Notes

A new 57-Year-Old Man Using COVID-19 Pneumonia That Needed Venovenous Extracorporeal Lifestyle Help Which has a Rapidly Escalating WBC Count.
To present the case of a patient diagnosed with aggressive angiomyxoma of the vagina and to conduct a review of the diagnosis, treatment and prognosis of this disease condition.

A 46-year old female patient complaining of dysuria and vaginal mass sensation. Physical exploration and imaging studies revealed a tumor extending into the pelvic cavity. The mass was resected through a vaginal approach and pathology of the surgical specimen showed an aggressive angiomyxoma of the vagina. New retrorectar surgery was performed three months after the initial resection because of recurrence. A search was conducted in the Medline via PubMed, Lilacs, Scielo and Google Scholar databases using the terms "Angiomyxoma," "Aggressive" and "Vagina." The search included review articles, case reports and case series published in English and Spanish since 1995. The information extracted included diagnosis, symptoms, signs, immunohistochemistry and imaging studies used, type of treatment surgical or other - and prognosis. Findinl treatment as an adjunct to surgery is required. Prognosis is good.
To report the case of a pregnant woman with a history of transverse plication abdominoplasty (TULUA) and to conduct a review of the available literature on the impact of this intervention on the course of gestation and vice versa.

Case report of a 23-year-old pregnant woman with a history of TULUA abdominoplasty performed eight months before pregnancy. A literature search was conducted in Medline, Cochrane Library, SciELO, LILACS, BVS and Google Scholar, with no restriction by language or date of publication. click here Studies of any design were included, including case reports. Book chapters and clinical practice guidelines were excluded.

Overall, 1,158 studies were identified, of which 13 case reports or case series met the inclusion and exclusion criteria, for a total of 111 patients. No reports of TULUA before pregnancy were found. Age at the time of delivery ranged between 19 and 37 years and all births were at term, with newborns of adequate birth weight. Eleven studies described the route of delivery, inclpic of pregnancy following abdominoplasty, and it is limited to case reports. The literature suggests that abdominoplasty could increase the frequency of cervical prolapse and cesarean section, although the impact on perinatal outcome is not clear. It appears that abdominal wall repair is maintained. Additional studies focusing on perinatal outcomes in women with abdominoplasty and the impact of gestation on the results of the intervention are required.
To report a case of pure red-cell aplasia secondary to pregnancy and to conduct a review of the literature regarding diagnosis and treatment, as well as maternal and perinatal prognosis.

This is the case of a 24-year-old patient at 34 weeks of gestation, referred to a regional public referral hospital due to anemia. Bone marrow biopsy was performed, leading to the diagnosis of pregnancy-related pure red-cell aplasia. The patient received serial red blood cell transfusions. Delivery by Cesarean section at term resulted in a healthy newborn. Hemoglobin values remained stable during the postoperative period. A literature search was conducted in Medline via PubMed, LILACS, SciELO and ScienceDirect using the terms "pregnancy" and "pure red-cell aplasia". Case reports, case series and literature reviews in English and Spanish published between January 1999 and January 2020 that report pregnant women with pure red-cell aplasia were included. Information on diagnosis, treatment and maternal and perinatal prognosiquired to assess the safety and efficacy of steroid use in this pregnancy-related condition.
To describe the frequency of gynecological surgery cancellation as well as the factors leading up to cancellation, and to examine how patients perceive this situation.

Case series including patients over 18 years of age scheduled for gynecological surgery due to benign conditions whose surgery was cancelled in a general referral hospital in Lima, Peru, between June 2019 and March 2020. Baseline characteristics of the patients and the reasons for cancellation were assessed, and the Patient Satisfaction Questionnaire Short Form (PSQ-18) tool was administered. Descriptive analysis.

The study included 84 patients. During the study period, the frequency of surgery cancellations was 11 %. Medical reasons were the main factor for surgery suspension, at 46.5 %; administrative causes accounted for 36.6 % of the cancellations, due mainly to lack of operation time in 25.4 %. In terms of satisfaction, 21,4 % of the patients were satisfied with the cancellation.

Good communication with patients whose surgery needs to be cancelled is essential. Further studies that look into this problem in our region are required.
Good communication with patients whose surgery needs to be cancelled is essential. Further studies that look into this problem in our region are required.
To determine the prevalence of anal infection caused by high risk human papilloma virus (HR-HPV) and of abnormal anal cytology in women with confirmed cervical dysplasia.

Cross sectional study that included patients between 30 and 65 years of age with a new diagnosis of cervical dysplasia by histopathology attended in two lower genital tract colposcopy and pathology units (one public and one private institution), conducted between December 2017 and April 2019. Women with human immunodeficiency virus (HIV) infection, immune compromise (use of steroids, transplant, chemo therapy), pregnancy or anorectal malformations were excluded. Consecutive sampling. Socio demographic variables, intercourse type, degree of cervical dysplasia, positive results of HR HPV Polymerase Chain Reaction test in anal canal and HR - HPV type indentified (16-18 or others) were evaluated. Descriptive statistics were used.

Of 188 candidates, 100 were included in the analysis. A 32 % prevalence of high-risk HPV infection and a 2.8 % prevalence of abnormal cytology in the anal canal (ASCUS) were found. Of the HR-HPV infections in the anal canal, 68.8 % corresponded to HR-HPV genotypes different from 16 or 18.

Prevalence of HR HPV infection in women with lower genital tract dysplasia was 32%. It is important to determine the usefulness of screening for anal mucosa compromise by HPV virus associated with a high risk of cancer in women with cervical dysplasia. Studies are needed on the prognosis of anal HR-HPV infection in women with cervical dysplasia.
Prevalence of HR HPV infection in women with lower genital tract dysplasia was 32%. It is important to determine the usefulness of screening for anal mucosa compromise by HPV virus associated with a high risk of cancer in women with cervical dysplasia. Studies are needed on the prognosis of anal HR-HPV infection in women with cervical dysplasia.
To understand institutional practices in healthcare as relates to women during pregnancy, childbirth and the postpartum period according to social class in Bogota.

Qualitative study based on the critical hermeneutics paradigm. Critical ethnographic method with theoretical sampling. The participants included 9 women and 8 health-care professionals from the city of Bogotá, attending public and private healthcare institutions that serve populations under both the subsidized as well as the contributive regimes of the General Social Security System. Overall, 38 in-depth interviews were conducted during a 13 month period, with 62 instances of support to the mothers in terms of prenatal care, vaccination, labor, postpartum visits, follow-up tests, psychoprophylactic course, hospitalization and waiting room. Triangulation analysis on Atlas Ti.

Taking into account the discourse of the different players, observations and context, two categories were found to be determining factors of inequities "Market-regulated health" and "Over- sight and control in health services".

It is advisable in medical practice to build competencies in the population in order to ensure the realization of the rights of women and healthcare personnel. Qualitative research offers the opportunity to promote the transformation of medical rationale affecting women.
It is advisable in medical practice to build competencies in the population in order to ensure the realization of the rights of women and healthcare personnel. Qualitative research offers the opportunity to promote the transformation of medical rationale affecting women.
Health care requirements and perception of people with differences of sex development (DSD) have changed enormously since the "Chicago Consensus Conference" in 2005. Therefore, new standards of care and evaluation of care have to be developed.

We summarize the social and legal approach to care for DSD during the last two decades and report the main results of European research activities.

The last two decades were accompanied by legal and societal discussion regarding how to deal with a nonbinary concept of sex. This leads to the necessity to assess health care requirements for individuals with DSD in an objective manner. We briefly review the results of the recently funded European research projects dealing with health-related issues in DSD like EU COST Action DSD, I-DSD, and dsd-LIFE, and address the compilation of quality indicators that will be needed to benchmark health care provision and health care-related outcomes.

The benchmarking process has to be implemented among health care providers for individuals with DSD within the European Reference Networks for Rare Conditions.
The benchmarking process has to be implemented among health care providers for individuals with DSD within the European Reference Networks for Rare Conditions.This study aimed to investigate the mechanism of type I interferon (IFN) in aggravating sepsis in bacterial infection, focusing on the roles of Caspase-11 (Casp11) and Gasdermin D (Gsdmd) in this process. Type I interferons, including IFNα and IFNβ, were used to treat peritoneal macrophage harvested from wild-type or IFNα/βR1 knockout (KO) mice, of which the levels of Casp11 and Gsdmd were monitored using real-time polymerase chain reaction (RT-PCR) and Western blot, the exposure to phosphatidylserine was monitored by flow cytometry, and tissue factor (TF) activation was assessed by RT-PCR and TF chromogenic assay. Endotoxemia in wild-type mice led to upregulation of Casp11 and Gsdmd in myeloid cells, which in contrast was attenuated in IFNα/βR1 KO mice. IFNα or IFNβ treatment led to dose-dependent upregulation of Casp11 and Gsdmd in peritoneal macrophages harvested from wild-type mice, but induced negligible changes in IFNα/βR1 KO mice. Type I IFN promoted phosphatidylserine exposure in peritoneal macrophage from wild-type mice but not IFNα/βR1 KO mice. Type I IFN induced insignificant changes of TF expression levels in both wild-type mice and IFNα/βR1 KO mice, but the TF activity was markedly increased in wild-type mice after type I IFN treatment. Our data suggested that the upregulation of Casp11 and Gsdmd in myeloid cells and macrophages induced by endotoxemia was reliant on the expression of IFNα/βR1. IFNα or IFNβ treatment efficiently upregulated Casp11 and Gsdmd, phosphatidylserine exposure, and TF activity of macrophages. Therefore, type I IFN could aggravate sepsis through upregulating Casp11 and Gsdmd.
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