ACVA I-PAST_MEDICAL_HISTORY +parietal I-PAST_MEDICAL_HISTORY +izquierdo I-PAST_MEDICAL_HISTORY +presentando I-PAST_MEDICAL_HISTORY +pérdida I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +fuerza I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY +hemicuerpo I-PAST_MEDICAL_HISTORY +derecho I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +dificultad I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +habla. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -espalda I-PAST_MEDICAL_HISTORY -(región I-PAST_MEDICAL_HISTORY -dorsal I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY +tomografía I-PAST_MEDICAL_HISTORY +axial I-PAST_MEDICAL_HISTORY +computerizada I-PAST_MEDICAL_HISTORY +(TAC) I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cráneo I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +apreció I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY +hipodensa I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY el I-PAST_MEDICAL_HISTORY -lado I-PAST_MEDICAL_HISTORY -izquierdo) I-PAST_MEDICAL_HISTORY -junto I-PAST_MEDICAL_HISTORY +brazo I-PAST_MEDICAL_HISTORY +anterior I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +cápsula I-PAST_MEDICAL_HISTORY +blanca I-PAST_MEDICAL_HISTORY +interna I-PAST_MEDICAL_HISTORY +izquierda, I-PAST_MEDICAL_HISTORY +así I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +también I-PAST_MEDICAL_HISTORY +otras I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +sutiles I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +región I-PAST_MEDICAL_HISTORY +fronto-parietal I-PAST_MEDICAL_HISTORY +izquierda. I-PAST_MEDICAL_HISTORY +Tras I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +administración I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +contraste I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +apreciaron I-PAST_MEDICAL_HISTORY +imágenes I-PAST_MEDICAL_HISTORY +compatibles I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -mayor I-PAST_MEDICAL_HISTORY -sensibilidad I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY +aneurisma, I-PAST_MEDICAL_HISTORY +pero I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +observó I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +tortuosidad I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +arteria I-PAST_MEDICAL_HISTORY +cerebral I-PAST_MEDICAL_HISTORY +media I-PAST_MEDICAL_HISTORY +derecha I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +podría I-PAST_MEDICAL_HISTORY +corresponder I-PAST_MEDICAL_HISTORY +bien I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +trombo I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +efecto I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +volumen I-PAST_MEDICAL_HISTORY +parcial I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY el I-PAST_MEDICAL_HISTORY -roce I-PAST_MEDICAL_HISTORY +contexto I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +vaso I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY +morfología I-PAST_MEDICAL_HISTORY +tortuosa. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +angio-resonancia I-PAST_MEDICAL_HISTORY +magnética I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +observó I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +arterias I-PAST_MEDICAL_HISTORY +cerebrales I-PAST_MEDICAL_HISTORY +medias I-PAST_MEDICAL_HISTORY +eran I-PAST_MEDICAL_HISTORY +asimétricas I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +cuanto I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +señal, I-PAST_MEDICAL_HISTORY +presentando I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -ropa I-PAST_MEDICAL_HISTORY +izquierda I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +disminución I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +señal I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -esa I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -(hiperestesia I-PAST_MEDICAL_HISTORY -mecánica). I-PAST_MEDICAL_HISTORY +todo I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +trayecto, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +estenosis. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +electrocardiograma I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +mostró I-PAST_MEDICAL_HISTORY +alteraciones. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +ecografía I-PAST_MEDICAL_HISTORY +carotídea, I-PAST_MEDICAL_HISTORY +arteriografía I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +troncos I-PAST_MEDICAL_HISTORY +cerebrales I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +supraórticos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +ecocardiograma I-PAST_MEDICAL_HISTORY +transesofágico I-PAST_MEDICAL_HISTORY +fueron I-PAST_MEDICAL_HISTORY +también I-PAST_MEDICAL_HISTORY +normales. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +determinaciones I-PAST_MEDICAL_HISTORY +analíticas I-PAST_MEDICAL_HISTORY +sanguíneas, I-PAST_MEDICAL_HISTORY +todos I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +parámetros I-PAST_MEDICAL_HISTORY +fueron I-PAST_MEDICAL_HISTORY +normales, I-PAST_MEDICAL_HISTORY +incluidos I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +estudios I-PAST_MEDICAL_HISTORY +realizados I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +llegar I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +etiológico I-PAST_MEDICAL_HISTORY +como: I-PAST_MEDICAL_HISTORY +anticoagulante I-PAST_MEDICAL_HISTORY +lúpico, I-PAST_MEDICAL_HISTORY +homocisteína, I-PAST_MEDICAL_HISTORY +anticuerpos I-PAST_MEDICAL_HISTORY +anticardiolipina, I-PAST_MEDICAL_HISTORY +(α2 I-PAST_MEDICAL_HISTORY +antiplasmina, I-PAST_MEDICAL_HISTORY +anticuerpos I-PAST_MEDICAL_HISTORY +anti-proteinasa-3, I-PAST_MEDICAL_HISTORY +anticuerpos I-PAST_MEDICAL_HISTORY +anti-mieloperoxidasa, I-PAST_MEDICAL_HISTORY +proteína I-PAST_MEDICAL_HISTORY +S, I-PAST_MEDICAL_HISTORY +actividad I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +proteína I-PAST_MEDICAL_HISTORY +C, I-PAST_MEDICAL_HISTORY +RPR, I-PAST_MEDICAL_HISTORY +anticuerpos I-PAST_MEDICAL_HISTORY +antinucleares, I-PAST_MEDICAL_HISTORY +anticuerpos I-PAST_MEDICAL_HISTORY +anticitoplasma I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +neutrófilos I-PAST_MEDICAL_HISTORY +(ANCA), I-PAST_MEDICAL_HISTORY +anticuerpos I-PAST_MEDICAL_HISTORY +anti I-PAST_MEDICAL_HISTORY +SSA I-PAST_MEDICAL_HISTORY +Ro I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +anti I-PAST_MEDICAL_HISTORY +SSB I-PAST_MEDICAL_HISTORY +LA. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +definitiva, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +trata I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +joven I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +presenta I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +cuadro I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ACVA I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +territorio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +cerebral I-PAST_MEDICAL_HISTORY +media I-PAST_MEDICAL_HISTORY +izquierda I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +etiología I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +filiada. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +momento I-PRESENT_ILLNESS +actual I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +masa I-PRESENT_ILLNESS +pétrea I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +paratesticular I-PRESENT_ILLNESS +izquierda. I-PRESENT_ILLNESS En B-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION +ecografía I-EXPLORATION +testicular I-EXPLORATION se I-EXPLORATION -objetivaba I-EXPLORATION -una I-EXPLORATION -zona I-EXPLORATION +observa I-EXPLORATION +un I-EXPLORATION +engrosamiento I-EXPLORATION +del I-EXPLORATION +cordón I-EXPLORATION +espermático I-EXPLORATION +izquierdo. I-EXPLORATION +Los I-EXPLORATION +testículos I-EXPLORATION +son I-EXPLORATION +de I-EXPLORATION +tamaño I-EXPLORATION +y I-EXPLORATION +morfología I-EXPLORATION +normal. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -hiperestesia I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -región I-EXPLORATION -escapular I-EXPLORATION -izquierda, I-EXPLORATION +Resonacia I-EXPLORATION +Magnética I-EXPLORATION +objetivándose I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +cordón I-EXPLORATION +espermático I-EXPLORATION +izquierdo I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +comporta I-EXPLORATION con I-EXPLORATION -hiperestesia I-EXPLORATION -cutánea I-EXPLORATION +alta I-EXPLORATION +señal I-EXPLORATION +en I-EXPLORATION +secuencias I-EXPLORATION +T1 I-EXPLORATION y I-EXPLORATION -dinámica, I-EXPLORATION +T2. I-EXPLORATION +Tras I-EXPLORATION +la I-EXPLORATION +administración I-EXPLORATION +de I-EXPLORATION +contraste I-EXPLORATION +se I-EXPLORATION +produce I-EXPLORATION +un I-EXPLORATION +realce I-EXPLORATION +periférico I-EXPLORATION +del I-EXPLORATION +mismo I-EXPLORATION +con I-EXPLORATION una I-EXPLORATION zona I-EXPLORATION -circular I-EXPLORATION -delimitada I-EXPLORATION +hipointensa I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +centro I-EXPLORATION que I-EXPLORATION -no I-EXPLORATION -correspondía I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION +representa I-EXPLORATION +a I-EXPLORATION +una I-EXPLORATION zona I-EXPLORATION +avascular I-EXPLORATION de I-EXPLORATION -hiperpigmentación. I-EXPLORATION -La I-EXPLORATION -RMN I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -cervical I-EXPLORATION +necrosis. I-EXPLORATION +Las I-EXPLORATION +posibilidades I-EXPLORATION +diagnósticas I-EXPLORATION +fueron I-EXPLORATION +dos: I-EXPLORATION +liposarcoma I-EXPLORATION +del I-EXPLORATION +cordón I-EXPLORATION +espermático I-EXPLORATION +o I-EXPLORATION +vasculitis. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +realiza I-TREATMENT +biopsia I-TREATMENT +de I-TREATMENT +cordón I-TREATMENT +espermático I-TREATMENT +y I-TREATMENT +testículo. I-TREATMENT +Macroscópicamente B-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +nodular, I-EXPLORATION +sólida I-EXPLORATION y I-EXPLORATION -dorsal I-EXPLORATION -mostraba I-EXPLORATION -protrusiones I-EXPLORATION -discales I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION +de I-EXPLORATION +coloración I-EXPLORATION +blanquecina, I-EXPLORATION +con I-EXPLORATION zona I-EXPLORATION +irregulares I-EXPLORATION +amarillentas I-EXPLORATION +que I-EXPLORATION +medía I-EXPLORATION +4 I-EXPLORATION +x I-EXPLORATION +2, I-EXPLORATION +5 I-EXPLORATION +x I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +cm. I-EXPLORATION +Histológicamente I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +una I-EXPLORATION +vasculitis I-EXPLORATION +granulomatosa I-EXPLORATION +necrotizante I-EXPLORATION +que I-EXPLORATION +afectaba I-EXPLORATION +fundamentalmente I-EXPLORATION +a I-EXPLORATION +vasos I-EXPLORATION de I-EXPLORATION -C4, I-EXPLORATION -C5, I-EXPLORATION -C6 I-EXPLORATION -y I-EXPLORATION -D1, I-EXPLORATION -sin I-EXPLORATION -afectación I-EXPLORATION -radicular, I-EXPLORATION -sin I-EXPLORATION -compromiso I-EXPLORATION -medular I-EXPLORATION +mediano I-EXPLORATION +tamaño I-EXPLORATION y I-EXPLORATION con I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -neurofisiológico I-EXPLORATION -normal. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -no I-TREATMENT -iniciar I-TREATMENT -tratamiento, I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -no I-TREATMENT -le I-TREATMENT -molestaban I-TREATMENT -dichos I-TREATMENT -síntomas I-TREATMENT -y I-TREATMENT -tampoco I-TREATMENT -era I-TREATMENT -partidario I-TREATMENT -de I-TREATMENT -ello. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -51 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -varias I-PRESENT_ILLNESS -manchas I-PRESENT_ILLNESS -cutáneas I-PRESENT_ILLNESS -extensas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -dorsal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -espalda, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -duración. I-PRESENT_ILLNESS -Refiere I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -leve I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -picor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -dichas I-PRESENT_ILLNESS -zonas, I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS -todo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -épocas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -calor. I-PRESENT_ILLNESS -Se B-EXPLORATION -le I-EXPLORATION -practicó I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -de I-EXPLORATION una I-EXPLORATION -de I-EXPLORATION -ellas, I-EXPLORATION -siendo I-EXPLORATION -compatible I-EXPLORATION +zona I-EXPLORATION +centra I-EXPLORATION +irregular I-EXPLORATION con I-EXPLORATION -un I-EXPLORATION +necrosis. I-EXPLORATION +El I-EXPLORATION infiltrado I-EXPLORATION -crónico I-EXPLORATION -perivascular I-EXPLORATION -junto I-EXPLORATION -a I-EXPLORATION -melanófagos I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -dermis I-EXPLORATION -superficial I-EXPLORATION +inflamatorio I-EXPLORATION +es I-EXPLORATION +transmural I-EXPLORATION y I-EXPLORATION -leve I-EXPLORATION -hiperpigmentación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -capa I-EXPLORATION -basal I-EXPLORATION +ocasiona I-EXPLORATION +una I-EXPLORATION +obliteración I-EXPLORATION +prácticamente I-EXPLORATION +total I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -epidermis. I-EXPLORATION -Fue I-EXPLORATION -Rojo I-EXPLORATION -Congo I-EXPLORATION -negativo. I-EXPLORATION -No I-EXPLORATION +luz I-EXPLORATION +vascular. I-EXPLORATION +Periféricamente I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +partes I-EXPLORATION +blandas I-EXPLORATION +adyacentes I-EXPLORATION se I-EXPLORATION -pudo I-EXPLORATION -practicar I-EXPLORATION -RMN I-EXPLORATION -por I-EXPLORATION -padecer I-EXPLORATION -claustrofobia. I-EXPLORATION -No B-TREATMENT -requirió I-TREATMENT -tratamiento. I-TREATMENT - I-TREATMENT - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -maculosa I-PRESENT_ILLNESS -adyacente I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -columna, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -D5-D7, I-PRESENT_ILLNESS -levemente I-PRESENT_ILLNESS -pruriginosa, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -En B-EXPLORATION +observa I-EXPLORATION +marcada I-EXPLORATION +fibrosis, I-EXPLORATION +necrosis I-EXPLORATION +grasa I-EXPLORATION +e I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION +agudo I-EXPLORATION +y I-EXPLORATION +crónico. I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +tinción I-EXPLORATION +con I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -neurológica, I-EXPLORATION -como I-EXPLORATION -única I-EXPLORATION -alteración I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -hiperestesia I-EXPLORATION -al I-EXPLORATION -pinchazo I-EXPLORATION -justo I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -área I-EXPLORATION +técnica I-EXPLORATION +de I-EXPLORATION +Ziehl-Neelsen I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +bacilos I-EXPLORATION +alcohol I-EXPLORATION +resistentes. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +anatomo I-EXPLORATION +patológico I-EXPLORATION +es I-EXPLORATION de I-EXPLORATION +vasculitis I-EXPLORATION +granulomatosa I-EXPLORATION +necrotizante I-EXPLORATION +en I-EXPLORATION +zona I-EXPLORATION +paratesticular. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -lesión. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -RMN I-EXPLORATION +biopsia I-EXPLORATION de I-EXPLORATION -columna I-EXPLORATION -dorsal I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -Tampoco B-TREATMENT -requirió I-TREATMENT -tratamiento I-TREATMENT -farmacológico. I-TREATMENT - I-TREATMENT +testículo I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +identifican I-EXPLORATION +alteraciones I-EXPLORATION +significativas. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +presentó I-EVOLUTION +complicaciones I-EVOLUTION +postoperatorias I-EVOLUTION +y B-TREATMENT +fue I-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +Deflazacort I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +30 I-TREATMENT +mg/día. I-TREATMENT +En B-EVOLUTION +el I-EVOLUTION +momento I-EVOLUTION +actual I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +16 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +evolución I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +presenta I-EVOLUTION +ninguna I-EVOLUTION +sintomatología I-EVOLUTION +y I-EVOLUTION +sigue I-EVOLUTION +con I-EVOLUTION +dosis I-EVOLUTION +de I-EVOLUTION +mantenimiento I-EVOLUTION +(6 I-EVOLUTION +mg/día). I-EVOLUTION + I-EVOLUTION -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +femenina I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -duración I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -prurito I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -zonas I-PRESENT_ILLNESS -paravertebrales I-PRESENT_ILLNESS -diferenciadas, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS +cual I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -D2 I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -D7, I-PRESENT_ILLNESS -paravertebrales I-PRESENT_ILLNESS -ambas. I-PRESENT_ILLNESS -Aumentaba I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -prurito I-PRESENT_ILLNESS -solo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -época I-PRESENT_ILLNESS +volumen I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +mandibular I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +lado I-PRESENT_ILLNESS +derecho, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -mayor I-PRESENT_ILLNESS -calor. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -fue I-EXPLORATION -normal, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -RMN I-EXPLORATION +4 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +crecimiento I-PRESENT_ILLNESS +rápido, I-PRESENT_ILLNESS +ligero I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +lesión. I-PRESENT_ILLNESS +Intraoralmente B-EXPLORATION +expansión I-EXPLORATION de I-EXPLORATION -columna I-EXPLORATION -practicada. I-EXPLORATION -Se B-TREATMENT -intentó I-TREATMENT -tratamiento I-TREATMENT +corticales I-EXPLORATION +óseas I-EXPLORATION +mandibulares I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +molares. I-EXPLORATION +Una I-EXPLORATION +tomografía I-EXPLORATION +tridimensional I-EXPLORATION +confirma I-EXPLORATION +extensa I-EXPLORATION +destrucción I-EXPLORATION +ósea. I-EXPLORATION +Resultado I-EXPLORATION +histopatológico, I-EXPLORATION +osteoblastoma I-EXPLORATION +benigno I-EXPLORATION +mandibular. I-EXPLORATION +Dada B-TREATMENT +la I-TREATMENT +amplia I-TREATMENT +destrucción, I-TREATMENT +y I-TREATMENT +el I-TREATMENT +comportamiento I-TREATMENT +local I-TREATMENT +agresivo I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +hemimandibulectomía I-TREATMENT +derecha, I-TREATMENT +y I-TREATMENT +se I-TREATMENT +coloca I-TREATMENT +prótesis I-TREATMENT +de I-TREATMENT +reconstrucción I-TREATMENT +mandibular I-TREATMENT con I-TREATMENT -capsaicina I-TREATMENT -tópica, I-TREATMENT -pero I-TREATMENT -como I-TREATMENT +cóndilo I-TREATMENT +en I-TREATMENT +el I-TREATMENT +lecho I-TREATMENT +quirúrgico. I-TREATMENT +Control B-EVOLUTION +postoperatorio I-EVOLUTION +con I-EVOLUTION +buena I-EVOLUTION +apertura I-EVOLUTION +bucal, I-EVOLUTION +sin I-EVOLUTION +daño I-EVOLUTION +a I-EVOLUTION +estructuras I-EVOLUTION +nerviosas I-EVOLUTION +de I-EVOLUTION +importancia, I-EVOLUTION +conservando I-EVOLUTION +continuidad I-EVOLUTION +de I-EVOLUTION +nervios I-EVOLUTION +sensitivos I-EVOLUTION +(dentario I-EVOLUTION +inferior), I-EVOLUTION +y I-EVOLUTION +motores. I-EVOLUTION +A B-TREATMENT la I-TREATMENT paciente I-TREATMENT -no I-TREATMENT -lo I-TREATMENT -toleraba I-TREATMENT -y I-TREATMENT +se I-TREATMENT +le I-TREATMENT +realizó I-TREATMENT +a I-TREATMENT +los I-TREATMENT +6 I-TREATMENT +meses I-TREATMENT +posteriores I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cirugía I-TREATMENT +inicial, I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +matriz I-TREATMENT +ósea I-TREATMENT +mezclada I-TREATMENT +con I-TREATMENT +aspirado I-TREATMENT +medular I-TREATMENT en I-TREATMENT -cambio I-TREATMENT -sí I-TREATMENT el I-TREATMENT -prurito, I-TREATMENT -prefirió I-TREATMENT -no I-TREATMENT -probar I-TREATMENT -otros I-TREATMENT -tratamientos I-TREATMENT -farmacológicos. I-TREATMENT - I-TREATMENT +lecho I-TREATMENT +quirúrgico, I-TREATMENT +observando B-EVOLUTION +al I-EVOLUTION +año I-EVOLUTION +y I-EVOLUTION +medio I-EVOLUTION +posterior I-EVOLUTION +ligera I-EVOLUTION +formación I-EVOLUTION +ósea I-EVOLUTION +conservando I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +fecha I-EVOLUTION +excelente I-EVOLUTION +oclusión I-EVOLUTION +dental I-EVOLUTION +y I-EVOLUTION +apertura I-EVOLUTION +bucal I-EVOLUTION +adecuadas I-EVOLUTION +así I-EVOLUTION +como I-EVOLUTION +estética I-EVOLUTION +facial I-EVOLUTION +satisfactorias, I-EVOLUTION +adecuada I-EVOLUTION +sensibilidad I-EVOLUTION +y I-EVOLUTION +motricidad, I-EVOLUTION +5 I-EVOLUTION +años I-EVOLUTION +de I-EVOLUTION +control I-EVOLUTION +sin I-EVOLUTION +complicaciones. I-EVOLUTION + I-EVOLUTION -En B-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2001, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -produce I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -altercado I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -agente I-PAST_MEDICAL_HISTORY -policial I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -joven I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -localidad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Bilbao. I-PAST_MEDICAL_HISTORY -Como I-PAST_MEDICAL_HISTORY -consecuencia I-PAST_MEDICAL_HISTORY +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +58 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -este I-PAST_MEDICAL_HISTORY -altercado I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -joven I-PAST_MEDICAL_HISTORY -sufre I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -herida I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -arma I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +hipercolesterolemia, I-PAST_MEDICAL_HISTORY +hiperuricemia, I-PAST_MEDICAL_HISTORY +fumador I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -fuego I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -nalga I-PAST_MEDICAL_HISTORY -izquierda. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -disparo I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -producido I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -arma I-PAST_MEDICAL_HISTORY -reglamentaria I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -agente I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -munición I-PAST_MEDICAL_HISTORY -utilizada I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -único I-PAST_MEDICAL_HISTORY -proyectil I-PAST_MEDICAL_HISTORY +40 I-PAST_MEDICAL_HISTORY +cigarrillos I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +día I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +33 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +bebedor I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -9 I-PAST_MEDICAL_HISTORY -mm I-PAST_MEDICAL_HISTORY -Parabellum I-PAST_MEDICAL_HISTORY -Sako-Luger I-PAST_MEDICAL_HISTORY -KPO I-PAST_MEDICAL_HISTORY -[1]. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Las I-PAST_MEDICAL_HISTORY -declaraciones I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -agente I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -lesionado I-PAST_MEDICAL_HISTORY -fueron I-PAST_MEDICAL_HISTORY -contradictorias. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -agente I-PAST_MEDICAL_HISTORY -relató I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -joven, I-PAST_MEDICAL_HISTORY -sentado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -asiento I-PAST_MEDICAL_HISTORY -posterior I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dentro I-PAST_MEDICAL_HISTORY +25-30 I-PAST_MEDICAL_HISTORY +unidades I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -turismo, I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -encaró I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -arma I-PAST_MEDICAL_HISTORY -hallándose I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -agente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -exterior I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -vehículo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY +alcohol I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -puerta I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -mismo I-PAST_MEDICAL_HISTORY -abierta. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -actitud I-PAST_MEDICAL_HISTORY -defensiva, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -agente I-PAST_MEDICAL_HISTORY -relata I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -disparó I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -lesionado I-PAST_MEDICAL_HISTORY +semana; I-PAST_MEDICAL_HISTORY +fibrilación I-PAST_MEDICAL_HISTORY +auricular I-PAST_MEDICAL_HISTORY +paroxística I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +última I-PAST_MEDICAL_HISTORY +revisión I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +problema I-PAST_MEDICAL_HISTORY +cardiológico, I-PAST_MEDICAL_HISTORY +cinco I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +antes, I-PAST_MEDICAL_HISTORY +mostró I-PAST_MEDICAL_HISTORY que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -hallaba I-PAST_MEDICAL_HISTORY -dentro I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -vehículo I-PAST_MEDICAL_HISTORY -y, I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -disparo, I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -arrastró I-PAST_MEDICAL_HISTORY -fuera I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -turismo. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -disparo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -escenario I-PAST_MEDICAL_HISTORY -nº I-PAST_MEDICAL_HISTORY -1, I-PAST_MEDICAL_HISTORY -correspondiente I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY +todas I-PAST_MEDICAL_HISTORY las I-PAST_MEDICAL_HISTORY -declaraciones I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -agente, I-PAST_MEDICAL_HISTORY +pruebas I-PAST_MEDICAL_HISTORY +complementarias I-PAST_MEDICAL_HISTORY se I-PAST_MEDICAL_HISTORY -esquematiza I-PAST_MEDICAL_HISTORY +encontraban I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +rangos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -imagen I-PAST_MEDICAL_HISTORY -nº I-PAST_MEDICAL_HISTORY -1. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY +normalidad I-PAST_MEDICAL_HISTORY +(incluidas I-PAST_MEDICAL_HISTORY +hormonas I-PAST_MEDICAL_HISTORY +tiroideas). I-PAST_MEDICAL_HISTORY En I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -declaraciones I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -lesionado I-PAST_MEDICAL_HISTORY -indicó I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -hallándose I-PAST_MEDICAL_HISTORY -sentado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY el I-PAST_MEDICAL_HISTORY -asiento I-PAST_MEDICAL_HISTORY -trasero I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -vehículo, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -abrió I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -puerta I-PAST_MEDICAL_HISTORY -posterior I-PAST_MEDICAL_HISTORY -izquierda I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -mismo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -arrastrado I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -asfalto I-PAST_MEDICAL_HISTORY +momento I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -carretera I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -agente I-PAST_MEDICAL_HISTORY -policial, I-PAST_MEDICAL_HISTORY -cayendo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -él I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -decúbito I-PAST_MEDICAL_HISTORY -prono I-PAST_MEDICAL_HISTORY -sobre I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -manos I-PAST_MEDICAL_HISTORY +consulta I-PAST_MEDICAL_HISTORY +seguía I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +enalapril I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +mg/día, I-PAST_MEDICAL_HISTORY +clortalidona I-PAST_MEDICAL_HISTORY +25 I-PAST_MEDICAL_HISTORY +mg/día, I-PAST_MEDICAL_HISTORY +atorvastatina I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +mg/día, I-PAST_MEDICAL_HISTORY +ácido I-PAST_MEDICAL_HISTORY +acetilsalicílico I-PAST_MEDICAL_HISTORY +200 I-PAST_MEDICAL_HISTORY +mg/día I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -quedando I-PAST_MEDICAL_HISTORY +amiodarona I-PAST_MEDICAL_HISTORY +400 I-PAST_MEDICAL_HISTORY +mg/día I-PAST_MEDICAL_HISTORY +excepto I-PAST_MEDICAL_HISTORY los I-PAST_MEDICAL_HISTORY -pies I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -interior I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -turismo. I-PAST_MEDICAL_HISTORY -Una I-PAST_MEDICAL_HISTORY -vez I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -suelo, I-PAST_MEDICAL_HISTORY -escuchó I-PAST_MEDICAL_HISTORY +sábados I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -sintió I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -disparo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -nalga I-PAST_MEDICAL_HISTORY -izquierda. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -disparo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -escenario I-PAST_MEDICAL_HISTORY -nº I-PAST_MEDICAL_HISTORY -2, I-PAST_MEDICAL_HISTORY -correspondiente I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -declaraciones I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -lesionado, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -recoge I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -imagen I-PAST_MEDICAL_HISTORY -nº I-PAST_MEDICAL_HISTORY -2. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -HALLAZGOS B-PRESENT_ILLNESS -EXPLORATORIOS I-PRESENT_ILLNESS -Y I-PRESENT_ILLNESS -PRUEBAS I-PRESENT_ILLNESS -COMPLEMENTARIAS: I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -lesionado I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -visto I-PRESENT_ILLNESS +domingos. I-PAST_MEDICAL_HISTORY +El B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +comenzó I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +constitucional I-PRESENT_ILLNESS +dominado I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -primera I-PRESENT_ILLNESS -vez I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS -forense I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +importante I-PRESENT_ILLNESS +astenia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Bilbao I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS +apetito I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +adelgazamiento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +8 I-PRESENT_ILLNESS +kilogramos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +(que I-PRESENT_ILLNESS +suponen I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +10% I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -hechos, I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS su I-PRESENT_ILLNESS -estancia I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -hospitalario I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +corporal). I-PRESENT_ILLNESS +Además I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +debilidad I-PRESENT_ILLNESS +importante I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +cinturas I-PRESENT_ILLNESS +escapular I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -asistencia I-PRESENT_ILLNESS -urgente I-PRESENT_ILLNESS +pélvica, I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +llamativa I-PRESENT_ILLNESS en I-PRESENT_ILLNESS la I-PRESENT_ILLNESS +primera. I-PRESENT_ILLNESS +Otro I-PRESENT_ILLNESS +dato I-PRESENT_ILLNESS +destacable I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -realizó I-PRESENT_ILLNESS -extracción I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -proyectil. I-PRESENT_ILLNESS -A B-EXPLORATION +aquejaba I-PRESENT_ILLNESS +insomnio I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +nerviosismo. I-PRESENT_ILLNESS +Una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +autolimitado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +diarrea I-PRESENT_ILLNESS +consistente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +líquidas I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +productos I-PRESENT_ILLNESS +patológicos I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -en I-EXPLORATION -esta I-EXPLORATION -clínica I-EXPLORATION -médico I-EXPLORATION -forense I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION +f��sica I-EXPLORATION +nos I-EXPLORATION +encontramos I-EXPLORATION +ante I-EXPLORATION un I-EXPLORATION -cicatriz I-EXPLORATION -oval I-EXPLORATION -de I-EXPLORATION -1 I-EXPLORATION -x I-EXPLORATION -1.5 I-EXPLORATION -cms I-EXPLORATION -en I-EXPLORATION -flanco I-EXPLORATION -posterior I-EXPLORATION -izquierdo I-EXPLORATION -(imagen I-EXPLORATION -3). I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -radiográficos I-EXPLORATION -realizados I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -asistencia I-EXPLORATION -en I-EXPLORATION -urgencias I-EXPLORATION -(radiografías I-EXPLORATION -simples I-EXPLORATION -AP I-EXPLORATION +paciente I-EXPLORATION +con I-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION +general I-EXPLORATION y I-EXPLORATION -laterales I-EXPLORATION -de I-EXPLORATION -pelvis I-EXPLORATION +buenas I-EXPLORATION +constantes I-EXPLORATION +(TA I-EXPLORATION +120/70 I-EXPLORATION +mm I-EXPLORATION +Hg, I-EXPLORATION +Tª I-EXPLORATION +36, I-EXPLORATION +5 I-EXPLORATION +ºC I-EXPLORATION y I-EXPLORATION -TAC I-EXPLORATION -pélvico) I-EXPLORATION -indicaban I-EXPLORATION +78 I-EXPLORATION +lpm, I-EXPLORATION +peso I-EXPLORATION +74 I-EXPLORATION +kg), I-EXPLORATION +eupneico, I-EXPLORATION +bien I-EXPLORATION +nutrido I-EXPLORATION +y I-EXPLORATION +coloreado, I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +palpaban I-EXPLORATION +adenopatías I-EXPLORATION +ni I-EXPLORATION +bocio. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -varios I-EXPLORATION -fragmentos I-EXPLORATION -radiopacos I-EXPLORATION -irregulares I-EXPLORATION -de I-EXPLORATION -diversos I-EXPLORATION -tamaños I-EXPLORATION -localizados I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -glútea I-EXPLORATION -izquierda I-EXPLORATION -(imagen I-EXPLORATION -4). I-EXPLORATION -No I-EXPLORATION +auscultación I-EXPLORATION +cardiopulmonar I-EXPLORATION +no I-EXPLORATION +había I-EXPLORATION +alteraciones. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +abdomen I-EXPLORATION se I-EXPLORATION -apreciaban I-EXPLORATION -lesiones I-EXPLORATION -óseas I-EXPLORATION -asociadas. I-EXPLORATION - I-EXPLORATION -Dos B-TREATMENT -años I-TREATMENT -después I-TREATMENT -de I-TREATMENT -los I-TREATMENT -hechos, I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -la I-TREATMENT -extracción I-TREATMENT -quirúrgica I-TREATMENT -de I-TREATMENT -dos I-TREATMENT -fragmentos I-TREATMENT -de I-TREATMENT -proyectil I-TREATMENT -de I-TREATMENT -la I-TREATMENT -nalga I-TREATMENT -izquierda. I-TREATMENT -El I-TREATMENT -médico I-TREATMENT -forense I-TREATMENT -se I-TREATMENT -halla I-TREATMENT -presente I-TREATMENT -en I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -y I-TREATMENT -los I-TREATMENT -fragmentos I-TREATMENT -son I-TREATMENT -recogidos I-TREATMENT -y, I-TREATMENT -sin I-TREATMENT -manipulación I-TREATMENT -previa, I-TREATMENT -remitidos I-TREATMENT -para I-TREATMENT -estudio I-TREATMENT -balístico. I-TREATMENT - I-TREATMENT -Se B-EXPLORATION -practicaron I-EXPLORATION -diversas I-EXPLORATION -pruebas I-EXPLORATION -complementarias: I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Estudio I-EXPLORATION -criminalístico I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -prendas I-EXPLORATION -del I-EXPLORATION -lesionado: I-EXPLORATION +palpaba I-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -camiseta I-EXPLORATION +hígado I-EXPLORATION +a I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION del I-EXPLORATION -lesionado I-EXPLORATION -indicó I-EXPLORATION -que I-EXPLORATION -existía I-EXPLORATION -un I-EXPLORATION -orifico I-EXPLORATION -de I-EXPLORATION -disparo I-EXPLORATION -con I-EXPLORATION -dos I-EXPLORATION -grandes I-EXPLORATION -desgarros I-EXPLORATION -radiales, I-EXPLORATION -ahumamiento I-EXPLORATION +reborde I-EXPLORATION +costal, I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -bordes I-EXPLORATION -(imagen I-EXPLORATION -5) I-EXPLORATION +consistencia I-EXPLORATION +blanda I-EXPLORATION y I-EXPLORATION -con I-EXPLORATION +sin I-EXPLORATION +otros I-EXPLORATION +hallazgos. I-EXPLORATION +Presentaba I-EXPLORATION un I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -residuos I-EXPLORATION -de I-EXPLORATION -plomo, I-EXPLORATION -bario I-EXPLORATION -y I-EXPLORATION -antimomio I-EXPLORATION -que I-EXPLORATION -indicaron I-EXPLORATION +discreto I-EXPLORATION +edema I-EXPLORATION +pretibial I-EXPLORATION +bilateral I-EXPLORATION que I-EXPLORATION -el I-EXPLORATION -disparo I-EXPLORATION -pudo I-EXPLORATION -ser I-EXPLORATION -producido I-EXPLORATION -a I-EXPLORATION -cañón I-EXPLORATION -tocante I-EXPLORATION -o I-EXPLORATION +dejaba I-EXPLORATION +fovea I-EXPLORATION a I-EXPLORATION -muy I-EXPLORATION -corta I-EXPLORATION -distancia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -camiseta. I-EXPLORATION -El I-EXPLORATION -orificio I-EXPLORATION -se I-EXPLORATION -hallaba I-EXPLORATION -situado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -parte I-EXPLORATION -posterior I-EXPLORATION -de I-EXPLORATION la I-EXPLORATION -camiseta, I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -cuadrante I-EXPLORATION -inferior I-EXPLORATION -izquierdo. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Estudio I-EXPLORATION -del I-EXPLORATION -arma I-EXPLORATION -reglamentaria I-EXPLORATION -utilizada: I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -del I-EXPLORATION -arma I-EXPLORATION -no I-EXPLORATION -permite I-EXPLORATION -identificar I-EXPLORATION -ninguna I-EXPLORATION -anomalía I-EXPLORATION -en I-EXPLORATION +presión I-EXPLORATION +con I-EXPLORATION +pulsos I-EXPLORATION +periféricos I-EXPLORATION +conservados I-EXPLORATION +y I-EXPLORATION +simétricos. I-EXPLORATION +Ante I-EXPLORATION esta I-EXPLORATION -que I-EXPLORATION -pudiese I-EXPLORATION -haber I-EXPLORATION -producido I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -proyectil I-EXPLORATION -[2]. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Estudio I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -dos I-EXPLORATION -fragmentos I-EXPLORATION -de I-EXPLORATION -proyectil I-EXPLORATION -extraídos I-EXPLORATION -del I-EXPLORATION -cuerpo I-EXPLORATION -del I-EXPLORATION -lesionado: I-EXPLORATION +situación I-EXPLORATION se I-EXPLORATION -identifican I-EXPLORATION -ambos I-EXPLORATION -fragmentos, I-EXPLORATION -deformados I-EXPLORATION -y I-EXPLORATION -correspondientes I-EXPLORATION -con I-EXPLORATION +solicitaron I-EXPLORATION +algunas I-EXPLORATION +pruebas I-EXPLORATION +complementarias I-EXPLORATION +cuyos I-EXPLORATION +resultados I-EXPLORATION +fueron I-EXPLORATION los I-EXPLORATION -extremos I-EXPLORATION -del I-EXPLORATION -culote I-EXPLORATION -y I-EXPLORATION +siguientes: I-EXPLORATION +Hemograma: I-EXPLORATION +4.640 I-EXPLORATION +leucocitos/ I-EXPLORATION +mm3 I-EXPLORATION +con I-EXPLORATION +fórmula I-EXPLORATION +normal, I-EXPLORATION +4, I-EXPLORATION +17 I-EXPLORATION +millones I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -punta I-EXPLORATION +hematíes/ I-EXPLORATION +mm3, I-EXPLORATION +Hb I-EXPLORATION +12, I-EXPLORATION +7g/dl, I-EXPLORATION +Hto I-EXPLORATION +36, I-EXPLORATION +3%, I-EXPLORATION +VCM I-EXPLORATION +87, I-EXPLORATION +1, I-EXPLORATION +HCM I-EXPLORATION +30, I-EXPLORATION +5, I-EXPLORATION +231.000 I-EXPLORATION +plaquetas/mm3. I-EXPLORATION +VSG I-EXPLORATION +23 I-EXPLORATION +mm/h. I-EXPLORATION +Bioquímica: I-EXPLORATION +glucosa I-EXPLORATION +83 I-EXPLORATION +mg/dl, I-EXPLORATION +creatinina I-EXPLORATION +0, I-EXPLORATION +7 I-EXPLORATION +mg/dl, I-EXPLORATION +urea I-EXPLORATION +54 I-EXPLORATION +mg/dl, I-EXPLORATION +ácido I-EXPLORATION +úrico I-EXPLORATION +7, I-EXPLORATION +10 I-EXPLORATION +mg/dl, I-EXPLORATION +GGT I-EXPLORATION +91 I-EXPLORATION +mg/dl, I-EXPLORATION +GPT I-EXPLORATION +143 I-EXPLORATION +mg/dl, I-EXPLORATION +GOT I-EXPLORATION +95 I-EXPLORATION +mg/dl, I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina I-EXPLORATION +59 I-EXPLORATION +mg/dl, I-EXPLORATION +bilirrubina I-EXPLORATION +total I-EXPLORATION +0, I-EXPLORATION +50 I-EXPLORATION +mg/dl, I-EXPLORATION +colesterol I-EXPLORATION +140 I-EXPLORATION +mg/dl, I-EXPLORATION +triglicéridos I-EXPLORATION +221 I-EXPLORATION +mg/dl, I-EXPLORATION +HDL I-EXPLORATION +colesterol I-EXPLORATION +24 I-EXPLORATION +mg/dl, I-EXPLORATION +colesterol I-EXPLORATION +VLDL I-EXPLORATION +44 I-EXPLORATION +mg/dl, I-EXPLORATION +colesterol I-EXPLORATION +LDL I-EXPLORATION +72 I-EXPLORATION +mg/dl. I-EXPLORATION +Ferritina I-EXPLORATION +1.172 I-EXPLORATION +mg/ml, I-EXPLORATION +hierro I-EXPLORATION +47 I-EXPLORATION +µg/dl, I-EXPLORATION +Transferrina I-EXPLORATION +148 I-EXPLORATION +mg/dl I-EXPLORATION +e I-EXPLORATION +índice I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -proyectil I-EXPLORATION -camisado I-EXPLORATION -tipo I-EXPLORATION -9 I-EXPLORATION -mm. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION +saturación I-EXPLORATION +25%. I-EXPLORATION +Radiografía I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -fragmentos I-EXPLORATION -se I-EXPLORATION -encuentran I-EXPLORATION -residuos I-EXPLORATION -químicos I-EXPLORATION +tórax: I-EXPLORATION +sin I-EXPLORATION +alteraciones I-EXPLORATION +significativas. I-EXPLORATION +Serología I-EXPLORATION de I-EXPLORATION -tejidos I-EXPLORATION -biológicos I-EXPLORATION +hepatitis: I-EXPLORATION +Ac I-EXPLORATION +HVC I-EXPLORATION +(-), I-EXPLORATION +Ac I-EXPLORATION +HB I-EXPLORATION +core I-EXPLORATION +(-), I-EXPLORATION +AcHBs I-EXPLORATION +(- I-EXPLORATION +) I-EXPLORATION y I-EXPLORATION -algún I-EXPLORATION -desinfectante, I-EXPLORATION -pero I-EXPLORATION -no I-EXPLORATION -restos I-EXPLORATION +HAV I-EXPLORATION +Ig I-EXPLORATION +M I-EXPLORATION +(-) I-EXPLORATION +Serología I-EXPLORATION de I-EXPLORATION -silicio. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -superficie, I-EXPLORATION -se I-EXPLORATION -encuentran I-EXPLORATION -surcos I-EXPLORATION -irregulares I-EXPLORATION -y I-EXPLORATION -signos I-EXPLORATION -del I-EXPLORATION -labrado I-EXPLORATION -del I-EXPLORATION -ánima I-EXPLORATION -del I-EXPLORATION -arma. I-EXPLORATION -La I-EXPLORATION -conclusión I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION -indica I-EXPLORATION -que I-EXPLORATION -ha I-EXPLORATION -existido I-EXPLORATION -fragmentación I-EXPLORATION +CMV I-EXPLORATION +: I-EXPLORATION +Ig I-EXPLORATION +M I-EXPLORATION +(-) I-EXPLORATION +e I-EXPLORATION +Ig I-EXPLORATION +G I-EXPLORATION +(+). I-EXPLORATION +Marcadores I-EXPLORATION +tumorales: I-EXPLORATION +alfa-fetoproteína, I-EXPLORATION +antígeno I-EXPLORATION +carcinoembrionario I-EXPLORATION y I-EXPLORATION -rebote I-EXPLORATION -del I-EXPLORATION -proyectil I-EXPLORATION -camisado I-EXPLORATION -9 I-EXPLORATION -mm I-EXPLORATION -contra I-EXPLORATION -una I-EXPLORATION -superficie I-EXPLORATION -irregular. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Estudio I-EXPLORATION +antígeno I-EXPLORATION +prostático I-EXPLORATION +específico I-EXPLORATION +total I-EXPLORATION +negativos. I-EXPLORATION +Ecografía I-EXPLORATION +abdominal: I-EXPLORATION +alteración I-EXPLORATION +difusa I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -escena I-EXPLORATION -descrita I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -atestado I-EXPLORATION -policial: I-EXPLORATION -según I-EXPLORATION -los I-EXPLORATION -datos I-EXPLORATION -del I-EXPLORATION -atestado I-EXPLORATION -policial, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lugar I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -hechos I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -apreciaron I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -impactos I-EXPLORATION +ecogenicidad I-EXPLORATION +hepática I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +esteatosis I-EXPLORATION +sin I-EXPLORATION +lesiones I-EXPLORATION +ocupantes I-EXPLORATION de I-EXPLORATION -proyectil I-EXPLORATION -ni I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -vehículo I-EXPLORATION +espacio I-EXPLORATION ni I-EXPLORATION -en I-EXPLORATION +otros I-EXPLORATION +hallazgos. I-EXPLORATION +Colonoscopia I-EXPLORATION +hasta I-EXPLORATION el I-EXPLORATION -entorno. I-EXPLORATION -Se I-EXPLORATION -encuentra I-EXPLORATION +polo I-EXPLORATION +cecal I-EXPLORATION +sin I-EXPLORATION +alteraciones. I-EXPLORATION +Hormonas I-EXPLORATION +tiroideas: I-EXPLORATION +TSH I-EXPLORATION +0, I-EXPLORATION +01 I-EXPLORATION +mUI/l I-EXPLORATION +(0,20-5,00), I-EXPLORATION +T4 I-EXPLORATION +libre I-EXPLORATION +9, I-EXPLORATION +86 I-EXPLORATION +ng/dl I-EXPLORATION +(0,85-2,1). I-EXPLORATION + I-EXPLORATION +DISCUSIÓN I-EXPLORATION +Nos I-EXPLORATION +encontramos I-EXPLORATION +ante I-EXPLORATION un I-EXPLORATION -casquillo I-EXPLORATION -de I-EXPLORATION -proyectil I-EXPLORATION -sobre I-EXPLORATION -el I-EXPLORATION -asfalto I-EXPLORATION -que I-EXPLORATION -coincide I-EXPLORATION +paciente I-EXPLORATION con I-EXPLORATION -el I-EXPLORATION -supuestamente I-EXPLORATION -disparado I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -agente. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -criminalísticos I-EXPLORATION -practicados I-EXPLORATION +un I-EXPLORATION +síndrome I-EXPLORATION +constitucional I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -análisis I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -datos I-EXPLORATION -derivados I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -del I-EXPLORATION -atestado, I-EXPLORATION +alteración I-EXPLORATION de I-EXPLORATION las I-EXPLORATION -heridas I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -imagen, I-EXPLORATION -permitieron I-EXPLORATION -establecer I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -disparo I-EXPLORATION -practicado I-EXPLORATION -había I-EXPLORATION -presentado I-EXPLORATION -las I-EXPLORATION -siguientes I-EXPLORATION -características I-EXPLORATION -generales: I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Disparo I-EXPLORATION -a I-EXPLORATION -cañón I-EXPLORATION -tocante I-EXPLORATION -o I-EXPLORATION -muy I-EXPLORATION -próximo I-EXPLORATION -al I-EXPLORATION -contacto I-EXPLORATION +función I-EXPLORATION +hepática. I-EXPLORATION +Debemos I-EXPLORATION +tener I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -camiseta. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Penetración I-EXPLORATION +cuenta I-EXPLORATION +que I-EXPLORATION +un I-EXPLORATION +incremento I-EXPLORATION de I-EXPLORATION -fragmentos I-EXPLORATION -como I-EXPLORATION -orificio I-EXPLORATION -único I-EXPLORATION +las I-EXPLORATION +transaminasas I-EXPLORATION +es I-EXPLORATION +un I-EXPLORATION +fenómeno I-EXPLORATION +inespecífico1 I-EXPLORATION +que I-EXPLORATION +puede I-EXPLORATION +ocurrir I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -cuerpo I-EXPLORATION +gran I-EXPLORATION +número I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -víctima I-EXPLORATION -con I-EXPLORATION -trayectoria I-EXPLORATION -descrita I-EXPLORATION -en I-EXPLORATION -imágenes I-EXPLORATION -6 I-EXPLORATION +situaciones I-EXPLORATION +patológicas I-EXPLORATION y I-EXPLORATION -7. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Ausencia I-EXPLORATION -de I-EXPLORATION -lesiones I-EXPLORATION -óseas I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -fracturas I-EXPLORATION -o I-EXPLORATION -fisuras I-EXPLORATION -evidenciables I-EXPLORATION -con I-EXPLORATION -estudios I-EXPLORATION -radiográficos. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Proyectil I-EXPLORATION -9 I-EXPLORATION -mm I-EXPLORATION -Pb I-EXPLORATION -KPO I-EXPLORATION -Sako. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Análisis I-EXPLORATION -balístico I-EXPLORATION -con I-EXPLORATION -datos I-EXPLORATION -de I-EXPLORATION -rebote I-EXPLORATION -(ricochet) I-EXPLORATION -sobre I-EXPLORATION -una I-EXPLORATION -superficie I-EXPLORATION -irregular. I-EXPLORATION -Se I-EXPLORATION -descarta I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +siempre I-EXPLORATION +traduce I-EXPLORATION una I-EXPLORATION -superficie I-EXPLORATION -metálica I-EXPLORATION -o I-EXPLORATION -pulida I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -irregularidad I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -surcos. I-EXPLORATION +enfermedad I-EXPLORATION +hepática. I-EXPLORATION La I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -silicio I-EXPLORATION -sobre I-EXPLORATION -los I-EXPLORATION -restos I-EXPLORATION -recogidos I-EXPLORATION -no I-EXPLORATION -permite I-EXPLORATION -confirmar I-EXPLORATION -impactos I-EXPLORATION -sobre I-EXPLORATION -asfalto. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Ausencia I-EXPLORATION +valoración I-EXPLORATION +e I-EXPLORATION +interpretación I-EXPLORATION de I-EXPLORATION -datos I-EXPLORATION +una I-EXPLORATION +hipertransaminasemia I-EXPLORATION +han I-EXPLORATION de I-EXPLORATION -anomalías I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -arma I-EXPLORATION -que I-EXPLORATION -pudieran I-EXPLORATION -sugerir I-EXPLORATION -alteraciones I-EXPLORATION +hacerse I-EXPLORATION +siempre I-EXPLORATION +dentro I-EXPLORATION del I-EXPLORATION -proyectil I-EXPLORATION -antes I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -salida I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -boca I-EXPLORATION +contexto I-EXPLORATION +clínico I-EXPLORATION del I-EXPLORATION -cañón I-EXPLORATION -que I-EXPLORATION -simulasen I-EXPLORATION -un I-EXPLORATION -rebote I-EXPLORATION +paciente I-EXPLORATION y I-EXPLORATION -fragmentación I-EXPLORATION -del I-EXPLORATION -proyectil I-EXPLORATION -[2]. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Ausencia I-EXPLORATION +han I-EXPLORATION de I-EXPLORATION -elementos I-EXPLORATION -en I-EXPLORATION +tenerse I-EXPLORATION +siempre I-EXPLORATION +presentes I-EXPLORATION +tanto I-EXPLORATION la I-EXPLORATION -indumentaria I-EXPLORATION -del I-EXPLORATION -lesionado I-EXPLORATION -que I-EXPLORATION -pudieran I-EXPLORATION -haber I-EXPLORATION -actuado I-EXPLORATION +importancia I-EXPLORATION +cuantitativa I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +elevación I-EXPLORATION como I-EXPLORATION -punto I-EXPLORATION +el I-EXPLORATION +tiempo I-EXPLORATION +durante I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +persiste I-EXPLORATION +la I-EXPLORATION +anomalía. I-EXPLORATION +La I-EXPLORATION +alta I-EXPLORATION +prevalencia I-EXPLORATION de I-EXPLORATION -impacto I-EXPLORATION -intermedio, I-EXPLORATION +enolismo I-EXPLORATION y I-EXPLORATION -fuente I-EXPLORATION +hepatitis I-EXPLORATION +víricas I-EXPLORATION +en I-EXPLORATION +nuestro I-EXPLORATION +entorno I-EXPLORATION +hacen I-EXPLORATION +que I-EXPLORATION +estas I-EXPLORATION +etiologías I-EXPLORATION +deban I-EXPLORATION +descartarse I-EXPLORATION de I-EXPLORATION -fragmentación I-EXPLORATION -y I-EXPLORATION -rebote, I-EXPLORATION -entre I-EXPLORATION +entrada2. I-EXPLORATION +Iniciamos I-EXPLORATION el I-EXPLORATION -arma I-EXPLORATION -y I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION la I-EXPLORATION -piel I-EXPLORATION -del I-EXPLORATION -lesionado. I-EXPLORATION - I-EXPLORATION - -El B-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -traemos I-PRESENT_ILLNESS -hoy I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -colación, I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -arpoximada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuarenta I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -miembro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -Fuerzas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Seguridad I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Estado, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -agónico, I-PRESENT_ILLNESS -presentando I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -heridas I-PRESENT_ILLNESS -localizadas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -parietal I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -respectivamente. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION +confirmación I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +alteraciones I-EXPLORATION +bioquímicas I-EXPLORATION +ya I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +primer I-EXPLORATION +paso I-EXPLORATION +siempre I-EXPLORATION +debe I-EXPLORATION +ser I-EXPLORATION +repetir I-EXPLORATION la I-EXPLORATION -región I-EXPLORATION -parietal I-EXPLORATION -derecha I-EXPLORATION +pruebas I-EXPLORATION +de I-EXPLORATION +laboratorio3 I-EXPLORATION +para I-EXPLORATION +descartar I-EXPLORATION +cualquier I-EXPLORATION +error. I-EXPLORATION +A B-PAST_MEDICAL_HISTORY +continuación I-PAST_MEDICAL_HISTORY +realizamos I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +anamnesis I-PAST_MEDICAL_HISTORY +exhaustiva I-PAST_MEDICAL_HISTORY +donde I-PAST_MEDICAL_HISTORY +encontramos I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +consumo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alcohol I-PAST_MEDICAL_HISTORY +moderado I-PAST_MEDICAL_HISTORY +(insuficiente I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +justificar I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +hepatopatía I-PAST_MEDICAL_HISTORY +alcohólica), I-PAST_MEDICAL_HISTORY +uso I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +atorvastatina I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +puede I-PAST_MEDICAL_HISTORY +aumentar I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +transaminasas I-PAST_MEDICAL_HISTORY +pero I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +alteración I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +estado I-PAST_MEDICAL_HISTORY +general, I-PAST_MEDICAL_HISTORY +así B-FAMILY_HISTORY +como I-FAMILY_HISTORY +la I-FAMILY_HISTORY +ausencia I-FAMILY_HISTORY +de I-FAMILY_HISTORY +datos I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +interés, I-FAMILY_HISTORY +prácticas B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +riesgo, I-PAST_MEDICAL_HISTORY +transfusiones I-PAST_MEDICAL_HISTORY +sanguíneas, I-PAST_MEDICAL_HISTORY +etc. I-PAST_MEDICAL_HISTORY +A B-EXPLORATION +continuación I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION +le I-EXPLORATION +hizo I-EXPLORATION una I-EXPLORATION -herida I-EXPLORATION -contusa, I-EXPLORATION -irregular, I-EXPLORATION -estrellada, I-EXPLORATION -con I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +completa I-EXPLORATION +sin I-EXPLORATION +obtener I-EXPLORATION +datos I-EXPLORATION +reseñables I-EXPLORATION +salvo I-EXPLORATION una I-EXPLORATION -cavidad I-EXPLORATION -anfractuosa I-EXPLORATION -debida I-EXPLORATION -al I-EXPLORATION -despegue I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -tegumentos, I-EXPLORATION -con I-EXPLORATION -algunos I-EXPLORATION -depósitos I-EXPLORATION -negruzcos. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -parietofrontal I-EXPLORATION -izquierda I-EXPLORATION -hay I-EXPLORATION -otra I-EXPLORATION -herida I-EXPLORATION -ovalada, I-EXPLORATION +discreta I-EXPLORATION +hepatomegalia. I-EXPLORATION +Con I-EXPLORATION +las I-EXPLORATION +serologías I-EXPLORATION +(primero I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -centímetro I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION -aproximado I-EXPLORATION +la I-EXPLORATION +hepatitis I-EXPLORATION y I-EXPLORATION -los I-EXPLORATION -bordes I-EXPLORATION -ligeramente I-EXPLORATION -evertidos. I-EXPLORATION -Otras I-EXPLORATION -lesiones I-EXPLORATION -asociadas I-EXPLORATION +posteriormente I-EXPLORATION +de I-EXPLORATION +otros I-EXPLORATION +virus I-EXPLORATION +hepatotropos I-EXPLORATION +como I-EXPLORATION son I-EXPLORATION -hematoma I-EXPLORATION -en I-EXPLORATION -gafas I-EXPLORATION +el I-EXPLORATION +citomegalovirus I-EXPLORATION y I-EXPLORATION -epistaxis. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION +el I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION +Epstein-Barr) I-EXPLORATION +descartamos I-EXPLORATION la I-EXPLORATION -autopsia, I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -una I-EXPLORATION -fractura I-EXPLORATION -radial I-EXPLORATION -del I-EXPLORATION -parietal I-EXPLORATION -derecho, I-EXPLORATION -que I-EXPLORATION -converge I-EXPLORATION -sobre I-EXPLORATION -un I-EXPLORATION -orificio I-EXPLORATION -redondeado I-EXPLORATION -con I-EXPLORATION -bordes I-EXPLORATION -cortantes I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tabla I-EXPLORATION -externa I-EXPLORATION -del I-EXPLORATION -hueso. I-EXPLORATION -La I-EXPLORATION -tabla I-EXPLORATION -interna I-EXPLORATION -biselada I-EXPLORATION -a I-EXPLORATION -modo I-EXPLORATION +posibilidad I-EXPLORATION de I-EXPLORATION -cono I-EXPLORATION -truncado I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION -hacia I-EXPLORATION +hepatitis I-EXPLORATION +vírica I-EXPLORATION +y I-EXPLORATION +otros I-EXPLORATION +cuadros I-EXPLORATION +infecciosos I-EXPLORATION +parecían I-EXPLORATION +poco I-EXPLORATION +probables I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -interior I-EXPLORATION +contexto I-EXPLORATION del I-EXPLORATION -cráneo. I-EXPLORATION - I-EXPLORATION +paciente. I-EXPLORATION En I-EXPLORATION -hemicráneo I-EXPLORATION -izquierdo I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION se I-EXPLORATION aprecia I-EXPLORATION -otro I-EXPLORATION -orificio I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -parietofrontal I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -tabla I-EXPLORATION -externa I-EXPLORATION -biselada I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -más I-EXPLORATION -ancha I-EXPLORATION -hacia I-EXPLORATION -el I-EXPLORATION -exterior. I-EXPLORATION -La I-EXPLORATION -tabla I-EXPLORATION -interna I-EXPLORATION -presentaba I-EXPLORATION -los I-EXPLORATION -bordes I-EXPLORATION -del I-EXPLORATION -orificio I-EXPLORATION -cortantes. I-EXPLORATION - I-EXPLORATION -COMENTARIO: B-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -España, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -tasa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -suicidios I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -decenio I-PRESENT_ILLNESS -comprendido I-PRESENT_ILLNESS -entre I-PRESENT_ILLNESS -1990 I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -1999 I-PRESENT_ILLNESS -era I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4, I-PRESENT_ILLNESS -63 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cien I-PRESENT_ILLNESS -mil I-PRESENT_ILLNESS -habitantes I-PRESENT_ILLNESS -[1], I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cuarta I-PRESENT_ILLNESS -causa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -muerte I-PRESENT_ILLNESS -entre I-PRESENT_ILLNESS -jóvenes I-PRESENT_ILLNESS -varones I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -edades I-PRESENT_ILLNESS -comprendidas I-PRESENT_ILLNESS -entre I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -25 I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -[2]. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -modalidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -suicidio I-PRESENT_ILLNESS -depende I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -numerosos I-PRESENT_ILLNESS -factores; I-PRESENT_ILLNESS -entre I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encuentran I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -disponibilidad I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fácil I-PRESENT_ILLNESS -acceso I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -medios I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -utilizar, I-PRESENT_ILLNESS -patología I-PRESENT_ILLNESS -previa, I-PRESENT_ILLNESS -influencia I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -medio, I-PRESENT_ILLNESS -etc. I-PRESENT_ILLNESS -Smith I-PRESENT_ILLNESS -[3] I-PRESENT_ILLNESS -encuentra I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -positiva I-PRESENT_ILLNESS -entre I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -accesibilidad I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -armas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fuego I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -proporción I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -suicidios I-PRESENT_ILLNESS -causados I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -tales I-PRESENT_ILLNESS -armas. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -relación I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -patología, I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -editorial I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Revista I-PRESENT_ILLNESS -Panamericana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Salud I-PRESENT_ILLNESS -[4] I-PRESENT_ILLNESS -indica I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -factores I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -mayor I-PRESENT_ILLNESS -riesgo I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -suicidio I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -consumo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -drogas, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -alcoholismo, I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -trastornos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -personalidad, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -esquizofrenia I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hombres I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -psicosis I-PRESENT_ILLNESS -orgánicas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -mujeres. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -influencia I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -medio I-PRESENT_ILLNESS -juega, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -mismo, I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -gran I-PRESENT_ILLNESS -importancia, I-PRESENT_ILLNESS -ascendiendo I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -proporción I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -suicidios I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -50, I-PRESENT_ILLNESS -3% I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -jóvenes I-PRESENT_ILLNESS -hispanos I-PRESENT_ILLNESS -residentes I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -USA I-PRESENT_ILLNESS -utilizando I-PRESENT_ILLNESS -armas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fuego I-PRESENT_ILLNESS -[5], I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ascendiendo I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -0, I-PRESENT_ILLNESS -1% I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -asiáticos I-PRESENT_ILLNESS -residentes I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -continente I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -45, I-PRESENT_ILLNESS -3% I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -asiáticos I-PRESENT_ILLNESS -residentes I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -Estados I-PRESENT_ILLNESS -Unidos I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -grupo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edades I-PRESENT_ILLNESS -comprendido I-PRESENT_ILLNESS -entre I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -[6]. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Hay I-PRESENT_ILLNESS -diversos I-PRESENT_ILLNESS -indicios I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -nos I-PRESENT_ILLNESS -permiten I-PRESENT_ILLNESS -etiquetar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -muerte I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -suicida I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -heridas I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -arma I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fuego. I-PRESENT_ILLNESS -Entre I-PRESENT_ILLNESS -ellos I-PRESENT_ILLNESS -encontramos I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -localización I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -herida, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -número I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -heridas, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -dirección I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -disparo, I-PRESENT_ILLNESS -señales I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pólvora I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mano I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -distancia I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -realizó I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -disparo I-PRESENT_ILLNESS -[7]. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Para I-PRESENT_ILLNESS -considerar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -muerte I-PRESENT_ILLNESS -suicida I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -disparo I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -estar I-PRESENT_ILLNESS -realizado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -corta I-PRESENT_ILLNESS -distancia, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -trayectoria I-PRESENT_ILLNESS -compatible I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -acceso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mano. I-PRESENT_ILLNESS -La B-EXPLORATION -configuración I-EXPLORATION -del I-EXPLORATION -orifico I-EXPLORATION -de I-EXPLORATION -entrada I-EXPLORATION -va I-EXPLORATION -a I-EXPLORATION -proporcionar I-EXPLORATION -datos I-EXPLORATION -valiosísimos I-EXPLORATION -para I-EXPLORATION -determinar I-EXPLORATION -la I-EXPLORATION -distancia I-EXPLORATION -del I-EXPLORATION -disparo. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -líneas I-EXPLORATION -generales, I-EXPLORATION -el I-EXPLORATION -orificio I-EXPLORATION -de I-EXPLORATION -entrada I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -proyectil I-EXPLORATION -suele I-EXPLORATION -ser I-EXPLORATION -circular I-EXPLORATION -u I-EXPLORATION -ovoide I-EXPLORATION -de I-EXPLORATION -pequeño I-EXPLORATION -tamaño I-EXPLORATION -salvo I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -casos I-EXPLORATION -[8]: I-EXPLORATION - I-EXPLORATION -● I-EXPLORATION -Disparos I-EXPLORATION -a I-EXPLORATION -cañón I-EXPLORATION -tocante I-EXPLORATION -o I-EXPLORATION -muy I-EXPLORATION -cercanos I-EXPLORATION -en I-EXPLORATION una I-EXPLORATION -zona I-EXPLORATION -situada I-EXPLORATION -sobre I-EXPLORATION -un I-EXPLORATION -plano I-EXPLORATION -óseo. I-EXPLORATION - I-EXPLORATION -● I-EXPLORATION -Disparos I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cabeza I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -cartucho I-EXPLORATION -de I-EXPLORATION -alta I-EXPLORATION -velocidad I-EXPLORATION -(con I-EXPLORATION -gran I-EXPLORATION -energía I-EXPLORATION -cinética) I-EXPLORATION -o I-EXPLORATION +alteración I-EXPLORATION +ecogénica I-EXPLORATION +del I-EXPLORATION +hígado I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -proyectiles I-EXPLORATION -de I-EXPLORATION -caza I-EXPLORATION -o I-EXPLORATION -semiblindados. I-EXPLORATION - I-EXPLORATION -● I-EXPLORATION -Con I-EXPLORATION +esteatosis I-EXPLORATION +hepática I-EXPLORATION +(no I-EXPLORATION +debemos I-EXPLORATION +olvidar I-EXPLORATION +que I-EXPLORATION +nuestro I-EXPLORATION +paciente I-EXPLORATION +presenta I-EXPLORATION +una I-EXPLORATION +hipercolesterolemia I-EXPLORATION +y I-EXPLORATION +consume I-EXPLORATION +alcohol) I-EXPLORATION +que, I-EXPLORATION +si I-EXPLORATION +bien I-EXPLORATION +podría I-EXPLORATION +justificar I-EXPLORATION +las I-EXPLORATION +alteraciones I-EXPLORATION +hepáticas, I-EXPLORATION +no I-EXPLORATION +parece I-EXPLORATION +justificar I-EXPLORATION +todo I-EXPLORATION el I-EXPLORATION -proyectil I-EXPLORATION -desestabilizado I-EXPLORATION -antes I-EXPLORATION -de I-EXPLORATION -impactar I-EXPLORATION -sobre I-EXPLORATION -la I-EXPLORATION -víctima; I-EXPLORATION -ya I-EXPLORATION -sea I-EXPLORATION -por I-EXPLORATION -rebote I-EXPLORATION -o I-EXPLORATION -por I-EXPLORATION -interposición I-EXPLORATION +cuadro I-EXPLORATION de I-EXPLORATION -algún I-EXPLORATION -material. I-EXPLORATION +deterioro I-EXPLORATION +general I-EXPLORATION +y I-EXPLORATION +diarrea. I-EXPLORATION I-EXPLORATION -Cuando I-EXPLORATION -el I-EXPLORATION -disparo I-EXPLORATION -se I-EXPLORATION -produce I-EXPLORATION -a I-EXPLORATION -cañón I-EXPLORATION -tocante, I-EXPLORATION -el I-EXPLORATION -orificio I-EXPLORATION -de I-EXPLORATION -entrada I-EXPLORATION -está I-EXPLORATION -constituido I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -herida I-EXPLORATION -contusa, I-EXPLORATION -irregular, I-EXPLORATION -estrellada, I-EXPLORATION +Dada I-EXPLORATION +la I-EXPLORATION +edad I-EXPLORATION +del I-EXPLORATION +paciente, I-EXPLORATION +la I-EXPLORATION +alteración I-EXPLORATION +del I-EXPLORATION +hábito I-EXPLORATION +intestinal I-EXPLORATION y I-EXPLORATION -sobre I-EXPLORATION -una I-EXPLORATION -cavidad I-EXPLORATION -anfractuosa I-EXPLORATION -debida I-EXPLORATION -al I-EXPLORATION -despegue I-EXPLORATION +la I-EXPLORATION +elevación I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -tegumentos: I-EXPLORATION +la I-EXPLORATION +ferritina, I-EXPLORATION +otra I-EXPLORATION +opción I-EXPLORATION +diagnóstica I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +nos I-EXPLORATION +plantea I-EXPLORATION es I-EXPLORATION -el I-EXPLORATION -cuarto I-EXPLORATION -de I-EXPLORATION -mina, I-EXPLORATION -cuyas I-EXPLORATION -paredes I-EXPLORATION -están I-EXPLORATION -tapizadas I-EXPLORATION -por I-EXPLORATION -restos I-EXPLORATION -negruzcos I-EXPLORATION -compuestos I-EXPLORATION +la I-EXPLORATION +etiología I-EXPLORATION +tumoral, I-EXPLORATION +aunque I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +habíamos I-EXPLORATION +descartado I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -humo, I-EXPLORATION -partículas I-EXPLORATION -metálicas, I-EXPLORATION -granos I-EXPLORATION +lesiones I-EXPLORATION +ocupantes I-EXPLORATION de I-EXPLORATION -pólvora I-EXPLORATION +espacio, I-EXPLORATION y I-EXPLORATION -restos I-EXPLORATION -tejidos I-EXPLORATION -mezclados I-EXPLORATION -con I-EXPLORATION -sangre I-EXPLORATION -[9]. I-EXPLORATION -En I-EXPLORATION +por I-EXPLORATION +ello I-EXPLORATION +decidimos I-EXPLORATION la I-EXPLORATION -configuración I-EXPLORATION +realización I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -herida I-EXPLORATION -también I-EXPLORATION -influye I-EXPLORATION +colonoscopia I-EXPLORATION +que I-EXPLORATION +descarta I-EXPLORATION la I-EXPLORATION -presión I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -gases I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -sobreestiramiento I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION +una I-EXPLORATION +neoformación. I-EXPLORATION +Otra I-EXPLORATION +posibilidad I-EXPLORATION +sería I-EXPLORATION la I-EXPLORATION -piel I-EXPLORATION -[10]. I-EXPLORATION - I-EXPLORATION -Por I-EXPLORATION -último I-EXPLORATION +hemocromatosis I-EXPLORATION +pero I-EXPLORATION +no I-EXPLORATION +hay I-EXPLORATION +otros I-EXPLORATION +datos I-EXPLORATION +sugestivos I-EXPLORATION +(articulares, I-EXPLORATION +miocárdicos, I-EXPLORATION +gonadales, I-EXPLORATION +cutáneos, I-EXPLORATION +etc.) I-EXPLORATION +ni I-EXPLORATION +antecedentes I-EXPLORATION +familiares I-EXPLORATION +sugestivos I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -dirección I-EXPLORATION -del I-EXPLORATION -disparo I-EXPLORATION -ha I-EXPLORATION +saturación I-EXPLORATION de I-EXPLORATION -ser I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION +la I-EXPLORATION +transferrina I-EXPLORATION +tampoco I-EXPLORATION +apoya I-EXPLORATION el I-EXPLORATION -mecanismo I-EXPLORATION -suicida. I-EXPLORATION -Un I-EXPLORATION -sujeto I-EXPLORATION -diestro I-EXPLORATION -habitualmente I-EXPLORATION -se I-EXPLORATION -dispara I-EXPLORATION +diagnóstico I-EXPLORATION +puesto I-EXPLORATION +que I-EXPLORATION +debería I-EXPLORATION +estar I-EXPLORATION +elevada. I-EXPLORATION +Antes I-EXPLORATION de I-EXPLORATION -derecha I-EXPLORATION +recurrir I-EXPLORATION a I-EXPLORATION -izquierda. I-EXPLORATION -La I-EXPLORATION -configuración I-EXPLORATION -del I-EXPLORATION -orificio I-EXPLORATION -de I-EXPLORATION -entrada I-EXPLORATION +otros I-EXPLORATION +estudios I-EXPLORATION +más I-EXPLORATION +complejos I-EXPLORATION y I-EXPLORATION -de I-EXPLORATION -salida I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hueso I-EXPLORATION -va I-EXPLORATION -a I-EXPLORATION -ser I-EXPLORATION -primordial I-EXPLORATION -para I-EXPLORATION +costosos, I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION +repetir I-EXPLORATION la I-EXPLORATION -interpretación I-EXPLORATION +determinación I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -dirección I-EXPLORATION -del I-EXPLORATION -disparo. I-EXPLORATION -Cuando I-EXPLORATION -el I-EXPLORATION -proyectil I-EXPLORATION -atraviesa I-EXPLORATION -el I-EXPLORATION -cráneo I-EXPLORATION -la I-EXPLORATION -confrontación I-EXPLORATION +hormonas I-EXPLORATION +tiroideas, I-EXPLORATION +a I-EXPLORATION +pesar I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -orificios I-EXPLORATION -constituye I-EXPLORATION +tener I-EXPLORATION un I-EXPLORATION -fiel I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -cual I-EXPLORATION -es I-EXPLORATION +estudio I-EXPLORATION +rigurosamente I-EXPLORATION +normal I-EXPLORATION +cinco I-EXPLORATION +meses I-EXPLORATION +antes, I-EXPLORATION +porque I-EXPLORATION el I-EXPLORATION -orificio I-EXPLORATION -de I-EXPLORATION -entrada I-EXPLORATION -y I-EXPLORATION -cual, I-EXPLORATION +paciente I-EXPLORATION +continuaba I-EXPLORATION +en I-EXPLORATION +tratamiento I-EXPLORATION +con I-EXPLORATION +amiodarona. I-EXPLORATION +Los I-EXPLORATION +resultados I-EXPLORATION +fueron I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -salida. I-EXPLORATION -En I-EXPLORATION +hipertiroidismo I-EXPLORATION +en I-EXPLORATION +paciente I-EXPLORATION +tratado I-EXPLORATION +con I-EXPLORATION +amiodarona. I-EXPLORATION +La B-TREATMENT +actitud I-TREATMENT +que I-TREATMENT +seguimos I-TREATMENT +fue I-TREATMENT +retirar I-TREATMENT +el I-TREATMENT +fármaco I-TREATMENT +e I-TREATMENT +iniciar I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +metimazol I-TREATMENT +y I-TREATMENT +betabloqueantes I-TREATMENT +para I-TREATMENT +controlar I-TREATMENT +su I-TREATMENT +arritmia. I-TREATMENT + I-TREATMENT +La I-TREATMENT +amiodarona I-TREATMENT +es I-TREATMENT +un I-TREATMENT +antiarrítmico I-TREATMENT +de I-TREATMENT +clase I-TREATMENT +III I-TREATMENT +cuya I-TREATMENT +estructura I-TREATMENT +molecular I-TREATMENT +es I-TREATMENT +muy I-TREATMENT +similar I-TREATMENT +a I-TREATMENT +la I-TREATMENT +triiodotironina. I-TREATMENT +Contiene I-TREATMENT +dos I-TREATMENT +átomos I-TREATMENT +de I-TREATMENT +yodo, I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +le I-TREATMENT +confiere I-TREATMENT +un I-TREATMENT +37, I-TREATMENT +2% I-TREATMENT +del I-TREATMENT +peso I-TREATMENT +en I-TREATMENT +yodo. I-TREATMENT +Esto I-TREATMENT +supone I-TREATMENT +que I-TREATMENT +con I-TREATMENT +una I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +mantenimiento I-TREATMENT +de I-TREATMENT +200 I-TREATMENT +a I-TREATMENT +600 I-TREATMENT +mg I-TREATMENT +se I-TREATMENT +aporten I-TREATMENT +75 I-TREATMENT +a I-TREATMENT +225 I-TREATMENT +mg/día I-TREATMENT +de I-TREATMENT +yodo4. I-TREATMENT +Este I-TREATMENT +exceso I-TREATMENT +de I-TREATMENT +yodo I-TREATMENT +puede I-TREATMENT +tener I-TREATMENT +consecuencias I-TREATMENT +sobre I-TREATMENT +la I-TREATMENT +fisiología I-TREATMENT +tiroidea. I-TREATMENT +Por I-TREATMENT +otra I-TREATMENT +parte I-TREATMENT +debemos I-TREATMENT +tener I-TREATMENT +en I-TREATMENT +cuenta I-TREATMENT +que I-TREATMENT +es I-TREATMENT +una I-TREATMENT +molécula I-TREATMENT +muy I-TREATMENT +lipofílica, I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +le I-TREATMENT +confiere I-TREATMENT +una I-TREATMENT +vida I-TREATMENT +media I-TREATMENT +muy I-TREATMENT +prolongada I-TREATMENT +(22-55 I-TREATMENT +días), I-TREATMENT +pudiendo I-TREATMENT +detectarse I-TREATMENT +en I-TREATMENT +plasma I-TREATMENT +hasta I-TREATMENT +9 I-TREATMENT +meses I-TREATMENT +después I-TREATMENT +de I-TREATMENT +retirado I-TREATMENT +el I-TREATMENT +fármaco. I-TREATMENT +El I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +amiodarona I-TREATMENT +provoca I-TREATMENT +una I-TREATMENT +serie I-TREATMENT +de I-TREATMENT +cambios I-TREATMENT +en I-TREATMENT +las I-TREATMENT +hormonas I-TREATMENT +tiroideas I-TREATMENT +que I-TREATMENT +consisten I-TREATMENT +en I-TREATMENT +un I-TREATMENT +aumento I-TREATMENT +de I-TREATMENT +la I-TREATMENT +T4 I-TREATMENT +total I-TREATMENT +y I-TREATMENT +libre I-TREATMENT +y I-TREATMENT +de I-TREATMENT +rT3, I-TREATMENT +una I-TREATMENT +disminución I-TREATMENT +de I-TREATMENT +la I-TREATMENT +T3 I-TREATMENT +total, I-TREATMENT +junto I-TREATMENT +con I-TREATMENT +un I-TREATMENT +aumento I-TREATMENT +inicial I-TREATMENT +y I-TREATMENT +precoz I-TREATMENT +de I-TREATMENT +TSH I-TREATMENT +que I-TREATMENT +tiende I-TREATMENT +a I-TREATMENT +normalizarse, I-TREATMENT +aunque I-TREATMENT +en I-TREATMENT +ocasiones I-TREATMENT +persiste I-TREATMENT +aumentado I-TREATMENT +tras I-TREATMENT +tratamientos I-TREATMENT +crónicos. I-TREATMENT +Estos I-TREATMENT +cambios I-TREATMENT +se I-TREATMENT +producen I-TREATMENT +en I-TREATMENT +más I-TREATMENT +del I-TREATMENT +50% I-TREATMENT +de I-TREATMENT +los I-TREATMENT +pacientes I-TREATMENT +en I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +amiodarona, I-TREATMENT +sin I-TREATMENT +ninguna I-TREATMENT +relevancia I-TREATMENT +clínica I-TREATMENT +(estado I-TREATMENT +eutiroideo). I-TREATMENT +La I-TREATMENT +incidencia I-TREATMENT +de I-TREATMENT +disfunción I-TREATMENT +tiroidea I-TREATMENT +oscila I-TREATMENT +entre I-TREATMENT +un I-TREATMENT +2 I-TREATMENT +y I-TREATMENT +un I-TREATMENT +24%5. I-TREATMENT +En I-TREATMENT +nuestro I-TREATMENT +medio I-TREATMENT +la I-TREATMENT +incidencia I-TREATMENT +de I-TREATMENT +tirotoxicosis I-TREATMENT +por I-TREATMENT +amiodarona I-TREATMENT +se I-TREATMENT +encuentra I-TREATMENT +en I-TREATMENT +torno I-TREATMENT +al I-TREATMENT +1, I-TREATMENT +5% I-TREATMENT +y I-TREATMENT +es I-TREATMENT +más I-TREATMENT +frecuente I-TREATMENT +en I-TREATMENT +zonas I-TREATMENT +con I-TREATMENT +déficit I-TREATMENT +de I-TREATMENT +yodo. I-TREATMENT +Se B-EXPLORATION +han I-EXPLORATION +descrito I-EXPLORATION +dos I-EXPLORATION +mecanismos I-EXPLORATION +fisiopatológicos I-EXPLORATION +diferentes6: I-EXPLORATION +Tipo I-EXPLORATION +I: I-EXPLORATION +se I-EXPLORATION +produce I-EXPLORATION +sobre I-EXPLORATION +tiroides I-EXPLORATION +con I-EXPLORATION +patología I-EXPLORATION +subyacente I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +alteración I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION +mecanismo I-EXPLORATION +autorregulador I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -dos I-EXPLORATION -tablas I-EXPLORATION -del I-EXPLORATION -diploe I-EXPLORATION -craneal, I-EXPLORATION la I-EXPLORATION -segunda I-EXPLORATION -atravesada I-EXPLORATION -presenta I-EXPLORATION +captación I-EXPLORATION +de I-EXPLORATION +yodo I-EXPLORATION +que I-EXPLORATION +llevaría I-EXPLORATION +a I-EXPLORATION un I-EXPLORATION -orifico I-EXPLORATION -mayor I-EXPLORATION -y I-EXPLORATION -más I-EXPLORATION -irregular, I-EXPLORATION -adoptando I-EXPLORATION -la I-EXPLORATION -típica I-EXPLORATION -imagen I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -cono I-EXPLORATION -truncado I-EXPLORATION -con I-EXPLORATION la I-EXPLORATION -base I-EXPLORATION -señalando I-EXPLORATION +misma I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +consiguiente I-EXPLORATION +aumento I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -salida I-EXPLORATION -del I-EXPLORATION -proyectil I-EXPLORATION -[11]. I-EXPLORATION -q I-EXPLORATION - I-EXPLORATION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -joven, I-PRESENT_ILLNESS -conductor I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -único I-PRESENT_ILLNESS -ocupante I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -turismo, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -sufre I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -salida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -calzada I-PRESENT_ILLNESS -cuando I-PRESENT_ILLNESS -circulaba I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -100 I-PRESENT_ILLNESS -Km. I-PRESENT_ILLNESS -según I-PRESENT_ILLNESS -estimación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Unidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Atestados I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Guardia I-PRESENT_ILLNESS -Civil I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Tráfico. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -vehículo I-PRESENT_ILLNESS -choca I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -acequia I-PRESENT_ILLNESS -quedando I-PRESENT_ILLNESS -deformado I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -habitáculo, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -necesaria I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -excarceración I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -parte I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -Bomberos. I-PRESENT_ILLNESS -Según I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -mismas I-PRESENT_ILLNESS -fuentes I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -accidente I-PRESENT_ILLNESS -debió I-PRESENT_ILLNESS -ocurrir I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -1.45 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -madrugada, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -hubiese I-PRESENT_ILLNESS -testigos I-PRESENT_ILLNESS -presenciales. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Ingresa B-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -UCI I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -Regional I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -estado I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -coma I-DERIVED_FROM/TO -procedente I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -otro I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -valoración I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -parte I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Neurocirugía, I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -parecer I-DERIVED_FROM/TO -tras I-DERIVED_FROM/TO -haber I-DERIVED_FROM/TO -sufrido I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -TCE I-DERIVED_FROM/TO -severo I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -accidente I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -tráfico. I-DERIVED_FROM/TO -En B-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION +síntesis I-EXPLORATION de I-EXPLORATION -imagen I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -practican, I-EXPLORATION +hormona I-EXPLORATION +tiroidea. I-EXPLORATION +Tipo I-EXPLORATION +II: I-EXPLORATION se I-EXPLORATION -aprecia I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -hematoma I-EXPLORATION +produce I-EXPLORATION +sobre I-EXPLORATION +glándulas I-EXPLORATION +aparentemente I-EXPLORATION +normales, I-EXPLORATION +sin I-EXPLORATION +bocio I-EXPLORATION +y I-EXPLORATION con I-EXPLORATION -esquirlas I-EXPLORATION -óseas I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -temporal I-EXPLORATION -derecho I-EXPLORATION -e I-EXPLORATION -imagen I-EXPLORATION +anticuerpos I-EXPLORATION +antiroideos I-EXPLORATION +y I-EXPLORATION +antirreceptor I-EXPLORATION de I-EXPLORATION -densidad I-EXPLORATION -metálica, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION +TSH I-EXPLORATION +negativos. I-EXPLORATION +El I-EXPLORATION +mecanismo I-EXPLORATION +sería I-EXPLORATION +una I-EXPLORATION +citotoxicidad I-EXPLORATION +inducida I-EXPLORATION +por I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION +amiodarona I-EXPLORATION +o I-EXPLORATION +el I-EXPLORATION +yodo. I-EXPLORATION +La I-EXPLORATION +manifestación I-EXPLORATION +clínica I-EXPLORATION +más I-EXPLORATION +frecuente I-EXPLORATION +en I-EXPLORATION +estos I-EXPLORATION +casos I-EXPLORATION +suele I-EXPLORATION +ser I-EXPLORATION un I-EXPLORATION -proyectil I-EXPLORATION -de I-EXPLORATION -arma I-EXPLORATION +empeoramiento I-EXPLORATION de I-EXPLORATION -fuego I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -contralateral. I-EXPLORATION -Ante I-EXPLORATION -ello, I-EXPLORATION la I-EXPLORATION -inspección I-EXPLORATION -evidencia I-EXPLORATION -que I-EXPLORATION -presenta, I-EXPLORATION -tras I-EXPLORATION -rasurar I-EXPLORATION +enfermedad I-EXPLORATION +cardiaca I-EXPLORATION +subyacente, I-EXPLORATION +aunque I-EXPLORATION +pueden I-EXPLORATION +existir I-EXPLORATION los I-EXPLORATION -cabellos, I-EXPLORATION -un I-EXPLORATION -orifico I-EXPLORATION +síntomas I-EXPLORATION +clásicos I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION +hipertiroidismo. I-EXPLORATION +En I-EXPLORATION +ocasiones I-EXPLORATION +el I-EXPLORATION +curso I-EXPLORATION de I-EXPLORATION -entrada I-EXPLORATION +la I-EXPLORATION +enfermedad I-EXPLORATION +es I-EXPLORATION +autolimitado, I-EXPLORATION +resolviéndose I-EXPLORATION +la I-EXPLORATION +situación I-EXPLORATION +tras I-EXPLORATION +la I-EXPLORATION +retirada I-EXPLORATION de I-EXPLORATION -proyectil I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -parietal I-EXPLORATION -derecha, I-EXPLORATION +la I-EXPLORATION +amiodarona I-EXPLORATION +y I-EXPLORATION sin I-EXPLORATION -orifico I-EXPLORATION +tratamiento I-EXPLORATION +adicional, I-EXPLORATION +aunque I-EXPLORATION +generalmente I-EXPLORATION +tras I-EXPLORATION +largos I-EXPLORATION +periodos I-EXPLORATION de I-EXPLORATION -salida. I-EXPLORATION - I-EXPLORATION -La B-EVOLUTION -evolución I-EVOLUTION -inmediata I-EVOLUTION -es I-EVOLUTION -hacia I-EVOLUTION -clínica I-EVOLUTION -de I-EVOLUTION -muerte I-EVOLUTION -encefálica, I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -confirma I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -correspondiente I-EVOLUTION -registro I-EVOLUTION -electroencefalográfico. I-EVOLUTION -Previa B-EXPLORATION -autorización I-EXPLORATION -judicial, I-EXPLORATION -se I-EXPLORATION -procede I-EXPLORATION +tiempo. I-EXPLORATION +La I-EXPLORATION +resolución I-EXPLORATION +del I-EXPLORATION +cuadro I-EXPLORATION +es I-EXPLORATION +más I-EXPLORATION +precoz I-EXPLORATION +cuando I-EXPLORATION +no I-EXPLORATION +existe I-EXPLORATION +patología I-EXPLORATION +subyacente. I-EXPLORATION +El B-TREATMENT +tratamiento I-TREATMENT +incluye I-TREATMENT +tionamidas I-TREATMENT +que I-TREATMENT +pueden I-TREATMENT +asociarse I-TREATMENT +con I-TREATMENT +perclorato I-TREATMENT +potásico I-TREATMENT +para I-TREATMENT +conseguir I-TREATMENT +una I-TREATMENT +rápida I-TREATMENT +descarga I-TREATMENT +del I-TREATMENT +yodo I-TREATMENT +intratiroideo I-TREATMENT +aumentando I-TREATMENT +su I-TREATMENT +eficacia, I-TREATMENT +corticoides, I-TREATMENT +plasmaféresis I-TREATMENT +en I-TREATMENT +casos I-TREATMENT +de I-TREATMENT +crisis I-TREATMENT +tireotóxicas I-TREATMENT +que I-TREATMENT +ponen I-TREATMENT +en I-TREATMENT +peligro I-TREATMENT +la I-TREATMENT +vida I-TREATMENT +del I-TREATMENT +paciente, I-TREATMENT +litio I-TREATMENT +y I-TREATMENT +tratamiento I-TREATMENT +quirúrgico. I-TREATMENT +Bartalena I-TREATMENT +ha I-TREATMENT +propuesto I-TREATMENT +un I-TREATMENT +tratamiento I-TREATMENT +específico I-TREATMENT +según I-TREATMENT +el I-TREATMENT +tipo. I-TREATMENT +En I-TREATMENT +el I-TREATMENT +tipo I-TREATMENT +I, I-TREATMENT +en I-TREATMENT +el I-TREATMENT +que I-TREATMENT +existe I-TREATMENT +una I-TREATMENT +síntesis I-TREATMENT +de I-TREATMENT +hormona I-TREATMENT +tiroidea I-TREATMENT +aumentada, I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +elección I-TREATMENT +serían I-TREATMENT +los I-TREATMENT +antitiroideos I-TREATMENT +junto I-TREATMENT +a I-TREATMENT +perclorato I-TREATMENT +potásico, I-TREATMENT +mientras I-TREATMENT +que I-TREATMENT +los I-TREATMENT +corticoides I-TREATMENT +tendrían I-TREATMENT +un I-TREATMENT +papel I-TREATMENT +limitado. I-TREATMENT +Sin I-TREATMENT +embargo, I-TREATMENT +en I-TREATMENT +el I-TREATMENT +tipo I-TREATMENT +II, I-TREATMENT +en I-TREATMENT +el I-TREATMENT +que I-TREATMENT +el I-TREATMENT +mecanismo I-TREATMENT +fundamental I-TREATMENT +es I-TREATMENT +una I-TREATMENT +destrucción I-TREATMENT +tisular, I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +elección I-TREATMENT +serían I-TREATMENT +los I-TREATMENT +corticoides I-TREATMENT +en I-TREATMENT +dosis I-TREATMENT +altas, I-TREATMENT +por I-TREATMENT +su I-TREATMENT +efecto I-TREATMENT +antiinflamatorio I-TREATMENT +y I-TREATMENT +estabilizador I-TREATMENT +de I-TREATMENT +membranas. I-TREATMENT +La I-TREATMENT +cirugía I-TREATMENT +está I-TREATMENT +indicada I-TREATMENT +en I-TREATMENT +casos I-TREATMENT +graves I-TREATMENT +con I-TREATMENT +arritmias I-TREATMENT +potencialmente I-TREATMENT +letales I-TREATMENT +para I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +en I-TREATMENT +los I-TREATMENT +que I-TREATMENT +se I-TREATMENT +requiera I-TREATMENT +una I-TREATMENT +solución I-TREATMENT +rápida, I-TREATMENT +cuando I-TREATMENT +no I-TREATMENT +se I-TREATMENT +pueda I-TREATMENT +retirar I-TREATMENT +la I-TREATMENT +amiodarona I-TREATMENT +y I-TREATMENT +cuando I-TREATMENT +se I-TREATMENT +haya I-TREATMENT +demostrado I-TREATMENT +una I-TREATMENT +resistencia I-TREATMENT +al I-TREATMENT +tratamiento I-TREATMENT +médico. I-TREATMENT +Debe I-TREATMENT +practicarse I-TREATMENT +una I-TREATMENT +tiroidectomía I-TREATMENT +total I-TREATMENT +o I-TREATMENT +casi I-TREATMENT +total I-TREATMENT +sobre I-TREATMENT +todo I-TREATMENT +en I-TREATMENT +aquellos I-TREATMENT +pacientes I-TREATMENT +que I-TREATMENT +vayan I-TREATMENT +a I-TREATMENT +seguir I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +amiodarona. I-TREATMENT + I-TREATMENT +CORRESPONDENCIA: I-TREATMENT +Carmen I-TREATMENT +G. I-TREATMENT +Suárez I-TREATMENT +Álvarez I-TREATMENT +Unidad I-TREATMENT +Hospitalización I-TREATMENT +a I-TREATMENT +Domicilio I-TREATMENT +Fundación I-TREATMENT +Jiménez I-TREATMENT +Díaz I-TREATMENT +Avda. I-TREATMENT +Reyes I-TREATMENT +Católicos, I-TREATMENT +2 I-TREATMENT +28040 I-TREATMENT +Madrid I-TREATMENT + I-TREATMENT + +Recién B-PRESENT_ILLNESS +nacido I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +término I-PRESENT_ILLNESS +40 I-PRESENT_ILLNESS +semanas, I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +mascu I-PRESENT_ILLNESS +lino, I-PRESENT_ILLNESS +embarazo B-PAST_MEDICAL_HISTORY +controlado, I-PAST_MEDICAL_HISTORY +parto I-PAST_MEDICAL_HISTORY +eutócico, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +mórbidos I-PAST_MEDICAL_HISTORY +perinatales. I-PAST_MEDICAL_HISTORY +Derivado B-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +dermatología I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +placa I-DERIVED_FROM/TO +eritematosa I-DERIVED_FROM/TO +levemente I-DERIVED_FROM/TO +infiltrada I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +región I-DERIVED_FROM/TO +peri I-DERIVED_FROM/TO +e I-DERIVED_FROM/TO +infraumbilical I-DERIVED_FROM/TO +presente I-DERIVED_FROM/TO +desde I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +nacimiento, I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +bordes I-DERIVED_FROM/TO +bien I-DERIVED_FROM/TO +definidos I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +descamación I-DERIVED_FROM/TO +amarillenta I-DERIVED_FROM/TO +superficial I-DERIVED_FROM/TO +adherente I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +polo I-DERIVED_FROM/TO +inferior, I-DERIVED_FROM/TO +sin I-DERIVED_FROM/TO +otros I-DERIVED_FROM/TO +signos I-DERIVED_FROM/TO +inflamatorios I-DERIVED_FROM/TO +locales. I-DERIVED_FROM/TO +Estudio B-EXPLORATION +ecográfico I-EXPLORATION +cutáneo I-EXPLORATION +reveló I-EXPLORATION +lesión I-EXPLORATION +dermoepidérmica I-EXPLORATION +hipoecogénica I-EXPLORATION +homogénea, I-EXPLORATION +con I-EXPLORATION +extensión I-EXPLORATION +leve I-EXPLORATION a I-EXPLORATION -la I-EXPLORATION -extracción I-EXPLORATION -de I-EXPLORATION -órganos I-EXPLORATION -para I-EXPLORATION -trasplante I-EXPLORATION +tejido I-EXPLORATION +subcutáneo I-EXPLORATION y I-EXPLORATION -posteriormente I-EXPLORATION -se I-EXPLORATION -practica I-EXPLORATION -la I-EXPLORATION -autopsia I-EXPLORATION -forense. I-EXPLORATION - I-EXPLORATION -Hallazgos I-EXPLORATION +escasos I-EXPLORATION +vasos I-EXPLORATION +sinuosos I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -autopsia I-EXPLORATION - I-EXPLORATION -Examen I-EXPLORATION -Externo: I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -trata I-EXPLORATION -del I-EXPLORATION -cadáver I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -individuo I-EXPLORATION -de I-EXPLORATION -sexo I-EXPLORATION -masculino, I-EXPLORATION -raza I-EXPLORATION -caucasoide, I-EXPLORATION -de I-EXPLORATION -25 I-EXPLORATION -años I-EXPLORATION -de I-EXPLORATION -edad I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -constitución I-EXPLORATION -leptosomática. I-EXPLORATION +su I-EXPLORATION +segmento I-EXPLORATION +más I-EXPLORATION +profundo. I-EXPLORATION I-EXPLORATION -En I-EXPLORATION -cuanto I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -violencia I-EXPLORATION -corporal I-EXPLORATION -reciente I-EXPLORATION +Dado I-EXPLORATION +las I-EXPLORATION +características I-EXPLORATION +clínicas, I-EXPLORATION se I-EXPLORATION -aprecian: I-EXPLORATION -un I-EXPLORATION -orificio I-EXPLORATION -redondeado I-EXPLORATION +realizó I-EXPLORATION +biopsia I-EXPLORATION +incisional I-EXPLORATION +profunda I-EXPLORATION +que I-EXPLORATION +evidenció I-EXPLORATION +proliferación I-EXPLORATION de I-EXPLORATION -1 I-EXPLORATION -cm. I-EXPLORATION +células I-EXPLORATION +fusiformes I-EXPLORATION +delgadas I-EXPLORATION +en I-EXPLORATION +dermis I-EXPLORATION +e I-EXPLORATION +hipodermis, I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION +morfología I-EXPLORATION +bifásica I-EXPLORATION con I-EXPLORATION un I-EXPLORATION -área I-EXPLORATION -concéntrica I-EXPLORATION -perilesional I-EXPLORATION +segmento I-EXPLORATION +dispuesto I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +patrón I-EXPLORATION +arremolinado I-EXPLORATION +infiltrante I-EXPLORATION +y I-EXPLORATION +otro I-EXPLORATION +con I-EXPLORATION +bandas I-EXPLORATION de I-EXPLORATION -excoriación I-EXPLORATION -desecada I-EXPLORATION +células I-EXPLORATION +fusadas I-EXPLORATION +con I-EXPLORATION +hábitos I-EXPLORATION +fibroblástico I-EXPLORATION +y I-EXPLORATION +miofibroblástico, I-EXPLORATION +con I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -color I-EXPLORATION -negro, I-EXPLORATION +zona I-EXPLORATION de I-EXPLORATION -2 I-EXPLORATION -mm. I-EXPLORATION +Grenz. I-EXPLORATION +En I-EXPLORATION +profundidad, I-EXPLORATION +presentaba I-EXPLORATION +un I-EXPLORATION +componente I-EXPLORATION de I-EXPLORATION -ancho I-EXPLORATION -(cintilla I-EXPLORATION +tejido I-EXPLORATION +adiposo I-EXPLORATION +maduro, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -contusión), I-EXPLORATION -con I-EXPLORATION -tumefacción I-EXPLORATION +atipía. I-EXPLORATION +Epidermis I-EXPLORATION +madura, I-EXPLORATION +parcialmente I-EXPLORATION +atrófica. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +necrosis I-EXPLORATION +ni I-EXPLORATION +mitosis I-EXPLORATION +atípicas. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +inmunohistoquímico I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +tumorales I-EXPLORATION +mos I-EXPLORATION +tró I-EXPLORATION +positividad I-EXPLORATION +intensa I-EXPLORATION y I-EXPLORATION -enrojecimiento I-EXPLORATION -periférico, I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -cabellos I-EXPLORATION -rasurados I-EXPLORATION +difusa I-EXPLORATION +a I-EXPLORATION +CD34 I-EXPLORATION y I-EXPLORATION +focal I-EXPLORATION +para I-EXPLORATION +FXIIIa, I-EXPLORATION con I-EXPLORATION -restos I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -impregnación I-EXPLORATION -antiséptica, I-EXPLORATION -situado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -temporal I-EXPLORATION -derecha, I-EXPLORATION -a I-EXPLORATION -7 I-EXPLORATION -cm. I-EXPLORATION -del I-EXPLORATION -ángulo I-EXPLORATION -externo I-EXPLORATION -del I-EXPLORATION -ojo I-EXPLORATION -derecho I-EXPLORATION -y I-EXPLORATION +inmunoreactividad I-EXPLORATION a I-EXPLORATION -6 I-EXPLORATION -cm. I-EXPLORATION -del I-EXPLORATION -conducto I-EXPLORATION -auditivo I-EXPLORATION -de I-EXPLORATION -este I-EXPLORATION -lado; I-EXPLORATION -otorragia I-EXPLORATION -bilateral; I-EXPLORATION -epistaxis; I-EXPLORATION -hematoma I-EXPLORATION -en I-EXPLORATION -anteojos; I-EXPLORATION -excoriaciones I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -frontal I-EXPLORATION -izquierda; I-EXPLORATION -ángulo I-EXPLORATION -externo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -derecho; I-EXPLORATION -región I-EXPLORATION -parieto-occipital I-EXPLORATION -izquierda I-EXPLORATION +actina, I-EXPLORATION +desmina, I-EXPLORATION +MyoD1, I-EXPLORATION +S100, I-EXPLORATION +HMB45, I-EXPLORATION +MelanA I-EXPLORATION y I-EXPLORATION -dorso I-EXPLORATION +EMA. I-EXPLORATION +Índice I-EXPLORATION de I-EXPLORATION -ambas I-EXPLORATION -manos. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -pequeña I-EXPLORATION -herida I-EXPLORATION -incisa I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -frontal I-EXPLORATION -derecha, I-EXPLORATION -equimosis I-EXPLORATION +proliferación I-EXPLORATION +con I-EXPLORATION +Ki67 I-EXPLORATION +moderado, I-EXPLORATION +con I-EXPLORATION +positividad I-EXPLORATION en I-EXPLORATION +aproximadamente I-EXPLORATION el I-EXPLORATION -reborde I-EXPLORATION -costal I-EXPLORATION -derecho, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -hematomas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -raíz I-EXPLORATION +20% I-EXPLORATION de I-EXPLORATION -ambos I-EXPLORATION -muslos, I-EXPLORATION -rodilla I-EXPLORATION -derecha I-EXPLORATION +las I-EXPLORATION +células. I-EXPLORATION +Se I-EXPLORATION +complementó I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +FISH I-EXPLORATION +para I-EXPLORATION +PDGF I-EXPLORATION +beta I-EXPLORATION y I-EXPLORATION -cara I-EXPLORATION -anterior I-EXPLORATION -de I-EXPLORATION -ambas I-EXPLORATION -piernas, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION +ETV6, I-EXPLORATION los I-EXPLORATION -signos I-EXPLORATION -característicos I-EXPLORATION +que I-EXPLORATION +resultaron I-EXPLORATION +negativos, I-EXPLORATION +excluyendo I-EXPLORATION +los I-EXPLORATION +diagnósticos I-EXPLORATION +diferenciales I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -manipulación I-EXPLORATION -quirúrgica I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -extracción I-EXPLORATION +dermatofobrosarcoma I-EXPLORATION +protuberans I-EXPLORATION +congénito I-EXPLORATION +y I-EXPLORATION +fibrosarcoma I-EXPLORATION +infantil, I-EXPLORATION +respec I-EXPLORATION +tivamente. I-EXPLORATION +Estos I-EXPLORATION +antecedentes, I-EXPLORATION +sumados I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +histológicos, I-EXPLORATION +fueron I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -órganos I-EXPLORATION -para I-EXPLORATION -trasplante. I-EXPLORATION - I-EXPLORATION -Examen I-EXPLORATION -Interno: I-EXPLORATION +HFI. I-EXPLORATION I-EXPLORATION -En I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +extirpación I-TREATMENT +quirúrgica I-TREATMENT +por I-TREATMENT +equipo I-TREATMENT +de I-TREATMENT +ci I-TREATMENT +rugía I-TREATMENT +pediátrica, I-TREATMENT +con I-TREATMENT +readecuación I-TREATMENT +umbilical I-TREATMENT +mediante I-TREATMENT +colgajos I-TREATMENT +de I-TREATMENT +rotación I-TREATMENT +laterales. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +histológico I-EXPLORATION +e I-EXPLORATION +inmunohistoquímico I-EXPLORATION +sostuvo I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +descritos I-EXPLORATION +previamente, I-EXPLORATION +comprometiendo I-EXPLORATION +márgenes I-EXPLORATION +de I-EXPLORATION +resección I-EXPLORATION +quirúrgica. I-EXPLORATION +Evolucionó B-EVOLUTION +sin I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +recidiva I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +7 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +seguimiento. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +35 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +procedente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Marruecos I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +colecistectomía, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +hábitos I-PAST_MEDICAL_HISTORY +tóxicos, I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +factores I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +riesgo I-PAST_MEDICAL_HISTORY +sexual. I-PAST_MEDICAL_HISTORY +Ingresó B-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +mayo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2011 I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +picos I-PRESENT_ILLNESS +febriles I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +38, I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +oC, I-PRESENT_ILLNESS +junto I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +cólico I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +epigastrio, I-PRESENT_ILLNESS +prurito I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +disfagia. I-PRESENT_ILLNESS +A B-EXPLORATION la I-EXPLORATION -autopsia I-EXPLORATION -cefálica, I-EXPLORATION -al I-EXPLORATION -poner I-EXPLORATION -al I-EXPLORATION -descubierto I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +presentaba I-EXPLORATION +dolor I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -bóveda I-EXPLORATION -craneal, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -colgajo I-EXPLORATION -cutáneo I-EXPLORATION -anterior I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -dos I-EXPLORATION -infiltraciones I-EXPLORATION -hemorrágicas, I-EXPLORATION -una I-EXPLORATION +palpación I-EXPLORATION +abdominal, I-EXPLORATION +focalizado I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -correspondiente I-EXPLORATION -al I-EXPLORATION -reborde I-EXPLORATION -supraorbitario I-EXPLORATION -izquierdo I-EXPLORATION +hipocondrio I-EXPLORATION +derecho I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +irritación I-EXPLORATION +peritoneal, I-EXPLORATION +tinte I-EXPLORATION +ictérico, I-EXPLORATION y I-EXPLORATION -otra, I-EXPLORATION +muguet I-EXPLORATION +oral. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -menor I-EXPLORATION -dimensión, I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -ángulo I-EXPLORATION -externo I-EXPLORATION -del I-EXPLORATION -ojo I-EXPLORATION -del I-EXPLORATION -mismo I-EXPLORATION -lado, I-EXPLORATION -subyacentes I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -descritas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -externo. I-EXPLORATION +anamnesis I-EXPLORATION +y I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION En I-EXPLORATION la I-EXPLORATION -región I-EXPLORATION -temporal I-EXPLORATION -derecha, I-EXPLORATION -en I-EXPLORATION -concordancia I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -orificio I-EXPLORATION -cutáneo, I-EXPLORATION -existe I-EXPLORATION -un I-EXPLORATION -orificio I-EXPLORATION -óseo I-EXPLORATION +analítica I-EXPLORATION +destacaban I-EXPLORATION +hemoglobina I-EXPLORATION +10, I-EXPLORATION +9 I-EXPLORATION +g/dl, I-EXPLORATION +VCM I-EXPLORATION +82 I-EXPLORATION +fl, I-EXPLORATION +leucocitos I-EXPLORATION +2.300 I-EXPLORATION +cél/μl, I-EXPLORATION +58, I-EXPLORATION +3% I-EXPLORATION de I-EXPLORATION -10 I-EXPLORATION -mm. I-EXPLORATION +neutrófilos, I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +0, I-EXPLORATION +1 I-EXPLORATION +mg/dl, I-EXPLORATION +bilirrubina I-EXPLORATION +total I-EXPLORATION +1, I-EXPLORATION +44 I-EXPLORATION +mg/dl, I-EXPLORATION +FA I-EXPLORATION +663 I-EXPLORATION +U/l, I-EXPLORATION +GGT I-EXPLORATION +185 I-EXPLORATION +U/l, I-EXPLORATION +GOT I-EXPLORATION +231U/l, I-EXPLORATION +GPT I-EXPLORATION +156 I-EXPLORATION +U/l; I-EXPLORATION +gammaglobulinas I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -cara I-EXPLORATION -externa I-EXPLORATION +2, I-EXPLORATION +04 I-EXPLORATION +g/dl, I-EXPLORATION +Ig I-EXPLORATION +A I-EXPLORATION +553 I-EXPLORATION +mg/dl, I-EXPLORATION +Ig I-EXPLORATION +G I-EXPLORATION +2400 I-EXPLORATION +mg/dl I-EXPLORATION +e I-EXPLORATION +IgM I-EXPLORATION +62 I-EXPLORATION +mg/dl; I-EXPLORATION +autoanticuerpos I-EXPLORATION +anticitoplasma I-EXPLORATION +de I-EXPLORATION +neutrófilo I-EXPLORATION +perinucleares I-EXPLORATION +(p-ANCA) I-EXPLORATION +positivos I-EXPLORATION +1: I-EXPLORATION +320 I-EXPLORATION +U/l I-EXPLORATION +patrón I-EXPLORATION +atípico, I-EXPLORATION y I-EXPLORATION -algo I-EXPLORATION -mayor I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -interna I-EXPLORATION -(signo I-EXPLORATION -del I-EXPLORATION -embudo). I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -colgajo I-EXPLORATION -cutáneo I-EXPLORATION -posterior I-EXPLORATION -existe I-EXPLORATION -un I-EXPLORATION -importante I-EXPLORATION -hematoma I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -témporo-parietal I-EXPLORATION -izquierda, I-EXPLORATION -desprendiéndose I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -disección I-EXPLORATION -un I-EXPLORATION -fragmento I-EXPLORATION -óseo I-EXPLORATION -irregular, I-EXPLORATION +antimúsculo I-EXPLORATION +liso I-EXPLORATION +(SMA) I-EXPLORATION +positivos I-EXPLORATION +1: I-EXPLORATION +320 I-EXPLORATION +U/l. I-EXPLORATION +Autoanticuerpos I-EXPLORATION +anticitoplasma I-EXPLORATION de I-EXPLORATION -1.5 I-EXPLORATION -x I-EXPLORATION -1.5 I-EXPLORATION -cm., I-EXPLORATION -situado I-EXPLORATION -a I-EXPLORATION -12 I-EXPLORATION -cm. I-EXPLORATION -del I-EXPLORATION -ángulo I-EXPLORATION -externo I-EXPLORATION -del I-EXPLORATION -ojo I-EXPLORATION -izquierdo I-EXPLORATION +neutrófilo I-EXPLORATION +citoplasmáticos I-EXPLORATION +(c-ANCA), I-EXPLORATION +antinucleares I-EXPLORATION +(ANA), I-EXPLORATION +antimitocondriales I-EXPLORATION +(AMA), I-EXPLORATION +antimicrosomales I-EXPLORATION +(LKM-1) I-EXPLORATION y I-EXPLORATION -a I-EXPLORATION -9 I-EXPLORATION -cm. I-EXPLORATION -del I-EXPLORATION -conducto I-EXPLORATION -auditivo I-EXPLORATION -del I-EXPLORATION -mismo I-EXPLORATION -lado, I-EXPLORATION +antisacaromices I-EXPLORATION +(ASCA) I-EXPLORATION +negativos. I-EXPLORATION +Serología I-EXPLORATION +VIH I-EXPLORATION +positiva I-EXPLORATION con I-EXPLORATION -borde I-EXPLORATION -biselado, I-EXPLORATION -correspondiendo I-EXPLORATION -el I-EXPLORATION -diámetro I-EXPLORATION +carga I-EXPLORATION +viral I-EXPLORATION mayor I-EXPLORATION -al I-EXPLORATION -diploe I-EXPLORATION -externo. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -este I-EXPLORATION -lugar, I-EXPLORATION -al I-EXPLORATION -retirar I-EXPLORATION -la I-EXPLORATION -bóveda I-EXPLORATION -craneal I-EXPLORATION -aparece I-EXPLORATION -un I-EXPLORATION -proyectil I-EXPLORATION de I-EXPLORATION -arma I-EXPLORATION -de I-EXPLORATION -fuego, I-EXPLORATION -deformado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -punta, I-EXPLORATION -situado I-EXPLORATION -entre I-EXPLORATION -la I-EXPLORATION -duramadre I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -hueso, I-EXPLORATION +10 I-EXPLORATION +millones I-EXPLORATION de I-EXPLORATION -unos I-EXPLORATION -6, I-EXPLORATION +copias/ml, I-EXPLORATION +CMV I-EXPLORATION +IgG I-EXPLORATION +positiva I-EXPLORATION +con I-EXPLORATION +carga I-EXPLORATION +viral I-EXPLORATION +2 I-EXPLORATION +a I-EXPLORATION 5 I-EXPLORATION -mm. I-EXPLORATION +millones I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION +copias/ml, I-EXPLORATION +rubéola I-EXPLORATION +IgG I-EXPLORATION +positiva I-EXPLORATION y I-EXPLORATION -unos I-EXPLORATION -13 I-EXPLORATION -mm. I-EXPLORATION -de I-EXPLORATION -longitud, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -una I-EXPLORATION -extensa I-EXPLORATION -hemorragia I-EXPLORATION -subaracnoidea I-EXPLORATION -difusa. I-EXPLORATION -Extraída I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -encefálica I-EXPLORATION -se I-EXPLORATION -comprueba I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION +Toxoplasma I-EXPLORATION +gondii I-EXPLORATION +IgG I-EXPLORATION +mayor I-EXPLORATION +a I-EXPLORATION +250 I-EXPLORATION +UI/ml. I-EXPLORATION +Serología I-EXPLORATION +VHB, I-EXPLORATION +VHC, I-EXPLORATION +VHA, I-EXPLORATION +LUES, I-EXPLORATION +Brucella, I-EXPLORATION +Cryptococcus, I-EXPLORATION +Leishmania, I-EXPLORATION +CMV I-EXPLORATION +IgM I-EXPLORATION +negativa; I-EXPLORATION +VEB I-EXPLORATION +IgM I-EXPLORATION +resultado I-EXPLORATION +indeterminado. I-EXPLORATION +Antígeno I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -fractura I-EXPLORATION -conminuta I-EXPLORATION +Giardia I-EXPLORATION +lamblia I-EXPLORATION +y I-EXPLORATION +Cryptosporidium I-EXPLORATION +en I-EXPLORATION +heces, I-EXPLORATION +antígeno I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -techos I-EXPLORATION +Legionella I-EXPLORATION +y I-EXPLORATION +neumococo I-EXPLORATION +en I-EXPLORATION +orina, I-EXPLORATION +baciloscopias I-EXPLORATION +en I-EXPLORATION +esputo I-EXPLORATION +y I-EXPLORATION +orina I-EXPLORATION +por I-EXPLORATION +tres, I-EXPLORATION +hemocultivos I-EXPLORATION +y I-EXPLORATION +urocultivos I-EXPLORATION +negativos. I-EXPLORATION +Desarrollo I-EXPLORATION de I-EXPLORATION -ambas I-EXPLORATION -órbitas I-EXPLORATION -oculares. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -disección I-EXPLORATION -del I-EXPLORATION -cerebro I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -laceración I-EXPLORATION -del I-EXPLORATION -parénquima I-EXPLORATION +Candida I-EXPLORATION +albicans I-EXPLORATION en I-EXPLORATION -forma I-EXPLORATION +cultivo I-EXPLORATION de I-EXPLORATION -trayecto I-EXPLORATION -que I-EXPLORATION -une I-EXPLORATION -los I-EXPLORATION -orificios I-EXPLORATION -descritos, I-EXPLORATION -con I-EXPLORATION -infiltración I-EXPLORATION -hemorrágica I-EXPLORATION -perifocal. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -necrópsico I-EXPLORATION -del I-EXPLORATION -resto I-EXPLORATION +esputo. I-EXPLORATION +Mantoux I-EXPLORATION +negativo. I-EXPLORATION +Las I-EXPLORATION +poblaciones I-EXPLORATION +linfocitarias I-EXPLORATION +eran I-EXPLORATION de I-EXPLORATION -regiones I-EXPLORATION -anatómicas I-EXPLORATION +177 I-EXPLORATION +CD4/μl, I-EXPLORATION +534 I-EXPLORATION +CD3/μl, I-EXPLORATION +346 I-EXPLORATION +CD8/μl I-EXPLORATION y I-EXPLORATION -vísceras I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -fueron I-EXPLORATION -extraídas I-EXPLORATION -para I-EXPLORATION -trasplante, I-EXPLORATION -no I-EXPLORATION -reveló I-EXPLORATION -lesiones I-EXPLORATION -macroscópicas I-EXPLORATION +un I-EXPLORATION +cociente I-EXPLORATION +CD4/CD8 I-EXPLORATION de I-EXPLORATION -interés. I-EXPLORATION - I-EXPLORATION -Estudios I-EXPLORATION -complementarios I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -remitió I-EXPLORATION -al I-EXPLORATION -Instituto I-EXPLORATION -Nacional I-EXPLORATION +0, I-EXPLORATION +51. I-EXPLORATION +Fondo I-EXPLORATION de I-EXPLORATION -Toxicología I-EXPLORATION -y I-EXPLORATION -Ciencias I-EXPLORATION -Forenses I-EXPLORATION +ojo I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +colédoco I-EXPLORATION +dilatado I-EXPLORATION de I-EXPLORATION -Sevilla I-EXPLORATION +aspecto I-EXPLORATION +fusiforme, I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +endoscopia I-EXPLORATION +digestiva I-EXPLORATION +alta I-EXPLORATION +placas I-EXPLORATION +blanquecinas I-EXPLORATION +por I-EXPLORATION +todo I-EXPLORATION el I-EXPLORATION -colgajo I-EXPLORATION -cutáneo I-EXPLORATION -de I-EXPLORATION -cuero I-EXPLORATION -cabelludo I-EXPLORATION +esófago I-EXPLORATION +sugerentes I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -temporal I-EXPLORATION -derecha I-EXPLORATION +candidiasis I-EXPLORATION +esofágica. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +colangiorresonancia I-EXPLORATION que I-EXPLORATION -incluía I-EXPLORATION -el I-EXPLORATION -orificio I-EXPLORATION +encontró I-EXPLORATION +una I-EXPLORATION +ectasia I-EXPLORATION de I-EXPLORATION -entrada I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +intrahepática I-EXPLORATION +con I-EXPLORATION +algún I-EXPLORATION +segmento I-EXPLORATION +estenótico I-EXPLORATION +y I-EXPLORATION +ligera I-EXPLORATION +dilatación I-EXPLORATION del I-EXPLORATION -proyectil, I-EXPLORATION -para I-EXPLORATION -estudio I-EXPLORATION -criminalístico, I-EXPLORATION -los I-EXPLORATION -cuales I-EXPLORATION -revelaron I-EXPLORATION +hepatocolédoco I-EXPLORATION +sin I-EXPLORATION +estenosis I-EXPLORATION +ni I-EXPLORATION +litiasis. I-EXPLORATION +Durante B-TREATMENT +el I-TREATMENT +ingreso I-TREATMENT +recibió I-TREATMENT +tratamiento I-TREATMENT +médico I-TREATMENT +con I-TREATMENT +ganciclovir I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +500 I-TREATMENT +mg I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas I-TREATMENT +intravenoso I-TREATMENT +durante I-TREATMENT +dos I-TREATMENT +semanas, I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +valganciclovir I-TREATMENT +900 I-TREATMENT +mg I-TREATMENT +cada I-TREATMENT +24 I-TREATMENT +horas. I-TREATMENT +A I-TREATMENT +partir I-TREATMENT +de I-TREATMENT +la I-TREATMENT +segunda I-TREATMENT +semana I-TREATMENT +se I-TREATMENT +instauró I-TREATMENT +tratamiento I-TREATMENT +antirretroviral I-TREATMENT +(emtricitabina/tenofovir, I-TREATMENT +darunavir I-TREATMENT +y I-TREATMENT +ritonavir) I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +tolerancia. I-TREATMENT +Junto I-TREATMENT +a I-TREATMENT +esto, I-TREATMENT +se I-TREATMENT +pautó I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT +fluconazol I-TREATMENT +100 I-TREATMENT +mg I-TREATMENT +cada I-TREATMENT +24 I-TREATMENT +horas I-TREATMENT +durante I-TREATMENT +7 I-TREATMENT +días, I-TREATMENT +ácido I-TREATMENT +ursodesoxicólico I-TREATMENT +300 I-TREATMENT +mg I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas, I-TREATMENT +colestiramina I-TREATMENT +4 I-TREATMENT +g I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas, I-TREATMENT +dexclorfeniramina I-TREATMENT +6 I-TREATMENT +mg I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +horas I-TREATMENT +y I-TREATMENT +cotrimoxazol I-TREATMENT +800/160 I-TREATMENT +mg I-TREATMENT +lunes, I-TREATMENT +miércoles I-TREATMENT +y I-TREATMENT +viernes. I-TREATMENT +A B-EXPLORATION +pesar I-EXPLORATION +del I-EXPLORATION +tratamiento I-EXPLORATION +médico I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -residuos, I-EXPLORATION -consistentes I-EXPLORATION -en I-EXPLORATION -negro I-EXPLORATION -de I-EXPLORATION -humo I-EXPLORATION -y I-EXPLORATION -elevadas I-EXPLORATION -concentraciones I-EXPLORATION -de I-EXPLORATION -plomo, I-EXPLORATION -antimonio I-EXPLORATION +paciente I-EXPLORATION +continuaba I-EXPLORATION +con I-EXPLORATION +colestasis I-EXPLORATION y I-EXPLORATION -bario, I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -indica I-EXPLORATION -que I-EXPLORATION +citolisis I-EXPLORATION +(bilirrubina I-EXPLORATION +total I-EXPLORATION +10, I-EXPLORATION +26 I-EXPLORATION +mg/dl, I-EXPLORATION +FA I-EXPLORATION +544 I-EXPLORATION +U/l, I-EXPLORATION +GGT I-EXPLORATION +175 I-EXPLORATION +U/l, I-EXPLORATION +GOT I-EXPLORATION +448 I-EXPLORATION +U/l, I-EXPLORATION +GPT I-EXPLORATION +170 I-EXPLORATION +U/l) I-EXPLORATION +motivo I-EXPLORATION +por I-EXPLORATION el I-EXPLORATION -disparo I-EXPLORATION que I-EXPLORATION -originó I-EXPLORATION -el I-EXPLORATION -orificio I-EXPLORATION -de I-EXPLORATION -entrada I-EXPLORATION -debió I-EXPLORATION -realizarse I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +CPRE I-EXPLORATION a I-EXPLORATION -escasa I-EXPLORATION -distancia. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -Policía I-EXPLORATION -Judicial I-EXPLORATION -envió I-EXPLORATION -al I-EXPLORATION -Departamento I-EXPLORATION +los I-EXPLORATION +25 I-EXPLORATION +días I-EXPLORATION +tras I-EXPLORATION +la I-EXPLORATION +instauración I-EXPLORATION de I-EXPLORATION -Análisis I-EXPLORATION +tratamiento I-EXPLORATION +con I-EXPLORATION +ganciclovir. I-EXPLORATION +La B-TREATMENT +CPRE I-TREATMENT +confirmó I-TREATMENT +la I-TREATMENT +presencia I-TREATMENT +de I-TREATMENT +dilatación I-TREATMENT +fusiforme I-TREATMENT +de I-TREATMENT +la I-TREATMENT +vía I-TREATMENT +biliar I-TREATMENT +extrahepática, I-TREATMENT +con I-TREATMENT +normalidad I-TREATMENT +de I-TREATMENT +la I-TREATMENT +intrahepática, I-TREATMENT +y I-TREATMENT +permitió I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +esfinterotomía, I-TREATMENT +colocándosele I-TREATMENT +una I-TREATMENT +endoprótesis I-TREATMENT +plástica I-TREATMENT +en I-TREATMENT +la I-TREATMENT +porción I-TREATMENT +extrahepática. I-TREATMENT +Cuatro B-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +CPRE I-EVOLUTION +mejoró I-EVOLUTION +tanto I-EVOLUTION +clínica I-EVOLUTION +como I-EVOLUTION +analíticamente I-EVOLUTION +(FA I-EVOLUTION +310 I-EVOLUTION +U/l, I-EVOLUTION +GGT I-EVOLUTION +94 I-EVOLUTION +U/l, I-EVOLUTION +GOT I-EVOLUTION +212 I-EVOLUTION +U/l, I-EVOLUTION +GPT I-EVOLUTION +84 I-EVOLUTION +U/l, I-EVOLUTION +carga I-EVOLUTION +viral I-EVOLUTION +de I-EVOLUTION +CMV I-EVOLUTION +negativa I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +VIH I-EVOLUTION +1.602 I-EVOLUTION +copias/ml). I-EVOLUTION +En I-EVOLUTION +las I-EVOLUTION +revisiones I-EVOLUTION +posteriores I-EVOLUTION +se I-EVOLUTION +ha I-EVOLUTION +mantenido I-EVOLUTION +estable I-EVOLUTION +con I-EVOLUTION +elevación I-EVOLUTION +persistente I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +fosfatasa I-EVOLUTION +alcalina I-EVOLUTION +en I-EVOLUTION +rangos I-EVOLUTION +de I-EVOLUTION +400-600 I-EVOLUTION +U/l, I-EVOLUTION +carga I-EVOLUTION +viral I-EVOLUTION +de I-EVOLUTION +VIH I-EVOLUTION +y I-EVOLUTION +CMV I-EVOLUTION +negativas. I-EVOLUTION + I-EVOLUTION + +Mujer, B-PRESENT_ILLNESS +39 I-PRESENT_ILLNESS +años. I-PRESENT_ILLNESS +Cinco B-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +ingreso I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +trató I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +cáncer I-PAST_MEDICAL_HISTORY +cervicouterino. I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +control I-PRESENT_ILLNESS +rutinario, I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +encontró I-PRESENT_ILLNESS +hidronefrosis I-PRESENT_ILLNESS +bilateral I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +atrofia I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +riñón I-PRESENT_ILLNESS +derecho. I-PRESENT_ILLNESS +Se B-TREATMENT +instalaron I-TREATMENT +catéteres I-TREATMENT +ureterales I-TREATMENT +y I-TREATMENT +se I-TREATMENT +intentó I-TREATMENT +infructuosamente I-TREATMENT +efectuar I-TREATMENT +ureterolisis. I-TREATMENT +La B-EXPLORATION +biopsia I-EXPLORATION del I-EXPLORATION -Centro I-EXPLORATION -de I-EXPLORATION -Investigación I-EXPLORATION +tejido I-EXPLORATION +retroperitoneal I-EXPLORATION +reveló I-EXPLORATION +FRP I-EXPLORATION y I-EXPLORATION -Criminalística I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Guardia I-EXPLORATION -Civil I-EXPLORATION -tres I-EXPLORATION -portamuestras I-EXPLORATION -conteniendo I-EXPLORATION -adhesivos I-EXPLORATION -de I-EXPLORATION -recogida I-EXPLORATION -de I-EXPLORATION -residuos I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -disparo, I-EXPLORATION -aplicados I-EXPLORATION -en I-EXPLORATION -ambas I-EXPLORATION -manos I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -sien I-EXPLORATION -del I-EXPLORATION -fallecido, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -casquillo I-EXPLORATION -que I-EXPLORATION +tumor. I-EXPLORATION +Se B-TREATMENT +prescribió I-TREATMENT +defazacort I-TREATMENT +30 I-TREATMENT +mg/día I-TREATMENT +y I-TREATMENT +colchicina I-TREATMENT +1, I-TREATMENT +0 I-TREATMENT +mg/día. I-TREATMENT +Al B-EVOLUTION +año I-EVOLUTION +la I-EVOLUTION +masa I-EVOLUTION +retroperitoneal I-EVOLUTION +había I-EVOLUTION +desaparecido I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +función I-EVOLUTION +renal I-EVOLUTION +era I-EVOLUTION +normal. I-EVOLUTION +A I-EVOLUTION +16 I-EVOLUTION +meses I-EVOLUTION +del I-EVOLUTION +diagnóstico I-EVOLUTION +de I-EVOLUTION +FRP, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +estaba I-EVOLUTION +asintomática I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +evidencias I-EVOLUTION +de I-EVOLUTION +cáncer. I-EVOLUTION + I-EVOLUTION + +Una B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +43 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +artritis I-PAST_MEDICAL_HISTORY +reumatoide I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +larga I-PAST_MEDICAL_HISTORY +evolución I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +metotrexate, I-PAST_MEDICAL_HISTORY +es B-PRESENT_ILLNESS +evaluada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +diarrea I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +mucorrea, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +rectorragia, I-PRESENT_ILLNESS +acompañada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +marcada I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +ponderal I-PRESENT_ILLNESS +(10 I-PRESENT_ILLNESS +kg). I-PRESENT_ILLNESS +La B-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION fue I-EXPLORATION -encontrado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -coche I-EXPLORATION +normal. I-EXPLORATION +Se I-EXPLORATION +detectó I-EXPLORATION +leve I-EXPLORATION +anemia I-EXPLORATION +ferropénica I-EXPLORATION +(hemoglobina I-EXPLORATION +9, I-EXPLORATION +2 I-EXPLORATION +g/dl, I-EXPLORATION +ferritina I-EXPLORATION +2 I-EXPLORATION +ng/ml) I-EXPLORATION +con I-EXPLORATION +marcadores I-EXPLORATION +tumorales I-EXPLORATION en I-EXPLORATION -una I-EXPLORATION -búsqueda I-EXPLORATION -posterior I-EXPLORATION -junto I-EXPLORATION +rango I-EXPLORATION +normal. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +ileocolonoscopia I-EXPLORATION con I-EXPLORATION -una I-EXPLORATION -pistola I-EXPLORATION -del I-EXPLORATION -mismo I-EXPLORATION -calibre, I-EXPLORATION +biopsias I-EXPLORATION +normales I-EXPLORATION a I-EXPLORATION -raíz I-EXPLORATION +ambos I-EXPLORATION +niveles. I-EXPLORATION +La I-EXPLORATION +endoscopia I-EXPLORATION +digestiva I-EXPLORATION +alta I-EXPLORATION +demostró I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -investigaciones I-EXPLORATION -oportunas I-EXPLORATION -cuando I-EXPLORATION -ya I-EXPLORATION -el I-EXPLORATION -vehículo I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION +mucosa I-EXPLORATION +nodular I-EXPLORATION +con I-EXPLORATION +erosiones I-EXPLORATION +milimétricas I-EXPLORATION +parcheadas I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -desguace, I-EXPLORATION -dado I-EXPLORATION +bulbo I-EXPLORATION +duodenal, I-EXPLORATION +mientras I-EXPLORATION que I-EXPLORATION -había I-EXPLORATION -pasado I-EXPLORATION -desapercibido I-EXPLORATION en I-EXPLORATION -un I-EXPLORATION -primer I-EXPLORATION -momento. I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION -revelaron I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -en I-EXPLORATION +2a I-EXPLORATION +y I-EXPLORATION +3a I-EXPLORATION +porción I-EXPLORATION +duodenales I-EXPLORATION +había I-EXPLORATION +erosiones I-EXPLORATION +superficiales I-EXPLORATION +longitudinales I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +mínimo I-EXPLORATION +acortamiento I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +pliegues. I-EXPLORATION +En I-EXPLORATION el I-EXPLORATION -portamuestras I-EXPLORATION -aplicado I-EXPLORATION -en I-EXPLORATION +interrogatorio I-EXPLORATION +dirigido, I-EXPLORATION la I-EXPLORATION -mano I-EXPLORATION -derecha, I-EXPLORATION -de I-EXPLORATION -partículas I-EXPLORATION -propias I-EXPLORATION -de I-EXPLORATION +paciente I-EXPLORATION +negó I-EXPLORATION la I-EXPLORATION -detonación I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -fulminante I-EXPLORATION -similar I-EXPLORATION -al I-EXPLORATION -del I-EXPLORATION -casquillo, I-EXPLORATION -que I-EXPLORATION -también I-EXPLORATION -fue I-EXPLORATION -remitido. I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION -efectos I-EXPLORATION +ingesta I-EXPLORATION de I-EXPLORATION -Interpretación I-EXPLORATION -Médico I-EXPLORATION -Forense I-EXPLORATION +aspirina I-EXPLORATION +o I-EXPLORATION +antiinflamatorios I-EXPLORATION +no I-EXPLORATION +esteroideos I-EXPLORATION +(AINE). I-EXPLORATION +La I-EXPLORATION +infección I-EXPLORATION +por I-EXPLORATION +Helicobacter I-EXPLORATION +pylori I-EXPLORATION se I-EXPLORATION -hicieron I-EXPLORATION -las I-EXPLORATION -siguientes I-EXPLORATION -consideraciones: I-EXPLORATION - I-EXPLORATION -A.- I-EXPLORATION -NATURALEZA I-EXPLORATION -DE I-EXPLORATION -LAS I-EXPLORATION -LESIONES. I-EXPLORATION -Se I-EXPLORATION -han I-EXPLORATION -encontrado I-EXPLORATION -lesiones I-EXPLORATION -de I-EXPLORATION -dos I-EXPLORATION -naturalezas I-EXPLORATION -diferentes: I-EXPLORATION - I-EXPLORATION -1. I-EXPLORATION -Lesiones I-EXPLORATION -de I-EXPLORATION -naturaleza I-EXPLORATION -contusa. I-EXPLORATION -Consistentes I-EXPLORATION -en I-EXPLORATION -hematomas, I-EXPLORATION -erosiones I-EXPLORATION +descartó I-EXPLORATION +mediante I-EXPLORATION +biopsias I-EXPLORATION +gástricas I-EXPLORATION +parcheadas. I-EXPLORATION +Los I-EXPLORATION +coprocultivos I-EXPLORATION +para I-EXPLORATION +parásitos, I-EXPLORATION +bacterias I-EXPLORATION y I-EXPLORATION -heridas I-EXPLORATION -contusas I-EXPLORATION +virus I-EXPLORATION +fueron I-EXPLORATION +negativos, I-EXPLORATION +mientras I-EXPLORATION que I-EXPLORATION -por I-EXPLORATION -sus I-EXPLORATION -características I-EXPLORATION -y I-EXPLORATION -localización, I-EXPLORATION -son I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -las I-EXPLORATION -producidas I-EXPLORATION -en I-EXPLORATION los I-EXPLORATION -accidentes I-EXPLORATION +niveles I-EXPLORATION de I-EXPLORATION -tráfico. I-EXPLORATION -Ninguna I-EXPLORATION +gastrina I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +TC I-EXPLORATION +abdominal I-EXPLORATION +multicorte I-EXPLORATION +descartaron I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -ellas I-EXPLORATION -reviste I-EXPLORATION -importancia I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -punto I-EXPLORATION +síndrome I-EXPLORATION de I-EXPLORATION -vista I-EXPLORATION -clínico, I-EXPLORATION -considerándose I-EXPLORATION -por I-EXPLORATION -tanto I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -fueron I-EXPLORATION -determinantes I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -causa I-EXPLORATION -ni I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -mecanismo I-EXPLORATION +Zollinger-Ellison. I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +histológico I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -muerte. I-EXPLORATION - I-EXPLORATION -2.- I-EXPLORATION -Lesiones I-EXPLORATION +las I-EXPLORATION +biopsias I-EXPLORATION +duodenales I-EXPLORATION +mostró I-EXPLORATION +atrofia I-EXPLORATION +vellositaria I-EXPLORATION +severa I-EXPLORATION +e I-EXPLORATION +infiltración I-EXPLORATION +masiva I-EXPLORATION por I-EXPLORATION -proyectil I-EXPLORATION +linfocitos I-EXPLORATION +intraepiteliales, I-EXPLORATION +sugestivo I-EXPLORATION de I-EXPLORATION -arma I-EXPLORATION +EC I-EXPLORATION +estadio I-EXPLORATION +3b I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +clasificación I-EXPLORATION de I-EXPLORATION -fuego. I-EXPLORATION +Marsh-Oberhuber. I-EXPLORATION La I-EXPLORATION -morfología I-EXPLORATION +determinación I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -orificios I-EXPLORATION -encontrados I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cráneo I-EXPLORATION -y I-EXPLORATION +anticuerpos I-EXPLORATION +fue I-EXPLORATION +igualmente I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +EC I-EXPLORATION +(Ig I-EXPLORATION +A I-EXPLORATION +anti-transglutaminasa I-EXPLORATION +tisular I-EXPLORATION +112 I-EXPLORATION +UI, I-EXPLORATION +rango I-EXPLORATION +normal I-EXPLORATION +< I-EXPLORATION +7). I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +alcanzó I-EVOLUTION +la I-EVOLUTION +remisión I-EVOLUTION +clínica, I-EVOLUTION +endoscópica I-EVOLUTION +e I-EVOLUTION +histológica I-EVOLUTION +tras I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +dieta I-EVOLUTION +sin I-EVOLUTION +gluten. I-EVOLUTION + I-EVOLUTION + +Acude B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nuestra I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nueve I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +indurada I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +cara I-PRESENT_ILLNESS +externa I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +muslo, I-PRESENT_ILLNESS +única, I-PRESENT_ILLNESS +lineal, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dudosa I-PRESENT_ILLNESS +adherencia I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +planos I-PRESENT_ILLNESS +profundos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +otra I-PRESENT_ILLNESS +sintomatología I-PRESENT_ILLNESS +asociada. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Dicha B-TREATMENT +lesión I-TREATMENT +es I-TREATMENT +extirpada I-TREATMENT +y B-EXPLORATION +Anatomía I-EXPLORATION +Patológica I-EXPLORATION +aporta I-EXPLORATION el I-EXPLORATION -hallazgo I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -proyectil, I-EXPLORATION -indica I-EXPLORATION -que I-EXPLORATION -nos I-EXPLORATION -encontramos I-EXPLORATION -ante I-EXPLORATION -un I-EXPLORATION -disparo I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -arma I-EXPLORATION +siguiente I-EXPLORATION +informe: I-EXPLORATION +“Paniculitits I-EXPLORATION +neutrofílica I-EXPLORATION de I-EXPLORATION -fuego I-EXPLORATION +predominio I-EXPLORATION +lobular I-EXPLORATION +con I-EXPLORATION +alta I-EXPLORATION +proporción I-EXPLORATION de I-EXPLORATION -proyectil I-EXPLORATION -único. I-EXPLORATION -La I-EXPLORATION -herida I-EXPLORATION -correspondiente I-EXPLORATION -al I-EXPLORATION -orificio I-EXPLORATION +esclerosis I-EXPLORATION +periférica. I-EXPLORATION +Existe I-EXPLORATION +destrucción I-EXPLORATION +masiva I-EXPLORATION de I-EXPLORATION -entrada I-EXPLORATION -se I-EXPLORATION -localiza I-EXPLORATION -en I-EXPLORATION +adipocitos I-EXPLORATION +con I-EXPLORATION +extenso I-EXPLORATION +granuloma I-EXPLORATION +lipofágico, I-EXPLORATION +todo I-EXPLORATION +delimitado I-EXPLORATION +por I-EXPLORATION +tejido I-EXPLORATION +conjuntivo I-EXPLORATION +fibroso I-EXPLORATION +abundante”. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -región I-EXPLORATION -temporal I-EXPLORATION -derecha. I-EXPLORATION -Sigue I-EXPLORATION -un I-EXPLORATION -trayecto I-EXPLORATION -de I-EXPLORATION -derecha-izquierda, I-EXPLORATION -ligeramente I-EXPLORATION +descripción I-EXPLORATION +microscópica, I-EXPLORATION +refiere I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -abajo-arriba I-EXPLORATION +restos I-EXPLORATION +intracelulares I-EXPLORATION +PAS+ I-EXPLORATION y I-EXPLORATION +células I-EXPLORATION +gigantes I-EXPLORATION +tipo I-EXPLORATION +Touton I-EXPLORATION +escasas. I-EXPLORATION +Las I-EXPLORATION +células I-EXPLORATION +inflamatorias I-EXPLORATION +presentan I-EXPLORATION +marcadores I-EXPLORATION de I-EXPLORATION -delante-atrás, I-EXPLORATION -atravesando I-EXPLORATION -completamente I-EXPLORATION -la I-EXPLORATION -masa I-EXPLORATION -encefálica I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -llegar I-EXPLORATION +superficie I-EXPLORATION +habituales I-EXPLORATION +descartando I-EXPLORATION +naturaleza I-EXPLORATION +neoplásica. I-EXPLORATION +Añaden I-EXPLORATION +como I-EXPLORATION +posibles I-EXPLORATION +causas5-8: I-EXPLORATION + I-EXPLORATION +• I-EXPLORATION +Reacción I-EXPLORATION +tipo I-EXPLORATION +autoeccematización I-EXPLORATION +asociada I-EXPLORATION a I-EXPLORATION -salir I-EXPLORATION -al I-EXPLORATION -exterior, I-EXPLORATION -quedando I-EXPLORATION +infección, I-EXPLORATION +predominantemente I-EXPLORATION +bacteriana8. I-EXPLORATION + I-EXPLORATION +• I-EXPLORATION +Esclerodermia I-EXPLORATION +localizada I-EXPLORATION +profunda I-EXPLORATION +juvenil5, I-EXPLORATION +aunque I-EXPLORATION +en I-EXPLORATION +esta I-EXPLORATION el I-EXPLORATION -proyectil I-EXPLORATION -alojado I-EXPLORATION +infiltrado I-EXPLORATION +neutrofílico I-EXPLORATION +suele I-EXPLORATION +ser I-EXPLORATION +menos I-EXPLORATION +patente. I-EXPLORATION + I-EXPLORATION +• I-EXPLORATION +Lesiones I-EXPLORATION +evolutivas I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -interior I-EXPLORATION -del I-EXPLORATION -cráneo. I-EXPLORATION -Las I-EXPLORATION -fracturas I-EXPLORATION -del I-EXPLORATION -techo I-EXPLORATION +síndrome I-EXPLORATION de I-EXPLORATION -ambas I-EXPLORATION -órbitas I-EXPLORATION -pudieran I-EXPLORATION -corresponder I-EXPLORATION +Weber I-EXPLORATION +Christian. I-EXPLORATION + I-EXPLORATION +• I-EXPLORATION +Paniculitis I-EXPLORATION +asociada I-EXPLORATION +al I-EXPLORATION +déficit I-EXPLORATION +de I-EXPLORATION +α1-antitripsina. I-EXPLORATION + I-EXPLORATION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +80 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso, I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +diarrea I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Antecedentes B-FAMILY_HISTORY +familiares: I-FAMILY_HISTORY +padres I-FAMILY_HISTORY +y I-FAMILY_HISTORY +ocho I-FAMILY_HISTORY +hermanos I-FAMILY_HISTORY +fallecidos I-FAMILY_HISTORY +sin I-FAMILY_HISTORY +patología I-FAMILY_HISTORY +digestiva I-FAMILY_HISTORY +de I-FAMILY_HISTORY +interés. I-FAMILY_HISTORY +Antecedentes B-PAST_MEDICAL_HISTORY +personales: I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +alergias, I-PAST_MEDICAL_HISTORY +hábito I-PAST_MEDICAL_HISTORY +tabáquico I-PAST_MEDICAL_HISTORY +(60 I-PAST_MEDICAL_HISTORY +cigarrillos/día) I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +etílico I-PAST_MEDICAL_HISTORY +(80 I-PAST_MEDICAL_HISTORY +g/día) I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +25 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +apendicectomizado, I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +pulmonar I-PAST_MEDICAL_HISTORY +obstructiva I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +enfisematosa, I-PAST_MEDICAL_HISTORY +hipertrofia I-PAST_MEDICAL_HISTORY +benigna I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +próstata I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +artrosis I-PAST_MEDICAL_HISTORY +generalizada. I-PAST_MEDICAL_HISTORY +Diagnosticado I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +diverticular I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +colon I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +enema I-PAST_MEDICAL_HISTORY +opaco, I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +referir I-PAST_MEDICAL_HISTORY +dolor I-PAST_MEDICAL_HISTORY +hipogástrico. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +practicó I-PAST_MEDICAL_HISTORY +colonoscopia I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +analítica I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +detectaron I-PAST_MEDICAL_HISTORY +alteraciones I-PAST_MEDICAL_HISTORY +significativas, I-PAST_MEDICAL_HISTORY +siendo I-PAST_MEDICAL_HISTORY +entonces I-PAST_MEDICAL_HISTORY +normal I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +cifra I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +proteínas I-PAST_MEDICAL_HISTORY +totales. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +habitual I-PAST_MEDICAL_HISTORY +con: I-PAST_MEDICAL_HISTORY +tamsulosina, I-PAST_MEDICAL_HISTORY +tartrato I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +zolpidem, I-PAST_MEDICAL_HISTORY +biotina, I-PAST_MEDICAL_HISTORY +candesartán, I-PAST_MEDICAL_HISTORY +fumarato I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +formoterol, I-PAST_MEDICAL_HISTORY +bromuro I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ipratropio I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +budesonida I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +vía I-PAST_MEDICAL_HISTORY +inhalatoria. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +ingesta I-PAST_MEDICAL_HISTORY +habitual I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +antiinflamatorios I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +esteroideos I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +antibióticos. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +último I-PAST_MEDICAL_HISTORY +mes, I-PAST_MEDICAL_HISTORY +dada I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +presencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +diarrea, I-PAST_MEDICAL_HISTORY +recibió I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +loperamida I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +ciprofloxacino, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +observarse I-PAST_MEDICAL_HISTORY +mejoría. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +- I-PAST_MEDICAL_HISTORY +Enfermedad B-PRESENT_ILLNESS +actual: I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hacía I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS +progresiva: I-PRESENT_ILLNESS +astenia, I-PRESENT_ILLNESS +anorexia, I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +(10 I-PRESENT_ILLNESS +kg), I-PRESENT_ILLNESS +numerosas I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +precedidas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +hipogástrico, I-PRESENT_ILLNESS +diurnas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +nocturnas, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +consistencia I-PRESENT_ILLNESS +blanda I-PRESENT_ILLNESS +o I-PRESENT_ILLNESS +líquida, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +contenido I-PRESENT_ILLNESS +hemático I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +abundante I-PRESENT_ILLNESS +mucosidad. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +fiebre, I-PRESENT_ILLNESS +vómitos, I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +otros I-PRESENT_ILLNESS +síntomas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +interés. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +- B-EXPLORATION +Exploración I-EXPLORATION +física: I-EXPLORATION +deterioro I-EXPLORATION +físico I-EXPLORATION +atribuible I-EXPLORATION a I-EXPLORATION -las I-EXPLORATION -denominadas I-EXPLORATION -fracturas I-EXPLORATION -secundarias I-EXPLORATION -ocasionadas I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -energía I-EXPLORATION -cinética I-EXPLORATION -procedente I-EXPLORATION -del I-EXPLORATION -proyectil I-EXPLORATION -[9]. I-EXPLORATION - I-EXPLORATION -B.- I-EXPLORATION -ETIOLOGÍA I-EXPLORATION -MÉDICO I-EXPLORATION -LEGAL I-EXPLORATION - I-EXPLORATION -Las I-EXPLORATION -investigaciones I-EXPLORATION -policiales I-EXPLORATION -posteriores, I-EXPLORATION -indicaron I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -fallecido, I-EXPLORATION -sin I-EXPLORATION -antecedentes I-EXPLORATION -médicos I-EXPLORATION -de I-EXPLORATION -interés, I-EXPLORATION -no I-EXPLORATION -tenía I-EXPLORATION -problemas I-EXPLORATION -económicos I-EXPLORATION -conocidos, I-EXPLORATION -siendo I-EXPLORATION -significativo I-EXPLORATION -el I-EXPLORATION -hecho I-EXPLORATION -de I-EXPLORATION -que I-EXPLORATION -poco I-EXPLORATION -antes I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -hechos I-EXPLORATION -había I-EXPLORATION -contratado I-EXPLORATION -un I-EXPLORATION -seguro I-EXPLORATION -de I-EXPLORATION -vida I-EXPLORATION +edad I-EXPLORATION +avanzada I-EXPLORATION y I-EXPLORATION -había I-EXPLORATION -adquirido I-EXPLORATION -una I-EXPLORATION -pistola I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -forma I-EXPLORATION -ilegal. I-EXPLORATION -El I-EXPLORATION -minucioso I-EXPLORATION -examen I-EXPLORATION -del I-EXPLORATION -vehículo, I-EXPLORATION -una I-EXPLORATION -vez I-EXPLORATION -depositado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -desguace, I-EXPLORATION -permitió I-EXPLORATION +masa I-EXPLORATION +muscular. I-EXPLORATION +Talla I-EXPLORATION +164 I-EXPLORATION +cm. I-EXPLORATION +Peso I-EXPLORATION +67 I-EXPLORATION +kg. I-EXPLORATION +Necesitaba I-EXPLORATION +ayuda I-EXPLORATION +para I-EXPLORATION la I-EXPLORATION -recogida I-EXPLORATION -de I-EXPLORATION -varios I-EXPLORATION -cartuchos I-EXPLORATION +deambulación. I-EXPLORATION +Ausencia I-EXPLORATION de I-EXPLORATION -pistola I-EXPLORATION +ictericia I-EXPLORATION +o I-EXPLORATION de I-EXPLORATION -calibre I-EXPLORATION -6, I-EXPLORATION -35 I-EXPLORATION -mm., I-EXPLORATION -uno I-EXPLORATION +palidez I-EXPLORATION de I-EXPLORATION -ellos I-EXPLORATION -percutido. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -base I-EXPLORATION -a I-EXPLORATION -estos I-EXPLORATION -antecedentes I-EXPLORATION +piel I-EXPLORATION y I-EXPLORATION -teniendo I-EXPLORATION -en I-EXPLORATION -cuenta I-EXPLORATION -la I-EXPLORATION -localización I-EXPLORATION -del I-EXPLORATION -orificio I-EXPLORATION +mucosas. I-EXPLORATION +Presencia I-EXPLORATION de I-EXPLORATION -entrada I-EXPLORATION -(región I-EXPLORATION -temporal I-EXPLORATION -derecha), I-EXPLORATION -la I-EXPLORATION -distancia I-EXPLORATION +máculas I-EXPLORATION +hiperpigmentadas I-EXPLORATION +en I-EXPLORATION +miembros I-EXPLORATION +superiores. I-EXPLORATION +Escaso I-EXPLORATION +vello I-EXPLORATION +corporal. I-EXPLORATION +No I-EXPLORATION +adenopatías I-EXPLORATION +periféricas. I-EXPLORATION +Auscultación I-EXPLORATION +cardiaca I-EXPLORATION +normal. I-EXPLORATION +Frecuencia I-EXPLORATION +cardiaca: I-EXPLORATION +80 I-EXPLORATION +sístoles/minuto. I-EXPLORATION +Tensión I-EXPLORATION +arterial: I-EXPLORATION +150/90 I-EXPLORATION +mmHg. I-EXPLORATION +Auscultación I-EXPLORATION +respiratoria: I-EXPLORATION +disminución I-EXPLORATION +difusa I-EXPLORATION del I-EXPLORATION -disparo I-EXPLORATION -(como I-EXPLORATION -mínimo I-EXPLORATION +murmullo I-EXPLORATION +vesicular I-EXPLORATION +con I-EXPLORATION +escasos I-EXPLORATION +roncus I-EXPLORATION +y I-EXPLORATION +sibilantes. I-EXPLORATION +Abdomen I-EXPLORATION +con I-EXPLORATION +auscultación I-EXPLORATION +normal, I-EXPLORATION +dolor I-EXPLORATION a I-EXPLORATION -corta I-EXPLORATION -distancia I-EXPLORATION -como I-EXPLORATION -acredita I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -criminalístico), I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -restos I-EXPLORATION -de I-EXPLORATION -residuos I-EXPLORATION -de I-EXPLORATION -disparo I-EXPLORATION +palpación I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -mano I-EXPLORATION -derecha I-EXPLORATION -del I-EXPLORATION -fallecido I-EXPLORATION +hipogastrio I-EXPLORATION y I-EXPLORATION -otras I-EXPLORATION -circunstancias I-EXPLORATION -del I-EXPLORATION -caso I-EXPLORATION -(único I-EXPLORATION -ocupante I-EXPLORATION +ambas I-EXPLORATION +fosas I-EXPLORATION +iliacas, I-EXPLORATION con I-EXPLORATION -incarceración I-EXPLORATION -del I-EXPLORATION -cuerpo I-EXPLORATION -e I-EXPLORATION -intervención I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -bomberos I-EXPLORATION -para I-EXPLORATION -su I-EXPLORATION -extracción, I-EXPLORATION -presencia I-EXPLORATION -del I-EXPLORATION -arma I-EXPLORATION +masas I-EXPLORATION +o I-EXPLORATION +visceromegalias. I-EXPLORATION +Atrofia I-EXPLORATION +muscular I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -vehículo, I-EXPLORATION -antecedentes I-EXPLORATION -de I-EXPLORATION -contratación I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -seguro, I-EXPLORATION -etc.) I-EXPLORATION +extremidades, I-EXPLORATION +pulsos I-EXPLORATION +normales I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION ausencia I-EXPLORATION de I-EXPLORATION -otros I-EXPLORATION -datos I-EXPLORATION -objetivos, I-EXPLORATION -consideramos I-EXPLORATION -que I-EXPLORATION -pudiera I-EXPLORATION -ser I-EXPLORATION -perfectamente I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -acto I-EXPLORATION -de I-EXPLORATION -carácter I-EXPLORATION -suicida. I-EXPLORATION +edemas. I-EXPLORATION I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -ex B-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -bebedor I-PAST_MEDICAL_HISTORY -moderado I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -hallado I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -vía I-PRESENT_ILLNESS -pública. I-PRESENT_ILLNESS -La B-EXPLORATION -autopsia I-EXPLORATION -se I-EXPLORATION -practica I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -19 I-EXPLORATION -horas I-EXPLORATION -del I-EXPLORATION -fallecimiento I-EXPLORATION -según I-EXPLORATION -las I-EXPLORATION -recomendaciones I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -armonización I-EXPLORATION -de I-EXPLORATION +- I-EXPLORATION +Analítica: I-EXPLORATION las I-EXPLORATION -autopsias I-EXPLORATION -médico-legales I-EXPLORATION -del I-EXPLORATION -Comité I-EXPLORATION -de I-EXPLORATION -Ministros I-EXPLORATION -del I-EXPLORATION -Consejo I-EXPLORATION -de I-EXPLORATION -Europa I-EXPLORATION -[3]. I-EXPLORATION -Concretamente I-EXPLORATION -se I-EXPLORATION -siguió I-EXPLORATION -el I-EXPLORATION -protocolo I-EXPLORATION -aprobado I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -Red I-EXPLORATION +cifras I-EXPLORATION de I-EXPLORATION -Muerte I-EXPLORATION -Súbita I-EXPLORATION -que I-EXPLORATION -incluye I-EXPLORATION -peso, I-EXPLORATION -talla I-EXPLORATION -y I-EXPLORATION -perímetro I-EXPLORATION -abdominal I-EXPLORATION -del I-EXPLORATION -cadáver; I-EXPLORATION -peso I-EXPLORATION +hematocrito, I-EXPLORATION +hemoglobina, I-EXPLORATION +volumen I-EXPLORATION +corpuscular I-EXPLORATION +medio, I-EXPLORATION +plaquetas, I-EXPLORATION +glucosa, I-EXPLORATION +urea, I-EXPLORATION +sodio, I-EXPLORATION +creatinina, I-EXPLORATION +bilirrubina, I-EXPLORATION +transaminasas, I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina, I-EXPLORATION +colesterol, I-EXPLORATION +triglicéridos, I-EXPLORATION +ácido I-EXPLORATION +fólico, I-EXPLORATION +ferritina I-EXPLORATION y I-EXPLORATION -examen I-EXPLORATION -macroscópico-microscópico I-EXPLORATION -de I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -órganos I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -investigación I-EXPLORATION -químico-toxicológica I-EXPLORATION -general I-EXPLORATION -en I-EXPLORATION -sangre. I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -complementarios I-EXPLORATION +vitamina I-EXPLORATION +B12 I-EXPLORATION se I-EXPLORATION -realizaron I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -Delegación I-EXPLORATION -de I-EXPLORATION -Tenerife I-EXPLORATION -(estudio I-EXPLORATION -histopatológico) I-EXPLORATION -y I-EXPLORATION +mantuvieron I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -Departamento I-EXPLORATION -de I-EXPLORATION -Sevilla I-EXPLORATION -(análisis I-EXPLORATION -químico-toxicológico) I-EXPLORATION -del I-EXPLORATION -Instituto I-EXPLORATION -Nacional I-EXPLORATION -de I-EXPLORATION -Toxicología I-EXPLORATION -y I-EXPLORATION -Ciencias I-EXPLORATION -Forenses. I-EXPLORATION - I-EXPLORATION -a) I-EXPLORATION -Examen I-EXPLORATION -de I-EXPLORATION -autopsia: I-EXPLORATION - I-EXPLORATION -Talla I-EXPLORATION -162 I-EXPLORATION -cm, I-EXPLORATION -peso I-EXPLORATION -84 I-EXPLORATION -kg, I-EXPLORATION -perímetro I-EXPLORATION -abdominal I-EXPLORATION -de I-EXPLORATION -104 I-EXPLORATION -cm. I-EXPLORATION -El I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -corporal I-EXPLORATION -(IMC) I-EXPLORATION -= I-EXPLORATION -peso I-EXPLORATION -(kg) I-EXPLORATION -/ I-EXPLORATION -[talla I-EXPLORATION -(m) I-EXPLORATION -] I-EXPLORATION -² I-EXPLORATION -era I-EXPLORATION +rango I-EXPLORATION de I-EXPLORATION -32 I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -significa I-EXPLORATION -una I-EXPLORATION -obesidad I-EXPLORATION +la I-EXPLORATION +normalidad. I-EXPLORATION +Elevación I-EXPLORATION +progresiva I-EXPLORATION de I-EXPLORATION -grado I-EXPLORATION -I I-EXPLORATION -con I-EXPLORATION -obesidad I-EXPLORATION -visceral I-EXPLORATION -[4, I-EXPLORATION -5]. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -externo I-EXPLORATION -sólo I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -intensa I-EXPLORATION -congestión I-EXPLORATION -cefálica. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -interno I-EXPLORATION -los I-EXPLORATION -pulmones I-EXPLORATION -estaban I-EXPLORATION -aumentados I-EXPLORATION +las I-EXPLORATION +cifras I-EXPLORATION de I-EXPLORATION -peso I-EXPLORATION -(D: I-EXPLORATION -675 I-EXPLORATION -g, I-EXPLORATION -I: I-EXPLORATION -490 I-EXPLORATION -g), I-EXPLORATION +leucocitos I-EXPLORATION +(13.900- I-EXPLORATION +30.900, I-EXPLORATION +normal I-EXPLORATION +4.600-10.200/mm3), I-EXPLORATION con I-EXPLORATION -patrón I-EXPLORATION -de I-EXPLORATION -congestión I-EXPLORATION +neutrofilia I-EXPLORATION +(70-90%), I-EXPLORATION y I-EXPLORATION -edema I-EXPLORATION de I-EXPLORATION -grado I-EXPLORATION -importante. I-EXPLORATION -Cardiomegalia I-EXPLORATION -de I-EXPLORATION -485 I-EXPLORATION -g, I-EXPLORATION -siendo I-EXPLORATION -el I-EXPLORATION -valor I-EXPLORATION -medio I-EXPLORATION -esperado I-EXPLORATION -según I-EXPLORATION -peso I-EXPLORATION -corporal I-EXPLORATION +la I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +(16, I-EXPLORATION +9-93, I-EXPLORATION +4, I-EXPLORATION +normal I-EXPLORATION +0-5 I-EXPLORATION +mg/l); I-EXPLORATION +descenso I-EXPLORATION de I-EXPLORATION -358 I-EXPLORATION -g I-EXPLORATION -(rango I-EXPLORATION -271-473 I-EXPLORATION -g) I-EXPLORATION -[6]. I-EXPLORATION -La I-EXPLORATION -pared I-EXPLORATION -libre I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -derecho I-EXPLORATION -tenía I-EXPLORATION -un I-EXPLORATION -espesor I-EXPLORATION +las I-EXPLORATION +cifras I-EXPLORATION de I-EXPLORATION +proteínas I-EXPLORATION +totales I-EXPLORATION +(4, I-EXPLORATION +4-5, I-EXPLORATION +3, I-EXPLORATION +normal I-EXPLORATION +6, I-EXPLORATION +6-8, I-EXPLORATION 7 I-EXPLORATION -mm I-EXPLORATION -(rango I-EXPLORATION -2-7 I-EXPLORATION -mm) I-EXPLORATION -mientras I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -espesor I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -15 I-EXPLORATION -mm I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -septum I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -libre I-EXPLORATION -(rango I-EXPLORATION -10-15 I-EXPLORATION -mm). I-EXPLORATION -Abundante I-EXPLORATION -infiltrado I-EXPLORATION -graso I-EXPLORATION -en I-EXPLORATION -miocardio I-EXPLORATION -de I-EXPLORATION -ventrículo I-EXPLORATION -derecho I-EXPLORATION +g/dl), I-EXPLORATION +calcio I-EXPLORATION +(4, I-EXPLORATION +7-7, I-EXPLORATION +0, I-EXPLORATION +normal I-EXPLORATION +8, I-EXPLORATION +5-10, I-EXPLORATION +5 I-EXPLORATION +mg/dl) I-EXPLORATION y I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -posterior I-EXPLORATION -de I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo I-EXPLORATION -formando I-EXPLORATION -una I-EXPLORATION -banda I-EXPLORATION -subepicárdica I-EXPLORATION -de I-EXPLORATION -2.5 I-EXPLORATION -x I-EXPLORATION -0.5 I-EXPLORATION -cm I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extendía I-EXPLORATION -desde I-EXPLORATION -mesocardio I-EXPLORATION -hasta I-EXPLORATION -ápex. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -otra I-EXPLORATION -zona I-EXPLORATION -más I-EXPLORATION -pequeña I-EXPLORATION -de I-EXPLORATION -infiltración I-EXPLORATION -grasa I-EXPLORATION -de I-EXPLORATION -0.5 I-EXPLORATION -cm I-EXPLORATION +colinesterasa I-EXPLORATION +(1.557-2.591, I-EXPLORATION +normal I-EXPLORATION +5.300-12.900 I-EXPLORATION +U/l). I-EXPLORATION +Estudio I-EXPLORATION de I-EXPLORATION -diámetro. I-EXPLORATION -Las I-EXPLORATION -arterias I-EXPLORATION -coronarias I-EXPLORATION -estaban I-EXPLORATION -permeables I-EXPLORATION -y I-EXPLORATION +coagulación I-EXPLORATION +normal. I-EXPLORATION +Proteinograma: I-EXPLORATION +hipoalbuminemia I-EXPLORATION +(2, I-EXPLORATION +49, I-EXPLORATION +normal I-EXPLORATION +4, I-EXPLORATION +0-4, I-EXPLORATION +7 I-EXPLORATION +g/dl) I-EXPLORATION +e I-EXPLORATION +hipogammaglobulinemia I-EXPLORATION +(0, I-EXPLORATION +39, I-EXPLORATION +normal I-EXPLORATION +0, I-EXPLORATION +80-1, I-EXPLORATION +35 I-EXPLORATION +g/dl), I-EXPLORATION con I-EXPLORATION -escasas I-EXPLORATION -placas I-EXPLORATION +proteínas I-EXPLORATION +totales I-EXPLORATION +4, I-EXPLORATION +7 I-EXPLORATION +g/dl. I-EXPLORATION +Las I-EXPLORATION +cifras I-EXPLORATION de I-EXPLORATION -ateroma I-EXPLORATION +potasio, I-EXPLORATION que I-EXPLORATION -determinaban I-EXPLORATION -una I-EXPLORATION -estenosis I-EXPLORATION -luminal I-EXPLORATION -inferior I-EXPLORATION -al I-EXPLORATION -25%. I-EXPLORATION - I-EXPLORATION -b) I-EXPLORATION -Estudio I-EXPLORATION -microscópico: I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histopatológico, I-EXPLORATION -utilizando I-EXPLORATION -Tricrómico I-EXPLORATION +fueron I-EXPLORATION +anodinas I-EXPLORATION +durante I-EXPLORATION +las I-EXPLORATION +primeras I-EXPLORATION +semanas I-EXPLORATION +del I-EXPLORATION +ingreso, I-EXPLORATION +alcanzaron I-EXPLORATION +cifras I-EXPLORATION de I-EXPLORATION -Masson, I-EXPLORATION -puso I-EXPLORATION +2, I-EXPLORATION +3-1, I-EXPLORATION +9, I-EXPLORATION +normal I-EXPLORATION +3, I-EXPLORATION +5-5 I-EXPLORATION +mEq/l). I-EXPLORATION +Elevación I-EXPLORATION de I-EXPLORATION -manifiesto I-EXPLORATION -abundante I-EXPLORATION -infiltrado I-EXPLORATION -graso I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -miocardio I-EXPLORATION -constituido I-EXPLORATION -por I-EXPLORATION -adipocitos I-EXPLORATION -maduros I-EXPLORATION -entre I-EXPLORATION -los I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -islotes I-EXPLORATION +las I-EXPLORATION +cifras I-EXPLORATION de I-EXPLORATION -miocardiocitos I-EXPLORATION -con I-EXPLORATION -estructura I-EXPLORATION +gastrina I-EXPLORATION +(263, I-EXPLORATION normal I-EXPLORATION +13-115 I-EXPLORATION +pg/ml) I-EXPLORATION y I-EXPLORATION -mínima I-EXPLORATION -fibrosis I-EXPLORATION -intersticial. I-EXPLORATION -Las I-EXPLORATION -arterias I-EXPLORATION -coronarias I-EXPLORATION -presentan I-EXPLORATION -placas I-EXPLORATION -fibrolipídicas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -íntima I-EXPLORATION -determinando I-EXPLORATION -una I-EXPLORATION -estenosis I-EXPLORATION -luminal I-EXPLORATION -no I-EXPLORATION -superior I-EXPLORATION -al I-EXPLORATION -25% I-EXPLORATION -(aterosclerosis I-EXPLORATION -leve). I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -ni I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -necrosis I-EXPLORATION -miocárdica I-EXPLORATION -reciente I-EXPLORATION -y/o I-EXPLORATION -fibrosis I-EXPLORATION -de I-EXPLORATION -reparación. I-EXPLORATION - I-EXPLORATION -c) I-EXPLORATION -Análisis I-EXPLORATION -químico-toxicológico: I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -investigación I-EXPLORATION -toxicológica I-EXPLORATION -general I-EXPLORATION -detectó I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -alcohol I-EXPLORATION -etílico I-EXPLORATION -en I-EXPLORATION -concentración I-EXPLORATION de I-EXPLORATION -2.59 I-EXPLORATION -g/L. I-EXPLORATION - I-EXPLORATION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Sra. I-PRESENT_ILLNESS -A, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -quien I-PRESENT_ILLNESS -viene I-PRESENT_ILLNESS -citada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -programada I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -juzgado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -instrucción, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -fin I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dilucidar I-PRESENT_ILLNESS -si I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -víctima I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -negligencia I-PRESENT_ILLNESS -médica. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Como I-PRESENT_ILLNESS -prolegómeno I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -caso, I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -hospitalarias I-PRESENT_ILLNESS -refiriendo I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -sufrido I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -posteriormente I-PRESENT_ILLNESS -fuera I-PRESENT_ILLNESS -catalogado I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -luxación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -rodilla I-PRESENT_ILLNESS -izquierda, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -resolvió I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -manera I-PRESENT_ILLNESS -espontánea. I-PRESENT_ILLNESS -Se B-TREATMENT -actúa I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -conservadora, I-TREATMENT -observándose I-TREATMENT -tras I-TREATMENT -dos I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -inmovilización I-TREATMENT -inguino-pédica I-TREATMENT -una I-TREATMENT -buena I-TREATMENT -evolución I-TREATMENT -clínica I-TREATMENT -que I-TREATMENT -no I-TREATMENT -se I-TREATMENT -corresponde I-TREATMENT -con I-TREATMENT -la I-TREATMENT -percepción I-TREATMENT -de I-TREATMENT -la I-TREATMENT -propia I-TREATMENT -lesionada. I-TREATMENT -Desde I-TREATMENT -entonces I-TREATMENT -se I-TREATMENT -manifiesta I-TREATMENT -como I-TREATMENT -un I-TREATMENT -cuadro I-TREATMENT -clínico I-TREATMENT -de I-TREATMENT -anquilosis I-TREATMENT -de I-TREATMENT -rodilla, I-TREATMENT -siendo I-TREATMENT -sometida I-TREATMENT -a I-TREATMENT -tratamiento I-TREATMENT -rehabilitador I-TREATMENT -sin I-TREATMENT -éxito I-TREATMENT -alguno. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -del I-EVOLUTION -proceso I-EVOLUTION -fue I-EVOLUTION -tórpida, I-EVOLUTION -proponiéndose I-EVOLUTION -finalmente I-EVOLUTION -intervención I-EVOLUTION -quirúrgica I-EVOLUTION -de I-EVOLUTION -rodilla I-EVOLUTION -bajo I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -clínico I-EVOLUTION -de I-EVOLUTION -"artrofibrosis", I-EVOLUTION -que I-EVOLUTION -es I-EVOLUTION -suspendida I-EVOLUTION -a I-EVOLUTION -criterio I-EVOLUTION -del I-EVOLUTION -cirujano, I-EVOLUTION -por I-EVOLUTION -no I-EVOLUTION -encontrar I-EVOLUTION -base I-EVOLUTION -clínica I-EVOLUTION -que I-EVOLUTION -justificara I-EVOLUTION -la I-EVOLUTION -sintomatología I-EVOLUTION -padecida. I-EVOLUTION - I-EVOLUTION -Tras I-EVOLUTION -este I-EVOLUTION -último I-EVOLUTION -episodio, I-EVOLUTION -la I-EVOLUTION -interesada I-EVOLUTION -decide I-EVOLUTION -emitir I-EVOLUTION -denuncia I-EVOLUTION -por I-EVOLUTION -negligencia I-EVOLUTION -médica, I-EVOLUTION -haciéndola I-EVOLUTION -extensible I-EVOLUTION -a I-EVOLUTION -todos I-EVOLUTION -aquellos I-EVOLUTION -especialistas I-EVOLUTION -que I-EVOLUTION -estuvieron I-EVOLUTION -atendiéndola I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -principio. I-EVOLUTION - I-EVOLUTION -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -Médico I-PRESENT_ILLNESS -Forense I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -primera I-PRESENT_ILLNESS -asistencia I-PRESENT_ILLNESS -recibida I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -urgencias, I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -poco I-PRESENT_ILLNESS -tiempo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ser I-PRESENT_ILLNESS -emitida I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -denuncia, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -citada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -programada I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -dependencias I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Instituto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Medicina I-PRESENT_ILLNESS -Legal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Huelva, I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -compañía I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -cónyuge I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -muleta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -descarga. I-PRESENT_ILLNESS -Se B-EXPLORATION -aprecia I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -hipotrofia I-EXPLORATION -moderada I-EXPLORATION -global I-EXPLORATION +tirotropina I-EXPLORATION +(TSH) I-EXPLORATION +(33, I-EXPLORATION +9-17, I-EXPLORATION +3, I-EXPLORATION +normal I-EXPLORATION +0, I-EXPLORATION +12-5 I-EXPLORATION +uU/ml), I-EXPLORATION +descenso I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -musculatura I-EXPLORATION +tiroxina I-EXPLORATION +(T4) I-EXPLORATION +(0, I-EXPLORATION +56-0, I-EXPLORATION +27, I-EXPLORATION +normal I-EXPLORATION +0, I-EXPLORATION +8-1, I-EXPLORATION +8 I-EXPLORATION +ng/dl) I-EXPLORATION +y I-EXPLORATION +normalidad I-EXPLORATION +de I-EXPLORATION +cortisol I-EXPLORATION +sérico. I-EXPLORATION +Las I-EXPLORATION +cifras I-EXPLORATION +de I-EXPLORATION +TSH I-EXPLORATION +y I-EXPLORATION +T4 I-EXPLORATION +eran I-EXPLORATION +normales I-EXPLORATION +al I-EXPLORATION +ingreso. I-EXPLORATION +Anticuerpos I-EXPLORATION +anti-peroxidasa I-EXPLORATION +tiroidea, I-EXPLORATION +anti-tiroglobulina, I-EXPLORATION +antinucleares I-EXPLORATION +y I-EXPLORATION +anti-transglutaminasa I-EXPLORATION +negativos. I-EXPLORATION +Sedimento I-EXPLORATION +urinario I-EXPLORATION +normal. I-EXPLORATION +Elevación I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +cifras I-EXPLORATION +de I-EXPLORATION +antígeno I-EXPLORATION +carcinoembrionario I-EXPLORATION +(28, I-EXPLORATION +5-88, I-EXPLORATION +1, I-EXPLORATION +normal I-EXPLORATION +0-5 I-EXPLORATION +ng/ml) I-EXPLORATION +y I-EXPLORATION del I-EXPLORATION -miembro I-EXPLORATION -inferior I-EXPLORATION -izquierdo I-EXPLORATION +antígeno I-EXPLORATION +CA I-EXPLORATION +19., I-EXPLORATION +9 I-EXPLORATION +(57, I-EXPLORATION +8, I-EXPLORATION +normal I-EXPLORATION +0-37 I-EXPLORATION +U/ml); I-EXPLORATION +las I-EXPLORATION +cifras I-EXPLORATION +de I-EXPLORATION +antígeno I-EXPLORATION +específico I-EXPLORATION +prostático, I-EXPLORATION +alfa-fetoproteína I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -total I-EXPLORATION -falta I-EXPLORATION +antígeno I-EXPLORATION +CA I-EXPLORATION +125 I-EXPLORATION +resultaron I-EXPLORATION +normales. I-EXPLORATION +Cuantificación I-EXPLORATION de I-EXPLORATION -movilidad I-EXPLORATION +grasas I-EXPLORATION +en I-EXPLORATION +heces I-EXPLORATION +no I-EXPLORATION +valorable. I-EXPLORATION +Microbiología: I-EXPLORATION +negatividad I-EXPLORATION de I-EXPLORATION -rodilla I-EXPLORATION -homolateral I-EXPLORATION +coprocultivos, I-EXPLORATION +urocultivos, I-EXPLORATION +parásitos I-EXPLORATION en I-EXPLORATION -flexoextensión. I-EXPLORATION -No I-EXPLORATION -existe I-EXPLORATION -componente I-EXPLORATION -inflamatorio I-EXPLORATION -asociado I-EXPLORATION +heces, I-EXPLORATION +toxina I-EXPLORATION +de I-EXPLORATION +Clostridium I-EXPLORATION +difficile, I-EXPLORATION +Mantoux I-EXPLORATION y I-EXPLORATION -presenta I-EXPLORATION -genu I-EXPLORATION -valgo I-EXPLORATION -bilateral. I-EXPLORATION -Se I-EXPLORATION -detecta I-EXPLORATION -durante I-EXPLORATION -la I-EXPLORATION -entrevista I-EXPLORATION -un I-EXPLORATION -marcado I-EXPLORATION -componente I-EXPLORATION -conversivo. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -inicial I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -mediante I-EXPLORATION -entrevista I-EXPLORATION -semiestructurada I-EXPLORATION -bajo I-EXPLORATION -los I-EXPLORATION -criterios I-EXPLORATION -propuestos I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -clasificación I-EXPLORATION -DSM I-EXPLORATION -IV-TR. I-EXPLORATION - I-EXPLORATION -Tras I-EXPLORATION -acordarse I-EXPLORATION -entrevista I-EXPLORATION +serología I-EXPLORATION +a I-EXPLORATION +Helicobacter I-EXPLORATION +pylori, I-EXPLORATION +VIH, I-EXPLORATION +citomegalovirus, I-EXPLORATION +Salmonella I-EXPLORATION y I-EXPLORATION -exploración I-EXPLORATION -pormenorizada I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -Psicólogo I-EXPLORATION -Forense I-EXPLORATION +Yersinia I-EXPLORATION +enterocolítica. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Exploraciones I-EXPLORATION +complementarias: I-EXPLORATION + I-EXPLORATION +• I-EXPLORATION +Colonoscopia I-EXPLORATION +(practicada I-EXPLORATION +en I-EXPLORATION +dos I-EXPLORATION +ocasiones): I-EXPLORATION se I-EXPLORATION -decide I-EXPLORATION -pasar I-EXPLORATION -el I-EXPLORATION -test I-EXPLORATION -MMPI I-EXPLORATION -(Inventario I-EXPLORATION -Multifásico I-EXPLORATION +observaron I-EXPLORATION de I-EXPLORATION -Personalidad I-EXPLORATION +forma I-EXPLORATION +difusa, I-EXPLORATION +principalmente I-EXPLORATION +desde I-EXPLORATION +la I-EXPLORATION +unión I-EXPLORATION +rectosigmoidea I-EXPLORATION +y I-EXPLORATION +hasta I-EXPLORATION +la I-EXPLORATION +válvula I-EXPLORATION +ileocecal, I-EXPLORATION +numerosas I-EXPLORATION +lesiones I-EXPLORATION +nodulares I-EXPLORATION +o I-EXPLORATION +polipoides I-EXPLORATION +sésiles, I-EXPLORATION de I-EXPLORATION -Minessotta), I-EXPLORATION -destacando I-EXPLORATION +variable I-EXPLORATION +tamaño, I-EXPLORATION +llegando I-EXPLORATION en I-EXPLORATION +algunos I-EXPLORATION +tramos I-EXPLORATION +a I-EXPLORATION +ocupar I-EXPLORATION +casi I-EXPLORATION +la I-EXPLORATION +totalidad I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +luz I-EXPLORATION +del I-EXPLORATION +colon, I-EXPLORATION +dificultando I-EXPLORATION el I-EXPLORATION -mismo I-EXPLORATION -un I-EXPLORATION -marcado I-EXPLORATION -perfil I-EXPLORATION -represivo I-EXPLORATION +paso I-EXPLORATION +del I-EXPLORATION +endoscopio. I-EXPLORATION +Las I-EXPLORATION +lesiones I-EXPLORATION +muestran I-EXPLORATION +una I-EXPLORATION +superficie I-EXPLORATION +enrojecida I-EXPLORATION +con I-EXPLORATION +lesiones I-EXPLORATION +petequiales I-EXPLORATION y I-EXPLORATION +equimóticas. I-EXPLORATION +Se I-EXPLORATION +obtuvieron I-EXPLORATION +biopsias I-EXPLORATION +a I-EXPLORATION +distintos I-EXPLORATION +niveles I-EXPLORATION +y, I-EXPLORATION +en I-EXPLORATION una I-EXPLORATION -elevada I-EXPLORATION -preocupación I-EXPLORATION -por I-EXPLORATION +segunda I-EXPLORATION +exploración, I-EXPLORATION +una I-EXPLORATION +macrobiopsia I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +rectal I-EXPLORATION +con I-EXPLORATION +asa I-EXPLORATION +de I-EXPLORATION +polipectomía. I-EXPLORATION + I-EXPLORATION +• I-EXPLORATION +Gastroscopia: I-EXPLORATION +esófago, I-EXPLORATION +fundus I-EXPLORATION +y I-EXPLORATION +cuerpo I-EXPLORATION +gástrico I-EXPLORATION +normales. I-EXPLORATION +La I-EXPLORATION +mucosa I-EXPLORATION +de I-EXPLORATION +antro I-EXPLORATION +gástrico, I-EXPLORATION +sobre I-EXPLORATION +todo I-EXPLORATION +prepilórico, I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -salud I-EXPLORATION -en I-EXPLORATION +mucosa I-EXPLORATION +duodenal I-EXPLORATION +mostraban, I-EXPLORATION +de I-EXPLORATION forma I-EXPLORATION +difusa, I-EXPLORATION +nódulos I-EXPLORATION de I-EXPLORATION -hipocondría, I-EXPLORATION -que I-EXPLORATION -daría I-EXPLORATION -finalmente I-EXPLORATION -lugar I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -manifestaciones I-EXPLORATION -histéricas I-EXPLORATION -a I-EXPLORATION -modo I-EXPLORATION +pequeño I-EXPLORATION +tamaño. I-EXPLORATION + I-EXPLORATION +• I-EXPLORATION +Radiología I-EXPLORATION +del I-EXPLORATION +tórax: I-EXPLORATION +bullas I-EXPLORATION +enfisematosas I-EXPLORATION +en I-EXPLORATION +base I-EXPLORATION +pulmonar I-EXPLORATION +derecha. I-EXPLORATION +No I-EXPLORATION +derrame I-EXPLORATION +pleural. I-EXPLORATION +Sospecha I-EXPLORATION de I-EXPLORATION -quejas I-EXPLORATION -somáticas I-EXPLORATION -(somatizaciones). I-EXPLORATION +leve I-EXPLORATION +derrame I-EXPLORATION +pericárdico. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -decide I-EXPLORATION -corroborar I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -mediante I-EXPLORATION -sesión I-EXPLORATION -programada I-EXPLORATION +• I-EXPLORATION +Radiología I-EXPLORATION +baritada I-EXPLORATION de I-EXPLORATION -hipnosis, I-EXPLORATION -previo I-EXPLORATION -consentimiento I-EXPLORATION +esófago, I-EXPLORATION +estómago I-EXPLORATION +e I-EXPLORATION +intestino I-EXPLORATION +delgado: I-EXPLORATION +pliegues I-EXPLORATION +gástricos I-EXPLORATION +antrales I-EXPLORATION +engrosados, I-EXPLORATION +irregulares I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +defectos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -interesada, I-EXPLORATION +repleción. I-EXPLORATION +Engrosamiento I-EXPLORATION +de I-EXPLORATION +pliegues I-EXPLORATION +de I-EXPLORATION +intestino I-EXPLORATION +delgado, I-EXPLORATION con I-EXPLORATION -el I-EXPLORATION -objetivo I-EXPLORATION +patrón I-EXPLORATION +nodular, I-EXPLORATION +sobre I-EXPLORATION +todo I-EXPLORATION +en I-EXPLORATION +yeyuno, I-EXPLORATION +y I-EXPLORATION +dilución I-EXPLORATION +del I-EXPLORATION +contraste. I-EXPLORATION + I-EXPLORATION +• I-EXPLORATION +Enema I-EXPLORATION +opaco: I-EXPLORATION +divertículos I-EXPLORATION +en I-EXPLORATION +colon I-EXPLORATION +sigmoideo I-EXPLORATION +y I-EXPLORATION +descendente. I-EXPLORATION +Múltiples I-EXPLORATION +defectos I-EXPLORATION de I-EXPLORATION -conseguir I-EXPLORATION +repleción I-EXPLORATION +en I-EXPLORATION +toda I-EXPLORATION la I-EXPLORATION -flexión I-EXPLORATION +extensión I-EXPLORATION +del I-EXPLORATION +colon. I-EXPLORATION + I-EXPLORATION +• I-EXPLORATION +Tomografía I-EXPLORATION +computarizada I-EXPLORATION +abdominal: I-EXPLORATION +quistes I-EXPLORATION +en I-EXPLORATION +riñón I-EXPLORATION +izquierdo. I-EXPLORATION +Probable I-EXPLORATION +adenoma I-EXPLORATION +suprarrenal I-EXPLORATION +derecho. I-EXPLORATION +Divertículos I-EXPLORATION +en I-EXPLORATION +colon I-EXPLORATION +descendente I-EXPLORATION +y I-EXPLORATION +sigmoides. I-EXPLORATION +Engrosamiento I-EXPLORATION +difuso I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -rodilla I-EXPLORATION -anquilosada. I-EXPLORATION - I-EXPLORATION -Método: I-EXPLORATION +pared I-EXPLORATION +del I-EXPLORATION +colon. I-EXPLORATION +Hipertrofia I-EXPLORATION +prostática. I-EXPLORATION I-EXPLORATION -El I-EXPLORATION -proceso I-EXPLORATION -hipnótico I-EXPLORATION -se I-EXPLORATION -desarrolla I-EXPLORATION +• I-EXPLORATION +Ecografía I-EXPLORATION +tiroidea: I-EXPLORATION +tiroides I-EXPLORATION +de I-EXPLORATION +tamaño I-EXPLORATION +normal. I-EXPLORATION +Pequeños I-EXPLORATION +quistes I-EXPLORATION en I-EXPLORATION -las I-EXPLORATION -propias I-EXPLORATION -dependencias I-EXPLORATION -del I-EXPLORATION -Instituto I-EXPLORATION +lóbulo I-EXPLORATION +derecho. I-EXPLORATION +Lóbulo I-EXPLORATION +izquierdo I-EXPLORATION +con I-EXPLORATION +ecogenicidad I-EXPLORATION +homogénea I-EXPLORATION +y I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +• I-EXPLORATION +Ecocardiograma I-EXPLORATION +transtorácico: I-EXPLORATION +no I-EXPLORATION +derrame I-EXPLORATION +pericárdico, I-EXPLORATION +función I-EXPLORATION +sistólica I-EXPLORATION +conservada, I-EXPLORATION +insuficiencia I-EXPLORATION +valvular I-EXPLORATION +mitral I-EXPLORATION +y I-EXPLORATION +aórtica. I-EXPLORATION + I-EXPLORATION +• I-EXPLORATION +Histología I-EXPLORATION de I-EXPLORATION -Medicina I-EXPLORATION -Legal I-EXPLORATION +biopsias I-EXPLORATION de I-EXPLORATION -Huelva, I-EXPLORATION -previa I-EXPLORATION -sesión I-EXPLORATION -preparatoria I-EXPLORATION -en I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -explican I-EXPLORATION -las I-EXPLORATION -bases I-EXPLORATION -del I-EXPLORATION -mismo I-EXPLORATION +colon I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -trata I-EXPLORATION +macrobiopsia I-EXPLORATION +rectal: I-EXPLORATION +mucosa I-EXPLORATION +con I-EXPLORATION +distorsión I-EXPLORATION +intensa I-EXPLORATION de I-EXPLORATION -conseguir I-EXPLORATION -un I-EXPLORATION -adecuado I-EXPLORATION -vínculo I-EXPLORATION -explorador-explorada, I-EXPLORATION -estando I-EXPLORATION -presentes I-EXPLORATION -durante I-EXPLORATION -su I-EXPLORATION -desarrollo I-EXPLORATION -tanto I-EXPLORATION -el I-EXPLORATION -Médico I-EXPLORATION -Forense I-EXPLORATION -como I-EXPLORATION -el I-EXPLORATION -Psicólogo I-EXPLORATION -Forense I-EXPLORATION -encargado I-EXPLORATION +la I-EXPLORATION +arquitectura I-EXPLORATION +glandular, I-EXPLORATION +dilataciones I-EXPLORATION +glandulares I-EXPLORATION +microquísticas I-EXPLORATION +y I-EXPLORATION +colecciones I-EXPLORATION de I-EXPLORATION -llevarlo I-EXPLORATION -a I-EXPLORATION -cabo. I-EXPLORATION -Para I-EXPLORATION -ello I-EXPLORATION -se I-EXPLORATION -coloca I-EXPLORATION +mucina, I-EXPLORATION +lámina I-EXPLORATION +propia I-EXPLORATION +edematosa I-EXPLORATION +con I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION +moderado I-EXPLORATION a I-EXPLORATION +severo I-EXPLORATION +con I-EXPLORATION +abundantes I-EXPLORATION +células I-EXPLORATION +plasmáticas, I-EXPLORATION +neutrófilos I-EXPLORATION +y I-EXPLORATION +eosinófilos. I-EXPLORATION +Las I-EXPLORATION +alteraciones I-EXPLORATION +detectadas I-EXPLORATION +son I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION la I-EXPLORATION -Sra. I-EXPLORATION -A I-EXPLORATION -en I-EXPLORATION -posición I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -decúbito I-EXPLORATION -supino, I-EXPLORATION -sobre I-EXPLORATION -una I-EXPLORATION -camilla I-EXPLORATION -estándar I-EXPLORATION +hamartomas I-EXPLORATION de I-EXPLORATION -consulta, I-EXPLORATION -cuya I-EXPLORATION -base I-EXPLORATION -basculante I-EXPLORATION -fue I-EXPLORATION -recogida, I-EXPLORATION +colon I-EXPLORATION +y I-EXPLORATION +recto. I-EXPLORATION + I-EXPLORATION +• I-EXPLORATION +Histología I-EXPLORATION de I-EXPLORATION -manera I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -rodilla I-EXPLORATION -sana I-EXPLORATION -cayera I-EXPLORATION -en I-EXPLORATION -flexión I-EXPLORATION -por I-EXPLORATION +biopsias I-EXPLORATION +gástricas I-EXPLORATION +y I-EXPLORATION +duodenales: I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +dilataciones I-EXPLORATION +glandulares I-EXPLORATION +e I-EXPLORATION +intenso I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION +mixto, I-EXPLORATION +siendo I-EXPLORATION el I-EXPLORATION -efecto I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +hamartomas I-EXPLORATION +de I-EXPLORATION +estómago I-EXPLORATION +y I-EXPLORATION +duodeno. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Evolución B-EVOLUTION +cl��nica: I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +es I-EVOLUTION +diagnosticado I-EVOLUTION +de I-EVOLUTION +síndrome I-EVOLUTION +de I-EVOLUTION +Cronkhite-Canadá, I-EVOLUTION +falleciendo I-EVOLUTION +tras I-EVOLUTION +dos I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +ingreso I-EVOLUTION +hospitalario I-EVOLUTION +sin I-EVOLUTION +detectarse I-EVOLUTION +en I-EVOLUTION +ningún I-EVOLUTION +momento I-EVOLUTION +una I-EVOLUTION +mejoría I-EVOLUTION +evidente I-EVOLUTION +del I-EVOLUTION +cuadro I-EVOLUTION +clínico I-EVOLUTION +inicial. I-EVOLUTION +Mantuvo I-EVOLUTION +el I-EVOLUTION +estado I-EVOLUTION +de I-EVOLUTION +astenia I-EVOLUTION +y I-EVOLUTION +anorexia, I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +número I-EVOLUTION +variable I-EVOLUTION +de I-EVOLUTION +deposiciones I-EVOLUTION +con I-EVOLUTION +abundante I-EVOLUTION +contenido I-EVOLUTION +mucoso, I-EVOLUTION +mayor I-EVOLUTION +pérdida I-EVOLUTION +de I-EVOLUTION +peso I-EVOLUTION +y I-EVOLUTION +persistencia I-EVOLUTION +de I-EVOLUTION +hipoproteinemia I-EVOLUTION +con I-EVOLUTION +edemas I-EVOLUTION +en I-EVOLUTION +miembros I-EVOLUTION +inferiores. I-EVOLUTION +Presencia I-EVOLUTION +de I-EVOLUTION +fiebre I-EVOLUTION +(38 I-EVOLUTION +oC) I-EVOLUTION +en I-EVOLUTION +días I-EVOLUTION +aislados I-EVOLUTION +con I-EVOLUTION +hemocultivos I-EVOLUTION +positivos I-EVOLUTION +a I-EVOLUTION +E. I-EVOLUTION +coli I-EVOLUTION +atribuible I-EVOLUTION +a I-EVOLUTION +flebitis I-EVOLUTION +e I-EVOLUTION +infecciones I-EVOLUTION +urinarias, I-EVOLUTION +un I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +tetania I-EVOLUTION +hipocalcémica, I-EVOLUTION +dolor I-EVOLUTION +en I-EVOLUTION +miembros I-EVOLUTION +inferiores I-EVOLUTION +de I-EVOLUTION +probable I-EVOLUTION +origen I-EVOLUTION +neuropático I-EVOLUTION +y I-EVOLUTION +lesiones I-EVOLUTION +ungueales I-EVOLUTION +con I-EVOLUTION +onicólisis I-EVOLUTION +muy I-EVOLUTION +evidente. I-EVOLUTION +Es I-EVOLUTION +destacable I-EVOLUTION +el I-EVOLUTION +desarrollo I-EVOLUTION +de I-EVOLUTION +hipotiroidismo I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +elevación I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +cifras I-EVOLUTION +de I-EVOLUTION +antígeno I-EVOLUTION +carcinoembrionario. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +fallece I-EVOLUTION +tras I-EVOLUTION +presentar, I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +últimas I-EVOLUTION +24 I-EVOLUTION +horas, I-EVOLUTION +fiebre, I-EVOLUTION +tos I-EVOLUTION +con I-EVOLUTION +expectoración I-EVOLUTION +hemoptoica, I-EVOLUTION +disnea, I-EVOLUTION +datos I-EVOLUTION +de I-EVOLUTION +insuficiencia I-EVOLUTION +respiratoria I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +gasometría I-EVOLUTION +arterial I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +neumonía I-EVOLUTION +de I-EVOLUTION +base I-EVOLUTION +izquierda I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +radiología I-EVOLUTION +de I-EVOLUTION +tórax. I-EVOLUTION +Se B-EXPLORATION +practicó I-EXPLORATION +necropsia. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Tratamientos: B-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +durante I-TREATMENT +su I-TREATMENT +prolongada I-TREATMENT +estancia I-TREATMENT +hospitalaria I-TREATMENT +recibió I-TREATMENT +tratamiento, I-TREATMENT +no I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +simultánea, I-TREATMENT +con: I-TREATMENT +nutrición I-TREATMENT +enteral I-TREATMENT +oral I-TREATMENT +y I-TREATMENT +por I-TREATMENT +sonda, I-TREATMENT +sueroterapia I-TREATMENT +con I-TREATMENT +aporte I-TREATMENT +de I-TREATMENT +cloruro I-TREATMENT +potásico, I-TREATMENT +calcio I-TREATMENT +oral I-TREATMENT +y I-TREATMENT +sistémico, I-TREATMENT +albúmina I-TREATMENT +intravenosa, I-TREATMENT +omeprazol I-TREATMENT +20 I-TREATMENT +mg/día, I-TREATMENT +mesalazina, I-TREATMENT +complejos I-TREATMENT +vitamínicos, I-TREATMENT +loratadina I-TREATMENT +10 I-TREATMENT +mg/día, I-TREATMENT +corticoides I-TREATMENT +orales I-TREATMENT +y I-TREATMENT +sistémicos, I-TREATMENT +loperamida, I-TREATMENT +octeótrida I-TREATMENT +subcutánea I-TREATMENT +50 I-TREATMENT +mcg/8 I-TREATMENT +h, I-TREATMENT +gabapentina I-TREATMENT +300 I-TREATMENT +mg/8 I-TREATMENT +h, I-TREATMENT +antibióticos I-TREATMENT +(piperacilina-tazobactam, I-TREATMENT +amoxicilina-clavulámico, I-TREATMENT +metronidazol I-TREATMENT +y I-TREATMENT +ciprofloxacino), I-TREATMENT +levotiroxina I-TREATMENT +y I-TREATMENT +medicación I-TREATMENT +para I-TREATMENT +su I-TREATMENT +patología I-TREATMENT +previas: I-TREATMENT +hipertensión I-TREATMENT +arterial, I-TREATMENT +broncopatía I-TREATMENT +crónica I-TREATMENT +e I-TREATMENT +hipertrofia I-TREATMENT +prostática. I-TREATMENT + I-TREATMENT +- B-EXPLORATION +Informe I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -gravedad, I-EXPLORATION -quedando I-EXPLORATION -la I-EXPLORATION -rodilla I-EXPLORATION -izquierda I-EXPLORATION +necropsia: I-EXPLORATION +los I-EXPLORATION +hallazgos I-EXPLORATION +autópsicos I-EXPLORATION +resultan I-EXPLORATION +concordantes I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +síndrome I-EXPLORATION +de I-EXPLORATION +Cronkhite-Canadá. I-EXPLORATION + I-EXPLORATION +- I-EXPLORATION +Examen I-EXPLORATION +externo: I-EXPLORATION +disminución I-EXPLORATION +del I-EXPLORATION +vello I-EXPLORATION +corporal I-EXPLORATION +y I-EXPLORATION +máculas I-EXPLORATION +de I-EXPLORATION +coloración I-EXPLORATION +pardo-oscuras I-EXPLORATION en I-EXPLORATION -extensión I-EXPLORATION -completa I-EXPLORATION +miembros I-EXPLORATION +superiores, I-EXPLORATION +especialmente I-EXPLORATION +en I-EXPLORATION +cara I-EXPLORATION +dorsal I-EXPLORATION +de I-EXPLORATION +mano I-EXPLORATION +derecha I-EXPLORATION y I-EXPLORATION -sobresaliendo I-EXPLORATION +anterior I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -límites I-EXPLORATION +antebrazo I-EXPLORATION +izquierdo. I-EXPLORATION +Los I-EXPLORATION +dedos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -camilla. I-EXPLORATION +ambas I-EXPLORATION +manos I-EXPLORATION +presentan I-EXPLORATION +onicólisis I-EXPLORATION +con I-EXPLORATION +coloración I-EXPLORATION +ungueal I-EXPLORATION +blanquecino-amarillenta. I-EXPLORATION +Hidrocele I-EXPLORATION +bilateral. I-EXPLORATION +Edemas I-EXPLORATION +en I-EXPLORATION +miembros I-EXPLORATION +inferiores. I-EXPLORATION I-EXPLORATION -El I-EXPLORATION -proceso I-EXPLORATION +-Examen I-EXPLORATION +interno: I-EXPLORATION +derrame I-EXPLORATION +pericárdico, I-EXPLORATION +pleural I-EXPLORATION +y I-EXPLORATION +peritoneal. I-EXPLORATION +Hipotrofia I-EXPLORATION +tiroides. I-EXPLORATION +Enfisema I-EXPLORATION +pulmonar I-EXPLORATION +y I-EXPLORATION +neumonía I-EXPLORATION +pulmón I-EXPLORATION +izquierdo. I-EXPLORATION +Hiperplasia I-EXPLORATION +nodular I-EXPLORATION +suprarrenal I-EXPLORATION +bilateral. I-EXPLORATION +Arterioesclerosis I-EXPLORATION +moderada. I-EXPLORATION +Adenocarcinoma I-EXPLORATION +de I-EXPLORATION +próstata I-EXPLORATION +localizado I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +lóbulos I-EXPLORATION +sin I-EXPLORATION +afectación I-EXPLORATION +extracapsular I-EXPLORATION +ni I-EXPLORATION +metástasica. I-EXPLORATION +Atrofia I-EXPLORATION +testicular. I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -desarrolló I-EXPLORATION -bajo I-EXPLORATION +detectan I-EXPLORATION +alteraciones I-EXPLORATION +destacables I-EXPLORATION +en I-EXPLORATION +hígado, I-EXPLORATION +vías I-EXPLORATION +biliares I-EXPLORATION +o I-EXPLORATION +páncreas. I-EXPLORATION +Estudio I-EXPLORATION +del I-EXPLORATION +tubo I-EXPLORATION +digestivo: I-EXPLORATION +esófago I-EXPLORATION +sin I-EXPLORATION +datos I-EXPLORATION +de I-EXPLORATION +interés. I-EXPLORATION +El I-EXPLORATION +cuerpo I-EXPLORATION +gástrico I-EXPLORATION +muestra I-EXPLORATION +disminución I-EXPLORATION +de I-EXPLORATION +pliegues. I-EXPLORATION +El I-EXPLORATION +antro I-EXPLORATION +gástrico I-EXPLORATION +muestra I-EXPLORATION una I-EXPLORATION -atmósfera I-EXPLORATION -empática I-EXPLORATION -y I-EXPLORATION -relajada, I-EXPLORATION +superficie I-EXPLORATION +rugosa, I-EXPLORATION +"en I-EXPLORATION +empedrado", I-EXPLORATION con I-EXPLORATION -una I-EXPLORATION -buena I-EXPLORATION -predisposición I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -colaboración I-EXPLORATION -por I-EXPLORATION -parte I-EXPLORATION +engrosamienro I-EXPLORATION +nodular I-EXPLORATION de I-EXPLORATION +los I-EXPLORATION +pliegues I-EXPLORATION +y I-EXPLORATION +equimosis I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -paciente. I-EXPLORATION -La I-EXPLORATION -inducción I-EXPLORATION -hipnótica I-EXPLORATION -se I-EXPLORATION -inició I-EXPLORATION -a I-EXPLORATION -partir I-EXPLORATION -de I-EXPLORATION -instrucciones I-EXPLORATION -dirigidas I-EXPLORATION -a I-EXPLORATION -favorecer I-EXPLORATION +superficie, I-EXPLORATION +persistiendo I-EXPLORATION +estas I-EXPLORATION +alteraciones I-EXPLORATION +hasta I-EXPLORATION +segunda I-EXPLORATION +porción I-EXPLORATION +duodenal, I-EXPLORATION +donde I-EXPLORATION +es I-EXPLORATION +más I-EXPLORATION +evidente I-EXPLORATION la I-EXPLORATION -relajación I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +pólipos I-EXPLORATION +sésiles. I-EXPLORATION +En I-EXPLORATION +yeyuno I-EXPLORATION +e I-EXPLORATION +íleon I-EXPLORATION +no I-EXPLORATION +aparecen I-EXPLORATION +alteraciones I-EXPLORATION +significativas. I-EXPLORATION +La I-EXPLORATION +mucosa I-EXPLORATION +del I-EXPLORATION +colon I-EXPLORATION +muestra, I-EXPLORATION +en I-EXPLORATION +toda I-EXPLORATION +su I-EXPLORATION +extensión, I-EXPLORATION +una I-EXPLORATION +morfología I-EXPLORATION +polipoidea, I-EXPLORATION +con I-EXPLORATION +múltiples I-EXPLORATION +prominencias I-EXPLORATION +sésiles, I-EXPLORATION de I-EXPLORATION +superficie I-EXPLORATION +equimótica I-EXPLORATION +y I-EXPLORATION +aspecto I-EXPLORATION +friable. I-EXPLORATION +Las I-EXPLORATION +alteraciones I-EXPLORATION +son I-EXPLORATION +menos I-EXPLORATION +evidentes I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +colon I-EXPLORATION +derecho. I-EXPLORATION +Divertículos I-EXPLORATION +en I-EXPLORATION +colon I-EXPLORATION +izquierdo. I-EXPLORATION + I-EXPLORATION +Microscópicamente I-EXPLORATION +lo I-EXPLORATION +más I-EXPLORATION +llamativo I-EXPLORATION +era I-EXPLORATION la I-EXPLORATION -paciente, I-EXPLORATION -empleando I-EXPLORATION -para I-EXPLORATION -ello I-EXPLORATION +afectación I-EXPLORATION +del I-EXPLORATION +antro, I-EXPLORATION +duodeno, I-EXPLORATION +colon I-EXPLORATION +y I-EXPLORATION +recto I-EXPLORATION +(en I-EXPLORATION +su I-EXPLORATION +totalidad), I-EXPLORATION +que I-EXPLORATION +mostraban I-EXPLORATION una I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -relajación I-EXPLORATION -muscular I-EXPLORATION -(visualización I-EXPLORATION -corporal I-EXPLORATION -o I-EXPLORATION -"imaging"), I-EXPLORATION -seguida I-EXPLORATION +histopatología I-EXPLORATION +similar, I-EXPLORATION +con I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -"instrucciones I-EXPLORATION +múltiples I-EXPLORATION +formaciones I-EXPLORATION +polipoides, I-EXPLORATION +algunos I-EXPLORATION de I-EXPLORATION -imaginación" I-EXPLORATION -(visualización I-EXPLORATION +ellos I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -escalera I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION +tipo I-EXPLORATION +hamartomatoso, I-EXPLORATION +con I-EXPLORATION +criptas I-EXPLORATION +dilatadas I-EXPLORATION +y I-EXPLORATION +quísticas I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -desciende I-EXPLORATION -peldaño I-EXPLORATION -a I-EXPLORATION -peldaño, I-EXPLORATION -acompañando I-EXPLORATION -ésta I-EXPLORATION -del I-EXPLORATION -mensaje I-EXPLORATION -sugestivo I-EXPLORATION -de I-EXPLORATION -"profundización I-EXPLORATION +disminuyen I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -estado I-EXPLORATION -hipnótico") I-EXPLORATION +número I-EXPLORATION y I-EXPLORATION -finalizando I-EXPLORATION -este I-EXPLORATION -primer I-EXPLORATION -estadio I-EXPLORATION +que I-EXPLORATION +presentan I-EXPLORATION +hipersecreción I-EXPLORATION +de I-EXPLORATION +moco. I-EXPLORATION +En I-EXPLORATION +lámina I-EXPLORATION +propia I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +edema I-EXPLORATION con I-EXPLORATION -instrucciones I-EXPLORATION +hiperplasia I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +fibras I-EXPLORATION de I-EXPLORATION -actuación, I-EXPLORATION -en I-EXPLORATION -concreto I-EXPLORATION la I-EXPLORATION +muscularis I-EXPLORATION +mucosa, I-EXPLORATION +e I-EXPLORATION +inflamación I-EXPLORATION +crónica I-EXPLORATION +leve-moderada. I-EXPLORATION +Existe I-EXPLORATION +una I-EXPLORATION +disminución I-EXPLORATION de I-EXPLORATION -"elevación I-EXPLORATION -del I-EXPLORATION -brazo". I-EXPLORATION -Dichas I-EXPLORATION -técnicas I-EXPLORATION -están I-EXPLORATION -encaminadas I-EXPLORATION +las I-EXPLORATION +vellosidades I-EXPLORATION +intestinales I-EXPLORATION tanto I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -mayor I-EXPLORATION -predisposición I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -sugestión I-EXPLORATION +de I-EXPLORATION +duodeno I-EXPLORATION como I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -evaluación I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -misma. I-EXPLORATION -Una I-EXPLORATION -vez I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -Inducción I-EXPLORATION -Hipnótica I-EXPLORATION -ha I-EXPLORATION -logrado I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -focalice I-EXPLORATION -su I-EXPLORATION -atención I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -instrucciones I-EXPLORATION -emitidas I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -psicólogo I-EXPLORATION +colon, I-EXPLORATION y I-EXPLORATION -que I-EXPLORATION -otras I-EXPLORATION -fuentes I-EXPLORATION +una I-EXPLORATION +disminución I-EXPLORATION de I-EXPLORATION -información I-EXPLORATION -pasen I-EXPLORATION -a I-EXPLORATION -ser I-EXPLORATION -secundarias I-EXPLORATION -(ruidos I-EXPLORATION -ambientales, I-EXPLORATION -presencia I-EXPLORATION +los I-EXPLORATION +pliegues I-EXPLORATION +gástricos I-EXPLORATION de I-EXPLORATION -otras I-EXPLORATION -personas, I-EXPLORATION -etcétera), I-EXPLORATION -se I-EXPLORATION -ha I-EXPLORATION -logrado I-EXPLORATION -una I-EXPLORATION -buena I-EXPLORATION -disposición I-EXPLORATION -a I-EXPLORATION -que I-EXPLORATION -las I-EXPLORATION -instrucciones I-EXPLORATION -hipnóticas I-EXPLORATION -cobren I-EXPLORATION -más I-EXPLORATION -relevancia I-EXPLORATION +fondo I-EXPLORATION y I-EXPLORATION +cuerpo. I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -pueda I-EXPLORATION -iniciar I-EXPLORATION -el I-EXPLORATION -trabajo I-EXPLORATION -sugestivo I-EXPLORATION -propuesto. I-EXPLORATION -Logrado I-EXPLORATION -el I-EXPLORATION -estado I-EXPLORATION +reconocen I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -sugestionabilidad I-EXPLORATION -perseguido, I-EXPLORATION +displasia I-EXPLORATION +en I-EXPLORATION +ninguno I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +cortes I-EXPLORATION +examinados. I-EXPLORATION + I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -procedió I-EXPLORATION -a I-EXPLORATION -orientar I-EXPLORATION +detectó I-EXPLORATION +justificación I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION las I-EXPLORATION -sugestiones I-EXPLORATION -hacia I-EXPLORATION -el I-EXPLORATION -síntoma I-EXPLORATION -motor, I-EXPLORATION -ligando I-EXPLORATION -elementos I-EXPLORATION +cifras I-EXPLORATION de I-EXPLORATION -relajación I-EXPLORATION -muscular I-EXPLORATION -con I-EXPLORATION -mensajes I-EXPLORATION +antígeno I-EXPLORATION +carcinoembrionario. I-EXPLORATION + I-EXPLORATION +Causa I-EXPLORATION de I-EXPLORATION -carácter I-EXPLORATION -positivo I-EXPLORATION -centrados I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -flexión I-EXPLORATION +muerte: I-EXPLORATION +malnutrición I-EXPLORATION +grave I-EXPLORATION +secundaria I-EXPLORATION +al I-EXPLORATION +síndrome I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -rodilla I-EXPLORATION -[12, I-EXPLORATION -13]. I-EXPLORATION -Tras B-EVOLUTION -aproximadamente I-EVOLUTION -una I-EVOLUTION -hora I-EVOLUTION -de I-EVOLUTION -proceso, I-EVOLUTION -iniciado I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -técnica I-EVOLUTION -de I-EVOLUTION -relajación I-EVOLUTION -y I-EVOLUTION -finalizado I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -recuperación I-EVOLUTION -del I-EVOLUTION -estado I-EVOLUTION -de I-EVOLUTION -vigilia, I-EVOLUTION -se I-EVOLUTION -acabó I-EVOLUTION -consiguiendo I-EVOLUTION -una I-EVOLUTION -flexión I-EVOLUTION -de I-EVOLUTION -rodilla I-EVOLUTION -izquierda I-EVOLUTION -de I-EVOLUTION -90º, I-EVOLUTION -recuperando I-EVOLUTION -la I-EVOLUTION -posición I-EVOLUTION -anquilótica I-EVOLUTION -inicial I-EVOLUTION -una I-EVOLUTION -vez I-EVOLUTION -concluido. I-EVOLUTION - I-EVOLUTION -Posteriormente I-EVOLUTION -se I-EVOLUTION -realizaron I-EVOLUTION -dos I-EVOLUTION -entrevistas I-EVOLUTION -adicionales I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -Sra. I-EVOLUTION -A, I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -otra I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -cónyuge, I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -fin I-EVOLUTION -de I-EVOLUTION -conocer I-EVOLUTION -mejor I-EVOLUTION -el I-EVOLUTION -entorno I-EVOLUTION -psicobiográfico I-EVOLUTION -y I-EVOLUTION -contextualizar I-EVOLUTION -adecuadamente I-EVOLUTION -el I-EVOLUTION -proceso I-EVOLUTION -psicogénico. I-EVOLUTION - I-EVOLUTION +Cronkhite I-EXPLORATION +Canada. I-EXPLORATION +Neumonía I-EXPLORATION +en I-EXPLORATION +pulmón I-EXPLORATION +izquierdo. I-EXPLORATION + I-EXPLORATION -Niña B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS +66 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +ex-fumadora B-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +bebedora I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +aproximadamente I-PAST_MEDICAL_HISTORY +70 I-PAST_MEDICAL_HISTORY +g I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alcohol I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +día. I-PAST_MEDICAL_HISTORY +Menopausia I-PAST_MEDICAL_HISTORY +precoz I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +estrógenos I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Ingresa B-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +otro I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +hidrotórax I-PRESENT_ILLNESS +derecho. I-PRESENT_ILLNESS +Fue I-PRESENT_ILLNESS +diagnosticada I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -segunda I-PRESENT_ILLNESS -hija I-PRESENT_ILLNESS +hidrotórax I-PRESENT_ILLNESS +hepático I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -hermano I-PRESENT_ILLNESS +biopsia I-PRESENT_ILLNESS +hepática I-PRESENT_ILLNESS +diagnóstica I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -6 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sano, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -derivada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -pediatra I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lenta I-PRESENT_ILLNESS -somatometría I-PRESENT_ILLNESS -(Percentil I-PRESENT_ILLNESS -3), I-PRESENT_ILLNESS -IMC I-PRESENT_ILLNESS +cirrosis I-PRESENT_ILLNESS +macro-micronodular I-PRESENT_ILLNESS +poco I-PRESENT_ILLNESS +evolucionada, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +moderada I-PRESENT_ILLNESS +actividad I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +esteatosis I-PRESENT_ILLNESS +focal. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +estudio I-PRESENT_ILLNESS +viral, I-PRESENT_ILLNESS +metabólico I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +autoinmune I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -14 I-PRESENT_ILLNESS -kg/m2 I-PRESENT_ILLNESS -(desnutrición I-PRESENT_ILLNESS -leve) I-PRESENT_ILLNESS +hepatopatía I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +negativo. I-PRESENT_ILLNESS +Se I-PRESENT_ILLNESS +descartó I-PRESENT_ILLNESS +patología I-PRESENT_ILLNESS +cardiopulmonar I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +causante I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +derrame I-PRESENT_ILLNESS +pleural, I-PRESENT_ILLNESS +así I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +patología I-PRESENT_ILLNESS +infecciosa I-PRESENT_ILLNESS +o I-PRESENT_ILLNESS +tuberculosa I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -rechazo I-PRESENT_ILLNESS +neoplásica I-PRESENT_ILLNESS +pleuropulmonar. I-PRESENT_ILLNESS +Ante I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +falta I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -alimento. I-PRESENT_ILLNESS -A B-EXPLORATION +respuesta I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +restricción I-PRESENT_ILLNESS +hidrosalina I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +diurético, I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +sometida I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +toracocentesis I-PRESENT_ILLNESS +evacuadoras I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +colocación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tubo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tórax I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +alivio I-PRESENT_ILLNESS +sintomático. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Ingresa I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +tarde I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +hidrotórax I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +recidivante. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -inicial I-EXPLORATION +física I-EXPLORATION +destacaba I-EXPLORATION +hipoventilación I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +2/3 I-EXPLORATION +inferiores I-EXPLORATION +del I-EXPLORATION +campo I-EXPLORATION +pulmonar I-EXPLORATION +derecho. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +hemograma I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -desnutrición, I-EXPLORATION -acrocianosis I-EXPLORATION -que I-EXPLORATION -aumentaba I-EXPLORATION +detectó I-EXPLORATION +leucocitosis I-EXPLORATION +de I-EXPLORATION +20.500/µL I-EXPLORATION con I-EXPLORATION -el I-EXPLORATION -llanto, I-EXPLORATION -taquicardia, I-EXPLORATION -ligera I-EXPLORATION -disnea I-EXPLORATION +77% I-EXPLORATION +de I-EXPLORATION +PMN, I-EXPLORATION +sin I-EXPLORATION +anemia I-EXPLORATION +ni I-EXPLORATION +trombopenia. I-EXPLORATION +La I-EXPLORATION +bioquímica I-EXPLORATION +mostraba I-EXPLORATION +una I-EXPLORATION +creatinina I-EXPLORATION +de I-EXPLORATION +1, I-EXPLORATION +9 I-EXPLORATION +mg/dl, I-EXPLORATION +con I-EXPLORATION +sodio I-EXPLORATION +129 I-EXPLORATION +mEq/litro; I-EXPLORATION +potasio I-EXPLORATION +5, I-EXPLORATION +4 I-EXPLORATION +mEq/litro; I-EXPLORATION +proteínas I-EXPLORATION +totales: I-EXPLORATION +5, I-EXPLORATION +68 I-EXPLORATION +g/dl; I-EXPLORATION +albúmina: I-EXPLORATION +2, I-EXPLORATION +44 I-EXPLORATION +g/dl; I-EXPLORATION +GOT: I-EXPLORATION +107 I-EXPLORATION +UI/L; I-EXPLORATION +GPT: I-EXPLORATION +52 I-EXPLORATION +UI/L; I-EXPLORATION +LDH: I-EXPLORATION +157UI/L; I-EXPLORATION +bilirrubina I-EXPLORATION +total I-EXPLORATION +1, I-EXPLORATION +81 I-EXPLORATION +mg/dl; I-EXPLORATION +GGT I-EXPLORATION +370 I-EXPLORATION +UI/L, I-EXPLORATION +F.A. I-EXPLORATION +278 I-EXPLORATION +UI/L; I-EXPLORATION +actividad I-EXPLORATION +de I-EXPLORATION +protrombina I-EXPLORATION +69%; I-EXPLORATION +TTPA I-EXPLORATION +30'', I-EXPLORATION +fibrinógeno I-EXPLORATION +283 I-EXPLORATION +mg/dl. I-EXPLORATION +AFP I-EXPLORATION +6 I-EXPLORATION +ng/ml, I-EXPLORATION +serologías I-EXPLORATION +de I-EXPLORATION +VHB, I-EXPLORATION +VHC, I-EXPLORATION +virus I-EXPLORATION +de I-EXPLORATION +Epstein-Barr I-EXPLORATION y I-EXPLORATION -soplo I-EXPLORATION -pansistólico I-EXPLORATION -II-III I-EXPLORATION -en I-EXPLORATION -varias I-EXPLORATION -localizaciones I-EXPLORATION +sífilis I-EXPLORATION +negativas; I-EXPLORATION +la I-EXPLORATION +bioquímica I-EXPLORATION +del I-EXPLORATION +líquido I-EXPLORATION +pleural I-EXPLORATION a I-EXPLORATION +su I-EXPLORATION +ingreso I-EXPLORATION +era I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +exudado I-EXPLORATION +(proteínas I-EXPLORATION +totales I-EXPLORATION +de I-EXPLORATION +3, I-EXPLORATION +34 I-EXPLORATION +g/dl; I-EXPLORATION +LDH I-EXPLORATION +427 I-EXPLORATION +UI/L; I-EXPLORATION +pH I-EXPLORATION +7, I-EXPLORATION +073, I-EXPLORATION +glucosa I-EXPLORATION +62 I-EXPLORATION +mg/dl; I-EXPLORATION +albúmina I-EXPLORATION +1, I-EXPLORATION +82 I-EXPLORATION +mg/Dl, I-EXPLORATION +leucocitos I-EXPLORATION +648 I-EXPLORATION +cel/mm3 I-EXPLORATION +con I-EXPLORATION +50% I-EXPLORATION +PMN) I-EXPLORATION +con I-EXPLORATION +cultivo I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +Staphylococcus I-EXPLORATION +aureus I-EXPLORATION +coagulasa I-EXPLORATION +positivo I-EXPLORATION +oxacilin I-EXPLORATION +sensible. I-EXPLORATION +Se I-EXPLORATION +descartó I-EXPLORATION +tuberculosis I-EXPLORATION +mediante I-EXPLORATION la I-EXPLORATION -auscultación. I-EXPLORATION -Fue B-TREATMENT -diagnosticada I-TREATMENT +determinación I-EXPLORATION +de I-EXPLORATION +bacilos I-EXPLORATION +ácido-alcohol I-EXPLORATION +resistentes I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +gamma-interferón I-EXPLORATION +en I-EXPLORATION +líquido I-EXPLORATION +pleural I-EXPLORATION +y I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +negatividad I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +reacción I-EXPLORATION +de I-EXPLORATION +Mantoux. I-EXPLORATION +Asímismo I-EXPLORATION +se I-EXPLORATION +descartó I-EXPLORATION +malignidad I-EXPLORATION +mediante I-EXPLORATION +citologías I-EXPLORATION +de I-EXPLORATION +líquido I-EXPLORATION +pleural I-EXPLORATION +y I-EXPLORATION +biopsias I-EXPLORATION +pleurales. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +doppler I-EXPLORATION +abdominal I-EXPLORATION +mostraba I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +hepatopatía I-EXPLORATION +crónica I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +morfológicos I-EXPLORATION +ni I-EXPLORATION +hemodinámicos I-EXPLORATION +de I-EXPLORATION +hipertensión I-EXPLORATION +portal, I-EXPLORATION +con I-EXPLORATION +ascitis I-EXPLORATION +mínima I-EXPLORATION +y I-EXPLORATION +derrame I-EXPLORATION +pleural I-EXPLORATION +derecho. I-EXPLORATION +Tras B-TREATMENT +comprobar I-TREATMENT +que I-TREATMENT +no I-TREATMENT +había I-TREATMENT +respuesta I-TREATMENT +al I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +restricción I-TREATMENT +hidrosalina I-TREATMENT +y I-TREATMENT +diuréticos, I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +la I-TREATMENT +colocación I-TREATMENT de I-TREATMENT -cardiopatía I-TREATMENT -congénita: I-TREATMENT -Transposición I-TREATMENT +un I-TREATMENT +tubo I-TREATMENT +torácico I-TREATMENT +como I-TREATMENT +tratamiento I-TREATMENT +sintomático I-TREATMENT +del I-TREATMENT +hidrotórax I-TREATMENT +drenando I-TREATMENT +2000-2500 I-TREATMENT +cc I-TREATMENT de I-TREATMENT -grandes I-TREATMENT -vasos I-TREATMENT +líquido I-TREATMENT +al I-TREATMENT +día. I-TREATMENT +Como B-EVOLUTION +complicaciones I-EVOLUTION +del I-EVOLUTION +derrame I-EVOLUTION +pleural I-EVOLUTION +presentó I-EVOLUTION +insuficiencia I-EVOLUTION +renal I-EVOLUTION +prerrenal I-EVOLUTION +por I-EVOLUTION +alto I-EVOLUTION +débito I-EVOLUTION +e I-EVOLUTION +hipoproteinemia I-EVOLUTION +con I-EVOLUTION +hipoalbuminemia. I-EVOLUTION +En B-TREATMENT +un I-TREATMENT +intento I-TREATMENT +de I-TREATMENT +controlar I-TREATMENT +la I-TREATMENT +producción I-TREATMENT +de I-TREATMENT +líquido I-TREATMENT +pleural I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +minitoracotomía I-TREATMENT con I-TREATMENT -septum I-TREATMENT -integro I-TREATMENT -(TGV I-TREATMENT +pleurodesis I-TREATMENT con I-TREATMENT -SI), I-TREATMENT -siendo I-TREATMENT -intervenida I-TREATMENT -quirúrgicamente I-TREATMENT +talco I-TREATMENT +que I-TREATMENT +no I-TREATMENT +fue I-TREATMENT +efectiva. I-TREATMENT +Ante I-TREATMENT +el I-TREATMENT +fracaso I-TREATMENT de I-TREATMENT -forma I-TREATMENT -urgente. I-TREATMENT -En I-TREATMENT -primer I-TREATMENT -lugar I-TREATMENT +la I-TREATMENT +pleurodesis I-TREATMENT se I-TREATMENT -procedió I-TREATMENT +decidió I-TREATMENT +colocar I-TREATMENT +una I-TREATMENT +DPPI, I-TREATMENT +tras I-TREATMENT +hallar I-TREATMENT +en I-TREATMENT +las I-TREATMENT +medidas I-TREATMENT +de I-TREATMENT +presión I-TREATMENT +datos I-TREATMENT +de I-TREATMENT +hipertensión I-TREATMENT +portal I-TREATMENT +leve I-TREATMENT +(gradiente I-TREATMENT +de I-TREATMENT +presión I-TREATMENT +enclavamiento-libre: I-TREATMENT +13 I-TREATMENT +mmHg) I-TREATMENT +sugestivo I-TREATMENT +de I-TREATMENT +hidrotórax I-TREATMENT +de I-TREATMENT +origen I-TREATMENT +hepático. I-TREATMENT +Con I-TREATMENT +ello I-TREATMENT +se I-TREATMENT +consiguió I-TREATMENT +un I-TREATMENT +descenso I-TREATMENT +transitorio I-TREATMENT +(2-3 I-TREATMENT +días) I-TREATMENT +del I-TREATMENT +débito I-TREATMENT +torácico. I-TREATMENT +Se B-EXPLORATION +descartó I-EXPLORATION +disfunción I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +DPPI I-EXPLORATION +mediante I-EXPLORATION +eco-doppler. I-EXPLORATION +Se B-TREATMENT +desestimó I-TREATMENT +el I-TREATMENT +trasplante I-TREATMENT +hepático I-TREATMENT +debido I-TREATMENT a I-TREATMENT la I-TREATMENT -ampliación I-TREATMENT -mediante I-TREATMENT -cateterismo I-TREATMENT +ingesta I-TREATMENT +reciente I-TREATMENT +de I-TREATMENT +alcohol. I-TREATMENT +Ante I-TREATMENT +la I-TREATMENT +gravedad I-TREATMENT del I-TREATMENT -foramen I-TREATMENT -oval, I-TREATMENT +cuadro I-TREATMENT y I-TREATMENT -posteriormente I-TREATMENT +la I-TREATMENT +ausencia I-TREATMENT +de I-TREATMENT +otras I-TREATMENT +opciones I-TREATMENT +terapéuticas, I-TREATMENT +quince I-TREATMENT +días I-TREATMENT +más I-TREATMENT +tarde I-TREATMENT se I-TREATMENT -realizó I-TREATMENT -fístula I-TREATMENT -subclavia-pulmonar I-TREATMENT +decidió I-TREATMENT +iniciar I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +octreótido I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +25 I-TREATMENT +µg/h I-TREATMENT +i.v. I-TREATMENT +el I-TREATMENT +primer I-TREATMENT +día, I-TREATMENT +50 I-TREATMENT +el I-TREATMENT +segundo I-TREATMENT y I-TREATMENT -banding I-TREATMENT -en I-TREATMENT -arteria I-TREATMENT -pulmonar. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -fue I-EVOLUTION -desfavorable, I-EVOLUTION -falleciendo I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -UCI I-EVOLUTION +100 I-TREATMENT +durante I-TREATMENT +otros I-TREATMENT +5 I-TREATMENT +días. I-TREATMENT +La I-TREATMENT +paciente I-TREATMENT +presentó I-TREATMENT +muy I-TREATMENT +buena I-TREATMENT +respuesta I-TREATMENT +a I-TREATMENT +dicho I-TREATMENT +tratamiento, I-TREATMENT +con I-TREATMENT +disminución I-TREATMENT +progresiva I-TREATMENT +del I-TREATMENT +débito I-TREATMENT +por I-TREATMENT +el I-TREATMENT +tubo I-TREATMENT +de I-TREATMENT +tórax, I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +permitió I-TREATMENT +la I-TREATMENT +retirada I-TREATMENT +del I-TREATMENT +mismo I-TREATMENT +sin I-TREATMENT +posterior I-TREATMENT +recidiva I-TREATMENT +del I-TREATMENT +derrame I-TREATMENT +pleural. I-TREATMENT +Se I-TREATMENT +pautó I-TREATMENT +una I-TREATMENT +dosis I-TREATMENT +10 I-TREATMENT +mg I-TREATMENT +de I-TREATMENT +octreótido I-TREATMENT +subcutáneo I-TREATMENT +antes I-TREATMENT +del I-TREATMENT +alta. I-TREATMENT +En B-EVOLUTION +los I-EVOLUTION +seis I-EVOLUTION +meses I-EVOLUTION +siguientes, I-EVOLUTION +no I-EVOLUTION +ha I-EVOLUTION +presentado I-EVOLUTION +derrame I-EVOLUTION +pleural I-EVOLUTION +ni I-EVOLUTION +ascitis I-EVOLUTION +bajo I-EVOLUTION +tratamiento I-EVOLUTION +con I-EVOLUTION +dosis I-EVOLUTION de I-EVOLUTION -pediatría I-EVOLUTION -8 I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -ingreso. I-EVOLUTION +25 I-EVOLUTION +mg I-EVOLUTION +de I-EVOLUTION +aldactone I-EVOLUTION +al I-EVOLUTION +día. I-EVOLUTION I-EVOLUTION -Los B-EXPLORATION -padres I-EXPLORATION -solicitaron I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -autopsia I-EXPLORATION -médico-legal I-EXPLORATION -ante I-EXPLORATION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +23 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +artritis. I-PRESENT_ILLNESS +Tres B-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +ingreso I-PAST_MEDICAL_HISTORY +comienza I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +fiebre I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +39º I-PAST_MEDICAL_HISTORY +C I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +carácter I-PAST_MEDICAL_HISTORY +intermitente I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +artralgias I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tumefacción I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +ambos I-PAST_MEDICAL_HISTORY +tobillos, I-PAST_MEDICAL_HISTORY +rodillas, I-PAST_MEDICAL_HISTORY +codos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +muñecas. I-PAST_MEDICAL_HISTORY +A B-EXPLORATION la I-EXPLORATION -sospecha I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -mala I-EXPLORATION -actuación I-EXPLORATION -facultativa. I-EXPLORATION - I-EXPLORATION -Autopsia: I-EXPLORATION - I-EXPLORATION -a) I-EXPLORATION -Examen I-EXPLORATION -Externo I-EXPLORATION - I-EXPLORATION -Peso I-EXPLORATION -de I-EXPLORATION -6440 I-EXPLORATION -g, I-EXPLORATION -talla I-EXPLORATION -de I-EXPLORATION -64 I-EXPLORATION -cm I-EXPLORATION -(IMC: I-EXPLORATION -15.6 I-EXPLORATION -kg/m2), I-EXPLORATION -perímetro I-EXPLORATION -cefálico I-EXPLORATION -de I-EXPLORATION -39.5 I-EXPLORATION -cm, I-EXPLORATION -perímetro I-EXPLORATION -torácico I-EXPLORATION -de I-EXPLORATION -45 I-EXPLORATION -cm I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +destaca I-EXPLORATION +palidez I-EXPLORATION y I-EXPLORATION +discreto I-EXPLORATION +dolor I-EXPLORATION abdominal I-EXPLORATION -de I-EXPLORATION -42 I-EXPLORATION -cm. I-EXPLORATION - I-EXPLORATION -b) I-EXPLORATION -Examen I-EXPLORATION -Interno I-EXPLORATION - I-EXPLORATION -Encéfalo I-EXPLORATION -de I-EXPLORATION -620 I-EXPLORATION -g I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -infarto I-EXPLORATION -cerebral I-EXPLORATION -isquémico I-EXPLORATION -extenso I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -parieto-occipital I-EXPLORATION -izquierdo I-EXPLORATION -correspondiente I-EXPLORATION -al I-EXPLORATION -territorio I-EXPLORATION -de I-EXPLORATION -irrigación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -cerebral I-EXPLORATION -media. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -procedió I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -extracción I-EXPLORATION -y I-EXPLORATION -fijación I-EXPLORATION -del I-EXPLORATION -bloque I-EXPLORATION -cardiopulmonar I-EXPLORATION -para I-EXPLORATION -su I-EXPLORATION -posterior I-EXPLORATION -examen I-EXPLORATION -macroscópico, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -destacaba I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -TGV I-EXPLORATION -intervenida I-EXPLORATION -quirúrgicamente I-EXPLORATION -presentando I-EXPLORATION -un I-EXPLORATION -banding I-EXPLORATION +difuso I-EXPLORATION en I-EXPLORATION -arteria I-EXPLORATION -pulmonar, I-EXPLORATION -una I-EXPLORATION -fístula I-EXPLORATION -entre I-EXPLORATION -subclavia I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -arteria I-EXPLORATION -pulmonar, I-EXPLORATION -y I-EXPLORATION -ampliación I-EXPLORATION -de I-EXPLORATION -comunicación I-EXPLORATION -interauricular I-EXPLORATION -(foramen I-EXPLORATION -oval), I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -hipertrofia I-EXPLORATION -de I-EXPLORATION -ventrículo I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -adelgazamiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo. I-EXPLORATION -Presentaba I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -vez I-EXPLORATION -una I-EXPLORATION -anomalía I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -salida I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -arterias I-EXPLORATION -coronarias, I-EXPLORATION -observándose I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +palpación I-EXPLORATION +profunda. I-EXPLORATION +Datos I-EXPLORATION +analíticos: I-EXPLORATION +Hb I-EXPLORATION +9, I-EXPLORATION +6 I-EXPLORATION +mg/dL; I-EXPLORATION +HTO I-EXPLORATION +31%, I-EXPLORATION +VCM I-EXPLORATION +65 I-EXPLORATION +mm, I-EXPLORATION +660.000 I-EXPLORATION +plaquetas/mL, I-EXPLORATION +ferritina I-EXPLORATION +65 I-EXPLORATION +ng/mL, I-EXPLORATION +Fe I-EXPLORATION +15 I-EXPLORATION +microg/dL, I-EXPLORATION +fibrinógeno I-EXPLORATION +644 I-EXPLORATION +mg/dL, I-EXPLORATION +PCR I-EXPLORATION +55 I-EXPLORATION +mg/dL. I-EXPLORATION +Resto I-EXPLORATION de I-EXPLORATION -dos I-EXPLORATION -ostium I-EXPLORATION -coronarios I-EXPLORATION -que I-EXPLORATION -salían I-EXPLORATION -del I-EXPLORATION -mismo I-EXPLORATION -seno. I-EXPLORATION - I-EXPLORATION +los I-EXPLORATION +estudios I-EXPLORATION +bioquímicos, I-EXPLORATION +serológicos I-EXPLORATION +e I-EXPLORATION +inmunológicos I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +Ecografía I-EXPLORATION +abdominal I-EXPLORATION +sin I-EXPLORATION +alteraciones. I-EXPLORATION En I-EXPLORATION el I-EXPLORATION -examen I-EXPLORATION -histológico I-EXPLORATION -del I-EXPLORATION -corazón I-EXPLORATION +enema I-EXPLORATION +opaco I-EXPLORATION se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -pericarditis I-EXPLORATION -serofibrinosa I-EXPLORATION -y, I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION +objetiva I-EXPLORATION +afectación I-EXPLORATION del I-EXPLORATION -miocardio, I-EXPLORATION -focos I-EXPLORATION -de I-EXPLORATION -necrosis I-EXPLORATION -subendocárdica I-EXPLORATION +colon I-EXPLORATION +sigmoide I-EXPLORATION +hasta I-EXPLORATION +ciego, I-EXPLORATION +observándose I-EXPLORATION +úlceras I-EXPLORATION +transversales I-EXPLORATION +y I-EXPLORATION +longitudinales I-EXPLORATION +del I-EXPLORATION +colon. I-EXPLORATION +La I-EXPLORATION +colonoscopia I-EXPLORATION +demuestra I-EXPLORATION +en I-EXPLORATION +colon I-EXPLORATION +descendente I-EXPLORATION +y I-EXPLORATION +sigmoide, I-EXPLORATION +una I-EXPLORATION +mucosa I-EXPLORATION +eritematosa I-EXPLORATION +y I-EXPLORATION +edematosa, I-EXPLORATION con I-EXPLORATION -calcificación I-EXPLORATION -distrófica I-EXPLORATION -secundarios I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -cirugía. I-EXPLORATION -En I-EXPLORATION +múltiples I-EXPLORATION +ulceraciones I-EXPLORATION +y I-EXPLORATION +pseudopólipos I-EXPLORATION los I-EXPLORATION -pulmones I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -membranas I-EXPLORATION -hialinas I-EXPLORATION -como I-EXPLORATION -signo I-EXPLORATION -de I-EXPLORATION -distrés I-EXPLORATION -respiratorio. I-EXPLORATION -Por I-EXPLORATION -otro I-EXPLORATION -lado, I-EXPLORATION -el I-EXPLORATION -encéfalo I-EXPLORATION -presentaba I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -encefalopatía I-EXPLORATION -anóxica I-EXPLORATION -e I-EXPLORATION -infarto I-EXPLORATION -parietal I-EXPLORATION -reciente. I-EXPLORATION - I-EXPLORATION -Así, I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION +hallazgos I-EXPLORATION +anatomopatológicos I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION -macro I-EXPLORATION -y I-EXPLORATION -microscópicos, I-EXPLORATION -se I-EXPLORATION -determinó I-EXPLORATION -que I-EXPLORATION la I-EXPLORATION -causa I-EXPLORATION -de I-EXPLORATION +biopsia I-EXPLORATION +son I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION la I-EXPLORATION -muerte I-EXPLORATION -fue I-EXPLORATION -un I-EXPLORATION -Infarto I-EXPLORATION -cerebral I-EXPLORATION -isquémico I-EXPLORATION -en I-EXPLORATION -paciente I-EXPLORATION -intervenida I-EXPLORATION -de I-EXPLORATION -Transposición I-EXPLORATION +enfermedad I-EXPLORATION de I-EXPLORATION -grandes I-EXPLORATION -arterias. I-EXPLORATION +Crohn. I-EXPLORATION I-EXPLORATION +Curso B-EVOLUTION +evolutivo: I-EVOLUTION +la I-EVOLUTION +enferma I-EVOLUTION +cursó I-EVOLUTION +posteriormente I-EVOLUTION +con I-EVOLUTION +diarrea I-EVOLUTION +con I-EVOLUTION +2-3 I-EVOLUTION +deposiciones I-EVOLUTION +líquidas I-EVOLUTION +diarias I-EVOLUTION +sin I-EVOLUTION +productos I-EVOLUTION +patológicos I-EVOLUTION +y I-EVOLUTION +lesiones I-EVOLUTION +cutáneas I-EVOLUTION +de I-EVOLUTION +eritema I-EVOLUTION +nodoso. I-EVOLUTION + I-EVOLUTION -Se B-PRESENT_ILLNESS -reporta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS +Niño B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS +13 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -género I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +cuando I-PRESENT_ILLNESS +sufrió I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +esguince I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +tobillo I-PRESENT_ILLNESS +derecho. I-PRESENT_ILLNESS +Fue I-PRESENT_ILLNESS +diagnosticado I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +tratado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS +Traumatología I-PRESENT_ILLNESS +Pediátrica I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +remitido I-PRESENT_ILLNESS a I-PRESENT_ILLNESS la I-PRESENT_ILLNESS unidad I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +inicio I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +cuadro. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Se B-TREATMENT +inició I-TREATMENT +un I-TREATMENT +tratamiento I-TREATMENT +farmacológico I-TREATMENT +(gabapentina I-TREATMENT +más I-TREATMENT +tramadol) I-TREATMENT +con I-TREATMENT +remisión I-TREATMENT +completa I-TREATMENT +del I-TREATMENT +cuadro I-TREATMENT +de I-TREATMENT +dolor I-TREATMENT +que I-TREATMENT +permitió I-TREATMENT +el I-TREATMENT +inicio I-TREATMENT +de I-TREATMENT +la I-TREATMENT +rehabilitación I-TREATMENT +del I-TREATMENT +pie. I-TREATMENT +Continúa B-EVOLUTION +en I-EVOLUTION +igual I-EVOLUTION +situación. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS +31 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +fumadora B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +paquetes/año, I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +anticonceptivos I-PAST_MEDICAL_HISTORY +orales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +intermitente I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +últimos I-PAST_MEDICAL_HISTORY +8 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +1 I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +antes, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +octubre I-PRESENT_ILLNESS de I-PRESENT_ILLNESS +1997 I-PRESENT_ILLNESS un I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tercer I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -sangrado I-PRESENT_ILLNESS -vaginal, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -antecedente I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -previo. I-PRESENT_ILLNESS -No B-PAST_MEDICAL_HISTORY -hay I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -abuso I-PAST_MEDICAL_HISTORY -sexual I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -trauma I-PAST_MEDICAL_HISTORY -genital. I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +ictericia I-PRESENT_ILLNESS +progresiva, I-PRESENT_ILLNESS +náuseas, I-PRESENT_ILLNESS +orinas I-PRESENT_ILLNESS +colúricas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +heces I-PRESENT_ILLNESS +acólicas. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION se I-EXPLORATION evidenció I-EXPLORATION -abundante I-EXPLORATION -sangrado I-EXPLORATION -genital I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -consideraron I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -sus I-EXPLORATION -diagnósticos I-EXPLORATION -diferenciales: I-EXPLORATION -trauma, I-EXPLORATION -abuso I-EXPLORATION -sexual I-EXPLORATION +eritema I-EXPLORATION +palmar I-EXPLORATION +bilateral, I-EXPLORATION +ictericia I-EXPLORATION y I-EXPLORATION -maltrato I-EXPLORATION -infantil, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -caso I-EXPLORATION -es I-EXPLORATION -reportado I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -autoridad, I-EXPLORATION -quienes I-EXPLORATION -por I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -grupo I-EXPLORATION -élite I-EXPLORATION -de I-EXPLORATION -manejo I-EXPLORATION +hepatomegalia. I-EXPLORATION +En I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -delitos I-EXPLORATION -sexuales, I-EXPLORATION -deciden I-EXPLORATION -remitir I-EXPLORATION -para I-EXPLORATION -examen I-EXPLORATION -médico-legal. I-EXPLORATION - I-EXPLORATION -Durante I-EXPLORATION -la I-EXPLORATION -anamnesis, I-EXPLORATION -el I-EXPLORATION -médico I-EXPLORATION -especialista I-EXPLORATION -forense I-EXPLORATION -tomó I-EXPLORATION -toda I-EXPLORATION -la I-EXPLORATION -información I-EXPLORATION -disponible I-EXPLORATION +imagen I-EXPLORATION +(ecografía I-EXPLORATION y I-EXPLORATION -ante I-EXPLORATION -la I-EXPLORATION -información I-EXPLORATION -aportada I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -madre, I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -recalcaba I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -sospechaba I-EXPLORATION +TAC I-EXPLORATION +abdominal) I-EXPLORATION +se I-EXPLORATION +puso I-EXPLORATION de I-EXPLORATION -abuso I-EXPLORATION -sexual, I-EXPLORATION -prosiguió I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -genital, I-EXPLORATION -encontrando I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -menor I-EXPLORATION -presentaba I-EXPLORATION -genitales I-EXPLORATION -femeninos I-EXPLORATION -infantiles I-EXPLORATION -normoconfigurados I-EXPLORATION +manifiesto I-EXPLORATION +una I-EXPLORATION +hepatomegalia I-EXPLORATION +homogénea. I-EXPLORATION +Los I-EXPLORATION +análisis I-EXPLORATION +practicados I-EXPLORATION +demostraron: I-EXPLORATION +GOT I-EXPLORATION +384 I-EXPLORATION +UI/L, I-EXPLORATION +GPT I-EXPLORATION +496 I-EXPLORATION +UI/L, I-EXPLORATION +GGT I-EXPLORATION +78 I-EXPLORATION +UI/L, I-EXPLORATION +FA I-EXPLORATION +553 I-EXPLORATION +UI/L I-EXPLORATION +y I-EXPLORATION +bilirrubina I-EXPLORATION +11, I-EXPLORATION +5 I-EXPLORATION +mg/dl I-EXPLORATION +(directa I-EXPLORATION +4, I-EXPLORATION +8 I-EXPLORATION +mg/dl), I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +hipergammaglobulinemia I-EXPLORATION +policlonal, I-EXPLORATION con I-EXPLORATION -hematoma I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -meridiano I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -12 I-EXPLORATION +3030 I-EXPLORATION +mg/dl I-EXPLORATION de I-EXPLORATION -0.3 I-EXPLORATION -x I-EXPLORATION -0.3 I-EXPLORATION -cm I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -permitía I-EXPLORATION -ver I-EXPLORATION -el I-EXPLORATION -borde I-EXPLORATION -libre I-EXPLORATION -del I-EXPLORATION -himen, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -fue I-EXPLORATION -posible I-EXPLORATION -descartar I-EXPLORATION -desgarros I-EXPLORATION +IgG. I-EXPLORATION +Las I-EXPLORATION +serologías I-EXPLORATION a I-EXPLORATION -éste I-EXPLORATION -nivel, I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -sangrado I-EXPLORATION -reciente I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -vaginal, I-EXPLORATION -pañal I-EXPLORATION +VHA, I-EXPLORATION +VHB I-EXPLORATION y I-EXPLORATION -pantalón. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -otras I-EXPLORATION -lesiones. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -grupo I-EXPLORATION -élite I-EXPLORATION -de I-EXPLORATION -manejo I-EXPLORATION -de I-EXPLORATION -delitos I-EXPLORATION -sexuales I-EXPLORATION -entregó I-EXPLORATION -al I-EXPLORATION -médico I-EXPLORATION -especialista I-EXPLORATION -forense I-EXPLORATION -muestras I-EXPLORATION -que I-EXPLORATION +VHC I-EXPLORATION +resultaron I-EXPLORATION +negativas. I-EXPLORATION +Los I-EXPLORATION +ANA I-EXPLORATION fueron I-EXPLORATION -tomadas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -centro I-EXPLORATION -hospitalario I-EXPLORATION -donde I-EXPLORATION -fue I-EXPLORATION -inicialmente I-EXPLORATION -valorada I-EXPLORATION -la I-EXPLORATION -menor, I-EXPLORATION -muestras I-EXPLORATION -que I-EXPLORATION -ante I-EXPLORATION +negativos. I-EXPLORATION +Los I-EXPLORATION +AMA I-EXPLORATION +resultaron I-EXPLORATION +positivos I-EXPLORATION +(1/1280), I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION los I-EXPLORATION -hallazgos I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -físico, I-EXPLORATION -el I-EXPLORATION -médico I-EXPLORATION -especialista I-EXPLORATION -forense I-EXPLORATION -consideró I-EXPLORATION -pertinente I-EXPLORATION -enviar I-EXPLORATION -al I-EXPLORATION -laboratorio I-EXPLORATION -de I-EXPLORATION -biología I-EXPLORATION -del I-EXPLORATION -Instituto I-EXPLORATION -Nacional I-EXPLORATION -de I-EXPLORATION -Medicina I-EXPLORATION -Legal I-EXPLORATION -y I-EXPLORATION -Ciencias I-EXPLORATION -Forenses I-EXPLORATION -para I-EXPLORATION -búsqueda I-EXPLORATION -de I-EXPLORATION -evidencia I-EXPLORATION -traza I-EXPLORATION -(espermatozoides I-EXPLORATION +ASMA I-EXPLORATION +(1/320), I-EXPLORATION +Anti-LKM1 I-EXPLORATION +(1/640) I-EXPLORATION y I-EXPLORATION -ADN) I-EXPLORATION -bajo I-EXPLORATION -cadena I-EXPLORATION -de I-EXPLORATION -custodia. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -conclusión, I-EXPLORATION -el I-EXPLORATION -médico I-EXPLORATION -especialista I-EXPLORATION -forense I-EXPLORATION -asocia I-EXPLORATION +ANCA I-EXPLORATION +(1/40). I-EXPLORATION +Se I-EXPLORATION +procedió I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -lesión I-EXPLORATION -encontrada I-EXPLORATION -con I-EXPLORATION -trauma I-EXPLORATION -genital I-EXPLORATION -y I-EXPLORATION -describe I-EXPLORATION +realización I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +hepática I-EXPLORATION que I-EXPLORATION -no I-EXPLORATION -es I-EXPLORATION -posible I-EXPLORATION +mostró I-EXPLORATION +leve I-EXPLORATION +distorsión I-EXPLORATION +focal I-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION +bandas I-EXPLORATION +fibrosas I-EXPLORATION +porto-portales I-EXPLORATION +ocasionales, I-EXPLORATION con I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION +linfocitario I-EXPLORATION +en I-EXPLORATION los I-EXPLORATION -hallazgos I-EXPLORATION -determinar I-EXPLORATION -si I-EXPLORATION -es I-EXPLORATION -de I-EXPLORATION -origen I-EXPLORATION -accidental I-EXPLORATION -o I-EXPLORATION -no. I-EXPLORATION - I-EXPLORATION -Posterior B-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -examen I-DERIVED_FROM/TO -médico-legal, I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -menor I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -Infantil, I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -gran I-DERIVED_FROM/TO -experiencia I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -manejo I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -abuso I-DERIVED_FROM/TO -sexual I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -maltrato I-DERIVED_FROM/TO -infantil. I-DERIVED_FROM/TO -El B-EXPLORATION -personal I-EXPLORATION -médico I-EXPLORATION +espacios I-EXPLORATION +porta I-EXPLORATION +formando I-EXPLORATION +folículos I-EXPLORATION +linfoides, I-EXPLORATION +en I-EXPLORATION +ocasiones I-EXPLORATION +alrededor I-EXPLORATION de I-EXPLORATION -dicho I-EXPLORATION -Hospital I-EXPLORATION -solicita I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -valoración I-EXPLORATION -por I-EXPLORATION -otro I-EXPLORATION -médico I-EXPLORATION -especialista I-EXPLORATION -forense, I-EXPLORATION -quien I-EXPLORATION -acude I-EXPLORATION -al I-EXPLORATION -Hospital I-EXPLORATION -para I-EXPLORATION -un I-EXPLORATION -nuevo I-EXPLORATION -examen. I-EXPLORATION +los I-EXPLORATION +ductos I-EXPLORATION +biliares. I-EXPLORATION Dicho I-EXPLORATION -examen I-EXPLORATION -es I-EXPLORATION -realizado I-EXPLORATION -bajo I-EXPLORATION -sedación, I-EXPLORATION -utilizando I-EXPLORATION -lupa I-EXPLORATION -durante I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -genital, I-EXPLORATION -encontrando I-EXPLORATION -que I-EXPLORATION +infiltrado I-EXPLORATION +traspasaba I-EXPLORATION +los I-EXPLORATION +límites I-EXPLORATION +del I-EXPLORATION +espacio I-EXPLORATION +porta, I-EXPLORATION +observándose I-EXPLORATION +necrosis I-EXPLORATION +"piecemeal" I-EXPLORATION +moderada/severa. I-EXPLORATION +Se I-EXPLORATION +apreciaron I-EXPLORATION +hepatocitos I-EXPLORATION +alrededor I-EXPLORATION +del I-EXPLORATION +espacio I-EXPLORATION +porta I-EXPLORATION +con I-EXPLORATION +acúmulo I-EXPLORATION +de I-EXPLORATION +proteína I-EXPLORATION +transportadora I-EXPLORATION +de I-EXPLORATION +cobre, I-EXPLORATION +e I-EXPLORATION +incremento I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -lesión I-EXPLORATION -descrita I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -primer I-EXPLORATION -médico I-EXPLORATION -no I-EXPLORATION -era I-EXPLORATION -más I-EXPLORATION -que I-EXPLORATION -mucosa I-EXPLORATION -uretral I-EXPLORATION -prolapsada, I-EXPLORATION -que I-EXPLORATION -simulaba I-EXPLORATION -un I-EXPLORATION -hematoma I-EXPLORATION +celularidad I-EXPLORATION +inflamatoria I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -meridiano I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -12 I-EXPLORATION -horas. I-EXPLORATION -Se I-EXPLORATION -hace I-EXPLORATION -entonces I-EXPLORATION +lobulillo, I-EXPLORATION +tanto I-EXPLORATION +en I-EXPLORATION +sinusoides I-EXPLORATION +como I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION +parénquima, I-EXPLORATION +con I-EXPLORATION +citolisis I-EXPLORATION +e I-EXPLORATION +incremento I-EXPLORATION de I-EXPLORATION -prolapso I-EXPLORATION -uretral. I-EXPLORATION -La B-EVOLUTION -menor I-EVOLUTION -es I-EVOLUTION -llevada I-EVOLUTION -a I-EVOLUTION -manejo I-EVOLUTION -quirúrgico I-EVOLUTION -con I-EVOLUTION -corrección I-EVOLUTION +la I-EXPLORATION +trama I-EXPLORATION +fibrosa I-EXPLORATION +intersticial. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +30 I-TREATMENT +mg I-TREATMENT +de I-TREATMENT +prednisona I-TREATMENT +con I-TREATMENT +posterior I-TREATMENT +reducción I-TREATMENT +de I-TREATMENT +su I-TREATMENT +dosis, I-TREATMENT +50 I-TREATMENT +mg I-TREATMENT +de I-TREATMENT +azatioprina I-TREATMENT +y I-TREATMENT +ácido I-TREATMENT +ursodesoxicólico. I-TREATMENT +Se B-EVOLUTION +produjo I-EVOLUTION +la I-EVOLUTION +resolución I-EVOLUTION +completa I-EVOLUTION del I-EVOLUTION -prolapso. I-EVOLUTION +cuadro I-EVOLUTION +clínico I-EVOLUTION +con I-EVOLUTION +normalización I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +análisis, I-EVOLUTION +persistiendo I-EVOLUTION +discretamente I-EVOLUTION +elevadas, I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +seis I-EVOLUTION +años I-EVOLUTION +de I-EVOLUTION +evolución, I-EVOLUTION +la I-EVOLUTION +FA I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +GGT. I-EVOLUTION I-EVOLUTION -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -joven I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS +69 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encontraba I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -aguas I-PRESENT_ILLNESS +mayo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -playa I-PRESENT_ILLNESS -Red I-PRESENT_ILLNESS -Frog I-PRESENT_ILLNESS +2011 I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Isla I-PRESENT_ILLNESS -Bastimentos. I-PRESENT_ILLNESS -Los I-PRESENT_ILLNESS -testigos I-PRESENT_ILLNESS -observaron I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -joven I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encontraba I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -mar I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -"pidió I-PRESENT_ILLNESS -ayuda", I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -sumergió I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -volvió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -salir I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -metros I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +presentando I-PRESENT_ILLNESS +edema I-PRESENT_ILLNESS +peneano I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -sumergido I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS y I-PRESENT_ILLNESS +erección I-PRESENT_ILLNESS no I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -volvieron I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -ver. I-PRESENT_ILLNESS +completa I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +horas, I-PRESENT_ILLNESS +hemoglobina I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +sangre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +8, I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +mg/dl I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +140 I-PRESENT_ILLNESS +hematíes I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +campo I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +análisis I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +orina. I-PRESENT_ILLNESS I-PRESENT_ILLNESS +Entre B-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +encuentra I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2001 I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +carcinoma I-PAST_MEDICAL_HISTORY +vesical I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +urotelio I-PAST_MEDICAL_HISTORY +T2b, I-PAST_MEDICAL_HISTORY +G3 I-PAST_MEDICAL_HISTORY +diagnosticado I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +RTU I-PAST_MEDICAL_HISTORY +vesical I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tratado I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +ciclos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +quimioterapia I-PAST_MEDICAL_HISTORY +consistente I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +taxol I-PAST_MEDICAL_HISTORY +245 I-PAST_MEDICAL_HISTORY +mg, I-PAST_MEDICAL_HISTORY +cisplatino I-PAST_MEDICAL_HISTORY +136 I-PAST_MEDICAL_HISTORY +mg, I-PAST_MEDICAL_HISTORY +gemcitabina I-PAST_MEDICAL_HISTORY +1.456 I-PAST_MEDICAL_HISTORY +mg I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +radioterapia I-PAST_MEDICAL_HISTORY +externa I-PAST_MEDICAL_HISTORY +64Gy I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +mitad I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ciclos I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +concluyó I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +remisión I-PAST_MEDICAL_HISTORY +completa I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +2005. I-PAST_MEDICAL_HISTORY +Los I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +sucesivos I-PAST_MEDICAL_HISTORY +presenta I-PAST_MEDICAL_HISTORY +recidivas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tumores I-PAST_MEDICAL_HISTORY +vesicales I-PAST_MEDICAL_HISTORY +superficiales I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +electrocoagulan. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +2008 I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +elevación I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +PSA I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +ng/ml I-PAST_MEDICAL_HISTORY +realizando I-PAST_MEDICAL_HISTORY +biopsia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +próstata I-PAST_MEDICAL_HISTORY +informada I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +adenocarcinoma I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +próstata I-PAST_MEDICAL_HISTORY +3+3, I-PAST_MEDICAL_HISTORY +Gleason I-PAST_MEDICAL_HISTORY +6. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +trató I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +braquiterapia I-PAST_MEDICAL_HISTORY +intersticial I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +semillas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Iodo125 I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2009. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +finales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2010 I-PAST_MEDICAL_HISTORY +refirió I-PAST_MEDICAL_HISTORY +molestias I-PAST_MEDICAL_HISTORY +premiccionales I-PAST_MEDICAL_HISTORY +observando I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +cistoscopia I-PAST_MEDICAL_HISTORY +lesión I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +uretra I-PAST_MEDICAL_HISTORY +prostática. I-PAST_MEDICAL_HISTORY Se B-EXPLORATION -recuperó I-EXPLORATION -el I-EXPLORATION -cadáver I-EXPLORATION -tres I-EXPLORATION -días I-EXPLORATION -después, I-EXPLORATION -en I-EXPLORATION -avanzado I-EXPLORATION -estado I-EXPLORATION +realizó I-EXPLORATION +RTU-biópsica I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +informada I-EXPLORATION +como I-EXPLORATION +infiltración I-EXPLORATION de I-EXPLORATION -descomposición, I-EXPLORATION -sin I-EXPLORATION -prendas I-EXPLORATION +carcinoma I-EXPLORATION de I-EXPLORATION -vestir, I-EXPLORATION +urotelio I-EXPLORATION con I-EXPLORATION -antropofagia I-EXPLORATION -cadavérica I-EXPLORATION +diferenciación I-EXPLORATION +escamosa. I-EXPLORATION +La B-TREATMENT +lesión I-TREATMENT +fue I-TREATMENT +tratada I-TREATMENT +mediante I-TREATMENT +resección I-TREATMENT +y I-TREATMENT +6 I-TREATMENT +ciclos I-TREATMENT +de I-TREATMENT +quimioterapia I-TREATMENT +consistente I-TREATMENT +en I-TREATMENT +gemcitabina I-TREATMENT +3.300 I-TREATMENT +mg I-TREATMENT +(1.750 I-TREATMENT +mg/m2), I-TREATMENT +cisplatino I-TREATMENT +94 I-TREATMENT +mg I-TREATMENT +(50 I-TREATMENT +mg/m2) I-TREATMENT +finalizado I-TREATMENT +en I-TREATMENT +marzo I-TREATMENT +de I-TREATMENT +2011. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +revisión I-EVOLUTION +de I-EVOLUTION +abril I-EVOLUTION +de I-EVOLUTION +2012 I-EVOLUTION +continuaba I-EVOLUTION +con I-EVOLUTION +disminución I-EVOLUTION +del I-EVOLUTION +PSA I-EVOLUTION +hasta I-EVOLUTION +valor I-EVOLUTION +de I-EVOLUTION +0, I-EVOLUTION +6 I-EVOLUTION +ng/ml; I-EVOLUTION +la B-EXPLORATION +cistoscopia I-EXPLORATION +mostraba I-EXPLORATION +un I-EXPLORATION +proceso I-EXPLORATION +inflamatorio-cicatricial I-EXPLORATION a I-EXPLORATION nivel I-EXPLORATION -del I-EXPLORATION -rostro. I-EXPLORATION -Presentaba I-EXPLORATION -ausencia I-EXPLORATION de I-EXPLORATION +uretra I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -porción I-EXPLORATION -anterior I-EXPLORATION +tomografía I-EXPLORATION +por I-EXPLORATION +emisión I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -parrilla I-EXPLORATION -costal I-EXPLORATION -bilateralmente, I-EXPLORATION -también I-EXPLORATION +positrones I-EXPLORATION +(PET/CT). I-EXPLORATION +Se I-EXPLORATION +veían I-EXPLORATION +varias I-EXPLORATION +imágenes I-EXPLORATION +hipermetabólicas, I-EXPLORATION +sugestivas I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION +enfermedad I-EXPLORATION +en I-EXPLORATION pared I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -pélvica I-EXPLORATION -anterior I-EXPLORATION -cubriendo I-EXPLORATION -un I-EXPLORATION -área I-EXPLORATION +lateral I-EXPLORATION +derecha I-EXPLORATION +e I-EXPLORATION +izquierda I-EXPLORATION de I-EXPLORATION -39 I-EXPLORATION -x I-EXPLORATION -22 I-EXPLORATION -cm. I-EXPLORATION -La I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -músculos I-EXPLORATION -presentaban I-EXPLORATION -bordes I-EXPLORATION -desgarrados, I-EXPLORATION -las I-EXPLORATION -costillas I-EXPLORATION -presentaban I-EXPLORATION -fracturas I-EXPLORATION -con I-EXPLORATION -bordes I-EXPLORATION -astillados. I-EXPLORATION -Había I-EXPLORATION -ausencia I-EXPLORATION +vejiga, I-EXPLORATION +infiltración I-EXPLORATION de I-EXPLORATION -todos I-EXPLORATION -los I-EXPLORATION -órganos I-EXPLORATION -internos I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -torácico I-EXPLORATION -y I-EXPLORATION -abdominal I-EXPLORATION -a I-EXPLORATION -excepción I-EXPLORATION -del I-EXPLORATION -tercio I-EXPLORATION -superior I-EXPLORATION -del I-EXPLORATION -esófago I-EXPLORATION +vesícula I-EXPLORATION +seminal I-EXPLORATION y I-EXPLORATION -vías I-EXPLORATION -respiratorias I-EXPLORATION -altas. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -subescapular I-EXPLORATION -bilateral I-EXPLORATION -presentaba I-EXPLORATION -lesiones I-EXPLORATION -contuso-cortantes I-EXPLORATION -(aspecto I-EXPLORATION -de I-EXPLORATION -sierra) I-EXPLORATION +depósito I-EXPLORATION +en I-EXPLORATION +uretra I-EXPLORATION +peneana I-EXPLORATION +englobando I-EXPLORATION +cuerpo I-EXPLORATION +cavernoso I-EXPLORATION +izquierdo, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +afectación I-EXPLORATION +ganglionar. I-EXPLORATION +Se B-TREATMENT +le I-TREATMENT +recomendó I-TREATMENT +tratamiento I-TREATMENT +quimioterápico I-TREATMENT +que I-TREATMENT +no I-TREATMENT +llegó I-TREATMENT +a I-TREATMENT +recibir. I-TREATMENT + I-TREATMENT +Revisada I-TREATMENT +su I-TREATMENT +historia I-TREATMENT +clínica I-TREATMENT +en I-TREATMENT +el I-TREATMENT +servicio I-TREATMENT +de I-TREATMENT +Urgencias I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +el I-TREATMENT +ingreso. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +tratamiento I-TREATMENT +sintomático, I-TREATMENT +transfusión I-TREATMENT +de I-TREATMENT +hemoderivados, I-TREATMENT +tomografía I-TREATMENT +axial I-TREATMENT +computerizada I-TREATMENT +de I-TREATMENT +abdomen I-TREATMENT +(TAC) I-TREATMENT +para I-TREATMENT +re-estadificación I-TREATMENT +y I-TREATMENT +tratamiento I-TREATMENT +quimioterápico I-TREATMENT +de I-TREATMENT +segunda I-TREATMENT +línea I-TREATMENT +mediante I-TREATMENT +vinflunina I-TREATMENT +bitartrato I-TREATMENT +500 I-TREATMENT +mg I-TREATMENT +(280 I-TREATMENT +mg/m2) I-TREATMENT +dosis I-TREATMENT +única. I-TREATMENT + I-TREATMENT +El B-EVOLUTION +edema I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +erección I-EVOLUTION +desaparecieron I-EVOLUTION +y I-EVOLUTION +recibió I-EVOLUTION +el I-EVOLUTION +alta I-EVOLUTION +tras I-EVOLUTION +cinco I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +ingreso. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +falleció I-EVOLUTION +2 I-EVOLUTION +meses I-EVOLUTION +después. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +55 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tabaquismo I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +15 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +EPOC I-PAST_MEDICAL_HISTORY +grado I-PAST_MEDICAL_HISTORY +II. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +mayo I-EXPLORATION de I-EXPLORATION -forma I-EXPLORATION -semiovalada. I-EXPLORATION -Además I-EXPLORATION -presentaba I-EXPLORATION -pérdida I-EXPLORATION +2012 I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +tomografía I-EXPLORATION +computerizada I-EXPLORATION +(TC) I-EXPLORATION de I-EXPLORATION -músculos I-EXPLORATION -del I-EXPLORATION -glúteo I-EXPLORATION -izquierdo I-EXPLORATION +tórax, I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION de I-EXPLORATION -tipo I-EXPLORATION -avulsivo I-EXPLORATION +27 I-EXPLORATION +mm I-EXPLORATION +en I-EXPLORATION +lóbulo I-EXPLORATION +superior I-EXPLORATION +derecho, I-EXPLORATION con I-EXPLORATION -bordes I-EXPLORATION -irregulares I-EXPLORATION -y I-EXPLORATION -pérdida I-EXPLORATION +probable I-EXPLORATION +infiltración I-EXPLORATION de I-EXPLORATION -masa I-EXPLORATION -muscular I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION +primera I-EXPLORATION +costilla. I-EXPLORATION +Fue I-EXPLORATION +diagnosticada I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -cara I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -muslo I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION - -Un B-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -residente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Puerto I-PAST_MEDICAL_HISTORY -Vallarta, I-PAST_MEDICAL_HISTORY -se B-PRESENT_ILLNESS -encontraba I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -pareja I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -interior I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -campo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -golf I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -orilla I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -trampa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -agua, I-PRESENT_ILLNESS -alrededor I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -22: I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -h. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -sujeto I-PRESENT_ILLNESS -ingresó I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -permiso I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -campo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -golf I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -acceso I-PRESENT_ILLNESS -restringido. I-PRESENT_ILLNESS -Según I-PRESENT_ILLNESS -relata I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -víctima, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -pie I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -tocó I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -espejo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -agua I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -trampa I-PRESENT_ILLNESS -(se I-PRESENT_ILLNESS -asume I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -esto I-PRESENT_ILLNESS -ocurrió I-PRESENT_ILLNESS -mientras I-PRESENT_ILLNESS -sostenía I-PRESENT_ILLNESS -coito I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -pareja), I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cocodrilo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -río I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -americano I-PRESENT_ILLNESS -mayor I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -metros I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -largo, I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -sujetó I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -pie. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -cuerpo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -bomberos I-PRESENT_ILLNESS -municipal I-PRESENT_ILLNESS -arribó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -auxilio I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -observó I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cocodrilo I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -mantenía I-PRESENT_ILLNESS -sujeto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -extremidad I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -izquierda, I-PRESENT_ILLNESS -mientras I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -aferraba I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -sus I-PRESENT_ILLNESS -brazos I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -árbol I-PRESENT_ILLNESS -cercano I-PRESENT_ILLNESS -(al I-PRESENT_ILLNESS -menos I-PRESENT_ILLNESS -permaneció I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -par I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -esta I-PRESENT_ILLNESS -situación I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -recibir I-PRESENT_ILLNESS -ayuda). I-PRESENT_ILLNESS -Los I-PRESENT_ILLNESS -bomberos I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -arrojaron I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -cuerda I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -rescatarlo I-PRESENT_ILLNESS -(ya I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -parte I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -cuerpo I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encontraba I-PRESENT_ILLNESS -dentro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -trampa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -agua); I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -embargo, I-PRESENT_ILLNESS -cuando I-PRESENT_ILLNESS -tensaron I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cuerda I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -liberarlo, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cocodrilo I-PRESENT_ILLNESS -realizó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -giro I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -propio I-PRESENT_ILLNESS -cuerpo, I-PRESENT_ILLNESS -conocido I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -"giro I-PRESENT_ILLNESS -mortal", I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -provocó I-PRESENT_ILLNESS -politraumatismo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -pantorrilla I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -fracturas I-PRESENT_ILLNESS -expuestas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -espiral I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -compuesta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tibia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -peroné, I-PRESENT_ILLNESS -conminuta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -astrágalo I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -partes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -conexión I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tejidos I-PRESENT_ILLNESS -blandos, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -laceraciones I-PRESENT_ILLNESS -mayores I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -músculos I-PRESENT_ILLNESS -gastrocnemio, I-PRESENT_ILLNESS -sóleo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tibial I-PRESENT_ILLNESS -anterior. I-PRESENT_ILLNESS -Al B-TREATMENT -rescatarlo I-TREATMENT +un I-EXPLORATION +tumor I-EXPLORATION +de I-EXPLORATION +Pancoast I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +estadiaje I-EXPLORATION +inicial I-EXPLORATION +T4N0M0. I-EXPLORATION +En B-TREATMENT +julio I-TREATMENT +de I-TREATMENT +2012 I-TREATMENT +recibió I-TREATMENT +quimioterapia I-TREATMENT y I-TREATMENT -llevarlo I-TREATMENT -al I-TREATMENT -hospital, I-TREATMENT -los I-TREATMENT -médicos I-TREATMENT -decidieron I-TREATMENT -amputarle I-TREATMENT -la I-TREATMENT -extremidad I-TREATMENT -izquierda I-TREATMENT +radioterapia I-TREATMENT +concomitante. I-TREATMENT +Presentó B-EVOLUTION +una I-EVOLUTION +respuesta I-EVOLUTION +completa I-EVOLUTION +y, B-TREATMENT +en I-TREATMENT +octubre I-TREATMENT +de I-TREATMENT +2012, I-TREATMENT +se I-TREATMENT +le I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +lobectomía I-TREATMENT +superior I-TREATMENT +derecha I-TREATMENT +videotoracoscópica I-TREATMENT +y I-TREATMENT +linfadenectomía. I-TREATMENT +El B-EVOLUTION +postoperatorio I-EVOLUTION +fue I-EVOLUTION +tórpido, I-EVOLUTION +con I-EVOLUTION +shock I-EVOLUTION +séptico I-EVOLUTION +de I-EVOLUTION +origen I-EVOLUTION +respiratorio, I-EVOLUTION +insuficiencia I-EVOLUTION +cardiaca, I-EVOLUTION +fracaso I-EVOLUTION +renal I-EVOLUTION +agudo I-EVOLUTION +y B-TREATMENT +requirió I-TREATMENT +ingreso I-TREATMENT +en I-TREATMENT +UVI I-TREATMENT por I-TREATMENT -debajo I-TREATMENT +insuficiencia I-TREATMENT +respiratoria, I-TREATMENT +precisando I-TREATMENT +nutrición I-TREATMENT +parenteral I-TREATMENT +total I-TREATMENT +(NPT). I-TREATMENT +Allí B-EVOLUTION +permaneció I-EVOLUTION +ingresada I-EVOLUTION +2 I-EVOLUTION +meses, I-EVOLUTION +hasta I-EVOLUTION +que I-EVOLUTION +fue I-EVOLUTION +trasladada I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +planta, I-EVOLUTION +donde I-EVOLUTION +presentó I-EVOLUTION +un I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +abdomen I-EVOLUTION +agudo, I-EVOLUTION +practicándose I-EVOLUTION +una I-EVOLUTION +laparotomía I-EVOLUTION +exploradora. I-EVOLUTION +Tras B-TREATMENT +observarse I-TREATMENT +una I-TREATMENT +ileítis I-TREATMENT +con I-TREATMENT +componente I-TREATMENT +infeccioso I-TREATMENT +y I-TREATMENT +necrótico I-TREATMENT +junto I-TREATMENT +con I-TREATMENT +asas I-TREATMENT +isquémicas I-TREATMENT +y I-TREATMENT +abundante I-TREATMENT +líquido I-TREATMENT +libre I-TREATMENT de I-TREATMENT -la I-TREATMENT -rodilla. I-TREATMENT +aspecto I-TREATMENT +hemático I-TREATMENT +antiguo I-TREATMENT +y I-TREATMENT +fecaloideo, I-TREATMENT +se I-TREATMENT +practicó I-TREATMENT +resección I-TREATMENT +de I-TREATMENT +aproximadamente I-TREATMENT +60 I-TREATMENT +cm I-TREATMENT +de I-TREATMENT +íleon I-TREATMENT +terminal I-TREATMENT +hasta I-TREATMENT +válvula I-TREATMENT +cecal I-TREATMENT +y I-TREATMENT +se I-TREATMENT +dejó I-TREATMENT +ileostomía I-TREATMENT +terminal I-TREATMENT +en I-TREATMENT +fosa I-TREATMENT +ilíaca I-TREATMENT +derecha. I-TREATMENT +Los B-EXPLORATION +cultivos I-EXPLORATION +fueron I-EXPLORATION +positivos I-EXPLORATION +para I-EXPLORATION +estafilococos I-EXPLORATION +y I-EXPLORATION +bacilos I-EXPLORATION +gram I-EXPLORATION +positivos, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +intravenoso I-TREATMENT +empírico I-TREATMENT +con I-TREATMENT +piperacilina-tazobactam I-TREATMENT +4 I-TREATMENT +g I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +horas I-TREATMENT +y I-TREATMENT +vancomicina I-TREATMENT +1 I-TREATMENT +g I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas I-TREATMENT +durante I-TREATMENT +14 I-TREATMENT +días. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +con B-TREATMENT +dieta I-TREATMENT +oral, I-TREATMENT +suplementos I-TREATMENT +hiperproteicos I-TREATMENT +de I-TREATMENT +nutrición I-TREATMENT +enteral I-TREATMENT +y I-TREATMENT +complejo I-TREATMENT +polivitamínico I-TREATMENT +con I-TREATMENT +minerales. I-TREATMENT I-TREATMENT - -Un B-PRESENT_ILLNESS -joven I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -manifestó I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -sido I-PRESENT_ILLNESS -agredido I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cocodrilo. I-PRESENT_ILLNESS -Se I-PRESENT_ILLNESS -encontró I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pie I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -shock I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -01: I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -inmediaciones I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -campo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -golf I-PRESENT_ILLNESS -Marina I-PRESENT_ILLNESS -Vallarta I-PRESENT_ILLNESS -(la I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -está I-PRESENT_ILLNESS -limitada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -cerca I-PRESENT_ILLNESS -perimetral I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -alambre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -púas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tiene I-PRESENT_ILLNESS -letreros I-PRESENT_ILLNESS -informativos I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -prohíben I-PRESENT_ILLNESS -ingresar I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -privada I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -alertan I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -presencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cocodrilos). I-PRESENT_ILLNESS -La B-EXPLORATION -víctima I-EXPLORATION -tenía I-EXPLORATION -amputado I-EXPLORATION +Un B-EVOLUTION +mes I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +alta, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +volvió I-EVOLUTION +a I-EVOLUTION +acudir I-EVOLUTION +al I-EVOLUTION +hospital I-EVOLUTION +por I-EVOLUTION +disnea, I-EVOLUTION +fiebre, I-EVOLUTION +náuseas, I-EVOLUTION +vómitos I-EVOLUTION +alimentarios, I-EVOLUTION +febrícula, I-EVOLUTION +astenia, I-EVOLUTION +hiporexia I-EVOLUTION +y I-EVOLUTION +decaimiento I-EVOLUTION +importantes, I-EVOLUTION +acompañados I-EVOLUTION +de I-EVOLUTION +débito I-EVOLUTION +elevado I-EVOLUTION +por I-EVOLUTION +la I-EVOLUTION +ileostomia I-EVOLUTION +(1.500-2.000 I-EVOLUTION +mL/día). I-EVOLUTION +Se B-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +TC, I-EXPLORATION +observándose I-EXPLORATION +una I-EXPLORATION +colección I-EXPLORATION +postquirúrgica I-EXPLORATION +abundante I-EXPLORATION +en I-EXPLORATION +hemitórax I-EXPLORATION +derecho I-EXPLORATION +con I-EXPLORATION +probable I-EXPLORATION +fístula I-EXPLORATION +broncopleural, I-EXPLORATION +ingresando I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -brazo I-EXPLORATION -izquierdo, I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -altura I-EXPLORATION +Servicio I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -porción I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -húmero. I-EXPLORATION -Fue B-TREATMENT -asistido I-TREATMENT -en I-TREATMENT -primera I-TREATMENT -instancia I-TREATMENT -por I-TREATMENT -elementos I-TREATMENT -de I-TREATMENT -la I-TREATMENT -policía I-TREATMENT -municipal I-TREATMENT -y, I-TREATMENT -posteriormente, I-TREATMENT -recibió I-TREATMENT -atención I-TREATMENT -de I-TREATMENT -socorristas I-TREATMENT -de I-TREATMENT -un I-TREATMENT -hospital I-TREATMENT -privado, I-TREATMENT -quienes I-TREATMENT -le I-TREATMENT -aplicaron I-TREATMENT -sedantes. I-TREATMENT -Se I-TREATMENT -le I-TREATMENT -trasladó I-TREATMENT -al I-TREATMENT -nosocomio, I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -le I-TREATMENT -práctico I-TREATMENT -la I-TREATMENT -amputación I-TREATMENT -total I-TREATMENT -del I-TREATMENT -brazo I-TREATMENT -izquierdo I-TREATMENT +Cirugía I-EXPLORATION +Torácica. I-EXPLORATION +Se B-TREATMENT +sospechó I-TREATMENT +empiema I-TREATMENT y I-TREATMENT se I-TREATMENT -le I-TREATMENT -administró I-TREATMENT -como I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -inicio I-TREATMENT -100 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -Pentamin, I-TREATMENT +colocaron I-TREATMENT +dos I-TREATMENT +drenajes I-TREATMENT +"pigtail". I-TREATMENT +Se I-TREATMENT +inició I-TREATMENT +antibioterapia I-TREATMENT +con I-TREATMENT +piperacilina-tazobactam I-TREATMENT +4 I-TREATMENT +g I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +horas I-TREATMENT +y I-TREATMENT +vancomicina I-TREATMENT 1 I-TREATMENT g I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas I-TREATMENT +a I-TREATMENT +través I-TREATMENT de I-TREATMENT -Amikasina, I-TREATMENT -2 I-TREATMENT -g I-TREATMENT +catéter I-TREATMENT +central I-TREATMENT de I-TREATMENT -Rosephin® I-TREATMENT -y I-TREATMENT -500 I-TREATMENT -mg I-TREATMENT +inserción I-TREATMENT +periférica I-TREATMENT +(PICC) I-TREATMENT +en I-TREATMENT +miembro I-TREATMENT +superior I-TREATMENT +izquierdo. I-TREATMENT +No I-TREATMENT +era I-TREATMENT +posible I-TREATMENT +otro I-TREATMENT +acceso I-TREATMENT +central, I-TREATMENT +ya I-TREATMENT +que I-TREATMENT +presentaba I-TREATMENT +trombosis I-TREATMENT +completa I-TREATMENT de I-TREATMENT -Histaline. I-TREATMENT -Como I-TREATMENT +vena I-TREATMENT +yugular I-TREATMENT +derecha I-TREATMENT +por I-TREATMENT +su I-TREATMENT +larga I-TREATMENT +estancia I-TREATMENT +en I-TREATMENT +la I-TREATMENT +UVI. I-TREATMENT +En B-EXPLORATION +la I-EXPLORATION +bioquímica I-EXPLORATION +general I-EXPLORATION +destacaba I-EXPLORATION +hipocalcemia I-EXPLORATION +(pese I-EXPLORATION +a I-EXPLORATION +tratamiento I-EXPLORATION +con I-EXPLORATION +Natecal® I-EXPLORATION +2 I-EXPLORATION +comprimidos I-EXPLORATION +al I-EXPLORATION +día), I-EXPLORATION +hipopotasemia I-EXPLORATION +e I-EXPLORATION +hipomagnesemia I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +presentaba I-EXPLORATION +previamente. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT tratamiento I-TREATMENT -de I-TREATMENT -mantenimiento, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -aplicó I-TREATMENT -una I-TREATMENT -ámpula I-TREATMENT -de I-TREATMENT -Pantosin I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -h, I-TREATMENT +intravenoso I-TREATMENT +con I-TREATMENT +gluconato I-TREATMENT +cálcico I-TREATMENT 1 I-TREATMENT -g I-TREATMENT -cada I-TREATMENT -24 I-TREATMENT -h I-TREATMENT -vía I-TREATMENT -intravenosa I-TREATMENT +ampolla I-TREATMENT de I-TREATMENT -Amikasina, I-TREATMENT -30 I-TREATMENT -mg I-TREATMENT +10 I-TREATMENT +mL I-TREATMENT +al I-TREATMENT +10% I-TREATMENT cada I-TREATMENT -8 I-TREATMENT -h I-TREATMENT -vía I-TREATMENT -intravenosa I-TREATMENT -de I-TREATMENT -Ketorolaco, I-TREATMENT -una I-TREATMENT -ámpula I-TREATMENT +6 I-TREATMENT +horas, I-TREATMENT +sulfato I-TREATMENT de I-TREATMENT -Pantozol® I-TREATMENT +magnesio I-TREATMENT +2 I-TREATMENT +gramos I-TREATMENT cada I-TREATMENT 24 I-TREATMENT -h I-TREATMENT -vía I-TREATMENT -intravenosa, I-TREATMENT -una I-TREATMENT -ámpula I-TREATMENT +horas I-TREATMENT +y I-TREATMENT +suplementos I-TREATMENT +orales I-TREATMENT de I-TREATMENT -Stadium® I-TREATMENT +potasio I-TREATMENT +(1 I-TREATMENT +Boi-K® I-TREATMENT cada I-TREATMENT 8 I-TREATMENT -h I-TREATMENT -vía I-TREATMENT -intravenosa, I-TREATMENT +horas), I-TREATMENT +calcio I-TREATMENT +(Natecal® I-TREATMENT +2 I-TREATMENT +comprimidos I-TREATMENT +al I-TREATMENT +día) I-TREATMENT +y I-TREATMENT +magnesio I-TREATMENT +(2 I-TREATMENT +comprimidos I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +horas), I-TREATMENT +solicitándose I-TREATMENT +consulta I-TREATMENT +al I-TREATMENT +Servicio I-TREATMENT +de I-TREATMENT +Nutrición. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +continuaba I-EVOLUTION +con I-EVOLUTION +diarrea I-EVOLUTION +líquida I-EVOLUTION +abundante I-EVOLUTION +por I-EVOLUTION +la I-EVOLUTION +ileostomía I-EVOLUTION +(más I-EVOLUTION +de I-EVOLUTION +1500 I-EVOLUTION +mL/día), I-EVOLUTION +refería I-EVOLUTION +anorexia, I-EVOLUTION +astenia, I-EVOLUTION +decaimiento I-EVOLUTION +y I-EVOLUTION +calambres. I-EVOLUTION +Pese I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +suplementacion I-EVOLUTION +oral, I-EVOLUTION +continuaba I-EVOLUTION +con I-EVOLUTION +niveles I-EVOLUTION +indectables I-EVOLUTION +de I-EVOLUTION +magnesio I-EVOLUTION +(< I-EVOLUTION +0, I-EVOLUTION +6 I-EVOLUTION +mg/dL). I-EVOLUTION +Dada B-TREATMENT +la I-TREATMENT +baja I-TREATMENT +ingesta I-TREATMENT +y I-TREATMENT +la I-TREATMENT +mala I-TREATMENT +tolerancia I-TREATMENT +oral I-TREATMENT +a I-TREATMENT +los I-TREATMENT +suplementos I-TREATMENT +de I-TREATMENT +magnesio, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +iniciar I-TREATMENT +nutrición I-TREATMENT +parenteral I-TREATMENT +central I-TREATMENT +por I-TREATMENT +el I-TREATMENT +PICC. I-TREATMENT + I-TREATMENT +Tras I-TREATMENT +la I-TREATMENT +normalización I-TREATMENT +hidroelectrolítica I-TREATMENT +y I-TREATMENT un I-TREATMENT -ámpula I-TREATMENT +correcto I-TREATMENT +aporte I-TREATMENT +nutricional, I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +intervenida I-TREATMENT +para I-TREATMENT +el I-TREATMENT +cierre I-TREATMENT de I-TREATMENT -toxoide I-TREATMENT -tetánico I-TREATMENT +la I-TREATMENT +fístula I-TREATMENT +broncopleural. I-TREATMENT +Una B-EVOLUTION +semana I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +cirugía, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +tomaba I-EVOLUTION +suplementos I-EVOLUTION +nutricionales I-EVOLUTION +y I-EVOLUTION +dieta I-EVOLUTION +por I-EVOLUTION +vía I-EVOLUTION +oral, I-EVOLUTION +mejorando I-EVOLUTION +los I-EVOLUTION +calambres I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +estado I-EVOLUTION +anímico, I-EVOLUTION +sin I-EVOLUTION +necesidad I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION +antidepresivo. I-EVOLUTION +La I-EVOLUTION +hipomagnesemia I-EVOLUTION +aislada I-EVOLUTION +tardó I-EVOLUTION +7 I-EVOLUTION +días I-EVOLUTION +en I-EVOLUTION +recuperarse, I-EVOLUTION +siendo I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +con B-TREATMENT +suplementos I-TREATMENT +nutricionales I-TREATMENT +orales I-TREATMENT y I-TREATMENT -una I-TREATMENT -tableta I-TREATMENT +magnesio I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT de I-TREATMENT -Gabapentina; I-TREATMENT -además I-TREATMENT +1 I-TREATMENT +comprimido I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +horas. I-TREATMENT +Al I-TREATMENT +no I-TREATMENT +normalizarse I-TREATMENT +completamente I-TREATMENT +las I-TREATMENT +cifras I-TREATMENT de I-TREATMENT -solución I-TREATMENT -Hartmann I-TREATMENT +magnesio I-TREATMENT y I-TREATMENT -solución I-TREATMENT -salina I-TREATMENT -0.9% I-TREATMENT -alternadas. I-TREATMENT - I-TREATMENT -La B-PRESENT_ILLNESS -víctima, I-PRESENT_ILLNESS -residente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Guadalajara, I-PRESENT_ILLNESS -Jalisco, I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -entrevistada I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -relató I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -recordar I-PRESENT_ILLNESS -lapsos I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -incidente. I-PRESENT_ILLNESS -Sin I-PRESENT_ILLNESS -embargo, I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -pesar I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -esto I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -declararse I-PRESENT_ILLNESS -también I-PRESENT_ILLNESS -desorientada I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ataque, I-PRESENT_ILLNESS -recuerda I-PRESENT_ILLNESS -encontrarse I-PRESENT_ILLNESS -dentro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -trampas I-PRESENT_ILLNESS +dada I-TREATMENT +la I-TREATMENT +buena I-TREATMENT +tolerancia, I-TREATMENT +se I-TREATMENT +aumentó I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT +a I-TREATMENT +2 I-TREATMENT +comprimidos I-TREATMENT +cada I-TREATMENT +8 I-TREATMENT +horas, I-TREATMENT +consiguiendo B-EVOLUTION +remontar I-EVOLUTION +los I-EVOLUTION +niveles I-EVOLUTION +hasta I-EVOLUTION +límites I-EVOLUTION +dentro I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +normalidad. I-EVOLUTION +Quedaron I-EVOLUTION +descartadas I-EVOLUTION +las I-EVOLUTION +pérdidas I-EVOLUTION +urinarias, I-EVOLUTION +con I-EVOLUTION +unos I-EVOLUTION +niveles I-EVOLUTION +magnesio I-EVOLUTION +en I-EVOLUTION +orina I-EVOLUTION +indetectables I-EVOLUTION +(< I-EVOLUTION +1, I-EVOLUTION +81 I-EVOLUTION +mg/dL), I-EVOLUTION +confirmando I-EVOLUTION +el I-EVOLUTION +diagnóstico I-EVOLUTION +de I-EVOLUTION +malabsorción I-EVOLUTION +intestinal. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -agua I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -campo I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -golf I-PRESENT_ILLNESS -(cercana I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -playa). I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -este I-PRESENT_ILLNESS -espacio, I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -arremetida I-PRESENT_ILLNESS -varias I-PRESENT_ILLNESS -veces I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -mordeduras I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sacudidas I-PRESENT_ILLNESS -(giros) I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cocodrilo I-PRESENT_ILLNESS -(presentó I-PRESENT_ILLNESS -heridas I-PRESENT_ILLNESS -avulsivas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -cara I-PRESENT_ILLNESS -exterior I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -interior I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -muslo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -porción I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -pecho, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -escoriaciones I-PRESENT_ILLNESS -leves I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +vista I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -genitales). I-PRESENT_ILLNESS -Comenta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -joven I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -golpeó I-PRESENT_ILLNESS -repetidamente I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cabeza I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -rocas, I-PRESENT_ILLNESS -además I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sentir I-PRESENT_ILLNESS -cómo I-PRESENT_ILLNESS el I-PRESENT_ILLNESS -reptil I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -sujetaba I-PRESENT_ILLNESS +Hospital I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -pierna, I-PRESENT_ILLNESS -mientras I-PRESENT_ILLNESS -luchaba I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -mantenerse I-PRESENT_ILLNESS -asido I-PRESENT_ILLNESS +Carabineros I-PRESENT_ILLNESS +Santiago, I-PRESENT_ILLNESS +Chile, I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -mano I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -ramas I-PRESENT_ILLNESS -cercanas I-PRESENT_ILLNESS -(no I-PRESENT_ILLNESS -recuerda I-PRESENT_ILLNESS -si I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -ese I-PRESENT_ILLNESS -momento, I-PRESENT_ILLNESS -ya I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -perdido I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -brazo). I-PRESENT_ILLNESS -Una I-PRESENT_ILLNESS -vez I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cocodrilo I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -soltó, I-PRESENT_ILLNESS -logró I-PRESENT_ILLNESS -llegar I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -orilla I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -perdió I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -conocimiento I-PRESENT_ILLNESS +parto I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -ocasiones. I-PRESENT_ILLNESS -Ingresó I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuevo I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -trampa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -agua, I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -llegar I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -edificio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -condominios I-PRESENT_ILLNESS -aledaño I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -campo I-PRESENT_ILLNESS +madre I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -golf I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -asistido I-PRESENT_ILLNESS +28 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -condóminos I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -llegada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -policía I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -socorristas. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS +cesárea. I-PRESENT_ILLNESS +Con B-EXPLORATION +un I-EXPLORATION +peso I-EXPLORATION +de I-EXPLORATION +3.163 I-EXPLORATION +gramos, I-EXPLORATION +talla I-EXPLORATION +49cm I-EXPLORATION +y I-EXPLORATION +perímetro I-EXPLORATION +craneal I-EXPLORATION +cercano I-EXPLORATION +a I-EXPLORATION +35cm. I-EXPLORATION +Al I-EXPLORATION +momento I-EXPLORATION +del I-EXPLORATION +nacimiento I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +lesiones I-EXPLORATION +vesiculosas I-EXPLORATION +en I-EXPLORATION +extremidades I-EXPLORATION +inferiores, I-EXPLORATION +zona I-EXPLORATION +glútea I-EXPLORATION +y I-EXPLORATION +axilas I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +rompen I-EXPLORATION +al I-EXPLORATION +retirar I-EXPLORATION +el I-EXPLORATION +unto I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +piel I-EXPLORATION +quedando I-EXPLORATION +lesiones I-EXPLORATION +eritematosas I-EXPLORATION +y I-EXPLORATION +descamativas. I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +diagnosticó I-EXPLORATION +en I-EXPLORATION +primera I-EXPLORATION +instancia I-EXPLORATION +epidermolisis I-EXPLORATION +bulosa, I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +posteriormente I-EXPLORATION +fue I-EXPLORATION +descartada. I-EXPLORATION +Destacaba I-EXPLORATION +además I-EXPLORATION +zona I-EXPLORATION +de I-EXPLORATION +alopecia I-EXPLORATION +en I-EXPLORATION +vértex I-EXPLORATION +y I-EXPLORATION +paladar I-EXPLORATION +fisurado. I-EXPLORATION + I-EXPLORATION +Se B-DERIVED_FROM/TO +da I-DERIVED_FROM/TO +refiere I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +oftalmología I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +realiza I-DERIVED_FROM/TO +examen I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +fondo I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +ojo I-DERIVED_FROM/TO +observándose I-DERIVED_FROM/TO +epitelio I-DERIVED_FROM/TO +pigmentario I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +poco I-DERIVED_FROM/TO +pigmento I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +forma I-DERIVED_FROM/TO +generalizada, I-DERIVED_FROM/TO +resto I-DERIVED_FROM/TO +normal. I-DERIVED_FROM/TO +Evaluación B-EXPLORATION +por I-EXPLORATION +neurólogo I-EXPLORATION +normal. I-EXPLORATION +Dermatólogo I-EXPLORATION +plantea I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +IP I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +piel I-EXPLORATION +encontrándose I-EXPLORATION +la I-EXPLORATION +muestra I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +limites I-EXPLORATION +histológicos I-EXPLORATION +normales, I-EXPLORATION +pero I-EXPLORATION +se I-EXPLORATION +recomienda I-EXPLORATION +otra I-EXPLORATION +nueva I-EXPLORATION +muestra. I-EXPLORATION +Visto I-EXPLORATION +por I-EXPLORATION +genetista I-EXPLORATION +clínicamente I-EXPLORATION +se I-EXPLORATION +confirma I-EXPLORATION +el I-EXPLORATION +cuadro I-EXPLORATION +de I-EXPLORATION +herencia I-EXPLORATION +ligada I-EXPLORATION +a I-EXPLORATION +X I-EXPLORATION +dominante, I-EXPLORATION +ya B-FAMILY_HISTORY +que I-FAMILY_HISTORY +la I-FAMILY_HISTORY +madre I-FAMILY_HISTORY +presentó I-FAMILY_HISTORY +las I-FAMILY_HISTORY +mismas I-FAMILY_HISTORY +lesiones I-FAMILY_HISTORY +al I-FAMILY_HISTORY +nacimiento. I-FAMILY_HISTORY +Se B-DERIVED_FROM/TO +derivó I-DERIVED_FROM/TO +también I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +unidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +maxilofacial I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +CP. I-DERIVED_FROM/TO +A B-EVOLUTION +los I-EVOLUTION +10 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +edad I-EVOLUTION +fue I-EVOLUTION +operada I-EVOLUTION +de I-EVOLUTION +paladar I-EVOLUTION +fisurado, I-EVOLUTION +reconstituyendo I-EVOLUTION +funcionalmente I-EVOLUTION +los I-EVOLUTION +anillos I-EVOLUTION +musculares I-EVOLUTION +del I-EVOLUTION +velo I-EVOLUTION +palatino I-EVOLUTION +y I-EVOLUTION +evolucionó I-EVOLUTION +sin I-EVOLUTION +presentar I-EVOLUTION +complicaciones I-EVOLUTION +postoperatorias. I-EVOLUTION + I-EVOLUTION -Un B-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -74 I-PRESENT_ILLNESS +25 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -residente B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Puerto I-PAST_MEDICAL_HISTORY -Vallarta, I-PAST_MEDICAL_HISTORY -fue B-PRESENT_ILLNESS -atacado I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cocodrilo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -río I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -8: I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -h I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -junio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2010 I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -orilla I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -estero I-PRESENT_ILLNESS -Boca I-PRESENT_ILLNESS -Negra, I-PRESENT_ILLNESS -mientras I-PRESENT_ILLNESS -realizaba I-PRESENT_ILLNESS -faenas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -pesca I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -atarraya. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -víctima I-PRESENT_ILLNESS -relata I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -observó I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -cocodrilo I-PRESENT_ILLNESS -"saltar" I-PRESENT_ILLNESS -fuera I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -agua I-PRESENT_ILLNESS -y, I-PRESENT_ILLNESS -aunque I-PRESENT_ILLNESS -intentó I-PRESENT_ILLNESS -esquivarlo, I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -atrapado I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -brazo I-PRESENT_ILLNESS -izquierdo. I-PRESENT_ILLNESS -Posteriormente, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -reptil I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -haló I-PRESENT_ILLNESS -hacia I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -agua I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -hundió. I-PRESENT_ILLNESS -Aunque I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hombre I-PRESENT_ILLNESS -logró I-PRESENT_ILLNESS -liberarse, I-PRESENT_ILLNESS -sufrió I-PRESENT_ILLNESS -amputación I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -desgarre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -antebrazo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -músculo I-PRESENT_ILLNESS -braquiorradial I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -tríceps I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cabeza I-PRESENT_ILLNESS -lateral I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tríceps I-PRESENT_ILLNESS -braquial, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -exposición I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -cóndilo I-PRESENT_ILLNESS -humeral I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -articulación I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -fragmento I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -cúbito I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -tuberosidad I-PRESENT_ILLNESS -radial. I-PRESENT_ILLNESS +remitido B-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Cirugía I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +tumoración I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +hipocondrio I-DERIVED_FROM/TO +izquierdo I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +seis I-DERIVED_FROM/TO +meses I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +evolución I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +crecimiento I-DERIVED_FROM/TO +progresivo. I-DERIVED_FROM/TO +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +se I-EXPLORATION +palpaba I-EXPLORATION +gran I-EXPLORATION +masa I-EXPLORATION +en I-EXPLORATION +hipocondrio I-EXPLORATION +izquierdo I-EXPLORATION +de I-EXPLORATION +consistencia I-EXPLORATION +pétrea, I-EXPLORATION +discretamente I-EXPLORATION +dolorosa. I-EXPLORATION +La I-EXPLORATION +analítica I-EXPLORATION +no I-EXPLORATION +aportaba I-EXPLORATION +datos I-EXPLORATION +de I-EXPLORATION +interés. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +TAC I-EXPLORATION +abdominal I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +retroperitoneal I-EXPLORATION +de I-EXPLORATION +aproximadamente I-EXPLORATION +20 I-EXPLORATION +cm I-EXPLORATION +que I-EXPLORATION +desplazaba I-EXPLORATION +hacia I-EXPLORATION +delante I-EXPLORATION +la I-EXPLORATION +cola I-EXPLORATION +del I-EXPLORATION +páncreas. I-EXPLORATION +Radiológicamente I-EXPLORATION +su I-EXPLORATION +estructura I-EXPLORATION +era I-EXPLORATION +compleja, I-EXPLORATION +con I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +necrosis I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +calcificación, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +tumor I-EXPLORATION +de I-EXPLORATION +baja I-EXPLORATION +malignidad. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +esplenopancreatectomía I-TREATMENT +distal I-TREATMENT +con I-TREATMENT +exéresis I-TREATMENT +de I-TREATMENT +la I-TREATMENT +tumoración, I-TREATMENT +que I-TREATMENT +presentaba I-TREATMENT +un I-TREATMENT +diámetro I-TREATMENT +máximo I-TREATMENT +de I-TREATMENT +24 I-TREATMENT +cm, I-TREATMENT +y I-TREATMENT +estaba I-TREATMENT +adherida I-TREATMENT +al I-TREATMENT +hilio I-TREATMENT +esplénico, I-TREATMENT +bazo, I-TREATMENT +epiplon I-TREATMENT +mayor I-TREATMENT +y I-TREATMENT +gastrocólico, I-TREATMENT +sin I-TREATMENT +aparente I-TREATMENT +fijación I-TREATMENT +al I-TREATMENT +páncreas. I-TREATMENT + I-TREATMENT +En B-EXPLORATION +la I-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +se I-EXPLORATION +describió I-EXPLORATION +como I-EXPLORATION +neoplasia I-EXPLORATION +epitelial I-EXPLORATION +papilar I-EXPLORATION +sólida-quística I-EXPLORATION +del I-EXPLORATION +páncreas. I-EXPLORATION +Inmunohistoquímica: I-EXPLORATION +vimentina I-EXPLORATION +positivo; I-EXPLORATION +cromogranina I-EXPLORATION +y I-EXPLORATION +marcadores I-EXPLORATION +epiteliales I-EXPLORATION +negativos. I-EXPLORATION + I-EXPLORATION La B-EVOLUTION -persona I-EVOLUTION +evolución I-EVOLUTION +postoperatoria I-EVOLUTION fue I-EVOLUTION -trasladada I-EVOLUTION -al I-EVOLUTION -hospital I-EVOLUTION -donde I-EVOLUTION -se I-EVOLUTION -recuperó I-EVOLUTION +normal I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presenta I-EVOLUTION +controles I-EVOLUTION +normales I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +cuatro I-EVOLUTION +años I-EVOLUTION de I-EVOLUTION -sus I-EVOLUTION -lesiones. I-EVOLUTION -Cabe B-PRESENT_ILLNESS -destacar I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -víctima I-PRESENT_ILLNESS -manifiesta I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -golpeado I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -ojos I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -cocodrilo I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -lograr I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -liberación. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS +su I-EVOLUTION +intervención. I-EVOLUTION + I-EVOLUTION -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -cadáver I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -36 I-PRESENT_ILLNESS +35 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY +usuaria B-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +drogas I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +vía I-PAST_MEDICAL_HISTORY +parenteral, I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -melanoma I-PAST_MEDICAL_HISTORY +infección I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +VIH I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +VHC I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +seguía I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +antirretroviral I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -coroides I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -ojo I-PAST_MEDICAL_HISTORY -derecho I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -quirúrgicamente I-PAST_MEDICAL_HISTORY -(enucleación) I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -fallecimiento I-PAST_MEDICAL_HISTORY +alta I-PAST_MEDICAL_HISTORY +resolución. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +ocasiones I-PAST_MEDICAL_HISTORY +(hacía I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -que, I-PAST_MEDICAL_HISTORY -posteriormente, I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY +1 I-PAST_MEDICAL_HISTORY +mes), I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +relación I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +consumo I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -hepatectomía I-PAST_MEDICAL_HISTORY -parcial I-PAST_MEDICAL_HISTORY +droga I-PAST_MEDICAL_HISTORY +(heroína), I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +episodios I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +foliculitis I-PAST_MEDICAL_HISTORY +candidiásica I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -cistectomía I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -posibles I-PAST_MEDICAL_HISTORY -metástasis I-PAST_MEDICAL_HISTORY -(un I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -inicial I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -tumor I-PAST_MEDICAL_HISTORY +costocondritis I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -coroides). I-PAST_MEDICAL_HISTORY -Desde I-PAST_MEDICAL_HISTORY -entonces, I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -revisiones I-PAST_MEDICAL_HISTORY -médicas, I-PAST_MEDICAL_HISTORY -según I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -familia, I-PAST_MEDICAL_HISTORY -han I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -normales. I-PAST_MEDICAL_HISTORY -Inesperadamente B-PRESENT_ILLNESS -comienza I-PRESENT_ILLNESS +2º I-PAST_MEDICAL_HISTORY +arco I-PAST_MEDICAL_HISTORY +costal I-PAST_MEDICAL_HISTORY +derecho I-PAST_MEDICAL_HISTORY +respectivamente. I-PAST_MEDICAL_HISTORY +Fue I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +fluconazol I-PAST_MEDICAL_HISTORY +400 I-PAST_MEDICAL_HISTORY +mg/día I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +precisando, I-PAST_MEDICAL_HISTORY +además, I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +resección I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +cartílago I-PAST_MEDICAL_HISTORY +costal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +trayecto I-PAST_MEDICAL_HISTORY +fistuloso. I-PAST_MEDICAL_HISTORY +A B-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ingreso, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +anamnesis, I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +explicaba I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +clínico, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +productiva I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -respiratoria, I-PRESENT_ILLNESS -falleciendo I-PRESENT_ILLNESS +expectoración I-PRESENT_ILLNESS +purulenta, I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +torácico I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -súbita I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -minutos, I-PRESENT_ILLNESS -encontrándose I-PRESENT_ILLNESS -junto I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -cadáver, I-PRESENT_ILLNESS -restos I-PRESENT_ILLNESS +características I-PRESENT_ILLNESS +pleuríticas, I-PRESENT_ILLNESS +adelgazamiento I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +cuantificado I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +localizado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +dorsal I-PRESENT_ILLNESS +bajo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -biliosos. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -externo I-EXPLORATION -destaca I-EXPLORATION -tinte I-EXPLORATION -ictérico I-EXPLORATION -generalizado, I-EXPLORATION -restos I-EXPLORATION -biliosos I-EXPLORATION -que I-EXPLORATION -salen I-EXPLORATION -por I-EXPLORATION +característica I-PRESENT_ILLNESS +mecánicas. I-PRESENT_ILLNESS +A B-EXPLORATION la I-EXPLORATION -fosa I-EXPLORATION -nasal I-EXPLORATION -derecha, I-EXPLORATION -edema I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -miembros I-EXPLORATION -inferiores I-EXPLORATION -(sobre I-EXPLORATION -todo I-EXPLORATION +exploración, I-EXPLORATION +no I-EXPLORATION +impresionaba I-EXPLORATION +de I-EXPLORATION +afectada, I-EXPLORATION +destacando I-EXPLORATION +semiología I-EXPLORATION +de I-EXPLORATION +neumonía I-EXPLORATION en I-EXPLORATION -pie, I-EXPLORATION -antepié I-EXPLORATION +1/3 I-EXPLORATION +inferior I-EXPLORATION +de I-EXPLORATION +hemotórax I-EXPLORATION +izquierdo I-EXPLORATION y I-EXPLORATION -tobillo), I-EXPLORATION -congestión I-EXPLORATION -conjuntival I-EXPLORATION +dolor I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION en I-EXPLORATION -ojo I-EXPLORATION -izquierdo, I-EXPLORATION -prótesis I-EXPLORATION +apófisis I-EXPLORATION +espinosas I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION -derecho, I-EXPLORATION -abdomen I-EXPLORATION -globuloso I-EXPLORATION -con I-EXPLORATION -protusión I-EXPLORATION -umbilical, I-EXPLORATION -cicatrices I-EXPLORATION -quirúrgicas I-EXPLORATION -antiguas I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -subcostal I-EXPLORATION +última I-EXPLORATION +vértebra I-EXPLORATION +dorsal I-EXPLORATION y I-EXPLORATION -flanco I-EXPLORATION -abdominal I-EXPLORATION -derechos. I-EXPLORATION +primeras I-EXPLORATION +lumbares. I-EXPLORATION I-EXPLORATION En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -interno I-EXPLORATION -apreciamos I-EXPLORATION -una I-EXPLORATION -nodulación I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION -encefálica I-EXPLORATION -frontal I-EXPLORATION -derecha, I-EXPLORATION -que I-EXPLORATION -penetra I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -sustancia I-EXPLORATION -blanca I-EXPLORATION +los I-EXPLORATION +datos I-EXPLORATION +complementarios: I-EXPLORATION +leucocitos I-EXPLORATION +11.800 I-EXPLORATION +(67%N), I-EXPLORATION +hemoglobina I-EXPLORATION +10, I-EXPLORATION +6, I-EXPLORATION +hematocrito I-EXPLORATION +34, I-EXPLORATION +VCM I-EXPLORATION +123 I-EXPLORATION y I-EXPLORATION +plaquetas I-EXPLORATION +normales. I-EXPLORATION +VSG I-EXPLORATION de I-EXPLORATION -coloración I-EXPLORATION -pardo-negruzca. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION +117 I-EXPLORATION +mm I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -cavidad I-EXPLORATION -torácica I-EXPLORATION -encontramos I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -bilateral I-EXPLORATION +primera I-EXPLORATION +hora. I-EXPLORATION +Los I-EXPLORATION +parámetros I-EXPLORATION +bioquímicos I-EXPLORATION +de I-EXPLORATION +rutina, I-EXPLORATION +coagulación I-EXPLORATION y I-EXPLORATION -derrame I-EXPLORATION -pericárdico I-EXPLORATION +el I-EXPLORATION +análisis I-EXPLORATION +elemental I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -turbio. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -disección I-EXPLORATION +orina I-EXPLORATION +no I-EXPLORATION +mostraron I-EXPLORATION +alteraciones. I-EXPLORATION +Las I-EXPLORATION +determinaciones I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -vasos I-EXPLORATION -pulmonares I-EXPLORATION -observamos I-EXPLORATION -un I-EXPLORATION -trombo I-EXPLORATION +subpoblaciones I-EXPLORATION +linfocitarias I-EXPLORATION +CD4 I-EXPLORATION +fueron I-EXPLORATION de I-EXPLORATION -características I-EXPLORATION -vitales I-EXPLORATION -adherido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -pulmonar I-EXPLORATION -derecha I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -introduce I-EXPLORATION -por I-EXPLORATION -las I-EXPLORATION -ramas I-EXPLORATION -intraparenquimatosas. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION +944/mm3 I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -pared I-EXPLORATION -interna I-EXPLORATION +carga I-EXPLORATION +viral I-EXPLORATION de I-EXPLORATION +VIH I-EXPLORATION +indetectable. I-EXPLORATION +En I-EXPLORATION +los I-EXPLORATION +estudios I-EXPLORATION +microbiológicos, I-EXPLORATION +los I-EXPLORATION +hemocultivos I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -aurícula I-EXPLORATION -derecha I-EXPLORATION -existía I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION +serología I-EXPLORATION de I-EXPLORATION -1 I-EXPLORATION -x I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -adherida I-EXPLORATION +brucella I-EXPLORATION +fueron I-EXPLORATION +negativas. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +constataron I-EXPLORATION +vegetaciones I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -pared I-EXPLORATION -latero-interna, I-EXPLORATION -que I-EXPLORATION -ocupaba I-EXPLORATION +exploración I-EXPLORATION +ecocardiográfica. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -cavidad I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -orejuela, I-EXPLORATION +tórax I-EXPLORATION +se I-EXPLORATION +evidenció I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION de I-EXPLORATION -coloración I-EXPLORATION -pardo-negruzca I-EXPLORATION -y I-EXPLORATION -aspecto I-EXPLORATION -pediculado I-EXPLORATION +radioopacidad I-EXPLORATION +en I-EXPLORATION +lóbulo I-EXPLORATION +inferior I-EXPLORATION +izquierdo I-EXPLORATION con I-EXPLORATION -amplia I-EXPLORATION -base I-EXPLORATION +derrame I-EXPLORATION +pleural I-EXPLORATION +asociado. I-EXPLORATION +Los I-EXPLORATION +estudios I-EXPLORATION +microbiológicos I-EXPLORATION de I-EXPLORATION -implantación. I-EXPLORATION -La I-EXPLORATION -superficie I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -discretamente I-EXPLORATION -excavada I-EXPLORATION -y I-EXPLORATION +esputo I-EXPLORATION +resultaron I-EXPLORATION +estériles I-EXPLORATION con I-EXPLORATION -una I-EXPLORATION -zona I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -hemorrágico I-EXPLORATION +negatividad I-EXPLORATION +para I-EXPLORATION +BAAR I-EXPLORATION +y, I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -cuadrante I-EXPLORATION -infero-interno. I-EXPLORATION +líquido I-EXPLORATION +pleural I-EXPLORATION +(exudado I-EXPLORATION +de I-EXPLORATION +predominio I-EXPLORATION +mononuclear) I-EXPLORATION +el I-EXPLORATION +cultivo I-EXPLORATION +fue I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +candida I-EXPLORATION +albicans. I-EXPLORATION I-EXPLORATION En I-EXPLORATION la I-EXPLORATION -cavidad I-EXPLORATION -abdominal I-EXPLORATION -existían I-EXPLORATION -1.500 I-EXPLORATION -cc I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -ascítico I-EXPLORATION -con I-EXPLORATION -restos I-EXPLORATION -de I-EXPLORATION -heces, I-EXPLORATION -adherencias I-EXPLORATION -peritoneales I-EXPLORATION -marcadas, I-EXPLORATION -nódulos I-EXPLORATION -linfáticos I-EXPLORATION -paravertebrales I-EXPLORATION -aumentados I-EXPLORATION +Tac I-EXPLORATION de I-EXPLORATION -tamaño, I-EXPLORATION +columna I-EXPLORATION +dorso-lumbar I-EXPLORATION +se I-EXPLORATION +hallaron I-EXPLORATION +signos I-EXPLORATION +radiológicos I-EXPLORATION de I-EXPLORATION -coloración I-EXPLORATION -negruzca I-EXPLORATION -y I-EXPLORATION -duros I-EXPLORATION -al I-EXPLORATION -corte. I-EXPLORATION -Así I-EXPLORATION -mismo, I-EXPLORATION -también I-EXPLORATION -encontramos I-EXPLORATION -nódulos I-EXPLORATION -con I-EXPLORATION -semejantes I-EXPLORATION -características I-EXPLORATION -adheridos I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -paredes I-EXPLORATION -peritoneales. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -hígado I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -quística I-EXPLORATION +espondilodiscitis I-EXPLORATION con I-EXPLORATION -restos I-EXPLORATION -de I-EXPLORATION -sangre I-EXPLORATION -coagulada I-EXPLORATION -y I-EXPLORATION -material I-EXPLORATION -necrótico I-EXPLORATION -de I-EXPLORATION -coloración I-EXPLORATION -verduzca I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior. I-EXPLORATION -La I-EXPLORATION -cabeza I-EXPLORATION -del I-EXPLORATION -páncreas I-EXPLORATION -tenía I-EXPLORATION -aspecto I-EXPLORATION -congestivo I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -tacto I-EXPLORATION -presentaba I-EXPLORATION -consistencia I-EXPLORATION -dura I-EXPLORATION -y I-EXPLORATION -fibrosa. I-EXPLORATION - I-EXPLORATION -Las I-EXPLORATION -paredes I-EXPLORATION -del I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -aparecían I-EXPLORATION -adelgazadas I-EXPLORATION -y I-EXPLORATION +afectación I-EXPLORATION +tanto I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -necrótico, I-EXPLORATION -con I-EXPLORATION -perforaciones I-EXPLORATION -en I-EXPLORATION -íleon I-EXPLORATION +cuerpos I-EXPLORATION +vertebrales I-EXPLORATION +D-11, I-EXPLORATION +D-12 I-EXPLORATION y I-EXPLORATION -yeyuno I-EXPLORATION -que I-EXPLORATION -permitían I-EXPLORATION -la I-EXPLORATION -salida I-EXPLORATION +L-1, I-EXPLORATION +como I-EXPLORATION de I-EXPLORATION -material I-EXPLORATION -fecaloideo I-EXPLORATION +espacios I-EXPLORATION +intervertebrales I-EXPLORATION +D10-D11, I-EXPLORATION +D11-D12 I-EXPLORATION y I-EXPLORATION -alimenticio I-EXPLORATION -sin I-EXPLORATION -digerir. I-EXPLORATION -Existían I-EXPLORATION -segmentos I-EXPLORATION -intestinales I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -obstructivo, I-EXPLORATION -que I-EXPLORATION -coincidían I-EXPLORATION -con I-EXPLORATION -implantes I-EXPLORATION -tumorales I-EXPLORATION -necróticos. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -intestino I-EXPLORATION -grueso I-EXPLORATION -presentaba I-EXPLORATION -también I-EXPLORATION -áreas I-EXPLORATION +D12-L1, I-EXPLORATION +además I-EXPLORATION de I-EXPLORATION -infiltración I-EXPLORATION -tumoral I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -coloración I-EXPLORATION -pardo-negruzca. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicitaron I-EXPLORATION -estudios I-EXPLORATION -químico-toxicológicos I-EXPLORATION +masa I-EXPLORATION de I-EXPLORATION -sangre, I-EXPLORATION -humor I-EXPLORATION -vítreo I-EXPLORATION -y I-EXPLORATION -líquido I-EXPLORATION -ascítico I-EXPLORATION +tejidos I-EXPLORATION +blandos I-EXPLORATION +paravertebral I-EXPLORATION y I-EXPLORATION -estudios I-EXPLORATION -histopatológicos I-EXPLORATION +afectación I-EXPLORATION +intrarraquídea I-EXPLORATION de I-EXPLORATION -encéfalo, I-EXPLORATION -corazón, I-EXPLORATION -pulmón I-EXPLORATION -y I-EXPLORATION -trombos I-EXPLORATION -pulmonares, I-EXPLORATION -hígado, I-EXPLORATION -páncreas, I-EXPLORATION -intestino I-EXPLORATION -(duodeno, I-EXPLORATION -yeyuno I-EXPLORATION -e I-EXPLORATION -íleon) I-EXPLORATION -y I-EXPLORATION -ganglios I-EXPLORATION -linfáticos I-EXPLORATION -paravertebrales I-EXPLORATION -y I-EXPLORATION -nódulos I-EXPLORATION +localización I-EXPLORATION +epidural I-EXPLORATION +anterior. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +punción I-EXPLORATION +directa I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -pared I-EXPLORATION -del I-EXPLORATION -peritoneo. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -primeros I-EXPLORATION -se I-EXPLORATION -obtuvieron I-EXPLORATION -resultados I-EXPLORATION -negativos I-EXPLORATION -a I-EXPLORATION -todas I-EXPLORATION -aquellas I-EXPLORATION -sustancias I-EXPLORATION -estudiadas. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -estudios I-EXPLORATION -histopatológicos I-EXPLORATION -se I-EXPLORATION -demostró I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -neoplasia I-EXPLORATION -compuesta I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -poligonales I-EXPLORATION +masa I-EXPLORATION +paravertebral. I-EXPLORATION +Se I-EXPLORATION +obtuvo I-EXPLORATION +material I-EXPLORATION +purulento I-EXPLORATION y I-EXPLORATION -fusiformes I-EXPLORATION -dispuestas I-EXPLORATION -formando I-EXPLORATION -sábanas I-EXPLORATION -o I-EXPLORATION -nidos I-EXPLORATION -sólidos. I-EXPLORATION -Estos I-EXPLORATION -crecimientos I-EXPLORATION -tumorales I-EXPLORATION -infiltraban I-EXPLORATION -el I-EXPLORATION -miocardio I-EXPLORATION -auricular I-EXPLORATION -pero I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -acompañaban I-EXPLORATION -de I-EXPLORATION -reacción I-EXPLORATION -desmoplásica. I-EXPLORATION -En I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -seno I-EXPLORATION -de I-EXPLORATION +estudio I-EXPLORATION +microbiológico I-EXPLORATION la I-EXPLORATION -neoplasia I-EXPLORATION -existen I-EXPLORATION -zonas I-EXPLORATION +determinación I-EXPLORATION de I-EXPLORATION -necrosis I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION -externa I-EXPLORATION -se I-EXPLORATION -identifica I-EXPLORATION -un I-EXPLORATION -trombo I-EXPLORATION -adherido I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -zona I-EXPLORATION -ulcerada. I-EXPLORATION -Las I-EXPLORATION -células I-EXPLORATION -tumorales I-EXPLORATION -presentaban I-EXPLORATION -nucléolos I-EXPLORATION -prominentes I-EXPLORATION +BAAR I-EXPLORATION +fue I-EXPLORATION +negativa I-EXPLORATION y I-EXPLORATION -frecuentes I-EXPLORATION -figuras I-EXPLORATION +el I-EXPLORATION +cultivo I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +Candida I-EXPLORATION +albicans. I-EXPLORATION +Se B-TREATMENT +establecieron I-TREATMENT +medidas I-TREATMENT +ortésicas I-TREATMENT +y I-TREATMENT +tratamiento I-TREATMENT +secuencial I-TREATMENT +con I-TREATMENT +anfotericina I-TREATMENT +B I-TREATMENT +liposomal I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +150 I-TREATMENT +mg/día I-TREATMENT +durante I-TREATMENT +20 I-TREATMENT +días, I-TREATMENT +seguido I-TREATMENT +de I-TREATMENT +fluconazol I-TREATMENT +400 I-TREATMENT +mg/día I-TREATMENT +durante I-TREATMENT +un I-TREATMENT +total I-TREATMENT +de I-TREATMENT +6 I-TREATMENT +meses, I-TREATMENT +evolucionando B-EVOLUTION +con I-EVOLUTION +mejoría I-EVOLUTION +clínica I-EVOLUTION +y I-EVOLUTION +radiológica I-EVOLUTION +(tanto I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +neumonía I-EVOLUTION +como I-EVOLUTION +del I-EVOLUTION +derrame I-EVOLUTION +pleural I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +lesiones I-EVOLUTION +de I-EVOLUTION +espondilodiscitis I-EVOLUTION +con I-EVOLUTION +afectación I-EVOLUTION +de I-EVOLUTION +cuerpos I-EVOLUTION +vertebrales). I-EVOLUTION + I-EVOLUTION +En I-EVOLUTION +la I-EVOLUTION +Tabla I-EVOLUTION +I I-EVOLUTION +se I-EVOLUTION +exponen I-EVOLUTION +diversas I-EVOLUTION +características I-EVOLUTION +de I-EVOLUTION +ambos I-EVOLUTION +casos. I-EVOLUTION + I-EVOLUTION + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +51 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +evolución I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cirugía I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +disección I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +aorta I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +B I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +clasificación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Stanford, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +colocación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +prótesis I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +teflón, I-PAST_MEDICAL_HISTORY +cuatro I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +consulta. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Una B-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +previa I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Terapia I-PRESENT_ILLNESS +Intensiva I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +melena I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +lipotimia. I-PRESENT_ILLNESS +Ingresó I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +hematemesis I-PRESENT_ILLNESS +abundante I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +melena I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +shock I-PRESENT_ILLNESS +hipovolémico, I-PRESENT_ILLNESS +siendo B-TREATMENT +estabilizado I-TREATMENT +con I-TREATMENT +fluidos. I-TREATMENT +Un B-EVOLUTION +nuevo I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +hematemesis I-EVOLUTION +masiva I-EVOLUTION +lo I-EVOLUTION +lleva I-EVOLUTION +al I-EVOLUTION +paro I-EVOLUTION +cardiorrespiratorio I-EVOLUTION +y B-TREATMENT +tras I-TREATMENT +una I-TREATMENT +adecuada I-TREATMENT +resucitación I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +quirúrgica, I-TREATMENT +con I-TREATMENT +el I-TREATMENT +hallazgo I-TREATMENT +quirúrgico I-TREATMENT +de I-TREATMENT +FAE I-TREATMENT +al I-TREATMENT +nivel I-TREATMENT +de I-TREATMENT +la I-TREATMENT +tercera I-TREATMENT +porción I-TREATMENT +duodenal, I-TREATMENT +y I-TREATMENT +un I-TREATMENT +orificio I-TREATMENT +de I-TREATMENT +2 I-TREATMENT +x I-TREATMENT +1, I-TREATMENT +5 I-TREATMENT +cm I-TREATMENT +de I-TREATMENT +diámetro. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +cierre I-TREATMENT +simple, I-TREATMENT +gastroyeyuno I-TREATMENT +anastomosis I-TREATMENT +y I-TREATMENT +anastomosis I-TREATMENT +coledocoduodenal. I-TREATMENT +Falleció B-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +postoperatorio I-EVOLUTION +inmediato. I-EVOLUTION + I-EVOLUTION + +Se B-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +refiriendo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +tenía I-PRESENT_ILLNESS +«el I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +hundido» I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +aportaba I-PRESENT_ILLNESS +fotografías I-PRESENT_ILLNESS +anteriores I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +problema I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +evidenciar I-PRESENT_ILLNESS +ese I-PRESENT_ILLNESS +cambio I-PRESENT_ILLNESS +facial I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +sufrido. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +No B-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +La B-EXPLORATION +exploración I-EXPLORATION +oftalmológica I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION de I-EXPLORATION -mitosis. I-EXPLORATION -Con I-EXPLORATION -frecuencia, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -citoplasma I-EXPLORATION -existía I-EXPLORATION -abundante I-EXPLORATION -pigmento I-EXPLORATION -melánico. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -émbolos I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -apreciaban I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -arterias I-EXPLORATION -pulmonares I-EXPLORATION -presentaban I-EXPLORATION -distintos I-EXPLORATION -estadios I-EXPLORATION -evolutivos. I-EXPLORATION -Unos I-EXPLORATION -se I-EXPLORATION -encontraban I-EXPLORATION +1 I-EXPLORATION en I-EXPLORATION -fase I-EXPLORATION -de I-EXPLORATION -organización, I-EXPLORATION -observándose I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -fibroblastos I-EXPLORATION +ambos I-EXPLORATION +ojos I-EXPLORATION +sin I-EXPLORATION +corrección I-EXPLORATION +con I-EXPLORATION +motilidad I-EXPLORATION +ocular I-EXPLORATION +intrínseca I-EXPLORATION y I-EXPLORATION -yemas I-EXPLORATION -vasculares I-EXPLORATION -que I-EXPLORATION -iban I-EXPLORATION -infiltrando I-EXPLORATION -la I-EXPLORATION -formación I-EXPLORATION -trombótica I-EXPLORATION -; I-EXPLORATION -otros, I-EXPLORATION -en I-EXPLORATION -cambio, I-EXPLORATION -estaban I-EXPLORATION -completamente I-EXPLORATION -tapizados I-EXPLORATION +extrínseca I-EXPLORATION +normales. I-EXPLORATION +La I-EXPLORATION +exoftalmometría I-EXPLORATION +era I-EXPLORATION de I-EXPLORATION -endotelio I-EXPLORATION -y I-EXPLORATION +12, I-EXPLORATION +5 I-EXPLORATION +mm I-EXPLORATION en I-EXPLORATION -su I-EXPLORATION -seno I-EXPLORATION -comenzaban I-EXPLORATION -a I-EXPLORATION -proliferar I-EXPLORATION -los I-EXPLORATION -vasos I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -arterial; I-EXPLORATION -y, I-EXPLORATION -por I-EXPLORATION -último, I-EXPLORATION -los I-EXPLORATION -más I-EXPLORATION -recientes I-EXPLORATION -estaban I-EXPLORATION -constituidos I-EXPLORATION -por I-EXPLORATION -fibrina I-EXPLORATION +ojo I-EXPLORATION +derecho I-EXPLORATION y I-EXPLORATION -ocluían I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION de I-EXPLORATION -luz I-EXPLORATION -residual I-EXPLORATION -y I-EXPLORATION -fueron I-EXPLORATION -los I-EXPLORATION -responsables I-EXPLORATION +16 I-EXPLORATION +mm I-EXPLORATION +en I-EXPLORATION +ojo I-EXPLORATION +izquierdo. I-EXPLORATION +Se I-EXPLORATION +apreciaba I-EXPLORATION +un I-EXPLORATION +desplazamiento I-EXPLORATION +inferior I-EXPLORATION +de I-EXPLORATION +1 I-EXPLORATION +mm I-EXPLORATION del I-EXPLORATION -fallecimiento I-EXPLORATION -repentino I-EXPLORATION +globo I-EXPLORATION +ocular I-EXPLORATION +derecho. I-EXPLORATION +Había I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION del I-EXPLORATION -paciente. I-EXPLORATION -La I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -émbolos I-EXPLORATION -en I-EXPLORATION -diferentes I-EXPLORATION -estadios I-EXPLORATION -evolutivos I-EXPLORATION -implica I-EXPLORATION -que, I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -trombo I-EXPLORATION -adherido I-EXPLORATION +surco I-EXPLORATION +palpebral I-EXPLORATION +superior, I-EXPLORATION +con I-EXPLORATION +retracción I-EXPLORATION +palpebral I-EXPLORATION +superior I-EXPLORATION a I-EXPLORATION la I-EXPLORATION -superficie I-EXPLORATION +mirada I-EXPLORATION +inferior. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -metástasis I-EXPLORATION -auricular, I-EXPLORATION -se I-EXPLORATION -han I-EXPLORATION -ido I-EXPLORATION -desprendiendo I-EXPLORATION -numerosos I-EXPLORATION -émbolos I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -espacio I-EXPLORATION -de I-EXPLORATION -tiempo I-EXPLORATION -que I-EXPLORATION -puede I-EXPLORATION -oscilar I-EXPLORATION -entre I-EXPLORATION -3 I-EXPLORATION -y I-EXPLORATION -4 I-EXPLORATION -semanas I-EXPLORATION -de I-EXPLORATION -evolución. I-EXPLORATION +exploración I-EXPLORATION +oftalmológica I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -macroscópicos I-EXPLORATION -y I-EXPLORATION -microscópicos I-EXPLORATION -sustentan I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -muerte I-EXPLORATION -súbita, I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -tromboembolismo I-EXPLORATION -pulmonar I-EXPLORATION -masivo, I-EXPLORATION -que I-EXPLORATION -ha I-EXPLORATION -tenido I-EXPLORATION -su I-EXPLORATION -origen I-EXPLORATION -sobre I-EXPLORATION -la I-EXPLORATION -tumoración I-EXPLORATION -maligna I-EXPLORATION -metastásica I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -melanoma I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +TAC I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -cara I-EXPLORATION -interna I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -aurícula I-EXPLORATION -derecha, I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -ha I-EXPLORATION -ido I-EXPLORATION -organizando I-EXPLORATION -en I-EXPLORATION -distintos I-EXPLORATION -estadios I-EXPLORATION -a I-EXPLORATION -lo I-EXPLORATION -largo I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -o I-EXPLORATION -4 I-EXPLORATION -semanas I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -ha I-EXPLORATION -finalizado I-EXPLORATION -ocluyendo I-EXPLORATION -completamente I-EXPLORATION -las I-EXPLORATION -arterias I-EXPLORATION -pulmonares I-EXPLORATION -y I-EXPLORATION -ocasionando I-EXPLORATION -la I-EXPLORATION -muerte I-EXPLORATION -del I-EXPLORATION -sujeto. I-EXPLORATION - I-EXPLORATION -Por I-EXPLORATION -otro I-EXPLORATION -lado, I-EXPLORATION -y I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -lo I-EXPLORATION -anterior, I-EXPLORATION -nos I-EXPLORATION -encontramos I-EXPLORATION +objetivó I-EXPLORATION +un I-EXPLORATION +seno I-EXPLORATION +maxilar I-EXPLORATION +derecho I-EXPLORATION +colapsado, I-EXPLORATION con I-EXPLORATION un I-EXPLORATION -cuadro I-EXPLORATION -de I-EXPLORATION -shock I-EXPLORATION -séptico I-EXPLORATION -por I-EXPLORATION -peritonitis I-EXPLORATION -secundaria I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -perforación I-EXPLORATION -intestinal, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -marco I-EXPLORATION +descenso I-EXPLORATION de I-EXPLORATION +volumen, I-EXPLORATION una I-EXPLORATION -enfermedad I-EXPLORATION -metastásica I-EXPLORATION -generalizada I-EXPLORATION -cuyo I-EXPLORATION -origen I-EXPLORATION -es I-EXPLORATION -el I-EXPLORATION -melanoma I-EXPLORATION -de I-EXPLORATION -coroides. I-EXPLORATION - I-EXPLORATION - -En B-PRESENT_ILLNESS -enero I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2011 I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encontró I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cadáver I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -avanzado I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -descomposición I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -orilla I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -embalse I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Canales I-PRESENT_ILLNESS -(Granada). I-PRESENT_ILLNESS -Presentaba B-EXPLORATION -mancha I-EXPLORATION -verde I-EXPLORATION -generalizada, I-EXPLORATION -red I-EXPLORATION -vascular I-EXPLORATION -muy I-EXPLORATION -definida, I-EXPLORATION -zonas I-EXPLORATION -de I-EXPLORATION -inicio I-EXPLORATION -de I-EXPLORATION -adipocera, I-EXPLORATION -maceración I-EXPLORATION +retracción I-EXPLORATION +interna I-EXPLORATION de I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -faneras I-EXPLORATION +las I-EXPLORATION +paredes I-EXPLORATION y I-EXPLORATION -entomofauna I-EXPLORATION -sarcosaprófaga. I-EXPLORATION -Debido I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -procesos I-EXPLORATION -putrefactivos, I-EXPLORATION -la I-EXPLORATION -identificación I-EXPLORATION -positiva I-EXPLORATION -a I-EXPLORATION -partir I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -rasgos I-EXPLORATION -faciales I-EXPLORATION -era I-EXPLORATION -imposible, I-EXPLORATION -pero I-EXPLORATION -se I-EXPLORATION -sospechó I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -trataba I-EXPLORATION -de I-EXPLORATION un I-EXPLORATION -varón I-EXPLORATION -que I-EXPLORATION -desapareció I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -domicilio I-EXPLORATION -a I-EXPLORATION -finales I-EXPLORATION -de I-EXPLORATION -noviembre I-EXPLORATION +adelgazamiento I-EXPLORATION +y I-EXPLORATION +desplazamiento I-EXPLORATION +inferior I-EXPLORATION del I-EXPLORATION -año I-EXPLORATION -anterior I-EXPLORATION -ya I-EXPLORATION -que, I-EXPLORATION -según I-EXPLORATION -informó I-EXPLORATION +suelo I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -Policía, I-EXPLORATION +órbita. I-EXPLORATION +El I-EXPLORATION +proceso I-EXPLORATION +uncinado I-EXPLORATION +estaba I-EXPLORATION +retraído I-EXPLORATION +hacia I-EXPLORATION la I-EXPLORATION -zona I-EXPLORATION -era I-EXPLORATION -frecuentada I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -desaparecido I-EXPLORATION -desde I-EXPLORATION -que I-EXPLORATION -inició I-EXPLORATION -los I-EXPLORATION -trámites I-EXPLORATION -de I-EXPLORATION -divorcio. I-EXPLORATION -La I-EXPLORATION -temperatura I-EXPLORATION -en I-EXPLORATION +pared I-EXPLORATION +orbitaria, I-EXPLORATION +obstruyendo I-EXPLORATION el I-EXPLORATION -lugar I-EXPLORATION +infundíbulo I-EXPLORATION del I-EXPLORATION -levantamiento I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -5oC. I-EXPLORATION +seno I-EXPLORATION +maxilar. I-EXPLORATION I-EXPLORATION -El I-EXPLORATION -lugar I-EXPLORATION -del I-EXPLORATION -levantamiento I-EXPLORATION -consistía I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -cornisa I-EXPLORATION -de I-EXPLORATION -terreno I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -levantaba I-EXPLORATION -por I-EXPLORATION -encima I-EXPLORATION -del I-EXPLORATION -pantano I-EXPLORATION -de I-EXPLORATION -Canales. I-EXPLORATION -El I-EXPLORATION -piso I-EXPLORATION -era I-EXPLORATION -de I-EXPLORATION -textura I-EXPLORATION -arenosa I-EXPLORATION + +Hombre B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +86 I-PRESENT_ILLNESS +años. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +enero I-PRESENT_ILLNESS +2008 I-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +hipoglucemia I-PRESENT_ILLNESS +secundaria I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +antidiabéticos I-PRESENT_ILLNESS +orales, I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +demencia I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +baja I-PRESENT_ILLNESS +ingesta, I-PRESENT_ILLNESS +se B-TREATMENT +decide I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +sonda I-TREATMENT +nasogástrica I-TREATMENT +(SNG) I-TREATMENT +para I-TREATMENT +alimentación I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +enteral, I-TREATMENT +tras I-TREATMENT +presentar I-TREATMENT +varios I-TREATMENT +episodios I-TREATMENT +de I-TREATMENT +arrancamiento I-TREATMENT +de I-TREATMENT +sonda, I-TREATMENT +se I-TREATMENT +practicó I-TREATMENT +gastrostomía I-TREATMENT +radiológica I-TREATMENT +percutánea I-TREATMENT +(GRP). I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +2 I-EVOLUTION +meses I-EVOLUTION +del I-EVOLUTION +alta I-EVOLUTION +acude I-EVOLUTION +al I-EVOLUTION +servicio I-EVOLUTION +de I-EVOLUTION +urgencias I-EVOLUTION +por I-EVOLUTION +arrancamiento I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +sonda I-EVOLUTION +de I-EVOLUTION +gastrostomía, I-EVOLUTION +ante B-TREATMENT +la I-TREATMENT +ausencia I-TREATMENT +de I-TREATMENT +sondas I-TREATMENT +de I-TREATMENT +recambio, I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +sonda I-TREATMENT +Foley I-TREATMENT +de I-TREATMENT +14 I-TREATMENT +french, I-TREATMENT +desde B-EVOLUTION +entonces I-EVOLUTION +son I-EVOLUTION +múltiples I-EVOLUTION +las I-EVOLUTION +visitas I-EVOLUTION +al I-EVOLUTION +servicio I-EVOLUTION +de I-EVOLUTION +urgencias I-EVOLUTION +con I-EVOLUTION +problemas I-EVOLUTION +en I-EVOLUTION +relación I-EVOLUTION +con I-EVOLUTION +la I-EVOLUTION +sonda. I-EVOLUTION +Es I-EVOLUTION +ingresado I-EVOLUTION +por I-EVOLUTION +vómitos I-EVOLUTION +e I-EVOLUTION +intolerancia I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +nutrición I-EVOLUTION +enteral. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +presenta I-EVOLUTION +abundante I-EVOLUTION +residuo I-EVOLUTION +bilioso I-EVOLUTION +por I-EVOLUTION +la I-EVOLUTION +sonda I-EVOLUTION +Foley. I-EVOLUTION +Se B-EXPLORATION +decide I-EXPLORATION +realizar I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION +radiológico I-EXPLORATION con I-EXPLORATION -algunas I-EXPLORATION -formaciones I-EXPLORATION -arbustivas I-EXPLORATION -de I-EXPLORATION -escasa I-EXPLORATION -frondosidad. I-EXPLORATION -Se I-EXPLORATION -describieron I-EXPLORATION -restos I-EXPLORATION -mucilaginosos I-EXPLORATION -de I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -pudieron I-EXPLORATION -ser I-EXPLORATION -algas I-EXPLORATION -que I-EXPLORATION -quedaron I-EXPLORATION -depositadas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -descenso I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -llenado I-EXPLORATION -del I-EXPLORATION -embalse. I-EXPLORATION -Debido I-EXPLORATION +contraste I-EXPLORATION +radiológico I-EXPLORATION a I-EXPLORATION -la I-EXPLORATION -dificultad I-EXPLORATION -de I-EXPLORATION -acceso I-EXPLORATION -al I-EXPLORATION -lugar I-EXPLORATION -exacto I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -hallaba I-EXPLORATION -el I-EXPLORATION -cadáver, I-EXPLORATION -tuvieron I-EXPLORATION -que I-EXPLORATION -intervenir I-EXPLORATION -efectivos I-EXPLORATION +través I-EXPLORATION de I-EXPLORATION -Protección I-EXPLORATION -Civil I-EXPLORATION -para I-EXPLORATION -trasladar I-EXPLORATION -el I-EXPLORATION -cuerpo I-EXPLORATION -en I-EXPLORATION -lancha I-EXPLORATION -hasta I-EXPLORATION -un I-EXPLORATION -lugar I-EXPLORATION -seguro I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -continuaron I-EXPLORATION -las I-EXPLORATION -diligencias I-EXPLORATION -oportunas. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -caso I-EXPLORATION -que I-EXPLORATION -presentamos I-EXPLORATION -es I-EXPLORATION -paradigmático I-EXPLORATION -ya I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -sospecha I-EXPLORATION -una I-EXPLORATION -inmersión I-EXPLORATION -del I-EXPLORATION -cuerpo I-EXPLORATION -previa I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -colonización I-EXPLORATION -por I-EXPLORATION -parte I-EXPLORATION -de I-EXPLORATION -dípteros I-EXPLORATION -necrófagos I-EXPLORATION -y, I-EXPLORATION -por I-EXPLORATION -tanto, I-EXPLORATION -un I-EXPLORATION -retraso I-EXPLORATION -considerable I-EXPLORATION -entre I-EXPLORATION -el I-EXPLORATION -fallecimiento I-EXPLORATION -y I-EXPLORATION +sonda, I-EXPLORATION +ante I-EXPLORATION la I-EXPLORATION -llegada I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -primeros I-EXPLORATION -insectos I-EXPLORATION -de I-EXPLORATION -interés I-EXPLORATION -forense. I-EXPLORATION -A I-EXPLORATION -partir I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -datos I-EXPLORATION -meteorológicos I-EXPLORATION +mala I-EXPLORATION +tolerancia I-EXPLORATION +enteral I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -conocimiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -secuencia I-EXPLORATION -temporal I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -desarrollo I-EXPLORATION -larvario I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -especie I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -díptero I-EXPLORATION -necrófago I-EXPLORATION -hallada I-EXPLORATION -sobre I-EXPLORATION -los I-EXPLORATION -restos I-EXPLORATION -humanos, I-EXPLORATION +alteraciones I-EXPLORATION +radiológicas I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +intestinal, I-EXPLORATION +observándose I-EXPLORATION +como I-EXPLORATION se I-EXPLORATION -ha I-EXPLORATION -podido I-EXPLORATION -determinar I-EXPLORATION -el I-EXPLORATION -intervalo I-EXPLORATION -mínimo I-EXPLORATION -que I-EXPLORATION -transcurrió I-EXPLORATION -desde I-EXPLORATION -que I-EXPLORATION +puede I-EXPLORATION +ver I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +figura I-EXPLORATION +1 I-EXPLORATION el I-EXPLORATION -cuerpo I-EXPLORATION -emergió I-EXPLORATION +paso I-EXPLORATION +directo I-EXPLORATION del I-EXPLORATION -agua I-EXPLORATION -hasta I-EXPLORATION -su I-EXPLORATION -hallazgo. I-EXPLORATION - I-EXPLORATION -El B-DERIVED_FROM/TO -cuerpo I-DERIVED_FROM/TO +contraste I-EXPLORATION +directamente I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +luz I-EXPLORATION +intestinal. I-EXPLORATION +Se B-TREATMENT +extrajo I-TREATMENT +la I-TREATMENT +sonda I-TREATMENT +Foley I-TREATMENT +por I-TREATMENT +el I-TREATMENT +servicio I-TREATMENT +de I-TREATMENT +cirugía I-TREATMENT +sin I-TREATMENT +presentar I-TREATMENT +complicaciones I-TREATMENT +y I-TREATMENT +se I-TREATMENT +colocó I-TREATMENT +sonda I-TREATMENT +de I-TREATMENT +gastrostomía I-TREATMENT +por I-TREATMENT +parte I-TREATMENT +del I-TREATMENT +servicio I-TREATMENT +de I-TREATMENT +radiología I-TREATMENT +intervencionista, I-TREATMENT +siendo B-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +con B-TREATMENT +nutrición I-TREATMENT +enteral I-TREATMENT +en I-TREATMENT +bolos. I-TREATMENT + I-TREATMENT + +Recién B-PRESENT_ILLNESS +nacido I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino, I-PRESENT_ILLNESS +cesárea I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +38 I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +gestacional I-PRESENT_ILLNESS +debido I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +cardiopatía I-PRESENT_ILLNESS +compleja; I-PRESENT_ILLNESS +peso B-EXPLORATION +de I-EXPLORATION +nacimiento I-EXPLORATION +2.860 I-EXPLORATION +g I-EXPLORATION +(p15), I-EXPLORATION +longitud I-EXPLORATION +44 I-EXPLORATION +cm I-EXPLORATION +(p3), I-EXPLORATION +perímetro I-EXPLORATION +cefálico I-EXPLORATION +33 I-EXPLORATION +cm I-EXPLORATION +(p I-EXPLORATION +3). I-EXPLORATION +Padres B-FAMILY_HISTORY +no I-FAMILY_HISTORY +consanguíneos I-FAMILY_HISTORY +sin I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +personales I-FAMILY_HISTORY +ni I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +importancia, I-FAMILY_HISTORY +madre I-FAMILY_HISTORY +primigesta I-FAMILY_HISTORY +de I-FAMILY_HISTORY +19 I-FAMILY_HISTORY +años. I-FAMILY_HISTORY + I-FAMILY_HISTORY +A B-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +12 I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +gestación I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +encontró I-PAST_MEDICAL_HISTORY +translucencia I-PAST_MEDICAL_HISTORY +nucal I-PAST_MEDICAL_HISTORY +mayor I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +p95, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +realizó I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +cariotipo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +biopsia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vellosidades I-PAST_MEDICAL_HISTORY +coriales I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +mostró I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +resultado I-PAST_MEDICAL_HISTORY +46, I-PAST_MEDICAL_HISTORY +XY; I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +18 I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +ecografía I-PAST_MEDICAL_HISTORY +evidenció I-PAST_MEDICAL_HISTORY +cardiopatía I-PAST_MEDICAL_HISTORY +compleja, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +canal I-PAST_MEDICAL_HISTORY +aurículoventricular I-PAST_MEDICAL_HISTORY +completo, I-PAST_MEDICAL_HISTORY +mientras I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +ecografía I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tercer I-PAST_MEDICAL_HISTORY +trimestre I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +huesos I-PAST_MEDICAL_HISTORY +largos I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +encontraban I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +p5. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Al B-DERIVED_FROM/TO +nacimiento I-DERIVED_FROM/TO fue I-DERIVED_FROM/TO -trasladado I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Instituto I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Medicina I-DERIVED_FROM/TO -Legal I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Granada, I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -le I-DERIVED_FROM/TO -practicó I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -autopsia I-DERIVED_FROM/TO -según I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -normativa I-DERIVED_FROM/TO -europea12. I-DERIVED_FROM/TO -La I-DERIVED_FROM/TO -recogida I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -evidencias I-DERIVED_FROM/TO -entomológicas I-DERIVED_FROM/TO -durante I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -práctica I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -autopsia I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -interpretación I-DERIVED_FROM/TO +hospitalizado I-DERIVED_FROM/TO en I-DERIVED_FROM/TO -todas I-DERIVED_FROM/TO -las I-DERIVED_FROM/TO -fases I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -investigación I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -realizó I-DERIVED_FROM/TO -siguiendo I-DERIVED_FROM/TO -las I-DERIVED_FROM/TO -recomendaciones I-DERIVED_FROM/TO +unidad I-DERIVED_FROM/TO de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -European I-DERIVED_FROM/TO -Association I-DERIVED_FROM/TO -for I-DERIVED_FROM/TO -Forensic I-DERIVED_FROM/TO -Entomology I-DERIVED_FROM/TO -(EAFE) I-DERIVED_FROM/TO -13. I-DERIVED_FROM/TO -Las B-EXPLORATION -muestras I-EXPLORATION -fueron I-EXPLORATION -fotografiadas I-EXPLORATION -con I-EXPLORATION -testigo I-EXPLORATION -métrico I-EXPLORATION -y I-EXPLORATION -recogidas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -cefálica I-EXPLORATION +cuidados I-DERIVED_FROM/TO +intensivos I-DERIVED_FROM/TO +neonatal. I-DERIVED_FROM/TO +Evaluado B-EXPLORATION por I-EXPLORATION -la I-EXPLORATION -médico I-EXPLORATION -forense I-EXPLORATION -encargada I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -autopsia, I-EXPLORATION -se I-EXPLORATION -conservaron I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -temperatura I-EXPLORATION +genetista I-EXPLORATION +clínico, I-EXPLORATION +quien I-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +dismorfológico I-EXPLORATION +describió: I-EXPLORATION +microcefalia, I-EXPLORATION +orejas I-EXPLORATION de I-EXPLORATION -18oC I-EXPLORATION -y I-EXPLORATION -fueron I-EXPLORATION -trasportadas I-EXPLORATION +implantación I-EXPLORATION +baja I-EXPLORATION +con I-EXPLORATION +rotación I-EXPLORATION +hacia I-EXPLORATION +atrás, I-EXPLORATION +puente I-EXPLORATION +nasal I-EXPLORATION +deprimido, I-EXPLORATION +pliegue I-EXPLORATION +epicántico I-EXPLORATION +interno, I-EXPLORATION +estrabismo I-EXPLORATION +convergente, I-EXPLORATION en I-EXPLORATION -recipiente I-EXPLORATION -isotérmico I-EXPLORATION -dos I-EXPLORATION -horas I-EXPLORATION -después I-EXPLORATION +boca I-EXPLORATION +labio I-EXPLORATION +superior I-EXPLORATION +corto I-EXPLORATION +unido I-EXPLORATION por I-EXPLORATION -el I-EXPLORATION -responsable I-EXPLORATION +frenillos I-EXPLORATION +al I-EXPLORATION +reborde I-EXPLORATION +alveolar, I-EXPLORATION +extremidades I-EXPLORATION +con I-EXPLORATION +huesos I-EXPLORATION +largos I-EXPLORATION +cortos, I-EXPLORATION +rizomelia, I-EXPLORATION +manos I-EXPLORATION +pequeñas, I-EXPLORATION +braquidactilia, I-EXPLORATION +pliegue I-EXPLORATION +palmar I-EXPLORATION +único, I-EXPLORATION +polidactilia I-EXPLORATION +post I-EXPLORATION +axial I-EXPLORATION +en I-EXPLORATION +miembros I-EXPLORATION +superiores, I-EXPLORATION +polisindactilia I-EXPLORATION +preaxial I-EXPLORATION +bilateral I-EXPLORATION +en I-EXPLORATION +miembros I-EXPLORATION +inferiores I-EXPLORATION +y I-EXPLORATION +uñas I-EXPLORATION +hipoplásicas. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +ecocardiograma I-EXPLORATION +mostró I-EXPLORATION +canal I-EXPLORATION +aurículo-ventricular, I-EXPLORATION +estenosis I-EXPLORATION +aórtica, I-EXPLORATION +hipoplasia I-EXPLORATION del I-EXPLORATION -análisis I-EXPLORATION -entomológico I-EXPLORATION -forense. I-EXPLORATION -Doce I-EXPLORATION -larvas I-EXPLORATION -vivas I-EXPLORATION -fueron I-EXPLORATION -criadas I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -fase I-EXPLORATION -adulta I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -incubadora I-EXPLORATION -Heraeus I-EXPLORATION -B-12, I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -temperatura I-EXPLORATION +arco I-EXPLORATION +aórtico, I-EXPLORATION +ductus I-EXPLORATION +arterioso I-EXPLORATION +e I-EXPLORATION +hipoplasia I-EXPLORATION +leve I-EXPLORATION de I-EXPLORATION -25oC, I-EXPLORATION -humedad I-EXPLORATION -relativa I-EXPLORATION -del I-EXPLORATION -80% I-EXPLORATION +arteria I-EXPLORATION +pulmonar I-EXPLORATION +derecha, I-EXPLORATION +también I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +ecografía I-EXPLORATION +transfontanelar I-EXPLORATION y I-EXPLORATION -alimentadas I-EXPLORATION -con I-EXPLORATION -hígado I-EXPLORATION -de I-EXPLORATION -cerdo I-EXPLORATION -ad I-EXPLORATION -libitum I-EXPLORATION -para I-EXPLORATION -realizar I-EXPLORATION -la I-EXPLORATION -identificación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -especie I-EXPLORATION -a I-EXPLORATION -partir I-EXPLORATION +renal I-EXPLORATION +que I-EXPLORATION +resultaron I-EXPLORATION +normales; I-EXPLORATION +radiografías I-EXPLORATION de I-EXPLORATION +miembros I-EXPLORATION +inferiores I-EXPLORATION +mostraron I-EXPLORATION +fémur I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -fase I-EXPLORATION -adulta. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -fueron I-EXPLORATION -sacrificadas I-EXPLORATION -sumergiéndolas I-EXPLORATION -en I-EXPLORATION -agua I-EXPLORATION -cercana I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -ebullición I-EXPLORATION -durante I-EXPLORATION -1 I-EXPLORATION -minuto I-EXPLORATION -y, I-EXPLORATION -posteriormente, I-EXPLORATION -conservadas I-EXPLORATION +tibia I-EXPLORATION +cortos I-EXPLORATION +con I-EXPLORATION +adecuada I-EXPLORATION +osificación, I-EXPLORATION en I-EXPLORATION -alcohol I-EXPLORATION -al I-EXPLORATION -70% I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -identificación I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -larvas. I-EXPLORATION -De I-EXPLORATION -las I-EXPLORATION -larvas I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -criadas, I-EXPLORATION -emergieron I-EXPLORATION -9 I-EXPLORATION -adultos. I-EXPLORATION -Dos I-EXPLORATION -larvas I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -que I-EXPLORATION +radiografía I-EXPLORATION +toracoabdominal I-EXPLORATION se I-EXPLORATION -remitieron I-EXPLORATION -muertas I-EXPLORATION -fueron I-EXPLORATION -sometidas I-EXPLORATION -a I-EXPLORATION +observó I-EXPLORATION un I-EXPLORATION -aclaramiento I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -disolución I-EXPLORATION -de I-EXPLORATION -hidróxido I-EXPLORATION -sódico I-EXPLORATION +tórax I-EXPLORATION +estrecho I-EXPLORATION al I-EXPLORATION -10% I-EXPLORATION -m/v I-EXPLORATION -durante I-EXPLORATION -24 I-EXPLORATION -horas. I-EXPLORATION -Posteriormente, I-EXPLORATION -se I-EXPLORATION -montaron I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -preparación I-EXPLORATION -microscópica I-EXPLORATION -con I-EXPLORATION -DPX I-EXPLORATION -(VWR I-EXPLORATION -International®) I-EXPLORATION -para I-EXPLORATION -observar I-EXPLORATION +comparar I-EXPLORATION con I-EXPLORATION -mayor I-EXPLORATION -detalle I-EXPLORATION -las I-EXPLORATION -características I-EXPLORATION -morfoanatómicas. I-EXPLORATION -De I-EXPLORATION -los I-EXPLORATION -adultos, I-EXPLORATION el I-EXPLORATION -muerto I-EXPLORATION -fue I-EXPLORATION -directamente I-EXPLORATION -conservado I-EXPLORATION -en I-EXPLORATION -alcohol I-EXPLORATION -al I-EXPLORATION -70% I-EXPLORATION +abdomen I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -otro I-EXPLORATION -sacrificado I-EXPLORATION -con I-EXPLORATION -acetato I-EXPLORATION +una I-EXPLORATION +silueta I-EXPLORATION +cardíaca I-EXPLORATION +aumentada I-EXPLORATION de I-EXPLORATION -etilo I-EXPLORATION -y I-EXPLORATION -posteriormente I-EXPLORATION -conservado I-EXPLORATION +tamaño I-EXPLORATION +al I-EXPLORATION +comparar I-EXPLORATION con I-EXPLORATION el I-EXPLORATION -mismo I-EXPLORATION -método I-EXPLORATION -que I-EXPLORATION +tórax I-EXPLORATION +; I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -muestra I-EXPLORATION -que I-EXPLORATION +columna I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -remitió I-EXPLORATION -muerta. I-EXPLORATION +observaron I-EXPLORATION +alteraciones I-EXPLORATION +vertebrales. I-EXPLORATION + I-EXPLORATION La I-EXPLORATION -totalidad I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -muestras I-EXPLORATION -fueron I-EXPLORATION -identificadas I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION +suma I-EXPLORATION de I-EXPLORATION -especie14, I-EXPLORATION -15. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -recogieron I-EXPLORATION -muestras I-EXPLORATION -entomológicas I-EXPLORATION -durante I-EXPLORATION -el I-EXPLORATION -levantamiento I-EXPLORATION -del I-EXPLORATION -cadáver. I-EXPLORATION - I-EXPLORATION -Datos I-EXPLORATION -ambientales I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -datos I-EXPLORATION -meteorológicos I-EXPLORATION -diarios I-EXPLORATION -(en I-EXPLORATION +hallazgos I-EXPLORATION +permitió I-EXPLORATION +diagnosticar I-EXPLORATION el I-EXPLORATION -presente I-EXPLORATION -trabajo, I-EXPLORATION -tomamos I-EXPLORATION -las I-EXPLORATION -temperaturas I-EXPLORATION -diarias I-EXPLORATION -al I-EXPLORATION -no I-EXPLORATION -disponer I-EXPLORATION +síndrome I-EXPLORATION de I-EXPLORATION +Ellis I-EXPLORATION +Van I-EXPLORATION +Creveld. I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +tuvo I-EVOLUTION +una I-EVOLUTION +evolución I-EVOLUTION +desfavorable I-EVOLUTION +falleciendo I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +8 I-EVOLUTION +semanas I-EVOLUTION +de I-EVOLUTION +nacido, I-EVOLUTION +por I-EVOLUTION +problemas I-EVOLUTION +secundarios I-EVOLUTION +a I-EVOLUTION +su I-EVOLUTION +cardiopatía I-EVOLUTION +compleja. I-EVOLUTION + I-EVOLUTION + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +niño I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +7 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +relevantes, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +comienza I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +febril I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +foco I-PRESENT_ILLNESS +detectable. I-PRESENT_ILLNESS +A B-EXPLORATION las I-EXPLORATION -horarias) I-EXPLORATION -fueron I-EXPLORATION -tomados I-EXPLORATION +72 I-EXPLORATION +h I-EXPLORATION de I-EXPLORATION -dos I-EXPLORATION -estaciones I-EXPLORATION -agroclimáticas I-EXPLORATION -distintas I-EXPLORATION -con I-EXPLORATION +iniciado I-EXPLORATION el I-EXPLORATION -fin I-EXPLORATION -de I-EXPLORATION -evaluar I-EXPLORATION -cuál I-EXPLORATION +cuadro I-EXPLORATION +clínico, I-EXPLORATION +el I-EXPLORATION +niño I-EXPLORATION +refiere I-EXPLORATION +dolor I-EXPLORATION +e I-EXPLORATION +impotencia I-EXPLORATION +funcional I-EXPLORATION +en I-EXPLORATION +hombro I-EXPLORATION +derecho, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -ellas I-EXPLORATION -se I-EXPLORATION -ajustaba I-EXPLORATION -mejor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -temperatura I-EXPLORATION -del I-EXPLORATION -lugar I-EXPLORATION -del I-EXPLORATION -levantamiento16, I-EXPLORATION -17, I-EXPLORATION -ambas I-EXPLORATION -pertenecientes I-EXPLORATION -a I-EXPLORATION +flogosis I-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +físico. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -red I-EXPLORATION -de I-EXPLORATION -estaciones I-EXPLORATION -agroclimáticas I-EXPLORATION +evaluación I-EXPLORATION +inicial I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +una I-EXPLORATION +radiografía I-EXPLORATION +simple I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION del I-EXPLORATION -Instituto I-EXPLORATION +hombro I-EXPLORATION +afectado, I-EXPLORATION +ambos I-EXPLORATION +estudios I-EXPLORATION +con I-EXPLORATION +resultados I-EXPLORATION +normales. I-EXPLORATION +Luego I-EXPLORATION de I-EXPLORATION -Investigación I-EXPLORATION -Agraria I-EXPLORATION +presentar I-EXPLORATION +fiebre I-EXPLORATION +elevada I-EXPLORATION y I-EXPLORATION -Pesquera I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -Junta I-EXPLORATION -de I-EXPLORATION -Andalucía. I-EXPLORATION -La I-EXPLORATION -estación I-EXPLORATION -1 I-EXPLORATION -(IFAPA I-EXPLORATION -de I-EXPLORATION -Camino I-EXPLORATION -del I-EXPLORATION -Purchil, I-EXPLORATION -coordenadas I-EXPLORATION -UTM I-EXPLORATION -X=443423.0 I-EXPLORATION -Y=4114357.0, I-EXPLORATION -altura I-EXPLORATION -sobre I-EXPLORATION -el I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -mar: I-EXPLORATION -630 I-EXPLORATION -metros) I-EXPLORATION -está I-EXPLORATION -situada I-EXPLORATION -a I-EXPLORATION -unos I-EXPLORATION -13 I-EXPLORATION -kilómetros I-EXPLORATION -del I-EXPLORATION -lugar I-EXPLORATION -del I-EXPLORATION -levantamiento, I-EXPLORATION +persistente I-EXPLORATION +durante I-EXPLORATION +6 I-EXPLORATION +días, I-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +se I-EXPLORATION +detecta I-EXPLORATION +eritema I-EXPLORATION +y I-EXPLORATION +edema I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -estación I-EXPLORATION -2 I-EXPLORATION -(Jerez I-EXPLORATION -del I-EXPLORATION -Marquesado, I-EXPLORATION -coordenadas I-EXPLORATION -UTM, I-EXPLORATION -X=486806.0 I-EXPLORATION -Y=4116224.0, I-EXPLORATION -altura I-EXPLORATION -sobre I-EXPLORATION +región I-EXPLORATION +esternoclavicular I-EXPLORATION +derecha, I-EXPLORATION +motivo I-EXPLORATION +por I-EXPLORATION el I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -mar: I-EXPLORATION -1212 I-EXPLORATION -metros) I-EXPLORATION +cual I-EXPLORATION se I-EXPLORATION -halla I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -distancia I-EXPLORATION +decide I-EXPLORATION +su I-EXPLORATION +internación. I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -27 I-EXPLORATION -kilómetros I-EXPLORATION -del I-EXPLORATION -lugar I-EXPLORATION -del I-EXPLORATION -levantamiento. I-EXPLORATION -Para I-EXPLORATION -poder I-EXPLORATION -llevar I-EXPLORATION -a I-EXPLORATION -cabo I-EXPLORATION +laboratorio I-EXPLORATION +iniciales I-EXPLORATION +revelan I-EXPLORATION +leucocitosis I-EXPLORATION +(GB: I-EXPLORATION +19.890/mm3 I-EXPLORATION +) I-EXPLORATION +con I-EXPLORATION +neutrofilia I-EXPLORATION +(85%) I-EXPLORATION +proteína I-EXPLORATION +C-reactiva I-EXPLORATION +(PC-R: I-EXPLORATION +90) I-EXPLORATION +y I-EXPLORATION +eritrosedimentación I-EXPLORATION +elevadas I-EXPLORATION +(ERS: I-EXPLORATION +57 I-EXPLORATION +mm). I-EXPLORATION +La I-EXPLORATION +CPK I-EXPLORATION +informa I-EXPLORATION +valores I-EXPLORATION +normales I-EXPLORATION +(50 I-EXPLORATION +UI/L). I-EXPLORATION +Ante I-EXPLORATION la I-EXPLORATION -evaluación I-EXPLORATION +sospecha I-EXPLORATION de I-EXPLORATION -ese I-EXPLORATION -ajuste I-EXPLORATION +un I-EXPLORATION +foco I-EXPLORATION +profundo I-EXPLORATION de I-EXPLORATION -temperaturas, I-EXPLORATION +infección, I-EXPLORATION se I-EXPLORATION -colocó I-EXPLORATION +solicita I-EXPLORATION +una I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RMN) I-EXPLORATION +que I-EXPLORATION +evidencia I-EXPLORATION un I-EXPLORATION -data I-EXPLORATION -logger I-EXPLORATION -(ILOG I-EXPLORATION -S/INT-ESCORT®) I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -proximidades I-EXPLORATION -del I-EXPLORATION -lugar I-EXPLORATION -del I-EXPLORATION -hallazgo I-EXPLORATION -del I-EXPLORATION -cuerpo I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -imposibilidad I-EXPLORATION +intenso I-EXPLORATION +mioedema I-EXPLORATION +que I-EXPLORATION +compromete I-EXPLORATION +los I-EXPLORATION +músculos I-EXPLORATION +trapecio I-EXPLORATION +y I-EXPLORATION +pectoral I-EXPLORATION +mayor I-EXPLORATION +derecho. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizan I-EXPLORATION +dos I-EXPLORATION +hemocultivos I-EXPLORATION +y B-TREATMENT +se I-TREATMENT +inicia I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +cefalotina I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +parenteral. I-TREATMENT +Luego B-EVOLUTION +de I-EVOLUTION +48 I-EVOLUTION +h I-EVOLUTION +de I-EVOLUTION +iniciado I-EVOLUTION +el I-EVOLUTION +tratamiento, I-EVOLUTION +el I-EVOLUTION +niño I-EVOLUTION +continúa I-EVOLUTION +febril; I-EVOLUTION +además, I-EVOLUTION +presenta I-EVOLUTION +aumento I-EVOLUTION +del I-EVOLUTION +eritema I-EVOLUTION +y I-EVOLUTION +edema I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +zona I-EVOLUTION +afectada. I-EVOLUTION +Se B-EXPLORATION +reciben I-EXPLORATION +los I-EXPLORATION +resultados I-EXPLORATION de I-EXPLORATION -acceder I-EXPLORATION +los I-EXPLORATION +hemocultivos I-EXPLORATION +tomados I-EXPLORATION al I-EXPLORATION -sitio I-EXPLORATION -exacto I-EXPLORATION -del I-EXPLORATION -levantamiento I-EXPLORATION +ingreso, I-EXPLORATION +que I-EXPLORATION +resultan I-EXPLORATION +positivos I-EXPLORATION +para I-EXPLORATION +SAMRC I-EXPLORATION +(resistente I-EXPLORATION +a I-EXPLORATION +clindamicina); I-EXPLORATION +se B-TREATMENT +modifica I-TREATMENT +el I-TREATMENT +esquema I-TREATMENT +terapéutico I-TREATMENT +y I-TREATMENT +se I-TREATMENT +indica I-TREATMENT +vancomicina I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +endovenosa I-TREATMENT +y I-TREATMENT +rifampicina I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +oral. I-TREATMENT +Dos B-EVOLUTION +días I-EVOLUTION +más I-EVOLUTION +tarde, I-EVOLUTION +la I-EVOLUTION +fiebre I-EVOLUTION +comienza I-EVOLUTION +a I-EVOLUTION +disminuir I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +lesión I-EVOLUTION +se I-EVOLUTION +torna I-EVOLUTION +circunscripta I-EVOLUTION +y I-EVOLUTION +fluctuante. I-EVOLUTION +Aparece I-EVOLUTION +además I-EVOLUTION +un I-EVOLUTION +exantema I-EVOLUTION +cutáneo I-EVOLUTION +eritematopustuloso I-EVOLUTION +con I-EVOLUTION +descamación I-EVOLUTION +que I-EVOLUTION +predomina I-EVOLUTION +en I-EVOLUTION +tronco I-EVOLUTION +y I-EVOLUTION +axila. I-EVOLUTION +Se B-EXPLORATION +realiza I-EXPLORATION +hisopado I-EXPLORATION +nasal, I-EXPLORATION +axilar I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -registraron I-EXPLORATION -las I-EXPLORATION -temperaturas I-EXPLORATION -máximas I-EXPLORATION +anal, I-EXPLORATION y I-EXPLORATION -mínimas I-EXPLORATION -durante I-EXPLORATION -cinco I-EXPLORATION -días, I-EXPLORATION -concretamente I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -1 I-EXPLORATION -de I-EXPLORATION -febrero I-EXPLORATION -de I-EXPLORATION -2011 I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -día I-EXPLORATION -5 I-EXPLORATION -del I-EXPLORATION -mismo I-EXPLORATION -mes. I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION -fueron I-EXPLORATION -analizados I-EXPLORATION -con I-EXPLORATION +se I-EXPLORATION +obtiene I-EXPLORATION el I-EXPLORATION -paquete I-EXPLORATION -estadístico I-EXPLORATION -SPSS I-EXPLORATION -15.0 I-EXPLORATION -y I-EXPLORATION -complementados I-EXPLORATION -con I-EXPLORATION -UNStat, I-EXPLORATION -aplicación I-EXPLORATION -desarrollada I-EXPLORATION -por I-EXPLORATION +germen I-EXPLORATION +aislado I-EXPLORATION +previamente I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -Universidad I-EXPLORATION -de I-EXPLORATION -Navarra. I-EXPLORATION +mucosa I-EXPLORATION +nasal. I-EXPLORATION I-EXPLORATION -Para I-EXPLORATION -diferenciar I-EXPLORATION -entre I-EXPLORATION -las I-EXPLORATION -larvas I-EXPLORATION -que I-EXPLORATION -todavía I-EXPLORATION +En I-EXPLORATION +una I-EXPLORATION +segunda I-EXPLORATION +RMN, I-EXPLORATION se I-EXPLORATION -están I-EXPLORATION -alimentando I-EXPLORATION +comprueba I-EXPLORATION +mayor I-EXPLORATION +jerarquía I-EXPLORATION del I-EXPLORATION -cuerpo I-EXPLORATION +edema I-EXPLORATION en I-EXPLORATION -descomposición I-EXPLORATION +los I-EXPLORATION +músculos I-EXPLORATION +trapecio I-EXPLORATION y I-EXPLORATION -las I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -están I-EXPLORATION -alejando I-EXPLORATION -ya I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -fuente I-EXPLORATION -de I-EXPLORATION -alimentación I-EXPLORATION -para I-EXPLORATION -pupar, I-EXPLORATION -se I-EXPLORATION -diseccionan I-EXPLORATION -dorsalmente I-EXPLORATION -las I-EXPLORATION -larvas I-EXPLORATION +pectoral I-EXPLORATION +mayor I-EXPLORATION +derecho, I-EXPLORATION +extendiéndose I-EXPLORATION +el I-EXPLORATION +proceso I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +músculos I-EXPLORATION +pectoral I-EXPLORATION +menor, I-EXPLORATION +subclavio, I-EXPLORATION +romboides I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -comprueba I-EXPLORATION -si I-EXPLORATION -existe I-EXPLORATION -un I-EXPLORATION -depósito I-EXPLORATION +al I-EXPLORATION +tejido I-EXPLORATION +blando I-EXPLORATION +adyacente. I-EXPLORATION +Formación I-EXPLORATION de I-EXPLORATION -grasa I-EXPLORATION -subcuticular I-EXPLORATION +una I-EXPLORATION +colección I-EXPLORATION +líquida I-EXPLORATION que I-EXPLORATION -impida I-EXPLORATION -la I-EXPLORATION -observación I-EXPLORATION -dorsal I-EXPLORATION -del I-EXPLORATION -tracto I-EXPLORATION -digestivo I-EXPLORATION -relleno I-EXPLORATION -de I-EXPLORATION -alimento. I-EXPLORATION -Ese I-EXPLORATION -depósito I-EXPLORATION -es I-EXPLORATION -observable I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -larvas I-EXPLORATION -migratorias3. I-EXPLORATION -Además, I-EXPLORATION -la I-EXPLORATION -medición I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -longitud I-EXPLORATION -del I-EXPLORATION -tracto I-EXPLORATION -digestivo I-EXPLORATION -relleno I-EXPLORATION -permite I-EXPLORATION -discernir I-EXPLORATION -entre I-EXPLORATION -ambas I-EXPLORATION -fases18. I-EXPLORATION -Mientras I-EXPLORATION -las I-EXPLORATION -larvas I-EXPLORATION -se I-EXPLORATION -alimenten, I-EXPLORATION +rodea I-EXPLORATION el I-EXPLORATION -contenido I-EXPLORATION -digestivo I-EXPLORATION -va I-EXPLORATION -aumentando I-EXPLORATION -su I-EXPLORATION -longitud I-EXPLORATION -de I-EXPLORATION -relleno I-EXPLORATION -mientras I-EXPLORATION -que, I-EXPLORATION -cuando I-EXPLORATION -entran I-EXPLORATION -en I-EXPLORATION -fase I-EXPLORATION -migratoria, I-EXPLORATION -existe I-EXPLORATION -un I-EXPLORATION -vaciado I-EXPLORATION -del I-EXPLORATION -contenido I-EXPLORATION -digestivo I-EXPLORATION -que I-EXPLORATION -implica I-EXPLORATION -un I-EXPLORATION -acortamiento I-EXPLORATION +tercio I-EXPLORATION +proximal I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -longitud I-EXPLORATION -de I-EXPLORATION -tracto I-EXPLORATION -digestivo I-EXPLORATION -relleno. I-EXPLORATION +clavícula I-EXPLORATION +derecha. I-EXPLORATION I-EXPLORATION +Posteriormente, B-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +el I-TREATMENT +drenaje I-TREATMENT +del I-TREATMENT +absceso I-TREATMENT +por I-TREATMENT +punción I-TREATMENT +y I-TREATMENT +se I-TREATMENT +solicita I-TREATMENT +un I-TREATMENT +centellograma I-TREATMENT +que I-TREATMENT +descarta I-TREATMENT +el I-TREATMENT +compromiso I-TREATMENT +óseo. I-TREATMENT +El B-EVOLUTION +niño I-EVOLUTION +evoluciona I-EVOLUTION +favorablemente I-EVOLUTION +y B-TREATMENT +completa I-TREATMENT +diez I-TREATMENT +días I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +vancomicina I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +parenteral I-TREATMENT +y I-TREATMENT +luego, I-TREATMENT +veinte I-TREATMENT +días I-TREATMENT +con I-TREATMENT +trimetroprimasulfametoxasol I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +oral. I-TREATMENT + I-TREATMENT -Mujer B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -47 I-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -mórbida, I-PAST_MEDICAL_HISTORY -fumadora. I-PAST_MEDICAL_HISTORY -Múltiples I-PAST_MEDICAL_HISTORY -ingresos I-PAST_MEDICAL_HISTORY -hospitalarios, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ellos I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -muerte, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -sobreinfección I-PAST_MEDICAL_HISTORY -respiratoria. I-PAST_MEDICAL_HISTORY -Antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -fiebre I-PAST_MEDICAL_HISTORY -reumática I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -infancia. I-PAST_MEDICAL_HISTORY -Diagnosticada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -larga I-PAST_MEDICAL_HISTORY -evolución, I-PAST_MEDICAL_HISTORY -miocardiopatía I-PAST_MEDICAL_HISTORY -dilatada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -posible I-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -enólico, I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -aórtica I-PAST_MEDICAL_HISTORY -moderada, I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -cardiaca I-PAST_MEDICAL_HISTORY -congestiva, I-PAST_MEDICAL_HISTORY -EPOC I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -depresivo. I-PAST_MEDICAL_HISTORY -Múltiples I-PAST_MEDICAL_HISTORY -ingresos I-PAST_MEDICAL_HISTORY -hospitalarios I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipoventilación I-PAST_MEDICAL_HISTORY -asociada, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ellos I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -muerte I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -cardiaca I-PAST_MEDICAL_HISTORY -congestiva I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -respiratoria I-PAST_MEDICAL_HISTORY -global I-PAST_MEDICAL_HISTORY -reagudizada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -sobre-infección I-PAST_MEDICAL_HISTORY -respiratoria. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -primeras I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -mañana I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -fallecimiento, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -familia I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -respiratoria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -seguidamente I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +ictericia I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -conciencia. I-PRESENT_ILLNESS -Avisados B-EVOLUTION -los I-EVOLUTION -Servicios I-EVOLUTION -de I-EVOLUTION -Urgencia I-EVOLUTION -y I-EVOLUTION -tras I-EVOLUTION -aplicar I-EVOLUTION -maniobras I-EVOLUTION -de I-EVOLUTION -RCP I-EVOLUTION -avanzada, I-EVOLUTION -acreditan I-EVOLUTION -su I-EVOLUTION -defunción. I-EVOLUTION +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +con B-EXPLORATION +una I-EXPLORATION +analítica I-EXPLORATION +que I-EXPLORATION +evidenciaba I-EXPLORATION +anemia, I-EXPLORATION +trombopenia I-EXPLORATION +y I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +bilirrubina I-EXPLORATION +y I-EXPLORATION +enzimas I-EXPLORATION +de I-EXPLORATION +colestasis. I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +computerizada I-EXPLORATION +(TC) I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +de I-EXPLORATION +13 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION +segmentos I-EXPLORATION +IV, I-EXPLORATION +V I-EXPLORATION +y I-EXPLORATION +VIII. I-EXPLORATION +Al B-EVOLUTION +mes I-EVOLUTION +del I-EVOLUTION +ingreso I-EVOLUTION +falleció I-EVOLUTION +por I-EVOLUTION +shock I-EVOLUTION +hipovolémico I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +autopsia I-EVOLUTION +compatible I-EVOLUTION +con I-EVOLUTION +ASH. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -87 I-PRESENT_ILLNESS +67 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY +cirrosis I-PAST_MEDICAL_HISTORY +hepática I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -C I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY +origen I-PAST_MEDICAL_HISTORY +enólico I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY sin I-PAST_MEDICAL_HISTORY -constancia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -traumatismo I-PAST_MEDICAL_HISTORY -abdominal I-PAST_MEDICAL_HISTORY -previo I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +cardiopulmonares I-PAST_MEDICAL_HISTORY que B-PRESENT_ILLNESS -presentó I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -inespecífico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -varias I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -motivo I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -visitada I-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS por I-PRESENT_ILLNESS un I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -familia I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -domicilio I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -administró I-PRESENT_ILLNESS -metoclopramida. I-PRESENT_ILLNESS -Falleció B-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -pocas I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -atención I-EVOLUTION -médica, I-EVOLUTION -motivo I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -cual I-EVOLUTION -se I-EVOLUTION -practicó I-EVOLUTION -autopsia I-EVOLUTION -judicial. I-EVOLUTION - I-EVOLUTION -Del B-EXPLORATION -examen I-EXPLORATION -externo I-EXPLORATION -destacó I-EXPLORATION -la I-EXPLORATION -palidez I-EXPLORATION -cutáneo-mucosa I-EXPLORATION -y I-EXPLORATION -disposición I-EXPLORATION -en I-EXPLORATION -martillo I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -segundos I-EXPLORATION -dedos I-EXPLORATION +encefalopatía I-PRESENT_ILLNESS +hepática I-PRESENT_ILLNESS +secundario I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +estreñimiento. I-PRESENT_ILLNESS +En B-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -ambos I-EXPLORATION -pies. I-EXPLORATION -Durante I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -interno I-EXPLORATION +tórax I-EXPLORATION se I-EXPLORATION -detectó I-EXPLORATION -calcificación I-EXPLORATION -mitral, I-EXPLORATION -ateromatosis I-EXPLORATION -coronaria I-EXPLORATION -con I-EXPLORATION -obstrucción I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -mismas I-EXPLORATION -de I-EXPLORATION -entre I-EXPLORATION -un I-EXPLORATION -25-50%, I-EXPLORATION -hipertrofia I-EXPLORATION -ventricular I-EXPLORATION -concéntrica, I-EXPLORATION -ateromatosis I-EXPLORATION -generalizada I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -grandes I-EXPLORATION -vasos I-EXPLORATION +observó I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +radiopaca, I-EXPLORATION +redondeada I-EXPLORATION y I-EXPLORATION -hemoperitoneo I-EXPLORATION -de I-EXPLORATION -3.000 I-EXPLORATION -cc, I-EXPLORATION -parcialmente I-EXPLORATION -coagulado. I-EXPLORATION -Hígado I-EXPLORATION con I-EXPLORATION -un I-EXPLORATION -peso I-EXPLORATION -de I-EXPLORATION -1.585 I-EXPLORATION -g I-EXPLORATION +bordes I-EXPLORATION +regulares I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION +hemitórax I-EXPLORATION +izquierdo I-EXPLORATION que I-EXPLORATION -macroscópicamente I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -una I-EXPLORATION -cirrosis I-EXPLORATION -macronodular I-EXPLORATION -generalizada I-EXPLORATION -y I-EXPLORATION +no I-EXPLORATION +existía I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -lóbulo I-EXPLORATION -hepático I-EXPLORATION -izquierdo I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -esférica I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -sin I-EXPLORATION -pedículo, I-EXPLORATION -blanda I-EXPLORATION -y I-EXPLORATION -móvil I-EXPLORATION -a I-EXPLORATION +controles I-EXPLORATION +previos I-EXPLORATION +iniciándose I-EXPLORATION +tratamiento I-EXPLORATION +antibiótico I-EXPLORATION +empírico I-EXPLORATION +ante I-EXPLORATION la I-EXPLORATION -palpación, I-EXPLORATION -con I-EXPLORATION -cápsula I-EXPLORATION +sospecha I-EXPLORATION de I-EXPLORATION -color I-EXPLORATION -gris-amarillento, I-EXPLORATION -muy I-EXPLORATION -vascularizada, I-EXPLORATION -que I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -rotura I-EXPLORATION -parcial. I-EXPLORATION -Al I-EXPLORATION -corte I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -tumoración I-EXPLORATION -hepática I-EXPLORATION -tenía I-EXPLORATION una I-EXPLORATION -coloración I-EXPLORATION -más I-EXPLORATION -pálida I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -tejido I-EXPLORATION -circundante, I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -heterogéneo, I-EXPLORATION -con I-EXPLORATION -escasa I-EXPLORATION -pigmentación I-EXPLORATION -biliar I-EXPLORATION -y I-EXPLORATION -zonas I-EXPLORATION -necrohemorrágicas I-EXPLORATION -cercanas I-EXPLORATION -a I-EXPLORATION +neumonía. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -zona I-EXPLORATION -de I-EXPLORATION -rotura I-EXPLORATION -capsular. I-EXPLORATION -La I-EXPLORATION -histopatología I-EXPLORATION -de I-EXPLORATION +TC I-EXPLORATION +torácica I-EXPLORATION la I-EXPLORATION -tumoración I-EXPLORATION -informó I-EXPLORATION +colección I-EXPLORATION +era I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -carcinoma I-EXPLORATION -hepatocelular I-EXPLORATION +bordes I-EXPLORATION +lisos I-EXPLORATION +y I-EXPLORATION +regulares I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +contenido I-EXPLORATION de I-EXPLORATION -alto I-EXPLORATION -grado. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -interpretó I-EXPLORATION +densidad I-EXPLORATION +"agua" I-EXPLORATION +planteándose I-EXPLORATION la I-EXPLORATION -causa I-EXPLORATION -de I-EXPLORATION -muerte I-EXPLORATION -como I-EXPLORATION -consecuencia I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -shock I-EXPLORATION -hipovolémico I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION -hemoperitoneo I-EXPLORATION -por I-EXPLORATION -rotura I-EXPLORATION -del I-EXPLORATION -carcinoma I-EXPLORATION -hepatocelular I-EXPLORATION -(según I-EXPLORATION -clasificación I-EXPLORATION -CIE I-EXPLORATION -10: I-EXPLORATION -C22.0). I-EXPLORATION -Siendo I-EXPLORATION -este I-EXPLORATION -tipo I-EXPLORATION +posibilidad I-EXPLORATION de I-EXPLORATION -complicación I-EXPLORATION -es I-EXPLORATION -extremadamente I-EXPLORATION -infrecuente I-EXPLORATION -en I-EXPLORATION -nuestro I-EXPLORATION -medio. I-EXPLORATION - I-EXPLORATION +una I-EXPLORATION +ascitis I-EXPLORATION +intratorácica I-EXPLORATION +loculada. I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +mejoró I-EVOLUTION +rápidamente I-EVOLUTION +de I-EVOLUTION +sus I-EVOLUTION +síntomas, I-EVOLUTION +pero I-EVOLUTION +al I-EVOLUTION +alta I-EVOLUTION +persistía I-EVOLUTION +la I-EVOLUTION +lesión I-EVOLUTION +anteriormente I-EVOLUTION +descrita, I-EVOLUTION +la I-EVOLUTION +cual I-EVOLUTION +desapareció I-EVOLUTION +al I-EVOLUTION +cabo I-EVOLUTION +de I-EVOLUTION +un I-EVOLUTION +mes I-EVOLUTION +con B-TREATMENT +terapia I-TREATMENT +diurética. I-TREATMENT + I-TREATMENT -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS +59 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +candidato I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +trasplante I-PRESENT_ILLNESS +hepático. I-PRESENT_ILLNESS +Presentó I-PRESENT_ILLNESS un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +hepatorenal I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +motivó I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +importante I-PRESENT_ILLNESS +aporte I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +volumen I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +furosemida, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +obtener I-PRESENT_ILLNESS +respuesta I-PRESENT_ILLNESS +diurética. I-PRESENT_ILLNESS +A I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cual I-PRESENT_ILLNESS +esto I-PRESENT_ILLNESS se I-PRESENT_ILLNESS -desplomó I-PRESENT_ILLNESS -súbitamente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -vía I-PRESENT_ILLNESS -pública. I-PRESENT_ILLNESS -En B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -clínicos I-PAST_MEDICAL_HISTORY -constaba I-PAST_MEDICAL_HISTORY -estar I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -Síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Noonan I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -desarrollo I-PAST_MEDICAL_HISTORY -psicomotor I-PAST_MEDICAL_HISTORY -normal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -óbito. I-PAST_MEDICAL_HISTORY -En B-FAMILY_HISTORY -la I-FAMILY_HISTORY -familia I-FAMILY_HISTORY -no I-FAMILY_HISTORY -existían I-FAMILY_HISTORY -otros I-FAMILY_HISTORY -miembros I-FAMILY_HISTORY -que I-FAMILY_HISTORY -tuvieran I-FAMILY_HISTORY -un I-FAMILY_HISTORY -fenotipo I-FAMILY_HISTORY -similar. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Hallazgos B-EXPLORATION -destacados I-EXPLORATION -en I-EXPLORATION +encontró I-PRESENT_ILLNESS +donante. I-PRESENT_ILLNESS +En B-EXPLORATION +ese I-EXPLORATION +momento I-EXPLORATION el I-EXPLORATION -examen I-EXPLORATION -externo: I-EXPLORATION -cadáver I-EXPLORATION -correspondiente I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -varón I-EXPLORATION -de I-EXPLORATION -175 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -altura I-EXPLORATION -y I-EXPLORATION -78 I-EXPLORATION -Kg I-EXPLORATION -de I-EXPLORATION -peso I-EXPLORATION -(IMC I-EXPLORATION -25, I-EXPLORATION -5 I-EXPLORATION -kg/m2) I-EXPLORATION +paciente I-EXPLORATION +estaba I-EXPLORATION +soporoso, I-EXPLORATION con I-EXPLORATION -diversas I-EXPLORATION -características I-EXPLORATION -anatómicas I-EXPLORATION -destacadas: I-EXPLORATION -frente I-EXPLORATION -amplia, I-EXPLORATION -mentón I-EXPLORATION -prominente, I-EXPLORATION -pabellones I-EXPLORATION -auriculares I-EXPLORATION +escasa I-EXPLORATION +respuesta I-EXPLORATION +a I-EXPLORATION +estímulos I-EXPLORATION +verbales, I-EXPLORATION +PA I-EXPLORATION +110/60, I-EXPLORATION +FC I-EXPLORATION +115 I-EXPLORATION +por I-EXPLORATION +minuto, I-EXPLORATION +frecuencia I-EXPLORATION +respiratoria I-EXPLORATION +35x'. I-EXPLORATION +Un I-EXPLORATION +ecocardiograma I-EXPLORATION de I-EXPLORATION -inserción I-EXPLORATION -baja I-EXPLORATION -y I-EXPLORATION -con I-EXPLORATION -lóbulos I-EXPLORATION +superficie I-EXPLORATION +mostró I-EXPLORATION +buena I-EXPLORATION +función I-EXPLORATION +ventricular I-EXPLORATION +global, I-EXPLORATION +dilatación I-EXPLORATION de I-EXPLORATION las I-EXPLORATION -orejas I-EXPLORATION -hacia I-EXPLORATION -delante, I-EXPLORATION -ojos I-EXPLORATION -con I-EXPLORATION -hendiduras I-EXPLORATION -palpebrales I-EXPLORATION -hacia I-EXPLORATION -abajo, I-EXPLORATION -puente I-EXPLORATION -nasal I-EXPLORATION -grueso, I-EXPLORATION -cuello I-EXPLORATION -corto, I-EXPLORATION -deformidad I-EXPLORATION -esternal I-EXPLORATION -con I-EXPLORATION -pectus I-EXPLORATION -carinatum I-EXPLORATION -(tórax I-EXPLORATION -en I-EXPLORATION -quilla) I-EXPLORATION -prominencia I-EXPLORATION -del I-EXPLORATION -pubis I-EXPLORATION +cuatro I-EXPLORATION +cavidades I-EXPLORATION y I-EXPLORATION -primer I-EXPLORATION -dedo I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -pies I-EXPLORATION -en I-EXPLORATION -garra. I-EXPLORATION - I-EXPLORATION -Hallazgos I-EXPLORATION -destacados I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -interno: I-EXPLORATION -corazón I-EXPLORATION -de I-EXPLORATION -395 I-EXPLORATION -g I-EXPLORATION +presión I-EXPLORATION +sistólica I-EXPLORATION de I-EXPLORATION -peso I-EXPLORATION -(valor I-EXPLORATION -medio I-EXPLORATION -según I-EXPLORATION -peso I-EXPLORATION -corporal: I-EXPLORATION -345 I-EXPLORATION -g I-EXPLORATION -[rango I-EXPLORATION -261-455 I-EXPLORATION -g]). I-EXPLORATION -Grosor I-EXPLORATION -pared I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo: I-EXPLORATION -1, I-EXPLORATION -1cm, I-EXPLORATION -tabique I-EXPLORATION -interventricular: I-EXPLORATION -1, I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -y I-EXPLORATION -ventrículo I-EXPLORATION -derecho: I-EXPLORATION -0, I-EXPLORATION -1 I-EXPLORATION -cm. I-EXPLORATION -Agujero I-EXPLORATION -oval I-EXPLORATION -no I-EXPLORATION -permeable. I-EXPLORATION -Válvulas I-EXPLORATION -aurículo-ventriculares I-EXPLORATION -y I-EXPLORATION +arteria I-EXPLORATION pulmonar I-EXPLORATION -normales. I-EXPLORATION -Válvula I-EXPLORATION -aórtica I-EXPLORATION -bicúspide. I-EXPLORATION -Severa I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -raíz I-EXPLORATION -aórtica I-EXPLORATION -con I-EXPLORATION -disección I-EXPLORATION -circular I-EXPLORATION -completa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -íntima I-EXPLORATION -arterial I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -altura I-EXPLORATION -del I-EXPLORATION -anillo I-EXPLORATION +(PSAP) I-EXPLORATION de I-EXPLORATION -inserción I-EXPLORATION -valvular I-EXPLORATION -con I-EXPLORATION -desprendimiento I-EXPLORATION -completo I-EXPLORATION +50 I-EXPLORATION +mmHg. I-EXPLORATION +En I-EXPLORATION +pabellón, I-EXPLORATION +se I-EXPLORATION +intubó I-EXPLORATION e I-EXPLORATION -intususpección I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -longitud I-EXPLORATION +instaló I-EXPLORATION +sonda I-EXPLORATION +para I-EXPLORATION +ETE I-EXPLORATION +y I-EXPLORATION +CAP I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +PVC I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -capa I-EXPLORATION -interna I-EXPLORATION -disecada I-EXPLORATION -hasta I-EXPLORATION -un I-EXPLORATION -área I-EXPLORATION +25 I-EXPLORATION +mmHg, I-EXPLORATION +PCP I-EXPLORATION +26 I-EXPLORATION +mm I-EXPLORATION +Hg, I-EXPLORATION +RVSI I-EXPLORATION de I-EXPLORATION -menor I-EXPLORATION -calibre I-EXPLORATION -del I-EXPLORATION -cayado I-EXPLORATION -aórtico, I-EXPLORATION -extendiéndose I-EXPLORATION +987 I-EXPLORATION +dinas*segundo/cm5/m2. I-EXPLORATION +El I-EXPLORATION +IC I-EXPLORATION +y I-EXPLORATION +PSAP I-EXPLORATION +medidas I-EXPLORATION por I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -subclavia I-EXPLORATION -izquierda I-EXPLORATION +CAP I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -tronco I-EXPLORATION -braquiocefálico, I-EXPLORATION +ETE I-EXPLORATION +fueron I-EXPLORATION +respectivamente I-EXPLORATION +4, I-EXPLORATION +7 I-EXPLORATION y I-EXPLORATION -obstruyendo I-EXPLORATION -completamente I-EXPLORATION -las I-EXPLORATION -tres I-EXPLORATION -luces I-EXPLORATION -vasculares. I-EXPLORATION - I-EXPLORATION +5, I-EXPLORATION +3 I-EXPLORATION +1/ I-EXPLORATION +m2, I-EXPLORATION +y I-EXPLORATION +49/32 I-EXPLORATION +y I-EXPLORATION +48. I-EXPLORATION El I-EXPLORATION -estudio I-EXPLORATION -microscópico I-EXPLORATION -ofreció I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -datos I-EXPLORATION +volumen I-EXPLORATION de I-EXPLORATION -interés: I-EXPLORATION -signos I-EXPLORATION -moderados I-EXPLORATION +fin I-EXPLORATION de I-EXPLORATION -hipertrofia I-EXPLORATION -miocitaria I-EXPLORATION -en I-EXPLORATION -miocardio I-EXPLORATION -ventricular I-EXPLORATION +diástole I-EXPLORATION +del I-EXPLORATION +ventrículo I-EXPLORATION izquierdo I-EXPLORATION -con I-EXPLORATION -patrón I-EXPLORATION -desorganizativo I-EXPLORATION -focal I-EXPLORATION -en I-EXPLORATION -tabique I-EXPLORATION -interventricular. I-EXPLORATION -Infiltración I-EXPLORATION -adiposa I-EXPLORATION -miocárdica I-EXPLORATION -ventricular I-EXPLORATION -derecha I-EXPLORATION -anterior I-EXPLORATION -y I-EXPLORATION -posterior I-EXPLORATION -con I-EXPLORATION -fibrosis I-EXPLORATION -intersticial I-EXPLORATION -sin I-EXPLORATION -reacción I-EXPLORATION -inflamatoria I-EXPLORATION -crónica. I-EXPLORATION -Necrosis I-EXPLORATION -quística I-EXPLORATION +indexado I-EXPLORATION +(VFDVII) I-EXPLORATION +fue I-EXPLORATION +98 I-EXPLORATION +ml/m2 I-EXPLORATION +(valor I-EXPLORATION +normal: I-EXPLORATION +35-75 I-EXPLORATION +ml/m2). I-EXPLORATION +Se B-TREATMENT +aportaron I-TREATMENT +fluidos I-TREATMENT +de I-TREATMENT +manera I-TREATMENT +muy I-TREATMENT +restringida, I-TREATMENT +observándose I-TREATMENT +durante I-TREATMENT +todo I-TREATMENT +el I-TREATMENT +procedimiento I-TREATMENT +buena I-TREATMENT +concordancia I-TREATMENT +entre I-TREATMENT +los I-TREATMENT +valores I-TREATMENT +de I-TREATMENT +IC I-TREATMENT +y I-TREATMENT +PSAP I-TREATMENT +medidos I-TREATMENT +con I-TREATMENT +CAP I-TREATMENT +y I-TREATMENT +ETE. I-TREATMENT +Al B-EXPLORATION +término I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -media I-EXPLORATION -arterial I-EXPLORATION -aórtica. I-EXPLORATION -Arterioloesclerosis I-EXPLORATION -renal I-EXPLORATION -con I-EXPLORATION -microlitiasis I-EXPLORATION +cirugía I-EXPLORATION +la I-EXPLORATION +PVC I-EXPLORATION +era I-EXPLORATION +14 I-EXPLORATION +mmHg, I-EXPLORATION +PCP I-EXPLORATION +19 I-EXPLORATION +mmHg, I-EXPLORATION +PAP I-EXPLORATION +33/22 I-EXPLORATION +e I-EXPLORATION +IC I-EXPLORATION +5, I-EXPLORATION +1/ I-EXPLORATION +m2. I-EXPLORATION +El I-EXPLORATION +ETE I-EXPLORATION +mostraba I-EXPLORATION +una I-EXPLORATION +PSAP I-EXPLORATION +de I-EXPLORATION +32, I-EXPLORATION +IC I-EXPLORATION +de I-EXPLORATION +5 I-EXPLORATION +1/ I-EXPLORATION +m2, I-EXPLORATION y I-EXPLORATION -esteatosis I-EXPLORATION -hepática I-EXPLORATION -en I-EXPLORATION -grado I-EXPLORATION -leve. I-EXPLORATION +VFDVI67ml/m2. I-EXPLORATION I-EXPLORATION -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -sujeto I-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -45 I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -soltero, B-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -convive I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -madre, I-PAST_MEDICAL_HISTORY +sin B-PAST_MEDICAL_HISTORY +hábitos I-PAST_MEDICAL_HISTORY +tóxicos, I-PAST_MEDICAL_HISTORY que B-PRESENT_ILLNESS -mientras I-PRESENT_ILLNESS -cuidaba I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -menor I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -vecino I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -lugar I-PRESENT_ILLNESS -donde I-PRESENT_ILLNESS -reside, I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -sorprendido I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -madre I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -pequeño I-PRESENT_ILLNESS -cuando I-PRESENT_ILLNESS -tocaba I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -genitales I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -niño, I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -colocaba I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -pene I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -erección I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -glútea I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -pequeño. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -acusado I-PRESENT_ILLNESS -acepta I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -cometido I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hecho I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -tener I-PRESENT_ILLNESS -explicación I-PRESENT_ILLNESS -ante I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -ocurrido. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Entre B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY +torácico. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +recurrentes I-PRESENT_ILLNESS +similares I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +últimos I-PRESENT_ILLNESS +cinco I-PRESENT_ILLNESS +años. I-PRESENT_ILLNESS +En B-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +ocasión I-PAST_MEDICAL_HISTORY se I-PAST_MEDICAL_HISTORY -comprobó I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -estuvo I-PAST_MEDICAL_HISTORY -ingresado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2003 I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -Hospital I-PAST_MEDICAL_HISTORY -Psiquiátrico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -Habana I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -Trastorno I-PAST_MEDICAL_HISTORY -Orgánico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -Personalidad. I-PAST_MEDICAL_HISTORY -Refiere I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -producto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -múltiple I-PAST_MEDICAL_HISTORY -(trillizos) I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -cual I-PAST_MEDICAL_HISTORY -solo I-PAST_MEDICAL_HISTORY -él I-PAST_MEDICAL_HISTORY -sobrevivió. I-PAST_MEDICAL_HISTORY -Estudió I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -enseñanza I-PAST_MEDICAL_HISTORY -especial I-PAST_MEDICAL_HISTORY -alcanzando I-PAST_MEDICAL_HISTORY -9o I-PAST_MEDICAL_HISTORY -grado, I-PAST_MEDICAL_HISTORY -luego I-PAST_MEDICAL_HISTORY -abandonó I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -estudios. I-PAST_MEDICAL_HISTORY -Huérfano I-PAST_MEDICAL_HISTORY +diagnosticó I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -padre I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Trauma I-PAST_MEDICAL_HISTORY -craneoencefálico I-PAST_MEDICAL_HISTORY +probable I-PAST_MEDICAL_HISTORY +abdomen I-PAST_MEDICAL_HISTORY +agudo, I-PAST_MEDICAL_HISTORY +habiendo I-PAST_MEDICAL_HISTORY +estado I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -pérdida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -conciencia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -atención I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -neurología. I-PAST_MEDICAL_HISTORY -Lleva I-PAST_MEDICAL_HISTORY -varios I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -desvinculado I-PAST_MEDICAL_HISTORY -laboralmente. I-PAST_MEDICAL_HISTORY -Según I-PAST_MEDICAL_HISTORY -explicó I-PAST_MEDICAL_HISTORY -tuvo I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -única I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY +punto I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -pareja I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -juventud. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Fue B-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestra I-DERIVED_FROM/TO -institución I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -objetivo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -realizar I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -evaluación I-DERIVED_FROM/TO -psiquiátrica I-DERIVED_FROM/TO -forense. I-DERIVED_FROM/TO -Los B-EXPLORATION -peritos I-EXPLORATION -psiquiatras I-EXPLORATION -actuantes I-EXPLORATION -solicitaron I-EXPLORATION -una I-EXPLORATION -evaluación I-EXPLORATION -por I-EXPLORATION -parte I-EXPLORATION -del I-EXPLORATION -Laboratorio I-EXPLORATION -de I-EXPLORATION -Neurofisiología I-EXPLORATION -Clínica I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -entrevista I-EXPLORATION -clínica I-EXPLORATION -al I-EXPLORATION -paciente, I-EXPLORATION -se I-EXPLORATION -registró I-EXPLORATION +ser I-PAST_MEDICAL_HISTORY +laparotomizado. I-PAST_MEDICAL_HISTORY +El B-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +actual I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +39, I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +ºC, I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +pleurítico I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +hemitórax I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +La B-EXPLORATION +exploración I-EXPLORATION +mostró I-EXPLORATION un I-EXPLORATION -EEG I-EXPLORATION -en I-EXPLORATION -condiciones I-EXPLORATION -basales I-EXPLORATION +abdomen I-EXPLORATION +doloroso, I-EXPLORATION +sobre I-EXPLORATION +todo I-EXPLORATION en I-EXPLORATION -estado I-EXPLORATION -de I-EXPLORATION -vigilia I-EXPLORATION -utilizando I-EXPLORATION -el I-EXPLORATION -equipo I-EXPLORATION -Medicid I-EXPLORATION -V I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -programa I-EXPLORATION -Track I-EXPLORATION -Walker I-EXPLORATION -(Neuronic, I-EXPLORATION -SA I-EXPLORATION -Cuba). I-EXPLORATION -Se I-EXPLORATION -registraron I-EXPLORATION -3 I-EXPLORATION -minutos I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -ojos I-EXPLORATION -cerrados, I-EXPLORATION -2 I-EXPLORATION -minutos I-EXPLORATION +fosa I-EXPLORATION +iliaca I-EXPLORATION +derecha, I-EXPLORATION con I-EXPLORATION -los I-EXPLORATION -ojos I-EXPLORATION -abiertos, I-EXPLORATION -3 I-EXPLORATION -minutos I-EXPLORATION -durante I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +irritación I-EXPLORATION +peritoneal. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -hiperventilación I-EXPLORATION +analítica I-EXPLORATION +destacaba I-EXPLORATION +PCR I-EXPLORATION +25 I-EXPLORATION +mg/dl I-EXPLORATION y I-EXPLORATION -2 I-EXPLORATION -minutos I-EXPLORATION -de I-EXPLORATION -recuperación. I-EXPLORATION -Se I-EXPLORATION -seleccionaron I-EXPLORATION -de I-EXPLORATION -20 I-EXPLORATION -a I-EXPLORATION -24 I-EXPLORATION -ventanas I-EXPLORATION -del I-EXPLORATION -estado I-EXPLORATION -de I-EXPLORATION -ojos I-EXPLORATION -cerrados, I-EXPLORATION -libres I-EXPLORATION +leucocitos I-EXPLORATION +18.109/ml I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -artefactos I-EXPLORATION +tórax I-EXPLORATION +fue I-EXPLORATION +normal I-EXPLORATION y I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +no I-EXPLORATION +evidenció I-EXPLORATION +datos I-EXPLORATION +sugestivos I-EXPLORATION +de I-EXPLORATION +apendicitis I-EXPLORATION +aguda. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +analgésico I-TREATMENT +con I-TREATMENT +remisión I-TREATMENT +del I-TREATMENT +cuadro I-TREATMENT +en I-TREATMENT +24 I-TREATMENT +horas, I-TREATMENT +siendo I-TREATMENT +dado I-TREATMENT +de I-TREATMENT +alta. I-TREATMENT +Posteriormente B-EXPLORATION se I-EXPLORATION -procedió I-EXPLORATION -al I-EXPLORATION -análisis I-EXPLORATION -cuantitativo I-EXPLORATION -del I-EXPLORATION -EEG I-EXPLORATION -comparándose I-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +ambulatorio I-EXPLORATION con I-EXPLORATION -individuos I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -misma I-EXPLORATION -edad I-EXPLORATION -y I-EXPLORATION -sexo I-EXPLORATION +TC I-EXPLORATION +abdominal I-EXPLORATION y I-EXPLORATION +fibrocolonoscopia I-EXPLORATION que I-EXPLORATION -forman I-EXPLORATION -parte I-EXPLORATION -de I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +Ante I-EXPLORATION la I-EXPLORATION -base I-EXPLORATION -de I-EXPLORATION -datos I-EXPLORATION -normativa I-EXPLORATION -cubana. I-EXPLORATION -Se I-EXPLORATION -calculó I-EXPLORATION -el I-EXPLORATION -espectro I-EXPLORATION +remisión I-EXPLORATION +total I-EXPLORATION de I-EXPLORATION -frecuencia I-EXPLORATION -en I-EXPLORATION -cada I-EXPLORATION -una I-EXPLORATION +la I-EXPLORATION +clínica, I-EXPLORATION +los I-EXPLORATION +antecedentes I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -derivaciones I-EXPLORATION +episodios I-EXPLORATION +recurrentes I-EXPLORATION y I-EXPLORATION -luego I-EXPLORATION -las I-EXPLORATION -medidas I-EXPLORATION -espectrales I-EXPLORATION -de I-EXPLORATION -banda I-EXPLORATION -ancha; I-EXPLORATION -el I-EXPLORATION -Poder I-EXPLORATION -Absoluto I-EXPLORATION -(PA), I-EXPLORATION -que I-EXPLORATION -representa I-EXPLORATION -la I-EXPLORATION -energía I-EXPLORATION -que I-EXPLORATION -contiene I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -EEG I-EXPLORATION -(PA I-EXPLORATION -Total) I-EXPLORATION -o I-EXPLORATION la I-EXPLORATION -contenida I-EXPLORATION +negatividad I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +practicadas I-EXPLORATION +se I-EXPLORATION +orientó I-EXPLORATION +como I-EXPLORATION +una I-EXPLORATION +posible I-EXPLORATION +FMF, I-EXPLORATION +procediéndose I-EXPLORATION +a I-EXPLORATION +estudio I-EXPLORATION +genético. I-EXPLORATION +Este I-EXPLORATION +mostró I-EXPLORATION +dos I-EXPLORATION +mutaciones I-EXPLORATION en I-EXPLORATION +el I-EXPLORATION +gen I-EXPLORATION +MEFV: I-EXPLORATION una I-EXPLORATION -banda I-EXPLORATION -de I-EXPLORATION -frecuencia I-EXPLORATION -particular I-EXPLORATION -(delta, I-EXPLORATION -theta, I-EXPLORATION -alfa I-EXPLORATION -y I-EXPLORATION -beta); I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -Poder I-EXPLORATION -Relativo I-EXPLORATION -(PR), I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -es I-EXPLORATION -más I-EXPLORATION -que I-EXPLORATION +exón I-EXPLORATION +2, I-EXPLORATION +detectándose I-EXPLORATION la I-EXPLORATION -contribución I-EXPLORATION -de I-EXPLORATION -cada I-EXPLORATION -banda I-EXPLORATION +sustitución I-EXPLORATION del I-EXPLORATION -EEG I-EXPLORATION -a I-EXPLORATION +nucleótido I-EXPLORATION +guanina I-EXPLORATION +por I-EXPLORATION +citosina I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -energía I-EXPLORATION -total I-EXPLORATION +primera I-EXPLORATION +posición I-EXPLORATION del I-EXPLORATION -espectro, I-EXPLORATION +triplete I-EXPLORATION +148, I-EXPLORATION +dando I-EXPLORATION +lugar I-EXPLORATION +al I-EXPLORATION +cambio I-EXPLORATION +de I-EXPLORATION +aminoácido I-EXPLORATION +glutámico I-EXPLORATION +por I-EXPLORATION +glutamina. I-EXPLORATION +Dicha I-EXPLORATION +mutuación I-EXPLORATION +recibe I-EXPLORATION +el I-EXPLORATION +nombre I-EXPLORATION +de I-EXPLORATION +E148Q, I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -Frecuencia I-EXPLORATION -Media I-EXPLORATION -(FM), I-EXPLORATION -que I-EXPLORATION se I-EXPLORATION -corresponde I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -frecuencia I-EXPLORATION -(en I-EXPLORATION -Hz) I-EXPLORATION +detectó I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +solo I-EXPLORATION +alelo, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION que I-EXPLORATION -constituyen I-EXPLORATION el I-EXPLORATION -"centro I-EXPLORATION -de I-EXPLORATION -gravedad", I-EXPLORATION -ya I-EXPLORATION -sea I-EXPLORATION -de I-EXPLORATION +paciente I-EXPLORATION +es I-EXPLORATION +heterozigoto I-EXPLORATION +para I-EXPLORATION +esta I-EXPLORATION +mutuación. I-EXPLORATION +Se I-EXPLORATION +detectó I-EXPLORATION una I-EXPLORATION -banda I-EXPLORATION -o I-EXPLORATION -bien I-EXPLORATION -de I-EXPLORATION +segunda I-EXPLORATION +mutuación I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +exón I-EXPLORATION +10, I-EXPLORATION +que I-EXPLORATION +consistía I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -totalidad I-EXPLORATION +sustitución I-EXPLORATION del I-EXPLORATION -espectro. I-EXPLORATION -Se I-EXPLORATION -estimaron I-EXPLORATION -los I-EXPLORATION -generadores I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -actividad I-EXPLORATION -lenta I-EXPLORATION +nucleótido I-EXPLORATION +guanina I-EXPLORATION +por I-EXPLORATION +adenina I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -frecuencia I-EXPLORATION -7.031 I-EXPLORATION -Hz, I-EXPLORATION -utilizando I-EXPLORATION -el I-EXPLORATION -programa I-EXPLORATION -Localizador I-EXPLORATION +tercera I-EXPLORATION +posición I-EXPLORATION +del I-EXPLORATION +triplete I-EXPLORATION +694, I-EXPLORATION +dando I-EXPLORATION +lugar I-EXPLORATION +al I-EXPLORATION +cambio I-EXPLORATION de I-EXPLORATION -Fuentes I-EXPLORATION -(Neuronic, I-EXPLORATION -SA I-EXPLORATION -Cuba) I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -modelo I-EXPLORATION -bayesiano I-EXPLORATION -promediado I-EXPLORATION -(BMA) I-EXPLORATION -12, I-EXPLORATION +aminoácido I-EXPLORATION +metionina I-EXPLORATION +por I-EXPLORATION +isoleucina. I-EXPLORATION +Dicha I-EXPLORATION +mutuación I-EXPLORATION +recibe I-EXPLORATION el I-EXPLORATION -cual I-EXPLORATION -permite I-EXPLORATION -encontrar I-EXPLORATION -la I-EXPLORATION -densidad I-EXPLORATION +nombre I-EXPLORATION de I-EXPLORATION -corriente I-EXPLORATION -primaria I-EXPLORATION -dentro I-EXPLORATION -del I-EXPLORATION -cerebro, I-EXPLORATION -sin I-EXPLORATION -estar I-EXPLORATION -condicionada I-EXPLORATION +M694I I-EXPLORATION +y I-EXPLORATION +también I-EXPLORATION +se I-EXPLORATION +detectó I-EXPLORATION en I-EXPLORATION +un I-EXPLORATION +solo I-EXPLORATION +alelo, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION el I-EXPLORATION -modelo I-EXPLORATION -asumido. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -evaluó I-EXPLORATION +paciente I-EXPLORATION +es I-EXPLORATION +también I-EXPLORATION +heterozigoto I-EXPLORATION +para I-EXPLORATION +esta I-EXPLORATION +mutuación. I-EXPLORATION +Ambas I-EXPLORATION +mutaciones I-EXPLORATION +están I-EXPLORATION +descritas I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -respuesta I-EXPLORATION -simpática I-EXPLORATION +FMF. I-EXPLORATION +Asimismo I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION +del I-EXPLORATION +exón I-EXPLORATION +3 I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -piel, I-EXPLORATION -utilizando I-EXPLORATION -dos I-EXPLORATION -diseños I-EXPLORATION -experimentales, I-EXPLORATION -el I-EXPLORATION -primero I-EXPLORATION -conformado I-EXPLORATION -con I-EXPLORATION -16 I-EXPLORATION -imágenes I-EXPLORATION -neutras I-EXPLORATION -obtenidas I-EXPLORATION -a I-EXPLORATION -partir I-EXPLORATION -de I-EXPLORATION -imágenes I-EXPLORATION -estandarizadas I-EXPLORATION +proteina I-EXPLORATION +sérica I-EXPLORATION del I-EXPLORATION -Sistema I-EXPLORATION -Internacional I-EXPLORATION -de I-EXPLORATION -Imágenes I-EXPLORATION -Afectivas I-EXPLORATION -(IAPS; I-EXPLORATION -Center I-EXPLORATION -for I-EXPLORATION -the I-EXPLORATION -Study I-EXPLORATION -of I-EXPLORATION -Emotion I-EXPLORATION -and I-EXPLORATION -Attention-NIMH, I-EXPLORATION -1999) I-EXPLORATION -13 I-EXPLORATION -y I-EXPLORATION -6 I-EXPLORATION -imágenes I-EXPLORATION -de I-EXPLORATION -menores I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -sexos I-EXPLORATION -desnudos, I-EXPLORATION -el I-EXPLORATION -segundo I-EXPLORATION -utilizó I-EXPLORATION -16 I-EXPLORATION -fotos I-EXPLORATION -neutras I-EXPLORATION -y I-EXPLORATION -6 I-EXPLORATION +amiloide I-EXPLORATION +SAA-1, I-EXPLORATION que I-EXPLORATION -son I-EXPLORATION -representativas I-EXPLORATION -de I-EXPLORATION -estímulos I-EXPLORATION -sexuales I-EXPLORATION -de I-EXPLORATION -adultos I-EXPLORATION -(parejas I-EXPLORATION -eróticas), I-EXPLORATION -todas I-EXPLORATION -obtenidas I-EXPLORATION -del I-EXPLORATION -sistema I-EXPLORATION -internacional I-EXPLORATION -antes I-EXPLORATION -referido. I-EXPLORATION -Este I-EXPLORATION -tipo I-EXPLORATION -de I-EXPLORATION -evaluación I-EXPLORATION -forma I-EXPLORATION -parte I-EXPLORATION -de I-EXPLORATION +mostró I-EXPLORATION un I-EXPLORATION -nuevo I-EXPLORATION -método I-EXPLORATION +genotipo I-EXPLORATION +alfa/beta, I-EXPLORATION +considerado I-EXPLORATION +de I-EXPLORATION +bajo I-EXPLORATION +riesgo I-EXPLORATION para I-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION -experimental I-EXPLORATION +desarrollo I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -emociones, I-EXPLORATION -tiene I-EXPLORATION -además I-EXPLORATION -la I-EXPLORATION -ventaja I-EXPLORATION +amiloidosis. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +colchicina I-TREATMENT +a I-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +1 I-TREATMENT +mg/día I-TREATMENT +con B-EVOLUTION +buena I-EVOLUTION +evolución I-EVOLUTION +posterior I-EVOLUTION +y I-EVOLUTION +desaparición I-EVOLUTION +paulatina I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +crisis. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +25 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +residente I-PRESENT_ILLNESS +en B-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +provincia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Buenos I-PAST_MEDICAL_HISTORY +Aires, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +paludismo I-PAST_MEDICAL_HISTORY +después I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +viaje I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +región I-PAST_MEDICAL_HISTORY +amazónica I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Bolivia, I-PAST_MEDICAL_HISTORY +Perú, I-PAST_MEDICAL_HISTORY +Ecuador I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +Brasil, I-PAST_MEDICAL_HISTORY +tratado I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +mefloquina I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +otra I-PAST_MEDICAL_HISTORY +institución. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +regresó I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +área I-PAST_MEDICAL_HISTORY +endémica. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Tres B-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +completado I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +se I-EXPLORATION +constató I-EXPLORATION +un I-EXPLORATION +peso I-EXPLORATION +corporal I-EXPLORATION de I-EXPLORATION -emplear I-EXPLORATION -estímulos I-EXPLORATION -que I-EXPLORATION -pueden I-EXPLORATION -ser I-EXPLORATION -fácilmente I-EXPLORATION -presentados I-EXPLORATION -en I-EXPLORATION -contextos I-EXPLORATION +72 I-EXPLORATION +kg, I-EXPLORATION +palidez I-EXPLORATION +generalizada I-EXPLORATION +y I-EXPLORATION +esplenomegalia I-EXPLORATION +leve. I-EXPLORATION +Entre I-EXPLORATION +los I-EXPLORATION +análisis I-EXPLORATION de I-EXPLORATION -laboratorio, I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -formato I-EXPLORATION -analógico I-EXPLORATION -como I-EXPLORATION -digitalizado, I-EXPLORATION -permitiendo I-EXPLORATION -el I-EXPLORATION -control I-EXPLORATION -preciso I-EXPLORATION +laboratorio I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +leucocitosis I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -momento I-EXPLORATION +14.300/mm3 I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +fórmula I-EXPLORATION +leucocitaria I-EXPLORATION +conservada, I-EXPLORATION +plaquetas I-EXPLORATION +84.000/mm3. I-EXPLORATION +La I-EXPLORATION +función I-EXPLORATION +renal I-EXPLORATION y I-EXPLORATION -tiempo I-EXPLORATION +hepática I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +normal. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +frotis I-EXPLORATION de I-EXPLORATION -exposición. I-EXPLORATION +sangre I-EXPLORATION +periférica I-EXPLORATION +(FSP) I-EXPLORATION +observándose I-EXPLORATION +trofozoítos I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +P. I-EXPLORATION +vivax, I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +parasitemia I-EXPLORATION +< I-EXPLORATION +2%. I-EXPLORATION El I-EXPLORATION -IAPS I-EXPLORATION -consiste I-EXPLORATION +diagnóstico I-EXPLORATION +fue I-EXPLORATION +realizado I-EXPLORATION en I-EXPLORATION -un I-EXPLORATION -conjunto I-EXPLORATION -estandarizado I-EXPLORATION +el I-EXPLORATION +Laboratorio I-EXPLORATION de I-EXPLORATION -imágenes I-EXPLORATION +Referencia I-EXPLORATION en I-EXPLORATION -color I-EXPLORATION -con I-EXPLORATION -capacidad I-EXPLORATION -para I-EXPLORATION -evocar I-EXPLORATION -emociones I-EXPLORATION -y I-EXPLORATION -cuyos I-EXPLORATION -contenidos I-EXPLORATION -recorren I-EXPLORATION -un I-EXPLORATION -amplio I-EXPLORATION -abanico I-EXPLORATION -de I-EXPLORATION -categorías: I-EXPLORATION -deporte, I-EXPLORATION -moda, I-EXPLORATION -paisajes, I-EXPLORATION -desastres I-EXPLORATION -naturales, I-EXPLORATION -erotismo, I-EXPLORATION -violencia, I-EXPLORATION -etc., I-EXPLORATION -además, I-EXPLORATION -facilita I-EXPLORATION -enormemente I-EXPLORATION -las I-EXPLORATION -tareas I-EXPLORATION +Parasitología I-EXPLORATION +del I-EXPLORATION +Hospital I-EXPLORATION de I-EXPLORATION -selección I-EXPLORATION -y I-EXPLORATION -control I-EXPLORATION +Enfermedades I-EXPLORATION +Infecciosas I-EXPLORATION +"Francisco I-EXPLORATION +J. I-EXPLORATION +Muñiz". I-EXPLORATION +Recibió B-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +cloroquina I-TREATMENT +(CQ) I-TREATMENT +1.500 I-TREATMENT +mg I-TREATMENT +de I-TREATMENT +dosis I-TREATMENT +total, I-TREATMENT +constatándose B-EVOLUTION +una I-EVOLUTION +remisión I-EVOLUTION +clínica I-EVOLUTION +y I-EVOLUTION +parasitemia I-EVOLUTION +negativa I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +h. I-EVOLUTION +El B-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -estímulos. I-EXPLORATION -Cada I-EXPLORATION -imagen I-EXPLORATION -del I-EXPLORATION -IAPS I-EXPLORATION -posee I-EXPLORATION -un I-EXPLORATION -valor I-EXPLORATION +glucosa-6-fosfato I-EXPLORATION +deshidrogenasa I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +266 I-EXPLORATION +mg/dl I-EXPLORATION +(rango I-EXPLORATION +normal), I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION que I-EXPLORATION -ha I-EXPLORATION -sido I-EXPLORATION -normalizado I-EXPLORATION +recibió I-EXPLORATION +PQ I-EXPLORATION +15 I-EXPLORATION +mg I-EXPLORATION +al I-EXPLORATION +día I-EXPLORATION +durante I-EXPLORATION +15 I-EXPLORATION +días, I-EXPLORATION +con I-EXPLORATION +buena I-EXPLORATION +adherencia. I-EXPLORATION +Se B-EVOLUTION +realizaron I-EVOLUTION +parasitemias I-EVOLUTION +de I-EVOLUTION +control I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +primera I-EVOLUTION +y I-EVOLUTION +cuarta I-EVOLUTION +semana I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +tratamiento I-EVOLUTION +resultando I-EVOLUTION +negativas. I-EVOLUTION + I-EVOLUTION +Posteriormente I-EVOLUTION +presentó I-EVOLUTION +dos I-EVOLUTION +nuevos I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION +recaída I-EVOLUTION +por I-EVOLUTION +P. I-EVOLUTION +vivax. I-EVOLUTION +Siete I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +consultó I-EVOLUTION +por I-EVOLUTION +fiebre I-EVOLUTION +de I-EVOLUTION +cuatro I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +evolución I-EVOLUTION +asociada I-EVOLUTION +a I-EVOLUTION +calofríos, I-EVOLUTION +cefalea I-EVOLUTION +holocraneana, I-EVOLUTION +artralgias I-EVOLUTION +y I-EVOLUTION +dolor I-EVOLUTION +abdominal. I-EVOLUTION +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +palidez I-EXPLORATION +de I-EXPLORATION +piel I-EXPLORATION +y I-EXPLORATION +mucosas, I-EXPLORATION +ictericia I-EXPLORATION en I-EXPLORATION -las I-EXPLORATION -dimensiones I-EXPLORATION -bipolares I-EXPLORATION +conjuntivas I-EXPLORATION +y I-EXPLORATION +petequias I-EXPLORATION +en I-EXPLORATION +miembros I-EXPLORATION +inferiores. I-EXPLORATION +En I-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -valencia I-EXPLORATION -afectiva I-EXPLORATION -(con I-EXPLORATION +laboratorio I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION un I-EXPLORATION -rango I-EXPLORATION -que I-EXPLORATION -va I-EXPLORATION -desde I-EXPLORATION -lo I-EXPLORATION -agradable I-EXPLORATION -a I-EXPLORATION -lo I-EXPLORATION -desagradable) I-EXPLORATION +hemograma I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -arousal I-EXPLORATION -o I-EXPLORATION -activación I-EXPLORATION -(cuyo I-EXPLORATION -rango I-EXPLORATION -oscila I-EXPLORATION -entre I-EXPLORATION -la I-EXPLORATION -excitación I-EXPLORATION +recuento I-EXPLORATION +plaquetario I-EXPLORATION +normales, I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -calma). I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -experimentos I-EXPLORATION -fueron I-EXPLORATION -diseñados I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -programa I-EXPLORATION -Mindtracer I-EXPLORATION -(Neuronic I-EXPLORATION -SA, I-EXPLORATION -Cuba). I-EXPLORATION -Cada I-EXPLORATION -estímulo I-EXPLORATION -tenía I-EXPLORATION una I-EXPLORATION -duración I-EXPLORATION +bilirrubina I-EXPLORATION de I-EXPLORATION -2000 I-EXPLORATION -milisegundos I-EXPLORATION +2, I-EXPLORATION +5 I-EXPLORATION +mg/dl I-EXPLORATION +de I-EXPLORATION +predominio I-EXPLORATION +indirecto. I-EXPLORATION +El I-EXPLORATION +FSP I-EXPLORATION +informó I-EXPLORATION +una I-EXPLORATION +parasitemia I-EXPLORATION +< I-EXPLORATION +2%. I-EXPLORATION +Completó B-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +CQ I-TREATMENT +1.500 I-TREATMENT +mg I-TREATMENT +de I-TREATMENT +dosis I-TREATMENT +total I-TREATMENT +y I-TREATMENT +PQ I-TREATMENT +30 I-TREATMENT +mg I-TREATMENT +al I-TREATMENT +día I-TREATMENT +durante I-TREATMENT +15 I-TREATMENT +días, I-TREATMENT +con B-EVOLUTION +una I-EVOLUTION +buena I-EVOLUTION +adherencia I-EVOLUTION +y I-EVOLUTION +parasitemia I-EVOLUTION +negativa I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +cuatro I-EVOLUTION +semanas. I-EVOLUTION + I-EVOLUTION +Cinco I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +consultó I-EVOLUTION +por I-EVOLUTION +presentar I-EVOLUTION +fiebre I-EVOLUTION +intermitente I-EVOLUTION +de I-EVOLUTION +dos I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +evolución I-EVOLUTION +asociada I-EVOLUTION +a I-EVOLUTION +cefalea I-EVOLUTION +y I-EVOLUTION +astenia. I-EVOLUTION +El B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION y I-EXPLORATION el I-EXPLORATION -intervalo I-EXPLORATION -inter-estímulo I-EXPLORATION -fue I-EXPLORATION +laboratorio I-EXPLORATION +no I-EXPLORATION +presentaron I-EXPLORATION +hallazgos I-EXPLORATION +patológicos. I-EXPLORATION +Se I-EXPLORATION +constató I-EXPLORATION +una I-EXPLORATION +parasitemia I-EXPLORATION +< I-EXPLORATION +2%. I-EXPLORATION +Reinició B-TREATMENT +el I-TREATMENT +mismo I-TREATMENT +esquema I-TREATMENT +con B-EVOLUTION +buena I-EVOLUTION +adherencia I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +parasitemia I-EVOLUTION +negativa I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +cuatro I-EVOLUTION +semanas. I-EVOLUTION +No I-EVOLUTION +presentó I-EVOLUTION +nuevas I-EVOLUTION +recaídas I-EVOLUTION +durante I-EVOLUTION +los I-EVOLUTION +15 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +seguimiento. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +52 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +ictericia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +diez I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +analítica I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +evidenciaba I-PRESENT_ILLNESS +trombopenia, I-PRESENT_ILLNESS +elevación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +bilirrubina I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +enzimas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +colestasis. I-PRESENT_ILLNESS +La B-EXPLORATION +TC I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION de I-EXPLORATION -200.000 I-EXPLORATION -milisegundos. I-EXPLORATION -El I-EXPLORATION -registro I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION +16 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION +lóbulo I-EXPLORATION +hepático I-EXPLORATION +derecho I-EXPLORATION con I-EXPLORATION -el I-EXPLORATION -equipo I-EXPLORATION -BioDerm I-EXPLORATION -Modelo I-EXPLORATION -2701 I-EXPLORATION -y I-EXPLORATION -dos I-EXPLORATION -electrodos I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -colocaron I-EXPLORATION +múltiples I-EXPLORATION +nódulos I-EXPLORATION en I-EXPLORATION +lóbulo I-EXPLORATION +izquierdo I-EXPLORATION +y I-EXPLORATION +bazo. I-EXPLORATION +Al B-EVOLUTION +cuarto I-EVOLUTION +día I-EVOLUTION +del I-EVOLUTION +ingreso I-EVOLUTION +falleció I-EVOLUTION +por I-EVOLUTION +un I-EVOLUTION +shock I-EVOLUTION +hipovolémico I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +autopsia I-EVOLUTION +compatible I-EVOLUTION +con I-EVOLUTION +ASH I-EVOLUTION +con I-EVOLUTION +metástasis I-EVOLUTION +esplénicas. I-EVOLUTION + I-EVOLUTION + +Niño B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +20 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +enviado I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +evaluar I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +exoftalmos I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +(OD) I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION -falange I-EXPLORATION -media I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -dedos I-EXPLORATION -índice I-EXPLORATION +primera I-EXPLORATION +visita I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +pediátrica I-EXPLORATION +general I-EXPLORATION +era I-EXPLORATION +buena I-EXPLORATION y I-EXPLORATION -medio I-EXPLORATION +no I-EXPLORATION +presentó I-EXPLORATION +anomalías I-EXPLORATION +neurológicas. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +oftalmológica, I-EXPLORATION +se I-EXPLORATION +apreciaba I-EXPLORATION +proptosis I-EXPLORATION +e I-EXPLORATION +hipertropia I-EXPLORATION +del I-EXPLORATION +OD I-EXPLORATION +con I-EXPLORATION +franca I-EXPLORATION +asimetría I-EXPLORATION +facial. I-EXPLORATION +Con I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -mano I-EXPLORATION -dominante. I-EXPLORATION - I-EXPLORATION - -Se B-PRESENT_ILLNESS -practicó I-PRESENT_ILLNESS -autopsia I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -buen I-PAST_MEDICAL_HISTORY -desarrollo I-PAST_MEDICAL_HISTORY -óseo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -muscular, I-PAST_MEDICAL_HISTORY -pastora I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -rebaño I-PAST_MEDICAL_HISTORY -caprino, I-PAST_MEDICAL_HISTORY -quien I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -encontrada I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -atacada I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -felino I-PAST_MEDICAL_HISTORY -salvaje I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -pre-Puna I-PAST_MEDICAL_HISTORY -salteña, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -Finca I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -Alfarcito, I-PAST_MEDICAL_HISTORY -situada I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -entrada I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -Cerro I-PAST_MEDICAL_HISTORY -Negro, I-PAST_MEDICAL_HISTORY -departamento I-PAST_MEDICAL_HISTORY -Rosario I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Lerma I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -Provincia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Salta, I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -Noroeste I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -República I-PAST_MEDICAL_HISTORY -Argentina. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -examen I-EXPLORATION -externo I-EXPLORATION +región I-EXPLORATION +fronto-temporal I-EXPLORATION +el I-EXPLORATION +niño I-EXPLORATION +tenía I-EXPLORATION +dolor. I-EXPLORATION +El I-EXPLORATION +segmento I-EXPLORATION +anterior I-EXPLORATION +del I-EXPLORATION +OD I-EXPLORATION +explorado I-EXPLORATION +con I-EXPLORATION +linterna I-EXPLORATION +era I-EXPLORATION +aparentemente I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +motilidad I-EXPLORATION +intrínseca I-EXPLORATION +fue I-EXPLORATION +normal I-EXPLORATION +mientras I-EXPLORATION +la I-EXPLORATION +motilidad I-EXPLORATION +extrínseca I-EXPLORATION presentaba I-EXPLORATION -las I-EXPLORATION -siguientes I-EXPLORATION +limitación I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +abducción I-EXPLORATION +y I-EXPLORATION +descenso I-EXPLORATION +del I-EXPLORATION +OD. I-EXPLORATION +La I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +nuclear I-EXPLORATION +(RMN) I-EXPLORATION +demostró I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +infiltrante I-EXPLORATION +que I-EXPLORATION +desplazaba I-EXPLORATION +el I-EXPLORATION +globo I-EXPLORATION +ocular I-EXPLORATION +hacia I-EXPLORATION +arriba I-EXPLORATION +con I-EXPLORATION +destrucción I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +orbitaria I-EXPLORATION +lateral I-EXPLORATION +y I-EXPLORATION +múltiples I-EXPLORATION lesiones I-EXPLORATION -traumáticas. I-EXPLORATION - I-EXPLORATION -Tres I-EXPLORATION -excoriaciones I-EXPLORATION en I-EXPLORATION -región I-EXPLORATION -maxilar I-EXPLORATION +sacabocado I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +calota I-EXPLORATION +craneal. I-EXPLORATION +Otros I-EXPLORATION +estudios I-EXPLORATION +radiológicos I-EXPLORATION +demostraron I-EXPLORATION +lesiones I-EXPLORATION +semejantes I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +vértebras I-EXPLORATION y I-EXPLORATION -submaxilar I-EXPLORATION -inferior I-EXPLORATION -izquierda, I-EXPLORATION -inmediatamente I-EXPLORATION -por I-EXPLORATION -debajo I-EXPLORATION -de I-EXPLORATION -éstas, I-EXPLORATION en I-EXPLORATION -región I-EXPLORATION -anterior I-EXPLORATION +los I-EXPLORATION +huesos I-EXPLORATION +largos I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +piernas. I-EXPLORATION +Las I-EXPLORATION +pruebas I-EXPLORATION +hematológicas I-EXPLORATION y I-EXPLORATION -lateral I-EXPLORATION -izquierda I-EXPLORATION +bioquímicas I-EXPLORATION +mostraron I-EXPLORATION +valores I-EXPLORATION +normales. I-EXPLORATION +Una I-EXPLORATION +biopsia I-EXPLORATION +ósea I-EXPLORATION del I-EXPLORATION -cuello, I-EXPLORATION -presentaba I-EXPLORATION -tres I-EXPLORATION -heridas I-EXPLORATION -cortantes, I-EXPLORATION +fémur I-EXPLORATION +demostró I-EXPLORATION +células I-EXPLORATION de I-EXPLORATION -bordes I-EXPLORATION -irregulares I-EXPLORATION +Langerhans I-EXPLORATION con I-EXPLORATION -retracción I-EXPLORATION -e I-EXPLORATION -infiltración I-EXPLORATION -hemática, I-EXPLORATION -separadas I-EXPLORATION -una I-EXPLORATION -de I-EXPLORATION -otra I-EXPLORATION -por I-EXPLORATION -puentes I-EXPLORATION -cutáneos, I-EXPLORATION -las I-EXPLORATION -mismas I-EXPLORATION -medían I-EXPLORATION -4x2 I-EXPLORATION -cm, I-EXPLORATION -3, I-EXPLORATION -5x1, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION y I-EXPLORATION -2, I-EXPLORATION -5x1 I-EXPLORATION -cm I-EXPLORATION -respectivamente, I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -lesiones I-EXPLORATION -por I-EXPLORATION -garras I-EXPLORATION -de I-EXPLORATION -felino. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -región I-EXPLORATION -clavicular I-EXPLORATION -izquierda I-EXPLORATION -presentaba I-EXPLORATION -excoriaciones I-EXPLORATION -pequeñas I-EXPLORATION -sobre I-EXPLORATION -equimosis. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +immunohistológico I-EXPLORATION +para I-EXPLORATION la I-EXPLORATION -región I-EXPLORATION -posterior I-EXPLORATION -del I-EXPLORATION -cuello, I-EXPLORATION -en I-EXPLORATION +proteína I-EXPLORATION +S100 I-EXPLORATION +(indica I-EXPLORATION su I-EXPLORATION -parte I-EXPLORATION -media, I-EXPLORATION -herida I-EXPLORATION -de I-EXPLORATION -bordes I-EXPLORATION -irregulares, I-EXPLORATION -retraídos I-EXPLORATION -e I-EXPLORATION -infiltrados, I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION +origen I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cresta I-EXPLORATION +neural) I-EXPLORATION +y I-EXPLORATION +para I-EXPLORATION +las I-EXPLORATION +proteínas I-EXPLORATION de I-EXPLORATION -longitud I-EXPLORATION +superficie I-EXPLORATION +CD68 I-EXPLORATION +(proteína I-EXPLORATION +lisosomal I-EXPLORATION que I-EXPLORATION -interesa I-EXPLORATION -piel, I-EXPLORATION -tejido I-EXPLORATION -celular I-EXPLORATION -subcutáneo I-EXPLORATION +se I-EXPLORATION +expresa I-EXPLORATION +en I-EXPLORATION +macrófagos I-EXPLORATION y I-EXPLORATION -músculos I-EXPLORATION -angular I-EXPLORATION +en I-EXPLORATION +células I-EXPLORATION +dendríticas I-EXPLORATION +inmaduras) I-EXPLORATION y I-EXPLORATION -escaleno; I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -trayecto I-EXPLORATION -descendente I-EXPLORATION +CD1a I-EXPLORATION +(glicoproteína I-EXPLORATION de I-EXPLORATION -arriba I-EXPLORATION -hacia I-EXPLORATION -abajo. I-EXPLORATION - I-EXPLORATION -Presentaba I-EXPLORATION -herida I-EXPLORATION +membrana I-EXPLORATION de I-EXPLORATION -bordes I-EXPLORATION -irregulares I-EXPLORATION +49 I-EXPLORATION +KDa I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +expresa I-EXPLORATION en I-EXPLORATION -dedo I-EXPLORATION -pulgar I-EXPLORATION -de I-EXPLORATION -mano I-EXPLORATION -izquierda I-EXPLORATION +asociación I-EXPLORATION a I-EXPLORATION -la I-EXPLORATION -altura I-EXPLORATION -del I-EXPLORATION -pliegue I-EXPLORATION -entre I-EXPLORATION -la I-EXPLORATION -articulación I-EXPLORATION +ß2 I-EXPLORATION +microglobulinas) I-EXPLORATION +confirmó I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +histiocitosis I-EXPLORATION de I-EXPLORATION +Langerhans. I-EXPLORATION +Dos B-EVOLUTION +meses I-EVOLUTION +más I-EVOLUTION +tarde I-EVOLUTION +el I-EVOLUTION +niño I-EVOLUTION +estaba I-EVOLUTION +hipersomnoliento I-EVOLUTION +día I-EVOLUTION +y I-EVOLUTION +noche I-EVOLUTION +con I-EVOLUTION +ingesta I-EVOLUTION +excesiva I-EVOLUTION +de I-EVOLUTION +líquidos. I-EVOLUTION +En B-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +RMN I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +infiltrante I-EXPLORATION +que I-EXPLORATION +afectaba I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -1a I-EXPLORATION +zona I-EXPLORATION +hipotálamo-hipofisaria I-EXPLORATION con I-EXPLORATION -la I-EXPLORATION -2a I-EXPLORATION -falange. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -interno I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION +lo I-EXPLORATION que I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -descritas I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -anterior I-EXPLORATION -y I-EXPLORATION -lateral I-EXPLORATION -izquierda I-EXPLORATION -del I-EXPLORATION -cuello I-EXPLORATION -comprometían I-EXPLORATION +se I-EXPLORATION +añadió I-EXPLORATION el I-EXPLORATION -tejido I-EXPLORATION -celular I-EXPLORATION -subcutáneo, I-EXPLORATION -aponeurosis I-EXPLORATION -superficial I-EXPLORATION -y I-EXPLORATION -profunda I-EXPLORATION -de I-EXPLORATION -cuello, I-EXPLORATION -músculos I-EXPLORATION -esternocleidomastoideo, I-EXPLORATION -esternocleidohioideo I-EXPLORATION -y I-EXPLORATION -esternohioideo, I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -desgarrado. I-EXPLORATION - I-EXPLORATION -Compromiso I-EXPLORATION -de I-EXPLORATION -vasos I-EXPLORATION -superficiales I-EXPLORATION -y I-EXPLORATION -profundos, I-EXPLORATION -con I-EXPLORATION -sección I-EXPLORATION -completa I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -yugular I-EXPLORATION -interna I-EXPLORATION -izquierda; I-EXPLORATION -provocando I-EXPLORATION -una I-EXPLORATION -hemorragia I-EXPLORATION -aguda I-EXPLORATION -vital, I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -fue I-EXPLORATION -la I-EXPLORATION -causa I-EXPLORATION -del I-EXPLORATION -deceso. I-EXPLORATION +diabetes I-EXPLORATION +insípida. I-EXPLORATION I-EXPLORATION -El B-PRESENT_ILLNESS -cadáver I-PRESENT_ILLNESS -carbonizado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -campesina I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS +28 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad, I-PRESENT_ILLNESS -que B-PAST_MEDICAL_HISTORY -vivía I-PAST_MEDICAL_HISTORY -sola I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -apartado I-PAST_MEDICAL_HISTORY -lugar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -provincia I-PAST_MEDICAL_HISTORY +ingresado I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +fosas I-PRESENT_ILLNESS +lumbares, I-PRESENT_ILLNESS +fatiga I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +náuseas, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +diuresis I-PRESENT_ILLNESS +conservada. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +El B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Panamá, I-PAST_MEDICAL_HISTORY -fue B-PRESENT_ILLNESS -encontrado I-PRESENT_ILLNESS -entre I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -restos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -vivienda I-PRESENT_ILLNESS -rural I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -madera, I-PRESENT_ILLNESS -completamente I-PRESENT_ILLNESS -quemada. I-PRESENT_ILLNESS -El B-DERIVED_FROM/TO -cuerpo I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -morgue I-DERIVED_FROM/TO -judicial I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -ciudad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Panamá I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -identificación I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -determinación I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -causa I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -muerte. I-DERIVED_FROM/TO -No B-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -registros I-PAST_MEDICAL_HISTORY +consumo I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY +cocaína I-PAST_MEDICAL_HISTORY +intranasal I-PAST_MEDICAL_HISTORY +(1 I-PAST_MEDICAL_HISTORY +g) I-PAST_MEDICAL_HISTORY +cinco I-PAST_MEDICAL_HISTORY +días I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -fallecida. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Examen B-EXPLORATION -necrópsico I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -recibió I-EXPLORATION +admisión. I-PAST_MEDICAL_HISTORY +Negó B-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +todo I-PRESENT_ILLNESS +momento I-PRESENT_ILLNESS +ingesta I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +antiinflamatorios I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +esteroideos I-PRESENT_ILLNESS +u I-PRESENT_ILLNESS +otros I-PRESENT_ILLNESS +medicamentos. I-PRESENT_ILLNESS +En B-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION un I-EXPLORATION -cuerpo I-EXPLORATION -incompleto, I-EXPLORATION -quemado I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -carbonización, I-EXPLORATION +buen I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION con I-EXPLORATION -amputaciones I-EXPLORATION -térmicas I-EXPLORATION -y I-EXPLORATION -pérdida I-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION +ligeramente I-EXPLORATION +elevada I-EXPLORATION de I-EXPLORATION -estructuras I-EXPLORATION -anatómicas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -tronco I-EXPLORATION +147/97 I-EXPLORATION +mmHg, I-EXPLORATION +sin I-EXPLORATION +fiebre, I-EXPLORATION +erupción I-EXPLORATION +cutánea I-EXPLORATION +o I-EXPLORATION +artralgias. I-EXPLORATION + I-EXPLORATION +Las I-EXPLORATION +exploraciones I-EXPLORATION +cardiovascular I-EXPLORATION y I-EXPLORATION -los I-EXPLORATION -miembros. I-EXPLORATION -Fue I-EXPLORATION -identificado I-EXPLORATION +respiratoria I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +El I-EXPLORATION +abdomen I-EXPLORATION +era I-EXPLORATION +blando, I-EXPLORATION +depresible I-EXPLORATION +e I-EXPLORATION +indoloro, I-EXPLORATION +el I-EXPLORATION +hígado I-EXPLORATION +era I-EXPLORATION +palpable I-EXPLORATION +a I-EXPLORATION +1 I-EXPLORATION +cm I-EXPLORATION por I-EXPLORATION -sus I-EXPLORATION -características I-EXPLORATION -antropológicas I-EXPLORATION +debajo I-EXPLORATION +del I-EXPLORATION +reborde I-EXPLORATION +costal I-EXPLORATION y I-EXPLORATION -por I-EXPLORATION +presentaba I-EXPLORATION +discreto I-EXPLORATION +dolor I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -información I-EXPLORATION -recibida I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -investigadores. I-EXPLORATION +palpación I-EXPLORATION +lumbar I-EXPLORATION +bilateral. I-EXPLORATION I-EXPLORATION -Al I-EXPLORATION -revisar I-EXPLORATION -las I-EXPLORATION -cavidades, I-EXPLORATION -las I-EXPLORATION -vísceras I-EXPLORATION -estaban I-EXPLORATION -bien I-EXPLORATION -conservadas. I-EXPLORATION -Había I-EXPLORATION -coágulos I-EXPLORATION -cocidos I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hemitórax I-EXPLORATION -izquierdo. I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -vías I-EXPLORATION -aéreas I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -partículas I-EXPLORATION +La I-EXPLORATION +analítica I-EXPLORATION +inicial I-EXPLORATION +mostraba I-EXPLORATION +un I-EXPLORATION +hemograma I-EXPLORATION +anodino I-EXPLORATION +(sin I-EXPLORATION +eosinofilia), I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -carbón, I-EXPLORATION +función I-EXPLORATION +hepática I-EXPLORATION +normales I-EXPLORATION y I-EXPLORATION -tampoco I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -partículas I-EXPLORATION +albúmina I-EXPLORATION +dentro I-EXPLORATION +del I-EXPLORATION +rango I-EXPLORATION de I-EXPLORATION -hollín I-EXPLORATION -al I-EXPLORATION -examen I-EXPLORATION -microscópico. I-EXPLORATION +la I-EXPLORATION +normalidad; I-EXPLORATION +creatinina I-EXPLORATION +sérica: I-EXPLORATION +160 I-EXPLORATION +μmol/l; I-EXPLORATION +urea: I-EXPLORATION +7, I-EXPLORATION +5 I-EXPLORATION +mmol/l; I-EXPLORATION +potasio: I-EXPLORATION +3, I-EXPLORATION +9 I-EXPLORATION +mmol/l; I-EXPLORATION +sodio: I-EXPLORATION +139 I-EXPLORATION +mmol/l; I-EXPLORATION +cloruro: I-EXPLORATION +101 I-EXPLORATION +mmol/l. I-EXPLORATION +La I-EXPLORATION +creatina I-EXPLORATION +cinasa I-EXPLORATION +total I-EXPLORATION +fue I-EXPLORATION +normal I-EXPLORATION +(3, I-EXPLORATION +3 I-EXPLORATION +μkat/l), I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +fracción I-EXPLORATION +MB I-EXPLORATION +normal. I-EXPLORATION El I-EXPLORATION -saco I-EXPLORATION -pericárdico I-EXPLORATION -estaba I-EXPLORATION -roto I-EXPLORATION +sedimento I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION +mostró I-EXPLORATION +2 I-EXPLORATION +leucocitos I-EXPLORATION y I-EXPLORATION -contenía I-EXPLORATION -coágulos I-EXPLORATION -cocidos I-EXPLORATION -; I-EXPLORATION -al I-EXPLORATION -evacuarlos, I-EXPLORATION +3 I-EXPLORATION +hematíes I-EXPLORATION +por I-EXPLORATION +campo I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -herida I-EXPLORATION -punzo-cortante, I-EXPLORATION +observaron I-EXPLORATION +hematíes I-EXPLORATION +dismórficos I-EXPLORATION +ni I-EXPLORATION +eosinófilos. I-EXPLORATION +Bioquímica I-EXPLORATION +orina: I-EXPLORATION +sodio: I-EXPLORATION +46 I-EXPLORATION +mmol/l, I-EXPLORATION +potasio: I-EXPLORATION +33 I-EXPLORATION +mmol/l I-EXPLORATION +y I-EXPLORATION +cloruro: I-EXPLORATION +63 I-EXPLORATION +mmol/l, I-EXPLORATION +cociente I-EXPLORATION +proteína: I-EXPLORATION +creatinina I-EXPLORATION +en I-EXPLORATION +5 I-EXPLORATION +g/mol; I-EXPLORATION +urocultivo I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION +Proteinograma I-EXPLORATION +electroforético, I-EXPLORATION +inmunoglobulinas, I-EXPLORATION +complemento, I-EXPLORATION +niveles I-EXPLORATION de I-EXPLORATION -1, I-EXPLORATION -2 I-EXPLORATION -× I-EXPLORATION -0, I-EXPLORATION -8 I-EXPLORATION -cm, I-EXPLORATION -que I-EXPLORATION -interesaba I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -espesor I-EXPLORATION +enzima I-EXPLORATION +convertidora I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -izquierdo. I-EXPLORATION -Al I-EXPLORATION -examen I-EXPLORATION -microscópico I-EXPLORATION +angiotensina I-EXPLORATION +y I-EXPLORATION +títulos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -fragmentación I-EXPLORATION +anticuerpos I-EXPLORATION +antinucleares I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +La I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION -fibras I-EXPLORATION -miocárdicas I-EXPLORATION -y I-EXPLORATION -hemorragia I-EXPLORATION -reciente. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -estableció I-EXPLORATION -que I-EXPLORATION la I-EXPLORATION -causa I-EXPLORATION +inmunodeficiencia I-EXPLORATION +humana, I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -muerte I-EXPLORATION -fue I-EXPLORATION -la I-EXPLORATION -herida I-EXPLORATION -punzo-cortante I-EXPLORATION -que I-EXPLORATION -interesó I-EXPLORATION -el I-EXPLORATION -corazón, I-EXPLORATION +Epstein-Barr, I-EXPLORATION +citomegalovirus, I-EXPLORATION +hepatitis I-EXPLORATION +A, I-EXPLORATION +B, I-EXPLORATION y I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -deceso I-EXPLORATION -ocurrió I-EXPLORATION -antes I-EXPLORATION +C I-EXPLORATION +y I-EXPLORATION +micoplasma I-EXPLORATION +no I-EXPLORATION +detectó I-EXPLORATION +infección I-EXPLORATION +activa. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +demostró I-EXPLORATION +unos I-EXPLORATION +riñones I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -exposición I-EXPLORATION -térmica. I-EXPLORATION -Basándose B-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -resultados I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -necropsia, I-EVOLUTION -los I-EVOLUTION -investigadores I-EVOLUTION -interrogaron I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -familiar I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -fallecida, I-EVOLUTION -quien I-EVOLUTION -confesó I-EVOLUTION -ser I-EVOLUTION -el I-EVOLUTION -autor I-EVOLUTION -del I-EVOLUTION -femicidio. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -soltera, B-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -niños I-PAST_MEDICAL_HISTORY -menores I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -cuales I-PAST_MEDICAL_HISTORY -convivía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -les I-PAST_MEDICAL_HISTORY -provocó I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -muerte. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -mantenía I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -adecuada I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -respectivos I-PAST_MEDICAL_HISTORY -padres. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -hecho I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontraba I-PAST_MEDICAL_HISTORY -embarazada I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -resultó I-PAST_MEDICAL_HISTORY -evidente I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -actitud I-PAST_MEDICAL_HISTORY -irresponsable I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -relaciones I-PAST_MEDICAL_HISTORY -sexuales I-PAST_MEDICAL_HISTORY -íntimas, I-PAST_MEDICAL_HISTORY -ya I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -mantenía I-PAST_MEDICAL_HISTORY -protección, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -asistido I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -captarse I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -embarazo, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -cual I-PAST_MEDICAL_HISTORY -resultó I-PAST_MEDICAL_HISTORY -finalmente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -aborto I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -solicitud I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -evaluada, I-PAST_MEDICAL_HISTORY -argumentando I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -otro I-PAST_MEDICAL_HISTORY -hijo I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -deseado, I-PAST_MEDICAL_HISTORY -pues I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -relación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pareja I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -rota. I-PAST_MEDICAL_HISTORY -Sin I-PAST_MEDICAL_HISTORY -vínculo I-PAST_MEDICAL_HISTORY -laboral I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -psicosocial I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -evaluada I-PAST_MEDICAL_HISTORY -destacan I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -siguientes I-PAST_MEDICAL_HISTORY -elementos: I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -pequeña I-PAST_MEDICAL_HISTORY -consideró I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -hija I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -deseada, I-PAST_MEDICAL_HISTORY -sintiendo I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -esto I-PAST_MEDICAL_HISTORY -resentimiento I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -celos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -hermanos. I-PAST_MEDICAL_HISTORY -Nunca I-PAST_MEDICAL_HISTORY -"sintió" I-PAST_MEDICAL_HISTORY -amor I-PAST_MEDICAL_HISTORY -maternal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -reconoció I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -figura I-PAST_MEDICAL_HISTORY -afectiva I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -padre, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -pesar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -padres I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -divorciaron I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -ella I-PAST_MEDICAL_HISTORY -tenía I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -desarrolló I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -medio I-PAST_MEDICAL_HISTORY -familiar I-PAST_MEDICAL_HISTORY -disfuncional, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -padrastro I-PAST_MEDICAL_HISTORY -maltratador I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -todas I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -casa. I-PAST_MEDICAL_HISTORY -Refirió I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -sufrido I-PAST_MEDICAL_HISTORY -maltrato, I-PAST_MEDICAL_HISTORY -incluso I-PAST_MEDICAL_HISTORY -físico, I-PAST_MEDICAL_HISTORY -proveniente I-PAST_MEDICAL_HISTORY -tanto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -madre I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -padrastro. I-PAST_MEDICAL_HISTORY -Su I-PAST_MEDICAL_HISTORY -desarrollo I-PAST_MEDICAL_HISTORY -escolar I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -enseñanza I-PAST_MEDICAL_HISTORY -primaria I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -adecuado; I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -gustaba I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pequeña I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -líder I-PAST_MEDICAL_HISTORY -ante I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -amigos. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -secundario I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -adolescente I-PAST_MEDICAL_HISTORY -rebelde I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -impulsiva. I-PAST_MEDICAL_HISTORY -Ha I-PAST_MEDICAL_HISTORY -tenido I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -cinco I-PAST_MEDICAL_HISTORY -parejas, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ellas I-PAST_MEDICAL_HISTORY -considera I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -formales, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -relaciones I-PAST_MEDICAL_HISTORY -también I-PAST_MEDICAL_HISTORY -han I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -caracterizadas I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -maltrato. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Entre I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -comprobó I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -estuvo I-PAST_MEDICAL_HISTORY -ingresada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2012, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -Sala I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Psiquiatría I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -Hospital I-PAST_MEDICAL_HISTORY -General, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -atentado I-PAST_MEDICAL_HISTORY -contra I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -menores, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -diagnosticó I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -trastorno I-PAST_MEDICAL_HISTORY -situacional I-PAST_MEDICAL_HISTORY -ansioso. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -mental I-EXPLORATION +tamaño I-EXPLORATION +normal, I-EXPLORATION +difusamente I-EXPLORATION +ecogénicos I-EXPLORATION +con I-EXPLORATION +flujo I-EXPLORATION +arterial I-EXPLORATION +y I-EXPLORATION +venoso I-EXPLORATION +apropiado. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +electrocardiograma I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -urgencia I-EXPLORATION -realizado I-EXPLORATION +tórax I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +índice I-EXPLORATION +cardiotorácico I-EXPLORATION +< I-EXPLORATION +0, I-EXPLORATION +5 I-EXPLORATION +y I-EXPLORATION +unos I-EXPLORATION +campos I-EXPLORATION +pulmonares I-EXPLORATION +sin I-EXPLORATION +infiltrados. I-EXPLORATION + I-EXPLORATION +Después B-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +admisión, I-EVOLUTION +el I-EVOLUTION +débito I-EVOLUTION +urinario I-EVOLUTION +se I-EVOLUTION +mantuvo I-EVOLUTION +en I-EVOLUTION +50 I-EVOLUTION +a I-EVOLUTION +75 I-EVOLUTION +ml/h I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +creatinina I-EVOLUTION +se I-EVOLUTION +mantuvo I-EVOLUTION +sin I-EVOLUTION +cambios. I-EVOLUTION +El B-EXPLORATION +paciente I-EXPLORATION +se I-EXPLORATION +sometió I-EXPLORATION +a I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +renal. I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +hallazgos I-EXPLORATION +histológicos I-EXPLORATION +son I-EXPLORATION +los I-EXPLORATION +siguientes: I-EXPLORATION +la I-EXPLORATION +microscopía I-EXPLORATION +óptica I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +total I-EXPLORATION +de I-EXPLORATION +13 I-EXPLORATION +glomérulos, I-EXPLORATION +todos I-EXPLORATION +ellos I-EXPLORATION +normales, I-EXPLORATION +sin I-EXPLORATION +esclerosis, I-EXPLORATION +proliferación I-EXPLORATION +o I-EXPLORATION +lesiones I-EXPLORATION +necróticas. I-EXPLORATION +Las I-EXPLORATION +membranas I-EXPLORATION +basales I-EXPLORATION +y I-EXPLORATION el I-EXPLORATION -día I-EXPLORATION +mesangio I-EXPLORATION +glomerular I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +El I-EXPLORATION +intersticio I-EXPLORATION +mostraba I-EXPLORATION +moderado I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION +mononuclear I-EXPLORATION +con I-EXPLORATION +abundantes I-EXPLORATION +eosinófilos, I-EXPLORATION +con I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -hechos I-EXPLORATION +tubulitis I-EXPLORATION +focal I-EXPLORATION +y I-EXPLORATION +atrofia. I-EXPLORATION +Las I-EXPLORATION +arteriolas I-EXPLORATION no I-EXPLORATION -se I-EXPLORATION -describen I-EXPLORATION -alteraciones I-EXPLORATION -psiquiátricas. I-EXPLORATION -Explica I-EXPLORATION -que I-EXPLORATION -estaba I-EXPLORATION -"cansada I-EXPLORATION -de I-EXPLORATION -pasar I-EXPLORATION -trabajo, I-EXPLORATION -que I-EXPLORATION -intentó I-EXPLORATION -matarse I-EXPLORATION -pero I-EXPLORATION +presentaban I-EXPLORATION +lesiones I-EXPLORATION +destacables I-EXPLORATION +y I-EXPLORATION no I-EXPLORATION -pudo". I-EXPLORATION -Redactó I-EXPLORATION -tres I-EXPLORATION -notas I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -dirigían I-EXPLORATION +existían I-EXPLORATION +depósitos I-EXPLORATION +inmunes I-EXPLORATION a I-EXPLORATION -los I-EXPLORATION -padres I-EXPLORATION +la I-EXPLORATION +inmunofluorescencia. I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +hallazgos I-EXPLORATION +fueron I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +patológico I-EXPLORATION de I-EXPLORATION +nefritis I-EXPLORATION +tubulointersticial I-EXPLORATION +aguda I-EXPLORATION +(NIA). I-EXPLORATION + I-EXPLORATION +Este I-EXPLORATION +hecho, I-EXPLORATION +junto I-EXPLORATION +con I-EXPLORATION las I-EXPLORATION -víctimas I-EXPLORATION +características I-EXPLORATION +clínicas I-EXPLORATION y I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -madre. I-EXPLORATION -Sobre I-EXPLORATION el I-EXPLORATION -hecho I-EXPLORATION -refirió I-EXPLORATION -"mi I-EXPLORATION -cabeza I-EXPLORATION -tenía I-EXPLORATION -deseos I-EXPLORATION +consumo I-EXPLORATION +reciente I-EXPLORATION de I-EXPLORATION -hacer I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -hice, I-EXPLORATION -pero I-EXPLORATION -que I-EXPLORATION +cocaína, I-EXPLORATION nos I-EXPLORATION -fuéramos I-EXPLORATION -los I-EXPLORATION -tres I-EXPLORATION -juntos, I-EXPLORATION -lo I-EXPLORATION -intenté I-EXPLORATION -pero I-EXPLORATION -no I-EXPLORATION -pude". I-EXPLORATION +llevó I-EXPLORATION +a I-EXPLORATION +definir I-EXPLORATION +este I-EXPLORATION +caso I-EXPLORATION +como I-EXPLORATION +NIA I-EXPLORATION +inducida I-EXPLORATION +por I-EXPLORATION +cocaína. I-EXPLORATION I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT +obviamente I-TREATMENT +interrumpió I-TREATMENT +el I-TREATMENT +consumo I-TREATMENT +de I-TREATMENT +la I-TREATMENT +droga I-TREATMENT +y I-TREATMENT +se I-TREATMENT +trató I-TREATMENT +con I-TREATMENT +prednisona I-TREATMENT +oral I-TREATMENT +(1 I-TREATMENT +mg/kg/día I-TREATMENT +dosis I-TREATMENT +inicial), I-TREATMENT +que I-TREATMENT +se I-TREATMENT +disminuyó I-TREATMENT +progresivamente I-TREATMENT +y I-TREATMENT +se I-TREATMENT +interrumpió I-TREATMENT +después I-TREATMENT +de I-TREATMENT +12 I-TREATMENT +semanas. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +el I-EVOLUTION +seguimiento I-EVOLUTION +posterior I-EVOLUTION +ha I-EVOLUTION +presentado I-EVOLUTION +una I-EVOLUTION +buena I-EVOLUTION +evolución I-EVOLUTION +con I-EVOLUTION +mejoría I-EVOLUTION +progresiva I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +función I-EVOLUTION +renal I-EVOLUTION +hasta I-EVOLUTION +la I-EVOLUTION +recuperación I-EVOLUTION +completa I-EVOLUTION +ya I-EVOLUTION +al I-EVOLUTION +mes I-EVOLUTION +del I-EVOLUTION +inicio I-EVOLUTION +del I-EVOLUTION +tratamiento. I-EVOLUTION + I-EVOLUTION -Varón B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -27 I-PRESENT_ILLNESS +19 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +leve I-PRESENT_ILLNESS +recurrente I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +hemimandíbula I-PRESENT_ILLNESS +izquierda, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +parestesia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +zona I-PRESENT_ILLNESS +mencionada, I-PRESENT_ILLNESS +especialmente I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +labio I-PRESENT_ILLNESS +inferior. I-PRESENT_ILLNESS +Además, I-PRESENT_ILLNESS +describe I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +leve I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +masticar I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +molares I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -hemoptisis. I-PRESENT_ILLNESS -Entre B-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destacan I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -neumonía I-PAST_MEDICAL_HISTORY -bilateral I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -año, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -resolución I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -mejoría I-PAST_MEDICAL_HISTORY -radiológica I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -convencional, I-PAST_MEDICAL_HISTORY -aunque I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -persistencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -infiltrado I-PAST_MEDICAL_HISTORY -alveolar I-PAST_MEDICAL_HISTORY -izquierdo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -radiografías I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tórax I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -control. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -presenta I-PAST_MEDICAL_HISTORY -factores I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -riesgo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -VIH, I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -inmunosupresión. I-PAST_MEDICAL_HISTORY -Trabaja I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -mecánico I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -contacto I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -ambientes I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -usan I-PAST_MEDICAL_HISTORY -soldaduras, I-PAST_MEDICAL_HISTORY -grasas, I-PAST_MEDICAL_HISTORY -ácidos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -irritantes. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La B-EXPLORATION -exploración I-EXPLORATION -física, I-EXPLORATION -analítica I-EXPLORATION -y I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -respiratoria I-EXPLORATION -son I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -que I-EXPLORATION -revela I-EXPLORATION +premolares I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +lado I-PRESENT_ILLNESS +afectado. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +leve I-EXPLORATION +asimetría I-EXPLORATION +facial I-EXPLORATION +por I-EXPLORATION un I-EXPLORATION -infiltrado I-EXPLORATION -alveolar I-EXPLORATION -bilateral I-EXPLORATION -similar I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -radiografías I-EXPLORATION -anteriores. I-EXPLORATION -Se I-EXPLORATION -decide I-EXPLORATION -entonces I-EXPLORATION -hacer I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -torácica I-EXPLORATION -con I-EXPLORATION -cortes I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -alta I-EXPLORATION -resolución, I-EXPLORATION -que I-EXPLORATION -consiste I-EXPLORATION +volumen I-EXPLORATION +ubicado I-EXPLORATION en I-EXPLORATION -cortes I-EXPLORATION -finos I-EXPLORATION -de I-EXPLORATION -1mm I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +más I-EXPLORATION +posterior I-EXPLORATION +del I-EXPLORATION +cuerpo I-EXPLORATION +mandibular I-EXPLORATION +y I-EXPLORATION +rama I-EXPLORATION +ascendente I-EXPLORATION +izquierda. I-EXPLORATION +El I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -colimación I-EXPLORATION +volumen I-EXPLORATION +es I-EXPLORATION +indoloro. I-EXPLORATION +Intrabucalmente I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +tabla I-EXPLORATION +ósea I-EXPLORATION +externa I-EXPLORATION +abombada I-EXPLORATION a I-EXPLORATION -intervalos I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -10 I-EXPLORATION -mm I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION del I-EXPLORATION -parénquima I-EXPLORATION -pulmonar, I-EXPLORATION -en I-EXPLORATION -inspiración I-EXPLORATION -y I-EXPLORATION +segundo I-EXPLORATION +molar. I-EXPLORATION +Situación I-EXPLORATION +similar, I-EXPLORATION +pero I-EXPLORATION con I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -en I-EXPLORATION -decúbito I-EXPLORATION -supino. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -muestra I-EXPLORATION -áreas I-EXPLORATION +expansión I-EXPLORATION de I-EXPLORATION -opacificación I-EXPLORATION -alveolar I-EXPLORATION -en I-EXPLORATION -vidrio I-EXPLORATION -deslustrado I-EXPLORATION -dispersos I-EXPLORATION -con I-EXPLORATION -superposición I-EXPLORATION +ambas I-EXPLORATION +tablas, I-EXPLORATION +se I-EXPLORATION +pesquisa I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -engrosamiento I-EXPLORATION -liso I-EXPLORATION -lineal I-EXPLORATION -septal I-EXPLORATION -inter I-EXPLORATION -e I-EXPLORATION -intralobular, I-EXPLORATION -conocido I-EXPLORATION -como I-EXPLORATION -patrón I-EXPLORATION -'crazy-paving' I-EXPLORATION +la I-EXPLORATION +rama I-EXPLORATION +ascendente I-EXPLORATION +mandibular. I-EXPLORATION +Tercer I-EXPLORATION +molar I-EXPLORATION +ausente I-EXPLORATION +clínicamente. I-EXPLORATION + I-EXPLORATION +Con I-EXPLORATION +la I-EXPLORATION +hipótesis I-EXPLORATION +diagnóstica I-EXPLORATION +de I-EXPLORATION +quiste I-EXPLORATION +mandibular I-EXPLORATION +odontogénico I-EXPLORATION o I-EXPLORATION -en I-EXPLORATION -empedrado, I-EXPLORATION -con I-EXPLORATION +tumor I-EXPLORATION +odontogénico, I-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +estudio I-EXPLORATION +imagenológico I-EXPLORATION +previo I-EXPLORATION +a I-EXPLORATION +biopsia. I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION +panorámica I-EXPLORATION +revela I-EXPLORATION +una I-EXPLORATION extensa I-EXPLORATION -afectación I-EXPLORATION -dispersa I-EXPLORATION -y I-EXPLORATION -parcheada I-EXPLORATION -del I-EXPLORATION -pulmón I-EXPLORATION -izquierdo I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -perihiliar I-EXPLORATION +lesión I-EXPLORATION +radiolúcida I-EXPLORATION +de I-EXPLORATION +límites I-EXPLORATION +netos, I-EXPLORATION +uniloculada I-EXPLORATION y I-EXPLORATION -del I-EXPLORATION -lóbulo I-EXPLORATION -medio I-EXPLORATION -en I-EXPLORATION +que I-EXPLORATION +afecta I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +totalidad I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +rama I-EXPLORATION +ascendente I-EXPLORATION +mandibular. I-EXPLORATION +Asociada I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +lesión, I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION el I-EXPLORATION -lado I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION -Teniendo I-EXPLORATION +tercer I-EXPLORATION +molar I-EXPLORATION +incluido I-EXPLORATION en I-EXPLORATION -cuenta I-EXPLORATION -el I-EXPLORATION -patrón I-EXPLORATION -radiológico I-EXPLORATION +posición I-EXPLORATION +baja I-EXPLORATION +y I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -TCAR I-EXPLORATION +distoversión. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +programa I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +incisional, I-EXPLORATION +durante B-TREATMENT +la I-TREATMENT +cual, I-TREATMENT +y I-TREATMENT +de I-TREATMENT +acuerdo I-TREATMENT +a I-TREATMENT +las I-TREATMENT +características I-TREATMENT +clínicas I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión, I-TREATMENT +se I-TREATMENT +instala I-TREATMENT +una I-TREATMENT +cánula I-TREATMENT +de I-TREATMENT +descompresión. I-TREATMENT +El B-EXPLORATION +informe I-EXPLORATION +histopatológico I-EXPLORATION +informa I-EXPLORATION +ameloblastoma I-EXPLORATION +uniquístico I-EXPLORATION +de I-EXPLORATION +crecimiento I-EXPLORATION +intramural I-EXPLORATION +tipo I-EXPLORATION +IIIa I-EXPLORATION +de I-EXPLORATION +Ackerman9. I-EXPLORATION + I-EXPLORATION +Después B-TREATMENT +de I-TREATMENT +10 I-TREATMENT +meses I-TREATMENT +de I-TREATMENT +seguimiento I-TREATMENT +clínico-radiográfico, I-TREATMENT +con I-TREATMENT +la I-TREATMENT +presencia I-TREATMENT +de I-TREATMENT +una I-TREATMENT +cánula I-TREATMENT +de I-TREATMENT +descompresión I-TREATMENT +cuya I-TREATMENT +longitud I-TREATMENT +se I-TREATMENT +reduce I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +gradual, I-TREATMENT +se I-TREATMENT +constata I-TREATMENT +reducción I-TREATMENT +casi I-TREATMENT +total I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +quística I-TREATMENT +ameloblástica, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +efectúa I-TREATMENT +cirugía I-TREATMENT +de I-TREATMENT +enucleación I-TREATMENT +y I-TREATMENT +curetaje I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cavidad I-TREATMENT +residual, I-TREATMENT +además I-TREATMENT +de I-TREATMENT +exodoncia I-TREATMENT +del I-TREATMENT +tercer I-TREATMENT +molar I-TREATMENT +involucrado. I-TREATMENT + I-TREATMENT + +En B-PRESENT_ILLNESS +enero I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2011 I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +encontró I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cadáver I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +avanzado I-PRESENT_ILLNESS +estado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +descomposición I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +orilla I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +embalse I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Canales I-PRESENT_ILLNESS +(Granada). I-PRESENT_ILLNESS +Presentaba B-EXPLORATION +mancha I-EXPLORATION +verde I-EXPLORATION +generalizada, I-EXPLORATION +red I-EXPLORATION +vascular I-EXPLORATION +muy I-EXPLORATION +definida, I-EXPLORATION +zonas I-EXPLORATION +de I-EXPLORATION +inicio I-EXPLORATION +de I-EXPLORATION +adipocera, I-EXPLORATION +maceración I-EXPLORATION +de I-EXPLORATION +piel I-EXPLORATION y I-EXPLORATION +faneras I-EXPLORATION +y I-EXPLORATION +entomofauna I-EXPLORATION +sarcosaprófaga. I-EXPLORATION +Debido I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +procesos I-EXPLORATION +putrefactivos, I-EXPLORATION la I-EXPLORATION -exposición I-EXPLORATION +identificación I-EXPLORATION +positiva I-EXPLORATION a I-EXPLORATION -agentes I-EXPLORATION -tóxicos I-EXPLORATION -inhalados, I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -diferencial I-EXPLORATION +partir I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +rasgos I-EXPLORATION +faciales I-EXPLORATION +era I-EXPLORATION +imposible, I-EXPLORATION +pero I-EXPLORATION se I-EXPLORATION -reduce I-EXPLORATION -a I-EXPLORATION -PAP I-EXPLORATION -y I-EXPLORATION +sospechó I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +trataba I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +varón I-EXPLORATION +que I-EXPLORATION +desapareció I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +domicilio I-EXPLORATION a I-EXPLORATION -neumonía I-EXPLORATION -lipoidea. I-EXPLORATION +finales I-EXPLORATION +de I-EXPLORATION +noviembre I-EXPLORATION +del I-EXPLORATION +año I-EXPLORATION +anterior I-EXPLORATION +ya I-EXPLORATION +que, I-EXPLORATION +según I-EXPLORATION +informó I-EXPLORATION +la I-EXPLORATION +Policía, I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +era I-EXPLORATION +frecuentada I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +desaparecido I-EXPLORATION +desde I-EXPLORATION +que I-EXPLORATION +inició I-EXPLORATION +los I-EXPLORATION +trámites I-EXPLORATION +de I-EXPLORATION +divorcio. I-EXPLORATION +La I-EXPLORATION +temperatura I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lugar I-EXPLORATION +del I-EXPLORATION +levantamiento I-EXPLORATION +era I-EXPLORATION +de I-EXPLORATION +5oC. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -entonces I-EXPLORATION -fibrobroncoscopia I-EXPLORATION -con I-EXPLORATION -BAL, I-EXPLORATION +El I-EXPLORATION +lugar I-EXPLORATION +del I-EXPLORATION +levantamiento I-EXPLORATION +consistía I-EXPLORATION +en I-EXPLORATION +una I-EXPLORATION +cornisa I-EXPLORATION +de I-EXPLORATION +terreno I-EXPLORATION que I-EXPLORATION -no I-EXPLORATION -resulta I-EXPLORATION -concluyente, I-EXPLORATION -y I-EXPLORATION se I-EXPLORATION -completa I-EXPLORATION +levantaba I-EXPLORATION +por I-EXPLORATION +encima I-EXPLORATION +del I-EXPLORATION +pantano I-EXPLORATION +de I-EXPLORATION +Canales. I-EXPLORATION +El I-EXPLORATION +piso I-EXPLORATION +era I-EXPLORATION +de I-EXPLORATION +textura I-EXPLORATION +arenosa I-EXPLORATION con I-EXPLORATION -biopsia I-EXPLORATION -transbronquial; I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -ultraestructural I-EXPLORATION -identifica I-EXPLORATION +algunas I-EXPLORATION +formaciones I-EXPLORATION +arbustivas I-EXPLORATION +de I-EXPLORATION +escasa I-EXPLORATION +frondosidad. I-EXPLORATION +Se I-EXPLORATION +describieron I-EXPLORATION +restos I-EXPLORATION +mucilaginosos I-EXPLORATION +de I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +pudieron I-EXPLORATION +ser I-EXPLORATION +algas I-EXPLORATION +que I-EXPLORATION +quedaron I-EXPLORATION +depositadas I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -interior I-EXPLORATION +descenso I-EXPLORATION de I-EXPLORATION los I-EXPLORATION -alvéolos I-EXPLORATION -un I-EXPLORATION -material I-EXPLORATION -granular I-EXPLORATION -amorfo I-EXPLORATION -eosinófilo I-EXPLORATION -PAS I-EXPLORATION -positivo I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +llenado I-EXPLORATION +del I-EXPLORATION +embalse. I-EXPLORATION +Debido I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -pared I-EXPLORATION -alveolar I-EXPLORATION -algún I-EXPLORATION -lipófago I-EXPLORATION -con I-EXPLORATION -microvacuolas, I-EXPLORATION -llegando I-EXPLORATION +dificultad I-EXPLORATION +de I-EXPLORATION +acceso I-EXPLORATION al I-EXPLORATION -diagnóstico I-EXPLORATION +lugar I-EXPLORATION +exacto I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +hallaba I-EXPLORATION +el I-EXPLORATION +cadáver, I-EXPLORATION +tuvieron I-EXPLORATION +que I-EXPLORATION +intervenir I-EXPLORATION +efectivos I-EXPLORATION de I-EXPLORATION -PAP. I-EXPLORATION +Protección I-EXPLORATION +Civil I-EXPLORATION +para I-EXPLORATION +trasladar I-EXPLORATION +el I-EXPLORATION +cuerpo I-EXPLORATION +en I-EXPLORATION +lancha I-EXPLORATION +hasta I-EXPLORATION +un I-EXPLORATION +lugar I-EXPLORATION +seguro I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +continuaron I-EXPLORATION +las I-EXPLORATION +diligencias I-EXPLORATION +oportunas. I-EXPLORATION I-EXPLORATION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -remitido B-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -disminución I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -nivel I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -conciencia I-DERIVED_FROM/TO -tras I-DERIVED_FROM/TO -consumo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -heroína I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -depresión I-DERIVED_FROM/TO -respiratoria I-DERIVED_FROM/TO -(presión I-DERIVED_FROM/TO -parcial I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -O2 I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -sangre I-DERIVED_FROM/TO -arterial: I-DERIVED_FROM/TO -73 I-DERIVED_FROM/TO -mmHg I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -fracción I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -oxígeno I-DERIVED_FROM/TO -inspirado I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -50%), I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -revierte I-DERIVED_FROM/TO -tras I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -oxigenoterapia I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -naloxona. I-DERIVED_FROM/TO -Presenta I-DERIVED_FROM/TO -tumefacción I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -brazo I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -glúteo I-DERIVED_FROM/TO -derechos I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -anuria. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -En B-EXPLORATION +El I-EXPLORATION +caso I-EXPLORATION +que I-EXPLORATION +presentamos I-EXPLORATION +es I-EXPLORATION +paradigmático I-EXPLORATION +ya I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +sospecha I-EXPLORATION +una I-EXPLORATION +inmersión I-EXPLORATION +del I-EXPLORATION +cuerpo I-EXPLORATION +previa I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -analítica I-EXPLORATION +colonización I-EXPLORATION +por I-EXPLORATION +parte I-EXPLORATION de I-EXPLORATION -ingreso I-EXPLORATION -destacan I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -datos: I-EXPLORATION -GOT: I-EXPLORATION -1.212 I-EXPLORATION -UI/l, I-EXPLORATION -GPT: I-EXPLORATION -343 I-EXPLORATION -UI/l, I-EXPLORATION -CPK I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -pocas I-EXPLORATION -horas I-EXPLORATION -del I-EXPLORATION -ingreso: I-EXPLORATION -47.876 I-EXPLORATION -UI/l, I-EXPLORATION -creatinina: I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -mg/dl I-EXPLORATION +dípteros I-EXPLORATION +necrófagos I-EXPLORATION +y, I-EXPLORATION +por I-EXPLORATION +tanto, I-EXPLORATION +un I-EXPLORATION +retraso I-EXPLORATION +considerable I-EXPLORATION +entre I-EXPLORATION +el I-EXPLORATION +fallecimiento I-EXPLORATION y I-EXPLORATION -potasio: I-EXPLORATION -6, I-EXPLORATION -1 I-EXPLORATION -mmol/l. I-EXPLORATION +la I-EXPLORATION +llegada I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +primeros I-EXPLORATION +insectos I-EXPLORATION +de I-EXPLORATION +interés I-EXPLORATION +forense. I-EXPLORATION A I-EXPLORATION -tenor I-EXPLORATION +partir I-EXPLORATION de I-EXPLORATION los I-EXPLORATION datos I-EXPLORATION -se I-EXPLORATION -diagnostica I-EXPLORATION +meteorológicos I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +conocimiento I-EXPLORATION de I-EXPLORATION -posible I-EXPLORATION -síndrome I-EXPLORATION -compartimental I-EXPLORATION -con I-EXPLORATION -rabdomiolisis I-EXPLORATION -e I-EXPLORATION -IRA I-EXPLORATION -secundaria. I-EXPLORATION -Se B-TREATMENT -decide I-TREATMENT -su I-TREATMENT -paso I-TREATMENT -a I-TREATMENT -quirófano I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -realizan I-TREATMENT -fasciotomías I-TREATMENT -de I-TREATMENT -tríceps I-TREATMENT -y I-TREATMENT -glúteo I-TREATMENT -derechos, I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -perfusión I-TREATMENT -de I-TREATMENT -dopamina I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -pre-ß, I-TREATMENT -manitol I-TREATMENT -a I-TREATMENT -0, I-TREATMENT -5 I-TREATMENT -g/kg I-TREATMENT -y I-TREATMENT -corrección I-TREATMENT -de I-TREATMENT -la I-TREATMENT -hiperpotasemia I-TREATMENT -con I-TREATMENT -la I-TREATMENT -terapia I-TREATMENT -habitual: I-TREATMENT -sueros I-TREATMENT -glucosados I-TREATMENT -con I-TREATMENT -insulina I-TREATMENT -y I-TREATMENT -bicarbonato. I-TREATMENT -Durante B-EVOLUTION -su I-EVOLUTION -evolución I-EVOLUTION -presenta I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -edema I-EVOLUTION -agudo I-EVOLUTION -de I-EVOLUTION -pulmón I-EVOLUTION -por I-EVOLUTION -sobrecarga I-EVOLUTION -hídrica I-EVOLUTION -que I-EVOLUTION -responde I-EVOLUTION -bien I-EVOLUTION -al I-EVOLUTION -tratamiento. I-EVOLUTION -Es I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -sin I-EVOLUTION -secuelas. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -76 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Cardiología I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -infarto I-PRESENT_ILLNESS -agudo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -miocardio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -localización I-PRESENT_ILLNESS -anterior I-PRESENT_ILLNESS -complicado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -insuficiencia I-PRESENT_ILLNESS -cardiaca. I-PRESENT_ILLNESS -Se B-TREATMENT -decide I-TREATMENT -la I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -un I-TREATMENT -catéter I-TREATMENT -venoso I-TREATMENT -central I-TREATMENT -accediendo I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -subclavia I-TREATMENT -derecha. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION +la I-EXPLORATION +secuencia I-EXPLORATION +temporal I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +desarrollo I-EXPLORATION +larvario I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION +una I-EXPLORATION +especie I-EXPLORATION de I-EXPLORATION -control I-EXPLORATION -muestra I-EXPLORATION -un I-EXPLORATION -trayecto I-EXPLORATION -anómalo I-EXPLORATION -del I-EXPLORATION -catéter I-EXPLORATION +díptero I-EXPLORATION +necrófago I-EXPLORATION +hallada I-EXPLORATION +sobre I-EXPLORATION +los I-EXPLORATION +restos I-EXPLORATION +humanos, I-EXPLORATION +se I-EXPLORATION +ha I-EXPLORATION +podido I-EXPLORATION +determinar I-EXPLORATION +el I-EXPLORATION +intervalo I-EXPLORATION +mínimo I-EXPLORATION +que I-EXPLORATION +transcurrió I-EXPLORATION +desde I-EXPLORATION que I-EXPLORATION -desciende I-EXPLORATION -por I-EXPLORATION el I-EXPLORATION -lado I-EXPLORATION -derecho I-EXPLORATION +cuerpo I-EXPLORATION +emergió I-EXPLORATION del I-EXPLORATION -mediastino I-EXPLORATION -para I-EXPLORATION -desviarse I-EXPLORATION -posteriormente I-EXPLORATION -siguiendo I-EXPLORATION -un I-EXPLORATION -perfil I-EXPLORATION -cardiaco I-EXPLORATION -izquierdo. I-EXPLORATION +agua I-EXPLORATION +hasta I-EXPLORATION +su I-EXPLORATION +hallazgo. I-EXPLORATION I-EXPLORATION -Con I-EXPLORATION -el I-EXPLORATION -objetivo I-EXPLORATION +El B-DERIVED_FROM/TO +cuerpo I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +trasladado I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Instituto I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Medicina I-DERIVED_FROM/TO +Legal I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Granada, I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +le I-DERIVED_FROM/TO +practicó I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +autopsia I-DERIVED_FROM/TO +según I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +normativa I-DERIVED_FROM/TO +europea12. I-DERIVED_FROM/TO +La I-DERIVED_FROM/TO +recogida I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +evidencias I-DERIVED_FROM/TO +entomológicas I-DERIVED_FROM/TO +durante I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +práctica I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +autopsia I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +interpretación I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +todas I-DERIVED_FROM/TO +las I-DERIVED_FROM/TO +fases I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +investigación I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +realizó I-DERIVED_FROM/TO +siguiendo I-DERIVED_FROM/TO +las I-DERIVED_FROM/TO +recomendaciones I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +European I-DERIVED_FROM/TO +Association I-DERIVED_FROM/TO +for I-DERIVED_FROM/TO +Forensic I-DERIVED_FROM/TO +Entomology I-DERIVED_FROM/TO +(EAFE) I-DERIVED_FROM/TO +13. I-DERIVED_FROM/TO +Las B-EXPLORATION +muestras I-EXPLORATION +fueron I-EXPLORATION +fotografiadas I-EXPLORATION +con I-EXPLORATION +testigo I-EXPLORATION +métrico I-EXPLORATION +y I-EXPLORATION +recogidas I-EXPLORATION de I-EXPLORATION -descartar I-EXPLORATION la I-EXPLORATION -canulación I-EXPLORATION +región I-EXPLORATION +cefálica I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +médico I-EXPLORATION +forense I-EXPLORATION +encargada I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -vaso I-EXPLORATION -arterial I-EXPLORATION -(subclavia I-EXPLORATION -o I-EXPLORATION -carótida I-EXPLORATION -común I-EXPLORATION -derechas), I-EXPLORATION +la I-EXPLORATION +autopsia, I-EXPLORATION se I-EXPLORATION -solicita I-EXPLORATION +conservaron I-EXPLORATION +a I-EXPLORATION una I-EXPLORATION -gasometría I-EXPLORATION -(pH: I-EXPLORATION -7, I-EXPLORATION -35, I-EXPLORATION -pO2: I-EXPLORATION -40, I-EXPLORATION -pCO2: I-EXPLORATION -48) I-EXPLORATION +temperatura I-EXPLORATION +de I-EXPLORATION +18oC I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -registra I-EXPLORATION +fueron I-EXPLORATION +trasportadas I-EXPLORATION +en I-EXPLORATION +recipiente I-EXPLORATION +isotérmico I-EXPLORATION +dos I-EXPLORATION +horas I-EXPLORATION +después I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +responsable I-EXPLORATION +del I-EXPLORATION +análisis I-EXPLORATION +entomológico I-EXPLORATION +forense. I-EXPLORATION +Doce I-EXPLORATION +larvas I-EXPLORATION +vivas I-EXPLORATION +fueron I-EXPLORATION +criadas I-EXPLORATION +hasta I-EXPLORATION la I-EXPLORATION -curva I-EXPLORATION +fase I-EXPLORATION +adulta I-EXPLORATION +en I-EXPLORATION +una I-EXPLORATION +incubadora I-EXPLORATION +Heraeus I-EXPLORATION +B-12, I-EXPLORATION +a I-EXPLORATION +una I-EXPLORATION +temperatura I-EXPLORATION de I-EXPLORATION -presión I-EXPLORATION -intraluminal I-EXPLORATION -(15 I-EXPLORATION -mmHg). I-EXPLORATION -Ambas I-EXPLORATION -demuestran I-EXPLORATION +25oC, I-EXPLORATION +humedad I-EXPLORATION +relativa I-EXPLORATION +del I-EXPLORATION +80% I-EXPLORATION +y I-EXPLORATION +alimentadas I-EXPLORATION +con I-EXPLORATION +hígado I-EXPLORATION +de I-EXPLORATION +cerdo I-EXPLORATION +ad I-EXPLORATION +libitum I-EXPLORATION +para I-EXPLORATION +realizar I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION +identificación I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -flujo I-EXPLORATION -venoso I-EXPLORATION +la I-EXPLORATION +especie I-EXPLORATION a I-EXPLORATION -través I-EXPLORATION +partir I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -vía. I-EXPLORATION - I-EXPLORATION -A B-TREATMENT -continuación, I-TREATMENT -se I-TREATMENT -implanta I-TREATMENT -un I-TREATMENT -catéter I-TREATMENT -de I-TREATMENT -Swan-Ganz I-TREATMENT -en I-TREATMENT -la I-TREATMENT -rama I-TREATMENT -principal I-TREATMENT -derecha I-TREATMENT -de I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -pulmonar, I-TREATMENT -también I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -subclavia I-TREATMENT -derecha. I-TREATMENT -Se B-EXPLORATION -realiza I-EXPLORATION -un I-EXPLORATION -ecocardiograma I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -dilatación I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -coronario I-EXPLORATION -(diámetro I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -cm). I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -interior I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -coronario I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -el I-EXPLORATION -catéter I-EXPLORATION -abocando I-EXPLORATION +fase I-EXPLORATION +adulta. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +fueron I-EXPLORATION +sacrificadas I-EXPLORATION +sumergiéndolas I-EXPLORATION +en I-EXPLORATION +agua I-EXPLORATION +cercana I-EXPLORATION a I-EXPLORATION la I-EXPLORATION -aurícula I-EXPLORATION -derecha, I-EXPLORATION -al I-EXPLORATION -ventrículo I-EXPLORATION -derecho I-EXPLORATION +ebullición I-EXPLORATION +durante I-EXPLORATION +1 I-EXPLORATION +minuto I-EXPLORATION y, I-EXPLORATION -finalmente, I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -pulmonar. I-EXPLORATION -Ninguna I-EXPLORATION -otra I-EXPLORATION -vena I-EXPLORATION -conecta I-EXPLORATION -con I-EXPLORATION +posteriormente, I-EXPLORATION +conservadas I-EXPLORATION +en I-EXPLORATION +alcohol I-EXPLORATION +al I-EXPLORATION +70% I-EXPLORATION +para I-EXPLORATION la I-EXPLORATION -aurícula I-EXPLORATION -derecha. I-EXPLORATION - I-EXPLORATION -Todos I-EXPLORATION -estos I-EXPLORATION -datos I-EXPLORATION -son I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -malformación I-EXPLORATION -venosa I-EXPLORATION +identificación I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +larvas. I-EXPLORATION +De I-EXPLORATION +las I-EXPLORATION +larvas I-EXPLORATION que I-EXPLORATION -consiste I-EXPLORATION +fueron I-EXPLORATION +criadas, I-EXPLORATION +emergieron I-EXPLORATION +9 I-EXPLORATION +adultos. I-EXPLORATION +Dos I-EXPLORATION +larvas I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +remitieron I-EXPLORATION +muertas I-EXPLORATION +fueron I-EXPLORATION +sometidas I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +aclaramiento I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -persistencia I-EXPLORATION +una I-EXPLORATION +disolución I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -VCSI I-EXPLORATION +hidróxido I-EXPLORATION +sódico I-EXPLORATION +al I-EXPLORATION +10% I-EXPLORATION +m/v I-EXPLORATION +durante I-EXPLORATION +24 I-EXPLORATION +horas. I-EXPLORATION +Posteriormente, I-EXPLORATION +se I-EXPLORATION +montaron I-EXPLORATION +en I-EXPLORATION +una I-EXPLORATION +preparación I-EXPLORATION +microscópica I-EXPLORATION con I-EXPLORATION -desembocadura I-EXPLORATION +DPX I-EXPLORATION +(VWR I-EXPLORATION +International®) I-EXPLORATION +para I-EXPLORATION +observar I-EXPLORATION +con I-EXPLORATION +mayor I-EXPLORATION +detalle I-EXPLORATION +las I-EXPLORATION +características I-EXPLORATION +morfoanatómicas. I-EXPLORATION +De I-EXPLORATION +los I-EXPLORATION +adultos, I-EXPLORATION +el I-EXPLORATION +muerto I-EXPLORATION +fue I-EXPLORATION +directamente I-EXPLORATION +conservado I-EXPLORATION en I-EXPLORATION +alcohol I-EXPLORATION +al I-EXPLORATION +70% I-EXPLORATION +y I-EXPLORATION el I-EXPLORATION -seno I-EXPLORATION -coronario, I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -permeabilidad I-EXPLORATION +otro I-EXPLORATION +sacrificado I-EXPLORATION +con I-EXPLORATION +acetato I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -anastomosis I-EXPLORATION -entre I-EXPLORATION -el I-EXPLORATION -sistema I-EXPLORATION -venoso I-EXPLORATION -derecho I-EXPLORATION +etilo I-EXPLORATION y I-EXPLORATION +posteriormente I-EXPLORATION +conservado I-EXPLORATION +con I-EXPLORATION el I-EXPLORATION -izquierdo. I-EXPLORATION - I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -89 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2, I-PAST_MEDICAL_HISTORY -fibrilación I-PAST_MEDICAL_HISTORY -aurícular I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -EPOC, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -cutaneomucosa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -acompañada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -prurito I-PRESENT_ILLNESS -intenso, I-PRESENT_ILLNESS -coluria I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -astenia. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -anorexia I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal. I-PRESENT_ILLNESS -En B-EXPLORATION +mismo I-EXPLORATION +método I-EXPLORATION +que I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION +muestra I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -palpaba I-EXPLORATION -zona I-EXPLORATION -indurada I-EXPLORATION -no I-EXPLORATION -dolorosa I-EXPLORATION -en I-EXPLORATION -epigastrio I-EXPLORATION -siendo I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION +remitió I-EXPLORATION +muerta. I-EXPLORATION +La I-EXPLORATION +totalidad I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -irrelevante. I-EXPLORATION +las I-EXPLORATION +muestras I-EXPLORATION +fueron I-EXPLORATION +identificadas I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +especie14, I-EXPLORATION +15. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +recogieron I-EXPLORATION +muestras I-EXPLORATION +entomológicas I-EXPLORATION +durante I-EXPLORATION +el I-EXPLORATION +levantamiento I-EXPLORATION +del I-EXPLORATION +cadáver. I-EXPLORATION I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION +Datos I-EXPLORATION +ambientales I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +datos I-EXPLORATION +meteorológicos I-EXPLORATION +diarios I-EXPLORATION +(en I-EXPLORATION +el I-EXPLORATION +presente I-EXPLORATION +trabajo, I-EXPLORATION +tomamos I-EXPLORATION +las I-EXPLORATION +temperaturas I-EXPLORATION +diarias I-EXPLORATION +al I-EXPLORATION +no I-EXPLORATION +disponer I-EXPLORATION de I-EXPLORATION -sangre I-EXPLORATION -destacaban I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -parámetros: I-EXPLORATION -bilirrubina I-EXPLORATION -total I-EXPLORATION +las I-EXPLORATION +horarias) I-EXPLORATION +fueron I-EXPLORATION +tomados I-EXPLORATION de I-EXPLORATION -12, I-EXPLORATION -88 I-EXPLORATION -mg/dl I-EXPLORATION -(rango, I-EXPLORATION -0, I-EXPLORATION -1-1), I-EXPLORATION -bilirrubina I-EXPLORATION -directa I-EXPLORATION +dos I-EXPLORATION +estaciones I-EXPLORATION +agroclimáticas I-EXPLORATION +distintas I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +fin I-EXPLORATION de I-EXPLORATION -9, I-EXPLORATION -92 I-EXPLORATION -mg/dl I-EXPLORATION -(rango, I-EXPLORATION -0, I-EXPLORATION -01-0, I-EXPLORATION -25), I-EXPLORATION -AST I-EXPLORATION +evaluar I-EXPLORATION +cuál I-EXPLORATION de I-EXPLORATION -244 I-EXPLORATION -U/L I-EXPLORATION -(rango, I-EXPLORATION -5-35), I-EXPLORATION -ALT I-EXPLORATION +ellas I-EXPLORATION +se I-EXPLORATION +ajustaba I-EXPLORATION +mejor I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +temperatura I-EXPLORATION +del I-EXPLORATION +lugar I-EXPLORATION +del I-EXPLORATION +levantamiento16, I-EXPLORATION +17, I-EXPLORATION +ambas I-EXPLORATION +pertenecientes I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +red I-EXPLORATION de I-EXPLORATION -272 I-EXPLORATION -U/L I-EXPLORATION -(rango, I-EXPLORATION -5-44), I-EXPLORATION -GGT I-EXPLORATION +estaciones I-EXPLORATION +agroclimáticas I-EXPLORATION +del I-EXPLORATION +Instituto I-EXPLORATION de I-EXPLORATION -420 I-EXPLORATION -U/L I-EXPLORATION -(rango, I-EXPLORATION -5-46) I-EXPLORATION +Investigación I-EXPLORATION +Agraria I-EXPLORATION y I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION +Pesquera I-EXPLORATION de I-EXPLORATION -1.926 I-EXPLORATION -U/L I-EXPLORATION -(rango, I-EXPLORATION -90-360) I-EXPLORATION -con I-EXPLORATION -resto I-EXPLORATION +la I-EXPLORATION +Junta I-EXPLORATION de I-EXPLORATION -parámetros I-EXPLORATION -bioquímicos, I-EXPLORATION -incluidos I-EXPLORATION -amilasa I-EXPLORATION -y I-EXPLORATION -lipasa, I-EXPLORATION -dentro I-EXPLORATION +Andalucía. I-EXPLORATION +La I-EXPLORATION +estación I-EXPLORATION +1 I-EXPLORATION +(IFAPA I-EXPLORATION de I-EXPLORATION +Camino I-EXPLORATION +del I-EXPLORATION +Purchil, I-EXPLORATION +coordenadas I-EXPLORATION +UTM I-EXPLORATION +X=443423.0 I-EXPLORATION +Y=4114357.0, I-EXPLORATION +altura I-EXPLORATION +sobre I-EXPLORATION +el I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +mar: I-EXPLORATION +630 I-EXPLORATION +metros) I-EXPLORATION +está I-EXPLORATION +situada I-EXPLORATION +a I-EXPLORATION +unos I-EXPLORATION +13 I-EXPLORATION +kilómetros I-EXPLORATION +del I-EXPLORATION +lugar I-EXPLORATION +del I-EXPLORATION +levantamiento, I-EXPLORATION la I-EXPLORATION -normalidad. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION +estación I-EXPLORATION +2 I-EXPLORATION +(Jerez I-EXPLORATION +del I-EXPLORATION +Marquesado, I-EXPLORATION +coordenadas I-EXPLORATION +UTM, I-EXPLORATION +X=486806.0 I-EXPLORATION +Y=4116224.0, I-EXPLORATION +altura I-EXPLORATION +sobre I-EXPLORATION +el I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +mar: I-EXPLORATION +1212 I-EXPLORATION +metros) I-EXPLORATION +se I-EXPLORATION +halla I-EXPLORATION +a I-EXPLORATION una I-EXPLORATION -ecografía I-EXPLORATION +distancia I-EXPLORATION de I-EXPLORATION -urgencia, I-EXPLORATION -en I-EXPLORATION +27 I-EXPLORATION +kilómetros I-EXPLORATION +del I-EXPLORATION +lugar I-EXPLORATION +del I-EXPLORATION +levantamiento. I-EXPLORATION +Para I-EXPLORATION +poder I-EXPLORATION +llevar I-EXPLORATION +a I-EXPLORATION +cabo I-EXPLORATION la I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -puso I-EXPLORATION +evaluación I-EXPLORATION de I-EXPLORATION -manifiesto I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -voluminosa I-EXPLORATION -localizada I-EXPLORATION +ese I-EXPLORATION +ajuste I-EXPLORATION +de I-EXPLORATION +temperaturas, I-EXPLORATION +se I-EXPLORATION +colocó I-EXPLORATION +un I-EXPLORATION +data I-EXPLORATION +logger I-EXPLORATION +(ILOG I-EXPLORATION +S/INT-ESCORT®) I-EXPLORATION en I-EXPLORATION +las I-EXPLORATION +proximidades I-EXPLORATION +del I-EXPLORATION +lugar I-EXPLORATION +del I-EXPLORATION +hallazgo I-EXPLORATION +del I-EXPLORATION +cuerpo I-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -cabeza I-EXPLORATION -pancreática, I-EXPLORATION +imposibilidad I-EXPLORATION de I-EXPLORATION -predominio I-EXPLORATION -quístico I-EXPLORATION -multitabicada I-EXPLORATION +acceder I-EXPLORATION +al I-EXPLORATION +sitio I-EXPLORATION +exacto I-EXPLORATION +del I-EXPLORATION +levantamiento I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +registraron I-EXPLORATION +las I-EXPLORATION +temperaturas I-EXPLORATION +máximas I-EXPLORATION y I-EXPLORATION +mínimas I-EXPLORATION +durante I-EXPLORATION +cinco I-EXPLORATION +días, I-EXPLORATION +concretamente I-EXPLORATION +desde I-EXPLORATION +el I-EXPLORATION +1 I-EXPLORATION de I-EXPLORATION -contornos I-EXPLORATION -lobulados, I-EXPLORATION -con I-EXPLORATION -dilatación I-EXPLORATION +febrero I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -principal I-EXPLORATION +2011 I-EXPLORATION +hasta I-EXPLORATION +el I-EXPLORATION +día I-EXPLORATION +5 I-EXPLORATION +del I-EXPLORATION +mismo I-EXPLORATION +mes. I-EXPLORATION +Los I-EXPLORATION +resultados I-EXPLORATION +fueron I-EXPLORATION +analizados I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +paquete I-EXPLORATION +estadístico I-EXPLORATION +SPSS I-EXPLORATION +15.0 I-EXPLORATION y I-EXPLORATION -las I-EXPLORATION -vías I-EXPLORATION -biliares I-EXPLORATION -intrahepáticas. I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computarizada, I-EXPLORATION -en I-EXPLORATION +complementados I-EXPLORATION +con I-EXPLORATION +UNStat, I-EXPLORATION +aplicación I-EXPLORATION +desarrollada I-EXPLORATION +por I-EXPLORATION la I-EXPLORATION +Universidad I-EXPLORATION +de I-EXPLORATION +Navarra. I-EXPLORATION + I-EXPLORATION +Para I-EXPLORATION +diferenciar I-EXPLORATION +entre I-EXPLORATION +las I-EXPLORATION +larvas I-EXPLORATION que I-EXPLORATION +todavía I-EXPLORATION se I-EXPLORATION -objetivó I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cabeza I-EXPLORATION +están I-EXPLORATION +alimentando I-EXPLORATION del I-EXPLORATION -páncreas, I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -multiquístico I-EXPLORATION -con I-EXPLORATION -tabiques I-EXPLORATION +cuerpo I-EXPLORATION +en I-EXPLORATION +descomposición I-EXPLORATION y I-EXPLORATION -calcificaciones I-EXPLORATION -«en I-EXPLORATION -puesta I-EXPLORATION -de I-EXPLORATION -sol», I-EXPLORATION +las I-EXPLORATION que I-EXPLORATION -provocaba I-EXPLORATION -dilatación I-EXPLORATION +se I-EXPLORATION +están I-EXPLORATION +alejando I-EXPLORATION +ya I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -Wirsung; I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -cistoadenoma I-EXPLORATION -seroso I-EXPLORATION -pancreático. I-EXPLORATION -Además I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -vesícula I-EXPLORATION -biliar I-EXPLORATION -muy I-EXPLORATION -distendida I-EXPLORATION -y I-EXPLORATION -marcada I-EXPLORATION -dilatación I-EXPLORATION +fuente I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -intrahepática I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -colédoco. I-EXPLORATION - I-EXPLORATION -Dada B-TREATMENT -la I-TREATMENT -edad I-TREATMENT -y I-TREATMENT -los I-TREATMENT -antecedentes I-TREATMENT -personales I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -no I-TREATMENT -fue I-TREATMENT -considerada I-TREATMENT -subsidiaria I-TREATMENT -de I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -y B-EXPLORATION -se I-EXPLORATION -practicó I-EXPLORATION -una I-EXPLORATION -colangiopancreatografía I-EXPLORATION -retrógrada I-EXPLORATION -endoscópica I-EXPLORATION -(CPRE). I-EXPLORATION -Al I-EXPLORATION -realizar I-EXPLORATION -la I-EXPLORATION -CPRE I-EXPLORATION +alimentación I-EXPLORATION +para I-EXPLORATION +pupar, I-EXPLORATION se I-EXPLORATION -objetivó I-EXPLORATION -cierta I-EXPLORATION -dificultad I-EXPLORATION +diseccionan I-EXPLORATION +dorsalmente I-EXPLORATION +las I-EXPLORATION +larvas I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +comprueba I-EXPLORATION +si I-EXPLORATION +existe I-EXPLORATION +un I-EXPLORATION +depósito I-EXPLORATION de I-EXPLORATION -paso I-EXPLORATION +grasa I-EXPLORATION +subcuticular I-EXPLORATION +que I-EXPLORATION +impida I-EXPLORATION +la I-EXPLORATION +observación I-EXPLORATION +dorsal I-EXPLORATION del I-EXPLORATION -endoscopio I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION +tracto I-EXPLORATION +digestivo I-EXPLORATION +relleno I-EXPLORATION de I-EXPLORATION -rodilla I-EXPLORATION -duodenal I-EXPLORATION -superior, I-EXPLORATION +alimento. I-EXPLORATION +Ese I-EXPLORATION +depósito I-EXPLORATION +es I-EXPLORATION +observable I-EXPLORATION en I-EXPLORATION -probable I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -compresión I-EXPLORATION -por I-EXPLORATION +las I-EXPLORATION +larvas I-EXPLORATION +migratorias3. I-EXPLORATION +Además, I-EXPLORATION la I-EXPLORATION -lesión I-EXPLORATION -primaria I-EXPLORATION -pancreática. I-EXPLORATION -En I-EXPLORATION +medición I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -colangiografía I-EXPLORATION +longitud I-EXPLORATION +del I-EXPLORATION +tracto I-EXPLORATION +digestivo I-EXPLORATION +relleno I-EXPLORATION +permite I-EXPLORATION +discernir I-EXPLORATION +entre I-EXPLORATION +ambas I-EXPLORATION +fases18. I-EXPLORATION +Mientras I-EXPLORATION +las I-EXPLORATION +larvas I-EXPLORATION se I-EXPLORATION -apreció I-EXPLORATION -una I-EXPLORATION -gran I-EXPLORATION -dilatación I-EXPLORATION +alimenten, I-EXPLORATION +el I-EXPLORATION +contenido I-EXPLORATION +digestivo I-EXPLORATION +va I-EXPLORATION +aumentando I-EXPLORATION +su I-EXPLORATION +longitud I-EXPLORATION de I-EXPLORATION -colédoco I-EXPLORATION -proximal I-EXPLORATION -con I-EXPLORATION -estenosis I-EXPLORATION -distal I-EXPLORATION +relleno I-EXPLORATION +mientras I-EXPLORATION +que, I-EXPLORATION +cuando I-EXPLORATION +entran I-EXPLORATION +en I-EXPLORATION +fase I-EXPLORATION +migratoria, I-EXPLORATION +existe I-EXPLORATION +un I-EXPLORATION +vaciado I-EXPLORATION +del I-EXPLORATION +contenido I-EXPLORATION +digestivo I-EXPLORATION +que I-EXPLORATION +implica I-EXPLORATION +un I-EXPLORATION +acortamiento I-EXPLORATION de I-EXPLORATION -aproximadamente I-EXPLORATION -3-4 I-EXPLORATION -cm I-EXPLORATION +la I-EXPLORATION +longitud I-EXPLORATION de I-EXPLORATION -longitud. I-EXPLORATION -Se B-TREATMENT -colocó I-TREATMENT -una I-TREATMENT -prótesis I-TREATMENT -biliar I-TREATMENT -metálica I-TREATMENT -autoexpandible I-TREATMENT -tipo I-TREATMENT -Wallstent I-TREATMENT -(Boston I-TREATMENT -Scientific, I-TREATMENT -Natick, I-TREATMENT -MA, I-TREATMENT -USA) I-TREATMENT -de I-TREATMENT -8 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -longitud I-TREATMENT -y I-TREATMENT -1 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -calibre I-TREATMENT -sin I-TREATMENT -incidencias, I-TREATMENT -comprobando I-TREATMENT -la I-TREATMENT -correcta I-TREATMENT -colocación I-TREATMENT -y I-TREATMENT -drenaje I-TREATMENT -posterior. I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -progresiva I-EVOLUTION -despigmentación I-EVOLUTION -cutaneomucosa I-EVOLUTION -con I-EVOLUTION -descenso I-EVOLUTION -de I-EVOLUTION -niveles I-EVOLUTION -de I-EVOLUTION -bilirrubina. I-EVOLUTION -Finalmente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -asintomática. I-EVOLUTION - I-EVOLUTION +tracto I-EXPLORATION +digestivo I-EXPLORATION +relleno. I-EXPLORATION + I-EXPLORATION Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -69 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -procedente B-PAST_MEDICAL_HISTORY +36 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Guinea I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -llevaba I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -mes I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -España. I-PAST_MEDICAL_HISTORY -Acudió B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -atención I-PRESENT_ILLNESS -primaria I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -tiempo I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -expectoración, I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS -mialgias, I-PRESENT_ILLNESS -prurito I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -(que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -objetiva I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta). I-PRESENT_ILLNESS +tiroidectomía I-PAST_MEDICAL_HISTORY +total I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +CPT. I-PAST_MEDICAL_HISTORY La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -es I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -remiten I-EXPLORATION -muestras I-EXPLORATION -al I-EXPLORATION -laboratorio I-EXPLORATION -para I-EXPLORATION -bioquímica I-EXPLORATION -básica I-EXPLORATION -y I-EXPLORATION -hemograma. I-EXPLORATION -Sólo I-EXPLORATION -son I-EXPLORATION -destacables I-EXPLORATION -una I-EXPLORATION -ligera I-EXPLORATION -anemia I-EXPLORATION -11, I-EXPLORATION -3 I-EXPLORATION -g/dL I-EXPLORATION +biopsia I-EXPLORATION +quirúrgica I-EXPLORATION +informó I-EXPLORATION +un I-EXPLORATION +CPT I-EXPLORATION +bifocal, I-EXPLORATION +variedad I-EXPLORATION +usual, I-EXPLORATION +con I-EXPLORATION +foco I-EXPLORATION de I-EXPLORATION -hemoglobina I-EXPLORATION +20 I-EXPLORATION +mm I-EXPLORATION +en I-EXPLORATION +lóbulo I-EXPLORATION +derecho I-EXPLORATION y I-EXPLORATION -eosinofilia I-EXPLORATION -2, I-EXPLORATION -6*1.000/ml. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -revisión I-EXPLORATION +15 I-EXPLORATION +mm I-EXPLORATION +en I-EXPLORATION +lóbulo I-EXPLORATION +izquierdo, I-EXPLORATION +sin I-EXPLORATION +permea-ción I-EXPLORATION +vascular, I-EXPLORATION +infiltración I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -extensión I-EXPLORATION +cápsula I-EXPLORATION +ni I-EXPLORATION +compromiso I-EXPLORATION de I-EXPLORATION -sangre I-EXPLORATION -teñida I-EXPLORATION +borde I-EXPLORATION +quirúrgico. I-EXPLORATION +Recibió B-TREATMENT +150 I-TREATMENT +mCi I-TREATMENT +I131 I-TREATMENT +y B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +sistémica I-EXPLORATION +posdosis I-EXPLORATION +mostró I-EXPLORATION +remanente I-EXPLORATION +tiroideo I-EXPLORATION con I-EXPLORATION -Giemsa I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -microfilarias I-EXPLORATION -envainadas. I-EXPLORATION - B-EVOLUTION -Dadas I-EVOLUTION -las I-EVOLUTION -diferencias I-EVOLUTION -de I-EVOLUTION -periodicidad I-EVOLUTION -de I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -microfilarias I-EVOLUTION +compromiso I-EXPLORATION +ganglionar I-EXPLORATION +derecho. I-EXPLORATION +Inició B-TREATMENT +terapia I-TREATMENT +supresiva I-TREATMENT +con I-TREATMENT +levotiroxina I-TREATMENT +y B-EVOLUTION en I-EVOLUTION -sangre I-EVOLUTION -periférica I-EVOLUTION -(diurna I-EVOLUTION -y I-EVOLUTION -nocturna), I-EVOLUTION -se I-EVOLUTION -decidió I-EVOLUTION -ingresar I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -para I-EVOLUTION -tomar I-EVOLUTION -una I-EVOLUTION -segunda I-EVOLUTION -muestra I-EVOLUTION +controles I-EVOLUTION +posteriores I-EVOLUTION +presentó I-EVOLUTION +niveles I-EVOLUTION de I-EVOLUTION -sangre I-EVOLUTION -que I-EVOLUTION -confirmase I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION +Tg I-EVOLUTION +indetectables I-EVOLUTION +(<0, I-EVOLUTION +2 I-EVOLUTION +ng/ml) I-EVOLUTION +en I-EVOLUTION +ausencia I-EVOLUTION de I-EVOLUTION -filariasis. I-EVOLUTION -En B-EXPLORATION +AcTg I-EVOLUTION +y B-EXPLORATION +las I-EXPLORATION +ecografías I-EXPLORATION +cervicales I-EXPLORATION +no I-EXPLORATION +mostraron I-EXPLORATION +evidencias I-EXPLORATION +de I-EXPLORATION +recidiva I-EXPLORATION +tumoral. I-EXPLORATION +En I-EXPLORATION +control I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +18 I-EXPLORATION +meses I-EXPLORATION +poscirugía I-EXPLORATION la I-EXPLORATION -segunda I-EXPLORATION -muestra I-EXPLORATION +ecografía I-EXPLORATION +cervical I-EXPLORATION +mostró I-EXPLORATION +imagen I-EXPLORATION +nodular I-EXPLORATION de I-EXPLORATION -sangre I-EXPLORATION -periférica, I-EXPLORATION -tras I-EXPLORATION -concentración I-EXPLORATION +10 I-EXPLORATION +mm I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +cervical I-EXPLORATION +derecha, I-EXPLORATION +sugerente I-EXPLORATION de I-EXPLORATION -Knott I-EXPLORATION -y I-EXPLORATION -tinción I-EXPLORATION +linfonodo. I-EXPLORATION +En I-EXPLORATION +forma I-EXPLORATION +simultánea, I-EXPLORATION +la I-EXPLORATION +Tg-s I-EXPLORATION +estimulada I-EXPLORATION +(TSH I-EXPLORATION +=105 I-EXPLORATION +uUI/mL) I-EXPLORATION +fue I-EXPLORATION +<0, I-EXPLORATION +2 I-EXPLORATION +ng/ml, I-EXPLORATION +en I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +AcTg. I-EXPLORATION +La I-EXPLORATION +exploración I-EXPLORATION +sistémica I-EXPLORATION +mostró I-EXPLORATION +captación I-EXPLORATION +aumentada I-EXPLORATION +en I-EXPLORATION +compartimento I-EXPLORATION +central I-EXPLORATION +a I-EXPLORATION +ambos I-EXPLORATION +lados I-EXPLORATION +de I-EXPLORATION +línea I-EXPLORATION +media, I-EXPLORATION +mayor I-EXPLORATION +a I-EXPLORATION +derecha. I-EXPLORATION +La I-EXPLORATION +biopsia I-EXPLORATION +por I-EXPLORATION +punción I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +fue I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -Giemsa, I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -microfilarias I-EXPLORATION -envainadas I-EXPLORATION -y I-EXPLORATION +CPT. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +disección I-TREATMENT +cervical, I-TREATMENT +cuya B-EXPLORATION +biopsia I-EXPLORATION +confirmó I-EXPLORATION +metástasis I-EXPLORATION +de I-EXPLORATION +CPT I-EXPLORATION +en I-EXPLORATION +ganglio I-EXPLORATION +del I-EXPLORATION +grupo I-EXPLORATION +VI, I-EXPLORATION +intrano-dal, I-EXPLORATION sin I-EXPLORATION -envainar. I-EXPLORATION +extensión I-EXPLORATION +al I-EXPLORATION +tejido I-EXPLORATION +adiposo. I-EXPLORATION +La I-EXPLORATION +tinción I-EXPLORATION +para I-EXPLORATION +Tg I-EXPLORATION +fue I-EXPLORATION +positiva I-EXPLORATION +en I-EXPLORATION +forma I-EXPLORATION +difusa I-EXPLORATION +tanto I-EXPLORATION +en I-EXPLORATION +coloide I-EXPLORATION +como I-EXPLORATION +en I-EXPLORATION +citoplasma I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +tumorales. I-EXPLORATION I-EXPLORATION -Se B-DERIVED_FROM/TO -remitió I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -muestra I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Centro I-DERIVED_FROM/TO -Nacional I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Microbiología, I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -identificaron I-DERIVED_FROM/TO -como I-DERIVED_FROM/TO -Loa I-DERIVED_FROM/TO -loa I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -Mansonella I-DERIVED_FROM/TO -perstans. I-DERIVED_FROM/TO -Se B-TREATMENT -inició I-TREATMENT -un I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -dietilcarbamicina I-TREATMENT -6 I-TREATMENT -mg I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -única I-TREATMENT -y I-TREATMENT -100 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -mebendazol I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas I-TREATMENT -durante I-TREATMENT -30 I-TREATMENT -días I-TREATMENT -bajo I-TREATMENT -supervisión I-TREATMENT -médica I-TREATMENT -los I-TREATMENT -primeros I-TREATMENT -días I-TREATMENT -en I-TREATMENT -previsión I-TREATMENT -de I-TREATMENT -una I-TREATMENT -posible I-TREATMENT -reacción I-TREATMENT -de I-TREATMENT -Herxheimer. I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -buena, I-EVOLUTION -con I-EVOLUTION -disminución I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -cifra I-EVOLUTION -de I-EVOLUTION -eosinófilos, I-EVOLUTION -mejoría I-EVOLUTION -del I-EVOLUTION -prurito I-EVOLUTION -y I-EVOLUTION -desaparición I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -microfilarias I-EVOLUTION -en I-EVOLUTION -sangre I-EVOLUTION -periférica. I-EVOLUTION - I-EVOLUTION -Varón B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -no B-PAST_MEDICAL_HISTORY -fumador. I-PAST_MEDICAL_HISTORY -Como I-PAST_MEDICAL_HISTORY +72 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -ingresos I-PAST_MEDICAL_HISTORY -hospitalarios I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -intoxicación I-PAST_MEDICAL_HISTORY -aguda I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -organofosforados. I-PAST_MEDICAL_HISTORY -Aporta I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -informes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -reconocimientos I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -periódicos I-PAST_MEDICAL_HISTORY -realizados I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -23 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -trabajado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -empresa I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -fabricaba I-PAST_MEDICAL_HISTORY -diversos I-PAST_MEDICAL_HISTORY -productos I-PAST_MEDICAL_HISTORY -fitosanitarios I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -obtención I-PAST_MEDICAL_HISTORY -empleaba I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -amplio I-PAST_MEDICAL_HISTORY -número I-PAST_MEDICAL_HISTORY +fumador I-PAST_MEDICAL_HISTORY +intenso, I-PAST_MEDICAL_HISTORY +bronquítico I-PAST_MEDICAL_HISTORY +crónico, I-PAST_MEDICAL_HISTORY +portador I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -disolventes I-PAST_MEDICAL_HISTORY -orgánicos, I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -ellos I-PAST_MEDICAL_HISTORY -acetona, I-PAST_MEDICAL_HISTORY -acetofenona, I-PAST_MEDICAL_HISTORY -ciclohexanona, I-PAST_MEDICAL_HISTORY -nafta, I-PAST_MEDICAL_HISTORY -tolueno I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +(HTA) I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -xileno, I-PAST_MEDICAL_HISTORY -donde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -único I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -específico I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -esporádicamente I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -exposición I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -organofosforados I-PAST_MEDICAL_HISTORY -(determinación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -acetilcolinesterasa I-PAST_MEDICAL_HISTORY -intraeritrocitaria), I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -presenta I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -familiares I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -nefropatías, I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -analíticas I-PAST_MEDICAL_HISTORY -generales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -sangre I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -orina I-PAST_MEDICAL_HISTORY -son I-PAST_MEDICAL_HISTORY -normales, I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -tensiones I-PAST_MEDICAL_HISTORY -arteriales I-PAST_MEDICAL_HISTORY -oscilan I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -100/60 I-PAST_MEDICAL_HISTORY -mm/Hg I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -120/80 I-PAST_MEDICAL_HISTORY -mm/Hg. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -uno I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY +prostático I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -reconocimientos I-PAST_MEDICAL_HISTORY -realizados I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY años I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -detectó I-PAST_MEDICAL_HISTORY -proteinuria I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -microhematuria, I-PAST_MEDICAL_HISTORY -creatinina I-PAST_MEDICAL_HISTORY -sérica I-PAST_MEDICAL_HISTORY -1, I-PAST_MEDICAL_HISTORY -06 I-PAST_MEDICAL_HISTORY -mg/dl; I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -nuevo I-PAST_MEDICAL_HISTORY -reconocimiento I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -siguiente I-PAST_MEDICAL_HISTORY -presenta I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -creatinina I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -1, I-PAST_MEDICAL_HISTORY -43 I-PAST_MEDICAL_HISTORY -mg/dl, I-PAST_MEDICAL_HISTORY -hematuria I-PAST_MEDICAL_HISTORY -(10 I-PAST_MEDICAL_HISTORY -hematíes/campo), I-PAST_MEDICAL_HISTORY -proteinuria I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -g/día. I-PAST_MEDICAL_HISTORY -Hace B-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -diagnosticado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -glomerulonefritis I-PRESENT_ILLNESS -proliferativa I-PRESENT_ILLNESS -mesangial I-PRESENT_ILLNESS -difusa I-PRESENT_ILLNESS +evolución. I-PAST_MEDICAL_HISTORY +Enfermedad B-PRESENT_ILLNESS +actual: I-PRESENT_ILLNESS +comenzó I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +4/6/04 I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -depósitos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -IgA. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION +dolor I-PRESENT_ILLNESS +precordial I-PRESENT_ILLNESS +opresivo. I-PRESENT_ILLNESS +Se B-TREATMENT +diagnosticó I-TREATMENT +infarto I-TREATMENT +agudo I-TREATMENT +de I-TREATMENT +miocardio I-TREATMENT +y I-TREATMENT +recibió I-TREATMENT +tratamiento I-TREATMENT +fibrinolítico I-TREATMENT +sistémico I-TREATMENT +con I-TREATMENT +estreptoquinasa. I-TREATMENT +Reapareció B-EXPLORATION +angor, I-EXPLORATION +realizándose I-EXPLORATION +cineangiocoronariografía I-EXPLORATION +(CACG) I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -biopsia I-EXPLORATION -renal I-EXPLORATION +urgencia I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +arterias I-EXPLORATION +coronarias I-EXPLORATION +sin I-EXPLORATION +lesiones I-EXPLORATION +significativas. I-EXPLORATION +En B-EVOLUTION +forma I-EVOLUTION +inmediata I-EVOLUTION +al I-EVOLUTION +inicio I-EVOLUTION +del I-EVOLUTION +procedimiento, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +frialdad I-EVOLUTION +intensa I-EVOLUTION +y I-EVOLUTION +dolor I-EVOLUTION +en I-EVOLUTION +ambos I-EVOLUTION +miembros I-EVOLUTION +inferiores I-EVOLUTION +de I-EVOLUTION +predominio I-EVOLUTION +distal, I-EVOLUTION +con I-EVOLUTION +cianosis I-EVOLUTION +de I-EVOLUTION +dedos I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +pies. I-EVOLUTION +Concomitantemente I-EVOLUTION +apareció I-EVOLUTION +epigastralgia, I-EVOLUTION +náuseas I-EVOLUTION +y I-EVOLUTION +vómitos. I-EVOLUTION + I-EVOLUTION +Al B-EXPLORATION +examen I-EXPLORATION destacaba I-EXPLORATION -un I-EXPLORATION -20% I-EXPLORATION +cianosis I-EXPLORATION de I-EXPLORATION -glomérulos I-EXPLORATION +dedos I-EXPLORATION +de I-EXPLORATION +pies, I-EXPLORATION con I-EXPLORATION -esclerosis I-EXPLORATION -severa, I-EXPLORATION -un I-EXPLORATION -10% I-EXPLORATION -estaban I-EXPLORATION -obliterados, I-EXPLORATION -había I-EXPLORATION -una I-EXPLORATION -fibrosis I-EXPLORATION -intersticial, I-EXPLORATION -atrofia I-EXPLORATION -tubular, I-EXPLORATION -discreto I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -crónico I-EXPLORATION +necrosis I-EXPLORATION +seca I-EXPLORATION +en I-EXPLORATION +3º, I-EXPLORATION +4º I-EXPLORATION +y I-EXPLORATION +5º I-EXPLORATION +dedos I-EXPLORATION +derechos I-EXPLORATION +y I-EXPLORATION +3º I-EXPLORATION y I-EXPLORATION +5º I-EXPLORATION +dedos I-EXPLORATION +izquierdos. I-EXPLORATION + I-EXPLORATION +Examen I-EXPLORATION +cardiovascular: I-EXPLORATION +ritmo I-EXPLORATION +irregular I-EXPLORATION +110 I-EXPLORATION +lpm, I-EXPLORATION +pulsos I-EXPLORATION +distales I-EXPLORATION +conservados, I-EXPLORATION +simétricos I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -inmunofluorescencia I-EXPLORATION -se I-EXPLORATION -detectaban I-EXPLORATION -depósitos I-EXPLORATION -mesangiales I-EXPLORATION -difusos I-EXPLORATION +4 I-EXPLORATION +miembros. I-EXPLORATION + I-EXPLORATION +Exámenes I-EXPLORATION de I-EXPLORATION -IgA I-EXPLORATION +laboratorio. I-EXPLORATION +Azoemia: I-EXPLORATION +140 I-EXPLORATION +mg/dL. I-EXPLORATION +Creatininemia: I-EXPLORATION +5, I-EXPLORATION +8 I-EXPLORATION +mg/dL I-EXPLORATION +(función I-EXPLORATION +renal I-EXPLORATION +3 I-EXPLORATION +meses I-EXPLORATION +previos I-EXPLORATION +normal). I-EXPLORATION +Depuración I-EXPLORATION +de I-EXPLORATION +creatinina: I-EXPLORATION +11 I-EXPLORATION +ml/min. I-EXPLORATION +Hemograma, I-EXPLORATION +ionograma I-EXPLORATION +sanguíneo I-EXPLORATION y I-EXPLORATION -C3; I-EXPLORATION -a B-EVOLUTION -pesar I-EVOLUTION +glicemia: I-EXPLORATION +normales. I-EXPLORATION +Examen I-EXPLORATION +de I-EXPLORATION +orina: I-EXPLORATION +densidad I-EXPLORATION +1015; I-EXPLORATION +proteínas I-EXPLORATION +2, I-EXPLORATION +09 I-EXPLORATION +g/L; I-EXPLORATION +hematíes+++; I-EXPLORATION +leucocitos++. I-EXPLORATION +Antígeno I-EXPLORATION +prostático I-EXPLORATION +específico: I-EXPLORATION +2, I-EXPLORATION +4 I-EXPLORATION +ng/mL. I-EXPLORATION +Ecografía I-EXPLORATION +aparato I-EXPLORATION +urinario: I-EXPLORATION +tamaño I-EXPLORATION +renal I-EXPLORATION +y I-EXPLORATION +espesor I-EXPLORATION +parenquimatoso I-EXPLORATION +conservados, I-EXPLORATION +leve I-EXPLORATION +dilatación I-EXPLORATION +pielocalicial I-EXPLORATION +izquierda, I-EXPLORATION +hipertrofia I-EXPLORATION +prostática I-EXPLORATION +grado I-EXPLORATION +III. I-EXPLORATION +ECG: I-EXPLORATION +fibrilación I-EXPLORATION +auricular I-EXPLORATION +con I-EXPLORATION +frecuencia I-EXPLORATION +promedio I-EXPLORATION +de I-EXPLORATION +90 I-EXPLORATION +lpm. I-EXPLORATION +Radiografía I-EXPLORATION +de I-EXPLORATION +tórax: I-EXPLORATION +normal. I-EXPLORATION +Ecocardiograma: I-EXPLORATION +hipertrofia I-EXPLORATION +ventricular I-EXPLORATION +izquierda, I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +aurícula I-EXPLORATION +izquierda, I-EXPLORATION +fracción I-EXPLORATION +de I-EXPLORATION +eyección I-EXPLORATION +ventricular I-EXPLORATION +izquierda: I-EXPLORATION +57%. I-EXPLORATION +Doppler I-EXPLORATION +arterial I-EXPLORATION +miembros I-EXPLORATION +inferiores: I-EXPLORATION +lesiones I-EXPLORATION +hemodinámicamente I-EXPLORATION +significativas I-EXPLORATION +en I-EXPLORATION +sector I-EXPLORATION +ilíaco I-EXPLORATION +y I-EXPLORATION +femoral I-EXPLORATION +común, I-EXPLORATION +bilaterales; I-EXPLORATION +arterias I-EXPLORATION +distales I-EXPLORATION +sin I-EXPLORATION +lesiones I-EXPLORATION +significativas. I-EXPLORATION +Colonoscopia: I-EXPLORATION +edema I-EXPLORATION +y I-EXPLORATION +lesiones I-EXPLORATION +ulceradas I-EXPLORATION +superficiales I-EXPLORATION +cubiertas I-EXPLORATION +por I-EXPLORATION +fibrina, I-EXPLORATION +desde I-EXPLORATION +recto I-EXPLORATION +bajo I-EXPLORATION +hasta I-EXPLORATION +sigmoides I-EXPLORATION +proximal, I-EXPLORATION +donde I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +eran I-EXPLORATION +más I-EXPLORATION +extensas I-EXPLORATION +e I-EXPLORATION +impidieron I-EXPLORATION +proseguir I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +(aspecto I-EXPLORATION +de I-EXPLORATION +colitis I-EXPLORATION +isquémica). I-EXPLORATION +Biopsia I-EXPLORATION +de I-EXPLORATION +colon I-EXPLORATION +sigmoides: I-EXPLORATION +sin I-EXPLORATION +elementos I-EXPLORATION +de I-EXPLORATION +especificidad. I-EXPLORATION +Gastroscopia: I-EXPLORATION +lesiones I-EXPLORATION +ulceradas I-EXPLORATION +en I-EXPLORATION +cara I-EXPLORATION +anterior I-EXPLORATION +y I-EXPLORATION +posterior I-EXPLORATION +de I-EXPLORATION +duodeno. I-EXPLORATION +Fondo I-EXPLORATION +de I-EXPLORATION +ojo: I-EXPLORATION +embolias I-EXPLORATION +colesterínicas I-EXPLORATION +en I-EXPLORATION +retina I-EXPLORATION +izquierda. I-EXPLORATION +Biopsia I-EXPLORATION +de I-EXPLORATION +piel: I-EXPLORATION +cristales I-EXPLORATION +de I-EXPLORATION +colesterol I-EXPLORATION +ocluyendo I-EXPLORATION +la I-EXPLORATION +luz I-EXPLORATION +de I-EXPLORATION +vasos I-EXPLORATION +de I-EXPLORATION +mediano I-EXPLORATION +calibre; I-EXPLORATION +trombosis I-EXPLORATION +vascular I-EXPLORATION +en I-EXPLORATION +vasos I-EXPLORATION +de I-EXPLORATION +pequeño I-EXPLORATION +calibre. I-EXPLORATION + I-EXPLORATION +Evolución B-EVOLUTION +y I-EVOLUTION +tratamiento. I-EVOLUTION +En I-EVOLUTION +la I-EVOLUTION +evolución, I-EVOLUTION +destacó I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +hemorragia I-EVOLUTION +digestiva I-EVOLUTION +masiva I-EVOLUTION +(reiterado I-EVOLUTION +en I-EVOLUTION +dos I-EVOLUTION +oportunidades) I-EVOLUTION +que B-TREATMENT +requirió I-TREATMENT +uso I-TREATMENT +de I-TREATMENT +tranfusiones; I-TREATMENT +posteriormente, B-EVOLUTION +diarrea I-EVOLUTION +mantenida. I-EVOLUTION +Esto I-EVOLUTION +impidió I-EVOLUTION +su I-EVOLUTION +traslado I-EVOLUTION +para I-EVOLUTION +realización I-EVOLUTION de I-EVOLUTION -ello, I-EVOLUTION -siguió I-EVOLUTION -trabajando I-EVOLUTION -hasta I-EVOLUTION -hace I-EVOLUTION -un I-EVOLUTION -año, I-EVOLUTION -que I-EVOLUTION -fue I-EVOLUTION -diagnosticado I-EVOLUTION +angiorresonancia I-EVOLUTION +magnética I-EVOLUTION +para I-EVOLUTION +evaluación I-EVOLUTION de I-EVOLUTION -una I-EVOLUTION -enfermedad I-EVOLUTION -renal I-EVOLUTION -crónica I-EVOLUTION +aorta I-EVOLUTION +torácica I-EVOLUTION +y I-EVOLUTION +abdominal. I-EVOLUTION +A I-EVOLUTION +nivel I-EVOLUTION +ocular, I-EVOLUTION +presentó I-EVOLUTION +gran I-EVOLUTION +disminución I-EVOLUTION de I-EVOLUTION -grado I-EVOLUTION -3. I-EVOLUTION - I-EVOLUTION -La I-EVOLUTION -evolución I-EVOLUTION +agudeza I-EVOLUTION +visual. I-EVOLUTION +Hubo I-EVOLUTION +franco I-EVOLUTION +empeoramiento I-EVOLUTION +del I-EVOLUTION +dolor I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -analíticas I-EVOLUTION -renales, I-EVOLUTION -realizadas I-EVOLUTION -cada I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -desde I-EVOLUTION -que I-EVOLUTION +ambos I-EVOLUTION +miembros I-EVOLUTION +inferiores, I-EVOLUTION +llegando B-TREATMENT +a I-TREATMENT +requerir I-TREATMENT +opiáceos, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +simpaticectomía I-TREATMENT +lumbar I-TREATMENT +unilateral, I-TREATMENT +con I-TREATMENT +criterio I-TREATMENT +analgésico, I-TREATMENT +con I-TREATMENT +resultado I-TREATMENT +favorable. I-TREATMENT + I-TREATMENT +Bajo B-EVOLUTION +tratamiento I-EVOLUTION +médico, I-EVOLUTION se I-EVOLUTION -realizó I-EVOLUTION +logró I-EVOLUTION +estabilización I-EVOLUTION +de I-EVOLUTION +cifras I-EVOLUTION +de I-EVOLUTION +creatinina, I-EVOLUTION +destacando I-EVOLUTION el I-EVOLUTION -diagnóstico I-EVOLUTION -hasta I-EVOLUTION -la I-EVOLUTION -actualidad, I-EVOLUTION -vienen I-EVOLUTION -expresadas I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -tabla I-EVOLUTION -2. I-EVOLUTION -Las I-EVOLUTION -determinaciones I-EVOLUTION -puntuales I-EVOLUTION +difícil I-EVOLUTION +manejo I-EVOLUTION de I-EVOLUTION -beta I-EVOLUTION -2-microglobulina I-EVOLUTION -y I-EVOLUTION -NAG I-EVOLUTION -urinarios I-EVOLUTION -se I-EVOLUTION -encontraban I-EVOLUTION -dentro I-EVOLUTION +la I-EVOLUTION +HTA, I-EVOLUTION +que I-EVOLUTION +requirió I-EVOLUTION de I-EVOLUTION +múltiples I-EVOLUTION +fármacos. I-EVOLUTION + I-EVOLUTION +Como B-TREATMENT +tratamiento I-TREATMENT +tentativo I-TREATMENT +de I-TREATMENT +la I-TREATMENT +enfermedad I-TREATMENT +de I-TREATMENT +base, I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +terapia I-TREATMENT +anticoagulante I-TREATMENT +(enoxaparina I-TREATMENT +1 I-TREATMENT +mg/kg I-TREATMENT +peso I-TREATMENT +corporal I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +h) I-TREATMENT +y I-TREATMENT +corticoides I-TREATMENT +(prednisona I-TREATMENT +0, I-TREATMENT +5 I-TREATMENT +mg/kg I-TREATMENT +peso I-TREATMENT +corporal), I-TREATMENT +debiendo I-TREATMENT +ser I-TREATMENT +suspendida I-TREATMENT +por I-TREATMENT +la I-TREATMENT +hemorragia I-TREATMENT +digestiva I-TREATMENT +relatada. I-TREATMENT + I-TREATMENT +Evolución B-EVOLUTION +a I-EVOLUTION los I-EVOLUTION -valores I-EVOLUTION +6 I-EVOLUTION +meses. I-EVOLUTION +En I-EVOLUTION +el I-EVOLUTION +control: I-EVOLUTION +hubo I-EVOLUTION +caída I-EVOLUTION +espontánea I-EVOLUTION de I-EVOLUTION -normalidad. I-EVOLUTION -Después I-EVOLUTION +falanges I-EVOLUTION +distales I-EVOLUTION +del I-EVOLUTION +tercer I-EVOLUTION +dedo I-EVOLUTION de I-EVOLUTION -un I-EVOLUTION -año I-EVOLUTION +ambos I-EVOLUTION +pies I-EVOLUTION +y I-EVOLUTION +quinto I-EVOLUTION +dedo I-EVOLUTION de I-EVOLUTION -haber I-EVOLUTION -cesado I-EVOLUTION -su I-EVOLUTION -actividad I-EVOLUTION -laboral I-EVOLUTION -la I-EVOLUTION -proteinuria I-EVOLUTION +pie I-EVOLUTION +izquierdo, I-EVOLUTION +estabilización I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +cifras I-EVOLUTION +de I-EVOLUTION +insuficiencia I-EVOLUTION +renal. I-EVOLUTION +Azoemia: I-EVOLUTION +80 I-EVOLUTION +mg/dL. I-EVOLUTION +Creatininemia: I-EVOLUTION +2, I-EVOLUTION +5 I-EVOLUTION +mg/dL. I-EVOLUTION +Continúa I-EVOLUTION +actualmente I-EVOLUTION +bajo I-EVOLUTION +tratamiento I-EVOLUTION +médico I-EVOLUTION y I-EVOLUTION +no I-EVOLUTION +ha I-EVOLUTION +repetido I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION +deterioro I-EVOLUTION +de I-EVOLUTION la I-EVOLUTION -hematuria I-EVOLUTION -se I-EVOLUTION -normalizaron I-EVOLUTION -pero I-EVOLUTION -la I-EVOLUTION -creatinina I-EVOLUTION -sérica I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -alta. I-EVOLUTION +agudeza I-EVOLUTION +visual I-EVOLUTION +ni I-EVOLUTION +de I-EVOLUTION +sangrado I-EVOLUTION +digestivo. I-EVOLUTION I-EVOLUTION Presentamos B-PRESENT_ILLNESS el I-PRESENT_ILLNESS caso I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -74 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -conocidas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY +33 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -bronquitis I-PAST_MEDICAL_HISTORY -asmática, I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -portadora I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -marcapasos I-PAST_MEDICAL_HISTORY -(desde I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -años), I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -intervenida I-PAST_MEDICAL_HISTORY -quirúrgicamente I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -prótesis I-PAST_MEDICAL_HISTORY -valvular I-PAST_MEDICAL_HISTORY -mitral I-PAST_MEDICAL_HISTORY -(hacía I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años) I-PAST_MEDICAL_HISTORY +ansiedad, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +sigue I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +escitalopram I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +mg I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -cáncer I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mama I-PAST_MEDICAL_HISTORY -(dieciocho I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -antes). I-PAST_MEDICAL_HISTORY -Seguía B-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -habitual I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -acenocumarol, I-PRESENT_ILLNESS -furosemida, I-PRESENT_ILLNESS -bisoprolol, I-PRESENT_ILLNESS -espironolactona, I-PRESENT_ILLNESS -enalapril, I-PRESENT_ILLNESS -pantoprazol I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -hierro I-PRESENT_ILLNESS -oral. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -clínica I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -occipital I-PRESENT_ILLNESS -unilateral, I-PRESENT_ILLNESS -irradiada I-PRESENT_ILLNESS +alprazolam I-PAST_MEDICAL_HISTORY +0, I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +mg. I-PAST_MEDICAL_HISTORY +Exfumador I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +meses. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Acude B-PRESENT_ILLNESS a I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -frontal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -temporal, I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -opresivo, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -cedía I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -analgésicos I-PRESENT_ILLNESS -habituales I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -acompañada I-PRESENT_ILLNESS +Atención I-PRESENT_ILLNESS +Primaria I-PRESENT_ILLNESS +refiriendo I-PRESENT_ILLNESS +"asfixia", I-PRESENT_ILLNESS +sensación I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -astenia, I-PRESENT_ILLNESS -hiporexia, I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -ponderal I-PRESENT_ILLNESS +falta I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -Kg I-PRESENT_ILLNESS +aire I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -claudicación I-PRESENT_ILLNESS -mandibular I-PRESENT_ILLNESS -intermitente. I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cuerpo I-PRESENT_ILLNESS +extraño I-PRESENT_ILLNESS +faríngeo. I-PRESENT_ILLNESS A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -física, I-EXPLORATION -destacaba I-EXPLORATION -palidez I-EXPLORATION -de I-EXPLORATION -mucosas. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -palpaban I-EXPLORATION -adenopatías. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION +presenta I-EXPLORATION +buen I-EXPLORATION +murmullo I-EXPLORATION +vesicular I-EXPLORATION +sin I-EXPLORATION +ruidos I-EXPLORATION +sobreañadidos, I-EXPLORATION +saturación I-EXPLORATION de I-EXPLORATION +oxígeno I-EXPLORATION +98 I-EXPLORATION +%. I-EXPLORATION +A I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -otros I-EXPLORATION -hallazgos I-EXPLORATION -significativos. I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION -neurológica I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -Se I-EXPLORATION -solicitaron I-EXPLORATION -como I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -analítica I-EXPLORATION +inspección I-EXPLORATION de I-EXPLORATION -sangre I-EXPLORATION -y I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -craneal. I-EXPLORATION -En I-EXPLORATION la I-EXPLORATION -analítica I-EXPLORATION -no I-EXPLORATION -existía I-EXPLORATION -anemia I-EXPLORATION -y I-EXPLORATION -sí I-EXPLORATION -leucocitosis I-EXPLORATION +faringe I-EXPLORATION +presenta I-EXPLORATION +una I-EXPLORATION +úvula I-EXPLORATION con I-EXPLORATION -neutrofilia. I-EXPLORATION -Asimismo I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION +prolongación I-EXPLORATION +filiforme I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +base I-EXPLORATION una I-EXPLORATION -glucemia I-EXPLORATION +lesión I-EXPLORATION +papilomatosa I-EXPLORATION +engrosada. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +tranquiliza I-EXPLORATION +al I-EXPLORATION +paciente I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +explica I-EXPLORATION +la I-EXPLORATION +patología. I-EXPLORATION +Se B-DERIVED_FROM/TO +aconseja I-DERIVED_FROM/TO +valoración I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +médico I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +familia, I-DERIVED_FROM/TO +quien I-DERIVED_FROM/TO +deriva I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +otorrinolaringólogo I-DERIVED_FROM/TO +(ORL). I-DERIVED_FROM/TO +Se B-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +cribado I-EXPLORATION de I-EXPLORATION -128 I-EXPLORATION -mg/dl. I-EXPLORATION -La I-EXPLORATION -PCR I-EXPLORATION -fue I-EXPLORATION +otras I-EXPLORATION +patologías I-EXPLORATION de I-EXPLORATION -3, I-EXPLORATION -99 I-EXPLORATION -mg/dl. I-EXPLORATION -La I-EXPLORATION -velocidad I-EXPLORATION +transmisión I-EXPLORATION +sexual I-EXPLORATION +con I-EXPLORATION +resultados I-EXPLORATION +negativos I-EXPLORATION +para I-EXPLORATION +infección I-EXPLORATION +por I-EXPLORATION +sífilis, I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION -sedimentación I-EXPLORATION -globular I-EXPLORATION -(VSG) I-EXPLORATION -fue I-EXPLORATION +inmunodeficiencia I-EXPLORATION +humana, I-EXPLORATION +herpes I-EXPLORATION +y I-EXPLORATION +hepatitis. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +ORL I-EXPLORATION +le I-EXPLORATION +diagnostica I-EXPLORATION +de I-EXPLORATION +poliposis I-EXPLORATION +senonasal I-EXPLORATION +izquierda I-EXPLORATION +con I-EXPLORATION +remodelación I-EXPLORATION +ósea, I-EXPLORATION +desviación I-EXPLORATION +del I-EXPLORATION +tabique I-EXPLORATION +nasal, I-EXPLORATION +ensanchamiento I-EXPLORATION +del I-EXPLORATION +infundíbulo I-EXPLORATION +del I-EXPLORATION +seno I-EXPLORATION +maxilar I-EXPLORATION +y I-EXPLORATION +úvula I-EXPLORATION +con I-EXPLORATION +formación I-EXPLORATION +papilomatosa I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +base I-EXPLORATION +y I-EXPLORATION +engrosamiento I-EXPLORATION de I-EXPLORATION -83 I-EXPLORATION -mm I-EXPLORATION -(en I-EXPLORATION la I-EXPLORATION -1a I-EXPLORATION -hora). I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -otras I-EXPLORATION -alteraciones I-EXPLORATION -analíticas. I-EXPLORATION -En I-EXPLORATION +misma. I-EXPLORATION +Se B-TREATMENT +interviene I-TREATMENT +y B-EXPLORATION +desde I-EXPLORATION +Anatomía I-EXPLORATION +Patológica I-EXPLORATION +informan I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +papiloma I-EXPLORATION +invertido I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +seno I-EXPLORATION +nasal I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -TC I-EXPLORATION -craneal I-EXPLORATION +lesión I-EXPLORATION +en I-EXPLORATION +úvula I-EXPLORATION +como I-EXPLORATION +papiloma I-EXPLORATION +escamoso. I-EXPLORATION + I-EXPLORATION +Actualmente B-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +ha I-EVOLUTION +mejorado I-EVOLUTION +notablemente I-EVOLUTION +tanto I-EVOLUTION +por I-EVOLUTION +la I-EVOLUTION +sintomatología I-EVOLUTION +nasal I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +que I-EVOLUTION +no I-EVOLUTION +hizo I-EVOLUTION +referencia I-EVOLUTION +hasta I-EVOLUTION +llegar I-EVOLUTION +al I-EVOLUTION +ORL I-EVOLUTION +como I-EVOLUTION +por I-EVOLUTION +la I-EVOLUTION +sensación I-EVOLUTION +de I-EVOLUTION +cuerpo I-EVOLUTION +extraño. I-EVOLUTION + I-EVOLUTION +En B-EXPLORATION +este I-EXPLORATION +caso I-EXPLORATION +en I-EXPLORATION +particular I-EXPLORATION +sería I-EXPLORATION +interesante I-EXPLORATION +poner I-EXPLORATION +en I-EXPLORATION +conocimiento I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION no I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -lesiones I-EXPLORATION -ocupantes I-EXPLORATION +mantiene I-EXPLORATION +buena I-EXPLORATION +relación I-EXPLORATION +con I-EXPLORATION +su I-EXPLORATION +médico I-EXPLORATION de I-EXPLORATION -espacio I-EXPLORATION -y I-EXPLORATION -sí I-EXPLORATION -una I-EXPLORATION -hiperostosis I-EXPLORATION -cortical I-EXPLORATION -frontoparietal I-EXPLORATION -interna. I-EXPLORATION -Con B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -inicial I-TREATMENT -de I-TREATMENT -arteritis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -arteria I-TREATMENT -temporal, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT +familia I-EXPLORATION +porque I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +opinión I-EXPLORATION +no I-EXPLORATION +le I-EXPLORATION +trata I-EXPLORATION +bien I-EXPLORATION +su I-EXPLORATION +clínica I-EXPLORATION +ansioso-depresiva. I-EXPLORATION +El I-EXPLORATION +paciente I-EXPLORATION +suele I-EXPLORATION +acudir I-EXPLORATION +a I-EXPLORATION +consulta I-EXPLORATION +cuando I-EXPLORATION +su I-EXPLORATION +médico I-EXPLORATION +esta I-EXPLORATION +saliente I-EXPLORATION +de I-EXPLORATION +guardia I-EXPLORATION +o I-EXPLORATION +de I-EXPLORATION +vacaciones; I-EXPLORATION +de B-TREATMENT +hecho I-TREATMENT +el I-TREATMENT tratamiento I-TREATMENT -corticoideo I-TREATMENT -con I-TREATMENT -metilprednisolona I-TREATMENT -a I-TREATMENT -la I-TREATMENT -dosis I-TREATMENT +antidepresivo I-TREATMENT +y I-TREATMENT +ansiolítico I-TREATMENT +no I-TREATMENT +fue I-TREATMENT +instaurado I-TREATMENT +por I-TREATMENT +su I-TREATMENT +médico, I-TREATMENT +haciendo I-TREATMENT +complicado I-TREATMENT +el I-TREATMENT +seguimiento I-TREATMENT de I-TREATMENT -1 I-TREATMENT -mg/Kg I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -mejorando I-TREATMENT -la I-TREATMENT -clínica I-TREATMENT -inicial. I-TREATMENT -Tres B-EXPLORATION -días I-EXPLORATION -después I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION +su I-TREATMENT +patología. I-TREATMENT +El B-EXPLORATION +paciente I-EXPLORATION +no I-EXPLORATION +comentó I-EXPLORATION +nada I-EXPLORATION +sobre I-EXPLORATION la I-EXPLORATION -arteria I-EXPLORATION -temporal, I-EXPLORATION -confirmándose I-EXPLORATION +congestión I-EXPLORATION +que I-EXPLORATION +le I-EXPLORATION +provocaba I-EXPLORATION +la I-EXPLORATION +poliposis I-EXPLORATION +nasal I-EXPLORATION +por I-EXPLORATION el I-EXPLORATION +mismo I-EXPLORATION +motivo. I-EXPLORATION +La I-EXPLORATION +relación I-EXPLORATION +que I-EXPLORATION +tiene I-EXPLORATION +con I-EXPLORATION +su I-EXPLORATION +médico I-EXPLORATION +de I-EXPLORATION +familia I-EXPLORATION +también I-EXPLORATION +ayuda I-EXPLORATION +a I-EXPLORATION +explicar I-EXPLORATION +por I-EXPLORATION +qué I-EXPLORATION +acude I-EXPLORATION +a I-EXPLORATION +urgencias I-EXPLORATION +por I-EXPLORATION +una I-EXPLORATION +consulta I-EXPLORATION +que I-EXPLORATION +realmente I-EXPLORATION +no I-EXPLORATION +es I-EXPLORATION +aguda. I-EXPLORATION +Tampoco I-EXPLORATION +podemos I-EXPLORATION +descartar I-EXPLORATION +que I-EXPLORATION +sus I-EXPLORATION +síntomas I-EXPLORATION +hayan I-EXPLORATION +pasado I-EXPLORATION +desapercibidos I-EXPLORATION +por I-EXPLORATION +los I-EXPLORATION +facultativos I-EXPLORATION +relacionándolos I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +ansiedad. I-EXPLORATION + I-EXPLORATION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +43 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +lista I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +espera I-PRESENT_ILLNESS +quirúrgica I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +colecistectomía I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +litiasis I-PRESENT_ILLNESS +biliar I-PRESENT_ILLNESS +sintomática I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +resección I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +adenoma I-PRESENT_ILLNESS +hepático I-PRESENT_ILLNESS +(de I-PRESENT_ILLNESS +6, I-PRESENT_ILLNESS +7 I-PRESENT_ILLNESS +cm I-PRESENT_ILLNESS +x I-PRESENT_ILLNESS +5, I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +cm I-PRESENT_ILLNESS +x I-PRESENT_ILLNESS +6, I-PRESENT_ILLNESS +8 I-PRESENT_ILLNESS +cm, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +segmento I-PRESENT_ILLNESS +II-III). I-PRESENT_ILLNESS +Consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +agudo I-PRESENT_ILLNESS +epigástrico I-PRESENT_ILLNESS +irradiado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +ambos I-PRESENT_ILLNESS +hipocondrios, I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +sanguínea I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +amilasa I-EXPLORATION +de I-EXPLORATION +3315 I-EXPLORATION +UI/L I-EXPLORATION +(rango I-EXPLORATION +de I-EXPLORATION +normalidad: I-EXPLORATION +25-115 I-EXPLORATION +UI/L), I-EXPLORATION +sin I-EXPLORATION +otros I-EXPLORATION +hallazgos; I-EXPLORATION +ingresándose I-EXPLORATION +con I-EXPLORATION diagnóstico I-EXPLORATION -anatomopatológico. I-EXPLORATION -A B-EVOLUTION -las I-EVOLUTION -cuarenta I-EVOLUTION -y I-EVOLUTION -ocho I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -dicha I-EVOLUTION -biopsia, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -refiere I-EVOLUTION -dolor I-EVOLUTION -intenso I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -lengua, I-EVOLUTION -con I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -lesión I-EVOLUTION -ulcerada I-EVOLUTION -en I-EVOLUTION -hemilengua I-EVOLUTION -derecha, I-EVOLUTION -realizándose B-EXPLORATION -cultivos I-EXPLORATION -microbiológicos, I-EXPLORATION -siendo I-EXPLORATION -negativos, I-EXPLORATION -TC I-EXPLORATION -cervical, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -tumoración I-EXPLORATION de I-EXPLORATION -hemilengua I-EXPLORATION -derecha I-EXPLORATION +pancreatitis I-EXPLORATION +aguda I-EXPLORATION +biliar, I-EXPLORATION sin I-EXPLORATION -adenopatías I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION +criterios I-EXPLORATION de I-EXPLORATION +Ranson. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -misma, I-EXPLORATION +ecografía I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +se I-EXPLORATION +evidenció I-EXPLORATION +una I-EXPLORATION +vesícula I-EXPLORATION con I-EXPLORATION -el I-EXPLORATION -resultado I-EXPLORATION +múltiples I-EXPLORATION +litiasis, I-EXPLORATION +con I-EXPLORATION +dilatación I-EXPLORATION de I-EXPLORATION -necrosis I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +intra I-EXPLORATION +y I-EXPLORATION +extrahepática, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +páncreas I-EXPLORATION +aumentado I-EXPLORATION de I-EXPLORATION -coagulación I-EXPLORATION +tamaño I-EXPLORATION de I-EXPLORATION -etiología I-EXPLORATION -isquémica. I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -favorablemente, I-EVOLUTION -resolviéndose I-EVOLUTION -la I-EVOLUTION -lesión I-EVOLUTION -lingual I-EVOLUTION -espontáneamente, I-EVOLUTION -siendo I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta, I-EVOLUTION -para I-EVOLUTION -realizar I-EVOLUTION -seguimiento I-EVOLUTION -y I-EVOLUTION -control I-EVOLUTION +forma I-EXPLORATION +difusa. I-EXPLORATION + I-EXPLORATION +Requirió B-EVOLUTION +estancia I-EVOLUTION +en I-EVOLUTION +Unidad I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION +Medicina I-EVOLUTION +Intensiva I-EVOLUTION +por I-EVOLUTION +mala I-EVOLUTION evolución I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION +con I-EVOLUTION +oligoanuria I-EVOLUTION +los I-EVOLUTION +primeros I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +ingreso; I-EVOLUTION +realizándose B-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +(TAC) I-EXPLORATION +de I-EXPLORATION +abdomen, I-EXPLORATION +que I-EXPLORATION +mostraba I-EXPLORATION +una I-EXPLORATION +pancreatitis I-EXPLORATION +grado I-EXPLORATION +E I-EXPLORATION +de I-EXPLORATION +Balthazar. I-EXPLORATION +Durante B-EVOLUTION +su I-EVOLUTION +estancia I-EVOLUTION +prolongada I-EVOLUTION en I-EVOLUTION -consultas I-EVOLUTION -externas. I-EVOLUTION - I-EVOLUTION -Dos I-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -acude I-EVOLUTION -a I-EVOLUTION -urgencias I-EVOLUTION +planta I-EVOLUTION +presentó I-EVOLUTION +numerosas I-EVOLUTION +complicaciones: I-EVOLUTION +condensación I-EVOLUTION +pulmonar I-EVOLUTION +con I-EVOLUTION +derrame I-EVOLUTION +pleural I-EVOLUTION +asociado I-EVOLUTION +(Klebsiella I-EVOLUTION +pneumoniae I-EVOLUTION +en I-EVOLUTION +esputo), I-EVOLUTION +infección I-EVOLUTION +del I-EVOLUTION +tracto I-EVOLUTION +urinario I-EVOLUTION +(Candida I-EVOLUTION +albicans), I-EVOLUTION +sepsis I-EVOLUTION +por I-EVOLUTION +catéter I-EVOLUTION +(Stafilococo I-EVOLUTION +haemolyticus), I-EVOLUTION +trombosis I-EVOLUTION +venosa I-EVOLUTION +profunda I-EVOLUTION +de I-EVOLUTION +yugular I-EVOLUTION +interna I-EVOLUTION +y I-EVOLUTION +subclavia I-EVOLUTION +derecha I-EVOLUTION por I-EVOLUTION -debilidad I-EVOLUTION -en I-EVOLUTION -hemicuerpo I-EVOLUTION -derecho I-EVOLUTION +catéter I-EVOLUTION +central, I-EVOLUTION +desnutrición I-EVOLUTION +proteica I-EVOLUTION +severa, I-EVOLUTION +e I-EVOLUTION +imposibilidad I-EVOLUTION +de I-EVOLUTION +reintroducir I-EVOLUTION +alimentación I-EVOLUTION +por I-EVOLUTION +vía I-EVOLUTION +enteral I-EVOLUTION +por I-EVOLUTION +cuadros I-EVOLUTION +suboclusivos I-EVOLUTION +con I-EVOLUTION +vómitos I-EVOLUTION y I-EVOLUTION -alteración I-EVOLUTION -del I-EVOLUTION -lenguaje. I-EVOLUTION -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -hemiparesia I-EXPLORATION -derecha I-EXPLORATION -(balance I-EXPLORATION -motor I-EXPLORATION +distensión I-EVOLUTION +abdominal. I-EVOLUTION +En B-EXPLORATION +TAC I-EXPLORATION de I-EXPLORATION -extremidad I-EXPLORATION -superior I-EXPLORATION -3-/5 I-EXPLORATION -y I-EXPLORATION -extremidad I-EXPLORATION -inferior I-EXPLORATION +abdomen I-EXPLORATION de I-EXPLORATION -2/5), I-EXPLORATION -afasia I-EXPLORATION -global, I-EXPLORATION -paresia I-EXPLORATION -facial I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -hemianopsia I-EXPLORATION -homónima I-EXPLORATION -derecha. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -TC I-EXPLORATION -craneal I-EXPLORATION +control, I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION -un I-EXPLORATION -extenso I-EXPLORATION -infarto I-EXPLORATION -agudo I-EXPLORATION -isquémico I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -territorio I-EXPLORATION +visualizó I-EXPLORATION +estenosis I-EXPLORATION +severa I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +ángulo I-EXPLORATION +hepático I-EXPLORATION +del I-EXPLORATION +colon I-EXPLORATION +con I-EXPLORATION +engrosamiento I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -cerebral I-EXPLORATION -media I-EXPLORATION +pliegues I-EXPLORATION y I-EXPLORATION -arteria I-EXPLORATION -cerebral I-EXPLORATION -posterior I-EXPLORATION -izquierdas. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -electrocardiograma I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -ritmo I-EXPLORATION -de I-EXPLORATION -marcapasos. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -coagulación, I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -INR I-EXPLORATION -de I-EXPLORATION -1, I-EXPLORATION -48. I-EXPLORATION -No I-EXPLORATION +varios I-EXPLORATION +trayectos I-EXPLORATION +fistulosos, I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -realizaron I-EXPLORATION -otras I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION +confirmaron I-EXPLORATION +con I-EXPLORATION +enema I-EXPLORATION +opaco I-EXPLORATION +; I-EXPLORATION +así I-EXPLORATION como I-EXPLORATION -angiorresonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -cerebral, I-EXPLORATION -ecografía-doppler I-EXPLORATION -transcraneal I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -troncos I-EXPLORATION -supraaórticos, I-EXPLORATION -ni I-EXPLORATION -ecocardiograma I-EXPLORATION -(transtorácico I-EXPLORATION -ni I-EXPLORATION -transesofágico). I-EXPLORATION -La B-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -larga I-DERIVED_FROM/TO -estancia I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -realización I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -rehabilitación I-DERIVED_FROM/TO -intensiva. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO +colecciones I-EXPLORATION +multiloculadas I-EXPLORATION +en I-EXPLORATION +psoas-iliaco I-EXPLORATION +derecho. I-EXPLORATION + I-EXPLORATION +Ante B-TREATMENT +la I-TREATMENT +falta I-TREATMENT +de I-TREATMENT +respuesta I-TREATMENT +a I-TREATMENT +tratamiento I-TREATMENT +conservador I-TREATMENT +se I-TREATMENT +programó I-TREATMENT +para I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +realizándose I-TREATMENT +bypass I-TREATMENT +íleo-cólico, I-TREATMENT +colecistectomía I-TREATMENT +y I-TREATMENT +resección I-TREATMENT +del I-TREATMENT +adenoma I-TREATMENT +hepático. I-TREATMENT + I-TREATMENT +Actualmente B-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +asintomática, I-EVOLUTION +con I-EVOLUTION +TAC I-EVOLUTION +abdomen I-EVOLUTION +de I-EVOLUTION +control I-EVOLUTION +normal. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS -masculino I-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +describe I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -77 I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -disartria, I-PRESENT_ILLNESS -disfasia I-PRESENT_ILLNESS -expresiva, I-PRESENT_ILLNESS -hemiparesia I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -deterioro I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS del I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS +Hospital I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -conciencia. I-PRESENT_ILLNESS -Fue B-PAST_MEDICAL_HISTORY -informado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -familiares I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY +Valme I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +ideación I-PRESENT_ILLNESS +autolítica I-PRESENT_ILLNESS +persistente I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +alucinaciones I-PRESENT_ILLNESS +auditivas. I-PRESENT_ILLNESS +En B-PAST_MEDICAL_HISTORY +relación I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY +psiquiátricos, I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +ingresado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +Unidad I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -esencial I-PAST_MEDICAL_HISTORY +Agudos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Salud I-PAST_MEDICAL_HISTORY +Mental I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +diversas I-PAST_MEDICAL_HISTORY +ocasiones I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +2007, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +orientación I-PAST_MEDICAL_HISTORY +diagnóstica, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +último I-PAST_MEDICAL_HISTORY +ingreso I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +episodio I-PAST_MEDICAL_HISTORY +depresivo I-PAST_MEDICAL_HISTORY +moderado I-PAST_MEDICAL_HISTORY +(F32.1 I-PAST_MEDICAL_HISTORY +CIE-10). I-PAST_MEDICAL_HISTORY +Estaba I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY tratamiento I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -50 I-PAST_MEDICAL_HISTORY -miligramos I-PAST_MEDICAL_HISTORY +risperidona I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +mg/24h, I-PAST_MEDICAL_HISTORY +ac. I-PAST_MEDICAL_HISTORY +valproico I-PAST_MEDICAL_HISTORY +1500 I-PAST_MEDICAL_HISTORY +mg/24h, I-PAST_MEDICAL_HISTORY +citalopram I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +mg/24h I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +flunitrazepam I-PAST_MEDICAL_HISTORY +1mg/24h. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +momento I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +actual I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hacía I-PRESENT_ILLNESS +seis I-PRESENT_ILLNESS +meses, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +contexto I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +duelo I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +fallecimiento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +hija, I-PRESENT_ILLNESS +relataba I-PRESENT_ILLNESS +incremento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +ansiedad, I-PRESENT_ILLNESS +tristeza, I-PRESENT_ILLNESS +anhedonia, I-PRESENT_ILLNESS +apatía, I-PRESENT_ILLNESS +abandono I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +actividades, I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +alucinaciones I-PRESENT_ILLNESS +auditivas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +espacio I-PRESENT_ILLNESS +externo. I-PRESENT_ILLNESS +Eran I-PRESENT_ILLNESS +voces I-PRESENT_ILLNESS +imperativas I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +insultantes I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +tenían I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +él I-PRESENT_ILLNESS +importante I-PRESENT_ILLNESS +repercusión I-PRESENT_ILLNESS +conductual I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +afectiva: I-PRESENT_ILLNESS +"Empezó I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +rumor I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +ahora I-PRESENT_ILLNESS +son I-PRESENT_ILLNESS +claras, I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +si I-PRESENT_ILLNESS +alguien I-PRESENT_ILLNESS +me I-PRESENT_ILLNESS +hablara. I-PRESENT_ILLNESS +Se I-PRESENT_ILLNESS +hacen I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +fuertes I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +puedo I-PRESENT_ILLNESS +controlarlas, I-PRESENT_ILLNESS +me I-PRESENT_ILLNESS +dicen I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +me I-PRESENT_ILLNESS +haga I-PRESENT_ILLNESS +daño, I-PRESENT_ILLNESS +también I-PRESENT_ILLNESS +me I-PRESENT_ILLNESS +insultan.". I-PRESENT_ILLNESS +Estaba B-EXPLORATION +consciente, I-EXPLORATION +orientado I-EXPLORATION +auto I-EXPLORATION +y I-EXPLORATION +alopsíquicamente, I-EXPLORATION +euproséxico. I-EXPLORATION +Su I-EXPLORATION +actitud I-EXPLORATION +era I-EXPLORATION +de I-EXPLORATION +colaboración I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +presentaba I-EXPLORATION +alteraciones I-EXPLORATION +groseras I-EXPLORATION +en I-EXPLORATION +funciones I-EXPLORATION +superiores. I-EXPLORATION +El I-EXPLORATION +lenguaje I-EXPLORATION +era I-EXPLORATION +fluido, I-EXPLORATION +espontáneo I-EXPLORATION +y I-EXPLORATION +coherente. I-EXPLORATION +Refería I-EXPLORATION +sentimientos I-EXPLORATION +de I-EXPLORATION +culpa I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +reciente I-EXPLORATION +muerte I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +hija, I-EXPLORATION +desconfianza I-EXPLORATION +de I-EXPLORATION +todos I-EXPLORATION +aquellos I-EXPLORATION +que I-EXPLORATION +le I-EXPLORATION +rodeaban, I-EXPLORATION +y I-EXPLORATION +desamparo I-EXPLORATION +y I-EXPLORATION +soledad I-EXPLORATION +en I-EXPLORATION +relación I-EXPLORATION +a I-EXPLORATION +su I-EXPLORATION +situación I-EXPLORATION +vital. I-EXPLORATION +Tenía I-EXPLORATION +ideas I-EXPLORATION +de I-EXPLORATION +muerte I-EXPLORATION +y I-EXPLORATION +autolisis. I-EXPLORATION +Se I-EXPLORATION +quejaba I-EXPLORATION +de I-EXPLORATION +insomnio I-EXPLORATION +con I-EXPLORATION +despertares I-EXPLORATION +intermitentes I-EXPLORATION +y I-EXPLORATION +frecuentes I-EXPLORATION +pesadillas. I-EXPLORATION +Disponía I-EXPLORATION +de I-EXPLORATION +nulo I-EXPLORATION +soporte I-EXPLORATION +familiar I-EXPLORATION +y I-EXPLORATION +social I-EXPLORATION +y I-EXPLORATION +había I-EXPLORATION +abandonado I-EXPLORATION +progresivamente I-EXPLORATION +su I-EXPLORATION +trabajo. I-EXPLORATION + I-EXPLORATION +Datos B-PAST_MEDICAL_HISTORY +biográficos I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Niñez I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +adolescencia I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Siendo I-PAST_MEDICAL_HISTORY +muy I-PAST_MEDICAL_HISTORY +pequeño I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +padres I-PAST_MEDICAL_HISTORY +emigraron I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +él, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +era I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +mayor I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -captopril I-PAST_MEDICAL_HISTORY -cada I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -horas I-PAST_MEDICAL_HISTORY +seis I-PAST_MEDICAL_HISTORY +hermanos, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +quedó I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +España, I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +cuidado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +abuelos I-PAST_MEDICAL_HISTORY +paternos. I-PAST_MEDICAL_HISTORY +Recuerda I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +infancia I-PAST_MEDICAL_HISTORY +feliz, I-PAST_MEDICAL_HISTORY +protegido I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -aspirina I-PAST_MEDICAL_HISTORY -100 I-PAST_MEDICAL_HISTORY -miligramos I-PAST_MEDICAL_HISTORY -diarios. I-PAST_MEDICAL_HISTORY -Adicionalmente, I-PAST_MEDICAL_HISTORY -informaron I-PAST_MEDICAL_HISTORY +arropado I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +ellos, I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY que I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY +llegó I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +considerar I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +padres. I-PAST_MEDICAL_HISTORY +Definía I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY su I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -trauma I-PAST_MEDICAL_HISTORY -occipital I-PAST_MEDICAL_HISTORY -cerrado I-PAST_MEDICAL_HISTORY +abuelo I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +buena I-PAST_MEDICAL_HISTORY +persona, I-PAST_MEDICAL_HISTORY +responsable I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +trabajador. I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +abuela, I-PAST_MEDICAL_HISTORY +"Una I-PAST_MEDICAL_HISTORY +santa, I-PAST_MEDICAL_HISTORY +volcada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +mi I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +todos.". I-PAST_MEDICAL_HISTORY +Con I-PAST_MEDICAL_HISTORY +ellos I-PAST_MEDICAL_HISTORY +vivía I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +tía I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +hijo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ésta, I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -pérdida I-PAST_MEDICAL_HISTORY -transitoria I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +compartió I-PAST_MEDICAL_HISTORY +juegos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +afecto. I-PAST_MEDICAL_HISTORY +Paso I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +infancia I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +adolescencia I-PAST_MEDICAL_HISTORY +separado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +padres. I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +pesar I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +estos I-PAST_MEDICAL_HISTORY +regresaron I-PAST_MEDICAL_HISTORY del I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY +país I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +emigraron, I-PAST_MEDICAL_HISTORY +nunca I-PAST_MEDICAL_HISTORY +consiguió I-PAST_MEDICAL_HISTORY +integrarse I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +familia I-PAST_MEDICAL_HISTORY +nuclear. I-PAST_MEDICAL_HISTORY +Sin I-PAST_MEDICAL_HISTORY +entender I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +qué, I-PAST_MEDICAL_HISTORY +comentaba I-PAST_MEDICAL_HISTORY +haber I-PAST_MEDICAL_HISTORY +sentido I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +ocasiones I-PAST_MEDICAL_HISTORY +culpa I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +ello. I-PAST_MEDICAL_HISTORY +Describía I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +madre I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +distante I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +egoísta; I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +padre I-PAST_MEDICAL_HISTORY +más I-PAST_MEDICAL_HISTORY +afectuoso, I-PAST_MEDICAL_HISTORY +pero I-PAST_MEDICAL_HISTORY +ambos, I-PAST_MEDICAL_HISTORY +"Incapaces I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -conciencia, I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -tropezar I-PAST_MEDICAL_HISTORY +hacer I-PAST_MEDICAL_HISTORY +nada I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +mí". I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +crió I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +mayor I-PAST_MEDICAL_HISTORY +nivel I-PAST_MEDICAL_HISTORY +económico I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +hermanos, I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +despertó I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +éstos I-PAST_MEDICAL_HISTORY +recelos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +críticas I-PAST_MEDICAL_HISTORY +constantes I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -caer; I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -embargo, I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -aquel I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY +él, I-PAST_MEDICAL_HISTORY +clara I-PAST_MEDICAL_HISTORY +desconfianza I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +relación. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +colegio I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +instituto I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +ejemplar, I-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +buenas I-PAST_MEDICAL_HISTORY +notas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +nunca I-PAST_MEDICAL_HISTORY +tuvo I-PAST_MEDICAL_HISTORY +problemas I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +compañeros I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +profesores. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +aquella I-PAST_MEDICAL_HISTORY +época, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +describía I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +sí I-PAST_MEDICAL_HISTORY +mismo I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +"Trabajador, I-PAST_MEDICAL_HISTORY +guasón, I-PAST_MEDICAL_HISTORY +amable I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +entregado I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +todos...". I-PAST_MEDICAL_HISTORY +Cursó I-PAST_MEDICAL_HISTORY +estudios I-PAST_MEDICAL_HISTORY +superiores, I-PAST_MEDICAL_HISTORY +ejerciendo I-PAST_MEDICAL_HISTORY +posteriormente I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +profesión I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +éxito I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Vida I-PAST_MEDICAL_HISTORY +adulta I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Después I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +noviazgo I-PAST_MEDICAL_HISTORY +normalizado I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +casó I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tuvo I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +hijos: I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +niña I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +niño, I-PAST_MEDICAL_HISTORY +seis I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +menor. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +matrimonio I-PAST_MEDICAL_HISTORY no I-PAST_MEDICAL_HISTORY -acudió I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +bien, I-PAST_MEDICAL_HISTORY +sentía I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +esposa I-PAST_MEDICAL_HISTORY +estaba I-PAST_MEDICAL_HISTORY +aliada I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +madre I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sólo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +escasas I-PAST_MEDICAL_HISTORY +ocasiones I-PAST_MEDICAL_HISTORY +podía I-PAST_MEDICAL_HISTORY +imponer I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +criterio. I-PAST_MEDICAL_HISTORY +Su I-PAST_MEDICAL_HISTORY +hija, I-PAST_MEDICAL_HISTORY +era I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +él, I-PAST_MEDICAL_HISTORY +"La I-PAST_MEDICAL_HISTORY +única I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +mundo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +me I-PAST_MEDICAL_HISTORY +defendía I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +apoyaba I-PAST_MEDICAL_HISTORY +ante I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +críticas". I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +primer I-PAST_MEDICAL_HISTORY +conflicto I-PAST_MEDICAL_HISTORY +relevante I-PAST_MEDICAL_HISTORY +surgió I-PAST_MEDICAL_HISTORY +quince I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +atrás I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +morir I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +abuelos. I-PAST_MEDICAL_HISTORY +Por I-PAST_MEDICAL_HISTORY +cuestiones I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +relación I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +herencia, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +sintió I-PAST_MEDICAL_HISTORY +duramente I-PAST_MEDICAL_HISTORY +criticado I-PAST_MEDICAL_HISTORY por I-PAST_MEDICAL_HISTORY -atención I-PAST_MEDICAL_HISTORY -médica. I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +padres I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +hermanos, I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +llamaron I-PAST_MEDICAL_HISTORY +entonces I-PAST_MEDICAL_HISTORY +"Niño I-PAST_MEDICAL_HISTORY +rico I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +aprovechado.". I-PAST_MEDICAL_HISTORY +Dos I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +después I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +episodio I-PAST_MEDICAL_HISTORY +comentado, I-PAST_MEDICAL_HISTORY +tuvo I-PAST_MEDICAL_HISTORY +importantes I-PAST_MEDICAL_HISTORY +problemas I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +nivel I-PAST_MEDICAL_HISTORY +laboral; I-PAST_MEDICAL_HISTORY +tema I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +generó I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +él I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +profundo I-PAST_MEDICAL_HISTORY +malestar; I-PAST_MEDICAL_HISTORY +comenzó I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +sentirse I-PAST_MEDICAL_HISTORY +intensamente I-PAST_MEDICAL_HISTORY +inseguro I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +desconfiado, I-PAST_MEDICAL_HISTORY +reduciendo I-PAST_MEDICAL_HISTORY +progresivamente I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +labor I-PAST_MEDICAL_HISTORY +profesional. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +hizo I-PAST_MEDICAL_HISTORY +entonces I-PAST_MEDICAL_HISTORY +patente I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +conflictiva I-PAST_MEDICAL_HISTORY +conyugal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +separación I-PAST_MEDICAL_HISTORY +matrimonial, I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +ingreso, I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +hija I-PAST_MEDICAL_HISTORY +mayor I-PAST_MEDICAL_HISTORY +enfermó I-PAST_MEDICAL_HISTORY +gravemente I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +falleció I-PAST_MEDICAL_HISTORY +seis I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +después. I-PAST_MEDICAL_HISTORY +Ahora I-PAST_MEDICAL_HISTORY +vivía I-PAST_MEDICAL_HISTORY +sólo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +mantenía I-PAST_MEDICAL_HISTORY +relación I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +vecinos I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +barrio I-PAST_MEDICAL_HISTORY +donde I-PAST_MEDICAL_HISTORY +residía. I-PAST_MEDICAL_HISTORY +Disfrutaba I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +pequeñas I-PAST_MEDICAL_HISTORY +tertulias I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +bares I-PAST_MEDICAL_HISTORY +cercanos I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +abandonando I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +irritabilidad I-PAST_MEDICAL_HISTORY +creciente, I-PAST_MEDICAL_HISTORY +facilitada I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +consumo I-PAST_MEDICAL_HISTORY +abusivo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alcohol. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -A B-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -presentaba I-EXPLORATION -intensa I-EXPLORATION -agitación I-EXPLORATION -motora, I-EXPLORATION -con I-EXPLORATION -tensión I-EXPLORATION -arterial I-EXPLORATION -175/98 I-EXPLORATION -mm I-EXPLORATION +Psicoterapia B-TREATMENT +breve I-TREATMENT + I-TREATMENT +Se I-TREATMENT +propuso I-TREATMENT +al I-TREATMENT +paciente I-TREATMENT +la I-TREATMENT +realización I-TREATMENT +de I-TREATMENT +una I-TREATMENT +psicoterapia I-TREATMENT +dinámica I-TREATMENT +breve I-TREATMENT +durante I-TREATMENT +su I-TREATMENT +ingreso I-TREATMENT +en I-TREATMENT +la I-TREATMENT +Unidad I-TREATMENT +de I-TREATMENT +Agudos. I-TREATMENT +El I-TREATMENT +número I-TREATMENT +de I-TREATMENT +sesiones I-TREATMENT +no I-TREATMENT +se I-TREATMENT +concretó I-TREATMENT +al I-TREATMENT +inicio, I-TREATMENT +quedando I-TREATMENT +esto I-TREATMENT +a I-TREATMENT +expensas I-TREATMENT +de I-TREATMENT +la I-TREATMENT +evolución I-TREATMENT +y I-TREATMENT +tiempo I-TREATMENT +del I-TREATMENT +ingreso. I-TREATMENT +Se I-TREATMENT +realizaron I-TREATMENT +doce I-TREATMENT +sesiones I-TREATMENT +de I-TREATMENT +cuarenta I-TREATMENT +minutos I-TREATMENT +de I-TREATMENT +duración. I-TREATMENT +Como I-TREATMENT +criterios I-TREATMENT +de I-TREATMENT +inclusión I-TREATMENT +se I-TREATMENT +tuvieron I-TREATMENT +en I-TREATMENT +cuenta: I-TREATMENT +la I-TREATMENT +capacidad I-TREATMENT +que I-TREATMENT +presentaba I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +para I-TREATMENT +pensar I-TREATMENT +sobre I-TREATMENT +sus I-TREATMENT +sentimientos, I-TREATMENT +la I-TREATMENT +existencia I-TREATMENT +de I-TREATMENT +varias I-TREATMENT +relaciones I-TREATMENT +significativas I-TREATMENT +en I-TREATMENT +el I-TREATMENT +pasado I-TREATMENT +y I-TREATMENT +la I-TREATMENT +buena I-TREATMENT +capacidad I-TREATMENT +de I-TREATMENT +vinculación I-TREATMENT +con I-TREATMENT +el I-TREATMENT +terapeuta. I-TREATMENT + I-TREATMENT +Hipótesis B-EXPLORATION +Psicodinámica I-EXPLORATION +Inicial I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +mecanismos I-EXPLORATION +adaptativos I-EXPLORATION +del I-EXPLORATION +yo I-EXPLORATION +desplegados I-EXPLORATION +desde I-EXPLORATION +la I-EXPLORATION +infancia I-EXPLORATION +como I-EXPLORATION +la I-EXPLORATION +constancia, I-EXPLORATION +capacidad I-EXPLORATION de I-EXPLORATION -Hg, I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION +trabajo, I-EXPLORATION +responsabilidad, I-EXPLORATION +entrega I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +demás I-EXPLORATION +y I-EXPLORATION +calidez I-EXPLORATION +afectiva I-EXPLORATION +proporcionaron I-EXPLORATION +al I-EXPLORATION +paciente I-EXPLORATION +una I-EXPLORATION +adecuada I-EXPLORATION +imagen I-EXPLORATION +del I-EXPLORATION +sí I-EXPLORATION +durante I-EXPLORATION +años. I-EXPLORATION +Ninguna I-EXPLORATION de I-EXPLORATION -96 I-EXPLORATION -latidos I-EXPLORATION +estas I-EXPLORATION +cualidades I-EXPLORATION +habían I-EXPLORATION +logrado I-EXPLORATION +mantenerse I-EXPLORATION +tras I-EXPLORATION +el I-EXPLORATION +duro I-EXPLORATION +golpe I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +muerte I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +hija I-EXPLORATION +(factor I-EXPLORATION +desencadenante). I-EXPLORATION +Debilitado I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +emocional I-EXPLORATION por I-EXPLORATION -minuto, I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION +el I-EXPLORATION +fracaso I-EXPLORATION de I-EXPLORATION -20/minuto I-EXPLORATION +la I-EXPLORATION +relación I-EXPLORATION +conyugal, I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +profesional I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +conflicto I-EXPLORATION +laboral I-EXPLORATION y I-EXPLORATION -temperatura I-EXPLORATION +aislado I-EXPLORATION +socialmente I-EXPLORATION +por I-EXPLORATION +las I-EXPLORATION +consecuencias I-EXPLORATION +del I-EXPLORATION +consumo I-EXPLORATION +excesivo I-EXPLORATION de I-EXPLORATION -36, I-EXPLORATION -4 I-EXPLORATION -grados I-EXPLORATION -centígrados. I-EXPLORATION -Se I-EXPLORATION -encontró I-EXPLORATION -una I-EXPLORATION -pequeña I-EXPLORATION -excoriación I-EXPLORATION -superficial I-EXPLORATION +alcohol, I-EXPLORATION +fue I-EXPLORATION +invadido I-EXPLORATION +por I-EXPLORATION +sentimientos I-EXPLORATION +reactivados I-EXPLORATION +desde I-EXPLORATION +el I-EXPLORATION +pasado, I-EXPLORATION +surgidos I-EXPLORATION en I-EXPLORATION -fase I-EXPLORATION +etapas I-EXPLORATION +no I-EXPLORATION +resueltas I-EXPLORATION +del I-EXPLORATION +desarrollo I-EXPLORATION +infantil, I-EXPLORATION +cuando I-EXPLORATION +fue I-EXPLORATION +excluido I-EXPLORATION de I-EXPLORATION -cicatrización I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -región I-EXPLORATION -parieto-occipital I-EXPLORATION -izquierda. I-EXPLORATION -Las I-EXPLORATION -pupilas I-EXPLORATION -eran I-EXPLORATION -iguales I-EXPLORATION -y I-EXPLORATION -reaccionaban I-EXPLORATION -simétricamente I-EXPLORATION -al I-EXPLORATION -reflejo I-EXPLORATION -foto-motor I-EXPLORATION -directo I-EXPLORATION -y I-EXPLORATION -consensual. I-EXPLORATION -Al I-EXPLORATION -realizar I-EXPLORATION -estímulos I-EXPLORATION -dolorosos, I-EXPLORATION -realizaba I-EXPLORATION -apertura I-EXPLORATION -ocular, I-EXPLORATION -emitía I-EXPLORATION -palabras I-EXPLORATION +familia I-EXPLORATION +nuclear I-EXPLORATION +(conflicto I-EXPLORATION +nuclear). I-EXPLORATION +Sentimientos I-EXPLORATION +de I-EXPLORATION +culpa, I-EXPLORATION +desconfianza, I-EXPLORATION +desamparo I-EXPLORATION y I-EXPLORATION -localizaba I-EXPLORATION +soledad, I-EXPLORATION +que I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -sitio I-EXPLORATION -estimulado, I-EXPLORATION -sin I-EXPLORATION -embargo, I-EXPLORATION -con I-EXPLORATION -hemiparesia I-EXPLORATION -derecha I-EXPLORATION -(Escala I-EXPLORATION -de I-EXPLORATION -coma I-EXPLORATION -de I-EXPLORATION -Glasgow: I-EXPLORATION -10/15). I-EXPLORATION -El I-EXPLORATION -signo I-EXPLORATION -de I-EXPLORATION -Babinski I-EXPLORATION -estaba I-EXPLORATION presente I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -bilateral. I-EXPLORATION - I-EXPLORATION -Fue I-EXPLORATION -realizado I-EXPLORATION -un I-EXPLORATION -escáner I-EXPLORATION -cerebral I-EXPLORATION -de I-EXPLORATION -urgencia, I-EXPLORATION -previa B-TREATMENT -administración I-TREATMENT -de I-TREATMENT -haloperidol I-TREATMENT -para I-TREATMENT -disminuir I-TREATMENT -la I-TREATMENT -agitación, I-TREATMENT -la B-EVOLUTION -cual I-EVOLUTION -tuvo I-EVOLUTION -pobre I-EVOLUTION -calidad I-EVOLUTION -técnica I-EVOLUTION -dada I-EVOLUTION -la I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -movimientos I-EVOLUTION -del I-EVOLUTION -paciente. I-EVOLUTION -En B-EXPLORATION -dicho I-EXPLORATION -estudio, I-EXPLORATION -fue I-EXPLORATION -observada I-EXPLORATION +provocaron I-EXPLORATION una I-EXPLORATION -imagen I-EXPLORATION -extra-axial, I-EXPLORATION -hiperdensa I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -al I-EXPLORATION -parénquima I-EXPLORATION -cerebral, I-EXPLORATION -con I-EXPLORATION -forma I-EXPLORATION -semilunar I-EXPLORATION +importante I-EXPLORATION +quiebra I-EXPLORATION de I-EXPLORATION -concavidad I-EXPLORATION -medial I-EXPLORATION +la I-EXPLORATION +imagen I-EXPLORATION de I-EXPLORATION -17 I-EXPLORATION -milímetros I-EXPLORATION +sí, I-EXPLORATION de I-EXPLORATION -espesor, I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -frontal, I-EXPLORATION -parietal I-EXPLORATION +los I-EXPLORATION +límites I-EXPLORATION +del I-EXPLORATION +yo I-EXPLORATION y I-EXPLORATION -occipital I-EXPLORATION -izquierda, I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -desviaba I-EXPLORATION -las I-EXPLORATION -estructuras I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -media I-EXPLORATION -en I-EXPLORATION -14 I-EXPLORATION -milímetros, I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -parecía I-EXPLORATION -corresponder I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -hematoma I-EXPLORATION -subdural. I-EXPLORATION -La I-EXPLORATION -magnitud I-EXPLORATION -desproporcionada I-EXPLORATION del I-EXPLORATION -efecto I-EXPLORATION +sentido I-EXPLORATION de I-EXPLORATION -masa I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -edema I-EXPLORATION -adyacente I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -lesión I-EXPLORATION -alertaron I-EXPLORATION -sobre I-EXPLORATION -las I-EXPLORATION -posibles I-EXPLORATION -características I-EXPLORATION -neoplásicas I-EXPLORATION -de I-EXPLORATION +realidad. I-EXPLORATION +Vencido I-EXPLORATION +por I-EXPLORATION la I-EXPLORATION -lesión. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -cerebral I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -demostró I-EXPLORATION -una I-EXPLORATION -imagen, I-EXPLORATION -extra-axial, I-EXPLORATION -hiperdensa I-EXPLORATION +puesta I-EXPLORATION en I-EXPLORATION -relación I-EXPLORATION -al I-EXPLORATION -parénquima I-EXPLORATION -cerebral, I-EXPLORATION -que I-EXPLORATION -ocupaba I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION -dorso-lateral I-EXPLORATION -fronto-temporo-parietal I-EXPLORATION -izquierda, I-EXPLORATION -con I-EXPLORATION -intensa I-EXPLORATION -captación I-EXPLORATION -del I-EXPLORATION -medio I-EXPLORATION +marcha I-EXPLORATION de I-EXPLORATION -contraste I-EXPLORATION -endovenoso, I-EXPLORATION +mecanismos I-EXPLORATION +defensivos I-EXPLORATION +como I-EXPLORATION la I-EXPLORATION -cual I-EXPLORATION -infiltraba I-EXPLORATION +introyección, I-EXPLORATION +interiorizando I-EXPLORATION +el I-EXPLORATION +objeto I-EXPLORATION +persecutorio, I-EXPLORATION +las I-EXPLORATION +voces I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -profundidad I-EXPLORATION +identificación I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +objeto I-EXPLORATION +idealizado, I-EXPLORATION +las I-EXPLORATION +figuras I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -surcos I-EXPLORATION -cerebrales I-EXPLORATION -frontales. I-EXPLORATION -Adicionalmente, I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -ventana I-EXPLORATION -ósea I-EXPLORATION +abuela I-EXPLORATION +e I-EXPLORATION +hija, I-EXPLORATION +deseando I-EXPLORATION +morir I-EXPLORATION +como I-EXPLORATION +ellas, I-EXPLORATION se I-EXPLORATION -demostró I-EXPLORATION -adelgazamiento I-EXPLORATION -del I-EXPLORATION -cráneo I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -región I-EXPLORATION -temporo-parietal I-EXPLORATION -izquierda I-EXPLORATION -a I-EXPLORATION -causa I-EXPLORATION +mostraba I-EXPLORATION +incapaz I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -lesión. I-EXPLORATION +enfrentar I-EXPLORATION +su I-EXPLORATION +propio I-EXPLORATION +sustento I-EXPLORATION +y I-EXPLORATION +destino. I-EXPLORATION I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -craneotomía I-TREATMENT -fronto-parietal I-TREATMENT -izquierda I-TREATMENT -durante I-TREATMENT +Trabajo B-TREATMENT +en I-TREATMENT +el I-TREATMENT +Foco I-TREATMENT + I-TREATMENT +Teniendo I-TREATMENT +en I-TREATMENT +cuenta I-TREATMENT la I-TREATMENT -cual I-TREATMENT +hipótesis I-TREATMENT +psicodinámica I-TREATMENT +inicial, I-TREATMENT se I-TREATMENT -encontró I-TREATMENT -el I-TREATMENT -hueso I-TREATMENT -erosionado I-TREATMENT -e I-TREATMENT -infiltrado I-TREATMENT -por I-TREATMENT +seleccionaron I-TREATMENT +los I-TREATMENT +sentimientos I-TREATMENT +de I-TREATMENT +culpa, I-TREATMENT +desconfianza, I-TREATMENT +desamparo I-TREATMENT +y I-TREATMENT +soledad I-TREATMENT +como I-TREATMENT +foco I-TREATMENT +terapéutico. I-TREATMENT +Estos I-TREATMENT +sentimientos I-TREATMENT +se I-TREATMENT +abordaron I-TREATMENT +desde I-TREATMENT una I-TREATMENT -lesión I-TREATMENT -violácea, I-TREATMENT -firme, I-TREATMENT -muy I-TREATMENT -vascularizada, I-TREATMENT +perspectiva I-TREATMENT +cognitiva, I-TREATMENT +emocional I-TREATMENT +y I-TREATMENT +conductual, I-TREATMENT +intentando I-TREATMENT +facilitar I-TREATMENT +al I-TREATMENT +paciente I-TREATMENT +su I-TREATMENT +identificación, I-TREATMENT +expresión, I-TREATMENT +regulación I-TREATMENT +y I-TREATMENT +transformación: I-TREATMENT + I-TREATMENT +Sentimiento I-TREATMENT +de I-TREATMENT +culpa: I-TREATMENT +se I-TREATMENT +sentía I-TREATMENT +terriblemente I-TREATMENT +culpable I-TREATMENT +de I-TREATMENT la I-TREATMENT -cual I-TREATMENT +enfermedad I-TREATMENT +y I-TREATMENT +posterior I-TREATMENT +fallecimiento I-TREATMENT +de I-TREATMENT +su I-TREATMENT +hija. I-TREATMENT +Se I-TREATMENT +facilitó I-TREATMENT +la I-TREATMENT +expresión I-TREATMENT +de I-TREATMENT +este I-TREATMENT +sentimiento, I-TREATMENT +aumentando I-TREATMENT +la I-TREATMENT +conciencia I-TREATMENT +de I-TREATMENT +su I-TREATMENT +presencia I-TREATMENT +en I-TREATMENT +el I-TREATMENT +pasado. I-TREATMENT +Se I-TREATMENT +abordaron I-TREATMENT +las I-TREATMENT +fantasías I-TREATMENT +de I-TREATMENT +omnipotencia I-TREATMENT +y I-TREATMENT +creencias I-TREATMENT +mágicas, I-TREATMENT +la I-TREATMENT +aceptación I-TREATMENT +de I-TREATMENT +los I-TREATMENT +límites I-TREATMENT +propios I-TREATMENT +y I-TREATMENT +el I-TREATMENT +reconocimiento I-TREATMENT +de I-TREATMENT +los I-TREATMENT +límites I-TREATMENT +de I-TREATMENT +la I-TREATMENT +naturaleza I-TREATMENT +humana. I-TREATMENT +Para I-TREATMENT +favorecer I-TREATMENT +la I-TREATMENT +reparación I-TREATMENT +del I-TREATMENT +daño I-TREATMENT +y I-TREATMENT +la I-TREATMENT +transformación I-TREATMENT +del I-TREATMENT +sentimiento, I-TREATMENT se I-TREATMENT -extendía I-TREATMENT +le I-TREATMENT +animó I-TREATMENT a I-TREATMENT -través I-TREATMENT +la I-TREATMENT +conducta I-TREATMENT +de I-TREATMENT +ayuda I-TREATMENT +y I-TREATMENT +entrega I-TREATMENT +a I-TREATMENT +los I-TREATMENT +demás I-TREATMENT +pacientes, I-TREATMENT +personas I-TREATMENT +necesitadas I-TREATMENT +como I-TREATMENT +él. I-TREATMENT + I-TREATMENT +Sentimiento I-TREATMENT de I-TREATMENT +desconfianza: I-TREATMENT +sentimiento I-TREATMENT +que I-TREATMENT +emergió I-TREATMENT +tras I-TREATMENT la I-TREATMENT -duramadre, I-TREATMENT -llegando I-TREATMENT +conflictiva I-TREATMENT +familiar I-TREATMENT +y I-TREATMENT +laboral. I-TREATMENT +Con I-TREATMENT +la I-TREATMENT +intención I-TREATMENT +de I-TREATMENT +trabajar I-TREATMENT +la I-TREATMENT +confianza I-TREATMENT +en I-TREATMENT +sí I-TREATMENT +mismo, I-TREATMENT +base I-TREATMENT +de I-TREATMENT +la I-TREATMENT +posibilidad I-TREATMENT +de I-TREATMENT +confiar I-TREATMENT +en I-TREATMENT +los I-TREATMENT +demás, I-TREATMENT +se I-TREATMENT +hizo I-TREATMENT +un I-TREATMENT +intento I-TREATMENT +de I-TREATMENT +reestructurar I-TREATMENT +la I-TREATMENT +imagen I-TREATMENT +de I-TREATMENT +sí I-TREATMENT +y I-TREATMENT +la I-TREATMENT +autoestima I-TREATMENT +perdida, I-TREATMENT +ofreciéndole I-TREATMENT +una I-TREATMENT +experiencia I-TREATMENT +emocional I-TREATMENT +correctiva, I-TREATMENT +en I-TREATMENT +el I-TREATMENT +contexto I-TREATMENT +de I-TREATMENT +la I-TREATMENT +relación I-TREATMENT +terapéutica, I-TREATMENT +al I-TREATMENT +valorarle I-TREATMENT +y I-TREATMENT +reforzar I-TREATMENT +con I-TREATMENT +frecuencia I-TREATMENT +sus I-TREATMENT +cualidades, I-TREATMENT +entre I-TREATMENT +ellas, I-TREATMENT +su I-TREATMENT +generosidad, I-TREATMENT +entrega I-TREATMENT +y I-TREATMENT +capacidad I-TREATMENT +de I-TREATMENT +apego. I-TREATMENT +Además I-TREATMENT +se I-TREATMENT +le I-TREATMENT +instó I-TREATMENT a I-TREATMENT -las I-TREATMENT -leptomeninges, I-TREATMENT -infiltrándolas I-TREATMENT +contactar I-TREATMENT +con I-TREATMENT +su I-TREATMENT +tía I-TREATMENT +y I-TREATMENT +primo I-TREATMENT +que I-TREATMENT +residían I-TREATMENT +ahora I-TREATMENT +en I-TREATMENT +otra I-TREATMENT +ciudad, I-TREATMENT +con I-TREATMENT +los I-TREATMENT +que I-TREATMENT +había I-TREATMENT +mantenido I-TREATMENT +una I-TREATMENT +relación I-TREATMENT +de I-TREATMENT +confianza I-TREATMENT +y I-TREATMENT +apego. I-TREATMENT + I-TREATMENT +Sentimiento I-TREATMENT +de I-TREATMENT +desamparo I-TREATMENT +y I-TREATMENT +soledad: I-TREATMENT +La I-TREATMENT +muerte I-TREATMENT +de I-TREATMENT +sus I-TREATMENT +abuelos I-TREATMENT +y I-TREATMENT +su I-TREATMENT +hija, I-TREATMENT +el I-TREATMENT +divorcio I-TREATMENT +y I-TREATMENT +el I-TREATMENT +aislamiento I-TREATMENT +social I-TREATMENT +favorecieron I-TREATMENT +ambos I-TREATMENT +sentimientos. I-TREATMENT +Se I-TREATMENT +trabajó I-TREATMENT +la I-TREATMENT +resolución I-TREATMENT +del I-TREATMENT +duelo, I-TREATMENT +facilitando I-TREATMENT +la I-TREATMENT +identificación I-TREATMENT y I-TREATMENT +expresión I-TREATMENT +de I-TREATMENT +la I-TREATMENT +rabia I-TREATMENT +por I-TREATMENT +la I-TREATMENT +muerte I-TREATMENT +de I-TREATMENT +sus I-TREATMENT +seres I-TREATMENT más I-TREATMENT -profundamente I-TREATMENT -al I-TREATMENT -parénquima I-TREATMENT -cerebral I-TREATMENT +queridos I-TREATMENT +y I-TREATMENT +señalando I-TREATMENT +la I-TREATMENT +permanencia I-TREATMENT +de I-TREATMENT +las I-TREATMENT +relaciones I-TREATMENT de I-TREATMENT +objeto I-TREATMENT +en I-TREATMENT +el I-TREATMENT +interior. I-TREATMENT +Además, I-TREATMENT +se I-TREATMENT +destacó I-TREATMENT la I-TREATMENT -región I-TREATMENT -frontal, I-TREATMENT -temporal I-TREATMENT +importancia I-TREATMENT +de I-TREATMENT +la I-TREATMENT +ayuda I-TREATMENT +recibida I-TREATMENT +desde I-TREATMENT +el I-TREATMENT +exterior, I-TREATMENT +de I-TREATMENT +la I-TREATMENT +institución I-TREATMENT +sanitaria. I-TREATMENT +Tomó I-TREATMENT +en I-TREATMENT +aquel I-TREATMENT +momento I-TREATMENT +conciencia I-TREATMENT +del I-TREATMENT +miedo I-TREATMENT +a I-TREATMENT +enfrentar I-TREATMENT +su I-TREATMENT +situación, I-TREATMENT +a I-TREATMENT +vivir I-TREATMENT +en I-TREATMENT +soledad I-TREATMENT y I-TREATMENT -parietal. I-TREATMENT +se I-TREATMENT +le I-TREATMENT +propuso I-TREATMENT +entonces I-TREATMENT +reiniciar I-TREATMENT +el I-TREATMENT +contacto I-TREATMENT +telefónico I-TREATMENT +con I-TREATMENT +amigos I-TREATMENT +y I-TREATMENT +compañeros. I-TREATMENT + I-TREATMENT + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +40 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +litiasis I-PRESENT_ILLNESS +piélica I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +riñón I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +diámetro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +cm. I-PRESENT_ILLNESS +Se B-TREATMENT +le I-TREATMENT +propone I-TREATMENT +la I-TREATMENT +realización I-TREATMENT +de I-TREATMENT +una I-TREATMENT +NLPC. I-TREATMENT +Bajo I-TREATMENT +anestesia I-TREATMENT +general I-TREATMENT +y I-TREATMENT +en I-TREATMENT +posición I-TREATMENT +de I-TREATMENT +decúbito I-TREATMENT +prono I-TREATMENT +se I-TREATMENT +accede I-TREATMENT +al I-TREATMENT +riñón I-TREATMENT +por I-TREATMENT +grupo I-TREATMENT +calicial I-TREATMENT +inferior, I-TREATMENT +bajo I-TREATMENT +control I-TREATMENT +de I-TREATMENT +escopia. I-TREATMENT Se I-TREATMENT -realizó I-TREATMENT -resección I-TREATMENT -parcial, I-TREATMENT -dejando I-TREATMENT -material I-TREATMENT -anormal I-TREATMENT -adherido I-TREATMENT +dilata I-TREATMENT +el I-TREATMENT +trayecto I-TREATMENT +de I-TREATMENT +acceso I-TREATMENT +percutáneo I-TREATMENT +con I-TREATMENT +dilatadores I-TREATMENT +metálicos I-TREATMENT +coaxiales I-TREATMENT +de I-TREATMENT +Alken. I-TREATMENT +Se I-TREATMENT +procede I-TREATMENT a I-TREATMENT la I-TREATMENT -superficie I-TREATMENT -cerebral. I-TREATMENT - I-TREATMENT -El B-EVOLUTION +fragmentación I-TREATMENT +de I-TREATMENT +la I-TREATMENT +litiasis I-TREATMENT +con I-TREATMENT +el I-TREATMENT +litotriptor I-TREATMENT +intracorpóreo I-TREATMENT +StoneBreakerTM I-TREATMENT +(LMA I-TREATMENT +Urology, I-TREATMENT +Gland, I-TREATMENT +Switzerland). I-TREATMENT +El I-TREATMENT +tiempo I-TREATMENT +de I-TREATMENT +fragmentación I-TREATMENT +de I-TREATMENT +la I-TREATMENT +litiasis I-TREATMENT +fue I-TREATMENT +de I-TREATMENT +30 I-TREATMENT +minutos I-TREATMENT +utilizando I-TREATMENT +tres I-TREATMENT +cartuchos I-TREATMENT +de I-TREATMENT +dióxido I-TREATMENT +de I-TREATMENT +carbono I-TREATMENT +comprimido. I-TREATMENT +No B-EVOLUTION +existieron I-EVOLUTION +complicaciones I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION paciente I-EVOLUTION -presentó I-EVOLUTION -mejoría I-EVOLUTION -del I-EVOLUTION -estado I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION de I-EVOLUTION -conciencia, I-EVOLUTION -alcanzando I-EVOLUTION +alta I-EVOLUTION a I-EVOLUTION -estar I-EVOLUTION -alerta, I-EVOLUTION -con I-EVOLUTION -notable I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -fuerza I-EVOLUTION -muscular I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -lado I-EVOLUTION -derecho, I-EVOLUTION -aunque I-EVOLUTION -con I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -disfasia I-EVOLUTION -sensitiva. I-EVOLUTION - I-EVOLUTION -Ante B-EXPLORATION -la I-EXPLORATION -impresión I-EXPLORATION -clínica I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -metástasis I-EXPLORATION -meníngea I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tumor I-EXPLORATION -primario I-EXPLORATION -desconocido I-EXPLORATION -fueron I-EXPLORATION -solicitadas I-EXPLORATION -tomografía I-EXPLORATION -con I-EXPLORATION -contraste I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -abdomen I-EXPLORATION -y I-EXPLORATION -pelvis, I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -cuales I-EXPLORATION -solo I-EXPLORATION -se I-EXPLORATION -documento I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -tamaño I-EXPLORATION -de I-EXPLORATION +las I-EVOLUTION +72 I-EVOLUTION +horas I-EVOLUTION +del I-EVOLUTION +procedimiento I-EVOLUTION +con B-TREATMENT +un I-TREATMENT +catéter I-TREATMENT +doble I-TREATMENT +J I-TREATMENT +por I-TREATMENT +la I-TREATMENT +existencia I-TREATMENT +de I-TREATMENT +restos I-TREATMENT +litiásicos I-TREATMENT +menores I-TREATMENT +de I-TREATMENT +3 I-TREATMENT +mm. I-TREATMENT + I-TREATMENT + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +56 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-DERIVED_FROM/TO +acude I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +consultas I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Cirugía I-DERIVED_FROM/TO +Oral I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +Maxilofacial I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +Hospital I-DERIVED_FROM/TO +Infanta I-DERIVED_FROM/TO +Cristina I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Badajoz, I-DERIVED_FROM/TO +derivada I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +Médico I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Familia. I-DERIVED_FROM/TO +La B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +sensación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tensión I-PRESENT_ILLNESS +hemifacial I-PRESENT_ILLNESS +derecha I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +palpación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dicha I-PRESENT_ILLNESS +región. I-PRESENT_ILLNESS +Refiere I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolorinflamación I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +cedieron I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +antibióticos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +antiinflamatorios. I-PRESENT_ILLNESS +Describe I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +así I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +discreta I-PRESENT_ILLNESS +asimetría I-PRESENT_ILLNESS +facial I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ha I-PRESENT_ILLNESS +ido I-PRESENT_ILLNESS +evolucionando I-PRESENT_ILLNESS +progresivamente I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +hacerse I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +patente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +últimos I-PRESENT_ILLNESS +meses. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION -próstata. I-EXPLORATION -Al I-EXPLORATION -tacto I-EXPLORATION -rectal I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION se I-EXPLORATION -encontró I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -prostático I-EXPLORATION -pétreo I-EXPLORATION +aprecia I-EXPLORATION +abombamiento I-EXPLORATION de I-EXPLORATION -bordes I-EXPLORATION -indefinidos I-EXPLORATION +vestíbulo I-EXPLORATION +superior I-EXPLORATION +derecho, I-EXPLORATION +doloroso I-EXPLORATION a I-EXPLORATION la I-EXPLORATION palpación. I-EXPLORATION -El I-EXPLORATION -antígeno I-EXPLORATION -prostático I-EXPLORATION -específico I-EXPLORATION -sérico I-EXPLORATION -obtenido I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -588 I-EXPLORATION -ng/dL, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -próstata I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -demostró I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +una I-EXPLORATION +ortopantomografía I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +una I-EXPLORATION +TAC I-EXPLORATION +facial I-EXPLORATION +apreciándose I-EXPLORATION +en I-EXPLORATION +ambas I-EXPLORATION un I-EXPLORATION -adenocarcinoma I-EXPLORATION -pobremente I-EXPLORATION -diferenciado. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -intracraneal I-EXPLORATION -también I-EXPLORATION -correspondió I-EXPLORATION +tercer I-EXPLORATION +molar I-EXPLORATION +(18) I-EXPLORATION +incluido I-EXPLORATION a I-EXPLORATION -un I-EXPLORATION -adenocarcinoma I-EXPLORATION -metastásico I-EXPLORATION -pobremente I-EXPLORATION -diferenciado. I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +techo I-EXPLORATION +del I-EXPLORATION +seno I-EXPLORATION +maxilar I-EXPLORATION +derecho I-EXPLORATION +- I-EXPLORATION +región I-EXPLORATION +infraorbitaria I-EXPLORATION +derecha. I-EXPLORATION I-EXPLORATION -Por B-TREATMENT -deseo I-TREATMENT +Dada B-TREATMENT +la I-TREATMENT +sintomatología I-TREATMENT +clínica I-TREATMENT de I-TREATMENT -sus I-TREATMENT -familiares, I-TREATMENT -el I-TREATMENT +la I-TREATMENT paciente I-TREATMENT -no I-TREATMENT -fue I-TREATMENT -sometido I-TREATMENT -a I-TREATMENT -ningún I-TREATMENT +se I-TREATMENT +optó I-TREATMENT +por I-TREATMENT +realizar I-TREATMENT tratamiento I-TREATMENT -oncológico I-TREATMENT -complementario I-TREATMENT -y B-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con B-TREATMENT -cuidados I-TREATMENT -ambulatorios I-TREATMENT -paliativos. I-TREATMENT - I-TREATMENT +quirúrgico I-TREATMENT +mediante I-TREATMENT +abordaje I-TREATMENT +de I-TREATMENT +Caldwell- I-TREATMENT +Luc.13-21 I-TREATMENT +Bajo I-TREATMENT +anestesia I-TREATMENT +general I-TREATMENT +e I-TREATMENT +intubación I-TREATMENT +oro-traqueal I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +incisión I-TREATMENT +de I-TREATMENT +Neumann I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +de I-TREATMENT +vestíbulo I-TREATMENT +superior I-TREATMENT +derecho. I-TREATMENT +Tras I-TREATMENT +elevación I-TREATMENT +de I-TREATMENT +colgajo I-TREATMENT +mucoperióstico I-TREATMENT +se I-TREATMENT +visualizó I-TREATMENT +la I-TREATMENT +cápsula I-TREATMENT +quística I-TREATMENT +y I-TREATMENT +la I-TREATMENT +cortical I-TREATMENT +maxilar I-TREATMENT +de I-TREATMENT +aspecto I-TREATMENT +papiráceo I-TREATMENT +con I-TREATMENT +adherencias I-TREATMENT +y I-TREATMENT +fibrosis. I-TREATMENT +Posteriormente I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +la I-TREATMENT +exéresis I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cavidad I-TREATMENT +quística I-TREATMENT +y I-TREATMENT +exodoncia I-TREATMENT +del I-TREATMENT +cordal I-TREATMENT +mediante I-TREATMENT +el I-TREATMENT +uso I-TREATMENT +de I-TREATMENT +fórceps. I-TREATMENT +Finalmente I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +legrado I-TREATMENT +intenso I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cavidad I-TREATMENT +y I-TREATMENT +sutura I-TREATMENT +del I-TREATMENT +colgajo I-TREATMENT +mediante I-TREATMENT +material I-TREATMENT +reabsorbible. I-TREATMENT + B-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION +fue I-EXPLORATION +informado I-EXPLORATION +como I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +quiste I-EXPLORATION +radicular. I-EXPLORATION + I-EXPLORATION -Varón B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -75 I-PRESENT_ILLNESS +72 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY +con B-PAST_MEDICAL_HISTORY +diabetes I-PAST_MEDICAL_HISTORY +mellitus I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +únicos I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS +acude B-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS un I-PRESENT_ILLNESS cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS +ictericia I-PRESENT_ILLNESS +mucocutánea I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -curso I-PRESENT_ILLNESS -lentamente I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -describe I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -«pinchazos» I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -puntas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -dedos, I-PRESENT_ILLNESS +coluria, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +epigástrico I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -«acorchamiento», I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -inicialmente I-PRESENT_ILLNESS -notaba I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -ambas I-PRESENT_ILLNESS -manos I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tacto, I-PRESENT_ILLNESS -pero I-PRESENT_ILLNESS -que, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -mes, I-PRESENT_ILLNESS -también I-PRESENT_ILLNESS -afecta I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -pies. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION +características I-PRESENT_ILLNESS +cólicas, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +La B-EXPLORATION exploración I-EXPLORATION -neurológica, I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -hipoestesia I-EXPLORATION -táctil I-EXPLORATION -con I-EXPLORATION -distribución I-EXPLORATION -en I-EXPLORATION -«guante» I-EXPLORATION -y I-EXPLORATION -«calcetín», I-EXPLORATION -apalestesia I-EXPLORATION -maleolar I-EXPLORATION -e I-EXPLORATION -hipopalestesia I-EXPLORATION +física I-EXPLORATION +mostraba I-EXPLORATION +dolor I-EXPLORATION en I-EXPLORATION -crestas I-EXPLORATION -tibiales I-EXPLORATION -y I-EXPLORATION -codos. I-EXPLORATION -Los I-EXPLORATION -reflejos I-EXPLORATION -estaban I-EXPLORATION -presentes I-EXPLORATION -y I-EXPLORATION -eran I-EXPLORATION -simétricos. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -neurológica I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -presencia I-EXPLORATION +hipocondrio I-EXPLORATION +derecho I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -parestesias, I-EXPLORATION -con I-EXPLORATION +peritonismo. I-EXPLORATION +En I-EXPLORATION una I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -sensibilidad I-EXPLORATION -vibratoria I-EXPLORATION +analítica I-EXPLORATION +sanguínea I-EXPLORATION +destacaba I-EXPLORATION +bilirrubina I-EXPLORATION +5, I-EXPLORATION +6 I-EXPLORATION +mg/dl, I-EXPLORATION +GOT I-EXPLORATION +608 I-EXPLORATION +UI/l I-EXPLORATION y I-EXPLORATION -preservación I-EXPLORATION -de I-EXPLORATION -reflejos I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -exploración I-EXPLORATION -neurológica, I-EXPLORATION -obliga I-EXPLORATION -a I-EXPLORATION -considerar I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -sufra I-EXPLORATION +GPT I-EXPLORATION +720 I-EXPLORATION +UI/l. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -lesión I-EXPLORATION -medular I-EXPLORATION -cervical I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +que I-EXPLORATION +evidenció I-EXPLORATION +coledocolitiasis I-EXPLORATION con I-EXPLORATION -afectación I-EXPLORATION +dilatación I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -cordones I-EXPLORATION -posteriores. I-EXPLORATION +colédoco I-EXPLORATION +(22, I-EXPLORATION +4 I-EXPLORATION +mm) I-EXPLORATION +y I-EXPLORATION +colelitiasis. I-EXPLORATION Se I-EXPLORATION -solicitó I-EXPLORATION -analítica I-EXPLORATION -(incluyendo I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -vitamina I-EXPLORATION -B12), I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -RM I-EXPLORATION -cervical I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -neurofisiológico. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -RM I-EXPLORATION -cervical I-EXPLORATION -(Magnetom-Trio, I-EXPLORATION -Siemens, I-EXPLORATION -Erlangen, I-EXPLORATION -Germany) I-EXPLORATION +CPRE, I-EXPLORATION +confirmándose I-EXPLORATION +la I-EXPLORATION +coledocolitiasis; I-EXPLORATION +se B-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +realizar I-TREATMENT +esfinterotomía I-TREATMENT +endoscópica I-TREATMENT +y I-TREATMENT +extracción I-TREATMENT +del I-TREATMENT +cálculo I-TREATMENT +en I-TREATMENT +colédoco. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +las I-EVOLUTION +2 I-EVOLUTION +horas I-EVOLUTION +de I-EVOLUTION +finalizar I-EVOLUTION +la I-EVOLUTION +prueba, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +comienza I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +dolor I-EVOLUTION +súbito I-EVOLUTION +en I-EVOLUTION +hipocondrio I-EVOLUTION +derecho. I-EVOLUTION +La B-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION mostró I-EXPLORATION +un I-EXPLORATION +dolor I-EXPLORATION en I-EXPLORATION -secuencias I-EXPLORATION -potenciadas I-EXPLORATION -en I-EXPLORATION -T2 I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -plano I-EXPLORATION -sagital I-EXPLORATION -una I-EXPLORATION -hiperintensidad I-EXPLORATION +hipocondrio I-EXPLORATION +derecho I-EXPLORATION +con I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -señal I-EXPLORATION -sin I-EXPLORATION -efecto I-EXPLORATION +irritación I-EXPLORATION +peritoneal, I-EXPLORATION +taquicardia, I-EXPLORATION +taquipnea I-EXPLORATION +e I-EXPLORATION +hipotensión I-EXPLORATION +arterial I-EXPLORATION de I-EXPLORATION -masa I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -cordonal I-EXPLORATION -posterior I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extendía I-EXPLORATION -desde I-EXPLORATION -C1-C2 I-EXPLORATION -a I-EXPLORATION -C6-C7. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -cortes I-EXPLORATION -axiales I-EXPLORATION -y I-EXPLORATION -coronales I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -afectación I-EXPLORATION -era I-EXPLORATION -bilateral I-EXPLORATION +95/60. I-EXPLORATION +Analíticamente I-EXPLORATION +destacaba I-EXPLORATION +bilirrubina I-EXPLORATION +3, I-EXPLORATION +4 I-EXPLORATION +mg/dl, I-EXPLORATION +GOT I-EXPLORATION +315, I-EXPLORATION +amilasa I-EXPLORATION +64 I-EXPLORATION +U/l, I-EXPLORATION +GPT I-EXPLORATION +450, I-EXPLORATION +leucocitos I-EXPLORATION +15.400/mm3, I-EXPLORATION +hemoglobina I-EXPLORATION +5, I-EXPLORATION +5 I-EXPLORATION +g/dl I-EXPLORATION y I-EXPLORATION -simétrica. I-EXPLORATION -Estos I-EXPLORATION -hallazgos I-EXPLORATION -son I-EXPLORATION -característicos I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -DCS. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -signos I-EXPLORATION +creatinina I-EXPLORATION de I-EXPLORATION -polineuropatía I-EXPLORATION +2, I-EXPLORATION +4 I-EXPLORATION +mg/dl. I-EXPLORATION +Se B-TREATMENT +administró I-TREATMENT +fluidoterapia I-TREATMENT +con I-TREATMENT +parcial I-TREATMENT +respuesta I-TREATMENT +hemodinámica. I-TREATMENT +Se B-EXPLORATION +realizó I-EXPLORATION +TC I-EXPLORATION +abdominal I-EXPLORATION +evidenciándose I-EXPLORATION +líquido I-EXPLORATION +libre I-EXPLORATION +intraperitoneal I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -velocidades I-EXPLORATION -de I-EXPLORATION -conducción, I-EXPLORATION -mientras I-EXPLORATION -que I-EXPLORATION -los I-EXPLORATION -potenciales I-EXPLORATION -evocados I-EXPLORATION -somatosensoriales I-EXPLORATION -estaban I-EXPLORATION -desestructurados I-EXPLORATION +ambas I-EXPLORATION +gotieras I-EXPLORATION y I-EXPLORATION -con I-EXPLORATION -aumento I-EXPLORATION +fondo I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -latencias I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -cuatro I-EXPLORATION -miembros, I-EXPLORATION -indicando I-EXPLORATION -una I-EXPLORATION -afectación I-EXPLORATION -cordonal I-EXPLORATION -posterior. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION -mostró I-EXPLORATION +saco I-EXPLORATION +de I-EXPLORATION +Douglas, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION una I-EXPLORATION -discreta I-EXPLORATION -anemia I-EXPLORATION -megaloblástica, I-EXPLORATION -con I-EXPLORATION -4, I-EXPLORATION -44 I-EXPLORATION -10E12/L I-EXPLORATION +lesión I-EXPLORATION +hipodensa I-EXPLORATION de I-EXPLORATION -hematíes I-EXPLORATION -(4, I-EXPLORATION -7-5, I-EXPLORATION -1 I-EXPLORATION -10E12/L), I-EXPLORATION -VCM: I-EXPLORATION -108 I-EXPLORATION -fL I-EXPLORATION -(80-95 I-EXPLORATION -fL) I-EXPLORATION +bordes I-EXPLORATION +mal I-EXPLORATION +definidos I-EXPLORATION +en I-EXPLORATION +lóbulo I-EXPLORATION +hepático I-EXPLORATION +derecho I-EXPLORATION y I-EXPLORATION -HCM: I-EXPLORATION -34, I-EXPLORATION -9 I-EXPLORATION -pg I-EXPLORATION -(27-31 I-EXPLORATION -pg), I-EXPLORATION -siendo I-EXPLORATION +aerobilia I-EXPLORATION +en I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +extrahepática, I-EXPLORATION +sin I-EXPLORATION +neumoperitoneo. I-EXPLORATION + I-EXPLORATION +Ante B-TREATMENT +estos I-TREATMENT +hallazgos I-TREATMENT +y I-TREATMENT +la I-TREATMENT +persistencia I-TREATMENT +de I-TREATMENT +la I-TREATMENT +inestabilidad I-TREATMENT +hemodinámica I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +intervenir I-TREATMENT +quirúrgicamente I-TREATMENT +a I-TREATMENT +la I-TREATMENT +paciente. I-TREATMENT +En B-EXPLORATION la I-EXPLORATION -hemoglobina I-EXPLORATION -(15, I-EXPLORATION -5 I-EXPLORATION -g/dl) I-EXPLORATION +cirugía I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +hemoperitoneo I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -hematocrito I-EXPLORATION -(47,9%) I-EXPLORATION -normales. I-EXPLORATION -Los I-EXPLORATION -niveles I-EXPLORATION +un I-EXPLORATION +hematoma I-EXPLORATION +subcapsular I-EXPLORATION +hepático I-EXPLORATION de I-EXPLORATION -vitamina I-EXPLORATION -B12 I-EXPLORATION +8 I-EXPLORATION +cm I-EXPLORATION +parcialmente I-EXPLORATION +roto I-EXPLORATION +localizado I-EXPLORATION en I-EXPLORATION -suero I-EXPLORATION -fueron I-EXPLORATION +segmentos I-EXPLORATION +V-VI I-EXPLORATION +hepáticos. I-EXPLORATION +Se B-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +evacuación I-TREATMENT +del I-TREATMENT +mismo I-TREATMENT +y I-TREATMENT +hemostasia I-TREATMENT +local I-TREATMENT +con I-TREATMENT +electrocoagulación I-TREATMENT +y I-TREATMENT +Surgicel®, I-TREATMENT +dejando I-TREATMENT +un I-TREATMENT +drenaje I-TREATMENT +tipo I-TREATMENT +Jackson-Pratt I-TREATMENT +en I-TREATMENT +espacio I-TREATMENT +subfrénico I-TREATMENT +derecho. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +estuvo I-EVOLUTION +ingresada I-EVOLUTION +en I-EVOLUTION +UCI I-EVOLUTION +durante I-EVOLUTION +48 I-EVOLUTION +horas. I-EVOLUTION +La I-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +presentó I-EVOLUTION +nuevos I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION +sangrado I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +TC I-EVOLUTION +de I-EVOLUTION +control I-EVOLUTION +no I-EVOLUTION +se I-EVOLUTION +objetivó I-EVOLUTION +ninguna I-EVOLUTION +colección, I-EVOLUTION +siendo I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +4 I-EVOLUTION +semanas I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +intervención. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS +internada I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +vida I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +ictericia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +siete I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +según I-PRESENT_ILLNESS +referencia I-PRESENT_ILLNESS +materna I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +tumoración I-PRESENT_ILLNESS +frontoparietal I-PRESENT_ILLNESS +izquierda I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +empeoró I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +h I-PRESENT_ILLNESS +previas I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +ingreso. I-PRESENT_ILLNESS +Antecedentes: B-PAST_MEDICAL_HISTORY +recién I-PAST_MEDICAL_HISTORY +nacida I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +término, I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +peso I-PAST_MEDICAL_HISTORY +adecuado I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +edad I-PAST_MEDICAL_HISTORY +gestacional. I-PAST_MEDICAL_HISTORY +Tuvo I-PAST_MEDICAL_HISTORY +buena I-PAST_MEDICAL_HISTORY +progresión I-PAST_MEDICAL_HISTORY +ponderal I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +ictericia I-PAST_MEDICAL_HISTORY +clínica. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +madre I-PAST_MEDICAL_HISTORY +refirió I-PAST_MEDICAL_HISTORY +ictericia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +siete I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vida. I-PAST_MEDICAL_HISTORY +Evolución: B-EVOLUTION +al I-EVOLUTION +ingreso I-EVOLUTION +presentaba I-EVOLUTION +sopor, I-EVOLUTION +ictericia I-EVOLUTION +generalizada, I-EVOLUTION +hepatomegalia I-EVOLUTION +y I-EVOLUTION +tumoración I-EVOLUTION +frontoparietal I-EVOLUTION +izquierda. I-EVOLUTION +Laboratorio B-EXPLORATION de I-EXPLORATION -78 I-EXPLORATION -pg/mL I-EXPLORATION -(210-930 I-EXPLORATION -pg/mL) I-EXPLORATION +ingreso: I-EXPLORATION +GOT I-EXPLORATION +262 I-EXPLORATION +UI/L, I-EXPLORATION +GPT I-EXPLORATION +143 I-EXPLORATION +UI/L, I-EXPLORATION +FAL I-EXPLORATION +2289 I-EXPLORATION +UI/L, I-EXPLORATION +bilirrubinemia I-EXPLORATION +total I-EXPLORATION +12, I-EXPLORATION +3 I-EXPLORATION +mg/dl I-EXPLORATION y I-EXPLORATION -los I-EXPLORATION -de I-EXPLORATION -ácido I-EXPLORATION -fólico I-EXPLORATION +directa I-EXPLORATION +8, I-EXPLORATION +6 I-EXPLORATION +mg/ I-EXPLORATION +dl, I-EXPLORATION +coagulograma I-EXPLORATION +informado I-EXPLORATION +como I-EXPLORATION +"no I-EXPLORATION +coagula". I-EXPLORATION +TC: I-EXPLORATION +hemorragia I-EXPLORATION de I-EXPLORATION -26, I-EXPLORATION +ventrículos I-EXPLORATION +laterales I-EXPLORATION +e I-EXPLORATION +intraparenquimatosa I-EXPLORATION +temporal I-EXPLORATION +derecha. I-EXPLORATION +Fue B-DERIVED_FROM/TO +evaluada I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +Neurocirugía I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +indicación I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +conducta I-DERIVED_FROM/TO +expectante. I-DERIVED_FROM/TO +Recibió B-EXPLORATION +vitamina I-EXPLORATION +K I-EXPLORATION 5 I-EXPLORATION -ng/mL I-EXPLORATION -(2, I-EXPLORATION -2-16, I-EXPLORATION -9 I-EXPLORATION -ng/mL), I-EXPLORATION -siendo I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -determinaciones I-EXPLORATION -bioquímicas I-EXPLORATION -en I-EXPLORATION -sangre I-EXPLORATION -normales. I-EXPLORATION -Los I-EXPLORATION -anticuerpos I-EXPLORATION -frente I-EXPLORATION -a I-EXPLORATION -células I-EXPLORATION -parietales I-EXPLORATION -gástricas I-EXPLORATION -fueron I-EXPLORATION -positivos I-EXPLORATION -(1/40), I-EXPLORATION -así I-EXPLORATION +mg I-EXPLORATION +diarios I-EXPLORATION +por I-EXPLORATION +48 I-EXPLORATION +h I-EXPLORATION como I-EXPLORATION -los I-EXPLORATION -anticuerpos I-EXPLORATION -anti-FI I-EXPLORATION -(factor I-EXPLORATION -intrínseco) I-EXPLORATION -(>97, I-EXPLORATION -9; I-EXPLORATION +único I-EXPLORATION +tratamiento I-EXPLORATION +corrector I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +coagulopatía I-EXPLORATION +con I-EXPLORATION +laboratorio I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION normal: I-EXPLORATION -0-25). I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -gástrica I-EXPLORATION +tiempo I-EXPLORATION +de I-EXPLORATION +protrombina I-EXPLORATION +100%, I-EXPLORATION +KPTT I-EXPLORATION +45 I-EXPLORATION +segundos, I-EXPLORATION +fibrinógeno I-EXPLORATION +274 I-EXPLORATION +mg/dl. I-EXPLORATION +El I-EXPLORATION +centellograma I-EXPLORATION +con I-EXPLORATION +HIDA I-EXPLORATION +no I-EXPLORATION mostró I-EXPLORATION -signos I-EXPLORATION +captación I-EXPLORATION +hepática I-EXPLORATION +del I-EXPLORATION +contraste, I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +visualizó I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +intrahepática I-EXPLORATION +ni I-EXPLORATION +extrahepática, I-EXPLORATION +ni I-EXPLORATION +pasaje I-EXPLORATION +al I-EXPLORATION +intestino I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +24 I-EXPLORATION +h. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +portoentero-anastomosis, I-TREATMENT +después I-TREATMENT +de I-TREATMENT +confirmar I-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +atresia I-TREATMENT +de I-TREATMENT +vías I-TREATMENT +biliares I-TREATMENT +durante I-TREATMENT +la I-TREATMENT +cirugía. I-TREATMENT +En B-EVOLUTION +el I-EVOLUTION +seguimiento I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +vida I-EVOLUTION +presentaba I-EVOLUTION +valoración I-EVOLUTION +clínico-neurológica I-EVOLUTION +normal I-EVOLUTION +y I-EVOLUTION +recibió I-EVOLUTION +trasplante I-EVOLUTION +de I-EVOLUTION +hígado I-EVOLUTION +al I-EVOLUTION +año I-EVOLUTION +de I-EVOLUTION +edad. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +tórax I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +0, I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +× I-PRESENT_ILLNESS +0, I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +cm, I-PRESENT_ILLNESS +eritematosas, I-PRESENT_ILLNESS +ligeramente I-PRESENT_ILLNESS +descamativas, I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +pruriginosas. I-PRESENT_ILLNESS +En B-EXPLORATION +el I-EXPLORATION +brazo I-EXPLORATION +presenta I-EXPLORATION +otra I-EXPLORATION +lesión I-EXPLORATION de I-EXPLORATION -gastritis I-EXPLORATION -crónica I-EXPLORATION +características I-EXPLORATION +similares, I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -atrófico, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT +mayor I-EXPLORATION +tamaño, I-EXPLORATION +también I-EXPLORATION +asintomática. I-EXPLORATION +Ante B-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT de I-TREATMENT -DSC I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -tratado I-TREATMENT -con I-TREATMENT -cianocobalamina I-TREATMENT -(1.000 I-TREATMENT -µ/día I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -intramuscular, I-TREATMENT -durante I-TREATMENT -dos I-TREATMENT -semanas I-TREATMENT +pitiriasis I-TREATMENT +rosada, I-TREATMENT +no I-TREATMENT +se I-TREATMENT +pauta I-TREATMENT +tratamiento I-TREATMENT y I-TREATMENT -después I-TREATMENT -mensualmente). I-TREATMENT -En B-EVOLUTION -los I-EVOLUTION -meses I-EVOLUTION -siguientes I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -progresiva I-EVOLUTION -mejoría I-EVOLUTION +se I-TREATMENT +espera I-TREATMENT +para I-TREATMENT +ver I-TREATMENT +la I-TREATMENT +evolución I-TREATMENT +del I-TREATMENT +cuadro. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +la I-EVOLUTION +semana I-EVOLUTION +acude I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -alteraciones I-EVOLUTION -sensitivas. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -10 I-EVOLUTION -meses I-EVOLUTION +nuevo I-EVOLUTION +a I-EVOLUTION +consulta, I-EVOLUTION +presentando I-EVOLUTION +un I-EVOLUTION +aumento I-EVOLUTION +del I-EVOLUTION +número I-EVOLUTION de I-EVOLUTION -evolución, I-EVOLUTION +lesiones, I-EVOLUTION +distribuidas I-EVOLUTION +por I-EVOLUTION el I-EVOLUTION -paciente I-EVOLUTION -refería I-EVOLUTION -una I-EVOLUTION -leve I-EVOLUTION -e I-EVOLUTION -inconstante I-EVOLUTION -sensación I-EVOLUTION -de I-EVOLUTION -«hormigueos» I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -pies I-EVOLUTION -y B-EXPLORATION +tronco, I-EVOLUTION +el I-EVOLUTION +abdomen, I-EVOLUTION +el I-EVOLUTION +dorso I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +región I-EVOLUTION +cervical, I-EVOLUTION +y I-EVOLUTION +respetando I-EVOLUTION +la I-EVOLUTION +cara, I-EVOLUTION +el I-EVOLUTION +cuero I-EVOLUTION +cabelludo I-EVOLUTION +y I-EVOLUTION +las I-EVOLUTION +extremidades I-EVOLUTION +inferiores. I-EVOLUTION +Al B-EXPLORATION +igual I-EXPLORATION +que I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -neurológica I-EXPLORATION -solo I-EXPLORATION -mostraba I-EXPLORATION -una I-EXPLORATION -discreta I-EXPLORATION -hipopalestesia I-EXPLORATION -maleolar. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION +semana I-EXPLORATION +anterior, I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +son I-EXPLORATION +asintomáticas. I-EXPLORATION + I-EXPLORATION +Dado I-EXPLORATION +la I-EXPLORATION +cantidad I-EXPLORATION de I-EXPLORATION -control I-EXPLORATION -mostró I-EXPLORATION +lesiones, I-EXPLORATION +se I-EXPLORATION +decide I-EXPLORATION +consultar I-EXPLORATION +vía I-EXPLORATION +telemática I-EXPLORATION +a I-EXPLORATION +Dermatología, I-EXPLORATION +quienes I-EXPLORATION +emiten I-EXPLORATION +como I-EXPLORATION +diagnóstico I-EXPLORATION +más I-EXPLORATION +probable I-EXPLORATION una I-EXPLORATION -resolución I-EXPLORATION -de I-EXPLORATION +pitiriasis I-EXPLORATION +rosada, I-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -anemia I-EXPLORATION -megaloblásica I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION -de I-EXPLORATION -vitamina I-EXPLORATION -B12 I-EXPLORATION -(438 I-EXPLORATION -pg/mL). I-EXPLORATION -Una I-EXPLORATION -RM I-EXPLORATION -medular I-EXPLORATION -de I-EXPLORATION -control, I-EXPLORATION -utilizando I-EXPLORATION -el I-EXPLORATION -mismo I-EXPLORATION -equipo, I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION +probable I-EXPLORATION +lesión I-EXPLORATION +heraldo I-EXPLORATION +del I-EXPLORATION +brazo, I-EXPLORATION la I-EXPLORATION -completa I-EXPLORATION -desaparición I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION +descamación I-EXPLORATION +periférica I-EXPLORATION +en I-EXPLORATION +algunas I-EXPLORATION lesiones I-EXPLORATION y I-EXPLORATION la I-EXPLORATION -normalidad I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -intensidad I-EXPLORATION -de I-EXPLORATION -señal I-EXPLORATION -del I-EXPLORATION -cordón I-EXPLORATION -medular. I-EXPLORATION +distribución. I-EXPLORATION I-EXPLORATION +Aconsejan B-TREATMENT +no I-TREATMENT +tratar I-TREATMENT +y I-TREATMENT +nos I-TREATMENT +recuerdan I-TREATMENT +que I-TREATMENT +el I-TREATMENT +cuadro I-TREATMENT +puede I-TREATMENT +durar I-TREATMENT +un I-TREATMENT +total I-TREATMENT +de I-TREATMENT +6-8 I-TREATMENT +semanas. I-TREATMENT + I-TREATMENT Presentamos B-PRESENT_ILLNESS el I-PRESENT_ILLNESS @@ -233693,31784 +123648,29753 @@ de I-PRESENT_ILLNESS una I-PRESENT_ILLNESS mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS +75 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS con B-PAST_MEDICAL_HISTORY -múltiples I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -destacan I-PAST_MEDICAL_HISTORY -asma I-PAST_MEDICAL_HISTORY -bronquial, I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -mórbida, I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -apnea I-PAST_MEDICAL_HISTORY -obstructiva I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -sueño, I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -anemia I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hiperparatiroidismo I-PAST_MEDICAL_HISTORY -secundarios, I-PAST_MEDICAL_HISTORY -adenocarcinoma I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -mama I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -QT I-PAST_MEDICAL_HISTORY +varias I-PAST_MEDICAL_HISTORY +cirugías I-PAST_MEDICAL_HISTORY +abdominales I-PAST_MEDICAL_HISTORY +(colecistectomía, I-PAST_MEDICAL_HISTORY +histerectomía I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -RT, I-PAST_MEDICAL_HISTORY -valvulopatía I-PAST_MEDICAL_HISTORY -mitral I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -cardiaca, I-PAST_MEDICAL_HISTORY -fibrilación I-PAST_MEDICAL_HISTORY -auricular, I-PAST_MEDICAL_HISTORY -HTA, I-PAST_MEDICAL_HISTORY -DM I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2, I-PAST_MEDICAL_HISTORY -glaucoma I-PAST_MEDICAL_HISTORY -bilateral, I-PAST_MEDICAL_HISTORY -colelitiasis I-PAST_MEDICAL_HISTORY +eventroplastia) I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -colecistitis I-PAST_MEDICAL_HISTORY -crónica. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Ingresa B-PRESENT_ILLNESS +pólipos I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +colon, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +remitida I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS +cambios I-PRESENT_ILLNESS +recientes I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +hábito I-PRESENT_ILLNESS +intestinal. I-PRESENT_ILLNESS +La B-EXPLORATION +colonoscopia I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +segmento I-EXPLORATION +de I-EXPLORATION +colon I-EXPLORATION +sigmoideo I-EXPLORATION +muy I-EXPLORATION +angulado I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +divertículos I-EXPLORATION +que I-EXPLORATION +impedía I-EXPLORATION +el I-EXPLORATION +paso I-EXPLORATION +del I-EXPLORATION +endoscopio I-EXPLORATION +a I-EXPLORATION +su I-EXPLORATION +través. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +otras I-EXPLORATION +anomalías. I-EXPLORATION +Dada I-EXPLORATION +la I-EXPLORATION +situación, I-EXPLORATION +decidimos I-EXPLORATION +realizar I-EXPLORATION +una I-EXPLORATION +colonoscopia I-EXPLORATION +con I-EXPLORATION +cápsula I-EXPLORATION +para I-EXPLORATION +evaluar I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION +del I-EXPLORATION +colon, I-EXPLORATION +observándose I-EXPLORATION +un I-EXPLORATION +segmento I-EXPLORATION +de I-EXPLORATION +colon I-EXPLORATION +izquierdo I-EXPLORATION +estenótico, I-EXPLORATION +escasamente I-EXPLORATION +distensible I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +divertículos. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +otras I-EXPLORATION +lesiones. I-EXPLORATION +A I-EXPLORATION +pesar I-EXPLORATION +de I-EXPLORATION +todo, I-EXPLORATION +la I-EXPLORATION +colonoscopia I-EXPLORATION +con I-EXPLORATION +cápsula I-EXPLORATION +fue I-EXPLORATION +completa I-EXPLORATION +siendo I-EXPLORATION +esta I-EXPLORATION +excretada I-EXPLORATION +antes I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +finalización I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +baterías I-EXPLORATION +(< I-EXPLORATION +10 I-EXPLORATION +horas). I-EXPLORATION + I-EXPLORATION + +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -hematoquecia I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +infección I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +VIH I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +transmisión I-PRESENT_ILLNESS +vertical, I-PRESENT_ILLNESS +diagnosticada I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS +edad. I-PRESENT_ILLNESS +Tenía B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +mala I-PAST_MEDICAL_HISTORY +adherencia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +varios I-PAST_MEDICAL_HISTORY +regímenes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +propuestos, I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +madre I-PAST_MEDICAL_HISTORY +también I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +rechazado I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +TAR. I-PAST_MEDICAL_HISTORY +Había I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +internado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +varias I-PAST_MEDICAL_HISTORY +ocasiones I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +enfermedades I-PAST_MEDICAL_HISTORY +intercurrentes I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +microorganismos I-PAST_MEDICAL_HISTORY +habituales I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +oportunistas. I-PAST_MEDICAL_HISTORY +Fue B-PRESENT_ILLNESS +internado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +historia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS abdominal, I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -cambios I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ritmo I-PRESENT_ILLNESS -intestinal I-PRESENT_ILLNESS -asociados I-PRESENT_ILLNESS +acompañados I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +38, I-PRESENT_ILLNESS +5° I-PRESENT_ILLNESS +C I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -refiriendo I-PRESENT_ILLNESS un I-PRESENT_ILLNESS -marcado I-PRESENT_ILLNESS -empeoramiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -habitual. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS +exantema I-PRESENT_ILLNESS +máculo-papular I-PRESENT_ILLNESS +generalizado. I-PRESENT_ILLNESS En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destacaba I-EXPLORATION +el I-EXPLORATION +momento I-EXPLORATION +del I-EXPLORATION +ingreso I-EXPLORATION +se I-EXPLORATION +constató I-EXPLORATION +además I-EXPLORATION +del I-EXPLORATION +exantema, I-EXPLORATION una I-EXPLORATION -molestia I-EXPLORATION -difusa I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION +desnutrición I-EXPLORATION +secundaria, I-EXPLORATION +mal I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +adenopatías I-EXPLORATION +cervicales, I-EXPLORATION +estertores I-EXPLORATION +húmedos I-EXPLORATION en I-EXPLORATION -hipocondrio I-EXPLORATION -derecho, I-EXPLORATION +ambos I-EXPLORATION +campos I-EXPLORATION +pulmonares, I-EXPLORATION +caries I-EXPLORATION +dentales I-EXPLORATION y I-EXPLORATION -analíticamente I-EXPLORATION -presentaba I-EXPLORATION -anemia I-EXPLORATION -con I-EXPLORATION -Hb I-EXPLORATION +otorrea I-EXPLORATION +purulenta I-EXPLORATION +a I-EXPLORATION +izquierda. I-EXPLORATION +En I-EXPLORATION +ese I-EXPLORATION +momento I-EXPLORATION +tenía I-EXPLORATION +una I-EXPLORATION +carga I-EXPLORATION +viral I-EXPLORATION +(CV) I-EXPLORATION de I-EXPLORATION -7, I-EXPLORATION -3 I-EXPLORATION -g/dl I-EXPLORATION -(N: I-EXPLORATION -12-16), I-EXPLORATION -fibrinógeno I-EXPLORATION +95.000 I-EXPLORATION +copias/ml I-EXPLORATION +y I-EXPLORATION +linfocitos I-EXPLORATION +CD4 I-EXPLORATION de I-EXPLORATION -727 I-EXPLORATION -mg/dl I-EXPLORATION -(N:150-400), I-EXPLORATION -hiperglucemia I-EXPLORATION -e I-EXPLORATION -insuficiencia I-EXPLORATION -renal I-EXPLORATION -ya I-EXPLORATION -conocida I-EXPLORATION -con I-EXPLORATION -cifra I-EXPLORATION +26 I-EXPLORATION +céls/mm3. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +antibioterapia, I-TREATMENT +sin B-EVOLUTION +embargo, I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +h I-EVOLUTION +persistía I-EVOLUTION +con I-EVOLUTION +fiebre I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +agregó I-EVOLUTION +cefalea I-EVOLUTION +intensa, I-EVOLUTION +vómitos, I-EVOLUTION +fotofobia I-EVOLUTION +y I-EVOLUTION +acusofobia. I-EVOLUTION + I-EVOLUTION +Se B-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +TAC I-EXPLORATION de I-EXPLORATION -urea I-EXPLORATION +cráneo I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +normal; I-EXPLORATION +el I-EXPLORATION +análisis I-EXPLORATION +citoquímico I-EXPLORATION de I-EXPLORATION -148 I-EXPLORATION -mg/dl I-EXPLORATION +LCR: I-EXPLORATION +glucosa I-EXPLORATION +0, I-EXPLORATION +43 I-EXPLORATION +g/l, I-EXPLORATION +proteínas I-EXPLORATION +1, I-EXPLORATION +15 I-EXPLORATION +gr/l, I-EXPLORATION +celularidad: I-EXPLORATION +5 I-EXPLORATION +leucocitos/mm3; I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +microbio-lógico I-EXPLORATION +directo I-EXPLORATION +(tinta I-EXPLORATION +china) I-EXPLORATION y I-EXPLORATION -creatinina I-EXPLORATION +cultivo I-EXPLORATION +fueron I-EXPLORATION +positivos I-EXPLORATION +para I-EXPLORATION +C. I-EXPLORATION +neoformans. I-EXPLORATION +Se B-TREATMENT +trató I-TREATMENT +con I-TREATMENT +anfotericina I-TREATMENT +B I-TREATMENT +deoxicolato I-TREATMENT +i.v. I-TREATMENT +durante I-TREATMENT +21 I-TREATMENT +días I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +fluconazol I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT +en I-TREATMENT +plan I-TREATMENT +de I-TREATMENT +mantención. I-TREATMENT +Hubo B-EVOLUTION +mejoría I-EVOLUTION +clínica I-EVOLUTION +y B-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -2, I-EXPLORATION -1 I-EXPLORATION -mg/dl, I-EXPLORATION -ambas I-EXPLORATION -cifras I-EXPLORATION -similares I-EXPLORATION +LCR I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +21 I-EXPLORATION +días I-EXPLORATION +fue I-EXPLORATION +normal I-EXPLORATION +con I-EXPLORATION +cultivo I-EXPLORATION +negativo. I-EXPLORATION +Fue B-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +33 I-EVOLUTION +días I-EVOLUTION +y I-EVOLUTION +al I-EVOLUTION +mes I-EVOLUTION +de I-EVOLUTION +evolución I-EVOLUTION +ya I-EVOLUTION +evidenciaba I-EVOLUTION +aumento I-EVOLUTION +de I-EVOLUTION +peso I-EVOLUTION +y I-EVOLUTION +buen I-EVOLUTION +estado I-EVOLUTION +general. I-EVOLUTION +El B-EXPLORATION +test I-EXPLORATION +de I-EXPLORATION +genotipificación I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION +mutaciones I-EXPLORATION +asociadas I-EXPLORATION a I-EXPLORATION +resistencia I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +AZT, I-TREATMENT +lamivudina I-TREATMENT +(3TC) I-TREATMENT +y I-TREATMENT +lopinavir/ritonavir. I-TREATMENT + I-TREATMENT + +Niña B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +remitida B-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +dermatólogo I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +diagnóstico I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +IP, I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +descartar I-DERIVED_FROM/TO +patología I-DERIVED_FROM/TO +ocular I-DERIVED_FROM/TO +asociada. I-DERIVED_FROM/TO +En B-EXPLORATION +la I-EXPLORATION +piel I-EXPLORATION +se I-EXPLORATION +observaban I-EXPLORATION +lesiones I-EXPLORATION +típicas I-EXPLORATION +de I-EXPLORATION +esta I-EXPLORATION +enfermedad, I-EXPLORATION las I-EXPLORATION +denominadas I-EXPLORATION +líneas I-EXPLORATION de I-EXPLORATION -analíticas I-EXPLORATION -previas. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -colonoscopia I-EXPLORATION +Blaschko. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +ocular I-EXPLORATION +realizada I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -que I-EXPLORATION +consulta I-EXPLORATION se I-EXPLORATION -apreciaba I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION +constató I-EXPLORATION +buen I-EXPLORATION +comportamiento I-EXPLORATION +visual I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +ojos I-EXPLORATION +(AO), I-EXPLORATION +segmento I-EXPLORATION +anterior I-EXPLORATION +normal, I-EXPLORATION +motilidad I-EXPLORATION +ocular I-EXPLORATION +intrínseca I-EXPLORATION +y I-EXPLORATION +extrínseca I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +exploración I-EXPLORATION de I-EXPLORATION -doble I-EXPLORATION -luz I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -del I-EXPLORATION -ángulo I-EXPLORATION -hepático I-EXPLORATION -del I-EXPLORATION -colon, I-EXPLORATION -presentando I-EXPLORATION -además I-EXPLORATION +fondo I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION -natural I-EXPLORATION -del I-EXPLORATION -colon I-EXPLORATION +ojo I-EXPLORATION +(FO) I-EXPLORATION +con I-EXPLORATION +oftalmoscopio I-EXPLORATION +indirecto I-EXPLORATION +era I-EXPLORATION +normal I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +ojo I-EXPLORATION +derecho I-EXPLORATION +(OD) I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +ojo I-EXPLORATION +izquierdo I-EXPLORATION +(OI) I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION una I-EXPLORATION -segunda I-EXPLORATION -luz I-EXPLORATION -de I-EXPLORATION -menor I-EXPLORATION -calibre, I-EXPLORATION +tenue I-EXPLORATION +hemorragia I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +parte I-EXPLORATION +nasal. I-EXPLORATION +Dada I-EXPLORATION +la I-EXPLORATION +dificultad I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +exploración, I-EXPLORATION por I-EXPLORATION +movimientos I-EXPLORATION +continuos I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -que I-EXPLORATION -salía I-EXPLORATION -un I-EXPLORATION -contenido I-EXPLORATION +paciente, I-EXPLORATION +se I-EXPLORATION +programó I-EXPLORATION +nueva I-EXPLORATION +exploración I-EXPLORATION +del I-EXPLORATION +FO I-EXPLORATION +bajo I-EXPLORATION +narcosis I-EXPLORATION +y I-EXPLORATION +angiografía I-EXPLORATION +fluoresceinica I-EXPLORATION +ante I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -bilioso. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION +lesiones I-EXPLORATION +vasculares I-EXPLORATION +ocultas. I-EXPLORATION +En I-EXPLORATION +dicha I-EXPLORATION +exploración I-EXPLORATION se I-EXPLORATION -solicitó I-EXPLORATION -un I-EXPLORATION -TC I-EXPLORATION -abdominal, I-EXPLORATION +realizó I-EXPLORATION +nueva I-EXPLORATION +exploración I-EXPLORATION +del I-EXPLORATION +FO I-EXPLORATION +con I-EXPLORATION +oftalmoscopio I-EXPLORATION +indirecto I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +Retcam I-EXPLORATION +II I-EXPLORATION +(Massie I-EXPLORATION +Lab.) I-EXPLORATION que I-EXPLORATION -mostraba I-EXPLORATION -aerobilia, I-EXPLORATION +permite I-EXPLORATION +archivar I-EXPLORATION +las I-EXPLORATION +imágenes I-EXPLORATION +en I-EXPLORATION +formato I-EXPLORATION +digital, I-EXPLORATION +para I-EXPLORATION +su I-EXPLORATION +ulterior I-EXPLORATION +análisis I-EXPLORATION +detallado. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +OD I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +hipopigmentada I-EXPLORATION +paramacular I-EXPLORATION y I-EXPLORATION una I-EXPLORATION -vesícula I-EXPLORATION -escleroatrófica I-EXPLORATION +discreta I-EXPLORATION +alteración I-EXPLORATION en I-EXPLORATION -íntimo I-EXPLORATION -contacto I-EXPLORATION -con I-EXPLORATION el I-EXPLORATION -ángulo I-EXPLORATION -hepático I-EXPLORATION -del I-EXPLORATION -colon, I-EXPLORATION -cuya I-EXPLORATION -pared I-EXPLORATION -aparecía I-EXPLORATION -engrosada, I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -alteración I-EXPLORATION +trayecto I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -grasa I-EXPLORATION -subyacente. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -decidió I-EXPLORATION -completar I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION un I-EXPLORATION -enema I-EXPLORATION -opaco I-EXPLORATION +vaso I-EXPLORATION en I-EXPLORATION +extrema I-EXPLORATION +periferia I-EXPLORATION +temporal. I-EXPLORATION +En I-EXPLORATION el I-EXPLORATION -que I-EXPLORATION -finalmente I-EXPLORATION +OI I-EXPLORATION se I-EXPLORATION -objetivó I-EXPLORATION +comprobó I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -trayecto I-EXPLORATION -fistuloso I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION +una I-EXPLORATION +hemorragia I-EXPLORATION +lineal I-EXPLORATION +en I-EXPLORATION +periferia I-EXPLORATION +nasal I-EXPLORATION +sin I-EXPLORATION +evidencia I-EXPLORATION de I-EXPLORATION -ángulo I-EXPLORATION -hepático I-EXPLORATION -del I-EXPLORATION -colon, I-EXPLORATION +otros I-EXPLORATION +hallazgos. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +angiografía I-EXPLORATION +fluoresceinica, I-EXPLORATION +inyectando I-EXPLORATION +vía I-EXPLORATION +intravenosa I-EXPLORATION +5 I-EXPLORATION +ml I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -calibre I-EXPLORATION -aproximado I-EXPLORATION +fluoresceína I-EXPLORATION +sódica I-EXPLORATION +por I-EXPLORATION +kilogramo I-EXPLORATION de I-EXPLORATION -unos I-EXPLORATION -6 I-EXPLORATION -mm, I-EXPLORATION +peso, I-EXPLORATION que I-EXPLORATION -parecía I-EXPLORATION -comunicar I-EXPLORATION +en I-EXPLORATION +nuestro I-EXPLORATION +caso I-EXPLORATION +fueron I-EXPLORATION +0, I-EXPLORATION +35 I-EXPLORATION +ml. I-EXPLORATION +Se I-EXPLORATION +tomaron I-EXPLORATION +fotografías I-EXPLORATION +seriadas I-EXPLORATION con I-EXPLORATION -el I-EXPLORATION -colédoco, I-EXPLORATION -obteniéndose I-EXPLORATION -posteriormente I-EXPLORATION -relleno I-EXPLORATION +la I-EXPLORATION +Retcam I-EXPLORATION +II I-EXPLORATION +que I-EXPLORATION +pusieron I-EXPLORATION de I-EXPLORATION +manifiesto I-EXPLORATION +lesiones I-EXPLORATION +no I-EXPLORATION +observadas I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -vía I-EXPLORATION -biliar I-EXPLORATION -intrahepática. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -final I-EXPLORATION -fue I-EXPLORATION +oftalmoscopia I-EXPLORATION +previa. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +OD I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +exudación I-EXPLORATION +puntiforme I-EXPLORATION +en I-EXPLORATION +extrema I-EXPLORATION +periferia I-EXPLORATION +temporal. I-EXPLORATION +En I-EXPLORATION +OI I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +la I-EXPLORATION +no I-EXPLORATION +perfusión I-EXPLORATION de I-EXPLORATION -colecistitis I-EXPLORATION -crónica I-EXPLORATION -con I-EXPLORATION -fístula I-EXPLORATION -biliar I-EXPLORATION -interna I-EXPLORATION -a I-EXPLORATION -ángulo I-EXPLORATION -hepático I-EXPLORATION -del I-EXPLORATION -colon I-EXPLORATION -y I-EXPLORATION -hemorragia I-EXPLORATION -digestiva I-EXPLORATION -baja I-EXPLORATION -secundaria. I-EXPLORATION - I-EXPLORATION -Durante B-TREATMENT -su I-TREATMENT -ingreso I-TREATMENT -precisó I-TREATMENT -transfusión I-TREATMENT -de I-TREATMENT -4 I-TREATMENT -concentrados I-TREATMENT -de I-TREATMENT -hematíes, I-TREATMENT -permaneciendo B-EVOLUTION -hemodinámicamente I-EVOLUTION -estable I-EVOLUTION -y I-EVOLUTION -afebril, I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -diarrea I-EVOLUTION -ni I-EVOLUTION -nuevos I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -hematoquecia. I-EVOLUTION -Dada B-TREATMENT -la I-TREATMENT -pluripatología I-TREATMENT -de I-TREATMENT -base I-TREATMENT +toda I-EXPLORATION +la I-EXPLORATION +periferia I-EXPLORATION +nasal. I-EXPLORATION +Se B-TREATMENT +trató I-TREATMENT +con I-TREATMENT +láser I-TREATMENT de I-TREATMENT +diodo I-TREATMENT +toda I-TREATMENT la I-TREATMENT -paciente I-TREATMENT -y I-TREATMENT -la I-TREATMENT -buena I-TREATMENT -evolución I-TREATMENT +zona I-TREATMENT +nasal I-TREATMENT +afectada I-TREATMENT del I-TREATMENT -cuadro I-TREATMENT -agudo I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -un I-TREATMENT -manejo I-TREATMENT -conservador, I-TREATMENT -descartando I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -y I-TREATMENT -CPRE I-TREATMENT -terapeútica. I-TREATMENT -Evolucionó B-EVOLUTION -favorablemente I-EVOLUTION -y I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -sin I-EVOLUTION -incidencias. I-EVOLUTION -Continuaba I-EVOLUTION -asintomática I-EVOLUTION -dos I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -alta I-EVOLUTION -aunque I-EVOLUTION -falleció I-EVOLUTION -un I-EVOLUTION -tiempo I-EVOLUTION -después I-EVOLUTION -por I-EVOLUTION -patología I-EVOLUTION -cardiorrespiratoria. I-EVOLUTION - I-EVOLUTION +OI I-TREATMENT +(1.200 I-TREATMENT +impactos, I-TREATMENT +300 I-TREATMENT +mW, I-TREATMENT +300 I-TREATMENT +ms). I-TREATMENT + I-TREATMENT Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -74 I-PRESENT_ILLNESS +51 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY +monorrena I-PRESENT_ILLNESS +derecha, I-PRESENT_ILLNESS +incluída I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +programa I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hemodiálisis I-PRESENT_ILLNESS +9 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +previos I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +trasplante I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +IRC I-PRESENT_ILLNESS +secundaria I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +pielonefritis I-PRESENT_ILLNESS +crónica I-PRESENT_ILLNESS +derecha. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Antecedentes B-PAST_MEDICAL_HISTORY +personales: I-PAST_MEDICAL_HISTORY +nefrectomía I-PAST_MEDICAL_HISTORY +izquierda I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +absceso I-PAST_MEDICAL_HISTORY +pararrenal I-PAST_MEDICAL_HISTORY +secundario I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +rotura I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +riñón I-PAST_MEDICAL_HISTORY +izquierdo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +contenía I-PAST_MEDICAL_HISTORY +cálculo I-PAST_MEDICAL_HISTORY +coraliforme I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +ureteroscopia I-PAST_MEDICAL_HISTORY +derecha I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +cálculo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +uréter I-PAST_MEDICAL_HISTORY +pelviano I-PAST_MEDICAL_HISTORY +derecho I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +febrero I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -tiroidectomía I-PAST_MEDICAL_HISTORY -total I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -linfadenectomía I-PAST_MEDICAL_HISTORY +1990. I-PAST_MEDICAL_HISTORY +Hígado I-PAST_MEDICAL_HISTORY +graso I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +control I-PAST_MEDICAL_HISTORY por I-PAST_MEDICAL_HISTORY -carcinoma I-PAST_MEDICAL_HISTORY -papilar I-PAST_MEDICAL_HISTORY +Servicio I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -tiroides I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY +Digestivo, I-PAST_MEDICAL_HISTORY +HTA, I-PAST_MEDICAL_HISTORY +hipertrigliceridemia, I-PAST_MEDICAL_HISTORY +sobrepeso I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +gota. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Trasplante I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +riñón I-PAST_MEDICAL_HISTORY +derecho I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +fosa I-PAST_MEDICAL_HISTORY +ilíaca I-PAST_MEDICAL_HISTORY +derecha I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +incidencias I-PAST_MEDICAL_HISTORY +(también I-PAST_MEDICAL_HISTORY +arteria I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +doble I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -levotiroxina I-PAST_MEDICAL_HISTORY -sódica I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hipercolesterolemia I-PAST_MEDICAL_HISTORY +parche I-PAST_MEDICAL_HISTORY +único I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +anastomosis I-PAST_MEDICAL_HISTORY +vasculares I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +ilíacas I-PAST_MEDICAL_HISTORY +externas, I-PAST_MEDICAL_HISTORY +implante I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +uréter I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +vejiga I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +Paquin). I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +día I-PAST_MEDICAL_HISTORY ++5 I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +trasplante I-PAST_MEDICAL_HISTORY +rechazo I-PAST_MEDICAL_HISTORY +agudo I-PAST_MEDICAL_HISTORY +siendo I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +pulses I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +6-Metil-Prednisolona I-PAST_MEDICAL_HISTORY +(400mg/día, I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +días) I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +dada I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alta I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +niveles I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +creatinina I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2'3 I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +progresivamente I-PAST_MEDICAL_HISTORY +descenderán I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +mantendrán I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +actualidad I-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY +0'8-1'1. I-PAST_MEDICAL_HISTORY +Al I-PAST_MEDICAL_HISTORY +alta I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +seguía I-PAST_MEDICAL_HISTORY tratamiento I-PAST_MEDICAL_HISTORY +inmunosupresor I-PAST_MEDICAL_HISTORY +también I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -pravastatina. I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS +ciclosporina I-PAST_MEDICAL_HISTORY +8mg/Kg, I-PAST_MEDICAL_HISTORY +micofenolato I-PAST_MEDICAL_HISTORY +mofetilo I-PAST_MEDICAL_HISTORY +2gr/día I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +prednisona I-PAST_MEDICAL_HISTORY +1mg/Kg. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +abril I-PAST_MEDICAL_HISTORY +de1999, I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +después I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +trasplante, I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +refiere I-PAST_MEDICAL_HISTORY +cuadro I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +temblor I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +ambas I-PAST_MEDICAL_HISTORY +manos I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +inicialmente I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +atribuído I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +toxicidad I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ciclosporina I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +comenzó I-PAST_MEDICAL_HISTORY +descenso I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +pauta I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +corticoides. I-PAST_MEDICAL_HISTORY +Sin I-PAST_MEDICAL_HISTORY +embargo, I-PAST_MEDICAL_HISTORY +ante I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +empeoramiento I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +cuadro, I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +asintomática, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +inició I-PAST_MEDICAL_HISTORY +estudio I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +Servicio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Neurología. I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +ese I-PRESENT_ILLNESS +momento, I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +medio I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +trasplante I-PRESENT_ILLNESS +(marzo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +2000) I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS +inestabilidad I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -expectoración I-PRESENT_ILLNESS -blanquecina, I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +marcha, I-PRESENT_ILLNESS +temblores I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -disnea. I-PRESENT_ILLNESS -Inicialmente B-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT -con I-TREATMENT -dos I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -antibióticos I-TREATMENT -con I-TREATMENT -mejoría I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fiebre. I-TREATMENT -Posteriormente B-PRESENT_ILLNESS -comenzó I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -expectoración I-PRESENT_ILLNESS -hemoptoica, I-PRESENT_ILLNESS -autolimitada I-PRESENT_ILLNESS +parestesias I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -siguientes. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -general. I-PRESENT_ILLNESS +miembros I-PRESENT_ILLNESS +inferiores. I-PRESENT_ILLNESS En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION física I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -masa I-EXPLORATION -corporal I-EXPLORATION -(IMC) I-EXPLORATION -de I-EXPLORATION -38, I-EXPLORATION -67 I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -obesidad I-EXPLORATION -grado I-EXPLORATION -2 I-EXPLORATION -y I-EXPLORATION -roncus I-EXPLORATION -espiratorios I-EXPLORATION -bilaterales. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -alteraciones I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -Mantoux I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -función I-EXPLORATION -pulmonar I-EXPLORATION se I-EXPLORATION -objetivó I-EXPLORATION -una I-EXPLORATION -obstrucción I-EXPLORATION -muy I-EXPLORATION -leve I-EXPLORATION -al I-EXPLORATION -flujo I-EXPLORATION -aéreo I-EXPLORATION -(capacidad I-EXPLORATION -vital I-EXPLORATION -forzada I-EXPLORATION -[CVF] I-EXPLORATION -2.570 I-EXPLORATION -cc I-EXPLORATION -(110% I-EXPLORATION -del I-EXPLORATION -valor I-EXPLORATION -teórico); I-EXPLORATION -volumen I-EXPLORATION -espirado I-EXPLORATION +objetivaron I-EXPLORATION +moderados I-EXPLORATION +signos I-EXPLORATION +piramidales I-EXPLORATION +en I-EXPLORATION +ambas I-EXPLORATION +EEII, I-EXPLORATION +más I-EXPLORATION +acusados I-EXPLORATION en I-EXPLORATION +eI I-EXPLORATION +izquierdo, I-EXPLORATION +sin I-EXPLORATION +claro I-EXPLORATION +déficit I-EXPLORATION +motor; I-EXPLORATION +la I-EXPLORATION +sensibilidad I-EXPLORATION +profunda I-EXPLORATION +estaba I-EXPLORATION +también I-EXPLORATION +levemente I-EXPLORATION +alterada. I-EXPLORATION +Las I-EXPLORATION +pruebas I-EXPLORATION +complementarias I-EXPLORATION +ayudaron I-EXPLORATION +a I-EXPLORATION +esclarecer I-EXPLORATION el I-EXPLORATION -primer I-EXPLORATION -segundo I-EXPLORATION -[VEF1] I-EXPLORATION -1.730 I-EXPLORATION -cc I-EXPLORATION -(92,7%); I-EXPLORATION -FEV1/FVC I-EXPLORATION -67%; I-EXPLORATION -test I-EXPLORATION -broncodilatador I-EXPLORATION -negativo). I-EXPLORATION +diagnóstico: I-EXPLORATION I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -puso I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -densidad I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +RMN I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +2 I-EXPLORATION +lesiones I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +mielitis I-EXPLORATION a I-EXPLORATION nivel I-EXPLORATION -del I-EXPLORATION -lóbulo I-EXPLORATION -inferior I-EXPLORATION -derecho I-EXPLORATION -(LID). I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -atelectasia I-EXPLORATION -sin I-EXPLORATION -broncograma I-EXPLORATION -aéreo I-EXPLORATION -del I-EXPLORATION -segmento I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -LID I-EXPLORATION +cervical I-EXPLORATION +C2-C4 I-EXPLORATION y I-EXPLORATION -dilatación I-EXPLORATION -proximal I-EXPLORATION +dorsal I-EXPLORATION +alto I-EXPLORATION +D1. I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +potenciales I-EXPLORATION +evocados I-EXPLORATION +demostraron I-EXPLORATION +retraso I-EXPLORATION +significativo I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +latencia I-EXPLORATION del I-EXPLORATION -bronquio I-EXPLORATION +nervio I-EXPLORATION +tibial. I-EXPLORATION + I-EXPLORATION +LCR: I-EXPLORATION +leve I-EXPLORATION +pleocitosis I-EXPLORATION +linfocítica, I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -dicho I-EXPLORATION -segmento, I-EXPLORATION -ocupado I-EXPLORATION -por I-EXPLORATION -material I-EXPLORATION -hipodenso I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -densidad I-EXPLORATION -grasa I-EXPLORATION +la I-EXPLORATION +concentración I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -nodular, I-EXPLORATION +proteínas I-EXPLORATION +y I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -1, I-EXPLORATION -6 I-EXPLORATION -cm.. I-EXPLORATION +bandas I-EXPLORATION +IgG I-EXPLORATION +oligoclonales. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -fibrobroncoscopia I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -polipoide I-EXPLORATION -de I-EXPLORATION -superficie I-EXPLORATION -lisa I-EXPLORATION -que I-EXPLORATION -obstruía I-EXPLORATION -por I-EXPLORATION -completo I-EXPLORATION +Pruebas I-EXPLORATION +serológicas, I-EXPLORATION +ELISA I-EXPLORATION +y I-EXPLORATION +Western I-EXPLORATION +Blot, I-EXPLORATION +resultaron I-EXPLORATION +positivas I-EXPLORATION +para I-EXPLORATION +HTLV-I I-EXPLORATION +en I-EXPLORATION +LCR I-EXPLORATION +y I-EXPLORATION +sangre. I-EXPLORATION + I-EXPLORATION +PCR I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +positiva I-EXPLORATION +también I-EXPLORATION +para I-EXPLORATION el I-EXPLORATION -bronquio I-EXPLORATION -basal I-EXPLORATION -anterior I-EXPLORATION -del I-EXPLORATION -LID. I-EXPLORATION -La I-EXPLORATION -biopsia I-EXPLORATION -bronquial I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -proliferación I-EXPLORATION -bronquial I-EXPLORATION -de I-EXPLORATION -tejido I-EXPLORATION -adiposo I-EXPLORATION -maduro I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -lipoma I-EXPLORATION -endobronquial. I-EXPLORATION +virus I-EXPLORATION +detectándose I-EXPLORATION +también I-EXPLORATION +en I-EXPLORATION +este I-EXPLORATION +caso I-EXPLORATION +carga I-EXPLORATION +viral I-EXPLORATION +elevada. I-EXPLORATION I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -lipoma I-TREATMENT -endobronquial I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -tratamiento I-TREATMENT -endoscópico I-TREATMENT -mediante I-TREATMENT -resección I-TREATMENT -láser. I-TREATMENT -Se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -fotocoagulación I-TREATMENT -superficial I-TREATMENT -con I-TREATMENT -láser I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT -intento I-TREATMENT -infructuoso I-TREATMENT -de I-TREATMENT -extracción I-TREATMENT +La B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +tratada I-TREATMENT con I-TREATMENT -asa I-TREATMENT -de I-TREATMENT -diatermia I-TREATMENT -por I-TREATMENT -dificultad I-TREATMENT -para I-TREATMENT -ver I-TREATMENT -la I-TREATMENT -parte I-TREATMENT -distal I-TREATMENT -de I-TREATMENT -la I-TREATMENT -lesión, I-TREATMENT -extrayéndose I-TREATMENT -sólo I-TREATMENT -una I-TREATMENT -parte I-TREATMENT +pulses I-TREATMENT de I-TREATMENT -la I-TREATMENT -lesión, I-TREATMENT -que I-TREATMENT -se I-TREATMENT -envió I-TREATMENT -para I-TREATMENT -análisis I-TREATMENT -anatomopatológico, I-TREATMENT -quedando I-TREATMENT +6-Metil-Prednisolona I-TREATMENT +en I-TREATMENT el I-TREATMENT -resto I-TREATMENT +momento I-TREATMENT de I-TREATMENT -la I-TREATMENT -tumoración I-TREATMENT -fotocoagulada I-TREATMENT +agudización I-TREATMENT +del I-TREATMENT +proceso I-TREATMENT +y I-TREATMENT +pauta I-TREATMENT +descendente I-TREATMENT +progresivamente I-TREATMENT de I-TREATMENT -forma I-TREATMENT -superficial. I-TREATMENT -Un B-EVOLUTION -mes I-EVOLUTION -después, I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -un I-EVOLUTION -segundo I-EVOLUTION -procedimiento, I-EVOLUTION -siendo I-EVOLUTION -extraído I-EVOLUTION -todo I-EVOLUTION +corticoides. I-TREATMENT +Sin B-EVOLUTION +embargo, I-EVOLUTION +además I-EVOLUTION +de I-EVOLUTION +hábito I-EVOLUTION +cushingoide, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +presenta I-EVOLUTION +pérdida I-EVOLUTION +de I-EVOLUTION +audición I-EVOLUTION +progresiva, I-EVOLUTION +incontinencia I-EVOLUTION +de I-EVOLUTION +orina I-EVOLUTION +de I-EVOLUTION +predominio I-EVOLUTION +nocturno I-EVOLUTION +que I-EVOLUTION +ha I-EVOLUTION +mejorado I-EVOLUTION +con I-EVOLUTION +Tolterodina I-EVOLUTION +(pendiente I-EVOLUTION +de I-EVOLUTION +estudio I-EVOLUTION +urodinámico I-EVOLUTION +en I-EVOLUTION el I-EVOLUTION -material I-EVOLUTION -restante. I-EVOLUTION -No I-EVOLUTION -se I-EVOLUTION -objetivaron I-EVOLUTION -complicaciones I-EVOLUTION -tras I-EVOLUTION -los I-EVOLUTION -procedimientos. I-EVOLUTION +momento I-EVOLUTION +actual) I-EVOLUTION +y I-EVOLUTION +evoluciona I-EVOLUTION +hacia I-EVOLUTION +discreta I-EVOLUTION +invalidez. I-EVOLUTION I-EVOLUTION -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -69 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -mayo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2011 I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -presentando I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -peneano I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -erección I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -completa I-PRESENT_ILLNESS +Exponemos B-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +efectos I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +programa I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas, I-PRESENT_ILLNESS -hemoglobina I-PRESENT_ILLNESS +ejercicio I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -sangre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -8, I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -mg/dl I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +(55 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +58 I-PRESENT_ILLNESS +kg, I-PRESENT_ILLNESS +158 I-PRESENT_ILLNESS +cm I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -140 I-PRESENT_ILLNESS -hematíes I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -campo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -análisis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -orina. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Entre B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encuentra I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2001 I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -carcinoma I-PAST_MEDICAL_HISTORY -vesical I-PAST_MEDICAL_HISTORY +22, I-PRESENT_ILLNESS +83 I-PRESENT_ILLNESS +kg/m2), I-PRESENT_ILLNESS +jubilada I-PRESENT_ILLNESS +por B-PAST_MEDICAL_HISTORY +incapacidad I-PAST_MEDICAL_HISTORY +física, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +MG I-PAST_MEDICAL_HISTORY +grado I-PAST_MEDICAL_HISTORY +III I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -urotelio I-PAST_MEDICAL_HISTORY -T2b, I-PAST_MEDICAL_HISTORY -G3 I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -RTU I-PAST_MEDICAL_HISTORY -vesical I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tratado I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -ciclos I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -quimioterapia I-PAST_MEDICAL_HISTORY -consistente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -taxol I-PAST_MEDICAL_HISTORY -245 I-PAST_MEDICAL_HISTORY -mg, I-PAST_MEDICAL_HISTORY -cisplatino I-PAST_MEDICAL_HISTORY -136 I-PAST_MEDICAL_HISTORY -mg, I-PAST_MEDICAL_HISTORY -gemcitabina I-PAST_MEDICAL_HISTORY -1.456 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY +evolución, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +marcada I-PAST_MEDICAL_HISTORY +debilidad I-PAST_MEDICAL_HISTORY +muscular, I-PAST_MEDICAL_HISTORY +especialmente I-PAST_MEDICAL_HISTORY +cervical I-PAST_MEDICAL_HISTORY +(necesitaba I-PAST_MEDICAL_HISTORY +sujetar I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +manos I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +cabeza I-PAST_MEDICAL_HISTORY +cuando I-PAST_MEDICAL_HISTORY +comía I-PAST_MEDICAL_HISTORY +o I-PAST_MEDICAL_HISTORY +cuando I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +iba I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +tumbar) I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -radioterapia I-PAST_MEDICAL_HISTORY -externa I-PAST_MEDICAL_HISTORY -64Gy I-PAST_MEDICAL_HISTORY +que, I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY -mitad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ciclos I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -concluyó I-PAST_MEDICAL_HISTORY +nivel I-PAST_MEDICAL_HISTORY +dorsal, I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +causaba I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +actitud I-PAST_MEDICAL_HISTORY +cifótica. I-PAST_MEDICAL_HISTORY +Había I-PAST_MEDICAL_HISTORY +recibido I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -remisión I-PAST_MEDICAL_HISTORY -completa I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -2005. I-PAST_MEDICAL_HISTORY -Los I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -sucesivos I-PAST_MEDICAL_HISTORY -presenta I-PAST_MEDICAL_HISTORY -recidivas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tumores I-PAST_MEDICAL_HISTORY -vesicales I-PAST_MEDICAL_HISTORY -superficiales I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -electrocoagulan. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY +plasmaféresis, I-PAST_MEDICAL_HISTORY +Prograf® I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +Inmurel® I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY el I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -2008 I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -elevación I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -PSA I-PAST_MEDICAL_HISTORY +programa I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY +ejercicio I-PAST_MEDICAL_HISTORY +tomaba I-PAST_MEDICAL_HISTORY +Ciclosporina® I-PAST_MEDICAL_HISTORY +(500 I-PAST_MEDICAL_HISTORY +mg/15días), I-PAST_MEDICAL_HISTORY +Dacortin® I-PAST_MEDICAL_HISTORY +(5 I-PAST_MEDICAL_HISTORY +mg/24 I-PAST_MEDICAL_HISTORY +h), I-PAST_MEDICAL_HISTORY +Escitalopram® I-PAST_MEDICAL_HISTORY +(10 I-PAST_MEDICAL_HISTORY +mg/24 I-PAST_MEDICAL_HISTORY +h), I-PAST_MEDICAL_HISTORY +Mestinon® I-PAST_MEDICAL_HISTORY +(60 I-PAST_MEDICAL_HISTORY +mg/8 I-PAST_MEDICAL_HISTORY +h), I-PAST_MEDICAL_HISTORY +Lanzoprazol® I-PAST_MEDICAL_HISTORY +(30 I-PAST_MEDICAL_HISTORY +mg/24 I-PAST_MEDICAL_HISTORY +h), I-PAST_MEDICAL_HISTORY +Lexatin® I-PAST_MEDICAL_HISTORY +(1, I-PAST_MEDICAL_HISTORY 5 I-PAST_MEDICAL_HISTORY -ng/ml I-PAST_MEDICAL_HISTORY -realizando I-PAST_MEDICAL_HISTORY -biopsia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -próstata I-PAST_MEDICAL_HISTORY -informada I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -adenocarcinoma I-PAST_MEDICAL_HISTORY +mg/24 I-PAST_MEDICAL_HISTORY +h) I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +Calcium I-PAST_MEDICAL_HISTORY +Sandoz I-PAST_MEDICAL_HISTORY +D® I-PAST_MEDICAL_HISTORY +(1.000 I-PAST_MEDICAL_HISTORY +mg/880 I-PAST_MEDICAL_HISTORY +UI/24 I-PAST_MEDICAL_HISTORY +h). I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +practicado I-PAST_MEDICAL_HISTORY +timectomía I-PAST_MEDICAL_HISTORY +aunque I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +situación I-PAST_MEDICAL_HISTORY +era I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -próstata I-PAST_MEDICAL_HISTORY -3+3, I-PAST_MEDICAL_HISTORY -Gleason I-PAST_MEDICAL_HISTORY -6. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -trató I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -braquiterapia I-PAST_MEDICAL_HISTORY -intersticial I-PAST_MEDICAL_HISTORY +eutiroidismo I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -semillas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Iodo125 I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2009. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A I-PAST_MEDICAL_HISTORY -finales I-PAST_MEDICAL_HISTORY +presencia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -2010 I-PAST_MEDICAL_HISTORY -refirió I-PAST_MEDICAL_HISTORY -molestias I-PAST_MEDICAL_HISTORY -premiccionales I-PAST_MEDICAL_HISTORY -observando I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -cistoscopia I-PAST_MEDICAL_HISTORY -lesión I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -uretra I-PAST_MEDICAL_HISTORY -prostática. I-PAST_MEDICAL_HISTORY -Se B-EXPLORATION -realizó I-EXPLORATION -RTU-biópsica I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -de I-EXPLORATION -urotelio I-EXPLORATION -con I-EXPLORATION -diferenciación I-EXPLORATION -escamosa. I-EXPLORATION -La B-TREATMENT -lesión I-TREATMENT -fue I-TREATMENT -tratada I-TREATMENT -mediante I-TREATMENT -resección I-TREATMENT +nódulos I-PAST_MEDICAL_HISTORY +tiroideos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +además I-PAST_MEDICAL_HISTORY +padecía I-PAST_MEDICAL_HISTORY +osteoporosis. I-PAST_MEDICAL_HISTORY +Tras B-TREATMENT +ser I-TREATMENT +informada I-TREATMENT +dio I-TREATMENT +su I-TREATMENT +consentimiento I-TREATMENT +por I-TREATMENT +escrito I-TREATMENT +para I-TREATMENT +su I-TREATMENT +participación I-TREATMENT +en I-TREATMENT +el I-TREATMENT +estudio. I-TREATMENT +El I-TREATMENT +diseño I-TREATMENT y I-TREATMENT -6 I-TREATMENT -ciclos I-TREATMENT +realización I-TREATMENT de I-TREATMENT -quimioterapia I-TREATMENT -consistente I-TREATMENT -en I-TREATMENT -gemcitabina I-TREATMENT -3.300 I-TREATMENT -mg I-TREATMENT -(1.750 I-TREATMENT -mg/m2), I-TREATMENT -cisplatino I-TREATMENT -94 I-TREATMENT -mg I-TREATMENT -(50 I-TREATMENT -mg/m2) I-TREATMENT -finalizado I-TREATMENT -en I-TREATMENT -marzo I-TREATMENT +esta I-TREATMENT +investigación I-TREATMENT +respetaron I-TREATMENT +las I-TREATMENT +recomendaciones I-TREATMENT +éticas I-TREATMENT de I-TREATMENT -2011. I-TREATMENT +la I-TREATMENT +Asociación I-TREATMENT +Médica I-TREATMENT +Mundial I-TREATMENT +y I-TREATMENT +la I-TREATMENT +Declaración I-TREATMENT +de I-TREATMENT +Helsinki I-TREATMENT +y I-TREATMENT +fue I-TREATMENT +aprobado I-TREATMENT +por I-TREATMENT +el I-TREATMENT +comité I-TREATMENT +de I-TREATMENT +Ética I-TREATMENT +de I-TREATMENT +Asociación I-TREATMENT +Miastenia I-TREATMENT +de I-TREATMENT +España I-TREATMENT +(AMES). I-TREATMENT I-TREATMENT -En B-EVOLUTION -revisión I-EVOLUTION -de I-EVOLUTION -abril I-EVOLUTION -de I-EVOLUTION -2012 I-EVOLUTION -continuaba I-EVOLUTION -con I-EVOLUTION -disminución I-EVOLUTION -del I-EVOLUTION -PSA I-EVOLUTION -hasta I-EVOLUTION -valor I-EVOLUTION -de I-EVOLUTION -0, I-EVOLUTION -6 I-EVOLUTION -ng/ml; I-EVOLUTION -la B-EXPLORATION -cistoscopia I-EXPLORATION -mostraba I-EXPLORATION -un I-EXPLORATION -proceso I-EXPLORATION -inflamatorio-cicatricial I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -uretra I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tomografía I-EXPLORATION -por I-EXPLORATION -emisión I-EXPLORATION -de I-EXPLORATION -positrones I-EXPLORATION -(PET/CT). I-EXPLORATION -Se I-EXPLORATION -veían I-EXPLORATION -varias I-EXPLORATION -imágenes I-EXPLORATION -hipermetabólicas, I-EXPLORATION -sugestivas I-EXPLORATION -de I-EXPLORATION -enfermedad I-EXPLORATION -en I-EXPLORATION -pared I-EXPLORATION -lateral I-EXPLORATION -derecha I-EXPLORATION -e I-EXPLORATION -izquierda I-EXPLORATION -de I-EXPLORATION -vejiga, I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -vesícula I-EXPLORATION -seminal I-EXPLORATION -y I-EXPLORATION -depósito I-EXPLORATION -en I-EXPLORATION -uretra I-EXPLORATION -peneana I-EXPLORATION -englobando I-EXPLORATION -cuerpo I-EXPLORATION -cavernoso I-EXPLORATION -izquierdo, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -afectación I-EXPLORATION -ganglionar. I-EXPLORATION -Se B-TREATMENT -le I-TREATMENT -recomendó I-TREATMENT -tratamiento I-TREATMENT -quimioterápico I-TREATMENT -que I-TREATMENT -no I-TREATMENT -llegó I-TREATMENT -a I-TREATMENT -recibir. I-TREATMENT +Programa I-TREATMENT +de I-TREATMENT +ejercicio I-TREATMENT +y I-TREATMENT +valoraciones I-TREATMENT +efectuadas I-TREATMENT I-TREATMENT -Revisada I-TREATMENT -su I-TREATMENT -historia I-TREATMENT -clínica I-TREATMENT -en I-TREATMENT -el I-TREATMENT -servicio I-TREATMENT +El I-TREATMENT +programa I-TREATMENT de I-TREATMENT -Urgencias I-TREATMENT +ejercicio I-TREATMENT se I-TREATMENT -decidió I-TREATMENT +inició I-TREATMENT el I-TREATMENT -ingreso. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -tratamiento I-TREATMENT -sintomático, I-TREATMENT -transfusión I-TREATMENT +20 I-TREATMENT de I-TREATMENT -hemoderivados, I-TREATMENT -tomografía I-TREATMENT -axial I-TREATMENT -computerizada I-TREATMENT +junio I-TREATMENT de I-TREATMENT -abdomen I-TREATMENT -(TAC) I-TREATMENT -para I-TREATMENT -re-estadificación I-TREATMENT +2012 I-TREATMENT y I-TREATMENT -tratamiento I-TREATMENT -quimioterápico I-TREATMENT +concluyó I-TREATMENT +el I-TREATMENT +17 I-TREATMENT de I-TREATMENT -segunda I-TREATMENT -línea I-TREATMENT +julio I-TREATMENT +de I-TREATMENT +2012 I-TREATMENT +y I-TREATMENT +consistió I-TREATMENT +en I-TREATMENT +la I-TREATMENT +realización I-TREATMENT +de I-TREATMENT +2 I-TREATMENT +sesiones I-TREATMENT +matinales I-TREATMENT +semanales. I-TREATMENT +Los I-TREATMENT +componentes I-TREATMENT +de I-TREATMENT +cada I-TREATMENT +sesión I-TREATMENT +consistían I-TREATMENT +en I-TREATMENT +ejercicios I-TREATMENT +de I-TREATMENT +Pilates I-TREATMENT +suelo, I-TREATMENT +ejercicios I-TREATMENT +de I-TREATMENT +fuerza I-TREATMENT +para I-TREATMENT +los I-TREATMENT +grupos I-TREATMENT +musculares I-TREATMENT +de I-TREATMENT +bíceps, I-TREATMENT +tríceps, I-TREATMENT +pectoral I-TREATMENT +y I-TREATMENT +dorsal I-TREATMENT +ancho, I-TREATMENT mediante I-TREATMENT -vinflunina I-TREATMENT -bitartrato I-TREATMENT -500 I-TREATMENT -mg I-TREATMENT -(280 I-TREATMENT -mg/m2) I-TREATMENT -dosis I-TREATMENT -única. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -edema I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -erección I-EVOLUTION -desaparecieron I-EVOLUTION -y I-EVOLUTION -recibió I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -tras I-EVOLUTION -cinco I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -ingreso. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -falleció I-EVOLUTION -2 I-EVOLUTION -meses I-EVOLUTION -después. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -47 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -lumbar I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -brusca I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dificultad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -marcha, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -progresó I-PRESENT_ILLNESS -rápidamente I-PRESENT_ILLNESS -hacia I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -paraplejia I-PRESENT_ILLNESS -completa. I-PRESENT_ILLNESS -Entre B-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -destacaban I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -alergia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -penicilina I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -clasificada I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -idiopática, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -siete I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -atrás I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tratada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -enalapril-hidroclorotiazida I-PAST_MEDICAL_HISTORY -(20-12.5mg/24h). I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -anamnesis I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refirió I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -súbito, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -llegó I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -despertar I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -noche. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -irradiaba I-PRESENT_ILLNESS -hacia I-PRESENT_ILLNESS -ambas I-PRESENT_ILLNESS -extremidades I-PRESENT_ILLNESS -inferiores I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dificultaba I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -marcha. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -negaba I-PRESENT_ILLNESS -antecedente I-PRESENT_ILLNESS -traumático I-PRESENT_ILLNESS -alguno. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -inicial I-EXPLORATION +contracciones I-TREATMENT +auxotónicas, I-TREATMENT +con I-TREATMENT +banda I-TREATMENT +elástica I-TREATMENT +de I-TREATMENT +dureza I-TREATMENT +baja I-TREATMENT +(Domyos® I-TREATMENT +Villeneuve I-TREATMENT +D'Ascq. I-TREATMENT +Francia), I-TREATMENT +ejercicios I-TREATMENT +de I-TREATMENT +propiocepción I-TREATMENT +de I-TREATMENT +tobillo I-TREATMENT +con I-TREATMENT +pelota I-TREATMENT +100% I-TREATMENT +de I-TREATMENT +FOAM I-TREATMENT +de I-TREATMENT +16 I-TREATMENT +cm I-TREATMENT +(Gui-an I-TREATMENT +S.L. I-TREATMENT +Servicios I-TREATMENT +Deportivos®, I-TREATMENT +San I-TREATMENT +Sebastián I-TREATMENT +de I-TREATMENT +los I-TREATMENT +Reyes, I-TREATMENT +Madrid), I-TREATMENT +ejercicios I-TREATMENT +de I-TREATMENT +flexibilidad I-TREATMENT +(ejercicios I-TREATMENT +pasivos I-TREATMENT +asistidos I-TREATMENT +de I-TREATMENT +cuádriceps, I-TREATMENT +isquiotibiliales, I-TREATMENT +sóleo, I-TREATMENT +cuadrado I-TREATMENT +lumbar, I-TREATMENT +dorsal I-TREATMENT +ancho, I-TREATMENT +trapecios, I-TREATMENT +esternocleidomastoideo, I-TREATMENT +tríceps, I-TREATMENT +deltoides I-TREATMENT +y I-TREATMENT +pectoral) I-TREATMENT +y I-TREATMENT +ejercicios I-TREATMENT +de I-TREATMENT +facilitación I-TREATMENT +neuromuscular I-TREATMENT +propioceptiva I-TREATMENT +(PNF) I-TREATMENT +asistidos I-TREATMENT +por I-TREATMENT +un I-TREATMENT +fisioterapeuta I-TREATMENT +profesional I-TREATMENT +(isquiotibiales, I-TREATMENT +cuádriceps, I-TREATMENT +cuadrado I-TREATMENT +lumbar, I-TREATMENT +dorsal I-TREATMENT +y I-TREATMENT +trapecios). I-TREATMENT +Durante B-EXPLORATION +las I-EXPLORATION +sesiones I-EXPLORATION +de I-EXPLORATION +ejercicio I-EXPLORATION se I-EXPLORATION -objetivó I-EXPLORATION -un I-EXPLORATION -balance I-EXPLORATION -motor I-EXPLORATION +monitorizó I-EXPLORATION +la I-EXPLORATION +frecuencia I-EXPLORATION +cardíaca I-EXPLORATION +(FC) I-EXPLORATION +para I-EXPLORATION +evitar I-EXPLORATION +que I-EXPLORATION +esta I-EXPLORATION +aumentase I-EXPLORATION +más I-EXPLORATION de I-EXPLORATION -3/5 I-EXPLORATION -en I-EXPLORATION -psoas I-EXPLORATION +30 I-EXPLORATION +pulsaciones I-EXPLORATION +por I-EXPLORATION +minuto I-EXPLORATION +(ppm). I-EXPLORATION + I-EXPLORATION +Al I-EXPLORATION +inicio I-EXPLORATION y I-EXPLORATION -cuádriceps I-EXPLORATION -con I-EXPLORATION -0/5 I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -flexo-extensión I-EXPLORATION -plantar. I-EXPLORATION -Igualmente I-EXPLORATION +al I-EXPLORATION +final I-EXPLORATION +del I-EXPLORATION +estudio I-EXPLORATION se I-EXPLORATION -detectó I-EXPLORATION -una I-EXPLORATION -anestesia I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -extremidad I-EXPLORATION -inferior I-EXPLORATION -derecha I-EXPLORATION +midieron: I-EXPLORATION +peso I-EXPLORATION +(kg), I-EXPLORATION +talla I-EXPLORATION +(cm) I-EXPLORATION +mediante I-EXPLORATION +báscula I-EXPLORATION con I-EXPLORATION -hipoestesia I-EXPLORATION -termoalgésica I-EXPLORATION +tallímetro I-EXPLORATION +(modelo I-EXPLORATION +PS10®DINA, I-EXPLORATION +Derio, I-EXPLORATION +España), I-EXPLORATION +FC I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -extremidad I-EXPLORATION -inferior I-EXPLORATION -izquierda I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -anestesia I-EXPLORATION -perineal, I-EXPLORATION -globo I-EXPLORATION -vesical I-EXPLORATION -e I-EXPLORATION -incontinencia I-EXPLORATION -fecal. I-EXPLORATION -El I-EXPLORATION -balance I-EXPLORATION -motor I-EXPLORATION +reposo, I-EXPLORATION en I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -superiores I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -5/5. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -fiebre I-EXPLORATION -o I-EXPLORATION -signos I-EXPLORATION +ejercicio I-EXPLORATION +y I-EXPLORATION +a I-EXPLORATION +1 I-EXPLORATION +y I-EXPLORATION +3 I-EXPLORATION +minutos I-EXPLORATION de I-EXPLORATION -irritación I-EXPLORATION -meníngea. I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -urgente I-EXPLORATION +recuperación I-EXPLORATION +mediante I-EXPLORATION +pulsímetro I-EXPLORATION +(modelo I-EXPLORATION +M22 I-EXPLORATION +Polar®, I-EXPLORATION +Helsinki, I-EXPLORATION +Finlandia) I-EXPLORATION +y I-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION +(PA, I-EXPLORATION +en I-EXPLORATION +mmHg) I-EXPLORATION +mediante I-EXPLORATION +tensiómetro I-EXPLORATION +(modelo I-EXPLORATION +M2 I-EXPLORATION +BASIC I-EXPLORATION +OMRON I-EXPLORATION +HEALTHCARE®, I-EXPLORATION +Hoofddorp, I-EXPLORATION +Holanda). I-EXPLORATION +En I-EXPLORATION +cada I-EXPLORATION +sesión I-EXPLORATION de I-EXPLORATION +ejercicio I-EXPLORATION +se I-EXPLORATION +determinaron I-EXPLORATION la I-EXPLORATION -región I-EXPLORATION -lumbar, I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -alteración I-EXPLORATION -alguna. I-EXPLORATION -Ante I-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION +temperatura I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +humedad I-EXPLORATION +ambientales I-EXPLORATION +mediante I-EXPLORATION +un I-EXPLORATION +termómetro-higrómetro-barómetro-altímetro-cronómetro I-EXPLORATION +digital I-EXPLORATION +modelo I-EXPLORATION +AT701-H® I-EXPLORATION +(Atech I-EXPLORATION +Navigator, I-EXPLORATION +Hirschau, I-EXPLORATION +Alemania). I-EXPLORATION +Para I-EXPLORATION +valorar I-EXPLORATION +el I-EXPLORATION +ejercicio I-EXPLORATION +realizado I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RMN) I-EXPLORATION +midió I-EXPLORATION +el I-EXPLORATION +tiempo I-EXPLORATION de I-EXPLORATION -columna I-EXPLORATION -lumbar I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION +ejercicio I-EXPLORATION +completado. I-EXPLORATION + I-EXPLORATION +A I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +paciente I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +practicaron, I-EXPLORATION +al I-EXPLORATION +inicio I-EXPLORATION +y I-EXPLORATION +al I-EXPLORATION +final I-EXPLORATION +del I-EXPLORATION +programa, I-EXPLORATION +los I-EXPLORATION +siguientes I-EXPLORATION +test: I-EXPLORATION + I-EXPLORATION +-Caminata I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -intradural I-EXPLORATION +6 I-EXPLORATION +minutos I-EXPLORATION +(Six-minute I-EXPLORATION +Walk I-EXPLORATION +Test, I-EXPLORATION +6MWT) I-EXPLORATION +11, I-EXPLORATION +la I-EXPLORATION +distancia I-EXPLORATION +recorrida I-EXPLORATION +se I-EXPLORATION +midió I-EXPLORATION +mediante I-EXPLORATION +un I-EXPLORATION +podómetro I-EXPLORATION +modelo I-EXPLORATION +Dista I-EXPLORATION +Newfeel I-EXPLORATION +100® I-EXPLORATION +(Oxylane, I-EXPLORATION +Madrid, I-EXPLORATION +España) I-EXPLORATION + I-EXPLORATION +-Dinamometría I-EXPLORATION +manual: I-EXPLORATION +se I-EXPLORATION +midió I-EXPLORATION +la I-EXPLORATION +fuerza I-EXPLORATION +máxima I-EXPLORATION +ejercida I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +al I-EXPLORATION +instante I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +fuerza I-EXPLORATION +resistencia I-EXPLORATION +(aquella I-EXPLORATION que I-EXPLORATION -ocupaba I-EXPLORATION +aplica I-EXPLORATION +el I-EXPLORATION +sujeto I-EXPLORATION +durante I-EXPLORATION +10" I-EXPLORATION +con I-EXPLORATION +cada I-EXPLORATION +mano, I-EXPLORATION +manteniendo I-EXPLORATION +el I-EXPLORATION +brazo I-EXPLORATION +estirado I-EXPLORATION +y I-EXPLORATION +presionando I-EXPLORATION la I-EXPLORATION -totalidad I-EXPLORATION +perilla I-EXPLORATION del I-EXPLORATION -saco I-EXPLORATION -dural I-EXPLORATION +dinamómetro I-EXPLORATION +tanto I-EXPLORATION +como I-EXPLORATION +se I-EXPLORATION +pueda) I-EXPLORATION en I-EXPLORATION +ambos I-EXPLORATION +miembros I-EXPLORATION +superiores12, I-EXPLORATION +13. I-EXPLORATION +Para I-EXPLORATION +evitar I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +fatiga I-EXPLORATION +alterase I-EXPLORATION los I-EXPLORATION -niveles I-EXPLORATION -L2-L3-L4 I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -satélite I-EXPLORATION -asociada I-EXPLORATION +resultados, I-EXPLORATION +se I-EXPLORATION +instruyó I-EXPLORATION a I-EXPLORATION -nivel I-EXPLORATION -sacro. I-EXPLORATION - I-EXPLORATION -Con B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -clínica I-TREATMENT -y I-TREATMENT -radiológica I-TREATMENT -inicial I-TREATMENT -de I-TREATMENT -ependimoma I-TREATMENT -se I-TREATMENT -intervino I-TREATMENT -de I-TREATMENT -urgencia I-TREATMENT -practicando I-TREATMENT -una I-TREATMENT -laminectomía I-TREATMENT -y I-TREATMENT -fijación I-TREATMENT -pedicular I-TREATMENT -L2-L3-L4. I-TREATMENT -Al I-TREATMENT -proceder I-TREATMENT -a I-TREATMENT -la I-TREATMENT -apertura I-TREATMENT -dural I-TREATMENT -observamos I-TREATMENT -una I-TREATMENT -tumoración I-TREATMENT -de I-TREATMENT -color I-TREATMENT -rojo I-TREATMENT -violáceo, I-TREATMENT -encapsulada, I-TREATMENT -que I-TREATMENT -desplazaba I-TREATMENT -las I-TREATMENT -raíces I-TREATMENT -nerviosas I-TREATMENT -lateralmente. I-TREATMENT -Mediante I-TREATMENT -microcirugía I-TREATMENT -se I-TREATMENT -disecó I-TREATMENT -con I-TREATMENT -facilidad I-TREATMENT -el I-TREATMENT -tumor I-TREATMENT -de I-TREATMENT -las I-TREATMENT -raíces I-TREATMENT -adyacentes I-TREATMENT -y I-TREATMENT -se I-TREATMENT -extirpó I-TREATMENT -en I-TREATMENT -su I-TREATMENT -totalidad I-TREATMENT -en I-TREATMENT -una I-TREATMENT -única I-TREATMENT -pieza. I-TREATMENT -La I-TREATMENT -lesión I-TREATMENT -se I-TREATMENT -encontraba I-TREATMENT -adherida I-TREATMENT -únicamente I-TREATMENT -al I-TREATMENT -filum I-TREATMENT -terminal. I-TREATMENT -El B-EVOLUTION -postoperatorio I-EVOLUTION -transcurrió I-EVOLUTION -sin I-EVOLUTION -complicaciones, I-EVOLUTION -experimentando I-EVOLUTION -una I-EVOLUTION -progresiva I-EVOLUTION -recuperación I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -función I-EVOLUTION -motora I-EVOLUTION -e I-EVOLUTION -inicio I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -de I-EVOLUTION -esfínteres. I-EVOLUTION -Ante I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -anatomopatológico I-EVOLUTION -de I-EVOLUTION -paraganglioma, I-EVOLUTION -se I-EVOLUTION -solicitaron I-EVOLUTION -niveles I-EVOLUTION -de I-EVOLUTION -catecolaminas I-EVOLUTION -en I-EVOLUTION -sangre I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -orina, I-EVOLUTION -resultando I-EVOLUTION -todos I-EVOLUTION -ellos I-EVOLUTION -normales. I-EVOLUTION -La I-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -centro I-EVOLUTION -rehabilitador I-EVOLUTION -para I-EVOLUTION -completar I-EVOLUTION -su I-EVOLUTION -recuperación. I-EVOLUTION - I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -estudiado B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -alteración I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ritmo I-PRESENT_ILLNESS -intestinal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -rectorragias, I-PRESENT_ILLNESS -que B-EXPLORATION -tras I-EXPLORATION -endoscopia I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +un I-EXPLORATION +día I-EXPLORATION y I-EXPLORATION -biopsia I-EXPLORATION -es I-EXPLORATION -diagnosticado I-EXPLORATION -de I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +la I-EXPLORATION +prueba I-EXPLORATION +al I-EXPLORATION +siguiente. I-EXPLORATION +Ambas I-EXPLORATION +variables I-EXPLORATION +se I-EXPLORATION +midieron I-EXPLORATION +en I-EXPLORATION +kg I-EXPLORATION +mediante I-EXPLORATION un I-EXPLORATION -adenocarcinoma I-EXPLORATION +dinamómetro I-EXPLORATION de I-EXPLORATION -tercio I-EXPLORATION -inferior I-EXPLORATION +precisión I-EXPLORATION +100 I-EXPLORATION +g I-EXPLORATION +(modelo I-EXPLORATION +SH50008 I-EXPLORATION +Squeeze I-EXPLORATION +Saehan I-EXPLORATION +Corporation®, I-EXPLORATION +North I-EXPLORATION +Lincolnshire, I-EXPLORATION +Inglaterra). I-EXPLORATION + I-EXPLORATION +-Flexibilidad I-EXPLORATION de I-EXPLORATION -recto, I-EXPLORATION -bien I-EXPLORATION -diferenciado, I-EXPLORATION +tronco, I-EXPLORATION +extremidades I-EXPLORATION +superiores I-EXPLORATION +e I-EXPLORATION +inferiores14: I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +se I-EXPLORATION +sentó I-EXPLORATION +al I-EXPLORATION +borde I-EXPLORATION de I-EXPLORATION -alto I-EXPLORATION -grado, I-EXPLORATION +una I-EXPLORATION +silla I-EXPLORATION +de I-EXPLORATION +44 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +altura. I-EXPLORATION +Una I-EXPLORATION +pierna I-EXPLORATION +permanecía I-EXPLORATION +flexionada I-EXPLORATION con I-EXPLORATION -diferenciación I-EXPLORATION -mucinosa I-EXPLORATION -en I-EXPLORATION -menos I-EXPLORATION +la I-EXPLORATION +planta I-EXPLORATION del I-EXPLORATION -50%, I-EXPLORATION +pie I-EXPLORATION +apoyada I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +suelo. I-EXPLORATION +La I-EXPLORATION +otra I-EXPLORATION +estirada I-EXPLORATION +lo I-EXPLORATION +máximo I-EXPLORATION +posible, I-EXPLORATION con I-EXPLORATION -estadiaje I-EXPLORATION -clínico-radiológico I-EXPLORATION -(tomografía I-EXPLORATION -computerizada I-EXPLORATION +el I-EXPLORATION +talón I-EXPLORATION +en I-EXPLORATION +contacto I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +suelo I-EXPLORATION y I-EXPLORATION -resonancia I-EXPLORATION -magnética) I-EXPLORATION -T3 I-EXPLORATION -N2M0. I-EXPLORATION - I-EXPLORATION -El B-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -tratado I-TREATMENT -inicialmente I-TREATMENT -con I-TREATMENT -radioquimioterapia I-TREATMENT -neoadyuvante; I-TREATMENT -radioterapia I-TREATMENT -en I-TREATMENT -esquema I-TREATMENT -de I-TREATMENT -ciclo I-TREATMENT -largo I-TREATMENT -con I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -total I-TREATMENT -de I-TREATMENT -50, I-TREATMENT -4 I-TREATMENT -Gy I-TREATMENT -durante I-TREATMENT -5 I-TREATMENT -semanas, I-TREATMENT -y I-TREATMENT -capecitabina I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -a I-TREATMENT -razón I-TREATMENT -de I-TREATMENT -825 I-TREATMENT -mg/m2/12h I-TREATMENT -(1650 I-TREATMENT -mg/12h), I-TREATMENT -cada I-TREATMENT -15 I-TREATMENT -días. I-TREATMENT - I-TREATMENT -Ocho I-TREATMENT -semanas I-TREATMENT -después I-TREATMENT -de I-TREATMENT -finalizar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -fue I-TREATMENT -intervenido I-TREATMENT -quirúrgicamente I-TREATMENT -realizándose I-TREATMENT -una I-TREATMENT -amputación I-TREATMENT -abdominoperineal I-TREATMENT -extendida. I-TREATMENT -El B-EXPLORATION +el I-EXPLORATION +pie I-EXPLORATION +en I-EXPLORATION +flexión I-EXPLORATION +de I-EXPLORATION +90o. I-EXPLORATION +Espalda I-EXPLORATION +y I-EXPLORATION +cabeza I-EXPLORATION +erectas. I-EXPLORATION +La I-EXPLORATION +mano I-EXPLORATION +derecha I-EXPLORATION +colocada I-EXPLORATION +encima I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +izquierda, I-EXPLORATION +con I-EXPLORATION +los I-EXPLORATION +terceros I-EXPLORATION +dedos I-EXPLORATION +superpuestos. I-EXPLORATION +Se I-EXPLORATION +invitó I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +a I-EXPLORATION +alcanzar I-EXPLORATION +la I-EXPLORATION +punta I-EXPLORATION +del I-EXPLORATION +pie I-EXPLORATION +con I-EXPLORATION +las I-EXPLORATION +manos I-EXPLORATION +mientras I-EXPLORATION +se I-EXPLORATION +expulsa I-EXPLORATION +el I-EXPLORATION +aire. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +intento I-EXPLORATION +con I-EXPLORATION +cada I-EXPLORATION +pierna. I-EXPLORATION +Se I-EXPLORATION +permitió I-EXPLORATION +una I-EXPLORATION +familiarización I-EXPLORATION +previa I-EXPLORATION +al I-EXPLORATION +test. I-EXPLORATION +El I-EXPLORATION resultado I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION +es I-EXPLORATION la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -adenocarcinoma I-EXPLORATION -mucinoso I-EXPLORATION -de I-EXPLORATION -recto, I-EXPLORATION -a I-EXPLORATION -4, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION +máxima I-EXPLORATION +distancia I-EXPLORATION +alcanzada I-EXPLORATION +(cm), I-EXPLORATION +mantenida I-EXPLORATION +durante I-EXPLORATION +2", I-EXPLORATION +medida I-EXPLORATION +con I-EXPLORATION +cinta I-EXPLORATION +antropométrica I-EXPLORATION +(Clase I-EXPLORATION +I I-EXPLORATION +modelo I-EXPLORATION +CM040 I-EXPLORATION +Gisibérica®, I-EXPLORATION +Cáceres, I-EXPLORATION +España). I-EXPLORATION + I-EXPLORATION +-Flexibilidad I-EXPLORATION de I-EXPLORATION -margen I-EXPLORATION -anal, I-EXPLORATION -cuya I-EXPLORATION -infiltración I-EXPLORATION -sobrepasaba I-EXPLORATION -2 I-EXPLORATION -mm I-EXPLORATION +extremidades I-EXPLORATION +superiores14: I-EXPLORATION la I-EXPLORATION -muscular I-EXPLORATION -propia, I-EXPLORATION +participante I-EXPLORATION +se I-EXPLORATION +colocó I-EXPLORATION +en I-EXPLORATION +bipedestación, I-EXPLORATION con I-EXPLORATION -bordes I-EXPLORATION -quirúrgicos I-EXPLORATION -proximal I-EXPLORATION -y I-EXPLORATION -distal I-EXPLORATION -sin I-EXPLORATION -tumor, I-EXPLORATION -y I-EXPLORATION -margen I-EXPLORATION +una I-EXPLORATION de I-EXPLORATION -resección I-EXPLORATION -circular I-EXPLORATION -a I-EXPLORATION -20 I-EXPLORATION -mm I-EXPLORATION +las I-EXPLORATION +manos I-EXPLORATION +por I-EXPLORATION +encima I-EXPLORATION del I-EXPLORATION -tumor I-EXPLORATION -y I-EXPLORATION +hombro, I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +codo I-EXPLORATION +apuntando I-EXPLORATION +hacia I-EXPLORATION +arriba, I-EXPLORATION +los I-EXPLORATION +dedos I-EXPLORATION +extendidos I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +palma I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +mano I-EXPLORATION +hacia I-EXPLORATION +la I-EXPLORATION +escápula I-EXPLORATION +e I-EXPLORATION +intentando I-EXPLORATION +deslizar I-EXPLORATION +esta I-EXPLORATION +lo I-EXPLORATION +máximo I-EXPLORATION +posible I-EXPLORATION a I-EXPLORATION -2 I-EXPLORATION -mm I-EXPLORATION +lo I-EXPLORATION +largo I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -adenopatía I-EXPLORATION -metastatizada, I-EXPLORATION +la I-EXPLORATION +espalda. I-EXPLORATION +Al I-EXPLORATION +mismo I-EXPLORATION +tiempo, I-EXPLORATION +se I-EXPLORATION +colocaba I-EXPLORATION +la I-EXPLORATION +otra I-EXPLORATION +mano I-EXPLORATION +detrás I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +espalda, I-EXPLORATION con I-EXPLORATION +el I-EXPLORATION +dorso I-EXPLORATION +hacia I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +dorsal, I-EXPLORATION +intentando I-EXPLORATION +alcanzar I-EXPLORATION +o I-EXPLORATION +sobrepasar I-EXPLORATION +la I-EXPLORATION +otra I-EXPLORATION +mano. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION un I-EXPLORATION -total I-EXPLORATION +intento I-EXPLORATION +con I-EXPLORATION +cada I-EXPLORATION +brazo. I-EXPLORATION +Hubo I-EXPLORATION +una I-EXPLORATION +familiarización I-EXPLORATION +previa I-EXPLORATION +al I-EXPLORATION +test. I-EXPLORATION +El I-EXPLORATION +resultado I-EXPLORATION +es I-EXPLORATION +la I-EXPLORATION +mínima I-EXPLORATION +distancia I-EXPLORATION +(cm) I-EXPLORATION +alcanzada I-EXPLORATION +entre I-EXPLORATION +los I-EXPLORATION +terceros I-EXPLORATION +dedos I-EXPLORATION de I-EXPLORATION -3 I-EXPLORATION -ganglios I-EXPLORATION -positivos I-EXPLORATION +ambas I-EXPLORATION +manos, I-EXPLORATION +mantenida I-EXPLORATION +durante I-EXPLORATION +2", I-EXPLORATION +medida I-EXPLORATION +mediante I-EXPLORATION +cinta I-EXPLORATION +antropométrica I-EXPLORATION +(Clase I-EXPLORATION +I I-EXPLORATION +modelo I-EXPLORATION +CM040 I-EXPLORATION +Gisibérica®, I-EXPLORATION +Cáceres, I-EXPLORATION +España). I-EXPLORATION + I-EXPLORATION +-Fuerza I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -10 I-EXPLORATION -disecados. I-EXPLORATION -La I-EXPLORATION -escisión I-EXPLORATION -mesorrectal I-EXPLORATION -(en I-EXPLORATION +las I-EXPLORATION +extremidades I-EXPLORATION +inferiores: I-EXPLORATION +se I-EXPLORATION +midió I-EXPLORATION el I-EXPLORATION -plano I-EXPLORATION -del I-EXPLORATION -mesorrecto) I-EXPLORATION -y I-EXPLORATION +número I-EXPLORATION de I-EXPLORATION -canal I-EXPLORATION -anal I-EXPLORATION -(en I-EXPLORATION +sentadillas I-EXPLORATION +realizadas I-EXPLORATION +en I-EXPLORATION +30" I-EXPLORATION +con I-EXPLORATION +las I-EXPLORATION +manos I-EXPLORATION +cruzadas I-EXPLORATION +sobre I-EXPLORATION el I-EXPLORATION -plano I-EXPLORATION +pecho14. I-EXPLORATION +Se I-EXPLORATION +ha I-EXPLORATION +utilizado I-EXPLORATION +una I-EXPLORATION +silla I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -elevadores) I-EXPLORATION -fueron I-EXPLORATION -satisfactorias I-EXPLORATION -(ypT3bN1). I-EXPLORATION +44 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +altura I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +cronómetro I-EXPLORATION +(modelo I-EXPLORATION +AT701-H® I-EXPLORATION +Atech, I-EXPLORATION +Hirschau, I-EXPLORATION +Alemania). I-EXPLORATION I-EXPLORATION -El B-EVOLUTION -postoperatorio I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -cursó I-EVOLUTION -sin I-EVOLUTION -complicaciones, I-EVOLUTION -y B-TREATMENT -posteriormente I-TREATMENT -recibió I-TREATMENT -6 I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -quimioterapia I-TREATMENT -con I-TREATMENT -capecitabina I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT -a I-TREATMENT -razón I-TREATMENT -de I-TREATMENT -2.000 I-TREATMENT -mg/12h I-TREATMENT -cada I-TREATMENT -21 I-TREATMENT -días. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -su I-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -controlado I-EVOLUTION -por I-EVOLUTION -los I-EVOLUTION -servicios I-EVOLUTION -de I-EVOLUTION -Oncología I-EVOLUTION -y I-EVOLUTION -Cirugía I-EVOLUTION -General, I-EVOLUTION -con I-EVOLUTION -TC, I-EVOLUTION -colonoscopia I-EVOLUTION -y I-EVOLUTION -marcadores I-EVOLUTION -tumorales I-EVOLUTION -normales I-EVOLUTION -al I-EVOLUTION -año I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION -En I-EVOLUTION -su I-EVOLUTION -revisión I-EVOLUTION -rutinaria I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -18 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -refiere I-EVOLUTION -la I-EVOLUTION -aparición I-EVOLUTION -progresiva I-EVOLUTION -de I-EVOLUTION -nódulos I-EVOLUTION -subcutáneos I-EVOLUTION -faciales I-EVOLUTION -en I-EVOLUTION -zona I-EVOLUTION -frontal, I-EVOLUTION -en I-EVOLUTION -axila I-EVOLUTION -izquierda, I-EVOLUTION -pectoral I-EVOLUTION -derecho, I-EVOLUTION -flanco I-EVOLUTION -izquierdo I-EVOLUTION -y I-EVOLUTION -extremidades I-EVOLUTION -inferiores. I-EVOLUTION -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -corrobora I-EXPLORATION +Para I-EXPLORATION +valorar I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION +percepción I-EXPLORATION +del I-EXPLORATION +estado I-EXPLORATION de I-EXPLORATION -nódulos I-EXPLORATION -subcutáneos I-EXPLORATION +salud I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +aplicó I-EXPLORATION +el I-EXPLORATION +cuestionario I-EXPLORATION de I-EXPLORATION -entre I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -y I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -localizaciones I-EXPLORATION -descritas, I-EXPLORATION +Percepción I-EXPLORATION +del I-EXPLORATION +Estado I-EXPLORATION de I-EXPLORATION -consistencia I-EXPLORATION -elástica I-EXPLORATION +Salud I-EXPLORATION y I-EXPLORATION -rodaderos. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -TC I-EXPLORATION -tóracoabdominal I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -objetivaron I-EXPLORATION -múltiples I-EXPLORATION -imágenes I-EXPLORATION -sugestivas I-EXPLORATION +Calidad I-EXPLORATION de I-EXPLORATION -metástasis I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -hepático I-EXPLORATION -y I-EXPLORATION -pulmonar, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -lesiones I-EXPLORATION -subcutáneas I-EXPLORATION -localizadas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -área I-EXPLORATION -pectoral I-EXPLORATION -derecha I-EXPLORATION -área I-EXPLORATION -axilar I-EXPLORATION -izquierda, I-EXPLORATION -pared I-EXPLORATION -abdominal I-EXPLORATION -anterior, I-EXPLORATION -flanco I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -áreas I-EXPLORATION -glúteas. I-EXPLORATION +Vida I-EXPLORATION +SF-36 I-EXPLORATION +validada I-EXPLORATION +para I-EXPLORATION +español I-EXPLORATION +por I-EXPLORATION +Alonso I-EXPLORATION +et I-EXPLORATION +al.15. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -exéresis-biopsia I-EXPLORATION -de I-EXPLORATION -uno I-EXPLORATION +Los I-EXPLORATION +resultados I-EXPLORATION de I-EXPLORATION los I-EXPLORATION -nódulos I-EXPLORATION -subcutáneos I-EXPLORATION -localizado I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -pectoral I-EXPLORATION -derecha I-EXPLORATION -con I-EXPLORATION -resultado I-EXPLORATION -anatomopatológico I-EXPLORATION +test I-EXPLORATION +funcionales I-EXPLORATION +y I-EXPLORATION +del I-EXPLORATION +test I-EXPLORATION de I-EXPLORATION -metástasis I-EXPLORATION -subcutánea I-EXPLORATION +Percepción I-EXPLORATION +del I-EXPLORATION +Estado I-EXPLORATION de I-EXPLORATION -adenocarcinoma I-EXPLORATION -bien I-EXPLORATION -diferenciado I-EXPLORATION +Salud, I-EXPLORATION +SF-36, I-EXPLORATION +obtenidos I-EXPLORATION +al I-EXPLORATION +inicio I-EXPLORATION +y I-EXPLORATION +tras I-EXPLORATION +realizar I-EXPLORATION +el I-EXPLORATION +programa I-EXPLORATION de I-EXPLORATION -recto. I-EXPLORATION -Ante B-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -de I-EVOLUTION -recidiva I-EVOLUTION -tumoral I-EVOLUTION -diseminada I-EVOLUTION -se I-EVOLUTION -valoró I-EVOLUTION -nuevamente I-EVOLUTION -tratamiento I-EVOLUTION -quimioterápico I-EVOLUTION -que I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -llegó I-EVOLUTION -a I-EVOLUTION -recibir I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -rápido I-EVOLUTION -deterioro I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION -que I-EVOLUTION -le I-EVOLUTION -llevó I-EVOLUTION -al I-EVOLUTION -exitus. I-EVOLUTION - I-EVOLUTION +ejercicios, I-EXPLORATION +se I-EXPLORATION +muestran I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +tablas I-EXPLORATION +2 I-EXPLORATION +y I-EXPLORATION +3 I-EXPLORATION +respectivamente. I-EXPLORATION + I-EXPLORATION -Secundigesta B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +44 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +diagnosticado I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -natural B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Colombia, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY +Enfermedad I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Huntington, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +deterioro I-PRESENT_ILLNESS +cognitivo I-PRESENT_ILLNESS +severo, I-PRESENT_ILLNESS +disfagia I-PRESENT_ILLNESS +neurogénica, I-PRESENT_ILLNESS +broncoaspiraciones I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +desnutrición, I-PRESENT_ILLNESS +motivo B-TREATMENT +por I-TREATMENT +el I-TREATMENT +que I-TREATMENT +se I-TREATMENT +realiza I-TREATMENT +GEP I-TREATMENT +para I-TREATMENT +nutrición I-TREATMENT +enteral I-TREATMENT +domiciliaria. I-TREATMENT +Durante I-TREATMENT +el I-TREATMENT +procedimiento, I-TREATMENT +por I-TREATMENT +imposibilidad I-TREATMENT +de I-TREATMENT +obtener I-TREATMENT +un I-TREATMENT +punto I-TREATMENT +de I-TREATMENT +contacto I-TREATMENT +entre I-TREATMENT +estómago I-TREATMENT +y I-TREATMENT +pared I-TREATMENT +abdominal I-TREATMENT +por I-TREATMENT +transiluminación I-TREATMENT +y I-TREATMENT +digitopresión, I-TREATMENT +se I-TREATMENT +añadió I-TREATMENT +la I-TREATMENT +asistencia I-TREATMENT +de I-TREATMENT +laparoscópia I-TREATMENT +para I-TREATMENT +concluir I-TREATMENT +el I-TREATMENT +procedimiento I-TREATMENT +de I-TREATMENT +inserción I-TREATMENT +de I-TREATMENT +la I-TREATMENT +sonda I-TREATMENT +de I-TREATMENT +gastrostomía. I-TREATMENT + I-TREATMENT + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +76 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -anterior I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -complicaciones I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -presenta I-PAST_MEDICAL_HISTORY -obesidad I-PAST_MEDICAL_HISTORY -mórbida I-PAST_MEDICAL_HISTORY -(IMC I-PAST_MEDICAL_HISTORY -43) I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -cólicos I-PAST_MEDICAL_HISTORY -biliares I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -repetición. I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -30+ I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -gestación I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS +Crohn I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +prednisona I-PAST_MEDICAL_HISTORY +(30mg I-PAST_MEDICAL_HISTORY +diarios) I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +mesazalina, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS +otro I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -prurito I-PRESENT_ILLNESS -generalizado I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +febril I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS evolución I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -pseudogripal I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -febrícula, I-PRESENT_ILLNESS -artromialgias I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -clínica I-EXPLORATION -se I-EXPLORATION -objetivaron I-EXPLORATION -lesiones I-EXPLORATION -de I-EXPLORATION -rascado I-EXPLORATION -sin I-EXPLORATION -lesiones I-EXPLORATION -urticariformes I-EXPLORATION -y I-EXPLORATION -febrícula I-EXPLORATION -de I-EXPLORATION -37oC. I-EXPLORATION -Se I-EXPLORATION -constató I-EXPLORATION -el I-EXPLORATION -bienestar I-EXPLORATION -fetal I-EXPLORATION -mediante I-EXPLORATION -ecografía I-EXPLORATION -obstétrica I-EXPLORATION -(feto I-EXPLORATION -en I-EXPLORATION -cefálica I-EXPLORATION -dorso I-EXPLORATION -anterior, I-EXPLORATION -placenta I-EXPLORATION -posterior I-EXPLORATION -normoinserta, I-EXPLORATION -y I-EXPLORATION -líquido I-EXPLORATION -amniótico I-EXPLORATION -normal) I-EXPLORATION -y I-EXPLORATION -registro I-EXPLORATION -cardiotocográfico I-EXPLORATION -(patrón I-EXPLORATION -reactivo, I-EXPLORATION -adinamia). I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -hemograma I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -evidenció I-EXPLORATION -alteraciones I-EXPLORATION -significativas, I-EXPLORATION -excepto I-EXPLORATION -anemia I-EXPLORATION -moderada I-EXPLORATION -(Hb I-EXPLORATION -10 I-EXPLORATION -g/dl), I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -transaminasas I-EXPLORATION -(AST I-EXPLORATION -y I-EXPLORATION -ALT I-EXPLORATION -208 I-EXPLORATION -y I-EXPLORATION -238 I-EXPLORATION -U/L) I-EXPLORATION -y I-EXPLORATION -ácidos I-EXPLORATION -biliares I-EXPLORATION -56, I-EXPLORATION -9 I-EXPLORATION -µmol/L. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -coagulación I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -el I-TREATMENT -ingreso I-TREATMENT -de I-TREATMENT +artralgias I-PRESENT_ILLNESS +generalizadas. I-PRESENT_ILLNESS +Ante B-TREATMENT la I-TREATMENT -paciente I-TREATMENT +presencia I-TREATMENT +de I-TREATMENT +hipotensión I-TREATMENT +con I-TREATMENT +una I-TREATMENT +presión I-TREATMENT +arterial I-TREATMENT +media I-TREATMENT +(PAM) I-TREATMENT +<55mmHg I-TREATMENT +e I-TREATMENT +hiponatremia I-TREATMENT +(129mEq/l) I-TREATMENT +se I-TREATMENT +sospecha I-TREATMENT +insuficiencia I-TREATMENT +suprarrenal I-TREATMENT por I-TREATMENT -colestasis I-TREATMENT -gravídica I-TREATMENT +deprivación I-TREATMENT +(abandono I-TREATMENT +de I-TREATMENT +la I-TREATMENT +prednisona I-TREATMENT +48h I-TREATMENT +antes) I-TREATMENT y I-TREATMENT se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ácido I-TREATMENT -ursodesoxicólico I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT +administran I-TREATMENT +60mg I-TREATMENT de I-TREATMENT -13 I-TREATMENT -mg/kg/día, I-TREATMENT -loratadina I-TREATMENT -10 I-TREATMENT -mg/ I-TREATMENT -24h I-TREATMENT -y I-TREATMENT -colestiramina I-TREATMENT -3 I-TREATMENT -gr/ I-TREATMENT -8h. I-TREATMENT -A B-EVOLUTION +metilprednisolona, I-TREATMENT +con I-TREATMENT +mejoría I-TREATMENT +hemodinámica. I-TREATMENT +Las B-EXPLORATION +artralgias I-EXPLORATION +se I-EXPLORATION +atribuyen I-EXPLORATION +también I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +brote I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +enfermedad I-EXPLORATION +inflamatoria I-EXPLORATION +intestinal I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +cese I-EXPLORATION +brusco I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +medicación. I-EXPLORATION + I-EXPLORATION +En B-EVOLUTION las I-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -ingreso I-EVOLUTION -la I-EVOLUTION +siguientes I-EVOLUTION +24h I-EVOLUTION +el I-EVOLUTION paciente I-EVOLUTION -comenzó I-EVOLUTION -con I-EVOLUTION -fiebre I-EVOLUTION -de I-EVOLUTION -hasta I-EVOLUTION -38, I-EVOLUTION -6 I-EVOLUTION -oC, I-EVOLUTION -tos I-EVOLUTION -no I-EVOLUTION -productiva, I-EVOLUTION +refiere I-EVOLUTION disnea I-EVOLUTION -y I-EVOLUTION -otalgia, I-EVOLUTION -siendo I-EVOLUTION -la I-EVOLUTION -auscultación I-EVOLUTION -broncopulmonar I-EVOLUTION -normal I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -saturación I-EVOLUTION -de I-EVOLUTION -98%. I-EVOLUTION -Se B-TREATMENT -solicitó I-TREATMENT -radiografía I-TREATMENT -de I-TREATMENT -tórax, I-TREATMENT -hemocultivos I-TREATMENT -y I-TREATMENT -frotis I-TREATMENT -nasofaríngeo I-TREATMENT -(PCR I-TREATMENT -gripe) I-TREATMENT +con I-EVOLUTION +desaturación I-EVOLUTION +progresiva I-EVOLUTION +(hasta I-EVOLUTION +el I-EVOLUTION +76%) I-EVOLUTION +sin I-EVOLUTION +oxigenoterapia. I-EVOLUTION +Se B-EXPLORATION +realiza I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +torácica, I-EXPLORATION +que I-EXPLORATION +observa I-EXPLORATION +patrón I-EXPLORATION +en I-EXPLORATION +vidrio I-EXPLORATION +deslustrado I-EXPLORATION +inespecífico I-EXPLORATION +bilateral. I-EXPLORATION +La B-TREATMENT +sospecha I-TREATMENT +diagnóstica I-TREATMENT +en I-TREATMENT +ese I-TREATMENT +momento I-TREATMENT +corresponde I-TREATMENT +a I-TREATMENT +enfermedad I-TREATMENT +pulmonar I-TREATMENT +intersticial I-TREATMENT +versus I-TREATMENT +neumonía I-TREATMENT +adquirida I-TREATMENT +en I-TREATMENT +la I-TREATMENT +comunidad, I-TREATMENT y I-TREATMENT se I-TREATMENT -inició I-TREATMENT +inicia I-TREATMENT tratamiento I-TREATMENT -empírico I-TREATMENT con I-TREATMENT -ampicilina I-TREATMENT -2g/4h, I-TREATMENT -gentamicina I-TREATMENT -240 I-TREATMENT -mg/24h I-TREATMENT +oxigenoterapia, I-TREATMENT +levofloxacino I-TREATMENT y I-TREATMENT -oseltamivir I-TREATMENT -75 I-TREATMENT -mg. I-TREATMENT -Al B-EXPLORATION -mismo I-EXPLORATION -tiempo, I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -ecografía I-EXPLORATION -abdominal, I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal, I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -colelitiasis/colecistitis I-EXPLORATION -dada I-EXPLORATION +metilprednisolona. I-TREATMENT + I-TREATMENT +El B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +trasladó I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +diagnóstico I-DERIVED_FROM/TO +principal I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +insuficiencia I-DERIVED_FROM/TO +respiratoria I-DERIVED_FROM/TO +hipoxémica I-DERIVED_FROM/TO +aguda. I-DERIVED_FROM/TO +Al B-TREATMENT +presentar I-TREATMENT +4 I-TREATMENT +signos I-TREATMENT +de I-TREATMENT +gravedad I-TREATMENT +de I-TREATMENT +la I-TREATMENT +British I-TREATMENT +Thoracic I-TREATMENT +Society4 I-TREATMENT +para I-TREATMENT +neumonía I-TREATMENT +adquirida I-TREATMENT +en I-TREATMENT +la I-TREATMENT +comunidad I-TREATMENT +ingresó I-TREATMENT +en I-TREATMENT +nuestra I-TREATMENT +Unidad I-TREATMENT +de I-TREATMENT +Cuidados I-TREATMENT +Críticos: I-TREATMENT +taquipnea I-TREATMENT +>30 I-TREATMENT +respiraciones I-TREATMENT +por I-TREATMENT +minuto, I-TREATMENT +urea I-TREATMENT +>42mg/dl, I-TREATMENT +enfermedad I-TREATMENT +preexistente, I-TREATMENT +edad I-TREATMENT +superior I-TREATMENT +a I-TREATMENT +50 I-TREATMENT +años I-TREATMENT +y I-TREATMENT +afectación I-TREATMENT +pulmonar I-TREATMENT +bilateral I-TREATMENT +en I-TREATMENT +la I-TREATMENT +radiografía I-TREATMENT +de I-TREATMENT +tórax. I-TREATMENT + I-TREATMENT +En B-EXPLORATION la I-EXPLORATION -frecuente I-EXPLORATION -asociación I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -ambos I-EXPLORATION -procesos I-EXPLORATION +tórax I-EXPLORATION +presentó I-EXPLORATION +cuadro I-EXPLORATION +indicativo I-EXPLORATION +de I-EXPLORATION +neumonía I-EXPLORATION +intersticial I-EXPLORATION +bilateral I-EXPLORATION +difusa, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +acompañó I-EXPLORATION +de I-EXPLORATION +extensas I-EXPLORATION +manifestaciones I-EXPLORATION +de I-EXPLORATION +alveolitis I-EXPLORATION +exudativa I-EXPLORATION con I-EXPLORATION -colestasis, I-EXPLORATION -sobre I-EXPLORATION -todo I-EXPLORATION +ensanchamiento I-EXPLORATION +mediastínico I-EXPLORATION +superior, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +adenopatías I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +cadenas I-EXPLORATION +paratraqueales I-EXPLORATION +derecha I-EXPLORATION +e I-EXPLORATION +izquierda. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +hemograma I-EXPLORATION +no I-EXPLORATION +había I-EXPLORATION +eosinofilia I-EXPLORATION en I-EXPLORATION -mujeres I-EXPLORATION -obesas I-EXPLORATION -y I-EXPLORATION -multíparas, I-EXPLORATION -condiciones I-EXPLORATION -que I-EXPLORATION -cumplía I-EXPLORATION -la I-EXPLORATION -paciente. I-EXPLORATION -Ante I-EXPLORATION la I-EXPLORATION -evolución I-EXPLORATION -analítica I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -antecedentes I-EXPLORATION -de I-EXPLORATION -cólicos I-EXPLORATION -biliares, I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -segunda I-EXPLORATION -ecografía I-EXPLORATION -que, I-EXPLORATION +fórmula I-EXPLORATION +leucocitaria I-EXPLORATION +ni I-EXPLORATION +leucocitosis, I-EXPLORATION +esperable I-EXPLORATION en I-EXPLORATION -esta I-EXPLORATION -ocasión, I-EXPLORATION -confirmó I-EXPLORATION +una I-EXPLORATION +infección I-EXPLORATION +parasitaria; I-EXPLORATION +además, I-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION +recuento I-EXPLORATION de I-EXPLORATION -colelitiasis. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -frotis I-EXPLORATION -nasofaríngeo I-EXPLORATION +leucocitos I-EXPLORATION +tampoco I-EXPLORATION +fue I-EXPLORATION +llamativo. I-EXPLORATION +Se I-EXPLORATION +observó I-EXPLORATION +antígeno I-EXPLORATION para I-EXPLORATION -gripe I-EXPLORATION -resultó I-EXPLORATION -negativo I-EXPLORATION -y I-EXPLORATION +neumococo I-EXPLORATION +positivo I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -hemocultivo I-EXPLORATION -se I-EXPLORATION -aisló I-EXPLORATION -Listeria I-EXPLORATION -monocytogenes I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -ampicilina, I-EXPLORATION -gentamicina I-EXPLORATION -y I-EXPLORATION -penicilina I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT +análisis I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION +y B-TREATMENT se I-TREATMENT -suspendió I-TREATMENT -oseltamivir I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +linezolid, I-TREATMENT +cefotaxima I-TREATMENT y I-TREATMENT -se I-TREATMENT -continuó I-TREATMENT +fluconazol, I-TREATMENT +ventilación I-TREATMENT +no I-TREATMENT +invasiva I-TREATMENT con I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -pautado. I-TREATMENT -Así I-TREATMENT -mismo, I-TREATMENT +ventilación I-TREATMENT +con I-TREATMENT +presión I-TREATMENT +positiva I-TREATMENT +continua I-TREATMENT +de I-TREATMENT ++7 I-TREATMENT +cmH2O I-TREATMENT +y I-TREATMENT +asistencia I-TREATMENT +inspiratoria I-TREATMENT +de I-TREATMENT ++15cm I-TREATMENT +H2O I-TREATMENT +y I-TREATMENT +FiO2 I-TREATMENT +al I-TREATMENT +60%, I-TREATMENT +que I-TREATMENT se I-TREATMENT -suspendió I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT +alternó I-TREATMENT con I-TREATMENT -preparados I-TREATMENT -orales I-TREATMENT +períodos I-TREATMENT de I-TREATMENT -hierro. I-TREATMENT - I-TREATMENT -La B-EVOLUTION +oxigenoterapia I-TREATMENT +con I-TREATMENT +Ventimask. I-TREATMENT +Progresivamente, B-EVOLUTION +el I-EVOLUTION paciente I-EVOLUTION presentó I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -tórpida I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -colestasis I-EVOLUTION +un I-EVOLUTION +deterioro I-EVOLUTION +general I-EVOLUTION con I-EVOLUTION -descenso I-EVOLUTION -parcial I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -transaminasas I-EVOLUTION +sepsis I-EVOLUTION +grave I-EVOLUTION y I-EVOLUTION -episodios I-EVOLUTION -aislados I-EVOLUTION -de I-EVOLUTION -prurito I-EVOLUTION -a I-EVOLUTION -pesar I-EVOLUTION -del I-EVOLUTION -tratamiento. I-EVOLUTION - I-EVOLUTION -Las I-EVOLUTION -determinaciones I-EVOLUTION -analíticas I-EVOLUTION -sucesivas I-EVOLUTION -evidenciaron I-EVOLUTION -modificaciones I-EVOLUTION +disfunción I-EVOLUTION +multiorgánica, I-EVOLUTION con I-EVOLUTION -elevaciones I-EVOLUTION -y I-EVOLUTION -descensos I-EVOLUTION -de I-EVOLUTION -transaminasas I-EVOLUTION -y I-EVOLUTION -ácidos I-EVOLUTION -biliares, I-EVOLUTION -tal I-EVOLUTION -y I-EVOLUTION -como I-EVOLUTION -se I-EVOLUTION -recoge I-EVOLUTION -en I-EVOLUTION la I-EVOLUTION -tabla I-EVOLUTION -1. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -cuadro I-EVOLUTION +presencia I-EVOLUTION de I-EVOLUTION -listeriosis I-EVOLUTION -presentó I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -favorable, I-EVOLUTION -permaneciendo I-EVOLUTION -apirética I-EVOLUTION -y I-EVOLUTION -evidenciándose I-EVOLUTION -el I-EVOLUTION -descenso I-EVOLUTION -paulatino I-EVOLUTION +shock, I-EVOLUTION +necesidad I-EVOLUTION de I-EVOLUTION -PCR I-EVOLUTION -desde I-EVOLUTION -el I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -antibiótico. I-EVOLUTION - I-EVOLUTION +inotropos I-EVOLUTION +y I-EVOLUTION +vasopresores I-EVOLUTION +para I-EVOLUTION +conseguir I-EVOLUTION +una I-EVOLUTION +PAM I-EVOLUTION +>60mmHg, I-EVOLUTION +insuficiencia I-EVOLUTION +renal I-EVOLUTION +aguda I-EVOLUTION +que B-TREATMENT +requirió I-TREATMENT +hemodiafiltración I-TREATMENT +venovenosa I-TREATMENT +continua I-TREATMENT +e I-TREATMENT +insuficiencia I-TREATMENT +respiratoria I-TREATMENT +con I-TREATMENT +necesidad I-TREATMENT +de I-TREATMENT +intubación I-TREATMENT +orotraqueal I-TREATMENT +y I-TREATMENT +ventilación I-TREATMENT +mecánica. I-TREATMENT +Ante I-TREATMENT +este I-TREATMENT +deterioro, I-TREATMENT +se I-TREATMENT +sospechó I-TREATMENT +de I-TREATMENT +la I-TREATMENT +existencia I-TREATMENT +de I-TREATMENT +una I-TREATMENT +sobreinfección I-TREATMENT +bacteriana I-TREATMENT +o I-TREATMENT +por I-TREATMENT +hongos I-TREATMENT +concomitantes, I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +llevó I-TREATMENT +al I-TREATMENT +cambio I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +(imipenem, I-TREATMENT +linezolid I-TREATMENT +y I-TREATMENT +anidulofungina) I-TREATMENT +y I-TREATMENT +extracción I-TREATMENT +de I-TREATMENT +nuevas I-TREATMENT +muestras I-TREATMENT +microbiológicas: I-TREATMENT +broncoaspirado I-TREATMENT +(BAS), I-TREATMENT +hemocultivo I-TREATMENT +y I-TREATMENT +urinocultivo. I-TREATMENT +Fue I-TREATMENT +en I-TREATMENT +este I-TREATMENT +último I-TREATMENT +BAS I-TREATMENT +donde I-TREATMENT +se I-TREATMENT +observaron I-TREATMENT +larvas I-TREATMENT +de I-TREATMENT +Ss, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +añadió I-TREATMENT +al I-TREATMENT +tratamiento I-TREATMENT +ivermectina I-TREATMENT +(16,5mg/24h) I-TREATMENT +por I-TREATMENT +sonda I-TREATMENT +nasogástrica I-TREATMENT +(SNG). I-TREATMENT +Tras I-TREATMENT +repetir I-TREATMENT +a I-TREATMENT +las I-TREATMENT +48h I-TREATMENT +los I-TREATMENT +cultivos I-TREATMENT +biológicos I-TREATMENT +y I-TREATMENT +mostrar I-TREATMENT +la I-TREATMENT +presencia I-TREATMENT +de I-TREATMENT +larvas I-TREATMENT +de I-TREATMENT +Ss I-TREATMENT +aún I-TREATMENT +activas I-TREATMENT +en I-TREATMENT +BAS, I-TREATMENT +jugo I-TREATMENT +gástrico I-TREATMENT +y I-TREATMENT +heces, I-TREATMENT +se I-TREATMENT +asoció I-TREATMENT +al I-TREATMENT +tratamiento I-TREATMENT +albendazol I-TREATMENT +(400mg/24h) I-TREATMENT +por I-TREATMENT +SNG. I-TREATMENT Se B-EXPLORATION realizó I-EXPLORATION +posterior I-EXPLORATION control I-EXPLORATION -de I-EXPLORATION -bienestar I-EXPLORATION -fetal I-EXPLORATION -seriado I-EXPLORATION -mediante I-EXPLORATION -ecografía I-EXPLORATION -obstétrica I-EXPLORATION -y I-EXPLORATION -registro I-EXPLORATION -cardiotocográfico I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -semana I-EXPLORATION -32+ I-EXPLORATION -4, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -inició I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -espontánea I-EXPLORATION -el I-EXPLORATION -trabajo I-EXPLORATION -de I-EXPLORATION -parto I-EXPLORATION +microbiológico I-EXPLORATION tras I-EXPLORATION -completar I-EXPLORATION -14 I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION +48h I-EXPLORATION +del I-EXPLORATION tratamiento I-EXPLORATION -con I-EXPLORATION -ampicilina I-EXPLORATION +combinado, I-EXPLORATION y I-EXPLORATION -7 I-EXPLORATION -días I-EXPLORATION -con I-EXPLORATION -gentamicina, I-EXPLORATION -ambas I-EXPLORATION -por I-EXPLORATION -vía I-EXPLORATION -endovenosa. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -comprobó I-EXPLORATION -bienestar I-EXPLORATION -fetal I-EXPLORATION -intraparto I-EXPLORATION -mediante I-EXPLORATION -monitorización I-EXPLORATION -maternofetal, I-EXPLORATION -objetivando I-EXPLORATION -líquido I-EXPLORATION -amniótico I-EXPLORATION -meconial. I-EXPLORATION -El B-EVOLUTION -parto I-EVOLUTION +se I-EXPLORATION +observaron I-EXPLORATION +en I-EXPLORATION +BAS I-EXPLORATION +Ss I-EXPLORATION +inactivos. I-EXPLORATION +Sin B-EVOLUTION +embargo, I-EVOLUTION +la I-EVOLUTION +evolución I-EVOLUTION +posterior I-EVOLUTION fue I-EVOLUTION -eutócico, I-EVOLUTION -obteniendo I-EVOLUTION -una I-EVOLUTION -niña I-EVOLUTION de I-EVOLUTION -2.225 I-EVOLUTION -g I-EVOLUTION -de I-EVOLUTION -peso, I-EVOLUTION -test I-EVOLUTION +síndrome I-EVOLUTION de I-EVOLUTION -Apgar I-EVOLUTION -9/10 I-EVOLUTION +distrés I-EVOLUTION +respiratorio I-EVOLUTION +agudo I-EVOLUTION +(SDRA) I-EVOLUTION +con I-EVOLUTION +hipoxemia I-EVOLUTION +grave I-EVOLUTION y I-EVOLUTION -pH I-EVOLUTION +shock I-EVOLUTION +séptico I-EVOLUTION +refractario I-EVOLUTION +al I-EVOLUTION +soporte I-EVOLUTION +vasoconstrictor I-EVOLUTION +e I-EVOLUTION +inotropo. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +falleció I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +17 I-EVOLUTION +días I-EVOLUTION de I-EVOLUTION -cordón I-EVOLUTION -7, I-EVOLUTION -36 I-EVOLUTION -arterial I-EVOLUTION -y I-EVOLUTION -7, I-EVOLUTION -37 I-EVOLUTION -venoso. I-EVOLUTION - I-EVOLUTION -La I-EVOLUTION -RN I-EVOLUTION -ingresó I-EVOLUTION +su I-EVOLUTION +ingreso I-EVOLUTION en I-EVOLUTION -neonatología I-EVOLUTION -por I-EVOLUTION -prematuridad I-EVOLUTION -y I-EVOLUTION -antecedente I-EVOLUTION -de I-EVOLUTION -listeriosis I-EVOLUTION -materna. I-EVOLUTION -Los B-EXPLORATION -cultivos I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizaron I-EXPLORATION -(frotis I-EXPLORATION -faríngeo, I-EXPLORATION -vermis, I-EXPLORATION -umbilical, I-EXPLORATION -hemocultivo, I-EXPLORATION -urocultivo I-EXPLORATION -y I-EXPLORATION -coprocultivo) I-EXPLORATION -fueron I-EXPLORATION -negativos, I-EXPLORATION -siendo I-EXPLORATION -dada I-EXPLORATION -de I-EXPLORATION -alta I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -10 I-EXPLORATION -días I-EXPLORATION -de I-EXPLORATION -vida. I-EXPLORATION -La B-EVOLUTION -evolución I-EVOLUTION -puerperal I-EVOLUTION -fue I-EVOLUTION -normal I-EVOLUTION -con I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION -del I-EVOLUTION -parto. I-EVOLUTION +nuestra I-EVOLUTION +unidad. I-EVOLUTION I-EVOLUTION -El B-EXPLORATION -examen I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -placenta I-EXPLORATION -evidenció I-EXPLORATION -múltiples I-EXPLORATION -infartos I-EXPLORATION -«sépticos» I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -aisladas I-EXPLORATION -formaciones I-EXPLORATION -bacilares I-EXPLORATION -Gram I-EXPLORATION -positivas, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -estado I-EXPLORATION -de I-EXPLORATION -infección I-EXPLORATION -por I-EXPLORATION -Listeria. I-EXPLORATION - I-EXPLORATION Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS +50 I-PRESENT_ILLNESS años, I-PRESENT_ILLNESS -natural B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Marruecos, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -reside I-PAST_MEDICAL_HISTORY +IRC B-PAST_MEDICAL_HISTORY +terminal I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +nefropatía I-PAST_MEDICAL_HISTORY +diabética I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -España I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +sustitutivo I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +hemodiálisis, I-PAST_MEDICAL_HISTORY +cardiopatía I-PAST_MEDICAL_HISTORY +isquémica I-PAST_MEDICAL_HISTORY +crónica, I-PAST_MEDICAL_HISTORY +miocardiopatía I-PAST_MEDICAL_HISTORY +dilatada I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -intermitente I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -motivos I-PAST_MEDICAL_HISTORY -laborales. I-PAST_MEDICAL_HISTORY -Fue B-PRESENT_ILLNESS -trasladado I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -país I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS +origen I-PAST_MEDICAL_HISTORY +isquémico, I-PAST_MEDICAL_HISTORY +retinopatía I-PAST_MEDICAL_HISTORY +diabética, I-PAST_MEDICAL_HISTORY +accidente I-PAST_MEDICAL_HISTORY +vascular I-PAST_MEDICAL_HISTORY +cerebral I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +años; I-PAST_MEDICAL_HISTORY +ingresa B-PRESENT_ILLNESS +en I-PRESENT_ILLNESS servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS +medicina I-PRESENT_ILLNESS +interna I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -ingresado I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -previos I-PRESENT_ILLNESS -debido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -suboclusivo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -respondió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -médico. I-PRESENT_ILLNESS -En B-TREATMENT -el I-TREATMENT -informe I-TREATMENT -que I-TREATMENT -aportó I-TREATMENT -constaba I-TREATMENT -que I-TREATMENT -se I-TREATMENT -le I-TREATMENT -practicó I-TREATMENT -enterolisis I-TREATMENT -después I-TREATMENT -de I-TREATMENT -un I-TREATMENT -mes I-TREATMENT -de I-TREATMENT -ayuno I-TREATMENT -terapéutico I-TREATMENT -sin I-TREATMENT -observarse I-TREATMENT -mejoría. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -postoperatorio I-EVOLUTION -presentó I-EVOLUTION -retraso I-EVOLUTION -del I-EVOLUTION -vaciado I-EVOLUTION -gástrico I-EVOLUTION -e I-EVOLUTION -íleo I-EVOLUTION -prolongado, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -tuvo I-EVOLUTION -que I-EVOLUTION -ser I-EVOLUTION -reintervenido. I-EVOLUTION -Se B-TREATMENT -le I-TREATMENT -hizo I-TREATMENT -una I-TREATMENT -colectomía I-TREATMENT -derecha I-TREATMENT -ampliada, I-TREATMENT -anastomosis I-TREATMENT -gastroyeyunal, I-TREATMENT -ileostomía I-TREATMENT -lateral I-TREATMENT -derecha I-TREATMENT -y I-TREATMENT -colostomía I-TREATMENT -lateral I-TREATMENT -izquierda. I-TREATMENT -En B-EXPLORATION +episodio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cetoacidosis I-PRESENT_ILLNESS +diabética. I-PRESENT_ILLNESS +Durante B-EXPLORATION el I-EXPLORATION -informe I-EXPLORATION -anatomopatológico I-EXPLORATION -constaba I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -14 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -íleon I-EXPLORATION -y I-EXPLORATION -140 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -colon I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -extirparon, I-EXPLORATION +ingreso I-EXPLORATION se I-EXPLORATION -observaron I-EXPLORATION -unas I-EXPLORATION -zonas I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -retráctiles I-EXPLORATION -y I-EXPLORATION -otras I-EXPLORATION -muy I-EXPLORATION -dilatadas, I-EXPLORATION -con I-EXPLORATION -zonas I-EXPLORATION -de I-EXPLORATION -mucosa I-EXPLORATION -inflamadas I-EXPLORATION -y I-EXPLORATION -otras I-EXPLORATION -con I-EXPLORATION -extensa I-EXPLORATION -necrosis, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -fibrosis I-EXPLORATION -peritonítica I-EXPLORATION -extensa I-EXPLORATION -y I-EXPLORATION +detectan I-EXPLORATION múltiples I-EXPLORATION -adherencias, I-EXPLORATION -pero I-EXPLORATION -no I-EXPLORATION -encontraron I-EXPLORATION lesiones I-EXPLORATION -específicas. I-EXPLORATION -Después B-TREATMENT -de I-TREATMENT -dos I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -ayuno I-TREATMENT -total I-TREATMENT +maculopapulosas, I-EXPLORATION +eritematosas, I-EXPLORATION +con I-EXPLORATION +zona I-EXPLORATION +descamativa I-EXPLORATION +hiperqueratósica I-EXPLORATION +central, I-EXPLORATION +de I-EXPLORATION +distribución I-EXPLORATION +universal. I-EXPLORATION +Se B-DERIVED_FROM/TO +consulta I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +dermatología, I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +realiza I-DERIVED_FROM/TO +biopsia I-DERIVED_FROM/TO +cutánea I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +las I-DERIVED_FROM/TO +lesiones I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +diagnostica I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +enfermedad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Kyrle. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +49 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +remitida B-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Dermatología I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +carcinoma I-DERIVED_FROM/TO +basocelular I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +columela I-DERIVED_FROM/TO +nasal I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +2 I-DERIVED_FROM/TO +años I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +evolución. I-DERIVED_FROM/TO +Tras B-TREATMENT +resección I-TREATMENT +tumoral I-TREATMENT con I-TREATMENT -fluidoterapia I-TREATMENT -iv I-TREATMENT -por I-TREATMENT -intolerancia I-TREATMENT -a I-TREATMENT +límites I-TREATMENT +negativos I-TREATMENT +en I-TREATMENT la I-TREATMENT -nutrición I-TREATMENT -enteral I-TREATMENT -(NE), I-TREATMENT -y B-EVOLUTION -habiendo I-EVOLUTION -perdido I-EVOLUTION -más I-EVOLUTION -de I-EVOLUTION -25 I-EVOLUTION -kilos I-EVOLUTION +biopsia I-TREATMENT +por I-TREATMENT +congelación, I-TREATMENT +se I-TREATMENT +hizo I-TREATMENT +reconstrucción I-TREATMENT +con I-TREATMENT +colgajo I-TREATMENT +frontal I-TREATMENT +paramediano I-TREATMENT +izquierdo I-TREATMENT +de I-TREATMENT +base I-TREATMENT +estrecha I-TREATMENT +prolongado I-TREATMENT +hacia I-TREATMENT +el I-TREATMENT +mismo I-TREATMENT +lado. I-TREATMENT + I-TREATMENT +El B-EVOLUTION +colgajo I-EVOLUTION +quedó I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +ligera I-EVOLUTION +tensión, I-EVOLUTION +pero I-EVOLUTION +esto I-EVOLUTION +no I-EVOLUTION +produjo I-EVOLUTION +ningún I-EVOLUTION +sufrimiento I-EVOLUTION +ni I-EVOLUTION +necrosis I-EVOLUTION +del I-EVOLUTION +mismo. I-EVOLUTION +Se I-EVOLUTION +autonomizó I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +3 I-EVOLUTION +semanas I-EVOLUTION +y I-EVOLUTION +a I-EVOLUTION +pesar I-EVOLUTION de I-EVOLUTION -peso, I-EVOLUTION -el I-EVOLUTION +quedar I-EVOLUTION +un I-EVOLUTION +poco I-EVOLUTION +redundante, I-EVOLUTION +la I-EVOLUTION paciente I-EVOLUTION -solicitó I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -voluntaria I-EVOLUTION -para I-EVOLUTION -trasladarse I-EVOLUTION -a I-EVOLUTION -España. I-EVOLUTION +se I-EVOLUTION +mostró I-EVOLUTION +satisfecha I-EVOLUTION +y I-EVOLUTION +no I-EVOLUTION +quiso I-EVOLUTION +otro I-EVOLUTION +procedimiento. I-EVOLUTION I-EVOLUTION -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -refería I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cuadros I-PAST_MEDICAL_HISTORY -suboclusivos I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY -resueltos I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -médico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -intervenciones I-PAST_MEDICAL_HISTORY -quirúrgicas: I-PAST_MEDICAL_HISTORY -laparoscopia I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -resección I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vólvulo I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -13 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -resección I-PAST_MEDICAL_HISTORY -duodenal I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -gastroenteroanastomosis I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -29 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -drenaje I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -absceso I-PAST_MEDICAL_HISTORY -perihepático I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -afectación I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -pared I-PAST_MEDICAL_HISTORY -intercostal I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -probable I-PAST_MEDICAL_HISTORY -perforación I-PAST_MEDICAL_HISTORY -duodenal I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -etiología I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -filiada I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -30 I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Entre B-FAMILY_HISTORY -los I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -destacaba I-FAMILY_HISTORY -un I-FAMILY_HISTORY -hermano I-FAMILY_HISTORY -fallecido I-FAMILY_HISTORY -a I-FAMILY_HISTORY -los I-FAMILY_HISTORY -39 I-FAMILY_HISTORY -años I-FAMILY_HISTORY -en I-FAMILY_HISTORY -una I-FAMILY_HISTORY -cirugía I-FAMILY_HISTORY -abdominal I-FAMILY_HISTORY -urgente I-FAMILY_HISTORY -(supuestamente I-FAMILY_HISTORY -por I-FAMILY_HISTORY -cáncer I-FAMILY_HISTORY -de I-FAMILY_HISTORY -colon I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -ser I-FAMILY_HISTORY -documentado I-FAMILY_HISTORY -por I-FAMILY_HISTORY -autopsia) I-FAMILY_HISTORY -e I-FAMILY_HISTORY -hijo I-FAMILY_HISTORY -de I-FAMILY_HISTORY -8 I-FAMILY_HISTORY -años I-FAMILY_HISTORY -con I-FAMILY_HISTORY -cuadros I-FAMILY_HISTORY -suboclusivos I-FAMILY_HISTORY -similares I-FAMILY_HISTORY -a I-FAMILY_HISTORY -los I-FAMILY_HISTORY -que I-FAMILY_HISTORY -presenta I-FAMILY_HISTORY -el I-FAMILY_HISTORY -paciente I-FAMILY_HISTORY -desde I-FAMILY_HISTORY -su I-FAMILY_HISTORY -infancia. I-FAMILY_HISTORY - I-FAMILY_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -presentaba I-EXPLORATION -mal I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -desnutrición I-EXPLORATION -severa I-EXPLORATION -y I-EXPLORATION -anasarca, I-EXPLORATION -y I-EXPLORATION -edemas I-EXPLORATION -con I-EXPLORATION -fóvea I-EXPLORATION -hasta I-EXPLORATION -rodillas. I-EXPLORATION -Abdomen I-EXPLORATION -blando I-EXPLORATION -y I-EXPLORATION -depresible I-EXPLORATION -con I-EXPLORATION -molestias I-EXPLORATION -difusas I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +21 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +quien I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +volumen I-PRESENT_ILLNESS +cervical. I-PRESENT_ILLNESS +El B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +bocio I-EXPLORATION +difuso I-EXPLORATION a I-EXPLORATION la I-EXPLORATION palpación I-EXPLORATION y I-EXPLORATION -peristaltismo I-EXPLORATION -ausente. I-EXPLORATION -No I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal. I-EXPLORATION -Dos I-EXPLORATION -estomas I-EXPLORATION -sin I-EXPLORATION -contenido I-EXPLORATION -en I-EXPLORATION -línea I-EXPLORATION -de I-EXPLORATION -laparatomía I-EXPLORATION -media. I-EXPLORATION -Peso I-EXPLORATION -58, I-EXPLORATION -6 I-EXPLORATION -Kg I-EXPLORATION -(IMC I-EXPLORATION -16, I-EXPLORATION -2 I-EXPLORATION -Kg/m2). I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION +sus I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION +laboratorio I-EXPLORATION +revelaron I-EXPLORATION +hormonas I-EXPLORATION +tiroideas I-EXPLORATION +normales I-EXPLORATION y I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -fue I-EXPLORATION -normal, I-EXPLORATION -salvo I-EXPLORATION -los I-EXPLORATION -parámetros I-EXPLORATION -analíticos. I-EXPLORATION - I-EXPLORATION -Fue I-EXPLORATION -ingresado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -servicio I-EXPLORATION -de I-EXPLORATION -Cirugía; I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -colocó I-EXPLORATION -una I-EXPLORATION -sonda I-EXPLORATION +anticuerpos I-EXPLORATION +anti-tiroglobulina I-EXPLORATION +(AAT) I-EXPLORATION +positivos. I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +tiroidea I-EXPLORATION +reveló I-EXPLORATION +tres I-EXPLORATION +nódulos I-EXPLORATION +tiroideos, I-EXPLORATION +el I-EXPLORATION +mayor I-EXPLORATION de I-EXPLORATION -aspiración, I-EXPLORATION -se I-EXPLORATION -pautó I-EXPLORATION -antieméticos I-EXPLORATION -y I-EXPLORATION -procinéticos, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -comenzó I-EXPLORATION -a I-EXPLORATION -renutrir I-EXPLORATION -progresivamente I-EXPLORATION +7 I-EXPLORATION +mm I-EXPLORATION con I-EXPLORATION -nutrición I-EXPLORATION -parenteral I-EXPLORATION -total I-EXPLORATION -(NPT). I-EXPLORATION -Se B-EVOLUTION -mantuvo I-EVOLUTION -la I-EVOLUTION -NPT I-EVOLUTION -durante I-EVOLUTION -dos I-EVOLUTION -meses I-EVOLUTION -hasta I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -pasó I-EVOLUTION -a I-EVOLUTION -NE I-EVOLUTION -continua, I-EVOLUTION -y I-EVOLUTION -finalmente, I-EVOLUTION -se I-EVOLUTION -pudo I-EVOLUTION -retirar I-EVOLUTION -la I-EVOLUTION -sonda I-EVOLUTION +microcalcificaciones I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +interior. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +punción-biopsia I-EXPLORATION +bajo I-EXPLORATION +ecografía, I-EXPLORATION +demostrándose I-EXPLORATION +cáncer I-EXPLORATION +papilar I-EXPLORATION +del I-EXPLORATION +tiroides. I-EXPLORATION +Se B-TREATMENT +sometió I-TREATMENT +a I-TREATMENT +tiroidectomía I-TREATMENT +total, I-TREATMENT +resultando I-TREATMENT +un I-TREATMENT +foco I-TREATMENT +de I-TREATMENT +cáncer I-TREATMENT +papilar I-TREATMENT +de I-TREATMENT +6x5x5 I-TREATMENT +mm I-TREATMENT +y I-TREATMENT +metástasis I-TREATMENT +paratraqueales I-TREATMENT +bilaterales. I-TREATMENT +Recibió I-TREATMENT +200 I-TREATMENT +mCi I-TREATMENT +de I-TREATMENT +radioyodo I-TREATMENT +con I-TREATMENT +rastreo I-TREATMENT +sistémico I-TREATMENT +post-dosis I-TREATMENT +terapéutica I-TREATMENT +negativo. I-TREATMENT +Se I-TREATMENT +mantuvo I-TREATMENT +con I-TREATMENT +dosis I-TREATMENT +supresiva I-TREATMENT +de I-TREATMENT +levotiroxina I-TREATMENT +(Eutirox®). I-TREATMENT + I-TREATMENT +Al B-EVOLUTION +año I-EVOLUTION de I-EVOLUTION -aspiración I-EVOLUTION -e I-EVOLUTION -introducir I-EVOLUTION -nutrición I-EVOLUTION -oral I-EVOLUTION +seguimiento I-EVOLUTION +se I-EVOLUTION +realizó I-EVOLUTION +un I-EVOLUTION +nuevo I-EVOLUTION +rastreo I-EVOLUTION +sistémico I-EVOLUTION con I-EVOLUTION -ayuda I-EVOLUTION +dosis I-EVOLUTION +trazadora I-EVOLUTION de I-EVOLUTION -procinéticos I-EVOLUTION -y I-EVOLUTION -medidas I-EVOLUTION -higiénico-dietéticas I-EVOLUTION -favorecedoras I-EVOLUTION -del I-EVOLUTION -peristaltismo. I-EVOLUTION -A I-EVOLUTION -las I-EVOLUTION -14 I-EVOLUTION -semanas I-EVOLUTION -del I-EVOLUTION -ingreso I-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -dio I-EVOLUTION +10 I-EVOLUTION +mCi, I-EVOLUTION +resultando I-EVOLUTION +negativo, I-EVOLUTION +la I-EVOLUTION +tiroglobulina I-EVOLUTION +no I-EVOLUTION +fue I-EVOLUTION de I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -peso I-EVOLUTION +utilidad I-EVOLUTION +dado I-EVOLUTION +la I-EVOLUTION +presencia I-EVOLUTION de I-EVOLUTION -79 I-EVOLUTION -Kg I-EVOLUTION -(IMC I-EVOLUTION -21, I-EVOLUTION -9 I-EVOLUTION -Kg/m2). I-EVOLUTION - I-EVOLUTION -Tres I-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -vuelve I-EVOLUTION -a I-EVOLUTION -ingresar I-EVOLUTION -en I-EVOLUTION +anticuerpos I-EVOLUTION +AAT: I-EVOLUTION +164 I-EVOLUTION +ng/mL. I-EVOLUTION +En I-EVOLUTION el I-EVOLUTION -servicio I-EVOLUTION -de I-EVOLUTION -Cirugía I-EVOLUTION -por I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION +segundo I-EVOLUTION +año I-EVOLUTION de I-EVOLUTION -deshidratación I-EVOLUTION -hiponatrémica I-EVOLUTION -severa I-EVOLUTION -debido I-EVOLUTION -al I-EVOLUTION -aumento I-EVOLUTION -del I-EVOLUTION -débito I-EVOLUTION +seguimiento I-EVOLUTION por I-EVOLUTION -ileostomía I-EVOLUTION -de I-EVOLUTION -unos I-EVOLUTION -3-4 I-EVOLUTION -litros/día I-EVOLUTION -e I-EVOLUTION -intolerancia I-EVOLUTION -oral I-EVOLUTION +ecografía I-EVOLUTION +cervical, I-EVOLUTION +se I-EVOLUTION +detectó I-EVOLUTION +la I-EVOLUTION +aparición I-EVOLUTION de I-EVOLUTION -varios I-EVOLUTION -días I-EVOLUTION +un I-EVOLUTION +nódulo I-EVOLUTION de I-EVOLUTION -evolución; I-EVOLUTION -episodio I-EVOLUTION -que I-EVOLUTION +9, I-EVOLUTION +6 I-EVOLUTION +mm, I-EVOLUTION +el I-EVOLUTION +cual I-EVOLUTION +no I-EVOLUTION fue I-EVOLUTION -relacionado I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -suboclusivo I-EVOLUTION -según I-EVOLUTION -los I-EVOLUTION -resultados I-EVOLUTION +técnicamente I-EVOLUTION +posible I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -pruebas I-EVOLUTION -complementarias I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -hicieron. I-EVOLUTION -Se I-EVOLUTION -le I-EVOLUTION -corrigieron I-EVOLUTION -las I-EVOLUTION -alteraciones I-EVOLUTION -hidroelectolíticas I-EVOLUTION +puncionar, I-EVOLUTION que I-EVOLUTION -presentaba, I-EVOLUTION -y I-EVOLUTION -ante I-EVOLUTION -la I-EVOLUTION -intolerancia I-EVOLUTION -oral, I-EVOLUTION -se I-EVOLUTION -comenzó I-EVOLUTION -al I-EVOLUTION -tercer I-EVOLUTION -día I-EVOLUTION -del I-EVOLUTION -ingreso I-EVOLUTION -la I-EVOLUTION -NPT I-EVOLUTION -y I-EVOLUTION se I-EVOLUTION -mantuvo I-EVOLUTION +asoció I-EVOLUTION +a I-EVOLUTION +un I-EVOLUTION +aumento I-EVOLUTION +de I-EVOLUTION los I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -siguientes. I-EVOLUTION - I-EVOLUTION -En B-TREATMENT -el I-TREATMENT -cuarto I-TREATMENT -mes I-TREATMENT -del I-TREATMENT -segundo I-TREATMENT -ingreso, I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT +títulos I-EVOLUTION +de I-EVOLUTION +AAT I-EVOLUTION +174 I-EVOLUTION +ng/mL. I-EVOLUTION +Se B-TREATMENT +decidió I-TREATMENT +dar I-TREATMENT una I-TREATMENT -enterolisis I-TREATMENT +nueva I-TREATMENT +dosis I-TREATMENT +terapéutica I-TREATMENT de I-TREATMENT -todo I-TREATMENT -el I-TREATMENT -paquete I-TREATMENT -intestinal, I-TREATMENT -se I-TREATMENT -desmontó I-TREATMENT -la I-TREATMENT -gastroenteroanastomosis I-TREATMENT -previa, I-TREATMENT -se I-TREATMENT -resecó I-TREATMENT -el I-TREATMENT -intestino I-TREATMENT -delgado I-TREATMENT +200 I-TREATMENT +mCi I-TREATMENT +con I-TREATMENT +rastreo I-TREATMENT +que I-TREATMENT +mostró I-TREATMENT +captación I-TREATMENT a I-TREATMENT -unos I-TREATMENT -40-50 I-TREATMENT -cm I-TREATMENT -del I-TREATMENT -ángulo I-TREATMENT -de I-TREATMENT -Treiz I-TREATMENT -y I-TREATMENT -se I-TREATMENT -extirparon I-TREATMENT -80 I-TREATMENT -y I-TREATMENT -130 I-TREATMENT -cm I-TREATMENT -de I-TREATMENT -íleon I-TREATMENT -de I-TREATMENT -sendos I-TREATMENT -extremos, I-TREATMENT -se I-TREATMENT -liberó I-TREATMENT -el I-TREATMENT -colon I-TREATMENT -y I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT +nivel I-TREATMENT +cervical. I-TREATMENT + I-TREATMENT +En B-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +al I-EXPLORATION +año I-EXPLORATION +post I-EXPLORATION +segunda I-EXPLORATION +dosis I-EXPLORATION +de I-EXPLORATION +radioyodo, I-EXPLORATION +se I-EXPLORATION +detectó I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +de I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +supraesternal I-EXPLORATION +central I-EXPLORATION +y I-EXPLORATION +3 I-EXPLORATION +ganglios I-EXPLORATION +de I-EXPLORATION +1 I-EXPLORATION +cm I-EXPLORATION +cada I-EXPLORATION +uno, I-EXPLORATION +en I-EXPLORATION +cadena I-EXPLORATION +cervical I-EXPLORATION +izquierda, I-EXPLORATION +sugerentes I-EXPLORATION +de I-EXPLORATION +neoplasia, I-EXPLORATION +contralaterales I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +primaria, I-EXPLORATION +asociado I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +ascenso I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +AAT I-EXPLORATION +a I-EXPLORATION +217 I-EXPLORATION +ng/mL. I-EXPLORATION +Se B-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT una I-TREATMENT -anastomosis I-TREATMENT -íleo-cólica I-TREATMENT -latero-lateral I-TREATMENT -mecánica. I-TREATMENT -Dos I-TREATMENT -meses I-TREATMENT -después, I-TREATMENT -tuvo I-TREATMENT -que I-TREATMENT -ser I-TREATMENT -reintervenido I-TREATMENT -por I-TREATMENT -mal I-TREATMENT -paso I-TREATMENT -en I-TREATMENT -anastomosis, I-TREATMENT -se I-TREATMENT -resecó I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -anastomótica I-TREATMENT -anterior I-TREATMENT +exploración I-TREATMENT +quirúrgica, I-TREATMENT con I-TREATMENT -la I-TREATMENT -extirpación I-TREATMENT +una I-TREATMENT +disección I-TREATMENT +selectiva I-TREATMENT de I-TREATMENT -12 I-TREATMENT -cm I-TREATMENT +cuello I-TREATMENT +bilateral I-TREATMENT de I-TREATMENT -íleon I-TREATMENT +los I-TREATMENT +niveles I-TREATMENT +II, I-TREATMENT +III, I-TREATMENT +IV I-TREATMENT +y I-TREATMENT +Vb I-TREATMENT y I-TREATMENT -se I-TREATMENT -le I-TREATMENT -realizó I-TREATMENT una I-TREATMENT -nueva I-TREATMENT -anastomosis I-TREATMENT -íleo-cólica I-TREATMENT -termino-lateral I-TREATMENT -manual. I-TREATMENT -En B-EXPLORATION +disección I-TREATMENT +del I-TREATMENT +nivel I-TREATMENT +VI I-TREATMENT +izquierdo I-TREATMENT +y I-TREATMENT +pretraqueal. I-TREATMENT +La B-EXPLORATION +biopsia I-EXPLORATION +confirmó I-EXPLORATION el I-EXPLORATION -análisis I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -boca I-EXPLORATION +compromiso I-EXPLORATION +neoplásico I-EXPLORATION +ganglionar I-EXPLORATION de I-EXPLORATION -ileostomía I-EXPLORATION +los I-EXPLORATION +niveles I-EXPLORATION +IV I-EXPLORATION y I-EXPLORATION -colostomía I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -hiperganglionosis I-EXPLORATION -en I-EXPLORATION -plexos I-EXPLORATION -parasimpáticos, I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -ganglios I-EXPLORATION -inmaduros I-EXPLORATION -bcl2+ I-EXPLORATION +Vb I-EXPLORATION +derechos I-EXPLORATION y I-EXPLORATION de I-EXPLORATION -linfocitos I-EXPLORATION -intraepiteliales, I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -intersticiales I-EXPLORATION -de I-EXPLORATION -Cajal, I-EXPLORATION -todo I-EXPLORATION -ello I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -DNIB. I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -8 I-EVOLUTION -meses I-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -dio I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -con I-EVOLUTION -síndrome I-EVOLUTION -de I-EVOLUTION -malabsorción I-EVOLUTION -y I-EVOLUTION -esteatorrea I-EVOLUTION -crónica I-EVOLUTION -secundaria I-EVOLUTION -a I-EVOLUTION -intervenciones I-EVOLUTION -previas, I-EVOLUTION -se I-EVOLUTION -pautaron I-EVOLUTION -medidas I-EVOLUTION -dietéticas I-EVOLUTION -y I-EVOLUTION -enzimas I-EVOLUTION -pancreáticos I-EVOLUTION -en I-EVOLUTION -cada I-EVOLUTION -ingesta, I-EVOLUTION -junto I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -antidiarreico I-EVOLUTION -y I-EVOLUTION -resíncolestiramina I-EVOLUTION -a I-EVOLUTION -demanda. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -18 I-EVOLUTION -meses I-EVOLUTION -acude I-EVOLUTION -a I-EVOLUTION -revisión I-EVOLUTION -con I-EVOLUTION -excelente I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -hace I-EVOLUTION -vida I-EVOLUTION -normal, I-EVOLUTION -sigue I-EVOLUTION -los I-EVOLUTION -consejos I-EVOLUTION -dietéticos I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -indicaron, I-EVOLUTION -hace I-EVOLUTION -2-3 I-EVOLUTION -deposiciones I-EVOLUTION -diarias I-EVOLUTION -no I-EVOLUTION -esteatorreicas, I-EVOLUTION -toma I-EVOLUTION -4-6 I-EVOLUTION -comprimidos I-EVOLUTION -al I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -suplementos I-EVOLUTION -enzimáticos I-EVOLUTION -(Kreon®10000) I-EVOLUTION -y I-EVOLUTION -su I-EVOLUTION -peso I-EVOLUTION -es I-EVOLUTION -90, I-EVOLUTION -5 I-EVOLUTION -kilos I-EVOLUTION -(IMC I-EVOLUTION -25, I-EVOLUTION -1 I-EVOLUTION -Kg/m2). I-EVOLUTION - I-EVOLUTION +los I-EXPLORATION +niveles I-EXPLORATION +IIb, I-EXPLORATION +III, I-EXPLORATION +IV, I-EXPLORATION +Vb I-EXPLORATION +y I-EXPLORATION +VI I-EXPLORATION +izquierdo. I-EXPLORATION +Recibió B-TREATMENT +300 I-TREATMENT +mCi I-TREATMENT +de I-TREATMENT +radioyodo I-TREATMENT +con I-TREATMENT +rastreo I-TREATMENT +post-dosis I-TREATMENT +negativo I-TREATMENT +y I-TREATMENT +los I-TREATMENT +AAT I-TREATMENT +se I-TREATMENT +hicieron I-TREATMENT +negativos I-TREATMENT +con I-TREATMENT +una I-TREATMENT +tiroglobulina I-TREATMENT +(TG) I-TREATMENT +menor I-TREATMENT +de I-TREATMENT +0, I-TREATMENT +2 I-TREATMENT +ng/mL, I-TREATMENT +con I-TREATMENT +85% I-TREATMENT +de I-TREATMENT +recuperación. I-TREATMENT + I-TREATMENT +A B-FAMILY_HISTORY +solicitud I-FAMILY_HISTORY +de I-FAMILY_HISTORY +la I-FAMILY_HISTORY +familia, I-FAMILY_HISTORY +se I-FAMILY_HISTORY +realizó I-FAMILY_HISTORY +estudio I-FAMILY_HISTORY +tiroideo I-FAMILY_HISTORY +a I-FAMILY_HISTORY +padres I-FAMILY_HISTORY +y I-FAMILY_HISTORY +dos I-FAMILY_HISTORY +hermanos I-FAMILY_HISTORY +quienes I-FAMILY_HISTORY +no I-FAMILY_HISTORY +presentaban I-FAMILY_HISTORY +evidencia I-FAMILY_HISTORY +de I-FAMILY_HISTORY +enfermedad. I-FAMILY_HISTORY +La I-FAMILY_HISTORY +madre I-FAMILY_HISTORY +presentó I-FAMILY_HISTORY +en I-FAMILY_HISTORY +la I-FAMILY_HISTORY +ecografía I-FAMILY_HISTORY +tiroidea I-FAMILY_HISTORY +un I-FAMILY_HISTORY +nódulo I-FAMILY_HISTORY +de I-FAMILY_HISTORY +7 I-FAMILY_HISTORY +mm, I-FAMILY_HISTORY +el I-FAMILY_HISTORY +cual I-FAMILY_HISTORY +resultó I-FAMILY_HISTORY +ser I-FAMILY_HISTORY +cáncer I-FAMILY_HISTORY +papilar, I-FAMILY_HISTORY +sin I-FAMILY_HISTORY +compromiso I-FAMILY_HISTORY +capsular I-FAMILY_HISTORY +ni I-FAMILY_HISTORY +ganglionar. I-FAMILY_HISTORY +El I-FAMILY_HISTORY +hermano I-FAMILY_HISTORY +presentó I-FAMILY_HISTORY +2 I-FAMILY_HISTORY +nódulos I-FAMILY_HISTORY +de I-FAMILY_HISTORY +8 I-FAMILY_HISTORY +y I-FAMILY_HISTORY +5 I-FAMILY_HISTORY +mm I-FAMILY_HISTORY +cuyo I-FAMILY_HISTORY +estudio I-FAMILY_HISTORY +con I-FAMILY_HISTORY +biopsia I-FAMILY_HISTORY +fue I-FAMILY_HISTORY +negativo I-FAMILY_HISTORY +para I-FAMILY_HISTORY +células I-FAMILY_HISTORY +neoplásicas I-FAMILY_HISTORY +y I-FAMILY_HISTORY +la I-FAMILY_HISTORY +hermana I-FAMILY_HISTORY +presentó I-FAMILY_HISTORY +signos I-FAMILY_HISTORY +ecográficos I-FAMILY_HISTORY +de I-FAMILY_HISTORY +tiroiditis I-FAMILY_HISTORY +crónica I-FAMILY_HISTORY +con I-FAMILY_HISTORY +AAT I-FAMILY_HISTORY +positivos. I-FAMILY_HISTORY + I-FAMILY_HISTORY Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -83 I-PRESENT_ILLNESS +72 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS con B-PAST_MEDICAL_HISTORY -factores I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -riesgo I-PAST_MEDICAL_HISTORY -vascular I-PAST_MEDICAL_HISTORY -(hipertensión I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dislipemia). I-PAST_MEDICAL_HISTORY -Entre I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -destacaban: I-PAST_MEDICAL_HISTORY -diverticulosis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -colon I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -pólipos I-PAST_MEDICAL_HISTORY -adenomatosos I-PAST_MEDICAL_HISTORY -tubulares. I-PAST_MEDICAL_HISTORY -Había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -intervenida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -amígdalas, I-PAST_MEDICAL_HISTORY -apéndice I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY +artritis I-PAST_MEDICAL_HISTORY +reumatoide I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -eventración I-PAST_MEDICAL_HISTORY -abdominal. I-PAST_MEDICAL_HISTORY -Como B-FAMILY_HISTORY -antecedente I-FAMILY_HISTORY -familiar I-FAMILY_HISTORY -destacaba I-FAMILY_HISTORY -su I-FAMILY_HISTORY -hija I-FAMILY_HISTORY -fallecida I-FAMILY_HISTORY -a I-FAMILY_HISTORY -los I-FAMILY_HISTORY -52 I-FAMILY_HISTORY -años I-FAMILY_HISTORY -de I-FAMILY_HISTORY -cáncer I-FAMILY_HISTORY -gástrico. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Acudió B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS +larga I-PAST_MEDICAL_HISTORY +evolución I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +corticoides I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +tumefacción I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +largo I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +2º I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +3er. I-PRESENT_ILLNESS +radios I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +mano I-PRESENT_ILLNESS +izquierda I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS evolución I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -persistente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hemiabdomen I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -periumbilical I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -predominio I-PRESENT_ILLNESS -postprandial, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nauseas I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -ritmo I-PRESENT_ILLNESS -intestinal I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +punción I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -tendencia I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -estreñimiento I-PRESENT_ILLNESS -exacerbado I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -dicho I-PRESENT_ILLNESS -periodo. I-PRESENT_ILLNESS -Presentaba I-PRESENT_ILLNESS -además I-PRESENT_ILLNESS -anorexia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -ponderal I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +aguja I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +palma I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -7kg. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Estaba B-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con: I-PAST_MEDICAL_HISTORY -artilog I-PAST_MEDICAL_HISTORY -200 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -0-1-0, I-PAST_MEDICAL_HISTORY -enalapril I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -1-0-0, I-PAST_MEDICAL_HISTORY -nerdipina I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -1-0-1, I-PAST_MEDICAL_HISTORY -pantoprazol I-PAST_MEDICAL_HISTORY -40 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -1-0-0, I-PAST_MEDICAL_HISTORY -simvastatina I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -0-0-1, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -venlafaxina I-PAST_MEDICAL_HISTORY -75 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -0-0-1. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY +la I-PRESENT_ILLNESS +mano. I-PRESENT_ILLNESS A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION física I-EXPLORATION -presentaba: I-EXPLORATION -tensión I-EXPLORATION -arterial: I-EXPLORATION -120/80; I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca: I-EXPLORATION -81 I-EXPLORATION -latidos/min. I-EXPLORATION -Afebril. I-EXPLORATION -Regular I-EXPLORATION -estado I-EXPLORATION -general. I-EXPLORATION -Bien I-EXPLORATION -hidratada I-EXPLORATION -y I-EXPLORATION -ligera I-EXPLORATION -palidez I-EXPLORATION -mucocutánea. I-EXPLORATION -Nódulo I-EXPLORATION -supraclavicular I-EXPLORATION -izquierdo, I-EXPLORATION -duro I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación, I-EXPLORATION -móvil, I-EXPLORATION -no I-EXPLORATION -doloroso. I-EXPLORATION -Auscultación I-EXPLORATION -cardiaca I-EXPLORATION -normal. I-EXPLORATION -Auscultación I-EXPLORATION -pulmonar I-EXPLORATION -sin I-EXPLORATION -hallazgos. I-EXPLORATION -Abdomen I-EXPLORATION -blando, I-EXPLORATION -depresible, I-EXPLORATION -doloroso I-EXPLORATION +se I-EXPLORATION +objetiva I-EXPLORATION +dolor I-EXPLORATION a I-EXPLORATION la I-EXPLORATION palpación I-EXPLORATION -profunda I-EXPLORATION en I-EXPLORATION -hemiabdomen I-EXPLORATION -superior I-EXPLORATION +el I-EXPLORATION +trayecto I-EXPLORATION +flexor I-EXPLORATION +del I-EXPLORATION +2º I-EXPLORATION y I-EXPLORATION -periumbilical, I-EXPLORATION -sin I-EXPLORATION -masas I-EXPLORATION -ni I-EXPLORATION -megalias, I-EXPLORATION -peristaltismo I-EXPLORATION -disminuido. I-EXPLORATION -Extremidades I-EXPLORATION -inferiores I-EXPLORATION -sin I-EXPLORATION -edemas I-EXPLORATION -ni I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -trombosis I-EXPLORATION -venosa I-EXPLORATION -profunda. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -exploraciones I-EXPLORATION -complementarias: I-EXPLORATION -radiología I-EXPLORATION -de I-EXPLORATION -tórax: I-EXPLORATION -nódulo I-EXPLORATION -pulmonar I-EXPLORATION +3er. I-EXPLORATION +radios I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +actitud I-EXPLORATION de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION +los I-EXPLORATION +dedos I-EXPLORATION en I-EXPLORATION -LSD. I-EXPLORATION -ECG: I-EXPLORATION -ritmo I-EXPLORATION -sinusal I-EXPLORATION -a I-EXPLORATION -86 I-EXPLORATION -latidos/min. I-EXPLORATION -Analítica I-EXPLORATION -de I-EXPLORATION -sangre: I-EXPLORATION -anemia I-EXPLORATION -microcítica I-EXPLORATION -(Hb: I-EXPLORATION -10 I-EXPLORATION -g/dl I-EXPLORATION -(11,9-16,5), I-EXPLORATION -VCM: I-EXPLORATION -77, I-EXPLORATION -4 I-EXPLORATION -(80,2-99,4). I-EXPLORATION -Leucocitosis I-EXPLORATION -con I-EXPLORATION -neutrofilia I-EXPLORATION -(20.000 I-EXPLORATION -leucocitos/ml I-EXPLORATION -(3,5-10,5) I-EXPLORATION -con I-EXPLORATION -84% I-EXPLORATION -de I-EXPLORATION -neutrófilos I-EXPLORATION -(37-73). I-EXPLORATION -VSG I-EXPLORATION -67 I-EXPLORATION -mm/h I-EXPLORATION -(2-10). I-EXPLORATION -PCR I-EXPLORATION -150 I-EXPLORATION -mg/l I-EXPLORATION -(0-10). I-EXPLORATION +hiperextensión, I-EXPLORATION +por I-EXPLORATION +probable I-EXPLORATION +rotura I-EXPLORATION +tendinosa. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -completó I-EXPLORATION +Los I-EXPLORATION +hallazgos I-EXPLORATION +ecográficos I-EXPLORATION +revelaron I-EXPLORATION +un I-EXPLORATION +área I-EXPLORATION +hipoecogénica I-EXPLORATION +rodeando I-EXPLORATION +los I-EXPLORATION +tendones I-EXPLORATION +flexores I-EXPLORATION +a I-EXPLORATION +lo I-EXPLORATION +largo I-EXPLORATION +del I-EXPLORATION +2º I-EXPLORATION +y I-EXPLORATION +3er. I-EXPLORATION +radio I-EXPLORATION +desde I-EXPLORATION +la I-EXPLORATION +articulación I-EXPLORATION +metacarpofalángica I-EXPLORATION +hasta I-EXPLORATION +la I-EXPLORATION +falange I-EXPLORATION +distal, I-EXPLORATION +una I-EXPLORATION +desestructuración I-EXPLORATION +del I-EXPLORATION +flexor I-EXPLORATION +profundo I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +sinovial I-EXPLORATION +engrosada I-EXPLORATION +hipervascularizada I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION -analítico I-EXPLORATION -con I-EXPLORATION -perfil I-EXPLORATION -férrico I-EXPLORATION -completo: I-EXPLORATION -hierro I-EXPLORATION -sérico I-EXPLORATION -14 I-EXPLORATION -µg/dl I-EXPLORATION -(37-145 I-EXPLORATION -µg/dl), I-EXPLORATION +doppler I-EXPLORATION +color. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +drenaje I-TREATMENT +abierto I-TREATMENT +de I-TREATMENT +gran I-TREATMENT +cantidad I-TREATMENT +de I-TREATMENT +pus I-TREATMENT +mediante I-TREATMENT +incisiones I-TREATMENT +volares I-TREATMENT +tipo I-TREATMENT +Brunner. I-TREATMENT + I-TREATMENT + +Niña B-PRESENT_ILLNESS +recién I-PRESENT_ILLNESS +nacida I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +forceps I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +gran I-PRESENT_ILLNESS +fractura I-PRESENT_ILLNESS +deprimida I-PRESENT_ILLNESS +frontal I-PRESENT_ILLNESS +derecha I-PRESENT_ILLNESS +mostrada I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +TAC. I-PRESENT_ILLNESS +Fue B-TREATMENT +intervenida I-TREATMENT +de I-TREATMENT +urgencia I-TREATMENT +elevando I-TREATMENT +la I-TREATMENT +depresión. I-TREATMENT +Se B-EVOLUTION +remitió I-EVOLUTION +a I-EVOLUTION +su I-EVOLUTION +domicilio I-EVOLUTION +tras I-EVOLUTION +5 I-EVOLUTION +días I-EVOLUTION +postoperatorio; I-EVOLUTION +tras I-EVOLUTION +dos I-EVOLUTION +años I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +es I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +definitivamente I-EVOLUTION +con I-EVOLUTION +TAC I-EVOLUTION +normal. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +78 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hematoquecia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +otra I-PRESENT_ILLNESS +sintomatología. I-PRESENT_ILLNESS +Destaca B-EXPLORATION +hemiabdomen I-EXPLORATION +derecho I-EXPLORATION +doloroso I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación, I-EXPLORATION +sin I-EXPLORATION +masas, I-EXPLORATION +anemia I-EXPLORATION +ferropénica I-EXPLORATION +(hemoglobina I-EXPLORATION +6, I-EXPLORATION +6 I-EXPLORATION +g/dl I-EXPLORATION +e I-EXPLORATION índice I-EXPLORATION de I-EXPLORATION saturación I-EXPLORATION de I-EXPLORATION transferrina I-EXPLORATION -15% I-EXPLORATION -(20-50%) I-EXPLORATION +de I-EXPLORATION +4 I-EXPLORATION +%) I-EXPLORATION y I-EXPLORATION -ferritina I-EXPLORATION -463 I-EXPLORATION -ng/ml I-EXPLORATION -(valores<30ng/ml I-EXPLORATION -implica I-EXPLORATION -ferropenia). I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -determinó I-EXPLORATION antígeno I-EXPLORATION carcinoembrionario I-EXPLORATION -(CEA) I-EXPLORATION -pensando I-EXPLORATION -en I-EXPLORATION -neoplasias I-EXPLORATION -malignas I-EXPLORATION -gastrointestinales I-EXPLORATION -y I-EXPLORATION -anticuerpos I-EXPLORATION -anti-transglutaminasa I-EXPLORATION -siendo I-EXPLORATION -sus I-EXPLORATION -valores I-EXPLORATION -normales. I-EXPLORATION +normal. I-EXPLORATION I-EXPLORATION -Ante I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -persistencia I-EXPLORATION -del I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -que I-EXPLORATION -requería I-EXPLORATION -de I-EXPLORATION -opiáceos I-EXPLORATION -intravenosos I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -donde I-EXPLORATION +gastroscopia I-EXPLORATION +y I-EXPLORATION +colonoscopia I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -observaron I-EXPLORATION -adenopatías I-EXPLORATION -mesentéricas I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -patológico, I-EXPLORATION -completándose I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -tomografia I-EXPLORATION -axial I-EXPLORATION -computarizada I-EXPLORATION -(TAC) I-EXPLORATION -abdomino-pélvica. I-EXPLORATION - I-EXPLORATION +encuentran I-EXPLORATION +lesiones I-EXPLORATION +potencialmente I-EXPLORATION +sangrantes. I-EXPLORATION En I-EXPLORATION -dicha I-EXPLORATION -TAC I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -engrosamiento I-EXPLORATION -mural I-EXPLORATION -de I-EXPLORATION +el I-EXPLORATION +tránsito I-EXPLORATION +gastrointestinal, I-EXPLORATION un I-EXPLORATION -segmento I-EXPLORATION -de I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION -proximal I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -4, I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION +dudoso I-EXPLORATION +defecto I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -acompañaba I-EXPLORATION +repleción I-EXPLORATION de I-EXPLORATION -múltiples I-EXPLORATION -adenopatías I-EXPLORATION -mesentéricas I-EXPLORATION -con I-EXPLORATION -centro I-EXPLORATION -hipodenso. I-EXPLORATION - I-EXPLORATION +contraste I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +último I-EXPLORATION +asa I-EXPLORATION +ileal. I-EXPLORATION Se I-EXPLORATION -realizó I-EXPLORATION +realiza I-EXPLORATION una I-EXPLORATION -enteroscopia I-EXPLORATION -anterógrada I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -ángulo I-EXPLORATION +cápsula I-EXPLORATION +endoscópica I-EXPLORATION +que I-EXPLORATION +detecta I-EXPLORATION +10 I-EXPLORATION +minutos I-EXPLORATION +antes I-EXPLORATION de I-EXPLORATION -Treitz, I-EXPLORATION +la I-EXPLORATION +primera I-EXPLORATION +imagen I-EXPLORATION +del I-EXPLORATION +ciego I-EXPLORATION +una I-EXPLORATION formación I-EXPLORATION -polipoidea I-EXPLORATION -con I-EXPLORATION -ulceración I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -15 I-EXPLORATION -mm I-EXPLORATION de I-EXPLORATION -diámetro, I-EXPLORATION +aspecto I-EXPLORATION +submucoso I-EXPLORATION +erosionada I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION +1 I-EXPLORATION +cm, I-EXPLORATION +con I-EXPLORATION +sangrado I-EXPLORATION +en I-EXPLORATION +sábana. I-EXPLORATION + I-EXPLORATION +Ante I-EXPLORATION +este I-EXPLORATION +hallazgo I-EXPLORATION se I-EXPLORATION -tomaron I-EXPLORATION -biopsias. I-EXPLORATION +decide I-EXPLORATION +una I-EXPLORATION +exploración I-EXPLORATION +quirúrgica. I-EXPLORATION Se I-EXPLORATION -introdujo I-EXPLORATION -el I-EXPLORATION -endoscopio I-EXPLORATION -hasta I-EXPLORATION -yeyuno I-EXPLORATION -proximal I-EXPLORATION -(50-60 I-EXPLORATION -cm I-EXPLORATION -distales I-EXPLORATION +identifica I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +superficie I-EXPLORATION +del I-EXPLORATION +intestino I-EXPLORATION a I-EXPLORATION -píloro) I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -tomaron I-EXPLORATION -biopsias I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -neoformación I-EXPLORATION -ulcerada, I-EXPLORATION -rígida I-EXPLORATION -y I-EXPLORATION -friable, I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -4 I-EXPLORATION +70 I-EXPLORATION cm I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -ocupaba I-EXPLORATION -la I-EXPLORATION -mitad I-EXPLORATION -de I-EXPLORATION la I-EXPLORATION -circunferencia, I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -4 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -impidió I-EXPLORATION +válvula I-EXPLORATION +ileocecal I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +< I-EXPLORATION +1 I-EXPLORATION +cm, I-EXPLORATION +rosada I-EXPLORATION +sobre I-EXPLORATION +mucosa I-EXPLORATION +pálida; I-EXPLORATION +sin I-EXPLORATION +otras I-EXPLORATION +lesiones I-EXPLORATION +ni I-EXPLORATION +adenopatías I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -paso I-EXPLORATION -del I-EXPLORATION -endoscopio. I-EXPLORATION -A I-EXPLORATION -unos I-EXPLORATION -30 I-EXPLORATION -cm I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -píloro I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -otra I-EXPLORATION -zona I-EXPLORATION -ulcerada, I-EXPLORATION -rígida, I-EXPLORATION +asas, I-EXPLORATION +mesenterio I-EXPLORATION +y I-EXPLORATION +cavidad I-EXPLORATION +abdominal. I-EXPLORATION +Se B-TREATMENT +realiza I-TREATMENT +una I-TREATMENT +enterectomía I-TREATMENT +de I-TREATMENT +7 I-TREATMENT +cm I-TREATMENT +con I-TREATMENT +márgenes I-TREATMENT +de I-TREATMENT +seguridad I-TREATMENT +de I-TREATMENT +3 I-TREATMENT +cm I-TREATMENT +y I-TREATMENT +anastomosis I-TREATMENT +término-terminal. I-TREATMENT + I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION +describe I-EXPLORATION +una I-EXPLORATION +proliferación I-EXPLORATION de I-EXPLORATION -unos I-EXPLORATION -2 I-EXPLORATION -cms I-EXPLORATION +células I-EXPLORATION +eosinófilas I-EXPLORATION +epitelioides I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION +tamaño I-EXPLORATION +irregular I-EXPLORATION +y I-EXPLORATION +nucléolos I-EXPLORATION +prominentes, I-EXPLORATION +formando I-EXPLORATION +lóbulos I-EXPLORATION +y I-EXPLORATION +pequeñas I-EXPLORATION +luces I-EXPLORATION +vasculares I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -biopsió I-EXPLORATION -(C).. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -análisis I-EXPLORATION -histológico I-EXPLORATION -fue I-EXPLORATION -compatible I-EXPLORATION +contienen I-EXPLORATION +hematíes. I-EXPLORATION +La I-EXPLORATION +inmunohistoquímica I-EXPLORATION +CD34+ I-EXPLORATION con I-EXPLORATION -metástasis I-EXPLORATION -yeyunales I-EXPLORATION +índice I-EXPLORATION de I-EXPLORATION -carcinoma I-EXPLORATION -pobremente I-EXPLORATION -diferenciado. I-EXPLORATION -Tanto I-EXPLORATION -la I-EXPLORATION -morfología I-EXPLORATION -como I-EXPLORATION -el I-EXPLORATION -inmunofenotipo I-EXPLORATION -fueron I-EXPLORATION -compatibles I-EXPLORATION +proliferación I-EXPLORATION +Ki67 I-EXPLORATION +del I-EXPLORATION +20 I-EXPLORATION +% I-EXPLORATION +traduce I-EXPLORATION +malignidad I-EXPLORATION +intermedia, I-EXPLORATION +siendo I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -carcinoma I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -grandes I-EXPLORATION -de I-EXPLORATION -pulmón. I-EXPLORATION - I-EXPLORATION -Inmunofenotipo: I-EXPLORATION -citoqueratinas I-EXPLORATION -AE1-AE3: I-EXPLORATION -(+); I-EXPLORATION -S100, I-EXPLORATION -HMB I-EXPLORATION -45: I-EXPLORATION -(-); I-EXPLORATION -citoqueratina I-EXPLORATION -20: I-EXPLORATION -(-), I-EXPLORATION -citoqueratina I-EXPLORATION -7: I-EXPLORATION -(+); I-EXPLORATION -TTF1: I-EXPLORATION -(-); I-EXPLORATION -napsina: I-EXPLORATION -(-); I-EXPLORATION -vimentina: I-EXPLORATION -(+); I-EXPLORATION -p63: I-EXPLORATION -(+); I-EXPLORATION -cd10: I-EXPLORATION -(-); I-EXPLORATION -WT1: I-EXPLORATION -(-) I-EXPLORATION -; I-EXPLORATION -GCDFP I-EXPLORATION -15: I-EXPLORATION -(-); I-EXPLORATION -citoqueratina I-EXPLORATION -19: I-EXPLORATION -(+); I-EXPLORATION -citoqueratina I-EXPLORATION -5-6: I-EXPLORATION -(-), I-EXPLORATION -citoqueratina I-EXPLORATION -34 I-EXPLORATION -beta I-EXPLORATION -12; I-EXPLORATION -CDX2: I-EXPLORATION -(-). I-EXPLORATION +un I-EXPLORATION +hemangioendotelioma. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -completó I-EXPLORATION -el I-EXPLORATION +El I-EXPLORATION estudio I-EXPLORATION -con I-EXPLORATION -TAC I-EXPLORATION -torácico I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -pulmonar I-EXPLORATION -sólido I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -espiculado I-EXPLORATION -en I-EXPLORATION -apex I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -6 I-EXPLORATION -cm, I-EXPLORATION -de I-EXPLORATION -contacto I-EXPLORATION -pleural; I-EXPLORATION -adenopatías I-EXPLORATION -mediastínicas I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -compartimento I-EXPLORATION -paratraqueal I-EXPLORATION -superiores I-EXPLORATION -e I-EXPLORATION -inferiores I-EXPLORATION -y I-EXPLORATION -pretraqueales, I-EXPLORATION -hiliares I-EXPLORATION -derechas I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -bifurcación I-EXPLORATION -bronquial. I-EXPLORATION -Adenopatías I-EXPLORATION -supraclaviculares I-EXPLORATION -bilaterales. I-EXPLORATION - I-EXPLORATION -Dada B-TREATMENT -la I-TREATMENT -edad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -y I-TREATMENT -el I-TREATMENT -estadio I-TREATMENT -avanzado I-TREATMENT -de I-TREATMENT -la I-TREATMENT -enfermedad I-TREATMENT -y I-TREATMENT -la I-TREATMENT -presentación I-TREATMENT -un I-TREATMENT -ECOG I-TREATMENT -3 I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -tratamiento I-TREATMENT -paliativo, I-TREATMENT -falleciendo I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -a I-TREATMENT -los I-TREATMENT -22 I-TREATMENT -días I-TREATMENT -de I-TREATMENT -su I-TREATMENT -alta I-TREATMENT -hospitalaria. I-TREATMENT - I-TREATMENT +extensión I-EXPLORATION +mediante I-EXPLORATION +PET-TAC I-EXPLORATION +no I-EXPLORATION +detectó I-EXPLORATION +captación I-EXPLORATION +patológica. I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +en I-EVOLUTION +remisión I-EVOLUTION +tras I-EVOLUTION +tres I-EVOLUTION +años I-EVOLUTION +de I-EVOLUTION +seguimiento. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -13 I-PRESENT_ILLNESS +33 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +32 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +naturales B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Perú, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +acuden I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS dolor I-PRESENT_ILLNESS -torácico I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -incapacitante I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -3 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +doce I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +localizado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +epigástrico, I-PRESENT_ILLNESS no I-PRESENT_ILLNESS -calma I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -analgésicos. I-PRESENT_ILLNESS -Sin B-PAST_MEDICAL_HISTORY +irradiado, I-PRESENT_ILLNESS +continuo, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +otra I-PRESENT_ILLNESS +sintomatología I-PRESENT_ILLNESS +asociada. I-PRESENT_ILLNESS +Como B-PAST_MEDICAL_HISTORY +único I-PAST_MEDICAL_HISTORY antecedente I-PAST_MEDICAL_HISTORY -traumático. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La B-EXPLORATION -palpación I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -cartílagos I-EXPLORATION -costales I-EXPLORATION -es I-EXPLORATION -dolorosa, I-EXPLORATION -refiriendo I-EXPLORATION -como I-EXPLORATION -punto I-EXPLORATION -más I-EXPLORATION +de I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +referían I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +noche I-PAST_MEDICAL_HISTORY +previa I-PAST_MEDICAL_HISTORY +ingesta I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +comida I-PAST_MEDICAL_HISTORY +típica I-PAST_MEDICAL_HISTORY +peruana, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +pescado I-PAST_MEDICAL_HISTORY +crudo. I-PAST_MEDICAL_HISTORY +El B-EXPLORATION +abdomen I-EXPLORATION +era I-EXPLORATION +blando, I-EXPLORATION +depresible I-EXPLORATION +pero I-EXPLORATION doloroso I-EXPLORATION -la I-EXPLORATION -7a I-EXPLORATION -unión I-EXPLORATION -costoesternal I-EXPLORATION -derecha, I-EXPLORATION -sin I-EXPLORATION -apreciarse I-EXPLORATION -alteraciones I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -contorno I-EXPLORATION +epigastrio. I-EXPLORATION +No I-EXPLORATION +había I-EXPLORATION +masas, I-EXPLORATION +organomegalias I-EXPLORATION +abdominales I-EXPLORATION ni I-EXPLORATION signos I-EXPLORATION -inflamatorios I-EXPLORATION -cutáneos. I-EXPLORATION -La I-EXPLORATION -maniobra I-EXPLORATION -del I-EXPLORATION -gancho, I-EXPLORATION -que I-EXPLORATION -consiste I-EXPLORATION -en I-EXPLORATION -producir I-EXPLORATION -una I-EXPLORATION -elevación I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -cartílagos I-EXPLORATION -costales I-EXPLORATION -inferiores I-EXPLORATION -mediante I-EXPLORATION +irritación I-EXPLORATION +peritoneal. I-EXPLORATION +Se I-EXPLORATION +observó I-EXPLORATION +leucocitosis I-EXPLORATION +importante I-EXPLORATION +con I-EXPLORATION +neutrofilia I-EXPLORATION +(16.000 I-EXPLORATION +L), I-EXPLORATION +sin I-EXPLORATION +eosinofilia. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +endoscópico I-EXPLORATION +de I-EXPLORATION +ambos I-EXPLORATION +pacientes I-EXPLORATION +mostró I-EXPLORATION la I-EXPLORATION -introducción I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -dedos I-EXPLORATION -del I-EXPLORATION -explorador I-EXPLORATION -por I-EXPLORATION -debajo I-EXPLORATION -del I-EXPLORATION -último I-EXPLORATION -arco I-EXPLORATION -costal I-EXPLORATION +incontables I-EXPLORATION +AS I-EXPLORATION +adheridos I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +gástrica I-EXPLORATION y I-EXPLORATION -traccionando I-EXPLORATION +duodenal, I-EXPLORATION +la I-EXPLORATION +mayoría I-EXPLORATION de I-EXPLORATION -él I-EXPLORATION +ellos I-EXPLORATION +agrupados I-EXPLORATION en I-EXPLORATION -sentido I-EXPLORATION -craneal, I-EXPLORATION -es I-EXPLORATION -muy I-EXPLORATION -dolorosa. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION +nidos I-EXPLORATION +con I-EXPLORATION +más I-EXPLORATION de I-EXPLORATION -exploración I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION +diez I-EXPLORATION +parásitos. I-EXPLORATION +También I-EXPLORATION +los I-EXPLORATION +había I-EXPLORATION +aislados I-EXPLORATION +entre I-EXPLORATION +los I-EXPLORATION +pliegues I-EXPLORATION +mucosos, I-EXPLORATION +donde I-EXPLORATION +producían I-EXPLORATION +intenso I-EXPLORATION +edema I-EXPLORATION +y I-EXPLORATION +múltiples I-EXPLORATION +erosiones I-EXPLORATION +por I-EXPLORATION +toda I-EXPLORATION la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -es I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Dada B-TREATMENT +cavidad I-EXPLORATION +gástrica I-EXPLORATION +y I-EXPLORATION +duodenal. I-EXPLORATION +Se B-TREATMENT +procedió I-TREATMENT +a I-TREATMENT la I-TREATMENT -exploración I-TREATMENT -tan I-TREATMENT -característica, I-TREATMENT -se I-TREATMENT -pensó I-TREATMENT -en I-TREATMENT -el I-TREATMENT -SCD I-TREATMENT -y I-TREATMENT -se I-TREATMENT -optó I-TREATMENT -por I-TREATMENT -un I-TREATMENT -tratamiento I-TREATMENT -conservador I-TREATMENT -con I-TREATMENT -antiinflamatorios I-TREATMENT -orales. I-TREATMENT +extracción I-TREATMENT +de I-TREATMENT +los I-TREATMENT +mismos I-TREATMENT +mediante I-TREATMENT +pinza I-TREATMENT +de I-TREATMENT +biopsia. I-TREATMENT I-TREATMENT -Tras I-TREATMENT -un I-TREATMENT -mes I-TREATMENT -sin I-TREATMENT -mejoría, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -propuso I-TREATMENT -bloqueo I-TREATMENT -anestésico I-TREATMENT -intercostal I-TREATMENT -o I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -definitivo. I-TREATMENT -Dado I-TREATMENT -que I-TREATMENT -el I-TREATMENT -dolor I-TREATMENT + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +41 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +ERC I-PRESENT_ILLNESS +estadio I-PRESENT_ILLNESS +V I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +perfil I-PRESENT_ILLNESS +intersticial I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +recibir I-PRESENT_ILLNESS +educación I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +opciones I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +elige I-PRESENT_ILLNESS +DPCA. I-PRESENT_ILLNESS +En B-TREATMENT +septiembre I-TREATMENT de I-TREATMENT +2014 I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT la I-TREATMENT -niña I-TREATMENT -cada I-TREATMENT -vez I-TREATMENT -es I-TREATMENT -más I-TREATMENT -limitante I-TREATMENT +implantación I-TREATMENT +de I-TREATMENT +catéter I-TREATMENT +de I-TREATMENT +silicona I-TREATMENT +Swan-neck I-TREATMENT +con I-TREATMENT +doble I-TREATMENT +cuff I-TREATMENT y I-TREATMENT -que I-TREATMENT -la I-TREATMENT -primera I-TREATMENT -opción I-TREATMENT -aportaría I-TREATMENT -un I-TREATMENT -alivio I-TREATMENT -temporal, I-TREATMENT -se I-TREATMENT +reparación I-TREATMENT +de I-TREATMENT +dos I-TREATMENT +hernias, I-TREATMENT +inguinal I-TREATMENT +y I-TREATMENT +umbilical. I-TREATMENT +Su B-EXPLORATION +superficie I-EXPLORATION +corporal I-EXPLORATION +era I-EXPLORATION +2.06 I-EXPLORATION +m2 I-EXPLORATION +y I-EXPLORATION +su I-EXPLORATION +Indice I-EXPLORATION +de I-EXPLORATION +Masa I-EXPLORATION +Corporal I-EXPLORATION +26.1. I-EXPLORATION +Se B-TREATMENT realizó I-TREATMENT la I-TREATMENT -intervención I-TREATMENT -quirúrgica. I-TREATMENT -Al I-TREATMENT -año I-TREATMENT -del I-TREATMENT -diagnóstico, I-TREATMENT -bajo I-TREATMENT -anestesia I-TREATMENT -general I-TREATMENT -y I-TREATMENT -a I-TREATMENT -través I-TREATMENT +educación I-TREATMENT +para I-TREATMENT +el I-TREATMENT +aprendizaje I-TREATMENT de I-TREATMENT -una I-TREATMENT -incisión I-TREATMENT -transversa I-TREATMENT +la I-TREATMENT +técnica I-TREATMENT +y I-TREATMENT +en I-TREATMENT +Noviembre I-TREATMENT de I-TREATMENT +2014 I-TREATMENT +comenzó I-TREATMENT +tratamiento I-TREATMENT +en I-TREATMENT +domicilio I-TREATMENT +con I-TREATMENT 4 I-TREATMENT -cm I-TREATMENT -sobre I-TREATMENT -el I-TREATMENT -arco I-TREATMENT -costal I-TREATMENT -afectado, I-TREATMENT -extirpamos I-TREATMENT -el I-TREATMENT -7o, I-TREATMENT -8o I-TREATMENT +intercambios I-TREATMENT +de I-TREATMENT +Bicavera I-TREATMENT +al I-TREATMENT +1, I-TREATMENT +5% I-TREATMENT +de I-TREATMENT +glucosa I-TREATMENT y I-TREATMENT -9o I-TREATMENT -cartílagos I-TREATMENT -costales, I-TREATMENT -preservando I-TREATMENT -el I-TREATMENT -pericondrio. I-TREATMENT - I-TREATMENT -Transcurrido B-EVOLUTION -un I-EVOLUTION -año, I-EVOLUTION -el I-EVOLUTION -resultado I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -satisfactorio. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -81 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -fibrilación I-PAST_MEDICAL_HISTORY -auricular I-PAST_MEDICAL_HISTORY -(por I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontraba I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -anticoagulante) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -adenocarcinoma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -próstata I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -encontraba I-PAST_MEDICAL_HISTORY -libre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermedad. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acudió B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -precordial I-PRESENT_ILLNESS -irradiado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -hipocondrio I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -varias I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -acompañado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -disnea I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -mínimos I-PRESENT_ILLNESS -esfuerzos. I-PRESENT_ILLNESS -En B-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION +2000 I-TREATMENT +ml I-TREATMENT +de I-TREATMENT +volumen, I-TREATMENT +sin I-TREATMENT +complicaciones. I-TREATMENT +Los B-EXPLORATION +volúmenes I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -valoración I-EXPLORATION -la I-EXPLORATION -sintomatología I-EXPLORATION -había I-EXPLORATION -disminuido. I-EXPLORATION -Inicialmente I-EXPLORATION -se I-EXPLORATION -diagnosticó I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -posible I-EXPLORATION -síndrome I-EXPLORATION -coronario I-EXPLORATION -agudo I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -inició I-EXPLORATION -tratamiento I-EXPLORATION +UF I-EXPLORATION +eran I-EXPLORATION +de I-EXPLORATION +500-700 I-EXPLORATION +ml/ I-EXPLORATION +24 I-EXPLORATION +horas I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -analítica I-EXPLORATION -con I-EXPLORATION -enzimas I-EXPLORATION +la I-EXPLORATION +diuresis I-EXPLORATION +residual I-EXPLORATION +de I-EXPLORATION +1700 I-EXPLORATION +ml. I-EXPLORATION +En B-EVOLUTION +diciembre I-EVOLUTION +de I-EVOLUTION +2014 I-EVOLUTION +se I-EVOLUTION +realizó I-EVOLUTION +Prueba I-EVOLUTION +de I-EVOLUTION +función I-EVOLUTION +peritoneal I-EVOLUTION +catalogándose I-EVOLUTION +como I-EVOLUTION +alto I-EVOLUTION +transportador I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +volumen I-EVOLUTION +residual I-EVOLUTION +de I-EVOLUTION +411, I-EVOLUTION +39 I-EVOLUTION +ml I-EVOLUTION +y I-EVOLUTION +Presión I-EVOLUTION +Intraperitoneal I-EVOLUTION +(PIP) I-EVOLUTION +de I-EVOLUTION +16, I-EVOLUTION +05 I-EVOLUTION +cm I-EVOLUTION +H2O. I-EVOLUTION +El I-EVOLUTION +2 I-EVOLUTION +de I-EVOLUTION +febrero I-EVOLUTION +de I-EVOLUTION +2015 I-EVOLUTION +acudió I-EVOLUTION +a I-EVOLUTION +urgencias I-EVOLUTION +por I-EVOLUTION +dificultad I-EVOLUTION +para I-EVOLUTION +el I-EVOLUTION +drenaje, I-EVOLUTION +su I-EVOLUTION +patrón I-EVOLUTION +intestinal I-EVOLUTION +era I-EVOLUTION +normal I-EVOLUTION +sin I-EVOLUTION +estreñimiento I-EVOLUTION +ni I-EVOLUTION +diarrea I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +radiografía I-EVOLUTION +de I-EVOLUTION +abdomen I-EVOLUTION +mostró I-EVOLUTION +migración I-EVOLUTION +del I-EVOLUTION +catéter, I-EVOLUTION +tratado I-EVOLUTION +con I-EVOLUTION +laxantes I-EVOLUTION +mejoraron I-EVOLUTION +los I-EVOLUTION +drenajes I-EVOLUTION +pero I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +ganancia I-EVOLUTION +de I-EVOLUTION +4 I-EVOLUTION +kg I-EVOLUTION +de I-EVOLUTION +peso. I-EVOLUTION +Se B-TREATMENT +cambió I-TREATMENT +pauta I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +a I-TREATMENT +2 I-TREATMENT +intercambios I-TREATMENT +de I-TREATMENT +2, I-TREATMENT +3 I-TREATMENT +% I-TREATMENT +y I-TREATMENT +2 I-TREATMENT +de I-TREATMENT +1, I-TREATMENT +5% I-TREATMENT +de I-TREATMENT +glucosa I-TREATMENT +bajando I-TREATMENT +800 I-TREATMENT +gr I-TREATMENT +de I-TREATMENT +peso. I-TREATMENT +Al B-EVOLUTION +día I-EVOLUTION +siguiente I-EVOLUTION +en I-EVOLUTION +consulta I-EVOLUTION +telefónica I-EVOLUTION +se I-EVOLUTION +percibió I-EVOLUTION +disnea I-EVOLUTION +al I-EVOLUTION +hablar I-EVOLUTION +y I-EVOLUTION +tos, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +le I-EVOLUTION +indicó I-EVOLUTION +acudir I-EVOLUTION +urgentemente I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +consulta I-EVOLUTION +del I-EVOLUTION +hospital. I-EVOLUTION +La B-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -daño I-EXPLORATION -miocárdico I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -electrocardiograma I-EXPLORATION +tórax, I-EXPLORATION +mostró I-EXPLORATION +gran I-EXPLORATION +derrame I-EXPLORATION +pleural I-EXPLORATION +derecho I-EXPLORATION que I-EXPLORATION no I-EXPLORATION -presentaban I-EXPLORATION -anomalías. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -refería I-EXPLORATION -astenia I-EXPLORATION -y I-EXPLORATION -molestias I-EXPLORATION +existía I-EXPLORATION en I-EXPLORATION -hipocondrio I-EXPLORATION -derecho I-EXPLORATION -de I-EXPLORATION -7 I-EXPLORATION -días I-EXPLORATION +radiografías I-EXPLORATION de I-EXPLORATION -evolución, I-EXPLORATION -pero I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION +tórax I-EXPLORATION +posteriores I-EXPLORATION +al I-EXPLORATION +comienzo I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -valoración I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -dolor I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -era I-EXPLORATION -anodina I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -tras I-EXPLORATION -ser I-EXPLORATION -valorado I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -servicio I-EXPLORATION +DP. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +toracentesis, I-TREATMENT +mostrando I-TREATMENT +la I-TREATMENT +bioquímica I-TREATMENT +del I-TREATMENT +líquido I-TREATMENT +una I-TREATMENT +concentración I-TREATMENT +de I-TREATMENT +glucosa I-TREATMENT +en I-TREATMENT +líquido I-TREATMENT +pleural I-TREATMENT +mayor I-TREATMENT +de I-TREATMENT +la I-TREATMENT +presentada I-TREATMENT +en I-TREATMENT +plasma I-TREATMENT +y I-TREATMENT +compatible I-TREATMENT +con I-TREATMENT +líquido I-TREATMENT +de I-TREATMENT +diálisis. I-TREATMENT +Ante I-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +fuga I-TREATMENT +de I-TREATMENT +líquido I-TREATMENT +hacia I-TREATMENT +la I-TREATMENT +cavidad I-TREATMENT +pleural, I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT +la I-TREATMENT +diálisis I-TREATMENT +peritoneal. I-TREATMENT + I-TREATMENT +Se B-EXPLORATION +realizó I-EXPLORATION +gammagrafía I-EXPLORATION +administrando I-EXPLORATION +117 I-EXPLORATION +MBq I-EXPLORATION de I-EXPLORATION -Cardiología I-EXPLORATION -se I-EXPLORATION -dio I-EXPLORATION +Nanocoloide I-EXPLORATION de I-EXPLORATION -alta. I-EXPLORATION +albumina I-EXPLORATION +TC I-EXPLORATION +99 I-EXPLORATION +m. I-EXPLORATION I-EXPLORATION -Seis B-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -acudió I-EVOLUTION -al I-EVOLUTION -servicio I-EVOLUTION -de I-EVOLUTION -Urgencias I-EVOLUTION -por I-EVOLUTION -persistencia I-EVOLUTION -del I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -hipocondrio I-EVOLUTION -derecho I-EVOLUTION -acompañado I-EVOLUTION -de I-EVOLUTION -naúseas I-EVOLUTION -e I-EVOLUTION -hiporexia. I-EVOLUTION -No B-EXPLORATION -presentaba I-EXPLORATION -fiebre I-EXPLORATION -ni I-EXPLORATION -otra I-EXPLORATION -clínica I-EXPLORATION -acompañante. I-EXPLORATION -A I-EXPLORATION +La I-EXPLORATION +administración I-EXPLORATION +del I-EXPLORATION +radio I-EXPLORATION +fármaco I-EXPLORATION +requirió I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -abdomen I-EXPLORATION -distendido, I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION +colaboración I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -palpación I-EXPLORATION -en I-EXPLORATION -hipocondrio I-EXPLORATION -y I-EXPLORATION -flanco I-EXPLORATION -derecho I-EXPLORATION -con I-EXPLORATION -defensa I-EXPLORATION -pero I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION +enfermería I-EXPLORATION de I-EXPLORATION -Blumberg I-EXPLORATION +DP I-EXPLORATION y I-EXPLORATION -Murphy I-EXPLORATION -negativos. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -analítica I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -una I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -11 I-EXPLORATION -g/dl, I-EXPLORATION -hematocrito I-EXPLORATION de I-EXPLORATION -32, I-EXPLORATION -6%, I-EXPLORATION -leucocitos I-EXPLORATION -14.000 I-EXPLORATION -con I-EXPLORATION -74% I-EXPLORATION +Medicina I-EXPLORATION +Nuclear I-EXPLORATION +(MN). I-EXPLORATION +La I-EXPLORATION +enfermera I-EXPLORATION de I-EXPLORATION -neutrófilos, I-EXPLORATION -INR I-EXPLORATION -2, I-EXPLORATION -95 I-EXPLORATION +DP I-EXPLORATION +realizó I-EXPLORATION +el I-EXPLORATION +intercambio I-EXPLORATION +manual I-EXPLORATION y I-EXPLORATION -fibrinógeno I-EXPLORATION -816 I-EXPLORATION -mg/dl. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -vesícula I-EXPLORATION -con I-EXPLORATION -paredes I-EXPLORATION -mal I-EXPLORATION -definidas I-EXPLORATION -y I-EXPLORATION -colelitiasis, I-EXPLORATION -además I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -hipoecoica I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -líquido I-EXPLORATION -libre I-EXPLORATION -perivesicular I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -interpretó I-EXPLORATION -como I-EXPLORATION -colecistitis I-EXPLORATION -aguda I-EXPLORATION -perforada I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -completar I-EXPLORATION +MN I-EXPLORATION +dosificó I-EXPLORATION +e I-EXPLORATION +inyectó I-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC). I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -TC I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION +radiofármaco I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +solución I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -vesícula I-EXPLORATION -con I-EXPLORATION -paredes I-EXPLORATION -mal I-EXPLORATION -definidas I-EXPLORATION -junto I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION +diálisis, I-EXPLORATION +según I-EXPLORATION +protocolo I-EXPLORATION de I-EXPLORATION -líquido I-EXPLORATION +administración I-EXPLORATION de I-EXPLORATION -alta I-EXPLORATION -densidad I-EXPLORATION +medicación I-EXPLORATION +en I-EXPLORATION +líquido I-EXPLORATION de I-EXPLORATION -7x3 I-EXPLORATION -cm I-EXPLORATION -que I-EXPLORATION -alteraba I-EXPLORATION -la I-EXPLORATION -grasa I-EXPLORATION -circundante I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -colecistitis I-EXPLORATION -aguda I-EXPLORATION -perforada. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -estable I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -presentaba I-EXPLORATION -signos I-EXPLORATION +diálisis, I-EXPLORATION +antes I-EXPLORATION de I-EXPLORATION -irritación I-EXPLORATION -peritoneal I-EXPLORATION +infundirlo I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION +cavidad I-EXPLORATION +peritoneal. I-EXPLORATION + I-EXPLORATION +A I-EXPLORATION +los I-EXPLORATION +10-15 I-EXPLORATION +minutos I-EXPLORATION se I-EXPLORATION -decidió I-EXPLORATION -el I-EXPLORATION -ingreso I-EXPLORATION -en I-EXPLORATION +hizo I-EXPLORATION la I-EXPLORATION -planta I-EXPLORATION -de I-EXPLORATION -Cirugía I-EXPLORATION -para I-EXPLORATION -tratamiento I-EXPLORATION -conservador. I-EXPLORATION -Se B-TREATMENT -instauró I-TREATMENT -tratamiento I-TREATMENT -analgésico I-TREATMENT -y I-TREATMENT -antibiótico I-TREATMENT -(Piperacilina-Tazobactan). I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION -del I-EVOLUTION -ingreso I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -continuaba I-EVOLUTION -con I-EVOLUTION -molestias I-EVOLUTION -en I-EVOLUTION -hipocondrio I-EVOLUTION -derecho I-EVOLUTION -y I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -análisis I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -persistía I-EVOLUTION -la I-EVOLUTION -leucocitosis I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -decidió I-EVOLUTION -realizar I-EVOLUTION -una I-EVOLUTION -TC I-EVOLUTION -de I-EVOLUTION -control. I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -prueba I-EVOLUTION -de I-EVOLUTION -imagen I-EVOLUTION -se I-EVOLUTION -confirmó I-EVOLUTION -la I-EVOLUTION -mala I-EVOLUTION -evolución I-EVOLUTION -del I-EVOLUTION -proceso I-EVOLUTION -con I-EVOLUTION -aumento I-EVOLUTION -del I-EVOLUTION -líquido I-EVOLUTION -libre I-EVOLUTION -intraabdominal. I-EVOLUTION -Con B-TREATMENT -estos I-TREATMENT -hallazgos I-TREATMENT +primera I-EXPLORATION +lectura I-EXPLORATION +y I-EXPLORATION +tras I-EXPLORATION +3-4 I-EXPLORATION +horas I-EXPLORATION +las I-EXPLORATION +imágenes I-EXPLORATION +tardías. I-EXPLORATION +Al B-TREATMENT +finalizar, I-TREATMENT se I-TREATMENT realizó I-TREATMENT -una I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -urgente. I-TREATMENT - I-TREATMENT -Fue I-TREATMENT -intervenido I-TREATMENT -mediante I-TREATMENT -una I-TREATMENT -incisión I-TREATMENT -subcostal I-TREATMENT -derecha I-TREATMENT -por I-TREATMENT -la I-TREATMENT -que I-TREATMENT -se I-TREATMENT -accedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -cavidad I-TREATMENT -peritoneal. I-TREATMENT -Se I-TREATMENT -localizó I-TREATMENT un I-TREATMENT -plastrón I-TREATMENT -de I-TREATMENT -epiplón I-TREATMENT -que I-TREATMENT -cubría I-TREATMENT -la I-TREATMENT -vesícula, I-TREATMENT -de I-TREATMENT -aspecto I-TREATMENT -tumoral, I-TREATMENT -con I-TREATMENT -sufusión I-TREATMENT -hemorrágica I-TREATMENT +nuevo I-TREATMENT +intercambio I-TREATMENT +manual I-TREATMENT +para I-TREATMENT +drenar I-TREATMENT +completamente I-TREATMENT +el I-TREATMENT +abdomen, I-TREATMENT +desechando I-TREATMENT +el I-TREATMENT +líquido I-TREATMENT +drenado I-TREATMENT en I-TREATMENT -espacio I-TREATMENT -subfrénico I-TREATMENT -y I-TREATMENT -perirrenal, I-TREATMENT -así I-TREATMENT -como I-TREATMENT -un I-TREATMENT -hemoperitoneo I-TREATMENT +el I-TREATMENT +contenedor I-TREATMENT +específico I-TREATMENT +según I-TREATMENT +protocolo I-TREATMENT de I-TREATMENT -2, I-TREATMENT -7 I-TREATMENT -litros I-TREATMENT -sin I-TREATMENT -apreciarse I-TREATMENT -punto I-TREATMENT +MN. I-TREATMENT +El I-TREATMENT +estudio I-TREATMENT +fue I-TREATMENT +indicativo I-TREATMENT de I-TREATMENT -hemorragia. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -colecistectomía I-TREATMENT -subtotal I-TREATMENT +comunicación I-TREATMENT +peritoneopleural, I-TREATMENT por I-TREATMENT -invasión I-TREATMENT -tumoral I-TREATMENT -del I-TREATMENT -parénquima I-TREATMENT -hepático I-TREATMENT -y I-TREATMENT +lo I-TREATMENT +que I-TREATMENT se I-TREATMENT -extirpó I-TREATMENT +suspendió I-TREATMENT +definitivamente I-TREATMENT la I-TREATMENT -mayor I-TREATMENT -parte I-TREATMENT -del I-TREATMENT -epiplón I-TREATMENT -quedando I-TREATMENT -residuo I-TREATMENT -tumoral I-TREATMENT -macroscópico. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -postoperatoria I-EVOLUTION -fue I-EVOLUTION -favorable I-EVOLUTION -y I-EVOLUTION +DP. I-TREATMENT +Se I-TREATMENT +transfirió I-TREATMENT +a I-TREATMENT +hemodialisis I-TREATMENT +(HD), I-TREATMENT +resolviendose I-TREATMENT +el I-TREATMENT +hidrotórax. I-TREATMENT +Actualmente B-EVOLUTION el I-EVOLUTION paciente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -al I-EVOLUTION -6o I-EVOLUTION -día I-EVOLUTION -postoperatorio. I-EVOLUTION +esta I-EVOLUTION +trasplantado. I-EVOLUTION I-EVOLUTION -A I-EVOLUTION -la I-EVOLUTION -semana I-EVOLUTION -del I-EVOLUTION -alta, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -reingresó I-EVOLUTION -por I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -en I-EVOLUTION -hipocondrio I-EVOLUTION -derecho I-EVOLUTION -asociado I-EVOLUTION -a I-EVOLUTION -astenia I-EVOLUTION -y I-EVOLUTION -anorexia. I-EVOLUTION -En B-EXPLORATION -los I-EXPLORATION -análisis I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -hemoglobina I-EXPLORATION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +55 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +estudiado B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +alteración I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +ritmo I-PRESENT_ILLNESS +intestinal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +rectorragias, I-PRESENT_ILLNESS +que B-EXPLORATION +tras I-EXPLORATION +endoscopia I-EXPLORATION +y I-EXPLORATION +biopsia I-EXPLORATION +es I-EXPLORATION +diagnosticado I-EXPLORATION de I-EXPLORATION -7, I-EXPLORATION -5 I-EXPLORATION -g/dL, I-EXPLORATION -hematocrito I-EXPLORATION +un I-EXPLORATION +adenocarcinoma I-EXPLORATION de I-EXPLORATION -22, I-EXPLORATION -7% I-EXPLORATION -y I-EXPLORATION -32.500 I-EXPLORATION -leucocitos I-EXPLORATION -con I-EXPLORATION -desviación I-EXPLORATION -izquierda. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -mal I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -con I-EXPLORATION -dolor I-EXPLORATION -en I-EXPLORATION -mesogastrio I-EXPLORATION -e I-EXPLORATION -hipocondrio I-EXPLORATION -derecho. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -apreció I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION +tercio I-EXPLORATION +inferior I-EXPLORATION de I-EXPLORATION -4x4 I-EXPLORATION -cm I-EXPLORATION +recto, I-EXPLORATION +bien I-EXPLORATION +diferenciado, I-EXPLORATION +de I-EXPLORATION +alto I-EXPLORATION +grado, I-EXPLORATION +con I-EXPLORATION +diferenciación I-EXPLORATION +mucinosa I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -lecho I-EXPLORATION -quirúrgico. I-EXPLORATION +menos I-EXPLORATION +del I-EXPLORATION +50%, I-EXPLORATION +con I-EXPLORATION +estadiaje I-EXPLORATION +clínico-radiológico I-EXPLORATION +(tomografía I-EXPLORATION +computerizada I-EXPLORATION +y I-EXPLORATION +resonancia I-EXPLORATION +magnética) I-EXPLORATION +T3 I-EXPLORATION +N2M0. I-EXPLORATION I-EXPLORATION -Se B-TREATMENT -estableció I-TREATMENT -tratamiento I-TREATMENT -sintomático I-TREATMENT -pero I-TREATMENT -el I-TREATMENT +El B-TREATMENT paciente I-TREATMENT -presentó I-TREATMENT -un I-TREATMENT -deterioro I-TREATMENT -progresivo I-TREATMENT -durante I-TREATMENT -los I-TREATMENT -días I-TREATMENT -siguientes I-TREATMENT -marcado I-TREATMENT -por I-TREATMENT -disnea, I-TREATMENT -dolor I-TREATMENT -abdominal I-TREATMENT +fue I-TREATMENT +tratado I-TREATMENT +inicialmente I-TREATMENT +con I-TREATMENT +radioquimioterapia I-TREATMENT +neoadyuvante; I-TREATMENT +radioterapia I-TREATMENT en I-TREATMENT -aumento, I-TREATMENT -melenas I-TREATMENT -y I-TREATMENT +esquema I-TREATMENT +de I-TREATMENT +ciclo I-TREATMENT +largo I-TREATMENT +con I-TREATMENT una I-TREATMENT -anemización I-TREATMENT -progresiva I-TREATMENT -asociada I-TREATMENT -a I-TREATMENT -hipotensión I-TREATMENT -a I-TREATMENT -pesar I-TREATMENT +dosis I-TREATMENT +total I-TREATMENT de I-TREATMENT -transfusiones I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -finalmente I-TREATMENT -falleció I-TREATMENT +50, I-TREATMENT +4 I-TREATMENT +Gy I-TREATMENT +durante I-TREATMENT +5 I-TREATMENT +semanas, I-TREATMENT +y I-TREATMENT +capecitabina I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT a I-TREATMENT -los I-TREATMENT -20 I-TREATMENT -días I-TREATMENT +razón I-TREATMENT de I-TREATMENT -ser I-TREATMENT -intervenido. I-TREATMENT +825 I-TREATMENT +mg/m2/12h I-TREATMENT +(1650 I-TREATMENT +mg/12h), I-TREATMENT +cada I-TREATMENT +15 I-TREATMENT +días. I-TREATMENT I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION +Ocho I-TREATMENT +semanas I-TREATMENT +después I-TREATMENT +de I-TREATMENT +finalizar I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +fue I-TREATMENT +intervenido I-TREATMENT +quirúrgicamente I-TREATMENT +realizándose I-TREATMENT +una I-TREATMENT +amputación I-TREATMENT +abdominoperineal I-TREATMENT +extendida. I-TREATMENT +El B-EXPLORATION +resultado I-EXPLORATION +anatomopatológico I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -muestras I-EXPLORATION -remitidas I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +quirúrgica I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +adenocarcinoma I-EXPLORATION +mucinoso I-EXPLORATION +de I-EXPLORATION +recto, I-EXPLORATION a I-EXPLORATION -anatomía I-EXPLORATION -patológica. I-EXPLORATION -En I-EXPLORATION -ellas I-EXPLORATION -se I-EXPLORATION -identificaron I-EXPLORATION -áreas I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -infiltrado I-EXPLORATION -en I-EXPLORATION -células I-EXPLORATION -entremezclado I-EXPLORATION +4, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +margen I-EXPLORATION +anal, I-EXPLORATION +cuya I-EXPLORATION +infiltración I-EXPLORATION +sobrepasaba I-EXPLORATION +2 I-EXPLORATION +mm I-EXPLORATION +la I-EXPLORATION +muscular I-EXPLORATION +propia, I-EXPLORATION con I-EXPLORATION -focos I-EXPLORATION -hemorrágicos I-EXPLORATION +bordes I-EXPLORATION +quirúrgicos I-EXPLORATION +proximal I-EXPLORATION y I-EXPLORATION -zonas I-EXPLORATION -en I-EXPLORATION -donde I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -se I-EXPLORATION -disponen I-EXPLORATION -formando I-EXPLORATION -canales I-EXPLORATION -vasculares. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -completó I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION +distal I-EXPLORATION +sin I-EXPLORATION +tumor, I-EXPLORATION +y I-EXPLORATION +margen I-EXPLORATION +de I-EXPLORATION +resección I-EXPLORATION +circular I-EXPLORATION +a I-EXPLORATION +20 I-EXPLORATION +mm I-EXPLORATION +del I-EXPLORATION +tumor I-EXPLORATION +y I-EXPLORATION +a I-EXPLORATION +2 I-EXPLORATION +mm I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +adenopatía I-EXPLORATION +metastatizada, I-EXPLORATION con I-EXPLORATION un I-EXPLORATION -análisis I-EXPLORATION -inmunohistoquímico I-EXPLORATION -en I-EXPLORATION +total I-EXPLORATION +de I-EXPLORATION +3 I-EXPLORATION +ganglios I-EXPLORATION +positivos I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +10 I-EXPLORATION +disecados. I-EXPLORATION +La I-EXPLORATION +escisión I-EXPLORATION +mesorrectal I-EXPLORATION +(en I-EXPLORATION el I-EXPLORATION -que I-EXPLORATION -destacaba I-EXPLORATION -la I-EXPLORATION -queratina I-EXPLORATION -7 I-EXPLORATION -positivo I-EXPLORATION -intenso, I-EXPLORATION -D2.40, I-EXPLORATION -CD-31 I-EXPLORATION +plano I-EXPLORATION +del I-EXPLORATION +mesorrecto) I-EXPLORATION y I-EXPLORATION -vimentina I-EXPLORATION -intensamente I-EXPLORATION -positivo. I-EXPLORATION -Todo I-EXPLORATION -ello I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION de I-EXPLORATION -angiosarcoma I-EXPLORATION -epitelioide I-EXPLORATION -primario I-EXPLORATION +canal I-EXPLORATION +anal I-EXPLORATION +(en I-EXPLORATION +el I-EXPLORATION +plano I-EXPLORATION de I-EXPLORATION -vesícula I-EXPLORATION -biliar. I-EXPLORATION +los I-EXPLORATION +elevadores) I-EXPLORATION +fueron I-EXPLORATION +satisfactorias I-EXPLORATION +(ypT3bN1). I-EXPLORATION I-EXPLORATION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -distensión I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -intenso, I-PRESENT_ILLNESS -rectorragia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -náuseas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -En B-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -mes I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -presentado I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -abdominal I-PAST_MEDICAL_HISTORY -cólico I-PAST_MEDICAL_HISTORY -recidivante. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -alteraciones I-PAST_MEDICAL_HISTORY -analíticas I-PAST_MEDICAL_HISTORY -relevantes. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION +El B-EVOLUTION +postoperatorio I-EVOLUTION +del I-EVOLUTION +paciente I-EVOLUTION +cursó I-EVOLUTION +sin I-EVOLUTION +complicaciones, I-EVOLUTION +y B-TREATMENT +posteriormente I-TREATMENT +recibió I-TREATMENT +6 I-TREATMENT +ciclos I-TREATMENT +de I-TREATMENT +quimioterapia I-TREATMENT +con I-TREATMENT +capecitabina I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT +a I-TREATMENT +razón I-TREATMENT +de I-TREATMENT +2.000 I-TREATMENT +mg/12h I-TREATMENT +cada I-TREATMENT +21 I-TREATMENT +días. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +su I-EVOLUTION +evolución I-EVOLUTION +fue I-EVOLUTION +controlado I-EVOLUTION +por I-EVOLUTION +los I-EVOLUTION +servicios I-EVOLUTION +de I-EVOLUTION +Oncología I-EVOLUTION +y I-EVOLUTION +Cirugía I-EVOLUTION +General, I-EVOLUTION +con I-EVOLUTION +TC, I-EVOLUTION +colonoscopia I-EVOLUTION +y I-EVOLUTION +marcadores I-EVOLUTION +tumorales I-EVOLUTION +normales I-EVOLUTION +al I-EVOLUTION +año I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +intervención. I-EVOLUTION +En I-EVOLUTION +su I-EVOLUTION +revisión I-EVOLUTION +rutinaria I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +18 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +intervención, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +refiere I-EVOLUTION +la I-EVOLUTION +aparición I-EVOLUTION +progresiva I-EVOLUTION +de I-EVOLUTION +nódulos I-EVOLUTION +subcutáneos I-EVOLUTION +faciales I-EVOLUTION +en I-EVOLUTION +zona I-EVOLUTION +frontal, I-EVOLUTION +en I-EVOLUTION +axila I-EVOLUTION +izquierda, I-EVOLUTION +pectoral I-EVOLUTION +derecho, I-EVOLUTION +flanco I-EVOLUTION +izquierdo I-EVOLUTION +y I-EVOLUTION +extremidades I-EVOLUTION +inferiores. I-EVOLUTION +A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION física I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -un I-EXPLORATION -abdomen I-EXPLORATION -distendido, I-EXPLORATION -timpanizado, I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION +corrobora I-EXPLORATION la I-EXPLORATION -palpación, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -peritonismo. I-EXPLORATION -El I-EXPLORATION -tacto I-EXPLORATION -rectal I-EXPLORATION -mostró I-EXPLORATION -restos I-EXPLORATION -hemáticos. I-EXPLORATION -La I-EXPLORATION -colonoscopia I-EXPLORATION -objetivó I-EXPLORATION -una I-EXPLORATION -formación I-EXPLORATION -friable I-EXPLORATION +nódulos I-EXPLORATION +subcutáneos I-EXPLORATION +de I-EXPLORATION +entre I-EXPLORATION +0, I-EXPLORATION +5 I-EXPLORATION y I-EXPLORATION -violácea, I-EXPLORATION +1 I-EXPLORATION +cm I-EXPLORATION en I-EXPLORATION -válvula I-EXPLORATION -ileocecal, I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION +las I-EXPLORATION +localizaciones I-EXPLORATION +descritas, I-EXPLORATION de I-EXPLORATION -rotación I-EXPLORATION -o I-EXPLORATION -invaginación. I-EXPLORATION -El I-EXPLORATION -TAC I-EXPLORATION -evidenció I-EXPLORATION -una I-EXPLORATION -invaginación I-EXPLORATION -ileo-cólica I-EXPLORATION +consistencia I-EXPLORATION +elástica I-EXPLORATION +y I-EXPLORATION +rodaderos. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +TC I-EXPLORATION +tóracoabdominal I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +objetivaron I-EXPLORATION +múltiples I-EXPLORATION +imágenes I-EXPLORATION +sugestivas I-EXPLORATION de I-EXPLORATION -12 I-EXPLORATION -cm I-EXPLORATION -con I-EXPLORATION -sus I-EXPLORATION -paredes I-EXPLORATION -engrosadas I-EXPLORATION +metástasis I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +hepático I-EXPLORATION y I-EXPLORATION -sin I-EXPLORATION -obstrucción I-EXPLORATION -intestinal. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -tratamiento I-TREATMENT -quirúrgico, I-TREATMENT -objetivando I-TREATMENT -la I-TREATMENT -invaginación I-TREATMENT -ileocecal I-TREATMENT -y I-TREATMENT -un I-TREATMENT -pequeño I-TREATMENT -deserosamiento I-TREATMENT -de I-TREATMENT -ciego. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -resección I-TREATMENT -ampliada I-TREATMENT -de I-TREATMENT -ciego I-TREATMENT -con I-TREATMENT -anastomosis I-TREATMENT -ileocólica I-TREATMENT -mecánica. I-TREATMENT -El B-EXPLORATION -diagnóstico I-EXPLORATION -anatomopatológico I-EXPLORATION -fue I-EXPLORATION +pulmonar, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +lesiones I-EXPLORATION +subcutáneas I-EXPLORATION +localizadas I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +área I-EXPLORATION +pectoral I-EXPLORATION +derecha I-EXPLORATION +área I-EXPLORATION +axilar I-EXPLORATION +izquierda, I-EXPLORATION +pared I-EXPLORATION +abdominal I-EXPLORATION +anterior, I-EXPLORATION +flanco I-EXPLORATION +izquierdo I-EXPLORATION +y I-EXPLORATION +áreas I-EXPLORATION +glúteas. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +exéresis-biopsia I-EXPLORATION de I-EXPLORATION -invaginación I-EXPLORATION -del I-EXPLORATION -intestino I-EXPLORATION -delgado I-EXPLORATION +uno I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +nódulos I-EXPLORATION +subcutáneos I-EXPLORATION +localizado I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +pectoral I-EXPLORATION +derecha I-EXPLORATION con I-EXPLORATION -lesión I-EXPLORATION -polipoide I-EXPLORATION -formada I-EXPLORATION -por I-EXPLORATION -adipocitos I-EXPLORATION -maduros I-EXPLORATION -sin I-EXPLORATION -lipoblastos, I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -la I-EXPLORATION -causa I-EXPLORATION +resultado I-EXPLORATION +anatomopatológico I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -invaginada. I-EXPLORATION -El B-EVOLUTION +metástasis I-EXPLORATION +subcutánea I-EXPLORATION +de I-EXPLORATION +adenocarcinoma I-EXPLORATION +bien I-EXPLORATION +diferenciado I-EXPLORATION +de I-EXPLORATION +recto. I-EXPLORATION +Ante B-EVOLUTION +el I-EVOLUTION +diagnóstico I-EVOLUTION +de I-EVOLUTION +recidiva I-EVOLUTION +tumoral I-EVOLUTION +diseminada I-EVOLUTION +se I-EVOLUTION +valoró I-EVOLUTION +nuevamente I-EVOLUTION +tratamiento I-EVOLUTION +quimioterápico I-EVOLUTION +que I-EVOLUTION +el I-EVOLUTION paciente I-EVOLUTION -presentó I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -postoperatoria. I-EVOLUTION +no I-EVOLUTION +llegó I-EVOLUTION +a I-EVOLUTION +recibir I-EVOLUTION +por I-EVOLUTION +el I-EVOLUTION +rápido I-EVOLUTION +deterioro I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +estado I-EVOLUTION +general I-EVOLUTION +que I-EVOLUTION +le I-EVOLUTION +llevó I-EVOLUTION +al I-EVOLUTION +exitus. I-EVOLUTION I-EVOLUTION -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -55 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +80 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -ulcus I-PAST_MEDICAL_HISTORY -bulbar I-PAST_MEDICAL_HISTORY -(Helicobacter I-PAST_MEDICAL_HISTORY -pylori I-PAST_MEDICAL_HISTORY -positivo, I-PAST_MEDICAL_HISTORY -erradicada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2005), I-PAST_MEDICAL_HISTORY -tromboembolismo I-PAST_MEDICAL_HISTORY +valvulopatía I-PAST_MEDICAL_HISTORY +mitral, I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY pulmonar I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2012 I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -intervenido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hernia I-PAST_MEDICAL_HISTORY -inguinal I-PAST_MEDICAL_HISTORY -derecha. I-PAST_MEDICAL_HISTORY -Fumador, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -total I-PAST_MEDICAL_HISTORY -acumulado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -paquetes/año. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -mayo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2011 I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS +y I-PAST_MEDICAL_HISTORY +fibrilación I-PAST_MEDICAL_HISTORY +auricular, I-PAST_MEDICAL_HISTORY +estudiada B-PRESENT_ILLNESS por I-PRESENT_ILLNESS cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -inestabilidad I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -marcha I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -lateropulsión I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -bradipsiquia I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -disnomia I-PRESENT_ILLNESS +astenia I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -Se B-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -TAC I-EXPLORATION -craneal I-EXPLORATION -que I-EXPLORATION -mostraba I-EXPLORATION +anemia I-PRESENT_ILLNESS +ferropénica. I-PRESENT_ILLNESS +La B-EXPLORATION +colonoscopia I-EXPLORATION +mostró I-EXPLORATION una I-EXPLORATION lesión I-EXPLORATION -en I-EXPLORATION -hemisferio I-EXPLORATION -cerebeloso I-EXPLORATION -derecho. I-EXPLORATION -Tras I-EXPLORATION -completar I-EXPLORATION -estudio I-EXPLORATION +vegetante I-EXPLORATION +polilobulada, I-EXPLORATION +que I-EXPLORATION +ocupaba I-EXPLORATION +el I-EXPLORATION +60-70 I-EXPLORATION +% I-EXPLORATION de I-EXPLORATION -extensión I-EXPLORATION +la I-EXPLORATION +luz I-EXPLORATION +cecal, I-EXPLORATION con I-EXPLORATION +resultado I-EXPLORATION +histopatológico I-EXPLORATION +de I-EXPLORATION +adenocarcinoma I-EXPLORATION +moderadamente I-EXPLORATION +diferenciado. I-EXPLORATION +La I-EXPLORATION TAC I-EXPLORATION -toraco-abdominal, I-EXPLORATION -RM I-EXPLORATION -craneal, I-EXPLORATION -broncoscopia I-EXPLORATION -y I-EXPLORATION -PET I-EXPLORATION -fue I-EXPLORATION -diagnosticado I-EXPLORATION +evidenció I-EXPLORATION +un I-EXPLORATION +marcado I-EXPLORATION +estrechamiento I-EXPLORATION +cecal I-EXPLORATION +de I-EXPLORATION +5, I-EXPLORATION +8 I-EXPLORATION +x I-EXPLORATION +4, I-EXPLORATION +9 I-EXPLORATION +x I-EXPLORATION +3, I-EXPLORATION +7 I-EXPLORATION +cm, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION +obstrucción. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +paravertebral I-EXPLORATION +derecha, I-EXPLORATION +entre I-EXPLORATION +D1-D2, I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION una I-EXPLORATION lesión I-EXPLORATION -cerebral I-EXPLORATION -sugestiva I-EXPLORATION -de I-EXPLORATION -metástasis I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -contexto I-EXPLORATION +reloj I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -posible I-EXPLORATION -neoplasia I-EXPLORATION -pulmonar I-EXPLORATION -localizada. I-EXPLORATION -Se B-TREATMENT -decidió I-TREATMENT -realizar I-TREATMENT -metastasectomía I-TREATMENT -cerebral I-TREATMENT -diagnóstico-terapéutica. I-TREATMENT -El B-EXPLORATION -resultado I-EXPLORATION -anatomopatológico I-EXPLORATION -fue I-EXPLORATION +arena I-EXPLORATION de I-EXPLORATION -carcinoma I-EXPLORATION -microcítico I-EXPLORATION +22 I-EXPLORATION +x I-EXPLORATION +29 I-EXPLORATION +x I-EXPLORATION +21mm, I-EXPLORATION +que I-EXPLORATION +crecía I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION +del I-EXPLORATION +canal I-EXPLORATION +espinal, I-EXPLORATION +ensanchando I-EXPLORATION +el I-EXPLORATION +orificio I-EXPLORATION +intervertebral. I-EXPLORATION +Mediante I-EXPLORATION +PAAF-USE, I-EXPLORATION +se I-EXPLORATION +accedió I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +desde I-EXPLORATION +la I-EXPLORATION +cara I-EXPLORATION +posterior I-EXPLORATION +del I-EXPLORATION +esófago, I-EXPLORATION +observando I-EXPLORATION +en I-EXPLORATION +disposición I-EXPLORATION +para-espinal I-EXPLORATION +derecha I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +redondeada I-EXPLORATION de I-EXPLORATION -pulmón. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo I-EXPLORATION -fue I-EXPLORATION +30 I-EXPLORATION +mm I-EXPLORATION de I-EXPLORATION -CPCP I-EXPLORATION -T1N0M1b, I-EXPLORATION -estadio I-EXPLORATION -IV. I-EXPLORATION -Se B-TREATMENT -administró I-TREATMENT -tratamiento I-TREATMENT -adyuvante I-TREATMENT -con I-TREATMENT -radioterapia I-TREATMENT -holocraneal I-TREATMENT -hasta I-TREATMENT -alcanzar I-TREATMENT -dosis I-TREATMENT -total I-TREATMENT -de I-TREATMENT -37.5 I-TREATMENT -Gys I-TREATMENT -que I-TREATMENT -finalizó I-TREATMENT -en I-TREATMENT -julio I-TREATMENT -de I-TREATMENT -2011 I-TREATMENT -tras I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -quimioterapia I-TREATMENT -con I-TREATMENT -cisplatino I-TREATMENT --VP16. I-TREATMENT - I-TREATMENT -Precisó I-TREATMENT -cambio I-TREATMENT -a I-TREATMENT -carboplatino I-TREATMENT -por I-TREATMENT -emesis I-TREATMENT -e I-TREATMENT -insuficiencia I-TREATMENT -renal I-TREATMENT -recibiendo I-TREATMENT -en I-TREATMENT -total I-TREATMENT -4 I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -mala I-TREATMENT -tolerancia I-TREATMENT -clínica I-TREATMENT -y I-TREATMENT -hematológica I-TREATMENT -finalizando I-TREATMENT -en I-TREATMENT -octubre I-TREATMENT -de I-TREATMENT -2011. I-TREATMENT -Posteriormente, I-TREATMENT -en I-TREATMENT -diciembre I-TREATMENT -de I-TREATMENT -2011, I-TREATMENT -recibió I-TREATMENT -radioterapia I-TREATMENT -torácica I-TREATMENT -de I-TREATMENT -consolidación, I-TREATMENT -45 I-TREATMENT -Gys I-TREATMENT -en I-TREATMENT -15 I-TREATMENT -fracciones I-TREATMENT -siguiendo I-TREATMENT -las I-TREATMENT -recomendaciones I-TREATMENT -RTOG I-TREATMENT -09372, I-TREATMENT -consiguiendo I-TREATMENT -mantener I-TREATMENT -la I-TREATMENT -estabilidad I-TREATMENT -de I-TREATMENT -la I-TREATMENT -enfermedad I-TREATMENT -en I-TREATMENT -los I-TREATMENT -siguientes I-TREATMENT -controles. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -julio I-EVOLUTION -de I-EVOLUTION -2012 I-EVOLUTION -ingresó I-EVOLUTION -procedente I-EVOLUTION -del I-EVOLUTION -servicio I-EVOLUTION -de I-EVOLUTION -Urgencias I-EVOLUTION -por I-EVOLUTION -pérdida I-EVOLUTION -de I-EVOLUTION -fuerza I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -extremidad I-EVOLUTION -inferior I-EVOLUTION -izquierda I-EVOLUTION -de I-EVOLUTION -varios I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -evolución. I-EVOLUTION -Se B-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -RM I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -metástasis I-EXPLORATION -leptomeníngeas I-EXPLORATION +diámetro, I-EXPLORATION +hiperecogénica I-EXPLORATION +y I-EXPLORATION con I-EXPLORATION -implante I-EXPLORATION -dorsal I-EXPLORATION -(D2-D3) I-EXPLORATION +ecogenicidad I-EXPLORATION +grasa, I-EXPLORATION +sobre I-EXPLORATION +la I-EXPLORATION que I-EXPLORATION -provocaba I-EXPLORATION -una I-EXPLORATION -compresión I-EXPLORATION -medular I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -radioterapia I-TREATMENT -sobre I-TREATMENT -niveles I-TREATMENT -D1-D4 I-TREATMENT -administrándose I-TREATMENT -20 I-TREATMENT -Gy I-TREATMENT -en I-TREATMENT -5 I-TREATMENT -fracciones I-TREATMENT -con I-TREATMENT -excelente I-TREATMENT -respuesta I-TREATMENT -clínica. I-TREATMENT - I-TREATMENT -Asimismo B-EXPLORATION +se I-EXPLORATION +realizaron I-EXPLORATION +3 I-EXPLORATION +pases I-EXPLORATION +con I-EXPLORATION +aguja I-EXPLORATION +de I-EXPLORATION +25-gauge I-EXPLORATION +(ECHO-25-HD I-EXPLORATION +Cook©). I-EXPLORATION +La I-EXPLORATION +punción I-EXPLORATION se I-EXPLORATION realizó I-EXPLORATION -TAC I-EXPLORATION -toracoabdominal I-EXPLORATION -que I-EXPLORATION -mostraba I-EXPLORATION -adenopatía I-EXPLORATION -hiliar I-EXPLORATION -derecha I-EXPLORATION +sin I-EXPLORATION +jeringa I-EXPLORATION de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION +aspiración, I-EXPLORATION +mediante I-EXPLORATION +técnica I-EXPLORATION de I-EXPLORATION -nueva I-EXPLORATION -aparición I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -comenzó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -carboplatino-etopósido, I-TREATMENT -con I-TREATMENT -respuesta I-TREATMENT -parcial I-TREATMENT -tras I-TREATMENT -3 I-TREATMENT -ciclos I-TREATMENT -y I-TREATMENT -estabilización I-TREATMENT -tras I-TREATMENT -el I-TREATMENT -6o I-TREATMENT -ciclo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -administró I-TREATMENT -en I-TREATMENT -diciembre I-TREATMENT -de I-TREATMENT -2012. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -RM I-EXPLORATION +retirada I-EXPLORATION +lenta I-EXPLORATION +del I-EXPLORATION +estilete I-EXPLORATION +y I-EXPLORATION +movimientos I-EXPLORATION de I-EXPLORATION -control, I-EXPLORATION -en I-EXPLORATION -junio I-EXPLORATION +entrada-salida, I-EXPLORATION +con I-EXPLORATION +patólogo I-EXPLORATION +in I-EXPLORATION +situ, I-EXPLORATION +obteniéndose I-EXPLORATION +material I-EXPLORATION +suficiente I-EXPLORATION +para I-EXPLORATION +establecer I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -2013 I-EXPLORATION -se I-EXPLORATION -visualizaron I-EXPLORATION -múltiples I-EXPLORATION -imágenes I-EXPLORATION +meningioma I-EXPLORATION +(inmunorreactividad I-EXPLORATION +intensa I-EXPLORATION +para I-EXPLORATION +receptores I-EXPLORATION +progesterona; I-EXPLORATION +TTF-1 I-EXPLORATION +y I-EXPLORATION +CK I-EXPLORATION +AE3-AE1 I-EXPLORATION +negativas) I-EXPLORATION +(parte I-EXPLORATION +inferior I-EXPLORATION +Fig. I-EXPLORATION +1), I-EXPLORATION +apreciándose I-EXPLORATION +células I-EXPLORATION +redondas I-EXPLORATION de I-EXPLORATION -captación I-EXPLORATION -puntiformes I-EXPLORATION -compatibles I-EXPLORATION +mediano I-EXPLORATION +tamaño, I-EXPLORATION +sin I-EXPLORATION +atipia I-EXPLORATION +pero I-EXPLORATION con I-EXPLORATION -diseminación I-EXPLORATION -leptomeníngea I-EXPLORATION -a I-EXPLORATION -lo I-EXPLORATION -largo I-EXPLORATION -del I-EXPLORATION -raquis, I-EXPLORATION -tanto I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -dorsal I-EXPLORATION -como I-EXPLORATION -lumbar, I-EXPLORATION -encontrándose I-EXPLORATION -los I-EXPLORATION -implantes I-EXPLORATION -más I-EXPLORATION -destacables I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -lumbar I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -planificó I-EXPLORATION -RT I-EXPLORATION -a I-EXPLORATION -ese I-EXPLORATION -nivel I-EXPLORATION -(L1-L5). I-EXPLORATION -Se B-TREATMENT -administraron I-TREATMENT -20 I-TREATMENT -Gys I-TREATMENT -en I-TREATMENT -5 I-TREATMENT -fracciones I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -mes I-TREATMENT -de I-TREATMENT -junio I-TREATMENT -de I-TREATMENT -2013. I-TREATMENT - I-TREATMENT -En B-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -mediante I-EXPLORATION -TAC I-EXPLORATION -toracoabdominal I-EXPLORATION +modificaciones I-EXPLORATION +nucleares I-EXPLORATION en I-EXPLORATION -junio I-EXPLORATION +forma I-EXPLORATION de I-EXPLORATION -ese I-EXPLORATION -año I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION +pseudoinclusiones I-EXPLORATION +y I-EXPLORATION +cuerpos I-EXPLORATION +de I-EXPLORATION +psammoma, I-EXPLORATION que I-EXPLORATION -la I-EXPLORATION -adenopatía I-EXPLORATION -hiliar I-EXPLORATION -derecha I-EXPLORATION -había I-EXPLORATION -aumentado I-EXPLORATION -ligeramente I-EXPLORATION +formaban I-EXPLORATION +estructuras I-EXPLORATION +lobuladas I-EXPLORATION +rodeadas I-EXPLORATION +por I-EXPLORATION +tabiques I-EXPLORATION de I-EXPLORATION -tamaño I-EXPLORATION -respecto I-EXPLORATION -al I-EXPLORATION -TAC I-EXPLORATION -previo I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -administrar I-TREATMENT -radioterapia I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -hiliar I-TREATMENT +colágeno. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +hemicolectomía I-TREATMENT +derecha I-TREATMENT con I-TREATMENT -un I-TREATMENT -esquema I-TREATMENT +diagnóstico I-TREATMENT de I-TREATMENT -40 I-TREATMENT -Gy I-TREATMENT -en I-TREATMENT -15 I-TREATMENT -fracciones, I-TREATMENT -finalizando I-TREATMENT -tratamiento I-TREATMENT +adenocarcinoma I-TREATMENT +de I-TREATMENT +ciego, I-TREATMENT +sin I-TREATMENT +afectación I-TREATMENT en I-TREATMENT -noviembre I-TREATMENT -2013. I-TREATMENT - I-TREATMENT -Desde B-EVOLUTION -entonces I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -en I-EVOLUTION -revisiones, I-EVOLUTION -con I-EVOLUTION -buen I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -vida I-EVOLUTION -activa I-EVOLUTION -e I-EVOLUTION -independiente I-EVOLUTION -para I-EVOLUTION -las I-EVOLUTION -actividades I-EVOLUTION -básicas I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -vida I-EVOLUTION -diaria. I-EVOLUTION -En I-EVOLUTION -los I-EVOLUTION -estudios I-EVOLUTION +los I-TREATMENT +11 I-TREATMENT +ganglios I-TREATMENT +resecados, I-TREATMENT +ni I-TREATMENT +factores I-TREATMENT +de I-TREATMENT +riesgo I-TREATMENT +(pT2 I-TREATMENT +pN0 I-TREATMENT +Mx). I-TREATMENT +Se B-EVOLUTION +recomendó I-EVOLUTION +inicio I-EVOLUTION de I-EVOLUTION -control I-EVOLUTION +revisiones, I-EVOLUTION no I-EVOLUTION -hay I-EVOLUTION -datos I-EVOLUTION +hallándose, I-EVOLUTION +cumplidos I-EVOLUTION +los I-EVOLUTION +3 I-EVOLUTION +años I-EVOLUTION de I-EVOLUTION -progresión I-EVOLUTION +seguimiento I-EVOLUTION +hasta I-EVOLUTION +la I-EVOLUTION +actualidad, I-EVOLUTION +signos I-EVOLUTION de I-EVOLUTION -enfermedad. I-EVOLUTION -No B-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -realces I-EXPLORATION -patológicos I-EXPLORATION -leptomeníngeos I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -última I-EXPLORATION -RM I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -ha I-EXPLORATION -comprobado I-EXPLORATION -por I-EXPLORATION -TAC I-EXPLORATION -la I-EXPLORATION -disminución I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -adenopatía I-EXPLORATION -hiliar I-EXPLORATION -derecha I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -estos I-EXPLORATION -momentos I-EXPLORATION -es I-EXPLORATION -infracentimétrica. I-EXPLORATION - I-EXPLORATION +recaída I-EVOLUTION +local I-EVOLUTION +o I-EVOLUTION +a I-EVOLUTION +distancia. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS -varón, I-PRESENT_ILLNESS -fruto I-PRESENT_ILLNESS +Niño B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -primera I-PRESENT_ILLNESS -gestación I-PRESENT_ILLNESS +diez I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sano, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +celulitis I-PRESENT_ILLNESS +indurada I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +violácea I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +muslo, I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +conglomerado I-PRESENT_ILLNESS +adenopático I-PRESENT_ILLNESS +inguinal, I-PRESENT_ILLNESS +acompañados I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +febrícula I-PRESENT_ILLNESS +intermitente. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +puerta I-PRESENT_ILLNESS de I-PRESENT_ILLNESS +entrada I-PRESENT_ILLNESS +era I-PRESENT_ILLNESS una I-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS +herida I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +pie I-PRESENT_ILLNESS +producida I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +playa I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS -años. I-PRESENT_ILLNESS -El B-EXPLORATION -embarazo I-EXPLORATION -había I-EXPLORATION -transcurrido I-EXPLORATION -sin I-EXPLORATION -incidencias, I-EXPLORATION -con I-EXPLORATION -cribado I-EXPLORATION -del I-EXPLORATION -primer I-EXPLORATION -trimestre I-EXPLORATION -de I-EXPLORATION -bajo I-EXPLORATION -riesgo. I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -serológicos I-EXPLORATION -habituales I-EXPLORATION -estaban I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -normalidad. I-EXPLORATION -En I-EXPLORATION +Brasil I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +antes, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +cicatrizado. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +A I-PRESENT_ILLNESS +pesar I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +amoxicilina-clavulánico I-PRESENT_ILLNESS +endovenoso, I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +mejoró I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +sintomatología. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION ecografía I-EXPLORATION -antenatal I-EXPLORATION se I-EXPLORATION -detecta I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -37 I-EXPLORATION -semanas I-EXPLORATION -de I-EXPLORATION -edad I-EXPLORATION -gestacional I-EXPLORATION -la I-EXPLORATION -dilatación I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -lateral I-EXPLORATION -derecho, I-EXPLORATION -sin I-EXPLORATION -otras I-EXPLORATION -anomalías I-EXPLORATION -morfológicas I-EXPLORATION -a I-EXPLORATION -destacar. I-EXPLORATION - I-EXPLORATION -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -nació I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -39+3 I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -gestacional, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -vaginal I-PAST_MEDICAL_HISTORY -instrumentado. I-PAST_MEDICAL_HISTORY -La I-PAST_MEDICAL_HISTORY -presentación I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -cefálica I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -puntuación I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -test I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Apgar I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -9-9-10. I-PAST_MEDICAL_HISTORY -La B-EXPLORATION -exploración I-EXPLORATION -tras I-EXPLORATION -el I-EXPLORATION -parto I-EXPLORATION +observaba I-EXPLORATION +conglomerado I-EXPLORATION +adenopático. I-EXPLORATION +La I-EXPLORATION +punción I-EXPLORATION +aspiración I-EXPLORATION +con I-EXPLORATION +aguja I-EXPLORATION +fina I-EXPLORATION +(PAAF) I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +adenopatías I-EXPLORATION mostraba I-EXPLORATION -buen I-EXPLORATION -tono I-EXPLORATION -y I-EXPLORATION -vitalidad; I-EXPLORATION -fontanela I-EXPLORATION -anterior I-EXPLORATION -normotensa, I-EXPLORATION -sin I-EXPLORATION -anomalías I-EXPLORATION -morfológicas I-EXPLORATION -a I-EXPLORATION -destacar I-EXPLORATION -ni I-EXPLORATION -disrafismos. I-EXPLORATION -Reflejos I-EXPLORATION -arcaicos I-EXPLORATION -presentes. I-EXPLORATION -Los I-EXPLORATION -estudios I-EXPLORATION -analíticos, I-EXPLORATION -serológicos, I-EXPLORATION -el I-EXPLORATION -cribado I-EXPLORATION +histológicamente I-EXPLORATION +granulomas I-EXPLORATION +epitelioides I-EXPLORATION +con I-EXPLORATION +necrosis. I-EXPLORATION +La I-EXPLORATION +prueba I-EXPLORATION de I-EXPLORATION -metabolopatías I-EXPLORATION -y I-EXPLORATION +Mantoux I-EXPLORATION +mostraba I-EXPLORATION +una I-EXPLORATION +induración I-EXPLORATION de I-EXPLORATION -sordera I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Fondo I-EXPLORATION +20 I-EXPLORATION +mm I-EXPLORATION de I-EXPLORATION -ojo I-EXPLORATION -normal I-EXPLORATION -El I-EXPLORATION -ecocardiograma I-EXPLORATION -demostró I-EXPLORATION -comunicación I-EXPLORATION -interauricular I-EXPLORATION -sin I-EXPLORATION -repercusión I-EXPLORATION -hemodinámica. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -transfontanelar I-EXPLORATION -demostró I-EXPLORATION -dilatación I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -lateral I-EXPLORATION -derecho, I-EXPLORATION -en I-EXPLORATION -probable I-EXPLORATION -relación I-EXPLORATION +diámetro I-EXPLORATION +con I-EXPLORATION +vesículas I-EXPLORATION +y I-EXPLORATION +necrosis I-EXPLORATION a I-EXPLORATION -obstrucción I-EXPLORATION -del I-EXPLORATION -foramen I-EXPLORATION +las I-EXPLORATION +48 I-EXPLORATION +horas. I-EXPLORATION +La I-EXPLORATION +cuantificación I-EXPLORATION de I-EXPLORATION -Monro I-EXPLORATION -derecho. I-EXPLORATION -En I-EXPLORATION -este I-EXPLORATION -momento I-EXPLORATION -el I-EXPLORATION -índice I-EXPLORATION +interferón I-EXPLORATION +gamma I-EXPLORATION +fue I-EXPLORATION +positiva. I-EXPLORATION +No I-EXPLORATION +había I-EXPLORATION +recibido I-EXPLORATION +vacunación I-EXPLORATION +con I-EXPLORATION +bacilo I-EXPLORATION de I-EXPLORATION -resistencia I-EXPLORATION +Calmette-Guérin I-EXPLORATION +(BCG). I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -arteria I-EXPLORATION -pericallosa I-EXPLORATION -se I-EXPLORATION -situaba I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION +herida I-EXPLORATION +del I-EXPLORATION +pie, I-EXPLORATION +siendo I-EXPLORATION +positiva I-EXPLORATION la I-EXPLORATION -normalidad, I-EXPLORATION -sin I-EXPLORATION -aumentar I-EXPLORATION -tras I-EXPLORATION -ejercer I-EXPLORATION -presión I-EXPLORATION +reacción I-EXPLORATION en I-EXPLORATION +cadena I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -fontanela I-EXPLORATION -anterior. I-EXPLORATION -A I-EXPLORATION +polimerasa I-EXPLORATION +para I-EXPLORATION la I-EXPLORATION -semana I-EXPLORATION +detección I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -nacimiento I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -cerebral I-EXPLORATION -que I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -dilatación I-EXPLORATION -ventricular I-EXPLORATION -con I-EXPLORATION -calibre I-EXPLORATION +ADN I-EXPLORATION de I-EXPLORATION -8 I-EXPLORATION -mm I-EXPLORATION -del I-EXPLORATION -asta I-EXPLORATION -frontal, I-EXPLORATION -32 I-EXPLORATION -mm I-EXPLORATION -del I-EXPLORATION -asta I-EXPLORATION -occipital I-EXPLORATION -y I-EXPLORATION -14 I-EXPLORATION -mm I-EXPLORATION -del I-EXPLORATION -asta I-EXPLORATION -temporal. I-EXPLORATION +Mycobacterium I-EXPLORATION +tuberculosis I-EXPLORATION +(PCR-TB). I-EXPLORATION Se I-EXPLORATION -asociaba I-EXPLORATION +confirmó I-EXPLORATION +microbiológicamente I-EXPLORATION +aislando I-EXPLORATION +Mycobacterium I-EXPLORATION +tuberculosis I-EXPLORATION +sensible I-EXPLORATION a I-EXPLORATION -un I-EXPLORATION -desplazamiento I-EXPLORATION -de I-EXPLORATION -4 I-EXPLORATION -mm I-EXPLORATION +isoniazida I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +cultivo I-EXPLORATION de I-EXPLORATION +PAAF I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -línea I-EXPLORATION -media, I-EXPLORATION -sin I-EXPLORATION -observarse I-EXPLORATION -masas I-EXPLORATION -ni I-EXPLORATION -tabiques I-EXPLORATION -intraventriculares. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -sistema I-EXPLORATION -ventricular I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Por I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -datos I-EXPLORATION +biopsia I-EXPLORATION +cutánea. I-EXPLORATION +La I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -hipertensión I-EXPLORATION -intracraneal I-EXPLORATION +tórax I-EXPLORATION y I-EXPLORATION la I-EXPLORATION -edad I-EXPLORATION -del I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -seguimiento I-EXPLORATION -inicial I-EXPLORATION -clínico I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +fueron I-EXPLORATION +normales, I-EXPLORATION y I-EXPLORATION -radiológico I-EXPLORATION -mediante I-EXPLORATION -ecografías I-EXPLORATION -seriadas. I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION las I-EXPLORATION -10 I-EXPLORATION -semanas I-EXPLORATION -de I-EXPLORATION -edad, I-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION -transfontanelar I-EXPLORATION -demostró I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -dilatación I-EXPLORATION -(asta I-EXPLORATION -frontal I-EXPLORATION -11 I-EXPLORATION -mm, I-EXPLORATION -occipital I-EXPLORATION -27 I-EXPLORATION -mm I-EXPLORATION +baciloscopias I-EXPLORATION y I-EXPLORATION -temporal I-EXPLORATION -19 I-EXPLORATION -mm), I-EXPLORATION -desplazamiento I-EXPLORATION +cultivos I-EXPLORATION de I-EXPLORATION -6 I-EXPLORATION -mm I-EXPLORATION +jugo I-EXPLORATION +gástrico, I-EXPLORATION +negativos. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +inmunitario I-EXPLORATION +(con I-EXPLORATION +detección I-EXPLORATION de I-EXPLORATION +inmunoglobulinas, I-EXPLORATION +inmunidad I-EXPLORATION +celular I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -línea I-EXPLORATION -media I-EXPLORATION -e I-EXPLORATION -índice I-EXPLORATION -de I-EXPLORATION -resistencia I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -arteria I-EXPLORATION -pericallosa I-EXPLORATION -incrementado, I-EXPLORATION -aumentando I-EXPLORATION -de I-EXPLORATION -manera I-EXPLORATION -significativa I-EXPLORATION -tras I-EXPLORATION -presión I-EXPLORATION -ligera I-EXPLORATION -sobre I-EXPLORATION -fontanela I-EXPLORATION -anterior, I-EXPLORATION -hallazgo I-EXPLORATION -sugestivo I-EXPLORATION -de I-EXPLORATION -hidrocefalia I-EXPLORATION -a I-EXPLORATION -tensión. I-EXPLORATION -Ante B-TREATMENT -estos I-TREATMENT -hallazgos, I-TREATMENT -a I-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -presentaba I-TREATMENT -perímetro I-TREATMENT -cefálico I-TREATMENT -normal I-TREATMENT -y I-TREATMENT -exploración I-TREATMENT -clínica I-TREATMENT -normal, I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -realizar I-TREATMENT +inmunodeficiencia I-EXPLORATION +humana) I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT tratamiento I-TREATMENT -quirúrgico I-TREATMENT -de I-TREATMENT -la I-TREATMENT -hidrocefalia. I-TREATMENT - I-TREATMENT -El I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -intervenido I-TREATMENT -a I-TREATMENT -los I-TREATMENT -3 I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -edad. I-TREATMENT -Se I-TREATMENT -empleó I-TREATMENT -un I-TREATMENT -ventriculoscopio I-TREATMENT -rígido I-TREATMENT -a I-TREATMENT -0o I-TREATMENT -(Kart I-TREATMENT -Storz I-TREATMENT -®, I-TREATMENT -Tuttlingen, I-TREATMENT -Alemania). I-TREATMENT -Bajo I-TREATMENT -anestesia I-TREATMENT -general I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -colocó I-TREATMENT -en I-TREATMENT -decúbito I-TREATMENT -supino, I-TREATMENT con I-TREATMENT -la I-TREATMENT -cabeza I-TREATMENT -neutra I-TREATMENT -elevada I-TREATMENT -unos I-TREATMENT -20o. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT -agujero I-TREATMENT -de I-TREATMENT -trépano I-TREATMENT -derecho, I-TREATMENT -justo I-TREATMENT -anterior I-TREATMENT -a I-TREATMENT -la I-TREATMENT -sutura I-TREATMENT -coronal I-TREATMENT -y I-TREATMENT -3 I-TREATMENT -cm I-TREATMENT -lateral I-TREATMENT -a I-TREATMENT -la I-TREATMENT -línea I-TREATMENT -media. I-TREATMENT -El I-TREATMENT -acceso I-TREATMENT -al I-TREATMENT -ventrículo I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -siguiendo I-TREATMENT -las I-TREATMENT -referencias I-TREATMENT -anatómicas I-TREATMENT -habituales, I-TREATMENT -dirigiendo I-TREATMENT -el I-TREATMENT -endoscopio I-TREATMENT -hacia I-TREATMENT -el I-TREATMENT -canto I-TREATMENT -interno I-TREATMENT -del I-TREATMENT -ojo I-TREATMENT -ipsilateral I-TREATMENT -en I-TREATMENT -el I-TREATMENT -plano I-TREATMENT -coronal I-TREATMENT -y I-TREATMENT -hacia I-TREATMENT -el I-TREATMENT -conducto I-TREATMENT -auditivo I-TREATMENT -externo I-TREATMENT -en I-TREATMENT -el I-TREATMENT -plano I-TREATMENT -sagital. I-TREATMENT -Tras I-TREATMENT -acceder I-TREATMENT -al I-TREATMENT -asta I-TREATMENT -frontal I-TREATMENT -derecha, I-TREATMENT -se I-TREATMENT -identificó I-TREATMENT -la I-TREATMENT -anatomía I-TREATMENT -ventricular I-TREATMENT +terapia I-TREATMENT +antituberculosa I-TREATMENT +(isoniazida, I-TREATMENT +rifampicina I-TREATMENT y I-TREATMENT -se I-TREATMENT -localizó I-TREATMENT +pirazinamida). I-TREATMENT +Esta I-TREATMENT +tuvo I-TREATMENT +que I-TREATMENT +ser I-TREATMENT +sustituida I-TREATMENT +por I-TREATMENT +etambutol I-TREATMENT +tras I-TREATMENT la I-TREATMENT -ubicación I-TREATMENT -teórica I-TREATMENT -del I-TREATMENT -foramen I-TREATMENT -de I-TREATMENT -Monro I-TREATMENT -siguiendo I-TREATMENT -las I-TREATMENT -venas I-TREATMENT -talamoestriada I-TREATMENT -y I-TREATMENT -septal I-TREATMENT -anterior I-TREATMENT -y I-TREATMENT -el I-TREATMENT -plexo I-TREATMENT -coroideo. I-TREATMENT -Se I-TREATMENT -identificó I-TREATMENT -una I-TREATMENT -membrana I-TREATMENT -avascular I-TREATMENT -a I-TREATMENT -través I-TREATMENT +aparición I-TREATMENT de I-TREATMENT -la I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -intuía I-TREATMENT +un I-TREATMENT +exantema I-TREATMENT +cutáneo I-TREATMENT +pruriginoso I-TREATMENT +presuntamente I-TREATMENT +causado I-TREATMENT por I-TREATMENT -transparencia I-TREATMENT -el I-TREATMENT -foramen I-TREATMENT -de I-TREATMENT -Monro. I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -coagulación I-TREATMENT -y I-TREATMENT -posterior I-TREATMENT -apertura I-TREATMENT -de I-TREATMENT -esta I-TREATMENT -membrana I-TREATMENT -empleando I-TREATMENT -la I-TREATMENT -punta I-TREATMENT -bipolar I-TREATMENT +pirazinamida I-TREATMENT y I-TREATMENT -posteriormente I-TREATMENT -se I-TREATMENT -dilató I-TREATMENT -con I-TREATMENT -un I-TREATMENT -balón I-TREATMENT -de I-TREATMENT -Fogarty I-TREATMENT -de I-TREATMENT -4 I-TREATMENT -French. I-TREATMENT -A I-TREATMENT -través I-TREATMENT -del I-TREATMENT -nuevo I-TREATMENT -foramen I-TREATMENT -creado, I-TREATMENT -se I-TREATMENT -introdujo I-TREATMENT -el I-TREATMENT -endoscopio I-TREATMENT -hasta I-TREATMENT -visualizar I-TREATMENT -el I-TREATMENT -tercer I-TREATMENT -ventrículo. I-TREATMENT -Tras I-TREATMENT -crear I-TREATMENT -una I-TREATMENT -adecuada I-TREATMENT -comunicación I-TREATMENT -del I-TREATMENT -asta I-TREATMENT -frontal I-TREATMENT -derecha I-TREATMENT -con I-TREATMENT -el I-TREATMENT -tercer I-TREATMENT -ventrículo, I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -fenestración I-TREATMENT -en I-TREATMENT -la I-TREATMENT -porción I-TREATMENT -anterior I-TREATMENT -del I-TREATMENT -septo I-TREATMENT -pellucidum, I-TREATMENT -para I-TREATMENT -asegurar I-TREATMENT -otra I-TREATMENT -vía I-TREATMENT -de I-TREATMENT -comunicación I-TREATMENT -entre I-TREATMENT -las I-TREATMENT -astas I-TREATMENT -frontales I-TREATMENT -de I-TREATMENT -los I-TREATMENT -ventrículos I-TREATMENT -laterales. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -postoperatorio I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -cursó I-EVOLUTION -sin I-EVOLUTION -incidencias. I-EVOLUTION -La I-EVOLUTION -evolución I-EVOLUTION -del I-EVOLUTION -perímetro I-EVOLUTION -craneal I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -exploración I-EVOLUTION -física I-EVOLUTION -y I-EVOLUTION -neurológica I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -primeros I-EVOLUTION -6 I-EVOLUTION +que I-TREATMENT +desapareció I-TREATMENT +tras I-TREATMENT +su I-TREATMENT +retirada. I-TREATMENT +Un B-EVOLUTION +mes I-EVOLUTION +después I-EVOLUTION +aparecieron I-EVOLUTION +dos I-EVOLUTION +fístulas I-EVOLUTION +cutáneas I-EVOLUTION +profundas, I-EVOLUTION +que B-TREATMENT +requirieron I-TREATMENT +desbridamiento I-TREATMENT +quirúrgico. I-TREATMENT +Tras B-EVOLUTION +seis I-EVOLUTION meses I-EVOLUTION de I-EVOLUTION -seguimiento I-EVOLUTION -fueron I-EVOLUTION -normales. I-EVOLUTION -Las I-EVOLUTION -ecografias I-EVOLUTION -transfontanelares I-EVOLUTION -de I-EVOLUTION -seguimiento I-EVOLUTION -mostraron I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION +tratamiento I-EVOLUTION +se I-EVOLUTION +resolvieron I-EVOLUTION la I-EVOLUTION -dilatación I-EVOLUTION +escrófula I-EVOLUTION +cutánea I-EVOLUTION +y I-EVOLUTION +las I-EVOLUTION +adenopatías I-EVOLUTION +inguinales. I-EVOLUTION +No B-EXPLORATION +se I-EXPLORATION +detectó I-EXPLORATION +contacto I-EXPLORATION +con I-EXPLORATION +paciente I-EXPLORATION +bacilífero I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +familiar I-EXPLORATION +con I-EXPLORATION +prueba I-EXPLORATION +de I-EXPLORATION +Mantoux I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +50 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +diagnosticado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hernia I-PRESENT_ILLNESS +discal, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +Durogesic® I-PRESENT_ILLNESS +150 I-PRESENT_ILLNESS +μg/h I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +buena I-PRESENT_ILLNESS +eficacia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +seguridad. I-PRESENT_ILLNESS +Se B-TREATMENT +cambia I-TREATMENT +por I-TREATMENT +un I-TREATMENT +genérico, I-TREATMENT +notándose B-EVOLUTION +un I-EVOLUTION +empeoramiento I-EVOLUTION del I-EVOLUTION -ventrículo I-EVOLUTION -lateral I-EVOLUTION -derecho, I-EVOLUTION -con I-EVOLUTION -índice I-EVOLUTION +cuadro I-EVOLUTION +doloroso I-EVOLUTION +y I-EVOLUTION +síntomas I-EVOLUTION +neurológicos I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -arteria I-EVOLUTION -pericallosa I-EVOLUTION -dentro I-EVOLUTION +inestabilidad. I-EVOLUTION +Se B-TREATMENT +vuelve I-TREATMENT +a I-TREATMENT +cambiar I-TREATMENT +a I-TREATMENT +Durogesic®, I-TREATMENT +y B-EVOLUTION de I-EVOLUTION +nuevo I-EVOLUTION +se I-EVOLUTION +estabiliza I-EVOLUTION la I-EVOLUTION -normalidad. I-EVOLUTION -La I-EVOLUTION -RM I-EVOLUTION -realizada I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -9 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -edad I-EVOLUTION -confirmó I-EVOLUTION -estos I-EVOLUTION -hallazgos I-EVOLUTION -de I-EVOLUTION -ecografía. I-EVOLUTION +analgesia I-EVOLUTION +y I-EVOLUTION +desaparece I-EVOLUTION +la I-EVOLUTION +sintomatología I-EVOLUTION +neurológica. I-EVOLUTION I-EVOLUTION -Varón B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -ingresado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Unidad I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Cuidados I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +y B-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Down, I-PAST_MEDICAL_HISTORY +hipotiroidismo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +cardiopatía I-PAST_MEDICAL_HISTORY +congénita I-PAST_MEDICAL_HISTORY +operada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +primer I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vida I-PAST_MEDICAL_HISTORY +(canal I-PAST_MEDICAL_HISTORY +aurículo-ventricular I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +ductus I-PAST_MEDICAL_HISTORY +arterioso I-PAST_MEDICAL_HISTORY +persistente). I-PAST_MEDICAL_HISTORY +Tenía B-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +vacunas I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +Programa I-PRESENT_ILLNESS +Nacional I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Intensivos I-PRESENT_ILLNESS -(UCI) I-PRESENT_ILLNESS +Inmunizaciones I-PRESENT_ILLNESS +(PNI) I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +día, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +vacunas I-PRESENT_ILLNESS +extra-PNI. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Consultó I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +veces I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -situación I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -daño I-PRESENT_ILLNESS -cerebral I-PRESENT_ILLNESS -catastrófico I-PRESENT_ILLNESS -secundario I-PRESENT_ILLNESS +Urgencia I-PRESENT_ILLNESS +Infantil I-PRESENT_ILLNESS +(SUI) I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -accidente I-PRESENT_ILLNESS -cerebrovascular I-PRESENT_ILLNESS -isquémico I-PRESENT_ILLNESS -establecido I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cinco I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +eritrodermia. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +eritema I-PRESENT_ILLNESS +comenzó I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -territorio I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +hemi-cara I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +luego I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +extendió I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +lado I-PRESENT_ILLNESS +contra-lateral. I-PRESENT_ILLNESS +Al I-PRESENT_ILLNESS +segundo I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +40° I-PRESENT_ILLNESS +C, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +eritema I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +progresión I-PRESENT_ILLNESS +descendente, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +comprometió I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +cuello, I-PRESENT_ILLNESS +tronco I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +ambas I-PRESENT_ILLNESS +extremidades I-PRESENT_ILLNESS +superiores. I-PRESENT_ILLNESS +Además I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +acompañó I-PRESENT_ILLNESS de I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -arteria I-PRESENT_ILLNESS -cerebral I-PRESENT_ILLNESS -media I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -transformación I-PRESENT_ILLNESS -hemorrágica. I-PRESENT_ILLNESS -Tras B-EXPLORATION -cuatro I-EXPLORATION -días I-EXPLORATION +aparición I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +flictenas I-PRESENT_ILLNESS +eritematosas, I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +pruriginosas, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +mentoniana I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +preauricular I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +desaparecieron I-PRESENT_ILLNESS +espontáneamente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +transcurso I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +día. I-PRESENT_ILLNESS +Se B-EXPLORATION +evaluó I-EXPLORATION +con I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -ingreso I-EXPLORATION -en I-EXPLORATION -UCI I-EXPLORATION -y I-EXPLORATION -ante I-EXPLORATION -el I-EXPLORATION -infausto I-EXPLORATION -pronóstico I-EXPLORATION -neurológico, I-EXPLORATION -se I-EXPLORATION -decidió I-EXPLORATION -aplicar I-EXPLORATION -LTSV I-EXPLORATION +laboratorio, I-EXPLORATION +destacando I-EXPLORATION +un I-EXPLORATION +hemograma I-EXPLORATION +con I-EXPLORATION +recuento I-EXPLORATION de I-EXPLORATION -forma I-EXPLORATION -consensuada I-EXPLORATION -entre I-EXPLORATION -el I-EXPLORATION -equipo I-EXPLORATION +leucocitos I-EXPLORATION +normales I-EXPLORATION +(10.470/mm3) I-EXPLORATION +con I-EXPLORATION +predominio I-EXPLORATION +polimorfonuclear I-EXPLORATION +(92,3%), I-EXPLORATION +sin I-EXPLORATION +alteración I-EXPLORATION de I-EXPLORATION -UCI I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -familia. I-EXPLORATION -Una I-EXPLORATION -vez I-EXPLORATION -establecida I-EXPLORATION la I-EXPLORATION -LTSV, I-EXPLORATION +serie I-EXPLORATION +roja I-EXPLORATION y I-EXPLORATION -ante I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +(PCR) I-EXPLORATION +de I-EXPLORATION +6, I-EXPLORATION +5 I-EXPLORATION +mg/dl I-EXPLORATION +(VN I-EXPLORATION +< I-EXPLORATION +1 I-EXPLORATION +mg/dl). I-EXPLORATION +Se B-TREATMENT +le I-TREATMENT +hizo I-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +una I-TREATMENT +dermatitis I-TREATMENT +alérgica I-TREATMENT +y I-TREATMENT +se I-TREATMENT +indicó I-TREATMENT +clorfenamina I-TREATMENT +y I-TREATMENT +glucocorticoides I-TREATMENT +vía I-TREATMENT +oral, I-TREATMENT +durante I-TREATMENT +tres I-TREATMENT +días. I-TREATMENT + I-TREATMENT +Por B-DERIVED_FROM/TO +persistencia I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +sintomatología, I-DERIVED_FROM/TO +consultó I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +pediatra I-DERIVED_FROM/TO +tratante I-DERIVED_FROM/TO +quien I-DERIVED_FROM/TO +lo I-DERIVED_FROM/TO +derivó I-DERIVED_FROM/TO +nuevamente I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +SUI. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +En B-EVOLUTION +ese I-EVOLUTION +momento, I-EVOLUTION +en I-EVOLUTION +su I-EVOLUTION +8° I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +evolución I-EVOLUTION +y I-EVOLUTION +7° I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +fiebre, I-EVOLUTION +se I-EVOLUTION +apreciaba I-EVOLUTION +en I-EVOLUTION +buenas I-EVOLUTION +condiciones I-EVOLUTION +generales. I-EVOLUTION +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +se I-EXPLORATION +describía I-EXPLORATION +una I-EXPLORATION +"lesión I-EXPLORATION +eritro-descamativa I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -posibilidad I-EXPLORATION -de I-EXPLORATION +cara I-EXPLORATION que I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -pudiera I-EXPLORATION -ser I-EXPLORATION -donante I-EXPLORATION -de I-EXPLORATION -órganos I-EXPLORATION +respetaba I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +peribucal I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +placa I-EXPLORATION +eritematosa I-EXPLORATION en I-EXPLORATION -asistolia I-EXPLORATION -controlada, I-EXPLORATION -el I-EXPLORATION -coordinador I-EXPLORATION -de I-EXPLORATION -trasplantes I-EXPLORATION -se I-EXPLORATION -entrevistó I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -familiares I-EXPLORATION +las I-EXPLORATION +extremidades I-EXPLORATION +superiores I-EXPLORATION que I-EXPLORATION -mostraron I-EXPLORATION -su I-EXPLORATION -deseo I-EXPLORATION -de I-EXPLORATION -donación I-EXPLORATION +respetaba I-EXPLORATION +las I-EXPLORATION +muñecas, I-EXPLORATION +manos I-EXPLORATION y I-EXPLORATION -firmaron I-EXPLORATION +cara I-EXPLORATION +anterior I-EXPLORATION +de I-EXPLORATION +codo. I-EXPLORATION +También I-EXPLORATION +afectaba I-EXPLORATION el I-EXPLORATION -consiguiente I-EXPLORATION -consentimiento I-EXPLORATION -informado I-EXPLORATION -(que I-EXPLORATION -incluye I-EXPLORATION -canulación I-EXPLORATION +cuero I-EXPLORATION +cabelludo, I-EXPLORATION +cuello I-EXPLORATION y I-EXPLORATION -heparinización I-EXPLORATION -premortem). I-EXPLORATION - I-EXPLORATION -Tras I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION +mitad I-EXPLORATION +superior I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -clínicas I-EXPLORATION +tronco, I-EXPLORATION +con I-EXPLORATION +bordes I-EXPLORATION +bien I-EXPLORATION +delimitados, I-EXPLORATION +sin I-EXPLORATION +adenopatías I-EXPLORATION +palpables. I-EXPLORATION +Presentaba I-EXPLORATION +una I-EXPLORATION +inyección I-EXPLORATION +conjuntival I-EXPLORATION +sin I-EXPLORATION +secreción I-EXPLORATION y I-EXPLORATION -analíticas I-EXPLORATION -necesarias, I-EXPLORATION -se I-EXPLORATION -procedió I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -canulación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION +lengua I-EXPLORATION +aframbuesada. I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +cardíaco I-EXPLORATION +era I-EXPLORATION +normal, I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -femorales I-EXPLORATION -derechas I-EXPLORATION -(necesarias I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -NECMO), I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -femoral I-EXPLORATION -contralateral I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -colocación I-EXPLORATION +no I-EXPLORATION +presentaba I-EXPLORATION +descamación I-EXPLORATION +periungueal". I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +solicitaron I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION +laboratorio, I-EXPLORATION +destacando I-EXPLORATION un I-EXPLORATION -catéter I-EXPLORATION -de I-EXPLORATION -oclusión I-EXPLORATION -aórtico I-EXPLORATION -tipo I-EXPLORATION -Fogarty. I-EXPLORATION -Una I-EXPLORATION -vez I-EXPLORATION -confirmada I-EXPLORATION -la I-EXPLORATION -adecuada I-EXPLORATION -colocación I-EXPLORATION +hemograma I-EXPLORATION +con I-EXPLORATION +leucopenia I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -cánulas I-EXPLORATION +4.880/mm3, I-EXPLORATION +con I-EXPLORATION +predominio I-EXPLORATION +polimorfonuclear I-EXPLORATION +(90%), I-EXPLORATION +plaquetas I-EXPLORATION +198.000/mm3, I-EXPLORATION +PCR I-EXPLORATION de I-EXPLORATION -NECMO I-EXPLORATION +20, I-EXPLORATION +2 I-EXPLORATION +mg/dl I-EXPLORATION y I-EXPLORATION -del I-EXPLORATION -catéter I-EXPLORATION -Fogarty, I-EXPLORATION -el I-EXPLORATION -enfermo I-EXPLORATION -fue I-EXPLORATION -trasladado I-EXPLORATION -a I-EXPLORATION -quirófano I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -procedió I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -LTSV I-EXPLORATION -acordada. I-EXPLORATION -Tras I-EXPLORATION -la I-EXPLORATION -retirada I-EXPLORATION -de I-EXPLORATION -soporte I-EXPLORATION -vital I-EXPLORATION +anticuerpos I-EXPLORATION +anti-estreptolisina I-EXPLORATION +O I-EXPLORATION +759 I-EXPLORATION +U/ I-EXPLORATION +ml I-EXPLORATION +(VN: I-EXPLORATION +< I-EXPLORATION +200). I-EXPLORATION +Además I-EXPLORATION se I-EXPLORATION -administraron I-EXPLORATION -300 I-EXPLORATION -UI/Kg I-EXPLORATION -de I-EXPLORATION -heparina I-EXPLORATION -sódica I-EXPLORATION -i.v., I-EXPLORATION -y I-EXPLORATION -12 I-EXPLORATION -minutos I-EXPLORATION -más I-EXPLORATION -tarde I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -comenzó I-EXPLORATION -con I-EXPLORATION -hipoperfusión I-EXPLORATION -verdadera I-EXPLORATION -(tensión I-EXPLORATION -arterial I-EXPLORATION -sistólica I-EXPLORATION -(TAS) I-EXPLORATION -menor I-EXPLORATION -de I-EXPLORATION -60 I-EXPLORATION -mmHg), I-EXPLORATION -presentando I-EXPLORATION -asistolia I-EXPLORATION -cinco I-EXPLORATION -minutos I-EXPLORATION -después I-EXPLORATION +tomaron I-EXPLORATION +un I-EXPLORATION +cultivo I-EXPLORATION +faríngeo I-EXPLORATION y I-EXPLORATION -confirmando I-EXPLORATION -el I-EXPLORATION -fallecimiento I-EXPLORATION -otros I-EXPLORATION -cinco I-EXPLORATION -minutos I-EXPLORATION -más I-EXPLORATION -tarde. I-EXPLORATION -Así, I-EXPLORATION -el I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -isquemia I-EXPLORATION -caliente I-EXPLORATION -total I-EXPLORATION -(TICT, I-EXPLORATION -desde I-EXPLORATION +dos I-EXPLORATION +hemocultivos I-EXPLORATION +periféricos. I-EXPLORATION + I-EXPLORATION +Ingresó B-EVOLUTION +al I-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Pediatría I-EVOLUTION +al I-EVOLUTION +8° I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +evolución, I-EVOLUTION +en I-EVOLUTION +buenas I-EVOLUTION +condiciones I-EVOLUTION +generales, I-EVOLUTION +con I-EVOLUTION +estabilidad I-EVOLUTION +hemodinámica I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +compromiso I-EVOLUTION +de I-EVOLUTION +conciencia. I-EVOLUTION +Se B-TREATMENT +planteó I-TREATMENT +el I-TREATMENT +diagnóstico I-TREATMENT +de I-TREATMENT +escarlatina I-TREATMENT +e I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +antimicrobiano I-TREATMENT +con I-TREATMENT +amoxicilina, I-TREATMENT +vía I-TREATMENT +oral. I-TREATMENT +Además B-EXPLORATION +se I-EXPLORATION +planteó I-EXPLORATION la I-EXPLORATION -retirada I-EXPLORATION -de I-EXPLORATION -soporte I-EXPLORATION -vital I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -inicio I-EXPLORATION -de I-EXPLORATION -perfusión I-EXPLORATION -fría I-EXPLORATION -o I-EXPLORATION -NECMO) I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -22 I-EXPLORATION -minutos I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -isquemia I-EXPLORATION -caliente I-EXPLORATION -funcional I-EXPLORATION -(TICF, I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -comienzo I-EXPLORATION +necesidad I-EXPLORATION de I-EXPLORATION +realizar I-EXPLORATION +un I-EXPLORATION +ecocardiograma I-EXPLORATION +para I-EXPLORATION +descartar I-EXPLORATION una I-EXPLORATION -hipoperfusión I-EXPLORATION -significativa I-EXPLORATION --TAS<60 I-EXPLORATION -mmHg- I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -inicio I-EXPLORATION +enfermedad I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -perfusión I-EXPLORATION -fría I-EXPLORATION +Kawasaki I-EXPLORATION +atípica I-EXPLORATION o I-EXPLORATION -NECMO) I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -minutos. I-EXPLORATION -Se I-EXPLORATION -puede I-EXPLORATION -ver I-EXPLORATION -la I-EXPLORATION -evolución I-EXPLORATION -del I-EXPLORATION -potencial I-EXPLORATION -donante I-EXPLORATION -durante I-EXPLORATION -este I-EXPLORATION -período I-EXPLORATION -de I-EXPLORATION -observación I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -Tabla I-EXPLORATION -1. I-EXPLORATION - I-EXPLORATION -LTSV: I-EXPLORATION -limitación I-EXPLORATION -del I-EXPLORATION -tratamiento I-EXPLORATION -de I-EXPLORATION -soporte I-EXPLORATION -vital; I-EXPLORATION -min: I-EXPLORATION -minutos; I-EXPLORATION -TAS: I-EXPLORATION -tensión I-EXPLORATION -arterial I-EXPLORATION -sistólica; I-EXPLORATION -TAD: I-EXPLORATION -tensión I-EXPLORATION -arterial I-EXPLORATION -diastólica; I-EXPLORATION -FC: I-EXPLORATION -frecuencia I-EXPLORATION -cardíaca; I-EXPLORATION -FR: I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria; I-EXPLORATION -Sat. I-EXPLORATION -O2: I-EXPLORATION -saturación I-EXPLORATION -de I-EXPLORATION -oxígeno; I-EXPLORATION -lpm: I-EXPLORATION -latidos/minuto; I-EXPLORATION -rpm: I-EXPLORATION -respiraciones/minuto; I-EXPLORATION -ml: I-EXPLORATION -mililitros I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -cuanto I-EXPLORATION -se I-EXPLORATION -confirmó I-EXPLORATION -la I-EXPLORATION -muerte, I-EXPLORATION -se I-EXPLORATION -inició I-EXPLORATION -la I-EXPLORATION -NECMO I-EXPLORATION -(previo I-EXPLORATION -hinchado I-EXPLORATION -del I-EXPLORATION -balón I-EXPLORATION -de I-EXPLORATION -Fogarty I-EXPLORATION -contralateral) I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -intubado I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -iniciar I-EXPLORATION -ventilación I-EXPLORATION -(tubo I-EXPLORATION -al I-EXPLORATION -aire). I-EXPLORATION -Seguidamente, I-EXPLORATION -el I-EXPLORATION -cirujano I-EXPLORATION -torácico I-EXPLORATION -realizó I-EXPLORATION una I-EXPLORATION -esternotomía I-EXPLORATION -rápida I-EXPLORATION -y, I-EXPLORATION -en I-EXPLORATION +endocarditis I-EXPLORATION +infecciosa. I-EXPLORATION +Se B-EVOLUTION +controlaron I-EVOLUTION +exámenes I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +24 I-EVOLUTION +h I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +ingreso. I-EVOLUTION +Tenía I-EVOLUTION +una I-EVOLUTION +PCR I-EVOLUTION +de I-EVOLUTION +23, I-EVOLUTION +9 I-EVOLUTION +mg/dl I-EVOLUTION +y I-EVOLUTION +un I-EVOLUTION +perfil I-EVOLUTION +bioquímico I-EVOLUTION +normal. I-EVOLUTION +Evaluada B-TREATMENT +por I-TREATMENT +infectología, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +cambiar I-TREATMENT +tratamiento I-TREATMENT +antimicrobiano I-TREATMENT +a I-TREATMENT +penicilina I-TREATMENT +sódica I-TREATMENT +i.v. I-TREATMENT + I-TREATMENT +Evolucionó B-EVOLUTION +desde I-EVOLUTION +el I-EVOLUTION +inicio I-EVOLUTION +del I-EVOLUTION +tratamiento I-EVOLUTION +antimicrobiano, I-EVOLUTION +en I-EVOLUTION +buenas I-EVOLUTION +condiciones I-EVOLUTION +generales. I-EVOLUTION +A I-EVOLUTION +las I-EVOLUTION +48 I-EVOLUTION +h I-EVOLUTION +de I-EVOLUTION +incubación I-EVOLUTION +se I-EVOLUTION +informaron I-EVOLUTION +los I-EVOLUTION +dos I-EVOLUTION +hemocultivos I-EVOLUTION +positivos I-EVOLUTION +para I-EVOLUTION +Streptococcus I-EVOLUTION +ß- I-EVOLUTION +hemolítico I-EVOLUTION +del I-EVOLUTION +grupo I-EVOLUTION +G, I-EVOLUTION +con I-EVOLUTION +susceptibilidad I-EVOLUTION +in I-EVOLUTION +vitro I-EVOLUTION +a I-EVOLUTION +penicilina, I-EVOLUTION +clindamicina, I-EVOLUTION +cloxacilina, I-EVOLUTION +eritromicina I-EVOLUTION +y I-EVOLUTION +levofloxacino, I-EVOLUTION +y I-EVOLUTION +resistencia I-EVOLUTION +a I-EVOLUTION +cotrimoxazol. I-EVOLUTION +El I-EVOLUTION +ecocardiograma I-EVOLUTION +realizado I-EVOLUTION +fue I-EVOLUTION +normal I-EVOLUTION +y I-EVOLUTION +no I-EVOLUTION +hubo I-EVOLUTION +detección I-EVOLUTION +de I-EVOLUTION +otros I-EVOLUTION +focos I-EVOLUTION +clínicos I-EVOLUTION +secundarios. I-EVOLUTION + I-EVOLUTION +Evolucionó I-EVOLUTION +afebril, I-EVOLUTION +con I-EVOLUTION +franca I-EVOLUTION +disminución I-EVOLUTION +del I-EVOLUTION +eritema I-EVOLUTION +facial I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +tronco. I-EVOLUTION +Al I-EVOLUTION +5° I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION +antimicrobiano, I-EVOLUTION +se I-EVOLUTION +informó I-EVOLUTION +que I-EVOLUTION +la I-EVOLUTION +especie I-EVOLUTION +identificada, I-EVOLUTION +por I-EVOLUTION +método I-EVOLUTION +de I-EVOLUTION +Vitek®, I-EVOLUTION +correspondía I-EVOLUTION +a I-EVOLUTION +Streptococcus I-EVOLUTION +dysgalactiae I-EVOLUTION +subespecie I-EVOLUTION +equisimilis. I-EVOLUTION + I-EVOLUTION +La B-TREATMENT +paciente I-TREATMENT +recibió I-TREATMENT +10 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +antimicrobiano I-TREATMENT +i.v. I-TREATMENT +más I-TREATMENT +cuatro I-TREATMENT +días I-TREATMENT +de I-TREATMENT +amoxicilina/ácido I-TREATMENT +clavulánico, I-TREATMENT +vía I-TREATMENT +oral, I-TREATMENT +completando I-TREATMENT +en I-TREATMENT +la I-TREATMENT +fase I-TREATMENT +ambulatoria I-TREATMENT +14 I-TREATMENT +días I-TREATMENT +de I-TREATMENT +tratamiento. I-TREATMENT +El B-EVOLUTION +control I-EVOLUTION +posterior I-EVOLUTION +demostró I-EVOLUTION +una I-EVOLUTION +evolución I-EVOLUTION +satisfactoria. I-EVOLUTION +Se B-EXPLORATION +realizó I-EXPLORATION un I-EXPLORATION -tiempo I-EXPLORATION -de I-EXPLORATION -7-8 I-EXPLORATION -minutos, I-EXPLORATION -revisó I-EXPLORATION -la I-EXPLORATION -cavidad I-EXPLORATION -torácica I-EXPLORATION -y I-EXPLORATION -clampó I-EXPLORATION -la I-EXPLORATION -aorta I-EXPLORATION -torácica I-EXPLORATION -justo I-EXPLORATION -por I-EXPLORATION -encima I-EXPLORATION -del I-EXPLORATION -catéter I-EXPLORATION +estudio I-EXPLORATION +básico I-EXPLORATION de I-EXPLORATION -Fogarty. I-EXPLORATION -Inmediatamente I-EXPLORATION -después I-EXPLORATION -se I-EXPLORATION -inició I-EXPLORATION -ventilación I-EXPLORATION -mecánica I-EXPLORATION -con I-EXPLORATION +inmunodeficiencia I-EXPLORATION +descartándose I-EXPLORATION una I-EXPLORATION -fracción I-EXPLORATION -inspirada I-EXPLORATION -de I-EXPLORATION -oxígeno I-EXPLORATION -(FiO2) I-EXPLORATION -del I-EXPLORATION -100%, I-EXPLORATION -presión I-EXPLORATION -positiva I-EXPLORATION +hipogamaglobulinemia, I-EXPLORATION +hipocomplementemia I-EXPLORATION +o I-EXPLORATION +leucopenia I-EXPLORATION +secundaria I-EXPLORATION al I-EXPLORATION -final I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -espiración I-EXPLORATION -(PEEP) I-EXPLORATION +Síndrome I-EXPLORATION de I-EXPLORATION -5 I-EXPLORATION -y I-EXPLORATION -12 I-EXPLORATION -respiraciones/minuto. I-EXPLORATION -El I-EXPLORATION -cirujano I-EXPLORATION -canuló I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -pulmonar I-EXPLORATION -y I-EXPLORATION +Down. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +cepa I-EXPLORATION se I-EXPLORATION -perfundieron I-EXPLORATION -los I-EXPLORATION -pulmones I-EXPLORATION -con I-EXPLORATION -Perfadex I-EXPLORATION -(solución I-EXPLORATION +envió I-EXPLORATION +al I-EXPLORATION +Laboratorio I-EXPLORATION de I-EXPLORATION -preservación I-EXPLORATION +Biología I-EXPLORATION +Molecular I-EXPLORATION de I-EXPLORATION -órganos) I-EXPLORATION -hasta I-EXPLORATION -alcanzar I-EXPLORATION la I-EXPLORATION -limpieza I-EXPLORATION -del I-EXPLORATION -circuito I-EXPLORATION -pulmonar, I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -una I-EXPLORATION -extracción I-EXPLORATION -reglada, I-EXPLORATION -realizando I-EXPLORATION -maniobras I-EXPLORATION -de I-EXPLORATION -Valsalva I-EXPLORATION -(o I-EXPLORATION -suspiros) I-EXPLORATION +Universidad I-EXPLORATION +Católica I-EXPLORATION para I-EXPLORATION -valorar I-EXPLORATION -la I-EXPLORATION -distensibilidad I-EXPLORATION -del I-EXPLORATION -pulmón. I-EXPLORATION -Simultáneamente, I-EXPLORATION -la I-EXPLORATION -NECMO I-EXPLORATION -siguió I-EXPLORATION -funcionando I-EXPLORATION -y I-EXPLORATION +genotipificación. I-EXPLORATION +Por I-EXPLORATION +técnica I-EXPLORATION +de I-EXPLORATION +RPC I-EXPLORATION +universal I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +Streptococcus I-EXPLORATION +dysgalactiae I-EXPLORATION +subespecie I-EXPLORATION +equisimilis, I-EXPLORATION +genotipo I-EXPLORATION +stg653.0. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +76 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +quien B-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +operado I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +urgencia I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +1974 I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +lesión I-PAST_MEDICAL_HISTORY +ulcerada I-PAST_MEDICAL_HISTORY +gástrica I-PAST_MEDICAL_HISTORY +sangrante. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +practicó I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +gastrectomía I-PAST_MEDICAL_HISTORY +subtotal I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +reconstrucción I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +Billroth I-PAST_MEDICAL_HISTORY +II. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +evolución I-PAST_MEDICAL_HISTORY +postoperatoria I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +normal. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +pieza I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +gastrectomía I-PAST_MEDICAL_HISTORY +subtotal I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +encontró I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +tumor I-PAST_MEDICAL_HISTORY +ulcerado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +cara I-PAST_MEDICAL_HISTORY +anterior, I-PAST_MEDICAL_HISTORY +distante I-PAST_MEDICAL_HISTORY +15 I-PAST_MEDICAL_HISTORY +mm I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +sección I-PAST_MEDICAL_HISTORY +gástrica I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +cm I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +píloro. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +tumor I-PAST_MEDICAL_HISTORY +medía I-PAST_MEDICAL_HISTORY +3, I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +cm I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +eje I-PAST_MEDICAL_HISTORY +longitudinal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +7 I-PAST_MEDICAL_HISTORY +cm I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +transversal, I-PAST_MEDICAL_HISTORY +comprometiendo I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +curvatura I-PAST_MEDICAL_HISTORY +menor I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +extendiéndose I-PAST_MEDICAL_HISTORY +2, I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +cm I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +cara I-PAST_MEDICAL_HISTORY +posterior. I-PAST_MEDICAL_HISTORY +Al I-PAST_MEDICAL_HISTORY +corte, I-PAST_MEDICAL_HISTORY +estaba I-PAST_MEDICAL_HISTORY +constituido I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +tejido I-PAST_MEDICAL_HISTORY +rosado I-PAST_MEDICAL_HISTORY +pálido I-PAST_MEDICAL_HISTORY +lobulado, I-PAST_MEDICAL_HISTORY +liso I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +brillante, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +reemplazaba I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +túnicas I-PAST_MEDICAL_HISTORY +submucosa, I-PAST_MEDICAL_HISTORY +muscular I-PAST_MEDICAL_HISTORY +propia I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +subserosa, I-PAST_MEDICAL_HISTORY +abombando I-PAST_MEDICAL_HISTORY +levemente I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +serosa. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +examen I-PAST_MEDICAL_HISTORY +histopatológico I-PAST_MEDICAL_HISTORY +demostró I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +linfoma I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +Hodgkin I-PAST_MEDICAL_HISTORY +mixto I-PAST_MEDICAL_HISTORY +linfo-histiocítico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +clasificación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Rappaport I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +1966, I-PAST_MEDICAL_HISTORY +vigente I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +formularon I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +clasificaciones I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Kiel I-PAST_MEDICAL_HISTORY +(1974) I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Lukes I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +Collins I-PAST_MEDICAL_HISTORY +(1974). I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +encontró I-PAST_MEDICAL_HISTORY +compromiso I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +ganglios I-PAST_MEDICAL_HISTORY +linfáticos I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +linfoma. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +enfermo I-PAST_MEDICAL_HISTORY +recibió I-PAST_MEDICAL_HISTORY +radioterapia I-PAST_MEDICAL_HISTORY +adyuvante I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +seguido I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +endoscopias I-PAST_MEDICAL_HISTORY +anuales I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +23 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +observaron I-PAST_MEDICAL_HISTORY +nuevas I-PAST_MEDICAL_HISTORY +lesiones I-PAST_MEDICAL_HISTORY +gástricas I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +demostró I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +presencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Helicobacter I-PAST_MEDICAL_HISTORY +pylori. I-PAST_MEDICAL_HISTORY +Durante I-PAST_MEDICAL_HISTORY +este I-PAST_MEDICAL_HISTORY +período, I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +desarrolló I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +tumores I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Warthin I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ambas I-PAST_MEDICAL_HISTORY +glándulas I-PAST_MEDICAL_HISTORY +parótidas, I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +cuales I-PAST_MEDICAL_HISTORY +sólo I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +resecó I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +derecho I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +cáncer I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +piel I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +epidermoide I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +extremidad I-PAST_MEDICAL_HISTORY +inferior I-PAST_MEDICAL_HISTORY +derecha. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +septiembre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2006, I-PRESENT_ILLNESS +32 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +operación I-PRESENT_ILLNESS +gástrica, I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +síntomas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +anemia. I-PRESENT_ILLNESS +En B-EXPLORATION el I-EXPLORATION -cirujano I-EXPLORATION -hepático I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -laparotomía I-EXPLORATION -media I-EXPLORATION -para I-EXPLORATION -valorar I-EXPLORATION -la I-EXPLORATION -viabilidad I-EXPLORATION -y I-EXPLORATION -confirmar I-EXPLORATION -la I-EXPLORATION -adecuada I-EXPLORATION -perfusión I-EXPLORATION -hepática. I-EXPLORATION -Preventivamente I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION se I-EXPLORATION -infundieron I-EXPLORATION -dos I-EXPLORATION -concentrados I-EXPLORATION +observó I-EXPLORATION +palidez, I-EXPLORATION +sin I-EXPLORATION +masas I-EXPLORATION +abdominales. I-EXPLORATION +El I-EXPLORATION +hematocrito I-EXPLORATION +fue I-EXPLORATION de I-EXPLORATION -hematíes I-EXPLORATION +34, I-EXPLORATION +5% I-EXPLORATION y I-EXPLORATION -un I-EXPLORATION -litro I-EXPLORATION -de I-EXPLORATION -suero I-EXPLORATION -salino I-EXPLORATION -0, I-EXPLORATION -9%, I-EXPLORATION -para I-EXPLORATION -así I-EXPLORATION -aumentar I-EXPLORATION -el I-EXPLORATION -circuito I-EXPLORATION -de I-EXPLORATION -ECMO I-EXPLORATION -previo I-EXPLORATION -al I-EXPLORATION -clampaje I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -cava I-EXPLORATION -inferior. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION +una I-EXPLORATION +endoscopia I-EXPLORATION +digestiva I-EXPLORATION +alta I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +proliferativa I-EXPLORATION +y I-EXPLORATION +ulcerada I-EXPLORATION en I-EXPLORATION -que I-EXPLORATION el I-EXPLORATION -cirujano I-EXPLORATION -torácico I-EXPLORATION -informó I-EXPLORATION -de I-EXPLORATION +muñón I-EXPLORATION +gástrico I-EXPLORATION que I-EXPLORATION -iba I-EXPLORATION -a I-EXPLORATION -ligar I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -cava I-EXPLORATION -inferior I-EXPLORATION -en I-EXPLORATION +obstruía I-EXPLORATION +parcialmente I-EXPLORATION la I-EXPLORATION -desembocadura I-EXPLORATION -de I-EXPLORATION +anastomosis I-EXPLORATION +gastroyeyunal. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION +mostró I-EXPLORATION +que I-EXPLORATION la I-EXPLORATION -aurícula I-EXPLORATION -derecha, I-EXPLORATION -ambos I-EXPLORATION -cirujanos I-EXPLORATION -movilizaron I-EXPLORATION -conjuntamente I-EXPLORATION +mucosa I-EXPLORATION +gástrica I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +infiltrada I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +adenocarcinoma I-EXPLORATION +tubular I-EXPLORATION +moderadamente I-EXPLORATION +diferenciado. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +comprobó I-EXPLORATION la I-EXPLORATION -cánula I-EXPLORATION -venosa I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -ECMO I-EXPLORATION -para I-EXPLORATION -bajarla I-EXPLORATION -varios I-EXPLORATION -centímetros I-EXPLORATION +Helicobacter I-EXPLORATION +pylori. I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +computada I-EXPLORATION +de I-EXPLORATION +tórax, I-EXPLORATION +abdomen I-EXPLORATION y I-EXPLORATION -dejar I-EXPLORATION -el I-EXPLORATION -extremo I-EXPLORATION -distal I-EXPLORATION -por I-EXPLORATION -debajo I-EXPLORATION +pelvis I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +operado I-TREATMENT +y I-TREATMENT +se I-TREATMENT +le I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +gastrectomía I-TREATMENT +total I-TREATMENT +con I-TREATMENT +disección I-TREATMENT +ganglionar. I-TREATMENT +La B-EVOLUTION +recuperación I-EVOLUTION +postoperatoria I-EVOLUTION +fue I-EVOLUTION +normal. I-EVOLUTION +El B-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -aurícula I-EXPLORATION -derecha. I-EXPLORATION -Una I-EXPLORATION -vez I-EXPLORATION -recolocada I-EXPLORATION +pieza I-EXPLORATION +quirúrgica I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +tumoral I-EXPLORATION +ulcerada I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +muñón I-EXPLORATION +gástrico I-EXPLORATION +con I-EXPLORATION +infiltración I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -cánula I-EXPLORATION -venosa I-EXPLORATION -y I-EXPLORATION -clampada I-EXPLORATION +anastomosis I-EXPLORATION +gastroyeyunal. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +microscópico I-EXPLORATION +demostró I-EXPLORATION +un I-EXPLORATION +adenocarcinoma I-EXPLORATION +tubular I-EXPLORATION +moderadamente I-EXPLORATION +diferenciado I-EXPLORATION +con I-EXPLORATION +compromiso I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -vena I-EXPLORATION -cava I-EXPLORATION -inferior, I-EXPLORATION -los I-EXPLORATION -flujos I-EXPLORATION +subserosa I-EXPLORATION de I-EXPLORATION -ECMO I-EXPLORATION -bajaron I-EXPLORATION -ligeramente I-EXPLORATION -requiriendo I-EXPLORATION la I-EXPLORATION -administración I-EXPLORATION +pared I-EXPLORATION +gástrica, I-EXPLORATION +metástasis I-EXPLORATION +en I-EXPLORATION +10 I-EXPLORATION +linfonodos I-EXPLORATION de I-EXPLORATION -otros I-EXPLORATION -dos I-EXPLORATION -hemoconcentrados I-EXPLORATION +16 I-EXPLORATION +resecados I-EXPLORATION y I-EXPLORATION -500 I-EXPLORATION -ml I-EXPLORATION +permeaciones I-EXPLORATION +vasculares I-EXPLORATION +linfáticas I-EXPLORATION +(T2bN2M0, I-EXPLORATION +Etapa I-EXPLORATION +IIIB). I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +65 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +larga I-PAST_MEDICAL_HISTORY +data, I-PAST_MEDICAL_HISTORY +trasplante I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +1999 I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +rechazó I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +8 I-PAST_MEDICAL_HISTORY +meses, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +hemodiálisis I-PAST_MEDICAL_HISTORY +trisemanal I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +2000 I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +secundaria. I-PAST_MEDICAL_HISTORY +Tratada I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +eritropoyetina, I-PAST_MEDICAL_HISTORY +ácido I-PAST_MEDICAL_HISTORY +fólico, I-PAST_MEDICAL_HISTORY +atenolol I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +losartan. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +historia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +caracterizada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lesiones I-PRESENT_ILLNESS +pruriginosas I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +manos, I-PRESENT_ILLNESS +antebrazos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +espalda. I-PRESENT_ILLNESS +En B-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +destacaban I-EXPLORATION +hiperpigmentación I-EXPLORATION +difusa, I-EXPLORATION +erosiones, I-EXPLORATION +úlceras I-EXPLORATION +y I-EXPLORATION +pápulas I-EXPLORATION +costrosas, I-EXPLORATION +ubicadas I-EXPLORATION +preferentemente I-EXPLORATION +en I-EXPLORATION +dorso I-EXPLORATION de I-EXPLORATION -suero I-EXPLORATION -salino I-EXPLORATION -0, I-EXPLORATION -9%. I-EXPLORATION -En I-EXPLORATION -esta I-EXPLORATION -fase I-EXPLORATION -ya I-EXPLORATION -estaban I-EXPLORATION -separados I-EXPLORATION +manos, I-EXPLORATION +antebrazos, I-EXPLORATION tórax I-EXPLORATION +anterior I-EXPLORATION y I-EXPLORATION -abdomen I-EXPLORATION -con I-EXPLORATION -ligadura I-EXPLORATION -previa I-EXPLORATION +región I-EXPLORATION +interescapular. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +biopsia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -aorta I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -cava, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -procedió I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -extracción I-EXPLORATION -reglada I-EXPLORATION -pulmonar I-EXPLORATION -mientras I-EXPLORATION -se I-EXPLORATION -continuaba I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +piel I-EXPLORATION con I-EXPLORATION -NECMO. I-EXPLORATION -Una I-EXPLORATION -vez I-EXPLORATION -extraídos I-EXPLORATION -los I-EXPLORATION -pulmones I-EXPLORATION -se I-EXPLORATION -mantuvo I-EXPLORATION -la I-EXPLORATION -NECMO I-EXPLORATION -16 I-EXPLORATION -minutos I-EXPLORATION -más I-EXPLORATION -(tiempo I-EXPLORATION -total I-EXPLORATION -de I-EXPLORATION -NECMO I-EXPLORATION +úlcera I-EXPLORATION +y I-EXPLORATION +costra I-EXPLORATION +fibrinoleucocitaria. I-EXPLORATION +El I-EXPLORATION +fondo I-EXPLORATION de I-EXPLORATION -84 I-EXPLORATION -minutos), I-EXPLORATION -se I-EXPLORATION -inició I-EXPLORATION la I-EXPLORATION -perfusión I-EXPLORATION -abdominal I-EXPLORATION +úlcera I-EXPLORATION con I-EXPLORATION -Celsior I-EXPLORATION -(solución I-EXPLORATION -de I-EXPLORATION -preservación I-EXPLORATION -de I-EXPLORATION -órganos I-EXPLORATION -abdominales) I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cánula I-EXPLORATION -arterial I-EXPLORATION +haces I-EXPLORATION de I-EXPLORATION -ECMO I-EXPLORATION -y I-EXPLORATION -finalmente I-EXPLORATION -se I-EXPLORATION -extrajeron I-EXPLORATION +colágeno I-EXPLORATION de I-EXPLORATION -forma I-EXPLORATION -reglada I-EXPLORATION -el I-EXPLORATION -hígado I-EXPLORATION +disposición I-EXPLORATION +vertical, I-EXPLORATION +epidermis I-EXPLORATION +adyacente I-EXPLORATION +con I-EXPLORATION +hiperortoqueratosis, I-EXPLORATION +acantosis I-EXPLORATION y I-EXPLORATION -los I-EXPLORATION -riñones. I-EXPLORATION - I-EXPLORATION -Durante I-EXPLORATION -todo I-EXPLORATION -el I-EXPLORATION -proceso I-EXPLORATION -se I-EXPLORATION -realizaron I-EXPLORATION -determinaciones I-EXPLORATION -seriadas I-EXPLORATION -cada I-EXPLORATION -20 I-EXPLORATION -minutos I-EXPLORATION -del I-EXPLORATION -equilibrio I-EXPLORATION -ácido-base I-EXPLORATION +leve I-EXPLORATION +espongiosis. I-EXPLORATION +La I-EXPLORATION +dermis I-EXPLORATION +con I-EXPLORATION +leve I-EXPLORATION +infiltrado I-EXPLORATION +inflamatorio I-EXPLORATION +disperso I-EXPLORATION y I-EXPLORATION -perfil I-EXPLORATION -iónico, I-EXPLORATION -hematología I-EXPLORATION +perivascular I-EXPLORATION +superfcial I-EXPLORATION +linfocitario, I-EXPLORATION +con I-EXPLORATION +algunos I-EXPLORATION +plasmocitos I-EXPLORATION y I-EXPLORATION -bioquímica I-EXPLORATION -hepática I-EXPLORATION +neutróflos I-EXPLORATION y I-EXPLORATION -renal. I-EXPLORATION - I-EXPLORATION -PaO2: I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -de I-EXPLORATION -oxígeno I-EXPLORATION -(mmHg); I-EXPLORATION -PaCO2: I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -de I-EXPLORATION -dióxido I-EXPLORATION +foco I-EXPLORATION +hemorrágico. I-EXPLORATION +Los I-EXPLORATION +hallazgos I-EXPLORATION +informados I-EXPLORATION +fueron I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +colagenosis I-EXPLORATION +perforante I-EXPLORATION de I-EXPLORATION -carbono I-EXPLORATION -(mmHg); I-EXPLORATION -HCO3-: I-EXPLORATION -bicarbonato I-EXPLORATION -(mmol/L); I-EXPLORATION -Lact.: I-EXPLORATION -lactato I-EXPLORATION -(mg/dL); I-EXPLORATION -Bil.: I-EXPLORATION -bilirrubina I-EXPLORATION -(mg/dL); I-EXPLORATION -Hto.: I-EXPLORATION -hematocrito I-EXPLORATION -(%); I-EXPLORATION -Hb.: I-EXPLORATION -hemoglobina I-EXPLORATION -(g/dL); I-EXPLORATION -Gluc.: I-EXPLORATION -glucemia I-EXPLORATION -(mg/dL); I-EXPLORATION -Na+: I-EXPLORATION -ión I-EXPLORATION -sodio I-EXPLORATION -(mmol/L); I-EXPLORATION -K+: I-EXPLORATION -ión I-EXPLORATION -potasio I-EXPLORATION -(mmol/L); I-EXPLORATION -min: I-EXPLORATION -minutos I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -cuanto I-EVOLUTION +tipo I-EXPLORATION +reactivo. I-EXPLORATION +Se B-TREATMENT +indicaron I-TREATMENT +antihistamínicos I-TREATMENT +orales I-TREATMENT +y I-TREATMENT +clobetasol I-TREATMENT +0, I-TREATMENT +05% I-TREATMENT ++ I-TREATMENT +cloranfenicol I-TREATMENT +2% I-TREATMENT +con B-EVOLUTION +respuesta I-EVOLUTION +parcial I-EVOLUTION a I-EVOLUTION -los I-EVOLUTION -receptores I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -injertos I-EVOLUTION -extraídos, I-EVOLUTION -todos I-EVOLUTION -han I-EVOLUTION -presentado I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -favorable I-EVOLUTION -postrasplante. I-EVOLUTION -El I-EVOLUTION -receptor I-EVOLUTION -pulmonar I-EVOLUTION -recibió I-EVOLUTION un I-EVOLUTION -trasplante I-EVOLUTION -bipulmonar I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -durante I-EVOLUTION -su I-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION -ingreso I-EVOLUTION -en I-EVOLUTION -UCI I-EVOLUTION -y I-EVOLUTION -posterior I-EVOLUTION -estancia I-EVOLUTION -en I-EVOLUTION -planta I-EVOLUTION +año I-EVOLUTION de I-EVOLUTION -hospitalización. I-EVOLUTION +seguimiento. I-EVOLUTION I-EVOLUTION -Paciente, B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -74 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -atendida I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Postgrado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Rehabilitación I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -Prótesis I-PRESENT_ILLNESS -Maxilofacial I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Universidad I-PRESENT_ILLNESS +Recién B-PRESENT_ILLNESS +nacida I-PRESENT_ILLNESS +(RN) I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Barcelona, I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -sustituir I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -prótesis I-PRESENT_ILLNESS -óculo-palpebral I-PRESENT_ILLNESS +término, I-PRESENT_ILLNESS +segunda B-PAST_MEDICAL_HISTORY +hija I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +madre I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +19 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +sana I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +embarazo I-PAST_MEDICAL_HISTORY +controlado. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Parto I-PAST_MEDICAL_HISTORY +vaginal I-PAST_MEDICAL_HISTORY +espontáneo, I-PAST_MEDICAL_HISTORY +Apgar I-PAST_MEDICAL_HISTORY +9 I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +minuto I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +minutos, I-PAST_MEDICAL_HISTORY +peso I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +nacimiento: I-PAST_MEDICAL_HISTORY +3.370 I-PAST_MEDICAL_HISTORY +g. I-PAST_MEDICAL_HISTORY +A B-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +34 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS +vida, I-PRESENT_ILLNESS la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +38, I-PRESENT_ILLNESS +8 I-PRESENT_ILLNESS +°C, I-PRESENT_ILLNESS +quejido I-PRESENT_ILLNESS +respiratorio I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +distensión I-PRESENT_ILLNESS +abdominal, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -era I-PRESENT_ILLNESS -portadora. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Tras B-EXPLORATION -realizar I-EXPLORATION -un I-EXPLORATION +se I-PRESENT_ILLNESS +decidió I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Neonatología I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +Hospital I-PRESENT_ILLNESS +Parroquial I-PRESENT_ILLNESS +San I-PRESENT_ILLNESS +Bernardo. I-PRESENT_ILLNESS +Al B-EXPLORATION examen I-EXPLORATION -minucioso I-EXPLORATION +físico I-EXPLORATION +destacaban I-EXPLORATION +su I-EXPLORATION +hipoactividad, I-EXPLORATION +mala I-EXPLORATION +perfusión I-EXPLORATION +periférica, I-EXPLORATION +ictericia I-EXPLORATION +moderada I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +abdomen I-EXPLORATION +distendido I-EXPLORATION +con I-EXPLORATION +leve I-EXPLORATION +resistencia I-EXPLORATION +muscular. I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +mostraban I-EXPLORATION +leucocitos I-EXPLORATION +de I-EXPLORATION +5.300/mm3 I-EXPLORATION +sin I-EXPLORATION +desviación I-EXPLORATION +a I-EXPLORATION +izquierda, I-EXPLORATION +PCR: I-EXPLORATION +204 I-EXPLORATION +mg/l I-EXPLORATION +y I-EXPLORATION +gases I-EXPLORATION +sanguíneos I-EXPLORATION +con I-EXPLORATION +acidosis I-EXPLORATION +metabólica. I-EXPLORATION +Orina I-EXPLORATION +completa I-EXPLORATION +y I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +normales. I-EXPLORATION +La I-EXPLORATION +punción I-EXPLORATION +lumbar I-EXPLORATION +dio I-EXPLORATION +un I-EXPLORATION +LCR I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +turbio. I-EXPLORATION +Citoquímico I-EXPLORATION del I-EXPLORATION -defecto I-EXPLORATION -facial, I-EXPLORATION -se I-EXPLORATION -evaluaron I-EXPLORATION -las I-EXPLORATION -zonas I-EXPLORATION +LCR: I-EXPLORATION +glucosa I-EXPLORATION +49 I-EXPLORATION +mg/dl, I-EXPLORATION +proteínas I-EXPLORATION +266 I-EXPLORATION +mg/dl I-EXPLORATION +y I-EXPLORATION +leucocitos: I-EXPLORATION +950/mm3 I-EXPLORATION +con I-EXPLORATION +70% I-EXPLORATION +PMN, I-EXPLORATION +tinción I-EXPLORATION de I-EXPLORATION -soporte I-EXPLORATION -para I-EXPLORATION -ver I-EXPLORATION -las I-EXPLORATION -posibilidades I-EXPLORATION +Gram: I-EXPLORATION +cocáceas I-EXPLORATION +grampositivas I-EXPLORATION +en I-EXPLORATION +pares I-EXPLORATION +(diplo). I-EXPLORATION +Los I-EXPLORATION +látex I-EXPLORATION de I-EXPLORATION -obtención I-EXPLORATION +orina I-EXPLORATION +y I-EXPLORATION +LCR I-EXPLORATION +para I-EXPLORATION +detección I-EXPLORATION de I-EXPLORATION -estabilidad, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -forma I-EXPLORATION +antígeno I-EXPLORATION de I-EXPLORATION -retención I-EXPLORATION +S. I-EXPLORATION +agalactiae I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +ampicilina I-TREATMENT +y I-TREATMENT +cefotaxima. I-TREATMENT +Los B-EXPLORATION +hemocultivos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -prótesis4.. I-EXPLORATION -Éste I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -superficie I-EXPLORATION -cubierta I-EXPLORATION -totalmente I-EXPLORATION +ingreso I-EXPLORATION +se I-EXPLORATION +hicieron I-EXPLORATION +positivos I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +7, I-EXPLORATION +3 I-EXPLORATION +horas I-EXPLORATION de I-EXPLORATION -piel, I-EXPLORATION -firme, I-EXPLORATION -estable, I-EXPLORATION +incubación, I-EXPLORATION +informándose I-EXPLORATION +cocáceas I-EXPLORATION +grampositivas I-EXPLORATION en I-EXPLORATION -forma I-EXPLORATION +cadena. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +RN I-EXPLORATION +persistió I-EXPLORATION +febril, I-EXPLORATION +hipoactiva I-EXPLORATION +y I-EXPLORATION +hemodinámicamente I-EXPLORATION +estable. I-EXPLORATION +Un I-EXPLORATION +nuevo I-EXPLORATION +LCR I-EXPLORATION +obtenido I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +72 I-EXPLORATION +horas I-EXPLORATION +era I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -concavidad I-EXPLORATION -comunicada I-EXPLORATION +aspecto I-EXPLORATION +turbio I-EXPLORATION +y I-EXPLORATION +tenía I-EXPLORATION +5.050 I-EXPLORATION +leucocitos/mm3 I-EXPLORATION con I-EXPLORATION -la I-EXPLORATION -fosa I-EXPLORATION -temporal I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION +100% I-EXPLORATION +PMN. I-EXPLORATION +El I-EXPLORATION +cultivo I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -agujero I-EXPLORATION +esta I-EXPLORATION +muestra I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION +Se I-EXPLORATION +recibió I-EXPLORATION +informe I-EXPLORATION de I-EXPLORATION -aproximadamente I-EXPLORATION -5 I-EXPLORATION -mm I-EXPLORATION -resultado I-EXPLORATION -del I-EXPLORATION -fracaso I-EXPLORATION +hemocultivos I-EXPLORATION +(2), I-EXPLORATION +urocultivo I-EXPLORATION +y I-EXPLORATION +LCR I-EXPLORATION +tomados I-EXPLORATION +al I-EXPLORATION +ingreso I-EXPLORATION +con I-EXPLORATION +desarrollo I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -osteointegración I-EXPLORATION +Streptococcus I-EXPLORATION +grupo I-EXPLORATION +viridans I-EXPLORATION +sensible I-EXPLORATION +a I-EXPLORATION +penicilina I-EXPLORATION +y I-EXPLORATION +cefotaxima. I-EXPLORATION +El I-EXPLORATION +laboratorio I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -implante. I-EXPLORATION - I-EXPLORATION -Para B-TREATMENT -la I-TREATMENT -elaboración I-TREATMENT -de I-TREATMENT -la I-TREATMENT -prótesis I-TREATMENT -óculo-palpebral I-TREATMENT -flexible I-TREATMENT -se I-TREATMENT -debe I-TREATMENT -obtener I-TREATMENT -una I-TREATMENT -impresión I-TREATMENT -que I-TREATMENT -reproduzca I-TREATMENT -fielmente I-TREATMENT -los I-TREATMENT -tejidos I-TREATMENT -remanentes. I-TREATMENT -Para I-TREATMENT -ello I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -una I-TREATMENT -delimitación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -extensión I-TREATMENT -de I-TREATMENT -la I-TREATMENT -prótesis I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -que I-TREATMENT -sus I-TREATMENT -márgenes I-TREATMENT -deben I-TREATMENT -estar I-TREATMENT -apoyados I-TREATMENT -en I-TREATMENT -superficies I-TREATMENT -estables. I-TREATMENT -La I-TREATMENT -finalidad I-TREATMENT -es I-TREATMENT -obtener I-TREATMENT -un I-TREATMENT -modelo I-TREATMENT -de I-TREATMENT -trabajo I-TREATMENT -y I-TREATMENT -de I-TREATMENT -estudio I-TREATMENT -en I-TREATMENT -yeso I-TREATMENT -piedra I-TREATMENT -o I-TREATMENT -yeso I-TREATMENT -extraduro. I-TREATMENT -Se I-TREATMENT -individualizaron I-TREATMENT -las I-TREATMENT -zonas I-TREATMENT -facial I-TREATMENT -y I-TREATMENT -temporal I-TREATMENT -a I-TREATMENT -impresionar I-TREATMENT -tapando I-TREATMENT -el I-TREATMENT -orificio I-TREATMENT -creado I-TREATMENT -por I-TREATMENT -la I-TREATMENT -perdida I-TREATMENT -del I-TREATMENT -implante I-TREATMENT -con I-TREATMENT -cera I-TREATMENT -«Utility», I-TREATMENT -para I-TREATMENT -que I-TREATMENT -en I-TREATMENT -el I-TREATMENT -momento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -impresión I-TREATMENT -éste I-TREATMENT -no I-TREATMENT -bloquease I-TREATMENT -su I-TREATMENT -retirada. I-TREATMENT -Se I-TREATMENT -aplicó I-TREATMENT -vaselina I-TREATMENT -en I-TREATMENT -las I-TREATMENT -regiones I-TREATMENT -que I-TREATMENT -puedan I-TREATMENT -retener I-TREATMENT -el I-TREATMENT -material I-TREATMENT -de I-TREATMENT -impresión I-TREATMENT -como I-TREATMENT -las I-TREATMENT -cejas I-TREATMENT -o I-TREATMENT -cabello, I-TREATMENT -además I-TREATMENT -también I-TREATMENT -se I-TREATMENT -puede I-TREATMENT -utilizar I-TREATMENT -como I-TREATMENT -material I-TREATMENT -de I-TREATMENT -impresión I-TREATMENT -siliconas I-TREATMENT -fluidas, I-TREATMENT -agár, I-TREATMENT -materiales I-TREATMENT -de I-TREATMENT -poliéter I-TREATMENT -o I-TREATMENT -alginato2, I-TREATMENT -5*, I-TREATMENT -6, I-TREATMENT -8*. I-TREATMENT -En I-TREATMENT -este I-TREATMENT -caso I-TREATMENT -se I-TREATMENT -utilizó I-TREATMENT -alginato, I-TREATMENT -el I-TREATMENT -cual I-TREATMENT -debe I-TREATMENT -ser I-TREATMENT -muy I-TREATMENT -fluido I-TREATMENT -para I-TREATMENT -no I-TREATMENT -deformar I-TREATMENT -los I-TREATMENT -tegumentos I-TREATMENT -y I-TREATMENT -se I-TREATMENT -comienza I-TREATMENT -a I-TREATMENT -colocar I-TREATMENT -en I-TREATMENT -las I-TREATMENT -zonas I-TREATMENT -más I-TREATMENT -profundas I-TREATMENT -del I-TREATMENT -defecto, I-TREATMENT -para I-TREATMENT -evitar I-TREATMENT -la I-TREATMENT -formación I-TREATMENT -de I-TREATMENT -burbujas. I-TREATMENT - I-TREATMENT -Después I-TREATMENT -se I-TREATMENT -colocó I-TREATMENT -una I-TREATMENT -gasa I-TREATMENT -sobre I-TREATMENT -el I-TREATMENT -alginato I-TREATMENT -para I-TREATMENT -evitar I-TREATMENT -su I-TREATMENT -escurrimiento I-TREATMENT -y I-TREATMENT -que I-TREATMENT -además I-TREATMENT -sirvió I-TREATMENT -de I-TREATMENT -unión I-TREATMENT -a I-TREATMENT -la I-TREATMENT -capa I-TREATMENT -de I-TREATMENT -yeso I-TREATMENT -de I-TREATMENT -fraguado I-TREATMENT -rápido I-TREATMENT -que I-TREATMENT -se I-TREATMENT -coloca I-TREATMENT -sobre I-TREATMENT -el I-TREATMENT -material I-TREATMENT -de I-TREATMENT -impresión2, I-TREATMENT -6. I-TREATMENT - I-TREATMENT -Es I-TREATMENT -importante I-TREATMENT -mantener I-TREATMENT -libres I-TREATMENT -las I-TREATMENT -vías I-TREATMENT -respiratorias I-TREATMENT +microbiología I-EXPLORATION +comunicó I-EXPLORATION +la I-EXPLORATION +identificación I-EXPLORATION +como I-EXPLORATION +preliminar I-EXPLORATION +y I-EXPLORATION +sujeta I-EXPLORATION +a I-EXPLORATION +confirmación. I-EXPLORATION + I-EXPLORATION +Al B-TREATMENT +cuarto I-TREATMENT +día I-TREATMENT de I-TREATMENT -la I-TREATMENT -paciente, I-TREATMENT -diciéndole I-TREATMENT -que I-TREATMENT -respire I-TREATMENT -por I-TREATMENT -la I-TREATMENT -boca I-TREATMENT +hospitalización I-TREATMENT y I-TREATMENT -conversando I-TREATMENT -con I-TREATMENT -ella I-TREATMENT -durante I-TREATMENT -el I-TREATMENT -procedimiento, I-TREATMENT -para I-TREATMENT -tranquilizarla I-TREATMENT -e I-TREATMENT -informarla2. I-TREATMENT - I-TREATMENT -La I-TREATMENT -confección I-TREATMENT -de I-TREATMENT -la I-TREATMENT -prótesis I-TREATMENT -ocular I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT +debido I-TREATMENT a I-TREATMENT -continuación, I-TREATMENT -imitando I-TREATMENT -el I-TREATMENT -ojo I-TREATMENT -remanente. I-TREATMENT -Por I-TREATMENT -las I-TREATMENT -características I-TREATMENT -individuales I-TREATMENT -de I-TREATMENT -la I-TREATMENT -misma I-TREATMENT -algunos I-TREATMENT -autores I-TREATMENT -la I-TREATMENT -denominan I-TREATMENT -«almendra»3*. I-TREATMENT -Su I-TREATMENT -tamaño I-TREATMENT -corresponderá I-TREATMENT -al I-TREATMENT -ancho I-TREATMENT -entre I-TREATMENT -el I-TREATMENT -canto I-TREATMENT -interno I-TREATMENT -y I-TREATMENT -externo I-TREATMENT -del I-TREATMENT -ojo I-TREATMENT -sano. I-TREATMENT -La I-TREATMENT -cara I-TREATMENT -externa I-TREATMENT -es I-TREATMENT -totalmente I-TREATMENT -convexa I-TREATMENT -y I-TREATMENT -recubierta I-TREATMENT -de I-TREATMENT -acrílico I-TREATMENT -transparente I-TREATMENT -para I-TREATMENT -obtener I-TREATMENT -mejor I-TREATMENT -resultado I-TREATMENT -estético. I-TREATMENT -Su I-TREATMENT -cara I-TREATMENT -interna I-TREATMENT -será I-TREATMENT -plana I-TREATMENT -y I-TREATMENT -se I-TREATMENT -apoyará I-TREATMENT -en I-TREATMENT la I-TREATMENT -pared I-TREATMENT -posterior I-TREATMENT -de I-TREATMENT -la I-TREATMENT -prótesis I-TREATMENT -óculo-palpebral3*. I-TREATMENT - I-TREATMENT -Para I-TREATMENT -esta I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -utilizó I-TREATMENT -un I-TREATMENT -molde I-TREATMENT -de I-TREATMENT -silicona, I-TREATMENT -que I-TREATMENT -había I-TREATMENT -sido I-TREATMENT -confeccionado I-TREATMENT -de I-TREATMENT -unas I-TREATMENT -impresiones I-TREATMENT -de I-TREATMENT -otra I-TREATMENT -paciente. I-TREATMENT -Se I-TREATMENT -pueden I-TREATMENT -utilizar I-TREATMENT -numerosas I-TREATMENT -ceras, I-TREATMENT -que I-TREATMENT -sean I-TREATMENT -duras I-TREATMENT -y I-TREATMENT -que I-TREATMENT -pesen I-TREATMENT -poco. I-TREATMENT -Aquí I-TREATMENT -que I-TREATMENT -se I-TREATMENT -utilizó I-TREATMENT -cera I-TREATMENT -color I-TREATMENT -marfil I-TREATMENT -de I-TREATMENT -una I-TREATMENT -consistencia I-TREATMENT -dura. I-TREATMENT - I-TREATMENT -El I-TREATMENT -iris I-TREATMENT -debe I-TREATMENT -ser I-TREATMENT -caracterizado I-TREATMENT -previamente, I-TREATMENT -para I-TREATMENT -esto I-TREATMENT -se I-TREATMENT -han I-TREATMENT -descrito I-TREATMENT -muchas I-TREATMENT -técnicas4. I-TREATMENT -En I-TREATMENT -este I-TREATMENT -caso I-TREATMENT -se I-TREATMENT -utilizaron I-TREATMENT -discos I-TREATMENT -de I-TREATMENT -grafito I-TREATMENT +mala I-TREATMENT +evolución, I-TREATMENT +fue I-TREATMENT +evaluada I-TREATMENT por I-TREATMENT -ser I-TREATMENT -muy I-TREATMENT -resistentes, I-TREATMENT -retienen I-TREATMENT -mejor I-TREATMENT -la I-TREATMENT -pintura I-TREATMENT -y I-TREATMENT -los I-TREATMENT -hay I-TREATMENT -de I-TREATMENT -varios I-TREATMENT -tamaños. I-TREATMENT -El I-TREATMENT -disco I-TREATMENT -de I-TREATMENT -grafito I-TREATMENT -se I-TREATMENT -selecciona I-TREATMENT -según I-TREATMENT -el I-TREATMENT -tamaño I-TREATMENT -del I-TREATMENT -iris I-TREATMENT -del I-TREATMENT -paciente. I-TREATMENT -El I-TREATMENT -diámetro I-TREATMENT -del I-TREATMENT -iris I-TREATMENT -varía I-TREATMENT -entre I-TREATMENT -11, I-TREATMENT -5-12 I-TREATMENT -mm, I-TREATMENT -y I-TREATMENT -el I-TREATMENT -diámetro I-TREATMENT -de I-TREATMENT -la I-TREATMENT -pupila I-TREATMENT -varia I-TREATMENT -entre I-TREATMENT -2, I-TREATMENT -5-3 I-TREATMENT -mm5. I-TREATMENT -Dicha I-TREATMENT -caracterización I-TREATMENT -precisa I-TREATMENT -de I-TREATMENT -una I-TREATMENT -mezcla I-TREATMENT -de I-TREATMENT -monómero I-TREATMENT -(líquido) I-TREATMENT -con I-TREATMENT -polímero I-TREATMENT -(polvo I-TREATMENT -de I-TREATMENT -acrílico) I-TREATMENT +infectóloga, I-TREATMENT +suspendiéndose I-TREATMENT +ampicilina I-TREATMENT y I-TREATMENT -óleo, I-TREATMENT -haciéndola I-TREATMENT -lo I-TREATMENT -más I-TREATMENT -suave I-TREATMENT -posible5*. I-TREATMENT -Se I-TREATMENT -colocaron I-TREATMENT -los I-TREATMENT -colores I-TREATMENT -base I-TREATMENT +agregando I-TREATMENT en I-TREATMENT -una I-TREATMENT -paleta7. I-TREATMENT -La I-TREATMENT -fijación I-TREATMENT -del I-TREATMENT -disco I-TREATMENT -a I-TREATMENT -un I-TREATMENT -puntero I-TREATMENT -facilita I-TREATMENT su I-TREATMENT -pintura I-TREATMENT -de I-TREATMENT -una I-TREATMENT -forma I-TREATMENT -radial4, I-TREATMENT -5*. I-TREATMENT -Existen I-TREATMENT -varias I-TREATMENT -técnicas I-TREATMENT -para I-TREATMENT -la I-TREATMENT -mejor I-TREATMENT -disposición I-TREATMENT -de I-TREATMENT -colores. I-TREATMENT -La I-TREATMENT -que I-TREATMENT -se I-TREATMENT -utilizó I-TREATMENT -fue I-TREATMENT -la I-TREATMENT -que I-TREATMENT -empieza I-TREATMENT -con I-TREATMENT -colores I-TREATMENT -más I-TREATMENT -claros I-TREATMENT -y I-TREATMENT -sigue I-TREATMENT -subiendo I-TREATMENT -las I-TREATMENT -tonalidades, I-TREATMENT -pintando I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -centro I-TREATMENT -hacia I-TREATMENT -la I-TREATMENT -periferia. I-TREATMENT -Se I-TREATMENT -consigue I-TREATMENT -así I-TREATMENT -una I-TREATMENT -mejor I-TREATMENT -perspectiva I-TREATMENT -de I-TREATMENT -profundidad. I-TREATMENT -Este I-TREATMENT -paso I-TREATMENT -depende I-TREATMENT -un I-TREATMENT -50% I-TREATMENT -de I-TREATMENT -la I-TREATMENT -técnica I-TREATMENT -y I-TREATMENT -otro I-TREATMENT -50% I-TREATMENT -del I-TREATMENT -arte3*, I-TREATMENT -5*, I-TREATMENT -8. I-TREATMENT - I-TREATMENT -El I-TREATMENT -color I-TREATMENT -de I-TREATMENT -un I-TREATMENT -objeto, I-TREATMENT -no I-TREATMENT -es I-TREATMENT -otra I-TREATMENT -cosa I-TREATMENT -que I-TREATMENT -la I-TREATMENT -propiedad I-TREATMENT -que I-TREATMENT -él I-TREATMENT -mismo I-TREATMENT -tiene I-TREATMENT -de I-TREATMENT -absorber I-TREATMENT -una I-TREATMENT -determinada I-TREATMENT -cantidad I-TREATMENT -de I-TREATMENT -radiación I-TREATMENT -de I-TREATMENT -luz I-TREATMENT +reemplazo I-TREATMENT +penicilina I-TREATMENT +400.000 I-TREATMENT +UI/kg/día I-TREATMENT y I-TREATMENT -emitir I-TREATMENT -otras. I-TREATMENT -Por I-TREATMENT -eso I-TREATMENT -es I-TREATMENT -importante I-TREATMENT -utilizar I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -tipo I-TREATMENT -de I-TREATMENT -luz I-TREATMENT -a I-TREATMENT -la I-TREATMENT -hora I-TREATMENT +gentamicina I-TREATMENT +4 I-TREATMENT +mg/kg/día I-TREATMENT +como I-TREATMENT +esquema I-TREATMENT de I-TREATMENT -examinar I-TREATMENT -el I-TREATMENT -color I-TREATMENT -del I-TREATMENT -iris. I-TREATMENT -Es I-TREATMENT -aconsejable I-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -del I-TREATMENT -paciente I-TREATMENT +tratamiento I-TREATMENT +asociado I-TREATMENT para I-TREATMENT -una I-TREATMENT -mejor I-TREATMENT -reproducción I-TREATMENT -de I-TREATMENT -los I-TREATMENT -colores I-TREATMENT -del I-TREATMENT -ojo I-TREATMENT -sano3*, I-TREATMENT -5*, I-TREATMENT -8. I-TREATMENT - I-TREATMENT -Existen I-TREATMENT -varias I-TREATMENT -maneras I-TREATMENT +Streptococcus I-TREATMENT +grupo I-TREATMENT +viridans. I-TREATMENT +La I-TREATMENT +dosis I-TREATMENT de I-TREATMENT -hacer I-TREATMENT -la I-TREATMENT -pupila. I-TREATMENT -También I-TREATMENT +cefotaxima I-TREATMENT se I-TREATMENT -pueden I-TREATMENT -adquirir I-TREATMENT -conformadores I-TREATMENT +aumentó I-TREATMENT de I-TREATMENT -córnea I-TREATMENT -preformados I-TREATMENT -que I-TREATMENT -la I-TREATMENT -incorporan, I-TREATMENT +100 I-TREATMENT +a I-TREATMENT +150 I-TREATMENT +mg/kg/día I-TREATMENT para I-TREATMENT -ser I-TREATMENT -adheridos I-TREATMENT -al I-TREATMENT -disco I-TREATMENT -donde I-TREATMENT -está I-TREATMENT -pintado I-TREATMENT -el I-TREATMENT -iris4. I-TREATMENT -Estos I-TREATMENT -conformadores I-TREATMENT -permiten I-TREATMENT -comprobar I-TREATMENT -en I-TREATMENT -cera I-TREATMENT -el I-TREATMENT -centrado I-TREATMENT -del I-TREATMENT -ojo I-TREATMENT -sobre I-TREATMENT -el I-TREATMENT -paciente. I-TREATMENT - I-TREATMENT -Tras I-TREATMENT -adaptar I-TREATMENT -el I-TREATMENT -conjunto I-TREATMENT -iris-pupila I-TREATMENT -al I-TREATMENT -modelo I-TREATMENT +optimizar I-TREATMENT +su I-TREATMENT +concentración I-TREATMENT en I-TREATMENT -cera, I-TREATMENT -se I-TREATMENT -construyó I-TREATMENT -una I-TREATMENT -mufla I-TREATMENT -para I-TREATMENT -obtener I-TREATMENT el I-TREATMENT -ojo I-TREATMENT -protésico I-TREATMENT -en I-TREATMENT -acrílico. I-TREATMENT -Se I-TREATMENT -cargó I-TREATMENT -la I-TREATMENT -mufla I-TREATMENT -con I-TREATMENT -resina I-TREATMENT -blanca, I-TREATMENT -incluyendo I-TREATMENT -pigmentos I-TREATMENT -que I-TREATMENT -se I-TREATMENT -asemejen I-TREATMENT -lo I-TREATMENT -más I-TREATMENT -posible I-TREATMENT -a I-TREATMENT -la I-TREATMENT -esclerótica I-TREATMENT +SNC I-TREATMENT y I-TREATMENT -se I-TREATMENT -polimerizó I-TREATMENT -en I-TREATMENT -agua I-TREATMENT -hirviendo I-TREATMENT -durante I-TREATMENT -30 I-TREATMENT -minutos. I-TREATMENT -Tras I-TREATMENT -el I-TREATMENT -enfriamiento I-TREATMENT -se I-TREATMENT -desgastó I-TREATMENT -el I-TREATMENT -exceso I-TREATMENT -de I-TREATMENT -resina I-TREATMENT -existente I-TREATMENT -en I-TREATMENT +por I-TREATMENT la I-TREATMENT -superficie I-TREATMENT -del I-TREATMENT -iris, I-TREATMENT -dejándola I-TREATMENT -inclusive I-TREATMENT -cóncava, I-TREATMENT -para I-TREATMENT -dar I-TREATMENT -una I-TREATMENT -mayor I-TREATMENT -apariencia I-TREATMENT +sospecha I-TREATMENT de I-TREATMENT -profundidad; I-TREATMENT -lo I-TREATMENT -mismo I-TREATMENT -se I-TREATMENT -hizo I-TREATMENT -con I-TREATMENT -el I-TREATMENT -espacio I-TREATMENT -correspondiente I-TREATMENT -a I-TREATMENT -la I-TREATMENT -esclerótica. I-TREATMENT +absceso I-TREATMENT +cerebral. I-TREATMENT I-TREATMENT -La I-TREATMENT -caracterización I-TREATMENT -de I-TREATMENT -la I-TREATMENT -esclerótica I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -imitando I-TREATMENT -los I-TREATMENT -vasos I-TREATMENT -sanguíneos I-TREATMENT +Hemocultivos B-EXPLORATION +obtenidos I-EXPLORATION +intra-tratamiento I-EXPLORATION +resultaron I-EXPLORATION +negativos, I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +ecográfico I-EXPLORATION +de I-EXPLORATION +cerebro I-EXPLORATION +y I-EXPLORATION +abdomen I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +La I-EXPLORATION +ecocardiografía I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +foramen I-EXPLORATION +oval I-EXPLORATION +permeable, I-EXPLORATION +descartándose I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +vegetaciones. I-EXPLORATION +La I-EXPLORATION +RN I-EXPLORATION +evolucionó I-EXPLORATION +afebril I-EXPLORATION +desde I-EXPLORATION +las I-EXPLORATION +48 I-EXPLORATION +horas I-EXPLORATION +de I-EXPLORATION +cambiado I-EXPLORATION +el I-EXPLORATION +esquema I-EXPLORATION +antimicrobiano. I-EXPLORATION +Al I-EXPLORATION +séptimo I-EXPLORATION +día I-EXPLORATION +de I-EXPLORATION +vida I-EXPLORATION +se I-EXPLORATION +controló I-EXPLORATION +el I-EXPLORATION +LCR I-EXPLORATION +informándose: I-EXPLORATION +38 I-EXPLORATION +leucocitos/mm3, I-EXPLORATION +93% I-EXPLORATION +PMN, I-EXPLORATION +proteínas I-EXPLORATION +164 I-EXPLORATION +mg/dl I-EXPLORATION +y I-EXPLORATION +glucosa I-EXPLORATION +46 I-EXPLORATION +mg/dl, I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +Gram I-EXPLORATION +sin I-EXPLORATION +bacterias I-EXPLORATION +y I-EXPLORATION +cultivo I-EXPLORATION +negativo. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +control I-EXPLORATION +ulterior I-EXPLORATION +del I-EXPLORATION +LCR. I-EXPLORATION + I-EXPLORATION +Una I-EXPLORATION +vez I-EXPLORATION +recibido, I-EXPLORATION +al I-EXPLORATION +octavo I-EXPLORATION +día I-EXPLORATION +de I-EXPLORATION +tratamiento, I-EXPLORATION +el I-EXPLORATION +informe I-EXPLORATION +microbiológico I-EXPLORATION +definitivo I-EXPLORATION +de I-EXPLORATION +Streptococcus I-EXPLORATION +pneumoniae I-EXPLORATION +y I-EXPLORATION +susceptibilidad I-EXPLORATION +corregida I-EXPLORATION +según I-EXPLORATION +los I-EXPLORATION +puntos I-EXPLORATION +de I-EXPLORATION +corte I-EXPLORATION +para I-EXPLORATION +meningitis, I-EXPLORATION +se B-TREATMENT +completó I-TREATMENT +tratamiento I-TREATMENT +sólo I-TREATMENT con I-TREATMENT -hilos I-TREATMENT -de I-TREATMENT -lana I-TREATMENT -o I-TREATMENT -seda I-TREATMENT -cortados I-TREATMENT -y I-TREATMENT -pegados I-TREATMENT -en I-TREATMENT -la I-TREATMENT -esclerótica I-TREATMENT -en I-TREATMENT -sentido I-TREATMENT -longitudinal, I-TREATMENT -partiendo I-TREATMENT -de I-TREATMENT -los I-TREATMENT -ángulos I-TREATMENT -donde I-TREATMENT -hay I-TREATMENT -mas I-TREATMENT -concentración I-TREATMENT -y I-TREATMENT -disminuyendo I-TREATMENT -de I-TREATMENT -intensidad I-TREATMENT -cuando I-TREATMENT -se I-TREATMENT -aproximan I-TREATMENT -al I-TREATMENT -iris3*, I-TREATMENT -5*, I-TREATMENT -8*, I-TREATMENT -9. I-TREATMENT -Se I-TREATMENT -utilizan I-TREATMENT -las I-TREATMENT -mismas I-TREATMENT -pinturas I-TREATMENT -usadas I-TREATMENT -para I-TREATMENT -el I-TREATMENT -iris. I-TREATMENT +cefotaxima. I-TREATMENT I-TREATMENT -Terminada I-TREATMENT -la I-TREATMENT -pigmentación I-TREATMENT -externa I-TREATMENT -de I-TREATMENT -la I-TREATMENT -prótesis I-TREATMENT -esta I-TREATMENT -se I-TREATMENT -reubicó I-TREATMENT -en I-TREATMENT -la I-TREATMENT -mufla I-TREATMENT -y I-TREATMENT -se I-TREATMENT -carga I-TREATMENT -con I-TREATMENT -una I-TREATMENT -capa I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +hacia I-EVOLUTION +la I-EVOLUTION +mejoría I-EVOLUTION +recibiendo I-EVOLUTION +cefotaxima I-EVOLUTION +durante I-EVOLUTION +21 I-EVOLUTION +días, I-EVOLUTION +duración I-EVOLUTION +determinada I-EVOLUTION +por I-EVOLUTION +la I-EVOLUTION +lenta I-EVOLUTION +recuperación I-EVOLUTION +clínica I-EVOLUTION +y I-EVOLUTION +de I-EVOLUTION +parámetros I-EVOLUTION +de I-EVOLUTION +laboratorio. I-EVOLUTION +Fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +22 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +vida, I-EVOLUTION +en I-EVOLUTION +buenas I-EVOLUTION +condiciones, I-EVOLUTION +no I-EVOLUTION +siendo I-EVOLUTION +posible I-EVOLUTION +realizar I-EVOLUTION +seguimiento I-EVOLUTION +post I-EVOLUTION +alta. I-EVOLUTION + I-EVOLUTION +Informe B-EXPLORATION +microbiológico. I-EXPLORATION +Dos I-EXPLORATION +hemocultivos, I-EXPLORATION +un I-EXPLORATION +urocultivo I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +LCR I-EXPLORATION +obtenidos I-EXPLORATION +al I-EXPLORATION +ingresar I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +resultaron I-EXPLORATION +positivos I-EXPLORATION +para I-EXPLORATION +cocáceas I-EXPLORATION +grampositivas I-EXPLORATION +en I-EXPLORATION +cadena I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +diplo. I-EXPLORATION +Los I-EXPLORATION +hemocultivos I-EXPLORATION +se I-EXPLORATION +hicieron I-EXPLORATION +positivos I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +7, I-EXPLORATION +3 I-EXPLORATION +horas I-EXPLORATION +de I-EXPLORATION +incubación I-EXPLORATION +(sistema I-EXPLORATION +BacT/Alert®, I-EXPLORATION +bioMérieux). I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +subcultivo I-EXPLORATION +en I-EXPLORATION +agar I-EXPLORATION +sangre I-EXPLORATION +de I-EXPLORATION +cordero I-EXPLORATION +5% I-EXPLORATION +y I-EXPLORATION +agar I-EXPLORATION +chocolate I-EXPLORATION +(bioMérieux). I-EXPLORATION +Las I-EXPLORATION +placas I-EXPLORATION +se I-EXPLORATION +incubaron I-EXPLORATION +por I-EXPLORATION +24 I-EXPLORATION +horas I-EXPLORATION +a I-EXPLORATION +35°C I-EXPLORATION +en I-EXPLORATION +atmósfera I-EXPLORATION +con I-EXPLORATION +3 I-EXPLORATION +a I-EXPLORATION +5% I-EXPLORATION +de I-EXPLORATION +CO2 I-EXPLORATION +obteniéndose I-EXPLORATION +desarrollo I-EXPLORATION +de I-EXPLORATION +colonias I-EXPLORATION +a I-EXPLORATION +hemolíticas I-EXPLORATION +umbilicadas. I-EXPLORATION +Dado I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +obtuvo I-EXPLORATION +crecimiento I-EXPLORATION +de I-EXPLORATION +colonias I-EXPLORATION +fenotípicamente I-EXPLORATION +similares I-EXPLORATION +en I-EXPLORATION +todos I-EXPLORATION +los I-EXPLORATION +cultivos, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +la I-EXPLORATION +identificación I-EXPLORATION +a I-EXPLORATION +partir I-EXPLORATION +del I-EXPLORATION +crecimiento I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +hemocultivos. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +prueba I-EXPLORATION +de I-EXPLORATION +susceptibilidad I-EXPLORATION +a I-EXPLORATION +optoquina I-EXPLORATION +detectó I-EXPLORATION +resistencia I-EXPLORATION +a I-EXPLORATION +ella, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +emitió I-EXPLORATION +un I-EXPLORATION +informe I-EXPLORATION +preliminar I-EXPLORATION +de: I-EXPLORATION +Streptococcus I-EXPLORATION +grupo I-EXPLORATION +viridans. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +susceptibilidad I-EXPLORATION +para I-EXPLORATION +penicilina I-EXPLORATION +y I-EXPLORATION +cefotaxima I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +mediante I-EXPLORATION +E- I-EXPLORATION +test I-EXPLORATION +y I-EXPLORATION +fue I-EXPLORATION +interpretado I-EXPLORATION +utilizando I-EXPLORATION +los I-EXPLORATION +puntos I-EXPLORATION +de I-EXPLORATION +corte I-EXPLORATION +NCCLS/CLSI I-EXPLORATION +vigentes4 I-EXPLORATION +para I-EXPLORATION +Streptococcus I-EXPLORATION +no I-EXPLORATION +pneumoniae I-EXPLORATION +resultando I-EXPLORATION +sensible I-EXPLORATION +para I-EXPLORATION +penicilina I-EXPLORATION +y I-EXPLORATION +cefotaxima I-EXPLORATION +(penicilina I-EXPLORATION +0, I-EXPLORATION +015 I-EXPLORATION +µg/ml I-EXPLORATION +y I-EXPLORATION +cefotaxima I-EXPLORATION +0, I-EXPLORATION +032 I-EXPLORATION +µg/ml). I-EXPLORATION +Debido I-EXPLORATION +a I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +aspecto I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +colonia I-EXPLORATION +era I-EXPLORATION +sugerente I-EXPLORATION +de I-EXPLORATION +S. I-EXPLORATION +pneumoniae, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +identificación I-EXPLORATION +mediante I-EXPLORATION +API I-EXPLORATION +20 I-EXPLORATION +Strep I-EXPLORATION +(bioMérieux) I-EXPLORATION +el I-EXPLORATION +cual I-EXPLORATION +no I-EXPLORATION +arrojó I-EXPLORATION +resultados I-EXPLORATION +concluyentes I-EXPLORATION +(S. I-EXPLORATION +mitis I-EXPLORATION +(33%), I-EXPLORATION +S. I-EXPLORATION +oralis I-EXPLORATION +(20%), I-EXPLORATION +S. I-EXPLORATION +sanguis I-EXPLORATION +(29%)). I-EXPLORATION +La I-EXPLORATION +cepa I-EXPLORATION +fue I-EXPLORATION +enviada I-EXPLORATION +al I-EXPLORATION +Programa I-EXPLORATION +de I-EXPLORATION +Microbiología, I-EXPLORATION +I.C.B.M., I-EXPLORATION +Universidad I-EXPLORATION +de I-EXPLORATION +Chile, I-EXPLORATION +donde I-EXPLORATION +uno I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +autores I-EXPLORATION +(MTUF) I-EXPLORATION +realizó I-EXPLORATION +prueba I-EXPLORATION +de I-EXPLORATION +solubilidad I-EXPLORATION +en I-EXPLORATION +bilis I-EXPLORATION +(soluble), I-EXPLORATION +detección I-EXPLORATION +de I-EXPLORATION +antígeno I-EXPLORATION +de I-EXPLORATION +pared I-EXPLORATION +celular I-EXPLORATION +de I-EXPLORATION +S. I-EXPLORATION +pneumoniae I-EXPLORATION +por I-EXPLORATION +inmunocromatografía I-EXPLORATION +(BinaxNow®)(positivo) I-EXPLORATION +y I-EXPLORATION +RPC I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +gen I-EXPLORATION +de I-EXPLORATION +neumolisina I-EXPLORATION +(positivo), I-EXPLORATION +identificándose I-EXPLORATION +el I-EXPLORATION +microorganismo I-EXPLORATION +definitivamente I-EXPLORATION +como I-EXPLORATION +Streptococcus I-EXPLORATION +pneumoniae. I-EXPLORATION +La I-EXPLORATION +cepa I-EXPLORATION +fue I-EXPLORATION +enviada I-EXPLORATION +al I-EXPLORATION +Instituto I-EXPLORATION +de I-EXPLORATION +Salud I-EXPLORATION +Pública I-EXPLORATION +cumpliendo I-EXPLORATION +la I-EXPLORATION +normativa I-EXPLORATION +vigente I-EXPLORATION +de I-EXPLORATION +envío I-EXPLORATION +de I-EXPLORATION +S. I-EXPLORATION +pneumoniae I-EXPLORATION +invasores I-EXPLORATION +al I-EXPLORATION +centro I-EXPLORATION +de I-EXPLORATION +referencia. I-EXPLORATION +Se I-EXPLORATION +recibió I-EXPLORATION +informe I-EXPLORATION +de I-EXPLORATION +identificación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +cepa I-EXPLORATION +como I-EXPLORATION +Streptococcus I-EXPLORATION +pneumoniae I-EXPLORATION +serotipo I-EXPLORATION +5, I-EXPLORATION +sensible I-EXPLORATION +a I-EXPLORATION +penicilina. I-EXPLORATION + I-EXPLORATION +Una I-EXPLORATION +vez I-EXPLORATION +hecho I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +microbiológico, I-EXPLORATION +se I-EXPLORATION +corrigió I-EXPLORATION +la I-EXPLORATION +interpretación I-EXPLORATION +de I-EXPLORATION +susceptibilidad I-EXPLORATION +para I-EXPLORATION +cefotaxima I-EXPLORATION +según I-EXPLORATION +los I-EXPLORATION +puntos I-EXPLORATION +de I-EXPLORATION +corte I-EXPLORATION +correspondientes I-EXPLORATION +a I-EXPLORATION +S. I-EXPLORATION +pneumoniae I-EXPLORATION +de I-EXPLORATION +localización I-EXPLORATION +meníngea, I-EXPLORATION +permaneciendo I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +categoría I-EXPLORATION +de I-EXPLORATION +susceptible I-EXPLORATION +tanto I-EXPLORATION +a I-EXPLORATION +penicilina I-EXPLORATION +como I-EXPLORATION +a I-EXPLORATION +cefotaxima. I-EXPLORATION + I-EXPLORATION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +61 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +con B-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS +inespecífica I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal, I-PRESENT_ILLNESS +incremento I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +perímetro I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +constitucional. I-PRESENT_ILLNESS +Intervenido B-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +urgencia I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +otro I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +sospecha I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +apendicitis, I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +le I-DERIVED_FROM/TO +diagnosticó I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +pseudomixoma, I-DERIVED_FROM/TO +practicándole I-DERIVED_FROM/TO +exclusivamente I-DERIVED_FROM/TO +toma I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +biopsias, I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +remitiéndolo I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestra I-DERIVED_FROM/TO +atención. I-DERIVED_FROM/TO +A B-TREATMENT +pesar I-TREATMENT de I-TREATMENT -acrílico I-TREATMENT -transparente I-TREATMENT que I-TREATMENT -tiene I-TREATMENT -la I-TREATMENT -función I-TREATMENT -de I-TREATMENT -proteger I-TREATMENT -y I-TREATMENT -dar I-TREATMENT -translucidez I-TREATMENT -a I-TREATMENT la I-TREATMENT -prótesis4, I-TREATMENT -5. I-TREATMENT - I-TREATMENT -Tras I-TREATMENT -el I-TREATMENT -pulido I-TREATMENT +enfermedad I-TREATMENT +comprometía I-TREATMENT +todas I-TREATMENT las I-TREATMENT -dos I-TREATMENT -resinas I-TREATMENT -tienen I-TREATMENT -que I-TREATMENT -quedar I-TREATMENT -perfectamente I-TREATMENT -unidas, I-TREATMENT -sin I-TREATMENT -irregularidades. I-TREATMENT -Para I-TREATMENT -eso, I-TREATMENT -se I-TREATMENT -puede I-TREATMENT -utilizar I-TREATMENT -fresas I-TREATMENT -de I-TREATMENT -diamante, I-TREATMENT -conos I-TREATMENT -de I-TREATMENT -silicona, I-TREATMENT -papel I-TREATMENT -de I-TREATMENT -lija, I-TREATMENT -y I-TREATMENT -siempre I-TREATMENT -a I-TREATMENT -baja I-TREATMENT -velocidad. I-TREATMENT -El I-TREATMENT -pulido I-TREATMENT -se I-TREATMENT -hizo I-TREATMENT -con I-TREATMENT -agua, I-TREATMENT -polvo I-TREATMENT -de I-TREATMENT -piedra-pómez I-TREATMENT -y I-TREATMENT -algodón5, I-TREATMENT -10. I-TREATMENT - I-TREATMENT -El I-TREATMENT -encerado I-TREATMENT -del I-TREATMENT -globo I-TREATMENT -ocular I-TREATMENT -empieza I-TREATMENT -a I-TREATMENT -partir I-TREATMENT -de I-TREATMENT -una I-TREATMENT -hoja I-TREATMENT -de I-TREATMENT -cera I-TREATMENT -rosa I-TREATMENT -bien I-TREATMENT -adaptada I-TREATMENT -al I-TREATMENT -modelo I-TREATMENT -de I-TREATMENT -trabajo, I-TREATMENT -rellenando I-TREATMENT -los I-TREATMENT -espacios I-TREATMENT -y I-TREATMENT -esculpiendo I-TREATMENT -los I-TREATMENT -límites I-TREATMENT +regiones I-TREATMENT +abdominales I-TREATMENT y I-TREATMENT -los I-TREATMENT -salientes I-TREATMENT -de I-TREATMENT -la I-TREATMENT -prótesis, I-TREATMENT -los I-TREATMENT -cuales I-TREATMENT -tienen I-TREATMENT que I-TREATMENT -estar I-TREATMENT -perfectamente I-TREATMENT -definidos I-TREATMENT -y I-TREATMENT -adaptados2, I-TREATMENT -6, I-TREATMENT -10, I-TREATMENT -11. I-TREATMENT - I-TREATMENT -La I-TREATMENT -ubicación I-TREATMENT -del I-TREATMENT -ojo I-TREATMENT -protésico I-TREATMENT -constituye I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +presentaba I-TREATMENT un I-TREATMENT -paso I-TREATMENT -extremadamente I-TREATMENT -crítico I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -recomienda I-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -del I-TREATMENT -paciente8*, I-TREATMENT -11. I-TREATMENT -Se I-TREATMENT -debe I-TREATMENT -conseguir I-TREATMENT -que I-TREATMENT -la I-TREATMENT -«almendra» I-TREATMENT -ocupe I-TREATMENT -la I-TREATMENT -posición I-TREATMENT -correcta I-TREATMENT -en I-TREATMENT -los I-TREATMENT -tres I-TREATMENT -planos I-TREATMENT -del I-TREATMENT -espacio12. I-TREATMENT -Se I-TREATMENT -usan I-TREATMENT -diferentes I-TREATMENT -técnicas I-TREATMENT -de I-TREATMENT -alineación; I-TREATMENT -todas I-TREATMENT -ellas I-TREATMENT -tienen I-TREATMENT -la I-TREATMENT -finalidad I-TREATMENT -de I-TREATMENT -lograr I-TREATMENT -la I-TREATMENT -posición I-TREATMENT -correcta I-TREATMENT -en I-TREATMENT -la I-TREATMENT -lámina I-TREATMENT -de I-TREATMENT -cera. I-TREATMENT -Aparatos I-TREATMENT -como I-TREATMENT -la I-TREATMENT -regla I-TREATMENT -de I-TREATMENT -Vernier I-TREATMENT -y I-TREATMENT -pupilómetros, I-TREATMENT -se I-TREATMENT -usan I-TREATMENT -para I-TREATMENT -ayudar I-TREATMENT -a I-TREATMENT -conseguir I-TREATMENT -la I-TREATMENT -ubicación I-TREATMENT -de I-TREATMENT -la I-TREATMENT -prótesis I-TREATMENT -ocular I-TREATMENT -dentro I-TREATMENT +índice I-TREATMENT de I-TREATMENT -la I-TREATMENT -órbita. I-TREATMENT -La I-TREATMENT -regla I-TREATMENT +carcinomatosis I-TREATMENT +peritoneal I-TREATMENT de I-TREATMENT -Vernier I-TREATMENT -mide I-TREATMENT +32, I-TREATMENT +acorde I-TREATMENT +con I-TREATMENT la I-TREATMENT -distancia I-TREATMENT -interpupilar I-TREATMENT -que I-TREATMENT -normalmente I-TREATMENT -es I-TREATMENT +clasificación I-TREATMENT de I-TREATMENT -60 I-TREATMENT -mm, I-TREATMENT -aproximadamente2, I-TREATMENT -3*, I-TREATMENT -10. I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -ubicada I-TREATMENT -la I-TREATMENT -«almendra» I-TREATMENT +Sugarbaker I-TREATMENT +(4), I-TREATMENT se I-TREATMENT -comienza I-TREATMENT -la I-TREATMENT -escultura., I-TREATMENT -confeccionando I-TREATMENT +consiguió I-TREATMENT +realizar I-TREATMENT un I-TREATMENT -ojo I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -un I-TREATMENT -tamaño I-TREATMENT -mayor I-TREATMENT -que I-TREATMENT -permite I-TREATMENT -una I-TREATMENT -mayor I-TREATMENT -adaptación I-TREATMENT -a I-TREATMENT -la I-TREATMENT -cavidad. I-TREATMENT - I-TREATMENT -La I-TREATMENT -escultura I-TREATMENT -intenta I-TREATMENT -copiar I-TREATMENT -todas I-TREATMENT -las I-TREATMENT -líneas I-TREATMENT -de I-TREATMENT -expresión I-TREATMENT -e I-TREATMENT -irregularidades I-TREATMENT +intención I-TREATMENT +curativa I-TREATMENT +mediante I-TREATMENT +citorreducción I-TREATMENT +completa I-TREATMENT de I-TREATMENT la I-TREATMENT -piel I-TREATMENT -en I-TREATMENT -la I-TREATMENT -cera. I-TREATMENT -Se I-TREATMENT -crean I-TREATMENT -los I-TREATMENT -párpados I-TREATMENT -y I-TREATMENT -la I-TREATMENT -abertura I-TREATMENT -palpebral, I-TREATMENT -siempre I-TREATMENT -comparándolos I-TREATMENT +enfermedad I-TREATMENT +macroscópica I-TREATMENT +tipo I-TREATMENT +CC0, I-TREATMENT +precisando I-TREATMENT +las I-TREATMENT +6 I-TREATMENT +peritonectomías I-TREATMENT +parietales I-TREATMENT con I-TREATMENT -el I-TREATMENT -ojo I-TREATMENT -sano I-TREATMENT -del I-TREATMENT -paciente. I-TREATMENT -Las I-TREATMENT -marcas I-TREATMENT -en I-TREATMENT -el I-TREATMENT -yeso I-TREATMENT -que I-TREATMENT -se I-TREATMENT -aprecian I-TREATMENT -en I-TREATMENT -la I-TREATMENT -foto, I-TREATMENT -corresponden I-TREATMENT -a I-TREATMENT -la I-TREATMENT -línea I-TREATMENT -media I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cara I-TREATMENT +omentectomía I-TREATMENT +mayor I-TREATMENT y I-TREATMENT -a I-TREATMENT -la I-TREATMENT -línea I-TREATMENT -bipupilar. I-TREATMENT -Los I-TREATMENT -límites I-TREATMENT -de I-TREATMENT -la I-TREATMENT -prótesis I-TREATMENT -deben I-TREATMENT -quedar I-TREATMENT -disimulados I-TREATMENT -con I-TREATMENT -las I-TREATMENT -arrugas I-TREATMENT +menor, I-TREATMENT +colecistectomía I-TREATMENT y I-TREATMENT -salientes I-TREATMENT -naturales I-TREATMENT -de I-TREATMENT -la I-TREATMENT -piel, I-TREATMENT -con I-TREATMENT -la I-TREATMENT -intención I-TREATMENT -de I-TREATMENT -conseguir I-TREATMENT -la I-TREATMENT -correcta I-TREATMENT -expresión I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cara I-TREATMENT +resección I-TREATMENT del I-TREATMENT -paciente8. I-TREATMENT -La I-TREATMENT -prueba I-TREATMENT -de I-TREATMENT -la I-TREATMENT -épitesis I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -permite I-TREATMENT -verificar I-TREATMENT -la I-TREATMENT -alineación I-TREATMENT -de I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -ojos. I-TREATMENT +tumor I-TREATMENT +primario I-TREATMENT +mediante I-TREATMENT +apendicectomía I-TREATMENT +con I-TREATMENT +cequectomía. I-TREATMENT Se I-TREATMENT -pide I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -que I-TREATMENT -imite I-TREATMENT -la I-TREATMENT -acción I-TREATMENT -de I-TREATMENT -leer I-TREATMENT -un I-TREATMENT -periódico. I-TREATMENT - I-TREATMENT -Cuando I-TREATMENT -todo I-TREATMENT -es I-TREATMENT -correcto I-TREATMENT -se I-TREATMENT -incluye I-TREATMENT +completó I-TREATMENT el I-TREATMENT -encerado I-TREATMENT -de I-TREATMENT -la I-TREATMENT -épitesis I-TREATMENT -en I-TREATMENT -la I-TREATMENT -mufla, I-TREATMENT -donde I-TREATMENT -la I-TREATMENT -cara I-TREATMENT -interna I-TREATMENT +tratamiento I-TREATMENT de I-TREATMENT la I-TREATMENT -escultura I-TREATMENT -corresponde I-TREATMENT +posible I-TREATMENT +enfermedad I-TREATMENT +microscópica I-TREATMENT +residual I-TREATMENT +con I-TREATMENT +QIIH I-TREATMENT +con I-TREATMENT +mitomicina I-TREATMENT +C I-TREATMENT a I-TREATMENT -la I-TREATMENT -cavidad I-TREATMENT -del I-TREATMENT -defecto. I-TREATMENT -Este I-TREATMENT -tipo I-TREATMENT -de I-TREATMENT -prótesis I-TREATMENT -es I-TREATMENT -la I-TREATMENT -única I-TREATMENT -que I-TREATMENT -permite I-TREATMENT -reproducir I-TREATMENT -las I-TREATMENT -zonas I-TREATMENT -retentivas I-TREATMENT -del I-TREATMENT -fondo I-TREATMENT -cavitario. I-TREATMENT -Las I-TREATMENT -muflas I-TREATMENT -deben I-TREATMENT -tener I-TREATMENT -guías I-TREATMENT -que I-TREATMENT -nos I-TREATMENT -aseguren I-TREATMENT -la I-TREATMENT -correcta I-TREATMENT -colocación I-TREATMENT -y I-TREATMENT -por I-TREATMENT -ello I-TREATMENT -se I-TREATMENT -realiza I-TREATMENT -una I-TREATMENT -retención I-TREATMENT -en I-TREATMENT -el I-TREATMENT -ojo I-TREATMENT -que I-TREATMENT -permite I-TREATMENT -su I-TREATMENT -ubicación I-TREATMENT +12 I-TREATMENT +mg/m2 I-TREATMENT +disueltos I-TREATMENT en I-TREATMENT -la I-TREATMENT -mufla. I-TREATMENT -Es I-TREATMENT -muy I-TREATMENT -importante I-TREATMENT -que I-TREATMENT -los I-TREATMENT -márgenes I-TREATMENT +1, I-TREATMENT +5 I-TREATMENT +l I-TREATMENT de I-TREATMENT -la I-TREATMENT -cera I-TREATMENT -estén I-TREATMENT -en I-TREATMENT -una I-TREATMENT -base I-TREATMENT -pulida I-TREATMENT +solución I-TREATMENT de I-TREATMENT -yeso I-TREATMENT -para I-TREATMENT -que I-TREATMENT -queden I-TREATMENT -bien I-TREATMENT -definidos. I-TREATMENT -La I-TREATMENT -silicona I-TREATMENT -fue I-TREATMENT -el I-TREATMENT -material I-TREATMENT +diálisis I-TREATMENT +peritoneal I-TREATMENT de I-TREATMENT -elección I-TREATMENT -para I-TREATMENT -confeccionar I-TREATMENT -la I-TREATMENT -épitesis. I-TREATMENT -Viene I-TREATMENT +dianeal I-TREATMENT +al I-TREATMENT +0, I-TREATMENT +33% I-TREATMENT +a I-TREATMENT +42 I-TREATMENT +ºC I-TREATMENT +durante I-TREATMENT +60 I-TREATMENT +min, I-TREATMENT con I-TREATMENT -una I-TREATMENT -presentación I-TREATMENT -de I-TREATMENT -un I-TREATMENT -endurecedor I-TREATMENT -o I-TREATMENT -«crosslinker», I-TREATMENT un I-TREATMENT -catalizador I-TREATMENT -y I-TREATMENT -una I-TREATMENT -base I-TREATMENT -de I-TREATMENT -coloración I-TREATMENT +flujo I-TREATMENT de I-TREATMENT -la I-TREATMENT -piel I-TREATMENT -en I-TREATMENT -diferentes I-TREATMENT -tonalidades, I-TREATMENT -para I-TREATMENT -facilitar I-TREATMENT -la I-TREATMENT -mezcla I-TREATMENT -y I-TREATMENT -poder I-TREATMENT -encontrar I-TREATMENT -los I-TREATMENT -colores I-TREATMENT -adecuados I-TREATMENT -en I-TREATMENT -cada I-TREATMENT -caso. I-TREATMENT -En I-TREATMENT -éste I-TREATMENT -se I-TREATMENT -utilizó I-TREATMENT -una I-TREATMENT -silicona I-TREATMENT -catalizada I-TREATMENT -con I-TREATMENT -platina I-TREATMENT -(Episyl, I-TREATMENT +perfusión I-TREATMENT +continua I-TREATMENT de I-TREATMENT +1, I-TREATMENT +5 I-TREATMENT +l/min, I-TREATMENT +mediante I-TREATMENT la I-TREATMENT -casa I-TREATMENT -Dreve), I-TREATMENT -que I-TREATMENT -ya I-TREATMENT -viene I-TREATMENT -pre-coloreada. I-TREATMENT -Algunos I-TREATMENT -profesionales I-TREATMENT -prefieren I-TREATMENT -siliconas I-TREATMENT -transparentes I-TREATMENT -de I-TREATMENT -otras I-TREATMENT -casas I-TREATMENT -comerciales. I-TREATMENT -Si I-TREATMENT -se I-TREATMENT -utiliza I-TREATMENT -una I-TREATMENT -u I-TREATMENT -otra I-TREATMENT -silicona, I-TREATMENT -es I-TREATMENT -necesario I-TREATMENT -añadir I-TREATMENT -pigmentos, I-TREATMENT -que I-TREATMENT -pueden I-TREATMENT -ser I-TREATMENT -minerales I-TREATMENT -u I-TREATMENT -orgánicos13. I-TREATMENT -Aquí I-TREATMENT -se I-TREATMENT -utilizaron I-TREATMENT -pigmentos I-TREATMENT -orgánicos, I-TREATMENT -que I-TREATMENT -ya I-TREATMENT -vienen I-TREATMENT -mezclados I-TREATMENT -con I-TREATMENT -aceite I-TREATMENT +técnica I-TREATMENT +abierta I-TREATMENT +o I-TREATMENT +"técnica I-TREATMENT de I-TREATMENT -silicona. I-TREATMENT - I-TREATMENT -Por I-TREATMENT -otro I-TREATMENT -lado I-TREATMENT -la I-TREATMENT -iluminación I-TREATMENT -del I-TREATMENT -local I-TREATMENT -debe I-TREATMENT -ser I-TREATMENT -natural, I-TREATMENT -para I-TREATMENT -evitar I-TREATMENT -errores. I-TREATMENT -El I-TREATMENT -paciente I-TREATMENT -debe I-TREATMENT -estar I-TREATMENT -presente I-TREATMENT +coliseo". I-TREATMENT +Durante I-TREATMENT +su I-TREATMENT +estancia I-TREATMENT en I-TREATMENT -el I-TREATMENT -momento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -caracterización I-TREATMENT -de I-TREATMENT -la I-TREATMENT -silicona. I-TREATMENT -Primero I-TREATMENT -se I-TREATMENT -determina I-TREATMENT -el I-TREATMENT -color I-TREATMENT -base I-TREATMENT -de I-TREATMENT la I-TREATMENT -piel I-TREATMENT -mezclando I-TREATMENT -las I-TREATMENT -siliconas I-TREATMENT +unidad I-TREATMENT de I-TREATMENT -vulcanización I-TREATMENT +cuidados I-TREATMENT +intensivos, I-TREATMENT +recibió I-TREATMENT +QIPP I-TREATMENT +los I-TREATMENT +días I-TREATMENT +1º I-TREATMENT a I-TREATMENT -frío I-TREATMENT -y I-TREATMENT -haciendo I-TREATMENT -presión. I-TREATMENT -Después I-TREATMENT -de I-TREATMENT -presionar I-TREATMENT -con I-TREATMENT -el I-TREATMENT -dedo I-TREATMENT -durante I-TREATMENT -unos I-TREATMENT -segundos I-TREATMENT -la I-TREATMENT -piel I-TREATMENT +5º I-TREATMENT del I-TREATMENT -paciente, I-TREATMENT -ésta I-TREATMENT -presenta I-TREATMENT -un I-TREATMENT -color I-TREATMENT -sin I-TREATMENT -afluencia I-TREATMENT -sanguínea. I-TREATMENT -Es I-TREATMENT -este I-TREATMENT -el I-TREATMENT -momento I-TREATMENT -en I-TREATMENT -que I-TREATMENT -se I-TREATMENT -debe I-TREATMENT -comparar I-TREATMENT -el I-TREATMENT -color. I-TREATMENT -En I-TREATMENT -seguida I-TREATMENT -se I-TREATMENT -intenta I-TREATMENT -llegar I-TREATMENT -al I-TREATMENT -color I-TREATMENT -exterior I-TREATMENT -de I-TREATMENT -la I-TREATMENT -piel. I-TREATMENT -Se I-TREATMENT -separa I-TREATMENT -los I-TREATMENT -diferentes I-TREATMENT -colores I-TREATMENT -y I-TREATMENT -se I-TREATMENT -van I-TREATMENT -mezclando I-TREATMENT -los I-TREATMENT -pigmentos I-TREATMENT -hasta I-TREATMENT -conseguir I-TREATMENT -imitar I-TREATMENT -las I-TREATMENT -regiones I-TREATMENT -de I-TREATMENT -los I-TREATMENT -párpados I-TREATMENT -superior I-TREATMENT -e I-TREATMENT -inferior I-TREATMENT -y I-TREATMENT -de I-TREATMENT -las I-TREATMENT -zonas I-TREATMENT -aledañas5. I-TREATMENT -Se I-TREATMENT -pueden I-TREATMENT -ir I-TREATMENT -agregando I-TREATMENT +postoperatorio I-TREATMENT +inmediato I-TREATMENT con I-TREATMENT -un I-TREATMENT -pincel I-TREATMENT -diferentes I-TREATMENT -colores I-TREATMENT -directamente I-TREATMENT +5-fluorouracilo I-TREATMENT +750 I-TREATMENT +mg/m2 I-TREATMENT en I-TREATMENT -las I-TREATMENT -distintas I-TREATMENT -áreas I-TREATMENT +1, I-TREATMENT +5 I-TREATMENT +l I-TREATMENT de I-TREATMENT -la I-TREATMENT -mufla. I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -colocado I-TREATMENT -el I-TREATMENT -ojo I-TREATMENT -en I-TREATMENT -la I-TREATMENT -mufla, I-TREATMENT -se I-TREATMENT -cargó I-TREATMENT -con I-TREATMENT -la I-TREATMENT -silicona I-TREATMENT -correspondiente I-TREATMENT +glucosado I-TREATMENT al I-TREATMENT -color I-TREATMENT -base I-TREATMENT -de I-TREATMENT -la I-TREATMENT -piel. I-TREATMENT -Cargada I-TREATMENT +5% I-TREATMENT +durante I-TREATMENT +23 I-TREATMENT +horas. I-TREATMENT +Su B-EVOLUTION +evolución I-EVOLUTION +postoperatoria I-EVOLUTION +fue I-EVOLUTION +satisfactoria I-EVOLUTION +con I-EVOLUTION +estancia I-EVOLUTION +de I-EVOLUTION +19 I-EVOLUTION +días I-EVOLUTION +sin I-EVOLUTION +complicaciones. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +permanece I-EVOLUTION +vivo I-EVOLUTION +y I-EVOLUTION +libre I-EVOLUTION +de I-EVOLUTION +enfermedad I-EVOLUTION +más I-EVOLUTION +de I-EVOLUTION +10 I-EVOLUTION +años I-EVOLUTION +después, I-EVOLUTION +habiendo I-EVOLUTION +sufrido I-EVOLUTION +un I-EVOLUTION +AVC I-EVOLUTION +por I-EVOLUTION +HTA, I-EVOLUTION +con I-EVOLUTION +hemiplejía I-EVOLUTION +residual. I-EVOLUTION + I-EVOLUTION + +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +hombre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +47 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +diagnosticado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +adenocarcinoma I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +vejiga, I-PRESENT_ILLNESS +tratado I-PRESENT_ILLNESS +mediante I-PRESENT_ILLNESS +derivación I-PRESENT_ILLNESS +intestinal I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +Mainz I-PRESENT_ILLNESS +II. I-PRESENT_ILLNESS +Durante B-TREATMENT la I-TREATMENT -mufla, I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -su I-TREATMENT -prensado, I-TREATMENT -hasta I-TREATMENT -que I-TREATMENT -los I-TREATMENT -bordes I-TREATMENT -metálicos I-TREATMENT +realización I-TREATMENT de I-TREATMENT -la I-TREATMENT -mufla I-TREATMENT -contactaron. I-TREATMENT -Hecho I-TREATMENT -esto, I-TREATMENT -se I-TREATMENT -coloca I-TREATMENT -en I-TREATMENT -agua I-TREATMENT -y I-TREATMENT +una I-TREATMENT +colonoscopia I-TREATMENT +posterior, I-TREATMENT se I-TREATMENT -hace I-TREATMENT -hervir I-TREATMENT -durante I-TREATMENT +extirparon I-TREATMENT dos I-TREATMENT -horas I-TREATMENT -hasta I-TREATMENT -que I-TREATMENT -el I-TREATMENT -material I-TREATMENT -polimerice I-TREATMENT -o I-TREATMENT -se I-TREATMENT -sigue I-TREATMENT -las I-TREATMENT -instrucciones I-TREATMENT -del I-TREATMENT -fabricante. I-TREATMENT -Luego I-TREATMENT +lesiones I-TREATMENT +polipoides I-TREATMENT +sesiles, I-TREATMENT que I-TREATMENT -se I-TREATMENT -comprueba I-TREATMENT -la I-TREATMENT -vulcanización I-TREATMENT +resultaron I-TREATMENT +ser I-TREATMENT +granulomas I-TREATMENT de I-TREATMENT la I-TREATMENT -silicona, I-TREATMENT -se I-TREATMENT -abre I-TREATMENT -la I-TREATMENT -mufla I-TREATMENT -con I-TREATMENT -cuidado I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -la I-TREATMENT -silicona I-TREATMENT -puede I-TREATMENT -rasgarse I-TREATMENT +ureterosigmoidostomía. I-TREATMENT +En B-EVOLUTION +los I-EVOLUTION +controles I-EVOLUTION +posteriores I-EVOLUTION +apareció I-EVOLUTION +una I-EVOLUTION +dilatación I-EVOLUTION +ureteral I-EVOLUTION +y I-EVOLUTION +estenosis I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +anastomosis I-EVOLUTION +del I-EVOLUTION +uréter I-EVOLUTION +izquierdo I-EVOLUTION +a I-EVOLUTION +consecuencia I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +cicatrización I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +"polipectomía". I-EVOLUTION +Se B-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +un I-TREATMENT +tratamiento I-TREATMENT +combinado I-TREATMENT +uro-endoscópico I-TREATMENT en I-TREATMENT -los I-TREATMENT -bordes I-TREATMENT +quirófano I-TREATMENT y I-TREATMENT -estropear I-TREATMENT -el I-TREATMENT -trabajo. I-TREATMENT - I-TREATMENT -Con I-TREATMENT -la I-TREATMENT -epítesis I-TREATMENT -en I-TREATMENT -mano, I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT +radioguiado: I-TREATMENT a I-TREATMENT -recortar I-TREATMENT -los I-TREATMENT -márgenes. I-TREATMENT -Se I-TREATMENT -limpian I-TREATMENT -los I-TREATMENT -restos I-TREATMENT +través I-TREATMENT de I-TREATMENT -yeso I-TREATMENT -que I-TREATMENT -pueden I-TREATMENT -haber I-TREATMENT -quedado. I-TREATMENT -También I-TREATMENT +una I-TREATMENT +nefrostomía I-TREATMENT +izquierda, I-TREATMENT se I-TREATMENT -retira I-TREATMENT +pasó I-TREATMENT +una I-TREATMENT +guía I-TREATMENT +radio-opaca I-TREATMENT +que I-TREATMENT +atravesó I-TREATMENT el I-TREATMENT -ojo I-TREATMENT -para I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -pulido I-TREATMENT +estoma I-TREATMENT +estenosado I-TREATMENT y I-TREATMENT +apareció I-TREATMENT +en I-TREATMENT +sigma. I-TREATMENT +Por I-TREATMENT +endoscopia, I-TREATMENT +sobre I-TREATMENT +la I-TREATMENT +guía, I-TREATMENT se I-TREATMENT -rellena I-TREATMENT -el I-TREATMENT -agujero I-TREATMENT -efectuado, I-TREATMENT -para I-TREATMENT -colocar I-TREATMENT -el I-TREATMENT -ojo. I-TREATMENT -Con I-TREATMENT -una I-TREATMENT -aguja I-TREATMENT -hipodérmica, I-TREATMENT +aplicó I-TREATMENT +un I-TREATMENT +balón I-TREATMENT +de I-TREATMENT +dilatación I-TREATMENT +de I-TREATMENT +6 I-TREATMENT +mm I-TREATMENT +Ø, I-TREATMENT +sin I-TREATMENT +conseguir I-TREATMENT +un I-TREATMENT +aumento I-TREATMENT +significativo I-TREATMENT +del I-TREATMENT +calibre I-TREATMENT +de I-TREATMENT +la I-TREATMENT +misma. I-TREATMENT +Finalmente, I-TREATMENT se I-TREATMENT -cose I-TREATMENT +decidió I-TREATMENT +ampliar I-TREATMENT +la I-TREATMENT +estenosis I-TREATMENT +utilizando I-TREATMENT +un I-TREATMENT +esfinterótomo I-TREATMENT +convencional, I-TREATMENT con I-TREATMENT -cabello I-TREATMENT -las I-TREATMENT -cejas I-TREATMENT -y I-TREATMENT -las I-TREATMENT -pestañas. I-TREATMENT -El I-TREATMENT -color I-TREATMENT -debe I-TREATMENT -ser I-TREATMENT -lo I-TREATMENT -más I-TREATMENT -parecido I-TREATMENT -posible I-TREATMENT -a I-TREATMENT -las I-TREATMENT -del I-TREATMENT -paciente, I-TREATMENT -por I-TREATMENT lo I-TREATMENT que I-TREATMENT -es I-TREATMENT -ideal I-TREATMENT -utilizar I-TREATMENT -los I-TREATMENT -propios I-TREATMENT -cabellos I-TREATMENT -del I-TREATMENT -paciente3*. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -coloca I-TREATMENT -la I-TREATMENT -prótesis I-TREATMENT -y I-TREATMENT se I-TREATMENT -verifican I-TREATMENT -los I-TREATMENT -márgenes. I-TREATMENT -La I-TREATMENT -utilización I-TREATMENT +consiguió I-TREATMENT +una I-TREATMENT +apertura I-TREATMENT +significativa I-TREATMENT de I-TREATMENT -gafas I-TREATMENT -es I-TREATMENT -recomendable I-TREATMENT -porque I-TREATMENT -ayuda I-TREATMENT -a I-TREATMENT -la I-TREATMENT -protección I-TREATMENT -del I-TREATMENT -ojo I-TREATMENT -natural I-TREATMENT -y I-TREATMENT -disimula I-TREATMENT -la I-TREATMENT -prótesis14. I-TREATMENT - I-TREATMENT -Es I-TREATMENT -imprescindible I-TREATMENT -explicar I-TREATMENT -a I-TREATMENT -cada I-TREATMENT -paciente I-TREATMENT la I-TREATMENT -adecuada I-TREATMENT -manipulación I-TREATMENT +anastomosis I-TREATMENT +comprobando I-TREATMENT +débito I-TREATMENT de I-TREATMENT -su I-TREATMENT -epítesis I-TREATMENT -óculo-palpebral, I-TREATMENT -su I-TREATMENT -colocación, I-TREATMENT -limpieza I-TREATMENT -y I-TREATMENT -adhesivo I-TREATMENT -médico I-TREATMENT -más I-TREATMENT -adecuado8*. I-TREATMENT -Los I-TREATMENT -adhesivos I-TREATMENT -utilizados I-TREATMENT -son I-TREATMENT -a I-TREATMENT -base I-TREATMENT +suero I-TREATMENT +salino. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +muy I-EVOLUTION +satisfactoria. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +55 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +médicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +astenia, I-PRESENT_ILLNESS +hiporexia, I-PRESENT_ILLNESS +ictericia I-PRESENT_ILLNESS +cutánea I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +conjuntival, I-PRESENT_ILLNESS +orinas I-PRESENT_ILLNESS +colúricas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +heces I-PRESENT_ILLNESS +hipocólicas. I-PRESENT_ILLNESS +En B-EXPLORATION +el I-EXPLORATION +análisis I-EXPLORATION +urgente I-EXPLORATION +destaca I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +citolisis I-EXPLORATION +(GOT I-EXPLORATION +1720 I-EXPLORATION +UI/dl, I-EXPLORATION +GPT I-EXPLORATION +2660 I-EXPLORATION +UI/dl), I-EXPLORATION +hiperbilirrubinemia I-EXPLORATION +(bilirrubina I-EXPLORATION +total I-EXPLORATION +20, I-EXPLORATION +94 I-EXPLORATION +mg/dl) I-EXPLORATION +y I-EXPLORATION +coagulopatía I-EXPLORATION +(actividad I-EXPLORATION +de I-EXPLORATION +protrombina I-EXPLORATION +45%, I-EXPLORATION +INR I-EXPLORATION +1, I-EXPLORATION +79). I-EXPLORATION +En I-EXPLORATION +las I-EXPLORATION +serologías I-EXPLORATION +virales I-EXPLORATION +destaca I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +HBsAg I-EXPLORATION +positivo I-EXPLORATION +con I-EXPLORATION +antiHBc I-EXPLORATION +IgM I-EXPLORATION +positivo I-EXPLORATION +y I-EXPLORATION +AgHBe I-EXPLORATION +positivo. I-EXPLORATION +Las I-EXPLORATION +serologías I-EXPLORATION +del I-EXPLORATION +VHC, I-EXPLORATION +VHD I-EXPLORATION +y I-EXPLORATION +VIH I-EXPLORATION +resultaron I-EXPLORATION +negativas. I-EXPLORATION + I-EXPLORATION +Ante B-TREATMENT +la I-TREATMENT +presencia I-TREATMENT de I-TREATMENT -silicona I-TREATMENT -médica I-TREATMENT -(siliconas I-TREATMENT -externas I-TREATMENT -sin I-TREATMENT -plomo). I-TREATMENT -Normalmente I-TREATMENT +insuficiencia I-TREATMENT +hepática I-TREATMENT +aguda I-TREATMENT +grave, I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +instaurar I-TREATMENT +tratamiento I-TREATMENT +específico I-TREATMENT +para I-TREATMENT +la I-TREATMENT +hepatitis I-TREATMENT +aguda I-TREATMENT +por I-TREATMENT +VHB I-TREATMENT +con I-TREATMENT +tenofovir I-TREATMENT +245 I-TREATMENT +mg/24 I-TREATMENT +horas I-TREATMENT +desde I-TREATMENT el I-TREATMENT -tiempo I-TREATMENT -de I-TREATMENT -efectividad I-TREATMENT -de I-TREATMENT -los I-TREATMENT -adhesivos I-TREATMENT -cutáneos I-TREATMENT -es I-TREATMENT +día I-TREATMENT +1 I-TREATMENT de I-TREATMENT -48 I-TREATMENT -horas, I-TREATMENT -pero I-TREATMENT -depende I-TREATMENT -del I-TREATMENT -clima. I-TREATMENT -Pasado I-TREATMENT -ese I-TREATMENT -tiempo, I-TREATMENT +ingreso I-TREATMENT +hospitalario. I-TREATMENT + I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +permaneció I-EVOLUTION +ingresado I-EVOLUTION +durante I-EVOLUTION +14 I-EVOLUTION +días, I-EVOLUTION +sin I-EVOLUTION +presentar I-EVOLUTION +encefalopatía I-EVOLUTION +hepática I-EVOLUTION +ni I-EVOLUTION +signos I-EVOLUTION +externos I-EVOLUTION +de I-EVOLUTION +sangrado I-EVOLUTION +en I-EVOLUTION +ningún I-EVOLUTION +momento, I-EVOLUTION +mejorando I-EVOLUTION +las I-EVOLUTION +cifras I-EVOLUTION +analíticas I-EVOLUTION +a I-EVOLUTION +partir I-EVOLUTION +del I-EVOLUTION +día I-EVOLUTION ++7 I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION +antiviral. I-EVOLUTION +Posteriormente, B-TREATMENT el I-TREATMENT paciente I-TREATMENT -deberá I-TREATMENT -retirar I-TREATMENT -la I-TREATMENT -prótesis, I-TREATMENT -limpiarla I-TREATMENT -correctamente, I-TREATMENT -limpiando I-TREATMENT -también I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -donde I-TREATMENT -ésta I-TREATMENT -se I-TREATMENT -asienta. I-TREATMENT -Esta I-TREATMENT -tarea I-TREATMENT -casi I-TREATMENT -diaria I-TREATMENT -debe I-TREATMENT -ser I-TREATMENT -muy I-TREATMENT -cuidadosa I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -los I-TREATMENT -bordes I-TREATMENT -finos I-TREATMENT +continuó I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +tenofovir I-TREATMENT de I-TREATMENT +manera I-TREATMENT +ambulatoria, I-TREATMENT +produciéndose I-TREATMENT la I-TREATMENT -prótesis I-TREATMENT -no I-TREATMENT -deben I-TREATMENT -recibir I-TREATMENT -el I-TREATMENT -adhesivo, I-TREATMENT -evitando I-TREATMENT -así I-TREATMENT -el I-TREATMENT -deterioro I-TREATMENT -de I-TREATMENT -los I-TREATMENT -mismos3*. I-TREATMENT -También I-TREATMENT -se I-TREATMENT -debe I-TREATMENT -advertir I-TREATMENT +seroconversión I-TREATMENT +antiHBe I-TREATMENT al I-TREATMENT -paciente I-TREATMENT -para I-TREATMENT -proteger I-TREATMENT -su I-TREATMENT -prótesis I-TREATMENT +mes I-TREATMENT de I-TREATMENT -los I-TREATMENT -limpiadores I-TREATMENT -abrasivos, I-TREATMENT -solventes I-TREATMENT -o I-TREATMENT -volátiles, I-TREATMENT -perfumes, I-TREATMENT -colonias I-TREATMENT +tratamiento I-TREATMENT y I-TREATMENT -sprays. I-TREATMENT -Solamente I-TREATMENT +negativizando I-TREATMENT +el I-TREATMENT +AgHBs I-TREATMENT +a I-TREATMENT +las I-TREATMENT +8 I-TREATMENT +semanas I-TREATMENT +de I-TREATMENT +tratamiento. I-TREATMENT +Tras I-TREATMENT +2 I-TREATMENT +serologías I-TREATMENT +consecutivas I-TREATMENT +AgHBs I-TREATMENT +negativo I-TREATMENT +y I-TREATMENT +antiHBs I-TREATMENT +positivo I-TREATMENT se I-TREATMENT -deberá I-TREATMENT -usar I-TREATMENT -agua I-TREATMENT -tibia, I-TREATMENT -jabón I-TREATMENT -suave I-TREATMENT -o I-TREATMENT -detergente I-TREATMENT -para I-TREATMENT -limpiar I-TREATMENT -la I-TREATMENT -prótesis. I-TREATMENT +suspendió I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +antiviral. I-TREATMENT I-TREATMENT -Varón B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -gingival I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -tiene I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS +63 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +esencial I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +valsartan I-PAST_MEDICAL_HISTORY +(80 I-PAST_MEDICAL_HISTORY +mg/día), I-PAST_MEDICAL_HISTORY +temblor I-PAST_MEDICAL_HISTORY +esencial I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +propanolol I-PAST_MEDICAL_HISTORY +(80 I-PAST_MEDICAL_HISTORY +mg/día), I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +venosa I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +miembros I-PAST_MEDICAL_HISTORY +inferiores I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +medidas I-PAST_MEDICAL_HISTORY +higiénico-posturales, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +otros I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés. I-PAST_MEDICAL_HISTORY +Acude B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -primera I-PRESENT_ILLNESS -infancia I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -sangrado I-PRESENT_ILLNESS -ocasional I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +externa I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Medicina I-PRESENT_ILLNESS +Interna I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +valoración I-PRESENT_ILLNESS y I-PRESENT_ILLNESS +seguimiento I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +clínico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +insuficiencia I-PRESENT_ILLNESS +venosa I-PRESENT_ILLNESS +crónica I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +miembros I-PRESENT_ILLNESS +inferiores, I-PRESENT_ILLNESS sin I-PRESENT_ILLNESS -dolor. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION +referir I-PRESENT_ILLNESS +ninguna I-PRESENT_ILLNESS +otra I-PRESENT_ILLNESS +sintomatología. I-PRESENT_ILLNESS +La B-EXPLORATION exploración I-EXPLORATION -intraoral I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION +física I-EXPLORATION +estaba I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +normalidad, I-EXPLORATION +salvo I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +soplo I-EXPLORATION +sistólico I-EXPLORATION +grado I-EXPLORATION +II/VI I-EXPLORATION +en I-EXPLORATION +borde I-EXPLORATION +esternal I-EXPLORATION +izquierdo I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -encía I-EXPLORATION -vestibular I-EXPLORATION -superior, I-EXPLORATION +auscultación I-EXPLORATION +cardiaca I-EXPLORATION +y I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +insuficiencia I-EXPLORATION +venosa I-EXPLORATION +crónica I-EXPLORATION +en I-EXPLORATION +miembros I-EXPLORATION +inferiores. I-EXPLORATION +En I-EXPLORATION +las I-EXPLORATION +exploraciones I-EXPLORATION +complementarias I-EXPLORATION +destacaba I-EXPLORATION +hemograma, I-EXPLORATION +VSG, I-EXPLORATION +coagulación, I-EXPLORATION +bioquímica I-EXPLORATION +y I-EXPLORATION +orina I-EXPLORATION +normales. I-EXPLORATION +ECG: I-EXPLORATION +normal. I-EXPLORATION +Radiografía I-EXPLORATION +de I-EXPLORATION +tórax: I-EXPLORATION +imagen I-EXPLORATION +vascular I-EXPLORATION +bien I-EXPLORATION +delimitada I-EXPLORATION a I-EXPLORATION nivel I-EXPLORATION -interincisal I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION de I-EXPLORATION -coloración I-EXPLORATION -rojiza, I-EXPLORATION -blanda I-EXPLORATION -a I-EXPLORATION +mediastino I-EXPLORATION +superior I-EXPLORATION +izquierdo. I-EXPLORATION +Ecocardiografía I-EXPLORATION +doppler: I-EXPLORATION +normal. I-EXPLORATION +TAC I-EXPLORATION +torácica I-EXPLORATION +con I-EXPLORATION +contraste I-EXPLORATION +intravenoso: I-EXPLORATION +dilatación I-EXPLORATION +aneurismática I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -presión, I-EXPLORATION -similar I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -granuloma I-EXPLORATION -telangiectásico, I-EXPLORATION -pero I-EXPLORATION +arteria I-EXPLORATION +pulmonar I-EXPLORATION +izquierda I-EXPLORATION +de I-EXPLORATION +47x75 I-EXPLORATION +mm I-EXPLORATION +de I-EXPLORATION +diámetro, I-EXPLORATION +sin I-EXPLORATION +otros I-EXPLORATION +hallazgos. I-EXPLORATION +Cateterismo I-EXPLORATION +cardiaco I-EXPLORATION con I-EXPLORATION -algunas I-EXPLORATION -pequeñas I-EXPLORATION -vesículas I-EXPLORATION -rojizas I-EXPLORATION +angiografía I-EXPLORATION +pulmonar I-EXPLORATION +y I-EXPLORATION +coronaria: I-EXPLORATION +coronarias I-EXPLORATION +sin I-EXPLORATION +lesiones I-EXPLORATION +y I-EXPLORATION +dilatación I-EXPLORATION +aneurismática I-EXPLORATION +del I-EXPLORATION +tronco I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +pulmonar I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +pulmonar I-EXPLORATION +izquierda. I-EXPLORATION +La B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Cirugía I-DERIVED_FROM/TO +Cardiovascular I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +referencia, I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +sometida I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +intervención I-DERIVED_FROM/TO +quirúrgica, I-DERIVED_FROM/TO +objetivándose B-TREATMENT +en I-TREATMENT +el I-TREATMENT +acto I-TREATMENT +quirúrgico I-TREATMENT +una I-TREATMENT +arteria I-TREATMENT +pulmonar I-TREATMENT +derecha I-TREATMENT +de I-TREATMENT +calibre I-TREATMENT +normal I-TREATMENT +y I-TREATMENT +realizándose I-TREATMENT +resección I-TREATMENT +parcial I-TREATMENT +y I-TREATMENT +plicatura I-TREATMENT +de I-TREATMENT +las I-TREATMENT +arterias I-TREATMENT +pulmonares I-TREATMENT +común I-TREATMENT +e I-TREATMENT +izquierda I-TREATMENT +hasta I-TREATMENT +reducir I-TREATMENT +a I-TREATMENT +un I-TREATMENT +diámetro I-TREATMENT +de I-TREATMENT +2-3 I-TREATMENT +centímetros, I-TREATMENT +cursando B-EVOLUTION +el I-EVOLUTION +postoperatorio I-EVOLUTION +sin I-EVOLUTION +complicaciones I-EVOLUTION +y I-EVOLUTION +permaneciendo I-EVOLUTION +asintomática I-EVOLUTION +tras I-EVOLUTION +la I-EVOLUTION +cirugía. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +hialinosis I-PRESENT_ILLNESS +segmentaria I-PRESENT_ILLNESS +focal I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +respuesta I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +esteroides, I-PRESENT_ILLNESS +ciclofosfamida I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vincristina. I-PRESENT_ILLNESS +Comenzó I-PRESENT_ILLNESS +DP I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +1990. I-PRESENT_ILLNESS +Durante B-TREATMENT +los I-TREATMENT +siguientes I-TREATMENT +11 I-TREATMENT +años I-TREATMENT +recibió I-TREATMENT +3 I-TREATMENT +trasplantes I-TREATMENT +renales, I-TREATMENT +con I-TREATMENT +un I-TREATMENT +tiempo I-TREATMENT +total I-TREATMENT +fuera I-TREATMENT +de I-TREATMENT +diálisis I-TREATMENT +de I-TREATMENT +5 I-TREATMENT +años. I-TREATMENT +Fue I-TREATMENT +paratiroidectomizado I-TREATMENT +por I-TREATMENT +hiperparatiroidismo I-TREATMENT +grave. I-TREATMENT + I-TREATMENT +El B-EVOLUTION +transporte I-EVOLUTION +peritoneal I-EVOLUTION +se I-EVOLUTION +mantuvo I-EVOLUTION +como I-EVOLUTION +medio-alto I-EVOLUTION +con I-EVOLUTION +tendencia I-EVOLUTION +al I-EVOLUTION +alza. I-EVOLUTION +Con B-TREATMENT +el I-TREATMENT +tiempo I-TREATMENT +se I-TREATMENT +redujo I-TREATMENT +la I-TREATMENT +ultrafiltración I-TREATMENT +y I-TREATMENT +aumentaron I-TREATMENT +las I-TREATMENT +necesidades I-TREATMENT +osmóticas I-TREATMENT +de I-TREATMENT +las I-TREATMENT +soluciones. I-TREATMENT +Medimos B-EXPLORATION +CA-125 I-EXPLORATION en I-EXPLORATION -su I-EXPLORATION -superficie. I-EXPLORATION -En I-EXPLORATION +efluente I-EXPLORATION +en I-EXPLORATION +diferentes I-EXPLORATION +momentos, I-EXPLORATION +encontrándose I-EXPLORATION +un I-EXPLORATION +progresivo I-EXPLORATION +descenso. I-EXPLORATION +Sufrió B-EVOLUTION +12 I-EVOLUTION +peritonitis, I-EVOLUTION +todas I-EVOLUTION +por I-EVOLUTION +gérmenes I-EVOLUTION +Gram I-EVOLUTION +positivos. I-EVOLUTION +Se I-EVOLUTION +insistió I-EVOLUTION +al I-EVOLUTION +paciente I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +necesidad I-EVOLUTION +de I-EVOLUTION +ser I-EVOLUTION +transferido I-EVOLUTION +a I-EVOLUTION +HD, I-EVOLUTION +circunstancia I-EVOLUTION +que I-EVOLUTION +trataba I-EVOLUTION +de I-EVOLUTION +evitar; I-EVOLUTION +finalmente I-EVOLUTION +inició I-EVOLUTION +HD I-EVOLUTION +en I-EVOLUTION +2011. I-EVOLUTION + I-EVOLUTION +Seis I-EVOLUTION +meses I-EVOLUTION +después, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +ingresó I-EVOLUTION +por I-EVOLUTION +dolor I-EVOLUTION +y I-EVOLUTION +distensión I-EVOLUTION +abdominal. I-EVOLUTION +Una B-EXPLORATION +TAC I-EXPLORATION +abdominal I-EXPLORATION +evidenció I-EXPLORATION +dilatación I-EXPLORATION +gástrica I-EXPLORATION +y I-EXPLORATION +duodenal I-EXPLORATION +con I-EXPLORATION +líquido I-EXPLORATION +libre I-EXPLORATION +loculado, I-EXPLORATION +y I-EXPLORATION +asas I-EXPLORATION +edematosas. I-EXPLORATION +Se I-EXPLORATION +obtuvo I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +del I-EXPLORATION +peritoneo: I-EXPLORATION +proliferación I-EXPLORATION +de I-EXPLORATION +pequeños I-EXPLORATION +vasos, I-EXPLORATION +celularidad I-EXPLORATION +inflamatoria I-EXPLORATION +y I-EXPLORATION +fibrosis. I-EXPLORATION +Se B-TREATMENT +diagnosticó I-TREATMENT +de I-TREATMENT +EPE, I-TREATMENT +comenzando I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +prednisona I-TREATMENT +y I-TREATMENT +tamoxifeno. I-TREATMENT +Tras B-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +la I-EVOLUTION +colección I-EVOLUTION +había I-EVOLUTION +disminuido I-EVOLUTION +de I-EVOLUTION +tamaño, I-EVOLUTION +no I-EVOLUTION +observándose I-EVOLUTION +dilatación I-EVOLUTION +de I-EVOLUTION +asas. I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +no I-EVOLUTION +sufrió I-EVOLUTION +más I-EVOLUTION +complicaciones. I-EVOLUTION +Se B-TREATMENT +encuentra I-TREATMENT +en I-TREATMENT +HD I-TREATMENT +y I-TREATMENT +continúa I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +tamoxifeno. I-TREATMENT + I-TREATMENT + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +hija B-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +anterior, I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +infancia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +OI I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +raíz I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +fractura I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tibia I-PAST_MEDICAL_HISTORY +desplazada I-PAST_MEDICAL_HISTORY +seguida I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +fractura I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +clavícula I-PAST_MEDICAL_HISTORY +tras I-PAST_MEDICAL_HISTORY +traumatismos I-PAST_MEDICAL_HISTORY +leves. I-PAST_MEDICAL_HISTORY +Posteriormente I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +nuevas I-PAST_MEDICAL_HISTORY +fracturas, I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +última I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +12 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +precisando I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ellas I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +quirúrgico I-PAST_MEDICAL_HISTORY +(olécranon). I-PAST_MEDICAL_HISTORY +Entre I-PAST_MEDICAL_HISTORY +otros I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +destacaban I-PAST_MEDICAL_HISTORY +múltiples I-PAST_MEDICAL_HISTORY +esguinces I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tobillo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +estapedectomía I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +oído I-PAST_MEDICAL_HISTORY +derecho. I-PAST_MEDICAL_HISTORY +Nunca I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +recibido I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +encontraba I-PAST_MEDICAL_HISTORY +asintomática. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +La B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +deseaba I-PRESENT_ILLNESS +conocer I-PRESENT_ILLNESS +sus I-PRESENT_ILLNESS +opciones I-PRESENT_ILLNESS +reproductivas I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +tener I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +hijo I-PRESENT_ILLNESS +libre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +enfermedad. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION -papila I-EXPLORATION -que I-EXPLORATION -separa I-EXPLORATION -el I-EXPLORATION -12 I-EXPLORATION -del I-EXPLORATION -13 I-EXPLORATION -se I-EXPLORATION -manifiesta I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -rojiza I-EXPLORATION -con I-EXPLORATION -pequeñas I-EXPLORATION -proyecciones I-EXPLORATION -papilares I-EXPLORATION -sobreelevadas, I-EXPLORATION -del I-EXPLORATION -tamaño I-EXPLORATION -de I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +destacaba I-EXPLORATION una I-EXPLORATION -cabeza I-EXPLORATION +talla I-EXPLORATION de I-EXPLORATION -alfiler I-EXPLORATION +153 I-EXPLORATION +cm, I-EXPLORATION +escleras I-EXPLORATION +azules I-EXPLORATION y I-EXPLORATION -entre I-EXPLORATION -ambas I-EXPLORATION -lesiones I-EXPLORATION +dientes I-EXPLORATION +normales. I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -observan I-EXPLORATION -pequeñas I-EXPLORATION -zonas I-EXPLORATION -puntiformes I-EXPLORATION +apreciaron I-EXPLORATION +deformidades I-EXPLORATION +a I-EXPLORATION +ningún I-EXPLORATION +nivel. I-EXPLORATION + I-EXPLORATION +Las I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -coloración I-EXPLORATION -rojiza. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -porción I-EXPLORATION +laboratorio I-EXPLORATION +resultaron I-EXPLORATION +normales, I-EXPLORATION +salvo I-EXPLORATION +los I-EXPLORATION +niveles I-EXPLORATION de I-EXPLORATION -encía I-EXPLORATION -insertada I-EXPLORATION -en I-EXPLORATION -palatino, I-EXPLORATION -entre I-EXPLORATION -el I-EXPLORATION -12 I-EXPLORATION +25OHCC: I-EXPLORATION +23 I-EXPLORATION +ng/ml, I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -13 I-EXPLORATION también I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -rojiza I-EXPLORATION -con I-EXPLORATION -elevaciones I-EXPLORATION -papilares I-EXPLORATION -similares I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -descritas I-EXPLORATION -en I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION +del I-EXPLORATION +estudio I-EXPLORATION +realizado I-EXPLORATION +(radiografía I-EXPLORATION +de I-EXPLORATION +columna I-EXPLORATION +cervical, I-EXPLORATION +ecocardiograma, I-EXPLORATION +espirometría, I-EXPLORATION +ecografía I-EXPLORATION +abdominal). I-EXPLORATION +Los I-EXPLORATION +resultados I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -zona I-EXPLORATION -vestibular. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -toma I-EXPLORATION +densitometría I-EXPLORATION +mostraron I-EXPLORATION una I-EXPLORATION -biopsia I-EXPLORATION +densidad I-EXPLORATION +mineral I-EXPLORATION +ósea I-EXPLORATION +normal: I-EXPLORATION +T-scores I-EXPLORATION +de I-EXPLORATION +-0, I-EXPLORATION +9 I-EXPLORATION +en I-EXPLORATION +columna I-EXPLORATION +lumbar I-EXPLORATION +(L1-L4), I-EXPLORATION +0, I-EXPLORATION +0 I-EXPLORATION +en I-EXPLORATION +cuello I-EXPLORATION +femoral I-EXPLORATION +y I-EXPLORATION +-0, I-EXPLORATION +1 I-EXPLORATION en I-EXPLORATION +fémur I-EXPLORATION +total. I-EXPLORATION +Se B-TREATMENT +recomendó I-TREATMENT +suplementación I-TREATMENT +con I-TREATMENT +vitamina I-TREATMENT +D. I-TREATMENT + I-TREATMENT +Se B-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +genético I-EXPLORATION +dirigido I-EXPLORATION +para I-EXPLORATION la I-EXPLORATION -zona I-EXPLORATION +búsqueda I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -lesión I-EXPLORATION -vestibular I-EXPLORATION -del I-EXPLORATION -12 I-EXPLORATION -al I-EXPLORATION -13 I-EXPLORATION +mutación I-EXPLORATION +identificada I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +padre, I-EXPLORATION +confirmando I-EXPLORATION que I-EXPLORATION +la I-EXPLORATION +hija I-EXPLORATION es I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -hemolinfangioma. I-EXPLORATION +portadora I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +misma I-EXPLORATION +deleción I-EXPLORATION +en I-EXPLORATION +heterocigosis I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +gen I-EXPLORATION +COL1A1 I-EXPLORATION +que I-EXPLORATION +presentaba I-EXPLORATION +su I-EXPLORATION +padre. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +asesoramiento I-EXPLORATION +genético I-EXPLORATION +para I-EXPLORATION +informar I-EXPLORATION +sobre I-EXPLORATION +las I-EXPLORATION +posibles I-EXPLORATION +consecuencias I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +afecto I-EXPLORATION +a I-EXPLORATION +su I-EXPLORATION +descendencia, I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +resultados I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION +genético I-EXPLORATION +y I-EXPLORATION +sus I-EXPLORATION +ventajas I-EXPLORATION +y I-EXPLORATION +riesgos, I-EXPLORATION +además I-EXPLORATION +de I-EXPLORATION +informarle I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +posibles I-EXPLORATION +alternativas I-EXPLORATION +derivadas I-EXPLORATION +del I-EXPLORATION +análisis. I-EXPLORATION I-EXPLORATION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS +34 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS sin B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -salvo I-PAST_MEDICAL_HISTORY -estar I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -fase I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -terapia I-PAST_MEDICAL_HISTORY -hormonal I-PAST_MEDICAL_HISTORY -sustitutiva, I-PAST_MEDICAL_HISTORY -que B-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -referida I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -clínica I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -odontología I-DERIVED_FROM/TO -general I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -clínica I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -periodoncia I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -iniciar I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -multidisciplinario. I-DERIVED_FROM/TO -El B-PRESENT_ILLNESS -motivo I-PRESENT_ILLNESS +mórbidos; I-PAST_MEDICAL_HISTORY +consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +asintomática I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +muslo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -corregir I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -frente I-PRESENT_ILLNESS -estético, I-PRESENT_ILLNESS -solucionar I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -movilidad I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -22 I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -reposición I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -molares I-PRESENT_ILLNESS -inferiores. I-PRESENT_ILLNESS -En B-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -anamnesis I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -dental I-PAST_MEDICAL_HISTORY -constaba I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -fumadora I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -cigarrillos I-PAST_MEDICAL_HISTORY -diarios I-PAST_MEDICAL_HISTORY -y B-FAMILY_HISTORY -tenía I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -maternos I-FAMILY_HISTORY -de I-FAMILY_HISTORY -enfermedad I-FAMILY_HISTORY -periodontal. I-FAMILY_HISTORY - I-FAMILY_HISTORY -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -dental, I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -presentaba: I-EXPLORATION -ausencia I-EXPLORATION +evolución. I-PRESENT_ILLNESS +Se B-TREATMENT +trató I-TREATMENT +como I-TREATMENT +piodermia I-TREATMENT +con I-TREATMENT +múltiples I-TREATMENT +antibióticos I-TREATMENT +orales, I-TREATMENT +sin I-TREATMENT +respuesta. I-TREATMENT +Al B-EXPLORATION +examen, I-EXPLORATION +presentaba I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +eritematoso I-EXPLORATION de I-EXPLORATION -18/28/35/ I-EXPLORATION -36/38/45/46 I-EXPLORATION +5 I-EXPLORATION +x I-EXPLORATION +8 I-EXPLORATION +cm, I-EXPLORATION +con I-EXPLORATION +pequeñas I-EXPLORATION +ulceraciones I-EXPLORATION y I-EXPLORATION -obturaciones I-EXPLORATION -en I-EXPLORATION -diversas I-EXPLORATION -piezas. I-EXPLORATION +erosiones. I-EXPLORATION A I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -periodontal I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -placa I-EXPLORATION -bacteriana I-EXPLORATION -y I-EXPLORATION +compresión I-EXPLORATION +no I-EXPLORATION +hubo I-EXPLORATION +salida I-EXPLORATION de I-EXPLORATION -hemorragia I-EXPLORATION -gingival, I-EXPLORATION -profundidad I-EXPLORATION +exudado I-EXPLORATION +ni I-EXPLORATION de I-EXPLORATION -sondaje I-EXPLORATION -entre I-EXPLORATION -4 I-EXPLORATION -y I-EXPLORATION -7 I-EXPLORATION -mm, I-EXPLORATION -pérdida I-EXPLORATION +granos. I-EXPLORATION +Además, I-EXPLORATION +presentaba I-EXPLORATION +dos I-EXPLORATION +adenopatías I-EXPLORATION +inguinales I-EXPLORATION +ipsilaterales, I-EXPLORATION +no I-EXPLORATION +dolorosas, I-EXPLORATION de I-EXPLORATION -soporte I-EXPLORATION -generalizado; I-EXPLORATION -furca I-EXPLORATION -vestibular I-EXPLORATION -grado I-EXPLORATION +aproximadamente I-EXPLORATION 1 I-EXPLORATION -y I-EXPLORATION -lingual I-EXPLORATION -grado I-EXPLORATION -2 I-EXPLORATION -en I-EXPLORATION -37; I-EXPLORATION -furca I-EXPLORATION -vestibular I-EXPLORATION -grado I-EXPLORATION -2 I-EXPLORATION -en I-EXPLORATION -47; I-EXPLORATION -abundantes I-EXPLORATION -recesiones; I-EXPLORATION -movilidad I-EXPLORATION -+1 I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -sextante I-EXPLORATION -anterosuperior I-EXPLORATION -y I-EXPLORATION -+2 I-EXPLORATION -en I-EXPLORATION +cm. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +palparon I-EXPLORATION +otras I-EXPLORATION +adenopatías I-EXPLORATION +ni I-EXPLORATION +visceromegalia. I-EXPLORATION +Se I-EXPLORATION +planteó I-EXPLORATION el I-EXPLORATION -grupo I-EXPLORATION -anteroinferior; I-EXPLORATION -mesialización I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -37, I-EXPLORATION -47 I-EXPLORATION -y I-EXPLORATION -48, I-EXPLORATION -y I-EXPLORATION -diastemas I-EXPLORATION -en I-EXPLORATION -frente I-EXPLORATION -anterosuperior. I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION -ortodóncica I-EXPLORATION -mostró I-EXPLORATION -clase I-EXPLORATION -III I-EXPLORATION -esquelética I-EXPLORATION -y I-EXPLORATION -dentaria, I-EXPLORATION -mordida I-EXPLORATION -cruzada I-EXPLORATION -anterior I-EXPLORATION -y, I-EXPLORATION -en I-EXPLORATION -relación I-EXPLORATION -céntrica, I-EXPLORATION un I-EXPLORATION -contacto I-EXPLORATION -prematuro, I-EXPLORATION -asociado I-EXPLORATION -a I-EXPLORATION -sobrecarga I-EXPLORATION -funcional I-EXPLORATION +linfoma I-EXPLORATION +cutáneo I-EXPLORATION +y I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -dientes I-EXPLORATION -anteriores. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -ortopantomografía I-EXPLORATION +un I-EXPLORATION +actinomicetoma, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -comprobó I-EXPLORATION -ausencia I-EXPLORATION +solicitaron I-EXPLORATION +exámenes I-EXPLORATION +serológicos, I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TAC) I-EXPLORATION +con I-EXPLORATION +contraste I-EXPLORATION de I-EXPLORATION -dientes, I-EXPLORATION -buena I-EXPLORATION -relación I-EXPLORATION -corono I-EXPLORATION -radicular, I-EXPLORATION -pérdida I-EXPLORATION -ósea I-EXPLORATION -generalizada I-EXPLORATION +tórax, I-EXPLORATION +abdomen I-EXPLORATION y I-EXPLORATION -horizontal I-EXPLORATION -de I-EXPLORATION -más I-EXPLORATION -del I-EXPLORATION -50%, I-EXPLORATION -espacio I-EXPLORATION -periodontal I-EXPLORATION -ensanchado I-EXPLORATION -en I-EXPLORATION -12, I-EXPLORATION -defecto I-EXPLORATION -angular I-EXPLORATION -en I-EXPLORATION -22 I-EXPLORATION +pelvis I-EXPLORATION +(TAC-TAP), I-EXPLORATION +múltiples I-EXPLORATION +cultivos I-EXPLORATION +bacterianos-micológicos I-EXPLORATION y I-EXPLORATION -37, I-EXPLORATION -defecto I-EXPLORATION -en I-EXPLORATION -furca I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION de I-EXPLORATION -37 I-EXPLORATION +piel. I-EXPLORATION +Tenía I-EXPLORATION +hemograma, I-EXPLORATION +deshidrogensa I-EXPLORATION +láctica I-EXPLORATION +(LDH) I-EXPLORATION y I-EXPLORATION -47 I-EXPLORATION +calcio I-EXPLORATION +sérico I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +rangos I-EXPLORATION +normales; I-EXPLORATION +además I-EXPLORATION +de I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +HTLV-1 I-EXPLORATION +negativa. I-EXPLORATION +El I-EXPLORATION +TAC-TAP I-EXPLORATION +mostró I-EXPLORATION +sólo I-EXPLORATION +las I-EXPLORATION +adenopatías I-EXPLORATION +ipsilaterales I-EXPLORATION +pesquisadas I-EXPLORATION +clínicamente. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +histopatología I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +dérmico I-EXPLORATION +ulcerado, I-EXPLORATION +compuesto I-EXPLORATION +por I-EXPLORATION +células I-EXPLORATION +linfoides I-EXPLORATION +grandes, I-EXPLORATION +con I-EXPLORATION +pleomorfismo I-EXPLORATION +nuclear I-EXPLORATION y I-EXPLORATION -cortical I-EXPLORATION -ósea I-EXPLORATION -reforzada I-EXPLORATION -en I-EXPLORATION -grupo I-EXPLORATION -anteroinferior. I-EXPLORATION +mitosis I-EXPLORATION +atípicas. I-EXPLORATION +Además, I-EXPLORATION +había I-EXPLORATION +abundantes I-EXPLORATION +eosinófilos. I-EXPLORATION El I-EXPLORATION estudio I-EXPLORATION -cefalométrico I-EXPLORATION -reveló I-EXPLORATION -clase I-EXPLORATION -III I-EXPLORATION -esquelética, I-EXPLORATION -protrusión I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -incisivos I-EXPLORATION -inferiores I-EXPLORATION -y I-EXPLORATION -altura I-EXPLORATION -facial I-EXPLORATION -aumentada. I-EXPLORATION -Exploración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -articulación I-EXPLORATION -temporo-mandibular: I-EXPLORATION -sin I-EXPLORATION -interés. I-EXPLORATION -A I-EXPLORATION -partir I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -datos I-EXPLORATION -previamente I-EXPLORATION -expuestos, I-EXPLORATION -se I-EXPLORATION -estableció I-EXPLORATION -el I-EXPLORATION -siguiente I-EXPLORATION -diagnóstico: I-EXPLORATION -enfermedad I-EXPLORATION -periodontal I-EXPLORATION -generalizada I-EXPLORATION +inmunohistoquímico I-EXPLORATION +(IHQ) I-EXPLORATION +mostró I-EXPLORATION +reacción I-EXPLORATION +positiva I-EXPLORATION +para I-EXPLORATION +CD30 I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +grandes I-EXPLORATION y I-EXPLORATION -avanzada; I-EXPLORATION -clase I-EXPLORATION -III I-EXPLORATION -esquelética I-EXPLORATION +reacción I-EXPLORATION +negativa I-EXPLORATION +para I-EXPLORATION +ALK-1 I-EXPLORATION y I-EXPLORATION -dentaria. I-EXPLORATION - I-EXPLORATION -Exposición B-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT - I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -planificó I-TREATMENT -en I-TREATMENT -cuatro I-TREATMENT -fases: I-TREATMENT -regeneración I-TREATMENT -periodontal, I-TREATMENT -nivelación I-TREATMENT -de I-TREATMENT -arcadas I-TREATMENT -mediante I-TREATMENT -ortodoncia, I-TREATMENT -reposición I-TREATMENT -de I-TREATMENT -dientes I-TREATMENT -mediante I-TREATMENT -prótesis I-TREATMENT -implantosoportada I-TREATMENT -y I-TREATMENT -terapia I-TREATMENT -periodontal I-TREATMENT -de I-TREATMENT -soporte. I-TREATMENT - I-TREATMENT -Primera I-TREATMENT -fase: I-TREATMENT -comenzamos I-TREATMENT -por I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -periodontal. I-TREATMENT -La I-TREATMENT -paciente I-TREATMENT -había I-TREATMENT -sido I-TREATMENT -ya I-TREATMENT -motivada I-TREATMENT -e I-TREATMENT -instruida I-TREATMENT -en I-TREATMENT -normas I-TREATMENT -y I-TREATMENT -hábitos I-TREATMENT -de I-TREATMENT -higiene I-TREATMENT -oral I-TREATMENT -por I-TREATMENT -su I-TREATMENT -dentista, I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -permitió I-TREATMENT -pasar I-TREATMENT -directamente I-TREATMENT -al I-TREATMENT -debridamiento I-TREATMENT -de I-TREATMENT -las I-TREATMENT -superficies I-TREATMENT -radiculares, I-TREATMENT -efectuando I-TREATMENT -raspajes, I-TREATMENT -alisados I-TREATMENT -y I-TREATMENT -pulido I-TREATMENT -de I-TREATMENT -superficies I-TREATMENT -contaminadas. I-TREATMENT -Dado I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -era I-TREATMENT -muy I-TREATMENT -fumadora, I-TREATMENT -esta I-TREATMENT -fase I-TREATMENT -resultó I-TREATMENT -algo I-TREATMENT -laboriosa. I-TREATMENT -Completamos I-TREATMENT -esta I-TREATMENT -fase I-TREATMENT -con I-TREATMENT -cirugía I-TREATMENT -periodontal I-TREATMENT -de I-TREATMENT -bolsas I-TREATMENT -residuales, I-TREATMENT -es I-TREATMENT -decir, I-TREATMENT -las I-TREATMENT -que I-TREATMENT -presentaban I-TREATMENT -hemorragia I-TREATMENT -al I-TREATMENT -sondaje I-TREATMENT -cuatro I-TREATMENT -semanas I-TREATMENT -después I-TREATMENT -de I-TREATMENT -concluida I-TREATMENT -la I-TREATMENT -fase I-TREATMENT -básica. I-TREATMENT -A I-TREATMENT -la I-TREATMENT -vez, I-TREATMENT -procedimos I-TREATMENT -a I-TREATMENT -tratar I-TREATMENT -los I-TREATMENT -defectos I-TREATMENT -óseos I-TREATMENT -angulares I-TREATMENT -y I-TREATMENT -de I-TREATMENT -furcas I-TREATMENT -de I-TREATMENT -12, I-TREATMENT -22, I-TREATMENT -37 I-TREATMENT -y I-TREATMENT -47 I-TREATMENT -y I-TREATMENT -efectuamos I-TREATMENT -en I-TREATMENT -cada I-TREATMENT -uno I-TREATMENT -de I-TREATMENT -ellos I-TREATMENT -un I-TREATMENT -pequeño I-TREATMENT -colgajo I-TREATMENT -para I-TREATMENT -regenerar I-TREATMENT -los I-TREATMENT -tejidos I-TREATMENT -periodontales I-TREATMENT -con I-TREATMENT -Emdogain®. I-TREATMENT -El I-TREATMENT -plazo I-TREATMENT -de I-TREATMENT -tiempo I-TREATMENT -transcurrido I-TREATMENT -en I-TREATMENT -los I-TREATMENT -pasos I-TREATMENT -previos I-TREATMENT -sirvió I-TREATMENT -para I-TREATMENT -reforzar I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -en I-TREATMENT -hábitos I-TREATMENT -de I-TREATMENT -higiene I-TREATMENT -interdental I-TREATMENT -y I-TREATMENT -para I-TREATMENT -animarle I-TREATMENT -a I-TREATMENT -que I-TREATMENT -suprimiera I-TREATMENT -el I-TREATMENT -hábito I-TREATMENT -del I-TREATMENT -tabaquismo, I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -consiguió. I-TREATMENT -Hubo I-TREATMENT -que I-TREATMENT -preparar I-TREATMENT -una I-TREATMENT -férula I-TREATMENT -de I-TREATMENT -relajación I-TREATMENT -porque I-TREATMENT -la I-TREATMENT -supresión I-TREATMENT -del I-TREATMENT -tabaco I-TREATMENT -le I-TREATMENT -provocaba I-TREATMENT -mucha I-TREATMENT -ansiedad, I-TREATMENT -sensibilidad I-TREATMENT -y I-TREATMENT -dolor I-TREATMENT -dental. I-TREATMENT -Además I-TREATMENT -se I-TREATMENT -le I-TREATMENT -propuso I-TREATMENT -revisión I-TREATMENT -de I-TREATMENT -mantenimiento I-TREATMENT -cada I-TREATMENT -cuatro I-TREATMENT -meses I-TREATMENT -una I-TREATMENT -vez I-TREATMENT -finalizadas I-TREATMENT -las I-TREATMENT -restantes I-TREATMENT -fases I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -si I-TREATMENT -la I-TREATMENT -situación I-TREATMENT -periodontal I-TREATMENT -y I-TREATMENT -de I-TREATMENT -los I-TREATMENT -implantes I-TREATMENT -no I-TREATMENT -variaba. I-TREATMENT - I-TREATMENT -Segunda B-DERIVED_FROM/TO -fase. I-DERIVED_FROM/TO -Doce I-DERIVED_FROM/TO -meses I-DERIVED_FROM/TO -después I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -regeneración I-DERIVED_FROM/TO -periodontal I-DERIVED_FROM/TO -guiada, I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -referida I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -ortodoncista I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -continuar I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -tratamiento. I-DERIVED_FROM/TO -Esta B-TREATMENT -fase I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -con I-TREATMENT -ortodoncia I-TREATMENT -fija, I-TREATMENT -nivelando I-TREATMENT -la I-TREATMENT -arcada I-TREATMENT -maxilar I-TREATMENT -con I-TREATMENT -un I-TREATMENT -levante I-TREATMENT -de I-TREATMENT -mordida I-TREATMENT -mandibular. I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -resuelta I-TREATMENT -la I-TREATMENT -mordida I-TREATMENT -anterior, I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -nivelar I-TREATMENT -la I-TREATMENT -arcada I-TREATMENT -mandibular, I-TREATMENT -preparando I-TREATMENT -los I-TREATMENT -espacios I-TREATMENT -que I-TREATMENT -más I-TREATMENT -adelante I-TREATMENT -servirían I-TREATMENT -para I-TREATMENT -colocar I-TREATMENT -implantes, I-TREATMENT -si I-TREATMENT -el I-TREATMENT -ancho I-TREATMENT -de I-TREATMENT -hueso I-TREATMENT -lo I-TREATMENT -permitía. I-TREATMENT -Para I-TREATMENT -conseguir I-TREATMENT -esos I-TREATMENT -espacios I-TREATMENT -se I-TREATMENT -nivelaron I-TREATMENT -los I-TREATMENT -molares I-TREATMENT -posteriores I-TREATMENT -mandibulares, I-TREATMENT -empleando I-TREATMENT -arcos I-TREATMENT -con I-TREATMENT -escalones I-TREATMENT -para I-TREATMENT -no I-TREATMENT -interferir I-TREATMENT -la I-TREATMENT -masticación. I-TREATMENT -Aunque I-TREATMENT -se I-TREATMENT -trataba I-TREATMENT -de I-TREATMENT -una I-TREATMENT -clase I-TREATMENT -III, I-TREATMENT -fue I-TREATMENT -preciso I-TREATMENT -empujar I-TREATMENT -hacia I-TREATMENT -mesial I-TREATMENT -el I-TREATMENT -tercer I-TREATMENT -cuadrante I-TREATMENT -que I-TREATMENT -estaba I-TREATMENT -en I-TREATMENT -clase I-TREATMENT -II I-TREATMENT -dentaria I-TREATMENT -sin I-TREATMENT -sobrecargar I-TREATMENT -los I-TREATMENT -incisivos I-TREATMENT -superiores, I-TREATMENT -por I-TREATMENT -eso I-TREATMENT -evitamos I-TREATMENT -el I-TREATMENT -uso I-TREATMENT -de I-TREATMENT -elásticos I-TREATMENT -para I-TREATMENT -corregir I-TREATMENT -la I-TREATMENT -Clase I-TREATMENT -II I-TREATMENT -en I-TREATMENT -el I-TREATMENT -lado I-TREATMENT -izquierdo I-TREATMENT -desde I-TREATMENT -el I-TREATMENT -22 I-TREATMENT -hasta I-TREATMENT -el I-TREATMENT -34. I-TREATMENT -Para I-TREATMENT -mesializar I-TREATMENT -el I-TREATMENT -tercer I-TREATMENT -cuadrante I-TREATMENT -se I-TREATMENT -recurrió I-TREATMENT -a I-TREATMENT -un I-TREATMENT -anclaje I-TREATMENT -óseo I-TREATMENT -mediante I-TREATMENT -un I-TREATMENT -microtornillo I-TREATMENT -y I-TREATMENT -un I-TREATMENT -resorte I-TREATMENT -de I-TREATMENT -19 I-TREATMENT -x I-TREATMENT -25 I-TREATMENT -de I-TREATMENT -TMA®, I-TREATMENT -donde I-TREATMENT -podemos I-TREATMENT -observar I-TREATMENT -el I-TREATMENT -canino I-TREATMENT -en I-TREATMENT -clase I-TREATMENT -I I-TREATMENT -de I-TREATMENT -Angle. I-TREATMENT -Los I-TREATMENT -registros I-TREATMENT -finales I-TREATMENT -pueden I-TREATMENT -verse I-TREATMENT -en I-TREATMENT -la I-TREATMENT -figura I-TREATMENT -9. I-TREATMENT -Para I-TREATMENT -finalizar, I-TREATMENT -el I-TREATMENT -ortodoncista I-TREATMENT -hizo I-TREATMENT -una I-TREATMENT -retención I-TREATMENT -intracoronaria, I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -deberá I-TREATMENT -llevar I-TREATMENT -de I-TREATMENT -por I-TREATMENT -vida. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -tercera I-EXPLORATION -fase, I-EXPLORATION -o I-EXPLORATION -fase I-EXPLORATION -de I-EXPLORATION -reposición I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -molares I-EXPLORATION -ausentes, I-EXPLORATION -requirió I-EXPLORATION -inicialmente I-EXPLORATION +CD25. I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +además I-EXPLORATION una I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION -de I-EXPLORATION -zonas I-EXPLORATION -desdentadas I-EXPLORATION -para I-EXPLORATION -valorar I-EXPLORATION -la I-EXPLORATION -posibilidad I-EXPLORATION -de I-EXPLORATION -colocar I-EXPLORATION -implantes. I-EXPLORATION -Gracias I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -imágenes I-EXPLORATION -obtenidas I-EXPLORATION -en I-EXPLORATION -diversos I-EXPLORATION -cortes, I-EXPLORATION -posteriormente I-EXPLORATION -manipuladas I-EXPLORATION -con I-EXPLORATION -programas I-EXPLORATION +biopsia I-EXPLORATION de I-EXPLORATION -simulación I-EXPLORATION -para I-EXPLORATION -implantes, I-EXPLORATION -se I-EXPLORATION -concluyó I-EXPLORATION +médula I-EXPLORATION +ósea, I-EXPLORATION que I-EXPLORATION -era I-EXPLORATION -viable I-EXPLORATION -colocar I-EXPLORATION -fijaciones I-EXPLORATION -de I-EXPLORATION -3, I-EXPLORATION -5 I-EXPLORATION -mm I-EXPLORATION -x I-EXPLORATION -9 I-EXPLORATION -mm I-EXPLORATION -(Astra®) I-EXPLORATION -a I-EXPLORATION -cada I-EXPLORATION -lado I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -tramos I-EXPLORATION -desdentados I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mandíbula. I-EXPLORATION -Estas B-TREATMENT -fijaciones I-TREATMENT -fueron I-TREATMENT -guiadas I-TREATMENT -e I-TREATMENT -instaladas I-TREATMENT -por I-TREATMENT -una I-TREATMENT -férula I-TREATMENT -diagnóstico-quirúrgica, I-TREATMENT -previamente I-TREATMENT -confeccionada I-TREATMENT -por I-TREATMENT -el I-TREATMENT -prostodoncista, I-TREATMENT -en I-TREATMENT -los I-TREATMENT -lugares I-TREATMENT -correspondientes I-TREATMENT -a I-TREATMENT -los I-TREATMENT -dientes I-TREATMENT -35, I-TREATMENT -36, I-TREATMENT -45, I-TREATMENT -46. I-TREATMENT - I-TREATMENT -Como I-TREATMENT -es I-TREATMENT -habitual I-TREATMENT -en I-TREATMENT -estos I-TREATMENT -tratamientos I-TREATMENT -quirúrgicos, I-TREATMENT -se I-TREATMENT -le I-TREATMENT -presentó I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente, I-TREATMENT -días I-TREATMENT -antes I-TREATMENT -de I-TREATMENT -la I-TREATMENT -cirugía, I-TREATMENT -junto I-TREATMENT -con I-TREATMENT -el I-TREATMENT -presupuesto I-TREATMENT -y I-TREATMENT -plan I-TREATMENT -de I-TREATMENT -tratamiento, I-TREATMENT -el I-TREATMENT -formulario I-TREATMENT -del I-TREATMENT -Colegio I-TREATMENT -de I-TREATMENT -Odontólogos I-TREATMENT -y I-TREATMENT -Estomatólogos I-TREATMENT -de I-TREATMENT -Aragón I-TREATMENT -para I-TREATMENT -informarle I-TREATMENT -de I-TREATMENT -los I-TREATMENT -posibles I-TREATMENT -riesgos I-TREATMENT -que I-TREATMENT -pudieran I-TREATMENT -surgir I-TREATMENT -a I-TREATMENT -consecuencia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -intervención. I-TREATMENT -Tras I-TREATMENT -meditada I-TREATMENT -lectura, I-TREATMENT +mostró I-EXPLORATION +arquitectura I-EXPLORATION +y I-EXPLORATION +celularidad I-EXPLORATION +normales. I-EXPLORATION + I-EXPLORATION +Con I-EXPLORATION +todos I-EXPLORATION +estos I-EXPLORATION +elementos I-EXPLORATION +se I-EXPLORATION +diagnosticó I-EXPLORATION +un I-EXPLORATION +LACGPC. I-EXPLORATION +Se B-TREATMENT +planteó I-TREATMENT +realizar I-TREATMENT +radioterapia I-TREATMENT +(RT) I-TREATMENT +local, I-TREATMENT +pero I-TREATMENT +cuando I-TREATMENT la I-TREATMENT paciente I-TREATMENT -procedió I-TREATMENT +volvió I-TREATMENT a I-TREATMENT -firmar I-TREATMENT -el I-TREATMENT -preceptivo I-TREATMENT -consentimiento I-TREATMENT -informado. I-TREATMENT -Por I-TREATMENT -otra I-TREATMENT -parte, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -siguió I-TREATMENT -llevando I-TREATMENT -la I-TREATMENT -férula I-TREATMENT +consultar I-TREATMENT +al I-TREATMENT +mes, I-TREATMENT +presentaba I-TREATMENT +clara I-TREATMENT +disminución I-TREATMENT de I-TREATMENT -relajación I-TREATMENT -durante I-TREATMENT -el I-TREATMENT -periodo I-TREATMENT +tamaño I-TREATMENT de I-TREATMENT la I-TREATMENT -integración, I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -la I-TREATMENT -comodidad I-TREATMENT -que I-TREATMENT -le I-TREATMENT -proporcionaba. I-TREATMENT - I-TREATMENT -En I-TREATMENT -la I-TREATMENT -cuarta I-TREATMENT -fase, I-TREATMENT -el I-TREATMENT -prostodoncista I-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -prótesis I-TREATMENT -implanto-soportada I-TREATMENT -en I-TREATMENT -metal I-TREATMENT -cerámica I-TREATMENT -y I-TREATMENT -la I-TREATMENT -cementó I-TREATMENT -ya I-TREATMENT +lesión I-TREATMENT +del I-TREATMENT +muslo, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT que I-TREATMENT -el I-TREATMENT -generalista I-TREATMENT -en I-TREATMENT -aquel I-TREATMENT -momento I-TREATMENT no I-TREATMENT -colocaba I-TREATMENT -implantes I-TREATMENT -ni I-TREATMENT -hacía I-TREATMENT -prótesis I-TREATMENT -implanto-soportadas. I-TREATMENT -En I-TREATMENT -la I-TREATMENT -figura I-TREATMENT -11 I-TREATMENT -vemos I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -un I-TREATMENT -año I-TREATMENT -después I-TREATMENT -del I-TREATMENT -tratamiento I-TREATMENT -ortodóncico I-TREATMENT -con I-TREATMENT -la I-TREATMENT -boca I-TREATMENT -rehabilitada. I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -tercer I-EVOLUTION -control I-EVOLUTION -radiológico I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -colocación I-EVOLUTION +se I-TREATMENT +inició I-TREATMENT +tratamiento. I-TREATMENT +Se B-EVOLUTION +controló I-EVOLUTION +cada I-EVOLUTION +4 I-EVOLUTION +meses I-EVOLUTION +y I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +24 I-EVOLUTION +meses I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -fijaciones I-EVOLUTION +seguimiento I-EVOLUTION se I-EVOLUTION -apreció I-EVOLUTION -pérdida I-EVOLUTION -de I-EVOLUTION -hueso I-EVOLUTION -en I-EVOLUTION -varias I-EVOLUTION -espiras I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -fijaciones I-EVOLUTION -correspondientes I-EVOLUTION -al I-EVOLUTION -35' I-EVOLUTION -y I-EVOLUTION -45'. I-EVOLUTION -Se B-TREATMENT -decidió I-TREATMENT -mantener I-TREATMENT -esa I-TREATMENT -mucosa I-TREATMENT -bajo I-TREATMENT -un I-TREATMENT -régimen I-TREATMENT -de I-TREATMENT -higiene I-TREATMENT -oral I-TREATMENT -muy I-TREATMENT -estricto, I-TREATMENT -efectuando I-TREATMENT -controles I-TREATMENT -quincenales I-TREATMENT -de I-TREATMENT -placa, I-TREATMENT -pulido I-TREATMENT -de I-TREATMENT -la I-TREATMENT -superficie I-TREATMENT -de I-TREATMENT -piezas I-TREATMENT -e I-TREATMENT -implantes I-TREATMENT -con I-TREATMENT -taza I-TREATMENT -de I-TREATMENT -goma I-TREATMENT -y I-TREATMENT -enjuagues I-TREATMENT -con I-TREATMENT -clorhexidina I-TREATMENT -al I-TREATMENT -0, I-TREATMENT -20% I-TREATMENT -cada I-TREATMENT -doce I-TREATMENT -horas, I-TREATMENT -hasta I-TREATMENT -conseguir I-TREATMENT -que I-TREATMENT -los I-TREATMENT -tejidos I-TREATMENT -periimplantarios I-TREATMENT -no I-TREATMENT -presentaran I-TREATMENT -hemorragia I-TREATMENT -al I-TREATMENT -sondaje. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -paciente I-EVOLUTION -continua I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION +encontraba I-EVOLUTION en I-EVOLUTION -tratamiento I-EVOLUTION -de I-EVOLUTION -mantenimiento I-EVOLUTION -periodontal, I-EVOLUTION -con I-EVOLUTION -revisiones I-EVOLUTION -trimestrales I-EVOLUTION -para I-EVOLUTION -comprobar I-EVOLUTION -la I-EVOLUTION -estabilidad I-EVOLUTION -de I-EVOLUTION -sus I-EVOLUTION -piezas, I-EVOLUTION -implantes I-EVOLUTION -y I-EVOLUTION -prótesis. I-EVOLUTION +regresión I-EVOLUTION +total. I-EVOLUTION I-EVOLUTION -Varón B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -66 I-PRESENT_ILLNESS +46 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -al B-PAST_MEDICAL_HISTORY -inicio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -DP I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -sustitutivo I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -IRCT I-PAST_MEDICAL_HISTORY +que B-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Cirugía I-DERIVED_FROM/TO +Oral I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +Maxilofacial I-DERIVED_FROM/TO +desde I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Oftalmología I-DERIVED_FROM/TO +para B-PRESENT_ILLNESS +valoración I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +exoftalmos I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presenta. I-PRESENT_ILLNESS +Como B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +destaca I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +obesidad I-PAST_MEDICAL_HISTORY +mórbida I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +alergia I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +yodo. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +1980 I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -larga I-PAST_MEDICAL_HISTORY -evolución, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -consecuencia I-PAST_MEDICAL_HISTORY +hipertiroidismo I-PAST_MEDICAL_HISTORY +originado I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +Enfermedad I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -severa I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -hiperuricemia. I-PAST_MEDICAL_HISTORY -Al I-PAST_MEDICAL_HISTORY -inicio I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY +Graves-Basedow, I-PAST_MEDICAL_HISTORY +siendo I-PAST_MEDICAL_HISTORY +operada I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +después, I-PAST_MEDICAL_HISTORY +realizándose I-PAST_MEDICAL_HISTORY +tiroidectomía I-PAST_MEDICAL_HISTORY +subtotal, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +pauta I-PAST_MEDICAL_HISTORY tratamiento I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -siguiente I-PAST_MEDICAL_HISTORY -perfil I-PAST_MEDICAL_HISTORY -respeto I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -situación I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +Levotiroxina I-PAST_MEDICAL_HISTORY +50 I-PAST_MEDICAL_HISTORY +mg/día. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +1999 I-PAST_MEDICAL_HISTORY +acude I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +Servicio I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -acidosis. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Dado I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY -general I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -bueno I-PAST_MEDICAL_HISTORY +Oftalmología I-PAST_MEDICAL_HISTORY +refiriendo I-PAST_MEDICAL_HISTORY +lento I-PAST_MEDICAL_HISTORY +pero I-PAST_MEDICAL_HISTORY +progresivo I-PAST_MEDICAL_HISTORY +empeoramiento I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +exoftalmos, I-PAST_MEDICAL_HISTORY +así I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +signos I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -mantenía I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -diuresis I-PAST_MEDICAL_HISTORY -residual I-PAST_MEDICAL_HISTORY +síntomas I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -(2000 I-PAST_MEDICAL_HISTORY -ml/d, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -decidió I-PAST_MEDICAL_HISTORY -iniciar I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY +queratitis. I-PAST_MEDICAL_HISTORY +Tras I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY tratamiento I-PAST_MEDICAL_HISTORY -depurador I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -intercambios I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -día I-PAST_MEDICAL_HISTORY +megadosis I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -2l, I-PAST_MEDICAL_HISTORY -(4 I-PAST_MEDICAL_HISTORY -l I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -1’26% I-PAST_MEDICAL_HISTORY -+ I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -l I-PAST_MEDICAL_HISTORY +esteroides I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +desestimar I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +radioterapia, I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +intervenida I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +dicho I-PAST_MEDICAL_HISTORY +Servicio I-PAST_MEDICAL_HISTORY +realizándose I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +descompresión I-PAST_MEDICAL_HISTORY +quirúrgica I-PAST_MEDICAL_HISTORY +(pared I-PAST_MEDICAL_HISTORY +medial I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +suelo) I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +ojo I-PAST_MEDICAL_HISTORY +izquierdo I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +abordaje I-PAST_MEDICAL_HISTORY +subciliar. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +Marzo I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Icodextrina I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -recambio I-PAST_MEDICAL_HISTORY -nocturno). I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +2002 I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +realiza I-PAST_MEDICAL_HISTORY +tiroidectomía I-PAST_MEDICAL_HISTORY +total. I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +Junio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -iniciada I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -DP I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -incluido I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -estudio I-PRESENT_ILLNESS -multicéntrico I-PRESENT_ILLNESS +2003 I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nuestra I-PRESENT_ILLNESS +Consulta, I-PRESENT_ILLNESS +presentando I-PRESENT_ILLNESS +retracción I-PRESENT_ILLNESS +palpebral I-PRESENT_ILLNESS +severa, I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +acentuada I-PRESENT_ILLNESS en I-PRESENT_ILLNESS el I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -evaluaba I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -líquido I-PRESENT_ILLNESS +tercio I-PRESENT_ILLNESS +externo I-PRESENT_ILLNESS +o I-PRESENT_ILLNESS +temporal I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +párpado I-PRESENT_ILLNESS +superior; I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +zona I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +limbo I-PRESENT_ILLNESS +corneal I-PRESENT_ILLNESS +superior I-PRESENT_ILLNESS +queda I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +descubierto, I-PRESENT_ILLNESS +dejando I-PRESENT_ILLNESS +porción I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -diálisis I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -bicarbonato, I-PRESENT_ILLNESS -Physioneal®. I-PRESENT_ILLNESS -Las B-EXPLORATION -características I-EXPLORATION -dialíticas I-EXPLORATION -del I-EXPLORATION -paciente I-EXPLORATION -al I-EXPLORATION -inicio I-EXPLORATION +esclera I-PRESENT_ILLNESS +expuesta. I-PRESENT_ILLNESS +Se B-EXPLORATION +objetiva I-EXPLORATION +hipertrofia I-EXPLORATION de I-EXPLORATION -este I-EXPLORATION -estudio I-EXPLORATION -se I-EXPLORATION -reflejan I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -tabla I-EXPLORATION -2. I-EXPLORATION - I-EXPLORATION -Al I-EXPLORATION -poco I-EXPLORATION -tiempo I-EXPLORATION +grasa I-EXPLORATION +suborbicular I-EXPLORATION de I-EXPLORATION -utilizar I-EXPLORATION -esta I-EXPLORATION -solución I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +subciliar I-EXPLORATION +del I-EXPLORATION +párpado I-EXPLORATION +inferior. I-EXPLORATION + I-EXPLORATION +Es I-EXPLORATION +evidente I-EXPLORATION el I-EXPLORATION +exoftalmos, I-EXPLORATION +que I-EXPLORATION +es I-EXPLORATION +bilateral. I-EXPLORATION +La I-EXPLORATION paciente I-EXPLORATION -refiere I-EXPLORATION -algunas I-EXPLORATION -molestias I-EXPLORATION -como: I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Aumento I-EXPLORATION +se I-EXPLORATION +queja I-EXPLORATION de I-EXPLORATION +incapacidad I-EXPLORATION +para I-EXPLORATION +mantener I-EXPLORATION la I-EXPLORATION -sensación I-EXPLORATION -de I-EXPLORATION -sed I-EXPLORATION -y I-EXPLORATION -discreta I-EXPLORATION -distensión I-EXPLORATION -abdominal I-EXPLORATION -los I-EXPLORATION -primeros I-EXPLORATION -días. I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Manifiesta I-EXPLORATION -que I-EXPLORATION -ocasionalmente I-EXPLORATION +lectura I-EXPLORATION +durante I-EXPLORATION +un I-EXPLORATION +tiempo I-EXPLORATION +prolongado, I-EXPLORATION +con I-EXPLORATION +fatiga I-EXPLORATION y I-EXPLORATION -al I-EXPLORATION -finalizar I-EXPLORATION -los I-EXPLORATION -drenajes I-EXPLORATION -siente I-EXPLORATION -dolor, I-EXPLORATION -que I-EXPLORATION -atribuye I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -posición I-EXPLORATION -del I-EXPLORATION -catéter. I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Aparición I-EXPLORATION +disconfort, I-EXPLORATION +síntomas I-EXPLORATION de I-EXPLORATION -coágulos I-EXPLORATION +restricción I-EXPLORATION de I-EXPLORATION -fibrina I-EXPLORATION +la I-EXPLORATION +motilidad I-EXPLORATION +ocular. I-EXPLORATION +La I-EXPLORATION +enfermedad I-EXPLORATION +se I-EXPLORATION +encuentra I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -líquido I-EXPLORATION -drenado. I-EXPLORATION +fase I-EXPLORATION +no I-EXPLORATION +inflamatoria, I-EXPLORATION +no I-EXPLORATION +presentando I-EXPLORATION +queratitis I-EXPLORATION +severa, I-EXPLORATION +hiperemia, I-EXPLORATION +quemosis I-EXPLORATION +conjuntival, I-EXPLORATION +ni I-EXPLORATION +diplopia. I-EXPLORATION I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -da I-EXPLORATION -importancia I-EXPLORATION -a I-EXPLORATION -estas I-EXPLORATION -manifestaciones I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -atribuyen, I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -parte I-EXPLORATION -al I-EXPLORATION -incumplimiento I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -dieta I-EXPLORATION -por I-EXPLORATION -parte I-EXPLORATION +El I-EXPLORATION +TAC I-EXPLORATION +orbitario I-EXPLORATION +muestra I-EXPLORATION +exoftalmos, I-EXPLORATION +engrosamiento I-EXPLORATION +muscular, I-EXPLORATION +aumento I-EXPLORATION del I-EXPLORATION -paciente, I-EXPLORATION -ya I-EXPLORATION -que I-EXPLORATION -tenía I-EXPLORATION -un I-EXPLORATION -sodio I-EXPLORATION -alto I-EXPLORATION -(141mEq/L), I-EXPLORATION +volumen I-EXPLORATION +graso I-EXPLORATION +orbitario I-EXPLORATION y I-EXPLORATION -por I-EXPLORATION -otra, I-EXPLORATION +rectificación I-EXPLORATION +del I-EXPLORATION +nervio I-EXPLORATION +óptico. I-EXPLORATION +Tiene I-EXPLORATION +la I-EXPLORATION +ventaja I-EXPLORATION +respecto I-EXPLORATION a I-EXPLORATION la I-EXPLORATION -incomodidad I-EXPLORATION +RM I-EXPLORATION +de I-EXPLORATION que I-EXPLORATION -ocasionalmente I-EXPLORATION -provoca I-EXPLORATION +muestra I-EXPLORATION el I-EXPLORATION -líquido I-EXPLORATION -IP I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION +detalle I-EXPLORATION +óseo, I-EXPLORATION +que I-EXPLORATION +tiene I-EXPLORATION +un I-EXPLORATION +gran I-EXPLORATION +valor I-EXPLORATION +para I-EXPLORATION la I-EXPLORATION -adaptación I-EXPLORATION -al I-EXPLORATION -tratamiento. I-EXPLORATION -Para B-TREATMENT -evitar I-TREATMENT +planificación I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +procedimientos I-EXPLORATION +quirúrgicos I-EXPLORATION +de I-EXPLORATION +descompresión. I-EXPLORATION +La I-EXPLORATION +RM I-EXPLORATION +muestra I-EXPLORATION +exoftalmos, I-EXPLORATION +con I-EXPLORATION +engrosamiento I-EXPLORATION +muscular I-EXPLORATION +severo I-EXPLORATION +con I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +porción I-EXPLORATION +ventral I-EXPLORATION +y I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +graso. I-EXPLORATION + I-EXPLORATION +Con B-TREATMENT +los I-TREATMENT +antecedentes I-TREATMENT +descritos, I-TREATMENT la I-TREATMENT -formación I-TREATMENT -de I-TREATMENT -coágulos I-TREATMENT -se I-TREATMENT -administraron I-TREATMENT -15 I-TREATMENT -mg I-TREATMENT -de I-TREATMENT -heparina I-TREATMENT -sódica I-TREATMENT -en I-TREATMENT -el I-TREATMENT -líquido I-TREATMENT -de I-TREATMENT -diálisis. I-TREATMENT -Esta B-EVOLUTION -sintomatología I-EVOLUTION -remitió I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -era I-EVOLUTION -satisfactorio. I-EVOLUTION -El I-EVOLUTION -estudio I-EVOLUTION -tuvo I-EVOLUTION -una I-EVOLUTION -duración I-EVOLUTION -de I-EVOLUTION -tres I-EVOLUTION -meses; I-EVOLUTION -al I-EVOLUTION -final I-EVOLUTION -del I-EVOLUTION -mismo I-EVOLUTION -los I-EVOLUTION -valores I-EVOLUTION -analíticos I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -y I-EVOLUTION -características I-EVOLUTION -dialíticas I-EVOLUTION -se I-EVOLUTION -reflejan I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -tabla I-EVOLUTION -3. I-EVOLUTION - I-EVOLUTION -Se B-TREATMENT -reinicia I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -habitual I-TREATMENT -con I-TREATMENT -4 I-TREATMENT -l I-TREATMENT -de I-TREATMENT -con I-TREATMENT -glucosa I-TREATMENT -al I-TREATMENT -1’5%, I-TREATMENT -Ca I-TREATMENT -normal I-TREATMENT +clínica I-TREATMENT y I-TREATMENT -2 I-TREATMENT -l I-TREATMENT +las I-TREATMENT +pruebas I-TREATMENT de I-TREATMENT -solución I-TREATMENT -con I-TREATMENT -Icodextrina I-TREATMENT -para I-TREATMENT -el I-TREATMENT -recambio I-TREATMENT -nocturno. I-TREATMENT -Tras B-EVOLUTION -estos I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -solución I-EVOLUTION -de I-EVOLUTION -bicarbonato, I-EVOLUTION -la I-EVOLUTION -situación I-EVOLUTION -clínica I-EVOLUTION -del I-EVOLUTION -paciente I-EVOLUTION -era I-EVOLUTION -buena I-EVOLUTION -(aunque I-EVOLUTION -había I-EVOLUTION -manifestado I-EVOLUTION -alguna I-EVOLUTION -molestia) I-EVOLUTION -y I-EVOLUTION -los I-EVOLUTION -valores I-EVOLUTION -analíticos I-EVOLUTION -aceptables, I-EVOLUTION -pero I-EVOLUTION -se I-EVOLUTION -hade I-EVOLUTION -destacar I-EVOLUTION -que I-EVOLUTION -en I-EVOLUTION -un I-EVOLUTION -periodo I-EVOLUTION -corto I-EVOLUTION -de I-EVOLUTION -tiempo, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -había I-EVOLUTION -pasado I-EVOLUTION -de I-EVOLUTION -ser I-EVOLUTION -"Medio I-EVOLUTION -alto I-EVOLUTION -transportador" I-EVOLUTION -a I-EVOLUTION -"Alto I-EVOLUTION -transportador", I-EVOLUTION -disminuyendo I-EVOLUTION -los I-EVOLUTION -valores I-EVOLUTION -de I-EVOLUTION -Kt/V. I-EVOLUTION - I-EVOLUTION -Cinco B-TREATMENT -meses I-TREATMENT -más I-TREATMENT -tarde, I-TREATMENT +imagen I-TREATMENT se I-TREATMENT decide I-TREATMENT -reiniciar I-TREATMENT el I-TREATMENT tratamiento I-TREATMENT -con I-TREATMENT -bicarbonato. I-TREATMENT -El I-TREATMENT -paciente I-TREATMENT -desea I-TREATMENT -volver I-TREATMENT -a I-TREATMENT -utilizar I-TREATMENT +quirúrgico I-TREATMENT +mediante I-TREATMENT la I-TREATMENT -nueva I-TREATMENT -solución I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -le I-TREATMENT -parecía I-TREATMENT -que I-TREATMENT -con I-TREATMENT -ella"se I-TREATMENT -encontraba I-TREATMENT -mejor" I-TREATMENT -(menos I-TREATMENT -astenia I-TREATMENT -y I-TREATMENT -mejor I-TREATMENT -estado I-TREATMENT -de I-TREATMENT -ánimo). I-TREATMENT -Aunque I-TREATMENT -el I-TREATMENT -Kt/V I-TREATMENT -era I-TREATMENT -ligeramente I-TREATMENT -inferior I-TREATMENT -a I-TREATMENT -los I-TREATMENT -valores I-TREATMENT -recomendados, I-TREATMENT -al I-TREATMENT -mantener I-TREATMENT -diuresis, I-TREATMENT -buen I-TREATMENT -aclaramiento I-TREATMENT +remoción I-TREATMENT +parcial I-TREATMENT de I-TREATMENT -creatinina I-TREATMENT -y I-TREATMENT -buen I-TREATMENT -estado I-TREATMENT -general, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -no I-TREATMENT -aumentar I-TREATMENT la I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -diálisis. I-TREATMENT -No I-TREATMENT -se I-TREATMENT -considero I-TREATMENT -importante I-TREATMENT -el I-TREATMENT -que I-TREATMENT -hubieran I-TREATMENT -aumentado I-TREATMENT -ligeramente I-TREATMENT -los I-TREATMENT -valores I-TREATMENT -del I-TREATMENT -HCO3. I-TREATMENT - I-TREATMENT -En B-EVOLUTION -el I-EVOLUTION -control I-EVOLUTION -realizado I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -tres I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -reiniciar I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -solución I-EVOLUTION -de I-EVOLUTION -bicarbonato I-EVOLUTION -se I-EVOLUTION -obtuvieron I-EVOLUTION -los I-EVOLUTION -resultados I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -observan I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -tabla I-EVOLUTION -5. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -presentaba I-EVOLUTION -muy I-EVOLUTION -buen I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -incluso I-EVOLUTION -deseaba I-EVOLUTION -irse I-EVOLUTION -de I-EVOLUTION -vacaciones I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -decidió I-EVOLUTION -continuar I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -misma I-EVOLUTION -pauta I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION - I-EVOLUTION -Tres I-EVOLUTION -meses I-EVOLUTION -después, I-EVOLUTION -y I-EVOLUTION -coincidiendo I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -siguiente I-EVOLUTION -control, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -continúa I-EVOLUTION -sintiéndose I-EVOLUTION -bien I-EVOLUTION -y I-EVOLUTION -ha I-EVOLUTION -decidido I-EVOLUTION -irse I-EVOLUTION -de I-EVOLUTION -vacaciones. I-EVOLUTION -No I-EVOLUTION -obstante, I-EVOLUTION -su I-EVOLUTION -diuresis I-EVOLUTION -y I-EVOLUTION -Kt/V I-EVOLUTION -han I-EVOLUTION -disminuido I-EVOLUTION -y I-EVOLUTION -está I-EVOLUTION -hipertenso. I-EVOLUTION -Se B-TREATMENT -le I-TREATMENT -prescribe I-TREATMENT -mayor I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -hipotensores I-TREATMENT +pared I-TREATMENT +lateral I-TREATMENT y I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -aumentar I-TREATMENT -el I-TREATMENT -flujo I-TREATMENT -peritoneal I-TREATMENT +del I-TREATMENT +suelo I-TREATMENT +orbitario, I-TREATMENT +junto I-TREATMENT a I-TREATMENT -cuatro I-TREATMENT -recambios I-TREATMENT -/día: I-TREATMENT -6 I-TREATMENT -l I-TREATMENT -al I-TREATMENT -1.36% I-TREATMENT +lipectomía I-TREATMENT y I-TREATMENT -Icodextrina I-TREATMENT +osteotomía I-TREATMENT +con I-TREATMENT +avance I-TREATMENT +del I-TREATMENT +marco I-TREATMENT +orbitario I-TREATMENT +superior, I-TREATMENT +lateral I-TREATMENT +e I-TREATMENT +inferior. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +abordaje I-TREATMENT +bicoronal, I-TREATMENT +con I-TREATMENT +un I-TREATMENT +colgajo I-TREATMENT +subgaleal I-TREATMENT +hasta I-TREATMENT +aproximadamente I-TREATMENT 2 I-TREATMENT -l, I-TREATMENT -en I-TREATMENT -el I-TREATMENT -recambio I-TREATMENT -nocturno. I-TREATMENT - I-TREATMENT -Un B-EVOLUTION -mes I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -acude I-EVOLUTION -al I-EVOLUTION -hospital I-EVOLUTION -con I-EVOLUTION -carácter I-EVOLUTION -urgente, I-EVOLUTION -por I-EVOLUTION -presentar I-EVOLUTION -un I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -líquido I-EVOLUTION -turbio I-EVOLUTION -con I-EVOLUTION -cultivo I-EVOLUTION -negativo I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -abdominal, I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -cree I-EVOLUTION -es I-EVOLUTION -consecuencia I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -irritación I-EVOLUTION -peritoneal I-EVOLUTION -producida I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -excesiva I-EVOLUTION -UF I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -Icodextrina, I-EVOLUTION -ya I-EVOLUTION -que I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -infusión I-EVOLUTION -de I-EVOLUTION -2 I-EVOLUTION -l I-EVOLUTION -drena I-EVOLUTION -(3'8 I-EVOLUTION -l. I-EVOLUTION -Se B-TREATMENT -le I-TREATMENT -administran I-TREATMENT -antibióticos I-TREATMENT -y I-TREATMENT +cm. I-TREATMENT +del I-TREATMENT +reborde I-TREATMENT +supraorbitario, I-TREATMENT +donde I-TREATMENT se I-TREATMENT -reduce I-TREATMENT -el I-TREATMENT -volumen I-TREATMENT -de I-TREATMENT -la I-TREATMENT -infusión I-TREATMENT -de I-TREATMENT -Icodextrina I-TREATMENT -a I-TREATMENT -1’5 I-TREATMENT -l. I-TREATMENT -El B-EVOLUTION -cuadro I-EVOLUTION -se I-EVOLUTION -soluciona I-EVOLUTION -favorablemente. I-EVOLUTION - I-EVOLUTION -Quince I-EVOLUTION -días I-EVOLUTION -más I-EVOLUTION -tarde, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -acude I-EVOLUTION -al I-EVOLUTION -hospital I-EVOLUTION -presentando I-EVOLUTION -una I-EVOLUTION -alteración I-EVOLUTION -importante I-EVOLUTION -del I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION -sin I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -infección, I-EVOLUTION -destacando: B-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Descenso I-EXPLORATION -brusco I-EXPLORATION -del I-EXPLORATION -Hto I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Hipertensión I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Hiperhidratación I-EXPLORATION -(aumento I-EXPLORATION -de I-EXPLORATION -peso I-EXPLORATION -con I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -edemas I-EXPLORATION -maleolares) I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Disnea I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Desorientación I-EXPLORATION -importante I-EXPLORATION -en I-EXPLORATION -espacio-tiempo I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Elevación I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -diafragmas I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -RX I-EXPLORATION -tórax, I-EXPLORATION -con I-EXPLORATION -reducción I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -campos I-EXPLORATION -pulmonares I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION -analíticos I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -reflejan I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tabla I-EXPLORATION -6 I-EXPLORATION -demuestran I-EXPLORATION -una I-EXPLORATION -ALCALOSIS I-EXPLORATION -METABÓLICA. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -esta I-TREATMENT -situación, I-TREATMENT +realiza I-TREATMENT +una I-TREATMENT +incisión I-TREATMENT +del I-TREATMENT +periostio I-TREATMENT +y I-TREATMENT se I-TREATMENT -suspende I-TREATMENT +continúa I-TREATMENT +hasta I-TREATMENT la I-TREATMENT -infusión I-TREATMENT +órbita I-TREATMENT +por I-TREATMENT +el I-TREATMENT +plano I-TREATMENT +subperióstico. I-TREATMENT +La I-TREATMENT +porción I-TREATMENT +anterior I-TREATMENT del I-TREATMENT -líquido I-TREATMENT +músculo I-TREATMENT +temporal I-TREATMENT +fue I-TREATMENT +liberada I-TREATMENT +de I-TREATMENT +su I-TREATMENT +inserción I-TREATMENT +para I-TREATMENT +permitir I-TREATMENT +un I-TREATMENT +mejor I-TREATMENT +acceso I-TREATMENT +a I-TREATMENT +la I-TREATMENT +pared I-TREATMENT +lateral I-TREATMENT +orbitaria. I-TREATMENT +El I-TREATMENT +abordaje I-TREATMENT +se I-TREATMENT +completó I-TREATMENT con I-TREATMENT -bicarbonato I-TREATMENT +una I-TREATMENT +incisión I-TREATMENT +subciliar I-TREATMENT +bilateral I-TREATMENT +que I-TREATMENT +permitió I-TREATMENT +el I-TREATMENT +acceso I-TREATMENT +al I-TREATMENT +reborde I-TREATMENT +infraorbitario I-TREATMENT y I-TREATMENT +a I-TREATMENT +la I-TREATMENT +región I-TREATMENT +medial I-TREATMENT +del I-TREATMENT +suelo I-TREATMENT +orbitario. I-TREATMENT + I-TREATMENT +Realizamos I-TREATMENT +una I-TREATMENT +osteotomía I-TREATMENT +bilateral I-TREATMENT +-orbitotomía- I-TREATMENT +del I-TREATMENT +marco I-TREATMENT +orbitario I-TREATMENT +superior, I-TREATMENT +lateral I-TREATMENT +e I-TREATMENT +inferior; I-TREATMENT +que I-TREATMENT se I-TREATMENT -inicia I-TREATMENT +avanza I-TREATMENT +8 I-TREATMENT +mm I-TREATMENT +respecto I-TREATMENT +a I-TREATMENT +su I-TREATMENT +posición I-TREATMENT +de I-TREATMENT +origen. I-TREATMENT +Se I-TREATMENT +realiza I-TREATMENT la I-TREATMENT -DP I-TREATMENT -con I-TREATMENT -líquido I-TREATMENT +osteosíntesis I-TREATMENT con I-TREATMENT -lactato I-TREATMENT -PD1, I-TREATMENT -aumentando I-TREATMENT +miniplacas I-TREATMENT +2, I-TREATMENT +0. I-TREATMENT +Se I-TREATMENT +procede I-TREATMENT +a I-TREATMENT la I-TREATMENT -frecuencia I-TREATMENT +eliminación I-TREATMENT de I-TREATMENT -los I-TREATMENT -recambios I-TREATMENT -a10 I-TREATMENT -l/día. I-TREATMENT -Para I-TREATMENT -optimizar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -utiliza I-TREATMENT -runa I-TREATMENT -cicladora, I-TREATMENT -para I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -instruye I-TREATMENT -a I-TREATMENT la I-TREATMENT -esposa I-TREATMENT +pared I-TREATMENT +lateral I-TREATMENT +orbitaria I-TREATMENT +y I-TREATMENT del I-TREATMENT -paciente I-TREATMENT -ya I-TREATMENT -que I-TREATMENT +suelo I-TREATMENT +en I-TREATMENT +su I-TREATMENT +porción I-TREATMENT +medial I-TREATMENT +y I-TREATMENT +lateral, I-TREATMENT +respetando I-TREATMENT el I-TREATMENT -estado I-TREATMENT +trayecto I-TREATMENT +del I-TREATMENT +nervio I-TREATMENT +infraorbitario. I-TREATMENT +Se I-TREATMENT +realizan I-TREATMENT +incisiones I-TREATMENT +en I-TREATMENT +la I-TREATMENT +periórbita I-TREATMENT +y I-TREATMENT +lipectomía I-TREATMENT +tras I-TREATMENT +la I-TREATMENT +liberación I-TREATMENT de I-TREATMENT -conciencia I-TREATMENT +la I-TREATMENT +grasa I-TREATMENT +periorbitaria. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +colocó I-TREATMENT +un I-TREATMENT +drenaje I-TREATMENT +aspirativo I-TREATMENT +subgaleal I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +retirado I-TREATMENT +a I-TREATMENT +las I-TREATMENT +48 I-TREATMENT +horas. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +mantuvo I-TREATMENT +una I-TREATMENT +tarsorrafia I-TREATMENT +temporal I-TREATMENT +(punto I-TREATMENT de I-TREATMENT -éste I-TREATMENT -no I-TREATMENT -permite I-TREATMENT -entrenarlo. I-TREATMENT +Frost) I-TREATMENT +las I-TREATMENT +primeras I-TREATMENT +48 I-TREATMENT +horas. I-TREATMENT A B-EVOLUTION +las I-EVOLUTION +72 I-EVOLUTION +horas I-EVOLUTION la I-EVOLUTION -semana I-EVOLUTION -de I-EVOLUTION -iniciar I-EVOLUTION -del I-EVOLUTION -nuevo I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -cicladora I-EVOLUTION -hospitalaria, I-EVOLUTION -el I-EVOLUTION -estado I-EVOLUTION -del I-EVOLUTION paciente I-EVOLUTION -ha I-EVOLUTION -mejorado, I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION -la I-EVOLUTION -situación I-EVOLUTION -de I-EVOLUTION -acidosis. I-EVOLUTION -Es I-EVOLUTION -capaz, I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -apoyo I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -esposa, I-EVOLUTION -de I-EVOLUTION -iniciar I-EVOLUTION -la I-EVOLUTION -diálisis I-EVOLUTION -peritoneal I-EVOLUTION -automatizada I-EVOLUTION -(DPA) I-EVOLUTION +presentó I-EVOLUTION +un I-EVOLUTION +dolor I-EVOLUTION +intenso I-EVOLUTION en I-EVOLUTION -su I-EVOLUTION -casa. I-EVOLUTION - I-EVOLUTION -Al I-EVOLUTION -mes I-EVOLUTION +región I-EVOLUTION +posterior I-EVOLUTION de I-EVOLUTION -iniciada I-EVOLUTION la I-EVOLUTION -diálisis I-EVOLUTION -peritoneal I-EVOLUTION +pierna I-EVOLUTION +izquierda, I-EVOLUTION +que I-EVOLUTION +fue I-EVOLUTION +diagnosticado I-EVOLUTION +como I-EVOLUTION +trombosis I-EVOLUTION +del I-EVOLUTION +lago I-EVOLUTION +gemelar I-EVOLUTION +y I-EVOLUTION +tratada I-EVOLUTION con I-EVOLUTION -cicladora I-EVOLUTION +heparina. I-EVOLUTION +La I-EVOLUTION +sutura I-EVOLUTION +subciliar I-EVOLUTION se I-EVOLUTION -normalizaron I-EVOLUTION +retiró I-EVOLUTION +a I-EVOLUTION los I-EVOLUTION -valores I-EVOLUTION -analíticos I-EVOLUTION +5 I-EVOLUTION +días I-EVOLUTION y I-EVOLUTION -las I-EVOLUTION -cifras I-EVOLUTION -de I-EVOLUTION -tensión I-EVOLUTION -arterial, I-EVOLUTION -siendo I-EVOLUTION -su I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION -bueno. I-EVOLUTION -Los I-EVOLUTION -parámetros I-EVOLUTION -más I-EVOLUTION -destacables I-EVOLUTION -se I-EVOLUTION -reflejan I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -tabla I-EVOLUTION -8. I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION la I-EVOLUTION -actualidad I-EVOLUTION -(30 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -inicio I-EVOLUTION -de I-EVOLUTION -DP), I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -ninguna I-EVOLUTION -complicación, I-EVOLUTION -ningún I-EVOLUTION -nuevo I-EVOLUTION -episodio I-EVOLUTION -de I-EVOLUTION -líquido I-EVOLUTION -turbio I-EVOLUTION -y I-EVOLUTION -su I-EVOLUTION -estado I-EVOLUTION -general I-EVOLUTION -es I-EVOLUTION -correcto, I-EVOLUTION -con I-EVOLUTION -tendencia I-EVOLUTION -al I-EVOLUTION -aumento I-EVOLUTION -de I-EVOLUTION -peso I-EVOLUTION -sin I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -edemas. I-EVOLUTION +coronal I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +10 I-EVOLUTION +días. I-EVOLUTION I-EVOLUTION -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +género I-PRESENT_ILLNESS +masculino, I-PRESENT_ILLNESS +32 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -obesidad, I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -controlada I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -dieta I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -tabaquismo, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -diagnosticado I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -insuficiencia I-PRESENT_ILLNESS -renal I-PRESENT_ILLNESS -secundaria I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -glomerulonefritis I-PRESENT_ILLNESS -rápidamente I-PRESENT_ILLNESS -progresiva, I-PRESENT_ILLNESS +Estomatología I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +Facultad I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Odontología I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Bauru I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +Universidad I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +São I-PRESENT_ILLNESS +Paulo, I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -anticuerpos I-PRESENT_ILLNESS -antimembrana I-PRESENT_ILLNESS -basal I-PRESENT_ILLNESS -glomerular. I-PRESENT_ILLNESS -Por B-TREATMENT -este I-TREATMENT -motivo, I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -inmunosupresor I-TREATMENT -con I-TREATMENT -esteroides, I-TREATMENT -ciclofosfamida I-TREATMENT -y I-TREATMENT -también I-TREATMENT -plasmaféresis, I-TREATMENT -todo I-TREATMENT -ello, I-TREATMENT -sin I-TREATMENT -resultado I-TREATMENT -satisfactorio I-TREATMENT -para I-TREATMENT -su I-TREATMENT -función I-TREATMENT -renal. I-TREATMENT - I-TREATMENT -Inicialmente I-TREATMENT -recibió I-TREATMENT -tratamiento I-TREATMENT -renal I-TREATMENT -sustitutivo I-TREATMENT -mediante I-TREATMENT -HD I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -pasó I-TREATMENT -a I-TREATMENT -DP. I-TREATMENT -Durante B-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -años I-EVOLUTION -en I-EVOLUTION -esta I-EVOLUTION -técnica, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -desarrolló I-EVOLUTION -10 I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -peritonitis, I-EVOLUTION -9 I-EVOLUTION -de I-EVOLUTION -ellos I-EVOLUTION -por I-EVOLUTION -Staphilococcus I-EVOLUTION -(8 I-EVOLUTION -epidermidis I-EVOLUTION -y I-EVOLUTION -1 I-EVOLUTION -capitis). I-EVOLUTION -El I-EVOLUTION -último I-EVOLUTION -de I-EVOLUTION -ellos I-EVOLUTION -por I-EVOLUTION -Candida I-EVOLUTION -albicans, I-EVOLUTION -que I-EVOLUTION -motivó I-EVOLUTION -la I-EVOLUTION -retirada I-EVOLUTION -del I-EVOLUTION -catéter I-EVOLUTION -de I-EVOLUTION -DP I-EVOLUTION -y I-EVOLUTION -su I-EVOLUTION -transferencia I-EVOLUTION -a I-EVOLUTION -HD. I-EVOLUTION -Durante I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -DP I-EVOLUTION -se I-EVOLUTION -transformó I-EVOLUTION -en I-EVOLUTION -un I-EVOLUTION -"alto I-EVOLUTION -transportador". I-EVOLUTION - I-EVOLUTION -Seis I-EVOLUTION -meses I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -cambio I-EVOLUTION -de I-EVOLUTION -modalidad I-EVOLUTION -terapéutica, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -sufre I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -con I-EVOLUTION -vómitos, I-EVOLUTION -pérdida I-EVOLUTION -de I-EVOLUTION -peso, I-EVOLUTION -distensión I-EVOLUTION -abdominal I-EVOLUTION -y I-EVOLUTION -efecto I-EVOLUTION -masa I-EVOLUTION -en I-EVOLUTION -hipogastrio. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -ecografía I-EXPLORATION -abdominal, I-EXPLORATION -apreciándose I-EXPLORATION -marcada I-EXPLORATION -dilatación I-EXPLORATION +queja I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +"diente I-PRESENT_ILLNESS +dentro I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +hueso" I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +realizarse I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +examen I-PRESENT_ILLNESS +radiográfico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +rutina. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Clínicamente, B-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +diente I-EXPLORATION +83 I-EXPLORATION +estaba I-EXPLORATION +presente I-EXPLORATION +dentro I-EXPLORATION del I-EXPLORATION -estómago I-EXPLORATION +arco I-EXPLORATION +dentario I-EXPLORATION y I-EXPLORATION -asa I-EXPLORATION -proximal I-EXPLORATION -del I-EXPLORATION -intestino I-EXPLORATION -delgado, I-EXPLORATION -que I-EXPLORATION -presenta I-EXPLORATION -pared I-EXPLORATION -moderadamente I-EXPLORATION -engrosada; I-EXPLORATION -colección I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -septos I-EXPLORATION -en I-EXPLORATION -hipogastrio. I-EXPLORATION - I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -axial I-EXPLORATION -computorizada I-EXPLORATION -(TAC) I-EXPLORATION -abdominal, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -constató I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -pequeña I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -perihepático I-EXPLORATION -además I-EXPLORATION +el I-EXPLORATION +elemento I-EXPLORATION +dentario I-EXPLORATION +43 I-EXPLORATION +estaba I-EXPLORATION +ausente. I-EXPLORATION +Se I-EXPLORATION +confirmó I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -periesplénico, I-EXPLORATION -con I-EXPLORATION -engrosamiento I-EXPLORATION -peritoneal, I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -colección I-EXPLORATION -líquida I-EXPLORATION -pélvica I-EXPLORATION +tamaño I-EXPLORATION +óseo I-EXPLORATION +asintomático, I-EXPLORATION con I-EXPLORATION -septos I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -interior I-EXPLORATION -que I-EXPLORATION -engloba I-EXPLORATION -asas I-EXPLORATION +evolución I-EXPLORATION +aproximada I-EXPLORATION de I-EXPLORATION -intestino I-EXPLORATION -delgado, I-EXPLORATION -condicionando I-EXPLORATION -gran I-EXPLORATION -dilatación I-EXPLORATION -gástrica, I-EXPLORATION -duodenal I-EXPLORATION -y I-EXPLORATION +cinco I-EXPLORATION +años, I-EXPLORATION +extendiéndose I-EXPLORATION de I-EXPLORATION -yeyuno, I-EXPLORATION -con I-EXPLORATION -niveles I-EXPLORATION -hidroaéreos, I-EXPLORATION -lo I-EXPLORATION -cual I-EXPLORATION -condujo I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +del I-EXPLORATION +diente I-EXPLORATION +32 I-EXPLORATION al I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -esclerosis I-EXPLORATION -peritoneal. I-EXPLORATION - I-EXPLORATION -Por B-TREATMENT -otra I-TREATMENT -parte, I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -le I-TREATMENT -propuso I-TREATMENT -tratamiento I-TREATMENT -quirúrgico, I-TREATMENT -que I-TREATMENT -desestimó. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -tórpida, I-EVOLUTION -con I-EVOLUTION -varios I-EVOLUTION -ingresos I-EVOLUTION -por I-EVOLUTION -cuadros I-EVOLUTION -de I-EVOLUTION -oclusión I-EVOLUTION -intestinal, I-EVOLUTION -precisando I-EVOLUTION -alimentación I-EVOLUTION -parenteral, I-EVOLUTION -administración I-EVOLUTION -sin I-EVOLUTION -éxito I-EVOLUTION -de I-EVOLUTION -esteroides I-EVOLUTION -y I-EVOLUTION -progresivo I-EVOLUTION -deterioro I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -estado, I-EVOLUTION -con I-EVOLUTION -ascitis I-EVOLUTION -y I-EVOLUTION -desnutrición I-EVOLUTION -que I-EVOLUTION -motivaron I-EVOLUTION -su I-EVOLUTION -fallecimiento I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -6 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -diagnóstico. I-EVOLUTION - I-EVOLUTION -Resultados B-EXPLORATION -y I-EXPLORATION -descripción I-EXPLORATION +diente I-EXPLORATION +44. I-EXPLORATION I-EXPLORATION -Tenemos I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +visualización I-EXPLORATION +del I-EXPLORATION +examen I-EXPLORATION +radiográfico I-EXPLORATION +panorámico I-EXPLORATION +fue I-EXPLORATION +detectada I-EXPLORATION una I-EXPLORATION -serie I-EXPLORATION -de I-EXPLORATION -marcadores I-EXPLORATION -predictivos I-EXPLORATION +alteración I-EXPLORATION +radiolúcida I-EXPLORATION de I-EXPLORATION -esta I-EXPLORATION -entidad, I-EXPLORATION -como I-EXPLORATION -son I-EXPLORATION -el I-EXPLORATION -tiempo I-EXPLORATION +límites I-EXPLORATION +bien I-EXPLORATION +definidos I-EXPLORATION +con I-EXPLORATION +material I-EXPLORATION +amorfo I-EXPLORATION +radiopaco I-EXPLORATION en I-EXPLORATION -DP, I-EXPLORATION -el I-EXPLORATION -que I-EXPLORATION -sea I-EXPLORATION -alto I-EXPLORATION -transportador, I-EXPLORATION -y I-EXPLORATION -factores I-EXPLORATION -predisponentes I-EXPLORATION -como I-EXPLORATION -son, I-EXPLORATION -el I-EXPLORATION -hiperparatiroidismo I-EXPLORATION -grave I-EXPLORATION -(primer I-EXPLORATION -caso) I-EXPLORATION -o I-EXPLORATION -los I-EXPLORATION -episodios I-EXPLORATION -de I-EXPLORATION -peritonitis I-EXPLORATION -de I-EXPLORATION -repetición I-EXPLORATION -(en I-EXPLORATION el I-EXPLORATION -segundo). I-EXPLORATION -Hay I-EXPLORATION -que I-EXPLORATION -tener I-EXPLORATION -en I-EXPLORATION -cuenta, I-EXPLORATION -que I-EXPLORATION -más I-EXPLORATION +centro, I-EXPLORATION +con I-EXPLORATION +aspecto I-EXPLORATION +lobular, I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -mitad I-EXPLORATION +reabsorción I-EXPLORATION +radicular I-EXPLORATION de I-EXPLORATION los I-EXPLORATION -casos, I-EXPLORATION -se I-EXPLORATION -producen I-EXPLORATION -tras I-EXPLORATION -el I-EXPLORATION -abandono I-EXPLORATION -de I-EXPLORATION +dientes I-EXPLORATION +adyacentes I-EXPLORATION la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -DP. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -se I-EXPLORATION -efectúa I-EXPLORATION -mediante I-EXPLORATION -pruebas I-EXPLORATION -de I-EXPLORATION -imagen: I-EXPLORATION -Rx I-EXPLORATION -simple, I-EXPLORATION -ecografía I-EXPLORATION -o I-EXPLORATION -TAC I-EXPLORATION -abdominal, I-EXPLORATION -aunque I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo I-EXPLORATION -se I-EXPLORATION -puede I-EXPLORATION -obtener I-EXPLORATION -mediante I-EXPLORATION -biopsia I-EXPLORATION -peritoneal, I-EXPLORATION -donde I-EXPLORATION -se I-EXPLORATION -puede I-EXPLORATION -apreciar, I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION -del I-EXPLORATION -tamaño I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -fibroblastos, I-EXPLORATION -depósito I-EXPLORATION -de I-EXPLORATION -fibrina, I-EXPLORATION -angiogénesis I-EXPLORATION -capilar, I-EXPLORATION -sangrado I-EXPLORATION -perivascular I-EXPLORATION -e I-EXPLORATION -infiltración I-EXPLORATION -de I-EXPLORATION -mononucleares. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -tratamiento I-EXPLORATION -de I-EXPLORATION -este I-EXPLORATION -grave I-EXPLORATION -cuadro, I-EXPLORATION -dependerá I-EXPLORATION -del I-EXPLORATION -grado I-EXPLORATION -de I-EXPLORATION -afectación I-EXPLORATION -peritoneal. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -estadios I-EXPLORATION -iniciales I-EXPLORATION -podría I-EXPLORATION -ser I-EXPLORATION -suficiente I-EXPLORATION -el I-EXPLORATION -reposo I-EXPLORATION -peritoneal; I-EXPLORATION -con I-EXPLORATION -lavados I-EXPLORATION -peritoneales I-EXPLORATION +lesión I-EXPLORATION y I-EXPLORATION -esteroides. I-EXPLORATION -En I-EXPLORATION -casos I-EXPLORATION -más I-EXPLORATION -avanzados I-EXPLORATION -se I-EXPLORATION -necesitará I-EXPLORATION -tratamiento I-EXPLORATION -inmunosupresor I-EXPLORATION -(ciclofosfamida, I-EXPLORATION -azatioprina, I-EXPLORATION -ciclosporina) I-EXPLORATION -e I-EXPLORATION -incluso I-EXPLORATION -tamoxifeno. I-EXPLORATION -En I-EXPLORATION -casos I-EXPLORATION -extremos I-EXPLORATION -con I-EXPLORATION -compromiso I-EXPLORATION -visceral, I-EXPLORATION -puede I-EXPLORATION -ser I-EXPLORATION -necesario I-EXPLORATION -recurrir I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -cirugía, I-EXPLORATION -realizando I-EXPLORATION -enterolisis, I-EXPLORATION -técnica I-EXPLORATION -que I-EXPLORATION -tiene I-EXPLORATION -una I-EXPLORATION -mortalidad I-EXPLORATION -entre I-EXPLORATION -40-80%. I-EXPLORATION - I-EXPLORATION -Entre I-EXPLORATION -las I-EXPLORATION -medidas I-EXPLORATION -de I-EXPLORATION -prevención I-EXPLORATION +presencia I-EXPLORATION del I-EXPLORATION -desarrollo I-EXPLORATION +elemento I-EXPLORATION +dentario I-EXPLORATION +43 I-EXPLORATION +no I-EXPLORATION +erupcionado. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +presuntivo I-EXPLORATION +fue I-EXPLORATION de I-EXPLORATION +odontoma I-EXPLORATION +complejo. I-EXPLORATION + I-EXPLORATION +Bajo B-TREATMENT +anestesia I-TREATMENT +local, I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +el I-TREATMENT +acceso I-TREATMENT +por I-TREATMENT +medio I-TREATMENT +de I-TREATMENT +una I-TREATMENT +incisión I-TREATMENT +intra-sulcular I-TREATMENT +extendiéndose I-TREATMENT +de I-TREATMENT +la I-TREATMENT +región I-TREATMENT +de I-TREATMENT +los I-TREATMENT +dientes I-TREATMENT +34 I-TREATMENT +al I-TREATMENT +45 I-TREATMENT +con I-TREATMENT +consecuente I-TREATMENT +exposición I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +a I-TREATMENT +través I-TREATMENT +de I-TREATMENT +la I-TREATMENT +ventana I-TREATMENT +ósea I-TREATMENT +creada I-TREATMENT +con I-TREATMENT +fresa I-TREATMENT +quirúrgica I-TREATMENT +bajo I-TREATMENT +irrigación I-TREATMENT +constante. I-TREATMENT +La I-TREATMENT +lesión I-TREATMENT +fue I-TREATMENT +removida I-TREATMENT +por I-TREATMENT +enucleación I-TREATMENT +con I-TREATMENT +un I-TREATMENT +curetaje I-TREATMENT +agresivo I-TREATMENT +juntamente I-TREATMENT +con I-TREATMENT +el I-TREATMENT +diente I-TREATMENT +43 I-TREATMENT +no I-TREATMENT +erupcionado. I-TREATMENT +Los B-EXPLORATION +cortes I-EXPLORATION +microscópicos I-EXPLORATION +revelaron I-EXPLORATION la I-EXPLORATION -peritonitis I-EXPLORATION -esclerosante, I-EXPLORATION -cabe I-EXPLORATION -destacar I-EXPLORATION -la I-EXPLORATION -importancia I-EXPLORATION -del I-EXPLORATION -papel I-EXPLORATION +proliferación I-EXPLORATION de I-EXPLORATION -enfermería I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +epiteliales I-EXPLORATION +odontogénicas I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -entrenamiento I-EXPLORATION -del I-EXPLORATION -paciente I-EXPLORATION -para I-EXPLORATION -reducir I-EXPLORATION -al I-EXPLORATION -máximo I-EXPLORATION -los I-EXPLORATION -episodios I-EXPLORATION -de I-EXPLORATION -peritonitis I-EXPLORATION -y I-EXPLORATION -tratarlos I-EXPLORATION -adecuadamente I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -precoz; I-EXPLORATION -además I-EXPLORATION -debemos I-EXPLORATION -utilizar I-EXPLORATION -soluciones I-EXPLORATION -lo I-EXPLORATION -más I-EXPLORATION -biocompatibles I-EXPLORATION -posible, I-EXPLORATION -evitando I-EXPLORATION +íntimo I-EXPLORATION +contacto I-EXPLORATION +con I-EXPLORATION +inúmeros I-EXPLORATION +focos I-EXPLORATION +redondeados I-EXPLORATION +concéntricos I-EXPLORATION de I-EXPLORATION -ese I-EXPLORATION -modo I-EXPLORATION -altas I-EXPLORATION -concentraciones I-EXPLORATION +mineralización I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +anillos I-EXPLORATION de I-EXPLORATION -glucosa. I-EXPLORATION -Así I-EXPLORATION -mismo, I-EXPLORATION -es I-EXPLORATION -muy I-EXPLORATION -importante I-EXPLORATION -el I-EXPLORATION -control I-EXPLORATION -del I-EXPLORATION -hiperparatiroidismo I-EXPLORATION -secundario I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -pacientes I-EXPLORATION -urémicos. I-EXPLORATION - I-EXPLORATION -Finalmente, I-EXPLORATION -debemos I-EXPLORATION -estar I-EXPLORATION -alerta I-EXPLORATION -en I-EXPLORATION -aquellos I-EXPLORATION -pacientes I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -convierten I-EXPLORATION +Liesegang, I-EXPLORATION +a I-EXPLORATION +veces I-EXPLORATION +resultando I-EXPLORATION en I-EXPLORATION -altos I-EXPLORATION -transportadores I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -paso I-EXPLORATION +densas I-EXPLORATION +masas I-EXPLORATION +sean I-EXPLORATION +eosinofílicas I-EXPLORATION +o I-EXPLORATION +basofílicas. I-EXPLORATION +Las I-EXPLORATION +células I-EXPLORATION +presentaban I-EXPLORATION +puentes I-EXPLORATION +intercelulares I-EXPLORATION +bien I-EXPLORATION +evidentes, I-EXPLORATION +además I-EXPLORATION del I-EXPLORATION -tiempo I-EXPLORATION +pleomorfismo, I-EXPLORATION +hipercromatismo I-EXPLORATION +y I-EXPLORATION +variación I-EXPLORATION en I-EXPLORATION -DP. I-EXPLORATION -Por I-EXPLORATION -tanto, I-EXPLORATION -es I-EXPLORATION -conveniente I-EXPLORATION -realizar I-EXPLORATION -un I-EXPLORATION -PET I-EXPLORATION -(test I-EXPLORATION -de I-EXPLORATION -equilibrio I-EXPLORATION -peritoneal), I-EXPLORATION -al I-EXPLORATION -menos I-EXPLORATION -una I-EXPLORATION -vez I-EXPLORATION +relación I-EXPLORATION al I-EXPLORATION -año I-EXPLORATION -y I-EXPLORATION -tras I-EXPLORATION -episodios I-EXPLORATION +tamaño I-EXPLORATION de I-EXPLORATION -peritonitis. I-EXPLORATION +los I-EXPLORATION +núcleos. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +tejido I-EXPLORATION +conjuntivo I-EXPLORATION +fibroso, I-EXPLORATION +se I-EXPLORATION +observaban I-EXPLORATION +cordones I-EXPLORATION +o I-EXPLORATION +islas I-EXPLORATION +de I-EXPLORATION +epitelio I-EXPLORATION +odontogénico. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +histopatológico I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +TEOC. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +radiográfico I-EXPLORATION +de I-EXPLORATION +proservación I-EXPLORATION +de I-EXPLORATION +cinco I-EXPLORATION +años I-EXPLORATION +muestra I-EXPLORATION +la I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +señales I-EXPLORATION +de I-EXPLORATION +recurrencia I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lesión. I-EXPLORATION I-EXPLORATION -Lactante B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -46 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS +Hombre B-PRESENT_ILLNESS de I-PRESENT_ILLNESS +45 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS edad, I-PRESENT_ILLNESS -fruto B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -embarazo I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -término, I-PAST_MEDICAL_HISTORY +con B-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -adecuado I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -gestacional. I-PAST_MEDICAL_HISTORY -Embarazo I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +portador I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -riesgo I-PAST_MEDICAL_HISTORY +VIH, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +terapia I-PAST_MEDICAL_HISTORY +anti-retro I-PAST_MEDICAL_HISTORY +viral I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -controlado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -antecedente B-FAMILY_HISTORY -de I-FAMILY_HISTORY -lupus I-FAMILY_HISTORY -eritematoso I-FAMILY_HISTORY -sistémico I-FAMILY_HISTORY -(LES) I-FAMILY_HISTORY -materno I-FAMILY_HISTORY -en I-FAMILY_HISTORY -tratamiento I-FAMILY_HISTORY -con I-FAMILY_HISTORY -cloroquina, I-FAMILY_HISTORY -siendo I-FAMILY_HISTORY -negativos I-FAMILY_HISTORY -los I-FAMILY_HISTORY -marcadores I-FAMILY_HISTORY -maternos I-FAMILY_HISTORY -para I-FAMILY_HISTORY -LES I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -momento I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -concepción; I-FAMILY_HISTORY -exámenes B-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -rutina I-PAST_MEDICAL_HISTORY -normales. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -lactante I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS +sífilis I-PAST_MEDICAL_HISTORY +genital. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS por I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -ocasiones, I-PRESENT_ILLNESS -mientras I-PRESENT_ILLNESS -estaba I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -lactancia I-PRESENT_ILLNESS -mixta, I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -41.º I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nuevo I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +evolucionaba I-PRESENT_ILLNESS +hacían I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +semanas, I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -este I-PRESENT_ILLNESS -motivo, I-PRESENT_ILLNESS -realizándose B-EXPLORATION -una I-EXPLORATION -analítica I-EXPLORATION +ojo I-PRESENT_ILLNESS +rojo I-PRESENT_ILLNESS +bilateral, I-PRESENT_ILLNESS +mayor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +OD. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +oftalmológico I-EXPLORATION +presentaba I-EXPLORATION +AVMC I-EXPLORATION +igual I-EXPLORATION +a I-EXPLORATION +0, I-EXPLORATION +05 I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -presentó I-EXPLORATION -9.220 I-EXPLORATION -leucocitos I-EXPLORATION -con I-EXPLORATION -11, I-EXPLORATION -9% I-EXPLORATION -de I-EXPLORATION -eosinófilos, I-EXPLORATION -hemograma, I-EXPLORATION -sedimento I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION +el I-EXPLORATION +OD I-EXPLORATION y I-EXPLORATION -urocultivo I-EXPLORATION -negativos. I-EXPLORATION -Ante B-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -presencia I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -eosinofilia I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -analítica I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -clínica I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -vómitos I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -le I-DERIVED_FROM/TO -diagnostica I-DERIVED_FROM/TO -intolerancia I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -proteínas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -leche I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -vaca, I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -lo I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -especialista I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Alergología. I-DERIVED_FROM/TO -Con B-EVOLUTION -46 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -acude I-EVOLUTION -a I-EVOLUTION -consulta I-EVOLUTION -con I-EVOLUTION -máculas I-EVOLUTION -anulares, I-EVOLUTION -policíclicas, I-EVOLUTION -localizadas I-EVOLUTION -en I-EVOLUTION -cabeza I-EVOLUTION -y I-EVOLUTION -zona I-EVOLUTION -anterior I-EVOLUTION -del I-EVOLUTION -tronco I-EVOLUTION -y I-EVOLUTION -pubis. I-EVOLUTION -Ante B-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -duda I-DERIVED_FROM/TO -diagnóstica I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -afectación I-DERIVED_FROM/TO -lúpica I-DERIVED_FROM/TO -o I-DERIVED_FROM/TO -bien I-DERIVED_FROM/TO -posible I-DERIVED_FROM/TO -reacción I-DERIVED_FROM/TO -adversa I-DERIVED_FROM/TO -medicamentosa I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -cloroquina, I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -LES I-DERIVED_FROM/TO -materno, I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -referencia I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -le I-DERIVED_FROM/TO -cita I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -biopsia I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -las I-DERIVED_FROM/TO -lesiones I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -analítica. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -La B-EXPLORATION -biopsia I-EXPLORATION -realizada I-EXPLORATION +0, I-EXPLORATION +1 I-EXPLORATION en I-EXPLORATION -región I-EXPLORATION -suprapúbica, I-EXPLORATION -junto I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION -analíticos I-EXPLORATION +el I-EXPLORATION +Oí. I-EXPLORATION +PIÓ I-EXPLORATION de I-EXPLORATION -anticuerpos I-EXPLORATION -anti-La I-EXPLORATION -y I-EXPLORATION -anti-Ro I-EXPLORATION -positivos I-EXPLORATION -confirman I-EXPLORATION +27 I-EXPLORATION +mm I-EXPLORATION +Hg I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION +OD I-EXPLORATION +y I-EXPLORATION +25 I-EXPLORATION +mm I-EXPLORATION +Hg I-EXPLORATION en I-EXPLORATION -nuestro I-EXPLORATION -caso. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -ECG I-EXPLORATION -fue I-EXPLORATION -normal, I-EXPLORATION -descartándose I-EXPLORATION -la I-EXPLORATION -afectación I-EXPLORATION -cardíaca. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -hemograma I-EXPLORATION +el I-EXPLORATION +Oí. I-EXPLORATION +Al I-EXPLORATION +examen I-EXPLORATION +al I-EXPLORATION +biomicroscopio I-EXPLORATION presentaba I-EXPLORATION -una I-EXPLORATION -anemia I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -ferropénica, I-EXPLORATION +hiperemia I-EXPLORATION +conjuntival I-EXPLORATION +bilateral, I-EXPLORATION +cornea I-EXPLORATION +con I-EXPLORATION +precipitados I-EXPLORATION +queráticos I-EXPLORATION +pequeños, I-EXPLORATION +mayor I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +OD, I-EXPLORATION +sinequias I-EXPLORATION +posteriores I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +Oí, I-EXPLORATION +Tyndall I-EXPLORATION +++ I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +OD I-EXPLORATION y I-EXPLORATION ++ I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -fórmula I-EXPLORATION -leucocitaria I-EXPLORATION +el I-EXPLORATION +Oí. I-EXPLORATION +Al I-EXPLORATION +examen I-EXPLORATION +del I-EXPLORATION +fondo I-EXPLORATION +de I-EXPLORATION +ojo I-EXPLORATION destacaba I-EXPLORATION -una I-EXPLORATION -neutropenia. I-EXPLORATION +vitreítis I-EXPLORATION +bilateral, I-EXPLORATION +papila I-EXPLORATION +rosada, I-EXPLORATION +bordes I-EXPLORATION +netos, I-EXPLORATION +excavación I-EXPLORATION +de I-EXPLORATION +0, I-EXPLORATION +3 I-EXPLORATION +bilateral. I-EXPLORATION I-EXPLORATION -Al B-TREATMENT -momento I-TREATMENT -del I-TREATMENT -diagnóstico I-TREATMENT +Los I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +mostraron I-EXPLORATION +VDRL I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION +(+), I-EXPLORATION +título I-EXPLORATION +1/32, I-EXPLORATION +VDRL I-EXPLORATION +en I-EXPLORATION +LCR I-EXPLORATION +(+), I-EXPLORATION +estudio I-EXPLORATION +cito-químico I-EXPLORATION +de I-EXPLORATION +LCR I-EXPLORATION +normal, I-EXPLORATION +FTA-ABS I-EXPLORATION +(+). I-EXPLORATION +TAC I-EXPLORATION +de I-EXPLORATION +cerebro I-EXPLORATION +sin I-EXPLORATION +hallazgos I-EXPLORATION +patológicos. I-EXPLORATION +Se B-TREATMENT +diagnosticó I-TREATMENT +una.panuveítis I-TREATMENT +bilateral I-TREATMENT +por I-TREATMENT +sífilis I-TREATMENT +y I-TREATMENT se I-TREATMENT le I-TREATMENT -indicó I-TREATMENT -al I-TREATMENT -paciente I-TREATMENT -fotoprotección; I-TREATMENT -metilprednisolona I-TREATMENT -oral, I-TREATMENT +practicó I-TREATMENT +tratamiento I-TREATMENT con I-TREATMENT -protección I-TREATMENT -gástrica I-TREATMENT -por I-TREATMENT -el I-TREATMENT -antecedente I-TREATMENT +esquema I-TREATMENT +habitual I-TREATMENT de I-TREATMENT -vómitos; I-TREATMENT -y I-TREATMENT -sulfato I-TREATMENT -ferroso I-TREATMENT -para I-TREATMENT -corregir I-TREATMENT -su I-TREATMENT -anemia. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -2 I-EVOLUTION -meses I-EVOLUTION -y I-EVOLUTION -medio I-EVOLUTION +penicilina. I-TREATMENT +Evoluciono B-EVOLUTION +con I-EVOLUTION +disminución I-EVOLUTION de I-EVOLUTION -vida I-EVOLUTION +la I-EVOLUTION +inflamación I-EVOLUTION +bilateral I-EVOLUTION +a I-EVOLUTION las I-EVOLUTION -lesiones I-EVOLUTION -habían I-EVOLUTION -remitido, I-EVOLUTION -suspendiéndose B-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -corticoideo I-TREATMENT -a I-TREATMENT -los I-TREATMENT -3 I-TREATMENT -meses I-TREATMENT -y I-TREATMENT -medio. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -5 I-EVOLUTION -meses I-EVOLUTION -se I-EVOLUTION -habían I-EVOLUTION -negativizado I-EVOLUTION -los I-EVOLUTION -anticuerpos I-EVOLUTION -lúpicos I-EVOLUTION -maternos I-EVOLUTION -en I-EVOLUTION +dos I-EVOLUTION +semanas I-EVOLUTION +de I-EVOLUTION +iniciado I-EVOLUTION el I-EVOLUTION -niño I-EVOLUTION +tratamiento I-EVOLUTION y I-EVOLUTION -había I-EVOLUTION -desaparecido I-EVOLUTION -la I-EVOLUTION -neutropenia, I-EVOLUTION -persistiendo I-EVOLUTION +mejoría I-EVOLUTION +de I-EVOLUTION la I-EVOLUTION -anemia. I-EVOLUTION +AV. I-EVOLUTION I-EVOLUTION -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY +Paciente B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +sexo I-PAST_MEDICAL_HISTORY +masculino I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Desde B-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -varios I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -recurrentes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -elevada I-PRESENT_ILLNESS -(cada I-PRESENT_ILLNESS -4 I-PRESENT_ILLNESS -semanas), I-PRESENT_ILLNESS -adenopatías I-PRESENT_ILLNESS -laterocervicales I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -faringitis. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Los I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -cursan I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -(39-40 I-PRESENT_ILLNESS -oC) I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -3-4 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -duración I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -escasa I-PRESENT_ILLNESS -respuesta I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -antitérmicos. I-PRESENT_ILLNESS -La B-EXPLORATION -niña I-EXPLORATION -está I-EXPLORATION -asintomática I-EXPLORATION -entre I-EXPLORATION -los I-EXPLORATION -episodios I-EXPLORATION -y I-EXPLORATION -tiene I-EXPLORATION -un I-EXPLORATION -desarrollo I-EXPLORATION -normal I-EXPLORATION -para I-EXPLORATION -su I-EXPLORATION -edad. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica I-EXPLORATION -aparecen I-EXPLORATION -leucocitosis I-EXPLORATION -con I-EXPLORATION -neutrofilia I-EXPLORATION -moderada, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -elevación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -velocidad I-EXPLORATION -de I-EXPLORATION -sedimentación I-EXPLORATION -globular I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -(PCR). I-EXPLORATION -En I-EXPLORATION -varias I-EXPLORATION -ocasiones I-EXPLORATION -se I-EXPLORATION -realizaron I-EXPLORATION -frotis I-EXPLORATION -faríngeos I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Los B-TREATMENT -primeros I-TREATMENT -episodios I-TREATMENT +diabetes I-PAST_MEDICAL_HISTORY +mellitus I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +consumo I-PAST_MEDICAL_HISTORY +crónico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alcohol. I-PAST_MEDICAL_HISTORY +Diagnóstico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cirrosis I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +2002 I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +48 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +estudió I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +2004, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +PCR I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +VHC I-PAST_MEDICAL_HISTORY +positiva, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +carga I-PAST_MEDICAL_HISTORY +viral I-PAST_MEDICAL_HISTORY +280.998 I-PAST_MEDICAL_HISTORY +UI/ml I-PAST_MEDICAL_HISTORY +(Log I-PAST_MEDICAL_HISTORY +5, I-PAST_MEDICAL_HISTORY +45) I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +genotipo I-PAST_MEDICAL_HISTORY +3a. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +recibió I-PAST_MEDICAL_HISTORY +tratamiento. I-PAST_MEDICAL_HISTORY +Derivado B-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +2005 I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +presencia I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +2 I-DERIVED_FROM/TO +lesiones I-DERIVED_FROM/TO +compatibles I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +hepatocarcinoma. I-DERIVED_FROM/TO +Quimioembolización B-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +octubre I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2005, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +múltiples I-PAST_MEDICAL_HISTORY +quimioembolizaciones I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +alcoholizaciones I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +julio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +2006 I-PAST_MEDICAL_HISTORY +cuando I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +trasplantado. I-PAST_MEDICAL_HISTORY +Post B-TREATMENT +trasplante I-TREATMENT se I-TREATMENT -trataron I-TREATMENT +inició I-TREATMENT +inmunosupresión I-TREATMENT con I-TREATMENT -antibiótico. I-TREATMENT -No B-EVOLUTION -presentó I-EVOLUTION -mejoría I-EVOLUTION +prednisona I-TREATMENT +y I-TREATMENT +ciclosporina. I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +5 I-EVOLUTION +meses I-EVOLUTION +post I-EVOLUTION +trasplante, I-EVOLUTION +con I-EVOLUTION +transaminasas I-EVOLUTION hasta I-EVOLUTION +12 I-EVOLUTION +veces I-EVOLUTION el I-EVOLUTION -3.o-5.o I-EVOLUTION -día. I-EVOLUTION - I-EVOLUTION -Ante I-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -descritos, I-EVOLUTION -su I-EVOLUTION -recurrencia I-EVOLUTION -y I-EVOLUTION -los I-EVOLUTION -cultivos I-EVOLUTION -faríngeos I-EVOLUTION -negativos, I-EVOLUTION -que I-EVOLUTION +valor I-EVOLUTION +normal, I-EVOLUTION se I-EVOLUTION -producían I-EVOLUTION +planteó I-EVOLUTION +rechazo I-EVOLUTION +vs I-EVOLUTION +reactivación I-EVOLUTION de I-EVOLUTION -forma I-EVOLUTION -repetida, I-EVOLUTION +VHC. I-EVOLUTION +Se B-TREATMENT +agregó I-TREATMENT +sirolimus. I-TREATMENT +Biopsia B-EXPLORATION +hepática I-EXPLORATION +mostró I-EXPLORATION +esteatosis I-EXPLORATION +y I-EXPLORATION +hepatitis I-EXPLORATION +aguda I-EXPLORATION +leve, I-EXPLORATION +sin I-EXPLORATION +elementos I-EXPLORATION +de I-EXPLORATION +especificidad. I-EXPLORATION +Carga I-EXPLORATION +viral I-EXPLORATION +3.000.694 I-EXPLORATION +UI/ml I-EXPLORATION +(Log I-EXPLORATION +6, I-EXPLORATION +48). I-EXPLORATION +Persistió B-EVOLUTION +con I-EVOLUTION +transaminasas I-EVOLUTION +1, I-EVOLUTION +5 I-EVOLUTION +a I-EVOLUTION +3 I-EVOLUTION +veces I-EVOLUTION +el I-EVOLUTION +valor I-EVOLUTION +normal. I-EVOLUTION +Debido I-EVOLUTION +a I-EVOLUTION +pancitopenia I-EVOLUTION se I-EVOLUTION -pensó I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -posibilidad I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -síndrome I-EVOLUTION -de I-EVOLUTION -Marshall. I-EVOLUTION -Coincidiendo B-TREATMENT -con I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -pico I-TREATMENT -febril, I-TREATMENT +suspendió I-EVOLUTION +sirolimus. I-EVOLUTION +A B-TREATMENT +los I-TREATMENT +3 I-TREATMENT +años I-TREATMENT +y I-TREATMENT +medio I-TREATMENT +post I-TREATMENT +trasplante I-TREATMENT se I-TREATMENT -inició I-TREATMENT -corticoterapia I-TREATMENT -oral. I-TREATMENT -La B-EVOLUTION -duración I-EVOLUTION -del I-EVOLUTION -episodio I-EVOLUTION -se I-EVOLUTION -acortó I-EVOLUTION -a I-EVOLUTION -menos I-EVOLUTION -de I-EVOLUTION -6 I-EVOLUTION -horas I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -toma I-EVOLUTION -de I-EVOLUTION -prednisona. I-EVOLUTION -Dicha I-EVOLUTION -respuesta I-EVOLUTION -fue I-EVOLUTION -comprobada I-EVOLUTION -en I-EVOLUTION -episodios I-EVOLUTION -posteriores, I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -sugiere I-EVOLUTION -un I-EVOLUTION -síndrome I-EVOLUTION -PFAPA. I-EVOLUTION - I-EVOLUTION - -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -revisión I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Programa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Salud I-PRESENT_ILLNESS -Infantil I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -lactante I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida. I-PRESENT_ILLNESS -Antecedentes B-PAST_MEDICAL_HISTORY -personales: I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -ecografía I-PAST_MEDICAL_HISTORY -fetal I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -tercer I-PAST_MEDICAL_HISTORY -trimestre I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -dilatación I-PAST_MEDICAL_HISTORY -pielocalicial I-PAST_MEDICAL_HISTORY -bilateral I-PAST_MEDICAL_HISTORY -(derecha: I-PAST_MEDICAL_HISTORY -4, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -mm; I-PAST_MEDICAL_HISTORY -izquierda: I-PAST_MEDICAL_HISTORY -4, I-PAST_MEDICAL_HISTORY -1 I-PAST_MEDICAL_HISTORY -mm). I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cesárea I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -semana I-PAST_MEDICAL_HISTORY -41+4 I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -gestación I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -fallo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -inducción. I-PAST_MEDICAL_HISTORY -Su I-PAST_MEDICAL_HISTORY -Apgar I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -5/9 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -precisó I-PAST_MEDICAL_HISTORY -reanimación I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -III; I-PAST_MEDICAL_HISTORY -permaneció I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -transición I-PAST_MEDICAL_HISTORY -menos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -24 I-PAST_MEDICAL_HISTORY -horas. I-PAST_MEDICAL_HISTORY -Antecedentes B-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés: I-FAMILY_HISTORY -prima I-FAMILY_HISTORY -hermana I-FAMILY_HISTORY -paterna I-FAMILY_HISTORY -con I-FAMILY_HISTORY -escoliosis I-FAMILY_HISTORY -congénita. I-FAMILY_HISTORY -Exploración: B-EXPLORATION -Peso: I-EXPLORATION -3, I-EXPLORATION -960 I-EXPLORATION -kg I-EXPLORATION -(percentil I-EXPLORATION -25); I-EXPLORATION -talla: I-EXPLORATION -53 I-EXPLORATION -cm I-EXPLORATION -(percentil I-EXPLORATION -50); I-EXPLORATION -y I-EXPLORATION -perímetro I-EXPLORATION -cefálico: I-EXPLORATION -37 I-EXPLORATION -cm I-EXPLORATION -(percentil I-EXPLORATION -25). I-EXPLORATION -Se I-EXPLORATION -aprecian I-EXPLORATION -un I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -cráneo I-EXPLORATION +vuelve I-TREATMENT +a I-TREATMENT +plantear I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +VHC I-TREATMENT +con B-EXPLORATION +nueva I-EXPLORATION +biopsia I-EXPLORATION +hepática I-EXPLORATION +que I-EXPLORATION +muestra I-EXPLORATION +hepatitis I-EXPLORATION +crónica I-EXPLORATION con I-EXPLORATION -fontanela I-EXPLORATION -anterior I-EXPLORATION +leve I-EXPLORATION +inflamación I-EXPLORATION +portal I-EXPLORATION de I-EXPLORATION -1 I-EXPLORATION -x I-EXPLORATION -1 I-EXPLORATION -cm, I-EXPLORATION -plagiocefalia I-EXPLORATION +interfase I-EXPLORATION +y I-EXPLORATION +lobulillar, I-EXPLORATION +fibrosis I-EXPLORATION +perisinusoideal I-EXPLORATION leve, I-EXPLORATION -cuello I-EXPLORATION -corto I-EXPLORATION -con I-EXPLORATION -desviación I-EXPLORATION -lateral I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -cabeza I-EXPLORATION -al I-EXPLORATION -lado I-EXPLORATION -izquierdo I-EXPLORATION +colangitis I-EXPLORATION +linfocítica I-EXPLORATION +focal I-EXPLORATION y I-EXPLORATION -ligera I-EXPLORATION -limitación I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -movilidad, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -escoliosis I-EXPLORATION -congénita I-EXPLORATION -cervical. I-EXPLORATION -Se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -asimetría I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -parte I-EXPLORATION -superior I-EXPLORATION -del I-EXPLORATION -tórax I-EXPLORATION -posterior, I-EXPLORATION -con I-EXPLORATION -elevación I-EXPLORATION +esteatosis I-EXPLORATION +hepática I-EXPLORATION +mínima. I-EXPLORATION +En B-EVOLUTION +ese I-EVOLUTION +momento I-EVOLUTION +evoluciona I-EVOLUTION +con I-EVOLUTION +colestasia, I-EVOLUTION +que I-EVOLUTION +resulta I-EVOLUTION +ser I-EVOLUTION +secundaria I-EVOLUTION +a I-EVOLUTION +estenosis I-EVOLUTION +de I-EVOLUTION +anastomosis I-EVOLUTION +biliar. I-EVOLUTION +Se I-EVOLUTION +controló I-EVOLUTION +con I-EVOLUTION +nueva I-EVOLUTION +carga I-EVOLUTION +viral I-EVOLUTION +con I-EVOLUTION +355.882 I-EVOLUTION +UI/ml I-EVOLUTION +(Log I-EVOLUTION +5, I-EVOLUTION +55) I-EVOLUTION +en I-EVOLUTION +octubre I-EVOLUTION +de I-EVOLUTION +2010. I-EVOLUTION +Con B-EXPLORATION +intención I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -escápula I-EXPLORATION -izquierda: I-EXPLORATION +iniciar I-EXPLORATION +tratamiento I-EXPLORATION en I-EXPLORATION +marzo I-EXPLORATION +de I-EXPLORATION +2011 I-EXPLORATION +se I-EXPLORATION +solicitó I-EXPLORATION +nueva I-EXPLORATION +carga I-EXPLORATION +viral I-EXPLORATION la I-EXPLORATION -inspección I-EXPLORATION +que I-EXPLORATION +resultó I-EXPLORATION +negativa; I-EXPLORATION +además I-EXPLORATION se I-EXPLORATION -aprecia I-EXPLORATION -un I-EXPLORATION -hoyuelo I-EXPLORATION -cutáneo I-EXPLORATION -en I-EXPLORATION -esa I-EXPLORATION -escápula, I-EXPLORATION +realizó I-EXPLORATION +PCR I-EXPLORATION +para I-EXPLORATION +VHC, I-EXPLORATION +también I-EXPLORATION +negativa, I-EXPLORATION la I-EXPLORATION -cual I-EXPLORATION -presenta I-EXPLORATION -un I-EXPLORATION -tamaño I-EXPLORATION -inferior I-EXPLORATION -y I-EXPLORATION -parece I-EXPLORATION -más I-EXPLORATION -horizontalizada I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +confirma I-EXPLORATION con I-EXPLORATION -respecto I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -contralateral. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION +nueva I-EXPLORATION +muestra. I-EXPLORATION +En B-TREATMENT +ese I-TREATMENT +momento I-TREATMENT +perfil I-TREATMENT +hepático I-TREATMENT +normal, I-TREATMENT +recibiendo I-TREATMENT +inmunosupresión I-TREATMENT +con I-TREATMENT +ciclosporina I-TREATMENT +100 I-TREATMENT +mg I-TREATMENT +al I-TREATMENT +día. I-TREATMENT +Se B-EVOLUTION +interpretó I-EVOLUTION +como I-EVOLUTION +eliminación I-EVOLUTION +espontánea I-EVOLUTION +del I-EVOLUTION +VHC. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +34 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +diagnosticado B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Síndrome I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Sturge-Weber I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +infancia, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +glaucoma I-PRESENT_ILLNESS +agudo I-PRESENT_ILLNESS +secundario I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +luxación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cristalino I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +cámara I-PRESENT_ILLNESS +anterior I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +bloqueo I-PRESENT_ILLNESS +pupilar, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +intervenido I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +urgencia. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -física I-EXPLORATION -y I-EXPLORATION -neurológica I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Ante B-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -hallazgos I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -escápula I-DERIVED_FROM/TO -elevada, I-DERIVED_FROM/TO -escoliosis, I-DERIVED_FROM/TO -tortícolis I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -plagiocefalia I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -decide I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -derivación I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -traumatología I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -referencia. I-DERIVED_FROM/TO -Debido B-EXPLORATION -a I-EXPLORATION -sus I-EXPLORATION -antecedentes I-EXPLORATION -de I-EXPLORATION -dilatación I-EXPLORATION -pielocalicial I-EXPLORATION se I-EXPLORATION -solicita I-EXPLORATION +evidenciaba I-EXPLORATION una I-EXPLORATION -ecografía I-EXPLORATION -abdominorrenal I-EXPLORATION +mancha I-EXPLORATION +en I-EXPLORATION +«vino I-EXPLORATION de I-EXPLORATION -control. I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -la I-EVOLUTION -revisión I-EVOLUTION -del I-EVOLUTION -cuarto I-EVOLUTION -mes I-EVOLUTION -la I-EVOLUTION -asimetría I-EVOLUTION -escapular I-EVOLUTION -es I-EVOLUTION -más I-EVOLUTION -manifiesta, I-EVOLUTION -se I-EVOLUTION -observa I-EVOLUTION -una I-EVOLUTION -mayor I-EVOLUTION -discrepancia I-EVOLUTION -entre I-EVOLUTION -el I-EVOLUTION -tamaño I-EVOLUTION -de I-EVOLUTION -ambas I-EVOLUTION -escápulas I-EVOLUTION -(la I-EVOLUTION -derecha I-EVOLUTION -mide I-EVOLUTION -7 I-EVOLUTION -cm, I-EVOLUTION -frente I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -4, I-EVOLUTION -5 I-EVOLUTION -cm I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -izquierda), I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -altura I-EVOLUTION -del I-EVOLUTION -ángulo I-EVOLUTION -inferior I-EVOLUTION -de I-EVOLUTION -ambas I-EVOLUTION -dista I-EVOLUTION -2, I-EVOLUTION -5 I-EVOLUTION -cm. I-EVOLUTION -La B-EXPLORATION -movilidad I-EXPLORATION -del I-EXPLORATION -brazo I-EXPLORATION -está I-EXPLORATION -conservada, I-EXPLORATION -aunque I-EXPLORATION -existe I-EXPLORATION -una I-EXPLORATION -limitación I-EXPLORATION +Oporto» I-EXPLORATION +hemifacial I-EXPLORATION +izquierda, I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +territorio I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -abducción I-EXPLORATION +primera I-EXPLORATION +y I-EXPLORATION +segunda I-EXPLORATION +ramas I-EXPLORATION +trigeminales, I-EXPLORATION +exoftalmos I-EXPLORATION +severo I-EXPLORATION +con I-EXPLORATION +rechazo I-EXPLORATION +ínfero-temporal I-EXPLORATION del I-EXPLORATION -hombro I-EXPLORATION -izquierdo I-EXPLORATION -(activa: I-EXPLORATION -85o; I-EXPLORATION -pasiva: I-EXPLORATION -115o). I-EXPLORATION -La I-EXPLORATION -plagiocefalia I-EXPLORATION -ahora I-EXPLORATION -es I-EXPLORATION -moderada, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -derivar I-EXPLORATION -al I-EXPLORATION -servicio I-EXPLORATION +globo I-EXPLORATION +ocular I-EXPLORATION +e I-EXPLORATION +ingurgitación I-EXPLORATION +marcada I-EXPLORATION de I-EXPLORATION -neurocirugía I-EXPLORATION -para I-EXPLORATION -valorar I-EXPLORATION -ortesis I-EXPLORATION -craneal. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -el I-EXPLORATION -fin I-EXPLORATION +vasos I-EXPLORATION +epiesclerales I-EXPLORATION +inferiores I-EXPLORATION +«en I-EXPLORATION +cabeza I-EXPLORATION de I-EXPLORATION -confirmar I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -y I-EXPLORATION -descartar I-EXPLORATION -otras I-EXPLORATION -alteraciones I-EXPLORATION -asociadas I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -realizan I-EXPLORATION -las I-EXPLORATION -siguientes I-EXPLORATION -pruebas I-EXPLORATION -complementarias: I-EXPLORATION +Medusa». I-EXPLORATION I-EXPLORATION -- I-EXPLORATION -Ecografía I-EXPLORATION -renal I-EXPLORATION -(mayo I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +con I-EXPLORATION +lámpara I-EXPLORATION de I-EXPLORATION -2009): I-EXPLORATION +hendidura I-EXPLORATION se I-EXPLORATION -aprecian I-EXPLORATION +observaba I-EXPLORATION una I-EXPLORATION -dilatación I-EXPLORATION -pielocalicial I-EXPLORATION -bilateral I-EXPLORATION -de I-EXPLORATION -grado I-EXPLORATION -II/IV, I-EXPLORATION -pelvis I-EXPLORATION -renal I-EXPLORATION -derecha I-EXPLORATION +catarata I-EXPLORATION +madura I-EXPLORATION +totalmente I-EXPLORATION +luxada I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +cámara I-EXPLORATION +anterior I-EXPLORATION +en I-EXPLORATION +contacto I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +endotelio I-EXPLORATION +corneal I-EXPLORATION +con I-EXPLORATION +bloqueo I-EXPLORATION +pupilar I-EXPLORATION +y I-EXPLORATION +presión I-EXPLORATION +intraocular I-EXPLORATION de I-EXPLORATION -9 I-EXPLORATION +60 I-EXPLORATION mm I-EXPLORATION -e I-EXPLORATION -izquierda I-EXPLORATION +Hg, I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +mostraba I-EXPLORATION +un I-EXPLORATION +desprendimiento I-EXPLORATION de I-EXPLORATION -1 I-EXPLORATION -cm. I-EXPLORATION +retina I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +polo I-EXPLORATION +posterior I-EXPLORATION +junto I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +subyacente I-EXPLORATION +hiperecogénica. I-EXPLORATION I-EXPLORATION -- I-EXPLORATION -Ecografía I-EXPLORATION -de I-EXPLORATION -caderas I-EXPLORATION -(mayo I-EXPLORATION +Tras B-TREATMENT +un I-TREATMENT +infructuoso I-TREATMENT +tratamiento I-TREATMENT +médico I-TREATMENT +hipotensor, I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +la I-TREATMENT +intervención, I-TREATMENT +realizándose I-TREATMENT +extracción I-TREATMENT +intracapsular I-TREATMENT +de I-TREATMENT +cristalino. I-TREATMENT +El B-EXPLORATION +fondo I-EXPLORATION de I-EXPLORATION -2009) I-EXPLORATION -por I-EXPLORATION +ojo I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION sospecha I-EXPLORATION de I-EXPLORATION -displasia I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +coroidea I-EXPLORATION +peripapilar I-EXPLORATION +nasal I-EXPLORATION +superior I-EXPLORATION +con I-EXPLORATION +desprendimiento I-EXPLORATION de I-EXPLORATION -caderas: I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -significativos. I-EXPLORATION +retina I-EXPLORATION +exudativo I-EXPLORATION +asociado. I-EXPLORATION I-EXPLORATION -- I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -completa I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +nuclear I-EXPLORATION +(RMN) I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +lesiones I-EXPLORATION +hiperintensas I-EXPLORATION +en I-EXPLORATION +T1 I-EXPLORATION y I-EXPLORATION -escápula I-EXPLORATION -(mayo I-EXPLORATION -de I-EXPLORATION -2009): I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -alteraciones I-EXPLORATION +T2 I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -fusión I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -cuerpos I-EXPLORATION -vertebrales I-EXPLORATION +leptomeninges I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -columna I-EXPLORATION -dorsal I-EXPLORATION -alta I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -cervical I-EXPLORATION -baja. I-EXPLORATION -Primera I-EXPLORATION -costilla I-EXPLORATION +región I-EXPLORATION +frontoparietal I-EXPLORATION izquierda I-EXPLORATION -hipoplásica. I-EXPLORATION -Costillas I-EXPLORATION -2.a I-EXPLORATION -a I-EXPLORATION -5.a I-EXPLORATION -izquierdas I-EXPLORATION con I-EXPLORATION -disminución I-EXPLORATION +calcificaciones I-EXPLORATION +y I-EXPLORATION +atrofia I-EXPLORATION del I-EXPLORATION -espacio I-EXPLORATION -intercostal. I-EXPLORATION -Elevación I-EXPLORATION +lóbulo I-EXPLORATION +frontal. I-EXPLORATION +Una I-EXPLORATION +lesión I-EXPLORATION +coroidea I-EXPLORATION +y I-EXPLORATION +dos I-EXPLORATION +lesiones I-EXPLORATION +orbitarias I-EXPLORATION +extraconales I-EXPLORATION +en I-EXPLORATION +cuadrante I-EXPLORATION +nasal I-EXPLORATION +superior I-EXPLORATION +y I-EXPLORATION +temporal I-EXPLORATION +superior, I-EXPLORATION +bien I-EXPLORATION +delimitadas, I-EXPLORATION +asociadas I-EXPLORATION +a I-EXPLORATION +dilatación I-EXPLORATION de I-EXPLORATION -escápula I-EXPLORATION -izquierda I-EXPLORATION -("escápula I-EXPLORATION -alada"). I-EXPLORATION +vena I-EXPLORATION +oftálmica I-EXPLORATION +superior. I-EXPLORATION +Todas I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +eran I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +hemangiomas I-EXPLORATION +cavernosos. I-EXPLORATION I-EXPLORATION -- I-EXPLORATION -Radiografía I-EXPLORATION -de I-EXPLORATION -columna I-EXPLORATION -lateral I-EXPLORATION -(junio I-EXPLORATION -de I-EXPLORATION -2009): I-EXPLORATION -se I-EXPLORATION -objetivan I-EXPLORATION -alteraciones I-EXPLORATION -de I-EXPLORATION -segmentación I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -cuerpos I-EXPLORATION -vertebrales I-EXPLORATION -de I-EXPLORATION +La I-EXPLORATION +presión I-EXPLORATION +intraocular I-EXPLORATION +tras I-EXPLORATION la I-EXPLORATION -columna I-EXPLORATION -vertebral I-EXPLORATION -dorsal I-EXPLORATION -alta I-EXPLORATION +cirugía I-EXPLORATION +se I-EXPLORATION +mantuvo I-EXPLORATION +entre I-EXPLORATION +10 I-EXPLORATION y I-EXPLORATION -cervical I-EXPLORATION -baja, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -elevación I-EXPLORATION +16 I-EXPLORATION +mm I-EXPLORATION +Hg I-EXPLORATION +sin I-EXPLORATION +necesidad I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -escápula I-EXPLORATION -izquierda. I-EXPLORATION - I-EXPLORATION -- I-EXPLORATION -Ecocardiograma I-EXPLORATION +tratamiento I-EXPLORATION +antihipertensivo I-EXPLORATION y I-EXPLORATION -electrocardiograma: I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION +la I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +final I-EXPLORATION +fue I-EXPLORATION +menor I-EXPLORATION +de I-EXPLORATION +20/200 I-EXPLORATION +(visión I-EXPLORATION +de I-EXPLORATION +bultos). I-EXPLORATION +En B-EVOLUTION +la I-EVOLUTION +actualidad I-EVOLUTION +las I-EVOLUTION +lesiones I-EVOLUTION +coroideas I-EVOLUTION +y I-EVOLUTION +orbitarias I-EVOLUTION +siguen I-EVOLUTION +estables, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +no I-EVOLUTION +precisan I-EVOLUTION +tratamiento. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -13 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -viene I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -revisión I-PRESENT_ILLNESS -odontológica. I-PRESENT_ILLNESS -A B-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -tuvo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -acudir I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -exfoliarse I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -segundo I-PAST_MEDICAL_HISTORY -molar I-PAST_MEDICAL_HISTORY -temporal I-PAST_MEDICAL_HISTORY -izquierdo. I-PAST_MEDICAL_HISTORY -Le I-PAST_MEDICAL_HISTORY -realizaron I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -ortopantomografía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -observaron I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -agenesia I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -segundo I-PAST_MEDICAL_HISTORY -premolar I-PAST_MEDICAL_HISTORY -inferior I-PAST_MEDICAL_HISTORY -izquierdo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -mesiodens I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -arcada I-PAST_MEDICAL_HISTORY -superior. I-PAST_MEDICAL_HISTORY -Le I-PAST_MEDICAL_HISTORY -recomendaron I-PAST_MEDICAL_HISTORY -realizarse I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -periódicos. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -exploración I-PAST_MEDICAL_HISTORY -bucodental I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -13 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -observa I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -persistencia I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -molar I-PAST_MEDICAL_HISTORY -temporal. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -sector I-PAST_MEDICAL_HISTORY -anterior I-PAST_MEDICAL_HISTORY -está I-PAST_MEDICAL_HISTORY -erupcionado I-PAST_MEDICAL_HISTORY -correctamente. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -mesiodens I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -provocado I-PAST_MEDICAL_HISTORY -ninguna I-PAST_MEDICAL_HISTORY -anomalía I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -posición I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -incisivos I-PAST_MEDICAL_HISTORY -superiores. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -ortopantomografía I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -aprecia I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -mesiodens I-PAST_MEDICAL_HISTORY -incluido I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -ligera I-PAST_MEDICAL_HISTORY -distoversión, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cúspide I-PAST_MEDICAL_HISTORY -localizada I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -raíces I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -incisivo I-PAST_MEDICAL_HISTORY -central I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -incisivo I-PAST_MEDICAL_HISTORY -lateral I-PAST_MEDICAL_HISTORY -superior I-PAST_MEDICAL_HISTORY -izquierdo, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -1/3 I-PAST_MEDICAL_HISTORY -medio I-PAST_MEDICAL_HISTORY -radicular, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -ápice I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -línea I-PAST_MEDICAL_HISTORY -media. I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -16 I-PRESENT_ILLNESS +78 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -caries I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -molar I-PRESENT_ILLNESS -temporal. I-PRESENT_ILLNESS -Solicitamos B-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION +que B-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +hospital I-DERIVED_FROM/TO +cuando I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +le I-DERIVED_FROM/TO +detectó I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +bloqueo I-DERIVED_FROM/TO +auriculoventricular I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +tercer I-DERIVED_FROM/TO +grado I-DERIVED_FROM/TO +durante I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +examen I-DERIVED_FROM/TO +rutinario. I-DERIVED_FROM/TO +La B-TREATMENT +paciente I-TREATMENT +quedó I-TREATMENT +ingresada I-TREATMENT +y I-TREATMENT +se I-TREATMENT +implantó I-TREATMENT +un I-TREATMENT +marcapasos I-TREATMENT +temporal I-TREATMENT +endovenoso I-TREATMENT +7F I-TREATMENT +(electrodos I-TREATMENT +de I-TREATMENT +platino) I-TREATMENT +en I-TREATMENT +el I-TREATMENT +ventrículo I-TREATMENT +derecho I-TREATMENT +a I-TREATMENT +través I-TREATMENT +de I-TREATMENT +la I-TREATMENT +vena I-TREATMENT +yugular I-TREATMENT +interna I-TREATMENT +derecha. I-TREATMENT +Fue I-TREATMENT +necesario I-TREATMENT +recolocarlo I-TREATMENT +en I-TREATMENT +cinco I-TREATMENT +ocasiones I-TREATMENT +durante I-TREATMENT +las I-TREATMENT +primeras I-TREATMENT +24 I-TREATMENT +horas I-TREATMENT +debido I-TREATMENT +a I-TREATMENT +un I-TREATMENT +insuficiente I-TREATMENT +sensado I-TREATMENT +auricular. I-TREATMENT +El I-TREATMENT +tercer I-TREATMENT +día I-TREATMENT +de I-TREATMENT +ingreso I-TREATMENT +se I-TREATMENT +colocó I-TREATMENT +un I-TREATMENT +marcapasos I-TREATMENT +permanente I-TREATMENT +VDD I-TREATMENT +a I-TREATMENT +través I-TREATMENT +de I-TREATMENT +la I-TREATMENT +vía I-TREATMENT +subclavia I-TREATMENT +izquierda I-TREATMENT +sin I-TREATMENT +incidencias. I-TREATMENT +Al B-EVOLUTION +día I-EVOLUTION +siguiente I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +tuvo I-EVOLUTION +febrícula I-EVOLUTION +y B-TREATMENT +fue I-TREATMENT +tratada I-TREATMENT +ambulatoriamente I-TREATMENT +con I-TREATMENT +cloxacilina. I-TREATMENT +Los B-EXPLORATION +hemocultivos I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Diez B-EVOLUTION +días I-EVOLUTION +mas I-EVOLUTION +tarde, I-EVOLUTION +ingresó I-EVOLUTION +de I-EVOLUTION +nuevo I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +hospital I-EVOLUTION +debido I-EVOLUTION +a I-EVOLUTION +febrícula I-EVOLUTION +intermitente, I-EVOLUTION +disnea, I-EVOLUTION +tos I-EVOLUTION +no I-EVOLUTION +productiva I-EVOLUTION +y I-EVOLUTION +dolor I-EVOLUTION +pleurítico I-EVOLUTION +en I-EVOLUTION +hemitórax I-EVOLUTION +derecho. I-EVOLUTION +La B-EXPLORATION +herida I-EXPLORATION +quirúrgica I-EXPLORATION +estaba I-EXPLORATION +limpia I-EXPLORATION +e I-EXPLORATION +indolora. I-EXPLORATION +La I-EXPLORATION radiografía I-EXPLORATION -para I-EXPLORATION -valorar I-EXPLORATION -si I-EXPLORATION -se I-EXPLORATION -puede I-EXPLORATION -obturar I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +reveló I-EXPLORATION +cardiomegalia I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +derrame I-EXPLORATION +pleural I-EXPLORATION +derecho. I-EXPLORATION +El I-EXPLORATION +ECG I-EXPLORATION +mostraba I-EXPLORATION +un I-EXPLORATION +bloqueo I-EXPLORATION +auriculoventricular I-EXPLORATION +de I-EXPLORATION +tercer I-EXPLORATION +grado I-EXPLORATION +con I-EXPLORATION +ritmo I-EXPLORATION +de I-EXPLORATION +escape I-EXPLORATION +de I-EXPLORATION +marcapasos. I-EXPLORATION +No B-TREATMENT +había I-TREATMENT +sensado I-TREATMENT +de I-TREATMENT +la I-TREATMENT +onda I-TREATMENT +P, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +aumentó I-TREATMENT +la I-TREATMENT +sensibilidad I-TREATMENT +del I-TREATMENT +electrodo I-TREATMENT +auricular I-TREATMENT +y I-TREATMENT +el I-TREATMENT +dispositivo I-TREATMENT +funcionó I-TREATMENT +adecuadamente. I-TREATMENT +Al B-EVOLUTION +día I-EVOLUTION +siguiente I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +tenía I-EVOLUTION +mayor I-EVOLUTION +disnea, I-EVOLUTION +ingurgitación I-EVOLUTION +yugular I-EVOLUTION +y I-EVOLUTION +edemas I-EVOLUTION +en I-EVOLUTION +miembros I-EVOLUTION +inferiores. I-EVOLUTION +Se B-EXPLORATION +auscultó I-EXPLORATION +por I-EXPLORATION +primera I-EXPLORATION +vez I-EXPLORATION +un I-EXPLORATION +fuerte I-EXPLORATION +roce I-EXPLORATION +pericárdico I-EXPLORATION +sobre I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +precordial. I-EXPLORATION +En I-EXPLORATION el I-EXPLORATION -molar, I-EXPLORATION -controlar I-EXPLORATION +ecocardiograma I-EXPLORATION +se I-EXPLORATION +vio I-EXPLORATION +un I-EXPLORATION +derrame I-EXPLORATION +pericárdico I-EXPLORATION +de I-EXPLORATION +5 I-EXPLORATION +mm I-EXPLORATION +sin I-EXPLORATION +colapso I-EXPLORATION +ventricular I-EXPLORATION +derecho. I-EXPLORATION +El I-EXPLORATION +cable I-EXPLORATION +del I-EXPLORATION +electrodo I-EXPLORATION +estaba I-EXPLORATION +dentro I-EXPLORATION +del I-EXPLORATION +tracto I-EXPLORATION +de I-EXPLORATION +salida I-EXPLORATION +del I-EXPLORATION +ventrículo I-EXPLORATION +derecho. I-EXPLORATION +La I-EXPLORATION +proteína I-EXPLORATION +C-reactiva I-EXPLORATION +era I-EXPLORATION +de I-EXPLORATION +153 I-EXPLORATION +mg/dl, I-EXPLORATION el I-EXPLORATION -supernumerario I-EXPLORATION +fibrinógeno I-EXPLORATION +de I-EXPLORATION +659 I-EXPLORATION +mg/dl I-EXPLORATION y I-EXPLORATION -valorar I-EXPLORATION -los I-EXPLORATION -cordales. I-EXPLORATION -En I-EXPLORATION la I-EXPLORATION -ortopantomografía I-EXPLORATION -observamos I-EXPLORATION -el I-EXPLORATION -mesiodens I-EXPLORATION +VSG I-EXPLORATION +de I-EXPLORATION +57 I-EXPLORATION +mm I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -línea I-EXPLORATION -media, I-EXPLORATION -ligeramente I-EXPLORATION -más I-EXPLORATION -verticalizado, I-EXPLORATION -pero I-EXPLORATION -sin I-EXPLORATION -cambios I-EXPLORATION -significativos I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -posición I-EXPLORATION -respecto I-EXPLORATION +primera I-EXPLORATION +hora. I-EXPLORATION +Los I-EXPLORATION +anticuerpos I-EXPLORATION +antinucleares, I-EXPLORATION +anticuerpos I-EXPLORATION +antimúsculo I-EXPLORATION +cardiaco, I-EXPLORATION +complemento I-EXPLORATION +y I-EXPLORATION +factor I-EXPLORATION +reumatoide I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Los I-EXPLORATION +anticuerpos I-EXPLORATION +frente I-EXPLORATION +Coxsackie I-EXPLORATION +B1 I-EXPLORATION a I-EXPLORATION -las I-EXPLORATION -radiografías I-EXPLORATION -anteriores. I-EXPLORATION -Decidimos B-TREATMENT -seguir I-TREATMENT -realizando I-TREATMENT -controles I-TREATMENT -periódicos I-TREATMENT -del I-TREATMENT -supernumerario I-TREATMENT +B6 I-EXPLORATION +y I-EXPLORATION +Echovirus I-EXPLORATION +fueron I-EXPLORATION +también I-EXPLORATION +negativos. I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +tratada I-TREATMENT +con I-TREATMENT +diuréticos I-TREATMENT +y I-TREATMENT +prednisona I-TREATMENT +(30 I-TREATMENT +mg/día). I-TREATMENT +Su B-EVOLUTION +estado I-EVOLUTION +mejoró I-EVOLUTION +rápidamente. I-EVOLUTION +Dos I-EVOLUTION +semanas I-EVOLUTION +después, I-EVOLUTION +el I-EVOLUTION +roce I-EVOLUTION +pericárdico I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +derrame I-EVOLUTION +pleural I-EVOLUTION +habían I-EVOLUTION +desaparecido I-EVOLUTION +y I-EVOLUTION +los I-EVOLUTION +marcadores I-EVOLUTION +inflamatorios I-EVOLUTION +se I-EVOLUTION +habían I-EVOLUTION +normalizado. I-EVOLUTION +La B-TREATMENT +dosis I-TREATMENT +de I-TREATMENT +prednisona I-TREATMENT +fue I-TREATMENT +reduciéndose I-TREATMENT +gradualmente I-TREATMENT +a I-TREATMENT +los I-TREATMENT +dos I-TREATMENT +meses I-TREATMENT +hasta I-TREATMENT +suspender, I-TREATMENT +con I-TREATMENT +recurrencia I-TREATMENT +de I-TREATMENT +los I-TREATMENT +síntomas I-TREATMENT +(dolor I-TREATMENT +torácico I-TREATMENT +pleurítico I-TREATMENT y I-TREATMENT -lo B-DERIVED_FROM/TO -remitimos I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -cirugía I-DERIVED_FROM/TO -maxilofacial I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -exodoncia I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -cordales I-DERIVED_FROM/TO -inferiores I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -presentar I-DERIVED_FROM/TO -falta I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -espacio I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -erupción. I-DERIVED_FROM/TO -Recomendamos B-TREATMENT -la I-TREATMENT -obturación I-TREATMENT -del I-TREATMENT -molar I-TREATMENT -temporal. I-TREATMENT +elevación I-TREATMENT +de I-TREATMENT +los I-TREATMENT +marcadores I-TREATMENT +de I-TREATMENT +inflamación) I-TREATMENT +dos I-TREATMENT +meses I-TREATMENT +después. I-TREATMENT +Se I-TREATMENT +trató I-TREATMENT +con I-TREATMENT +un I-TREATMENT +nuevo I-TREATMENT +curso I-TREATMENT +de I-TREATMENT +prednisona I-TREATMENT +sin I-TREATMENT +recurrencias I-TREATMENT +posteriores. I-TREATMENT I-TREATMENT -Un B-PRESENT_ILLNESS -niño I-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -pediatra I-PRESENT_ILLNESS +18 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Atención I-PRESENT_ILLNESS -Primaria I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general, I-PRESENT_ILLNESS -febrícula, I-PRESENT_ILLNESS -hiporexia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -blandas I-PRESENT_ILLNESS -frecuentes. I-PRESENT_ILLNESS -Fue B-EXPLORATION -diagnosticado I-EXPLORATION -de I-EXPLORATION -gastroenteritis I-EXPLORATION -aguda. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -auscultación I-EXPLORATION -cardíaca, I-EXPLORATION -además I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -tonos I-EXPLORATION -rítmicos I-EXPLORATION -sin I-EXPLORATION -soplos I-EXPLORATION -ni I-EXPLORATION -anomalías I-EXPLORATION +edad, I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +cual I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +desplomó I-PRESENT_ILLNESS +súbitamente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +vía I-PRESENT_ILLNESS +pública. I-PRESENT_ILLNESS +En B-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +clínicos I-PAST_MEDICAL_HISTORY +constaba I-PAST_MEDICAL_HISTORY +estar I-PAST_MEDICAL_HISTORY +diagnosticado I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +Síndrome I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Noonan I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +infancia I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +desarrollo I-PAST_MEDICAL_HISTORY +psicomotor I-PAST_MEDICAL_HISTORY +normal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +controles I-PAST_MEDICAL_HISTORY +médicos I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +momento I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +óbito. I-PAST_MEDICAL_HISTORY +En B-FAMILY_HISTORY +la I-FAMILY_HISTORY +familia I-FAMILY_HISTORY +no I-FAMILY_HISTORY +existían I-FAMILY_HISTORY +otros I-FAMILY_HISTORY +miembros I-FAMILY_HISTORY +que I-FAMILY_HISTORY +tuvieran I-FAMILY_HISTORY +un I-FAMILY_HISTORY +fenotipo I-FAMILY_HISTORY +similar. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Hallazgos B-EXPLORATION +destacados I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -segundo I-EXPLORATION -tono, I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION +examen I-EXPLORATION +externo: I-EXPLORATION +cadáver I-EXPLORATION +correspondiente I-EXPLORATION +a I-EXPLORATION un I-EXPLORATION -dato I-EXPLORATION -que I-EXPLORATION -llamó I-EXPLORATION -la I-EXPLORATION -atención. I-EXPLORATION -Se I-EXPLORATION -interrogó I-EXPLORATION -al I-EXPLORATION -niño I-EXPLORATION -sobre I-EXPLORATION -antecedentes I-EXPLORATION +varón I-EXPLORATION de I-EXPLORATION -precordalgias, I-EXPLORATION -presíncopes, I-EXPLORATION -síncopes, I-EXPLORATION -síntomas I-EXPLORATION -relacionados I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -ejercicio I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -la I-EXPLORATION -tolerancia I-EXPLORATION -a I-EXPLORATION -éste, I-EXPLORATION -palpitaciones I-EXPLORATION +175 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +altura I-EXPLORATION y I-EXPLORATION -sensación I-EXPLORATION +78 I-EXPLORATION +Kg I-EXPLORATION de I-EXPLORATION -disritmia I-EXPLORATION -cardíaca, I-EXPLORATION -sin I-EXPLORATION -respuestas I-EXPLORATION -sugerentes I-EXPLORATION +peso I-EXPLORATION +(IMC I-EXPLORATION +25, I-EXPLORATION +5 I-EXPLORATION +kg/m2) I-EXPLORATION +con I-EXPLORATION +diversas I-EXPLORATION +características I-EXPLORATION +anatómicas I-EXPLORATION +destacadas: I-EXPLORATION +frente I-EXPLORATION +amplia, I-EXPLORATION +mentón I-EXPLORATION +prominente, I-EXPLORATION +pabellones I-EXPLORATION +auriculares I-EXPLORATION de I-EXPLORATION -patología. I-EXPLORATION -Tras I-EXPLORATION -realizar I-EXPLORATION -un I-EXPLORATION -electrocardiograma I-EXPLORATION -(ECG) I-EXPLORATION +inserción I-EXPLORATION +baja I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION +con I-EXPLORATION +lóbulos I-EXPLORATION de I-EXPLORATION -tórax, I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -vez I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -pediatra I-EXPLORATION -confirma I-EXPLORATION -su I-EXPLORATION -sospecha, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -es I-EXPLORATION -remitido I-EXPLORATION -a I-EXPLORATION -cardiología I-EXPLORATION -infantil I-EXPLORATION -para I-EXPLORATION -completar I-EXPLORATION -el I-EXPLORATION -estudio. I-EXPLORATION - I-EXPLORATION -¿Cuál I-EXPLORATION -es I-EXPLORATION -la I-EXPLORATION -interpretación I-EXPLORATION +las I-EXPLORATION +orejas I-EXPLORATION +hacia I-EXPLORATION +delante, I-EXPLORATION +ojos I-EXPLORATION +con I-EXPLORATION +hendiduras I-EXPLORATION +palpebrales I-EXPLORATION +hacia I-EXPLORATION +abajo, I-EXPLORATION +puente I-EXPLORATION +nasal I-EXPLORATION +grueso, I-EXPLORATION +cuello I-EXPLORATION +corto, I-EXPLORATION +deformidad I-EXPLORATION +esternal I-EXPLORATION +con I-EXPLORATION +pectus I-EXPLORATION +carinatum I-EXPLORATION +(tórax I-EXPLORATION +en I-EXPLORATION +quilla) I-EXPLORATION +prominencia I-EXPLORATION del I-EXPLORATION -ECG?, I-EXPLORATION -¿y I-EXPLORATION -el I-EXPLORATION -hallazgo I-EXPLORATION -auscultatorio I-EXPLORATION -que I-EXPLORATION -llamó I-EXPLORATION -la I-EXPLORATION -atención I-EXPLORATION -al I-EXPLORATION -pediatra?, I-EXPLORATION -¿y I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -diagnóstica? I-EXPLORATION -Es I-EXPLORATION -necesario I-EXPLORATION -revisar I-EXPLORATION -el I-EXPLORATION -ECG I-EXPLORATION -antes I-EXPLORATION -de I-EXPLORATION -seguir I-EXPLORATION -leyendo. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -ECG I-EXPLORATION -muestra, I-EXPLORATION -siguiendo I-EXPLORATION -la I-EXPLORATION -lectura I-EXPLORATION -sistemática, I-EXPLORATION -un I-EXPLORATION -ritmo I-EXPLORATION -auricular I-EXPLORATION -ectópico I-EXPLORATION -procedente I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -parte I-EXPLORATION -superior I-EXPLORATION +pubis I-EXPLORATION +y I-EXPLORATION +primer I-EXPLORATION +dedo I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -aurícula I-EXPLORATION -izquierda I-EXPLORATION -(onda I-EXPLORATION -P I-EXPLORATION -negativa I-EXPLORATION +ambos I-EXPLORATION +pies I-EXPLORATION en I-EXPLORATION -I, I-EXPLORATION -positiva I-EXPLORATION +garra. I-EXPLORATION + I-EXPLORATION +Hallazgos I-EXPLORATION +destacados I-EXPLORATION en I-EXPLORATION -aVF). I-EXPLORATION -Sin I-EXPLORATION -embargo, I-EXPLORATION -observamos I-EXPLORATION -un I-EXPLORATION -eje I-EXPLORATION -anómalo I-EXPLORATION -(derecho) I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +interno: I-EXPLORATION +corazón I-EXPLORATION de I-EXPLORATION -QRS I-EXPLORATION +395 I-EXPLORATION +g I-EXPLORATION +de I-EXPLORATION +peso I-EXPLORATION +(valor I-EXPLORATION +medio I-EXPLORATION +según I-EXPLORATION +peso I-EXPLORATION +corporal: I-EXPLORATION +345 I-EXPLORATION +g I-EXPLORATION +[rango I-EXPLORATION +261-455 I-EXPLORATION +g]). I-EXPLORATION +Grosor I-EXPLORATION +pared I-EXPLORATION +ventrículo I-EXPLORATION +izquierdo: I-EXPLORATION +1, I-EXPLORATION +1cm, I-EXPLORATION +tabique I-EXPLORATION +interventricular: I-EXPLORATION +1, I-EXPLORATION +1 I-EXPLORATION +cm I-EXPLORATION y I-EXPLORATION -T I-EXPLORATION -(aproximadamente I-EXPLORATION -180o I-EXPLORATION -en I-EXPLORATION -ambos), I-EXPLORATION -pues I-EXPLORATION -tanto I-EXPLORATION -los I-EXPLORATION -complejos I-EXPLORATION -QRS I-EXPLORATION -como I-EXPLORATION -las I-EXPLORATION -ondas I-EXPLORATION -T I-EXPLORATION -son I-EXPLORATION -negativas I-EXPLORATION -donde I-EXPLORATION -habitualmente I-EXPLORATION -son I-EXPLORATION -positivas I-EXPLORATION -(I, I-EXPLORATION -II, I-EXPLORATION -aVL, I-EXPLORATION -aVF), I-EXPLORATION +ventrículo I-EXPLORATION +derecho: I-EXPLORATION +0, I-EXPLORATION +1 I-EXPLORATION +cm. I-EXPLORATION +Agujero I-EXPLORATION +oval I-EXPLORATION +no I-EXPLORATION +permeable. I-EXPLORATION +Válvulas I-EXPLORATION +aurículo-ventriculares I-EXPLORATION y I-EXPLORATION -viceversa. I-EXPLORATION - I-EXPLORATION -Estos I-EXPLORATION -hallazgos I-EXPLORATION -electrocardiográficos I-EXPLORATION -sólo I-EXPLORATION -pueden I-EXPLORATION -deberse I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -incorrecta I-EXPLORATION -colocación I-EXPLORATION +pulmonar I-EXPLORATION +normales. I-EXPLORATION +Válvula I-EXPLORATION +aórtica I-EXPLORATION +bicúspide. I-EXPLORATION +Severa I-EXPLORATION +dilatación I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -totalidad I-EXPLORATION +raíz I-EXPLORATION +aórtica I-EXPLORATION +con I-EXPLORATION +disección I-EXPLORATION +circular I-EXPLORATION +completa I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -electrodos I-EXPLORATION -(en I-EXPLORATION -el I-EXPLORATION -hemitórax I-EXPLORATION -equivocado) I-EXPLORATION -o I-EXPLORATION +la I-EXPLORATION +íntima I-EXPLORATION +arterial I-EXPLORATION a I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -dextrocardia I-EXPLORATION -(ubicación I-EXPLORATION +altura I-EXPLORATION del I-EXPLORATION -corazón I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hemitórax I-EXPLORATION -derecho). I-EXPLORATION -El I-EXPLORATION -dato I-EXPLORATION -auscultatorio I-EXPLORATION -fue I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -tonos I-EXPLORATION -cardíacos I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hemitórax I-EXPLORATION -derecho; I-EXPLORATION -asimismo, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -dextrocardia, I-EXPLORATION -hígado I-EXPLORATION -situado I-EXPLORATION -en I-EXPLORATION -hemiabdomen I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -burbuja I-EXPLORATION -gástrica I-EXPLORATION -en I-EXPLORATION -hemiabdomen I-EXPLORATION -derecho. I-EXPLORATION -Con B-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -confirmación I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -situs I-DERIVED_FROM/TO -inversus I-DERIVED_FROM/TO -totalis, I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -niño I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -cardiología I-DERIVED_FROM/TO -infantil I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -descartar I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -presencia I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -cardiopatía I-DERIVED_FROM/TO -congénita. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO - -Niño B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ocho I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -procedente B-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -África I-PAST_MEDICAL_HISTORY -subsahariana, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -estudio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hematuria I-PRESENT_ILLNESS -macroscópica I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -final I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -micción I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -proteinuria I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Lleva B-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -viviendo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -nuestra I-PAST_MEDICAL_HISTORY -comunidad. I-PAST_MEDICAL_HISTORY -Refiere I-PAST_MEDICAL_HISTORY -baños I-PAST_MEDICAL_HISTORY -anteriores I-PAST_MEDICAL_HISTORY -frecuentes I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -río. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -tiene I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -ni B-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -a I-FAMILY_HISTORY -destacar. I-FAMILY_HISTORY -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -análisis I-EXPLORATION +anillo I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -muestran I-EXPLORATION -un I-EXPLORATION -hemograma I-EXPLORATION -con I-EXPLORATION -anemia I-EXPLORATION -microcítica, I-EXPLORATION -con I-EXPLORATION -Hb I-EXPLORATION -10, I-EXPLORATION -9 I-EXPLORATION -g/dL, I-EXPLORATION -Hto I-EXPLORATION -32, I-EXPLORATION -8%, I-EXPLORATION -VCM I-EXPLORATION -74, I-EXPLORATION -9 I-EXPLORATION -fL I-EXPLORATION -y I-EXPLORATION -eosinofilia I-EXPLORATION +inserción I-EXPLORATION +valvular I-EXPLORATION con I-EXPLORATION -767 I-EXPLORATION -eosinófilos/µL; I-EXPLORATION -VSG I-EXPLORATION -40 I-EXPLORATION -mm/h. I-EXPLORATION -La I-EXPLORATION -bioquímica I-EXPLORATION -muestra I-EXPLORATION -urea I-EXPLORATION -y I-EXPLORATION -creatinina I-EXPLORATION +desprendimiento I-EXPLORATION +completo I-EXPLORATION e I-EXPLORATION -iones I-EXPLORATION -normales. I-EXPLORATION -Estudio I-EXPLORATION -inmunológico I-EXPLORATION -con I-EXPLORATION -niveles I-EXPLORATION +intususpección I-EXPLORATION de I-EXPLORATION -inmunoglobulinas I-EXPLORATION -y I-EXPLORATION -complemento I-EXPLORATION -dentro I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +longitud I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -normalidad. I-EXPLORATION -El I-EXPLORATION -sistemático I-EXPLORATION +capa I-EXPLORATION +interna I-EXPLORATION +disecada I-EXPLORATION +hasta I-EXPLORATION +un I-EXPLORATION +área I-EXPLORATION de I-EXPLORATION -orina I-EXPLORATION -muestra I-EXPLORATION -hematuria I-EXPLORATION -microscópica I-EXPLORATION +menor I-EXPLORATION +calibre I-EXPLORATION +del I-EXPLORATION +cayado I-EXPLORATION +aórtico, I-EXPLORATION +extendiéndose I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +subclavia I-EXPLORATION +izquierda I-EXPLORATION y I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -cristales I-EXPLORATION -de I-EXPLORATION -oxalato I-EXPLORATION -cálcico. I-EXPLORATION +el I-EXPLORATION +tronco I-EXPLORATION +braquiocefálico, I-EXPLORATION +y I-EXPLORATION +obstruyendo I-EXPLORATION +completamente I-EXPLORATION +las I-EXPLORATION +tres I-EXPLORATION +luces I-EXPLORATION +vasculares. I-EXPLORATION I-EXPLORATION -La I-EXPLORATION -ecografía I-EXPLORATION -abdominal I-EXPLORATION -fue I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -hidronefrosis I-EXPLORATION -grado I-EXPLORATION -II I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +microscópico I-EXPLORATION +ofreció I-EXPLORATION +los I-EXPLORATION +siguientes I-EXPLORATION +datos I-EXPLORATION de I-EXPLORATION -pelvis I-EXPLORATION -renal I-EXPLORATION -izquierda. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -investigación I-EXPLORATION +interés: I-EXPLORATION +signos I-EXPLORATION +moderados I-EXPLORATION de I-EXPLORATION -Schistosoma I-EXPLORATION -sp. I-EXPLORATION +hipertrofia I-EXPLORATION +miocitaria I-EXPLORATION en I-EXPLORATION -orina I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -visualizándose I-EXPLORATION -huevos I-EXPLORATION -de I-EXPLORATION -S. I-EXPLORATION -haematobium. I-EXPLORATION -El I-EXPLORATION -coprocultivo I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION -Las I-EXPLORATION -serologías I-EXPLORATION -para I-EXPLORATION -Plasmodium I-EXPLORATION -falciparum, I-EXPLORATION -Entamoeba I-EXPLORATION -histolytica, I-EXPLORATION -Schistosoma I-EXPLORATION -sp., I-EXPLORATION +miocardio I-EXPLORATION +ventricular I-EXPLORATION +izquierdo I-EXPLORATION +con I-EXPLORATION +patrón I-EXPLORATION +desorganizativo I-EXPLORATION +focal I-EXPLORATION +en I-EXPLORATION +tabique I-EXPLORATION +interventricular. I-EXPLORATION +Infiltración I-EXPLORATION +adiposa I-EXPLORATION +miocárdica I-EXPLORATION +ventricular I-EXPLORATION +derecha I-EXPLORATION +anterior I-EXPLORATION y I-EXPLORATION -virus I-EXPLORATION +posterior I-EXPLORATION +con I-EXPLORATION +fibrosis I-EXPLORATION +intersticial I-EXPLORATION +sin I-EXPLORATION +reacción I-EXPLORATION +inflamatoria I-EXPLORATION +crónica. I-EXPLORATION +Necrosis I-EXPLORATION +quística I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -hepatitis I-EXPLORATION -A, I-EXPLORATION -B I-EXPLORATION +la I-EXPLORATION +media I-EXPLORATION +arterial I-EXPLORATION +aórtica. I-EXPLORATION +Arterioloesclerosis I-EXPLORATION +renal I-EXPLORATION +con I-EXPLORATION +microlitiasis I-EXPLORATION y I-EXPLORATION -C I-EXPLORATION -fueron I-EXPLORATION -negativas. I-EXPLORATION +esteatosis I-EXPLORATION +hepática I-EXPLORATION +en I-EXPLORATION +grado I-EXPLORATION +leve. I-EXPLORATION I-EXPLORATION -El B-TREATMENT -tratamiento I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -mediante I-TREATMENT -dos I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -praziquantel I-TREATMENT -a I-TREATMENT -20 I-TREATMENT -mg/kg/dosis I-TREATMENT -separadas I-TREATMENT -por I-TREATMENT -12 I-TREATMENT -horas. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -acudió I-EVOLUTION -a I-EVOLUTION -posteriores I-EVOLUTION -revisiones. I-EVOLUTION - I-EVOLUTION -Niña B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -22 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -de B-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -chino, I-PAST_MEDICAL_HISTORY +36 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +colecistectomía I-PAST_MEDICAL_HISTORY +abierta I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS Urgencias I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -presentado I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -minutos I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS un I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -movimientos I-PRESENT_ILLNESS -tónico-clónicos I-PRESENT_ILLNESS -generalizados, I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -conciencia I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -incontinencia I-PRESENT_ILLNESS -esfinteriana I-PRESENT_ILLNESS +3 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -minutos I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -duración I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -cedió I-PRESENT_ILLNESS -espontáneamente. I-PRESENT_ILLNESS -Desde I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -previas I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -líquidas I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +cólico I-PRESENT_ILLNESS +intermitente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +epigastrio I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +hipocondrio I-PRESENT_ILLNESS +derecho, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -vómitos. I-PRESENT_ILLNESS -Estaba I-PRESENT_ILLNESS -afebril. I-PRESENT_ILLNESS -Antecedentes B-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -y B-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-EXPLORATION +vómitos I-PRESENT_ILLNESS +biliosos, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +cual I-PRESENT_ILLNESS +ha I-PRESENT_ILLNESS +consultado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +diversas I-PRESENT_ILLNESS +ocasiones I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +médico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +atención I-PRESENT_ILLNESS +primaria I-PRESENT_ILLNESS +realizándose I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +sintomático I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +omeprazol. I-PRESENT_ILLNESS +A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -física I-EXPLORATION -únicamente I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION +física, I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +afebril, I-EXPLORATION +hemodinámicamente I-EXPLORATION +estable I-EXPLORATION +con I-EXPLORATION leve I-EXPLORATION -sequedad I-EXPLORATION +dolor I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +profunda I-EXPLORATION +en I-EXPLORATION +hipocondrio I-EXPLORATION +derecho, I-EXPLORATION +sin I-EXPLORATION +datos I-EXPLORATION de I-EXPLORATION -mucosas. I-EXPLORATION +irritación I-EXPLORATION +peritoneal. I-EXPLORATION +La I-EXPLORATION +analítica I-EXPLORATION +no I-EXPLORATION +mostraba I-EXPLORATION +alteraciones. I-EXPLORATION Se I-EXPLORATION -le I-EXPLORATION realizó I-EXPLORATION -hemograma, I-EXPLORATION -bioquímica I-EXPLORATION -y I-EXPLORATION -gasometría I-EXPLORATION -venosa, I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -las I-EVOLUTION -siguientes I-EVOLUTION -ocho I-EVOLUTION -horas, I-EVOLUTION -presenta I-EVOLUTION -tres I-EVOLUTION -nuevas I-EVOLUTION -crisis I-EVOLUTION -de I-EVOLUTION -similares I-EVOLUTION -características I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -inicial, I-EVOLUTION -que B-TREATMENT -ceden I-TREATMENT -con I-TREATMENT -diazepam I-TREATMENT -intravenoso I-TREATMENT -(IV) I-TREATMENT -y/o I-TREATMENT -ácido I-TREATMENT -valproico I-TREATMENT -IV I-TREATMENT -en I-TREATMENT -cinco I-TREATMENT -minutos. I-TREATMENT -Se B-EXPLORATION -realizaron I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +y, I-EXPLORATION +posteriormente, I-EXPLORATION una I-EXPLORATION tomografía I-EXPLORATION -computarizada I-EXPLORATION +computerizada I-EXPLORATION +(TC) I-EXPLORATION +abdominal I-EXPLORATION +que I-EXPLORATION +revelaba I-EXPLORATION +una I-EXPLORATION +dilatación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +hepática I-EXPLORATION +propia I-EXPLORATION +próxima I-EXPLORATION +a I-EXPLORATION +su I-EXPLORATION +bifurcación I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +pseudoaneurisma, I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +luz I-EXPLORATION +de I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION y I-EXPLORATION un I-EXPLORATION -electroencefalograma, I-EXPLORATION +componente I-EXPLORATION +mural I-EXPLORATION +trombosado I-EXPLORATION +de I-EXPLORATION +4, I-EXPLORATION +4 I-EXPLORATION +cm I-EXPLORATION que I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -Permaneció B-EVOLUTION -hospitalizada I-EVOLUTION +condicionaba I-EXPLORATION +una I-EXPLORATION +compresión I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +con I-EXPLORATION +dilatación I-EXPLORATION +secundaria. I-EXPLORATION +Al I-EXPLORATION +día I-EXPLORATION +siguiente I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +por I-EXPLORATION +vía I-EXPLORATION +femoral I-EXPLORATION +derecha I-EXPLORATION +una I-EXPLORATION +arteriografía I-EXPLORATION +selectiva I-EXPLORATION +del I-EXPLORATION +tronco I-EXPLORATION +celiaco, I-EXPLORATION +arteria I-EXPLORATION +hepática I-EXPLORATION +común I-EXPLORATION +y I-EXPLORATION +mesentérica I-EXPLORATION +superior I-EXPLORATION +objetivando I-EXPLORATION +un I-EXPLORATION +aneurisma I-EXPLORATION +sacular I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +bifurcación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +hepática I-EXPLORATION +propia, I-EXPLORATION +con I-EXPLORATION +vascularización I-EXPLORATION +distal I-EXPLORATION +intrahepática I-EXPLORATION +normal I-EXPLORATION +y I-EXPLORATION +relleno I-EXPLORATION +retrógrado I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arcada I-EXPLORATION +pancreatoduodenal. I-EXPLORATION +Se B-TREATMENT +decidió I-TREATMENT +la I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +una I-TREATMENT +prótesis I-TREATMENT +metálica I-TREATMENT +autoexpandible I-TREATMENT +y I-TREATMENT +embolización I-TREATMENT +del I-TREATMENT +pseudoaneurisma I-TREATMENT +mediante I-TREATMENT +coils I-TREATMENT +con I-TREATMENT +una I-TREATMENT +oclusión I-TREATMENT +efectiva I-TREATMENT +y I-TREATMENT +sin I-TREATMENT +complicaciones I-TREATMENT +en I-TREATMENT +el I-TREATMENT +control. I-TREATMENT +Al B-EVOLUTION +tercer I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +estancia I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Reanimación, I-EVOLUTION +presentó I-EVOLUTION +un I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +dolor I-EVOLUTION +e I-EVOLUTION +hipotensión I-EVOLUTION +brusca I-EVOLUTION +secundaria I-EVOLUTION +a I-EVOLUTION +rotura I-EVOLUTION +del I-EVOLUTION +aneurisma I-EVOLUTION +hacia I-EVOLUTION +la I-EVOLUTION +cavidad I-EVOLUTION +peritoneal I-EVOLUTION +falleciendo I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION durante I-EVOLUTION -cuatro I-EVOLUTION -días I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -nuevas I-EVOLUTION -crisis. I-EVOLUTION -En B-EXPLORATION -el I-EXPLORATION -coprocultivo I-EXPLORATION -se I-EXPLORATION -aisló I-EXPLORATION -rotavirus. I-EXPLORATION -Su B-EVOLUTION -evolución I-EVOLUTION -posterior I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -favorable, I-EVOLUTION -sin I-EVOLUTION -crisis I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -desarrollo I-EVOLUTION -psicomotor I-EVOLUTION -normal. I-EVOLUTION +la I-EVOLUTION +intervención I-EVOLUTION +quirúrgica. I-EVOLUTION I-EVOLUTION -Lactante B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -47 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -pediatra I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -mucosidad I-PRESENT_ILLNESS -nasal I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +varón, I-PRESENT_ILLNESS +fruto I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -habiéndose I-PRESENT_ILLNESS -hecho I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -tos I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -persistente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS +primera I-PRESENT_ILLNESS +gestación I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -accesos I-PRESENT_ILLNESS -repetidos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -han I-PRESENT_ILLNESS -observado I-PRESENT_ILLNESS -cianosis I-PRESENT_ILLNESS -perioral I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ocasionalmente I-PRESENT_ILLNESS -terminan I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -vómito; I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -encuentra I-PRESENT_ILLNESS -afebril I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS una I-PRESENT_ILLNESS -reducción I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -ingesta I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -leche I-PRESENT_ILLNESS -materna. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION +33 I-PRESENT_ILLNESS +años. I-PRESENT_ILLNESS +El B-EXPLORATION +embarazo I-EXPLORATION +había I-EXPLORATION +transcurrido I-EXPLORATION +sin I-EXPLORATION +incidencias, I-EXPLORATION +con I-EXPLORATION +cribado I-EXPLORATION +del I-EXPLORATION +primer I-EXPLORATION +trimestre I-EXPLORATION +de I-EXPLORATION +bajo I-EXPLORATION +riesgo. I-EXPLORATION +Los I-EXPLORATION +estudios I-EXPLORATION +serológicos I-EXPLORATION +habituales I-EXPLORATION +estaban I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION +normalidad. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +antenatal I-EXPLORATION se I-EXPLORATION -objetiva I-EXPLORATION -un I-EXPLORATION +detecta I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +37 I-EXPLORATION +semanas I-EXPLORATION +de I-EXPLORATION +edad I-EXPLORATION +gestacional I-EXPLORATION +la I-EXPLORATION +dilatación I-EXPLORATION +del I-EXPLORATION +ventrículo I-EXPLORATION +lateral I-EXPLORATION +derecho, I-EXPLORATION +sin I-EXPLORATION +otras I-EXPLORATION +anomalías I-EXPLORATION +morfológicas I-EXPLORATION +a I-EXPLORATION +destacar. I-EXPLORATION + I-EXPLORATION +El B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +nació I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +39+3 I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +edad I-PAST_MEDICAL_HISTORY +gestacional, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +parto I-PAST_MEDICAL_HISTORY +vía I-PAST_MEDICAL_HISTORY +vaginal I-PAST_MEDICAL_HISTORY +instrumentado. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +presentación I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +cefálica I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +puntuación I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +test I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Apgar I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +9-9-10. I-PAST_MEDICAL_HISTORY +La B-EXPLORATION +exploración I-EXPLORATION +tras I-EXPLORATION +el I-EXPLORATION +parto I-EXPLORATION +mostraba I-EXPLORATION buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -con I-EXPLORATION -buena I-EXPLORATION -coloración I-EXPLORATION +tono I-EXPLORATION y I-EXPLORATION -perfusión I-EXPLORATION -periférica, I-EXPLORATION +vitalidad; I-EXPLORATION +fontanela I-EXPLORATION +anterior I-EXPLORATION +normotensa, I-EXPLORATION sin I-EXPLORATION -signos I-EXPLORATION +anomalías I-EXPLORATION +morfológicas I-EXPLORATION +a I-EXPLORATION +destacar I-EXPLORATION +ni I-EXPLORATION +disrafismos. I-EXPLORATION +Reflejos I-EXPLORATION +arcaicos I-EXPLORATION +presentes. I-EXPLORATION +Los I-EXPLORATION +estudios I-EXPLORATION +analíticos, I-EXPLORATION +serológicos, I-EXPLORATION +el I-EXPLORATION +cribado I-EXPLORATION de I-EXPLORATION -dificultad I-EXPLORATION -respiratoria I-EXPLORATION +metabolopatías I-EXPLORATION y I-EXPLORATION -auscultación I-EXPLORATION -cardiopulmonar I-EXPLORATION -normal; I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -dejar I-EXPLORATION +de I-EXPLORATION +sordera I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +Fondo I-EXPLORATION +de I-EXPLORATION +ojo I-EXPLORATION +normal I-EXPLORATION +El I-EXPLORATION +ecocardiograma I-EXPLORATION +demostró I-EXPLORATION +comunicación I-EXPLORATION +interauricular I-EXPLORATION +sin I-EXPLORATION +repercusión I-EXPLORATION +hemodinámica. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +ecografía I-EXPLORATION +transfontanelar I-EXPLORATION +demostró I-EXPLORATION +dilatación I-EXPLORATION +del I-EXPLORATION +ventrículo I-EXPLORATION +lateral I-EXPLORATION +derecho, I-EXPLORATION en I-EXPLORATION -observación, I-EXPLORATION -durante I-EXPLORATION +probable I-EXPLORATION +relación I-EXPLORATION +a I-EXPLORATION +obstrucción I-EXPLORATION +del I-EXPLORATION +foramen I-EXPLORATION +de I-EXPLORATION +Monro I-EXPLORATION +derecho. I-EXPLORATION +En I-EXPLORATION +este I-EXPLORATION +momento I-EXPLORATION +el I-EXPLORATION +índice I-EXPLORATION +de I-EXPLORATION +resistencia I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -cual I-EXPLORATION +arteria I-EXPLORATION +pericallosa I-EXPLORATION se I-EXPLORATION -objetiva I-EXPLORATION -uno I-EXPLORATION +situaba I-EXPLORATION +dentro I-EXPLORATION de I-EXPLORATION -estos I-EXPLORATION -episodios I-EXPLORATION +la I-EXPLORATION +normalidad, I-EXPLORATION +sin I-EXPLORATION +aumentar I-EXPLORATION +tras I-EXPLORATION +ejercer I-EXPLORATION +presión I-EXPLORATION en I-EXPLORATION -los I-EXPLORATION +la I-EXPLORATION +fontanela I-EXPLORATION +anterior. I-EXPLORATION +A I-EXPLORATION +la I-EXPLORATION +semana I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +nacimiento I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +resonancia I-EXPLORATION +magnética I-EXPLORATION +(RM) I-EXPLORATION +cerebral I-EXPLORATION que I-EXPLORATION -presenta I-EXPLORATION -un I-EXPLORATION -acceso I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION +dilatación I-EXPLORATION +ventricular I-EXPLORATION con I-EXPLORATION -varios I-EXPLORATION -golpes I-EXPLORATION +calibre I-EXPLORATION de I-EXPLORATION -tos I-EXPLORATION -durante I-EXPLORATION -la I-EXPLORATION -espiración I-EXPLORATION +8 I-EXPLORATION +mm I-EXPLORATION +del I-EXPLORATION +asta I-EXPLORATION +frontal, I-EXPLORATION +32 I-EXPLORATION +mm I-EXPLORATION +del I-EXPLORATION +asta I-EXPLORATION +occipital I-EXPLORATION y I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -inspiración I-EXPLORATION -ruidosa I-EXPLORATION -en I-EXPLORATION -forma I-EXPLORATION +14 I-EXPLORATION +mm I-EXPLORATION +del I-EXPLORATION +asta I-EXPLORATION +temporal. I-EXPLORATION +Se I-EXPLORATION +asociaba I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +desplazamiento I-EXPLORATION de I-EXPLORATION -gallo I-EXPLORATION -al I-EXPLORATION -finalizar I-EXPLORATION -el I-EXPLORATION -acceso, I-EXPLORATION -acompañado I-EXPLORATION +4 I-EXPLORATION +mm I-EXPLORATION de I-EXPLORATION -cianosis I-EXPLORATION -facial. I-EXPLORATION +la I-EXPLORATION +línea I-EXPLORATION +media, I-EXPLORATION +sin I-EXPLORATION +observarse I-EXPLORATION +masas I-EXPLORATION +ni I-EXPLORATION +tabiques I-EXPLORATION +intraventriculares. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +del I-EXPLORATION +sistema I-EXPLORATION +ventricular I-EXPLORATION +era I-EXPLORATION +normal. I-EXPLORATION I-EXPLORATION -Se B-TREATMENT +Por I-EXPLORATION +la I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +datos I-EXPLORATION +de I-EXPLORATION +hipertensión I-EXPLORATION +intracraneal I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +edad I-EXPLORATION +del I-EXPLORATION +paciente I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION +seguimiento I-EXPLORATION +inicial I-EXPLORATION +clínico I-EXPLORATION +y I-EXPLORATION +radiológico I-EXPLORATION +mediante I-EXPLORATION +ecografías I-EXPLORATION +seriadas. I-EXPLORATION + I-EXPLORATION +A I-EXPLORATION +las I-EXPLORATION +10 I-EXPLORATION +semanas I-EXPLORATION +de I-EXPLORATION +edad, I-EXPLORATION +la I-EXPLORATION +ecografía I-EXPLORATION +transfontanelar I-EXPLORATION +demostró I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +dilatación I-EXPLORATION +(asta I-EXPLORATION +frontal I-EXPLORATION +11 I-EXPLORATION +mm, I-EXPLORATION +occipital I-EXPLORATION +27 I-EXPLORATION +mm I-EXPLORATION +y I-EXPLORATION +temporal I-EXPLORATION +19 I-EXPLORATION +mm), I-EXPLORATION +desplazamiento I-EXPLORATION +de I-EXPLORATION +6 I-EXPLORATION +mm I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +línea I-EXPLORATION +media I-EXPLORATION +e I-EXPLORATION +índice I-EXPLORATION +de I-EXPLORATION +resistencia I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +pericallosa I-EXPLORATION +incrementado, I-EXPLORATION +aumentando I-EXPLORATION +de I-EXPLORATION +manera I-EXPLORATION +significativa I-EXPLORATION +tras I-EXPLORATION +presión I-EXPLORATION +ligera I-EXPLORATION +sobre I-EXPLORATION +fontanela I-EXPLORATION +anterior, I-EXPLORATION +hallazgo I-EXPLORATION +sugestivo I-EXPLORATION +de I-EXPLORATION +hidrocefalia I-EXPLORATION +a I-EXPLORATION +tensión. I-EXPLORATION +Ante B-TREATMENT +estos I-TREATMENT +hallazgos, I-TREATMENT +a I-TREATMENT +pesar I-TREATMENT +de I-TREATMENT +que I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +presentaba I-TREATMENT +perímetro I-TREATMENT +cefálico I-TREATMENT +normal I-TREATMENT +y I-TREATMENT +exploración I-TREATMENT +clínica I-TREATMENT +normal, I-TREATMENT +se I-TREATMENT decide I-TREATMENT -ingresarlo I-TREATMENT -bajo I-TREATMENT +realizar I-TREATMENT +tratamiento I-TREATMENT +quirúrgico I-TREATMENT +de I-TREATMENT la I-TREATMENT -sospecha I-TREATMENT +hidrocefalia. I-TREATMENT + I-TREATMENT +El I-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +intervenido I-TREATMENT +a I-TREATMENT +los I-TREATMENT +3 I-TREATMENT +meses I-TREATMENT de I-TREATMENT -síndrome I-TREATMENT -pertusoide, I-TREATMENT +edad. I-TREATMENT +Se I-TREATMENT +empleó I-TREATMENT +un I-TREATMENT +ventriculoscopio I-TREATMENT +rígido I-TREATMENT +a I-TREATMENT +0o I-TREATMENT +(Kart I-TREATMENT +Storz I-TREATMENT +®, I-TREATMENT +Tuttlingen, I-TREATMENT +Alemania). I-TREATMENT +Bajo I-TREATMENT +anestesia I-TREATMENT +general I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +se I-TREATMENT +colocó I-TREATMENT +en I-TREATMENT +decúbito I-TREATMENT +supino, I-TREATMENT con I-TREATMENT -monitorización I-TREATMENT -continua I-TREATMENT -de I-TREATMENT -saturación I-TREATMENT +la I-TREATMENT +cabeza I-TREATMENT +neutra I-TREATMENT +elevada I-TREATMENT +unos I-TREATMENT +20o. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +un I-TREATMENT +agujero I-TREATMENT de I-TREATMENT -oxígeno, I-TREATMENT -frecuencia I-TREATMENT -cardiaca I-TREATMENT +trépano I-TREATMENT +derecho, I-TREATMENT +justo I-TREATMENT +anterior I-TREATMENT +a I-TREATMENT +la I-TREATMENT +sutura I-TREATMENT +coronal I-TREATMENT y I-TREATMENT -respiratoria. I-TREATMENT -Durante B-EVOLUTION -su I-EVOLUTION -ingreso I-EVOLUTION -aumenta I-EVOLUTION -la I-EVOLUTION -frecuencia I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -accesos I-EVOLUTION -de I-EVOLUTION -tos I-EVOLUTION -de I-EVOLUTION -tipo I-EVOLUTION -pertusoide, I-EVOLUTION -se I-EVOLUTION -objetiva I-EVOLUTION -repercusión I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -frecuencia I-EVOLUTION -cardiaca I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -saturación I-EVOLUTION -de I-EVOLUTION -oxígeno I-EVOLUTION -durante I-EVOLUTION -dichos I-EVOLUTION -accesos I-EVOLUTION -e, I-EVOLUTION -incluso, I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -periodos I-EVOLUTION -intercríticos I-EVOLUTION -presenta I-EVOLUTION -pausas I-EVOLUTION -de I-EVOLUTION -apnea I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -recuperan I-EVOLUTION -con I-EVOLUTION -estimulación, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT +3 I-TREATMENT +cm I-TREATMENT +lateral I-TREATMENT +a I-TREATMENT +la I-TREATMENT +línea I-TREATMENT +media. I-TREATMENT +El I-TREATMENT +acceso I-TREATMENT +al I-TREATMENT +ventrículo I-TREATMENT se I-TREATMENT -le I-TREATMENT -administra I-TREATMENT -oxigenoterapia I-TREATMENT -con I-TREATMENT -gafas I-TREATMENT -nasales I-TREATMENT +realizó I-TREATMENT +siguiendo I-TREATMENT +las I-TREATMENT +referencias I-TREATMENT +anatómicas I-TREATMENT +habituales, I-TREATMENT +dirigiendo I-TREATMENT +el I-TREATMENT +endoscopio I-TREATMENT +hacia I-TREATMENT +el I-TREATMENT +canto I-TREATMENT +interno I-TREATMENT +del I-TREATMENT +ojo I-TREATMENT +ipsilateral I-TREATMENT +en I-TREATMENT +el I-TREATMENT +plano I-TREATMENT +coronal I-TREATMENT y I-TREATMENT -también I-TREATMENT -sueroterapia I-TREATMENT -intravenosa I-TREATMENT -hasta I-TREATMENT -que I-TREATMENT -recupera I-TREATMENT -una I-TREATMENT -alimentación I-TREATMENT -enteral I-TREATMENT -suficiente; I-TREATMENT -se I-TREATMENT -trata I-TREATMENT -con I-TREATMENT -azitromicina I-TREATMENT +hacia I-TREATMENT +el I-TREATMENT +conducto I-TREATMENT +auditivo I-TREATMENT +externo I-TREATMENT +en I-TREATMENT +el I-TREATMENT +plano I-TREATMENT +sagital. I-TREATMENT +Tras I-TREATMENT +acceder I-TREATMENT al I-TREATMENT -paciente I-TREATMENT +asta I-TREATMENT +frontal I-TREATMENT +derecha, I-TREATMENT +se I-TREATMENT +identificó I-TREATMENT +la I-TREATMENT +anatomía I-TREATMENT +ventricular I-TREATMENT y I-TREATMENT +se I-TREATMENT +localizó I-TREATMENT +la I-TREATMENT +ubicación I-TREATMENT +teórica I-TREATMENT +del I-TREATMENT +foramen I-TREATMENT +de I-TREATMENT +Monro I-TREATMENT +siguiendo I-TREATMENT +las I-TREATMENT +venas I-TREATMENT +talamoestriada I-TREATMENT +y I-TREATMENT +septal I-TREATMENT +anterior I-TREATMENT +y I-TREATMENT +el I-TREATMENT +plexo I-TREATMENT +coroideo. I-TREATMENT +Se I-TREATMENT +identificó I-TREATMENT +una I-TREATMENT +membrana I-TREATMENT +avascular I-TREATMENT a I-TREATMENT -los I-TREATMENT -contactos I-TREATMENT -cercanos. I-TREATMENT - I-TREATMENT -Durante B-EXPLORATION -su I-EXPLORATION -ingreso I-EXPLORATION -hospitalario, I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -serológico I-EXPLORATION -para I-EXPLORATION -Bordetella I-EXPLORATION -pertussis I-EXPLORATION -que I-EXPLORATION -resulta I-EXPLORATION -negativo I-EXPLORATION -tanto I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -determinación I-EXPLORATION -inicial I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -siguiente, I-EXPLORATION -un I-EXPLORATION -mes I-EXPLORATION -después. I-EXPLORATION - I-EXPLORATION - -Lactante B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS -días, I-PRESENT_ILLNESS -hijo B-PAST_MEDICAL_HISTORY -único, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Atención I-PRESENT_ILLNESS -Primaria I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -secreción I-PRESENT_ILLNESS -blanquecina I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -conducto I-PRESENT_ILLNESS -auditivo I-PRESENT_ILLNESS -externo I-PRESENT_ILLNESS -(CAE). I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Se B-EXPLORATION -realiza I-EXPLORATION -un I-EXPLORATION -cultivo I-EXPLORATION -de I-EXPLORATION -dicha I-EXPLORATION -secreción, I-EXPLORATION -que I-EXPLORATION -resulta I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -SAMR. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -familiar, I-EXPLORATION -obteniéndose I-EXPLORATION -cultivo I-EXPLORATION -nasal I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -padres, I-EXPLORATION -que I-EXPLORATION -resulta I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -Al B-FAMILY_HISTORY -analizar I-FAMILY_HISTORY -la I-FAMILY_HISTORY -historia I-FAMILY_HISTORY -familiar, I-FAMILY_HISTORY -tenemos I-FAMILY_HISTORY -conocimiento I-FAMILY_HISTORY -de I-FAMILY_HISTORY -que I-FAMILY_HISTORY -la I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -había I-FAMILY_HISTORY -presentado I-FAMILY_HISTORY -una I-FAMILY_HISTORY -herida I-FAMILY_HISTORY -quirúrgica I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -momento I-FAMILY_HISTORY -del I-FAMILY_HISTORY -parto, I-FAMILY_HISTORY -cuyo I-FAMILY_HISTORY -cultivo I-FAMILY_HISTORY -fue I-FAMILY_HISTORY -positivo I-FAMILY_HISTORY -para I-FAMILY_HISTORY -SARM I-FAMILY_HISTORY -con I-FAMILY_HISTORY -el I-FAMILY_HISTORY -mismo I-FAMILY_HISTORY -antibiograma I-FAMILY_HISTORY -que I-FAMILY_HISTORY -el I-FAMILY_HISTORY -hallado I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -niño I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -CAE, I-FAMILY_HISTORY -por I-FAMILY_HISTORY -lo I-FAMILY_HISTORY -que I-FAMILY_HISTORY -suponemos I-FAMILY_HISTORY -que I-FAMILY_HISTORY -se I-FAMILY_HISTORY -ha I-FAMILY_HISTORY -producido I-FAMILY_HISTORY -una I-FAMILY_HISTORY -transmisión I-FAMILY_HISTORY -vertical I-FAMILY_HISTORY -de I-FAMILY_HISTORY -dicho I-FAMILY_HISTORY -germen. I-FAMILY_HISTORY -Tras B-EXPLORATION -realizar I-EXPLORATION -estas I-EXPLORATION -investigaciones, I-EXPLORATION -se I-EXPLORATION -vuelve I-EXPLORATION -a I-EXPLORATION -tomar I-EXPLORATION -una I-EXPLORATION -muestra I-EXPLORATION -del I-EXPLORATION -CAE I-EXPLORATION -del I-EXPLORATION -niño, I-EXPLORATION -siendo I-EXPLORATION -de I-EXPLORATION -nuevo I-EXPLORATION -positivo I-EXPLORATION -para I-EXPLORATION -SARM, I-EXPLORATION -cuyo I-EXPLORATION -antibiograma I-EXPLORATION -se I-EXPLORATION -muestra I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -tabla I-EXPLORATION -1. I-EXPLORATION - I-EXPLORATION -Dado B-TREATMENT -que I-TREATMENT -este I-TREATMENT -segundo I-TREATMENT -cultivo I-TREATMENT -es I-TREATMENT -sensible I-TREATMENT -a I-TREATMENT -ciprofloxacino, I-TREATMENT +través I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cual I-TREATMENT se I-TREATMENT +intuía I-TREATMENT +por I-TREATMENT +transparencia I-TREATMENT +el I-TREATMENT +foramen I-TREATMENT +de I-TREATMENT +Monro. I-TREATMENT +Se I-TREATMENT realizó I-TREATMENT -tratamiento I-TREATMENT -local I-TREATMENT +coagulación I-TREATMENT +y I-TREATMENT +posterior I-TREATMENT +apertura I-TREATMENT +de I-TREATMENT +esta I-TREATMENT +membrana I-TREATMENT +empleando I-TREATMENT +la I-TREATMENT +punta I-TREATMENT +bipolar I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +se I-TREATMENT +dilató I-TREATMENT con I-TREATMENT -esa I-TREATMENT -quinolona I-TREATMENT -siendo I-TREATMENT +un I-TREATMENT +balón I-TREATMENT +de I-TREATMENT +Fogarty I-TREATMENT +de I-TREATMENT +4 I-TREATMENT +French. I-TREATMENT +A I-TREATMENT +través I-TREATMENT +del I-TREATMENT +nuevo I-TREATMENT +foramen I-TREATMENT +creado, I-TREATMENT +se I-TREATMENT +introdujo I-TREATMENT el I-TREATMENT -cultivo I-TREATMENT +endoscopio I-TREATMENT +hasta I-TREATMENT +visualizar I-TREATMENT +el I-TREATMENT +tercer I-TREATMENT +ventrículo. I-TREATMENT +Tras I-TREATMENT +crear I-TREATMENT +una I-TREATMENT +adecuada I-TREATMENT +comunicación I-TREATMENT +del I-TREATMENT +asta I-TREATMENT +frontal I-TREATMENT +derecha I-TREATMENT +con I-TREATMENT +el I-TREATMENT +tercer I-TREATMENT +ventrículo, I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +fenestración I-TREATMENT +en I-TREATMENT +la I-TREATMENT +porción I-TREATMENT +anterior I-TREATMENT +del I-TREATMENT +septo I-TREATMENT +pellucidum, I-TREATMENT +para I-TREATMENT +asegurar I-TREATMENT +otra I-TREATMENT +vía I-TREATMENT de I-TREATMENT -control I-TREATMENT -negativo. I-TREATMENT +comunicación I-TREATMENT +entre I-TREATMENT +las I-TREATMENT +astas I-TREATMENT +frontales I-TREATMENT +de I-TREATMENT +los I-TREATMENT +ventrículos I-TREATMENT +laterales. I-TREATMENT I-TREATMENT +El B-EVOLUTION +postoperatorio I-EVOLUTION +del I-EVOLUTION +paciente I-EVOLUTION +cursó I-EVOLUTION +sin I-EVOLUTION +incidencias. I-EVOLUTION +La I-EVOLUTION +evolución I-EVOLUTION +del I-EVOLUTION +perímetro I-EVOLUTION +craneal I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +exploración I-EVOLUTION +física I-EVOLUTION +y I-EVOLUTION +neurológica I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +primeros I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +fueron I-EVOLUTION +normales. I-EVOLUTION +Las I-EVOLUTION +ecografias I-EVOLUTION +transfontanelares I-EVOLUTION +de I-EVOLUTION +seguimiento I-EVOLUTION +mostraron I-EVOLUTION +mejoría I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +dilatación I-EVOLUTION +del I-EVOLUTION +ventrículo I-EVOLUTION +lateral I-EVOLUTION +derecho, I-EVOLUTION +con I-EVOLUTION +índice I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +arteria I-EVOLUTION +pericallosa I-EVOLUTION +dentro I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +normalidad. I-EVOLUTION +La I-EVOLUTION +RM I-EVOLUTION +realizada I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +9 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +edad I-EVOLUTION +confirmó I-EVOLUTION +estos I-EVOLUTION +hallazgos I-EVOLUTION +de I-EVOLUTION +ecografía. I-EVOLUTION + I-EVOLUTION -S. B-PRESENT_ILLNESS -Piris I-PRESENT_ILLNESS -Borregasa, I-PRESENT_ILLNESS -M.R. I-PRESENT_ILLNESS -Acuña I-PRESENT_ILLNESS -Allerb I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -aMIR-Pediatría. I-PRESENT_ILLNESS -Hospital I-PRESENT_ILLNESS -Universitario I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Octubre. I-PRESENT_ILLNESS -Madrid. I-PRESENT_ILLNESS -España. I-PRESENT_ILLNESS -bPediatra. I-PRESENT_ILLNESS -CS I-PRESENT_ILLNESS -Martín I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Vargas. I-PRESENT_ILLNESS -Madrid. I-PRESENT_ILLNESS -España. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -revisión I-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS una I-PRESENT_ILLNESS -niña I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS +22 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad, I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -pediatra I-PRESENT_ILLNESS +primípara I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -cabecera I-PRESENT_ILLNESS -descubre I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -marcha I-PRESENT_ILLNESS -torpe: I-PRESENT_ILLNESS -sabe I-PRESENT_ILLNESS -ponerse I-PRESENT_ILLNESS +18 I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -pie I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -ayuda, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -sabe I-PRESENT_ILLNESS -correr, I-PRESENT_ILLNESS -chuta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -balón I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -pies I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sube I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -baja I-PRESENT_ILLNESS -escaleras I-PRESENT_ILLNESS -agarrada I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +h I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -manos. I-PRESENT_ILLNESS -No B-FAMILY_HISTORY -se I-FAMILY_HISTORY -describen I-FAMILY_HISTORY -alteraciones I-FAMILY_HISTORY -neurológicas I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Antecedentes B-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Nacida I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -gestación I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -término I-PAST_MEDICAL_HISTORY -mediante I-PAST_MEDICAL_HISTORY -cesárea I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -presentación I-PAST_MEDICAL_HISTORY -podálica. I-PAST_MEDICAL_HISTORY -Peso I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -nacer, I-PAST_MEDICAL_HISTORY -2780 I-PAST_MEDICAL_HISTORY -g; I-PAST_MEDICAL_HISTORY -test I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Apgar, I-PAST_MEDICAL_HISTORY -8/9; I-PAST_MEDICAL_HISTORY -reanimación I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -II. I-PAST_MEDICAL_HISTORY -Pruebas I-PAST_MEDICAL_HISTORY -endocrinometabólicas I-PAST_MEDICAL_HISTORY -normales. I-PAST_MEDICAL_HISTORY -Vacunación I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -día. I-PAST_MEDICAL_HISTORY -Desarrollo I-PAST_MEDICAL_HISTORY -psicomotor: I-PAST_MEDICAL_HISTORY -sonrisa I-PAST_MEDICAL_HISTORY -social I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -meses, I-PAST_MEDICAL_HISTORY -sostén I-PAST_MEDICAL_HISTORY -cefálico I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -meses, I-PAST_MEDICAL_HISTORY -sedestación I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -siete I-PAST_MEDICAL_HISTORY -meses, I-PAST_MEDICAL_HISTORY -gateo I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -ocho I-PAST_MEDICAL_HISTORY -meses, I-PAST_MEDICAL_HISTORY -marcha I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -apoyo I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -17 I-PAST_MEDICAL_HISTORY -meses, I-PAST_MEDICAL_HISTORY -motricidad I-PAST_MEDICAL_HISTORY -fina I-PAST_MEDICAL_HISTORY -normal. I-PAST_MEDICAL_HISTORY -Bisílabos I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -referenciales I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -ocho I-PAST_MEDICAL_HISTORY -meses, I-PAST_MEDICAL_HISTORY -bisílabos I-PAST_MEDICAL_HISTORY -referenciales I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -meses. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Exploración B-EXPLORATION -física I-EXPLORATION - I-EXPLORATION -Talla, I-EXPLORATION -92 I-EXPLORATION -cm I-EXPLORATION -(percentil I-EXPLORATION -97 I-EXPLORATION -[P97]); I-EXPLORATION -peso, I-EXPLORATION -11, I-EXPLORATION -8 I-EXPLORATION -kg I-EXPLORATION -(P25-50); I-EXPLORATION -perímetro I-EXPLORATION -craneal. I-EXPLORATION -53, I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION -(P97). I-EXPLORATION -Buen I-EXPLORATION -estado I-EXPLORATION -general. I-EXPLORATION -Bien I-EXPLORATION -nutrida. I-EXPLORATION -Sin I-EXPLORATION -dismorfias I-EXPLORATION -ni I-EXPLORATION -discromías. I-EXPLORATION -Cráneo I-EXPLORATION -normoconfigurado. I-EXPLORATION -Auscultación I-EXPLORATION -cardiopulmonar I-EXPLORATION -normal. I-EXPLORATION -Abdomen I-EXPLORATION -depresible I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -organomegalias. I-EXPLORATION -Genitales I-EXPLORATION -externos I-EXPLORATION -femeninos I-EXPLORATION -y I-EXPLORATION -normales. I-EXPLORATION -Exploración I-EXPLORATION -neurológica: I-EXPLORATION -hábito I-EXPLORATION -longilíneo I-EXPLORATION -con I-EXPLORATION -buena I-EXPLORATION -alineación I-EXPLORATION +evolución, I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +fiebre. I-PRESENT_ILLNESS +Presentaba B-EXPLORATION +un I-EXPLORATION +hematocrito I-EXPLORATION del I-EXPLORATION -raquis I-EXPLORATION -y I-EXPLORATION +29%, I-EXPLORATION +leucocitosis I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -extremidades; I-EXPLORATION -pares I-EXPLORATION -craneales I-EXPLORATION -normales; I-EXPLORATION -tono I-EXPLORATION -activo I-EXPLORATION -normal; I-EXPLORATION -leve I-EXPLORATION -hipotonía I-EXPLORATION -pasiva I-EXPLORATION +12, I-EXPLORATION +6 I-EXPLORATION +x I-EXPLORATION +109/L I-EXPLORATION con I-EXPLORATION -signo I-EXPLORATION +89, I-EXPLORATION +7% I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -bufanda I-EXPLORATION -que I-EXPLORATION -sobrepasa I-EXPLORATION -la I-EXPLORATION -línea I-EXPLORATION -media I-EXPLORATION -y I-EXPLORATION -dedo I-EXPLORATION -al I-EXPLORATION -antebrazo; I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -miembros I-EXPLORATION -inferiores, I-EXPLORATION -el I-EXPLORATION -ángulo I-EXPLORATION -poplíteo I-EXPLORATION -supera I-EXPLORATION -los I-EXPLORATION -90o I-EXPLORATION -y I-EXPLORATION -hace I-EXPLORATION -abducción I-EXPLORATION -completa I-EXPLORATION +neutrófilos, I-EXPLORATION +amilasemia I-EXPLORATION de I-EXPLORATION -caderas; I-EXPLORATION -reflejos I-EXPLORATION -osteotendinosos I-EXPLORATION -presentes I-EXPLORATION -y I-EXPLORATION -simétricos; I-EXPLORATION -llama I-EXPLORATION -la I-EXPLORATION -atención I-EXPLORATION -la I-EXPLORATION -marcha I-EXPLORATION -ligeramente I-EXPLORATION -oscilante, I-EXPLORATION -no I-EXPLORATION -claudicante; I-EXPLORATION -no I-EXPLORATION -dismetría, I-EXPLORATION -signo I-EXPLORATION +1.684 I-EXPLORATION +UI/L, I-EXPLORATION +AST I-EXPLORATION de I-EXPLORATION -Romberg I-EXPLORATION -negativo; I-EXPLORATION -ausencia I-EXPLORATION +41 I-EXPLORATION +UI/L, I-EXPLORATION +ALT I-EXPLORATION de I-EXPLORATION -disdiadococinesia; I-EXPLORATION -pinza I-EXPLORATION -digital I-EXPLORATION -normal; I-EXPLORATION -maniobra I-EXPLORATION +75 I-EXPLORATION +UI/L, I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina I-EXPLORATION de I-EXPLORATION -Gowers I-EXPLORATION -negativa; I-EXPLORATION -sin I-EXPLORATION -hipertrofia I-EXPLORATION -gemelar. I-EXPLORATION - I-EXPLORATION -Evolución B-DERIVED_FROM/TO -posterior I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -El I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -remitido I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Neurología I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -control I-DERIVED_FROM/TO -clínico I-DERIVED_FROM/TO -cada I-DERIVED_FROM/TO -tres I-DERIVED_FROM/TO -meses. I-DERIVED_FROM/TO -Se B-EXPLORATION -solicitó I-EXPLORATION -un I-EXPLORATION -hemograma, I-EXPLORATION -una I-EXPLORATION -bioquímica I-EXPLORATION -general, I-EXPLORATION -pruebas I-EXPLORATION -tiroideas I-EXPLORATION +81 I-EXPLORATION +UI/L I-EXPLORATION y I-EXPLORATION -creatinfosfocinasa, I-EXPLORATION -con I-EXPLORATION -resultados I-EXPLORATION -normales. I-EXPLORATION -Durante B-EVOLUTION -los I-EVOLUTION -siguientes I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -la I-EVOLUTION -niña I-EVOLUTION -desarrolló I-EVOLUTION -una I-EVOLUTION -macrocefalia I-EVOLUTION -de I-EVOLUTION -+3, I-EVOLUTION -6 I-EVOLUTION -desviaciones I-EVOLUTION -estándar I-EVOLUTION -(DS) I-EVOLUTION -y I-EVOLUTION -un I-EVOLUTION -discreto I-EVOLUTION -temblor I-EVOLUTION -intencional, I-EVOLUTION -sin I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -torpeza I-EVOLUTION -motora I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -deambulación, I-EVOLUTION -por B-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -un I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -cerebral, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -descubrió I-EXPLORATION una I-EXPLORATION -llamativa I-EXPLORATION -dilatación I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -cuatro I-EXPLORATION -ventrículos I-EXPLORATION -cerebrales I-EXPLORATION -con I-EXPLORATION -quiste I-EXPLORATION -retrocerebeloso I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION +bGT I-EXPLORATION de I-EXPLORATION -otras I-EXPLORATION -malformaciones I-EXPLORATION -asociadas, I-EXPLORATION -sugerente I-EXPLORATION -todo I-EXPLORATION -ello I-EXPLORATION +28 I-EXPLORATION +UI/L. I-EXPLORATION +Una I-EXPLORATION +ecografía I-EXPLORATION +mostró I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION +colecistitis I-EXPLORATION +litiásica, I-EXPLORATION una I-EXPLORATION -alteración I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -fosa I-EXPLORATION -posterior I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -contexto I-EXPLORATION -del I-EXPLORATION -complejo I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +intrahepática I-EXPLORATION +y I-EXPLORATION +extrahepática I-EXPLORATION +y I-EXPLORATION +páncreas I-EXPLORATION +sin I-EXPLORATION +alteraciones. I-EXPLORATION +Una I-EXPLORATION +ecografía I-EXPLORATION +fetal I-EXPLORATION +comprobó I-EXPLORATION +una I-EXPLORATION +gestación I-EXPLORATION de I-EXPLORATION -Dandy-Walker. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -recomendó, I-TREATMENT -por I-TREATMENT -parte I-TREATMENT +18 I-EXPLORATION +semanas I-EXPLORATION +sin I-EXPLORATION +complicaciones. I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +ingresó I-TREATMENT +bajo I-TREATMENT +tratamiento I-TREATMENT +médico I-TREATMENT +antibiótico I-TREATMENT +pero I-TREATMENT +con I-TREATMENT +persistencia I-TREATMENT de I-TREATMENT -Neurología, I-TREATMENT -fisioterapia I-TREATMENT -mediante I-TREATMENT -el I-TREATMENT -método I-TREATMENT -Bobath, I-TREATMENT +los I-TREATMENT +síntomas I-TREATMENT +a I-TREATMENT +las I-TREATMENT +48 I-TREATMENT +horas. I-TREATMENT +Se I-TREATMENT +decidió I-TREATMENT +CL I-TREATMENT +electiva. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +CL I-TREATMENT +hallando I-TREATMENT +una I-TREATMENT +colelitiasis I-TREATMENT +simple I-TREATMENT con I-TREATMENT -la I-TREATMENT -que I-TREATMENT -se I-TREATMENT -ha I-TREATMENT -detenido, I-TREATMENT -por I-TREATMENT -el I-TREATMENT -momento, I-TREATMENT -el I-TREATMENT -deterioro I-TREATMENT -neurológico. I-TREATMENT - I-TREATMENT -Dirección I-TREATMENT -para I-TREATMENT -correspondencia: I-TREATMENT -Salvador I-TREATMENT -Piris I-TREATMENT -Borregas I-TREATMENT -dockbps@hotmail.com I-TREATMENT - I-TREATMENT +mínimos I-TREATMENT +signos I-TREATMENT +de I-TREATMENT +colecistitis, I-TREATMENT +con I-TREATMENT +una I-TREATMENT +presión I-TREATMENT +intraabdominal I-TREATMENT +inferior I-TREATMENT +a I-TREATMENT +12 I-TREATMENT +mmHg I-TREATMENT +y I-TREATMENT +en I-TREATMENT +un I-TREATMENT +tiempo I-TREATMENT +de I-TREATMENT +40 I-TREATMENT +minutos. I-TREATMENT +El B-EVOLUTION +postoperatorio I-EVOLUTION +y I-EVOLUTION +el I-EVOLUTION +embarazo I-EVOLUTION +transcurrieron I-EVOLUTION +sin I-EVOLUTION +incidencias. I-EVOLUTION + I-EVOLUTION -Niño B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS +32 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -previamente B-PAST_MEDICAL_HISTORY -sano I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -correctamente I-PAST_MEDICAL_HISTORY -vacunado, I-PAST_MEDICAL_HISTORY -excepto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -varicela. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Tuvo B-PRESENT_ILLNESS -escarlatina I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS +hospitalizada I-PRESENT_ILLNESS +doce I-PRESENT_ILLNESS días I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -exantema. I-PRESENT_ILLNESS -Al I-PRESENT_ILLNESS -quinto I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -persiste I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -alta I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -pie I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -tobillo I-PRESENT_ILLNESS -izquierdos. I-PRESENT_ILLNESS -Es I-PRESENT_ILLNESS -diagnosticado I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +unidad I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -celulitis I-PRESENT_ILLNESS +cuidado I-PRESENT_ILLNESS +intensivo, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tobillo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tratado I-PRESENT_ILLNESS -ambulatoriamente I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +epigastralgia I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +irradiada, I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +cual I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +cede I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -amoxicilina-clavulánico I-PRESENT_ILLNESS -oral I-PRESENT_ILLNESS +administración I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +ranitidina, I-PRESENT_ILLNESS +valorada I-PRESENT_ILLNESS +inicialmente I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -dosis I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -80 I-PRESENT_ILLNESS -mg/kg/día I-PRESENT_ILLNESS -(de I-PRESENT_ILLNESS -amoxicilina). I-PRESENT_ILLNESS -A I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -48 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -aumenta I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -tumefacción, I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -decide I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -presenta I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION +urgencias, I-PRESENT_ILLNESS +donde B-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +hiperamilasemia I-EXPLORATION +e I-EXPLORATION +hipertrigliceridemia I-EXPLORATION +(5.080 I-EXPLORATION +mg/dl) I-EXPLORATION con I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -de I-EXPLORATION -varicela I-EXPLORATION +ecografía I-EXPLORATION de I-EXPLORATION -predominio I-EXPLORATION -pustuloso, I-EXPLORATION -dolor, I-EXPLORATION -tumefacción, I-EXPLORATION -edema I-EXPLORATION -importante I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -pie I-EXPLORATION +hígado I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -tobillo I-EXPLORATION -izquierdos I-EXPLORATION +vías I-EXPLORATION +biliares I-EXPLORATION +más I-EXPLORATION +colangiorresonancia I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +límites I-EXPLORATION +normales. I-EXPLORATION +Por I-EXPLORATION +estado I-EXPLORATION +de I-EXPLORATION +deshidratación I-EXPLORATION +grado I-EXPLORATION +III, I-EXPLORATION +SIRS I-EXPLORATION y I-EXPLORATION -placa I-EXPLORATION -eritematosa I-EXPLORATION +dolor I-EXPLORATION +severo, I-EXPLORATION +se I-EXPLORATION +manejó I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -planta I-EXPLORATION -del I-EXPLORATION -pie. I-EXPLORATION -No I-EXPLORATION -realiza I-EXPLORATION -deambulación I-EXPLORATION -autónoma. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION +unidad I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -está I-EXPLORATION -dentro I-EXPLORATION +cuidado I-EXPLORATION +intensivo. I-EXPLORATION +Como B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +importancia I-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +obesidad I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +dislipidemia I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +manejo I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +lovastatina I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +mg/día I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +gemfibrozilo I-PAST_MEDICAL_HISTORY +irregularmente, I-PAST_MEDICAL_HISTORY +adicionalmente I-PAST_MEDICAL_HISTORY +uso I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +productos I-PAST_MEDICAL_HISTORY +homeopáticos I-PAST_MEDICAL_HISTORY +(espirulina I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +vinagre I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +manzana), I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +G2P1C1 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +12 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +planifica I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +anticonceptivos I-PAST_MEDICAL_HISTORY +orales. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION de I-EXPLORATION +ingreso, I-EXPLORATION +como I-EXPLORATION +hallazgos I-EXPLORATION +relevantes I-EXPLORATION +se I-EXPLORATION +encontraron I-EXPLORATION +paciente I-EXPLORATION +somnolienta, I-EXPLORATION +taquicárdica, I-EXPLORATION +taquipneica, I-EXPLORATION +deshidratada; I-EXPLORATION +signos I-EXPLORATION +vitales: I-EXPLORATION +TA I-EXPLORATION +114/70; I-EXPLORATION +FC: I-EXPLORATION +105 I-EXPLORATION +por I-EXPLORATION +minuto; I-EXPLORATION +FR: I-EXPLORATION +28 I-EXPLORATION +por I-EXPLORATION +min: I-EXPLORATION +SaO2: I-EXPLORATION +90% I-EXPLORATION +con I-EXPLORATION +FIO2 I-EXPLORATION +28%; I-EXPLORATION +IMC I-EXPLORATION +32, I-EXPLORATION +5, I-EXPLORATION +abdomen I-EXPLORATION +blando I-EXPLORATION +doloroso I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -normalidad. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -control I-EXPLORATION -analítico I-EXPLORATION -muestra I-EXPLORATION -13 I-EXPLORATION -600 I-EXPLORATION -leucocitos/mm3 I-EXPLORATION -(68, I-EXPLORATION -3% I-EXPLORATION -neutrófilos); I-EXPLORATION -hemoglobina, I-EXPLORATION -10, I-EXPLORATION -7 I-EXPLORATION -g/dl; I-EXPLORATION -hematocrito, I-EXPLORATION -31, I-EXPLORATION -1%; I-EXPLORATION -plaquetas, I-EXPLORATION -374 I-EXPLORATION -000/mm3, I-EXPLORATION -y I-EXPLORATION -velocidad I-EXPLORATION +palpación I-EXPLORATION +en I-EXPLORATION +epigastrio I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -sedimentación I-EXPLORATION -globular I-EXPLORATION -(VSG), I-EXPLORATION -116. I-EXPLORATION -Hemocultivo I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -trata I-TREATMENT -con I-TREATMENT -amoxicilina/clavulánico I-TREATMENT -intravenoso I-TREATMENT -(IV), I-TREATMENT -pero I-TREATMENT -al I-TREATMENT -cuarto I-TREATMENT -día I-TREATMENT -presenta I-TREATMENT -un I-TREATMENT -empeoramiento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tumefacción. I-TREATMENT -Se B-EXPLORATION -le I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION -del I-EXPLORATION -miembro I-EXPLORATION -inferior I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION +irritación I-EXPLORATION +peritoneal, I-EXPLORATION +sin I-EXPLORATION +otro I-EXPLORATION +hallazgo I-EXPLORATION +anormal I-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +físico. I-EXPLORATION +Se I-EXPLORATION +hace I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -partes I-EXPLORATION -blandas, I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -un I-EXPLORATION -músculo I-EXPLORATION -gemelo I-EXPLORATION -interno I-EXPLORATION -con I-EXPLORATION -hipoecogenicidad I-EXPLORATION -y I-EXPLORATION -tumefacción I-EXPLORATION +pancreatitis I-EXPLORATION +aguda I-EXPLORATION +severa I-EXPLORATION +secundaria I-EXPLORATION +a I-EXPLORATION +hipertrigliceridemia, I-EXPLORATION con I-EXPLORATION -pérdida I-EXPLORATION +puntuación I-EXPLORATION de I-EXPLORATION -patrón I-EXPLORATION -fibroadiposo, I-EXPLORATION -que I-EXPLORATION -refleja I-EXPLORATION -edema I-EXPLORATION -e I-EXPLORATION -infiltración I-EXPLORATION +11 I-EXPLORATION +en I-EXPLORATION +APACHE I-EXPLORATION +inicial I-EXPLORATION +y I-EXPLORATION +5 I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +24 I-EXPLORATION +horas, I-EXPLORATION +se I-EXPLORATION +realiza I-EXPLORATION +TAC I-EXPLORATION +contrastada I-EXPLORATION de I-EXPLORATION -tejido I-EXPLORATION -graso I-EXPLORATION +abdomen I-EXPLORATION compatible I-EXPLORATION con I-EXPLORATION -piomiositis. I-EXPLORATION -No I-EXPLORATION -hay I-EXPLORATION -constancia I-EXPLORATION -de I-EXPLORATION -absceso I-EXPLORATION -susceptible I-EXPLORATION +Baltazar I-EXPLORATION +E I-EXPLORATION +con I-EXPLORATION +necrosis I-EXPLORATION de I-EXPLORATION -drenaje. I-EXPLORATION - I-EXPLORATION +menos I-EXPLORATION +del I-EXPLORATION +30%. I-EXPLORATION Se B-TREATMENT -instaura I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT +manejó I-TREATMENT +multidisciplinariamente I-TREATMENT con I-TREATMENT -cefotaxima I-TREATMENT -y I-TREATMENT -cloxacilina, I-TREATMENT -pero I-TREATMENT -al I-TREATMENT -ser I-TREATMENT -la I-TREATMENT -evolución I-TREATMENT -clínica, I-TREATMENT -analítica I-TREATMENT +los I-TREATMENT +servicios I-TREATMENT +de I-TREATMENT +gastroenterología I-TREATMENT y I-TREATMENT -ecográfica I-TREATMENT -desfavorable, I-TREATMENT +soporte I-TREATMENT +nutricional, I-TREATMENT se I-TREATMENT -decide I-TREATMENT -un I-TREATMENT -cambio I-TREATMENT +inició I-TREATMENT +infusión I-TREATMENT de I-TREATMENT -pauta I-TREATMENT -por I-TREATMENT -clindamicina I-TREATMENT -y I-TREATMENT -vancomicina I-TREATMENT -IV I-TREATMENT +insulina I-TREATMENT con I-TREATMENT -posterior I-TREATMENT -disminución I-TREATMENT +descenso I-TREATMENT +significativo I-TREATMENT de I-TREATMENT -la I-TREATMENT -VSG I-TREATMENT +triglicéridos I-TREATMENT +a I-TREATMENT +las I-TREATMENT +48 I-TREATMENT +horas I-TREATMENT +(valor I-TREATMENT +inicial I-TREATMENT +5.080, I-TREATMENT +control I-TREATMENT +a I-TREATMENT +las I-TREATMENT +48 I-TREATMENT +h: I-TREATMENT +369), I-TREATMENT +al I-TREATMENT +séptimo I-TREATMENT +día I-TREATMENT +se I-TREATMENT +observó I-TREATMENT +aumento I-TREATMENT +de I-TREATMENT +leucocitos, I-TREATMENT +persistencia I-TREATMENT +de I-TREATMENT +taquicardia I-TREATMENT y I-TREATMENT -ecografía I-TREATMENT -sin I-TREATMENT -alteraciones I-TREATMENT -significativas. I-TREATMENT +PCR I-TREATMENT +mayor I-TREATMENT +a I-TREATMENT +16 I-TREATMENT +mg/dl, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +cual I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +iniciar I-TREATMENT +cubrimiento I-TREATMENT +antibiótico I-TREATMENT +con I-TREATMENT +meropenem. I-TREATMENT Al B-EVOLUTION -alta I-EVOLUTION -realizaba I-EVOLUTION -deambulación I-EVOLUTION -autónoma I-EVOLUTION +noveno I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +hospitalización, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +mostraba I-EVOLUTION +una I-EVOLUTION +apariencia I-EVOLUTION +clínica I-EVOLUTION +normal I-EVOLUTION +sin I-EVOLUTION +dolor, I-EVOLUTION +con I-EVOLUTION +descenso I-EVOLUTION +de I-EVOLUTION +leucocitosis I-EVOLUTION y I-EVOLUTION -no I-EVOLUTION -presentaba I-EVOLUTION -secuelas I-EVOLUTION -funcionales. I-EVOLUTION +bandemia; I-EVOLUTION +dada I-EVOLUTION +su I-EVOLUTION +evolución, I-EVOLUTION +se I-EVOLUTION +decide I-EVOLUTION +traslado I-EVOLUTION +a I-EVOLUTION +planta. I-EVOLUTION I-EVOLUTION -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +El B-PRESENT_ILLNESS +primer I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +hombre I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -diez I-PRESENT_ILLNESS +54 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +consumo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +licor I-PAST_MEDICAL_HISTORY +cada I-PAST_MEDICAL_HISTORY +fin I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +semana I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +embriaguez, I-PAST_MEDICAL_HISTORY +cuatro B-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +expectoración I-PRESENT_ILLNESS +purulenta, I-PRESENT_ILLNESS +disnea I-PRESENT_ILLNESS de I-PRESENT_ILLNESS +moderados I-PRESENT_ILLNESS +esfuerzos, I-PRESENT_ILLNESS fiebre I-PRESENT_ILLNESS de I-PRESENT_ILLNESS +38, I-PRESENT_ILLNESS +5°C, I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +pleurítico I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +hemitórax I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +automedicación I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS +dosis I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -odinofagia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -palpebral I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS -llamativo, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -edemas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -otras I-PRESENT_ILLNESS -localizaciones. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -evidencia I-EXPLORATION -hipertrofia I-EXPLORATION -amigdalar I-EXPLORATION -con I-EXPLORATION -exudado I-EXPLORATION -bilateral, I-EXPLORATION +dexametasona I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +mg I-PRESENT_ILLNESS +intramuscular I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +admisión. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Ingresó B-EXPLORATION +febril, I-EXPLORATION +taquicárdico, I-EXPLORATION +taquipneico, I-EXPLORATION +hipo-xémico I-EXPLORATION y I-EXPLORATION -adenopatías I-EXPLORATION -laterocervicales I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION -pequeño I-EXPLORATION -tamaño, I-EXPLORATION -además I-EXPLORATION -del I-EXPLORATION -edema I-EXPLORATION -descrito. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -sedimento I-EXPLORATION -urinario I-EXPLORATION +tórax I-EXPLORATION +presentaba I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +derrame I-EXPLORATION +pleural I-EXPLORATION y I-EXPLORATION -determinación I-EXPLORATION +consolidación I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +base I-EXPLORATION +derecha. I-EXPLORATION +La I-EXPLORATION +evaluación I-EXPLORATION de I-EXPLORATION -cifras I-EXPLORATION +laboratorio I-EXPLORATION +muestra I-EXPLORATION +leucocitosis I-EXPLORATION de I-EXPLORATION -tensión I-EXPLORATION -arterial I-EXPLORATION -siendo I-EXPLORATION -normales. I-EXPLORATION -Ante B-TREATMENT -dichos I-TREATMENT -hallazgos, I-TREATMENT -se I-TREATMENT -toma I-TREATMENT -frotis I-TREATMENT -faríngeo I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -con I-TREATMENT -amoxicilina I-TREATMENT -oral I-TREATMENT -durante I-TREATMENT -una I-TREATMENT -semana. I-TREATMENT -Al B-EVOLUTION -concluir I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -vuelve I-EVOLUTION -a I-EVOLUTION -consultar, I-EVOLUTION -manifestando I-EVOLUTION -haber I-EVOLUTION -padecido I-EVOLUTION -fiebre I-EVOLUTION -durante I-EVOLUTION -12 I-EVOLUTION -días I-EVOLUTION -junto I-EVOLUTION -con I-EVOLUTION -astenia. I-EVOLUTION -No I-EVOLUTION -apareció I-EVOLUTION -exantema I-EVOLUTION -tras I-EVOLUTION -la I-EVOLUTION -toma I-EVOLUTION -de I-EVOLUTION -antibiótico. I-EVOLUTION -El B-EXPLORATION -cultivo I-EXPLORATION -del I-EXPLORATION -exudado I-EXPLORATION -faríngeo I-EXPLORATION -resultó I-EXPLORATION -negativo I-EXPLORATION -para I-EXPLORATION -S. I-EXPLORATION -pyogenes. I-EXPLORATION -Al I-EXPLORATION -explorarlo I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -menor I-EXPLORATION -edema I-EXPLORATION -palpebral, I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -palpa I-EXPLORATION -mínima I-EXPLORATION -hepatoesplenomegalia I-EXPLORATION +14.500 I-EXPLORATION por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION +mm3, I-EXPLORATION +neutrofilia I-EXPLORATION de I-EXPLORATION -síndrome I-EXPLORATION -mononuclésico I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -realizar I-EXPLORATION -control I-EXPLORATION -analítico I-EXPLORATION -con I-EXPLORATION -hemograma, I-EXPLORATION -perfil I-EXPLORATION -hepático I-EXPLORATION -y I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -virus I-EXPLORATION +96%, I-EXPLORATION +hiperglucemia I-EXPLORATION de I-EXPLORATION -hepatitis I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C, I-EXPLORATION -VEB I-EXPLORATION -y I-EXPLORATION -citomegalovirus. I-EXPLORATION -Se I-EXPLORATION -encuentra I-EXPLORATION -linfocitosis I-EXPLORATION -relativa I-EXPLORATION -(leucocitos I-EXPLORATION -7480/µl I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -68% I-EXPLORATION +638 I-EXPLORATION +mg/dl, I-EXPLORATION +hiperazoemia I-EXPLORATION +(nitrógeno I-EXPLORATION +ureico I-EXPLORATION +en I-EXPLORATION +sangre I-EXPLORATION de I-EXPLORATION -linfocitos), I-EXPLORATION -aumento I-EXPLORATION +27, I-EXPLORATION +45 I-EXPLORATION +mg/dl). I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +hospitalizado I-EVOLUTION +con I-EVOLUTION +diagnóstico I-EVOLUTION +de I-EVOLUTION +neumonía I-EVOLUTION +grave I-EVOLUTION +extrahospitalaria I-EVOLUTION +IIIA, I-EVOLUTION +según I-EVOLUTION +las I-EVOLUTION +guías I-EVOLUTION +nacionales I-EVOLUTION +de I-EVOLUTION +manejo I-EVOLUTION +de I-EVOLUTION +esta I-EVOLUTION +enfermedad I-EVOLUTION +(6). I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +progresó I-EVOLUTION +rápidamente I-EVOLUTION +a I-EVOLUTION +falla I-EVOLUTION +respiratoria I-EVOLUTION +hipoxémica, I-EVOLUTION +con I-EVOLUTION +choque I-EVOLUTION +séptico I-EVOLUTION +y, I-EVOLUTION +posteriormente, I-EVOLUTION +disfunción I-EVOLUTION +orgánica I-EVOLUTION +múltiple. I-EVOLUTION +Se B-DERIVED_FROM/TO +trasladó I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +unidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +cuidados I-DERIVED_FROM/TO +intensivos, I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +se B-TREATMENT +inició I-TREATMENT +manejo I-TREATMENT +antibiótico I-TREATMENT +con I-TREATMENT +ceftriaxona, I-TREATMENT +2 I-TREATMENT +g I-TREATMENT +endovenosos I-TREATMENT +al I-TREATMENT +día, I-TREATMENT +y I-TREATMENT +claritromicina, I-TREATMENT +500 I-TREATMENT +mg I-TREATMENT +endovenosos I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas. I-TREATMENT +Se B-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +computadorizada I-EXPLORATION de I-EXPLORATION -transaminasas I-EXPLORATION -(GOT I-EXPLORATION -125 I-EXPLORATION -UI/l, I-EXPLORATION -GPT I-EXPLORATION -171 I-EXPLORATION -UI/l) I-EXPLORATION -y I-EXPLORATION -serología I-EXPLORATION +tórax I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +consolidación I-EXPLORATION +multilobar I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +lóbulos I-EXPLORATION +inferiores I-EXPLORATION con I-EXPLORATION -IgM I-EXPLORATION -positiva I-EXPLORATION -frente I-EXPLORATION -a I-EXPLORATION -VEB. I-EXPLORATION -A B-EVOLUTION +derrame I-EXPLORATION +pleural I-EXPLORATION +bilateral, I-EXPLORATION +no I-EXPLORATION +libre I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +base I-EXPLORATION +derecha. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +estudió I-EXPLORATION +del I-EXPLORATION +líquido I-EXPLORATION +pleural I-EXPLORATION +indicó I-EXPLORATION +empiema I-EXPLORATION +con I-EXPLORATION +presencia I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +cocos I-EXPLORATION +Gram I-EXPLORATION +positivos. I-EXPLORATION +Requirió B-TREATMENT +toracostomía I-TREATMENT +de I-TREATMENT +drenaje I-TREATMENT +cerrado I-TREATMENT +y I-TREATMENT +se I-TREATMENT +indicó I-TREATMENT +posteriormente I-TREATMENT +toracotomía I-TREATMENT +más I-TREATMENT +decorticación. I-TREATMENT +Durante B-EVOLUTION +las I-EVOLUTION +primeras I-EVOLUTION +72 I-EVOLUTION +horas I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +postoperatorio, I-EVOLUTION +persistieron I-EVOLUTION los I-EVOLUTION -17 I-EVOLUTION -días I-EVOLUTION -del I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -cuadro I-EVOLUTION -encontramos I-EVOLUTION -remisión I-EVOLUTION -completa I-EVOLUTION -del I-EVOLUTION -edema I-EVOLUTION -palpebral I-EVOLUTION -bilateral, I-EVOLUTION -mejoría I-EVOLUTION +signos I-EVOLUTION +de I-EVOLUTION +respuesta I-EVOLUTION +inflamatoria I-EVOLUTION +sistémica. I-EVOLUTION +Ante B-TREATMENT +el I-TREATMENT +deterioro I-TREATMENT +de I-TREATMENT +la I-TREATMENT +función I-TREATMENT +renal, I-TREATMENT +requirió I-TREATMENT +soporte I-TREATMENT +dialítico I-TREATMENT +y I-TREATMENT +se I-TREATMENT +cambió I-TREATMENT +el I-TREATMENT +antibiótico I-TREATMENT +a I-TREATMENT +linezolide. I-TREATMENT +Posterior B-EVOLUTION +al I-EVOLUTION +cambio I-EVOLUTION +de I-EVOLUTION +antimicrobiano I-EVOLUTION +su I-EVOLUTION +evolución I-EVOLUTION +fue I-EVOLUTION +adecuada, I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +permitió I-EVOLUTION +retirarlo I-EVOLUTION del I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -resolución I-EVOLUTION +respirador I-EVOLUTION +sin I-EVOLUTION +necesidad I-EVOLUTION de I-EVOLUTION -la I-EVOLUTION -hepatoesplenomegalia I-EVOLUTION +soporte I-EVOLUTION +vasopresor. I-EVOLUTION +Se I-EVOLUTION +completaron I-EVOLUTION +21 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION +con I-EVOLUTION +respuesta I-EVOLUTION +satisfactoria I-EVOLUTION y I-EVOLUTION -normalización I-EVOLUTION -del I-EVOLUTION -control I-EVOLUTION -analítico. I-EVOLUTION +sin I-EVOLUTION +necesidad I-EVOLUTION +de I-EVOLUTION +terapia I-EVOLUTION +antimicrobiana I-EVOLUTION +ambulatoria I-EVOLUTION +adicional. I-EVOLUTION I-EVOLUTION -Lactante B-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -34 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -revisión. I-PRESENT_ILLNESS -Primer I-PRESENT_ILLNESS -hijo, I-PRESENT_ILLNESS -fruto I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -embarazo I-PRESENT_ILLNESS -controlado. I-PRESENT_ILLNESS -Varicela I-PRESENT_ILLNESS -materna I-PRESENT_ILLNESS +61 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +transplantado I-PRESENT_ILLNESS +cardiaco I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +décimo I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +postoperatorio I-PRESENT_ILLNESS +desarrolló I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +vólvulo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -gestación. I-PRESENT_ILLNESS -Parto B-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY +ciego. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +El B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +miocardiopatía I-PAST_MEDICAL_HISTORY +dilatada I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +fracción I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +eyección I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +23% I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +cardiopatía I-PAST_MEDICAL_HISTORY +isquémica I-PAST_MEDICAL_HISTORY +tratado I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +doble I-PAST_MEDICAL_HISTORY +bypass I-PAST_MEDICAL_HISTORY +aortocoronario. I-PAST_MEDICAL_HISTORY +Como I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +destacar I-PAST_MEDICAL_HISTORY +apendicectomía, I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +diabetes I-PAST_MEDICAL_HISTORY +mellitus I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +crónica. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Fue I-PAST_MEDICAL_HISTORY +sometido I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +trasplante I-PAST_MEDICAL_HISTORY +cardiaco I-PAST_MEDICAL_HISTORY +ortotópico I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +anastomosis I-PAST_MEDICAL_HISTORY +bicava. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +tiempo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +isquemia I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +280 I-PAST_MEDICAL_HISTORY +min I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +duración I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -semana I-PAST_MEDICAL_HISTORY -35 I-PAST_MEDICAL_HISTORY -+ I-PAST_MEDICAL_HISTORY -6, I-PAST_MEDICAL_HISTORY -vaginal, I-PAST_MEDICAL_HISTORY -instrumentado I-PAST_MEDICAL_HISTORY +circulación I-PAST_MEDICAL_HISTORY +extracorpórea I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +200 I-PAST_MEDICAL_HISTORY +min. I-PAST_MEDICAL_HISTORY +Presentó I-PAST_MEDICAL_HISTORY +tendencia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +hipotensión I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -ventosa. I-PAST_MEDICAL_HISTORY -Apgar I-PAST_MEDICAL_HISTORY -9/10. I-PAST_MEDICAL_HISTORY -Somatometría I-PAST_MEDICAL_HISTORY -adecuada I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -nacimiento I-PAST_MEDICAL_HISTORY -(perímetro I-PAST_MEDICAL_HISTORY -cefálico: I-PAST_MEDICAL_HISTORY -33 I-PAST_MEDICAL_HISTORY -cm, I-PAST_MEDICAL_HISTORY -percentil I-PAST_MEDICAL_HISTORY -50-75 I-PAST_MEDICAL_HISTORY -[P50-75]). I-PAST_MEDICAL_HISTORY -No B-FAMILY_HISTORY -refieren I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés. I-FAMILY_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -objetiva I-EXPLORATION -escafocefalia I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -palpa I-EXPLORATION -una I-EXPLORATION -cresta I-EXPLORATION -ósea I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -sutura I-EXPLORATION -sagital. I-EXPLORATION -Este I-EXPLORATION -hallazgo I-EXPLORATION -se I-EXPLORATION -interpreta I-EXPLORATION -como I-EXPLORATION -un I-EXPLORATION -posible I-EXPLORATION -acabalgamiento I-EXPLORATION -de I-EXPLORATION -suturas. I-EXPLORATION -La I-EXPLORATION -exploración I-EXPLORATION -neurológica I-EXPLORATION -era I-EXPLORATION -adecuada I-EXPLORATION -a I-EXPLORATION -su I-EXPLORATION -edad. I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -dos I-EXPLORATION -meses I-EXPLORATION -presenta I-EXPLORATION -deformidad I-EXPLORATION -craneal I-EXPLORATION -más I-EXPLORATION -manifiesta, I-EXPLORATION -con I-EXPLORATION -persistencia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -prominencia I-EXPLORATION -ósea I-EXPLORATION -sagital. I-EXPLORATION -Se I-EXPLORATION -palpa I-EXPLORATION -fontanela I-EXPLORATION -anterior I-EXPLORATION -a I-EXPLORATION -punta I-EXPLORATION -de I-EXPLORATION -dedo. I-EXPLORATION -Mantiene I-EXPLORATION -desarrollo I-EXPLORATION -neurológico I-EXPLORATION -adecuado I-EXPLORATION -y I-EXPLORATION -crecimiento I-EXPLORATION -del I-EXPLORATION -perímetro I-EXPLORATION -cefálico I-EXPLORATION -(perímetro I-EXPLORATION -cefálico: I-EXPLORATION -40 I-EXPLORATION -cm, I-EXPLORATION -P75). I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION +requerimiento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +drogas I-PAST_MEDICAL_HISTORY +vasoactivas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +hemoderivados. I-PAST_MEDICAL_HISTORY +Recibió I-PAST_MEDICAL_HISTORY +profilaxis I-PAST_MEDICAL_HISTORY +antibiótica I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +inducción I-PAST_MEDICAL_HISTORY +inmunosupresor I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +micofenolato I-PAST_MEDICAL_HISTORY +mofetil, I-PAST_MEDICAL_HISTORY +solu-moderin I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +daclizumab. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +postoperatorio I-PAST_MEDICAL_HISTORY +inmediato I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +diarreas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +fiebre, I-PAST_MEDICAL_HISTORY +descartándose I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +presencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Clostridium I-PAST_MEDICAL_HISTORY +difficile I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +determinación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +toxina I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +B I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +heces I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +enzimoinmunoanálisis. I-PAST_MEDICAL_HISTORY +El B-PRESENT_ILLNESS +décimo I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +postoperatorio I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +intenso, I-PRESENT_ILLNESS +distensión I-PRESENT_ILLNESS +abdominal, I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +palpación I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +fosa I-PRESENT_ILLNESS +iliaca I-PRESENT_ILLNESS +derecha I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +leucocitosis I-PRESENT_ILLNESS +(35.000 I-PRESENT_ILLNESS +l/mm3). I-PRESENT_ILLNESS +Se B-EXPLORATION +realizó I-EXPLORATION +TAC I-EXPLORATION +abdominal I-EXPLORATION +urgente, I-EXPLORATION +objetivándose I-EXPLORATION +distensión I-EXPLORATION de I-EXPLORATION -craneosinostosis I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -Rx I-EXPLORATION -simple I-EXPLORATION +ciego I-EXPLORATION de I-EXPLORATION -cráneo, I-EXPLORATION -informada I-EXPLORATION -como I-EXPLORATION -probable I-EXPLORATION -cierre I-EXPLORATION -precoz I-EXPLORATION +hasta I-EXPLORATION +12 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -sutura I-EXPLORATION -sagital I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -deriva I-EXPLORATION -a I-EXPLORATION -Cirugía I-EXPLORATION -Pediátrica. I-EXPLORATION -Con I-EXPLORATION +diámetro, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION el I-EXPLORATION diagnóstico I-EXPLORATION -probable I-EXPLORATION de I-EXPLORATION -craneosinostosis I-EXPLORATION -sagital I-EXPLORATION +vólvulo I-EXPLORATION +tipo I-EXPLORATION +"báscula I-EXPLORATION +cecal". I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +laparotomía I-EXPLORATION +urgente I-EXPLORATION y I-EXPLORATION -lambdoidea, I-EXPLORATION -solicitaron I-EXPLORATION -una I-EXPLORATION -TC I-EXPLORATION -craneal I-EXPLORATION -tridimensional I-EXPLORATION -que I-EXPLORATION +se I-EXPLORATION confirmó I-EXPLORATION el I-EXPLORATION -cierre I-EXPLORATION -parcial I-EXPLORATION +vólvulo I-EXPLORATION +cecal I-EXPLORATION +con I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -sutura I-EXPLORATION -sagital. I-EXPLORATION -Se B-EVOLUTION -derivó I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -Unidad I-EVOLUTION +necrosis I-EXPLORATION +intestinal, I-EXPLORATION +sin I-EXPLORATION +perforación. I-EXPLORATION +Se B-TREATMENT +practicó I-TREATMENT +hemicolectomía I-TREATMENT +derecha I-TREATMENT +con I-TREATMENT +anastomosis I-TREATMENT +íleo-cólica I-TREATMENT +manual. I-TREATMENT + I-TREATMENT +El B-EVOLUTION +enfermo I-EVOLUTION +desarrolló I-EVOLUTION +un I-EVOLUTION +postoperatorio I-EVOLUTION +sin I-EVOLUTION +incidencias. I-EVOLUTION +El B-EXPLORATION +informe I-EXPLORATION +anatomopatológico: I-EXPLORATION +infarto I-EXPLORATION +hemorrágico I-EXPLORATION +intestinal I-EXPLORATION +con I-EXPLORATION +necrosis I-EXPLORATION +transmural. I-EXPLORATION +Fue B-EVOLUTION +dado I-EVOLUTION de I-EVOLUTION -Neurocirugía I-EVOLUTION +alta I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +45 I-EVOLUTION +días I-EVOLUTION +post-trasplante I-EVOLUTION +sin I-EVOLUTION +presentar I-EVOLUTION +complicaciones I-EVOLUTION +postquirúrgicas I-EVOLUTION +abdominales. I-EVOLUTION +La I-EVOLUTION +función I-EVOLUTION +del I-EVOLUTION +injerto I-EVOLUTION +fue I-EVOLUTION +normal, I-EVOLUTION +con I-EVOLUTION +fracción I-EVOLUTION de I-EVOLUTION -referencia I-EVOLUTION +eyección I-EVOLUTION +del I-EVOLUTION +77% I-EVOLUTION a I-EVOLUTION los I-EVOLUTION -seis I-EVOLUTION +dos I-EVOLUTION meses I-EVOLUTION +del I-EVOLUTION +trasplante. I-EVOLUTION + I-EVOLUTION +En I-EVOLUTION +nuestra I-EVOLUTION +experiencia I-EVOLUTION +las I-EVOLUTION +complicaciones I-EVOLUTION +colónicas I-EVOLUTION +agudas I-EVOLUTION +afectan I-EVOLUTION +al I-EVOLUTION +2% I-EVOLUTION de I-EVOLUTION -edad. I-EVOLUTION +los I-EVOLUTION +trasplantados, I-EVOLUTION +siendo I-EVOLUTION +más I-EVOLUTION +frecuentes I-EVOLUTION +en I-EVOLUTION +varones I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +edad I-EVOLUTION +media I-EVOLUTION +superior I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +55 I-EVOLUTION +años I-EVOLUTION +(2,3). I-EVOLUTION I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -14 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -salud I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -febril I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -oC I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -tos, I-PRESENT_ILLNESS -mocos, I-PRESENT_ILLNESS -deposiciones I-PRESENT_ILLNESS -líquidas I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -frecuentes, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -inapetencia I-PRESENT_ILLNESS -parcial. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración, I-EXPLORATION -destaca I-EXPLORATION -eritema I-EXPLORATION -amigdalar I-EXPLORATION -con I-EXPLORATION -exudado I-EXPLORATION -escaso, I-EXPLORATION -moco I-EXPLORATION -en I-EXPLORATION -cavum, I-EXPLORATION -eritema I-EXPLORATION -timpánico I-EXPLORATION -sin I-EXPLORATION -otros I-EXPLORATION -signos I-EXPLORATION -y I-EXPLORATION -eritema I-EXPLORATION -conjuntival I-EXPLORATION -sin I-EXPLORATION -otras I-EXPLORATION -alteraciones. I-EXPLORATION -Se B-TREATMENT -diagnostica I-TREATMENT -de I-TREATMENT -viriasis I-TREATMENT -y I-TREATMENT -se I-TREATMENT -recomienda I-TREATMENT -tratamiento I-TREATMENT -sintomático. I-TREATMENT - I-TREATMENT -A B-EVOLUTION +La I-EVOLUTION +patogenia I-EVOLUTION +se I-EVOLUTION +ha I-EVOLUTION +relacionado I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +inmunosupresor, I-EVOLUTION +especialmente I-EVOLUTION los I-EVOLUTION -tres I-EVOLUTION -días, I-EVOLUTION -acude I-EVOLUTION -al I-EVOLUTION -hospital I-EVOLUTION +esteroides, I-EVOLUTION +bien I-EVOLUTION por I-EVOLUTION -aparición I-EVOLUTION +presentar I-EVOLUTION +un I-EVOLUTION +episodio I-EVOLUTION de I-EVOLUTION -lesiones I-EVOLUTION -purpúricas I-EVOLUTION +rechazo I-EVOLUTION +agudo I-EVOLUTION +o I-EVOLUTION +por I-EVOLUTION +acontecer I-EVOLUTION en I-EVOLUTION los I-EVOLUTION -miembros I-EVOLUTION -inferiores I-EVOLUTION +primeros I-EVOLUTION +días I-EVOLUTION +post-trasplante. I-EVOLUTION +La I-EVOLUTION +otra I-EVOLUTION +causa I-EVOLUTION +posible I-EVOLUTION +son I-EVOLUTION +las I-EVOLUTION +derivadas I-EVOLUTION +del I-EVOLUTION +compromiso I-EVOLUTION +vascular I-EVOLUTION +gastrointestinal I-EVOLUTION +bien I-EVOLUTION +por I-EVOLUTION +patología I-EVOLUTION +vascular I-EVOLUTION +previa I-EVOLUTION +abdominal I-EVOLUTION +o I-EVOLUTION +por I-EVOLUTION +el I-EVOLUTION +bajo I-EVOLUTION +gasto I-EVOLUTION +cardiaco I-EVOLUTION +tras I-EVOLUTION +el I-EVOLUTION +trasplante I-EVOLUTION +(isquemia I-EVOLUTION +intestinal I-EVOLUTION +no I-EVOLUTION +oclusiva) I-EVOLUTION +(1-3). I-EVOLUTION +Deben I-EVOLUTION +descartarse I-EVOLUTION +las I-EVOLUTION +infecciones, I-EVOLUTION +especialmente I-EVOLUTION +cuando I-EVOLUTION +el I-EVOLUTION +enfermo I-EVOLUTION +había I-EVOLUTION +desarrollado I-EVOLUTION +fiebre, I-EVOLUTION +leucocitosis I-EVOLUTION y I-EVOLUTION +diarrea. I-EVOLUTION +En I-EVOLUTION los I-EVOLUTION -pabellones I-EVOLUTION -auriculares, I-EVOLUTION +primeros I-EVOLUTION +días I-EVOLUTION +post-trasplante I-EVOLUTION +la I-EVOLUTION +infección I-EVOLUTION +por I-EVOLUTION +Clostridium I-EVOLUTION +difficile I-EVOLUTION +cursa I-EVOLUTION +con I-EVOLUTION +diarreas, I-EVOLUTION +fiebre I-EVOLUTION y I-EVOLUTION -edema I-EVOLUTION +leucocitosis, I-EVOLUTION +descartándose I-EVOLUTION en I-EVOLUTION -el I-EVOLUTION -dorso I-EVOLUTION +nuestro I-EVOLUTION +caso I-EVOLUTION +por I-EVOLUTION +la I-EVOLUTION +determinación I-EVOLUTION de I-EVOLUTION -manos I-EVOLUTION +la I-EVOLUTION +toxina I-EVOLUTION +A I-EVOLUTION y I-EVOLUTION -pies. I-EVOLUTION -Se B-EXPLORATION -ingresa I-EXPLORATION -durante I-EXPLORATION -cinco I-EXPLORATION -días I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -púrpura I-EXPLORATION -de I-EXPLORATION -Schönlein-Henoch I-EXPLORATION -con I-EXPLORATION -estudio I-EXPLORATION -analítico I-EXPLORATION -sanguíneo I-EXPLORATION -con I-EXPLORATION -coagulación I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -(tanto I-EXPLORATION -en I-EXPLORATION -fase I-EXPLORATION -aguda I-EXPLORATION -como I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -dos I-EXPLORATION -meses I-EXPLORATION -posteriores) I-EXPLORATION -sin I-EXPLORATION -proteinuria I-EXPLORATION -ni I-EXPLORATION -hematuria. I-EXPLORATION -Recibe B-TREATMENT -penicilina I-TREATMENT -oral I-TREATMENT -por I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -etiología I-TREATMENT -estreptocócica, I-TREATMENT -encontrándose I-TREATMENT -en I-TREATMENT -el I-TREATMENT -cultivo I-TREATMENT -del I-TREATMENT -frotis I-TREATMENT -faríngeo I-TREATMENT -un I-TREATMENT -S. I-TREATMENT -pyogenes I-TREATMENT -del I-TREATMENT -grupo I-TREATMENT -A. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -nueve I-EVOLUTION -días I-EVOLUTION -del I-EVOLUTION -ingreso, I-EVOLUTION -acude I-EVOLUTION -al I-EVOLUTION -centro I-EVOLUTION +B I-EVOLUTION +(6). I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +descrito I-EVOLUTION +presentaba I-EVOLUTION +varios I-EVOLUTION +factores I-EVOLUTION de I-EVOLUTION -salud, I-EVOLUTION -donde I-EVOLUTION -se I-EVOLUTION -objetivan I-EVOLUTION -lesiones I-EVOLUTION -residuales I-EVOLUTION +riesgo I-EVOLUTION +como I-EVOLUTION +el I-EVOLUTION +tratarse I-EVOLUTION de I-EVOLUTION -púrpura, I-EVOLUTION -sin I-EVOLUTION -edema I-EVOLUTION -articular. I-EVOLUTION -Se B-EXPLORATION -realiza I-EXPLORATION -un I-EXPLORATION -nuevo I-EXPLORATION -frotis I-EXPLORATION -faríngeo, I-EXPLORATION -que I-EXPLORATION -resulta I-EXPLORATION -negativo. I-EXPLORATION - I-EXPLORATION +una I-EVOLUTION +reintervención, I-EVOLUTION +duración I-EVOLUTION +prolongada I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +intervención, I-EVOLUTION +transfusión I-EVOLUTION +de I-EVOLUTION +hemoderivados I-EVOLUTION +y I-EVOLUTION +necesidad I-EVOLUTION +de I-EVOLUTION +drogas I-EVOLUTION +vasoactivas I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +postoperatorio I-EVOLUTION +inmediato I-EVOLUTION +(dobutamina, I-EVOLUTION +noradrenalina). I-EVOLUTION + I-EVOLUTION -Niño B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS +74 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS que I-PRESENT_ILLNESS acude I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -pediatra I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -revisión I-PRESENT_ILLNESS -rutinaria. I-PRESENT_ILLNESS -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -niño I-PAST_MEDICAL_HISTORY -sano I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -ningún I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -personal I-PAST_MEDICAL_HISTORY +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +epífora I-PRESENT_ILLNESS +bilateral, I-PRESENT_ILLNESS +mayor I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +(OI), I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dacriocistitis I-PRESENT_ILLNESS +aguda. I-PRESENT_ILLNESS +Como B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Durante B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física, I-EXPLORATION -el I-EXPLORATION -pediatra I-EXPLORATION -detecta I-EXPLORATION -un I-EXPLORATION -soplo I-EXPLORATION -cardiaco I-EXPLORATION -sistólico I-EXPLORATION -vibratorio I-EXPLORATION -2/6 I-EXPLORATION -en I-EXPLORATION -borde I-EXPLORATION -esternal I-EXPLORATION -izquierdo I-EXPLORATION -bajo, I-EXPLORATION -no I-EXPLORATION -irradiado I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -modifica I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -postura, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -segundo I-EXPLORATION -tono I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -tonos I-EXPLORATION -arrítmicos I-EXPLORATION -sin I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -fase I-EXPLORATION -respiratoria. I-EXPLORATION -Los I-EXPLORATION -pulsos I-EXPLORATION -periféricos I-EXPLORATION -son I-EXPLORATION -palpables I-EXPLORATION -y I-EXPLORATION -simétricos. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -del I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -es I-EXPLORATION -normal. I-EXPLORATION -La I-EXPLORATION -tensión I-EXPLORATION -arterial I-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -dentro I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -percentiles I-EXPLORATION -para I-EXPLORATION -su I-EXPLORATION -edad I-EXPLORATION -y I-EXPLORATION -talla. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -está I-EXPLORATION -asintomático; I-EXPLORATION -no I-EXPLORATION -refiere I-EXPLORATION -haber I-EXPLORATION -presentado I-EXPLORATION -palpitaciones, I-EXPLORATION -precordalgia I-EXPLORATION -ni I-EXPLORATION -síncopes I-EXPLORATION -y I-EXPLORATION -tiene I-EXPLORATION +interés I-PAST_MEDICAL_HISTORY +presenta I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +drenaje I-PAST_MEDICAL_HISTORY +quirúrgico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +senos I-PAST_MEDICAL_HISTORY +etmoidales I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +sinusitis I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +juventud. I-PAST_MEDICAL_HISTORY +Presenta B-EXPLORATION una I-EXPLORATION -buena I-EXPLORATION -tolerancia I-EXPLORATION -al I-EXPLORATION -ejercicio I-EXPLORATION -físico. I-EXPLORATION - I-EXPLORATION -En B-FAMILY_HISTORY -la I-FAMILY_HISTORY -familia I-FAMILY_HISTORY -no I-FAMILY_HISTORY -refieren I-FAMILY_HISTORY -enfermedades I-FAMILY_HISTORY -cardiovasculares I-FAMILY_HISTORY -ni I-FAMILY_HISTORY -hay I-FAMILY_HISTORY -antecedente I-FAMILY_HISTORY -de I-FAMILY_HISTORY -muerte I-FAMILY_HISTORY -súbita. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Ante B-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +agudeza I-EXPLORATION +visual I-EXPLORATION +(AV) I-EXPLORATION de I-EXPLORATION -tonos I-EXPLORATION -arrítmicos I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -auscultación, I-EXPLORATION -el I-EXPLORATION -pediatra I-EXPLORATION -realiza I-EXPLORATION -un I-EXPLORATION -electrocardiograma I-EXPLORATION -(ECG) I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -consulta I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -muestra I-EXPLORATION +0, I-EXPLORATION +3 I-EXPLORATION en I-EXPLORATION +ambos I-EXPLORATION +ojos. I-EXPLORATION +Esta I-EXPLORATION +visión I-EXPLORATION +estaba I-EXPLORATION +justificada I-EXPLORATION +por I-EXPLORATION la I-EXPLORATION -Fig. I-EXPLORATION -1. I-EXPLORATION - I-EXPLORATION -¿Cuál I-EXPLORATION -es I-EXPLORATION -la I-EXPLORATION -lectura I-EXPLORATION -e I-EXPLORATION -interpretación I-EXPLORATION -del I-EXPLORATION -electrocardiograma? I-EXPLORATION -1 I-EXPLORATION - I-EXPLORATION -Aunque I-EXPLORATION -lo I-EXPLORATION -primero I-EXPLORATION -que I-EXPLORATION -nos I-EXPLORATION -llama I-EXPLORATION -la I-EXPLORATION -atención I-EXPLORATION -es I-EXPLORATION -la I-EXPLORATION -irregularidad I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ritmo, I-EXPLORATION -empezamos I-EXPLORATION -nuestra I-EXPLORATION -lectura I-EXPLORATION -sistemática I-EXPLORATION -comprobando I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -un I-EXPLORATION -ritmo I-EXPLORATION -sinusal I-EXPLORATION -(onda I-EXPLORATION -P I-EXPLORATION -positiva I-EXPLORATION -en I-EXPLORATION -I I-EXPLORATION -y I-EXPLORATION -aVF) I-EXPLORATION -a I-EXPLORATION -una I-EXPLORATION -frecuencia I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -55 I-EXPLORATION -lpm. I-EXPLORATION - I-EXPLORATION -Seguidamente I-EXPLORATION -analizamos I-EXPLORATION -el I-EXPLORATION -eje I-EXPLORATION -del I-EXPLORATION -QRS I-EXPLORATION -siguiendo I-EXPLORATION -tres I-EXPLORATION -pasos: I-EXPLORATION -1) I-EXPLORATION -localizar I-EXPLORATION -el I-EXPLORATION -cuadrante I-EXPLORATION -utilizando I-EXPLORATION -las I-EXPLORATION -derivaciones I-EXPLORATION -I I-EXPLORATION +cataratas I-EXPLORATION y I-EXPLORATION -aVF; I-EXPLORATION -2) I-EXPLORATION -encontrar I-EXPLORATION -la I-EXPLORATION -derivación I-EXPLORATION -con I-EXPLORATION -complejo I-EXPLORATION -QRS I-EXPLORATION -equifásico I-EXPLORATION -(altura I-EXPLORATION +además I-EXPLORATION +tenía I-EXPLORATION +una I-EXPLORATION +obstrucción I-EXPLORATION +bilateral I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -onda I-EXPLORATION -R I-EXPLORATION -similar I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -de I-EXPLORATION +vía I-EXPLORATION +lagrimal. I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +dacriocistografía I-TREATMENT +izquierda I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +se I-TREATMENT +le I-TREATMENT +implantó I-TREATMENT +una I-TREATMENT +prótesis I-TREATMENT +recta I-TREATMENT +de I-TREATMENT +Wacrees I-TREATMENT +sin I-TREATMENT +complicaciones. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +las I-EVOLUTION +24 I-EVOLUTION +horas I-EVOLUTION +comienzó I-EVOLUTION +una I-EVOLUTION +inflamación I-EVOLUTION +palpebral I-EVOLUTION +y I-EVOLUTION +dolor I-EVOLUTION +en I-EVOLUTION +región I-EVOLUTION +orbitaria I-EVOLUTION +izquierda. I-EVOLUTION +Tras I-EVOLUTION +48 I-EVOLUTION +horas I-EVOLUTION +refirió I-EVOLUTION +pérdida I-EVOLUTION +brusca I-EVOLUTION +de I-EVOLUTION +agudeza I-EVOLUTION +visual I-EVOLUTION +del I-EVOLUTION +OI I-EVOLUTION +con I-EVOLUTION +mal I-EVOLUTION +estado I-EVOLUTION +general I-EVOLUTION +y I-EVOLUTION +febrícula I-EVOLUTION +(37,6º). I-EVOLUTION +A I-EVOLUTION +las I-EVOLUTION +72 I-EVOLUTION +horas I-EVOLUTION +acudió I-EVOLUTION +a I-EVOLUTION +urgencias, I-EVOLUTION +presentando I-EVOLUTION +una I-EVOLUTION +visión I-EVOLUTION +de I-EVOLUTION +movimiento I-EVOLUTION +de I-EVOLUTION +manos I-EVOLUTION +a I-EVOLUTION +50 I-EVOLUTION +cms, I-EVOLUTION +marcado I-EVOLUTION +exoftalmos I-EVOLUTION +con I-EVOLUTION +clínica I-EVOLUTION +inflamatoria I-EVOLUTION +periocular, I-EVOLUTION +oftalmoplejia I-EVOLUTION +con I-EVOLUTION +dolor I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +movimientos I-EVOLUTION +oculares I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +biomicroscopía I-EVOLUTION +midriasis I-EVOLUTION +paralítica I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +OI I-EVOLUTION +con I-EVOLUTION +anestesia I-EVOLUTION +corneal. I-EVOLUTION +Oftalmoscópicamente B-EXPLORATION la I-EXPLORATION -onda I-EXPLORATION -S) I-EXPLORATION -entre I-EXPLORATION -las I-EXPLORATION -derivaciones I-EXPLORATION +papila I-EXPLORATION +era I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -miembros I-EXPLORATION -(I, I-EXPLORATION -II, I-EXPLORATION -III, I-EXPLORATION -aVR, I-EXPLORATION -aVL, I-EXPLORATION -aVF), I-EXPLORATION -y I-EXPLORATION -3) I-EXPLORATION -el I-EXPLORATION -eje I-EXPLORATION -QRS I-EXPLORATION -será I-EXPLORATION -perpendicular I-EXPLORATION -a I-EXPLORATION -esta I-EXPLORATION -derivación I-EXPLORATION -dentro I-EXPLORATION -del I-EXPLORATION -cuadrante I-EXPLORATION -localizado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -paso I-EXPLORATION -1. I-EXPLORATION +aspecto I-EXPLORATION +normal I-EXPLORATION +con I-EXPLORATION +pulso I-EXPLORATION +venoso I-EXPLORATION +espontáneo I-EXPLORATION +negativo. I-EXPLORATION En I-EXPLORATION -nuestro I-EXPLORATION -caso: I-EXPLORATION -1) I-EXPLORATION -el I-EXPLORATION -QRS I-EXPLORATION -es I-EXPLORATION -positivo I-EXPLORATION -en I-EXPLORATION -ambas I-EXPLORATION -derivaciones I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION el I-EXPLORATION -eje I-EXPLORATION -se I-EXPLORATION -encontrará I-EXPLORATION -entre I-EXPLORATION -0 I-EXPLORATION -y I-EXPLORATION -90o; I-EXPLORATION -2) I-EXPLORATION -la I-EXPLORATION -derivación I-EXPLORATION +hemograma I-EXPLORATION +de I-EXPLORATION +urgencias I-EXPLORATION +presentaba I-EXPLORATION +leucocitosis I-EXPLORATION con I-EXPLORATION -complejo I-EXPLORATION -más I-EXPLORATION -equifásico I-EXPLORATION -sería I-EXPLORATION -la I-EXPLORATION -derivación I-EXPLORATION -I, I-EXPLORATION -cuya I-EXPLORATION -perpendicular I-EXPLORATION -es I-EXPLORATION -90o, I-EXPLORATION -por I-EXPLORATION -tanto I-EXPLORATION -el I-EXPLORATION -eje I-EXPLORATION -QRS I-EXPLORATION -está I-EXPLORATION -a I-EXPLORATION -90o. I-EXPLORATION - I-EXPLORATION +desviación I-EXPLORATION +izquierda. I-EXPLORATION El I-EXPLORATION -eje I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -onda I-EXPLORATION -T I-EXPLORATION -es I-EXPLORATION -normal I-EXPLORATION -también I-EXPLORATION -pues I-EXPLORATION -está I-EXPLORATION -entre I-EXPLORATION -0 I-EXPLORATION -y I-EXPLORATION -90o. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -duración I-EXPLORATION -del I-EXPLORATION -complejo I-EXPLORATION -QRS I-EXPLORATION -es I-EXPLORATION -normal I-EXPLORATION -(0, I-EXPLORATION -04 I-EXPLORATION -seg). I-EXPLORATION -No I-EXPLORATION -observamos I-EXPLORATION -morfología I-EXPLORATION -de I-EXPLORATION -QRS I-EXPLORATION -que I-EXPLORATION -sugiera I-EXPLORATION -alteración I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -conducción I-EXPLORATION -intraventricular I-EXPLORATION -(por I-EXPLORATION -ejemplo, I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -rR´ I-EXPLORATION -en I-EXPLORATION -V1) I-EXPLORATION -ni I-EXPLORATION -hallazgos I-EXPLORATION -sugestivos I-EXPLORATION -de I-EXPLORATION -hipertrofia I-EXPLORATION -ventricular. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -onda I-EXPLORATION -T I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -segmento I-EXPLORATION -ST I-EXPLORATION -son I-EXPLORATION -normales; I-EXPLORATION -no I-EXPLORATION -hay I-EXPLORATION -alteraciones I-EXPLORATION -en I-EXPLORATION +TAC I-EXPLORATION +craneal I-EXPLORATION +realizado I-EXPLORATION +era I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +celulitis I-EXPLORATION +orbitaria I-EXPLORATION +OI. I-EXPLORATION +Asimismo I-EXPLORATION la I-EXPLORATION -repolarización. I-EXPLORATION +paciente I-EXPLORATION +tenía I-EXPLORATION +una I-EXPLORATION +neuritis I-EXPLORATION +óptica I-EXPLORATION +izquierda I-EXPLORATION +por I-EXPLORATION +compresión I-EXPLORATION +intraorbitaria. I-EXPLORATION I-EXPLORATION -A I-EXPLORATION -continuación I-EXPLORATION -analizamos I-EXPLORATION -los I-EXPLORATION -intervalos I-EXPLORATION -PR2: I-EXPLORATION -llama I-EXPLORATION -la I-EXPLORATION -atención I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -intervalo I-EXPLORATION -PR I-EXPLORATION -(desde I-EXPLORATION -el I-EXPLORATION -inicio I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -onda I-EXPLORATION -P I-EXPLORATION -hasta I-EXPLORATION -el I-EXPLORATION -inicio I-EXPLORATION -del I-EXPLORATION -QRS) I-EXPLORATION -va I-EXPLORATION -variando I-EXPLORATION -a I-EXPLORATION -lo I-EXPLORATION -largo I-EXPLORATION -del I-EXPLORATION -registro, I-EXPLORATION -no I-EXPLORATION -es I-EXPLORATION -constante. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -Fig. I-EXPLORATION -2 I-EXPLORATION +Se B-TREATMENT +instaura I-TREATMENT +tratamiento I-TREATMENT +sistémico I-TREATMENT +con I-TREATMENT +metil-prednisolona I-TREATMENT +(250 I-TREATMENT +mgr/iv/6 I-TREATMENT +h), I-TREATMENT +ceftriaxona I-TREATMENT +(2 I-TREATMENT +gr/iv/12 I-TREATMENT +h) I-TREATMENT +y I-TREATMENT +Vancomicina I-TREATMENT +(1 I-TREATMENT +gr/iv/12 I-TREATMENT +h), I-TREATMENT +así I-TREATMENT +como I-TREATMENT +tratamiento I-TREATMENT +tópico I-TREATMENT +en I-TREATMENT +OI. I-TREATMENT + I-TREATMENT +El B-EVOLUTION +cuadro I-EVOLUTION +inflamatorio I-EVOLUTION +periocular I-EVOLUTION +mejoró I-EVOLUTION +notablemente I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +primeras I-EVOLUTION +24 I-EVOLUTION +horas, I-EVOLUTION +pero I-EVOLUTION +no I-EVOLUTION +la I-EVOLUTION +agudeza I-EVOLUTION +visual, I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +limitaba I-EVOLUTION +a I-EVOLUTION +percepción I-EVOLUTION +de I-EVOLUTION +colores I-EVOLUTION +parcheados I-EVOLUTION +(azul, I-EVOLUTION +marrón). I-EVOLUTION + I-EVOLUTION +Transcurrida B-EXPLORATION +1 I-EXPLORATION +semana I-EXPLORATION se I-EXPLORATION -muestra I-EXPLORATION -el I-EXPLORATION -trazado I-EXPLORATION -en I-EXPLORATION -DII I-EXPLORATION +retiró I-EXPLORATION +la I-EXPLORATION +prótesis I-EXPLORATION +lacrimonasal, I-EXPLORATION a I-EXPLORATION -partir I-EXPLORATION -del I-EXPLORATION -quinto I-EXPLORATION -latido I-EXPLORATION -del I-EXPLORATION -ECG I-EXPLORATION -basal: I-EXPLORATION -el I-EXPLORATION -intervalo I-EXPLORATION -PR I-EXPLORATION -del I-EXPLORATION -primer I-EXPLORATION -latido I-EXPLORATION -mide I-EXPLORATION -4, I-EXPLORATION -5 I-EXPLORATION -cuadritos I-EXPLORATION -o I-EXPLORATION -milímetros I-EXPLORATION -(0, I-EXPLORATION -04 I-EXPLORATION -x I-EXPLORATION -4, I-EXPLORATION -5=0, I-EXPLORATION -18 I-EXPLORATION -seg), I-EXPLORATION -que I-EXPLORATION -está I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -límite I-EXPLORATION -superior I-EXPLORATION +pesar I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -normalidad I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -edad, I-EXPLORATION -el I-EXPLORATION -segundo I-EXPLORATION -latido I-EXPLORATION -tiene I-EXPLORATION +su I-EXPLORATION +buena I-EXPLORATION +localización I-EXPLORATION +y I-EXPLORATION +funcionamiento, I-EXPLORATION +haciéndose I-EXPLORATION un I-EXPLORATION -intervalo I-EXPLORATION -PR I-EXPLORATION -de I-EXPLORATION -5, I-EXPLORATION -5 I-EXPLORATION -mm I-EXPLORATION -(0, I-EXPLORATION -22 I-EXPLORATION -seg), I-EXPLORATION -el I-EXPLORATION -tercero I-EXPLORATION -de I-EXPLORATION -6 I-EXPLORATION -mm I-EXPLORATION -(0, I-EXPLORATION -24 I-EXPLORATION -seg), I-EXPLORATION -el I-EXPLORATION -cuarto I-EXPLORATION -de I-EXPLORATION -8 I-EXPLORATION -mm I-EXPLORATION -(0, I-EXPLORATION -32 I-EXPLORATION -seg), I-EXPLORATION -todos I-EXPLORATION -ellos I-EXPLORATION -por I-EXPLORATION -encima I-EXPLORATION -del I-EXPLORATION -límite I-EXPLORATION -superior I-EXPLORATION +estudio I-EXPLORATION +microbiológico I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -normalidad. I-EXPLORATION -Vemos I-EXPLORATION -también I-EXPLORATION -que I-EXPLORATION -después I-EXPLORATION -del I-EXPLORATION -cuarto I-EXPLORATION -latido I-EXPLORATION -hay I-EXPLORATION -una I-EXPLORATION -onda I-EXPLORATION -P I-EXPLORATION -(marcada I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -flecha) I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -va I-EXPLORATION -seguida I-EXPLORATION -de I-EXPLORATION -complejo I-EXPLORATION -QRS. I-EXPLORATION -Este I-EXPLORATION -registro I-EXPLORATION -electrocardiográfico I-EXPLORATION -(intervalo I-EXPLORATION -PR I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -alarga I-EXPLORATION -progresivamente I-EXPLORATION -hasta I-EXPLORATION -que I-EXPLORATION -una I-EXPLORATION -onda I-EXPLORATION -P I-EXPLORATION -no I-EXPLORATION -conduce) I-EXPLORATION -refleja I-EXPLORATION +misma I-EXPLORATION +y I-EXPLORATION +aislándose I-EXPLORATION +tres I-EXPLORATION +gérmenes: I-EXPLORATION +Streptococcus I-EXPLORATION +mitis, I-EXPLORATION +Staphylococcus I-EXPLORATION +epidérmidis I-EXPLORATION +y I-EXPLORATION un I-EXPLORATION -bloqueo I-EXPLORATION -auriculoventricular I-EXPLORATION -(BAV) I-EXPLORATION -de I-EXPLORATION -segundo I-EXPLORATION -grado I-EXPLORATION -tipo I-EXPLORATION -Mobitz I-EXPLORATION -I. I-EXPLORATION -El I-EXPLORATION -intervalo I-EXPLORATION -QTc I-EXPLORATION -es I-EXPLORATION -normal I-EXPLORATION -(0, I-EXPLORATION -38 I-EXPLORATION -seg). I-EXPLORATION +bacilo I-EXPLORATION +gram I-EXPLORATION +negativo I-EXPLORATION +oxidasa I-EXPLORATION +positivo I-EXPLORATION +(sin I-EXPLORATION +determinar). I-EXPLORATION I-EXPLORATION -Ante B-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -hallazgos I-DERIVED_FROM/TO -electrocardiográficos, I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -pediatra I-DERIVED_FROM/TO -decide I-DERIVED_FROM/TO -remitir I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -hospital, I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -consulta I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cardiología I-DERIVED_FROM/TO -Pediátrica, I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -valoración I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -esta I-DERIVED_FROM/TO -arritmia. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO +Durante B-TREATMENT +la I-TREATMENT +evolución I-TREATMENT +se I-TREATMENT +desarrolló I-TREATMENT +un I-TREATMENT +piocele I-TREATMENT +que I-TREATMENT +precisó I-TREATMENT +dacriocistectomía I-TREATMENT +izquierda. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +la I-EVOLUTION +actualidad I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +presenta I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +OI I-EVOLUTION +una I-EVOLUTION +visión I-EVOLUTION +de I-EVOLUTION +percepción I-EVOLUTION +de I-EVOLUTION +luz, I-EVOLUTION +con I-EVOLUTION +leve I-EVOLUTION +midriasis I-EVOLUTION +arreactiva I-EVOLUTION +y I-EVOLUTION +atrofia I-EVOLUTION +óptica I-EVOLUTION +izquierda. I-EVOLUTION En B-EXPLORATION la I-EXPLORATION -consulta I-EXPLORATION -de I-EXPLORATION -Cardiología I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -ecocardiograma I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal, I-EXPLORATION -descartando I-EXPLORATION -patología I-EXPLORATION -estructural. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -nuevo I-EXPLORATION -electrocardiograma I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -ritmo I-EXPLORATION -sinusal I-EXPLORATION -a I-EXPLORATION -60 I-EXPLORATION -lpm I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -PR I-EXPLORATION -alargado I-EXPLORATION -(BAV I-EXPLORATION -de I-EXPLORATION -primer I-EXPLORATION -grado), I-EXPLORATION -siendo I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lectura I-EXPLORATION -sistemática I-EXPLORATION -normal. I-EXPLORATION -Tras I-EXPLORATION -realizar I-EXPLORATION -ejercicio I-EXPLORATION -leve, I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -finalidad I-EXPLORATION -de I-EXPLORATION -aumentar I-EXPLORATION -la I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca, I-EXPLORATION +angiografía I-EXPLORATION +fluoresceínica I-EXPLORATION se I-EXPLORATION -repitió I-EXPLORATION -el I-EXPLORATION -ECG, I-EXPLORATION -con I-EXPLORATION -normalización I-EXPLORATION -(acortamiento) I-EXPLORATION -del I-EXPLORATION -intervalo I-EXPLORATION -PR. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -resumen, I-EXPLORATION -estamos I-EXPLORATION -ante I-EXPLORATION -un I-EXPLORATION -paciente I-EXPLORATION -asintomático I-EXPLORATION -desde I-EXPLORATION -el I-EXPLORATION -punto I-EXPLORATION -de I-EXPLORATION -vista I-EXPLORATION -cardiovascular, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -soplo I-EXPLORATION -cardiaco I-EXPLORATION -de I-EXPLORATION -características I-EXPLORATION -funcionales, I-EXPLORATION -una I-EXPLORATION -ecocardiografía I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -hallazgo I-EXPLORATION -casual I-EXPLORATION -de I-EXPLORATION -BAV I-EXPLORATION -de I-EXPLORATION -primer I-EXPLORATION -grado I-EXPLORATION +observa I-EXPLORATION +hipofluorescencia I-EXPLORATION +papilar I-EXPLORATION +durante I-EXPLORATION +todo I-EXPLORATION +el I-EXPLORATION +angiograma I-EXPLORATION y I-EXPLORATION -de I-EXPLORATION -segundo I-EXPLORATION -grado I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -ECG. I-EXPLORATION - I-EXPLORATION -Para I-EXPLORATION -ampliar I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -se I-EXPLORATION -solicitó I-EXPLORATION -un I-EXPLORATION -Holter-ECG I-EXPLORATION -de I-EXPLORATION -24 I-EXPLORATION -horas I-EXPLORATION -que I-EXPLORATION -constató I-EXPLORATION +la I-EXPLORATION +RMN I-EXPLORATION un I-EXPLORATION -BAV I-EXPLORATION -de I-EXPLORATION -primer I-EXPLORATION -grado I-EXPLORATION -con I-EXPLORATION -dos I-EXPLORATION -episodios I-EXPLORATION -de I-EXPLORATION -BAV I-EXPLORATION +dudoso I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -segundo I-EXPLORATION -grado I-EXPLORATION -tipo I-EXPLORATION -Mobitz I-EXPLORATION -I I-EXPLORATION -durante I-EXPLORATION +señal I-EXPLORATION +tardío I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -descanso I-EXPLORATION -nocturno. I-EXPLORATION +nervio I-EXPLORATION +óptico. I-EXPLORATION I-EXPLORATION -Niña B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS +20 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -medio, I-PRESENT_ILLNESS -de B-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -asiático, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS +que I-PRESENT_ILLNESS acude I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS consulta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Atención I-PRESENT_ILLNESS -Primaria I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -siguiente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -llegar I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -orfanato I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -China I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -viviendo, I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -sido I-PRESENT_ILLNESS -adoptada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -familia I-PRESENT_ILLNESS -española I-PRESENT_ILLNESS -compuesta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -padre, I-PRESENT_ILLNESS -madre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -hijos I-PRESENT_ILLNESS -biológicos I-PRESENT_ILLNESS -adolescentes. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -acompaña I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -madre I-PRESENT_ILLNESS -adoptiva, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -solicita I-PRESENT_ILLNESS +solicitando I-PRESENT_ILLNESS una I-PRESENT_ILLNESS -valoración I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -estado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -salud, I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -espera I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ser I-PRESENT_ILLNESS -atendida I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -referencia I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Comunidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Madrid I-PRESENT_ILLNESS -establece I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS +solución I-PRESENT_ILLNESS +estética I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS su I-PRESENT_ILLNESS -Protocolo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Adopción I-PRESENT_ILLNESS -Internacional. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -inspección I-EXPLORATION -destaca I-EXPLORATION -su I-EXPLORATION -fenotipo I-EXPLORATION -mongoloide I-EXPLORATION -racial, I-EXPLORATION -un I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -nutricional I-EXPLORATION -y I-EXPLORATION -un I-EXPLORATION -comportamiento I-EXPLORATION -tranquilo. I-EXPLORATION -En I-EXPLORATION +frente I-PRESENT_ILLNESS +anterior. I-PRESENT_ILLNESS +Durante B-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +primeros I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +vida I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +sometido I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +intervenciones I-PAST_MEDICAL_HISTORY +quirúrgicas I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +conseguir I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +cierre I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tejidos I-PAST_MEDICAL_HISTORY +blandos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +labio I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +paladar. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION +extraoral I-EXPLORATION se I-EXPLORATION -descubre I-EXPLORATION +podía I-EXPLORATION +observar I-EXPLORATION +una I-EXPLORATION +asimetría I-EXPLORATION +del I-EXPLORATION +labio I-EXPLORATION +superior I-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +diversas I-EXPLORATION +operaciones I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION que I-EXPLORATION +fue I-EXPLORATION +sometido I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -periné I-EXPLORATION -hay I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -lineal I-EXPLORATION -entre I-EXPLORATION -la I-EXPLORATION -horquilla I-EXPLORATION -vulvar I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -ano, I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -de I-EXPLORATION -herida I-EXPLORATION -incisa, I-EXPLORATION -de I-EXPLORATION -fondo I-EXPLORATION -eritematoso, I-EXPLORATION -recubierta I-EXPLORATION -de I-EXPLORATION -mucosa I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -sangrado. I-EXPLORATION -La I-EXPLORATION -uretra, I-EXPLORATION -la I-EXPLORATION -vagina, I-EXPLORATION la I-EXPLORATION -vulva I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -ano I-EXPLORATION -tienen I-EXPLORATION -un I-EXPLORATION -aspecto I-EXPLORATION -normal. I-EXPLORATION +infancia. I-EXPLORATION I-EXPLORATION -La I-EXPLORATION -primera I-EXPLORATION -sospecha I-EXPLORATION -diagnóstica I-EXPLORATION -fue I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -agresión I-EXPLORATION -sexual, I-EXPLORATION -pero I-EXPLORATION +exploración I-EXPLORATION +intraoral I-EXPLORATION se I-EXPLORATION -optó I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -actitud I-EXPLORATION -expectante, I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION +pone I-EXPLORATION de I-EXPLORATION -sangrado I-EXPLORATION -activo I-EXPLORATION +manifiesto I-EXPLORATION +una I-EXPLORATION +evidente I-EXPLORATION +malposición I-EXPLORATION y I-EXPLORATION -de I-EXPLORATION -dolor, I-EXPLORATION -al I-EXPLORATION -aspecto I-EXPLORATION -normal I-EXPLORATION -del I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -genitales I-EXPLORATION -externos I-EXPLORATION +maloclusión I-EXPLORATION +dentaria I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +distintas I-EXPLORATION +agenesias I-EXPLORATION +dentales I-EXPLORATION +(15, I-EXPLORATION +12, I-EXPLORATION +11, I-EXPLORATION +25, I-EXPLORATION +34, I-EXPLORATION +33 I-EXPLORATION y I-EXPLORATION -al I-EXPLORATION -comportamiento I-EXPLORATION -tranquilo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -niña I-EXPLORATION -durante I-EXPLORATION -la I-EXPLORATION -exploración. I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -renal I-EXPLORATION +44) I-EXPLORATION y I-EXPLORATION +discrepancia I-EXPLORATION +maxilo-mandibular. I-EXPLORATION +Apreciándose I-EXPLORATION +también I-EXPLORATION +una I-EXPLORATION +gingivitis I-EXPLORATION +moderada I-EXPLORATION +por I-EXPLORATION +falta I-EXPLORATION de I-EXPLORATION -vías I-EXPLORATION -urinarias, I-EXPLORATION -que I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION +control I-EXPLORATION +de I-EXPLORATION +placa. I-EXPLORATION I-EXPLORATION -Tras B-EVOLUTION -los I-EVOLUTION -primeros I-EVOLUTION -controles I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -hospital I-EVOLUTION -de I-EVOLUTION -referencia I-EVOLUTION -antes I-EVOLUTION -mencionado, I-EVOLUTION -la I-EVOLUTION -madre I-EVOLUTION -acude I-EVOLUTION -angustiada I-EVOLUTION -al I-EVOLUTION -centro I-EVOLUTION -de I-EVOLUTION -salud, I-EVOLUTION -porque I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -hospital I-EVOLUTION -sospechan I-EVOLUTION -que I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -familia I-EVOLUTION -se I-EVOLUTION -está I-EVOLUTION -abusando I-EVOLUTION -sexualmente I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -niña, I-EVOLUTION -e I-EVOLUTION -incluso I-EVOLUTION -se I-EVOLUTION -les I-EVOLUTION -ha I-EVOLUTION -amenazado I-EVOLUTION -con I-EVOLUTION -denunciarlo I-EVOLUTION -así I-EVOLUTION -ante I-EVOLUTION -las I-EVOLUTION -autoridades. I-EVOLUTION -En I-EVOLUTION -este I-EVOLUTION -intervalo, I-EVOLUTION -la I-EVOLUTION -oportuna I-EVOLUTION -lectura I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -artículo I-EVOLUTION -relacionado I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -surco I-EVOLUTION -perineal3 I-EVOLUTION -proporciona I-EVOLUTION -la I-EVOLUTION -clave I-EVOLUTION -para I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -definitivo I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -malformación, I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -consiguiente I-EVOLUTION -alivio I-EVOLUTION -de I-EVOLUTION -todos I-EVOLUTION -los I-EVOLUTION -implicados. I-EVOLUTION -El B-EXPLORATION -estudio I-EXPLORATION -microbiológico I-EXPLORATION -solicitado I-EXPLORATION -por I-EXPLORATION +Vemos I-EXPLORATION +que I-EXPLORATION el I-EXPLORATION -hospital I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -enfermedades I-EXPLORATION +paciente I-EXPLORATION +presenta I-EXPLORATION +una I-EXPLORATION +grave I-EXPLORATION +dismorfosis I-EXPLORATION +maxilo-mandibular I-EXPLORATION +que I-EXPLORATION +aconsejaba I-EXPLORATION +la I-EXPLORATION +realización I-EXPLORATION de I-EXPLORATION -transmisión I-EXPLORATION -sexual I-EXPLORATION -fue I-EXPLORATION -negativo I-EXPLORATION -(lúes, I-EXPLORATION -virus I-EXPLORATION +un I-EXPLORATION +tratamiento I-EXPLORATION +ortodóncico I-EXPLORATION +previo I-EXPLORATION +a I-EXPLORATION +cualquier I-EXPLORATION +toma I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana I-EXPLORATION -y I-EXPLORATION +decisión I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -hepatitis I-EXPLORATION -B, I-EXPLORATION -C I-EXPLORATION -y I-EXPLORATION -A, I-EXPLORATION -herpes I-EXPLORATION +tipo I-EXPLORATION +prostodóncico. I-EXPLORATION +El I-EXPLORATION +caso I-EXPLORATION +fue I-EXPLORATION +consultado I-EXPLORATION +al I-EXPLORATION +especialista I-EXPLORATION +en I-EXPLORATION +ortodoncia I-EXPLORATION y I-EXPLORATION -gonococo). I-EXPLORATION -La B-EVOLUTION -niña I-EVOLUTION -refiere, I-EVOLUTION -de I-EVOLUTION -modo I-EVOLUTION -ocasional, I-EVOLUTION -dolor I-EVOLUTION -leve I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -vulva I-EVOLUTION -y I-EVOLUTION -tiene I-EVOLUTION -cierta I-EVOLUTION -tendencia I-EVOLUTION -al I-EVOLUTION -estreñimiento, I-EVOLUTION -aunque I-EVOLUTION -estas I-EVOLUTION -molestias I-EVOLUTION -no I-EVOLUTION -interfieren I-EVOLUTION -con I-EVOLUTION -su I-EVOLUTION -actividad I-EVOLUTION -habitual I-EVOLUTION -y I-EVOLUTION -no I-EVOLUTION -hay I-EVOLUTION -signos I-EVOLUTION -de I-EVOLUTION -irritación I-EVOLUTION -local. I-EVOLUTION - I-EVOLUTION - -Niño B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -octubre I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -39, I-PRESENT_ILLNESS -7 I-PRESENT_ILLNESS -oC, I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -ocular I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -En B-EXPLORATION +este I-EXPLORATION +planteo I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -leve I-EXPLORATION -eritema I-EXPLORATION -palpebral, I-EXPLORATION -sin I-EXPLORATION -oftalmoplejia I-EXPLORATION -ni I-EXPLORATION -proptosis, I-EXPLORATION +necesidad I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +cirugía I-EXPLORATION +ortognática I-EXPLORATION +previa I-EXPLORATION +al I-EXPLORATION +tratamiento I-EXPLORATION +protético. I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +explicó I-EXPLORATION +al I-EXPLORATION +paciente I-EXPLORATION y I-EXPLORATION -con I-EXPLORATION -agudeza I-EXPLORATION -visual I-EXPLORATION -normal. I-EXPLORATION -Se B-TREATMENT -pauta I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -amoxicilina/clavulánico I-TREATMENT +este I-EXPLORATION +se I-EXPLORATION +opuso I-EXPLORATION +a I-EXPLORATION +someterse I-EXPLORATION +al I-EXPLORATION +tratamiento I-EXPLORATION +quirúrgico. I-EXPLORATION + I-EXPLORATION +Analizado B-TREATMENT +los I-TREATMENT +hábitos I-TREATMENT +higiénicos I-TREATMENT +del I-TREATMENT +paciente I-TREATMENT +y I-TREATMENT +observando I-TREATMENT +una I-TREATMENT +clara I-TREATMENT +deficiencia I-TREATMENT en I-TREATMENT -dosis I-TREATMENT +su I-TREATMENT +control I-TREATMENT de I-TREATMENT -80 I-TREATMENT -mg/kg/día I-TREATMENT +placa, I-TREATMENT +se I-TREATMENT +opta I-TREATMENT por I-TREATMENT -vía I-TREATMENT -oral I-TREATMENT +realizar I-TREATMENT +una I-TREATMENT +prótesis I-TREATMENT +fija I-TREATMENT +sobre I-TREATMENT +coronas I-TREATMENT +telescópicas, I-TREATMENT +facultativamente I-TREATMENT +removible, I-TREATMENT +lo I-TREATMENT +cual, I-TREATMENT +por I-TREATMENT +un I-TREATMENT +lado I-TREATMENT +mejorará I-TREATMENT +el I-TREATMENT +control I-TREATMENT +de I-TREATMENT +placa I-TREATMENT +por I-TREATMENT +parte I-TREATMENT +del I-TREATMENT +paciente, I-TREATMENT +cuestión I-TREATMENT +fundamental I-TREATMENT +para I-TREATMENT +el I-TREATMENT +pronóstico I-TREATMENT +del I-TREATMENT +tratamiento, I-TREATMENT y I-TREATMENT +por I-TREATMENT +otro I-TREATMENT +lado I-TREATMENT se I-TREATMENT -informa I-TREATMENT -sobre I-TREATMENT +cumple I-TREATMENT +la I-TREATMENT +necesidad I-TREATMENT +de I-TREATMENT +ferulización I-TREATMENT +de I-TREATMENT +la I-TREATMENT +arcada I-TREATMENT +a I-TREATMENT +ambos I-TREATMENT +lados I-TREATMENT +de I-TREATMENT +la I-TREATMENT +fisura I-TREATMENT +palatina. I-TREATMENT + I-TREATMENT +Las I-TREATMENT +coronas I-TREATMENT +telescópicas I-TREATMENT +como I-TREATMENT +sistema I-TREATMENT +prostodóncico I-TREATMENT +de I-TREATMENT +doble I-TREATMENT +corona I-TREATMENT +permite I-TREATMENT +realizar I-TREATMENT +una I-TREATMENT +ferulización I-TREATMENT +cruzada I-TREATMENT +de I-TREATMENT +la I-TREATMENT +arcada I-TREATMENT +dentaria I-TREATMENT +(en I-TREATMENT +nuestro I-TREATMENT +paciente I-TREATMENT +se I-TREATMENT +limita I-TREATMENT +a I-TREATMENT +la I-TREATMENT +zona I-TREATMENT +anterior I-TREATMENT +del I-TREATMENT +maxilar), I-TREATMENT +lo I-TREATMENT +cual I-TREATMENT +va I-TREATMENT +a I-TREATMENT +permitir I-TREATMENT +una I-TREATMENT +estabilización I-TREATMENT +de I-TREATMENT +los I-TREATMENT +dientes I-TREATMENT +a I-TREATMENT +largo I-TREATMENT +plazo. I-TREATMENT +El I-TREATMENT +concepto I-TREATMENT +de I-TREATMENT +doble I-TREATMENT +corona I-TREATMENT +y I-TREATMENT +el I-TREATMENT +diseño I-TREATMENT +intrínseco I-TREATMENT +de I-TREATMENT las I-TREATMENT -posibles I-TREATMENT -complicaciones. I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -iniciar I-EVOLUTION +mismas I-TREATMENT +hace I-TREATMENT +que I-TREATMENT +la I-TREATMENT +transmisión I-TREATMENT +de I-TREATMENT +las I-TREATMENT +fuerzas I-TREATMENT +masticatorias I-TREATMENT +sean I-TREATMENT +lo I-TREATMENT +más I-TREATMENT +favorable I-TREATMENT +al I-TREATMENT +diente I-TREATMENT +ya I-TREATMENT +que I-TREATMENT +estas I-TREATMENT +se I-TREATMENT +van I-TREATMENT +a I-TREATMENT +producir I-TREATMENT +siempre I-TREATMENT +en I-TREATMENT +sentido I-TREATMENT +axial I-TREATMENT +al I-TREATMENT +eje I-TREATMENT +del I-TREATMENT +diente. I-TREATMENT +La I-TREATMENT +posibilidad I-TREATMENT +de I-TREATMENT +que I-TREATMENT +el I-TREATMENT +paciente I-TREATMENT +pueda I-TREATMENT +retirar I-TREATMENT +la I-TREATMENT +estructura I-TREATMENT +secundaria I-TREATMENT +hace I-TREATMENT +más I-TREATMENT +fácil I-TREATMENT +la I-TREATMENT +higiene I-TREATMENT +de I-TREATMENT +los I-TREATMENT +dientes I-TREATMENT +pilares I-TREATMENT +sobre I-TREATMENT +todo I-TREATMENT +si I-TREATMENT +se I-TREATMENT +compara I-TREATMENT +con I-TREATMENT +la I-TREATMENT +dificultad I-TREATMENT +de I-TREATMENT +limpieza I-TREATMENT +de I-TREATMENT +un I-TREATMENT +puente I-TREATMENT +fijo I-TREATMENT +convencional, I-TREATMENT +esta I-TREATMENT +circunstancia I-TREATMENT +fue I-TREATMENT +uno I-TREATMENT +de I-TREATMENT +los I-TREATMENT +principales I-TREATMENT +motivos I-TREATMENT +por I-TREATMENT +el I-TREATMENT +que I-TREATMENT +optamos I-TREATMENT +en I-TREATMENT +nuestro I-TREATMENT +paciente I-TREATMENT +para I-TREATMENT +realizar I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +coronas I-TREATMENT +telescópicas, I-TREATMENT +ya I-TREATMENT +que I-TREATMENT +la I-TREATMENT +higiene I-TREATMENT +del I-TREATMENT +paciente I-TREATMENT +no I-TREATMENT +era I-TREATMENT +del I-TREATMENT +todo I-TREATMENT +satisfactoria, I-TREATMENT +tal I-TREATMENT +y I-TREATMENT +como I-TREATMENT +hemos I-TREATMENT +mencionado I-TREATMENT +anteriormente. I-TREATMENT + I-TREATMENT +Desde B-EVOLUTION el I-EVOLUTION -tratamiento, I-EVOLUTION -acude I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -urgencia I-EVOLUTION -hospitalaria I-EVOLUTION -por I-EVOLUTION -no I-EVOLUTION -tolerar I-EVOLUTION +primer I-EVOLUTION +momento I-EVOLUTION +se I-EVOLUTION +informa I-EVOLUTION +al I-EVOLUTION +paciente I-EVOLUTION +que I-EVOLUTION el I-EVOLUTION -antibiótico I-EVOLUTION -oral I-EVOLUTION +resultado I-EVOLUTION +estético I-EVOLUTION y I-EVOLUTION -persistir I-EVOLUTION +funcional I-EVOLUTION +no I-EVOLUTION +va I-EVOLUTION +a I-EVOLUTION +ser I-EVOLUTION el I-EVOLUTION -dolor I-EVOLUTION -ocular I-EVOLUTION +idóneo, I-EVOLUTION +cuestión I-EVOLUTION +que I-EVOLUTION +en I-EVOLUTION +todo I-EVOLUTION +momento I-EVOLUTION +entiende I-EVOLUTION y I-EVOLUTION -la I-EVOLUTION -fiebre. I-EVOLUTION -En B-EXPLORATION -el I-EXPLORATION -hospital, I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -ocular I-EXPLORATION -detectó I-EXPLORATION -ptosis I-EXPLORATION -palpebral I-EXPLORATION -derecha I-EXPLORATION -con I-EXPLORATION -dolor I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -movilidad I-EXPLORATION -ocular, I-EXPLORATION -discreto I-EXPLORATION -eritema I-EXPLORATION -palpebral, I-EXPLORATION -pupilas I-EXPLORATION -isocóricas I-EXPLORATION -y I-EXPLORATION -normorreactivas, I-EXPLORATION -motilidad I-EXPLORATION -ocular I-EXPLORATION -conservada I-EXPLORATION -y I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo I-EXPLORATION -normal. I-EXPLORATION -Entre I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -complementarias, I-EXPLORATION -destaca: I-EXPLORATION -hemograma I-EXPLORATION -con I-EXPLORATION -leucocitos, I-EXPLORATION -14 I-EXPLORATION -720/μl I-EXPLORATION -(N: I-EXPLORATION -76, I-EXPLORATION -7%; I-EXPLORATION -L: I-EXPLORATION -15, I-EXPLORATION -5%; I-EXPLORATION -M: I-EXPLORATION -7, I-EXPLORATION -7%); I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -(PCR), I-EXPLORATION -227, I-EXPLORATION -1 I-EXPLORATION -mg/l; I-EXPLORATION -hemocultivo, I-EXPLORATION -negativo; I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -normal; I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -orbital, I-EXPLORATION -informada I-EXPLORATION -con I-EXPLORATION -cambios I-EXPLORATION -inflamatorios I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -grasa I-EXPLORATION -intraorbitaria I-EXPLORATION -extraconal I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -órbita I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -cambios I-EXPLORATION -inflamatorios I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -senos I-EXPLORATION -paranasales. I-EXPLORATION -Es B-TREATMENT -ingresado I-TREATMENT +acepta. I-EVOLUTION +Previo B-TREATMENT +al I-TREATMENT +tratamiento I-TREATMENT +prostodóncico I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +la I-TREATMENT +exodoncia I-TREATMENT +del I-TREATMENT +resto I-TREATMENT +radicular I-TREATMENT +del I-TREATMENT +diente I-TREATMENT +13 I-TREATMENT +y I-TREATMENT +una I-TREATMENT +vez I-TREATMENT +cicatrizada I-TREATMENT +la I-TREATMENT +herida I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +realizar I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +definitivo. I-TREATMENT +Este I-TREATMENT +consistió I-TREATMENT +en I-TREATMENT +la I-TREATMENT +preparación I-TREATMENT +de I-TREATMENT +los I-TREATMENT +dientes I-TREATMENT +pilares I-TREATMENT +15, I-TREATMENT +21, I-TREATMENT +22, I-TREATMENT +23 I-TREATMENT +y I-TREATMENT +24, I-TREATMENT +realizando I-TREATMENT +tallados I-TREATMENT +convencionales I-TREATMENT +para I-TREATMENT +coronas I-TREATMENT +telescópicas. I-TREATMENT +Cabe I-TREATMENT +resaltar I-TREATMENT +el I-TREATMENT +importante I-TREATMENT +tallado I-TREATMENT +que I-TREATMENT +hubo I-TREATMENT +que I-TREATMENT +realizar I-TREATMENT +a I-TREATMENT +la I-TREATMENT +corona I-TREATMENT +del I-TREATMENT +diente I-TREATMENT +21, I-TREATMENT +para I-TREATMENT +poder I-TREATMENT +conseguir I-TREATMENT +el I-TREATMENT +paralelismo I-TREATMENT +entre I-TREATMENT +pilares, I-TREATMENT +cuestión I-TREATMENT +ésta I-TREATMENT +que I-TREATMENT +es I-TREATMENT +de I-TREATMENT +crucial I-TREATMENT +importancia I-TREATMENT +en I-TREATMENT +todos I-TREATMENT +los I-TREATMENT +trabajos I-TREATMENT +con I-TREATMENT +coronas I-TREATMENT +telescópicas. I-TREATMENT + I-TREATMENT +Posteriormente I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +la I-TREATMENT +toma I-TREATMENT +de I-TREATMENT +impresiones I-TREATMENT y I-TREATMENT +registros I-TREATMENT +intermaxilares I-TREATMENT +para I-TREATMENT +que I-TREATMENT +con I-TREATMENT +los I-TREATMENT +modelos I-TREATMENT +obtenidos I-TREATMENT se I-TREATMENT -pauta I-TREATMENT -tratamiento I-TREATMENT +confeccionen I-TREATMENT +en I-TREATMENT +el I-TREATMENT +laboratorio I-TREATMENT +las I-TREATMENT +cofias I-TREATMENT +primarias. I-TREATMENT +Estas I-TREATMENT +son I-TREATMENT +probadas I-TREATMENT +en I-TREATMENT +la I-TREATMENT +boca I-TREATMENT +del I-TREATMENT +paciente I-TREATMENT +en I-TREATMENT +donde I-TREATMENT +se I-TREATMENT +verifica I-TREATMENT +su I-TREATMENT +correcto I-TREATMENT +ajuste I-TREATMENT +para I-TREATMENT +a I-TREATMENT +continuación I-TREATMENT +tomar I-TREATMENT +una I-TREATMENT +segunda I-TREATMENT +impresión I-TREATMENT +"de I-TREATMENT +arrastre" I-TREATMENT +que I-TREATMENT +nos I-TREATMENT +posiciona I-TREATMENT +las I-TREATMENT +cofias I-TREATMENT +primarias I-TREATMENT con I-TREATMENT -amoxicilina/clavulánico I-TREATMENT -intravenoso, I-TREATMENT +respecto I-TREATMENT +al I-TREATMENT +resto I-TREATMENT +de I-TREATMENT +estructuras I-TREATMENT +de I-TREATMENT +la I-TREATMENT +boca I-TREATMENT +del I-TREATMENT +paciente. I-TREATMENT +Obteniéndose I-TREATMENT +un I-TREATMENT +nuevo I-TREATMENT +modelo I-TREATMENT +donde I-TREATMENT +van I-TREATMENT +a I-TREATMENT +ser I-TREATMENT +confeccionadas I-TREATMENT +las I-TREATMENT +coronas I-TREATMENT +secundarias I-TREATMENT que I-TREATMENT -se I-TREATMENT -mantiene I-TREATMENT -durante I-TREATMENT -seis I-TREATMENT -días, I-TREATMENT -y I-TREATMENT +conforman I-TREATMENT +la I-TREATMENT +prótesis I-TREATMENT +fija I-TREATMENT +facultativamente I-TREATMENT +removible. I-TREATMENT +Esta I-TREATMENT +estructura I-TREATMENT +secundaria I-TREATMENT es I-TREATMENT -dado I-TREATMENT -de I-TREATMENT -alta I-TREATMENT -con I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -antibiótico I-TREATMENT -oral I-TREATMENT -hasta I-TREATMENT -completar I-TREATMENT -15 I-TREATMENT -días. I-TREATMENT -Su B-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -favorable I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -complicaciones. I-EVOLUTION - I-EVOLUTION - -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diez I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -previamente B-PAST_MEDICAL_HISTORY -sana, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -inicia, I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso, I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cuero I-PRESENT_ILLNESS -cabelludo, I-PRESENT_ILLNESS -posteriormente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -nariz, I-PRESENT_ILLNESS -luego I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cara I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -boca. I-PRESENT_ILLNESS -Es B-TREATMENT -valorada I-TREATMENT -por I-TREATMENT -el I-TREATMENT -dermatólogo, I-TREATMENT +probada I-TREATMENT +en I-TREATMENT +la I-TREATMENT +boca I-TREATMENT +del I-TREATMENT +paciente I-TREATMENT +en I-TREATMENT +donde I-TREATMENT +se I-TREATMENT +comprueba I-TREATMENT +tanto I-TREATMENT el I-TREATMENT -odontólogo I-TREATMENT -y I-TREATMENT +ajuste I-TREATMENT +como I-TREATMENT +la I-TREATMENT +relación I-TREATMENT +oclusal. I-TREATMENT + I-TREATMENT +Una I-TREATMENT +vez I-TREATMENT +seleccionado I-TREATMENT el I-TREATMENT -otorrinolaringólogo; I-TREATMENT +color I-TREATMENT se I-TREATMENT -realiza I-TREATMENT -tratamiento I-TREATMENT -por I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -impétigo. I-TREATMENT -No B-EVOLUTION +procede I-TREATMENT +a I-TREATMENT +su I-TREATMENT +terminación I-TREATMENT +y I-TREATMENT +colocación. I-TREATMENT +El B-EVOLUTION +resultado I-EVOLUTION +final, I-EVOLUTION +que I-EVOLUTION se I-EVOLUTION -observa I-EVOLUTION -mejoría; I-EVOLUTION +aprecia I-EVOLUTION en I-EVOLUTION -las I-EVOLUTION -dos I-EVOLUTION -semanas I-EVOLUTION -siguientes, I-EVOLUTION -presenta I-EVOLUTION -lesiones I-EVOLUTION -eritematosas I-EVOLUTION +la I-EVOLUTION +imagen, I-EVOLUTION +podemos I-EVOLUTION +ver I-EVOLUTION +un I-EVOLUTION +resultado I-EVOLUTION +que I-EVOLUTION +desde I-EVOLUTION +nuestro I-EVOLUTION +punto I-EVOLUTION +de I-EVOLUTION +vista I-EVOLUTION +es I-EVOLUTION +simplemente I-EVOLUTION +aceptable, I-EVOLUTION +pero I-EVOLUTION +que I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +valoró I-EVOLUTION +como I-EVOLUTION +muy I-EVOLUTION +satisfactorio, I-EVOLUTION +quizás I-EVOLUTION +debido I-EVOLUTION +a, I-EVOLUTION +lógicamente, I-EVOLUTION +al I-EVOLUTION +estado I-EVOLUTION +inicial I-EVOLUTION +que I-EVOLUTION +presentaba I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +y I-EVOLUTION +que I-EVOLUTION +el I-EVOLUTION +creía I-EVOLUTION +imposible I-EVOLUTION +de I-EVOLUTION +mejorar, I-EVOLUTION +y I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +predisposición I-EVOLUTION +favorable I-EVOLUTION +que I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION en I-EVOLUTION +todo I-EVOLUTION +momento. I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +caso I-EVOLUTION +ha I-EVOLUTION +sido I-EVOLUTION +revisado I-EVOLUTION +a I-EVOLUTION +lo I-EVOLUTION +largo I-EVOLUTION +de I-EVOLUTION +cinco I-EVOLUTION +años I-EVOLUTION +consecutivos I-EVOLUTION +y I-EVOLUTION +a I-EVOLUTION +pesar I-EVOLUTION +del I-EVOLUTION +mal I-EVOLUTION +control I-EVOLUTION +de I-EVOLUTION +placa I-EVOLUTION +por I-EVOLUTION +parte I-EVOLUTION +del I-EVOLUTION +paciente, I-EVOLUTION +que I-EVOLUTION +no I-EVOLUTION +hemos I-EVOLUTION +conseguido I-EVOLUTION +que I-EVOLUTION +adquiera I-EVOLUTION +unos I-EVOLUTION +hábitos I-EVOLUTION +adecuados I-EVOLUTION +de I-EVOLUTION +higiene, I-EVOLUTION los I-EVOLUTION -dedos I-EVOLUTION +pilares I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -manos I-EVOLUTION +la I-EVOLUTION +prótesis I-EVOLUTION +están I-EVOLUTION +en I-EVOLUTION +perfecto I-EVOLUTION +estado I-EVOLUTION +y I-EVOLUTION +tanto I-EVOLUTION +el I-EVOLUTION +confort I-EVOLUTION y I-EVOLUTION +la I-EVOLUTION +estética I-EVOLUTION +para I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +siguen I-EVOLUTION +siendo I-EVOLUTION +satisfactorias. I-EVOLUTION +De I-EVOLUTION +esta I-EVOLUTION +manera I-EVOLUTION se I-EVOLUTION -diagnostica I-EVOLUTION +pone I-EVOLUTION de I-EVOLUTION -viriasis. I-EVOLUTION -Sigue I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -mejoría, I-EVOLUTION -se I-EVOLUTION -observan I-EVOLUTION -también I-EVOLUTION -dichas I-EVOLUTION -lesiones I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -dedos I-EVOLUTION +manifiesto I-EVOLUTION +el I-EVOLUTION +correcto I-EVOLUTION +funcionamiento I-EVOLUTION de I-EVOLUTION -ambos I-EVOLUTION -pies, I-EVOLUTION -asociando I-EVOLUTION -abdominalgias I-EVOLUTION +los I-EVOLUTION +tratamientos I-EVOLUTION +con I-EVOLUTION +coronas I-EVOLUTION +telescópicas I-EVOLUTION +a I-EVOLUTION +medio I-EVOLUTION y I-EVOLUTION -vómitos I-EVOLUTION -ocasionales. I-EVOLUTION -Siempre I-EVOLUTION -afebril, I-EVOLUTION +largo I-EVOLUTION +plazo I-EVOLUTION +siendo I-EVOLUTION +una I-EVOLUTION +posibilidad I-EVOLUTION +que I-EVOLUTION +siempre I-EVOLUTION +debemos I-EVOLUTION +tener I-EVOLUTION +en I-EVOLUTION +cuenta I-EVOLUTION +a I-EVOLUTION la I-EVOLUTION -madre I-EVOLUTION -refiere I-EVOLUTION -observar I-EVOLUTION -"caída I-EVOLUTION -del I-EVOLUTION -cabello", I-EVOLUTION -sin I-EVOLUTION -otros I-EVOLUTION -signos I-EVOLUTION -clínicos I-EVOLUTION -asociados. I-EVOLUTION -Antecedentes B-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Antecedentes B-FAMILY_HISTORY -familiares: I-FAMILY_HISTORY -padre I-FAMILY_HISTORY -diagnosticado I-FAMILY_HISTORY -de I-FAMILY_HISTORY -colon I-FAMILY_HISTORY -irritable, I-FAMILY_HISTORY -sin I-FAMILY_HISTORY -casos I-FAMILY_HISTORY -reumatológicos I-FAMILY_HISTORY -ni I-FAMILY_HISTORY -clínica I-FAMILY_HISTORY -similar I-FAMILY_HISTORY -a I-FAMILY_HISTORY -la I-FAMILY_HISTORY -de I-FAMILY_HISTORY -la I-FAMILY_HISTORY -niña; I-FAMILY_HISTORY -una I-FAMILY_HISTORY -prima I-FAMILY_HISTORY -hermana I-FAMILY_HISTORY -materna I-FAMILY_HISTORY -diagnosticada I-FAMILY_HISTORY -hace I-FAMILY_HISTORY -un I-FAMILY_HISTORY -año I-FAMILY_HISTORY -de I-FAMILY_HISTORY -púrpura I-FAMILY_HISTORY -de I-FAMILY_HISTORY -Schonlein-Henoch. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Cuando B-EXPLORATION -ingresa I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -hospital I-EXPLORATION -está I-EXPLORATION -febril I-EXPLORATION -(38 I-EXPLORATION -oC), I-EXPLORATION -con I-EXPLORATION -buen I-EXPLORATION -aspecto I-EXPLORATION -general. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -eritema I-EXPLORATION -malar I-EXPLORATION -derecho I-EXPLORATION -que I-EXPLORATION -respeta I-EXPLORATION -el I-EXPLORATION -pliegue I-EXPLORATION -nasolabial; I-EXPLORATION -eritema I-EXPLORATION -y I-EXPLORATION -leve I-EXPLORATION +hora I-EVOLUTION +de I-EVOLUTION +planificar I-EVOLUTION +nuestros I-EVOLUTION +tratamientos, I-EVOLUTION +sobre I-EVOLUTION +todo I-EVOLUTION +en I-EVOLUTION +pacientes I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +mal I-EVOLUTION +pronóstico I-EVOLUTION +de I-EVOLUTION +sus I-EVOLUTION +dientes I-EVOLUTION +ya I-EVOLUTION +que I-EVOLUTION +el I-EVOLUTION +comportamiento I-EVOLUTION +biomecánico I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +coronas I-EVOLUTION +telescópicas I-EVOLUTION +hace I-EVOLUTION +que I-EVOLUTION +la I-EVOLUTION +supervivencia I-EVOLUTION +a I-EVOLUTION +largo I-EVOLUTION +plazo I-EVOLUTION +de I-EVOLUTION +estos I-EVOLUTION +dientes I-EVOLUTION +sea I-EVOLUTION +prolongada. I-EVOLUTION + I-EVOLUTION + +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +63 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +remitida B-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestra I-DERIVED_FROM/TO +consulta I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +su I-DERIVED_FROM/TO +odontólogo, I-DERIVED_FROM/TO +quejándose I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +masa I-DERIVED_FROM/TO +dolorosa I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +región I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +canino I-DERIVED_FROM/TO +inferior I-DERIVED_FROM/TO +derecho, I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +había I-DERIVED_FROM/TO +descubierto I-DERIVED_FROM/TO +cuatro I-DERIVED_FROM/TO +semanas I-DERIVED_FROM/TO +antes. I-DERIVED_FROM/TO +Negaba B-PRESENT_ILLNESS +historia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +alteración I-PRESENT_ILLNESS +neurosensorial, I-PRESENT_ILLNESS +disfagia, I-PRESENT_ILLNESS +odinofagia, I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +o I-PRESENT_ILLNESS +fiebre. I-PRESENT_ILLNESS +El B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +demostraba I-EXPLORATION +una I-EXPLORATION +mínima I-EXPLORATION tumefacción I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -área I-EXPLORATION -del I-EXPLORATION -lacrimal I-EXPLORATION -izquierdo. I-EXPLORATION -Lesiones I-EXPLORATION -purpúricas I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -pulpejos I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -manos, I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -pies I-EXPLORATION +facial I-EXPLORATION y I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -talones. I-EXPLORATION -Presenta I-EXPLORATION -en I-EXPLORATION +asimetría. I-EXPLORATION +Intraoralmente, I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +un I-EXPLORATION +abombamiento I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -orofaringe I-EXPLORATION -aftas, I-EXPLORATION -estomatitis I-EXPLORATION -y I-EXPLORATION -enantema. I-EXPLORATION +tabla I-EXPLORATION +lingual I-EXPLORATION +derecha I-EXPLORATION +mandibular I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +canino, I-EXPLORATION +con I-EXPLORATION +vestibulización I-EXPLORATION +del I-EXPLORATION +mismo. I-EXPLORATION No I-EXPLORATION -tiene I-EXPLORATION -adenopatías. I-EXPLORATION -Las I-EXPLORATION -exploraciones I-EXPLORATION -osteoarticular I-EXPLORATION -y I-EXPLORATION -neurológica, I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -auscultación I-EXPLORATION -cardiopulmonar, I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Estudios I-EXPLORATION -complementarios I-EXPLORATION -solicitados: I-EXPLORATION +se I-EXPLORATION +palpaban I-EXPLORATION +adenopatías I-EXPLORATION +cervicales. I-EXPLORATION +La I-EXPLORATION +ortopantomografía I-EXPLORATION +demostró I-EXPLORATION +un I-EXPLORATION +area I-EXPLORATION +radiolúcida, I-EXPLORATION +de I-EXPLORATION +bordes I-EXPLORATION +regulares, I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -hemograma, I-EXPLORATION -Hb I-EXPLORATION -10, I-EXPLORATION -6 I-EXPLORATION -g/dl, I-EXPLORATION -leucocitos I-EXPLORATION -3500/μl I-EXPLORATION +relación I-EXPLORATION con I-EXPLORATION -fórmula I-EXPLORATION -normal, I-EXPLORATION -plaquetas I-EXPLORATION -126 I-EXPLORATION -000/ I-EXPLORATION -μl I-EXPLORATION -(un I-EXPLORATION -mes I-EXPLORATION -antes I-EXPLORATION -solo I-EXPLORATION -destacar I-EXPLORATION -4400 I-EXPLORATION -leucocitos/ I-EXPLORATION -μl). I-EXPLORATION -Frotis I-EXPLORATION -sanguíneo I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION -morfológicas. I-EXPLORATION -Velocidad I-EXPLORATION -de I-EXPLORATION -sedimentación I-EXPLORATION -44 I-EXPLORATION -mm/hora. I-EXPLORATION -Reactantes I-EXPLORATION -fase I-EXPLORATION -aguda: I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -0, I-EXPLORATION -18 I-EXPLORATION -mg/dl, I-EXPLORATION -procalcitonina I-EXPLORATION -0, I-EXPLORATION -06 I-EXPLORATION -ng/ml. I-EXPLORATION -Estudio I-EXPLORATION +el I-EXPLORATION +canino, I-EXPLORATION de I-EXPLORATION -coagulación, I-EXPLORATION -pruebas I-EXPLORATION -reumáticas I-EXPLORATION -y I-EXPLORATION -proteinograma I-EXPLORATION -normales. I-EXPLORATION -Inmunoglobulinas I-EXPLORATION -con I-EXPLORATION -IgG I-EXPLORATION -1830 I-EXPLORATION -mg/dl I-EXPLORATION -e I-EXPLORATION -IgA I-EXPLORATION -271 I-EXPLORATION -mg/dl. I-EXPLORATION -Complementos I-EXPLORATION -C3 I-EXPLORATION -23, I-EXPLORATION -7 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -C4 I-EXPLORATION -4, I-EXPLORATION 2 I-EXPLORATION -mg/dl. I-EXPLORATION -Autoinmunidad: I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares I-EXPLORATION -(ANA) I-EXPLORATION -+ I-EXPLORATION -1/1280, I-EXPLORATION -anti-SM I-EXPLORATION -positivo, I-EXPLORATION -anti-ADN I-EXPLORATION -fuertemente I-EXPLORATION -positivo. I-EXPLORATION -Sistemático I-EXPLORATION -de I-EXPLORATION -orina I-EXPLORATION -150-250 I-EXPLORATION -eritrocitos/campo. I-EXPLORATION -Serologías I-EXPLORATION -bacteriana I-EXPLORATION -a I-EXPLORATION -Mycoplasma, I-EXPLORATION -parasitaria I-EXPLORATION -a I-EXPLORATION -toxoplasma I-EXPLORATION -y I-EXPLORATION -vírica I-EXPLORATION -a I-EXPLORATION -virus I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -Epstein-Barr, I-EXPLORATION -parvovirus I-EXPLORATION -B19, I-EXPLORATION -adenovirus, I-EXPLORATION -echovirus I-EXPLORATION -y I-EXPLORATION -coxsakie I-EXPLORATION -negativas. I-EXPLORATION -Destacar I-EXPLORATION +diámetro I-EXPLORATION +máximo. I-EXPLORATION +Se I-EXPLORATION +diagnosticó I-EXPLORATION +como I-EXPLORATION +patología I-EXPLORATION +quística I-EXPLORATION +benigna. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -IgM I-EXPLORATION -a I-EXPLORATION -citomegalovirus I-EXPLORATION -positiva. I-EXPLORATION -Hemocultivo I-EXPLORATION -y I-EXPLORATION -frotis I-EXPLORATION -faríngeo, I-EXPLORATION -bucal, I-EXPLORATION -conjuntiva I-EXPLORATION -y I-EXPLORATION -punción I-EXPLORATION -púrpura, I-EXPLORATION -negativos. I-EXPLORATION -Radiografía I-EXPLORATION +biopsia I-EXPLORATION +incisional I-EXPLORATION +bajo I-EXPLORATION +anestesia I-EXPLORATION +local. I-EXPLORATION +Los I-EXPLORATION +estudios I-EXPLORATION +microscópicos I-EXPLORATION +concluyeron I-EXPLORATION +que I-EXPLORATION +era I-EXPLORATION +una I-EXPLORATION +neoplasia I-EXPLORATION +maligna I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -ecografía I-EXPLORATION -abdominal, I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION +células I-EXPLORATION +fusiformes. I-EXPLORATION I-EXPLORATION -Con I-EXPLORATION -la I-EXPLORATION -clínica I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -datos I-EXPLORATION -complementarios I-EXPLORATION -referidos, I-EXPLORATION -ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION +Como I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -lupus I-EXPLORATION -eritematoso I-EXPLORATION -sistémico I-EXPLORATION -(LES), I-EXPLORATION +extensión I-EXPLORATION se I-EXPLORATION -solicitan I-EXPLORATION -anticuerpos I-EXPLORATION -antifosfolípidos I-EXPLORATION -(AAF), I-EXPLORATION -antilúpicos I-EXPLORATION -positivos I-EXPLORATION -y I-EXPLORATION -anticardiolipina I-EXPLORATION -positiva I-EXPLORATION -(IgG, I-EXPLORATION -IgM), I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -ecocardiografía I-EXPLORATION -(función I-EXPLORATION -y I-EXPLORATION -estructura I-EXPLORATION -cardiacas I-EXPLORATION -normales) I-EXPLORATION -y I-EXPLORATION -opinión I-EXPLORATION -dermatológica. I-EXPLORATION - I-EXPLORATION -Al I-EXPLORATION -cumplir I-EXPLORATION -más I-EXPLORATION +TC I-EXPLORATION de I-EXPLORATION -cuatro I-EXPLORATION +tórax, I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -criterios I-EXPLORATION +abdomen I-EXPLORATION +y I-EXPLORATION de I-EXPLORATION +pelvis, I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +absolutamente I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +intervenida I-TREATMENT +bajo I-TREATMENT +anestesia I-TREATMENT +general I-TREATMENT +tres I-TREATMENT +semanas I-TREATMENT +después I-TREATMENT +de I-TREATMENT +su I-TREATMENT +primera I-TREATMENT +visita. I-TREATMENT +En B-EXPLORATION +ese I-EXPLORATION +momento, I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +que I-EXPLORATION +había I-EXPLORATION +emergido I-EXPLORATION +por I-EXPLORATION la I-EXPLORATION -Asociación I-EXPLORATION -Americana I-EXPLORATION -de I-EXPLORATION -Reumatología, I-EXPLORATION -se I-EXPLORATION -confirma I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +cara I-EXPLORATION +vestibular, I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION de I-EXPLORATION -LES I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION la I-EXPLORATION -valoración I-EXPLORATION -nefrológica I-EXPLORATION -y I-EXPLORATION -reumatológica. I-EXPLORATION +biopsia. I-EXPLORATION Se B-TREATMENT -pauta I-TREATMENT -tratamiento I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +disección I-TREATMENT +cervical I-TREATMENT +supraomohioidea I-TREATMENT +derecha, I-TREATMENT con I-TREATMENT -medidas I-TREATMENT -generales, I-TREATMENT -antipalúdicos I-TREATMENT -(hidroxicloroquina) I-TREATMENT +exéresis I-TREATMENT +de I-TREATMENT +la I-TREATMENT +glándula I-TREATMENT +submaxilar I-TREATMENT y I-TREATMENT -corticoides I-TREATMENT -(prednisona) I-TREATMENT -orales, I-TREATMENT -manteniéndose I-TREATMENT -revisiones I-TREATMENT -correspondientes I-TREATMENT -en I-TREATMENT -su I-TREATMENT -seguimiento I-TREATMENT -multidisciplinar. I-TREATMENT - I-TREATMENT - -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -contusión I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -parte I-PRESENT_ILLNESS -lateral I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -pie I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS -Durante B-EXPLORATION -la I-EXPLORATION -exploración, I-EXPLORATION -presenta I-EXPLORATION -cierta I-EXPLORATION -tumefacción I-EXPLORATION -sin I-EXPLORATION -hematoma I-EXPLORATION +los I-TREATMENT +ganglios I-TREATMENT +linfáticos I-TREATMENT +regionales. I-TREATMENT +La I-TREATMENT +mandíbula I-TREATMENT +fue I-TREATMENT +resecada I-TREATMENT +desde I-TREATMENT +la I-TREATMENT +sínfisis I-TREATMENT +hasta I-TREATMENT +el I-TREATMENT +primer I-TREATMENT +molar I-TREATMENT +inferior I-TREATMENT +derecho. I-TREATMENT +La B-EXPLORATION +pieza I-EXPLORATION +quirúrgica I-EXPLORATION y I-EXPLORATION -escaso I-EXPLORATION -dolor I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cara I-EXPLORATION -lateral I-EXPLORATION -del I-EXPLORATION -pie, I-EXPLORATION -siendo I-EXPLORATION el I-EXPLORATION -tobillo I-EXPLORATION -normal. I-EXPLORATION -Al B-TREATMENT -no I-TREATMENT -sospechar I-TREATMENT -fractura, I-TREATMENT +vaciamiento I-EXPLORATION +cervical I-EXPLORATION +estaban, I-EXPLORATION +macroscópicamente, I-EXPLORATION +libres I-EXPLORATION +de I-EXPLORATION +tumor. I-EXPLORATION +Para B-TREATMENT +la I-TREATMENT +reconstrucción I-TREATMENT +primaria I-TREATMENT +del I-TREATMENT +defecto I-TREATMENT se I-TREATMENT -recomienda I-TREATMENT -inmovilización I-TREATMENT -y I-TREATMENT -reposo I-TREATMENT -físico I-TREATMENT -relativo, I-TREATMENT -además I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -analgésico, I-TREATMENT -indicando I-TREATMENT -control I-TREATMENT -en I-TREATMENT +utilizó I-TREATMENT una I-TREATMENT -semana I-TREATMENT -según I-TREATMENT -la I-TREATMENT -evolución I-TREATMENT -clínica. I-TREATMENT -Transcurrido B-EVOLUTION -el I-EVOLUTION -periodo I-EVOLUTION -de I-EVOLUTION -inmovilización, I-EVOLUTION -acude I-EVOLUTION -a I-EVOLUTION -consulta, I-EVOLUTION -se I-EVOLUTION -retira I-EVOLUTION -la I-EVOLUTION -inmovilización I-EVOLUTION -y, I-EVOLUTION -ante I-EVOLUTION -la I-EVOLUTION -ausencia I-EVOLUTION -de I-EVOLUTION -sintomatología, I-EVOLUTION -se I-EVOLUTION -da I-EVOLUTION -de I-EVOLUTION -alta, I-EVOLUTION -retomando I-EVOLUTION -su I-EVOLUTION -actividad I-EVOLUTION -física I-EVOLUTION -habitual I-EVOLUTION -como I-EVOLUTION -portero I-EVOLUTION -de I-EVOLUTION -waterpolo. I-EVOLUTION - I-EVOLUTION -Al I-EVOLUTION -cabo I-EVOLUTION -de I-EVOLUTION -dos I-EVOLUTION -semanas, I-EVOLUTION -acude I-EVOLUTION -a I-EVOLUTION -Urgencias I-EVOLUTION -del I-EVOLUTION -centro I-EVOLUTION -de I-EVOLUTION -salud I-EVOLUTION -por I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -cara I-EVOLUTION -lateral I-EVOLUTION -del I-EVOLUTION -pie I-EVOLUTION -derecho. I-EVOLUTION -Ha I-EVOLUTION -estado I-EVOLUTION -practicando I-EVOLUTION -waterpolo I-EVOLUTION -y I-EVOLUTION -niega I-EVOLUTION -antecedente I-EVOLUTION -traumático I-EVOLUTION -en I-EVOLUTION -este I-EVOLUTION -periodo I-EVOLUTION -de I-EVOLUTION -tiempo. I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -exploración I-EVOLUTION -destaca I-EVOLUTION -la I-EVOLUTION -presencia I-EVOLUTION -de I-EVOLUTION -dolor I-EVOLUTION -y I-EVOLUTION -tumefacción I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -proximal I-EVOLUTION -del I-EVOLUTION -quinto I-EVOLUTION -metatarsiano I-EVOLUTION -del I-EVOLUTION -pie I-EVOLUTION -derecho, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -realizan I-EVOLUTION -una I-EVOLUTION -radiología I-EVOLUTION -frontal I-EVOLUTION -y I-EVOLUTION -otra I-EVOLUTION -lateral I-EVOLUTION -de I-EVOLUTION -dicho I-EVOLUTION -pie, I-EVOLUTION -informándose I-EVOLUTION -como I-EVOLUTION -posible I-EVOLUTION -fractura I-EVOLUTION -de I-EVOLUTION -Jones. I-EVOLUTION -Posteriormente, I-EVOLUTION -es I-EVOLUTION -valorado I-EVOLUTION -por I-EVOLUTION -su I-EVOLUTION -pediatra, I-EVOLUTION -que I-EVOLUTION -observa I-EVOLUTION -tumefacción I-EVOLUTION -no I-EVOLUTION -dolorosa I-EVOLUTION -también I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -pie I-EVOLUTION -izquierdo; I-EVOLUTION -al I-EVOLUTION -tratarse I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -preadolescente I-EVOLUTION -que I-EVOLUTION -realiza I-EVOLUTION -deporte I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -habitual, I-EVOLUTION -sin I-EVOLUTION -un I-EVOLUTION -antecedente I-EVOLUTION -traumático I-EVOLUTION -conocido, I-EVOLUTION -y I-EVOLUTION -ante I-EVOLUTION +placa I-TREATMENT +de I-TREATMENT +reconstrucción. I-TREATMENT + I-TREATMENT +En B-EVOLUTION +el I-EVOLUTION +postoperatorio I-EVOLUTION +inmediato, I-EVOLUTION la I-EVOLUTION -sospecha I-EVOLUTION -de I-EVOLUTION -posible I-EVOLUTION -apofisitis, I-EVOLUTION -decide I-EVOLUTION -realizar I-EVOLUTION +paciente I-EVOLUTION +desarrolló I-EVOLUTION una I-EVOLUTION -radiología I-EVOLUTION -bilateral I-EVOLUTION -oblicua, I-EVOLUTION -que I-EVOLUTION -presenta I-EVOLUTION +infección I-EVOLUTION +cervical, I-EVOLUTION +con I-EVOLUTION una I-EVOLUTION -imagen I-EVOLUTION +comunicación I-EVOLUTION +orocervical, I-EVOLUTION +a I-EVOLUTION +pesar I-EVOLUTION de I-EVOLUTION -fragmentación I-EVOLUTION -en I-EVOLUTION la I-EVOLUTION -base I-EVOLUTION -del I-EVOLUTION -quinto I-EVOLUTION -metatarsiano I-EVOLUTION +sonda I-EVOLUTION +nasogástrica I-EVOLUTION +colocada I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +momento I-EVOLUTION de I-EVOLUTION -ambos I-EVOLUTION -pies. I-EVOLUTION -Se B-TREATMENT -diagnostica I-TREATMENT -de I-TREATMENT -apofisitis I-TREATMENT +la I-EVOLUTION +cirugía. I-EVOLUTION +A B-TREATMENT +pesar I-TREATMENT del I-TREATMENT -quinto I-TREATMENT -metatarsiano, I-TREATMENT -también I-TREATMENT -conocida I-TREATMENT -como I-TREATMENT -enfermedad I-TREATMENT -de I-TREATMENT -Iselin, I-TREATMENT -recibiendo I-TREATMENT tratamiento I-TREATMENT -analgésico I-TREATMENT -y I-TREATMENT -antiinflamatorio, I-TREATMENT -junto I-TREATMENT +antibiótico I-TREATMENT +intravenoso, I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +no I-TREATMENT +mejoró, I-TREATMENT con I-TREATMENT -reposo I-TREATMENT -deportivo I-TREATMENT -hasta I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +retiró I-TREATMENT la I-TREATMENT -desaparición I-TREATMENT -del I-TREATMENT -dolor. I-TREATMENT - I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -ha I-EVOLUTION -vuelto I-EVOLUTION -a I-EVOLUTION +placa I-TREATMENT +de I-TREATMENT +reconstrucción I-TREATMENT +bajo I-TREATMENT +anestesia I-TREATMENT +general. I-TREATMENT +Posteriormente, B-EVOLUTION la I-EVOLUTION -práctica I-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente, I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION de I-EVOLUTION -su I-EVOLUTION -actividad I-EVOLUTION -deportiva I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -molestias I-EVOLUTION +alta I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +20 I-EVOLUTION +día I-EVOLUTION +postoperatorio. I-EVOLUTION + I-EVOLUTION +El B-EXPLORATION +estudio I-EXPLORATION +inmunohistoquímico I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +quirúrgica I-EXPLORATION +mostraban I-EXPLORATION +que I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +tumorales I-EXPLORATION +eran I-EXPLORATION +reactivas I-EXPLORATION +para I-EXPLORATION +vimentina I-EXPLORATION +y I-EXPLORATION +actina I-EXPLORATION +músculo-específica. I-EXPLORATION +Asimismo, I-EXPLORATION +también I-EXPLORATION +eran I-EXPLORATION +reactivas I-EXPLORATION +para I-EXPLORATION +desmina. I-EXPLORATION +Finalmente, I-EXPLORATION +se I-EXPLORATION +diagnosticó I-EXPLORATION +de I-EXPLORATION +leiomiosarcoma I-EXPLORATION +grado I-EXPLORATION +II. I-EXPLORATION + I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +presenta I-EVOLUTION +seguimientos I-EVOLUTION +periódicos I-EVOLUTION +en I-EVOLUTION +nuestra I-EVOLUTION +consulta, I-EVOLUTION +hace I-EVOLUTION +ya I-EVOLUTION +15 I-EVOLUTION +meses I-EVOLUTION +del I-EVOLUTION +diagnóstico, I-EVOLUTION +y I-EVOLUTION +está I-EVOLUTION +libre I-EVOLUTION de I-EVOLUTION -nuevo. I-EVOLUTION +recidivas I-EVOLUTION +o I-EVOLUTION +metástasis. I-EVOLUTION I-EVOLUTION -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +47 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS sin B-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -medicamentosas I-PAST_MEDICAL_HISTORY -conocidas. I-PAST_MEDICAL_HISTORY -Entre I-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -episodio I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -bronquiolitis I-PAST_MEDICAL_HISTORY +mórbidos I-PAST_MEDICAL_HISTORY +mayores; I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY los I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -brotes I-PAST_MEDICAL_HISTORY -recurrentes I-PAST_MEDICAL_HISTORY +27 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -dermatitis I-PAST_MEDICAL_HISTORY -atópica. I-PAST_MEDICAL_HISTORY -En I-PAST_MEDICAL_HISTORY -seguimiento I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -consultas I-PAST_MEDICAL_HISTORY +edad I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +extirpado I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +cuerpo I-PAST_MEDICAL_HISTORY +extraño I-PAST_MEDICAL_HISTORY +(cuesco I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Alergología I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -asma I-PAST_MEDICAL_HISTORY -episódica I-PAST_MEDICAL_HISTORY -estacional I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -sensibilización I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -pólenes I-PAST_MEDICAL_HISTORY -(gramíneas, I-PAST_MEDICAL_HISTORY -olivos, I-PAST_MEDICAL_HISTORY -malezas), I-PAST_MEDICAL_HISTORY -ácaros I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -queso, I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -asocia I-PAST_MEDICAL_HISTORY -rinoconjuntivitis. I-PAST_MEDICAL_HISTORY -Precisa I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -inmunoterapia I-PAST_MEDICAL_HISTORY -específica I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -pólenes I-PAST_MEDICAL_HISTORY -(gramíneas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -olivo) I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -sublingual, I-PAST_MEDICAL_HISTORY -fluticasona I-PAST_MEDICAL_HISTORY -tópica I-PAST_MEDICAL_HISTORY -nasal I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -antihistamínicos I-PAST_MEDICAL_HISTORY -orales, I-PAST_MEDICAL_HISTORY -asociando I-PAST_MEDICAL_HISTORY -budesonida I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -salbutamol I-PAST_MEDICAL_HISTORY -inhalados I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -periodos I-PAST_MEDICAL_HISTORY +cereza) I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -crisis. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Durante B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -brote I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dermatitis I-PRESENT_ILLNESS -atópica, I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -administran I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -jugo I-PRESENT_ILLNESS -directo I-PRESENT_ILLNESS +la I-PAST_MEDICAL_HISTORY +fosa I-PAST_MEDICAL_HISTORY +nasal I-PAST_MEDICAL_HISTORY +derecha. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -planta I-PRESENT_ILLNESS -Aloe I-PRESENT_ILLNESS -vera I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS -uno I-PRESENT_ILLNESS +aproximadamente I-PRESENT_ILLNESS +cinco I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -hombros, I-PRESENT_ILLNESS -desarrollando I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +consistente I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -pocos I-PRESENT_ILLNESS -minutos I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -habonosas I-PRESENT_ILLNESS -confluentes I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -intensamente I-PRESENT_ILLNESS -pruriginosas I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -toda I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -superficie I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -espalda, I-PRESENT_ILLNESS +descarga I-PRESENT_ILLNESS +posterior I-PRESENT_ILLNESS +recurrente, I-PRESENT_ILLNESS +muco-purulenta I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +restos I-PRESENT_ILLNESS +hemáticos, I-PRESENT_ILLNESS sin I-PRESENT_ILLNESS -asociar I-PRESENT_ILLNESS -afectación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -vía I-PRESENT_ILLNESS -aérea. I-PRESENT_ILLNESS -Se B-TREATMENT -pauta I-TREATMENT -dexclorfeniramina I-TREATMENT +respuesta I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +terapia I-PRESENT_ILLNESS +antibacteriana. I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +destacaba I-EXPLORATION +la I-EXPLORATION +desviación I-EXPLORATION +del I-EXPLORATION +tabique I-EXPLORATION +nasal I-EXPLORATION +a I-EXPLORATION +derecha, I-EXPLORATION +sin I-EXPLORATION +otros I-EXPLORATION +hallazgos I-EXPLORATION +patológicos. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +imagenológico I-EXPLORATION +con I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +cavidades I-EXPLORATION +paranasales I-EXPLORATION +mostró I-EXPLORATION +opacidad I-EXPLORATION +del I-EXPLORATION +seno I-EXPLORATION +maxilar I-EXPLORATION +derecho I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +TAC I-EXPLORATION +de I-EXPLORATION +cavidades I-EXPLORATION +paranasales I-EXPLORATION +fue I-EXPLORATION +informada I-EXPLORATION +como: I-EXPLORATION +"seno I-EXPLORATION +maxilar I-EXPLORATION +derecho I-EXPLORATION +ocupado I-EXPLORATION +por I-EXPLORATION +material I-EXPLORATION +con I-EXPLORATION +densidad I-EXPLORATION +de I-EXPLORATION +tejidos I-EXPLORATION +blandos, I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +burbujas I-EXPLORATION +de I-EXPLORATION +gas, I-EXPLORATION +con I-EXPLORATION +extensión I-EXPLORATION +hacia I-EXPLORATION +el I-EXPLORATION +canal I-EXPLORATION +osteo-infundibular I-EXPLORATION +y I-EXPLORATION +levemente I-EXPLORATION +hacia I-EXPLORATION +la I-EXPLORATION +fosa I-EXPLORATION +nasal I-EXPLORATION +ipsilateral, I-EXPLORATION +ensanchamiento I-EXPLORATION +y I-EXPLORATION +remodelación I-EXPLORATION +ósea I-EXPLORATION +del I-EXPLORATION +canal I-EXPLORATION +infundibular, I-EXPLORATION +sin I-EXPLORATION +evidencias I-EXPLORATION +de I-EXPLORATION +erosiones". I-EXPLORATION +La I-EXPLORATION +naso-fibro-broncoscopia I-EXPLORATION +detectó I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +polipoidea I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +fosa I-EXPLORATION +nasal I-EXPLORATION +derecha I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +altura I-EXPLORATION +del I-EXPLORATION +meato I-EXPLORATION +medio, I-EXPLORATION +hacia I-EXPLORATION +posterior, I-EXPLORATION +sin I-EXPLORATION +alcanzar I-EXPLORATION +la I-EXPLORATION +coana, I-EXPLORATION +vascularizada. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +rinofaringe I-EXPLORATION +se I-EXPLORATION +apreciaba I-EXPLORATION +tejido I-EXPLORATION +adenoideo I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +orofaringe I-EXPLORATION +e I-EXPLORATION +hipofaringe I-EXPLORATION +tenían I-EXPLORATION +aspecto I-EXPLORATION +normal. I-EXPLORATION +Exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +destacables: I-EXPLORATION +hemograma I-EXPLORATION +con I-EXPLORATION +hemoglobina I-EXPLORATION +12, I-EXPLORATION +5 I-EXPLORATION +g/dl, I-EXPLORATION +leucocitos I-EXPLORATION +4.500 I-EXPLORATION +céls/mm3 I-EXPLORATION +(eosinófilos I-EXPLORATION +2%, I-EXPLORATION +segmentados I-EXPLORATION +58%, I-EXPLORATION +linfocitos I-EXPLORATION +31%y I-EXPLORATION +monocitos I-EXPLORATION +8%), I-EXPLORATION +plaquetas I-EXPLORATION +312.000 I-EXPLORATION +céls/mm3, I-EXPLORATION +VHS I-EXPLORATION +44 I-EXPLORATION +mm/h. I-EXPLORATION + B-TREATMENT +Se I-TREATMENT +le I-TREATMENT +realizó I-TREATMENT +cirugía I-TREATMENT +de I-TREATMENT +remoción I-TREATMENT +del I-TREATMENT +contenido I-TREATMENT +sinusal I-TREATMENT +mediante I-TREATMENT +técnica I-TREATMENT +de I-TREATMENT +Caldwell-Luc, I-TREATMENT con I-TREATMENT -mejoría I-TREATMENT +una I-TREATMENT +incisión I-TREATMENT +por I-TREATMENT +el I-TREATMENT +reborde I-TREATMENT +alveolar I-TREATMENT +superior I-TREATMENT +derecho I-TREATMENT +y I-TREATMENT +apertura I-TREATMENT +de I-TREATMENT +una I-TREATMENT +ventana I-TREATMENT +ósea I-TREATMENT +en I-TREATMENT +el I-TREATMENT +seno I-TREATMENT +maxilar, I-TREATMENT +dando I-TREATMENT +salida I-TREATMENT +a I-TREATMENT +secreción I-TREATMENT +negruzca I-TREATMENT +barrosa I-TREATMENT +de I-TREATMENT +gran I-TREATMENT +cantidad. I-TREATMENT +No I-TREATMENT +se I-TREATMENT +encontró I-TREATMENT +lesiones I-TREATMENT de I-TREATMENT la I-TREATMENT -clínica I-TREATMENT +fosa I-TREATMENT +nasal I-TREATMENT +derecha I-TREATMENT +ni I-TREATMENT +tejido I-TREATMENT +adenoideo I-TREATMENT +anómalo I-TREATMENT en I-TREATMENT las I-TREATMENT -siguientes I-TREATMENT -horas. I-TREATMENT -Tras B-EVOLUTION -tres I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION +coanas I-TREATMENT +o I-TREATMENT +rinofaringe. I-TREATMENT +Evolucionó B-EVOLUTION en I-EVOLUTION -dosis I-EVOLUTION -habituales, I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -desaparecieron I-EVOLUTION -por I-EVOLUTION -completo I-EVOLUTION -sin I-EVOLUTION -dejar I-EVOLUTION -cicatrices. I-EVOLUTION - I-EVOLUTION +forma I-EVOLUTION +satisfactoria I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +post-operatorio. I-EVOLUTION +El B-EXPLORATION +material I-EXPLORATION +obtenido I-EXPLORATION +fue I-EXPLORATION +enviado I-EXPLORATION +a I-EXPLORATION +estudio I-EXPLORATION +microbiológico I-EXPLORATION +e I-EXPLORATION +histopatológico. I-EXPLORATION +El I-EXPLORATION +informe I-EXPLORATION +anátomo-patológico I-EXPLORATION +fue: I-EXPLORATION +"sinusitis I-EXPLORATION +crónica I-EXPLORATION +erosiva, I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +hongo I-EXPLORATION +filamentoso I-EXPLORATION +con I-EXPLORATION +hifas I-EXPLORATION +hialinas I-EXPLORATION +septadasy I-EXPLORATION +ramificadas, I-EXPLORATION +sugerente I-EXPLORATION +deAspergillus I-EXPLORATION +sp. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +invasión I-EXPLORATION +micótica I-EXPLORATION +ni I-EXPLORATION +atiplas".. I-EXPLORATION +Se I-EXPLORATION +aisló I-EXPLORATION +un I-EXPLORATION +hongo I-EXPLORATION +filamentoso I-EXPLORATION +de I-EXPLORATION +crecimiento I-EXPLORATION +rápido I-EXPLORATION +a I-EXPLORATION +25 I-EXPLORATION +°C, I-EXPLORATION +con I-EXPLORATION +colonias I-EXPLORATION +de I-EXPLORATION +textura I-EXPLORATION +aterciopelada I-EXPLORATION +a I-EXPLORATION +algodonosa, I-EXPLORATION +de I-EXPLORATION +color I-EXPLORATION +crema I-EXPLORATION +a I-EXPLORATION +café I-EXPLORATION +canela, I-EXPLORATION +bordes I-EXPLORATION +irregulares I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +leve I-EXPLORATION +pigmento I-EXPLORATION +café. I-EXPLORATION +Microscópicamente I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +hifas I-EXPLORATION +hialinas I-EXPLORATION +septadas I-EXPLORATION +con I-EXPLORATION +conidióforos I-EXPLORATION +rectos, I-EXPLORATION +de I-EXPLORATION +largo I-EXPLORATION +variable I-EXPLORATION +con I-EXPLORATION +generación I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +porción I-EXPLORATION +distal I-EXPLORATION +de I-EXPLORATION +aneloconidio I-EXPLORATION +unicelular I-EXPLORATION +oval I-EXPLORATION +y I-EXPLORATION +base I-EXPLORATION +trunca, I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +identificado I-EXPLORATION +como I-EXPLORATION +S. I-EXPLORATION +apios-permum, I-EXPLORATION +forma I-EXPLORATION +anamorfa I-EXPLORATION +o I-EXPLORATION +asexuada I-EXPLORATION +de I-EXPLORATION +Pseudallescheria I-EXPLORATION +boydii. I-EXPLORATION +Se I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION +identificación I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +Laboratorio I-EXPLORATION +de I-EXPLORATION +Micología I-EXPLORATION +del I-EXPLORATION +Instituto I-EXPLORATION +de I-EXPLORATION +Ciencias I-EXPLORATION +Biomédicas I-EXPLORATION +(ICBM), I-EXPLORATION +Facultad I-EXPLORATION +de I-EXPLORATION +Medicina, I-EXPLORATION +Universidad I-EXPLORATION +de I-EXPLORATION +Chile. I-EXPLORATION + I-EXPLORATION +Dada B-TREATMENT +su I-TREATMENT +larga I-TREATMENT +evolución I-TREATMENT +sintomática I-TREATMENT +y I-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +de I-TREATMENT +una I-TREATMENT +lesión I-TREATMENT +polipoidea I-TREATMENT +de I-TREATMENT +tipo I-TREATMENT +invasora I-TREATMENT +se I-TREATMENT +dejó I-TREATMENT +inicialmente I-TREATMENT +tratamiento I-TREATMENT +antifúngico I-TREATMENT +con I-TREATMENT +200 I-TREATMENT +mg I-TREATMENT +de I-TREATMENT +itraconazol I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas, I-TREATMENT +siendo I-TREATMENT +bien I-TREATMENT +tolerado, I-TREATMENT +sin I-TREATMENT +alteración I-TREATMENT +de I-TREATMENT +las I-TREATMENT +pruebas I-TREATMENT +hepáticas, I-TREATMENT +el I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +suspendido I-TREATMENT +al I-TREATMENT +no I-TREATMENT +evidenciarse I-TREATMENT +compromiso I-TREATMENT +micótico I-TREATMENT +invasor I-TREATMENT +en I-TREATMENT +la I-TREATMENT +biopsia. I-TREATMENT + B-EVOLUTION +La I-EVOLUTION +evolución I-EVOLUTION +clínica I-EVOLUTION +a I-EVOLUTION +tres I-EVOLUTION +meses I-EVOLUTION +plazo I-EVOLUTION +fue I-EVOLUTION +satisfactoria; I-EVOLUTION +una B-EXPLORATION +nueva I-EXPLORATION +TAC I-EXPLORATION +de I-EXPLORATION +cavidades I-EXPLORATION +paranasales I-EXPLORATION +mostró I-EXPLORATION +su I-EXPLORATION +total I-EXPLORATION +neumatización I-EXPLORATION +y I-EXPLORATION +simetría, I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +maxilectomía I-EXPLORATION +medial I-EXPLORATION +derecha I-EXPLORATION +y I-EXPLORATION +elementos I-EXPLORATION +inflamatorios I-EXPLORATION +marginales I-EXPLORATION +con I-EXPLORATION +pequeño I-EXPLORATION +nivel I-EXPLORATION +hidro-aéreo I-EXPLORATION +del I-EXPLORATION +seno I-EXPLORATION +maxilar I-EXPLORATION +derecho. I-EXPLORATION + I-EXPLORATION -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS presenta I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -hipopigmentadas I-PRESENT_ILLNESS -posinflamatorias I-PRESENT_ILLNESS -residuales I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -dibujan I-PRESENT_ILLNESS el I-PRESENT_ILLNESS -contorno I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -uno I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -estos I-PRESENT_ILLNESS -tatuajes I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -realización, I-PRESENT_ILLNESS -afectando I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -superficie I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -extensión I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -antebrazos. I-PRESENT_ILLNESS -Las I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -representan I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Ash® I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -Pikachu®, I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -personajes I-PRESENT_ILLNESS -protagonistas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -serie I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dibujos I-PRESENT_ILLNESS -animados I-PRESENT_ILLNESS -Pokemon®. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -previas I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -consultado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -localidad I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -veraneaba I-PRESENT_ILLNESS -porque I-PRESENT_ILLNESS -presentaba, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tatuaje, I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -vesiculoampollosas I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS una I-PRESENT_ILLNESS -base I-PRESENT_ILLNESS -eritematosa, I-PRESENT_ILLNESS -pruriginosas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -signos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -sobreinfección I-PRESENT_ILLNESS -secundaria. I-PRESENT_ILLNESS -Pasado B-EVOLUTION -un I-EVOLUTION -año, I-EVOLUTION -aún I-EVOLUTION -se I-EVOLUTION -aprecian I-EVOLUTION -lesiones I-EVOLUTION -residuales I-EVOLUTION -con I-EVOLUTION -prurito I-EVOLUTION -ocasional. I-EVOLUTION - I-EVOLUTION - -Niño B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -afebril, I-PRESENT_ILLNESS +72 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +cardiaca I-PAST_MEDICAL_HISTORY +grave, I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +pulmonar I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +crónica. I-PAST_MEDICAL_HISTORY +Debutó B-PRESENT_ILLNESS con I-PRESENT_ILLNESS -amigdalitis I-PRESENT_ILLNESS -pultácea, I-PRESENT_ILLNESS -frotis I-PRESENT_ILLNESS -faríngeo I-PRESENT_ILLNESS -negativo I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -estreptococo, I-PRESENT_ILLNESS +tumoración I-PRESENT_ILLNESS +eritematosa, I-PRESENT_ILLNESS +dura I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -resto I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +dolorosa I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -exploración I-PRESENT_ILLNESS -física I-PRESENT_ILLNESS -normal. I-PRESENT_ILLNESS -Dos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -tuvo I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -diarrea. I-PRESENT_ILLNESS -Por B-TREATMENT -todo I-TREATMENT -ello I-TREATMENT -se I-TREATMENT -orienta I-TREATMENT -como I-TREATMENT -un I-TREATMENT -cuadro I-TREATMENT -vírico, I-TREATMENT -realizando I-TREATMENT -tratamiento I-TREATMENT -sintomático. I-TREATMENT -A B-EXPLORATION -los I-EXPLORATION -dos I-EXPLORATION -días, I-EXPLORATION -por I-EXPLORATION -persistencia I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -deposiciones I-EXPLORATION -líquidas, I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -coprocultivo I-EXPLORATION -que I-EXPLORATION -es I-EXPLORATION -positivo I-EXPLORATION -a I-EXPLORATION -Salmonella I-EXPLORATION -typhimurium. I-EXPLORATION -A B-EVOLUTION -los I-EVOLUTION -15 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -cuadro, I-EVOLUTION -el I-EVOLUTION -niño I-EVOLUTION -presenta I-EVOLUTION -unas I-EVOLUTION -lesiones I-EVOLUTION -eritematosas I-EVOLUTION -y I-EVOLUTION -algunos I-EVOLUTION -nódulos I-EVOLUTION -pretibiales, I-EVOLUTION -dolorosas, I-EVOLUTION -en I-EVOLUTION -ambas I-EVOLUTION -extremidades I-EVOLUTION -inferiores, I-EVOLUTION -en I-EVOLUTION -número I-EVOLUTION -de I-EVOLUTION -8-9, I-EVOLUTION -de I-EVOLUTION -tamaño I-EVOLUTION -de I-EVOLUTION -2-3 I-EVOLUTION -cm I-EVOLUTION -de I-EVOLUTION -diámetro, I-EVOLUTION -sin I-EVOLUTION -otros I-EVOLUTION -signos I-EVOLUTION -ni I-EVOLUTION -síntomas. I-EVOLUTION - I-EVOLUTION -Ante B-EXPLORATION -la I-EXPLORATION -clínica, I-EXPLORATION -orientamos I-EXPLORATION -el I-EXPLORATION -cuadro I-EXPLORATION -como I-EXPLORATION -EN I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION -S. I-EXPLORATION -typhimurium. I-EXPLORATION -Solicitamos I-EXPLORATION -radiografía I-EXPLORATION +unos I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +cm I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +subcutáneo I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +esternal I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +extirpó. I-PRESENT_ILLNESS +El B-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION +informó I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -y I-EXPLORATION -analítica I-EXPLORATION +tejido I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -hemograma, I-EXPLORATION -bioquímica, I-EXPLORATION -velocidad I-EXPLORATION +metástasis I-EXPLORATION +subcutánea I-EXPLORATION de I-EXPLORATION -sedimentación I-EXPLORATION -globular I-EXPLORATION -(VSG), I-EXPLORATION -factor I-EXPLORATION -reumatoide, I-EXPLORATION -antiestreptolisinas I-EXPLORATION -y I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares I-EXPLORATION -(ANA), I-EXPLORATION -para I-EXPLORATION -descartar I-EXPLORATION -otras I-EXPLORATION -posibles I-EXPLORATION -etiologías1. I-EXPLORATION +cistoadenocarcinoma I-EXPLORATION +mucinoso I-EXPLORATION +de I-EXPLORATION +origen I-EXPLORATION +biliar. I-EXPLORATION La I-EXPLORATION -radiografía I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION +abdominal I-EXPLORATION +evidenció I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +hepática I-EXPLORATION +central I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +colangiocarcinoma I-EXPLORATION +hiliar I-EXPLORATION +o I-EXPLORATION +tumor I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -no I-EXPLORATION -objetiva I-EXPLORATION -alteraciones I-EXPLORATION -radiológicas I-EXPLORATION -y I-EXPLORATION -las I-EXPLORATION -determinaciones I-EXPLORATION -analíticas I-EXPLORATION -son I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -A B-EVOLUTION -la I-EVOLUTION -semana I-EVOLUTION -desaparecen I-EVOLUTION -los I-EVOLUTION -nódulos, I-EVOLUTION -con I-EVOLUTION -curación I-EVOLUTION -completa. I-EVOLUTION - I-EVOLUTION +Klatskin. I-EXPLORATION +Dada B-TREATMENT +la I-TREATMENT +situación I-TREATMENT +basal I-TREATMENT +se I-TREATMENT +instauró I-TREATMENT +tratamiento I-TREATMENT +paliativo. I-TREATMENT + I-TREATMENT -Paciente B-PRESENT_ILLNESS +Escolar B-PRESENT_ILLNESS de I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS siete I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -llevada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +procedente B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +área I-PAST_MEDICAL_HISTORY +urbana I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Santiago I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +Estero. I-PAST_MEDICAL_HISTORY +Sin I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +epidemiológicos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +importancia. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -frontal, I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -máxima I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -40 I-PRESENT_ILLNESS -°C I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -vómitos I-PRESENT_ILLNESS +hemiparesia I-PRESENT_ILLNESS +facio-braquio-crural I-PRESENT_ILLNESS +izquierda I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS de I-PRESENT_ILLNESS evolución, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS +asociada I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -cervical I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tumefacción I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +quística I-PRESENT_ILLNESS +infratemporal I-PRESENT_ILLNESS +derecha I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -últimas I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas. I-PRESENT_ILLNESS -Presentaba B-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -corrección I-PAST_MEDICAL_HISTORY -quirúrgica I-PAST_MEDICAL_HISTORY -endoscópica I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -trigonocefalia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -meses. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Al B-EXPLORATION -ingreso, I-EXPLORATION -presentaba I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION -de I-EXPLORATION -137 I-EXPLORATION -lpm, I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION -de I-EXPLORATION -25 I-EXPLORATION -rpm, I-EXPLORATION -tensión I-EXPLORATION -arterial I-EXPLORATION -de I-EXPLORATION -102/60 I-EXPLORATION -mm I-EXPLORATION -Hg I-EXPLORATION -y I-EXPLORATION -temperatura I-EXPLORATION -de I-EXPLORATION -36, I-EXPLORATION -8 I-EXPLORATION -°C. I-EXPLORATION -Neurológicamente I-EXPLORATION -estaba I-EXPLORATION -consciente, I-EXPLORATION -orientada I-EXPLORATION -y I-EXPLORATION -colaboradora, I-EXPLORATION -con I-EXPLORATION -Glasgow I-EXPLORATION -15/15. I-EXPLORATION -Rigidez I-EXPLORATION +la I-PRESENT_ILLNESS +TC I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cerebro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +cm I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +diámetro. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +tuvo I-PRESENT_ILLNESS +compromiso I-PRESENT_ILLNESS +hepático I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +pulmonar. I-PRESENT_ILLNESS +La B-EXPLORATION +prueba I-EXPLORATION de I-EXPLORATION -nuca I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION +HAI I-EXPLORATION +fue I-EXPLORATION +negativa I-EXPLORATION +para I-EXPLORATION +hidatidosis I-EXPLORATION +antes I-EXPLORATION de I-EXPLORATION -Kernig I-EXPLORATION -y I-EXPLORATION -Brudzinski I-EXPLORATION -positivos. I-EXPLORATION -En I-EXPLORATION la I-EXPLORATION -región I-EXPLORATION -periorbitaria I-EXPLORATION -derecha I-EXPLORATION -presentaba I-EXPLORATION -tumefacción I-EXPLORATION -con I-EXPLORATION -eritema, I-EXPLORATION -calor I-EXPLORATION -local I-EXPLORATION -y I-EXPLORATION -movimientos I-EXPLORATION -oculares I-EXPLORATION -conservados. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -analítica I-EXPLORATION -con I-EXPLORATION -leucocitosis I-EXPLORATION -14 I-EXPLORATION -500/mm3, I-EXPLORATION -neutrofilia I-EXPLORATION -13 I-EXPLORATION -900/mm3, I-EXPLORATION -linfopenia I-EXPLORATION -390/mm3 I-EXPLORATION -y I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -reactantes I-EXPLORATION -de I-EXPLORATION -fase I-EXPLORATION -aguda: I-EXPLORATION -fibrinógeno I-EXPLORATION -881 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -241 I-EXPLORATION -mg/l. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -punción I-EXPLORATION -lumbar, I-EXPLORATION -tras I-EXPLORATION -confirmar I-EXPLORATION -normalidad I-EXPLORATION -de I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo, I-EXPLORATION -obteniéndose I-EXPLORATION -líquido I-EXPLORATION -cefalorraquídeo I-EXPLORATION -de I-EXPLORATION -aspecto I-EXPLORATION -turbio, I-EXPLORATION -que I-EXPLORATION +cirugía. I-EXPLORATION +No I-EXPLORATION +tuvo I-EXPLORATION +alteraciones I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -análisis I-EXPLORATION -citoquímico I-EXPLORATION -mostraba I-EXPLORATION -380 I-EXPLORATION -leucocitos/mm3 I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -38% I-EXPLORATION -de I-EXPLORATION -polimorfonucleares, I-EXPLORATION -hipoglucorraquia I-EXPLORATION -41 I-EXPLORATION -mg/dl I-EXPLORATION -e I-EXPLORATION -hiperproteinorraquia I-EXPLORATION -240 I-EXPLORATION -mg/dl; I-EXPLORATION +hemograma I-EXPLORATION +ni I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -tinción I-EXPLORATION -de I-EXPLORATION -Gram I-EXPLORATION -no I-EXPLORATION -mostró I-EXPLORATION -bacterias. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -hemocultivo I-EXPLORATION -se I-EXPLORATION -aisló I-EXPLORATION -S. I-EXPLORATION -pyogenes. I-EXPLORATION -La I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -craneal I-EXPLORATION -evidenciaba I-EXPLORATION -ocupación I-EXPLORATION -parcial I-EXPLORATION -de I-EXPLORATION -celdillas I-EXPLORATION -etmoidales I-EXPLORATION -izquierdas I-EXPLORATION -y I-EXPLORATION -frontales I-EXPLORATION -asociada I-EXPLORATION -a I-EXPLORATION -tumefacción I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -periorbitaria I-EXPLORATION -derecha. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT +función I-EXPLORATION +hepática I-EXPLORATION +al I-EXPLORATION +momento I-EXPLORATION +del I-EXPLORATION +diagnóstico. I-EXPLORATION +Inició B-TREATMENT tratamiento I-TREATMENT -empírico I-TREATMENT con I-TREATMENT -cefotaxima I-TREATMENT -y I-TREATMENT -vancomicina, I-TREATMENT -suspendiendo I-TREATMENT -este I-TREATMENT -último I-TREATMENT -al I-TREATMENT -aislarse I-TREATMENT -S. I-TREATMENT -pyogenes, I-TREATMENT -y I-TREATMENT +albendazol I-TREATMENT +30 I-TREATMENT +días I-TREATMENT +previos I-TREATMENT +a I-TREATMENT +la I-TREATMENT +cirugía, I-TREATMENT +la I-TREATMENT +que I-TREATMENT se I-TREATMENT -asoció I-TREATMENT -clindamicina I-TREATMENT -por I-TREATMENT -presentar I-TREATMENT -exantema I-TREATMENT -escarlatiniforme. I-TREATMENT - I-TREATMENT -Al B-EVOLUTION -séptimo I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -ingreso I-EVOLUTION -tuvo I-EVOLUTION -un I-EVOLUTION -episodio I-EVOLUTION -convulsivo I-EVOLUTION -tónico-clónico I-EVOLUTION -focalizado I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -hemicuerpo I-EVOLUTION -izquierdo I-EVOLUTION -que I-EVOLUTION -posteriormente I-EVOLUTION -se I-EVOLUTION -generalizó. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -craneal, I-EXPLORATION -encontrando I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -sugestiva I-EXPLORATION +realizó I-TREATMENT +sin I-TREATMENT +complicaciones. I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +histopatológico I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -trombosis I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +quística I-EXPLORATION +con I-EXPLORATION +escólices I-EXPLORATION de I-EXPLORATION -vena I-EXPLORATION -oftálmica I-EXPLORATION -derecha I-EXPLORATION -y I-EXPLORATION -ocupación I-EXPLORATION -parcial I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -cavernoso I-EXPLORATION -derecho, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -persistencia I-EXPLORATION +E. I-EXPLORATION +granulosus I-EXPLORATION +en I-EXPLORATION +estadio I-EXPLORATION de I-EXPLORATION -realce I-EXPLORATION -meníngeo. I-EXPLORATION -Fue B-TREATMENT -tratada I-TREATMENT -con I-TREATMENT -ácido I-TREATMENT -valpróico I-TREATMENT -y I-TREATMENT -dexametasona, I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -anticoagulación. I-TREATMENT -Posteriormente, B-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -evolucionó I-EVOLUTION -satisfactoriamente I-EVOLUTION -manteniéndose B-TREATMENT -21 I-TREATMENT -días I-TREATMENT +degeneración. I-EXPLORATION +Presentó B-EVOLUTION +como I-EVOLUTION +complicación I-EVOLUTION +una I-EVOLUTION +hidrocefalia I-EVOLUTION +transitoria I-EVOLUTION +que B-TREATMENT +no I-TREATMENT +requirió I-TREATMENT +tratamiento. I-TREATMENT +Completó I-TREATMENT +seis I-TREATMENT +semanas I-TREATMENT +post-quirúrgicas I-TREATMENT de I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -intravenoso, I-TREATMENT +albendazol I-TREATMENT con B-EVOLUTION -controles I-EVOLUTION -clínicos, I-EVOLUTION -neurológico, I-EVOLUTION -electrocardiográfico I-EVOLUTION -y I-EVOLUTION -mediante I-EVOLUTION -resonancia I-EVOLUTION -magnética I-EVOLUTION -normales I-EVOLUTION +resolución I-EVOLUTION +ad I-EVOLUTION +integrum I-EVOLUTION y I-EVOLUTION sin I-EVOLUTION -secuelas I-EVOLUTION -neurológicas. I-EVOLUTION +secuelas. I-EVOLUTION I-EVOLUTION -Adolescente B-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -16 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS -constante I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -fosa I-PRESENT_ILLNESS -iliaca I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS +78 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +múltiples I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +destacan I-PAST_MEDICAL_HISTORY +asma I-PAST_MEDICAL_HISTORY +bronquial, I-PAST_MEDICAL_HISTORY +obesidad I-PAST_MEDICAL_HISTORY +mórbida, I-PAST_MEDICAL_HISTORY +síndrome I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +apnea I-PAST_MEDICAL_HISTORY +obstructiva I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +sueño, I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +anemia I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +hiperparatiroidismo I-PAST_MEDICAL_HISTORY +secundarios, I-PAST_MEDICAL_HISTORY +adenocarcinoma I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +mama I-PAST_MEDICAL_HISTORY +intervenido I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tratado I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +QT I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +RT, I-PAST_MEDICAL_HISTORY +valvulopatía I-PAST_MEDICAL_HISTORY +mitral I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +cardiaca, I-PAST_MEDICAL_HISTORY +fibrilación I-PAST_MEDICAL_HISTORY +auricular, I-PAST_MEDICAL_HISTORY +HTA, I-PAST_MEDICAL_HISTORY +DM I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +2, I-PAST_MEDICAL_HISTORY +glaucoma I-PAST_MEDICAL_HISTORY +bilateral, I-PAST_MEDICAL_HISTORY +colelitiasis I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +colecistitis I-PAST_MEDICAL_HISTORY +crónica. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Ingresa B-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -junto I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -vómito I-PRESENT_ILLNESS -aislado. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -previos I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -tenido I-PRESENT_ILLNESS -molestias I-PRESENT_ILLNESS -inespecíficas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -pierna I-PRESENT_ILLNESS -derecha I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -apreciar I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -calor. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -fecha I-PRESENT_ILLNESS +hematoquecia I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -última I-PRESENT_ILLNESS -regla I-PRESENT_ILLNESS -fue I-PRESENT_ILLNESS -diez I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS días I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -visita I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -acné, I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +fiebre, I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal, I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +cambios I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -ciproterona I-PRESENT_ILLNESS -50 I-PRESENT_ILLNESS -mg I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +ritmo I-PRESENT_ILLNESS +intestinal I-PRESENT_ILLNESS +asociados I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -asociación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -acetato I-PRESENT_ILLNESS +refiriendo I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +marcado I-PRESENT_ILLNESS +empeoramiento I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -ciproterona, I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -mg, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -etinilestradiol, I-PRESENT_ILLNESS -35 I-PRESENT_ILLNESS -µg. I-PRESENT_ILLNESS -Sin B-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY +su I-PRESENT_ILLNESS +disnea I-PRESENT_ILLNESS +habitual. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS En B-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -físico I-EXPLORATION -únicamente I-EXPLORATION -destaca I-EXPLORATION -dolor I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +destacaba I-EXPLORATION +una I-EXPLORATION +molestia I-EXPLORATION +difusa I-EXPLORATION a I-EXPLORATION la I-EXPLORATION palpación I-EXPLORATION -profunda I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -fosa I-EXPLORATION -iliaca I-EXPLORATION -derecha, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -irritación I-EXPLORATION -peritoneal. I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -diagnóstica I-EXPLORATION -de I-EXPLORATION -patología I-EXPLORATION -apendicular, I-EXPLORATION -se I-EXPLORATION -realiza, I-EXPLORATION -una I-EXPLORATION -analítica, I-EXPLORATION -que I-EXPLORATION -resulta I-EXPLORATION -normal I-EXPLORATION -excepto I-EXPLORATION -por I-EXPLORATION -el I-EXPLORATION -dímero I-EXPLORATION -D I-EXPLORATION -de I-EXPLORATION -alta I-EXPLORATION -sensibilidad, I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -valor I-EXPLORATION -de I-EXPLORATION -9958 I-EXPLORATION -ng/ml, I-EXPLORATION +hipocondrio I-EXPLORATION +derecho, I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -abdominal, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -un I-EXPLORATION -aumento I-EXPLORATION +analíticamente I-EXPLORATION +presentaba I-EXPLORATION +anemia I-EXPLORATION +con I-EXPLORATION +Hb I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -ecogenicidad I-EXPLORATION -del I-EXPLORATION -contenido I-EXPLORATION +7, I-EXPLORATION +3 I-EXPLORATION +g/dl I-EXPLORATION +(N: I-EXPLORATION +12-16), I-EXPLORATION +fibrinógeno I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -iliaca I-EXPLORATION -común I-EXPLORATION -derecha I-EXPLORATION -compatible I-EXPLORATION +727 I-EXPLORATION +mg/dl I-EXPLORATION +(N:150-400), I-EXPLORATION +hiperglucemia I-EXPLORATION +e I-EXPLORATION +insuficiencia I-EXPLORATION +renal I-EXPLORATION +ya I-EXPLORATION +conocida I-EXPLORATION con I-EXPLORATION -un I-EXPLORATION -trombo I-EXPLORATION +cifra I-EXPLORATION de I-EXPLORATION -unos I-EXPLORATION -10 I-EXPLORATION -cm I-EXPLORATION -sin I-EXPLORATION -ocupación I-EXPLORATION -completa I-EXPLORATION +urea I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -luz I-EXPLORATION +148 I-EXPLORATION +mg/dl I-EXPLORATION y I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -desde I-EXPLORATION -la I-EXPLORATION -porción I-EXPLORATION -distal I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -cava I-EXPLORATION -inferior I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -iliaca I-EXPLORATION -superficial I-EXPLORATION -ipsilateral, I-EXPLORATION -estando I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -femoral I-EXPLORATION -común I-EXPLORATION -permeable. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -trombosis I-EXPLORATION -de I-EXPLORATION -vena I-EXPLORATION -cava I-EXPLORATION -inferior, I-EXPLORATION -se I-EXPLORATION -completa I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -imagen I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -helicoidal I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -cuyos I-EXPLORATION -hallazgos I-EXPLORATION -son I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -defectos I-EXPLORATION +creatinina I-EXPLORATION de I-EXPLORATION -repleción I-EXPLORATION -en I-EXPLORATION +2, I-EXPLORATION +1 I-EXPLORATION +mg/dl, I-EXPLORATION +ambas I-EXPLORATION +cifras I-EXPLORATION +similares I-EXPLORATION +a I-EXPLORATION las I-EXPLORATION -arterias I-EXPLORATION -pulmonares I-EXPLORATION -lobares I-EXPLORATION de I-EXPLORATION -ambos I-EXPLORATION -lóbulos I-EXPLORATION -inferiores I-EXPLORATION -y I-EXPLORATION +analíticas I-EXPLORATION +previas. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +colonoscopia I-EXPLORATION en I-EXPLORATION -ambas I-EXPLORATION -arterias I-EXPLORATION -pulmonares I-EXPLORATION -principales, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -de I-EXPLORATION -dilatación I-EXPLORATION -del I-EXPLORATION -tronco I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -arteria I-EXPLORATION -pulmonar I-EXPLORATION -ni I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -dilatación I-EXPLORATION -del I-EXPLORATION -ventrículo I-EXPLORATION -derecho. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -radiológicos I-EXPLORATION -resultan I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -tromboembolismo I-EXPLORATION -pulmonar I-EXPLORATION -(TEP) I-EXPLORATION -masivo. I-EXPLORATION -En I-EXPLORATION la I-EXPLORATION -TC I-EXPLORATION -abdominal I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -aprecia I-EXPLORATION -la I-EXPLORATION -extensión I-EXPLORATION -caudal I-EXPLORATION -del I-EXPLORATION -trombo I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -cava I-EXPLORATION -inferior. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -recibe I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -heparina I-TREATMENT -de I-TREATMENT -bajo I-TREATMENT -peso I-TREATMENT -molecular I-TREATMENT -subcutánea I-TREATMENT -y I-TREATMENT -presenta I-TREATMENT -una I-TREATMENT -evolución I-TREATMENT -clínica I-TREATMENT -favorable. I-TREATMENT -Se B-EXPLORATION -realiza I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION +apreciaba I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION de I-EXPLORATION -trombofilia I-EXPLORATION -encontrando I-EXPLORATION -como I-EXPLORATION -única I-EXPLORATION -alteración I-EXPLORATION -un I-EXPLORATION +doble I-EXPLORATION +luz I-EXPLORATION +a I-EXPLORATION nivel I-EXPLORATION +del I-EXPLORATION +ángulo I-EXPLORATION +hepático I-EXPLORATION +del I-EXPLORATION +colon, I-EXPLORATION +presentando I-EXPLORATION +además I-EXPLORATION de I-EXPLORATION -proteína I-EXPLORATION -S I-EXPLORATION -libre I-EXPLORATION -antigénica I-EXPLORATION +la I-EXPLORATION +luz I-EXPLORATION +natural I-EXPLORATION del I-EXPLORATION -19% I-EXPLORATION -(valor I-EXPLORATION +colon I-EXPLORATION +una I-EXPLORATION +segunda I-EXPLORATION +luz I-EXPLORATION de I-EXPLORATION -referencia I-EXPLORATION -normal I-EXPLORATION +menor I-EXPLORATION +calibre, I-EXPLORATION por I-EXPLORATION -encima I-EXPLORATION -del I-EXPLORATION -54%). I-EXPLORATION - I-EXPLORATION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -embarazo I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -controlado, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -madre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -(G4A0V3), I-PRESENT_ILLNESS -inmune I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -rubeola I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -toxoplasma. I-PRESENT_ILLNESS -Exudado I-PRESENT_ILLNESS -rectovaginal I-PRESENT_ILLNESS -estreptocócico I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -recogido. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -gestacional I-PRESENT_ILLNESS -estimada I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -biometría I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -33-34 I-PRESENT_ILLNESS -semanas. I-PRESENT_ILLNESS -Recibe B-TREATMENT -un I-TREATMENT -ciclo I-TREATMENT -de I-TREATMENT -corticoides I-TREATMENT -completo I-TREATMENT -y I-TREATMENT -precisa I-TREATMENT -tratamiento I-TREATMENT -por I-TREATMENT -preeclampsia I-TREATMENT -y I-TREATMENT -edema I-TREATMENT -agudo I-TREATMENT -de I-TREATMENT -pulmón. I-TREATMENT -Se I-TREATMENT -realiza I-TREATMENT -una I-TREATMENT -cesárea I-TREATMENT -urgente I-TREATMENT -por I-TREATMENT -causa I-TREATMENT -materna, I-TREATMENT -con I-TREATMENT -bolsa I-TREATMENT -rota I-TREATMENT -intraoperatoria I-TREATMENT -y I-TREATMENT -líquido I-TREATMENT -amniótico I-TREATMENT -claro. I-TREATMENT -Test B-EVOLUTION -de I-EVOLUTION -Apgar I-EVOLUTION -7/9, I-EVOLUTION -REA I-EVOLUTION -III. I-EVOLUTION -Peso I-EVOLUTION -del I-EVOLUTION -recién I-EVOLUTION -nacido I-EVOLUTION -(RN) I-EVOLUTION -de I-EVOLUTION -1600 I-EVOLUTION -g. I-EVOLUTION -No I-EVOLUTION -fue I-EVOLUTION -tallado I-EVOLUTION -por I-EVOLUTION -inestabilidad I-EVOLUTION -clínica. I-EVOLUTION -Precisa B-DERIVED_FROM/TO -traslado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -Unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cuidados I-DERIVED_FROM/TO -Intensivos I-DERIVED_FROM/TO -Neonatales I-DERIVED_FROM/TO -(UCIN) I-DERIVED_FROM/TO -tipo I-DERIVED_FROM/TO -IIIC I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -las I-DERIVED_FROM/TO -12 I-DERIVED_FROM/TO -horas I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -vida I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -cuadro I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -enfermedad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -membrana I-DERIVED_FROM/TO -hialina, I-DERIVED_FROM/TO -hipertensión I-DERIVED_FROM/TO -pulmonar I-DERIVED_FROM/TO -grave I-DERIVED_FROM/TO -e I-DERIVED_FROM/TO -inestabilidad I-DERIVED_FROM/TO -hemodinámica. I-DERIVED_FROM/TO -En B-TREATMENT -este I-TREATMENT -centro I-TREATMENT -precisa I-TREATMENT -varios I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -antibioterapia I-TREATMENT -por I-TREATMENT -sepsis I-TREATMENT -nosocomial I-TREATMENT -y I-TREATMENT -por I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -enterocolitis I-TREATMENT -necrotizante I-TREATMENT -no I-TREATMENT -confirmada, I-TREATMENT -y I-TREATMENT -recibe I-TREATMENT -una I-TREATMENT -transfusión I-TREATMENT -de I-TREATMENT -concentrado I-TREATMENT -de I-TREATMENT -hematíes. I-TREATMENT -Se B-EVOLUTION -realiza I-EVOLUTION -seguimiento I-EVOLUTION -con I-EVOLUTION -ecografías I-EVOLUTION -cerebrales I-EVOLUTION -seriadas, I-EVOLUTION -sin I-EVOLUTION -hallazgos I-EVOLUTION -significativos. I-EVOLUTION -Electroencefalografía I-EVOLUTION -normal. I-EVOLUTION - I-EVOLUTION -A B-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -26 I-DERIVED_FROM/TO -días I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -vida, I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -edad I-DERIVED_FROM/TO -gestacional I-DERIVED_FROM/TO -corregida I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -36+4 I-DERIVED_FROM/TO -semanas, I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -trasladado I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -vuelta I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -centro. I-DERIVED_FROM/TO -A B-EVOLUTION -los I-EVOLUTION -38 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -vida, I-EVOLUTION -se I-EVOLUTION -objetiva I-EVOLUTION -ausencia I-EVOLUTION -de I-EVOLUTION -movimiento I-EVOLUTION -espontáneo I-EVOLUTION -del I-EVOLUTION -brazo I-EVOLUTION -derecho, I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -reflejo I-EVOLUTION -de I-EVOLUTION -Moro I-EVOLUTION -asimétrico I-EVOLUTION -y I-EVOLUTION -escasa I-EVOLUTION -prensión I-EVOLUTION -palmar, I-EVOLUTION -junto I-EVOLUTION -con I-EVOLUTION -tumefacción I-EVOLUTION -y I-EVOLUTION -mínimo I-EVOLUTION -eritema I-EVOLUTION -del I-EVOLUTION -hombro I-EVOLUTION -derecho, I-EVOLUTION -que I-EVOLUTION -resulta I-EVOLUTION -doloroso, I-EVOLUTION -con I-EVOLUTION -llanto I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -palpación I-EVOLUTION -y I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -movilización. I-EVOLUTION -En B-EXPLORATION la I-EXPLORATION -ecografía I-EXPLORATION -articular I-EXPLORATION -se I-EXPLORATION -evidencia I-EXPLORATION -derrame I-EXPLORATION -articular I-EXPLORATION -leve-moderado, I-EXPLORATION -hiperecogénico I-EXPLORATION -y I-EXPLORATION -sugerente I-EXPLORATION -de I-EXPLORATION -derrame I-EXPLORATION -complicado. I-EXPLORATION -Se B-TREATMENT -realiza I-TREATMENT -punción I-TREATMENT -y I-TREATMENT -drenaje I-TREATMENT -con I-TREATMENT -aguja I-TREATMENT -fina I-TREATMENT -sin I-TREATMENT -incidencias, I-TREATMENT -obteniendo I-TREATMENT -2 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -líquido I-TREATMENT -hemopurulento I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -empírico I-TREATMENT -con I-TREATMENT -cefotaxima I-TREATMENT -y I-TREATMENT -cloxacilina I-TREATMENT -intravenosa. I-TREATMENT -Tras B-EVOLUTION -el I-EVOLUTION -drenaje I-EVOLUTION -se I-EVOLUTION -reduce I-EVOLUTION -la I-EVOLUTION -tumefacción I-EVOLUTION -si I-EVOLUTION -bien I-EVOLUTION -persiste I-EVOLUTION -una I-EVOLUTION -asimetría I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -tamaño I-EVOLUTION -del I-EVOLUTION -hombro I-EVOLUTION -derecho I-EVOLUTION -respecto I-EVOLUTION -al I-EVOLUTION -izquierdo. I-EVOLUTION -A I-EVOLUTION -las I-EVOLUTION -48 I-EVOLUTION -horas I-EVOLUTION -se I-EVOLUTION -confirma I-EVOLUTION -que I-EVOLUTION -crece I-EVOLUTION -E. I-EVOLUTION -coli I-EVOLUTION -sin I-EVOLUTION -resistencias I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -antibiograma, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -suspende I-EVOLUTION -la I-EVOLUTION -cloxacilina, I-EVOLUTION -manteniendo I-EVOLUTION -la I-EVOLUTION -cefotaxima I-EVOLUTION -en I-EVOLUTION -monoterapia. I-EVOLUTION -A B-EXPLORATION -los I-EXPLORATION -cinco I-EXPLORATION -días I-EXPLORATION +que I-EXPLORATION +salía I-EXPLORATION +un I-EXPLORATION +contenido I-EXPLORATION de I-EXPLORATION -tratamiento I-EXPLORATION -intravenoso, I-EXPLORATION +aspecto I-EXPLORATION +bilioso. I-EXPLORATION + I-EXPLORATION +Ante I-EXPLORATION +estos I-EXPLORATION +hallazgos I-EXPLORATION se I-EXPLORATION -obtiene I-EXPLORATION +solicitó I-EXPLORATION +un I-EXPLORATION +TC I-EXPLORATION +abdominal, I-EXPLORATION +que I-EXPLORATION +mostraba I-EXPLORATION +aerobilia, I-EXPLORATION +y I-EXPLORATION una I-EXPLORATION -nueva I-EXPLORATION -muestra I-EXPLORATION +vesícula I-EXPLORATION +escleroatrófica I-EXPLORATION +en I-EXPLORATION +íntimo I-EXPLORATION +contacto I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +ángulo I-EXPLORATION +hepático I-EXPLORATION +del I-EXPLORATION +colon, I-EXPLORATION +cuya I-EXPLORATION +pared I-EXPLORATION +aparecía I-EXPLORATION +engrosada, I-EXPLORATION +pero I-EXPLORATION +sin I-EXPLORATION +alteración I-EXPLORATION de I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -(PCR) I-EXPLORATION +la I-EXPLORATION +grasa I-EXPLORATION +subyacente. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +decidió I-EXPLORATION +completar I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +enema I-EXPLORATION +opaco I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION que I-EXPLORATION -es I-EXPLORATION +finalmente I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -14, I-EXPLORATION -6 I-EXPLORATION -mg/dl, I-EXPLORATION +un I-EXPLORATION +trayecto I-EXPLORATION +fistuloso I-EXPLORATION a I-EXPLORATION -pesar I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION -no I-EXPLORATION -presentar I-EXPLORATION -empeoramiento I-EXPLORATION -clínico I-EXPLORATION +ángulo I-EXPLORATION +hepático I-EXPLORATION del I-EXPLORATION -hombro. I-EXPLORATION -Se I-EXPLORATION -repite I-EXPLORATION +colon, I-EXPLORATION de I-EXPLORATION -nuevo I-EXPLORATION -la I-EXPLORATION -ecografía, I-EXPLORATION -que I-EXPLORATION -evidencia I-EXPLORATION un I-EXPLORATION -mínimo I-EXPLORATION -derrame I-EXPLORATION -articular I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -colección I-EXPLORATION -abscesificada I-EXPLORATION -incipiente I-EXPLORATION -en I-EXPLORATION +calibre I-EXPLORATION +aproximado I-EXPLORATION +de I-EXPLORATION +unos I-EXPLORATION +6 I-EXPLORATION +mm, I-EXPLORATION +que I-EXPLORATION +parecía I-EXPLORATION +comunicar I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +colédoco, I-EXPLORATION +obteniéndose I-EXPLORATION +posteriormente I-EXPLORATION +relleno I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -cara I-EXPLORATION -anterior I-EXPLORATION -capsular. I-EXPLORATION -Se B-TREATMENT -realiza I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -drenaje I-TREATMENT -guiado I-TREATMENT -por I-TREATMENT -ecografía. I-TREATMENT -Se I-TREATMENT -obtienen I-TREATMENT -0, I-TREATMENT -3 I-TREATMENT -ml I-TREATMENT +vía I-EXPLORATION +biliar I-EXPLORATION +intrahepática. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +final I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +colecistitis I-EXPLORATION +crónica I-EXPLORATION +con I-EXPLORATION +fístula I-EXPLORATION +biliar I-EXPLORATION +interna I-EXPLORATION +a I-EXPLORATION +ángulo I-EXPLORATION +hepático I-EXPLORATION +del I-EXPLORATION +colon I-EXPLORATION +y I-EXPLORATION +hemorragia I-EXPLORATION +digestiva I-EXPLORATION +baja I-EXPLORATION +secundaria. I-EXPLORATION + I-EXPLORATION +Durante B-TREATMENT +su I-TREATMENT +ingreso I-TREATMENT +precisó I-TREATMENT +transfusión I-TREATMENT de I-TREATMENT -muestra, I-TREATMENT -en I-TREATMENT -cuyo I-TREATMENT -cultivo I-TREATMENT -crece I-TREATMENT -el I-TREATMENT -mismo I-TREATMENT -E. I-TREATMENT -coli I-TREATMENT -multisensible. I-TREATMENT -A I-TREATMENT -los I-TREATMENT -siete I-TREATMENT -días I-TREATMENT +4 I-TREATMENT +concentrados I-TREATMENT de I-TREATMENT -tratamiento, I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -asociar I-TREATMENT -amikacina I-TREATMENT -intravenosa I-TREATMENT -para I-TREATMENT -potenciar I-TREATMENT -el I-TREATMENT -efecto I-TREATMENT -antibiótico I-TREATMENT -por I-TREATMENT -aumento I-TREATMENT -leve I-TREATMENT +hematíes, I-TREATMENT +permaneciendo B-EVOLUTION +hemodinámicamente I-EVOLUTION +estable I-EVOLUTION +y I-EVOLUTION +afebril, I-EVOLUTION +sin I-EVOLUTION +presentar I-EVOLUTION +diarrea I-EVOLUTION +ni I-EVOLUTION +nuevos I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION +hematoquecia. I-EVOLUTION +Dada B-TREATMENT +la I-TREATMENT +pluripatología I-TREATMENT +de I-TREATMENT +base I-TREATMENT de I-TREATMENT la I-TREATMENT -PCR. I-TREATMENT -Tras B-EVOLUTION -esto, I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -72 I-EVOLUTION -horas I-EVOLUTION -presenta I-EVOLUTION -una I-EVOLUTION -marcada I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -analítica. I-EVOLUTION -Ante B-TREATMENT +paciente I-TREATMENT +y I-TREATMENT la I-TREATMENT buena I-TREATMENT evolución I-TREATMENT -clínica I-TREATMENT -y I-TREATMENT -analítica, I-TREATMENT +del I-TREATMENT +cuadro I-TREATMENT +agudo I-TREATMENT se I-TREATMENT -decide I-TREATMENT -pasar I-TREATMENT -a I-TREATMENT -cefuroxima-axetilo I-TREATMENT -para I-TREATMENT -completar I-TREATMENT -tres I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -antibiótico I-TREATMENT -oral. I-TREATMENT - I-TREATMENT +decidió I-TREATMENT +un I-TREATMENT +manejo I-TREATMENT +conservador, I-TREATMENT +descartando I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +y I-TREATMENT +CPRE I-TREATMENT +terapeútica. I-TREATMENT +Evolucionó B-EVOLUTION +favorablemente I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +sin I-EVOLUTION +incidencias. I-EVOLUTION +Continuaba I-EVOLUTION +asintomática I-EVOLUTION +dos I-EVOLUTION +meses I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +alta I-EVOLUTION +aunque I-EVOLUTION +falleció I-EVOLUTION +un I-EVOLUTION +tiempo I-EVOLUTION +después I-EVOLUTION +por I-EVOLUTION +patología I-EVOLUTION +cardiorrespiratoria. I-EVOLUTION + I-EVOLUTION -Niño B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -cuyos I-PRESENT_ILLNESS -padres I-PRESENT_ILLNESS -consultaron I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -revisión I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -salud I-PRESENT_ILLNESS -porque I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -diario I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -sueño I-PRESENT_ILLNESS -muy I-PRESENT_ILLNESS -inquieto I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -ronquido I-PRESENT_ILLNESS -continuo, I-PRESENT_ILLNESS -respiración I-PRESENT_ILLNESS -bucal, I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -profusa I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -frecuentes I-PRESENT_ILLNESS -despertares I-PRESENT_ILLNESS -nocturnos. I-PRESENT_ILLNESS -Sus I-PRESENT_ILLNESS -ronquidos I-PRESENT_ILLNESS -eran I-PRESENT_ILLNESS -muy I-PRESENT_ILLNESS -ruidosos, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -modificaban I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -cambiar I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -postura I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -acentuaban I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -cuadros I-PRESENT_ILLNESS -catarrales. I-PRESENT_ILLNESS -Los I-PRESENT_ILLNESS -padres I-PRESENT_ILLNESS -dudaban I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -pudiera I-PRESENT_ILLNESS -tener I-PRESENT_ILLNESS -apneas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -negaban I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -presencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cianosis. I-PRESENT_ILLNESS -Durante I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -niño I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -mostraba I-PRESENT_ILLNESS -cansado, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -quejaba I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -matutina I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -habitual I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -tenía I-PRESENT_ILLNESS -poco I-PRESENT_ILLNESS -apetito. I-PRESENT_ILLNESS -Durante I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -periodo I-PRESENT_ILLNESS -escolar I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -padecido I-PRESENT_ILLNESS -infecciones I-PRESENT_ILLNESS -respiratorias I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -repetida. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -colegio, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -maestra I-PRESENT_ILLNESS -les I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -comentado I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS +80 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS no I-PRESENT_ILLNESS -prestaba I-PRESENT_ILLNESS -atención I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -jugaba I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -poco I-PRESENT_ILLNESS -entusiasmo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -energía. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dormir I-PRESENT_ILLNESS +conocida I-PRESENT_ILLNESS del I-PRESENT_ILLNESS -niño I-PRESENT_ILLNESS -afectaba I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -calidad I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -padres, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -lograban I-PRESENT_ILLNESS -conseguir I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -sueño I-PRESENT_ILLNESS -reparador I-PRESENT_ILLNESS -debido I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -continuas I-PRESENT_ILLNESS -interrupciones I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -mostraban I-PRESENT_ILLNESS -preocupados I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -rendidos. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS +servicio, I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +traumático I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ojo I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +(OI). I-PRESENT_ILLNESS +Entre B-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +destacamos I-PAST_MEDICAL_HISTORY +conjuntivitis I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +repetición I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +infancia, I-PAST_MEDICAL_HISTORY +artrosis I-PAST_MEDICAL_HISTORY +senil I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +hijos I-PAST_MEDICAL_HISTORY +sanos. I-PAST_MEDICAL_HISTORY En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -física I-EXPLORATION +oftalmológica I-EXPLORATION +observamos I-EXPLORATION +una I-EXPLORATION +abrasión I-EXPLORATION +corneal I-EXPLORATION +en I-EXPLORATION +OI, I-EXPLORATION +que B-TREATMENT +curará I-TREATMENT +con I-TREATMENT +oclusión I-TREATMENT +y I-TREATMENT +pomada I-TREATMENT +epitelizante I-TREATMENT +en I-TREATMENT +1 I-TREATMENT +semana. I-TREATMENT +Además B-EXPLORATION se I-EXPLORATION -detectó I-EXPLORATION +aprecia I-EXPLORATION +en I-EXPLORATION +ambos I-EXPLORATION +ojos I-EXPLORATION +(AO) I-EXPLORATION un I-EXPLORATION -estancamiento I-EXPLORATION -importante I-EXPLORATION +iris I-EXPLORATION +atrófico, I-EXPLORATION +desdoblado, I-EXPLORATION +desflecado I-EXPLORATION +con I-EXPLORATION +atrofia I-EXPLORATION +en I-EXPLORATION +sector I-EXPLORATION +inferior, I-EXPLORATION +más I-EXPLORATION +en I-EXPLORATION +OI I-EXPLORATION y I-EXPLORATION -progresivo I-EXPLORATION +una I-EXPLORATION +reducción I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -curva I-EXPLORATION -ponderoestatural I-EXPLORATION -desde I-EXPLORATION -los I-EXPLORATION -18 I-EXPLORATION -meses. I-EXPLORATION -Presentaba I-EXPLORATION -facies I-EXPLORATION -adenoidea I-EXPLORATION -con I-EXPLORATION -hipertofia I-EXPLORATION -amigdalar I-EXPLORATION -grado I-EXPLORATION -IV/IV I-EXPLORATION -y I-EXPLORATION -respiración I-EXPLORATION -oral. I-EXPLORATION -La I-EXPLORATION -tensión I-EXPLORATION -arterial I-EXPLORATION -era I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -practicó I-EXPLORATION -un I-EXPLORATION -estudio I-EXPLORATION -polisomnográfico I-EXPLORATION -nocturno I-EXPLORATION +cámara I-EXPLORATION +anterior I-EXPLORATION +visible I-EXPLORATION +también I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -Unidad I-EXPLORATION -del I-EXPLORATION -Sueño I-EXPLORATION -que I-EXPLORATION -confirmó I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +gonioscopia. I-EXPLORATION +Presenta I-EXPLORATION +cifras I-EXPLORATION de I-EXPLORATION -sospecha I-EXPLORATION +tensión I-EXPLORATION +ocular I-EXPLORATION de I-EXPLORATION -SAOS I-EXPLORATION -infantil I-EXPLORATION +24 I-EXPLORATION +mm I-EXPLORATION +Hg. I-EXPLORATION +en I-EXPLORATION +AO, I-EXPLORATION con I-EXPLORATION -predominio I-EXPLORATION -obstructivo. I-EXPLORATION -Los I-EXPLORATION -datos I-EXPLORATION -registrados I-EXPLORATION -pusieron I-EXPLORATION +un I-EXPLORATION +campo I-EXPLORATION +visual I-EXPLORATION +(Humphrey I-EXPLORATION +30-2) I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +reducción I-EXPLORATION +general I-EXPLORATION de I-EXPLORATION -manifiesto I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION +sensibilidad. I-EXPLORATION +Explorando I-EXPLORATION +el I-EXPLORATION +fondo I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -sueño I-EXPLORATION -anómalo, I-EXPLORATION -fragmentado I-EXPLORATION +ojo I-EXPLORATION +encontramos I-EXPLORATION +lesiones I-EXPLORATION +hiperpigmentadas I-EXPLORATION y I-EXPLORATION -con I-EXPLORATION -dificultad I-EXPLORATION +atróficas I-EXPLORATION +(en I-EXPLORATION +«sal I-EXPLORATION +y I-EXPLORATION +pimienta»). I-EXPLORATION + I-EXPLORATION +Con I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +presunción I-EXPLORATION +de I-EXPLORATION +sífilis I-EXPLORATION +congénita, I-EXPLORATION +aún I-EXPLORATION +sin I-EXPLORATION +leucomas I-EXPLORATION +propios I-EXPLORATION +de I-EXPLORATION +queratitis I-EXPLORATION +intersticial I-EXPLORATION +antigua, I-EXPLORATION +solicitamos I-EXPLORATION +pruebas I-EXPLORATION +serológicas I-EXPLORATION para I-EXPLORATION -su I-EXPLORATION -mantenimiento I-EXPLORATION -por I-EXPLORATION -eventos I-EXPLORATION -respiratorios I-EXPLORATION -obstructivos I-EXPLORATION +lues I-EXPLORATION +obteniendo I-EXPLORATION +resultados I-EXPLORATION +positivos I-EXPLORATION en I-EXPLORATION -número I-EXPLORATION -patológico. I-EXPLORATION +test I-EXPLORATION +treponémicos I-EXPLORATION +(TPHA, I-EXPLORATION +FTA I-EXPLORATION +abs) I-EXPLORATION +y I-EXPLORATION +negativos I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +no I-EXPLORATION +treponémicos I-EXPLORATION +(RPR). I-EXPLORATION I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -consistente I-TREATMENT -en I-TREATMENT -adenoidectomía I-TREATMENT +En B-PAST_MEDICAL_HISTORY +este I-PAST_MEDICAL_HISTORY +punto I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +evaluada I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +medicina I-PAST_MEDICAL_HISTORY +interna I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +cuando I-PAST_MEDICAL_HISTORY +averiguamos I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +desconoce I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +causa I-PAST_MEDICAL_HISTORY +real I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +conjuntivitis, I-PAST_MEDICAL_HISTORY +aunque I-PAST_MEDICAL_HISTORY +relata, I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +detallada: I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +tratamientos I-PAST_MEDICAL_HISTORY +recibidos I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +9 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +plena I-PAST_MEDICAL_HISTORY +era I-PAST_MEDICAL_HISTORY +preantibiótica, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +neobismuto I-PAST_MEDICAL_HISTORY +oral, I-PAST_MEDICAL_HISTORY +que B-FAMILY_HISTORY +su I-FAMILY_HISTORY +madre I-FAMILY_HISTORY +«soltera» I-FAMILY_HISTORY +muere I-FAMILY_HISTORY +joven I-FAMILY_HISTORY +«deformada» I-FAMILY_HISTORY +y B-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +60, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +problemas I-PAST_MEDICAL_HISTORY +inespecíficos I-PAST_MEDICAL_HISTORY +articulares, I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +pautaron I-PAST_MEDICAL_HISTORY +unas I-PAST_MEDICAL_HISTORY +inyecciones I-PAST_MEDICAL_HISTORY +semanales I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +mensuales I-PAST_MEDICAL_HISTORY +(penicilina I-PAST_MEDICAL_HISTORY +probablemente). I-PAST_MEDICAL_HISTORY +Hallazgos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +anamnesis I-PAST_MEDICAL_HISTORY +compatible I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +sífilis I-PAST_MEDICAL_HISTORY +congénita I-PAST_MEDICAL_HISTORY +tardía, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +queratitis I-PAST_MEDICAL_HISTORY +intersticial I-PAST_MEDICAL_HISTORY +tratada I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +éxito, I-PAST_MEDICAL_HISTORY +pues I-PAST_MEDICAL_HISTORY +carece I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +leucomas. I-PAST_MEDICAL_HISTORY +Adquirida I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +infección I-PAST_MEDICAL_HISTORY +trasplacentaria: I-PAST_MEDICAL_HISTORY +madre B-FAMILY_HISTORY +con I-FAMILY_HISTORY +artropatía I-FAMILY_HISTORY +severa I-FAMILY_HISTORY +compatible I-FAMILY_HISTORY +con I-FAMILY_HISTORY +sífilis I-FAMILY_HISTORY +secundaria. I-FAMILY_HISTORY +Y B-PAST_MEDICAL_HISTORY +curada I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +resultado I-PAST_MEDICAL_HISTORY +negativo I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +test I-PAST_MEDICAL_HISTORY +RPR. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +89 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +HTA, I-PAST_MEDICAL_HISTORY +DM I-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +varios I-PAST_MEDICAL_HISTORY +accidentes I-PAST_MEDICAL_HISTORY +cerebrovasculares I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +repetición I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +consecuencia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +cuales I-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +hemiplejía I-PAST_MEDICAL_HISTORY +derecha I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +alteraciones I-PAST_MEDICAL_HISTORY +deglutorias I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +habían I-PAST_MEDICAL_HISTORY +requerido I-PAST_MEDICAL_HISTORY +nutrición I-PAST_MEDICAL_HISTORY +enteral I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +través I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +sonda I-PAST_MEDICAL_HISTORY +nasogástrica I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +últimos I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +De B-PRESENT_ILLNESS +acuerdo I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +familia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +geriatra I-PRESENT_ILLNESS +habitual I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +indicó I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +colocación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +sonda I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +gastrostomía I-PRESENT_ILLNESS +percutánea I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +control I-PRESENT_ILLNESS +endoscópico. I-PRESENT_ILLNESS +El B-TREATMENT +procedimiento I-TREATMENT +fue I-TREATMENT +realizado I-TREATMENT +bajo I-TREATMENT +sedación I-TREATMENT +profunda I-TREATMENT +por I-TREATMENT +un I-TREATMENT +anestesiólogo I-TREATMENT y I-TREATMENT -radiofrecuencia I-TREATMENT -inducida I-TREATMENT -amigdalar. I-TREATMENT -El B-EVOLUTION -niño I-EVOLUTION -mejoró, I-EVOLUTION -presentando I-EVOLUTION -remisión I-EVOLUTION +siguiendo I-TREATMENT +las I-TREATMENT +pautas I-TREATMENT +de I-TREATMENT +profilaxis I-TREATMENT +antibiótica I-TREATMENT +recomendadas I-TREATMENT +actualmente. I-TREATMENT +La I-TREATMENT +técnica I-TREATMENT +de I-TREATMENT +colocación I-TREATMENT +por I-TREATMENT +tracción I-TREATMENT +se I-TREATMENT +llevó I-TREATMENT +a I-TREATMENT +cabo I-TREATMENT +con I-TREATMENT +set I-TREATMENT +comercializado I-TREATMENT +por I-TREATMENT +dos I-TREATMENT +endoscopistas I-TREATMENT +expertos. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +estricta I-TREATMENT +desinfección I-TREATMENT +de I-TREATMENT +la I-TREATMENT +zona, I-TREATMENT +colocando I-TREATMENT +la I-TREATMENT +presilla I-TREATMENT +externa I-TREATMENT +de I-TREATMENT +la I-TREATMENT +sonda I-TREATMENT +a I-TREATMENT +una I-TREATMENT +distancia I-TREATMENT +entre I-TREATMENT +2-3 I-TREATMENT +cm I-TREATMENT +de I-TREATMENT +la I-TREATMENT +superficie I-TREATMENT +de I-TREATMENT +la I-TREATMENT +piel I-TREATMENT +a I-TREATMENT +través I-TREATMENT +de I-TREATMENT +una I-TREATMENT +incisión I-TREATMENT +de I-TREATMENT +aproximadamente I-TREATMENT +1 I-TREATMENT +cm. I-TREATMENT +A B-EVOLUTION +las I-EVOLUTION +12 I-EVOLUTION +horas I-EVOLUTION +del I-EVOLUTION +proceso I-EVOLUTION +se I-EVOLUTION +inició I-EVOLUTION +alimentación I-EVOLUTION +a I-EVOLUTION +través I-EVOLUTION de I-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -nocturnos I-EVOLUTION +la I-EVOLUTION +PEG I-EVOLUTION y I-EVOLUTION -diurnos I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +24 I-EVOLUTION +horas I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION de I-EVOLUTION -forma I-EVOLUTION -inmediata. I-EVOLUTION -En I-EVOLUTION +alta I-EVOLUTION +sin I-EVOLUTION +complicaciones I-EVOLUTION +aconsejándose I-EVOLUTION los I-EVOLUTION -siguientes I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -recuperó I-EVOLUTION -un I-EVOLUTION -crecimiento I-EVOLUTION -y I-EVOLUTION -ganancia I-EVOLUTION -ponderal I-EVOLUTION -adecuados I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -vio I-EVOLUTION -libre I-EVOLUTION +cuidados I-EVOLUTION +domiciliarios I-EVOLUTION +habituales. I-EVOLUTION +Transcurridas I-EVOLUTION +48 I-EVOLUTION +horas I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +ingresa I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +Servicio I-EVOLUTION de I-EVOLUTION -los I-EVOLUTION -procesos I-EVOLUTION -respiratorios I-EVOLUTION +Urgencias I-EVOLUTION de I-EVOLUTION -repetición I-EVOLUTION -que I-EVOLUTION -venía I-EVOLUTION -padeciendo I-EVOLUTION -con I-EVOLUTION -anterioridad. I-EVOLUTION -La I-EVOLUTION -familia I-EVOLUTION -manifestó I-EVOLUTION -estar I-EVOLUTION -muy I-EVOLUTION -contenta I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -evolución I-EVOLUTION +nuestro I-EVOLUTION +hospital I-EVOLUTION +por I-EVOLUTION +deterioro I-EVOLUTION del I-EVOLUTION -niño I-EVOLUTION -y, I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -también I-EVOLUTION -es I-EVOLUTION -importante, I-EVOLUTION -todos I-EVOLUTION -habían I-EVOLUTION -vuelto I-EVOLUTION -a I-EVOLUTION -dormir I-EVOLUTION -bien. I-EVOLUTION - I-EVOLUTION - -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diez I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -alta, I-PRESENT_ILLNESS -cefalea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -odinofagia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -azitromicina I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -últimas I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -genitales I-PRESENT_ILLNESS -muy I-PRESENT_ILLNESS -dolorosas. I-PRESENT_ILLNESS -Ausencia B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -menarquia, I-PAST_MEDICAL_HISTORY -contacto I-PAST_MEDICAL_HISTORY -sexual I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -traumatismos I-PAST_MEDICAL_HISTORY -genitales I-PAST_MEDICAL_HISTORY -previos. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A B-EXPLORATION +estado I-EVOLUTION +general; I-EVOLUTION +eritema, I-EVOLUTION +edema I-EVOLUTION +e I-EVOLUTION +induración I-EVOLUTION +en I-EVOLUTION +pared I-EVOLUTION +abdominal I-EVOLUTION +con I-EVOLUTION +supuración I-EVOLUTION +de I-EVOLUTION +líquido I-EVOLUTION +purulento I-EVOLUTION +a I-EVOLUTION +través I-EVOLUTION +y I-EVOLUTION +alrededor I-EVOLUTION +del I-EVOLUTION +orificio I-EVOLUTION +de I-EVOLUTION +gastrostomía. I-EVOLUTION +En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -genital I-EXPLORATION -presenta I-EXPLORATION -eritema I-EXPLORATION +física I-EXPLORATION +destacaban I-EXPLORATION +un I-EXPLORATION +claro I-EXPLORATION +empeoramiento I-EXPLORATION +del I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +tiraje I-EXPLORATION +intercostal I-EXPLORATION y I-EXPLORATION -edema I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -labios I-EXPLORATION -mayores, I-EXPLORATION -con I-EXPLORATION -úlceras I-EXPLORATION -profundas, I-EXPLORATION -simétricas, I-EXPLORATION -negruzcas, I-EXPLORATION -la I-EXPLORATION -mayor I-EXPLORATION -de I-EXPLORATION -ellas I-EXPLORATION -de I-EXPLORATION -3 I-EXPLORATION -cm I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION -longitudinal I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -labios I-EXPLORATION -menores I-EXPLORATION +hipoperfusión I-EXPLORATION +periférica. I-EXPLORATION +La I-EXPLORATION +pared I-EXPLORATION +abdominal I-EXPLORATION +presentaba I-EXPLORATION +extensa I-EXPLORATION +crepitación, I-EXPLORATION +edema I-EXPLORATION y I-EXPLORATION -varias I-EXPLORATION -lesiones I-EXPLORATION -satélites I-EXPLORATION -menores I-EXPLORATION -perivulvares, I-EXPLORATION -recubiertas I-EXPLORATION -algunas I-EXPLORATION -de I-EXPLORATION -material I-EXPLORATION -fibrinoide I-EXPLORATION +eritema I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +perigastrostomía I-EXPLORATION +con I-EXPLORATION +supuración I-EXPLORATION +espontánea I-EXPLORATION y I-EXPLORATION -muy I-EXPLORATION -dolorosa I-EXPLORATION a I-EXPLORATION la I-EXPLORATION -manipulación. I-EXPLORATION -Resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -sin I-EXPLORATION -hallazgos I-EXPLORATION -relevantes. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -pruebas I-EXPLORATION -complementarias I-EXPLORATION -destaca I-EXPLORATION -leucocitosis I-EXPLORATION +presión I-EXPLORATION de I-EXPLORATION -22, I-EXPLORATION -38/µl I-EXPLORATION -y I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION +material I-EXPLORATION +purulento I-EXPLORATION +por I-EXPLORATION +orificio I-EXPLORATION de I-EXPLORATION -138, I-EXPLORATION -9 I-EXPLORATION -mg/l, I-EXPLORATION +gastrostomía. I-EXPLORATION +La I-EXPLORATION +analítica I-EXPLORATION +mostraba I-EXPLORATION +intensa I-EXPLORATION +leucocitosis I-EXPLORATION con I-EXPLORATION -función I-EXPLORATION -renal, I-EXPLORATION -hepática I-EXPLORATION +desviación I-EXPLORATION +izquierda, I-EXPLORATION +plaquetopenia I-EXPLORATION y I-EXPLORATION -sedimento I-EXPLORATION -urinario I-EXPLORATION -normales. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -una I-EXPLORATION -úlcera I-EXPLORATION -genital I-EXPLORATION -aguda, I-EXPLORATION -planteamos I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -diferencial I-EXPLORATION -entre I-EXPLORATION -el I-EXPLORATION -origen I-EXPLORATION -infeccioso, I-EXPLORATION -ya I-EXPLORATION -sea I-EXPLORATION -venéreo I-EXPLORATION -(sífilis, I-EXPLORATION -virus I-EXPLORATION -herpes I-EXPLORATION -simple, I-EXPLORATION -linfogranuloma I-EXPLORATION -venéreo, I-EXPLORATION -chancroide) I-EXPLORATION -o I-EXPLORATION -no I-EXPLORATION -venéreo I-EXPLORATION -(virus I-EXPLORATION +alteraciones I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +tiempos I-EXPLORATION de I-EXPLORATION -Epstein-Barr I-EXPLORATION -[VEB], I-EXPLORATION -citomegalovirus I-EXPLORATION -[CMV], I-EXPLORATION -Brucella), I-EXPLORATION +protrombina I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -origen I-EXPLORATION -no I-EXPLORATION -infeccioso I-EXPLORATION -(enfermedad I-EXPLORATION -de I-EXPLORATION -Crohn, I-EXPLORATION -síndrome I-EXPLORATION +cefalina. I-EXPLORATION +Se I-EXPLORATION +decidió I-EXPLORATION +realizar I-EXPLORATION +TAC I-EXPLORATION +abdominal I-EXPLORATION +urgente I-EXPLORATION +que I-EXPLORATION +demostró I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -Behçet, I-EXPLORATION -pénfigo I-EXPLORATION -vulgar, I-EXPLORATION -liquen I-EXPLORATION -escleroso, I-EXPLORATION -aftosis I-EXPLORATION -idiopática, I-EXPLORATION -eritema I-EXPLORATION -fijo I-EXPLORATION -medicamentoso, I-EXPLORATION -eritema I-EXPLORATION -multiforme) I-EXPLORATION -1-3. I-EXPLORATION - I-EXPLORATION +extenso I-EXPLORATION +enfisema I-EXPLORATION +subcutáneo I-EXPLORATION +en I-EXPLORATION +pared I-EXPLORATION +abdominal I-EXPLORATION +: I-EXPLORATION +imagen I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +abscesificación I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +subyacente I-EXPLORATION +a I-EXPLORATION +gastrostomía; I-EXPLORATION +importante I-EXPLORATION +íleo I-EXPLORATION +paralítico I-EXPLORATION +y I-EXPLORATION +pneumoperitoneo. I-EXPLORATION Se B-TREATMENT -ingresa I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -con I-TREATMENT -analgesia, I-TREATMENT -lubricante I-TREATMENT -cicratizante I-TREATMENT -y I-TREATMENT -fomentos I-TREATMENT -con I-TREATMENT -suero I-TREATMENT -fisiológico. I-TREATMENT -Ante I-TREATMENT -la I-TREATMENT -evolución I-TREATMENT -tórpida, I-TREATMENT -se I-TREATMENT -añaden I-TREATMENT -al I-TREATMENT +inició I-TREATMENT tratamiento I-TREATMENT +con I-TREATMENT antibióticos I-TREATMENT de I-TREATMENT amplio I-TREATMENT espectro, I-TREATMENT -aciclovir I-TREATMENT -IV I-TREATMENT +desbridamiento I-TREATMENT +quirúrgico I-TREATMENT +del I-TREATMENT +absceso I-TREATMENT +abdominal I-TREATMENT y I-TREATMENT -corticoterapia I-TREATMENT -oral, I-TREATMENT -en I-TREATMENT -espera I-TREATMENT -de I-TREATMENT -los I-TREATMENT -resultados I-TREATMENT +estrictos I-TREATMENT +cuidados I-TREATMENT +locales I-TREATMENT de I-TREATMENT -los I-TREATMENT -cultivos. I-TREATMENT +la I-TREATMENT +herida. I-TREATMENT +Pese B-EVOLUTION +a I-EVOLUTION +todo I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +falleció I-EVOLUTION +una I-EVOLUTION +semana I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +inicio I-EVOLUTION +del I-EVOLUTION +tratamiento. I-EVOLUTION El B-EXPLORATION -urocultivo, I-EXPLORATION -el I-EXPLORATION -hemocultivo I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION cultivo I-EXPLORATION de I-EXPLORATION -exudado I-EXPLORATION -vaginal I-EXPLORATION -y I-EXPLORATION -cervical I-EXPLORATION -(para I-EXPLORATION -C. I-EXPLORATION -trachomatis), I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -los I-EXPLORATION -frotis I-EXPLORATION -de I-EXPLORATION las I-EXPLORATION -úlceras I-EXPLORATION -genitales, I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Las I-EXPLORATION -serologías I-EXPLORATION -para I-EXPLORATION -VEB, I-EXPLORATION -CMV, I-EXPLORATION -Brucella, I-EXPLORATION -Rosa I-EXPLORATION -de I-EXPLORATION -Bengala, I-EXPLORATION -virus I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana I-EXPLORATION -y I-EXPLORATION -lúes I-EXPLORATION -fueron I-EXPLORATION -negativas. I-EXPLORATION -Se I-EXPLORATION -solicita I-EXPLORATION -determinación I-EXPLORATION -de I-EXPLORATION -ADN I-EXPLORATION -del I-EXPLORATION -virus I-EXPLORATION -herpes I-EXPLORATION -simple I-EXPLORATION -tipos I-EXPLORATION -I I-EXPLORATION -y I-EXPLORATION -II, I-EXPLORATION -mediante I-EXPLORATION -reacción I-EXPLORATION +muestras I-EXPLORATION +tomada I-EXPLORATION en I-EXPLORATION -cadena I-EXPLORATION -de I-EXPLORATION la I-EXPLORATION -polimerasa I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -úlcera I-EXPLORATION -genital, I-EXPLORATION -que I-EXPLORATION +región I-EXPLORATION resultó I-EXPLORATION -finalmente I-EXPLORATION -negativa. I-EXPLORATION +positivo I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +diez I-EXPLORATION +días I-EXPLORATION +del I-EXPLORATION +ingreso I-EXPLORATION +para I-EXPLORATION +Pseudomonas I-EXPLORATION +putrida I-EXPLORATION +y I-EXPLORATION +Acinetobacter. I-EXPLORATION I-EXPLORATION -Se B-EVOLUTION -establece I-EVOLUTION -el I-EVOLUTION -diagnóstico, I-EVOLUTION -por I-EVOLUTION -exclusión, I-EVOLUTION -de I-EVOLUTION -úlcera I-EVOLUTION -de I-EVOLUTION -Lipschütz I-EVOLUTION -en I-EVOLUTION -su I-EVOLUTION -forma I-EVOLUTION -gangrenosa I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -decide I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -siete I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -ingreso, I-EVOLUTION -persistiendo I-EVOLUTION -las I-EVOLUTION -ulceraciones I-EVOLUTION -múltiples I-EVOLUTION -con I-EVOLUTION -pérdida I-EVOLUTION -de I-EVOLUTION -tejido, I-EVOLUTION -sin I-EVOLUTION -aspecto I-EVOLUTION -inflamatorio I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -inicio I-EVOLUTION -de I-EVOLUTION -cicatrización, I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -más I-EVOLUTION -externas, I-EVOLUTION -sin I-EVOLUTION -apreciarse I-EVOLUTION -retracción I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -mucosas I-EVOLUTION -genitales I-EVOLUTION -ni I-EVOLUTION -secreciones I-EVOLUTION -vaginales. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -cuadro I-EVOLUTION -estaba I-EVOLUTION -casi I-EVOLUTION -totalmente I-EVOLUTION -resuelto I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -siete I-EVOLUTION -semanas I-EVOLUTION -del I-EVOLUTION -diagnóstico. I-EVOLUTION - I-EVOLUTION -Presentamos B-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -caso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -niña I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diez I-PAST_MEDICAL_HISTORY -días I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vida, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -chino, I-PAST_MEDICAL_HISTORY -con B-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS fiebre I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -38 I-PRESENT_ILLNESS -°C I-PRESENT_ILLNESS +38º I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS +48 I-PRESENT_ILLNESS horas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS evolución, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -sintomatología. I-PRESENT_ILLNESS -Alimentada I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -lactancia I-PRESENT_ILLNESS -artificial. I-PRESENT_ILLNESS -Sin B-FAMILY_HISTORY -ambiente I-FAMILY_HISTORY -epidémico I-FAMILY_HISTORY -familiar. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -gestación I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -mantenido I-PAST_MEDICAL_HISTORY -controles I-PAST_MEDICAL_HISTORY -normales; I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -eutócico I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -factores I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -riesgo I-PAST_MEDICAL_HISTORY -infeccioso, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -precisó I-PAST_MEDICAL_HISTORY -reanimación I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -nacimiento I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -pruebas I-PAST_MEDICAL_HISTORY -metabólicas I-PAST_MEDICAL_HISTORY -estaban I-PAST_MEDICAL_HISTORY -pendientes I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ese I-PAST_MEDICAL_HISTORY -momento. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A B-EXPLORATION +tos I-PRESENT_ILLNESS +escasa I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +expectoración I-PRESENT_ILLNESS +blanquecina. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -física I-EXPLORATION -presentaba I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -sin I-EXPLORATION -aspecto I-EXPLORATION -séptico, I-EXPLORATION -siendo I-EXPLORATION -normal I-EXPLORATION -por I-EXPLORATION -aparatos. I-EXPLORATION - I-EXPLORATION -En B-TREATMENT -Urgencias I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -protocolo I-TREATMENT -de I-TREATMENT -fiebre I-TREATMENT -sin I-TREATMENT -foco I-TREATMENT -en I-TREATMENT -paciente I-TREATMENT -neonatal I-TREATMENT -(analítica I-TREATMENT -sanguínea, I-TREATMENT -urinaria I-TREATMENT -y I-TREATMENT -de I-TREATMENT -líquido I-TREATMENT -cefalorraquídeo I-TREATMENT -normales) I-TREATMENT -y I-TREATMENT -se I-TREATMENT -pauta I-TREATMENT -antibioterapia I-TREATMENT -empírica. I-TREATMENT - I-TREATMENT -Permanece B-EVOLUTION -afebril I-EVOLUTION -desde I-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -ingreso I-EVOLUTION -y I-EVOLUTION -hasta I-EVOLUTION -el I-EVOLUTION -alta, I-EVOLUTION -sin I-EVOLUTION -incidencias I-EVOLUTION -salvo I-EVOLUTION -por I-EVOLUTION -aparición I-EVOLUTION -de I-EVOLUTION -exantema I-EVOLUTION -maculopapular I-EVOLUTION -al I-EVOLUTION -segundo I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -ingreso, I-EVOLUTION -que I-EVOLUTION -remite I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -espontánea I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -siguientes I-EVOLUTION -24-48 I-EVOLUTION -horas. I-EVOLUTION +sólo I-EXPLORATION +se I-EXPLORATION +apreció I-EXPLORATION +hipertrofia I-EXPLORATION +en I-EXPLORATION +amígdala I-EXPLORATION +izquierda I-EXPLORATION +con I-EXPLORATION +adenopatías I-EXPLORATION +en I-EXPLORATION +cadena I-EXPLORATION +yugular I-EXPLORATION +izquierda I-EXPLORATION +de I-EXPLORATION +gran I-EXPLORATION +tamaño I-EXPLORATION +(3x3 I-EXPLORATION +cm). I-EXPLORATION Ante B-TREATMENT la I-TREATMENT sospecha I-TREATMENT de I-TREATMENT -viriasis, I-TREATMENT -y I-TREATMENT -una I-TREATMENT -vez I-TREATMENT -que I-TREATMENT -se I-TREATMENT -confirman I-TREATMENT -los I-TREATMENT -resultados I-TREATMENT -definitivos I-TREATMENT -de I-TREATMENT -los I-TREATMENT -cultivos I-TREATMENT -(negativos), I-TREATMENT +faringoamigdalitis I-TREATMENT +bacteriana I-TREATMENT se I-TREATMENT -suspende I-TREATMENT -la I-TREATMENT -antibioterapia. I-TREATMENT -Se B-EVOLUTION -decide I-EVOLUTION -el I-EVOLUTION -alta I-EVOLUTION +pautó I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +amoxicilina I-TREATMENT +e I-TREATMENT +ibuprofeno. I-TREATMENT +No B-EXPLORATION +obstante, I-EXPLORATION +ante I-EXPLORATION +el I-EXPLORATION +tamaño I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +adenopatías I-EXPLORATION +se I-EXPLORATION +decide I-EXPLORATION +solicitar I-EXPLORATION +test I-EXPLORATION +de I-EXPLORATION +mononucleosis I-EXPLORATION +infecciosa I-EXPLORATION +(MI) I-EXPLORATION +y I-EXPLORATION +analítica I-EXPLORATION +general. I-EXPLORATION + I-EXPLORATION +Acude B-EVOLUTION +de I-EVOLUTION +nuevo I-EVOLUTION a I-EVOLUTION los I-EVOLUTION -15 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -vida. I-EVOLUTION - I-EVOLUTION -Dos I-EVOLUTION +14 I-EVOLUTION días I-EVOLUTION -después, I-EVOLUTION -acude I-EVOLUTION -al I-EVOLUTION -Servicio I-EVOLUTION -de I-EVOLUTION -Urgencias I-EVOLUTION por I-EVOLUTION -un I-EVOLUTION -exantema I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -evolución, I-EVOLUTION -generalizado, I-EVOLUTION -a I-EVOLUTION -expensas I-EVOLUTION -de I-EVOLUTION -elementos I-EVOLUTION -“en I-EVOLUTION -diana” I-EVOLUTION -con I-EVOLUTION -aclaramiento I-EVOLUTION -central, I-EVOLUTION -sobreelevados I-EVOLUTION +fiebre I-EVOLUTION +alta, I-EVOLUTION +malestar I-EVOLUTION +general, I-EVOLUTION +cansancio I-EVOLUTION +intenso I-EVOLUTION y I-EVOLUTION -confluyentes. I-EVOLUTION -Leve B-EXPLORATION -coloración I-EXPLORATION -amoratada, I-EXPLORATION -más I-EXPLORATION -intensa I-EXPLORATION +dolor I-EVOLUTION +en I-EVOLUTION +región I-EVOLUTION +laterocervical I-EVOLUTION +izquierda. I-EVOLUTION +En B-EXPLORATION +este I-EXPLORATION +momento I-EXPLORATION en I-EXPLORATION -miembros I-EXPLORATION -inferiores, I-EXPLORATION -que I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION se I-EXPLORATION -borra I-EXPLORATION -parcialmente I-EXPLORATION +aprecia I-EXPLORATION +gran I-EXPLORATION +adenopatía I-EXPLORATION +submaxilar I-EXPLORATION +izquierda I-EXPLORATION +de I-EXPLORATION +3 I-EXPLORATION +x I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION +dolorosa I-EXPLORATION a I-EXPLORATION la I-EXPLORATION -presión, I-EXPLORATION -sin I-EXPLORATION -petequias. I-EXPLORATION -Como I-EXPLORATION -única I-EXPLORATION -clínica I-EXPLORATION -acompañante, I-EXPLORATION -presentaba I-EXPLORATION -deposiciones I-EXPLORATION -líquidas I-EXPLORATION -escasas. I-EXPLORATION - I-EXPLORATION -Se B-EVOLUTION -mantuvo I-EVOLUTION -en I-EVOLUTION -observación I-EVOLUTION -durante I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -y, I-EVOLUTION -ante I-EVOLUTION -la I-EVOLUTION -no I-EVOLUTION -progresión I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -buen I-EVOLUTION -estado I-EVOLUTION -general, I-EVOLUTION -se I-EVOLUTION -decidió I-EVOLUTION -el I-EVOLUTION -alta. I-EVOLUTION - I-EVOLUTION -Tras I-EVOLUTION -dos I-EVOLUTION -días I-EVOLUTION -en I-EVOLUTION -domicilio, I-EVOLUTION -acude I-EVOLUTION -nuevamente I-EVOLUTION -por I-EVOLUTION -shock I-EVOLUTION -hipovolémico I-EVOLUTION -secundario I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -cuadro I-EVOLUTION -de I-EVOLUTION -diarrea I-EVOLUTION -abundante I-EVOLUTION -desde I-EVOLUTION -18 I-EVOLUTION -horas I-EVOLUTION -antes, I-EVOLUTION -sin I-EVOLUTION -vómitos I-EVOLUTION -ni I-EVOLUTION -rechazo I-EVOLUTION -de I-EVOLUTION -tomas. I-EVOLUTION -Las B-EXPLORATION +palpación I-EXPLORATION +y I-EXPLORATION +otra I-EXPLORATION +supraclavicular I-EXPLORATION +izquierda. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +adenopatías I-EXPLORATION +en I-EXPLORATION +otros I-EXPLORATION +grupos I-EXPLORATION +ganglionares, I-EXPLORATION +hepatoesplenomegalia, I-EXPLORATION lesiones I-EXPLORATION cutáneas I-EXPLORATION -habían I-EXPLORATION -desaparecido. I-EXPLORATION +o I-EXPLORATION +afectación I-EXPLORATION +articular. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +aprecian I-EXPLORATION +lesiones I-EXPLORATION +locales, I-EXPLORATION +la I-EXPLORATION +otoscopia I-EXPLORATION +es I-EXPLORATION +normal, I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +faríngea I-EXPLORATION +y I-EXPLORATION +tiroidea I-EXPLORATION +son I-EXPLORATION +normales. I-EXPLORATION En I-EXPLORATION -el I-EXPLORATION -coprocultivo I-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +destaca: I-EXPLORATION +LDH I-EXPLORATION +1400 I-EXPLORATION +UI/l, I-EXPLORATION +Got I-EXPLORATION +56, I-EXPLORATION +gpt I-EXPLORATION +47 I-EXPLORATION +UI/l, I-EXPLORATION no I-EXPLORATION -se I-EXPLORATION -aisló I-EXPLORATION -germen I-EXPLORATION +existe I-EXPLORATION +leucocitosis, I-EXPLORATION +sólo I-EXPLORATION +una I-EXPLORATION +leve I-EXPLORATION +linfocitosis. I-EXPLORATION +Test I-EXPLORATION +de I-EXPLORATION +MI: I-EXPLORATION +negativo. I-EXPLORATION +Se I-EXPLORATION +solicita I-EXPLORATION +test I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +virus I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +inmunodeficiencia I-EXPLORATION +humana I-EXPLORATION +(VIH), I-EXPLORATION +análisis I-EXPLORATION +anatomopatológico I-EXPLORATION +mediante I-EXPLORATION +punción I-EXPLORATION +aspiración I-EXPLORATION +con I-EXPLORATION +aguja I-EXPLORATION +fina I-EXPLORATION +(PAAF) I-EXPLORATION y I-EXPLORATION +de I-EXPLORATION +nuevo I-EXPLORATION +test I-EXPLORATION +de I-EXPLORATION +MI. I-EXPLORATION +Para I-EXPLORATION +evitar I-EXPLORATION +demoras I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +acude I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +centro I-EXPLORATION +privado I-EXPLORATION +para I-EXPLORATION la I-EXPLORATION -virología I-EXPLORATION -fecal I-EXPLORATION -fue I-EXPLORATION -negativa. I-EXPLORATION -Recibió B-TREATMENT -reposición I-TREATMENT -con I-TREATMENT -fluidoterapia I-TREATMENT -intravenosa, I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -retirándose I-TREATMENT -según I-TREATMENT -mejoraba I-TREATMENT -la I-TREATMENT -tolerancia I-TREATMENT -oral I-TREATMENT -con I-TREATMENT -leche I-TREATMENT -hidrolizada I-TREATMENT -y I-TREATMENT -tras I-TREATMENT -descartar I-TREATMENT -afectación I-TREATMENT -intestinal. I-TREATMENT -Las B-EVOLUTION -deposiciones I-EVOLUTION -mejoraron I-EVOLUTION -progresivamente I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -dio I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -asintomática. I-EVOLUTION - I-EVOLUTION -En I-EVOLUTION -controles I-EVOLUTION -sucesivos I-EVOLUTION -en I-EVOLUTION -consulta I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -adecuada I-EVOLUTION -ganancia I-EVOLUTION -ponderoestatural, I-EVOLUTION -con I-EVOLUTION -deposiciones I-EVOLUTION -de I-EVOLUTION -consistencia I-EVOLUTION -normal. I-EVOLUTION -Mantuvo I-EVOLUTION -la I-EVOLUTION -alimentación I-EVOLUTION -con I-EVOLUTION -fórmula I-EVOLUTION -hidrolizada I-EVOLUTION +realización I-EXPLORATION +de I-EXPLORATION +PAAF I-EXPLORATION +y I-EXPLORATION +los I-EXPLORATION +cirujanos I-EXPLORATION +encargados I-EXPLORATION +de I-EXPLORATION +realizarla, I-EXPLORATION +ante I-EXPLORATION +el I-EXPLORATION +tamaño I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +adenopatías, I-EXPLORATION +deciden I-EXPLORATION +la I-EXPLORATION +realización I-EXPLORATION +de I-EXPLORATION +biopsia. I-EXPLORATION +El I-EXPLORATION +resultado I-EXPLORATION +del I-EXPLORATION +test I-EXPLORATION +de I-EXPLORATION +MI I-EXPLORATION +es I-EXPLORATION +nuevamente I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION +La B-EVOLUTION +evolución I-EVOLUTION +fue I-EVOLUTION +favorable, I-EVOLUTION +persistiendo I-EVOLUTION +febrícula I-EVOLUTION durante I-EVOLUTION -unas I-EVOLUTION -semanas, I-EVOLUTION +20 I-EVOLUTION +días I-EVOLUTION +y I-EVOLUTION con I-EVOLUTION -posterior I-EVOLUTION -tolerancia I-EVOLUTION -de I-EVOLUTION -fórmula I-EVOLUTION -artificial, I-EVOLUTION -sin I-EVOLUTION -aparición I-EVOLUTION +disminución I-EVOLUTION +lenta I-EVOLUTION +y I-EVOLUTION +paulatina I-EVOLUTION +del I-EVOLUTION +tamaño I-EVOLUTION de I-EVOLUTION -nuevas I-EVOLUTION -lesiones I-EVOLUTION -cutáneas. I-EVOLUTION - I-EVOLUTION +las I-EVOLUTION +adenopatías. I-EVOLUTION +El B-EXPLORATION +resultado I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +se I-EXPLORATION +informa I-EXPLORATION +como: I-EXPLORATION +linfadenitis I-EXPLORATION +histiocitaria I-EXPLORATION +necrotizante I-EXPLORATION +o I-EXPLORATION +enfermedad I-EXPLORATION +de I-EXPLORATION +Kikuchi. I-EXPLORATION +Ante I-EXPLORATION +este I-EXPLORATION +resultado I-EXPLORATION +se I-EXPLORATION +solicita I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +analítica I-EXPLORATION +y I-EXPLORATION +otras I-EXPLORATION +pruebas I-EXPLORATION +complementarias I-EXPLORATION +para I-EXPLORATION +descartar I-EXPLORATION +posibles I-EXPLORATION +procesos I-EXPLORATION +asociados I-EXPLORATION +a I-EXPLORATION +esta I-EXPLORATION +enfermedad. I-EXPLORATION +Los I-EXPLORATION +resultados I-EXPLORATION +son I-EXPLORATION +los I-EXPLORATION +siguientes: I-EXPLORATION +factor I-EXPLORATION +reumatoide I-EXPLORATION +negativo, I-EXPLORATION +anticuerpos I-EXPLORATION +antinucleares I-EXPLORATION +(ANAs) I-EXPLORATION +negativos, I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +normal. I-EXPLORATION + I-EXPLORATION -Paciente B-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia, I-PAST_MEDICAL_HISTORY -de B-PRESENT_ILLNESS -21 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +clínico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +tercer I-PRESENT_ILLNESS +molar I-PRESENT_ILLNESS +fusionado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuarto I-PRESENT_ILLNESS +molar I-PRESENT_ILLNESS +supernumerario I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad. I-PRESENT_ILLNESS -Refiere I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -madre I-PRESENT_ILLNESS +36 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -inicia I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -padecimiento I-PRESENT_ILLNESS -actual I-PRESENT_ILLNESS -11 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -previos I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso, I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS al I-PRESENT_ILLNESS -detectar I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -manera I-PRESENT_ILLNESS -súbita I-PRESENT_ILLNESS -alteración I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -marcha, I-PRESENT_ILLNESS -descrito I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -“arrastrando I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -pie I-PRESENT_ILLNESS -izquierdo”; I-PRESENT_ILLNESS -esto I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -causaba I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -equilibrio, I-PRESENT_ILLNESS -caída I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -inhabilidad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -desplazarse. I-PRESENT_ILLNESS -Así I-PRESENT_ILLNESS -mismo, I-PRESENT_ILLNESS -nota I-PRESENT_ILLNESS -debilidad I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -brazo I-PRESENT_ILLNESS -ipsilateral I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -disminución I-PRESENT_ILLNESS +Departamento I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -movimientos I-PRESENT_ILLNESS +Medicina I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -discapacidad I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -manipular I-PRESENT_ILLNESS -objetos, I-PRESENT_ILLNESS -caracterizada I-PRESENT_ILLNESS +Cirugía I-PRESENT_ILLNESS +Bucofacial I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -pasarlos I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -mano, I-PRESENT_ILLNESS -niega I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -poder I-PRESENT_ILLNESS -localizar I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -exactitud I-PRESENT_ILLNESS -si I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -predominio I-PRESENT_ILLNESS -proximal I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -distal; I-PRESENT_ILLNESS -esto I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS +dolor, I-PRESENT_ILLNESS +inflamación I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +trismo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -manera I-PRESENT_ILLNESS -constante, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -ceder, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -horario I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -calendario, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -atenuantes, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -exacerbantes I-PRESENT_ILLNESS -o I-PRESENT_ILLNESS -acompañantes. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-EXPLORATION +repetición I-PRESENT_ILLNESS +causados I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +tercer I-PRESENT_ILLNESS +molar I-PRESENT_ILLNESS +inferior I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +semierupcionado. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -neurológica I-EXPLORATION se I-EXPLORATION -encuentran I-EXPLORATION -funciones I-EXPLORATION -superiores I-EXPLORATION -preservadas, I-EXPLORATION -nervios I-EXPLORATION -craneales I-EXPLORATION -sin I-EXPLORATION -alteraciones, I-EXPLORATION -sistema I-EXPLORATION -sensorial I-EXPLORATION -—lo I-EXPLORATION -posible I-EXPLORATION +observa I-EXPLORATION +un I-EXPLORATION +tercer I-EXPLORATION +molar I-EXPLORATION de I-EXPLORATION -valorar I-EXPLORATION -por I-EXPLORATION +grandes I-EXPLORATION +dimensiones I-EXPLORATION +en I-EXPLORATION +posición I-EXPLORATION +mesioangular I-EXPLORATION +semierupcionado, I-EXPLORATION +responsable I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +episodios I-EXPLORATION +de I-EXPLORATION +pericoronaritis. I-EXPLORATION +Realizamos I-EXPLORATION +una I-EXPLORATION +ortopantomografía I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -edad I-EXPLORATION -y I-EXPLORATION -cooperación I-EXPLORATION -del I-EXPLORATION -paciente— I-EXPLORATION -normal, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +el I-EXPLORATION +tercer I-EXPLORATION +molar I-EXPLORATION +unido I-EXPLORATION a I-EXPLORATION +un I-EXPLORATION +supernumerario I-EXPLORATION +por I-EXPLORATION la I-EXPLORATION -inspección I-EXPLORATION -muscular I-EXPLORATION -se I-EXPLORATION -encuentran I-EXPLORATION -las I-EXPLORATION -cuatro I-EXPLORATION -extremidades I-EXPLORATION -simétricas I-EXPLORATION +corona I-EXPLORATION y I-EXPLORATION -eutróficas I-EXPLORATION -con I-EXPLORATION -tono I-EXPLORATION -muscular I-EXPLORATION -sin I-EXPLORATION -alteraciones, I-EXPLORATION la I-EXPLORATION -fase I-EXPLORATION -activa I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -fuerza I-EXPLORATION -3/5 I-EXPLORATION -en I-EXPLORATION -porcion I-EXPLORATION -distal I-EXPLORATION -y I-EXPLORATION -4/5 I-EXPLORATION -en I-EXPLORATION -seccion I-EXPLORATION -proximal I-EXPLORATION +raíz. I-EXPLORATION +Se I-EXPLORATION +da I-EXPLORATION +la I-EXPLORATION +circunstancia I-EXPLORATION de I-EXPLORATION -hemicuerpo I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -5/5 I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +presenta I-EXPLORATION +otro I-EXPLORATION +molar I-EXPLORATION +supernumerario I-EXPLORATION en I-EXPLORATION -extremidades I-EXPLORATION -de I-EXPLORATION -hemicuerpo I-EXPLORATION +el I-EXPLORATION +maxilar I-EXPLORATION +superior I-EXPLORATION +lado I-EXPLORATION derecho. I-EXPLORATION -No I-EXPLORATION -presenta I-EXPLORATION -dificultad I-EXPLORATION -para I-EXPLORATION -mantener I-EXPLORATION + I-EXPLORATION +Tras B-PAST_MEDICAL_HISTORY +realizar I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +clínica I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +(sin I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés), I-PAST_MEDICAL_HISTORY +se B-TREATMENT +explica I-TREATMENT +al I-TREATMENT +paciente I-TREATMENT +el I-TREATMENT +propósito I-TREATMENT +y I-TREATMENT +los I-TREATMENT +riesgos I-TREATMENT +de I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +y I-TREATMENT +firma I-TREATMENT +el I-TREATMENT +consentimiento I-TREATMENT +informado. I-TREATMENT +El B-EXPLORATION +paciente I-EXPLORATION +rechaza I-EXPLORATION la I-EXPLORATION -bipedestación I-EXPLORATION -sin I-EXPLORATION -apoyo. I-EXPLORATION -La I-EXPLORATION -marcha I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -sin I-EXPLORATION -aumento I-EXPLORATION +posibilidad I-EXPLORATION de I-EXPLORATION +realizar I-EXPLORATION +un I-EXPLORATION +escáner I-EXPLORATION +para I-EXPLORATION +conocer I-EXPLORATION la I-EXPLORATION -base I-EXPLORATION -de I-EXPLORATION -sustentación, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -fase I-EXPLORATION -de I-EXPLORATION -contacto I-EXPLORATION -simetrica I-EXPLORATION -bilateral, I-EXPLORATION -pero I-EXPLORATION +relación I-EXPLORATION +del I-EXPLORATION +molar I-EXPLORATION con I-EXPLORATION -discreta I-EXPLORATION -rotación I-EXPLORATION -externa I-EXPLORATION -de I-EXPLORATION -todo I-EXPLORATION el I-EXPLORATION -miembro I-EXPLORATION -pelvico I-EXPLORATION -izquierdo I-EXPLORATION -con I-EXPLORATION -caída I-EXPLORATION +conducto I-EXPLORATION del I-EXPLORATION -pie I-EXPLORATION -golpeando I-EXPLORATION +nervio I-EXPLORATION +dentario I-EXPLORATION +inferior. I-EXPLORATION +Se B-TREATMENT +procede I-TREATMENT +a I-TREATMENT +la I-TREATMENT +extracción I-TREATMENT +quirúrgica I-TREATMENT +del I-TREATMENT +tercer I-TREATMENT +y I-TREATMENT +cuarto I-TREATMENT +molar, I-TREATMENT +con I-TREATMENT +anestesia I-TREATMENT +local, I-TREATMENT +siendo I-TREATMENT +necesario I-TREATMENT +hacer I-TREATMENT +odontosección I-TREATMENT +por I-TREATMENT +el I-TREATMENT +gran I-TREATMENT +tamaño I-TREATMENT +del I-TREATMENT +molar I-TREATMENT +fusionado. I-TREATMENT + I-TREATMENT +No B-EVOLUTION +hubo I-EVOLUTION +complicaciones I-EVOLUTION +ni I-EVOLUTION +intra I-EVOLUTION +ni I-EVOLUTION +postoperatorias. I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +paciente I-EVOLUTION +acude I-EVOLUTION +a I-EVOLUTION +revisión I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +tres I-EVOLUTION +meses, I-EVOLUTION +descartándose I-EVOLUTION +problemas I-EVOLUTION +periodontales I-EVOLUTION +y I-EVOLUTION +presencia I-EVOLUTION +de I-EVOLUTION +caries I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +segundo I-EVOLUTION +molar. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +38 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +periorbitario I-PRESENT_ILLNESS +izquierdo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +semana I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +diplopía I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +últimas I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +horas. I-PRESENT_ILLNESS +La B-EXPLORATION +exploración I-EXPLORATION +motora I-EXPLORATION +reveló I-EXPLORATION +una I-EXPLORATION +paresia I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +músculos I-EXPLORATION +recto I-EXPLORATION +superior I-EXPLORATION +e I-EXPLORATION +interno I-EXPLORATION +y I-EXPLORATION +ptosis I-EXPLORATION +moderada I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -suelo I-EXPLORATION -con I-EXPLORATION -toda I-EXPLORATION +ojo I-EXPLORATION +izquierdo. I-EXPLORATION +No I-EXPLORATION +hubo I-EXPLORATION +otros I-EXPLORATION +hallazgos I-EXPLORATION +oculares I-EXPLORATION +o I-EXPLORATION +neurológicos. I-EXPLORATION +La I-EXPLORATION +resonancia I-EXPLORATION +nuclear I-EXPLORATION +magnética I-EXPLORATION +(RNM) I-EXPLORATION +craneal I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +Se B-TREATMENT +diagnosticó I-TREATMENT +un I-TREATMENT +síndrome I-TREATMENT +de I-TREATMENT +Tolosa-Hunt I-TREATMENT +y I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +corticoides. I-TREATMENT +Dos B-EVOLUTION +días I-EVOLUTION +después, I-EVOLUTION +la I-EVOLUTION +oftalmoplejía I-EVOLUTION +dolorosa I-EVOLUTION +persistía I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +comenzó I-EVOLUTION +a I-EVOLUTION +referir I-EVOLUTION +disminución I-EVOLUTION +de I-EVOLUTION +agudeza I-EVOLUTION +visual I-EVOLUTION +próxima. I-EVOLUTION +En B-EXPLORATION la I-EXPLORATION -planta I-EXPLORATION -y I-EXPLORATION -sin I-EXPLORATION -aumento I-EXPLORATION +exploración I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -fase I-EXPLORATION -de I-EXPLORATION -oscilación, I-EXPLORATION -con I-EXPLORATION -movimientos I-EXPLORATION -asimétricos, I-EXPLORATION -acompañados I-EXPLORATION -de I-EXPLORATION -extensión I-EXPLORATION -incompleta I-EXPLORATION +paciente I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +midriasis I-EXPLORATION +izquierda. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +RNM I-EXPLORATION +orbitaria I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +en I-EXPLORATION +T2 I-EXPLORATION +un I-EXPLORATION +aneurisma I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -rodilla I-EXPLORATION -izquierda. I-EXPLORATION -Puede I-EXPLORATION -realizar I-EXPLORATION +carótida I-EXPLORATION +interna-comunicante I-EXPLORATION +posterior I-EXPLORATION +(CI-CP) I-EXPLORATION +parcialmente I-EXPLORATION +trombosado. I-EXPLORATION +La I-EXPLORATION +angio-tomografía I-EXPLORATION +axial I-EXPLORATION +computerizada I-EXPLORATION +(angio-TAC) I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +aneurisma I-EXPLORATION +CI-CP I-EXPLORATION +izquierdo I-EXPLORATION +multilobulado I-EXPLORATION +de I-EXPLORATION +10x5 I-EXPLORATION +mm. I-EXPLORATION +Se B-TREATMENT +realizaron I-TREATMENT +angiografía I-TREATMENT +cerebral I-TREATMENT +y I-TREATMENT +embolización, I-TREATMENT +siendo I-TREATMENT +rellenado I-TREATMENT +completamente I-TREATMENT +el I-TREATMENT +aneurisma I-TREATMENT +con I-TREATMENT +Hydrocoil I-TREATMENT +(MicroVention, I-TREATMENT +Aliso I-TREATMENT +Viejo, I-TREATMENT +CA) I-TREATMENT +Cerecyte® I-TREATMENT +(Micrus, I-TREATMENT +Sunnyvale, I-TREATMENT +CA). I-TREATMENT +El B-EVOLUTION +tamaño I-EVOLUTION +pupilar I-EVOLUTION +se I-EVOLUTION +normalizó I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +ptosis I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +adducción I-EVOLUTION +mejoraron I-EVOLUTION +completamente I-EVOLUTION +dos I-EVOLUTION +semanas I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +embolización. I-EVOLUTION +Ocho I-EVOLUTION +meses I-EVOLUTION +tras I-EVOLUTION +el I-EVOLUTION +tratamiento I-EVOLUTION +persistía I-EVOLUTION +un I-EVOLUTION +ligero I-EVOLUTION +déficit I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +elevación, I-EVOLUTION +sin I-EVOLUTION +que I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +refiriese I-EVOLUTION +diplopía. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +60 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +epigástrico I-PRESENT_ILLNESS +irradiado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +espalda I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +consuntivo. I-PRESENT_ILLNESS +En B-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +se I-EXPLORATION +halló I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -marcha I-EXPLORATION -sin I-EXPLORATION -apoyo. I-EXPLORATION -Reflejos I-EXPLORATION -primitivos I-EXPLORATION -ausentes, I-EXPLORATION -Babinski I-EXPLORATION -negativo, I-EXPLORATION -reflejo I-EXPLORATION -braquioradial I-EXPLORATION -2/4, I-EXPLORATION -bicipital I-EXPLORATION -2/4, I-EXPLORATION -tricipital I-EXPLORATION -2/4, I-EXPLORATION -rotulaino I-EXPLORATION -2/4, I-EXPLORATION -aquileo I-EXPLORATION -2/4 I-EXPLORATION -bilaterales. I-EXPLORATION -Rigidez I-EXPLORATION -nucal, I-EXPLORATION -signo I-EXPLORATION +cabeza I-EXPLORATION de I-EXPLORATION -Brudsinski I-EXPLORATION -y I-EXPLORATION -signo I-EXPLORATION +páncreas I-EXPLORATION de I-EXPLORATION -Kernig I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicitan I-EXPLORATION -radiografías I-EXPLORATION +4 I-EXPLORATION +x I-EXPLORATION +6 I-EXPLORATION +cm, I-EXPLORATION de I-EXPLORATION -columna I-EXPLORATION -y I-EXPLORATION -cadera, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -reportan I-EXPLORATION -como I-EXPLORATION -normales I-EXPLORATION +bordes I-EXPLORATION +mal I-EXPLORATION +definidos, I-EXPLORATION +heterogénea I-EXPLORATION +e I-EXPLORATION +hipoecogénica, I-EXPLORATION +sin I-EXPLORATION +invasión I-EXPLORATION +vascular I-EXPLORATION +ni I-EXPLORATION +líquido I-EXPLORATION +libre I-EXPLORATION y I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -solicita I-EXPLORATION -una I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION -simple I-EXPLORATION +dos I-EXPLORATION +nódulos I-EXPLORATION +hepáticos I-EXPLORATION de I-EXPLORATION -cráneo, I-EXPLORATION -sin I-EXPLORATION -encontrar I-EXPLORATION -datos I-EXPLORATION -radiográficos I-EXPLORATION -sugestivos I-EXPLORATION -del I-EXPLORATION -origen I-EXPLORATION +naturaleza I-EXPLORATION +incierta. I-EXPLORATION +Se I-EXPLORATION +completó I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +inyección I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -causa I-EXPLORATION +un I-EXPLORATION +bolo I-EXPLORATION +convencional I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -sintomatología, I-EXPLORATION -razón I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -cual I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -solicita I-EXPLORATION -una I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -(RM) I-EXPLORATION -simple I-EXPLORATION -y I-EXPLORATION -contrastada I-EXPLORATION +2, I-EXPLORATION +4 I-EXPLORATION +ml I-EXPLORATION +del I-EXPLORATION +contraste I-EXPLORATION +ecográfico I-EXPLORATION +hexafluoruro I-EXPLORATION de I-EXPLORATION -cráneo I-EXPLORATION -y I-EXPLORATION -médula I-EXPLORATION -espinal, I-EXPLORATION -encontrándose I-EXPLORATION +azufre I-EXPLORATION +(Sonovue®, I-EXPLORATION +Bracco, I-EXPLORATION +Milán). I-EXPLORATION +La I-EXPLORATION +fase I-EXPLORATION +arterial I-EXPLORATION +(10-30 I-EXPLORATION +segundos) I-EXPLORATION +definió I-EXPLORATION una I-EXPLORATION -lesión I-EXPLORATION -intramedular I-EXPLORATION -heterogénea I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -desde I-EXPLORATION -C3 I-EXPLORATION -hasta I-EXPLORATION -T3 I-EXPLORATION -con I-EXPLORATION -zonas I-EXPLORATION -hipointensas I-EXPLORATION -en I-EXPLORATION -T1 I-EXPLORATION -y I-EXPLORATION -zonas I-EXPLORATION -hiperintensas I-EXPLORATION +masa I-EXPLORATION +pancreática I-EXPLORATION +hipocaptante I-EXPLORATION en I-EXPLORATION -T2 I-EXPLORATION +relación I-EXPLORATION +al I-EXPLORATION +parénquima I-EXPLORATION +vecino I-EXPLORATION que I-EXPLORATION -involucran I-EXPLORATION -el I-EXPLORATION -espesor I-EXPLORATION -del I-EXPLORATION -canal I-EXPLORATION -medular I-EXPLORATION -y I-EXPLORATION +estenosaba I-EXPLORATION la I-EXPLORATION -cual I-EXPLORATION -mide I-EXPLORATION -7, I-EXPLORATION -6 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -longitud I-EXPLORATION +arteria I-EXPLORATION +hepática I-EXPLORATION y I-EXPLORATION -oblitera I-EXPLORATION -el I-EXPLORATION -espacio I-EXPLORATION -subaracnoideo. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -preparó I-EXPLORATION -a I-EXPLORATION +esplénica. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -paciente I-EXPLORATION -y I-EXPLORATION +fase I-EXPLORATION +venosa I-EXPLORATION +(30-120 I-EXPLORATION +segundos) I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -biopsia, I-EXPLORATION -extrayéndose I-EXPLORATION -muestras I-EXPLORATION -para I-EXPLORATION -análisis I-EXPLORATION -por I-EXPLORATION -parte I-EXPLORATION +demostró I-EXPLORATION +la I-EXPLORATION +permeabilidad I-EXPLORATION del I-EXPLORATION -Servicio I-EXPLORATION -de I-EXPLORATION -Patología, I-EXPLORATION -que I-EXPLORATION -observó I-EXPLORATION -neoplasia I-EXPLORATION -fibrilar I-EXPLORATION -compuesta I-EXPLORATION -de I-EXPLORATION -hipercelularidad I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -astrocítica I-EXPLORATION +eje I-EXPLORATION +venoso I-EXPLORATION +esplenoportomesentérico I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +barrido I-EXPLORATION +hepático I-EXPLORATION +en I-EXPLORATION +fase I-EXPLORATION +tardía I-EXPLORATION +(> I-EXPLORATION +120 I-EXPLORATION +segundos) I-EXPLORATION +detectó I-EXPLORATION +múltiples I-EXPLORATION +lesiones I-EXPLORATION +hipocaptantes. I-EXPLORATION +En I-EXPLORATION +resumen, I-EXPLORATION +las I-EXPLORATION +imágenes I-EXPLORATION +ecográficas I-EXPLORATION +fueron I-EXPLORATION +compatibles I-EXPLORATION con I-EXPLORATION -áreas I-EXPLORATION +masa I-EXPLORATION +pancreática I-EXPLORATION de I-EXPLORATION -hemorragia; I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -necrosis I-EXPLORATION -ni I-EXPLORATION -hiperplasia I-EXPLORATION -vascular, I-EXPLORATION -se I-EXPLORATION -encontraron I-EXPLORATION -células I-EXPLORATION -irregulares, I-EXPLORATION -cromatina I-EXPLORATION -grumosa I-EXPLORATION +naturaleza I-EXPLORATION +maligna I-EXPLORATION +con I-EXPLORATION +invasión I-EXPLORATION +vascular I-EXPLORATION +arterial I-EXPLORATION y I-EXPLORATION -no I-EXPLORATION +metastásica I-EXPLORATION +hepática. I-EXPLORATION +Estos I-EXPLORATION +datos I-EXPLORATION +fueron I-EXPLORATION +corroborados I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +TAC I-EXPLORATION +helicoidal. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +figura I-EXPLORATION +1 I-EXPLORATION se I-EXPLORATION -observó I-EXPLORATION -ninguna I-EXPLORATION -mitosis, I-EXPLORATION -realizándose I-EXPLORATION -el I-EXPLORATION -diagnostico I-EXPLORATION -de I-EXPLORATION -astrocitoma I-EXPLORATION -fibrilar I-EXPLORATION -difuso I-EXPLORATION -grado I-EXPLORATION -II I-EXPLORATION +observa I-EXPLORATION +cómo I-EXPLORATION +las I-EXPLORATION +imágenes I-EXPLORATION +angiográficas I-EXPLORATION +con I-EXPLORATION +ecografía I-EXPLORATION +contrastada I-EXPLORATION +y I-EXPLORATION +angioTAC I-EXPLORATION +fueron I-EXPLORATION +equiparables. I-EXPLORATION +La I-EXPLORATION +PAAF I-EXPLORATION +guiada I-EXPLORATION +por I-EXPLORATION +ecografía I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -OMS I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +hepático I-EXPLORATION +fue I-EXPLORATION +diagnóstica I-EXPLORATION de I-EXPLORATION -localización I-EXPLORATION -intramedular. I-EXPLORATION - I-EXPLORATION -Posteriormente B-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -traslada I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -especializado I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -patología I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -los I-DERIVED_FROM/TO -EE. I-DERIVED_FROM/TO -UU., I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -realiza I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -extracción I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -mayor I-DERIVED_FROM/TO -cantidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -tumoración, I-DERIVED_FROM/TO -aproximadamente I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -80-90%, I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -envía I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -muestra I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -patología I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -encuentran I-DERIVED_FROM/TO -dos I-DERIVED_FROM/TO -mitosis I-DERIVED_FROM/TO -positivas, I-DERIVED_FROM/TO -reclasificando I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -tumoración I-DERIVED_FROM/TO +adenocarcinoma I-EXPLORATION +pancreático. I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +sometida I-TREATMENT +a I-TREATMENT +quimioterapia I-TREATMENT +paliativa. I-TREATMENT + I-TREATMENT + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +67 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +linfedema I-PRESENT_ILLNESS +facial I-PRESENT_ILLNESS +inexorable. I-PRESENT_ILLNESS +Dos B-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +intervenido I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +carcinoma I-PAST_MEDICAL_HISTORY +epidermoide I-PAST_MEDICAL_HISTORY +supraglótico. I-PAST_MEDICAL_HISTORY +Se B-TREATMENT +le I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +laringectomía I-TREATMENT +supraglótica I-TREATMENT +con I-TREATMENT +vaciamiento I-TREATMENT +cervical I-TREATMENT +bilateral I-TREATMENT +y I-TREATMENT +RT. I-TREATMENT +El I-TREATMENT +tratamiento I-TREATMENT +farmacológico I-TREATMENT +empleado I-TREATMENT +fue I-TREATMENT +amlodipino, I-TREATMENT +manitol, I-TREATMENT +acetazolamida, I-TREATMENT +furosemida I-TREATMENT +y I-TREATMENT +dexametasona. I-TREATMENT +Le B-EVOLUTION +provocó I-EVOLUTION +tensiones I-EVOLUTION +arteriales I-EVOLUTION +inestables I-EVOLUTION +y I-EVOLUTION +fluctuantes, I-EVOLUTION +hiperglucemia I-EVOLUTION +e I-EVOLUTION +hiponatremia I-EVOLUTION +afectando I-EVOLUTION +al I-EVOLUTION +estado I-EVOLUTION +hemodinámico I-EVOLUTION +del I-EVOLUTION +paciente. I-EVOLUTION +Se B-TREATMENT +utilizó I-TREATMENT +también I-TREATMENT +tratamiento I-TREATMENT +rehabilitador, I-TREATMENT +punciones I-TREATMENT +transcutáneas I-TREATMENT +y I-TREATMENT +cámara I-TREATMENT +hiperbárica, I-TREATMENT +pero I-TREATMENT +sin I-TREATMENT +éxito. I-TREATMENT + I-TREATMENT +En B-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +momento I-DERIVED_FROM/TO en I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +nos I-DERIVED_FROM/TO +remiten I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +presenta I-DERIVED_FROM/TO un I-DERIVED_FROM/TO -grado I-DERIVED_FROM/TO -III I-DERIVED_FROM/TO +edema I-DERIVED_FROM/TO +facial I-DERIVED_FROM/TO +masivo, I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +gran I-DERIVED_FROM/TO +fibrosis I-DERIVED_FROM/TO +cervical, I-DERIVED_FROM/TO +traqueotomía, I-DERIVED_FROM/TO +gastrostomía, I-DERIVED_FROM/TO +disnea I-DERIVED_FROM/TO +con I-DERIVED_FROM/TO +saturaciones I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +ox��geno I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +85%, I-DERIVED_FROM/TO +edema I-DERIVED_FROM/TO +bipalpebral I-DERIVED_FROM/TO +bilateral I-DERIVED_FROM/TO +sin I-DERIVED_FROM/TO +apertura I-DERIVED_FROM/TO +voluntaria I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +párpados, I-DERIVED_FROM/TO +hipoacusia I-DERIVED_FROM/TO de I-DERIVED_FROM/TO +transmisión, I-DERIVED_FROM/TO +incompetencia I-DERIVED_FROM/TO +labial I-DERIVED_FROM/TO +e I-DERIVED_FROM/TO +imposibilidad I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO la I-DERIVED_FROM/TO -OMS. I-DERIVED_FROM/TO +deglución. I-DERIVED_FROM/TO I-DERIVED_FROM/TO - -Niña B-PRESENT_ILLNESS -previamente I-PRESENT_ILLNESS -sana, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés; I-PAST_MEDICAL_HISTORY -está I-PAST_MEDICAL_HISTORY -correctamente I-PAST_MEDICAL_HISTORY -vacunada. I-PAST_MEDICAL_HISTORY -A B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -tiene I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -primer I-PRESENT_ILLNESS -episodio I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -inflamación I-PRESENT_ILLNESS -parotídea. I-PRESENT_ILLNESS -Cuadro I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -inflamación I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -parotídea I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -borraba I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ángulo I-PRESENT_ILLNESS -mandibular, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -signos I-PRESENT_ILLNESS -inflamatorios I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -supuración I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -conducto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Stenon. I-PRESENT_ILLNESS -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -analítica I-EXPLORATION -sanguínea I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -leucocitosis I-EXPLORATION -(19 I-EXPLORATION -700/mm3) I-EXPLORATION -con I-EXPLORATION -neutrofilia I-EXPLORATION -(65%), I-EXPLORATION -PCR I-EXPLORATION -de I-EXPLORATION -5, I-EXPLORATION -45 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -amilasa I-EXPLORATION -de I-EXPLORATION -881 I-EXPLORATION -U/l. I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -inflamación I-EXPLORATION -bilateral I-EXPLORATION -de I-EXPLORATION -ambas I-EXPLORATION -parótidas, I-EXPLORATION -sin I-EXPLORATION -colecciones. I-EXPLORATION Se B-TREATMENT -realizó I-TREATMENT -ingreso I-TREATMENT -para I-TREATMENT -antibioterapia I-TREATMENT -intravenosa I-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +un I-TREATMENT +colgajo I-TREATMENT +miocutáneo I-TREATMENT +deltopectoral I-TREATMENT +diferido I-TREATMENT con I-TREATMENT -amoxicilina-clavulánico, I-TREATMENT -analgesia I-TREATMENT +el I-TREATMENT +objetivo I-TREATMENT +de I-TREATMENT +introducir I-TREATMENT +nuevos I-TREATMENT +vasos I-TREATMENT +linfáticos I-TREATMENT +en I-TREATMENT +la I-TREATMENT +mejilla I-TREATMENT y I-TREATMENT -antiinflamatorios. I-TREATMENT -Dada B-EVOLUTION +mejorar I-TREATMENT +su I-TREATMENT +situación. I-TREATMENT + I-TREATMENT +Un I-TREATMENT +colgajo I-TREATMENT +deltopectoral I-TREATMENT +derecho I-TREATMENT +fue I-TREATMENT +tallado, I-TREATMENT +un I-TREATMENT +área I-TREATMENT +distal I-TREATMENT +de I-TREATMENT +6 I-TREATMENT +× I-TREATMENT +5 I-TREATMENT +cm I-TREATMENT +se I-TREATMENT +desepiteliza I-TREATMENT +y I-TREATMENT +se I-TREATMENT +introduce I-TREATMENT +en I-TREATMENT +un I-TREATMENT +bolsillo I-TREATMENT +subdérmico I-TREATMENT +en I-TREATMENT +la I-TREATMENT +mejilla. I-TREATMENT +Se I-TREATMENT +realiza I-TREATMENT +cierre I-TREATMENT +directo I-TREATMENT +del I-TREATMENT +defecto I-TREATMENT +salvo I-TREATMENT +el I-TREATMENT +extremo I-TREATMENT +distal I-TREATMENT +que I-TREATMENT +se I-TREATMENT +cubre I-TREATMENT +con I-TREATMENT +el I-TREATMENT +tejido I-TREATMENT +desepitelizado I-TREATMENT +como I-TREATMENT +injerto I-TREATMENT +cutáneo I-TREATMENT +libre. I-TREATMENT +A B-EVOLUTION +las I-EVOLUTION +72 I-EVOLUTION +h I-EVOLUTION +comenzó I-EVOLUTION +a I-EVOLUTION +oír, I-EVOLUTION +a I-EVOLUTION +ver, I-EVOLUTION +mejoró I-EVOLUTION la I-EVOLUTION -buena I-EVOLUTION -evolución, I-EVOLUTION -fue I-EVOLUTION -dada I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -tres I-EVOLUTION -días I-EVOLUTION -después I-EVOLUTION -para I-EVOLUTION -continuar I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -ambulatoria. I-EVOLUTION - I-EVOLUTION -Posteriormente I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -sucesivos I-EVOLUTION -episodios I-EVOLUTION -(cuatro I-EVOLUTION -más) I-EVOLUTION -de I-EVOLUTION -características I-EVOLUTION -clínicas I-EVOLUTION +competencia I-EVOLUTION +labial I-EVOLUTION y I-EVOLUTION -analíticas I-EVOLUTION -similares, I-EVOLUTION -que I-EVOLUTION -han I-EVOLUTION -sido I-EVOLUTION -tratados I-EVOLUTION -con I-EVOLUTION -antibioterapia I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -ambulatoria I-EVOLUTION -con I-EVOLUTION -buena I-EVOLUTION -evolución. I-EVOLUTION -Son I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION +el I-EVOLUTION +volumen I-EVOLUTION +facial I-EVOLUTION +había I-EVOLUTION +disminuido. I-EVOLUTION +Una I-EVOLUTION semana I-EVOLUTION +después I-EVOLUTION +presenta I-EVOLUTION +dificultad I-EVOLUTION +respiratoria I-EVOLUTION +provocada I-EVOLUTION +por I-EVOLUTION +una I-EVOLUTION +atelectasia I-EVOLUTION +basal I-EVOLUTION +derecha I-EVOLUTION +que I-EVOLUTION +empeora I-EVOLUTION +progresivamente. I-EVOLUTION +Se I-EVOLUTION +acompaña I-EVOLUTION de I-EVOLUTION -duración I-EVOLUTION -aproximadamente, I-EVOLUTION -bilaterales, I-EVOLUTION -pero I-EVOLUTION -con I-EVOLUTION -predominio I-EVOLUTION +fibrilación I-EVOLUTION +auricular, I-EVOLUTION +hiponatremia I-EVOLUTION +e I-EVOLUTION +hiperglucemia. I-EVOLUTION +Finalmente, I-EVOLUTION +fallece I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +31 I-EVOLUTION +días I-EVOLUTION de I-EVOLUTION -afectación I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -lado I-EVOLUTION -izquierdo. I-EVOLUTION +la I-EVOLUTION +cirugía I-EVOLUTION +por I-EVOLUTION +fallo I-EVOLUTION +multiorgánico. I-EVOLUTION I-EVOLUTION -Es I-EVOLUTION -seguida I-EVOLUTION -en I-EVOLUTION -consulta I-EVOLUTION -de I-EVOLUTION -Infectología I-EVOLUTION -Pediátrica I-EVOLUTION -donde I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -completado I-EVOLUTION -el I-EVOLUTION -estudio. I-EVOLUTION -Todas B-EXPLORATION -las I-EXPLORATION -serologías I-EXPLORATION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +que B-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +dolor I-EXPLORATION +abdominal I-EXPLORATION +con I-EXPLORATION +TAC I-EXPLORATION +mostró I-EXPLORATION +tumor I-EXPLORATION +ovárico I-EXPLORATION +derecho I-EXPLORATION +de I-EXPLORATION +13 I-EXPLORATION +cm I-EXPLORATION y I-EXPLORATION -pruebas I-EXPLORATION -reumatoideas I-EXPLORATION -son I-EXPLORATION -negativas. I-EXPLORATION -Se I-EXPLORATION -repiten I-EXPLORATION -ecografías I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -que I-EXPLORATION +ascitis. I-EXPLORATION +Resto I-EXPLORATION +del I-EXPLORATION +estudio I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +Cal25 I-EXPLORATION += I-EXPLORATION +2.526 I-EXPLORATION +(U/ml). I-EXPLORATION +Se B-TREATMENT +realizó I-TREATMENT +cirugía I-TREATMENT +oncoló I-TREATMENT +gica. I-TREATMENT +Cal25 B-EXPLORATION +post-operatorio I-EXPLORATION +174 I-EXPLORATION +(U/ml). I-EXPLORATION +Biopsia I-EXPLORATION +mostró I-EXPLORATION +adenocarcinoma I-EXPLORATION +endometrioide I-EXPLORATION +Grado I-EXPLORATION +3. I-EXPLORATION +Etapificada I-EXPLORATION +como I-EXPLORATION +IC, I-EXPLORATION se I-EXPLORATION -aprecia I-EXPLORATION -el I-EXPLORATION -aumento I-EXPLORATION -glandular, I-EXPLORATION +tomó I-EXPLORATION +muestra I-EXPLORATION +de I-EXPLORATION +ascitis I-EXPLORATION +para I-EXPLORATION +block I-EXPLORATION +celular I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +cultivó I-EXPLORATION +para I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +QS I-EXPLORATION +in I-EXPLORATION +vitro. I-EXPLORATION +Se B-TREATMENT +administró I-TREATMENT +QMT I-TREATMENT +de I-TREATMENT +carboplatino-paclitaxel, I-TREATMENT +con I-TREATMENT +normalización I-TREATMENT +del I-TREATMENT +Cal25. I-TREATMENT +El B-EVOLUTION +seguimiento I-EVOLUTION +a I-EVOLUTION +tres I-EVOLUTION +años I-EVOLUTION +fue I-EVOLUTION +normal. I-EVOLUTION +Estudio B-EXPLORATION +in I-EXPLORATION +vitro I-EXPLORATION +mostró I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +citotoxicidad I-EXPLORATION +al I-EXPLORATION +esquema I-EXPLORATION +carboplatino-paclitaxel I-EXPLORATION +mayor I-EXPLORATION +al I-EXPLORATION +70%, I-EXPLORATION +correlacionándose I-EXPLORATION con I-EXPLORATION -fotos I-EXPLORATION -heterogéneos I-EXPLORATION -hipoecogénicos. I-EXPLORATION -En B-EVOLUTION -la I-EVOLUTION -actualidad I-EVOLUTION -sin I-EVOLUTION -nuevos I-EVOLUTION -episodios. I-EVOLUTION - I-EVOLUTION +la I-EXPLORATION +respuesta I-EXPLORATION +clínica. I-EXPLORATION + I-EXPLORATION -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +clínico I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -diagnostica I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -neumonía I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -condensación I-PRESENT_ILLNESS -parenquimatosa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -lóbulo I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -derecho. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY +74 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +alergias I-PAST_MEDICAL_HISTORY +conocidas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -hay I-PAST_MEDICAL_HISTORY -datos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Embarazo I-PAST_MEDICAL_HISTORY -controlado I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -incidencias, I-PAST_MEDICAL_HISTORY -nacida I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -38 I-PAST_MEDICAL_HISTORY -semanas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -edad I-PAST_MEDICAL_HISTORY -gestacional, I-PAST_MEDICAL_HISTORY -cesárea I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -falta I-PAST_MEDICAL_HISTORY +médicos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -progresión. I-PAST_MEDICAL_HISTORY -Peso I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -nacimiento I-PAST_MEDICAL_HISTORY +bronquitis I-PAST_MEDICAL_HISTORY +asmática, I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +portadora I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -2870 I-PAST_MEDICAL_HISTORY -g. I-PAST_MEDICAL_HISTORY -Vacunas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -desarrollo I-PAST_MEDICAL_HISTORY -psicomotor I-PAST_MEDICAL_HISTORY -normal. I-PAST_MEDICAL_HISTORY -Refieren I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -primer I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY +marcapasos I-PAST_MEDICAL_HISTORY +(desde I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +años), I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +intervenida I-PAST_MEDICAL_HISTORY +quirúrgicamente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -bebe I-PAST_MEDICAL_HISTORY -bastantes I-PAST_MEDICAL_HISTORY -líquidos, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -diuresis I-PAST_MEDICAL_HISTORY -abundante. I-PAST_MEDICAL_HISTORY -Peso I-PAST_MEDICAL_HISTORY +prótesis I-PAST_MEDICAL_HISTORY +valvular I-PAST_MEDICAL_HISTORY +mitral I-PAST_MEDICAL_HISTORY +(hacía I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +años) I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -talla I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -percentil I-PAST_MEDICAL_HISTORY -50. I-PAST_MEDICAL_HISTORY -Refieren I-PAST_MEDICAL_HISTORY -avidez I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -sal I-PAST_MEDICAL_HISTORY -(se I-PAST_MEDICAL_HISTORY -bebe I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -agua I-PAST_MEDICAL_HISTORY +cáncer I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -playa I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -avidez I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -prefiere I-PAST_MEDICAL_HISTORY -alimentos I-PAST_MEDICAL_HISTORY -salados) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -calambres I-PAST_MEDICAL_HISTORY -musculares I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -ocasiones. I-PAST_MEDICAL_HISTORY -No B-FAMILY_HISTORY -hay I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -a I-FAMILY_HISTORY -destacar. I-FAMILY_HISTORY - I-FAMILY_HISTORY -Peso B-EXPLORATION -12, I-EXPLORATION -4 I-EXPLORATION -kg I-EXPLORATION -(p10-25), I-EXPLORATION -talla I-EXPLORATION -95 I-EXPLORATION -cm I-EXPLORATION -(p50), I-EXPLORATION -tensión I-EXPLORATION -arterial I-EXPLORATION -100/60 I-EXPLORATION -mmHg, I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca I-EXPLORATION -90 I-EXPLORATION -lpm, I-EXPLORATION -frecuencia I-EXPLORATION -respiratoria I-EXPLORATION -28 I-EXPLORATION -rpm, I-EXPLORATION -temperatura I-EXPLORATION -38, I-EXPLORATION -3 I-EXPLORATION -oC. I-EXPLORATION -Regular I-EXPLORATION -aspecto I-EXPLORATION -general I-EXPLORATION -por I-EXPLORATION -facies I-EXPLORATION -febril, I-EXPLORATION -decaída I-EXPLORATION -y I-EXPLORATION -discreta I-EXPLORATION -sequedad I-EXPLORATION +mama I-PAST_MEDICAL_HISTORY +(dieciocho I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes). I-PAST_MEDICAL_HISTORY +Seguía B-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +habitual I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +acenocumarol, I-PRESENT_ILLNESS +furosemida, I-PRESENT_ILLNESS +bisoprolol, I-PRESENT_ILLNESS +espironolactona, I-PRESENT_ILLNESS +enalapril, I-PRESENT_ILLNESS +pantoprazol I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +hierro I-PRESENT_ILLNESS +oral. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +clínica I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cefalea I-PRESENT_ILLNESS +occipital I-PRESENT_ILLNESS +unilateral, I-PRESENT_ILLNESS +irradiada I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +zona I-PRESENT_ILLNESS +frontal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +temporal, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +opresivo, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +cedía I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +analgésicos I-PRESENT_ILLNESS +habituales I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +acompañada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +astenia, I-PRESENT_ILLNESS +hiporexia, I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +ponderal I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +Kg I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +claudicación I-PRESENT_ILLNESS +mandibular I-PRESENT_ILLNESS +intermitente. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física, I-EXPLORATION +destacaba I-EXPLORATION +palidez I-EXPLORATION de I-EXPLORATION mucosas. I-EXPLORATION -Cráneo I-EXPLORATION -normal. I-EXPLORATION -Signos I-EXPLORATION -meníngeos I-EXPLORATION -negativos. I-EXPLORATION No I-EXPLORATION -presenta I-EXPLORATION -exantemas I-EXPLORATION -ni I-EXPLORATION -petequias. I-EXPLORATION -Otoscopia I-EXPLORATION -y I-EXPLORATION -orofaringe I-EXPLORATION -normal. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -auscultación I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -disminución I-EXPLORATION +palpaban I-EXPLORATION +adenopatías. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -entrada I-EXPLORATION -de I-EXPLORATION -aire I-EXPLORATION -en I-EXPLORATION -base I-EXPLORATION -derecha. I-EXPLORATION -Abdomen I-EXPLORATION -blando I-EXPLORATION -y I-EXPLORATION -depresible, I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION no I-EXPLORATION se I-EXPLORATION -palpan I-EXPLORATION -masas, I-EXPLORATION -ni I-EXPLORATION -visceromegalias. I-EXPLORATION -Genitales I-EXPLORATION -normales I-EXPLORATION -de I-EXPLORATION -niña. I-EXPLORATION -Región I-EXPLORATION -lumbosacra I-EXPLORATION -normal. I-EXPLORATION -Resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION +encontraron I-EXPLORATION +otros I-EXPLORATION +hallazgos I-EXPLORATION +significativos. I-EXPLORATION +La I-EXPLORATION exploración I-EXPLORATION +neurológica I-EXPLORATION +fue I-EXPLORATION normal. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -análisis I-EXPLORATION -realizados I-EXPLORATION -para I-EXPLORATION -valorar I-EXPLORATION -parámetros I-EXPLORATION -de I-EXPLORATION -infección I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -leucocitosis I-EXPLORATION +Se I-EXPLORATION +solicitaron I-EXPLORATION +como I-EXPLORATION +pruebas I-EXPLORATION +complementarias I-EXPLORATION +analítica I-EXPLORATION de I-EXPLORATION -22 I-EXPLORATION -000 I-EXPLORATION -con I-EXPLORATION -neutrofilia I-EXPLORATION -(neutrófilos I-EXPLORATION -87%) I-EXPLORATION +sangre I-EXPLORATION y I-EXPLORATION -proteína I-EXPLORATION -C I-EXPLORATION -reactiva I-EXPLORATION -(PCR) I-EXPLORATION -de I-EXPLORATION -200 I-EXPLORATION -mg/l, I-EXPLORATION -pero I-EXPLORATION -destacaba I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION +craneal. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -hipopotasemia I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -2 I-EXPLORATION -mmol/l I-EXPLORATION -con I-EXPLORATION -Na I-EXPLORATION -129 I-EXPLORATION -mmol/l, I-EXPLORATION -Cl I-EXPLORATION -92, I-EXPLORATION -2 I-EXPLORATION -mmol/l, I-EXPLORATION -Ca I-EXPLORATION -9, I-EXPLORATION -5 I-EXPLORATION -mg/dl, I-EXPLORATION -Mg I-EXPLORATION -1, I-EXPLORATION -7 I-EXPLORATION -mg/dl, I-EXPLORATION -Cr I-EXPLORATION -0, I-EXPLORATION -5 I-EXPLORATION -mg/dl I-EXPLORATION -y I-EXPLORATION -alcalosis I-EXPLORATION -metabólica I-EXPLORATION -(pH I-EXPLORATION -7, I-EXPLORATION -50 I-EXPLORATION -y I-EXPLORATION -bicarbonato I-EXPLORATION -24, I-EXPLORATION -1 I-EXPLORATION -mmol/l). I-EXPLORATION -Renina I-EXPLORATION -y I-EXPLORATION -aldosterona I-EXPLORATION -elevadas. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -orina: I-EXPLORATION -densidad I-EXPLORATION -1005, I-EXPLORATION -PH I-EXPLORATION -8, I-EXPLORATION -sedimento I-EXPLORATION -normal. I-EXPLORATION -Iones I-EXPLORATION -en I-EXPLORATION -orina: I-EXPLORATION -K I-EXPLORATION -17, I-EXPLORATION -5 I-EXPLORATION -mEq/l, I-EXPLORATION -Cl I-EXPLORATION -10 I-EXPLORATION -mEq/l, I-EXPLORATION -Na I-EXPLORATION -7 I-EXPLORATION -mEq/l; I-EXPLORATION -Na I-EXPLORATION -orina/K I-EXPLORATION -orina I-EXPLORATION -0, I-EXPLORATION -4. I-EXPLORATION -Excreciones I-EXPLORATION -fraccionadas I-EXPLORATION -de I-EXPLORATION -K I-EXPLORATION -elevadas I-EXPLORATION -(8,32%), I-EXPLORATION -de I-EXPLORATION -Na I-EXPLORATION -(0,06%) I-EXPLORATION +analítica I-EXPLORATION +no I-EXPLORATION +existía I-EXPLORATION +anemia I-EXPLORATION y I-EXPLORATION +sí I-EXPLORATION +leucocitosis I-EXPLORATION +con I-EXPLORATION +neutrofilia. I-EXPLORATION +Asimismo I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +una I-EXPLORATION +glucemia I-EXPLORATION de I-EXPLORATION -Cl I-EXPLORATION -(0,11%) I-EXPLORATION -en I-EXPLORATION -valores I-EXPLORATION -de I-EXPLORATION -normalidad. I-EXPLORATION -Ca/Cr I-EXPLORATION -0, I-EXPLORATION -56 I-EXPLORATION -mg/mg. I-EXPLORATION -Aclaramiento I-EXPLORATION +128 I-EXPLORATION +mg/dl. I-EXPLORATION +La I-EXPLORATION +PCR I-EXPLORATION +fue I-EXPLORATION de I-EXPLORATION -creatinina I-EXPLORATION -normal, I-EXPLORATION -filtrado I-EXPLORATION -glomerular I-EXPLORATION -104, I-EXPLORATION -50 I-EXPLORATION -ml/min/1, I-EXPLORATION -73m2, I-EXPLORATION - I-EXPLORATION +3, I-EXPLORATION +99 I-EXPLORATION +mg/dl. I-EXPLORATION La I-EXPLORATION -ecografía I-EXPLORATION -renal I-EXPLORATION +velocidad I-EXPLORATION +de I-EXPLORATION +sedimentación I-EXPLORATION +globular I-EXPLORATION +(VSG) I-EXPLORATION fue I-EXPLORATION -normal I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -electrocardiograma I-EXPLORATION -(ECG) I-EXPLORATION +de I-EXPLORATION +83 I-EXPLORATION +mm I-EXPLORATION +(en I-EXPLORATION +la I-EXPLORATION +1a I-EXPLORATION +hora). I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -confirmó I-EXPLORATION +observaron I-EXPLORATION +otras I-EXPLORATION +alteraciones I-EXPLORATION +analíticas. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -hipopotasemia I-EXPLORATION -por I-EXPLORATION -prolongación I-EXPLORATION -del I-EXPLORATION -PR I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -ECG. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -neumonía I-TREATMENT -basal I-TREATMENT -derecha, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -con I-TREATMENT -cefuroxima I-TREATMENT -intravenosa I-TREATMENT -y B-EVOLUTION -de I-EVOLUTION -modo I-EVOLUTION -progresivo I-EVOLUTION -fue I-EVOLUTION -mejorando I-EVOLUTION -clínica, I-EVOLUTION -radiológica I-EVOLUTION -y I-EVOLUTION -analíticamente. I-EVOLUTION - I-EVOLUTION -Ante B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -tubulopatía, I-TREATMENT -dada I-TREATMENT -la I-TREATMENT -hipopotasemia I-TREATMENT -y I-TREATMENT -la I-TREATMENT -pérdida I-TREATMENT -urinaria I-TREATMENT -elevada I-TREATMENT -de I-TREATMENT -este I-TREATMENT -electrolito, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -suplementos I-TREATMENT -intravenosos I-TREATMENT -de I-TREATMENT -potasio I-TREATMENT -y B-EVOLUTION -se I-EVOLUTION -corrigieron I-EVOLUTION -poco I-EVOLUTION -a I-EVOLUTION -poco I-EVOLUTION -las I-EVOLUTION -cifras, I-EVOLUTION -siendo I-EVOLUTION -al I-EVOLUTION -alta I-EVOLUTION -el I-EVOLUTION -K I-EVOLUTION -de I-EVOLUTION -3, I-EVOLUTION -9 I-EVOLUTION -mmol/l. I-EVOLUTION - I-EVOLUTION -Se I-EVOLUTION -controló I-EVOLUTION -en I-EVOLUTION -consultas I-EVOLUTION -de I-EVOLUTION -Nefrología I-EVOLUTION -Pediátrica, I-EVOLUTION -confirmándose I-EVOLUTION -la I-EVOLUTION -tubulopatía I-EVOLUTION -genéticamente I-EVOLUTION -(síndrome I-EVOLUTION -de I-EVOLUTION -Gitelman) I-EVOLUTION -y I-EVOLUTION -manteniendo I-EVOLUTION -adecuados I-EVOLUTION -niveles I-EVOLUTION -de I-EVOLUTION -K I-EVOLUTION -sérico I-EVOLUTION -con B-TREATMENT -suplementos I-TREATMENT -orales I-TREATMENT -y I-TREATMENT -dieta I-TREATMENT -rica I-TREATMENT -en I-TREATMENT -este I-TREATMENT -electrolito. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -paciente I-EXPLORATION -es I-EXPLORATION -portadora I-EXPLORATION +TC I-EXPLORATION +craneal I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +lesiones I-EXPLORATION +ocupantes I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -variaciones I-EXPLORATION -p. I-EXPLORATION -Gly741Arg I-EXPLORATION +espacio I-EXPLORATION y I-EXPLORATION -p. I-EXPLORATION -Cys994Tyr, I-EXPLORATION -ambas I-EXPLORATION -en I-EXPLORATION -heterocigosis, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -gen I-EXPLORATION -SLC12A3, I-EXPLORATION -localizado I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -brazo I-EXPLORATION -largo I-EXPLORATION -del I-EXPLORATION -cromosoma I-EXPLORATION -16. I-EXPLORATION -Transmisión I-EXPLORATION -autosómica I-EXPLORATION -recesiva. I-EXPLORATION - I-EXPLORATION -Nuestra B-TREATMENT -paciente, I-TREATMENT -desde I-TREATMENT -su I-TREATMENT -diagnóstico, I-TREATMENT -recibe I-TREATMENT -una I-TREATMENT -dieta I-TREATMENT -rica I-TREATMENT -en I-TREATMENT -potasio I-TREATMENT -y I-TREATMENT -magnesio I-TREATMENT -y I-TREATMENT -suplementos I-TREATMENT -orales I-TREATMENT -de I-TREATMENT -potasio. I-TREATMENT -Tras I-TREATMENT -varios I-TREATMENT -años I-TREATMENT -de I-TREATMENT -tratamiento, I-TREATMENT -dada I-TREATMENT -las I-TREATMENT -altas I-TREATMENT -dosis I-TREATMENT -de I-TREATMENT -suplementos I-TREATMENT -orales I-TREATMENT +sí I-EXPLORATION +una I-EXPLORATION +hiperostosis I-EXPLORATION +cortical I-EXPLORATION +frontoparietal I-EXPLORATION +interna. I-EXPLORATION +Con B-TREATMENT +la I-TREATMENT +sospecha I-TREATMENT +inicial I-TREATMENT de I-TREATMENT -K I-TREATMENT -(4, I-TREATMENT -3 I-TREATMENT -mEq/kg/día) I-TREATMENT -para I-TREATMENT -mantener I-TREATMENT -niveles I-TREATMENT -séricos I-TREATMENT +arteritis I-TREATMENT de I-TREATMENT -K I-TREATMENT -3, I-TREATMENT -1-3, I-TREATMENT -5 I-TREATMENT -mmol/l, I-TREATMENT +la I-TREATMENT +arteria I-TREATMENT +temporal, I-TREATMENT se I-TREATMENT -decide I-TREATMENT -asociar I-TREATMENT -al I-TREATMENT +inició I-TREATMENT tratamiento I-TREATMENT -diuréticos I-TREATMENT -ahorradores I-TREATMENT -de I-TREATMENT -potasio. I-TREATMENT - I-TREATMENT -En I-TREATMENT -ocasiones, I-TREATMENT -coincidiendo I-TREATMENT +corticoideo I-TREATMENT con I-TREATMENT -episodios I-TREATMENT -de I-TREATMENT -diarrea I-TREATMENT -y I-TREATMENT -vómitos, I-TREATMENT -presenta I-TREATMENT -hipopotasemia I-TREATMENT -sintomática, I-TREATMENT -que I-TREATMENT -precisa I-TREATMENT -suplementos I-TREATMENT -intravenosos I-TREATMENT -de I-TREATMENT -potasio. I-TREATMENT - I-TREATMENT -No I-TREATMENT -hay I-TREATMENT -datos I-TREATMENT -de I-TREATMENT -hipomagnesemia I-TREATMENT -en I-TREATMENT -ningún I-TREATMENT -momento, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -no I-TREATMENT -recibe I-TREATMENT -suplementos I-TREATMENT +metilprednisolona I-TREATMENT +a I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT de I-TREATMENT -magnesio I-TREATMENT -orales, I-TREATMENT -solo I-TREATMENT -una I-TREATMENT -dieta I-TREATMENT -rica I-TREATMENT -en I-TREATMENT -magnesio. I-TREATMENT - I-TREATMENT -Se B-EVOLUTION -trata I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION -enfermedad I-EVOLUTION +1 I-TREATMENT +mg/Kg I-TREATMENT +vía I-TREATMENT +oral, I-TREATMENT +mejorando I-TREATMENT +la I-TREATMENT +clínica I-TREATMENT +inicial. I-TREATMENT +Tres B-EXPLORATION +días I-EXPLORATION +después I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +temporal, I-EXPLORATION +confirmándose I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +anatomopatológico. I-EXPLORATION +A B-EVOLUTION +las I-EVOLUTION +cuarenta I-EVOLUTION +y I-EVOLUTION +ocho I-EVOLUTION +horas I-EVOLUTION de I-EVOLUTION -carácter I-EVOLUTION -permanente I-EVOLUTION +dicha I-EVOLUTION +biopsia, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +refiere I-EVOLUTION +dolor I-EVOLUTION +intenso I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +lengua, I-EVOLUTION con I-EVOLUTION +aparición I-EVOLUTION +de I-EVOLUTION +lesión I-EVOLUTION +ulcerada I-EVOLUTION +en I-EVOLUTION +hemilengua I-EVOLUTION +derecha, I-EVOLUTION +realizándose B-EXPLORATION +cultivos I-EXPLORATION +microbiológicos, I-EXPLORATION +siendo I-EXPLORATION +negativos, I-EXPLORATION +TC I-EXPLORATION +cervical, I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +tumoración I-EXPLORATION +de I-EXPLORATION +hemilengua I-EXPLORATION +derecha I-EXPLORATION +sin I-EXPLORATION +adenopatías I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +misma, I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +resultado I-EXPLORATION +de I-EXPLORATION +necrosis I-EXPLORATION +de I-EXPLORATION +coagulación I-EXPLORATION +de I-EXPLORATION +etiología I-EXPLORATION +isquémica. I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente, I-EVOLUTION +resolviéndose I-EVOLUTION +la I-EVOLUTION +lesión I-EVOLUTION +lingual I-EVOLUTION +espontáneamente, I-EVOLUTION +siendo I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta, I-EVOLUTION +para I-EVOLUTION +realizar I-EVOLUTION +seguimiento I-EVOLUTION +y I-EVOLUTION +control I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION evolución I-EVOLUTION y I-EVOLUTION -pronóstico I-EVOLUTION -favorables I-EVOLUTION -si I-EVOLUTION -se I-EVOLUTION -cumple I-EVOLUTION el I-EVOLUTION -tratamiento. I-EVOLUTION +tratamiento I-EVOLUTION +en I-EVOLUTION +consultas I-EVOLUTION +externas. I-EVOLUTION I-EVOLUTION - -Varón B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -cutáneas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -cuyo I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -coincidió I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -faringoamigdalitis I-PRESENT_ILLNESS -tratada I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -amoxicilina. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -últimas I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -vesículo-ampollosas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -artralgias I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ambos I-PRESENT_ILLNESS -tobillos, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -impiden I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -deambulación. I-PRESENT_ILLNESS -En B-EXPLORATION +Dos I-EVOLUTION +meses I-EVOLUTION +después, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +acude I-EVOLUTION +a I-EVOLUTION +urgencias I-EVOLUTION +por I-EVOLUTION +debilidad I-EVOLUTION +en I-EVOLUTION +hemicuerpo I-EVOLUTION +derecho I-EVOLUTION +y I-EVOLUTION +alteración I-EVOLUTION +del I-EVOLUTION +lenguaje. I-EVOLUTION +A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -destaca I-EXPLORATION +física I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +paciente I-EXPLORATION +presentaba I-EXPLORATION +hemiparesia I-EXPLORATION +derecha I-EXPLORATION +(balance I-EXPLORATION +motor I-EXPLORATION de I-EXPLORATION -lesiones I-EXPLORATION -purpúricas I-EXPLORATION -palpables, I-EXPLORATION -localizadas I-EXPLORATION -en I-EXPLORATION -piernas, I-EXPLORATION -glúteos, I-EXPLORATION -codos I-EXPLORATION +extremidad I-EXPLORATION +superior I-EXPLORATION +3-/5 I-EXPLORATION y I-EXPLORATION -dorso I-EXPLORATION -de I-EXPLORATION -manos, I-EXPLORATION -acompañadas I-EXPLORATION -de I-EXPLORATION -ampollas I-EXPLORATION +extremidad I-EXPLORATION +inferior I-EXPLORATION de I-EXPLORATION -contenido I-EXPLORATION -serohemorrágico. I-EXPLORATION -Además I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -edema I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION +2/5), I-EXPLORATION +afasia I-EXPLORATION +global, I-EXPLORATION +paresia I-EXPLORATION +facial I-EXPLORATION +derecha I-EXPLORATION +y I-EXPLORATION +hemianopsia I-EXPLORATION +homónima I-EXPLORATION +derecha. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -palpación I-EXPLORATION +TC I-EXPLORATION +craneal I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +un I-EXPLORATION +extenso I-EXPLORATION +infarto I-EXPLORATION +agudo I-EXPLORATION +isquémico I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -dorso I-EXPLORATION +territorio I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -mano I-EXPLORATION -izquierda, I-EXPLORATION -pies I-EXPLORATION +arteria I-EXPLORATION +cerebral I-EXPLORATION +media I-EXPLORATION y I-EXPLORATION -tobillos, I-EXPLORATION -e I-EXPLORATION -hiperemia I-EXPLORATION -amigdalar I-EXPLORATION -sin I-EXPLORATION -exudados. I-EXPLORATION - I-EXPLORATION -Las I-EXPLORATION -exploraciones I-EXPLORATION +arteria I-EXPLORATION +cerebral I-EXPLORATION +posterior I-EXPLORATION +izquierdas. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +electrocardiograma I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +ritmo I-EXPLORATION +de I-EXPLORATION +marcapasos. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +coagulación, I-EXPLORATION +destacaba I-EXPLORATION +un I-EXPLORATION +INR I-EXPLORATION +de I-EXPLORATION +1, I-EXPLORATION +48. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +realizaron I-EXPLORATION +otras I-EXPLORATION +pruebas I-EXPLORATION complementarias I-EXPLORATION -(hemograma, I-EXPLORATION -bioquímica, I-EXPLORATION -coagulación I-EXPLORATION +como I-EXPLORATION +angiorresonancia I-EXPLORATION +magnética I-EXPLORATION +(RM) I-EXPLORATION +cerebral, I-EXPLORATION +ecografía-doppler I-EXPLORATION +transcraneal I-EXPLORATION y I-EXPLORATION -tira I-EXPLORATION -reactiva I-EXPLORATION de I-EXPLORATION -orina) I-EXPLORATION -resultaron I-EXPLORATION -normales. I-EXPLORATION -Con B-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -de I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -PSH I-TREATMENT -con I-TREATMENT -afectación I-TREATMENT -sistémica, I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -fue I-TREATMENT -hospitalizado I-TREATMENT -para I-TREATMENT -iniciar I-TREATMENT -tratamiento I-TREATMENT -esteroideo I-TREATMENT -(prednisona I-TREATMENT -2 I-TREATMENT -mg/kg/día). I-TREATMENT -La B-EVOLUTION -evolución I-EVOLUTION -fue I-EVOLUTION -favorable, I-EVOLUTION -con I-EVOLUTION -mejoría I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -síntomas I-EVOLUTION -articulares, I-EVOLUTION -siendo I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -hospitalización. I-EVOLUTION - I-EVOLUTION +troncos I-EXPLORATION +supraaórticos, I-EXPLORATION +ni I-EXPLORATION +ecocardiograma I-EXPLORATION +(transtorácico I-EXPLORATION +ni I-EXPLORATION +transesofágico). I-EXPLORATION +La B-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +remitida I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +centro I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +larga I-DERIVED_FROM/TO +estancia I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +realización I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +rehabilitación I-DERIVED_FROM/TO +intensiva. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestra I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -nueve I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +recién I-PRESENT_ILLNESS +nacida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +pretérmino, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +24 I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad I-PRESENT_ILLNESS +gestacional I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nacimiento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +685 I-PRESENT_ILLNESS +g. I-PRESENT_ILLNESS +Embarazo I-PRESENT_ILLNESS +gemelar I-PRESENT_ILLNESS +controlado, I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -indurada I-PRESENT_ILLNESS +fecundación I-PRESENT_ILLNESS +in I-PRESENT_ILLNESS +vitro. I-PRESENT_ILLNESS +Tras I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +parto I-PRESENT_ILLNESS +vaginal I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +presentación I-PRESENT_ILLNESS +cefálica I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +sufrimiento I-PRESENT_ILLNESS +fetal I-PRESENT_ILLNESS +(Apgar I-PRESENT_ILLNESS +4-6), I-PRESENT_ILLNESS +debió I-PRESENT_ILLNESS +ser I-PRESENT_ILLNESS +intubada I-PRESENT_ILLNESS en I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -cara I-PRESENT_ILLNESS -externa I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -muslo, I-PRESENT_ILLNESS -única, I-PRESENT_ILLNESS -lineal, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -dudosa I-PRESENT_ILLNESS -adherencia I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -planos I-PRESENT_ILLNESS -profundos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -asociada. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Dicha B-TREATMENT -lesión I-TREATMENT -es I-TREATMENT -extirpada I-TREATMENT +sala I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +parto. I-PRESENT_ILLNESS +Se B-TREATMENT +trasladó I-TREATMENT +a I-TREATMENT +la I-TREATMENT +unidad I-TREATMENT +de I-TREATMENT +cuidados I-TREATMENT +intensivos I-TREATMENT +siendo I-TREATMENT +conectada I-TREATMENT +a I-TREATMENT +ventilación I-TREATMENT +mecánica. I-TREATMENT +Permaneció I-TREATMENT +desde I-TREATMENT +el I-TREATMENT +primer I-TREATMENT +día I-TREATMENT +con I-TREATMENT +nutrición I-TREATMENT +parenteral I-TREATMENT +y I-TREATMENT +catéter I-TREATMENT +venoso I-TREATMENT +central I-TREATMENT +y I-TREATMENT +precisando I-TREATMENT +administración I-TREATMENT +de I-TREATMENT +surfactante I-TREATMENT +pulmonar I-TREATMENT +exógeno I-TREATMENT +con I-TREATMENT +escasa I-TREATMENT +respuesta. I-TREATMENT +Se B-EXPLORATION +obtuvieron I-EXPLORATION +muestras I-EXPLORATION +para I-EXPLORATION +hemocultivo I-EXPLORATION +y I-EXPLORATION +urocultivo I-EXPLORATION +al I-EXPLORATION +ingreso I-EXPLORATION +e B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +empírico I-TREATMENT +de I-TREATMENT +sepsis I-TREATMENT +neonatal I-TREATMENT +precoz I-TREATMENT +(ampi-cilina I-TREATMENT +y I-TREATMENT +gentamicina). I-TREATMENT +Tras B-EVOLUTION +cinco I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION +antimicrobiano I-EVOLUTION +presentó I-EVOLUTION +empeoramiento I-EVOLUTION +clínico I-EVOLUTION +y I-EVOLUTION +alteración I-EVOLUTION +de I-EVOLUTION +exámenes I-EVOLUTION +laboratorio I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +cambió I-TREATMENT +la I-TREATMENT +antibioterapia I-TREATMENT +para I-TREATMENT +cobertura I-TREATMENT +de I-TREATMENT +sepsis I-TREATMENT +nosocomial I-TREATMENT +(vancomicina I-TREATMENT +y I-TREATMENT +ceftazidima) I-TREATMENT y B-EXPLORATION -Anatomía I-EXPLORATION -Patológica I-EXPLORATION -aporta I-EXPLORATION -el I-EXPLORATION -siguiente I-EXPLORATION -informe: I-EXPLORATION -“Paniculitits I-EXPLORATION -neutrofílica I-EXPLORATION -de I-EXPLORATION -predominio I-EXPLORATION -lobular I-EXPLORATION -con I-EXPLORATION -alta I-EXPLORATION -proporción I-EXPLORATION -de I-EXPLORATION -esclerosis I-EXPLORATION -periférica. I-EXPLORATION -Existe I-EXPLORATION -destrucción I-EXPLORATION -masiva I-EXPLORATION -de I-EXPLORATION -adipocitos I-EXPLORATION -con I-EXPLORATION -extenso I-EXPLORATION -granuloma I-EXPLORATION -lipofágico, I-EXPLORATION -todo I-EXPLORATION -delimitado I-EXPLORATION -por I-EXPLORATION -tejido I-EXPLORATION -conjuntivo I-EXPLORATION -fibroso I-EXPLORATION -abundante”. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -descripción I-EXPLORATION -microscópica, I-EXPLORATION -refiere I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -restos I-EXPLORATION -intracelulares I-EXPLORATION -PAS+ I-EXPLORATION +se I-EXPLORATION +obtuvieron I-EXPLORATION +nuevas I-EXPLORATION +muestras I-EXPLORATION +para I-EXPLORATION +cultivo I-EXPLORATION +(sangre, I-EXPLORATION +orina I-EXPLORATION y I-EXPLORATION -células I-EXPLORATION -gigantes I-EXPLORATION -tipo I-EXPLORATION -Touton I-EXPLORATION -escasas. I-EXPLORATION -Las I-EXPLORATION -células I-EXPLORATION -inflamatorias I-EXPLORATION -presentan I-EXPLORATION -marcadores I-EXPLORATION -de I-EXPLORATION -superficie I-EXPLORATION -habituales I-EXPLORATION -descartando I-EXPLORATION -naturaleza I-EXPLORATION -neoplásica. I-EXPLORATION -Añaden I-EXPLORATION -como I-EXPLORATION -posibles I-EXPLORATION -causas5-8: I-EXPLORATION +LCR). I-EXPLORATION I-EXPLORATION -• I-EXPLORATION -Reacción I-EXPLORATION -tipo I-EXPLORATION -autoeccematización I-EXPLORATION -asociada I-EXPLORATION +A B-TREATMENT +la I-TREATMENT +semana I-TREATMENT +de I-TREATMENT +vida I-TREATMENT +se I-TREATMENT +retiró I-TREATMENT +el I-TREATMENT +catéter I-TREATMENT +de I-TREATMENT +la I-TREATMENT +arteria I-TREATMENT +umbilical, I-TREATMENT +en B-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +aisló I-EXPLORATION +Staphylococcus I-EXPLORATION +epider-midis I-EXPLORATION +sensible I-EXPLORATION a I-EXPLORATION -infección, I-EXPLORATION -predominantemente I-EXPLORATION -bacteriana8. I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Esclerodermia I-EXPLORATION -localizada I-EXPLORATION -profunda I-EXPLORATION -juvenil5, I-EXPLORATION -aunque I-EXPLORATION -en I-EXPLORATION -esta I-EXPLORATION +vancomicina. I-EXPLORATION +Se B-TREATMENT +suspendió I-TREATMENT +la I-TREATMENT +ceftazidima I-TREATMENT +y I-TREATMENT +se I-TREATMENT +mantuvo I-TREATMENT +la I-TREATMENT +vancomicina I-TREATMENT +durante I-TREATMENT +10 I-TREATMENT +días I-TREATMENT +más. I-TREATMENT +Los B-EXPLORATION +cultivos I-EXPLORATION +realizados I-EXPLORATION +(sangre, I-EXPLORATION +orina I-EXPLORATION +y I-EXPLORATION +LCR) I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Persistieron B-EVOLUTION +las I-EVOLUTION +alteraciones I-EVOLUTION +hemodi-námicas, I-EVOLUTION +respiratorias I-EVOLUTION +y I-EVOLUTION +hematológicas, I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +empeoramiento I-EVOLUTION +progresivo I-EVOLUTION +hasta I-EVOLUTION +el I-EVOLUTION +fallecimiento I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +20 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +vida. I-EVOLUTION +Tras B-EXPLORATION +su I-EXPLORATION +deceso I-EXPLORATION +se I-EXPLORATION +cultivaron I-EXPLORATION +los I-EXPLORATION +catéteres I-EXPLORATION +(venoso I-EXPLORATION +central I-EXPLORATION +y I-EXPLORATION +arterial) I-EXPLORATION +y I-EXPLORATION el I-EXPLORATION -infiltrado I-EXPLORATION -neutrofílico I-EXPLORATION -suele I-EXPLORATION -ser I-EXPLORATION -menos I-EXPLORATION -patente. I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Lesiones I-EXPLORATION -evolutivas I-EXPLORATION +tubo I-EXPLORATION +endotraqueal I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -síndrome I-EXPLORATION +caldo I-EXPLORATION de I-EXPLORATION -Weber I-EXPLORATION -Christian. I-EXPLORATION - I-EXPLORATION -• I-EXPLORATION -Paniculitis I-EXPLORATION -asociada I-EXPLORATION -al I-EXPLORATION -déficit I-EXPLORATION +enriquecimiento I-EXPLORATION +tioglicolato I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +agar I-EXPLORATION +chocolate. I-EXPLORATION +En I-EXPLORATION +todos I-EXPLORATION +ellos, I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +24 I-EXPLORATION +horas I-EXPLORATION de I-EXPLORATION -α1-antitripsina. I-EXPLORATION - I-EXPLORATION - -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diez I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que, B-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -recordar I-PRESENT_ILLNESS -traumatismo I-PRESENT_ILLNESS -previo, I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -refiriendo I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -dolorosa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -muslo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -advertida I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -antes. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -fiebre, I-PRESENT_ILLNESS -pérdida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -otra I-PRESENT_ILLNESS -sintomatología. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION +incubación I-EXPLORATION +a I-EXPLORATION +37 I-EXPLORATION +°C I-EXPLORATION se I-EXPLORATION -palpa I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -dolorosa I-EXPLORATION -de I-EXPLORATION -7 I-EXPLORATION -× I-EXPLORATION -11 I-EXPLORATION -cm I-EXPLORATION +observó, I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -tercio I-EXPLORATION -medio-distal I-EXPLORATION -del I-EXPLORATION -muslo I-EXPLORATION -izquierdo. I-EXPLORATION -La I-EXPLORATION -extremidad I-EXPLORATION -está I-EXPLORATION -mínimamente I-EXPLORATION -aumentada I-EXPLORATION +cultivo I-EXPLORATION +puro, I-EXPLORATION +colonias I-EXPLORATION +secas I-EXPLORATION de I-EXPLORATION -tamaño I-EXPLORATION -respecto I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -contralateral. I-EXPLORATION -La I-EXPLORATION -piel I-EXPLORATION -presenta I-EXPLORATION coloración I-EXPLORATION +crema I-EXPLORATION y I-EXPLORATION -temperatura I-EXPLORATION -normales. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -es I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -clínicos I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION -del I-EXPLORATION -fémur I-EXPLORATION -izquierdo I-EXPLORATION -que I-EXPLORATION -evidencia I-EXPLORATION -una I-EXPLORATION -masa I-EXPLORATION -calcificada. I-EXPLORATION -Posteriormente I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -ecografía I-EXPLORATION -del I-EXPLORATION -muslo, I-EXPLORATION +superficie I-EXPLORATION +rugosa I-EXPLORATION que I-EXPLORATION -pone I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -oval I-EXPLORATION -con I-EXPLORATION -múltiples I-EXPLORATION -imágenes I-EXPLORATION -hiperecogénicas I-EXPLORATION +fueron I-EXPLORATION +resembradas I-EXPLORATION +en I-EXPLORATION +agar I-EXPLORATION +Albicans I-EXPLORATION +(Biomerieux®) I-EXPLORATION +y I-EXPLORATION en I-EXPLORATION +agar I-EXPLORATION +SGC2 I-EXPLORATION +(Biomerieux®) I-EXPLORATION +e I-EXPLORATION +incubadas I-EXPLORATION +a I-EXPLORATION +30 I-EXPLORATION +°C I-EXPLORATION +Posteriormente, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION su I-EXPLORATION -interior I-EXPLORATION -que I-EXPLORATION -provocan I-EXPLORATION -sombras I-EXPLORATION -acústicas I-EXPLORATION -posteriores, I-EXPLORATION -lo I-EXPLORATION +identificación I-EXPLORATION +mediante I-EXPLORATION +tarjeta I-EXPLORATION +ID I-EXPLORATION +Yeast I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +sistema I-EXPLORATION +automatizado I-EXPLORATION +Vitek I-EXPLORATION +(Biomerieux I-EXPLORATION +®), I-EXPLORATION +obteniéndose I-EXPLORATION +como I-EXPLORATION +resultado I-EXPLORATION +T. I-EXPLORATION +asahii. I-EXPLORATION +Paralelamente, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +visión I-EXPLORATION +directa I-EXPLORATION +al I-EXPLORATION +microscopio I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION que I-EXPLORATION -no I-EXPLORATION -sugiere I-EXPLORATION -un I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +hifas I-EXPLORATION +ramificadas I-EXPLORATION +con I-EXPLORATION +artroconidios I-EXPLORATION +intercalares I-EXPLORATION +y I-EXPLORATION +terminales I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +rectangular. I-EXPLORATION +Por I-EXPLORATION +último, I-EXPLORATION +se I-EXPLORATION +comprobó I-EXPLORATION +la I-EXPLORATION +positividad I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +ureasa I-EXPLORATION +como I-EXPLORATION diagnóstico I-EXPLORATION -definitivo. I-EXPLORATION +diferencial I-EXPLORATION +con I-EXPLORATION +Geotrichum I-EXPLORATION +sp. I-EXPLORATION Para I-EXPLORATION -concretar I-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +susceptibilidad I-EXPLORATION se I-EXPLORATION -solicita I-EXPLORATION +practicó I-EXPLORATION +un I-EXPLORATION +Sensititre I-EXPLORATION +YeastOne I-EXPLORATION +Y I-EXPLORATION +07 I-EXPLORATION +(Trek I-EXPLORATION +Diagnostic I-EXPLORATION +Systems®) I-EXPLORATION +que, I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +lectura I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +24 I-EXPLORATION +horas, I-EXPLORATION +arrojó I-EXPLORATION +una I-EXPLORATION +CIM I-EXPLORATION +de I-EXPLORATION +16 I-EXPLORATION +μg/ml I-EXPLORATION +para I-EXPLORATION +flucona-zol, I-EXPLORATION +0, I-EXPLORATION +25 I-EXPLORATION +μg/ml I-EXPLORATION +para I-EXPLORATION +itraconazol I-EXPLORATION +y I-EXPLORATION +1 I-EXPLORATION +μg/ml I-EXPLORATION +para I-EXPLORATION +keto-conazol, I-EXPLORATION +para I-EXPLORATION +5-fluocitosina I-EXPLORATION una I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC), I-EXPLORATION -que I-EXPLORATION -pone I-EXPLORATION +CIM I-EXPLORATION de I-EXPLORATION -manifiesto I-EXPLORATION +0, I-EXPLORATION +5 I-EXPLORATION +μg/ml I-EXPLORATION +y I-EXPLORATION +para I-EXPLORATION +anfotericina I-EXPLORATION +B I-EXPLORATION una I-EXPLORATION -masa I-EXPLORATION -calcificada I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -engloba I-EXPLORATION -estructuras I-EXPLORATION -neuromusculares, I-EXPLORATION +CIM, I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +48 I-EXPLORATION +horas, I-EXPLORATION de I-EXPLORATION -características I-EXPLORATION -aparentemente I-EXPLORATION -benignas, I-EXPLORATION -pero I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -permite I-EXPLORATION -descartar I-EXPLORATION +2 I-EXPLORATION +μg/ml. I-EXPLORATION +En I-EXPLORATION +los I-EXPLORATION +cultivos I-EXPLORATION +del I-EXPLORATION +otro I-EXPLORATION +gemelo, I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -trate I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -condroma I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas. I-EXPLORATION - I-EXPLORATION -Ante I-EXPLORATION +también I-EXPLORATION +ingresó I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -posibilidad I-EXPLORATION -de I-EXPLORATION -patología I-EXPLORATION -maligna, I-EXPLORATION -se I-EXPLORATION -deriva I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -hospital I-EXPLORATION +Unidad I-EXPLORATION de I-EXPLORATION -tercer I-EXPLORATION -nivel I-EXPLORATION -para I-EXPLORATION -su I-EXPLORATION -valoración, I-EXPLORATION -donde I-EXPLORATION +Ciudados I-EXPLORATION +Intensivos I-EXPLORATION +Neonatales, I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -reevalúa I-EXPLORATION -el I-EXPLORATION -caso. I-EXPLORATION -Un I-EXPLORATION -familiar I-EXPLORATION -recuerda I-EXPLORATION -un I-EXPLORATION -traumatismo I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -manillar I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -bicicleta I-EXPLORATION -unos I-EXPLORATION -cuatro I-EXPLORATION -meses I-EXPLORATION -antes I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -consulta I-EXPLORATION -inicial, I-EXPLORATION -seguido I-EXPLORATION +aisló I-EXPLORATION +patógeno I-EXPLORATION de I-EXPLORATION -dolor I-EXPLORATION -e I-EXPLORATION -inflamación I-EXPLORATION -los I-EXPLORATION -siete I-EXPLORATION -días I-EXPLORATION -posteriores. I-EXPLORATION -El B-TREATMENT -caso I-TREATMENT -se I-TREATMENT -orienta I-TREATMENT -inicialmente I-TREATMENT -como I-TREATMENT -un I-TREATMENT -hematoma I-TREATMENT -calcificado I-TREATMENT -y I-TREATMENT -se I-TREATMENT -sugiere I-TREATMENT -un I-TREATMENT -tratamiento I-TREATMENT -conservador I-TREATMENT -y I-TREATMENT -una I-TREATMENT -visita I-TREATMENT -de I-TREATMENT -seguimiento I-TREATMENT -tres I-TREATMENT -meses I-TREATMENT -después. I-TREATMENT -Pasado B-EVOLUTION -ese I-EVOLUTION -tiempo, I-EVOLUTION -solicitan I-EVOLUTION +interés I-EXPLORATION +alguno, I-EXPLORATION +teniendo B-EVOLUTION una I-EVOLUTION -radiografía I-EVOLUTION -simple I-EVOLUTION -de I-EVOLUTION -control I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -muestra I-EVOLUTION -cambios I-EVOLUTION -respecto I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -previa. I-EVOLUTION -Ante I-EVOLUTION -la I-EVOLUTION +buena I-EVOLUTION evolución I-EVOLUTION -clínica, I-EVOLUTION -revaloran I-EVOLUTION -la I-EVOLUTION -TC I-EVOLUTION -inicial I-EVOLUTION -y I-EVOLUTION -reorientan I-EVOLUTION -el I-EVOLUTION -diagnóstico I-EVOLUTION -como I-EVOLUTION -miositis I-EVOLUTION -osificante I-EVOLUTION -traumática I-EVOLUTION -(MOT). I-EVOLUTION -Cuatro I-EVOLUTION -años I-EVOLUTION -después I-EVOLUTION -la I-EVOLUTION -lesión I-EVOLUTION -apenas I-EVOLUTION -ha I-EVOLUTION -disminuido I-EVOLUTION +clínica I-EVOLUTION +en I-EVOLUTION su I-EVOLUTION -tamaño, I-EVOLUTION -pero I-EVOLUTION -la I-EVOLUTION -cirugía I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -plantea I-EVOLUTION -ya I-EVOLUTION -que I-EVOLUTION -clínicamente I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -está I-EVOLUTION -asintomática. I-EVOLUTION +estadía I-EVOLUTION +hospitalaria. I-EVOLUTION I-EVOLUTION -Lactante B-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -primera I-PRESENT_ILLNESS -visita I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -control I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -recién I-PRESENT_ILLNESS -nacido. I-PRESENT_ILLNESS -Varón, B-PAST_MEDICAL_HISTORY -fruto I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -segunda I-PAST_MEDICAL_HISTORY -gestación I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -término I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -complicaciones I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -parto I-PAST_MEDICAL_HISTORY -eutócico I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -incidencias. I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -madre I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS +23 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -aproximadamente I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +procedente B-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +zona I-PAST_MEDICAL_HISTORY +rural I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +municipio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Carepa, I-PAST_MEDICAL_HISTORY +quien B-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +llevada I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -diámetro I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -vértice I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -cuero I-PRESENT_ILLNESS -cabelludo I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -momento I-PRESENT_ILLNESS +urgencias I-PRESENT_ILLNESS del I-PRESENT_ILLNESS -nacimiento. I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +seis I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +rinorrea I-PRESENT_ILLNESS +hialina I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +deposiciones I-PRESENT_ILLNESS +diarreicas I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +moco I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +sangre. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +anterior I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +presentó I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +epistaxis. I-PRESENT_ILLNESS I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -evidencia I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION +Al B-EXPLORATION +ingreso I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +hipoactiva, I-EXPLORATION +con I-EXPLORATION +palidez I-EXPLORATION +generalizada I-EXPLORATION +y I-EXPLORATION +signos I-EXPLORATION +epistaxis I-EXPLORATION +reciente I-EXPLORATION +en I-EXPLORATION +narina I-EXPLORATION +derecha, I-EXPLORATION +temperatura I-EXPLORATION +axilar I-EXPLORATION de I-EXPLORATION -1 I-EXPLORATION -cm I-EXPLORATION +37, I-EXPLORATION +5 I-EXPLORATION +°C, I-EXPLORATION +frecuencia I-EXPLORATION +cardiaca I-EXPLORATION de I-EXPLORATION -diámetro, I-EXPLORATION +96 I-EXPLORATION +por I-EXPLORATION +minuto I-EXPLORATION +y I-EXPLORATION +frecuencia I-EXPLORATION +respiratoria I-EXPLORATION de I-EXPLORATION -bordes I-EXPLORATION -limpios, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION +32 I-EXPLORATION +por I-EXPLORATION +minuto. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +abdomen I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +hepatoesplenomegalia. I-EXPLORATION +Con B-TREATMENT +esta I-TREATMENT +historia I-TREATMENT +se I-TREATMENT +hizo I-TREATMENT +una I-TREATMENT +impresión I-TREATMENT +diagnóstica I-TREATMENT +de I-TREATMENT +dengue I-TREATMENT +con I-TREATMENT +manifestaciones I-TREATMENT +hemorrágicas I-TREATMENT +y I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +líquidos I-TREATMENT +y I-TREATMENT +antipiréticos. I-TREATMENT + I-TREATMENT +Los B-EXPLORATION +exámenes I-EXPLORATION +paraclínicos I-EXPLORATION de I-EXPLORATION -sobreinfección. I-EXPLORATION -Ante I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION +ingreso I-EXPLORATION +reportaron I-EXPLORATION +valores I-EXPLORATION de I-EXPLORATION -aplasia I-EXPLORATION -cutis I-EXPLORATION -congénita I-EXPLORATION -(ACC) I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -radiografía I-EXPLORATION +hemoglobina I-EXPLORATION +6, I-EXPLORATION +5 I-EXPLORATION +g/dl, I-EXPLORATION +hematocrito I-EXPLORATION +18, I-EXPLORATION +4%, I-EXPLORATION +recuento I-EXPLORATION de I-EXPLORATION -cráneo I-EXPLORATION +leucocitos I-EXPLORATION +8.600/ml, I-EXPLORATION +recuento I-EXPLORATION +de I-EXPLORATION +plaquetas I-EXPLORATION +30.000/µl, I-EXPLORATION +bilirrubina I-EXPLORATION +total I-EXPLORATION +2, I-EXPLORATION +2 I-EXPLORATION +mg/dl I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -ecografía I-EXPLORATION -cerebral I-EXPLORATION -transfontanelar, I-EXPLORATION +bilirrubina I-EXPLORATION +directa I-EXPLORATION +0, I-EXPLORATION +7 I-EXPLORATION +mg/dl. I-EXPLORATION +A B-EVOLUTION +los I-EVOLUTION +dos I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +hospitalización, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +persistió I-EVOLUTION +con I-EVOLUTION +fiebre I-EVOLUTION +por B-EXPLORATION +lo I-EXPLORATION que I-EXPLORATION -fueron I-EXPLORATION -normales. I-EXPLORATION -El I-EXPLORATION -genograma I-EXPLORATION -no I-EXPLORATION -evidenció I-EXPLORATION -enfermedades I-EXPLORATION -genéticas, I-EXPLORATION -pero B-FAMILY_HISTORY -el I-FAMILY_HISTORY -padre I-FAMILY_HISTORY -también I-FAMILY_HISTORY -presentaba I-FAMILY_HISTORY -una I-FAMILY_HISTORY -zona I-FAMILY_HISTORY -de I-FAMILY_HISTORY -alopecia I-FAMILY_HISTORY -cicatricial I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -vértice I-FAMILY_HISTORY -del I-FAMILY_HISTORY -cuero I-FAMILY_HISTORY -cabelludo, I-FAMILY_HISTORY -que I-FAMILY_HISTORY -refiere I-FAMILY_HISTORY -desde I-FAMILY_HISTORY -la I-FAMILY_HISTORY -infancia. I-FAMILY_HISTORY - I-FAMILY_HISTORY +se I-EXPLORATION +solicitó I-EXPLORATION +gota I-EXPLORATION +gruesa, I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +fue I-EXPLORATION +positiva I-EXPLORATION +para I-EXPLORATION +P. I-EXPLORATION +vivax. I-EXPLORATION +Con B-TREATMENT +este I-TREATMENT +resultado I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +cloroquina. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +mejoría I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +cuadro I-EVOLUTION +febril. I-EVOLUTION +A B-TREATMENT +pesar I-TREATMENT +de I-TREATMENT +su I-TREATMENT +estado I-TREATMENT +hematológico, I-TREATMENT +no I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +ninguna I-TREATMENT +intervención. I-TREATMENT +Al B-EVOLUTION +sexto I-EVOLUTION +día I-EVOLUTION +se I-EVOLUTION +dio I-EVOLUTION +de I-EVOLUTION +alta. I-EVOLUTION + I-EVOLUTION -Niña B-PRESENT_ILLNESS +Varón, B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -ocho I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -natural B-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -provincia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Huesca I-PAST_MEDICAL_HISTORY -(España), I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -ante I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -presencia I-PRESENT_ILLNESS +22 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +(170 I-PRESENT_ILLNESS +cm, I-PRESENT_ILLNESS +70 I-PRESENT_ILLNESS +Kg), I-PRESENT_ILLNESS +ASA I-PRESENT_ILLNESS +I I-PRESENT_ILLNESS +U, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +evacuado I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +diagnóstico I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -dérmica I-PRESENT_ILLNESS +fractura I-PRESENT_ILLNESS +conminuta I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -cuero I-PRESENT_ILLNESS -cabelludo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -adenopatías I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -localización I-PRESENT_ILLNESS -cérvico-occipital I-PRESENT_ILLNESS +fémur I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +arma I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -varios I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS +fuego I-PRESENT_ILLNESS +subsidiaria I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION +tratamiento I-PRESENT_ILLNESS +quirúrgico. I-PRESENT_ILLNESS +Al B-EXPLORATION +paciente I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -costrosa I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cuero I-EXPLORATION -cabelludo I-EXPLORATION -occipital, I-EXPLORATION +le I-EXPLORATION +monitorizó I-EXPLORATION de I-EXPLORATION -3 I-EXPLORATION -× I-EXPLORATION -3 I-EXPLORATION -cm, I-EXPLORATION +igual I-EXPLORATION +forma I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -desprende I-EXPLORATION -fácilmente, I-EXPLORATION -sin I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -escara I-EXPLORATION -ni I-EXPLORATION -zona I-EXPLORATION -eritematosa. I-EXPLORATION -De I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -manera, I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -tres I-EXPLORATION -adenopatías I-EXPLORATION -retroauriculares I-EXPLORATION +al I-EXPLORATION +primer I-EXPLORATION +caso I-EXPLORATION +clínico: I-EXPLORATION +SaO2, I-EXPLORATION +frecuencia I-EXPLORATION +cardíaca, I-EXPLORATION +tensión I-EXPLORATION +arterial I-EXPLORATION +no I-EXPLORATION +invasiva, I-EXPLORATION +temperatura, I-EXPLORATION +capnografía I-EXPLORATION y I-EXPLORATION -occipitales, I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -muy I-EXPLORATION -dolorosas I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación, I-EXPLORATION -sin I-EXPLORATION -otros I-EXPLORATION -hallazgos I-EXPLORATION +grado I-EXPLORATION de I-EXPLORATION -interés. I-EXPLORATION -La B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -picadura I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -garrapata I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -15 I-PAST_MEDICAL_HISTORY -días, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cual I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -identificada I-PAST_MEDICAL_HISTORY -dentro I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -especie I-PAST_MEDICAL_HISTORY -Dermacentor I-PAST_MEDICAL_HISTORY -marginatus. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Se B-TREATMENT -pauta I-TREATMENT -eritromicina I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT +hipnosis I-EXPLORATION +mediante I-EXPLORATION +el I-EXPLORATION +monitor I-EXPLORATION +BIS®. I-EXPLORATION + I-EXPLORATION +Tras B-TREATMENT +administración I-TREATMENT +de I-TREATMENT +250 I-TREATMENT +ml I-TREATMENT de I-TREATMENT +coloide I-TREATMENT +en I-TREATMENT +bolo I-TREATMENT +iv, I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +anestesia I-TREATMENT +intradural I-TREATMENT +empleando I-TREATMENT +bupivacaína I-TREATMENT +0, I-TREATMENT +5% I-TREATMENT +hiperbara I-TREATMENT +10 I-TREATMENT +mg I-TREATMENT +y I-TREATMENT +fentanilo I-TREATMENT +10 I-TREATMENT +µg. I-TREATMENT +La I-TREATMENT +medicación I-TREATMENT +coadyuvante I-TREATMENT +fue I-TREATMENT +midazolam I-TREATMENT +(3 I-TREATMENT +mg I-TREATMENT +en I-TREATMENT +bolo I-TREATMENT +iv) I-TREATMENT +y I-TREATMENT +propofol I-TREATMENT +(1, I-TREATMENT +5 I-TREATMENT +mg/Kg/h). I-TREATMENT +La I-TREATMENT +profilaxis I-TREATMENT +antibiótica I-TREATMENT +fue I-TREATMENT +cefazolina I-TREATMENT +2 I-TREATMENT +g I-TREATMENT +iv. I-TREATMENT +Asimismo I-TREATMENT +también I-TREATMENT +se I-TREATMENT +pautó I-TREATMENT +omeprazol I-TREATMENT 40 I-TREATMENT -mg/kg/día I-TREATMENT -durante I-TREATMENT -ocho I-TREATMENT -días I-TREATMENT +mg I-TREATMENT +iv, I-TREATMENT +granisetron I-TREATMENT +3 I-TREATMENT +mg I-TREATMENT +iv I-TREATMENT y I-TREATMENT +ácido I-TREATMENT +tranexámico I-TREATMENT +1 I-TREATMENT +g I-TREATMENT +iv. I-TREATMENT +Al I-TREATMENT +de I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT se I-TREATMENT -solicita I-TREATMENT -serología I-TREATMENT -para I-TREATMENT -Toxoplasma, I-TREATMENT -Borrelia, I-TREATMENT -citomegalovirus, I-TREATMENT -virus I-TREATMENT +administró I-TREATMENT +desketoprofeno I-TREATMENT +(50 I-TREATMENT +mg I-TREATMENT +iv), I-TREATMENT +se I-TREATMENT +finalizó I-TREATMENT +la I-TREATMENT +perfusión I-TREATMENT de I-TREATMENT -Epstein-Barr I-TREATMENT +propofol I-TREATMENT y I-TREATMENT -Rickettsia I-TREATMENT -conorii, I-TREATMENT -evidenciándose I-TREATMENT -una I-TREATMENT -positivización I-TREATMENT +se I-TREATMENT +infiltró I-TREATMENT +la I-TREATMENT +herida I-TREATMENT +con I-TREATMENT +mepivacaína I-TREATMENT +2% I-TREATMENT +200 I-TREATMENT +mg. I-TREATMENT +El I-TREATMENT +paciente I-TREATMENT +ingresó I-TREATMENT +en I-TREATMENT +la I-TREATMENT +unidad I-TREATMENT de I-TREATMENT -IgG I-TREATMENT -para I-TREATMENT -citomegalovirus I-TREATMENT -y I-TREATMENT +reanimación I-TREATMENT +postquirúrgica, I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +la I-TREATMENT +realización I-TREATMENT de I-TREATMENT -anticuerpos I-TREATMENT -para I-TREATMENT -Rickettsia I-TREATMENT -conorii I-TREATMENT -(1/640) I-TREATMENT -mediante I-TREATMENT -inmonofluorescencia I-TREATMENT -indirecta I-TREATMENT +un I-TREATMENT +bloqueo I-TREATMENT +nervioso I-TREATMENT +ecoguiado I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +femoral I-TREATMENT +con I-TREATMENT +bupivacaína I-TREATMENT +0, I-TREATMENT +25% I-TREATMENT +25 I-TREATMENT +mg I-TREATMENT y I-TREATMENT -posterior I-TREATMENT -aumento I-TREATMENT +tras I-TREATMENT +recobrar I-TREATMENT +la I-TREATMENT +sensibilidad I-TREATMENT +y I-TREATMENT +motricidad I-TREATMENT +en I-TREATMENT +miembros I-TREATMENT +inferiores I-TREATMENT +fue I-TREATMENT +dado I-TREATMENT +de I-TREATMENT +alta I-TREATMENT a I-TREATMENT -los I-TREATMENT -40 I-TREATMENT -días. I-TREATMENT -Tras B-EVOLUTION -la I-EVOLUTION -medicación I-EVOLUTION -pautada, I-EVOLUTION -presenta I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -una I-EVOLUTION +sala I-TREATMENT +de I-TREATMENT +hospitalización I-TREATMENT +sin I-TREATMENT +incidencias. I-TREATMENT + I-TREATMENT +La B-EVOLUTION +monitorización I-EVOLUTION +mediante I-EVOLUTION +BIS® I-EVOLUTION +mostró I-EVOLUTION +unos I-EVOLUTION +valores I-EVOLUTION +comprendidos I-EVOLUTION +entre I-EVOLUTION +97 I-EVOLUTION +y I-EVOLUTION +30. I-EVOLUTION +La I-EVOLUTION +curva I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -tres I-EVOLUTION -adenopatías I-EVOLUTION -durante I-EVOLUTION -un I-EVOLUTION -mes, I-EVOLUTION -que I-EVOLUTION -sigue I-EVOLUTION -siendo I-EVOLUTION -dolorosa I-EVOLUTION -al I-EVOLUTION -tacto, I-EVOLUTION -con I-EVOLUTION -desaparición I-EVOLUTION -posterior. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -cuatro I-EVOLUTION -años I-EVOLUTION +la I-EVOLUTION +capnografía I-EVOLUTION +fue I-EVOLUTION +normal I-EVOLUTION y I-EVOLUTION -habiéndose I-EVOLUTION -encontrado I-EVOLUTION -asintomática I-EVOLUTION -durante I-EVOLUTION -este I-EVOLUTION -periodo, I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION -consulta I-EVOLUTION -por I-EVOLUTION -aparición I-EVOLUTION -nuevamente I-EVOLUTION +valoración I-EVOLUTION de I-EVOLUTION -pequeños I-EVOLUTION -nódulos I-EVOLUTION -discretamente I-EVOLUTION -dolorosos I-EVOLUTION -a I-EVOLUTION la I-EVOLUTION -palpación I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -de I-EVOLUTION +sedación I-EVOLUTION +en I-EVOLUTION la I-EVOLUTION -región I-EVOLUTION -cráneo-cervical I-EVOLUTION -bilateral, I-EVOLUTION -apreciándose I-EVOLUTION -ecográficamente I-EVOLUTION -cuatro I-EVOLUTION -lesiones I-EVOLUTION -compatibles I-EVOLUTION -con I-EVOLUTION -adenopatías I-EVOLUTION -de I-EVOLUTION -aspecto I-EVOLUTION -inflamatorio I-EVOLUTION -residual I-EVOLUTION -sin I-EVOLUTION -otros I-EVOLUTION -hallazgos I-EVOLUTION -valorables, I-EVOLUTION -ninguna I-EVOLUTION -de I-EVOLUTION -ellas I-EVOLUTION +unidad I-EVOLUTION de I-EVOLUTION -tamaño I-EVOLUTION -significativo, I-EVOLUTION -que I-EVOLUTION -fueron I-EVOLUTION -tratadas I-EVOLUTION +reanimación I-EVOLUTION +postquirúrgica I-EVOLUTION +fue I-EVOLUTION +máxima I-EVOLUTION +(10 I-EVOLUTION +puntos I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +Escala I-EVOLUTION de I-EVOLUTION -manera I-EVOLUTION -sintomática. I-EVOLUTION +Aldrete). I-EVOLUTION I-EVOLUTION -Niño B-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -diez I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +41 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -sano, I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -celulitis I-PRESENT_ILLNESS -indurada I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -violácea I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -muslo, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -conglomerado I-PRESENT_ILLNESS -adenopático I-PRESENT_ILLNESS -inguinal, I-PRESENT_ILLNESS -acompañados I-PRESENT_ILLNESS +realizó I-PRESENT_ILLNESS +múltiples I-PRESENT_ILLNESS +consultas I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +largo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -febrícula I-PRESENT_ILLNESS -intermitente. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -puerta I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +año I-PRESENT_ILLNESS +debido I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +sensación I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -entrada I-PRESENT_ILLNESS -era I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -herida I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -pie I-PRESENT_ILLNESS -producida I-PRESENT_ILLNESS +oído I-PRESENT_ILLNESS +tapado I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +hipoacusia I-PRESENT_ILLNESS +ligera, I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -playa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Brasil I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -antes, I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +lado I-PRESENT_ILLNESS +derecho, I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -cicatrizado. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A I-PRESENT_ILLNESS -pesar I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +manejada I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +tapón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cerumen I-PRESENT_ILLNESS +repetidamente I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +medicina I-PRESENT_ILLNESS +general I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -amoxicilina-clavulánico I-PRESENT_ILLNESS -endovenoso, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -mejoró I-PRESENT_ILLNESS +lavados I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +oído. I-PRESENT_ILLNESS +Sin I-PRESENT_ILLNESS +embargo, I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +síntomas I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +incrementaron I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +profundizó I-PRESENT_ILLNESS la I-PRESENT_ILLNESS -sintomatología. I-PRESENT_ILLNESS +hipoacusia I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +llegar I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +sordera I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +conducción I-PRESENT_ILLNESS +definida I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +otorrinolaringólogo. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +consulta I-EXPLORATION +con I-EXPLORATION +este I-EXPLORATION +especialista, I-EXPLORATION +también I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +una I-EXPLORATION +pequeña I-EXPLORATION +masa I-EXPLORATION +de I-EXPLORATION +apariencia I-EXPLORATION +tumoral I-EXPLORATION +que I-EXPLORATION +protruía I-EXPLORATION +del I-EXPLORATION +oído I-EXPLORATION +medio I-EXPLORATION +con I-EXPLORATION +lesión I-EXPLORATION +parcial I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +membrana I-EXPLORATION +timpánica. I-EXPLORATION +Fue B-TREATMENT +llevada I-TREATMENT +a I-TREATMENT +cirugía I-TREATMENT +para I-TREATMENT +resección-biopsia I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +y I-TREATMENT +se I-TREATMENT +obtuvieron, I-TREATMENT +mediante I-TREATMENT +miringotomía, I-TREATMENT +múltiples I-TREATMENT +fragmentos I-TREATMENT +de I-TREATMENT +tejido I-TREATMENT +de I-TREATMENT +consistencia I-TREATMENT +firme, I-TREATMENT +de I-TREATMENT +color I-TREATMENT +parduzco, I-TREATMENT +con I-TREATMENT +escaso I-TREATMENT +sangrado. I-TREATMENT +No I-TREATMENT +se I-TREATMENT +mencionó I-TREATMENT +por I-TREATMENT +parte I-TREATMENT +del I-TREATMENT +especialista I-TREATMENT +el I-TREATMENT +compromiso I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cadena I-TREATMENT +de I-TREATMENT +huesecillos I-TREATMENT +ni I-TREATMENT +del I-TREATMENT +nervio I-TREATMENT +facial. I-TREATMENT + I-TREATMENT En B-EXPLORATION -la I-EXPLORATION -ecografía I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +histológico, I-EXPLORATION se I-EXPLORATION -observaba I-EXPLORATION -conglomerado I-EXPLORATION -adenopático. I-EXPLORATION -La I-EXPLORATION -punción I-EXPLORATION -aspiración I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina I-EXPLORATION -(PAAF) I-EXPLORATION +observó I-EXPLORATION +un I-EXPLORATION +fragmento I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -adenopatías I-EXPLORATION -mostraba I-EXPLORATION -histológicamente I-EXPLORATION -granulomas I-EXPLORATION -epitelioides I-EXPLORATION +tejido I-EXPLORATION +recubierto I-EXPLORATION +por I-EXPLORATION +epitelio I-EXPLORATION +escamoso I-EXPLORATION con I-EXPLORATION -necrosis. I-EXPLORATION -La I-EXPLORATION -prueba I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +epitelial I-EXPLORATION +benigno I-EXPLORATION de I-EXPLORATION -Mantoux I-EXPLORATION -mostraba I-EXPLORATION -una I-EXPLORATION -induración I-EXPLORATION +crecimiento I-EXPLORATION +expansivo, I-EXPLORATION +compuesto I-EXPLORATION +por I-EXPLORATION +estructuras I-EXPLORATION de I-EXPLORATION -20 I-EXPLORATION -mm I-EXPLORATION +aspecto I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION -con I-EXPLORATION -vesículas I-EXPLORATION +trabécula I-EXPLORATION y I-EXPLORATION -necrosis I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -48 I-EXPLORATION -horas. I-EXPLORATION -La I-EXPLORATION -cuantificación I-EXPLORATION +tubulares I-EXPLORATION +revestidas I-EXPLORATION +por I-EXPLORATION +una I-EXPLORATION +capa I-EXPLORATION de I-EXPLORATION -interferón I-EXPLORATION -gamma I-EXPLORATION -fue I-EXPLORATION -positiva. I-EXPLORATION -No I-EXPLORATION -había I-EXPLORATION -recibido I-EXPLORATION -vacunación I-EXPLORATION +células I-EXPLORATION +rectangulares I-EXPLORATION +sin I-EXPLORATION +atipias I-EXPLORATION +ni I-EXPLORATION +mitosis, I-EXPLORATION con I-EXPLORATION -bacilo I-EXPLORATION +secreción I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +luz, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +áreas I-EXPLORATION +sólidas I-EXPLORATION +compuestas I-EXPLORATION +por I-EXPLORATION +células I-EXPLORATION de I-EXPLORATION -Calmette-Guérin I-EXPLORATION -(BCG). I-EXPLORATION +escaso I-EXPLORATION +citoplasma I-EXPLORATION +y I-EXPLORATION +núcleo I-EXPLORATION +pequeño I-EXPLORATION +hipercromático. I-EXPLORATION +El I-EXPLORATION +estroma I-EXPLORATION +estaba I-EXPLORATION +ricamente I-EXPLORATION +irrigado. I-EXPLORATION I-EXPLORATION Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -herida I-EXPLORATION -del I-EXPLORATION -pie, I-EXPLORATION -siendo I-EXPLORATION -positiva I-EXPLORATION -la I-EXPLORATION -reacción I-EXPLORATION -en I-EXPLORATION -cadena I-EXPLORATION +realizaron I-EXPLORATION +estudios I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -polimerasa I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -detección I-EXPLORATION +histoquímica I-EXPLORATION +con I-EXPLORATION +coloraciones I-EXPLORATION de I-EXPLORATION -ADN I-EXPLORATION +ácido I-EXPLORATION +peryódico I-EXPLORATION de I-EXPLORATION -Mycobacterium I-EXPLORATION -tuberculosis I-EXPLORATION -(PCR-TB). I-EXPLORATION -Se I-EXPLORATION -confirmó I-EXPLORATION -microbiológicamente I-EXPLORATION -aislando I-EXPLORATION -Mycobacterium I-EXPLORATION -tuberculosis I-EXPLORATION -sensible I-EXPLORATION -a I-EXPLORATION -isoniazida I-EXPLORATION +Schiff I-EXPLORATION +(PAS), I-EXPLORATION +Ziehl-Nielsen I-EXPLORATION +(ZN) I-EXPLORATION +y I-EXPLORATION +azul I-EXPLORATION +alciano I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -cultivo I-EXPLORATION +Laboratorio I-EXPLORATION +de I-EXPLORATION +Patología I-EXPLORATION +Interfacultades I-EXPLORATION de I-EXPLORATION -PAAF I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION la I-EXPLORATION -biopsia I-EXPLORATION -cutánea. I-EXPLORATION -La I-EXPLORATION -radiografía I-EXPLORATION +Universidad I-EXPLORATION +Nacional I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION +Colombia, I-EXPLORATION +acorde I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +metodología I-EXPLORATION +adaptada I-EXPLORATION +del I-EXPLORATION +Armed I-EXPLORATION +Forces I-EXPLORATION +Institute I-EXPLORATION +of I-EXPLORATION +Pathology I-EXPLORATION +(AFIP) I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +Estados I-EXPLORATION +Unidos I-EXPLORATION +(10), I-EXPLORATION y I-EXPLORATION +se I-EXPLORATION +demostró I-EXPLORATION la I-EXPLORATION -tomografía I-EXPLORATION -computarizada I-EXPLORATION -(TC) I-EXPLORATION +secreción I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -fueron I-EXPLORATION -normales, I-EXPLORATION +mucoproteínas I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +luz I-EXPLORATION y I-EXPLORATION +mínimo I-EXPLORATION +componente I-EXPLORATION +intracitoplasmático I-EXPLORATION +; I-EXPLORATION +igualmente, I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +pigmento I-EXPLORATION +pardo I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +citoplasma I-EXPLORATION +celular. I-EXPLORATION + I-EXPLORATION +Para I-EXPLORATION las I-EXPLORATION -baciloscopias I-EXPLORATION -y I-EXPLORATION -cultivos I-EXPLORATION +tinciones I-EXPLORATION de I-EXPLORATION -jugo I-EXPLORATION -gástrico, I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunitario I-EXPLORATION -(con I-EXPLORATION -detección I-EXPLORATION +inmunohistoquímica, I-EXPLORATION +se I-EXPLORATION +empleó I-EXPLORATION +la I-EXPLORATION +metodología I-EXPLORATION +propia I-EXPLORATION +del I-EXPLORATION +Laboratorio I-EXPLORATION +de I-EXPLORATION +Patología I-EXPLORATION +Interfacultades I-EXPLORATION de I-EXPLORATION -inmunoglobulinas, I-EXPLORATION -inmunidad I-EXPLORATION -celular I-EXPLORATION -y I-EXPLORATION la I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -virus I-EXPLORATION +Universidad I-EXPLORATION +Nacional I-EXPLORATION +de I-EXPLORATION +Colombia, I-EXPLORATION +adaptada I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +insertos I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +reactivos. I-EXPLORATION +Previa I-EXPLORATION +inhibición I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana) I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -terapia I-TREATMENT -antituberculosa I-TREATMENT -(isoniazida, I-TREATMENT -rifampicina I-TREATMENT -y I-TREATMENT -pirazinamida). I-TREATMENT -Esta I-TREATMENT -tuvo I-TREATMENT -que I-TREATMENT -ser I-TREATMENT -sustituida I-TREATMENT -por I-TREATMENT -etambutol I-TREATMENT -tras I-TREATMENT -la I-TREATMENT -aparición I-TREATMENT -de I-TREATMENT -un I-TREATMENT -exantema I-TREATMENT -cutáneo I-TREATMENT -pruriginoso I-TREATMENT -presuntamente I-TREATMENT -causado I-TREATMENT -por I-TREATMENT -pirazinamida I-TREATMENT -y I-TREATMENT -que I-TREATMENT -desapareció I-TREATMENT -tras I-TREATMENT -su I-TREATMENT -retirada. I-TREATMENT -Un B-EVOLUTION -mes I-EVOLUTION -después I-EVOLUTION -aparecieron I-EVOLUTION -dos I-EVOLUTION -fístulas I-EVOLUTION -cutáneas I-EVOLUTION -profundas, I-EVOLUTION -que B-TREATMENT -requirieron I-TREATMENT -desbridamiento I-TREATMENT -quirúrgico. I-TREATMENT -Tras B-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -se I-EVOLUTION -resolvieron I-EVOLUTION -la I-EVOLUTION -escrófula I-EVOLUTION -cutánea I-EVOLUTION -y I-EVOLUTION -las I-EVOLUTION -adenopatías I-EVOLUTION -inguinales. I-EVOLUTION -No B-EXPLORATION +actividad I-EXPLORATION +peroxidasa I-EXPLORATION +endógena I-EXPLORATION +con I-EXPLORATION +H2O2 I-EXPLORATION +al I-EXPLORATION +3%, I-EXPLORATION se I-EXPLORATION -detectó I-EXPLORATION -contacto I-EXPLORATION +hizo I-EXPLORATION +la I-EXPLORATION +recuperación I-EXPLORATION +antigénica I-EXPLORATION +en I-EXPLORATION +Target I-EXPLORATION +10x I-EXPLORATION +(Dako®) I-EXPLORATION +y I-EXPLORATION +lavados I-EXPLORATION +seriados I-EXPLORATION con I-EXPLORATION -paciente I-EXPLORATION -bacilífero I-EXPLORATION +TBS, I-EXPLORATION +se I-EXPLORATION +incubó I-EXPLORATION +por I-EXPLORATION +30 I-EXPLORATION +minutos I-EXPLORATION +con I-EXPLORATION +cromogranín I-EXPLORATION +A I-EXPLORATION +en I-EXPLORATION +dilución I-EXPLORATION +1: I-EXPLORATION +200 I-EXPLORATION +(Novocastra®) I-EXPLORATION +y I-EXPLORATION +RTU-S100p I-EXPLORATION +prediluida I-EXPLORATION +(Novocastra®), I-EXPLORATION y I-EXPLORATION +se I-EXPLORATION +valoró I-EXPLORATION +la I-EXPLORATION +reactividad I-EXPLORATION +con I-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION -familiar I-EXPLORATION +sistema I-EXPLORATION +de I-EXPLORATION +estreptavidina-HRP I-EXPLORATION +(Dako®), I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +cual I-EXPLORATION +se I-EXPLORATION +usó I-EXPLORATION +como I-EXPLORATION +cromógeno I-EXPLORATION +diaminobencidina I-EXPLORATION +(DAB). I-EXPLORATION +Luego I-EXPLORATION +del I-EXPLORATION +montaje I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +láminas, I-EXPLORATION +se I-EXPLORATION +pudo I-EXPLORATION +demostrar I-EXPLORATION +la I-EXPLORATION +positividad, I-EXPLORATION +tanto I-EXPLORATION +de I-EXPLORATION +cromogranina I-EXPLORATION +como I-EXPLORATION +de I-EXPLORATION +S100 I-EXPLORATION con I-EXPLORATION -prueba I-EXPLORATION +intensidad I-EXPLORATION +leve I-EXPLORATION +a I-EXPLORATION +moderada, I-EXPLORATION +en I-EXPLORATION +todos I-EXPLORATION +los I-EXPLORATION +patrones I-EXPLORATION +observados I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +lesión. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +evidenció I-EXPLORATION +patrón I-EXPLORATION de I-EXPLORATION -Mantoux I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION +células I-EXPLORATION +mioepiteliales I-EXPLORATION +con I-EXPLORATION +S100. I-EXPLORATION I-EXPLORATION -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -niña I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -nueve I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -salud I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -cervical I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -fiebre. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -antecedente, I-PAST_MEDICAL_HISTORY -destaca I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -traumatismo I-PAST_MEDICAL_HISTORY -directo I-PAST_MEDICAL_HISTORY +39 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +mestiza, B-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +ingresó I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +primera I-PAST_MEDICAL_HISTORY +vez I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -misma I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -semana I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY +febrero I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +1999 I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +nuestro I-PAST_MEDICAL_HISTORY +hospital. I-PAST_MEDICAL_HISTORY +Desde I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +diez I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +comenzado I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +presentar I-PAST_MEDICAL_HISTORY +dolor I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +rodillas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tobillos, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +aparentes I-PAST_MEDICAL_HISTORY +signos I-PAST_MEDICAL_HISTORY +inflamatorios, I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +aliviaban I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -manillar I-PAST_MEDICAL_HISTORY +Indometacina I-PAST_MEDICAL_HISTORY +y, I-PAST_MEDICAL_HISTORY +además I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +acompañaba I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +astenia. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +provincia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY +origen I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +ingresado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +varias I-PAST_MEDICAL_HISTORY +ocasiones I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +llegara I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY un I-PAST_MEDICAL_HISTORY -patinete. I-PAST_MEDICAL_HISTORY -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -presenta I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION +diagnóstico I-PAST_MEDICAL_HISTORY +etiológico. I-PAST_MEDICAL_HISTORY +Este B-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +articular I-PRESENT_ILLNESS +evolucionaba I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +episodios, I-PRESENT_ILLNESS +acompañándose I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +anemia I-PRESENT_ILLNESS +comprobada. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +El B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +sólo I-EXPLORATION +mostró I-EXPLORATION +palidez I-EXPLORATION de I-EXPLORATION -4 I-EXPLORATION +las I-EXPLORATION +mucosas, I-EXPLORATION +ligero I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +ambos I-EXPLORATION +tobillos, I-EXPLORATION +adenopatía I-EXPLORATION +de I-EXPLORATION +1 I-EXPLORATION cm, I-EXPLORATION -blanda I-EXPLORATION -y I-EXPLORATION -móvil, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -inflamatorios I-EXPLORATION -adyacentes I-EXPLORATION +movible I-EXPLORATION y I-EXPLORATION -dolorosa I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación. I-EXPLORATION -Es B-TREATMENT -diagnosticada I-TREATMENT -de I-TREATMENT -adenitis I-TREATMENT -laterocervical, I-TREATMENT -iniciando I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -amoxicilina-clavulánico I-TREATMENT -oral. I-TREATMENT - I-TREATMENT -Tras B-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -semana I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -revisada I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -consulta, I-DERIVED_FROM/TO -persistiendo I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -dolor I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -tumoración, I-DERIVED_FROM/TO -esta I-DERIVED_FROM/TO -vez I-DERIVED_FROM/TO -indurada, I-DERIVED_FROM/TO -sin I-DERIVED_FROM/TO -otros I-DERIVED_FROM/TO -síntomas I-DERIVED_FROM/TO -acompañantes, I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -lo I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -Urgencias I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -hospital I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -referencia, I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -le I-DERIVED_FROM/TO -realiza I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -ecografía I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -visualiza I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -lesión I-DERIVED_FROM/TO -abscesificada I-DERIVED_FROM/TO -subyacente I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -músculo I-DERIVED_FROM/TO -esternocleidomastoideo I-DERIVED_FROM/TO -(ECM), I-DERIVED_FROM/TO -decidiéndose I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -ingreso I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -administrar I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -antibiótico I-DERIVED_FROM/TO -intravenoso. I-DERIVED_FROM/TO -Reexplorando B-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -paciente, I-EXPLORATION -se I-EXPLORATION -palpa I-EXPLORATION +elástica I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +inguinal I-EXPLORATION +derecha. I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -músculo I-EXPLORATION -ECM I-EXPLORATION -izquierdo I-EXPLORATION -engrosado I-EXPLORATION +primer I-EXPLORATION +ingreso I-EXPLORATION +fueron I-EXPLORATION +los I-EXPLORATION +siguientes: I-EXPLORATION +hemoglobina I-EXPLORATION +98 I-EXPLORATION +g/l, I-EXPLORATION +hematocrito I-EXPLORATION +30 I-EXPLORATION +vol%, I-EXPLORATION +leucograma I-EXPLORATION +y I-EXPLORATION +plaquetas I-EXPLORATION +normales, I-EXPLORATION +reticolocitos, I-EXPLORATION +glucemias, I-EXPLORATION +creatinina, I-EXPLORATION +TGO I-EXPLORATION +y I-EXPLORATION +TGP, I-EXPLORATION +fosfatasa I-EXPLORATION +alcalina, I-EXPLORATION +TP I-EXPLORATION +y I-EXPLORATION +TPT, I-EXPLORATION +todos I-EXPLORATION +dentro I-EXPLORATION +de I-EXPLORATION +límites I-EXPLORATION +normales. I-EXPLORATION +La I-EXPLORATION +electroforesis I-EXPLORATION +de I-EXPLORATION +proteínas I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +hipergammaglobulinemia I-EXPLORATION +32, I-EXPLORATION +85 I-EXPLORATION +g/l, I-EXPLORATION +eritrosedimentación I-EXPLORATION +115 I-EXPLORATION +mm/h I-EXPLORATION +y I-EXPLORATION +106 I-EXPLORATION en I-EXPLORATION -toda I-EXPLORATION -su I-EXPLORATION -extensión, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -repetir I-EXPLORATION la I-EXPLORATION -ecografía I-EXPLORATION -cervical I-EXPLORATION -de I-EXPLORATION -forma I-EXPLORATION -bilateral. I-EXPLORATION +segunda I-EXPLORATION +oportunidad. I-EXPLORATION El I-EXPLORATION -informe I-EXPLORATION -indica I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +ultrasonido I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -engrosamiento I-EXPLORATION -del I-EXPLORATION -músculo I-EXPLORATION -ECM I-EXPLORATION -izquierdo I-EXPLORATION -con I-EXPLORATION -respecto I-EXPLORATION -al I-EXPLORATION -derecho, I-EXPLORATION +hemiabdomen I-EXPLORATION +superior I-EXPLORATION +no I-EXPLORATION +demostró I-EXPLORATION +ninguna I-EXPLORATION +alteración. I-EXPLORATION + I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +sin I-EVOLUTION +diagnóstico I-EVOLUTION +preciso. I-EVOLUTION +Reingresa I-EVOLUTION +en I-EVOLUTION +enero I-EVOLUTION +del I-EVOLUTION +2004 I-EVOLUTION +por I-EVOLUTION +astenia I-EVOLUTION +y I-EVOLUTION +fiebre I-EVOLUTION +de I-EVOLUTION +38 I-EVOLUTION +a I-EVOLUTION +39 I-EVOLUTION +ºC I-EVOLUTION +en I-EVOLUTION +forma I-EVOLUTION +periódica I-EVOLUTION +de I-EVOLUTION +una I-EVOLUTION +semana I-EVOLUTION +de I-EVOLUTION +duración I-EVOLUTION +con I-EVOLUTION +intervalos I-EVOLUTION +de I-EVOLUTION +remisiones I-EVOLUTION +espontáneas I-EVOLUTION +cada I-EVOLUTION +dos I-EVOLUTION +o I-EVOLUTION +tres I-EVOLUTION +meses. I-EVOLUTION +Mantenía I-EVOLUTION +dolores I-EVOLUTION +articulares I-EVOLUTION +en I-EVOLUTION +rodillas I-EVOLUTION +y I-EVOLUTION +tobillos I-EVOLUTION +que I-EVOLUTION +mejoraban I-EVOLUTION +con I-EVOLUTION +medicamentos I-EVOLUTION +antinflamatorios I-EVOLUTION +no I-EVOLUTION +esteroideos. I-EVOLUTION + I-EVOLUTION +El B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +demostró I-EXPLORATION +una I-EXPLORATION +adenopatía I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +supraclavicular I-EXPLORATION +derecha I-EXPLORATION +de I-EXPLORATION +unos I-EXPLORATION +2 I-EXPLORATION +cm, I-EXPLORATION +de I-EXPLORATION +consistencia I-EXPLORATION +elástica I-EXPLORATION +y I-EXPLORATION +fija I-EXPLORATION +a I-EXPLORATION +planos I-EXPLORATION +profundos. I-EXPLORATION + I-EXPLORATION +Exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio: I-EXPLORATION +hemoglobina I-EXPLORATION +110 I-EXPLORATION +g/l, I-EXPLORATION +eritrosedimentación I-EXPLORATION +130 I-EXPLORATION +mm/h, I-EXPLORATION +hipergammaglobulinemia I-EXPLORATION +policlonal I-EXPLORATION +de I-EXPLORATION +36 I-EXPLORATION +g/l; I-EXPLORATION +medulograma: I-EXPLORATION +médula I-EXPLORATION +reactiva I-EXPLORATION con I-EXPLORATION -alteración I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -ecogenicidad, I-EXPLORATION -visualizándose I-EXPLORATION -dos I-EXPLORATION -focos I-EXPLORATION -hipoecoicos I-EXPLORATION -intramusculares I-EXPLORATION -compatibles I-EXPLORATION +plasmocitos. I-EXPLORATION +Ultrasonido I-EXPLORATION +de I-EXPLORATION +abdomen: I-EXPLORATION +ligera I-EXPLORATION +hepatomegalia I-EXPLORATION +difusa I-EXPLORATION con I-EXPLORATION -piomiositis, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +ecorrefringencia; I-EXPLORATION +placa I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -absceso I-EXPLORATION -subyacente I-EXPLORATION +tórax: I-EXPLORATION +ensanchamiento I-EXPLORATION +del I-EXPLORATION +contorno I-EXPLORATION +superior I-EXPLORATION +derecho I-EXPLORATION +del I-EXPLORATION +mediastino; I-EXPLORATION +TAC I-EXPLORATION de I-EXPLORATION -1, I-EXPLORATION -6 I-EXPLORATION -× I-EXPLORATION -2, I-EXPLORATION -7 I-EXPLORATION -cm. I-EXPLORATION - I-EXPLORATION -La B-TREATMENT -paciente I-TREATMENT -permanece I-TREATMENT -en I-TREATMENT -tratamiento I-TREATMENT -intravenoso I-TREATMENT -con I-TREATMENT -cloxacilina I-TREATMENT -y I-TREATMENT -clindamicina I-TREATMENT -durante I-TREATMENT -siete I-TREATMENT -días, I-TREATMENT -presentando I-TREATMENT -una I-TREATMENT -mejoría I-TREATMENT -progresiva I-TREATMENT -de I-TREATMENT -la I-TREATMENT -clínica, I-TREATMENT -y I-TREATMENT -se I-TREATMENT -da I-TREATMENT -de I-TREATMENT -alta I-TREATMENT -en I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -clindamicina I-TREATMENT -oral. I-TREATMENT - I-TREATMENT -La B-EXPLORATION -paciente I-EXPLORATION -es I-EXPLORATION -nuevamente I-EXPLORATION -revisada I-EXPLORATION +mediastino: I-EXPLORATION +adenomegalia I-EXPLORATION en I-EXPLORATION -consulta I-EXPLORATION -15 I-EXPLORATION -días I-EXPLORATION -después, I-EXPLORATION -presentando I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -la I-EXPLORATION -persistencia I-EXPLORATION +mediastino I-EXPLORATION +superior I-EXPLORATION +derecho, I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -tumoración I-EXPLORATION -cervical I-EXPLORATION -izquierda, I-EXPLORATION -aunque I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -menor I-EXPLORATION -tamaño. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realiza I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -ecografía I-EXPLORATION -cervical I-EXPLORATION -bilateral I-EXPLORATION -donde I-EXPLORATION -ya I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -datos I-EXPLORATION -sugestivos I-EXPLORATION +diámetro, I-EXPLORATION +sin I-EXPLORATION +alteraciones I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +campos I-EXPLORATION +pulmonares. I-EXPLORATION + I-EXPLORATION +Biopsia I-EXPLORATION +de I-EXPLORATION +ganglio I-EXPLORATION +linfático I-EXPLORATION +cervical: I-EXPLORATION +pérdida I-EXPLORATION +parcial I-EXPLORATION de I-EXPLORATION -piomiositis, I-EXPLORATION -pero I-EXPLORATION -sí I-EXPLORATION la I-EXPLORATION -persistencia I-EXPLORATION -del I-EXPLORATION -absceso I-EXPLORATION -subyacente I-EXPLORATION -al I-EXPLORATION -músculo, I-EXPLORATION -aunque I-EXPLORATION +arquitectura I-EXPLORATION con I-EXPLORATION -una I-EXPLORATION -reducción I-EXPLORATION -significativa I-EXPLORATION +hiperplasia I-EXPLORATION +linfoide I-EXPLORATION +focal I-EXPLORATION +marcada I-EXPLORATION +y I-EXPLORATION +expansión I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -tamaño. I-EXPLORATION -Se B-EVOLUTION -mantiene I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -durante I-EVOLUTION -cuatro I-EVOLUTION -semanas, I-EVOLUTION -presentando I-EVOLUTION -buena I-EVOLUTION -evolución I-EVOLUTION -hasta I-EVOLUTION -la I-EVOLUTION -total I-EVOLUTION -resolución I-EVOLUTION -del I-EVOLUTION -cuadro. I-EVOLUTION +la I-EXPLORATION +zona I-EXPLORATION +interfolicular, I-EXPLORATION +ocupada I-EXPLORATION +por I-EXPLORATION +abundantes I-EXPLORATION +plasmocitos I-EXPLORATION +y I-EXPLORATION +cuerpos I-EXPLORATION +de I-EXPLORATION +Russel. I-EXPLORATION + I-EXPLORATION +Inmunohistoquímica: I-EXPLORATION +CD20 I-EXPLORATION +positivo I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +linfoides I-EXPLORATION +T, I-EXPLORATION +kappa I-EXPLORATION +y I-EXPLORATION +lambda I-EXPLORATION +positivo I-EXPLORATION +en I-EXPLORATION +plasmocitos. I-EXPLORATION + I-EXPLORATION +Conclusiones: I-EXPLORATION +EC I-EXPLORATION +plasmocelular. I-EXPLORATION +El B-TREATMENT +tratamiento I-TREATMENT +consistió I-TREATMENT +en I-TREATMENT +un I-TREATMENT +esquema I-TREATMENT +de I-TREATMENT +poliquimioterapia I-TREATMENT +con I-TREATMENT +adriamicina, I-TREATMENT +vincristina, I-TREATMENT +bleomicina I-TREATMENT +y I-TREATMENT +prednisona I-TREATMENT +y B-EVOLUTION +fue I-EVOLUTION +egresada I-EVOLUTION +para I-EVOLUTION +seguimiento I-EVOLUTION +ambulatorio. I-EVOLUTION I-EVOLUTION -Niño B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -asma I-PAST_MEDICAL_HISTORY -bronquial I-PAST_MEDICAL_HISTORY -intermitente I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY +40 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +HIV+, B-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +4 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +embarazo I-PAST_MEDICAL_HISTORY +(único I-PAST_MEDICAL_HISTORY +momento I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +recibió I-PAST_MEDICAL_HISTORY tratamiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -base, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Pediatría I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -salud I-PRESENT_ILLNESS +antirretroviral), I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +acude B-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -brusca I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -edema I-PRESENT_ILLNESS -cervical, I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -torácico I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -esa I-PRESENT_ILLNESS -mañana I-PRESENT_ILLNESS -(aproximadamente I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +insuficiencia I-PRESENT_ILLNESS +respiratoria I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución), I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -contexto I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -crisis I-PRESENT_ILLNESS -asmática I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -niño I-PRESENT_ILLNESS -estaba I-PRESENT_ILLNESS -tratando I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -salbutamol I-PRESENT_ILLNESS -inhalado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -domicilio. I-PRESENT_ILLNESS -A B-EXPLORATION -su I-EXPLORATION -llegada I-EXPLORATION -presenta I-EXPLORATION -un I-EXPLORATION -regular I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -palidez I-EXPLORATION -cutánea, I-EXPLORATION -taquipnea I-EXPLORATION -y I-EXPLORATION -tiraje I-EXPLORATION -intercostal; I-EXPLORATION -con I-EXPLORATION -hipoventilación I-EXPLORATION -generalizada I-EXPLORATION -en I-EXPLORATION +evolución. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION -auscultación. I-EXPLORATION -Se I-EXPLORATION -observa I-EXPLORATION -un I-EXPLORATION -edema I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -cervical I-EXPLORATION -bilateral, I-EXPLORATION -con I-EXPLORATION -crepitación I-EXPLORATION +exploración I-EXPLORATION +inicial I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +tos I-EXPLORATION +seca, I-EXPLORATION +crepitantes I-EXPLORATION en I-EXPLORATION -dicha I-EXPLORATION -zona. I-EXPLORATION -Ante B-TREATMENT -crisis I-TREATMENT -asmática I-TREATMENT -con I-TREATMENT -score I-TREATMENT -moderado I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -broncodilatador I-TREATMENT -y I-TREATMENT -corticoideo I-TREATMENT -y B-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -deriva I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -Urgencias I-DERIVED_FROM/TO -hospitalarias. I-DERIVED_FROM/TO -Allí B-EXPLORATION -realizan I-EXPLORATION +ambas I-EXPLORATION +bases I-EXPLORATION +y I-EXPLORATION +febrícula. I-EXPLORATION +La B-FAMILY_HISTORY +paciente I-FAMILY_HISTORY +no I-FAMILY_HISTORY +presentó I-FAMILY_HISTORY +otros I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +de I-FAMILY_HISTORY +interés, I-FAMILY_HISTORY +enfermedades I-FAMILY_HISTORY +respiratorias I-FAMILY_HISTORY +en I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +cercanos, I-FAMILY_HISTORY +ni I-FAMILY_HISTORY +viajes I-FAMILY_HISTORY +recientes. I-FAMILY_HISTORY +No B-EXPLORATION +se I-EXPLORATION +evidenciaron I-EXPLORATION +adenomegalias, I-EXPLORATION +insuficiencia I-EXPLORATION +cardiaca I-EXPLORATION +o I-EXPLORATION +troboembolismo I-EXPLORATION +venoso I-EXPLORATION +profundo. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +último I-EXPLORATION +control, I-EXPLORATION +6 I-EXPLORATION +meses I-EXPLORATION +previos I-EXPLORATION +al I-EXPLORATION +ingreso, I-EXPLORATION +presentó I-EXPLORATION +49 I-EXPLORATION +5 I-EXPLORATION +x I-EXPLORATION +106/L I-EXPLORATION +CD4 I-EXPLORATION +(33%) I-EXPLORATION +y I-EXPLORATION una I-EXPLORATION +carga I-EXPLORATION +viral I-EXPLORATION +de I-EXPLORATION +51.000 I-EXPLORATION +copias. I-EXPLORATION +Al I-EXPLORATION +ingreso, I-EXPLORATION +estas I-EXPLORATION +cifras I-EXPLORATION +fueron I-EXPLORATION +de I-EXPLORATION +129 I-EXPLORATION +x I-EXPLORATION +106/L I-EXPLORATION +CD4 I-EXPLORATION +(16%) I-EXPLORATION +y I-EXPLORATION +330.000 I-EXPLORATION +copias. I-EXPLORATION + I-EXPLORATION +La B-EVOLUTION +evolución I-EVOLUTION +inicial I-EVOLUTION +fue I-EVOLUTION +tórpida, I-EVOLUTION +con I-EVOLUTION +dificultad I-EVOLUTION +respiratoria I-EVOLUTION +progresiva. I-EVOLUTION +La B-EXPLORATION radiografía I-EXPLORATION de I-EXPLORATION -tórax, I-EXPLORATION -encontrando I-EXPLORATION -neumomediastino I-EXPLORATION +tórax I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +patrón I-EXPLORATION +reticular-intersticial, I-EXPLORATION y I-EXPLORATION +la I-EXPLORATION +gammagrafía I-EXPLORATION +pulmonar I-EXPLORATION +descartó I-EXPLORATION un I-EXPLORATION -enfisema I-EXPLORATION -subcutáneo I-EXPLORATION -torácico I-EXPLORATION +tromboembolismo I-EXPLORATION +pulmonar. I-EXPLORATION +Se I-EXPLORATION +recogieron I-EXPLORATION +muestras I-EXPLORATION +de I-EXPLORATION +esputo I-EXPLORATION y I-EXPLORATION -cervical, I-EXPLORATION -sin I-EXPLORATION -neumotórax. I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +fibrobroncoscopia I-EXPLORATION +con I-EXPLORATION +lavado I-EXPLORATION +broncoalveolar I-EXPLORATION +(BAL). I-EXPLORATION Se B-TREATMENT -pauta I-TREATMENT -analgesia I-TREATMENT -y I-TREATMENT +inició I-TREATMENT +cotrimoxazol I-TREATMENT ++ I-TREATMENT +levofloxacino I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +intravenosa, I-TREATMENT +pero I-TREATMENT +ante I-TREATMENT +el I-TREATMENT +hallazgo I-TREATMENT +posterior I-TREATMENT +de I-TREATMENT +P. I-TREATMENT +jirovecii I-TREATMENT +en I-TREATMENT +el I-TREATMENT +BAL, I-TREATMENT +se I-TREATMENT +retiró I-TREATMENT +la I-TREATMENT +quinolona. I-TREATMENT +A B-EVOLUTION +las I-EVOLUTION +24 I-EVOLUTION +h I-EVOLUTION +del I-EVOLUTION +inicio I-EVOLUTION +del I-EVOLUTION +tratamiento I-EVOLUTION +antibiótico I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +mejoró I-EVOLUTION +notablemente, I-EVOLUTION +disminuyó I-EVOLUTION +la I-EVOLUTION +demanda I-EVOLUTION +de I-EVOLUTION +O2 I-EVOLUTION +y B-TREATMENT +en I-TREATMENT +el I-TREATMENT +sexto I-TREATMENT +día I-TREATMENT +se I-TREATMENT +pasó I-TREATMENT +el I-TREATMENT tratamiento I-TREATMENT -con I-TREATMENT -oxígeno, I-TREATMENT -broncodilatadores I-TREATMENT +a I-TREATMENT +vía I-TREATMENT +oral. I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +11 I-EVOLUTION +días, I-EVOLUTION +apareció I-EVOLUTION +una I-EVOLUTION +erupción I-EVOLUTION +cutánea I-EVOLUTION +eritematosa I-EVOLUTION +en I-EVOLUTION +espalda I-EVOLUTION +y I-EVOLUTION +cuello, I-EVOLUTION +no I-EVOLUTION +pruriginosa, I-EVOLUTION +junto I-EVOLUTION +con I-EVOLUTION +fiebre I-EVOLUTION +de I-EVOLUTION +39o I-EVOLUTION +C. I-EVOLUTION +Ante B-TREATMENT +el I-TREATMENT +cuadro I-TREATMENT +sugestivo I-TREATMENT +de I-TREATMENT +reacción I-TREATMENT +alérgica I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT +la I-TREATMENT +administración I-TREATMENT +de I-TREATMENT +cotrimoxazol I-TREATMENT y I-TREATMENT -prednisona I-TREATMENT -oral; I-TREATMENT -experimentó B-EVOLUTION -mejoría I-EVOLUTION -progresiva, I-EVOLUTION -dándole I-EVOLUTION +se I-TREATMENT +pasó I-TREATMENT +a I-TREATMENT +pentamidina I-TREATMENT +IV. I-TREATMENT +Sin I-TREATMENT +embargo, I-TREATMENT +ante I-TREATMENT +la I-TREATMENT +buena I-TREATMENT +evolución I-TREATMENT +de I-TREATMENT +la I-TREATMENT +neumonía I-TREATMENT +y I-TREATMENT +la I-TREATMENT +desaparición I-TREATMENT +del I-TREATMENT +rash I-TREATMENT +y I-TREATMENT +la I-TREATMENT +fiebre I-TREATMENT +a I-TREATMENT +las I-TREATMENT +48 I-TREATMENT +h, I-TREATMENT +se I-TREATMENT +valoró I-TREATMENT +la I-TREATMENT +posibilidad I-TREATMENT +de I-TREATMENT +administrar I-TREATMENT +trimetroprim I-TREATMENT +y I-TREATMENT +dapsona I-TREATMENT +oral, I-TREATMENT +como I-TREATMENT +alternativa I-TREATMENT +a I-TREATMENT +cotrimoxazol, I-TREATMENT +con I-TREATMENT +el I-TREATMENT +objetivo I-TREATMENT +de I-TREATMENT +plantear I-TREATMENT +la I-TREATMENT +continuación I-TREATMENT +del I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +ambulatoria. I-TREATMENT +Sin B-EVOLUTION +embargo, I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +24 I-EVOLUTION +h I-EVOLUTION de I-EVOLUTION -alta I-EVOLUTION -cuatro I-EVOLUTION -días I-EVOLUTION -después. I-EVOLUTION - I-EVOLUTION +la I-EVOLUTION +administración I-EVOLUTION +de I-EVOLUTION +dapsona, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +volvió I-EVOLUTION +a I-EVOLUTION +presentar I-EVOLUTION +el I-EVOLUTION +rash I-EVOLUTION +morbiliforme I-EVOLUTION +y B-TREATMENT +fiebre, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +retiró I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +oral I-TREATMENT +y I-TREATMENT +finalizó I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +pentamidina I-TREATMENT +IV I-TREATMENT +hasta I-TREATMENT +completar I-TREATMENT +21 I-TREATMENT +días. I-TREATMENT + I-TREATMENT -Se B-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -clínico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -niña I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -siete I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés, I-FAMILY_HISTORY -salvo I-FAMILY_HISTORY -un I-FAMILY_HISTORY -caso I-FAMILY_HISTORY -de I-FAMILY_HISTORY -liquen I-FAMILY_HISTORY -plano I-FAMILY_HISTORY -cutáneo I-FAMILY_HISTORY -en I-FAMILY_HISTORY -el I-FAMILY_HISTORY -padre I-FAMILY_HISTORY -años I-FAMILY_HISTORY -antes. I-FAMILY_HISTORY -No B-PAST_MEDICAL_HISTORY -hay I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -salvo I-PAST_MEDICAL_HISTORY -estreñimiento I-PAST_MEDICAL_HISTORY -funcional I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -dermatitis I-PAST_MEDICAL_HISTORY -atópica I-PAST_MEDICAL_HISTORY -leve. I-PAST_MEDICAL_HISTORY -Consulta B-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -ungueales I-PRESENT_ILLNESS -(piqueteado, I-PRESENT_ILLNESS -líneas I-PRESENT_ILLNESS -transversales, I-PRESENT_ILLNESS -descamación I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -uñas I-PRESENT_ILLNESS -quebradizas) I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +cuyo I-PRESENT_ILLNESS +aspecto I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -algunas I-PRESENT_ILLNESS -uñas I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +momento I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +diagnóstico I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +muestra I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +Figura I-PRESENT_ILLNESS +1; I-PRESENT_ILLNESS +además I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -manos I-PRESENT_ILLNESS +alteraciones I-PRESENT_ILLNESS +dermatológicas, I-PRESENT_ILLNESS +marcado I-PRESENT_ILLNESS +plexo I-PRESENT_ILLNESS +venoso I-PRESENT_ILLNESS +subdérmico I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -pies, I-PRESENT_ILLNESS +asimetría I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -varios I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS +volumen, I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +refería I-PRESENT_ILLNESS +molestias I-PRESENT_ILLNESS +físicas, I-PRESENT_ILLNESS +psíquicas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dificultades I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +vestirse I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +realizar I-PRESENT_ILLNESS +ejercicios I-PRESENT_ILLNESS +físicos, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +hacían I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +situación I-PRESENT_ILLNESS +insostenible I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +desarrollo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Sin I-PRESENT_ILLNESS -traumatismo I-PRESENT_ILLNESS -referido. I-PRESENT_ILLNESS -No B-PAST_MEDICAL_HISTORY -tiene I-PAST_MEDICAL_HISTORY -hábito I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -chupeteado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dedos. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -hay I-PAST_MEDICAL_HISTORY -otras I-PAST_MEDICAL_HISTORY -lesiones I-PAST_MEDICAL_HISTORY -cutáneas I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -mucosas. I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -presenta I-PAST_MEDICAL_HISTORY -otra I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -asociada. I-PAST_MEDICAL_HISTORY -Refiere I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -dieta I-PAST_MEDICAL_HISTORY -variada, I-PAST_MEDICAL_HISTORY -aunque I-PAST_MEDICAL_HISTORY -algo I-PAST_MEDICAL_HISTORY -deficitaria I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -frutas. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Exploración B-EXPLORATION -clínica I-EXPLORATION -normal, I-EXPLORATION -salvo I-EXPLORATION +su I-PRESENT_ILLNESS +vida I-PRESENT_ILLNESS +cotidiana. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Se B-EXPLORATION +practicó I-EXPLORATION +examen I-EXPLORATION +anatomopatológico I-EXPLORATION +de I-EXPLORATION +biopsia I-EXPLORATION +obtenida I-EXPLORATION por I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -ungueales I-EXPLORATION -descritas; I-EXPLORATION -peso I-EXPLORATION -y I-EXPLORATION -talla I-EXPLORATION -en I-EXPLORATION -percentil I-EXPLORATION -50-75. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT +punción I-EXPLORATION +aspiración, I-EXPLORATION +encontrando I-EXPLORATION +una I-EXPLORATION +proliferación I-EXPLORATION +mamaria I-EXPLORATION +tisular I-EXPLORATION +tanto I-EXPLORATION +del I-EXPLORATION +estroma I-EXPLORATION +como I-EXPLORATION +del I-EXPLORATION +epitelio, I-EXPLORATION +con I-EXPLORATION +dificultad I-EXPLORATION +para I-EXPLORATION +diferenciarla I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +patrones I-EXPLORATION +de I-EXPLORATION +fibroadenoma I-EXPLORATION +filoides I-EXPLORATION +Las B-TREATMENT +propuestas I-TREATMENT +terapéuticas I-TREATMENT +hormonales I-TREATMENT +se I-TREATMENT +excluyeron, I-TREATMENT +como I-TREATMENT +ya I-TREATMENT +hemos I-TREATMENT +explicado, I-TREATMENT +por I-TREATMENT +sus I-TREATMENT +posibles I-TREATMENT +efectos I-TREATMENT +secundarios. I-TREATMENT +El I-TREATMENT tratamiento I-TREATMENT -con I-TREATMENT +realizado I-TREATMENT +consistió I-TREATMENT +en I-TREATMENT +una I-TREATMENT +mamoplastia I-TREATMENT +reductora I-TREATMENT +siguiendo I-TREATMENT +el I-TREATMENT +patrón I-TREATMENT +de I-TREATMENT +Wise I-TREATMENT +en I-TREATMENT +el I-TREATMENT +marcaje I-TREATMENT +dérmico; I-TREATMENT +tallamos I-TREATMENT un I-TREATMENT -polivitamínico I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT +amplio I-TREATMENT +colgajo I-TREATMENT +horizontal I-TREATMENT +bipediculado I-TREATMENT +cuya I-TREATMENT +desepidermización I-TREATMENT +se I-TREATMENT +aprovechó I-TREATMENT +para I-TREATMENT +disminuir I-TREATMENT +el I-TREATMENT +tamaño I-TREATMENT de I-TREATMENT -déficit I-TREATMENT -vitamínico, I-TREATMENT -pero I-TREATMENT -tras I-TREATMENT -dos I-TREATMENT -meses I-TREATMENT -seguían I-TREATMENT las I-TREATMENT -lesiones I-TREATMENT -sin I-TREATMENT -cambios. I-TREATMENT +areolas, I-TREATMENT +que I-TREATMENT +trasladamos I-TREATMENT +a I-TREATMENT +su I-TREATMENT +nueva I-TREATMENT +ubicación I-TREATMENT +conservando I-TREATMENT +la I-TREATMENT +sensibilidad I-TREATMENT +y I-TREATMENT +evitando I-TREATMENT +así I-TREATMENT +el I-TREATMENT +injerto I-TREATMENT +libre I-TREATMENT +tipo I-TREATMENT +Thoreck. I-TREATMENT I-TREATMENT -El B-DERIVED_FROM/TO -piqueteado I-DERIVED_FROM/TO -ungueal I-DERIVED_FROM/TO -nos I-DERIVED_FROM/TO -hacía I-DERIVED_FROM/TO -sospechar I-DERIVED_FROM/TO -varias I-DERIVED_FROM/TO -enfermedades I-DERIVED_FROM/TO -como I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -diferencial I-DERIVED_FROM/TO -(eccema, I-DERIVED_FROM/TO -psoriasis I-DERIVED_FROM/TO -ungueal, I-DERIVED_FROM/TO -liquen I-DERIVED_FROM/TO -plano I-DERIVED_FROM/TO -ungueal I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -alopecia I-DERIVED_FROM/TO -areata), I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -lo I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -fue I-DERIVED_FROM/TO -remitida I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -Dermatología I-DERIVED_FROM/TO +Empleamos I-TREATMENT +el I-TREATMENT +material I-TREATMENT +autólogo I-TREATMENT +de I-TREATMENT +los I-TREATMENT +colgajos I-TREATMENT +a I-TREATMENT +modo I-TREATMENT +de I-TREATMENT +relleno, I-TREATMENT +evitando I-TREATMENT +de I-TREATMENT +esta I-TREATMENT +manera I-TREATMENT +también I-TREATMENT +el I-TREATMENT +uso I-TREATMENT +de I-TREATMENT +prótesis. I-TREATMENT + I-TREATMENT +La I-TREATMENT +resección I-TREATMENT +en I-TREATMENT +la I-TREATMENT +mama I-TREATMENT +derecha I-TREATMENT +fue I-TREATMENT +de I-TREATMENT +1.050 I-TREATMENT +gr. I-TREATMENT +de I-TREATMENT +peso I-TREATMENT +y I-TREATMENT +en I-TREATMENT +la I-TREATMENT +izquierda I-TREATMENT +llegó I-TREATMENT +a I-TREATMENT +los I-TREATMENT +1.800 I-TREATMENT +gr. I-TREATMENT + I-TREATMENT +Colocamos I-TREATMENT +drenajes I-TREATMENT +en I-TREATMENT +ambas I-TREATMENT +mamas I-TREATMENT +que I-TREATMENT +fueron I-TREATMENT +retirados I-TREATMENT +a I-TREATMENT +las I-TREATMENT +48h. I-TREATMENT +y B-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +hospitalaria I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +buena I-EVOLUTION +evolución, I-EVOLUTION +sin I-EVOLUTION +complicaciones I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +mismo I-EVOLUTION +diagnóstico I-EVOLUTION +anatomopatológico I-EVOLUTION +de I-EVOLUTION +hipertrofia I-EVOLUTION +con I-EVOLUTION +patrón I-EVOLUTION +proliferativo I-EVOLUTION +del I-EVOLUTION +estroma I-EVOLUTION +y I-EVOLUTION +epitelio I-EVOLUTION +a I-EVOLUTION +modo I-EVOLUTION +de I-EVOLUTION +fibroadenoma I-EVOLUTION +filoides. I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +aspecto I-EVOLUTION +del I-EVOLUTION +resultado I-EVOLUTION +reciente, I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +pocos I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +intervención, I-EVOLUTION +podemos I-EVOLUTION +verlo I-EVOLUTION +en I-EVOLUTION +las I-EVOLUTION +Figuras I-EVOLUTION +3: I-EVOLUTION +en I-EVOLUTION +él I-EVOLUTION +se I-EVOLUTION +aprecian I-EVOLUTION +unas I-EVOLUTION +mamas I-EVOLUTION +voluminosas I-EVOLUTION +aun I-EVOLUTION +para I-EVOLUTION +el I-EVOLUTION +tamaño I-EVOLUTION +y I-EVOLUTION +edad I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +paciente, I-EVOLUTION +pero I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +diferencia I-EVOLUTION +notable I-EVOLUTION +respecto I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +situación I-EVOLUTION +previa. I-EVOLUTION + I-EVOLUTION +El I-EVOLUTION +resultado I-EVOLUTION +más I-EVOLUTION +tardío, I-EVOLUTION +ya I-EVOLUTION +con I-EVOLUTION +17 I-EVOLUTION +años I-EVOLUTION +y I-EVOLUTION +6 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +edad I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +paciente, I-EVOLUTION +presenta I-EVOLUTION +un I-EVOLUTION +tamaño I-EVOLUTION +y I-EVOLUTION +una I-EVOLUTION +forma I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +mamas I-EVOLUTION +más I-EVOLUTION +proporcionados I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +edad I-EVOLUTION +y I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +circunstancias I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +paciente; I-EVOLUTION +ha I-EVOLUTION +mejorado I-EVOLUTION +el I-EVOLUTION +aspecto I-EVOLUTION +dérmico I-EVOLUTION +y I-EVOLUTION +vascular I-EVOLUTION +de I-EVOLUTION +sus I-EVOLUTION +mamas I-EVOLUTION +y I-EVOLUTION +no I-EVOLUTION +ha I-EVOLUTION +habido I-EVOLUTION +recurrencia I-EVOLUTION +del I-EVOLUTION +cuadro, I-EVOLUTION +mantiene I-EVOLUTION +la I-EVOLUTION +sensibilidad I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +complejos I-EVOLUTION +areolares, I-EVOLUTION +las I-EVOLUTION +cicatrices I-EVOLUTION +son I-EVOLUTION +muy I-EVOLUTION +aceptables I-EVOLUTION +por I-EVOLUTION +su I-EVOLUTION +discreción I-EVOLUTION +y I-EVOLUTION +la I-EVOLUTION +satisfacción I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +le I-EVOLUTION +lleva I-EVOLUTION +a I-EVOLUTION +rechazar I-EVOLUTION +cualquier I-EVOLUTION +retoque I-EVOLUTION +de I-EVOLUTION +mejora. I-EVOLUTION + I-EVOLUTION + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +joven, I-PRESENT_ILLNESS +conductor I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +único I-PRESENT_ILLNESS +ocupante I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +turismo, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +sufre I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +salida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +calzada I-PRESENT_ILLNESS +cuando I-PRESENT_ILLNESS +circulaba I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +unos I-PRESENT_ILLNESS +100 I-PRESENT_ILLNESS +Km. I-PRESENT_ILLNESS +según I-PRESENT_ILLNESS +estimación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +Unidad I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Atestados I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +Guardia I-PRESENT_ILLNESS +Civil I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Tráfico. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +vehículo I-PRESENT_ILLNESS +choca I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +acequia I-PRESENT_ILLNESS +quedando I-PRESENT_ILLNESS +deformado I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +habitáculo, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +necesaria I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +excarceración I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +parte I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +Bomberos. I-PRESENT_ILLNESS +Según I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +mismas I-PRESENT_ILLNESS +fuentes I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +accidente I-PRESENT_ILLNESS +debió I-PRESENT_ILLNESS +ocurrir I-PRESENT_ILLNESS +sobre I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +1.45 I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +madrugada, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +hubiese I-PRESENT_ILLNESS +testigos I-PRESENT_ILLNESS +presenciales. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Ingresa B-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +UCI I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +Hospital I-DERIVED_FROM/TO +Regional I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +estado I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +coma I-DERIVED_FROM/TO +procedente I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +otro I-DERIVED_FROM/TO +Hospital I-DERIVED_FROM/TO para I-DERIVED_FROM/TO -valoración. I-DERIVED_FROM/TO -Fue B-EXPLORATION -diagnosticada I-EXPLORATION -inicialmente I-EXPLORATION -de I-EXPLORATION -sospecha I-EXPLORATION +su I-DERIVED_FROM/TO +valoración I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +parte I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Neurocirugía, I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +parecer I-DERIVED_FROM/TO +tras I-DERIVED_FROM/TO +haber I-DERIVED_FROM/TO +sufrido I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +TCE I-DERIVED_FROM/TO +severo I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +accidente I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +tráfico. I-DERIVED_FROM/TO +En B-EXPLORATION +los I-EXPLORATION +estudios I-EXPLORATION de I-EXPLORATION -dermatitis I-EXPLORATION +imagen I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +practican, I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -contacto I-EXPLORATION -o I-EXPLORATION -lesiones I-EXPLORATION -secundarias I-EXPLORATION +un I-EXPLORATION +hematoma I-EXPLORATION +con I-EXPLORATION +esquirlas I-EXPLORATION +óseas I-EXPLORATION a I-EXPLORATION -atopia. I-EXPLORATION -Se I-EXPLORATION -descartaron I-EXPLORATION -alergias, I-EXPLORATION -inclusive I-EXPLORATION +nivel I-EXPLORATION +temporal I-EXPLORATION +derecho I-EXPLORATION +e I-EXPLORATION +imagen I-EXPLORATION +de I-EXPLORATION +densidad I-EXPLORATION +metálica, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +proyectil I-EXPLORATION +de I-EXPLORATION +arma I-EXPLORATION +de I-EXPLORATION +fuego I-EXPLORATION a I-EXPLORATION -metales I-EXPLORATION -pesados I-EXPLORATION -y I-EXPLORATION -níquel. I-EXPLORATION - I-EXPLORATION +nivel I-EXPLORATION +contralateral. I-EXPLORATION Ante I-EXPLORATION +ello, I-EXPLORATION la I-EXPLORATION -ausencia I-EXPLORATION -de I-EXPLORATION -contacto I-EXPLORATION -con I-EXPLORATION -materiales I-EXPLORATION -o I-EXPLORATION -productos I-EXPLORATION +inspección I-EXPLORATION +evidencia I-EXPLORATION que I-EXPLORATION -le I-EXPLORATION -pudiesen I-EXPLORATION -causar I-EXPLORATION -dermatitis I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lecho I-EXPLORATION -ungueal, I-EXPLORATION -la I-EXPLORATION -ausencia I-EXPLORATION +presenta, I-EXPLORATION +tras I-EXPLORATION +rasurar I-EXPLORATION +los I-EXPLORATION +cabellos, I-EXPLORATION +un I-EXPLORATION +orifico I-EXPLORATION de I-EXPLORATION -lesiones I-EXPLORATION +aspecto I-EXPLORATION de I-EXPLORATION -atopia I-EXPLORATION +entrada I-EXPLORATION +de I-EXPLORATION +proyectil I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION +región I-EXPLORATION +parietal I-EXPLORATION +derecha, I-EXPLORATION +sin I-EXPLORATION +orifico I-EXPLORATION de I-EXPLORATION +salida. I-EXPLORATION + I-EXPLORATION +La B-EVOLUTION +evolución I-EVOLUTION +inmediata I-EVOLUTION +es I-EVOLUTION +hacia I-EVOLUTION +clínica I-EVOLUTION +de I-EVOLUTION +muerte I-EVOLUTION +encefálica, I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +confirma I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +correspondiente I-EVOLUTION +registro I-EVOLUTION +electroencefalográfico. I-EVOLUTION +Previa B-EXPLORATION +autorización I-EXPLORATION +judicial, I-EXPLORATION +se I-EXPLORATION +procede I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -consulta I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -persistencia I-EXPLORATION +extracción I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -lesiones, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -analítico I-EXPLORATION +órganos I-EXPLORATION para I-EXPLORATION -completar I-EXPLORATION -el I-EXPLORATION -estudio. I-EXPLORATION -Se I-EXPLORATION -analizó I-EXPLORATION -el I-EXPLORATION -metabolismo I-EXPLORATION -férrico, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -otros I-EXPLORATION -posibles I-EXPLORATION -déficits I-EXPLORATION -nutricionales I-EXPLORATION -(zinc, I-EXPLORATION -1-25 I-EXPLORATION -hidroxi-colecalciferol, I-EXPLORATION -vitaminas I-EXPLORATION -B12 I-EXPLORATION -y I-EXPLORATION -B6), I-EXPLORATION -tirotropina I-EXPLORATION -(TSH) I-EXPLORATION +trasplante I-EXPLORATION y I-EXPLORATION -tiroxina I-EXPLORATION -(T4), I-EXPLORATION -resultando I-EXPLORATION -todos I-EXPLORATION -normales. I-EXPLORATION +posteriormente I-EXPLORATION +se I-EXPLORATION +practica I-EXPLORATION +la I-EXPLORATION +autopsia I-EXPLORATION +forense. I-EXPLORATION + I-EXPLORATION +Hallazgos I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +autopsia I-EXPLORATION + I-EXPLORATION +Examen I-EXPLORATION +Externo: I-EXPLORATION + I-EXPLORATION Se I-EXPLORATION -solicitaron I-EXPLORATION -también I-EXPLORATION -parámetros I-EXPLORATION +trata I-EXPLORATION +del I-EXPLORATION +cadáver I-EXPLORATION de I-EXPLORATION -autoinmunidad I-EXPLORATION -ante I-EXPLORATION -la I-EXPLORATION -posibilidad I-EXPLORATION +un I-EXPLORATION +individuo I-EXPLORATION de I-EXPLORATION -psoriasis I-EXPLORATION -ungueal, I-EXPLORATION -siendo I-EXPLORATION -negativos I-EXPLORATION -el I-EXPLORATION -factor I-EXPLORATION -reumatoide I-EXPLORATION -y I-EXPLORATION -los I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -normalidad I-TREATMENT -de I-TREATMENT -los I-TREATMENT -resultados I-TREATMENT -analíticos I-TREATMENT -y I-TREATMENT -la I-TREATMENT -persistencia I-TREATMENT -de I-TREATMENT -las I-TREATMENT -lesiones, I-TREATMENT -que I-TREATMENT -hacían I-TREATMENT -sospechar I-TREATMENT -como I-TREATMENT -posibilidades I-TREATMENT -diagnósticas I-TREATMENT -la I-TREATMENT -psoriasis I-TREATMENT -ungueal, I-TREATMENT -sin I-TREATMENT -poder I-TREATMENT -descartar I-TREATMENT -un I-TREATMENT -liquen I-TREATMENT -plano I-TREATMENT -ungueal, I-TREATMENT -o I-TREATMENT -lesiones I-TREATMENT -de I-TREATMENT -eccema I-TREATMENT -ungueal, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -tazaroteno I-TREATMENT -tópico I-TREATMENT -(un I-TREATMENT -derivado I-TREATMENT -de I-TREATMENT -vitamina I-TREATMENT -A) I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -lámina I-TREATMENT -ungueal I-TREATMENT -durante I-TREATMENT -tres I-TREATMENT -meses. I-TREATMENT -Evolucionó B-EVOLUTION -favorablemente, I-EVOLUTION -normalizándose I-EVOLUTION -las I-EVOLUTION -lesiones I-EVOLUTION -ungueales. I-EVOLUTION - I-EVOLUTION - -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -Urgencias I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -días I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -autolimitados I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hipotermia I-PRESENT_ILLNESS -asociados I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -sudoración I-PRESENT_ILLNESS -fría I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -palidez I-PRESENT_ILLNESS -cutánea. I-PRESENT_ILLNESS -Ocurren I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -forma I-PRESENT_ILLNESS -diaria, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -duración I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -minutos I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -varias I-PRESENT_ILLNESS -horas, I-PRESENT_ILLNESS -siendo I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -frecuentes I-PRESENT_ILLNESS -durante I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -sueño. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -acompañan I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -movimientos I-PRESENT_ILLNESS -tónico-clónicos, I-PRESENT_ILLNESS -desconexión I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -medio, I-PRESENT_ILLNESS -relajación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -esfínteres I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -periodo I-PRESENT_ILLNESS -poscrítico. I-PRESENT_ILLNESS -Así I-PRESENT_ILLNESS -mismo I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -asocia I-PRESENT_ILLNESS -tiritona. I-PRESENT_ILLNESS -Entre I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -mantiene I-PRESENT_ILLNESS -asintomática. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Entre B-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -consta I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -sospecha I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -crisis I-PAST_MEDICAL_HISTORY -comicial I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -confirmada, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -ecografía I-PAST_MEDICAL_HISTORY -transfontanelar I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -electroencefalograma I-PAST_MEDICAL_HISTORY -(EEG) I-PAST_MEDICAL_HISTORY -normal. I-PAST_MEDICAL_HISTORY -No B-FAMILY_HISTORY -hay I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -de I-FAMILY_HISTORY -epilepsia I-FAMILY_HISTORY -familiar. I-FAMILY_HISTORY -Un I-FAMILY_HISTORY -tío I-FAMILY_HISTORY -materno I-FAMILY_HISTORY -está I-FAMILY_HISTORY -afecto I-FAMILY_HISTORY -de I-FAMILY_HISTORY -migraña. I-FAMILY_HISTORY - I-FAMILY_HISTORY -A B-EXPLORATION -su I-EXPLORATION -llegada I-EXPLORATION -a I-EXPLORATION -Urgencias, I-EXPLORATION -presenta I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION +sexo I-EXPLORATION +masculino, I-EXPLORATION +raza I-EXPLORATION +caucasoide, I-EXPLORATION +de I-EXPLORATION +25 I-EXPLORATION +años I-EXPLORATION +de I-EXPLORATION +edad I-EXPLORATION y I-EXPLORATION -neurológica I-EXPLORATION -normal, I-EXPLORATION -con I-EXPLORATION -constantes I-EXPLORATION -normales, I-EXPLORATION -salvo I-EXPLORATION -una I-EXPLORATION -discreta I-EXPLORATION -disminución I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -frecuencia I-EXPLORATION -cardiaca. I-EXPLORATION +constitución I-EXPLORATION +leptosomática. I-EXPLORATION + I-EXPLORATION En I-EXPLORATION -el I-EXPLORATION -momento I-EXPLORATION +cuanto I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -no I-EXPLORATION +violencia I-EXPLORATION +corporal I-EXPLORATION +reciente I-EXPLORATION se I-EXPLORATION -observa I-EXPLORATION -hipotermia, I-EXPLORATION -aunque I-EXPLORATION -la I-EXPLORATION -familia I-EXPLORATION -aporta I-EXPLORATION +aprecian: I-EXPLORATION un I-EXPLORATION -registro I-EXPLORATION -exhaustivo I-EXPLORATION +orificio I-EXPLORATION +redondeado I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -días I-EXPLORATION -previos, I-EXPLORATION +1 I-EXPLORATION +cm. I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION con I-EXPLORATION -valores I-EXPLORATION +un I-EXPLORATION +área I-EXPLORATION +concéntrica I-EXPLORATION +perilesional I-EXPLORATION de I-EXPLORATION -temperatura I-EXPLORATION -rectal I-EXPLORATION +excoriación I-EXPLORATION +desecada I-EXPLORATION de I-EXPLORATION -entre I-EXPLORATION -34 I-EXPLORATION +color I-EXPLORATION +negro, I-EXPLORATION +de I-EXPLORATION +2 I-EXPLORATION +mm. I-EXPLORATION +de I-EXPLORATION +ancho I-EXPLORATION +(cintilla I-EXPLORATION +de I-EXPLORATION +contusión), I-EXPLORATION +con I-EXPLORATION +tumefacción I-EXPLORATION y I-EXPLORATION -35 I-EXPLORATION -°C. I-EXPLORATION - I-EXPLORATION -Todos I-EXPLORATION +enrojecimiento I-EXPLORATION +periférico, I-EXPLORATION +con I-EXPLORATION los I-EXPLORATION -estudios I-EXPLORATION -realizados I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -(analítica I-EXPLORATION -general, I-EXPLORATION -gasometría, I-EXPLORATION -estudio I-EXPLORATION -metabólico I-EXPLORATION +cabellos I-EXPLORATION +rasurados I-EXPLORATION y I-EXPLORATION -endocrinológico, I-EXPLORATION -tóxicos I-EXPLORATION +con I-EXPLORATION +restos I-EXPLORATION +de I-EXPLORATION +impregnación I-EXPLORATION +antiséptica, I-EXPLORATION +situado I-EXPLORATION en I-EXPLORATION -orina, I-EXPLORATION -EEG, I-EXPLORATION -resonancia I-EXPLORATION -magnética I-EXPLORATION -[RM], I-EXPLORATION -Holter I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +temporal I-EXPLORATION +derecha, I-EXPLORATION +a I-EXPLORATION +7 I-EXPLORATION +cm. I-EXPLORATION +del I-EXPLORATION +ángulo I-EXPLORATION +externo I-EXPLORATION +del I-EXPLORATION +ojo I-EXPLORATION +derecho I-EXPLORATION y I-EXPLORATION -ecocardiograma). I-EXPLORATION -Después I-EXPLORATION -de I-EXPLORATION -rehistoriar I-EXPLORATION a I-EXPLORATION -la I-EXPLORATION -familia, I-EXPLORATION -refieren I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -niña I-EXPLORATION -padece I-EXPLORATION -desde I-EXPLORATION -hace I-EXPLORATION -unos I-EXPLORATION -meses I-EXPLORATION -episodios I-EXPLORATION +6 I-EXPLORATION +cm. I-EXPLORATION +del I-EXPLORATION +conducto I-EXPLORATION +auditivo I-EXPLORATION de I-EXPLORATION -dolor I-EXPLORATION -abdominal I-EXPLORATION -recurrente, I-EXPLORATION -autolimitados, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION +este I-EXPLORATION +lado; I-EXPLORATION +otorragia I-EXPLORATION +bilateral; I-EXPLORATION +epistaxis; I-EXPLORATION +hematoma I-EXPLORATION +en I-EXPLORATION +anteojos; I-EXPLORATION +excoriaciones I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +frontal I-EXPLORATION +izquierda; I-EXPLORATION +ángulo I-EXPLORATION +externo I-EXPLORATION +de I-EXPLORATION +ojo I-EXPLORATION +derecho; I-EXPLORATION +región I-EXPLORATION +parieto-occipital I-EXPLORATION +izquierda I-EXPLORATION +y I-EXPLORATION +dorso I-EXPLORATION +de I-EXPLORATION +ambas I-EXPLORATION +manos. I-EXPLORATION +También I-EXPLORATION se I-EXPLORATION -añade I-EXPLORATION -al I-EXPLORATION -estudio I-EXPLORATION +observa I-EXPLORATION una I-EXPLORATION -ecografía I-EXPLORATION -abdominal, I-EXPLORATION -con I-EXPLORATION -resultado I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -HPE I-TREATMENT -y I-TREATMENT -teniendo I-TREATMENT -en I-TREATMENT -cuenta I-TREATMENT -el I-TREATMENT -alto I-TREATMENT -número I-TREATMENT -de I-TREATMENT -episodios, I-TREATMENT -junto I-TREATMENT -con I-TREATMENT -el I-TREATMENT -antecedente I-TREATMENT -familiar I-TREATMENT -migrañoso, I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -ciproheptadina. I-TREATMENT -Sin I-TREATMENT -embargo, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -rechaza I-TREATMENT -su I-TREATMENT -ingesta, I-TREATMENT -a B-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -lo I-EVOLUTION -cual I-EVOLUTION -los I-EVOLUTION -episodios I-EVOLUTION -se I-EVOLUTION -autolimitan I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -tiempo. I-EVOLUTION -A I-EVOLUTION -los I-EVOLUTION -seis I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -debut, I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -asintomática. I-EVOLUTION - I-EVOLUTION - -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -hiperemia I-PRESENT_ILLNESS -conjuntival I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -lagrimeo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -ojo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Entre B-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY -destacables I-PAST_MEDICAL_HISTORY -constan I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -alergia I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -ácaros, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -asma I-PAST_MEDICAL_HISTORY -bronquial I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -rinitis I-PAST_MEDICAL_HISTORY -alérgica I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -crónico I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -budesonida I-PAST_MEDICAL_HISTORY -inhalada I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -terbutalina I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -demanda. I-PAST_MEDICAL_HISTORY -No B-FAMILY_HISTORY -presenta I-FAMILY_HISTORY -antecedentes I-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés. I-FAMILY_HISTORY -Se B-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -tópico, I-TREATMENT -acudiendo B-EVOLUTION -de I-EVOLUTION -nuevo I-EVOLUTION -al I-EVOLUTION -cabo I-EVOLUTION -de I-EVOLUTION -cuatro I-EVOLUTION -semanas I-EVOLUTION -por I-EVOLUTION -persistencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -clínica I-EVOLUTION -bilateral, I-EVOLUTION -sin I-EVOLUTION -secreción I-EVOLUTION -purulenta. I-EVOLUTION -Durante I-EVOLUTION -los I-EVOLUTION -siete I-EVOLUTION -meses I-EVOLUTION -posteriores I-EVOLUTION -persiste I-EVOLUTION -la I-EVOLUTION -sintomatología I-EVOLUTION -intermitente I-EVOLUTION -a I-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -tratamiento I-EVOLUTION -con I-EVOLUTION -antihistáminicos I-EVOLUTION -orales I-EVOLUTION -y I-EVOLUTION -oftálmicos, I-EVOLUTION -asociando I-EVOLUTION -además I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -últimos I-EVOLUTION -días I-EVOLUTION -tumefacción I-EVOLUTION -palpebral I-EVOLUTION -con I-EVOLUTION -fotofobia I-EVOLUTION -e I-EVOLUTION -hiperemia I-EVOLUTION -conjuntival I-EVOLUTION -bilateral I-EVOLUTION -matutina, I-EVOLUTION -sin I-EVOLUTION -prurito, I-EVOLUTION -estornudos, I-EVOLUTION -cuadro I-EVOLUTION -catarral I-EVOLUTION -ni I-EVOLUTION -fiebre. I-EVOLUTION -Ante B-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -escasa I-DERIVED_FROM/TO -respuesta I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -tratamientos I-DERIVED_FROM/TO -habituales, I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -decide I-DERIVED_FROM/TO -derivar I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Oftalmología. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -En B-EXPLORATION +pequeña I-EXPLORATION +herida I-EXPLORATION +incisa I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +frontal I-EXPLORATION +derecha, I-EXPLORATION +equimosis I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +reborde I-EXPLORATION +costal I-EXPLORATION +derecho, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +hematomas I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -oftalmológica I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -queratitis I-EXPLORATION -bilateral I-EXPLORATION +raíz I-EXPLORATION de I-EXPLORATION -posible I-EXPLORATION -etiología I-EXPLORATION -herpética, I-EXPLORATION -pautándose B-TREATMENT -terapia I-TREATMENT -antiviral, I-TREATMENT -ciclopléjico I-TREATMENT -y I-TREATMENT -antibiótico I-TREATMENT -tópicos, I-TREATMENT -sin I-TREATMENT -apreciar I-TREATMENT -mejoría. I-TREATMENT -Dada B-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -persistencia I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -cuadro, I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -sospecha I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -queratitis I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -exposición I-DERIVED_FROM/TO -nocturna I-DERIVED_FROM/TO -secundaria I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -exoftalmos I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -deriva I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -endocrinología I-DERIVED_FROM/TO -pediátrica I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -estudio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -función I-DERIVED_FROM/TO -tiroidea, I-DERIVED_FROM/TO -alcanzando I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -final I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -hipertiroidismo I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -causa I-DERIVED_FROM/TO -autoinmune I-DERIVED_FROM/TO -o I-DERIVED_FROM/TO -enfermedad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Graves I-DERIVED_FROM/TO -(EG). I-DERIVED_FROM/TO - I-DERIVED_FROM/TO - -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -15 I-PRESENT_ILLNESS -meses, I-PRESENT_ILLNESS -de B-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -africano, I-PAST_MEDICAL_HISTORY -a B-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -detecta I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -genu I-PRESENT_ILLNESS -varo I-PRESENT_ILLNESS -simétrico I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS -llamativo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -revisión I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -puericultura. I-PRESENT_ILLNESS -No B-PAST_MEDICAL_HISTORY -tiene I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -ni B-FAMILY_HISTORY -familiares I-FAMILY_HISTORY -de I-FAMILY_HISTORY -interés. I-FAMILY_HISTORY -Presenta B-EXPLORATION -un I-EXPLORATION -desarrollo I-EXPLORATION -psicomotor I-EXPLORATION -normal. I-EXPLORATION -Es B-DERIVED_FROM/TO -derivada I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Traumatología, I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -realiza I-DERIVED_FROM/TO -estudio I-DERIVED_FROM/TO -radiológico I-DERIVED_FROM/TO -confirmándose I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -alteración I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -ángulo I-DERIVED_FROM/TO -metafisodiafisario, I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -componente I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -torsión I-DERIVED_FROM/TO -tibial I-DERIVED_FROM/TO -interna I-DERIVED_FROM/TO -marcado I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -alteración I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -cartílago I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -crecimiento I-DERIVED_FROM/TO -proximal I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -tibia. I-DERIVED_FROM/TO -Se B-EXPLORATION -completa I-EXPLORATION +ambos I-EXPLORATION +muslos, I-EXPLORATION +rodilla I-EXPLORATION +derecha I-EXPLORATION +y I-EXPLORATION +cara I-EXPLORATION +anterior I-EXPLORATION +de I-EXPLORATION +ambas I-EXPLORATION +piernas, I-EXPLORATION +además I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +signos I-EXPLORATION +característicos I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +manipulación I-EXPLORATION +quirúrgica I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +extracción I-EXPLORATION +de I-EXPLORATION +órganos I-EXPLORATION +para I-EXPLORATION +trasplante. I-EXPLORATION + I-EXPLORATION +Examen I-EXPLORATION +Interno: I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +autopsia I-EXPLORATION +cefálica, I-EXPLORATION +al I-EXPLORATION +poner I-EXPLORATION +al I-EXPLORATION +descubierto I-EXPLORATION +la I-EXPLORATION +bóveda I-EXPLORATION +craneal, I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -análisis I-EXPLORATION +colgajo I-EXPLORATION +cutáneo I-EXPLORATION +anterior I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +dos I-EXPLORATION +infiltraciones I-EXPLORATION +hemorrágicas, I-EXPLORATION +una I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +correspondiente I-EXPLORATION +al I-EXPLORATION +reborde I-EXPLORATION +supraorbitario I-EXPLORATION +izquierdo I-EXPLORATION +y I-EXPLORATION +otra, I-EXPLORATION +de I-EXPLORATION +menor I-EXPLORATION +dimensión, I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION del I-EXPLORATION -metabolismo I-EXPLORATION -óseo, I-EXPLORATION -siendo I-EXPLORATION -los I-EXPLORATION -resultados I-EXPLORATION -normales. I-EXPLORATION -Se B-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -ortésico I-TREATMENT -inicial I-TREATMENT -sin I-TREATMENT -observarse I-TREATMENT -mejoría I-TREATMENT -tras I-TREATMENT -diez I-TREATMENT -meses I-TREATMENT -de I-TREATMENT -seguimiento, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -realizar I-TREATMENT -tratamiento I-TREATMENT -quirúrgico I-TREATMENT -corrector I-TREATMENT -(osteotomía I-TREATMENT -desrotatoria I-TREATMENT -tibial I-TREATMENT -distal I-TREATMENT -y I-TREATMENT -posteriormente I-TREATMENT -osteotomía I-TREATMENT -valguizante I-TREATMENT -proximal) I-TREATMENT -con I-TREATMENT -muy I-TREATMENT -buena I-TREATMENT -evolución. I-TREATMENT -Los B-EVOLUTION -controles I-EVOLUTION -posteriores I-EVOLUTION -son I-EVOLUTION -favorables, I-EVOLUTION -manteniendo I-EVOLUTION -un I-EVOLUTION -alineamiento I-EVOLUTION -correcto I-EVOLUTION -de I-EVOLUTION -ambas I-EVOLUTION -extremidades. I-EVOLUTION - I-EVOLUTION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -12 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -tórax I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -0, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -× I-PRESENT_ILLNESS -0, I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -cm, I-PRESENT_ILLNESS -eritematosas, I-PRESENT_ILLNESS -ligeramente I-PRESENT_ILLNESS -descamativas, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -pruriginosas. I-PRESENT_ILLNESS -En B-EXPLORATION +ángulo I-EXPLORATION +externo I-EXPLORATION +del I-EXPLORATION +ojo I-EXPLORATION +del I-EXPLORATION +mismo I-EXPLORATION +lado, I-EXPLORATION +subyacentes I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +descritas I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -brazo I-EXPLORATION -presenta I-EXPLORATION -otra I-EXPLORATION -lesión I-EXPLORATION +examen I-EXPLORATION +externo. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +temporal I-EXPLORATION +derecha, I-EXPLORATION +en I-EXPLORATION +concordancia I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +orificio I-EXPLORATION +cutáneo, I-EXPLORATION +existe I-EXPLORATION +un I-EXPLORATION +orificio I-EXPLORATION +óseo I-EXPLORATION de I-EXPLORATION -características I-EXPLORATION -similares, I-EXPLORATION +10 I-EXPLORATION +mm. I-EXPLORATION de I-EXPLORATION +diámetro I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +cara I-EXPLORATION +externa I-EXPLORATION +y I-EXPLORATION +algo I-EXPLORATION mayor I-EXPLORATION -tamaño, I-EXPLORATION -también I-EXPLORATION -asintomática. I-EXPLORATION -Ante B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -pitiriasis I-TREATMENT -rosada, I-TREATMENT -no I-TREATMENT -se I-TREATMENT -pauta I-TREATMENT -tratamiento I-TREATMENT -y I-TREATMENT -se I-TREATMENT -espera I-TREATMENT -para I-TREATMENT -ver I-TREATMENT -la I-TREATMENT -evolución I-TREATMENT -del I-TREATMENT -cuadro. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -la I-EVOLUTION -semana I-EVOLUTION -acude I-EVOLUTION -de I-EVOLUTION -nuevo I-EVOLUTION -a I-EVOLUTION -consulta, I-EVOLUTION -presentando I-EVOLUTION -un I-EVOLUTION -aumento I-EVOLUTION -del I-EVOLUTION -número I-EVOLUTION -de I-EVOLUTION -lesiones, I-EVOLUTION -distribuidas I-EVOLUTION -por I-EVOLUTION -el I-EVOLUTION -tronco, I-EVOLUTION -el I-EVOLUTION -abdomen, I-EVOLUTION -el I-EVOLUTION -dorso I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -región I-EVOLUTION -cervical, I-EVOLUTION -y I-EVOLUTION -respetando I-EVOLUTION -la I-EVOLUTION -cara, I-EVOLUTION -el I-EVOLUTION -cuero I-EVOLUTION -cabelludo I-EVOLUTION -y I-EVOLUTION -las I-EVOLUTION -extremidades I-EVOLUTION -inferiores. I-EVOLUTION -Al B-EXPLORATION -igual I-EXPLORATION -que I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -semana I-EXPLORATION -anterior, I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -son I-EXPLORATION -asintomáticas. I-EXPLORATION +interna I-EXPLORATION +(signo I-EXPLORATION +del I-EXPLORATION +embudo). I-EXPLORATION I-EXPLORATION -Dado I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +colgajo I-EXPLORATION +cutáneo I-EXPLORATION +posterior I-EXPLORATION +existe I-EXPLORATION +un I-EXPLORATION +importante I-EXPLORATION +hematoma I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -cantidad I-EXPLORATION +región I-EXPLORATION +témporo-parietal I-EXPLORATION +izquierda, I-EXPLORATION +desprendiéndose I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +disección I-EXPLORATION +un I-EXPLORATION +fragmento I-EXPLORATION +óseo I-EXPLORATION +irregular, I-EXPLORATION de I-EXPLORATION -lesiones, I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -consultar I-EXPLORATION -vía I-EXPLORATION -telemática I-EXPLORATION +1.5 I-EXPLORATION +x I-EXPLORATION +1.5 I-EXPLORATION +cm., I-EXPLORATION +situado I-EXPLORATION a I-EXPLORATION -Dermatología, I-EXPLORATION -quienes I-EXPLORATION -emiten I-EXPLORATION +12 I-EXPLORATION +cm. I-EXPLORATION +del I-EXPLORATION +ángulo I-EXPLORATION +externo I-EXPLORATION +del I-EXPLORATION +ojo I-EXPLORATION +izquierdo I-EXPLORATION +y I-EXPLORATION +a I-EXPLORATION +9 I-EXPLORATION +cm. I-EXPLORATION +del I-EXPLORATION +conducto I-EXPLORATION +auditivo I-EXPLORATION +del I-EXPLORATION +mismo I-EXPLORATION +lado, I-EXPLORATION +con I-EXPLORATION +borde I-EXPLORATION +biselado, I-EXPLORATION +correspondiendo I-EXPLORATION +el I-EXPLORATION +diámetro I-EXPLORATION +mayor I-EXPLORATION +al I-EXPLORATION +diploe I-EXPLORATION +externo. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +este I-EXPLORATION +lugar, I-EXPLORATION +al I-EXPLORATION +retirar I-EXPLORATION +la I-EXPLORATION +bóveda I-EXPLORATION +craneal I-EXPLORATION +aparece I-EXPLORATION +un I-EXPLORATION +proyectil I-EXPLORATION +de I-EXPLORATION +arma I-EXPLORATION +de I-EXPLORATION +fuego, I-EXPLORATION +deformado I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +punta, I-EXPLORATION +situado I-EXPLORATION +entre I-EXPLORATION +la I-EXPLORATION +duramadre I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +hueso, I-EXPLORATION +de I-EXPLORATION +unos I-EXPLORATION +6, I-EXPLORATION +5 I-EXPLORATION +mm. I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +y I-EXPLORATION +unos I-EXPLORATION +13 I-EXPLORATION +mm. I-EXPLORATION +de I-EXPLORATION +longitud, I-EXPLORATION +así I-EXPLORATION como I-EXPLORATION -diagnóstico I-EXPLORATION -más I-EXPLORATION -probable I-EXPLORATION una I-EXPLORATION -pitiriasis I-EXPLORATION -rosada, I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION +extensa I-EXPLORATION +hemorragia I-EXPLORATION +subaracnoidea I-EXPLORATION +difusa. I-EXPLORATION +Extraída I-EXPLORATION la I-EXPLORATION -probable I-EXPLORATION -lesión I-EXPLORATION -heraldo I-EXPLORATION -del I-EXPLORATION -brazo, I-EXPLORATION +masa I-EXPLORATION +encefálica I-EXPLORATION +se I-EXPLORATION +comprueba I-EXPLORATION la I-EXPLORATION -descamación I-EXPLORATION -periférica I-EXPLORATION +existencia I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +fractura I-EXPLORATION +conminuta I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +techos I-EXPLORATION +de I-EXPLORATION +ambas I-EXPLORATION +órbitas I-EXPLORATION +oculares. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +disección I-EXPLORATION +del I-EXPLORATION +cerebro I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +laceración I-EXPLORATION +del I-EXPLORATION +parénquima I-EXPLORATION en I-EXPLORATION -algunas I-EXPLORATION +forma I-EXPLORATION +de I-EXPLORATION +trayecto I-EXPLORATION +que I-EXPLORATION +une I-EXPLORATION +los I-EXPLORATION +orificios I-EXPLORATION +descritos, I-EXPLORATION +con I-EXPLORATION +infiltración I-EXPLORATION +hemorrágica I-EXPLORATION +perifocal. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +necrópsico I-EXPLORATION +del I-EXPLORATION +resto I-EXPLORATION +de I-EXPLORATION +regiones I-EXPLORATION +anatómicas I-EXPLORATION +y I-EXPLORATION +vísceras I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +fueron I-EXPLORATION +extraídas I-EXPLORATION +para I-EXPLORATION +trasplante, I-EXPLORATION +no I-EXPLORATION +reveló I-EXPLORATION lesiones I-EXPLORATION +macroscópicas I-EXPLORATION +de I-EXPLORATION +interés. I-EXPLORATION + I-EXPLORATION +Estudios I-EXPLORATION +complementarios I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +remitió I-EXPLORATION +al I-EXPLORATION +Instituto I-EXPLORATION +Nacional I-EXPLORATION +de I-EXPLORATION +Toxicología I-EXPLORATION y I-EXPLORATION +Ciencias I-EXPLORATION +Forenses I-EXPLORATION +de I-EXPLORATION +Sevilla I-EXPLORATION +el I-EXPLORATION +colgajo I-EXPLORATION +cutáneo I-EXPLORATION +de I-EXPLORATION +cuero I-EXPLORATION +cabelludo I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -distribución. I-EXPLORATION - I-EXPLORATION -Aconsejan B-TREATMENT -no I-TREATMENT -tratar I-TREATMENT -y I-TREATMENT -nos I-TREATMENT -recuerdan I-TREATMENT -que I-TREATMENT -el I-TREATMENT -cuadro I-TREATMENT -puede I-TREATMENT -durar I-TREATMENT -un I-TREATMENT -total I-TREATMENT -de I-TREATMENT -6-8 I-TREATMENT -semanas. I-TREATMENT - I-TREATMENT - -Niña B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cinco I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -quística I-PRESENT_ILLNESS -sobreelevada I-PRESENT_ILLNESS -azulada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diámetro I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -raíz I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuero I-PRESENT_ILLNESS -cabelludo, I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -aumento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tamaño I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -sucesivas I-PRESENT_ILLNESS -visitas. I-PRESENT_ILLNESS -Según B-EXPLORATION +región I-EXPLORATION +temporal I-EXPLORATION +derecha I-EXPLORATION +que I-EXPLORATION +incluía I-EXPLORATION el I-EXPLORATION -especialista, I-EXPLORATION +orificio I-EXPLORATION +de I-EXPLORATION +entrada I-EXPLORATION +del I-EXPLORATION +proyectil, I-EXPLORATION +para I-EXPLORATION +estudio I-EXPLORATION +criminalístico, I-EXPLORATION +los I-EXPLORATION +cuales I-EXPLORATION +revelaron I-EXPLORATION la I-EXPLORATION -lesión I-EXPLORATION -sugiere I-EXPLORATION -un I-EXPLORATION -pilomatricoma I-EXPLORATION -o I-EXPLORATION -epitelioma I-EXPLORATION -calcificante I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +residuos, I-EXPLORATION +consistentes I-EXPLORATION +en I-EXPLORATION +negro I-EXPLORATION +de I-EXPLORATION +humo I-EXPLORATION +y I-EXPLORATION +elevadas I-EXPLORATION +concentraciones I-EXPLORATION +de I-EXPLORATION +plomo, I-EXPLORATION +antimonio I-EXPLORATION +y I-EXPLORATION +bario, I-EXPLORATION +lo I-EXPLORATION +cual I-EXPLORATION +indica I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +disparo I-EXPLORATION +que I-EXPLORATION +originó I-EXPLORATION +el I-EXPLORATION +orificio I-EXPLORATION +de I-EXPLORATION +entrada I-EXPLORATION +debió I-EXPLORATION +realizarse I-EXPLORATION +a I-EXPLORATION +escasa I-EXPLORATION +distancia. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +Policía I-EXPLORATION +Judicial I-EXPLORATION +envió I-EXPLORATION +al I-EXPLORATION +Departamento I-EXPLORATION +de I-EXPLORATION +Análisis I-EXPLORATION +del I-EXPLORATION +Centro I-EXPLORATION +de I-EXPLORATION +Investigación I-EXPLORATION +y I-EXPLORATION +Criminalística I-EXPLORATION de I-EXPLORATION -Malherbe I-EXPLORATION -(puede I-EXPLORATION -ser I-EXPLORATION -azulado I-EXPLORATION -por I-EXPLORATION -su I-EXPLORATION -componente I-EXPLORATION -cálcico). I-EXPLORATION -Recomienda B-TREATMENT -la I-TREATMENT -extirpación I-TREATMENT -quirúrgica I-TREATMENT -como I-TREATMENT -actuación I-TREATMENT -diagnóstico-terapéutica. I-TREATMENT - I-TREATMENT - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -29 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -de B-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -argelino I-PAST_MEDICAL_HISTORY -ingresado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -prisión. I-PAST_MEDICAL_HISTORY -Es I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tabaco I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -marihuana, I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -beber I-PAST_MEDICAL_HISTORY -cerveza I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -diaria I-PAST_MEDICAL_HISTORY -previamente I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -prisión, I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -niega I-PAST_MEDICAL_HISTORY -consumo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -otras I-PAST_MEDICAL_HISTORY -drogas I-PAST_MEDICAL_HISTORY -tanto I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -parenteral I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -otras I-PAST_MEDICAL_HISTORY -vías. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Presenta I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -trastorno I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -control I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -impulsos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sigue I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -benzodiacepinas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ansiolíticos. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Tiene I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -conducta I-PAST_MEDICAL_HISTORY -violenta I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -insultos I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -personal I-PAST_MEDICAL_HISTORY -sanitario I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -destrozo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -mobiliario. I-PAST_MEDICAL_HISTORY -También I-PAST_MEDICAL_HISTORY -existen I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diversas I-PAST_MEDICAL_HISTORY -autoagresiones: I-PAST_MEDICAL_HISTORY -huelgas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hambre, I-PAST_MEDICAL_HISTORY -autocontusiones, I-PAST_MEDICAL_HISTORY -lesiones I-PAST_MEDICAL_HISTORY -superficiales I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -brazos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -piernas, I-PAST_MEDICAL_HISTORY -así I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -ingesta I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -cuchillas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -objetos I-PAST_MEDICAL_HISTORY -extraños I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -finalmente I-PAST_MEDICAL_HISTORY -fueron I-PAST_MEDICAL_HISTORY -evacuados I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -natural I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -apoyo I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -dieta I-PAST_MEDICAL_HISTORY -rica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -fibra. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -En B-PRESENT_ILLNESS -esta I-PRESENT_ILLNESS -ocasión, I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -ingerido I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cortauñas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -queja I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal. I-PRESENT_ILLNESS -Al I-PRESENT_ILLNESS -mismo I-PRESENT_ILLNESS -tiempo I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -iniciado I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -huelga I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hambre, I-PRESENT_ILLNESS -ingiriendo I-PRESENT_ILLNESS -agua I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -infusiones I-PRESENT_ILLNESS -azucaradas. I-PRESENT_ILLNESS -En B-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -se I-EXPLORATION -aprecia I-EXPLORATION -un I-EXPLORATION -abdomen I-EXPLORATION -blando, I-EXPLORATION -depresible I-EXPLORATION +Guardia I-EXPLORATION +Civil I-EXPLORATION +tres I-EXPLORATION +portamuestras I-EXPLORATION +conteniendo I-EXPLORATION +adhesivos I-EXPLORATION +de I-EXPLORATION +recogida I-EXPLORATION +de I-EXPLORATION +residuos I-EXPLORATION +de I-EXPLORATION +disparo, I-EXPLORATION +aplicados I-EXPLORATION +en I-EXPLORATION +ambas I-EXPLORATION +manos I-EXPLORATION y I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION -se I-EXPLORATION -puede I-EXPLORATION -observar I-EXPLORATION +sien I-EXPLORATION +del I-EXPLORATION +fallecido, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +un I-EXPLORATION +casquillo I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +encontrado I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +coche I-EXPLORATION +en I-EXPLORATION una I-EXPLORATION -parte I-EXPLORATION +búsqueda I-EXPLORATION +posterior I-EXPLORATION +junto I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +pistola I-EXPLORATION del I-EXPLORATION -cortauñas I-EXPLORATION -situada I-EXPLORATION +mismo I-EXPLORATION +calibre, I-EXPLORATION +a I-EXPLORATION +raíz I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +investigaciones I-EXPLORATION +oportunas I-EXPLORATION +cuando I-EXPLORATION +ya I-EXPLORATION +el I-EXPLORATION +vehículo I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +desguace, I-EXPLORATION +dado I-EXPLORATION +que I-EXPLORATION +había I-EXPLORATION +pasado I-EXPLORATION +desapercibido I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +primer I-EXPLORATION +momento. I-EXPLORATION +Los I-EXPLORATION +resultados I-EXPLORATION +revelaron I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +portamuestras I-EXPLORATION +aplicado I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +mano I-EXPLORATION +derecha, I-EXPLORATION +de I-EXPLORATION +partículas I-EXPLORATION +propias I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +detonación I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +fulminante I-EXPLORATION +similar I-EXPLORATION +al I-EXPLORATION +del I-EXPLORATION +casquillo, I-EXPLORATION +que I-EXPLORATION +también I-EXPLORATION +fue I-EXPLORATION +remitido. I-EXPLORATION + I-EXPLORATION +A I-EXPLORATION +efectos I-EXPLORATION +de I-EXPLORATION +Interpretación I-EXPLORATION +Médico I-EXPLORATION +Forense I-EXPLORATION +se I-EXPLORATION +hicieron I-EXPLORATION +las I-EXPLORATION +siguientes I-EXPLORATION +consideraciones: I-EXPLORATION + I-EXPLORATION +A.- I-EXPLORATION +NATURALEZA I-EXPLORATION +DE I-EXPLORATION +LAS I-EXPLORATION +LESIONES. I-EXPLORATION +Se I-EXPLORATION +han I-EXPLORATION +encontrado I-EXPLORATION +lesiones I-EXPLORATION +de I-EXPLORATION +dos I-EXPLORATION +naturalezas I-EXPLORATION +diferentes: I-EXPLORATION + I-EXPLORATION +1. I-EXPLORATION +Lesiones I-EXPLORATION +de I-EXPLORATION +naturaleza I-EXPLORATION +contusa. I-EXPLORATION +Consistentes I-EXPLORATION +en I-EXPLORATION +hematomas, I-EXPLORATION +erosiones I-EXPLORATION +y I-EXPLORATION +heridas I-EXPLORATION +contusas I-EXPLORATION +que I-EXPLORATION +por I-EXPLORATION +sus I-EXPLORATION +características I-EXPLORATION +y I-EXPLORATION +localización, I-EXPLORATION +son I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +las I-EXPLORATION +producidas I-EXPLORATION en I-EXPLORATION -intestino I-EXPLORATION -delgado. I-EXPLORATION -A B-DERIVED_FROM/TO -pesar I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -quedar I-DERIVED_FROM/TO -descartado I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -clínica I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -abdomen I-DERIVED_FROM/TO -agudo I-DERIVED_FROM/TO -quirúrgico, I-DERIVED_FROM/TO -dado I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -sigue I-DERIVED_FROM/TO -quejando I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -intenso I-DERIVED_FROM/TO -dolor, I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -le I-DERIVED_FROM/TO -deriva I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -urgencias I-DERIVED_FROM/TO -hospitalario, I-DERIVED_FROM/TO -donde I-DERIVED_FROM/TO -confirman I-DERIVED_FROM/TO -nuestro I-DERIVED_FROM/TO -diagnóstico I-DERIVED_FROM/TO -prescribiendo I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -dieta I-DERIVED_FROM/TO -rica I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -fibra I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -aconsejado I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -seguimiento I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -paciente. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -A B-EXPLORATION los I-EXPLORATION -6 I-EXPLORATION -días I-EXPLORATION +accidentes I-EXPLORATION +de I-EXPLORATION +tráfico. I-EXPLORATION +Ninguna I-EXPLORATION +de I-EXPLORATION +ellas I-EXPLORATION +reviste I-EXPLORATION +importancia I-EXPLORATION +desde I-EXPLORATION +el I-EXPLORATION +punto I-EXPLORATION +de I-EXPLORATION +vista I-EXPLORATION +clínico, I-EXPLORATION +considerándose I-EXPLORATION +por I-EXPLORATION +tanto I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +fueron I-EXPLORATION +determinantes I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +causa I-EXPLORATION +ni I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +mecanismo I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +muerte. I-EXPLORATION + I-EXPLORATION +2.- I-EXPLORATION +Lesiones I-EXPLORATION +por I-EXPLORATION +proyectil I-EXPLORATION +de I-EXPLORATION +arma I-EXPLORATION +de I-EXPLORATION +fuego. I-EXPLORATION +La I-EXPLORATION +morfología I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +orificios I-EXPLORATION +encontrados I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +cráneo I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +hallazgo I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +proyectil, I-EXPLORATION +indica I-EXPLORATION +que I-EXPLORATION +nos I-EXPLORATION +encontramos I-EXPLORATION +ante I-EXPLORATION +un I-EXPLORATION +disparo I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +arma I-EXPLORATION +de I-EXPLORATION +fuego I-EXPLORATION +de I-EXPLORATION +proyectil I-EXPLORATION +único. I-EXPLORATION +La I-EXPLORATION +herida I-EXPLORATION +correspondiente I-EXPLORATION +al I-EXPLORATION +orificio I-EXPLORATION de I-EXPLORATION +entrada I-EXPLORATION +se I-EXPLORATION +localiza I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -primera I-EXPLORATION -placa, I-EXPLORATION -una I-EXPLORATION -nueva I-EXPLORATION -radiografía I-EXPLORATION -nos I-EXPLORATION -muestra I-EXPLORATION +región I-EXPLORATION +temporal I-EXPLORATION +derecha. I-EXPLORATION +Sigue I-EXPLORATION +un I-EXPLORATION +trayecto I-EXPLORATION +de I-EXPLORATION +derecha-izquierda, I-EXPLORATION +ligeramente I-EXPLORATION +de I-EXPLORATION +abajo-arriba I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +delante-atrás, I-EXPLORATION +atravesando I-EXPLORATION +completamente I-EXPLORATION la I-EXPLORATION -misma I-EXPLORATION -pieza I-EXPLORATION -descrita I-EXPLORATION -en I-EXPLORATION -colon I-EXPLORATION -ascendente, I-EXPLORATION +masa I-EXPLORATION +encefálica I-EXPLORATION pero I-EXPLORATION -vemos I-EXPLORATION -la I-EXPLORATION -otra I-EXPLORATION -parte I-EXPLORATION -del I-EXPLORATION -cortauñas I-EXPLORATION -ingerido I-EXPLORATION -posteriormente I-EXPLORATION +sin I-EXPLORATION +llegar I-EXPLORATION +a I-EXPLORATION +salir I-EXPLORATION +al I-EXPLORATION +exterior, I-EXPLORATION +quedando I-EXPLORATION +el I-EXPLORATION +proyectil I-EXPLORATION +alojado I-EXPLORATION en I-EXPLORATION -un I-EXPLORATION -tramo I-EXPLORATION -superior I-EXPLORATION -del I-EXPLORATION -tubo I-EXPLORATION -digestivo. I-EXPLORATION -Trascurridos I-EXPLORATION -9 I-EXPLORATION -días I-EXPLORATION +el I-EXPLORATION +interior I-EXPLORATION del I-EXPLORATION -inicio I-EXPLORATION +cráneo. I-EXPLORATION +Las I-EXPLORATION +fracturas I-EXPLORATION del I-EXPLORATION -cuadro, I-EXPLORATION -realizamos I-EXPLORATION -otra I-EXPLORATION -placa I-EXPLORATION +techo I-EXPLORATION de I-EXPLORATION -control I-EXPLORATION -y I-EXPLORATION -apreciamos I-EXPLORATION -cómo I-EXPLORATION ambas I-EXPLORATION -piezas I-EXPLORATION -de I-EXPLORATION -ese I-EXPLORATION -cortaúñas I-EXPLORATION -se I-EXPLORATION -han I-EXPLORATION -situado I-EXPLORATION -juntas I-EXPLORATION +órbitas I-EXPLORATION +pudieran I-EXPLORATION +corresponder I-EXPLORATION a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -colon I-EXPLORATION -descendente. I-EXPLORATION -Nos B-TREATMENT -refiere I-TREATMENT -que I-TREATMENT -abandona I-TREATMENT -la I-TREATMENT -huelga I-TREATMENT -de I-TREATMENT -hambre I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -instaura I-TREATMENT -una I-TREATMENT -dieta I-TREATMENT -rica I-TREATMENT -en I-TREATMENT -fibra. I-TREATMENT - I-TREATMENT -Nuevas B-EXPLORATION -radiografías I-EXPLORATION -de I-EXPLORATION -abdomen I-EXPLORATION -nos I-EXPLORATION -muestran I-EXPLORATION +las I-EXPLORATION +denominadas I-EXPLORATION +fracturas I-EXPLORATION +secundarias I-EXPLORATION +ocasionadas I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +energía I-EXPLORATION +cinética I-EXPLORATION +procedente I-EXPLORATION +del I-EXPLORATION +proyectil I-EXPLORATION +[9]. I-EXPLORATION + I-EXPLORATION +B.- I-EXPLORATION +ETIOLOGÍA I-EXPLORATION +MÉDICO I-EXPLORATION +LEGAL I-EXPLORATION + I-EXPLORATION +Las I-EXPLORATION +investigaciones I-EXPLORATION +policiales I-EXPLORATION +posteriores, I-EXPLORATION +indicaron I-EXPLORATION que I-EXPLORATION el I-EXPLORATION -citado I-EXPLORATION -cuerpo I-EXPLORATION -extraño I-EXPLORATION +fallecido, I-EXPLORATION +sin I-EXPLORATION +antecedentes I-EXPLORATION +médicos I-EXPLORATION +de I-EXPLORATION +interés, I-EXPLORATION no I-EXPLORATION -avanza I-EXPLORATION -del I-EXPLORATION -colon I-EXPLORATION -trasverso I-EXPLORATION -hasta I-EXPLORATION +tenía I-EXPLORATION +problemas I-EXPLORATION +económicos I-EXPLORATION +conocidos, I-EXPLORATION +siendo I-EXPLORATION +significativo I-EXPLORATION +el I-EXPLORATION +hecho I-EXPLORATION +de I-EXPLORATION que I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -placa I-EXPLORATION -realizada I-EXPLORATION -a I-EXPLORATION +poco I-EXPLORATION +antes I-EXPLORATION +de I-EXPLORATION los I-EXPLORATION -30 I-EXPLORATION -días I-EXPLORATION +hechos I-EXPLORATION +había I-EXPLORATION +contratado I-EXPLORATION +un I-EXPLORATION +seguro I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -ingesta, I-EXPLORATION -revela I-EXPLORATION -ambas I-EXPLORATION -partes I-EXPLORATION -del I-EXPLORATION -cortauñas I-EXPLORATION -en I-EXPLORATION -últimos I-EXPLORATION -tramos I-EXPLORATION -del I-EXPLORATION -tubo I-EXPLORATION -digestivo, I-EXPLORATION -siendo B-EVOLUTION -expulsados I-EVOLUTION -al I-EVOLUTION -día I-EVOLUTION -siguiente I-EVOLUTION -durante I-EVOLUTION -la I-EVOLUTION -defecación, I-EVOLUTION -según I-EVOLUTION -nos I-EVOLUTION -informa I-EVOLUTION -el I-EVOLUTION -propio I-EVOLUTION -paciente. I-EVOLUTION - I-EVOLUTION - -Se B-PRESENT_ILLNESS -trata I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -18 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -natural I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Perú, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ingresó I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -Centro I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -mayo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2012. I-PRESENT_ILLNESS -En B-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -reconocimiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ingresos I-PAST_MEDICAL_HISTORY -negó I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -presentado I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Dentro B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -hábitos I-PRESENT_ILLNESS -tóxicos I-PRESENT_ILLNESS -refirió I-PRESENT_ILLNESS -consumo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -150 I-PRESENT_ILLNESS -gr. I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -alcohol I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -fines I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -heroína I-PRESENT_ILLNESS -fumada I-PRESENT_ILLNESS -ocasional. I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -cuanto I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -prácticas I-PRESENT_ILLNESS -sexuales I-PRESENT_ILLNESS -manifestó I-PRESENT_ILLNESS -ser I-PRESENT_ILLNESS -heterosexual I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -tenido I-PRESENT_ILLNESS -múltiples I-PRESENT_ILLNESS -parejas, I-PRESENT_ILLNESS -frecuentemente I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -contexto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -intoxicación I-PRESENT_ILLNESS -enólica I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -tomar I-PRESENT_ILLNESS -medidas I-PRESENT_ILLNESS -preventivas. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -numerosas I-EXPLORATION -lesiones I-EXPLORATION -cutáneas I-EXPLORATION -maculares I-EXPLORATION +vida I-EXPLORATION +y I-EXPLORATION +había I-EXPLORATION +adquirido I-EXPLORATION +una I-EXPLORATION +pistola I-EXPLORATION de I-EXPLORATION -predominio I-EXPLORATION -en I-EXPLORATION -tórax, I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -orientó I-EXPLORATION -como I-EXPLORATION -pitiriasis I-EXPLORATION -rosada. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -analítica I-EXPLORATION -dentro I-EXPLORATION +forma I-EXPLORATION +ilegal. I-EXPLORATION +El I-EXPLORATION +minucioso I-EXPLORATION +examen I-EXPLORATION del I-EXPLORATION -protocolo I-EXPLORATION -de I-EXPLORATION -ingresos: I-EXPLORATION -hemograma, I-EXPLORATION -bioquímica I-EXPLORATION -y I-EXPLORATION -serologías I-EXPLORATION -VIH, I-EXPLORATION -hepatitis I-EXPLORATION -y I-EXPLORATION -lues, I-EXPLORATION -detectándose I-EXPLORATION -Treponema I-EXPLORATION -pallidum I-EXPLORATION -anticuerpos I-EXPLORATION -reagínicos I-EXPLORATION -1/8, I-EXPLORATION -Treponema I-EXPLORATION -pallidum I-EXPLORATION -anticuerpos I-EXPLORATION -treponémicos I-EXPLORATION -positivos, I-EXPLORATION -sin I-EXPLORATION -alteraciones I-EXPLORATION +vehículo, I-EXPLORATION +una I-EXPLORATION +vez I-EXPLORATION +depositado I-EXPLORATION en I-EXPLORATION el I-EXPLORATION -resto I-EXPLORATION +desguace, I-EXPLORATION +permitió I-EXPLORATION +la I-EXPLORATION +recogida I-EXPLORATION de I-EXPLORATION -resultados I-EXPLORATION -analíticos. I-EXPLORATION - I-EXPLORATION -Reinterrogado, I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -negó I-EXPLORATION -haber I-EXPLORATION -presentado I-EXPLORATION -ninguna I-EXPLORATION -manifestación I-EXPLORATION +varios I-EXPLORATION +cartuchos I-EXPLORATION de I-EXPLORATION -sífilis I-EXPLORATION -primaria, I-EXPLORATION -si I-EXPLORATION -bien, I-EXPLORATION -se I-EXPLORATION -observaron I-EXPLORATION -numerosas I-EXPLORATION -placas I-EXPLORATION -alopécicas I-EXPLORATION -en I-EXPLORATION -cuero I-EXPLORATION -cabelludo I-EXPLORATION +pistola I-EXPLORATION de I-EXPLORATION -distribución I-EXPLORATION -irregular, I-EXPLORATION +calibre I-EXPLORATION +6, I-EXPLORATION +35 I-EXPLORATION +mm., I-EXPLORATION +uno I-EXPLORATION de I-EXPLORATION -características I-EXPLORATION -no I-EXPLORATION -cicatriciales, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION -inflamatorios I-EXPLORATION -ni I-EXPLORATION -descamación, I-EXPLORATION -menores I-EXPLORATION +ellos I-EXPLORATION +percutido. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +base I-EXPLORATION +a I-EXPLORATION +estos I-EXPLORATION +antecedentes I-EXPLORATION +y I-EXPLORATION +teniendo I-EXPLORATION +en I-EXPLORATION +cuenta I-EXPLORATION +la I-EXPLORATION +localización I-EXPLORATION +del I-EXPLORATION +orificio I-EXPLORATION de I-EXPLORATION -un I-EXPLORATION -centímetro I-EXPLORATION +entrada I-EXPLORATION +(región I-EXPLORATION +temporal I-EXPLORATION +derecha), I-EXPLORATION +la I-EXPLORATION +distancia I-EXPLORATION +del I-EXPLORATION +disparo I-EXPLORATION +(como I-EXPLORATION +mínimo I-EXPLORATION +a I-EXPLORATION +corta I-EXPLORATION +distancia I-EXPLORATION +como I-EXPLORATION +acredita I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +criminalístico), I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -diámetro, I-EXPLORATION +restos I-EXPLORATION de I-EXPLORATION -bordes I-EXPLORATION -mal I-EXPLORATION -definidos, I-EXPLORATION -no I-EXPLORATION -desprovistas I-EXPLORATION -completamente I-EXPLORATION +residuos I-EXPLORATION de I-EXPLORATION -pelo, I-EXPLORATION +disparo I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +mano I-EXPLORATION +derecha I-EXPLORATION +del I-EXPLORATION +fallecido I-EXPLORATION y I-EXPLORATION +otras I-EXPLORATION +circunstancias I-EXPLORATION +del I-EXPLORATION +caso I-EXPLORATION +(único I-EXPLORATION +ocupante I-EXPLORATION +con I-EXPLORATION +incarceración I-EXPLORATION +del I-EXPLORATION +cuerpo I-EXPLORATION +e I-EXPLORATION +intervención I-EXPLORATION de I-EXPLORATION -predominio I-EXPLORATION +bomberos I-EXPLORATION +para I-EXPLORATION +su I-EXPLORATION +extracción, I-EXPLORATION +presencia I-EXPLORATION +del I-EXPLORATION +arma I-EXPLORATION en I-EXPLORATION -región I-EXPLORATION -temporo-occipital. I-EXPLORATION - I-EXPLORATION -Esta I-EXPLORATION -manifestación I-EXPLORATION -la I-EXPLORATION -había I-EXPLORATION -observado I-EXPLORATION el I-EXPLORATION -propio I-EXPLORATION -paciente I-EXPLORATION -hacía I-EXPLORATION -cinco I-EXPLORATION -días, I-EXPLORATION -coincidiendo I-EXPLORATION -con I-EXPLORATION +vehículo, I-EXPLORATION +antecedentes I-EXPLORATION +de I-EXPLORATION +contratación I-EXPLORATION +de I-EXPLORATION un I-EXPLORATION -corte I-EXPLORATION +seguro, I-EXPLORATION +etc.) I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -pelo, I-EXPLORATION -sin I-EXPLORATION +otros I-EXPLORATION +datos I-EXPLORATION +objetivos, I-EXPLORATION +consideramos I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -hubiese I-EXPLORATION -percatado I-EXPLORATION -antes. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -lesión I-EXPLORATION -dermatológica I-EXPLORATION -descrita I-EXPLORATION -es I-EXPLORATION -coincidente I-EXPLORATION +pudiera I-EXPLORATION +ser I-EXPLORATION +perfectamente I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -la I-EXPLORATION -denominada I-EXPLORATION -alopecia I-EXPLORATION -apolillada, I-EXPLORATION un I-EXPLORATION -signo I-EXPLORATION -infrecuente I-EXPLORATION +acto I-EXPLORATION de I-EXPLORATION -secundarismo I-EXPLORATION -luético. I-EXPLORATION +carácter I-EXPLORATION +suicida. I-EXPLORATION I-EXPLORATION -Se B-TREATMENT -trató I-TREATMENT -con I-TREATMENT -penicilina I-TREATMENT -G I-TREATMENT -benzatina I-TREATMENT -2.400.000 I-TREATMENT -UI. I-TREATMENT -en I-TREATMENT -dosis I-TREATMENT -única. I-TREATMENT -Posteriormente B-EVOLUTION -se I-EVOLUTION -procedió I-EVOLUTION -a I-EVOLUTION -seguimiento I-EVOLUTION -clínico I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +35 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +segundo I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +enseñanza I-PAST_MEDICAL_HISTORY +media I-PAST_MEDICAL_HISTORY +completa, I-PAST_MEDICAL_HISTORY +casada, I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +hija I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +8 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +hijo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +1 I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +edad. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Asistió B-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +consultorio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +atención I-PRESENT_ILLNESS +primaria I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +síntomas I-PRESENT_ILLNESS +angustiosos I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +depresivos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +ocho I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +iniciados I-PRESENT_ILLNESS +posteriormente I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +nacimiento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +hija I-PRESENT_ILLNESS +mayor. I-PRESENT_ILLNESS +La I-PRESENT_ILLNESS +sintomatología I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +exacerbado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +último I-PRESENT_ILLNESS +año, I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +nacimiento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +segundo I-PRESENT_ILLNESS +hijo. I-PRESENT_ILLNESS +Junto I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +anterior, I-PRESENT_ILLNESS +golpeaba I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +hija, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +marido I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +sugirió I-PRESENT_ILLNESS +consultar. I-PRESENT_ILLNESS +Fue B-DERIVED_FROM/TO +derivada I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +Unidad I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Psiquiatría I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +pesquisa I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +hizo I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +médico I-DERIVED_FROM/TO +general I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +antecedente I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +abuso I-DERIVED_FROM/TO +sexual I-DERIVED_FROM/TO +infantil, I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +hasta I-DERIVED_FROM/TO +esa I-DERIVED_FROM/TO +fecha I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +había I-DERIVED_FROM/TO +silenciado. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Antecedentes. B-PAST_MEDICAL_HISTORY +Fue I-PAST_MEDICAL_HISTORY +golpeada I-PAST_MEDICAL_HISTORY +durante I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +infancia I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +padre I-PAST_MEDICAL_HISTORY +alcohólico, I-PAST_MEDICAL_HISTORY +quién I-PAST_MEDICAL_HISTORY +abusó I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ella I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +caricias I-PAST_MEDICAL_HISTORY +sexuales I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +penetración, I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +15, I-PAST_MEDICAL_HISTORY +cuando I-PAST_MEDICAL_HISTORY +abandonó I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +colegio I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +trasladó I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +otra I-PAST_MEDICAL_HISTORY +ciudad I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +trabajar I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +asesora I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +hogar. I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +primera I-PAST_MEDICAL_HISTORY +casa I-PAST_MEDICAL_HISTORY +donde I-PAST_MEDICAL_HISTORY +trabajó I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +violada I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +hijo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +patrona. I-PAST_MEDICAL_HISTORY +Esta I-PAST_MEDICAL_HISTORY +experiencia I-PAST_MEDICAL_HISTORY +traumática I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +silenció I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +susto, I-PAST_MEDICAL_HISTORY +vergüenza I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +culpa. I-PAST_MEDICAL_HISTORY +Posteriormente I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +angustia, I-PAST_MEDICAL_HISTORY +pesadillas I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +imágenes I-PAST_MEDICAL_HISTORY +intrusivas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +violación I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +cedieron I-PAST_MEDICAL_HISTORY +espontáneamente I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +mes, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +abandono I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +lugar I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +trabajo. I-PAST_MEDICAL_HISTORY +Estos I-PAST_MEDICAL_HISTORY +síntomas I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +reactivaron I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +después, I-PAST_MEDICAL_HISTORY +cuando I-PAST_MEDICAL_HISTORY +divisó I-PAST_MEDICAL_HISTORY +casualmente I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +calle I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +victimario I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +nuevamente I-PAST_MEDICAL_HISTORY +cedieron I-PAST_MEDICAL_HISTORY +espontáneamente I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +regreso I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +lugar I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +origen. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Se I-PAST_MEDICAL_HISTORY +casó I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +inició I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +problemas I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +vida I-PAST_MEDICAL_HISTORY +sexual. I-PAST_MEDICAL_HISTORY +Durante I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +primer I-PAST_MEDICAL_HISTORY +embarazo I-PAST_MEDICAL_HISTORY +comenzó I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +presentar I-PAST_MEDICAL_HISTORY +angustia I-PAST_MEDICAL_HISTORY +relacionada I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +idea I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +tener I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +hija, I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +podría I-PAST_MEDICAL_HISTORY +suceder I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +mismo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +ella, I-PAST_MEDICAL_HISTORY +es I-PAST_MEDICAL_HISTORY +decir I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +violada. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +angustia I-PAST_MEDICAL_HISTORY +aumentó I-PAST_MEDICAL_HISTORY +cuando I-PAST_MEDICAL_HISTORY +nació I-PAST_MEDICAL_HISTORY +ésta, I-PAST_MEDICAL_HISTORY +agregándose I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +puerperio I-PAST_MEDICAL_HISTORY +anhedonia, I-PAST_MEDICAL_HISTORY +intolerancia, I-PAST_MEDICAL_HISTORY +irritabilidad I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +labilidad I-PAST_MEDICAL_HISTORY +emocional, I-PAST_MEDICAL_HISTORY +síntomas I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +cuales I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +consultó. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Al I-PAST_MEDICAL_HISTORY +reiniciar I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +vida I-PAST_MEDICAL_HISTORY +sexual, I-PAST_MEDICAL_HISTORY +después I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +parto, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +oportunidad I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +marido I-PAST_MEDICAL_HISTORY +estaba I-PAST_MEDICAL_HISTORY +bajo I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +efecto I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +alcohol, I-PAST_MEDICAL_HISTORY +reaparecieron I-PAST_MEDICAL_HISTORY +imágenes I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +percepciones I-PAST_MEDICAL_HISTORY +olfativas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cuando I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +padre I-PAST_MEDICAL_HISTORY +abusaba I-PAST_MEDICAL_HISTORY +sexualmente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ella. I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +volvió I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +«sentir I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +olor I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +padre» I-PAST_MEDICAL_HISTORY +cerca I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ella. I-PAST_MEDICAL_HISTORY +Antes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +este I-PAST_MEDICAL_HISTORY +episodio I-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +recuerdos I-PAST_MEDICAL_HISTORY +borrosos I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +abuso I-PAST_MEDICAL_HISTORY +sufrido I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +niñez. I-PAST_MEDICAL_HISTORY +Después I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +este I-PAST_MEDICAL_HISTORY +incidente, I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +imágenes I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +abuso I-PAST_MEDICAL_HISTORY +infantil I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +presentaron I-PAST_MEDICAL_HISTORY +egodistónicamente I-PAST_MEDICAL_HISTORY +cada I-PAST_MEDICAL_HISTORY +vez I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +relaciones I-PAST_MEDICAL_HISTORY +sexuales. I-PAST_MEDICAL_HISTORY +Además, I-PAST_MEDICAL_HISTORY +aparecieron I-PAST_MEDICAL_HISTORY +síntomas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hipervigilancia I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +conductas I-PAST_MEDICAL_HISTORY +evitativas I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +relación I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +vida I-PAST_MEDICAL_HISTORY +sexual, I-PAST_MEDICAL_HISTORY +originándose I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +frigidez I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +serios I-PAST_MEDICAL_HISTORY +problemas I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +relación I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +pareja. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +La I-PAST_MEDICAL_HISTORY +violación I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +disfunción I-PAST_MEDICAL_HISTORY +sexual I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +habían I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +develadas I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente. I-PAST_MEDICAL_HISTORY +Un I-PAST_MEDICAL_HISTORY +ejemplo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +lo I-PAST_MEDICAL_HISTORY +anterior I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +constata I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +ficha I-PAST_MEDICAL_HISTORY +clínica, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +consulta I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +ginecología I-PAST_MEDICAL_HISTORY +previa I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +matrimonio I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +fibroadenoma I-PAST_MEDICAL_HISTORY +mamario, I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +médico I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +atendió I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +esa I-PAST_MEDICAL_HISTORY +oportunidad I-PAST_MEDICAL_HISTORY +consignó I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +antecedentes: I-PAST_MEDICAL_HISTORY +nulípara I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +relaciones I-PAST_MEDICAL_HISTORY +sexuales, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +referencia I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +traumáticos I-PAST_MEDICAL_HISTORY +sexuales. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Evolución B-EVOLUTION +y I-EVOLUTION +tratamiento. I-EVOLUTION +La I-EVOLUTION +paciente I-EVOLUTION +experimentó I-EVOLUTION +un I-EVOLUTION +gran I-EVOLUTION +alivio I-EVOLUTION +cuando I-EVOLUTION +el I-EVOLUTION +médico I-EVOLUTION +general I-EVOLUTION +le I-EVOLUTION +preguntó I-EVOLUTION +por I-EVOLUTION +el I-EVOLUTION +antecedente I-EVOLUTION +de I-EVOLUTION +abuso I-EVOLUTION +sexual. I-EVOLUTION +Uno I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +aspectos I-EVOLUTION +que I-EVOLUTION +más I-EVOLUTION +la I-EVOLUTION +habían I-EVOLUTION +angustiado I-EVOLUTION +durante I-EVOLUTION +su I-EVOLUTION +vida I-EVOLUTION +era I-EVOLUTION +el I-EVOLUTION +miedo I-EVOLUTION +de I-EVOLUTION +que I-EVOLUTION +otras I-EVOLUTION +personas, I-EVOLUTION +incluyendo I-EVOLUTION +su I-EVOLUTION +marido, I-EVOLUTION +supiesen I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +historia I-EVOLUTION +traumática I-EVOLUTION +sexual, I-EVOLUTION +pues I-EVOLUTION +se I-EVOLUTION +imaginaba I-EVOLUTION +que I-EVOLUTION +sería I-EVOLUTION +rechazada I-EVOLUTION y I-EVOLUTION -serológico. I-EVOLUTION +enjuiciada, I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +para I-EVOLUTION +su I-EVOLUTION +alivio I-EVOLUTION +no I-EVOLUTION +ocurrió. I-EVOLUTION I-EVOLUTION -Se I-EVOLUTION -considera I-EVOLUTION +Con I-EVOLUTION +el I-EVOLUTION +equipo I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +especialidad I-EVOLUTION +habló I-EVOLUTION +de I-EVOLUTION +sus I-EVOLUTION +otros I-EVOLUTION +antecedentes I-EVOLUTION +traumáticos. I-EVOLUTION +Posteriormente I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +tercera I-EVOLUTION +intervención, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +refirió I-EVOLUTION +sus I-EVOLUTION +traumas I-EVOLUTION +a I-EVOLUTION +su I-EVOLUTION +marido, I-EVOLUTION +quien I-EVOLUTION +no I-EVOLUTION +sólo I-EVOLUTION +la I-EVOLUTION +comprendió I-EVOLUTION +sino I-EVOLUTION que I-EVOLUTION +también I-EVOLUTION +le I-EVOLUTION +brindó I-EVOLUTION +apoyo. I-EVOLUTION +Después I-EVOLUTION +de I-EVOLUTION +este I-EVOLUTION +acontecimiento I-EVOLUTION la I-EVOLUTION -alopecia I-EVOLUTION -se I-EVOLUTION -resuelve I-EVOLUTION -totalmente I-EVOLUTION +paciente I-EVOLUTION +mejoró I-EVOLUTION +sustancialmente, I-EVOLUTION +remitieron I-EVOLUTION +los I-EVOLUTION +síntomas I-EVOLUTION +depresivos, I-EVOLUTION +la I-EVOLUTION +disfunción I-EVOLUTION +sexual I-EVOLUTION y I-EVOLUTION -sin I-EVOLUTION -secuelas I-EVOLUTION -hacia I-EVOLUTION el I-EVOLUTION -tercer I-EVOLUTION -mes I-EVOLUTION -después I-EVOLUTION -del I-EVOLUTION -tratamiento1. I-EVOLUTION +maltrato I-EVOLUTION +a I-EVOLUTION +su I-EVOLUTION +hija. I-EVOLUTION I-EVOLUTION -La I-EVOLUTION -incidencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -infección I-EVOLUTION -por I-EVOLUTION -sífilis I-EVOLUTION +Asistió I-EVOLUTION en I-EVOLUTION -el I-EVOLUTION -medio I-EVOLUTION -penitenciario I-EVOLUTION -es I-EVOLUTION -más I-EVOLUTION -alta I-EVOLUTION -que I-EVOLUTION +total I-EVOLUTION +a I-EVOLUTION +cinco I-EVOLUTION +controles I-EVOLUTION en I-EVOLUTION la I-EVOLUTION -población I-EVOLUTION -general2. I-EVOLUTION -La I-EVOLUTION -alopecia I-EVOLUTION -en I-EVOLUTION -cuero I-EVOLUTION -cabelludo I-EVOLUTION -es I-EVOLUTION -una I-EVOLUTION -manifestación I-EVOLUTION -poco I-EVOLUTION -común I-EVOLUTION +Unidad I-EVOLUTION +de I-EVOLUTION +Psiquiatría I-EVOLUTION en I-EVOLUTION -la I-EVOLUTION -sífilis I-EVOLUTION -secundaria3, I-EVOLUTION -se I-EVOLUTION -estima I-EVOLUTION +los I-EVOLUTION que I-EVOLUTION se I-EVOLUTION -presenta I-EVOLUTION -entre I-EVOLUTION -el I-EVOLUTION -4 I-EVOLUTION -y I-EVOLUTION +constató I-EVOLUTION +su I-EVOLUTION +mejoría. I-EVOLUTION +Durante B-TREATMENT +ese I-TREATMENT +tiempo I-TREATMENT +se I-TREATMENT +la I-TREATMENT +trató I-TREATMENT +con I-TREATMENT +fluoxetina I-TREATMENT +20 I-TREATMENT +mg/día I-TREATMENT +y I-TREATMENT +meleril I-TREATMENT +25 I-TREATMENT +mg/día. I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +seis I-EVOLUTION +meses I-EVOLUTION el I-EVOLUTION -11% I-EVOLUTION -según I-EVOLUTION -diversos I-EVOLUTION -estudios I-EVOLUTION -publicados4, I-EVOLUTION -5, I-EVOLUTION -pudiendo I-EVOLUTION -tratarse I-EVOLUTION -tanto I-EVOLUTION -de I-EVOLUTION -alopecias I-EVOLUTION -difusas I-EVOLUTION -como I-EVOLUTION +equipo I-EVOLUTION de I-EVOLUTION -aspecto I-EVOLUTION -apolillado6. I-EVOLUTION - I-EVOLUTION -Si I-EVOLUTION -bien I-EVOLUTION +salud I-EVOLUTION +mental I-EVOLUTION +se I-EVOLUTION +enteró I-EVOLUTION +que I-EVOLUTION la I-EVOLUTION -sífilis I-EVOLUTION -es I-EVOLUTION -poco I-EVOLUTION -habitual I-EVOLUTION -dentro I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -diferencial I-EVOLUTION -de I-EVOLUTION -alopecia, I-EVOLUTION -debe I-EVOLUTION -ser I-EVOLUTION -tenido I-EVOLUTION -en I-EVOLUTION -cuenta I-EVOLUTION -el I-EVOLUTION -secundarismo I-EVOLUTION -luético, I-EVOLUTION -en I-EVOLUTION -un I-EVOLUTION -contexto I-EVOLUTION -epidemiológico I-EVOLUTION +paciente I-EVOLUTION +estaba I-EVOLUTION +asintomática, I-EVOLUTION +trabajando I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +conflictos I-EVOLUTION de I-EVOLUTION -riesgo. I-EVOLUTION +pareja. I-EVOLUTION I-EVOLUTION -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -español I-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -28 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +41 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +antecedentes I-PRESENT_ILLNESS +mórbidos I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -institucionalizado B-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -prisión I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -diciembre I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -2009 I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -salvo I-PAST_MEDICAL_HISTORY -asma I-PAST_MEDICAL_HISTORY -bronquial I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -broncodilatadores I-PAST_MEDICAL_HISTORY -inhalados. I-PAST_MEDICAL_HISTORY -Previo I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -ingreso I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -prisión, I-PAST_MEDICAL_HISTORY -residió I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -nordeste I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Brasil, I-PAST_MEDICAL_HISTORY -estado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Ceará, I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -marzo I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -2008 I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -agosto I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -2009, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -áreas I-PAST_MEDICAL_HISTORY -suburbanas I-PAST_MEDICAL_HISTORY -("favelas"). I-PAST_MEDICAL_HISTORY -Durante I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -estancia I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -Brasil I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -consumido I-PAST_MEDICAL_HISTORY -agua I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -grifo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -ensaladas I-PAST_MEDICAL_HISTORY -frescas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -caminado I-PAST_MEDICAL_HISTORY -descalzo I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -barro. I-PAST_MEDICAL_HISTORY -También I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -sufrido I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cuadro I-PAST_MEDICAL_HISTORY -diarreico I-PAST_MEDICAL_HISTORY -autolimitado I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -origen I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -aclarado. I-PAST_MEDICAL_HISTORY -Doce B-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS +importancia, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -prisión I-PRESENT_ILLNESS -inicia I-PRESENT_ILLNESS un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS -marcado I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -adelgazamiento I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -10 I-PRESENT_ILLNESS -Kgs I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -peso, I-PRESENT_ILLNESS -acompañado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -mareos, I-PRESENT_ILLNESS -cefaleas I-PRESENT_ILLNESS -ocasionales I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -dispépsica. I-PRESENT_ILLNESS -Presentó I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -líquida, I-PRESENT_ILLNESS -acompañados I-PRESENT_ILLNESS +evolución, I-PRESENT_ILLNESS +caracterizado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +disnea I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -abdominal I-PRESENT_ILLNESS +rápida I-PRESENT_ILLNESS +progresión, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +tos I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +expectoración I-PRESENT_ILLNESS +hemoptoica I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -sin I-PRESENT_ILLNESS -presencia I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -productos I-PRESENT_ILLNESS -patológicos. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -únicamente I-EXPLORATION -destacaba I-EXPLORATION -una I-EXPLORATION -palidez I-EXPLORATION -marcada I-EXPLORATION -de I-EXPLORATION -piel I-EXPLORATION -y I-EXPLORATION -mucosas. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -analítica, I-EXPLORATION -el I-EXPLORATION -hemograma I-EXPLORATION -mostraba I-EXPLORATION -una I-EXPLORATION -hemoglobina I-EXPLORATION -de I-EXPLORATION -9, I-EXPLORATION -4 I-EXPLORATION -gr/ I-EXPLORATION -dL, I-EXPLORATION -un I-EXPLORATION -hematocrito I-EXPLORATION -de I-EXPLORATION -29, I-EXPLORATION -3%, I-EXPLORATION -un I-EXPLORATION -volumen I-EXPLORATION -corpuscular I-EXPLORATION -medio I-EXPLORATION -de I-EXPLORATION -65fL, I-EXPLORATION -leucocitos I-EXPLORATION -de I-EXPLORATION -10.900/mm3 I-EXPLORATION -(eosinófilos I-EXPLORATION -2.800/mm3), I-EXPLORATION -plaquetas I-EXPLORATION -431.000/mm3. I-EXPLORATION -Las I-EXPLORATION -serologías I-EXPLORATION -de I-EXPLORATION -VIH, I-EXPLORATION -hepatitis I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C I-EXPLORATION -fueron I-EXPLORATION -negativas. I-EXPLORATION -Se I-EXPLORATION -derivó I-EXPLORATION -para I-EXPLORATION +compromiso I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +estado I-PRESENT_ILLNESS +general. I-PRESENT_ILLNESS +Al B-EXPLORATION ingreso I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +AngioTAC I-EXPLORATION +que I-EXPLORATION +evidenció I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +tumoral, I-EXPLORATION +intracavitaria I-EXPLORATION en I-EXPLORATION -su I-EXPLORATION -hospital I-EXPLORATION +aurícula I-EXPLORATION +izquierda I-EXPLORATION +infiltrativa I-EXPLORATION +a I-EXPLORATION +venas I-EXPLORATION +pulmonares. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +complementó I-EXPLORATION +con I-EXPLORATION +ecocardiograma I-EXPLORATION +confirmando I-EXPLORATION +masa I-EXPLORATION +hiperdensa I-EXPLORATION de I-EXPLORATION -referencia, I-EXPLORATION -donde I-EXPLORATION -la I-EXPLORATION -bioquímica I-EXPLORATION -completa, I-EXPLORATION -incluidas I-EXPLORATION -pruebas I-EXPLORATION +43 I-EXPLORATION +x I-EXPLORATION +38 I-EXPLORATION +mm I-EXPLORATION +ocupando I-EXPLORATION +el I-EXPLORATION +75% I-EXPLORATION de I-EXPLORATION -función I-EXPLORATION -hepática I-EXPLORATION -y I-EXPLORATION la I-EXPLORATION -radiología I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -no I-EXPLORATION -mostraron I-EXPLORATION -alteraciones. I-EXPLORATION +aurícula I-EXPLORATION +izquierda. I-EXPLORATION + I-EXPLORATION Se I-EXPLORATION -realizaron I-EXPLORATION -estudios I-EXPLORATION +resecó I-EXPLORATION +quirúrgicamente I-EXPLORATION +cerca I-EXPLORATION de I-EXPLORATION -parásitos I-EXPLORATION -en I-EXPLORATION -heces I-EXPLORATION -en I-EXPLORATION -3 I-EXPLORATION -muestras I-EXPLORATION -consecutivas I-EXPLORATION +95% I-EXPLORATION +del I-EXPLORATION +tumor I-EXPLORATION por I-EXPLORATION -la I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -concentración I-EXPLORATION -con I-EXPLORATION -éterformol, I-EXPLORATION -observándose I-EXPLORATION +infiltración I-EXPLORATION +a I-EXPLORATION +venas I-EXPLORATION +pulmonares. I-EXPLORATION + I-EXPLORATION +El I-EXPLORATION +examen I-EXPLORATION +histológico I-EXPLORATION +demostró I-EXPLORATION la I-EXPLORATION presencia I-EXPLORATION de I-EXPLORATION -huevos I-EXPLORATION -de I-EXPLORATION -uncinarias. I-EXPLORATION -La I-EXPLORATION -serología I-EXPLORATION -para I-EXPLORATION -Strongyloides I-EXPLORATION -stercoralis I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -mediante I-EXPLORATION -técnica I-EXPLORATION -de I-EXPLORATION -ELISA I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +fusado I-EXPLORATION con I-EXPLORATION -una I-EXPLORATION -titulación I-EXPLORATION -de I-EXPLORATION -0.6 I-EXPLORATION -unidades I-EXPLORATION -de I-EXPLORATION -densidad I-EXPLORATION -óptica. I-EXPLORATION -Se B-TREATMENT -pautó I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -albendazol I-TREATMENT -400 I-TREATMENT -mg/12 I-TREATMENT -horas I-TREATMENT -(d.u) I-TREATMENT -e I-TREATMENT -ivermectina I-TREATMENT -200 I-TREATMENT -microgramos/Kg/día I-TREATMENT -dos I-TREATMENT -días I-TREATMENT -consecutivos I-TREATMENT -junto I-TREATMENT -con I-TREATMENT -sulfato I-TREATMENT -férrico I-TREATMENT -oral I-TREATMENT -durante I-TREATMENT -3 I-TREATMENT -meses. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -3 I-EVOLUTION -meses I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -una I-EVOLUTION -recuperación I-EVOLUTION -de I-EVOLUTION -todos I-EVOLUTION -los I-EVOLUTION -parámetros I-EVOLUTION -hematológicos I-EVOLUTION -y I-EVOLUTION -negativización I-EVOLUTION -tanto I-EVOLUTION -del I-EVOLUTION -análisis I-EVOLUTION -coproparasitológico I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -parásitos I-EVOLUTION -intestinales I-EVOLUTION -como I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -serología I-EVOLUTION -para I-EVOLUTION -Strongiloydes I-EVOLUTION -stercoralis. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -67 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -portadora I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -prótesis I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -rodilla I-PRESENT_ILLNESS -y B-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -colecistectomía I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -herniorrafia I-PAST_MEDICAL_HISTORY -umbilical, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -geniana I-PRESENT_ILLNESS -izquierda I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -unos I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -ido I-PRESENT_ILLNESS -disminuyendo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tamaño I-PRESENT_ILLNESS -muy I-PRESENT_ILLNESS -lentamente. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -única I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -referida I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -derivada I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tamaño I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tumor. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION +algunas I-EXPLORATION +células I-EXPLORATION +ovaladas, I-EXPLORATION +pericitos, I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -aprecian I-EXPLORATION -dos I-EXPLORATION -tumoraciones, I-EXPLORATION -aparentemente I-EXPLORATION -independientes I-EXPLORATION -entre I-EXPLORATION -sí I-EXPLORATION -y I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -parótida, I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -2 I-EXPLORATION -ó I-EXPLORATION -3 I-EXPLORATION -cm, I-EXPLORATION -móviles, I-EXPLORATION -bien I-EXPLORATION -definidas I-EXPLORATION +disponían I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +patrón I-EXPLORATION +sólido, I-EXPLORATION +interrumpido I-EXPLORATION +por I-EXPLORATION +espacios I-EXPLORATION +vasculares I-EXPLORATION +delgados, I-EXPLORATION +revestidos I-EXPLORATION +por I-EXPLORATION +células I-EXPLORATION +endoteliales I-EXPLORATION y I-EXPLORATION -de I-EXPLORATION -consistencia I-EXPLORATION -elástica. I-EXPLORATION +aplanadas. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -realiza I-EXPLORATION -PAAF I-EXPLORATION -preoperatoria I-EXPLORATION -que I-EXPLORATION -muestra I-EXPLORATION -un I-EXPLORATION -frotis I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION con I-EXPLORATION -cuadro I-EXPLORATION -citológico I-EXPLORATION -sugestivo I-EXPLORATION -de I-EXPLORATION -tumor I-EXPLORATION -mixto I-EXPLORATION -de I-EXPLORATION -glándula I-EXPLORATION -salival. I-EXPLORATION -Dado I-EXPLORATION -que I-EXPLORATION +inmuno-histoquímica I-EXPLORATION +demostró I-EXPLORATION +reactividad I-EXPLORATION +positiva I-EXPLORATION +para I-EXPLORATION +vimentina I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -la I-EXPLORATION -tumoración I-EXPLORATION -se I-EXPLORATION -localiza, I-EXPLORATION +las I-EXPLORATION +células I-EXPLORATION +proliferantes, I-EXPLORATION +CD-34 I-EXPLORATION +positivo I-EXPLORATION en I-EXPLORATION -principio, I-EXPLORATION -independiente I-EXPLORATION +el I-EXPLORATION +endotelio I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -parótida I-EXPLORATION +los I-EXPLORATION +vasos I-EXPLORATION y I-EXPLORATION +pericitos, I-EXPLORATION +factor I-EXPLORATION +VIII I-EXPLORATION +positivo I-EXPLORATION +sólo I-EXPLORATION en I-EXPLORATION -una I-EXPLORATION -localización I-EXPLORATION -poco I-EXPLORATION -frecuente I-EXPLORATION +endotelio, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +negatividad I-EXPLORATION para I-EXPLORATION -un I-EXPLORATION -adenoma I-EXPLORATION -pleomorfo, I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -realizar I-EXPLORATION -RNM. I-EXPLORATION -Esta I-EXPLORATION -evidencia I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -ocupante I-EXPLORATION -de I-EXPLORATION -espacio I-EXPLORATION -en I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -mejilla I-EXPLORATION -izquierda, I-EXPLORATION -de I-EXPLORATION -señal I-EXPLORATION -homogénea, I-EXPLORATION -hipointensa I-EXPLORATION -en I-EXPLORATION -T1 I-EXPLORATION +S-100 I-EXPLORATION y I-EXPLORATION -marcadamente I-EXPLORATION -hiperintensa I-EXPLORATION -en I-EXPLORATION -T2. I-EXPLORATION -Esta I-EXPLORATION -imagen I-EXPLORATION -es I-EXPLORATION -compatible I-EXPLORATION +CD-68. I-EXPLORATION +Estos I-EXPLORATION +hallazgos, I-EXPLORATION +junto I-EXPLORATION con I-EXPLORATION -linfangioma, I-EXPLORATION -que I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -parte I-EXPLORATION -craneal I-EXPLORATION -se I-EXPLORATION -extiende I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -altura I-EXPLORATION -del I-EXPLORATION -límite I-EXPLORATION -superior I-EXPLORATION +el I-EXPLORATION +claro I-EXPLORATION +patrón I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -órbita I-EXPLORATION -y I-EXPLORATION -desciende I-EXPLORATION +reticulina I-EXPLORATION en I-EXPLORATION -contacto I-EXPLORATION -con I-EXPLORATION +las I-EXPLORATION +técnicas I-EXPLORATION +argénticas, I-EXPLORATION +indicaron I-EXPLORATION el I-EXPLORATION -borde I-EXPLORATION -externo I-EXPLORATION -del I-EXPLORATION -masetero I-EXPLORATION -hasta I-EXPLORATION -la I-EXPLORATION -altura I-EXPLORATION +carácter I-EXPLORATION +pericítico I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -cavidad I-EXPLORATION -bucal I-EXPLORATION -donde I-EXPLORATION -lo I-EXPLORATION -bordea I-EXPLORATION -anteriormente I-EXPLORATION +neoplasia I-EXPLORATION y I-EXPLORATION se I-EXPLORATION -introduce I-EXPLORATION -medialmente I-EXPLORATION -contactando I-EXPLORATION +confirmó I-EXPLORATION +su I-EXPLORATION +carácter I-EXPLORATION +benigno I-EXPLORATION +histológico, I-EXPLORATION con I-EXPLORATION -el I-EXPLORATION -maxilar I-EXPLORATION -superior I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -pared I-EXPLORATION -externa I-EXPLORATION -del I-EXPLORATION -seno I-EXPLORATION -maxilar. I-EXPLORATION - I-EXPLORATION -Tras B-TREATMENT -realizar I-TREATMENT -preoperatorio, I-TREATMENT -se I-TREATMENT -practica I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -mediante I-TREATMENT -un I-TREATMENT -abordaje I-TREATMENT -intraoral. I-TREATMENT -Al B-EXPLORATION -incidir I-EXPLORATION -la I-EXPLORATION -mucosa I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -una I-EXPLORATION -formación I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -hernia, I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -resulta I-EXPLORATION -fácil I-EXPLORATION -de I-EXPLORATION -separar I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -tejidos I-EXPLORATION -circundantes I-EXPLORATION -mediante I-EXPLORATION -disección I-EXPLORATION -roma. I-EXPLORATION -El I-EXPLORATION -resultado I-EXPLORATION -final I-EXPLORATION -nos I-EXPLORATION -muestra I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -x I-EXPLORATION -7 I-EXPLORATION -cm, I-EXPLORATION +un I-EXPLORATION +índice I-EXPLORATION +mitótico I-EXPLORATION +inferior I-EXPLORATION +a I-EXPLORATION +tres I-EXPLORATION +mitosis I-EXPLORATION +por I-EXPLORATION +10 I-EXPLORATION +campos I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -quístico I-EXPLORATION -y I-EXPLORATION -forma I-EXPLORATION -tubular I-EXPLORATION -arrosariada. I-EXPLORATION +mayor I-EXPLORATION +aumento. I-EXPLORATION I-EXPLORATION -El I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +satisfactoriamente I-EVOLUTION +post I-EVOLUTION +cirugía I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +decidió I-EVOLUTION +el I-EVOLUTION +alta. I-EVOLUTION + I-EVOLUTION +Al I-EVOLUTION +mes I-EVOLUTION +siguiente, I-EVOLUTION +volvió I-EVOLUTION +a I-EVOLUTION +consultar I-EVOLUTION +por I-EVOLUTION +presentar I-EVOLUTION +dolor I-EVOLUTION +cervical I-EVOLUTION +intenso I-EVOLUTION +asociado I-EVOLUTION +a I-EVOLUTION +odinofagia. I-EVOLUTION +Se B-EXPLORATION +realizó I-EXPLORATION estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -extirpada I-EXPLORATION -muestra I-EXPLORATION -macroscópicamente I-EXPLORATION -una I-EXPLORATION -formación I-EXPLORATION -elongada, I-EXPLORATION -cilíndrica, I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -11 I-EXPLORATION -x I-EXPLORATION -1, I-EXPLORATION -7 I-EXPLORATION -cm I-EXPLORATION -cubierta I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -cápsula I-EXPLORATION -con I-EXPLORATION -vasos I-EXPLORATION -prominentes I-EXPLORATION -en I-EXPLORATION -superficie I-EXPLORATION -y I-EXPLORATION -estructuras I-EXPLORATION -cilíndricas I-EXPLORATION -adheridas I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -formación I-EXPLORATION -principal. I-EXPLORATION -Al I-EXPLORATION -corte I-EXPLORATION -presenta I-EXPLORATION -áreas I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -fibroso I-EXPLORATION -denso, I-EXPLORATION -hialinizado, I-EXPLORATION -alternando I-EXPLORATION +diseminación I-EXPLORATION con I-EXPLORATION +PET-CP I-EXPLORATION +que I-EXPLORATION +mostraba I-EXPLORATION zonas I-EXPLORATION +hipermetabólicas I-EXPLORATION +en I-EXPLORATION +pulmón, I-EXPLORATION +base I-EXPLORATION de I-EXPLORATION -aspecto I-EXPLORATION -más I-EXPLORATION -laxo. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -microscópico I-EXPLORATION -reveló I-EXPLORATION -una I-EXPLORATION -proliferación I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -con I-EXPLORATION -citoplasma I-EXPLORATION -eosinófilo, I-EXPLORATION +cráneo, I-EXPLORATION +hígado, I-EXPLORATION +amígdala I-EXPLORATION +izquierda, I-EXPLORATION +aurícula I-EXPLORATION +izquierda, I-EXPLORATION +suprarrenal I-EXPLORATION +izquierda, I-EXPLORATION +cola I-EXPLORATION de I-EXPLORATION -bordes I-EXPLORATION -mal I-EXPLORATION -definidos, I-EXPLORATION -con I-EXPLORATION -núcleos I-EXPLORATION -fusiformes I-EXPLORATION -con I-EXPLORATION -sus I-EXPLORATION -extremos I-EXPLORATION -elongados, I-EXPLORATION -que I-EXPLORATION +páncreas I-EXPLORATION +y I-EXPLORATION +colon I-EXPLORATION +descendente. I-EXPLORATION +Esto I-EXPLORATION se I-EXPLORATION -disponen I-EXPLORATION -en I-EXPLORATION -haces I-EXPLORATION -adquiriendo I-EXPLORATION +explicó I-EXPLORATION +por I-EXPLORATION +embolización I-EXPLORATION +del I-EXPLORATION +tumor I-EXPLORATION a I-EXPLORATION -veces I-EXPLORATION -un I-EXPLORATION -aspecto I-EXPLORATION -serpenteante I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -células. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -figuras I-EXPLORATION -de I-EXPLORATION -mitosis. I-EXPLORATION -La I-EXPLORATION -tumoración I-EXPLORATION -presenta I-EXPLORATION -zonas I-EXPLORATION -más I-EXPLORATION -densas I-EXPLORATION -que I-EXPLORATION -alternan I-EXPLORATION +la I-EXPLORATION +circulación I-EXPLORATION +sistémica. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +presentó I-TREATMENT +caso I-TREATMENT +a I-TREATMENT +comité I-TREATMENT +oncológico I-TREATMENT +que I-TREATMENT +decidió I-TREATMENT +manejo I-TREATMENT +paliativo I-TREATMENT +y I-TREATMENT +del I-TREATMENT +dolor. I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +2 I-EVOLUTION +meses, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +falleció I-EVOLUTION +de I-EVOLUTION +falla I-EVOLUTION +multiorgánica. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +54 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +hipertenso B-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +tabáquico, I-PAST_MEDICAL_HISTORY +programado B-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +tiroidectomía I-PRESENT_ILLNESS +total. I-PRESENT_ILLNESS +Inducción B-EXPLORATION +anestésica I-EXPLORATION +sin I-EXPLORATION +alteraciones I-EXPLORATION +hemodinámicas, I-EXPLORATION +pero I-EXPLORATION con I-EXPLORATION -otras I-EXPLORATION -mucho I-EXPLORATION -más I-EXPLORATION -laxas, I-EXPLORATION -contiene I-EXPLORATION -vasos I-EXPLORATION +modificación I-EXPLORATION de I-EXPLORATION -paredes I-EXPLORATION -a I-EXPLORATION -veces I-EXPLORATION -hialinizadas, I-EXPLORATION -en I-EXPLORATION -general I-EXPLORATION -finas I-EXPLORATION -y I-EXPLORATION -algunas I-EXPLORATION -dilatadas I-EXPLORATION -quísticamente. I-EXPLORATION -La I-EXPLORATION -tumoración I-EXPLORATION -aparece I-EXPLORATION -bien I-EXPLORATION -delimitada I-EXPLORATION +onda I-EXPLORATION +T I-EXPLORATION y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cápsula I-EXPLORATION -se I-EXPLORATION -observan I-EXPLORATION -fascículos I-EXPLORATION -nerviosos, I-EXPLORATION -algunos I-EXPLORATION -con I-EXPLORATION -comienzo I-EXPLORATION -de I-EXPLORATION -proliferación. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -anatomopatológico I-EXPLORATION -definitivo I-EXPLORATION -fue I-EXPLORATION -el I-EXPLORATION +segmento I-EXPLORATION +ST I-EXPLORATION +sugerente I-EXPLORATION de I-EXPLORATION -neurofibroma I-EXPLORATION -plexiforme. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -nuestro I-EXPLORATION -caso I-EXPLORATION +isquemia. I-EXPLORATION +La I-EXPLORATION +ETE I-EXPLORATION no I-EXPLORATION -encontramos I-EXPLORATION -ningún I-EXPLORATION -hallazgo I-EXPLORATION -clínico I-EXPLORATION -ni I-EXPLORATION -antecedente I-EXPLORATION -personal I-EXPLORATION -ó I-EXPLORATION -familiar I-EXPLORATION -sugestivo I-EXPLORATION -de I-EXPLORATION -neurofibromatosis I-EXPLORATION -tipo I-EXPLORATION -I I-EXPLORATION -ó I-EXPLORATION +mostraba I-EXPLORATION +alteraciones I-EXPLORATION de I-EXPLORATION -síndrome I-EXPLORATION -poliglandular I-EXPLORATION -MEN I-EXPLORATION -III I-EXPLORATION -(MEN I-EXPLORATION -IIb) I-EXPLORATION +la I-EXPLORATION +motilidad I-EXPLORATION +ventricular. I-EXPLORATION +Se I-EXPLORATION +decide I-EXPLORATION +suspender I-EXPLORATION y I-EXPLORATION -parece I-EXPLORATION -confirmar I-EXPLORATION +realizar I-EXPLORATION +coronariografía I-EXPLORATION que I-EXPLORATION -las I-EXPLORATION -lesiones I-EXPLORATION -aisladas I-EXPLORATION -son I-EXPLORATION -independientes I-EXPLORATION -de I-EXPLORATION -estos I-EXPLORATION -síndromes. I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION I-EXPLORATION -En B-EVOLUTION -la I-EVOLUTION -actualidad, I-EVOLUTION -dos I-EVOLUTION -años I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -intervención, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -ha I-EVOLUTION -presentado I-EVOLUTION -ningún I-EVOLUTION -signo I-EVOLUTION -de I-EVOLUTION -recidiva I-EVOLUTION -tumoral I-EVOLUTION -en I-EVOLUTION -las I-EVOLUTION -sucesivas I-EVOLUTION -revisiones. I-EVOLUTION - I-EVOLUTION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestra I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS +46 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +ingresada I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -dolorosa, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -lento I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -seis I-PRESENT_ILLNESS -meses I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -maxilar I-PRESENT_ILLNESS -superior, I-PRESENT_ILLNESS -entre I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -premolares I-PRESENT_ILLNESS -14 I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS +anémico I-PRESENT_ILLNESS +(Hb I-PRESENT_ILLNESS +10 I-PRESENT_ILLNESS +g/dl, I-PRESENT_ILLNESS +Hto I-PRESENT_ILLNESS +30%) I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -15, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -permanecen I-PRESENT_ILLNESS -vitales, I-PRESENT_ILLNESS -desplazando I-PRESENT_ILLNESS -ligeramente I-PRESENT_ILLNESS -sus I-PRESENT_ILLNESS -raíces. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -hay I-PRESENT_ILLNESS -dolor, I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -alteraciones I-PRESENT_ILLNESS -tróficas I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -signos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -inflamación. I-PRESENT_ILLNESS +constitucional. I-PRESENT_ILLNESS A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -se I-EXPLORATION -apreciaba I-EXPLORATION -una I-EXPLORATION -expansión I-EXPLORATION +física I-EXPLORATION +presentaba I-EXPLORATION +manchas I-EXPLORATION +"café I-EXPLORATION +con I-EXPLORATION +leche" I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -corteza I-EXPLORATION -vestibular, I-EXPLORATION +espalda I-EXPLORATION +y I-EXPLORATION +cuello, I-EXPLORATION +y I-EXPLORATION +múltiples I-EXPLORATION +neurofibromas. I-EXPLORATION +El I-EXPLORATION +abdomen I-EXPLORATION +era I-EXPLORATION +blando, I-EXPLORATION +doloroso I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +en I-EXPLORATION +hipogastrio I-EXPLORATION +y I-EXPLORATION +zona I-EXPLORATION +periumbilical, I-EXPLORATION +sin I-EXPLORATION +masas I-EXPLORATION +palpables I-EXPLORATION +y I-EXPLORATION con I-EXPLORATION -integridad I-EXPLORATION +peristalsis I-EXPLORATION +conservada. I-EXPLORATION +El I-EXPLORATION +tacto I-EXPLORATION +rectal I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +refería I-EXPLORATION +presentar I-EXPLORATION +un I-EXPLORATION +fenotipo I-EXPLORATION +similar I-EXPLORATION +a I-EXPLORATION +su I-EXPLORATION +padre. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +ecografía I-EXPLORATION +abdominal, I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +engrosamiento I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -misma. I-EXPLORATION -En I-EXPLORATION +pared I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +asa I-EXPLORATION +intestinal I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +trayecto I-EXPLORATION +de I-EXPLORATION +3 I-EXPLORATION +cm, I-EXPLORATION +y I-EXPLORATION +TAC I-EXPLORATION +abdominal, I-EXPLORATION +objetivándose I-EXPLORATION la I-EXPLORATION -radiografía I-EXPLORATION -existía I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION una I-EXPLORATION -imagen I-EXPLORATION -radiolúcida I-EXPLORATION -entre I-EXPLORATION -las I-EXPLORATION -raíces I-EXPLORATION +tumoración I-EXPLORATION +intraluminal I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -premolares I-EXPLORATION -superiores. I-EXPLORATION +10 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION +colon I-EXPLORATION +ascendente. I-EXPLORATION +Se B-TREATMENT +intervino I-TREATMENT +quirúrgicamente, I-TREATMENT +hallándose I-TREATMENT +3 I-TREATMENT +tumoraciones, I-TREATMENT +la I-TREATMENT +mayor I-TREATMENT +de I-TREATMENT +12 I-TREATMENT +cm, I-TREATMENT +que I-TREATMENT +englobaba I-TREATMENT +íleon I-TREATMENT +terminal I-TREATMENT +y I-TREATMENT +ciego, I-TREATMENT +y I-TREATMENT +otras I-TREATMENT +dos I-TREATMENT +de I-TREATMENT +3, I-TREATMENT +5 I-TREATMENT +y I-TREATMENT +1, I-TREATMENT +2 I-TREATMENT +cm, I-TREATMENT +proximales I-TREATMENT +a I-TREATMENT +la I-TREATMENT +primera. I-TREATMENT +El B-EXPLORATION +informe I-EXPLORATION +anatomopatológico, I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +GIST, I-EXPLORATION +describía I-EXPLORATION +formación I-EXPLORATION +nodular I-EXPLORATION +fusiforme, I-EXPLORATION +con I-EXPLORATION +marcada I-EXPLORATION +positividad I-EXPLORATION +para I-EXPLORATION +CD I-EXPLORATION +117, I-EXPLORATION +CD I-EXPLORATION +34, I-EXPLORATION +y I-EXPLORATION +negatividad I-EXPLORATION +para I-EXPLORATION +S-100. I-EXPLORATION I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -nos I-EXPLORATION -dio I-EXPLORATION + +MRB. B-PRESENT_ILLNESS +Varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +67 I-PRESENT_ILLNESS +años. I-PRESENT_ILLNESS +Hermano. B-FAMILY_HISTORY +Casado I-FAMILY_HISTORY +y I-FAMILY_HISTORY +con I-FAMILY_HISTORY +2 I-FAMILY_HISTORY +hijos, I-FAMILY_HISTORY +uno I-FAMILY_HISTORY +afecto I-FAMILY_HISTORY +de I-FAMILY_HISTORY +esclerosis I-FAMILY_HISTORY +múltiple. I-FAMILY_HISTORY +Rinitis B-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +faringitis I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +repetición I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +infancia. I-PAST_MEDICAL_HISTORY +Lesiones I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +psoriasis I-PAST_MEDICAL_HISTORY +generalizada, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +codos, I-PAST_MEDICAL_HISTORY +rodillas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +cuero I-PAST_MEDICAL_HISTORY +cabelludo I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +25 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION +hemograma I-EXPLORATION +destaca I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +leucopenia I-EXPLORATION +mantenida I-EXPLORATION +(3.700), I-EXPLORATION +acompañada I-EXPLORATION de I-EXPLORATION -OKC I-EXPLORATION +ligero I-EXPLORATION +descenso I-EXPLORATION +de I-EXPLORATION +ferritina I-EXPLORATION +(21 I-EXPLORATION +ng/ml) I-EXPLORATION +sin I-EXPLORATION +anemia I-EXPLORATION +asociada I-EXPLORATION +y I-EXPLORATION con I-EXPLORATION -aisladas I-EXPLORATION -microinclusiones I-EXPLORATION -córneas I-EXPLORATION -en I-EXPLORATION +descenso I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +niveles I-EXPLORATION +séricos I-EXPLORATION +de I-EXPLORATION +vitamina I-EXPLORATION +B12 I-EXPLORATION +(177 I-EXPLORATION +pg/ml). I-EXPLORATION +La I-EXPLORATION +TTG I-EXPLORATION +estaba I-EXPLORATION +discretamente I-EXPLORATION +elevada I-EXPLORATION +(1, I-EXPLORATION +74 I-EXPLORATION +U/ml) I-EXPLORATION +(N I-EXPLORATION +≤ I-EXPLORATION +1). I-EXPLORATION +Es I-EXPLORATION +DQ2 I-EXPLORATION +(+) I-EXPLORATION +y I-EXPLORATION la I-EXPLORATION -pared I-EXPLORATION -quística I-EXPLORATION -que I-EXPLORATION -ofrece I-EXPLORATION -aislado I-EXPLORATION -componente I-EXPLORATION -cartilaginoso; I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -proliferación I-EXPLORATION -celular I-EXPLORATION -ameloblástica. I-EXPLORATION - I-EXPLORATION +biopsia I-EXPLORATION +duodenal I-EXPLORATION +fue I-EXPLORATION +interpretada I-EXPLORATION +como I-EXPLORATION +normal I-EXPLORATION +(estadio I-EXPLORATION +0 I-EXPLORATION +de I-EXPLORATION +Marsh). I-EXPLORATION +Se B-TREATMENT +le I-TREATMENT +diagnosticó I-TREATMENT +de I-TREATMENT +EC I-TREATMENT +hace I-TREATMENT +6 I-TREATMENT +meses I-TREATMENT +y I-TREATMENT +se I-TREATMENT +puso I-TREATMENT +a I-TREATMENT +DSG I-TREATMENT +con B-EVOLUTION +buena I-EVOLUTION +respuesta I-EVOLUTION +clínica I-EVOLUTION +y I-EVOLUTION +analítica I-EVOLUTION +al I-EVOLUTION +cabo I-EVOLUTION +de I-EVOLUTION +ellos. I-EVOLUTION + I-EVOLUTION Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -raza I-PRESENT_ILLNESS -blanca, I-PRESENT_ILLNESS -80 I-PRESENT_ILLNESS +50 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad, I-PRESENT_ILLNESS sin B-PAST_MEDICAL_HISTORY +alergias I-PAST_MEDICAL_HISTORY +medicamentosas I-PAST_MEDICAL_HISTORY +conocidas, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -acudió I-PRESENT_ILLNESS +ser I-PAST_MEDICAL_HISTORY +fumadora I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +20 I-PAST_MEDICAL_HISTORY +cigarrillos I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +día, I-PAST_MEDICAL_HISTORY +2 I-PAST_MEDICAL_HISTORY +embarazos I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +complicaciones I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +cirugía I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +estapedectomía I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +oído I-PAST_MEDICAL_HISTORY +izquierdo I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +otoesclerosis. I-PAST_MEDICAL_HISTORY +Acude B-PRESENT_ILLNESS a I-PRESENT_ILLNESS -nuestra I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS consulta I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Traumatología I-PRESENT_ILLNESS +derivada I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +Centro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Salud I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +Mayo I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +2002 I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -disfagia I-PRESENT_ILLNESS -progresiva I-PRESENT_ILLNESS +omalgia I-PRESENT_ILLNESS +izquierda I-PRESENT_ILLNESS +atraumática I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS evolución. I-PRESENT_ILLNESS +Previamente I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +sido I-PRESENT_ILLNESS +valorada I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +tratada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +servicios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Neurología, I-PRESENT_ILLNESS +Reumatología I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +Rehabilitación I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +mejoría. I-PRESENT_ILLNESS A B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -induración I-EXPLORATION -eritematosa, I-EXPLORATION -parcialmente I-EXPLORATION -ulcerada, I-EXPLORATION +presentaba I-EXPLORATION +un I-EXPLORATION +dolor I-EXPLORATION +inespecífico I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -dorso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lengua I-EXPLORATION -dolorosa I-EXPLORATION -al I-EXPLORATION -tacto. I-EXPLORATION -No I-EXPLORATION +tercio I-EXPLORATION +medio I-EXPLORATION +del I-EXPLORATION +brazo I-EXPLORATION +izquierdo, I-EXPLORATION +que I-EXPLORATION +en I-EXPLORATION +ocasiones I-EXPLORATION se I-EXPLORATION -objetivó, I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación, I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION -adenomegalias, I-EXPLORATION +exacerbaba I-EXPLORATION +sin I-EXPLORATION +relación I-EXPLORATION +con I-EXPLORATION +esfuerzos I-EXPLORATION ni I-EXPLORATION +cambios I-EXPLORATION +posturales. I-EXPLORATION +No I-EXPLORATION +habia I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -otras I-EXPLORATION -masas I-EXPLORATION -cervicales. I-EXPLORATION +atrapamiento I-EXPLORATION +subacromial I-EXPLORATION +ni I-EXPLORATION +atrofias I-EXPLORATION +musculares I-EXPLORATION +clínicamente I-EXPLORATION +evidentes. I-EXPLORATION +La I-EXPLORATION +movilidad I-EXPLORATION +era I-EXPLORATION +completa. I-EXPLORATION +Los I-EXPLORATION +reflejos I-EXPLORATION +eran I-EXPLORATION +normales I-EXPLORATION +y I-EXPLORATION +simétricos. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +RM I-EXPLORATION +cervical I-EXPLORATION +que I-EXPLORATION +aportaba I-EXPLORATION +(Abril I-EXPLORATION +2002) I-EXPLORATION +no I-EXPLORATION +presentaba I-EXPLORATION +hallazgos I-EXPLORATION +patológicos I-EXPLORATION +evidentes. I-EXPLORATION + I-EXPLORATION Se I-EXPLORATION -efectuó I-EXPLORATION +realiza I-EXPLORATION una I-EXPLORATION -biopsia I-EXPLORATION -incisional I-EXPLORATION -cuyo I-EXPLORATION -estudio I-EXPLORATION -histopatológico I-EXPLORATION -evidenció I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION +RM I-EXPLORATION de I-EXPLORATION +hombro I-EXPLORATION +(Mayo I-EXPLORATION +2002) I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION una I-EXPLORATION -proliferación I-EXPLORATION -uniforme I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -linfoides I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -linfoma. I-EXPLORATION -La I-EXPLORATION -analítica I-EXPLORATION -preoperatoria I-EXPLORATION -(hemograma, I-EXPLORATION -bioquímica) I-EXPLORATION +rotura I-EXPLORATION +parcial I-EXPLORATION +del I-EXPLORATION +tendón I-EXPLORATION +supraespinoso I-EXPLORATION y I-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -no I-EXPLORATION -mostraron I-EXPLORATION -alteraciones I-EXPLORATION -significativas. I-EXPLORATION -Bajo B-TREATMENT -anestesia I-TREATMENT -local I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -exéresis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -tumoración I-TREATMENT +bursitis I-EXPLORATION +subacromial I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +tratada I-TREATMENT +mediante I-TREATMENT +infiltraciones I-TREATMENT +locales I-TREATMENT con I-TREATMENT -amplios I-TREATMENT -márgenes I-TREATMENT -de I-TREATMENT -seguridad. I-TREATMENT +corticoides I-TREATMENT +y I-TREATMENT +rehabilitación I-TREATMENT +sin I-TREATMENT +mejoría. I-TREATMENT I-TREATMENT -Microscópicamente, B-EXPLORATION -el I-EXPLORATION -infiltrado I-EXPLORATION -linfoide I-EXPLORATION -ulceraba I-EXPLORATION -la I-EXPLORATION -superficie I-EXPLORATION -epitelial I-EXPLORATION -infiltrando, I-EXPLORATION -en I-EXPLORATION -profundidad, I-EXPLORATION -la I-EXPLORATION -musculatura I-EXPLORATION -lingual. I-EXPLORATION -Alrededor I-EXPLORATION -de I-EXPLORATION -este I-EXPLORATION -infiltrado I-EXPLORATION +La B-EVOLUTION +paciente I-EVOLUTION +seguía I-EVOLUTION +presentando I-EVOLUTION +la I-EVOLUTION +misma I-EVOLUTION +sintomatología I-EVOLUTION +por B-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -podían I-EXPLORATION -reconocer I-EXPLORATION -múltiples I-EXPLORATION -folículos I-EXPLORATION -linfoides; I-EXPLORATION -algunos I-EXPLORATION -mostraban I-EXPLORATION -centros I-EXPLORATION -germinales I-EXPLORATION -reactivos I-EXPLORATION -con I-EXPLORATION -histiocitos I-EXPLORATION -tipo I-EXPLORATION -cielo I-EXPLORATION -estrellado I-EXPLORATION -(starry-sky); I-EXPLORATION -otros I-EXPLORATION -mostraron I-EXPLORATION -cambios I-EXPLORATION -regresivos I-EXPLORATION -en I-EXPLORATION -los I-EXPLORATION -centros I-EXPLORATION -germinales I-EXPLORATION -con I-EXPLORATION -depósitos I-EXPLORATION -de I-EXPLORATION -sustancia I-EXPLORATION -eosinófila I-EXPLORATION -homogénea. I-EXPLORATION -Todos I-EXPLORATION -estaban I-EXPLORATION -rodeados I-EXPLORATION -por I-EXPLORATION +realizó I-EXPLORATION un I-EXPLORATION -importante I-EXPLORATION -infiltrado I-EXPLORATION -perifolicular I-EXPLORATION -compuesto I-EXPLORATION -por I-EXPLORATION -pequeñas I-EXPLORATION -células I-EXPLORATION -linfoides I-EXPLORATION -con I-EXPLORATION -núcleos I-EXPLORATION -ligeramente I-EXPLORATION -irregulares I-EXPLORATION -y I-EXPLORATION -acúmulos I-EXPLORATION +estudio I-EXPLORATION +neurofisiológico I-EXPLORATION +(Junio I-EXPLORATION +2003) I-EXPLORATION de I-EXPLORATION -cromatina I-EXPLORATION -moderadamente I-EXPLORATION -densos I-EXPLORATION -similares I-EXPLORATION -a I-EXPLORATION los I-EXPLORATION -centrocitos I-EXPLORATION +músculos I-EXPLORATION +dependientes I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -marginal. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -pudo I-EXPLORATION -reconocer I-EXPLORATION -la I-EXPLORATION -existencia I-EXPLORATION +C5-C6 I-EXPLORATION +izquierdos, I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +normal. I-EXPLORATION +Se I-EXPLORATION +realiza I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +RM I-EXPLORATION de I-EXPLORATION -numerosos I-EXPLORATION -histiocitos I-EXPLORATION +hombro I-EXPLORATION +(Agosto I-EXPLORATION +2003) I-EXPLORATION +que I-EXPLORATION +evidencia I-EXPLORATION +nuevamente I-EXPLORATION +una I-EXPLORATION +rotura I-EXPLORATION +parcial I-EXPLORATION +del I-EXPLORATION +tendón I-EXPLORATION +supraespinoso. I-EXPLORATION +Ante I-EXPLORATION +esta I-EXPLORATION +situación I-EXPLORATION y I-EXPLORATION -eosinófilos. I-EXPLORATION -Ocasionalmente I-EXPLORATION -algunas I-EXPLORATION -células I-EXPLORATION de I-EXPLORATION -gran I-EXPLORATION -tamaño, I-EXPLORATION -con I-EXPLORATION -varios I-EXPLORATION -nucleolos I-EXPLORATION -prominentes, I-EXPLORATION -se I-EXPLORATION -entremezclaban I-EXPLORATION +acuerdo I-EXPLORATION con I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -pequeñas I-EXPLORATION -formando I-EXPLORATION -columnas I-EXPLORATION -de I-EXPLORATION -centroblastos I-EXPLORATION -e I-EXPLORATION -inmunoblastos. I-EXPLORATION -También I-EXPLORATION -podía I-EXPLORATION -reconocerse I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION +paciente I-EXPLORATION +se I-EXPLORATION +decide I-EXPLORATION +exploración I-EXPLORATION +artroscópica I-EXPLORATION +(Diciembre I-EXPLORATION +2003) I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -importante I-EXPLORATION -diferenciación I-EXPLORATION -plasmocitoide, I-EXPLORATION -predominante I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -paraseptal I-EXPLORATION +bursitis I-EXPLORATION +subacromial I-EXPLORATION +con I-EXPLORATION +manguito I-EXPLORATION +íntegro, I-EXPLORATION +realizándose B-TREATMENT +una I-TREATMENT +acromioplastia I-TREATMENT +artroscópica. I-TREATMENT +Tras B-EXPLORATION +dicha I-EXPLORATION +intervención I-EXPLORATION y I-EXPLORATION -subepitelial. I-EXPLORATION -En I-EXPLORATION -los I-EXPLORATION -bordes I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -tumoración, I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION +nueva I-EXPLORATION +rehabilitación I-EXPLORATION la I-EXPLORATION -existencia I-EXPLORATION -de I-EXPLORATION -lóbulos, I-EXPLORATION -parcialmente I-EXPLORATION -conservados, I-EXPLORATION -de I-EXPLORATION -glándulas I-EXPLORATION -salivales I-EXPLORATION -menores I-EXPLORATION -de I-EXPLORATION -tipo I-EXPLORATION -mucoso, I-EXPLORATION -mostrando I-EXPLORATION +paciente I-EXPLORATION +no I-EXPLORATION +muestra I-EXPLORATION +mejoría I-EXPLORATION +clínica. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +decide I-EXPLORATION +realizar I-EXPLORATION una I-EXPLORATION -destacada I-EXPLORATION -infiltración I-EXPLORATION -linfoidea. I-EXPLORATION -Los I-EXPLORATION -conductos I-EXPLORATION -salivales I-EXPLORATION -estaban I-EXPLORATION -dilatados I-EXPLORATION -e I-EXPLORATION -infiltrados I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -B I-EXPLORATION -con I-EXPLORATION -formación I-EXPLORATION -ocasional I-EXPLORATION +serie I-EXPLORATION de I-EXPLORATION -islas I-EXPLORATION -epimioepiteliales. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -podían I-EXPLORATION -reconocer, I-EXPLORATION -abundantes I-EXPLORATION -células I-EXPLORATION -plasmáticas I-EXPLORATION -alrededor I-EXPLORATION +pruebas I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -conductos I-EXPLORATION -glandulares. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -se I-EXPLORATION -efectuó I-EXPLORATION -sobre I-EXPLORATION -secciones I-EXPLORATION -congeladas I-EXPLORATION -y I-EXPLORATION -fijadas I-EXPLORATION +imagen I-EXPLORATION +que I-EXPLORATION +consistieron I-EXPLORATION en I-EXPLORATION -formalina I-EXPLORATION -y I-EXPLORATION -parafina, I-EXPLORATION -utilizando I-EXPLORATION -el I-EXPLORATION -método I-EXPLORATION -estreptavidina-biotina. I-EXPLORATION -Se I-EXPLORATION -emplearon I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -anticuerpos: I-EXPLORATION -CD20, I-EXPLORATION -CD3, I-EXPLORATION -CD5, I-EXPLORATION -CD10, I-EXPLORATION -CD23, I-EXPLORATION -CD43, I-EXPLORATION -DBA44, I-EXPLORATION -CD68, I-EXPLORATION -inmunoglobulinas I-EXPLORATION -α, I-EXPLORATION -γ, I-EXPLORATION -µ I-EXPLORATION +un I-EXPLORATION +TAC I-EXPLORATION +torácico I-EXPLORATION +(Diciembre I-EXPLORATION +2004), I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION de I-EXPLORATION -cadena I-EXPLORATION -pesada I-EXPLORATION +hombro I-EXPLORATION +izquierdo I-EXPLORATION y I-EXPLORATION -κ, I-EXPLORATION -λ I-EXPLORATION -de I-EXPLORATION -cadena I-EXPLORATION -ligera. I-EXPLORATION -Las I-EXPLORATION -células I-EXPLORATION -centrocíticas, I-EXPLORATION +una I-EXPLORATION +RM I-EXPLORATION +del I-EXPLORATION +plexo I-EXPLORATION +braquial I-EXPLORATION +(Enero I-EXPLORATION +2005) I-EXPLORATION +que I-EXPLORATION mostraron I-EXPLORATION -un I-EXPLORATION -fenotipo I-EXPLORATION -B, I-EXPLORATION -con I-EXPLORATION -positividad I-EXPLORATION -para I-EXPLORATION -CD20, I-EXPLORATION -CD5 I-EXPLORATION -y I-EXPLORATION -CD43. I-EXPLORATION -CD10, I-EXPLORATION -CD23 I-EXPLORATION -y I-EXPLORATION -DBA44 I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -También I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION una I-EXPLORATION -pequeña I-EXPLORATION -proporción I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -T, I-EXPLORATION +lesión I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -positividad I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -CD3. I-EXPLORATION -Las I-EXPLORATION -células I-EXPLORATION -plasmáticas I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -bandas I-EXPLORATION -paraseptales I-EXPLORATION -y I-EXPLORATION -subepiteliales I-EXPLORATION +schwannoma I-EXPLORATION +del I-EXPLORATION +plexo I-EXPLORATION +braquial. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +RM I-EXPLORATION +del I-EXPLORATION +plexo I-EXPLORATION +braquial I-EXPLORATION +(Junio I-EXPLORATION +2005) I-EXPLORATION +mostrando I-EXPLORATION +la I-EXPLORATION +misma I-EXPLORATION +lesión I-EXPLORATION y I-EXPLORATION -también I-EXPLORATION -las I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -conductos I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -glándulas I-EXPLORATION -mucosas, I-EXPLORATION -mostraron I-EXPLORATION -producción I-EXPLORATION -de I-EXPLORATION -inmunoglobulina I-EXPLORATION -IgG/κ. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION -definitivo I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -linfoma I-EXPLORATION -MALT. I-EXPLORATION -Las I-EXPLORATION -alteraciones I-EXPLORATION -morfológicas I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -glándulas I-EXPLORATION -salivales I-EXPLORATION -menores I-EXPLORATION -próximas I-EXPLORATION -al I-EXPLORATION -tumor, I-EXPLORATION +nuevo I-EXPLORATION +estudio I-EXPLORATION +neurofisiológico I-EXPLORATION +(Julio I-EXPLORATION +2005) I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -interpretaron I-EXPLORATION +evidenciaba I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +afectación I-EXPLORATION +del I-EXPLORATION +plexo I-EXPLORATION +braquial. I-EXPLORATION +En B-TREATMENT +este I-TREATMENT +momento I-TREATMENT +se I-TREATMENT +plantea I-TREATMENT +a I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +la I-TREATMENT +posibilidad I-TREATMENT +de I-TREATMENT +una I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +para I-TREATMENT +su I-TREATMENT +resección. I-TREATMENT +El I-TREATMENT +tratamiento I-TREATMENT +de I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +en I-TREATMENT +ese I-TREATMENT +momento I-TREATMENT +incluía I-TREATMENT +pregabalina I-TREATMENT +(300 I-TREATMENT +mg/12 I-TREATMENT +horas), I-TREATMENT +fentanilo I-TREATMENT +transdermico I-TREATMENT +(50 I-TREATMENT +μg/72 I-TREATMENT +horas) I-TREATMENT +y I-TREATMENT +ketorolaco I-TREATMENT +(10 I-TREATMENT +mg/8 I-TREATMENT +horas). I-TREATMENT + I-TREATMENT +La I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +se I-TREATMENT +lleva I-TREATMENT +a I-TREATMENT +cabo I-TREATMENT +en I-TREATMENT +Agosto I-TREATMENT +2005 I-TREATMENT +procediéndose I-TREATMENT +a I-TREATMENT +la I-TREATMENT +extirpación I-TREATMENT +del I-TREATMENT +tumor I-TREATMENT +mediante I-TREATMENT +osteotomía I-TREATMENT +de I-TREATMENT +clavícula I-TREATMENT +con I-TREATMENT +posterior I-TREATMENT +reconstrucción I-TREATMENT +con I-TREATMENT +placa. I-TREATMENT +La B-EVOLUTION +anestesia I-EVOLUTION +y I-EVOLUTION +cirugía I-EVOLUTION +transcurren I-EVOLUTION +sin I-EVOLUTION +incidencias. I-EVOLUTION +La B-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +lo I-EXPLORATION +describe I-EXPLORATION como I-EXPLORATION -sialoadenitis I-EXPLORATION -mioepitelial. I-EXPLORATION +schwannoma I-EXPLORATION +(neurilenoma) I-EXPLORATION +antiguo. I-EXPLORATION I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -no I-EVOLUTION -sufrió I-EVOLUTION -otras I-EVOLUTION -manifestaciones I-EVOLUTION -de I-EVOLUTION -enfermedad I-EVOLUTION -como I-EVOLUTION -síndrome I-EVOLUTION +En B-EVOLUTION +posteriores I-EVOLUTION +consultas I-EVOLUTION +el I-EVOLUTION +dolor I-EVOLUTION de I-EVOLUTION -Sjögren, I-EVOLUTION -artritis I-EVOLUTION -reumatoide I-EVOLUTION -diseminada, I-EVOLUTION -lupus I-EVOLUTION -eritematoso, I-EVOLUTION +miembro I-EVOLUTION +superior I-EVOLUTION +izquierdo I-EVOLUTION +se I-EVOLUTION +había I-EVOLUTION +resuelto. I-EVOLUTION +Sólo I-EVOLUTION +quedó I-EVOLUTION +una I-EVOLUTION +ligera I-EVOLUTION +hipoestesia I-EVOLUTION +a I-EVOLUTION +nivel I-EVOLUTION +del I-EVOLUTION +territorio I-EVOLUTION +del I-EVOLUTION +nervio I-EVOLUTION +circunflejo, I-EVOLUTION +sin I-EVOLUTION +evidenciarse I-EVOLUTION +alteraciones I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +fuerza I-EVOLUTION o I-EVOLUTION -tiroiditis I-EVOLUTION +los I-EVOLUTION +reflejos, I-EVOLUTION +que I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +última I-EVOLUTION +revisión I-EVOLUTION de I-EVOLUTION -Hashimoto. I-EVOLUTION -El I-EVOLUTION -linfoma I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION se I-EVOLUTION -consideró I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -tanto I-EVOLUTION -en I-EVOLUTION -un I-EVOLUTION -estadio I-EVOLUTION -IE. I-EVOLUTION -La B-TREATMENT -paciente I-TREATMENT -no I-TREATMENT -ha I-TREATMENT -recibido I-TREATMENT -ningún I-TREATMENT -tratamiento I-TREATMENT -salvo I-TREATMENT -el I-TREATMENT -quirúrgico, I-TREATMENT -sin I-TREATMENT -presentar I-TREATMENT -signos I-TREATMENT -de I-TREATMENT -enfermedad I-TREATMENT -al I-TREATMENT -año I-TREATMENT -del I-TREATMENT -diagnóstico. I-TREATMENT - I-TREATMENT +había I-EVOLUTION +normalizado. I-EVOLUTION + I-EVOLUTION Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -63 I-PRESENT_ILLNESS +62 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -úlcera I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -encía I-PRESENT_ILLNESS -adherida I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -molar I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -mes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -cedido I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -conservador. I-PRESENT_ILLNESS -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -oral I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -presentaba I-EXPLORATION -una I-EXPLORATION -úlcera I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -zona I-EXPLORATION -molar I-EXPLORATION -superior I-EXPLORATION -izquierda, I-EXPLORATION -con I-EXPLORATION -fondo I-EXPLORATION -necrótico I-EXPLORATION -y I-EXPLORATION -bordes I-EXPLORATION -sobreelevados I-EXPLORATION -y I-EXPLORATION -eritematosos I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -mayor, I-EXPLORATION -junto I-EXPLORATION -a I-EXPLORATION -un I-EXPLORATION -abombamiento I-EXPLORATION -en I-EXPLORATION -fondo I-EXPLORATION -vestibular I-EXPLORATION -superior I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -paladar I-EXPLORATION -duro I-EXPLORATION -(lado I-EXPLORATION -izquierdo). I-EXPLORATION -Como B-PAST_MEDICAL_HISTORY +con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -fumador I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -bebedor I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -refería I-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -operado I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -adenocarcinoma I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +poliquística I-PAST_MEDICAL_HISTORY +hepatorenal, I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +crónica, I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -esófago I-PAST_MEDICAL_HISTORY +Crohn I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -1/3 I-PAST_MEDICAL_HISTORY -distal I-PAST_MEDICAL_HISTORY -hacía I-PAST_MEDICAL_HISTORY -cuatro I-PAST_MEDICAL_HISTORY -meses. I-PAST_MEDICAL_HISTORY -Se I-PAST_MEDICAL_HISTORY -trataba I-PAST_MEDICAL_HISTORY +fenotipo I-PAST_MEDICAL_HISTORY +inflamatorio I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +compromiso I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -adenocarcinoma I-PAST_MEDICAL_HISTORY +yeyuno I-PAST_MEDICAL_HISTORY +(demostrado I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +tomografía I-PAST_MEDICAL_HISTORY +computada I-PAST_MEDICAL_HISTORY +[TC] I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -esófago I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -enteroide, I-PAST_MEDICAL_HISTORY -pobremente I-PAST_MEDICAL_HISTORY -diferenciado, I-PAST_MEDICAL_HISTORY +abdomen I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +pelvis I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +cápsula I-PAST_MEDICAL_HISTORY +endoscópica) I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +íleon I-PAST_MEDICAL_HISTORY +terminal I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -infiltración I-PAST_MEDICAL_HISTORY -hasta I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -tejido I-PAST_MEDICAL_HISTORY -adiposo I-PAST_MEDICAL_HISTORY -periesofágico, I-PAST_MEDICAL_HISTORY +infliximab I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +azatioprina. I-PAST_MEDICAL_HISTORY +Había I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +sometido I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +resección I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +íleon I-PAST_MEDICAL_HISTORY +terminal I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -escasa I-PAST_MEDICAL_HISTORY -reacción I-PAST_MEDICAL_HISTORY -fibroblastica I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +ileoascendo I-PAST_MEDICAL_HISTORY +anastomosis, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +episodio I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hemorragia I-PAST_MEDICAL_HISTORY +digestiva I-PAST_MEDICAL_HISTORY +baja I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +base I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -linfoide I-PAST_MEDICAL_HISTORY -peritumoral, I-PAST_MEDICAL_HISTORY -así I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -metástasis I-PAST_MEDICAL_HISTORY -ganglionar, I-PAST_MEDICAL_HISTORY -presentando I-PAST_MEDICAL_HISTORY -extensión I-PAST_MEDICAL_HISTORY -extracapsular, I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +presentado I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +episodios I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +diverticulitis I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +motivaron I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +suspensión I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +terapia I-PAST_MEDICAL_HISTORY +biológica. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +últimos I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +desarrolló I-PAST_MEDICAL_HISTORY +seis I-PAST_MEDICAL_HISTORY +episodios I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +bacteriemia I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +Escherichia I-PAST_MEDICAL_HISTORY +coli, I-PAST_MEDICAL_HISTORY +siendo I-PAST_MEDICAL_HISTORY +tratado I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -atipias I-PAST_MEDICAL_HISTORY -intensas, I-PAST_MEDICAL_HISTORY -índice I-PAST_MEDICAL_HISTORY -mitótico I-PAST_MEDICAL_HISTORY -elevado I-PAST_MEDICAL_HISTORY +quinolonas I-PAST_MEDICAL_HISTORY +(ciprofloxacina) I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -necrosis I-PAST_MEDICAL_HISTORY -moderada. I-PAST_MEDICAL_HISTORY -El B-TREATMENT -paciente I-TREATMENT +cefalosporinas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +3era I-PAST_MEDICAL_HISTORY +generación I-PAST_MEDICAL_HISTORY +(ceftriaxona). I-PAST_MEDICAL_HISTORY +Se B-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +extenso I-EXPLORATION +estudio I-EXPLORATION +que I-EXPLORATION +descartó I-EXPLORATION +otro I-EXPLORATION +foco I-EXPLORATION +primario, I-EXPLORATION +incluyendo I-EXPLORATION +ecocardiograma I-EXPLORATION +y I-EXPLORATION +tomografía I-EXPLORATION +por I-EXPLORATION +emisión I-EXPLORATION +de I-EXPLORATION +positrones I-EXPLORATION +con I-EXPLORATION +tomografía I-EXPLORATION +computada I-EXPLORATION +(TEP-TC), I-EXPLORATION +entre I-EXPLORATION +otros. I-EXPLORATION +Un B-EVOLUTION +mes I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +segundo I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +bacteriemia I-EVOLUTION +por I-EVOLUTION +E. I-EVOLUTION +coli I-EVOLUTION +se I-EVOLUTION +hospitalizó I-EVOLUTION +por I-EVOLUTION +un I-EVOLUTION +síndrome I-EVOLUTION +febril I-EVOLUTION +y I-EVOLUTION +diarrea I-EVOLUTION +por I-EVOLUTION +CD I-EVOLUTION +(toxina I-EVOLUTION +A I-EVOLUTION +positiva) I-EVOLUTION +y I-EVOLUTION +colonoscopia I-EVOLUTION +completa I-EVOLUTION +con I-EVOLUTION +ileoscopia I-EVOLUTION +compatible I-EVOLUTION +con I-EVOLUTION +colitis I-EVOLUTION +pseudomebranosa I-EVOLUTION +siendo B-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +vancomicina I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT +por I-TREATMENT +14 I-TREATMENT +días I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +respuesta. I-TREATMENT +Aproximadamente B-EVOLUTION +un I-EVOLUTION +año I-EVOLUTION +después, I-EVOLUTION +presentó I-EVOLUTION +nuevo I-EVOLUTION +episodio I-EVOLUTION +febril. I-EVOLUTION +La B-EXPLORATION +TC I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +y I-EXPLORATION +pelvis I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +pequeña I-EXPLORATION +perforación I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +yeyuno I-EXPLORATION +atribuido I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +enfermedad I-EXPLORATION +de I-EXPLORATION +Crohn I-EXPLORATION +activa. I-EXPLORATION +Por B-TREATMENT +hemocultivos I-TREATMENT +positivos I-TREATMENT +a I-TREATMENT +E. I-TREATMENT +coli I-TREATMENT +fue I-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +ceftriaxona I-TREATMENT +y I-TREATMENT +metronidazol. I-TREATMENT +Posteriormente B-EVOLUTION +evolucionó I-EVOLUTION +con I-EVOLUTION +cuadro I-EVOLUTION +de I-EVOLUTION +diarrea I-EVOLUTION +por I-EVOLUTION +CD, I-EVOLUTION +con I-EVOLUTION +toxina I-EVOLUTION +A I-EVOLUTION +y I-EVOLUTION +B I-EVOLUTION +positiva, I-EVOLUTION +siendo B-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +vancomicina, I-TREATMENT +vía I-TREATMENT +oral, I-TREATMENT +por I-TREATMENT +14 I-TREATMENT +días I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +respuesta. I-TREATMENT + I-TREATMENT +Un B-EVOLUTION +mes I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +cuarto I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +bacteriemia I-EVOLUTION +por I-EVOLUTION +E. I-EVOLUTION +coli, I-EVOLUTION +presentó I-EVOLUTION +un I-EVOLUTION +nuevo I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +diarrea I-EVOLUTION +por I-EVOLUTION +CD, I-EVOLUTION +con I-EVOLUTION +toxina I-EVOLUTION +A I-EVOLUTION +y I-EVOLUTION +B I-EVOLUTION +positiva, I-EVOLUTION +siendo B-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +vancomicina, I-TREATMENT +vía I-TREATMENT +oral, I-TREATMENT +por I-TREATMENT +14 I-TREATMENT +días I-TREATMENT +con B-EVOLUTION +buena I-EVOLUTION +respuesta, I-EVOLUTION +sin I-EVOLUTION +embargo, I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +recaída I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +tres I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +haber I-EVOLUTION +completado I-EVOLUTION +el I-EVOLUTION +tratamiento, I-EVOLUTION +motivo B-TREATMENT +por I-TREATMENT +el I-TREATMENT +cual I-TREATMENT +se I-TREATMENT +trató I-TREATMENT +nuevamente I-TREATMENT +con I-TREATMENT +vancomicina I-TREATMENT +en I-TREATMENT +disminución I-TREATMENT +progresiva I-TREATMENT +y I-TREATMENT +probióticos I-TREATMENT +(Sacharomyces I-TREATMENT +boulardi), I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +respuesta. I-TREATMENT + I-TREATMENT +Un B-EVOLUTION +año I-EVOLUTION +después, I-EVOLUTION +estando I-EVOLUTION +con I-EVOLUTION +profilaxis I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +diverticulitis I-EVOLUTION +con I-EVOLUTION +rifaximina I-EVOLUTION +y I-EVOLUTION +mesalazina, I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +nueva I-EVOLUTION +diarrea I-EVOLUTION +por I-EVOLUTION +CD, I-EVOLUTION +con I-EVOLUTION +RPC I-EVOLUTION +positiva I-EVOLUTION +en I-EVOLUTION +deposiciones. I-EVOLUTION +Fue B-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +vancomicina, I-TREATMENT +vía I-TREATMENT +oral, I-TREATMENT +por I-TREATMENT +14 I-TREATMENT +días I-TREATMENT +con B-EVOLUTION +buena I-EVOLUTION +respuesta I-EVOLUTION +pero I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +nueva I-EVOLUTION +recaída I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +cuatro I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +haber I-EVOLUTION +terminado I-EVOLUTION +el I-EVOLUTION +tratamiento. I-EVOLUTION +Fue B-TREATMENT +tratado I-TREATMENT +nuevamente I-TREATMENT +con I-TREATMENT +vancomicina I-TREATMENT +en I-TREATMENT +disminución I-TREATMENT +progresiva I-TREATMENT +y I-TREATMENT +probióticos. I-TREATMENT +Evolucionó B-EVOLUTION +en I-EVOLUTION +forma I-EVOLUTION +tórpida I-EVOLUTION +con I-EVOLUTION +fiebre, I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +y I-EVOLUTION +diarrea, I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +fue I-TREATMENT +internado I-TREATMENT +y I-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +vancomicina I-TREATMENT +vía I-TREATMENT +oral I-TREATMENT +asociado I-TREATMENT +a I-TREATMENT +metronidazol I-TREATMENT +intravenoso I-TREATMENT +(IV). I-TREATMENT +Al I-TREATMENT no I-TREATMENT +presentar I-TREATMENT +mejoría I-TREATMENT +al I-TREATMENT +3° I-TREATMENT +día I-TREATMENT recibió I-TREATMENT -tratamiento I-TREATMENT -complementario I-TREATMENT +inmunoglobulina I-TREATMENT +IV I-TREATMENT +400 I-TREATMENT +mg/kg I-TREATMENT +al I-TREATMENT +día, I-TREATMENT +en I-TREATMENT +cinco I-TREATMENT +dosis, I-TREATMENT con I-TREATMENT -quimioterapia I-TREATMENT -ni I-TREATMENT -radioterapia I-TREATMENT -postoperatoria I-TREATMENT -debido I-TREATMENT +una I-TREATMENT +respuesta I-TREATMENT +clínica I-TREATMENT +parcial. I-TREATMENT + I-TREATMENT +Dada I-TREATMENT +la I-TREATMENT +mala I-TREATMENT +evolución I-TREATMENT a I-TREATMENT -que I-TREATMENT +pesar I-TREATMENT +de I-TREATMENT +todas I-TREATMENT +las I-TREATMENT +terapias I-TREATMENT +probadas I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +un I-TREATMENT +TMF I-TREATMENT +vía I-TREATMENT +colonoscopia I-TREATMENT +con I-TREATMENT +deposiciones I-TREATMENT +de I-TREATMENT +un I-TREATMENT +donante I-TREATMENT +familiar I-TREATMENT +directo I-TREATMENT +sin I-TREATMENT +antecedentes I-TREATMENT +de I-TREATMENT +patologías I-TREATMENT +y I-TREATMENT +con I-TREATMENT +estudio I-TREATMENT +pre-trasplante I-TREATMENT en I-TREATMENT +sangre I-TREATMENT +y I-TREATMENT +deposiciones I-TREATMENT +(3) I-TREATMENT +negativo. I-TREATMENT +Se I-TREATMENT +suspendió I-TREATMENT el I-TREATMENT -postoperatorio I-TREATMENT -inmediato I-TREATMENT -sufrió I-TREATMENT -dehiscencia I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +azatioprina I-TREATMENT +y I-TREATMENT +antimicrobianos, I-TREATMENT +cinco I-TREATMENT +días I-TREATMENT +y I-TREATMENT +24 I-TREATMENT +h I-TREATMENT +antes I-TREATMENT +del I-TREATMENT +TMF, I-TREATMENT +respectivamente. I-TREATMENT + I-TREATMENT +Descripción I-TREATMENT +del I-TREATMENT +procedimiento: I-TREATMENT +se I-TREATMENT +utilizaron I-TREATMENT +69 I-TREATMENT +g I-TREATMENT de I-TREATMENT -la I-TREATMENT -sutura I-TREATMENT -gastroesofágica I-TREATMENT +deposiciones I-TREATMENT +sólidas I-TREATMENT +diluidas I-TREATMENT +en I-TREATMENT +300 I-TREATMENT +cc I-TREATMENT +de I-TREATMENT +suero I-TREATMENT +fisiológico I-TREATMENT y I-TREATMENT -fistula I-TREATMENT -gastrocutánea I-TREATMENT -que I-TREATMENT -cedió I-TREATMENT -tras I-TREATMENT -nutricion I-TREATMENT -parenteral. I-TREATMENT +posteriormente I-TREATMENT +filtradas. I-TREATMENT +La I-TREATMENT +solución I-TREATMENT +fue I-TREATMENT +instilada I-TREATMENT +desde I-TREATMENT +el I-TREATMENT +íleon I-TREATMENT +terminal I-TREATMENT +hasta I-TREATMENT +el I-TREATMENT +sigmoides I-TREATMENT +incluyendo I-TREATMENT +el I-TREATMENT +área I-TREATMENT +con I-TREATMENT +divertículos. I-TREATMENT I-TREATMENT +A I-TREATMENT +las I-TREATMENT +24 I-TREATMENT +h I-TREATMENT +del I-TREATMENT +TMF I-TREATMENT +presentó I-TREATMENT +un I-TREATMENT +cuadro I-TREATMENT +febril I-TREATMENT +(T° I-TREATMENT +axilar I-TREATMENT +39°C) I-TREATMENT +con I-TREATMENT +hemocultivos I-TREATMENT +positivos I-TREATMENT +a I-TREATMENT +E. I-TREATMENT +coli. I-TREATMENT +Fue I-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +aztreonam I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +respuesta I-TREATMENT +clínica I-TREATMENT +y I-TREATMENT +de I-TREATMENT +laboratorio. I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +10 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +haber I-EVOLUTION +realizado I-EVOLUTION +el I-EVOLUTION +TMF, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +un I-EVOLUTION +nuevo I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +bacteriemia I-EVOLUTION +por I-EVOLUTION +E. I-EVOLUTION +coli I-EVOLUTION +siendo B-TREATMENT +nuevamente I-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +aztreonam. I-TREATMENT +A I-TREATMENT +las I-TREATMENT +dos I-TREATMENT +semanas I-TREATMENT +de I-TREATMENT +completar I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +antibacteriano I-TREATMENT +evolucionó I-TREATMENT +con I-TREATMENT +un I-TREATMENT +nuevo I-TREATMENT +cuadro I-TREATMENT +de I-TREATMENT +diarrea I-TREATMENT +por I-TREATMENT +CD I-TREATMENT +con I-TREATMENT +RPC I-TREATMENT +positiva I-TREATMENT +para I-TREATMENT +CD. I-TREATMENT +Fue I-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +vancomicina, I-TREATMENT +vía I-TREATMENT +oral, I-TREATMENT +por I-TREATMENT +14 I-TREATMENT +días I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +respuesta. I-TREATMENT +Un B-EVOLUTION +año I-EVOLUTION +y I-EVOLUTION +cuatro I-EVOLUTION +meses I-EVOLUTION +posterior I-EVOLUTION +al I-EVOLUTION +TMF I-EVOLUTION +volvió I-EVOLUTION +a I-EVOLUTION +presentar I-EVOLUTION +un I-EVOLUTION +nuevo I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +diarrea I-EVOLUTION +por I-EVOLUTION +CD I-EVOLUTION +(con I-EVOLUTION +RPC I-EVOLUTION +positiva) I-EVOLUTION +que B-TREATMENT +fue I-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +vancomicina, I-TREATMENT +vía I-TREATMENT +oral, I-TREATMENT +en I-TREATMENT +disminución I-TREATMENT +progresiva, I-TREATMENT +probióticos I-TREATMENT +e I-TREATMENT +inmunoglobulina I-TREATMENT +IV I-TREATMENT +400 I-TREATMENT +mg/kg I-TREATMENT +día I-TREATMENT +con I-TREATMENT +buena I-TREATMENT +respuesta. I-TREATMENT +Actualmente B-EVOLUTION +se I-EVOLUTION +mantiene I-EVOLUTION +en I-EVOLUTION +tratamiento I-EVOLUTION +con I-EVOLUTION +azatioprina I-EVOLUTION +por I-EVOLUTION +su I-EVOLUTION +enfermedad I-EVOLUTION +de I-EVOLUTION +Crohn. I-EVOLUTION + I-EVOLUTION + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +joven I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +20 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +encontraba I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +aguas I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +playa I-PRESENT_ILLNESS +Red I-PRESENT_ILLNESS +Frog I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Isla I-PRESENT_ILLNESS +Bastimentos. I-PRESENT_ILLNESS +Los I-PRESENT_ILLNESS +testigos I-PRESENT_ILLNESS +observaron I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +joven I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +encontraba I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +mar I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +"pidió I-PRESENT_ILLNESS +ayuda", I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +sumergió I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +volvió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +salir I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +unos I-PRESENT_ILLNESS +15 I-PRESENT_ILLNESS +metros I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +sumergido I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +volvieron I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +ver. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS Se B-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -radiológico I-EXPLORATION -simple I-EXPLORATION -a I-EXPLORATION -través I-EXPLORATION +recuperó I-EXPLORATION +el I-EXPLORATION +cadáver I-EXPLORATION +tres I-EXPLORATION +días I-EXPLORATION +después, I-EXPLORATION +en I-EXPLORATION +avanzado I-EXPLORATION +estado I-EXPLORATION de I-EXPLORATION -ortopantomografía I-EXPLORATION -y I-EXPLORATION -Waters I-EXPLORATION -apreciando I-EXPLORATION -imagen I-EXPLORATION +descomposición, I-EXPLORATION +sin I-EXPLORATION +prendas I-EXPLORATION de I-EXPLORATION -osteolisis I-EXPLORATION +vestir, I-EXPLORATION +con I-EXPLORATION +antropofagia I-EXPLORATION +cadavérica I-EXPLORATION a I-EXPLORATION nivel I-EXPLORATION +del I-EXPLORATION +rostro. I-EXPLORATION +Presentaba I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -hueso I-EXPLORATION -maxilar I-EXPLORATION -superior I-EXPLORATION -izquierdo I-EXPLORATION -e I-EXPLORATION -imagen I-EXPLORATION -de I-EXPLORATION -ocupación I-EXPLORATION -en I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -izquierdo. I-EXPLORATION -Se I-EXPLORATION -procedió I-EXPLORATION -a I-EXPLORATION -toma I-EXPLORATION +la I-EXPLORATION +porción I-EXPLORATION +anterior I-EXPLORATION de I-EXPLORATION -biopsia I-EXPLORATION +la I-EXPLORATION +parrilla I-EXPLORATION +costal I-EXPLORATION +bilateralmente, I-EXPLORATION +también I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -lesión I-EXPLORATION -intraoral, I-EXPLORATION -informando I-EXPLORATION -el I-EXPLORATION -anatomopatólogo I-EXPLORATION +pared I-EXPLORATION +abdominal I-EXPLORATION +y I-EXPLORATION +pélvica I-EXPLORATION +anterior I-EXPLORATION +cubriendo I-EXPLORATION +un I-EXPLORATION +área I-EXPLORATION de I-EXPLORATION -metástasis I-EXPLORATION +39 I-EXPLORATION +x I-EXPLORATION +22 I-EXPLORATION +cm. I-EXPLORATION +La I-EXPLORATION +piel I-EXPLORATION +y I-EXPLORATION +músculos I-EXPLORATION +presentaban I-EXPLORATION +bordes I-EXPLORATION +desgarrados, I-EXPLORATION +las I-EXPLORATION +costillas I-EXPLORATION +presentaban I-EXPLORATION +fracturas I-EXPLORATION +con I-EXPLORATION +bordes I-EXPLORATION +astillados. I-EXPLORATION +Había I-EXPLORATION +ausencia I-EXPLORATION de I-EXPLORATION -adenocarcinoma I-EXPLORATION +todos I-EXPLORATION +los I-EXPLORATION +órganos I-EXPLORATION +internos I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +torácico I-EXPLORATION +y I-EXPLORATION +abdominal I-EXPLORATION +a I-EXPLORATION +excepción I-EXPLORATION +del I-EXPLORATION +tercio I-EXPLORATION +superior I-EXPLORATION +del I-EXPLORATION +esófago I-EXPLORATION +y I-EXPLORATION +vías I-EXPLORATION +respiratorias I-EXPLORATION +altas. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +subescapular I-EXPLORATION +bilateral I-EXPLORATION +presentaba I-EXPLORATION +lesiones I-EXPLORATION +contuso-cortantes I-EXPLORATION +(aspecto I-EXPLORATION de I-EXPLORATION -esófago. I-EXPLORATION -El B-EVOLUTION -paciente I-EVOLUTION -fue I-EVOLUTION -ingresado I-EVOLUTION -para I-EVOLUTION -descartar I-EVOLUTION -que I-EVOLUTION -presentase I-EVOLUTION -más I-EVOLUTION -metástasis I-EVOLUTION -y I-EVOLUTION -delimitar I-EVOLUTION -la I-EVOLUTION -extensión I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -metástasis I-EVOLUTION -de I-EVOLUTION -hueso I-EVOLUTION -maxilar. I-EVOLUTION -La B-EXPLORATION -exploración I-EXPLORATION -cervical I-EXPLORATION -para I-EXPLORATION -valorar I-EXPLORATION -el I-EXPLORATION -estado I-EXPLORATION +sierra) I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -cadenas I-EXPLORATION -ganglionares I-EXPLORATION -fue I-EXPLORATION -negativo. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -TAC I-EXPLORATION -orofacial, I-EXPLORATION -apreciando I-EXPLORATION -destrucción I-EXPLORATION +forma I-EXPLORATION +semiovalada. I-EXPLORATION +Además I-EXPLORATION +presentaba I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -maxilar I-EXPLORATION -superior I-EXPLORATION +músculos I-EXPLORATION +del I-EXPLORATION +glúteo I-EXPLORATION izquierdo I-EXPLORATION -con I-EXPLORATION -afectación I-EXPLORATION de I-EXPLORATION -paladar I-EXPLORATION -duro, I-EXPLORATION -apófisis I-EXPLORATION -pterigoides, I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -izquierdo, I-EXPLORATION +tipo I-EXPLORATION +avulsivo I-EXPLORATION con I-EXPLORATION -rotura I-EXPLORATION -de I-EXPLORATION -pared I-EXPLORATION -posterior I-EXPLORATION +bordes I-EXPLORATION +irregulares I-EXPLORATION y I-EXPLORATION +pérdida I-EXPLORATION de I-EXPLORATION -pared I-EXPLORATION -interna I-EXPLORATION -de I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION -izquierdo, I-EXPLORATION -existiendo I-EXPLORATION -afectación I-EXPLORATION -del I-EXPLORATION -espacio I-EXPLORATION -masticador I-EXPLORATION -izquierdo, I-EXPLORATION -y I-EXPLORATION -estando I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -tumoral I-EXPLORATION -muy I-EXPLORATION -próximo I-EXPLORATION -al I-EXPLORATION -suelo I-EXPLORATION +masa I-EXPLORATION +muscular I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -órbita I-EXPLORATION -izquierda. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -ecográfico I-EXPLORATION -abdominal I-EXPLORATION -y I-EXPLORATION -estudio I-EXPLORATION -radiológico I-EXPLORATION -simple I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -siendo I-EXPLORATION -informado I-EXPLORATION -como I-EXPLORATION -normal. I-EXPLORATION +cara I-EXPLORATION +anterior I-EXPLORATION +del I-EXPLORATION +muslo I-EXPLORATION +derecho. I-EXPLORATION I-EXPLORATION -Se I-EXPLORATION -completó I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -con I-EXPLORATION -gammagrafía I-EXPLORATION -ósea, I-EXPLORATION -apreciando I-EXPLORATION -lesiones I-EXPLORATION -óseas I-EXPLORATION -sugerentes I-EXPLORATION -de I-EXPLORATION -malignidad I-EXPLORATION -en I-EXPLORATION -hueso I-EXPLORATION -maxilar I-EXPLORATION -superior I-EXPLORATION -izquierdo, I-EXPLORATION -pelvis I-EXPLORATION -derecha, I-EXPLORATION -séptima I-EXPLORATION -vértebra I-EXPLORATION -dorsal I-EXPLORATION -y I-EXPLORATION -parrilla I-EXPLORATION -costal I-EXPLORATION -derecha. I-EXPLORATION -Cuando B-EVOLUTION -se I-EVOLUTION -terminó I-EVOLUTION -de I-EVOLUTION -completar I-EVOLUTION -el I-EVOLUTION -estudio I-EVOLUTION -(dos I-EVOLUTION -semanas I-EVOLUTION -de I-EVOLUTION -duración I-EVOLUTION -desde I-EVOLUTION -la I-EVOLUTION -primera I-EVOLUTION -consulta I-EVOLUTION -y I-EVOLUTION -toma I-EVOLUTION -de I-EVOLUTION -biopsia I-EVOLUTION -intraoral), I-EVOLUTION -la I-EVOLUTION -lesión I-EVOLUTION -intraoral I-EVOLUTION -había I-EVOLUTION -crecido I-EVOLUTION -enormemente, I-EVOLUTION -presentando I-EVOLUTION -áreas I-EVOLUTION -necróticas I-EVOLUTION -y I-EVOLUTION -afectando I-EVOLUTION -a I-EVOLUTION -todo I-EVOLUTION -el I-EVOLUTION -fondo I-EVOLUTION -vestibular I-EVOLUTION -superior I-EVOLUTION -izquierdo, I-EVOLUTION -encía I-EVOLUTION -y I-EVOLUTION -paladar I-EVOLUTION -duro I-EVOLUTION -izquierdo, I-EVOLUTION -presentando I-EVOLUTION -así I-EVOLUTION -mismo I-EVOLUTION -impotencia I-EVOLUTION -funcional I-EVOLUTION -en I-EVOLUTION -pierna I-EVOLUTION -derecha I-EVOLUTION -que I-EVOLUTION -le I-EVOLUTION -impedía I-EVOLUTION -una I-EVOLUTION -correcta I-EVOLUTION -deambulación. I-EVOLUTION -El I-EVOLUTION -paciente I-EVOLUTION -murió I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -repentina I-EVOLUTION -tras I-EVOLUTION -presentar I-EVOLUTION -hemorragia I-EVOLUTION -masiva I-EVOLUTION -por I-EVOLUTION -cavidad I-EVOLUTION -oral. I-EVOLUTION - I-EVOLUTION -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS +60 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS con B-PAST_MEDICAL_HISTORY -antecedente I-PAST_MEDICAL_HISTORY -personal I-PAST_MEDICAL_HISTORY +peso I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -carcinoma I-PAST_MEDICAL_HISTORY +48 I-PAST_MEDICAL_HISTORY +kg, I-PAST_MEDICAL_HISTORY +talla I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -células I-PAST_MEDICAL_HISTORY -basales I-PAST_MEDICAL_HISTORY +156 I-PAST_MEDICAL_HISTORY +cm I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +ASA I-PAST_MEDICAL_HISTORY +III. I-PAST_MEDICAL_HISTORY +Exfumadora I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -piel I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -región I-PAST_MEDICAL_HISTORY -paranasal I-PAST_MEDICAL_HISTORY -izquierda, I-PAST_MEDICAL_HISTORY -acudió B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nuestra I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS +20 I-PAST_MEDICAL_HISTORY +cigarrillos I-PAST_MEDICAL_HISTORY +diarios, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ceguera I-PAST_MEDICAL_HISTORY +total I-PAST_MEDICAL_HISTORY +postraumática I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +dificultad I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +marcha I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +apoyo I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +estudiada. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Ingresó B-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cirugía I-PRESENT_ILLNESS +vascular I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS por I-PRESENT_ILLNESS presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -tumoración I-PRESENT_ILLNESS +isquemia I-PRESENT_ILLNESS +crónica I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -progresivo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -ángulo I-PRESENT_ILLNESS -mandibular I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS +miembro I-PRESENT_ILLNESS +inferior I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +grado I-PRESENT_ILLNESS +IV, I-PRESENT_ILLNESS +pendiente I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tres I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +quirúrgico I-PRESENT_ILLNESS +mediante I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +amputación I-PRESENT_ILLNESS +supracondílea I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -Aportaba B-EXPLORATION -un I-EXPLORATION -informe I-EXPLORATION -citopatológico I-EXPLORATION -procedente I-EXPLORATION -de I-EXPLORATION -dos I-EXPLORATION -punciones-aspiración I-EXPLORATION -con I-EXPLORATION -aguja I-EXPLORATION -fina I-EXPLORATION -(PAAF) I-EXPLORATION -efectuada I-EXPLORATION -en I-EXPLORATION -otro I-EXPLORATION -centro, I-EXPLORATION -con I-EXPLORATION -el I-EXPLORATION -resultado I-EXPLORATION -de I-EXPLORATION -frotis I-EXPLORATION -sugestivos I-EXPLORATION -de I-EXPLORATION -proliferación I-EXPLORATION -epitelial I-EXPLORATION -de I-EXPLORATION -baja I-EXPLORATION -agresividad I-EXPLORATION -citológica. I-EXPLORATION -Los I-EXPLORATION -hallazgos I-EXPLORATION -observados I-EXPLORATION -eran I-EXPLORATION -compatibles I-EXPLORATION -con I-EXPLORATION +dicho I-PRESENT_ILLNESS +miembro. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +El B-EXPLORATION +estudio I-EXPLORATION +preoperatorio I-EXPLORATION +mostró: I-EXPLORATION +anemia I-EXPLORATION +microcítica I-EXPLORATION +- I-EXPLORATION +hipocrómica, I-EXPLORATION +coagulación I-EXPLORATION +y I-EXPLORATION +bioquímica I-EXPLORATION +normales I-EXPLORATION +y I-EXPLORATION un I-EXPLORATION -adenoma I-EXPLORATION -pleomorfo I-EXPLORATION +trastorno I-EXPLORATION de I-EXPLORATION -glándula I-EXPLORATION -salivar, I-EXPLORATION -sin I-EXPLORATION -embargo I-EXPLORATION la I-EXPLORATION -cantidad I-EXPLORATION -de I-EXPLORATION -estroma I-EXPLORATION -era I-EXPLORATION -mínima, I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -patrón I-EXPLORATION -se I-EXPLORATION -desviaba I-EXPLORATION -de I-EXPLORATION -lo I-EXPLORATION -habitual I-EXPLORATION +repolarización I-EXPLORATION en I-EXPLORATION -estos I-EXPLORATION -casos, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -pudieron I-EXPLORATION -descartar I-EXPLORATION -otros I-EXPLORATION -tumores, I-EXPLORATION -incluído I-EXPLORATION el I-EXPLORATION -carcinoma. I-EXPLORATION -A I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -de I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -en I-EXPLORATION -región I-EXPLORATION -yugulodigástrica I-EXPLORATION -derecha, I-EXPLORATION -desplazable I-EXPLORATION -sobre I-EXPLORATION -planos I-EXPLORATION -profundos I-EXPLORATION -y I-EXPLORATION -no I-EXPLORATION -adherida I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -piel. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -objetivaron I-EXPLORATION -otras I-EXPLORATION -adenopatías I-EXPLORATION -ni I-EXPLORATION -tumoraciones I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -cervicofacial. I-EXPLORATION +electrocardiograma. I-EXPLORATION I-EXPLORATION -Con I-EXPLORATION -la I-EXPLORATION -sospecha I-EXPLORATION -diagnóstica I-EXPLORATION -de I-EXPLORATION -tumor I-EXPLORATION +Durante I-EXPLORATION +su I-EXPLORATION +estancia I-EXPLORATION en I-EXPLORATION -lóbulo I-EXPLORATION -superficial I-EXPLORATION +dicho I-EXPLORATION +servicio I-EXPLORATION +mantuvo I-EXPLORATION +dolor I-EXPLORATION +del I-EXPLORATION +miembro I-EXPLORATION +inferior I-EXPLORATION +derecho, I-EXPLORATION +continuo I-EXPLORATION y I-EXPLORATION -cola I-EXPLORATION -parotídea I-EXPLORATION -derecha, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION +progresivamente I-EXPLORATION +intolerable, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +precisó I-TREATMENT +la I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +un I-TREATMENT +catéter I-TREATMENT +epidural I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +de I-TREATMENT +L3-L4 I-TREATMENT +para I-TREATMENT +la I-TREATMENT +conexión I-TREATMENT +de I-TREATMENT +una I-TREATMENT +bomba I-TREATMENT +de I-TREATMENT +infusión I-TREATMENT +PCA I-TREATMENT +(Analgesia I-TREATMENT +Controlada I-TREATMENT +por I-TREATMENT +el I-TREATMENT +Paciente) I-TREATMENT +y I-TREATMENT +administración I-TREATMENT +de I-TREATMENT +una I-TREATMENT +solución I-TREATMENT +compuesta I-TREATMENT +por I-TREATMENT +ropivacaína I-TREATMENT +0, I-TREATMENT +2 I-TREATMENT +% I-TREATMENT +más I-TREATMENT +cloruro I-TREATMENT +mórfico I-TREATMENT +0, I-TREATMENT +004 I-TREATMENT +% I-TREATMENT +a I-TREATMENT +una I-TREATMENT +velocidad I-TREATMENT +de I-TREATMENT +4 I-TREATMENT +ml/h I-TREATMENT +y I-TREATMENT +bolos I-TREATMENT +de I-TREATMENT +rescate I-TREATMENT +de I-TREATMENT +4 I-TREATMENT +ml. I-TREATMENT +La I-TREATMENT +punción I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +con I-TREATMENT +una I-TREATMENT +aguja I-TREATMENT +Tuohy I-TREATMENT +18 I-TREATMENT +G. I-TREATMENT +La I-TREATMENT +colocación I-TREATMENT +del I-TREATMENT +catéter I-TREATMENT +fue I-TREATMENT +técnicamente I-TREATMENT +sencilla I-TREATMENT +y I-TREATMENT +sin I-TREATMENT +incidencias. I-TREATMENT +No I-TREATMENT +hubo I-TREATMENT +aspiración I-TREATMENT +de I-TREATMENT +sangre I-TREATMENT +o I-TREATMENT +de I-TREATMENT +líquido I-TREATMENT +cefalorraquídeo I-TREATMENT +y I-TREATMENT +la I-TREATMENT +dosis I-TREATMENT +test I-TREATMENT +(4 I-TREATMENT +ml I-TREATMENT +de I-TREATMENT +bupivacaína I-TREATMENT +0, I-TREATMENT +25 I-TREATMENT +% I-TREATMENT +con I-TREATMENT +vasoconstrictor) I-TREATMENT +fue I-TREATMENT +negativa. I-TREATMENT +La I-TREATMENT +paciente I-TREATMENT +no I-TREATMENT +había I-TREATMENT +recibido I-TREATMENT +tratamiento I-TREATMENT +anticoagulante I-TREATMENT +durante I-TREATMENT +las I-TREATMENT +12 I-TREATMENT +horas I-TREATMENT +previas I-TREATMENT +a I-TREATMENT +la I-TREATMENT +colocación I-TREATMENT +del I-TREATMENT +catéter. I-TREATMENT +Tras B-EVOLUTION +las I-EVOLUTION +primeras I-EVOLUTION +24 I-EVOLUTION +horas I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +colocación I-EVOLUTION +del I-EVOLUTION +catéter I-EVOLUTION +epidural I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +un I-EVOLUTION +empeoramiento I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +síntomas I-EVOLUTION +preexistentes: I-EVOLUTION +mayor I-EVOLUTION +severidad I-EVOLUTION +del I-EVOLUTION +dolor I-EVOLUTION +del I-EVOLUTION +miembro I-EVOLUTION +inferior I-EVOLUTION +derecho, I-EVOLUTION +asociado I-EVOLUTION +a I-EVOLUTION +un I-EVOLUTION +bloqueo I-EVOLUTION +motor I-EVOLUTION +completo I-EVOLUTION +de I-EVOLUTION +ambos I-EVOLUTION +miembros I-EVOLUTION +inferiores. I-EVOLUTION +Se B-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +suspender I-TREATMENT +la I-TREATMENT +perfusión I-TREATMENT +a I-TREATMENT +través I-TREATMENT +del I-TREATMENT +catéter I-TREATMENT +epidural I-TREATMENT +y I-TREATMENT +se I-TREATMENT +reevaluó I-TREATMENT +a I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +pasadas I-TREATMENT +2, I-TREATMENT +4 I-TREATMENT +y I-TREATMENT +8 I-TREATMENT +horas. I-TREATMENT + I-TREATMENT +La B-EXPLORATION +exploración I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +8 I-EXPLORATION +horas I-EXPLORATION +mostró I-EXPLORATION una I-EXPLORATION -tomografía I-EXPLORATION -computerizada I-EXPLORATION -(TC) I-EXPLORATION -cervicofacial I-EXPLORATION -con I-EXPLORATION -contraste, I-EXPLORATION -practicándose I-EXPLORATION -ventana I-EXPLORATION -de I-EXPLORATION -partes I-EXPLORATION -blandas I-EXPLORATION +monoplejía I-EXPLORATION +del I-EXPLORATION +miembro I-EXPLORATION +inferior I-EXPLORATION +derecho I-EXPLORATION y I-EXPLORATION -ventana I-EXPLORATION -de I-EXPLORATION -hueso. I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION -nivel I-EXPLORATION +una I-EXPLORATION +monoparesia I-EXPLORATION del I-EXPLORATION -lóbulo I-EXPLORATION -superficial I-EXPLORATION +miembro I-EXPLORATION +inferior I-EXPLORATION +izquierdo, I-EXPLORATION +sin I-EXPLORATION +incontinencia I-EXPLORATION +del I-EXPLORATION +esfínter I-EXPLORATION +anal I-EXPLORATION +(la I-EXPLORATION +paciente I-EXPLORATION +era I-EXPLORATION +portadora I-EXPLORATION de I-EXPLORATION +una I-EXPLORATION +sonda I-EXPLORATION +vesical). I-EXPLORATION +En I-EXPLORATION +todo I-EXPLORATION +momento, I-EXPLORATION +nuestra I-EXPLORATION +paciente I-EXPLORATION +negó I-EXPLORATION la I-EXPLORATION -glándula I-EXPLORATION -parotídea I-EXPLORATION -derecha, I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cola I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -parótida, I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -una I-EXPLORATION -imagen I-EXPLORATION -nodular, I-EXPLORATION -hipercaptante, I-EXPLORATION +dolor I-EXPLORATION +lumbar. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +la I-TREATMENT +retirada I-TREATMENT +del I-TREATMENT +catéter I-TREATMENT +epidural I-TREATMENT +solicitándose B-EXPLORATION +un I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -bordes I-EXPLORATION -bien I-EXPLORATION -definidos I-EXPLORATION +imagen I-EXPLORATION +con I-EXPLORATION +RM I-EXPLORATION de I-EXPLORATION -aproximadamente I-EXPLORATION -1, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION +columna I-EXPLORATION +lumbar I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +evidenciaron I-EXPLORATION +fracturas I-EXPLORATION +vertebrales I-EXPLORATION +L1, I-EXPLORATION +L2 I-EXPLORATION +y I-EXPLORATION +L4 I-EXPLORATION +y I-EXPLORATION +protrusión I-EXPLORATION +discal I-EXPLORATION +L3-L4 I-EXPLORATION +que I-EXPLORATION +condicionaba I-EXPLORATION +compromiso I-EXPLORATION +radicular I-EXPLORATION +(más I-EXPLORATION +marcado I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +lado I-EXPLORATION +derecho) I-EXPLORATION +e I-EXPLORATION +importante I-EXPLORATION +estenosis I-EXPLORATION +del I-EXPLORATION +canal I-EXPLORATION +lumbar, I-EXPLORATION +agravada I-EXPLORATION +por I-EXPLORATION +un I-EXPLORATION +hematoma I-EXPLORATION +epidural I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION -que, I-EXPLORATION -debido I-EXPLORATION +pequeño I-EXPLORATION +tamaño I-EXPLORATION a I-EXPLORATION -las I-EXPLORATION -características I-EXPLORATION -radiológicas I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -lenta I-EXPLORATION -evolución I-EXPLORATION +dicho I-EXPLORATION +nivel. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +dexametasona I-TREATMENT +4 I-TREATMENT +mg/6 I-TREATMENT +h, I-TREATMENT +y I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +su I-TREATMENT +traslado I-TREATMENT +al I-TREATMENT +servicio I-TREATMENT +de I-TREATMENT +neurocirugía I-TREATMENT +para I-TREATMENT +su I-TREATMENT +valoración. I-TREATMENT + I-TREATMENT +Durante B-EXPLORATION +su I-EXPLORATION +ingreso I-EXPLORATION en I-EXPLORATION -tres I-EXPLORATION -años, I-EXPLORATION +el I-EXPLORATION +servicio I-EXPLORATION +de I-EXPLORATION +neurocirugía I-EXPLORATION se I-EXPLORATION -interpretó I-EXPLORATION -como I-EXPLORATION +realizó I-EXPLORATION +electromiografía, I-EXPLORATION +objetivándose I-EXPLORATION una I-EXPLORATION -lesión I-EXPLORATION -tumoral I-EXPLORATION -benigna, I-EXPLORATION -a I-EXPLORATION -considerar I-EXPLORATION -las I-EXPLORATION -etiologías I-EXPLORATION -de I-EXPLORATION -adenoma I-EXPLORATION -pleomorfo, I-EXPLORATION -tumor I-EXPLORATION -de I-EXPLORATION -Warthin I-EXPLORATION -u I-EXPLORATION -otros I-EXPLORATION -tumores I-EXPLORATION +afectación I-EXPLORATION +del I-EXPLORATION +sistema I-EXPLORATION +nervioso I-EXPLORATION +periférico I-EXPLORATION +que I-EXPLORATION +podría I-EXPLORATION +corresponderse I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +polineuropatía I-EXPLORATION +mixta. I-EXPLORATION + I-EXPLORATION +Con I-EXPLORATION +todos I-EXPLORATION +estos I-EXPLORATION +datos, I-EXPLORATION +se I-EXPLORATION +consideró I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +clínica I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -glándula I-EXPLORATION -salivar I-EXPLORATION +paciente I-EXPLORATION +era I-EXPLORATION +el I-EXPLORATION +resultado I-EXPLORATION de I-EXPLORATION -naturaleza I-EXPLORATION -benigna. I-EXPLORATION -Se I-EXPLORATION -observaron I-EXPLORATION -adenopatías I-EXPLORATION +una I-EXPLORATION +conjunción I-EXPLORATION de I-EXPLORATION -tamaño I-EXPLORATION +múltiples I-EXPLORATION +patologías, I-EXPLORATION +desestimándose I-EXPLORATION +la I-EXPLORATION +intervención I-EXPLORATION +quirúrgica I-EXPLORATION +dado I-EXPLORATION +que I-EXPLORATION no I-EXPLORATION -significativo I-EXPLORATION -en I-EXPLORATION -sendas I-EXPLORATION -cadenas I-EXPLORATION -submandibulares, I-EXPLORATION -yugulodigástricas I-EXPLORATION -y I-EXPLORATION -en I-EXPLORATION -triángulos I-EXPLORATION -posteriores. I-EXPLORATION +se I-EXPLORATION +beneficiaría I-EXPLORATION +de I-EXPLORATION +dicho I-EXPLORATION +tratamiento. I-EXPLORATION I-EXPLORATION -Con B-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -clínico-radiológica I-TREATMENT -de I-TREATMENT -tumor I-TREATMENT -benigno I-TREATMENT -de I-TREATMENT -glándula I-TREATMENT -parótida I-TREATMENT -derecha, I-TREATMENT +Finalmente, B-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +trasladada I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +cirugía I-DERIVED_FROM/TO +vascular I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +completar I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +tratamiento I-DERIVED_FROM/TO +quirúrgico. I-DERIVED_FROM/TO +La B-TREATMENT +amputación I-TREATMENT +supracondílea I-TREATMENT +del I-TREATMENT +miembro I-TREATMENT +inferior I-TREATMENT +derecho I-TREATMENT se I-TREATMENT -intervino I-TREATMENT -quirúrgicamente I-TREATMENT +realizó I-TREATMENT bajo I-TREATMENT anestesia I-TREATMENT general I-TREATMENT -e I-TREATMENT -intubación I-TREATMENT -orotraqueal, I-TREATMENT -realizándose I-TREATMENT -parotidectomía I-TREATMENT -suprafacial I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -un I-TREATMENT -abordaje I-TREATMENT -de I-TREATMENT -ritidectomía, I-TREATMENT con I-TREATMENT -resección I-TREATMENT -del I-TREATMENT -lóbulo I-TREATMENT -parotídeo I-TREATMENT -superficial I-TREATMENT +mascarilla I-TREATMENT +laríngea I-TREATMENT +i-gel™ I-TREATMENT +(Intersurgical I-TREATMENT +Ltd., I-TREATMENT +Wokingham, I-TREATMENT +England) I-TREATMENT +número I-TREATMENT +4. I-TREATMENT +La I-TREATMENT +inducción I-TREATMENT de I-TREATMENT -5 I-TREATMENT -x I-TREATMENT -3 I-TREATMENT -cm I-TREATMENT +la I-TREATMENT +anestesia I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +mediante I-TREATMENT +la I-TREATMENT +administración I-TREATMENT +intravenosa I-TREATMENT +de I-TREATMENT +fentanilo I-TREATMENT +2 I-TREATMENT +µg/kg I-TREATMENT y I-TREATMENT -aplicación I-TREATMENT +propofol I-TREATMENT +2 I-TREATMENT +mg/kg. I-TREATMENT +El I-TREATMENT +mantenimiento I-TREATMENT de I-TREATMENT -cierre I-TREATMENT +la I-TREATMENT +misma I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT con I-TREATMENT -colgajo I-TREATMENT +sevofluorano I-TREATMENT +2 I-TREATMENT +% I-TREATMENT +en I-TREATMENT +una I-TREATMENT +mezcla I-TREATMENT de I-TREATMENT -SMAS. I-TREATMENT -En B-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -anatomopatológico I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza I-EXPLORATION -se I-EXPLORATION -objetivó I-EXPLORATION -una I-EXPLORATION -tumoración I-EXPLORATION -bien I-EXPLORATION -delimitada I-EXPLORATION -de I-EXPLORATION -18 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -diámetro, I-EXPLORATION -de I-EXPLORATION -color I-EXPLORATION -blanquecino I-EXPLORATION +oxígeno I-TREATMENT +- I-TREATMENT +aire I-TREATMENT +con I-TREATMENT +un I-TREATMENT +flujo I-TREATMENT +de I-TREATMENT +gas I-TREATMENT +fresco I-TREATMENT +de I-TREATMENT +2 I-TREATMENT +l/min. I-TREATMENT +La I-TREATMENT +administración I-TREATMENT +adicional I-TREATMENT +de I-TREATMENT +fentanilo I-TREATMENT +durante I-TREATMENT +el I-TREATMENT +procedimiento I-TREATMENT +quirúrgico I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +según I-TREATMENT +parámetros I-TREATMENT +clínicos, I-TREATMENT +cifras I-TREATMENT +de I-TREATMENT +tensión I-TREATMENT +arterial I-TREATMENT +y I-TREATMENT +frecuencia I-TREATMENT +cardiaca. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +monitorización I-TREATMENT +estándar I-TREATMENT +de I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +constatándose I-TREATMENT +estabilidad I-TREATMENT +hemodinámica I-TREATMENT +durante I-TREATMENT +toda I-TREATMENT +la I-TREATMENT +cirugía. I-TREATMENT +Al B-EVOLUTION +finalizar I-EVOLUTION +el I-EVOLUTION +procedimiento I-EVOLUTION +quirúrgico I-EVOLUTION +se I-EVOLUTION +retiró I-EVOLUTION +la I-EVOLUTION +mascarilla I-EVOLUTION +laríngea I-EVOLUTION +cuando I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +estuvo I-EVOLUTION +completamente I-EVOLUTION +despierta. I-EVOLUTION +Fue I-EVOLUTION +trasladada I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +Unidad I-EVOLUTION +de I-EVOLUTION +Recuperación I-EVOLUTION +Postanestésica I-EVOLUTION +donde I-EVOLUTION +permaneció I-EVOLUTION +durante I-EVOLUTION +2 I-EVOLUTION +horas. I-EVOLUTION +Su I-EVOLUTION +evolución I-EVOLUTION +fue I-EVOLUTION +favorable. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +66 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +diabética B-PAST_MEDICAL_HISTORY +tipo I-PAST_MEDICAL_HISTORY +II I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +insulina I-PAST_MEDICAL_HISTORY +bifásica I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +dosis I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +16 I-PAST_MEDICAL_HISTORY +UI I-PAST_MEDICAL_HISTORY +- I-PAST_MEDICAL_HISTORY +0 I-PAST_MEDICAL_HISTORY +- I-PAST_MEDICAL_HISTORY +18 I-PAST_MEDICAL_HISTORY +UI, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +mes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +otra I-PRESENT_ILLNESS +sintomatología I-PRESENT_ILLNESS +acompañante, I-PRESENT_ILLNESS +salvo I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +necesidad I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +aumentar I-PRESENT_ILLNESS +progresivamente I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +dosis I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +insulina I-PRESENT_ILLNESS +hasta I-PRESENT_ILLNESS +54 I-PRESENT_ILLNESS +UI I-PRESENT_ILLNESS +- I-PRESENT_ILLNESS +0 I-PRESENT_ILLNESS +- I-PRESENT_ILLNESS +54 I-PRESENT_ILLNESS +UI I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +optimizar I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +control I-PRESENT_ILLNESS +glucémico. I-PRESENT_ILLNESS +Su B-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +era I-EXPLORATION +normal I-EXPLORATION y I-EXPLORATION -superficie I-EXPLORATION -homogénea, I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -extremo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -pieza. I-EXPLORATION -Al I-EXPLORATION -corte, I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION +analíticamente I-EXPLORATION +destacaba I-EXPLORATION una I-EXPLORATION -tumoración I-EXPLORATION -bien I-EXPLORATION -delimitada, I-EXPLORATION +elevación I-EXPLORATION de I-EXPLORATION -textura I-EXPLORATION -homogénea, I-EXPLORATION -y I-EXPLORATION -características I-EXPLORATION -macroscópicas I-EXPLORATION +las I-EXPLORATION +cifras I-EXPLORATION de I-EXPLORATION -normalidad I-EXPLORATION -para I-EXPLORATION +plaquetas I-EXPLORATION +(601.000/l) I-EXPLORATION +y I-EXPLORATION +VSG I-EXPLORATION +(107 I-EXPLORATION +mm/1a I-EXPLORATION +hora), I-EXPLORATION +siendo I-EXPLORATION +normal I-EXPLORATION el I-EXPLORATION resto I-EXPLORATION de I-EXPLORATION +resultados I-EXPLORATION +que I-EXPLORATION +incluían I-EXPLORATION +transaminasas, I-EXPLORATION +autoinmunidad, I-EXPLORATION +hormonas I-EXPLORATION +tiroi-deas, I-EXPLORATION +inmunoglobulinas I-EXPLORATION +e I-EXPLORATION +IgG4, I-EXPLORATION +marcadores I-EXPLORATION +tumorales I-EXPLORATION +y I-EXPLORATION +serolo-gías I-EXPLORATION +virales I-EXPLORATION +(hepatitis, I-EXPLORATION +CMV, I-EXPLORATION +VIH, I-EXPLORATION +Epstein-Barr, I-EXPLORATION +amebiasis I-EXPLORATION +e I-EXPLORATION +hidatidosis). I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +con I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +demostró I-EXPLORATION la I-EXPLORATION -glándula. I-EXPLORATION -Asimismo, I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -biosia-exéresis I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -adenopatía I-EXPLORATION +dos I-EXPLORATION +lesiones I-EXPLORATION +ocupantes I-EXPLORATION de I-EXPLORATION -2, I-EXPLORATION +espacio I-EXPLORATION +localizadas I-EXPLORATION +en I-EXPLORATION +lóbulo I-EXPLORATION +hepático I-EXPLORATION +derecho, I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +tamaño I-EXPLORATION +de I-EXPLORATION +4, I-EXPLORATION +3 I-EXPLORATION +x I-EXPLORATION +3, I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION +y I-EXPLORATION +3, I-EXPLORATION 5 I-EXPLORATION x I-EXPLORATION -1 I-EXPLORATION +2, I-EXPLORATION +4 I-EXPLORATION cm I-EXPLORATION +respectivamente, I-EXPLORATION +y I-EXPLORATION +otra I-EXPLORATION +lesión I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION +4, I-EXPLORATION +6 I-EXPLORATION +x I-EXPLORATION +2, I-EXPLORATION +6 I-EXPLORATION +cm I-EXPLORATION en I-EXPLORATION -la I-EXPLORATION -proximidad I-EXPLORATION +lóbulo I-EXPLORATION +hepático I-EXPLORATION +izquierdo, I-EXPLORATION +y I-EXPLORATION +posteriormente I-EXPLORATION +un I-EXPLORATION +TAC I-EXPLORATION +abdominal I-EXPLORATION +con I-EXPLORATION +contraste I-EXPLORATION +también I-EXPLORATION +manifiesta I-EXPLORATION +dos I-EXPLORATION +masas I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -glándula I-EXPLORATION -parótida, I-EXPLORATION -que I-EXPLORATION -al I-EXPLORATION -corte I-EXPLORATION -presentó I-EXPLORATION -una I-EXPLORATION -textura I-EXPLORATION -homogénea, I-EXPLORATION -color I-EXPLORATION -blanquecino I-EXPLORATION +4 I-EXPLORATION y I-EXPLORATION -consistencia I-EXPLORATION -elástica. I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION -examen I-EXPLORATION -microscópico I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -encapsulada I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -nidos I-EXPLORATION -o I-EXPLORATION -trabéculas I-EXPLORATION -separadas I-EXPLORATION -por I-EXPLORATION +3, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +cada I-EXPLORATION una I-EXPLORATION -membrana I-EXPLORATION -basal I-EXPLORATION -eosinófila I-EXPLORATION +asentadas I-EXPLORATION +en I-EXPLORATION +lóbulo I-EXPLORATION +hepático I-EXPLORATION +derecho I-EXPLORATION y I-EXPLORATION -constituidas I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -basalioides I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -disponían I-EXPLORATION -a I-EXPLORATION -modo I-EXPLORATION +otra I-EXPLORATION +lesión I-EXPLORATION de I-EXPLORATION -empalizada I-EXPLORATION -periférica. I-EXPLORATION -La I-EXPLORATION -celularidad I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -estudio I-EXPLORATION -inmunohistoquímico I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -para I-EXPLORATION -citoqueratina I-EXPLORATION +lóbulo I-EXPLORATION +izquierdo, I-EXPLORATION +todas I-EXPLORATION +ellas I-EXPLORATION de I-EXPLORATION -alto I-EXPLORATION -peso I-EXPLORATION -molecular I-EXPLORATION -y I-EXPLORATION -focalmente I-EXPLORATION -positiva I-EXPLORATION +características I-EXPLORATION +densitométricas I-EXPLORATION +inespecíficas. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +hepática I-EXPLORATION +percutánea I-EXPLORATION +bajo I-EXPLORATION +control I-EXPLORATION +ecográfico I-EXPLORATION para I-EXPLORATION -S-100. I-EXPLORATION -El I-EXPLORATION -diagnóstico I-EXPLORATION +descartar I-EXPLORATION +malignidad, I-EXPLORATION +y I-EXPLORATION +su I-EXPLORATION +estudio I-EXPLORATION anatomopatológico I-EXPLORATION -fue I-EXPLORATION -de I-EXPLORATION -adenoma I-EXPLORATION -de I-EXPLORATION +revela I-EXPLORATION +un I-EXPLORATION +infiltrado I-EXPLORATION +extenso I-EXPLORATION +formado I-EXPLORATION +por I-EXPLORATION células I-EXPLORATION -basales I-EXPLORATION -de I-EXPLORATION -glándula I-EXPLORATION -parótida I-EXPLORATION +plasmáticas I-EXPLORATION +y, I-EXPLORATION +en I-EXPLORATION +menor I-EXPLORATION +medida, I-EXPLORATION +linfocitos I-EXPLORATION y I-EXPLORATION -ganglios I-EXPLORATION -linfáticos I-EXPLORATION +fibroblastos, I-EXPLORATION con I-EXPLORATION -hiperplasia I-EXPLORATION -folicular. I-EXPLORATION - I-EXPLORATION -El B-EVOLUTION -postoperatorio I-EVOLUTION -inmediato I-EVOLUTION -no I-EVOLUTION -presentó I-EVOLUTION -complicaciones I-EVOLUTION -importantes, I-EVOLUTION -salvo I-EVOLUTION -ligera I-EVOLUTION -paresia I-EVOLUTION -a I-EVOLUTION -nivel I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -ramas I-EVOLUTION -frontal I-EVOLUTION -y I-EVOLUTION -bucal I-EVOLUTION -del I-EVOLUTION -nervio I-EVOLUTION -facial, I-EVOLUTION -que I-EVOLUTION -experimentó I-EVOLUTION -mejoría I-EVOLUTION -progresiva I-EVOLUTION -en I-EVOLUTION -los I-EVOLUTION -días I-EVOLUTION -subsiguientes I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -intervención. I-EVOLUTION - I-EVOLUTION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -52 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -sintomatología I-PRESENT_ILLNESS -otica I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -craneofacial I-PRESENT_ILLNESS -referida I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -otalgia I-PRESENT_ILLNESS -izquierda, I-PRESENT_ILLNESS -tinitus I-PRESENT_ILLNESS -bilateral, I-PRESENT_ILLNESS -vértigo, I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -oído I-PRESENT_ILLNESS -tapado I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -bilateral I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nivel I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuello I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -cuero I-PRESENT_ILLNESS -cabelludo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -zona I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -Al B-EXPLORATION -examen I-EXPLORATION -otorrinolaringologico I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -encuentra I-EXPLORATION -patología I-EXPLORATION -localizada I-EXPLORATION -en I-EXPLORATION -oído, I-EXPLORATION -nariz I-EXPLORATION -o I-EXPLORATION -garganta. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -presenta I-EXPLORATION -compromiso I-EXPLORATION -músculo-esquelético I-EXPLORATION +alguna I-EXPLORATION +célula I-EXPLORATION +gigante I-EXPLORATION +multinucleada, I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -resentimiento I-EXPLORATION -muscular I-EXPLORATION -local I-EXPLORATION -en I-EXPLORATION -zonas I-EXPLORATION -de: I-EXPLORATION -pterigoideo I-EXPLORATION -externo I-EXPLORATION -bilateral, I-EXPLORATION -temporal I-EXPLORATION -bilateral, I-EXPLORATION -digastrico I-EXPLORATION -vientre I-EXPLORATION -posterior, I-EXPLORATION -esternocleidomastoideo I-EXPLORATION -bilateral, I-EXPLORATION -esplenio I-EXPLORATION -bilateral, I-EXPLORATION -occipitofrontal I-EXPLORATION -en I-EXPLORATION -zona I-EXPLORATION -izquierda. I-EXPLORATION -Se I-EXPLORATION -encuentran I-EXPLORATION -puntos I-EXPLORATION -gatillo I-EXPLORATION -en I-EXPLORATION -músculo I-EXPLORATION -trapecio I-EXPLORATION -bilateralmente. I-EXPLORATION -La I-EXPLORATION -paciente I-EXPLORATION -reporta I-EXPLORATION -dolor I-EXPLORATION -al I-EXPLORATION -masticar I-EXPLORATION +pseudotumor I-EXPLORATION +inflamatorio. I-EXPLORATION +El I-EXPLORATION +análisis I-EXPLORATION +inmunohistoquímico I-EXPLORATION +mostró I-EXPLORATION +células I-EXPLORATION +plasmáticas I-EXPLORATION +con I-EXPLORATION +cadenas I-EXPLORATION +kappa- I-EXPLORATION y I-EXPLORATION -dolor I-EXPLORATION -al I-EXPLORATION -tragar I-EXPLORATION -alimentos I-EXPLORATION -duros. I-EXPLORATION -También I-EXPLORATION -relata I-EXPLORATION -odontalgias I-EXPLORATION -fantasmas I-EXPLORATION -en I-EXPLORATION -zona I-EXPLORATION -de I-EXPLORATION -molares I-EXPLORATION -mandibulares I-EXPLORATION -izquierdos I-EXPLORATION -sin I-EXPLORATION -patología I-EXPLORATION -dental I-EXPLORATION -evidente I-EXPLORATION -al I-EXPLORATION -examen, I-EXPLORATION -igualmente I-EXPLORATION -describe I-EXPLORATION -dolor I-EXPLORATION -tipo I-EXPLORATION -hiperalgesia I-EXPLORATION -secundaria I-EXPLORATION -en I-EXPLORATION -cuero I-EXPLORATION -cabelludo I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -hace I-EXPLORATION -pensar I-EXPLORATION +lambda- I-EXPLORATION en I-EXPLORATION -un I-EXPLORATION -posible I-EXPLORATION -componente I-EXPLORATION -neuropatico I-EXPLORATION -de I-EXPLORATION -su I-EXPLORATION -queja. I-EXPLORATION -Reporta I-EXPLORATION -sabores I-EXPLORATION -agrio-amargos I-EXPLORATION -periódicamente I-EXPLORATION +igual I-EXPLORATION +proporción, I-EXPLORATION con I-EXPLORATION -sensación I-EXPLORATION +predominio I-EXPLORATION de I-EXPLORATION -quemadura I-EXPLORATION -en I-EXPLORATION -paladar. I-EXPLORATION -Se I-EXPLORATION -palpan I-EXPLORATION -los I-EXPLORATION -procesos I-EXPLORATION -hamulares, I-EXPLORATION -encontrando I-EXPLORATION -dolor I-EXPLORATION -intenso I-EXPLORATION -local I-EXPLORATION -del I-EXPLORATION -lado I-EXPLORATION -izquierdo I-EXPLORATION -y I-EXPLORATION -referido I-EXPLORATION -a I-EXPLORATION -oído I-EXPLORATION -y I-EXPLORATION -zona I-EXPLORATION -mandibular I-EXPLORATION -izquierda I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -palpación. I-EXPLORATION -Se B-TREATMENT -programa I-TREATMENT -la I-TREATMENT -infiltración I-TREATMENT -de I-TREATMENT +cadenas I-EXPLORATION +IgG I-EXPLORATION +pero I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +plasmáticas I-EXPLORATION +IgG4 I-EXPLORATION +positivas. I-EXPLORATION +Dado B-TREATMENT +que I-TREATMENT la I-TREATMENT -zona I-TREATMENT -hamular I-TREATMENT -izquierda I-TREATMENT -con I-TREATMENT -corticoide I-TREATMENT -sintético I-TREATMENT -(Betametasona I-TREATMENT -- I-TREATMENT -suspensión I-TREATMENT -de I-TREATMENT -4 I-TREATMENT -mg) I-TREATMENT -previa I-TREATMENT -anestesia I-TREATMENT -local. I-TREATMENT -La I-TREATMENT paciente I-TREATMENT -también I-TREATMENT -fue I-TREATMENT -manejada I-TREATMENT -con I-TREATMENT -dispositivo I-TREATMENT -intraoral I-TREATMENT -para I-TREATMENT -la I-TREATMENT -supresión I-TREATMENT -de I-TREATMENT -la I-TREATMENT -actividad I-TREATMENT -muscular I-TREATMENT -como I-TREATMENT -tratamiento I-TREATMENT -del I-TREATMENT -DTM I-TREATMENT +se I-TREATMENT +encontraba I-TREATMENT +asintomática I-TREATMENT y I-TREATMENT -la I-TREATMENT -sintomatología I-TREATMENT -otica I-TREATMENT -referida I-TREATMENT -1 I-TREATMENT -mes I-TREATMENT -posterior I-TREATMENT -a I-TREATMENT -la I-TREATMENT -sintomatología I-TREATMENT -de I-TREATMENT -la I-TREATMENT -Bursitis I-TREATMENT -Hamular. I-TREATMENT -Se B-EVOLUTION -ha I-EVOLUTION -controlado I-EVOLUTION -la I-EVOLUTION +con I-TREATMENT +mejor I-TREATMENT +control I-TREATMENT +glucémico I-TREATMENT +no I-TREATMENT +se I-TREATMENT +adoptó I-TREATMENT +ninguna I-TREATMENT +medida I-TREATMENT +especial I-TREATMENT +y B-EXPLORATION +se I-EXPLORATION +decide I-EXPLORATION +reevaluar I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +un I-EXPLORATION +mes I-EXPLORATION +más I-EXPLORATION +tarde I-EXPLORATION +mediante I-EXPLORATION +nuevo I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +ultrasonidos, I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +la I-EXPLORATION +resolución I-EXPLORATION +espontánea I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +hepáticas. I-EXPLORATION +La B-EVOLUTION paciente I-EVOLUTION durante I-EVOLUTION -18 I-EVOLUTION -meses I-EVOLUTION -sin I-EVOLUTION -recurrencia I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sintomatología. I-EVOLUTION -La I-EVOLUTION -presentacion I-EVOLUTION -clinica I-EVOLUTION -del I-EVOLUTION -compromiso I-EVOLUTION -músculo-esqueletico I-EVOLUTION -y I-EVOLUTION -otico, I-EVOLUTION -adicional I-EVOLUTION -al I-EVOLUTION -dolor I-EVOLUTION -en I-EVOLUTION -zona I-EVOLUTION -del I-EVOLUTION -proceso I-EVOLUTION -hamular I-EVOLUTION -y I-EVOLUTION -posible I-EVOLUTION -relacion I-EVOLUTION -concomitante I-EVOLUTION -pueden I-EVOLUTION -tener I-EVOLUTION -la I-EVOLUTION -misma I-EVOLUTION -base I-EVOLUTION -fisiopatologica I-EVOLUTION -del I-EVOLUTION -caso I-EVOLUTION -clínico I-EVOLUTION -anterior. I-EVOLUTION - I-EVOLUTION +este I-EVOLUTION +tiempo I-EVOLUTION +permaneció I-EVOLUTION +asintomática I-EVOLUTION +y B-TREATMENT +con I-TREATMENT +descenso I-TREATMENT +progresivo I-TREATMENT +en I-TREATMENT +las I-TREATMENT +necesidades I-TREATMENT +de I-TREATMENT +insulina I-TREATMENT +hasta I-TREATMENT +estabilizarse I-TREATMENT +en I-TREATMENT +su I-TREATMENT +dosis I-TREATMENT +basal I-TREATMENT +habitual. I-TREATMENT + I-TREATMENT -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -20 I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +35 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cirugía I-PAST_MEDICAL_HISTORY +litiásica I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +otro I-PAST_MEDICAL_HISTORY +centro I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +ambos I-PAST_MEDICAL_HISTORY +riñones. I-PAST_MEDICAL_HISTORY +Según I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +informaba I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +había I-PAST_MEDICAL_HISTORY +realizado, I-PAST_MEDICAL_HISTORY +pielolitotomía I-PAST_MEDICAL_HISTORY +derecha I-PAST_MEDICAL_HISTORY +hacía I-PAST_MEDICAL_HISTORY +15 I-PAST_MEDICAL_HISTORY +años. I-PAST_MEDICAL_HISTORY +Dos I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +después I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +practica I-PAST_MEDICAL_HISTORY +pielolitotomía I-PAST_MEDICAL_HISTORY +izquierda I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +10 I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +ser I-PAST_MEDICAL_HISTORY +atendida I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +nuestro I-PAST_MEDICAL_HISTORY +Servicio I-PAST_MEDICAL_HISTORY +(año I-PAST_MEDICAL_HISTORY +2005) I-PAST_MEDICAL_HISTORY +nueva I-PAST_MEDICAL_HISTORY +nefrolitotomía I-PAST_MEDICAL_HISTORY +sobre I-PAST_MEDICAL_HISTORY +riñón I-PAST_MEDICAL_HISTORY +izquierdo, I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +litiasis I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +compleja. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +La B-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +episodio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +infección I-PRESENT_ILLNESS +urinaria I-PRESENT_ILLNESS +complicada I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +pionefrosis I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +septicemia, I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +cual I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +coloca I-PRESENT_ILLNESS +cateter I-PRESENT_ILLNESS +doble I-PRESENT_ILLNESS +J I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -solicitando I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -solución I-PRESENT_ILLNESS -estética I-PRESENT_ILLNESS +queda I-PRESENT_ILLNESS +mal I-PRESENT_ILLNESS +posicionado, I-PRESENT_ILLNESS +subpiélico, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +resuelve I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +séptico, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +preciso I-PRESENT_ILLNESS +realizar I-PRESENT_ILLNESS +nefrostomia I-PRESENT_ILLNESS +percutánea I-PRESENT_ILLNESS +izquierda I-PRESENT_ILLNESS para I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -frente I-PRESENT_ILLNESS -anterior. I-PRESENT_ILLNESS -Durante B-PAST_MEDICAL_HISTORY -sus I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -primeros I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -sometido I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -intervenciones I-PAST_MEDICAL_HISTORY -quirúrgicas I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -conseguir I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -cierre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tejidos I-PAST_MEDICAL_HISTORY -blandos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -labio I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -paladar. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A B-EXPLORATION +drenaje I-PRESENT_ILLNESS +renal, I-PRESENT_ILLNESS +situación, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +cual I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +remitida I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nuestro I-PRESENT_ILLNESS +centro. I-PRESENT_ILLNESS +En B-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -extraoral I-EXPLORATION -se I-EXPLORATION -podía I-EXPLORATION -observar I-EXPLORATION -una I-EXPLORATION -asimetría I-EXPLORATION -del I-EXPLORATION -labio I-EXPLORATION -superior I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION -diversas I-EXPLORATION -operaciones I-EXPLORATION -a I-EXPLORATION -las I-EXPLORATION +urografía I-EXPLORATION +intravenosa I-EXPLORATION que I-EXPLORATION -fue I-EXPLORATION -sometido I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -infancia. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION +aporta I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -intraoral I-EXPLORATION +enferma, I-EXPLORATION se I-EXPLORATION -pone I-EXPLORATION -de I-EXPLORATION -manifiesto I-EXPLORATION -una I-EXPLORATION -evidente I-EXPLORATION -malposición I-EXPLORATION -y I-EXPLORATION -maloclusión I-EXPLORATION -dentaria I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -distintas I-EXPLORATION -agenesias I-EXPLORATION -dentales I-EXPLORATION -(15, I-EXPLORATION -12, I-EXPLORATION -11, I-EXPLORATION -25, I-EXPLORATION -34, I-EXPLORATION -33 I-EXPLORATION -y I-EXPLORATION -44) I-EXPLORATION -y I-EXPLORATION -discrepancia I-EXPLORATION -maxilo-mandibular. I-EXPLORATION -Apreciándose I-EXPLORATION -también I-EXPLORATION -una I-EXPLORATION -gingivitis I-EXPLORATION -moderada I-EXPLORATION +observa I-EXPLORATION +litiasis I-EXPLORATION +radiodensa I-EXPLORATION +infecciosa, I-EXPLORATION +pielolocalicial I-EXPLORATION +múltiple I-EXPLORATION +compleja, I-EXPLORATION +sobre I-EXPLORATION +riñón I-EXPLORATION +con I-EXPLORATION +hidronefrosis I-EXPLORATION +grado I-EXPLORATION +III-IV I-EXPLORATION por I-EXPLORATION -falta I-EXPLORATION -de I-EXPLORATION -control I-EXPLORATION -de I-EXPLORATION -placa. I-EXPLORATION - I-EXPLORATION -Vemos I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -presenta I-EXPLORATION -una I-EXPLORATION -grave I-EXPLORATION -dismorfosis I-EXPLORATION -maxilo-mandibular I-EXPLORATION -que I-EXPLORATION -aconsejaba I-EXPLORATION -la I-EXPLORATION -realización I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -tratamiento I-EXPLORATION -ortodóncico I-EXPLORATION -previo I-EXPLORATION +importante I-EXPLORATION +esclerosis I-EXPLORATION +piélica I-EXPLORATION +secundaria I-EXPLORATION a I-EXPLORATION -cualquier I-EXPLORATION -toma I-EXPLORATION +cirugías I-EXPLORATION +previas I-EXPLORATION +sobre I-EXPLORATION +dicha I-EXPLORATION +unidad I-EXPLORATION +renal. I-EXPLORATION +Presenta I-EXPLORATION +función I-EXPLORATION +renal I-EXPLORATION +relativamente I-EXPLORATION +conservada. I-EXPLORATION +Observamos I-EXPLORATION +asimismo, I-EXPLORATION +cambios I-EXPLORATION +postquirúrgicos I-EXPLORATION +con I-EXPLORATION +moderada I-EXPLORATION +atrofia I-EXPLORATION +parenquimatosa I-EXPLORATION de I-EXPLORATION -decisión I-EXPLORATION +unidad I-EXPLORATION +renal I-EXPLORATION +derecha. I-EXPLORATION +La I-EXPLORATION +analítica I-EXPLORATION de I-EXPLORATION -tipo I-EXPLORATION -prostodóncico. I-EXPLORATION -El I-EXPLORATION -caso I-EXPLORATION -fue I-EXPLORATION -consultado I-EXPLORATION -al I-EXPLORATION -especialista I-EXPLORATION -en I-EXPLORATION -ortodoncia I-EXPLORATION -y I-EXPLORATION -este I-EXPLORATION -planteo I-EXPLORATION la I-EXPLORATION -necesidad I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -cirugía I-EXPLORATION -ortognática I-EXPLORATION -previa I-EXPLORATION -al I-EXPLORATION -tratamiento I-EXPLORATION -protético. I-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -explicó I-EXPLORATION -al I-EXPLORATION paciente I-EXPLORATION +reflejaba I-EXPLORATION +cifras I-EXPLORATION +de I-EXPLORATION +urea I-EXPLORATION y I-EXPLORATION -este I-EXPLORATION -se I-EXPLORATION -opuso I-EXPLORATION -a I-EXPLORATION -someterse I-EXPLORATION -al I-EXPLORATION -tratamiento I-EXPLORATION -quirúrgico. I-EXPLORATION +creatinina I-EXPLORATION +normales. I-EXPLORATION I-EXPLORATION -Analizado B-TREATMENT +Ante B-TREATMENT los I-TREATMENT -hábitos I-TREATMENT -higiénicos I-TREATMENT -del I-TREATMENT -paciente I-TREATMENT -y I-TREATMENT -observando I-TREATMENT -una I-TREATMENT -clara I-TREATMENT -deficiencia I-TREATMENT -en I-TREATMENT -su I-TREATMENT -control I-TREATMENT -de I-TREATMENT -placa, I-TREATMENT -se I-TREATMENT -opta I-TREATMENT -por I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -prótesis I-TREATMENT -fija I-TREATMENT -sobre I-TREATMENT -coronas I-TREATMENT -telescópicas, I-TREATMENT -facultativamente I-TREATMENT -removible, I-TREATMENT -lo I-TREATMENT -cual, I-TREATMENT -por I-TREATMENT -un I-TREATMENT -lado I-TREATMENT -mejorará I-TREATMENT -el I-TREATMENT -control I-TREATMENT -de I-TREATMENT -placa I-TREATMENT -por I-TREATMENT -parte I-TREATMENT -del I-TREATMENT -paciente, I-TREATMENT -cuestión I-TREATMENT -fundamental I-TREATMENT -para I-TREATMENT -el I-TREATMENT -pronóstico I-TREATMENT -del I-TREATMENT -tratamiento, I-TREATMENT -y I-TREATMENT -por I-TREATMENT -otro I-TREATMENT -lado I-TREATMENT -se I-TREATMENT -cumple I-TREATMENT -la I-TREATMENT -necesidad I-TREATMENT -de I-TREATMENT -ferulización I-TREATMENT -de I-TREATMENT -la I-TREATMENT -arcada I-TREATMENT -a I-TREATMENT -ambos I-TREATMENT -lados I-TREATMENT -de I-TREATMENT -la I-TREATMENT -fisura I-TREATMENT -palatina. I-TREATMENT - I-TREATMENT -Las I-TREATMENT -coronas I-TREATMENT -telescópicas I-TREATMENT -como I-TREATMENT -sistema I-TREATMENT -prostodóncico I-TREATMENT -de I-TREATMENT -doble I-TREATMENT -corona I-TREATMENT -permite I-TREATMENT -realizar I-TREATMENT -una I-TREATMENT -ferulización I-TREATMENT -cruzada I-TREATMENT -de I-TREATMENT -la I-TREATMENT -arcada I-TREATMENT -dentaria I-TREATMENT -(en I-TREATMENT -nuestro I-TREATMENT -paciente I-TREATMENT -se I-TREATMENT -limita I-TREATMENT -a I-TREATMENT +hallazgos I-TREATMENT +urográficos, I-TREATMENT +dada I-TREATMENT la I-TREATMENT -zona I-TREATMENT -anterior I-TREATMENT +situación I-TREATMENT del I-TREATMENT -maxilar), I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -va I-TREATMENT -a I-TREATMENT -permitir I-TREATMENT -una I-TREATMENT -estabilización I-TREATMENT -de I-TREATMENT -los I-TREATMENT -dientes I-TREATMENT -a I-TREATMENT -largo I-TREATMENT -plazo. I-TREATMENT -El I-TREATMENT -concepto I-TREATMENT -de I-TREATMENT -doble I-TREATMENT -corona I-TREATMENT +riñón I-TREATMENT +contralateral I-TREATMENT y I-TREATMENT -el I-TREATMENT -diseño I-TREATMENT -intrínseco I-TREATMENT -de I-TREATMENT -las I-TREATMENT -mismas I-TREATMENT -hace I-TREATMENT -que I-TREATMENT -la I-TREATMENT -transmisión I-TREATMENT -de I-TREATMENT -las I-TREATMENT -fuerzas I-TREATMENT -masticatorias I-TREATMENT -sean I-TREATMENT -lo I-TREATMENT -más I-TREATMENT -favorable I-TREATMENT -al I-TREATMENT -diente I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -estas I-TREATMENT -se I-TREATMENT -van I-TREATMENT -a I-TREATMENT -producir I-TREATMENT -siempre I-TREATMENT -en I-TREATMENT -sentido I-TREATMENT -axial I-TREATMENT -al I-TREATMENT -eje I-TREATMENT -del I-TREATMENT -diente. I-TREATMENT -La I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -pueda I-TREATMENT -retirar I-TREATMENT -la I-TREATMENT -estructura I-TREATMENT -secundaria I-TREATMENT -hace I-TREATMENT -más I-TREATMENT -fácil I-TREATMENT -la I-TREATMENT -higiene I-TREATMENT -de I-TREATMENT -los I-TREATMENT -dientes I-TREATMENT -pilares I-TREATMENT -sobre I-TREATMENT -todo I-TREATMENT -si I-TREATMENT -se I-TREATMENT -compara I-TREATMENT -con I-TREATMENT la I-TREATMENT -dificultad I-TREATMENT -de I-TREATMENT -limpieza I-TREATMENT -de I-TREATMENT -un I-TREATMENT -puente I-TREATMENT -fijo I-TREATMENT -convencional, I-TREATMENT -esta I-TREATMENT -circunstancia I-TREATMENT -fue I-TREATMENT -uno I-TREATMENT +edad I-TREATMENT de I-TREATMENT -los I-TREATMENT -principales I-TREATMENT -motivos I-TREATMENT -por I-TREATMENT -el I-TREATMENT -que I-TREATMENT -optamos I-TREATMENT -en I-TREATMENT -nuestro I-TREATMENT -paciente I-TREATMENT -para I-TREATMENT -realizar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -coronas I-TREATMENT -telescópicas, I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -la I-TREATMENT -higiene I-TREATMENT -del I-TREATMENT -paciente I-TREATMENT -no I-TREATMENT -era I-TREATMENT -del I-TREATMENT -todo I-TREATMENT -satisfactoria, I-TREATMENT -tal I-TREATMENT -y I-TREATMENT -como I-TREATMENT -hemos I-TREATMENT -mencionado I-TREATMENT -anteriormente. I-TREATMENT - I-TREATMENT -Desde B-EVOLUTION -el I-EVOLUTION -primer I-EVOLUTION -momento I-EVOLUTION -se I-EVOLUTION -informa I-EVOLUTION -al I-EVOLUTION -paciente I-EVOLUTION -que I-EVOLUTION -el I-EVOLUTION -resultado I-EVOLUTION -estético I-EVOLUTION -y I-EVOLUTION -funcional I-EVOLUTION -no I-EVOLUTION -va I-EVOLUTION -a I-EVOLUTION -ser I-EVOLUTION -el I-EVOLUTION -idóneo, I-EVOLUTION -cuestión I-EVOLUTION -que I-EVOLUTION -en I-EVOLUTION -todo I-EVOLUTION -momento I-EVOLUTION -entiende I-EVOLUTION -y I-EVOLUTION -acepta. I-EVOLUTION -Previo B-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -prostodóncico I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -la I-TREATMENT -exodoncia I-TREATMENT -del I-TREATMENT -resto I-TREATMENT -radicular I-TREATMENT -del I-TREATMENT -diente I-TREATMENT -13 I-TREATMENT -y I-TREATMENT -una I-TREATMENT -vez I-TREATMENT -cicatrizada I-TREATMENT la I-TREATMENT -herida I-TREATMENT +paciente, I-TREATMENT se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -realizar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -definitivo. I-TREATMENT -Este I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -la I-TREATMENT -preparación I-TREATMENT -de I-TREATMENT -los I-TREATMENT -dientes I-TREATMENT -pilares I-TREATMENT -15, I-TREATMENT -21, I-TREATMENT -22, I-TREATMENT -23 I-TREATMENT -y I-TREATMENT -24, I-TREATMENT -realizando I-TREATMENT -tallados I-TREATMENT -convencionales I-TREATMENT -para I-TREATMENT -coronas I-TREATMENT -telescópicas. I-TREATMENT -Cabe I-TREATMENT -resaltar I-TREATMENT -el I-TREATMENT -importante I-TREATMENT -tallado I-TREATMENT -que I-TREATMENT -hubo I-TREATMENT -que I-TREATMENT -realizar I-TREATMENT -a I-TREATMENT -la I-TREATMENT -corona I-TREATMENT -del I-TREATMENT -diente I-TREATMENT -21, I-TREATMENT +decide I-TREATMENT +lumbotomía I-TREATMENT +exploradora I-TREATMENT para I-TREATMENT -poder I-TREATMENT -conseguir I-TREATMENT -el I-TREATMENT -paralelismo I-TREATMENT -entre I-TREATMENT -pilares, I-TREATMENT -cuestión I-TREATMENT -ésta I-TREATMENT -que I-TREATMENT -es I-TREATMENT -de I-TREATMENT -crucial I-TREATMENT -importancia I-TREATMENT +intentar I-TREATMENT +cirugía I-TREATMENT +conservadora, I-TREATMENT +consistente I-TREATMENT en I-TREATMENT -todos I-TREATMENT -los I-TREATMENT -trabajos I-TREATMENT +nefrectomía I-TREATMENT +polar I-TREATMENT +inferior I-TREATMENT con I-TREATMENT -coronas I-TREATMENT -telescópicas. I-TREATMENT - I-TREATMENT -Posteriormente I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -toma I-TREATMENT -de I-TREATMENT -impresiones I-TREATMENT +nefrolitotomía I-TREATMENT y I-TREATMENT -registros I-TREATMENT -intermaxilares I-TREATMENT -para I-TREATMENT -que I-TREATMENT -con I-TREATMENT -los I-TREATMENT -modelos I-TREATMENT -obtenidos I-TREATMENT -se I-TREATMENT -confeccionen I-TREATMENT -en I-TREATMENT -el I-TREATMENT -laboratorio I-TREATMENT -las I-TREATMENT -cofias I-TREATMENT -primarias. I-TREATMENT -Estas I-TREATMENT -son I-TREATMENT -probadas I-TREATMENT -en I-TREATMENT -la I-TREATMENT -boca I-TREATMENT -del I-TREATMENT -paciente I-TREATMENT -en I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -verifica I-TREATMENT -su I-TREATMENT -correcto I-TREATMENT -ajuste I-TREATMENT -para I-TREATMENT -a I-TREATMENT -continuación I-TREATMENT -tomar I-TREATMENT -una I-TREATMENT -segunda I-TREATMENT -impresión I-TREATMENT -"de I-TREATMENT -arrastre" I-TREATMENT -que I-TREATMENT -nos I-TREATMENT -posiciona I-TREATMENT -las I-TREATMENT -cofias I-TREATMENT -primarias I-TREATMENT -con I-TREATMENT -respecto I-TREATMENT -al I-TREATMENT -resto I-TREATMENT -de I-TREATMENT -estructuras I-TREATMENT +reconstrucción I-TREATMENT de I-TREATMENT la I-TREATMENT -boca I-TREATMENT -del I-TREATMENT -paciente. I-TREATMENT -Obteniéndose I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -modelo I-TREATMENT -donde I-TREATMENT -van I-TREATMENT -a I-TREATMENT -ser I-TREATMENT -confeccionadas I-TREATMENT -las I-TREATMENT -coronas I-TREATMENT -secundarias I-TREATMENT -que I-TREATMENT -conforman I-TREATMENT -la I-TREATMENT -prótesis I-TREATMENT -fija I-TREATMENT -facultativamente I-TREATMENT -removible. I-TREATMENT -Esta I-TREATMENT -estructura I-TREATMENT -secundaria I-TREATMENT -es I-TREATMENT -probada I-TREATMENT -en I-TREATMENT -la I-TREATMENT -boca I-TREATMENT -del I-TREATMENT -paciente I-TREATMENT -en I-TREATMENT -donde I-TREATMENT -se I-TREATMENT -comprueba I-TREATMENT -tanto I-TREATMENT -el I-TREATMENT -ajuste I-TREATMENT -como I-TREATMENT -la I-TREATMENT -relación I-TREATMENT -oclusal. I-TREATMENT +vía I-TREATMENT +urinaria I-TREATMENT +superior I-TREATMENT +mediante I-TREATMENT +uréterocalicostomía. I-TREATMENT I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -seleccionado I-TREATMENT -el I-TREATMENT -color I-TREATMENT -se I-TREATMENT -procede I-TREATMENT -a I-TREATMENT -su I-TREATMENT -terminación I-TREATMENT -y I-TREATMENT -colocación. I-TREATMENT -El B-EVOLUTION -resultado I-EVOLUTION -final, I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -aprecia I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -imagen, I-EVOLUTION -podemos I-EVOLUTION -ver I-EVOLUTION -un I-EVOLUTION -resultado I-EVOLUTION -que I-EVOLUTION -desde I-EVOLUTION -nuestro I-EVOLUTION -punto I-EVOLUTION -de I-EVOLUTION -vista I-EVOLUTION -es I-EVOLUTION -simplemente I-EVOLUTION -aceptable, I-EVOLUTION -pero I-EVOLUTION -que I-EVOLUTION +En B-EVOLUTION el I-EVOLUTION +postoperatorio I-EVOLUTION +la I-EVOLUTION paciente I-EVOLUTION -valoró I-EVOLUTION -como I-EVOLUTION -muy I-EVOLUTION -satisfactorio, I-EVOLUTION -quizás I-EVOLUTION -debido I-EVOLUTION -a, I-EVOLUTION -lógicamente, I-EVOLUTION +requiere I-EVOLUTION +la I-EVOLUTION +trasfusión I-EVOLUTION +de I-EVOLUTION +dos I-EVOLUTION +concentrados I-EVOLUTION +de I-EVOLUTION +hematíes I-EVOLUTION +por I-EVOLUTION +anemia I-EVOLUTION +persistente. I-EVOLUTION +La I-EVOLUTION +evolución I-EVOLUTION +posterior I-EVOLUTION +no I-EVOLUTION +presenta I-EVOLUTION +mayores I-EVOLUTION +complicaciones I-EVOLUTION +dándose I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION al I-EVOLUTION -estado I-EVOLUTION -inicial I-EVOLUTION -que I-EVOLUTION -presentaba I-EVOLUTION -el I-EVOLUTION +séptimo I-EVOLUTION +día. I-EVOLUTION +La B-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +informó I-EXPLORATION +de I-EXPLORATION +cambios I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +pielonefritis I-EXPLORATION +crónica I-EXPLORATION +postlitiásica I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +análisis I-EXPLORATION +del I-EXPLORATION +cálculo I-EXPLORATION +reveló I-EXPLORATION +su I-EXPLORATION +composición I-EXPLORATION +de I-EXPLORATION +fosfato I-EXPLORATION +amónico I-EXPLORATION +magnésico. I-EXPLORATION + I-EXPLORATION +Dos B-EVOLUTION +años I-EVOLUTION +y I-EVOLUTION +medio I-EVOLUTION +después I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +cirugía, I-EVOLUTION +la I-EVOLUTION paciente I-EVOLUTION +refiere I-EVOLUTION +únicamente I-EVOLUTION +molestias I-EVOLUTION +leves I-EVOLUTION +en I-EVOLUTION +flanco I-EVOLUTION +izquierdo. I-EVOLUTION + I-EVOLUTION +La B-EXPLORATION +urografía I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +refleja I-EXPLORATION +ausencia I-EXPLORATION +de I-EXPLORATION +litiasis I-EXPLORATION +con I-EXPLORATION +cierto I-EXPLORATION +retraso I-EXPLORATION +nefrográfico I-EXPLORATION +izquierdo I-EXPLORATION +y I-EXPLORATION +vía I-EXPLORATION +excretora I-EXPLORATION +derecha I-EXPLORATION +sin I-EXPLORATION +cambios I-EXPLORATION +respecto I-EXPLORATION +a I-EXPLORATION +previos. I-EXPLORATION +El I-EXPLORATION +renograma I-EXPLORATION +muestra I-EXPLORATION +una I-EXPLORATION +función I-EXPLORATION +renal I-EXPLORATION +izquierda I-EXPLORATION +del I-EXPLORATION +30%, I-EXPLORATION +con I-EXPLORATION +riñón I-EXPLORATION +derecho I-EXPLORATION +compensador, I-EXPLORATION +70%. I-EXPLORATION +Continúa B-EVOLUTION +con I-EVOLUTION +cifras I-EVOLUTION +de I-EVOLUTION +función I-EVOLUTION +renal I-EVOLUTION +dentro I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +normalidad, I-EVOLUTION y I-EVOLUTION +solo I-EVOLUTION +ha I-EVOLUTION +presentado I-EVOLUTION +un I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +ITU I-EVOLUTION que I-EVOLUTION -el I-EVOLUTION -creía I-EVOLUTION -imposible I-EVOLUTION +ha I-EVOLUTION +cedido I-EVOLUTION +con I-EVOLUTION +ciprofloxacino. I-EVOLUTION +Presencia B-EXPLORATION +de I-EXPLORATION +pequeños I-EXPLORATION +restos I-EXPLORATION +litiásicos I-EXPLORATION +bilaterales I-EXPLORATION +subclínicos I-EXPLORATION +según I-EXPLORATION +técnicas I-EXPLORATION +de I-EXPLORATION +imagen. I-EXPLORATION + I-EXPLORATION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +47 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +DM I-PAST_MEDICAL_HISTORY +diagnosticada I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +9 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +actual I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +esquema I-PAST_MEDICAL_HISTORY +insulínico I-PAST_MEDICAL_HISTORY +intensivo I-PAST_MEDICAL_HISTORY +(una I-PAST_MEDICAL_HISTORY +dosis I-PAST_MEDICAL_HISTORY +nocturna I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +insulina I-PAST_MEDICAL_HISTORY +glargina I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +insulina I-PAST_MEDICAL_HISTORY +lispro I-PAST_MEDICAL_HISTORY +previo I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +comidas). I-PAST_MEDICAL_HISTORY +Entre I-PAST_MEDICAL_HISTORY +sus I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +destacaban I-PAST_MEDICAL_HISTORY +gran I-PAST_MEDICAL_HISTORY +tabaquismo, I-PAST_MEDICAL_HISTORY +dislipidemia I-PAST_MEDICAL_HISTORY +mixta I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +irregular I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +ciprofibrato I-PAST_MEDICAL_HISTORY +100 I-PAST_MEDICAL_HISTORY +mg/día I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +microalbuminuria I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +50 I-PAST_MEDICAL_HISTORY +mg/12 I-PAST_MEDICAL_HISTORY +h, I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +enalapril I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +mg/día. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +centro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +salud I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +sensación I-PRESENT_ILLNESS +febril I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +cuantificada, I-PRESENT_ILLNESS +calofríos, I-PRESENT_ILLNESS +odinofagia, I-PRESENT_ILLNESS +náuseas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +vómitos I-PRESENT_ILLNESS +alimentarios I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Se B-EXPLORATION +constató I-EXPLORATION +deshidratación I-EXPLORATION +moderada, I-EXPLORATION +temperatura I-EXPLORATION +axilar I-EXPLORATION +de I-EXPLORATION +37, I-EXPLORATION +8°C I-EXPLORATION +y I-EXPLORATION +glicemia I-EXPLORATION +capilar I-EXPLORATION +mayor I-EXPLORATION +de I-EXPLORATION +400 I-EXPLORATION +mg/dl. I-EXPLORATION +Fue B-TREATMENT +internado, I-TREATMENT +recibiendo I-TREATMENT +solución I-TREATMENT +fisiológica I-TREATMENT +e I-TREATMENT +insulina I-TREATMENT +cristalina I-TREATMENT +en I-TREATMENT +esquema I-TREATMENT +de I-TREATMENT +minidosis. I-TREATMENT +Entre B-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +obtenidos I-EXPLORATION +al I-EXPLORATION +ingreso I-EXPLORATION +destacaban I-EXPLORATION +glicemia I-EXPLORATION +549 I-EXPLORATION +mg/dl, I-EXPLORATION +creatinina I-EXPLORATION +1, I-EXPLORATION +67 I-EXPLORATION +mg/dl, I-EXPLORATION +pH I-EXPLORATION +6, I-EXPLORATION +91, I-EXPLORATION +BE I-EXPLORATION +-27, I-EXPLORATION +HC03 I-EXPLORATION +4, I-EXPLORATION +6 I-EXPLORATION +(en I-EXPLORATION +sangre I-EXPLORATION +arterial), I-EXPLORATION +cetonemia I-EXPLORATION ++++, I-EXPLORATION +natremia I-EXPLORATION +141, I-EXPLORATION +7 I-EXPLORATION +mEq/L, I-EXPLORATION +kalemia I-EXPLORATION +5, I-EXPLORATION +92 I-EXPLORATION +mEq/L, I-EXPLORATION +cloremia I-EXPLORATION +98 I-EXPLORATION +mEq/L, I-EXPLORATION +amilasemia I-EXPLORATION +48 I-EXPLORATION +U/L, I-EXPLORATION +hematocrito I-EXPLORATION +40, I-EXPLORATION +5%, I-EXPLORATION +leucocitos I-EXPLORATION +9-100 I-EXPLORATION +mm3, I-EXPLORATION +VHS I-EXPLORATION +38 I-EXPLORATION +mm/h I-EXPLORATION +y I-EXPLORATION +urocultivo I-EXPLORATION +negativo. I-EXPLORATION +Fue B-EVOLUTION +dado I-EVOLUTION de I-EVOLUTION -mejorar, I-EVOLUTION -y I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -predisposición I-EVOLUTION -favorable I-EVOLUTION -que I-EVOLUTION +alta I-EVOLUTION +con I-EVOLUTION el I-EVOLUTION +diagnóstico I-EVOLUTION +de I-EVOLUTION +cetoacidosis I-EVOLUTION +diabética, I-EVOLUTION +se B-TREATMENT +le I-TREATMENT +indicó I-TREATMENT +mantener I-TREATMENT +el I-TREATMENT +esquema I-TREATMENT +insulínico I-TREATMENT +intensificado I-TREATMENT +y I-TREATMENT +asistir I-TREATMENT +a I-TREATMENT +control I-TREATMENT +ambulatorio. I-TREATMENT +El B-EVOLUTION paciente I-EVOLUTION -presentó I-EVOLUTION -en I-EVOLUTION -todo I-EVOLUTION -momento. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -caso I-EVOLUTION -ha I-EVOLUTION -sido I-EVOLUTION -revisado I-EVOLUTION +se I-EVOLUTION +trasladó I-EVOLUTION a I-EVOLUTION -lo I-EVOLUTION -largo I-EVOLUTION +la I-EVOLUTION +ciudad I-EVOLUTION de I-EVOLUTION -cinco I-EVOLUTION -años I-EVOLUTION -consecutivos I-EVOLUTION -y I-EVOLUTION -a I-EVOLUTION -pesar I-EVOLUTION +Temuco, I-EVOLUTION +consultando I-EVOLUTION +10 I-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION del I-EVOLUTION -mal I-EVOLUTION -control I-EVOLUTION -de I-EVOLUTION -placa I-EVOLUTION +alta I-EVOLUTION por I-EVOLUTION -parte I-EVOLUTION -del I-EVOLUTION -paciente, I-EVOLUTION -que I-EVOLUTION +sensación I-EVOLUTION +febril I-EVOLUTION no I-EVOLUTION -hemos I-EVOLUTION -conseguido I-EVOLUTION -que I-EVOLUTION -adquiera I-EVOLUTION -unos I-EVOLUTION -hábitos I-EVOLUTION -adecuados I-EVOLUTION -de I-EVOLUTION -higiene, I-EVOLUTION -los I-EVOLUTION -pilares I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -prótesis I-EVOLUTION -están I-EVOLUTION -en I-EVOLUTION -perfecto I-EVOLUTION -estado I-EVOLUTION -y I-EVOLUTION -tanto I-EVOLUTION -el I-EVOLUTION -confort I-EVOLUTION +cuantificada, I-EVOLUTION +sudoración I-EVOLUTION +nocturna, I-EVOLUTION +odinofagia I-EVOLUTION y I-EVOLUTION -la I-EVOLUTION -estética I-EVOLUTION -para I-EVOLUTION +dolor I-EVOLUTION +al I-EVOLUTION +movilizar I-EVOLUTION el I-EVOLUTION -paciente I-EVOLUTION -siguen I-EVOLUTION -siendo I-EVOLUTION -satisfactorias. I-EVOLUTION -De I-EVOLUTION -esta I-EVOLUTION -manera I-EVOLUTION -se I-EVOLUTION -pone I-EVOLUTION -de I-EVOLUTION -manifiesto I-EVOLUTION +cuello. I-EVOLUTION +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +destacaba I-EXPLORATION +un I-EXPLORATION +gran I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +volumen I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +posterior I-EXPLORATION +del I-EXPLORATION +cuello, I-EXPLORATION +sensible, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +inflamatorios I-EXPLORATION +ni I-EXPLORATION +crepitación, I-EXPLORATION +fetor I-EXPLORATION +pútrido I-EXPLORATION +y I-EXPLORATION +faringe I-EXPLORATION +congestiva I-EXPLORATION +con I-EXPLORATION +escaso I-EXPLORATION +exudado I-EXPLORATION +purulento. I-EXPLORATION +Se B-EVOLUTION +indicó I-EVOLUTION +hospitalización I-EVOLUTION +con I-EVOLUTION el I-EVOLUTION -correcto I-EVOLUTION -funcionamiento I-EVOLUTION +diagnóstico I-EVOLUTION de I-EVOLUTION -los I-EVOLUTION -tratamientos I-EVOLUTION -con I-EVOLUTION -coronas I-EVOLUTION -telescópicas I-EVOLUTION -a I-EVOLUTION -medio I-EVOLUTION +DM I-EVOLUTION +descompensada, I-EVOLUTION +faringo-amigdalitis I-EVOLUTION +pultácea I-EVOLUTION y I-EVOLUTION -largo I-EVOLUTION -plazo I-EVOLUTION -siendo I-EVOLUTION -una I-EVOLUTION -posibilidad I-EVOLUTION -que I-EVOLUTION -siempre I-EVOLUTION -debemos I-EVOLUTION -tener I-EVOLUTION -en I-EVOLUTION -cuenta I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -hora I-EVOLUTION -de I-EVOLUTION -planificar I-EVOLUTION -nuestros I-EVOLUTION -tratamientos, I-EVOLUTION -sobre I-EVOLUTION -todo I-EVOLUTION +masa I-EVOLUTION +cervical I-EVOLUTION en I-EVOLUTION -pacientes I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -mal I-EVOLUTION -pronóstico I-EVOLUTION -de I-EVOLUTION -sus I-EVOLUTION -dientes I-EVOLUTION -ya I-EVOLUTION -que I-EVOLUTION -el I-EVOLUTION -comportamiento I-EVOLUTION -biomecánico I-EVOLUTION +estudio. I-EVOLUTION +Entre B-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION +destacaban I-EXPLORATION +glicemia I-EXPLORATION +270 I-EXPLORATION +mg/dl, I-EXPLORATION +creatinina I-EXPLORATION +0, I-EXPLORATION +8 I-EXPLORATION +mg/ I-EXPLORATION +di, I-EXPLORATION +hematocrito I-EXPLORATION +35, I-EXPLORATION +7%, I-EXPLORATION +leucocitos I-EXPLORATION +18.800 I-EXPLORATION +por I-EXPLORATION +mm3, I-EXPLORATION +VHS I-EXPLORATION +91 I-EXPLORATION +mm/hora, I-EXPLORATION +PCR I-EXPLORATION +309 I-EXPLORATION +mg/L. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +hidratación I-TREATMENT +con I-TREATMENT +solución I-TREATMENT +fisiológica I-TREATMENT +e I-TREATMENT +infusión I-TREATMENT +endovenosa I-TREATMENT +continua I-TREATMENT +de I-TREATMENT +insulina, I-TREATMENT +fue B-EXPLORATION +evaluado I-EXPLORATION +por I-EXPLORATION +otorrinolaringólogo I-EXPLORATION +con I-EXPLORATION +nasofaringoscopia, I-EXPLORATION +pesquisándose I-EXPLORATION +flegmón I-EXPLORATION +faríngeo. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +terapia I-TREATMENT +con I-TREATMENT +penicilina I-TREATMENT +sódica I-TREATMENT +EV I-TREATMENT +20 I-TREATMENT +millones I-TREATMENT +U/día, I-TREATMENT +cloxacilina I-TREATMENT +12 I-TREATMENT +g I-TREATMENT +EV/ I-TREATMENT +día I-TREATMENT +y I-TREATMENT +ceftriaxona I-TREATMENT +2 I-TREATMENT +g I-TREATMENT +EV/día. I-TREATMENT +El B-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +volumen I-EXPLORATION +cervical I-EXPLORATION +fue I-EXPLORATION +estudiado I-EXPLORATION +con I-EXPLORATION +ecotomografía I-EXPLORATION +cervical, I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +una I-EXPLORATION +colección I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +compartimiento I-EXPLORATION +posterior I-EXPLORATION +del I-EXPLORATION +cuello I-EXPLORATION +y I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +multicorte I-EXPLORATION +de I-EXPLORATION +cuello I-EXPLORATION +en I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +apreciaba I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +volumen I-EXPLORATION +del I-EXPLORATION +espacio I-EXPLORATION +retrofa-ríngeo I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +compartimientos I-EXPLORATION +posteriores I-EXPLORATION +del I-EXPLORATION +cuello I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +flegmonoso. I-EXPLORATION + I-EXPLORATION +Evaluado B-TREATMENT +en I-TREATMENT +conjunto I-TREATMENT +con I-TREATMENT +otorrinolaringólogo I-TREATMENT +y I-TREATMENT +cirujano I-TREATMENT +de I-TREATMENT +cabeza I-TREATMENT +y I-TREATMENT +cuello, I-TREATMENT +se I-TREATMENT +decidió I-TREATMENT +practicar I-TREATMENT +drenaje I-TREATMENT +quirúrgico I-TREATMENT +de I-TREATMENT +la I-TREATMENT +colección. I-TREATMENT +Al I-TREATMENT +segundo I-TREATMENT +día I-TREATMENT +de I-TREATMENT +hospitalización I-TREATMENT +se I-TREATMENT +realizaron I-TREATMENT +2 I-TREATMENT +incisiones I-TREATMENT +en I-TREATMENT +la I-TREATMENT +región I-TREATMENT +posterior I-TREATMENT +del I-TREATMENT +cuello, I-TREATMENT +drenando I-TREATMENT +líquido I-TREATMENT +purulento. I-TREATMENT +No B-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +evidencias I-EXPLORATION +de I-EXPLORATION +necrosis I-EXPLORATION +o I-EXPLORATION +gas. I-EXPLORATION +Se I-EXPLORATION +obtuvo I-EXPLORATION +cultivo I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +secreción, I-EXPLORATION +aislándose I-EXPLORATION +Streptococcus I-EXPLORATION +grupo I-EXPLORATION +B, I-EXPLORATION +los I-EXPLORATION +hemocultivos I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Luego B-TREATMENT +de I-TREATMENT +una I-TREATMENT +semana I-TREATMENT +con I-TREATMENT +antibióticos I-TREATMENT +EV, I-TREATMENT +los I-TREATMENT +drenajes I-TREATMENT +Penrose I-TREATMENT +dejaron I-TREATMENT +de I-TREATMENT +entregar I-TREATMENT +secreción I-TREATMENT +y I-TREATMENT +fueron I-TREATMENT +retirados. I-TREATMENT +La B-EVOLUTION +exploración I-EVOLUTION de I-EVOLUTION las I-EVOLUTION -coronas I-EVOLUTION -telescópicas I-EVOLUTION -hace I-EVOLUTION -que I-EVOLUTION -la I-EVOLUTION -supervivencia I-EVOLUTION -a I-EVOLUTION -largo I-EVOLUTION -plazo I-EVOLUTION -de I-EVOLUTION -estos I-EVOLUTION -dientes I-EVOLUTION -sea I-EVOLUTION -prolongada. I-EVOLUTION - I-EVOLUTION +incisiones I-EVOLUTION +fue I-EVOLUTION +satisfactoria. I-EVOLUTION +Se B-TREATMENT +dio I-TREATMENT +de I-TREATMENT +alta I-TREATMENT +con I-TREATMENT +antibiótico I-TREATMENT +oral I-TREATMENT +hasta I-TREATMENT +completar I-TREATMENT +otra I-TREATMENT +semana I-TREATMENT +(Ampicilina/Sulbactam). I-TREATMENT + I-TREATMENT -Hombre B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -19 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -refiere B-PAST_MEDICAL_HISTORY -haber I-PAST_MEDICAL_HISTORY -acudido I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -dentista I-PAST_MEDICAL_HISTORY -particular I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -medio I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -presentar I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -nódulo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -dorso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -lengua, I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -mismo I-PAST_MEDICAL_HISTORY -color I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -mucosa I-PAST_MEDICAL_HISTORY -adyacente, I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -consistencia I-PAST_MEDICAL_HISTORY -firme, I-PAST_MEDICAL_HISTORY -asintomático, I-PAST_MEDICAL_HISTORY -aproximadamente I-PAST_MEDICAL_HISTORY +84 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +nacionalidad B-PAST_MEDICAL_HISTORY +chilena, I-PAST_MEDICAL_HISTORY +dueña I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -cm. I-PAST_MEDICAL_HISTORY +casa. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +policlínico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Dermatología I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +nódulos I-PRESENT_ILLNESS +cutáneos I-PRESENT_ILLNESS +eritematosos I-PRESENT_ILLNESS +ulcerados, I-PRESENT_ILLNESS +asintomáticos, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +palmar I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +dedo I-PRESENT_ILLNESS +meñique I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +zona I-PRESENT_ILLNESS +ventral I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +antebrazo I-PRESENT_ILLNESS +derecho, I-PRESENT_ILLNESS +siguiendo I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +patrón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +disposición I-PRESENT_ILLNESS +lineal I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +largo I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +trayecto I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +vasos I-PRESENT_ILLNESS +linfáticos I-PRESENT_ILLNESS +; I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +otros I-PRESENT_ILLNESS +síntomas I-PRESENT_ILLNESS +acompañantes. I-PRESENT_ILLNESS +La B-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +tenía I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -diámetro, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -realiza I-PAST_MEDICAL_HISTORY -biopsia I-PAST_MEDICAL_HISTORY -excisional I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -histopatológico I-PAST_MEDICAL_HISTORY +hipertensión I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +esencial, I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +cardíaca I-PAST_MEDICAL_HISTORY +congestiva, I-PAST_MEDICAL_HISTORY +hipotiroidis-mo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +anemia I-PAST_MEDICAL_HISTORY +hemolítica I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +crioaglutininas. I-PAST_MEDICAL_HISTORY +No I-PAST_MEDICAL_HISTORY +presentaba I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +previa I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -adenoma I-PAST_MEDICAL_HISTORY -monomorfo I-PAST_MEDICAL_HISTORY +tuberculosis, I-PAST_MEDICAL_HISTORY +uso I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -canalicular; I-PAST_MEDICAL_HISTORY -tres B-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -después, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -nuevamente I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -dentista I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -recidiva I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -lesión, I-PRESENT_ILLNESS -a B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -intraoral I-EXPLORATION -muestra I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -en I-EXPLORATION +corticoides, I-PAST_MEDICAL_HISTORY +inmunosupresión I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +trauma I-PAST_MEDICAL_HISTORY +reciente I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +las I-PAST_MEDICAL_HISTORY +zonas I-PAST_MEDICAL_HISTORY +afectadas. I-PAST_MEDICAL_HISTORY +No B-FAMILY_HISTORY +existían I-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +familiares I-FAMILY_HISTORY +de I-FAMILY_HISTORY +relevancia I-FAMILY_HISTORY +ni I-FAMILY_HISTORY +viajes I-FAMILY_HISTORY +en I-FAMILY_HISTORY +el I-FAMILY_HISTORY +último I-FAMILY_HISTORY +tiempo. I-FAMILY_HISTORY + I-FAMILY_HISTORY +Se B-EXPLORATION +planteó I-EXPLORATION el I-EXPLORATION -dorso I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lengua I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -misma I-EXPLORATION -localización I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -primera I-EXPLORATION -lesión, I-EXPLORATION -con I-EXPLORATION -dolor I-EXPLORATION -leve I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -presión, I-EXPLORATION -sin I-EXPLORATION -evidencia I-EXPLORATION -de I-EXPLORATION -linfadenopatía I-EXPLORATION -cervical, I-EXPLORATION -se I-EXPLORATION -solicita I-EXPLORATION -estudios I-EXPLORATION +diagnóstico I-EXPLORATION +diferencial I-EXPLORATION de I-EXPLORATION -laboratorio, I-EXPLORATION -biometría I-EXPLORATION -hemática I-EXPLORATION +micosis I-EXPLORATION +subcutánea, I-EXPLORATION +micobacteriosis I-EXPLORATION +tuberculosa I-EXPLORATION y I-EXPLORATION -química I-EXPLORATION -sanguínea, I-EXPLORATION -con I-EXPLORATION -resultados I-EXPLORATION -normales, I-EXPLORATION -decidiendo I-EXPLORATION -realizar I-EXPLORATION -segunda I-EXPLORATION +micobacteriosis I-EXPLORATION +atípica, I-EXPLORATION +realizándose I-EXPLORATION biopsia I-EXPLORATION -excisional. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -pieza I-EXPLORATION -macroscópica I-EXPLORATION -presenta I-EXPLORATION -consistencia I-EXPLORATION -firme, I-EXPLORATION -forma I-EXPLORATION y I-EXPLORATION -superficie I-EXPLORATION -irregular, I-EXPLORATION -color I-EXPLORATION -marrón I-EXPLORATION -de I-EXPLORATION -10 I-EXPLORATION -x I-EXPLORATION -6 I-EXPLORATION -x I-EXPLORATION -5 I-EXPLORATION -mm.. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -el I-EXPLORATION estudio I-EXPLORATION -histopatológico I-EXPLORATION -se I-EXPLORATION -podía I-EXPLORATION -observar I-EXPLORATION -múltiples I-EXPLORATION -cavidades I-EXPLORATION -pseudoquísticas I-EXPLORATION -de I-EXPLORATION -tamaño I-EXPLORATION -variable I-EXPLORATION -compuestos I-EXPLORATION -por I-EXPLORATION -células I-EXPLORATION -cúbicas I-EXPLORATION +microbiológico I-EXPLORATION de I-EXPLORATION -citoplasma I-EXPLORATION -escaso, I-EXPLORATION -núcleos I-EXPLORATION -ovales I-EXPLORATION -con I-EXPLORATION -contenido I-EXPLORATION -eosinófilo, I-EXPLORATION -rodeado I-EXPLORATION -por I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +cutáneas. I-EXPLORATION +El I-EXPLORATION +análisis I-EXPLORATION +histopatológico I-EXPLORATION +reveló I-EXPLORATION una I-EXPLORATION -banda I-EXPLORATION +paniculitis I-EXPLORATION +granulomatosa I-EXPLORATION +supurativa I-EXPLORATION +sin I-EXPLORATION +caseificación. I-EXPLORATION +Las I-EXPLORATION +tinciones I-EXPLORATION de I-EXPLORATION -tejido I-EXPLORATION -conjuntivo I-EXPLORATION -fibroso I-EXPLORATION -denso, I-EXPLORATION -bien I-EXPLORATION -vascularizado, I-EXPLORATION -e I-EXPLORATION -infiltrado I-EXPLORATION -inflamatorio I-EXPLORATION -crónico I-EXPLORATION -moderado I-EXPLORATION +PAS, I-EXPLORATION +Grocott, I-EXPLORATION +Ziehl-Neelsen I-EXPLORATION y I-EXPLORATION -difuso, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -tejido I-EXPLORATION -fibroso I-EXPLORATION -que I-EXPLORATION -rodea I-EXPLORATION -a I-EXPLORATION +Gram I-EXPLORATION +no I-EXPLORATION +revelaron I-EXPLORATION la I-EXPLORATION -lesión I-EXPLORATION -principal I-EXPLORATION -se I-EXPLORATION -encuentran I-EXPLORATION -cordones I-EXPLORATION -alineados I-EXPLORATION +presencia I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -cúbicas I-EXPLORATION -con I-EXPLORATION -núcleos I-EXPLORATION -hipercromáticos, I-EXPLORATION +microorganismos I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -periferia I-EXPLORATION -presenta I-EXPLORATION -infiltración I-EXPLORATION -perineural I-EXPLORATION -con I-EXPLORATION -tejido I-EXPLORATION -muscular I-EXPLORATION -estriado.. I-EXPLORATION - I-EXPLORATION -Con I-EXPLORATION -estas I-EXPLORATION -características I-EXPLORATION -se I-EXPLORATION -da I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION -de I-EXPLORATION -carcinoma I-EXPLORATION -adenoideo I-EXPLORATION -quístico I-EXPLORATION -siendo I-EXPLORATION -diferente I-EXPLORATION -al I-EXPLORATION -diagnóstico I-EXPLORATION -previo I-EXPLORATION -de I-EXPLORATION -adenoma I-EXPLORATION -canalicular, I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -decide I-EXPLORATION -solicitar I-EXPLORATION -el I-EXPLORATION -corte I-EXPLORATION -histológico I-EXPLORATION -de I-EXPLORATION +muestra. I-EXPLORATION +Sin I-EXPLORATION +embargo, I-EXPLORATION la I-EXPLORATION -primera I-EXPLORATION -biopsia, I-EXPLORATION -observándose I-EXPLORATION -las I-EXPLORATION -características I-EXPLORATION -de I-EXPLORATION -un I-EXPLORATION -CAQ I-EXPLORATION -con I-EXPLORATION -bordes I-EXPLORATION -tomados. I-EXPLORATION -Se I-EXPLORATION -decide I-EXPLORATION -realizar I-EXPLORATION -panel I-EXPLORATION -de I-EXPLORATION -inmunohistoquímica I-EXPLORATION -recomendado, I-EXPLORATION -el I-EXPLORATION -cual I-EXPLORATION -es I-EXPLORATION -el I-EXPLORATION -siguiente: I-EXPLORATION -proteína I-EXPLORATION -S-100, I-EXPLORATION -Actina I-EXPLORATION -para I-EXPLORATION -músculo I-EXPLORATION -liso I-EXPLORATION -específica, I-EXPLORATION -CALPONINA, I-EXPLORATION -CEA, I-EXPLORATION -Antígeno I-EXPLORATION -Epitelial I-EXPLORATION -de I-EXPLORATION -Membrana, I-EXPLORATION -PAGF, I-EXPLORATION -Ki67. I-EXPLORATION -(7-8) I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION +reacción I-EXPLORATION de I-EXPLORATION -estos I-EXPLORATION -marcadores I-EXPLORATION -fueron: I-EXPLORATION -CEA I-EXPLORATION -positiva I-EXPLORATION +polimerasa I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -citoplasma I-EXPLORATION +cadena I-EXPLORATION +(RPC) I-EXPLORATION y I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -membrana I-EXPLORATION +el I-EXPLORATION +cultivo I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -luminares I-EXPLORATION -(normalmente I-EXPLORATION -encontrado I-EXPLORATION -en I-EXPLORATION -conductos I-EXPLORATION -estriados I-EXPLORATION +tejido I-EXPLORATION +fueron I-EXPLORATION +positivos I-EXPLORATION +para I-EXPLORATION +M. I-EXPLORATION +tuberculosis. I-EXPLORATION +Dentro I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +se I-EXPLORATION +realizaron I-EXPLORATION +hemograma, I-EXPLORATION +velocidad I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -glándulas I-EXPLORATION -salivales I-EXPLORATION -menores), I-EXPLORATION -EMA I-EXPLORATION -positiva I-EXPLORATION -en I-EXPLORATION -citoplasma I-EXPLORATION +sedimentación, I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +VIH, I-EXPLORATION +perfil I-EXPLORATION +bioquímico, I-EXPLORATION +función I-EXPLORATION +renal, I-EXPLORATION +análisis I-EXPLORATION de I-EXPLORATION -conductos I-EXPLORATION -intercalados I-EXPLORATION +orina, I-EXPLORATION +función I-EXPLORATION +hepática I-EXPLORATION y I-EXPLORATION -estriados I-EXPLORATION -(abundante I-EXPLORATION -en I-EXPLORATION -células I-EXPLORATION -mioepiteliales I-EXPLORATION -alrededor I-EXPLORATION +radiografía I-EXPLORATION de I-EXPLORATION +tórax, I-EXPLORATION los I-EXPLORATION -acinos), I-EXPLORATION -S-100 I-EXPLORATION -positiva I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -células I-EXPLORATION -mioepiteliales, I-EXPLORATION -conductos I-EXPLORATION -intercalados I-EXPLORATION -y I-EXPLORATION -estriados. I-EXPLORATION -La I-EXPLORATION -CALP I-EXPLORATION -fue I-EXPLORATION -positiva I-EXPLORATION -por I-EXPLORATION -lo I-EXPLORATION que I-EXPLORATION -se I-EXPLORATION -confirma I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +resultaron I-EXPLORATION +todos I-EXPLORATION +normales. I-EXPLORATION +La I-EXPLORATION +determinación I-EXPLORATION de I-EXPLORATION -células I-EXPLORATION -mioepiteliales, I-EXPLORATION -también I-EXPLORATION -la I-EXPLORATION -tinción I-EXPLORATION -con I-EXPLORATION -Ki-67 I-EXPLORATION -demostró I-EXPLORATION -áreas I-EXPLORATION -focales I-EXPLORATION -escasas I-EXPLORATION -con I-EXPLORATION -aproximadamente I-EXPLORATION +Quantiferon I-EXPLORATION +TB I-EXPLORATION +gold® I-EXPLORATION +resultó I-EXPLORATION +positivo. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +PPD. I-EXPLORATION + I-EXPLORATION +Basado I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +resultados, I-EXPLORATION +se I-EXPLORATION +estableció I-EXPLORATION el I-EXPLORATION -15 I-EXPLORATION -al I-EXPLORATION -20% I-EXPLORATION +diagnóstico I-EXPLORATION de I-EXPLORATION -tinción I-EXPLORATION -nuclear, I-EXPLORATION -que I-EXPLORATION -al I-EXPLORATION -correlacionar I-EXPLORATION +tuberculosis I-EXPLORATION +cutánea I-EXPLORATION +y B-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +esquema I-TREATMENT +primario I-TREATMENT +de I-TREATMENT +cuatro I-TREATMENT +fármacos: I-TREATMENT +isoniacida, I-TREATMENT +pirazinamida, I-TREATMENT +rifampicina I-TREATMENT +y I-TREATMENT +etambutol. I-TREATMENT +Durante I-TREATMENT +dos I-TREATMENT +meses I-TREATMENT +de I-TREATMENT +seguimiento I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +continuó I-TREATMENT +con I-TREATMENT +el I-TREATMENT +esquema I-TREATMENT +de I-TREATMENT +terapia I-TREATMENT +antituberculosa I-TREATMENT +de I-TREATMENT +acuerdo I-TREATMENT +a I-TREATMENT +los I-TREATMENT +protocolos I-TREATMENT +establecidos, I-TREATMENT +demostrando B-EVOLUTION +una I-EVOLUTION +mejoría I-EVOLUTION +clínicamente I-EVOLUTION +significativa I-EVOLUTION +con I-EVOLUTION +regresión I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +lesiones I-EVOLUTION +ulcerativas I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +efectos I-EVOLUTION +secundarios I-EVOLUTION +reportados. I-EVOLUTION + I-EVOLUTION + +Niña B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés. I-PAST_MEDICAL_HISTORY +Desde B-PRESENT_ILLNESS +hace I-PRESENT_ILLNESS +varios I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +recurrentes I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +elevada I-PRESENT_ILLNESS +(cada I-PRESENT_ILLNESS +4 I-PRESENT_ILLNESS +semanas), I-PRESENT_ILLNESS +adenopatías I-PRESENT_ILLNESS +laterocervicales I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +faringitis. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Los I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +cursan I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +(39-40 I-PRESENT_ILLNESS +oC) I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +3-4 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +duración I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +escasa I-PRESENT_ILLNESS +respuesta I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +antitérmicos. I-PRESENT_ILLNESS +La B-EXPLORATION +niña I-EXPLORATION +está I-EXPLORATION +asintomática I-EXPLORATION +entre I-EXPLORATION +los I-EXPLORATION +episodios I-EXPLORATION +y I-EXPLORATION +tiene I-EXPLORATION +un I-EXPLORATION +desarrollo I-EXPLORATION +normal I-EXPLORATION +para I-EXPLORATION +su I-EXPLORATION +edad. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +aparecen I-EXPLORATION +leucocitosis I-EXPLORATION con I-EXPLORATION +neutrofilia I-EXPLORATION +moderada, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +elevación I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -clínica I-EXPLORATION -nos I-EXPLORATION -indica I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -tumor I-EXPLORATION -es I-EXPLORATION +velocidad I-EXPLORATION de I-EXPLORATION -bajo I-EXPLORATION -grado, I-EXPLORATION -corroborado B-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -diagnostico I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -envía I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -centro I-DERIVED_FROM/TO -oncológico I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -seguimiento I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -largo I-DERIVED_FROM/TO -plazo, I-DERIVED_FROM/TO -después B-EVOLUTION -de I-EVOLUTION -2 I-EVOLUTION -años I-EVOLUTION -presenta I-EVOLUTION +sedimentación I-EXPLORATION +globular I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +(PCR). I-EXPLORATION +En I-EXPLORATION +varias I-EXPLORATION +ocasiones I-EXPLORATION +se I-EXPLORATION +realizaron I-EXPLORATION +frotis I-EXPLORATION +faríngeos I-EXPLORATION +que I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Los B-TREATMENT +primeros I-TREATMENT +episodios I-TREATMENT +se I-TREATMENT +trataron I-TREATMENT +con I-TREATMENT +antibiótico. I-TREATMENT +No B-EVOLUTION +presentó I-EVOLUTION +mejoría I-EVOLUTION +hasta I-EVOLUTION +el I-EVOLUTION +3.o-5.o I-EVOLUTION +día. I-EVOLUTION + I-EVOLUTION +Ante I-EVOLUTION +los I-EVOLUTION +síntomas I-EVOLUTION +descritos, I-EVOLUTION +su I-EVOLUTION recurrencia I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION +y I-EVOLUTION +los I-EVOLUTION +cultivos I-EVOLUTION +faríngeos I-EVOLUTION +negativos, I-EVOLUTION que I-EVOLUTION se I-EVOLUTION -le I-EVOLUTION -realiza I-EVOLUTION -glosectomia I-EVOLUTION -parcial, I-EVOLUTION -con I-EVOLUTION -seguimiento I-EVOLUTION +producían I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +repetida, I-EVOLUTION +se I-EVOLUTION +pensó I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +posibilidad I-EVOLUTION +de I-EVOLUTION +un I-EVOLUTION +síndrome I-EVOLUTION +de I-EVOLUTION +Marshall. I-EVOLUTION +Coincidiendo B-TREATMENT +con I-TREATMENT +un I-TREATMENT +nuevo I-TREATMENT +pico I-TREATMENT +febril, I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +corticoterapia I-TREATMENT +oral. I-TREATMENT +La B-EVOLUTION +duración I-EVOLUTION +del I-EVOLUTION +episodio I-EVOLUTION +se I-EVOLUTION +acortó I-EVOLUTION a I-EVOLUTION -largo I-EVOLUTION -plazo. I-EVOLUTION +menos I-EVOLUTION +de I-EVOLUTION +6 I-EVOLUTION +horas I-EVOLUTION +tras I-EVOLUTION +la I-EVOLUTION +toma I-EVOLUTION +de I-EVOLUTION +prednisona. I-EVOLUTION +Dicha I-EVOLUTION +respuesta I-EVOLUTION +fue I-EVOLUTION +comprobada I-EVOLUTION +en I-EVOLUTION +episodios I-EVOLUTION +posteriores, I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +sugiere I-EVOLUTION +un I-EVOLUTION +síndrome I-EVOLUTION +PFAPA. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -56 I-PRESENT_ILLNESS +55 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -acude I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -extracción I-PRESENT_ILLNESS +remitido I-PRESENT_ILLNESS +a B-DERIVED_FROM/TO +nuestras I-DERIVED_FROM/TO +consultas I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +oftalmología I-DERIVED_FROM/TO +por B-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +exoftalmos I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -resto I-PRESENT_ILLNESS -radicular. I-PRESENT_ILLNESS -Durante B-EXPLORATION +globo I-PRESENT_ILLNESS +ocular I-PRESENT_ILLNESS +secundario I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +tumoración I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nivel I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +seno I-PRESENT_ILLNESS +maxilar I-PRESENT_ILLNESS +derecho. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Como B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +refería I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +fractura I-PAST_MEDICAL_HISTORY +máxilo-malar I-PAST_MEDICAL_HISTORY +derecha I-PAST_MEDICAL_HISTORY +28 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +antes, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +realizó I-PAST_MEDICAL_HISTORY +reducción I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +fijación I-PAST_MEDICAL_HISTORY +alámbrica I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +reborde I-PAST_MEDICAL_HISTORY +infraorbitario I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +arbotante I-PAST_MEDICAL_HISTORY +frontomalar. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -clínica I-EXPLORATION -se I-EXPLORATION -descubren I-EXPLORATION -múltiples I-EXPLORATION -lesiones I-EXPLORATION -papulares I-EXPLORATION -en I-EXPLORATION -encías, I-EXPLORATION -con I-EXPLORATION -tendencia I-EXPLORATION -a I-EXPLORATION -confluir, I-EXPLORATION -que I-EXPLORATION -adquieren I-EXPLORATION -aspecto I-EXPLORATION -de I-EXPLORATION -empedrado. I-EXPLORATION -La I-EXPLORATION -mucosa I-EXPLORATION -labial I-EXPLORATION -inferior I-EXPLORATION -tiene I-EXPLORATION -una I-EXPLORATION -disposición I-EXPLORATION -coarrugada I-EXPLORATION +oftalmológica I-EXPLORATION +encontramos I-EXPLORATION +exoftalmos, I-EXPLORATION +distopia I-EXPLORATION +vertical I-EXPLORATION +del I-EXPLORATION +globo I-EXPLORATION +ocular I-EXPLORATION y I-EXPLORATION +oftalmoplejia I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -lengua I-EXPLORATION -aparecen I-EXPLORATION -gran I-EXPLORATION -número I-EXPLORATION +mirada I-EXPLORATION +vertical. I-EXPLORATION +Se I-EXPLORATION +encontró I-EXPLORATION +una I-EXPLORATION +falta I-EXPLORATION de I-EXPLORATION -pápulas I-EXPLORATION +proyección I-EXPLORATION +del I-EXPLORATION +reborde I-EXPLORATION +infraorbitario I-EXPLORATION que I-EXPLORATION -confieren I-EXPLORATION +permitía I-EXPLORATION +palpar I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +blanda I-EXPLORATION a I-EXPLORATION -ésta, I-EXPLORATION -aspecto I-EXPLORATION -moriforme. I-EXPLORATION +dicho I-EXPLORATION +nivel. I-EXPLORATION + I-EXPLORATION En I-EXPLORATION la I-EXPLORATION -mucosa I-EXPLORATION -yugal I-EXPLORATION -aparece I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -polipoide I-EXPLORATION -que I-EXPLORATION -extirpamos I-EXPLORATION -a I-EXPLORATION +ortopantomografía I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +vió I-EXPLORATION +relación I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -vez I-EXPLORATION -que I-EXPLORATION -realizamos I-EXPLORATION +masa I-EXPLORATION +con I-EXPLORATION +dientes. I-EXPLORATION +La I-EXPLORATION +TC I-EXPLORATION +puso I-EXPLORATION +de I-EXPLORATION +manifiesto I-EXPLORATION una I-EXPLORATION -biopsia I-EXPLORATION +masa I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -encía I-EXPLORATION -cuyo I-EXPLORATION -resultado I-EXPLORATION -es I-EXPLORATION -hiperplasia I-EXPLORATION -inflamatoria I-EXPLORATION +partes I-EXPLORATION +blandas I-EXPLORATION +de I-EXPLORATION +aproximadamente I-EXPLORATION +de I-EXPLORATION +3, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION +seno I-EXPLORATION +maxilar I-EXPLORATION +derecho, I-EXPLORATION +bien I-EXPLORATION +delimitada, I-EXPLORATION +con I-EXPLORATION +remodelación I-EXPLORATION +ósea I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION +destrucción I-EXPLORATION +del I-EXPLORATION +suelo I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -mucosa I-EXPLORATION -yugal, I-EXPLORATION -pólipo I-EXPLORATION -fibroepitelial. I-EXPLORATION +órbita I-EXPLORATION +y I-EXPLORATION +desplazamiento I-EXPLORATION +del I-EXPLORATION +músculo I-EXPLORATION +recto I-EXPLORATION +inferior, I-EXPLORATION +provocando I-EXPLORATION +un I-EXPLORATION +exoftalmos I-EXPLORATION +secundario. I-EXPLORATION I-EXPLORATION -En B-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -anamnesis I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS +La B-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +consistió I-TREATMENT +en I-TREATMENT +la I-TREATMENT +exéresis I-TREATMENT +de I-TREATMENT +la I-TREATMENT +lesión I-TREATMENT +asociada I-TREATMENT +a I-TREATMENT +la I-TREATMENT +extracción I-TREATMENT +de I-TREATMENT +las I-TREATMENT +fijaciones I-TREATMENT +alámbricas I-TREATMENT +vía I-TREATMENT +subciliar I-TREATMENT +figura I-TREATMENT +3), I-TREATMENT +y I-TREATMENT +reconstrucción I-TREATMENT +con I-TREATMENT +prótesis I-TREATMENT +de I-TREATMENT +Medpor I-TREATMENT +del I-TREATMENT +complejo I-TREATMENT +máxilomalar I-TREATMENT +destruido I-TREATMENT +(reborde I-TREATMENT +infraorbitario, I-TREATMENT +suelo I-TREATMENT +de I-TREATMENT +órbita, I-TREATMENT +arbotante I-TREATMENT +frontomalar). I-TREATMENT + I-TREATMENT +El B-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION +confirmó I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +de I-EXPLORATION +mucocele I-EXPLORATION +maxilar. I-EXPLORATION + I-EXPLORATION +La B-EVOLUTION +evolución I-EVOLUTION +del I-EVOLUTION +enfermo I-EVOLUTION +fue I-EVOLUTION +satisfactoria, I-EVOLUTION +con I-EVOLUTION +buena I-EVOLUTION +motilidad I-EVOLUTION +ocular, I-EVOLUTION +sin I-EVOLUTION +diplopia I-EVOLUTION +y I-EVOLUTION +con I-EVOLUTION +un I-EVOLUTION +correcto I-EVOLUTION +resultado I-EVOLUTION +estético. I-EVOLUTION +El I-EVOLUTION +seguimiento I-EVOLUTION +actual I-EVOLUTION +tras I-EVOLUTION +tres I-EVOLUTION +años I-EVOLUTION +continúa I-EVOLUTION +siendo I-EVOLUTION +satisfactorio I-EVOLUTION +sin I-EVOLUTION +recidiva I-EVOLUTION +ni I-EVOLUTION +complicaciones. I-EVOLUTION + I-EVOLUTION + +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS paciente I-PRESENT_ILLNESS -refiere I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -sido I-PRESENT_ILLNESS -operada I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -bocio I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -ocasiones, I-PRESENT_ILLNESS -así I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -quistes I-PRESENT_ILLNESS -mamarios I-PRESENT_ILLNESS -bilaterales. I-PRESENT_ILLNESS -Padece I-PRESENT_ILLNESS -ulcera I-PRESENT_ILLNESS -gástrica, I-PRESENT_ILLNESS -esofagitis I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -pólipos I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -colon. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En I-PRESENT_ILLNESS -varias I-PRESENT_ILLNESS -ocasiones I-PRESENT_ILLNESS -le I-PRESENT_ILLNESS -han I-PRESENT_ILLNESS -extirpado I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -cutáneas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -brazos I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -plantas I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -pies. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Ante B-PAST_MEDICAL_HISTORY -esta I-PAST_MEDICAL_HISTORY -patología I-PAST_MEDICAL_HISTORY -tan I-PAST_MEDICAL_HISTORY -florida I-PAST_MEDICAL_HISTORY -solicitamos I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -historia I-PAST_MEDICAL_HISTORY -clínica I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -archivo I-PAST_MEDICAL_HISTORY -central I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -nuestro I-PAST_MEDICAL_HISTORY -hospital I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -referencia I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -realizando I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -resumen I-PAST_MEDICAL_HISTORY +edad, I-PRESENT_ILLNESS +derivado B-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +cirugía I-DERIVED_FROM/TO +máxilofacial I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +Hospital I-DERIVED_FROM/TO +Luis I-DERIVED_FROM/TO +Calvo I-DERIVED_FROM/TO +Mackenna, I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +presentar I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +lesión I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +zona I-DERIVED_FROM/TO +malar I-DERIVED_FROM/TO +derecha. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +Sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +mórbidos, I-PAST_MEDICAL_HISTORY +relata I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +aumento I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -ésta, I-PAST_MEDICAL_HISTORY +volumen I-PAST_MEDICAL_HISTORY +secundario I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -enferma I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -han I-PAST_MEDICAL_HISTORY -extirpado I-PAST_MEDICAL_HISTORY -nódulos I-PAST_MEDICAL_HISTORY -coloides I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -tiroides, I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -operado I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +traumatismo I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -fibroquística I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -mama, I-PAST_MEDICAL_HISTORY -presenta I-PAST_MEDICAL_HISTORY -ulcus I-PAST_MEDICAL_HISTORY -gástrico I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -varias I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -han I-PAST_MEDICAL_HISTORY -extirpado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -endoscópica I-PAST_MEDICAL_HISTORY -pólipos I-PAST_MEDICAL_HISTORY -gástricos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -colon. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Las I-PAST_MEDICAL_HISTORY -lesiones I-PAST_MEDICAL_HISTORY -extirpadas I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -brazo I-PAST_MEDICAL_HISTORY -resultaron I-PAST_MEDICAL_HISTORY -ser I-PAST_MEDICAL_HISTORY -hiperplasias I-PAST_MEDICAL_HISTORY -reactivas I-PAST_MEDICAL_HISTORY -inflamatorias I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Ackerman, I-PAST_MEDICAL_HISTORY +región I-PAST_MEDICAL_HISTORY +malar I-PAST_MEDICAL_HISTORY +derecha I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +persiste I-PAST_MEDICAL_HISTORY +hasta I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -pies I-PAST_MEDICAL_HISTORY -verrugas I-PAST_MEDICAL_HISTORY -plantares. I-PAST_MEDICAL_HISTORY +fecha.. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -Ante B-EXPLORATION -estos I-EXPLORATION -hallazgos I-EXPLORATION -realizamos I-EXPLORATION +Al B-EXPLORATION +examen I-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION +paciente I-EXPLORATION +presentaba I-EXPLORATION +aumento I-EXPLORATION de I-EXPLORATION -afectación I-EXPLORATION -oral I-EXPLORATION +volumen, I-EXPLORATION +asintomático, I-EXPLORATION +circunscrito, I-EXPLORATION de I-EXPLORATION -Síndrome I-EXPLORATION +consistencia I-EXPLORATION +firme, I-EXPLORATION +con I-EXPLORATION +tiempo I-EXPLORATION de I-EXPLORATION -Cowden. I-EXPLORATION +evolución I-EXPLORATION +indeterminado. I-EXPLORATION +Al I-EXPLORATION +examen I-EXPLORATION +intraoral I-EXPLORATION +el I-EXPLORATION +vestíbulo I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +desocupado I-EXPLORATION +y I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION +volumen I-EXPLORATION +del I-EXPLORATION +reborde I-EXPLORATION +óseo I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +más I-EXPLORATION +alta. I-EXPLORATION I-EXPLORATION - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -59 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sexo I-PRESENT_ILLNESS -femenino I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -raza I-PRESENT_ILLNESS -blanca, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -crecimiento I-PRESENT_ILLNESS -lento, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -cuatro I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -localizada I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -glándula I-PRESENT_ILLNESS -parótida I-PRESENT_ILLNESS -izquierda. I-PRESENT_ILLNESS -No B-PAST_MEDICAL_HISTORY -existían I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -y B-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -masa I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -motivó I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -era I-PRESENT_ILLNESS -asintomática. I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -permitió I-EXPLORATION -detectar I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION -presencia I-EXPLORATION -de I-EXPLORATION +tomografía I-EXPLORATION +axial I-EXPLORATION +computarizada I-EXPLORATION +(TAC) I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION una I-EXPLORATION -tumoración I-EXPLORATION -de I-EXPLORATION -3, I-EXPLORATION -5 I-EXPLORATION -cm I-EXPLORATION +masa I-EXPLORATION +que I-EXPLORATION +compromete I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +malar I-EXPLORATION +derecha, I-EXPLORATION +destruyendo I-EXPLORATION +el I-EXPLORATION +hueso I-EXPLORATION +cigomático, I-EXPLORATION +parte I-EXPLORATION +del I-EXPLORATION +piso I-EXPLORATION de I-EXPLORATION -diámetro, I-EXPLORATION -insensible I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -palpación I-EXPLORATION +órbita I-EXPLORATION y I-EXPLORATION -cubierta I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -piel I-EXPLORATION -de I-EXPLORATION -apariencia I-EXPLORATION -normal, I-EXPLORATION -desplazable I-EXPLORATION -con I-EXPLORATION -respecto I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -tejidos I-EXPLORATION -profundos. I-EXPLORATION -El I-EXPLORATION -resto I-EXPLORATION +el I-EXPLORATION +arco I-EXPLORATION +cigomático. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +biopsia I-EXPLORATION +incisional I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -cervicocefálica I-EXPLORATION -fue I-EXPLORATION -normal, I-EXPLORATION -no I-EXPLORATION -habiéndose I-EXPLORATION -detectado I-EXPLORATION -adenomegalias I-EXPLORATION -cervicales. I-EXPLORATION -Se I-EXPLORATION -practicaron I-EXPLORATION -estudios I-EXPLORATION -rutinarios I-EXPLORATION -(radiografías I-EXPLORATION -torácicas I-EXPLORATION +lesión. I-EXPLORATION + I-EXPLORATION +De I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +se I-EXPLORATION +obtuvo I-EXPLORATION +como I-EXPLORATION +resultado I-EXPLORATION +HCL, I-EXPLORATION +con I-EXPLORATION +marcadores I-EXPLORATION +inmunohistoquímicos I-EXPLORATION +CD1a I-EXPLORATION y I-EXPLORATION -analítica I-EXPLORATION -sistemática) I-EXPLORATION -que I-EXPLORATION -resultaron I-EXPLORATION -libres I-EXPLORATION -de I-EXPLORATION -hallazgos I-EXPLORATION -patológicos. I-EXPLORATION +S100 I-EXPLORATION +intensamente I-EXPLORATION +positivos. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +completo I-EXPLORATION +estudio I-EXPLORATION +del I-EXPLORATION +paciente, I-EXPLORATION +sin I-EXPLORATION +evidenciar I-EXPLORATION +compromiso I-EXPLORATION +en I-EXPLORATION +otras I-EXPLORATION +áreas I-EXPLORATION +del I-EXPLORATION +cuerpo. I-EXPLORATION + I-EXPLORATION La B-TREATMENT -tumoración I-TREATMENT +lesión I-TREATMENT fue I-TREATMENT -extirpada I-TREATMENT -mediante I-TREATMENT -una I-TREATMENT -parotidectomía I-TREATMENT -extrafacial, I-TREATMENT -observándose, I-TREATMENT -en I-TREATMENT +clasificada I-TREATMENT +como I-TREATMENT +lesión I-TREATMENT +ósea I-TREATMENT +única I-TREATMENT +de I-TREATMENT +sitio I-TREATMENT +especial I-TREATMENT +y I-TREATMENT +tratada I-TREATMENT +con I-TREATMENT el I-TREATMENT -transcurso I-TREATMENT +protocolo I-TREATMENT +correspondiente, I-TREATMENT +recibiendo I-TREATMENT +4 I-TREATMENT +semanas I-TREATMENT de I-TREATMENT -la I-TREATMENT -misma, I-TREATMENT -que I-TREATMENT -la I-TREATMENT -lesión I-TREATMENT -mostraba I-TREATMENT -un I-TREATMENT -aspecto I-TREATMENT -bien I-TREATMENT -delimitado, I-TREATMENT -un I-TREATMENT -color I-TREATMENT -amarillento I-TREATMENT -grisáceo I-TREATMENT +prednisona I-TREATMENT y I-TREATMENT -la I-TREATMENT -presencia I-TREATMENT +6 I-TREATMENT +dosis I-TREATMENT de I-TREATMENT -un I-TREATMENT -tejido I-TREATMENT -salival I-TREATMENT -circundante I-TREATMENT +vinblastina. I-TREATMENT + I-TREATMENT +Posteriormente I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +como I-TREATMENT +tratamiento I-TREATMENT +local, I-TREATMENT +infiltración I-TREATMENT +con I-TREATMENT +triamcinolona I-TREATMENT +y I-TREATMENT +curetaje I-TREATMENT +después I-TREATMENT de I-TREATMENT -apariencia I-TREATMENT -normal. I-TREATMENT +la I-TREATMENT +tercera I-TREATMENT +infiltración. I-TREATMENT I-TREATMENT -El B-EXPLORATION -procesamiento I-EXPLORATION -histológico I-EXPLORATION -de I-EXPLORATION +A B-EVOLUTION +los I-EVOLUTION +18 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +realizado I-EVOLUTION +el I-EVOLUTION +tratamiento, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +asintomático, I-EVOLUTION +sin I-EVOLUTION +aumento I-EVOLUTION +de I-EVOLUTION +volumen I-EVOLUTION +facial I-EVOLUTION +ni I-EVOLUTION +del I-EVOLUTION +reborde I-EVOLUTION +óseo. I-EVOLUTION +En B-EXPLORATION la I-EXPLORATION -pieza I-EXPLORATION -quirúrgica I-EXPLORATION -fue I-EXPLORATION -rutinario, I-EXPLORATION -practicándose I-EXPLORATION -secciones I-EXPLORATION -de I-EXPLORATION -5 I-EXPLORATION -mm I-EXPLORATION -de I-EXPLORATION -espesor I-EXPLORATION -que I-EXPLORATION -fueron I-EXPLORATION -teñidas I-EXPLORATION -con I-EXPLORATION -hematoxilina-eosina. I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION +TAC I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -mismas I-EXPLORATION -permitió I-EXPLORATION -constatar I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -lesión, I-EXPLORATION -que I-EXPLORATION -estaba I-EXPLORATION -rodeada I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -cápsula I-EXPLORATION -incompletamente I-EXPLORATION -formada, I-EXPLORATION +control I-EXPLORATION se I-EXPLORATION -encontraba I-EXPLORATION -constituida I-EXPLORATION -por I-EXPLORATION -masas I-EXPLORATION -sólidas I-EXPLORATION -de I-EXPLORATION -células I-EXPLORATION -epiteliales I-EXPLORATION -estrechamente I-EXPLORATION -asociadas I-EXPLORATION -a I-EXPLORATION -conductos I-EXPLORATION -tapizados I-EXPLORATION -por I-EXPLORATION -dos I-EXPLORATION -capas I-EXPLORATION -de I-EXPLORATION -células, I-EXPLORATION -y I-EXPLORATION -amplias I-EXPLORATION -áreas I-EXPLORATION -de I-EXPLORATION -diferenciación I-EXPLORATION -sebácea. I-EXPLORATION -En I-EXPLORATION -ocasiones, I-EXPLORATION -las I-EXPLORATION -estructuras I-EXPLORATION -ductales I-EXPLORATION -mostraban I-EXPLORATION -proliferaciones I-EXPLORATION -de I-EXPLORATION -apariencia I-EXPLORATION -quística I-EXPLORATION -cuyas I-EXPLORATION -luces I-EXPLORATION -estaban I-EXPLORATION -ocupadas I-EXPLORATION -por I-EXPLORATION -material I-EXPLORATION -sebáceo I-EXPLORATION +aprecia I-EXPLORATION +la I-EXPLORATION +regeneración I-EXPLORATION +ósea I-EXPLORATION +del I-EXPLORATION +hueso I-EXPLORATION +malar, I-EXPLORATION +el I-EXPLORATION +arco I-EXPLORATION +cigomático I-EXPLORATION y I-EXPLORATION -ocasionales I-EXPLORATION -áreas I-EXPLORATION +el I-EXPLORATION +piso I-EXPLORATION de I-EXPLORATION -metaplasia I-EXPLORATION -oncocítica. I-EXPLORATION -Tras B-EVOLUTION -cinco I-EVOLUTION -años I-EVOLUTION -de I-EVOLUTION -seguimiento, I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -ha I-EVOLUTION -producido I-EVOLUTION -una I-EVOLUTION -recidiva I-EVOLUTION -lesional. I-EVOLUTION - I-EVOLUTION +la I-EXPLORATION +órbita. I-EXPLORATION + I-EXPLORATION -Paciente B-PRESENT_ILLNESS +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +53 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -masculino, I-PRESENT_ILLNESS -remitido B-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -servicio I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Estomatología I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -Cirugía I-DERIVED_FROM/TO -Oral I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -Universidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -Cartagena I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -un I-DERIVED_FROM/TO -odontólogo I-DERIVED_FROM/TO -rehabilitador, I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -descubrió I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -imagen I-DERIVED_FROM/TO -radiolúcida I-DERIVED_FROM/TO -circunscrita I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -zona I-DERIVED_FROM/TO -periapical I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -órgano I-DERIVED_FROM/TO -dentario I-DERIVED_FROM/TO -21 I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -una I-DERIVED_FROM/TO -radiografía I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -propósito I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -tratamiento I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -rehabilitación. I-DERIVED_FROM/TO -Durante B-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -anamnesis I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -reportó I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -importancia. I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -refiere I-PAST_MEDICAL_HISTORY +dolor I-PRESENT_ILLNESS +anal, I-PRESENT_ILLNESS +sangrado I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +cambio I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +volumen I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +heces, I-PRESENT_ILLNESS +estudiado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +otro I-PRESENT_ILLNESS +centro, I-PRESENT_ILLNESS +donde I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +le I-PRESENT_ILLNESS +han I-PRESENT_ILLNESS +realizado I-PRESENT_ILLNESS +colonoscopia I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +resonancia I-PRESENT_ILLNESS +magnética I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +diagnóstico I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +masa I-PRESENT_ILLNESS +ano-rectal, I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +posterior I-PRESENT_ILLNESS +ecoendoscopia I-PRESENT_ILLNESS +diagnosticándose I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +anillo I-PRESENT_ILLNESS +estenótico I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +importantes I-PRESENT_ILLNESS +cambios I-PRESENT_ILLNESS +inflamatorios I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +desestructuran I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +pared, I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +poder I-PRESENT_ILLNESS +definir I-PRESENT_ILLNESS +infiltración, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +biospias I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +inflamación I-PRESENT_ILLNESS +crónica I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +displasia I-PRESENT_ILLNESS +compatible I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +úlcera I-PRESENT_ILLNESS +rectal I-PRESENT_ILLNESS +solitaria. I-PRESENT_ILLNESS +Se B-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +han I-PAST_MEDICAL_HISTORY +realizado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +dicho I-PAST_MEDICAL_HISTORY +centro I-PAST_MEDICAL_HISTORY dos I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -trauma I-PAST_MEDICAL_HISTORY +anorrectoplastias, I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +colgajo I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -anterior I-PAST_MEDICAL_HISTORY -superior I-PAST_MEDICAL_HISTORY +Z I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -relata I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY +posteriormente I-PAST_MEDICAL_HISTORY +dilataciones, I-PAST_MEDICAL_HISTORY +persistiendo I-PAST_MEDICAL_HISTORY dolor I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -malestar I-PAST_MEDICAL_HISTORY -relacionados I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -caso. I-PAST_MEDICAL_HISTORY -Radiográficamente B-EXPLORATION -muestra I-EXPLORATION -imagen I-EXPLORATION -radiolúcida I-EXPLORATION -ovalada I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -de I-EXPLORATION -vidrio I-EXPLORATION -esmerilado, I-EXPLORATION -bien I-EXPLORATION -circunscrita I-EXPLORATION -con I-EXPLORATION -bordes I-EXPLORATION -radiopacos, I-EXPLORATION -perirradicular I-EXPLORATION -al I-EXPLORATION -órgano I-EXPLORATION -dentario I-EXPLORATION -21. I-EXPLORATION -Los I-EXPLORATION -diagnósticos I-EXPLORATION -presuntivos I-EXPLORATION -fueron I-EXPLORATION -quiste I-EXPLORATION -óseo I-EXPLORATION -traumático I-EXPLORATION -y I-EXPLORATION -KCOT. I-EXPLORATION -Bajo I-EXPLORATION -anestesia I-EXPLORATION -local I-EXPLORATION -se I-EXPLORATION -realizó I-EXPLORATION -la I-EXPLORATION -incisión I-EXPLORATION -intraoral I-EXPLORATION -exponiendo I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -involucrada, I-EXPLORATION -encontrando I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -encapsulada I-EXPLORATION -que I-EXPLORATION -se I-EXPLORATION -rompe I-EXPLORATION -haciendo I-EXPLORATION -evidente I-EXPLORATION +crónico. I-PAST_MEDICAL_HISTORY +En B-EXPLORATION +nuestro I-EXPLORATION +centro I-EXPLORATION el I-EXPLORATION -contenido I-EXPLORATION -quístico I-EXPLORATION -color I-EXPLORATION -achocolatado; I-EXPLORATION -luego I-EXPLORATION -se I-EXPLORATION -separa I-EXPLORATION -la I-EXPLORATION -cápsula I-EXPLORATION -y I-EXPLORATION -se I-EXPLORATION -realiza I-EXPLORATION -un I-EXPLORATION -curetaje I-EXPLORATION -cuidadoso I-EXPLORATION +paciente I-EXPLORATION +presenta I-EXPLORATION +importante I-EXPLORATION +dolor I-EXPLORATION +mal I-EXPLORATION +controlado I-EXPLORATION +a I-EXPLORATION +pesar I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -cavidad. I-EXPLORATION -El I-EXPLORATION -material I-EXPLORATION -extraído I-EXPLORATION -fue I-EXPLORATION -enviado I-EXPLORATION -para I-EXPLORATION -análisis I-EXPLORATION -anatomohistopatológico. I-EXPLORATION -El I-EXPLORATION -informe I-EXPLORATION -reportó I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -quística I-EXPLORATION -benigna I-EXPLORATION -tapizada I-EXPLORATION -por I-EXPLORATION -un I-EXPLORATION -epitelio I-EXPLORATION +altas I-EXPLORATION +dosis I-EXPLORATION de I-EXPLORATION -apariencia I-EXPLORATION -escamosa, I-EXPLORATION -descansando I-EXPLORATION -en I-EXPLORATION -un I-EXPLORATION -estroma I-EXPLORATION -fibroconectivo I-EXPLORATION +mórficos, I-EXPLORATION +incontinencia I-EXPLORATION +rectal I-EXPLORATION +severa I-EXPLORATION +y I-EXPLORATION +exploración I-EXPLORATION +rectal I-EXPLORATION con I-EXPLORATION -escasas I-EXPLORATION -células I-EXPLORATION -inflamatorias I-EXPLORATION -tipo I-EXPLORATION -linfocitos, I-EXPLORATION -lo I-EXPLORATION +estenosis I-EXPLORATION +a I-EXPLORATION +1 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +línea I-EXPLORATION +pectínea I-EXPLORATION que I-EXPLORATION -confirma I-EXPLORATION +permite I-EXPLORATION +malamente I-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION +paso I-EXPLORATION de I-EXPLORATION -KCTO. I-EXPLORATION - I-EXPLORATION +un I-EXPLORATION +dedo. I-EXPLORATION +Ante B-TREATMENT +este I-TREATMENT +cuadro, I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +realizar I-TREATMENT +resección I-TREATMENT +anterior I-TREATMENT +laparoscópica I-TREATMENT +ultrabaja. I-TREATMENT +Intraoperatoriamente I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +realizar I-TREATMENT +pulltrough I-TREATMENT +endoanal, I-TREATMENT +a I-TREATMENT +expensas I-TREATMENT +de I-TREATMENT +la I-TREATMENT +anatomía I-TREATMENT +patológica I-TREATMENT +definitiva, I-TREATMENT +siendo I-TREATMENT +el I-TREATMENT +resultado I-TREATMENT +de I-TREATMENT +la I-TREATMENT +misma I-TREATMENT +adenocarcinoma I-TREATMENT +de I-TREATMENT +glándulas I-TREATMENT +anales I-TREATMENT +sin I-TREATMENT +áreas I-TREATMENT +mucinosas, I-TREATMENT +CD7 I-TREATMENT +(+) I-TREATMENT +/CD20 I-TREATMENT +(-) I-TREATMENT +/PSA I-TREATMENT +(-), I-TREATMENT +T3 I-TREATMENT +N0, I-TREATMENT +con I-TREATMENT +márgenes I-TREATMENT +radial I-TREATMENT +y I-TREATMENT +distal I-TREATMENT +afectos, I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +completar I-TREATMENT +el I-TREATMENT +tratamiento I-TREATMENT +mediante I-TREATMENT +amputación I-TREATMENT +abdómino-perineal I-TREATMENT +cilíndrica I-TREATMENT +laparoscópica. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +presenta I-EVOLUTION +supervivencia I-EVOLUTION +libre I-EVOLUTION +de I-EVOLUTION +enfermedad I-EVOLUTION +a I-EVOLUTION +12 I-EVOLUTION +meses I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +intervención. I-EVOLUTION + I-EVOLUTION -Comentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS un I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -larga I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +de B-PAST_MEDICAL_HISTORY +origen I-PAST_MEDICAL_HISTORY +argelino I-PAST_MEDICAL_HISTORY +ingresado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +prisión. I-PAST_MEDICAL_HISTORY +Es I-PAST_MEDICAL_HISTORY +fumador I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -torácico I-PAST_MEDICAL_HISTORY -atípico I-PAST_MEDICAL_HISTORY +tabaco I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY +marihuana, I-PAST_MEDICAL_HISTORY +refiere I-PAST_MEDICAL_HISTORY +beber I-PAST_MEDICAL_HISTORY +cerveza I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +forma I-PAST_MEDICAL_HISTORY +diaria I-PAST_MEDICAL_HISTORY +previamente I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +ingreso I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -cuyo I-PAST_MEDICAL_HISTORY -momento I-PAST_MEDICAL_HISTORY -presentaba I-PAST_MEDICAL_HISTORY -factores I-PAST_MEDICAL_HISTORY +prisión, I-PAST_MEDICAL_HISTORY +pero I-PAST_MEDICAL_HISTORY +niega I-PAST_MEDICAL_HISTORY +consumo I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -riesgo I-PAST_MEDICAL_HISTORY -cardiovascular I-PAST_MEDICAL_HISTORY +otras I-PAST_MEDICAL_HISTORY +drogas I-PAST_MEDICAL_HISTORY +tanto I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +vía I-PAST_MEDICAL_HISTORY +parenteral I-PAST_MEDICAL_HISTORY como I-PAST_MEDICAL_HISTORY -hipertensión I-PAST_MEDICAL_HISTORY -arterial I-PAST_MEDICAL_HISTORY -(HTA), I-PAST_MEDICAL_HISTORY -dislipemia I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -índice I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -masa I-PAST_MEDICAL_HISTORY -corporal I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -31 I-PAST_MEDICAL_HISTORY -(no I-PAST_MEDICAL_HISTORY -fumador, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -diabético, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -bebedor); I-PAST_MEDICAL_HISTORY -además, I-PAST_MEDICAL_HISTORY -estaba I-PAST_MEDICAL_HISTORY -diagnosticado I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +otras I-PAST_MEDICAL_HISTORY +vías. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Presenta I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +trastorno I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +control I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -depresión. I-PAST_MEDICAL_HISTORY -Seguía I-PAST_MEDICAL_HISTORY +impulsos I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +sigue I-PAST_MEDICAL_HISTORY tratamiento I-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -simvastatina I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -mg, I-PAST_MEDICAL_HISTORY -bisoprolol I-PAST_MEDICAL_HISTORY -2, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -mg, I-PAST_MEDICAL_HISTORY -enalapril I-PAST_MEDICAL_HISTORY -20 I-PAST_MEDICAL_HISTORY -mg, I-PAST_MEDICAL_HISTORY -ácido I-PAST_MEDICAL_HISTORY -acetilsalicílico I-PAST_MEDICAL_HISTORY -(AAS) I-PAST_MEDICAL_HISTORY -100 I-PAST_MEDICAL_HISTORY -mg, I-PAST_MEDICAL_HISTORY -alprazolam I-PAST_MEDICAL_HISTORY -0, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY +benzodiacepinas I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -ketazolam I-PAST_MEDICAL_HISTORY -45 I-PAST_MEDICAL_HISTORY -mg. I-PAST_MEDICAL_HISTORY -Acudió I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -médico I-PAST_MEDICAL_HISTORY +ansiolíticos. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Tiene I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -familia I-PAST_MEDICAL_HISTORY +conducta I-PAST_MEDICAL_HISTORY +violenta I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +insultos I-PAST_MEDICAL_HISTORY +al I-PAST_MEDICAL_HISTORY +personal I-PAST_MEDICAL_HISTORY +sanitario I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -urgencias I-PAST_MEDICAL_HISTORY -hospitalarias I-PAST_MEDICAL_HISTORY +destrozo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +mobiliario. I-PAST_MEDICAL_HISTORY +También I-PAST_MEDICAL_HISTORY +existen I-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +diversas I-PAST_MEDICAL_HISTORY +autoagresiones: I-PAST_MEDICAL_HISTORY +huelgas I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hambre, I-PAST_MEDICAL_HISTORY +autocontusiones, I-PAST_MEDICAL_HISTORY +lesiones I-PAST_MEDICAL_HISTORY +superficiales I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -numerosas I-PAST_MEDICAL_HISTORY -ocasiones I-PAST_MEDICAL_HISTORY -presentando I-PAST_MEDICAL_HISTORY -dolor I-PAST_MEDICAL_HISTORY -torácico I-PAST_MEDICAL_HISTORY -atípico I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -electrocardiogramas I-PAST_MEDICAL_HISTORY -normales, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -constatar I-PAST_MEDICAL_HISTORY -cambios I-PAST_MEDICAL_HISTORY -eléctricos I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -elevación I-PAST_MEDICAL_HISTORY -enzimática. I-PAST_MEDICAL_HISTORY -Hace I-PAST_MEDICAL_HISTORY -unos I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -valorado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -cardiología, I-PAST_MEDICAL_HISTORY -presentando I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -ecocardiografía I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -anomalías, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -ergometría I-PAST_MEDICAL_HISTORY -positiva I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -carga I-PAST_MEDICAL_HISTORY +brazos I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -tomografía I-PAST_MEDICAL_HISTORY -computerizada I-PAST_MEDICAL_HISTORY -coronaria I-PAST_MEDICAL_HISTORY -informada I-PAST_MEDICAL_HISTORY +piernas, I-PAST_MEDICAL_HISTORY +así I-PAST_MEDICAL_HISTORY como I-PAST_MEDICAL_HISTORY -aterosclerosis I-PAST_MEDICAL_HISTORY -coronaria I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -obstructiva. I-PAST_MEDICAL_HISTORY -Tras B-PRESENT_ILLNESS -numerosos I-PRESENT_ILLNESS -episodios, I-PRESENT_ILLNESS -finalmente I-PRESENT_ILLNESS -ingresa I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS +ingesta I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cuchillas I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +otros I-PAST_MEDICAL_HISTORY +objetos I-PAST_MEDICAL_HISTORY +extraños I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +finalmente I-PAST_MEDICAL_HISTORY +fueron I-PAST_MEDICAL_HISTORY +evacuados I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +vía I-PAST_MEDICAL_HISTORY +natural I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +apoyo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +dieta I-PAST_MEDICAL_HISTORY +rica I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +fibra. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +esta I-PRESENT_ILLNESS +ocasión, I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +haber I-PRESENT_ILLNESS +ingerido I-PRESENT_ILLNESS un I-PRESENT_ILLNESS -segundo I-PRESENT_ILLNESS -estudio I-PRESENT_ILLNESS +cortauñas I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +queja I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -posible I-PRESENT_ILLNESS -angina I-PRESENT_ILLNESS -inestable. I-PRESENT_ILLNESS -Se B-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION +dolor I-PRESENT_ILLNESS +abdominal. I-PRESENT_ILLNESS +Al I-PRESENT_ILLNESS +mismo I-PRESENT_ILLNESS +tiempo I-PRESENT_ILLNESS +ha I-PRESENT_ILLNESS +iniciado I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +huelga I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hambre, I-PRESENT_ILLNESS +ingiriendo I-PRESENT_ILLNESS +agua I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +infusiones I-PRESENT_ILLNESS +azucaradas. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION un I-EXPLORATION -cateterismo, I-EXPLORATION -visualizando I-EXPLORATION +abdomen I-EXPLORATION +blando, I-EXPLORATION +depresible I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +radiografía I-EXPLORATION +simple I-EXPLORATION +se I-EXPLORATION +puede I-EXPLORATION +observar I-EXPLORATION una I-EXPLORATION -enfermedad I-EXPLORATION -severa I-EXPLORATION -de I-EXPLORATION -monovaso I-EXPLORATION -(en I-EXPLORATION -concreto I-EXPLORATION +parte I-EXPLORATION +del I-EXPLORATION +cortauñas I-EXPLORATION +situada I-EXPLORATION +en I-EXPLORATION +intestino I-EXPLORATION +delgado. I-EXPLORATION +A B-DERIVED_FROM/TO +pesar I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +quedar I-DERIVED_FROM/TO +descartado I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +clínica I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +abdomen I-DERIVED_FROM/TO +agudo I-DERIVED_FROM/TO +quirúrgico, I-DERIVED_FROM/TO +dado I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +sigue I-DERIVED_FROM/TO +quejando I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +intenso I-DERIVED_FROM/TO +dolor, I-DERIVED_FROM/TO +se I-DERIVED_FROM/TO +le I-DERIVED_FROM/TO +deriva I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +urgencias I-DERIVED_FROM/TO +hospitalario, I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +confirman I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +diagnóstico I-DERIVED_FROM/TO +prescribiendo I-DERIVED_FROM/TO +una I-DERIVED_FROM/TO +dieta I-DERIVED_FROM/TO +rica I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +fibra I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +aconsejado I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +seguimiento I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +paciente. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +A B-EXPLORATION +los I-EXPLORATION +6 I-EXPLORATION +días I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -arteria I-EXPLORATION -circunfleja I-EXPLORATION -derecha I-EXPLORATION -media), I-EXPLORATION -precisando B-TREATMENT -angioplastia I-TREATMENT -coronaria I-TREATMENT -transluminal I-TREATMENT -percutánea I-TREATMENT -e I-TREATMENT -implantación I-TREATMENT +primera I-EXPLORATION +placa, I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +radiografía I-EXPLORATION +nos I-EXPLORATION +muestra I-EXPLORATION +la I-EXPLORATION +misma I-EXPLORATION +pieza I-EXPLORATION +descrita I-EXPLORATION +en I-EXPLORATION +colon I-EXPLORATION +ascendente, I-EXPLORATION +pero I-EXPLORATION +vemos I-EXPLORATION +la I-EXPLORATION +otra I-EXPLORATION +parte I-EXPLORATION +del I-EXPLORATION +cortauñas I-EXPLORATION +ingerido I-EXPLORATION +posteriormente I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +tramo I-EXPLORATION +superior I-EXPLORATION +del I-EXPLORATION +tubo I-EXPLORATION +digestivo. I-EXPLORATION +Trascurridos I-EXPLORATION +9 I-EXPLORATION +días I-EXPLORATION +del I-EXPLORATION +inicio I-EXPLORATION +del I-EXPLORATION +cuadro, I-EXPLORATION +realizamos I-EXPLORATION +otra I-EXPLORATION +placa I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +y I-EXPLORATION +apreciamos I-EXPLORATION +cómo I-EXPLORATION +ambas I-EXPLORATION +piezas I-EXPLORATION +de I-EXPLORATION +ese I-EXPLORATION +cortaúñas I-EXPLORATION +se I-EXPLORATION +han I-EXPLORATION +situado I-EXPLORATION +juntas I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +de I-EXPLORATION +colon I-EXPLORATION +descendente. I-EXPLORATION +Nos B-TREATMENT +refiere I-TREATMENT +que I-TREATMENT +abandona I-TREATMENT +la I-TREATMENT +huelga I-TREATMENT de I-TREATMENT -stent I-TREATMENT -farmacoactivo. I-TREATMENT -En I-TREATMENT -tratamiento I-TREATMENT -actual I-TREATMENT -con I-TREATMENT -nitroglicerina I-TREATMENT -sl I-TREATMENT -si I-TREATMENT -dolor I-TREATMENT -precordial, I-TREATMENT -ramipril I-TREATMENT -2, I-TREATMENT -5 I-TREATMENT -mg, I-TREATMENT -clopidogrel I-TREATMENT -75 I-TREATMENT -mg, I-TREATMENT -AAS I-TREATMENT -100 I-TREATMENT -mg, I-TREATMENT -simvastatina I-TREATMENT -40 I-TREATMENT -mg, I-TREATMENT -bisoprolol I-TREATMENT -2, I-TREATMENT -5 I-TREATMENT -mg, I-TREATMENT -ranitidina I-TREATMENT -150 I-TREATMENT -mg, I-TREATMENT -ketazolam I-TREATMENT -45 I-TREATMENT -mg I-TREATMENT -y I-TREATMENT -alprazolam I-TREATMENT -0, I-TREATMENT -5 I-TREATMENT -mg. I-TREATMENT -Tras B-EVOLUTION -la I-EVOLUTION -colocación I-EVOLUTION -del I-EVOLUTION -stent, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -refiere I-EVOLUTION -mejoría I-EVOLUTION -clínica. I-EVOLUTION - I-EVOLUTION -Posteriormente, I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -valoración I-EVOLUTION -de I-EVOLUTION -consulta I-EVOLUTION -de I-EVOLUTION -crónicos I-EVOLUTION -de I-EVOLUTION -enfermería I-EVOLUTION -se I-EVOLUTION -aprecia I-EVOLUTION -de I-EVOLUTION -forma I-EVOLUTION -casual I-EVOLUTION -una I-EVOLUTION -hendidura I-EVOLUTION -diagonal I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -lóbulo I-EVOLUTION -del I-EVOLUTION -pabellón I-EVOLUTION -auricular I-EVOLUTION -que I-EVOLUTION -discurre I-EVOLUTION -desde I-EVOLUTION -la I-EVOLUTION -porción I-EVOLUTION -anterior I-EVOLUTION -y I-EVOLUTION -cercano I-EVOLUTION +hambre I-TREATMENT +por I-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +instaura I-TREATMENT +una I-TREATMENT +dieta I-TREATMENT +rica I-TREATMENT +en I-TREATMENT +fibra. I-TREATMENT + I-TREATMENT +Nuevas B-EXPLORATION +radiografías I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +nos I-EXPLORATION +muestran I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +citado I-EXPLORATION +cuerpo I-EXPLORATION +extraño I-EXPLORATION +no I-EXPLORATION +avanza I-EXPLORATION +del I-EXPLORATION +colon I-EXPLORATION +trasverso I-EXPLORATION +hasta I-EXPLORATION +que I-EXPLORATION +por I-EXPLORATION +una I-EXPLORATION +placa I-EXPLORATION +realizada I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +30 I-EXPLORATION +días I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +primera I-EXPLORATION +ingesta, I-EXPLORATION +revela I-EXPLORATION +ambas I-EXPLORATION +partes I-EXPLORATION +del I-EXPLORATION +cortauñas I-EXPLORATION +en I-EXPLORATION +últimos I-EXPLORATION +tramos I-EXPLORATION +del I-EXPLORATION +tubo I-EXPLORATION +digestivo, I-EXPLORATION +siendo B-EVOLUTION +expulsados I-EVOLUTION al I-EVOLUTION -trago I-EVOLUTION -en I-EVOLUTION -45o I-EVOLUTION -hacia I-EVOLUTION +día I-EVOLUTION +siguiente I-EVOLUTION +durante I-EVOLUTION la I-EVOLUTION -cara I-EVOLUTION -posterior I-EVOLUTION -del I-EVOLUTION -pabellón I-EVOLUTION -auricular, I-EVOLUTION -bilateral, I-EVOLUTION -conocido I-EVOLUTION -como I-EVOLUTION -signo I-EVOLUTION -de I-EVOLUTION -Frank. I-EVOLUTION -Este I-EVOLUTION -hallazgo I-EVOLUTION +defecación, I-EVOLUTION +según I-EVOLUTION nos I-EVOLUTION -hizo I-EVOLUTION -pensar I-EVOLUTION -que I-EVOLUTION -pueda I-EVOLUTION -existir I-EVOLUTION -una I-EVOLUTION -interrelación I-EVOLUTION -entre I-EVOLUTION -este I-EVOLUTION -surco I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -cardiopatía I-EVOLUTION -diagnosticada. I-EVOLUTION +informa I-EVOLUTION +el I-EVOLUTION +propio I-EVOLUTION +paciente. I-EVOLUTION I-EVOLUTION -Presentamos B-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -caso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -33 I-PRESENT_ILLNESS +59 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ansiedad, I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -sigue I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -escitalopram I-PAST_MEDICAL_HISTORY -10 I-PAST_MEDICAL_HISTORY -mg I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -alprazolam I-PAST_MEDICAL_HISTORY -0, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -mg. I-PAST_MEDICAL_HISTORY -Exfumador I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -hace I-PAST_MEDICAL_HISTORY -6 I-PAST_MEDICAL_HISTORY -meses. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Acude B-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -urgencias I-PRESENT_ILLNESS +ingresado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +Unidad I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -Atención I-PRESENT_ILLNESS -Primaria I-PRESENT_ILLNESS -refiriendo I-PRESENT_ILLNESS -"asfixia", I-PRESENT_ILLNESS -sensación I-PRESENT_ILLNESS +Cuidados I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -falta I-PRESENT_ILLNESS +Intensivos I-PRESENT_ILLNESS +(UCI) I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +situación I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -aire I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS +daño I-PRESENT_ILLNESS +cerebral I-PRESENT_ILLNESS +catastrófico I-PRESENT_ILLNESS +secundario I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +accidente I-PRESENT_ILLNESS +cerebrovascular I-PRESENT_ILLNESS +isquémico I-PRESENT_ILLNESS +establecido I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +territorio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -cuerpo I-PRESENT_ILLNESS -extraño I-PRESENT_ILLNESS -faríngeo. I-PRESENT_ILLNESS -A B-EXPLORATION +la I-PRESENT_ILLNESS +arteria I-PRESENT_ILLNESS +cerebral I-PRESENT_ILLNESS +media I-PRESENT_ILLNESS +izquierda I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +transformación I-PRESENT_ILLNESS +hemorrágica. I-PRESENT_ILLNESS +Tras B-EXPLORATION +cuatro I-EXPLORATION +días I-EXPLORATION +de I-EXPLORATION +ingreso I-EXPLORATION +en I-EXPLORATION +UCI I-EXPLORATION +y I-EXPLORATION +ante I-EXPLORATION +el I-EXPLORATION +infausto I-EXPLORATION +pronóstico I-EXPLORATION +neurológico, I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION +aplicar I-EXPLORATION +LTSV I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +consensuada I-EXPLORATION +entre I-EXPLORATION +el I-EXPLORATION +equipo I-EXPLORATION +de I-EXPLORATION +UCI I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +familia. I-EXPLORATION +Una I-EXPLORATION +vez I-EXPLORATION +establecida I-EXPLORATION +la I-EXPLORATION +LTSV, I-EXPLORATION +y I-EXPLORATION +ante I-EXPLORATION +la I-EXPLORATION +posibilidad I-EXPLORATION +de I-EXPLORATION +que I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +pudiera I-EXPLORATION +ser I-EXPLORATION +donante I-EXPLORATION +de I-EXPLORATION +órganos I-EXPLORATION +en I-EXPLORATION +asistolia I-EXPLORATION +controlada, I-EXPLORATION +el I-EXPLORATION +coordinador I-EXPLORATION +de I-EXPLORATION +trasplantes I-EXPLORATION +se I-EXPLORATION +entrevistó I-EXPLORATION +con I-EXPLORATION +los I-EXPLORATION +familiares I-EXPLORATION +que I-EXPLORATION +mostraron I-EXPLORATION +su I-EXPLORATION +deseo I-EXPLORATION +de I-EXPLORATION +donación I-EXPLORATION +y I-EXPLORATION +firmaron I-EXPLORATION +el I-EXPLORATION +consiguiente I-EXPLORATION +consentimiento I-EXPLORATION +informado I-EXPLORATION +(que I-EXPLORATION +incluye I-EXPLORATION +canulación I-EXPLORATION +y I-EXPLORATION +heparinización I-EXPLORATION +premortem). I-EXPLORATION + I-EXPLORATION +Tras I-EXPLORATION +la I-EXPLORATION +realización I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +clínicas I-EXPLORATION +y I-EXPLORATION +analíticas I-EXPLORATION +necesarias, I-EXPLORATION +se I-EXPLORATION +procedió I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +canulación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +femorales I-EXPLORATION +derechas I-EXPLORATION +(necesarias I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +NECMO), I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -presenta I-EXPLORATION -buen I-EXPLORATION -murmullo I-EXPLORATION -vesicular I-EXPLORATION -sin I-EXPLORATION -ruidos I-EXPLORATION -sobreañadidos, I-EXPLORATION -saturación I-EXPLORATION +arteria I-EXPLORATION +femoral I-EXPLORATION +contralateral I-EXPLORATION +para I-EXPLORATION +la I-EXPLORATION +colocación I-EXPLORATION de I-EXPLORATION -oxígeno I-EXPLORATION -98 I-EXPLORATION -%. I-EXPLORATION -A I-EXPLORATION +un I-EXPLORATION +catéter I-EXPLORATION +de I-EXPLORATION +oclusión I-EXPLORATION +aórtico I-EXPLORATION +tipo I-EXPLORATION +Fogarty. I-EXPLORATION +Una I-EXPLORATION +vez I-EXPLORATION +confirmada I-EXPLORATION la I-EXPLORATION -inspección I-EXPLORATION +adecuada I-EXPLORATION +colocación I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +cánulas I-EXPLORATION de I-EXPLORATION +NECMO I-EXPLORATION +y I-EXPLORATION +del I-EXPLORATION +catéter I-EXPLORATION +Fogarty, I-EXPLORATION +el I-EXPLORATION +enfermo I-EXPLORATION +fue I-EXPLORATION +trasladado I-EXPLORATION +a I-EXPLORATION +quirófano I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +procedió I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -faringe I-EXPLORATION -presenta I-EXPLORATION -una I-EXPLORATION -úvula I-EXPLORATION +LTSV I-EXPLORATION +acordada. I-EXPLORATION +Tras I-EXPLORATION +la I-EXPLORATION +retirada I-EXPLORATION +de I-EXPLORATION +soporte I-EXPLORATION +vital I-EXPLORATION +se I-EXPLORATION +administraron I-EXPLORATION +300 I-EXPLORATION +UI/Kg I-EXPLORATION +de I-EXPLORATION +heparina I-EXPLORATION +sódica I-EXPLORATION +i.v., I-EXPLORATION +y I-EXPLORATION +12 I-EXPLORATION +minutos I-EXPLORATION +más I-EXPLORATION +tarde I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +comenzó I-EXPLORATION con I-EXPLORATION -prolongación I-EXPLORATION -filiforme I-EXPLORATION +hipoperfusión I-EXPLORATION +verdadera I-EXPLORATION +(tensión I-EXPLORATION +arterial I-EXPLORATION +sistólica I-EXPLORATION +(TAS) I-EXPLORATION +menor I-EXPLORATION +de I-EXPLORATION +60 I-EXPLORATION +mmHg), I-EXPLORATION +presentando I-EXPLORATION +asistolia I-EXPLORATION +cinco I-EXPLORATION +minutos I-EXPLORATION +después I-EXPLORATION y I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -base I-EXPLORATION +confirmando I-EXPLORATION +el I-EXPLORATION +fallecimiento I-EXPLORATION +otros I-EXPLORATION +cinco I-EXPLORATION +minutos I-EXPLORATION +más I-EXPLORATION +tarde. I-EXPLORATION +Así, I-EXPLORATION +el I-EXPLORATION +tiempo I-EXPLORATION +de I-EXPLORATION +isquemia I-EXPLORATION +caliente I-EXPLORATION +total I-EXPLORATION +(TICT, I-EXPLORATION +desde I-EXPLORATION +la I-EXPLORATION +retirada I-EXPLORATION +de I-EXPLORATION +soporte I-EXPLORATION +vital I-EXPLORATION +hasta I-EXPLORATION +el I-EXPLORATION +inicio I-EXPLORATION +de I-EXPLORATION +perfusión I-EXPLORATION +fría I-EXPLORATION +o I-EXPLORATION +NECMO) I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +22 I-EXPLORATION +minutos I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +tiempo I-EXPLORATION +de I-EXPLORATION +isquemia I-EXPLORATION +caliente I-EXPLORATION +funcional I-EXPLORATION +(TICF, I-EXPLORATION +desde I-EXPLORATION +el I-EXPLORATION +comienzo I-EXPLORATION +de I-EXPLORATION una I-EXPLORATION -lesión I-EXPLORATION -papilomatosa I-EXPLORATION -engrosada. I-EXPLORATION - I-EXPLORATION +hipoperfusión I-EXPLORATION +significativa I-EXPLORATION +-TAS<60 I-EXPLORATION +mmHg- I-EXPLORATION +hasta I-EXPLORATION +el I-EXPLORATION +inicio I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +perfusión I-EXPLORATION +fría I-EXPLORATION +o I-EXPLORATION +NECMO) I-EXPLORATION +de I-EXPLORATION +10 I-EXPLORATION +minutos. I-EXPLORATION Se I-EXPLORATION -tranquiliza I-EXPLORATION -al I-EXPLORATION -paciente I-EXPLORATION -y I-EXPLORATION +puede I-EXPLORATION +ver I-EXPLORATION +la I-EXPLORATION +evolución I-EXPLORATION +del I-EXPLORATION +potencial I-EXPLORATION +donante I-EXPLORATION +durante I-EXPLORATION +este I-EXPLORATION +período I-EXPLORATION +de I-EXPLORATION +observación I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +Tabla I-EXPLORATION +1. I-EXPLORATION + I-EXPLORATION +LTSV: I-EXPLORATION +limitación I-EXPLORATION +del I-EXPLORATION +tratamiento I-EXPLORATION +de I-EXPLORATION +soporte I-EXPLORATION +vital; I-EXPLORATION +min: I-EXPLORATION +minutos; I-EXPLORATION +TAS: I-EXPLORATION +tensión I-EXPLORATION +arterial I-EXPLORATION +sistólica; I-EXPLORATION +TAD: I-EXPLORATION +tensión I-EXPLORATION +arterial I-EXPLORATION +diastólica; I-EXPLORATION +FC: I-EXPLORATION +frecuencia I-EXPLORATION +cardíaca; I-EXPLORATION +FR: I-EXPLORATION +frecuencia I-EXPLORATION +respiratoria; I-EXPLORATION +Sat. I-EXPLORATION +O2: I-EXPLORATION +saturación I-EXPLORATION +de I-EXPLORATION +oxígeno; I-EXPLORATION +lpm: I-EXPLORATION +latidos/minuto; I-EXPLORATION +rpm: I-EXPLORATION +respiraciones/minuto; I-EXPLORATION +ml: I-EXPLORATION +mililitros I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +cuanto I-EXPLORATION se I-EXPLORATION -le I-EXPLORATION -explica I-EXPLORATION +confirmó I-EXPLORATION la I-EXPLORATION -patología. I-EXPLORATION -Se B-DERIVED_FROM/TO -aconseja I-DERIVED_FROM/TO -valoración I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -médico I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -familia, I-DERIVED_FROM/TO -quien I-DERIVED_FROM/TO -deriva I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -otorrinolaringólogo I-DERIVED_FROM/TO -(ORL). I-DERIVED_FROM/TO -Se B-EXPLORATION -le I-EXPLORATION +muerte, I-EXPLORATION +se I-EXPLORATION +inició I-EXPLORATION +la I-EXPLORATION +NECMO I-EXPLORATION +(previo I-EXPLORATION +hinchado I-EXPLORATION +del I-EXPLORATION +balón I-EXPLORATION +de I-EXPLORATION +Fogarty I-EXPLORATION +contralateral) I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +intubado I-EXPLORATION +pero I-EXPLORATION +sin I-EXPLORATION +iniciar I-EXPLORATION +ventilación I-EXPLORATION +(tubo I-EXPLORATION +al I-EXPLORATION +aire). I-EXPLORATION +Seguidamente, I-EXPLORATION +el I-EXPLORATION +cirujano I-EXPLORATION +torácico I-EXPLORATION realizó I-EXPLORATION -cribado I-EXPLORATION +una I-EXPLORATION +esternotomía I-EXPLORATION +rápida I-EXPLORATION +y, I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +tiempo I-EXPLORATION de I-EXPLORATION -otras I-EXPLORATION -patologías I-EXPLORATION +7-8 I-EXPLORATION +minutos, I-EXPLORATION +revisó I-EXPLORATION +la I-EXPLORATION +cavidad I-EXPLORATION +torácica I-EXPLORATION +y I-EXPLORATION +clampó I-EXPLORATION +la I-EXPLORATION +aorta I-EXPLORATION +torácica I-EXPLORATION +justo I-EXPLORATION +por I-EXPLORATION +encima I-EXPLORATION +del I-EXPLORATION +catéter I-EXPLORATION de I-EXPLORATION -transmisión I-EXPLORATION -sexual I-EXPLORATION +Fogarty. I-EXPLORATION +Inmediatamente I-EXPLORATION +después I-EXPLORATION +se I-EXPLORATION +inició I-EXPLORATION +ventilación I-EXPLORATION +mecánica I-EXPLORATION con I-EXPLORATION -resultados I-EXPLORATION -negativos I-EXPLORATION -para I-EXPLORATION -infección I-EXPLORATION -por I-EXPLORATION -sífilis, I-EXPLORATION -virus I-EXPLORATION +una I-EXPLORATION +fracción I-EXPLORATION +inspirada I-EXPLORATION de I-EXPLORATION -inmunodeficiencia I-EXPLORATION -humana, I-EXPLORATION -herpes I-EXPLORATION +oxígeno I-EXPLORATION +(FiO2) I-EXPLORATION +del I-EXPLORATION +100%, I-EXPLORATION +presión I-EXPLORATION +positiva I-EXPLORATION +al I-EXPLORATION +final I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +espiración I-EXPLORATION +(PEEP) I-EXPLORATION +de I-EXPLORATION +5 I-EXPLORATION y I-EXPLORATION -hepatitis. I-EXPLORATION - I-EXPLORATION +12 I-EXPLORATION +respiraciones/minuto. I-EXPLORATION El I-EXPLORATION -ORL I-EXPLORATION -le I-EXPLORATION -diagnostica I-EXPLORATION -de I-EXPLORATION -poliposis I-EXPLORATION -senonasal I-EXPLORATION -izquierda I-EXPLORATION +cirujano I-EXPLORATION +canuló I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +pulmonar I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +perfundieron I-EXPLORATION +los I-EXPLORATION +pulmones I-EXPLORATION con I-EXPLORATION -remodelación I-EXPLORATION -ósea, I-EXPLORATION -desviación I-EXPLORATION -del I-EXPLORATION -tabique I-EXPLORATION -nasal, I-EXPLORATION -ensanchamiento I-EXPLORATION +Perfadex I-EXPLORATION +(solución I-EXPLORATION +de I-EXPLORATION +preservación I-EXPLORATION +de I-EXPLORATION +órganos) I-EXPLORATION +hasta I-EXPLORATION +alcanzar I-EXPLORATION +la I-EXPLORATION +limpieza I-EXPLORATION del I-EXPLORATION -infundíbulo I-EXPLORATION +circuito I-EXPLORATION +pulmonar, I-EXPLORATION +como I-EXPLORATION +en I-EXPLORATION +una I-EXPLORATION +extracción I-EXPLORATION +reglada, I-EXPLORATION +realizando I-EXPLORATION +maniobras I-EXPLORATION +de I-EXPLORATION +Valsalva I-EXPLORATION +(o I-EXPLORATION +suspiros) I-EXPLORATION +para I-EXPLORATION +valorar I-EXPLORATION +la I-EXPLORATION +distensibilidad I-EXPLORATION del I-EXPLORATION -seno I-EXPLORATION -maxilar I-EXPLORATION +pulmón. I-EXPLORATION +Simultáneamente, I-EXPLORATION +la I-EXPLORATION +NECMO I-EXPLORATION +siguió I-EXPLORATION +funcionando I-EXPLORATION y I-EXPLORATION -úvula I-EXPLORATION -con I-EXPLORATION -formación I-EXPLORATION -papilomatosa I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -base I-EXPLORATION +el I-EXPLORATION +cirujano I-EXPLORATION +hepático I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +laparotomía I-EXPLORATION +media I-EXPLORATION +para I-EXPLORATION +valorar I-EXPLORATION +la I-EXPLORATION +viabilidad I-EXPLORATION y I-EXPLORATION -engrosamiento I-EXPLORATION -de I-EXPLORATION +confirmar I-EXPLORATION la I-EXPLORATION -misma. I-EXPLORATION -Se B-TREATMENT -interviene I-TREATMENT -y B-EXPLORATION -desde I-EXPLORATION -Anatomía I-EXPLORATION -Patológica I-EXPLORATION -informan I-EXPLORATION +adecuada I-EXPLORATION +perfusión I-EXPLORATION +hepática. I-EXPLORATION +Preventivamente I-EXPLORATION +se I-EXPLORATION +infundieron I-EXPLORATION +dos I-EXPLORATION +concentrados I-EXPLORATION de I-EXPLORATION +hematíes I-EXPLORATION +y I-EXPLORATION un I-EXPLORATION -papiloma I-EXPLORATION -invertido I-EXPLORATION -en I-EXPLORATION +litro I-EXPLORATION +de I-EXPLORATION +suero I-EXPLORATION +salino I-EXPLORATION +0, I-EXPLORATION +9%, I-EXPLORATION +para I-EXPLORATION +así I-EXPLORATION +aumentar I-EXPLORATION el I-EXPLORATION -seno I-EXPLORATION -nasal I-EXPLORATION -y I-EXPLORATION +circuito I-EXPLORATION +de I-EXPLORATION +ECMO I-EXPLORATION +previo I-EXPLORATION +al I-EXPLORATION +clampaje I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -lesión I-EXPLORATION -en I-EXPLORATION -úvula I-EXPLORATION -como I-EXPLORATION -papiloma I-EXPLORATION -escamoso. I-EXPLORATION - I-EXPLORATION -Actualmente B-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -ha I-EVOLUTION -mejorado I-EVOLUTION -notablemente I-EVOLUTION -tanto I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -sintomatología I-EVOLUTION -nasal I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -hizo I-EVOLUTION -referencia I-EVOLUTION -hasta I-EVOLUTION -llegar I-EVOLUTION -al I-EVOLUTION -ORL I-EVOLUTION -como I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -sensación I-EVOLUTION -de I-EVOLUTION -cuerpo I-EVOLUTION -extraño. I-EVOLUTION - I-EVOLUTION -En B-EXPLORATION -este I-EXPLORATION -caso I-EXPLORATION -en I-EXPLORATION -particular I-EXPLORATION -sería I-EXPLORATION -interesante I-EXPLORATION -poner I-EXPLORATION +vena I-EXPLORATION +cava I-EXPLORATION +inferior. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +momento I-EXPLORATION en I-EXPLORATION -conocimiento I-EXPLORATION que I-EXPLORATION el I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -mantiene I-EXPLORATION -buena I-EXPLORATION -relación I-EXPLORATION -con I-EXPLORATION -su I-EXPLORATION -médico I-EXPLORATION +cirujano I-EXPLORATION +torácico I-EXPLORATION +informó I-EXPLORATION de I-EXPLORATION -familia I-EXPLORATION -porque I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -opinión I-EXPLORATION -no I-EXPLORATION -le I-EXPLORATION -trata I-EXPLORATION -bien I-EXPLORATION -su I-EXPLORATION -clínica I-EXPLORATION -ansioso-depresiva. I-EXPLORATION -El I-EXPLORATION -paciente I-EXPLORATION -suele I-EXPLORATION -acudir I-EXPLORATION +que I-EXPLORATION +iba I-EXPLORATION a I-EXPLORATION -consulta I-EXPLORATION -cuando I-EXPLORATION -su I-EXPLORATION -médico I-EXPLORATION -esta I-EXPLORATION -saliente I-EXPLORATION -de I-EXPLORATION -guardia I-EXPLORATION -o I-EXPLORATION +ligar I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +cava I-EXPLORATION +inferior I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +desembocadura I-EXPLORATION de I-EXPLORATION -vacaciones; I-EXPLORATION -de B-TREATMENT -hecho I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -antidepresivo I-TREATMENT -y I-TREATMENT -ansiolítico I-TREATMENT -no I-TREATMENT -fue I-TREATMENT -instaurado I-TREATMENT -por I-TREATMENT -su I-TREATMENT -médico, I-TREATMENT -haciendo I-TREATMENT -complicado I-TREATMENT -el I-TREATMENT -seguimiento I-TREATMENT -de I-TREATMENT -su I-TREATMENT -patología. I-TREATMENT -El B-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -comentó I-EXPLORATION -nada I-EXPLORATION -sobre I-EXPLORATION la I-EXPLORATION -congestión I-EXPLORATION -que I-EXPLORATION -le I-EXPLORATION -provocaba I-EXPLORATION +aurícula I-EXPLORATION +derecha, I-EXPLORATION +ambos I-EXPLORATION +cirujanos I-EXPLORATION +movilizaron I-EXPLORATION +conjuntamente I-EXPLORATION la I-EXPLORATION -poliposis I-EXPLORATION -nasal I-EXPLORATION -por I-EXPLORATION +cánula I-EXPLORATION +venosa I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +ECMO I-EXPLORATION +para I-EXPLORATION +bajarla I-EXPLORATION +varios I-EXPLORATION +centímetros I-EXPLORATION +y I-EXPLORATION +dejar I-EXPLORATION el I-EXPLORATION -mismo I-EXPLORATION -motivo. I-EXPLORATION -La I-EXPLORATION -relación I-EXPLORATION -que I-EXPLORATION -tiene I-EXPLORATION +extremo I-EXPLORATION +distal I-EXPLORATION +por I-EXPLORATION +debajo I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +aurícula I-EXPLORATION +derecha. I-EXPLORATION +Una I-EXPLORATION +vez I-EXPLORATION +recolocada I-EXPLORATION +la I-EXPLORATION +cánula I-EXPLORATION +venosa I-EXPLORATION +y I-EXPLORATION +clampada I-EXPLORATION +la I-EXPLORATION +vena I-EXPLORATION +cava I-EXPLORATION +inferior, I-EXPLORATION +los I-EXPLORATION +flujos I-EXPLORATION +de I-EXPLORATION +ECMO I-EXPLORATION +bajaron I-EXPLORATION +ligeramente I-EXPLORATION +requiriendo I-EXPLORATION +la I-EXPLORATION +administración I-EXPLORATION +de I-EXPLORATION +otros I-EXPLORATION +dos I-EXPLORATION +hemoconcentrados I-EXPLORATION +y I-EXPLORATION +500 I-EXPLORATION +ml I-EXPLORATION +de I-EXPLORATION +suero I-EXPLORATION +salino I-EXPLORATION +0, I-EXPLORATION +9%. I-EXPLORATION +En I-EXPLORATION +esta I-EXPLORATION +fase I-EXPLORATION +ya I-EXPLORATION +estaban I-EXPLORATION +separados I-EXPLORATION +tórax I-EXPLORATION +y I-EXPLORATION +abdomen I-EXPLORATION con I-EXPLORATION -su I-EXPLORATION -médico I-EXPLORATION +ligadura I-EXPLORATION +previa I-EXPLORATION de I-EXPLORATION -familia I-EXPLORATION -también I-EXPLORATION -ayuda I-EXPLORATION -a I-EXPLORATION -explicar I-EXPLORATION -por I-EXPLORATION -qué I-EXPLORATION -acude I-EXPLORATION +la I-EXPLORATION +aorta I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +cava, I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +procedió I-EXPLORATION a I-EXPLORATION -urgencias I-EXPLORATION -por I-EXPLORATION -una I-EXPLORATION -consulta I-EXPLORATION -que I-EXPLORATION -realmente I-EXPLORATION -no I-EXPLORATION -es I-EXPLORATION -aguda. I-EXPLORATION -Tampoco I-EXPLORATION -podemos I-EXPLORATION -descartar I-EXPLORATION -que I-EXPLORATION -sus I-EXPLORATION -síntomas I-EXPLORATION -hayan I-EXPLORATION -pasado I-EXPLORATION -desapercibidos I-EXPLORATION -por I-EXPLORATION +la I-EXPLORATION +extracción I-EXPLORATION +reglada I-EXPLORATION +pulmonar I-EXPLORATION +mientras I-EXPLORATION +se I-EXPLORATION +continuaba I-EXPLORATION +con I-EXPLORATION +NECMO. I-EXPLORATION +Una I-EXPLORATION +vez I-EXPLORATION +extraídos I-EXPLORATION los I-EXPLORATION -facultativos I-EXPLORATION -relacionándolos I-EXPLORATION +pulmones I-EXPLORATION +se I-EXPLORATION +mantuvo I-EXPLORATION +la I-EXPLORATION +NECMO I-EXPLORATION +16 I-EXPLORATION +minutos I-EXPLORATION +más I-EXPLORATION +(tiempo I-EXPLORATION +total I-EXPLORATION +de I-EXPLORATION +NECMO I-EXPLORATION +de I-EXPLORATION +84 I-EXPLORATION +minutos), I-EXPLORATION +se I-EXPLORATION +inició I-EXPLORATION +la I-EXPLORATION +perfusión I-EXPLORATION +abdominal I-EXPLORATION con I-EXPLORATION +Celsior I-EXPLORATION +(solución I-EXPLORATION +de I-EXPLORATION +preservación I-EXPLORATION +de I-EXPLORATION +órganos I-EXPLORATION +abdominales) I-EXPLORATION +a I-EXPLORATION +través I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -ansiedad. I-EXPLORATION +cánula I-EXPLORATION +arterial I-EXPLORATION +de I-EXPLORATION +ECMO I-EXPLORATION +y I-EXPLORATION +finalmente I-EXPLORATION +se I-EXPLORATION +extrajeron I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +reglada I-EXPLORATION +el I-EXPLORATION +hígado I-EXPLORATION +y I-EXPLORATION +los I-EXPLORATION +riñones. I-EXPLORATION + I-EXPLORATION +Durante I-EXPLORATION +todo I-EXPLORATION +el I-EXPLORATION +proceso I-EXPLORATION +se I-EXPLORATION +realizaron I-EXPLORATION +determinaciones I-EXPLORATION +seriadas I-EXPLORATION +cada I-EXPLORATION +20 I-EXPLORATION +minutos I-EXPLORATION +del I-EXPLORATION +equilibrio I-EXPLORATION +ácido-base I-EXPLORATION +y I-EXPLORATION +perfil I-EXPLORATION +iónico, I-EXPLORATION +hematología I-EXPLORATION +y I-EXPLORATION +bioquímica I-EXPLORATION +hepática I-EXPLORATION +y I-EXPLORATION +renal. I-EXPLORATION + I-EXPLORATION +PaO2: I-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION +de I-EXPLORATION +oxígeno I-EXPLORATION +(mmHg); I-EXPLORATION +PaCO2: I-EXPLORATION +presión I-EXPLORATION +arterial I-EXPLORATION +de I-EXPLORATION +dióxido I-EXPLORATION +de I-EXPLORATION +carbono I-EXPLORATION +(mmHg); I-EXPLORATION +HCO3-: I-EXPLORATION +bicarbonato I-EXPLORATION +(mmol/L); I-EXPLORATION +Lact.: I-EXPLORATION +lactato I-EXPLORATION +(mg/dL); I-EXPLORATION +Bil.: I-EXPLORATION +bilirrubina I-EXPLORATION +(mg/dL); I-EXPLORATION +Hto.: I-EXPLORATION +hematocrito I-EXPLORATION +(%); I-EXPLORATION +Hb.: I-EXPLORATION +hemoglobina I-EXPLORATION +(g/dL); I-EXPLORATION +Gluc.: I-EXPLORATION +glucemia I-EXPLORATION +(mg/dL); I-EXPLORATION +Na+: I-EXPLORATION +ión I-EXPLORATION +sodio I-EXPLORATION +(mmol/L); I-EXPLORATION +K+: I-EXPLORATION +ión I-EXPLORATION +potasio I-EXPLORATION +(mmol/L); I-EXPLORATION +min: I-EXPLORATION +minutos I-EXPLORATION I-EXPLORATION +En B-EVOLUTION +cuanto I-EVOLUTION +a I-EVOLUTION +los I-EVOLUTION +receptores I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +injertos I-EVOLUTION +extraídos, I-EVOLUTION +todos I-EVOLUTION +han I-EVOLUTION +presentado I-EVOLUTION +una I-EVOLUTION +evolución I-EVOLUTION +favorable I-EVOLUTION +postrasplante. I-EVOLUTION +El I-EVOLUTION +receptor I-EVOLUTION +pulmonar I-EVOLUTION +recibió I-EVOLUTION +un I-EVOLUTION +trasplante I-EVOLUTION +bipulmonar I-EVOLUTION +con I-EVOLUTION +buena I-EVOLUTION +evolución I-EVOLUTION +durante I-EVOLUTION +su I-EVOLUTION +mes I-EVOLUTION +de I-EVOLUTION +ingreso I-EVOLUTION +en I-EVOLUTION +UCI I-EVOLUTION +y I-EVOLUTION +posterior I-EVOLUTION +estancia I-EVOLUTION +en I-EVOLUTION +planta I-EVOLUTION +de I-EVOLUTION +hospitalización. I-EVOLUTION + I-EVOLUTION -El B-PRESENT_ILLNESS -23 I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -agosto I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2011 I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -médico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Role I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -informa I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -Medical I-PRESENT_ILLNESS -Advisor I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -Operación I-PRESENT_ILLNESS -European I-PRESENT_ILLNESS -Union I-PRESENT_ILLNESS -Training I-PRESENT_ILLNESS -Mission I-PRESENT_ILLNESS -(EUTM) I-PRESENT_ILLNESS -Somalia I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -prueba I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -"quick I-PRESENT_ILLNESS -test" I-PRESENT_ILLNESS -realizada I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -enfermeras I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -Role I-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -ha I-PRESENT_ILLNESS -resultado I-PRESENT_ILLNESS -positiva. I-PRESENT_ILLNESS -Por B-DERIVED_FROM/TO -lo I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -va I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -proceder I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -traslado I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -forma I-DERIVED_FROM/TO -urgente I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -Hospital I-DERIVED_FROM/TO -Nakasero I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -Kampala I-DERIVED_FROM/TO -situado I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -400 I-DERIVED_FROM/TO -km I-DERIVED_FROM/TO -aproximadamente I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -carreteras I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -muy I-DERIVED_FROM/TO -malas I-DERIVED_FROM/TO -condiciones. I-DERIVED_FROM/TO -La I-DERIVED_FROM/TO -decisión I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -cómo I-DERIVED_FROM/TO -realizar I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -traslado I-DERIVED_FROM/TO -no I-DERIVED_FROM/TO -depende I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -EUTM-Somalia, I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -Role I-DERIVED_FROM/TO -2 I-DERIVED_FROM/TO -puede I-DERIVED_FROM/TO -decidir I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -forma I-DERIVED_FROM/TO -independiente I-DERIVED_FROM/TO -al I-DERIVED_FROM/TO -estar I-DERIVED_FROM/TO -éste I-DERIVED_FROM/TO -contratado I-DERIVED_FROM/TO -por I-DERIVED_FROM/TO -EUTM-Somalia. I-DERIVED_FROM/TO -El I-DERIVED_FROM/TO -personal I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Role-2 I-DERIVED_FROM/TO -tiene I-DERIVED_FROM/TO -su I-DERIVED_FROM/TO -propio I-DERIVED_FROM/TO -seguro I-DERIVED_FROM/TO -sanitario. I-DERIVED_FROM/TO -Quiere I-DERIVED_FROM/TO -decir I-DERIVED_FROM/TO -que, I-DERIVED_FROM/TO -pueden I-DERIVED_FROM/TO -gestionarse I-DERIVED_FROM/TO -sus I-DERIVED_FROM/TO -propias I-DERIVED_FROM/TO -evacuaciones I-DERIVED_FROM/TO -e I-DERIVED_FROM/TO -ingresos I-DERIVED_FROM/TO -en I-DERIVED_FROM/TO -hospitales. I-DERIVED_FROM/TO -Al I-DERIVED_FROM/TO -igual I-DERIVED_FROM/TO -que I-DERIVED_FROM/TO -cuentan I-DERIVED_FROM/TO -siempre I-DERIVED_FROM/TO -con I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -ayuda I-DERIVED_FROM/TO -y I-DERIVED_FROM/TO -colaboración I-DERIVED_FROM/TO -del I-DERIVED_FROM/TO -Cuartel I-DERIVED_FROM/TO -General I-DERIVED_FROM/TO -EUTM-Somalia. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -Los B-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -alarmantes I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -llevan I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -sus I-PRESENT_ILLNESS -compañeros I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -realizar I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -Quik I-PRESENT_ILLNESS -test I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -síndrome I-PRESENT_ILLNESS -agudo I-PRESENT_ILLNESS -pseudo-confusional, I-PRESENT_ILLNESS -asociado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -cansancio, I-PRESENT_ILLNESS -cefalea, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -38oC. I-PRESENT_ILLNESS -Al I-PRESENT_ILLNESS -parecer, I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -posteriores I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -confirmación I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -suman I-PRESENT_ILLNESS -antecedentes I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -revelado I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -ese I-PRESENT_ILLNESS -momento: I-PRESENT_ILLNESS -astenia I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -quince I-PRESENT_ILLNESS -días, I-PRESENT_ILLNESS -cefaleas, I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -aparentemente I-PRESENT_ILLNESS -infeccioso I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -comenzado I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -automedicarse I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -antibiótico I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -amoxicilina I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -ácido I-PRESENT_ILLNESS -clavulánico. I-PRESENT_ILLNESS -Como B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -sufría I-PAST_MEDICAL_HISTORY +83 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +terminal I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +etiología I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +filiada I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +programa I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hemodiálisis I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +centro I-PAST_MEDICAL_HISTORY +periférico I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +diálisis I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +Octubre I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -migrañas. I-PAST_MEDICAL_HISTORY +2004. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Antecedentes I-PAST_MEDICAL_HISTORY +personales: I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -personal I-PAST_MEDICAL_HISTORY +Hipertensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +dislipemia, I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +diabetes I-PAST_MEDICAL_HISTORY +mellitus, I-PAST_MEDICAL_HISTORY +artritis I-PAST_MEDICAL_HISTORY +reumatoide I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -este I-PAST_MEDICAL_HISTORY -Role I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -permanecía I-PAST_MEDICAL_HISTORY +larga I-PAST_MEDICAL_HISTORY +evolución I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +actual, I-PAST_MEDICAL_HISTORY +osteoporosis I-PAST_MEDICAL_HISTORY +severa I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +fractura I-PAST_MEDICAL_HISTORY +vertebral, I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +cardíaca I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +disfunción I-PAST_MEDICAL_HISTORY +diastólica I-PAST_MEDICAL_HISTORY +moderada/leve. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Desde I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +inicio I-PAST_MEDICAL_HISTORY en I-PAST_MEDICAL_HISTORY -zona I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -periodos I-PAST_MEDICAL_HISTORY -largos I-PAST_MEDICAL_HISTORY +programa I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -más I-PAST_MEDICAL_HISTORY +hemodiálisis I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +le I-PAST_MEDICAL_HISTORY +han I-PAST_MEDICAL_HISTORY +realizado I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +fístulas I-PAST_MEDICAL_HISTORY +arteriovenosas I-PAST_MEDICAL_HISTORY +internas I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +pérdida I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY +función I-PAST_MEDICAL_HISTORY +posterior, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +actualmente I-PAST_MEDICAL_HISTORY +porta I-PAST_MEDICAL_HISTORY un I-PAST_MEDICAL_HISTORY +catéter I-PAST_MEDICAL_HISTORY +venoso I-PAST_MEDICAL_HISTORY +central I-PAST_MEDICAL_HISTORY +tunelizado I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +yugular I-PAST_MEDICAL_HISTORY +interna I-PAST_MEDICAL_HISTORY +derecha I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +acceso I-PAST_MEDICAL_HISTORY +vascular. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Durante I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +último I-PAST_MEDICAL_HISTORY año I-PAST_MEDICAL_HISTORY -(con I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -mes I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +ha I-PAST_MEDICAL_HISTORY +presentado I-PAST_MEDICAL_HISTORY +complicaciones I-PAST_MEDICAL_HISTORY +ni I-PAST_MEDICAL_HISTORY +ingresos I-PAST_MEDICAL_HISTORY +hospitalarios. I-PAST_MEDICAL_HISTORY +Durante I-PAST_MEDICAL_HISTORY +este I-PAST_MEDICAL_HISTORY +tiempo I-PAST_MEDICAL_HISTORY +no I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +ha I-PAST_MEDICAL_HISTORY +modificado I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +pauta I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -descanso I-PAST_MEDICAL_HISTORY -cada I-PAST_MEDICAL_HISTORY -seis I-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY +diálisis, I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +cual I-PAST_MEDICAL_HISTORY +ha I-PAST_MEDICAL_HISTORY +sido I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +sesiones I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +240 I-PAST_MEDICAL_HISTORY +minutos I-PAST_MEDICAL_HISTORY +tres I-PAST_MEDICAL_HISTORY +días/semana, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +dializador I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +alta I-PAST_MEDICAL_HISTORY +permeabilidad I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +2m2 I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +superficie, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +Qb I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -estancia I-PAST_MEDICAL_HISTORY -aproximadamente), I-PAST_MEDICAL_HISTORY +350 I-PAST_MEDICAL_HISTORY +ml/min, I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY lo I-PAST_MEDICAL_HISTORY que I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY ha I-PAST_MEDICAL_HISTORY -llevado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -muchos I-PAST_MEDICAL_HISTORY -casos I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -abandono I-PAST_MEDICAL_HISTORY +conseguido I-PAST_MEDICAL_HISTORY +mantener I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +estable I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +sesiones I-PAST_MEDICAL_HISTORY +confortables I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +asintomáticas, I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +cifras I-PAST_MEDICAL_HISTORY +adecuadas I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -forma I-PAST_MEDICAL_HISTORY -voluntaria I-PAST_MEDICAL_HISTORY +tensión I-PAST_MEDICAL_HISTORY +arterial, I-PAST_MEDICAL_HISTORY +peso I-PAST_MEDICAL_HISTORY +seco I-PAST_MEDICAL_HISTORY +entre I-PAST_MEDICAL_HISTORY +42-43 I-PAST_MEDICAL_HISTORY +Kg, I-PAST_MEDICAL_HISTORY +e I-PAST_MEDICAL_HISTORY +índice I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -quimioprofilaxis I-PAST_MEDICAL_HISTORY -(Lariam®, I-PAST_MEDICAL_HISTORY -Malarone® I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -Doxiciclina). I-PAST_MEDICAL_HISTORY +diálisis I-PAST_MEDICAL_HISTORY +adecuada I-PAST_MEDICAL_HISTORY +Kt/v I-PAST_MEDICAL_HISTORY +>1.8. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -Se B-EVOLUTION -decide I-EVOLUTION -realizar I-EVOLUTION -el I-EVOLUTION -traslado I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -por I-EVOLUTION -carretera I-EVOLUTION -con I-EVOLUTION -ambulancia I-EVOLUTION -procedente I-EVOLUTION -de I-EVOLUTION -Kampala I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -informa I-EVOLUTION -al I-EVOLUTION -Medical I-EVOLUTION -Advisor I-EVOLUTION -que I-EVOLUTION -el I-EVOLUTION -ingreso I-EVOLUTION -será I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -hospital I-EVOLUTION -Nakasero I-EVOLUTION -de I-EVOLUTION -Kampala. I-EVOLUTION -A I-EVOLUTION -las I-EVOLUTION -12 I-EVOLUTION -horas I-EVOLUTION -aproximadamente I-EVOLUTION -del I-EVOLUTION -diagnóstico I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -ingresa I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -citado I-EVOLUTION -Hospital I-EVOLUTION -y I-EVOLUTION -pocas I-EVOLUTION -horas I-EVOLUTION -más I-EVOLUTION -tarde I-EVOLUTION -entra I-EVOLUTION -en I-EVOLUTION -coma. I-EVOLUTION -Ya I-EVOLUTION -entonces I-EVOLUTION -se I-EVOLUTION -estaba I-EVOLUTION -gestionando I-EVOLUTION -la I-EVOLUTION -aeroevacuación I-EVOLUTION -a I-EVOLUTION -Italia. I-EVOLUTION -Dado I-EVOLUTION -el I-EVOLUTION -estado I-EVOLUTION -avanzado I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -es I-EVOLUTION -aeroevacuada I-EVOLUTION -por I-EVOLUTION -la I-EVOLUTION -compañía I-EVOLUTION -de I-EVOLUTION -"Flying I-EVOLUTION -Doctors" I-EVOLUTION -a I-EVOLUTION -Nairobi I-EVOLUTION -dos I-EVOLUTION -días I-EVOLUTION -más I-EVOLUTION -tarde. I-EVOLUTION -Tras I-EVOLUTION -su I-EVOLUTION -ingreso I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -hospital I-EVOLUTION -de I-EVOLUTION -Nairobi I-EVOLUTION -su I-EVOLUTION -evolución I-EVOLUTION -persiste I-EVOLUTION -muy I-EVOLUTION -desfavorablemente I-EVOLUTION -falleciendo I-EVOLUTION -pocas I-EVOLUTION -horas I-EVOLUTION -después I-EVOLUTION -al I-EVOLUTION -cuarto I-EVOLUTION -día I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -diagnóstico I-EVOLUTION -inicial. I-EVOLUTION - I-EVOLUTION -Se I-EVOLUTION -puede I-EVOLUTION -pensar I-EVOLUTION -que I-EVOLUTION -una I-EVOLUTION -de I-EVOLUTION -las I-EVOLUTION -causas I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -rápida I-EVOLUTION -y I-EVOLUTION -mala I-EVOLUTION -evolución I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -enfermedad I-EVOLUTION -de I-EVOLUTION -nuestra I-EVOLUTION -compañera I-EVOLUTION -fue I-EVOLUTION -debido I-EVOLUTION -a I-EVOLUTION -un I-EVOLUTION -diagnóstico I-EVOLUTION -e I-EVOLUTION -inicio I-EVOLUTION -del I-EVOLUTION -tratamiento I-EVOLUTION -tardíos, I-EVOLUTION -la I-EVOLUTION -falta I-EVOLUTION -de I-EVOLUTION -inmunidad I-EVOLUTION -adquirida I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -abandono I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -quimioprofilaxis I-EVOLUTION -que I-EVOLUTION -pudo I-EVOLUTION -ayudar I-EVOLUTION -al I-EVOLUTION -plasmodium I-EVOLUTION -a I-EVOLUTION -una I-EVOLUTION -reproducción I-EVOLUTION -e I-EVOLUTION -invasión I-EVOLUTION -rápida. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -Medical I-EVOLUTION -Advisor I-EVOLUTION - I-EVOLUTION -Durante I-EVOLUTION -todo I-EVOLUTION -este I-EVOLUTION -proceso I-EVOLUTION -y I-EVOLUTION -como I-EVOLUTION -es I-EVOLUTION -habitual, I-EVOLUTION -el I-EVOLUTION -Medical I-EVOLUTION -Advisor I-EVOLUTION -informa I-EVOLUTION -en I-EVOLUTION -cada I-EVOLUTION -momento I-EVOLUTION -al I-EVOLUTION -Jefe I-EVOLUTION -de I-EVOLUTION -Estado I-EVOLUTION -Mayor I-EVOLUTION -y I-EVOLUTION -éste I-EVOLUTION -mantiene I-EVOLUTION -informado I-EVOLUTION -al I-EVOLUTION -Jefe I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -Mision, I-EVOLUTION -quien I-EVOLUTION -a I-EVOLUTION -su I-EVOLUTION -vez I-EVOLUTION -transmite I-EVOLUTION -todo I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -acontece I-EVOLUTION -en I-EVOLUTION -nuestra I-EVOLUTION -Misión I-EVOLUTION -en I-EVOLUTION -Uganda I-EVOLUTION -al I-EVOLUTION -Cuartel I-EVOLUTION -General I-EVOLUTION -en I-EVOLUTION -Bruselas. I-EVOLUTION -La I-EVOLUTION -preocupación I-EVOLUTION -de I-EVOLUTION -Bruselas I-EVOLUTION -se I-EVOLUTION -hace I-EVOLUTION -evidente. I-EVOLUTION -Asimismo I-EVOLUTION -el I-EVOLUTION -Medical I-EVOLUTION -Advisor I-EVOLUTION -informa I-EVOLUTION -al I-EVOLUTION -Mando I-EVOLUTION -de I-EVOLUTION -Operaciones I-EVOLUTION -(CMOPS) I-EVOLUTION -y I-EVOLUTION -al I-EVOLUTION -Instituto I-EVOLUTION -de I-EVOLUTION -Medicina I-EVOLUTION -Preventiva I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -Defensa I-EVOLUTION -(IMPDEF) I-EVOLUTION -para I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -informe I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -mayor I-EVOLUTION -brevedad I-EVOLUTION -posible I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -Inspección I-EVOLUTION -General I-EVOLUTION -de I-EVOLUTION -Sanidad. I-EVOLUTION - I-EVOLUTION -Tras I-EVOLUTION -esta I-EVOLUTION -amarga I-EVOLUTION -experiencia, I-EVOLUTION -cobra I-EVOLUTION -mayor I-EVOLUTION -relieve I-EVOLUTION -la I-EVOLUTION -figura I-EVOLUTION -del I-EVOLUTION -Medical I-EVOLUTION -Advisor I-EVOLUTION -en I-EVOLUTION -Uganda, I-EVOLUTION -una I-EVOLUTION -de I-EVOLUTION -cuyas I-EVOLUTION -funciones I-EVOLUTION -es I-EVOLUTION -la I-EVOLUTION -de I-EVOLUTION -recordar I-EVOLUTION -a I-EVOLUTION -todo I-EVOLUTION -el I-EVOLUTION -contingente I-EVOLUTION -desplegado I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -misión I-EVOLUTION -las I-EVOLUTION -enfermedades I-EVOLUTION -de I-EVOLUTION -riesgo I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -zona, I-EVOLUTION -les I-EVOLUTION -aconseja I-EVOLUTION -e I-EVOLUTION -instruye I-EVOLUTION -sobre I-EVOLUTION -la I-EVOLUTION -prevención I-EVOLUTION -de I-EVOLUTION -dichas I-EVOLUTION -enfermedades I-EVOLUTION -y I-EVOLUTION -sobre I-EVOLUTION -las I-EVOLUTION -medidas I-EVOLUTION -higiénico-sanitarias I-EVOLUTION -a I-EVOLUTION -tomar I-EVOLUTION -para I-EVOLUTION -prevenirlas. I-EVOLUTION -En B-TREATMENT -relación I-TREATMENT -a I-TREATMENT -la I-TREATMENT -Malaria I-TREATMENT -se I-TREATMENT -remarca I-TREATMENT -lo I-TREATMENT -importante I-TREATMENT -que I-TREATMENT -es I-TREATMENT -tomar I-TREATMENT -la I-TREATMENT -quimioprofilaxis, I-TREATMENT -además I-TREATMENT -de I-TREATMENT -llevar I-TREATMENT -a I-TREATMENT -cabo I-TREATMENT -medidas I-TREATMENT -defensivas I-TREATMENT -que I-TREATMENT -todos I-TREATMENT -conocemos I-TREATMENT -para I-TREATMENT -evitar I-TREATMENT -la I-TREATMENT -picadura I-TREATMENT -del I-TREATMENT -mosquito I-TREATMENT -como: I-TREATMENT - I-TREATMENT -1. I-TREATMENT -Utilizar I-TREATMENT -repelente I-TREATMENT -de I-TREATMENT -insectos I-TREATMENT -de I-TREATMENT -tipo I-TREATMENT -dietiltoluamida, I-TREATMENT -de I-TREATMENT -aplicación I-TREATMENT -en I-TREATMENT -zonas I-TREATMENT -expuestas I-TREATMENT -sobre I-TREATMENT -todo I-TREATMENT -desde I-TREATMENT -las I-TREATMENT -18 I-TREATMENT -p.m. I-TREATMENT -a I-TREATMENT -las I-TREATMENT -05 I-TREATMENT -a.m. I-TREATMENT - I-TREATMENT -2. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -exterior I-TREATMENT -utilizar I-TREATMENT -ropa I-TREATMENT -de I-TREATMENT -manga I-TREATMENT -larga I-TREATMENT -y I-TREATMENT -pantalón I-TREATMENT -largo. I-TREATMENT -Incluso I-TREATMENT -impregnar I-TREATMENT +Situación B-PRESENT_ILLNESS +actual: I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Aproximadamente I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +inicio I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +verano, I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +mala I-PRESENT_ILLNESS +tolerancia I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +ultrafiltración I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +episodios I-PRESENT_ILLNESS +severos I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hipotensión I-PRESENT_ILLNESS +arterial I-PRESENT_ILLNESS +prácticamente I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +todas I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +sesiones I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +diálisis, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +requirieron I-PRESENT_ILLNESS +infusión I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +fluidos I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +estabilización, I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +reprogramación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +sesiones I-PRESENT_ILLNESS +renunciando I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +lograr I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +peso I-PRESENT_ILLNESS +seco I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +final I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +sesiones. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Por B-DERIVED_FROM/TO +ello I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +día I-DERIVED_FROM/TO +8/08/16, I-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +trasladada I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +unidad I-DERIVED_FROM/TO +hospitalaria I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +diálisis I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +mejor I-DERIVED_FROM/TO +control I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +durante I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +hemodiálisis. I-DERIVED_FROM/TO + I-DERIVED_FROM/TO +A B-EXPLORATION +su I-EXPLORATION +llegada I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +unidad, I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +presenta I-EXPLORATION +signos I-EXPLORATION +evidentes I-EXPLORATION +de I-EXPLORATION +sobrecarga I-EXPLORATION +hídrica, I-EXPLORATION +con I-EXPLORATION +hipertensión I-EXPLORATION +arterial I-EXPLORATION +pre I-EXPLORATION +hemodiálisis, I-EXPLORATION +peso I-EXPLORATION +prediálisis I-EXPLORATION +de I-EXPLORATION +47.5 I-EXPLORATION +Kg I-EXPLORATION +que I-EXPLORATION +indica I-EXPLORATION +un I-EXPLORATION +sobrepeso I-EXPLORATION +de I-EXPLORATION +4.2 I-EXPLORATION +Kg I-EXPLORATION +sobre I-EXPLORATION +su I-EXPLORATION +peso I-EXPLORATION +seco I-EXPLORATION +anterior, I-EXPLORATION +ortopnea, I-EXPLORATION +y I-EXPLORATION +edemas I-EXPLORATION +muy I-EXPLORATION +intensos I-EXPLORATION +en I-EXPLORATION +MMII. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +anamnesis I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +refiere I-EXPLORATION +que I-EXPLORATION +desde I-EXPLORATION +que I-EXPLORATION +empezó I-EXPLORATION +el I-EXPLORATION +calor I-EXPLORATION +del I-EXPLORATION +verano, I-EXPLORATION +prácticamente I-EXPLORATION +no I-EXPLORATION +comía I-EXPLORATION +nada, I-EXPLORATION +y I-EXPLORATION +destaca I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +albuminemia I-EXPLORATION +2.6 I-EXPLORATION +g/dl I-EXPLORATION +y I-EXPLORATION +proteínas I-EXPLORATION +totales I-EXPLORATION +en I-EXPLORATION +suero I-EXPLORATION +5.5 I-EXPLORATION +g/dl, I-EXPLORATION +motivo B-TREATMENT +por I-TREATMENT el I-TREATMENT -uniforme I-TREATMENT +cual I-TREATMENT +se I-TREATMENT +le I-TREATMENT +prescribió I-TREATMENT +hace I-TREATMENT +10 I-TREATMENT +días I-TREATMENT +suplementación I-TREATMENT +oral I-TREATMENT con I-TREATMENT -permetrina. I-TREATMENT +Renilón7.5©, I-TREATMENT +1 I-TREATMENT +frasco I-TREATMENT +al I-TREATMENT +día. I-TREATMENT I-TREATMENT -3. I-TREATMENT -Disponer I-TREATMENT -de I-TREATMENT -mosquiteras I-TREATMENT -en I-TREATMENT +Durante I-TREATMENT las I-TREATMENT -ventanas I-TREATMENT +dos I-TREATMENT +primeras I-TREATMENT +semanas I-TREATMENT de I-TREATMENT -las I-TREATMENT -habitaciones. I-TREATMENT -Malla I-TREATMENT -mosquitera I-TREATMENT -impregnada I-TREATMENT -en I-TREATMENT -permetrina I-TREATMENT +su I-TREATMENT +estancia I-TREATMENT en I-TREATMENT la I-TREATMENT -cama, I-TREATMENT -que I-TREATMENT -se I-TREATMENT -mantenga I-TREATMENT -bien I-TREATMENT -tensada I-TREATMENT -y I-TREATMENT -metida I-TREATMENT -por I-TREATMENT -debajo I-TREATMENT -del I-TREATMENT -colchón, I-TREATMENT -y I-TREATMENT -que I-TREATMENT -nunca I-TREATMENT +unidad I-TREATMENT +hospitalaria, I-TREATMENT se I-TREATMENT -apoye I-TREATMENT -en I-TREATMENT -el I-TREATMENT -suelo. I-TREATMENT - I-TREATMENT -4. I-TREATMENT -En I-TREATMENT +intenta I-TREATMENT +sin I-TREATMENT +éxito I-TREATMENT +conseguir I-TREATMENT el I-TREATMENT -interior I-TREATMENT +peso I-TREATMENT +seco I-TREATMENT de I-TREATMENT la I-TREATMENT -habitación I-TREATMENT -utilizar I-TREATMENT -insecticidas I-TREATMENT -para I-TREATMENT -el I-TREATMENT -cuarto. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -les I-TREATMENT -informa I-TREATMENT -y I-TREATMENT -recuerda I-TREATMENT -continuamente I-TREATMENT -que I-TREATMENT -para I-TREATMENT -evitar I-TREATMENT -un I-TREATMENT -desenlace I-TREATMENT -fatal I-TREATMENT -con I-TREATMENT -la I-TREATMENT -malaria I-TREATMENT -es I-TREATMENT -fundamental I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -precoz I-TREATMENT -y, I-TREATMENT -para I-TREATMENT -ello I-TREATMENT -es I-TREATMENT -fundamental I-TREATMENT -que I-TREATMENT -adviertan I-TREATMENT +paciente I-TREATMENT al I-TREATMENT -médico I-TREATMENT -del I-TREATMENT -Role I-TREATMENT -1 I-TREATMENT -(en I-TREATMENT -Bihanga I-TREATMENT -o I-TREATMENT -Kampala) I-TREATMENT -de I-TREATMENT -cualquier I-TREATMENT -síntoma I-TREATMENT -que I-TREATMENT -se I-TREATMENT -presente, I-TREATMENT -en I-TREATMENT -general I-TREATMENT -"cuando I-TREATMENT -uno I-TREATMENT -se I-TREATMENT -encuentre I-TREATMENT -mal". I-TREATMENT -Se I-TREATMENT -dice I-TREATMENT -que I-TREATMENT -cuando I-TREATMENT -aparece I-TREATMENT -fiebre I-TREATMENT -en I-TREATMENT -zona I-TREATMENT -endémica I-TREATMENT +persistir I-TREATMENT +los I-TREATMENT +episodios I-TREATMENT de I-TREATMENT -malaria I-TREATMENT -"hay I-TREATMENT -que I-TREATMENT -pensar I-TREATMENT -como I-TREATMENT -primera I-TREATMENT -opción I-TREATMENT -en I-TREATMENT -esta I-TREATMENT -enfermedad". I-TREATMENT -Es I-TREATMENT -muy I-TREATMENT -importante I-TREATMENT -tener I-TREATMENT +hipotensión I-TREATMENT +intradiálisis. I-TREATMENT +Incluso I-TREATMENT +ganó I-TREATMENT +1 I-TREATMENT +Kg I-TREATMENT en I-TREATMENT -cuenta I-TREATMENT este I-TREATMENT -principio I-TREATMENT -pero, I-TREATMENT -no I-TREATMENT -hay I-TREATMENT -que I-TREATMENT -olvidar I-TREATMENT -además, I-TREATMENT -todos I-TREATMENT -los I-TREATMENT -síntomas I-TREATMENT -que I-TREATMENT -pueden I-TREATMENT -aparecer I-TREATMENT -en I-TREATMENT -la I-TREATMENT -malaria: I-TREATMENT -cefalea, I-TREATMENT -dolor I-TREATMENT -de I-TREATMENT -garganta, I-TREATMENT -astenia I-TREATMENT -intensa, I-TREATMENT -escalofríos, I-TREATMENT -sudoración, I-TREATMENT -náuseas, I-TREATMENT -diarrea I-TREATMENT -y I-TREATMENT -vómitos. I-TREATMENT -Estos, I-TREATMENT -son I-TREATMENT -síntomas I-TREATMENT -comunes I-TREATMENT +periodo, I-TREATMENT a I-TREATMENT -otras I-TREATMENT -afecciones I-TREATMENT -frecuentes I-TREATMENT -en I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -como I-TREATMENT -es I-TREATMENT -el I-TREATMENT -caso I-TREATMENT +pesar I-TREATMENT de I-TREATMENT -la I-TREATMENT -gastroenteritis, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -el I-TREATMENT -paciente I-TREATMENT -puede I-TREATMENT -no I-TREATMENT -darles I-TREATMENT -importancia. I-TREATMENT -Se I-TREATMENT -debe I-TREATMENT -insistir I-TREATMENT +poner I-TREATMENT en I-TREATMENT +práctica I-TREATMENT +diferentes I-TREATMENT +estrategias I-TREATMENT +como I-TREATMENT +limitar I-TREATMENT la I-TREATMENT -necesidad I-TREATMENT -de I-TREATMENT -consultar I-TREATMENT -con I-TREATMENT -el I-TREATMENT -médico I-TREATMENT -de I-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -cualquiera I-TREATMENT -de I-TREATMENT -ellos. I-TREATMENT - I-TREATMENT -Durante I-TREATMENT -la I-TREATMENT -misión, I-TREATMENT -el I-TREATMENT -Medical I-TREATMENT -Advisor I-TREATMENT -viaja I-TREATMENT +ultrafiltración I-TREATMENT +horaria I-TREATMENT a I-TREATMENT -la I-TREATMENT -capital I-TREATMENT -de I-TREATMENT -Kenya I-TREATMENT -para I-TREATMENT -informarse I-TREATMENT -de I-TREATMENT +300- I-TREATMENT +400 I-TREATMENT +ml/h, I-TREATMENT +haciendo I-TREATMENT +diálisis I-TREATMENT +secuencial I-TREATMENT +prolongando I-TREATMENT las I-TREATMENT -prestaciones I-TREATMENT -y I-TREATMENT -servicios I-TREATMENT -de I-TREATMENT -los I-TREATMENT -hospitales I-TREATMENT -que I-TREATMENT -allí I-TREATMENT -se I-TREATMENT -encuentran. I-TREATMENT -Así I-TREATMENT -mismo I-TREATMENT -se I-TREATMENT -informa I-TREATMENT -sobre I-TREATMENT -el I-TREATMENT -protocolo I-TREATMENT -que I-TREATMENT -siguen I-TREATMENT -para I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -malaria. I-TREATMENT -Todos I-TREATMENT -ellos I-TREATMENT -coinciden I-TREATMENT -en I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -precoz I-TREATMENT -de I-TREATMENT -la I-TREATMENT -enfermedad, I-TREATMENT -siendo I-TREATMENT -suficiente I-TREATMENT -la I-TREATMENT -presencia I-TREATMENT -de I-TREATMENT -síntomas I-TREATMENT -clínicos I-TREATMENT -aunque I-TREATMENT -el I-TREATMENT -diagnóstico I-TREATMENT -microscópico I-TREATMENT -sea I-TREATMENT -negativo. I-TREATMENT -En I-TREATMENT -la I-TREATMENT -mayoría I-TREATMENT -de I-TREATMENT -los I-TREATMENT -casos I-TREATMENT -se I-TREATMENT -utiliza I-TREATMENT -Artemether I-TREATMENT -20mg/Lumefantrine I-TREATMENT -120mg I-TREATMENT -cuatro I-TREATMENT -unidades I-TREATMENT -cada I-TREATMENT -12 I-TREATMENT -horas I-TREATMENT -durante I-TREATMENT -3 I-TREATMENT -días. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -Cuartel I-TREATMENT -General I-TREATMENT -de I-TREATMENT -Kampala, I-TREATMENT -se I-TREATMENT -trataron I-TREATMENT -dos I-TREATMENT -casos I-TREATMENT -sospechosos I-TREATMENT -de I-TREATMENT -malaria, I-TREATMENT -sin I-TREATMENT -diagnóstico I-TREATMENT -evidente I-TREATMENT -al I-TREATMENT -microscopio. I-TREATMENT -La I-TREATMENT -evolución I-TREATMENT -fue I-TREATMENT -muy I-TREATMENT -buena. I-TREATMENT - I-TREATMENT -Otra I-TREATMENT -medida I-TREATMENT -de I-TREATMENT -prevención I-TREATMENT -que I-TREATMENT -se I-TREATMENT -tuvo I-TREATMENT -en I-TREATMENT -cuenta, I-TREATMENT -fue I-TREATMENT -luchar I-TREATMENT -contra I-TREATMENT -el I-TREATMENT -vector. I-TREATMENT -Se I-TREATMENT -visitaron I-TREATMENT -varias I-TREATMENT -compañías I-TREATMENT -expertas I-TREATMENT -en I-TREATMENT -la I-TREATMENT -lucha I-TREATMENT -contra I-TREATMENT -el I-TREATMENT -vector I-TREATMENT -de I-TREATMENT -la I-TREATMENT -malaria I-TREATMENT -y I-TREATMENT -se I-TREATMENT -pidió I-TREATMENT -estudio I-TREATMENT -para I-TREATMENT -la I-TREATMENT -desinfección I-TREATMENT -del I-TREATMENT -Campamento I-TREATMENT -de I-TREATMENT -Bihanga. I-TREATMENT -En I-TREATMENT -el I-TREATMENT -Cuartel I-TREATMENT -General I-TREATMENT -de I-TREATMENT -Kampala I-TREATMENT -se I-TREATMENT -desinfecta I-TREATMENT -una I-TREATMENT -vez I-TREATMENT -al I-TREATMENT -mes I-TREATMENT -dentro I-TREATMENT +sesiones I-TREATMENT +con I-TREATMENT +tiempos I-TREATMENT de I-TREATMENT -las I-TREATMENT -habitaciones I-TREATMENT -y I-TREATMENT -en I-TREATMENT -el I-TREATMENT -exterior I-TREATMENT -más I-TREATMENT -próximo, I-TREATMENT -incluyendo I-TREATMENT -toda I-TREATMENT +ultrafiltración I-TREATMENT +aislada I-TREATMENT +pre I-TREATMENT +o I-TREATMENT +post I-TREATMENT +hemodiálisis, I-TREATMENT +bajando I-TREATMENT la I-TREATMENT -vegetación I-TREATMENT -que I-TREATMENT -allí I-TREATMENT -se I-TREATMENT -encuentra. I-TREATMENT - I-TREATMENT -La I-TREATMENT -desinfección I-TREATMENT -completa I-TREATMENT +temperatura I-TREATMENT del I-TREATMENT -Campamento I-TREATMENT -de I-TREATMENT -Bihanga I-TREATMENT -es I-TREATMENT -más I-TREATMENT -complicada, I-TREATMENT -al I-TREATMENT -estar I-TREATMENT -rodeado I-TREATMENT -de I-TREATMENT -zonas I-TREATMENT -verdes I-TREATMENT -muy I-TREATMENT -extensas I-TREATMENT -y I-TREATMENT -de I-TREATMENT -una I-TREATMENT -zona I-TREATMENT -de I-TREATMENT -vida I-TREATMENT -de I-TREATMENT -los I-TREATMENT -militares I-TREATMENT -de I-TREATMENT -Uganda I-TREATMENT -y I-TREATMENT -sus I-TREATMENT -familias I-TREATMENT -que I-TREATMENT -no I-TREATMENT -reúnen I-TREATMENT -las I-TREATMENT -condiciones I-TREATMENT -higiénico I-TREATMENT -sanitarias I-TREATMENT -suficientes I-TREATMENT -para I-TREATMENT -la I-TREATMENT -lucha I-TREATMENT -contra I-TREATMENT -el I-TREATMENT -vector, I-TREATMENT +baño I-TREATMENT +a I-TREATMENT +35oC, I-TREATMENT y I-TREATMENT -el I-TREATMENT -plan I-TREATMENT -de I-TREATMENT -desinfección I-TREATMENT -implicarían I-TREATMENT -medidas I-TREATMENT -que I-TREATMENT -precisaría I-TREATMENT -de I-TREATMENT -la I-TREATMENT -autorización I-TREATMENT -de I-TREATMENT -los I-TREATMENT -militares I-TREATMENT -Ugandeses. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -realizó I-TREATMENT -un I-TREATMENT -estudio I-TREATMENT -por I-TREATMENT -parte I-TREATMENT -de I-TREATMENT -la I-TREATMENT -compañía I-TREATMENT -experta I-TREATMENT -para I-TREATMENT +fijando I-TREATMENT la I-TREATMENT -desinfección I-TREATMENT -dentro I-TREATMENT -de I-TREATMENT -las I-TREATMENT -viviendas, I-TREATMENT -medidas I-TREATMENT -para I-TREATMENT -evitar I-TREATMENT -que I-TREATMENT -entren I-TREATMENT -mosquitos I-TREATMENT -en I-TREATMENT -el I-TREATMENT -interior, I-TREATMENT -drenaje I-TREATMENT -de I-TREATMENT -charcas I-TREATMENT -y I-TREATMENT -desecación I-TREATMENT -de I-TREATMENT -colecciones I-TREATMENT -de I-TREATMENT -agua I-TREATMENT -estancada, I-TREATMENT -además I-TREATMENT -de I-TREATMENT -eliminación I-TREATMENT -de I-TREATMENT -vegetación I-TREATMENT -que I-TREATMENT -pueda I-TREATMENT -favorecer I-TREATMENT -el I-TREATMENT -desarrollo I-TREATMENT -de I-TREATMENT -larvas. I-TREATMENT -Todo I-TREATMENT -ello I-TREATMENT -en I-TREATMENT -un I-TREATMENT -radio I-TREATMENT -mínimo I-TREATMENT -de I-TREATMENT -un I-TREATMENT -kilómetro. I-TREATMENT - I-TREATMENT -La I-TREATMENT -misión I-TREATMENT -del I-TREATMENT -Medical I-TREATMENT -Advisor I-TREATMENT -en I-TREATMENT -Uganda I-TREATMENT -terminó I-TREATMENT -sin I-TREATMENT -haberse I-TREATMENT -decidido I-TREATMENT -sobre I-TREATMENT -muchas I-TREATMENT -de I-TREATMENT -las I-TREATMENT -medidas I-TREATMENT -anteriores. I-TREATMENT -Al I-TREATMENT -no I-TREATMENT -poner I-TREATMENT -ningún I-TREATMENT -país I-TREATMENT -Europeo I-TREATMENT -un I-TREATMENT -Medical I-TREATMENT -Advisor I-TREATMENT -que I-TREATMENT -reemplace I-TREATMENT -al I-TREATMENT -anterior, I-TREATMENT -todos I-TREATMENT -estos I-TREATMENT -temas I-TREATMENT -quedan I-TREATMENT -abiertos I-TREATMENT -y I-TREATMENT -pendientes I-TREATMENT +concentración I-TREATMENT de I-TREATMENT -que I-TREATMENT +Na I-TREATMENT +en I-TREATMENT +el I-TREATMENT +baño I-TREATMENT +en I-TREATMENT +140 I-TREATMENT +meq/l. I-TREATMENT + I-TREATMENT +Durante I-TREATMENT +este I-TREATMENT +tiempo, I-TREATMENT se I-TREATMENT -tome I-TREATMENT -una I-TREATMENT -decisión I-TREATMENT -por I-TREATMENT +revisa I-TREATMENT el I-TREATMENT -nuevo I-TREATMENT -Jefe I-TREATMENT +tratamiento I-TREATMENT de I-TREATMENT la I-TREATMENT -Mision, I-TREATMENT -asesorado I-TREATMENT +paciente I-TREATMENT +retirándole I-TREATMENT +toda I-TREATMENT +la I-TREATMENT +medicación I-TREATMENT +hipotensora, I-TREATMENT +se B-EXPLORATION +realiza I-EXPLORATION +ecocardiograma I-EXPLORATION +descartando I-EXPLORATION +agravamiento I-EXPLORATION +de I-EXPLORATION +su I-EXPLORATION +insuficiencia I-EXPLORATION +cardíaca, I-EXPLORATION +y I-EXPLORATION +al I-EXPLORATION +persistir I-EXPLORATION +los I-EXPLORATION +intensos I-EXPLORATION +edemas I-EXPLORATION +en I-EXPLORATION +MMII, I-EXPLORATION +aparecen I-EXPLORATION +heridas I-EXPLORATION +ulcerosas I-EXPLORATION +que B-TREATMENT +requieren I-TREATMENT +curas I-TREATMENT +diarias I-TREATMENT +según I-TREATMENT +pauta I-TREATMENT +descrita I-TREATMENT por I-TREATMENT -el I-TREATMENT -Jefe I-TREATMENT -de I-TREATMENT -Estado I-TREATMENT -Mayor I-TREATMENT +cirugía I-TREATMENT +plástica, I-TREATMENT y I-TREATMENT -los I-TREATMENT -estudios I-TREATMENT -realizados. I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +IV I-TREATMENT +(Vancomicina) I-TREATMENT +por I-TREATMENT +cultivo I-TREATMENT ++ I-TREATMENT +a I-TREATMENT +staphylococo I-TREATMENT +epidermidis. I-TREATMENT I-TREATMENT En I-TREATMENT -las I-TREATMENT -Figuras I-TREATMENT -1 I-TREATMENT +la I-TREATMENT +cuarta I-TREATMENT +semana I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +en I-TREATMENT +la I-TREATMENT +unidad, I-TREATMENT +ante I-TREATMENT +la I-TREATMENT +intolerancia I-TREATMENT +a I-TREATMENT +la I-TREATMENT +ultrafiltración, I-TREATMENT y I-TREATMENT -2 I-TREATMENT +para I-TREATMENT +limitar I-TREATMENT +en I-TREATMENT +lo I-TREATMENT +posible I-TREATMENT +un I-TREATMENT +sobrepeso I-TREATMENT +excesivo I-TREATMENT +entre I-TREATMENT +sesiones, I-TREATMENT se I-TREATMENT -observan I-TREATMENT -las I-TREATMENT -condiciones I-TREATMENT -de I-TREATMENT -las I-TREATMENT -viviendas I-TREATMENT -de I-TREATMENT -las I-TREATMENT -familias I-TREATMENT -de I-TREATMENT -militares I-TREATMENT -Ugandeses I-TREATMENT -muy I-TREATMENT -próximas I-TREATMENT +pasa I-TREATMENT a I-TREATMENT la I-TREATMENT -zona I-TREATMENT -de I-TREATMENT -vida I-TREATMENT +paciente I-TREATMENT +a I-TREATMENT +hemodiálisis I-TREATMENT +diaria, I-TREATMENT +prescribiéndose I-TREATMENT +6 I-TREATMENT +sesiones I-TREATMENT +semanales I-TREATMENT de I-TREATMENT -los I-TREATMENT -europeos. I-TREATMENT -Debieran I-TREATMENT -tratarse I-TREATMENT -y I-TREATMENT -cerrar I-TREATMENT -ventanas I-TREATMENT +2.5 I-TREATMENT +h, I-TREATMENT +haciendo I-TREATMENT +ultrafiltración I-TREATMENT +aislada I-TREATMENT +pre I-TREATMENT +diálisis, I-TREATMENT y I-TREATMENT -puertas I-TREATMENT -con I-TREATMENT -mosquiteras I-TREATMENT +se I-TREATMENT +cursa I-TREATMENT +interconsulta I-TREATMENT +a I-TREATMENT +Endocrinología- I-TREATMENT +Nutrición, I-TREATMENT para I-TREATMENT -una I-TREATMENT -correcta I-TREATMENT -desinfección I-TREATMENT -y I-TREATMENT -eliminación I-TREATMENT -del I-TREATMENT -vector. I-TREATMENT - I-TREATMENT -La I-TREATMENT -Figura I-TREATMENT -3, I-TREATMENT -nos I-TREATMENT -da I-TREATMENT -clara I-TREATMENT -idea I-TREATMENT -de I-TREATMENT +valorar I-TREATMENT la I-TREATMENT -cercanía I-TREATMENT +indicación I-TREATMENT de I-TREATMENT +nutrición I-TREATMENT +parenteral I-TREATMENT +intradiálisis I-TREATMENT +(NPID), I-TREATMENT +ya I-TREATMENT +que I-TREATMENT +con I-TREATMENT +los I-TREATMENT +suplementos I-TREATMENT +orales I-TREATMENT las I-TREATMENT -viviendas I-TREATMENT +cifras I-TREATMENT de I-TREATMENT -militares I-TREATMENT -europeos I-TREATMENT -(con I-TREATMENT -tejados I-TREATMENT -azules) I-TREATMENT +albuminemia I-TREATMENT y I-TREATMENT -las I-TREATMENT -viviendas I-TREATMENT -de I-TREATMENT -militares I-TREATMENT -ugandeses I-TREATMENT -(construcciones I-TREATMENT -propias I-TREATMENT -de I-TREATMENT -la I-TREATMENT -zona). I-TREATMENT +proteínas I-TREATMENT +totales I-TREATMENT +en I-TREATMENT +suero I-TREATMENT +han I-TREATMENT +bajado I-TREATMENT +situándose I-TREATMENT +en I-TREATMENT +2.4 I-TREATMENT +g/dl I-TREATMENT +y I-TREATMENT +5.3 I-TREATMENT +g/dl I-TREATMENT +respectivamente. I-TREATMENT I-TREATMENT - -Paciente B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -22 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -(178 I-PRESENT_ILLNESS -cm, I-PRESENT_ILLNESS -70 I-PRESENT_ILLNESS -Kg), I-PRESENT_ILLNESS -varón, B-PAST_MEDICAL_HISTORY -militar I-PAST_MEDICAL_HISTORY -afgano, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -presentaba I-PRESENT_ILLNESS -quemadura I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -segundo I-PRESENT_ILLNESS -grado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cara I-PRESENT_ILLNESS -interna I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -antebrazo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -brazo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -(7% I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -superficie I-PRESENT_ILLNESS -corporal I-PRESENT_ILLNESS -quemada) I-PRESENT_ILLNESS -secundaria I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -explosión I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -hace I-PRESENT_ILLNESS -72 I-PRESENT_ILLNESS -horas. I-PRESENT_ILLNESS -Se B-TREATMENT -aplicó I-TREATMENT -tratamiento I-TREATMENT -tópico I-TREATMENT -que I-TREATMENT -resultó I-TREATMENT -ineficaz. I-TREATMENT -Debido I-TREATMENT -a I-TREATMENT +Aunque I-TREATMENT +en I-TREATMENT +principio I-TREATMENT +Endocrinología I-TREATMENT +descartó I-TREATMENT la I-TREATMENT -evolución I-TREATMENT -tórpida I-TREATMENT +prescripción I-TREATMENT de I-TREATMENT +nutrición I-TREATMENT +parenteral, I-TREATMENT +al I-TREATMENT +considerar I-TREATMENT +que I-TREATMENT la I-TREATMENT -lesión, I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -desbridamiento I-TREATMENT -mecánico I-TREATMENT -local I-TREATMENT -y I-TREATMENT -aplicación I-TREATMENT +paciente I-TREATMENT +tenía I-TREATMENT +posibilidad I-TREATMENT de I-TREATMENT -sulfadiacina I-TREATMENT -argéntica I-TREATMENT +alimentación I-TREATMENT +por I-TREATMENT +vía I-TREATMENT +oral, I-TREATMENT y I-TREATMENT -apósito I-TREATMENT -Tulgrasum® I-TREATMENT -cicatrizante I-TREATMENT -impregnado I-TREATMENT -de I-TREATMENT -antibiótico I-TREATMENT -(bacitracina-zinc, I-TREATMENT -neomicina, I-TREATMENT -sulfato I-TREATMENT -de I-TREATMENT -polimixina I-TREATMENT -B). I-TREATMENT -Para I-TREATMENT -permitir I-TREATMENT -el I-TREATMENT -procedimiento I-TREATMENT -se I-TREATMENT -administró I-TREATMENT +propuso I-TREATMENT +su I-TREATMENT +seguimiento I-TREATMENT +en I-TREATMENT +consulta I-TREATMENT de I-TREATMENT -forma I-TREATMENT -previa I-TREATMENT -midazolam I-TREATMENT -(3 I-TREATMENT -mg I-TREATMENT -i.m) I-TREATMENT -y I-TREATMENT -a I-TREATMENT +dietética I-TREATMENT +manteniendo I-TREATMENT los I-TREATMENT -5 I-TREATMENT -minutos I-TREATMENT -ketamina I-TREATMENT -(200 I-TREATMENT -mg I-TREATMENT -i.m). I-TREATMENT -Se I-TREATMENT -consiguió I-TREATMENT -analgesia I-TREATMENT -(grado I-TREATMENT -1 I-TREATMENT -según I-TREATMENT +suplementos I-TREATMENT +que I-TREATMENT +tenía I-TREATMENT +prescritos, I-TREATMENT +en I-TREATMENT la I-TREATMENT -escala I-TREATMENT -verbal I-TREATMENT -del I-TREATMENT -dolor) I-TREATMENT -y I-TREATMENT -sedación I-TREATMENT +sexta I-TREATMENT +semana I-TREATMENT +tras I-TREATMENT +valorar I-TREATMENT +de I-TREATMENT +nuevo I-TREATMENT a I-TREATMENT -los I-TREATMENT -12 I-TREATMENT -minutos I-TREATMENT -(puntuación I-TREATMENT -3 I-TREATMENT -en I-TREATMENT -escala I-TREATMENT -Ramsay), I-TREATMENT -permitiendo I-TREATMENT -realizar I-TREATMENT la I-TREATMENT -cura I-TREATMENT -sin I-TREATMENT -incidencias I-TREATMENT -durante I-TREATMENT -16 I-TREATMENT -minutos. I-TREATMENT -El I-TREATMENT paciente I-TREATMENT -recuperó I-TREATMENT -sensibilidad I-TREATMENT -y I-TREATMENT -vigilia I-TREATMENT -a I-TREATMENT -los I-TREATMENT -55 I-TREATMENT -minutos I-TREATMENT -de I-TREATMENT +prescribieron I-TREATMENT +NPID I-TREATMENT +con I-TREATMENT +bajo I-TREATMENT +volumen I-TREATMENT +(900 I-TREATMENT +ml/sesión), I-TREATMENT +al I-TREATMENT +considerar I-TREATMENT +que I-TREATMENT la I-TREATMENT -administración I-TREATMENT +paciente I-TREATMENT +estaba I-TREATMENT +en I-TREATMENT +riesgo I-TREATMENT +nutricional I-TREATMENT +alto/intermedio, I-TREATMENT +con I-TREATMENT +mala I-TREATMENT +respuesta I-TREATMENT +al I-TREATMENT +suplemento I-TREATMENT +oral. I-TREATMENT + I-TREATMENT +A I-TREATMENT +partir I-TREATMENT del I-TREATMENT -tratamiento. I-TREATMENT -El I-TREATMENT -grado I-TREATMENT +inicio I-TREATMENT de I-TREATMENT -amnesia I-TREATMENT -del I-TREATMENT -procedimiento I-TREATMENT -quirúrgico I-TREATMENT -valorado I-TREATMENT -por I-TREATMENT la I-TREATMENT -escala I-TREATMENT -de I-TREATMENT -Korttila I-TREATMENT -y I-TREATMENT -Linnolia I-TREATMENT -fue I-TREATMENT -total. I-TREATMENT - I-TREATMENT -Ambos I-TREATMENT -casos I-TREATMENT -presentaron I-TREATMENT -una I-TREATMENT -evolución I-TREATMENT -favorable I-TREATMENT -sin I-TREATMENT -efectos I-TREATMENT -adversos I-TREATMENT -durante I-TREATMENT -curas I-TREATMENT -posteriores. I-TREATMENT - I-TREATMENT -En I-TREATMENT -zona I-TREATMENT -de I-TREATMENT -combate, I-TREATMENT +NPID, I-TREATMENT +la I-TREATMENT +cual I-TREATMENT es I-TREATMENT -frecuente I-TREATMENT -encontrar I-TREATMENT -heridos I-TREATMENT -que I-TREATMENT -presentan I-TREATMENT -quemaduras I-TREATMENT -de I-TREATMENT -distinto I-TREATMENT -grado I-TREATMENT -y I-TREATMENT -extensión I-TREATMENT -debido I-TREATMENT -principalmente I-TREATMENT -al I-TREATMENT -empleo I-TREATMENT -de I-TREATMENT -artefactos I-TREATMENT -explosivos I-TREATMENT -por I-TREATMENT -parte I-TREATMENT -de I-TREATMENT -los I-TREATMENT -contendientes. I-TREATMENT -En I-TREATMENT -un I-TREATMENT -estudio I-TREATMENT -realizado I-TREATMENT -sobre I-TREATMENT -256 I-TREATMENT -heridos I-TREATMENT +bien I-TREATMENT +tolerada I-TREATMENT por I-TREATMENT -arma I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +sin I-TREATMENT +requerimientos I-TREATMENT de I-TREATMENT -fuego I-TREATMENT -o I-TREATMENT +insulina I-TREATMENT +adicionales I-TREATMENT por I-TREATMENT -artefacto I-TREATMENT -explosivo I-TREATMENT -improvisado I-TREATMENT -atendidos I-TREATMENT -en I-TREATMENT -el I-TREATMENT -hospital I-TREATMENT -militar I-TREATMENT -español I-TREATMENT -de I-TREATMENT -Herat I-TREATMENT -(Afganistán) I-TREATMENT -entre I-TREATMENT -2005 I-TREATMENT -y I-TREATMENT -2008, I-TREATMENT -se I-TREATMENT -describe I-TREATMENT +hiperglucemias, I-TREATMENT +la I-TREATMENT +paciente I-TREATMENT +presenta I-TREATMENT +buena I-TREATMENT +tolerancia I-TREATMENT +a I-TREATMENT +la I-TREATMENT +ultrafiltración I-TREATMENT que I-TREATMENT -23 I-TREATMENT -(9%) I-TREATMENT -sufrieron I-TREATMENT -quemaduras5. I-TREATMENT - I-TREATMENT -A I-TREATMENT -dosis I-TREATMENT -adecuadas I-TREATMENT +nos I-TREATMENT +permite I-TREATMENT +aumentar I-TREATMENT el I-TREATMENT -empleo I-TREATMENT +tiempo I-TREATMENT de I-TREATMENT -ketamina I-TREATMENT +las I-TREATMENT +sesiones I-TREATMENT +a I-TREATMENT +3 I-TREATMENT +horas I-TREATMENT +manteniendo I-TREATMENT +las I-TREATMENT +seis I-TREATMENT +semanales, I-TREATMENT y I-TREATMENT -midazolam I-TREATMENT +se I-TREATMENT consigue I-TREATMENT -un I-TREATMENT -adecuado I-TREATMENT -estado I-TREATMENT -analgésico, I-TREATMENT -hipnótico I-TREATMENT -y I-TREATMENT -ansiolítico I-TREATMENT -con I-TREATMENT -una I-TREATMENT -estabilidad I-TREATMENT -hemodinámica I-TREATMENT -notable I-TREATMENT -y I-TREATMENT -un I-TREATMENT -mantenimiento I-TREATMENT -espontáneo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -función I-TREATMENT -respiratoria. I-TREATMENT -Además, I-TREATMENT +bajar I-TREATMENT +el I-TREATMENT +peso I-TREATMENT +seco I-TREATMENT +(44.5 I-TREATMENT +Kg), I-TREATMENT +hasta I-TREATMENT +niveles I-TREATMENT +próximos I-TREATMENT +al I-TREATMENT +peso I-TREATMENT +seco I-TREATMENT +que I-TREATMENT la I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -emplear I-TREATMENT -ambos I-TREATMENT -fármacos I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -intramuscular I-TREATMENT -minimiza I-TREATMENT -ostensiblemente I-TREATMENT -los I-TREATMENT -requerimientos I-TREATMENT -logísticos I-TREATMENT -necesarios I-TREATMENT -en I-TREATMENT -cada I-TREATMENT -paciente. I-TREATMENT -La I-TREATMENT -sedación I-TREATMENT -con I-TREATMENT -midazolam I-TREATMENT -debe I-TREATMENT -ser I-TREATMENT -previa I-TREATMENT +paciente I-TREATMENT +tenía I-TREATMENT +antes I-TREATMENT +del I-TREATMENT +traslado I-TREATMENT a I-TREATMENT la I-TREATMENT -administración I-TREATMENT -de I-TREATMENT +unidad I-TREATMENT +hospitalaria I-TREATMENT +(43.3 I-TREATMENT +Kg). I-TREATMENT + I-TREATMENT +En I-TREATMENT la I-TREATMENT -ketamina, I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -en I-TREATMENT -caso I-TREATMENT -contrario I-TREATMENT -podría I-TREATMENT -producirse I-TREATMENT -una I-TREATMENT -marcada I-TREATMENT -estimulación I-TREATMENT -cardiovascular I-TREATMENT -y I-TREATMENT -presentarse I-TREATMENT -desagradables I-TREATMENT -reacciones I-TREATMENT -psicomiméticas I-TREATMENT -al I-TREATMENT -despertar. I-TREATMENT -Así I-TREATMENT -mismo I-TREATMENT +octava I-TREATMENT +semana I-TREATMENT se I-TREATMENT -podría I-TREATMENT -añadir I-TREATMENT -atropina I-TREATMENT -para I-TREATMENT -minimizar I-TREATMENT +revisa I-TREATMENT la I-TREATMENT -posible I-TREATMENT -aparición I-TREATMENT -de I-TREATMENT -sialorrea, I-TREATMENT -aunque I-TREATMENT -en I-TREATMENT -ninguno I-TREATMENT -de I-TREATMENT -los I-TREATMENT -dos I-TREATMENT -casos I-TREATMENT -fue I-TREATMENT -administrada I-TREATMENT -ni I-TREATMENT -apareció I-TREATMENT -un I-TREATMENT -aumento I-TREATMENT -de I-TREATMENT -secreciones I-TREATMENT -en I-TREATMENT -estos I-TREATMENT -pacientes. I-TREATMENT -Dichas I-TREATMENT -características I-TREATMENT -hacen I-TREATMENT -estos I-TREATMENT -fármacos I-TREATMENT +prescripción I-TREATMENT de I-TREATMENT -elección I-TREATMENT -para I-TREATMENT la I-TREATMENT -anestesia I-TREATMENT +NPID, I-TREATMENT +bajando I-TREATMENT +el I-TREATMENT +volumen I-TREATMENT +a I-TREATMENT +infundir I-TREATMENT en I-TREATMENT -ambientes I-TREATMENT -austeros, I-TREATMENT -como I-TREATMENT -es I-TREATMENT +cada I-TREATMENT +sesión I-TREATMENT +a I-TREATMENT +700 I-TREATMENT +ml, I-TREATMENT +los B-EVOLUTION +edemas I-EVOLUTION +en I-EVOLUTION +MMII I-EVOLUTION +persisten I-EVOLUTION +aunque I-EVOLUTION +son I-EVOLUTION +casi I-EVOLUTION +inapreciables I-EVOLUTION +post I-EVOLUTION +diálisis, I-EVOLUTION +las I-EVOLUTION +heridas I-EVOLUTION +ulcerosas I-EVOLUTION +están I-EVOLUTION +prácticamente I-EVOLUTION +cicatrizadas, I-EVOLUTION +y I-EVOLUTION +las I-EVOLUTION +sesiones I-EVOLUTION +transcurren I-EVOLUTION +sin I-EVOLUTION +episodios I-EVOLUTION +de I-EVOLUTION +hipotensión. I-EVOLUTION +Por B-TREATMENT +tanto I-TREATMENT +se I-TREATMENT +decide I-TREATMENT +reducir I-TREATMENT el I-TREATMENT +número I-TREATMENT de I-TREATMENT +sesiones I-TREATMENT +semanales I-TREATMENT +a I-TREATMENT +cinco, I-TREATMENT +y I-TREATMENT +seguir I-TREATMENT +bajando I-TREATMENT +el I-TREATMENT +peso I-TREATMENT +seco I-TREATMENT +paulatinamente I-TREATMENT +hasta I-TREATMENT +alcanzar I-TREATMENT +los I-TREATMENT +42 I-TREATMENT +Kg, I-TREATMENT +lo I-TREATMENT +cual I-TREATMENT +se I-TREATMENT +consigue I-TREATMENT +en I-TREATMENT la I-TREATMENT -guerra I-TREATMENT -de I-TREATMENT -Afganistán. I-TREATMENT +semana I-TREATMENT +décima. I-TREATMENT I-TREATMENT -Ricardo I-TREATMENT -Navarro I-TREATMENT -Suay1, I-TREATMENT -Sergio I-TREATMENT -Castillejo I-TREATMENT -Pérez2, I-TREATMENT -Javier I-TREATMENT +A B-EVOLUTION +partir I-EVOLUTION +de I-EVOLUTION +esta I-EVOLUTION +semana, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +ha I-EVOLUTION +permanecido I-EVOLUTION +estable I-EVOLUTION +hemodinámicamente I-EVOLUTION +durante I-EVOLUTION +las I-EVOLUTION +sesiones I-EVOLUTION +de I-EVOLUTION +hemodiálisis, I-EVOLUTION +sin I-EVOLUTION +presentar I-EVOLUTION +dificultades I-EVOLUTION +para I-EVOLUTION +la I-EVOLUTION +ultrafiltración I-EVOLUTION +ni I-EVOLUTION +para I-EVOLUTION +alcanzar I-EVOLUTION +el I-EVOLUTION +peso I-EVOLUTION +seco I-EVOLUTION +al I-EVOLUTION +final I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +sesiones, I-EVOLUTION +y B-TREATMENT +se I-TREATMENT +decide I-TREATMENT +mantener I-TREATMENT +la I-TREATMENT +NPID I-TREATMENT +hasta I-TREATMENT +recuperación I-TREATMENT +total I-TREATMENT de I-TREATMENT las I-TREATMENT -Heras I-TREATMENT -Díez3 I-TREATMENT +cifras I-TREATMENT +analíticas I-TREATMENT y I-TREATMENT -Rafael I-TREATMENT -Tamburri I-TREATMENT -Bariain4 I-TREATMENT -1Cte. I-TREATMENT -Médico. I-TREATMENT -2Cap. I-TREATMENT -Médico. I-TREATMENT -3Cap. I-TREATMENT -Médico. I-TREATMENT -Servicio I-TREATMENT +hasta I-TREATMENT +la I-TREATMENT +cicatrización I-TREATMENT +completa I-TREATMENT de I-TREATMENT -Anestesiología I-TREATMENT +las I-TREATMENT +úlceras I-TREATMENT +en I-TREATMENT +MMII, I-TREATMENT y I-TREATMENT -Reanimación I-TREATMENT -4Cte. I-TREATMENT -Médico. I-TREATMENT -Servicio I-TREATMENT -de I-TREATMENT -Traumatología. I-TREATMENT -Hospital I-TREATMENT -Central I-TREATMENT +cuando I-TREATMENT +la I-TREATMENT +dieta I-TREATMENT de I-TREATMENT la I-TREATMENT -Defensa I-TREATMENT -«Gómez I-TREATMENT -Ulla». I-TREATMENT -Madrid I-TREATMENT +paciente I-TREATMENT +se I-TREATMENT +corrija I-TREATMENT +para I-TREATMENT +que I-TREATMENT +tenga I-TREATMENT +todos I-TREATMENT +los I-TREATMENT +aportes I-TREATMENT +necesarios I-TREATMENT +asegurados, I-TREATMENT +e I-TREATMENT +ir I-TREATMENT +reduciendo I-TREATMENT +paulatinamente I-TREATMENT +los I-TREATMENT +días I-TREATMENT +de I-TREATMENT +diálisis I-TREATMENT +prescritos I-TREATMENT +hasta I-TREATMENT +llegar I-TREATMENT +a I-TREATMENT +su I-TREATMENT +esquema I-TREATMENT +original I-TREATMENT +de I-TREATMENT +tres I-TREATMENT +días I-TREATMENT +en I-TREATMENT +semana. I-TREATMENT I-TREATMENT -Un B-PRESENT_ILLNESS -soldado I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -25 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +Hombre B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -edad I-PRESENT_ILLNESS -y B-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY +45 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +previamente B-PAST_MEDICAL_HISTORY +sano, I-PAST_MEDICAL_HISTORY +derivado B-DERIVED_FROM/TO +desde I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Urgencia I-DERIVED_FROM/TO +al I-DERIVED_FROM/TO +Servicio I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Dermatología I-DERIVED_FROM/TO +del I-DERIVED_FROM/TO +Hospital I-DERIVED_FROM/TO +Barros I-DERIVED_FROM/TO +Luco I-DERIVED_FROM/TO +Trudeau, I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +un I-DERIVED_FROM/TO +cuadro I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +dos I-DERIVED_FROM/TO +semanas I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +evolución, I-DERIVED_FROM/TO +caracterizado I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +aparición I-DERIVED_FROM/TO +aguda I-DERIVED_FROM/TO +y I-DERIVED_FROM/TO +progresiva I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +lesiones I-DERIVED_FROM/TO +cutáneas I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +tronco. I-DERIVED_FROM/TO +En B-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY +clínica I-PAST_MEDICAL_HISTORY +sólo I-PAST_MEDICAL_HISTORY +destacaba I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -fue B-PRESENT_ILLNESS -evacuado I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -ROLE I-PRESENT_ILLNESS -1 I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -base I-PRESENT_ILLNESS -Miguel I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Cervantes I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -posición I-PRESENT_ILLNESS -cercana I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -sufrir I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -picaduras I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -escorpión, I-PRESENT_ILLNESS -localizadas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -pierna I-PRESENT_ILLNESS -derecha, I-PRESENT_ILLNESS -menos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -horas I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -llegada. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -primera I-PRESENT_ILLNESS -estaba I-PRESENT_ILLNESS -localizada I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -anterior I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tercio I-PRESENT_ILLNESS -medio I-PRESENT_ILLNESS -tibial. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -segunda, I-PRESENT_ILLNESS -prácticamente I-PRESENT_ILLNESS -indetectable, I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -hallaba I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -misma I-PRESENT_ILLNESS -altura I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -región I-PRESENT_ILLNESS -posterior. I-PRESENT_ILLNESS -El I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -refirió I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -como I-PRESENT_ILLNESS -única I-PRESENT_ILLNESS -manifestación, I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS -acentuado I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -segunda I-PRESENT_ILLNESS -picadura. I-PRESENT_ILLNESS -Durante B-EXPLORATION +una I-PAST_MEDICAL_HISTORY +erupción I-PAST_MEDICAL_HISTORY +recurrente I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +tronco I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +18 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +edad, I-PAST_MEDICAL_HISTORY +caracterizada I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +pápulas I-PAST_MEDICAL_HISTORY +eritematosas I-PAST_MEDICAL_HISTORY +asintomáticas I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +región I-PAST_MEDICAL_HISTORY +preesternal I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +brazos. I-PAST_MEDICAL_HISTORY +Sin B-FAMILY_HISTORY +antecedentes I-FAMILY_HISTORY +de I-FAMILY_HISTORY +infecciones I-FAMILY_HISTORY +herpéticas I-FAMILY_HISTORY +de I-FAMILY_HISTORY +la I-FAMILY_HISTORY +piel I-FAMILY_HISTORY +o I-FAMILY_HISTORY +genitales, I-FAMILY_HISTORY +ni I-FAMILY_HISTORY +enfermedades I-FAMILY_HISTORY +cutáneas I-FAMILY_HISTORY +familiares. I-FAMILY_HISTORY +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +en I-EXPLORATION +regular I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +afebril I-EXPLORATION +y I-EXPLORATION +presentaba I-EXPLORATION +múltiples I-EXPLORATION +pápulas I-EXPLORATION +y I-EXPLORATION +pústulas I-EXPLORATION +umbilicadas I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +tronco, I-EXPLORATION +confluentes, I-EXPLORATION +con I-EXPLORATION +algunas I-EXPLORATION +lesiones I-EXPLORATION +en I-EXPLORATION +etapa I-EXPLORATION +de I-EXPLORATION +costra. I-EXPLORATION +Sin I-EXPLORATION +lesiones I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -asistencia I-EXPLORATION -inicial, I-EXPLORATION +cara, I-EXPLORATION +genitales I-EXPLORATION +ni I-EXPLORATION +mucosas. I-EXPLORATION +En I-EXPLORATION +las I-EXPLORATION +manos I-EXPLORATION +destacaba I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +pápulas I-EXPLORATION +aplanadas I-EXPLORATION +color I-EXPLORATION +piel I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -paciente I-EXPLORATION -presentó I-EXPLORATION -valores I-EXPLORATION +dorso, I-EXPLORATION +pits I-EXPLORATION +palmares I-EXPLORATION +y I-EXPLORATION +alternancia I-EXPLORATION de I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -(PA) I-EXPLORATION +líneas I-EXPLORATION +rojas I-EXPLORATION +y I-EXPLORATION +blancas I-EXPLORATION +en I-EXPLORATION +las I-EXPLORATION +uñas, I-EXPLORATION +hallazgos I-EXPLORATION +sugerentes I-EXPLORATION de I-EXPLORATION -130/ I-EXPLORATION -60, I-EXPLORATION -una I-EXPLORATION -frecuencia I-EXPLORATION -cardíaca I-EXPLORATION +enfermedad I-EXPLORATION de I-EXPLORATION -62 I-EXPLORATION -latidos I-EXPLORATION -por I-EXPLORATION -minuto, I-EXPLORATION -una I-EXPLORATION -saturación I-EXPLORATION +Darier. I-EXPLORATION +Se I-EXPLORATION +hospitalizó I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +presuntivo I-EXPLORATION de I-EXPLORATION -oxígeno I-EXPLORATION -inicial I-EXPLORATION -del I-EXPLORATION -96% I-EXPLORATION +eccema I-EXPLORATION +herpético I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -temperatura I-EXPLORATION +enfermedad I-EXPLORATION de I-EXPLORATION -36oC. I-EXPLORATION -El I-EXPLORATION -electrocardiograma I-EXPLORATION -era I-EXPLORATION -normal I-EXPLORATION +Darier. I-EXPLORATION +Se I-EXPLORATION +realizaron I-EXPLORATION +exámenes I-EXPLORATION +generales, I-EXPLORATION +cultivo I-EXPLORATION +corriente I-EXPLORATION y I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -objetivaron I-EXPLORATION -otras I-EXPLORATION -manifestaciones I-EXPLORATION -sistémicas. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -el I-TREATMENT +reacción I-EXPLORATION +de I-EXPLORATION +polimerasa I-EXPLORATION +en I-EXPLORATION +cadena I-EXPLORATION +(RPC) I-EXPLORATION +para I-EXPLORATION +virus I-EXPLORATION +herpes I-EXPLORATION +simplex I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +pústulas, I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +de I-EXPLORATION +piel I-EXPLORATION +sugerentes I-EXPLORATION +de I-EXPLORATION +enfermedad I-EXPLORATION +de I-EXPLORATION +Darier. I-EXPLORATION +Empíricamente B-TREATMENT +se I-TREATMENT +indicó I-TREATMENT tratamiento I-TREATMENT con I-TREATMENT -2 I-TREATMENT -gramos I-TREATMENT -de I-TREATMENT -dipirona I-TREATMENT -intravenosa I-TREATMENT +aciclovir I-TREATMENT +oral I-TREATMENT +400 I-TREATMENT +mg I-TREATMENT +5 I-TREATMENT +veces I-TREATMENT +al I-TREATMENT +día I-TREATMENT y I-TREATMENT -la I-TREATMENT -vacuna I-TREATMENT -antitetánica. I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -local I-TREATMENT -incluyó I-TREATMENT -una I-TREATMENT -exhaustiva I-TREATMENT -irrigación I-TREATMENT -con I-TREATMENT -povidona I-TREATMENT -diluida I-TREATMENT -para I-TREATMENT -su I-TREATMENT -limpieza. I-TREATMENT -Tras I-TREATMENT -la I-TREATMENT -aparición I-TREATMENT -de I-TREATMENT -una I-TREATMENT -reacción I-TREATMENT -edematosa I-TREATMENT -localizada I-TREATMENT -en I-TREATMENT -la I-TREATMENT -pierna I-TREATMENT -derecha I-TREATMENT +cloxacilina I-TREATMENT +ev I-TREATMENT +1 I-TREATMENT +gr I-TREATMENT +cada I-TREATMENT +6 I-TREATMENT +hrs, I-TREATMENT +el I-TREATMENT +que I-TREATMENT se I-TREATMENT -administró I-TREATMENT -una I-TREATMENT -dosis I-TREATMENT -única I-TREATMENT -de I-TREATMENT -corticoterapia I-TREATMENT -intravenosa. I-TREATMENT -Durante B-EVOLUTION -el I-EVOLUTION -ingreso I-EVOLUTION -la I-EVOLUTION -PA I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -entre I-EVOLUTION -100 I-EVOLUTION -y I-EVOLUTION -130 I-EVOLUTION -(sistólica) I-EVOLUTION -y I-EVOLUTION -55 I-EVOLUTION -y I-EVOLUTION -70 I-EVOLUTION -(diastólica). I-EVOLUTION -La I-EVOLUTION -temperatura I-EVOLUTION -corporal I-EVOLUTION -nunca I-EVOLUTION -superó I-EVOLUTION -los I-EVOLUTION -36´5oC. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION +mantuvo I-TREATMENT +durante I-TREATMENT +10 I-TREATMENT +días. I-TREATMENT +Entre B-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION +generales I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +un I-EXPLORATION +hemograma I-EXPLORATION +normal, I-EXPLORATION +VHS I-EXPLORATION +29 I-EXPLORATION +mm/h, I-EXPLORATION +PCR I-EXPLORATION +123 I-EXPLORATION +mg/L, I-EXPLORATION +GGT I-EXPLORATION +108 I-EXPLORATION +U/L. I-EXPLORATION +Los I-EXPLORATION +resultados I-EXPLORATION +del I-EXPLORATION +VDRL I-EXPLORATION +y I-EXPLORATION +las I-EXPLORATION +serologías I-EXPLORATION +para I-EXPLORATION +VIH I-EXPLORATION +y I-EXPLORATION +VHB I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +El I-EXPLORATION +cultivo I-EXPLORATION +de I-EXPLORATION +piel I-EXPLORATION +fue I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +Staphylococcus I-EXPLORATION +aureus I-EXPLORATION +resistente I-EXPLORATION +sólo I-EXPLORATION +a I-EXPLORATION +clindamicina I-EXPLORATION +y I-EXPLORATION +eritromicina, I-EXPLORATION +y I-EXPLORATION +la I-EXPLORATION +RPC I-EXPLORATION +en I-EXPLORATION +tiempo I-EXPLORATION +real, I-EXPLORATION +realizada I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +Laboratorio I-EXPLORATION +de I-EXPLORATION +Virología I-EXPLORATION +del I-EXPLORATION +Instituto I-EXPLORATION +de I-EXPLORATION +Ciencias I-EXPLORATION +Biomédicas I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +Facultad I-EXPLORATION +de I-EXPLORATION +Medicina I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +Universidad I-EXPLORATION +de I-EXPLORATION +Chile, I-EXPLORATION +fue I-EXPLORATION +positiva I-EXPLORATION +para I-EXPLORATION +VHS I-EXPLORATION +2. I-EXPLORATION +Los I-EXPLORATION +hallazgos I-EXPLORATION +histopatológicos I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +piel I-EXPLORATION +fueron I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +enfermedad I-EXPLORATION +de I-EXPLORATION +Darier. I-EXPLORATION +El B-EVOLUTION paciente I-EVOLUTION -abandonó I-EVOLUTION -el I-EVOLUTION -ROLE I-EVOLUTION -1 I-EVOLUTION -24 I-EVOLUTION -horas I-EVOLUTION -después I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -ingreso I-EVOLUTION -sin I-EVOLUTION -requerir I-EVOLUTION -ningún I-EVOLUTION -tipo I-EVOLUTION +respondió I-EVOLUTION +rápidamente I-EVOLUTION +al I-EVOLUTION +tratamiento, I-EVOLUTION +siendo I-EVOLUTION +dado I-EVOLUTION de I-EVOLUTION -medicación I-EVOLUTION -(sólo I-EVOLUTION -analgesia I-EVOLUTION -convencional I-EVOLUTION +alta I-EVOLUTION a I-EVOLUTION -demanda). I-EVOLUTION -Las I-EVOLUTION -heridas I-EVOLUTION -cicatrizaron I-EVOLUTION -sin I-EVOLUTION -incidencias. I-EVOLUTION - I-EVOLUTION -El I-EVOLUTION -ejemplar I-EVOLUTION -fue I-EVOLUTION -capturado I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -mismo I-EVOLUTION -lugar I-EVOLUTION -donde I-EVOLUTION -se I-EVOLUTION -produjo I-EVOLUTION -la I-EVOLUTION -picadura. I-EVOLUTION -Se I-EVOLUTION -trataba I-EVOLUTION -de I-EVOLUTION -un I-EVOLUTION -escorpión I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -familia I-EVOLUTION -Buthidae, I-EVOLUTION -muy I-EVOLUTION -común I-EVOLUTION -en I-EVOLUTION -Líbano, I-EVOLUTION -aunque I-EVOLUTION -no I-EVOLUTION -se I-EVOLUTION -pudo I-EVOLUTION -precisar I-EVOLUTION -la I-EVOLUTION -especie. I-EVOLUTION +los I-EVOLUTION +10 I-EVOLUTION +días. I-EVOLUTION I-EVOLUTION Un B-PRESENT_ILLNESS @@ -266002,7397 +153926,7355 @@ por I-TREATMENT hora. I-TREATMENT I-TREATMENT -Paciente B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -42 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +64 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS sin B-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -conocidas I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY personales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -desprendimiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -retina I-PAST_MEDICAL_HISTORY -bilateral I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -paladar I-PAST_MEDICAL_HISTORY -hendido. I-PAST_MEDICAL_HISTORY -Valorado B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -consultas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Traumatología I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -traumatismo I-PRESENT_ILLNESS -casual I-PRESENT_ILLNESS -sobre I-PRESENT_ILLNESS -dorso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -mano I-PRESENT_ILLNESS -derecha. I-PRESENT_ILLNESS -En B-EXPLORATION +interés, I-PAST_MEDICAL_HISTORY +que B-DERIVED_FROM/TO +es I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +la I-DERIVED_FROM/TO +consulta I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +Dermatología I-DERIVED_FROM/TO +por I-DERIVED_FROM/TO +cuadro I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +unos I-DERIVED_FROM/TO +45 I-DERIVED_FROM/TO +días I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +evolución I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +nódulos I-DERIVED_FROM/TO +cutáneos I-DERIVED_FROM/TO +recidivantes, I-DERIVED_FROM/TO +indoloros I-DERIVED_FROM/TO +e I-DERIVED_FROM/TO +indurados I-DERIVED_FROM/TO +localizados I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +miembros I-DERIVED_FROM/TO +inferiores. I-DERIVED_FROM/TO +No B-EXPLORATION +impresionaba I-EXPLORATION +de I-EXPLORATION +enfermedad, I-EXPLORATION +ni I-EXPLORATION +refería I-EXPLORATION +pérdida I-EXPLORATION +de I-EXPLORATION +peso, I-EXPLORATION +fiebre, I-EXPLORATION +ni I-EXPLORATION +síndrome I-EXPLORATION +constitucional. I-EXPLORATION +En I-EXPLORATION la I-EXPLORATION exploración I-EXPLORATION -se I-EXPLORATION -observa I-EXPLORATION -eritema I-EXPLORATION -y I-EXPLORATION -tumefacción I-EXPLORATION +física I-EXPLORATION +destacaban I-EXPLORATION +varias I-EXPLORATION +lesiones I-EXPLORATION en I-EXPLORATION -dorso I-EXPLORATION -de I-EXPLORATION -mano I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION +forma I-EXPLORATION de I-EXPLORATION -cabeza I-EXPLORATION +placas I-EXPLORATION +nodulares I-EXPLORATION +subcutáneas I-EXPLORATION de I-EXPLORATION -4o I-EXPLORATION -metacarpiano, I-EXPLORATION -dolor I-EXPLORATION -leve I-EXPLORATION +1 I-EXPLORATION a I-EXPLORATION -la I-EXPLORATION -palpación I-EXPLORATION +3 I-EXPLORATION +cm. I-EXPLORATION de I-EXPLORATION -estructuras I-EXPLORATION -óseas I-EXPLORATION +diámetro, I-EXPLORATION +eritemato-violáceas, I-EXPLORATION +simétricas, I-EXPLORATION +duras I-EXPLORATION +e I-EXPLORATION +indoloras, I-EXPLORATION +localizadas I-EXPLORATION +en I-EXPLORATION +ambas I-EXPLORATION +caras I-EXPLORATION +internas I-EXPLORATION +de I-EXPLORATION +muslos, I-EXPLORATION +pantorrilla, I-EXPLORATION +abdomen I-EXPLORATION y I-EXPLORATION -una I-EXPLORATION -marcada I-EXPLORATION -limitación I-EXPLORATION -para I-EXPLORATION -la I-EXPLORATION -flexión I-EXPLORATION -completa I-EXPLORATION +hombro I-EXPLORATION +izquierdo. I-EXPLORATION +No I-EXPLORATION +presentaba I-EXPLORATION +adenopatías I-EXPLORATION +ni I-EXPLORATION +visceromegalias I-EXPLORATION +y I-EXPLORATION +se I-EXPLORATION +apreciaban I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -articulación I-EXPLORATION -metacarpofalángica I-EXPLORATION +tromboflebitis I-EXPLORATION +superficial I-EXPLORATION +en I-EXPLORATION +miembro I-EXPLORATION +inferior I-EXPLORATION +derecho. I-EXPLORATION +En I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +se I-EXPLORATION +objetivó: I-EXPLORATION +leucocitos I-EXPLORATION +12, I-EXPLORATION +3 I-EXPLORATION +x I-EXPLORATION +109/L I-EXPLORATION +(neutrófilos I-EXPLORATION +6, I-EXPLORATION +8, I-EXPLORATION +linfocitos I-EXPLORATION +1, I-EXPLORATION +1, I-EXPLORATION +monocitos I-EXPLORATION +4.3, I-EXPLORATION +eosinófilos I-EXPLORATION +0, I-EXPLORATION +1), I-EXPLORATION +Hb I-EXPLORATION +120 I-EXPLORATION +g/L, I-EXPLORATION +VCM I-EXPLORATION +109, I-EXPLORATION +8 I-EXPLORATION +fL; I-EXPLORATION +Hto. I-EXPLORATION +32%; I-EXPLORATION +plaquetas I-EXPLORATION +133 I-EXPLORATION +x I-EXPLORATION +109/L. I-EXPLORATION +Se I-EXPLORATION +observaban I-EXPLORATION +algunos I-EXPLORATION +granulocitos I-EXPLORATION de I-EXPLORATION -3o I-EXPLORATION +aspecto I-EXPLORATION +pelgueroide I-EXPLORATION +(núcleo I-EXPLORATION +no I-EXPLORATION +segmentado I-EXPLORATION +o I-EXPLORATION +hiposegmentado) I-EXPLORATION y I-EXPLORATION -4o I-EXPLORATION -dedos. I-EXPLORATION -El B-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -manifiesta I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -dicha I-PAST_MEDICAL_HISTORY -limitación I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -anterior I-PAST_MEDICAL_HISTORY -al I-PAST_MEDICAL_HISTORY -traumatismo I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -varios I-PAST_MEDICAL_HISTORY -años. I-PAST_MEDICAL_HISTORY -Presenta B-EXPLORATION -similar I-EXPLORATION -limitación I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -mano I-EXPLORATION -contralateral I-EXPLORATION -que I-EXPLORATION -afecta I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -mismos I-EXPLORATION -dedos, I-EXPLORATION -3o I-EXPLORATION +anisocitosis I-EXPLORATION +discreta. I-EXPLORATION +Reticulocitos: I-EXPLORATION +2, I-EXPLORATION +4% I-EXPLORATION +(totales I-EXPLORATION +86, I-EXPLORATION +4 I-EXPLORATION +x I-EXPLORATION +109/L), I-EXPLORATION +VSG I-EXPLORATION +60 I-EXPLORATION +mm/h; I-EXPLORATION +inmunoglobulinas, I-EXPLORATION +proteinograma, I-EXPLORATION +pruebas I-EXPLORATION +de I-EXPLORATION +hemostasia, I-EXPLORATION +orina I-EXPLORATION y I-EXPLORATION -4o. I-EXPLORATION - I-EXPLORATION +sedimento, I-EXPLORATION +estudio I-EXPLORATION +del I-EXPLORATION +hierro, I-EXPLORATION +vitamina I-EXPLORATION +B12 I-EXPLORATION +y I-EXPLORATION +ácido I-EXPLORATION +fólico, I-EXPLORATION +normales. I-EXPLORATION Se I-EXPLORATION -solicita I-EXPLORATION +practicó I-EXPLORATION +Eco-doppler I-EXPLORATION +de I-EXPLORATION +miembros I-EXPLORATION +inferiores, I-EXPLORATION +demostrándose I-EXPLORATION una I-EXPLORATION -radiografía I-EXPLORATION -simple I-EXPLORATION +tromboflebitis I-EXPLORATION +superficial I-EXPLORATION de I-EXPLORATION -ambas I-EXPLORATION -manos, I-EXPLORATION -donde I-EXPLORATION +safena I-EXPLORATION +interna I-EXPLORATION +del I-EXPLORATION +miembro I-EXPLORATION +inferior I-EXPLORATION +derecho I-EXPLORATION +con I-EXPLORATION +trombosis I-EXPLORATION +de I-EXPLORATION +dicha I-EXPLORATION +vena I-EXPLORATION +e I-EXPLORATION +importante I-EXPLORATION +componente I-EXPLORATION +edematoso I-EXPLORATION +del I-EXPLORATION +tejido I-EXPLORATION +graso I-EXPLORATION +circundante, I-EXPLORATION +sin I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +trombosis I-EXPLORATION +venosa I-EXPLORATION +profunda. I-EXPLORATION +En I-EXPLORATION +varios I-EXPLORATION +hemogramas I-EXPLORATION +posteriores I-EXPLORATION se I-EXPLORATION -objetiva I-EXPLORATION +mantuvo I-EXPLORATION +significativamente I-EXPLORATION +elevada I-EXPLORATION la I-EXPLORATION -ausencia I-EXPLORATION +cifra I-EXPLORATION de I-EXPLORATION -lesión I-EXPLORATION -traumática I-EXPLORATION -ósea I-EXPLORATION +monocitos I-EXPLORATION en I-EXPLORATION -zona I-EXPLORATION +sangre. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +practicó I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION de I-EXPLORATION -contusión, I-EXPLORATION -y I-EXPLORATION -como I-EXPLORATION -hallazgo I-EXPLORATION -radiológico, I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +cutánea I-EXPLORATION +que I-EXPLORATION +demostró I-EXPLORATION la I-EXPLORATION presencia I-EXPLORATION -de I-EXPLORATION -aplanamiento I-EXPLORATION -de I-EXPLORATION -las I-EXPLORATION -cabezas I-EXPLORATION -metacarpianas I-EXPLORATION -3a I-EXPLORATION -y I-EXPLORATION -4a I-EXPLORATION en I-EXPLORATION -ambas I-EXPLORATION -manos, I-EXPLORATION +tejido I-EXPLORATION +celular I-EXPLORATION +subcutáneo I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +paniculitis I-EXPLORATION +granulomatosa I-EXPLORATION +panlobular I-EXPLORATION con I-EXPLORATION -lesión I-EXPLORATION -espejo I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -base I-EXPLORATION +necrosis I-EXPLORATION +lobulillar I-EXPLORATION +tipo I-EXPLORATION +eritema I-EXPLORATION +indurado I-EXPLORATION de I-EXPLORATION -sus I-EXPLORATION -falanges I-EXPLORATION -correspondientes, I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -da I-EXPLORATION -un I-EXPLORATION -aspecto I-EXPLORATION -«cuadrado» I-EXPLORATION +Bazin I-EXPLORATION +o I-EXPLORATION +vasculitis I-EXPLORATION +nodular, I-EXPLORATION +asociada I-EXPLORATION a I-EXPLORATION -la I-EXPLORATION -articulación. I-EXPLORATION - I-EXPLORATION -Se B-TREATMENT -pauta I-TREATMENT -tratamiento I-TREATMENT -para I-TREATMENT -la I-TREATMENT -contusión I-TREATMENT -(reposo, I-TREATMENT -crioterapia I-TREATMENT -y I-TREATMENT -toma I-TREATMENT -de I-TREATMENT -AINEs) I-TREATMENT -y I-TREATMENT -se I-TREATMENT -le I-TREATMENT -cita I-TREATMENT -en I-TREATMENT -dos I-TREATMENT -semanas I-TREATMENT -para I-TREATMENT -una I-TREATMENT -exploración I-TREATMENT -funcional I-TREATMENT -no I-TREATMENT -alterada I-TREATMENT -por I-TREATMENT -el I-TREATMENT -dolor. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -las I-EVOLUTION -dos I-EVOLUTION -semanas, I-EVOLUTION -el I-EVOLUTION -paciente I-EVOLUTION -refiere I-EVOLUTION -mejoría I-EVOLUTION -completa I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -proceso I-EVOLUTION -traumático. I-EVOLUTION -Se I-EVOLUTION -observa I-EVOLUTION -disminución I-EVOLUTION -del I-EVOLUTION -arco I-EVOLUTION -de I-EVOLUTION -movilidad I-EVOLUTION -metacarpofalángico I-EVOLUTION -en I-EVOLUTION -ambas I-EVOLUTION -manos I-EVOLUTION -(valores I-EVOLUTION -normales: I-EVOLUTION -extensión I-EVOLUTION -0-20o I-EVOLUTION -y I-EVOLUTION -flexión I-EVOLUTION -0-90o) I-EVOLUTION -consistente I-EVOLUTION -en I-EVOLUTION -pérdida I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -mano I-EVOLUTION -derecha I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -últimos I-EVOLUTION -30o I-EVOLUTION -de I-EVOLUTION -flexión I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -3o I-EVOLUTION -dedo I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -últimos I-EVOLUTION -25o I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -4o. I-EVOLUTION -En I-EVOLUTION -la I-EVOLUTION -mano I-EVOLUTION -izquierda I-EVOLUTION -tan I-EVOLUTION -solo I-EVOLUTION -se I-EVOLUTION -aprecia I-EVOLUTION -la I-EVOLUTION -pérdida I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -últimos I-EVOLUTION -20o I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -flexión I-EVOLUTION -del I-EVOLUTION -3o I-EVOLUTION -y I-EVOLUTION -4o I-EVOLUTION -dedos I-EVOLUTION -(coincidente I-EVOLUTION -con I-EVOLUTION -una I-EVOLUTION -menor I-EVOLUTION -afectación I-EVOLUTION -radiológica I-EVOLUTION -en I-EVOLUTION -esa I-EVOLUTION -mano). I-EVOLUTION -Pese I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -afectación I-EVOLUTION -radiológica I-EVOLUTION -de I-EVOLUTION -más I-EVOLUTION -articulaciones, I-EVOLUTION -no I-EVOLUTION -objetivamos I-EVOLUTION -déficit I-EVOLUTION -de I-EVOLUTION -movilidad I-EVOLUTION -en I-EVOLUTION -ninguna I-EVOLUTION -otra. I-EVOLUTION - I-EVOLUTION -No I-EVOLUTION -tiene I-EVOLUTION -dolor I-EVOLUTION -actualmente, I-EVOLUTION -ni I-EVOLUTION -lo I-EVOLUTION -ha I-EVOLUTION -sufrido I-EVOLUTION -en I-EVOLUTION -el I-EVOLUTION -pasado, I-EVOLUTION -siendo I-EVOLUTION -su I-EVOLUTION -queja I-EVOLUTION -principal I-EVOLUTION -la I-EVOLUTION -limitación I-EVOLUTION -que I-EVOLUTION -presenta I-EVOLUTION -en I-EVOLUTION -actividades I-EVOLUTION -que I-EVOLUTION -requieren I-EVOLUTION -formar I-EVOLUTION -un I-EVOLUTION -puño I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -mano. I-EVOLUTION - I-EVOLUTION -Diagnóstico: I-EVOLUTION -enfermedad I-EVOLUTION -de I-EVOLUTION -dieterich I-EVOLUTION - I-EVOLUTION - -Un B-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -no B-PAST_MEDICAL_HISTORY -fumador, I-PAST_MEDICAL_HISTORY -originario I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Perú, I-PAST_MEDICAL_HISTORY -residente I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -España I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -últimos I-PAST_MEDICAL_HISTORY -8 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -médicos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -presentaba B-PRESENT_ILLNESS -2 I-PRESENT_ILLNESS -semanas I-PRESENT_ILLNESS -antes I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -ingreso I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -Servicio I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -cuadro I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tumefacción I-PRESENT_ILLNESS -dolorosa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -color I-PRESENT_ILLNESS -violáceo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -dorso I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -miembro I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -progresó I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cara I-PRESENT_ILLNESS -anterior I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -pierna I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -traumatismo I-PRESENT_ILLNESS -mínimo I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -zona. I-PRESENT_ILLNESS -La I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -mejoró I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -pesar I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -antibiótico I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -antiinflamatorio. I-PRESENT_ILLNESS -Una I-PRESENT_ILLNESS -semana I-PRESENT_ILLNESS -después I-PRESENT_ILLNESS -comenzó I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -mismos I-PRESENT_ILLNESS -síntomas I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -miembro I-PRESENT_ILLNESS -inferior I-PRESENT_ILLNESS -derecho, I-PRESENT_ILLNESS -añadiéndose I-PRESENT_ILLNESS -fiebre I-PRESENT_ILLNESS -termometrada I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -39oC. I-PRESENT_ILLNESS -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -el I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -encontraba I-EXPLORATION -afebril, I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -palpaban I-EXPLORATION -adenopatías, I-EXPLORATION -la I-EXPLORATION -auscultación I-EXPLORATION -pulmonar I-EXPLORATION -y I-EXPLORATION -cardíaca I-EXPLORATION -eran I-EXPLORATION -normales, I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -abdomen I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -apreciaban I-EXPLORATION -datos I-EXPLORATION -de I-EXPLORATION -interés. I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION +trombosis I-EXPLORATION +venosa I-EXPLORATION +organizada. I-EXPLORATION +Se I-EXPLORATION +practicó I-EXPLORATION +una I-EXPLORATION +batería I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -inferiores I-EXPLORATION -destacaba I-EXPLORATION -un I-EXPLORATION -eritema I-EXPLORATION +pruebas I-EXPLORATION +diagnósticas I-EXPLORATION +para I-EXPLORATION +descartar I-EXPLORATION +causas I-EXPLORATION +Infecciosas I-EXPLORATION +(BK, I-EXPLORATION +cultivo I-EXPLORATION y I-EXPLORATION -edema I-EXPLORATION -de I-EXPLORATION -borde I-EXPLORATION -no I-EXPLORATION -definido I-EXPLORATION -en I-EXPLORATION -cara I-EXPLORATION -anterior I-EXPLORATION +análisis I-EXPLORATION +por I-EXPLORATION +PCR I-EXPLORATION +para I-EXPLORATION +Mycobacterium I-EXPLORATION +tuberculosis: I-EXPLORATION +negativos; I-EXPLORATION +serologías I-EXPLORATION +para I-EXPLORATION +infección I-EXPLORATION +reciente I-EXPLORATION +por I-EXPLORATION +Toxoplasma, I-EXPLORATION +Legionela, I-EXPLORATION +Mycoplasma I-EXPLORATION +pneumoniae I-EXPLORATION y I-EXPLORATION -lateral I-EXPLORATION -de I-EXPLORATION -ambos I-EXPLORATION -miembros I-EXPLORATION -hasta I-EXPLORATION -las I-EXPLORATION -rodillas, I-EXPLORATION -más I-EXPLORATION -evidente I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -izquierdo, I-EXPLORATION -doloroso I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -presión I-EXPLORATION +para I-EXPLORATION +fiebre I-EXPLORATION +Q: I-EXPLORATION +negativas; I-EXPLORATION +ASLO, I-EXPLORATION +negativo; I-EXPLORATION +Singer I-EXPLORATION +Plotz I-EXPLORATION y I-EXPLORATION -sin I-EXPLORATION -inflamación I-EXPLORATION -articular. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION +VDRL, I-EXPLORATION +negativos), I-EXPLORATION +causas I-EXPLORATION +neoplásicas I-EXPLORATION +(alfa-feto-proteína, I-EXPLORATION +antígeno I-EXPLORATION +carcinoembrionario, I-EXPLORATION +b2-microglobulina, I-EXPLORATION +Ca-19.9, I-EXPLORATION +PSA: I-EXPLORATION +normales; I-EXPLORATION +TAC I-EXPLORATION +abdominopélvico: I-EXPLORATION +moderado I-EXPLORATION +aumento I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -analítica I-EXPLORATION -se I-EXPLORATION -observaba I-EXPLORATION -una I-EXPLORATION -leucocitosis I-EXPLORATION +densidad I-EXPLORATION de I-EXPLORATION -21.000 I-EXPLORATION -/ I-EXPLORATION -ml I-EXPLORATION +la I-EXPLORATION +grasa I-EXPLORATION +del I-EXPLORATION +mesenterio I-EXPLORATION +en I-EXPLORATION +flanco I-EXPLORATION +derecho I-EXPLORATION +que I-EXPLORATION +impronta I-EXPLORATION +asas I-EXPLORATION +intestinales, I-EXPLORATION +en I-EXPLORATION +probable I-EXPLORATION +relación I-EXPLORATION con I-EXPLORATION -neutrofilia I-EXPLORATION +paniculitis) I-EXPLORATION y I-EXPLORATION -linfopenia, I-EXPLORATION -velocidad I-EXPLORATION +enfermedades I-EXPLORATION +sistémicas I-EXPLORATION +(factor I-EXPLORATION +reumatoideo I-EXPLORATION +y I-EXPLORATION +anticuerpos I-EXPLORATION +antinúcleo I-EXPLORATION +negativos; I-EXPLORATION +niveles I-EXPLORATION +normales I-EXPLORATION de I-EXPLORATION -sedimentación: I-EXPLORATION -67 I-EXPLORATION -mm I-EXPLORATION -/ I-EXPLORATION -h, I-EXPLORATION +C3 I-EXPLORATION +y I-EXPLORATION +C4, I-EXPLORATION proteína I-EXPLORATION C I-EXPLORATION -reactiva: I-EXPLORATION -24, I-EXPLORATION -48 I-EXPLORATION -mg I-EXPLORATION -/ I-EXPLORATION -dl I-EXPLORATION -y I-EXPLORATION -aumento I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -reactantes I-EXPLORATION +reactiva, I-EXPLORATION +enzima I-EXPLORATION +convertidor I-EXPLORATION de I-EXPLORATION -fase I-EXPLORATION -aguda. I-EXPLORATION +angiotensina I-EXPLORATION +y I-EXPLORATION +alfa-1 I-EXPLORATION +antitripsina). I-EXPLORATION La I-EXPLORATION -radiografía I-EXPLORATION -postero-anterior I-EXPLORATION -de I-EXPLORATION -tórax I-EXPLORATION -revelaba I-EXPLORATION -una I-EXPLORATION -lesión I-EXPLORATION -nodular I-EXPLORATION -de I-EXPLORATION -2, I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION +tinción I-EXPLORATION de I-EXPLORATION -diámetro I-EXPLORATION +Ziehl-Neelsen I-EXPLORATION en I-EXPLORATION -hilio I-EXPLORATION -izquierdo, I-EXPLORATION -sugestiva I-EXPLORATION -de I-EXPLORATION -adenopatía I-EXPLORATION -hiliar. I-EXPLORATION -Los I-EXPLORATION -hemocultivos I-EXPLORATION -y I-EXPLORATION -urocultivos I-EXPLORATION -fueron I-EXPLORATION -negativos, I-EXPLORATION la I-EXPLORATION -serología I-EXPLORATION -a I-EXPLORATION -virus I-EXPLORATION +muestra I-EXPLORATION de I-EXPLORATION -Hepatitis I-EXPLORATION -A, I-EXPLORATION -B I-EXPLORATION -y I-EXPLORATION -C, I-EXPLORATION -borrelia, I-EXPLORATION -rickettsia I-EXPLORATION -conorii, I-EXPLORATION -coxiella, I-EXPLORATION -virus I-EXPLORATION +biopsia I-EXPLORATION +cutánea I-EXPLORATION +(pues I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +diferencial I-EXPLORATION de I-EXPLORATION -Epstein I-EXPLORATION -Barr, I-EXPLORATION -y I-EXPLORATION -citomegalovirus I-EXPLORATION -no I-EXPLORATION -aportaba I-EXPLORATION -datos I-EXPLORATION -concordantes I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +microscópica I-EXPLORATION +observada I-EXPLORATION +debe I-EXPLORATION +establecerse I-EXPLORATION +principalmente I-EXPLORATION con I-EXPLORATION +una I-EXPLORATION infección I-EXPLORATION -aguda. I-EXPLORATION -Los I-EXPLORATION -BAAR I-EXPLORATION -y I-EXPLORATION -cultivos I-EXPLORATION -de I-EXPLORATION -esputo I-EXPLORATION -en I-EXPLORATION -medios I-EXPLORATION -habituales I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -Mantoux I-EXPLORATION -fueron I-EXPLORATION -negativos. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -TC I-EXPLORATION -toraco-abdomino-pélvico I-EXPLORATION -en I-EXPLORATION +cutánea I-EXPLORATION +por I-EXPLORATION +micobacterias) I-EXPLORATION +fue I-EXPLORATION +así I-EXPLORATION +mismo I-EXPLORATION +negativa. I-EXPLORATION + I-EXPLORATION +La B-DERIVED_FROM/TO +presencia I-DERIVED_FROM/TO +en I-DERIVED_FROM/TO +sangre I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +formas I-DERIVED_FROM/TO +granulocíticas I-DERIVED_FROM/TO +displásicas I-DERIVED_FROM/TO +motivó I-DERIVED_FROM/TO +que I-DERIVED_FROM/TO +el I-DERIVED_FROM/TO +paciente I-DERIVED_FROM/TO +fuera I-DERIVED_FROM/TO +remitido I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +nuestro I-DERIVED_FROM/TO +Servicio, I-DERIVED_FROM/TO +en B-EXPLORATION el I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -pusieron I-EXPLORATION +realizó I-EXPLORATION +un I-EXPLORATION +aspirado I-EXPLORATION +medular, I-EXPLORATION +observándose I-EXPLORATION +una I-EXPLORATION +médula I-EXPLORATION +ósea I-EXPLORATION +hipercelular I-EXPLORATION +con I-EXPLORATION +megacariocitos I-EXPLORATION +conservados I-EXPLORATION +y I-EXPLORATION +algún I-EXPLORATION +micromegacariocito I-EXPLORATION +ocasionalmente, I-EXPLORATION +destacando I-EXPLORATION +una I-EXPLORATION +hiperplasia I-EXPLORATION de I-EXPLORATION -manifiesto I-EXPLORATION -adenopatías I-EXPLORATION -mediastínicas I-EXPLORATION +la I-EXPLORATION +serie I-EXPLORATION +monocítica I-EXPLORATION +(21% I-EXPLORATION de I-EXPLORATION -tamaño I-EXPLORATION -significativo I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -paratraqueal I-EXPLORATION -derecho, I-EXPLORATION -pretraqueal I-EXPLORATION +la I-EXPLORATION +celularidad I-EXPLORATION +medular I-EXPLORATION +global, I-EXPLORATION +entre I-EXPLORATION +promonocitos I-EXPLORATION y I-EXPLORATION -perivascular I-EXPLORATION +monocitos) I-EXPLORATION e I-EXPLORATION -hiliar I-EXPLORATION -bilateral I-EXPLORATION +hipoplasia I-EXPLORATION +moderada I-EXPLORATION de I-EXPLORATION -naturaleza I-EXPLORATION -indeterminada. I-EXPLORATION -Adyacente I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -cúpula I-EXPLORATION -diafragmática I-EXPLORATION +serie I-EXPLORATION +roja I-EXPLORATION +(13%) I-EXPLORATION +con I-EXPLORATION +displasia I-EXPLORATION +leve I-EXPLORATION +(puentes I-EXPLORATION +intercitoplasmáticos I-EXPLORATION y I-EXPLORATION -a I-EXPLORATION -nivel I-EXPLORATION -de I-EXPLORATION -los I-EXPLORATION -segmentos I-EXPLORATION -basales I-EXPLORATION -del I-EXPLORATION -LII, I-EXPLORATION -se I-EXPLORATION -observó I-EXPLORATION +algunas I-EXPLORATION +formas I-EXPLORATION +gigantes), I-EXPLORATION +y I-EXPLORATION +sobre I-EXPLORATION +todo I-EXPLORATION una I-EXPLORATION -imagen I-EXPLORATION -pseudonodular I-EXPLORATION -de I-EXPLORATION -unos I-EXPLORATION -2, I-EXPLORATION -2 I-EXPLORATION -cm I-EXPLORATION -de I-EXPLORATION -diámetro I-EXPLORATION -anteroposterior, I-EXPLORATION +disgranulopoyesis I-EXPLORATION +significativa I-EXPLORATION +(citoplasmas I-EXPLORATION +francamente I-EXPLORATION +agranulares, I-EXPLORATION +frecuentes I-EXPLORATION +elementos I-EXPLORATION de I-EXPLORATION aspecto I-EXPLORATION -inflamatorio, I-EXPLORATION -sin I-EXPLORATION -poderse I-EXPLORATION -descartar I-EXPLORATION -otras I-EXPLORATION -posibilidades. I-EXPLORATION -Ambas I-EXPLORATION -cisuras I-EXPLORATION -mayores I-EXPLORATION -presentaban I-EXPLORATION -aspecto I-EXPLORATION -engrosado I-EXPLORATION -con I-EXPLORATION -pequeña I-EXPLORATION -cuña I-EXPLORATION -de I-EXPLORATION -líquido I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -lado I-EXPLORATION -derecho. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -fibroboncoscopia I-EXPLORATION -con I-EXPLORATION -toma I-EXPLORATION -de I-EXPLORATION -broncoaspirado I-EXPLORATION -(BAS), I-EXPLORATION -lavado I-EXPLORATION -broncoalveolar I-EXPLORATION -(LBA), I-EXPLORATION -biopsia I-EXPLORATION -bronquial I-EXPLORATION +pelgueroide, I-EXPLORATION +asincronismo I-EXPLORATION +madurativo I-EXPLORATION +núcleo-citoplasmático I-EXPLORATION y I-EXPLORATION -transbronquial. I-EXPLORATION -El I-EXPLORATION -LBA I-EXPLORATION -revelo I-EXPLORATION -una I-EXPLORATION -celularidad I-EXPLORATION -de I-EXPLORATION predominio I-EXPLORATION -linfocitario I-EXPLORATION -con I-EXPLORATION -un I-EXPLORATION -cociente I-EXPLORATION -CD4/CD8 I-EXPLORATION -> I-EXPLORATION -3, I-EXPLORATION -5 I-EXPLORATION -y I-EXPLORATION +de I-EXPLORATION +formas I-EXPLORATION +madurativas I-EXPLORATION +intermedias); I-EXPLORATION la I-EXPLORATION -biopsia I-EXPLORATION -bronquial I-EXPLORATION -y I-EXPLORATION -transbronquial I-EXPLORATION -reveló I-EXPLORATION +blastosis I-EXPLORATION +constituía I-EXPLORATION +sólo I-EXPLORATION un I-EXPLORATION -epitelio I-EXPLORATION -respiratorio I-EXPLORATION -maduro, I-EXPLORATION -con I-EXPLORATION -glándulas I-EXPLORATION -mucosas I-EXPLORATION -y I-EXPLORATION -acúmulos I-EXPLORATION -linfoides I-EXPLORATION -aislados I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -lámina I-EXPLORATION -propia. I-EXPLORATION -No I-EXPLORATION +3%. I-EXPLORATION +El I-EXPLORATION +cariotipo I-EXPLORATION +fue I-EXPLORATION +normal, I-EXPLORATION +46XY. I-EXPLORATION +Con I-EXPLORATION +todo I-EXPLORATION +ello I-EXPLORATION +el I-EXPLORATION +enfermo I-EXPLORATION se I-EXPLORATION -encontraron I-EXPLORATION -elementos I-EXPLORATION -granulomatosos I-EXPLORATION -ni I-EXPLORATION -sugerentes I-EXPLORATION +diagnosticó I-EXPLORATION de I-EXPLORATION -malignidad. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -mediastinoscopia I-EXPLORATION +LMMC I-EXPLORATION con I-EXPLORATION -biopsia I-EXPLORATION -de I-EXPLORATION -una I-EXPLORATION -adenopatía I-EXPLORATION -paratraqueal I-EXPLORATION -derecha I-EXPLORATION -que I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -glanglio I-EXPLORATION -linfático I-EXPLORATION -ocupado I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -mayor I-EXPLORATION -parte I-EXPLORATION -por I-EXPLORATION -granulomas I-EXPLORATION -de I-EXPLORATION +afectación I-EXPLORATION +cutánea I-EXPLORATION +inespecífica I-EXPLORATION tipo I-EXPLORATION -sarcoideo, I-EXPLORATION -pequeños I-EXPLORATION -y I-EXPLORATION -coalescentes, I-EXPLORATION -con I-EXPLORATION -densa I-EXPLORATION -corona I-EXPLORATION -linfocitaria I-EXPLORATION -y I-EXPLORATION +paniculitis I-EXPLORATION +lobulillar. I-EXPLORATION +El B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +tratado I-TREATMENT +con I-TREATMENT +corticoides I-TREATMENT +orales I-TREATMENT +(prednisona I-TREATMENT +30 I-TREATMENT +mg/día, I-TREATMENT +con I-TREATMENT +pauta I-TREATMENT +de I-TREATMENT +descenso I-TREATMENT +semanal), I-TREATMENT +resolviéndose I-TREATMENT +las I-TREATMENT +lesiones I-TREATMENT +cutáneas I-TREATMENT +pocos I-TREATMENT +días I-TREATMENT +después I-TREATMENT +de I-TREATMENT +comenzar I-TREATMENT +este I-TREATMENT +tratamiento. I-TREATMENT +En B-EVOLUTION +la I-EVOLUTION +actualidad, I-EVOLUTION +tres I-EVOLUTION +años I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +diagnóstico I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +tratamiento I-EVOLUTION +desde I-EVOLUTION +entonces, I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +asintomático, I-EVOLUTION +con I-EVOLUTION +anemia I-EVOLUTION +leve, I-EVOLUTION +VCM I-EVOLUTION +110.9 I-EVOLUTION +fL, I-EVOLUTION +plaquetas I-EVOLUTION +143 I-EVOLUTION +x I-EVOLUTION +109/L, I-EVOLUTION +y I-EVOLUTION +monocitosis I-EVOLUTION +de I-EVOLUTION +2, I-EVOLUTION +3 I-EVOLUTION +x I-EVOLUTION +109/L I-EVOLUTION +en I-EVOLUTION +sangre, I-EVOLUTION +haciéndose I-EVOLUTION +controles I-EVOLUTION +trimestrales; I-EVOLUTION +en I-EVOLUTION +médula I-EVOLUTION +ósea I-EVOLUTION +persiste I-EVOLUTION +la I-EVOLUTION +displasia I-EVOLUTION +trilineal I-EVOLUTION +con I-EVOLUTION +una I-EVOLUTION +blastosis I-EVOLUTION +del I-EVOLUTION +6% I-EVOLUTION +y I-EVOLUTION +un I-EVOLUTION +componente I-EVOLUTION +monocítico I-EVOLUTION +del I-EVOLUTION +25%. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +11 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acude I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +contusión I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +parte I-PRESENT_ILLNESS +lateral I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +pie I-PRESENT_ILLNESS +derecho. I-PRESENT_ILLNESS +Durante B-EXPLORATION +la I-EXPLORATION +exploración, I-EXPLORATION +presenta I-EXPLORATION +cierta I-EXPLORATION +tumefacción I-EXPLORATION sin I-EXPLORATION -necrosis I-EXPLORATION -central, I-EXPLORATION -no I-EXPLORATION -objetivándose I-EXPLORATION -estructuras I-EXPLORATION -bacilares, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -linfadenitis I-EXPLORATION -granulomatosa, I-EXPLORATION -sarcoidosis. I-EXPLORATION -Se I-EXPLORATION -tomó I-EXPLORATION -una I-EXPLORATION -muestra I-EXPLORATION -de I-EXPLORATION -piel, I-EXPLORATION -cuya I-EXPLORATION -histología I-EXPLORATION -mostró I-EXPLORATION -un I-EXPLORATION -nódulo I-EXPLORATION -inflamatorio I-EXPLORATION -en I-EXPLORATION -tejido I-EXPLORATION -celular I-EXPLORATION -subcutáneo I-EXPLORATION -constituido I-EXPLORATION -por I-EXPLORATION -histiocitos, I-EXPLORATION -algunos I-EXPLORATION -con I-EXPLORATION -aspecto I-EXPLORATION -epitelioide, I-EXPLORATION -polimorfonucleares, I-EXPLORATION -neutrófilos I-EXPLORATION -y I-EXPLORATION -linfocitos I-EXPLORATION -aislados, I-EXPLORATION -compatible I-EXPLORATION -con I-EXPLORATION -eritema I-EXPLORATION -nodoso. I-EXPLORATION -La I-EXPLORATION -espirometría I-EXPLORATION +hematoma I-EXPLORATION y I-EXPLORATION +escaso I-EXPLORATION +dolor I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -difusión I-EXPLORATION -pulmonar I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION +cara I-EXPLORATION +lateral I-EXPLORATION +del I-EXPLORATION +pie, I-EXPLORATION +siendo I-EXPLORATION el I-EXPLORATION -fondo I-EXPLORATION -de I-EXPLORATION -ojo. I-EXPLORATION - I-EXPLORATION -Ante B-TREATMENT -los I-TREATMENT -hallazgos I-TREATMENT -clínicos I-TREATMENT +tobillo I-EXPLORATION +normal. I-EXPLORATION +Al B-TREATMENT +no I-TREATMENT +sospechar I-TREATMENT +fractura, I-TREATMENT +se I-TREATMENT +recomienda I-TREATMENT +inmovilización I-TREATMENT y I-TREATMENT +reposo I-TREATMENT +físico I-TREATMENT +relativo, I-TREATMENT +además I-TREATMENT +de I-TREATMENT +tratamiento I-TREATMENT +analgésico, I-TREATMENT +indicando I-TREATMENT +control I-TREATMENT +en I-TREATMENT +una I-TREATMENT +semana I-TREATMENT +según I-TREATMENT la I-TREATMENT -biopsia I-TREATMENT -compatible I-TREATMENT -con I-TREATMENT -granuloma I-TREATMENT -sarcoideo I-TREATMENT -se I-TREATMENT -instauró I-TREATMENT +evolución I-TREATMENT +clínica. I-TREATMENT +Transcurrido B-EVOLUTION +el I-EVOLUTION +periodo I-EVOLUTION +de I-EVOLUTION +inmovilización, I-EVOLUTION +acude I-EVOLUTION +a I-EVOLUTION +consulta, I-EVOLUTION +se I-EVOLUTION +retira I-EVOLUTION +la I-EVOLUTION +inmovilización I-EVOLUTION +y, I-EVOLUTION +ante I-EVOLUTION +la I-EVOLUTION +ausencia I-EVOLUTION +de I-EVOLUTION +sintomatología, I-EVOLUTION +se I-EVOLUTION +da I-EVOLUTION +de I-EVOLUTION +alta, I-EVOLUTION +retomando I-EVOLUTION +su I-EVOLUTION +actividad I-EVOLUTION +física I-EVOLUTION +habitual I-EVOLUTION +como I-EVOLUTION +portero I-EVOLUTION +de I-EVOLUTION +waterpolo. I-EVOLUTION + I-EVOLUTION +Al I-EVOLUTION +cabo I-EVOLUTION +de I-EVOLUTION +dos I-EVOLUTION +semanas, I-EVOLUTION +acude I-EVOLUTION +a I-EVOLUTION +Urgencias I-EVOLUTION +del I-EVOLUTION +centro I-EVOLUTION +de I-EVOLUTION +salud I-EVOLUTION +por I-EVOLUTION +persistencia I-EVOLUTION +de I-EVOLUTION +dolor I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +cara I-EVOLUTION +lateral I-EVOLUTION +del I-EVOLUTION +pie I-EVOLUTION +derecho. I-EVOLUTION +Ha I-EVOLUTION +estado I-EVOLUTION +practicando I-EVOLUTION +waterpolo I-EVOLUTION +y I-EVOLUTION +niega I-EVOLUTION +antecedente I-EVOLUTION +traumático I-EVOLUTION +en I-EVOLUTION +este I-EVOLUTION +periodo I-EVOLUTION +de I-EVOLUTION +tiempo. I-EVOLUTION +En I-EVOLUTION +la I-EVOLUTION +exploración I-EVOLUTION +destaca I-EVOLUTION +la I-EVOLUTION +presencia I-EVOLUTION +de I-EVOLUTION +dolor I-EVOLUTION +y I-EVOLUTION +tumefacción I-EVOLUTION +a I-EVOLUTION +nivel I-EVOLUTION +proximal I-EVOLUTION +del I-EVOLUTION +quinto I-EVOLUTION +metatarsiano I-EVOLUTION +del I-EVOLUTION +pie I-EVOLUTION +derecho, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +realizan I-EVOLUTION +una I-EVOLUTION +radiología I-EVOLUTION +frontal I-EVOLUTION +y I-EVOLUTION +otra I-EVOLUTION +lateral I-EVOLUTION +de I-EVOLUTION +dicho I-EVOLUTION +pie, I-EVOLUTION +informándose I-EVOLUTION +como I-EVOLUTION +posible I-EVOLUTION +fractura I-EVOLUTION +de I-EVOLUTION +Jones. I-EVOLUTION +Posteriormente, I-EVOLUTION +es I-EVOLUTION +valorado I-EVOLUTION +por I-EVOLUTION +su I-EVOLUTION +pediatra, I-EVOLUTION +que I-EVOLUTION +observa I-EVOLUTION +tumefacción I-EVOLUTION +no I-EVOLUTION +dolorosa I-EVOLUTION +también I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +pie I-EVOLUTION +izquierdo; I-EVOLUTION +al I-EVOLUTION +tratarse I-EVOLUTION +de I-EVOLUTION +un I-EVOLUTION +preadolescente I-EVOLUTION +que I-EVOLUTION +realiza I-EVOLUTION +deporte I-EVOLUTION +de I-EVOLUTION +forma I-EVOLUTION +habitual, I-EVOLUTION +sin I-EVOLUTION +un I-EVOLUTION +antecedente I-EVOLUTION +traumático I-EVOLUTION +conocido, I-EVOLUTION +y I-EVOLUTION +ante I-EVOLUTION +la I-EVOLUTION +sospecha I-EVOLUTION +de I-EVOLUTION +posible I-EVOLUTION +apofisitis, I-EVOLUTION +decide I-EVOLUTION +realizar I-EVOLUTION +una I-EVOLUTION +radiología I-EVOLUTION +bilateral I-EVOLUTION +oblicua, I-EVOLUTION +que I-EVOLUTION +presenta I-EVOLUTION +una I-EVOLUTION +imagen I-EVOLUTION +de I-EVOLUTION +fragmentación I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +base I-EVOLUTION +del I-EVOLUTION +quinto I-EVOLUTION +metatarsiano I-EVOLUTION +de I-EVOLUTION +ambos I-EVOLUTION +pies. I-EVOLUTION +Se B-TREATMENT +diagnostica I-TREATMENT +de I-TREATMENT +apofisitis I-TREATMENT +del I-TREATMENT +quinto I-TREATMENT +metatarsiano, I-TREATMENT +también I-TREATMENT +conocida I-TREATMENT +como I-TREATMENT +enfermedad I-TREATMENT +de I-TREATMENT +Iselin, I-TREATMENT +recibiendo I-TREATMENT tratamiento I-TREATMENT +analgésico I-TREATMENT +y I-TREATMENT +antiinflamatorio, I-TREATMENT +junto I-TREATMENT con I-TREATMENT -corticoides. I-TREATMENT +reposo I-TREATMENT +deportivo I-TREATMENT +hasta I-TREATMENT +la I-TREATMENT +desaparición I-TREATMENT +del I-TREATMENT +dolor. I-TREATMENT I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +ha I-EVOLUTION +vuelto I-EVOLUTION +a I-EVOLUTION +la I-EVOLUTION +práctica I-EVOLUTION +de I-EVOLUTION +su I-EVOLUTION +actividad I-EVOLUTION +deportiva I-EVOLUTION +sin I-EVOLUTION +presentar I-EVOLUTION +molestias I-EVOLUTION +de I-EVOLUTION +nuevo. I-EVOLUTION + I-EVOLUTION -Varón B-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -47 I-PRESENT_ILLNESS +28 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS de I-PRESENT_ILLNESS edad I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -consulta I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -prurito I-PRESENT_ILLNESS -intenso I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -piel I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -desemboca I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -aparición I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -lesión I-PRESENT_ILLNESS -eritematosa, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -bordes I-PRESENT_ILLNESS -vesiculosos I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -irregulares I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -superficie I-PRESENT_ILLNESS -ligeramente I-PRESENT_ILLNESS -escamosa I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -brazo I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -posteriormente I-PRESENT_ILLNESS -aparecen I-PRESENT_ILLNESS -lesiones I-PRESENT_ILLNESS -semejantes I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -resto I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -cuerpo I-PRESENT_ILLNESS -incluyendo I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -cara. I-PRESENT_ILLNESS -Unos B-PAST_MEDICAL_HISTORY -meses I-PAST_MEDICAL_HISTORY -antes I-PAST_MEDICAL_HISTORY -inició I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -hepatitis I-PAST_MEDICAL_HISTORY -C I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -135mg I-PAST_MEDICAL_HISTORY +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interferón I-PAST_MEDICAL_HISTORY -alfa-2a I-PAST_MEDICAL_HISTORY -semanalmente, I-PAST_MEDICAL_HISTORY -administrado I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -subcutánea I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +seguía I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +hormonal I-PAST_MEDICAL_HISTORY +anticonceptivo I-PAST_MEDICAL_HISTORY +(etonogestrel I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -ribavirina, I-PAST_MEDICAL_HISTORY -1.200 I-PAST_MEDICAL_HISTORY -mg/día I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -vía I-PAST_MEDICAL_HISTORY -oral. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -A B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -presenta I-EXPLORATION +etinilestradiol) I-PAST_MEDICAL_HISTORY +mediante I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +anillo I-PAST_MEDICAL_HISTORY +intravaginal I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +últimos I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +debido I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +trastornos I-PAST_MEDICAL_HISTORY +menstruales. I-PAST_MEDICAL_HISTORY + B-PRESENT_ILLNESS +Durante I-PRESENT_ILLNESS +este I-PRESENT_ILLNESS +tiempo I-PRESENT_ILLNESS +desarrolló I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +estreñimiento I-PRESENT_ILLNESS +crónico I-PRESENT_ILLNESS +por B-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -placa I-EXPLORATION -eccematosa, I-EXPLORATION -pruriginosa, I-EXPLORATION +colonoscopia I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -tercio I-EXPLORATION -inferior I-EXPLORATION -del I-EXPLORATION -brazo I-EXPLORATION -izquierdo. I-EXPLORATION -Ver I-EXPLORATION -figura. I-EXPLORATION -Se I-EXPLORATION -observan I-EXPLORATION -lesiones I-EXPLORATION -de I-EXPLORATION -características I-EXPLORATION -semejantes, I-EXPLORATION -de I-EXPLORATION -diversos I-EXPLORATION -tamaños I-EXPLORATION +la I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -distribuyen I-EXPLORATION -por I-EXPLORATION -los I-EXPLORATION -miembros I-EXPLORATION -inferiores I-EXPLORATION +encontró I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +colon I-EXPLORATION +descendente I-EXPLORATION +una I-EXPLORATION +mucosa I-EXPLORATION +edematosa I-EXPLORATION y I-EXPLORATION -superiores, I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION +friable I-EXPLORATION +con I-EXPLORATION +ulceraciones I-EXPLORATION +superficiales I-EXPLORATION +cubiertas I-EXPLORATION por I-EXPLORATION -el I-EXPLORATION -tórax, I-EXPLORATION -la I-EXPLORATION -cara I-EXPLORATION +fibrina. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +histopatológico I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +biopsias I-EXPLORATION +mostró I-EXPLORATION +cambios I-EXPLORATION +atróficos I-EXPLORATION y I-EXPLORATION -pabellones I-EXPLORATION -auriculares. I-EXPLORATION +regenerativos I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +epitelio I-EXPLORATION +con I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +microtrombos. I-EXPLORATION El I-EXPLORATION -estado I-EXPLORATION -general I-EXPLORATION -del I-EXPLORATION -paciente I-EXPLORATION -es I-EXPLORATION -bueno, I-EXPLORATION +infiltrado I-EXPLORATION +neutrofílico I-EXPLORATION +era I-EXPLORATION +mínimo, I-EXPLORATION +pero I-EXPLORATION +con I-EXPLORATION +importante I-EXPLORATION +edema I-EXPLORATION +submucoso. I-EXPLORATION +Los I-EXPLORATION +cambios I-EXPLORATION +eran I-EXPLORATION +atribuibles I-EXPLORATION +a I-EXPLORATION +isquemia, I-EXPLORATION +aunque I-EXPLORATION +las I-EXPLORATION +causas I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +isquemia I-EXPLORATION +estaban I-EXPLORATION +aún I-EXPLORATION +por I-EXPLORATION +determinar. I-EXPLORATION + I-EXPLORATION +Tras I-EXPLORATION +la I-EXPLORATION +colonoscopia, I-EXPLORATION +se I-EXPLORATION +retiró I-EXPLORATION el I-EXPLORATION -hemograma I-EXPLORATION +anillo I-EXPLORATION +vaginal I-EXPLORATION y I-EXPLORATION +se I-EXPLORATION +repitió I-EXPLORATION la I-EXPLORATION -bioquímica I-EXPLORATION -sanguínea I-EXPLORATION -son I-EXPLORATION -normales. I-EXPLORATION -Se I-EXPLORATION -practica I-EXPLORATION -una I-EXPLORATION -biopsia I-EXPLORATION -incisional I-EXPLORATION -del I-EXPLORATION -borde I-EXPLORATION -superior I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -lesión I-EXPLORATION -ubicada I-EXPLORATION +colonoscopia I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +4 I-EXPLORATION +meses I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -brazo I-EXPLORATION -izquierdo. I-EXPLORATION -El I-EXPLORATION -laboratorio I-EXPLORATION -de I-EXPLORATION -anatomía I-EXPLORATION -patológica I-EXPLORATION -informa I-EXPLORATION +la I-EXPLORATION que I-EXPLORATION se I-EXPLORATION -trata I-EXPLORATION +comprobó I-EXPLORATION +la I-EXPLORATION +resolución I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -dermatitis I-EXPLORATION -psoriasiforme I-EXPLORATION +las I-EXPLORATION +lesiones. I-EXPLORATION +El B-TREATMENT +estreñimiento I-TREATMENT +se I-TREATMENT +corrigió I-TREATMENT +con I-TREATMENT +medidas I-TREATMENT +convencionales. I-TREATMENT +Con B-EXPLORATION +la I-EXPLORATION +finalidad I-EXPLORATION +de I-EXPLORATION +excluir I-EXPLORATION +otras I-EXPLORATION +posibles I-EXPLORATION +causas I-EXPLORATION +de I-EXPLORATION +colitis I-EXPLORATION +isquémica, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +estudio I-EXPLORATION +analítico, I-EXPLORATION +electrocardiograma, I-EXPLORATION +ecocardiograma I-EXPLORATION y I-EXPLORATION -espongiótica I-EXPLORATION -con I-EXPLORATION -formación I-EXPLORATION +angio-TC I-EXPLORATION +abdominal I-EXPLORATION +que I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION de I-EXPLORATION -ampolla I-EXPLORATION -intracórnea I-EXPLORATION -con I-EXPLORATION -neutrófilos. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -establece I-EXPLORATION +hipercoagulabilidad I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +déficit I-EXPLORATION +de I-EXPLORATION +proteína I-EXPLORATION +S I-EXPLORATION +antigénica I-EXPLORATION +y I-EXPLORATION +anticoagulante. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +detectaron I-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION +factor I-EXPLORATION +V I-EXPLORATION de I-EXPLORATION -eccema I-EXPLORATION -nummular I-EXPLORATION -generalizado I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION +Leyden I-EXPLORATION +ni I-EXPLORATION la I-EXPLORATION -ingesta I-EXPLORATION +mutación I-EXPLORATION +FII I-EXPLORATION +G20210A I-EXPLORATION +del I-EXPLORATION +gen I-EXPLORATION de I-EXPLORATION -interferón I-EXPLORATION -alfa-2a I-EXPLORATION -y I-EXPLORATION -ribavirina I-EXPLORATION -para I-EXPLORATION +la I-EXPLORATION +protrombina. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +familiar I-EXPLORATION +puso I-EXPLORATION +de I-EXPLORATION +manifiesto I-EXPLORATION +la I-EXPLORATION +misma I-EXPLORATION +alteración I-EXPLORATION +en I-EXPLORATION el I-EXPLORATION -tratamiento I-EXPLORATION +padre I-EXPLORATION de I-EXPLORATION -una I-EXPLORATION -hepatitis I-EXPLORATION -C. I-EXPLORATION -Tras B-TREATMENT -consultar I-TREATMENT -con I-TREATMENT -el I-TREATMENT -especialista I-TREATMENT -de I-TREATMENT -Digestivo I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -retirar I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -y I-TREATMENT -se I-TREATMENT -inicia I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -hidroxicina I-TREATMENT -25 I-TREATMENT -mg I-TREATMENT -cada I-TREATMENT -8 I-TREATMENT -horas I-TREATMENT -y I-TREATMENT -beclometasona I-TREATMENT -dipropionato I-TREATMENT -al I-TREATMENT -0, I-TREATMENT -025% I-TREATMENT -tópico I-TREATMENT -cada I-TREATMENT -24 I-TREATMENT -horas I-TREATMENT -sobre I-TREATMENT -las I-TREATMENT -lesiones. I-TREATMENT -El B-EVOLUTION -cuadro I-EVOLUTION -cutáneo I-EVOLUTION -se I-EVOLUTION -resuelve I-EVOLUTION -a I-EVOLUTION -los I-EVOLUTION -15 I-EVOLUTION -días I-EVOLUTION -sin I-EVOLUTION -complicaciones. I-EVOLUTION - I-EVOLUTION -Diagnóstico: B-EXPLORATION -Eccema I-EXPLORATION -nummular I-EXPLORATION -generalizado I-EXPLORATION -secundario I-EXPLORATION -a I-EXPLORATION -interferón I-EXPLORATION -alfa-2a I-EXPLORATION -y I-EXPLORATION -ribavirina I-EXPLORATION +la I-EXPLORATION +paciente. I-EXPLORATION I-EXPLORATION -Paciente B-PRESENT_ILLNESS -mujer I-PRESENT_ILLNESS +Preescolar B-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -24 I-PRESENT_ILLNESS +cuatro I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -conocidas I-PAST_MEDICAL_HISTORY +de I-PRESENT_ILLNESS +edad I-PRESENT_ILLNESS +previamente B-PAST_MEDICAL_HISTORY +sano I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -personales I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +esquema I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interés. I-PAST_MEDICAL_HISTORY -Valorada B-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -consultas I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -Traumatología I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -hombro I-PRESENT_ILLNESS -izquierdo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -más I-PRESENT_ILLNESS +inmunizaciones I-PAST_MEDICAL_HISTORY +completas I-PAST_MEDICAL_HISTORY +para I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +edad. I-PAST_MEDICAL_HISTORY +Tres B-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +respiratorio I-PRESENT_ILLNESS +alto I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +diagnosticó I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +síndrome I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -evolución. I-PRESENT_ILLNESS -En B-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -profesión I-PAST_MEDICAL_HISTORY -realiza I-PAST_MEDICAL_HISTORY -esfuerzos I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -repetición I-PAST_MEDICAL_HISTORY -y B-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -limitación I-PRESENT_ILLNESS -funcional I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -actividades I-PRESENT_ILLNESS +Guillain I-PRESENT_ILLNESS +Barré, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ingresó I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +unidad I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -vida I-PRESENT_ILLNESS -diaria I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -miembro I-PRESENT_ILLNESS -superior I-PRESENT_ILLNESS -izquierdo. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS +terapia I-PRESENT_ILLNESS +intensiva I-PRESENT_ILLNESS +pediátrica. I-PRESENT_ILLNESS +Recibió B-TREATMENT +tratamientos I-TREATMENT +antibacterianos I-TREATMENT +de I-TREATMENT +amplio I-TREATMENT +espectro I-TREATMENT +(piperacilina/tazobactam I-TREATMENT +por I-TREATMENT +ocho I-TREATMENT +días I-TREATMENT +por I-TREATMENT +una I-TREATMENT +neumonía I-TREATMENT +asociada I-TREATMENT +a I-TREATMENT +ventilación I-TREATMENT +mecánica, I-TREATMENT +sin I-TREATMENT +aislamiento I-TREATMENT +microbiológico, I-TREATMENT +y I-TREATMENT +luego I-TREATMENT +meropenem I-TREATMENT +durante I-TREATMENT +10 I-TREATMENT +días I-TREATMENT +por I-TREATMENT +una I-TREATMENT +bacteriemia I-TREATMENT +asociada I-TREATMENT +a I-TREATMENT +un I-TREATMENT +catéter I-TREATMENT +venoso I-TREATMENT +central I-TREATMENT +(CVC) I-TREATMENT +por I-TREATMENT +Klebsiella I-TREATMENT +pneumoniae. I-TREATMENT +Durante I-TREATMENT +su I-TREATMENT +estancia I-TREATMENT +en I-TREATMENT +terapia I-TREATMENT +intensiva I-TREATMENT +fue I-TREATMENT +sometido I-TREATMENT +a I-TREATMENT +una I-TREATMENT +cateterización I-TREATMENT +urinaria I-TREATMENT +permanente I-TREATMENT +y I-TREATMENT +a I-TREATMENT +una I-TREATMENT +traqueostomía. I-TREATMENT + I-TREATMENT +Al B-EVOLUTION +quinto I-EVOLUTION +día I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION +con I-EVOLUTION +meropenem, I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +persistió I-EVOLUTION +febril, I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +se I-EVOLUTION +sospechó I-EVOLUTION +una I-EVOLUTION +infección I-EVOLUTION +fúngica. I-EVOLUTION En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION -destacaba I-EXPLORATION -dolor I-EXPLORATION -en I-EXPLORATION -espacio I-EXPLORATION -subacromial, I-EXPLORATION -con I-EXPLORATION -movilidad I-EXPLORATION -completa I-EXPLORATION +orina I-EXPLORATION +y I-EXPLORATION +sangre I-EXPLORATION +hubo I-EXPLORATION +aislamiento I-EXPLORATION de I-EXPLORATION -hombro, I-EXPLORATION -signo I-EXPLORATION +C. I-EXPLORATION +tropicalis. I-EXPLORATION +La I-EXPLORATION +tinción I-EXPLORATION de I-EXPLORATION -Yocum I-EXPLORATION -positivo I-EXPLORATION -y I-EXPLORATION -test I-EXPLORATION +Gram I-EXPLORATION de I-EXPLORATION -Jobe I-EXPLORATION -positivo. I-EXPLORATION -Además, I-EXPLORATION +la I-EXPLORATION +orina I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +levaduras I-EXPLORATION +y I-EXPLORATION el I-EXPLORATION -antebrazo I-EXPLORATION -izquierdo I-EXPLORATION -presentaba I-EXPLORATION -un I-EXPLORATION -bloqueo I-EXPLORATION -en I-EXPLORATION -pronación I-EXPLORATION +urocultivo I-EXPLORATION +se I-EXPLORATION +informó I-EXPLORATION +con I-EXPLORATION +30.000 I-EXPLORATION +ufc I-EXPLORATION de I-EXPLORATION -unos I-EXPLORATION -50o, I-EXPLORATION +C. I-EXPLORATION +tropicalis I-EXPLORATION con I-EXPLORATION una I-EXPLORATION -limitación I-EXPLORATION +CIM I-EXPLORATION +≤ I-EXPLORATION +0, I-EXPLORATION +25 I-EXPLORATION +μg/mL I-EXPLORATION +para I-EXPLORATION +anfotericina I-EXPLORATION +B I-EXPLORATION +y I-EXPLORATION +caspofungina, I-EXPLORATION +y I-EXPLORATION +≤ I-EXPLORATION +1 I-EXPLORATION +μg/mL I-EXPLORATION +para I-EXPLORATION +fluconazol. I-EXPLORATION +La I-EXPLORATION +cepa I-EXPLORATION +se I-EXPLORATION +identificó I-EXPLORATION +por I-EXPLORATION +CHROMagar; I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +asimilación I-EXPLORATION de I-EXPLORATION +azúcares. I-EXPLORATION +Se I-EXPLORATION +confirmó I-EXPLORATION +C. I-EXPLORATION +tropicalis I-EXPLORATION +por I-EXPLORATION +Vitek I-EXPLORATION +2 I-EXPLORATION +® I-EXPLORATION +2 I-EXPLORATION +compact I-EXPLORATION +60 I-EXPLORATION +(Biomérieux) I-EXPLORATION +y I-EXPLORATION los I-EXPLORATION -movimientos I-EXPLORATION +puntos I-EXPLORATION de I-EXPLORATION -pronación I-EXPLORATION -y I-EXPLORATION -supinación, I-EXPLORATION -que I-EXPLORATION +corte I-EXPLORATION +para I-EXPLORATION +CIM I-EXPLORATION se I-EXPLORATION -compensaban I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -movilización I-EXPLORATION -del I-EXPLORATION -hombro, I-EXPLORATION -y I-EXPLORATION +obtuvieron I-EXPLORATION +por I-EXPLORATION +microdilución I-EXPLORATION +en I-EXPLORATION +caldo I-EXPLORATION +según I-EXPLORATION +CLSI. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +anfotericina I-TREATMENT +B I-TREATMENT +deoxicolato I-TREATMENT +1 I-TREATMENT +mg/kg/día. I-TREATMENT +La B-EVOLUTION +fiebre I-EVOLUTION +bajó I-EVOLUTION +al I-EVOLUTION +tercer I-EVOLUTION +día I-EVOLUTION +y B-EXPLORATION +los I-EXPLORATION +hemocultivos I-EXPLORATION +se I-EXPLORATION +negativizaron I-EXPLORATION +al I-EXPLORATION +cuarto I-EXPLORATION +día I-EXPLORATION +de I-EXPLORATION +terapia. I-EXPLORATION +Anfotericina B-EVOLUTION +B I-EVOLUTION +deoxicolato I-EVOLUTION +fue I-EVOLUTION +bien I-EVOLUTION +tolerada, I-EVOLUTION +manteniéndose I-EVOLUTION +una I-EVOLUTION +función I-EVOLUTION +renal I-EVOLUTION +normal. I-EVOLUTION + I-EVOLUTION +Al B-EXPLORATION +séptimo I-EXPLORATION +día I-EXPLORATION +de I-EXPLORATION +tratamiento I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -flexoextensión I-EXPLORATION -completa I-EXPLORATION +ecotomografía I-EXPLORATION +renal I-EXPLORATION +y I-EXPLORATION de I-EXPLORATION -codo. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -radiográfico I-EXPLORATION -del I-EXPLORATION -codo I-EXPLORATION +vías I-EXPLORATION +urinarias, I-EXPLORATION +que I-EXPLORATION mostró I-EXPLORATION -las I-EXPLORATION -siguientes I-EXPLORATION -imágenes. I-EXPLORATION -En I-EXPLORATION +ambos I-EXPLORATION +riñones I-EXPLORATION +con I-EXPLORATION +cambios I-EXPLORATION +inflamatorios I-EXPLORATION +agudos: I-EXPLORATION el I-EXPLORATION -resto I-EXPLORATION -de I-EXPLORATION -articulaciones I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -apreciaron I-EXPLORATION -deformidades I-EXPLORATION -óseas, I-EXPLORATION +riñón I-EXPLORATION +derecho I-EXPLORATION +medía I-EXPLORATION +9 I-EXPLORATION +x I-EXPLORATION +3, I-EXPLORATION +6 I-EXPLORATION +x I-EXPLORATION +3, I-EXPLORATION +1 I-EXPLORATION +cm, I-EXPLORATION y I-EXPLORATION el I-EXPLORATION -resto I-EXPLORATION +riñón I-EXPLORATION +izquierdo, I-EXPLORATION +8, I-EXPLORATION +8 I-EXPLORATION +x I-EXPLORATION +3, I-EXPLORATION +5 I-EXPLORATION +x I-EXPLORATION +4, I-EXPLORATION +6 I-EXPLORATION +cm. I-EXPLORATION +La I-EXPLORATION +vejiga I-EXPLORATION +urinaria I-EXPLORATION +se I-EXPLORATION +encontraba I-EXPLORATION +engrosada I-EXPLORATION +(4 I-EXPLORATION +mm I-EXPLORATION de I-EXPLORATION -exploración I-EXPLORATION -por I-EXPLORATION -aparatos I-EXPLORATION -fue I-EXPLORATION -normal. I-EXPLORATION - I-EXPLORATION -Diagnóstico: B-EVOLUTION -sinostosis I-EVOLUTION -radiocubital I-EVOLUTION -proximal I-EVOLUTION -congénita I-EVOLUTION -"enfermedad I-EVOLUTION -de I-EVOLUTION -lennoire" I-EVOLUTION - I-EVOLUTION - -Varón, B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -39 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -(172 I-PRESENT_ILLNESS -cm, I-PRESENT_ILLNESS -78 I-PRESENT_ILLNESS -Kg), I-PRESENT_ILLNESS -ASA I-PRESENT_ILLNESS -I I-PRESENT_ILLNESS -U, I-PRESENT_ILLNESS -que B-PAST_MEDICAL_HISTORY -procedente I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -un I-PAST_MEDICAL_HISTORY -buque I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -Armada I-PAST_MEDICAL_HISTORY -española I-PAST_MEDICAL_HISTORY -es B-PRESENT_ILLNESS -evacuado I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fractura I-PRESENT_ILLNESS -bimaleolar I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -tobillo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -subsidiaria I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -osteosíntesis. I-PRESENT_ILLNESS -Se B-EXPLORATION -le I-EXPLORATION -monitorizó I-EXPLORATION -la I-EXPLORATION -SaO2, I-EXPLORATION -la I-EXPLORATION -frecuencia I-EXPLORATION -cardíaca, I-EXPLORATION -la I-EXPLORATION -tensión I-EXPLORATION -arterial I-EXPLORATION +espesor) I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +interior I-EXPLORATION +se I-EXPLORATION +identificó I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +única I-EXPLORATION +hiperecogénica I-EXPLORATION +que I-EXPLORATION no I-EXPLORATION -invasiva, I-EXPLORATION -la I-EXPLORATION -temperatura, I-EXPLORATION -la I-EXPLORATION -capnografía I-EXPLORATION +proyectaba I-EXPLORATION +sombra I-EXPLORATION +sónica I-EXPLORATION +posterior, I-EXPLORATION y I-EXPLORATION -el I-EXPLORATION -grado I-EXPLORATION +con I-EXPLORATION +discreta I-EXPLORATION +vascularidad I-EXPLORATION +central I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +fungoma, I-EXPLORATION +imagen I-EXPLORATION +que I-EXPLORATION +persistía I-EXPLORATION +al I-EXPLORATION +día I-EXPLORATION +14 I-EXPLORATION de I-EXPLORATION -hipnosis I-EXPLORATION -mediante I-EXPLORATION -el I-EXPLORATION -monitor I-EXPLORATION -BIS®. I-EXPLORATION -Tras B-TREATMENT -administración I-TREATMENT -de I-TREATMENT -250 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -coloide I-TREATMENT -en I-TREATMENT -bolo I-TREATMENT -iv, I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -anestesia I-TREATMENT -intradural I-TREATMENT -empleando I-TREATMENT -bupivacaína I-TREATMENT -0, I-TREATMENT -5% I-TREATMENT -hiperbara I-TREATMENT -10 I-TREATMENT -mg I-TREATMENT -y I-TREATMENT -fentanilo I-TREATMENT -10 I-TREATMENT -µg. I-TREATMENT -Como I-TREATMENT -medicación I-TREATMENT -coadyuvante I-TREATMENT -se I-TREATMENT -empleó I-TREATMENT -midazolam I-TREATMENT -(3 I-TREATMENT -mg I-TREATMENT -en I-TREATMENT -bolo I-TREATMENT -iv) I-TREATMENT -y I-TREATMENT -propofol I-TREATMENT -(1, I-TREATMENT -5 I-TREATMENT -mg/Kg/h). I-TREATMENT -La I-TREATMENT -profilaxis I-TREATMENT -antibiótica I-TREATMENT -fue I-TREATMENT -cefazolina I-TREATMENT -2 I-TREATMENT -g I-TREATMENT -iv. I-TREATMENT -Asimismo I-TREATMENT -se I-TREATMENT -pautó I-TREATMENT -omeprazol I-TREATMENT +tratamiento. I-EXPLORATION +Habiendo B-TREATMENT +completado I-TREATMENT 40 I-TREATMENT -mg I-TREATMENT -iv, I-TREATMENT -granisetron I-TREATMENT -3 I-TREATMENT -mg I-TREATMENT -iv I-TREATMENT -y I-TREATMENT -ácido I-TREATMENT -tranexámico I-TREATMENT -1 I-TREATMENT -g I-TREATMENT -iv. I-TREATMENT -Al I-TREATMENT -final I-TREATMENT +mg/kg I-TREATMENT de I-TREATMENT -la I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -se I-TREATMENT -administró I-TREATMENT -desketoprofeno I-TREATMENT -(50 I-TREATMENT -mg I-TREATMENT -iv) I-TREATMENT +anfotericina I-TREATMENT +B I-TREATMENT +deoxicolato, I-TREATMENT y I-TREATMENT -dexametasona I-TREATMENT -(4 I-TREATMENT -mg I-TREATMENT -iv). I-TREATMENT -Se I-TREATMENT -finalizó I-TREATMENT -la I-TREATMENT -perfusión I-TREATMENT -de I-TREATMENT -propofol I-TREATMENT -aproximadamente I-TREATMENT -5 I-TREATMENT -minutos I-TREATMENT -antes I-TREATMENT -de I-TREATMENT -la I-TREATMENT -finalización I-TREATMENT +por I-TREATMENT +persistencia I-TREATMENT +del I-TREATMENT +fungoma I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +resección I-TREATMENT de I-TREATMENT -la I-TREATMENT -cirugía. I-TREATMENT -El B-EVOLUTION -paciente I-EVOLUTION -ingresó I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -unidad I-EVOLUTION -de I-EVOLUTION -reanimación I-EVOLUTION -postquirúrgica I-EVOLUTION -y I-EVOLUTION -posteriormente I-EVOLUTION -fue I-EVOLUTION -dado I-EVOLUTION -de I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -sala I-EVOLUTION -de I-EVOLUTION -hospitalización I-EVOLUTION -sin I-EVOLUTION -incidencias. I-EVOLUTION - I-EVOLUTION -La B-EXPLORATION -monitorización I-EXPLORATION -mediante I-EXPLORATION -BIS® I-EXPLORATION -mostró I-EXPLORATION -unos I-EXPLORATION -valores I-EXPLORATION -comprendidos I-EXPLORATION -entre I-EXPLORATION -98 I-EXPLORATION +éste I-TREATMENT +por I-TREATMENT +cistoscopia. I-TREATMENT +Macroscópicamente B-EXPLORATION +el I-EXPLORATION +tejido I-EXPLORATION +tenía I-EXPLORATION +un I-EXPLORATION +color I-EXPLORATION +blanquecino I-EXPLORATION y I-EXPLORATION -47, I-EXPLORATION -la I-EXPLORATION -curva I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -capnografía I-EXPLORATION -fue I-EXPLORATION -normal I-EXPLORATION -(onda I-EXPLORATION -cuadrada I-EXPLORATION +consistencia I-EXPLORATION +blanda. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +histopatológico, I-EXPLORATION con I-EXPLORATION -valores I-EXPLORATION -comprendidos I-EXPLORATION -entre I-EXPLORATION -35 I-EXPLORATION +tinción I-EXPLORATION +con I-EXPLORATION +hematoxilina-eosina, I-EXPLORATION +se I-EXPLORATION +informó I-EXPLORATION +como I-EXPLORATION +mucosa I-EXPLORATION +vesical I-EXPLORATION +con I-EXPLORATION +edema I-EXPLORATION +estromal, I-EXPLORATION +erosiones I-EXPLORATION +del I-EXPLORATION +epitelio I-EXPLORATION +transicional I-EXPLORATION y I-EXPLORATION -45 I-EXPLORATION -mmHg) I-EXPLORATION -durante I-EXPLORATION -el I-EXPLORATION -acto I-EXPLORATION -quirúrgico I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +linfocitos I-EXPLORATION y I-EXPLORATION +macrófagos I-EXPLORATION +compatibles I-EXPLORATION +con I-EXPLORATION +una I-EXPLORATION +cistitis I-EXPLORATION +crónica. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +realizaron I-EXPLORATION +tinciones I-EXPLORATION +especiales I-EXPLORATION +para I-EXPLORATION +hongos. I-EXPLORATION +El I-EXPLORATION +urocultivo I-EXPLORATION +se I-EXPLORATION +negativizó I-EXPLORATION +posterior I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -valoración I-EXPLORATION +resección I-EXPLORATION +del I-EXPLORATION +fungoma, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +suspendió I-EXPLORATION +el I-EXPLORATION +antifúngico I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +48 I-EXPLORATION +h I-EXPLORATION +después I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -sedación I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -unidad I-EXPLORATION +cirugía, I-EXPLORATION +con I-EXPLORATION +ecografía I-EXPLORATION +post-quirúrgica I-EXPLORATION +sin I-EXPLORATION +evidencia I-EXPLORATION de I-EXPLORATION -reanimación I-EXPLORATION -postquirúrgica I-EXPLORATION -fue I-EXPLORATION -máxima: I-EXPLORATION -10 I-EXPLORATION -puntos I-EXPLORATION -en I-EXPLORATION +fungoma. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +permaneció I-EVOLUTION +en I-EVOLUTION +terapia I-EVOLUTION +intensiva I-EVOLUTION +durante I-EVOLUTION +16 I-EVOLUTION +días I-EVOLUTION +y B-DERIVED_FROM/TO +después I-DERIVED_FROM/TO +fue I-DERIVED_FROM/TO +trasladado I-DERIVED_FROM/TO +a I-DERIVED_FROM/TO +neurología I-DERIVED_FROM/TO +pediátrica I-DERIVED_FROM/TO +donde I-DERIVED_FROM/TO +permaneció I-DERIVED_FROM/TO +tres I-DERIVED_FROM/TO +meses I-DERIVED_FROM/TO +internado. I-DERIVED_FROM/TO +Egresó B-EVOLUTION +sin I-EVOLUTION +traqueostomía I-EVOLUTION +y I-EVOLUTION +sigue I-EVOLUTION +sus I-EVOLUTION +controles I-EVOLUTION +ambulatorios. I-EVOLUTION + I-EVOLUTION + +Varón B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +33 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +español, B-PAST_MEDICAL_HISTORY +ingeniero I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +caminos I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +ha I-PAST_MEDICAL_HISTORY +residido I-PAST_MEDICAL_HISTORY +18 I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +Costa I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +Marfil I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +motivos I-PAST_MEDICAL_HISTORY +laborales. I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +actualidad I-PRESENT_ILLNESS +regresa I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +España I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +presenta I-PRESENT_ILLNESS +prurito I-PRESENT_ILLNESS +perianal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +difuso I-PRESENT_ILLNESS +tipo I-PRESENT_ILLNESS +cólico. I-PRESENT_ILLNESS +No I-PRESENT_ILLNESS +asocia I-PRESENT_ILLNESS +fiebre I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +última I-PRESENT_ILLNESS +deposición I-PRESENT_ILLNESS +es I-PRESENT_ILLNESS +diarreica, I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +deja I-PRESENT_ILLNESS +entrever I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +gusano I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +gran I-PRESENT_ILLNESS +tamaño. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +A B-EXPLORATION la I-EXPLORATION -Escala I-EXPLORATION -de I-EXPLORATION -Aldrete I-EXPLORATION -(actividad I-EXPLORATION -muscular: I-EXPLORATION -0-2, I-EXPLORATION -respiración: I-EXPLORATION -0-2, I-EXPLORATION -hemodinámica: I-EXPLORATION -0-2, I-EXPLORATION -conciencia: I-EXPLORATION -0-2 I-EXPLORATION -y I-EXPLORATION -coloración I-EXPLORATION +exploración I-EXPLORATION +destaca I-EXPLORATION +dolor I-EXPLORATION +leve I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación I-EXPLORATION +profunda I-EXPLORATION +en I-EXPLORATION +fosa I-EXPLORATION +iliaca I-EXPLORATION +derecha. I-EXPLORATION +En I-EXPLORATION +las I-EXPLORATION +pruebas I-EXPLORATION +resalta I-EXPLORATION +discreta I-EXPLORATION +eosinofilia I-EXPLORATION +(750 I-EXPLORATION +eosinófilos I-EXPLORATION +por I-EXPLORATION +microlitro). I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +visualización I-EXPLORATION +macroscópica I-EXPLORATION +del I-EXPLORATION +parásito I-EXPLORATION +impresiona I-EXPLORATION de I-EXPLORATION -piel: I-EXPLORATION -0-2). I-EXPLORATION +Taenia. I-EXPLORATION +El I-EXPLORATION +análisis I-EXPLORATION +diferido I-EXPLORATION +microbiológico I-EXPLORATION +lo I-EXPLORATION +describe I-EXPLORATION +como I-EXPLORATION +Taenia I-EXPLORATION +saginata I-EXPLORATION +(T. I-EXPLORATION +saginata). I-EXPLORATION I-EXPLORATION -Varón, B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -22 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -(170 I-PRESENT_ILLNESS -cm, I-PRESENT_ILLNESS -70 I-PRESENT_ILLNESS -Kg), I-PRESENT_ILLNESS -ASA I-PRESENT_ILLNESS -I I-PRESENT_ILLNESS -U, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -es I-PRESENT_ILLNESS -evacuado I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -nuestro I-PRESENT_ILLNESS -centro I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -diagnóstico I-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -fractura I-PRESENT_ILLNESS -conminuta I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -fémur I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS +64 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -arma I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +difuso I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -fuego I-PRESENT_ILLNESS -subsidiaria I-PRESENT_ILLNESS +intensidad I-PRESENT_ILLNESS +progresiva I-PRESENT_ILLNESS +acompañado I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -quirúrgico. I-PRESENT_ILLNESS +malestar I-PRESENT_ILLNESS +general, I-PRESENT_ILLNESS +mareo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +sudoración I-PRESENT_ILLNESS +profusa. I-PRESENT_ILLNESS +Unas I-PRESENT_ILLNESS +horas I-PRESENT_ILLNESS +antes I-PRESENT_ILLNESS +había I-PRESENT_ILLNESS +estado I-PRESENT_ILLNESS +trabajando I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +campo I-PRESENT_ILLNESS +fumigando I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +insecticida I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +contenía I-PRESENT_ILLNESS +polvo I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +espolvoreo. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS Al B-EXPLORATION +ingreso I-EXPLORATION +el I-EXPLORATION paciente I-EXPLORATION -se I-EXPLORATION -le I-EXPLORATION -monitorizó I-EXPLORATION +mostraba I-EXPLORATION +importante I-EXPLORATION +diaforesis I-EXPLORATION +con I-EXPLORATION +leve I-EXPLORATION +bradipsiquia I-EXPLORATION +pero I-EXPLORATION +sin I-EXPLORATION +datos I-EXPLORATION de I-EXPLORATION -igual I-EXPLORATION -forma I-EXPLORATION +focalidad I-EXPLORATION +neurológica. I-EXPLORATION +Tras B-TREATMENT +estabilización I-TREATMENT +hemodinámica, I-TREATMENT +se B-EXPLORATION +realizó I-EXPLORATION +TC I-EXPLORATION +abdominal I-EXPLORATION que I-EXPLORATION -al I-EXPLORATION -primer I-EXPLORATION -caso I-EXPLORATION -clínico: I-EXPLORATION -SaO2, I-EXPLORATION -frecuencia I-EXPLORATION -cardíaca, I-EXPLORATION -tensión I-EXPLORATION -arterial I-EXPLORATION -no I-EXPLORATION -invasiva, I-EXPLORATION -temperatura, I-EXPLORATION -capnografía I-EXPLORATION +mostró I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +parénquima I-EXPLORATION +hepático I-EXPLORATION +áreas I-EXPLORATION +de I-EXPLORATION +distinta I-EXPLORATION +intensidad I-EXPLORATION +con I-EXPLORATION +gran I-EXPLORATION +colección I-EXPLORATION +subcapsular I-EXPLORATION +de I-EXPLORATION +11 I-EXPLORATION +x I-EXPLORATION +6 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION +probable I-EXPLORATION +relación I-EXPLORATION +con I-EXPLORATION +hemoperitoneo. I-EXPLORATION +La I-EXPLORATION +vesícula I-EXPLORATION +adyacente I-EXPLORATION +mostraba I-EXPLORATION +un I-EXPLORATION +nivel I-EXPLORATION +líquido-líquido I-EXPLORATION +sin I-EXPLORATION +poder I-EXPLORATION +descartar I-EXPLORATION +contenido I-EXPLORATION +hemático. I-EXPLORATION +Así I-EXPLORATION +mismo I-EXPLORATION +destacaba I-EXPLORATION +un I-EXPLORATION +engrosamiento I-EXPLORATION y I-EXPLORATION -grado I-EXPLORATION +realce I-EXPLORATION de I-EXPLORATION -hipnosis I-EXPLORATION -mediante I-EXPLORATION -el I-EXPLORATION -monitor I-EXPLORATION -BIS®. I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +de I-EXPLORATION +antro I-EXPLORATION +gástrico I-EXPLORATION +y I-EXPLORATION +duodeno I-EXPLORATION +con I-EXPLORATION +líquido I-EXPLORATION +libre I-EXPLORATION +periesplénico I-EXPLORATION +y I-EXPLORATION +en I-EXPLORATION +ambas I-EXPLORATION +gotieras, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +gastroscopia I-EXPLORATION +confirmando I-EXPLORATION +gastroduodenitis I-EXPLORATION +sin I-EXPLORATION +otras I-EXPLORATION +alteraciones. I-EXPLORATION I-EXPLORATION -Tras B-TREATMENT -administración I-TREATMENT -de I-TREATMENT -250 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -coloide I-TREATMENT -en I-TREATMENT -bolo I-TREATMENT -iv, I-TREATMENT -se I-TREATMENT -realizó I-TREATMENT -anestesia I-TREATMENT -intradural I-TREATMENT -empleando I-TREATMENT -bupivacaína I-TREATMENT -0, I-TREATMENT -5% I-TREATMENT -hiperbara I-TREATMENT -10 I-TREATMENT -mg I-TREATMENT -y I-TREATMENT -fentanilo I-TREATMENT -10 I-TREATMENT -µg. I-TREATMENT -La I-TREATMENT -medicación I-TREATMENT -coadyuvante I-TREATMENT -fue I-TREATMENT -midazolam I-TREATMENT -(3 I-TREATMENT -mg I-TREATMENT -en I-TREATMENT -bolo I-TREATMENT -iv) I-TREATMENT -y I-TREATMENT -propofol I-TREATMENT -(1, I-TREATMENT -5 I-TREATMENT -mg/Kg/h). I-TREATMENT -La I-TREATMENT -profilaxis I-TREATMENT -antibiótica I-TREATMENT -fue I-TREATMENT -cefazolina I-TREATMENT -2 I-TREATMENT -g I-TREATMENT -iv. I-TREATMENT -Asimismo I-TREATMENT -también I-TREATMENT +Ante B-TREATMENT +los I-TREATMENT +resultados, I-TREATMENT se I-TREATMENT -pautó I-TREATMENT -omeprazol I-TREATMENT -40 I-TREATMENT -mg I-TREATMENT -iv, I-TREATMENT -granisetron I-TREATMENT -3 I-TREATMENT -mg I-TREATMENT -iv I-TREATMENT -y I-TREATMENT -ácido I-TREATMENT -tranexámico I-TREATMENT -1 I-TREATMENT -g I-TREATMENT -iv. I-TREATMENT -Al I-TREATMENT -de I-TREATMENT -la I-TREATMENT +decidió I-TREATMENT intervención I-TREATMENT quirúrgica I-TREATMENT -se I-TREATMENT -administró I-TREATMENT -desketoprofeno I-TREATMENT -(50 I-TREATMENT -mg I-TREATMENT -iv), I-TREATMENT -se I-TREATMENT -finalizó I-TREATMENT -la I-TREATMENT -perfusión I-TREATMENT -de I-TREATMENT -propofol I-TREATMENT -y I-TREATMENT -se I-TREATMENT -infiltró I-TREATMENT -la I-TREATMENT -herida I-TREATMENT -con I-TREATMENT -mepivacaína I-TREATMENT -2% I-TREATMENT -200 I-TREATMENT -mg. I-TREATMENT -El I-TREATMENT -paciente I-TREATMENT -ingresó I-TREATMENT -en I-TREATMENT +urgente I-TREATMENT +durante I-TREATMENT la I-TREATMENT -unidad I-TREATMENT -de I-TREATMENT -reanimación I-TREATMENT -postquirúrgica, I-TREATMENT +cual I-TREATMENT se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -un I-TREATMENT -bloqueo I-TREATMENT -nervioso I-TREATMENT -ecoguiado I-TREATMENT -a I-TREATMENT -nivel I-TREATMENT -femoral I-TREATMENT +evidenció I-TREATMENT +gran I-TREATMENT +hemoperitoneo I-TREATMENT con I-TREATMENT -bupivacaína I-TREATMENT -0, I-TREATMENT -25% I-TREATMENT -25 I-TREATMENT -mg I-TREATMENT -y I-TREATMENT -tras I-TREATMENT -recobrar I-TREATMENT -la I-TREATMENT -sensibilidad I-TREATMENT +coágulos I-TREATMENT +suprahepáticos I-TREATMENT y I-TREATMENT -motricidad I-TREATMENT +brecha I-TREATMENT en I-TREATMENT -miembros I-TREATMENT -inferiores I-TREATMENT -fue I-TREATMENT -dado I-TREATMENT +lóbulo I-TREATMENT +hepático I-TREATMENT +derecho I-TREATMENT de I-TREATMENT -alta I-TREATMENT -a I-TREATMENT -sala I-TREATMENT +unos I-TREATMENT +10 I-TREATMENT +cm, I-TREATMENT de I-TREATMENT -hospitalización I-TREATMENT -sin I-TREATMENT -incidencias. I-TREATMENT - I-TREATMENT -La B-EVOLUTION -monitorización I-EVOLUTION -mediante I-EVOLUTION -BIS® I-EVOLUTION -mostró I-EVOLUTION -unos I-EVOLUTION -valores I-EVOLUTION -comprendidos I-EVOLUTION -entre I-EVOLUTION -97 I-EVOLUTION -y I-EVOLUTION -30. I-EVOLUTION -La I-EVOLUTION -curva I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -capnografía I-EVOLUTION -fue I-EVOLUTION -normal I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -valoración I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -sedación I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -unidad I-EVOLUTION -de I-EVOLUTION -reanimación I-EVOLUTION -postquirúrgica I-EVOLUTION -fue I-EVOLUTION -máxima I-EVOLUTION -(10 I-EVOLUTION -puntos I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -Escala I-EVOLUTION -de I-EVOLUTION -Aldrete). I-EVOLUTION - I-EVOLUTION - -Exponemos B-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -efectos I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -programa I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -ejercicio I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -una I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -(55 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -58 I-PRESENT_ILLNESS -kg, I-PRESENT_ILLNESS -158 I-PRESENT_ILLNESS -cm I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -22, I-PRESENT_ILLNESS -83 I-PRESENT_ILLNESS -kg/m2), I-PRESENT_ILLNESS -jubilada I-PRESENT_ILLNESS -por B-PAST_MEDICAL_HISTORY -incapacidad I-PAST_MEDICAL_HISTORY -física, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -MG I-PAST_MEDICAL_HISTORY -grado I-PAST_MEDICAL_HISTORY -III I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -evolución, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -marcada I-PAST_MEDICAL_HISTORY -debilidad I-PAST_MEDICAL_HISTORY -muscular, I-PAST_MEDICAL_HISTORY -especialmente I-PAST_MEDICAL_HISTORY -cervical I-PAST_MEDICAL_HISTORY -(necesitaba I-PAST_MEDICAL_HISTORY -sujetar I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -manos I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -cabeza I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -comía I-PAST_MEDICAL_HISTORY -o I-PAST_MEDICAL_HISTORY -cuando I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -iba I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -tumbar) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -que, I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -nivel I-PAST_MEDICAL_HISTORY -dorsal, I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -causaba I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -actitud I-PAST_MEDICAL_HISTORY -cifótica. I-PAST_MEDICAL_HISTORY -Había I-PAST_MEDICAL_HISTORY -recibido I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -plasmaféresis, I-PAST_MEDICAL_HISTORY -Prograf® I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -Inmurel® I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -durante I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -programa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ejercicio I-PAST_MEDICAL_HISTORY -tomaba I-PAST_MEDICAL_HISTORY -Ciclosporina® I-PAST_MEDICAL_HISTORY -(500 I-PAST_MEDICAL_HISTORY -mg/15días), I-PAST_MEDICAL_HISTORY -Dacortin® I-PAST_MEDICAL_HISTORY -(5 I-PAST_MEDICAL_HISTORY -mg/24 I-PAST_MEDICAL_HISTORY -h), I-PAST_MEDICAL_HISTORY -Escitalopram® I-PAST_MEDICAL_HISTORY -(10 I-PAST_MEDICAL_HISTORY -mg/24 I-PAST_MEDICAL_HISTORY -h), I-PAST_MEDICAL_HISTORY -Mestinon® I-PAST_MEDICAL_HISTORY -(60 I-PAST_MEDICAL_HISTORY -mg/8 I-PAST_MEDICAL_HISTORY -h), I-PAST_MEDICAL_HISTORY -Lanzoprazol® I-PAST_MEDICAL_HISTORY -(30 I-PAST_MEDICAL_HISTORY -mg/24 I-PAST_MEDICAL_HISTORY -h), I-PAST_MEDICAL_HISTORY -Lexatin® I-PAST_MEDICAL_HISTORY -(1, I-PAST_MEDICAL_HISTORY -5 I-PAST_MEDICAL_HISTORY -mg/24 I-PAST_MEDICAL_HISTORY -h) I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -Calcium I-PAST_MEDICAL_HISTORY -Sandoz I-PAST_MEDICAL_HISTORY -D® I-PAST_MEDICAL_HISTORY -(1.000 I-PAST_MEDICAL_HISTORY -mg/880 I-PAST_MEDICAL_HISTORY -UI/24 I-PAST_MEDICAL_HISTORY -h). I-PAST_MEDICAL_HISTORY -No I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -practicado I-PAST_MEDICAL_HISTORY -timectomía I-PAST_MEDICAL_HISTORY -aunque I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -situación I-PAST_MEDICAL_HISTORY -era I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -eutiroidismo I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -presencia I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -nódulos I-PAST_MEDICAL_HISTORY -tiroideos I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -además I-PAST_MEDICAL_HISTORY -padecía I-PAST_MEDICAL_HISTORY -osteoporosis. I-PAST_MEDICAL_HISTORY -Tras B-TREATMENT -ser I-TREATMENT -informada I-TREATMENT -dio I-TREATMENT -su I-TREATMENT -consentimiento I-TREATMENT -por I-TREATMENT -escrito I-TREATMENT -para I-TREATMENT -su I-TREATMENT -participación I-TREATMENT +aspecto I-TREATMENT +necrótico I-TREATMENT +con I-TREATMENT +sangrado I-TREATMENT +activo I-TREATMENT en I-TREATMENT -el I-TREATMENT -estudio. I-TREATMENT -El I-TREATMENT -diseño I-TREATMENT -y I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -esta I-TREATMENT -investigación I-TREATMENT -respetaron I-TREATMENT -las I-TREATMENT -recomendaciones I-TREATMENT -éticas I-TREATMENT -de I-TREATMENT -la I-TREATMENT -Asociación I-TREATMENT -Médica I-TREATMENT -Mundial I-TREATMENT -y I-TREATMENT -la I-TREATMENT -Declaración I-TREATMENT -de I-TREATMENT -Helsinki I-TREATMENT -y I-TREATMENT -fue I-TREATMENT -aprobado I-TREATMENT -por I-TREATMENT -el I-TREATMENT -comité I-TREATMENT -de I-TREATMENT -Ética I-TREATMENT -de I-TREATMENT -Asociación I-TREATMENT -Miastenia I-TREATMENT +sábana. I-TREATMENT +Se I-TREATMENT +drenó I-TREATMENT +un I-TREATMENT +total I-TREATMENT de I-TREATMENT -España I-TREATMENT -(AMES). I-TREATMENT - I-TREATMENT -Programa I-TREATMENT +200 I-TREATMENT +cc I-TREATMENT de I-TREATMENT -ejercicio I-TREATMENT +contenido I-TREATMENT +hemático I-TREATMENT y I-TREATMENT -valoraciones I-TREATMENT -efectuadas I-TREATMENT - I-TREATMENT -El I-TREATMENT -programa I-TREATMENT -de I-TREATMENT -ejercicio I-TREATMENT se I-TREATMENT -inició I-TREATMENT -el I-TREATMENT -20 I-TREATMENT -de I-TREATMENT -junio I-TREATMENT -de I-TREATMENT -2012 I-TREATMENT -y I-TREATMENT -concluyó I-TREATMENT +controló I-TREATMENT el I-TREATMENT -17 I-TREATMENT -de I-TREATMENT -julio I-TREATMENT -de I-TREATMENT -2012 I-TREATMENT -y I-TREATMENT -consistió I-TREATMENT -en I-TREATMENT -la I-TREATMENT -realización I-TREATMENT -de I-TREATMENT -2 I-TREATMENT -sesiones I-TREATMENT -matinales I-TREATMENT -semanales. I-TREATMENT -Los I-TREATMENT -componentes I-TREATMENT -de I-TREATMENT -cada I-TREATMENT -sesión I-TREATMENT -consistían I-TREATMENT -en I-TREATMENT -ejercicios I-TREATMENT -de I-TREATMENT -Pilates I-TREATMENT -suelo, I-TREATMENT -ejercicios I-TREATMENT -de I-TREATMENT -fuerza I-TREATMENT -para I-TREATMENT -los I-TREATMENT -grupos I-TREATMENT -musculares I-TREATMENT -de I-TREATMENT -bíceps, I-TREATMENT -tríceps, I-TREATMENT -pectoral I-TREATMENT -y I-TREATMENT -dorsal I-TREATMENT -ancho, I-TREATMENT +sangrado I-TREATMENT mediante I-TREATMENT -contracciones I-TREATMENT -auxotónicas, I-TREATMENT -con I-TREATMENT -banda I-TREATMENT -elástica I-TREATMENT -de I-TREATMENT -dureza I-TREATMENT -baja I-TREATMENT -(Domyos® I-TREATMENT -Villeneuve I-TREATMENT -D'Ascq. I-TREATMENT -Francia), I-TREATMENT -ejercicios I-TREATMENT -de I-TREATMENT -propiocepción I-TREATMENT -de I-TREATMENT -tobillo I-TREATMENT -con I-TREATMENT -pelota I-TREATMENT -100% I-TREATMENT -de I-TREATMENT -FOAM I-TREATMENT -de I-TREATMENT -16 I-TREATMENT -cm I-TREATMENT -(Gui-an I-TREATMENT -S.L. I-TREATMENT -Servicios I-TREATMENT -Deportivos®, I-TREATMENT -San I-TREATMENT -Sebastián I-TREATMENT -de I-TREATMENT -los I-TREATMENT -Reyes, I-TREATMENT -Madrid), I-TREATMENT -ejercicios I-TREATMENT -de I-TREATMENT -flexibilidad I-TREATMENT -(ejercicios I-TREATMENT -pasivos I-TREATMENT -asistidos I-TREATMENT -de I-TREATMENT -cuádriceps, I-TREATMENT -isquiotibiliales, I-TREATMENT -sóleo, I-TREATMENT -cuadrado I-TREATMENT -lumbar, I-TREATMENT -dorsal I-TREATMENT -ancho, I-TREATMENT -trapecios, I-TREATMENT -esternocleidomastoideo, I-TREATMENT -tríceps, I-TREATMENT -deltoides I-TREATMENT -y I-TREATMENT -pectoral) I-TREATMENT -y I-TREATMENT -ejercicios I-TREATMENT -de I-TREATMENT -facilitación I-TREATMENT -neuromuscular I-TREATMENT -propioceptiva I-TREATMENT -(PNF) I-TREATMENT -asistidos I-TREATMENT -por I-TREATMENT -un I-TREATMENT -fisioterapeuta I-TREATMENT -profesional I-TREATMENT -(isquiotibiales, I-TREATMENT -cuádriceps, I-TREATMENT -cuadrado I-TREATMENT -lumbar, I-TREATMENT -dorsal I-TREATMENT -y I-TREATMENT -trapecios). I-TREATMENT -Durante B-EXPLORATION -las I-EXPLORATION -sesiones I-EXPLORATION +medidas I-TREATMENT +hemostáticas. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente I-EVOLUTION +tras I-EVOLUTION +el I-EVOLUTION +postoperatorio. I-EVOLUTION +La B-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +mostró I-EXPLORATION +persistencia I-EXPLORATION de I-EXPLORATION -ejercicio I-EXPLORATION -se I-EXPLORATION -monitorizó I-EXPLORATION la I-EXPLORATION -frecuencia I-EXPLORATION -cardíaca I-EXPLORATION -(FC) I-EXPLORATION -para I-EXPLORATION -evitar I-EXPLORATION -que I-EXPLORATION -esta I-EXPLORATION -aumentase I-EXPLORATION -más I-EXPLORATION +colección I-EXPLORATION +aunque I-EXPLORATION de I-EXPLORATION -30 I-EXPLORATION -pulsaciones I-EXPLORATION -por I-EXPLORATION -minuto I-EXPLORATION -(ppm). I-EXPLORATION - I-EXPLORATION -Al I-EXPLORATION -inicio I-EXPLORATION -y I-EXPLORATION -al I-EXPLORATION -final I-EXPLORATION -del I-EXPLORATION -estudio I-EXPLORATION +menor I-EXPLORATION +tamaño I-EXPLORATION +que I-EXPLORATION se I-EXPLORATION -midieron: I-EXPLORATION -peso I-EXPLORATION -(kg), I-EXPLORATION -talla I-EXPLORATION -(cm) I-EXPLORATION -mediante I-EXPLORATION -báscula I-EXPLORATION -con I-EXPLORATION -tallímetro I-EXPLORATION -(modelo I-EXPLORATION -PS10®DINA, I-EXPLORATION -Derio, I-EXPLORATION -España), I-EXPLORATION -FC I-EXPLORATION -en I-EXPLORATION -reposo, I-EXPLORATION -en I-EXPLORATION -ejercicio I-EXPLORATION -y I-EXPLORATION -a I-EXPLORATION -1 I-EXPLORATION -y I-EXPLORATION -3 I-EXPLORATION -minutos I-EXPLORATION -de I-EXPLORATION -recuperación I-EXPLORATION -mediante I-EXPLORATION -pulsímetro I-EXPLORATION -(modelo I-EXPLORATION -M22 I-EXPLORATION -Polar®, I-EXPLORATION -Helsinki, I-EXPLORATION -Finlandia) I-EXPLORATION -y I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION -(PA, I-EXPLORATION +resolvió I-EXPLORATION en I-EXPLORATION -mmHg) I-EXPLORATION -mediante I-EXPLORATION -tensiómetro I-EXPLORATION -(modelo I-EXPLORATION -M2 I-EXPLORATION -BASIC I-EXPLORATION -OMRON I-EXPLORATION -HEALTHCARE®, I-EXPLORATION -Hoofddorp, I-EXPLORATION -Holanda). I-EXPLORATION -En I-EXPLORATION -cada I-EXPLORATION -sesión I-EXPLORATION -de I-EXPLORATION -ejercicio I-EXPLORATION -se I-EXPLORATION -determinaron I-EXPLORATION -la I-EXPLORATION -temperatura I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -humedad I-EXPLORATION -ambientales I-EXPLORATION -mediante I-EXPLORATION -un I-EXPLORATION -termómetro-higrómetro-barómetro-altímetro-cronómetro I-EXPLORATION -digital I-EXPLORATION -modelo I-EXPLORATION -AT701-H® I-EXPLORATION -(Atech I-EXPLORATION -Navigator, I-EXPLORATION -Hirschau, I-EXPLORATION -Alemania). I-EXPLORATION -Para I-EXPLORATION -valorar I-EXPLORATION -el I-EXPLORATION -ejercicio I-EXPLORATION -realizado I-EXPLORATION -se I-EXPLORATION -midió I-EXPLORATION +su I-EXPLORATION +práctica I-EXPLORATION +totalidad I-EXPLORATION +con I-EXPLORATION el I-EXPLORATION -tiempo I-EXPLORATION +drenaje I-EXPLORATION de I-EXPLORATION -ejercicio I-EXPLORATION -completado. I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION la I-EXPLORATION +misma. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +72 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cardiopatía I-PAST_MEDICAL_HISTORY +coronaria, I-PAST_MEDICAL_HISTORY +insuficiencia I-PAST_MEDICAL_HISTORY +renal I-PAST_MEDICAL_HISTORY +crónica I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +hemodiálisis I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +uropatía I-PAST_MEDICAL_HISTORY +obstructiva, I-PAST_MEDICAL_HISTORY +portador I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +una I-PAST_MEDICAL_HISTORY +cistostomía I-PAST_MEDICAL_HISTORY +hace I-PAST_MEDICAL_HISTORY +5 I-PAST_MEDICAL_HISTORY +años, I-PAST_MEDICAL_HISTORY +fue B-PRESENT_ILLNESS +hospitalizado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +medicina I-PRESENT_ILLNESS +interna I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +realizar I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +cambio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +catéter I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hemodiálisis, I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +contexto I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +catéter I-PRESENT_ILLNESS +disfuncional; I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +embargo, I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +ingreso I-PRESENT_ILLNESS +llamó I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +atención I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +cistostomía I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +estaba I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +mal I-PRESENT_ILLNESS +estado, I-PRESENT_ILLNESS +objetivándose I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +presencia I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +orina I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +color I-PRESENT_ILLNESS +púrpura I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +bolsa I-PRESENT_ILLNESS +colectora. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Dentro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +medicamentos I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +usaba I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +forma I-PRESENT_ILLNESS +crónica, I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +destacó I-PRESENT_ILLNESS +ninguno I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +pudiese I-PRESENT_ILLNESS +relacionarse I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +cambio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +coloración I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +orina. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +físico, I-EXPLORATION +el I-EXPLORATION paciente I-EXPLORATION se I-EXPLORATION -le I-EXPLORATION -practicaron, I-EXPLORATION -al I-EXPLORATION -inicio I-EXPLORATION +encontraba I-EXPLORATION +en I-EXPLORATION +buenas I-EXPLORATION +condiciones I-EXPLORATION +generales, I-EXPLORATION +afebril, I-EXPLORATION +hemodinámicamente I-EXPLORATION +estable, I-EXPLORATION +con I-EXPLORATION +cistostomía I-EXPLORATION +in I-EXPLORATION +situ, I-EXPLORATION +funcionante, I-EXPLORATION +pero I-EXPLORATION +con I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +deficiente I-EXPLORATION +autocuidado, I-EXPLORATION +sucia I-EXPLORATION y I-EXPLORATION -al I-EXPLORATION -final I-EXPLORATION -del I-EXPLORATION -programa, I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -test: I-EXPLORATION - I-EXPLORATION --Caminata I-EXPLORATION de I-EXPLORATION -6 I-EXPLORATION -minutos I-EXPLORATION -(Six-minute I-EXPLORATION -Walk I-EXPLORATION -Test, I-EXPLORATION -6MWT) I-EXPLORATION -11, I-EXPLORATION -la I-EXPLORATION -distancia I-EXPLORATION -recorrida I-EXPLORATION -se I-EXPLORATION -midió I-EXPLORATION -mediante I-EXPLORATION -un I-EXPLORATION -podómetro I-EXPLORATION -modelo I-EXPLORATION -Dista I-EXPLORATION -Newfeel I-EXPLORATION -100® I-EXPLORATION -(Oxylane, I-EXPLORATION -Madrid, I-EXPLORATION -España) I-EXPLORATION +muy I-EXPLORATION +mal I-EXPLORATION +olor. I-EXPLORATION I-EXPLORATION --Dinamometría I-EXPLORATION -manual: I-EXPLORATION -se I-EXPLORATION -midió I-EXPLORATION -la I-EXPLORATION -fuerza I-EXPLORATION -máxima I-EXPLORATION -ejercida I-EXPLORATION -por I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -al I-EXPLORATION -instante I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -fuerza I-EXPLORATION -resistencia I-EXPLORATION -(aquella I-EXPLORATION +Se I-EXPLORATION +solicitó I-EXPLORATION +un I-EXPLORATION +sedimento I-EXPLORATION +urinario I-EXPLORATION que I-EXPLORATION -aplica I-EXPLORATION +evidenció I-EXPLORATION +leucocitos I-EXPLORATION +5-10 I-EXPLORATION +x I-EXPLORATION +campo I-EXPLORATION +[valor I-EXPLORATION +normal I-EXPLORATION +(VN): I-EXPLORATION +1-5], I-EXPLORATION +abundantes I-EXPLORATION +bacterias I-EXPLORATION +y I-EXPLORATION +fosfatos I-EXPLORATION +amorfos I-EXPLORATION +abundantes I-EXPLORATION +x I-EXPLORATION +campo. I-EXPLORATION +En I-EXPLORATION el I-EXPLORATION -sujeto I-EXPLORATION -durante I-EXPLORATION -10" I-EXPLORATION -con I-EXPLORATION -cada I-EXPLORATION -mano, I-EXPLORATION -manteniendo I-EXPLORATION +examen I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION +completo I-EXPLORATION +destacó I-EXPLORATION el I-EXPLORATION -brazo I-EXPLORATION -estirado I-EXPLORATION +color I-EXPLORATION y I-EXPLORATION -presionando I-EXPLORATION -la I-EXPLORATION -perilla I-EXPLORATION -del I-EXPLORATION -dinamómetro I-EXPLORATION -tanto I-EXPLORATION -como I-EXPLORATION -se I-EXPLORATION -pueda) I-EXPLORATION -en I-EXPLORATION -ambos I-EXPLORATION -miembros I-EXPLORATION -superiores12, I-EXPLORATION -13. I-EXPLORATION -Para I-EXPLORATION -evitar I-EXPLORATION -que I-EXPLORATION -la I-EXPLORATION -fatiga I-EXPLORATION -alterase I-EXPLORATION -los I-EXPLORATION -resultados, I-EXPLORATION -se I-EXPLORATION -instruyó I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -un I-EXPLORATION -día I-EXPLORATION +aspecto I-EXPLORATION +turbio, I-EXPLORATION +pH I-EXPLORATION +de I-EXPLORATION +7, I-EXPLORATION +8 I-EXPLORATION +[VN: I-EXPLORATION +4, I-EXPLORATION +5-8, I-EXPLORATION +0] I-EXPLORATION y I-EXPLORATION +nitritos I-EXPLORATION +positivos. I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +urocultivo I-EXPLORATION se I-EXPLORATION -realizó I-EXPLORATION -la I-EXPLORATION -prueba I-EXPLORATION -al I-EXPLORATION -siguiente. I-EXPLORATION -Ambas I-EXPLORATION -variables I-EXPLORATION -se I-EXPLORATION -midieron I-EXPLORATION -en I-EXPLORATION -kg I-EXPLORATION -mediante I-EXPLORATION +objetivó I-EXPLORATION un I-EXPLORATION -dinamómetro I-EXPLORATION +recuento I-EXPLORATION +mayor I-EXPLORATION +a I-EXPLORATION +100.000 I-EXPLORATION +UFC/ml I-EXPLORATION de I-EXPLORATION -precisión I-EXPLORATION -100 I-EXPLORATION -g I-EXPLORATION -(modelo I-EXPLORATION -SH50008 I-EXPLORATION -Squeeze I-EXPLORATION -Saehan I-EXPLORATION -Corporation®, I-EXPLORATION -North I-EXPLORATION -Lincolnshire, I-EXPLORATION -Inglaterra). I-EXPLORATION - I-EXPLORATION --Flexibilidad I-EXPLORATION +Citrobacter I-EXPLORATION +freundii I-EXPLORATION +resistente I-EXPLORATION +a I-EXPLORATION +cefadroxilo, I-EXPLORATION +ciprofloxacino I-EXPLORATION +y I-EXPLORATION +nitrofurantoína. I-EXPLORATION +Entre I-EXPLORATION +los I-EXPLORATION +exámenes I-EXPLORATION de I-EXPLORATION -tronco, I-EXPLORATION -extremidades I-EXPLORATION -superiores I-EXPLORATION -e I-EXPLORATION -inferiores14: I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -se I-EXPLORATION -sentó I-EXPLORATION -al I-EXPLORATION -borde I-EXPLORATION +sangre, I-EXPLORATION +destacó I-EXPLORATION +una I-EXPLORATION +leucocitosis I-EXPLORATION de I-EXPLORATION +10.600 I-EXPLORATION +x I-EXPLORATION +mm3 I-EXPLORATION +[VN: I-EXPLORATION +4.000-9.000], I-EXPLORATION una I-EXPLORATION -silla I-EXPLORATION +PCR I-EXPLORATION de I-EXPLORATION -44 I-EXPLORATION -cm I-EXPLORATION +34 I-EXPLORATION +mg/dL I-EXPLORATION +[VN: I-EXPLORATION +0-5] I-EXPLORATION +y I-EXPLORATION +una I-EXPLORATION +VHS I-EXPLORATION de I-EXPLORATION -altura. I-EXPLORATION -Una I-EXPLORATION -pierna I-EXPLORATION -permanecía I-EXPLORATION -flexionada I-EXPLORATION +54 I-EXPLORATION +mm/h I-EXPLORATION +[VN: I-EXPLORATION +2-10]. I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +prostática, I-EXPLORATION +procedimiento I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +técnicamente I-EXPLORATION +limitado I-EXPLORATION +por I-EXPLORATION +parcial I-EXPLORATION +distensión I-EXPLORATION +vesical, I-EXPLORATION con I-EXPLORATION -la I-EXPLORATION -planta I-EXPLORATION +un I-EXPLORATION +volumen I-EXPLORATION +al I-EXPLORATION +momento I-EXPLORATION del I-EXPLORATION -pie I-EXPLORATION -apoyada I-EXPLORATION +estudio I-EXPLORATION +de I-EXPLORATION +26 I-EXPLORATION +cc, I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -suelo. I-EXPLORATION -La I-EXPLORATION -otra I-EXPLORATION -estirada I-EXPLORATION -lo I-EXPLORATION -máximo I-EXPLORATION -posible, I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +no I-EXPLORATION +fue I-EXPLORATION +posible I-EXPLORATION +evaluar I-EXPLORATION +la I-EXPLORATION +glándula I-EXPLORATION +prostática. I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +antibiótico I-TREATMENT +con I-TREATMENT +ceftriaxona I-TREATMENT +2 I-TREATMENT +g/día I-TREATMENT +endovenoso I-TREATMENT +y I-TREATMENT +se I-TREATMENT +solicitó I-TREATMENT +evaluación I-TREATMENT +por I-TREATMENT +urología, I-TREATMENT +quienes I-TREATMENT +decidieron I-TREATMENT +realizar I-TREATMENT +un I-TREATMENT +recambio I-TREATMENT +de I-TREATMENT +la I-TREATMENT +cistostomía, I-TREATMENT +en I-TREATMENT +contexto I-TREATMENT +de I-TREATMENT +la I-TREATMENT +infección I-TREATMENT +urinaria I-TREATMENT +y I-TREATMENT +el I-TREATMENT +aspecto I-TREATMENT +mal I-TREATMENT +cuidado I-TREATMENT +de I-TREATMENT +ésta. I-TREATMENT + I-TREATMENT +Con B-EVOLUTION +el I-EVOLUTION +transcurso I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +días, I-EVOLUTION +se I-EVOLUTION +observó I-EVOLUTION +un I-EVOLUTION +aclaramiento I-EVOLUTION +progresivo I-EVOLUTION +del I-EVOLUTION +color I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +orina, I-EVOLUTION +retornando I-EVOLUTION +a I-EVOLUTION +su I-EVOLUTION +color I-EVOLUTION +natural I-EVOLUTION +tras I-EVOLUTION +7 I-EVOLUTION +días I-EVOLUTION +de I-EVOLUTION +antibioterapia. I-EVOLUTION + I-EVOLUTION + +Paciente B-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +personal I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +carcinoma I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +células I-PAST_MEDICAL_HISTORY +basales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +piel I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +región I-PAST_MEDICAL_HISTORY +paranasal I-PAST_MEDICAL_HISTORY +izquierda, I-PAST_MEDICAL_HISTORY +acudió B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +nuestra I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +presentar I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +tumoración I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +crecimiento I-PRESENT_ILLNESS +progresivo I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +región I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +ángulo I-PRESENT_ILLNESS +mandibular I-PRESENT_ILLNESS +derecho, I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +tres I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Aportaba B-EXPLORATION +un I-EXPLORATION +informe I-EXPLORATION +citopatológico I-EXPLORATION +procedente I-EXPLORATION +de I-EXPLORATION +dos I-EXPLORATION +punciones-aspiración I-EXPLORATION con I-EXPLORATION -el I-EXPLORATION -talón I-EXPLORATION +aguja I-EXPLORATION +fina I-EXPLORATION +(PAAF) I-EXPLORATION +efectuada I-EXPLORATION en I-EXPLORATION -contacto I-EXPLORATION +otro I-EXPLORATION +centro, I-EXPLORATION con I-EXPLORATION el I-EXPLORATION -suelo I-EXPLORATION -y I-EXPLORATION -el I-EXPLORATION -pie I-EXPLORATION -en I-EXPLORATION -flexión I-EXPLORATION +resultado I-EXPLORATION de I-EXPLORATION -90o. I-EXPLORATION -Espalda I-EXPLORATION -y I-EXPLORATION -cabeza I-EXPLORATION -erectas. I-EXPLORATION -La I-EXPLORATION -mano I-EXPLORATION -derecha I-EXPLORATION -colocada I-EXPLORATION -encima I-EXPLORATION +frotis I-EXPLORATION +sugestivos I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -izquierda, I-EXPLORATION -con I-EXPLORATION -los I-EXPLORATION -terceros I-EXPLORATION -dedos I-EXPLORATION -superpuestos. I-EXPLORATION -Se I-EXPLORATION -invitó I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -a I-EXPLORATION -alcanzar I-EXPLORATION -la I-EXPLORATION -punta I-EXPLORATION -del I-EXPLORATION -pie I-EXPLORATION +proliferación I-EXPLORATION +epitelial I-EXPLORATION +de I-EXPLORATION +baja I-EXPLORATION +agresividad I-EXPLORATION +citológica. I-EXPLORATION +Los I-EXPLORATION +hallazgos I-EXPLORATION +observados I-EXPLORATION +eran I-EXPLORATION +compatibles I-EXPLORATION con I-EXPLORATION -las I-EXPLORATION -manos I-EXPLORATION -mientras I-EXPLORATION -se I-EXPLORATION -expulsa I-EXPLORATION -el I-EXPLORATION -aire. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION un I-EXPLORATION -intento I-EXPLORATION -con I-EXPLORATION -cada I-EXPLORATION -pierna. I-EXPLORATION -Se I-EXPLORATION -permitió I-EXPLORATION -una I-EXPLORATION -familiarización I-EXPLORATION -previa I-EXPLORATION -al I-EXPLORATION -test. I-EXPLORATION -El I-EXPLORATION -resultado I-EXPLORATION -es I-EXPLORATION -la I-EXPLORATION -máxima I-EXPLORATION -distancia I-EXPLORATION -alcanzada I-EXPLORATION -(cm), I-EXPLORATION -mantenida I-EXPLORATION -durante I-EXPLORATION -2", I-EXPLORATION -medida I-EXPLORATION -con I-EXPLORATION -cinta I-EXPLORATION -antropométrica I-EXPLORATION -(Clase I-EXPLORATION -I I-EXPLORATION -modelo I-EXPLORATION -CM040 I-EXPLORATION -Gisibérica®, I-EXPLORATION -Cáceres, I-EXPLORATION -España). I-EXPLORATION - I-EXPLORATION --Flexibilidad I-EXPLORATION +adenoma I-EXPLORATION +pleomorfo I-EXPLORATION de I-EXPLORATION -extremidades I-EXPLORATION -superiores14: I-EXPLORATION +glándula I-EXPLORATION +salivar, I-EXPLORATION +sin I-EXPLORATION +embargo I-EXPLORATION la I-EXPLORATION -participante I-EXPLORATION -se I-EXPLORATION -colocó I-EXPLORATION -en I-EXPLORATION -bipedestación, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION +cantidad I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -manos I-EXPLORATION -por I-EXPLORATION -encima I-EXPLORATION -del I-EXPLORATION -hombro, I-EXPLORATION -con I-EXPLORATION +estroma I-EXPLORATION +era I-EXPLORATION +mínima, I-EXPLORATION +y I-EXPLORATION el I-EXPLORATION -codo I-EXPLORATION -apuntando I-EXPLORATION -hacia I-EXPLORATION -arriba, I-EXPLORATION -los I-EXPLORATION -dedos I-EXPLORATION -extendidos I-EXPLORATION -con I-EXPLORATION -la I-EXPLORATION -palma I-EXPLORATION +patrón I-EXPLORATION +se I-EXPLORATION +desviaba I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -mano I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -escápula I-EXPLORATION -e I-EXPLORATION -intentando I-EXPLORATION -deslizar I-EXPLORATION -esta I-EXPLORATION lo I-EXPLORATION -máximo I-EXPLORATION -posible I-EXPLORATION -a I-EXPLORATION +habitual I-EXPLORATION +en I-EXPLORATION +estos I-EXPLORATION +casos, I-EXPLORATION +por I-EXPLORATION lo I-EXPLORATION -largo I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -espalda. I-EXPLORATION -Al I-EXPLORATION -mismo I-EXPLORATION -tiempo, I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION se I-EXPLORATION -colocaba I-EXPLORATION -la I-EXPLORATION -otra I-EXPLORATION -mano I-EXPLORATION -detrás I-EXPLORATION -de I-EXPLORATION -la I-EXPLORATION -espalda, I-EXPLORATION -con I-EXPLORATION +pudieron I-EXPLORATION +descartar I-EXPLORATION +otros I-EXPLORATION +tumores, I-EXPLORATION +incluído I-EXPLORATION el I-EXPLORATION -dorso I-EXPLORATION -hacia I-EXPLORATION -la I-EXPLORATION -zona I-EXPLORATION -dorsal, I-EXPLORATION -intentando I-EXPLORATION -alcanzar I-EXPLORATION -o I-EXPLORATION -sobrepasar I-EXPLORATION +carcinoma. I-EXPLORATION +A I-EXPLORATION la I-EXPLORATION -otra I-EXPLORATION -mano. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION +exploración I-EXPLORATION +presentaba I-EXPLORATION un I-EXPLORATION -intento I-EXPLORATION -con I-EXPLORATION -cada I-EXPLORATION -brazo. I-EXPLORATION -Hubo I-EXPLORATION -una I-EXPLORATION -familiarización I-EXPLORATION -previa I-EXPLORATION -al I-EXPLORATION -test. I-EXPLORATION -El I-EXPLORATION -resultado I-EXPLORATION -es I-EXPLORATION -la I-EXPLORATION -mínima I-EXPLORATION -distancia I-EXPLORATION -(cm) I-EXPLORATION -alcanzada I-EXPLORATION -entre I-EXPLORATION -los I-EXPLORATION -terceros I-EXPLORATION -dedos I-EXPLORATION +nódulo I-EXPLORATION de I-EXPLORATION -ambas I-EXPLORATION -manos, I-EXPLORATION -mantenida I-EXPLORATION -durante I-EXPLORATION -2", I-EXPLORATION -medida I-EXPLORATION -mediante I-EXPLORATION -cinta I-EXPLORATION -antropométrica I-EXPLORATION -(Clase I-EXPLORATION -I I-EXPLORATION -modelo I-EXPLORATION -CM040 I-EXPLORATION -Gisibérica®, I-EXPLORATION -Cáceres, I-EXPLORATION -España). I-EXPLORATION - I-EXPLORATION --Fuerza I-EXPLORATION +2 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -extremidades I-EXPLORATION -inferiores: I-EXPLORATION +diámetro I-EXPLORATION +en I-EXPLORATION +región I-EXPLORATION +yugulodigástrica I-EXPLORATION +derecha, I-EXPLORATION +desplazable I-EXPLORATION +sobre I-EXPLORATION +planos I-EXPLORATION +profundos I-EXPLORATION +y I-EXPLORATION +no I-EXPLORATION +adherida I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +piel. I-EXPLORATION +No I-EXPLORATION se I-EXPLORATION -midió I-EXPLORATION -el I-EXPLORATION -número I-EXPLORATION +objetivaron I-EXPLORATION +otras I-EXPLORATION +adenopatías I-EXPLORATION +ni I-EXPLORATION +tumoraciones I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +cervicofacial. I-EXPLORATION + I-EXPLORATION +Con I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION +diagnóstica I-EXPLORATION de I-EXPLORATION -sentadillas I-EXPLORATION -realizadas I-EXPLORATION +tumor I-EXPLORATION en I-EXPLORATION -30" I-EXPLORATION -con I-EXPLORATION -las I-EXPLORATION -manos I-EXPLORATION -cruzadas I-EXPLORATION -sobre I-EXPLORATION -el I-EXPLORATION -pecho14. I-EXPLORATION -Se I-EXPLORATION -ha I-EXPLORATION -utilizado I-EXPLORATION +lóbulo I-EXPLORATION +superficial I-EXPLORATION +y I-EXPLORATION +cola I-EXPLORATION +parotídea I-EXPLORATION +derecha, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -silla I-EXPLORATION -de I-EXPLORATION -44 I-EXPLORATION -cm I-EXPLORATION +tomografía I-EXPLORATION +computerizada I-EXPLORATION +(TC) I-EXPLORATION +cervicofacial I-EXPLORATION +con I-EXPLORATION +contraste, I-EXPLORATION +practicándose I-EXPLORATION +ventana I-EXPLORATION de I-EXPLORATION -altura I-EXPLORATION +partes I-EXPLORATION +blandas I-EXPLORATION y I-EXPLORATION -un I-EXPLORATION -cronómetro I-EXPLORATION -(modelo I-EXPLORATION -AT701-H® I-EXPLORATION -Atech, I-EXPLORATION -Hirschau, I-EXPLORATION -Alemania). I-EXPLORATION +ventana I-EXPLORATION +de I-EXPLORATION +hueso. I-EXPLORATION I-EXPLORATION -Para I-EXPLORATION -valorar I-EXPLORATION -la I-EXPLORATION -percepción I-EXPLORATION +A I-EXPLORATION +nivel I-EXPLORATION del I-EXPLORATION -estado I-EXPLORATION +lóbulo I-EXPLORATION +superficial I-EXPLORATION de I-EXPLORATION -salud I-EXPLORATION +la I-EXPLORATION +glándula I-EXPLORATION +parotídea I-EXPLORATION +derecha, I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +cola I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +parótida, I-EXPLORATION se I-EXPLORATION -le I-EXPLORATION -aplicó I-EXPLORATION -el I-EXPLORATION -cuestionario I-EXPLORATION +objetivó I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +nodular, I-EXPLORATION +hipercaptante, I-EXPLORATION de I-EXPLORATION -Percepción I-EXPLORATION -del I-EXPLORATION -Estado I-EXPLORATION +bordes I-EXPLORATION +bien I-EXPLORATION +definidos I-EXPLORATION de I-EXPLORATION -Salud I-EXPLORATION +aproximadamente I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +diámetro I-EXPLORATION +que, I-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +características I-EXPLORATION +radiológicas I-EXPLORATION y I-EXPLORATION -Calidad I-EXPLORATION +la I-EXPLORATION +lenta I-EXPLORATION +evolución I-EXPLORATION +en I-EXPLORATION +tres I-EXPLORATION +años, I-EXPLORATION +se I-EXPLORATION +interpretó I-EXPLORATION +como I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +tumoral I-EXPLORATION +benigna, I-EXPLORATION +a I-EXPLORATION +considerar I-EXPLORATION +las I-EXPLORATION +etiologías I-EXPLORATION de I-EXPLORATION -Vida I-EXPLORATION -SF-36 I-EXPLORATION -validada I-EXPLORATION -para I-EXPLORATION -español I-EXPLORATION -por I-EXPLORATION -Alonso I-EXPLORATION -et I-EXPLORATION -al.15. I-EXPLORATION - I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION +adenoma I-EXPLORATION +pleomorfo, I-EXPLORATION +tumor I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -test I-EXPLORATION -funcionales I-EXPLORATION -y I-EXPLORATION -del I-EXPLORATION -test I-EXPLORATION +Warthin I-EXPLORATION +u I-EXPLORATION +otros I-EXPLORATION +tumores I-EXPLORATION de I-EXPLORATION -Percepción I-EXPLORATION -del I-EXPLORATION -Estado I-EXPLORATION +la I-EXPLORATION +glándula I-EXPLORATION +salivar I-EXPLORATION de I-EXPLORATION -Salud, I-EXPLORATION -SF-36, I-EXPLORATION -obtenidos I-EXPLORATION -al I-EXPLORATION -inicio I-EXPLORATION -y I-EXPLORATION -tras I-EXPLORATION -realizar I-EXPLORATION -el I-EXPLORATION -programa I-EXPLORATION +naturaleza I-EXPLORATION +benigna. I-EXPLORATION +Se I-EXPLORATION +observaron I-EXPLORATION +adenopatías I-EXPLORATION de I-EXPLORATION -ejercicios, I-EXPLORATION -se I-EXPLORATION -muestran I-EXPLORATION +tamaño I-EXPLORATION +no I-EXPLORATION +significativo I-EXPLORATION en I-EXPLORATION -las I-EXPLORATION -tablas I-EXPLORATION -2 I-EXPLORATION +sendas I-EXPLORATION +cadenas I-EXPLORATION +submandibulares, I-EXPLORATION +yugulodigástricas I-EXPLORATION y I-EXPLORATION -3 I-EXPLORATION -respectivamente. I-EXPLORATION +en I-EXPLORATION +triángulos I-EXPLORATION +posteriores. I-EXPLORATION I-EXPLORATION - -Mujer B-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -47 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY -hábitos I-PAST_MEDICAL_HISTORY -tóxicos I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -alergias I-PAST_MEDICAL_HISTORY -conocidas I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -fármacos, I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -enfermedades I-PAST_MEDICAL_HISTORY -médicas I-PAST_MEDICAL_HISTORY -relevantes. I-PAST_MEDICAL_HISTORY -Acudió B-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -hospital I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -enero I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -2010 I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -presentar I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -tobillo I-PRESENT_ILLNESS -derecho I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -año I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -evolución, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -aumentaba I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -carga I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -se I-PRESENT_ILLNESS -acompañaba I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -signos I-PRESENT_ILLNESS -flogóticos. I-PRESENT_ILLNESS -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -gammagrafía I-EXPLORATION -ósea I-EXPLORATION -y I-EXPLORATION -una I-EXPLORATION -RMN I-EXPLORATION -que I-EXPLORATION -objetivó I-EXPLORATION -un I-EXPLORATION -intenso I-EXPLORATION -edema I-EXPLORATION -óseo I-EXPLORATION -con I-EXPLORATION -severa I-EXPLORATION -pérdida I-EXPLORATION -de I-EXPLORATION -densidad I-EXPLORATION -mineral, I-EXPLORATION -sugestivo I-EXPLORATION -de I-EXPLORATION -osteonecrosis I-EXPLORATION -del I-EXPLORATION -astrágalo I-EXPLORATION -con I-EXPLORATION -derrame I-EXPLORATION -articular I-EXPLORATION -asociado. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -pamidronato I-TREATMENT -intravenoso, I-TREATMENT -pero I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -presentó I-TREATMENT -fiebre I-TREATMENT -alta I-TREATMENT -tras I-TREATMENT +Con B-TREATMENT la I-TREATMENT -infusión I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT +sospecha I-TREATMENT +clínico-radiológica I-TREATMENT +de I-TREATMENT +tumor I-TREATMENT +benigno I-TREATMENT +de I-TREATMENT +glándula I-TREATMENT +parótida I-TREATMENT +derecha, I-TREATMENT se I-TREATMENT -suspendió I-TREATMENT -su I-TREATMENT -administración. I-TREATMENT -Se I-TREATMENT -pautó I-TREATMENT -tramadol, I-TREATMENT -diclofenaco I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -rehabilitador, I-TREATMENT -sin I-TREATMENT -evidente I-TREATMENT -mejoría I-TREATMENT +intervino I-TREATMENT +quirúrgicamente I-TREATMENT +bajo I-TREATMENT +anestesia I-TREATMENT +general I-TREATMENT +e I-TREATMENT +intubación I-TREATMENT +orotraqueal, I-TREATMENT +realizándose I-TREATMENT +parotidectomía I-TREATMENT +suprafacial I-TREATMENT +a I-TREATMENT +través I-TREATMENT +de I-TREATMENT +un I-TREATMENT +abordaje I-TREATMENT +de I-TREATMENT +ritidectomía, I-TREATMENT +con I-TREATMENT +resección I-TREATMENT del I-TREATMENT -dolor. I-TREATMENT -En B-EVOLUTION -septiembre I-EVOLUTION -de I-EVOLUTION -2010 I-EVOLUTION -refiere I-EVOLUTION -dolor I-EVOLUTION -intenso I-EVOLUTION -en I-EVOLUTION -región I-EVOLUTION -inguinal I-EVOLUTION -derecha, I-EVOLUTION -que I-EVOLUTION -aumentaba I-EVOLUTION -con I-EVOLUTION -la I-EVOLUTION -deambulación. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -una I-EXPLORATION -RMN I-EXPLORATION +lóbulo I-TREATMENT +parotídeo I-TREATMENT +superficial I-TREATMENT +de I-TREATMENT +5 I-TREATMENT +x I-TREATMENT +3 I-TREATMENT +cm I-TREATMENT +y I-TREATMENT +aplicación I-TREATMENT +de I-TREATMENT +cierre I-TREATMENT +con I-TREATMENT +colgajo I-TREATMENT +de I-TREATMENT +SMAS. I-TREATMENT +En B-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +anatomopatológico I-EXPLORATION de I-EXPLORATION -ambas I-EXPLORATION -caderas I-EXPLORATION -observándose I-EXPLORATION +la I-EXPLORATION +pieza I-EXPLORATION +se I-EXPLORATION +objetivó I-EXPLORATION una I-EXPLORATION -necrosis I-EXPLORATION -avascular I-EXPLORATION +tumoración I-EXPLORATION +bien I-EXPLORATION +delimitada I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -cabeza I-EXPLORATION -femoral I-EXPLORATION -derecha, I-EXPLORATION -estadío I-EXPLORATION -I-II I-EXPLORATION +18 I-EXPLORATION +mm I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -clasificación I-EXPLORATION +diámetro, I-EXPLORATION de I-EXPLORATION -FICAT. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -gabapentina I-TREATMENT -oral I-TREATMENT -(600 I-TREATMENT -mg/8 I-TREATMENT -horas), I-TREATMENT -y B-DERIVED_FROM/TO -se I-DERIVED_FROM/TO -remitió I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -unidad I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -metabolismo I-DERIVED_FROM/TO -óseo. I-DERIVED_FROM/TO -En B-EXPLORATION -la I-EXPLORATION -exploración I-EXPLORATION -física I-EXPLORATION +color I-EXPLORATION +blanquecino I-EXPLORATION +y I-EXPLORATION +superficie I-EXPLORATION +homogénea, I-EXPLORATION en I-EXPLORATION -nuestra I-EXPLORATION -consulta I-EXPLORATION -llamaba I-EXPLORATION -la I-EXPLORATION -atención I-EXPLORATION -la I-EXPLORATION -presencia I-EXPLORATION +un I-EXPLORATION +extremo I-EXPLORATION de I-EXPLORATION -escleras I-EXPLORATION -azuladas. I-EXPLORATION -Reinterrogada B-FAMILY_HISTORY -la I-FAMILY_HISTORY -paciente, I-FAMILY_HISTORY -señalaba I-FAMILY_HISTORY -que I-FAMILY_HISTORY -su I-FAMILY_HISTORY -madre I-FAMILY_HISTORY -había I-FAMILY_HISTORY -presentado I-FAMILY_HISTORY -múltiples I-FAMILY_HISTORY -fracturas I-FAMILY_HISTORY -desde I-FAMILY_HISTORY -los I-FAMILY_HISTORY -49 I-FAMILY_HISTORY -años, I-FAMILY_HISTORY -que I-FAMILY_HISTORY -la I-FAMILY_HISTORY -mantenían I-FAMILY_HISTORY -inmovilizada. I-FAMILY_HISTORY -Un I-FAMILY_HISTORY -hermano I-FAMILY_HISTORY -y I-FAMILY_HISTORY -dos I-FAMILY_HISTORY -tías I-FAMILY_HISTORY -maternas I-FAMILY_HISTORY -también I-FAMILY_HISTORY -habían I-FAMILY_HISTORY -padecido I-FAMILY_HISTORY -fracturas I-FAMILY_HISTORY -de I-FAMILY_HISTORY -cadera I-FAMILY_HISTORY -precoces. I-FAMILY_HISTORY -La B-EXPLORATION -densitometría I-EXPLORATION -mostró I-EXPLORATION +la I-EXPLORATION +pieza. I-EXPLORATION +Al I-EXPLORATION +corte, I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION una I-EXPLORATION -osteoporosis I-EXPLORATION -grave I-EXPLORATION -en I-EXPLORATION -las I-EXPLORATION -tres I-EXPLORATION -localizaciones I-EXPLORATION -habituales I-EXPLORATION -(columna I-EXPLORATION -lumbar: I-EXPLORATION -T-score=-3, I-EXPLORATION -Z-score=-1, I-EXPLORATION -8; I-EXPLORATION -cuello I-EXPLORATION -femoral: I-EXPLORATION -T-score=-3, I-EXPLORATION -1, I-EXPLORATION -Z-score=-2, I-EXPLORATION -3 I-EXPLORATION -y I-EXPLORATION -cadera I-EXPLORATION -total: I-EXPLORATION -T-score=-2, I-EXPLORATION -7, I-EXPLORATION -Z-score= I-EXPLORATION --2, I-EXPLORATION -0). I-EXPLORATION -La I-EXPLORATION -calciuria I-EXPLORATION -era I-EXPLORATION +tumoración I-EXPLORATION +bien I-EXPLORATION +delimitada, I-EXPLORATION de I-EXPLORATION -336 I-EXPLORATION -mg/dl, I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION +textura I-EXPLORATION +homogénea, I-EXPLORATION +y I-EXPLORATION +características I-EXPLORATION +macroscópicas I-EXPLORATION de I-EXPLORATION -25 I-EXPLORATION -(OH) I-EXPLORATION -vitamina I-EXPLORATION -D I-EXPLORATION +normalidad I-EXPLORATION +para I-EXPLORATION +el I-EXPLORATION +resto I-EXPLORATION de I-EXPLORATION -11 I-EXPLORATION -ng/ml I-EXPLORATION -y I-EXPLORATION la I-EXPLORATION -PTH I-EXPLORATION -intacta, I-EXPLORATION +glándula. I-EXPLORATION +Asimismo, I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +biosia-exéresis I-EXPLORATION de I-EXPLORATION -49 I-EXPLORATION -pg/ml. I-EXPLORATION -Los I-EXPLORATION -marcadores I-EXPLORATION +adenopatía I-EXPLORATION de I-EXPLORATION -remodelado I-EXPLORATION -óseo I-EXPLORATION -estaban I-EXPLORATION -elevados I-EXPLORATION +2, I-EXPLORATION +5 I-EXPLORATION +x I-EXPLORATION +1 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -forma I-EXPLORATION -franca I-EXPLORATION -(CTX: I-EXPLORATION -1, I-EXPLORATION -036 I-EXPLORATION -ng/ml). I-EXPLORATION -Dados I-EXPLORATION -los I-EXPLORATION -hallazgos I-EXPLORATION -clínicos I-EXPLORATION +diámetro I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +proximidad I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +glándula I-EXPLORATION +parótida, I-EXPLORATION +que I-EXPLORATION +al I-EXPLORATION +corte I-EXPLORATION +presentó I-EXPLORATION +una I-EXPLORATION +textura I-EXPLORATION +homogénea, I-EXPLORATION +color I-EXPLORATION +blanquecino I-EXPLORATION y I-EXPLORATION -los I-EXPLORATION -antecedentes I-EXPLORATION -familiares, I-EXPLORATION -se I-EXPLORATION -estableció I-EXPLORATION +consistencia I-EXPLORATION +elástica. I-EXPLORATION +En I-EXPLORATION el I-EXPLORATION -diagnóstico I-EXPLORATION +examen I-EXPLORATION +microscópico I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +encapsulada I-EXPLORATION +constituida I-EXPLORATION +por I-EXPLORATION +nidos I-EXPLORATION +o I-EXPLORATION +trabéculas I-EXPLORATION +separadas I-EXPLORATION +por I-EXPLORATION +una I-EXPLORATION +membrana I-EXPLORATION +basal I-EXPLORATION +eosinófila I-EXPLORATION +y I-EXPLORATION +constituidas I-EXPLORATION +por I-EXPLORATION +células I-EXPLORATION +basalioides I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +disponían I-EXPLORATION +a I-EXPLORATION +modo I-EXPLORATION de I-EXPLORATION -osteogénesis I-EXPLORATION -imperfecta I-EXPLORATION -tipo I-EXPLORATION -I. I-EXPLORATION +empalizada I-EXPLORATION +periférica. I-EXPLORATION La I-EXPLORATION -audiometría I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -mínima I-EXPLORATION -caída I-EXPLORATION +celularidad I-EXPLORATION en I-EXPLORATION -los I-EXPLORATION -tonos I-EXPLORATION -agudos. I-EXPLORATION -Se B-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -calcio I-TREATMENT -(1.000 I-TREATMENT -mg/día), I-TREATMENT -vitamina I-TREATMENT -D I-TREATMENT -(800 I-TREATMENT -UI/día) I-TREATMENT -y I-TREATMENT -risedronato I-TREATMENT -(35 I-TREATMENT -mg/semana), I-TREATMENT -en I-TREATMENT -enero I-TREATMENT -de I-TREATMENT -2011. I-TREATMENT -En I-TREATMENT -marzo I-TREATMENT -de I-TREATMENT -ese I-TREATMENT -año, I-TREATMENT -se I-TREATMENT -cambió I-TREATMENT -el I-TREATMENT -risedronato I-TREATMENT -por I-TREATMENT -teriparatida I-TREATMENT -subcutánea I-TREATMENT -(20 I-TREATMENT -mcg/día) I-TREATMENT -debido I-TREATMENT -a I-TREATMENT -intolerancia I-TREATMENT -digestiva. I-TREATMENT -En B-EXPLORATION -mayo I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +inmunohistoquímico I-EXPLORATION +fue I-EXPLORATION +positiva I-EXPLORATION +para I-EXPLORATION +citoqueratina I-EXPLORATION de I-EXPLORATION -2011, I-EXPLORATION -una I-EXPLORATION -RMN I-EXPLORATION +alto I-EXPLORATION +peso I-EXPLORATION +molecular I-EXPLORATION +y I-EXPLORATION +focalmente I-EXPLORATION +positiva I-EXPLORATION +para I-EXPLORATION +S-100. I-EXPLORATION +El I-EXPLORATION +diagnóstico I-EXPLORATION +anatomopatológico I-EXPLORATION +fue I-EXPLORATION de I-EXPLORATION -control I-EXPLORATION -mostró I-EXPLORATION -una I-EXPLORATION -franca I-EXPLORATION -disminución I-EXPLORATION -del I-EXPLORATION -edema I-EXPLORATION -óseo I-EXPLORATION +adenoma I-EXPLORATION +de I-EXPLORATION +células I-EXPLORATION +basales I-EXPLORATION +de I-EXPLORATION +glándula I-EXPLORATION +parótida I-EXPLORATION y I-EXPLORATION -del I-EXPLORATION -derrame I-EXPLORATION -articular I-EXPLORATION -del I-EXPLORATION -tobillo I-EXPLORATION -así I-EXPLORATION -como I-EXPLORATION -del I-EXPLORATION -edema I-EXPLORATION -medular I-EXPLORATION -en I-EXPLORATION -la I-EXPLORATION -cadera I-EXPLORATION -derecha. I-EXPLORATION -La B-EVOLUTION -paciente I-EVOLUTION -cumplió I-EVOLUTION -24 I-EVOLUTION -meses I-EVOLUTION -de I-EVOLUTION -teriparatida I-EVOLUTION -sin I-EVOLUTION +ganglios I-EXPLORATION +linfáticos I-EXPLORATION +con I-EXPLORATION +hiperplasia I-EXPLORATION +folicular. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +postoperatorio I-EVOLUTION +inmediato I-EVOLUTION +no I-EVOLUTION +presentó I-EVOLUTION complicaciones I-EVOLUTION -y I-EVOLUTION -con I-EVOLUTION -progresiva I-EVOLUTION -mejoría I-EVOLUTION -clínica. I-EVOLUTION -Los I-EVOLUTION -marcadores I-EVOLUTION +importantes, I-EVOLUTION +salvo I-EVOLUTION +ligera I-EVOLUTION +paresia I-EVOLUTION +a I-EVOLUTION +nivel I-EVOLUTION de I-EVOLUTION -formación I-EVOLUTION -se I-EVOLUTION -mantuvieron I-EVOLUTION -elevados I-EVOLUTION -durante I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -(propéptido I-EVOLUTION -aminoterminal I-EVOLUTION +las I-EVOLUTION +ramas I-EVOLUTION +frontal I-EVOLUTION +y I-EVOLUTION +bucal I-EVOLUTION del I-EVOLUTION -procolágeno I-EVOLUTION -tipo I-EVOLUTION -1 I-EVOLUTION --PINP-: I-EVOLUTION -45 I-EVOLUTION -ng/ml; I-EVOLUTION -osteocalcina: I-EVOLUTION ->100 I-EVOLUTION -ng/ml), I-EVOLUTION -así I-EVOLUTION -como I-EVOLUTION +nervio I-EVOLUTION +facial, I-EVOLUTION +que I-EVOLUTION +experimentó I-EVOLUTION +mejoría I-EVOLUTION +progresiva I-EVOLUTION +en I-EVOLUTION los I-EVOLUTION -niveles I-EVOLUTION -de I-EVOLUTION -25 I-EVOLUTION -(OH) I-EVOLUTION -vitamina I-EVOLUTION -D. I-EVOLUTION -En B-TREATMENT -marzo I-TREATMENT -de I-TREATMENT -2013 I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -denosumab I-TREATMENT -(60 I-TREATMENT -mg/6 I-TREATMENT -meses), I-TREATMENT -presentando B-EVOLUTION +días I-EVOLUTION +subsiguientes I-EVOLUTION +a I-EVOLUTION la I-EVOLUTION -paciente I-EVOLUTION -una I-EVOLUTION -evolución I-EVOLUTION -clínica I-EVOLUTION -y I-EVOLUTION -radiológica I-EVOLUTION -satisfactoria. I-EVOLUTION +intervención. I-EVOLUTION + I-EVOLUTION + +Presentamos B-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +caso I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +40 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +diaforesis I-PRESENT_ILLNESS +tras I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +ingesta I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +30 I-PRESENT_ILLNESS +g I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +hachís I-PRESENT_ILLNESS +para I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +transporte I-PRESENT_ILLNESS +ilegal, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +fue I-PRESENT_ILLNESS +custodiado I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +Policía I-PRESENT_ILLNESS +Nacional I-PRESENT_ILLNESS +durante I-PRESENT_ILLNESS +toda I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +estancia I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +hospital. I-PRESENT_ILLNESS En B-EXPLORATION -la I-EXPLORATION -última I-EXPLORATION -consulta, I-EXPLORATION -en I-EXPLORATION -enero I-EXPLORATION -de I-EXPLORATION -2015, I-EXPLORATION -los I-EXPLORATION -marcadores I-EXPLORATION +una I-EXPLORATION +tomografía I-EXPLORATION +computarizada I-EXPLORATION +(TC) I-EXPLORATION +abdominal I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +dos I-EXPLORATION +cuerpos I-EXPLORATION +extraños I-EXPLORATION de I-EXPLORATION -remodelado I-EXPLORATION -estaban I-EXPLORATION -suprimidos I-EXPLORATION -(PINP: I-EXPLORATION -5, I-EXPLORATION -8 I-EXPLORATION -ng/ml; I-EXPLORATION -telopéptido I-EXPLORATION -carboxiterminal I-EXPLORATION -del I-EXPLORATION -colágeno I-EXPLORATION -tipo I-EXPLORATION -1 I-EXPLORATION --CTX-: I-EXPLORATION -<0, I-EXPLORATION -030 I-EXPLORATION -ng/ml) I-EXPLORATION +4 I-EXPLORATION +cm I-EXPLORATION y I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION +3 I-EXPLORATION +cm I-EXPLORATION +en I-EXPLORATION +íleon, I-EXPLORATION +con I-EXPLORATION +signos I-EXPLORATION de I-EXPLORATION -25 I-EXPLORATION -(OH) I-EXPLORATION -vitamina I-EXPLORATION -D I-EXPLORATION -son I-EXPLORATION +obstrucción I-EXPLORATION +mecánica I-EXPLORATION +sin I-EXPLORATION +perforación, I-EXPLORATION +que I-EXPLORATION +se I-EXPLORATION +expulsaron I-EXPLORATION de I-EXPLORATION -31 I-EXPLORATION -ng/ml. I-EXPLORATION -La I-EXPLORATION -densidad I-EXPLORATION -mineral I-EXPLORATION -ósea I-EXPLORATION -(DMO) I-EXPLORATION +forma I-EXPLORATION +espontánea I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +24 I-EXPLORATION +horas, I-EXPLORATION +confirmándose I-EXPLORATION +su I-EXPLORATION +naturaleza I-EXPLORATION +tras I-EXPLORATION +el I-EXPLORATION +análisis I-EXPLORATION +específico. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +TC I-EXPLORATION de I-EXPLORATION control I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -redujo I-EXPLORATION -significativamente I-EXPLORATION -respecto I-EXPLORATION a I-EXPLORATION -la I-EXPLORATION -basal I-EXPLORATION -(columna I-EXPLORATION -lumbar: I-EXPLORATION -T-score=-3, I-EXPLORATION -1 I-EXPLORATION -y I-EXPLORATION -Z-score=-1, I-EXPLORATION -5; I-EXPLORATION -cuello I-EXPLORATION -femoral: I-EXPLORATION -T-score=-3, I-EXPLORATION -2 I-EXPLORATION -y I-EXPLORATION -Z-score=-2; I-EXPLORATION -cadera I-EXPLORATION -total: I-EXPLORATION -T-score=-3 I-EXPLORATION -y I-EXPLORATION -Z-score=-2), I-EXPLORATION -pero I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -no I-EXPLORATION -había I-EXPLORATION -sufrido I-EXPLORATION -ninguna I-EXPLORATION -fractura I-EXPLORATION -ni I-EXPLORATION -osteonecrosis I-EXPLORATION +las I-EXPLORATION +48 I-EXPLORATION +horas I-EXPLORATION +se I-EXPLORATION +describía I-EXPLORATION +otro I-EXPLORATION +cuerpo I-EXPLORATION +extraño I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -seguimiento. I-EXPLORATION - I-EXPLORATION +antro I-EXPLORATION +gástrico, I-EXPLORATION +no I-EXPLORATION +objetivado I-EXPLORATION +previamente, I-EXPLORATION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +endoscopia I-TREATMENT +oral I-TREATMENT +con I-TREATMENT +extracción I-TREATMENT +mediante I-TREATMENT +cesta I-TREATMENT +de I-TREATMENT +Dormia I-TREATMENT +de I-TREATMENT +un I-TREATMENT +tercer I-TREATMENT +paquete I-TREATMENT +de I-TREATMENT +4 I-TREATMENT +cm, I-TREATMENT +morfología I-TREATMENT +redondeada I-TREATMENT +y I-TREATMENT +consistencia I-TREATMENT +semidura. I-TREATMENT +El B-EVOLUTION +procedimiento I-EVOLUTION +se I-EVOLUTION +llevó I-EVOLUTION +a I-EVOLUTION +cabo I-EVOLUTION +sin I-EVOLUTION +complicaciones I-EVOLUTION +bajo I-EVOLUTION +sedación I-EVOLUTION +profunda I-EVOLUTION +por I-EVOLUTION +anestesista. I-EVOLUTION + I-EVOLUTION -Paciente B-PRESENT_ILLNESS -mujer, I-PRESENT_ILLNESS +Mujer B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -68 I-PRESENT_ILLNESS +86 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -edad, I-PRESENT_ILLNESS -sin B-PAST_MEDICAL_HISTORY +con B-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY -patológicos I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -interés, I-PAST_MEDICAL_HISTORY -que B-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS -por I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -repetidos I-PRESENT_ILLNESS +tiroidectomía I-PAST_MEDICAL_HISTORY +total I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +bocio I-PAST_MEDICAL_HISTORY +multinodular I-PAST_MEDICAL_HISTORY +endotorácico, I-PAST_MEDICAL_HISTORY +esofagitis I-PAST_MEDICAL_HISTORY +denudativa I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +2011 I-PAST_MEDICAL_HISTORY +secundaria I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +amoxicilina, I-PAST_MEDICAL_HISTORY +divertículo I-PAST_MEDICAL_HISTORY +esofágico I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +pequeña I-PAST_MEDICAL_HISTORY +hernia I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +hiato. I-PAST_MEDICAL_HISTORY +Presentaba B-PRESENT_ILLNESS +disfagia I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS -e I-PRESENT_ILLNESS -inflamación I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -ambas I-PRESENT_ILLNESS -rodillas, I-PRESENT_ILLNESS -atribuido I-PRESENT_ILLNESS -hasta I-PRESENT_ILLNESS -entonces I-PRESENT_ILLNESS +predominio I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -proceso I-PRESENT_ILLNESS -degenerativo, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS +líquidos I-PRESENT_ILLNESS +lo I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -mejoraban I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -antiinflamatorios I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -esteroideos. I-PRESENT_ILLNESS -Durante I-PRESENT_ILLNESS -los I-PRESENT_ILLNESS -últimos I-PRESENT_ILLNESS -dos I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -también I-PRESENT_ILLNESS -había I-PRESENT_ILLNESS -presentado I-PRESENT_ILLNESS -dolor I-PRESENT_ILLNESS +motivó I-PRESENT_ILLNESS +ingresos I-PRESENT_ILLNESS +hospitalarios I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +broncoaspiración I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -ambas I-PRESENT_ILLNESS -muñecas I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -raquis I-PRESENT_ILLNESS -cervical, I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -características I-PRESENT_ILLNESS -mecánicas. I-PRESENT_ILLNESS -No I-PRESENT_ILLNESS -refería I-PRESENT_ILLNESS -haber I-PRESENT_ILLNESS -padecido I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -diarrea I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -vómitos, I-PRESENT_ILLNESS -no I-PRESENT_ILLNESS -consumía I-PRESENT_ILLNESS -diuréticos I-PRESENT_ILLNESS -ni I-PRESENT_ILLNESS -ningún I-PRESENT_ILLNESS -otro I-PRESENT_ILLNESS -tipo I-PRESENT_ILLNESS -de I-PRESENT_ILLNESS -fármacos. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -La B-EXPLORATION -exploración I-EXPLORATION -mostraba I-EXPLORATION +3 I-PRESENT_ILLNESS +ocasiones. I-PRESENT_ILLNESS +En B-EXPLORATION +el I-EXPLORATION +último I-EXPLORATION +ingreso I-EXPLORATION +se I-EXPLORATION +confirmó I-EXPLORATION +el I-EXPLORATION +divertículo I-EXPLORATION +ya I-EXPLORATION +conocido I-EXPLORATION +situado I-EXPLORATION a I-EXPLORATION +unos I-EXPLORATION +28 I-EXPLORATION +cm I-EXPLORATION +de I-EXPLORATION +arcada I-EXPLORATION +dentaria I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +endoscopia. I-EXPLORATION + I-EXPLORATION +A I-EXPLORATION +los I-EXPLORATION +seis I-EXPLORATION +pacientes I-EXPLORATION +descritos I-EXPLORATION +se I-EXPLORATION +les I-EXPLORATION +realizó I-EXPLORATION una I-EXPLORATION -paciente I-EXPLORATION -con I-EXPLORATION -buen I-EXPLORATION -estado I-EXPLORATION -general, I-EXPLORATION -normohidratada, I-EXPLORATION -con I-EXPLORATION -una I-EXPLORATION -presión I-EXPLORATION -arterial I-EXPLORATION +manometría I-EXPLORATION de I-EXPLORATION -120/80 I-EXPLORATION -mmHg. I-EXPLORATION -Del I-EXPLORATION -resto I-EXPLORATION +alta I-EXPLORATION +resolución I-EXPLORATION +(MAR), I-EXPLORATION +identificándose I-EXPLORATION +en I-EXPLORATION +todos I-EXPLORATION +los I-EXPLORATION +casos I-EXPLORATION +un I-EXPLORATION +trastorno I-EXPLORATION +motor I-EXPLORATION +esofágico I-EXPLORATION +(TME) I-EXPLORATION +concomitante. I-EXPLORATION +Los I-EXPLORATION +hallazgos I-EXPLORATION +obtenidos I-EXPLORATION +con I-EXPLORATION +MAR I-EXPLORATION +en I-EXPLORATION +cada I-EXPLORATION +uno I-EXPLORATION de I-EXPLORATION +los I-EXPLORATION +pacientes I-EXPLORATION +se I-EXPLORATION +muestran I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -exploración I-EXPLORATION -destacaba I-EXPLORATION -el I-EXPLORATION -dolor I-EXPLORATION -y I-EXPLORATION -la I-EXPLORATION -limitación I-EXPLORATION -a I-EXPLORATION -flexo-extensión I-EXPLORATION +tabla I-EXPLORATION +I. I-EXPLORATION +Se I-EXPLORATION +utilizaron I-EXPLORATION +como I-EXPLORATION +valores I-EXPLORATION de I-EXPLORATION +referencia I-EXPLORATION +los I-EXPLORATION +parámetros I-EXPLORATION +descritos I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -rodilla I-EXPLORATION -derecha I-EXPLORATION -con I-EXPLORATION -maniobras I-EXPLORATION -meniscales I-EXPLORATION -positivas, I-EXPLORATION -sin I-EXPLORATION -signos I-EXPLORATION +clasificación I-EXPLORATION de I-EXPLORATION -derrame I-EXPLORATION -articular. I-EXPLORATION -En I-EXPLORATION -las I-EXPLORATION -manos I-EXPLORATION -mostraba I-EXPLORATION -signos I-EXPLORATION -degenerativos I-EXPLORATION +Chicago I-EXPLORATION +vigente I-EXPLORATION +(7). I-EXPLORATION +El I-EXPLORATION +paciente I-EXPLORATION +del I-EXPLORATION +primer I-EXPLORATION +caso I-EXPLORATION +presentaba I-EXPLORATION +ondas I-EXPLORATION +hipercontráctiles I-EXPLORATION en I-EXPLORATION -articulaciones I-EXPLORATION -interfalángicas I-EXPLORATION -distales I-EXPLORATION -sugestivas I-EXPLORATION +los I-EXPLORATION +segmentos I-EXPLORATION +S2 I-EXPLORATION +y I-EXPLORATION +S3, I-EXPLORATION +siendo I-EXPLORATION +compatible I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +diagnóstico I-EXPLORATION +manométrico I-EXPLORATION de I-EXPLORATION -nódulos I-EXPLORATION +TME I-EXPLORATION +hipercontráctil I-EXPLORATION +("jackhammer"). I-EXPLORATION +La I-EXPLORATION +MAR I-EXPLORATION +del I-EXPLORATION +segundo I-EXPLORATION +paciente I-EXPLORATION +puso I-EXPLORATION de I-EXPLORATION -Heberden. I-EXPLORATION - I-EXPLORATION +manifiesto I-EXPLORATION +un I-EXPLORATION +TME I-EXPLORATION +de I-EXPLORATION +tipo I-EXPLORATION +espasmo I-EXPLORATION +esofágico I-EXPLORATION +distal, I-EXPLORATION +con I-EXPLORATION +afectación I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +segmento I-EXPLORATION +S3. I-EXPLORATION En I-EXPLORATION -la I-EXPLORATION -analítica, I-EXPLORATION el I-EXPLORATION -hemograma I-EXPLORATION -y I-EXPLORATION -fórmula I-EXPLORATION -fueron I-EXPLORATION -normales; I-EXPLORATION -los I-EXPLORATION -análisis I-EXPLORATION -bioquímicos I-EXPLORATION -mostraron I-EXPLORATION -los I-EXPLORATION -siguientes I-EXPLORATION -resultados: I-EXPLORATION -urea, I-EXPLORATION -37 I-EXPLORATION -mg/dl; I-EXPLORATION -creatinina, I-EXPLORATION -0, I-EXPLORATION -71 I-EXPLORATION -mg/dl; I-EXPLORATION -filtrado I-EXPLORATION -glomerular, I-EXPLORATION ->60 I-EXPLORATION -mL/min/1, I-EXPLORATION -73m2; I-EXPLORATION -calcio I-EXPLORATION -total, I-EXPLORATION -9, I-EXPLORATION -45 I-EXPLORATION -mg/dl; I-EXPLORATION -fosfato I-EXPLORATION -inorgánico, I-EXPLORATION -3, I-EXPLORATION -51 I-EXPLORATION -mg/dl; I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina, I-EXPLORATION -56 I-EXPLORATION -U/L; I-EXPLORATION -sodio I-EXPLORATION -(Na), I-EXPLORATION -140 I-EXPLORATION -mEq/l; I-EXPLORATION -potasio I-EXPLORATION -(K), I-EXPLORATION -3, I-EXPLORATION -4 I-EXPLORATION -mEq/l; I-EXPLORATION -TSH, I-EXPLORATION -3, I-EXPLORATION -45 I-EXPLORATION -mUL; I-EXPLORATION -PTH I-EXPLORATION -plasma, I-EXPLORATION -2, I-EXPLORATION -9 I-EXPLORATION -pmol/L I-EXPLORATION -(1,6-6,9); I-EXPLORATION -25-hidroxicolecalciferol, I-EXPLORATION -30, I-EXPLORATION -9 I-EXPLORATION -ng/ml I-EXPLORATION -(30-100); I-EXPLORATION -fosfatasa I-EXPLORATION -alcalina I-EXPLORATION -ósea, I-EXPLORATION -9, I-EXPLORATION -7 I-EXPLORATION -ug/L; I-EXPLORATION -magnesio I-EXPLORATION -(Mg), I-EXPLORATION -0, I-EXPLORATION -54 I-EXPLORATION -mmol/L I-EXPLORATION -(0,66-0,99). I-EXPLORATION -En I-EXPLORATION -orina I-EXPLORATION +tercer I-EXPLORATION +caso, I-EXPLORATION +la I-EXPLORATION +MAR I-EXPLORATION +reveló I-EXPLORATION +un I-EXPLORATION +TME I-EXPLORATION de I-EXPLORATION -24 I-EXPLORATION -horas: I-EXPLORATION -proteinuria I-EXPLORATION -negativa; I-EXPLORATION -calciuria, I-EXPLORATION -69, I-EXPLORATION -56 I-EXPLORATION -mg I-EXPLORATION -(100-250); I-EXPLORATION -fosfaturia, I-EXPLORATION -588, I-EXPLORATION -30 I-EXPLORATION -mg; I-EXPLORATION -Mg, I-EXPLORATION -1, I-EXPLORATION -31 I-EXPLORATION -mg/dL I-EXPLORATION -(1,7-5,7); I-EXPLORATION -fosfato I-EXPLORATION +tipo I-EXPLORATION +peristalsis I-EXPLORATION +débil I-EXPLORATION +por I-EXPLORATION +defecto I-EXPLORATION +peristáltico I-EXPLORATION +de I-EXPLORATION +pequeño I-EXPLORATION +tamaño I-EXPLORATION en I-EXPLORATION -primera I-EXPLORATION -orina I-EXPLORATION +el I-EXPLORATION +contorno I-EXPLORATION +isobárico I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -mañana, I-EXPLORATION -15, I-EXPLORATION -9 I-EXPLORATION -mg/dL I-EXPLORATION -(40-136). I-EXPLORATION -Los I-EXPLORATION -reactantes I-EXPLORATION +20 I-EXPLORATION +mmHg I-EXPLORATION +(en I-EXPLORATION +el I-EXPLORATION +50% I-EXPLORATION de I-EXPLORATION -fase I-EXPLORATION -aguda, I-EXPLORATION -factor I-EXPLORATION -reumatoide, I-EXPLORATION -anticuerpo I-EXPLORATION -anticitrulinado I-EXPLORATION -y I-EXPLORATION -anticuerpos I-EXPLORATION -antinucleares I-EXPLORATION -(ANA, I-EXPLORATION -anti-ENA) I-EXPLORATION -fueron I-EXPLORATION -normales I-EXPLORATION -o I-EXPLORATION -negativos. I-EXPLORATION - I-EXPLORATION -El I-EXPLORATION -estudio I-EXPLORATION -radiológico I-EXPLORATION -mostró I-EXPLORATION -calcificaciones I-EXPLORATION +las I-EXPLORATION +degluciones), I-EXPLORATION +con I-EXPLORATION +ondas I-EXPLORATION de I-EXPLORATION -los I-EXPLORATION -meniscos I-EXPLORATION +duración I-EXPLORATION +prolongada I-EXPLORATION +y I-EXPLORATION +morfología I-EXPLORATION de I-EXPLORATION -ambas I-EXPLORATION -rodillas I-EXPLORATION -con I-EXPLORATION -signos I-EXPLORATION -degenerativos I-EXPLORATION -añadidos, I-EXPLORATION +doble I-EXPLORATION +y I-EXPLORATION +triple I-EXPLORATION +pico I-EXPLORATION +en I-EXPLORATION +un I-EXPLORATION +56% I-EXPLORATION +y I-EXPLORATION +11% I-EXPLORATION de I-EXPLORATION -sínfisis I-EXPLORATION -púbica, I-EXPLORATION -ambos I-EXPLORATION -carpos, I-EXPLORATION +las I-EXPLORATION +degluciones I-EXPLORATION +respectivamente I-EXPLORATION en I-EXPLORATION -cartílago I-EXPLORATION -hialino I-EXPLORATION +el I-EXPLORATION +segmento I-EXPLORATION +S3. I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +del I-EXPLORATION +caso I-EXPLORATION +4 I-EXPLORATION +presentaba I-EXPLORATION +una I-EXPLORATION +obstrucción I-EXPLORATION +al I-EXPLORATION +tracto I-EXPLORATION +de I-EXPLORATION +salida I-EXPLORATION de I-EXPLORATION -coxofemorales I-EXPLORATION +la I-EXPLORATION +unión I-EXPLORATION +gastroesofágica I-EXPLORATION +(UGE) I-EXPLORATION y I-EXPLORATION -también I-EXPLORATION -en I-EXPLORATION -metatarsofalángicas I-EXPLORATION +simultáneamente I-EXPLORATION +un I-EXPLORATION +TME I-EXPLORATION +con I-EXPLORATION +rasgos I-EXPLORATION de I-EXPLORATION -primer I-EXPLORATION -dedo I-EXPLORATION +acalasia I-EXPLORATION +tipo I-EXPLORATION +III I-EXPLORATION +(espástica) I-EXPLORATION de I-EXPLORATION -ambos I-EXPLORATION -pies. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -resonancia I-EXPLORATION -magnérico I-EXPLORATION -nuclear I-EXPLORATION -(RM) I-EXPLORATION +probable I-EXPLORATION +origen I-EXPLORATION +secundario, I-EXPLORATION +observándose I-EXPLORATION +gran I-EXPLORATION +duración I-EXPLORATION de I-EXPLORATION -rodilla I-EXPLORATION -derecha I-EXPLORATION -mostraba I-EXPLORATION -severos I-EXPLORATION -signos I-EXPLORATION -degenerativos I-EXPLORATION +las I-EXPLORATION +ondas I-EXPLORATION +peristálticas I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +segmento I-EXPLORATION +S2 I-EXPLORATION +(a I-EXPLORATION +unos I-EXPLORATION +30 I-EXPLORATION +cm I-EXPLORATION +del I-EXPLORATION +orificio I-EXPLORATION +nasal). I-EXPLORATION +La I-EXPLORATION +paciente I-EXPLORATION +5 I-EXPLORATION +presentó I-EXPLORATION +también I-EXPLORATION +un I-EXPLORATION +TME I-EXPLORATION de I-EXPLORATION -artrosis I-EXPLORATION -fémoro-rotuliana, I-EXPLORATION -fémoro-tibial I-EXPLORATION -interna I-EXPLORATION -y I-EXPLORATION -externa, I-EXPLORATION +tipo I-EXPLORATION +hipercontráctil I-EXPLORATION +("jackhammer") I-EXPLORATION con I-EXPLORATION -rotura I-EXPLORATION -degenerativa I-EXPLORATION +ondas I-EXPLORATION de I-EXPLORATION -ambos I-EXPLORATION -meniscos. I-EXPLORATION - I-EXPLORATION -Se I-EXPLORATION -solicitó I-EXPLORATION -estudio I-EXPLORATION -genético I-EXPLORATION -molecular I-EXPLORATION -mediante I-EXPLORATION -amplificación I-EXPLORATION -PCR I-EXPLORATION +gran I-EXPLORATION +tamaño I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +segmentos I-EXPLORATION +S2 I-EXPLORATION y I-EXPLORATION -secuenciación I-EXPLORATION +sobre I-EXPLORATION +todo I-EXPLORATION +en I-EXPLORATION +S3. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION del I-EXPLORATION -gen I-EXPLORATION -SCL112A3, I-EXPLORATION -detectando I-EXPLORATION -homozigosis I-EXPLORATION +caso I-EXPLORATION +6 I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +un I-EXPLORATION +TME I-EXPLORATION +consistente I-EXPLORATION +en I-EXPLORATION +obstrucción I-EXPLORATION +al I-EXPLORATION +flujo I-EXPLORATION +de I-EXPLORATION +salida I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -mutación I-EXPLORATION -c2576T>C I-EXPLORATION -(p. I-EXPLORATION -L859P) I-EXPLORATION +UGE, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +alteración I-EXPLORATION en I-EXPLORATION -el I-EXPLORATION -exón I-EXPLORATION +la I-EXPLORATION +secuencia I-EXPLORATION +contráctil I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION del I-EXPLORATION -citado I-EXPLORATION -gen I-EXPLORATION -y I-EXPLORATION -que I-EXPLORATION -confirmaba I-EXPLORATION -el I-EXPLORATION -diagnóstico I-EXPLORATION +divertículo I-EXPLORATION +esofágico I-EXPLORATION +consistente I-EXPLORATION +en I-EXPLORATION +ensanchamiento I-EXPLORATION de I-EXPLORATION -síndrome I-EXPLORATION +la I-EXPLORATION +onda I-EXPLORATION de I-EXPLORATION -Gitelman. I-EXPLORATION +contracción I-EXPLORATION +(entre I-EXPLORATION +segmentos I-EXPLORATION +S2-S3). I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +todos I-EXPLORATION +los I-EXPLORATION +casos I-EXPLORATION +el I-EXPLORATION +segmento I-EXPLORATION +predominantemente I-EXPLORATION +afectado I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +MAR, I-EXPLORATION +coincidió I-EXPLORATION +con I-EXPLORATION +la I-EXPLORATION +localización I-EXPLORATION +del I-EXPLORATION +DE I-EXPLORATION +objetivada I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +estudios I-EXPLORATION +radiológicos I-EXPLORATION +y I-EXPLORATION +endoscópicos. I-EXPLORATION I-EXPLORATION +Cinco B-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +los I-DERIVED_FROM/TO +pacientes I-DERIVED_FROM/TO +fueron I-DERIVED_FROM/TO +remitidos I-DERIVED_FROM/TO +para I-DERIVED_FROM/TO +valoración I-DERIVED_FROM/TO +de I-DERIVED_FROM/TO +tratamiento I-DERIVED_FROM/TO +quirúrgico. I-DERIVED_FROM/TO El B-TREATMENT -tratamiento I-TREATMENT +paciente I-TREATMENT +del I-TREATMENT +primer I-TREATMENT +caso I-TREATMENT +fue I-TREATMENT +tratado I-TREATMENT +mediante I-TREATMENT +diverticulectomía I-TREATMENT +que I-TREATMENT +se I-TREATMENT +complicó I-TREATMENT +con I-TREATMENT +fístula I-TREATMENT +esófago-pleural I-TREATMENT +y I-TREATMENT +que I-TREATMENT fue I-TREATMENT +tratada I-TREATMENT +mediante I-TREATMENT +la I-TREATMENT +colocación I-TREATMENT de I-TREATMENT -suplementos I-TREATMENT -orales I-TREATMENT +una I-TREATMENT +prótesis I-TREATMENT +esofágica I-TREATMENT +metálica I-TREATMENT +cubierta I-TREATMENT +(Wallflex®). I-TREATMENT +Los I-TREATMENT +pacientes I-TREATMENT +del I-TREATMENT +segundo I-TREATMENT +y I-TREATMENT +tercer I-TREATMENT +caso I-TREATMENT +decidieron I-TREATMENT +continuar I-TREATMENT +un I-TREATMENT +manejo I-TREATMENT +conservador, I-TREATMENT +tras I-TREATMENT +desestimar I-TREATMENT +la I-TREATMENT +opción I-TREATMENT de I-TREATMENT -magnesio I-TREATMENT -a I-TREATMENT -dosis I-TREATMENT -variables I-TREATMENT -según I-TREATMENT -resultados I-TREATMENT -analíticos I-TREATMENT +cirugía I-TREATMENT +debido I-TREATMENT +al I-TREATMENT +riesgo I-TREATMENT de I-TREATMENT -seguimiento, I-TREATMENT -y I-TREATMENT -colchicina I-TREATMENT -0, I-TREATMENT -5 I-TREATMENT -mg I-TREATMENT +morbi-mortalidad I-TREATMENT +asociado I-TREATMENT al I-TREATMENT -día I-TREATMENT +mismo. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +del I-EVOLUTION +cuarto I-EVOLUTION +caso I-EVOLUTION +presentó I-EVOLUTION +un I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +hemorragia I-EVOLUTION +digestiva I-EVOLUTION +alta, I-EVOLUTION +identificándose B-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +estudio I-EXPLORATION +endoscópico I-EXPLORATION +urgente I-EXPLORATION +un I-EXPLORATION +gran I-EXPLORATION +coágulo I-EXPLORATION +adherido I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +pared I-EXPLORATION +del I-EXPLORATION +divertículo. I-EXPLORATION +Ello B-EVOLUTION +aceleró I-EVOLUTION +la I-EVOLUTION +decisión I-EVOLUTION +de I-EVOLUTION +tratamiento I-EVOLUTION +quirúrgico I-EVOLUTION +del I-EVOLUTION +DE, I-EVOLUTION +una I-EVOLUTION +vez I-EVOLUTION +superado I-EVOLUTION +el I-EVOLUTION +episodio I-EVOLUTION +de I-EVOLUTION +sangrado I-EVOLUTION +digestivo. I-EVOLUTION +No I-EVOLUTION +obstante, I-EVOLUTION +en I-EVOLUTION +los I-EVOLUTION +días I-EVOLUTION +posteriores I-EVOLUTION +al I-EVOLUTION +evento I-EVOLUTION +hemorrágico, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +desarrolló I-EVOLUTION +un I-EVOLUTION +cuadro I-EVOLUTION +séptico I-EVOLUTION +secundario I-EVOLUTION +a I-EVOLUTION +neumonía I-EVOLUTION +de I-EVOLUTION +origen I-EVOLUTION +espirativo, I-EVOLUTION +falleciendo I-EVOLUTION +finalmente. I-EVOLUTION +La B-TREATMENT +paciente I-TREATMENT +del I-TREATMENT +quinto I-TREATMENT +caso I-TREATMENT +fue I-TREATMENT +tratada I-TREATMENT +quirúrgicamente I-TREATMENT +realizándose I-TREATMENT +diverticulectomía I-TREATMENT +y I-TREATMENT +miotomía I-TREATMENT +mediante I-TREATMENT +toracoscopia. I-TREATMENT +La B-EVOLUTION +evolución I-EVOLUTION +fue I-EVOLUTION +tórpida I-EVOLUTION +al I-EVOLUTION +presentar I-EVOLUTION +mediastinitis I-EVOLUTION +secundaria I-EVOLUTION +a I-EVOLUTION +fístula I-EVOLUTION +esófago-pleural. I-EVOLUTION +Se B-TREATMENT +trató I-TREATMENT +la I-TREATMENT +misma I-TREATMENT +mediante I-TREATMENT +la I-TREATMENT +colocación I-TREATMENT +de I-TREATMENT +prótesis I-TREATMENT +esofágica I-TREATMENT +metálica I-TREATMENT +cubierta I-TREATMENT +(Wallflex®). I-TREATMENT +La I-TREATMENT +paciente I-TREATMENT +número I-TREATMENT +seis I-TREATMENT +fue I-TREATMENT +tratada I-TREATMENT +mediante I-TREATMENT +inyección I-TREATMENT +de I-TREATMENT +toxina I-TREATMENT +botulínica I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +de I-TREATMENT +la I-TREATMENT +UGE I-TREATMENT para I-TREATMENT -evitar I-TREATMENT -los I-TREATMENT -episodios I-TREATMENT +resolver I-TREATMENT +el I-TREATMENT +cuadro I-TREATMENT de I-TREATMENT -pseudogota I-TREATMENT -que I-TREATMENT -venía I-TREATMENT -padeciendo I-TREATMENT +obstrucción I-TREATMENT +funcional. I-TREATMENT +Se I-TREATMENT +consideró I-TREATMENT +el I-TREATMENT +mejor I-TREATMENT +tratamiento I-TREATMENT +debido I-TREATMENT +a I-TREATMENT la I-TREATMENT -paciente. I-TREATMENT +edad I-TREATMENT +de I-TREATMENT +la I-TREATMENT +paciente, I-TREATMENT +mejorando I-TREATMENT +la I-TREATMENT +sintomatología. I-TREATMENT I-TREATMENT Paciente B-PRESENT_ILLNESS +RGP, I-PRESENT_ILLNESS +HC: I-PRESENT_ILLNESS +68 I-PRESENT_ILLNESS +14 I-PRESENT_ILLNESS +58 I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +sexo I-PRESENT_ILLNESS +femenino, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +tiene I-PRESENT_ILLNESS +como I-PRESENT_ILLNESS +motivo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -30 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -hija B-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -anterior, I-PAST_MEDICAL_HISTORY -diagnosticada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -infancia I-PAST_MEDICAL_HISTORY +ingreso I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +volumen I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +labio I-PRESENT_ILLNESS +inferior. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +La B-PAST_MEDICAL_HISTORY +historia I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -OI I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +enfermedad I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +remonta I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY -raíz I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +edad I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY +15 I-PAST_MEDICAL_HISTORY +años I-PAST_MEDICAL_HISTORY +cuando I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +recibió I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +mordisco I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +labio I-PAST_MEDICAL_HISTORY +inferior I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY una I-PAST_MEDICAL_HISTORY -fractura I-PAST_MEDICAL_HISTORY +intensa I-PAST_MEDICAL_HISTORY +hemorragia. I-PAST_MEDICAL_HISTORY +A I-PAST_MEDICAL_HISTORY +partir I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +traumatismo I-PAST_MEDICAL_HISTORY +apareció I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +región I-PAST_MEDICAL_HISTORY +central I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +derecha I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +labio I-PAST_MEDICAL_HISTORY +un I-PAST_MEDICAL_HISTORY +aumento I-PAST_MEDICAL_HISTORY +progresivo, I-PAST_MEDICAL_HISTORY +indoloro, I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -tibia I-PAST_MEDICAL_HISTORY -desplazada I-PAST_MEDICAL_HISTORY -seguida I-PAST_MEDICAL_HISTORY +color I-PAST_MEDICAL_HISTORY +azul I-PAST_MEDICAL_HISTORY +violáceo, I-PAST_MEDICAL_HISTORY +pulsátil, I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -fractura I-PAST_MEDICAL_HISTORY +3 I-PAST_MEDICAL_HISTORY +cm I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -clavícula I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -traumatismos I-PAST_MEDICAL_HISTORY -leves. I-PAST_MEDICAL_HISTORY -Posteriormente I-PAST_MEDICAL_HISTORY -presentó I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -nuevas I-PAST_MEDICAL_HISTORY -fracturas, I-PAST_MEDICAL_HISTORY +diámetro. I-PAST_MEDICAL_HISTORY +Clasificada I-PAST_MEDICAL_HISTORY la I-PAST_MEDICAL_HISTORY -última I-PAST_MEDICAL_HISTORY +lesión I-PAST_MEDICAL_HISTORY +como I-PAST_MEDICAL_HISTORY +hemangioma I-PAST_MEDICAL_HISTORY +traumático, I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +comenzó I-PAST_MEDICAL_HISTORY a I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -12 I-PAST_MEDICAL_HISTORY -años, I-PAST_MEDICAL_HISTORY -precisando I-PAST_MEDICAL_HISTORY -una I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -ellas I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -quirúrgico I-PAST_MEDICAL_HISTORY -(olécranon). I-PAST_MEDICAL_HISTORY -Entre I-PAST_MEDICAL_HISTORY -otros I-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -interés I-PAST_MEDICAL_HISTORY -destacaban I-PAST_MEDICAL_HISTORY -múltiples I-PAST_MEDICAL_HISTORY -esguinces I-PAST_MEDICAL_HISTORY +tratar I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +inyecciones I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -tobillo I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -estapedectomía I-PAST_MEDICAL_HISTORY +betametasona. I-PAST_MEDICAL_HISTORY +Luego I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -oído I-PAST_MEDICAL_HISTORY -derecho. I-PAST_MEDICAL_HISTORY -Nunca I-PAST_MEDICAL_HISTORY -había I-PAST_MEDICAL_HISTORY -recibido I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY +6 I-PAST_MEDICAL_HISTORY +dosis I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +betametasona, I-PAST_MEDICAL_HISTORY se I-PAST_MEDICAL_HISTORY -encontraba I-PAST_MEDICAL_HISTORY -asintomática. I-PAST_MEDICAL_HISTORY +realizó I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +exéresis I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +tumoración I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +vía I-PAST_MEDICAL_HISTORY +bucal. I-PAST_MEDICAL_HISTORY +El I-PAST_MEDICAL_HISTORY +diagnóstico I-PAST_MEDICAL_HISTORY +histopatológico I-PAST_MEDICAL_HISTORY +fue I-PAST_MEDICAL_HISTORY +compatible I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +hemangioma I-PAST_MEDICAL_HISTORY +traumático. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS +A B-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +este I-PRESENT_ILLNESS +tratamiento I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS paciente I-PRESENT_ILLNESS -deseaba I-PRESENT_ILLNESS -conocer I-PRESENT_ILLNESS -sus I-PRESENT_ILLNESS -opciones I-PRESENT_ILLNESS -reproductivas I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -tener I-PRESENT_ILLNESS +nos I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +nuevamente, I-PRESENT_ILLNESS +ya I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +presentaba I-PRESENT_ILLNESS un I-PRESENT_ILLNESS -hijo I-PRESENT_ILLNESS -libre I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -enfermedad. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -En B-EXPLORATION +volumen I-PRESENT_ILLNESS +labial I-PRESENT_ILLNESS +inferior I-PRESENT_ILLNESS +más I-PRESENT_ILLNESS +voluminoso, I-PRESENT_ILLNESS +pulsátil, I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +soplo I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +frenito. I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +intrabucal I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +los I-EXPLORATION +relieves I-EXPLORATION +vasculares I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +mucosa I-EXPLORATION +del I-EXPLORATION +labio I-EXPLORATION +inferior I-EXPLORATION +Indicamos I-EXPLORATION +ecografía I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION +región I-EXPLORATION +y B-TREATMENT +ejecutamos I-TREATMENT +una I-TREATMENT +disección I-TREATMENT +de I-TREATMENT +la I-TREATMENT +carótida I-TREATMENT +derecha I-TREATMENT +para I-TREATMENT +arteriografía I-TREATMENT +la I-TREATMENT +cual I-TREATMENT +informa I-TREATMENT +de I-TREATMENT +un I-TREATMENT +saco I-TREATMENT +aneurismático I-TREATMENT +a I-TREATMENT +nivel I-TREATMENT +de I-TREATMENT +las I-TREATMENT +regiones I-TREATMENT +labial I-TREATMENT +inferior I-TREATMENT +y I-TREATMENT +mentoniana. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +ligó I-TREATMENT +la I-TREATMENT +arteria I-TREATMENT +carótida I-TREATMENT +externa I-TREATMENT +entre I-TREATMENT +la I-TREATMENT +tiroidea I-TREATMENT +superior I-TREATMENT +y I-TREATMENT +la I-TREATMENT +lingual, I-TREATMENT +por I-TREATMENT +incisión I-TREATMENT +submentoniana I-TREATMENT +se I-TREATMENT +ligaron I-TREATMENT +los I-TREATMENT +vasos I-TREATMENT +venosos I-TREATMENT +del I-TREATMENT +aneurisma, I-TREATMENT +para I-TREATMENT +aislar I-TREATMENT +esta I-TREATMENT +cavidad I-TREATMENT +de I-TREATMENT +la I-TREATMENT +circulación. I-TREATMENT + I-TREATMENT +Al I-TREATMENT +final I-TREATMENT +de I-TREATMENT +la I-TREATMENT +intervención I-TREATMENT +quirúrgica I-TREATMENT +se I-TREATMENT +inyectaron I-TREATMENT +4cc I-TREATMENT +de I-TREATMENT +betametasona I-TREATMENT +en I-TREATMENT +la I-TREATMENT +tumoración I-TREATMENT +y I-TREATMENT +se I-TREATMENT +aplicó I-TREATMENT +un I-TREATMENT +esparadrapo I-TREATMENT +elástico. I-TREATMENT + I-TREATMENT +Se I-TREATMENT +aplicaron I-TREATMENT +4 I-TREATMENT +inyecciones I-TREATMENT +adicionales I-TREATMENT +con I-TREATMENT +triancinolona I-TREATMENT +a I-TREATMENT +intervalos I-TREATMENT +de I-TREATMENT +3 I-TREATMENT +semanas, I-TREATMENT +notándose I-TREATMENT +una I-TREATMENT +progresiva I-TREATMENT +reducción I-TREATMENT +y I-TREATMENT +fibrosis I-TREATMENT +de I-TREATMENT +la I-TREATMENT +tumoración I-TREATMENT +no I-TREATMENT +constatándose I-TREATMENT +soplo. I-TREATMENT + I-TREATMENT +A I-TREATMENT +los I-TREATMENT +tres I-TREATMENT +meses I-TREATMENT +de I-TREATMENT +la I-TREATMENT +ligadura I-TREATMENT +de I-TREATMENT +los I-TREATMENT +vasos I-TREATMENT +se I-TREATMENT +practicó I-TREATMENT +la I-TREATMENT +exéresis I-TREATMENT +de I-TREATMENT +la I-TREATMENT +fibrosis I-TREATMENT +de I-TREATMENT +la I-TREATMENT +tumoración I-TREATMENT +labial. I-TREATMENT +El B-EVOLUTION +resultado I-EVOLUTION +estético I-EVOLUTION +final I-EVOLUTION +fue I-EVOLUTION +aceptable. I-EVOLUTION +En I-EVOLUTION +estos I-EVOLUTION +momentos I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +lleva I-EVOLUTION +5 I-EVOLUTION +años I-EVOLUTION +desde I-EVOLUTION +la I-EVOLUTION +ultima I-EVOLUTION +intervención, I-EVOLUTION +no I-EVOLUTION +apareciendo I-EVOLUTION +recidiva I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +lesión. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +47 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +rectorragia I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +finalizar I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +deposición; I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +paciente I-PRESENT_ILLNESS +niega I-PRESENT_ILLNESS +otra I-PRESENT_ILLNESS +sintomatología I-PRESENT_ILLNESS +acompañante, I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +abdominal I-PRESENT_ILLNESS +ni I-PRESENT_ILLNESS +alteraciones I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +hábito I-PRESENT_ILLNESS +intestinal, I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso. I-PRESENT_ILLNESS +La B-EXPLORATION exploración I-EXPLORATION física I-EXPLORATION -destacaba I-EXPLORATION +es I-EXPLORATION +normal I-EXPLORATION +salvo I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +hemorroides I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +rectal. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +analítica I-EXPLORATION +tanto I-EXPLORATION +la I-EXPLORATION +hematimetría I-EXPLORATION +como I-EXPLORATION +la I-EXPLORATION +bioquímica I-EXPLORATION +son I-EXPLORATION +estrictamente I-EXPLORATION +normales. I-EXPLORATION +Se B-TREATMENT +le I-TREATMENT +solicita I-TREATMENT +una I-TREATMENT +colonoscopia I-TREATMENT +en I-TREATMENT +la I-TREATMENT +que I-TREATMENT +se I-TREATMENT +observa I-TREATMENT +pólipo I-TREATMENT +submucoso I-TREATMENT +que I-TREATMENT +se I-TREATMENT +extirpa I-TREATMENT +y I-TREATMENT +hemorroides I-TREATMENT +internas. I-TREATMENT +La B-EXPLORATION +histopatología I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +extirpada I-EXPLORATION +dio I-EXPLORATION +como I-EXPLORATION +resultado I-EXPLORATION +granuloma I-EXPLORATION +eosinofílico I-EXPLORATION +secundario I-EXPLORATION +a I-EXPLORATION +parásito I-EXPLORATION +Anisakis. I-EXPLORATION + I-EXPLORATION + +Niña B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +5 I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +15 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +edad, I-PRESENT_ILLNESS +segunda I-PRESENT_ILLNESS +hija I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +hermano I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +6 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +sano, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ingresó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +hospital I-PRESENT_ILLNESS +derivada I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +pediatra I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +lenta I-PRESENT_ILLNESS +somatometría I-PRESENT_ILLNESS +(Percentil I-PRESENT_ILLNESS +3), I-PRESENT_ILLNESS +IMC I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +14 I-PRESENT_ILLNESS +kg/m2 I-PRESENT_ILLNESS +(desnutrición I-PRESENT_ILLNESS +leve) I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +rechazo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +alimento. I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +inicial I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +desnutrición, I-EXPLORATION +acrocianosis I-EXPLORATION +que I-EXPLORATION +aumentaba I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +llanto, I-EXPLORATION +taquicardia, I-EXPLORATION +ligera I-EXPLORATION +disnea I-EXPLORATION +y I-EXPLORATION +soplo I-EXPLORATION +pansistólico I-EXPLORATION +II-III I-EXPLORATION +en I-EXPLORATION +varias I-EXPLORATION +localizaciones I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +auscultación. I-EXPLORATION +Fue B-TREATMENT +diagnosticada I-TREATMENT +de I-TREATMENT +cardiopatía I-TREATMENT +congénita: I-TREATMENT +Transposición I-TREATMENT +de I-TREATMENT +grandes I-TREATMENT +vasos I-TREATMENT +con I-TREATMENT +septum I-TREATMENT +integro I-TREATMENT +(TGV I-TREATMENT +con I-TREATMENT +SI), I-TREATMENT +siendo I-TREATMENT +intervenida I-TREATMENT +quirúrgicamente I-TREATMENT +de I-TREATMENT +forma I-TREATMENT +urgente. I-TREATMENT +En I-TREATMENT +primer I-TREATMENT +lugar I-TREATMENT +se I-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +la I-TREATMENT +ampliación I-TREATMENT +mediante I-TREATMENT +cateterismo I-TREATMENT +del I-TREATMENT +foramen I-TREATMENT +oval, I-TREATMENT +y I-TREATMENT +posteriormente I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +fístula I-TREATMENT +subclavia-pulmonar I-TREATMENT +y I-TREATMENT +banding I-TREATMENT +en I-TREATMENT +arteria I-TREATMENT +pulmonar. I-TREATMENT +La B-EVOLUTION +evolución I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +postoperatorio I-EVOLUTION +fue I-EVOLUTION +desfavorable, I-EVOLUTION +falleciendo I-EVOLUTION +en I-EVOLUTION +la I-EVOLUTION +UCI I-EVOLUTION +de I-EVOLUTION +pediatría I-EVOLUTION +8 I-EVOLUTION +días I-EVOLUTION +después I-EVOLUTION +del I-EVOLUTION +ingreso. I-EVOLUTION + I-EVOLUTION +Los B-EXPLORATION +padres I-EXPLORATION +solicitaron I-EXPLORATION +la I-EXPLORATION +realización I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +autopsia I-EXPLORATION +médico-legal I-EXPLORATION +ante I-EXPLORATION +la I-EXPLORATION +sospecha I-EXPLORATION +de I-EXPLORATION una I-EXPLORATION +mala I-EXPLORATION +actuación I-EXPLORATION +facultativa. I-EXPLORATION + I-EXPLORATION +Autopsia: I-EXPLORATION + I-EXPLORATION +a) I-EXPLORATION +Examen I-EXPLORATION +Externo I-EXPLORATION + I-EXPLORATION +Peso I-EXPLORATION +de I-EXPLORATION +6440 I-EXPLORATION +g, I-EXPLORATION talla I-EXPLORATION de I-EXPLORATION -153 I-EXPLORATION +64 I-EXPLORATION +cm I-EXPLORATION +(IMC: I-EXPLORATION +15.6 I-EXPLORATION +kg/m2), I-EXPLORATION +perímetro I-EXPLORATION +cefálico I-EXPLORATION +de I-EXPLORATION +39.5 I-EXPLORATION cm, I-EXPLORATION -escleras I-EXPLORATION -azules I-EXPLORATION +perímetro I-EXPLORATION +torácico I-EXPLORATION +de I-EXPLORATION +45 I-EXPLORATION +cm I-EXPLORATION y I-EXPLORATION -dientes I-EXPLORATION -normales. I-EXPLORATION -No I-EXPLORATION -se I-EXPLORATION -apreciaron I-EXPLORATION -deformidades I-EXPLORATION -a I-EXPLORATION -ningún I-EXPLORATION -nivel. I-EXPLORATION +abdominal I-EXPLORATION +de I-EXPLORATION +42 I-EXPLORATION +cm. I-EXPLORATION I-EXPLORATION -Las I-EXPLORATION -pruebas I-EXPLORATION +b) I-EXPLORATION +Examen I-EXPLORATION +Interno I-EXPLORATION + I-EXPLORATION +Encéfalo I-EXPLORATION de I-EXPLORATION -laboratorio I-EXPLORATION -resultaron I-EXPLORATION -normales, I-EXPLORATION -salvo I-EXPLORATION -los I-EXPLORATION -niveles I-EXPLORATION +620 I-EXPLORATION +g I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +infarto I-EXPLORATION +cerebral I-EXPLORATION +isquémico I-EXPLORATION +extenso I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +parieto-occipital I-EXPLORATION +izquierdo I-EXPLORATION +correspondiente I-EXPLORATION +al I-EXPLORATION +territorio I-EXPLORATION de I-EXPLORATION -25OHCC: I-EXPLORATION -23 I-EXPLORATION -ng/ml, I-EXPLORATION +irrigación I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +cerebral I-EXPLORATION +media. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +procedió I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +extracción I-EXPLORATION y I-EXPLORATION -también I-EXPLORATION -el I-EXPLORATION -resto I-EXPLORATION +fijación I-EXPLORATION del I-EXPLORATION -estudio I-EXPLORATION -realizado I-EXPLORATION -(radiografía I-EXPLORATION +bloque I-EXPLORATION +cardiopulmonar I-EXPLORATION +para I-EXPLORATION +su I-EXPLORATION +posterior I-EXPLORATION +examen I-EXPLORATION +macroscópico, I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +que I-EXPLORATION +destacaba I-EXPLORATION +la I-EXPLORATION +existencia I-EXPLORATION de I-EXPLORATION -columna I-EXPLORATION -cervical, I-EXPLORATION -ecocardiograma, I-EXPLORATION -espirometría, I-EXPLORATION -ecografía I-EXPLORATION -abdominal). I-EXPLORATION -Los I-EXPLORATION -resultados I-EXPLORATION +una I-EXPLORATION +TGV I-EXPLORATION +intervenida I-EXPLORATION +quirúrgicamente I-EXPLORATION +presentando I-EXPLORATION +un I-EXPLORATION +banding I-EXPLORATION +en I-EXPLORATION +arteria I-EXPLORATION +pulmonar, I-EXPLORATION +una I-EXPLORATION +fístula I-EXPLORATION +entre I-EXPLORATION +subclavia I-EXPLORATION +derecha I-EXPLORATION +y I-EXPLORATION +arteria I-EXPLORATION +pulmonar, I-EXPLORATION +y I-EXPLORATION +ampliación I-EXPLORATION +de I-EXPLORATION +comunicación I-EXPLORATION +interauricular I-EXPLORATION +(foramen I-EXPLORATION +oval), I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +hipertrofia I-EXPLORATION +de I-EXPLORATION +ventrículo I-EXPLORATION +derecho I-EXPLORATION +con I-EXPLORATION +adelgazamiento I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -densitometría I-EXPLORATION -mostraron I-EXPLORATION +pared I-EXPLORATION +del I-EXPLORATION +ventrículo I-EXPLORATION +izquierdo. I-EXPLORATION +Presentaba I-EXPLORATION +a I-EXPLORATION +su I-EXPLORATION +vez I-EXPLORATION una I-EXPLORATION -densidad I-EXPLORATION -mineral I-EXPLORATION -ósea I-EXPLORATION -normal: I-EXPLORATION -T-scores I-EXPLORATION +anomalía I-EXPLORATION de I-EXPLORATION --0, I-EXPLORATION -9 I-EXPLORATION -en I-EXPLORATION -columna I-EXPLORATION -lumbar I-EXPLORATION -(L1-L4), I-EXPLORATION -0, I-EXPLORATION -0 I-EXPLORATION -en I-EXPLORATION -cuello I-EXPLORATION -femoral I-EXPLORATION -y I-EXPLORATION --0, I-EXPLORATION -1 I-EXPLORATION -en I-EXPLORATION -fémur I-EXPLORATION -total. I-EXPLORATION -Se B-TREATMENT -recomendó I-TREATMENT -suplementación I-TREATMENT -con I-TREATMENT -vitamina I-TREATMENT -D. I-TREATMENT - I-TREATMENT -Se B-EXPLORATION -realizó I-EXPLORATION -estudio I-EXPLORATION -genético I-EXPLORATION -dirigido I-EXPLORATION -para I-EXPLORATION la I-EXPLORATION -búsqueda I-EXPLORATION +salida I-EXPLORATION de I-EXPLORATION +las I-EXPLORATION +arterias I-EXPLORATION +coronarias, I-EXPLORATION +observándose I-EXPLORATION la I-EXPLORATION -mutación I-EXPLORATION -identificada I-EXPLORATION -en I-EXPLORATION -su I-EXPLORATION -padre, I-EXPLORATION -confirmando I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +dos I-EXPLORATION +ostium I-EXPLORATION +coronarios I-EXPLORATION que I-EXPLORATION -la I-EXPLORATION -hija I-EXPLORATION -es I-EXPLORATION -portadora I-EXPLORATION +salían I-EXPLORATION +del I-EXPLORATION +mismo I-EXPLORATION +seno. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +el I-EXPLORATION +examen I-EXPLORATION +histológico I-EXPLORATION +del I-EXPLORATION +corazón I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +una I-EXPLORATION +pericarditis I-EXPLORATION +serofibrinosa I-EXPLORATION +y, I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +del I-EXPLORATION +miocardio, I-EXPLORATION +focos I-EXPLORATION de I-EXPLORATION +necrosis I-EXPLORATION +subendocárdica I-EXPLORATION +con I-EXPLORATION +calcificación I-EXPLORATION +distrófica I-EXPLORATION +secundarios I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -misma I-EXPLORATION -deleción I-EXPLORATION -en I-EXPLORATION -heterocigosis I-EXPLORATION -en I-EXPLORATION +cirugía. I-EXPLORATION +En I-EXPLORATION +los I-EXPLORATION +pulmones I-EXPLORATION +se I-EXPLORATION +observaba I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +membranas I-EXPLORATION +hialinas I-EXPLORATION +como I-EXPLORATION +signo I-EXPLORATION +de I-EXPLORATION +distrés I-EXPLORATION +respiratorio. I-EXPLORATION +Por I-EXPLORATION +otro I-EXPLORATION +lado, I-EXPLORATION el I-EXPLORATION -gen I-EXPLORATION -COL1A1 I-EXPLORATION -que I-EXPLORATION +encéfalo I-EXPLORATION presentaba I-EXPLORATION -su I-EXPLORATION -padre. I-EXPLORATION -Se I-EXPLORATION -realizó I-EXPLORATION -asesoramiento I-EXPLORATION -genético I-EXPLORATION -para I-EXPLORATION -informar I-EXPLORATION -sobre I-EXPLORATION -las I-EXPLORATION -posibles I-EXPLORATION -consecuencias I-EXPLORATION -para I-EXPLORATION -el I-EXPLORATION -afecto I-EXPLORATION +signos I-EXPLORATION +de I-EXPLORATION +encefalopatía I-EXPLORATION +anóxica I-EXPLORATION +e I-EXPLORATION +infarto I-EXPLORATION +parietal I-EXPLORATION +reciente. I-EXPLORATION + I-EXPLORATION +Así, I-EXPLORATION a I-EXPLORATION -su I-EXPLORATION -descendencia, I-EXPLORATION +la I-EXPLORATION +luz I-EXPLORATION de I-EXPLORATION los I-EXPLORATION resultados I-EXPLORATION +macro I-EXPLORATION +y I-EXPLORATION +microscópicos, I-EXPLORATION +se I-EXPLORATION +determinó I-EXPLORATION +que I-EXPLORATION +la I-EXPLORATION +causa I-EXPLORATION de I-EXPLORATION +la I-EXPLORATION +muerte I-EXPLORATION +fue I-EXPLORATION un I-EXPLORATION -estudio I-EXPLORATION -genético I-EXPLORATION -y I-EXPLORATION -sus I-EXPLORATION -ventajas I-EXPLORATION -y I-EXPLORATION -riesgos, I-EXPLORATION -además I-EXPLORATION +Infarto I-EXPLORATION +cerebral I-EXPLORATION +isquémico I-EXPLORATION +en I-EXPLORATION +paciente I-EXPLORATION +intervenida I-EXPLORATION de I-EXPLORATION -informarle I-EXPLORATION +Transposición I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -posibles I-EXPLORATION -alternativas I-EXPLORATION -derivadas I-EXPLORATION -del I-EXPLORATION -análisis. I-EXPLORATION +grandes I-EXPLORATION +arterias. I-EXPLORATION I-EXPLORATION -Mujer B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -26 I-PRESENT_ILLNESS +29 I-PRESENT_ILLNESS años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -ERC I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -glomerulonefritis I-PAST_MEDICAL_HISTORY -proliferativa I-PAST_MEDICAL_HISTORY -extracapilar I-PAST_MEDICAL_HISTORY +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +patológicos I-PAST_MEDICAL_HISTORY +que I-PAST_MEDICAL_HISTORY +consulta I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +año I-PAST_MEDICAL_HISTORY +2001 I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +diarrea I-PAST_MEDICAL_HISTORY +líquida I-PAST_MEDICAL_HISTORY +(7-10 I-PAST_MEDICAL_HISTORY +deposiciones I-PAST_MEDICAL_HISTORY +diarias), I-PAST_MEDICAL_HISTORY +dolor I-PAST_MEDICAL_HISTORY +difuso I-PAST_MEDICAL_HISTORY +abdominal, I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY tipo I-PAST_MEDICAL_HISTORY -I. I-PAST_MEDICAL_HISTORY -Fumadora I-PAST_MEDICAL_HISTORY -activa, I-PAST_MEDICAL_HISTORY -Hipertensa I-PAST_MEDICAL_HISTORY -aunque I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -precisa I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -farmacológico I-PAST_MEDICAL_HISTORY -actualmente. I-PAST_MEDICAL_HISTORY -Presenta I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY +cólico I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +pérdida I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -Darier I-PAST_MEDICAL_HISTORY -cutánea. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Recibió I-PAST_MEDICAL_HISTORY -14 I-PAST_MEDICAL_HISTORY -sesiones I-PAST_MEDICAL_HISTORY +peso I-PAST_MEDICAL_HISTORY +(18 I-PAST_MEDICAL_HISTORY +kg I-PAST_MEDICAL_HISTORY +desde I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +inicio I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -plasmaféresis I-PAST_MEDICAL_HISTORY -tras I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -diagnóstico I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -2006. I-PAST_MEDICAL_HISTORY -Posteriormente I-PAST_MEDICAL_HISTORY -abandonó I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -revisiones I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -consulta I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -finalmente I-PAST_MEDICAL_HISTORY -acudió I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -urgencias I-PAST_MEDICAL_HISTORY -3 I-PAST_MEDICAL_HISTORY -años I-PAST_MEDICAL_HISTORY -después I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -situación I-PAST_MEDICAL_HISTORY +los I-PAST_MEDICAL_HISTORY +síntomas) I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -uremia I-PAST_MEDICAL_HISTORY -terminal I-PAST_MEDICAL_HISTORY -iniciando I-PAST_MEDICAL_HISTORY -diálisis. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -La B-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -da I-PRESENT_ILLNESS -consentimiento I-PRESENT_ILLNESS -expreso I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -exposición I-PRESENT_ILLNESS +5 I-PAST_MEDICAL_HISTORY +meses I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +evolución. I-PAST_MEDICAL_HISTORY +En B-PRESENT_ILLNESS +las I-PRESENT_ILLNESS +últimas I-PRESENT_ILLNESS +semanas I-PRESENT_ILLNESS +refiere I-PRESENT_ILLNESS +artralgias I-PRESENT_ILLNESS +recurrentes I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +autolimitadas I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -caso. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Historia I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -acceso I-PRESENT_ILLNESS -vascular I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -• B-TREATMENT -Varios I-TREATMENT -intentos I-TREATMENT -de I-TREATMENT -Fístula I-TREATMENT -Arteriovenosa I-TREATMENT -(FAV), I-TREATMENT -todos I-TREATMENT -ellos I-TREATMENT -infructuosos: I-TREATMENT -FAV I-TREATMENT -radio-cefálica I-TREATMENT -izquierda I-TREATMENT -en I-TREATMENT -01-2009, I-TREATMENT -húmero-cefálica I-TREATMENT -izquierda I-TREATMENT -en I-TREATMENT -03-09, I-TREATMENT -radio-cefálica I-TREATMENT -derecha I-TREATMENT -en I-TREATMENT -04-09 I-TREATMENT -y I-TREATMENT -húmero-cefálica I-TREATMENT -derecha I-TREATMENT -en I-TREATMENT -05-11. I-TREATMENT -Se B-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -un I-EXPLORATION -mapa I-EXPLORATION -vascular I-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION +grandes I-PRESENT_ILLNESS +articulaciones. I-PRESENT_ILLNESS +Acude B-EXPLORATION +a I-EXPLORATION +su I-EXPLORATION +especialista I-EXPLORATION +de I-EXPLORATION +digestivo, I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +ambulatoria, I-EXPLORATION +quien I-EXPLORATION +solicita I-EXPLORATION +analítica I-EXPLORATION +elemental, I-EXPLORATION +coprocultivo, I-EXPLORATION +parásitos I-EXPLORATION +y I-EXPLORATION +enema I-EXPLORATION +opaco I-EXPLORATION que I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -evidenció I-EXPLORATION -ninguna I-EXPLORATION -vena I-EXPLORATION -apta I-EXPLORATION -en I-EXPLORATION -MMSS. I-EXPLORATION - I-EXPLORATION -• B-TREATMENT -Catéter I-TREATMENT -venoso I-TREATMENT -permanente I-TREATMENT -yugular I-TREATMENT -derecho, I-TREATMENT -implantado I-TREATMENT -el I-TREATMENT -14/01/09 I-TREATMENT -y I-TREATMENT -retirado I-TREATMENT -el I-TREATMENT -05/11/09 I-TREATMENT -por I-TREATMENT -Endocarditis I-TREATMENT -Tricuspídea I-TREATMENT -secundaria I-TREATMENT -a I-TREATMENT -MARS. I-TREATMENT - I-TREATMENT -• I-TREATMENT -Varios I-TREATMENT -catéteres I-TREATMENT -temporales I-TREATMENT -en I-TREATMENT -ambas I-TREATMENT -venas I-TREATMENT -femorales I-TREATMENT -retirados I-TREATMENT -por I-TREATMENT -trombosis I-TREATMENT -o I-TREATMENT -disfunción. I-TREATMENT - I-TREATMENT -• I-TREATMENT -Catéter I-TREATMENT -permanente I-TREATMENT -yugular I-TREATMENT -izquierdo I-TREATMENT -colocado I-TREATMENT -el I-TREATMENT -16/11/09 I-TREATMENT -y I-TREATMENT -retirado I-TREATMENT -el I-TREATMENT -21/06/10 I-TREATMENT -por I-TREATMENT -trombosis I-TREATMENT -de I-TREATMENT -la I-TREATMENT -vena I-TREATMENT -yugular I-TREATMENT -izquierda. I-TREATMENT - I-TREATMENT -• I-TREATMENT -Catéter I-TREATMENT -permanente I-TREATMENT -femoral I-TREATMENT -derecho I-TREATMENT -colocado I-TREATMENT -el I-TREATMENT -21/06/10 I-TREATMENT -y I-TREATMENT -retirado I-TREATMENT -4 I-TREATMENT -días I-TREATMENT -después I-TREATMENT -por I-TREATMENT -disfunción I-TREATMENT -persistente. I-TREATMENT - I-TREATMENT -• B-EXPLORATION -Tras I-EXPLORATION -ello I-EXPLORATION +son I-EXPLORATION +normales. I-EXPLORATION +Se I-EXPLORATION +hizo, I-EXPLORATION +posteriormente, I-EXPLORATION +colonoscopia I-EXPLORATION +que I-EXPLORATION +puso I-EXPLORATION +de I-EXPLORATION +manifiesto I-EXPLORATION +un I-EXPLORATION +colon I-EXPLORATION +normal. I-EXPLORATION +En I-EXPLORATION +íleon I-EXPLORATION se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION +objetivó I-EXPLORATION +mucosa I-EXPLORATION +hiperémica, I-EXPLORATION +edematosa I-EXPLORATION +y I-EXPLORATION +friable I-EXPLORATION +con I-EXPLORATION un I-EXPLORATION -estudio I-EXPLORATION -endovascular I-EXPLORATION +punteado I-EXPLORATION +blanquecino, I-EXPLORATION +granuloso I-EXPLORATION +y I-EXPLORATION +aislado I-EXPLORATION que I-EXPLORATION -mostraba I-EXPLORATION -oclusión I-EXPLORATION -completa I-EXPLORATION +se I-EXPLORATION +hace I-EXPLORATION +confluente I-EXPLORATION +en I-EXPLORATION +forma I-EXPLORATION de I-EXPLORATION -vena I-EXPLORATION -iliaca I-EXPLORATION -izquierda I-EXPLORATION -y I-EXPLORATION +"grano I-EXPLORATION de I-EXPLORATION -cava I-EXPLORATION -inferior, I-EXPLORATION -lo I-EXPLORATION +arroz" I-EXPLORATION +a I-EXPLORATION +medida I-EXPLORATION que I-EXPLORATION -inhabilitaba I-EXPLORATION -los I-EXPLORATION -accesos I-EXPLORATION -femorales. I-EXPLORATION +se I-EXPLORATION +progresa I-EXPLORATION +con I-EXPLORATION +el I-EXPLORATION +endoscopio. I-EXPLORATION + I-EXPLORATION +Mientras B-EVOLUTION +espera I-EVOLUTION +el I-EVOLUTION +resultado I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +biopsias, I-EVOLUTION +empeora I-EVOLUTION +su I-EVOLUTION +situación I-EVOLUTION +clínica I-EVOLUTION +con I-EVOLUTION +aumento I-EVOLUTION +del I-EVOLUTION +número I-EVOLUTION +de I-EVOLUTION +deposiciones I-EVOLUTION +e I-EVOLUTION +hipertermia I-EVOLUTION +de I-EVOLUTION +39o I-EVOLUTION +por I-EVOLUTION +lo I-EVOLUTION +que I-EVOLUTION +ingresa I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +hospital. I-EVOLUTION +Se B-EXPLORATION +aprecia I-EXPLORATION +afectación I-EXPLORATION +del I-EXPLORATION +estado I-EXPLORATION +general, I-EXPLORATION +fiebre I-EXPLORATION +de I-EXPLORATION +38, I-EXPLORATION +5o I-EXPLORATION +y I-EXPLORATION +dolor I-EXPLORATION +difuso I-EXPLORATION +abdominal. I-EXPLORATION +No I-EXPLORATION +hay I-EXPLORATION +lesiones I-EXPLORATION +cutáneas, I-EXPLORATION +ni I-EXPLORATION +se I-EXPLORATION +palpan I-EXPLORATION +adenopatías. I-EXPLORATION En I-EXPLORATION -lo I-EXPLORATION -que I-EXPLORATION -respecta I-EXPLORATION -a I-EXPLORATION -los I-EXPLORATION -troncos I-EXPLORATION -superiores I-EXPLORATION la I-EXPLORATION -situación I-EXPLORATION -no I-EXPLORATION -es I-EXPLORATION -mejor I-EXPLORATION -pues I-EXPLORATION -existe I-EXPLORATION -oclusión I-EXPLORATION +analítica I-EXPLORATION +resaltan I-EXPLORATION +los I-EXPLORATION +siguientes I-EXPLORATION +datos: I-EXPLORATION +hematocrito I-EXPLORATION +29, I-EXPLORATION +8% I-EXPLORATION +(40-50), I-EXPLORATION +plaquetas I-EXPLORATION +409.000 I-EXPLORATION +mm3 I-EXPLORATION +(140-400.000), I-EXPLORATION +proteínas I-EXPLORATION +totales I-EXPLORATION +4, I-EXPLORATION +9 I-EXPLORATION +g/dl, I-EXPLORATION +albúmina I-EXPLORATION +2 I-EXPLORATION +g/dl, I-EXPLORATION +hierro I-EXPLORATION +10 I-EXPLORATION +ng/dl I-EXPLORATION +(60-160), I-EXPLORATION +saturación I-EXPLORATION de I-EXPLORATION -venas I-EXPLORATION -subclavias, I-EXPLORATION -yugular I-EXPLORATION -derecha, I-EXPLORATION -tronco I-EXPLORATION -braquio-cefálico I-EXPLORATION -izquierdo I-EXPLORATION +transferrina I-EXPLORATION +3% I-EXPLORATION +(15-50) I-EXPLORATION y I-EXPLORATION -cava I-EXPLORATION -superior. I-EXPLORATION -Ante B-TREATMENT -esta I-TREATMENT -situación I-TREATMENT -se I-TREATMENT -colocó I-TREATMENT -catéter I-TREATMENT -permanente I-TREATMENT -por I-TREATMENT -abordaje I-TREATMENT -transhepático I-TREATMENT -a I-TREATMENT -través I-TREATMENT -de I-TREATMENT -vena I-TREATMENT -suprahepática I-TREATMENT -derecha, I-TREATMENT -con I-TREATMENT -extremo I-TREATMENT -en I-TREATMENT -aurícula I-TREATMENT -derecha9. I-TREATMENT -Se I-TREATMENT -recambió I-TREATMENT -el I-TREATMENT -03/07/2012 I-TREATMENT -por I-TREATMENT -disfunción. I-TREATMENT -Desde B-EVOLUTION -entonces I-EVOLUTION -ha I-EVOLUTION -sufrido I-EVOLUTION -continuas I-EVOLUTION -infecciones I-EVOLUTION -que I-EVOLUTION -han I-EVOLUTION -obligado I-EVOLUTION -a I-EVOLUTION -instaurar I-EVOLUTION -tratamiento I-EVOLUTION -antibiótico I-EVOLUTION -casi I-EVOLUTION -de I-EVOLUTION -manera I-EVOLUTION -continua. I-EVOLUTION - I-EVOLUTION -• I-EVOLUTION -En I-EVOLUTION -12/2012 I-EVOLUTION -sufre I-EVOLUTION -extrusión I-EVOLUTION -espontánea I-EVOLUTION -colocándose B-TREATMENT -catéter I-TREATMENT -femoral I-TREATMENT -provisional I-TREATMENT -izquierdo. I-TREATMENT - I-TREATMENT -• B-EXPLORATION -Se I-EXPLORATION -le I-EXPLORATION -realizó I-EXPLORATION -nuevo I-EXPLORATION -estudio I-EXPLORATION -de I-EXPLORATION -troncos I-EXPLORATION -venosos I-EXPLORATION -encontrando I-EXPLORATION -oclusión I-EXPLORATION +test I-EXPLORATION de I-EXPLORATION -vena I-EXPLORATION -iliaca I-EXPLORATION +D-xilosa I-EXPLORATION +compatible I-EXPLORATION con I-EXPLORATION -desviación I-EXPLORATION -del I-EXPLORATION -flujo I-EXPLORATION -por I-EXPLORATION -rama I-EXPLORATION -hipogástrica I-EXPLORATION -hasta I-EXPLORATION -iliaca I-EXPLORATION -común, I-EXPLORATION -de I-EXPLORATION -modo I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -es I-EXPLORATION -subsidiaria I-EXPLORATION -de I-EXPLORATION -catéter I-EXPLORATION +malabsorción. I-EXPLORATION +Las I-EXPLORATION +determinaciones I-EXPLORATION de I-EXPLORATION -diálisis I-EXPLORATION -permanente I-EXPLORATION -por I-EXPLORATION -este I-EXPLORATION -acceso. I-EXPLORATION -La I-EXPLORATION -vena I-EXPLORATION -femoral I-EXPLORATION -común I-EXPLORATION -derecha I-EXPLORATION -se I-EXPLORATION -encontró I-EXPLORATION -permeable I-EXPLORATION -pero I-EXPLORATION -no I-EXPLORATION -se I-EXPLORATION -detectó I-EXPLORATION -flujo I-EXPLORATION -doppler I-EXPLORATION -en I-EXPLORATION -vena I-EXPLORATION -iliaca, I-EXPLORATION -probablemente I-EXPLORATION -por I-EXPLORATION -trombosis. I-EXPLORATION -Se I-EXPLORATION -realizaron I-EXPLORATION -flebografías I-EXPLORATION +bilirrubina, I-EXPLORATION +glucosa, I-EXPLORATION +urea, I-EXPLORATION +creatinina, I-EXPLORATION +vitamina I-EXPLORATION +B12, I-EXPLORATION +ácido I-EXPLORATION +fólico, I-EXPLORATION +hormonas I-EXPLORATION +tiroideas, I-EXPLORATION +triglicéridos, I-EXPLORATION +fósforo, I-EXPLORATION +magnesio, I-EXPLORATION +pruebas I-EXPLORATION +hepáticas, I-EXPLORATION +inmunoglobulinas, I-EXPLORATION +transferrina, I-EXPLORATION +ferritina I-EXPLORATION +y I-EXPLORATION +anticuerpos I-EXPLORATION +antiendomisio I-EXPLORATION +y I-EXPLORATION +antigliadina I-EXPLORATION +son I-EXPLORATION +normales. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +microbiológico I-EXPLORATION de I-EXPLORATION -ambos I-EXPLORATION -brazos I-EXPLORATION -encontrando I-EXPLORATION -que I-EXPLORATION -el I-EXPLORATION -flujo I-EXPLORATION -va I-EXPLORATION -por I-EXPLORATION -colaterales I-EXPLORATION -a I-EXPLORATION -intercostales I-EXPLORATION -hasta I-EXPLORATION -acigos-hemiacigos I-EXPLORATION +heces, I-EXPLORATION +sangre I-EXPLORATION +y I-EXPLORATION +orina, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +la I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +virus I-EXPLORATION +y I-EXPLORATION +bacterias I-EXPLORATION +(virus I-EXPLORATION de I-EXPLORATION -forma I-EXPLORATION -bilateral I-EXPLORATION -debido I-EXPLORATION -a I-EXPLORATION la I-EXPLORATION -oclusión I-EXPLORATION +inmunodeficiencia I-EXPLORATION +humana, I-EXPLORATION +virus I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -venas I-EXPLORATION -subclavias. I-EXPLORATION -Se I-EXPLORATION -descartó I-EXPLORATION -colocar I-EXPLORATION -un I-EXPLORATION -catéter I-EXPLORATION -por I-EXPLORATION -subclavia. I-EXPLORATION +la I-EXPLORATION +hepatitis I-EXPLORATION +B I-EXPLORATION +y I-EXPLORATION +C, I-EXPLORATION +Salmonella, I-EXPLORATION +Clostridium I-EXPLORATION +difficile I-EXPLORATION +y I-EXPLORATION +micobacterias), I-EXPLORATION +fueron I-EXPLORATION +normales I-EXPLORATION +o I-EXPLORATION +negativas. I-EXPLORATION + I-EXPLORATION Se I-EXPLORATION realizó I-EXPLORATION +un I-EXPLORATION +tránsito I-EXPLORATION +intestinal, I-EXPLORATION ecografía I-EXPLORATION -doppler I-EXPLORATION -de I-EXPLORATION -ambas I-EXPLORATION -yugulares I-EXPLORATION -visualizando I-EXPLORATION -la I-EXPLORATION -vena I-EXPLORATION -yugular I-EXPLORATION -izquierda I-EXPLORATION -permeable I-EXPLORATION -aunque I-EXPLORATION -es I-EXPLORATION -muy I-EXPLORATION -probable I-EXPLORATION -estenosis I-EXPLORATION -central I-EXPLORATION -del I-EXPLORATION -tronco I-EXPLORATION -braquiocefálico I-EXPLORATION -venoso I-EXPLORATION -izquierdo I-EXPLORATION -dada I-EXPLORATION +y I-EXPLORATION +TAC I-EXPLORATION +abdominopélvica I-EXPLORATION +sin I-EXPLORATION +apreciarse I-EXPLORATION +hallazgos I-EXPLORATION +patológicos. I-EXPLORATION +La I-EXPLORATION +fibrogastroscopia I-EXPLORATION +detectó I-EXPLORATION +en I-EXPLORATION la I-EXPLORATION -flebografía I-EXPLORATION +segunda I-EXPLORATION +y I-EXPLORATION +tercera I-EXPLORATION +porción I-EXPLORATION +duodenal I-EXPLORATION +un I-EXPLORATION +engrosamiento I-EXPLORATION +marcado I-EXPLORATION de I-EXPLORATION -ese I-EXPLORATION -miembro I-EXPLORATION +pliegues I-EXPLORATION +con I-EXPLORATION +edema I-EXPLORATION y I-EXPLORATION +aspecto I-EXPLORATION +granular I-EXPLORATION +con I-EXPLORATION +infiltrados I-EXPLORATION +blanquecinos. I-EXPLORATION +La I-EXPLORATION +anatomía I-EXPLORATION +patológica I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -vena I-EXPLORATION -yugular I-EXPLORATION -derecha I-EXPLORATION -ocluida I-EXPLORATION -crónica I-EXPLORATION -(no I-EXPLORATION -visible I-EXPLORATION +mucosa I-EXPLORATION +duodenal I-EXPLORATION +confirmó I-EXPLORATION +la I-EXPLORATION +presencia I-EXPLORATION +de I-EXPLORATION +gránulos I-EXPLORATION +PAS I-EXPLORATION +positivos, I-EXPLORATION +diastasa I-EXPLORATION +resistentes, I-EXPLORATION +hallazgos I-EXPLORATION +también I-EXPLORATION +presentes I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +previa I-EXPLORATION +ileal. I-EXPLORATION +Se I-EXPLORATION +determinó I-EXPLORATION en I-EXPLORATION +el I-EXPLORATION +duodeno I-EXPLORATION la I-EXPLORATION -ecografía). I-EXPLORATION +secuencia I-EXPLORATION +de I-EXPLORATION +ARN I-EXPLORATION +ribosomal I-EXPLORATION +16 I-EXPLORATION +S I-EXPLORATION +de I-EXPLORATION +T. I-EXPLORATION +whippleii I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +positiva. I-EXPLORATION I-EXPLORATION -• B-TREATMENT -El I-TREATMENT -17/01/2013 I-TREATMENT -se I-TREATMENT -le I-TREATMENT -implantó I-TREATMENT -nuevo I-TREATMENT -catéter I-TREATMENT -transhepático I-TREATMENT -que I-TREATMENT -fue I-TREATMENT -recambiado I-TREATMENT -el I-TREATMENT -20/03/2013 I-TREATMENT -por I-TREATMENT -disfunción. I-TREATMENT -Este B-EVOLUTION -es I-EVOLUTION -su I-EVOLUTION -acceso I-EVOLUTION -actual I-EVOLUTION -y I-EVOLUTION -probablemente I-EVOLUTION -el I-EVOLUTION -único I-EVOLUTION -posible. I-EVOLUTION - I-EVOLUTION -A I-EVOLUTION -todos I-EVOLUTION -estos I-EVOLUTION -problemas I-EVOLUTION -vasculares I-EVOLUTION -que I-EVOLUTION -ponen I-EVOLUTION -en I-EVOLUTION -riesgo I-EVOLUTION -su I-EVOLUTION -supervivencia I-EVOLUTION -se I-EVOLUTION -suma I-EVOLUTION -la I-EVOLUTION -situación I-EVOLUTION -social I-EVOLUTION -complicadísima I-EVOLUTION -que I-EVOLUTION -vive I-EVOLUTION -la I-EVOLUTION -paciente, I-EVOLUTION -ya I-EVOLUTION -que I-EVOLUTION -no I-EVOLUTION -recibe I-EVOLUTION -ningún I-EVOLUTION -apoyo I-EVOLUTION -familiar I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -encuentra I-EVOLUTION -totalmente I-EVOLUTION -desmotivada I-EVOLUTION -presentando I-EVOLUTION -en I-EVOLUTION +El B-TREATMENT +paciente I-TREATMENT +recibió I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +penicilina I-TREATMENT +(1, I-TREATMENT +2 I-TREATMENT +x I-TREATMENT +106 I-TREATMENT +unidades I-TREATMENT +al I-TREATMENT +día) I-TREATMENT +más I-TREATMENT +estreptomicina I-TREATMENT +(1 I-TREATMENT +g/día) I-TREATMENT +durante I-TREATMENT +14 I-TREATMENT +días, I-TREATMENT +seguido I-TREATMENT +de I-TREATMENT +cotrimoxazol I-TREATMENT +(800/160 I-TREATMENT +mg I-TREATMENT +cada I-TREATMENT +12 I-TREATMENT +horas) I-TREATMENT +durante I-TREATMENT +un I-TREATMENT +año. I-TREATMENT +La B-EVOLUTION +evolución I-EVOLUTION +fue I-EVOLUTION +favorable I-EVOLUTION +desapareciendo I-EVOLUTION la I-EVOLUTION -mayoría I-EVOLUTION -de I-EVOLUTION -ocasiones I-EVOLUTION -un I-EVOLUTION -comportamiento I-EVOLUTION -rebelde I-EVOLUTION +fiebre I-EVOLUTION y I-EVOLUTION -de I-EVOLUTION -rechazo I-EVOLUTION -a I-EVOLUTION -cualquier I-EVOLUTION -cambio I-EVOLUTION +ganando I-EVOLUTION +peso I-EVOLUTION en I-EVOLUTION -sus I-EVOLUTION -opciones I-EVOLUTION -de I-EVOLUTION -tratamiento, I-EVOLUTION -hecho I-EVOLUTION -que I-EVOLUTION -dificulta I-EVOLUTION -enormemente I-EVOLUTION +las I-EVOLUTION +primeras I-EVOLUTION +dos I-EVOLUTION +semanas. I-EVOLUTION +A I-EVOLUTION +los I-EVOLUTION +10 I-EVOLUTION +meses, I-EVOLUTION la I-EVOLUTION -labor I-EVOLUTION +duodenoscopia I-EVOLUTION +era I-EVOLUTION +normal I-EVOLUTION +pero I-EVOLUTION +persistían I-EVOLUTION +focos I-EVOLUTION +aislados I-EVOLUTION de I-EVOLUTION -enfermería I-EVOLUTION +macrófagos I-EVOLUTION +PAS I-EVOLUTION +positivos I-EVOLUTION en I-EVOLUTION -el I-EVOLUTION -ámbito I-EVOLUTION -de I-EVOLUTION -educación I-EVOLUTION -para I-EVOLUTION la I-EVOLUTION -salud. I-EVOLUTION - I-EVOLUTION -Cabe B-TREATMENT -reseñar I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -rechaza I-TREATMENT -iniciar I-TREATMENT -cualquier I-TREATMENT -tipo I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -anticoagulante I-TREATMENT -(se I-TREATMENT -le I-TREATMENT -ha I-TREATMENT -propuesto I-TREATMENT -tomar I-TREATMENT -sintrom® I-TREATMENT -en I-TREATMENT -muchas I-TREATMENT -ocasiones). I-TREATMENT - I-TREATMENT -Por I-TREATMENT -otra I-TREATMENT -parte I-TREATMENT -se I-TREATMENT -descartó I-TREATMENT -su I-TREATMENT -inclusión I-TREATMENT +lámina I-EVOLUTION +propia. I-EVOLUTION +La B-EXPLORATION +PCR I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +mucosa I-EXPLORATION +duodenal I-EXPLORATION +fue I-EXPLORATION +negativa. I-EXPLORATION +A I-EXPLORATION +los I-EXPLORATION +8 I-EXPLORATION +años I-EXPLORATION +de I-EXPLORATION +evolución, I-EXPLORATION +las I-EXPLORATION +biopsias I-EXPLORATION +duodenal I-EXPLORATION +e I-EXPLORATION +ileal I-EXPLORATION +no I-EXPLORATION +mostraban I-EXPLORATION +hallazgos I-EXPLORATION +histológicos I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +enfermedad I-EXPLORATION +al I-EXPLORATION +microscopio I-EXPLORATION +óptico. I-EXPLORATION + I-EXPLORATION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +26 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +con B-PAST_MEDICAL_HISTORY +antecedente I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +dermatitis I-PAST_MEDICAL_HISTORY +seborreica I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +cuero I-PAST_MEDICAL_HISTORY +cabelludo I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +viaje I-PAST_MEDICAL_HISTORY +reciente I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +Ilhabela, I-PAST_MEDICAL_HISTORY +Brasil. I-PAST_MEDICAL_HISTORY +Después I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +permanecer I-PAST_MEDICAL_HISTORY +1 I-PAST_MEDICAL_HISTORY +semana I-PAST_MEDICAL_HISTORY +fuera I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +país, I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +retornó I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +Chile. I-PAST_MEDICAL_HISTORY +Consultó B-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +dermatólogo I-PRESENT_ILLNESS +2 I-PRESENT_ILLNESS +días I-PRESENT_ILLNESS +después I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +regreso, I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +malestar I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +zona I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +cuero I-PRESENT_ILLNESS +cabelludo I-PRESENT_ILLNESS +parieto I-PRESENT_ILLNESS +occipital, I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +sensación I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +objetos I-PRESENT_ILLNESS +extraños I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +se I-PRESENT_ILLNESS +mueven I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +su I-PRESENT_ILLNESS +cabeza. I-PRESENT_ILLNESS +Al B-EXPLORATION +examen I-EXPLORATION +físico, I-EXPLORATION +se I-EXPLORATION +identificaro I-EXPLORATION +3 I-EXPLORATION +úlceras I-EXPLORATION +de I-EXPLORATION +1, I-EXPLORATION +5 I-EXPLORATION +cm, I-EXPLORATION +aproximadamente, I-EXPLORATION +de I-EXPLORATION +los I-EXPLORATION +cuales I-EXPLORATION +supuraba I-EXPLORATION +abundante I-EXPLORATION +contenido I-EXPLORATION +seropurulento, I-EXPLORATION +en I-EXPLORATION +cuyos I-EXPLORATION +fondos I-EXPLORATION +se I-EXPLORATION +apreciaban I-EXPLORATION +múltiples I-EXPLORATION +larvas I-EXPLORATION +vivas I-EXPLORATION +y I-EXPLORATION +móviles. I-EXPLORATION +Se B-TREATMENT +procedió I-TREATMENT +a I-TREATMENT +extracción I-TREATMENT +manual I-TREATMENT en I-TREATMENT la I-TREATMENT -lista I-TREATMENT +sala I-TREATMENT de I-TREATMENT -trasplante I-TREATMENT -al I-TREATMENT -no I-TREATMENT -acudir I-TREATMENT -a I-TREATMENT -las I-TREATMENT -reiteradas I-TREATMENT -citas, I-TREATMENT -autoexcluyéndose I-TREATMENT -además I-TREATMENT -como I-TREATMENT -candidata I-TREATMENT -a I-TREATMENT -diálisis I-TREATMENT -peritoneal I-TREATMENT -dada I-TREATMENT -su I-TREATMENT -negativa I-TREATMENT -a I-TREATMENT -cumplir I-TREATMENT +atención, I-TREATMENT +mediante I-TREATMENT +pinzas, I-TREATMENT con I-TREATMENT -las I-TREATMENT -pautas I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -propuestas I-TREATMENT -por I-TREATMENT -el I-TREATMENT -personal I-TREATMENT -médico I-TREATMENT -y I-TREATMENT -de I-TREATMENT -enfermería. I-TREATMENT - I-TREATMENT -En I-TREATMENT -las I-TREATMENT -figuras I-TREATMENT -1 I-TREATMENT +bastante I-TREATMENT +facilidad I-TREATMENT y I-TREATMENT -2 I-TREATMENT -se I-TREATMENT -muestra I-TREATMENT -el I-TREATMENT -acceso I-TREATMENT -actual I-TREATMENT -de I-TREATMENT +sin I-TREATMENT +molestias I-TREATMENT +para I-TREATMENT la I-TREATMENT -paciente: I-TREATMENT +paciente I-TREATMENT +durante I-TREATMENT el I-TREATMENT -catéter I-TREATMENT -transhepático. I-TREATMENT - I-TREATMENT -Cuidados I-TREATMENT +procedimiento, I-TREATMENT +obteniéndose I-TREATMENT +25 I-TREATMENT +especímenes. I-TREATMENT +Se I-TREATMENT +indicó I-TREATMENT +ivermectina I-TREATMENT +oral I-TREATMENT +en I-TREATMENT +dosis I-TREATMENT +única I-TREATMENT de I-TREATMENT -enfermería I-TREATMENT - I-TREATMENT -En B-EVOLUTION -cada I-EVOLUTION -sesión I-EVOLUTION -se I-EVOLUTION -informa I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION +200 I-TREATMENT +ug/kg. I-TREATMENT +La B-EVOLUTION paciente I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -cuidados I-EVOLUTION -que I-EVOLUTION -debe I-EVOLUTION -tener I-EVOLUTION -para I-EVOLUTION -cuidar I-EVOLUTION -al I-EVOLUTION -máximo I-EVOLUTION -su I-EVOLUTION -AV I-EVOLUTION -haciendo I-EVOLUTION -especial I-EVOLUTION -hincapié I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -importancia I-EVOLUTION -de I-EVOLUTION -mantener I-EVOLUTION -el I-EVOLUTION -apósito I-EVOLUTION -seco I-EVOLUTION -y I-EVOLUTION -limpio I-EVOLUTION -y I-EVOLUTION -de I-EVOLUTION -informar I-EVOLUTION -al I-EVOLUTION -personal I-EVOLUTION -de I-EVOLUTION -enfermería I-EVOLUTION -acerca I-EVOLUTION -de I-EVOLUTION -cualquier I-EVOLUTION -incidencia I-EVOLUTION -que I-EVOLUTION -note, I-EVOLUTION -especialmente I-EVOLUTION -si I-EVOLUTION -aparece I-EVOLUTION -dolor I-EVOLUTION -o I-EVOLUTION -calor I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -zona I-EVOLUTION -de I-EVOLUTION -inserción I-EVOLUTION -y I-EVOLUTION -fiebre. I-EVOLUTION - I-EVOLUTION -Todo I-EVOLUTION -el I-EVOLUTION -equipo I-EVOLUTION -de I-EVOLUTION -enfermería I-EVOLUTION -cumple I-EVOLUTION +se I-EVOLUTION +presentó I-EVOLUTION +dos I-EVOLUTION +días I-EVOLUTION +más I-EVOLUTION +tarde I-EVOLUTION con I-EVOLUTION -los I-EVOLUTION -protocolos I-EVOLUTION -de I-EVOLUTION -cura I-EVOLUTION -del I-EVOLUTION -orificio I-EVOLUTION -de I-EVOLUTION -salida I-EVOLUTION -del I-EVOLUTION -catéter, I-EVOLUTION -conexión I-EVOLUTION -y I-EVOLUTION -desconexión I-EVOLUTION -según I-EVOLUTION -los I-EVOLUTION -criterios I-EVOLUTION -aceptados I-EVOLUTION -en I-EVOLUTION -nuestra I-EVOLUTION -unidad I-EVOLUTION +persistencia I-EVOLUTION de I-EVOLUTION -diálisis: I-EVOLUTION - I-EVOLUTION -• B-TREATMENT -La I-TREATMENT -cura I-TREATMENT -del I-TREATMENT -orificio I-TREATMENT -de I-TREATMENT -salida I-TREATMENT -del I-TREATMENT -catéter I-TREATMENT -(OSC) I-TREATMENT +sintomatología, I-EVOLUTION +por B-TREATMENT +lo I-TREATMENT +que I-TREATMENT se I-TREATMENT -realiza I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -aséptica I-TREATMENT -con I-TREATMENT -cloruro I-TREATMENT -sódico I-TREATMENT -al I-TREATMENT -20%, I-TREATMENT -clorhexidina I-TREATMENT -alcohólica I-TREATMENT -al I-TREATMENT -2% I-TREATMENT +decidió I-TREATMENT +realizar I-TREATMENT +cirugía I-TREATMENT +exploratoria I-TREATMENT y I-TREATMENT -gasas I-TREATMENT -estériles, I-TREATMENT -observando I-TREATMENT -de I-TREATMENT -forma I-TREATMENT -exhaustiva I-TREATMENT -la I-TREATMENT -zona I-TREATMENT -para I-TREATMENT -detectar I-TREATMENT -precozmente I-TREATMENT -la I-TREATMENT -aparición I-TREATMENT -de I-TREATMENT -eritema, I-TREATMENT -secreción, I-TREATMENT -etc. I-TREATMENT -Después I-TREATMENT -se I-TREATMENT -cubre I-TREATMENT -el I-TREATMENT -orificio I-TREATMENT -con I-TREATMENT -un I-TREATMENT -apósito I-TREATMENT -estéril. I-TREATMENT - I-TREATMENT -• I-TREATMENT -El I-TREATMENT -sellado I-TREATMENT -de I-TREATMENT -las I-TREATMENT -ramas I-TREATMENT -del I-TREATMENT -catéter I-TREATMENT +aseo I-TREATMENT +bajo I-TREATMENT +anestesia I-TREATMENT +local, I-TREATMENT se I-TREATMENT -realiza I-TREATMENT +logró I-TREATMENT +extraer I-TREATMENT +4 I-TREATMENT +larvas I-TREATMENT +más. I-TREATMENT +Se B-EXPLORATION +realizó I-EXPLORATION +ecografía I-EXPLORATION +de I-EXPLORATION +partes I-EXPLORATION +blandas, I-EXPLORATION +no I-EXPLORATION +evidenciándose I-EXPLORATION +más I-EXPLORATION +larvas, I-EXPLORATION +y I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +cráneo, I-EXPLORATION +que I-EXPLORATION +descartó I-EXPLORATION +compromiso I-EXPLORATION +óseo. I-EXPLORATION + I-EXPLORATION +La B-TREATMENT +paciente I-TREATMENT +fue I-TREATMENT +tratada I-TREATMENT con I-TREATMENT -Taurolock® I-TREATMENT +antibioterapia I-TREATMENT +oral I-TREATMENT y I-TREATMENT -tapones I-TREATMENT -tipo I-TREATMENT -luer-lock. I-TREATMENT -Desde I-TREATMENT -el I-TREATMENT -último I-TREATMENT -recambio I-TREATMENT -del I-TREATMENT -catéter I-TREATMENT -transhepático I-TREATMENT -en I-TREATMENT -la I-TREATMENT -primera I-TREATMENT -sesión I-TREATMENT -de I-TREATMENT -diálisis I-TREATMENT -semanal I-TREATMENT -se I-TREATMENT -sella I-TREATMENT -con I-TREATMENT -Urokinasa I-TREATMENT -50.000 I-TREATMENT -UI/rama I-TREATMENT -como I-TREATMENT -terapia I-TREATMENT -fibrinolítica I-TREATMENT -intraluminal I-TREATMENT -según I-TREATMENT -protocolo I-TREATMENT +curaciones I-TREATMENT de I-TREATMENT -nuestra I-TREATMENT -unidad. I-TREATMENT - I-TREATMENT -Se B-EXPLORATION -valora I-EXPLORATION +sitio I-TREATMENT +operatorio, I-TREATMENT +presentando B-EVOLUTION +una I-EVOLUTION +rápida I-EVOLUTION +y I-EVOLUTION +favorable I-EVOLUTION +respuesta I-EVOLUTION +clínica, I-EVOLUTION +logrando I-EVOLUTION +cierre I-EVOLUTION +por I-EVOLUTION +segunda I-EVOLUTION +intención I-EVOLUTION +de I-EVOLUTION +las I-EVOLUTION +heridas I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +recurrencias I-EVOLUTION +hasta I-EVOLUTION +la I-EVOLUTION +fecha. I-EVOLUTION + I-EVOLUTION +Todas B-EXPLORATION +las I-EXPLORATION +larvas I-EXPLORATION +obtenidas I-EXPLORATION +fueron I-EXPLORATION +analizadas I-EXPLORATION +por I-EXPLORATION el I-EXPLORATION -funcionamiento I-EXPLORATION -adecuado I-EXPLORATION +Laboratorio I-EXPLORATION +Parasitología I-EXPLORATION +Básico-Clínico I-EXPLORATION del I-EXPLORATION -catéter I-EXPLORATION -en I-EXPLORATION -cada I-EXPLORATION -sesión I-EXPLORATION +Instituto I-EXPLORATION de I-EXPLORATION -hemodiálisis I-EXPLORATION -alcanzando I-EXPLORATION -flujos I-EXPLORATION -sanguíneos I-EXPLORATION -adecuados I-EXPLORATION -superiores I-EXPLORATION -a I-EXPLORATION -300 I-EXPLORATION -ml/min I-EXPLORATION -y I-EXPLORATION -Kt I-EXPLORATION -mayor I-EXPLORATION +Ciencias I-EXPLORATION +Biomédicas I-EXPLORATION de I-EXPLORATION -45 I-EXPLORATION -L. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION la I-EXPLORATION -figura I-EXPLORATION -3 I-EXPLORATION -se I-EXPLORATION -muestran I-EXPLORATION -los I-EXPLORATION -datos I-EXPLORATION -obtenidos I-EXPLORATION +Facultad I-EXPLORATION de I-EXPLORATION -las I-EXPLORATION -sesiones I-EXPLORATION +Medicina I-EXPLORATION de I-EXPLORATION -diálisis I-EXPLORATION -desde I-EXPLORATION -enero I-EXPLORATION +la I-EXPLORATION +Universidad I-EXPLORATION de I-EXPLORATION -2013. I-EXPLORATION +Chile, I-EXPLORATION +identificándose I-EXPLORATION +larvas I-EXPLORATION +en I-EXPLORATION +estado I-EXPLORATION +L2 I-EXPLORATION +y I-EXPLORATION +L3 I-EXPLORATION +de I-EXPLORATION +Cochliomyia I-EXPLORATION +hominivorax. I-EXPLORATION I-EXPLORATION -Varón B-PRESENT_ILLNESS +Se B-PRESENT_ILLNESS +trata I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -41 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -ERC I-PRESENT_ILLNESS -estadio I-PRESENT_ILLNESS -V I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +varón I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -perfil I-PRESENT_ILLNESS -intersticial I-PRESENT_ILLNESS +45 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS que I-PRESENT_ILLNESS -tras I-PRESENT_ILLNESS -recibir I-PRESENT_ILLNESS -educación I-PRESENT_ILLNESS -en I-PRESENT_ILLNESS -opciones I-PRESENT_ILLNESS +sufrió I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +accidente I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -elige I-PRESENT_ILLNESS -DPCA. I-PRESENT_ILLNESS -En B-TREATMENT -septiembre I-TREATMENT -de I-TREATMENT -2014 I-TREATMENT -se I-TREATMENT -procedió I-TREATMENT -a I-TREATMENT -la I-TREATMENT -implantación I-TREATMENT -de I-TREATMENT -catéter I-TREATMENT -de I-TREATMENT -silicona I-TREATMENT -Swan-neck I-TREATMENT -con I-TREATMENT -doble I-TREATMENT -cuff I-TREATMENT -y I-TREATMENT -reparación I-TREATMENT -de I-TREATMENT -dos I-TREATMENT -hernias, I-TREATMENT -inguinal I-TREATMENT -y I-TREATMENT -umbilical. I-TREATMENT -Su B-EXPLORATION -superficie I-EXPLORATION +coche. I-PRESENT_ILLNESS +En B-EXPLORATION +la I-EXPLORATION +valoración I-EXPLORATION +inicial I-EXPLORATION +estaba I-EXPLORATION +estable I-EXPLORATION +hemodinámicamente. I-EXPLORATION +La I-EXPLORATION +TACHT I-EXPLORATION corporal I-EXPLORATION -era I-EXPLORATION -2.06 I-EXPLORATION -m2 I-EXPLORATION -y I-EXPLORATION -su I-EXPLORATION -Indice I-EXPLORATION +al I-EXPLORATION +ingreso I-EXPLORATION +mostraba: I-EXPLORATION +seudoaneurisma I-EXPLORATION de I-EXPLORATION -Masa I-EXPLORATION -Corporal I-EXPLORATION -26.1. I-EXPLORATION -Se B-TREATMENT -realizó I-TREATMENT +la I-EXPLORATION +aorta I-EXPLORATION +torácica I-EXPLORATION +distal I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +arteria I-EXPLORATION +subclavia I-EXPLORATION +izquierda I-EXPLORATION +con I-EXPLORATION +sangrado I-EXPLORATION +periaórtico. I-EXPLORATION +Ingresó B-TREATMENT +en I-TREATMENT la I-TREATMENT -educación I-TREATMENT -para I-TREATMENT +UCI, I-TREATMENT +donde I-TREATMENT +se I-TREATMENT +inició I-TREATMENT el I-TREATMENT -aprendizaje I-TREATMENT -de I-TREATMENT -la I-TREATMENT -técnica I-TREATMENT -y I-TREATMENT -en I-TREATMENT -Noviembre I-TREATMENT -de I-TREATMENT -2014 I-TREATMENT -comenzó I-TREATMENT tratamiento I-TREATMENT -en I-TREATMENT -domicilio I-TREATMENT +médico. I-TREATMENT +A I-TREATMENT +las I-TREATMENT +36 I-TREATMENT +horas I-TREATMENT +se I-TREATMENT +le I-TREATMENT +realizó I-TREATMENT +una I-TREATMENT +reparación I-TREATMENT +quirúrgica I-TREATMENT con I-TREATMENT -4 I-TREATMENT -intercambios I-TREATMENT -de I-TREATMENT -Bicavera I-TREATMENT -al I-TREATMENT -1, I-TREATMENT -5% I-TREATMENT -de I-TREATMENT -glucosa I-TREATMENT -y I-TREATMENT -2000 I-TREATMENT -ml I-TREATMENT +endoprótesis I-TREATMENT +en I-TREATMENT +la I-TREATMENT +aorta I-TREATMENT +torácica I-TREATMENT +descendente I-TREATMENT +por I-TREATMENT +la I-TREATMENT +vía I-TREATMENT +femoral I-TREATMENT +izquierda. I-TREATMENT +Hubo I-TREATMENT +una I-TREATMENT +oclusión I-TREATMENT +asintomática I-TREATMENT de I-TREATMENT -volumen, I-TREATMENT -sin I-TREATMENT -complicaciones. I-TREATMENT +la I-TREATMENT +arteria I-TREATMENT +subclavia I-TREATMENT +izquierda. I-TREATMENT + I-TREATMENT +La B-EXPLORATION +TACHT I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION +a I-EXPLORATION +los I-EXPLORATION +6 I-EXPLORATION +días I-EXPLORATION +mostraba I-EXPLORATION +una I-EXPLORATION +correcta I-EXPLORATION +localización I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +endoprótesis. I-EXPLORATION +Al B-EVOLUTION +décimo I-EVOLUTION +día I-EVOLUTION +presentó I-EVOLUTION +una I-EVOLUTION +pericarditis I-EVOLUTION +aguda I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +al I-EVOLUTION +decimosexto I-EVOLUTION +día, I-EVOLUTION +asintomático. I-EVOLUTION + I-EVOLUTION + +Masculino B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +14 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sentado I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +cinturón I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +seguridad I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +parte I-PRESENT_ILLNESS +trasera I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +automóvil, I-PRESENT_ILLNESS +participó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +accidente I-PRESENT_ILLNESS +automovilístico. I-PRESENT_ILLNESS +Se I-PRESENT_ILLNESS +mantuvo I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +asiento I-PRESENT_ILLNESS +posterior I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +evento I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +pérdida I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +conocimiento I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +momento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +arribo I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +los I-PRESENT_ILLNESS +paramédicos. I-PRESENT_ILLNESS +El I-PRESENT_ILLNESS +accidente I-PRESENT_ILLNESS +ocurrió I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +área I-PRESENT_ILLNESS +rural I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +traslado I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +DUP I-PRESENT_ILLNESS +duró I-PRESENT_ILLNESS +aprox. I-PRESENT_ILLNESS +90min. I-PRESENT_ILLNESS +Fue I-PRESENT_ILLNESS +transportado I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +collarín I-PRESENT_ILLNESS +e I-PRESENT_ILLNESS +inmovilizado I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +decúbito I-PRESENT_ILLNESS +dorsal I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +tabla I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +protección. I-PRESENT_ILLNESS Los B-EXPLORATION -volúmenes I-EXPLORATION +signos I-EXPLORATION +vitales I-EXPLORATION +a I-EXPLORATION +su I-EXPLORATION +llegada: I-EXPLORATION +temperatura, I-EXPLORATION +36, I-EXPLORATION +5oC; I-EXPLORATION +pulso, I-EXPLORATION +84/min; I-EXPLORATION +PA, I-EXPLORATION +110/63mm I-EXPLORATION +Hg I-EXPLORATION +y I-EXPLORATION +frecuencia I-EXPLORATION +respiratoria I-EXPLORATION +14. I-EXPLORATION +A I-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +física I-EXPLORATION +(EF) I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +DUP I-EXPLORATION +presentó I-EXPLORATION +dolor I-EXPLORATION +abdominal I-EXPLORATION +leve, I-EXPLORATION +escoriaciones I-EXPLORATION +en I-EXPLORATION +diferentes I-EXPLORATION +partes I-EXPLORATION +del I-EXPLORATION +cuerpo, I-EXPLORATION +sin I-EXPLORATION +embargo I-EXPLORATION +el I-EXPLORATION +ultrasonido I-EXPLORATION +inicial I-EXPLORATION +de I-EXPLORATION +abdomen I-EXPLORATION +y I-EXPLORATION +los I-EXPLORATION +rayos I-EXPLORATION +X I-EXPLORATION +solo I-EXPLORATION +evidenciaron I-EXPLORATION +rectificación I-EXPLORATION de I-EXPLORATION -UF I-EXPLORATION -eran I-EXPLORATION +la I-EXPLORATION +columna I-EXPLORATION +cervical. I-EXPLORATION +Estudios I-EXPLORATION de I-EXPLORATION -500-700 I-EXPLORATION -ml/ I-EXPLORATION -24 I-EXPLORATION -horas I-EXPLORATION +laboratorio: I-EXPLORATION +niveles I-EXPLORATION +de I-EXPLORATION +hemoglobina I-EXPLORATION y I-EXPLORATION -la I-EXPLORATION -diuresis I-EXPLORATION -residual I-EXPLORATION +creatinina I-EXPLORATION +normales; I-EXPLORATION +examen I-EXPLORATION de I-EXPLORATION -1700 I-EXPLORATION -ml. I-EXPLORATION -En B-EVOLUTION -diciembre I-EVOLUTION -de I-EVOLUTION -2014 I-EVOLUTION -se I-EVOLUTION -realizó I-EVOLUTION -Prueba I-EVOLUTION -de I-EVOLUTION -función I-EVOLUTION -peritoneal I-EVOLUTION -catalogándose I-EVOLUTION -como I-EVOLUTION -alto I-EVOLUTION -transportador I-EVOLUTION -con I-EVOLUTION -un I-EVOLUTION -volumen I-EVOLUTION -residual I-EVOLUTION -de I-EVOLUTION -411, I-EVOLUTION -39 I-EVOLUTION -ml I-EVOLUTION -y I-EVOLUTION -Presión I-EVOLUTION -Intraperitoneal I-EVOLUTION -(PIP) I-EVOLUTION -de I-EVOLUTION -16, I-EVOLUTION -05 I-EVOLUTION -cm I-EVOLUTION -H2O. I-EVOLUTION -El I-EVOLUTION -2 I-EVOLUTION -de I-EVOLUTION -febrero I-EVOLUTION +orina: I-EXPLORATION +microhematuria. I-EXPLORATION +Después B-EVOLUTION de I-EVOLUTION -2015 I-EVOLUTION -acudió I-EVOLUTION -a I-EVOLUTION -urgencias I-EVOLUTION -por I-EVOLUTION -dificultad I-EVOLUTION -para I-EVOLUTION +algunas I-EVOLUTION +horas, I-EVOLUTION el I-EVOLUTION -drenaje, I-EVOLUTION -su I-EVOLUTION -patrón I-EVOLUTION -intestinal I-EVOLUTION -era I-EVOLUTION -normal I-EVOLUTION -sin I-EVOLUTION -estreñimiento I-EVOLUTION -ni I-EVOLUTION -diarrea I-EVOLUTION -y I-EVOLUTION -la I-EVOLUTION -radiografía I-EVOLUTION -de I-EVOLUTION -abdomen I-EVOLUTION -mostró I-EVOLUTION -migración I-EVOLUTION -del I-EVOLUTION -catéter, I-EVOLUTION -tratado I-EVOLUTION -con I-EVOLUTION -laxantes I-EVOLUTION -mejoraron I-EVOLUTION -los I-EVOLUTION -drenajes I-EVOLUTION -pero I-EVOLUTION +paciente I-EVOLUTION presentó I-EVOLUTION -una I-EVOLUTION -ganancia I-EVOLUTION -de I-EVOLUTION -4 I-EVOLUTION -kg I-EVOLUTION +signos I-EVOLUTION de I-EVOLUTION -peso. I-EVOLUTION -Se B-TREATMENT -cambió I-TREATMENT -pauta I-TREATMENT -de I-TREATMENT -tratamiento I-TREATMENT -a I-TREATMENT -2 I-TREATMENT -intercambios I-TREATMENT -de I-TREATMENT -2, I-TREATMENT -3 I-TREATMENT -% I-TREATMENT -y I-TREATMENT -2 I-TREATMENT -de I-TREATMENT -1, I-TREATMENT -5% I-TREATMENT -de I-TREATMENT -glucosa I-TREATMENT -bajando I-TREATMENT -800 I-TREATMENT -gr I-TREATMENT -de I-TREATMENT -peso. I-TREATMENT -Al B-EVOLUTION -día I-EVOLUTION -siguiente I-EVOLUTION -en I-EVOLUTION -consulta I-EVOLUTION -telefónica I-EVOLUTION -se I-EVOLUTION -percibió I-EVOLUTION -disnea I-EVOLUTION -al I-EVOLUTION -hablar I-EVOLUTION +hemotórax I-EVOLUTION y I-EVOLUTION -tos, I-EVOLUTION -por I-EVOLUTION -lo I-EVOLUTION -que I-EVOLUTION -se I-EVOLUTION -le I-EVOLUTION -indicó I-EVOLUTION -acudir I-EVOLUTION -urgentemente I-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -consulta I-EVOLUTION -del I-EVOLUTION -hospital. I-EVOLUTION -La B-EXPLORATION -radiografía I-EXPLORATION -de I-EXPLORATION -tórax, I-EXPLORATION -mostró I-EXPLORATION -gran I-EXPLORATION -derrame I-EXPLORATION -pleural I-EXPLORATION -derecho I-EXPLORATION -que I-EXPLORATION -no I-EXPLORATION -existía I-EXPLORATION +continúo I-EVOLUTION +con I-EVOLUTION +dolor I-EVOLUTION +abdominal. I-EVOLUTION +Se B-TREATMENT +le I-TREATMENT +colocó I-TREATMENT +sonda I-TREATMENT +en I-TREATMENT +tórax I-TREATMENT +en I-TREATMENT +el I-TREATMENT +hemitórax I-TREATMENT +izquierdo I-TREATMENT +y B-EXPLORATION +se I-EXPLORATION +le I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +TAC I-EXPLORATION +contrastada. I-EXPLORATION +Al I-EXPLORATION +valorar I-EXPLORATION +la I-EXPLORATION +TAC, I-EXPLORATION +el I-EXPLORATION +caso I-EXPLORATION +fue I-EXPLORATION +comentado I-EXPLORATION +con I-EXPLORATION +nuestro I-EXPLORATION +departamento. I-EXPLORATION +En I-EXPLORATION +este I-EXPLORATION +momento I-EXPLORATION +el I-EXPLORATION +paciente I-EXPLORATION +contaba I-EXPLORATION +con I-EXPLORATION +8hrs I-EXPLORATION en I-EXPLORATION -radiografías I-EXPLORATION +observación. I-EXPLORATION +En I-EXPLORATION +nuestra I-EXPLORATION +evaluación, I-EXPLORATION +observamos I-EXPLORATION +equimosis I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +flanco I-EXPLORATION +izquierdo I-EXPLORATION +y I-EXPLORATION +drenaje I-EXPLORATION +escaso I-EXPLORATION +por I-EXPLORATION +la I-EXPLORATION +sonda I-EXPLORATION +en I-EXPLORATION +tórax. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +TAC I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +el I-EXPLORATION +riñón I-EXPLORATION +izquierdo I-EXPLORATION +sin I-EXPLORATION +captación I-EXPLORATION de I-EXPLORATION -tórax I-EXPLORATION -posteriores I-EXPLORATION -al I-EXPLORATION -comienzo I-EXPLORATION +medio I-EXPLORATION de I-EXPLORATION -la I-EXPLORATION -DP. I-EXPLORATION - I-EXPLORATION +contraste I-EXPLORATION +y I-EXPLORATION +un I-EXPLORATION +pequeño I-EXPLORATION +hematoma I-EXPLORATION +esplénico. I-EXPLORATION Se B-TREATMENT -realizó I-TREATMENT -toracentesis, I-TREATMENT -mostrando I-TREATMENT -la I-TREATMENT -bioquímica I-TREATMENT -del I-TREATMENT -líquido I-TREATMENT -una I-TREATMENT -concentración I-TREATMENT -de I-TREATMENT -glucosa I-TREATMENT -en I-TREATMENT -líquido I-TREATMENT -pleural I-TREATMENT -mayor I-TREATMENT -de I-TREATMENT -la I-TREATMENT -presentada I-TREATMENT -en I-TREATMENT -plasma I-TREATMENT -y I-TREATMENT -compatible I-TREATMENT -con I-TREATMENT -líquido I-TREATMENT -de I-TREATMENT -diálisis. I-TREATMENT -Ante I-TREATMENT -la I-TREATMENT -sospecha I-TREATMENT -de I-TREATMENT -fuga I-TREATMENT -de I-TREATMENT -líquido I-TREATMENT -hacia I-TREATMENT -la I-TREATMENT -cavidad I-TREATMENT -pleural, I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -la I-TREATMENT -diálisis I-TREATMENT -peritoneal. I-TREATMENT - I-TREATMENT -Se B-EXPLORATION +decidió I-TREATMENT +manejar I-TREATMENT +conservadoramente. I-TREATMENT +El B-EVOLUTION +paciente I-EVOLUTION +fue I-EVOLUTION +egresado I-EVOLUTION +6 I-EVOLUTION +días I-EVOLUTION +después. I-EVOLUTION + I-EVOLUTION + +Mujer B-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +60 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +sin B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +personales I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +interés, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +ingresó I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS +sugerente I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +colangitis. I-PRESENT_ILLNESS +Durante B-EXPLORATION +su I-EXPLORATION +ingreso I-EXPLORATION +se I-EXPLORATION realizó I-EXPLORATION -gammagrafía I-EXPLORATION -administrando I-EXPLORATION -117 I-EXPLORATION -MBq I-EXPLORATION +colangio-RMN I-EXPLORATION +que I-EXPLORATION +evidenció I-EXPLORATION +una I-EXPLORATION +litiasis I-EXPLORATION de I-EXPLORATION -Nanocoloide I-EXPLORATION +7, I-EXPLORATION +7 I-EXPLORATION +mm I-EXPLORATION +enclavada I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +colédoco, I-EXPLORATION +a I-EXPLORATION +unos I-EXPLORATION +4, I-EXPLORATION +4 I-EXPLORATION +cm I-EXPLORATION de I-EXPLORATION -albumina I-EXPLORATION -TC I-EXPLORATION -99 I-EXPLORATION -m. I-EXPLORATION - I-EXPLORATION -La I-EXPLORATION -administración I-EXPLORATION -del I-EXPLORATION -radio I-EXPLORATION -fármaco I-EXPLORATION -requirió I-EXPLORATION la I-EXPLORATION -colaboración I-EXPLORATION +papila, I-EXPLORATION +con I-EXPLORATION +dilatación I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -enfermería I-EXPLORATION -de I-EXPLORATION -DP I-EXPLORATION +vía I-EXPLORATION +biliar I-EXPLORATION +intra I-EXPLORATION y I-EXPLORATION +extrahepática. I-EXPLORATION +Ante I-EXPLORATION +estos I-EXPLORATION +hallazgos I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION +realizar I-EXPLORATION +una I-EXPLORATION +CPRE I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +se I-EXPLORATION +consiguió I-EXPLORATION +canular I-EXPLORATION la I-EXPLORATION +papila I-EXPLORATION de I-EXPLORATION -Medicina I-EXPLORATION -Nuclear I-EXPLORATION -(MN). I-EXPLORATION -La I-EXPLORATION -enfermera I-EXPLORATION +Vater. I-EXPLORATION +Dos I-EXPLORATION +días I-EXPLORATION +después, I-EXPLORATION +ante I-EXPLORATION +la I-EXPLORATION +persistencia I-EXPLORATION de I-EXPLORATION -DP I-EXPLORATION +la I-EXPLORATION +ictericia, I-EXPLORATION +se I-EXPLORATION realizó I-EXPLORATION -el I-EXPLORATION -intercambio I-EXPLORATION -manual I-EXPLORATION -y I-EXPLORATION +una I-EXPLORATION +nueva I-EXPLORATION +CPRE I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +coágulo I-EXPLORATION +fresco I-EXPLORATION +cubriendo I-EXPLORATION la I-EXPLORATION -de I-EXPLORATION -MN I-EXPLORATION -dosificó I-EXPLORATION -e I-EXPLORATION -inyectó I-EXPLORATION +papila. I-EXPLORATION +Tras I-EXPLORATION +retirarlo, I-EXPLORATION +se I-EXPLORATION +accedió I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +vía I-EXPLORATION +biliar, I-EXPLORATION +observando I-EXPLORATION el I-EXPLORATION -radiofármaco I-EXPLORATION +cálculo I-EXPLORATION +descrito I-EXPLORATION en I-EXPLORATION la I-EXPLORATION -solución I-EXPLORATION -de I-EXPLORATION -diálisis, I-EXPLORATION -según I-EXPLORATION -protocolo I-EXPLORATION +colangiorresonancia, I-EXPLORATION +que B-TREATMENT +fue I-TREATMENT +extraído I-TREATMENT +tras I-TREATMENT +realizar I-TREATMENT +una I-TREATMENT +esfinterotomía I-TREATMENT +biliar. I-TREATMENT +Finalmente, I-TREATMENT +se I-TREATMENT +inyectó I-TREATMENT +adrenalina I-TREATMENT +diluida I-TREATMENT +en I-TREATMENT +la I-TREATMENT +papila, I-TREATMENT +la I-TREATMENT +cual I-TREATMENT +continuaba I-TREATMENT +con I-TREATMENT +signos I-TREATMENT +de I-TREATMENT +hemorragia I-TREATMENT +reciente. I-TREATMENT + I-TREATMENT +A B-EVOLUTION +los I-EVOLUTION +siete I-EVOLUTION +días I-EVOLUTION +tras I-EVOLUTION +el I-EVOLUTION +alta, I-EVOLUTION +la I-EVOLUTION +paciente I-EVOLUTION +acudió I-EVOLUTION +de I-EVOLUTION +nuevo I-EVOLUTION +al I-EVOLUTION +Servicio I-EVOLUTION +de I-EVOLUTION +Urgencias I-EVOLUTION +por I-EVOLUTION +fiebre, I-EVOLUTION +dolor I-EVOLUTION +abdominal I-EVOLUTION +y I-EVOLUTION +astenia I-EVOLUTION +intensa. I-EVOLUTION +Analíticamente, B-EXPLORATION +destacaba I-EXPLORATION +Hb I-EXPLORATION +8, I-EXPLORATION +6 I-EXPLORATION +g/dl, I-EXPLORATION +hematocrito I-EXPLORATION +(Hto) I-EXPLORATION +27, I-EXPLORATION +2%, I-EXPLORATION +leucocitos I-EXPLORATION +10.000 I-EXPLORATION +U/ml I-EXPLORATION +con I-EXPLORATION +68% I-EXPLORATION de I-EXPLORATION -administración I-EXPLORATION +polimorfonucleares, I-EXPLORATION +plaquetas I-EXPLORATION +627.000 I-EXPLORATION +U/ml, I-EXPLORATION +y I-EXPLORATION +proteína I-EXPLORATION +C-reactiva I-EXPLORATION +(PCR) I-EXPLORATION +187, I-EXPLORATION +4 I-EXPLORATION +mg/l. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +una I-EXPLORATION +ecografía I-EXPLORATION +abdominal I-EXPLORATION +donde I-EXPLORATION +se I-EXPLORATION +observó I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +ocupante I-EXPLORATION +del I-EXPLORATION +espacio I-EXPLORATION +(LOE) I-EXPLORATION +hepática I-EXPLORATION de I-EXPLORATION -medicación I-EXPLORATION +unos I-EXPLORATION +10 I-EXPLORATION +x I-EXPLORATION +6 I-EXPLORATION +cm I-EXPLORATION en I-EXPLORATION -líquido I-EXPLORATION -de I-EXPLORATION -diálisis, I-EXPLORATION -antes I-EXPLORATION +segmento I-EXPLORATION +III, I-EXPLORATION +con I-EXPLORATION +características I-EXPLORATION +ecográficas I-EXPLORATION de I-EXPLORATION -infundirlo I-EXPLORATION -en I-EXPLORATION +absceso. I-EXPLORATION +Se I-EXPLORATION +intentó I-EXPLORATION +el I-EXPLORATION +drenaje I-EXPLORATION +percutáneo, I-EXPLORATION +que I-EXPLORATION +no I-EXPLORATION +fue I-EXPLORATION +posible I-EXPLORATION +debido I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -cavidad I-EXPLORATION -peritoneal. I-EXPLORATION - I-EXPLORATION -A I-EXPLORATION -los I-EXPLORATION -10-15 I-EXPLORATION -minutos I-EXPLORATION -se I-EXPLORATION -hizo I-EXPLORATION +densidad I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -primera I-EXPLORATION -lectura I-EXPLORATION +lesión. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +biopsia I-EXPLORATION +con I-EXPLORATION +aguja I-EXPLORATION +fina I-EXPLORATION y I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +cultivo I-EXPLORATION +del I-EXPLORATION +material I-EXPLORATION +obtenido I-EXPLORATION +se I-EXPLORATION +aisló I-EXPLORATION +Enterobacter I-EXPLORATION +cloacae. I-EXPLORATION + I-EXPLORATION +Una I-EXPLORATION +TC I-EXPLORATION +abdominal I-EXPLORATION +de I-EXPLORATION +control I-EXPLORATION tras I-EXPLORATION -3-4 I-EXPLORATION -horas I-EXPLORATION -las I-EXPLORATION -imágenes I-EXPLORATION -tardías. I-EXPLORATION -Al B-TREATMENT -finalizar, I-TREATMENT +el I-EXPLORATION +tratamiento I-EXPLORATION +antibiótico I-EXPLORATION +mostró I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +descrita I-EXPLORATION +previamente, I-EXPLORATION +que I-EXPLORATION +correspondía I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +posible I-EXPLORATION +hematoma I-EXPLORATION +hepático. I-EXPLORATION +Ante B-TREATMENT +la I-TREATMENT +persistencia I-TREATMENT +de I-TREATMENT +fiebre I-TREATMENT +elevada I-TREATMENT se I-TREATMENT -realizó I-TREATMENT +colocó I-TREATMENT un I-TREATMENT -nuevo I-TREATMENT -intercambio I-TREATMENT -manual I-TREATMENT -para I-TREATMENT -drenar I-TREATMENT -completamente I-TREATMENT -el I-TREATMENT -abdomen, I-TREATMENT -desechando I-TREATMENT -el I-TREATMENT -líquido I-TREATMENT -drenado I-TREATMENT -en I-TREATMENT -el I-TREATMENT -contenedor I-TREATMENT -específico I-TREATMENT -según I-TREATMENT -protocolo I-TREATMENT +catéter I-TREATMENT de I-TREATMENT -MN. I-TREATMENT -El I-TREATMENT -estudio I-TREATMENT -fue I-TREATMENT -indicativo I-TREATMENT +drenaje I-TREATMENT de I-TREATMENT -comunicación I-TREATMENT -peritoneopleural, I-TREATMENT -por I-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -suspendió I-TREATMENT -definitivamente I-TREATMENT -la I-TREATMENT -DP. I-TREATMENT -Se I-TREATMENT -transfirió I-TREATMENT -a I-TREATMENT -hemodialisis I-TREATMENT -(HD), I-TREATMENT -resolviendose I-TREATMENT -el I-TREATMENT -hidrotórax. I-TREATMENT -Actualmente B-EVOLUTION +8 I-TREATMENT +Fr. I-TREATMENT + I-TREATMENT +Tras B-EVOLUTION el I-EVOLUTION +drenaje, I-EVOLUTION +la I-EVOLUTION paciente I-EVOLUTION -esta I-EVOLUTION -trasplantado. I-EVOLUTION +permaneció I-EVOLUTION +asintomática, I-EVOLUTION +apirética I-EVOLUTION +y I-EVOLUTION +hemodinámicamente I-EVOLUTION +estable. I-EVOLUTION +Se B-EXPLORATION +realizaron I-EXPLORATION +ecografías I-EXPLORATION +abdominales I-EXPLORATION +semanales I-EXPLORATION +para I-EXPLORATION +control I-EXPLORATION +evolutivo I-EXPLORATION +del I-EXPLORATION +hematoma I-EXPLORATION +que I-EXPLORATION +mostraron I-EXPLORATION +la I-EXPLORATION +disminución I-EXPLORATION +progresiva I-EXPLORATION +del I-EXPLORATION +mismo. I-EXPLORATION +Tras B-EVOLUTION +seis I-EVOLUTION +semanas, I-EVOLUTION +se I-EVOLUTION +retiró I-EVOLUTION +el I-EVOLUTION +drenaje I-EVOLUTION +sin I-EVOLUTION +observar I-EVOLUTION +complicaciones. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Paciente B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -83 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -terminal I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -etiología I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -filiada I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -programa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hemodiálisis I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -centro I-PAST_MEDICAL_HISTORY -periférico I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diálisis I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -Octubre I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -2004. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Antecedentes I-PAST_MEDICAL_HISTORY -personales: I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -dislipemia, I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus, I-PAST_MEDICAL_HISTORY -artritis I-PAST_MEDICAL_HISTORY -reumatoide I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -larga I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -sin I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -actual, I-PAST_MEDICAL_HISTORY -osteoporosis I-PAST_MEDICAL_HISTORY -severa I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -fractura I-PAST_MEDICAL_HISTORY -vertebral, I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -insuficiencia I-PAST_MEDICAL_HISTORY -cardíaca I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -disfunción I-PAST_MEDICAL_HISTORY -diastólica I-PAST_MEDICAL_HISTORY -moderada/leve. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Desde I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -inicio I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -programa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hemodiálisis I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -le I-PAST_MEDICAL_HISTORY -han I-PAST_MEDICAL_HISTORY -realizado I-PAST_MEDICAL_HISTORY -dos I-PAST_MEDICAL_HISTORY -fístulas I-PAST_MEDICAL_HISTORY -arteriovenosas I-PAST_MEDICAL_HISTORY -internas I-PAST_MEDICAL_HISTORY +sexo I-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +42 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +soltero B-PAST_MEDICAL_HISTORY con I-PAST_MEDICAL_HISTORY -pérdida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -función I-PAST_MEDICAL_HISTORY -posterior, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -actualmente I-PAST_MEDICAL_HISTORY -porta I-PAST_MEDICAL_HISTORY un I-PAST_MEDICAL_HISTORY -catéter I-PAST_MEDICAL_HISTORY -venoso I-PAST_MEDICAL_HISTORY -central I-PAST_MEDICAL_HISTORY -tunelizado I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -yugular I-PAST_MEDICAL_HISTORY -interna I-PAST_MEDICAL_HISTORY -derecha I-PAST_MEDICAL_HISTORY -como I-PAST_MEDICAL_HISTORY -acceso I-PAST_MEDICAL_HISTORY -vascular. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Durante I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -año I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -presentado I-PAST_MEDICAL_HISTORY -complicaciones I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -ingresos I-PAST_MEDICAL_HISTORY -hospitalarios. I-PAST_MEDICAL_HISTORY -Durante I-PAST_MEDICAL_HISTORY -este I-PAST_MEDICAL_HISTORY -tiempo I-PAST_MEDICAL_HISTORY -no I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -modificado I-PAST_MEDICAL_HISTORY -su I-PAST_MEDICAL_HISTORY -pauta I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diálisis, I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -cual I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -sido I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -sesiones I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -240 I-PAST_MEDICAL_HISTORY -minutos I-PAST_MEDICAL_HISTORY -tres I-PAST_MEDICAL_HISTORY -días/semana, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -dializador I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -alta I-PAST_MEDICAL_HISTORY -permeabilidad I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -2m2 I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -superficie, I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -Qb I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -350 I-PAST_MEDICAL_HISTORY -ml/min, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -lo I-PAST_MEDICAL_HISTORY -que I-PAST_MEDICAL_HISTORY -se I-PAST_MEDICAL_HISTORY -ha I-PAST_MEDICAL_HISTORY -conseguido I-PAST_MEDICAL_HISTORY -mantener I-PAST_MEDICAL_HISTORY -a I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -paciente I-PAST_MEDICAL_HISTORY -estable I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -sesiones I-PAST_MEDICAL_HISTORY -confortables I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -asintomáticas, I-PAST_MEDICAL_HISTORY +hijo I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -cifras I-PAST_MEDICAL_HISTORY -adecuadas I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -tensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -peso I-PAST_MEDICAL_HISTORY -seco I-PAST_MEDICAL_HISTORY -entre I-PAST_MEDICAL_HISTORY -42-43 I-PAST_MEDICAL_HISTORY -Kg, I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -índice I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -diálisis I-PAST_MEDICAL_HISTORY -adecuada I-PAST_MEDICAL_HISTORY -Kt/v I-PAST_MEDICAL_HISTORY ->1.8. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Situación B-PRESENT_ILLNESS -actual: I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Aproximadamente I-PRESENT_ILLNESS -desde I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -inicio I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -verano, I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -paciente I-PRESENT_ILLNESS -presenta I-PRESENT_ILLNESS -mala I-PRESENT_ILLNESS -tolerancia I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -ultrafiltración I-PRESENT_ILLNESS -con I-PRESENT_ILLNESS -episodios I-PRESENT_ILLNESS -severos I-PRESENT_ILLNESS +comerciante, I-PAST_MEDICAL_HISTORY +que B-PRESENT_ILLNESS +consultó I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +marzo I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -hipotensión I-PRESENT_ILLNESS -arterial I-PRESENT_ILLNESS -prácticamente I-PRESENT_ILLNESS +2009 I-PRESENT_ILLNESS en I-PRESENT_ILLNESS -todas I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -sesiones I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +Servicio I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -diálisis, I-PRESENT_ILLNESS -que I-PRESENT_ILLNESS -requirieron I-PRESENT_ILLNESS -infusión I-PRESENT_ILLNESS +Urgencia I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -fluidos I-PRESENT_ILLNESS -para I-PRESENT_ILLNESS -su I-PRESENT_ILLNESS -estabilización, I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -reprogramación I-PRESENT_ILLNESS +Hospital I-PRESENT_ILLNESS +Dr. I-PRESENT_ILLNESS +Sótero I-PRESENT_ILLNESS +Del I-PRESENT_ILLNESS +Río I-PRESENT_ILLNESS +(HSDR) I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +masa I-PRESENT_ILLNESS +cervical I-PRESENT_ILLNESS +derecha. I-PRESENT_ILLNESS +Refería I-PRESENT_ILLNESS +cuadro I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -sesiones I-PRESENT_ILLNESS -renunciando I-PRESENT_ILLNESS +dos I-PRESENT_ILLNESS +meses I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +aumento I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +volumen I-PRESENT_ILLNESS +cervical I-PRESENT_ILLNESS +derecho I-PRESENT_ILLNESS +progresivo, I-PRESENT_ILLNESS +indoloro, I-PRESENT_ILLNESS +asociado I-PRESENT_ILLNESS a I-PRESENT_ILLNESS -lograr I-PRESENT_ILLNESS -el I-PRESENT_ILLNESS -peso I-PRESENT_ILLNESS -seco I-PRESENT_ILLNESS -al I-PRESENT_ILLNESS -final I-PRESENT_ILLNESS +disfagia I-PRESENT_ILLNESS +lógica I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +acompañado I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -sesiones. I-PRESENT_ILLNESS - I-PRESENT_ILLNESS -Por B-DERIVED_FROM/TO -ello I-DERIVED_FROM/TO -el I-DERIVED_FROM/TO -día I-DERIVED_FROM/TO -8/08/16, I-DERIVED_FROM/TO -es I-DERIVED_FROM/TO -trasladada I-DERIVED_FROM/TO -a I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -unidad I-DERIVED_FROM/TO -hospitalaria I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -diálisis I-DERIVED_FROM/TO -para I-DERIVED_FROM/TO -mejor I-DERIVED_FROM/TO -control I-DERIVED_FROM/TO -de I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -paciente I-DERIVED_FROM/TO -durante I-DERIVED_FROM/TO -la I-DERIVED_FROM/TO -hemodiálisis. I-DERIVED_FROM/TO - I-DERIVED_FROM/TO -A B-EXPLORATION -su I-EXPLORATION -llegada I-EXPLORATION -a I-EXPLORATION -la I-EXPLORATION -unidad, I-EXPLORATION -la I-EXPLORATION +compromiso I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +estado I-PRESENT_ILLNESS +general, I-PRESENT_ILLNESS +baja I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +peso, I-PRESENT_ILLNESS +sudoración I-PRESENT_ILLNESS +nocturna I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +sensación I-PRESENT_ILLNESS +febril I-PRESENT_ILLNESS +intermitente I-PRESENT_ILLNESS +con I-PRESENT_ILLNESS +temperatura I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +cuantificada. I-PRESENT_ILLNESS +En I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +revisión I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +sistemas I-PRESENT_ILLNESS +no I-PRESENT_ILLNESS +destacaban I-PRESENT_ILLNESS +otros I-PRESENT_ILLNESS +síntomas. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +Como B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +relevantes I-PAST_MEDICAL_HISTORY +destacaban I-PAST_MEDICAL_HISTORY +relaciones I-PAST_MEDICAL_HISTORY +sexuales I-PAST_MEDICAL_HISTORY +previas I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +hombres I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +uso I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +preservativo. I-PAST_MEDICAL_HISTORY +Negaba I-PAST_MEDICAL_HISTORY +el I-PAST_MEDICAL_HISTORY +consumo I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +drogas. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Al B-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +de I-EXPLORATION +ingreso I-EXPLORATION +se I-EXPLORATION +constató I-EXPLORATION +un I-EXPLORATION paciente I-EXPLORATION -presenta I-EXPLORATION +en I-EXPLORATION +buenas I-EXPLORATION +condiciones I-EXPLORATION +generales, I-EXPLORATION +afebril, I-EXPLORATION +piel I-EXPLORATION +con I-EXPLORATION +descamación I-EXPLORATION +fina I-EXPLORATION +difusa, I-EXPLORATION +algorra I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +paladar I-EXPLORATION +y I-EXPLORATION +leucoplaquia I-EXPLORATION +vellosa I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +lengua. I-EXPLORATION +Destacaba I-EXPLORATION +una I-EXPLORATION +masa I-EXPLORATION +cervical I-EXPLORATION +lateral I-EXPLORATION +derecha I-EXPLORATION +de I-EXPLORATION +10 I-EXPLORATION +cms, I-EXPLORATION +indolora, I-EXPLORATION +pétrea, I-EXPLORATION +adherida I-EXPLORATION +a I-EXPLORATION +planos I-EXPLORATION +profundos, I-EXPLORATION +de I-EXPLORATION +textura I-EXPLORATION +nodular I-EXPLORATION +y I-EXPLORATION +sin I-EXPLORATION signos I-EXPLORATION -evidentes I-EXPLORATION +inflamatorios. I-EXPLORATION +El I-EXPLORATION +resto I-EXPLORATION +del I-EXPLORATION +examen I-EXPLORATION +físico I-EXPLORATION +era I-EXPLORATION +normal. I-EXPLORATION +Se I-EXPLORATION +decidió I-EXPLORATION +hospitalizar I-EXPLORATION +para I-EXPLORATION +estudio I-EXPLORATION +por I-EXPLORATION +sospecha I-EXPLORATION de I-EXPLORATION -sobrecarga I-EXPLORATION -hídrica, I-EXPLORATION +neoplasia I-EXPLORATION +en I-EXPLORATION +el I-EXPLORATION +contexto I-EXPLORATION +de I-EXPLORATION +inmunosupresión. I-EXPLORATION + I-EXPLORATION +Los I-EXPLORATION +principales I-EXPLORATION +hallazgos I-EXPLORATION +de I-EXPLORATION +laboratorio I-EXPLORATION +fueron I-EXPLORATION +anemia I-EXPLORATION +normocítica I-EXPLORATION +- I-EXPLORATION +normocrómica I-EXPLORATION con I-EXPLORATION -hipertensión I-EXPLORATION -arterial I-EXPLORATION -pre I-EXPLORATION -hemodiálisis, I-EXPLORATION -peso I-EXPLORATION -prediálisis I-EXPLORATION +hematocrito I-EXPLORATION de I-EXPLORATION -47.5 I-EXPLORATION -Kg I-EXPLORATION +31, I-EXPLORATION +1%, I-EXPLORATION +leucocitos I-EXPLORATION +de I-EXPLORATION +5.900 I-EXPLORATION +céls/mm3 I-EXPLORATION +con I-EXPLORATION +65, I-EXPLORATION +6% I-EXPLORATION +de I-EXPLORATION +granulocitos I-EXPLORATION +y I-EXPLORATION +recuento I-EXPLORATION +de I-EXPLORATION +plaquetas I-EXPLORATION +de I-EXPLORATION +161.000 I-EXPLORATION +céls/mm3, I-EXPLORATION +proteína I-EXPLORATION +C I-EXPLORATION +reactiva I-EXPLORATION +(PCR) I-EXPLORATION +56 I-EXPLORATION +mg/L I-EXPLORATION +(N I-EXPLORATION +< I-EXPLORATION +5 I-EXPLORATION +mg/L). I-EXPLORATION +Creatininemia, I-EXPLORATION +pruebas I-EXPLORATION +de I-EXPLORATION +coagulación, I-EXPLORATION +electrolitos I-EXPLORATION +plasmáticos, I-EXPLORATION +perfil I-EXPLORATION +bioquímico I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +sedimento I-EXPLORATION +de I-EXPLORATION +orina I-EXPLORATION +fueron I-EXPLORATION +normales. I-EXPLORATION +Baciloscopias I-EXPLORATION +de I-EXPLORATION +expectoración I-EXPLORATION +y I-EXPLORATION +urocultivo I-EXPLORATION +fueron I-EXPLORATION +negativos. I-EXPLORATION +Radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +no I-EXPLORATION +demostró I-EXPLORATION +hallazgos I-EXPLORATION +patológicos. I-EXPLORATION +Se I-EXPLORATION +realizó I-EXPLORATION +test I-EXPLORATION +de I-EXPLORATION +ELISA I-EXPLORATION +para I-EXPLORATION +VIH I-EXPLORATION que I-EXPLORATION -indica I-EXPLORATION -un I-EXPLORATION -sobrepeso I-EXPLORATION +resultó I-EXPLORATION +positivo I-EXPLORATION +y I-EXPLORATION +serología I-EXPLORATION +para I-EXPLORATION +VHB I-EXPLORATION +y I-EXPLORATION +VHC, I-EXPLORATION +ambas I-EXPLORATION +negativas. I-EXPLORATION +Se I-EXPLORATION +le I-EXPLORATION +solicitó I-EXPLORATION +TAC I-EXPLORATION de I-EXPLORATION -4.2 I-EXPLORATION -Kg I-EXPLORATION -sobre I-EXPLORATION -su I-EXPLORATION -peso I-EXPLORATION -seco I-EXPLORATION -anterior, I-EXPLORATION -ortopnea, I-EXPLORATION +cerebro, I-EXPLORATION +cuello, I-EXPLORATION +abdomen I-EXPLORATION y I-EXPLORATION -edemas I-EXPLORATION -muy I-EXPLORATION -intensos I-EXPLORATION +pelvis I-EXPLORATION en I-EXPLORATION -MMII. I-EXPLORATION - I-EXPLORATION -En I-EXPLORATION -la I-EXPLORATION -anamnesis I-EXPLORATION -la I-EXPLORATION -paciente I-EXPLORATION -refiere I-EXPLORATION -que I-EXPLORATION -desde I-EXPLORATION -que I-EXPLORATION -empezó I-EXPLORATION el I-EXPLORATION -calor I-EXPLORATION +cual I-EXPLORATION +se I-EXPLORATION +informó I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +cervical I-EXPLORATION +derecho I-EXPLORATION +que I-EXPLORATION +parecía I-EXPLORATION +depender I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +glándula I-EXPLORATION +submandibular I-EXPLORATION +de I-EXPLORATION +tamaño I-EXPLORATION +8, I-EXPLORATION +4 I-EXPLORATION +x I-EXPLORATION +7 I-EXPLORATION +x I-EXPLORATION +6 I-EXPLORATION +cm, I-EXPLORATION +de I-EXPLORATION +aspecto I-EXPLORATION +neoplásico I-EXPLORATION +infiltrativo, I-EXPLORATION +en I-EXPLORATION +cuyo I-EXPLORATION +diagnóstico I-EXPLORATION +diferencial I-EXPLORATION +se I-EXPLORATION +sugería I-EXPLORATION +considerar I-EXPLORATION +carcinoma I-EXPLORATION +adenoide I-EXPLORATION +quístico I-EXPLORATION +con I-EXPLORATION +baja I-EXPLORATION +probabilidad I-EXPLORATION +de I-EXPLORATION +linfoma. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +recibieron I-EXPLORATION +los I-EXPLORATION +resultados I-EXPLORATION del I-EXPLORATION -verano, I-EXPLORATION -prácticamente I-EXPLORATION -no I-EXPLORATION -comía I-EXPLORATION -nada, I-EXPLORATION +hemocultivo I-EXPLORATION +positivo I-EXPLORATION +para I-EXPLORATION +Salmonella I-EXPLORATION +grupo I-EXPLORATION +B I-EXPLORATION +multisensible I-EXPLORATION +(sensible I-EXPLORATION +a I-EXPLORATION +cefo-taxima, I-EXPLORATION +ciprofloxacina, I-EXPLORATION +ácido I-EXPLORATION +nalidíxico, I-EXPLORATION +cloranfenicol I-EXPLORATION y I-EXPLORATION -destaca I-EXPLORATION -en I-EXPLORATION +cotrimoxazol) I-EXPLORATION +posterior I-EXPLORATION +a I-EXPLORATION +3, I-EXPLORATION +8 I-EXPLORATION +horas I-EXPLORATION +de I-EXPLORATION +incubación I-EXPLORATION +(automatizados). I-EXPLORATION + I-EXPLORATION +Además, I-EXPLORATION +se I-EXPLORATION +decidió I-EXPLORATION +realizar I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +incisional I-EXPLORATION +quirúrgica I-EXPLORATION +de I-EXPLORATION la I-EXPLORATION -analítica I-EXPLORATION -albuminemia I-EXPLORATION -2.6 I-EXPLORATION -g/dl I-EXPLORATION +lesión I-EXPLORATION +cervical I-EXPLORATION +que I-EXPLORATION +mostró I-EXPLORATION +tejido I-EXPLORATION +tumoral I-EXPLORATION +cerebroideo I-EXPLORATION +con I-EXPLORATION +sangrado I-EXPLORATION +profuso I-EXPLORATION y I-EXPLORATION -proteínas I-EXPLORATION -totales I-EXPLORATION -en I-EXPLORATION -suero I-EXPLORATION -5.5 I-EXPLORATION -g/dl, I-EXPLORATION -motivo B-TREATMENT -por I-TREATMENT -el I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -le I-TREATMENT -prescribió I-TREATMENT -hace I-TREATMENT -10 I-TREATMENT -días I-TREATMENT -suplementación I-TREATMENT -oral I-TREATMENT -con I-TREATMENT -Renilón7.5©, I-TREATMENT -1 I-TREATMENT -frasco I-TREATMENT -al I-TREATMENT -día. I-TREATMENT - I-TREATMENT -Durante I-TREATMENT -las I-TREATMENT -dos I-TREATMENT -primeras I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -su I-TREATMENT -estancia I-TREATMENT -en I-TREATMENT -la I-TREATMENT -unidad I-TREATMENT -hospitalaria, I-TREATMENT -se I-TREATMENT -intenta I-TREATMENT -sin I-TREATMENT -éxito I-TREATMENT -conseguir I-TREATMENT -el I-TREATMENT -peso I-TREATMENT -seco I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -al I-TREATMENT -persistir I-TREATMENT -los I-TREATMENT -episodios I-TREATMENT -de I-TREATMENT -hipotensión I-TREATMENT -intradiálisis. I-TREATMENT -Incluso I-TREATMENT -ganó I-TREATMENT -1 I-TREATMENT -Kg I-TREATMENT -en I-TREATMENT -este I-TREATMENT -periodo, I-TREATMENT -a I-TREATMENT -pesar I-TREATMENT -de I-TREATMENT -poner I-TREATMENT -en I-TREATMENT -práctica I-TREATMENT -diferentes I-TREATMENT -estrategias I-TREATMENT -como I-TREATMENT -limitar I-TREATMENT -la I-TREATMENT -ultrafiltración I-TREATMENT -horaria I-TREATMENT -a I-TREATMENT -300- I-TREATMENT -400 I-TREATMENT -ml/h, I-TREATMENT -haciendo I-TREATMENT -diálisis I-TREATMENT -secuencial I-TREATMENT -prolongando I-TREATMENT -las I-TREATMENT -sesiones I-TREATMENT -con I-TREATMENT -tiempos I-TREATMENT -de I-TREATMENT -ultrafiltración I-TREATMENT -aislada I-TREATMENT -pre I-TREATMENT -o I-TREATMENT -post I-TREATMENT -hemodiálisis, I-TREATMENT -bajando I-TREATMENT -la I-TREATMENT -temperatura I-TREATMENT -del I-TREATMENT -baño I-TREATMENT -a I-TREATMENT -35oC, I-TREATMENT -y I-TREATMENT -fijando I-TREATMENT -la I-TREATMENT -concentración I-TREATMENT -de I-TREATMENT -Na I-TREATMENT -en I-TREATMENT -el I-TREATMENT -baño I-TREATMENT -en I-TREATMENT -140 I-TREATMENT -meq/l. I-TREATMENT - I-TREATMENT -Durante I-TREATMENT -este I-TREATMENT -tiempo, I-TREATMENT -se I-TREATMENT -revisa I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -retirándole I-TREATMENT -toda I-TREATMENT -la I-TREATMENT -medicación I-TREATMENT -hipotensora, I-TREATMENT -se B-EXPLORATION -realiza I-EXPLORATION -ecocardiograma I-EXPLORATION -descartando I-EXPLORATION -agravamiento I-EXPLORATION +gran I-EXPLORATION +compromiso I-EXPLORATION +inflamatorio I-EXPLORATION +circundante. I-EXPLORATION +Se I-EXPLORATION +enviaron I-EXPLORATION +muestras I-EXPLORATION +a I-EXPLORATION +cultivos I-EXPLORATION de I-EXPLORATION -su I-EXPLORATION -insuficiencia I-EXPLORATION -cardíaca, I-EXPLORATION +tejido I-EXPLORATION +corriente I-EXPLORATION +y I-EXPLORATION +de I-EXPLORATION +Koch, I-EXPLORATION +tinción I-EXPLORATION +de I-EXPLORATION +Gram I-EXPLORATION +directa I-EXPLORATION y I-EXPLORATION +baciloscopia. I-EXPLORATION +Los I-EXPLORATION +cultivos I-EXPLORATION +de I-EXPLORATION +tejido I-EXPLORATION +fueron I-EXPLORATION +positivos I-EXPLORATION +para I-EXPLORATION +Salmonella I-EXPLORATION +grupo I-EXPLORATION +B I-EXPLORATION +multisensible, I-EXPLORATION al I-EXPLORATION -persistir I-EXPLORATION -los I-EXPLORATION -intensos I-EXPLORATION -edemas I-EXPLORATION -en I-EXPLORATION -MMII, I-EXPLORATION -aparecen I-EXPLORATION -heridas I-EXPLORATION -ulcerosas I-EXPLORATION -que B-TREATMENT -requieren I-TREATMENT -curas I-TREATMENT -diarias I-TREATMENT -según I-TREATMENT -pauta I-TREATMENT -descrita I-TREATMENT -por I-TREATMENT -cirugía I-TREATMENT -plástica, I-TREATMENT -y I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -IV I-TREATMENT -(Vancomicina) I-TREATMENT -por I-TREATMENT -cultivo I-TREATMENT -+ I-TREATMENT -a I-TREATMENT -staphylococo I-TREATMENT -epidermidis. I-TREATMENT - I-TREATMENT -En I-TREATMENT -la I-TREATMENT -cuarta I-TREATMENT -semana I-TREATMENT -de I-TREATMENT +tercer I-EXPLORATION +día I-EXPLORATION +de I-EXPLORATION +incubación. I-EXPLORATION +Ambos I-EXPLORATION +cultivos I-EXPLORATION +fueron I-EXPLORATION +enviados I-EXPLORATION +al I-EXPLORATION +Instituto I-EXPLORATION +de I-EXPLORATION +Salud I-EXPLORATION +Pública I-EXPLORATION +(ISP) I-EXPLORATION +para I-EXPLORATION +su I-EXPLORATION +confirmación I-EXPLORATION +y I-EXPLORATION +tipificación, I-EXPLORATION +correspondiendo I-EXPLORATION +a I-EXPLORATION +Salmonella I-EXPLORATION +Typhimurium. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +inició I-TREATMENT tratamiento I-TREATMENT -en I-TREATMENT -la I-TREATMENT -unidad, I-TREATMENT -ante I-TREATMENT -la I-TREATMENT -intolerancia I-TREATMENT -a I-TREATMENT -la I-TREATMENT -ultrafiltración, I-TREATMENT -y I-TREATMENT -para I-TREATMENT -limitar I-TREATMENT -en I-TREATMENT -lo I-TREATMENT -posible I-TREATMENT -un I-TREATMENT -sobrepeso I-TREATMENT -excesivo I-TREATMENT -entre I-TREATMENT -sesiones, I-TREATMENT -se I-TREATMENT -pasa I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -a I-TREATMENT -hemodiálisis I-TREATMENT -diaria, I-TREATMENT -prescribiéndose I-TREATMENT -6 I-TREATMENT -sesiones I-TREATMENT -semanales I-TREATMENT -de I-TREATMENT -2.5 I-TREATMENT -h, I-TREATMENT -haciendo I-TREATMENT -ultrafiltración I-TREATMENT -aislada I-TREATMENT -pre I-TREATMENT -diálisis, I-TREATMENT -y I-TREATMENT -se I-TREATMENT -cursa I-TREATMENT -interconsulta I-TREATMENT -a I-TREATMENT -Endocrinología- I-TREATMENT -Nutrición, I-TREATMENT -para I-TREATMENT -valorar I-TREATMENT -la I-TREATMENT -indicación I-TREATMENT -de I-TREATMENT -nutrición I-TREATMENT -parenteral I-TREATMENT -intradiálisis I-TREATMENT -(NPID), I-TREATMENT -ya I-TREATMENT -que I-TREATMENT -con I-TREATMENT -los I-TREATMENT -suplementos I-TREATMENT -orales I-TREATMENT -las I-TREATMENT -cifras I-TREATMENT -de I-TREATMENT -albuminemia I-TREATMENT -y I-TREATMENT -proteínas I-TREATMENT -totales I-TREATMENT -en I-TREATMENT -suero I-TREATMENT -han I-TREATMENT -bajado I-TREATMENT -situándose I-TREATMENT -en I-TREATMENT -2.4 I-TREATMENT -g/dl I-TREATMENT -y I-TREATMENT -5.3 I-TREATMENT -g/dl I-TREATMENT -respectivamente. I-TREATMENT - I-TREATMENT -Aunque I-TREATMENT -en I-TREATMENT -principio I-TREATMENT -Endocrinología I-TREATMENT -descartó I-TREATMENT -la I-TREATMENT -prescripción I-TREATMENT -de I-TREATMENT -nutrición I-TREATMENT -parenteral, I-TREATMENT -al I-TREATMENT -considerar I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -tenía I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -alimentación I-TREATMENT -por I-TREATMENT -vía I-TREATMENT -oral, I-TREATMENT -y I-TREATMENT -propuso I-TREATMENT -su I-TREATMENT -seguimiento I-TREATMENT -en I-TREATMENT -consulta I-TREATMENT -de I-TREATMENT -dietética I-TREATMENT -manteniendo I-TREATMENT -los I-TREATMENT -suplementos I-TREATMENT -que I-TREATMENT -tenía I-TREATMENT -prescritos, I-TREATMENT -en I-TREATMENT -la I-TREATMENT -sexta I-TREATMENT -semana I-TREATMENT -tras I-TREATMENT -valorar I-TREATMENT -de I-TREATMENT -nuevo I-TREATMENT -a I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -prescribieron I-TREATMENT -NPID I-TREATMENT -con I-TREATMENT -bajo I-TREATMENT -volumen I-TREATMENT -(900 I-TREATMENT -ml/sesión), I-TREATMENT -al I-TREATMENT -considerar I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -estaba I-TREATMENT -en I-TREATMENT -riesgo I-TREATMENT -nutricional I-TREATMENT -alto/intermedio, I-TREATMENT con I-TREATMENT -mala I-TREATMENT -respuesta I-TREATMENT -al I-TREATMENT -suplemento I-TREATMENT -oral. I-TREATMENT - I-TREATMENT -A I-TREATMENT -partir I-TREATMENT -del I-TREATMENT -inicio I-TREATMENT -de I-TREATMENT -la I-TREATMENT -NPID, I-TREATMENT -la I-TREATMENT -cual I-TREATMENT -es I-TREATMENT -bien I-TREATMENT -tolerada I-TREATMENT +ceftriaxona I-TREATMENT +ev I-TREATMENT +2 I-TREATMENT +g/día I-TREATMENT por I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -sin I-TREATMENT -requerimientos I-TREATMENT -de I-TREATMENT -insulina I-TREATMENT -adicionales I-TREATMENT +14 I-TREATMENT +días I-TREATMENT +seguido I-TREATMENT por I-TREATMENT -hiperglucemias, I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -presenta I-TREATMENT -buena I-TREATMENT -tolerancia I-TREATMENT -a I-TREATMENT -la I-TREATMENT -ultrafiltración I-TREATMENT -que I-TREATMENT -nos I-TREATMENT -permite I-TREATMENT -aumentar I-TREATMENT -el I-TREATMENT -tiempo I-TREATMENT -de I-TREATMENT -las I-TREATMENT -sesiones I-TREATMENT -a I-TREATMENT -3 I-TREATMENT -horas I-TREATMENT -manteniendo I-TREATMENT -las I-TREATMENT -seis I-TREATMENT -semanales, I-TREATMENT -y I-TREATMENT -se I-TREATMENT -consigue I-TREATMENT -bajar I-TREATMENT -el I-TREATMENT -peso I-TREATMENT -seco I-TREATMENT -(44.5 I-TREATMENT -Kg), I-TREATMENT -hasta I-TREATMENT -niveles I-TREATMENT -próximos I-TREATMENT -al I-TREATMENT -peso I-TREATMENT -seco I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -tenía I-TREATMENT -antes I-TREATMENT -del I-TREATMENT -traslado I-TREATMENT -a I-TREATMENT -la I-TREATMENT -unidad I-TREATMENT -hospitalaria I-TREATMENT -(43.3 I-TREATMENT -Kg). I-TREATMENT - I-TREATMENT -En I-TREATMENT -la I-TREATMENT -octava I-TREATMENT -semana I-TREATMENT -se I-TREATMENT -revisa I-TREATMENT -la I-TREATMENT -prescripción I-TREATMENT -de I-TREATMENT -la I-TREATMENT -NPID, I-TREATMENT -bajando I-TREATMENT -el I-TREATMENT -volumen I-TREATMENT -a I-TREATMENT -infundir I-TREATMENT -en I-TREATMENT +ciprofloxacina I-TREATMENT +oral I-TREATMENT +500 I-TREATMENT +mg I-TREATMENT cada I-TREATMENT -sesión I-TREATMENT -a I-TREATMENT -700 I-TREATMENT -ml, I-TREATMENT -los B-EVOLUTION -edemas I-EVOLUTION -en I-EVOLUTION -MMII I-EVOLUTION -persisten I-EVOLUTION -aunque I-EVOLUTION -son I-EVOLUTION -casi I-EVOLUTION -inapreciables I-EVOLUTION -post I-EVOLUTION -diálisis, I-EVOLUTION -las I-EVOLUTION -heridas I-EVOLUTION -ulcerosas I-EVOLUTION -están I-EVOLUTION -prácticamente I-EVOLUTION -cicatrizadas, I-EVOLUTION +12 I-TREATMENT +horas I-TREATMENT +por I-TREATMENT +30 I-TREATMENT +días. I-TREATMENT +El B-EXPLORATION +examen I-EXPLORATION +histológico I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +biopsia I-EXPLORATION +cervical I-EXPLORATION +mostró I-EXPLORATION +un I-EXPLORATION +proceso I-EXPLORATION +inflamatorio I-EXPLORATION +crónico I-EXPLORATION +granulomatoso I-EXPLORATION +no I-EXPLORATION +necrosante I-EXPLORATION +con I-EXPLORATION +focos I-EXPLORATION +supurativos. I-EXPLORATION +No I-EXPLORATION +se I-EXPLORATION +observaron I-EXPLORATION +elementos I-EXPLORATION +celulares I-EXPLORATION +malignos I-EXPLORATION +ni I-EXPLORATION +microorganismos I-EXPLORATION +al I-EXPLORATION +examen I-EXPLORATION +microscópico. I-EXPLORATION +El I-EXPLORATION +cultivo I-EXPLORATION +de I-EXPLORATION +Koch I-EXPLORATION +fue I-EXPLORATION +negativo. I-EXPLORATION + I-EXPLORATION +El B-EVOLUTION +paciente I-EVOLUTION +evolucionó I-EVOLUTION +favorablemente I-EVOLUTION +con I-EVOLUTION +disminución I-EVOLUTION +progresiva I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +masa I-EVOLUTION +cervical I-EVOLUTION y I-EVOLUTION -las I-EVOLUTION -sesiones I-EVOLUTION -transcurren I-EVOLUTION -sin I-EVOLUTION -episodios I-EVOLUTION +resolución I-EVOLUTION +del I-EVOLUTION +cuadro I-EVOLUTION +febril, I-EVOLUTION +no I-EVOLUTION +requiriendo I-EVOLUTION +nuevas I-EVOLUTION +intervenciones I-EVOLUTION +quirúrgicas. I-EVOLUTION +Fue I-EVOLUTION +dado I-EVOLUTION de I-EVOLUTION -hipotensión. I-EVOLUTION -Por B-TREATMENT -tanto I-TREATMENT -se I-TREATMENT -decide I-TREATMENT -reducir I-TREATMENT -el I-TREATMENT -número I-TREATMENT -de I-TREATMENT -sesiones I-TREATMENT -semanales I-TREATMENT -a I-TREATMENT -cinco, I-TREATMENT -y I-TREATMENT -seguir I-TREATMENT -bajando I-TREATMENT -el I-TREATMENT -peso I-TREATMENT -seco I-TREATMENT -paulatinamente I-TREATMENT -hasta I-TREATMENT -alcanzar I-TREATMENT -los I-TREATMENT -42 I-TREATMENT -Kg, I-TREATMENT -lo I-TREATMENT -cual I-TREATMENT -se I-TREATMENT -consigue I-TREATMENT -en I-TREATMENT -la I-TREATMENT -semana I-TREATMENT -décima. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -partir I-EVOLUTION +alta I-EVOLUTION +luego I-EVOLUTION de I-EVOLUTION -esta I-EVOLUTION -semana, I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -ha I-EVOLUTION -permanecido I-EVOLUTION -estable I-EVOLUTION -hemodinámicamente I-EVOLUTION -durante I-EVOLUTION -las I-EVOLUTION -sesiones I-EVOLUTION +44 I-EVOLUTION +días I-EVOLUTION de I-EVOLUTION -hemodiálisis, I-EVOLUTION -sin I-EVOLUTION -presentar I-EVOLUTION -dificultades I-EVOLUTION -para I-EVOLUTION +hospitalización I-EVOLUTION +con I-EVOLUTION +indicación I-EVOLUTION +de I-EVOLUTION +mantener I-EVOLUTION +ciprofloxacina I-EVOLUTION +oral I-EVOLUTION +hasta I-EVOLUTION +completar I-EVOLUTION +30 I-EVOLUTION +días. I-EVOLUTION +Se I-EVOLUTION +controló I-EVOLUTION +posteriormente I-EVOLUTION +en I-EVOLUTION la I-EVOLUTION -ultrafiltración I-EVOLUTION -ni I-EVOLUTION -para I-EVOLUTION -alcanzar I-EVOLUTION +policlínica I-EVOLUTION +de I-EVOLUTION +Infectología I-EVOLUTION +en I-EVOLUTION el I-EVOLUTION -peso I-EVOLUTION -seco I-EVOLUTION -al I-EVOLUTION -final I-EVOLUTION +HSDR I-EVOLUTION +y I-EVOLUTION +se I-EVOLUTION +constató I-EVOLUTION +en I-EVOLUTION +buenas I-EVOLUTION +condiciones, I-EVOLUTION +con I-EVOLUTION +aumento I-EVOLUTION de I-EVOLUTION -las I-EVOLUTION -sesiones, I-EVOLUTION -y B-TREATMENT -se I-TREATMENT -decide I-TREATMENT -mantener I-TREATMENT +peso I-EVOLUTION +y I-EVOLUTION +sin I-EVOLUTION +síntomas I-EVOLUTION +sistémicos; I-EVOLUTION +PCR I-EVOLUTION +3 I-EVOLUTION +mg/L. I-EVOLUTION +Con B-TREATMENT +confirmación I-TREATMENT +del I-TREATMENT +Instituto I-TREATMENT +de I-TREATMENT +Salud I-TREATMENT +Pública I-TREATMENT +de I-TREATMENT la I-TREATMENT -NPID I-TREATMENT -hasta I-TREATMENT -recuperación I-TREATMENT -total I-TREATMENT +serología I-TREATMENT +positiva I-TREATMENT +para I-TREATMENT +VIH I-TREATMENT +y I-TREATMENT +confirmación I-TREATMENT de I-TREATMENT -las I-TREATMENT -cifras I-TREATMENT -analíticas I-TREATMENT +identidad I-TREATMENT +informada I-TREATMENT +luego I-TREATMENT +del I-TREATMENT +alta, I-TREATMENT +se I-TREATMENT +realizó I-TREATMENT +ingreso I-TREATMENT +al I-TREATMENT +Programa I-TREATMENT +de I-TREATMENT +VIH/SIDA I-TREATMENT +para I-TREATMENT +iniciar I-TREATMENT +terapia I-TREATMENT +anti-retroviral I-TREATMENT +(TARV) I-TREATMENT +con I-TREATMENT +tenofovir, I-TREATMENT +lamivudina I-TREATMENT y I-TREATMENT -hasta I-TREATMENT -la I-TREATMENT -cicatrización I-TREATMENT -completa I-TREATMENT +atazanavir/ritonavir I-TREATMENT +con I-TREATMENT +un I-TREATMENT +recuento I-TREATMENT de I-TREATMENT -las I-TREATMENT -úlceras I-TREATMENT -en I-TREATMENT -MMII, I-TREATMENT +linfocitos I-TREATMENT +CD4 I-TREATMENT +de I-TREATMENT +12 I-TREATMENT +céls/mL I-TREATMENT y I-TREATMENT -cuando I-TREATMENT -la I-TREATMENT -dieta I-TREATMENT +carga I-TREATMENT +viral I-TREATMENT +de I-TREATMENT +1.800 I-TREATMENT +copias I-TREATMENT +ARN/ml. I-TREATMENT +La I-TREATMENT +decisión I-TREATMENT +de I-TREATMENT +utilizar I-TREATMENT +este I-TREATMENT +esquema, I-TREATMENT +el I-TREATMENT +cual I-TREATMENT +no I-TREATMENT +es I-TREATMENT +el I-TREATMENT +de I-TREATMENT +uso I-TREATMENT +habitual I-TREATMENT +como I-TREATMENT +primera I-TREATMENT +línea, I-TREATMENT +fue I-TREATMENT +decisión I-TREATMENT +del I-TREATMENT +equipo I-TREATMENT de I-TREATMENT +Infectología I-TREATMENT +para I-TREATMENT +mejorar I-TREATMENT la I-TREATMENT +adherencia I-TREATMENT +del I-TREATMENT paciente I-TREATMENT -se I-TREATMENT -corrija I-TREATMENT -para I-TREATMENT +ya I-TREATMENT que I-TREATMENT -tenga I-TREATMENT -todos I-TREATMENT -los I-TREATMENT -aportes I-TREATMENT -necesarios I-TREATMENT -asegurados, I-TREATMENT -e I-TREATMENT -ir I-TREATMENT -reduciendo I-TREATMENT -paulatinamente I-TREATMENT -los I-TREATMENT -días I-TREATMENT -de I-TREATMENT -diálisis I-TREATMENT -prescritos I-TREATMENT -hasta I-TREATMENT -llegar I-TREATMENT -a I-TREATMENT -su I-TREATMENT -esquema I-TREATMENT -original I-TREATMENT -de I-TREATMENT -tres I-TREATMENT -días I-TREATMENT +es I-TREATMENT +mejor I-TREATMENT +tolerado I-TREATMENT en I-TREATMENT -semana. I-TREATMENT - I-TREATMENT +pacientes I-TREATMENT +operados I-TREATMENT +y I-TREATMENT +con I-TREATMENT +un I-TREATMENT +nivel I-TREATMENT +avanzado I-TREATMENT +de I-TREATMENT +inmunosupresión. I-TREATMENT +Una B-EXPLORATION +nuevo I-EXPLORATION +TAC I-EXPLORATION +de I-EXPLORATION +cabeza I-EXPLORATION +y I-EXPLORATION +cuello I-EXPLORATION +posterior I-EXPLORATION +a I-EXPLORATION +18 I-EXPLORATION +días I-EXPLORATION +de I-EXPLORATION +tratamiento I-EXPLORATION +antimicrobiano, I-EXPLORATION +no I-EXPLORATION +mostró I-EXPLORATION +adenopatías I-EXPLORATION +susceptibles I-EXPLORATION +de I-EXPLORATION +ser I-EXPLORATION +biopsiadas I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +dado I-EXPLORATION +de I-EXPLORATION +alta I-EXPLORATION +por I-EXPLORATION +el I-EXPLORATION +equipo I-EXPLORATION +de I-EXPLORATION +Cirugía I-EXPLORATION +de I-EXPLORATION +Cabeza I-EXPLORATION +y I-EXPLORATION +Cuello. I-EXPLORATION + I-EXPLORATION +Un B-EVOLUTION +año I-EVOLUTION +después I-EVOLUTION +el I-EVOLUTION +paciente I-EVOLUTION +se I-EVOLUTION +encuentra I-EVOLUTION +en I-EVOLUTION +buenas I-EVOLUTION +condiciones, I-EVOLUTION +con I-EVOLUTION +resolución I-EVOLUTION +definitiva I-EVOLUTION +de I-EVOLUTION +la I-EVOLUTION +masa I-EVOLUTION +cervical I-EVOLUTION +y I-EVOLUTION +en I-EVOLUTION +tratamiento I-EVOLUTION +con I-EVOLUTION +el I-EVOLUTION +mismo I-EVOLUTION +esquema I-EVOLUTION +de I-EVOLUTION +TARV I-EVOLUTION +A I-EVOLUTION +15 I-EVOLUTION +meses I-EVOLUTION +plazo I-EVOLUTION +presentaba I-EVOLUTION +carga I-EVOLUTION +viral I-EVOLUTION +indetectable, I-EVOLUTION +con I-EVOLUTION +recuento I-EVOLUTION +de I-EVOLUTION +linfocitos I-EVOLUTION +CD4 I-EVOLUTION +de I-EVOLUTION +181 I-EVOLUTION +céls/mL I-EVOLUTION +y I-EVOLUTION +no I-EVOLUTION +ha I-EVOLUTION +presentado I-EVOLUTION +nuevas I-EVOLUTION +infecciones I-EVOLUTION +bacterianas I-EVOLUTION +graves. I-EVOLUTION + I-EVOLUTION Presentamos B-PRESENT_ILLNESS -un I-PRESENT_ILLNESS -varón I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +mujer I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -71 I-PRESENT_ILLNESS -años, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY -antecedentes I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -hipertensión, I-PAST_MEDICAL_HISTORY -diabetes I-PAST_MEDICAL_HISTORY -mellitus I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -2, I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -Von I-PAST_MEDICAL_HISTORY -Willebrand I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -múltiples I-PAST_MEDICAL_HISTORY -ingresos I-PAST_MEDICAL_HISTORY -por I-PAST_MEDICAL_HISTORY -hemorragia I-PAST_MEDICAL_HISTORY -digestiva I-PAST_MEDICAL_HISTORY -y I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -enfermedad I-PAST_MEDICAL_HISTORY -renal I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -secundaria I-PAST_MEDICAL_HISTORY -glomerulonefritis, I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -programa I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -DP I-PAST_MEDICAL_HISTORY -desde I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -2011. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Tuvo I-PAST_MEDICAL_HISTORY -cinco I-PAST_MEDICAL_HISTORY -episodios I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -peritonitis, I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -último I-PAST_MEDICAL_HISTORY -fue I-PAST_MEDICAL_HISTORY -en I-PAST_MEDICAL_HISTORY -diciembre I-PAST_MEDICAL_HISTORY -del I-PAST_MEDICAL_HISTORY -2015 I-PAST_MEDICAL_HISTORY -recibiendo I-PAST_MEDICAL_HISTORY -tratamiento I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -vancomicina I-PAST_MEDICAL_HISTORY -intraperitoneal, I-PAST_MEDICAL_HISTORY -con I-PAST_MEDICAL_HISTORY -buena I-PAST_MEDICAL_HISTORY -evolución I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -la I-PAST_MEDICAL_HISTORY -peritonitis. I-PAST_MEDICAL_HISTORY -El B-PRESENT_ILLNESS -último I-PRESENT_ILLNESS -día I-PRESENT_ILLNESS -del I-PRESENT_ILLNESS -tratamiento I-PRESENT_ILLNESS -consultó I-PRESENT_ILLNESS +40 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +acudió I-PRESENT_ILLNESS +a I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS por I-PRESENT_ILLNESS -ictericia I-PRESENT_ILLNESS -y I-PRESENT_ILLNESS -malestar I-PRESENT_ILLNESS -general I-PRESENT_ILLNESS +rectorragia I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -elevación I-PRESENT_ILLNESS +coágulos, I-PRESENT_ILLNESS de I-PRESENT_ILLNESS -las I-PRESENT_ILLNESS -transaminasas I-PRESENT_ILLNESS +1 I-PRESENT_ILLNESS +día I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +evolución. I-PRESENT_ILLNESS +Otros I-PRESENT_ILLNESS +síntomas: I-PRESENT_ILLNESS +dolor I-PRESENT_ILLNESS +anorrectal I-PRESENT_ILLNESS +al I-PRESENT_ILLNESS +defecar, I-PRESENT_ILLNESS +urgencia I-PRESENT_ILLNESS +defecatoria I-PRESENT_ILLNESS y I-PRESENT_ILLNESS -la I-PRESENT_ILLNESS -bilirrubina. I-PRESENT_ILLNESS -Tras B-TREATMENT -la I-TREATMENT -suspensión I-TREATMENT -del I-TREATMENT -fármaco I-TREATMENT -hubo I-TREATMENT -mejoría I-TREATMENT -clínica I-TREATMENT +estreñimiento I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +hacía I-PRESENT_ILLNESS +un I-PRESENT_ILLNESS +año. I-PRESENT_ILLNESS +La B-EVOLUTION +rectorragia I-EVOLUTION +cedió I-EVOLUTION +espontáneamente I-EVOLUTION +a I-EVOLUTION +las I-EVOLUTION +24 I-EVOLUTION +horas I-EVOLUTION +del I-EVOLUTION +ingreso. I-EVOLUTION + I-EVOLUTION +Como B-PAST_MEDICAL_HISTORY +antecedentes I-PAST_MEDICAL_HISTORY +la I-PAST_MEDICAL_HISTORY +paciente I-PAST_MEDICAL_HISTORY +se I-PAST_MEDICAL_HISTORY +autoadministraba I-PAST_MEDICAL_HISTORY +supositorios I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +paracetamol-codeína I-PAST_MEDICAL_HISTORY +(500/300 I-PAST_MEDICAL_HISTORY +mg) I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +cefalea I-PAST_MEDICAL_HISTORY +crónica. I-PAST_MEDICAL_HISTORY + I-PAST_MEDICAL_HISTORY +Exploración B-EXPLORATION +física: I-EXPLORATION +normal, I-EXPLORATION +pero I-EXPLORATION +tacto I-EXPLORATION +rectal I-EXPLORATION +muy I-EXPLORATION +doloroso, I-EXPLORATION +palpando I-EXPLORATION +zonas I-EXPLORATION +induradas I-EXPLORATION +e I-EXPLORATION +irregulares I-EXPLORATION +en I-EXPLORATION +mucosa I-EXPLORATION +rectal, I-EXPLORATION +apareciendo I-EXPLORATION +sangre I-EXPLORATION +fresca I-EXPLORATION +en I-EXPLORATION +guante. I-EXPLORATION + I-EXPLORATION +Analítica, I-EXPLORATION +radiografía I-EXPLORATION +de I-EXPLORATION +tórax I-EXPLORATION +y I-EXPLORATION +abdomen: I-EXPLORATION +normales. I-EXPLORATION +Colonoscopia I-EXPLORATION +total: I-EXPLORATION +pérdida I-EXPLORATION +del I-EXPLORATION +patrón I-EXPLORATION +vascular I-EXPLORATION +normal I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +rectal, I-EXPLORATION +así I-EXPLORATION +como I-EXPLORATION +gran I-EXPLORATION +ulceración I-EXPLORATION +difusa I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +con I-EXPLORATION +pseudopólipos I-EXPLORATION +aislados, I-EXPLORATION +extendiéndose I-EXPLORATION +unos I-EXPLORATION +10 I-EXPLORATION +cm I-EXPLORATION +desde I-EXPLORATION +margen I-EXPLORATION +anal. I-EXPLORATION +Anatomía-patológica: I-EXPLORATION +ulceración I-EXPLORATION +inespecífica. I-EXPLORATION +Tomografía I-EXPLORATION +computerizada: I-EXPLORATION +estenosis I-EXPLORATION +rectal I-EXPLORATION +concéntrica I-EXPLORATION +y I-EXPLORATION +adenopatías I-EXPLORATION +perirectales. I-EXPLORATION +Serologías I-EXPLORATION +y I-EXPLORATION +tuberculina: I-EXPLORATION +negativas. I-EXPLORATION + I-EXPLORATION +En I-EXPLORATION +este I-EXPLORATION +momento, I-EXPLORATION +se I-EXPLORATION +interrogó I-EXPLORATION +de I-EXPLORATION +nuevo I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +paciente, I-EXPLORATION +que I-EXPLORATION +finalmente I-EXPLORATION +admitió I-EXPLORATION +la I-EXPLORATION +administración I-EXPLORATION +de I-EXPLORATION +16 I-EXPLORATION +supositorios I-EXPLORATION +al I-EXPLORATION +día I-EXPLORATION +de I-EXPLORATION +paracetamol-codeína I-EXPLORATION +durante I-EXPLORATION +el I-EXPLORATION +último I-EXPLORATION +año. I-EXPLORATION +Entonces I-EXPLORATION +se I-EXPLORATION +diagnosticó I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +paciente I-EXPLORATION +como I-EXPLORATION +rectitis/úlcera I-EXPLORATION +rectal I-EXPLORATION +secundaria I-EXPLORATION +a I-EXPLORATION +supositorios I-EXPLORATION +de I-EXPLORATION +paracetamol-codeína, I-EXPLORATION +además I-EXPLORATION +de I-EXPLORATION +síndrome I-EXPLORATION +de I-EXPLORATION +adicción I-EXPLORATION +a I-EXPLORATION +opiáceos I-EXPLORATION +que I-EXPLORATION +fue I-EXPLORATION +confirmado I-EXPLORATION +y I-EXPLORATION +seguido I-EXPLORATION +por I-EXPLORATION +Psiquiatría. I-EXPLORATION + I-EXPLORATION +Se B-TREATMENT +suspendieron I-TREATMENT +los I-TREATMENT +supositorios I-TREATMENT y I-TREATMENT -normalización I-TREATMENT +se I-TREATMENT +inició I-TREATMENT +tratamiento I-TREATMENT +con I-TREATMENT +enemas I-TREATMENT de I-TREATMENT +hidrocortisona, I-TREATMENT +junto I-TREATMENT +con I-TREATMENT +benzodiazepinas I-TREATMENT +por I-TREATMENT la I-TREATMENT -analítica. I-TREATMENT - I-TREATMENT -En I-TREATMENT -marzo I-TREATMENT -del I-TREATMENT -2016, I-TREATMENT -tuvo I-TREATMENT -nuevo I-TREATMENT -episodio I-TREATMENT -de I-TREATMENT -peritonitis, I-TREATMENT -decidiéndose I-TREATMENT +adicción I-TREATMENT +a I-TREATMENT +opiáceos. I-TREATMENT +La B-EVOLUTION +paciente I-EVOLUTION +mejoró I-EVOLUTION +significativamente I-EVOLUTION +y I-EVOLUTION +fue I-EVOLUTION +dada I-EVOLUTION +de I-EVOLUTION +alta. I-EVOLUTION + I-EVOLUTION +Las B-EXPLORATION +colonoscopias I-EXPLORATION +realizadas I-EXPLORATION +al I-EXPLORATION +segundo I-EXPLORATION +y I-EXPLORATION +sexto I-EXPLORATION +mes I-EXPLORATION +después I-EXPLORATION +del I-EXPLORATION +alta I-EXPLORATION +demostraron I-EXPLORATION +progresiva I-EXPLORATION +mejoría I-EXPLORATION +y I-EXPLORATION +curación I-EXPLORATION +de I-EXPLORATION +las I-EXPLORATION +lesiones I-EXPLORATION +rectales. I-EXPLORATION +El B-TREATMENT tratamiento I-TREATMENT -empírico I-TREATMENT -con I-TREATMENT -teicoplanina I-TREATMENT -y I-TREATMENT -tobramicina. I-TREATMENT +se I-TREATMENT +suspendió I-TREATMENT +a I-TREATMENT +los I-TREATMENT +8 I-TREATMENT +meses. I-TREATMENT A B-EVOLUTION los I-EVOLUTION -3 I-EVOLUTION -días I-EVOLUTION -de I-EVOLUTION -estar I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -consulta I-EVOLUTION -por I-EVOLUTION -malestar I-EVOLUTION -generalizado, I-EVOLUTION -vómitos, I-EVOLUTION -diarrea, I-EVOLUTION -fiebre I-EVOLUTION -e I-EVOLUTION -ictericia. I-EVOLUTION +10 I-EVOLUTION +meses I-EVOLUTION +estaba I-EVOLUTION +completamente I-EVOLUTION +asintomática. I-EVOLUTION I-EVOLUTION -Mujer B-PRESENT_ILLNESS +Varón B-PRESENT_ILLNESS de I-PRESENT_ILLNESS -74 I-PRESENT_ILLNESS -años I-PRESENT_ILLNESS +12 I-PRESENT_ILLNESS +años, I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +consulta I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +una I-PRESENT_ILLNESS +lesión I-PRESENT_ILLNESS +gingival I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +tiene I-PRESENT_ILLNESS +desde I-PRESENT_ILLNESS +la I-PRESENT_ILLNESS +primera I-PRESENT_ILLNESS +infancia I-PRESENT_ILLNESS con I-PRESENT_ILLNESS -enfermedad I-PRESENT_ILLNESS -renal I-PRESENT_ILLNESS -crónica I-PRESENT_ILLNESS -(ERC) I-PRESENT_ILLNESS -estadio I-PRESENT_ILLNESS -5 I-PRESENT_ILLNESS -atribuida I-PRESENT_ILLNESS -a I-PRESENT_ILLNESS -nefroangioes-clerosis, I-PRESENT_ILLNESS -con B-PAST_MEDICAL_HISTORY +sangrado I-PRESENT_ILLNESS +ocasional I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +sin I-PRESENT_ILLNESS +dolor. I-PRESENT_ILLNESS + I-PRESENT_ILLNESS +A B-EXPLORATION +la I-EXPLORATION +exploración I-EXPLORATION +intraoral I-EXPLORATION +se I-EXPLORATION +aprecia I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +encía I-EXPLORATION +vestibular I-EXPLORATION +superior, I-EXPLORATION +a I-EXPLORATION +nivel I-EXPLORATION +interincisal I-EXPLORATION +una I-EXPLORATION +tumoración I-EXPLORATION +de I-EXPLORATION +coloración I-EXPLORATION +rojiza, I-EXPLORATION +blanda I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +presión, I-EXPLORATION +similar I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +granuloma I-EXPLORATION +telangiectásico, I-EXPLORATION +pero I-EXPLORATION +con I-EXPLORATION +algunas I-EXPLORATION +pequeñas I-EXPLORATION +vesículas I-EXPLORATION +rojizas I-EXPLORATION +en I-EXPLORATION +su I-EXPLORATION +superficie. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +papila I-EXPLORATION +que I-EXPLORATION +separa I-EXPLORATION +el I-EXPLORATION +12 I-EXPLORATION +del I-EXPLORATION +13 I-EXPLORATION +se I-EXPLORATION +manifiesta I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +rojiza I-EXPLORATION +con I-EXPLORATION +pequeñas I-EXPLORATION +proyecciones I-EXPLORATION +papilares I-EXPLORATION +sobreelevadas, I-EXPLORATION +del I-EXPLORATION +tamaño I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +cabeza I-EXPLORATION +de I-EXPLORATION +alfiler I-EXPLORATION +y I-EXPLORATION +entre I-EXPLORATION +ambas I-EXPLORATION +lesiones I-EXPLORATION +se I-EXPLORATION +observan I-EXPLORATION +pequeñas I-EXPLORATION +zonas I-EXPLORATION +puntiformes I-EXPLORATION +de I-EXPLORATION +coloración I-EXPLORATION +rojiza. I-EXPLORATION +En I-EXPLORATION +la I-EXPLORATION +porción I-EXPLORATION +de I-EXPLORATION +encía I-EXPLORATION +insertada I-EXPLORATION +en I-EXPLORATION +palatino, I-EXPLORATION +entre I-EXPLORATION +el I-EXPLORATION +12 I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +13 I-EXPLORATION +también I-EXPLORATION +se I-EXPLORATION +observa I-EXPLORATION +una I-EXPLORATION +lesión I-EXPLORATION +rojiza I-EXPLORATION +con I-EXPLORATION +elevaciones I-EXPLORATION +papilares I-EXPLORATION +similares I-EXPLORATION +a I-EXPLORATION +las I-EXPLORATION +descritas I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +vestibular. I-EXPLORATION + I-EXPLORATION +Se I-EXPLORATION +toma I-EXPLORATION +una I-EXPLORATION +biopsia I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +zona I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +vestibular I-EXPLORATION +del I-EXPLORATION +12 I-EXPLORATION +al I-EXPLORATION +13 I-EXPLORATION +que I-EXPLORATION +es I-EXPLORATION +informada I-EXPLORATION +como I-EXPLORATION +hemolinfangioma. I-EXPLORATION + I-EXPLORATION + +Paciente B-PRESENT_ILLNESS +masculino I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +77 I-PRESENT_ILLNESS +años I-PRESENT_ILLNESS +que I-PRESENT_ILLNESS +ingresa I-PRESENT_ILLNESS +en I-PRESENT_ILLNESS +el I-PRESENT_ILLNESS +servicio I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +Urgencias I-PRESENT_ILLNESS +por I-PRESENT_ILLNESS +disartria, I-PRESENT_ILLNESS +disfasia I-PRESENT_ILLNESS +expresiva, I-PRESENT_ILLNESS +hemiparesia I-PRESENT_ILLNESS +derecha I-PRESENT_ILLNESS +y I-PRESENT_ILLNESS +deterioro I-PRESENT_ILLNESS +progresivo I-PRESENT_ILLNESS +del I-PRESENT_ILLNESS +estado I-PRESENT_ILLNESS +de I-PRESENT_ILLNESS +conciencia. I-PRESENT_ILLNESS +Fue B-PAST_MEDICAL_HISTORY +informado I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +familiares I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY antecedentes I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY hipertensión I-PAST_MEDICAL_HISTORY -arterial, I-PAST_MEDICAL_HISTORY -hiperparatiroidismo I-PAST_MEDICAL_HISTORY -secundario, I-PAST_MEDICAL_HISTORY -síndrome I-PAST_MEDICAL_HISTORY -anémico I-PAST_MEDICAL_HISTORY +arterial I-PAST_MEDICAL_HISTORY +esencial I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +tratamiento I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +50 I-PAST_MEDICAL_HISTORY +miligramos I-PAST_MEDICAL_HISTORY +de I-PAST_MEDICAL_HISTORY +captopril I-PAST_MEDICAL_HISTORY +cada I-PAST_MEDICAL_HISTORY +12 I-PAST_MEDICAL_HISTORY +horas I-PAST_MEDICAL_HISTORY y I-PAST_MEDICAL_HISTORY -leucemia I-PAST_MEDICAL_HISTORY -linfática I-PAST_MEDICAL_HISTORY -crónica I-PAST_MEDICAL_HISTORY -tipo I-PAST_MEDICAL_HISTORY -B, I-PAST_MEDICAL_HISTORY +aspirina I-PAST_MEDICAL_HISTORY +100 I-PAST_MEDICAL_HISTORY +miligramos I-PAST_MEDICAL_HISTORY +diarios. I-PAST_MEDICAL_HISTORY +Adicionalmente, I-PAST_MEDICAL_HISTORY +informaron I-PAST_MEDICAL_HISTORY que I-PAST_MEDICAL_HISTORY -eligió I-PAST_MEDICAL_HISTORY -terapia I-PAST_MEDICAL_HISTORY -sustitutiva I-PAST_MEDICAL_HISTORY +dos I-PAST_MEDICAL_HISTORY +semanas I-PAST_MEDICAL_HISTORY +antes I-PAST_MEDICAL_HISTORY +a I-PAST_MEDICAL_HISTORY +su I-PAST_MEDICAL_HISTORY +ingreso I-PAST_MEDICAL_HISTORY +presentó I-PAST_MEDICAL_HISTORY +trauma I-PAST_MEDICAL_HISTORY +occipital I-PAST_MEDICAL_HISTORY +cerrado I-PAST_MEDICAL_HISTORY +con I-PAST_MEDICAL_HISTORY +pérdida I-PAST_MEDICAL_HISTORY +transitoria I-PAST_MEDICAL_HISTORY +del I-PAST_MEDICAL_HISTORY +estado I-PAST_MEDICAL_HISTORY de I-PAST_MEDICAL_HISTORY -DP I-PAST_MEDICAL_HISTORY +conciencia, I-PAST_MEDICAL_HISTORY tras I-PAST_MEDICAL_HISTORY -el I-PAST_MEDICAL_HISTORY -proceso I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -toma I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -decisión. I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -Tiene I-PAST_MEDICAL_HISTORY -4 I-PAST_MEDICAL_HISTORY -hijos I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -vive I-PAST_MEDICAL_HISTORY -acompañada I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -dos, I-PAST_MEDICAL_HISTORY -cuida I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -los I-PAST_MEDICAL_HISTORY -nietos, I-PAST_MEDICAL_HISTORY +tropezar I-PAST_MEDICAL_HISTORY +y I-PAST_MEDICAL_HISTORY +caer; I-PAST_MEDICAL_HISTORY +sin I-PAST_MEDICAL_HISTORY +embargo, I-PAST_MEDICAL_HISTORY +en I-PAST_MEDICAL_HISTORY +aquel I-PAST_MEDICAL_HISTORY +momento I-PAST_MEDICAL_HISTORY no I-PAST_MEDICAL_HISTORY -sabe I-PAST_MEDICAL_HISTORY -leer I-PAST_MEDICAL_HISTORY -ni I-PAST_MEDICAL_HISTORY -escribir, I-PAST_MEDICAL_HISTORY -pero I-PAST_MEDICAL_HISTORY -es I-PAST_MEDICAL_HISTORY -independiente I-PAST_MEDICAL_HISTORY -para I-PAST_MEDICAL_HISTORY -las I-PAST_MEDICAL_HISTORY -actividades I-PAST_MEDICAL_HISTORY -diarias I-PAST_MEDICAL_HISTORY -e I-PAST_MEDICAL_HISTORY -instrumentales: I-PAST_MEDICAL_HISTORY - I-PAST_MEDICAL_HISTORY -(Enero I-PAST_MEDICAL_HISTORY -2014) I-PAST_MEDICAL_HISTORY -= I-PAST_MEDICAL_HISTORY -Barthel I-PAST_MEDICAL_HISTORY -100%, I-PAST_MEDICAL_HISTORY -Lawton-Brody I-PAST_MEDICAL_HISTORY -8/8, I-PAST_MEDICAL_HISTORY -Calidad I-PAST_MEDICAL_HISTORY -de I-PAST_MEDICAL_HISTORY -vida I-PAST_MEDICAL_HISTORY -(sf-12): I-PAST_MEDICAL_HISTORY -PCS I-PAST_MEDICAL_HISTORY -50.6, I-PAST_MEDICAL_HISTORY -MCS I-PAST_MEDICAL_HISTORY -59, I-PAST_MEDICAL_HISTORY -7 I-PAST_MEDICAL_HISTORY +acudió I-PAST_MEDICAL_HISTORY +por I-PAST_MEDICAL_HISTORY +atención I-PAST_MEDICAL_HISTORY +médica. I-PAST_MEDICAL_HISTORY I-PAST_MEDICAL_HISTORY -El I-PAST_MEDICAL_HISTORY -10/04/2013 B-TREATMENT -se I-TREATMENT -colocó I-TREATMENT -catéter I-TREATMENT -peritoneal I-TREATMENT -e I-TREATMENT -inició I-TREATMENT -DPCA I-TREATMENT -en I-TREATMENT -domicilio I-TREATMENT -el I-TREATMENT -22/5/2013, I-TREATMENT -siendo I-TREATMENT -la I-TREATMENT -propia I-TREATMENT -paciente I-TREATMENT -la I-TREATMENT -cuidadora I-TREATMENT -principal. I-TREATMENT - I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -de I-TREATMENT -DPCA I-TREATMENT -inicial I-TREATMENT -fue I-TREATMENT -de: I-TREATMENT -3 I-TREATMENT -intercambios/ I-TREATMENT -día I-TREATMENT -(2 I-TREATMENT -con I-TREATMENT -Phisioneal I-TREATMENT -35 I-TREATMENT -1, I-TREATMENT -36% I-TREATMENT -de I-TREATMENT -glucosa I-TREATMENT -y I-TREATMENT -1 I-TREATMENT -con I-TREATMENT -Extraneal, I-TREATMENT -con I-TREATMENT -volúmenes I-TREATMENT -de I-TREATMENT -2000 I-TREATMENT -ml). I-TREATMENT -Diariamente I-TREATMENT -ultrafiltraba I-TREATMENT -500 I-TREATMENT -ml I-TREATMENT -con I-TREATMENT -los I-TREATMENT -intercambios I-TREATMENT -y I-TREATMENT -mantenía I-TREATMENT -un I-TREATMENT -volumen I-TREATMENT -de I-TREATMENT -diuresis I-TREATMENT +A B-EXPLORATION +su I-EXPLORATION +ingreso I-EXPLORATION +presentaba I-EXPLORATION +intensa I-EXPLORATION +agitación I-EXPLORATION +motora, I-EXPLORATION +con I-EXPLORATION +tensión I-EXPLORATION +arterial I-EXPLORATION +175/98 I-EXPLORATION +mm I-EXPLORATION +de I-EXPLORATION +Hg, I-EXPLORATION +frecuencia I-EXPLORATION +cardiaca I-EXPLORATION +de I-EXPLORATION +96 I-EXPLORATION +latidos I-EXPLORATION +por I-EXPLORATION +minuto, I-EXPLORATION +frecuencia I-EXPLORATION +respiratoria I-EXPLORATION +de I-EXPLORATION +20/minuto I-EXPLORATION +y I-EXPLORATION +temperatura I-EXPLORATION +de I-EXPLORATION +36, I-EXPLORATION +4 I-EXPLORATION +grados I-EXPLORATION +centígrados. I-EXPLORATION +Se I-EXPLORATION +encontró I-EXPLORATION +una I-EXPLORATION +pequeña I-EXPLORATION +excoriación I-EXPLORATION +superficial I-EXPLORATION +en I-EXPLORATION +fase I-EXPLORATION +de I-EXPLORATION +cicatrización I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +parieto-occipital I-EXPLORATION +izquierda. I-EXPLORATION +Las I-EXPLORATION +pupilas I-EXPLORATION +eran I-EXPLORATION +iguales I-EXPLORATION +y I-EXPLORATION +reaccionaban I-EXPLORATION +simétricamente I-EXPLORATION +al I-EXPLORATION +reflejo I-EXPLORATION +foto-motor I-EXPLORATION +directo I-EXPLORATION +y I-EXPLORATION +consensual. I-EXPLORATION +Al I-EXPLORATION +realizar I-EXPLORATION +estímulos I-EXPLORATION +dolorosos, I-EXPLORATION +realizaba I-EXPLORATION +apertura I-EXPLORATION +ocular, I-EXPLORATION +emitía I-EXPLORATION +palabras I-EXPLORATION +y I-EXPLORATION +localizaba I-EXPLORATION +el I-EXPLORATION +sitio I-EXPLORATION +estimulado, I-EXPLORATION +sin I-EXPLORATION +embargo, I-EXPLORATION +con I-EXPLORATION +hemiparesia I-EXPLORATION +derecha I-EXPLORATION +(Escala I-EXPLORATION +de I-EXPLORATION +coma I-EXPLORATION +de I-EXPLORATION +Glasgow: I-EXPLORATION +10/15). I-EXPLORATION +El I-EXPLORATION +signo I-EXPLORATION +de I-EXPLORATION +Babinski I-EXPLORATION +estaba I-EXPLORATION +presente I-EXPLORATION +de I-EXPLORATION +forma I-EXPLORATION +bilateral. I-EXPLORATION + I-EXPLORATION +Fue I-EXPLORATION +realizado I-EXPLORATION +un I-EXPLORATION +escáner I-EXPLORATION +cerebral I-EXPLORATION +de I-EXPLORATION +urgencia, I-EXPLORATION +previa B-TREATMENT +administración I-TREATMENT de I-TREATMENT -1500 I-TREATMENT -ml. I-TREATMENT -El B-EXPLORATION -resultado I-EXPLORATION +haloperidol I-TREATMENT +para I-TREATMENT +disminuir I-TREATMENT +la I-TREATMENT +agitación, I-TREATMENT +la B-EVOLUTION +cual I-EVOLUTION +tuvo I-EVOLUTION +pobre I-EVOLUTION +calidad I-EVOLUTION +técnica I-EVOLUTION +dada I-EVOLUTION +la I-EVOLUTION +persistencia I-EVOLUTION +de I-EVOLUTION +los I-EVOLUTION +movimientos I-EVOLUTION +del I-EVOLUTION +paciente. I-EVOLUTION +En B-EXPLORATION +dicho I-EXPLORATION +estudio, I-EXPLORATION +fue I-EXPLORATION +observada I-EXPLORATION +una I-EXPLORATION +imagen I-EXPLORATION +extra-axial, I-EXPLORATION +hiperdensa I-EXPLORATION +en I-EXPLORATION +relación I-EXPLORATION +al I-EXPLORATION +parénquima I-EXPLORATION +cerebral, I-EXPLORATION +con I-EXPLORATION +forma I-EXPLORATION +semilunar I-EXPLORATION +de I-EXPLORATION +concavidad I-EXPLORATION +medial I-EXPLORATION +de I-EXPLORATION +17 I-EXPLORATION +milímetros I-EXPLORATION +de I-EXPLORATION +espesor, I-EXPLORATION +localizada I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +frontal, I-EXPLORATION +parietal I-EXPLORATION +y I-EXPLORATION +occipital I-EXPLORATION +izquierda, I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +desviaba I-EXPLORATION +las I-EXPLORATION +estructuras I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +línea I-EXPLORATION +media I-EXPLORATION +en I-EXPLORATION +14 I-EXPLORATION +milímetros, I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +parecía I-EXPLORATION +corresponder I-EXPLORATION +con I-EXPLORATION +un I-EXPLORATION +hematoma I-EXPLORATION +subdural. I-EXPLORATION +La I-EXPLORATION +magnitud I-EXPLORATION +desproporcionada I-EXPLORATION del I-EXPLORATION -estudio I-EXPLORATION +efecto I-EXPLORATION de I-EXPLORATION +masa I-EXPLORATION +y I-EXPLORATION +el I-EXPLORATION +edema I-EXPLORATION +adyacente I-EXPLORATION +a I-EXPLORATION la I-EXPLORATION -membrana I-EXPLORATION -peritoneal I-EXPLORATION -antes I-EXPLORATION +lesión I-EXPLORATION +alertaron I-EXPLORATION +sobre I-EXPLORATION +las I-EXPLORATION +posibles I-EXPLORATION +características I-EXPLORATION +neoplásicas I-EXPLORATION de I-EXPLORATION la I-EXPLORATION -ultima I-EXPLORATION -peritonitis I-EXPLORATION -mostró I-EXPLORATION +lesión. I-EXPLORATION + I-EXPLORATION +La I-EXPLORATION +tomografía I-EXPLORATION +cerebral I-EXPLORATION +con I-EXPLORATION +contraste I-EXPLORATION +demostró I-EXPLORATION una I-EXPLORATION -membrana I-EXPLORATION -peritoneal I-EXPLORATION -HA I-EXPLORATION -(transportador I-EXPLORATION +imagen, I-EXPLORATION +extra-axial, I-EXPLORATION +hiperdensa I-EXPLORATION +en I-EXPLORATION +relación I-EXPLORATION +al I-EXPLORATION +parénquima I-EXPLORATION +cerebral, I-EXPLORATION +que I-EXPLORATION +ocupaba I-EXPLORATION +la I-EXPLORATION +superficie I-EXPLORATION +dorso-lateral I-EXPLORATION +fronto-temporo-parietal I-EXPLORATION +izquierda, I-EXPLORATION +con I-EXPLORATION +intensa I-EXPLORATION +captación I-EXPLORATION +del I-EXPLORATION medio I-EXPLORATION -alto). I-EXPLORATION - I-EXPLORATION -En B-EVOLUTION -8 I-EVOLUTION -meses I-EVOLUTION -presentó I-EVOLUTION -4 I-EVOLUTION -episodios I-EVOLUTION -de I-EVOLUTION -peritonitis, I-EVOLUTION -de I-EVOLUTION -los I-EVOLUTION -cuales I-EVOLUTION -3 I-EVOLUTION -fueron I-EVOLUTION -recidivante, I-EVOLUTION -con I-EVOLUTION -cultivo I-EVOLUTION -positivo I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -misma I-EVOLUTION -bacteria I-EVOLUTION -(Staphylococcus I-EVOLUTION -epidermidis). I-EVOLUTION - I-EVOLUTION -Se B-TREATMENT -administró I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -protocolizado: I-TREATMENT -Vancomicina I-TREATMENT -1gr/72h I-TREATMENT -intraperitoneal I-TREATMENT -(IP) I-TREATMENT -durante I-TREATMENT -15 I-TREATMENT -días I-TREATMENT -y I-TREATMENT -Fluconazol I-TREATMENT -via I-TREATMENT -oral I-TREATMENT -(vo) I-TREATMENT -durante I-TREATMENT -21 I-TREATMENT -días. I-TREATMENT -Tras I-TREATMENT -la I-TREATMENT -resolución I-TREATMENT -de I-TREATMENT -la I-TREATMENT -ultima I-TREATMENT -infección I-TREATMENT -peritoneal I-TREATMENT -se I-TREATMENT -decidió I-TREATMENT -realizar, I-TREATMENT -además, I-TREATMENT -sellados I-TREATMENT -del I-TREATMENT -catéter I-TREATMENT -con I-TREATMENT -Daptomicina I-TREATMENT -(35 I-TREATMENT -mg I-TREATMENT -en I-TREATMENT -7, I-TREATMENT -2 I-TREATMENT -ml I-TREATMENT -de I-TREATMENT -ringer/24h I-TREATMENT -después I-TREATMENT -del I-TREATMENT -último I-TREATMENT -intercambio I-TREATMENT -del I-TREATMENT -día) I-TREATMENT -medicación I-TREATMENT -que I-TREATMENT -se I-TREATMENT -preparaba I-TREATMENT -en I-TREATMENT -el I-TREATMENT -hospital, I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -recogía I-TREATMENT -semanalmente I-TREATMENT -y I-TREATMENT -se I-TREATMENT -auto I-TREATMENT -administraba I-TREATMENT -después I-TREATMENT -del I-TREATMENT -último I-TREATMENT -intercambio I-TREATMENT -del I-TREATMENT -día I-TREATMENT -en I-TREATMENT -el I-TREATMENT -domicilio. I-TREATMENT - I-TREATMENT -Episodio B-EVOLUTION -de I-EVOLUTION -peritonitis I-EVOLUTION -fúngica: I-EVOLUTION - I-EVOLUTION -Durante I-EVOLUTION -el I-EVOLUTION -periodo I-EVOLUTION -de I-EVOLUTION -sellado I-EVOLUTION -(14/8/2014) I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -avisa I-EVOLUTION -al I-EVOLUTION -teléfono I-EVOLUTION -de I-EVOLUTION -urgencias, I-EVOLUTION -por I-EVOLUTION -líquido I-EVOLUTION -turbio, I-EVOLUTION -dolor I-EVOLUTION -abdominal I-EVOLUTION -y I-EVOLUTION -malestar I-EVOLUTION -general. I-EVOLUTION -Se B-EXPLORATION -realizó I-EXPLORATION -cultivo I-EXPLORATION de I-EXPLORATION -líquido I-EXPLORATION -peritoneal I-EXPLORATION -protocolizado I-EXPLORATION -y I-EXPLORATION -quedó I-EXPLORATION -ingresada I-EXPLORATION -en I-EXPLORATION -espera I-EXPLORATION +contraste I-EXPLORATION +endovenoso, I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +infiltraba I-EXPLORATION +la I-EXPLORATION +profundidad I-EXPLORATION de I-EXPLORATION -resultados. I-EXPLORATION -Tras B-TREATMENT -el I-TREATMENT -resultado I-TREATMENT -del I-TREATMENT -recuento I-TREATMENT -celular, I-TREATMENT -se I-TREATMENT -inició I-TREATMENT -tratamiento I-TREATMENT -antibiótico I-TREATMENT -empírico I-TREATMENT -con I-TREATMENT -Vancomicina I-TREATMENT -1gr/72h I-TREATMENT -y I-TREATMENT -Ceftazidima I-TREATMENT -1gr/24h I-TREATMENT -IP. I-TREATMENT -El B-EXPLORATION -cultivo I-EXPLORATION -mostró I-EXPLORATION -crecimiento I-EXPLORATION +los I-EXPLORATION +surcos I-EXPLORATION +cerebrales I-EXPLORATION +frontales. I-EXPLORATION +Adicionalmente, I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +ventana I-EXPLORATION +ósea I-EXPLORATION +se I-EXPLORATION +demostró I-EXPLORATION +adelgazamiento I-EXPLORATION +del I-EXPLORATION +cráneo I-EXPLORATION +en I-EXPLORATION +la I-EXPLORATION +región I-EXPLORATION +temporo-parietal I-EXPLORATION +izquierda I-EXPLORATION +a I-EXPLORATION +causa I-EXPLORATION de I-EXPLORATION -BGN I-EXPLORATION -(Klebsiella I-EXPLORATION -oxytoca I-EXPLORATION -y I-EXPLORATION -Acinetobacter I-EXPLORATION -sp I-EXPLORATION -multisensible), I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -se I-TREATMENT -mantuvo I-TREATMENT -tratamiento I-TREATMENT -con I-TREATMENT -Ceftazidima I-TREATMENT -1gr/24h/IP, I-TREATMENT -añadiéndose I-TREATMENT -Gentamicina I-TREATMENT -40mgr/24h/IP I-TREATMENT -y I-TREATMENT -Ciprofloxacino I-TREATMENT -500 I-TREATMENT -mg/12h I-TREATMENT -vo. I-TREATMENT - I-TREATMENT -Ante B-EVOLUTION -la I-EVOLUTION -mejoría I-EVOLUTION -clínica I-EVOLUTION -(efluente I-EVOLUTION -claro I-EVOLUTION -y I-EVOLUTION -sin I-EVOLUTION -problemas I-EVOLUTION -de I-EVOLUTION -drenaje) I-EVOLUTION -se I-EVOLUTION -decidió I-EVOLUTION -alta I-EVOLUTION -a I-EVOLUTION -domicilio. I-EVOLUTION +la I-EXPLORATION +lesión. I-EXPLORATION + I-EXPLORATION Se B-TREATMENT realizó I-TREATMENT -reentrenamiento I-TREATMENT -de I-TREATMENT -la I-TREATMENT -técnica I-TREATMENT -y I-TREATMENT -manejo I-TREATMENT -de I-TREATMENT -la I-TREATMENT -medicación I-TREATMENT -antibiótica I-TREATMENT -domiciliaria I-TREATMENT -(tratamiento I-TREATMENT -IP I-TREATMENT +una I-TREATMENT +craneotomía I-TREATMENT +fronto-parietal I-TREATMENT +izquierda I-TREATMENT durante I-TREATMENT -21 I-TREATMENT -días). I-TREATMENT - I-TREATMENT -A B-EVOLUTION -los I-EVOLUTION -ocho I-EVOLUTION -días, I-EVOLUTION -acude I-EVOLUTION -nuevamente I-EVOLUTION -a I-EVOLUTION -urgencias I-EVOLUTION -por I-EVOLUTION -líquido I-EVOLUTION -turbio, I-EVOLUTION -apareciendo B-EXPLORATION -en I-EXPLORATION -el I-EXPLORATION -cultivo I-EXPLORATION -un I-EXPLORATION -nuevo I-EXPLORATION -patógeno I-EXPLORATION -(Cándida I-EXPLORATION -parapsilosis) I-EXPLORATION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT +la I-TREATMENT +cual I-TREATMENT se I-TREATMENT -añadió I-TREATMENT -al I-TREATMENT -tratamiento I-TREATMENT -Fluconazol I-TREATMENT -200 I-TREATMENT -mg I-TREATMENT -vo/24h, I-TREATMENT -y I-TREATMENT -quedó I-TREATMENT -nuevamente I-TREATMENT -ingresada. I-TREATMENT - I-TREATMENT -Debido B-EVOLUTION -a I-EVOLUTION -la I-EVOLUTION -mala I-EVOLUTION -respuesta I-EVOLUTION -al I-EVOLUTION -tratamiento I-EVOLUTION -se B-TREATMENT -decidió I-TREATMENT -retirar I-TREATMENT -el I-TREATMENT -catéter I-TREATMENT -Tenckoff, I-TREATMENT -como I-TREATMENT -recomienda I-TREATMENT +encontró I-TREATMENT el I-TREATMENT -protocolo, I-TREATMENT -y I-TREATMENT -transferirla I-TREATMENT -a I-TREATMENT -Hemodiálisis I-TREATMENT -definitivamente. I-TREATMENT - I-TREATMENT -Se I-TREATMENT -le I-TREATMENT -coloco I-TREATMENT -un I-TREATMENT -catéter I-TREATMENT -venoso I-TREATMENT -bilumen I-TREATMENT -(yugular I-TREATMENT -derecho) I-TREATMENT -provisional, I-TREATMENT -en I-TREATMENT -espera I-TREATMENT -de I-TREATMENT -programar I-TREATMENT -intervención I-TREATMENT -quirúrgica I-TREATMENT -de I-TREATMENT -fístula I-TREATMENT -arterio-venosa I-TREATMENT -interna I-TREATMENT -en I-TREATMENT -codo I-TREATMENT -derecho I-TREATMENT -(5/09/2014). I-TREATMENT - I-TREATMENT -Cinco B-EVOLUTION -días I-EVOLUTION -después, I-EVOLUTION -se I-EVOLUTION -recambió I-EVOLUTION -el I-EVOLUTION -catéter I-EVOLUTION -venoso I-EVOLUTION -por I-EVOLUTION -disfunción I-EVOLUTION -y I-EVOLUTION -se I-EVOLUTION -visualizó I-EVOLUTION -mediante I-EVOLUTION -angio I-EVOLUTION -TAC, I-EVOLUTION -importante I-EVOLUTION -trombo I-EVOLUTION -en I-EVOLUTION -vena I-EVOLUTION -yugular I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -precisó I-TREATMENT -cirugía, I-TREATMENT -ingreso I-TREATMENT -en I-TREATMENT -cuidados I-TREATMENT -intensivos I-TREATMENT -y I-TREATMENT -colocación I-TREATMENT -de I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -catéter I-TREATMENT -(ubicación I-TREATMENT -femoral). I-TREATMENT -Este B-EVOLUTION -nuevo I-EVOLUTION -catéter, I-EVOLUTION -también, I-EVOLUTION -presentó I-EVOLUTION -trombosis I-EVOLUTION -venosa I-EVOLUTION -no I-EVOLUTION -oclusiva, I-EVOLUTION -por B-TREATMENT -lo I-TREATMENT -que I-TREATMENT -precisó I-TREATMENT -anticoagulación I-TREATMENT -y I-TREATMENT -retirada I-TREATMENT -en I-TREATMENT -2-3 I-TREATMENT -semanas. I-TREATMENT - I-TREATMENT -A B-EVOLUTION -pesar I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -utilización I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -fistula I-EVOLUTION -arterio-venosa I-EVOLUTION -interna I-EVOLUTION -al I-EVOLUTION -mes I-EVOLUTION -de I-EVOLUTION -su I-EVOLUTION -intervención, I-EVOLUTION -se I-EVOLUTION -observó I-EVOLUTION -mala I-EVOLUTION -adaptación I-EVOLUTION -al I-EVOLUTION -tratamiento I-EVOLUTION -de I-EVOLUTION -HD I-EVOLUTION -por I-EVOLUTION -continuas I-EVOLUTION -hipotensiones, I-EVOLUTION -dificultad I-EVOLUTION -en I-EVOLUTION -la I-EVOLUTION -canalización I-EVOLUTION -venosa I-EVOLUTION -y I-EVOLUTION -dolor I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -extremidad I-EVOLUTION -por I-EVOLUTION -síndrome I-EVOLUTION -de I-EVOLUTION -"robo". I-EVOLUTION - I-EVOLUTION -La I-EVOLUTION -calidad I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -de I-EVOLUTION -la I-EVOLUTION -paciente I-EVOLUTION -había I-EVOLUTION -empeorado I-EVOLUTION -notablemente, I-EVOLUTION -tras I-EVOLUTION -el I-EVOLUTION -ingreso I-EVOLUTION -de I-EVOLUTION -74 I-EVOLUTION -días I-EVOLUTION -y I-EVOLUTION -el I-EVOLUTION -traspaso I-EVOLUTION -a I-EVOLUTION -hemodiálisis: I-EVOLUTION - I-EVOLUTION -(Octubre I-EVOLUTION -2014) I-EVOLUTION -= I-EVOLUTION -Barthel I-EVOLUTION -95%, I-EVOLUTION -Lawton-Brody I-EVOLUTION -6/8, I-EVOLUTION -Calidad I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -(sf-12): I-EVOLUTION -PCS I-EVOLUTION -20, I-EVOLUTION -1, I-EVOLUTION -MCS I-EVOLUTION -40, I-EVOLUTION -3 I-EVOLUTION - I-EVOLUTION -Debido I-EVOLUTION -a I-EVOLUTION -las I-EVOLUTION -complicaciones, I-EVOLUTION -la I-EVOLUTION -mala I-EVOLUTION -adaptación I-EVOLUTION -a I-EVOLUTION -HD I-EVOLUTION -y B-TREATMENT +hueso I-TREATMENT +erosionado I-TREATMENT +e I-TREATMENT +infiltrado I-TREATMENT por I-TREATMENT -petición I-TREATMENT -de I-TREATMENT +una I-TREATMENT +lesión I-TREATMENT +violácea, I-TREATMENT +firme, I-TREATMENT +muy I-TREATMENT +vascularizada, I-TREATMENT la I-TREATMENT -paciente, I-TREATMENT +cual I-TREATMENT se I-TREATMENT -replanteó I-TREATMENT -volver I-TREATMENT +extendía I-TREATMENT a I-TREATMENT -DP I-TREATMENT -con I-TREATMENT -el I-TREATMENT -tratamiento I-TREATMENT +través I-TREATMENT de I-TREATMENT -cicladora I-TREATMENT -nocturna. I-TREATMENT - I-TREATMENT -Regreso I-TREATMENT +la I-TREATMENT +duramadre, I-TREATMENT +llegando I-TREATMENT a I-TREATMENT -Dialisis I-TREATMENT -Peritoneal: I-TREATMENT - I-TREATMENT -Así I-TREATMENT -pues, I-TREATMENT -el I-TREATMENT -19/12/14 I-TREATMENT -se I-TREATMENT -colocó I-TREATMENT -catéter I-TREATMENT -Tenckoff I-TREATMENT -(vía I-TREATMENT -laparoscopia I-TREATMENT -para I-TREATMENT -poder I-TREATMENT -valorar I-TREATMENT las I-TREATMENT -posibles I-TREATMENT -adherencias, I-TREATMENT -que I-TREATMENT -pueden I-TREATMENT -aparecer I-TREATMENT -tras I-TREATMENT -la I-TREATMENT -peritonitis I-TREATMENT -fúngicas) I-TREATMENT -y I-TREATMENT -como I-TREATMENT -no I-TREATMENT -hubieron I-TREATMENT -problemas, I-TREATMENT -en I-TREATMENT -1 I-TREATMENT -mes I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -reinició I-TREATMENT -terapia I-TREATMENT -domiciliaria I-TREATMENT -de I-TREATMENT -diálisis I-TREATMENT -peritoneal I-TREATMENT -automática I-TREATMENT -(DPA). I-TREATMENT -Como I-TREATMENT -cuidador I-TREATMENT -principal I-TREATMENT -quedó I-TREATMENT -la I-TREATMENT -hija I-TREATMENT -menor I-TREATMENT -de I-TREATMENT -la I-TREATMENT -paciente, I-TREATMENT -que I-TREATMENT -aunque I-TREATMENT -no I-TREATMENT -vive I-TREATMENT -con I-TREATMENT -ella I-TREATMENT -realizaba I-TREATMENT -el I-TREATMENT -montaje I-TREATMENT +leptomeninges, I-TREATMENT +infiltrándolas I-TREATMENT y I-TREATMENT -conexión I-TREATMENT -desplazándose I-TREATMENT +más I-TREATMENT +profundamente I-TREATMENT al I-TREATMENT -domicilio I-TREATMENT -diariamente. I-TREATMENT -La I-TREATMENT -desconexión, I-TREATMENT -solución I-TREATMENT -de I-TREATMENT -alarmas I-TREATMENT -nocturnas I-TREATMENT -y I-TREATMENT -desmontaje I-TREATMENT +parénquima I-TREATMENT +cerebral I-TREATMENT de I-TREATMENT la I-TREATMENT -maquina, I-TREATMENT -lo I-TREATMENT -realiza I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -sin I-TREATMENT -supervisión. I-TREATMENT - I-TREATMENT -El I-TREATMENT -tratamiento I-TREATMENT -pautado I-TREATMENT -con I-TREATMENT -cicladora I-TREATMENT -fue I-TREATMENT -de: I-TREATMENT -8 I-TREATMENT -horas, I-TREATMENT -4 I-TREATMENT -ciclos I-TREATMENT -de I-TREATMENT -2000 I-TREATMENT -ml I-TREATMENT -(Phisioneal I-TREATMENT -35 I-TREATMENT -1, I-TREATMENT -36%), I-TREATMENT -80 I-TREATMENT -minutos I-TREATMENT -de I-TREATMENT -permanencia I-TREATMENT +región I-TREATMENT +frontal, I-TREATMENT +temporal I-TREATMENT y I-TREATMENT -día I-TREATMENT -seco. I-TREATMENT +parietal. I-TREATMENT +Se I-TREATMENT +realizó I-TREATMENT +resección I-TREATMENT +parcial, I-TREATMENT +dejando I-TREATMENT +material I-TREATMENT +anormal I-TREATMENT +adherido I-TREATMENT +a I-TREATMENT +la I-TREATMENT +superficie I-TREATMENT +cerebral. I-TREATMENT I-TREATMENT -Diariamente B-EVOLUTION -tiene I-EVOLUTION -una I-EVOLUTION -ultrafiltrafiltración I-EVOLUTION -con I-EVOLUTION -el I-EVOLUTION -tratamiento I-EVOLUTION -de I-EVOLUTION -400-500 I-EVOLUTION -ml I-EVOLUTION -y I-EVOLUTION -mantiene I-EVOLUTION -un I-EVOLUTION -volumen I-EVOLUTION -de I-EVOLUTION -diuresis I-EVOLUTION -de I-EVOLUTION -1500 I-EVOLUTION -ml. I-EVOLUTION -El I-EVOLUTION -test I-EVOLUTION -de I-EVOLUTION -equilibrio I-EVOLUTION -peritoneal I-EVOLUTION -se I-EVOLUTION -mantuvo I-EVOLUTION -igual I-EVOLUTION -que I-EVOLUTION -al I-EVOLUTION -inicio. I-EVOLUTION - I-EVOLUTION -Actualmente I-EVOLUTION -lleva I-EVOLUTION -> I-EVOLUTION +El B-EVOLUTION +paciente I-EVOLUTION +presentó I-EVOLUTION +mejoría I-EVOLUTION +del I-EVOLUTION +estado I-EVOLUTION de I-EVOLUTION -1 I-EVOLUTION -año I-EVOLUTION -sin I-EVOLUTION -ningún I-EVOLUTION -tipo I-EVOLUTION +conciencia, I-EVOLUTION +alcanzando I-EVOLUTION +a I-EVOLUTION +estar I-EVOLUTION +alerta, I-EVOLUTION +con I-EVOLUTION +notable I-EVOLUTION +mejoría I-EVOLUTION de I-EVOLUTION -problema, I-EVOLUTION -recuperando I-EVOLUTION -prácticamente I-EVOLUTION la I-EVOLUTION -autonomía I-EVOLUTION -y I-EVOLUTION -calidad I-EVOLUTION -de I-EVOLUTION -vida I-EVOLUTION -del I-EVOLUTION -inicio: I-EVOLUTION - I-EVOLUTION -(Septiembre I-EVOLUTION -2015) I-EVOLUTION -= I-EVOLUTION -Barthel I-EVOLUTION -100%, I-EVOLUTION -Lawton-Brody I-EVOLUTION -8/8, I-EVOLUTION -Calidad I-EVOLUTION +fuerza I-EVOLUTION +muscular I-EVOLUTION +en I-EVOLUTION +el I-EVOLUTION +lado I-EVOLUTION +derecho, I-EVOLUTION +aunque I-EVOLUTION +con I-EVOLUTION +persistencia I-EVOLUTION de I-EVOLUTION -vida I-EVOLUTION -(sf-12): I-EVOLUTION -PCS I-EVOLUTION -43, I-EVOLUTION -6, I-EVOLUTION -MCS I-EVOLUTION -51, I-EVOLUTION -5 I-EVOLUTION +la I-EVOLUTION +disfasia I-EVOLUTION +sensitiva. I-EVOLUTION I-EVOLUTION -Las B-TREATMENT -guías I-TREATMENT -SEN I-TREATMENT -recomiendan I-TREATMENT -realizar I-TREATMENT -reentrenamiento I-TREATMENT -después I-TREATMENT -de I-TREATMENT -cada I-TREATMENT -episodio I-TREATMENT -de I-TREATMENT -peritonitis. I-TREATMENT -El I-TREATMENT -objetivo I-TREATMENT -es I-TREATMENT -buscar I-TREATMENT -causas I-TREATMENT -posibles, I-TREATMENT -evaluar I-TREATMENT -la I-TREATMENT -capacitación I-TREATMENT -del I-TREATMENT -responsable I-TREATMENT -y I-TREATMENT -rectificar I-TREATMENT -aquellos I-TREATMENT -procedimientos I-TREATMENT -erróneos. I-TREATMENT -Esta I-TREATMENT -metodología I-TREATMENT -nos I-TREATMENT -ayuda I-TREATMENT -a I-TREATMENT -revelar I-TREATMENT -la I-TREATMENT -posible I-TREATMENT -causa I-TREATMENT +Ante B-EXPLORATION +la I-EXPLORATION +impresión I-EXPLORATION +clínica I-EXPLORATION +de I-EXPLORATION +una I-EXPLORATION +metástasis I-EXPLORATION +meníngea I-EXPLORATION +de I-EXPLORATION +un I-EXPLORATION +tumor I-EXPLORATION +primario I-EXPLORATION +desconocido I-EXPLORATION +fueron I-EXPLORATION +solicitadas I-EXPLORATION +tomografía I-EXPLORATION +con I-EXPLORATION +contraste I-EXPLORATION +de I-EXPLORATION +tórax, I-EXPLORATION +abdomen I-EXPLORATION +y I-EXPLORATION +pelvis, I-EXPLORATION +en I-EXPLORATION +los I-EXPLORATION +cuales I-EXPLORATION +solo I-EXPLORATION +se I-EXPLORATION +documento I-EXPLORATION +aumento I-EXPLORATION +del I-EXPLORATION +tamaño I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +próstata. I-EXPLORATION +Al I-EXPLORATION +tacto I-EXPLORATION +rectal I-EXPLORATION +se I-EXPLORATION +encontró I-EXPLORATION +un I-EXPLORATION +nódulo I-EXPLORATION +prostático I-EXPLORATION +pétreo I-EXPLORATION +de I-EXPLORATION +bordes I-EXPLORATION +indefinidos I-EXPLORATION +a I-EXPLORATION +la I-EXPLORATION +palpación. I-EXPLORATION +El I-EXPLORATION +antígeno I-EXPLORATION +prostático I-EXPLORATION +específico I-EXPLORATION +sérico I-EXPLORATION +obtenido I-EXPLORATION +fue I-EXPLORATION +de I-EXPLORATION +588 I-EXPLORATION +ng/dL, I-EXPLORATION +por I-EXPLORATION +lo I-EXPLORATION +cual I-EXPLORATION +se I-EXPLORATION +realizó I-EXPLORATION +biopsia I-EXPLORATION +de I-EXPLORATION +próstata I-EXPLORATION +la I-EXPLORATION +cual I-EXPLORATION +demostró I-EXPLORATION +un I-EXPLORATION +adenocarcinoma I-EXPLORATION +pobremente I-EXPLORATION +diferenciado. I-EXPLORATION +El I-EXPLORATION +estudio I-EXPLORATION +histopatológico I-EXPLORATION +de I-EXPLORATION +la I-EXPLORATION +lesión I-EXPLORATION +intracraneal I-EXPLORATION +también I-EXPLORATION +correspondió I-EXPLORATION +a I-EXPLORATION +un I-EXPLORATION +adenocarcinoma I-EXPLORATION +metastásico I-EXPLORATION +pobremente I-EXPLORATION +diferenciado. I-EXPLORATION + I-EXPLORATION +Por B-TREATMENT +deseo I-TREATMENT de I-TREATMENT -la I-TREATMENT -infección. I-TREATMENT -En I-TREATMENT -nuestro I-TREATMENT -caso, I-TREATMENT +sus I-TREATMENT +familiares, I-TREATMENT el I-TREATMENT -resultado I-TREATMENT -indicó I-TREATMENT -que I-TREATMENT -la I-TREATMENT paciente I-TREATMENT no I-TREATMENT -había I-TREATMENT -seguido I-TREATMENT -las I-TREATMENT -medidas I-TREATMENT -de I-TREATMENT -asepsia I-TREATMENT -recomendadas I-TREATMENT -en I-TREATMENT -la I-TREATMENT -manipulación I-TREATMENT -del I-TREATMENT -antibiótico I-TREATMENT -para I-TREATMENT -el I-TREATMENT -sellado. I-TREATMENT - I-TREATMENT -Con I-TREATMENT -el I-TREATMENT -primer I-TREATMENT -resultado I-TREATMENT -del I-TREATMENT -cultivo I-TREATMENT -del I-TREATMENT -líquido I-TREATMENT -peritoneal I-TREATMENT -se I-TREATMENT -diagnosticó I-TREATMENT -la I-TREATMENT -peritonitis I-TREATMENT -bacteriana, I-TREATMENT -pero I-TREATMENT -acabo I-TREATMENT -añadiendose, I-TREATMENT -también, I-TREATMENT -una I-TREATMENT -peritonitis I-TREATMENT -fúngica. I-TREATMENT -Así I-TREATMENT -pues, I-TREATMENT -la I-TREATMENT -infección I-TREATMENT -fúngica I-TREATMENT -condicionó I-TREATMENT -la I-TREATMENT -retirada I-TREATMENT -del I-TREATMENT -catéter I-TREATMENT -peritoneal I-TREATMENT -y I-TREATMENT -el I-TREATMENT -abandono I-TREATMENT -del I-TREATMENT -programa I-TREATMENT -de I-TREATMENT -diálisis I-TREATMENT -peritoneal. I-TREATMENT -El I-TREATMENT -equipo I-TREATMENT -multidisciplinar I-TREATMENT -tomó I-TREATMENT -la I-TREATMENT -decisión I-TREATMENT -de I-TREATMENT -transferirla I-TREATMENT -a I-TREATMENT -HD I-TREATMENT -definitivamente I-TREATMENT -tras I-TREATMENT -el I-TREATMENT -diagnostico I-TREATMENT -de I-TREATMENT -peritonitis I-TREATMENT -fúngica. I-TREATMENT - I-TREATMENT -Muchos I-TREATMENT -autores I-TREATMENT -describen I-TREATMENT -que I-TREATMENT -la I-TREATMENT -supervivencia I-TREATMENT -de I-TREATMENT -la I-TREATMENT -técnica I-TREATMENT -tras I-TREATMENT -una I-TREATMENT -peritonitis I-TREATMENT -fúngica I-TREATMENT -por I-TREATMENT -Candidas I-TREATMENT -no I-TREATMENT -Albicans I-TREATMENT -es I-TREATMENT -muy I-TREATMENT -baja, I-TREATMENT -y I-TREATMENT -además I-TREATMENT -existen I-TREATMENT -pocos I-TREATMENT -pacientes I-TREATMENT -que I-TREATMENT -pueden I-TREATMENT -retornar I-TREATMENT -de I-TREATMENT -nuevo I-TREATMENT -a I-TREATMENT -la I-TREATMENT -terapia I-TREATMENT -de I-TREATMENT -DP I-TREATMENT -tras I-TREATMENT -el I-TREATMENT -suceso, I-TREATMENT -así I-TREATMENT -lo I-TREATMENT -describen I-TREATMENT -García-Martos1, I-TREATMENT -2 I-TREATMENT -y I-TREATMENT -Molina3 I-TREATMENT -en I-TREATMENT -sus I-TREATMENT -estudios. I-TREATMENT - I-TREATMENT -Las I-TREATMENT -causas I-TREATMENT -de I-TREATMENT -que I-TREATMENT -nos I-TREATMENT -planteáramos I-TREATMENT -que I-TREATMENT -la I-TREATMENT -paciente I-TREATMENT -volviera I-TREATMENT -a I-TREATMENT -DP, I-TREATMENT -fueron: I-TREATMENT -la I-TREATMENT -mala I-TREATMENT -adaptación I-TREATMENT -a I-TREATMENT -la I-TREATMENT -HD, I-TREATMENT -las I-TREATMENT -complicaciones I-TREATMENT -surgidas I-TREATMENT -durante I-TREATMENT -el I-TREATMENT -traspaso I-TREATMENT -a I-TREATMENT -hemodiálisis I-TREATMENT -y I-TREATMENT -la I-TREATMENT -petición I-TREATMENT -de I-TREATMENT -la I-TREATMENT -propia I-TREATMENT -paciente. I-TREATMENT -También I-TREATMENT -se I-TREATMENT -tuvo I-TREATMENT -en I-TREATMENT -cuenta I-TREATMENT -la I-TREATMENT -recomendación I-TREATMENT -de I-TREATMENT -las I-TREATMENT -guías I-TREATMENT -sobre I-TREATMENT -la I-TREATMENT -posibilidad I-TREATMENT -de I-TREATMENT -reinserción I-TREATMENT -de I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -catéter I-TREATMENT -peritoneal I-TREATMENT -a I-TREATMENT -las I-TREATMENT -4-6 I-TREATMENT -semanas I-TREATMENT -de I-TREATMENT -la I-TREATMENT -resolución I-TREATMENT -del I-TREATMENT -cuadro I-TREATMENT -clínico. I-TREATMENT - I-TREATMENT -Una I-TREATMENT -vez I-TREATMENT -tomada I-TREATMENT -la I-TREATMENT -decisión I-TREATMENT -de I-TREATMENT -regresar I-TREATMENT -al I-TREATMENT -programa I-TREATMENT -de I-TREATMENT -DP, I-TREATMENT -estaba I-TREATMENT -claro I-TREATMENT -que I-TREATMENT -era I-TREATMENT -necesario I-TREATMENT -un I-TREATMENT -cambio I-TREATMENT -de I-TREATMENT -estrategia, I-TREATMENT -de I-TREATMENT -manera I-TREATMENT -que I-TREATMENT -se I-TREATMENT -propuso I-TREATMENT -iniciar I-TREATMENT -en I-TREATMENT -forma I-TREATMENT -de I-TREATMENT -cicladora I-TREATMENT -automática, I-TREATMENT -con I-TREATMENT -la I-TREATMENT -finalidad I-TREATMENT -de I-TREATMENT -disminuir I-TREATMENT -el I-TREATMENT -número I-TREATMENT -de I-TREATMENT -manipulaciones I-TREATMENT -del I-TREATMENT -paciente/familia I-TREATMENT -con I-TREATMENT -el I-TREATMENT -catéter. I-TREATMENT -Pero I-TREATMENT -también, I-TREATMENT -era I-TREATMENT -imprescindible I-TREATMENT -evitar I-TREATMENT -nuevos I-TREATMENT -episodios I-TREATMENT -de I-TREATMENT -infección, I-TREATMENT -por I-TREATMENT -eso, I-TREATMENT -se I-TREATMENT -pensó I-TREATMENT -en I-TREATMENT -buscar I-TREATMENT -un I-TREATMENT -nuevo I-TREATMENT -responsable I-TREATMENT -para I-TREATMENT -realizar I-TREATMENT -la I-TREATMENT -técnica I-TREATMENT -y I-TREATMENT -todo I-TREATMENT -ello I-TREATMENT -nos I-TREATMENT -condujo I-TREATMENT +fue I-TREATMENT +sometido I-TREATMENT a I-TREATMENT -reiniciar I-TREATMENT -el I-TREATMENT -proceso I-TREATMENT -de I-TREATMENT -entrenamiento I-TREATMENT -con I-TREATMENT -la I-TREATMENT -hija I-TREATMENT -y I-TREATMENT -puesta I-TREATMENT -en I-TREATMENT -marcha I-TREATMENT -de I-TREATMENT -la I-TREATMENT -técnica I-TREATMENT -en I-TREATMENT -casa. I-TREATMENT +ningún I-TREATMENT +tratamiento I-TREATMENT +oncológico I-TREATMENT +complementario I-TREATMENT +y B-EVOLUTION +fue I-EVOLUTION +dado I-EVOLUTION +de I-EVOLUTION +alta I-EVOLUTION +con B-TREATMENT +cuidados I-TREATMENT +ambulatorios I-TREATMENT +paliativos. I-TREATMENT I-TREATMENT