Chronic venous insufficiency (CVI) comprises a complete spectrum of morphological and functional abnormalities of the venous system1 including any long-term functional and morphological alteration. CVI accounts for several abnormalities of the venous system. It is a highly prevalent disease that causes serious economic consequences, a decrease in the quality of life and can lead to serious complications. An exhaustive review was performed with the available literature, using the PubMed, ScienceDirect, Scopus and Cochrane databases from 2004 to 2021. The search criteria were formulated to identify reports related to chronic venous insufficiency. The pathophysiology of chronic venous insufficiency begins with chronic venous hypertension and the dilation of the vessel, this leads to a series of pathological changes in the venous wall and surrounding tissues, in advanced stages of CVI, skin lesions are associated with an increased proliferation of skin capillaries and microcirculatory abnormalities that may be the result of an altered level of factors responsible for the angiogenic response, such as vascular endothelial growth factor (VEGF), fibroblast growth factor 2 (FGF2) and angiostatin. In this review, updates on pathophysiology, clinic, diagnosis, classification and treatment of this disease are analyzed, with special emphasis on therapeutic options. Chronic venous insufficiency is a disease that affects the patient at several levels, mainly diminishing his/her quality of life. Currently there are various treatments ranging from habit modifications, pharmacological, to endovenous and surgical treatment.
Background: They crayfish brain is segmented into two symmetrical hemiganglia. Normally both hemiganglia are in direct communication through a series of well-defined neural bridges that cross de midline to form reciprocal cross connections.Methods: An original study was carried out in the Department of Physiology of the Faculty of Medicine, UNAM during the period from August 2019 to August 2020. 13 Crayfish Procambarus clarkii weighing between 1g to 30g were used. Each eyestalk of the animals was tied to a displacement transducer coupled with a polygraph so that optomotor or electrical activity was bilaterally recorded. The separation of the right from the left hemiganglia from the cerebral or supraesophageal ganglion was performed with a sagittal section, splitbrain (SB).Results: The normal photo motor reflex in crayfish eye is measured as a gradual decrease in the ERG amplitude. During tactile stimulation, the visual activation of both eyestalks in normal crayfish leads to a highly regular bilateral activity. The regular activity can only be altered by disturbing the mechanoreceptors located in the shell surrounding the eyestalks.Conclusions: The procedure presented in this article provides unique characteristics for the study of the nervous system such as a detailed response of the bilateral optomotor reflex.
Venous thromboembolism is an entity that ranges from deep vein thrombosis to pulmonary embolism, both are highly prevalent diseases in our environment and potentially fatal. The intention of this review is to compile information regarding the indications, contraindications, complications and comparison of different therapeutic methods in order to create an algorithm. An exhaustive review was performed with the available literature, using the PubMed, ScienceDirect, Scopus and Cochrane databases from 2004 to 2021. The search criteria were formulated to identify reports related to inferior vena cava filters. Venous thrombosis manifested as deep vein thrombosis or pulmonary embolism is a highly prevalent disease in our setting with high morbidity and mortality. Currently, different therapeutic options have been presented to address this pathology, in this review we focus on the developments regarding the use of vena cava filters. Reviewing the indications for the placement of a vena cava filter, we find absolute indications such as a contraindication to anticoagulation and high risk of massive pulmonary embolism. Pulmonary thromboembolism is a disease with high prevalence and mortality, we have highly effective and novel treatments such as the vena cava filter, patients should be selected carefully always taking into account the absolute and relative indications.
Patients who undergo; anesthesia, neuraxial analgesia, or some type of neuraxial blockage are exposed to multiple complications. 33-year-old male patient, suffers a femur fracture with a long oblique trace causing pain and functional limitation for movements. Surgical resolution is determined using neuraxial block at L2-L3 level, and intravenous sedation. During his postoperative follow-up, a decrease in strength was confirmed in the lower limbs with 0/5 on the Daniels scale, 100% sensitivity without sphincter control, steroids were prescribed along with magnetic resonance imaging and a neurosurgical evaluation was requested. The MRI shows bulging of the fibrous annulus that obliterates the epidural fat and makes contact with the thecal sac in the L5-S1 intervertebral disc level. The neurosurgery service prescribes rehabilitation sessions at home, electrostimulation and neuropathic medications. Patient was discharged with rehabilitation sessions at home and medical treatment. In his last consultation, an evaluation from the psychiatry department was requested for ideas of disability, hopelessness, fantasies of death without a suicide plan related to limitations and loss of functionality. Patient does not return to external follow-up, cannot be located.
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